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Human Resources

Open Enrollment 2018

Open Enrollment is closed for the July-December 2018 Plan Year.

(There will be another Open Enrollment, in fall 2018, for the January 1, 2019 – December 31, 2019 Plan Year)

This is your 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 the 6-month plan year. 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 6-month plan year).

Open Enrollment, for the 6-month plan year (from July 1, 2018 through December 31, 2018), will be completed online via an electronic open enrollment form. 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 e-mail to your Pace account.

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. However, please review the “Updates for July 1, 2018 – December 31, 2018” section below (including the General Reminders), as there are some plan modifications that will take effect on July 1, 2018.

All changes made during this Open Enrollment period will take effect on July 1, 2018* and will remain in effect through December 31, 2018. You cannot change your benefit selections until the next Open Enrollment period (which will be in fall 2018 for an effective date of January 1, 2019), unless you experience a qualifying change in family status during the 6-month 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, or unpaid personal leave. Such changes will become effective on the first of the month following the employee’s return to work.

 


Updates For July 1, 2018 – December 31, 2018

Dental Plans, Vision Plan, Voluntary Life Insurance

We are pleased to announce that the premiums and plan designs will remain unchanged.


Medical Plan Waiver Reimbursement for those Newly Waiving Coverage

For those who are currently covered under our Cigna medical plans and will be waiving coverage for the first time as of July 1, 2018, you will receive an annual (12-month) reimbursement of $1,800 ($75 per paycheck). After 1 year (as of July 1, 2019), 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 July 1, 2018, will receive an annualized reimbursement of $750 ($31.25 per paycheck).


Medical Plans

Cigna will continue to administer the University’s medical plans; however, there are some important modifications that take effect on July 1, 2018:

  • Premium increase of 15.2% for all plans and coverage levels
  • Co-payments of $30 to see a Primary Care Physician and $50 to see a Specialist under the Network Core, Network Choice 90/70 , and 100/70 plans (although preventive care visits will continue to be covered at 100% under all plans)
  • Pharmacy co-payments of $20 (generic medications), $45 (preferred brand medications), and $70 (non-preferred brand medications) after the calendar year deductible, for non-generic prescriptions, has been satisfied
  • Adoption of the Value Prescription Drug List, which includes the following:
         - $0 co-payments for generic preventive medications on this list
         - no coverage for certain therapeutic medications (such as those used to treat stomach acid conditions and non-sedating antihistamines for allergies) if they are available over-the-counter (OTC)
         - narrowing the list of high-cost brand drugs used to treat the same medical condition (unless proven clinically necessary through the medical exception process)
         - moving certain drugs on the formulary to another tier

    Please review the Cigna Value 3-Tier Prescription Drug List, especially the section entitled, “Medications That Are Not Covered” (beginning on Page 17) and discuss covered alternative medications with your physician prior to July 1st.
  • Decrease in the University’s subsidy for individual coverage, under all plans (except the Consumer Core HDHP), to align more closely with the subsidies for employee + 1 and family coverage (Network Core: from 86% to 81%, Network Choice 90/70: from 81% to 76%, 100/70 [grandfathered plan]: from 67% to 62%, In-Net $50 [grandfathered plan]: from 91% to 86%).

HSA Contribution Limits for the 6-Month Plan Year

Coverage Type: Individual

$1,750

Coverage Type: Family

$3,525

Information concerning the Consumer Core HDHP Plan and Health Savings Account (HSA) will be updated to reflect the 6-month plan year maximums in July 2018.


Health Care FSA and Dependent Care FSA Limits for the 6-Month Plan Year

The limit for the Health Care FSA (for July 1, 2018 – December 31, 2018) is $1,350 ($112.50 per paycheck).

The limit for the Dependent Care FSA (for July 1, 2018 – December 31, 2018) is $2,500 ($208.33 per paycheck); $1,250 ($104.16 per paycheck) if both spouses contribute via separate employers.

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

Eligible Expense Items List

Reminder: Deductibles and annual limits are calculated on a calendar year basis. Please plan accordingly.


Per Paycheck Premiums (July 1, 2018 – December 31, 2018)


General Reminders:

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 he/she turns age 26. A dependent who ages off the plans at age 26 will be offered the opportunity to continue dental coverage on COBRA and medical coverage on COBRA or under the New York State Young Adult Option (premiums are 2% less than COBRA).


Cigna Telehealth

Cigna participants can see a board-certified doctor with private, online, and live appointments via a secure video or phone conversation. Participants are able to choose from two Telehealth vendors, American Well and MDLIVE, how they want to connect, and the time and day that works best for them with medical Telehealth services available 24/7/365. Telehealth doctors can treat many common health issues including cold & flu, joint aches and pains, fever, bronchitis and more. Participants with children can also turn to CignaTelehealth services for non-emergency pediatric care. Telehealth services provide a more immediate and potentially lower cost alternative to traditional ‘in person’ care, such as hospital ERs and Urgent Care clinics.

For more information - Cigna Telehealth.


Cigna Lab Services

In most instances you should not experience any issues, as your physician automatically sends your lab work to the correct Cigna-participating lab. However, if the in-network provider sends your lab work to a non-participating vendor, the claim will be processed at the out-of-network level or not covered at all (if you are enrolled in an in-network only plan). As such, we strongly recommend that you inform your provider of the participating labs whenever you utilize these services. The following provides some guidance on how to best handle these services.

What you need to do when lab work is needed:

  • Find network labs by going to mycigna.com or calling the number on your Cigna ID card.
  • Tell your doctor you want to use a Cigna network lab.
  • If your doctor takes a sample in the office, tell him/her to send it to a Cigna network lab.
  • Bring a print-out of participating labs to your appointment. Make sure that the lab is an in-network lab. Just because a lab accepts your Cigna ID card, it doesn’t necessarily mean that the lab is contracted within the Cigna Open Access Plus network.

If an in-network doctor does not send your lab work to a participating provider and your claim is processed at the out-of-network level (or not covered at all, if you are in the Consumer Core HDHP, Network Core, or In-Net 50 plan), you do have the right to appeal the decision. Please contact Cigna’s customer service department at the number listed on your ID card.


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 contact the University Benefits office, at 914-923-2828 (X22828), or via e-mail at openenrollment@pace.edu or at benefits@pace.edu.