Important Information from Aetna
Upcoming Changes to Your Aetna Health Plan
November 1, 2025
As part of our ongoing commitment to offer competitive and comprehensive benefits, PrestigePEO is introducing 26 new Aetna plan options for the upcoming plan year. These additions are designed to provide more flexibility, competitive rates, and expanded coverage choices for you and your employees.
Before reviewing all plan changes, please note that some plans will not be renewed for the upcoming plan year.
Plans No Longer Offered and Recommended Alternatives
The following plans will be discontinued for the 2025-2026 plan year. We’ve identified recommended alternatives for each termed plan to ensure a smooth transition and maintain comparable coverage.
Please note: If any employees are currently enrolled in these plans, they must select a new plan during Open Enrollment to avoid a lapse in coverage.
Sunsetted Plan |
Recommended Alternative(s) |
Why This Plan Is a Good Fit |
|---|---|---|
OAMC Plan 1 |
Plan 71 or Plan 72 |
Plan 71: Rich benefits with no in-network deductible and a small out-of-network deductible.Plan 72: Cost-sharing option with a lower premium and first-dollar coverage for preventive care, primary visits, labs, walk-in clinics, and generic drugs. |
EPO Plan 13 |
Plan 41 |
Closest match in benefits, copays, and network access. |
OA MC 300/90% (Plan 01) |
Plan 71 or Plan 72 |
Similar structure: Plan 71 offers a richer benefit designwhile Plan 72 provides a more cost-effective alternative. |
OA EPO 6350/80% (Plan 13) |
Plan 41 |
Aligns closely with the original plan’s design and network. |
By transitioning to one of these recommended plans, members can maintain consistent access to care while selecting an option that best fits their needs and budget.
Plan Changes Addressed Below
OAMC Plans
- Plans 18 & 19:
- Specialist copay increased (Plan 18).
- Ambulance copay increased to $400 (Plans 18 & 19).
- All 6 OAMC NY Plans:
- Out-of-network deductible and OOP maximum reduced from 2.5x to 2x the in-network amounts.
EPO Elect Choice Plans
- Plans 24 & 25:
- Ambulance copay increased to $400.
National OAMC Plans
- Plan 3 & Plan 8:
- In-network OOP maximums changed.
- Plan 8:
- ER and ambulance copays increased to $500.
- Plans 5, 6, 7, & 8:
- Out-of-network deductible and OOP maximum reduced from 2.5x to 2x the in-network amounts.
- Plans 8 & 9:
- RX copay updated to $15 / $55 / $90.
National EPO Elect Choice Plans
- Plans 11 & 12:
- Copays for primary and specialist visits decreased.
- Plans 12 & 41:
- Added copay for outpatient surgery after deductible.
- Plan 12:
- ER and ambulance copays increased to $500.
National HDHP Plans
- Minimal changes to Plans 14, 40, 15, 38, and 39.
National Open Choice Plans
- Designed for employees in areas without OAMC/Elect Choice networks (e.g., Montana, Idaho, Alaska).
- Expansion from 4 plans to 9 total plans with the addition of Plans 76–80.
Ambulance copay increased to $350.
5 New Plans: 87–91
6 New Plans: 81–86
- 5 HMO Network Plans (Northern & Southern CA).
- 4 Value Network HMO Plans (Northern & Southern CA).
- 5 HMO Plans specific to Southern CA.
Overview of New Plans Available for 2025-2026 Plan Year
- National OAMC: 2 New Plans (71 & 72).
- National EPO Elect Choice: 3 New Plans (73–75).
- National Open Choice: 5 New Plans (76–80).
- Arizona: 5 New Plans (87–91).
- Utah: 6 New Plans (81–86).
Maven Maternity (Included with Your Aetna Plan)
Your Aetna® health plan includes access to Maven Maternity at no cost, providing 24/7 pregnancy and postpartum support for you and your partner, all in one app.
Maven Benefits Include:
- Virtual appointments & messaging with providers in 35+ languages
- On-demand classes, groups, and culturally humble guidance
Important Information for Metlife Dental and Solstice Dental
MetLife and Solstice Dental Rate Updates – Effective at Renewal
As part of our continued commitment to transparency and proactive benefits planning, we share essential updates to your dental benefit options for the upcoming renewal period.
MetLife Dental Rate Adjustments
The following MetLife Dental plans will see a 3.5% increase, effective at your next renewal:
- MetLife Dental DHMO
- MetLife Standard Plan – $1,000 Annual Max
- MetLife Premium Plan – $2,000 Annual Max
- MetLife Enhanced Plan – $5,000 Annual Max
These modest adjustments reflect updated market conditions while preserving your employees’ value and quality of coverage.
Solstice Dental National Rates
Solstice continues to offer competitively priced DHMO plans to support employee access to quality dental care nationwide. Below are the updated monthly rates for Solstice DHMO plans:
Solstice Dental National Rates |
Low PLan |
High Plan |
|---|---|---|
Solstice DHMO R1 |
11.67 |
19.40 |
Solstice DHMO R2 |
23.34 |
38.8 |
Solstice DHMO R3 |
26.52 |
44.09 |
Solstice DHMO R4 |
37.13 |
61.72 |
What's New This Year?
MetLife and Solstice Dental Rate Updates – Effective at Renewal
We’ve made several enhancements to the Renewal Portal to help make Open Enrollment faster, easier, and more transparent for you and your team. Here’s what you can expect:
Smarter Plan Comparison Tools
- Side-by-side benefit summaries: Easily compare your current plans with multiple renewal options.
- Clear change indicators: See exactly what’s new or different with color-coded highlights.
- Streamlined summaries: Focused, easy-to-read benefit breakdowns for quick decision-making.
Simplified Contribution Modeling
- Build and track your own models: Create, rename, or delete contribution models based on your needs.
- See who created what: Know whether a model was built by your team, broker, or internal PrestigePEO support.
- Submission record: Automatically get a copy of the final model submitted for your records.
Enhanced HSA Contribution Inputs
- Employer contribution tracking: Tell us whether you’re contributing to HSAs and how you want those contributions structured (annually, monthly, or per pay period).
- Custom rules for new hires: Choose whether new participants receive prorated or full contributions.
Improved User Experience
- Client name displayed clearly on all screens and downloadable menus.
- Access to employee census reports directly from the Open Enrollment Report Center (no PII included).
- Full visibility into your current and renewal employer/employee contributions for better budgeting.
These updates are designed to support your Open Enrollment planning from start to finish. As always, your dedicated Benefits Specialist is here to help if you have any questions!
New Voluntary Benefits
We’re introducing new voluntary benefits and programs that will enhance your overall well-being and provide unprecedented family-building and caregiving support.
BenExtend
We’re proud to offer an exciting new benefit through Aflac:
BenExtend is a powerful, employer-paid plan that combines key features of accident, hospital indemnity, and critical illness coverage into one simplified policy.
If your employer offers BenExtend, you’ll have access to enhanced financial protection, with no restrictions based on your health history or pre-existing conditions. Its comprehensive coverage is made accessible for everyone.
Click here to learn more.
Resources & Support for a Successful Open Enrollment
Your Open Enrollment Resource Center
Visit www.prestigepeo.com/openenrollment to access everything you need for a smooth and informed Open Enrollment season.
You’ll find valuable tools, plan information, FAQs, and resources tailored for you, your broker, and your employees. We encourage you to explore this site to prepare for important decisions ahead.
Need Help? We're Here for You
Our benefits specialists are ready to assist with any Open Enrollment questions, reach us at 833-PEO-BEN1 or oequestions@prestigepeo.com You can also connect directly with your assigned Benefits Specialist via the PrestigeGO mobile app for quick access and real-time support.
Your Role as a PrestigePEO Client Manager
As a key leader in your organization, you play a vital role in guiding your employees through Open Enrollment. Here’s how you can support your team:
- Reinforce our shared commitment to offering competitive, comprehensive benefits tailored to employee needs.
- Direct employees to the Open Enrollment Resource Center to explore benefit options and helpful tools.
- Encourage your team to evaluate their coverage needs, compare plans, and complete their elections during the Open Enrollment window.
- Remind employees that they can contact the Prestige Benefits Team at 833-PEO-BEN1 or oequestions@prestigepeo.com or use PrestigePRO to access their benefits portal.
Thank you for your continued trust in PrestigePEO. We’re proud to support you and your team and look forward to another successful year together.