Choate House on the Pace Pleasantville campus

Open Enrollment

Annual Benefits Open Enrollment for the 2023 calendar year is now closed.

Open Enrollment is your annual opportunity to review your current benefit elections, make changes to your medical, dental, and life insurance coverage, as well as enroll (or re-enroll) in a health care or dependent care Flexible Spending Account (FSA) for an effective date of January 1, 2024. You must enroll in the Flexible Spending Accounts during this Open Enrollment period in order to participate (your current FSA election, if applicable, will not automatically roll over into the new plan/calendar year).

Access the 2024 Open Enrollment webinar, which includes information on the Aetna health plans and the Employee Assistance Program (EAP).

Open Enrollment, for the new plan year (from January 1, 2024 through December 31, 2024), will be completed online via an electronic open enrollment form. (To access the form, click on blue button below “Begin the Open Enrollment Selection Process.”) The form allows you to login with your Portal credentials and enroll or change your benefits online–at work, at home, or from any computer with Internet access–at any time during the Open Enrollment period. Note: VPN access is NOT required. After successful completion of the process, you will receive a confirmation via email to your Pace account.

Please read this entire webpage for important information.

If you are keeping the same plan and coverage level under Aetna (Network Core Plan, Choice Plan, High Deductible Health Plan, Vision Only Plan, Dental DPPO, Dental DMO), there is no need to re-elect the plan or coverage level during Open Enrollment.

If you would like to make changes to your medical, vision, dental and voluntary life insurance coverage, or to enroll in a health care and/or dependent child care Flexible Spending Account (FSA) as of January 1, 2024, your opportunity to make these updates is during the annual Open Enrollment Period. Reminder: You must re-enroll in the FSA plan(s) in order to participate during the January 1, 2024–December 31, 2024 plan year.

If you do not have changes to make and do not wish to participate in the Flexible Spending Accounts, it is not necessary to complete the Open Enrollment form–your benefits will continue as they are (under Aetna). However, please review the “Updates for January 1, 2024–December 31, 2024” section below (including the General Reminders), as there are changes that will take effect on January 1, 2024.

All changes made during this Open Enrollment period will take effect on January 1, 2024* and will remain in effect through December 31, 2024. You cannot change your benefit selections until the next Open Enrollment period (which will be in fall 2024 for an effective date of January 1, 2025), unless you experience a qualifying change in family status during the new plan year.

*With the exception of voluntary life insurance changes for those currently on short-term disability, Family and Medical Leave, New York Paid Family Leave, Workers Compensation disability, or unpaid personal leave. Such changes will become effective on the first of the month following the employee’s return to work.

Pre-Enrollment Information

Aetna Concierge Services Hotline

Aetna Concierge Services representatives are standing by to assist with your questions. Please contact Aetna Concierge Services (PDF) at 1 (833) 691-1359 (available from 8:00 a.m.–6:00 p.m. in all U.S. Time Zones).

Aetna Medical, Dental, and Vision Plan Names

The 3 Aetna medical plan options are: Consumer Core High Deductible Health Plan (HDHP), Network Core Plan, and the Choice Plan. The Side-By-Side Comparison (PDF) enables participants to evaluate one medical plan option in relation to the other two. The 2 Aetna dental plan options are: Dental PPO (PDF) and Dental DMO (PDF).

Per Paycheck Premiums (January 1, 2024–December 31, 2024)

Aetna ID Cards For Medical/Prescription Coverage, Virtual ID Card Only for Dental Coverage

Prior to January 1, 2024, new enrollees will receive ID cards from Aetna for medical and vision coverage. The medical ID card is a “family style” card, with the employee and up to 3 dependents (under age 18) included on the same card. If there are more than 3 dependents, a second ID card will be issued. A covered spouse/registered domestic partner will receive a medical ID card as will each dependent over the age of 18. The vision plan ID card will be mailed to your home by “EyeMed.” The vision plan ID card is in the name of the primary insured, but can be used for all covered family members. ID cards for the dental plans are available in digital format only and will be accessible by logging into your Aetna account or via the Aetna Health Mobile App (PDF).

Aetna Networks

For those who will be enrolled in the High Deductible Health Plan (HDHP) or in the Network Core Plan as of January 1, 2024, the network is the Aetna Elect Choice Network. For those who will be enrolled in the Choice Plan, the network is the Aetna Managed Choice Network. The same contracted providers are available in both networks (Aetna is required to offer 2 networks due to the out-of-network benefits associated with the Choice Plan).

Aetna Pre-Enrollment Provider Search

Aetna has provided search instructions for both in-network medical and dental providers. Access the medical plan search instructions (PDF); and access the dental plan search instructions (PDF). Once enrolled in the Aetna medical and dental plans, the provider search will be available by logging into the Aetna website. As a reminder, you may also ask your provider if they participate in the Aetna Elect Choice (for HDHP and Network Core enrollees) or the Aetna Managed Choice (for Choice Plan enrollees) network.

Updates For January 1, 2024–December 31, 2024

Medical Plan Updates

A new calendar year deductible will impact those covered under the Aetna Network Core Plan. The annual deductible is $250 for individual coverage and $500 for employee + 1 and family coverage.
Those covered under the Aetna Choice Plan will see an increase in the out-of-network deductible to $2,500 for an individual and $5,000 for employee +1 and family coverage (which was $2,000/$4,000 in 2023). The out-of-network member co-insurance will increase from 35% to 40%, and the out-of-network, out-of-pocket maximum will increase to $6,000 for an individual and $12,000 for employee +1 and family coverage (which was $5,000/$10,000 in 2023).
The in-network Emergency Room copayment will increase from $85 to $100 (which is waived if you or a covered dependent is admitted to the hospital).

Aetna Prescription Drug Formulary

The Aetna formulary is called the Advanced Control Plan. Employees can check their medication by accessing the drug guide brochure (PDF).

Key for the Formulary:

Generic (Tier 1): $20 copayment for a 30-day retail supply

PG = Preferred Generic

Preferred Brand (Tier 2): $45 copayment for a 30-day retail supply

PB=Preferred Brand

Non-Preferred (Tier 3): $70 copayment for a 30-day retail supply

NP=Non-preferred Brand and Generic**

There is a $0 co-payment for generic preventive medications on this list (PDF).
Aetna has several national chains in their Aetna National Pharmacy Network including CVS, Costco, Duane Reade, ShopRite, Stop and Shop, and Walgreens. Additionally, Aetna contracts with independent pharmacies.
Mail order is available through Aetna Rx Home Delivery. Please enroll in mail order (PDF) if you would like to continue to participate and include a 90-day prescription from your doctor.

Consumer Core High Deductible Health Plan (HDHP)–2024 Deductibles

The 2024 HSA deductibles will increase to $1,600 (individual) and $3,200 (family).

2024 HSA Contribution Limits

Coverage Type: Individual $4,150
Coverage Type: Family $8,300

Inspira Financial (PayFlex) HSA Presentation (PDF)

Inspira Financial (PayFlex) Mobile App for the HSA (PDF)

Inspira Financial (PayFlex Member Website (PDF)

Inspira Financial (PayFlex) HSA Fee Schedule (PDF)

HSA Quick Reference Guide (PDF)

Copayments for In-Network Mental Health and Substance Abuse (Outpatient) Visits

For the Network Core and Choice Plan medical plans, in-network mental health and substance abuse outpatient visits continue to be covered at the primary office visit copayment ($30) in 2024.

2024 Health Care FSA and Dependent Care FSA Limits

The limit for the Health Care FSA (January 1, 2024–December 31, 2024) has increased to $3,200 ($133.33 per paycheck).
The limit for the Dependent Care FSA (January 1, 2024–December 31, 2024) is unchanged at $5,000 ($208.33 per paycheck); $2,500 ($104.16 per paycheck) if both spouses contribute via separate employers.

You must enroll, during each Open Enrollment period, in order to participate in an FSA for the new plan year.

Eligible Expense Items List (scroll down to “Find Out if an Expense is Eligible”)

General Reminders

Medical Plan Waiver Reimbursement For Those Newly Waiving Coverage

For those who are currently covered under our Aetna medical plans and will be waiving coverage for the first time as of January 1, 2024, you will receive an annual (12-month) reimbursement of $1,800 ($75 per paycheck). After 1 year (as of January 1, 2025), your annual (12-month) reimbursement will revert to $750 ($31.25 per paycheck). Those who are currently waiving medical coverage, and will continue to do so as of January 1, 2024, will receive an annualized reimbursement of $750 ($31.25 per paycheck).

Coverage to End of Calendar Year in Which Dependent Turns Age 26

A dependent is eligible for coverage under the medical/vision and dental plans until the end of the calendar year in which they turn age 26. A dependent who ages off the plans at age 26 will be offered the opportunity to continue medical and dental coverage on COBRA or medical coverage under the New York State Young Adult Option (premiums are 2% less than COBRA).

Aetna Telemedicine Through Teladoc

Aetna offers telemedicine services through Teladoc (PDF). Create an account via Aetna's Teladoc website or by calling 1 (855) 835-2362. For those enrolled in the Network Core or Choice Plans:

General Medical follows the Primary Care Physician copayment - $30
Behavioral Health follows the Behavioral Health office visit/outpatient copayment - $30
Dermatology follows the Specialist copayment - $50

For those enrolled in the High Deductible Health Plan (HDHP), the amounts listed in the Teladoc brochure (above) will apply.

Urgent Care Facilities

In recent years, many Urgent Care centers have emerged in towns and cities, including within drug stores and medical groups. Urgent Care centers provide individuals with care when the situation isn’t life threating, but requires immediate attention. Urgent Care centers will typically cover conditions such as: earaches and infections, minor cuts, sprains and burns, fever and flu. Pace’s Network Core Plan and Choice Plan require a co-payment of $30 for Urgent Care vs. an Emergency Room co-payment of $85. If a participant is enrolled in the Consumer Core HDHP, the cost of services will be less at an Urgent Care center than at the Emergency Room, so out-of-pocket costs will be less.

It is important to note that while a facility may be advertised as “Urgent Care”, the Urgent Care center or medical offices providing “urgent care services” could very well not be contracted with Aetna as a participating Urgent Care facility. In order to find a contracted Urgent Care center ($30 co-payment), please contact Aetna Concierge Services, at 1 (833) 691-1359, or utilize the Aetna Mobile App (PDF) or provider search tool on Aetna's website to find a contracted provider in your area.

For severe and life-threatening conditions (such as shortness of breath, chest pain, uncontrollable bleeding, etc.), the Emergency Room could be the more appropriate setting and a hospital will be better-equipped to handle these situations.

Aetna Informed Health Line (for Medical Plan Participants)

The Informed Health Line (PDF) is a telephonic service provided to members 24 hours a day, seven days per week. This line provides live access to a Registered Nurse for health education and information. Informed Health nurses can be reached at 1 (800) 556-1555.

Fitness Reimbursement Program through GlobalFit (for Medical Plan Participants)

Aetna offers employees covered under the medical plan up to $200 for visiting the gym 50 times in a 6-month period. Covered spouses/registered domestic partners can receive up to $100 for visiting the gym 50 times in a 6-month period. Find out more information about the fitness reimbursement program (PDF).

Coverage for Implants Added to Aetna Dental Plans

Implant coverage was added to the Aetna DPPO and Aetna DMO plans in January 2023. Please review the 2024 plan summaries carefully (Aetna DPPO (PDF), Aetna DMO (PDF)), including the section on “Rules,” as certain restrictions apply.

Coverage for Acupuncture

The coverage is limited to 10 visits per calendar year:

High Deductible Health Plan: member pays 10% coinsurance after the deductible has been satisfied.
Network Core Plan: $30 copayment per visit.
Choice Plan: in-network, $30 copayment per visit; out-of-network, member pays 30% coinsurance after the deductible has been satisfied.

Coverage for Hearing Aids

The coverage is limited to 1 hearing aid per ear every 3 years.

High Deductible Health Plan: member pays 10% coinsurance after deductible has been satisfied.
Network Core Plan: covered at 100%.
Choice Plan: in-network, member pays 15% coinsurance after deductible has been satisfied; out-of-network, member pays 35% coinsurance after deductible has been satisfied.

Deductibles Under the Aetna Choice Plan

Under Aetna, the out-of-network deductibles and out-of-pocket maximums do not accumulate towards the in-network deductibles and in-network out-of-pocket maximums; they are separate accumulators.

Annual Deductibles, Out-Of-Pocket Maximums, Etc.

Annual deductibles, out-of-pocket maximums, etc. are based upon a calendar year.

Benefits to Consider During this Open Enrollment period

Benefits to Consider Throughout the Plan Year (Can Be Changed During the Year)

Need Help?

For assistance with your enrollment selections, please email the University Benefits office or Open Enrollment.