2013 and Rates-At-a-Glance. For Regular U.S. Employees. Please scroll down for 2014 information
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1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions and Benefits and Rates-At-a-Glance For Regular U.S. Employees Please scroll down for information
2 Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) Life Insurance Business Accident Travel Insurance Short Term Disability (STD) COMPANY-PAID BENEFITS Long Term Disability (LTD) Paid Time Off (PTO) & Holidays Wellness Works Medical Plans HRA 8 Plus HRA 8 HRA 8 Out-of-Network HSA 8 Plus HSA 8 Indemnity HSA 8 Dental Plans Dental Maintenance Organization (DMO ) Dental PPO Vision Benefits Aetna Vision Preferred SM Flexible Spending Accounts Health Care Dependent Care Aetna Commuter Benefit Parking Mass Transit Wellness & Incentive Programs Healthy Lifestyles incentive program Medical Plan premium credits Wellness Reimbursement Program OPTIONAL BENEFITS Life Insurance Employee Supplemental Term Life Insurance Adoption Assistance Program In general, US employees employed by Aetna or a participating company are eligible to participate in these benefit plans. Spouse/Partner Supplemental Term Life Insurance Child Term Life Insurance Accidental Death & Personal Loss (AD&PL) Insurance Employee Accidental Death & Personal Loss Insurance Spouse/Partner Accidental Death & Personal Loss Insurance Employee & Child(ren) Accidental Death & Personal Loss Insurance Employee, Spouse/Partner & Child(ren) Accidental Death & Personal Loss Insurance Optional Long-Term Disability Insurance % Taxable Benefit Financial Benefits (k) Plan Employee Stock Purchase Plan Employee Tuition Assistance Plan Financial Education Programs Aetna Voluntary Benefit Plans Voluntary Hospital Plan Critical Illness Plan Accident Insurance Plan
3 Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) COMPANY PAID BENEFITS Life Insurance x eligible pay or $5, (if eligible pay is more than $5,); plan minimum is $, Business Travel Accident Insurance An amount equal to the greater of $5, or x eligible pay to a maximum of $,, Short Term Disability (STD) One week waiting period Up to weeks of pay at 8% of base pay; and then up to weeks of pay at 6% of base pay, if short-term disability benefits continue to be approved Long Term Disability (LTD) 5% of eligible pay (taxable benefit), up to a monthly maximum benefit of $5, Paid Time Off (PTO) & Holidays PTO: 8 to 8 days based on length of service (prorated if less than full-time) Holidays: 8 company paid holidays Wellness Works Employee Work/Life Assistance Program Offers a wide range of support services such as confidential counselling services, resources for elder care, child care, legal and financial matters, web-based information and more Employee Assistance Program (EAP) Up to 5 confidential counseling sessions for each household member Simple Steps to A Healthier Life Take a Health Assessment and on-line healthy living classes Healthy Lifestyle Coaching/ Quit Tobacco Program Get one-on-one attention from a trained wellness coach to reach your health goals. If you re a tobacco user, Aetna s Tobacco Cessation Program is designed to help you quit the habit when you re ready Mind Body Stress Reduction Program On-site and online stress reduction program Employee Discount Program There are a number of discounts that are available to you as an Aetna employee
4 Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) OPTIONAL BENEFITS (shared cost or employee paid) Medical Plans % coverage for preventive care in-network for all Aetna medical plans % coverage for in-network, preventive eye exam every calendar year Aetna Performance Network offered and/or Aexcel in certain locations Employer Contribution* Deductible** Coinsurance HSA 8 Plus Individual: $/Family: $8 Individual: $,6/Family: $, 8% (in-network) HSA 8 Individual: $/Family: $8 Individual: $,8/Family: $,6 8% (in-network) Indemnity HSA 8 Individual: $/Family: $8 Individual: $,8/Family: $,8 8% Employer Contribution* Deductible Coinsurance HRA 8 Plus Individual: $/Family: $8 Individual: $,6/Family: $, 8% (in-network) HRA 8 Individual: $/Family: $8 Individual: $,8/Family: $,6 8% (in-network) HRA 8 Out-of-Network Individual: $/Family: $8 Individual: $ 9/Family: $,8 8% * The employer contribution to the HRA Fund or HSA is prorated for mid-year entry into a plan ** The full family deductible must be met for the HSA plan of benefits to apply; there is no individual limit within the family deductible Dental Plans Deductible Coinsurance Dental Maintenance Organization (DMO ) Network of Dentists Must elect primary care dentist No annual limit No deductible Preventive % Basic 9% Restorative 6% Orthodontics 75% (no lifetime maximum) In-Network Deductible In-Network Coinsurance Dental PPO In-network and out-of-network coverage Annual Dental benefit max $, Lifetime Ortho maximum $, ($,5 out-of-network) Individual Family $ 5/year $5/year Preventive % Basic 8% Restorative 6% Orthodontics 6% (5% out-of-network) Vision Plan SM Coverage for frames, lenses and contact lenses Aetna Vision Preferred Discounts on LASIK and additional pairs of glasses As available in various areas Available only if located outside a network area Out-of-network benefits will be lower
5 Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) OPTIONAL BENEFITS (continued) Flexible Spending Accounts Annual Minimum Annual Maximum Health Care $ $,5 Dependent Care $ $5, Aetna Commuter Benefits Monthly Minimum Monthly Maximum Transit $ $5 Parking $ $ Life Insurance Employee Supplemental Term Life Insurance 5 x to 5x eligible pay, up to maximum benefit of $,, Spouse/Partner Life Insurance 5 $, to $, in $, increments Child(ren) Term Life $5,; $, or $5, Accidental Death & Personal Loss (AD&PL) Employee x to 5x eligible pay to a maximum of $,, Dependent Spouse/ Partner: 5% of employee s optional AD&PL Spouse/ Partner and Child(ren): % of employee s optional AD&PL for spouse/partner and 5% for each child Child(ren) only: 5% of employee s optional AD&PL for each child 5 Optional Long-Term Disability Optional Long-Term disability Some restrictions apply Additional % of eligible pay (taxable benefit) Up to a monthly benefit maximum of $5,
6 OPTIONAL BENEFITS (continued) Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) Wealth Accumulation Aetna (k) Plan 6 Aetna Affiliate (k) Plan 7 Employee Stock Purchase Plan Employee Tuition Assistance Financial Education Programs Regular full-time and part-time employees and individuals employed by Aetna as temporary employees are eligible to participate Immediate eligibility for employee contributions Company matching contributions Discount off fair market value $5, toward degree programs $,5 toward non-degree college course Must be full time ( hours) for $5, cap, otherwise $,5 cap applies Onsite workshops and live webinars No cost for one-on-one financial planning with certified financial planners from Financial Finesse Full suite of tools and resources on the Financial Wellness Works website Aetna Voluntary Benefit Plans (available through Aetna Benefits Advisor Marketplace) Voluntary Hospital Plan Critical Illness Insurance Plan Accident Insurance Plan Provides financial protection from out-of-pocket expenses associated with a medically necessary hospital admission The plan pays cash benefits directly to the participant to help pay for out-of-pocket medical expenses incurred during the hospital stay, including deductibles, day care costs, mortgage payments and other living expenses Benefit premiums are automatic there are no claims forms to submit if you are enrolled in an Aetna medical plan Premiums are paid % by the employee through payroll deduction Pays cash benefits when the member or covered family member is diagnosed with a serious illness (such as heart attack, stroke or cancer) The plan helps pay out-of-pocket expenses associated with treatment and costs of living (such as rent, mortgage or day care costs) Benefits are paid directly to the participant in addition to any other medical coverage Premiums are paid % by the employee through payroll deduction Assists in covering out-of-pocket expenses associated with an accidental injury (such as dislocations, fractures and burns) The plan can also help protect your savings should an on- or off-the-job accidental injury occur Benefits are paid directly to the participant in addition to any other medical coverage Premiums are paid % by the employee through payroll deduction 6 In general, U.S. employees employed by Aetna or a participating company are eligible to participate in the Aetna (k) Plan. Meritain Health, Inc., ScripWorld, LLC and American Health Holding, Inc. (Prodigy) is not a participating company. 7 Employees of Prodigy companies are eligible to participate in the Aetna Affiliate (k) Plan.
7 Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) OPTIONAL BENEFITS (continued) Wellness & Incentive Programs Healthy Lifestyles incentive program Medical Plan premium credits Wellness Reimbursement Program Earn up to $5 for employee and an additional $5 for family members All benefits-eligible employees may participate, regardless of medical plan coverage Incentives provided for: Tracking physical activity and healthy eating habits Making progress in certain disease management programs (members only) Completing activities on the Member Health Engagement Plan (members only) Completing a financial assessment and participating in a financial education class or financial planning session offered through Aetna s financial wellness program. Medical plan premium credits are available to employees and their covered spouse/partner who are in an Aetna employee medical plan Credits available for: Being in range for at least of 5 metabolic syndrome risk factors; and Being a non-tobacco user Up to $ reimbursement for certain wellness expenses such as: gym memberships, exercise classes, fitness equipment, etc. Adoption Assistance Program Maximum $5, reimbursement for adoption expenses Available to all benefits-eligible employees
8 Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) Medical Plan Premium Credits Aetna currently offers two programs that you and your spouse/partner if he/she is covered under your Aetna medical plan can participate in that may allow you to earn premium credits on your medical plan contributions. One premium credit can be earned for each of the following: You have not used tobacco products in the past months and you complete the online attestation when you enroll in medical benefits Your spouse/partner has not used tobacco products in the past months and you complete the online attestation when you enroll in medical benefits You participate in the voluntary metabolic syndrome testing for all five risk factors and your results show that you are in-range for at least three of the five risk factors Your spouse/partner participates in the voluntary metabolic syndrome testing for all five risk factors and the results show that they are in-range for at least three of the five risk factors Each premium credit earned is equal to $.5 on a semi-monthly basis. You can earn up to two premium credits, and your spouse/partner if he/she is covered under your Aetna medical plan can earn up to an additional two premium credits. For more information on medical plan premium credits, refer to AccessHR. MEDICAL PLANS Medical Plans HSA 8 Plus HSA 8 HRA 8 Plus HRA 8 Indemnity HSA 8 HRA 8 Out-of- Network Premium Credits Earned Employee $5. $.5 $. $5. $.5 $. $.5 $7.75 $5.5 $.5 $9.75 $7.5 $5. $.5 $. $8.5 $5.65 $.5 Annual Salary of less than $, Child(ren) $7.7 $5. $.7 $6. $.9 $. $6.5 $8.65 $6.5 $8.7 $6. $.7 $6. $.9 $. $. $.5 $ 8. Semi-Monthly Employee Contributions Medical Plans Spouse/Partner $75. $6.9 $5. $7.9 $5. $7.86 $6.6 $7.86 $5.6 $.86 $7.5 $ 9.55 $ 8.5 $ $ 57.5 $9.5 $77.65 $65.5 $5.65 $.5 $9.9 $8. $67.9 $55. $.9 $8.85 $7.5 $57.85 $5.5 $.85 Family $88. $75.6 $6. $5.6 $8. $8.9 $7.79 $59.9 $6.79 $.9 $7.9 $5. $.9 $ 9. $ 77.9 $6.6 $ 9. $ 8.6 $ 69. $ 56.6 $. $.8 $ 89. $ 76.8 $ 6. $ $ 85.5 $ 7.75 $ 6.5 $ 7.75 Employee $5. $.5 $. $5. $.5 $. $5.5 $.95 $.5 $7.5 $.95 $.5 $5. $.5 $. $.65 $.5 $ 8.65 Annual Salary equal to $, and less than $5, Child(ren) $7.7 $5. $.7 $6. $.9 $. $68.95 $56.5 $.95 $56.5 $. $.5 $6. $.9 $. $5.5 $8.75 $6.5 Spouse/Partner $75. $6.9 $5. $7.9 $5. $7.86 $6.6 $7.86 $5.6 $.86 $7. $.9 $ 9. $ 79.9 $ 67. $.55 $ 88.5 $ $ 6.5 $ 5.55 $9.9 $8. $67.9 $55. $.9 $9.85 $8.5 $68.85 $56.5 $.85 Family $88. $75.6 $6. $5.6 $8. $8.9 $7.79 $59.9 $6.79 $.9 $.9 $8. $5.9 $. $ 9.9 $9.6 $7. $ 9.6 $ 8. $ 69.9 $. $.8 $ 89. $ 76.8 $ 6. $.5 $ 99. $ 86.5 $ 7. $ 6.5 Employee $5.86 $.6 $.86 $.6 $8. $5.6 $56.55 $.5 $.55 $8.55 $6.5 $.55 $5.7 $9. $6.7 $5. $.9 $. Annual Salary equal to $5, and less than $6, Child(ren) $69.75 $57.5 $.75 $58.56 $6.6 $.56 $85.6 $7. $6.6 $7.5 $6.65 $8,5 $87.96 $75.6 $6.96 $68.85 $56.5 $.85 Spouse/Partner $8. $5.6 $ 9. $ 8.6 $ 68. $.7 $ $ 76.7 $ 6.57 $ 5.7 $9.65 $7.5 $.65 $.5 $ $.75 $.5 $ $ 85.5 $ 7.75 $9.5 $6.75 $.5 $.75 $ 99.5 $7.5 $.85 $ 9.5 $ $ 67.5 Employee + Family $.5 $9. $6.5 $. $ 9.5 $8.6 $6. $ 9.6 $ 8. $ 68.6 $68.65 $56.5 $.65 $.5 $8.65 $7.5 $.85 $.5 $9.85 $ 97.5 $8.75 $7.5 $59.75 $7.5 $.75 $.9 $8. $5.9 $. $ 9.9
9 Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) Medical Plans (continued) Medical Plan HSA 8 Plus HSA 8 HRA 8 Plus HRA 8 Indemnity HSA 8 HRA 8 Out-of-Network Premium Credits Earned Employee $5.95 $8.5 $5.95 $.6 $.96 $9.6 $6.5 $8.65 $6.5 $5.5 $.65 $8.5 $59.6 $6.86 $.6 $5.5 $7.75 $5.5 Annual Salary equal to $6, and less than $9, Child(ren) $76.65 $6.5 $5.65 $6.7 $5. $8.7 $9.5 $8. $67.5 $8.5 $67.55 $55.5 $99. $86.9 $7. $76.5 $6.65 $5.5 Semi-Monthly Employee Contributions Medical Plans Spouse/Partner $7. $.8 $. $ 89.8 $ 77. $7.97 $ 95.7 $ 8.97 $ 7.7 $ $8.8 $6. $.8 $. $ 98.8 $.95 $9.5 $6.95 $ 9.5 $ 8.95 $6.55 $5.5 $9.55 $7.5 $.55 $7.5 $.55 $.5 $ $ 77.5 Family $5. $.5 $8. $5.5 $. $7.5 $.75 $.5 $ $ 77.5 $8.5 $67.65 $55.5 $.65 $.5 $58.85 $6.5 $.85 $.5 $8.85 $.9 $9.89 $79.9 $66.89 $5.9 $5. $.5 $8. $5.5 $. Employee $69. $56.7 $. $58.6 $5.66 $.6 $8.5 $69.55 $57.5 $7.5 $6.55 $9.5 $8.6 $69. $56.6 $7.5 $59.85 $7.5 Annual Salary equal to or more than $9, and less than $5, Child(ren) $7.95 $95.5 $8.95 $87. $7.7 $6. $.85 $.5 $ $. $ 98.9 $ 86. $.8 $.88 $8.8 $9. $ 96.8 $ 8. Spouse/Partner $69. $56.6 $. $.6 $9. $9. $6.8 $. $.8 $ 89. $9.6 $78. $65.6 $5. $.6 $7.75 $6.5 $8.75 $6.5 $.75 $. $97.6 $85. $7.6 $6. $7. $58.8 $6. $.8 $. Family $5. $9.7 $8. $67.7 $55. $66. $5.9 $. $8.9 $6. $. $9.9 $7. $9.9 $8. $. $98.6 $86. $7.6 $6. $6.79 $9.9 $6.79 $.9 $.79 $8.5 $95.75 $8.5 $7.75 $58.5 Employee $97.95 $85.5 $7.95 $79.7 $67. $5.7 $8.5 $ $ 8.5 $.5 $87.65 $75.5 $.6 $. $ 97.6 $ $ 87.5 $ 7.95 Annual Salary equal to or more than $5, Child(ren) $7. $.6 $. $6.57 $.7 $ 9.57 $6. $5.5 $8. $5.55 $8.5 $5.55 $9.86 $8.6 $69.86 $5.7 $8. $5.7 Spouse/Partner $. $8.8 $96. $8.8 $7. $78.7 $65.97 $5.7 $.97 $8.7 $.85 $.5 $7.85 $5.5 $9.85 $5.95 $.5 $.95 $88.5 $75.95 $9. $79.6 $67. $5.6 $. $6.5 $.95 $.5 $88.95 $76.5 Employee + Family $7.5 $57.95 $5.5 $.95 $.5 $5. $.8 $9. $77.8 $65. $97.65 $85.5 $7.65 $6.5 $7.65 $76.5 $6.85 $5.5 $8.85 $6.5 $6.5 $5.85 $9.5 $6.85 $.5 $77.5 $6.75 $5.5 $9.75 $7.5
10 Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) DENTAL PLANS Semi-Monthly Employee Contributions Dental Plans Dental Plans Coverage Options Employee Employee & Child(ren) Employee & Spouse/Partner Employee & Family Dental Maintenance Organization (DMO) $6.75 $.5 $. $7.8 Dental PPO $5.5 $.5 $.5 $9.5 Dental Plan of ND and SC $5.5 $.5 $.5 $9.5 VISION PLAN Semi-Monthly Employee Contributions Vision Plan Vision Plan Coverage Options Employee Employee & Child(ren) Employee & Spouse/Partner Employee & Family Aetna Vision Preferred SM $.8 $.6 $.5 $5.5
11 LIFE INSURANCE, AD&PL and LONG-TERM DISABILITY Aetna Benefits and Rates-at-a-Glance for Regular Employees (working hours or more per week) Employee Supplemental Term Life Insurance Spouse/Partner Supplemental Term Life Insurance Options Monthly Employee Rates (per $, of coverage)* x to 5x Age eligible pay < Tobacco $.6 $.6 $.8 $.9 $.6 $.7 $.8 $.599 $.98 $.7 $.88 Non-tobacco $. $.8 $.6 $.7 $.8 $.5 $.7 $.87 $.59 $.8 $.85 *Monthly cost = Eligible Pay Rounded to the next $, X Multiple of Eligible Pay (,,, or 5) = / $, = X Monthly Employee Rate above Options Monthly Employee Rates (per $, of coverage) $, to Age $,** < Tobacco $.7 $.7 $.9 $. $.7 $.9 $.9 $.78 $. $. $.97 Non-tobacco $.5 $.6 $.8 $.9 $. $. $. $.5 $.85 $.5 $.76 **increments of $, only Options Monthly Employee Rate Child Term Life Insurance $5, $.5 $, $.8 $5, $.6 Accidental Death and Personal Loss (AD&PL) Insurance Options x to 5x eligible pay ($,, maximum) Monthly Employee Rate (per $, of coverage) Employee $.6 Employee and Spouse/ Partner $. Employee and Child(ren) $. Employee, Spouse/ Partner and Child(ren) $. Additional Options Monthly Employee Rates *** Long-Term Disability (LTD) Insurance Age % taxable < benefit $.6 $.7 $. $.8 $.7 $.6 $. $.8 $. $.6 *** Monthly cost = Eligible pay = = x Monthly Employee Rate above
12 Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) Paid Time Off (PTO) & Holidays Life Insurance Business Travel Accident Insurance Short-Term Disability (STD) COMPANY-PAID BENEFITS Long-Term Disability (LTD) Adoption Assistance Program Employee Work/Life Assistance Program Employee Assistance Program OPTIONAL BENEFITS Medical Plans Open Access Select HSA 8 HealthFund HSA 8 HealthFund HRA 8 Whole Health HSA 8 (Houston, TX & Phoenix, AZ) HealthFund HRA 8 Out-of-Network Dental Plans Dental Maintenance Organization (DMO ) Dental PPO Dental Plan of ND and SC Vision Benefits Aetna Vision Preferred SM Flexible Spending Accounts Health Care Dependent Care Aetna Commuter Benefit Parking Mass Transit Life Insurance Employee Supplemental Term Life Insurance Spouse/Partner Supplemental Term Life Insurance Child Term Life Insurance Accidental Death & Personal Loss (AD&PL) Insurance Employee Accidental Death & Personal Loss Insurance Spouse/Partner Accidental Death & Personal Loss Insurance Employee & Child(ren) Accidental Death & Personal Loss Insurance Employee, Spouse/Partner & Child(ren) Accidental Death & Personal Loss Insurance Optional Long-Term Disability Insurance % Taxable Benefit Financial Benefits (k) Plan Employee Stock Purchase Plan Employee Tuition Assistance Program Financial Education Programs Aetna Voluntary Benefit Plan Voluntary Hospital Plan Critical Illness Plan Accident Insurance Plan Identity Theft Protection Legal Plan Wellness & Incentive Programs Healthy Lifestyles Incentive Program Medical Plan Premium Credits Wellness Reimbursement Program Financial Wellness Program Welvie Surgical Review Incentive Employee Discount Program In general, U.S. employees employed by Aetna or a participating company are eligible to participate in these benefit plans.
13 Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) COMPANY PAID BENEFITS Paid Time Off (PTO) & Holidays PTO: 8 to 8 days based on length of service (prorated if less than full-time) Holidays: 8 company paid holidays Life Insurance x eligible pay. If eligible pay is over $5,, employees can elect to cap life insurance at $5,. Plan minimum is $,. Business Travel Accident Insurance An amount equal to the greater of $5, or x eligible pay to a maximum of $,, Short-Term Disability (STD) For new hires, benefit becomes effective on the st day of the month following 6-day waiting period One week waiting period before STD benefits are payable Up to weeks of pay at 8% of base pay; and then up to weeks of pay at 6% of base pay, if short-term disability benefits continue to be approved Long-Term Disability (LTD) For new hires, benefit becomes effective on the st day of the month following 6-day waiting period 6-week waiting period before LTD benefits are payable 5% of eligible pay (taxable benefit), up to a monthly maximum benefit of $5, Adoption Assistance Program Maximum $5, reimbursement for adoption expenses Available to all benefits-eligible employees Employee Work/Life Assistance Program Offers a wide range of support services such as confidential counselling services, resources for elder care, child care, legal and financial matters, web-based information and more Employee Assistance Program Up to 5 confidential counseling sessions for each household member
14 OPTIONAL BENEFITS (shared cost or employee paid) Medical Plans Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) % coverage for in-network preventive care and an in-network, preventive eye exam every calendar year for all medical plans Telephone consults available /7 through the Teladoc network Aetna Performance Network and Aexcel offered in certain locations Aetna Whole Health HSA plans (Accountable Care Organizations) offered in Houston, TX and Phoenix, AZ only Employer Contribution* Deductible** Coinsurance Open Access Select HSA 8 Individual: $/Family: $8 Individual: $,/Family: $,6 8% (in-network) HealthFund HSA 8 Individual: $/Family: $8 Individual: $,6/Family: $, 8% (in-network) HealthFund HRA 8 Individual: $/Family: $8 Individual: $,6/Family: $, 8% (in-network) Whole Health HSA 8 (Houston, TX & Phoenix, AZ) Individual: $/Family: $8 Individual: $,/Family: $,6 8% (in-network) HRA 8 Out-of-Network Individual: $/Family: $8 Individual: $,/Family: $,6 8% *The employer contribution to the HRA Fund or HSA is prorated for mid-year entry into a plan **The full family deductible must be met for the HSA plan of benefits to apply; there is no individual limit within the family deductible As available in various areas Available only if located outside a network area Out-of-network benefits will be lower Dental Plans Deductible Coinsurance Dental Maintenance Network of dentists No deductible Preventive % Organization (DMO ) Must elect primary care dentist Basic 9% No annual limit Restorative 6% Orthodontics 75% (no lifetime maximum) In-Network Out-of-Network In-Network Out-of Network Deductible Deductible Coinsurance Coinsurance Dental PPO In-network and out-of-network coverage Individual $5/yr Individual $/yr Preventive % Preventive % Annual dental benefit maximum $, Family $5/yr Family $/yr Basic 8% Basic 6% Lifetime orthodontic maximum $, Restorative 6% Restorative 5% ($,5 out-of-network) Orthodontics 6% Orthodontics 5% Dental Plan of ND and SC In-network and out-of-network coverage Individual $5/yr Individual $5/yr Preventive % Preventive % Annual dental benefit maximum $, Family $5/yr Family $5/yr Basic 8% Basic 8% Lifetime orthodontic maximum $, Restorative 6% Restorative 6% Orthodontics 6% Orthodontics 6% As available in various areas Out-of-network benefits will be lower
15 Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) OPTIONAL BENEFITS (continued) Vision Plan Aetna Vision Preferred SM Coverage for frames, lenses and contact lenses Discounts on LASIK and additional pairs of glasses Flexible Spending Accounts Annual Minimum Annual Maximum Health Care $ $,5 Dependent Care $ $5, Aetna Commuter Benefits Monthly Minimum Monthly Maximum Transit $ $5 Parking $ $5 Life Insurance Employee Supplemental Term Life Insurance 5 x to 6x eligible pay, up to maximum benefit of $,, Spouse/Partner Life Insurance 5 $, to $, in $, increments, $5,, $5, Child(ren) Term Life $,, $5, or $, 5 Some restrictions apply Accidental Death & Personal Loss (AD&PL) Employee x to 6x eligible pay to a maximum of $,, Dependent Spouse/Partner: 5% of employee s optional AD&PL Spouse/Partner and Child(ren): % of employee s optional AD&PL for spouse/partner and 5% for each child Child(ren) only: 5% of employee s optional AD&PL for each child Optional Long-Term Disability Optional Long-Term Disability For new hires, benefit becomes effective on the st day of the month following 6-day waiting period Additional % of eligible pay (taxable benefit) Up to a monthly benefit maximum of $5,
16 OPTIONAL BENEFITS (continued) Financial Benefits Aetna (k) Plan 6 Aetna Affiliate (k) Plan 7 Employee Stock Purchase Plan Employee Tuition Assistance Financial Education Programs Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) Regular full-time and part-time employees and individuals employed by Aetna as temporary employees are eligible to participate Immediate eligibility for employee contributions Company matching contributions Discount off fair market value $5, toward degree programs $,5 toward non-degree college course Must be full time ( hours) for $5, cap, otherwise $,5 cap applies Onsite workshops and live webinars No cost for one-on-one consultations with a retirement specialist or a certified financial planner Full suite of tools and resources on the Financial Wellness Works website 6 In general, U.S. employees employed by Aetna or a participating company are eligible to participate in the Aetna (k) Plan. Meritain Health, Inc., ScripWorld, LLC and American Health Holding, Inc. (Prodigy) are not participating companies. 7 Employees of Prodigy companies are eligible to participate in the Aetna Affiliate (k) Plan. Aetna Voluntary Benefit Plans (available through Aetna Benefits Advisor Marketplace) Voluntary Hospital Plan Critical Illness Insurance Plan Accident Insurance Plan Identity Theft Protection Provides financial protection from out-of-pocket expenses associated with a medically necessary hospital admission The plan pays cash benefits directly to the participant to help pay for out-of-pocket medical expenses incurred during the hospital stay, including deductibles, day care costs, mortgage payments and other living expenses Benefit premiums are automatic there are no claims forms to submit if you are enrolled in an Aetna medical plan Premiums are paid % by the employee through payroll deduction Pays cash benefits when the member or covered family member is diagnosed with a serious illness (such as heart attack, stroke or cancer) The plan helps pay out-of-pocket expenses associated with treatment and costs of living (such as rent, mortgage or day care costs) Benefits are paid directly to the participant in addition to any other medical coverage Premiums are paid % by the employee through payroll deduction Assists in covering out-of-pocket expenses associated with an accidental injury (such as dislocations, fractures and burns) The plan can also help protect your savings should an on- or off-the-job accidental injury occur Benefits are paid directly to the participant in addition to any other medical coverage Premiums are paid % by the employee through payroll deduction Two levels of protection for personal information. Identity Theft Protection proactively safeguards personal information and send alerts of potential threats.. Ultimate most comprehensive identity theft protection service and includes monitoring of new and existing checking and savings accounts. Premiums are paid % by the employee through payroll deduction
17 Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) OPTIONAL BENEFITS (continued) Legal Plan (available through Hyatt) Legal Plan Provides a wide range of legal advice and fully covered legal services for employee and eligible dependents. The plan has a national network of over, attorneys. If a network attorney is used, covered legal services are provided with no additional attorney fees. If a non-plan attorney is used, the plan will pay fees as determined by the plan s fee schedule. Locate plan attorneys and legal information on Hyatt Legal Plan s website on info.legalplans.com and enter the password 697 under the heading Thinking about Enrolling, or call Premiums are paid % by the employee through payroll deduction Wellness & Incentive Programs Healthy Lifestyles Incentive Program Medical Plan Premium Credits Wellness Reimbursement Program Financial Wellness Program Welvie Incentive Employee Discount Program Earn up to $5 for employee and an additional $5 for family members Incentives are paid based on medical plan selection: If you have an HRA plan, incentives are paid into the HealthFund If you have an HSA plan, you will elect if you want your incentives paid into your HSA account or paycheck (taxes apply) during annual enrollment (default is HSA) If you have waived medical coverage, you will receive your incentives in your paycheck (taxes apply) All benefits-eligible employees may participate, regardless of medical plan coverage Incentives provided for: Tracking physical activity, healthy eating habits and other activities related to well-being Completing three sessions with a Healthy Lifestyle Coach Completing a financial assessment and participating in a financial education class or financial planning session offered through Aetna s financial wellness program Medical plan premium credits are available to employees and their covered spouse/partner who are in an Aetna employee medical plan Up to $6 in credits available for each covered employee and spouse/partner for: Being in range for at least of 5 metabolic syndrome risk factors, or, if not in range, completing an alternative wellness program in (newly hired employees only need to participate in testing); and Being a non-tobacco user Up to $ reimbursement for certain wellness expenses such as: gym memberships, exercise classes, fitness equipment, pedometers/devices, etc. A financial wellness website full of information and tips on maintaining good financial health A tool that helps you decide if you need elective surgery Provides guidance on how to talk to your doctor about and possible alternatives to consider before actually electing surgery Earn a $5 incentive if you use the tool and complete a survey, whether or not you choose to elect surgery There are a number of discounts that are available to you as an Aetna employee
18 Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) Medical Plan Premium Credits Aetna currently offers two programs that you and your spouse/partner if he/she is covered under your Aetna medical plan can participate in that may allow you to earn premium credits on your medical plan contributions. Premium credits can be earned for each of the following: You and/or your spouse/partner have not used tobacco products in the past months and you complete the online attestation You and/or your spouse/partner participate in the voluntary metabolic syndrome testing for all five risk factors and your results show that you are in range for at least three of the five risk factors (Newly hired/eligible employees and their spouse/partner only need to participate in the voluntary metabolic syndrome testing program to receive credit for their first year in the medical plan) Each premium credit earned is equal to $.5 on a semi-monthly basis. You can earn up to two premium credits, and your spouse/partner if he/she is covered under your Aetna medical plan can earn up to an additional two premium credits. For more information on medical plan premium credits, refer to AccessHR. MEDICAL PLAN RATES Semi-Monthly Employee Contributions Medical Plans Annual Salary of less than $5, Annual Salary equal to $5, and less than $6, Medical Plans Premium Employee Credits Child(ren) Spouse/Partner Family Employee Child(ren) Spouse/Partner Family Earned Select HSA $.6 $68.7 $7.8 $.9 $57.75 $88. $. $7.75 $. $56. $5. $9. $5.5 $75.9 $.6 $6.5 $9.6 $.7 $9.8 $6.9 $.75 $6. $9. $9.75 $8. $. $6.6 $7.5 $67.8 $9.9 $9. $.75 HSA 8 $5. $8.5 $76. $89. $.65 $5.55 $95. $.5 $.5 $5.55 $6.6 $76.6 $.5 $.5 $8.9 $.75 $. $.5 $5. $6. $9.65 $7.55 $7. $88.5 $8.6 $5.6 $57.9 $75.75 $6. $9. $5. $6.5 HRA 8 $. $9.5 $9.5 $8.5 $5.5 $68.8 $7.5 $.5 $9.5 $6.55 $78.65 $95.75 $.65 $56. $.95 $8.65 $7. $.5 $66.5 $8.5 $.5 $.8 $9.5 $6.5 $5.65 $7.75 $79.95 $.65 $.5 $58.5 $67.5 $9.5 Whole Health $7.5 $.8 $8. $95.5 $7.5 $56. $. $9.5 HSA 8 plans $5. $9. $68.6 $8.85 $6.65 $.8 $87.9 $7. $.5 $6.8 $56. $7.5 $.5 $. $75. $9.5 $.6 $57.85 $6.9 $8. $. $5.5 $5. $69.5 HRA 8 $8.5 $.55 $8.85 $99. $.65 $6.65 $.65 $.65 Out-of-Network $5.75 $.5 $7.5 $86.7 $9.5 $5.5 $98.5 $.5 $.5 $8.55 $58.85 $7. $6.65 $8.65 $85.65 $7.65 $6.5 $6.7 $7.5 $95.5 $.85 $9. $6.65 $8.65
19 Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) MEDICAL PLAN RATES Semi-Monthly Employee Contributions Medical Plans Annual Salary equal to Annual Salary equal to or more than $6, and less than $9, $9, and less than $5, Medical Plans Premium Employee Credits Child(ren) Spouse/Partner Family Employee Child(ren) Spouse/Partner Family Earned Select HSA $6.7 $95.85 $5. $87.5 $85.5 $9.8 $99. $.75 $5. $8.5 $.5 $7.65 $7.85 $7. $86.8 $.5 $7.7 $7.85 $9. $6.5 $6.5 $.8 $7. $8.75 $6.5 $9.65 $6.8 $6.5 $. $7.5 $9. $9.75 HSA 8 $9.6 $6. $5. $5.65 $6.5 $9.95 $5.6 $8.5 $7. $7.5 $9.8 $.5 $9.75 $8.5 $8. $69.75 $.6 $5. $8. $.65 $7.5 $68.95 $5.6 $57.5 $67.8 $88.5 $. $.75 $55. $75.65 $.6 $.5 HRA 8 $5. $76. $7.5 $5.5 $7.75 $. $7.65 $.5 $7.6 $6.7 $.85 $. $6.5 $97.7 $6.5 $97.65 $5. $5. $.5 $8.5 $7.75 $85. $7.65 $85.5 $89.85 $6. $5.5 $7.65 $77.5 $.5 $.65 $6.5 Whole Health $. $6.75 $. $.9 $6.75 $97.7 $55.6 $88.5 HSA 8 plans $9.6 $5.5 $97.8 $9. $5.5 $85. $. $76. $7. $8.75 $85. $6.9 $9.75 $7.7 $.6 $6.5 $7.8 $9. $8. $5. $6. $8.9 $5.6 $8.5 HRA 8 $6.7 $7. $.75 $5.5 $69.8 $5.85 $66.95 $. Out-of-Network $. $58.7 $8.5 $.75 $57. $9.5 $5.5 $9.5 $.7 $6. $95.75 $.5 $.8 $8.85 $.95 $78. $8.5 $7.75 $9.5 $65.5 $7.75 $95.5 $6.95 $5.
20 Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) MEDICAL PLAN RATES Semi-Monthly Employee Contributions Medical Plans Annual Salary equal to or more than $5, Medical Plans Premium Employee Credits Child(ren) Spouse/Partner Family Earned Select HSA $.65 $7.5 $55.9 $.5 $.5 $59.75 $. $. $88.65 $7.5 $.9 $89.5 $8. $77. $5.9 $6.5 HSA 8 $9.55 $6. $7. $5. $78.5 $.9 $9.7 $.5 $65.55 $. $8. $8. $69.7 $5.5 $57. $. HRA 8 $.5 $5.6 $9.5 $8.85 $88.55 $. $6.75 $68.5 $76.5 $7.6 $.5 $55.85 $9.75 $.5 $79.5 $.85 Whole Health $9.5 $.5 $. $59.5 HSA 8 plans $8.55 $7.65 $99.7 $6.75 $68.5 $5.5 $87. $.5 $7.7 $.75 $6. $9.5 HRA 8 $98.65 $9.5 $.65 $75.5 Out-of-Network $86.5 $6.65 $.5 $6.65 $7.65 $.5 $99.65 $5.5 $87.5 $7.65 $7.65 $5.5
21 Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) DENTAL PLAN RATES Semi-Monthly Employee Contributions Dental Plans Dental Plans Coverage Options Employee Employee & Child(ren) Employee & Spouse/Partner Employee & Family Dental Maintenance Organization (DMO) $5.8 $9.5 $.5 $5.5 Dental PPO $.6 $9.5 $6. $. Dental Plan of ND and SC $.6 $9.5 $6. $. VISION PLAN RATES Semi-Monthly Employee Contributions Vision Plan Vision Plan Coverage Options Employee Employee & Child(ren) Employee & Spouse/Partner Employee & Family Aetna Vision Preferred SM $. $.78 $.5 $7.5 LEGAL BENEFIT RATE Employee Monthly Rate Legal Benefit $5.6
22 LIFE INSURANCE, AD&PL and LONG-TERM DISABILITY RATES Employee Supplemental Term Life Insurance Aetna Benefits and Rates-at-a-Glance for Regular U.S. Employees (working hours or more per week) Options x to 6x eligible pay Monthly Employee Rates (per $, of coverage)* Age < Tobacco $.6 $.6 $.8 $.9 $.6 $.7 $.8 $.599 $.98 $.7 $.88 Non-tobacco $. $.8 $.6 $.7 $.8 $.5 $.7 $.87 $.59 $.8 $.85 *Monthly cost = Eligible Pay Rounded to the next $, X Multiple of Eligible Pay (,,,, 5 or 6) = / $, = X Monthly Employee Rate above Spouse/Partner Supplemental Term Life Insurance Options Monthly Employee Rates (per $, of coverage) $, to $5,** Age < Tobacco $.7 $.7 $.9 $. $.7 $.9 $.9 $.78 $. $. $.97 Non-tobacco $.5 $.6 $.8 $.9 $. $. $. $.5 $.85 $.5 $.76 **increments of $, up to $, Child Term Life Insurance Options Monthly Employee Rate $, $.8 $5, $.6 $, $.6 Accidental Death and Personal Loss (AD&PL) Insurance Options Monthly Employee Rate (per $, of coverage) x to 6x eligible pay Employee $.6 ($,, maximum) Employee and Spouse/ Partner $. Employee and Child(ren) $. Employee, Spouse/ Partner and Child(ren) $. Long-Term Disability (LTD) Insurance Additional Option Monthly Employee Rates *** Age < % taxable benefit $.6 $.7 $. $.8 $.7 $.6 $. $.8 $. $.6 *** Monthly cost = Eligible pay = = x Monthly Employee Rate above
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