Aetna Medical Plans

Aetna Benefits

You can find all of the Summary Plans, FAQs and any additional information here.

Find providers, manage claims, access your ID card, and more through your Aetna member portal at Aetna.com.

There are two Aetna plans to choose from (plus one extra if you live in California):

  • Aetna Open Access Managed Choice HDHP

  • Aetna Open Access Managed Choice PPO

  • Aetna HMO (CA Only)

The plans cover the same types of healthcare services and supplies, but have different plan design features, such as copays, coinsurance, deductible amounts, and other out-of-pocket costs. To determine which plan best meets your and your family’s needs, consider the plan design features that are important to you, review your cost when you access services, and know your share of costs from your paycheck.

Is my doctor in-network?

You’ll save money by using Aetna’s network of providers. You can confirm if your provider is in-network with Aetna by following the instructions here for the PPO and HDHP plan networks (the network is called Aetna Open Access Managed Choice) or click here for the California HMO network. If you have additional questions, reach out to Aetna at 833-554-1545.

Aetna Open Access Managed Choice HDHP

The Aetna Open Access Managed Choice HDHP + HSA plan is one of Samsara’s best-value medical plans for most employees.

It has two parts: a high deductible, HSA-compatible medical plan and a tax-advantaged health savings account.

This plan may be right for you if:

  • You rarely need to see a doctor; an annual checkup is usually it for the year.

  • You feel comfortable paying for a large health expense that costs almost as much as your deductible.

  • You want the opportunity to accumulate savings and to invest and take part in the plan’s triple tax advantage for future healthcare expenses.

  • You plan to use network providers for your care, but like having the option to go out of the network.

Here’s how it works:

Health Savings Account (HSA)
  • Samsara will maintain its annual HSA contributions for employees: $1,000 (for employee-only coverage) and $2,000 (if you cover one or more family members).

    • This amount is prorated throughout the year, so you’ll receive a portion of Samsara’s contribution to your HSA each pay period.

  • You can contribute your own money to your HSA, too.

  • Use your HSA funds to pay for healthcare expenses—including your annual deductible.

Doctors and other healthcare providers
  • Go to any provider, but you pay less when you use Aetna network providers. (These are doctors, hospitals, therapists, and other healthcare providers who have contracted with Aetna to furnish services and supplies for a negotiated charge.)

Cost sharing between you and the plan
  • You pay $0 for in-network preventive care and prescription drugs that qualify as preventive care.

  • For all other care, you must meet the annual deductible before the plan cost sharing begins.

  • The in-network annual deductible is $2,800 for an individual and $5,600 for families.

  • Once you hit the annual deductible, the plan pays 100% of eligible in-network medical expenses.

You can review the full plan design and benefits of the Aetna Open Access Managed Choice HDHP here. And be sure to review all the details about Health Savings Accounts here.

Aetna Open Access Managed Choice PPO plan

With the PPO plan, you may go to any provider, but you pay less when you use Aetna network providers.

This plan may be right for you if:

  • You and your family are frequent users of medical care.

  • You mostly use network providers, but you would like to have access to out-of-network providers in certain circumstances. 

Here’s how it works:

Doctors and other healthcare providers
  • Go to any provider, but you pay less when you use Aetna network providers.

Cost sharing between you and the plan
  • You pay $0 for eligible preventive care and prescription drugs that qualify as preventive care.

  • For in-network office visits you’ll have a flat $20 copay for visits to a primary care provider, specialist, walk-in clinic, or urgent care. Visits to CVS Minute Clinics or Health Hubs are free.

  • For all other care, you must meet the annual deductible before the plan pays benefits. You’ll have a separate deductible for in-network and out-of-network care.

  • In-network annual deductible:

    • $250 for an individual and $750 for families 

  • Out-of-network deductible:

    • $250 for an individual and $750 for families

  • Once you reach the annual deductible, you’ll pay 10% coinsurance for eligible in-network services until your reach out annual out-of-pocket maximum.

You can review the full plan design and benefits of the Aetna Open Access Managed Choice PPO here.

Aetna HMO Plan (California Only)

With the Aetna HMO plan, your plan only covers Aetna network providers within California. For non-routine care outside California you can access Teladoc or CVS Minute Clinic and CVS Health Hubs. You’ll also need to designate a Primary Care Provider who will coordinate all of your care including any referrals to see a specialist.

This plan may be right for you if:

  • You and your family are frequent users of medical care and want low predictable costs.

  • You live in California and don’t plan on needing care outside of the state.

  • You only use network providers and are comfortable with designating a Primary Care Provider to coordinate all of your care.

Here’s how it works:

Doctors and other healthcare providers
  • When you enroll in the Aetna HMO in Workday, you must indicate who you would like to be your Primary Care Provider. To find a provider follow the instructions here and use the 6-digit Primary Care ID when you enroll in the plan in Workday. This can be changed with Aetna after you enroll.

Cost sharing between you and the plan
  • You pay $0 for eligible preventive care and prescription drugs that qualify as preventive care.

  • For office visits you’ll have a flat $10 copay for visits to a primary care provider, specialist, walk-in clinic, or urgent care. Visits to CVS Minute Clinics or Health Hubs are free.

  • There is no annual deductible to meet before your plan starts paying benefits, and most care is covered at 100%

  • You’ll continue to pay copays for services and prescriptions until you reach the annual out-of-pocket maximum of $1,500 for an individual and $3,000 for family.

You can review the full plan design and benefits of the Aetna HMO plan here.

What’s my paycheck cost?

Samsara covers 100% of the cost of employee coverage for the Aetna HDHP plan, where applicable. If you select one of the other plans and/or cover dependents, you’ll share a portion of the cost with Samsara.

Monthly Employee Contribution
Plan Name EE Only EE + SP/DP EE + CH EE + FAM
Aetna HMO 72 245 187 375
Aetna OAMC HDHP 0 140 94 245
Aetna OAMC PPO 71 241 184 368

Aetna Programs (Available to all Samsara Aetna members)

Aetna Concierge - 833-554-1545

  • Personal health care assistant to locate providers, understand your benefits, estimate out of pocket costs, and more.

24 Hour Nurse Line - 800-556-1555

  • Talk to a registered nurse for information about tests, procedures and treatment options, 24 hours a day, 7 days a week for free.

Minute Clinic - cvs.com/minuteclinic

  • Access to convenient, local care at a MinuteClinic location at no cost (deductible applies for employees enrolled in HDHP). MinuteClinic is a walk-in clinic located inside select CVS Pharmacy and Target stores, treating a variety of illnesses, injuries and conditions.

Teladoc - Teladoc.com/Aetna 

  • 24/7 access to talk to a doctor, therapist, or medical expert anywhere you are by phone or video. You can request visits three ways: online, via the Teladoc app or by phone. You can speak to a doctor on demand in minutes, or schedule a time that’s more convenient.

Aetna Attain Wellness Program - attainbyaetna.com

  • The Attain by Aetna app combines your health history with your Apple Watch activity to offer personalized goals, achievable actions and big rewards — like an Apple Watch or gift cards.  

One Medical - onemedical.com

  • Samsara will reimburse the cost of a One Medical annual membership fee for employees and dependents enrolled in a Samsara Aetna* plan. Employees will need to purchase the membership fee out of pocket and then submit the expense through Expensify (code to 'Office Expenses').

  • *Please note that One Medical does not accept all insurance plans, and it varies by region. Before purchasing the membership, please see here to check which plans One Medical is currently accepting.

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