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Last updated date: 9/29/2023

Carlisle provides valuable benefits to help you and your family stay well and access quality health care when you need it.

Overview

Your medical plan options include a range of coverage levels and costs, so you can choose the one that’s best for you. These plans are administered by Aetna. You can enroll as a new hire, during Open Enrollment, or if you have a qualifying life event. To enroll, log in to MyADP.

Key features

All of our medical plans provide:

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Comprehensive, affordable coverage

for a wide range of health care services.

Free in-network preventive care

with services such as annual physicals, recommended immunizations, and routine screenings all 100% covered.

Prescription drug coverage

provided by Aetna.

Financial protection

through annual out-of-pocket maximums that limit how much you’ll pay each year.

2024 medical plans

Carlisle HSA

 

Take charge of your spending through lower contributions, higher deductibles, and a tax-free Health Savings Account (HSA) with contributions from Carlisle.

Carlisle Medical

 

If you are covered by a non-HDHP (i.e., spouse’s health plan, Health Care FSA or HRA), Medicare, TRICARE, VA benefits or claimed as a dependent on someone else’s tax return, you may enroll in the Carlisle Medical.

Carlisle HRA

 

If you are a Medicare recipient or have another first-dollar benefit plan, or if you are enrolled in a HRA-eligible HDHP, you may enroll in the Carlisle HRA.

How much does Carlisle medical coverage cost?

Carlisle pays a generous portion of the cost of your medical coverage. You’ll pay the remaining amount through pretax contributions from your paycheck. The amount you pay will depend on which plan you choose and whether you cover just yourself or family members, too. You can view your plan costs on the MyADP website.

Plan Comparison

Use this interactive side-by-side plan comparison to understand key differences between the plans.

Carlisle HSA Carlisle Medical Carlisle HRA
HSA features
HSA-eligible Yes No No
Company contribution to HSA $850 for employee-only coverage or $1,700 if you cover dependents* None $500 for employee-only coverage or $1,000 if you cover dependents*
Annual deductible (individual/family)
In-network $1,600/$3,200 $1,600/$3,200 $1,600/$3,200
Out-of-network $3,200/$6,400 $3,200/$6,400 $3,200/$6,400
Coinsurance
In-network You pay 20%, plan pays 80% You pay 20%, plan pays 80% You pay 20%, plan pays 80%
Out-of-network You pay 40%, plan pays 60% You pay 40%, plan pays 60% You pay 40%, plan pays 60%
Annual out-of-pocket maximum (individual/family)
In-network $3,200/$6,400 $3,200/$6,400 $3,200/$6,400
Out-of-network $6,400/$12,800 $6,400/$12,800 $6,400/$12,800
Health care visits: Your costs
Preventive care You pay nothing in-network, covered 100% You pay nothing in-network, covered 100% You pay nothing in-network, covered 100%
Primary care (in-network) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Primary care (out-of-network) You pay 40% after deductible You pay 40% after deductible You pay 40% after deductible
Specialist (in-network) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Specialist (out-of-network) You pay 40% after deductible You pay 40% after deductible You pay 40% after deductible
Behavioral health (in-network) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Behavioral health (out-of-network) You pay 40% after deductible You pay 40% after deductible You pay 40% after deductible
Telehealth You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Urgent care (in-network) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Urgent care (out-of-network) You pay 40% after deductible You pay 40% after deductible You pay 40% after deductible
Emergency room (in- and out-of-network) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Prescriptions – 30-day supply at in-network retail pharmacy: Your costs
Preventive Generic Preferred Preventive generics are covered at no charge and excluded from the plan deductible.
Generic 20% after deductible 20% after the 20% member copay 20% after deductible
Brand 20% after deductible 20% after the 20% member copay 20% after deductible
Specialty 20% after deductible 20% after the 20% member copay 20% after deductible
Prescriptions – 90-day supply from in-network mail order pharmacy: Your costs
Generic 20% after deductible Not covered 20% after deductible
Brand 20% after deductible Not covered 20% after deductible

*Carlisle prorates the annual HSA and HRA employer contributions if coverage begins after January 1.

Carlisle HSA Plan

The Carlisle HSA plan pairs low-contribution, high-deductible coverage with a tax-free Health Savings Account (HSA) that helps you save money and plan ahead for future medical expenses. This combination gives you more control over your money and rewards you for making healthy, cost-conscious choices.

As an added bonus, Carlisle will contribute to your HSA — $850 for employee-only coverage or $1,700 if you cover dependents. With this plan, you can see any provider you wish, but you will pay less when you stay in network.

How the Carlisle HSA works

You pay the plan contributions from your paycheck to have coverage. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:

You pay 100% of your medical and prescription costs until you meet the annual deductible.

Deductible

After meeting the deductible, you and the plan share the cost of covered medical care and prescriptions, with the plan paying the majority.

Coinsurance

You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

Out-of-Pocket Maximum

Remember to use your tax-free HSA to pay for eligible expenses and plan ahead for future costs. Carlisle contributes money to your account, too!

HSA

Use your HSA to save money and plan ahead!

Contributing to your HSA is a great way to budget for deductibles and other out-of-pocket expenses while also saving money — your HSA contributions are tax-free!*

Keep in mind:

  • The Carlisle HSA costs you less from your paycheck, so you may have extra money to put in your HSA.
  • You can only spend HSA money already deposited into your account. If you don’t have enough money in your HSA when you need it, you can pay another way and reimburse yourself later to take full advantage of your HSA’s tax savings.
  • You will never forfeit any money left in your HSA — it rolls over each year. To save for your health care costs in retirement or prepare for future expenses, set aside a little extra each paycheck to grow your balance.
  • You can change your HSA contribution amount throughout the year, if needed.

*HSA contributions are not subject to federal income tax, but are currently subject to state income tax in CA and NJ. Consult with your tax advisor to understand the potential tax implications of enrolling in an HSA. Money in an HSA can be withdrawn tax-free as long as it is used to pay for qualified health-related expenses. If money is used for ineligible expenses, you will pay ordinary income tax on the amount withdrawn, plus a 20% penalty tax if you withdraw the money before age 65.

Carlisle Medical Plan

If you are covered by a non-HDHP (i.e., your spouse’s health plan, Health Care FSA or HRA), Medicare, TRICARE, VA benefits or can be claimed as a dependent as someone else’s tax return, you are eligible to enroll in the Carlisle Medical plan.

Keep in mind:

  • Under the Carlisle Medical plan, you are not eligible to enroll in a HSA, HRA or Health Care FSA.
  • You can enjoy the same contributions and coinsurance as the Carlisle HSA plan.
  • Consider enrolling in the Carlisle Medical if you are a Medicare recipient or have another first-dollar benefit plan.

Carlisle HRA Plan

If you are currently enrolled in the Carlisle HRA, you will be eligible to enroll in a Health Reimbursement Account (HRA) that helps you save money and plan ahead for future medical expenses.

As an added bonus, Carlisle will contribute to your HRA — $500 for employee-only coverage or $1,000 if you cover dependents. With this plan, you can see any provider you wish, but you will pay less when you stay in network.

Carlisle HRA

No new enrollments in the Carlisle HRA plan will be accepted for the 2024 plan year. If you are currently enrolled in this plan, you may continue under this plan or you may select an alternative plan. Should you decide to opt for a different plan for 2024, please note that you may not reelect the HRA plan.

How the Carlisle HRA works

You pay the plan contributions from your paycheck to have coverage. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:

Your HRA helps pay your deductible and coinsurance amounts.

Expenses

Your HRA funds cover eligible expenses, and these payments apply toward your deductible. Carlisle contributes money to your account, too!

HRA

After you use all of your HRA funds, you pay the rest of the deductible amount out of your own pocket.

Deductible

Once you meet your deductible, you and the plan share in the cost of expenses, called coinsurance.

Coinsurance

Use your HRA to save money and plan ahead!

Contributing to your HRA is a great way to budget for deductibles and other out-of-pocket expenses while also saving money — Carlisle contributes to your HRA to help offset your medical expenses.

Keep in mind:

  • Only Carlisle can contribute to your account. You cannot make contributions to your HRA.
  • Funds are held in your name and can be used to pay for eligible medical expenses while you are enrolled in the plan. Please note: Funds available for reimbursement are limited to the balance in your HRA.
  • You may also enroll in a Health Care Flexible Spending Account (FSA). However, plan your FSA contributions carefully: money in your FSA does not carry over to the next plan year; you must “use it or lose it.”

*HSA contributions are not subject to federal income tax, but are currently subject to state income tax in CA and NJ. Consult with your tax advisor to understand the potential tax implications of enrolling in an HSA. Money in an HSA can be withdrawn tax-free as long as it is used to pay for qualified health-related expenses. If money is used for ineligible expenses, you will pay ordinary income tax on the amount withdrawn, plus a 20% penalty tax if you withdraw the money before age 65.

Prescription Drugs

When you enroll in a Carlisle medical plan, you automatically receive prescription drug benefits through Aetna.

Drug tiers

The cost of your prescription drugs under each medical plan depends on the tier of the medication — generic, preferred, or non-preferred. All prescription carriers have a formulary, or list of drugs based on effectiveness and cost. This list will determine how your prescriptions are covered. Keep in mind that the formulary may change as a result of regular reviews and updates.

Learn about the drug tiers

Generic drugs
Brand drugs
Specialty drugs

You pay: $

Generic drugs have the same active ingredients as brand-name equivalents and meet the same standards for quality and effectiveness, but usually cost much less.

You pay: $$

Brand drugs are brand-name medications included on the plan’s formulary and favored by Aetna.

You pay: $$$

Specialty drugs are brand-name medications not preferred by Aetna. They may still be covered, but may require prior authorization and cost more.

Pay less for your prescriptions

Ask your doctor about generic medications.

They’re generally just as effective as brand-name medications, but typically cost 80-85% less.

Use the home delivery feature.

Save time and money on maintenance medication for chronic conditions — such as an allergy, high blood pressure, or diabetes — with the convenient, cost-saving home delivery prescription program through Aetna.

Why use home delivery?

  • Free shipping on prescriptions.
  • No waiting in line at the pharmacy.
  • Reduced cost for a three-month supply.
  • Convenient, automatic refills.

Prescription programs

Your pharmacy benefits include several programs aimed at ensuring your safety and making sure you receive the most clinically appropriate and cost-effective medication.

Preventive generics

Preferred Preventive generic medications are covered at no charge to you under all Carlisle plans and are not subject to each plan’s deductible.

90-day refill requirement

All prescriptions for 90-day refills must be filled at either a CVS Caremark Mail Service Pharmacy or your local CVS pharmacy. However, you may contact Aetna to opt out of this requirement.

Dispense as written (DAW)

If your doctor writes DAW on a brand-name prescription when a generic alternative is available, you will pay the brand cost. Without DAW, you would also pay the price difference between the brand and generic drug.

Prior authorization

Some medications may require prior authorization from your doctor before receiving approval for coverage. This is done to ensure the medication is the best option for you.

Prescription tools

Visit your prescription plan website or download the mobile app to manage your prescriptions, order refills, sign up for home delivery, and more. Get started by creating an online account on the Aetna website.

Find a Doctor

Using in-network providers saves you money. Here’s how to find doctors in your medical plan network.

Aetna

  • Visit the Aetna website.
  • Click on Find a doctor and choose to log in or continue as a guest.
  • If you choose to continue as a guest, click Plan from an employer.
  • Enter your location and adjust the search area to find a provider near you.
  • Select your plan from the list that appears, or click Skip plan selection to continue to the next page.
  • From there, you can search for specific providers, facilities, provider types, and more. You can even search for nearby pharmacies, walk-in clinics, labs, and mental health resources.

Don’t have a personal doctor? You should. Here’s why.

  • Better health. Yearly health screenings can reduce your risk for many serious conditions. Preventive care is free, so there’s no excuse to skip it.
  • Greater savings. Having a doctor you can call helps you avoid costly trips to the emergency room.
  • Peace of mind. Your personal doctor gets to know you and your health history, provides advice you can trust, and helps coordinate your care.

Telehealth

Your medical plan gives you access to telehealth services through Teladoc. Consider using telehealth for non-emergency medical or behavioral health care — it’s available from the comfort of your home or wherever you are.

Telehealth is a great option when:

  • You don’t feel up to going to the doctor’s office.
  • You can’t get to your doctor because you’re traveling.
  • You need care after hours (nights, weekends, holidays).

Try telehealth for fast, affordable care

Teladoc provides convenient telehealth services anytime, anywhere. You have 24/7 access to board-certified doctors by phone or video using the Teladoc mobile app or website. Doctors can diagnose, treat, and prescribe medication when needed for many common conditions. The cost for a telehealth appointment varies by medical plan, but is typically less than going to an urgent care center.

Tools & Resources

Your medical plan offers additional features to help you get the most from your coverage.

Online tools

Log in to your medical plan website or download the mobile app to:

  • Find a doctor.
  • Compare costs.
  • Manage claims.
  • And much more.

Get started by setting up an online account for your plan — Aetna.