A GUIDE TO US HEALTH CARE BENEFITS

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Esmond Newton
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1 A GUIDE TO US HEALTH CARE BENEFITS FOR EMPLOYEES RETURNING FROM AN EXPATRIATE ASSIGNMENT 5/17/17 ENROLLING IN THE US HEALTH CARE PLANS

2 Human Resources in the US is responsible for updating the Eaton human resource information system (HRMS) with your transfer date and other applicable data. About a week before the effective date of your transfer you may wish to verify Human Resources that this information has been entered into HRMS. If your transfer information is in HRMS on or before the effective date of your transfer, then on the first Friday following your transfer date, your transfer information is provided to the Eaton Service Center at Fidelity. The next Monday your enrollment in the US health care plans will be reflected in the Service Center system. The Service Center will automatically enroll you in US health care coverage based on the CIGNA coverage you had immediately prior to your transfer (see chart below). You can view these default enrollments on line at Fidelity NetBenefits. Coverage Plan Enrollment Prior to Transfer After Transfer Medical No coverage No coverage CIGNA Enhanced Medical* BCBS Enhanced Medical* Dental No coverage No coverage CIGNA Dental* Delta Dental* Vision No coverage No coverage CIGNA Vision* EyeMed Vision* Employee Assistance Program (EAP) CIGNA EAP Work/Life Solutions EAP * If you are covering dependents under the CIGNA plans, those same dependents will be automatically covered under the US plans For information on the other medical, dental and vision options and associated costs available to you, you can contact a Service Center representative at or wait until you receive your personal fact sheet in the mail in approximately 10 business days. If you want to elect medical, dental or vision benefits other than the benefits indicated below, you will need to make your elections within the 60-day enrollment period following your transfer date by calling a Service Center representative. On Thursday, your default enrollments will be sent to the health care partners (Anthem Blue Cross Blue Shield, Delta Dental, etc.) By the middle of the following week, your enrollments will be in the health care partners systems. You should receive ID cards directly from the health care partners within 2 weeks. 2

3 USING YOUR US HEALTH CARE COVERAGE BEFORE RECEIVING YOUR ID CARDS REGARDLESS OF WHAT DATE YOUR COVERAGE FIRST APPEARS IN THE EATON SERVICE CENTER AT FIDELITY S OR HEALTH CARE PARTNER S SYSTEM, YOUR US HEALTH CARE PLANS COVERAGE IS EFFECTIVE ON THE DATE OF YOUR TRANSFER If the Eaton Service Center at Fidelity has enrolled you in US health care coverage, call the health care partner s customer service at the numbers listed below. Medical Plan Anthem Blue Cross Blue Shield (BCBS) Medical EATON02 ( ) Express Scripts Prescription Drug Program Delta Dental EATON03 ( ) EyeMed Vision Care If the Health Care Partner s customer service confirms that you or your family member has coverage in their system, follow the instructions below. Medical services - Have your doctor or other health care provider contact Anthem BCBS customer service to verify coverage, or you can print a temporary ID card from the BCBS web site - go to EatonBenefits.com (log in if you are not an employee accessing from JOE) and select Anthem BCBS from the left hand navigation bar. Prescription drugs Your medical (Anthem BCBS) ID serves as your prescription drug ID card. You can print a temporary ID card from the BCBS web site as described above. Instead of printing a temporary ID card, you can provide the pharmacy with the following information: RxBin# Group# EATONRX Processor: Express Scripts. Dental or Vision services - Have your doctor, dentist or other health care provider contact Delta Dental or EyeMed Vision Care customer service to verify coverage or print temporary ID cards from the respective website. Go to eatonbenefits.com (log in if you are not an employee accessing from JOE), and select the appropriate health partner website from the left navigation bar. If the Health Care Partner s customer service says that you or your family member does not have coverage in their system yet, follow the instructions below. Contact the Eaton Service Center at Fidelity at EATON01. Explain that you or your family member needs immediate health care and that the Anthem BCBS, Express Scripts, Delta Dental or EyeMed Vision system does not have record of your coverage yet. Ask the Service Center representative to do an emergency manual update of coverage in the health care partner s system. If you are unable to contact the Eaton Service Center or if the manual coverage update has not been completed before you need medical services, pay for your prescription or other health care service (if required by the provider). After coverage is showing in the Health Care Partner s system, you can do the following: File a paper claim for reimbursement. Contact the Health Care Partners customer service if you need assistance in filing claims. If you paid for a prescription, instead of filing a claim, you can call the pharmacy to see if it can reprocess your claim and pay you a refund of the plan s portion of the expense. Generally a refund can only be processed within 7 days of filling the prescription. 3

4 ON LINE PROVIDER DIRECTORIES For a list of network providers, follow the instructions below. ANTHEM BLUE CROSS BLUE SHIELD Select Anthem BCBS Medical from the list on the left. Click on Find a Doctor. In the Search using your plan section of the page, enter EAI if you will be living in the state of Georgia, EUI if you will living in the state of Wisconsin or EUL if you will be living in any other state in the Identification number or alpha prefix box. EXPRESS SCRIPTS You cannot search for a network retail pharmacy on the Express Scripts web site until you are enrolled in the Express Scripts system. Contact your pharmacy to see if it is part of the Express Scripts network or contact Express Scripts customer service. DELTA DENTAL Select Delta Dental from the list on the left side of the page and then click on Locate a Provider Non-Participants. Choose Delta Dental Premier* or Delta Dental PPO* under Network Selection. * Delta Dental PPO providers generally offer greater discounts than Delta Dental Premier providers EYEMED VISION CARE Select EyeMed Vision from the list on the left side of the page and then click on Locate a Provider Non-Participants. 4

5 US PLAN CREDIT FOR CIGNA PLAN DEDUCTIBLES & OUT-OF-POCKET MAXIMUMS If your transfer is effective with a date other than January 1, for the year in which you are transferred, you are entitled to credit under the US medical and dental plans during the year of your transfer for the amount applied toward your CIGNA International medical or dental plan s deductibles and out-of-pocket maximums during the year of your transfer. To receive this credit, you must obtain a copy of your most recent CIGNA plans Explanation of Benefits (EOB) document(s) showing the current amounts applied to your deductibles or out-of-pocket maximums. Send a copy of your CIGNA EOB to Anthem BCBS or Delta Dental at the addresses below. Anthem Blue Cross and Blue Shield PO Box Atlanta, GA ATTENTION: Angela Farella Eligibility Department Delta Dental Plan P O Box Lansing, MI Please mark documents with Eaton-Prior Deductible Met It takes a few weeks time for this information to be reflected under your new plans. If you need assistance with this process and Anthem BCBS or Delta Dental customer service is unable to help you, the Eaton Service Center at Fidelity can provide assistance through the HealthCare HelpLine service. Call Service Center at EATON01 ( ). Tell the Service Center representative that have not been able to resolve your claim issue by talking with Anthem BCBS or Delta Dental customer service and you would like to be transferred to the HealthCare HelpLine. 5

Important Health Care Information for US Employees. Preparing to Begin an International Assignment

Important Health Care Information for US Employees Preparing to Begin an International Assignment CIGNA Global Health Benefits Enrollment Medical, dental and vision coverage is provided through CIGNA Global.