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Postdoctoral Insurance PlanGARNETT-POWERS & ASSOCIATES, INC.Presented byOpen Enrollment | Plan Year 2016November 16th through November 27th

Benefits Offered Through the Postdoctoral Insurance Plan Benefit Plan Design & Rate Changes effective for the Plan Year 2016 Explanation of the Open Enrollment processQ & A2AgendaBumped Year 2016 to previous line2

The Postdoctoral Insurance PlanThe University of Pennsylvania has partnered with Garnett-Powers & Associates to provide marketing, administrative services and customer service for this program.

The University of Pennsylvania Postdoctoral Insurance Plan was implemented on March 1st, 2007, and is available to all Postdoctoral Scholars.

The program offers a package of benefits originally designed to closely match the benefits offered to the University of Pennsylvania faculty & staff.33Meet Your PostdoctoralInsurance Plan Representative!Dane Pisano is a graduate of California State University, Fullerton, with a Bachelors degree in Communications, and a licensed insurance agent.

He has over 5 years of experience as a Garnett-Powers & Associates University Services Account Manager, and is eager to assist you with any enrollment, benefits or billing questions you may have regarding the Postdoctoral Insurance Plan.

4Benefits Offered ThroughThe Postdoctoral Insurance Plan 5Plan NameInsurance TypeCompanyHMOMedicalPPOMedicalDMODentalPPODentalPPOVisionLife and AD&DLife

Resized The Standard logo to keep it within table borders.5

Benefit Plan/Rate Changes For 2016The HMO and PPO plan rates will be increasing 5%; there are no benefit plan changes.

There are no rate/benefit changes to the dental, vision or life insurance.

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Medical InsuranceProvided by

What is an Open Access HMO Plan?A Health Maintenance Organization (HMO) plan typically requires the selection of a Primary Care Physician (PCP) to act as your healthcare gatekeeper, referring you to specialists if necessary.

The Open Access component of this HMO plan allows you to choose a PCP as you seek service, as well as self- refer to specialists, as long as those providers are in the HMO network.

The Open Access HMO plan offers rich, in-network benefits, however there is no out-of-network benefit.

Unless it is a true emergency, any services rendered by an out-of-network provider will not be covered under the plan in any capacity.

Note: All work related injuries/sicknesses are managed through Occupational Health Services, located in the Ravdin Wing at the Hospital of The University of Pennsylvania on 34th Street main entrance.

8For more detailed plan design information go to: www.garnett-powers.com/upenn9Postdoctoral Insurance PlanAetna Open Access HMO Medical PlanAetna HMOCore BenefitsIn-NetworkDeductible None OOP Single/Family $1,500 / $3,000Office Visit, PCP/Specialist$20 / $30 CopayInpatient Hospital $250 Copay per admissionOutpatient Surgery $100 Copay per visitEmergency Room $75 Copay (waived if admitted)Rx: Generic/Brand Formulary/Non-Formulary$10 / $15 / $30Added grey border below heading (missing from this slide).9What is a PPO Plan?The member does not have to choose a PCP.

There is an In-Network and Out-of-Network component.

The In-Network benefits will be greater than the Out-of- Network benefits.

At the time of service, the member has the ability to seek care from a Specialist, without having to obtain a referral from a PCP.

The contractual agreement between the PPO Plan and the Provider is on a discounted fee for service basis.

Note: All work related injuries/sicknesses are managed through Occupational Health Services, located in the Ravdin Wing at the Hospital of The University of Pennsylvania on 34th Street main entrance.1011Postdoctoral Insurance PlanAetna PPO Medical PlanFor more detailed plan design information go to: www.garnett-powers.com/upenn*Deductible applies**An E-visit is an online internet consultation between a physician (with the technical capability) and an established patient about a non-emergency healthcare matter.Aetna PPOCore BenefitsIn-NetworkOut-of-NetworkDeductible (Individual/Family)$300 / $900$800 / $2,400OOP Single/Family$2,500 / $7,500$3,000 / $9,000Office Visit$30 / $40 Copay40%*E-Visit**$30 Copay40%*Inpatient Hospital20%*40%*Outpatient Surgery20%*40%*Emergency Room$150 Copay (waived if admitted)Rx: Gen./Brand/Non-Form.$20 / $30 / $50$20 / $30 / $50 (+40%)Expanded benefit table horizontally so there was room for the website info at the bottom. Moved E-visit language from header to below the table and reduced font size. Added grey border below heading (missing from this slide).

11Summaries of Benefits and CoverageThe Patient Protection and Affordable Care Act (PPACA) requires that you be notified that the Summaries of Benefits and Coverage for your medical plans are currently available on our website.

The Summaries of Benefits and Coverage follow the recommended guidelines of PPACA in a standardized format to make them easier to read and comprehend to better serve you in making your plan selections.

You may request a paper copy at no charge by calling the toll-free number on your new ID card.

You may also print a copy directly off of the GPA website.12Prescriptions Mail Order PharmacyYou can order maintenance medications through Aetnas Rx Home Delivery for chronic conditions as asthma, arthritis, diabetes, high cholesterol and heart conditions.

Under the HMO Plan, this service provides you up to a 90 day supply of these medications after a copay of $20 for generic, $30 for brand-name, and $60 for non-formulary brand name drugs.

Under the PPO plan, this service provides you up to a 90 day supply of these medications after a copay of $40 for generic, $60 for brand-name, and $100 for non-formulary brand name drugs.

Please click on Aetna RX Home Delivery/Order Form on the website for more information, as well as directions on how to order your prescriptions.

Please visit http://www.garnett-powers.com/upenn/rx15.htm for important information regarding the prescription coverage.13Wellness ProgramsAetna Navigator - This is an online member portal that allows you to view your medical visits and claims status, print temporary ID cards and gain access to more important information.

Once you have your member ID, you may register for access to this site. There will be instructions on the website to assist you.

Beginning Right Provides a pregnancy risk survey and a wealth of information to assist you with when either you or your spouse/partner become pregnant.

GlobalFit Offers discounts to a nationwide network of fitness clubs.

Health Connections Discounts are offered through this program for spas, health foods and fitness clothing.

Stress Management Information available for better mental and physical health.14Urgent CareThe hospital emergency room is to be used only if the situation is limb or life threatening.

The Urgent Care Center should be used as often as possible to avoid additional charges.

The Urgent Care Center is available to treat most non-life threatening emergencies, as broken bones (not multiple fractures), wounds not bleeding profusely, fevers and flu symptoms.

The copay is less: HMO Plan - $75 copay for emergency room vs $30 copay for urgent care.

PPO Plan - $150 copay for emergency room vs $35 copay for urgent care.

There are 7 Urgent Care Centers within 10 miles of the University of Pennsylvania.15Walk-In ClinicsThe Walk-In Clinic is an in-network, free-standing health care facility that is an alternative to a physicians office for treatment of unscheduled, non-emergency illnesses and injuries and administration of certain immunizations.

It is not an alternative for the emergency room or the outpatient department of a hospital.

It is generally found in a retail location as CVS or Walgreens.

If you use a Walk-In Clinic on the Medical HMO plan, you will pay $20.

If you use a Walk-In Clinic on the Medical PPO plan, you will pay $30 in-network.

There are 2 Walk-In Clinics within 5 miles of campus.16

Dental InsuranceProvided by

18Postdoctoral Insurance PlanAetna HMO PlanAetna HMOCore BenefitsIn-NetworkAnnual DeductibleNoneAnnual Benefit MaximumUnlimitedPreventive/Diagnostic CareRoutine ExamsTeeth Cleanings (Prophylaxis)X-raysNo ChargeNo ChargeNo ChargeBasic ProceduresFillingsEndodonticsPeriodonticsOral SurgeryVaries up to $75 copayVaries up to $380 copayVaries up to $300 CopayVaries up to $117 copayMajor ProceduresCrownsBridgeworkDenturesVaries up to $275 copayVaries up to $275 copayVaries up to $350 copayOrthodontiaAdolescentAdult$1,945 copay plus start-up fees and retention$1,945 copay plus start-up fees and retention19Accessing care through thePENN Dental SchoolThe DMO plan requires that you choose or be assigned a Primary Care Dentist (PCD) and access all care through this provider unless a specialist referral is necessary.

A vast majority of Postdocs are enrolled before they are able to choose a PCD, and if one is not chosen before accessing care for the first time, it can make the claims process difficult.

In order to alleviate this issue, all newly appointed postdocs are automatically enrolled with a dentist at the PENN dental school. Should you wish to change to a different PCD, you may do so through Aetna member services, or online through Aetna Navigator.

Moved Accessing care through portion to next slide so all bullet points could be together1920Accessing care through thePENN Dental SchoolAccessing care through the PENN Dental School offers a number of valuable benefits:

Direct supervision of care by faculty with national and international reputation

Convenient on-campus location all dental specialties under one roof

Collaboration with HUP and CHOP world renowned medical and pediatric care

Convenient evening clinic sessions options for convenient appointments

24/7 access to professional care for dental emergencies

High quality dental care at a reasonable cost maximize use of insurance benefits

Diverse international environment over 40 languages spoken

State of the art care in a comfortable environmentContinuedMerged Accessing care through portion of previous slide with this slide, re-spaced bullets to accommodate.2021Postdoctoral Insurance PlanAetna Dental PPO PlanAetna PPOCore BenefitsIn-NetworkOut-of-NetworkAnnual Deductible (waived for preventive)$50* per individual / $150* per familyAnnual Benefit Maximum$1,500Preventive/Diagnostic CareRoutine ExamsTeeth Cleanings (Prophylaxis)X-rays0%0%0%20% of UCR20% of UCR20% of UCRBasic ProceduresFillingsEndodonticsPeriodonticsOral Surgery20%20%20%20%50% of UCR50% of UCR50% of UCR50% of UCRMajor ProceduresCrownsBridgeworkDentures50%50%50%50% of UCR50% of UCR50% of UCROrthodontia (Child only)$2,000 Lifetime Maximum50%50% of UCR*Deductible waived for preventive servicesDeductible waived for preventive services language removed from heading and incorporated into benefit table.2122Accessing the Out-of-Network TierPorcelain Crown on a molar - We will estimate that the usual, customary and reasonable charge is considered $800.

Per the out-of-network benefit structure, you will pay 50% (your coinsurance) toward that crown, which would be $400.

In addition, if the out-of-network dentist performing your crown services charges more than what is considered usual, customary and reasonable, you will pay the $400 PLUS any additional amount that the dentist wishes to charge. So, if the dentist charged $900 for the crown in total, you would pay a total of $500 for the crown, which includes the extra $100 that the dentist charged above what is considered usual, customary and reasonable.

Using the out-of-network tier costs you more because the dentists do not discount their services per a provider contract, whereas those contracts do reduce your out-of-pocket costs in the in-network PPO tier.

When you access care out-of-network, you and the insurance carrier incur more costs, consequently affecting the overall pricing of the plan.

Aetna has a robust PPO network.An example of how seeking out-of-network services can impact your out-of-pocket costs:

An example of how seeking language moved up so as not to overlap supporting text.22

Vision InsuranceProvided by

24Postdoctoral Insurance PlanAetna PPO Vision PlanFor more detailed plan design information go to: www.garnett-powers.com/upenn*Contact lenses in lieu of traditional lensesAetna PPOCore BenefitsIn-NetworkOut-of-NetworkEye Exam (every 12 months)$10 CopayUp to $40 allowanceFrames (every 12 months)$130 allowance (20% off remaining balance)Up to $45 allowanceLenses (every 12 months)SingleBifocalTrifocalLenticular$25 Copay$25 Copay$25 Copay$25 CopayUp to $40 allowanceUp to $60 allowanceUp to $80 allowanceUp to $80 allowanceContact Lenses* (materials only)$25 Copay (up to 4 boxes)Up to $210 allowanceSlight reformatting of benefit table to reduce language spilling into second line. Moved benefit table to front, moved up, brought Contact lenses in lieu of language from header to below table.24

Life/AD&D InsuranceProvided by

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Postdoctoral Insurance PlanLife and Accidental Death & Dismemberment InsuranceThe plan pays $50,000 in the event of a death.

An additional benefit of $50,000 is paid for AD&D if the death is due to an accident.

The plan provides Postdocs and their dependents the $50,000 Medical Evacuation and $25,000 Repatriation of Mortal Remains benefits necessary to satisfy the J1 & J2 Visa requirements.

Accelerated Benefit Provision Allows eligible members who are terminally ill to receive an early allocation of up to 75% of their group life insurance benefit.27All currently enrolled Postdoctoral Scholars have the option of making changes during the Open Enrollment Period from November 16th November 27th, 2015.

If you are currently enrolled in the Medical PPO you may switch to the Medical HMO as long as you are in the Medical HMO service area. Please call GPA for assistance.

If you are currently enrolled in the Medical HMO, you may switch to the Medical PPO.

If you are currently enrolled in the Dental HMO, you may switch to the Dental PPO, or vice versa.

If you previously waived either yourself and/or your family members, you/they may be enrolled at this time.

All changes you make to your enrollment will be effective as of January 1st, 2016.

If you are not changing your current enrollment status, no action is necessary.The Open Enrollment Process28In order to make changes to your enrollment for Plan Year 2016, please follow these steps. Please note that all changes made to your current enrollment will take effect January 1st, 2016.

First, click on the Enrollment section of the website, then the sub-link Open Enrollment.

Click on the Open Enrollment Instructions link and print them out for assistance with completing the Open Enrollment Form properly.

Once the instructions are in hand, go directly to the Open Enrollment Form. You will need your Penn ID and previously created unique password to enter the site on the login page. Once you reach the Postdoc Dashboard, you may view your current enrollment and make the plan changes you desire online. Once complete, you may print a copy for your records.The Open Enrollment ProcessContinued29Once you access your online Open Enrollment Form you may do the following:

If you are currently enrolled, you may view your current Benefit enrollment.

Make the changes mentioned earlier regarding switching to medical PPO and/or dental PPO if desired. Please check all plans in which you wish to be enrolled for Plan Year 2016.

Enroll yourself and/or your eligible dependents if you previously waived.

Update your Life Insurance beneficiary information. If nothing has changed, you may leave this section as is.

If you previously waived or are enrolling for the first time, and choose the dental HMO, you must choose a Primary Care Dentist for all participating family members.The Open Enrollment ProcessContinued30Provider directory links are available at the GPA website.

All Postdoctoral Scholars making changes to their enrollment, whose dependent or PPO buy-up premiums are covered by their department, must complete the Dependent Contribution Worksheet.

Please have your Business Administrator sign the form, then either fax or email it to Garnett-Powers & Associates.

To obtain the form, click on Dependent Contribution Worksheets found in the Enrollment section on the website.The Open Enrollment ProcessContinued31An electronic version of the enrollment form will be submitted to the Garnett-Powers & Associates secure website for data entry.

An email will be sent no later than December 22nd confirming your new enrollment status.

Please make sure the email address that appears on your enrollment form is correct.

ID cards (if applicable) will be mailed to your home.The Open Enrollment ProcessContinued32The Major Family Member Categories Are:

Spouse

Natural or adopted children to age 26 regardless of student status

Stepchildren may be included if they live with the Postdoc and are supported at more than 50% and claimed as a tax dependent

Same-sex domestic partner. The required Declaration of Domestic Partnership form, found on the GPA website, must be completed, notarized, signed and forwarded to Garnett-Powers & AssociatesFamily Member EligibilityFamily member eligibility requirements are the same as the family member eligibility requirements for the University of Pennsylvania faculty/staff plans.34All UPENN Postdoctoral Scholars will automatically be enrolled in the Postdoctoral Insurance Plan (Medical, Dental, Vision and Life Insurance) as a single individual.

To be eligible and automatically enrolled in the program, Postdoctoral Scholars must be in the payroll system (minimum record okay) with the following codes to be eligible:Data Entry andPremium Payment ProcessSalary Key SActive Code APostdoc Indicator of:217500 PD Researcher217503 PD Researcher217603 PD Fellow217703 PD NRSA Fellow34A Dependent Contribution Worksheet must be submitted to GPA so the appropriate premium allocation is distributed between the department, grant and Postdoc, ONLY when the Department or grant is paying for:The up-charge for medical PPO or dental PPOThe dependent premiums

The worksheet must be submitted, prior to the final payroll for the month, to avoid charges being assigned to the Postdoc when they should not.

We at GPA do not need the worksheet unless the department or grant is paying for the up-charge or dependent premiums.

Please attempt to enter a phone number for the Postdoc to assist with their enrollment success. All zeros will work when a phone number is not available.Data Entry andPremium Payment ProcessContinued34When a Postdoc transfers to a faculty/staff position, we receive an A for active and an N for ineligible from the Penn eligibility file (for true terms, a T is transmitted instead of the A).

An e-mail is sent to the BA, copying the Postdoc, asking for confirmation of either reappointment or termination, and requiring the exact term date.

If a response is not received within 2 weeks, the Postdoc is termed from all coverage per the appointment end date in our system.

If a Postdoc is terminated per this process, a certified letter is mailed to their home address (taken from their Penn payroll record) advising them of the termination and why it occurred.Current Process to ConfirmAppointment End Date/Re-Appointment

33For general inquiries and customer service regarding enrollment, benefit questions and ID cards, please contactInformation SourcesGarnett-Powers & Associates, Inc.

Tell: 1 (800) 319-9557 | Fax (949) 583-2929 | Email: PDInsPlan@garnett-powers.comwww.garnett-powers.com/upenn

Thank you for joining us today!

Any Questions?

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