Residents and Fellows

Yes, we recommend that you review your benefits for accuracy.
During open enrollment, you will have the choice between two health plans in Workday:

1. EHP
2. EHP Plus (includes a national network of providers)

EHP
The EHP offering includes the Cleveland Clinic Quality Alliance (QA) network and the Florida Clinically Integrated Network (CIN). These networks include Cleveland Clinic facilities and employed physicians as well as contracted facilities and providers in Ohio and Florida.

Please note: University Hospitals Health System, Akron Children’s Hospital, Aultman Hospital, Summa Health System and their affiliates are not included in the EHP network.

EHP Plus 
The EHP Plus offering gives members access to the providers available in the EHP plan (above), PLUS Aetna's Open Access Select network, which includes providers nationwide. Akron Children’s Hospital is included in the EHP Plus network.

Please note: University Hospitals Health System, Aultman Hospital, Summa Health System and their affiliates are not included in the EHP Plus network.

Both plans offer the same benefits and coverage, while premium and network size differ. The choice is up to you when you make your health plan elections during open enrollment.

You must take action during open enrollment by logging into Workday and electing either EHP or EHP Plus.
*Residents/Fellows who do not complete open enrollment will default to the EHP plan. 

More details on these plans and the enrollment process will be available one week prior to open enrollment which is Oct. 17 – Nov. 1, 2024.
 

Yes. Cleveland Clinic provides comprehensive health and prescription drug coverage for our caregivers, and the benefit coverage is the same for both EHP and EHP Plus. The difference between the two plans is the network of providers and the benefit cost. Under the EHP Plus option, you receive access to the Aetna Select Open Access (national) network which also includes the Cleveland Clinic Quality Alliance network.  Because EHP Plus includes nationwide providers, the cost will be higher. This is the standard in any insurance offering.  Premiums will be available at open enrollment.

A provider search is available on the Employee Health Plan Website for the EHP and EHP Plus networks (see below).

EHP provider search
EHP Plus provider search

It is your responsibility to verify your provider’s participation in the networks. Please reference the Aetna provider search tools to identify physicians and facilities covered in each plan.

Having trouble finding your provider?  Contact the Aetna Concierge customer service unit at 833.414.2331.   
 

These medical institutions and their affiliates are excluded from both EHP and EHP Plus unless services provided are for emergency or urgent care.

In case of an emergency, services will be covered by either the EHP or EHP Plus plan at any location as outlined in the Summary Plan description.

In 2025, Akron Children’s Hospital (ACH) will be available to any caregiver who elects EHP Plus during open enrollment. If you would like to maintain your coverage for ACH, you must elect EHP Plus. There is no coverage for ACH under the EHP option.
 

Providers who are included in the Cleveland Clinic Quality Alliance or Aetna Select Open Access networks will be covered if you elect EHP Plus.  If your specialist is participating in either of these networks, they are considered in-network and services will be covered.  You can access the provider search tool for the EHP Plus option to confirm that your specialist participates in the Aetna Select Open Access network.
 

A referral is not required to see a specialist in EHP or EHP Plus.

Both EHP and EHP Plus have large networks of participating Behavioral Health providers. Before open enrollment, you will be able to search providers for each plan. There is no out-of-network coverage in either plan except emergency or urgent care. 

A provider search is available on the Employee Health Plan Website for the EHP and EHP Plus networks (see below).

EHP provider search
EHP Plus provider search

No, the current prescription drug plan will continue to be managed by the Employee Health Plan Pharmacy Management Department and insured by CVS/Caremark.

The health plan’s Prescription Drug Benefit Formulary can be found on the Employee Health Plan Website, along with other information related to the Prescription Drug Benefit Program. Medications may be added to the formulary four times a year and removed from the formulary twice a year, once at the start of the benefit year in January and again at mid-year in July. Caregivers should consult the health plan’s Prescription Drug Formulary to determine whether their current medications are included in the formulary, and to discuss alternative options with their healthcare provider if their current medication is not covered. Note: The pharmacy information on the Employee Health Plan website is subject to change in 2025. 

Yes, the Prescription Drug Benefit Program is the same for both EHP and EHP Plus members.

EHP and EHP Plus members can utilize any of the CVS store pharmacies, including those located inside Target stores, to obtain acute need prescription medications. Please note the charge will apply to your annual pharmacy deductible even if you fill the prescription with a generic medication. 

Yes, your vision exams are covered under the EHP and EHP Plus health plans. You also have the option to enroll in our vision plans, which provide discounts on glasses and contacts. More information about vision plan coverage will be provided closer to the open enrollment period.

If you are already registered with Aetna Health, you will receive a new digital health plan ID card. You can view your digital health plan ID card by logging into Aetna Health.
If you are not registered with Aetna Health, you will receive a physical health plan ID card in the mail. *Please be sure your address is up to date in Workday prior to open enrollment. 

Don’t have an account? Follow these instructions to register with Aetna Health.

You should use your existing health plan ID cards through December 2024 for services. 

Yes, if your OB provider is not in your network and you are experiencing a high-risk pregnancy or if you are having a routine pregnancy and are at 20 weeks or more gestation as of 1/1/2025.

Eligible dependents who are away at school, like college students, are covered no matter which plan option is selected, EHP or EHP Plus, if they use in-network providers for that plan. 

Both EHP and EHP Plus plans allow college students to visit their student health center for non-routine, non-preventive services. These services will be covered as a specialty visit with a $35 copay. Services may include, flu shots, tetanus shots, allergy therapy, and PT/OT/Speech Therapy, if these are provided at the student health center. It is your responsibility to ensure the service you need can be performed at the college’s student health center for coverage. 

There is no out-of-network coverage in either plan except for Emergency and Urgent Care visits. Urgent visits to the college student health centers for an acute illness are treated as such but may initially be denied as not all college student health centers are contracted with Aetna. If you receive a bill, contact Employee Health Plan Customer Service for resolution at 216-986.1050 or 888.246.6648.
 

Please bookmark this site for the most current information. You can also reach out to the following departments with general questions:

• Workday or benefits questions: Contact the HR Service Center at 216.448.2247 or 877.688.2247.
• Employee Health Plan questions:  Contact the Employee Health Plan at 216.986.1050 (option 1) or the Aetna Concierge Customer Service team at 833.414.2331.
• Employee Health Plan Pharmacy Management questions: Contact the Pharmacy Management Department at 216.986.1050 (option 4) or 888.246.6648 (option 4). You can also email the department at [email protected].