Healthcare Options for Part-time Employees

Employees who work less than 30 hours per week may choose among a Basic Plan, an Enhanced Plan and an Enhanced Plus Plan. You also may elect dental and/or vision coverage.

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The Aetna medical coverage option for part-time employees is not a major medical plan but provides benefits and discounts to help reduce your out-of-pocket medical costs. Fixed benefits are paid for doctor’s visits, medical imaging, prescriptions and hospital services. Though providers are paid directly, this plan does not pay the full cost of medical care. You are responsible for making sure your charges are completely satisfied.

You may choose between a Basic Plan, an Enhanced Plan and a new Enhanced Plus Plan. Enhanced and Enhanced Plus have higher allowances in exchange for higher premiums. Log in to Asurion Benefits Central to see your costs and benefit options.

Part-time Benefits at a Glance
Aetna Plan

Benefits

Basic

Enhanced

Enhanced Plus

Covered benefits for inpatient stays

Hospital stay—admission
Pays a lump sum benefit for the first day of your stay in a non—ICU room of a hospital. 2nd admission requires 30 day separation period from the first stay. Maximum 2 stays per plan year

$500

$700

$1,100

Hospital stay—intensive care unit (ICU)—admission
Pays a lump sum benefit for the initial day of your stay in an ICU room of a hospital. 2nd admission requires 30 day separation period from the first stay. Maximum 2 stays per plan year

$1,000

$1,400

$2,200

Hospital stay—daily
Pays a daily benefit beginning on day 2 for each day of your stay in a non-ICU room of a hospital. Maximum 365 days per plan year

$200

$500

$7,500

Hospital stay—ICU daily
Pays a daily benefit beginning on day 2 for each day of your stay in an ICU room of a hospital. Maximum 365 days per plan year

$400

$1,000

$2,200

Newborn routine care
Pays a lump sum benefit on the birth of your newborn with an inpatient stay. Maximum 1 day per plan year

$100

$300

$400

Observation unit
Pays a lump sum benefit for the initial day of your observation. Maximum 1 stay per plan year

$100

$300

$400

Substance abuse stay—daily
Pays a daily benefit beginning on day 1 for each day you have a stay in a substance abuse treatment facility. Maximum 365 days per plan year—shared with the hospital stay benefit max

$200

$500

$750

Mental disorder stay—daily
Pays a daily benefit for each day you have a stay in a mental disorder treatment facility. Maximum 365 days per plan year—shared with the hospital stay benefit max

$200

$500

$750

Rehabilitation unit stay—daily
Pays a daily benefit beginning on day 1 for each day of your stay in a rehabilitation unit immediately after your hospital stay. Maximum 365 days per plan year—shared with the hospital stay benefit max

$200

$500

$750

Skilled nursing facility stay—daily
Pays a daily benefit beginning on day 1 for each day you have a stay in a skilled nursing facility. Maximum 365 days per plan year—shared with the hospital stay benefit max

$200

$500

$750

Hospice care—daily
Pays a daily benefit beginning on day 1 for each day you have a stay in a hospice facility or each day you receive hospice care. Maximum 365 days per plan year—shared with the hospital stay benefit max

$500

$500

$750

Covered benefits for surgery

Inpatient surgery
Pays a daily benefit for each day you have an inpatient surgical procedure during your stay. Maximum 2 days per plan year

$200

$450

$675

Outpatient surgery—hospital outpatient or ambulatory surgical center
Pays a daily benefit for each day you have an outpatient surgical procedure performed by a physician. Maximum 2 days per plan year

$200

$450

$675

Outpatient surgery—doctor’s office, urgent care facility or hospital emergency room
Pays a daily benefit for each day you have an outpatient surgical procedure performed by a physician. Maximum 2 days per plan year

$50

$100

$150

Covered benefits for doctor’s visits

Doctor visits—office / urgent care facility
Pays a daily benefit for each day you visit a physician. Maximum 7 days per plan year

$50

$70

$90

Doctor visits—walk-in-clinic / telemedicine visit
Pays a daily benefit for each day you visit a physician. Maximum 7 days per plan year

$25

$35

$60

Covered benefits for outpatient services

Ambulance—ground
Pays a daily benefit for when you are transported by a licensed professional ambulance company by a ground ambulance to or from a hospital, or between medical facilities. Maximum 1 day per plan year

$100

$100

$100

Ambulance—air
Pays a daily benefit for when you are transported by a licensed professional ambulance company by Air ambulance to or from a hospital, or between medical facilities. Maximum 1 day per plan year

$500

$500

$500

Emergency room
Pays a daily benefit for each day you receive care in a hospital emergency room for an emergency medical condition. Maximum 2 days per plan year

$100

$275

$475

Equipment and supplies
Pays a daily benefit for each day on which equipment and supplies are purchased and for any associated maintenance and repair. Maximum 5 days per plan year

$20

$45

$65

X-ray and lab
Pays a daily benefit for each day on which you have an X-ray or lab. Maximum 3 days per plan year

$25

$50

$100

Medical imaging
Pays a daily benefit for each day on which you have a covered medical imaging test. Maximum 1 day per plan year

$150

$250

$250

Prescription drugs
Pays a daily benefit for each day you have a prescription filled by a licensed pharmacist on an outpatient basis. Maximum 12 days per plan year

$20

$45

$65

Accidental injury treatment
Pays a benefit when you are treated in a doctor’s office, hospital emergency room or walk-in clinic for an accidental injury. Maximum 1 day per plan year

$100

$300

$500

Lodging
Pays for one motel / hotel room for a companion to accompany you for each day of a stay. Your stay must be more than 50 miles from your home. Maximum 10 days per plan year

$100

$100

$100

Transportation
Pays a benefit for each day on which you travel from your residence more than 50 miles one way on doctor’s advice. Maximum 1 day per plan year

$100

$100

$100

Prescription drugs

We will pay the prescription drugs benefit amount shown in the schedule of benefits section of your certificate for each day you have a prescription filled. Prescription drugs must be dispensed by a licensed pharmacist on an outpatient basis.

The prescription drugs benefit amount will not be paid for:

  • Immunization agents, biological sera, blood or blood plasma
  • Any contraceptive method, device, material or medicine
  • Prescription drugs, medicine, or insulin used by, or administered to, you while you are confined as an inpatient to any facility or institution
  • Prescription drugs and medicine related to infertility
  • Therapeutic devices or appliances

Some benefits of choosing this coverage include:

  • Your enrollment is guaranteed with no eligibility screening.
  • You’ll benefit from negotiated group rates and in-network discounts for common services.
  • Your prescriptions will be filled at discounted rates through 96% of retail pharmacies across the country that participate in the Aetna network.
  • You’ll be able to cover eligible family members.
  • Your premiums will be made through convenient payroll deduction, and there’s even a missed premium forgiveness feature. (Refer to Plan literature for details.)
  • You can take your coverage with you if you leave Asurion.

Here’s an example of how the Plan pays benefits.

This coverage covers a portion of your bill for common dental procedures.

Dental Plan Benefits

Maximum benefit per coverage year

$500

Deductible per coverage year

$50

Preventive services (includes checkups and cleanings)

Member is responsible for paying up to 20% of the Recognized Charges. These services have no waiting period.

Basic services (includes fillings, oral surgery, and denture, crown, and bridge repair)

Member is responsible for paying up to 40% of the Recognized Charges. Member needs to be enrolled in the dental plan without interruption for 3 months before the plan begins to pay for these services.

Major services (includes perio and endodontics, crowns, bridges and dentures)

Member is responsible for paying up to 50% of the Recognized Charges. Member needs to be enrolled in the dental plan without interruption for 12 months before the plan begins to pay for these services.
The plan requires that a deductible is met before a benefit is paid. A deductible is the amount a member must pay for eligible expenses before the plan begins to pay benefits.

This coverage reimburses you for an exam, frames and lenses, or contact lenses up to an annual limit.

Vision Plan Benefits

Maximum benefit per coverage year for eye exams, frames, lenses, contacts and contact lens exams

$100

Fees for other services must be paid by the member. Benefit period is 12 consecutive months beginning on the later of member’s effective date or member’s most recent eye exam covered under this plan. This plan, alone, does not meet Massachusetts Minimum Creditable Coverage standards.

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