Important Aetna Renewal Information and Available Healthcare Options
Helping Employers Navigate Rising Healthcare Costs
At PrestigePEO, we’re committed to helping employers deliver high-quality healthcare benefits as they navigate an increasingly complex healthcare landscape.
Throughout the year, PrestigePEO closely monitored healthcare renewal trends across the market and identified significant increases impacting many employers nationwide.
As part of this year’s renewal process, employers may have access to multiple healthcare options for consideration. This Resource Center was developed to help brokers and clients review available information, compare healthcare solutions, and access resources that support informed benefits decisions.
This Resource Center was created to help brokers and employers:
- Understand the current renewal environment
- Review available healthcare options
- Compare carrier strengths and plan strategies
- Access resources needed to support informed decision-making
- Navigate the transition process with confidence
Why Additional Options Are Being Presented
Healthcare costs continue to rise across the industry, creating challenges for employers seeking to balance affordability, employee access to care, and long-term benefits strategy.
As part of the 2026-2027 renewal process, some affected clients may have the opportunity to review additional healthcare options alongside their current Aetna offering. This enables employers to evaluate available solutions and determine which approach best aligns with their workforce needs, provider preferences, and organizational goals.
Our objective remains simple:
Maintain quality healthcare coverage
Protect the value of employee benefits programs
Provide additional options for consideration
Support employers and brokers throughout the renewal process
Understanding Your Aetna Renewal
While PrestigePEO is presenting additional healthcare options for consideration, clients on Aetna may still evaluate their existing Aetna renewal alongside available alternatives.
Aetna continues to offer several strengths that may remain important considerations for certain employers and employee populations, including:
- Broad national provider network access and regional/joint-venture solutions
- Integrated CVS Health resources, including pharmacy and MinuteClinic services
- Up to $140 annually in OTC wellness benefits for eligible members
- Multiple plan designs supporting a range of employee and employer needs
- Digital tools and member resources that simplify healthcare management
- Preventive care, wellness initiatives, and whole-person health programs
- Member support and healthcare navigation resources
Employers should review available renewal information and alternative carrier solutions carefully to determine which option best aligns with workforce needs, provider preferences, and budget objectives.
What’s Changing for 2026-2027
While all current Aetna plan structures remain available, several plans include updates to cost-sharing provisions for the upcoming plan year.
Common Themes Across the Portfolio
- Emergency room and ambulance copays have been updated across multiple plans, with several moving to $500 and others improving to $350 after deductible.
- Tier 2 and Tier 3 prescription drug copays have been adjusted to $50 / $80 on several plans.
- Certain HDHP plans have updated deductible structures.
- Select regional plans include modifications to virtual care programs.
- Most plans remain structurally unchanged, with updates focused on member cost-sharing and plan provisions.
Any benefits not specifically listed remain unchanged.
Plan Changes 2026-2027
Review side-by-side plan updates, benefit enhancements, and new options for the 2026-2027 plan year.
As part of this year’s renewal season, we’ve summarized key plan updates and enhancements to help you evaluate available options with confidence.
Review the information below to compare current and renewal plan offerings, identify notable changes, and better understand the opportunities available for the 2026-2027 plan year. Any benefits not listed remain unchanged.
National OAMC Plans
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| Prescription Coverage | $10/$45/$70 | $10/$50/$80 |
| Pharmacy – RX Copay Tier | 50% after $10/$45/$70 | 50% after $10/$50/$80 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Specialist Office Visit | 0% | $40 after ded |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Specialist Office Visit | 0% | $10 after ded |
| Pharmacy – RX Copay Tier | 50% after $10/$55/$90 | 50% after $10/$50/$90 |
National OA EPO Plans
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Maximum OOP (Individual / Family) | $5,500 / $11,000 | $6,000/$12,000 |
| Prescription Coverage – Advanced Control-Aetna | $10/$45/$70 | $10/$50/$80 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Specialist Office Visit | $70 | $75 |
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| Pharmacy – RX Copay Tier | 50% after $10/$45/$70 | 50% after $10/$50/$80 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Specialist Office Visit | 0% | $10 after ded |
| Prescription Coverage – Advanced Control-Aetna | $10/$55/$90 | $10/$50/$90 |
National HDHP Plans
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Individual/Family Deductible | $3,300/$6,600 | $3,400/$6,800 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Individual/Family Deductible | $3,300/$6,600 | $3,400/$6,800 |
| Inpatient Hospital | $500/day, 3 days | $3,400/ $750; then 10% after ded |
National OOA Plans
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| Prescription Coverage Advanced Control-Aetna | $10/$45/$70 | $10/$50/$80 |
| Pharmacy – RX Copay Tier | 50% after $10/$45/$70 | 50% after $10/$50/$80 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Specialist Office Visit | 0% after ded | $40 after ded |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Individual/Family Deductible | $3,300/$6,600 | $3,400/$6,800 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Individual/Family Deductible | $5,950/$12,900 | $5,900/$12,800 |
NY OAMC Plans
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| OON Reimbursement | 80% UCR/HIAA | 80% Fair Health |
| Outpatient Surgery-Hospital | $0 | $75 |
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| OON Reimbursement | 80% UCR/HIAA | 80% Fair Health |
| Outpatient Surgery-Hospital | $0 | $75 |
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
NY EPO Plans
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Specialist Office Visit | $80 | $75 |
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Specialist Office Visit | 0% after Ded | $90 |
AZ Banner JV
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| “CVSH Virtual Care / CVSH Virtual PCP” | Not Covered | |
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| “CVSH Virtual Care / CVSH Virtual PCP” | Not Covered | |
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| “CVSH Virtual Care / CVSH Virtual PCP” | Not Covered | |
| Emergency | $400 | $350 |
| Ambulance | $400 | $350 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| “CVSH Virtual Care / CVSH Virtual PCP” | Not Covered |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| “CVSH Virtual Care / CVSH Virtual PCP” | Not Covered |
CA HMO-AWH
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| Standard Virtual Office Visit (Teladoc) | $56 | $58 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| Standard Virtual Office Visit (Teladoc) | $56 | $58 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| Standard Virtual Office Visit (Teladoc) | $56 | $58 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| Standard Virtual Office Visit (Teladoc) | $56 | $58 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| Standard Virtual Office Visit (Teladoc) | $56 | $58 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| Standard Virtual Office Visit (Teladoc) | $56 | $58 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| Standard Virtual Office Visit (Teladoc) | $56 | $58 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| CVSH Virtual Care / CVSH Virtual PCP – Not Covered | Not Covered | $0 Virtual Care only |
| Standard Virtual Office Visit (Teladoc) | $56 | $58 |
UT AWH
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| 2025-2026 Plan | 2026-2027 Plan | |
|---|---|---|
| Emergency | $350 | $500 |
| Ambulance | $350 | $500 |
| Prescription Coverage Advanced Control-Aetna | $10/$45/$70 | $10/$50/$80 |
| Pharmacy – RX Copay Tier | 50% after $10/$45/$70 | 50% after $10/$50/$80 |
Aetna Renewal User Guide
Compare Plans, Evaluate Option, and Confirm Your Renewal Strategy
To help simplify the renewal review process, we’ve created an Aetna Renewal User Guide that provides step-by-step instructions for reviewing and comparing available healthcare options directly within the PrestigePEO Benefits Renewal Portal.
The guide walks you through:
- Creating a renewal model
- Reviewing available plan comparisons
- Comparing current and renewal rates
- Evaluating available carrier options
- Selecting renewal plans
- Confirming enrollment transfers
- Managing multiple benefit groups
Whether you’re reviewing your current offering or evaluating additional healthcare options, this resource is designed to help make the decision-making process more efficient and informed.
Compare Your Available Options
Evaluating Aetna Alongside Available Alternatives
Aetna client groups may have the opportunity to evaluate:
- Remaining with Aetna
- Cigna
- UnitedHealthcare
- Oxford
- Open-market benefit programs (where applicable)
Each option offers different advantages related to provider access, employee experience, healthcare resources, and overall affordability strategy.
| Consideration | Aetna | Cigna | UnitedHealthcare | Oxford |
| Provider Network Access | Broad national network plus regional offerings | Open Access Plus Network | One of the largest national networks | Strong regional and Metro-focused access |
| Plan Availability | Existing plans remain available | Expanded portfolio and new options | Established plan portfolio and member resources | Additional Metro and HSA-compatible offerings |
| Virtual Care | CVS integration and virtual care offerings | Virtual care and wellness resources | Telehealth and digital care solutions | Carrier-specific virtual care resources |
| Member Programs | OTC benefits, CVS integration, wellness resources | Wellness and support programs | Rewards, advocacy, and wellness initiatives | Regional resources and support services |
| Best Suited For | Employers wishing to maintain current carrier relationships | Employers seeking expanded plan choice and affordability opportunities | Employers prioritizing provider access and member resources | Employers seeking flexibility and alternative plan strategies |
The best solution for each client will depend on employee demographics, provider needs, utilization patterns, budget objectives, and long-term benefits strategy.
Available Healthcare Options
Reviewing Alternative Solutions
Cigna
Expanded plan offerings
Additional lower-premium alternatives
Lower member cost-sharing opportunities in select plans
Nationwide Open Access Plus Network
UHC
One of the nation's largest provider networks
Virtual care and telehealth services
Wellness and rewards programs
Clinical advocacy and support resources
Oxford
Expanded Metro
plan offerings
Additional HSA-compatible options
Greater plan flexibility
Strong provider network options
Open Market Benefit Programs
Certain clients may also have access to alternative open-market solutions based on eligibility and group characteristics.
Dental and Vision Coverage Updates
Important Updates for the Upcoming Plan Year
As part of this year’s renewal season, updates have been made to certain dental and vision plan offerings for the 2026–2027 plan year.
We encourage you to review your renewal information carefully, as available coverage options, plan designs, and benefit details may vary by group. Your renewal materials will provide a complete overview of any applicable updates and available offerings.
As always, your PrestigePEO Benefits Team is available to help you evaluate your options and make informed decisions that best support your organization and employees.
Enhanced Tools Through the PrestigePEO Benefits Renewal Portal
Compare Plans with Confidence
- Side-by-side plan comparisons
- Easier visibility into plan changes
- Simplified benefit summaries
Evaluate Contribution Strategies
- Contribution modeling tools
- Employer and employee contribution visibility
- Improved budgeting support
Streamlined Renewal Experience
- Improved dashboard performance
- Centralized renewal information
- Convenient access to supporting resources
As always, your dedicated PrestigePEO Benefits team remains available to provide guidance and support throughout the renewal season.
Supporting You Through Open Enrollment
Questions about your renewal options?
Our Benefits Specialists and Benefits Account Managers are available to provide guidance, answer questions, and support you throughout the renewal process.
Contact us at: 833-PEO-BEN1 or [email protected]
Thank you for your continued trust in PrestigePEO. We’re proud to support you throughout another successful Open Enrollment season.