Aetna Story: Building a healthier world

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1 Quality health plans & benefits Call out bold Healthier living Call outwell-being light Financial Intelligent solutions Contact information, call X-XXX-XXX-XXXX or visit Call to action small copy (especially related to mobile apps). Hendani adionse rferum faceatis incte voluptassi aut maximpe rumquid ebitatur? Ut labo. Mil mo blabore ssumque conet officim. Aetna Story: Building a healthier world Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer. Disclaimer Aetna Inc. XX.XX.XXX.X (X/12) F (5/14)

2 A message from Chairman, CEO and President Mark T. Bertolini 2013 was a historic year for Aetna. We produced record results and successfully closed on our acquisition of Coventry Health Care. The aquistion has significantly improved our market position in both the commercial and government markets. Our larger geographic reach will enable us to strengthen our commitment to build a healthier world by working with others to redesign our health care system around the consumer. Delivering on this goal will not only improve the health of people around the world, but it will also increase the productivity of global economies and lead to healthier communities. Our annual operating revenues of $47.2 billion increased 33 percent from 2012 and set a company record. Operating earnings of $2.1 billion and medical membership of nearly 22.2 million are also at all-time highs. Our diversified portfolio continues to be a source of strength and presents us with strong platforms for growth, both nationally and around the globe. Our strategic plan for 2013 consisted of successfully integrating the Coventry acquisition, building out our new provider model called accountable care solutions and growing our core businesses. I am pleased to report that we exceeded our goals. We successfully reached our synergy targets with the Coventry acquisition. We completed more provider collaborations with over 32 accountable care organizations in operation, and a robust pipeline for 2014 and beyond. Our core businesses grew market share and increased medical membership by 4 million members from the acquisition of Coventry and very strong results coming from our government products. The success of these efforts is demonstrated by our 14 percent growth in operating earnings per share year over year, well in excess of our long-term objective. This year we also launched our health insurance exchange offerings. While implementation of the government s public exchanges has been rocky, we remain committed to the principle of increasing health care access across the country through guaranteed coverage. We believe that private and proprietary exchanges present an even greater opportunity for us in the long term as they will provide greater choice, customization and flexibility to consumers. Finally, we returned $1.7 billion of capital to our shareholders in share buybacks and dividends. At Aetna, we believe health care as an industry is primed for revolutionary disruption. Value-based provider payment models will continue to proliferate, and retail marketplaces will grow as employers shift to defined contribution arrangements. These changes will result in a consumer-empowered health care system. Because the health care sector is positioned for accelerated rates of change, we are well-positioned to create significant value for our shareholders and customers. As we look to 2014, we are committed to improving the consumer experience, providing not just access to quality health care but improved health. We are committed to offering consumers integrated, digital tools that will empower them with the convenience and control to manage their health. We are enabling providers to deliver on this new model of care through technology that seamlessly connects the health care community here and abroad. One of our core values at Aetna is caring. Our more than 48,000 employees demonstrate this value every day by meeting the needs of our customers and serving their communities. We look forward to 2014 and believe Aetna s future has never been stronger. I feel confident that we have the team and the resources to deliver on our commitment to improve the health of those we serve here and around the world. Thank you for joining us on our journey to create healthier communities, a healthier nation and a healthier world. We are grateful for your support and continued investment in Aetna.

3 Aetna is transforming health care to build healthier communities, a healthier nation and a healthier world. We want health care to work for you. Who we are Aetna is one of the nation s leading diversified health care benefits companies, serving an estimated 44 million people with information and resources to help them make better decisions about their health care. We offer a broad range of traditional, voluntary and consumer-directed health insurance products and related services. We offer medical, pharmacy, dental, behavioral health, and group life and disability plans. We also offer medical management capabilities, Medicaid health care management services, workers compensation administrative services and health information technology products and services. Locally, nationally and internationally, we continue to innovate and grow our available products and services: Our commercial business provides health benefits for more than 19.2 million of our 22.7 million medical members as we continue to expand our consumer-directed plan options and network access products. To meet the needs of a changing marketplace, we offer a growing number of self-insured options, particularly in the middle market, and plans for individuals and small businesses in the new health insurance marketplaces or exchanges, as well as private exchanges. We are one of the nation s largest combined Medicare Advantage, Medicare prescription drug plan and Medicaid businesses, and our Medicaid footprint now covers 15 states. Reflecting the quality and value we deliver, we have a higher percentage of members in four-star or greater plans in the Medicare star rating program than any of our national peers. Our Coventry acquisition in 2013 added medical membership that enhanced our diversified portfolio, increased our presence in government programs and improved our positioning and reach in local areas. We serve a broad array of customers. They include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. 10 th annual Aetna HealthFund study Employers: Saved $208 per member, per year Saved $12.5 million over 6 years per 10,000 members Members: Spent less on most types of health care services Received routine preventive care 9 percent more than preferred provider organization members Had higher rates of screenings for cervical cancer, colorectal cancer, prostate cancer, mammograms and immunizations

4 Transforming the health care experience As a nation, we deserve a better health care system, one that delivers quality care at an affordable cost. We are building a simpler, more integrated system that makes the right care at the right time possible, with less duplication and hassle. Connecting consumers using mobile access to health care information We are transforming the consumer experience with powerful health care information that consumers can easily access with a mobile device. We make it easy to connect consumers and their care teams so that they can get the data and analytics to make better clinical decisions. Through HealthagenSM, an Aetna company, we help providers connect meaningfully to one another and give them tools to help improve the quality of patient care. We also give consumers simple, convenient mobile and online services such as the itriage app that make it easy to get the care that best meets their needs. The CarePass platform is a digital health and wellness platform that is open to all consumers. In 2013, we continued to expand what our tools can do. For example, we added the Care4TodayTM* Mobile Health Manager app to our CarePass digital platform to help members better track their medication usage and stay on schedule. **Care4Today is a trademark of Johnson & Johnson. **As of January 1, Building a simpler, more integrated health care system We collaborate with doctors, hospitals, pharmacies and labs, and others to build a simpler, more integrated health care system. Our focus and incentives are designed to improve health and lower the overall cost of care. In 2013, we continued to advance the shift toward better integrated, accountable care models. More than 1.5 million medical members** get care through the spectrum of our value-based networks, including 32 accountable care organization collaborations, 112 patient-centered medical homes, 112 Medicare Advantage collaborations and 88 high-performance networks acquired through Coventry. As a key part of our Accountable Care Solutions approach, we have embedded a number of our nurse case managers in the offices of health care providers who support Aetna s Medicare Advantage members. Their collaborative work with physicians helped earn our program a 2013 Case in Point Platinum Award. To enable better-coordinated cancer care and improved quality outcomes and costs, Aetna and Consultants in Medical Oncology and Hematology, PC, in 2013 launched a first-of-its-kind patient-centered medical home model for oncology.

5 Offering a simpler, more transparent consumer experience We empower a healthier population through a simpler, more transparent consumer experience. When consumers do need care, we offer wellness and care management programs supported by rich, personalized information to help them better manage their unique health care issues. We enhanced our Healthy Lifestyle Coaching program in 2013 so that it now offers different strategies for success based on the unique preferences of the people we serve. As a result, we saw the following health improvements: 55 percent of program participants exercised more 54 percent of program participants lost weight 51 percent of program participants reduced stress Aetna and the Hawn Foundation are working together to highlight initiatives that demonstrate how mindfulness programs can help people achieve better overall health by reducing stress. The Mindful Works collaboration also includes a research component to look at the impact of mindfulness on productivity, engagement and satisfaction. In 2013, we developed important programs to help reduce the risk factors for metabolic syndrome. We launched Metabolic Health in Small Bytes and the Metabolic Health Advisor to help members better understand the condition and get screening tests. Improving the health of the communities where we live and work We are also committed to improving the health of communities where we live and work. In 2013, Aetna and the Aetna Foundation awarded more than $20 million to nonprofit organizations across the U.S. focused on: Improving nutrition and increasing physical activity Promoting equity in health and health care for chronic conditions Building a more diverse generation of health care professionals Exploring innovative solutions to promote wellness and achieve health equity for low-income and minority communities Aetna employees, retirees and directors recognize the need to lend a helping hand. During 2013, they generously donated $6.8 million through the company s matching gift program. In support of community initiatives, our employees also volunteered more than 401,000 hours of their time. Corporate responsibility Aetna has a long and rich history of commitment to social responsibility, as evidenced by our efforts to improve the quality of health care for everyone. In 2013, Aetna and the Aetna Foundation awarded more than $20 million to nonprofit organizations across the U.S. Diversity and inclusion Diversity and inclusion are both fundamental values that create a strategic competitive advantage. By leveraging all dimensions of our diversity, we are better able to understand and meet the unique needs of the people we serve and to help them lead healthier lives. We are committed to addressing the challenges facing our health care system. We are seeking solutions to help build a simpler, more integrated and more affordable health care system. We are employing innovation and determination to move the sustainability needle. We optimized our energy performance and reduced our energy consumption across the Aetna-owned portfolio of facilities, saving more than 17.8 million kilowatt hours across the enterprise from 2011 to 2013.

6 Awards and recognition In the past year, a wide range of public, private and nonprofit organizations and print publications recognized Aetna s work. The awards and recognition we earned include: Corporate In 2013, The Civic 50 rankings recognized Aetna as one of the most community-minded companies nationally. Aetna ranked in the top among 50 companies in the Fostering Civic Culture dimension. The National Committee for Quality Assurance named Delaware Physicians Care, an Aetna Medicaid plan, one of the top 50 Medicaid plans in the nation in its Medicaid Health Insurance Plan Rankings In its first report on accountable care payers, KLAS, an independent researcher of technology and solutions for health care providers, cited Aetna as having the most transformational relationships compared to other payers. They based their findings on interviews with providers who are part of accountable care models. Professional Adviser, a leading publication for financial advisers and insurance brokers in the United Kingdom, named Aetna the Best International Private Health Insurance Provider for The Aetna Medicare Advantage Provider Collaboration Embedded Case Management Program was recognized with a 2013 Case in Point Platinum Award. The award recognizes successful and innovative care management programs working to improve health care. Mena Insurance Review, the leading magazine covering the insurance sector in the Middle East and North Africa, recognized Aetna International as Health Insurer of the Year for Diversity and employment accolades The Human Rights Campaign Foundation named Aetna to its 2014 list of Best Places to Work for LGBT Equality. The list includes all companies that achieved a perfect score on the 2014 Corporate Equality Index, which rates companies on policies and practices related to the lesbian, gay, bisexual and transgender (LGBT) community. Aetna has earned this designation every year since the index was introduced in The National Business Group on Health honored Aetna with the 2014 Innovation in Reducing Health Care Disparities Award. Aetna is a three-time recipient of the award that recognizes organizations for their commitment to equality in health care and exceptional support for cultural diversity. For the 15th time, the National Association for Female Executives (NAFE) named Aetna as one of the 2014 NAFE Top 50 Companies for Executive Women. The list highlights companies whose practices identify and promote successful women. Aetna will be among the first companies to join the NAFE Top Companies for Executive Women Hall of Fame. The National Business Group on Health awarded Aetna a 2013 Best Employer for Healthy Lifestyles platinum award. Aetna has received the platinum award seven times and the gold award once for establishing healthy weight, healthy lifestyles programs with measurable documented outcomes. DiversityInc named Aetna to its 2013 list of Top 50 Companies for Diversity for the fifth straight year. The U.S. Chamber of Commerce s Center for Women in Business recognized Aetna in a 2013 report, Advancing Women to the Top: How the Best Do It. The report highlights the best practices of U.S. companies in achieving gender diversity at the executive level and among their boards of directors. Information tools and technology Healthagen, an Aetna company, received the 2013 CIO 100 Award in recognition of the company s operational and strategic excellence in information technology. Aetna was named a winner of the inaugural CSO40 Awards in 2013 for its international governance, risk and compliance program for compliance with in-country security and privacy rules around the world. For the third consecutive year, Aetna in 2013 won a ClearMark Award from the Center for Plain Language. Aetna was ranked #52 on InformationWeek s 2013 list of the 500 leading technology innovators, surging ahead of many of the top names associated with technological innovation. Aetna ranked first among health insurers. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna) Aetna Inc F (5/14)