Transcript Document

UC San Francisco
Postdoctoral
Scholar
Benefits Plan
Open Enrollment
(November 1, 2006 through November 21, 2006)
Effective January 1, 2007
Agenda

Introduction

Postdoc Titles and Title Codes

Review of Benefits & Plan Designs

Review of the Enrollment Process

Q&A
Introduction
The Postdoctoral Scholar Benefits Plan (PSBP)
• The University of California has partnered with
Garnett-Powers & Associates to implement the PSBP
on a systemwide basis.
• As of July 1, 2006 the systemwide University of
California Postdoctoral Scholar Benefits Plan was
made available to Postdoctoral Scholars (PDS) at
UCSF.
• The PSBP is a comprehensive package of benefits
designed to closely match the benefits offered through
the UC Faculty/Staff plan.
• GOOD NEWS!!! – PSBP Medical, Life and STD rates
are going down effective January 1, 2007. All other
rates will not change.
Postdoc Title Codes
The title of a Postdoctoral Scholar appointment is
determined by the requirements of the funding agencies.
• Since April 1, 2006, Postdocs paid through the UCSF
payroll system have been appointed in the title
“Postdoctoral Scholar-Employee” (title code 3252).
• Since July 1, 2003, Postdocs paid a stipend through the
UCSF stipend desk have been appointed in the title
“Postdoctoral Scholar-Fellow” (title code 3253).
• Since July 1, 2003, Postdocs paid directly from an
extramural agency have been appointed in the title
“Postdoctoral Scholar-Paid Direct” (title code 3254).
Postdoc Title Codes, cont.
• All “Visiting Postdoctoral Scholars” (title
code 3370) whose appointment started prior
to April 1, 2006 are required to enroll in the
PSBP at their next appointment anniversary
date (requiring a change to title code 3252).
Benefits Offered Through
The Postdoctoral Scholar
Benefits Plan (PSBP)
Medical Insurance – HMO and PPO
 Dental Insurance – HMO and PPO
 Vision Insurance
 Life and AD&D Insurance
 Short Term Disability Insurance
 Long Term Disability Insurance

MEDICAL
INSURANCE
What is an HMO Plan?

Under the HMO model, the member chooses a Primary Care Physician (PCP)
contracted with the HMO plan at the time of enrollment (provider directory links
are available on the GPA website). Each family member can have a different PCP.
Your PCP becomes your healthcare “gatekeeper”.

If the member is in need of treatment from a Specialist or is in need of an InPatient or Out-Patient procedure, he/she must obtain a referral from their 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).

HMO premiums as well as the out of pocket expenses (i.e. deductible, co-payments,
etc.) tend to be lower than their PPO counterpart due to the contractual element of
“capitation”.*
* Capitation: The PCP is compensated by the HMO plan in the form of a monthly
capitation fee for each member that signs up with him/her at the time of
enrollment. The PCP has agreed to provide all primary care, as well as the cost for
most Labs & X-rays for that capitated fee.
What is a PPO Plan?

When covered under a PPO plan, the member will not be assigned to a
Primary Care Physician (PCP) at the time of enrollment.

The PPO plan offer more flexibility than the HMO plan. As a result, the
out-of-pocket costs tend to be higher.

There is an In-Network and Out-of-Network component.

The In-Network benefits (deductible, coinsurance, etc.) 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. This means that the provider who
participates in the network has agreed to provide their service on an
agreed upon discounted fee. The Provider who is not in the network will
not agree to that discounted fee and will typically charge a “Reasonable
and Customary” fee. There is no “capitation” in a PPO contract
Postdoctoral Scholars’ 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 (Non-AB88):
Outpatient
Inpatient
Annual Maximum Out of Pocket:
Individual
Family
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
$30 Copay (20 visits per calendar year)
No Charge (30 days per calendar year)
$1,500
$4,500
None
None
Unlimited
For more detailed plan design information go to:
www.garnett-powers.com/postdoc/ucsf
Postdoctoral Scholars’ Medical PPO Plan
Health Net of California
Medical Benefits
Health Net PPO (In-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 (Non-AB88):
Outpatient
Inpatient
Annual Maximum Out of Pocket
(Does not include deductible)
Deductible:
Individual
Family
Lifetime Maximum
Health Net PPO (Out of Network)
Postdoctoral Scholar Pays
$20 Copay
40%
$250 Copay then 20%
20%
$250 Copay then 20%
$250 Copay then 40%
40%
$250 Copay then 40%
$10 Copay
$25 Copay
$35 Copay
50% + $10 Copay
50% + $25 Copay
50% + $35 Copay
20%
40%
$20 Copay
40%
Amount over the $75 allowance (20 visit max.)
20%- 30 days per year
20%-30 days per year
$1,500 Individual
$1,500 Individual
$4,500 Family
$4,500 Family
None
None
$200
$600
$1,000,000
For more detailed plan design information go to:
www.garnett-powers.com/postdoc/ucsf
DENTAL
INSURANCE
Postdoctoral Scholars’ Dental PPO Plan
Principal Financial Group
Annual Maximum $1,500
Principal PPO (In-Network) Principal PPO (Out-of-Network)
Postdoctoral Scholar Pays
Postdoctoral Scholar Pays
Calendar Year Deductible
Diagnostic and Preventative Care
Routine Exams
Routine Teeth Cleanings
Routine X-Rays
Basic Procedures
Fillings
Endodontics
Non-Surgical Periodontics
Simple Oral Surgery
Major Procedures
Crowns
Bridgework
Dentures
Complex Oral Surgery
Orthodontia
$1,000 Lifetime Maximum
None
$50 per person, waived for
Diagnostic and Preventative Care
No charge
No charge
No charge
The amount that the dentist’s
fee exceeds Principal’s
scheduled allowance
10%
10%
10%
10%
20% of the scheduled allowance,
after the deductible is met, plus
the amount of the dentist’s fee
exceeds Principal’s allowance
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 schedule
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
For more detailed plan design information go to : www.garnett-powers.com/postdoc/ucsf
VISION
INSURANCE
Postdoctoral Scholars’ Vision PPO Plan
Health Net of California
Vision Benefits
Health Net PPO (In-Network)
Postdoctoral Scholar Pays
Exam with Dilation (if necessary)
Standard Plastic Lenses:
Single Vision
Bifocal
Trifocal
Lenticular
Frames
Lens Options:
UV Coating
Tint (solid and gradient)
Standard Scratch Resistant
Standard Polycarbonate
Standard Progressive
Standard Anti-Reflection
Contact Lenses
Frequency:
Examination
Lenses or Contact Lenses
Frame
Health Net PPO (Out of Network)
Postdoctoral Scholar Allowance
$0 Copay
Up to $40
$10 Copay
$10 Copay
$10 Copay
$10 Copay
$0 Copay, $120 retail allowance
for any frame plus 20% off
balance over allowance
Up to $40
Up to $60
Up to $80
Up to $80
Up to $45
$12
$12
$15
$35
$45
$45
$105 Allowance
N/A
N/A
N/A
N/A
N/A
N/A
$105 Allowance
Once Every 12 Months
Once Every 12 Months
Once Every 24 Months
For more detailed plan design information go to : www.garnett-powers.com/postdoc/ucsf
LIFE AD&D
INSURANCE
AND
Postdoctoral Scholars’ Life Insurance
and
Accidental Death & Dismemberment (AD&D) 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.

AD&D Airbag Benefit – Provides further protection in the event of a covered
automobile accident for which an AD&D Seat Belt Benefit is payable.

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) will automatically
participate in the Life Insurance plan.
** NEW BENEFIT**
Effective January 1, 2007
Repatriation & Medical Evacuation Coverage


International Postdocs will no longer be required
to purchase supplemental coverage for their J1
Visa requirements. The PSBP Life Insurance plan
will now satisfy these requirements.
International Postdocs with dependents will be
able to purchase a separate plan, designed
specifically to satisfy the J2 Visa requirements,
through Garnett-Powers & Associates’ website at
www.garnett-powers.com/postdoc/ucsf . This
website will be available no later than November
15, 2006.
SHORT TERM
DISABILITY INSURANCE
Postdoctoral Scholars’
Short-Term Disability Plan
The Standard Insurance Company

The plan pays 60% of the first $1,667 weekly predisability earnings.

The maximum weekly benefit is $1,000 per week. This benefit is reduced
by deductible income such as workers’ compensation.

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) will
automatically participate in the STD plan.
LONG TERM
DISABILITY INSURANCE
** Open Enrollment for January 1, 2007 **
Postdoctoral Scholars’
Long-Term Disability Plan
The Standard Insurance Company

This benefit is voluntary and paid 100% by the Postdoctoral Scholar.

The Benefit Waiting Period is 180 days of disability.

The plan will pay 60% of the first $7,500 of your monthly predisability
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 benefit maximum is graded according to the Age
Discrimination Employment Act, if you are disabled after age 62.

An Employee Assistance Program (EAP) offered in partnership with
Horizon Behavioral Services includes legal and financial counseling, up to
three face-to-face assessment and counseling sessions and WorkLife
services.
Long Term Disability
Composite Rate

As of January 1, 2007 the Long Term
Disability Insurance monthly rate will be
$6.66 regardless of age or salary.
The Enrollment Process

It is important that Postdoctoral Scholars (PDS) follow the enrollment process
carefully. The process is the same whether you are enrolling for the first time
or if you are making changes during this open enrollment period (11/1/06
through 11/21/06).

Not adhering to the recommended enrollment process could result in a long
delay between the time the PDS completes the enrollment form and the time
he/she is active in the insurance carriers’ systems.

The PDS should go to the Garnett-Powers & Associates website at
www.garnett-powers.com/postdoc/ucsf and click on the “Enrollment” link.

The PDS should then click on the “PSBP Guidelines” link and print them out
for assistance with completing the enrollment form properly.

Once the guidelines are in hand, go directly to the “PSBP Enrollment Form”.
The enrollment form must be completed online before it will print out.
The Enrollment Process, continued

When the enrollment form is complete, the PDS must confirm that s/he has
read and understands the “COBRA Initial Notification” as required by federal
regulations.

The PDS will then print and sign the Enrollment Form & Beneficiary Form.

All Postdoctoral Scholars should print the Postdoc Premium / Opt Out
Worksheet and discuss the shared costs for premium payments with their
Principal Investigators. Upon completion, the PDS signs and dates this form.

Postdoctoral Scholar – Employees transitioning from title code 3370 to 3252
should print and sign the Postdoctoral Scholar Benefits Plan Acknowledgement
Form.
The Enrollment Process, continued

The Postdoctoral Scholar enrolling for the first time
must submit the following forms to the departmental
postdoc administrator:
-PSBP Enrollment/Change Form
-Life Insurance Beneficiary Form
-Postdoc Premium/Opt Out Worksheet
-UCSF Visiting Postdoctoral Scholar Benefits Plan
Acknowledgement Form (title code 3370’s transitioning to title
code 3252 only)

The Postdoctoral Scholar who is only making changes
during this open enrollment period must submit the
following form to the departmental postdoc
administrator:
-PSBP Enrollment/Change Form
The Enrollment Process, continued

The Postdoc Administrator reviews the documents for
accuracy and completeness, makes necessary changes
and completes the shaded areas. The department
retains copies of all forms in the Postdoctoral Scholar’s
file.

The Postdoc Administrator forwards the originals of all
the forms to the Postdoctoral Benefits Coordinator in
Human Resources, Box 0832 for secondary review. The
Benefits Coordinator then forwards all original forms
to Campus Payroll.

The Campus Payroll office enters all benefits
information into PPS.
The Enrollment Process, continued

ID cards will be mailed to the Postdoctoral Scholar’s
home address several weeks after the enrollment
process is complete.

If the PDS (Title Code 3252, 3253 and 3254) chooses
not to participate in the PSBP, s/he must complete the
waiver portion of the enrollment form and turn it into
the Departmental Postdoc Administrator.

All PDS (Title Code 3252, 3253 and 3254) will be
enrolled for the Short Term Disability and Life
Insurance plans.
Family Member Eligibility
Family member eligibility requirements are the same as the family
member eligibility requirements for the UC faculty/staff plans. The
major family member categories are the following:

Spouse

Natural or adopted child or children to age 23 and unmarried
(unless eligible to continue coverage because of disability)

Stepchild to age 23 if unmarried if they live with the Postdoctoral
Scholar, is supported by the Postdoctoral Scholar at more than
50% and is claimed as a tax dependent by the Postdoctoral
Scholar or spouse

Same-sex domestic partner

Opposite-sex domestic partner (per AB205)
Information Sources
GPA:
Go to the Garnett-Powers Postdoctoral Scholar Benefits Plan (PSBP) website at www.garnettpowers.com/postdoc/ucsf to view additional information regarding the PSBP and access a library of forms,
including the Enrollment/Change Form and Beneficiary form.
Postdoctoral Scholar Help Line: Postdoctoral Scholars with questions regarding benefit plans, eligibility,
enrollment, claims issues, etc. should contact the PSBP customer service staff at 800-254-1758 or e-mail
[email protected]
UCSF:
For questions regarding:
Benefit premium payments for Postdoctoral Scholar Fellows and Paid Directs: Garnett-Powers website at
http://www.garnett-powers.com/postdoc/ucsf/monthly_rates_2006.pdf or the department’s Postdoc
Administrator. The list of Postdoc Administrators is available on the Office of Postdoctoral Affairs website at
http://postdocs.ucsf.edu
Postdoctoral Scholar policies (including the new sick-leave and time-off policies), appointments, titles and title
codes: department’s Postdoc Administrator or the Graduate Division website:
http://saawww.ucsf.edu/graduate/postdoc.htm
General Postdoctoral Scholar – Employee benefits questions, problems, or issues: Garnett-Powers website at
http://www.garnett-powers.com/postdoc/ucsf or the Postdoctoral Benefits Coordinator at (415) 476-8093.
UC Savings Plans (i.e. DCP, 403(b), 457(b): Fidelity Investments Tax-Exempt Services Company at either
1-866-682-7787 or http://netbenefits.fidelity.com