Wake Forest University offers two medical plan options:
- Low Plan: Lower premiums, larger deductible and out-of-pocket maximum.
- High Plan: Higher premiums, lower deductible and out-of pocket maximum.
Both plans offer Prescription and Behavioral health coverage.
Provider
Aetna’s Health Concierge Team: 855-586-6961
Wake Forest University’s Dedicated Inbox: WFU@aetna.com
*Members enrolled in the Aetna Whole Health Network are eligible to take advantage of Maximum Savings Tier when using Atrium Providers
Low / High Plan Deductible
Maximum Savings*
Individual: $600 / $250
Family: $1,500 / $625
Standard Savings
Individual: $1,250 / $750
Family: $3,125 / $1,875
Low / High Plan Out-Of-Pocket Max
Maximum Savings*
Individual: $2,500 / $1,200
Family: $6,250 /$3,000
Standard Savings
Individual: $4,000 / $3000
Family: $10,000 / $7,500
Telehealth Services
Wake Forest University offers a telehealth option with Teladoc through Aetna for both medical plans. These secure video consults are available at a $10 copay for plan members and are a good option for minor health issues when you cannot see your regular doctor. An additional Teladoc Caregiver option is now available for $49 per visit. You can add a loved one you care for to your Teladoc account and have two or three-way visits with a doctor. You can register online or call 1-800-Teladoc, (1-800-835-2362). Learn more about Teledoc by reviewing this flyer.
Enrolling or Making Changes
New Hires
- Enrollment is completed in Workday during the onboarding process.
- If adding a spouse and/or dependent child, submit the required dependent verification documentation.
- You will receive an ID card from Aetna.
Throughout the Year
- Log into Workday to elect coverage throughout the year following a qualifying event.
- Provide supplemental documentation for the event.
- If adding a spouse and/or dependent child, submit the required dependent verification documentation via Workday within 30 days of the event or by the Annual Benefits Enrollment deadline.
- If you need a replacement ID card, call Aetna at (855) 586-6961.
Resources
Aetna Whole Health
- Aetna Whole Health (High and Low Plans) – Plan Document
- Aetna Whole Health (High Plan) – Schedule of Benefits
- Aetna Whole Health (Low Plan) – Schedule of Benefits
- Aetna Whole Health Choice POS II Summary of Benefits and Coverage – High
- Aetna Whole Health Choice POS II Summary of Benefits and Coverage – Low
Aetna Choice POS II
Prescription
If you have elected medical coverage through Wake Forest, you are automatically enrolled in the prescription drug plan. The Low and High Plans offer the following in-network copayments for prescription drugs:
- Generic brand: $15
- Preferred brand: $30
- Non-preferred brand: $60
- Specialty: 10%, minimum of $50, maximum of $100
Provider
Aetna / CVS Caremark®
(888) 792-3862
Specialty Medications (CVS Specialty® Pharmacy; 800.237.2767)
Mail Order
- Cost savings
- Convenient ordering
- Expedited shipping
- Delivery tracking
- Flexible payment options
- Refill reminders
- Mobile app
Preferred Network
Maintenance Medications
Beginning January 1, 2023, members must transition to a 90-day supply with CVS Caremark® Mail Service Pharmacy or a 90-day supply at a CVS Pharmacy®. However, members will be permitted two 30-day grace refills of maintenance medications at any covered retail pharmacy.
Enrolling
- If you have elected Wake Forest medical coverage, you are automatically enrolled in the prescription drug plan at no additional cost.
Behavioral
If you have elected medical coverage through Wake Forest, you are automatically enrolled in the behavioral health plan. Licensed clinical case managers will connect you or your covered family members with in-network providers, specializing in mental health and substance abuse issues. The behavioral health plan includes coverage for Adaptive Behavioral Treatment (ABT). There is a separate $1,000 out-of-pocket maximum for both in- and out-of-network providers, which includes office visit copays and coinsurance amounts associated with mental health and substance abuse services coordinate through CBHA.
Provider
Carolina Behavioral Health Alliance (CBHA)
Contact CBHA at 1 (800) 475-7900 (located on the back of your medical ID card) for a confidential assessment and service.
Inpatient Care
Low Plan:
100% covered in-network, 60% covered out-of-network
High Plan:
100% covered in-network, 70% covered out-of-network
Outpatient Care
Low Plan:
$30 copayment in-network, 60% covered out-of-network
High Plan:
$30 copayment in-network, 70% covered out-of-network
Enrolling
- If you have elected Wake Forest University medical coverage, you are automatically enrolled in the behavioral health plan at no additional cost.
- You will not receive a separate ID card.
- You can access Adaptive Behavioral Treatment services by calling CBHA at (800) 475-7900. A clinician will help determine the services needed, the diagnosis, treatment planning, or therapy, and will direct you to an in-network provider.
Your Health is in Your Hands! CBHA’s app provides a simple and convenient way to access care:
Find a Doctor –Search for network doctors and specialists in your area
Know Your Costs Ahead of Time – Compare the prices for services at different locations
Resources
- CBHA Website (Provider Search, Disease Management Program, Alcohol Assessment, Opiates Assessment, Depression Assessment, Information on support groups and community resources, Articles and e-Books about alcohol, depression, and drug abuse)
- Summary Plan Description
- App User Guide
- App Desktop
- App IOS
- App Android
2023 Benefits Guidebook
The 2023 Benefits Guidebook for Faculty and Staff outlines benefits specific to the Jan. 1 through Dec. 31, 2023 plan year. The information included in the guidebook is intended as a benefit summary only.
The above information is intended as a benefit summary only. It does not include all of the benefit provisions, limitations, and qualifications. If this information conflicts in any way with the contract, the contract will prevail. Any services rendered under the CBHA benefit do not apply towards the BCBS annual deductible or co-insurance.
Wake Forest University Human Resources
P.O. Box 7424, Winston-Salem, NC 27109
askHR@wfu.edu | P 336.758.4700 | F 336.758.6127