Aetna Insurance Group Health Insurance Plans

Friday, March 1, 2024 16:49 Posted by Admin

Based in Hartford, CT, Aetna is a healthcare company that has been offering traditional and consumer directed health care since 1853. In addition to health insurance, Aetna provides dental, vision, and other plans to help meet the unique needs of health care providers, individuals and families, and employers. It is estimated that currently 39 million people rely on Aetna for insurance. With this number in mind, what compels so many people to choose Aetna for their health insurance coverage?

For starters, Aetna boasts that work incredibly hard to achieve one vision – “to provide improved access to quality health care services for all Americans.” Though, there is much more to Aetna that this mission. Let’s dive in to obtain a greater understanding of what this provider can offer you when it comes to group health insurance plans.

What is Group Health Insurance?

Before we dive too deeply, it’s important that you know exactly what group health insurance is. Simply put, group health insurance provides insurances coverage to members of group, typically encompassing employees of a company or members of an organization. These group- or employer- sponsored health plans deliver coverage to both the members and their families, as desired.

The main advantage to this type of health insurance is that members typically get insurance at a lower rate than individual plans since the insurer’s risk is spread between all insured members of the group. Whereas, employers enjoy the benefit of addressing all their employee’s medical needs at an affordable price and all in one convenient plan. These types of plans are very common across the United States and Canada. They can only be purchased by groups and, in most cases, require no less than 70% participation by group members to be binding.

That said, here’s a brief rundown of group health insurance, or group health insurance plans:

  • Group members receive health insurance at a lower rate, as the insurer’s risk is dispersed between a group of policyholders.
  • To be valid or blinding, these plans usually must have at least 70% participation by members.
  • By offering health coverage to their employees, employers are subjected to a number of tax benefits.
  • The premiums are split between the organization and its members, and members also have the option of including their immediate family members or dependents on the policy for an extra cost.

Understanding the Different Forms of Group Health Insurance

When it comes to choosing group health insurance for your business or organization, a lot of acronyms get thrown around, including HMO, PPO, POS, EPO, and HSA. These all refer to the different plan types available for your business and your employees. The one you choose will ultimately depend on your preferences and priorities regarding coverage, cost, and choice in health care providers.

If you’re confused on what all these options mean, we’re here to help! We’ve provided a detailed look at each group health insurance option, whether you choose to go with Aetna or some other insurance provider:

What is an HMO insurance plan?

Standing for “Health Maintenance Organization,” and HMO plan includes a network of doctors, hospitals and other care providers. In order to receive the benefits outlined in the plan, members have to use the providers within the HMO network. The only exceptions are those approved by the plan or in the case of an emergency. Each member must also choose a single primary care physician within the network to handle their care.

This form of group health insurance is often the cheapest and involves low deductibles and premiums, and set copays for doctor visits. As such, and HMO plan will probably save you the most money on health care for both your business and your employees.

What is a PPO insurance plan?

This type of plan stands for “Preferred Provider Organization.” Unlike HMO plans, you do not have to choose a primary care physician to handle your care with PPO plans. These plans offer the most flexibility for members when it comes to choosing providers, as the PPO networks are usually much larger than HMO networks.

Though, the drawback is that premiums are usually higher with PPO plans and employees often end up paying higher out-of-pocket costs to go outside of the network. Regardless, this type of group health insurance may be ideal for your business if you want to offer more flexibility to your employees and moderate cost-savings.

What is an EPO insurance plan?

Standing for “Exclusive Provider Organization,” EPO plans are similar to HMO plans in that they usually only pay for covered services by providers in the network. Though, it differs from HMO plans in that members do not have to choose a primary care physician to facilitate their care. EPO plan premiums tend to be lower than PPO and HMO plans but they have much smaller networks with contributing providers.

This type of large group health insurance plan may be ideal for businesses and employees that understand the benefit of the cost-savings associated with a smaller network of providers but would prefer not to deal with the HMO restrictions regarding primary care physician selection and referrals.

What is a POS insurance plan?

Like HMO, “Point of Service” (POS) plans require you to get a referral from your primary care physician to see a specialist. Though, for marginally higher premiums than HMO plans, a POS plan also includes out-of-network providers. But, you will still pay more than you would for a doctor that is in-network. With that said, a POS insurance plan may be appealing to employers and employees who want the option of going out-of-network for care but still desire the level of savings that comes with HMO plans.

What is an HDHP with HSA plan?

HDHP stands for “High Deductible Health Plan” and it can be an HMO, PPO, EPO, or POS. This type of plan involves low premiums but higher out-of-pocket costs. In most cases, employers combine HDHPs with a Health Savings Account (HSA) to help take care of some or all of the deductibles. The members add pre-tax money to an HSA in order to cover health care expenses in the future.

Those who manage a pre-existing health condition and cannot afford high monthly premiums usually find that an HDHP, paired with an HSA, saves them money long-term.

Aetna Health Group Health Insurance Plans

Aetna strives deliver better access to high-quality health at affordable prices, for all American citizens. When you purchase group health insurance through Aetna, you and your employees have the solutions to better manage health needs. Though, since your company is unique, there is not a one-size-fits-all solution. Aetna works with you to understand your needs and goals, and the personalizes a health insurance package that meets them.

They provide group insurance options to businesses of all sizes and they break down their plan offerings based on how many employees you have:

  • Small businesses – 2 to 100 employees
  • Mid-sized businesses – 101 to 4,999 employees
  • National accounts – 5,000 or more employees

Have additional questions about group health insurance and what plans Aetna can offer you and your employees? We can help!

Whether you are located in the Bay Area or anywhere else in the nation, the experienced and professional brokers at Taylor Benefits Insurance Agency will explain your plan options, break down all the little details, and help you select the ideal Aetna Insurance group health insurance plan for your business.

So, what are you waiting for? Don’t hesitate – contact us now to get started.

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

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