1 Disclaimer - This presentation is brought to you by Aetna Life Insurance Company and/or its affiliates to educate you on the Aetna plan options available to you through the Federal Employees Health Benefits Program (FEHBP) or Federal Employees Dental and Vision Insurance Program (FEDVIP). The Aetna HealthFund® (HDHP/CDHP), the Aetna Open Access® HMO Plan, the Aetna Dental PPO Plan are not endorsed by the U.S. government and/or its federal agencies. Benefits 101: Choosing the right plan for you Federal Employee Plans
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Transcript
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Disclaimer - This presentation is brought to you by Aetna Life Insurance Company and/or its affiliates to educate you on the Aetna plan options available to you through the Federal Employees Health Benefits Program (FEHBP) or Federal Employees Dental and Vision Insurance Program (FEDVIP).
The Aetna HealthFund® (HDHP/CDHP), the Aetna Open Access® HMO Plan, the Aetna Dental PPO Plan are not endorsed by the U.S. government and/or its federal agencies.
Benefits 101:Choosing the right plan for you
Federal Employee Plans
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Choice of Plans and Coverage
No waiting period
No pre-existing condition limitations
Salary deduction
Government contributes 72%
Annual enrollment opportunity
FEHBP FeaturesFederal Employee Plans
Aetna, Inc. for presentation purposes only
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Provider/PCPReferralIn-Network vs. Out-of-NetworkCo-payCoinsuranceDeductible
Common Healthcare TermsFederal Employee Plans
Aetna, Inc. for presentation purposes only
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Plans and Coverage PPO
FFS
HDHP with an HSA
CDHP w/ HRA
HMO
And there’s more High, Basic, Standard FSA
FEDVIP
Making Sense of the Acronyms!Federal Employee Plans
Aetna, Inc. for presentation purposes only
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Plans and Coverage PPO (Preferred Provider Organization)
FFS (Fee For Service)
HDHP with an HSA (High Deductible Health Plan with a Health Savings Account)
CDHP w/ HRA (Consumer Driven Health Plan with Health Reimbursement Arrangement/Account)
HMO (Health Maintenance Organization)
And there’s more High, Basic, Standard (Same Insurance Company
might offer different plan options with different costs)
Making Sense of the Acronyms!Federal Employee Plans
Aetna, Inc. for presentation purposes only
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Comparing the types of plans: PPO vs. HMO
Federal Employee Plans
Aetna, Inc. for presentation purposes only
HMO•Must live or work in the geographic area to enroll•You must use network providers, except in emergencies•Most have no deductibles or coinsurance, just pay co-pays
PPO •Nationwide network of preferred providers •Allows you to choose providers in and out-of-network•No referrals•Deductible & Coinsurance
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Plans with no referrals*
Plans with no deductibles
Tax Savings
National networks
Out of Pocket Maximums
Dental benefits included
Vision benefits included
Discounts on: Weight loss programs
Massage, Chiropractic and Acupuncture
Gym Memberships
*Referrals required for California HMO.
What do you get for your healthplan dollars?
Federal Employee Plans
Aetna, Inc. for presentation purposes only
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Compare. There’s more to it than just the premium these days:
Federal Employee Plans
$773
Premium Savings
+
Annual Fund of
$1250
Self –Example OnlyCommon PPO Plans
PPO Network Plans
(CDHP)
Your Plan
Employee Premium Contribution(Bi-weekly premium x 26)
$1,825 $1,052
Carrier deposit to your fund (amount if any)
$0 $1,250
Deductible + HospitalCo-payment
$300 Annual$200/Admission
$750
In-Network Coinsurance Level
90% 90%
Catastrophic OOP Maximum (In Network)
$5,000 $3,000
Aetna, Inc. for presentation purposes only
Are there tax saving? Can you carry over unused funds? Is preventive care free?
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Example of CDHP Plan with PPO Network
Federal Employee Plans
1) Medical & Dental Funds Medical: Single- $1,250 / Family-$2,500