University of New England

I. Health Insurance - 3 Options to choose from:

OPTION A) AETNA High Option Enhanced HMO
Benefits are available to Aetna members when services are provided by their primary care physician or another Aetna participating provider (subject to prior authorization from the member's primary care physician). Services provided by non-participating providers are covered only when obtaining emergency care or when Aetna has authorized such care in advance of the member receiving such services. Members may utilize participating providers without prior authorization from the primary care physician and still receive benefits when securing the following benefits only: routine eye exams, gynecological services, maternity care, emergency care, up to 36 chiropractic visits for acute care treatment. A benefit for lens reimbursement reimburses members $100 every 24 months for the cost of lenses/contact lenses.  Benefit Summary Grid

OPTION B) AETNA Low Option HMO
Benefits under the Low Option HMO are accessed in the same manner as Option A above. Employees choosing Option B for themselves and their families will pay less in payroll deduction costs, but will see higher co-payments and co-insurance contributions when they access health care services. Benefit Summary Grid

OPTION C) AETNA QPOS (Quality Point of Service)

Benefits are available to Aetna members when in-network services are provided by their primary care physician or another Aetna participating provider (subject to prior authorization from the member's primary care physician). Members may utilize participating providers without prior authorization from the primary care physician and still receive in-network benefits when securing the following benefits only: routine eye exams, annual gynecological exam, maternity care, emergency care, up to 36 chiropractic visits for acute care treatment. Medically necessary health services may be obtained through any provider as non-referred/non-network services.  Benefit Summary Grid

More information about Aetna may be obtained by visiting the Aetna website.

Health Care Costs Summarized

OPTION A) AETNA High Option HMO
Under the HMO, you must choose a primary care physician (PCP). All care is provided by or approved by your PCP. Office visits require you to pay a $10.00 co-payment when you see your PCP. If you choose a PCP associated with the University Health Center, your office CO-payment will be $5.00. Prescription drugs require a CO-payment One CO-payment is required when you obtain a 30-day supply of prescription drugs. Two CO-payments are required for a 31 to 90 day supply for both retail and mail order prescription drugs. The CO-payment for prescriptions is $5.00 for generic drugs, $15.00 for preferred name brand drugs, and $30.00 for non-preferred name brand drugs.  Coverage Details.

OPTION B) AETNA Option HMO
Under the Low Option HMO, you must choose a primary care physician (PCP). All care is provided by or approved by your PCP. Office visits require you to pay a $25.00 co-payment when you see your PCP. If you choose a PCP associated with the University Health Center, your office CO-payment will be $20.00. Prescription drugs require a CO-payment One CO-payment is required when you obtain a 30-day supply of prescription drugs. Two co-payments are required for a 31 to 90 day supply for both retail and mail order prescription drugs. The CO-payment for prescriptions is $15.00 for generic drugs, $25.00 for preferred name brand drugs, and $40.00 for non-preferred name brand drugs.  Coverage Details.


OPTION C) AETNA QPOS (Quality Point of Service)
Highest Level of Benefits - Office visits to your primary care physician (PCP) are paid at 100% after a $25.00 CO-payment If you use only in-network services, your maximum cost in a calendar year will be $2,000 per person ($4,000 per family).

Self-referred Level of Benefits - Self-referred treatment not approved by your PCP will be reimbursed at 70% after a $250 deductible. Maximum out of pocket expense is $2,000 per person ($4,000 per family). Prescriptions will be reimbursed the same as the HMO Enhanced above. Members choosing physicians affiliated with the University Health Center will enjoy a $20.00 co-payment.

Coverage Details.


Your Monthly Cost

Full Time