Transcription of 2022 Aetna Summary of Benefits and Coverage: SERS
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2022 Aetna Summary of Benefits and Coverage: SERS
103039-945810-513005 Page 1 of 7 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services SCHOOL EMPLOYEES RETIREMENT SYSTEM OF OHIO : Aetna Choice POS II - HCPII Coverage Period: 01/01/2022-12/31/2022 Coverage for: Individual + Family | Plan Type: POSThe Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a Summary . For more information about your coverage, or to get a copy of the complete terms of coverage, or by calling 1-800-370-4526. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment, deductible, provider, or other underlined terms, see the Glossary.
In-Network: Individual $2,000 / Family $4,000. Out-of-Network: Individual $4,000 / Family $8,000. ... separate vision plan. Contact SERS. Children's dental check-up Not covered Not covered ... 2022 Aetna Summary of Benefits and Coverage: SERS ...
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