Portfolio & Network Glossary

Each carrier has it's own way of describing their portfolios, plans, networks, and more. And it's confusing! We've consolidated some of the most important terms and provided their definitions below. Contact your B&P Sales Rep if you have any questions about this information.

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Aetna Small Group Plan & Networks

Description

HMO

HMO plans available in 5 networks:

  • HMO: Full network HMO
  • Deductible HMO: Narrower network HMO
  • Aetna Value Network (AVN): Narrower network HMO 
  • Basic HMO: Narrower network HMO
  • Aetna Whole Health (AWH) ACO: Narrower network HMO in Southern California
OA Managed Choice POS

PPO plans, including some HDHPs, that are available in 2 networks:

  • OA Managed Choice POS: Full network PPO style plans
  • Savings Plus OA Managed Choice POS: Narrower network PPO style plans available in Southern California regions
  • Aetna Whole Health (AWH) Southern California OAMC: Narrower network PPO style plans available in Southern California regions
EPO

EPO plans (in-network only, no PCP required) available in two networks:

  • Elect Choice EPO: Full network EPO plans
  • Aetna Whole Health (AWH) Southern California EPO: Narrower network EPO plans available in Southern California regions
PPO

PPO plan that uses the Open Choice PPO network.

This plan was previously only available to Out-of-State or Out-of-Area employees. It is now available for California employees.

 

Other Important Information

Description

Pick-A-Plan Portfolio Allows the group to select up to 5 plans in Aetna's portfolio. There are no restrictions on plan types or metallic tiers.
Small Group ACA Formulary Four-tier formulary that applies to all small group ACA plans.
Rx Home Delivery Aetna's prescription mail order.
Behavioral Health Aetna Mental Health network.
Pediatric Dental Dental network (National PPO) for embedded pediatric Dental benefits within Medical plans.
Pediatric Vision Vision network (EyeMed) for embedded pediatric Vision benefits within Medical plans.

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