Aetna's Background

•Founded in 1853 in Hartford, USA, Aetna is one of the world's largest providers of:

  • health care,
  • dental,
  • pharmacy,
  • group life and
  • disability insurance,
  • and employee benefits.

Aetna offers the expertise of a premier U.S. healthcare provider, dedicated to understanding Hong Kong's culture and to serving your company and your employees.

Aetna is a U.S. Fortune 50 and global Fortune 500 company, with 160 years of expertise currently assisting more than 38 million members.

Its experience, strength and stability have been extended globally for more than 55 years, helping them become one of the largest, most reliable providers of international benefits.

Aetna employees around 50,000 people, of whom more than 1,000 are employees dedicated to Aetna International in 12 countries..

Aetna International insures around 900,000 people worldwide, mostly expatriates working in companies of 3-70,000 staff.

Aetna Global Benefits ( Asia Pacific) Limited in Hong Kong is a part of Aetna Inc.

In Hong Kong, Aetna had previously had an agency arrangement with Starr Insurance, but in 2018, Aetna obtained its own insurance license and launched a range of individal and group insurance products, aligned with products being sold internationally, iincluding Employee Assistance Programmes and its Red24 emergency assistance service that includes access to more than 160,000 direct settlement health care providers.

Aetna's commitment on turnatound times is as follow:

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Covid 19 update

If an Aetna member is treated for Coronavirus, or for the symptoms of the Coronavirus, this would be assessed under the terms and conditions of their policy in the same way as any other viral infection.

However, patients who test positive for novel coronavirus, MERS, SARS, etc cannot actually be treated in private hospitals or clinics in Hong Kong (government guidelines).

If they present at a private hospital, they will be directed to a public hospital for treatment.

If an Aetna member is treated at a public hospital with no charge, any claims submitted under the hospital cash benefit will be assessment normally.

For an initial 90 day period, all Aetna members free access to vHealth – a global service that provides medical consultations by telephone or by video call, from anywhere in the world.

Whether you are worried about COVID-19 or have other medical concerns, you can speak to a vHealth doctor about any aspect of your health.

From now on, you don’t have to worry about catching or spreading infection, or even leaving your home.

The 24/7 service is completely confidential, available in multiple languages and free to use as often as you like.

3 easy ways to book a vHealth by Aetna consultation

1. The vHealth by Aetna app

· Download the vHealth app from the App store or Google Play

· Register your details and enter the access code VHEALTH90

· Book an appointment by following the onscreen instructions

2. By telephone

· Call the vHealth helpline and book an appointment over the phone: +1-202-888-3462 (USA) or +44 203 695 6363 (UK)

3. By email

· Send your consultation request to vhealth90@teladochealth.com

· Include your full name, membership number, telephone number, preferred language and reason for the consultation

· A response will be sent back to you within 4 hours

Covid 19 and EMERGENCY EVACUATIONS

Due to the rapidly escalating global situation for COVID-19, undertaking medical evacuations across borders has become extremely challenging. Many countries have locked down their borders or have increased restrictions for entry into their country.

Emergency evacuation remains eligible under AETNA's terms and conditions if a member’s condition requires medical facilities that are not available locally.

However, controls and restrictions put in place by government bodies and medical evacuation providers may affect the transfer of a member as the COVID-19 situation progresses daily.

AETNA's Member Assistance and Medical Evacuations team has provided an update on the global situation:

· All patient transfers will be subject to additional screening of the patient, such as history of respiratory symptoms or fever; travel history; contact history; COVID-19 testing.

· Border restrictions also apply to healthcare workers escorting patients, which is creating a further challenge.

· Admission to receiving medical facilities requires close liaison to manage COVID-19 risk. Bed availability is becoming increasingly limited due to pressure on health systems and isolation requirements for incoming international patients.

Currently all evacuation cases will require additional consideration and escalation to understand how the current restrictions may affect the available options and evacuation strategy. We will continue to provide updates as they become available.

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Pioneer International Healthcare Plan

Aetna's 'Pioneer' plan was first launched in 2016 and is available in:

  • Hong Kong
  • Singapore
  • Europe and
  • the Middle East

The plan comes with the option Full Medical Underwriting or moratorium underwriting and a choice of excesses
and co-insurance optoins to allow you to reduce your premium.

Aetna Maternity

If you’re thinking about starting or adding to your family, Aetna Maternity will cover you for antenatal and postnatal checkups, delivery costs, routine newborn costs and more.

Aetna Travel

Whether you’re trekking the globe or travelling for business, Aetna offers worldwide travel insurance for trips of up to 180 days.*

Aetna Personal Accident

For complete peace of mind for your life abroad, Aetna offers you worldwide cover for accidental death as well as permanent total disablement and partial disablement

Pioneer Documents

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Aetna Insurance (Hong Kong) Limited's group plan "Summit" provides comprehensive and flexible employee health insurance, with a range of options as you can from the 'Summit' Individual and Group Benefit Table:

The Summit plan is available on :

  1. an underwritten basis for companies with as few as 3 staff.
  2. a conditional 'medical history disregarded' (MHD) basis for companies with 5-9 staff *.
  3. a medical history disregarded basis for companies of 10+ staff

* With conditional MHD, Aetna requires staff to complete a simplified heatlh declaration that asks:

1. Have you or any of your dependants ever had a past history of :

  • cancer (including benign brain tumours),
  • a heart condition or stroke,
  • joint replacement,
  • psychiatric or mental illness?

2. In the last 12 months have you or any of your dependants had any signs or symptoms that may require a visit to a medical professional or are you or any of your dependants awaiting any reviews, treatment or investigation for any current or past medical problems?

3. Do you or any of your dependants have any long-term, ongoing or chronic condition for which you have regular appointments or need a review or treatment for?

4. If the plan includes maternity cover, are you or any of your dependants currently pregnant?

5. In the last 2 years, have you or any of your dependants on this application had any other problems or concerns about their health which are not dealt with in questions 1-4 above?

The catch with this simplifed underwriting, is that it will often uncover some ongoing issues with cholestrol, blood pressure or diabetes and as a result, the premium for the group will be loaded.

An even greater catch, is that emplloyees must disclosed all material facts not only at the new business stage, but as well, BEFORE Aetna offers its renewal terms!

If your company does have 5-9 staff and you are keen on the Aetna plan and budget is an issue, you will likely be better off to apply for cover on a moratorium basis or look to place sublimits on benefits, as a cheaper option.

Aetna Summit SM Plan Group Member Declaration Medical History Disregarded (MHD) 5-9 employees form

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Cover for Group Leavers

Members under the Summit plan can transfer to one of Aetna's individual plans on leaving the group plan without the need for medical underwriting.

Please note following conditions:

1) Facility must be taken up at renewal, and additional premium for including 'Continuous Transfer' is 3% of the annual premium. This is a one-off charge and will not be applied again at subsequent renewals

2) Member must be enrolled to Aetna group plan for a minimum of one calendar year to be eligible for this option.

3) Member must be under age 65 and have no break in cover when effecting this option i.e. the individual plan commencement date should be the next day following the last coverage date in the group plan.

4) Member must submit a fully completed “Transfer Form – Aetna Group to Aetna Individual” at least 2 weeks before the last day of employment. Applicable individual plan premium will be the standard individual plan premium plus 30% loading.

5) Member must transfer to an individual plan of benefit design and limits equal or lower than that of the group plan. No plan upgrades are available f

6) There are legal and compliance regulations which may prevent a continuous transfer. For example, Aetna may not be able to cover local nationals returning to and residing in their home countries, due to local regulations. Also, AETNA does not offer coverage in OFAC Sanctioned countries. Such regulations change from time to time so do get in touch wih a representative from Navigator, well ahead of time.

For international companies headquatrered outside the US with operations in the US, and emplloying 51 or more staff , worldwide, Aetna offers a group plan called 'Access US'.

Offered in partnership with Total Benefits Solutions (TBS), these plans let you compete with U.S.-based employers by offering comparable health benefits.

Benefits to the Employer

  • One solution that’s ACA-compliant in all 50 U.S. states
  • Nine comprehensive plans at multiple price points — each including medical, pharmacy and wellness coverage
  • Flexible add-on options including vision, dental, life, and accidental death and personal loss coverage
  • The ability to customize plans (with a minimum number of employees)*
  • Help with U.S. plan design and compliance
  • Streamlined implementation and administration
  • Proven medical cost containment

Benefits to the Employee

  • Access to our direct settlement network of medical providers (1.2 million in U.S., 165,000 globally)
  • Convenient online directory to find a provider
  • Faster, easier ways for them to manage their benefits through Health Hub and our mobile apps
  • 24/7 help with their benefits from our multilingual Member Services team
  • 24/7 clinical assistance from our CARE team
  • Simplified claims process with reimbursement in 144 currencies
  • Health and wellness programs

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Email: crew@navigator-insurance.com
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Navigator Insurance Brokers Ltd
Unit E, 8/F Golden Sun Centre
No. 59-67 Bonham Strand West
Sheung Wan, Hong Kong