COBRA BENEFITS PREVIEW. Access Enrollment Material at Home! User Name : Benefits2016 Password : AE2016. https ://secure.prudential.
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1 Access Enrollment Material at Home! https ://secure.prudential.com/benefits User Name : Benefits2016 Password : AE2016 (See page 2 for more details) 2016 COBRA BENEFITS PREVIEW SMART CHOICES HEALTHY LIVES
2 Important Notice This 2016 COBRA Benefits Preview is intended to help you understand certain features of The Prudential Insurance Company of America (Prudential) benefit programs for 2016 that are applicable to eligible COBRA participants. It is not intended to address any person with a current employment relationship with Prudential or its Affiliates whose benefits may vary from those described in this 2016 COBRA Benefits Preview. For more details, please refer to your Summary Plan Description or SPD booklets, including any applicable Summaries of Material Modifications (SMMs) of the SPD booklets. This 2016 COBRA Benefits Preview is not a substitute for the official Plan Documents, which govern the operation of the programs and benefits described here. All terms and conditions of the programs, including your eligibility and any benefits, will be determined pursuant to and are governed by the provisions of the applicable Plan Documents. If there is any discrepancy between the information in this 2016 COBRA Benefits Preview, or in any other Prudential materials related to the programs and benefits described here, and the actual Plan Documents, or if there is a conflict between information discussed by anyone acting on Prudential s behalf and the actual Plan Documents, the Plan Documents, as interpreted by the applicable Plan Administrator in its sole discretion, will always govern. Prudential may, in its sole discretion, modify, amend, suspend or terminate any and all of its HR policies, programs, plans and benefits, including those described in this 2016 COBRA Benefits Preview, in whole or in part, at any time, without notice to or consent of any participant, employee or former employee to the extent permissible under applicable law.
3 Inside You Will Find 2016 COBRA Annual Enrollment Is Coming... 2 What Happens If You Don t Take Action During the COBRA Annual Enrollment Period... 3 What s Changing for Marketplace Reminder... 5 Health Care Reform Update For Your Information No Action Required... 5 What This Means for You... 5 What s Next?
4 2016 COBRA Annual Enrollment Is Coming Prudential s Annual Enrollment Period for COBRA participants begins Monday, October 19, and ends Friday, October 30, Beginning Monday, October 19, you will be able to access the Prudential Benefits Center website (at to: View and confirm your 2016 coverage options; and View and confirm your 2016 costs. This 2016 COBRA Benefits Preview is for your information only. With Annual Enrollment just around the corner, now is a good time to start thinking about your current coverage and considering whether your benefit needs have changed or will change for the coming year. Materials to help you evaluate your COBRA benefit program options are available online now when you visit the Annual Enrollment Extranet, including the 2016 Annual Enrollment Guide. These materials, as well as your personalized information your available program choices, contributions and default coverage if you do not take action will be available on the Prudential Benefits Center website on October 19. Annual Enrollment Materials Available Now! If you or your family members would like to view 2016 Annual Enrollment materials, Prudential has posted information in a secure section of the Prudential.com website again this year. This will allow other decision-making family members to have convenient access to benefits information without needing to know your Prudential Benefits Center website User ID and password. To access the Annual Enrollment Extranet: Log on to the Extranet (at Enter Benefits2016 as the user name and AE2016 as the password (the password is case-sensitive); Select the Benefits 2016 tab; then Click on Active COBRA Participants under the COBRA Participants section. Summaries of Benefits and Coverage Summaries of Benefits and Coverage (SBCs) are available for each medical coverage option that Prudential sponsors. Each SBC summarizes important information about each medical coverage option in a standard format to help you compare these options and make an informed choice. The SBCs and Uniform Glossary are available now on the Annual Enrollment Extranet and will be available on the Prudential Benefits Center website (at when Annual Enrollment begins on October 19. You may request a paper copy of these documents, free of charge, by calling the Prudential Benefits Center at PRU-EASY ( ) and following the prompts for Health and Welfare benefits. 2
5 What Happens If You Don t Take Action During the COBRA Annual Enrollment Period If your COBRA coverage is still in effect, and you do not take action during the COBRA Annual Enrollment Period, you will receive default coverage as follows: If you live in a location where your current medical program will continue to be available next year, your current medical program election and coverage level (for example, You only or You and Family coverage) will remain in place for 2016; If your current medical program will not be available next year, you will be automatically enrolled in the Consumer Directed Health Program 80 at your current coverage level (for example, You only or You and Family coverage), which may or may not be what you want in If you live in Hawaii, the default will be the Hawaii Indemnity Medical Program; or If you are not currently enrolled in medical coverage for 2015, your 2016 default will be no medical coverage. If you do not make a dental, vision and/or wellness program election during the COBRA Annual Enrollment Period, your default coverage will be your current 2015 coverage at your current coverage level (for example, You only or You and Family coverage), if your current coverage is available for If you are not currently enrolled in dental, vision and/or wellness program coverage for 2015, your 2016 default will be no dental, vision and/or wellness program coverage. Note For Subsidized COBRA Participants If you currently have subsidized COBRA and your subsidy will expire in 2016, you may visit the 2016 Annual Enrollment section of the Prudential Benefits Center website during the Annual Enrollment Period (beginning October 19) to find your current subsidized contributions that will remain in effect during your subsidy period. If you choose to continue your COBRA coverage when your subsidy period expires, you will be required to pay standard COBRA rates. This means you will pay a higher COBRA rate for the same program and coverage level. To review the standard COBRA rates, please refer to the 2016 Monthly COBRA Rates document, which is available now on the Annual Enrollment Extranet and will be available on the Prudential Benefits Center website on October 19. Note Regarding Medicare If you or your dependent became entitled for Medicare prior to becoming eligible for COBRA coverage, Prudential medical coverage under COBRA will be the secondary coverage and Medicare will be the primary coverage for the Medicare-eligible individual (whether or not that individual is actually enrolled in Medicare Parts A and B coverage). That means your Prudential medical program benefits are reduced by the value of your Medicare benefits. If you become entitled to Medicare while on COBRA coverage, your COBRA coverage will end and Medicare will be your primary coverage. For COBRA purposes, entitlement to Medicare means being enrolled in Medicare Part A and/or Part B. When you become eligible for Medicare, be sure to notify the Prudential Benefits Center to end your COBRA coverage. 3
6 What s Changing for 2016 Here s a high-level snapshot of what s changing, effective January 1, 2016: Medical program contributions may be higher for 2016; Changes to the prescription drug program, including certain preventive drugs not being subject to the deductible if you are enrolled in the High Deductible Health Program (visit the Express Scripts website for a list of preventive drugs); New administrator for the Cigna Health Savings Account (HSA), effective February 20, 2016; New maximum HSA contribution limit for family coverage; and Extended family members* will no longer be eligible for benefits. As a result, you will not be able to add a new extended family member to your coverage for Please note: If an extended family member is currently enrolled in COBRA-like coverage or experiences a Qualifying Event prior to December 31, 2015, and subsequently elected (or elects) COBRA-like continuation coverage, he/she may continue his/her COBRA-like continuation coverage for the remainder of the applicable period, provided coverage is elected and payment is submitted in a timely manner. For details on these changes, please refer to your 2016 Annual Enrollment Guide, as well as the 2016 Benefit Program Summary, both available now on the Annual Enrollment Extranet and on the Prudential Benefits Center website when enrollment begins. Because the 2016 Benefit Program Summary was developed specifically for active employees, please note that some of the information may not apply to you (for example, information regarding the Prudential Group Life and Accident Insurance Programs and the Prudential Disability Program). For cost information, visit the Prudential Benefits Center website when enrollment begins on October 19. Included with this 2016 COBRA Benefits Preview is a Medicare Part D Notice of Creditable Coverage beginning on page 7, which provides information about prescription drug coverage through Prudential and the prescription drug coverage option available under Medicare. Also included is a Notice of HIPAA Privacy Practices, beginning on page 13. * Extended family member includes mother, father, grandmother, grandfather, stepmother, stepfather, mother-in-law, father-in-law, brother, sister, stepbrother, stepsister, niece, nephew, aunt, uncle, stepson, stepdaughter, son-in-law, daughter-in-law, brother-in-law, sister-in-law or any person (other than your spouse) who, for that year, lives with you and is a member of your household. 4
7 Marketplace Reminder Health Care Reform Update For Your Information No Action Required Since January 1, 2014, the Health Care Reform law requires most individuals to have health coverage, which can include coverage provided by an employer, a private insurance company, through Medicare or through other similar government-sponsored programs. If you don t have minimum essential health coverage, you could be subject to a tax penalty. To help individuals comply with the requirement to enroll in some form of health coverage, the Health Care Reform law says that each state must offer a public Health Insurance Marketplace or a public Exchange. A Health Insurance Marketplace is available in each state and operated by the state, the federal government or through a partnership between the state and federal government. Individuals purchasing coverage through the Marketplace may qualify for premium tax credits and cost-sharing subsidies provided by the federal government, depending on their household income. What This Means for You If you receive Health Insurance Marketplace communications, it s likely that you will wonder how this might affect your Prudential-sponsored coverage. Prudential will continue to offer the medical programs in 2016 that are currently offered. Depending on your Medicare status, the Health Insurance Marketplace will mean different things for you: If you are not eligible for Medicare (Generally, those under age 65) If you are Medicare-eligible (Generally, those age 65 and older) You may want to determine whether you qualify for a premium tax credit. Visit for information about tax credits. If you do qualify, your premiums for Health Insurance Marketplace coverage would be offset by the tax credit; and you should compare the costs and benefits of your Prudential-sponsored coverage options against that of the offerings through your state s Health Insurance Marketplace. You can obtain details of your current coverage, including costs and program provisions, by visiting the Prudential Benefits Center website (at The Health Insurance Marketplace is probably not relevant to you. There are already a number of options to supplement or enhance your Medicare coverage. Please note: There is a growing individual market for health insurance for Medicare-eligible participants. You may want to evaluate and explore individual market coverage options to see how they compare with your current COBRA coverage options and the costs for those coverage options. For more information on programs available to individuals eligible for Medicare, visit the official Medicare website (at 5
8 What s Next? Health Insurance Marketplace enrollment begins November 1, 2015, and ends January 31, Enrollment in the Health Insurance Marketplace is effective January 1, 2016, or the first of a subsequent month, depending on when the enrollment is completed. The Prudential COBRA Annual Enrollment Period begins on October 19, and ends October 30, If you would like to compare your current Prudential coverage to options available in the Marketplace, you ll be able to access information on Prudential coverage options when Annual Enrollment begins. Then, you can compare it to the information you receive regarding Marketplace options. If You Have Questions Visit if you have questions about the Health Insurance Marketplace. If you have questions or need additional information about your Prudential medical program coverage, please contact the Prudential Benefits Center at PRU-EASY ( ) and follow the prompts for Health and Welfare benefits. Customer Service Representatives are available to answer your questions between 8 a.m. and 6 p.m., Eastern time, Monday through Friday, except on holidays. For the hearing-impaired, please contact your local relay service. 6
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