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September 21, 2001
Aetna to Offer PPO/Health Savings Plan
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The Aetna HealthFund, which is aimed at self-insured employers with 300 to 3,000 employees, allows employers to spend a fixed amount for the year on employee health benefits.
The HealthFund will offer the services of a preferred provider organization (PPO) but allows the employer to set up a health savings account to cover health care costs, including PPO deductibles, the Times-Union reports.
PPOs allow members to pay discounted prices for going to physicians in a predetermined group, though they can still go to providers outside the network at a higher price.
The amount of coverage and cost of HealthFund depends on the system set up between Aetna and the employer.
According to the Times-Union, Aetna expects annual PPO deductibles to range from $1,500 to $3,000 and the employer-funded health savings accounts to range from $500 to $1,000.
Some companies may choose to add a flexible spending account so employees can put pre-tax dollars aside to pay for the health costs that exceed the balance of their employer-sponsored health savings account or to pay for a supplemental insurance. The funds in the employer-sponsored account do not roll over from year to year, but funds in the employee account can.
While this is the first national launch of such a product by a major health insurer, there have been experiments by others on a regional or smaller basis.
The idea of offering more choice to clients while also shifting some spending responsibility onto employees is responsive to several trends in health care coverage.
Steven Wojcik, director of public policy for the Washington Business Group on Health, told the newspaper that employers and employees are increasingly looking for choice and say in their health benefits.
"These types of products are definitely being explored," Wojcik said. "What companies have to ask themselves is 'How do the costs of people who choose that product compare to those who choose a traditional plan?'"
As frustrations mount with the cost and access in typical health benefit plans, Wojcik said, employers and employees are more open to other options. But because this plan and others of similar nature are still new to large employers, their effectiveness should be regularly evaluated.
The Aetna plan is intended to be another option to offer along with traditional health benefit products, not as a replacement plan, Aetna said.
To view the Florida Times-Union article, click here.