Jun 15, 2023
Aetna has made some changes and enhancements to keep delivering strong value for your clients. These changes take effect for new and renewing business starting with September 1, 2023 effective dates.
You’ll be able to sell new leaner and richer plan options to help your clients find the right mix of coverage and cost, with deductibles ranging from $0 to $9,100. The leanest Standard plan options now include benefits that mirror the Essentials plans. To simplify the proposal output, you won’t see them as a separate plan offering.
Additions To The Current Portfolio Of Plans
- New lean options including 70/50, 50/50, IntRX and Value plans.
- New HSA plans with a non-embedded deductible and embedded out-of-pocket limits. These plans offer cost savings compared to non-embedded HSA plans. They will have “TE” in the plan name.
- Starting 10/1/23 effective dates: New “Premier” plans that will have lower member cost-sharing than Standard plans.
Changes to existing standard portfolio plans
- For plans that are not HSA or IntRx, the deductible will apply prior to copay and coinsurance for emergency room visits.
- The out-of-pocket limits will increase to align with regulatory and industry standards.
Member benefit and program additions
These additions complement the range of existing value-added programs and benefits that offer members services at no cost.*
Over-the-Counter Health Solution®
Each member gets a $25 Allowance every quarter for select CVS Health® brand health support products. There’s no enrollment process. At the register, they give the cashier their ID card and date of birth.** Members should use the catalog to find products that work with the benefit.
$0 Preferred Diabetic benefit
Offers $0 cost-sharing with a waived deductible for preferred insulins and diabetic supplies on all plans, including HSA.*** Members can use the Advanced Control Plan Aetna drug list to identify eligible insulin and supplies. Items marked “PG” or “PB” in the following categories are eligible: “Antidiabetics, insulin” and “Diabetic Supplies”.
Pharmacy Advisor®
Helps improve medication adherence, close gaps in pharmacy care and reduce overall health care costs. Aetna will identify members who need support. Then, they'll provide tools, resources and proactive support through customized, one-on-one outreach.
Talk to your Amwins Connect Sales Representative to see how Aetna AFA can meet your clients needs.
* If the member enrolls in a qualified high-deductible health plan, they can receive preventive services at no cost. To receive no-cost care on all covered non-preventive services, the member will first need to meet their deductible.
** The benefit can only be used at a staffed register, not a self checkout station. Does not include CVS Pharmacy locations inside Target stores.
***Excludes Oklahoma
