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 PDF will open in new window

Banner|Aetna ACA Individual and Family Plans - Pre-Enrollment Disclosure - Spanish PDF will open in new window

Affordable Care Act Individual Health Insurance Broker Compensation Information For Policies Sold in Arizona for the 2025 Calendar Year

2025 Broker Commission Schedule PDF will open in new window

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 PDF will open in new window

PPO, Open Access Managed Plus, Open Access HMO and Open Access HMO Option - Fully Insured plans PDF will open in new window

HMO PDF will open in new window

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.

Appeal Packets

Arizona Appeal Packet Commercial PDF will open in new window

Arizona Appeal Packet Commercial - Spanish PDF will open in new window

Arizona Appeal Packet IFP PDF will open in new window

Arizona Appeal Packet IFP - Spanish PDF will open in new window

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 PDF will open in new window

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

Learn more about Small Group AFA plans