FAQs: Open Enrollment 2024

Open Enrollment is an annual two-week period of time in which employees make their desired insurance elections for coverage that begins January 1 of the following year. All employees MUST select coverage during Open Enrollment to have insurance in 2024. Previous coverage selections will not automatically carry over to next year.

Open Enrollment takes place from October 30 - November 13, 2023. All insurance selections will take effect January 1, 2024. The deadline to make benefit elections for 2024 coverage is 9 PM (PST) on November 13.

Employees have two options to enroll in benefits during Open Enrollment (October 30 - November 13):

1. Self-service. Employees may review plan details and make their insurance elections on the benefits portal at mybenefits.pepperdine.edu.

2. Enrollment Support Counselor. Employees may schedule an appointment with an Enrollment Support Counselor during Open Enrollment.

Yes. Employees are required to actively elect or decline each benefit (medical, dental, vision, FSAs, HSA, and voluntary plans) during the Open Enrollment period. If you take no action, your current insurance benefits will end on December 31, 2023. Previous coverage selections will not automatically carry over to next year.

No. Apart from a qualifying life event, once the Open Enrollment deadline has passed, the benefits you elect will take effect January 1, 2024, and remain in effect until December 31, 2024, assuming you remain employed in a benefits-eligible position for the entire year. 

Yes. All employees must complete the Open Enrollment process on the benefits portal or through an Enrollment Support Counselor for 2024 insurance coverage. If you do not take action, your benefits will automatically end on December 31, 2023. Previous coverage selections will not automatically carry over to next year.

Yes. Employees may choose to waive/decline health insurance. If your spouse also works at Pepperdine, you may choose to each elect separate coverage or elect family coverage (meaning one of you will elect family coverage and one of you will waive coverage). 

New plan rates are effective January 1, 2024. To represent the University's commitment to your well-being and continued investment in our shared benefits program, Pepperdine will pay 100% of medical premiums for all eligible employees in January 2024, meaning no money will be deducted from your paycheck for medical insurance costs during that month. You will first see new medical plan premium rates deducted from your February paycheck(s).

No. The Kaiser Permanente HMO Southern California network and coverage will remain the same in 2024. 

Pepperdine experienced challenges with Anthem, including a large rate increase, a reduction in services, a lack of transparency in reporting, and poor customer service. These issues created inadequate coverage for faculty and staff, leading to a request for proposal (RFP) to hold insurance carriers accountable for good service and the ultimate decision to offer Aetna.

Pepperdine will offer three Aetna plans - two HMOs and one High Deductible Health Plan - to employees. These plans are structured similarly to current Anthem plans, but there are important differences. Please review the cost and coverage associated with each plan in the plan comparisons chart.

Aetna is owned by CVS Health, and this unique partnership allows Aetna to offer unique additional benefits to those who enroll in their plans.

• CVS CarePass. Aetna members receive a monthly $10 promotional discount for CVS retail items, a 20% savings on favorite CVS Health products, and 24/7 access to a CVS pharmacist.

Enrollment eligibility for the CVS CarePass will occur in Aetna Health on or shortly after the Aetna member's effective date of January 1, 2024. To enroll, an Aetna member would log in through their Aetna HealthSM app or the Aetna member website and select the link to enroll in CarePass. After the member signs the online consent form, they will create an account on CVS.com to complete enrollment and become an active subscriber in the CarePass program.

• MinuteClinic. Aetna members have no-cost or lower-cost access to convenient MinuteClinic providers who can administer vaccines, treat common chronic conditions, and address 100+ illnesses and injuries at a local CVS store.
• HealthHUB. CVS HealthHUB locations offer standard MinuteClinic services as well as expanded services for screenings and health assessments at no-cost or lower-cost to Aetna members.
• Teladoc. Teladoc provides Aetna members 24/7 access to doctors by phone, video, or mobile app. Speak to a doctor with a shorter wait time and get a diagnosis, treatment, and prescription (as needed) for non-emergency medical needs.
• AbleTo. AbleTo is a telemedicine benefit comprised of an eight-week program that offers a combination of therapy and coaching from a licensed therapist to assist Aetna members with challenging life changes. Sessions are confidential and offered virtually and telephonically.

If this is the first time you are adding a dependent to your benefits, then yes. You must provide documentation for verification purposes, such as a certified marriage license for a spouse or birth certificate for a child.

If your dependents are currently enrolled in your Pepperdine benefits, then no. You will not need to submit documentation to add the individual(s) to your desired 2024 coverage.

You can verify which plans include your current doctors (including primary care providers (PCPs) and specialists), medical facilities, laboratories, hospitals, and clinics by following the instructions listed in the What is Covered by Aetna section.

Please note that doctors practicing these specialties may be considered a PCP: Adolescent Medicine, Pediatrician, Family Practice, General Practice, Geriatrician, Internist/Internal Medicine, and OB-GYN (California only).

It depends. If you elect an Aetna HMO plan, then no. You are limited to visiting an urgent care and hospital that is within your medical group (i.e., UCLA Health, Cedars Medical Group, Good Samaritan, etc.). As a first time, please visit your medical group's website and see what urgent care and hospital locations are covered. If you cannot locate this information, contact your Primarcy Care Provider (PCP) and inquire.

If you elect the Aetna HDHP, then yes. You are not restricted to certain urgent care and hospitals. However, if you utilize a facility not contracted with Aetna, you will be subject to all out-of-network expenses and lesser insurance benefits.

If you elected an Aetna HMO plan, you may only self-refer to a chiropractor, OB-GYN (women), and mental health professional. All other specialists require a doctor's referral prior to seeing you.

After clicking the appropriate plan link below, use the “Continue as a Guest” field to search for an Optometrist or Ophthalmologist Specialist in your service area and within your network. The search tool will return in-network specialists you may contact for scheduling a vision exam in 2024.

• Aetna Value Network HMO
• Aetna Broad HMO
• Aetna High Deductible Health Plan

 

While the University prioritized network continuation when considering new carriers, limited disruption was unavoidable. You may encourage your provider or facility to join Aetna’s network of providers by inviting them to complete the Request to Join the Aetna Network online submission. Human Resources has also contacted more highly used facilities, encouraging providers and facilities to join Aetna's networks.

If your preferred doctor or facility chooses not to contract with Aetna, you may consider utilizing the services out-of-network if you elected the high deductible health plan (HDHP), knowing you will be subject to a higher deductible and out-of-pocket maximum. HMO plans do not provide insurance benefits for out-of-network doctors and facilities (meaning you would be responsible for 100% of costs if utilized). The alternative options would be to choose a new in-network provider by utilizing Aetna’s Directory of Health Professionals website(s), or you can consider electing the Kaiser Permanente HMO plan.

You can verify which plans include your current prescription drugs and preferred pharmacy by following the instructions listed in the What is Covered by Aetna section.

It is important you talk with your doctor about any change to your insurance ahead of January 1, 2024. Once you select your healthcare plan during open enrollment, notify your doctor(s) that your medical coverage is changing on January 1, 2024, and discuss what options are available to ensure continuity. Many providers offer to prescribe a 90-day supply or suggest timing more frequent refills appropriately with your preferred pharmacy.

If you are currently taking a prescribed medication that will no longer be covered by your medical plan in 2024, consider talking to your current doctor about alternative prescription(s) that are covered under your 2024 insurance. If alternative medication is not possible, review the “Next Steps” information for your 2024 insurance carrier below and take action to request an exception.

• Next Steps:  Pharmacy Transition and Exception Requests with Aetna
• Next Steps:  Pharmacy Transition and Exception Requests with Kaiser Permanente

Yes. If you change medical carriers for 2024 coverage and your existing doctor is in-network with your chosen Aetna plan, you will need to notify your doctor of your new insurance, effective January 1, 2024, and ask that they update your referral on file. You will not be able to use the existing referral if you have change insurance carriers.

If you or an enrolled dependent are currently in an active course of treatment for surgery, pregnancy, or terminal illness, and you elected a new medical carrier for 2024, please review the "Next Steps" information below and take action. Please know Human Resources is available to assist you with navigating transition of care.

• Next Steps:  Transition and Continuity of Care with Aetna
• Next Steps:  Transition and Continuity of Care with Kaiser Permanente
  Employees may call Kaiser Permanente’s New Member Entry Department (888.956.1616) as early as December 20.

Pepperdine offers both an HSA and Health FSAs. The University will continue to offer an HSA, administered through Chard Snyder, for those enrolled in a high deductible plan. For those enrolled in HMO plans, the University will continue to offer FSAs. Please see additional descriptions below.

HSAs and Health FSAs function very similarly: both are a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified healthcare expenses, and both types of accounts are regulated by the IRS. The two primary differences are:

• An HSA is only available to employees enrolled in a high deductible health plan and not enrolled in a Medicare plan. The account operates like a bank account in that the funds are subject to interest gains and stay with an employee indefinitely, even after separation from employment. 
• A Health FSA is not contingent upon enrollment in a medical plan and has a lower contribution than an HSA. The IRS defines this account type as "use it or lose it," and requires unused funds to be forfeited by the employee 90 days after separation of employment or March 31st of the following plan year, whichever occurs first.

The University will continue its original plan to gradually reduce employer contributions to HSAs. Effective January 2024, the University will no longer provide matching HSA contributions for employees enrolled in the high deductible health plan. Employees are encouraged to continue contributing pre-tax dollars to their HSA through a convenient payroll deduction.

Existing HSA funds in your Chard Snyder account will remain available to you indefinitely, regardless of which health plan you select for 2024. These funds can be used for eligible healthcare expenses in 2024 and beyond.

No. This benefit for individuals ineligible to contribute to an HSA due to their enrollment in Medicare will sunset with the HSA employer contributions on December 31, 2023.

Yes. The three FSA options available to you are not changing in 2024.

1. Healthcare FSA: Pretax savings to cover out-of-pocket healthcare expenses during the year (up to the IRS maximum; limited rollover to the following year).
2. Dependent Care FSA: Pretax savings to cover expenses incurred for the supervision of your child(ren) and elderly dependents during the year (up to $5,000; no rollover to the following year).
3. Limited Purpose FSA: Pretax savings to cover out-of-pocket dental and vision care expenses during the year (up to the IRS maximum; limited rollover to the following year). This type of flexible spending account is available to those who enroll in the Aetna HDHP with HSA.

The same two plans - Delta Dental PPO and HMO - remain available to you for 2024 coverage.

While there are no major changes to dental coverage in 2024, the existing Delta Dental PPO plan has been enhanced to remove the twelve-month waiting period for major dental services and orthodontic treatment. As of January 1, 2024, employees and their enrolled dependent(s) can seek these services on the first day of coverage.

All medical plans offer a routine vision exam with a covered optometrist. This benefit is coordinated through your medical plan provider.

You may also consider electing the VSP vision plan, which offers allowances for frames and lenses, or contacts. This benefit is not coordinated through your medical plan.

While there are no major changes to vision coverage in 2024, the existing VSP vision plan has been enhanced to realign plan benefits from a service-year to a calendar-year model. This modification allows employees and their enrolled dependent(s) the flexibility to seek vision care at any time during 2024, regardless of when they sought care in 2023.

Yes. As an added benefit during Open Enrollment, you have the option to elect up to $150,000 in voluntary life insurance for themself and up to $50,000 for your spouse with a guarantee issue and without the requirement of an approved Evidence of Insurability (EOI) online form. Employees requesting more than these amounts are subject to an EOI form and review by UNUM, Pepperdine's life insurance policy administrator.

Employees residing outside of California have the option to elect the Aetna High Deductible Health Plan for medical insurance, and the Delta Dental PPO for dental insurance. All HMO plans require employees to reside in the service area of Southern California. The vision and voluntary insurance benefits are available to employees regardless of their state of residence.

Employees residing in Hawaii should contact Human Resources at benefits@pepperdine.edu to inquire about available medical insurance.

Dependent children attending college out of state may continue on their parents' healthcare plan (including HMOs) until age 26. Review the documents below for additional information.

Out-of-Area coverage details for enrolled dependents of Aetna plans

Out-of Area coverage details for enrolled dependents of Kaiser Permanente HMO

If you are currently in an active course of treatment for surgery, pregnancy, or terminal illness, and you elected a new medical carrier for 2024, please review the "Next Steps" information below and take action. Please know Human Resources is available to assist you with navigating transition of care.

• Next Steps:  Transition and Continuity of Care with Aetna
• Next Steps:  Transition and Continuity of Care with Kaiser Permanente
  Employees may call Kaiser Permanente’s New Member Entry Department (888.956.1616) as early as December 20.

If you have a disabled child dependent age 26 or older on your current medical plan, you will need to have their status reverified by your 2024 insurance carrier. Review the "Next Steps" information for your 2024 insurance carrier below and take action.

• Next Steps:  Reverifying Disabled Child Dependents with Aetna
• Next Steps:  Reverifying Disabled Child Dependents with Kaiser Permanente