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Required Benefits Notices and Related Information

Federal regulations require employers to furnish employees with documents and notices related to health care plan coverage which includes information on plan participant rights and responsibilities, the availability of benefits and details about plan coverage.  Below you will find information which Fashion Institute of Technology is required to provide.  It is encouraged that you review the information and contact an FIT benefits representative if you have questions.

Aetna Choice POS II Plan for Full-Time Employees - Benefit Booklet (.pdf) 
This booklet describes how benefits are covered and paid by the plan, the rights and obligations of plan enrollees, and other important information about plan benefits and coverage.

Aetna Choice POS II Plan for Full-Time Employees - Summary of Benefits and Coverage (.pdf) 
As required under the Affordable Care Act (ACA), the Summary of Benefits and Coverage provides clear, consistent and comparable information about a health care plan’s benefits and coverage. This document is meant to assist you in better understanding your coverage.

Aetna Open Access Elect Choice Plan for Part-Time Employees - Benefit Booklet (.pdf) 
This booklet describes how benefits are covered and paid by the plan, the rights and obligations of plan enrollees, and other important information about plan benefits and coverage.

Aetna Open Access Elect Choice Plan for Part-Time Employee - Summary of Benefits and Coverage (.pdf)
As required under the Affordable Care Act (ACA), the Summary of Benefits and Coverage provides clear, consistent and comparable information about a health care plan’s benefits and coverage. This document is meant to assist you in better understanding your coverage.

Children’s Health Insurance Program Reauthorization Act (CHIPRA)
If you or your children are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) and you are eligible for health coverage from your employer, your state may have a premium assistance program that can help you pay for coverage, using funds from the state’s Medicaid or CHIP programs.  Please review the Department of Labor’s information (.doc) for details on CHIPRA.

Women’s Health and Cancer Care Act (WHCRA)
As required by the Women’s Health and Cancer Rights Act (WHCRA) of 1998, the Aetna Choice POS II Plan   provides the following coverage as determined in consultation with the attending physician and the patient.

  1. All stages of reconstruction of the breast on which the mastectomy was performed;

2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; and

3. Prostheses and treatment of physical complications of mastectomy, including lymphedema

The coverage will be provided in accordance with the plan design, limitations, any annual deductibles, coinsurance or copayment amounts, and referral requirements, if any, as outlined in the plan documents. 

Contact an FIT benefits representative if you need more information or Aetna Member Services at the telephone number on your Member ID Card. 

Newborns' and Mothers' Health Protection Act of 1996 (NMHPA)
Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtains authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).  

Centers for Medicare and Medicaid Services (CMS) Creditable Coverage
The Medicare Modernization Act (MMA) requires entities which offer health care plan coverage that includes prescription drug coverage to notify Medicare-eligible plan enrollees if their prescription drug coverage is considered “creditable coverage”, which means that the coverage is expected to pay, on average, as much as the standard Medicare prescription drug coverage.  The Aetna EPO Plan which is offered to part-time FIT employees includes prescription drug which is considered to be “creditable coverage” for these purposes.  Please review the Creditable Coverage Notice (.pdf) for more information. 

Military Service Notice Pursuant to the USERRA
In the event a health care plan participant enters service in the military or other uniformed services of the United States, the participant and his or her covered dependents shall be eligible to continue their health care plan coverage under the same terms and conditions as all other participants on application for such coverage.  If the participant’s military service is thirty-one (31) days or more, he or she may have to pay a monthly premium which may be up to the maximum premium allowable under the Uniformed Services Employment and Reemployment Rights Act of 1994 (“USERRA”), as in effect at that time.  Such coverage shall extend for a period ending the earlier of 24 months, beginning the date the participant’s absence begins, or the date the participant fails to apply for or return to employment with the employer, as required under Federal law.  The participant’s health benefits coverage will be reinstated upon his or her reemployment without an exclusion or waiting period, provided he or she applies for reemployment with his or her employer within the time limits set by USERRA. 

Health Insurance Portability and Accountability Act (HIPAA)
The Fashion Institute of Technology’s full-time Health Care Plan (the Aetna Choice POS II Plan) and the Health Care Flexible Spending Account Plan are covered entities under the Health Insurance Portability and Accountability Act (HIPAA).  As the Plan Sponsor of these Health Plans, FIT is required to provide Plan Participants with notice of how it protects and maintains the privacy, security, and confidentiality of Plan Participants’ protected health information (PHI), and the participants’ rights in connection with their PHI.  This information is contained in FIT’s Notice of Privacy Practices (.pdf).  

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