AIR AMBULANCE TRANSPORT SERVICES AGREEMENT
This Air Ambulance Transport Services Agreement ("Agreement") is made and
entered into this 1st day of January, 1996, by and between ProFlight, Inc., a
corporation organized and existing under the laws of the State of Colorado
(hereinafter referred to as "ProFlight") and Aetna Health Management, Inc., a
corporation organized and existing under the laws of the State of Delaware
(hereinafter referred to as "AHM").
WHEREAS, AHM desires to engage ProFlight to provide certain air transport
services for individuals entitled to receive health care services through health
benefit plans administered or serviced by AHM; and
WHEREAS, ProFlight desires to provide such services on the following terms and
conditions.
NOW, THEREFORE, it is mutually agreed, as follows:
ARTICLE I -- DEFINITIONS
As used in this Agreement, each of the following terms (and the plural thereof,
when appropriate) shall have the meaning set forth herein.
A. "Air Transport Services" mean those Covered Services identified in
Attachment A related to the transportation of an individual requiring
transplant services or other health care services that are to be
provided at a distant facility.
B. "Affiliate" means a corporation or other legal entity related by common
ownership, management or control.
C. "Covered Services" means those health care services for which a Member
is entitled to benefits under the terms of a Health Benefit Program.
Services that are not Medically Necessary will not be deemed Covered
Services for purposes of this Agreement.
D. "Health Benefit Program" means a benefit program (i) specifying health
care services to be reimbursed, paid for or provided to individuals
lawfully participating in that benefits program; (ii) employing
financial incentives to utilize Participating Providers; and (iii)
issued, administered or serviced by AHM or an Affiliate.
E. "Member" means an individual covered by or enrolled in a Health Benefit
Program.
F. "Participating" means credentialed by AHM or its designee consistent
with AHM's credentialing policies, as applicable, and designated as
Participating by AHM. When used in conjunction with, for example,
"Physician," "Ancillary Provider," "Facility," "Provider" or "Facility,"
Participating means the named party or parties credentialed by AHM and
under contract with AHM, directly or indirectly, to provide Covered
Services to Members.
G. "Payor" means an employer, labor union, insurer, health maintenance
organization ("HMO") or other person or entity which has agreed to be
responsible for funding benefit payments, or otherwise paying, for
Covered Services provided to Members under the terms of a Health Benefit
Program.
ARTICLE II -- OBLIGATIONS AND RESPONSIBILITIES OF PROFLIGHT
ProFlight, being fully accredited and licensed in all phases of air medical
transport services with the credentials listed in Attachment A, is an
independent contractor of AHM. As such, its obligations and responsibilities
include, but are not limited to, the following:
A. ProFlight will provide Air Transport Services requested and approved in
accordance with Section N of this Article II on a twenty-four (24) hour
per day, seven (7) days per week basis as required for Members who need
to be transported in connection with the provision of transplant
services and/or other health care services.
B. ProFlight certifies that it is, and it shall remain, in full compliance
with the applicable provisions of Part 91 and Part 135 of the Federal
Aviation Regulations, and will comply with any subsequent changes and
amendments to such regulations. Any and all pilots and aircraft
personnel shall be properly licensed and certified in accordance with
applicable law and industry standards.
C. ProFlight will provide properly directed and staffed air medical
personnel according to the nature and extent of health care needs
anticipated and the scope of services offered. Such personnel may
include, but shall not be limited to, board certified emergency room
physicians, critical care registered professional nurses, medical
technicians, paramedics, respiratory therapists, and perfusion
therapists.
ProFlight shall require that each physician have and maintain valid,
unrestricted, unencumbered licenses to practice in the state in which
such physician provides services to Members hereunder. ProFlight shall
also require that each physician satisfy the following criteria: (a)
current, unrestricted DEA certificate (or other state narcotics
registration or certificate); (b) absence of a history of any adverse
action, including but not limited to restriction, suspensions, fines,
exclusion or debarment, related to the physician's participation in the
Medicaid or Medicare programs; (c) absence of a history of professional
liability claims or evidence that such history does not demonstrate
probable future substandard professional performance; (d) absence of
professional disciplinary action or evidence that such history does not
demonstrate probable future substandard professional performance or
business practices; (e) absence of current mental or physical impairment
or condition (including substance abuse) that would adversely affect the
physician's ability to competently and safely perform the essential
functions of a physician in the same area of practice; (f) absence of a
history of criminal investigation, indictment or conviction or evidence
that such history does not demonstrate probable future substandard
professional performance; (g) absence of any information that
demonstrates that the physician has engaged in conduct unbecoming to a
professional; and (h) absence of a history of denial or cancellation of
professional liability insurance or evidence that such history does not
demonstrate probable future substandard performance or business
practices. ProFlight shall report to AHM within five (5) days any
information which it learns about a physician with regard to the
foregoing criteria.
ProFlight shall require that all non-physician providers under contract
with ProFlight and all ancillary personnel employed by ProFlight are and
shall remain licensed, registered or certified and supervised (when and
as required by state law), and qualified by training and experience to
perform their professional duties. ProFlight shall further require that
all licensed or certified non-physician providers and ancillary
personnel are and will be acting within the scope of their licensure,
registration or certification, as the case may be.
D. ProFlight will ensure that all training and experience requirements will
be commensurate to the critical care, advanced life support, specialty
care, and basic life support airborne environment.
E. ProFlight agrees to coordinate the transfer of Members from the point of
origin to their final destination. Further, ProFlight will provide
continuity and stable transition of care between the site from which
such Member is transferred and the receiving facility designated by AHM.
F. ProFlight will ensure that the quality and appropriateness of medical
care provided by ProFlight medical personnel (including any and all such
personnel providing services to Members on behalf of ProFlight, pursuant
to a contract between such personnel and ProFlight) will be continuously
reviewed and evaluated through the establishment of written quality
assurance policy procedures, a copy of which will be provided to AHM.
G. ProFlight will provide management information reports to AHM on a
regularly scheduled basis. Format and frequency of said management
reports will be determined by mutual agreement between ProFlight and
AHM, provided that, at a minimum, such reports shall list the number of
flights during the period, and for each flight, shall provide specific
information regarding dates of service. destination, number of air
miles, and flight time, patient name, patient diagnosis, staffing, and
all costs incurred by ProFlight and included in the compensation to
ProFlight pursuant to Article IV. These reports shall be provided at no
additional cost to AHM or the applicable Payor.
H. Medical and administrative personnel from ProFlight will be reasonably
available for consultation during normal business hours. Such hours
shall be between 9:00 a.m. and 5:00 p.m., Monday through Friday of each
week except holidays.
I. ProFlight will provide itemized invoices to AHM in such format and with
such frequency mutually determined by ProFlight and AHM.
J. ProFlight will provide emergency service twenty-four (24) hours a day,
seven (7) days a week, 365 days a year.
K. ProFlight shall maintain at all times during the term of this Agreement
the following insurance:
(i) Worker's Compensation in minimum amounts required by statute and
Employer's Liability limits of $500,000;
(ii) comprehensive and general liability insurance in the minimum
amounts of $1 million dollars per occurrence and $2 million dollars in
the annual aggregate, with AHM listed as an additional insured with
respect to the provision of Air Transport Services pursuant to this
Agreement;
(iii) medical professional liability insurance in the minimum amounts of
$1 million per occurrence and $3 million in the annual aggregate,
including medical professional liability insurance for ProFlight
employed and/or contracted health care providers in the minimum amounts
of $1 million per occurrence and $3 million in the annual aggregate,
with AHM listed as an additional insured with respect to the provision
of Air Transport Services pursuant to this Agreement; and
(iv) aircraft insurance insuring against any claim, loss, liability or
damage in minimum amounts of $20 million, with AHM listed as an
additional insured with respect to the services provided pursuant to
this Agreement.
ProFlight shall require each and every land transport company or
supplier with which it contracts to provide land transportation services
to Members hereunder to maintain automobile insurance applicable to any
land transportation services provided pursuant to this Agreement in
minimum amounts of $1 million per accident and $2 million in the annual
aggregate.
ProFlight shall deliver to AHM evidence of such coverages in force.
Notice shall be provided to AHM within one business day of ProFlight's
notice of (i) cancellation, nonrenewal or suspension of any of the
aforementioned insurance coverages, or (ii) reduction in the coverage
limits below the minimum levels set forth in this Section.
L. ProFlight agrees to abide by the utilization management and quality
management programs applicable to each Member's Health Benefit Program.
M. ProFlight agrees that it shall provide Air Transport Services to Members
pursuant to this Agreement only after obtaining authorization from the
appropriate UM case manager in accordance with the particular Member's
Health Benefit Program. Notwithstanding the previous sentence, in the
event of an emergency, if ProFlight is unable to obtain such
preauthorization due to the unavailability of the appropriate case
manager (despite ProFlight's best efforts to contact such individual),
ProFlight may provide Air Transport Services to a Member upon the
request of a Participating Physician, and AHM shall instruct the
applicable Payor to pay ProFlight for such services in accordance with
Article IV, provided that such services are determined to be medically
necessary pursuant to such Member's Health Benefit Program.
ARTICLE III - GENERAL PROVISIONS
A. Nothing contained in this Agreement shall be construed to require
ProFlight's medical director or appointed staff to perform any
procedure, course treatment, or transport which staff deems
professionally unacceptable.
B. Neither party shall subcontract nor otherwise delegate its rights,
obligations, or duties under this Agreement except as otherwise provided
herein, without the express written consent of the other.
C. ProFlight shall maintain or cause to be maintained adequate medical
records relating to the provision of services to Members. ProFlight and
AHM agree that all Member medical records shall be treated as
confidential so as to comply with all state and federal laws regarding
the confidentiality of patient records. AHM shall have the right to
inspect, at all reasonable times, any accounting and administrative
records maintained by ProFlight pertaining to AHM or Members. However,
ProFlight shall not be required to disclose the medical records of any
Member without his or her written consent, to other than Participating
Providers, AHM or to the applicable Payor.
D. ProFlight warrants that it is in compliance with all applicable federal,
state, and local laws relating to the provision of Air Transport
Services and that ProFlight shall cause all its employees and other
contracted personnel or entities to perform their duties in accordance
with all applicable federal, state, and local standards of professional
ethics and practice as may be applicable.
E. Agreement, together with any supplements, addenda, amendments,
modifications, or attachments, comprises the complete modifications, or
attachments, comprises the complete agreement. Neither of the parties
has made any representations nor warranties other than those set forth
in this Agreement and such attachments, supplements, addenda, amendments
or modifications, if any.
F. In the event that any portion of this Agreement is found to be void or
illegal, the validity or enforceability of any other portion shall not
be affected.
G. The waiver by either party of a breach or violation of any provision of
this Agreement shall not operate as or be construed to be a waiver of
any subsequent breach thereof. To be effective, waivers must be in
writing and signed.
H. The headings of the various Articles of this Agreement are inserted
merely for the purpose of convenience and do not, expressly or by
implication, limit or define or extend the specific terms of the
Articles so designated.
I. All the rights and remedies hereunder will be cumulative and not
alternative, and this Agreement shall be construed and governed by the
laws of the State of Connecticut.
J. This Agreement may be executed in any number of counterparts which, when
read together, shall constitute one instrument.
K. ProFlight acknowledges that the terms of this Agreement (including
without limitation reimbursement rates), membership lists, lists of
sponsors of Health Benefit Programs, and the utilization management
programs and other policies and procedures of AHM and its Affiliates
constitute confidential and proprietary information, the unauthorized
use or disclosure of which would cause irreparable harm to AHM and/or
its Affiliates. ProFlight shall maintain such information in confidence
and shall not disclose such information to any person, except as may be
required by law, without the written consent of AHM. The obligations of
this Section L shall survive the termination of this Agreement
regardless of the cause of termination.
L. ProFlight agrees to indemnify, defend and hold AHM, Payors and Members,
and their respective officers, directors, employees, Affiliates and
successors and assigns harmless from any loss, claim, damage, cost or
expense, including but not limited to reasonable attorneys' fees and
costs, that AHM, Payors, Members, or their respective officers,
directors, employees, Affiliates and successors and assigns may incur
arising out of or related to ProFlight's performance under this
Memorandum.
ARTICLE IV - COMPENSATION
ProFlight's compensation shall be subject to the following conditions:
A. AHM shall instruct Payors to remit payment for Air Transport Services,
provided such services are requested and are authorized in accordance
with Article II, Section N of this Agreement, within thirty (30) days of
receipt of an undisputed claim. Billing by ProFlight for Air Transport
Services shall be in accordance with the fee schedule listed in
Attachment A.
ProFlight agrees to xxxx the applicable Payor within thirty (30) days of
its provision of Air Transport Services on behalf of a Member. Any Air
Transport Services not billed to Payors within ninety (90) days from the
date of service shall require approval by AHM to be eligible for
reimbursement.
B. Payment by Payors to ProFlight for Air Transport Services shall be
deemed full compensation for all of the services that are provided or
arranged by ProFlight relating to such services, including all
equipment, supplies, personnel, aircraft and non-aircraft transport
vehicles and services, and all other costs incurred by ProFlight
relating to the provision of such services, except that ProFlight shall
xxxx and collect from Members any applicable copayments, coinsurance or
deductibles.
C. ProFlight agrees to look solely to Payors for compensation of Air
Transport Services rendered to Members and, with the exception of any
copayments, coinsurance or deductibles required under the Member's
Health Benefit Program, ProFlight shall not assert any claim for
compensation against Members in the event of non-payment by Payors or as
a result of any breach of this Agreement.
The above provision shall not prohibit ProFlight from providing to
Members services that are not Covered Services provided that, prior to
the provision of Air Transport Services: (1) ProFlight informs such
Member, in writing, that the services are not covered under the terms of
such member's Health Benefit Program; and (2) such Member agrees in
writing to assume the full responsibility for payment for such services.
D. ProFlight agrees that it will provide AHM with the necessary billing
information required to pursue coordination of benefits with other
health care plans or any other permitted method of third party recovery.
ProFlight further agrees that, where duplicate coverage exists and the
Health Benefit Program appears to be the secondary coverage, ProFlight
shall so notify AHM.
If ProFlight has collected a copayment, deductibles or coinsurance from
a Member, where duplicate coverage exists and ProFlight is subsequently
reimbursed for the service by another health care plan, ProFlight shall
refund or credit to the Member the portion, if any, of the copayment,
deductible or coinsurance which represents an overpayment to ProFlight.
ARTICLE V - TERM AND TERMINATIONS
Subject to the conditions set forth in this Article V, the term of this
Agreement shall be for a period of twelve (12) months, commencing on
[1/9/96]; provided, however, this Agreement may be unilaterally terminated
sooner, without cause, by either party, by giving ninety (90) days written
notice to the other party. In addition, this Agreement may be terminated
immediately by AHM, upon delivery of notice to ProFlight, if (i) AHM determines,
in its sole discretion, that the health, safety or welfare of Members is
jeopardized by the continuation of this Agreement, or (ii) AHM determines that
ProFlight has failed to satisfy any of its obligations hereunder.
The parties agree that, in the event of a termination of this Agreement, the
obligations of ProFlight and AHM shall continue in full force and effect with
respect to services already identified and agreed to for the transportation of
Members hereunder.
ARTICLE VI - CHANGES IN THIS AGREEMENT
This Agreement, including any attachments, supplements, addenda, amendments or
modifications, may only be changed by a written document executed by both
parties.
ARTICLE VII - NOTICES
Any notices required to be given pursuant to the terms and provisions of this
Agreement shall be in writing and shall be sent by certified mail, return
receipt requested, prepaid to:
ProFlight: 00000 Xxxx Xxxxxxx Xxxxx Xxxx
Xxxxxxxxx,XX 00000
Attn: Xxxx Xxxxx
AHM: 000 Xxxxxxxxxx Xxxxxx
Xxxxxxxx, XX 00000
Either party may, at any time, designate any other address in place of those
given above by written notice to the other party.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
PROFLIGHT, INC. AETNA HEALTH MANAGEMENT, INC.
By: Xxxxx X. Xxxxxxxxx By: A. Xxxxx Xxxxxxxx
Printed Name: Xxxxx X Xxxxxxxxx Printed Name: X.X. Xxxxxxxx
Title: President Title: SVP
Date: 1/9/96 Date: 12/23/95
ATTACHMENT A
COMPENSATION
1. The applicable Payor shall reimburse ProFlight for all Air Transport Services
provided to Members pursuant to this Attachment A. For purposes of the Agreement
and this Attachment A, "Air Transport Services" shall mean any and all necessary
services and supplies relating to the transfer of a member from point of origin
to final destination, including, without limitation, all equipment, supplies,
medical and other personnel, aircraft and ground transport vehicles and
services.
2. Reimbursement Rate
Subject to the terms of this Agreement and the applicable Health Benefit
Program, ProFlight shall accept reimbursement for Air Transport Services
provided to Members ("Reimbursement Rate") in accordance with the following:
Aircraft Pass Seats Cruise Speed Rate/Hour
---------------------------------------------------------------------------
Xxxx Jet 24(Normal Config.) 5 500 MPH $1175.00**
Xxxx Jet 24(Ambulance Config.) 2 500 MPH $1250.00*
Catering ....................................................... At Cost
Nurse and Supplies (Per 24 Hour Period) ........................ $800.00
Respiratory Therapist or 2nd Nurse (Per 24 Hour Period,......... $250.00
not including airline transportation)
Medical Doctor (Per 24 Hour Period, not including............... $850.00
airline transportation)
Ground Ambulance ............................................... At Cost
International Handling ......................................... At Cost
All other services not listed separately above shall be provided at no
additional cost.
--------
* Where applicable, an additional amount in respect of federal excise taxes
shall be added based on the then existing federal rate.
In calculating the Reimbursement Rate, AHM and ProFlight agree as follows:
(a) The Reimbursement Rate that is derived for services provided
hereunder on behalf of a particular Member (based on the above-listed schedule
of rates) shall constitute the Reimbursement Rate for all services provided or
arranged by ProFlight in connection with the transportation of such Member to
the specified destination.
(b) The hourly rate indicated above for the use of an aircraft shall be
based on the following principles:
(i) the length of time to be used to measure the number of "hours" of
use of the aircraft (the "Aircraft Use Time") shall be equal to
the sum of (A) the actual flight time for the flight from the
Member's departure airport (the "designated departure airport")
to the destination airport and (B) the length of time, if any,
applicable to transporting the aircraft to the designated
departure airport, as determined in accordance with clause (ii)
below.
(ii) In the event that the aircraft is located at an airport other
than the designated departure airport at the time the use of such
aircraft is required hereunder, the Aircraft Use Time shall
include the lesser of (A) the actual flight time to the
designated departure airport, or (B) twice the actual flight time
from the designated departure airport to the designated
destination airport. Notwithstanding the foregoing, the Aircraft
Use Time shall not include any flight time relating to the
transportation of the aircraft to the designated departure
airport if ProFlight is charging any other person or payor for
such flight time to the designated departure airport, whether
because such aircraft is being used to provide Air Transport
Services hereunder or otherwise.
(iii) Aircraft Use Time shall be rounded to the nearest tenth of an
hour and the portion of the Reimbursement Rate relating to the
use of the aircraft shall be equal to the specified hourly rate
multiplied by the Aircraft Use Time, as rounded to the nearest
tenth of an hour.
(iv) The Aircraft Use Time shall end at the time the aircraft lands at
the designated destination airport; Aircraft Use Time shall not
include any flight time associated with a return of the aircraft
to the airport from which it departed.
(c) The rate indicated above relating to the personnel provided hereunder
by ProFlight shall be based on the following principles:
(i) The applicable rates indicated for nurses, respiratory therapists
and physicians are fixed rates per twenty-four (24) hour period;
in the event that any single transport of a Member exceeds
twenty-four (24) hours or consecutive transports of Members
involving the same personnel exceed twenty-four (24) hours, the
aggregate time period shall be measured (to the nearest hour) and
the fee shall be prorated for the number of hours in excess of
twenty-four (24) hours.
(ii) In measuring the number of hours of service of such personnel,
the flight time involved in flying such personnel to the
designated departure airport shall be included, along with the
flight time with the Member to the destination airport.
(iii) As part of the Reimbursement Rate, an amount shall be added for
the cost of transporting Additional Medical Personnel (as defined
herein) back to their point of origin on a commercial flight,
provided that ProFlight's aircraft is not to return to such point
of origin within a reasonable amount of time. The parties agree
that the cost of any such commercial flight shall not exceed the
cost of the lowest reasonably available airfare to such point of
origin. For purposes hereof, "Additional Medical Personnel" shall
mean any second nurse, and/or any respiratory therapist or
physician who is/are required to accompany the Member and the
standard flight crew (which standard flight crew shall include a
nurse) due to the medical needs of the Member.
(d) The Reimbursement Rate shall be deemed to include the cost of all drugs,
pharmaceutical services and other supplies, and no additional amounts shall be
added to the Reimbursement Rate in respect thereof.
(e) With respect to the Ground Ambulance or other ground transportation (for
which the payor shall reimburse ProFlight at its cost), ProFlight's "cost" shall
be the lesser of (i) ProFlight's actual cost or (ii) the reasonable and
customary fee for such services in the geographic region. In addition, ProFlight
agrees to use AHM's preferred provider of such services, if AHM has contracted
with such a provider and that provider is available; in such event, such AHM
preferred provider shall be compensated pursuant to the arrangement between AHM
and such provider, and the Reimbursement Rate hereunder shall not include any
amounts relating to such services.
3. Reimbursement from Members
ProFlight shall xxxx and collect from Members any copayments,
coinsurance or deductibles applicable under such Members' Health Benefit
Program.
4. Compensation to ProFlight
The compensation per claim payable by the applicable Payor to
ProFlight, subject to the terms of this Agreement and the applicable
Health Benefit Program, shall be equal to the Reimbursement Rate minus
any applicable copayments, coinsurance or deductibles.
AMENDMENT TO THE AIR AMBULANCE
TRANSPORT SERVICES AGREEMENT
This amendment ("Amendment") to the Air Ambulance Transport Services Agreement
by and between ProFlight, Inc. ("ProFlight") and Aetna Health Management, Inc.
("AHM") dated January 1, 1996 (hereinafter referred to as the "Agreement") is
made and entered into to be effective on January 1, 1996.
WHEREAS, AHM and ProFlight have entered into the Agreement so that ProFlight may
provide Air Transport Services to Members;
WHEREAS, the parties desire to amend the Agreement so that ProFlight may
participate in the indemnity product administered by Aetna Life Insurance
Company, of which AHM is a subsidiary ("Traditional Choice Product");
WHEREAS, ProFlight desires to provide such services on the following terms and
conditions;
NOW, THEREFORE, in consideration of the mutual covenants in this Amendment, the
parties agree as follows:
1. For purposes of this Amendment, Article II shall be amended to include the
following term which shall apply in addition to the terms contained in the
Agreement as to ProFlight's participation in the Traditional Choice Product and
its provision of services to Members.
"N. ProFlight shall obtain from all Members to whom Air Transport
Services are provided by ProFlight signed assignment of benefits
authorizing payment for Air Transport Services to be made directly to
ProFlight."
2. For purposes of ProFlight's participation in the Traditional Choice Product
only, the following terms shall apply:
A. Article I, section D of the Agreement is hereby revised and amended
to read as follows:
"D. Health Benefit Indemnity Program means a benefit program (i)
specifying health care services to be reimbursed, paid for or provided
to individuals lawfully participating in such benefit program; and (ii)
issued, administered or serviced by Aetna Life Insurance Company."
B. The first paragraph of Article IV, section C of the Agreement is
hereby revised and amended to read as follows:
"C. In the event that ProFlight fails to obtain assignment of
benefits from Member, or if Payor fails to pay ProFlight for Air
Transport Services rendered to Member, ProFlight may xxxx such Member
for such Air Transport Services rendered to Member, in addition to any
copayments, coinsurance or deductibles required under the Member's
Health Benefit Indemnity Program."
C. Article IV of the Agreement is hereby amended to include the
following provision:
"E. ProFlight shall accept compensation in accordance with the
Agreement, the Health Benefit Indemnity Program and Attachment A of the
Agreement as payment in full for Air Transport Services."
3. All other terms of the Agreement not amended herein remain in full force and
effect. If the terms of this Amendment conflicts with any term of the Agreement,
the terms of thi~ Amendment shall prevail.
IN WITNESS WHEREOF, the parties have caused this Amendment to be executed below.
PROFLIGHT, INC. AETNA HEALTH MANAGEMENT, INC.
By: /s/ Xxxxx X. Xxxxxxxxx By: /s/ A. Xxxxx Xxxxxxxx
_____________________________ ________________________________
Printed Name: Xxxxx X. Xxxxxxxxx Printed Name: X.X. Xxxxxxxx
___________________ ______________________
Title: President Title: SVP
__________________________ _____________________________
Date: 2/6/96 Date: 2/9/96
___________________________ ______________________________
AETNA LIFE INSURANCE COMPANY
By: /s/ A. Xxxxx Xxxxxxxx
_____________________________
Printed Name: X.X. Xxxxxxxx
___________________
Title: SVP
__________________________
Date: 2/9/96
___________________________
