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Section 3 - Proposed Benefits 5 <br />• City of Sunny Isles <br />USAccess® <br />Provider network <br />Yes <br />PCP required/role <br />PCP selection encouraged/PCP can render <br />and coordinate care, and make specialty <br />referrals; members may self -refer to any <br />recognized in- network or out -of- network <br />provider <br />Member cost sharing <br />- Copay applies to all covered services <br />rendered, coordinated or referred by a <br />PCP <br />- Higher copay /coinsurance applies to all <br />in- network, self - referred covered <br />services <br />- Deductible /coinsurance applies to all <br />self- referred, out -of- network covered` <br />services <br />Claim forms required <br />Possible for out -of- network services <br />Available funding <br />Full -risk, prospectively rated; also available <br />options <br />self- funded for 250+ life groups <br />Includes* <br />A Healthy Outlook Program' <br />A External Review Policy <br />A Fitness Program <br />A Informed Health" Line <br />A Member Health Education <br />A Women's Health for Life <br />Programs <br />Options* <br />A Employee Assistance Program <br />A National Medical Excellence <br />Program" <br />A Natural Alternatives" Program <br />A Safety Net <br />A Vision One °discount program <br />• *Described in the Programs section of this proposal; brochures also available from your Aetna U.S. Healthcare representative. <br />Visit our website: www.aetnaushc.com 1 I/I7/20(X) <br />