Clerical and Technical Benefits Enrollment

Yale offers options for your medical coverage, including Yale Health; the preferred healthcare provider for over 50 years. Alternately, you may enroll in Aetna Select or Aetna Smart Care Health Savings Account (HSA) and Accident coverage through Yale’s Aetna program.

Additionally, Yale offers a Flexible Spending Account (FSA) to reduce your taxable earnings and receive reimbursement of eligible out-of-pocket expenses.

Delta Dental is Yale’s exclusive dental carrier. Now is the time to make changes to dependent or family dental coverage. Review the dental plan documents and plan summary for more information.

EyeMed offers two options: EyeMed Basic, which provides allowances for frames and lenses, and EyeMed Enhanced, which also covers eye exams and more frequent hardware allowances as well as other valuable enhancements.

1. Yale Health only provides out-of-area coverage for emergency and urgent care. A $45 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 applies to new hires. In the first three (3) years of service employees 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 services, after the deductible has been paid.
5. The maximum amount you have to pay toward the cost of your medical care in the course of the calendar year including deductible and 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 a lifetime limit per contract regardless of carrier chosen.
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 a summary of the benefits provided under each option. For complete details, refer to the Yale Health and Aetna Plan Summary of Benefits and Plan documents located on the Plan Documents and Notices page.

The applicable plan documents govern all questions of interpretation.

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