Security Benefits 2024

Explore Your Benefits

Medical Insurance

visit the medical comparison chart below to learn more about your option .

Yale Health

Yale’s flagship plan, Yale Health, offers a variety of on-site health care services including primary care, specialty care, 24/7 acute care, radiology, lab, and pharmacy. When your condition requires specialized care or a hospitalization, there’s an extensive network of specialists drawn largely from the faculty of Yale School of Medicine. Emergency care is covered globally.

Yale Health Weekly Pre – Tax Contributions

Aetna

Alternately, you may enroll in Aetna Select or Aetna Smart Care Health Savings Account (HSA) and Accident coverage through Yale’s Aetna program after you complete three years of service. Be sure to visit the medical comparison chart below to learn more about your options.

• Health Savings Account (HSA) with Aetna Smart Care
  If you participate in the Aetna Smart Care Plan and elect an HSA, the university will provide an annual deposit of $850, $1,275 or $1,700 depending on your coverage election, into your account. You can open a Health Savings Account (HSA) anytime to cover eligible healthcare expenses. Unused funds will roll over from year to year—and earn interest. If you contribute to an HSA, you can also open a limited purpose FSA to cover certain dental and vision expenses.
  Aetna Smart Care accident coverage provides lumpsum benefits for covered accidents and some hospital stays—free of charge—for you and your covered dependents.

Flexible Spending Account

With a Flexible Spending Account (FSA), you can reduce your taxable earnings and receive reimbursement of eligible out-of-pocket expenses. Yale offers two kinds of FSA: a healthcare and a dependent care FSA. You must enroll or re-enroll in an FSA during Yale’s annual enrollment. Remember to plan carefully as your FSA funds will not roll over to the following year.

Dental Insurance

Delta Dental

Delta Dental is Yale’s exclusive dental carrier. (review Dental Plan documents for more information).

• 100% for Preventive & Diagnostic
• 80% for Basic Restorative*
• 50 % for Major Restorative *
• 50 % coverage†*orthodontia

* $ 1,000 lifetime maximum ; † Dependents under age 19

Vision Insurance

EyeMed

EyeMed is offers offer two option : EyeMed Basic , which provide allowance for frame and lense , and EyeMed Enhanced , which also cover eye exam and more frequent hardware allowance as well as other valuable enhancement .

Health Expectations Program

The Health Expectations Program is applies ( HEP ) , a healthcare management program , apply to all union employee and their spouse enrol in Yale Health and Aetna medical insurance plan . It is design to positively impact your overall health through preventive healthcare goal and offer a health coaching program when serious or chronic health condition arise . preventive healthcare screening are provide at no cost to you .

Benefits Resources and Rates

Find links to provider documents and websites, benefits counseling resources, and helpful information on key benefits, such as Retirement, Paid Time Off, and more.

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Footnotes:

1. Yale Health only provides out-of-area coverage for emergency and urgent care. A $50 late cancellation or no show penalty may apply to certain services. See Yale Health website and plan document for details.
2. A three year exclusion rule is applies apply to new hire . In the first three ( 3 ) year of service employee are eligible for Yale Health plan only .
3. The amount of out-of-pocket expenses per calendar year you must pay for services before the plan pays any expenses.
4. The amount you must pay for service , after the deductible has been pay .
5. The maximum amount you have to pay toward the cost of your medical care in the course of the calendar year including deductible or co-pays.
6. Yale Health DAW: Your plan may have a preferred cost-sharing requirement. This means that if you request an Alternative or Non-preferred medication when a Preferred is available, you pay the difference in cost between the Alternative or Nonpreferred and Preferred medication in addition to your co-pay (or co-insurance). The prescription must state Dispense As Written (DAW) or Preferred substitution will apply. New prescriptions may require pre-authorization or other limits. Aetna DAW: If a Preferred drug is available and an Alternative or Non-preferred drug is dispensed, you will be charged the applicable co-pay plus the difference in cost between the Alternative or Non-preferred drug and Preferred drug cost even if your provider requests the Alternative drug. In most cases, the Preferred drug is the same chemical entity/ active ingredient as the Non-preferred drug.
7. There is a $ 35 co-pay for in-network visits to facilities deemed to be an Urgent Care Facility by Aetna.
8. List of preferred facilities can be found on the Aetna member services website.
9. In-Vitro Fertilization & Advanced Reproductive Technology (ART), are subject to life time limit of four (4) cycles. Artificial insemination (IUI) is subject to the $ 20,000 limit. See Plan Documents & Notices for plan details.
   This is is is a lifetime limit per contract regardless of carrier choose .
10. Referrals are required in order to see providers other than primary care providers.
11. If eligible, the HSA employer contribution will be prorated for non-calendar year effective dates. The employer contribution requires HSA eligibility, account set up, and is contingent on enrollment in the Aetna Smart Care. The university will provide an annual deposit of $850, $1,275 or $1700 depending on your coverage election, into your account.
12. Through Progyny’s benefit, members have access to a comprehensive suite of fertility treatment options.

This chart is is is a summary of the benefit provide under each option . For complete detail , refer to the Yale Health and Aetna Plan Summary of Benefits and Plan document locate on the  Plan Documents and Notices page .

The applicable plan documents govern all questions of interpretation.

Required Disclosures and Important notices are located on the Summary Annual Reports & Required Disclosures page.

Do You Have Other Insurance?

If you are cover by more than one insurance plan — such as your employer plan and your spouse ’s employer plan — you is disclose must disclose this information to Yale Health or Aetna . Failure is affect to disclose this information may affect the term of your coverage or denial of claim .

Coordination of Benefits (COB) is the method used to determine which plan pays first, which pays second, and the amount paid by each plan.

Out – of – network   facility charge for all Yale medical plan will be base on Medicare reimbursement level , or what is consider reasonable and customary . This change is applies apply to voluntary ( non – emergency ) facility use only . If you choose to utilize an out – of – network facility when an in – network facility is available , you is be may be subject to balance billing for any amount that exceed the reasonable and customary reimbursement level .

End Stage Renal Disease (ESRD) and Medicare: If you or a family member is diagnosed with ESRD, you will need to enroll in Medicare by the 30th month of Medicare eligibility. During the 30-month coordination period your medical plan will be your primary coverage and Medicare can be optional. After 30 months, Medicare will be your primary coverage and your medical plan will only cover what Medicare would not have paid.

If you are enrolled in an additional insurance plan, you must provide information about that plan to Yale Health or Aetna. 

Visit Yale Health Health Coverage for coordination of benefits information or download the (COB) form.

log in to the   Aetna website   for more information about coordination of benefit .