Let's go! Get the most from your 2023 health benefits
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Let’s go! Get the most from your 2023 health benefits
Care for the whole you Health care made simple
At Aetna®, a CVS Health® company,
we bring you a connected,
convenient and affordable health
care experience with:
Large national provider networks
for physical and mental health
care
One-on-one personalized support
programs
Check to see if your providers
are in our network at
Aetna is the brand name used for products and services provided by one or more of the Aetna group
Aetna-JPMC.com.
of companies, including Aetna Life Insurance Company (Aetna).
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 2
Support & access
Support when you want it
Seamlessly connect with care and manage your benefits — at home or on the go. Get
smart, simple, convenient ways to take charge of your health care and benefits.
PayFlex® app and
Aetna Health℠ app and website
Aetna® member website
The PayFlex app and
Keep up with your health, website give you
track your benefits, control and flexibility to
access your medical ID manage your Medical
card and more, at home or on the Reimbursement Account
go. Once you’re a member, (MRA), Health Care
register at Aetna.com or text Spending Account (HCSA)
AETNA to 90156 for a link to and Dependent Care
download the app and create Spending Account (DCSA) in
an account.* real time. Visit PayFlex.com
or download the app.
Aetna Concierge
Health care is personal and
full of tough questions. Call
one number for all of your needs,
1-800-468-1266 (TTY: 711),
Monday through Friday,
8 AM to 8 PM local time.
Easily access your PayFlex accounts through
single sign-on from MyHealth or when logged
*Terms and conditions: aet.na/Terms. Privacy policy: Aetna.com/legal-notices/privacy.html. in at Aetna.com.
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 3
The network
Know your network
Check to see if your providers are in our network.
A network is a group of health care providers. It includes doctors, specialists, mental health providers,
hospitals, surgical centers and other facilities. In-network providers charge lower rates. You can search for
in-network doctors, labs, urgent care centers, hospitals and more at Aetna-JPMC.com. Or use the Aetna
Health℠ app to find providers when you’re on the go.
High-performing facilities
You’ll also have access to a special network of health care facilities:
• Institutes of Excellence™ for transplants, fertility treatment (Family Building benefits), rare conditions
and more
• Institutes of Quality® for bariatric, heart and spine surgeries, behavioral health, and knee and hip replacements Continue your
• National Medical Excellence Program® for organ transplants, rare diseases and heart surgery for children
current treatment
Are you new to Aetna and receiving ongoing
treatment from a provider who’s not in the
The Aetna® network is vast and growing.1 network? If approved, you may be eligible to
See what it has to offer. continue seeing the provider for a limited time
period and receive in-network benefits.
5,000+ Some situations that may qualify for transition
hospitals of care include:
• Chemo or radiation therapy
800,000+ • Organ transplant
primary care doctors • Pregnancy
and specialists
• Recent major surgery
1.6 million • Terminal illness
health care providers To learn more or apply, call your Aetna Concierge
or click here.
1
Internal Aetna data. Accessed June 2022.
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 4
Health resources
Support for physical and
mental health
Your medical plan does more than pay claims. It also helps you manage
your overall health and well-being.
Primary care provider (PCP) Family Building benefits
Your PCP knows you and your health history. They WINFertility nurses can help you select a high-quality
provide annual physicals and vaccines, diagnose, provider, understand your treatment options, and
and treat problems. Many PCPs now offer telehealth provide clinical and emotional support along your
visits and after-hours appointments. Talk to your PCP family planning journey.
about your options. Family Building benefits have a $30,000 medical
Virtual care with Teladoc® lifetime limit. (Enrollment with WINFertility and
completion of a nurse consultation is required to
Connect with a provider by video, phone or app for:
unlock this benefit level. Otherwise the medical
• Non-emergency medical care 24/7, for things like lifetime limit is $10,000.)
colds, flu, allergies and urinary tract infections
To enroll with WINFertility, call 1-833-439-1517,
• Mental health counseling by appointment, for Monday through Friday, 9:00 AM to 7:30 PM ET.
things like addiction, depression, anxiety or family
difficulties Emotional and behavioral health
Staying healthy is more than just taking care of your
Visit Teladoc.com/Aetna, call 1-855-TELADOC
physical body. Taking care of your mental health is
(1-855-835-2362) or download the Teladoc app.
just as important. It’s part of caring for the whole you.
No-cost preventive care No matter what you’re facing — a mental health
condition, a parenting challenge or a few tough weeks
Preventive care, such as an annual checkup, routine
— you’re not alone. Connect with someone, find
colonoscopy or vaccines, help prevent health
community support or learn more on your own to feel
problems or catch them early when they’re usually
better, sooner.
easier to treat. As long as you stay in network, you
pay nothing for preventive care, subject to age and To learn more, log in at AetnaBehavioralHealth.com
frequency limits. Learn more about preventive care. or call your Aetna Concierge.
Continued
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 5
Health resources
When you need support
Wherever you are on your health journey, there’s probably a program
or resource that can support you on your way.
24-Hour Nurse Line Aetna One® Choice program
Talk with a registered nurse about a health Get personal attention from a nurse for your
condition or an upcoming test or procedure. chronic condition to stay healthy and achieve
your goals.
Virtual doctor visits 24/7/365
Connect with a licensed doctor by phone, Online Cancer Support Center
video or app. Find information on everything from routine
screenings to resources for patients and
Mental health support families.
Connect with care and resources for your
emotional and mental well-being, in person Online Back and Joint Care Support
or by phone or video. Center
Work with a personal advocate if your child
Enhanced maternity and fertility has a special need, such as autism or a
support behavioral health issue.
Enjoy extra support for a healthy pregnancy
right from the start, including support from a FACT (Family Advocacy Care Team)
trained fertility advocate as needed. Find information on back and joint pain,
including causes of pain, treatment options
Health coaching and tips for long-term health.
Work with a nurse, social worker or dietitian
to make healthy lifestyle changes that last. Centers of Excellence and Quality
Don’t forget: To qualify for Wellness Access high-performing facilities for bariatric
Rewards, telephone coaching must be surgery, transplants, specialty surgery,
completed by December 30, 2022. infertility treatment, rare conditions, mental
health and substance abuse.
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 6
MRA & spending accounts
Ways to save and pay
Stretch your health care dollars.
Medical Reimbursement Account (MRA) Manage your accounts through PayFlex®
Your MRA is funded by JPMorgan Chase when you You’ll manage your MRA and spending accounts
and your covered spouse/domestic partner complete through Aetna/PayFlex. Log in to your Aetna website
wellness activities. You can’t contribute to the MRA. once you’re a member and scroll down to the
MRA funds can only be used to pay for eligible Manage in PayFlex link on your home page.
medical and prescription drug expenses and are During Annual Enrollment, you’ll decide how you
used before the Health Care Spending Account want to access the funds in your MRA and HCSA.
(HCSA) for these expenses. This election can’t be changed at any other time
Complete your biometric Wellness Screening and of year.
Wellness Assessment between November 20, 2021 Choose either:
and November 18, 2022 (11:59 PM ET) to earn
• Automatic Claim Payment — funds from your
Wellness Rewards in 2023.
MRA and then HCSA (if you have one) are
For details on how to earn MRA funds, visit MyHealth. automatically used to pay your portion of medical
care and prescription expenses until funds run out.
Two spending accounts
Automatic verification takes place to confirm the
In addition, you can sign up for one or both of these
expense is eligible.
spending accounts that you contribute to and spend
• Debit card — use your PayFlex Card® to pay for
tax free:
eligible expenses directly. In some cases, you’ll
• Health Care Spending Account (HCSA) to pay for need to submit documentation to confirm the
eligible health care expenses purchase was an eligible expense, so be sure to
• Dependent Care Spending Account (DCSA) to keep your receipts.
pay for eligible day care expenses
Easily access your PayFlex accounts through
single sign-on from MyHealth or when logged
in at Aetna.com.
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 7
Plan options
Know the basics
Learn the definitions of any unfamiliar terms with
the glossary on page 12.
Compare and decide
This chart shows your JPMorgan Chase Core medical plan options for 2023 for Active employees.
2023 medical benefits provisions (what you pay) Option 1 Option 2
In network Out of network In network Out of network
Deductible
Total annual cash compensation: under $60,000 $500/$1,375/$2,250* $2,750/$4,125/$5,500* $1,500/$2,875/$4,250* $4,750/$7,125/$9,500*
Total annual cash compensation: $60,000 and over $1,250/$2,125/$3,000* $2,750/$4,125/$5,500* $2,250/$3,625/$5,000* $4,750/$7,125/$9,500*
Coinsurance max (excludes deductible and Rx)
Total annual cash compensation: under $60,000 $1,500/$2,000/$2,500*
$3,250/$4,625/$6,000*
Total annual cash compensation: $60,000–$149,999 $2,000/$2,750/$3,500* $6,000/$8,000/$12,000* $6,000/$8,000/$12,000*
Total annual cash compensation: $150,000+ $2,750/$3,875/$5,000* $3,550/$5,075/$6,600*
Coinsurance levels
Preventive care Free 50% after deductible
Primary care office visit (PCP, pediatrician, ob/gyn) 10%; not subject to deductible 50% after deductible
Mental health/substance abuse outpatient therapy
• Psychologist, social worker, therapist 10%; not subject to deductible 50% after deductible
• Psychiatrist 20%; not subject to deductible 50% after deductible
Virtual care with Teladoc®
• General medicine 10%; not subject to deductible
• Mental health Not applicable Same as Option 1
- Psychologist, social worker, therapist 10%; not subject to deductible
- Psychiatrist 20%; not subject to deductible
Specialist office visit 20% after deductible 50% after deductible
Other medical costs
20% after deductible 50% after deductible
(hospitalization, labs, etc.)
20% after deductible
Emergency care
(50% after deductible for non-emergencies)
Prescription drug benefits
Deductible and coinsurance maximum vary based on total annual cash compensation. Prescription drug benefits are managed by CVS Caremark®.
*Benefits coverage tiering: Employee, Employee + spouse/domestic partner or child(ren), Employee + spouse/domestic partner + child(ren) Continued
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 8
Plan options
Dental plan
During Annual Enrollment, you can sign up for the Aetna Dental® DMO®
plan, with access to over 118,0001 network dentists. You don’t need to
have an Aetna® medical plan to enroll in the Aetna dental plan. But with
the Aetna Dental/Medical Integration℠ program, combining both can
lead to better health.
22% fewer
hospital 5% lower Easy-to-use coverage with
admissions* medical costs* the DMO Plan
• Pick a primary care dentist (PCD) from the
42% fewer The benefits Aetna network. Covered family members can
major and basic of integrated 45% improvement each choose their own PCD.
dental services* in diabetes • See your PCD for regular exams, and to get
dental care management* referrals if you need specialty care.
• If you want, change your PCD once a month on
10% increase in 27% lower risk your member website. Switch by the 15th day
preventive scores for chronic of the current month. The change will start
the first day of the next month.
dental care* conditions*
Find network dentists
To see if your current dentist is in our network,
visit Aetna-JPMC.com or log in at Aetna.com if
*Ongoing, statistically valid analysis of Aetna Dental/Medical Integration program members. Aetna data. Of the you’re already a member. You can also call
diabetic members in the Aetna Dental/Medical Integration program who started going to the dentist, only 1-800-843-3661 (TTY: 711) to find network
17.8% are poorly controlled. For diabetic members in a comparable group with no Aetna Dental/Medical dentists or for more information.
Integration program, 32.6% are poorly controlled.
1
Internal Aetna data. Accessed July 2022.
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 9Getting started
Enroll
1 Sign up with Aetna during Annual Enrollment.
Aetna® makes Receive
it easy 2 If you’re new to Aetna, look for your ID card in the mail shortly
after you enroll.
Connect
3 Get the most from your plan by following the steps below.
Put your Aetna member Register for your member Register for your PayFlex® account online. Set up Teladoc® — virtual
ID card in your wallet, or website at Aetna.com. Seamlessly manage your MRA, HCSA and DCSA, if elected. doctor visits.
store a digital copy in the It’s your one-stop online resource To access your PayFlex account, log in to your Create an account now with your
mobile wallet on your to manage your benefits, find member website at Aetna.com and click the Manage information and medical history,
smartphone. network doctors, look up costs, in PayFlex link. Then, create a profile and register your so you’ll have quicker access to a
check on a claim, print an ID card account using your JPMorgan Chase Standard ID (SID) and doctor or mental health provider — by
Your Aetna ID card was mailed
and much more. debit card number (if you have one). Once registered, access phone or video — when you need care.
shortly after you enrolled.
To register, visit Aetna.com and your account anytime through single sign-on from MyHealth Doctors are available 24/7/365 for
Get a digital copy of click Login to get started. or when logged in at Aetna.com or PayFlex.com. non-emergency medical issues. Mental
your ID card through your health providers, such as a counselor,
Aetna member website or During Annual Enrollment, if you chose:
therapist or psychiatrist, are available by
the Aetna Health℠ app. • Automatic Claim Payment: There’s nothing more you appointment.
need to do.
To register, go to
• Debit card: If you already have a PayFlex debit card,
Teladoc.com/Aetna,
continue to use it in 2023. If not, you’ll receive a new card.
call 1-855-TELADOC
Call the number on the card to activate it. Enter your card
(1-855-835-2362) or
number and PIN, which is the last four digits of your SID.
download the Teladoc app.
Continued
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 10Getting started
Understanding the EOB
After you use your plan, you’ll receive an Explanation of Benefits (EOB).
It’s a document that shows details of claims that are processed over a short span of time. EOBs are typically
sent monthly. We like to show claims that occur together to give a full view of charges and health plan
payments. If there’s a delay in receiving your EOB, it might be because of this.
Look at your EOB carefully to make sure it’s correct. If you owe anything, you’ll receive a bill from your doctor
or health care provider(s).
Your EOB will show: Aetna Life Insurance Company
PO BOX 14079
LEXINGTON, KY 40512-4079
January 23, 2020
XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX
The amount you saved by using a
network provider
Explanation of Benefits (EOB) - This is not a bill
A summary of your deductible and
out-of-pocket limit balance for the plan year Track your health care costs
Definitions of commonly used terms A guide to key terms
Detailed information about any payments
made for the claims on the EOB
Your payment summary
Your plan paid You owe or already paid
What you may owe or have already paid Xxxxxxx Xxxxxxx
Amount
$56.42
Sent to
Xxxxxxx
Xxxxxxx Xxxxxxx $23.30 Xxxxxxx
$79.72
Access anytime
Notes or details about your claims Register at Aetna.com to receive your EOBs
electronically and to access them anytime on
the website or Aetna Health℠ app.
Continued
Care for the Support & The Health MRA & spending Plan Getting
whole you access network resources accounts options started
Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 11Getting started
Important terms to know
Here are common health insurance terms you may see throughout this
guide. Knowing what they mean can help you feel confident you’re
choosing the plan that’s right for you.
Claim Deductible Out of network
A request from a provider to be The amount you pay out of A provider or facility that doesn’t
paid by a health plan for health pocket for covered services have a contract with your health
services given. An example would before your plan starts to pay. plan. If you choose a doctor or
be the claim your doctor sends With a $1,500 deductible, for other health care provider that is
your health plan for an office visit. example, you pay the first $1,500 out of network, your plan may or
of covered services yourself. After may not pay some of that bill.
Coinsurance paying your deductible, you Choosing an out-of-network doctor
The percentage of the bill you pay contribute a portion of the cost or facility will cost you more.
after you meet your deductible. toward coinsurance for some
After you have paid your Although a provider may accept
covered services.
deductible in full, you pay only a Aetna®, they may be out of
percentage of your health care Explanation of Benefits (EOB) network, so you should always
expenses — your health plan Similar to a credit card statement check their status. Log in at
pays the rest. The most you’ll pay from your health plan. It highlights Aetna.com if you’re already a
in coinsurance is known as your charges, payments and any member, visit Aetna-JPMC.com
coinsurance maximum. balances that may be owed. EOBs or call your Aetna Concierge at
are available when you log in at 1-800-468-1266 (TTY: 711).
Covered Aetna.com and can also be mailed
Out-of-pocket maximum
When a health care service is to you. Learn more on page 11.
The most you’ll pay each year for
included in your plan benefits.
Network covered medical expenses. Once
Some services are covered
The facilities, providers and you hit your limit, you’re no longer
before you meet your deductible,
suppliers your health insurer or responsible for coinsurance.
while others might be covered
only after you’ve met your plan has contracted with to provide Full glossary
deductible. Check your plan health care services. To search For more health insurance term definitions,
documents for these details. the network, log in at Aetna.com visit Aetna.com/glossary.html.
if you’re already a member, or visit
Aetna-JPMC.com. Continued
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We’re here
for you
Health benefits and health insurance plans
contain exclusions and limitations. Not all health
services are covered. See plan documents for a
complete description of benefits, exclusions,
limitations and conditions of coverage. Plan
features and availability may vary by location
and are subject to change. Health information
programs provide general health information
and are not a substitute for diagnosis or
treatment by a dentist, doctor or other health
care professional.
PayFlex Systems USA, Inc. is an affiliate of Aetna
Life Insurance Company. This material does not
contain legal or tax advice. You should contact your
Find Get Enroll legal counsel if you have any questions. For more
information about PayFlex®, go to PayFlex.com.
your doctor in the answers to your during Annual Teladoc® is not available to all members. Teladoc
Aetna® network at questions. Call your Enrollment or if you and Teladoc physicians are independent
contractors and are not agents of Aetna®. Visit
Aetna-JPMC.com. Aetna Concierge at have a qualifying Teladoc.com/Aetna for a complete description
1-800-468-1266 life event. of the limitations of Teladoc services. Teladoc is
a registered trademark of Teladoc Health, Inc.
(TTY: 711).
Information is believed to be accurate as of the
production date; however, it is subject to change.
Refer to Aetna.com for more information about
Aetna plans.
CCG JPMORGAAN-0042 (9/22) ©2022 Aetna Inc.
Care for the Support & The Health MRA & spending Plan Getting
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Questions? Call your 24/7 Aetna Concierge at 1-800-468-1266 (TTY: 711), Monday through Friday, 8 AM to 8 PM local time. 13You can also read
