Health Plans

Health Plan Overview

Aetna POS :

A Point-of-Service (POS) plan allows members to choose to receive services from a participating or non-participating network provider or facility. The Emory Aetna POS is an open-access plan that provides the freedom to choose any provider and does not require a primary care physician (PCP) referral unless you see an Out-of-Network specialist. The plan features a network of providers and facilities. This plan has the lowest deductibles and co-pays. However, it has the highest employee contributions.

BCBS of GA PPO:

A Preferred Provider Organization (PPO) is a managed care plan that has arrangements with doctors, hospitals and other providers of health care. The plan does not require a primary care physician, but participants are encouraged to use network providers to receive higher benefit levels. This plan offers the broadest network of physicians in Georgia and has lower employee contributions.

What is "alike" among the Health Plans?

Emory's heath plans:

• Offer a broad network of physicians in Georgia
• Do not require selecting a primary care physician
• Do not require a referral to see a specialist
• Have an out-of-pocket maximum
• Have a lifetime maximum of $2 million
• Tier Zero (no co-pay for certain generic prescription drugs)

What are the "differences" among the Health Plans?

Everyone’s health care needs are different. That’s why it’s important to carefully decide which medical plan will work best for you and your family. In choosing a medical plan, you should ask yourself several questions and consider each answer as you evaluate all of Emory’s medical plans:

•   How much health care will I need next year?

•   What will it cost me?

•   Am I more concerned about the cost of my monthly contributions or my out-of-pocket cost?

Important Notes:

• Pre-Tax Savings - Your health contributions are withheld from your paycheck on a pre-tax basis. These pre-tax contributions are deducted before federal and most state and local taxes are collected, therefore helping you offset your contributions to the plans via the taxes you save.

Network Definitions

Each of the medical plans offer three network options:

• Core Network providers have lower co-pays, co-insurance, and deductibles.
  
  Core Network hospitals include:
• Emory University Hospital Midtown
• Emory University Hospital
• Emory University Orthopaedic & Spine Hospital
• Emory Johns Creek Hospital
• Emory Eastside Medical Center
• Emory Adventist Hospital
• Wesley Woods Hospital
• Children's Healthcare of Atlanta (Egleston and Scottish Rite)
• Northside Hospital (Johnson Ferry Road location only)
• Newton Medical Center

Core Network Physicians include:
Emory physicians
Other participating physicians as specified by each plan

• In-Network providers are part of Aetna POS and/or BCBS-GA PPO plan networks and provide In-Network benefits. The co-pays, co-insurance, and deductibles are higher than in the Core Network.
  
  To locate a participating Core or In-Network physician or facility, contact the appropriate vendor:
  

  Aetna POS	www.aetna.com/docfind/custom/emory	(800) 847-9026
  BCBS of GA PPO	www.bcbsga.com/emory Select "Find a Doctor"	(800) 414-7977

• Out-of-Network providers are not participating providers with either Aetna POS or BCBS-GA PPO. The co-pays, co-insurance, and deductibles are the highest, and the costs of services can be higher than In-Network costs.

Health Plan Employee Contributions

Please note that the premiums listed below will be deducted from your monthly payroll.

2009 - 2010 Health Plan Rates

*Special Family: A married couple in the Emory Residency Training Program insuring their dependent child(ren). Both spouses must be in the Residency Training Program at the same time.

Vendor Contacts

Aetna
(800) 847-9026

Blue Cross Blue Shield of Georgia
(800) 411-2273

Plan Information Documents

2009-2010 POS Medical Plan in Detail	PPO Summary Plan Description
2009-2010 BCBS Medical Plan in Detail	POS Summary Plan Description

Emory University Benefits

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Atlanta, GA 30322
(404) 727-7613

Disclaimer

Emory reserves the right to terminate, suspend, withdraw, amend or modify the Plan in whole or in part at any time. Further, Emory reserves the right to terminate or modify coverage for any group of employees, active or retired and their dependents or a class of dependents at any time.