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Invest in your health care and focus on managing your long-term costs.

payflex is now inspira

PayFlex is now Inspira Financial. Inspira Financial has been updated on the website and mobile app. Inspira Financial will mail new debit cards starting April 2024 (only for new, expired or reissued cards).  Your current PayFlex debit card will continue to work until its expiration date. If you have any questions, please contact Inspira Financial at 1-888-678-7821.

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: 

  1. An Aetna high deductible medical insurance plan that includes prescription drug coverage at retail and mail order offered through OptumRx.  
  2. 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 2024 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 Inspira Financial 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

Using Your Inspira Financial Card

Also see: Covid-19 Benefits Info  

HDHP/HSA Plan Details 


Eligibility part 1 of 2: High Deductible Health Plan (HDHP)

  • 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:

  1. Due to the bank account feature, the employee is required to have a social security number.
  2. Covered only by an HSA-compatible high deductible health plan.
  3. Not covered by any other health plan that is not an HSA-compatible high deductible health plan (including spousal coverage).
  4. Not enrolled in Medicare (parts A, B, C, and D).
  5. 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.
  6. 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.


2024 Rates

Coverage Type Hourly/Non-exempt Salary/Exempt




Individual + child(ren)



Individual + Spouse/Domestic Partner



Individual + Spouse/Domestic Partner + child(ren)



Individual + Spouse/Domestic Partner working at Cornell (dual eligibility) + child(ren)



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.

Also see Compare rates across all Endowed Health Plans.


For 2024

Type of coverage In-Network Out-of-Network







** If covering dependents, you'll need to meet the entire family deductible before the plan reimburses for medical care.  

HSA Contributions

For 2024

Coverage Type Your Contribution Cornell's Contribution Total Contribution Limit


Up to $3,150




Up to $7,300



*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.


Plan Documentation

Plan Coverage Details:

Financial Details:

Investing With Your HSA


General Questions

How much can I deposit in my account?

You are allowed to deposit up to $4,150 for single or $8,300 for a family into your tax-free 2024 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 Inspira Pretax Accounts & Benefits | Inspira Financial 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 Inspira 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. Inspira 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 Inspira Financial, you have three ways to access your HSA funds:

  1. Inspira debit card. Use it for qualified expenses. Pay directly with a debit card linked to your HSA.
  2. Online withdrawal. Transfer funds from your HSA to your personal bank account.
  3. 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 Inspira 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 Inspira Financial 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-Inspira 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
  • If you decide not to collect Social Security income (including enrolling in Medicare), you can continue making and receiving contributions to your HSA.
Note: Cornell cannot act as a personal tax consultant. The contents of this page are for informational purposes only. All U.S. citizens and foreign national visitors to the U.S. are personally responsible for knowing the tax laws and penalties, and how they pertain to him/her individually.

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.