Transcript University of California PSBP New Postdoc Orientation
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?
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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.
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If you enroll through the GPA hosted PSBP website, Health Net will automatically assign you to a PCP.
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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.
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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.
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You can choose a PCP for each family member, or change the PCP assigned to you by calling Health Net.
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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.
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There is no Out-of-Network benefit (except in the case of an emergency).
PSBP Medical HMO Plan Health Net of California
Medical Benefits 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: Health Net HMO Postdoctoral Scholar Pays $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?
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When covered under a PPO plan, there is no need to be assigned a Primary Care Physician.
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There is an In-Network and Out-of-Network component.
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You have the flexibility to see a doctor without a referral either in network or out-of-network.
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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.
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The In-Network benefit coverage (deductible, coinsurance, etc.) will be greater than the Out-of-Network benefit coverage.
Medical Benefits
PSBP Medical PPO Plan Health Net of California
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 $250 Copay then 20% $0 Copay $250 Copay then 20% $10 Copay $25 Copay $35 Copay 20% $20 Copay $250 Copay then 20% $0 Copay $1,500 Individual $4,500 Family None None Unlimited *Out of Network reimbursement based on limited fee schedule.
40% $250 Copay then 40% 40% $250 Copay then 40% 50% + $10 Copay 50% + $25 Copay 50% + $35 Copay 40% 40% $250 Copay then 40% 40% $1,500 Individual $4,500 Family $200 $600
Wellness Programs
The following benefits are included in your Health Net medical plan:
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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.
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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.
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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.
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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.
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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.
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To access detailed information about these valuable programs, go to www.garnett-powers.com/postdoc/wellness
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DENTAL INSURANCE
PSBP Dental DHMO Plan Health Net of California
Dental Benefits Health Net DHMO Postdoctoral Scholar Pays None Deductible: Diagnostic and Preventative Care: Routine Oral Exams Routine Teeth Cleanings Routine X-Rays No charge No charge No charge Basic Procedures: Fillings Oral Surgery Endodontics Periodontics Major Procedures: Crowns Orthodontics: Comprehensive Treatment- Child Comprehensive Treatment- Adult Annual Maximum: Varies up to $80 copay Varies up to $130 copay Varies up to $150 copay Varies up to $300 copay Varies up to $200 copay $1,950 copay plus start-up fees and retention $2,250 copay plus start-up fees and retention Unlimited
What is a POS Plan?
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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.
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The POS plan offers more flexibility than the HMO plan resulting in the out-of-pocket costs being a bit higher.
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There are two In-Network options: An Exclusive Provider Organization (EPO) and a Preferred Provider Organization (PPO).
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There is also an Out-of-Network option. You will pay less for services if an In-Network provider is used.
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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.
Calendar Year Deductible:
PSBP Dental POS Plan Principal Financial Group
Principal EPO/PPO (In-Network) Postdoctoral Scholar Pays None Principal PPO (Out-of-Network) Postdoctoral Scholar Pays $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 Major Procedures: Crowns Bridgework Dentures Complex Oral Surgery Orthodontia (Adult and Child): $1,000 Lifetime Maximum 10% 10% 10% 10% 50% 50% 50% 50% 50% 20% of the scheduled allowance, after the deductible is met, plus the amount of the dentist’s fee that exceeds Principal’s scheduled allowance 50% of the scheduled allowance, after the deductible is met, plus the amount of the dentist’s fee that exceeds Principal’s scheduled allowance 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 Frames: Lens Options: UV Coating Tint (solid and gradient) Standard Scratch Resistant Standard Progressive Conventional Contact Lenses: Frequency: Examination Lenses or Contact Lenses Frame $10 Copay $10 Copay $10 Copay $10 Copay $0 Copay, $120 retail allowance for any frame, plus 20% off balance over allowance $15 $15 $15 $45 $105 allowance toward contacts, plus 15% discount off balance over allowance Once Every 12 Months Once Every 12 Months Once Every 24 Months Up to $40 Up to $60 Up to $80 Up to $80 Up to $45 N/A N/A N/A N/A Up to $105
LIFE
and
AD&D INSURANCE
PSBP Life Insurance and Accidental Death & Dismemberment Plan The Standard Insurance Company
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The plan pays $50,000 in the event of a death.
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The plan pays an additional $50,000 in the event of an Accidental Death.
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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.
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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.
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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
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The plan will pay 70% of the first $1,429 weekly pre-disability earnings.
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The maximum weekly benefit is $1,000 per week.
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The minimum benefit is $25.00.
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The benefit waiting period is 0 days for disability caused by an accidental injury and 7 days for disability caused by sickness or pregnancy.
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The maximum benefit period is 180 days.
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The plan covers non-occupational disability only.
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All Postdoctoral Scholars (Title Code 3252, 3253 and 3254) are automatically enrolled in the STD plan.
Repatriation & Medical Evacuation Coverage
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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.
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International Postdocs and their dependents are not required to purchase supplemental coverage for their J1 and J2 Visa requirements.
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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
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This benefit is voluntary and is paid 100% by the Postdoctoral Scholar.
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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.
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The Benefit Waiting Period is 180 days of disability. This program starts when the Short Term Disability ends.
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The plan will pay 60% of the first $7,500 of your monthly pre-disability earnings.
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The maximum monthly benefit is $4,500. This benefit is reduced by deductible income such as workers’ compensation.
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Once approved, benefits are payable each month while you are disabled, up to age 65.
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The monthly premium for the Long-Term Disability Insurance is $7.95 for Plan Year 2014.
Bright Horizons
Bright Horizons
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This program offers you access to babysitters, mother’s helpers, pet sitters, dog walkers, senior companions, tutors and several other types of helpful services.
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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
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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.
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You have access to profiles and reviews of caregivers.
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Checking caregivers’ references is made simple.
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You may view background checks for the candidates you prefer.
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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
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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.
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First, click on the ‘Enrollment’ section of the PSBP website.
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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.
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If you answered ‘No’ to the questions that are asked, you can use the UC AtYourServiceOnline (AYSO)website to enroll.
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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.
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First, please print out the Enrollment Form Instructions. These will assist you in efficiently completing the online form.
THE ENROLLMENT PROCESS, Cont.
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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.
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Please always make sure that you keep a copy of the enrollment form for your own records as well.
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It may take up to 6 weeks for your information to reach the carriers due to the timing of your enrollment.
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If you need to seek services during this time, please contact the PSBP Customer Service Representative listed at the bottom of each website page.
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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
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Postdoc Only
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Postdoc + Spouse or Domestic Partner
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Postdoc + Child(ren)
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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
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Postdoc Only
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Postdoc + Spouse or Domestic Partner
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Postdoc + Child(ren)
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Postdoc + Spouse + Child(ren) Monthly Contribution $20.00
$40.00
$40.00
$60.00
THE COLLECTION PROCESS
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Postdoctoral Scholars with sufficient funds, have their contributions deducted from their checks via the payroll system.
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Postdoctoral Scholars with insufficient funds, have their contributions collected via invoice through GPA.
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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.