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“I do not think there is any other quality so essential to success of any kind as the quality of perseverance.” – John D. Rockefeller. The University Of. Chicago. Postdoctoral Researcher Benefits Plan. Open Enrollment – Plan Year 2012 November 7 th through November 23 rd , 2011.
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“I do not think there is any other quality so essential to success of any kind as the quality of perseverance.” – John D. Rockefeller The University Of Chicago Postdoctoral Researcher Benefits Plan Open Enrollment – Plan Year 2012 November 7th through November 23rd, 2011 Effective January 1, 2012
AGENDA Introduction Review of Benefit & Plan Designs Explanation of Open Enrollment Process Q & A
In 2008, the University of Chicago partnered with • Garnett-Powers & Associates to administer the Postdoctoral • Researcher Benefits Plan (PRBP). INTRODUCTION • University of Chicago PRBP is available to all Postdoctoral • Researchers. Visiting scholars (Postdoc Indicator 910xxx) whose stay at the campus is longer than 30 days, are also • eligible. The Postdoctoral Researcher Benefits Plan • The PRBP is a package of benefits designed to closely match • the benefits offered to the University of Chicago faculty & • staff. • There is a Medical premium decrease for 2012! You may view • these changes at www.garnett-powers.com/uchicago by • clicking on “Enrollment ”, then “2012 Monthly Rates and • Contributions”. All other premiums remain the same.
All University of Chicago Postdoctoral Researchers may do the following during the Open Enrollment period of November 7th – November 23rd, 2011: WHAT IS OPEN ENROLLMENT? • If you are currently enrolled in the PPO medical plan, you may • switch to the HMO medical plan as long as you are in the • HMO service area. • If you are currently enrolled in the HMO medical plan, you • may switch to the PPO medical plan. • If you are currently enrolled in the Principal Dental High Plan, • you may switch to the Principal Dental Low Plan, or vice • versa. • If you previously waived either yourself and/or your family • members, you may enroll yourself and your family members • at this time.
Benefits offered through thePostdoctoral ResearcherBenefit Program
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”. WHAT IS AN HMO PLAN? • 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. 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).
Postdoctoral Researcher Benefit ProgramBCBSIL HMO Medical PlanMedical BenefitsIn-NetworkScholar PaysPhysician Office Visit $10 Copay Specialist Office Visit$20 Copay Hospitalization: Inpatient $250 Copay per admission Outpatient $0 Maternity $250 Copay per admission Prescription Drugs: Tier 1 $7 Copay Tier 2 $15 Copay Tier 3 $30 CopayEmergency Room Visits $75 Copay (waived if admitted) Routine Physical Exam $0 Mental Health Outpatient $10 Copay Inpatient $250 Copay per admission Annual Maximum Out of Pocket $1,500 Individual $3,000 Family Deductible: Individual None Family None Lifetime Maximum Unlimited For more detailed plan design information go to: www.garnett-powers.com/uchicago
There is an In-Network and Out-of-Network component. WHAT IS A PPO PLAN? • 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.
Postdoctoral Researcher Benefit ProgramBCBSIL PPO Medical PlanMedical Benefits In-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:Prescription Drug Card Tier 1 $7 Copay Tier 2 $15 Copay Tier 3 $30 CopayEmergency Room Visits $75 Copay $75 CopayRoutine Physical Exam $0 50%*Mental Health Outpatient $15 Copay 50%* Inpatient $0* $300 Copay | 50%*Annual Maximum Out of Pocket $0 Individual $10,000 Individual(Does not include deductible) $0 Family $20,000 FamilyDeductible: Individual $250 $5,000 Family $500 $10,000Lifetime Maximum Unlimited Unlimited * Subject to DeductibleFor more detailed plan design information go to: www.garnett-powers.com/uchicago
BlueAccess – 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. WELLNESS PROGRAMS • Special Beginnings – This program provides valuable info 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. More info on wellness programs may be found at: http://www.garnett-powers.com/uchicago/wellness.htm
HMO – One exam every 12 months ($0 copay) • PPO – One exam every 12months ($15 copay) • Davis Vision Discount Program Vision Benefits offered throughthe BCBSIL Medical Plans • 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 • website at www.garnett-powers.com/uchicago.
Important Information RegardingServices at the University of Chicago Medical Center As a BCBS PPO medical plan member, when you visit a physician at the University of Chicago Medical Center, the visit is billed as an outpatient service, which means: • Your Annual Deductible will apply for services at the medical • center, as an Outpatient procedure. • You may be billed for both your deductible and an office visit • co-pay, depending on how the Medical Center bills the • insurance company.
Postdoctoral Researcher Benefit ProgramDental Low Option PPO Annual Maximum $5,000 per person In-Network Out-of-Network Scholar PaysScholar Pays Calendar Year DeductibleNone $75 per person / $225 per family Diagnostic and Preventative Care -Routine Exams No charge 30% + any amount over Usual, -Teeth Cleanings Customary, Reasonable (UCR) -X-Rays Basic Procedures -Fillings 20% 60% + any amount over UCR -Endodontics -Periodontics -Oral Surgery Major Procedures -Crowns 50% 70% + any amount over UCR -Bridgework -Dentures Orthodontia (child only) -$1,500 Lifetime Maximum 50% 60% + any amount over UCR For more detailed plan design information go to: www.garnett-powers.com/uchicago
Postdoctoral Researcher Benefit ProgramDental High Option PPO Annual Maximum $1,500 per person In-Network Out-of-Network Scholar PaysScholar Pays Calendar Year Deductible$60 per person, $180 per family $60 per person / $180 per family (Waived for diagnostic and (Waived for diagnostic and Preventive Care) Preventive Care) Diagnostic and Preventative Care -Routine Exams No charge 0% + any amount over UCR -Teeth Cleanings -X-Rays Basic Procedures -Fillings 20% 20% + any amount over UCR -Endodontics -Periodontics -Oral Surgery Major Procedures -Crowns 50% 50% + any amount over UCR -Bridgework -Dentures Orthodontia (child only) -$1,000 Lifetime Maximum 50% 50% + any amount over UCR For more detailed plan design information go to: www.garnett-powers.com/uchicago
Postdoctoral Researcher Benefit Program Life Insurance and Accidental Death & Dismemberment (AD&D) Plan • 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.
This is not an open enrollment option; however, if you would • like to purchase additional life insurance, you can apply by • completing a Medical History Statement, found on the GPA • website under ‘Life and AD&D Insurance’. The acceptance of • your application is subject to medical underwriting. • Additional Life coverage can be purchased in increments of • $10,000, to a maximum of $200,000. • 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 on the • Garnett-Powers & Associates website. Postdoctoral Researcher Benefit Program Voluntary Supplemental Life Insurance
In order to make changes to your enrollment for 2012 plan year please follow these steps. Please note that all changes made to your current enrollment will take effect January 1st, 2012: THE OPEN ENROLLMENT PROCESS • 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 choose all plans in • which you wish to be enrolled for Plan Year 2012. Once • complete, you may print a copy for your records.
Once you access your online Open Enrollment Form you may do the following: THE OPEN ENROLLMENT PROCESS, cont. • Make the changes mentioned earlier regarding switching to a • different plan. Please check all plans in which you wish to be • enrolled for Plan Year 2012. • Update your Life Insurance beneficiary information. If nothing • has changed, you may leave this section as is. • If you choose the Medical HMO, you must choose a Primary • Care Physician for all enrolling family members. Provider • Directory links are available on the GPA web site. 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 • enrollment & billing purposes. • An e-mail will be sent no later than December 17th 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 regarding any plan changes you make • (BlueCrossBlueShield Medical and/or Principal Dental). • All Postdoctoral Researchers and Visiting Scholars will be • enrolled in the Life Insurance and Accidental Death & • Dismemberment plans. • If you are not making any changes to your enrollment, you do • not need to take any action. Your current enrollment will • remain the same for Plan Year 2012. THE OPEN ENROLLMENT PROCESS, cont.
VISITING SCHOLAR REQUIREMENTS(Postdoc Indicator 910xxx) • 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 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 (includes J2 • dependents).
For general inquiries and customer service regarding enrollment, benefit questions and ID cards, you should contact: Garnett-Powers & Associates, Inc. INFORMATION SOURCES • Website: • www.garnett-powers.com/uchicago • Toll Free Phone: • 800-261-7109 • Fax #: • 949-583-2929 • Email Address: • prbp@garnett-powers.com