• The Aetna Consumer Choice (HSA) Plan(Click here for summary) is a qualified high deductible health plan and is the only plan that allows you to contribute to a Health Savings Account (HSA).

• An HSA allows you and the college to set aside funds on a pre-tax basis to pay for qualified medical care (including deductibles and coinsurance). It also requires the lowest amount of employee payroll contribution towards the cost of the premium. 

• The plan pays for preventive medical care at 100% and also certain preventive drugs at 100%.  All other services and prescription drugs are subject to a deductible before the plan begins to pay for in-network services at 80% up to the out-of-pocket limit. 

• With this plan, all providers in the Aetna network are covered at the same level.  If you enroll in the HSA Plan you will automatically be enrolled in the Hospital Indemnity Plan (HIP) and Bates will cover the cost.  The HIP provides a $1,000 benefit if a covered member is admitted for an inpatient hospital stay, as well as other daily benefits for extended hospital stays (see HIP Plan for more information including the definition of being admitted).

Click here for the Aetna Preventative Medicine List for the Aetna Consumer Choice (HSA) Plan (paid at 100% – not subject to the deductible)

+More information on the HSA:

• The Aetna Whole Health (ACO) Plan (Click here for summary) is a unique plan that features varying levels of coverage based on three provider networks. Members incur the lowest annual deductible and out-of-pocket expenses when receiving care from providers in the Aetna Whole Health Tier 1 network (Maximum Savings).

• When obtaining care from a Tier 2 (Standard Savings) network provider or a non-participating provider, you will incur a higher deductible and additional out-of-pocket costs. To receive the highest level of benefit under this plan, you are required to select a PCP from the Tier 1 network, but you do not need referrals for specialist services.  

• The Aetna PPO Plan (Click here for summary) is the most expensive plan, but you have the same access to Aetna’s full network similar to the HSA Plan.  You will incur a flat copay for most services outside of the hospital. This plan does not require the selection of a PCP or referrals.

• All three plans use the same Aetna Standard prescription drug formulary. 

• Coverage for some drugs where there are lower-cost options is not covered.

• If a doctor shows there is a medical necessity for continuing on an excluded drug, coverage may be continued with an override.  Some prescription drugs will switch from Tier 2 to Tier 3 and vice versa.   

• There are two cost management programs for certain drugs (see listings below).  Questions for Aetna?

• Call the concierge services line listed on the back of your card at 1-855-586-6963 or the NFP Benefit Support Team at 1-844-348-1463.

• If you elect the [HSA] Aetna Consumer Choice Plan then the college will cover the cost and automatically enroll you in this plan. 

• You may also elect the HIP if you are covered under the ACO or PPO or even if you opt-out of the Bates medical plan.  The premium will be deducted from your check on an after-tax basis.

• The HIP plan provides a $1,000 benefit should any covered member of your family be admitted* to the hospital for an overnight stay. You will receive an additional $100 for any additional day spent in the hospital, $200 a day in the ICU, or $50 a day in a rehabilitation unit following a hospital stay. If you do not want to enroll in the HIP we ask that you elect to Opt Out of the HIP.

* See Hospital Indemnity Plan brochure for the definition of Admission, there are times you may be in a hospital overnight and not be “admitted”. For example, some outpatient procedures such as joint replacements may require you to stay in the hospital overnight but this is not an admission to the hospital. You must be admitted to receive the $1,000 benefit.

+Monthly Premiums

• Whole Health Provider Summary
• Whole Health FAQs
• Instructions on how to find if a doctor is in Aetna’s PPO/HSA or Whole Health (ACO) network
• Aetna Standard Rx Formulary
• Rx Pre-certification and Step Therapy Overview
• RX listing needing Pre-cert or Step Therapy
• RX Excluded Drugs
• Your personalized Aetna Navigator Account
• Aetna Concierge Service
• Aetna’s Mobile App
• Aetna’s Discount Program

• Aetna Whole Health Member brochure
• Side by side quick plan comparison
• Aetna Preventive Medicine List for the Aetna Consumer Choice (HSA) Plan
  (paid at 100% – not subject to the deductible)
• Transform Oncology
• Transparency in Coverage