泫圖弝け

Choate House on the Pace Pleasantville campus
Human Resources

Medical Plans

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Fitness Reimbursement Information
Aetna Mobile App and Website
Aetna Plan Basics
Aetna Telemedicine

January 1, 2024 through December 31, 2024

Aetna is the administrator for 泫圖弝けs medical plans. Please review the for updates impacting the health plans as of January 1, 2024.

FOR ALL HEALTH PLANS: annual deductibles, plan maximums, etc., are based upon a calendar year.

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 of Medical Plans (PDF) enables participants to evaluate one medical plan option in relation to the other two.

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 . 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.

Aetna ID Cards

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.

Aetna Networks

For those who will be enrolled in the Consumer Core High Deductible Health Plan (HDHP) or in the Network Core Plan, 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 Mobile App and Website

With the Aetna Mobile App (PDF), its 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 .

Aetna Telemedicine Through Teladoc

Aetna offers telemedicine services through Teladoc (PDF). A participant can set up an account via 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.

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 Acupuncture

The Aetna medical plans covers 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

Coverage under the Aetna medical plans includes 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, no deductible; out-of-network, member pays 40% coinsurance after deductible has been satisfied.

Plan Basics

Plan Highlights

  • No referrals to see in-network specialists
  • No requirement to select a Primary Care Physician (although it is recommended for coordination of care)
  • Co-payments of $30 to see a Primary Care Physician and $50 to see a Specialist under the Network Core and Choice plans
  • In-network preventive care exams are covered at 100%
  • Emergency care is covered 24 hours/day, no matter where the member receives such services (for the Network Core and Choice plans, the ER co-payment is waived if you or a covered dependent are admitted to the hospital)
  • For the Network Core and Choice medical plans, in-network mental health and substance abuse outpatient visits will be covered at the primary office visit copayment ($30). Previously these services were covered at the specialist office visit copayment ($50).

Coverage to the End of Calendar Year in Which a 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 may 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 isnt 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. Paces Network Core and Choice plans require a co-payment of $30 for Urgent Care vs. an Emergency Room co-payment of $100. 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. Aetna participants may encounter this issue when a medical group has an Urgent Care center; however, this center is actually contracted with Aetna as a specialist provider. In this case, the Network Core and Choice specialist co-payment of $50 - applies. In order to find a contracted Urgent Care center ($30 co-payment), please contact Aetna or utilize the Aetna Health Mobile App (PDF).

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.

Benefits Disclaimer
The HR/Benefits website is intended only to provide information for the guidance of 泫圖弝け employees. The writers of the content have exercised their best efforts to ensure accuracy of the information, but accuracy is not guaranteed. If there are any discrepancies between the information on the website, verbal representations and the Plan documents, the Plan documents will always govern. The information is subject to change from time to time, and the University reserves the right to change or terminate these Plans at any time. The information contained on the website is not intended to replace the plan documents, nor is the information in any way intended to imply a contract.