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Aetna Aetna
Frequently Asked Questions

We receive many questions about Aetna Affordable Health Choices® limited benefits insurance plan.* Here are some of the most frequently asked questions:

What are limited benefits?
Limited benefit insurance plans focus on the common services including inpatient and outpatient benefit coverage for office visits, lab, diagnostic tests, X-rays, surgery, anesthesiology, room and board and other hospital expenses, and prescription drug coverage (based on plan design). By offering limited benefits for these services, we can keep the premiums affordable.

Who can participate?
Aetna Affordable Health Choices® insurance plans are available to groups with employees who are paid an hourly wage, work on a seasonal basis or must fulfill a waiting period for other company-sponsored benefits.
We have a number of plan sponsors in the service, retail and entertainment industries including, but not limited to, restaurants, convenience and grocery stores, staffing services, security guard services, telemarketing firms, hotels and health care.

Why is a limited benefits plan a good choice?
Cost is a major factor for both the employer and employee. Traditional insurance plans often require employer contributions and participation requirements. Employees are often asked to share in the high cost.
The Aetna Affordable Health Choices® insurance plans are priced with the hourly employee in mind and can be completely employee-funded. We have lower participation requirements and have created an administrative process to help relieve the responsibility associated with offering a voluntary benefit.

What types of plans are available?
There are several Medical plans (PPO and indemnity) as well as a full suite of supplemental products Dental, Hospital Indemnity, Short Term Disability (STD)1, Term Life & Accidental Death and Vision Care. All plans are fully insured, group issued limited plans.

What are the benefits of offering a limited benefit plan?
Employees have access to care at an affordable price. The network discounts, copayments, and availability of network providers help manage out-of-pocket costs for those people in need of care.
Employers can help reduce the costs associated with turnover while offering coverage to an employee population that might otherwise be without healthcare coverage.

How do employees pay their premiums?
All premiums are collected through payroll deductions. We work with the plan sponsor to determine the best means of submitting those deductions. Our goal is to make the benefit offering very straightforward without distracting the employer from their core business.

We also offer a missed premium payment feature coupled with our self billing model. This feature is designed to accommodate the employee who does not have enough in his or her pay for a full deduction to be taken. If an employee fails to have a payroll deduction for a particular period, the employee's coverage will not be canceled, he or she will just be without coverage for that period unless the employee sends the missed premium to SRC.

* Except in NY, this plan is filed as a major medical plan that contains an annual benefit maximum and a number of additional coverage limitations and exclusions. In DC, ID, ME, & RI this is not considered a "limited benefits" insurance plan.

1 Coverage for employee only; coverage not available in California, Hawaii, New Jersey, New York, Rhode Island, and Puerto Rico.


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