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Updates For January 1, 2025�鶹��ý�December 31, 2025

Medical Plan Updates

• All Aetna medical plan participants will receive a new Aetna ID card for 2025.
• Gallagher Advocate Center (PDF) �鶹��ý� for assistance with Aetna-related issues and concerns.

Aetna Prescription Drug Formulary

The Aetna formulary is called the Advanced Control Plan. Employees can check their medication by accessing the drug guide brochure (PDF).

Key for the Formulary:

• Generic (Tier 1): $20 copayment for a 30-day retail supply

PG = Preferred Generic

• Preferred Brand (Tier 2): $45 copayment for a 30-day retail supply

PB=Preferred Brand

• Non-Preferred (Tier 3): $70 copayment for a 30-day retail supply

NP=Non-preferred Brand and Generic**

• There is a $0 co-payment for generic preventive medications on this list (PDF).
• Aetna has several national chains in their Aetna National Pharmacy Network including CVS, Costco, Duane Reade, ShopRite, Stop and Shop, and Walgreens. Additionally, Aetna contracts with independent pharmacies.
• Mail order is available through Aetna Rx Home Delivery. Please enroll in mail order (PDF) if you would like to continue to participate and include a 90-day prescription from your doctor.

Consumer Core High Deductible Health Plan (HDHP)�鶹��ý�2024 Deductibles

The 2025 HSA deductibles will increase to $1,650 (individual) and $3,300 (family).

2025 HSA Contribution Limits

Coverage Type: Individual $4,300

Coverage Type: Family $8,550

• Inspira Financial HSA �鶹��ý� Save Now and For Your Future (PDF)
• Inspira Financial HSA �鶹��ý� Health Savings Account Review 2025 (PDF)
• Inspira Financial HSA - Fee Schedule (PDF)
• Inspira Financial HSA - Protecting Your HSA (PDF)
• Inspira Financial HSA �鶹��ý� Debit Card (PDF)
• Inspira Financial HSA �鶹��ý� Mobile App (PDF)

Copayments for In-Network Mental Health and Substance Abuse (Outpatient) Visits

For the Network Core and Choice Plan medical plans, in-network mental health and substance abuse outpatient visits continue to be covered at the primary office visit copayment ($30) in 2025.

2025 Health Care FSA and Dependent Care FSA Limits

• The limit for the Health Care FSA (January 1, 2025�鶹��ý�December 31, 2025) has increased to $3,300 ($137.50 per paycheck).
• The limit for the Dependent Care FSA (January 1, 2025�鶹��ý�December 31, 2025) is unchanged at $5,000 ($208.33 per paycheck); $2,500 ($104.16 per paycheck) if both spouses contribute via separate employers

You must enroll, during each Open Enrollment period, in order to participate in an FSA for the new plan year.

(scroll down to �鶹��ý�Find Out if an Expense is Eligible�鶹��ý�)

Per Paycheck Premiums (January 1, 2025�鶹��ý�December 31, 2025)

• Medical Plans (PDF)
• Dental Plans (PDF)
• Vision Only Plan (PDF)
• New York Life Voluntary Life Insurance - please review your life insurance beneficiaries via your UKG Dashboard. If you are enrolled in Dependent Life Insurance coverage, please verify the names of those covered under this benefit.

Benefits Disclaimer
_{The HR/Benefits website is intended only to provide information for the guidance of �鶹��ý employees. The writers of the content have exercised their best efforts to ensure accuracy of the information, but accuracy is not guaranteed. If there are any discrepancies between the information on the website, verbal representations and the Plan documents, the Plan documents will always govern. The information is subject to change from time to time, and the University reserves the right to change or terminate these Plans at any time. The information contained on the website is not intended to replace the plan documents, nor is the information in any way intended to imply a contract.}