OPEN ENROLLMENT April 23 May 6, 2018 Make Your Elections Online by May 6! Open Enrollment is just around the corner. Now is the time to understand the benefits available to you, review your current benefit elections and enroll for coverage. You must take action between 12:01 a.m. on Monday, April 23 and 11:59 p.m. on Sunday, May 6, to confirm your benefit elections. Highlights NEW! Top-Tier Coverage Available at Penn Medicine Princeton Health Penn Medicine Princeton Health is the newest member of the University of Pennsylvania Health System and provides top-tier coverage under our PennCare PPO Plan. Learn more on page 1. Win with the Wellfocused App When you use the Wellfocused app powered by Jiff to track your nutrition, activity and sleep, you earn points that you can trade in for cash (up to $200) and prizes. Find out more on pages 7 and 8. Visit the HR&You Website to Learn More Find out what s changing for 2018 2019, get rates, access resources and enroll at www.uphshrandyou.com.
WELCOME TO OPEN ENROLLMENT Penn Medicine employees are actively engaged and committed to our mission. Together, we make medical advances that help people live longer, healthier lives. We believe that the best care of our patients starts with the best care for our employees. Our employee benefits program helps you get healthy and stay healthy. Read this benefits newsletter and review the information available to you on www.uphshrandyou.com to learn more about and take advantage of the benefits available to you and your family. CONTENTS What s New... 1 Open Enrollment Is April 23 May 6, 2018... 2 Medical... 3 The PennCare PPO Plan at a Glance... 4 Prescription Drugs... 5 Dental... 6 Vision... 6 Additional Benefits... 6 Succeed with Wellfocused... 7 Health Advocate... 9 How to Enroll... 10 2018 2019 Employee Contributions... 11 What's New Access Top-Tier Coverage at Penn Medicine Princeton Health Penn Medicine Princeton Health is the newest member of the University of Pennsylvania Health System and one of the most comprehensive health care systems in New Jersey. If you enroll in the PennCare PPO Plan, you and your covered dependents will receive top-tier coverage when your care is from: Princeton Health s employed physician group Princeton Medicine Physicians: A network of primary care physicians, specialists and surgeons with practice locations throughout Central New Jersey. Princeton Medical Center: An acute care hospital in Plainsboro, New Jersey. Princeton House Behavioral Health: Facilities that provide inpatient, partial hospital and intensive outpatient services at locations in Princeton, Moorestown, Hamilton, North Brunswick and Eatontown, New Jersey. Princeton HomeCare: In-home nursing, rehabilitation and hospice care throughout the greater Central New Jersey region. Important: Deductibles and coinsurance will apply when care is provided by non-employed, hospital-based physicians such as anesthesiologists and radiologists. For more information about Penn Medicine Princeton Health and its clinical units, visit www.princetonhcs.org. To find a provider with Princeton Medicine Physicians, visit www.findadr.com. No Rate Increases for Medical and Dental Benefits We are pleased to announce that your biweekly contributions for medical and dental coverage will not increase for the 2018 2019 plan year! Biweekly contributions for vision coverage will increase slightly across all coverage levels for 2018 2019. Improved Top-Tier Provider Search Tool Independence Blue Cross (IBC), our medical plan administrator, has partnered with UPHS to offer a custom PennCare PPO provider search function. You can now search for these top-tier providers by visiting www.ibxpress.com, logging on to your account and selecting the Find a Doctor tool. You can also access the Find a Doctor tool without creating an account by visiting http://bit.ly/penncareibc. New Limits for Tax-Advantaged Accounts For 2018, the IRS contribution limit for Health Care Flexible Spending Accounts is $2,650. The Transit and Commuter benefits contribution limit has also increased to $260. For more information about these plans, see page 6. Penn Dental Family Plan Coinsurance Changes For 2018 2019, the coinsurance you pay for some dental services in the Penn Dental Family Plan will change. These changes are designed to offset the cost of providing top-tier service without increasing the biweekly contributions you pay for Plan coverage. See page 6 for more information. 1
Open Enrollment Is April 23 May 6, 2018 Take action during Open Enrollment if you want to: Make changes to your current benefit elections for the 2018 2019 benefit plan year. Add or drop a dependent from your benefits coverage. Contribute to a Health Care or Dependent Care Flexible Spending Account (FSA) for the 2018 2019 benefit plan year. What Happens If You Don t Take Any Action? If you waived coverage Medical Dental Vision Flexible Spending Accounts Life Insurance Supplemental Life and AD&D Insurance (Employee and Dependent Coverage) Short-Term Disability Long-Term Disability You will continue to waive coverage. You will keep your current coverage, at the same coverage level. You will keep your current coverage, at the same coverage level. You will keep your current coverage, at the same coverage level. No coverage. You must enroll each year to participate. You will keep your current coverage. You will keep your current coverage. You will keep your current coverage. You are auto enrolled if you meet eligibility requirements. Benefits You Receive Automatically As a UPHS employee, you automatically receive benefits paid by UPHS for: Life insurance coverage equal to one times your base pay. Long-term disability coverage for full-time employees after one year of continuous service. Open Enrollment Resources My Benefits UPHS Benefits Team HR&You Website You will make your benefit elections through our secure, online benefits enrollment website My Benefits. Beginning April 23, select the My Benefits icon on the home page of www.uphshrandyou.com, log on and make your benefit elections for coverage effective July 1, 2018. A UPHS benefits representative is available to answer your questions when you call 215-615-2675 and select option 4, or you can simply send an email to BenefitsQuestions@uphs.upenn.edu. During Open Enrollment, visit the HR&You website, www.uphshrandyou.com and learn about all of your benefits, find providers, complete your enrollment and much more! 2
Medical The PennCare PPO Plan When you enroll in medical coverage, you have comprehensive coverage for services including zero-cost preventive care, behavioral health services through the Penn Behavioral Health Regional Network and Prescription Drug coverage through Caremark. What you pay for care depends on the provider you visit, the facility you go to and how you fill your prescriptions. For more information on provider and pharmacy networks, select Medical or Prescription/RX from the Health Benefits page on www.uphshrandyou.com. Convenient Care for UPHS Employees When you need to feel better or want to take action to improve your health, UPHS provides the following resources to make that easy. You take care of patients. Let us take care of you. Contact... When you need... By calling or visiting... Penn Primary Care Connection Concierge Services FirstCall Employee Health Management Programs for Hypertension and Cholesterol Management Diabetes Prevention Program Walk-in Employee Health Clinic To schedule new patient appointments with PennCare PPO providers Medical care or answers to medical questions right away available free for employees and covered adult dependents over age 18 To take control of high blood pressure, lower cholesterol and/or reduce your risk of heart disease Help with diabetes prevention To schedule a same-day sick visit 267-414-2208 215-615-2222, open 24/7 215-615-5252 wellfocused@uphs.upenn.edu 215-615-5252 Know Before You Go Your PennCare PPO physician or provider may work in a facility that is not part of the PennCare PPO network. If you receive services from that facility, such as lab work or X-rays, you will pay more because those services are not part of the PennCare PPO network. Alternatively, the facility or service may be in the PennCare PPO network, but your provider is not part of the top-tier network for coverage and you will pay more for provider services. Before receiving any medical service, access the Find a Doctor tool by logging on to www.ibxpress.com or accessing http://bit.ly/penncareibc to find providers and facilities in the PennCare PPO network. Centers of Excellence Certain services require you to receive care from a PennCare provider under the Centers of Excellence. The benefit plan offers best-in-class services provided by the following UPHS departments: oncology, cardiology, neuroscience and othopedics. If you do not receive the service from a provider in the Centers of Excellence of UPHS, you will pay a $1,000 copay in addition to the regular cost share of the service* (does not apply to emergency services). For a list of services available through the Centers of Excellence of UPHS, visit www.uphshrandyou.com and click the link for Centers of Excellence on the Medical page under Health Benefits. If you have questions about these services, or about when to use a Center of Excellence, call Health Advocate at 866-695-8622. * If you or a covered dependent lives more than 50 miles from Philadelphia, you will be eligible for consideration of a waiver of the $1,000 copay if you receive the service from a provider outside of the Centers of Excellence of UPHS. 3
The PennCare PPO Plan at a Glance If you are covered under the PennCare PPO, you pay the least when you visit a PennCare provider, more when you visit an IBC in-network provider and the most when you visit an out-of-network provider. When you see a PennCare provider, you have no deductible and a lower out-of-pocket maximum, and you can receive preventive care, inpatient hospital and advanced radiology care at zero cost. PennCare Network IBC In-Network Out-of-Network How to Access Care Go to any PennCare provider Go to any IBC in-network provider Go to any out-of-network provider Deductible - Employee - Employee + Spouse/Child(ren) - Family None $250 $500 $750 $750 $1,500 $2,250 Preventive Care (Plan pays) 100% 100% 60% after deductible Coinsurance (Plan pays) 100% 80% 60% Office Visit (You pay) - Primary Care/Specialist $20 copay $35 copay/$50 copay 40% after deductible Medical Out-of-Pocket Maximum (Includes deductible, coinsurance and medical copays) - Employee - Employee + Spouse/Child(ren) - Family $1,000 $1,500 $2,000 $3,000 $5,000 $7,000 $6,350 $9,500 $12,700 Emergency Room Fee (You pay; waived if admitted) $150 copay $150 copay $150 copay Inpatient Hospital* (You pay) $0 $1,000 copay; no deductible or coinsurance (Physician services: 20% coinsurance after deductible) Maternity: $750 copay (No deductible or coinsurance) 40% after deductible Outpatient Facility* (You pay) $0 $500 copay; no deductible or coinsurance (Physician services: 20% coinsurance after deductible) 40% after deductible Advanced Radiology (You pay) $0 $250 copay $250 copay; then 40% after deductible Penn Behavioral Health In-Network (PBH Preferred) In-Network (PBH Regional Network) Out-of-Network Inpatient Mental Health and Substance Abuse (You pay) $0 $1,000 copay; no deductible or coinsurance (Physician services: 20% coinsurance after deductible) 40% after deductible Outpatient Mental Health and Substance Abuse (You pay) $20 copay $35 copay 40% after deductible * If you do not receive care from a provider for certain services in the Centers of Excellence of UPHS for oncology, cardiology, neuroscience or orthopedics, you may be required to pay an additional $1,000 copay (copay will be waived for emergency care). 4
Prescription Drugs When you enroll in medical coverage, you automatically receive prescription drug benefits through Caremark. Any out-of-pocket costs, including copays, will count toward the prescription drug out-of-pocket maximum. There is no change to prescription drug coverage for 2018 2019. For more information on your prescription drug benefits, visit www.uphshrandyou.com. 30-Day Supply (You pay) UPHS Pharmacy Retail Generic - Hypertension prescriptions - Hyperlipidemia prescriptions $5 No cost No cost $15 Preferred $15 $45 Non-Preferred $30 $75 90-Day Supply (You pay) Generic - Hypertension prescriptions - Hyperlipidemia prescriptions UPHS Mail Order* $10 No cost No cost Caremark Mail Order $30 Preferred $30 $90 Non-Preferred $60 $150 Specialty Drugs (You pay) 30-Day Supply Only No Cost 20% coinsurance; $100 per prescription maximum Out-of-Pocket Maximum $1,000 per member/$2,000 per family * You may access a 90-day supply through the outpatient pharmacies at any UPHS pharmacy location. Save on Prescription Drugs You save on prescription drug copays when you visit a UPHS pharmacy. You also have the option to fill your prescriptions through a retail pharmacy or out of network. Visit www.uphshrandyou.com and click Health Benefits. Then select UPHS Pharmacy Locations on the Prescription/Rx page for a list of locations. Prescriptions for specialty drugs filled at a UPHS pharmacy are covered at no cost to you, and you have the option to have your specialty drugs mailed to your home through the Hospital of the University of Pennsylvania Radnor Pharmacy. For more information about home delivery of specialty drugs, call 610-902-1700. Behavioral Health Benefits Remember, if you use Penn Behavioral Health s Preferred provider, you will pay less out of pocket. When you go to a provider in the Penn Behavioral Health Regional Network or out of network, you will be subject to a deductible and coinsurance. For more information, please call 888-321-5533. The phone number for Behavioral Health is on the back of your PennCare PPO Plan insurance card. 5
Dental UPHS helps you maintain good dental health by providing you with three dental plan options: Penn Dental Family Plan, Delta Dental Standard and Delta Dental Premium. For 2018 2019, the coinsurance for some services in the Penn Dental Family Plan will change. Deductible - Employee - Family Penn Dental Family Plan $50 $150 Delta Dental Standard (PPO Network) $50 $150 Delta Dental Premium (PPO Network) $25 $75 Penn Dental Family Practice Locations If you enroll in the Penn Dental Family Plan, you must receive care at these three locations to receive plan benefits. Make sure these locations are convenient for your family and you. Note the current Bryn Mawr clinic will relocate to Berwyn in the summer of 2018. Annual Maximum Plan Benefit $3,000 $1,500 $2,000 Preventive Care 100% 100% 100% Basic Services 80% 80% 80% Major Services 60% 50% 80% Orthodontia 60% Not Covered 50% Orthodontia Lifetime Maximum $2,000 Not Covered $2,000 Penn Dental Family Practice at Locust Walk 240 South 40th Street Philadelphia, PA 19104 Penn Dental Family Practice at University City 3737 Market Street Philadelphia, PA 19104 Penn Dental Family Practice, Main Line 1205 Westlakes Berwyn, PA 19312 Vision UPHS offers two vision plans that allow you to select the coverage level and cost that best meet your needs. You may choose either the Davis Standard plan or the Davis Premium plan. Both plans cover eye exams, standard lenses and frames. Scheie Eye is a participating provider with both vision plans; however, if you elect the Davis Premium plan and use Scheie providers, you will receive enhanced vision care benefits. For the 2018 2019 benefit plan year, there are no changes to the vision plan design. To learn more, visit www.uphshrandyou.com. Additional Benefits Flexible Spending Accounts (FSAs) FSAs allow you to contribute money on a pre-tax basis to help pay for eligible health care and/or dependent care expenses. For the 2018 2019 benefit plan year, you can contribute from $60 to $2,650 in pre-tax earnings to the Health Care FSA, or from $260 to $5,000* in pre-tax earnings to the Dependent Care FSA. For the Health Care FSA, any unused funds left after September 15, 2019, will be forfeited. You can submit expenses until December 31 after the end of the plan year. * Employees making $120,000 or more will be able to contribute a maximum of $1,800 this plan year to a Dependent Care FSA in order to meet IRS regulations. Employee Assistance Program (EAP) The EAP is provided by Penn Behavioral Health. All UPHS employees are eligible for the EAP, which is 100% paid for by UPHS. The EAP, available to you 24 hours a day, seven days a week, offers confidential assistance to all employees and dependents. For more information about the benefits provided through Penn Behavioral Health, call 888-321-4433. Transit and Commuter Benefits The IRS sets annual limits for transit and commuter benefits. You may elect pre-tax deductions of up to $260 per month for both the Parking Program and the Public Transit Program. Life Insurance and AD&D Insurance Life insurance is a core benefit, automatically provided to you at one times your annual base salary. You have the opportunity during Open Enrollment to purchase supplemental life and AD&D coverage for yourself or your dependents. Disability Disability benefits can replace a portion of your base pay if you are unable to work because of illness or injury. You pay for short-term disability benefits, while UPHS pays for long-term coverage. 6
Succeed with Wellfocused The best care for our patients starts with healthy employees. The Wellfocused program is dedicated to making living a healthy lifestyle easier by providing tools and resources that help you take steps to improve your overall well-being. When you participate in Wellfocused, you earn points in the Wellfocused app, powered by Jiff, for tracking nutrition, activity and sleep, and for participating in Employee Health Management initiatives offered FREE to employees. The current program year ends June 30, 2018, so you still have time to earn points to trade in for cash (up to $200) or prizes. Download the Wellfocused App The Wellfocused app, powered by Jiff, makes it easy for you to manage your health and well-being on the go. Download the Jiff Health Benefits app today by: Visiting the itunes or Google Play store. Searching for the Jiff-Health Benefits app. Selecting Activate your account and using the Jiff token wellfocused to create your personalized account. Enter your last name and date of birth for future verification, and you re ready to start. Inviting your spouse to sign up if he/she is enrolled in the PennCare PPO. No smartphone? No problem! You can also access the program by visiting app.jiff.com. To learn more about the Wellfocused program and the app, go to the Wellfocused tab on www.uphshrandyou.com. Spring Challenge: Wander the Wonders Earn 250 points by participating in this spring s Wellfocused challenge, Wander the Wonders. This race-based step challenge takes you on a virtual trip to the eight natural wonders of the world. Registration is open! Visit the Wellfocused app, tap progress and tap Wander the Wonders to register. Visit www.uphshrandyou.com and click on the Monthly News page under Wellfocused to stay up to date on monthly Wellfocused happenings. Biometric Screenings If you missed the on-site biometric screenings, you can still earn up to 575 Wellfocused points for Knowing Your Numbers by completing your screening at your primary care physician s (PCP s) office* or at a Quest Biometric location. Register through the Wellfocused app by clicking on the Quest Biometrics icon in the Explore tab. To schedule a screening or access the Physician Form on the Wellfocused app: 1. Go to the Wellfocused app or visit app.jiff.com. 2. Tap the Quest Biometrics icon under the Explore tab. 3. Under Schedule Your Screening, tap Details. 4. Tap Make a Selection. 5. Agree to the terms and conditions and confirm your demographic information. You will then be taken to the Wellness Screening page, where you can schedule a screening or access the Physician Form. Take the Physician Form to your PCP or a Quest Biometric location. * If you have seen your PCP on or after July 1, 2017, those numbers are acceptable for submission. 7
Health Assessment When you understand your current health, you are better informed to make the right healthy lifestyle choices. By completing a health assessment, you will learn about different aspects of your health, how well you are doing and where there are areas for improvement. You can also earn 125 Wellfocused points! Tap Health Assessment on the Wellfocused app to complete your health assessment. Free Nutrition Counseling Take advantage of the free, on-site nutrition counseling program available to employees at most of our larger UPHS locations. UPHS employees covered under the PennCare PPO Plan can receive six free visits with a registered dietician and get personalized help with food choices, portion control, diabetes management and more. To make an appointment, visit www.uphshrandyou.com and select Manage Your Weight under the Wellfocused tab. Start your healthy eating journey today! Meet Us at the Fair! Join the UPHS Wellfocused and Benefits teams at an Open Enrollment Health Fair. You can visit with many of our health and benefit vendors, enter raffles for cool prizes, grab free giveaways and learn about your medical plan and other benefits as a UPHS employee. We hope to see you there! Remaining health fairs for this year are: Location Date and Time Room Location Hospital of the University of Pennsylvania April 11 10 a.m. 2 p.m. Mezzanine 1500 Market Street April 12 10 a.m. 2 p.m. Home Care and Hospice Services April 13 8 a.m. 11 a.m. 3025 Market Street April 16 10 a.m. 2 p.m. PAH April 18 10 a.m. 2 p.m. Chester County Hospital April 20 10 a.m. 2 p.m. Kahunatorium Conference Rooms A & B Training Room Café Conference Rooms A & B June is Employee Health and Well-Being Month Be on the lookout for exciting activities and programs coming your way this June in celebration of Employee Health and Well-Being month! 8
Health Advocate Get Free Help with Your Medical or Insurance-Related Problems The world of health care can be complex Health Advocate makes it easier for you and your family to get the help you need, when you need it. Health Advocate is a free, confidential service available to you, your spouse, your dependent children and your parents and parents-in-law, regardless of medical plan enrollment. Health Advocate is not affiliated with any insurance or third-party provider and complies with all government privacy standards related to your personal and medical information. Use Health Advocate for free, expert help when you need to: Find the right doctor, specialist or facility within your network. Schedule appointments with providers and arrange second opinions. Resolve insurance claims and coordinate benefits. Find eldercare resources, including adult day care. Get estimates for upcoming procedures. Work with insurance companies and obtain approvals for needed services. Transfer medical records. As a UPHS employee and health plan participant, you also have the opportunity to participate in Health Advocate s free tobacco cessation program. This program provides you and your covered dependents with 13 weeks of telephonic coaching and free nicotine replacement therapy (patch, lozenge or gum) mailed straight to your home. There is no copay for all quit-smoking medications prescribed by your doctor. See What People Are Saying about Health Advocate I can t thank you enough for all of your help, especially expediting this information. My whole family is so grateful. Your support has helped us focus on my father and his recovery. Thank you so much. After several attempts, I quit smoking with your program! Thanks! I have used this service several times and, every time, I have had an exceptional experience working with the advocates and resolving issues. Download the Health Advocate app or visit www.healthadvocate.com/uphs to receive important alerts, upload relevant documents and forms, access trusted health care information and get answers to your questions. You can also reach Health Advocate 24/7 by calling 866-695-8622. 9
How to Enroll Starting April 23, visit the My Benefits website by clicking on the My Benefits icon on the home page of www.uphshrandyou.com to enroll for benefits. Then, log on to our secure site using your network username and password the same information you use when logging on to your work computer. Once you are logged on to My Benefits, you can: Enroll for benefits. During the Open Enrollment window, April 23 May 6, 2018, you may enroll for benefits 24 hours a day, seven days a week. Your elections will be in effect for July 1, 2018, through June 30, 2019. Print your online confirmation statement. If you want a copy of your elections, you must print your confirmation page after you complete your enrollment. View your benefits profile page. Your profile will show your benefit elections for the 2018 2019 plan year. Update Your Beneficiary Information During Open Enrollment, please review your beneficiary information for your life insurance benefits and make any necessary changes. A beneficiary is the person(s) who receives your benefits if you die. For the UPHS 403(b) Plan If you are married, your spouse is automatically your beneficiary. To choose a beneficiary other than your spouse, you must obtain your spouse s consent in writing. Visit www.uphshrandyou.com and click Retirement under Financial Support to access the link for your plan vendor (Vanguard or TIAA) to get further information. Are You Saving Enough for Retirement? UPHS offers retirement savings plans for all employees. You can contribute on a pretax or after-tax (Roth) basis. In either case, you will build a foundation for a stronger retirement. Your contributions are immediately 100% vested in the plan, and you choose how to invest your savings. For employees who are not covered under the UPHS pension plan, UPHS makes a contribution to your savings too. To learn more, including how to change your contribution rate or manage your investments, visit www.uphshrandyou.com during Open Enrollment and select Retirement under the Financial Support tab. Online Total Rewards Statements Your benefits are an important part of your total compensation. Beginning in May, you may log on to www.uphshrandyou.com to review your Total Rewards statement for calendar year 2017 and see the value of your UPHS health and welfare benefits and retirement benefits. Legal Notices summarize the legal protections, rights and responsibilities related to your participation in UPHS benefit offerings. These notices are available to you on our HR&You website. View them by visiting www.uphshrandyou.com and clicking on Legal Notices on the main menu on your home screen. 10
2018 2019 Employee Contributions The rates listed below for the PennCare PPO Plan include prescription drug coverage. Full-Time Employee Biweekly Contributions Plan Option Employee Employee + Children Employee + Spouse Employee + Family PennCare PPO $61.57 $119.74 $128.95 $187.12 No Coverage $0 $0 $0 $0 Dental Plans Delta Dental Standard $5.33 $11.50 $12.03 $18.48 Delta Dental Premium $6.35 $15.01 $14.27 $23.43 Penn Dental Family Plan $10.36 $22.02 $20.72 $29.79 Vision Plans Davis Standard $0.71 $1.23 $1.63 $2.09 Davis Premium $2.19 $3.78 $5.05 $6.44 Part-Time Employee Biweekly Contributions Plan Option Employee Employee + Children Employee + Spouse Employee + Family PennCare PPO $103.74 $280.15 $288.65 $446.08 No Coverage $0 $0 $0 $0 Dental Plans Delta Dental Standard $9.59 $20.70 $21.65 $33.27 Delta Dental Premium $11.44 $27.02 $25.69 $42.18 Penn Dental Family Plan $18.65 $39.63 $37.30 $53.61 Vision Plans Davis Standard $0.71 $1.23 $1.63 $2.09 Davis Premium $2.19 $3.78 $5.05 $6.44 11