Richmond,Virginia network update

(Aetna letterhead not reproduced)

November 5, 1999

Mr. William Hildenbrand
CRLO Administrator
Railroad Employee Health/Welfare
26555 Evergreen Road
Southfield, MI. 48076 4225

Mr. Joseph Epstein
Director Employee Benefits
Railroad Employee Health/Welfare
1901 L Street N.W.
Washington, D.C. 20036

Dear Bill and Joe:

I am writing you with an update on the Richmond, Virginia network. Previously on October 5th I provided a heads up that Bon Secours which consists of four hospitals will be terminating from the Aetna U.S. Healthcare network. On October 20th I sent the formal notice regarding the termination advising there were 19 PCP's who currently have admitting privileges only at Bon Secours hospitals. At that time there were 32 Railroad employees or dependents affected by this change.

More recently, AUSHC was advised by Bon Secours that the sixteen physician groups they manage would also be terminating. This represents a total of 43 PCP's. Therefore, we have run a disruption report including these PCP's and now find 227 Railroad employees or dependents may be impacted by this change.

The enclosed information includes a list of the Potentially Terminating Providers and Alternate Providers within 5 miles. I have reviewed the member list available to determine the actual PCP's your members use. There are 33 used by Railroad and these members have anywhere from 3 to 25 participating PCP's to choose from should they wish to continue in MMCP.

The following provides a recap and update:

What's Happening?

Effective January 1, 2000, the Bon Secours Hospital System, consisting of four (4) hospitals will no longer be considered participating hospitals in the network due to expiration of the current contract. This network change applies to all products, but does not affect the provider accessibility within this geographical area.

Terminating Hospital Addresses

Bon Secours Memorial Regional Medical Center
8260 Atlee Road
Mechanicsville, VA 23116

Bon Secours Stuart Circle Hospital
413 Stuart Circle
Richmond, VA 23220

St. Mary's Hospital
5801 Bremo Road
Richmond, VA 23226

Richmond Community Hospital
1500 N 28th Street
Richmond, VA 23223

Alternate Participating Hospitals

Henrico Doctor's Hospital
1602 Skipwith Road
Richmond, VA

Cumberland Children's Hospital
9407 Cumberland Road
New Kent, VA

Medical College of Virginia Hospitals
401 North 12th Street
Richmond,VA

Health South Rehabilitation of Virginia
5700 Fitzhugh Avenue
Richmond, VA

Capital Medical Center
701 West Grace St.
Richmond, VA

Healthsouth Medical Center
7700 East Parham Road
Richmond,VA

Other Area Hospitals

Children's Hospital
2924 Brook Road
Richmond, VA

Johnston-Willis Hospital
1401 Johnston Willis Drive
Richmond, VA

Cumberland Children's
9407 Cumberland Road
New Kent, VA

Hospital Retreat Hospital
2621 Grove Avenue
Richmond, VA

Sheltering Arms Rehabilitation Hospital
8226 Meadowbridge Road
Mechanicsville,VA

Southside Regional Medical
801 South Adams Street
Petersburg, VA

Columbia John Randolph Inc.
411 West Randolph Road
Hopewell, VA

Chippenham Medical Center
7101 Jahnke Road
Richmond, VA

Physician Impact

There are 43 primary care physicians (PCPs) that will no longer participate in the network

because they only have admitting privileges at the four Bon Secours; Hospitals. The termination of these physicians does not impact the adequacy of the network. For your convenience, I have included a list of alternate physicians that are within five miles of the terminating office locations.

Member Disruption

There are 227 Railroad employees or dependents - associated with any of the terminating physicians and will be required to select a new PCP.

Member Letters

Member termination notifications were mailed on Monday November 1, 1999 notifying members of the PCP termination and the need to select another PCP. Sample is enclosed.

Directory Information

The hospitals have been listed in the Fall 1999 Provider Directory. They are also listed on DocFind however they will be removed from DocFind when the contract expires.

Please feel free to contact me with any questions you may have regarding this change. I will keep you updated with any new information.

Sincerely,

Peggy Shea Colangelo
Aetna U.S. Healthcare Inc.

Cc: Jim Hewett
Jackie Furr