Group Medical

Important Update: New Healthcare Administrator for Employees

• Aetna Advantage Medical Plans

  Applies to non-bargaining and bargaining employees in GSAF Professional, GSAF Supervisory, and IAFF hired on or after January 1, 2019, to bargaining employees in AFSCME Aviation, AFSCME Solid Waste and AFSCME General hired on or after January 1, 2020, to Transport Workers Union employees hired on or after January 1, 2021, to AFSCME Water & Sewer employees hired on or after July 1, 2021, and to PBA Rank & File/Supervisory employees hired on or after January 1, 2022.
  
  

  • Aetna First Choice Advantage HMO
  • Aetna Select Advantage HMO

  
  Applies to non-bargaining, and bargaining employees in GSAF Professional, GSAF Supervisory, and IAFF hired prior to January 1, 2019, to bargaining employees in AFSCME Aviation, AFSCME Solid Waste and AFSCME General hired prior to January 1, 2020, to Transport Workers Union employees hired prior to January 1, 2021, to AFSCME Water & Sewer employees hired prior to July 1, 2021, and to PBA Rank & File/Supervisory employees hired prior to January 1, 2022. POS Advantage is available only to those PBA Rank/File & Supervisory Employees hired prior to January 1, 2019.
  
  

  • Aetna First Choice Advantage HMO
  • Aetna Select Advantage HMO
  • Aetna Advantage HMO
  • Aetna Advantage POS

• Aetna Summary of Benefits and Coverage – Effective 1/1/2026

  • SBC Aetna First Choice Advantage HMO
  • SBC Aetna Select Advantage HMO
  • SBC Aetna Advantage HMO
  • SBC Aetna Advantage POS

• Meet Aetna

  • Aetna Welcome Letter
  • Aetna Plan Overview
  • Aetna website

• What to expect

  • Coverage remains the same. Your coverage under the County’s self-funded plan will not change. You will still have access to the same covered services as you have today.
  • More access, better care: Aetna offers a wide network of providers, enhanced wellness programs, and tools like telehealth and chronic condition support to help you and your family stay healthy
  • No disruption to ongoing care: If you're currently receiving treatment, you’ll be able to continue without interruption. We’re working closely with Aetna to make sure the transition is smooth for everyone
  • Simplified experience: With modern tools and platforms, managing your healthcare will be easier and more efficient
  • Pharmacy access: You’ll still be able to use many retail and local pharmacies, just as you do now for non-specialty medications. The Aetna pharmacy network includes 66,000 pharmacies nationwide, including retail chains and independent pharmacies. Participating retail chains include Publix, Walmart, Walgreens, CVS, and Costco

  This year, Open Enrollment ranges from Oct. 20 to Nov. 3. Employees will have plenty of opportunities to ask questions and get to know Aetna with various scheduled sessions, both in-person and virtual presentations. Employees will have plenty of helpful resources and materials available, as we strive to make this transition as smooth as possible.

  To facilitate the transition, employees who do not wish to make a change will automatically be placed in the respective Aetna Advantage plan during Open Enrollment to take effect Jan. 1, 2026.

  During Open Enrollment, employees are encouraged review their plan elections and make changes to their coverage levels as needed.

• Finding your Aetna coverage network

  • If you are currently on the Select Advantage plan or the HMO Advantage plan, your new network will be Aetna Select (Open Access)
  • If you are currently on the POS Advantage plan, your new network will be Aetna Choice® POS II (Open Access)
  • If you are currently on the First Choice Advantage/Jackson First HMO, your network will continue to be the Jackson Health System and University of Miami with savings on certain services. If you or a dependent have an emergency or need care outside of Miami-Dade or Broward, the new national Aetna Select (Open Access) network is available to you

• Steps to confirm your doctor is in-network

  1. Visit www.aetna.com and select “Find a Doctor.”
  2. Under “Don’t have a member account?” Select “Plan from an employer”
  3. Under “Continue as a Guest,” enter your location (ZIP code, city, county, or state) to view providers specific to your plan. You can also set a search radius of up to 100 miles
  4. Select the appropriate plan option under “Aetna Open Access Plans” 
  5. You can search by provider name, provider type, or category
  6. View results in either list view or map view to explore your options