BENEFITS/OPEN ENROLLMENT

Changes and Choices: Comparing Some of the Options

This week, the Benefits Open Enrollment planning meetings begin (see full schedule in Almanac April 8, or refer to the "Your Guide to Open Enrollment" flyer mailed around campus last week). Please bring to those meetings the materials sent to homes under the "PennChoice" name. Having the material close at hand will help in making informed choices as to Benefits options.

Several changes are in effect this year, and this is a summary of the changes that will be made in the University of Pennsylvania's Medical and Life Insurance Benefits Programs effective July 1, 1997. Overall, the Programs will offer flexibility and choice, take advantage of current tax laws, and compare favorably with programs offered by other employers.

If you have any questions about PennChoice, contact the following:: PennChoice Hotline (April 28 to May 7): (215) 898-0852; Benefits Office: (215) 898-7282; Medical School Benefits Office: (215) 898-7993; Clinical Practices of the U. of P. Office: (215) 349-5435

Following are changes in medical coverage and life insurance that take effect July 1.

Medical options will change, as follows:

a new option--the UPHS/Keystone Point of Service Plan--will be introduced
both the Keystone and US Healthcare HMOs will provide prescription drug coverage for the first time
employee cost sharing will be reintroduced
the BC/BS Comprehensive Plan and the QualMed HMO will no longer be offered, and
new financial incentives will be added in the form of lower copays, to encourage plan participants to use UPHS participating physicians.

Life Insurance Flexcredits--which are based on your age and benefits base salary --will no longer be part of the Program. However, the increase in benefits base salary described next, will make up for this change. (This will not apply to employees in collective bargaining units.)

Benefits Base Salary--if you are actively at work on July 1, 1997 and eligible for PennChoice, you will receive a one-time increase in benefits base salary. The amount of the increase will equal the net dollar value of the difference between the Flexcredits you would have otherwise received and the cost of the basic insurance described below.

Life Insurance--will be redesigned. All employees will receive Basic Life Insurance coverage of up to one times benefits base salary up to $300,000. In addition, employees who want or need more financial protection will be able to purchase Optional Life Insurance coverage. What is more, maximum insurance will be increased from $300,000 to $750,000.

Dependent Life Insurance--if you purchase life insurance for your spouse or eligible children, your premiums will now be paid on an after-tax basis; that way, you will not incur any imputed income.

Medical

Employee Cost Sharing--Effective July 1, 1997, all employees will contribute toward the cost of their medical coverage. Up to now, the University has based employee contributions on the cost of Blue Cross/Blue Shield Plan 100 (the costliest option). As the cost of that plan rose, employee contributions for other, more cost-effective options decreased.

Now, all employees will share the cost of the option they elect. The University will continue to pay the majority of the cost.

The contribution rates for each of the available options are shown here.

Keep in mind that your contributions will be made with before-tax dollars,which provide valuable tax-savings and lower your net cost.

					Monthly Contribution For
                         	     Single           Family                
Option                    	Coverage     	Coverage

BC/BS Plan 100               		$ 66          	$ 172     
PENNCare PPO               		$ 40          	$ 104     
UPHS/Keystone Point of Service     	$ 20          	$  52     
Keystone HMO               		$ 10          	$  26     
US Healthcare HMO          		$ 10          	$  26     
HIP Health Plan of NJ          		$ 10          	$  26

Options Discontinued: The BC/BS Comprehensive option and the QualMed HMO option will no longer be available. However, similar benefits will be available under other options. If you are currently enrolled in either of these options, you must choose a new medical plan during the open enrollment period.

Options Continued: BC/BS Plan 100 and PENNCare PPO will continue unchanged, except for employee contributions.

Options Expanded: The Keystone and US Healthcare HMOs will be improved through two new features:

New Prescription Drug Coverage--Both the Keystone and US Healthcare HMOs will offer prescription drug benefits through PCS Health System, Inc. Pharmacies affiliated with PCS include all major pharmacy chains (CVS, Drug Emporium, Eckerd Drug, KMart, Pathmark, Rite-Aid, Thrift Drug and Wal-Mart). If you use your PCS ID card at a participating pharmacy, you pay 20% of the covered amount (50% for mental health related prescriptions).
There is a $25 individual annual deductible and a $50 family deductible. There is also a $5 minimum for each brand name prescription you purchase. If you do not use your PCS ID card or go to a non-participating pharmacy, you will pay more.
Incentives for Using UPHS Providers--If your Keystone or US Healthcare primary care physician is also part of the UPHS network, your copayment for office visits will be less.

New Options: You will also have the added opportunity to elect the new UPHS/Keystone Point of Service (POS) option. This option offers flexibility and freedom of choice. You can choose between Referred Care and Self-Referred Care whenever you need medical treatment. Referred Care is care provided by your primary care physician.

For Referred Care, benefit levels are high--most eligible expenses are covered at 100% after you make a small copayment for doctors' office visits. If your Keystone primary care physician is also part of the UPHS

Network, your copayment will be even lower. If you choose Self-Referred Care, benefits are generally 80% after a $200 individual, annual deductible.

Life Insurance

Life Insurance coverage will be redesigned. All employees will automatically receive basic, non-contributory coverage up to one times benefits base salary--up to a maximum of $300,000. Additional, contributory coverage of another one to four times benefits base salary will continue to be available to employees who want or need more financial protection (subject to last year's coverage). The maximum for non-contributory and contributory coverage combined will be $750,000. Coverage in excess of $500,000 is subject to evidence of insurability.

If you purchase contributory life insurance coverage, your contributions will be made with after-tax dollars. That way, you will not incur any imputed income which is subject to income taxes.

-- Human Resources/Benefits

Six Addenda to the Booklet

In the "PennChoice" Open Enrollment booklet mailed to homes last week, there are six important addenda; the new information is shown in italics below:

Page 4, under "PENNCare Preferred Providers" column

Skilled Nursing Facility: covered at 100% (replacing "Non-Preferred benefits apply")

Durable Medical Equipment: covered at 100% (replacing "None")

Page 5, under the "PENNCare Non-Preferred Providers" column

Hospitalization: covered at 80% after deductible (replacing 100%)

Page 5, under the "UPHS/Keystone Point of Service (POS)" column

Preventive Care, routine eye exam: covered at 100% after $10 copay (replacing "Provider not currently available")
Skilled Nursing Facility: covered at 100% (replacing "Provider not currently available")

Page 6, column 2, paragraph 2, last "bulleted" item: should read "selected physicians from Presbyterian Hospital and the Chestnut Hill Health System."

For any questions about the above material, please contact Human Resources Benefits, 898-7282.

Almanac

Volume 43 Number 30
April 15, 1997

Return to Almanac's homepage.

Return to index for this issue.