A comprehensive medical insurance PPO plan that encourages your progress toward healthier living with Fitness Benefit discounts (for Ithaca-area members).
The Aetna PPO Cornell Program for Healthy Living (CPHL) plan offers the freedom to choose any doctor — in or out of the Aetna network. Keep in mind, however, that your share of the medical cost is usually lower when you stay in the network. And, with so many doctors and hospitals on the list, that’s not hard to do. Your participation in any of the endowed medical plans, includes prescription drug coverage administered by OptumRx.
If you live outside of the Ithaca area, you can receive routine and covered medical services from any participating Aetna provider. You do not need to identify a PCP or obtain a referral to see a specialist.
Endowed benefits-eligible* faculty and staff members can enroll in the CPHL plan.
*If you are uncertain of your eligibility status for this benefit, please contact your HR representative to review.
Your Dependents
The employee must qualify for and be actively enrolled in Cornell’s medical plan for a spouse/domestic partner and child(ren) to be enrolled.
Children are eligible for coverage through December 31st of the year they turn age 26.
Children may be eligible to continue coverage beyond 26 years old. Both below “Request for Continuation of Coverage for Disabled Child” forms must be completed and returned to Aetna prior to the child turning age 26.
The above eligibility is a high-level summary. Please review the CPHLBenefit Plan Bookletfor details on who is eligible for coverage.
Plan Highlights
In-Network
Out-of-Network
Level of Health Plan Support
You pay less out of pocket:
$100 deductible
$20 office visit copay
90% for other services
Pharmacy administered by Optum Rx
You pay more out of pocket:
$400 deductible
80% after deductible
Pharmacy administered by Optum Rx
PCP Requirement
Applies to Enhanced Wellness Exam only
N/A
Referral Requirement to a Specialist
No referrals needed
No referrals needed
Preventive Care
Covered at 100%, regardless of where you live and the network PCP you choose.
Covered at 80% after deductible
Broad national network of physicians and hospitals
Fully available at discount prices
You may use out-of-network providers but it will cost you more
Balance Billing (the amount billed by your provider that is over the insurance company's allowed amount)
Providers have agreed not to bill you over allowed amount
Providers are free to bill you over the allowed amount
Certification for inpatient hospital and other medical services
Participating provider precertifies for you
You precertify by calling the toll-free number on your ID card. Failure to precertify may result in substantially reduced benefits
Individual + Spouse/Domestic Partner working at Cornell (dual eligibility) + child(ren)
$152.08
$164.75
NOTE: The dual eligibility category is available to an endowed staff or faculty member with dependent children whose spouse or domestic partner is also a benefits-eligible staff or faculty member paid from endowed funds at Cornell University.
While every attempt has been made to ensure the accuracy of this Summary, in the event of any discrepancy the Summary Plan Description and Plan Document will prevail.
HR Services and Transitions Center hrservices@cornell.edu
(607) 255-3936
395 Pine Tree Road, East Hill Office Building, Suite 130, Ithaca, NY 14850; M-F 8:30 am - 4:30 pm
