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Plan Disclosures

Choose the disclosure that applies to your plan.

These disclosure documents describe Banner|Aetna health benefits and health insurance plans. Find your plan type.

Medical

Affordable Care Act (ACA) Individual and Family Plans

Banner|Aetna ACA Individual and Family Plans - Pre-Enrollment Disclosure

Affordable Care Act Individual Health Insurance Broker Compensation Information For Policies Sold in Arizona for the 2022 Calendar Year

2022 Broker Commission Schedule

State

Amount per enrolled member per month*

Arizona

$20

*Commissions are payable to a maximum of five members per policy.

In addition to direct commissions, your broker may also be eligible for a bonus program.

A one-time bonus for new members enrolled on January 1, 2022, and February 1, 2022, according to the following schedule:

Amount of members

Amount of payment per enrolled member

10-24 members

$25

25-49 members

$50

50+ members

$75

The broker bonus program applies only to policies sold in Arizona for the 2022 calendar year. Certain other conditions apply.

Plan Sponsor / Employer Plans

How Banner|Aetna Pays Out-of-Network Benefits

PPO, Open Access EPO Plus and Open Access POS II - Self Insured plans

PPO, Open Access Managed Plus, Open Access HMO and Open Access HMO Option - Fully Insured plans

HMO

Note about employer-funded plans: State mandates do not apply to most self-funded plans governed by ERISA. If you are unsure if your plan is self-funded and/or governed by ERISA, please confer with your benefits administrator. Plan documents may supersede the information on this website.

Dental

Banner|Aetna members receive dental benefits from Aetna. Aetna provides certain management services to Banner|Aetna. Please refer to aetna.com for more information.

Important benefits for women

Women’s Health and Cancer Rights Act of 1998

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, 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.

Benefits will be provided to a person who has already undergone a mastectomy as a result of breast cancer while covered under a different health plan. Coverage is provided in accordance with your plan design and is subject to plan limitations, copays, deductibles, coinsurance and referral requirements, if any, as outlined in your plan documents. For more information, please contact Member Services at the number on your ID card, or the links below.

Centers for Medicare & Medicaid Services fact sheet
U.S. Department of Labor website

Member Rights and Responsibilities

View the Members Rights

Note about employer-funded plans: State mandates do not apply to self-funded plans governed by ERISA. If you are unsure if your plan is self-funded and/or governed by ERISA, please confer with your benefits administrator. Specific plan documents supersede general disclosures contained within, as applicable.

Dental benefits and dental insurance plans are offered, underwritten or administered by: Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York,  Aetna Health Insurance Company, Aetna Life Insurance Company, Aetna Dental Inc., and/or Aetna Dental of California Inc. (Aetna).

Transparency in coverage

Banner|Aetna – machine readable files

If you are looking for Small Group AFA plans click here.

Transforming health care, together

Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions.

Contact us

Banner Aetna Partnership Logo Banner Aetna Partnership Logo

Health benefits and health insurance plans are offered, underwritten, and/or administered by Banner Health and Aetna Health Insurance Company and/or Banner Health and Aetna Health Plan Inc. (Banner|Aetna). Banner|Aetna is an affiliate of Banner Health and of Aetna Life Insurance Company and its affiliates (Aetna). Each insurer has sole financial responsibility for its own products. Aetna and Banner Health provide certain management services to Banner|Aetna.  Aetna and CVS Pharmacy® are part of the CVS Health family of companies. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are both within the CVS Health family.

Access to the 98point6 application is included in all Banner|Aetna ACA individual & family plans. 98point6 is not available in all Banner|Aetna plans offered through employers. 98point6 is a registered trademark of 98point6 inc.

This material is for information only and is not an offer or invitation to contract. Providers are independent contractors and are not agents of Banner l Aetna. Provider participation may change without notice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Information is believed to be accurate as of the production date; however, it is subject to change.

Language Assistance Language services can be provided by calling the number on your member ID card. For additional language assistance: Español | 中文 | Tiếng Việt | 한국어 | Tagalog | Pусский | العربية | Kreyòl | Français | Polski | Português | Italiano | Deutsch | 日本語 | فارسی | Other Languages…