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Aetna Medical Plan Changes for the 2022 Benefits Plan YearAetna PPO and POS Plan Changes . . . . . . . .Aetna HNO and HMO Plan Changes . . . . . . .Aetna Tri-state Plan Changes . . . . . . . . . . . . .Aetna ACO Plan Changes . . . . . . . . . . . . . . . . .Pages 1-3Pages 4-6Page 7Pages 8-9All Aetna PlansEffective April 1, 2022, acupuncture will be a covered benefit offering 10 visits percalendar year for disease, injury and chronic pain.Aetna PPO and POS Plan Changes Aetna is eliminating the POS 30 plan. Worksite employees who do not activelymake an election during open enrollment will be automatically enrolled in thePPO 1000 plan. Please reference the client renewal site for further plan details.CurrentAetna Plan NamePOS 30NewAetna Plan NamePPO 1000 The PCP copay is decreasing from 45 to 40 for the PPO 5000 plan. The specialist copay is increasing for the following plans as outlined in the chartbelow:Aetna Plan NamePPO 1500PPO 2000PPO 5000 CurrentSpecialist copay 50 50 65NewSpecialist copay 70 70 80The urgent care copay is increasing from 75 to 85 for plans listed in the chartbelow.Aetna Plan NamePPO 500PPO Choice 500PPO 1000PPO Choice 1000PPO 1500PPO 2000PPO 3000PPO 5000 The following plans have Rx copay changes as outlined in the chart below:Page 1
Aetna Plan NamePPO 500PPO Choice 500PPO 1000PPO Choice 1000PPO 1500PPO 2000PPO 3000PPO 5000PPO 7150PPO Choice 7150HDHP 3000HDHP Choice 3000Indemnity 1000 NewRx copay25% 250 max30% 300 maxAdding a 5th specialty drug tier fornon-preferred drugs50% ( 500 max)The individual and family in-network out-of-pocket maximums are increasing forthe following plans as outlined in the chart below:Aetna Plan NamePPO 500PPO 1000PPO 1500PPO 2000PPO 3000PPO 5000PPO 7150PPO Choice 500PPO Choice 1000PPO Choice 7150HDHP 3000HDHP Choice 3000Indemnity 1000 CurrentRx copayCurrentIndividual/FamilyIn-network OOP Max 3,000/ 6,000 4,000/ 8,000 4,000/ 8,000 6,350/ 12,700 4,000/ 8,000 6,350/ 12,700 7,150/ 14,300 3,000/ 6,000 4,000/ 8,000 7,150/ 14,300 5,000/ 10,000 5,000/ 10,000 4,000/ 8,000NewIndividual/FamilyIn-network OOP Max 3,500/ 7,000 4,500/ 9,000 4,500/ 9,000 6,850/ 13,700 4,500/ 9,000 6,850/ 13,700 7,600/ 15,200 3,500/ 7,000 4,500/ 9,000 7,600/ 15,200 5,500/ 11,000 5,500/ 11,000 4,500/ 9,000The individual and family out-of-network deductible is increasing for thefollowing plans listed in the chart below. Please reference the client renewal sitefor further plan details.Aetna Plan NamePPO 7150PPO Choice 7150HDHP 6350Page 2
The individual and family out-of-network out-of-pocket maximums areincreasing for the following plans listed in the chart below. Please reference theclient renewal site for further plan details.Aetna Plan NamePPO 500PPO Choice 500PPO 1000PPO Choice 1000PPO 1500PPO 7150PPO Choice 7150HDHP 6350HDHP 3000HDHP Choice 3000Page 3
Aetna HNO and HMO Plan Changes Aetna is eliminating the following plans in these states as listed in chart below:Aetna Plan NameHNO 20 IN and OK regionsHNO 1500 INHNO 40 OK and TNHMO HDHP 5000 OK and TN The following plans have Rx copay changes as outlined in the chart below:Aetna Plan NameHNO 20 (All regions except MD)HNO 1500(All regions except MD)HNO 40 (All regions except MD)HNO 6350 FLHMO HDHP 5000(All regions except MD) Adding a 5th specialty drug tier fornon-preferred drugs50% ( 500 max)Current Rx copayNew Rx copay20% 250 max30% 250 maxThe individual and family in-network out-of-pocket maximums are increasing forthe following plans as outlined in the chart below:Aetna Plan NameHNO 20HNO 40HNO 1500HNO 6350 FLHNO 5000 TXHMO 0 CAHMO Value 30 CABasic HMO 30 CAHMO 2000 CAHMO HDHP 5000 25% 250 max 4th tierNew Rx copay30% 300 maxThe following plans have Rx copay changes as outlined in the chart below:Aetna Plan NameHMO 0 CAHMO 2000 CAHMO Value 30 CABasic HMO 30 CA Current Rx copayCurrent Individual/FamilyIn-network OOP Max 2,500/ 5,000 6,850/ 13,700 5,000/ 10,000 6,850/ 13,700 6,450/ 12,900 3,500/ 7,000 5,500/ 11,000 5,500/ 11,000 6,500/ 13,000 6,450/ 12,900New Individual/FamilyIn-network OOP Max 3,000/ 6,000 7,350/ 14,700 5,500/ 11,000 7,350/ 14,700 6,900/ 13,800 4,000/ 8,000 6,000/ 12,000 6,000/ 12,000 7,000/ 14,000 6,900/ 13,800The PCP office visit copay is decreasing from 50 to 40 on the HNO 5000 TX plan.Page 4
The urgent care copay is increasing from 75 to 85 for the following plans asoutlined in the chart below:Aetna Plan NameHNO 20 (all regions except SC)HNO 1500 (all regions except SC)HNO 40 (all regions except SC)HNO 6350 FLHNO 5000 TX The urgent care copay is decreasing from 350 to 85 for the following plans asoutlined in the chart below:Aetna Plan NameHNO 20 SCHNO 1500 SCHNO 40 SC The specialist copay is increasing for the following plans as outlined in the chartbelow:Aetna Plan NameHNO 40HNO 1500HNO 5000 TXHNO 6350 FLHMO 2000 CA NewSpecialist copay 80 60 80 80 70The in-network individual and family calendar year deductible will be increasingfor the following plan, as outlined in the chart below:Aetna Plan NameHMO HDHP 5000 AZ CurrentSpecialist copay 65 55 70 65 60CurrentIndividual/FamilyAnnual Deductible 2,500/ 5,000NewIndividual/FamilyAnnual Deductible 5,000/ 10,000Effective April 1, 2022, Aetna will enforce the use of CVS Specialty Pharmacy afterthe 1st fill for the following Arizona region plans listed in chart below. Pleasereference the client renewal site for further plan details.Page 5
Aetna Plan NameHNO 20HNO 1500HNO 40HMO HDHP 5000 Effective April 1, 2022, Aetna is removing step therapy and adding Value 1agenerics for the following Tennessee region plans listed in chart below. Pleasereference the client renewal site for further plan details.Aetna Plan NameHNO 20HNO 1500Aetna Tri-state Plan Changes Effective April 1, 2022, Value 1a generics under the Aetna Tri-state plans will fallunder a different formulary tier, which may result in a higher copay.Page 6
The PCP copay is decreasing from 45 to 40 for the EPO 4000 plan. The specialist copay is increasing for the following plans as outlined in the chartbelow:Aetna Plan NamePPO 750PPO 1000EPO 4000 CurrentSpecialist copay 30 40 70NewSpecialist copay 40 50 80The individual and family in-network out-of-pocket maximums are increasing forthe following plans as outlined in the chart below:Aetna Plan NamePPO 0PPO 750PPO 1000PPO 2000HDHP 3000EPO 30EPO 45EPO 1000EPO 4000CurrentIndividual/FamilyIn-network OOP Max 4,000/ 10,000 5,500/ 13,750 6,000/ 12,000 6,000/ 12,000 6,000/ 12,000 3,500/ 8,750 4,000/ 10,000 4,000/ 10,000 6,350/ 12,700NewIndividual/FamilyIn-network OOP Max 4,500/ 11,250 6,000/ 15,000 6,500/ 13,000 6,500/ 13,000 6,500/ 13,000 4,000/ 10,000 4,500/ 11,250 4,500/ 11,250 6,850/ 13,700 The individual and family out-of-network deductible is increasing for PPO 1000.Please reference the client renewal site for further plan details. The individual and family out-of-network out-of-pocket maximums areincreasing for the following plans listed in the chart below. Please reference theclient renewal site for further plan details.Aetna Plan NamePPO 0PPO 750PPO 1000HDHP 3000Aetna ACO Plan Changes Aetna is eliminating the ACO 3500 CO plan. Worksite employees who do notactively make an election during open enrollment will be automatically enrolledPage 7
in the ACO 2500 CO plan. Please reference the client renewal site for further plandetails.CurrentAetna Plan NameACO 3500 CO NewAetna Plan NameACO 2500 COAetna is eliminating the ACO 3500 Austin TX plan. Worksite employees who donot actively make an election during open enrollment will be automaticallyenrolled in the ACO 2500 Austin TX plan. Please reference the client renewal sitefor further plan details.CurrentAetna Plan NameACO 3500 Austin TX NewAetna Plan NameACO 2500 Austin TXAetna is eliminating the ACO 3500 San Antonio TX plan. Worksite employees whodo not actively make an election during open enrollment will be automaticallyenrolled in the ACO 2500 San Antonio TX plan. Please reference the clientrenewal site for further plan details.CurrentAetna Plan NameNewAetna Plan NameACO 3500 San Antonio TX ACO 2500 San Antonio TXAetna is eliminating the ACO 3500 Houston TX plan. Worksite employees who donot actively make an election during open enrollment will be automaticallyenrolled in the ACO 2500 Houston TX plan. Please reference the client renewalsite for further plan details.CurrentAetna Plan NameNewAetna Plan NameACO 3500 Houston TX ACO 2500 Houston TXThe individual and family in-network out-of-pocket maximums are increasing forthe following plans as outlined in the chart below:Aetna Plan NameCurrentPage 8New
ACO 6500 COACO 6500 TX Individual/FamilyIn-network OOP Max 6,500/ 13,000 6,500/ 13,000Individual/FamilyIn-network OOP Max 7,000/ 14,000 7,000/ 14,000The following plans have Rx copay changes as outlined in the chart below:Aetna Plan NameACO 6500 COCurrentRx copayNewRx copay 10/ 35/ 75ACO 6500 TX 10/ 45/ 80Adding a 5th specialty drug tier fornon-preferred drugs50% ( 500 max)Disclaimer: 2022 TriNet Group, Inc. All rights reserved. This communication is for informational purposes only, is not legal, tax oraccounting advice, and is not an offer to sell, buy or procure insurance. TriNet is the single-employer sponsor of all itsbenefit plans, which does not include voluntary benefits that are not ERISA-covered group health insurance plans andenrollment is voluntary. Official plan documents always control and TriNet reserves the right to amend the benefit plansor change the offerings and deadlines.TN II- cAetnaCh22NNPage 9
Effective April 1, 2022, Aetna is removing step therapy and adding Value 1a generics for the following Tennessee region plans listed in chart below. Please reference the client renewal site for further plan details. Aetna Tri-state Plan Changes Effective April 1, 2022, Value 1a generics under the Aetna Tri-state plans will fall
