Aetna Medical Insurance
Trinity University contracts with Aetna to process our claims and as our Aetna Choice POS II (Open Access) Network Provider.
There are three plan options available to you and your family: Aetna 80 plan, Aetna 70 PPO plan, and Aetna HDHP Plan.
What is a PPO?
A PPO, or Preferred Provider Organization, contracts with physicians and hospitals to secure preferred rates for you and your covered family members. A PPO allows you the freedom to choose virtually any health care provider and no physician referral is required. It is up to you whether you go in-network and receive a higher benefit or go out-of-network and pay more.
Patient and Affordable Care Act
Patient protection information about essential wellness services including filing claims, appeals, and external reviews.
Complaints and Appeals
The amendment for Aetna complaints, appeals, and claims procedure.
Mental Health Parity Plan
Important notices and procedures about mental health disorders and substance abuse treatment for inpatient and outpatient care.
Plan employees may:
- Disclose PHI to a Plan Sponsor in order to carry out administrative functions that the Plan Sponsor performs, but only according to the Policy regarding Uses and Disclosures to the Plan Sponsor
- Not disclose PHI to the Plan Sponsor for the purpose of employment-related actions or decision or in connection with any other employee or benefit plan of the Plan Sponsor
- Use and Disclose PHI for Treatment, Payment, and Health Care Operations. However, the Plan and its employees shall only Use and Disclose the Minimum Necessary amount of information required to complete the desired task.
Women’s Health and Cancer Rights Act Annual Notice
The Women's Health and Cancer Rights Act (WHCRA) of 1998 requires group health plans to make certain benefits available to participants who have undergone a mastectomy. In particular, a plan must offer mastectomy patient benefits for:
- All stages of reconstruction of the breast on which the mastectomy was performed;
- Surgery and reconstruction of the other breast to produce a symmetrical appearance;
- Prostheses; and
- Treatment of physical complications of the mastectomy, including lymphedema.
Our plan complies with these requirements. Benefits for these items generally are comparable to those provided under our plan for similar types of medical services and supplies. Of course, the extent to which any of these items is appropriate following mastectomy is a matter to be determined by consultation between the attending physician and the patient. Our plan neither imposes penalties (for example, reducing or limiting reimbursements) nor provides incentives to induce attending providers to provide care inconsistent with these requirements