Some benefits are changing as a result of this transition and we are also adding some new plan options that we feel will be beneficial to our membership. The changes are outlined below:
• We have greatly enhanced all of our plans to accommodate the change from reference-based pricing to a traditional network PPO model. These changes consisted of adding a network for facility services (there was previously no network and all services were considered out-of-network and were paid accordingly). All plans will now have a robust network of facilities for access to. These Aetna network facilities will be applied to a new in-network benefit and all other facilities that do not participate with Aetna will be applied to the out-of-network benefit. More details on these benefits can be found in the new benefit summaries.
• We have also made enhancements to most of our plans in network copays, coinsurance and out-of-pocket maximums, including the Classic 500 Plan, Classic 1000 Plan, Classic 2000 Plan, Classic 3500 Plan and HSA 5000 Plan. More details on these benefits can be found in the new benefit summaries.
• We are eliminating the Value 1000 Plan, the Value 3000 Plan and the HSA 3000 Plan – there is little to no membership in these plans. However, if you are enrolled or have employees in these plans, we will be reaching out to you to advise how we will be handling your enrollment.
• We have also added 3 new plan options and more information will be provided to you at renewal on these plans so you can make an informed decision on your plan options:
• Pharmacy Plans are changing as well to offer you more choices to fit your needs. The current 4 pharmacy plans are being consolidated into 3 plans – 2 copay plans and one HSA-compatible deductible plan as outlined above. The great news is that all 3 prescription options can now be selected with any medical plan to give you more flexibility and choice. Note that copay plans are not eligible with HSA plans as they would make the plan non-HSA compatible. More details on the pharmacy benefits can be found in the new benefit summaries.
You will be given the choice at renewal to keep your existing coverage or change to any of the new or existing Medical and Prescription Plans being offered and the TDA Insurance team and your Broker will help you navigate these decisions.