Why Have I been assigned out of network (ONA) for open enrollment
Category : Benefits
ONA simply means that the employee/retiree lives Outside the Network Area. ONA is determined by zip code. Zip codes must meet the network access standards and for us they are: 2 Participating Internists, 2 Participating Pediatricians, 2 Participating OB-GYNs within a 5 mile radius and 1 Participating Hospital in 15 miles. When those standards are not met; the zip code is ONA. ONA status means that the participant can use any provider and the claim is paid at in-network PPO levels even when the provider is not a Network/PPO provider. This is not a bad thing for those of you who get assigned ONA. In fact it is likely a good thing to keep when assigned. Remember that the treatment still must be medically necessary and be a covered item to be paid.
All ONA or enrollment questions should be referred to Hewitt 1-877-722-0020.