Health Benefits:
MEDICAL Coverage
Health Benefits:
MEDICAL Coverage
PRIMERICA offers four medical plan options. Review the chart for a side-by-side comparison of the plans. Remember, your deductibles for each plan option starts every January 1.
MEDICAL Comparison Chart
In-Network Coverage
*There may be limits to the number of physical/speech/occupational therapies in a year; you may be eligible for additional visits with Plan approval after a medical necessity review. Approved visits over plan limits will be covered at 70% after deductible In-Network.
NOTE: Under the Choice Plan, the individual deductible and out-of-pocket amounts are applied to each individual, even if the family amount has not yet been met. If you cover a dependent under the HDHP, no benefits are payable until the family deductible is met. In addition, the entire family out-of-pocket maximum must be satisfied before the plan pays all costs of covered care for the rest of the plan year. However, individuals will not pay more out-of-pocket for in-network services than what’s permitted by the Affordable Care Act for medical and prescriptions drugs combined $9,200 in 2025.
MEDICAL Comparison Chart
In-Network Coverage
IN-NETWORK DEDUCTIBLE
AETNA Choice Plan
$600 individual/ $1,200 family
AETNA HDHP Mid Level
$1,650 individual/ $3,300 family
AETNA HDHP High Level
$2,100 individual/ $4,200 family
GEORGIA KAISER HMO
$600 individual/ $1,200 family
IN-NETWORK OUT-OF-POCKET MAXIMUM
AETNA Choice Plan
$3,000 individual/ $6,000 family
AETNA HDHP Mid Level
$4,000 individual/ $8,000 family
AETNA HDHP High Level
$5,950 individual/ $11,900 family
GEORGIA KAISER HMO
$3,000 individual/$6,000 family
FSA/HSA AVAILABLE
AETNA Choice Plan
FSA
AETNA HDHP Mid Level
HSA
AETNA HDHP High Level
HSA
GEORGIA KAISER HMO
FSA
PREVENTIVE CARE Well-Adult Visits, Well-Child Visits, Cancer Screenings
AETNA Choice Plan
100%, no deductible
AETNA HDHP Mid Level
100%, no deductible
AETNA HDHP High Level
100%, no deductible
GEORGIA KAISER HMO
100%, no deductible
ER VISIT No Coverage under any medical plan if not a true emergency
AETNA Choice Plan
$200 copay
AETNA HDHP Mid Level
80% after deductible; authorization required within 48 hours if admitted
AETNA HDHP High Level
$2,100 individual/ $4,200 family
GEORGIA KAISER HMO
$200 copay; authorization required within 24 hours if admitted
COINSURANCE Primary Care Physician (PCP) Visits, Specialist Visits, Inpatient and Outpatient Hospital Services, Mental Health & Substance Abuse Services, Chiropractor Services, Therapies (Physical / Speech / Occupational*)
AETNA Choice Plan
80% after deductible
AETNA HDHP Mid Level
80% after deductible
AETNA HDHP High Level
80% after deductible
GEORGIA KAISER HMO
80% after deductible
*There may be limits to the number of physical/speech/occupational therapies in a year; you may be eligible for additional visits with Plan approval after a medical necessity review. Approved visits over plan limits will be covered at 70% after deductible In-Network.
NOTE: Under the Choice Plan, the individual deductible and out-of-pocket amounts are applied to each individual, even if the family amount has not yet been met. If you cover a dependent under the HDHP, no benefits are payable until the family deductible is met. In addition, the entire family out-of-pocket maximum must be satisfied before the plan pays all costs of covered care for the rest of the plan year. However, individuals will not pay more out-of-pocket for in-network services than what’s permitted by the Affordable Care Act for medical and prescriptions drugs combined $9,200 in 2025.
IN-NETWORK Coverage
While you have the option to choose out-of-network providers, staying in-network costs you less out-of-pocket with lower deductibles and out-of-pocket maximums. In addition, if you go out-of-network, you are responsible for 100% of the amounts over the recognized charge, as determined by Aetna, which may be substantial.
OUT-OF-NETWORK Coverage
Learn more about your out-of-network coverage for Aetna.
