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Enrollment Forms and Glossary of Terms

• Enrollment Forms - fax completed forms to (914) 989-8506 or Scan/Email to benefits@pace.edu
• Glossary of Terms (PDF)

Medical Plans – January 1, 2024 – December 31, 2024

• Network Core Plan
• Choice Plan
• Consumer Core HDHP/HSA Plan
• Aetna Vision Preferred Plan
• Per Paycheck Premiums for Medical Plans (PDF)
• Side-by-Side Comparison (PDF)
• Prescription Coverage
• Dependent Tax Affidavit (PDF)
• Preventive Care Incentive Program

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Dental Plans - January 1, 2024– December 31, 2024

• Aetna Dental Care (DMO)
• Aetna Dental PPO
• Per Paycheck Premiums for Dental Plans (PDF)

COBRA

• Initial Notice (PDF)

HIPAA

• Initial Notice (HIPAA)

Medicare Part D

• Initial Notice (Medicare)

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403(b) Retirement Plan

• The ÌÒñ«ÉçÇø 403(b) Defined Contribution Retirement Plan at a Glance
• Qualified Default Investment Alternative (QDIA) Notice (PDF)
• TIAA ÌÒñ«ÉçÇø Target Retirement Series (PDF)

Life Insurance

• Basic Life Insurance
• Voluntary Life Insurance
• Voluntary Life Insurance Per Paycheck Premiums
• Dependent Life Insurance
• New York Life Group Benefit Solutions Secure Travel

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Flexible Spending Accts - January 1, 2024 – December 31, 2024

• Health Care FSA (if not enrolled in the Aetna HDHP medical plan)
• Child and Dependent Care FSA

Commuter Reimbursement Accounts - January 1, 2024 – December 31, 2024

• Mass Transit Account
• Parking Account

Employee Assistance Program (EAP)

• Aetna's Employee Assistance Program

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Income Protection

• Short-Term Disability
• Long-Term Disability
• Workers’ Compensation
• Long Term Care
• NY Paid Family Leave

Education

• On-Campus Tuition Remission
• Off-Campus Tuition Remission (Employee)
• Off-Campus Tuition Remission (Dependent Child)
• Tuition Exchange – Tuition Exchange, Inc.
• Tuition Exchange – Council of Independent Colleges
• NY 529 College Savings Program

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