New Aetna Network

As you may know, national health care costs are increasing at a faster pace than in years past due to inflation, health care labor shortages, and new specialty prescription drugs—and this trend is expected to continue. In recent years, Princeton and its faculty and staff have taken important actions to mitigate increases in the cost of medical plans, which provide affordable health care options for all University employees. For 2025, Princeton is introducing the following changes to its medical plans that can reduce your costs while continuing to provide the same high-quality choices you have today.

• Contributions: If you are enrolled in an Aetna plan, 2025 contributions will not increase (with the exception of the J-1 Visa plan). Contributions for J-1 Visa and the UnitedHealthcare plan will increase 9%. 
• Plan Names: The Aetna and UnitedHealthcare Princeton Health Plans (PHP) will be renamed the Point of Service (POS) plans. 
• Plan Change: The HMO Plan is changing to an Exclusive Provider Organization (EPO) plan. The EPO offers more flexibility; referrals for specialists are no longer required and you do not need to select a primary care physician. 
• New Aetna Network for those living in NJ and Southeastern PA: We will introduce a high-performing network, the Aetna Premier Care Network Plus (APCN+), for the Aetna CDHP, POS, and EPO Plans. This new multi-tier network will provide the greatest amount of savings and flexibility so you can get the most out of your coverage. The new Aetna network applies to employees living in New Jersey and Southeastern Pennsylvania, which is based on your zip code listed in HR Self Service under home/local address.  Since your home address will be used to determine network coverage under the Aetna CDHP, POS, and EPO plans, you should make sure that your address is up-to-date. 
• Coverage for those living in NY or outside of NJ/Southeastern PA:  If you live in New York, or any other location outside of NJ or Southeastern PA (as listed in HR Self Service), and enroll in the CDHP or Aetna Point-of Service Plan, you will continue to use Aetna's standard broad Choice POS II network that is currently place; your network is not changing.  If you elect the Exclusive Provider Organization Plan, you will utilize Aetna's standard broad Open Access Select network in 2025.  This network is similar to the HMO network in place in today. As long as you are utilizing an in-network provider, you will receive the Tier 1 level of coverage.
• Increased Princeton HSA Contribution: For the CDHP, Princeton’s HSA contribution will increase—for 2025 only—from $200 to $500 for individual coverage and from $400 to $1,000 for employee and children, spouse, or family coverage.
• UnitedHealthcare (UHC) Plan:  We know that some employees will still want to be able to choose UHC.  While the UHC Princeton Health Plan will now be called the UHC Point-of-Service (POS) plan, the network will remain the same, however, there will be some plan design changes to the deductible, coinsuranceAfter meeting the annual deductible, participants and the medical plan share coinsurance costs of some services, calculated by percent paid by both until reaching the annual out-of-pocket maximum. For out-of-network, participants pay above reasonable and customary limits. , out-of-pocket maximum and copays.  If you are enrolled in UHC today, it might be a good time to consider the Aetna plans for 2025.  Most providers who participate with UHC are also in-network with Princeton's Aetna medical plans, so your out-of-pocket costs will be lower in most situations. More details will be provided during Open Enrollment. 
• Learn More: Register for a webinar or attend an on-campus information session.  Additional sessions will be announced during open enrollment next month.

New Aetna Network – For Individuals Living in New Jersey and Southeastern PA

For individuals living in New Jersey and Southeastern PA, the Aetna plans will utilize a high-performing network, the Aetna Premier Care Network Plus (APCN+) This network has distinct tiers that offer different levels of coverage:

• Tier 1 – maximum savings; using this tier reduces your costs in most instances
• Tier 2 – standard savings; using this tier increases your costs in most instances
• Tier 3 – out-of-network (not available in the EPO Plan except for emergencies)

When you receive care, you will receive the highest level of coverage – tier 1 – when utilizing doctors and hospitals in the APCN+ network.   All other in-network doctors, hospitals, and providers will be covered at tier 2.   A review of our plans by Aetna indicates that 90% of in-network services provided to employees and their family members today are being provided by doctors and facilities that are Tier 1 in the APCN+ network. This means that most employees enrolled in Aetna plans today will be able to continue to use the same providers in 2025 while paying the same or less for services.  

Aetna Network – For Individuals Living in NY and other states other than NJ or Southeastern PA

If you elect the CDHP or Aetna POS Plan you will be using Aetna’s standard broad network to search for providers, which is the Choice POS II network of providers; the APCN+ network does not apply to you.     The Choice POS II network may sound familiar, as this is the network that was previously used for these plans in 2024.  You will have two levels of coverage, in-network tier 1 and out-of-network.  As long as your provider is in-network in the Choice POS II network, you will pay the tier 1 cost share for your care.   If you travel outside your home service area, you will continue to use the Choice POS II Network.

If you elect the EPO Plan, you will be using Aetna's standard broad Open Access Select network of providers; the APCN+ network does not apply to you.  This network is similar to the HMO network that was offered in 2024.  As long as your provider is in-network in the EPO plan, you will pay the tier 1 cost share for your care.  Out-of-network providers are not covered in this plan, unless the service is an emergency.    If you travel outside your home service area, you will continue to use the Open Access Select network.