2026 AtlantiCare Benefits Booklet

GETTINGTOKNOWYOURNEW MEDICAL PLANTHIRDPARTY ADMINISTRATOR

WELCOME....................................2 WHAT’S NEW..............................3 HOW TO ENROLL......................4 HEALTHCARE TRANSFORMATION CONSORTIUM (HTC)...............6 GETTING TO KNOW YOUR PLAN.................................7 MEDICAL......................................8 PRESCRIPTION DRUG.......... 17 FQHC........................................... 19 ADDITIONAL MEDICAL PLAN RESOURCES................. 20 WELLNESS PROGRAM......... 21 DENTAL...................................... 23 VISION........................................ 25 LIFE INSURANCE.................... 28 DISABILITY............................... 30 VOLUNTARY OFFERINGS... 31 EDUCATIONAL SUPPORT & CAREER DEVELOPMENT...................... 31 FINANCIAL WELL-BEING.... 32 HEALTH &WELLNESS.......... 33 SAVINGS.................................... 34 VOLUNTARY BENEFITS....... 35 SPENDING ACCOUNTS............................... 38 RETIREMENT BENEFITS................................... 39 CONTACTS................................ 41 LEGAL NOTICES....................... 43 WELLNESS CHECKLIST........ 45

FAQ Q: What does a Third-Party Administrator (TPA) do? A: A TPA processes claims, manages provider networks, issues ID cards, and provides customer service. The health plan itself continues to be AtlantiCare’s. Q: Will my benefits change under Aetna? A: The plan design remains AtlantiCare’s. While the administrator changes, our benefits strategy, oferings, and priorities continue to be guided by AtlantiCare. Through Aetna and the HTC network, you will have more options for care and resources available.

Beginning in January 2026, Aetna will be acting as the Third-Party Administrator (TPA) for the AtlantiCare Health Plan. Aetna is one of the nation’s leading diversified health care benefits companies which includes a provider network spanning hundreds of thousands of doctors and thousands of hospitals. With Aetna, you’ll have access to the following: • Care Management including personalized nurse support through the 24/7 Nurse Help Line. 1-833-590-1141 • Tools, tips and support centers are available through the Aetna/ AtlantiCare member microsite – Locate a provider, review your personal health record, and watch informational health videos. • Access to information—whenever, wherever – Your member website is fully mobile. Remember,

this is your one-stop shop for getting the help you need. And when you download the Aetna Health TM app, you can access it all from the palm of your hand.

Search for Aetna Health SM app in the App Store or Google Play, or scan this QR code to download the app

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