The university offers three healthcare plans with Aetna. These plans do not require the designation of a primary care physician and do not require referrals for visits to specialists.
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.
Refer to the
Health Care Plan Comparison Chart to view the differences in coverage between the plans, and refer to the information below for specifics
on each plan. If you have questions about coverage, call Aetna at 833.770.1099.
You can access the Aetna Presentation on our medical, dental, vision, and Rx plans online.
We are pleased to announce that we have launched a Benefits Virtual Fair.
Aetna Choice Plan (POS)
The Choice is a point-of-service (POS) plan that allows you to receive care from either Aetna participating (in-network) providers or providers who do not participate in the Aetna provider network (out-of-network).
There is a $30 co-payment for in-network primary care physician office visits (including visits to outpatient mental health providers) and a $50 co-payment for in-network specialist office visits. There is no co-payment for annual preventive care services.
There is also a $300 for individual and a $600 for family calendar-year in-network deductible (the amount you pay in a calendar year for certain services before the services are paid). To find Choice in-network providers, go to aetna.com,
click on “Find a doctor” and then "Guest." Next enter your zip code, city, and state or county. When “Select a plan” appears, select Aetna Choice POS II”; then click “search” to continue.
You can also receive care from out-of-network providers, but at a greater cost. There is a calendar-year out-of-network deductible (the amount you pay in a calendar year before eligible out-of-network expenses are considered for reimbursement) of $2,000
for an individual and $4,000 for a family.
Thereafter the plans pay 70 percent of the Usual and Customary Rate (UCR); you are responsible for the remaining 30 percent of the UCR plus any billed amount exceeding the UCR. You must complete a claim form and submit it to Aetna. The request for reimbursement must
be received by Aetna within 12 months of the date of service. The employer name is The New School, and our group number is 170211. Call Aetna at 833.770.1099 before seeking services from out-of-network providers, as pre-certification may be required.
The POS Summary Plan Description (SPD), Schedule of Benefits, and Summary of Benefits and Coverage (SBC) provide additional information
about this plan.
Aetna Select EPO Plan
The Aetna Select EPO Plan covers services received from Aetna participating (in-network) providers. There is no coverage for services provided by nonparticipating providers except in the case of emergency care. To
find Aetna Select in-network providers, go to aetna.com, click on “Find a doctor,” and then "Guest." Next enter your zip code, city, and state or county. When “Select a plan” appears, select “Aetna
Open Access Select”; then click “search” to continue.
You can also call Aetna at 833.770.1099 for provider information. Primary care physician visits (including visits to outpatient mental health providers) require a $30 co-payment, and specialist visits require a $50 co-payment. There is no co-payment for
annual preventive care services. There is also a calendar-year in-network deductible (the amount you pay in a calendar year for certain services before the services are paid) of $200 for individuals and $400 for families and a 10 percent co-insurance fee on lab work, x-rays, and other services
after your deductible is met.
The Choice EPO Summary Plan Description (SPD), Schedule of Benefits and Summary of Benefits and Coverage (SBC) provide additional
information about the plan.
The Value Plan with Health Savings Account
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). To find Value in-network providers, go to
aetna.com; click on “Find a doctor,” then "Guest." Next enter your zip code, city, and state or county. When “Select a plan” appears, select "Aetna Choice POS II”; then click “search” to continue.
You can also call Aetna at 833.770.1099.
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: $1,500 individual/$3,000 family
- Out of network: $3,000 individual/$6,000 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.
The Value Summary Plan Description (SPD), Schedule of Benefits, and
Summary of Benefits and Coverage (SBC) provide additional information about the plan.
If you enroll in the Value Plan, you can 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 2023 maximum allowable contribution is $3,850 for those enrolled in employee-only coverage and $7,750 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.
Please refer to this Quick Reference Guide for steps on creating an account, view eligible expense items and much more.
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 in 2021 (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.
Please complete this form to transfer your current HSA funds to your HSA with PayFlex.
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 PayFlex directly at 888.678.8242.
Please note that if you enroll in the HDHP 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.
Prescription Drug Program
The University's Prescription Drug Program is administered by Express Scripts. Present your Express Scripts member ID card when filling
a prescription at the pharmacy. The following co-payment amounts apply for a one-month (30-day) prescription at the retail pharmacy:
- $15 co-payment for tier 1 medications
- $50 co-payment for tier 2 medications
- $100 co-payment for tier 3 medications
If you have not received your Express Script ID card, please present this letter to your pharmacist to accurately process your prescriptions.
Stay on track with the help of theExpress Scripts Mobile App. You can download it free from your mobile app store. From anywhere, anytime, you can check order status; refill and renew orders; locate a pharmacy and get directions; check
drug interactions; set up medication alerts; access your virtual member ID card and much more.
If you have questions about your prescription drug coverage or the mail order delivery program, call Express Scripts at 877.354.2007, or visit: www.express-scripts.com/thenewschool.
Health Care Coverage and Medicare
If you or an enrolled dependent becomes eligible for Medicare, we
encourage you to review the important information available at medicare.gov
and 1.800.Medicare to understand your options. If you enroll in any
parts of the Medicare plan (hospital, medical, prescription drug,
medigap) and are also enrolled on the university's health care coverage
with Aetna, your university coverage will be your primary coverage (and
Medicare secondary). It is important that you contact each carrier to
notify it about the other. When calling, ask to speak with someone in
the Coordination of Care area.
Please contact firstname.lastname@example.org or call us at 212.229.5671
x4942 if you wish to speak with someone on the New School Benefits
Healthcare Coverage for New School Students Who Are Also Employees
If you are a student in a New School degree program and are also a member of the full-time faculty, full-time administrative staff, or regular part-time (20+ hours
per week) administrative staff, you must enroll for employee healthcare coverage at whatever point you become eligible; your student health insurance coverage (if you are enrolled) will be waived automatically. At that point, you are no longer eligible
to receive services from the Student Health Center. Student health insurance coverage for a dependent (spouse, domestic partner, or child) enrolled in a degree program is not waived automatically. If you choose to cover such a dependent on your employee
insurance, they must file the proper forms at registration to waive student health insurance. For more information, including instructions for waiving student health insurance for a dependent, go to the Student Health Services website;
contact Student Health Services at 212.229.1671, option 3; or visit the Student Health Center.