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Disclaimer - This presentation is brought to you by Aetna Life Insurance Company and/or its affiliates to educate you on the Aetna plan options available to you through the Federal Employees Health Benefits Program (FEHBP) or Federal Employees Dental and Vision Insurance Program (FEDVIP).

The Aetna HealthFund® (HDHP/CDHP), the Aetna Open Access® HMO Plan, the Aetna Dental PPO Plan are not endorsed by the U.S. government and/or its federal agencies.

Benefits 101:Choosing the right plan for you

Federal Employee Plans

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Choice of Plans and Coverage

No waiting period

No pre-existing condition limitations

Salary deduction

Government contributes 72%

Annual enrollment opportunity

FEHBP FeaturesFederal Employee Plans

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Provider/PCPReferralIn-Network vs. Out-of-NetworkCo-payCoinsuranceDeductible

Common Healthcare TermsFederal Employee Plans

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Plans and Coverage PPO

FFS

HDHP with an HSA

CDHP w/ HRA

HMO

And there’s more High, Basic, Standard FSA

FEDVIP

Making Sense of the Acronyms!Federal Employee Plans

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Plans and Coverage PPO (Preferred Provider Organization)

FFS (Fee For Service)

HDHP with an HSA (High Deductible Health Plan with a Health Savings Account)

CDHP w/ HRA (Consumer Driven Health Plan with Health Reimbursement Arrangement/Account)

HMO (Health Maintenance Organization)

And there’s more High, Basic, Standard (Same Insurance Company

might offer different plan options with different costs)

FSA (Flexible Spending Account)

FEDVIP (Federal Employee Dental Vision Insurance Plans)

Making Sense of the Acronyms!Federal Employee Plans

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Comparing the types of plans: PPO vs. HMO

Federal Employee Plans

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HMO•Must live or work in the geographic area to enroll•You must use network providers, except in emergencies•Most have no deductibles or coinsurance, just pay co-pays

PPO •Nationwide network of preferred providers •Allows you to choose providers in and out-of-network•No referrals•Deductible & Coinsurance

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Plans with no referrals*

Plans with no deductibles

Tax Savings

National networks

Out of Pocket Maximums

Dental benefits included

Vision benefits included

Discounts on: Weight loss programs

Massage, Chiropractic and Acupuncture

Gym Memberships

*Referrals required for California HMO.

What do you get for your healthplan dollars?

Federal Employee Plans

Aetna, Inc. for presentation purposes only

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Compare. There’s more to it than just the premium these days:

Federal Employee Plans

$773

Premium Savings

+

Annual Fund of

$1250

Self –Example OnlyCommon PPO Plans

PPO Network Plans

(CDHP)

Your Plan

Employee Premium Contribution(Bi-weekly premium x 26)

$1,825 $1,052

Carrier deposit to your fund (amount if any)

$0 $1,250

Deductible + HospitalCo-payment

$300 Annual$200/Admission

$750

In-Network Coinsurance Level

90% 90%

Catastrophic OOP Maximum (In Network)

$5,000 $3,000

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Are there tax saving? Can you carry over unused funds? Is preventive care free?

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Example of CDHP Plan with PPO Network

Federal Employee Plans

1) Medical & Dental Funds Medical: Single- $1,250 / Family-$2,500

Dental: Single- $300 / Family-$600

2) DeductibleMedical: Single- $750 / Family-$1,500

3) CoinsurancePlan pays for covered services:

In-network: 90% Out-of-network: 60%

Rx: $10/$25/$40 (your copay)

100% Preventive Care

In-Network

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Example of HDHP Plan with PPO Network

Federal Employee Plans

100% Preventive Care

In-Network

2) DeductibleIn-network: Single- $1,500 / Family-$3,000

Out-of-Network: Single- $2,500 / Family- $5,000

3) CoinsuranceIn-network: 90%/ 10%

Out-of-network: 70%/ 30% Rx: $10/$25/$40

Monthly Deposits Single- $62.50/monthFamily- $125/month

Member Contributions(optional)

Single- up to $2,250/yearFamily- up to $4,450/year

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FFS PPO Network PlansFederal Employee Plans

In-network BenefitsUsing participating facilities and Providers

-A’Richer’ benefit level-Mostly co-insurance

-Negotiated Fees/Rates

Out-of-Network Benefits Non-Participating Providers

-more cost sharing

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HMO Network PlansFederal Employee Plans

In-network BenefitsMust use participating facilities and Providers

-Mostly co-payments-Possible Referrals

-MUCH less paperwork!

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Eyewear & Vision services

Weight loss programs

Fitness programs

Chiropractic & Acupuncture services

Massage Therapy

Vitamins

Mail Order Rx

What about Perks?Federal Employee Plans

Common Special Discounts :

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What dental and vision benefits are in your Medical Plan:

Screenings?

Cleanings?

Fillings?

Reimbursement for eyewear?

Do you need a separateDental or Vision plan?

Federal Employee Plans

Aetna, Inc. for presentation purposes only

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How can you choose the right plan?Federal Employee Plans

Compare Plans and Plan features, like…

Premiums, Coinsurance, Copays and Network

Tax Savings, Rollover feature

Prescription drug coverage – Generic drugs and Mail Order benefit

Understand Vision and Dental benefits included with Medical Plans

Discounts – Access to discounts that could save money on services

and items you use already!

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Research now before Open Season

www.OPM.gov/Insure

www.benefeds.com

Do the math now – Budget your expected medical expenses

Do you now how to enroll?

Now what?Federal Employee Plans

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Thanks for coming!

Questions?Federal Employee Plans

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