Aetna Value Plan with HSA
Eligibility
The below populations are eligible for this benefit:
- Full-time faculty members
- Full-time administrative staff
- Part-time administrative staff who are scheduled to work 20 hours or more per week
- Eligible Dependents
Overview
The Value Plan with Health Savings Account (HSA) allows you to receive care from either Aetna participating (in-network) providers or providers who do not participate in the Aetna network (out-of-network).
The Value Plan has a calendar-year in-network deductible and in-network co-insurance (office visit co-payments do not apply) in addition to a calendar-year out-of-network deductible and out-of-network co-insurance. The deductible is the amount you pay in a calendar year before eligible expenses are considered for reimbursement. The only services not subject to the deductible or co-insurance are in-network annual preventive care services (covered at 100 percent). All other expenses, including prescriptions, are not considered for reimbursement until the calendar-year deductible is met.
The calendar-year deductibles are:
- In network: $1,600 individual/$3,200 family
- Out of network: $3,200 individual/$6,400 family
Thereafter the plan pays 80 percent of the contracted rate for in-network services; you pay the remaining 20 percent. For out-of-network services, the plan pays 60 percent of the Usual and Customary Rate (UCR); you pay the remaining 40 percent of the UCR plus any billed amount exceeding the UCR. You must complete and submit an Aetna claim form to receive reimbursement for out-of-network services (request for reimbursement must be received by Aetna within 12 months of the date of service). Call Aetna at 833.770.1099 before seeking services from out-of-network providers, as pre-certification may be required.
Detailed Plan Information
Helpful Links
- Be Proactive About Your Health and Learn About Preventive Screening.
- 2024 Aetna Plan Comparison
- Preventive Care Services are covered at no extra cost through your insurance plan when you see a physician or other provider in your plan’s network.
- MinuteClinic, located inside some CVS pharmacies, treats a variety of illnesses, injuries, and conditions.
Health Savings Account (HSA)
If you enroll in the Value Plan, you will open a Health Savings Account (HSA). The HSA is an account to which the university contributes and to which you can contribute to pay for current and future qualified health care–related expenses not covered by the plan. The 2024 maximum allowable contribution is $4,150 for those enrolled in employee-only coverage and $8,300 for those enrolled in family coverage. The maximum allowable contribution includes both employee and employer contributions. Contributions roll over from year to year, and you can take your account, including any accumulated contributions, with you if you leave The New School.
The university contributes $500 to the HSA if you are enrolled in employee-only coverage and $1,000 if you are enrolled in employee-plus-dependent coverage (note that domestic partners are not eligible dependents for reimbursement through the HSA, per IRS rules). Half of the annual university contribution is made in the first half of the calendar year, and the second half is made during the second half of the year.
You can elect to make pre-tax payroll contributions to your HSA in MyDay after your account has been opened. Please refer to this HSA MyDay Guide You can also make after-tax contributions to your HSA by contacting Inspira Financial directly at 888.678.8242.
Please refer to this Quick Reference Guide for steps on creating an account, view eligible expense items and much more.
You will need to complete this form to transfer your current HSA funds to your HSA with Inspira Financial.
Please note that if you enroll in the Value Plan with HSA, you cannot enroll in The New School's health care flexible spending account (FSA). For important information about HSAs, refer to the HSA section of IRS publication 969.
NOTE: if you enroll in the Value Plan with HSA, you cannot enroll in The New School's Health Care Flexible Spending Account (FSA).
Helpful Links
- Quick Reference Guide for steps on creating an account, view eligible expense items and much more.
- Complete this form to transfer your current HSA funds to your HSA with PayFlex.
Enrollment and Modifications
You may enroll in this plan or modify your elections during the below:
- Your initial phase of eligibility as a new hire
- When your employment status changes resulting in eligibility for benefits
- Due to a qualifying life event
- During the annual open enrollment period
You may modify your pre-tax payroll contributions to your HSA anytime in MyDay by following the instructions for Health Savings Account (HSA) Contribution Change (HSA contributions only, not Value Plan enrollment). You can also make after-tax contributions to your HSA by contacting PayFlex directly at 888.678.8242.
Unless you take action during Open Enrollment, your healthcare plan elections will remain the same for the following year. However, we strongly recommend that you review your benefits to make sure that you have selected the best options for yourself and/or your family.
You may view your current benefits and per-paycheck contributions anytime. Once you are enrolled, you will receive an Aetna ID, with your covered dependents (if any) listed on it at your home address of record with The New School. Present your ID card whenever you receive medical services. Once you become a member, you can find information about eligibility, benefits, claims payments, discounts, and special programs by going to Aetna's member portal, and registering with the ID number on the front of your Aetna card.
Return to * Medical, Vision, and Dental Insurance Overview.
Related Links
- Benefits - Overview - summary of available university benefits
- Benefits - Terminology (Glossary)