University of California PSBP New Postdoc Orientation

Report
University of California
Postdoctoral Scholar
Benefits Program
New Postdoc Orientation
Presented by
Garnett-Powers & Associates
Postdoc Title Codes
•Title Code 3252 - Postdocs paid through the UC payroll
system have been appointed in the title “Postdoctoral
Scholar-Employee”.
•Title Code 3253 - Postdocs paid a stipend have been
appointed in the title “Postdoctoral Scholar-Fellow”.
•Title Code 3254 - Postdocs paid directly from an
extramural agency have been appointed in the title
“Postdoctoral Scholar-Paid Direct”.
Note: The title of a Postdoctoral Scholar appointment is determined by the
requirements of the funding agencies.
Benefits Offered
Through The PSBP
•Medical Insurance – Health Net HMO and PPO.
•Dental Insurance – Health Net HMO and Principal POS.
•Vision Insurance – Health Net/EyeMed PPO.
•Life and AD&D Insurance – Standard Insurance.
•Short-Term Disability Insurance – Standard Insurance.
•Voluntary Long-Term Disability Insurance – Standard
Insurance.
•Bright Horizons – A program that offers a variety of
helpful caregiver services.
MEDICAL
INSURANCE
What is an HMO Plan?
• One of the main components of an HMO that distinguishes the model from other
types of plans is the Primary Care Physician who acts as your gatekeeper for all of
your care.
• If you enroll through the GPA hosted PSBP website, Health Net will automatically
assign you to a PCP.
• If you enroll through At Your Service Online (AYSO), the UC sponsored enrollment
service, you will be able to choose your own PCP using a link to the Health Net
provider directory.
• You will learn of whether you may enroll through AYSO or through the GPA PSBP
website when you click on ‘Enrollment’ on the GPA PSBP website by answering a
series of questions.
• You can choose a PCP for each family member, or change the PCP assigned to you
by calling Health Net.
• If you or a family member is in need of treatment from a Specialist or is in need of
an In-Patient or Out-Patient procedure, you must obtain a referral from the PCP
prior to any type of consultation or treatment (except in the case of an
emergency). If the referral is not obtained, no benefits will be paid.
• There is no Out-of-Network benefit (except in the case of an emergency).
PSBP Medical HMO Plan
Health Net of California
Medical Benefits
Health Net HMO
Postdoctoral Scholar Pays
Physician Office Visit:
Hospitalization:
Inpatient
Outpatient
Pregnancy
Prescription Drugs:
Generic
Brand Name
Non-Formulary
Emergency Room Visits:
Health Evaluation:
Mental Health :
Inpatient
Outpatient
Annual Maximum Out of Pocket:
Individual
Family
Annual Deductible:
Individual
Family
Lifetime Maximum:
$10 Copay
No Charge
No Charge
No Charge
$10 Copay
$20 Copay
$35 Copay
$35 Copay (waived if admitted)
$10 Copay
No Charge
$10 Copay
$1,500
$4,500
None
None
Unlimited
What is a PPO Plan?
• When covered under a PPO plan, there is no need to be assigned a
Primary Care Physician.
• There is an In-Network and Out-of-Network component.
• You have the flexibility to see a doctor without a referral either innetwork or out-of-network.
• The PPO plan offers more flexibility in physician access than the HMO
plan. As a result, the out-of-pocket costs tend to be higher.
• The In-Network benefit coverage (deductible, coinsurance, etc.) will be
greater than the Out-of-Network benefit coverage.
PSBP Medical PPO Plan
Health Net of California
Medical Benefits
Health Net PPO (In-Network)
Postdoctoral Scholar Pays
Health Net PPO (Out of Network)*
Postdoctoral Scholar Pays
Physician Office Visit:
Hospitalization:
Inpatient
Outpatient
Pregnancy
Prescription Drugs:
Generic
Brand Name
Non-Formulary
Emergency Room Visits:
Routine Physical Exam:
Mental Health (Severe):
Inpatient
Outpatient
Annual Maximum Out of Pocket:
(Does not include deductible)
Annual Deductible:
Individual
Family
Lifetime Maximum:
$20 Copay
40%
$250 Copay then 20%
$0 Copay
$250 Copay then 20%
$250 Copay then 40%
40%
$250 Copay then 40%
$10 Copay
$25 Copay
$35 Copay
20%
$20 Copay
50% + $10 Copay
50% + $25 Copay
50% + $35 Copay
40%
40%
$250 Copay then 20%
$0 Copay
$1,500 Individual
$4,500 Family
$250 Copay then 40%
40%
$1,500 Individual
$4,500 Family
None
None
$200
$600
Unlimited
*Out of Network reimbursement based on limited fee schedule.
Wellness Programs
The following benefits are included in your
Health Net medical plan:
• Health Net offers Text4Baby, a free service that provides free text
messages up to 3 times a week with information to assist you
through your pregnancy and your baby’s first year. In order to
register, text BABY to 511411.
• If you are pregnant, or thinking of starting a family, the Decision
Power® Healthy Pregnancy offered through Health Net provides
you valuable information to assist you in having a healthy
pregnancy and delivering a healthy baby. This valuable program
offers three confidential pregnancy assessments, access to a
personalized website resource, a toll-free BabyLine ® answered by
experienced nurses until your baby is six weeks old, and other
important services.
Wellness Programs, cont.
• Decision Power is a program through Health Net that offers a
variety of methods to track possible health risks and identify
potential problems. The goal of this program is to assist through
online coaching with a guide to pregnancy, tobacco use, weight
management, nutrition and stress reduction.
• If you wish to make the healthy decision to quit smoking, Smoking
Cessation offers a plan to help you kick the habit with the
assistance of either online or telephone support.
• Lose Weight is another health-wise program offered through
Decision Power that keeps you motivated to lose weight, offers
healthy eating choices and counseling from a health coach.
• To access detailed information about these valuable programs, go
to www.garnett-powers.com/postdoc/wellness.
DENTAL
INSURANCE
PSBP Dental DHMO Plan
Health Net of California
Dental Benefits
Deductible:
Diagnostic and Preventative Care:
Routine Oral Exams
Routine Teeth Cleanings
Routine X-Rays
Health Net DHMO
Postdoctoral Scholar Pays
None
No charge
No charge
No charge
Basic Procedures:
Fillings
Oral Surgery
Endodontics
Periodontics
Varies up to $80 copay
Varies up to $130 copay
Varies up to $150 copay
Varies up to $300 copay
Major Procedures:
Crowns
Varies up to $200 copay
Orthodontics:
Comprehensive Treatment- Child
Comprehensive Treatment- Adult
$1,950 copay plus start-up fees and retention
$2,250 copay plus start-up fees and retention
Annual Maximum:
Unlimited
What is a POS Plan?
• When you enroll in the Point-of-Service (POS) plan, you will not be
assigned to a Primary Care Dentist at the time of enrollment.
• The POS plan offers more flexibility than the HMO plan resulting in the
out-of-pocket costs being a bit higher.
• There are two In-Network options: An Exclusive Provider Organization
(EPO) and a Preferred Provider Organization (PPO).
• There is also an Out-of-Network option. You will pay less for services if an
In-Network provider is used.
• The EPO discounts up to 50% and the PPO discounts up to 30% for
procedures performed by participating providers, greatly reducing your
out-of-pocket costs.
PSBP Dental POS Plan
Principal Financial Group
Principal EPO/PPO (In-Network)
Postdoctoral Scholar Pays
Principal PPO (Out-of-Network)
Postdoctoral Scholar Pays
Calendar Year Deductible:
None
$50 per person, waived for
diagnostic and preventative Care
Diagnostic and Preventative Care:
Routine Exams
Teeth Cleanings
Routine X-Rays
No charge
No charge
No charge
No charge, except for the amount
of the dentist’s fee that exceeds
Principal’s scheduled allowance
Basic Procedures:
Fillings
Endodontics
Non-Surgical Periodontics
Simple Oral Surgery
10%
10%
10%
10%
20% of the scheduled allowance,
after the deductible is met, plus
the amount of the dentist’s fee that
exceeds Principal’s scheduled
allowance
Major Procedures:
Crowns
Bridgework
Dentures
Complex Oral Surgery
50%
50%
50%
50%
50% of the scheduled allowance,
after the deductible is met, plus the
amount of the dentist’s fee that
exceeds Principal’s scheduled
allowance
Orthodontia (Adult and Child):
$1,000 Lifetime Maximum
50%
50% of the scheduled allowance,
after the deductible is met, plus
the amount of the dentist’s fee
that exceeds Principal’s scheduled
allowance
VISION
INSURANCE
PSBP Vision PPO Plan
EyeMed through Health Net of California
Vision Benefits
Health Net PPO (In-Network)
Postdoctoral Scholar Pays
Health Net PPO (Out of Network)
Postdoctoral Scholar Allowance
Exam with Dilation (if necessary):
$0 Copay
Up to $40
Standard Plastic Lenses:
Single Vision
Bifocal
Trifocal
Lenticular
$10 Copay
$10 Copay
$10 Copay
$10 Copay
Up to $40
Up to $60
Up to $80
Up to $80
$0 Copay, $120 retail allowance
for any frame, plus 20% off
balance over allowance
Up to $45
Frames:
Lens Options:
UV Coating
Tint (solid and gradient)
Standard Scratch Resistant
Standard Progressive
Conventional Contact Lenses:
$15
$15
$15
$45
N/A
N/A
N/A
N/A
$105 allowance toward contacts,
plus 15% discount off balance over
allowance
Up to $105
Frequency:
Examination
Lenses or Contact Lenses
Frame
Once Every 12 Months
Once Every 12 Months
Once Every 24 Months
LIFE and AD&D
INSURANCE
PSBP Life Insurance and
Accidental Death & Dismemberment Plan
The Standard Insurance Company
• The plan pays $50,000 in the event of a death.
• The plan pays an additional $50,000 in the event of an Accidental
Death.
• AD&D Seat Belt Benefit – Up to $10,000 is payable for death as a
result of a car accident while wearing a seat belt.
• 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.
• All Postdoctoral Scholars (Title Code 3252, 3253 and 3254) are
automatically enrolled in the Life and AD&D insurance.
SHORT - TERM
DISABILITY
INSURANCE
PSBP Short Term Disability Plan
The Standard Insurance Company
• The plan will pay 70% of the first $1,429 weekly pre-disability
earnings.
• The maximum weekly benefit is $1,000 per week.
• The minimum benefit is $25.00.
• The benefit waiting period is 0 days for disability caused by an
accidental injury and 7 days for disability caused by sickness or
pregnancy.
• The maximum benefit period is 180 days.
• The plan covers non-occupational disability only.
• All Postdoctoral Scholars (Title Code 3252, 3253 and 3254) are
automatically enrolled in the STD plan.
Repatriation & Medical
Evacuation Coverage
• All Postdoctoral Scholars in job codes 3252, 3253 and
3254 and their dependents are automatically covered
for medical evacuation and repatriation benefits
necessary to satisfy the J Visa Program.
• International Postdocs and their dependents are not
required to purchase supplemental coverage for their
J1 and J2 Visa requirements.
• The PSBP Short-Term Disability plan satisfies these
requirements even if the Postdoc waives the medical,
dental, and/or vision coverage.
VOLUNTARY
LONG-TERM
DISABILITY
INSURANCE
PSBP Voluntary Long-Term
Disability Plan
The Standard Insurance Plan
• This benefit is voluntary and is paid 100% by the Postdoctoral Scholar.
• This benefit is not an open enrollment choice and is only available during
your period of initial eligibility. If you decide to enroll at a later date, you
will have to complete a medical questionnaire and you may be declined
or approved. This process may take as long as fifteen weeks.
• The Benefit Waiting Period is 180 days of disability. This program starts
when the Short Term Disability ends.
• The plan will pay 60% of the first $7,500 of your monthly pre-disability
earnings.
• The maximum monthly benefit is $4,500. This benefit is reduced by
deductible income such as workers’ compensation.
• Once approved, benefits are payable each month while you are disabled,
up to age 65.
• The monthly premium for the Long-Term Disability Insurance is $7.95 for
Plan Year 2014.
Bright Horizons
Bright Horizons
• This program offers you access to babysitters, mother’s helpers, pet
sitters, dog walkers, senior companions, tutors and several other types of
helpful services.
• When you register for membership with Bright Horizons, you will have
access to all of their available services; information on how to register is
on the Bright Horizons section of the GPA PSBP website at this link:
http://www.garnett-powers.com/postdoc/bright_horizons.htm
• You may search for caregivers using a direct search based on criteria
important to you, or post a job and have candidates apply to you.
• You have access to profiles and reviews of caregivers.
• Checking caregivers’ references is made simple.
• You may view background checks for the candidates you prefer.
• The cost of membership is paid for by the University of California; you
simply pay for the cost of services of the caregivers you hire.
THE ENROLLMENT PROCESS
• Before you begin the enrollment process, it’s important to review
the detailed plan information on the GPA PSBP website so you are
aware of what benefits you wish to choose before visiting the
enrollment form.
• First, click on the ‘Enrollment’ section of the PSBP website.
• When you click on this link, you will be asked to answer a series of
questions that will determine which of two methods you will use
to enroll in the PSBP. You must do this within 31 days of your hire
date.
• If you answered ‘No’ to the questions that are asked, you can use
the UC AtYourServiceOnline (AYSO)website to enroll.
• If you answer ‘Yes’ to one of the questions, you will click on the
link provided that will take you to the enrollment section of the
GPA PSBP website where you will complete the enrollment form.
• First, please print out the Enrollment Form Instructions. These will
assist you in efficiently completing the online form.
THE ENROLLMENT PROCESS, Cont.
• Once you have completed your enrollment form, please print,
sign and date it and turn it into your department administrator
for processing. Your enrollment is not complete and you may
not access service until the form is turned in to the appropriate
party that will enter your information into the payroll system.
• Please always make sure that you keep a copy of the enrollment
form for your own records as well.
• It may take up to 6 weeks for your information to reach the
carriers due to the timing of your enrollment.
• If you need to seek services during this time, please contact the
PSBP Customer Service Representative listed at the bottom of
each website page.
• You have 31 days from your hire date or qualifying event (such
as a marriage or a birth) in order to enroll in the PSBP.
PDS MONTHLY CONTRIBUTIONS
FOR THE HMO MEDICAL PLAN
Effective 1-1-2015, all PDS will make the following
monthly contribution if enrolled in the Medical HMO
Plan:
Coverage Type
• Postdoc Only
• Postdoc + Spouse or Domestic Partner
• Postdoc + Child(ren)
• Postdoc + Spouse + Child(ren)
Monthly Contribution
$10.16
$36.59
$17.79
$46.49
PDS MONTHLY CONTRIBUTIONS
FOR THE PPO MEDICAL PLAN
Effective 1-1-2015 the PDS will make the following
monthly contribution if enrolled in the Medical PPO
Plan:
Coverage Type
• Postdoc Only
• Postdoc + Spouse or Domestic Partner
• Postdoc + Child(ren)
• Postdoc + Spouse + Child(ren)
Monthly Contribution
$20.00
$40.00
$40.00
$60.00
THE COLLECTION PROCESS
•Postdoctoral Scholars with sufficient
funds, have their contributions deducted
from their checks via the payroll system.
•Postdoctoral Scholars with insufficient
funds, have their contributions collected
via invoice through GPA.
•GPA collects contributions for the HMO
and PPO Medical plans and the
Voluntary Long Term Disability plan.
FAMILY MEMBER ELIGIBILITY
Family member eligibility requirements are the same as the
family member eligibility requirements for the UC Faculty
and Staff plans. The major family member categories are
the following:
Spouse
Natural or adopted child or children to age 26 for medical plans
(unless eligible to continue coverage because of disability). Adult
age children are not eligible to enroll if they are eligible for their
own employer-sponsored plan.
Same-sex domestic partner
Opposite-sex domestic partner (per AB205)
Note:
When two family members are employed through the UC,
duplicate coverage is not allowed.
INFORMATION SOURCES
Website: Garnett-Powers’ PSBP website
www.garnett-powers.com/postdoc
Toll Free Phone: Garnett-Powers’ PSBP customer
service
800-254-1758
Email Address: Garnett-Powers’ email address
[email protected]

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