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Tiered-Network Incentive Program

For Plan Year 2025, the State Health Benefits Program (SHBP) will continue to offer an Incentive Program for the Aetna Liberty Plus and Horizon OMNIA Tiered-Network plans. This program encourages employees to subscribe to the Tiered-Network Plan by offering a one-time financial incentive. Newly eligible employees enrolling during the remainder of 2024 as well as Plan Year 2025 are eligible for this incentive.

The Incentive Program is available to first-time enrollees who must remain enrolled in the plan for 12 consecutive months. This program does not extend to over age children under the provisions of Chapter 375 or COBRA members. The program offers a $1,000 financial incentive to first-time enrollees at any coverage level. (e.g., Single, Member and Spouse, Parent and Child, or Family coverage).

IMPORTANT – The incentive shall be forfeited and returned to the SHBP if you fail to remain enrolled in the Tiered Plan for one plan year, except if you become ineligible for healthcare due to layoff, involuntary separation, reduction to part-time status, or classification into an ineligible position.

State employees are automatically eligible to participate in the program. For local employees, the incentive program is voluntary and at the option of the employer; therefore, eligibility for the incentive is based on whether the employer chooses to participate. Local employers should complete a Resolution for the Incentive Program for the Tiered-Network plans .

What is a Tiered-Network Plan?

The Aetna Liberty Plus and Horizon OMNIA Health Plans give members the flexibility to visit practitioners in the carrier’s managed care network with significant premium share reductions and no referrals required. The plans offer members lower cost sharing, with copays as low as $5.00 for an office visit, when utilizing Tier 1 providers. Tier 1 refers to specific doctors, hospitals and other health care professionals who offer cost-effective care. Liberty Plus and OMNIA plan members also have the flexibility to see any Tier 2 provider included in the managed care network, but with higher cost sharing. There is no out-of-network coverage with either tier.

Note: This incentive is for active members enrolled in the SHBP only.

For more information about the tiered-network plans:

Aetna’s Liberty Plus Health Plan – Members can identify Tier 1 and Tier 2 providers on the Aetna online Doctor & Hospital finder

Horizon’s OMNIA Health Plan -- Members can identify Tier 1 and Tier 2 providers on the Horizon online Doctor & Hospital finder