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WASHINGTON

    Producers

    Group Medical Plans

    Understanding that small business clients’ needs are different from those of large companies, Total Benefits Solutions (TBS) offers a wide range of group medical plans. Your clients and their employees will appreciate the flexibility to balance premium costs by offering up to two medical plans.

    Plans
    Forms
    Overview
    Providers

    Summary of Benefits and Coverage (SBCs)

    SBCs are group effective date specific and can be downloaded via the public Aetna website at: https://www.aetna.com/sbcsearch/home


     Benefit Grids

    2022

    2021

    2020


    Plan Summaries

    The following summaries are listed for your convenience. For the most up-to-date information please visit https://www.aetna.com/sbcsearch/home and click on the tab labeled "PDD Search."

    Small Group Plan Summaries Effective 1/1/22 and Later

    Small Group Plan Summaries Effective 1/1/21 and Later

    Small Group Plan Summaries Effective 1/1/20 and Later


    Middle Market (51-100) Plan Summaries

    The following summaries are listed for your convenience. The most up-to-date information for groups of 51+ can be found online in Aetna's Producer World at: https://www.aetna.com/producer/Login.do

    WA PPO

    WA AWH OAMC

    New Business

    Renewal

    Aetna HSA, HRA, and FSA

    COBRA Admin

    Small Group Wellness (1-50)

    Member Forms & Flyers

    Billing

    Middle Market Forms & Flyers (50+ employees)

    Aetna – Helping people achieve health and financial security

    Aetna is one of the nation’s leaders in health care, dental, pharmacy, group life, and disability insurance, and employee benefits. Dedicated to helping people achieve health and financial security, Aetna offers a broad range of insurance and employee benefits products plus vast resources for producers and employers to help them make the right choices.

    The Aetna health care network has:

    • More than 1 million health care professionals
    • More than 575,000 primary care doctors and specialists
    • More than 5,400 hospitals
    • A network of specialist physicians, recognized with Aexcel® designation, based on clinical performance and cost efficiency.

    Aetna provides benefits through employers in the United States and internationally, with products and services targeted specifically to small, mid-sized and large multi-site national employers, as well as global health insurance for employees on temporary or permanent foreign assignments.

    Ask us about Aetna’s health insurance products including Medical, Dental, Life and Global insurance.

     

    Producer Appointment

    If you or your firm is not yet appointed with Aetna, please apply online:

    https://pangea.geninfo.com/Aetna/Apply

    Provider Network Information

    http://www.aetna.com/docfind

    Dental Plans

    We offer a wide range of dental plans. Ask about our ability to match or exceed your clients’ existing dental plan with a custom quote.

    PLANS
    FORMS
    OVERVIEW
    PROVIDERS

    The following summaries are listed for your convenience. For the most up-to-date information and additional plans please visit Aetna's Producer World at: https://www.aetna.com/producer/Login.do. Other dental plan design documents, including more voluntary plan designs are available by request.

    Effective 2021

    Groups of 2-9*

    *Voluntary dental plans are available to groups with 3+ eligible employees.

    Groups of 10+

    Effective 2020

    Small Groups of 2-9*

    *Voluntary dental plans are available to groups with 3+ eligible employees.

    Groups of 10+

    Aetna – Helping people achieve health and financial security

    Aetna is one of the nation’s leaders in health care, dental, pharmacy, group life, and disability insurance, and employee benefits. Dedicated to helping people achieve health and financial security, Aetna offers a broad range of insurance and employee benefits products plus vast resources for producers and employers to help them make the right choices.

    The Aetna health care network has:

    • More than 1 million health care professionals
    • More than 575,000 primary care doctors and specialists
    • More than 5,400 hospitals
    • A network of specialist physicians, recognized with Aexcel® designation, based on clinical performance and cost efficiency.

    Aetna provides benefits through employers in the United States and internationally, with products and services targeted specifically to small, mid-sized and large multi-site national employers, as well as global health insurance for employees on temporary or permanent foreign assignments.

    Ask us about Aetna’s health insurance products including Medical, Dental, Life and Global insurance.

     

    Producer Appointment

    If you or your firm is not yet appointed with Aetna, please apply online:

    https://pangea.geninfo.com/Aetna/Apply

     

    Provider Network Information

    http://www.aetna.com/docfind/

     

    PLANS
    FORMS
    OVERVIEW
    PROVIDERS

    The following summaries are listed for your convenience. Upon implementation benefit summaries will be generated for the group, and  groups should review their Policy and Certificate for complete details. If you'd like to request a summary not seen below then please contact us.

    New Business

    • Coming Soon... in the meantime please contact us for assistance.

    Member Forms

    MetLife has been in the business of making and keeping promises for more than 150 years, helping millions of customers protect their future with smart products and targeted services. They apply the same principles to operate responsibly and confidently in more than 40 markets around the world.

     

    Producer Appointment

    If you or your firm is not yet appointed with MetLife, then please complete the following and submit as directed on the form:

    Broker Appointment Paperwork

     

    To locate a dental provider please visit https://www.metlife.com/  and follow the instructions listed on the Find a Dental Provider brochure.

     

    Life Insurance Plans

    Employees can provide their families with peace-of-mind with our Life and Accidental Death & Dismemberment (AD&D) plans from trusted carriers.

    PLANS
    FORMS
    OVERVIEW
    PROVIDERS

    **As of 4/1/18 Aetna Life plans are no longer available.**

    Aetna – Helping people achieve health and financial security

    Aetna is one of the nation’s leaders in health care, dental, pharmacy, group life, and disability insurance, and employee benefits. Dedicated to helping people achieve health and financial security, Aetna offers a broad range of insurance and employee benefits products plus vast resources for producers and employers to help them make the right choices.

    The Aetna health care network has:

    • More than 1 million health care professionals
    • More than 575,000 primary care doctors and specialists
    • More than 5,400 hospitals
    • A network of specialist physicians, recognized with Aexcel® designation, based on clinical performance and cost efficiency.

    Aetna provides benefits through employers in the United States and internationally, with products and services targeted specifically to small, mid-sized and large multi-site national employers, as well as global health insurance for employees on temporary or permanent foreign assignments.

    Ask us about Aetna’s health insurance products including Medical, Dental, Life and Global insurance.

     

    Producer Appointment

    If you or your firm is not yet appointed with Aetna, please apply online:

    https://pangea.geninfo.com/Aetna/Apply

    The Aetna Life products do not have a provider network.
    PLANS
    FORMS
    OVERVIEW
    PROVIDERS

    The following summaries are listed for your convenience. Upon implementation benefit summaries will be generated for the group, and groups should review their Policy and Certificate for complete details. If you'd like to request a summary not seen below then please contact us.

    New Business
    • Coming Soon... in the meantime please contact us for assistance.

    Member Forms

     

    MetLife has been in the business of making and keeping promises for more than 150 years, helping millions of customers protect their future with smart products and targeted services. They apply the same principles to operate responsibly and confidently in more than 40 markets around the world.

    Producer Appointment

    If you or your firm is not yet appointed with MetLife, then please complete the following and submit as directed on the form:

    Broker Appointment Paperwork

    The MetLife Life product does not have a provider network.

     

     

    Vision Plans

    We offer your clients affordable, high-quality eye care plans with an eye care specialist network of over 26,000 in the U.S. Our comprehensive eye care plans cover all or a portion of optometrist visits, eyeglasses, contact lenses and even laser surgery.

    PLANS
    FORMS
    OVERVIEW
    PROVIDERS

    2021 VSP WA Rate Sheet

    VSP Signature Plan Summary

    The differences in the following plans is the intervals when services are available, as shown below. The 12/12/12 option includes tinted or photochromic lenses at no extra cost.

    Signature Plan A  Eye Exam 12 months, Lenses 24 months, Frames 24 months, 11 options:

    • Signature Plan A – $0 copay
    • Signature Plan A – $5 copay
    • Signature Plan A – $10 copay
    • Signature Plan A – $20 copay
    • Signature Plan A – $25 copay
    • Signature Plan A – $0/$20 copay
    • Signature Plan A – $10/$10 copay
    • Signature Plan A – $10/$20 copay
    • Signature Plan A – $10/$25 copay
    • Signature Plan A – $10/$30 copay
    • Signature Plan A – $20/$20 copay

    Signature Plan B  Eye Exam 12 months, Lenses 12 months, Frames 24 months, 11 options:

    • Signature Plan B – $0 copay
    • Signature Plan B – $5 copay
    • Signature Plan B – $10 copay
    • Signature Plan B – $20 copay
    • Signature Plan B – $25 copay
    • Signature Plan B – $0/$20 copay
    • Signature Plan B – $10/$10 copay
    • Signature Plan B – $10/$20 copay
    • Signature Plan B – $10/$25 copay
    • Signature Plan B – $10/$30 copay
    • Signature Plan B – $20/$20 copay

    Signature Plan C  Eye Exam 12 months, Lenses 12 months, Frames 12 months, 11 options:

    • Signature Plan C – $0 copay
    • Signature Plan C – $5 copay
    • Signature Plan C – $10 copay
    • Signature Plan C – $20 copay
    • Signature Plan C – $25 copay
    • Signature Plan C – $0/$20 copay
    • Signature Plan C – $10/$10 copay
    • Signature Plan C – $10/$20 copay
    • Signature Plan C – $10/$25 copay
    • Signature Plan C – $10/$30 copay
    • Signature Plan C – $20/$20 copay

    How do I use my VSP benefit?

    Getting started with VSP is easy! After you enroll with your employer during your open enrollment period you can:

    1. Create an account on vsp.com, where you can review your personalized plan details and eligibility.
    2. Find a doctor who's in network and conveniently located near you.
    3. Schedule your appointment! There's no ID card required; however, if you'd like to download or print your Member Vision Card, simply log in to your account on vsp.com.

    Finding a doctor you love—or keeping your current doctor—is important!

    With VSP, most members have access to five VSP network doctors within five miles of where they live or work. When you see an in-network doctor, you’ll get more out of your vision coverage and can count on low out-of-pocket costs and take advantage of exclusive member-only offers on contacts, sunglasses, lens enhancements, and more! Maximize your benefits when you choose to visit a Premier Program location, including private practice doctors and Visionworks retail locations nationwide.

     

    PLANS
    FORMS
    OVERVIEW
    PROVIDERS

    The following summaries are listed for your convenience. Upon implementation benefit summaries will be generated for the group, and  groups should review their Policy and Certificate for complete details. If you'd like to request a summary not seen below then please contact us.

    New Business

    • Coming Soon... in the meantime please contact us for assistance.

    Member Forms

    MetLife has been in the business of making and keeping promises for more than 150 years, helping millions of customers protect their future with smart products and targeted services. They apply the same principles to operate responsibly and confidently in more than 40 markets around the world.

    Producer Appointment

    If you or your firm is not yet appointed with MetLife, then please complete the following and submit as directed on the form:

    Broker Appointment Paperwork

    To locate a vision provider please visit https://www.metlife.com/ 

    Short Term Disability, and Long Term Disability Plans

    Our competitive Short Term Disability (STD), and Long Term Disability (LTD) plans help to shorten the down-time following an accident or illness while assisting employees who are suddenly faced with a loss of income, and expenses associated with rehabilitation. 

    PLANS
    FORMS
    OVERVIEW
    PROVIDERS

    The following summaries are listed for your convenience. Upon implementation benefit summaries will be generated for the group, and groups should review their Policy and Certificate for complete details. If you'd like to request a summary not seen below then please contact us.

    Short Term Disability 

    Long Term Disability 

    New Business

    • Coming Soon... in the meantime please contact us for assistance.

    Member Forms


     

    MetLife has been in the business of making and keeping promises for more than 150 years, helping millions of customers protect their future with smart products and targeted services. They apply the same principles to operate responsibly and confidently in more than 40 markets around the world.

     

    Producer Appointment

    If you or your firm is not yet appointed with MetLife, then please complete the following and submit as directed on the form:

    Broker Appointment Paperwork

    The MetLife Disability products do not have a provider network.
    Global Health Insurance Plans

    We recognize that many businesses in Washington State have employees located across the country and around the world. Offer your clients medical insurance options that meet their needs nationally and globally with our expatriate and short-term global travel options.


    You can offer your clients benefit plans that deliver on quality and value

    Clients come in all sizes. And while large companies usually have the resources for high quality benefit plans, small businesses may not. With Total Benefit Solutions, you can offer clients of all sizes fully integrated plans that help keep health care costs down while delivering on quality and flexibility.

    A wholesale insurance brokerage, Total Benefit Solutions is the liaison between insurance brokers and top national and global insurance carriers. Our extensive product portfolio means your clients have access to a wide selection of trusted insurance options for the group insurance market in Washington State.

    Why work with Total Benefit Solutions?

    • TBS is the only source of Aetna group plans in Washington. A leader in healthcare, Aetna has a large, national provider network. In addition, Aetna provides numerous online services for members to access claims, coverage, and consumer health information.
    • Our easy-to-read quotes allow you and your clients to compare our rates to other insurance carriers in the market.
    • You can count on us for extensive support and administration services that make it easy for you to focus on growing your business:
      • Broker education: sales ideas, leads, and strategies for selling our products
      • Expertise in Consumer Directed Health Plans (CDHP), defined contribution, provider recruitment assistance and enrollment
      • Our New Business Team ensures paperwork for new groups is properly completed, provides enrollment assistance and quoting, and billing support
      • Our Renewal Team provides pro-active renewal support, ensures the smooth migration of groups from one plan to another, assists with renewals including strategies to mitigate high renewals, and provides on-going support
      • Fewer billing errors and timely payments – We conduct automatic reviews of charges for new groups and renewals and keep you informed of any issues so you can act immediately
    • Broker incentives and flat commissions from Vision Service Plan are some of the additional perks that come with being a partner of TBS.

    At Total Benefit Solutions, we are always looking for ways to improve our service and grow your business. We strive to make selling insurance easier by offering value-based products, excellent support and a better experience for producers and their clients overall.

    Find out how we can help build your health insurance business today.