OVERVIEW
Health Plan CDHP Overview 2024
Aetna CDHP
Exchanges a lower employee contributions for more cost when you see a provider
In and out-of-network coverage available
Tax Advantaged Account
Health Savings Account
What is the program?
At News Corp we offer three distinct health plan choices for our employees. Our Aetna CDHP plan trades off a guaranteed lower payment (your paycheck deductions) for higher out of pocket payments if you go to the doctor. You also have the ability to contribute into and use a Health Savings Account.
Who is this program for?
Employees who would like to pay less in employee contributions and assumes more responsibility when incurring healthcare costs.
Key program benefits:
- You pay a lower per paycheck deduction but may incur higher out of pocket costs for services as you get through your deductible.
- The company will provide you with $500 or $1,000 (individual / family enrollment) into a Health Savings Account.
- You yourself can contribute to the Health Savings Account up to the annual maximum.
- For any doctor visit, or procedure you would pay the first $1,600 in costs (individual enrolled in individual coverage) or $3,200 in costs (family – even if only one family member is claiming a benefit) and then 20% for any amounts above that.
- Prescription drugs have a per prescription maximum.
- If you hit the plan’s out of pocket maximum – all allowed medical and prescription drug charges for the year will be paid 100% by the plan.
- Plan Compare
Network | Aetna Choice POS II | This is the network you would ask your doctor if she or he accept to make sure they are “in-network” |
Can you use out of network doctors? | Yes | |
In-Network Deductible | $1,600 / $3,200 (Individual / Family) | The individual deductible applies to a person who is enrolled for self-only coverage. The family deductible applies to a person enrolled with one or more dependents. Once satisfied it is satisfied for all members. |
Out-of-Network Deductible | $3,200 / $6,400 (Individual / Family) | The individual deductible applies to a person who is enrolled for self-only coverage. The family deductible applies to a person enrolled with one or more dependents. Once satisfied it is satisfied for all members. |
Copays for In-Network Office visits | N/A | This plan has no copays. You pay the cost of the service until the deductible is satisfied. Then you pay the coinsurance % thereafter. |
In-Network Coinsurance – Amount you pay | 20% after deductible | This amount is capped at the plan’s Out of Pocket Maximum |
Out-of-Network Coinsurance – Amount you pay | 50% of reasonable and customary | Reasonable and Customary is the prevailing charge for a service in a geographic area. |
In-Network Out of Pocket Maximum | $4,000 / $8,000 (Individual / Family) | The individual out of pocket maximum applies to a person who is enrolled for self-only coverage. The family out of pocket maximum applies to a person enrolled with one or more dependents. Unlike the POS, the CDHP does include all of your prescription drug expenses in a single out of pocket maximum. |
Out-of-Network Out of Pocket Maximum | $6,000 / $12,000 (Individual / Family) | The individual out of pocket maximum applies to a person who is enrolled for self-only coverage. The family out of pocket maximum applies to a person enrolled with one or more dependents. Does not include any amounts in excess of the reasonable and customary limit. |
Copay for Emergency Room | 20% of after deductible | All Emergency Rooms are considered in network for true emergencies |
Prescription Drug Out of Pocket | N/A | In the CDHP it is combined with the medical maximum above. |
Generic Prescription Drugs | 30 day supply: Full cost applies toward deductible then 20% ($75 max for generic and formulary, $100 max for non-formulary) 90 day mail order supply: Full cost applies toward deductible then 20% after deductible ($150 max for generic and formulary, $200 max for non-formulary) | Mail order drugs come direct from Caremark. |
Formulary Prescription Drugs | 30 day supply: Full cost applies toward deductible then 20% ($75 max for generic and formulary, $100 max for non-formulary) 90 day mail order supply: Full cost applies toward deductible then 20% after deductible ($150 max for generic and formulary, $200 max for non-formulary) | Formulary Drugs are discounted Brand Drugs. To find the Caremark formulary list – log on to www.caremark.com |
Non-Formulary Prescription Drugs | 30 day supply: Full cost applies toward deductible then 20% ($75 max for generic and formulary, $100 max for non-formulary) 90 day mail order supply: Full cost applies toward deductible then 20% after deductible ($150 max for generic and formulary, $200 max for non-formulary) | These are fully patented brand drugs with no discount. |
How can I enroll?
Log onto www.link2mybenefits.com to make your healthcare election.