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Solo W-2™ — Group Medical and Dental Insurance from Aetna

Guarantee Issue Insurance
VSP Vision Care
Two Exceptional Medical Plans
Medicare Coverage
Two Exceptional Dental Plans


Guarantee Issue. You Cannot be Turned Down or Rated Up.
 
 
All Full-time Employees Qualify
All full-time Solo W-2™ employees and their dependent family members qualify for Solo W-2™ group medical, dental and vision insurance. Coverage goes into effect on the first day of the month following your first 30 days of employment.
 
No Individual Underwriting
Insurance is guarantee issue, meaning that plan availability and premium cost are unaffected by preexisting medical conditions. (Note: If there has been a lapse in coverage, then preexisting conditions may be excluded for a period of one year.) Premium cost is based solely on the type of plan you select and the number of parties insured (e.g., you, you plus your spouse or domestic partner, you plus your children, or your entire family). Federal law prohibits individual underwriting of employees in group plans. You cannot be turned down or rated up.
 
Funded by Your Revenue Stream
Your Solo W-2™ division will pay for 80% of your group insurance premiums with tax-free dollars funded by your division's revenue stream. You pay the other 20% with tax-free dollars from your gross wage. This particular 80% + 20% arrangement is a requirement of Aetna that allows employees to opt out of coverage.
 
Tax-free Reimbursement of Medical Expenses
Your division will also reimburse you with tax-free dollars for out-of-pocket copays, deductibles, and other non-covered dental and medical expenses up to $10,000 per year. Qualified expenses must be supported by proof of payment. Reimbursement is subject to the availability of funds in your Solo W-2™ division operating account.
 
Easy Enrollment
Your Division Administrator will send you an application packet when you become a Solo W-2™ employee.
 


VSP Vision Care is Available with All Medical and/or Dental Plans
 
 

VSP Vision Care Coverage
Available Nationwide

  • Detailed VSP Vision Plan Description (PDF Document)

  • Plan Cost for VSP Vision Care in 2010:
    (Note: VSP Vision Care must be purchased with Medical and/or Dental insurance to qualify for these very low rates.)

    Coverage For Monthly Premium
    Employee only $9.93
    Employee + Spouse or Domestic Partner $17.02
    Employee + Children $17.38
    Family
    $28.01
 
 


Choose From Two Exceptional Medical Plans
 
 

Preferred Provider Organization – PPO Plan
Available nationwide.

  • Detailed PPO Medical Plan Description (PDF Document)

  • Plan Cost for PPO in 2010:

    Coverage For Monthly Premium
    Employee only $782.68
    Employee + Spouse or Domestic Partner $1,800.15
    Employee + Children $1,565.37
    Family
    $2,504.57
 

High Deductible Health Savings Account – PPO/HSA Plan
Available nationwide.

  • Detailed HSA Medical Plan Description (PDF Document)

  • HSA Pamphlet (PDF Document)

  • HSA Custodial Account Information (PDF Document)

  • Highlights of the Aetna HSA Savings Account

    • You may make contributions to your HSA up to the annual limits set by the IRS.

    • Your HSA contributions are tax-free.

    • Your HSA funds are invested in a fixed-interest account that earns interest tax free! In this regard, your HSA account is similar to a typical IRA.

    • You may pay for all qualified out-of-pocket medical expenses such as deductibles, copays, prescriptions, non-covered medical products and procedures, and a wide variety of over-the-counter items (typically by using your HSA debit card) with tax-free dollars from your health savings account.

    • You may pay for COBRA premiums from your HSA account during periods of unemployment.

    • You may pay for long term care and home care from your HSA account.

    • At the end of the year, money left in the account rolls over to the next year.

    • Should you leave Solo W-2, Inc., you take your HSA with you.
  • Plan Cost for High Deductible HSA in 2010:

    Coverage For Monthly Premium
    Employee only $540.48
    Employee + Spouse or Domestic Partner $1,243.19
    Employee + Children $1,080.97
    Family
    $1,729.58
 

DocFind Provider Directory
Click here for Step-by-Step Instructions to find a participating physician near you.

To access DocFind, simply log on to www.aetna.com. If you are not yet a member, go directly to DocFind from the Aetna home page. If you are already a member, go to Aetna Navigator to access DocFind.

 


Medicare Coverage
 
 

All Medicare Recipients Qualify
Your division of Solo W-2, Inc. will reimburse you and your Medicare-qualified dependent family members for the out-of-pocket costs of Medicare premiums and third-party Medicare insurance premiums, including parts A, B, C and D.

 

 

Funded by Your Revenue Stream
Your Solo W-2™ division will pay for 100% of your Medicare premiums and third-party Medicare insurance premiums with tax-free dollars funded by your division's revenue stream. As with all reimbursed expenses, reimbursement for Medicare premiums and third-party Medicare insurance is subject to the availability of funds in your Solo W-2™ division operating account.

 

 

Not Subject to Standard Reimbursement Limits
Medicare coverage replaces the coverage provided by Solo W-2™ group medical insurance. Therefore, your division of Solo W-2, Inc. excludes reimbursements for Medicare premiums and third-party Medicare insurance premiums from both the standard $10,000 limit on out-of-pocket medical expense reimbursements and the 50%-of-gross-wage limit on reimbursements for all out-of-pocket expenses (medical + business). See Tax-free Expense Reimbursements.

 


Choose From Two Exceptional Dental Plans
 
 

Dental Health Maintenance Organization – DMO Plan
Available nationwide.

Dental Preferred Provider Organization – PPO Plan
Available nationwide.

  • Detailed DMO Dental Plan Description (PDF Document)

  • Detailed PPO Dental Plan Description (PDF Document)

  • Choose either plan. You may switch from DMO plan to PPO plan and back again monthly.

  • Plan Cost for Both DMO and PPO Dental Plans in 2010:

    Coverage For Monthly Premium
    Employee only $47.36
    Employee + Spouse or Domestic Partner $95.59
    Employee + Children $103.66
    Family
    $151.90
 

DocFind Provider Directory
Click here for Step-by-Step Instructions to find a participating dentist near you.

To access DocFind, simply log on to www.aetna.com. If you are not yet a member, go directly to DocFind from the Aetna home page. If you are already a member, go to Aetna Navigator to access DocFind.

 


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