Health Coverage : Full-Time Employees
Information for: Full-Time Employees
The Transparency in Coverage final rule requires health plans and issuers to publicly
disclose pricing information via machine-readable files. You will find the machine-readable files on Aetna's website. Additionally, you will find information about the No Surprises Act on the Aetna website.
FIT offers full-time employees the Aetna Choice POS II Plan described below. New hires have 31 days from their date of hire to enroll in the plan or to waive coverage. If you enroll in the plan, coverage begins on your 31st day of employment with FIT. Employee premium cost per semi-monthly pay period is as follows: Employee only $40; Employee + one dependent $70; and Employee + two or more dependents $90 (subject to change).
Plan features include:
- Option of receiving services from In-Network (participating) or Out-of-Network (non-participating) providers anywhere in the U.S.
- No requirement to designate a Primary Care Physician (PCP)
- No referrals required for care by an In-Network Specialist
- Most In-Network services are covered with a copayment of $25 for a PCP type provider or a copayment of $50 for a Specialist
- No copayment is required when you receive preventive services from an In-Network provider, such as routine adult physical exams, routine gynecological exams, and routine mammograms (subject to frequency limitations)
- Laboratory and/or X-Ray services from an In-Network provider require a $25 copayment
- No cost or low-cost services at CVS Minute Clinic or CVS HealthHub locations
Out-of-network coverage of eligible services. You must meet a $500 calendar year deductible ($1,500 family deductible) before eligible out-of-network services are covered. Once the deductible is met claims are reimbursed at 80% as follows:
Beginning on September 1, 2022, the reimbursement levels will be set to 300% of Medicare rates for all services, except physical therapy, acupuncture, and chiropractic services which will have a reimbursement level of 100% of Medicare rates.
You can find an In-Network provider through Aetna's online provider directory. Enter your search criteria and when prompted chose "Aetna Choice® POS II (Open Access)" from the "Aetna Open Access Plans" section. The Aetna Choice POS II Plan Booklet (.pdf) provides a comprehensive guide to plan benefits and coverage. You may also refer to the Choice POS II Plan Schedule of Benefits (.pdf), the Choice POS II Plan Schedule of Benefits - Korea (.pdf), the Summary of Benefits and Coverage (.pdf), the Summary of Benefits and Coverage - Korea (.pdf), and the Choice POS II Plan Guide (.pdf).
You may cover a spouse, a same or opposite-gender domestic partner (if you cover a domestic partner, a portion of the employee contribution will be taken from your paycheck on an after-tax basis), and qualified children under the age of 26. Along with the health care plan enrollment form, supporting documentation is required when enrolling a dependent such as your marriage certificate, a child's birth certificate, a certificate of registered domestic partnership or alternative documentation (.pdf) if domestic partnership registration is not available where you reside, and copies of Social Security cards for each person enrolling in the Plan. Imputed income taxation applies to domestic partner coverage. For information on the current taxation rates, please contact a benefits representative.
Once you are enrolled, you may register and create an account on Aetna's website to view eligibility, claims history, and discounts (.pdf) available to Aetna members. A mobile app is also available. You may contact Aetna's members' services department by calling (800) 962-6842.
Waiver of Coverage:
If you are covered by another Health Care Plan, you may elect to waive coverage in FIT's plan and currently receive a $50.00 per pay period taxable waiver payment from the College. To receive waiver payments you must complete and submit a health care plan enrollment form within 31 days of your date of hire indicating that you want to waive coverage.
Important Enrollment Information:
As a new hire, if you do not enroll in the Health Care Plan within 31 days of your date of hire, you will have an opportunity to enroll during the next Annual Benefits Open Enrollment Period which is held in November of each year for coverage that will become effective the following January 1.
If you wish to enroll or add/remove a dependent from your coverage outside the Annual
Benefits Open Enrollment Period due to a qualified life event as defined by the IRS
(e.g. marriage, birth, divorce, loss of other coverage), you must notify a benefits representative in the Office of Human Resources within 31 days of the event. If notification does
not occur within 31 days of the event, you must wait until the next Annual Benefits
Open Enrollment Period to make the change that will become effective the following
January 1. Be advised that you may not cover a divorced spouse or domestic partner
after the partnership is dissolved. Even if you miss the 31 day notification deadline
you must notify a benefits representative immediately to report the change in family status.
Aetna Open Access Choice POS II Customer Service