We receive many questions about Aetna Affordable Health ChoicesSM (AAHC), here are some of the most frequently asked questions:
What are limited benefits?
Limited benefit plans focus on the most common services – including in- and outpatient benefit coverage for office visits, lab, diagnostic tests, X-rays, surgery, anesthesiology, room and board and other hospital expenses as well as prescription drug coverage (based on plan design). By offering only the most requested benefits, we can keep the premiums affordable.
Who can participate?
AAHC products 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 are these employees uninsured?
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 AAHC products are priced with the hourly employee in mind and can be completely employee-funded; we have low/ no participation requirements and have created administrative process to help relive the burden 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), 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, co-payments and general availability to care help manage the potential out of pocket cost while granting them coverage.
Employers can help reduce the costs associated with turnover while offering coverage to an employee population that would otherwise be without healthcare coverage or are possibly accessing benefits for the first time.
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 straight forward 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/ her pay for a full deduction to be taken. If an employee fails to have a payroll deduction for a particular period the employee will not be termed, they will just be without coverage for that period unless he/ she sends the missed premium to SRC.
Plan features and availability may vary by location and group size. Aetna does not provide care or guarantee access to health services. Not all services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features are subject to change. Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna’s Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. Information subject to change. Plans are underwritten by Aetna Life Insurance Company and administered by Strategic Resource Company (SRC).
