HDHP/HSA Plan

Invest in your health care and focus on managing your long-term costs.
COVID-19 Updated benefits information: The Federal government has announced the COVID-19 Public Health Emergency (PHE) will end May 11, 2023. Please review changes to various special benefit provisions.
The High Deductible Health Plan (HDHP) and Health Savings Account (HSA) offer the lowest payroll deductions among the endowed medical plans. It provides a comprehensive healthcare plan with two components:
- An Aetna high deductible medical insurance plan that includes prescription drug coverage at retail and mail order offered through OptumRx.
- A PayFlex Health Savings Account (HSA) which can be used to pay your health care costs or pay those costs out of your own pocket to take advantage of tax-free investment growth.
How It Works
High-Deductible Coverage
Coverage is provided by Aetna and is similar to the Cornell Program for Healthy Living (CPHL) plans and Weill Cornell Medicine PPO (WCM-PPO). You are encouraged to use a nationwide panel of preferred providers that Aetna maintains. Using in-network providers will result in lower healthcare costs than using providers who are out of network.
See the 2023 Comparison Chart for an overview of the in and out of network benefits for all three endowed medical plans
Health Savings Account
Cornell contributes $1,000 per year into your health savings account; employees can also add their own contributions so that the total adds up to the federal limit for that year.
You can use the account to pay for a health insurance deductible and any qualified health care expenses including those not covered by the high-deductible medical plan like dental and vision care. You can pay with your PayFlex debit card (this draws money from your HSA account) or pay out of pocket instead. Please note, you must pay for all medical services until your HDHP deductible is met.
Tools & Resources
Health Plan Support
- Find In-Network Doctor Save money by staying in-network!
- 2023 HDHP/HSA Preventive Drug List (pdf) Special coverage for preventive medications where the deductible does not apply, please also see the OptumRx Formulary for complete list of medications however, deductible may apply; any differences between this list and your benefit plan, the benefit plan documents rule.
- 2023 OptumRx Formulary (pdf) Effective 07/01/2023 Standard HDHP coverage; where differences between this formulary and your benefit plan exist, the benefit plan documents rule.
- Instructions to print temporary ID Cards
- Breastfeeding Supplies (pdf)
- Aetna International for Business Travel
- Bilingual and Translation Assistance
- Contact Aetna
- (877) 371-2007
- Contact OptumRx
- (866) 533-6977
Using Your PayFlex Card
- PayFlex Card (pdf) How to use your PayFlex card
- PayFlex login
- PayFlex Mobile App
- Managing Your HSA Quick Reference Guide (pdf) Instructions on how to manage your HSA online
- Contact Payflex: (888) 678-7821
HDHP/HSA Plan Details
Eligibility
Eligibility part 1 of 2: High Deductible Health Plan (HDHP)
You
- Endowed benefits-eligible* faculty and staff members can enroll in the Weill Cornell Medicine PPO 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 WCM-PPO plan for a spouse/domestic partner and child(ren) to be enrolled.
- Children are eligible for coverage through December 31 of the year they turn age 26.
- Children may be eligible to continue coverage beyond 26 years old. Both “Request for Continuation of Coverage for Disabled Child” forms (see below under "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 HDHP/HSA Benefit Plan Booklet under plan documents for details on who is eligible for coverage.
Eligibility part 2 of 2: Health Savings Account (HSA)
An employee and their applicable dependent(s) are only eligible to enroll in Cornell University’s Health Savings Account (HSA) Plan if ALL the below listed requirements are met:
- Due to the bank account feature, the employee is required to have a social security number.
- See "What You Need To Know When Opening Your Account" from PayFlex.
- Covered only by an HSA-compatible high deductible health plan.
- Not covered by any other health plan that is not an HSA-compatible high deductible health plan (including spousal coverage).
- Not enrolled in Medicare (parts A, B, C, and D).
- Not participating and/or have an account balance in a Cornell Medical Care Flexible Spending Account (FSA) (or have a spouse who participates in a general-purpose FSA) at the same time.
- Not claimed as a dependent on another person’s taxes (in the case of a dependent, such dependent must be claimed as a dependent on your taxes in order to qualify for use of your HSA funds).
- Dependents are eligible up to age 26 on the Aetna Health Savings Account. However, if the dependent does not meet the IRS tax dependent criteria and the employee use the savings account to cover their medical expenses, then the employee will be responsible for paying a penalty.
Dual HSA Eligibility
Special Instructions for Dual Spouse/Domestic Partners enrolling in an HSA (pdf) Endowed staff or faculty with dependent children, whose spouse or domestic partner is also an endowed employee at Cornell need to read these important instructions.
The above eligibility is a high-level summary. Please review the HDHP/HSA Benefit Plan Booklet under plan documents for details on who is eligible for coverage.
Rates
2023 Rates
Coverage Type | Hourly/Non-exempt | Salary/Exempt |
---|---|---|
Individual |
$13.57 |
$14.70 |
Individual + child(ren) |
$110.49 |
$119.70 |
Individual + Spouse/Domestic Partner |
$119.70 |
$129.68 |
Individual + Spouse/Domestic Partner + child(ren) |
$143.45 |
$155.40 |
Individual + Spouse/Domestic Partner working at Cornell (dual eligibility) + child(ren) |
$96.92 |
$105.00 |
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.
Deductibles
For 2023
Type of coverage | In-Network | Out-of-Network |
---|---|---|
Individual |
$1,500 |
$3,000 |
Family** |
$3,000 |
$6,000 |
** If covering dependents, you'll need to meet the entire family deductible before the plan reimburses for medical care.
HSA Contributions
For 2023
Coverage Type | Your Contribution | Cornell's Contribution | Total Contribution Limit |
---|---|---|---|
Individual |
Up to $2,850 |
$1,000 |
$3,850 |
Family |
Up to $6,750 |
$1,000 |
$7,750 |
*Please note: For enrollments outside of the November annual open enrollment period, Cornell's $1,000 contribution is pro-rated based on the enrollment effective date.
If you are age 55 or older, you can contribute an additional $1000.
Forms
- 2023 HSA Enrollment Form
- Special Dependent Enrollment Form (pdf)
- Member Form Request for Continuation of Coverage for Disabled Child (pdf)
- Physician Form Request for Continuation of Coverage for Disabled Child (pdf)
- Required Documentation for Endowed Health Plans
- Aetna Claim Form (pdf)
- FSA Claim Form (pdf)
- Release of Protected Health Information Form (pdf)
- Domestic Partnership FAQ
Plan Documentation
Plan Coverage Details:
- HDHP/HSA Summary Plan Description (SPD) (pdf)
- Schedule of Benefits (pdf): An overview chart of coverage and explanation of terminology
- Booklet (pdf):Consult this booklet for detailed information regarding plan coverage
- Addendum (pdf): Lists updates to the plan booklet
- Summary of Benefits and Coverage 2023 (SBC) (pdf): A standardized overview of what the HDHP with an HSA plan covers, per government regulations
- Summary of Benefits and Coverage 2024 (SBC) (pdf): A standardized overview of what the HDHP with an HSA plan covers, per government regulations
Financial Details:
- HSA Custodial Agreement (pdf) Details the agreement with PayFlex as to the management of HSA funds
- HSA Fee Schedule (pdf) Explanation of fees that may apply to your HSA account
Investing With Your HSA
- HSA Overview (pdf) From Cornell Benefit Services: overview of HSA program tailored for Cornell employees.
-
Investing with your PayFlex HSA (pdf) From Payflex: introduction to how investing with an HSA works
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For Your Protection-Customer Identification Process (CIP) (pdf) PayFlex is required by law to confirm your name, home address, date of birth, and social security number to enroll in a health savings account.
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Special Instructions for Dual Spouse/Domestic Partners enrolling in an HSA (pdf) Endowed staff or faculty with dependent children, whose spouse or domestic partner is also an endowed employee at Cornell need to read these important instructions.
FAQs
General Questions
How much can I deposit in my account?
You are allowed to deposit up to $3,850 for single or $7,750 for a family into your tax-free 2023 Health Savings Account to earn interest and put toward future medical expenses. If you enroll during the annual November open enrollment period and are age 55 or older, you can contribute an additional $1000.
(Cornell contributes $1,000 up front towards your limit. If you join the plan after January 1st, the amount is pro-rated.)
How is the contribution limit determined?
Contribution amounts are set by the IRS each year.
When can you use HSA funds?
The funds in your HSA account can be withdrawn at any time for qualified health care expenses that were incurred after your HSA was established. If funds are withdrawn for non-qualified medical expenses, by someone under age 65, the amount withdrawn is taxable and subject to a penalty.
What medical expenses are qualified?
Examples of qualified medical expenses include but are not limited to medical fees and deductibles at doctors’ offices, pharmacies, dentists, vision centers, medical labs and some medical supplies that traditional healthcare plans do not cover. Visit Individual & Family Health Insurance Plans & Coverage | Aetna, for general information about qualified and non-qualified medical expenses. Or you can choose to go directly to the PayFlex Pretax Accounts & Benefits | PayFlex website. Use the Medical Expense Tracker to help organize them online. Make sure you keep your receipts so you can document for the IRS the appropriate use of these funds.
Qualified medical expenses are described in detail in Section 213(d) of the Internal Revenue Service Tax Code and IRS Publication 502. You must be sure that you have not been otherwise compensated or reimbursed by insurance for the treatment. For help from the IRS, call 1-800-829-3676 or visit the IRS website.
How does a typical doctor office visit work?
When you go to your in-network doctor for a sick visit (beyond preventive care), your share of the cost is based on a negotiated rate. Your doctor’s office will send the claim to Aetna. Once Aetna processes the claim, you and your provider will know the amount you are responsible for paying. If you have a sufficient balance in your HSA fund, you can use your PayFlex debit card to cover the costs of the treatment.
After the deductible is met, you pay only the part of the cost each time you visit the doctor or medical provider. Once you have met the annual out of pocket maximum, the plan reimburses at 100% for the rest of the calendar year. Aetna provides online tools through Aetna Navigator to keep track of what you have paid. PayFlex administers the health savings account.
Once you meet the deductible, you pay for only part of the cost each time you visit a doctor or hospital. For in-network services, the plan reimburses at 90% and you pay 10% for medical care that is not preventive (for out of network services you pay more). Once the amount you have paid reaches the out of pocket maximum for the calendar year, the plan reimburses at 100%. (Medical care received out of network are subject to reasonable and customary charges so you could pay more).
How do I access the funds in my health savings account?
With PayFlex, you have three ways to access your HSA funds:
- PayFlex debit card. Use it for qualified expenses. Pay directly with a debit card linked to your HSA.
- Online withdrawal. Transfer funds from your HSA to your personal bank account.
- Online bill payment. Pay your healthcare expenses on your computer, directly from your HSA.
You decide when the medical claim is processed, whether to pay the provider, send money to your personal account or hold the HSA claim for a later decision.
Is preventive medical care subject to the deductible?
Preventive care is usually covered in full or subject to a copay and it does not count toward your deductible. Services may include routine exams, vaccinations, wellness exams and routine mammograms.
What are the IRS rules governing health savings accounts?
Please visit the IRS website for the latest governing HSA rules.
Why Do I have to Use a High Deductible Health Insurance Plan?
All HSAs are required by law to combine the savings account with high-deductible health insurance.
When you pay medical expenses from your HSA account, how does Aetna know when you have paid your deductible?
When Aetna processes a claim, the applicable amount you are responsible for is applied to your deductible with Aetna. If you use an in-network provider, the doctor’s office will file your claim with Aetna for you. This will ensure you receive the negotiated rate. You could also save the bills and submit them to Aetna yourself. All out-of-network providers will be subject to the out-of-network deductible and reimbursed at 80% of reasonable and customary limits.
What happens if there isn’t enough money in my HSA when I need to pay for qualified medical expenses?
If you use your PayFlex debit card to pay for qualified medical expenses and there is not enough money in the account to cover the cost, your transaction will be denied and you may incur a fee.
Are prescription drugs covered under the Aetna HSA?
Yes, the HDHP includes coverage for prescription drugs through OptumRx. Drugs that are considered preventive by OptumRx and the IRS are not subject to the deductible. You pay the copay. The copay is applied to the out of pocket maximum. Drugs that are not preventive in nature are applied to the deductible. To check the cost of any medication, contact OptumRx Member Services at (866) 533-6977.
What happens if I enroll in the HSA any time after January 1?
This typically applies to new employees.
If you enroll after January 1st, Cornell's contribution will be pro-rated based on the number of pay periods remaining in the year and deposited in your PayFlex account. For example, if you enroll mid-year with 13 pays remaining out of 24 (semi-monthly) for the year, the amount Cornell contributes up front will look like the following:
$1,000/24 pays = $41.66 regular contribution effective January 1
$41.66 x 13 pays remaining = $541.58
Cornell’s prorated calendar year contribution would be $541.58
You can also make contributions, which are not prorated. But the total amount you elect to contribute is spread out even over the remaining pay periods.
Does Aetna/PayFlex withdraw my HSA funds or keep track of them?
No. It is your responsibility to keep track of your own medical expenses. Individual contributions and taxable distributions should be reported on your Form 1040 tax filing
FAQ for 65+ Participants
What happens to the money in my Health Savings Account (HSA) if I leave, retire or change jobs?
You can take the money in the HSA account wherever you go. You own the HSA.
If you retire at age 65 or older, you are no longer eligible to remain in an active health plan like the HSA and will be moved to the Aetna Retiree 80/20 plan, provided you meet the eligibility requirements to retire from Cornell. You will be required to enroll in both Medicare Parts A & B. You will also be given the option to enroll in the Medicare Advantage Plan, as will your spouse/domestic partner over the age of 65. If your dependent is under 65, they will be moved to the Retiree Pre-Medicare Plan. The Aetna’s Retiree Service Center will be able to answer your questions about coverage (800) -338-4533.
You can continue to use HSA funds to reimburse yourself for qualified medical expenses until the funds are exhausted.
Can I use HSA money to pay for Medicare expenses?
You can use HSA contributions to pay for Medicare Parts A and B, Medicare Advantage, and Medicare Part D prescription drugs, as well as out of pocket expenses and employment-based retirement health insurance premiums including those through Cornell.
Can I still make contributions to my HSA if I turn 65 this year and continue working in a benefits eligible position?
It depends. The IRS allows you to continue to make and receive contributions to the HSA provided you do not apply for Social Security, you do not begin receiving income benefits and you do not enroll in Medicare.
If you apply for Social Security and begin receiving income benefits, you will be automatically enrolled in Medicare Part A and be ineligible for the HSA plan in accordance with the IRS regulations, starting with the month your income benefit is effective. You will no longer be able to make or receive contributions to your HSA effective the first day of the month in which you turn 65.
For example, if you turn age 65 on May 23, you can no longer contribute or receive contributions (your own or Cornell's) starting May 1. In addition, it is your responsibility to:
- Go into Workday and stop your HSA contributions as soon as you become ineligible.
- As soon as you become ineligible, please contact the HR Services and Transition Center by phone 607.255.3936; TTY: 711 or send a message to hrservices@cornell.edu.
- If you decide not to collect Social Security income (including enrolling in Medicare), you can continue making and receiving contributions to your HSA.
While every attempt has been made to ensure the accuracy of this Summary, in the event of any discrepancy the Summary Plan Description, Plan Document and IRS regulations will prevail.