The annual 1996-97 Pennflex Open Enrollment period begins April 8. This is the time to review your Pennflex plan selections, learn about plan changes and alternate options, and choose the benefits coverages you will have during the 1996-97 Plan Year, which begins July 1.
Important Open Enrollment Dates: April 8 - April 19
How To Obtain Additional Information/Assistance:
What You Need to Do:
Once again, your completed enrollment form(s) must be submitted to the Benefits Office by April 19, 1996. The Benefits Office staff is happy to answer your questions or to assist you with the enrollment process.
-- Albert Johnson, Acting Manager, Benefits Office
-- Fina Maniaci, Acting Manager, Benefits Office
Tuesday, April 9
Benefits Question & Answer Session, New Bolton Center, 11 a.m.-2 p.m. Stop in to speak with medical and dental plan representatives. Members of the Benefits staff will also be available to answer questions, help with Pennflex enrollment form(s) and accept your completed Pennflex forms.
Quick and Healthy Meals for Working Families, Room 305, Houston Hall, 1-2 p.m. (light refreshments). Do you find it challenging to make healthy choices for your family when you're working and eating on the run? Learn about how to prepare quick, healthy meals even if you do not have time to plan. Lisa Hark, director, Nutrition Education and Prevention, School of Medicine.
Wednesday, April 10
Benefits Fair, Alumni Hall, Faculty Club, 10:30 a.m.-2:30 p.m.
Thursday, April 11
Life in the Stressed Lane, Smith-Penniman Room, Houston Hall, noon-1 p.m. (light refreshments). A few scientists believe research is suggesting that stress may be a contributing risk factor for cardiovascular disease. Research suggests that chronic stress may be associated with increased blood pressure and cholesterol. Although we live in a fast-paced, high stress culture, people can do things to reduce the negative impact of stress on their physical, emotional and mental health. The contents of this seminar has been developed by the American Heart Association. (Greater Atlantic Health Service/QualMed Plans for Health)
Friday, April 12
Fitness Tips, Smith-Penniman Room, Houston Hall, noon-1 p.m. (light refreshments). Armand Tecco, a certified physiologist, will speak about starting and maintaining a qualified fitness program. He will offer fitness tips and answers to most commonly asked questions. There will be time available for questions and answers. (U.S. Healthcare)
Monday, April 15
Campus Walking Route, The Button (in front of Van Pelt Library), noon-1 p.m. Put on your walking shoes and try out a one-mile walk around the campus. Benefits Staff
Utilizing your medical benefits, Room 245, Houston Hall, 1-2 p.m. (light refreshments). Members of the Benefits Staff will be available to answer questions on the difference between the various medical plans and on how to get the most out of your coverage.
They will address the following issues:
Tuesday, April 16
Social Security & Medicare, Smith-Penniman Room, Houston Hall, noon-1 p.m. (light refreshments). This program will answer the "Who, What, When and How" questions on Social Security and Medicare.
Wednesday, April 17
Benefits Question & Answer Session, Dunlop Lobby, Stemmler Hall, 11 a.m.-2 p.m. Stop in to speak with medical and dental plan representatives and members of the Benefits Staff.
Benefits Update, Smith-Penniman Room, Houston Hall, noon-1 p.m. (light refreshments). Come learn about prescription drug benefits through PCS. What pharmacies are affiliated, how to process claim forms, and information about the Mail Service Program. PCS Representative & Benefits Staff
Thursday, April 18
Benefits Question & Answer Session, Dental School Lobby, 11 a.m.-2 p.m. This is the last Benefits Q & A session during Open Enrollment. The medical and dental plan representatives will be available to answer your questions along with the Benefits Staff.
How Does Your Health Measure Up? Smith-Penniman Room, Houston Hall, noon-1p.m. (light refreshments) The Health Lifestyle Appraisal Survey is aimed at improving the quality of your life by evaluating your present health status and making suggestions for the future. Bring your completed Health Lifestyle Appraisal survey to this session. Within seconds, you'll receive a confidential personalized assessment report of your health risk. (Independence Blue Cross/Pennsylvania Blue Shield)
Friday, April 19
Open Enrollment Ends
This is the last day to submit Open Enrollment forms. The coverages you elect will be effective July 1, 1996.
Balancing Your "Fat" Budget, Smith-Penniman Room, Houston Hall, noon-1 p.m. (light refreshments). Fat is a very important part of our diet. We need a certain amount of it to be healthy. However, the problem is that too many Americans consume much more fat than is needed, therefore increasing their risk for certain diseases. This program focuses on the relationship between a high-fat diet and many disease states, particularly heart disease and obesity. Learn to balance high and low-fat foods to develop a low-fat diet based on individual food preferences. (Keystone Health Plan East)
The Chart reproduced (in the print version of this issue of Almanac is too large to display here); it appears on pages 20 and 21 of the 1996-97 PENNFLEX brochure (mailed to Penn employees). The PENN Care column (Pennflex option 11) shown (in Almanac) has been modified to reflect more current information on the affiliation of the Presbyterian Medical Center with UPHS. In addition, this chart (available during Open Enrollment) reflects a correction. For the Plan Features: Mental Outpatient: Physician, under the Preferred Provider column of the PENN Care (option 11) the correct percent is 80% UCR and not 50% UCR.
PFPP Prudential PENNFLEX OPTION 1 2
Service or Treatment % Paid % Paid
Diagnostics (exams, x-rays) 100% 100% R&C* Preventive (teeth cleaning) 100% 2 visits/plan year, (7/1-6/30) reimbursements limited Restorative (fillings) 100% 90% R&C* Oral Surgery (extractions) 100% 100% R&C* (NOTE: Some oral surgery may be covered under your medical plan.) Endodontics (root canal therapy) 90% 80% R&C* Periodontics (gum disorders) 90% 80% R&C* Prosthodontics (bridges, false teeth) 60% 50% R&C* Crowns and Restorations 60% 50% R&C* (gold crowns, restorations, caps) Orthodontics** 60% 50% up to $1,000 lifetime (teeth straightening, maximum per person R&C* children under age 19 only) Plan Year Benefits Maximum none $1000 per person
* R&C--A Reasonable & Customary charge is the charge usually made by the provider when there is no dental coverage and which does not exceed the prevailing charge in the area for dental care of a comparable nature, by a person of similar training and experience.
** Note that if you change from one dental assistance plan to the other, certain treatments that have already begun under the first plan will continue to be covered by that plan. However, for orthodontia treatment, if banding has begun prior to July, 1996, and if you change plans, neither the new plan nor the old plan will provide coverage for the remaining expenses. For the Penn Faculty Practice Plan: There is a 24-month waiting period for orthodontic services if a dependent age 5 or older is not enrolled within the initial 31-day enrollment period.
Since July 1, 1995, prescription drug benefits available under the Blue Cross plans and PENN Care--including those associated with drugs dispensed and billed separately during a doctor's visit--are no longer being provided by Blue Cross. See pages 14 and 15 of your PENNFLEX brochure for more information about the prescription drug benefits, PCS administrative changes and exclusions.
Effective July 1, 1996, for the Comprehensive Plan and PENN Care, a separate $500 annual out-of-pocket maximum per individual ($1,500 aggregate per family) applies to prescription drug benefits. For the Blue Cross Plan 100, the out-of-pocket remains combined with the Major Medical's $2,000 out-of pocket per individual per plan year.
A minimum $5 copay per prescription will be required for brand-name drugs covered through PCS.
Coverage for same-sex domestic partners is now available under all medical plans, including the BlueCross Plan 100.
Blue Cross plans including PENN Care do not provide benefits for spinal manipulation.
Effective July 1, 1996, benefits will be provided for Occupational and Speech Therapy under the Blue Cross Plans and PENN Care. (The continuation of these benefits is subject to review in 1997.)
April 2, 1996
Volume 42 Number 26
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