Medical Benefits

Your employer offers medical insurance to all full-time employees working 30 or more hours per week (or 130 or more per month). It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.

Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit aetna.com/asa.

	In-Network	Out-of-Network
Deductible (Individual/Family)	$3,500/$7,000	$6,000/$12,000
Member Coinsurance	20%	50%
Out-of-Pocket Max (Individual/Family)	$6,250/$12,500	$12,500/$25,000
Physician Visits
Preventive Care	Covered at 100%	50% Coinsurance
Primary Care Visit	Deductible, then Coinsurance	50% Coinsurance
Specialist Visit	Deductible, then Coinsurance	50% Coinsurance
Physician’s Office (Outpatient Mental Health/Outpatient Substance Use Disorder)	Deductible, then covered at 100%	50% Coinsurance
Hospital Services
Physician Services	Deductible, then Coinsurance	50% Coinsurance
Inpatient Hospitalization	Deductible, then Coinsurance	50% Coinsurance
Outpatient Surgery	Deductible, then Coinsurance	50% Coinsurance
Outpatient Diagnostics	Deductible, then Coinsurance	50% Coinsurance
Urgent Care	Deductible, then Coinsurance	50% Coinsurance
Emergency Room	Deductible, then Coinsurance	50% Coinsurance
Retail Prescriptions (30 Days)
Tier 1-Generic & Specialty	Deductible, then $15 Copay	N/A
Tier 2-Preferred Brand Name	Deductible, then $40 Copay	N/A
Tier 3-Non-Preferred Brand Name	Deductible, then $75 Copay	N/A
Mail Order Prescriptions (90 Days)
Tier 1-Generic & Specialty	Deductible, then $38 Copay	N/A
Tier 2-Preferred Brand Name	Deductible, then $100 Copay	N/A
Tier 3-Non-Preferred Brand Name	Deductible, then $188 Copay	N/A

	Per Pay Period Cost
Employee Only	$0.00
Employee + Spouse	$187.50
Employee + Child(ren)	$162.50
Employee + Family	$347.50

Downloads

Summary of Benefits

Healthlink Fact Sheet

Auxiant Health for Members

Auxiant Mobile App

Auxiant ID Card Access

Enrolling in Paperless EOBs

Teladoc Flyer

Getting Started with Teladoc

Teladoc Quality Care

Health Joy Benefit Guide Insert

Health Joy Download

Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit aetna.com/asa.

	In-Network	Out-of-Network
Deductible (Individual/Family)	$2,000/$4,000	$6,000/$12,000
Member Coinsurance	0%	30%
Out-of-Pocket Max (Individual/Family)	$4,000/$8,000	$8,000/$16,000
Physician Visits
Preventive Care	Covered at 100%	30% Coinsurance
Primary Care Visit	$25 Copay	30% Coinsurance
Specialist Visit	$30 Copay	30% Coinsurance
Physician’s Office (Outpatient Mental Health/Outpatient Substance Use Disorder)	Covered at 100%	50% Coinsurance
Hospital Services
Physician Services	Deductible, then Coinsurance	30% Coinsurance
Inpatient Hospitalization	Deductible, then Coinsurance	30% Coinsurance
Outpatient Surgery	Deductible, then Coinsurance	30% Coinsurance
Outpatient Diagnostics	Deductible, then Coinsurance	30% Coinsurance
Urgent Care	$100 Copay	30% Coinsurance
Emergency Room	$300 Copay	$300 Copay
Retail Prescriptions (30 Days)
Tier 1-Generic & Specialty	$15 Copay	Not Covered
Tier 2-Preferred Brand Name	$40 Copay	Not Covered
Tier 3-Non-Preferred Brand Name	$75 Copay	Not Covered
Mail Order Prescriptions (90 Days)
Tier 1-Generic & Specialty	$38 Copay	Not Covered
Tier 2-Preferred Brand Name	$100 Copay	Not Covered
Tier 3-Non-Preferred Brand Name	$188 Copay	Not Covered