2019 Open Enrollment SSA. October 29 November 16, Benefits Effective January 1, Your Columbia University Benefits. Inside This Brochure

Transcription

1 2019 Open Enrollment October 29 November 16, 2018 SSA Benefits Effective January 1, 2019 Your Columbia University Benefits As a member of SSA, you can take advantage of a comprehensive benefits package. This brochure will help you understand the benefits options available to you. Now is the time to review your options, think about any changes in your personal situation and choose the benefits that will best meet your needs for Inside This Brochure Learn about benefits changes for View 2019 Monthly Pre-Tax Contributions for Coverage...3 Important Reminders...5 How To Enroll: Log in to CUBES CUBES gives you secure access to personalized information about your benefits. The site is available 24/7 from any computer with Internet access, which means you can enroll anytime during Open Enrollment. To get started: 1. Go to and click on the CUBES logo. 2. You will be asked to enter your UNI and password and then confirm your access using multifactor authentication (DUO). 3. Select Get Started to make your elections. Remember: You must enroll in your 2019 benefits by November 16, The choices you make during Open Enrollment will stay in effect all year unless you experience a Qualified Life Status Change (see page 4 for more details). Enroll in your benefits on CUBES, the University s new enrollment system. What Happens If You Don t Enroll If you do not make an election for 2019: You will no longer have coverage for: Healthcare FSA* Dependent Care FSA Note: You must re-enroll for 2019 in order to have coverage under these programs for the calendar year beginning January 1, You will be automatically re-enrolled in your current 2018: Medical Dental Vision Transit/Parking Reimbursement Program (T/PRP) Optional Life Insurance * If you are enrolled in the Choice Plus 90 medical plan, you will still be eligible for the University s contribution to your Healthcare FSA. 1

2 Before you log in to CUBES to make your choices, think about your benefits needs for next year and learn about the 2019 changes. What s New for 2019 New Part-Time contribution rates. Go to page 3 to view the 2019 rates. Introducing CUBES, the University s new benefits enrollment system. See insert for more details. Employee Assistance Program (EAP) now includes legal services.* To learn more, go to columbia.edu/well-being. New Health Care Spending Card. If you elected a Healthcare or Dependent Care FSA in 2015, your card(s) will expire at the end of UHC will send new cards to your home mailing address in mid-november. Quest Diagnostics is now in-network. With the addition of Quest Diagnostics, you ll have greater access to in-network laboratories. * Legal services provided by Humana, the University's EAP provider. 2

3 Cost of Coverage Your 2019 Monthly Pre-Tax Contributions for Medical, Vision & Rx Coverage Contributions are the amount you pay toward the cost of your medical, dental, vision and prescription drug ( Rx ) coverage through your pre-tax payroll deductions. Your healthcare contributions are deducted from your pay before any taxes are taken out. Monthly Medical Contributions Health Plan Yourself Only Yourself & Child(ren) Yourself & Spouse or Same-Sex Domestic Partner Family Full-Time Choice In-Network $0 $0 $0 $0 Choice Plus 90 $0 $0 $0 $0 Part-Time Choice In-Network $376 $713 $789 $1,127 Choice Plus 90 $376 $713 $789 $1,127 Same-Sex Domestic Partners Federal income tax rules require that contributions toward coverage of a same-sex domestic partner be deducted from your pay on an after-tax basis. In addition, University contributions toward the total cost of coverage for your same-sex domestic partner are taxable to you Monthly Pre-Tax Contributions for Dental Your Monthly Contributions for EmblemHealth Dental* Yourself $0 Family** $0 Your Monthly Contributions for Aetna Dental* Yourself $27 You Plus One $68 Family $109 * Part-Time SSA members are not eligible for dental coverage. ** Dependent children can only be covered under EmblemHealth Dental through the end of the calendar year in which they turn age 19. 3

4 Making Changes to Your Benefits The IRS restricts when you can add coverage for a dependent or make changes to your healthcare benefits during the year. After annual Benefits Open Enrollment, you will only be able to change most benefits for the remainder of the calendar year if you experience a Qualified Life Status Change. Examples of a Qualified Life Status Change include marriage, divorce, birth or adoption of a child, and loss of eligibility for coverage. For a list of examples, go to and click on Making Changes to Your Benefits. If you have a Qualified Life Status Change during the year, you must go to CUBES and make your changes within 31 days of the event. For example, if you welcome a new baby to the family, you have 31 days from the baby s birth to add him or her to your health insurance. The benefits changes must be consistent with the nature of your Qualified Life Status Change. In addition, you must provide proper documentation for your change, such as a birth certificate, marriage certificate or divorce decree. Making a Qualified Life Status Change on CUBES To change your benefits during the year, go to and click on the CUBES logo. You will be asked to enter your UNI and password, and then confirm your access using multifactor authentication (DUO). Please contact the Columbia Benefit Service Center at if you have any problems changing your benefits for your Qualified Life Status Change. Important Note: You cannot enter the Qualified Life Status Change in CUBES earlier than the event date the change must be submitted within 31 days of the event date. 4

5 Important Reminders Choose Your Coverage Carefully Elections or changes you make during Benefits Open Enrollment will become effective on January 1, 2019, and will be in effect for the 2019 calendar year. If you do not enroll between October 29 and November 16, you will need to wait until next year s Open Enrollment to enroll or make changes to your benefits unless you experience a Qualified Life Status Change. Enrolling in the T/PRP Program You may enroll in the Transit/Parking Reimbursement Program (T/PRP) at any time during the year. If you would like to newly enroll in or make changes to your T/PRP account, you must do so during Open Enrollment. If you enroll or make changes to the T/PRP before the 20th of the month, your enrollment will be effective the first day of the next month. The current IRS limit is $260 per month.* Renew or Open an FSA Flexible Spending Accounts (FSAs) allow you to set aside money on a pre-tax basis (in equal installments from your first two paychecks each month) to pay for eligible healthcare and dependent care expenses. Healthcare and Dependent Care FSAs can help you save money by giving you a tax break. The current IRS limit for the Healthcare FSA is $2,650 and $5,000 for the Dependent Care FSA.* To contribute your own funds to either the Healthcare or Dependent Care FSA for 2019, you must enroll during Open Enrollment. If you enroll in the Choice Plus 90 plan, you will automatically receive the University s contribution to your Healthcare FSA. Coverage in Medical Plan Individual Employee $120 Employee + Spouse or Child(ren) $240 Family $360 Annual University Contribution Make Catch-up Contributions to the VRSP If you are age 50 (or will turn 50 in 2019), you can contribute an additional $6,000 in pre- or post-tax contributions to your Voluntary Retirement Savings Program (VRSP) account. This means you can contribute a total of $24,500 to the VRSP in 2019.* Review Beneficiaries Update your beneficiary information for life insurance and the retirement plans. * IRS limits are subject to change. 5

6 Comparing Your Medical Plans Only you can decide which coverage levels are best for you and your family. Here is an overview of medical plan options to consider before enrolling. Medical Plan Comparison Chart Benefit Choice In-Network Choice Plus 90 In-Network Out-of-Network In-Network Out-of-Network* Annual Deductible (per person) N/A N/A $200 $600 Coinsurance (% paid by CU) 100% N/A 90% after deductible 60% after deductible Out-of-Pocket Maximum (Individual) $3,500 N/A $2,500 $4,500 Out-of-Pocket Maximum (Family) $7,000 N/A $5,000 $9,000 Preventive Care 100% N/A 100% Not covered Physician Office Visits $30 copay N/A $30 copay 60% after deductible Laboratory/Radiology Services, including services rendered in a physician s office 100% if non-hospital location; if hospital** N/A 90% after deductible 60% after deductible Inpatient Hospital Care $500 copay per admission N/A 90% after deductible 60% after deductible; Precertification required Outpatient Hospital Care Mental Health and Substance Abuse Inpatient care Mental Health and Substance Abuse Outpatient programs Mental Health and Substance Abuse Outpatient Counseling Emergency Room Basic and Comprehensive Infertility Treatment Advanced Infertility Treatment Prescription Drug coverage with OptumRx (including lab and radiology)** N/A 90% after deductible 60% after deductible; Precertification required $500 copay per admission N/A 90% after deductible 60% after deductible; Precertification required $30 copay N/A $30 copay 70% after deductible for facility-based care, including intensive outpatient programs; Precertification required $30 copay N/A $30 copay 70% after deductible (waived if admitted) Unlimited benefit for diagnosis and basic medical treatment, including artificial insemination $30,000 lifetime maximum for advanced treatments and Assisted Reproductive Technology including IVF, GIFT and ZIFT Retail (30-days) Generic: $10 copay Single-source: $25 copay Multi-source: $45 copay Mail-order (90-days) Generic: $15 copay Single-source: $50 copay Multi-source: $90 copay (waived if admitted) N/A N/A N/A (waived if admitted) (waived if admitted) Unlimited benefit for diagnosis and basic medical treatment, including artificial insemination $30,000 lifetime maximum for advanced treatments and Assisted Reproductive Technology including IVF, GIFT and ZIFT Retail (30-days) Generic: $10 copay Single-source: $25 copay Multi-source: $45 copay Mail-order (90-days) Generic: $15 copay Single-source: $50 copay Multi-source: $90 copay * Out-of-Network coinsurance reimbursement is indexed to 190% of the Medical Maximum Allowance Charge (MAC), including expenses in excess of the out-of-network out-of-pocket maximum. ** No copay for Lab and Radiology at certain designated NYP locations. For a list of NYP participating locations, go to click on the Forms & Documents icon and search under NYP. Note: The in-network deductible, coinsurance and medical and prescription drug copays accumulate toward the in-network out-of-pocket maximum. In the Choice Plus 90 plan, out-of-network out-of-pocket expenses accumulate toward the in-network out-of-pocket maximum. The above chart represents highlights of Plan provisions. Clinical medical management restrictions and other limits apply. Go to and click on the Forms & Documents icon to view the Summary of Benefits Coverage (SBC) and the Summary Plan Descriptions (SPDs). Important Notes: UHC s Choice network is a national provider network and does not require a primary care physician or referrals to see specialists. UHC requires precertification for some services. If you use an in-network provider, your participating network physician or hospital generally handles the precertification process. However, it is your responsibility to confirm that your provider has obtained the necessary authorizations from UHC. If you see a provider who is out-of-network, you are responsible for obtaining precertification for most services except routine office visits. 6

7 Vision Coverage All Support Staff and their covered dependents who participate in any of Columbia s medical plans are covered by a vision benefit. Vision Benefits Choice In-Network Choice Plus 90 Routine Eye Exams Lenses Frames Contact Lenses In-Network Adults: One exam every 12 months with a $10 copay Children:* One exam every 12 months with a $10 copay Adults:** Every 24 months, $20 allowance for single lenses, $30 for bifocal, $40 for trifocal or $75 for lenticular Children:* Lenses covered in full every 12 months (more frequently if medically necessary) Adults:** $30 allowance every 12 months Children:* Up to $100 covered in full every 12 months (more frequently if medically necessary). Cost above $100 covered at 60% Adults:** $75 allowance every 12 months Children:* Single purchase of a pair of contact lenses or 1 box of contact lenses per eye covered at 100% In-Network and Out-of-Network Adults: One exam every 12 months with a $10 copay Children:* One exam every 12 months with a $10 copay Adults:** Every 24 months, $20 allowance for single lenses, $30 for bifocal, $40 for trifocal or $75 for lenticular Children:* Lenses covered in full every 12 months (more frequently if medically necessary) Adults:** $30 allowance every 12 months Children:* Up to $100 covered in full every 12 months (more frequently if medically necessary). Cost above $100 covered at 60% Adults:** $75 allowance every 12 months Children:* Single purchase of a pair of contact lenses or 1 box of contact lenses per eye covered at 100% * Child is defined as a member less than age 19. ** Available for either frames and lenses OR contact lenses. Provider might require payment in full at the time of service. The patient then submits a claim to UHC for reimbursement. To search for a vision provider, please visit Click Coverage & Benefits, Vision and then Vision benefits highlights to be taken to the UHC vision website. Dental Coverage Emblem Health Preferred Dental Benefits Plan B covers preventive, basic and major services. You may choose to use a participating EmblemHealth Preferred Program dentist or go to a nonparticipating dentist. When you receive care from a nonparticipating dentist, you pay the provider up front, and then file a claim for reimbursement. You ll be reimbursed up to the allowance shown on the EmblemHealth Dental fee schedule for covered services, which is available from EmblemHealth. If you use a participating dentist, no forms are required. For a listing of EmblemHealth dentists, go to emblemhealth.com/find-a-doctor/directory and select Dental Preferred from the menu. For more information, call EmblemHealth at Aetna Columbia Dental Plan provides you with the flexibility to see Columbia University College of Dental Medicine faculty and alumni, called the Columbia Preferred Dental Network, along with the national Aetna PPO network of dentists, all under one comprehensive program. You may also see a dentist outside of the network, although your cost will be significantly higher whenever you use out-of-network dentists. For a listing of participating dentists, go to and click on Vendor Contacts. There are no changes to your dental plan options for For more information, go to columbia.edu/benefits to view the Benefits Highlights. 7

8 Important Events Benefits Expos Locations Manhattanville Campus Lenfest Center for the Arts The Lantern (8th Floor) 615 W. 129th Street New York, NY Morningside Campus Alfred Lerner Hall Roone Arledge Auditorium 2920 Broadway (at 115th Street) New York, NY Lamont-Doherty Earth Observatory: Benefits Forum Monell Building Lobby 61 Route 9W Palisades, NY CUIMC Armand Hammer Health Sciences Center Teaching and Learning Center (lower level) 701 W. 168th Street (at Ft. Washington Ave.) New York, NY Dates and Times Wednesday, October 31: 9:00 a.m. 2:00 p.m. Preventive Health Screenings: 8:30 a.m. 1:30 p.m. Thursday, November 1: 10:00 a.m. 4:00 p.m. Preventive Health Screenings: 8:30 a.m. 2:30 p.m. Flu Vaccines: 9:30 a.m. 4:00 p.m. Wednesday, November 7: 10:00 a.m. 12:30 p.m. Thursday, November 8: 10:00 a.m. 4:00 p.m. Preventive Health Screenings: 8:00 a.m. 2:00 p.m. Know Your Numbers Free Preventive Health Screenings Join us this fall at the Benefits Expos, where you can take advantage of complimentary health screenings to check your blood pressure, cholesterol and glucose levels. Results are available while you wait and a certified health professional will help you understand them. If you register in advance, you can fast before your appointment to check LDL cholesterol and total triglyceride levels. Pre-register online at my.questforhealth.com and select Register Now (Registration Key: cu2018). Don t take your health for granted know your numbers! References and Resources Reference materials are available on the Columbia Benefits website. Go to benefits to review the Benefits Highlights, SPDs, SBCs, annual legal notices, Benefits FAQs, vendor contacts and glossary. Questions? If you have any questions, please contact the Columbia Benefits Service Center at Please note our extended hours during Open Enrollment, Monday through Friday 9:00 a.m. to 5:00 p.m. About This Communication The Benefits Brochure summarizes the changes to the benefits programs that are available to benefits-eligible employees of Columbia University. This communication is intended to be a Summary of Material Modifications (SMM) to the Medical Plans and other benefits programs. It does not include important information about exclusions and limitations. For additional details of benefits coverage, eligibility, limitations and exclusions, you must refer to the Summary Plan Description (SPD), the Summary of Benefits and Coverage (SBC) and the Benefits Highlights online at You may also want to request to receive a paper copy of an SPD, SBC or SMM by contacting the Columbia Benefits Service Center at As a requirement of the Patient Protection and Affordable Care Act, Columbia University must provide a SBC to all participants and their dependents. The SBC is designed to provide you with an easy-to-understand summary about a health plan s benefits and coverage and to help you better understand and evaluate your health insurance choices. You are entitled to receive these Plan documents under the Employee Retirement Income Security Act of 1974 (ERISA). You also have other important rights and protections under ERISA, which are explained in more detail in the SPDs. If there are any discrepancies between the information in this publication, verbal representations and the Plan documents, the Plan documents will always govern. Columbia University reserves the right to change or terminate these benefits Plans at any time. This publication is in no way intended to imply a contract of employment. The Columbia University Group Benefit Plan (the Plan ) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. 8