Caregiver Frequently Asked Questions

Answers to frequently asked questions about our new medical and prescription drug plan administrator coming in 2025.

In the months to come, we will be preparing benefit information for caregivers to review prior to open enrollment this fall. To help answer questions you may have, please refer to the below FAQ.

Read the announcement from Greg Till, our Chief People Officer.

1. What is changing?

Aetna will become the third party administrator (TPA) for our caregiver medical and prescription drug plans beginning Jan. 1, 2025. Our HMO plans, where currently offered, will not be changing.

2. What is a third party administrator (TPA)?

A TPA is engaged to handle certain administrative functions for self-funded medical and pharmacy benefit plans. Aetna, as the new TPA, will perform streamlined administrative services for claims processing, network administration, billing, record keeping, customer service and utilization and care management for medical, surgical, mental and behavioral health and prescription drugs benefits. Aetna will administer the benefits in accordance with the plan design and various regulations governing the plans.

3. What does this mean for me?

Nothing is changing this year. During open enrollment in the fall, you’ll have the opportunity to evaluate and choose your benefits for 2025. Your medical plan options and key features such as deductibles and out-of-pocket maximums are not changing with the TPA change. As always, our goal is to continue to provide you with care and well-being support for you and your family.

4. Why are you informing us about this change now?

At Providence and our family of organizations, we are committed to keeping you informed, which is why we are providing a brief update at this time. We are following a thoughtful and transparent approach to this transition and taking time to connect with leaders and caregivers across our family of organizations.

5. Why is Providence changing from Providence Health Plan (and Baylor Scott & White in Texas) for our medical and pharmacy plan administration?

Operating nationwide, Aetna is one of the largest and most diversified health care benefits companies. Aetna offers robust member support through advocacy, an integrated medical and behavioral health network, care management and 24/7 access. We believe that Aetna’s scope and scale will offer streamlined and enhanced benefit services to our caregivers and their family members.

6. Will this change affect my current benefits for 2024?

The change to Aetna in 2025 will not affect your benefits in 2024.

7. Do I need to do anything right now?

No. Caregivers will receive more details about their health plan options and benefits before the open enrollment period this fall.

8. When can we expect more detailed information about this transition?

We plan to begin sharing more details with you later in the summer.