OVERVIEW
Health Plan Choice POS II Overview 2024
Aetna Choice POS II
Exchanges a lower cost share when going to the doctor
Higher payroll contributions to participate in the plan
Tax Advantaged Account
Flexible Savings Account
What is the program?
At News Corp we offer three distinct health plan choices for our employees. Our Aetna Choice POS II plan is our most traditional health plan, geared toward those who have fairly regular ongoing medical care or prescription drug needs.
Who is this program for?
Employees who would like to pay less when going to the doctor and assumes more in payroll contributions.
Key program benefits:
- You pay a higher per-paycheck deduction for the benefit of lower out of pocket costs per service.
- Fixed copays for in-network services ($35 primary care, and $50 for specialists).
- For lab, x-ray, or any procedure you would pay the first $600 in costs and then 20% for any amounts above that.
- The most any one person in the plan would pay out of your pocket for in-network services in this plan is $4,000 after which the plan would pick up 100% of the costs
- 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 | Yes but the services will cost more when rendered out-of-network |
In-Network Deductible | $600 / $1,200 (Individual / Family) | For a person enrolled with one or more dependents, the individual deductible applies separately to each covered person until the family deductible has been met. |
Out-of-Network Deductible | $1,200 / $2,400 (Individual / Family) | For a person enrolled with one or more dependents, the individual deductible applies separately to each covered person until the family deductible has been met. |
Copays for In-Network Office visits | $35 Primary Care Physician $50 Specialist | |
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 | 40% 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) | For a person enrolled with one or more dependents, the individual out of pocket maximum applies separately to each covered person until the family out of pocket maximum has been met. Does not include prescription drugs. |
Out-of-Network Out of Pocket Maximum | $8,000 / $16,000 (Individual / Family) | For a person enrolled with one or more dependents, the individual out of pocket maximum applies separately to each covered person until the family out of pocket maximum has been met. Does not include any amounts in excess of the reasonable and customary limit. |
Copay for Emergency Room | $300 + 20% of remaining costs | All Emergency Rooms are considered in network for true emergencies |
Prescription Drug Out of Pocket | $3,000 Individual / $6,000 Family | This is in addition to the Medical Out of Pocket Maximum above. For a person enrolled with one or more dependents, the individual out of pocket maximum applies separately to each covered person until the family out of pocket maximum has been met. |
Generic Prescription Drugs | $10 for a 30 day supply $20 for a 90 days mail order supply | Mail order drugs come direct from Caremark. |
Formulary Prescription Drugs | 30% ($30 minimum / $75 maximum) for a 30 day supply 30% ($60 minimum / $150 maximum) for a 90 days mail order supply | Formulary Drugs are discounted Brand Drugs. To find the Caremark formulary list – log on to www.caremark.com |
Non-Formulary Prescription Drugs | 50% ($50 minimum / $100 maximum) for a 30 day supply 50% ($100 minimum / $200 maximum) for a 90 days mail order supply | These are fully patented brand drugs with no discount. |
How can I enroll?
Log onto www.link2mybenefits.com to make your healthcare election.