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Postdoctoral Researcher Benefits Plan Open Enrollment – Plan Year 2010

Postdoctoral Researcher Benefits Plan Open Enrollment – Plan Year 2010 (November 12, 2009 through November 23, 2009). Effective January 1, 2010. Agenda. Introduction Review of Benefits & Plan Designs Explanation of Open Enrollment Process Q & A.

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Postdoctoral Researcher Benefits Plan Open Enrollment – Plan Year 2010

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  1. PostdoctoralResearcher Benefits Plan Open Enrollment – Plan Year 2010 (November 12, 2009 through November 23, 2009) Effective January 1, 2010

  2. Agenda • Introduction • Review of Benefits & Plan Designs • Explanation of Open Enrollment Process • Q & A

  3. IntroductionThe Postdoctoral Researcher Benefits Plan • The University of Chicago has partnered with Garnett-Powers & Associates to implement and administer the Postdoctoral Researcher Benefits Plan (PRBP). • University of Chicago PRBP is available to all Postdoctoral Researchers. Visiting Scholars (Postdoc Indicator 910081) whose stay at the campus is longer than 30 days, are also eligible. • The PRBP is a package of benefits designed to closely match the benefits offered to the University of Chicago faculty and staff.

  4. IntroductionThe Postdoctoral Researcher Benefits Plan • There is one benefit change for Plan Year 2010 – The UnitedHealthcare PPO Medical Plan will be replaced by two new comprehensive plan choices: The BlueCross BlueShield of Illinois HMO & PPO Medical plans. • All currently enrolled Postdoctoral Researchers and Visiting Scholars should visit the Garnett-Powers (GPA) website to complete an Open Enrollment Form to make their medical plan choice for Plan Year 2010. • Rates have changed on the Medical & Dental plans for 2010 and the new rate sheet may be viewed on the GPA website.

  5. Benefits offered through thePostdoctoral Researcher Benefit Program • PPO Medical Insurance – BlueCross BlueShield effective January 1, 2010 • HMO Medical Insurance – BlueCross BlueShield effective January 1, 2010 • PPO Dental Insurance – Principal Dental • Group Life and AD&D Insurance – The Standard • Voluntary Supplemental Life Insurance – The Standard

  6. MEDICALINSURANCE

  7. What is a PPO Plan? • There is an In-Network and Out-of-Network component. • The In-Network benefits will be greater than the Out-of-Network benefits. • At the time of service, the member has the ability to seek care from a Specialist, without having to obtain a referral from a PCP • The contractual agreement between the PPO Plan and the Provider is on a “discounted fee for service” basis. This means that the provider who participates in the network has agreed to provide their service on an agreed upon discounted fee. The Provider who is not in the network will not agree to that discounted fee and will typically charge a “Reasonable and Customary” fee.

  8. What is an HMO Plan? • Under the HMO model, the member must choose a Primary Care Physician (PCP) contracted with the HMO plan at the time of enrollment (provider directory links are available on the GPA website). Each family member can have a different PCP. Your PCP becomes your healthcare “gatekeeper”. • You are allowed to change your PCP once a month if you are not satisfied with your current choice. • If the member is in need of treatment from a Specialist or is in need of an In-Patient or Out-Patient procedure, he/she must obtain a referral from their PCP prior to any type of consultation or treatment (except in the case of an emergency). If the referral is not obtained, no benefits will be paid. • There is no Out-of-Network benefit (except in the case of an emergency).

  9. Postdoctoral Researcher Benefit ProgramBlueCross BlueShield PPO Medical PlanMedical BenefitsIn-Network Out-of-NetworkScholar PaysScholar PaysPhysician Office Visit $15 Copay 50%*Specialist Office Visit$15 Copay 50%*Hospitalization: Inpatient $0* $300 Copay | 50%* Outpatient $0* 50%* Pregnancy $0* $300 Copay | 50%*Prescription Drugs: Tier 1 **$7 Copay **contracted pharmacies Tier 2 **$15 Copay Tier 3 **$30 CopayEmergency Room Visits $75 Copay $75 CopayRoutine Physical Exam $15 Copay 50%*Mental Health Outpatient $15 Copay 50%* Inpatient $0* $300 Copay | 50%*Annual Maximum Out of Pocket $250 Individual $10,000 Individual(Does not include deductible) $500 Family $20,000 FamilyDeductible: Individual $250 $5,000 Family $500 $10,000Lifetime Maximum $2,000,000 $2,000,000* Subject to DeductibleFor more detailed plan design information go to: www.garnett-powers.com/uchicago

  10. Postdoctoral Researcher Benefit ProgramBlueCross BlueShield HMO Medical PlanMedical BenefitsIn-Network Scholar PaysPhysician Office Visit $10 CopaySpecialist Office Visit$20 CopayHospitalization: Inpatient $250 Copay Outpatient $0 Pregnancy $250 CopayPrescription Drugs: Tier 1 $7 Copay Tier 2 $15 Copay Tier 3 $30 CopayEmergency Room Visits $75 CopayRoutine Physical Exam $10 CopayMental Health Outpatient $20 Copay Inpatient $250 CopayAnnual Maximum Out of Pocket $1,500 Individual (Does not include deductible) $3,000 Family Deductible: Individual n/a Family n/a Lifetime Maximum Unlimited For more detailed plan design information go to: www.garnett-powers.com/uchicago

  11. Wellness ProgramsBlueCross BlueShield of Illinois offers a variety of wellness programs to help both you and your family attain and maintain good health. • Blue Access - This is an online member portal. Once you have your member ID, you may register for access to this site. You may view your medical visits and claims status, print temporary ID cards, and gain access to other important informational sources. • Special Beginnings – This program provides valuable information for expectant mothers, providing resources and tools dedicated to the health of mother and baby. A 24 hour, toll free number staffed by maternity nurses is also available. • Personal Health Manager – This is an online health resource providing information and tools designed to help you maintain your health.

  12. Vision Benefits offered through the BlueCross BlueShield Medical Plans • HMO – One exam every 12 months ($10 copay) • PPO – One exam every 24 months ($15 copay) Davis Vision Discount Program • Receive discounted pricing on vision materials by accessing service through Davis Vision Providers • For information on discounts, vision materials available and accessing Davis Vision providers, visit the Garnett-Powers’ web site For more detailed plan design information go to: www.garnett-powers.com/uchicago

  13. Prescriptions • If you have a prescription that has not yet been filled, please do so prior to January 1, 2010 to avoid any delays by switching to the new plans. • Go to www.garnett-powers.com/uchicagofor important information regarding the prescription coverage.

  14. DENTALINSURANCE

  15. Postdoctoral Researcher Benefit Program Dental PPO Low Option PlanPrincipal Financial GroupAnnual Maximum $5,000In-Network Out-of-NetworkPlan PaysPlan PaysCalendar Year Deductible None $75 per person / $225 per family Diagnostic and Preventative Care- Routine Exams 100% 70% of UCR - Teeth Cleanings - X-Rays Basic Procedures- Fillings 80% 40% of UCR- Endodontics - Periodontics - Oral Surgery Major Procedures- Crowns 50% 30% of UCR- Bridgework - Dentures Orthodontia (child only)- $1,500 Lifetime Maximum 50% 40% of UCRFor more detailed plan design information go to :www.garnett-powers.com/uchicago

  16. Postdoctoral Researcher Benefit Program Dental PPO High Option PlanPrincipal Financial GroupAnnual Maximum $1,500In-Network Out-of-NetworkPlan PaysPlan PaysCalendar Year Deductible $60 per person, $180 per family $60 per person / $180 per family (Waived for Diagnostic and (Waived for Diagnostic and Preventative Care) Preventative Care)Diagnostic and Preventative Care- Routine Exams 100% 100% of UCR - Teeth Cleanings - X-Rays Basic Procedures- Fillings 80% 80% of UCR- Endodontics - Periodontics - Oral Surgery Major Procedures- Crowns 50% 50% of UCR - Bridgework - Dentures Orthodontia (child only)- $1,000 Lifetime Maximum 50% 50% of UCRFor more detailed plan design information go to : www.garnett-powers.com/uchicago

  17. LIFE AND AD&DINSURANCE

  18. Postdoctoral Researcher Benefit Program Life Insurance and Accidental Death & Dismemberment (AD&D) PlanThe Standard Insurance Company • The plan pays $12,000 in the event of a death. • An additional benefit of $12,000 is paid for AD&D if the death is due to an accident. • Postdoctoral Researchers holding J-1 Visa status will have the medical evacuation and repatriation of mortal remains coverage necessary to fulfill the visa requirements included in their Life and AD&D policy. In addition, family members holding J-2 Visa status will also be covered for this benefit even if the Postdoctoral Researcher waives Medical or Dental coverage.

  19. Postdoctoral Researcher Benefit Program Voluntary Supplemental Life Insurance The Standard Insurance Company • Additional Life coverage can be purchased in increments of $10,000, to a maximum of $200,000. The guarantee issue amount is $100,000. • Accelerated Benefit Provision – Allows eligible members, who are terminally ill to receive an early allocation of up to 75% of their group life insurance benefit. • Rates for Additional Life coverage will automatically be calculated for you on the enrollment form in Section 5b at the Garnett-Powers & Associates website.

  20. The Open Enrollment Process All University of Chicago Postdoctoral Researchers have the option of the following during the Open Enrollment Period from November 12th – November 23rd, 2009: • If you are currently enrolled in the Medical PPO, you may switch to the BlueCross BlueShield Medical HMO as long as you are in the Medical HMO service area, or choose the BlueCross BlueShield Medical PPO • If you are currently enrolled in the Dental High Plan, you may switch to the Dental Low Plan, or vice versa. • If you previously waived either yourself and/or your family members, they may be added at this time. • If you are currently enrolled in the Medical PPO, and you do not fill out an Open Enrollment form, you will be enrolled into the BlueCross BlueShield Medical PPO plan.

  21. The Open Enrollment Process, cont. In order to make changes to your enrollment for Plan Year 2010 please follow these steps. Please note that all changes made to your current enrollment will take effect January 1st, 2010: • Go to the Garnett-Powers & Associates website at www.garnett-powers.com/uchicago and click on “Enrollment”, then the sub-link “Open Enrollment”. • Click on the “Open Enrollment Instructions” link and print them out for assistance with completing the Open Enrollment Form properly. • Once the instructions are in hand, go directly to the “Open Enrollment Form”. You will need your Chicago ID and previously created unique password to enter the site. Once there, you may view your current enrollment and make the plan changes you desire online. Please check all plans in which you wish to be enrolled for Plan Year 2010. Once complete, you may print a copy for your records.

  22. The Open Enrollment Process, cont. Once you access your online Open Enrollment Form you may do the following: • Make the changes mentioned prior regarding switching to Medical PPO/HMO and/or Dental High/Low if desired. Please check all plans in which you wish to be enrolled for Plan Year 2010. • Enroll yourself and/or your eligible dependents if you previously waived. • Switch from the PPO plan to the HMO plan if you are not living outside of the HMO service area. • Update your Life Insurance beneficiary information. If nothing has changed, you may leave this section as is.

  23. The Open Enrollment Process, cont. • If you choose the Medical HMO, you must choose a Primary Care Physician for all participating family members. Provider directory links are available at the GPA website. Please enter the 3-digit Medical Group number, as well as the 9-digit Primary Care Physician number for yourself and all enrolling family members. • An electronic version of the enrollment form will be submitted to the Garnett-Powers & Associates’ secure website for data entry. • An e-mail will be sent no later than December 18th confirming your new enrollment status. Please make sure the e-mail address that appears on your enrollment form is correct. • ID cards will be mailed to your home directly from the Insurance Carriers (BlueCross BlueShield Medical & Principal Dental). • All Postdoctoral Researchers will be enrolled in the Life Insurance and Accidental Death & Dismemberment plans.

  24. Visiting Scholar(Postdoc Indicator 910081)Requirements • If a Visiting Scholar holding J1 Visa status chooses to waive out of the plan, they must fax/e-mail proof of coverage (i.e. a copy of their insurance ID card) to Garnett-Powers & Associates to verify that their coverage satisfies the J1 Visa requirements. • Minimum J1 Visa insurance requirements are: - $50,000 per accident/illness in medical coverage - An annual deductible of no more than $500 - Copayments that do not exceed 25% • All Visiting Scholars will be automatically enrolled in the University sponsored Basic Life and AD&D plan which includes the Medical Evacuation and Repatriation of Mortal Remains coverage required by their J1 Visa.

  25. Family Member EligibilityFamily member eligibility requirements are the same as the family member eligibility requirements for the University of Chicago faculty/staff plans. The major family member categories are: • Spouse • Natural or adopted children to age 23 and unmarried (unless eligible to continue coverage because of disability), regardless of student status. • Stepchildren may be included, if they live with the Postdoctoral Researcher, are supported by the Postdoctoral Researcher at more than 50% and claimed as a tax dependent. • Same-sex domestic partner. The required Affidavit of Domestic Partnership (located at the GPA website) must be completed, signed and forwarded to Garnett-Powers & Associates.

  26. Important information on usingthe Chicago Medical center When you visit a physician at the University of Chicago Medical Center, that visit is billed as an outpatient service, which means: On the PPO plan, instead of a $15 doctors visit copay, you will be billed your annual deductible Once you meet your annual deductible, all future physician visits to the Medical Center in the same year are covered at 100% The Medical Center does not accept the HMO insurance plan for PCP visits

  27. Information Sources For general inquiries and customer service regarding enrollment, benefit questions and ID cards, you should contact: Garnett-Powers & Associates • Website: www.garnett-powers.com/uchicago • Toll Free Phone: 800-261-7109 • Fax #:949-583-2929 • Email Address: prbp@garnett-powers.com

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