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15.02.342.1 B2012-2013Policy No.697407Brought to you by Seton HallUniversity Law School andAetna Student Health

The Seton Hall University Law School Student Insurance Plan isunderwritten by Aetna Life Insurance Company (Aetna) andadministered by Chickering Claims Administrators, Inc. Aetna StudentHealthSM is the brand name for products and services provided by thesecompanies and their applicable affiliated companies.WhoIs Aetna Student Health?Aetna has a strong knowledge of health insurance benefits and anexpansive network of physicians, hospitals, and other health care providers.We’ve been offering health insurance coverage to students like you for30 years at colleges and universities across the country. We work withSeton Hall University Law School professionals and administrators to giveyou access to medical care when you need it. You are even covered whenyou travel home or to another country, throughout the policy/school year.WhyIs a Student Health Insurance Plan Important?Health care costs are at an all-time high. Don’t let an unexpected trip tothe doctor or hospital set you back financially. Here are some things tothink about: Take a look at the Seton Hall University Law School StudentHealth Insurance Plan and compare it to your current coverage.Look at premiums, deductibles, benefits provided and the time covered.You are automatically covered for as long as you are registered with theSeton Hall University Law School as a full-time student. You may not be covered away from home or abroad. If you travelin the U.S. or study abroad, it’s good to know you’re covered if youneed health care. Under the Seton Hall University Law Student Health InsurancePlan, you pay a copay each time you need to fill a prescription.Under the Seton Hall University Student Health Insurance Plan you paya 25 copay for generic drugs and a 40 copay for brand-name drugseach time you need to fill a prescription. Mail Order Prescriptions arecovered at 3 times the copay per 90 day supply.Visit http://www.aetnastudenthealth.com/seton to learn more.

WhatIs This Health Insurance Plan All AboutThe Seton Hall Law School Student Health Insurance Plan is designed tohelp keep health care costs effective.Your student health insurance coverage, offered by Aetna Student Health*,may not meet the minimum standards required by the health care reformlaw for the restrictions on annual dollar limits. The annual dollar limitsensure that consumers have sufficient access to medical benefitsthroughout the annual term of the policy. Restrictions for annual dollarlimits for group and individual health insurance coverage are 1.25 millionfor policy years before September 23, 2012; and 2 million for policy yearsbeginning on or after September 23, 2012 but before January 1, 2014.Restrictions for annual dollar limits for student health insurance coverageare 100,000 for policy years before September 23, 2012, and 500,000for policy years beginning on or after September 23, 2012, but beforeJanuary 1, 2014. Your student health insurance coverage includes anannual limit of 100,000 per condition on all covered services includingEssential Health Benefits. Other internal maximums (on Essential HealthBenefits and certain other services) are described more fully in the benefitschart included inside this Plan summary. If you have any questions orconcerns about this notice, contact (866) 725-4410. Be advised thatyou may be eligible for coverage under a group health plan of a parent’semployer or under a parent’s individual health insurance policy if youare under the age of 26. Contact the plan administrator of the parent’semployer plan or the parent’s individual health insurance issuer formore information.*Fully insured Aetna Student Health Insurance Plans are underwritten by AetnaLife Insurance Company (Aetna) and administered by Chickering ClaimsAdministrators, Inc. Aetna Student Health is the brand name for products andservices provided by these companies and their applicable affiliated companies.Visit http://www.aetnastudenthealth.com/seton to learn more.

Your Benefits at a GlanceHere is a brief description of the Plan benefits.Aggregate Maximum 100,000 per Accident or Sickness per Policy YearPharmacy Maximum 100,000 per Policy YearDeductibleNo deductible Preferred Provider Care 100 per Accident or Sickness for Non-Preferred Provider CareAnnual Preferred and 2,500 (Note: Once the Out-of-pocket limit has been metNon Preferred Provider covered Medical expenses will be payable at 100% of theCare Out-of-PocketNegotiated Charge for Preferred Provider Care and 100%Maximum Limitof Recognized Charge for Non Preferred care for the(includes deductibles)remainder of the Policy Year, up to aggregate maximum.)Covered ExpensesPreferred Provider CareNon-Preferred Provider CarePhysician’s Office Visit100% of the Negotiated 80% of the Recognized ChargeCharge after a 35 copayOutpatient100% of the Negotiated 80% of the Recognized ChargeMental HealthCharge after a 20 copayHospital Room100% of the Negotiated 80% of the Recognized Charge& BoardChargeEmergency Room100% of the Negotiated 100% of the Recognized ChargeCharge after a 50 copay after a 50 DeductibleX-ray and Lab100% of the Negotiated 80% of the RecognizedChargeChargePrescription Drug100% of the Negotiated 100% of the Recognized 25 copay for generic drugs; Charge after a copayCharge after a copay 40 copay for brand-namedrugs Mail Order Prescriptionsare covered at 3 times thecopay per 90 day supplyPLEASE READ CAREFULLY BEFORE DECIDING WHETHER THIS PLAN IS RIGHT FOR YOU: This plan will not pay more than the overall maximum benefit of 100,000 peraccident or sickness during the plan year. This plan will not pay more than 100, 000 for prescription medication during theplan year. Once any of these limits have been reached, the plan will not pay any more towardsthe cost of the applicable services, and your health provider can bill you for what theplan does not pay. Some illnesses cost more to treat than this plan will cover. Please read the Seton Hall University Law School Student Insurance Plan brochurelocated at www.aetnastudenthealth.com carefully before enrolling. While this documentand the Seton Hall University Law School Student Insurance Plan describe importantfeatures of the plan, there may be other specifics of the plan that are important to youand some limit what the plan will pay. If you want to look at the full plan description, which is contained in the MasterPolicy issued to the school, you may view it at the Dean of Students Office, Room 300of the Law School or contact us at (866) 725-4410.For more information on plan exclusions, limitations and benefit maximums, please referto the Seton Hall University Law School Student Insurance Plan and Master Policy. Thisplan pays benefits only for expenses incurred while the coverage is in force and only forthe medically necessary treatment of injury or disease. The coverage displayed in thisdocument reflects certain mandate(s) of the state in which the policy was written.However, certain federal laws and regulations could also affect how this coverage pays.Unless otherwise indicated, all benefits and limitations are per covered person.Visit http://www.aetnastudenthealth.com/seton to learn more.

WhereCan I Go for Service?Seton Hall University (SHU) Heath Services, Accredited by theAccreditation Association for Ambulatory Health Care -index.cfmWhen you need care, contact Health Services at (973) 761-9175, located at303 South Centre Street (across from the South Orange Campus main gate).They can provide many of the routine health services you need. If you needcare they can’t provide, they’ll refer you to a doctor or other health careprovider who belongs to Aetna’s Preferred Provider* Network (doctors,specialists and facilities). It is to your advantage to utilize a Preferred Providerbecause the savings may be achieved from the Negotiated Charges.To learn more about Preferred Providers, visit www.aetnastudenthealth.com.*Providers are independent contractors and are not agents of Aetna. Providerparticipation may change without notice. Aetna does not provide care orguarantee access to health services.Health Services Hours of OperationHours: September – MayHealth Professionals on DutyMonday – Friday 8:45 am – 4:45 pmHours: June – AugustHealth Professionals on DutyMonday – Thursday 8:30 am – 5:00 pmFriday 8:30 am – 12:30 pmLocation303 Centre StreetSouth Orange, NJTelephone: (973) 761-9175Fax: (973) 761-9193HowMuch Does It Cost?CoverageAnnual8/15/12 –8/14/13Student Only* 3,276Spouse 4,382Child(ren) 2,898Fall Semester8/15/12 –1/17/13 1,638 2,191 1,449Spring Semester1/18/13 –8/14/13 1,638 2,191 1,449The rate above includes both the premium for the student health plan underwrittenby Aetna Life Insurance Company, as well as Seton Hall University Law School’sadministrative fee.Visit http://www.aetnastudenthealth.com/seton to learn more.

HowAnd When Do I Enroll in the Plan?New Jersey State Law requires that all full-time registered students becovered by Health Insurance. In order to comply, Seton Hall University LawSchool requires all full-time students in on-campus attendance (includingstudent/teachers) to provide proof of health coverage; those who cannotare automatically enrolled into the Student Health Insurance Plan.Students who are enrolled are responsible for the premium which ischarged to the student account.If you do have other health coverage you must waive the Student HealthInsurance by logging on the PirateNet and clicking on the “myInfo” tab inBanner Self Service.Sign into the form using your “short name” e-mail identifier. This is thefirst six letters of your last name followed by the first two letters of yourfirst name. There are eight characters in your “short name” of your SetonHall University Law School e-mail address – those that appear before the@ symbol. For example, if your name is Mark Washington, your “shortname” is washinma. If you have less than six letters in your last name,make up the difference using your first name. All law students have aSeton Hall University Law School e-mail address. For more information onyour e-mail address and account, please visithttp://law.shu.edu/it/Student/email blackboard.cfm or call thetechnology help desk at (973) 275-2222.Waiver Deadline DatesFall – 9/07/2012Spring – 1/29/2013Waiver submissions may be audited by Seton Hall University Law School,Aetna Student Health, and/or their contractors or representatives. You may berequired to provide, upon request, any coverage documents and/or other recordsdemonstrating that you meet the school’s requirements for waiving the studenthealth insurance plan. By submitting the waiver request, you agree that yourcurrent insurance plan may be contacted for confirmation that your coverageis in force for the applicable policy year and that it meets the school’swaiver requirements.Please make sure you understand your school’s credit hour and otherrequirements for enrolling in this plan. Aetna Student Health reserves the rightto review, at any time, your eligibility to enroll in this plan. If it is determinedthat you did not meet the school’s eligibility requirements for enrollment, yourparticipation in the plan may be terminated or rescinded in accordance with itsterms and applicable law.Visit http://www.aetnastudenthealth.com/seton to learn more.