Aetna Medical Plan Availability

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This article is about Justworks PEO. What product am I using?

While our Aetna plans are generally widely available nationwide, there are some limitations in a few states: Alaska, Hawaii, Idaho, Maryland, Missouri, Montana, South Dakota, and Vermont. Any company offering Aetna PPO variant plans will have a slightly higher price.

Alaska

Our standard national POS network plans are not available in AK, ID, MT, MO, SD, and much of VT. Additionally, U.S.-based employees who live in Alaska will not have access to EPO plans but will have access to a PPO variant of the following plans:

  • C3; AET NYPPO HDHP 3300/100% JNY 
  • F1; AET PPO 25/50 750/90% JNY
  • F3; AET PPO 25/50 1000/80% JNY
  • G1; AET PPO 30/60 2000/80% JNY
  • G2; AET PPO HDHP 3300/90% JNY
  • H3; AET PPO VAL 25 6350/100% JNY 

Hawaii

Employers with one or more U.S.-based employees located in Hawaii are legally obligated to offer health insurance coverage that meets the minimum coverage requirements set by the Hawaii Prepaid Health Care Act (HPHCA). Justworks has chosen a Kaiser Permanente Hawaii plan, which all client companies with employees in Hawaii must offer to their Hawaii worksite employees only, regardless of whether or not they offer benefits to their non-Hawaii employees.

Idaho

Our standard national POS network plans are not available in AK, ID, MT, MO, SD, and much of VT.  Additionally, U.S.-based employees who live in Idaho will not have access to EPO plans but will have access to a PPO variant of the following plans: 

  • C3; AET NYPPO HDHP 3300/100% JNY 
  • F1; AET PPO 25/50 750/90% JNY
  • F3; AET PPO 25/50 1000/80% JNY
  • G1; AET PPO 30/60 2000/80% JNY
  • G2; AET PPO HDHP 3300/90% JNY
  • H3; AET PPO VAL 25 6350/100% JNY 

Maryland and Maine

The state of Maryland does not recognize a PEO as the employer of record, and therefore, companies headquartered in Maryland with 50 or fewer employees are restricted from providing access to Medical through Justworks but dental/vision are not restricted.

Companies with 51 or more employees are not restricted from joining.

Missouri

Our standard national POS network plans are not available in AK, ID, MT, MO, SD, and much of VT. Some regions of Missouri do have EPO network availability; however, because it is very limited, employers will still need to offer a PPO variant of the following:

  • C3; AET NYPPO HDHP 3300/100% JNY 
  • F1; AET PPO 25/50 750/90% JNY
  • F3; AET PPO 25/50 1000/80% JNY
  • G1; AET PPO 30/60 2000/80% JNY
  • G2; AET PPO HDHP 3300/90% JNY
  • H3; AET PPO VAL 25 6350/100% JNY 

Montana

Our standard national POS network plans are not available in AK, ID, MT, MO, SD, and much of VT.  Additionally, U.S.-based employees who live in Montana will not have access to EPO plans but will have access to a PPO variant of the following:

  • C3; AET NYPPO HDHP 3300/100% JNY 
  • F1; AET PPO 25/50 750/90% JNY
  • F3; AET PPO 25/50 1000/80% JNY
  • G1; AET PPO 30/60 2000/80% JNY
  • G2; AET PPO HDHP 3300/90% JNY
  • H3; AET PPO VAL 25 6350/100% JNY 

South Dakota

Our standard national POS network plans are not available in AK, ID, MT, MO, SD, and much of VT.  Additionally, U.S.-based employees who live in South Dakota will not have access to EPO plans but will have access to a PPO variant of the following:

  • C3; AET NYPPO HDHP 3300/100% JNY 
  • F1; AET PPO 25/50 750/90% JNY
  • F3; AET PPO 25/50 1000/80% JNY
  • G1; AET PPO 30/60 2000/80% JNY
  • G2; AET PPO HDHP 3300/90% JNY
  • H3; AET PPO VAL 25 6350/100% JNY 

Vermont

Our standard national POS network plans are not available in AK, ID, MT, MO, SD, and much of VT. There are some regions of Vermont that do have POS and EPO network availability; however, due to the fact it is very limited, employers will still need to offer a PPO variant of the following: 

  • C3; AET NYPPO HDHP 3300/100% JNY 
  • F1; AET PPO 25/50 750/90% JNY
  • F3; AET PPO 25/50 1000/80% JNY
  • G1; AET PPO 30/60 2000/80% JNY
  • G2; AET PPO HDHP 3300/90% JNY
  • H3; AET PPO VAL 25 6350/100% JNY 

New Mexico

Our national POS and EPO plans have limited access.

Wyoming 

Wyoming has mostly PPO access with limited access to POS.

USVI & Puerto Rico

Access to Indemnity/CMED only

Disclaimer

This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.