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From Human Resources
March 23, 2010, Volume 56, No. 26

Benefits Open Enrollment 2010-2011

Monday, April 5–Friday, April 16

Benefits Open Enrollment, your annual opportunity to make changes to your healthcare elections, is almost here! Even if you’re satisfied with your current healthcare coverage, it’s important to understand what changes are being made for the upcoming plan year. And don’t miss the opportunity to find out what Penn’s other plans have to offer. Open Enrollment runs from Monday, April 5 through midnight on Friday, April 16. You should receive a personalized enrollment packet at your home address in early April. Visit the Human Resources website at www.hr.upenn.edu for more details about Open Enrollment.

How Do I Make Changes During Benefits Open Enrollment?

You can make changes to your benefits coverage 24 hours a day, 7 days a week online at www.pennbenefits.upenn.edu. Once you provide your PennKey and password, the online system will walk you through the enrollment process step-by-step. If you don’t have online access or are having problems enrolling online, contact the Penn Benefits Center at 1–888–PENN–BEN (1–888–736–6236), Monday–Friday between 8 a.m. and 6 p.m.

Keep in mind if you’re newly eligible for benefits or making changes to your current plan year elections between now and May 15, 2010, you’ll need to enroll twice: once to newly elect or change your benefits for the current plan year (through June 30), and then again to elect your coverage for the next plan year (starting July 1). Be sure to follow the instructions completely when you log on to enroll.

What Can I Change During Benefits Open Enrollment?

From April 5–April 16, you can make any changes you’d like to your benefits coverage, such as:

• Enroll in a healthcare plan for the first time, or drop an existing plan

• Switch to a new or different medical or dental plan

• Increase or decrease your life insurance coverage

• Change how much you contribute to a Pre-Tax Expense Account

• Add or drop a dependent from your benefits coverage*

*If you add a new dependent or re-enroll a dependent who was previously covered, you will receive a letter requesting that you provide verification of that dependent’s eligibility under Penn’s plan rules.

When Will Changes Be Effective?

Any changes made during Benefits Open Enrollment will be effective as of July 1, 2010. Outside of Open Enrollment, you may only modify your elections when you experience a life event change—such as marriage or the birth of a child—and even then, the IRS limits the types of changes you are allowed to make.

What Happens if I Don’t Make Changes to My Benefits Coverage During Open Enrollment?

If you don’t make changes to your benefits coverage by April 16:

• Your current coverage will continue into the new plan year (July 1, 2010–June 30, 2011). All plan changes will take effect on July 1, 2010.

• New rates for your existing medical, dental and vision plans will be reflected in your June paycheck.

• If you’re covering a dependent child age 19–23, his/her coverage will end as of July 1 unless you actively certify his/her status as a full-time college student during Benefits Open Enrollment. This certification must be done every year, either online or by calling the Penn Benefits Center.*

*There are two parts to the student certification process. Once you’ve declared your child’s status during Open Enrollment, you’ve completed Part I. In late summer/early fall, you’ll receive a communication requesting paperwork to verify your child’s student status; this is Part II. You must complete both parts of the process (certify during Open Enrollment and submit verification of student status when requested) in order to maintain coverage for your child.

Premium Assistance through Medicaid and CHIP

If you’re unable to afford the premiums for Penn’s coverage, you may be able to get free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). For more information, visit the Division of Human Resources website at www.hr.upenn.edu/Benefits/Medical.

How Do I Find Out More?

• Attend a Benefits Open Enrollment Fair

• Visit the Human Resources website at www.hr.upenn.edu

• Call the Penn Benefits Center at 1–888–PENN–BEN (1–888–736–6236), Monday–Friday, 8 a.m.–6 p.m.

• Look for your personalized Benefits Open Enrollment packet at your home address in early April.

• E-mail Human Resources at askhr@hr.upenn.edu.

What’s Changing as of July 1, 2010?

As the global financial crisis continues, the road to full economic recovery remains uncertain. Throughout this period, the Penn community has pulled together as a team to keep the University moving forward and focused on our goals. In the Division of Human Resources, we continue to seek out ways to contain costs yet maintain our competitive benefits. We realize this is a difficult time for many of you financially, and Penn has made every effort to mitigate the premium increases for our health plans this year. To do this, we had to make some plan design changes that may cost you more out of your pocket in deductibles, copays, and coinsurance amounts. The good news is, we’re also making some changes that may save you money! All of the changes that will be made as of July 1, 2010 are listed here. As you review them, please keep in mind that you can take advantage of the Health Care Pre-Tax Expense Account to pay for eligible out-of-pocket expenses with pre-tax dollars. This is a great way to save money and reduce your taxes.

Medical Plans

A number of changes will be made to the medical plans as of July 1. These changes are described below.

Premiums: A premium is the amount an insurance carrier charges for benefits coverage. Penn pays a significant portion of the premium costs. The portion you’re responsible for is deducted from your paycheck each week or month.

All medical plans

• Penn continues to pay the majority of the premium costs for medical, mental health and prescription drug coverage.

Copays and Coinsurance: A copay is the flat dollar amount you pay for certain services such as doctor visits. You only pay a copay on services that are otherwise covered at 100%. If services aren’t covered at 100%, you pay a coinsuranceamount, which is the portion of covered medical bills that you pay once your annual deductible is satisfied.

Keystone/AmeriHealth HMO and Aetna HMO

• You’ll pay higher copays for most services.

UPHS POS and PENNCare/Personal Choice PPO

• You’ll pay higher copays and coinsurance amounts for most services.

Deductibles and Out-of-Pocket Maximums: A deductible is the dollar amount you must pay each plan year before the plan begins to pay benefits. An out-of-pocket maximum is the highest amount you’re responsible for paying out of your own pocket for eligible medical expenses each year (not including what comes out of your paycheck). If your out-of-pocket costs reach the maximum during a plan year, your eligible medical costs are covered at 100% for the rest of that plan year. For the HMO plans, the out-of-pocket maximum applies only to copays since you don’t pay a deductible or coinsurance on any services in those plans. For the UPHS POS and PENNCare/Personal Choice PPO plans, you have a copay maximum and a separate coinsurance/deductible maximum.

Keystone/AmeriHealth HMO

• No changes.

Aetna HMO

• You’ll now have a copay maximum.


• You’ll pay a higher deductible for services in the Keystone/AmeriHealth network and out-of-network.

• Your copay maximum for the UPHS network will be lowered.

• Your coinsurance maximum will be increased for the Keystone/AmeriHealth network and out-of-network.

PENNCare/Personal Choice PPO

• You’ll now have a copay maximum for the PENNCare and Personal Choice networks.

• Your coinsurance maximum will be increased for out-of-network.

Self-Injectable Drugs

As of July 1, coverage for most self-injectable drugs will go through CVS Caremark instead of your medical carrier. A self-injectable drug is a prescription drug that’s delivered into a muscle or under the skin with a syringe and needle. Although medical supervision or instruction may be needed in the beginning, the patient or caregiver can administer self-injectable drugs safely and effectively. If you’re currently taking a self-injectable drug and it’s being covered through your medical plan, you’ll receive detailed information about the change from CVS Caremark and your medical carrier. For more information on CVS Caremark Specialty Pharmacy, please call 1-800-237-2767 or visit www.caremark.com.
Mental Health and Substance Abuse Coverage

As of July 1, all of Penn’s medical plans will cover mental health and substance abuse benefits at the same level as medical and surgical bene fits. You’ll pay the same copays and coinsurance amounts as you do for medical and surgical coverage, and your mental health and substance abuse costs will count toward your medical plan’s deductible and out-of-pocket maximums. One of the biggest advantages of this change is that mental health and substance abuse benefits will no longer be restricted to a certain number of days or visits per year—in other words, days and visits will be unlimited. These changes are described below.

All medical plans

• You’ll have coverage for unlimited inpatient days and outpatient visits per year, subject to medical necessity.

• Your mental health and substance abuse costs will count toward your medical plan’s annual out-of-pocket maximum.

• You’ll pay higher copays for inpatient admissions and outpatient visits.

Additional changes for UPHS POS and PENNCare/Personal Choice PPO plans

• If you receive out-of-network care in these plans, you’ll have to meet a deductible and pay a higher coinsurance amount. In addition, your benefits will be limited to a lifetime maximum.

Maintenance Drugs: Use CVS Pharmacies or Mail Order to Pay Less

In the new plan year, you’ll pay more for maintenance medications if you choose to obtain them at a non-CVS retail pharmacy instead of using a CVS pharmacy or the mail order program. Maintenance medications are drugs you take regularly for an ongoing condition, such as diabetes, high blood pressure and asthma. It’s important to note:

You’ll pay double the minimum and maximum copays if you go to a non-CVS retail pharmacy. You’ll still have the option to obtain your maintenance drugs either at a retail pharmacy or via mail order. However, if you pick up your maintenance medication at a non-CVS retail pharmacy each month, you’ll pay double the minimum and maximum copays. If you go to a CVS pharmacy or use the mail order service, you’ll continue paying the current minimum and maximum copay amounts. 

You’ll have three months to make the switch to a CVS pharmacy or to mail order. If you’re currently taking a maintenance medication, you’ll have three months from July 1 to start going to a CVS pharmacy or receiving it via mail order in order to keep paying the current copays. If you start taking one after July 1, you’ll have three months from the time you start taking it. Once those three months are up, if you go to a non-CVS retail pharmacy for your prescription, you’ll pay double the normal minimum and maximum copay amounts.

You’ll be able to pick up your mail order supply at your local CVS pharmacy. As an added convenience, you can either choose to have your mail-ordered maintenance medications delivered to your home or you can pick them up at any CVS pharmacy.

This only applies to maintenance drugs. If you’re taking a medication that’s non-maintenance, you’ll continue to pay the current minimum and maximum copay amounts at any retail pharmacy.

Extended Coverage for Student Dependents on Medically Necessary Leave of Absence

If you’re covering a child between the age of 19 and 23 who is a full-time student, a new law (Michelle’s Law) provides that your child will continue to be covered under your insurance plan if he/she needs to take a medically necessary leave of absence from school. Assuming other eligibility requirements are satisfied, coverage for the child will continue for one year after the leave begins or until coverage would otherwise end (e.g., the child reaches the maximum age for full-time student coverage), whichever comes first.

Benefits Open Enrollment and Health Fair

April 13; 10 a.m.-2 p.m.; Houston Hall

Ask questions about your coverage and gather information at the Benefits Open Enrollment and Health Fair. Representatives from Penn’s healthcare providers and administrators will be onsite to share information about medical plans (Independence Blue Cross, Aetna), prescription drug coverage (CVS Caremark), vision coverage (Davis Vision), dental plans (Penn Faculty Practice, MetLife), pre-tax expense accounts (ADP) and the Penn Benefits Center (ADP). Penn’s retirement vendors—TIAA-CREF and Vanguard—will also be onsite to answer questions and provide information about retirement plans.

While at the fair, take advantage of free health screenings and wellness information on several topics, including blood pressure, cholesterol, glaucoma, Body Mass Index, recreation and fitness, women’s health, environmental safety and ergonomics, Employee Assistance Program, occupational and physical therapy, diabetes and heart health, oral and dental care and more. Pre-registration will be required for the cholesterol tests. To pre-register, visit the Human Resources online course catalog at www.hr.upenn.edu (click on “Course Catalog” at the top of the screen, then select “Health Promotions” from the “Browse by Category” menu).

New Bolton Center Benefits Open Enrollment Fair

Representatives from Penn’s healthcare providers and administrators will also be available to answer your questions at the New Bolton Center Benefits Open Enrollment Fair on April 14, from 10 a.m.–2 p.m. in Alumni Hall.

Campus Locations for Online Enrollment

If you don’t have internet access at home or at work, don’t worry—you can log on to manage your benefits at one of these convenient locations:

Goldstein Undergraduate Study Center
3420 Walnut Street
Ground level of Van Pelt-Dietrich Library
Monday–Thursday: 24 hours daily
Friday: 8:30 a.m.–midnight
Saturday: 10 a.m.–2 a.m.
Sunday: opens 10 a.m.

Human Resources
3401 Walnut Street
5th Floor
Monday–Friday: 8:30 a.m.–5 p.m.

Unique Advantage
3624 Market Street, Suite 1SD
Monday–Friday: 8:30 a.m.–5:30 p.m.

Healthcare Rates for 2010–2011

While it’s no surprise that healthcare costs are rising this year, Penn continues to pay a significant portion of the premium costs for benefits coverage. The new premium rates will take effect with your first June paycheck. Keep in mind that both the University and you pre-pay healthcare premiums one month in advance, so your June deductions pay for your July healthcare coverage.

—Division of Human Resources

Healthcare Rates for 2010–2011


Full-time Weekly Paid
(per pay period)

Full-time Monthly Paid
(per pay period)



Employee + 1

Employee + 2 or more


Employee + 1

Employee + 2 or more


PENNCare/Personal Choice







UPHS POS (administered by Keystone/AmeriHealth)







Keystone/AmeriHealth HMO







Aetna HMO








Penn Faculty Practice Plan







MetLife Dental








Davis Vision









Almanac - March 23, 2010, Volume 56, No. 26