l~r' 1~ He~~t~hu
F%5e V Health
Kerr County
November 2007
Presentation for:
Medical Claim Administration
Care Management Services
HIPAA Administration
COBRA Administration
Prescription Drug Administration
Stop Loss
Consumer-Driven Products
Flexible Spending Account Administration
Retiree Billing Administration
The information contained in this response to the request for proposal is considered confidential. We are providing this infomtation
with the understanding the information will not be used for any purpose other than the specific purpose of evaluating our capabilities
to provide the services requested. In addition, this information will not be disclosed to person(s) or entity(s) other than those who
are involved in the process of evaluating our response. Written permission must be obtained prior to any exceptions of these
obligations to maintain the confidentiality of our responses.
Fis t'~ Heal th.
Kerr County
Page
Why Fiserv Health? ................................... 1
What is Our Approach? ..............................2
Product Overview .....................................4
Administrative Services ........................... 20
Stop Loss Proposal
GeoAccess Reports
Aetna Discount Analysis
Exhibits
FiswHealth....
Why Fiserv Health?
Fiserv Health offers advanced technologies, comprehensive solutions, and
tailored services to meet the specific interests of our clients. We help our clients not only to
manage their benefit plans but also understand them.
Offering access to a full menu of self-funded services that provide innovative, client-tailored
solutions and benefit plans, we're flexible and dedicated to providing benefit solutions that work
for our clients.
Fiserv Health businesses can provide:
• Medical and dental claim
administration
• Flexible spending account
administration
• Care management services
• Prescription benefits administration
• Stop loss underwriting and
administration
• Consumer-driven health plan
administration
• Retiree claim and billing
administration
• Long-term and short-term disability
claim administration
• COBRA and HIPAA administration
• Access to insured life, long-term and
short-term disability, and insured
transplant coverage
We recognize the challenges Kerr County faces as benefit costs continue to rise. We will
manage expenses, monitor legislative changes, and assist members in a timely and accurate
manner. To combat rising costs, we continue to invest in innovative technologies, expanded
product offerings, and solutions designed to save clients time and money.
Fiserv Health believes the client comes first. To support client needs, we have sales and
account management representatives throughout the country. These representatives ensure
access to the personalized service and prompt resolutions our clients deserve.
~~ ~ 5~,;/

John C. Sickels, CEBS
Senior Vice President Sales
Steve McBride, CEBS, CLU, ChFC
Sales Executive
Kerr County ~
Fis re V Healfh.
What is Our Approach?
F i s e rv H e a l t h h a s t W O g o a l s: to provide top-notch customer service and save
clients money. We realize every client's needs are unique and no single solution can meet
each of those needs. To address these needs we have adopted a proactive approach to
benefits administration. We offer solutions that integrate care management, consumer-driven
health care, network utilization, pharmacy administration, and external vendor partnerships.
Through these offerings, Fiserv Health delivers a comprehensive benefits package designed to
meet the administration needs of our clients.
Integration
Fiserv Health products and services are fully integrated, which translates into increased
savings and better service. This multi-faceted approach allows us to regularly monitor plan
performance. While our care management team is focusing on the health and wellness of
members, our pharmacy benefits staff is negotiating prescription drug discounts and rebates,
and our network professionals are seeking out new applications for cost containment products
and developing relationships with multiple provider networks.
We understand the intricacies of stop loss insurance and consider value when selecting a
err' program. We've established and maintained strong relationships with leading carriers, who
can customize products according to client specifications. Our stop loss activity monitoring
gives added peace of mind, providing immediate notification of high dollar claims. We have a
fully loaded, user-friendly Web site that provides clients with accurate benefit information any
time of the day or night. Check it out at www.fiservhealthservices.com.
Performance standards
Fiserv Health monitors our claim processing functions for financial, payment, and procedural
accuracy. We provide our clients regular reports that highlight their plan performance and
monitor our administration functions. From medical to dental, disability to flex, our customer
service representatives are thoroughly trained on our product lines. We strive to exceed your
expectations and surpass the industry standards in customer service.
Don't just take our word for it. Fiserv Health is a leader in URAC accreditation, which is
nationally recognized as the benchmark for quality in managed care organizations. Fiserv
Health Care Management holds accreditation in utilization management, case management,
and disease management. Fiserv Health is also accredited in claims processing, HIPAA
privacy, and HIPAA security.
URAC URAC URA URA
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CASC: MANAGIiA11;NT CI 11MS PROC'1?SRIy~; FIIPA,1 PRIVACY I IIP,AA SECURITY
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IIIALTII UTILIZATIO\
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Kerr County 2
Fly to V ealth.
With you every step of the way
When selecting Fiserv Health, clients gain more than athird-party administrator they gain a
partner, a resource for benefit questions, and an extension of their human resources
department. We'll make sure plan implementation is seamless and coverage is uninterrupted.
Our dedicated team of transition coordinators and account managers is available to assist with
enrollment meetings, administrative needs, and financial questions. To ensure smooth
transitions, we hold frequent transition meetings between the client and key coordinators. A
detailed project list is established and maintained throughout the process. Once things are
fully functional, we will always be on hand to address questions and respond to client needs.
Kerr County
F%5L~ V Health.
Claim Administration
C I a i m processing and customer service is handled by knowledgeable,
courteous, and confident staff members. We utilize teams for specific lines of coverage and
dedicate them to specific clients. These associates are thoroughly trained on the benefit plans
they administer, through a formalized internal education program.
Our claim payment system is designed to provide consistent administration for a wide variety of
medical and dental plans and pricing arrangements. The functionality of our processing
system allows us to meet the needs of a diverse client base as well as accommodate changes
in the benefits environment. Our administration system is fully integrated and uses common
databases and processing functions. We employ sophisticated integrated logic with claims
administration edits to auto-adjudicate all types of benefit structures. Auto-adjudication allows
claims to be turned around quickly and limits the possibility of human error. Our system is not
only designed to accommodate flexibility in benefit plan design and claim administration, but to
allow for customer-specific functionality and self-service features.
Medical
Through the use of internal coding, medical benefits are programmed specific to each client's
plan document. Benefit coding automatically controls payments, tracks deductibles,
out-of-pocket maximums, participation, and plan maximums. Service screening functions
within our system review claims prior to payment and allow for the automatic denial or pending
of a claim for further review. System flexibility allows us to administer all levels of fee
schedules and PPO configurations, usual and customary fees, per diem rates, or any
combination of these elements. We have the ability to administer three-tier benefit plan
designs, client-specific contract arrangements and to interact with Medicare as a secondary
payor of Part A and B claims. We also provide reasonable and customary processing reports
upon request (with a maximum of two per year).
COBRA administration services
The following services are included in the COBRA administrative fee:
Fiserv Health sends COBRA notification letters and election forms to qualified beneficiaries
and/or dependents by certified mail whenever a qualifying event occurs. The information
provided addresses COBRA rights and obligations and also includes a monthly payment
schedule. In addition, we provide service when second qualifying events arise.
We collect and process monthly payments and answer questions from qualified beneficiaries,
send confirmation letters and payment coupons to those electing COBRA continuation, and, if
applicable, inform them of health conversion rights at the proper time during the COBRA
continuation period. When required, rate change letters are sent to participants, as are
termination notices prior to the end of the COBRA period, and unavailability letters to
individuals who have requested COBRA continuation if COBRA is unavailable to them.
Kerr County
F%S~Health.
Fiserv Health also reviews disability status and approves or denies COBRA extensions.
Monthly reports are prepared and provided documenting a current list of active enrollees,
COBRA notification letters sent, and enrollee payments received.
Flexible spending account (FSA)
Our flexible spending account (FSA) program is a great way for employees and their families to
manage health and dependent care expenses with pretax dollars. With an FSA account,
employees can stretch their paychecks by paying for select services with pretax money,
thereby reducing their taxable income and total tax liability. Claim information is accessible via
the Internet and claims can be paid by electronic fund transfer (EFT) or by a check and EOB
mailed to the employee.
health care accounts
Health care spending accounts can be used for a variety of expenses that may not be covered
by other sources, including some over-the-counter (OTC) medications. Medical, dental and/or
prescription drug claims administered by approved pharmacy benefits managers (PBMs) may
qualify for automatic reimbursement or the use of a prompt-pay debit card.
dependent care accounts
Dependent care accounts allow the use of pretax dollars for qualifying expenses including
childcare, in-home housekeepers for qualified individuals, or outside services for dependents
unable to care for themselves.
healfh care account debit cards
The BennyT"^ Card from Fiserv Health is a MasterCardฎ that gives members an easy,
automatic way to pay for qualified health care expenses. The BennyT"" Card lets members
electronically access pretax contributions they set aside in their flexible spending accounts
(FBAs). It works like a MasterCardฎ, with the value of the account(s) contributions stored on it.
When members incur qualified eligible expenses at a business that accepts MasterCardฎ,
simply use the BennyT"" Card. The amount of qualified purchases will be deducted
automatically from the account and the pretax dollars will be electronically transferred to the
provider/merchant for immediate payment.
Retiree
We offer Medicare interactive claims payment as a separate service from retiree billing
administration. Our dedicated claim teams have training in retiree health plan administration
and senior health issues. We provide retiree-friendly explanation of benefits (EOB) forms.
We've also customized our Web site to include retiree health content resources. With
Medicare crossover services, retirees over age 65 won't need to submit claim forms or paper
coordination of benefits (COB) details for Medicare Part A or B claims. Benefit payments are
automatically coordinated. As part of our services, we will survey your Medicare-eligible
retirees to capture Medicare ID numbers (HIC numbers).
Kerr County 5
Fiserv Heal th.
Stop loss
Stop loss services included in the medical administrative fee include plan document changes
and updates to the carrier, in addition to:
claims interface
This includes daily trigger diagnosis reporting, which reviews pre-certification and other intake
sources for specific conditions. These conditions vary by company and generally include but
are not limited to: potential or planned organ transplants, premature infants, traumatic brain
injury, spinal cord injuries, burns (if 20 percent or more of the body is covered), severe multiple
fractures, crushing or massive injuries, all cancers, AIDs, and hospitalizations longer than 30
days.
monthly reports
This includes monthly reports of enrollees who have accumulated claims in excess of 50
percent or 75 percent (where applicable) and monthly aggregate reporting.
Kerr County 6
F15e V Health...
Care Management
Our integrated care management program helps control health care costs,
provide appropriate and timely member care, and increase member understanding of the
health care system. Fiserv Health identifies eligible members through an integrated care
management process. Front-end utilization and case management edits and processes are
applied to identify members who might require intervention beyond the normal utilization
management process. The edits and processes in place allow daily review of medical
information and provide advanced notice of a possible health concern.
Utilization Management
Utilization management (UM) is designed to primarily monitor hospital admissions, from pre-
admission to discharge to ensure that the admission does not deviate from the expected
treatment course and become complicated and costly. This URAC-approved program is based
on three basic concepts:
• Timely review and determination of medical necessity
• Determination of the appropriate inpatient lengths-of--stay
• Identification of potential case management and disease management referrals
Our experienced review specialists use advanced software, extensive databases and
nationally recognized review criteria to ensure that our utilization management
recommendations are consistent. We can also provide outpatient review according to the
customer requirements outlined in the plan language.
Case Management
Case management (CM) assists with a member's complex, catastrophic or potentially long-
term claim by exploring medical care options to determine which are the most appropriate and
cost effective. Resource management is a priority. Case management specialists become
involved in coordinating care for the member by communicating with the member, family, care
providers, and facility personnel. Their involvement ensures the member is receiving the
appropriate care and offers the member and their family a resource for their questions. The
nurse case manager also works to negotiate fees with providers and facilities in an effort to
reduce the burden of high claim dollars to both the member and the employer/customer.
Basic utilization and case management
Our utilization and case management program reviews medical services for necessity and
appropriateness. We provide ongoing reviews for both preferred and non-preferred providers
and when appropriate, refer to disease management. Savings are reported to the client on a
monthly basis.
Kerr County 7
F%5 t'Ve Health.
Basic UM/CM includes:
Inpatient hospital certification
Home health care
Catastrophic case management
Enhanced utilization and case management
Our health information services enhance the standard UM/CM by adding:
Inpatient behavioral health certification
Online Internet resources
Durable medical equipment
Kerr County 8
Pis re V ealth.
Pharmacy Benefits
Innoviant I S a l e a d i n g p r O V l d e r of prescription benefits administration for
third party administrators, self-funded employer groups, labor organizations, managed care
organizations, municipalities, and coalitions. Innoviant aligns with plan sponsor goals by
offering 100 percent full disclosure, lowest net cost, clinical expertise, and service excellence.
This effective combination provides valuable prescription benefits with an ethical approach and
common sense business principles.
100 percent full disclosure
Innoviant is willing to fully disclose all rates, fees, discounts, as well as terms and conditions
negotiated with pharmacies and pharmaceutical manufacturers to plan sponsors. Whether
utilizing a traditional or fixed fee pricing model, their pharmacy benefit administration strategies
result in cost savings, along with well educated plan sponsors and members.
Lowest net cost
Innoviant is focused on a strong combination of prescription management strategies, program
offerings, and business initiatives geared toward managing prescription benefits at the lowest
net cost. The lowest net cost focuses on:
Preferred product list (PPL) management
Robust pharmaceutical manufacturer rebates
National pharmacy networks -including retail, mail order, Internet, and Retail 90 Rx
Generic product utilization programs
Innovative clinical programs
As a result of these efforts, their plan sponsors' average cost per prescription has been
4 percent lower than the industry average, for the last six years.*
*Based upon figures from Novartis Pharmacy Benefit Report, Facts & Figures, 2005 Edition.
Kerr County 9
Fis r Health.
Clinical expertise
Innoviant offers a wealth of industry experience and expertise. Their staff of pharmacists and
Certified Pharmacy Technicians (CPhT) provides plan sponsors with a menu of clinical
programs that can be selected to match specific management goals. Clinical opportunities
include:
• Preferred product list (PPL) • Rx Instep
management
• Drug utilization review (DUR) • Rx OTC
• Specialty pharmacy program • Wise Choice Rx
• Prior authorization • Half Tab Rx
• Quantity limits
All Innoviant clinical offerings are provided at no additional cost to plan sponsors. When
considering the total value of this strategy, it is important to note Innoviant believes clinical
programs are a source of savings for our customers, not a source of revenue for their
organization.
Retail 90 Rx
Retail and mail order programs have distinct advantages for plan sponsors and members. The
Retail 90 Rx program takes the best of both and combines them to create the ultimate
convenience for members and real savings for employers.
A "90-days at retail" program allows members to receive up to 90 days of medication from
participating retail pharmacies or mailed directly to their doors via mail service, for a reduced
ingredient cost. Members have exceptional access to this program through the Innoviant
Retail 90 Rx Pharmacy Network -more than 30,000 retail pharmacies nationwide.
Retail 90 Rx often targets a different audience than the traditional mail order user, one who is
willing to receive a 90-day prescription, but still wishes to visit directly with his or her
pharmacist.
Service excellence
The Innoviant multi-faceted combination of account management, clinical consultation,
reporting, educational tools and resources, and customer service act as the foundation for
service excellence. In concert with other health product and service offerings, the prescription
benefits systems and customer services are seamlessly integrated to provide a comprehensive
Fiserv Health package solution to plan sponsors.
Kerr County 10
Fis re v Heal th.
Highlights include:
• Account management flexibility and
adaptability
• Customer service center - 24
hours a day, seven days a week
• Clinical consultation expertise
• Strategic reporting focused on
utilization trends and cost savings
opportunities
Goal alignment
• Comprehensive Fiserv Health
service integration goal alignment
The combination of 100 percent full disclosure, lowest net cost, clinical expertise, and service
excellence creates goal alignment between Innoviant and plan sponsors. The true value of the
Innoviant solution is realized when combined with the other Fiserv Health products and
services offered in a fully integrated package.
Kerr County 11
P%5 re V Health..
Consumer-Driven Products
Fiserv Health offers services and programs designed to encourage
member involvement in the management of health care expenses. Our services provide
access to knowledgeable staff members dedicated to providing information, education,
resource connectivity, clarification, and support. Our flexible plan designs for these programs
allow employers to predict medical expenses and lower yearly cost increases.
Health reimbursement account (HRA)
HRAs allow employers to control the benefits they fund to provide long-term incentives for the
member's wise use of medical care dollars. Through our system integration the beneficiary
receives a single explanation of benefits (EOB) and the provider receives a single remittance
all without the member having to submit a claim. If we administer the flexible spending account
(FSA), any claim that exceeds the HRA balance can automatically be sent for FSA
reimbursement.
HRA plans are designed so client funds not used by the member can be rolled over from
year-to-year. These rolled-over funds can be used to cover a member's major medical
deductible amount if needed in another year. This feature encourages conservative medical
err` purchases and motivates members to better understand how they are using their medical
benefits. Clients can limit maximum accumulated rollover amounts. Pharmacy claims and
other benefits we do not administer are carved out in stand-alone programs. They do not
accrue to the HRA or medical deductible. Wellness benefits are typically carved out, but can
be included in the HRA.
Kerr County 12
F/5e V Health::
Retiree Billing Administration
Retiree billing services are designed to simplify split-billing
arrangements in which retirees are required to pay part of the premium for their health plan
coverage. We can make this process easier by:
• Sending confirmation letters and payment notices to participants
• Collecting and processing retiree payments and sending late payment or termination
notices, as appropriate
• Generating monthly aging reports to document late payments
• Answering client and participant billing questions
• Preparing and providing monthly reports documenting participant enrollment and
payments
Kerr County 13
F/5 rV Health...
Ancillary Products
A s a f u l l-service administrator , Fiserv Health recognizes employers want
to offer their employees benefit options, while saving themselves money and their HR staff
time. We simplify the experience by offering ancillary benefits through specialized carriers.
Life, disability and employee assistance programs (EAPs) are available for your review and
consideration.
Insured transplant coverage
Fiserv Health offers innovative options to control medical costs, including an insured Managed
Transplant program through Zurich Transplant Services. This insured product assists
self-insured employers in managing the catastrophic costs of organ and tissue transplants.
This program protects self-insured employers from the financial, administrative and
fiduciary burdens associated with a transplant while ensuring each patient has access to
and receives the quality medical care they deserve. In addition, when an employer has
this coverage, discounts are available on specific stop-loss rates. It also eliminates stoploss
lasers at renewal for transplant candidates and protects the self-insured employer
from paying multiple year specific deductibles.
Employee Assistance Program (EAP)
Employee assistance programs (EAPs) have become a standard among companies offering
employee benefit programs. Offering an EAP provides employees with a resource that
supports and encourages them when the stresses of life that can affect their health, happiness
and productivity are overwhelming. EAPs offer confidential services that allow employees to
discuss their concerns. They offer suggestions and information on resource availability, while
maintaining an impersonal and nonjudgmental attitude.
Kerr Counfy 74
F%S~Health~
Provider Networks
W e have extensive e x p e r i e n c e developing and administering network
arrangements. Our provider network strategy centers on flexibility and maximizing accessibility
to in-network providers and discounts.
In forming provider network relationships, we evaluate discounts, access to preferred
providers, electronic data interchange (EDI) capabilities, repricing, claim turnaround time, and
quality control measures.
Our national provider network relationships include but are not limited to:
Aetna Signature AdministratorsS"' PPO Network
Private Health Care Systems (PHCS)
First Health Network
Whether national, regional or a combination of both, we have the tools needed to determine
the best network solution for clients.
Flexibility
Our contracted preferred provider organization (PPO) relationships meet most clients needs;
however, there are times when more flexible cost containment arrangements are required.
Through our diverse system capabilities, Fiserv Health is able to provide flexible network and
alternative cost-saving products, including open-model PPO options, open access
point-of-service offerings (in select markets), and direct client/provider contract administrations.
We also put specialty network program arrangements in place.
Institutes of Excellence
An added benefit to the Aetna Signature Administrators network is their Institutes of Excellence
program. Aetna has selected qualified and credentialed hospitals for participation in their
Institutes of Excellence program. Located throughout the country, Institutes of Excellence
facilities are contracted on atransplant-specific basis. The facilities selected have exhibited
successful clinical outcomes and have met stringent quality of care standards. The network
provides average savings of 35 percent to 40 percent off of billed charges. URN credentialing
takes into consideration facility transplant volumes and outcomes, transplant team experience
and education, and patient and family support services.
Kerr County 15
Fis re V Health...
cost reduction and savings program
To assist customers Fiserv Health offers a cost reduction and savings (CRS) program. The
goal of the program is to ensure customers receive value for their health care dollars. The
program incorporates the offerings of travel and secondary network options, fee negotiation
and large bill review at the cost of 30 percent of savings.
Travel networks allow members full access to a national network when outside their regional
network's service area. Through travel networks, members traveling outside the service area
(for business or personal reasons) or those who have college students away from home are
reimbursed at the preferred level of benefits.
Secondary PPO networks, behind our national PPO offerings, allow the review of claims for
potential primary and secondary level claims repricing.
Employers offering traditional-type plan designs and/or having members residing outside of
areas meeting full network access criteria are often able to realize medical cost savings
through contracted discount arrangements.
We will continue to attempt fee negotiations on large dollar claims for providers who do not
participate in the primary network or the discount programs.
discount card program
Fiserv Health is committed to offering value added services to our members and customers.
With our discount card program, clients can offer member access to health care services not
covered under current medical plan benefits. The program offers employees and their family
members discounted services, at designated providers, simply by presenting their card. Our
card program is available in the following prepackaged combinations: vision only, dental only,
vision and dental, and vision, dental, and hearing.
Through our relationship with Careington International Corporation, clients also have access to
a full portfolio of other products and services at additional fees. Please contact your sales
executive for more information.
dental networks
To help control the rising costs of dental care, we offer managed care dental plans. The use of
network providers is voluntary in most plans and allows both clients and members to save
money on dental expenses. For employers with members residing outside of full network
access, we can offer our networks as an overlay product. Overlay products allow employers to
realize cost-savings typically found only in managed care plans.
Kerr County 16
F15 CB V Heal th.
Administrative Resources
During the transition process clients witness our commitment to providing
excellent and personalized service that is crucial to the implementation and administration of
their benefit programs.
Implementation
Our implementation team consists of a dedicated implementation coordinator, as well as
managerial, supervisory, and technical experts. This team works directly with a client's
designated staff to ensure a smooth transition that minimizes disruptions for members.
The implementation team develops a customized time frame identifying the tasks that need to
be completed, the individuals responsible for each task, and any client-specific needs. Regular
communication between the client and the team are essential elements of the transition
process.
Account management
Working closely with the implementation team is a designated account manager. This person
has global management responsibility for the client, overseeing their benefit plans and account
administration. The account manager is asingle-source point of contact, coordinating three to
five enrollment site visits for the client.
Enrollment
Fiserv Health accepts standard electronic, Internet, or paper enrollment submissions, including
HIPAA's 834 format. We provide eligibility data transfers to outside vendors (other than as
offered in this proposal) for an additional fee.
EPIC Hearing Healthcare
Fiserv Health offers discounts through EPIC Hearing Healthcare. EPIC Hearing Healthcare is
a trusted partner who can help our clients and their employees by providing heavily discounted
hearing aids and exams to employees and their families. They have a network of screened
and qualified physicians and audiologist to help diagnosis and recommend the right hearing aid
to help with hearing impairment. The implementation team will assist in enrolling the client in
this no-charge program.
Web Enrollment
We customize the Web enrollment process to meet the client's specific requirements. This
allows the employees to self-enroll via the Web any time, day or night. Web enrollment is a
convenient way to reduce the paperwork involved in traditional methods of enrollment. In
addition, we have a call center available to employees without Internet access.
Kerr County 17
P%5e V Hea l th,~
Banking
Fiserv Health works with the customer to set up banking options that meet their needs. Checks
are issued through system technologies as claims are processed. Signatures on the checks
are facsimile signatures only. We offer secure fund transfer methods and online check register
reporting capabilities. We've also established a system for single provider payments of claims
funded by a health reimbursement account (HRA), medical, dental, and/or flexible spending
account (FSA). The single payment solution allows all consumer-driven health plan payments
to come directly from the customer's bank account, requires less member involvement, and
lessens the number of checks clearing the customer's account.
Line of credit
Fiserv Health offers the CLEAR program, a guaranteed line of credit access to employees.
The intent of CLEAR is to assist members with their out-of-pocket health care expenses.
CLEAR works as any other credit, debit or check card, members present the card and the
payment is processed. Repayments are made through convenient payroll deductions over a
two-month period at 0 percent interest (upon request payments can be spread over six months
for medical expenses).
The CLEAR card is an optional service offered at no charge to employers. Employer
responsibility is limited to recordkeeping functions for payroll deductions and eligibility.
Employees will be assessed a participant charge that is deducted from their first two payroll
cycles following enrollment.
Reporting
Through our online reporting tools, clients have access to prompt and accurate monthly activity
reports within a secure environment. Our systems are designed to provide the financial and
plan management information needed to administer effective cost containment programs.
We are a partner in lowering overall plan costs. Through plan analysis, Fiserv Health provides
information to help clients make sound management decisions.
Medstat
Our Medstat reporting system integrates medical and pharmacy data into one database,
providing employers with access to up to 24 months of plan performance, claim experience,
clinical analysis, prescription drug, and cost trend information. Data is updated on a monthly
basis and is available in 21 user-modifiable report formats. Year-to-year assessments of client
data and comparisons to other lines of business, the national database, and Market Scan allow
for customized benchmarking and predictive modeling.
Compliance services
Our compliance department is committed to ensuring that our administrative services comply
with applicable law. We offer general benefit plan guidance and provide plan document
Kerr County 18
Pis rve Health.
solutions for a variety of benefit programs. Additionally, we will work with our clients to ensure
that the unique requirements applicable to their employee benefit plan(s) are met.
Identification (I D) cards
We produce ID cards in-house on 8'/z" x 11" laminated, double-sided, card-carrier stock
(additional fees may apply if extra materials are included or ID cards are mailed to employee
homes). Our ID card design allows us to combine medical, dental, and pharmacy information
for our clients.
Electronic data capabilities
Provider and vendor electronic data interchange (EDI) capabilities allow us to receive medical
and hospital claims electronically, facilitate Medicare crossover coordination for Medicare Part
A and B claims, and interact with PPO networks. Our imaging system electronically captures
and delivers paper documents daily. This increases efficiency and accuracy of claims
processing by permitting high levels of auto-adjudication and minimal manual intervention.
Interactive voice response (IVR) system
An interactive voice response (IVR) telephone system provides prompt access to member
specific information and directs callers to the appropriate service area, improving customer
service and reducing the cost of paper documentation storage and retrieval.
Web site
Our Web site uses trend-setting initiatives and provides accessible information for members,
employers, providers, producers, and our partners. The online applications are completely
secure and use a combination of well-established security methodologies including secure
sockets layer (SSL) encryption, firewall protection, and intrusion detection software. We invite
you to visit our Web site at www.fiservhealthservices.com to preview the information available.
To us it makes sense to use the Web as an informational tool, not just a brochure. Our online
services give clients, members, providers, producers, and partners the information they need,
when they need it. It's quick and easy to access online services through Fiserv Health. Users
will discover a wealth of information that's as close as their computer terminal. Online options
include:
• Care management
• Claim inquiry
• Coverage advisor
• Contact information
• Eligibility and benefits inquiry
• Flexible spending account inquiry
• Frequently used forms
• Healthcare Advisory"'
• Online reporting
• Health care cost summary
• Health information
• Health spending account access
• Invoice inquiry
• ID card ordering
• Pharmacy benefits information
• Provider network links
Kerr County 19
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Administrative Services
Rates effective 01/01/2008 to 01/01/2011
All fees shown as PEPM unless noted
All fees assume we provide at a minimum, medical administration,
utilization and case management, and prescription drug coverage.
Medical claims* - 243 employees
12/12 first year, paid second and third year
Insured Transplant Coordination Fee
$13.32
$0.35
Consultant Compensation (paid on behalf of the County) $3.00
COBRA
HIPAA Certificates of Creditable Coverage
$0.95
$0.25
Stop loss interface $2.00
*All fees, except network access fees, are guaranteed for three years. If the contract
is terminated prior to the third year a $2,500 fee applies. Fee includes two hours of
ad hoc reports and analysis and three enrollment site visits.
Medical network access*
Aetna Signature Administratorss"' - 243 employees $12.95
*Network access fees are only guaranteed for the first year.
Care management services
Enhanced utilization and case management (UM/CM) $3.00
Kerr County 20
Pis r Health..

Basic utilization and case management (UM/CM) $2.35
Outpatient Pre-Certification: 1-6 Procedures Lisfed $0.30
Outpatient Pre-Certification: 7-15 Procedures Listed $0.45
Outpatient Pre-Certification: 16-20 Procedures Lisfed $0.60
Outpatient Pre-Certification: 21+ Procedures Listed Will quote
Flexible spending account (FSA)
Health care account -per employee per account per month (PEPAPM) $4.95
~'" Dependent care account -per employee per account per month
(PEPAPM) $3.95
*Fees include FSA administration; claim payment, submission, and system options;
enrollment, billing, customer support, standard reports, and electronic copies of the
FSA plan document. Health care assumes 20 percent participation rate; dependent
care assumes 20 percent of the health care participation rate. The first month's fee
for health and dependent care account administration will be waived for new
customers.
Consumer-Driven products
Health reimbursement account (HRA) $4.00"
*Assumes 20 percent participation.
Retiree billing
ACH debit $4.00
Check payment $5.60
Kerr County 21
F%5 V Health.
Pharmacy Benefits Pricing -standard pricing
The following fees apply to all retail network pharmacies with the exception of pharmacies
located in states that may elect to participate on a state fee schedule. Fees assume pharmacy
benefits program is not a discount card program.
Electronic claim adjudication -per claim"
$0.30
*An additional $1.75 per claim applies to the electronic per claim fee for paper
claims
Retail brand claims -AWP minus percent or usual & customary 15.5%
(U&C), whichever is less
Retail generic claims MAC
Retail generic claims non -MAC -AWP minus percent or U&C, 15.5%
whichever is less
Retail dispensing fee
$1.90
Retail 90 Rx (Optional) brand claims -AWP minus percent or usual 18%
& customary (U&C), whichever is less
Retail 90 Rx (Optional) generic claims MAC
Retail 90 Rx (Optional) generic claims non -MAC -AWP minus 18%
percent or U&C, whichever is less
Retail 90 Rx (Optional) dispensing fee $3.25
Mail order brand claims -AWP minus percent 21
Mail order generic claims -AWP minus percent MAC
Mail order dispensing fee $0.00
Kerr County 22
1 ~~5 re V Heal th.

Two Tier Rebate Share (retail) -returned to fhe client	$0.75
Two Tier Rebate Share (mail order) -returned to fhe client	$2.25
Three Tier Rebate Share (retail) -returned to the client	$1.00
Three Tier Rebate Share (mail order) -returned to the client	$3.00
Prior authorizations -per prior authorization $20.00


Specialty pharmacy program rate - AWP minus percent, with an 12% - 50%
average anticipated discount of 17%
Specialty pharmacy program dispensing fee $2.50
Medicare Part D support services
Certificates of creditable coverage -Data analysis for simplified
determination of creditable coverage sfatus (existing clients with No charge
data -not valid for subsidy filing)
Certificates of creditable coverage -Data experience extracts to No charge
quantify subsidy potential
Certificates of creditable coverage -Certificates of creditable /non- $1 per certificate,
creditable coverage (production and mailing) subject to a $100
minimum
Kerr County 23
F%5 Health

Pharmacy Benefits -fixed fee pricing	
The following fees apply to all retail network pharmacies wifh the exception of pharmacies
located in states that may elect to participate on a state fee schedule.	Discounts and fees
illustrated below are based on the Innoviant book of business average.	Actual discounts
may vary. All discounts and fees will be passed through to the customer.
Electronic claim adjudication - per claim*	$6.10
`An additional $1.75 per claim applies to the electronic per claim fee for paper	
claims	
Retail brand claims - AWP minus percent	15.80%
Retail generic claims MAC -AWP minus percent	64.00%
Retail generic claims non-MAC -AWP minus percent	26.48%
Retail brand dispensing fee	$1.82
Retail generic dispensing fee	$2.02
Retail 90 Rx (Optional) brand claims -AWP minus percent	23.85%
Retai190 Rx (Optional) generic claims MAC -AWP minus percent	71.68%
Generic claims non -MAC -AWP minus percent	20.53%
Retai190 Rx (Optional) brand dispensing fee	$2.80
Retail 90 Rx (Optional) generic dispensing fee	$2.80
Mail order brand claims -AWP minus percent	24%

Kerr County 24
F%5 Health
Mail order generic claims -AWP minus percent 56%
Mail order dispensing fee $0.00
Rebate share - percent of the rebate to be returned to the client 100%
Prior authorization -per prior authorization $20.00
Specialty pharmacy program rate -AWP minus percent, with an ฐ ฐ
average anticipated discount of 17% 12 /o - 50 /o
Specialty pharmacy program dispensing fee $0.00
Medicare Part D support services
Certificates of creditable coverage -Data analysis for simplified
determination of creditable coverage status (existing clients with No charge
data -not valid for subsidy filing)
Certificates of creditable coverage -Data experience extracts to No charge
quantify subsidy potential
Certificates of creditable coverage -Certificates of creditable /non- $1 per certificate,
creditable coverage (production and mailing) subject to a $100
minimum
Kerr County 25
F%5 V Health.:
Optional Services
This section provides an overview of some of the frequently requested optional services available
through Fiserv Healfh. Your sales executive is available to discuss specific needs and services to
meef client requirements.
Medical
New York surcharge reporting -annual fee $1,000.00
ID card mailing charge -employee residence -PEPM Included in Medical
administration fee
Customized ID cards -per card set up $1,000.00
Cost Reduction and Savings (CRS) Program (formerly known as large o
bill review/fee negotiation and secondary/fravel network) 30 /o of savings
Health care discount card -Vision, dental and hearing -PEPM $1.95
COBRA
Initial COBRA letters for new employees (DOL) letter -PEPM $0.30
Consumer-Driven products
Debit card (required if the pharmacy and medical deductibles are $1.50
integrated)
Medical and pharmacy integration (required if the pharmacy and
medical deductibles are integrated) $1.00
Kerr County 26
Fis re V Health.
Flexible spending account (FSA)
FSA run-in claims -set up $2,000.00
FSA mailing statements to participants' home addresses -per account $0.05
per month (PAPM) x number of statements requested
FSA print plan booklet and mail to client -PEPAPM $0.15
$1.50 (with medical)
Bennyr"' card (not available with HSA) -per card per month or $2.00 (stand-
alone)
Aufo-reimbursement not selected -PEPAPM $0.50
Reporting
Results IC reporting licenses -per license, two included $1,000.00
Ad hoc reports and analysis -per hour $100.00
Medstat reporting - (additional fees will apply for history loads) $0.40
Medstaf user licenses -per license, three included $500.00
Banking
Check deposit split by other than bank account -for each additional
source code $450.00
Reconciliation -setup and annual fee $4,000.00 and
$1,000.00
Custodial banking -set up and monthly fee (deposit required) $1,200.00 and
$500.00
Positive pay agreement -annual fee $1,000.00
Kerr County 27
F%5 CB V Health.
Health and Wellness
Web-based assessment with results printed by the employee -per
assessment $3.50
Web-based assessment with results packet mailed to employee's
residence -per assessment $6.00
Paper assessment -per assessment
$12.00
Coaching -ten sessions with a specially trained coach -per participant
$350.00
per year
Standard wellness newsletters -quarterly mailing -per participant per
quarter $1.65
All products
Subrogation -percent of recoveries
33%
Kerr County 28
FiSerV Heal th.
Proposal Conditions
• Fiserv Health assumes all services provided will be handled according to our standard format
and procedures, unless otherwise specifically addressed within this proposal. Specialized
services will be priced as necessary.
• Fees proposed assume Fiserv Health will provide at a minimum medical administration,
network access, utilization and case management, and stop loss purchased through Fiserv
Health on an Aetna stop loss policy to access the Aetna Signature Administrators "' network.
• Aetna Signature Adminisfratorss"' network access fees assume a standard PPO plan design
with a minimum differential of 20 percent coinsurance between in-network and out-of-network
benefits, no referral administration, and no primary care physician tracking.
• Fees proposed assume That the schedule of benefits complies with the minimum differential
which maybe required by the network(s). Fiserv Health will assist with that determination if
needed.
• Fees proposed are subject to change if a division, subsidiary, affiliated company is added or
deleted from the plan, or if the number of covered employees changes by 15 percent or more
from this proposal.
• Fees proposed are based on the plan of benefits as submitted and do not assume duplication
of benefits or provisions.
• Fees proposed assume athree-year contract. Additional fees apply if contract is terminated
early.
• This proposal is valid unti130 days before the effective date and does not bind coverage or
obligate Fiserv Health.
• All quoted product fees assume Fiserv Health administers the medical plan.
• Requirements for Fiserv Health to pay run-in claims: Claims must be 100 percent repriced by
the current network prior to coming to Fiserv Health for processing. The plan holder must
coordinate mail distributions between the network(s) and Fiserv Health.
• To comply with the Department of Labor's (DOL) claims regulations, we encourage pre-
notification of at least 60 calendar days prior to the effective date of this contract. In the
event that a 60-day notice is not feasible, Fiserv Health does not guarantee, but will make
every reasonable effort to have new plan(s) programmed quickly so claims can be processed
within the required DOL timelines.
• Claims reprocessing due to situations such as retroactive benefit or eligibility changes may
require additional fees.
• Deductible integration of prescription drug and medical claims requires daily connectivity
between the pharmacy benefits manager (PBM) and the plan administrator, and may require
additional fees. External vendors are subject to prior approval.
• Fiserv Health cannot support the drug data requirements for Medicare Part D subsidy
submission of plans where the pharmacy claims are paid under the medical plan. We
recommend these pharmacy benefits be provided by a pharmacy benefits manager (PBM).
• Do not cancel in-force plan(s) and/or policy(ies) until final approval is received.
• Fiserv Health and the stop loss carriers are not bound by any typographical errors and/or
omissions contained herein. Refer to actual proposal rates, contingencies, and other
conditions.
Kerr County 29
Kerr County
Stop Loss Caveat Information
1~Aetna
Signature
Administrators'"
STOP LOSS CAVEAT INFORMATION
Policy Period: 12 months - 01/01/2008 - 12/31/2008
We are pleased to provide you with our proposal for Stop Loss insurance. The information
contained in this proposal is confidential and should not be shared with anyone other than
your broker or benefits plan consultant. This proposal assumes an effective date of January
1, 2008. This proposal reflects certain assumptions and should be used in conjunction with
your rate sheet.
• Administrative services will be provided by Fiserv Health, Preferred Provider Network
must be Aetna's PPO and Stop Loss coverage will be provided by Aetna Life Insurance
Company.
• Eligibility will apply to active, permanent full-time, U.S. employees working a minimum
of 20 hours per week on a regularly scheduled basis, as well as to their dependents. It
will also apply to COBRA continues and those who are entitled to extended benefits
under the plan following termination. This quotation assumes that all retired employees
and their dependents, both under and over age 65 will be included under the Individual
Stop Loss (ISL), and Aggregate Stop Loss (ASL). All retirees over age 65 are assumed to
have Medicare Primary (Parts A, B & D).
• 18/12 policy with cap -Run-in or claims incurred in the 6 months prior to the effective
date and paid during the Stop Loss policy period are included under the Stop Loss
coverage. The ASL is subject to the dollar limits identified on the rate page.
• SIC Code -Your business and/or Standard Industrial Code is 9111.
• Stop Loss Situs Requirements -This quote assumes that the customer will be sitused in
TX.
• Plan Design -The plan design is assumed to be consistent with those illustrated in the
proposal (90/70 PPO).
• HRA /HSA Plan Design -Employer contributions to any HRA or HSA Plan will not
accumulate towards the ISL Deductible or ASL Maximum.
• Pre-Certification - A11 plans must included pre-certification of services.
• Contribution -Employer contribution is no less than 75 percent of employee's cost or 50
percent of the total plan cost.
• Participation -Aetna is the sole stop loss carrier and no less than 75% of eligible
employees enroll, or at least 50% of total number of eligible employees when excluding
those who provide spousal waiver documentation.
• Underwriting Rules -For existing enrollees, our standard Pre-Existing Conditions and
AAW/DNC Rules may apply on the effective date of the Stop Loss policy unless waived
by underwriting. Our Stop Loss coverage includes aPre-Existing Condition rule for new
08/30/2007 www.aetna.com Page 1
t~crr Cr ~unrv
Stop Loss Caveat Information
entrants after the original effective date of the Stop Loss Policy (even if this provision is
waived on the underlying self funded plan).
• Financial Condition -Employer is a legitimate business and is financially sound.
• Common Ownership -There must be common ownership among all participating
divisions for this quote to remain valid.
• Aggregate Advanced Funding -can be added to our quote for an additional $ I.00 per
employee per month.
• Transplant Network - We have assumed the Aetna lOE Transplant Network will apply
to all Aetna Network participants.
• Promotional Network Access Fee Pricing -This case qualities for ASA retrospective
pricing whereby ASA will match your current network access fee and provide you with a
discount guarantee. If ASA achieves the guaranteed network discount, you would be
required to pay the difference between your current network access fee and the full
standard ASA network access fee at the end of the plan year. For more information on
this arrangement, please ask your Fiserv Health Account Executive.
Our Stop Loss policy has other features and conditions, which are described in the attached
General Description document. The General Description document and rate sheet are also
part of this proposal. Please review them carefully and notify us immediately if any of the
features do not meet your expectations or if any of our assumptions are incorrect.
T}~e following is a list of additional factors that may impact our Stop Loss premiums. We
reserve the right to change our rates and factors, at any time during the policy year, effective
on the date the change occurred, in the following circumstances:
~'~'e assumed the following for purposes of our
proposal:
Network enrollment assumptions would be as follows:
Aetna Signature ,Administrators PPO 243 lives
Out of Area 0 lives
We reserve the right to change our rates if:
The actual enrollment in the Aetna Network ehanzcs
from the assumed enrollment,
The percentage of retirees under /over age 65 and their
dependents who are under age 65 would be no more than
6~r~, and the percentage of COF3RA participants would be
nv more than '%,. Eligible retirees over age 65 will be
Medicare primary, and the employer's plan will be
seamdarv.
We have assumed aSingle /Family split of 165 Single
and 7R Family.
Your plan design remains unchanged.
The actual percentage of enrolled mtirecs undercover age
65 and their dependents who arc under age 65 or
COBRA participants exceeds the assumed perccntage_
Eligible retirees over age 65 arc not Medicare prinr<iry.
I-he actual SinglelFamily split changes From the assumed
split by 1030.
Any plan design changes from the }?rupuscd benefits
must be approved by Aetna. Note: there must be at
least a 20% coinsurance differential behveen
Participating Provider and Non-Narticipatink
Provider benefits.
Ili 30i20tf? www.actna_com 1'<<?-'~ ~'
Date: 8/30/200 ~ A ~tn~,
Case Name: Kerr County ~i~
Policy Year: o>/oi/2oo8-12/31,/2oo8 Signature
Underwriter Phil Sperry Administrators`"
Illustrative Quote
STOP LOSS QUOTE SPECIFICATIONS
	O tion 1	O tion 2
Number of Employees Covered Under Stop Loss:
Number of Single Covered Under Stop Loss:
Number of Family Covered Under Stop Loss:	243
165
78	243
165
78
		
Enrollment by product:
Aetna Signature Administrators PPO:	
243	
243
Brokerage Commission %:
Terminal Liability Option:	0.0 %
No Extension (N/A)	0.0
No Extension (N/A)
Reimbursement Basis:	18/12	18/12
Individual Coinsurance %:	100 %	100%
Individual Stop Loss Amount.	$50,000	$60,000
Single Individual Premium Rate:	$77.94	$67.67
Family Individual Premium Rate:	$212.]9	$184.24
Composite Individual Premium Rate (PEPM)**:	$121.03	$105.09
Annualized Individual Premium:	$352,923	$306,445
Prior Carrier Run-In Limit:	$0	$0
Aggregating Specific Stop Loss Amount:	$0	$0
Individual Specific Stop Loss Limits (Lasering):	TBD	TBD
Individual Lifetime Stop Loss Payment Amount:	$1,000,000	$1,000,000
Covered Benefits That Apply to Individual Stop Loss:	Medical, Rx	Medical, Rx
Aggregate Stop Loss Percentage: 125 % 125
Composite Aggregate Premium Rate**	$5.77	$5.98
Annualized Aggregate Premium	$16,832	$17,448
Single Aggregate Stop Loss Factor:	$350.79	$363.62
Family Aggregate Stop Loss Factor:	$955.03	$989.96
Composite Aggregate Stop Loss Factor (PEPM): **	$544.75	$564.67
Stop Loss Aggregate Limit*:	$1,588,479	$1,646,576
Prior Carrier Run-in Limit:	$243,481	$243,481
Aggregate Advanced Funding:	Excluded	Excluded
Maximum Annual Aggregate Payment Amount:	$1,000,000	$1,000,000
Covered Benefits That Apply to Aggregate Stop Loss:	Medical, Rx	Medical, Rx
FINANCIAL SUMMARY
Combined Premium (PEPM) Composite Rate: ** $126.80 $111.07
Total Stop Loss Premium: $369,756 $323,893
Composite Aggregate Factor (PEPM): ** $544.75 $564.67
Stop Loss Aggregate Limit*: $1,588,479 $1,646,576
*Minimum Stop Loss Aggregate Limit will be set using the first month enrollment x Composite Aggregate Factor (PEPM) x # of contract Months.
"ISL Premium rates are billed on a single/family basis and Aggregate premium and Aggregate Factors are billed/administered on a composite basis.
Please refer to the Stop Loss Caveat docttment for detailed quote contingencies and assumptions.
Page 1 of 1
Kerr County
Stop Loss Caveat Information
This proposal is preliminary. In order to provide you a final, firm proposal, we will need the
following updated information no later than 15 days prior to the effective date:
• Census data for all employees eligible for coverage, including: each employee's date of
birth, insurance status, dependent coverage, gender, and home zip code. Census should
also identify whether each employee is active, COBRA, part-time, union, early retiree,
retiree or waiver and the plan/product in which the employee is currently enrolled.
Additional information maybe required if union members, retirees or part-time workers
are eligible.
• A description of your plan design -for prior year and proposal year.
• Large claim information for the last I2 months within 60 days prior to the effective date,
including diagnosis for all individuals with claims for the 12-month period in excess of
$25,000. Additional information maybe required to validate this information.
• We will require a completed and signed Aetna Life Insurance Company Disclosure
Statement. In the event that we do not receive a completed and signed disclosure
statement on a timely basis prior to the effective date of Stop Loss coverage, we reserve
the right to withdraw our Stop Loss proposal.
• Updated monthly claims on a rolling 12-month basis with corresponding exposures up to
60 days prior to the effective date.
• We have reviewed claim data through July 2007. Based on this information, there are
claimants of concern. Additional information (i.e., more specific diagnosis, treatment
plan, incurral dates, etc.) will be required to determine, if lasering is necessary, and the
appropriate Individual Stop Loss (ISL) level. For privacy reasons, we have not included
names in this document.
• We will require a complete, signed plan document (or multiple documents if multiple
plans exist) within 90 days of the effective date in order to issue a policy.
• Please note: Aetna has in place procedures for handling "protected health information"
that are compliant with HIPAA. Disclosure of the requested information is permitted by
HIPAA. If you need additional information or require a confidentiality agreement, please
contact your account representative.
We reserve the right to amend or withdraw our proposal to reflect the underwriting impact of
any additional information we obtain or in the event you are unable to provide us any of the
information we need to fully underwrite the risk. If the enrolled participation in the Aetna
Network is less than 80% at final sale we will reserve the right to rescind our stop loss quote
and denyprovider network access.
08/30/2007 www.aetna.com Page 3
Fiserv Health
GEONETWORK REPORTS SUMMARY
Kerr County
Medical Networks Proposed:
Aetna
GeoNetworks Report Results (Using specified access criteria):
Access to Hospitals (1 in 20 miles)

Network	
Total Employees	Employees With
Access	Employees
Without Access	Percent With
Access
Aetna	243	220	23	90.5%
Total Access	243	220	23	90.5%
Access to PCPs (2 in 15 miles)

Network	
Total Employees	Employees With
Access	Employees
Without Access	Percent With
Access
Aetna	243	198	45	81.5%
Total Access	243	198	45	81.5%
Access to Specialists (2 in 15 miles)

Network	
Total Employees	Employees With
Access	Employees
Without Access	Percent With
Access
Aetna	243	222	21	91.4%
Total Access	243	222	21	91.4%
9/5/2007
Fiserv Health
Network Savings- Weighted
Kerr County
Market Rating Area
San Antonio/South Texas
Aetna
Inpatient	Outpatient	Ph icfan	Overall
63.0%	62.6%	52.5%	58.2%
**Aetna has access to the Greater Hill Country physicians in Kerr Co.
F%5 CB V Health..
Exhibits
Number
Aetna General Overview
Aetna Institutes of Excellence Directory 2
Aetna National Transplant Program 3
Financial Information -Stop Loss General Description
- Aetna will cover run-in claims only when the claims under the prior plan were subject
to medical management.
- Any individual who has an individual specific amount (that is, "lasered") will have
their run-in claims also applied to that special limit.
• Run-Out Included - (3 months for new business -first policy year only 12/15 contract).
Aetna can offer run-out coverage in the first policy year with a 12/15 policy. A 12/15
policy includes all claims incurred within a 12-month policy period but paid within 15
months ending 3 months after the end of the policy period. Pooled claims reimbursed
under Aetna's stop loss as a result of the run-out period claims will not accumulate
toward the subsequent year's pooling or aggregate limits.
Claims paid until the end of the 15-month period will be covered by Stop Loss assuming
the policy is kept in force or that termination occurs no earlier than policy year-end (12
months). Should the Stop Loss policy be terminated earlier than the 12 months, Stop
Loss coverage would extend for 3 months following termination.
Note: All first-year policies will be renewed on a paid basis in the second and
subsequent policy years.
Terminal Liability Option (TLO-3 or TLO-6) -Terminal Liability Option is Stop Loss
run-out protection only in the event of termination of Stop Loss coverage.
• Covers claims incurred under the plan prior to termination and paid within three months
of the termination date. TLO may only be added to the Stop Loss coverage in advance of
the renewal policy year.
• The customer must advise Aetna, in writing, that they intend to terminate and use their
run-out protection at least 31 days in advance of the date of termination. When the option
is exercised, two months of premium will be due at termination for the TLO-3 product
and three months of premium will be due at termination for the TLO-6 product.
• The Individual Stop Loss amount is continued through the three-month run-out period
(TLO-3) or six-month run-out period (TLO-6).
• The Aggregate Stop Loss amount is increased by three months of additional aggregate
liability for either the TLO-3 or TLO- 6 products.
• Total aggregate liability limit is subject to minimum level specified in the policy.
Aggregate coverage is subject to a minimum attachment level to protect against declining
enrollments throughout the policy period.
Monthly Aggregate Advance Funding Option- Aetna will reimburse the Insured during
the policy year if, at the end of any month during the policy year, the net eligible claim
expenses exceed the monthly Aggregate Stop Loss Amount subject to the minimum
attachment point.
"Aetna" is the brand name used for products and services provided by one or more of the Aetna group of
subsidiary companies. These companies include: Aetna Life Insurance Company and Aetna Insurance
Company of Connecticut.
www.aetna.com Page 5
Financial Information -Stop Loss CGeneral Descrip~iota
Stop los.~~ polkies rnur ~10~ eoi~e~~ ul! health cure es/cerise c<wcrecf by thc~ inidcrlvin,~=C~l~urs_ C`~~~rtrurt~~ slrnrrlcl 1~~~
rc~ud c~ure~irllt to deter•rnlne i~~hich losses are not cove re~I.
/~~or nx~re specific i~tJi~rnurtion chart the co~~crnge dctarls, incluc/in,~r /inaitutinn,~~, c~rclu.ti~in~zc crnc/ n/her plan
reyi~ircmenls. ple~rs~~ co~rtac! cm Aetna represeruatii~e.

Financial Information -Stop Loss General Description
Terminal Liability Option for ISL and Provides run-out protection at Often not a product offering
ASL can be applied to any contract type a nominal up front cost and of competitors.
(except 12/15). additional mature premium is
due only if the case
terminates and TLO is
invoked.
Underwriting Rules
Our Stop Loss contains the following standard exclusions and coverage rules. These apply
even if the underlying plan has different provisions or no pre-existing condition limitations.
• Pre-Existing Conditions Rule (PEC) -Stop Loss coverage includes a PEC rule for a
member who became enrolled after the original effective date of the Stop Loss policy
(even when the PEC rule is waived after the effective date on the underlying self-funded
plan).
• Actively-At-Work (AAW) and Dependent Non-Confinement (DNC) Rules -The
AAW/DNC rules apply only on the effective date of the Stop Loss policy but maybe
waived after a review of the specific claimant information provided.
Late Enrollees
Stop Loss coverage for claims of all late enrollees will automatically be postponed until the
self-funded plan's next Open Enrollment Period, and the individual will be subject to the Pre-
Existing Conditions Rule, as stated in the Stop Loss policy. A late enrollee's pre-existing
conditions period will begin on the first day of the late enrollee's coverage under the self-
fundedplan. (For self-funded plans that do not have an Open Enrollment Period, a Late
Enrollee Enrollment Period of 31 days will occur 2 months prior to the self-funded plan's
next renewal date.)
Development of Stop Loss Insurance Rates and Factors
Individual Stop Loss rates are per employee, per month and are developed before the start of
the policy period. Rates are based on the following assumptions: demographics, type of Stop
Loss coverage, self-funded plan design and length of the Stop Loss policy period.
Aggregate Stop Loss rates and factors are per employee, per month and are based on the
customer's expected claims, census (including age, gender and family status), self-funded
plan design, length of the Stop Loss policy period and level of aggregate coverage chosen.
The aggregate factor maybe adjusted to reflect a special, higher Individual Stop Loss amount
for individuals of extraordinary risk.
Renewal Stop Loss Rates and Factors
Individual Stop Loss key factors that will impact renewal rates include the following:
- Changes in any of the assumptions used in the quotation (including self-funded plan
design and demographic changes).
- Catastrophic medical trend (inflation in the cost and utilization of services for
catastrophic medical conditions) and the effects of leveraging relative to a fixed
Individual Stop Loss amount.
www.aetna.com Page 3
Financial Information -Stop Loss Gener<i] Description
- Change from an immature period to a mature, paid policy period.
- ~I~hc cost of known catastrophic claims that continue from period to period. Stop LOSS i~
priced to cover unknown catastrophic risks, as opposed to risks that are known, ongoing
and predictable.
.~t~,~grc~ncrtc Stn~~ Loss key factors that will impact renewal rates and factors arc:
- Medical trend.
- Change from an immature period to a mature, paid policy period.
- C)emographic and self=funded plan changes.
Billing
A monthly Stop Loss premium bill is prepared, based on the customer's submitted eligihility.
Premium
Stop Loss premiums arc payable monthly during the contract year, based on the number of
awercd employees. Premium rates are developed annually and may also be recalculated at
the time of any significant plan or demographic changes in the underlying self=funded plan.
Broker Commissions
Aetna can include broker commissions of up to 15ฐ/, provided all licensing, and appointment
rec~uirerr~ents are met at the time of sale. [f commissions exceed 10ฐ%~, a letter must be sig~ncd
by the broker agreeing to specific broker duties that must be performed in conjunction with
the higher rate of compensation.
Excess Loss Claims
Aeb~a reserves the right to fully audit the claims paying practices of the "CPA. A claim
submission packet will provide details on what is required in order to submit claims. Provt
of loss may not be given later than 6 months after the end of the policy year in which the TPA
paid the loss.
Stop Loss Insurance Policy Basis
One oF~ the Stop Loss policy periods below will apply to the Individual, Aggregate; or botl~i
[ndividual and Aggregate Stop Loss coverage.
• Run-ln Excluded -Prior carrier claims incurred prior to, but recorded after the effecti~~~e
date of this Stop Loss policy, are excluded under the Stop Loss coverage.
• Run-In [ncluded (for existing stop loss renewal customers) -Run-in or claims incurred
at any time prior to the effective date and paid during the Stop Loss policy period are
included under the Stop Loss coverage. This is a paid policy.
• Nun-tn Included (three months or six months) -Run-in or claims incurred prior to the
effective date and paid during the fiirst policy period are included under the Stop Loss
coverage. This is a 15/12 or 18/12 policy. The Individual Stop Loss cap includes a de~llar
limit per Participant with an overall run-in limit for the group in total. 7-he Aggregate
Stop Loss cap includes a dollar limit. The aggregate nm-in claims up to the run-in cap
amount will be considered against the aggregate attachment point for rcirnbursemcnt
determination. The following rules apply to this coverage:
u~~~w.aetna.com ~'~,~~ ~}
Financial Information -Stop Loss General Description
~~~~
~~n~tur~
Aclministr~tors~"
STOP LOSS
GENERAL DESCRIPTION
Aetna Signature Administrators sM provides you with the ability to purchase the Aetna
Signature Administrators PPO Network and Aetna Stop Loss when utilizing an
approved Third Party Administrator. This arrangement will automatically include
Aetna's Large Claims Management review and access to Aetna's Institute of
ExcellenceT""(IOE) Facilities for transplant services. In order to have access to the Aetna
Signature Administrators s"' PPO network, you must purchase an Aetna Stop Loss insurance
policy.
What Is Stop Loss Insurance?
A Stop Loss policy is designed to provide catastrophic risk protection to self-funded
customers.
Generally, Individual Stop Loss provides protection from the financial impact of a large
catastrophic claim. Aggregate Stop Loss provides protection from the risk of aggregate
claims paid over a limit predetermined by the customer.
Stop Loss is available to cover claims for a customer's eligible employees and their
dependents who satisfy the Stop Loss policy's definition of an employee.
Why Choose Aetna for Stop Loss Insurance?
In addition to having access to Aetna Signature Administrators s"' you should know that
Aetna has a proven track record of more than 20 years of controlling costs for self-funded
customers through Stop Loss insurance. Customers benefit from the advantages of a self-
funded arrangement with protection against financial risk from catastrophic claims.
Customers achieve better cost control through a predetermined liability limit and a fixed,
monthly premium.
How Does Stop Loss Insurance Work?
Individual Stop Loss (ISL) -Aetna assumes the financial responsibility for any claim that
exceeds the mutually agreed upon Individual Stop Loss amount, also known as the deductible
level, up to the Individual Lifetime Maximum of the base self-funded plan. Aetna currently
offers Individual Stop Loss amounts ranging from $25,000 to $500,000, with coinsurance
options of 100 percent, 90 percent or 80 percent.
www.aetna.com Page 1
Financial Information -Stop Loss General Description
:~gsrr~E~gate Stogy Loss (,ISL) -Aetna will reimburse the balance of the claims in excess of the
Aggregate Stop Loss limit, up to the Maximum Annual Aggregate Stop Loss Payment
Amount, in accordance with the terms of the Stop Loss policy.
What Are the Features and Benefits of Stop Loss Insurance:'
Stop Loss [nsurance combined with the Aetna Signature Administrators ~"' PPO network
access offers a number of features and benefits to the customer. This is what "The Aetna
,Advantage" is all about -how we have differentiated ourselves from the competition. Each
one of the features and benefits listed in the "Features and 1enefits" chart on the following;
page provides an important return to customers and demonstrates ""hhe Aetna Advantage"
Features and Benefits
Feature	Benefit	Competiti~~e Advantage
,'~CCeSS ~o Anna PPO network	As of 6i U2004, our PPO	Better disevunts and more
	network is made up of	participating providers than
	628,665 total providers.	competing vendor networks.
Aetna assumes 100"4 of Stop Loss risk	Aetna is dedicated to the stop	[Vtanv competitors arc heavily
without external reinsurance.	loss product offering. Our	reinsured which matt- result in
	claim decisions are	short term market presence.
	independent and we do not	Additionally, reinsurers
	rely on a reinsurer for claim	establish clam p~rymcni
	approvals.	guidelines that nnist be
		adhered to b~~ our
~
		compctitors_
Dedicated Stop Loss claims examiners	Prompt acid reliable	Competiturs may hire a [-
fr~r expediting reimbursement requests	reimbursement maximizes	to- 12- month reimbursement
on eligible individual claims.	customer cash slow,	delay until documentation is
		suhmittcd and approved.
viedicai Claim Management (MCM)	Aetrla's auditing and MCM	Sivp Loss vendors may not
progrrms ensures potential stop loss	avoid some claims that	of~ter case management
'
claims arc managed to an appropriate	utherwise would have. been	leading to overpayment oi
level.	paid. This benefit is included	claims.
	at no additional charge to the	
	customer.	
ACCCSS to Actna's Institute of	Provides highly negotiated	If an Aetna approved facility
Lxceilencc program.	rates at quality transplant	is utilized, seep down
	facilities. Medical claim	transplant deductible will
	management and specialized	apply.
	claims adjudication for	
	transplant claims	
ivtont}ily advance aggre~~ate feature for	Less variability in month-to-	Competitors may not of~f~er
,~lggrcgatc Stop Loss available for	month costs and cash-t7ow	monthly hudgrting.
minimal cost. ~I"his option allows for	advantages.	
simple monthly budgeting and tracking		
of Stop Loss aggregate liability.		
L.iletimc pay-out limits for Individual	Added risk protection for	Some cu-riers set loucr
Stop Loss for options of 51,000,000;	medical plans with higher	Individual Stop Loss limits.
2000,000 or $5,000,000 (subject to	lifetime maximums. A multi-	Sl ~7ullion is most common.
underl~ ing plan lifetime maximums).	million dollar claim could	
	cause financial hardship to	
	the company.	
tivww.aetna.com 1'~~"e
,, Institutes of Excellence
Transplant Facilities
Hospitals that have met enhanced quality review criteria have been selected
by Aetna to participate in our Institutes of Excellence network for transplant
and transplant-related services. These facilities have been contracted on a
transplant-specific basis, and facilities are considered participating only for the
transplant type listed in this directory. To be considered in-network for coverage
of transplant-related services, including evaluation, transplant and follow-up care,
you must utilize an Institutes of Excellence participating facility that has been
specifically contracted by Aetna for your transplant type. Services must be
preauthorized by Aetna for coverage to be effective. Any facility that is not
specified as an Institutes of Excellence transplant network facility is considered
non-participating or non-preferred for transplant-related services, even if it is
considered participating for other types of services.
-,, Facilities are listed in the Institutes of Excellence section of this directory
by transplant type, then by state. You must look for the transplant type first,
and within that transplant type, facilities are listed by state in alphabetical order.
www.aetna.com
Bone Marrow Transplant - Allo
BONE MARROW
TRANSPLANT - ALLO
ARIZONA
City of Hope Samaritan Bone
Marrow Transplantation Program
1111 East McDowell Road
Phoenix, AZ 85006
Adult
The Childrens Hospital
1056 East 19th Avenue
Denver, CO 80218
Pediatric
CONNECTICUT
Yale-New Haven Hospital
20 York Street
New Haven, CT 06504
Adult
ARKANSAS
University of Arkansas for Medical
Sciences
4301 West Markham
Little Rock, AR 72205
Adult
CALIFORNIA
Children's Hospital Los Angeles
4650 Sunset Boulevard
Los Angeles, CA 90027
Pediatric
Childrens Hospital of Orange County
455 South Main Street
Orange, CA 92868-3874
Pediatric
Childrens Hospital of San Diego
3020 Childrens Way, MC 5046
San Diego, CA 92123
Pediatric
City of Hope National Medical
Center
1500 East Duarte Road
Duarte, CA 91010-3000
Adult & Pediatric
Lucile Salter Packard Children's
Hospital at Stanford
725 Welch Road
Palo Alto, CA 94304
Pediatric
Stanford Hospital and Clinic
300 Pasteur Drive
Palo Alto, CA 94304
Adult
UCLA Medical Center
10833 Le Conte Avenue
Los Angeles, CA 90095
Adult & Pediatric
UCSD Medical Center
200 West Arbor Drive
San Diego, CA 92103
Adult
UCSF Medical Center
505 Parnassus Avenue
San Francisco, CA 94117
Adult & Pediatric
COLORADO
Presbyterian/St. Luke's Hospital
1719 East 19th Avenue
Denver, CO 80218
Adult
DISTRICT OF COLUMBIA
Childrens National Medical Center
111 Michigan Ave, Northwest
Washington, DC 20010-2970
Pediatric
FLORIDA
H. Lee Moffitt Cancer Center
12902 Magnolia Drive
Tampa, FL 33612-9497
Adult
Shands Transplant Center at
University of Florida
1600 Southwest Archer Road
P.O. Box 100251
Gainesville, FL 32610
Adult & Pediatric
GEORGIA
Emory University Hospital
1364 Clifton Road, Northeast
Atlanta, GA 30322
Adult
Northside Hospital
The Blood and Marrow Transplant
Group of GA at Northside Hospital
960 Johnson Ferry Road
Suite 400
Atlanta, GA 30342
Adult
ILLINOIS
Children's Memorial Hospital
2300 Children's Plaza
Fullerton at Lincoln
Chicago, IL 60614
Pediatric
Northwestern Memorial Hospital
251 East Huron
Chicago, IL 60611
Adult
University of Chicago Hospital
5841 South Maryland
Chicago, IL 60637
Adult
INDIANA
Indiana University Hospital
550 North University Boulevard
Indianapolis, IN 46202
Adult
Riley Children's Hospital
702 Barnhill Drive
Indianapolis, IN 46202
Pediatric
KANSAS
University of Kansas Hospital
Authority
3901 Rainbow Boulevard
Kansas City, KS 66205
Adult
KENTUCKY
University of Kentucky
Chandler Medical Center
800 Rose Street
Lexington, KY 40508
Adult
MARYLAN D
Johns Hopkins Hospital
600 North Wolfe Street
Baltimore, MD 21287
Adult & Pediatric
University of Maryland Medical
System
22 South Greene Street
Baltimore, MD 2 1 201-1 544
Adult
MASSACHUSETTS
Brigham and Women's Hospital
75 Francis Street
Boston, MA 02115
Adult
Children's Hospital
300 Longwood Avenue
Boston, MA 02115-5724
Pediatric
Dana-Farber Cancer Institute
44 Binney Street
Boston, MA 02115
Adult
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Adult
MICHIGAN
The Regents of the University of
Michigan
1500 East Medical Center Drive
Ann Arbor, MI 48109
Adult & Pediatric
MINNESOTA
University of Minnesota Medical
Center
420 Delaware Street Southeast
Minneapolis, MN 55455
Adult & Pediatric
Institutes of Excellence
MISSOURI
Barnes-Jewish Hospital
1 Barnes-Jewish Hospital Plaza
St. Louis, MO 63110
Adult
Children's Mercy Hospital
2401 Gillham Road
Kansas City, MO 64108-4619
Pediatric
St. Louis Children's Hospital
1 Children's Place
St. Louis, MO 63110
Pediatric
NEBRASKA
Nebraska Medical Center
Emile at 42nd Street
Omaha, NE 68198
Adult & Pediatric
NEW JERSEY
Hackensack University Medical
Center
30 Prospect Avenue
Hackensack, NJ 07601
Adult & Pediatric
Robert Wood Johnson University
Hospital
One Robert Wood Johnson Place
New Brunswick, Nl 08901
Adult
NEW YORK
Long Island Jewish Medical Center
1979 Marcus Avenue
Lake Success, NY 11042
Adult
Memorial Sloan-Kettering Cancer
Center
1275 York Avenue
New York, NY 10021
Adult & Pediatric
Mount Sinai Hospital
One Gustave L Levy Place
New York, NY 10029-6500
Adult
New York Presbyterian Hospital
Columbia Presbyterian Campus
622 West 168th Street
New York, NY 10032
Pediatric
North Shore University Hospital
330 Community Drive
Manhasset, NY 11030
Adult & Pediatric
Schneider Children's Hospital
270-OS 76th Avenue
New Hyde Park, NY 11042
Pediatric
6
Institutes of Excellence		Bone M	arrow Transplant -Auto
Strong Memorial Hospital -	PENNSYLVANIA	The Methodist Hospital	ARKANSAS
University of Rochester		6565 Fannin Street	
601 Elmwood Avenue	Childrens Hospital of Philadelphia	Houston, TX 77030	University of Arkansas for Medical
Rochester, NY 14642	(CHOP)	Adult	Sciences
Adult & Pediatric	34th Street & Civic Center Boulevard		4301 West Markham
	Philadelphia, PA 19104-4399	The University of Texas	Little Rock, AR 72205
The Presbyterian Hospital-Cornell	Pediatric	MD Anderson Cancer Center	Adult
333 East 38th Street		1515 Holcombe Boulevard	
New York, NY 10016	Childrens Hospital of Pittsburgh	Houston, TX 77030	
Adult	3705 Fifth Avenue	Adult & Pediatnc	CALIFORNIA
	Pittsburgh, PA 15213-2583		
Westchester Medical Center	Pediatric	UT Southwestern Zale Lipshy	Children's Hospital Los Angeles

95 Grasslands Road		
Hospital	4650 Sunset Boulevard

Valhalla
NY 10595	Hos ital of Universit of
Y	
5151 Harry Hines Boulevard	Los Angeles, CA 90027
,
Adult & Pediatric	Penns Ivania (HUP)
Y	
Dallas, TX 75235	pediatric
	3400 Spruce Street	Adult	
	Philadelphia, PA 1 91 04-42 04		Childrens Hospital of Orange County
NORTH CAROLINA	Adult		455 South Main Street
		VIRGINIA	Orange, CA 92868-3874
Duke University Medical Center	Pennsylvania Hospital		Pediatric
Trent Drive	8th & Spruce Streets	Medical College of Virginia	
Durham, NC 27710	Philadelphia, PA 19107	401 North 12th Street, Suite 2-300	Childrens Hospital of San Diego
Adult & Pediatric	Adult	P.O. Box 980510	3020 Childrens Way, MC 5046
		Richmond, Virginia 23298-0510	San Diego, CA 92123
University of North Carolina	Temple University Hospital	Adult & Pediatric	Pediatric
Hospitals	Temple University Health System		
101 Manning Drive	3401 North Broad Street		City of Hope National Medical
Chapel Hill, NC 27514	Philadelphia, PA 19140	WASHINGTON	Center
Adult	Adult		1500 East Duarte Road
		Children's Hospital and Regional	Duarte, CA 91010-3000
	Thomas Jefferson University	Medical Center	Adult & Pediatric
OHIO	Hospital	4800 Sand Point Way Northeast	
'
	111 South 11th Street	Seattle, WA 98105	Lucile Salter Packard Children
s
Arthur G. James Cancer Hospital &	Philadelphia, PA 19107-4824	Pediatric	Hospital at Stanford
Richard J. Solove Research Institute	Adult		725 Welch Road
300 West Tenth Avenue		Seattle Cancer Care Alliance	Palo Alto, CA 94304
Columbus, OH 43210	West Penn Hospital	(including Fred Hutchinson Cancer	Pediatric
Adult	4800 Friendship Avenue	Research Center)	
	Pittsburgh, PA 15224	825 Eastlake Avenue East	Stanford Hospital and Clinics
r Children's Hospital	Adult	Seattle, WA 98109-1023	300 Pasteur Drive
700 Children's Drive		Adult and Pediatric	Palo Alto, CA 94304
Columbus, OH 43205			Adult
Pediatric	TENNESSEE	University of Washington Medical	
		Center	UCLA Medical Center
Cincinnati Children's Medical Center	St. Jude Children's Research Hospital	1959 Northeast Pacific Street	10833 Le Conte Avenue
3333 Burnet Avenue	332 North Lauderdale	Seattle, WA 98195	Los Angeles, CA 90095
Cincinnati, OH 45229	Memphis, TN 38105	Adult & Pediatric	Adult & Pediatric
Pediatric	Pediatrc		
			UCSD Medical Center
Cleveland Clinic Foundation	Vanderbik University Hospital	WISCONSIN	200 West Arbor Drive
Transplant Center A110	1211 22nd Avenue South		San Diego, CA 92103
9500 Euclid Avenue	Nashville, TN 37232	Children's Hospital of Wisconsin	Adult
Cleveland, OH 44195	Adult & Pediatric	9000 West Wisconsin Avenue	
Adult		Milwaukee, WI 53226	UCSF Medical Center
		Pediatric	505 Parnassus Avenue
Jewish Hospital	TEXAS		San Francisco, CA 94117
4777 East Galbraith Road		Froedtert Memorial Lutheran	Adult & Pediatric
Cincinnati, OH 45236	Baylor University Medical Center	Hospkal	
Adult	3500 Gaston Avenue	9200 West Wisconsin Avenue	
	Dallas, TX 75246	Milwaukee, WI 53226	COLORADO
University Hospitals of Cleveland	Adult	Adult	
11100 Euclid Avenue			Presbyterian/St. Luke's Hospital
Cleveland, OH 44106	Cook Children's Medical Center
801 S
th A		1719 East 19th Avenue
er
CO 80218
Den
Adult & Pediatric	venue
even		,
v
	Fort worth, TX 76104	BONE MARROW	Adulr
	Pediatric	TRANSPLANT -AUTO	
OREGON			The Childrens Hospital
	Texas Children's Hospital		1056 East 19th Avenue
Oregon Health & Science University	6621 Fannin Street	ARIZONA	Denver, CO 80218
(including University Hospkal &	Houston, TX 77030	
City of Hope Samaritan Bone	Pediatric
Doernbecher Children's Hospital)	Pediatric	Marrow Transplantation Program	
3181 Southwest Sam Jackson Park Road		1111 East McDowell Road	
Portland, OR 97239	Texas Transplant Institute	
Phoenix
AZ 85006	CONNECTICUT
Adult & Pediatric	San Antonio, TX 78297	,
Adult	
	Adult & Pediatric		Yale-New Haven Hospital
			20 York Street
			New Haven, CT 06504
			Adult
7
Bone Marrow Transplant -Auto
Institutes of Excellence
DISTRICT OF COLUMBIA	KENTUCKY	St. Louis Children's Hospital	NORTH CAROLINA
		1 Children's Place	
Childrens National Medical Center	University of Kentucky	St. Louis, MO 63110	Duke University Medical Center
111 Michigan Ave, Northwest	Chandler Medical Center	Pediatric	Trent Drive
Washington, DC 20010-2970	800 Rose Street		Durham, NC 27710
Pediatric	Lexington, KY 40508		Adult & Pediatric
	Adun	NEBRASKA	
			University of North Carolina
FLORIDA		Nebraska Medical Center	Hospitals
	MARYLAND	Emile at 42nd Street	101 Manning Drive
H. Lee Moffitt Cancer Center		Omaha, NE 68198	Chapel Hill, NC 27514
12902 Magnolia Drive	Johns Hopkins Hospital	Adult & Pediatric	Adult
Tampa, FL 33612-9497	600 North Wolfe Street		
Adult	Baltimore, MD 21287		
	Adult & Pediatric	N EW J ERSEY	OH10
Shands Transplant Center at			
University of Florida	University of Maryland Medical	Hackensack University Medical	Arthur G. James Cancer Hospital &
1600 Southwest Archer Road	System	Center	Richard 1. Solove Research Institute
P.O. Box 100251	22 South Greene Street	30 Prospect Avenue	300 West Tenth Avenue
Gainesville, EL 32610	Baltimore, MD 2 1 2 01-1 544	Hackensack, Nl 07601	Columbus, OH 43210
Adult & Pediatric	Adult	Adult &Pedratric	Adult
		Robert Wood Johnson University	Children's Hospital
GEORGIA	MASSACHUSETTS	Hospital	70o Children's Drive
		One Robert Wood Johnson Place	Columbus, OH 43205
Emory University Hospital	Brigham and Women's Hospital	New Brunswick, Nl 08901	Pediatric
1364 Clifton Road, Northeast	75 Francis Street	Adult	
Atlanta, GA 30322	Boston, MA 02115		Cincinnati Children's Medical Center
Adult	Adult		3333 Burnet Avenue
		NEW YORK	Cincinnati, OH 45229
Northside Hospital	Children's Hospital		Pediatric
The Blood and Marrow Transplant	300 Longwood Avenue	Long Island Jewish Medical Center	
Group of GA at Northside Hospital	Boston, MA 02115-5724	1979 Marcus Avenue	Cleveland Clinic Foundation
960 Johnson Ferry Road	Pediatric	Lake Success, NY 11042	Transplant Center A110
Suite 400		Adult	9500 Euclid Avenue
Atlanta, GA 30342	Dana-Farber Cancer Institute		Cleveland, OH 44195
Adult	44 Binney Street	Memorial Sloan-Kettering Cancer	Adult
	Boston, MA 02115	Center	
	Adult	1275 York Avenue	Jewish Hospital
ILLINOIS		New York, NY 10021	4777 East Galbraith Road
	Massachusetts General Hospital	Adult &Pedratric	Cincinnati, OH 45236
Children's Memorial Hospital	55 Fruit Street		Adult
2300 Children's Plaza	Boston, MA 02114	Mount Sinai Hospital	
Fullerton at Lincoln	Adult	One Gustave L Levy Place	University Hospital of Cleveland
Chicago, IL 60614		New York, NY 10029-6500	11100 Euclid Avenue
Pediatric		Adult	Cleveland, OH 44106
	MICHIGAN		Adult & Pediatric
Northwestern Memorial Hos rtal
P~		New York Presbyterian Hospital	
251 East Huron	The Regents of the University of	Columbia Presbyterian Campus	
Chicago, IL 60611	Michigan	622 West 168th Street	OREGON
Adult	1500 East Medical Center Drive	New York, NY 10032	
	Ann Arbor, MI 48109	Pediatric	Legacy Good Samaritan Hospital
University of Chicago Hospital	Adult &Pedratric		and Medical Center dba Northwest
5841 South Maryland		North Shore University Hospital	Marrow Transplant Program
Chicago, IL 60637		330 Community Drive	1919 Northwest Lovejoy
Adult	MINNESOTA	Manhasset, NY 11030	Portland, OR 97209
		Adult &Pedratric	Adult
	University of Minnesota Medical		
INDIANA	Center	Schneider Children's Hospital	Oregon Health & Science University
	420 Delaware Street Southeast	270-05 76th Avenue	(including University Hospital &
Indiana University Hospital	Minneapolis, MN 55455	New Hyde Park, NY 11042	Doernbecher Children's Hospital)
550 North University Boulevard	Adult & Pediatric	Pediatric	3181 Southwest Sam Jackson Park Road
Indianapolis, IN 46202			Portland, OR 97239
Adult		Strong Memorial Hospital -	Adult & Pediatric
	MISSOURI	University of Rochester	
Riley Children's Hospital
70Z Barnhill Drive	Barnes-Jewish Hospital	601 Elmwood Avenue	
Indiana olis, IN 46202
p	1Barnes-Jewish Hospital Plaza	Rochester, NY 14642
Adult & Pediatric	PENNSYLVANIA
Pediatric	St. Louis, MO 63110		Childrens Hospital of Philadelphia
	Adult	The Presbyterian Hospital-Cornell	(CHOP)

KANSAS	Children's Merc Hos ital
y P	333 East 38th Street
k
N
100
6	34th Street & Civic Center Boulevard
Philadelphia
PA 19104-4399
	2401 Gillham Road	New Yor
,
Y
1	,
Pediatric
University of Kansas Hospital	Kansas City, MO 64108-4619	Adult	
Authority	Pediatric	
Westchester Medical Center	Childrens Hos ital of Pittsbur h
P g
3901 Rainbow Boulevard		95 Grasslands Road	~
ft
Kansas City, KS 66205		
Valhalla
NY 10595	p tt
h, PA 15213-2583
bur
g
Adult		,
Adult & Pediatric	Pediatric
8
Institutes of Excellence
Hospital of University of
Pennsylvania (HUP)
3400 Spruce Street
~'~pฐ Philadelphia, PA 1 91 04-42 04
Adult
Pennsylvania Hospital
8th & Spruce Streets
Philadelphia, PA 19107
Adult
Temple University Hospital
Temple University Health System
3401 North Broad Street
Philadelphia, PA 19140
Adult
Thomas Jefferson University
Hospital
111 South 11th Street
Philadelphia, PA 19107-4824
Adult
West Penn Hospital
4800 Friendship Avenue
Pittsburgh, PA 15224
Adult
TENNESSEE
St. Jude Children's Research Hospital
332 North Lauderdale
Memphis, TN 38105
Pediatric
Vanderbilt University Hospital
1211 22nd Avenue South
Nashville, TN 37232
F Adult & Pediatric
TEXAS
Baylor University Medical Center
3500 Gaston Avenue
Dallas, TX 75246
Adult
Cook Children's Medical Center
801 Seventh Avenue
Fort Worth, TX 76104
Pediatric
Texas Children's Hospital
6621 Fannin Street
Houston, TX 77030
Pediatric
Texas Transplant Institute
San Antonio, TX 78297
Adult & Pediatric
The Methodist Hospital
6565 Fannin Street
Houston, TX 77030
Adult
The University of Texas
MD Anderson Cancer Center
1515 Holcombe Boulevard
Houston, TX 77030
Adult & Pediatric
UT Southwestern Zale Lipshy
mow'` Hospital
5151 Harry Hines Boulevard
Dallas, TX 75235
Adult
VIRGINIA
Medical College of Virginia
401 North 12th Street, Suite 2-300
P0. Box 980510
Richmond, Virginia 23298-0510
Adult & Pediatric
WASHINGTON
Children's Hospital and Regional
Medical Center
4800 Sand Point Way Northeast
Seattle, WA 98105
Pediatric
Seattle Cancer Care Alliance
(including Fred Hutchinson Cancer
Research Center)
825 Eastlake Avenue East
Seattle, WA 98109-1023
Adult and Pediatric
University of Washington Medical
Center
1959 Northeast Pacific Street
Seattle, WA 98195
Adult & Pediatric
WISCONSIN
Children's Hospital of Wisconsin
9000 West Wisconsin Avenue
Milwaukee, WI 53226
Pediatric
Froedtert Memorial Lutheran
Hospital
9200 West Wisconsin Avenue
Milwaukee, WI 53226
Adult
HEART
CALIFORNIA
California Pacific Medical Center
2333 Buchanan Street
San Francisco, CA 94115
Adult
Children's Hospital Los Angeles
4650 Sunset Boulevard
Los Angeles, CA 90027
Pediatric
Loma Linda University Medical
Center
11234 Anderson Street
Loma Linda, CA 92354
Pediatric
Lucile Salter Packard Children's
Hospital at Stanford
725 Welch Road
Palo Alto, CA 94304
Pediatric
Stanford Hospital and Clinics
300 Pasteur Drive
Palo Alto, CA 94304
Adult
UCLA Medical Center
10833 Le Conte Avenue
Los Angeles, CA 90095
Adult
COLORADO
The Childrens Hospital
1056 East 19th Avenue
Denver, CO 80218
Pediatric
The University of Colorado Hospital
Authority
4200 East 9th Avenue
Denver, CO 80220
Adult
FLORIDA
Shands Transplant Center at
University of Florida
1600 Southwest Archer Road
P.0. Box 100251
Gainesville, FL 32610
Adult
Tampa General Hospital
2 Columbia Drive
Tampa, FL 33606
Adult
GEORGIA
Emory University Hospital
1364 Clifton Road, Northeast
Atlanta, GA 30322
Adult
ILLINOIS
Children's Memorial Hospital
2300 Children's Plaza
Fullerton at Lincoln
Chicago, IL 60614
Pediatric
University of Chicago Hospital
5841 South Maryland
Chicago, IL 60637
Adult
INDIANA
Methodist Hospital
I-65 at 21st Street
Indianapolis, IN 46202
Adult
KENTUCKY
Jewish Hospital
217 Easi Chestnut Street
Louisville, KY 40202
Adult
LOUISIANA
Ochsner Foundation Hospital
1514 Jefferson Highway
New Orleans, LA 70121
Adult
Heart
MARYLAND
Johns Hopkins Hospital
600 North Wolfe Street
Baltimore, MD 21287
Adult
MASSACHUSETTS
Brigham and Women's Hospital
75 Francis Street
Boston, MA 02115
Adult
Children's Hospital
300 Longwood Avenue
Boston, MA 02115-5724
Pediatric
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Adult
MICHIGAN
The Regents of the University of
Michigan
1500 East Medical Center Drive
Ann Arbor, MI 48109
Adult & Pediatric
MINNESOTA
University of Minnesota Medical
Center
420 Delaware Street Southeast
Minneapolis, MN 55455
Adult
MISSOURI
Barnes-Jewish Hospital
1 Barnes-Jewish Hospital Plaza
St. Louis, MO 63110
Adult
St. Louis Children's Hospital
1 Children's Place
St. Louis, MO 63110
Pediatric
NEW JERSEY
Newark Beth Israel Medical Center
201 Lyons Avenue
Newark, NJ 07112
Adult
NEW YORK
Mount Sinai Hospital
One Gustave L. Levy Place
New York, NY 10029-6500
Adult & Pediatric
New York Presbyterian Hospital
Columbia Presbyterian Campus
622 West 168th Street
New York, NY 10032
Adult & Pediatric
9
Heart
Strong Memorial Hospital
University of Rochester
601 Elmwood Avenue
Rochester, NY 14642
Adult
NORTH CAROLINA
Carolinas Medical Center
1000 Blythe Boulevard
Charlotte, NC 28203
Adult
Duke University Medical Center
Trent Drive
Durham, NC 27710
Adult & Pediatric
OHIO
Cleveland Clinic Foundation
Transplant Center A110
9500 Euclid Avenue
Cleveland, OH 44195
Adult
University Hospital of Cincinnati
234 Goodman Street
Cincinnati, OH 45219
Adult
OREGON
Oregon Heahh & Science University
(including University Hospital &
Doernbecher Children's Hospital)
3181 Southwest Sam Jackson Park Road
Portland, OR 97239
Adult
PENNSYLVANIA
Childrens Hospital of Philadelphia
(CHOP)
34th Street & Civic Center Boulevard
Philadelphia, PA 19104-4399
Pediatric
Childrens Hospital of Pittsburgh
3705 Fifth Avenue
Pittsburgh, PA 15213-2583
Pediatric
Hospital of University of
Pennsylvania (HUP)
3400 Spruce Street
Philadelphia, PA 19104-4204
Adult
Temple University Hospital
Temple University Health System
3401 North Broad Street
Philadelphia, PA 19140
Adult
TENNESSEE
Vanderbilt University Hospital
1211 22nd Avenue South
Nashville, TN 37232
Adult & Pediatric
TEXAS
St. Luke's Episcopal Hospital
Texas Medical Center
6720 Bertner Avenue
Houston, TX 77030
Adult
Texas Children's Hospital
6621 Fannin Street
Houston, TX 77030
Pediatric
Texas Transplant Institute
San Antonio, TX 78297
Adult
The Methodist Hospital
6565 Fannin Street
Houston, TX 77030
Adult
The Transplant Center at Medical
City Dallas Hospital
7777 Forest Lane
Bldg. A 14th Floor
Dallas, TX 75230
Adult
VIRGINIA
University of Virginia Medical
Center
Hospital Drive & Jefferson Park Avenue
Charlottesville, VA 22908
Adult
WASHINGTON
University of Washington Medical
Center
1959 Northeast Pacific Street
Seattle, WA 98195
Adult
WISCONSIN
St Lukes Medical Center
2900 West Oklahoma Avenue
Milwaukee, WI 53215
Adult
HEART/LUNG
CALIFORNIA
Lucile Salter Packard Children's
Hospital at Stanford
725 Welch Road
Palo Alto, CA 94304
Pediatric
Stanford Hospital and Clinics
300 Pasteur Drive
Palo Alto, CA 94304
Adult
UCSD Medical Center
200 West Arbor Drive
San Diego, CA 92103
Adult
MARYLAND
Johns Hopkins Hospital
600 North Wolfe Street
Baltimore, MD 21287
Adult
NORTH CAROLINA
Duke University Medical Center
Trent Drive
Durham, NC 27710
Adult
PENNSYLVANIA
Childrens Hospital of Philadelphia
(CHOP)
34th Street & Civic Center Boulevard
Philadelphia, PA 19104-4399
Pediatric
Childrens Hospital of Pittsburgh
3705 Fifth Avenue
Pittsburgh, PA 15213-2583
Pediatric
Hospital of University of
Pennsylvania (HUP)
3400 Spruce Street
Philadelphia, PA 1 91 04-42 04
Adult
Temple University Hospital
Temple University Health System
3401 North Broad Street
Philadelphia, PA 19140
Adult
TENNESSEE
Vanderbilt University Hospital
1211 22nd Avenue South
Nashville, TN 37232
Adult
TEXAS
Texas Children's Hospital
6621 Fannin Street
Houston, TX 77030
Pediatric
INTESTINE
DISTRICT OF COLUMBIA
Georgetown University Medical
Center
3800 Reservoir Road NW
Washington, D.C. 20007
Adult& Pediatric
NEBRASKA
Nebraska Medical Center
Emile at 42nd Street
Omaha, NE 68198
Adult & Pediatric
Institutes of Excellence
NEW YORK
Mount Sinai Hospital
One Gustave L Levy Place
New York, NY 10029-6500
Adult and Pediatric
PENNSYLVANIA
Childrens Hospital of Philadelphia
(CHOP)
34th Street & Civic Center Boulevard
Philadelphia, PA 19104-4399
Pediatric
Children's Hospital of Pittsburgh
3705 Fifth Avenue
Pittsburgh, PA 15213-2583
Pediatric
KIDNEY
ARIZONA
City of Hope Samaritan Bone
Marrow Transplantation Program
1111 East McDowell Road
Phoenix, AZ 85006
Adult
CALIFORNIA
California Pacific Medical Center
2333 Buchanan Street
San Francisco, CA 94115
Adult
Children's Hospital Los Angeles
4650 Sunset Boulevard
Los Angeles, CA 90027
Pediatric
Loma Linda University Medical
Center
11234 Anderson Street
Loma Linda, CA 92354
Adult & Pediatric
Lucile Salter Packard Children's
Hospital at Stanford
725 Welch Road
Palo Alto, CA 94304
Pediatric
Stanford Hospital and Clinics
300 Pasteur Drive
Palo Alto, CA 94304
Adult
UCLA Medical Center
10833 Le Conte Avenue
Los Angeles, CA 90095
Adult & Pediatric
UCSD Medical Center
200 West Arbor Drive
San Diego, CA 92103
Adult
UCSF Medical Center
505 Parnassus Avenue
San Francisco, CA 94117
Adult & Pediatric
10
Institutes of Excellence			Kidney
COLORADO	ILLINOIS	MARYLAND	Robert Wood Johnson University
				Hospital
The Childrens Hospital	Children's Memorial Hospital	Johns Hopkins Hospital		One Robert Wood Johnson Place
1056 East 19th Avenue	2300 Children's Plaza	600 North Wolfe Street		New Brunswick, NJ 08901
Denver, CO 80218	Fullerton at Lincoln	Baltimore, MD 21287		Adult
Pediatric	Chicago, IL 60614	Pediatric		
	Pediatric			St. Barnabas Medical Center
The University of Colorado Hospital		University of Maryland Medical		95 Old Short Hills Road
Authority	Northwestern Memorial Hospital	System		West Orange, NJ 07052
4200 East 9th Avenue	251 East Huron	22 South Greene Street		Adult
Denver, CO 80220	Chicago, IL 60611	Baltimore, MD 21201-1544		
Adult	Adult	Adult		
				NEW YORK
	University of Chicago Hospital			
CONNECTICUT	5841 South Maryland	MASSACHUSETTS		Albany Medical Center
	go, IL 60637			venue
1
Hartford Hospital	Adult	Children's Hos ital
P		22pg
A bany, NY 1
80 Seymour Street		300 Longwood Avenue		Adult
Hartford, CT 06102	University of Illinois at Chicago	Boston, MA 02 1 1 5-5724		
Adult	Hospital	Pediatric		Montefiore Medical Center
	1740 W Taylor Street			111 East 210th Street
Yale-New Haven Hospital	Chicago, IL 60612	Massachusetts General Hospital		Bronx, NY 10467
20 York Street	Adult	55 Fruit Street		Adult
New Haven, CT 06504		Boston, MA 02114		
Adult		Adult		Mount Sinai Hospital
	INDIANA			One Gustave L. Levy Place
				New York, NY 10029-6500
DISTRICT OF COLUMBIA	Indiana University Hospital	MICHIGAN		Adult and Pediatric
	550 North University Boulevard			
Childrens National Medical Center	Indiana olis, IN 46202-5270
P	The Regents of the University of		
New York Presbyterian Hospital
111 Michigan Ave, Northwest	Adult	Michigan		Columbia Presbyterian Campus
Washington, DC 20010-2970		1500 East Medical Center Drive		622 West 168th Street
Pediatric	Methodist Hospital	Ann Arbor, MI 48109		New York, NY 10032
	I-65 at 21st Street	Adult & Pediatric		Adult & Pediatric
Georgetown University Medical	Indianapolis, IN 46202			
Center	Adult			
Strong Memorial Hospital -
3800 Reservoir Road NW		MINNESOTA		University of Rochester
Washington, D.C. 20007
lt
Ad	Riley Children's Hospital	
University of Minnesota Medical		601 Elmwood Avenue
u	702 Barnhill Drive	
Center		Rochester, NY 14642

~tir-' Washin ton Hos ital Center
P	Indianapolis, IN 46202

P
di
i	
420 Delaware Street Southeast		Adult
9
110 Irving Street NW	atr
e
c	
Minneapolis, MN 55455		
The Presbyterian Hospital-Cornell
Washington, D.C. 20010		Adult & Pediatric		333 East 38th Street
Adult	KANSAS			New York, NY 10016
	
University of Kansas Hospital	
MISSOURI		Adult
DELAWARE	Authority
3901 Rainbow Boulevard	
Barnes-Jewish Hospital		Westchester Medical Center
duPont Hospital for Children	Kansas City, KS 66205	1 Barnes-Jewish Hospital Plaza		95 Grasslands Road
Valhalla
NY 10595
1600 Rockland Road	Adult	St. Louis, MO 63110
Ad
lt		,
Adult& Pediatric
P0. Box 269		u		
Wilmington, DE 19899				
Pediatric	KENTUCKY	Children's Mercy Hospital		
		2401 Gillham Road		NORTH CAROLINA
	Jewish Hospital	Kansas City, KS 64108-4619		
Carolinas Medical Center
FLORIDA	217 East Chestnut Street	Pediatric		1000 Blythe Boulevard

Shands Transplant Center at	Louisville, KY 40202
Adult	
St. Louis Children's Hospital		Charlotte, NC 28203

University of Florida		
1 Children's Place		Adult
1600 Southwest Archer Road		Si. Louis, MO 63110		
ersity Medical Center
n
D
P.O. Box 100251	LOUISIANA	Pediatric		reki Dr
T
e
Gainesville, FL 32610				Durham
NC 27710
Adult & Pediatric	Tulane University Hospital and Clinic			,
Adult
	1415 Tulane Avenue	NEBRASKA		
Tampa General Hospital	New Orleans, LA 70112			
2 Columbia Drive	Adult & Pediatric	Nebraska Medical Center		
Tampa, FL 33606		Emile at 42nd Street		OHIO
Adult		Omaha, NE 68198
Adult & Pediatric		
Cincinnati Children's Medical Center
	MAINE			3333 Burnet Avenue
GEORGIA	Maine Medical Center			Pediatricti, OH 45229
	22 Bramhall Street	NEW JERSEY		
Emory University Hospital
Northeast
1364 Clifton Road	Portland, ME 04102
Adult	
Newark Beth Israel Medical Center		
Cleveland Clinic Foundation
,
Atlanta
GA 30322		201 Lyons Avenue		Transplant Center A110
,
Adult		Newark, NJ 07112		9500 Euclid Avenue
		Adult		Cleveland, OH 44195
				Adult
11
Kidney
Ohio State University Hospitals
410 West Tenth Avenue
Columbus, OH 43210-1240
Adult
The Christ Hospital
2139 Auburn Avenue
Cincinnati, OH 45219
Adult
University Hospital of Cincinnati
234 Goodman Street
Cincinnati, OH 45219
Adult
University Hospitals of Cleveland
11100 Euclid Avenue
Cleveland, OH 44106
Adult & Pediatric
OREGON
Oregon Health & Science University
(including University Hospital &
Doernbecher Children's Hospital)
3181 Southwest Sam Jackson Park Road
Portland, OR 97239
Adult & Pediatric
PENNSYLVANIA
Albert Einstein Medical Center
5501 Old York Road
Philadelphia, PA 1 91 41-3000
Adult
Allegheny General Hospital
320 East North Avenue
Pittsburgh, PA 15212
Adult
Childrens Hospital of Philadelphia
(CHOP)
34th Street & Civic Center Boulevard
Philadelphia, PA 19104-4399
Pediatric
Childrens Hospital of Pittsburgh
3705 Fifth Avenue
Pittsburgh, PA 15213-2583
Pediatric
Hahnemann University Hospital
Broad and Vine Street
Philadelphia, PA 19102
Adult
Hospital of University of
Pennsylvania (HUP)
3400 Spruce Street
Philadelphia, PA 19104-4204
Adult
Milton S Hershey Medical Center
500 University Drive
Hershey, PA 17033
Adult
Pinnacle Health System at
Harrisburg Hospital
111 South Front Street
Harrisburg, PA 17101-2010
Adult
St. Christopher's Hospital For
Children
Erie Avenue at Front Street
Philadelphia, PA 19134
Pediatric
Thomas Jefferson University
Hospital
111 South 11th Street
Philadelphia, PA 19107-4824
Adult
TENNESSEE
Methodist University Hospital
1265 Union Avenue
Memphis, TN 38104
Adult
Vanderbilt University Hospital
1211 22nd Avenue South
Nashville, TN 37232
Adult
TEXAS
Baylor All Saints Medical Center
1400 Eighth Avenue
Fort Worth, TX 76104
Adult
Baylor University Medical Center
3500 Gaston Avenue
Dallas, TX 75246
Adult
St. Luke's Episcopal Hospital
Texas Medical Center
6720 Bertner Avenue
Houston, TX 77030
Adult
Texas Children's Hospital
6621 Fannin Street
Houston, TX 77030
Pediatric
Texas Transplant Institute
San Antonio, TX 78297
Adult
University Health System
4502 Medical Drive
San Antonio, TX 78229
Adult & Pediatric
University of Texas Medical Branch
at Galveston
301 University Boulevard
Galveston, TX 77555
Adult
VIRGINIA
Inova Fairfax
300 Gallows Road
Falls Church, VA 22042
Adult
Medical College of Virginia
401 North 12th Street, Suite 2-300
P.O. Box 980510
Richmond, Virginia 23298-0510
Adult
University of Virginia Medical
Center
Hospital Drive & Jefferson Park Avenue
Charlottesville, VA 22908
Adult
WASHINGTON
Swedish Medical Center
747 Broadway
Seattle, WA 98122
Adult
University of Washington Medical
Center
1959 Northeast Pacific Street
Seattle, WA 98195
Adult
Virginia Mason Medical Center
925 Seneca Street
Seattle, WA 98101
Adult
WISCONSIN
Froedtert Memorial Lutheran
Hospital
9200 West Wisconsin Avenue
Milwaukee, WI 53226
Adulr
LIVER
ARIZONA
City of Hope Samaritan Bone
Marrow Transplantation Program
1111 East McDowell Road
Phoenix, AZ 85006
Adult
CALIFORNIA
California Pacffic Medical Center
2333 Buchanan Street
San Francisco, CA 94115
Adult
Children's Hospital Los Angeles
4650 Sunset Boulevard
Los Angeles, CA 90027
Pediatric
Lucile Salter Packard Children's
Hospital at Stanford
725 Welch Road
Palo Alto, CA 94304
Pediatric
Stanford Hospital and Clinics
300 Pasteur Drive
Palo Alto, CA 94304
Adult
UCLA Medical Center
10833 Le Conte Avenue
Los Angeles, CA 90095
Adult & Pediatric
UCSD Medical Center
200 West Arbor Drive
San Diego, CA 92103
Adult
Institutes of Excellence
UCSF Medical Center
505 Parnassus Avenue
San Francisco, CA 94117
Adult & Pediatric
COLORADO
The University of Colorado Hospital
Authority
4200 East 9th Avenue
Denver, CO 80220
Adult
CONNECTICUT
Hartford Hospital
80 Seymour Street
Hartford, CT 06102
Adult
DELAWARE
duPont Hospital for Children
1600 Rockland Road
P.O. Box 269
Wilmington, DE 19899
Pediatric
DISTRICT OF COLUMBIA
Georgetown University Medical
Center
3800 Reservoir Road NW
Washington, D.C. 20007
Adult & Pediatric
FLORIDA
Shands Transplant Center at
University of Florida
1600 Southwest Archer Road
P.O. Box 100251
Gainesville, FL 32610
Adult & Pediatric
Tampa General Hospital
2 Columbia Drive
Tampa, FL 33606
Adult
GEORGIA
Emory University Hospital
1364 Clifton Road, Northeast
Atlanta, GA 30322
Adult
ILLINOIS
Children's Memorial Hospital
2300 Children's Plaza
Fullerton at Lincoln
Chicago, IL 60614
Pediatric
Northwestern Memorial Hospital
251 East Huron
Chicago, IL 60611
Adult
12
Institutes of Excellence			Liver
University of Chicago Hospital	Lahey Clinic Hospital	NORTH CAROLINA	Hospital of University of
5841 South Maryland	41 Mall Road		Pennsylvania (HUP)
Chicago, IL 60637	Burlington, MA 01805	Carolinas Medical Center	3400 Spruce Street
Adult	Adult	1000 Blythe Boulevard	Philadelphia, PA 19104-4204
		Charlotte, NC 28203	Adult
University of Illinois at Chicago		Adult	
Hos ital
1740 W Taylor Street	
MICHIGAN	
Duke University Medical Center	
TENNESSEE
Chicago, IL 60612	The Regents of the University of	Trent Drive	
Adult	Michigan	Durham, NC 27710	Methodist University Hospital
	1500 East Medical Center Drive	Adult	1265 Union Avenue
	Ann Arbor, MI 48109		Memphis, TN 38104
INDIANA	Adult	University of North Carolina	Adult
		Hospitals	
Indiana University Hospital		101 Manning Drive	Vanderbilt University Hospital
550 North University Boulevard	MINNESOTA	Chapel Hill, NC 27514	1211 22nd Avenue South
Indianapolis, IN 46202-5270		Adult	Nashville, TN 37232
Adult	University of Minnesota Medical		Adult
	Center		
James Whitcomb Riley Hospital	420 Delaware Street Southeast	OHIO	
702 Barnhill Drive	Minneapolis, MN 55455		TEXAS
Indianapolis, IN 46202	Adult	Cincinnati Children's Medical Center	
Pediatric		3333 Burnet Avenue	Baylor All Saints Medical Center
		Cincinnati, OH 45229	1400 Eighth Avenue
Methodist Hospital	MISSOURI	Pediatric	Fort Worth, TX 76104
I-65 at 21st Street			Adult
Indianapolis, IN 46202	Barnes-Jewish Hospital	Cleveland Clinic Foundation	
Adult	1Barnes-Jewish Hospital Plaza	Transplant Center A110	Baylor University Medical Center
	St. Louis, MO 63110	9500 Euclid Avenue	3500 Gaston Avenue
	Adult	Cleveland, OH 44195	Dallas, TX 75246
KANSAS	
'	Adult	Adulr
	St. Louis Children
s Hospital		
University of Kansas Hospital	1 Children's Place	Ohio State University Hospitals	St. Luke's Episcopal Hospital
Authority	St. Louis, MO 63110	410 West Tenth Avenue	Texas Medical Center
3901 Rainbow Boulevard	Pediatric	Columbus, OH 43210-1240	6720 Bertner Avenue
Kansas City, KS 66205		Adult	Houston, TX 77030
Adult			Adult
	NEBRASKA	University Hospkal of Cincinnati	
		234 Goodman Street	Texas Children's Hospital
~1rr~ KENTUCKY	Nebraska Medical Center	Cincinnati, OH 45219	6621 Fannin Street
	Emile at 42nd Street	Adult	Houston, TX 77030
Jewish Hospital	Omaha, NE 68198		Pediatric
217 East Chestnut Street	Adult & Pediatric		
Louisville, KY 40202		OKLAHOMA	The Methodist Hospital
Adult			6565 Fannin Street
	NEW JERSEY	INTEGRIS Baptist Medical Center	Houston, TX 77030
		3300 Northwest Expressway	Adult
LOUISIANA	University of Medicine and Dentistry	Oklahoma City, OK 73112	
	of NJ	Adult	
University Health System
Ochsner Foundation Hos ital
P	150 Bergen Street		4502 Medical Drive
1514 Jefferson Highway	D-17 University Heights		San Antonio, TX 78229
New Orleans, LA 70121	Newark, NJ 07103	
OREGON	
Adult & Pediatric
Adult	Adult		
		Oregon Health & Science University	
		(including University Hospital &
'	VIRGINIA
MARYLAND	NEW YORK	s Hospital)
Doernbecher Children	
		3181 Southwest Sam Jackson Park Road	Medical College of Virginia
Johns Hopkins Hospital	Mount Sinai Hospital	Portland, OR 97239	401 North 12th Street, Suite 2-300
600 North Wolfe Street	One Gustave L. Levy Place	Adult	P.O. Box 980510
Baltimore, MD 21287	New York, NY 10029-6500		
Richmond, Virginia 23298-0510
Adult & Pediatric	Adult and Pediatric		Adult

University of Maryland Medical	New York Presb Brian Hos ital
Yt P	PENNSYLVANIA	
University of Virginia Medical
System	Columbia Presbyterian Campus	Albert Einstein Medical Center	Center
22 South Greene Street	622 West 168th Street	5501 Old York Road	
Hospital Drive & Jefferson Park Avenue
Baltimore, MD 2 1 2 01-1 544	New York, NY 10032	Philadelphia, PA 19141-3000	Charlottesville, VA 22908
Adult	Adult & Pediatric	Adult	Adult
	New York University	Childrens Hospital of Philadelphia	
MASSACHUSETTS	403 East 34th Street	(CHOP)	WASHINGTON
	Third Floor	34th Street & Civic Center Boulevard	
Children's Hospital Medical Center	New York, NY 10016	Philadelphia, PA 19104-4399	University of Washington Medical
300 Longwood Avenue	Aduli & Pediatric	Pediatric	Center
Boston, MA 02115-5724			1959 Northeast Pacific Street
Pediatric	Strong Memorial Hospital -	Childrens Hospital of Pittsburgh	Seattle, WA 98195
	University of Rochester	3705 fifth Avenue	Adult
~rro	601 Elmwood Avenue	Pittsburgh, PA 15213-2583	
	Rochester, NY 14642	Pediatric	
	Adult		
13
Lung
LUNG
CALIFORNIA
Children's Hospital Los Angeles
4650 Sunset Boulevard
Los Angeles, CA 90027
Pediatric
Stanford Hospital and Clinic
300 Pasteur Drive
Palo Alto, CA 94304
Adult
UCLA Medical Center
10833 Le Conte Avenue
Los Angeles, CA 90095
Adult
UCSD Medical Center
200 West Arbor Drive
San Diego, CA 92103
Adult
UCSF Medical Center
505 Parnassus Avenue
San Francisco, CA 94117
Adult
COLORADO
The University of Colorado Hospital
Authority
4200 East 9th Avenue
Denver, CO 80220
Adult
FLORIDA
Shands Transplant Center at
University of Florida
1600 Southwest Archer Road
P.O. Box 100251
Gainesville, FL 32610
Adult
ILLINOIS
Loyola University Medical Center
2160 South First Avenue
Maywood, IL 60153
Adult
INDIANA
Methodist Hospital
I-65 at 21st Street
Indianapolis, IN 46202
Adult
MARYLAND
Johns Hopkins Hospital
600 North Wolfe Street
Baltimore, MD 21287
Adult
MASSACHUSETTS
Brigham and Women's Hospital
75 Francis Street
Boston, MA 02115
Adult
Children's Hospital
300 Longwood Avenue
Boston, MA 02115-5724
Pediatric
Massachusetts General Hospital
55 fruit Street
Boston, MA 02114
Adult
MICHIGAN
The Regents of the University of
Michigan
1500 East Medical Center Drive
Ann Arbor, MI 48109
Adult
MINNESOTA
University of Minnesota Medical
Center
420 Delaware Street Southeast
Minneapolis, MN 55455
Adult
MISSOURI
Barnes-Jewish Hospital
1 Barnes-Jewish Hospital Plaza
St. Louis, MO 631 10
Adult
St. Louis Children's Hospital
1 Children's Place
St. Louis, MO 63110
Pediatric
NEW YORK
New York Presbyterian Hospital
Columbia Presbyterian Campus
622 West 168th Street
New York, NY 10032
Adult
NORTH CAROLINA
Duke University Medical Center
Trent Drive
Durham, NC 27710
Adult
University of North Carolina
Hospitals
101 Manning Drive
Chapel Hill, NC 27514
Adult
OHIO
Cleveland Clinic Foundation
Transplant Center A110
9500 Euclid Avenue
Cleveland, OH 44195
Adult
PENNSYLVANIA
Childrens Hospital of Philadelphia
(CHOP)
34th Street & Civic Center Boulevard
Philadelphia, PA 19104-4399
Pediatric
Childrens Hospital of Pittsburgh
3705 Fifth Avenue
Pittsburgh, PA 15213-2583
Pediatric
Hospital of University of
Pennsylvania (HUP)
3400 Spruce Street
Philadelphia, PA 19104-4204
Adult
Temple University Hospital
Temple University Health System
3401 North Broad Street
Philadelphia, PA 19140
Adult
TEXAS
Baylor University Medical Center
3500 Gaston Avenue
Dallas, TX 75246
Adult
Texas Children's Hospital
6621 Fannin Street
Houston, TX 77030
Pediatric
The Methodist Hospital
6565 Fannin Street
Houston, TX 77030
Adult
VIRGINIA
(nova Fairfax
300 Gallows Road
Falls Church, VA 22042
Adult
University of Virginia Medical
Center
Hospital Drive & Jefferson Park Avenue
Charlottesville, VA 22908
Adult
WASHINGTON
University of Washington Medical
Center
1959 Northeast Pacific Street
Seattle, WA 98195
Adult
PANCREAS
ARIZONA
City of Hope Samaritan Bone
Marrow Transplantation Program
1111 East McDowell Road
Phoenix, AZ 85006
Adult
Institutes of Excellence
CALIFORNIA
California Pacific Medical Center
2333 Buchanan Street
San Francisco, CA 94115
Adult
Loma Linda University Medical
Center
11234 Anderson Street
Loma Linda, CA 92354
Adult
FLORIDA
Shands Transplant Center at
University of Florida
1600 Southwest Archer Road
P.O. Box 100251
Gainesville, FL 32610
Adult
Tampa General Hospital
2 Columbia Drive
Tampa, FL 33606
Adult
GEORGIA
Emory University Hospital
1364 Clifton Road, Northeast
Atlanta, GA 30322
Adult
ILLINOIS
Northwestern Memorial Hospital
251 East Huron
Chicago, IL 60611
Adult
University of Chicago Hospital
5841 South Maryland
Chicago, IL 60637
Adult
INDIANA
Indiana University Hospital
550 North University Boulevard
Indianapolis, IN 46202-5270
Adult
MARYLAND
University of Maryland Medical
System
22 South Greene Street
Baltimore, MD 2 1 201-1 544
Adult
MICHIGAN
The Regents of the University of
Michigan
1500 East Medical Center Drive
Ann Arbor, MI 48109
Adult
14
Institutes of Excellence
MINNESOTA
University of Minnesota Medical
Center
~Wllrr' 420 Delaware Street Southeast
Minneapolis, MN 55455
Adult
OHIO
Cleveland Clinic Foundation
Transplant Center A110
9500 Euclid Avenue
Cleveland, OH 44195
Adult
Ohio State University Hospitals
410 West Tenth Avenue
Columbus, OH 43210-1240
Adult
University Hospitals of Cleveland
11100 Euclid Avenue
Cleveland, OH 44106
Adult
PENNSYLVANIA
Childrens Hospital of Philadelphia
(CHOP)
34th Street & Civic Center Boulevard
Philadelphia, PA 19104-4399
Pediatric
Hospital of University of
Pennsylvania (HUP)
3400 Spruce Street
Philadelphia, PA 19104-4204
Adult
Thomas Jefferson University
Hospital
111 South 11th Street
Philadelphia, PA 19107-4824
Adult
TENNESSEE
Methodist University Hospital
1265 Union Avenue
Memphis, TN 38104
Adult
TEXAS
Baylor All Saints Medical Center
1400 Eighth Avenue
Fort Worth, TX 76104
Adult
Baylor University Medical Center
3500 Gaston Avenue
Dallas, TX 75246
Adult
Simultaneous Pancreas Kidney (includes Pancreas after Kidney)
SIMULTANEOUS
PANCREAS KIDNEY
ARIZONA
City of Hope Samaritan Bone
Marrow Transplantation Program
1111 East McDowell Road
Phoenix, AZ 85006
Adult
CALIFORNIA
California Pacific Medical Center
2333 Buchanan Street
San Francisco, CA 94115
Adult
UCLA Medical Center
10833 Le Conte Avenue
Los Angeles, CA 90095
Adult
ILLINOIS
Northwestern Memorial Hospital
251 East Huron
Chicago, IL 60611
Adult
University of Chicago Hospital
5841 South Maryland
Chicago, IL 60637
Adult
INDIANA
Indiana University Hospital
550 North University Boulevard
Indianapolis, IN 46202-5270
Adult
LOUISIANA
Tulane University Hospital and Clinic
1415 Tulane Avenue
New Orleans, LA 70112
Adult
NEW YORK
The Presbyterian Hospital-Cornell
333 East 38th Street
New York, NY 10016
Adult
NORTH CAROLINA
Duke University Medical Center
Trent Drive
Durham, NC 27710
Adult
PENNSYLVANIA
Childrens Hospital of Philadelphia
(CHOP)
34th Street & Civic Center Boulevard
Philadelphia, PA 1 9 1 04-43 99
Pediatric
TEXAS
Baylor All Saints Medical Center
1400 Eighth Avenue
Fort Worth, TX 76104
Adult
WASHINGTON
Swedish Medical Center
747 Broadway
Seattle, WA 98122
Adult
SIMULTANEOUS
PANCREAS KIDNEY
(INCLUDES PANCREAS
AFTER KIDNEY)
ARIZONA
City of Hope Samaritan Bone
Marrow Transplantation Program
1111 East McDowell Road
Phoenix, AZ 85006
Adult
CALIFORNIA
California Pacific Medical Center
2333 Buchanan Street
San Francisco, CA 94115
Adult
Loma Linda University Medical
Center
11234 Anderson Street
Loma Linda, CA 92354
Adult
UCSF Medical Center
505 Parnassus Avenue
San Francisco, CA 94117
Adult
FLORIDA
Shands Transplant Center at
University of Florida
1600 Southwest Archer Road
P.O. Box 100251
Gainesville, FL 32610
Adult
Tampa General Hospital
2 Columbia Drive
Tampa, FL 33606
Adult
GEORGIA
Emory University Hospital
1364 Clifton Road, Northeast
Atlanta, GA 30322
Adult
ILLINOIS
Northwestern Memorial Hospital
251 East Huron
Chicago, IL 60611
Adult
University of Chicago Hospital
5841 South Maryland
Chicago, IL 60637
Adult
INDIANA
Indiana University Hospital
550 North University Boulevard
Indianapolis, IN 46202-5270
Adult
MARYLAND
University of Maryland Medical
System
22 South Greene Street
Baltimore, MD 2 1 2 01-1 544
Adult
MICHIGAN
The Regents of the University of
Michigan
1500 East Medical Center Drive
Ann Arbor, MI 48109
Adult
MINNESOTA
University of Minnesota Medical
Center
420 Delaware Street Southeast
Minneapolis, MN 55455
Adult
NEW YORK
Mount Sinai Hospital
One Gustave L. Levy Place
New York, NY 10029-6500
Adult
OHIO
Cleveland Clinic foundation
Transplant Center A110
9500 Euclid Avenue
Cleveland, OH 44195
Adult
Ohio State University Hospitals
410 West Tenth Avenue
Columbus, OH 43210-1240
Adult
University Hospitals of Cleveland
11100 Euclid Avenue
Cleveland, OH 44106
Adult
15
Simultaneous Pancreas Kidney (includes Pancreas after Kidney) Institutes of Excellence
PENNSYLVANIA
Childrens Hospital of Philadelphia
(CHOP)
34th Street & Civic Center Boulevard
Philadelphia, PA 19104-4399
Pediatric
Hospital of University of
Pennsylvania (HUP)
3400 Spruce Street
Philadelphia, PA 1 91 04-42 04
Adult
Thomas Jefferson University
Hospital
111 South 11th Street
Philadelphia, PA 1 9 1 07-482 4
Adult
TENNESSEE
Methodist University Hospital
1265 Union Avenue
Memphis, TN 38104
Adult
TEXAS
Baylor All Saints Medical Center
1400 Eighth Avenue
Fort Worth, TX 76104
Adult
Baylor University Medical Center
3500 Gaston Avenue
Dallas, TX 75246
Adult
VIRGINIA
(nova Fairfax
300 Gallows Road
Falls Church, VA 22042
Adult
WASHINGTON
University of Washington Medical
Center
1959 Northeast Pacific Street
Seattle, WA 98195
Adult
WISCONSIN
Froedtert Memorial Lutheran
Hospital
9200 West Wisconsin Avenue
Milwaukee, WI 53226
Adult
16
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