New York, NY–(HISPANIC PR WIRE – BUSINESS WIRE)–November 6, 2007–Aetna (NYSE: AET) today introduced an innovative new plan designed to make health benefits more affordable for small businesses whose employees live or work and access health care in New York City’s five boroughs.
The NYC Community Plan(SM) also targets cultural disparities in health care by utilizing local physicians and diverse Aetna sales and service teams who live and work in the community and are more familiar with the health care needs, preferences and the overall environment in New York communities. Aetna will provide cultural competency training for its own workers as well as physicians working in the community. In addition, many Aetna employees speak multiple languages, which will make it easier to interact with customers from diverse ethnic backgrounds.
Aetna recognizes the unique cultural diversity of New York and its small businesses, said Miguel Centeno, vice president of business development in Aetna’s New York market. “To meet the needs of people in this city, you first have to understand the world they live in, the languages they speak, and the challenges they face,” he said. “We’ve designed the NYC Community Plan to provide more than just insurance.”
“One of the things that struck me as unique about the plan was that it used a network of culturally competent providers,” said George Zeppenfeldt, chief executive officer, National Hispanic Chamber of Commerce on Health. “That component is particularly important in our population to make sure that not only the language is appropriate, but the cultural issues within our community are being addressed by providers.”
Aetna will draw on its expertise in addressing community issues, such as racial and ethnic disparities in health care, Centeno said.
The company will make it easier for diverse people to obtain access to culturally appropriate information and health care. Aetna’s wellness and disease management programs offer outreach and support that are culturally sensitive, and plan materials are being developed in different languages.
The NYC Community Plan makes health care more affordable by using a smaller network of providers. In exchange for receiving care through the newly formed NYC Community Plan Referred Network, Aetna members will receive preventive care at 100 percent, with no co-pays, at a significantly reduced premium.
And by covering preventive care at 100 percent, Aetna is removing a financial barrier for many employees, helping to increase access and encourage people to take advantage of wellness programs and preventive screenings.
“This is a win-win plan,” said Glenis Henriquez, of the New York City Department of Small Business Services. “The general health and economy of New York’s diverse neighborhoods benefits, with more people using local hospitals and small businesses saving money on health insurance.”
The plan, which will be offered in Manhattan, Staten Island, Queens, Brooklyn and the Bronx, features two in-network benefit levels, referred and self-referred.
Members will be eligible for referred benefits when they receive covered medical services from or through a primary care physician (PCP) who participates in the new NYC Community Plan Referred Network.
The PCP will coordinate care, and members will pay no co-pays for routine and preventive services. Out-of-pocket expenses will be limited to any applicable co-pays, and there will be no claim forms. Referrals will be required for services not provided by the PCP.
Members may also directly access providers in the NYC Community Plan Self-Referred Network without receiving referrals from their PCP. They will be responsible for an annual deductible and coinsurance, and subject to a lifetime benefits maximum. Out-of-pocket costs will be significantly more affordable when members use referred, participating providers.
Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 36.4 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, government-sponsored plans and expatriates. http://www.aetna.com