Baptist Health System & HealthTexas Medical Group commitment

Baptist Health System & HealthTexas Medical Group commitment

? Appointment slots

held open for

members with

chronic care, urgent

care, or acute needs

? Physicians available at ? Access to

all times, day and night, appointments on

for all patients

Saturdays

? Immediate access to ? Access to extended

each patient's personal hours before and

health history and

after normal

information

business hours

A member-centric,

effective and efficient health care model that

meets the needs of each individual family

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The Aetna Whole Health network includes:

Primary Care ? HealthTexas Medical Group ? MedFirst (Baptist Health

System)

Pediatricians ? San Antonio Pediatric

Associates ? ABCD Pediatrics ? A Plus Pediatrics ? Leon Valley Pediatrics

Urgent Care ? Concentra Health Services ? Texas Med Clinic ? Alamo Heights Minor

Emergency Clinic

Hospitals ? Northeast Baptist ? Baptist Medical Center ? St Luke's Baptist Hospital ? North Central Baptist Hospital ? Baptist Emergency Hospital ? Mission Trail Baptist Hospital

*For a complete list of physicians and specialists refer to DocFind

2

Quality health plans & benefits Healthier living Financial well-being Intelligent solutions

Building your care team

First, choose a primary care doctor to lead your care team. ? Visit docfind ? Type a name, specialty, procedure or

condition in the "Who or what are you looking for?" box ? Enter your ZIP code in the "Where?" box ? Choose (TX) Aetna Whole Health ? Baptist Health System & HealthTexas Medical Group

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South San Antonio ISD November 1, 2016 Renewal

AETNA HEALTH PLANS

Plan 1 - EPO / Open access ACO Plan 2 - Open Access Managed Plan 3 - Open Access Managed Plan 4 - Open Access Managed

Plan

choice

Choice

Choice

Coinsurance

20%

In-

Network Benefits only

Annual Deductible/Family Cap (In-network)

Annual Max Out of Pocket/Fam Cap (MOOP) MOOP = Med Services Max + Rx Max

MEDICAL SERVICES

Hospital Services

In-Patient

Physician Office Visit

Out-Patient

$5,000/ $10,000 $6,350 / 2x

20% after deductible 20% after deductible

Office Visit Copay (PCP/Specialist/Urgent) Diagnostic Laboratory

Diagnostic Outpatient Complex Imaging

$30/$70/$100 20% after deductible 20% after deductible

Preventive Care

Covered in full

ER Visit

Non-

Emergency Care in ER - NOT covered

20% after deductible

Other Medical Services

PRESCRIPTION DRUGS

20% after deductible

Retail Pharmacy-30 day supply

Generic/

Formulary / Non-formulary brand-name

$15 / $35 / $70

Mail Order 30-90 day supply

Generic/

Formulary / Non-formulary brand-name

District Contribution

AETNA RATES EFFECTIVE 09/01/2016 Employee Only Employee & Spouse Employee & Children Employee & Family

$37.50 / $87.50 / $175

Monthly Premium $338.63 $610.23 $542.04 $812.49

Employee Monthly Cost

$0.00 $271.60 $203.41 $473.86

20% In-Network 50% Out-of-Network

$5,000/ $10,000

$6,350 / 2x

20% after deductible 20% after deductible

$35/$70/$100

20% after deductible

20% after deductible Covered in full

$250 copay

*copay

waived if admitted

20% after deductible

$15 / $35 / $70 $37.50 / $87.50 / $175

Monthly Premium $373.44 $670.90 $579.06 $894.52

Employee Monthly Cost

$17.55 $315.01 $223.17 $538.63

80% In-Network 50% Out-of-Network

$1,000 / $2,000

$2,500 / 2x

20% after deductible 20% after deductible

$20/$40/$75

20% after deductible 20% after deductible

Covered in full

$150 copay

*copay

waived if admitted

20% after deductible

$15 / $35 / $70 $37.50 / $87.50 / $175

Monthly Premium $585.30 $1,052.88 $936.26 $1,403.84

Employee Monthly Cost

$229.41 $696.99 $580.37 $1,047.95

80% In-Network 50% Out-of-Network

$2,000 / $6,000

$6,000 / 2x

20% after deductible 20% after deductible

$25/$25/$75

20% after deductible 20% after deductible

Covered in full

$200 copay

*copay

waived if admitted

20% after deductible

$15 / $35 / $70 $37.50 / $87.50 / $175

Monthly Premium $548.90 $987.60 $878.48 $1,316.10

Employee Monthly Cost

$193.01 $631.71 $522.59 $960.21

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