2019 Open Enrollment. Postdoctoral Fellows. October 29 November 16, Benefits Effective January 1, Your Columbia University Benefits

Transcription

1 2019 Open Enrollment October 29 November 16, 2018 Postdoctoral Fellows Benefits Effective January 1, 2019 Your Columbia University Benefits As a Postdoctoral Fellow at Columbia University, you can take advantage of medical, dental and life insurance benefits. We are committed to providing you with valuable benefits and resources to help manage your healthcare costs. 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 the 2019 Monthly Contributions for Coverage...3 Making Changes to Your Benefits...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. Important You must make an election for 2019 even if you waive the University s medical coverage. You will also be required to complete an Attestation Statement. 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 5 for more details). Enroll in your benefits on CUBES, the University s new enrollment system. 1

2 Before you log in to CUBES to make your choices, think about your benefits needs for next year and learn what s new for What s New for 2019 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. Expanded coverage beginning January 1, 2019: Quest Diagnostics is now in-network. With the addition of Quest Diagnostics, you ll have greater access to in-network laboratories. Need Help with Benefits Enrollment on CUBES? Personal enrollment assistance is available at the Benefits Expos and the Lamont-Doherty Earth Observatory Forum. Times and locations for these events can be found on page 8. In-network breast ultrasounds to be covered as preventive care at no cost, when billed by a physician with a preventive diagnosis. For more on preventive care, go to preventive-care. Acupuncture benefits will be covered for all diagnoses as standard office visit up to 20 visits per calendar year. Medical coverage to include hearing aids every two years with no maximum coverage limit. Hearing aid exams will continue to be covered. * Legal services provided by Humana, the University's EAP provider. 2

3 Cost of Coverage Your 2019 Monthly 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. Monthly Medical Contributions Health Plan Yourself Only Yourself & Spouse or Same-Sex Domestic Partner Yourself & Child(ren) Family Choice Plus 80 $36 $36 $36 $ Monthly Contributions for Dental Your Monthly Cost (Contributions) Yourself $40 You Plus One $80 Family $119 Billing Information After your elections have been processed, EBPA, our third party billing administrator, will send billing statements (also called coupons) for your medical and/or dental contributions through the end of the calendar year to your home mailing address. You are responsible for remitting payment to EBPA promptly, as instructed on the coupons. If payment is not received by the stated deadline, insurance coverage will be canceled for non-payment. Note: Your contribution is $36 per month, with your fellowship allowance or training grant expense account and departmental or other unrestricted funds available to the Principal Investigator (PI) covering the remainder of the cost. Up to 75% of your fellowship or training grant may be used by your department or PI to pay for the departmental/pi share of the costs. Contributions made by your department, fellowship allowance or training grant for your medical and/ or dental coverage are treated as taxable income for you. 3

4 Aetna Columbia Dental Plan The 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. Dental Benefits Benefit Preventive Care Includes routine cleanings, routine exams and X-rays Basic Restorative Care Includes fillings and extractions Major Restorative Care Includes crowns, root canals, bridges and dentures Columbia Preferred Dental Network Aetna Dental Network 100% 100% 100% 100% 80% 80% 60% 50% 50% Out-of-Network* Orthodontia for Adults & Children 50% 50% 50% Annual Deductible (per person) none $25 $25 Annual Maximum Benefit (per person) $1,500 $1,250 $1,250 Orthodontic Lifetime Maximum (per person) $1,500 $1,250 $1,250 * The percentage paid by Aetna Dental is limited to the network-negotiated fees. This means if you use an out-of-network dentist, your reimbursement will be based on the network fees for the services provided. For example, if your dentist bills you $800 for a crown but the network-negotiated fee is $400, you will be reimbursed for 50% of the $400 (the network-negotiated fee) totaling $200. You are responsible for paying the balance of $600 to your out-of-network dentist. Using the Columbia Preferred Dental Network When you use a dentist who participates in the Columbia University network, you receive a greater benefit for services. To locate a Columbia Preferred dentist, go to and select Vendor Contacts. Columbia Preferred dentists are located throughout the tristate area of New York, New Jersey and Connecticut. Columbia Preferred dentists accept reimbursement for services covered at 100% as payment in full. You are not responsible for paying any fees that exceed the networknegotiated fees. You also do not have to submit any claim forms when you use a network participating dentist. 4

5 Important Reminders Qualified Life Status Change Term Life Insurance 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 full list of examples, go to and click on Making Changes to Your Benefits. The Basic Term Life Insurance Plan of $50,000 is automatically provided by Columbia University at no cost to you. You should designate a beneficiary for this policy if you have not done so already. Because of your enrollment in the Basic Term Life Insurance plan, you can take advantage of the Cigna Secure Travel, Online Will Prep, Identity Theft and Health Advocate programs. Please see edu/well-being for more details. If you have a Qualified Life Status Change during the year, you must go to the CU Benefits Enrollment System 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 humanresources.columbia.edu/ 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 your Qualified Life Status Change in CUBES earlier than the event date the change must be submitted within 31 days of the event date. 5

6 Your Medical Plan Medical Plan Summary Benefit Choice Plus 80 In-Network Out-of-Network* Annual Deductible Individual Family $600 per person** $850 per person Coinsurance 80% after deductible 60% after deductible Out-of-pocket Maximum Individual Family $3,750 $7,500 $5,250 $10,500 Preventive Care 100% Not covered Physician Office Visits, including specialists Laboratory/Radiology Services, including services rendered in a physician s office Inpatient Hospital Care Outpatient Hospital Care Mental Health and Substance Abuse Inpatient Care Mental Health and Substance Abuse Outpatient Programs Mental Health and Substance Abuse Outpatient Counseling $30 copay 60% after deductible 80% after deductible 60% after deductible 80% after deductible 80% after deductible 80% after deductible $30 copay 60% after deductible; Precertification required 60% after deductible; Precertification required 60% after deductible; Precertification required 70% after deductible for facility-based care, including intensive outpatient programs; Precertification required $30 copay 70% after deductible Emergency Room $150 copay (waived if admitted) $150 copay (waived if admitted) Basic and Comprehensive Infertility Treatment Advanced Infertility Treatment Prescription Drug Coverage with OptumRx 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 Medicare Maximum Allowable Charge (MAC), including expenses in excess of the out-of-network out-of-pocket maximum. ** To meet the requirements of the U.S. Department of State, J-1 Visa holders will have a $500 per person deductible applied. 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 Postdoctoral Fellows and their covered dependents who participate in Columbia s medical plan are covered by a vision benefit. Vision Benefits Choice Plus 80 In-Network and Out-of-Network Routine Eye Exams Lenses Frames Contact Lenses 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. 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. 8