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 2023 Calendar Year
2023 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. It’s a one-time bonus for new Banner|Aetna members enrolled with 2023 effective dates according to the schedule below.
Note: The broker bonus program applies only to policies sold in Arizona for the 2023 calendar year. Certain other conditions apply.
- Members must be considered active 90 days after the effective date to be eligible for payment.
- New business qualification tracked by state and quarter; no combining business across states. New business qualification levels will reset at the end of each quarter.
- For the purpose of calculating enrolled member credits, broker shall be subject to a per-policy maximum of five members for both qualification and payment.
- We will pay credits quarterly, within 120 days of the end of the quarter.
New enrolled members |
Earned credit per new enrolled member |
|---|---|
0 - 14 |
N/A |
15 - 29 |
$25 |
30 - 59 |
$50 |
60+ |
$75 |
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
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
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.
