Here is a comparison of the three endowed health plans the university offers

HealthNow POS, Aetna Open Choice PPO and the 80/20 Plan, in brief:

• Both HealthNow POS and the Aetna Open Choice PPO plans are managed-care plans.
• In both, each time you seek care, you have a choice of using either physicians who are in the plan network or physicians who are not in the plan network.
• In both, you get a cost break when you use health-care providers within the network.
• In the 80/20 Plan, there are no networks of providers with negotiated rates, so you do not get the cost breaks available with the managed-care plans.

The role of the primary-care physician and the differences in national provider networks are the two key differences between the HealthNow POS and the Aetna Open Choice PPO plans.

HealthNow POS (point of service plan) Plan:

• HealthNow POS plan participants are required to select a primary-care physician.
• Primary-care physicians provide much of the participants' care and refer care to other in-network specialists and facilities.
• You pay a $10 copay for office visits and 10 percent for other medical procedures.
• Your primary-care physician and all other in-network providers have agreed with a set of rates for their services. Your provider will not bill you for any excess over the negotiated rate.
• At the time you seek medical care (the "point of service"), you can decide to use an out-of-network provider for eligible medical services.
• Out-of-network providers have not agreed to negotiated rates. The POS Plan will pay 70 percent of reasonable and customary charges after a $250 deductible. There are no quick and easy copays, and you must submit claim forms for reimbursement.

Aetna's Open Choice PPO (preferred provider organization) Plan:

• Open Choice PPO Plan participants are not required to pick a primary-care physician.
• You are encouraged to use in-network providers from the Aetna preferred provider network. You will pay for many office visits with a $10 copay, but the plan may cover tests and other medical procedures only at the 90 percent level after a $150 deductible ($300/family).
• Providers in Aetna's network have agreed to a set of negotiated rates for the
  ir services.
• You may also use an out-of-network provider for eligible medical services.
• Out-of-network providers have not agreed to a set of reimbursement rates. Your expenses would be covered at 70 percent of reasonable and customary charges after a $300 deductible ($600/family). You must submit claims forms for reimbursement for out-of-network services.

Aetna 80/20 Plan (traditional indemnity coverage):

• Participants in the Aetna 80/20 Plan do not have a network of providers with negotiated rates to choose from.
• Most eligible medical services are reimbursed at 80 percent of reasonable and customary charges after a $300 deductible ($600/family).
• You are responsible for submitting properly completed claims forms for reimbursement.