Engaged employees, easy benefits administration
It’s no secret that high costs can keep some people from getting the health care they need. That’s not good for any of us.
Engaged employees can be key to a healthy workforce. Here’s our approach:
- Share in healthy activities to promote wellness
- Consider cost shifting and changing in-network copays
- Target negative trends during the year by leading people to the right care
Consumer-directed health plans encourage employees to make informed decisions about their care. Ideally, this leads them to spend wisely and ultimately reduce their health care costs (and yours).
As another way to help you manage costs, we can give you the administrative tools you need to make day-to-day benefits decisions with ease.
Consumer-directed health plans
Winning the battle against rising costs isn’t easy. With our tax-advantaged options, you can deliver benefits that allow for:
- Reductions in FICA, unemployment and workers’ compensation taxes
- Ongoing annual savings
- An enhanced employee benefit package
- Tax savings that help the program pay for itself
You can lower your taxes and help your workforce with:
- Premium-only plans
- Flexible spending accounts
- Transit reimbursement
Aetna’s health expense funds can save you money
You benefit from tax savings when you contribute to these funds. And your employees get cost-effective, quality health benefits and insurance plans. Funds are broken into three groups:
- Health reimbursement arrangement (HRA)*
You set the amount that employees can use to pay for covered health care costs.
- Health savings account (HSA)**
Tax-advantaged contributions – made by you and/or your employees -- can help people save for future expenses.
- Flexible spending account (FSA)
Your employees can put part of their salary – before taxes – into this account and reimburse themselves for eligible expenses.
Health care administration made easy
Aetna Joint Claim AdministrationSM lets you perform key services, such as benefits determination, while we handle provider services and care management.
You (or your third-party administrator) maintain control over:
- Benefits determination
- Member eligibility
- Member explanation of benefits (EOBs)
- Member services
We can handle:
- Claims intake
- Claims pricing
- Claims editing
- Network management and provider services
- Provider payment and remittance
- Precertification and care management
Secure access to real-time information
With our Strategic Desktop Customer Service Portal, you get a real-time view of your members’ benefits information. A single screen highlights the most important plan, eligibility and coverage information, giving you the ability to maintain an active role in the customer service experience. This is a level of transparency that’s rare in the marketplace.
The system provides easy access to clear, organized information on:
- Claims – a robust view of all aspects of the life of a claim, including attachments
- Benefits – easy-to-use tabbed format with a link to plan sponsor benefits information
- Referrals – a direct link from claim screens to referral details
- Precertification – quick access to precertification status information
- Accumulators – tracks in- and out-of-network usage and other benefits (such as number of provider visits), including individual and family totals
*HRAs are currently not available to HMO members in Illinois and Small Group members in Florida.
**HSAs are currently not available to HMO members in California and Illinois.
Health benefits and health insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Florida by Aetna Health Inc. and/or Aetna Life Insurance Company. In Maryland by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.
This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Investment services are independently offered by the HSA Administrator. Aetna HealthFund HRAs are subject to employer-defined use and forfeiture rules and are unfunded liabilities of your employer. Fund balances are not vested benefits. Information is believed to be accurate as of the production date; however, it is subject to change.
Policy forms issued in OK include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER 08/07, GR-23 and/or GR-29/GR-29N.