The Web Page is intended only as a general overview and guide. Additional coverage information about each plan and/or insurance program is available by contacting your campus Human Resources Office directly.

This Web Page does not state all of the plans’ and or insurance programs’ terms and conditions. In all cases, the plan documents and not this Web Page will govern the benefits paid.

Pace University and its sponsored plan administrators/insurance carriers reserve the right to update this Web Page as needed.

At Pace University, you have a number of choices for medical protection including the main medical plan administered under Health Net Point-of-Service Plan and Health Maintenance Organizations, or HMO’s. We summarize key features of the plans we offer.

Health Maintenance Organizations are alternatives to traditional insured medical plans. There are two types of HMO’s.

If you choose an HMO, you and your dependents are not eligible for benefit payments under Health Net’s Point of Service Plan. Your medical and prescription drug coverage will be provided by the HMO. Typically there are no forms to complete or charges made for service you receive. However, co-payments will be required for some services, including office visits.  In addition, you will get receive medical care from doctors who work for or are participating in the HMO you select.

Here are some things to keep in mind as you make your decisions about medical coverage:

During the enrollment period, you may elect to remain with your current coverage, change health plans and/or add or drop dependent coverage. Please keep in mind that your elections will remain in effect for the entire calendar year. Also, please refer to each individual plan summary to determine if the plan permits enrollment of domestic partners.

• At this time, you may select either the Health Net Point of Service Plan or an available HMO. You may choose coverage for yourself alone, yourself and one other family member, family, or domestic partner coverage.

• You can add dependents to your coverage whenever you have a qualifying and relevant change in your family status, such as marriage, birth, etc. If you do not enroll dependents when they first become eligible, you will have to wait until the next annual enrollment. See Qualifying Events for more information

• If you’re married and your spouse has medical coverage under his or her employer’s plan, you should take that coverage into account as you decide on your Pace medical coverage.

• If you are covering a dependent child who attends college out of the area, he or she will need to choose a primary care physician near your place of residence for routine care. (If a medical emergency occurs at college, he or she will still receive network benefits).

• Dependent children are covered through age 19 or the end of the month in which they reach age 25 (if in school full time).

• Pace pays the full cost of your medical coverage for the Health Net Point of Service and for HMO coverage. You will be responsible for the cost of your family’s coverage.

Be sure to indicate a primary care physician for each family member you enroll in an HMO.

If you are not changing plans but simply want to change your primary care physician, you may do so by contacting Member Services for your HMO.

Copyright © 1998 Pace University
Last updated on 06/14/01