YOUR 2018 PROGRAMS AND PREMIUMS AT A GLANCE STAFF MEMBERS IN THE BARGAINING UNITS OF ATC, HUCTW, HUPA, HUSPMGU, AND SEIU CUSTODIANS
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1 YOUR 2018 PROGRAMS AND PREMIUMS AT A GLANCE STAFF MEMBERS IN THE BARGAINING UNITS OF ATC, HUCTW, HUPA, HUSPMGU, AND SEIU CUSTODIANS
2 WELCOME TO YOUR HARVARD UNIVERSITY BENEFITS! At Harvard, we are committed to offering an array of benefits that are part of your generous total rewards package. We encourage you to take the time to review your benefit options so that you can make the best choices for you and your family. And remember: You have 30 days from your date of hire or qualifying life event to make your benefit elections.
3 ATC, HUCTW, HUPA, HUSPMGU, AND SEIU CUSTODIANS 2018 HEALTH PLANS (HUGHP AND HPHC) Harvard offers subsidized medical coverage from Harvard University Group Health Plan (HUGHP) and Harvard Pilgrim Health Care (HPHC). You may select individual or family coverage from the following types of plans: Health Maintenance Organization (HMO) With an HMO, you select a primary care physician (PCP) who coordinates your care and can provide you with referrals to in-network specialists. Out-of-network care is not covered, except in certain emergency situations. Point-of-Service Plan (POS) As with an HMO, you designate a PCP. However, you have the flexibility to use out-of-network providers with higher out-of-pocket costs. IN-NETWORK OUT-OF-POCKET (OOP) MAXIMUM INDIVIDUAL FAMILY Medical $2,000 $6,000 Prescription Drug $4,600 $7,200 MEMBER COSTS HMO POS Inpatient Hospital $100 copayment $100 copayment Outpatient Hospital $100 copayment $100 copayment Emergency Room $100 copayment $100 copayment Preventive Care as Defined by Affordable Care Act Covered in full Covered in full Office Visits PCP and Specialist $25 copayment $25 copayment Physical/Occupational Therapy (limited to 60 visits per calendar year) Chiropractic Care (limited to 18 visits per calendar year) $25 copayment $25 copayment $25 copayment $25 copayment Acupuncture (limited to 20 visits per calendar year) $25 copayment $25 copayment High-Tech Imaging (e.g., MRI, PET scan, CT scan) $50 copayment $50 copayment Mental Health/Substance Abuse Inpatient: $100 copayment per admission Outpatient: $25 copayment Inpatient: $100 copayment per admission Outpatient: $25 copayment Outpatient Diagnostic Labs/X-rays Covered in full Covered in full You have 30 DAYS from your date of hire or qualifying life event to make your benefit elections.
4 2018 HEALTH PLANS (HUGHP AND HPHC) OUT-OF-NETWORK DEDUCTIBLE POS Per Individual $750 Family Maximum $2,500 OUT-OF-POCKET (OOP) MAXIMUM Per Individual $2,500 Family Maximum $7,500 MEMBER COSTS Member-Paid Coinsurance Mental Health/ Substance Abuse 30% after out-of-network deductible Inpatient: deductible, then 30% coinsurance Outpatient: 20% coinsurance; no deductible PRESCRIPTION DRUG COSTS GENERIC PREFERRED BRAND NON-PREFERRED BRAND Retail at participating pharmacy (up to 30-day supply) IN-NETWORK $7 $20 $45 Mail order through OptumRx (up to 90-day supply) $14 $50 $110 OUT-OF-NETWORK (POS ONLY) Submit receipt to be reimbursed for cost minus applicable in-network copayment. You have 30 DAYS from your date of hire or qualifying life event to make your benefit elections.
5 HUCTW, ATC, HUPA, HUSPMGU, AND SEIU CUSTODIANS TIERED RATES FOR 2018 Harvard offers four salary tiers for premiums based on your full-time equivalent (FTE) salary. If you work part time, your salary tier and premiums are based on your FTE salary. MONTHLY COST BY SALARY TIER TIER 1: LESS THAN $55,000 TIER 2: $55,000 $74,999 TIER 3: $75,000 $99,999 TIER 4: $100,000 AND ABOVE INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY INDIVIDUAL FAMILY HMO Harvard University Group Health Plan (HUGHP) Harvard Pilgrim Health Care (HPHC) $85 $230 $98 $265 $131 $354 $164 $442 $98 $266 $111 $301 $144 $390 $177 $478 POS HUGHP $118 $320 $131 $355 $164 $444 $197 $532 HPHC $132 $359 $145 $394 $178 $483 $211 $571 DENTAL PLAN PREMIUMS Monthly Cost INDIVIDUAL $19 FAMILY $55 VISION PLAN PREMIUMS Monthly Cost INDIVIDUAL $6.11 FAMILY $14.05 HYATT LEGAL PLAN Monthly Cost of Coverage $16.50 LONG TERM DISABILITY (LTD) PREMIUMS Salary Annual Cost per $100 of Salary Less than $15,000 $0.229 $15,000 $69,999 $0.261 $70,000 $94,999 $0.563 $95,000 and above $0.710 SUPPLEMENTAL LIFE INSURANCE PREMIUMS Cost per Covered Individual (Employee, Spouse/Domestic Partner) Age Monthly Cost per $1,000 of Insurance* Age Monthly Cost per $1,000 of Insurance* < 25 $ $ $ $ $ $ $ $ $ $ $ $ $0.102 * Based on age of employee, not age of spouse / domestic partner. Cost of Coverage for Dependent Child(ren) Coverage Amount Monthly Cost of Coverage $5,000 $0.50 $10,000 $1.00 One monthly premium covers all of your eligible children. You have 30 DAYS from your date of hire or qualifying life event to make your benefit elections.
6 BENEFITS CONTACTS Have questions or need more information about your benefits? Here s where you can find more information and answers. Remember: You can always find the latest benefits contact information at hr.harvard.edu/vendor-contacts. TOPIC WHOM TO CONTACT PHONE ONLINE General Benefits Questions Harvard Benefits hr.harvard.edu/health-welfare-benefits benefits@harvard.edu Dental Coverage Delta Dental deltadentalma.com Disability Short-Term (STD) and Long-Term (LTD) Liberty Life Assurance Company of Boston (toll-free Harvarddedicated line) mylibertyconnection.com Flexible Spending Accounts (FSAs) Health Care and Dependent Care Benefit Strategies 855-HVD-FLEX ( ) (F) benstrat.com hvdflex@benstrat.com Legal Coverage Hyatt Legal Plan info.legalplans.com Access code: Life Insurance MetLife (Prompt 1) metlife.com Long Term Care (LTC) Insurance Genworth Life Insurance Company genworth.com/groupltc Group ID: Harvard; Code: groupltc Medical Coverage Questions: Service Areas, Costs, Provider Networks, Emergency Coverage, and Referrals Prescription Drug Coverage Harvard University Group Health Plan (HUGHP): HMO, POS, POS Plus, and HDHP Harvard Pilgrim Health Care (HPHC): HMO, POS, POS Plus, and HDHP OptumRx (Harvard s Pharmacy Benefit Manager) hughp.harvard.edu harvardpilgrim.org optumrx.com Copayment Reimbursement Program Benefit Strategies 855-HVD-FLEX ( ) (F) benstrat.com hvdflex@benstrat.com Harvard University Retirement Center (HURC) hr.harvard.edu/retirement Fidelity fidelity.com/atwork Tax-Deferred Annuity (TDA) Plan and Retirement Programs TIAA Appointments: tiaa-cref.org Vanguard Appointments: , ext vanguard.com meetvanguard.com Tuition Assistance Program (TAP) and Tuition Reimbursement Program (TRP) TAP Guidelines hr.harvard.edu/tuition-assistance Non-Harvard course reimbursements: Benefit Strategies, LLC (BSL) 855-HVD-FLEX ( ) (F) benstrat.com hvdtuition@benstrat.com Vision Care Davis Vision davisvision.com/members Client Code 2556 SEIU Custodians 1 HUSPMGU - 7 HUPA 12 ATC 41, 42, 44, 45 HUCTW - 55
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Standard Gold Point-of-Service (POS) : POS HD 1000 Gold Coverage Period: 2014 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy
Coverage for: Individual Plan Type: POS. Important Questions Answers Why this Matters: In network: $0 Out-of -network: $300 Individual; $600 Family
Doctors Community Hospital BlueChoice Opt-Out Plus OA Coverage Period: 01/01/2016 12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Plan Type:
Chemeketa Community College 2017 Open Enrollment
Chemeketa Community College 2017 Open Enrollment Open Enrollment for Benefits Effective January 1, 2017: This summary provides the following 2017 Plan details: Kaiser Deductible changes New plan rates
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthplan.memorialhermann.org or by calling 1-888-594-0671.
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthplan.memorialhermann.org or by calling 1-888-594-0671.
Coverage for: All Coverage Tiers Plan Type: POS. 1 of 9
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.paramounthealthcare.com or by calling 1-800-462-3589.
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-800-421-1880. Important Questions
AvMed Network: $1,500 individual / $3,000 family Doesn t apply to preventive care. What is the overall deductible?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.avmed.org or by calling 1-800-376-6651. Important Questions
[Ambetter Secure Care 1 (2018) with 3 Free PCP Visits-Standard Gold On Exchange Plan]
![[Ambetter Secure Care 1 (2018) with 3 Free PCP Visits-Standard Gold On Exchange Plan]](/thumbs/72/67333205.jpg "[Ambetter Secure Care 1 (2018) with 3 Free PCP Visits-Standard Gold On Exchange Plan]")
[Plan Information] [Health Plan:] [Primary Member:] [Ambetter Secure Care 1 (2018) with 3 Free PCP Visits-Standard Gold On Exchange Plan] [John Doe] [Member ID:] [01213456] [Date of Birth:] [08/12/62]
What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com/cuhealthplan or by calling 1-800-735-6072.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.summacare.com or by calling 1-800-996-8701. Important
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthplan.memorialhermann.org or by calling 1-888-594-0671.
$ 400 person/ $1,200 family; Waived for inpatient and outpatient hospital charges at Centers of Excellence and Hospitals of Distinction.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.mbpet.net or by calling 1-888-742-3380. Important Questions
Montgomery County Public Schools- PPO Coverage Period: 10/01/ /30/2017
Montgomery County Public Schools- PPO Coverage Period: 10/01/2016 09/30/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO This
For non-participating providers: $11,000 Person/$22,000 Family. Doesn t apply to preventive care. Are there other deductibles for specific services?
Arise Health Plan: POS HDHP Bronze 5500 Coverage Period: 1/1/2017 12/31/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Single/Family Plan Type: POS This is only
What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.avmed.org or by calling 1-800-376-6651. Important Questions
The HPHC Insurance Company PPO Summary of Benefits and Coverage: WhatthisPlanCovers&WhatitCosts
Massachusetts The HPHC Insurance Company PPO Summary of Benefits and Coverage: WhatthisPlanCovers&WhatitCosts Coverage Period: 07/01/2016 06/30/2017 Coverage for: Individual + Family Plan Type: PPO This
PEBTF: PEBTF CUSTOM HMO
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the Summary Plan Description (SPD) of Plan Document at www.pebtf.org or by calling 1-800-522-7279.
BENEFITS FACT SHEET. Coverage Options 2017 Bi-Weekly Employee Contribution
BENEFITS FACT SHEET Eligibility Regular, full-time and part-time employees in a budgeted position of 30 hours or more per week. The normal waiting period is 90 days for medical, dental, vision, life insurance,
Table of Contents. Pre-Tax Benefits. Anthem Health Insurance Plans Anthem Health Insurance Plans Comparison 5
Table of Contents Pre-Tax Benefits Anthem Health Insurance Plans 2018-2019 3 Anthem Health Insurance Plans Comparison 5 Anthem Lumenos HSA Health Insurance Plan 7 Anthem HMO Health Insurance Plan 14 Anthem
CASA, INC. : Health Network Only SM - HDHP (ACO Plan)
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthreformplansbc.com or by calling 1-888-982-3862.
Are there services covered before you meet your deductible? Yes, Preventive Care
Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Univera Healthcare: Essential Plan 2 Plus Vision and Dental Coverage Period: 01/01/2019-12/31/2019 Coverage for: