Choate House on the Pace Pleasantville campus

Updates For January 1, 2024 - December 31, 2024

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”)

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