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Summary of Benefits & Coverage

Important information for individuals

What you need to know

It’s easy to know about your benefits and coverage

In March 2010, Congress passed a historic health care reform law called the Affordable Care Act (ACA). Under it, health plans are required to provide consumers with a document giving them information about health plan benefits and coverage. This is a Summary of Benefits and Coverage (SBC) document.

The SBC gives you helpful information about what the plan covers. It also has examples of how much you might pay for certain health events or conditions. Remember, the SBC is only a summary. So, we’ve added other details about your plan here for you.

Be sure to visit these links for more information:

Find out what the bolded words in the SBC mean. Check out our glossary of coverage and medical terms. (Note: Some of the terms may not have the same meaning when used in your policy or plan. Your policy or plan governs)

Need to know which providers are in Allina Health | Aetna’s network or have questions about prescription drug coverage?

  • Current Allina Health | Aetna members: Just login to your secure member website using the link in the navigation bar to get information about your current plan.
  • Not a member yet:
  1. To check if a doctor is in network, go to our provider search tool and make sure to choose the plan that matches the one you are considering.
  2. For pharmacy benefit information, visit our pharmacy resources page. Allina Health | Aetna pharmacy benefits are administered by Aetna. Aetna provides certain management services to Allina Health | Aetna.

    Please note that these formularies are standard and may not reflect the formulary in your specific plan.

To obtain the terms of your policy or a copy of your plan document, please see below. Which policy or plan document do you need?

  • Does your employer have less than 100 employees?
    • Read more about our 1-100 policy certificatesClick here 
    • Does your employer have over 100 employees?
    • Look up our large group policyClick here 

Questions?

Already an Allina Health | Aetna member? Call Member Services at the toll-free number on your member ID card.

Not a member yet? Call the toll-free number on your SBC if you have any questions.

Important information for employers

Allina Health | Aetna will give employers the information they need, but the law says employers have to give the SBCs to their employees. There are very specific rules about what employers have to provide and when. Read more about the standards to create and provide an accurate SBC.

Better health care, together

Allina Health and Aetna have partnered to transform the way you experience health care. Our plans are designed to offer members more personal, affordable and effective health care right in their community.

Together, we’re reinventing the health care system and helping members achieve their health goals.

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Health plans are offered, underwritten or administered by Allina Health and Aetna Insurance Company (Allina Health | Aetna). Allina Health l Aetna is an affiliate of Aetna Life Insurance Company and its affiliates (Aetna). Allina Health | Aetna has sole responsibility for its products and services. Aetna provides certain administrative services to Allina Health | Aetna.

Allina Health | Aetna is the brand name used for products and services provided by Allina Health and Aetna Insurance Company.

This material is for information only and is not an offer or invitation to contract. Health benefit plans contain exclusions and limitations. Providers are independent contractors and not our agents. Provider participation may change without notice. We do not provide care or guarantee access to health services. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability are subject to change and may vary by location. If you are in a plan that requires the selection of a primary care physician and your primary care physician is part of an integrated delivery system or physician group, your primary care physician will generally refer you to specialists and hospitals that are part of the delivery system or physician group. Information is believed to be accurate as of the production date; however, it is subject to change.

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Aetna is the brand name for Aetna Life Insurance Company and its affiliated companies. Allina Health and Aetna Insurance Company is an affiliate of Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain administrative services for Allina Health and Aetna.

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You are now being redirected to www.allinahealth.org. Allina Health and Aetna Insurance Company (Allina Health | Aetna), a health insurer jointly owned by Allina Health and Aetna, will offer, underwrite or administer health insurance plans.

Aetna is the brand name for Aetna Life Insurance Company and its affiliated companies. Allina Health and Aetna Insurance Company is an affiliate of Aetna. Aetna provides certain administrative services for Allina Health and Aetna.

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