Aetna Savings Plus plan guide
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1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Savings Plus plan guide New health plans designed with Florida businesses in mind For businesses with eligible employees FL (4/12)
2 Aetna Savings Plus plans The Aetna Savings Plus health benefits plans are helping Florida businesses access health services that fit their needs and their budgets. They give members access to an affordable network of health providers right in their own community. These lower-priced plans generate savings through a concentric network of high-quality providers. They are ideal for businesses that think affordable health coverage for their employees is out of reach. Building on a history of innovation These plans are built around fair value, freedom and flexibility, so that businesses get what matters most to them: solutions that offer personal service at a fair price, in a way that allows them to focus their time and efforts on running their business. Not only is Aetna Savings Plus the solution, but it includes these benefits: Benefits for doctor visits, hospital stays, preventive care and prescription drugs Secure member portal, Aetna Navigator Payment Estimator, to help members understand costs before receiving services Online health assessment and programs to help members manage their health Programs that treat individuals, not conditions, to help members achieve better health 2
3 Aetna makes it easier to save Same quality local care at a lower cost The Aetna Savings Plus health benefits plans provide Florida members with the same type of coverage as other Aetna medical plans, but at a lower premium cost. Savings are generated through the use of the Savings Plus network, a quality network of local health care providers. How do the Savings Plus insurance plans work? The Aetna Savings Plus insurance plans in Florida give businesses the flexibility and choice to best meet their needs. These plans use the Aetna HMO Savings Plus network. Let Aetna be your guide With 150 years of experience, we can deliver the right solution for your business. It is a community-based network that is made up of local providers who understand community diversity, preferences and common medical conditions. When members use the Savings Plus network, they realize maximum savings. Members can select a primary care physician (PCP) from the network of preferred participating providers to coordinate care for covered services. All Savings Plus plans include coverage for doctor s office visits, hospital stays, preventive care, pharmacy and more. (Refer to the benefits summaries on pages 3 and 4 for more details.) Each plan offers three levels of benefits to your employees. Premiums and out-of-pocket expense levels vary select the plan that s right for you and your employees. A smarter network strategy designed to... Reduce health care costs for employers and create savings opportunities for employees through a designated network of quality, cost-effective doctors and hospitals, plus provide employee access to online tools and services through a secure member website Fair Value Flexibility Freedom Everyone wants a good deal. Whether you re looking to cut costs as much as possible, or seeking long-term value and greater employee productivity. Choice matters. Every business is different. And the people who make up those businesses have different health needs. Time spent investing with a health plan, should be time well spent. Whether you re managing the business, or an employee on the front line, we try to make it easier with intelligent solutions. Network design = savings Performance network 100% preventive care Unlimited lifetime maximums Range of options Multiple benefits levels Use of physician or hospital Online enrollment and billing Easy to navigate Personal Health Record Member Payment Estimator 3
4 Savings Plus plans Florida (2-100 Eligible Employees) FL HMO Savings Plus Plan 2 FL HMO Savings Plus Plan 3 Lifetime Maximum Unlimited Unlimited In-Network Services Coinsurance 70% 50% Annual Deductible: Individual/Family $2,000 / $4,000 $3,000 / $6,000 Type of Deductible Embedded Embedded Annual Out of Pocket (OOP): Individual/Family (deductible included) $7,000 / $14,000 $9,000 / $18,000 Wellness On Us TM Well-Child Care (Age/frequency schedules apply; includes coverage for immunizations) Preventive Care, including annual adult physicals, well-women visits, mammograms, colorectal cancer screening and other preventive care services. $0, ded waived $0, ded waived $0, ded waived $0, ded waived Physician Services Primary Care Physician Office Visit $30, ded waived $50, ded waived Specialist Office Visit $60, ded waived $100, ded waived Walk-In Clinic Visit $30, ded waived $50, ded waived Outpatient Mental Health (20 visits per year - Mental Health Parity applies to groups over 50) $60, ded waived $100, ded waived Inpatient Services Hospital Inpatient 70%, ded applies 50%, ded applies Mental Health Inpatient (30 days per year Mental Health Parity applies to groups over 50) 70%, ded applies 50%, ded applies Outpatient/Other Services Diagnostic Lab $0, ded waived $0, ded waived Diagnostic X-Ray $60, ded waived 50%, ded waived Diagnostic Complex Imaging (CAT, MRI, MRA/MRS and PET scans) 70%, ded applies 50%, ded applies Outpatient Surgery 70%, ded applies 50%, ded applies Emergency Room (copay waived if admitted) 70%, ded waived 70%, ded waived Urgent Care $75, ded waived $125, ded waived Ambulance (emergency transport) Durable Medical Equipment ($2,000 maximum per year) Outpatient Rehabilitative Therapy (30 visits per year) 70%, ded applies 50%, ded applies 70%, ded applies 50%, ded applies $60, ded waived 50%, ded applies Pharmacy Retail Pharmacy Copay Step therapy and precertification apply; mail-order drugs (MODs) available at 2x copay for a day supply $20/ $50/ $75 $20/ $50/ $75 Aetna Specialty Pharmacy RM (after first refill, must use Aetna Specialty Pharmacy) 30% Min/Max. copay $30/$120 30% Min/Max. copay $30/$120 4
5 Savings Plus plans Florida (2-100 Eligible Employees) FL HMO Savings Plus Plan 10 Lifetime Maximum Unlimited In-Network Services Coinsurance 0% Annual Deductible: Individual/Family $10,000 / $10,000 Type of Deductible Annual Out of Pocket (OOP): Individual/Family (deductible included) Embedded (1x) $10,000 / $10,000 Wellness On Us Well-Child Care (Age/frequency schedules apply; includes coverage for immunizations) Preventive Care, including annual adult physicals, well-women visits, mammograms, colorectal cancer screening and other preventive care services. $0, ded waived $0, ded waived Physician Services Primary Care Physician Office Visit Specialist Office Visit Walk-In Clinic Visit Outpatient Mental Health (20 visits per year - Mental Health Parity applies to groups over 50) $50, ded waived $100, ded waived $50, ded waived $100, ded waived Inpatient Services Hospital Inpatient Mental Health Inpatient (30 days per year Mental Health Parity applies to groups over 50) Outpatient/Other Services Diagnostic Lab Diagnostic X-Ray Diagnostic Complex Imaging (CAT, MRI, MRA/MRS and PET scans) Outpatient Surgery Emergency Room (copay waived if admitted) Urgent Care Ambulance (emergency transport) Durable Medical Equipment ($2,000 maximum per year) Outpatient Rehabilitative Therapy (30 visits per year) Pharmacy Retail Pharmacy Copay Step therapy and precertification apply; mail-order drugs (MODs) available at 2x copay for a day supply $20/ $50/ $75 Aetna Specialty Pharmacy (after first refill, must use Aetna Specialty Pharmacy) 30% Min/Max. copay $30/$120 5
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8 Health benefits plans are offered or underwritten by Aetna Health Inc. (Aetna). This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Rates and benefits vary by location. Health benefits plans contain exclusions and limitations. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna s Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. If you are in a plan that requires the selection of a primary care physician and your primary care physician is part of an integrated delivery system or physician group, your primary care physician will generally refer you to specialists and hospitals that are affiliated with the delivery system or physicians group. Information is believed to be accurate as of the production date; however it is subject to change. For more information about Aetna plans, refer to Aetna Inc FL (4/12)
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What Your Plan Covers and How Benefits are Paid BENEFIT PLAN. Prepared Exclusively for SAMPLE. Open Access Aetna Select
BENEFIT PLAN Prepared Exclusively for SAMPLE What Your Plan Covers and How Benefits are Paid Open Access Aetna Select Table of Contents Schedule of Benefits... 1 Preface...20 Coverage for You and Your
Pennsylvania 2 100 Plan guide
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Pennsylvania 2 100 Plan guide The health of business, well planned. Plans effective August 1, 2012 For businesses
IL Small Group PPO Aetna Life Insurance Company Plan Effective Date: 04/01/2009 PLAN DESIGN AND BENEFITS- PPO HSA HDHP $2,500 100/80 (04/09)
PLAN FEATURES OUT-OF- Deductible (per calendar ) $2,500 Individual $5,000 Individual $5,000 Family $10,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable.
Land of Lincoln Health : Family Health Network LLH 3-Tier Bronze PPO Coverage Period: 01/01/2016 12/31/2016
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.landoflincolnhealth.org or by calling 1-844-FHN-4YOU.
PLAN DESIGN AND BENEFITS AETNA LIFE INSURANCE COMPANY - Insured
PLAN FEATURES Deductible (per calendar year) Individual $750 Individual $1,500 Family $2,250 Family $4,500 All covered expenses accumulate simultaneously toward both the preferred and non-preferred Deductible.
BlueCross 750.0, a Multi-State Plan STD
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at https://www.capbluecross.com/sbcsia or by calling 1-800-730-7219.
The Deductible is applicable to all covered services except for flat dollar Copayment services.
PRIORITY HEALTH www.priorityhealth.com/mpsers PRIORITYHMO SM PLUS PLAN MICHIGAN PUBLIC SCHOOL EMPLOYEES RETIREMENT SYSTEM (MPSERS) Effective January 1, 2016 through December 31, 2016 The HMO Plus plan
Your Plan: Value HMO 25/40/20% (RX $10/$30/$45/30%) Your Network: Select Plus HMO
Your Plan: Value HMO 25/40/20% (RX $10/$30/$45/30%) Your Network: Select Plus HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary
$0. See the chart starting on page 2 for your costs for services this plan covers.
San Francisco Electrical Workers Custom HMO Coverage Period: 08/01/2015-07/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family Plan Type: HMO
Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthnet.com/cvscaremark or by calling 1-888-893-1598
20% 40% Individual Family
PLAN FEATURES NON-* Deductible (per calendar year) $2,500 Individual $3,000 Individual $5,000 Family $6,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable.
: Coverage Period: 01/01/2016-12/31/2016
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthreformplansbc.com or by calling 1-844-241-0208.
CARING FOR NEW YORK S SMALL BUSINESSES Off-Exchange 2016 Plans and Services for Downstate Groups With Up to 100 Employees
CARING FOR NEW YORK S SMALL BUSINESSES Off-Exchange 2016 Plans and Services for Downstate Groups With Up to 100 Employees SMALL GROUP PLANS AT A GLANCE With the needs and budgets of small businesses in