Page 5 - 5.11 Benefit Guide 2018 CA PRINT

MEDICAL

OPTION 1 – OPEN ACCESS MANAGED CHOICE HSA
The OAMC HDHP HSA (Open Access Managed Choice High Deductible Plan with Health Savings Account) plan through
Aetna combines a high deductible health plan (HDHP) with a special, tax-qualified savings account. You have the freedom
to choose your doctor without using a Primary Care Physician (PCP) and you may self-refer to specialists. You may use
an Aetna Managed Choice provider whose negotiated rates provide richer levels of benefits with claim forms filed by the
providers. You may also obtain services using a non-network provider; however, you will be responsible for the difference
between the covered amount and the actual charges and you may be responsible for filing claims. You may use your HSA
funds to pay for current medical expenses or save toward future medical expenses. 5.11 will contribute $500 toward
Employee Only Health Savings, $750 toward Employee + Spouse or Child(ren) and $1,200 for Employee + Family. In addition
to the company contributions, you may elect to make contributions into the account up to your IRS maximums. Additional
information is located on page 7 of this guide.

OPTION 2 - OPEN ACCESS MANAGED CHOICE PPO
The Aetna OAMC PPO (Open Access Managed Choice Preferred Provider Organization) plan allows you to direct your own
care. If you receive care from a physician who is a member of the Aetna Managed Choice network, a greater percentage of
the entire cost will be paid by the insurance plan, however, you are not limited to the physicians within the network and you
may self-refer to specialists. If you obtain services using a non-network provider, please note that you will be responsible
for the difference between the covered amount and the actual charges, and you may be responsible for filing claims.

OPTION 3 - HMO
With the Aetna Health Maintenance Organization (HMO) plan, you must choose a primary care physician (PCP) or medical
group within the HMO network. All of your care must be directed through your PCP or medical group. Any specialty care you
need will be coordinated through your PCP and will generally require a referral or authorization. You will receive benefits
only if you use the doctors, clinics and hospitals that belong to the medical group in which you are enrolled, except in the
case of an emergency.

FINDING A MEDICAL PROVIDER:
You can locate a doctor or facility through Aetna’s DocFind® Online Directory. Go to www.aetna.com/
docfind and fill in the fields as indicated online.
• HSA & PPO Participants: When prompted to select a plan, please choose “Aetna Open Access®
Plans” then select “Managed Choice® (Open Access)”.
• HMO Participants: When prompted to select a plan, please choose “Aetna Standard Plans” then
select “HMO”.

AETNA DISCOUNTS
Included with your medical insurance plan from Aetna are extras that will help you save on products and services to keep
you healthy and happy. There are no claims forms, referrals or limits on how much you can save. You can receive fitness
discounts, hearing discounts, weight management discounts, natural product and service discounts, and vision discounts.

START SAVING TODAY:
To get started, become an Aetna member, then log in to the secure member website at www.aetna.
SAVE com. Choose “Health Programs,” then “See the discounts”, then follow the steps for each discount
you want to use.

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