Health Coverage : Full-Time Employees
Information for: Full-Time Employees
Enrollment Information and Dependent Coverage
Full-time employees are offered the Aetna Choice POS II Plan. New Hires have 31 days from their hire date to enroll in the plan or waive coverage. If enrolled, coverage begins 31 calendar days from your FIT hire date. The current semi-monthly payroll contribution* is:
- Employee only: $40
- Employee + one dependent: $70
- Employee + two or more dependents: $90
You may cover a spouse, a qualified domestic partner**, and qualified children under 26. When enrolling a dependent, you must provide supporting documentation along with the health care plan enrollment form, such as your marriage certificate, a child's birth certificate, a certificate of registered domestic partnership, or alternative supporting documentation (.pdf) if domestic partnership registration is unavailable where you reside.
*Subject to change.
**The portion of your semi-monthly payroll contribution applicable to your domestic
partner is taken from your paychecks on an after-tax basis. Imputed income taxation
on the value of employer-provided coverage applicable to your domestic partner is
applied to your paychecks.
Coverage Information
You may choose to receive services from participating (“in-network”) or non-participating
(“out-of-network”) providers. Receiving services from in-network providers will result
in lower costs than out-of-network providers.
In-Network Coverage
- Primary Care Physician (PCP) designation is not required.
- Referrals are not required for in-network specialist visits.
- In-network services generally require a copayment of $25 for a provider categorized as a PCP or a copayment of $50 for a specialist.
- In-network annual preventive services such as routine adult physical exams, routine gynecological exams, and routine mammograms do not require a copayment.
- In-network laboratory or X-ray services require a copayment of $25.
- No-cost or low-cost services are available at CVS Minute Clinic or CVS HealthHub locations.
Finding In-Network Providers
- Please refer to Aetna's online provider directory. Enter your search criteria and, when prompted, choose "Aetna Choice® POS II (Open Access)" from the "Aetna Open Access Plans" section.
Out-of-Network Coverage
- When you choose to receive services from out-of-network providers, you must meet a $500 individual calendar year deductible ($1,500 family deductible) before you may begin receiving reimbursement for eligible services.
- Once the deductible is met, most eligible services are reimbursed at 80%, based on
300% of the Medicare rate for the service.
- The exceptions are physcial therapy, acupuncture, and chiropractic services, which are reimbursed at 80%, based on 100% of the applicable Medicare rate.
Please visit FIT's Aetna microsite for quick, convenient access to plan information and resources.
Hinge Health
Aetna Choice POS II Plan enrollees aged 18 and over can participate in virtual musculoskeletal-related
services through Hinge Health. The Hinge Health program is free, and you can receive
services from the comfort of home!
Treatment plans can be tailored to:
- Receive virtual consultations and services from a personal care team, including a physical therapist and health coach.
- Schedule virtual personal physical therapy sessions as needed.
- Receive wearable sensors that provide live feedback in the Hinge Health app to ensure proper form while exercising.
- Get a second opinion on your recommended surgery and treatment plan.
You can also sign up for the free Hinge Health app for personalized, recommended exercises to stay pain-free. To learn more, visit hinge.health/for-individuals (search for employer “Fashion Institute of Technology” to begin) or call Hinge Health at (855) 902-2777.
Detailed Plan Information and Resources
The Aetna Choice POS II Plan Booklet (.pdf) provides comprehensive plan benefits and coverage information. Please also review
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) for more information.
Once enrolled, register and create your account on the Aetna members’ website to view eligibility, claims history, and member discounts (.pdf). Downloading the Aetna mobile app provides a convenient way to access your ID card, submit claims, and view your Explanation of Benefits statements, among other features. Call (800) 962-6842 to speak with an Aetna members' services representative.
The Transparency in Coverage final rule requires health plans and issuers to disclose pricing information publicly 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.
Waiving FIT Health Care Coverage
If covered by another health care plan, you may waive coverage in FIT's Aetna plan
and receive a taxable, per-pay period waiver amount of $50.00***. To waive coverage,
you must complete and submit a health care plan enrollment form within 31 days of your hire date.
***Employees covered by FIT’s Aetna Choice POS II Plan through another FIT employee are not eligible for this payment. Waiver payment is subject to change.
Opportunities to Enroll in or Make Changes to Your Coverage
If you do not enroll in the Aetna Choice POS II Plan within 31 days of your hire date
or want to change your existing FIT coverage, you will have other opportunities to
do so.
- You may enroll during each Annual Benefits Open Enrollment Period, generally held in November, for coverage effective the following January 1.
- Within 31 days of a qualified life event, defined by the IRS, such as marriage, a child’s birth or adoption, divorce, loss of coverage elsewhere, etc., you may enroll in coverage or otherwise make changes to your covered dependents. Please ensure that you contact a benefits representative within 31 days of the event to make a change.
- You may not cover your former spouse once the divorce is finalized or your domestic partner after the dissolution of the partnership. Even if the 31-day window for a change is missed, you must notify a benefits representative immediately to drop the ineligible plan participant.
Aetna Open Access Choice POS II Customer Service
(800) 962-6842