Healthcare Benefits for Greater New York-New Jersey Benefit Fund Members

Effective September 1, 2022, eligible Greater New York-New Jersey members will receive medical coverage through the Aetna Premier Care Network Plus Plan. By choosing participating providers within the Aetna network, you receive quality care with minimal co-pays for certain services.

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.

Aetna Premier Care Network Plus Plan

  • Administered by Aetna
  • New Aetna ID card Only,* Prescription and Dental ID Cards remain the same
  • Co-pays for visits and hospital stays
  • Use out-of-network provider in emergency only
  • $15 weekly co-premium for spouse*
  • $10 weekly co-premium for children, no matter how many you are covering*
  • Two open-enrollment periods – January and July*

*Updated plan change, effective September 1, 2022.

To confirm your existing provider is still in-network or to find a new provider, please visit www.aetnadocfind.com/2022-apcn-plus-oaas and follow these steps:

  • Click on “Find a Doctor”
  • Enter your ZIP code and click on “Start Your Search”
  • Enter your home location under “Continue as a Guest” and click on “Search”
  • Search for your existing provider by name or search for a new provider by category

If you are currently receiving care, please complete and submit an Aetna Transition Coverage Request Form.

Additional Resources