Differential Rates Explained
Differential Medical Rates
Beginning with the 2027 Plan Year, members will see two medical rate options: one for Aetna and one for Blue Cross and Blue Shield of Kansas.
This change is called differential rates.
Why are there two medical rates?
The Health Care Commission (HCC) voted to offer differential rates because the medical vendors submitted different proposed costs to administer the medical portion of the State Employee Health Plan.
Blue Cross and Blue Shield of Kansas submitted a proposal that was considerably higher than Aetna’s proposal. Rather than offering only the lower-cost option, the HCC chose to offer both vendors and allow members to decide which option works best for them. This gives members the flexibility to choose the medical vendor that best suited to their needs.
Are the benefits different?
No. The medical benefits are the same whether you choose Aetna or Blue Cross and Blue Shield of Kansas.
That means services such as preventive care, covered medical services, Deductibles, Copays, Coinsurance, and Out-of-Pocket Maximums are based on the plan you choose, not the medical vendor.
The main differences are the provider Network and the monthly premium.
What should I consider when choosing?
When reviewing your options, consider:
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Whether your doctors, hospitals, and specialists are in the vendor’s Network.
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The monthly premium for each vendor
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Your family’s health care needs
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Your preferred providers and locations
Before making your election, use the vendor provider search tools to confirm whether your providers are Network.
What does this mean for me?
You will choose your medical vendor during Open Enrollment. This is either Aetna or Blue Cross and Blue Cross and Blue Shield of Kansas.
The premium you pay will depend on the medical vendor you select:
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Aetna will have one medical rate.
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Blue Cross and Blue Shield of Kansas will have a different medical rate.
Key takeaway
Differential rates mean there are two medical rates because the vendors’ costs are different.
The benefits are the same. The Networks and rates are different.
Review both options carefully during Open Enrollment so you can choose the medical vendor that best fits your needs.
Contact Health Plan Operations when you have questions about benefit/vendor coverage or general claim issues, with voluntary prescription eyewear, medical, dental, pharmacy or voluntary benefits for all member groups. Email Health Plan Operations.
Contact Membership Services when you have questions about the membership portal, eligibility, new hires, termination, retirees or spending accounts. Email Member Services.
