Medical Benefit for GNY–New Jersey Members

You have access to a large network of primary care physicians (PCPs), specialists and hospitals in your Aetna Premier Care Network Plus–Aetna Whole Health Network through your Benefit Fund health coverage.

You can choose a Primary Care Physician (PCP) based on geographic location, group practice, medical specialty, language spoken or hospital affiliation. You may also request a printed copy of the provider directory by calling the toll-free number on your Aetna ID card.

Who Is Eligible?

Eligibility Class I, II and III members receive all the benefits listed below; a weekly $15 premium is required for spousal coverage, and a weekly $10 premium is required for eligible children coverage, no matter the number of children you cover.

Medical Benefit

Comprehensive medical, hospital and telemedicine care with small point-of-service costs.

Mental and Behavioral Health Benefit

Support through talk therapy, inpatient and outpatient treatment programs and coordinated care with small point-of-service costs.

Prescription Benefit

Prescription coverage with $10 co-pay for generic drugs and $15 co-pay for preferred brand name drugs.

Dental Benefit

Basic coverage through CIGNA, with modest co-payments and limitations for some procedures, excluding essential oral pediatric services, with no annual maximum.

Vision Benefit

One eye exam with $10 co-pay every two years, with $125 allowance once every two years for one pair of eyeglasses or contact lenses.

Life Insurance Benefit

Life Insurance benefit based on Eligibility Class.

Additional Resources

• Summary Plan Description (SPD)
• Overview
• Summary of Benefits and Coverage (SBC)