BeneFlex Program

Mount Sinai’s BeneFlex Program offers maximum flexibility for you to tailor a benefits package to meet your unique lifestyle and family needs. Costs vary based upon your specific circumstances and choices.

Faculty hired on or after January 1, 2004 must be employed a minimum of 24 hours per week to be eligible for benefits. Faculty hired on or before December 31, 2003 who were benefits eligible must continue to be employed a minimum of 17.5 hours per week to remain eligible for benefits.

Effective Date of Coverage

If you are a new hire or otherwise newly eligible for benefits, your coverage will begin on your first day of work only if it is also the first day of the month. If your hire date is not the first day of the month, your coverage will begin on the first day of the following month.

Newly hired and otherwise newly eligible faculty must enroll within 30 days (from date of hire or new eligibility date). Those who do not enroll in BeneFlex by the last day of the enrollment period (30 days from date of hire or newly eligible date) will be assigned limited coverage until the annual open enrollment period or a qualifying event occurs.

Open Enrollment and Changes to Benefits

Open Enrollment takes place annually for all benefits-eligible employees. During the open enrollment period, you can review your current benefits and either make changes to your benefits or allow your current selections to rollover to the following year.

Rollover to the following year does not apply to the following programs. If you wish to participate, you must re-enroll annually:

  • Dependent Care Reimbursement
  • Health Care Reimbursement
  • Limited Purpose Health Care Reimbursement

Use the BeneFlex website (a password protected site) to enroll, re-enroll, change your benefits if a qualifying event occurs, or obtain information and claim forms. If you are enrolling for the first time, you can also refer to the instructions and information provided in your enrollment package.

Medical benefits cover a full range of health needs. It is your prerogative to make selections based on your personal and family circumstances upon reviewing the following medical care benefit options. You have choices within each category. Review the details of each plan carefully before making your selections.

Mount Sinai offers you a choice of four medical options covered under UMR, a division of UnitedHealthcare. All plans are comprised of three components a top tier, a second or commercial provider network, and an out-of-network option. The price points and employee cost share requirements vary by plan:

  • Choice Plan (formerly known as the EPO plan)
  • High Deductible Health Plan (HDHP)
  • Traditional Plan

Learn more about each plan.

If you enroll in any of Mount Sinai's medical plans, you automatically receive basic prescription drug coverage. If you decline medical coverage through Mount Sinai, you are not eligible for the prescription drug coverage benefit. Mount Sinai's prescription vendor is CVS/Caremark.

You have a choice of three dental plans. You have the option of declining dental coverage.

Each of the three plans provide different levels of benefits, and each plan gives you and your family access to affordable, quality dental care:

  • Cigna Basic (Preferred Provider Organization) PPO Plan
  • Cigna Plus PPO Plan
  • Aetna Dental Health Maintenance Organization (DHMO)

The Aetna DHMO plan only covers services provided by a select network of Aetna dentists. ,Aetna DHMO features the lowest premiums of any dental plan offering. Dental services are covered based on a pre-established schedule of simple, affordable copays.

Cigna PPO plans provide flexibility in terms of service providers.

Please note dental plan providers do not issue ID cards; you can print your own ID card:

  • Cigna: Go to mycigna.com. Use Mount Sinai Group #2499504 and your Social Security Number to access your card.
  • Aetna: Go to aetna.com. Use Mount Sinai Group #0839208 and your Social Security Number to access your card.

Mount Sinai offers vision care coverage through UnitedHealthcare Vision (UHC Vision). You may elect to decline vision care coverage. After applicable copays, the vision benefit offers a comprehensive vision exam and eyeglasses (lenses and frames) or contact lenses in lieu of eyeglasses. Vision services are available out-of-network, but you receive the highest level of benefits when you use vision care from providers within the UHC Vision Network.

Short-Term Disability (STD) Coverage

Aetna Life Insurance provides non-occupational STD coverage You must notify your supervisor and also call Aetna at 888-714-4380 to register your claim to avoid suspension of your pay. You can also manage your claims with the Aetna WorkAbility website at www.aetnadisability.com or download the Aetna Mobile App at www.aetna.com/mobile.  For information on STD payment levels, contact Human Resources at 646-605-4620.

Long-Term Disability (LTD) Coverage

Aetna Life Insurance provides LTD coverage. To receive this benefit, you must be certified by Aetna as disabled due to occupational or non-occupational causes beyond the 26-week Short Term Disability period. For information on LTD payment levels, contact Human Resources at 646-605-4620.

The Internal Revenue Service (IRS) allows employers to set up accounts for employees to set aside money on a pre-tax basis to be used to pay for eligible health care, dependent care and transportation expenses.

Each year you must re-enroll and decide how much you wish to contribute to each of your tax-free reimbursement accounts, and that amount will be deducted from your paycheck on a pre-tax basis. The money set aside will be used to reimburse you for eligible expenses, and you are not taxed on the reimbursement. The IRS places important restrictions on these accounts in return for the tax advantages, so you must plan carefully to avoid forfeiture of unused monies.

The following are eligible reimbursement accounts:

  • Healthcare Reimbursement Account (HCRA)
    You may contribute up to $2,600 annually in pre-tax dollars towards medical, dental and drug expenses not covered under your health insurance.

  • Dependent Care Reimbursement Account (DCRA)
    • If you earn less than $115,000 per year, you may contribute up to $5,000 in pre-tax dollars annually per household towards care of eligible dependents.
    • If you earn more than $115,000 per year, the IRS puts a cap of $1,385 in pre-tax dollars that you can contribute annually per household towards care of eligible dependents.

  • Transportation Reimbursement Incentive Program (TRIP)
    You may contribute pre-tax dollars towards the cost of qualified transportation to and from work for mass transit, carpooling, and parking expenses.

Monitor your reimbursement accounts at https://myspendingaccount.adp.com.

Life insurance provides a lump sum benefit to your beneficiaries in the event of your death. As of January 1, 2015, Mount Sinai's program gives you basic coverage (1.0 x your base salary up to a maximum of one million dollars) at no cost to you. You also have an option of purchasing supplemental life insurance for yourself and your dependents. Aetna Life Insurance is the carrier for basic and supplemental life insurance, accidental death and dismemberment insurance, and dependent life insurance.

If a faculty member covered under Mount Sinai’s medical benefits plan loses group health coverage because of a reduction in hours of employment to a benefits ineligible level or termination of employment for reasons other than gross misconduct on the employee’s part, the former faculty member can choose a temporary extension of health coverage at group rates.

Note: All benefits and programs are subject to change from time to time in accordance with institutional policy. A full policy description is available on the Mount Sinai Health System intranet.