Open Enrollment has closed for the 2022 plan year.
As announced on October 21, 2021, Pace University’s medical, vision, dental insurance, and Employee Assistance Program (EAP) provider, beginning in January 2022, will change from Cigna to Aetna.
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, 2022. 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).
Open Enrollment, for the new plan year (from January 1, 2022 through December 31, 2022), 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 email to your Pace account.
If you are keeping the same plan design and coverage level under Aetna that you had with Cigna (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. We will automatically transfer you to the same plan design and coverage level under Aetna as of January 1, 2022.
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, 2022, 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, 2022 – December 31, 2022 plan year. (Due to the pandemic, the grace period for the 2021 Flexible Spending Accounts has been extended through December 31, 2022.)
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, 2022–December 31, 2022” section below (including the General Reminders), as there are changes that will take effect on January 1, 2022.
All changes made during this Open Enrollment period will take effect on January 1, 2022* and will remain in effect through December 31, 2022. You cannot change your benefit selections until the next Open Enrollment period (which will be in fall 2022 for an effective date of January 1, 2023), 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.
Aetna Concierge Services Pre-Enrollment Hotline
Aetna Concierge Services representatives are standing by to assist with your pre-enrollment 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 (formerly, the Choice PPO 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 and Dental DMO.
Aetna ID Cards For Medical/Prescription Coverage, Virtual ID Card Only for Dental Coverage
Prior to January 1, 2022, you 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, as of January 1, 2022, by logging into your Aetna account or via the Aetna Health Mobile App (PDF).
For those who will be enrolled in the High Deductible Health Plan (HDHP) or in the Network Core Plan as of January 1, 2022, 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, 2022–December 31, 2022
Aetna Mobile App and Website
With the Aetna Mobile App (PDF), it’s easy to view your plan summary, review and pay claims, search for providers, access your ID cards, etc. This information can also be accessed by logging into the Aetna website.
Transition of Care
As of January 1, 2022, if a participant is undergoing an active course of treatment with a participating Cigna provider, who is not contracted with Aetna, then the member can apply to Aetna for Transition of Care. Transition of Care is a temporary, defined period of time (typically 90 days) during which a participant may continue to see their current provider at the in-network benefit level under Aetna. Participants must request Transition of Care upon enrollment in the Aetna plan. The Transition of Care form cannot be submitted until the participant appears in Aetna’s system, as it requires an Aetna ID number. Aetna will review the Transition of Care request and will respond directly to the participant.
Examples of Transition of Care may include:
- Pregnancy (second and third trimester)
- Ongoing treatment plan, such as chemotherapy or radiation therapy
- Recent major surgeries where the participant is still within the follow-up period
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).
Aetna Telemedicine Through Teladoc
Aetna offers telemedicine services through Teladoc (PDF). Beginning in January 2022, you can set up 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 attached brochure will apply.
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.
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
- 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) – Deductible and Transition to PayFlex HSA
- The 2022 HSA deductibles will remain the same at $1,400 (individual) and $2,800 (family).
The Health Savings Account (HSA), which may accompany the HDHP, will transition from HSA Bank (under Cigna) to PayFlex HSA (under Aetna). If you would like to move your HSA Bank funds to the new PayFlex HSA, please submit the PayFlex HSA Transfer Form (PDF) to HSA Bank in 2022 (HSA Bank, P.O. Box 939, Sheboygan, WI 53082-0939). It will generally take 3 – 4 weeks for the funds (from your HSA Bank account) to appear in your PayFlex HSA account.
Please refer to information concerning the Individual Transfer Option (PDF) from HSA Bank (current Cigna HSA provider).
Current funds may remain in your HSA Bank account; however, no new funds will be contributed to HSA Bank via payroll deduction after December 31, 2021.
2022 HSA Contribution Limits
- Coverage Type: Individual $3,650
- Coverage Type: Family $7,300
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 2022.
2022 Health Care FSA and Dependent Care FSA Limits
- The limit for the Health Care FSA (January 1, 2022–December 31, 2022) has increase to $2,850 ($118.75 per paycheck).
- The limit for the Dependent Care FSA (January 1, 2022–December 31, 2022) 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”)
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. This is a change from the way that in-network and out-of-network deductibles were handled under the Cigna Choice PPO Plan.
Reminder: Deductibles and annual limits are calculated on a calendar year basis. Please plan accordingly.
Per Paycheck Premiums (January 1, 2022–December 31, 2022)
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 January 1, 2022, you will receive an annual (12-month) reimbursement of $1,800 ($75 per paycheck). After 1 year (as of January 1, 2023), 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, 2022, 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 dental coverage on COBRA and medical coverage on COBRA or under the New York State Young Adult Option (premiums are 2% less than COBRA).
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 or utilize the Aetna Mobile App or provider search tool 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.
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
- Aetna Medical Plans
- Medical Plan Waiver
- Aetna Vision Preferred Plan
- Aetna Dental Plans
- Health Care Flexible Spending Account (FSA)
- Child and Dependent Care Flexible Spending Account (FSA)
- Cigna Voluntary Life Insurance
Benefits to Consider Throughout the Plan Year (Can Be Changed During the Year)
- Commuter Reimbursement Accounts (CRA)
- New York 529 College Savings Program
- Long Term Care
- Employee Assistance Program (EAP)
- 403b Defined Contribution Retirement Plan