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UC San Francisco

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.

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UC San Francisco

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  1. UC San Francisco Postdoctoral Scholar Benefits Plan Open Enrollment (November 1, 2006 through November 21, 2006) Effective January 1, 2007

  2. Agenda • Introduction • Postdoc Titles and Title Codes • Review of Benefits & Plan Designs • Review of the Enrollment Process • Q & A

  3. IntroductionThe 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.

  4. Postdoc Title CodesThe 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” (titlecode 3254).

  5. 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).

  6. 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

  7. MEDICALINSURANCE

  8. 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 In-Patient 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.

  9. 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

  10. Postdoctoral Scholars’ Medical HMO PlanHealth Net of CaliforniaMedical BenefitsHealth Net HMOPostdoctoral Scholar PaysPhysician Office Visit$10 CopayHospitalization:Inpatient No Charge Outpatient No Charge Pregnancy No ChargePrescription Drugs:Generic $10 Copay Brand Name $20 Copay Non-Formulary $35 CopayEmergency Room Visits$35 Copay (waived if admitted)Health Evaluation$10 CopayMental Health (Non-AB88):Outpatient $30 Copay (20 visits per calendar year) Inpatient No Charge (30 days per calendar year)Annual Maximum Out of Pocket:Individual $1,500 Family $4,500Deductible:Individual None Family NoneLifetime MaximumUnlimitedFor more detailed plan design information go to: www.garnett-powers.com/postdoc/ucsf

  11. Postdoctoral Scholars’ Medical PPO PlanHealth Net of CaliforniaMedical Benefits Health Net PPO (In-Network) Health Net PPO (Out of Network)Postdoctoral Scholar PaysPostdoctoral Scholar PaysPhysician Office Visit $20 Copay 40%Hospitalization: Inpatient $250 Copay then 20% $250 Copay then 40% Outpatient 20% 40% Pregnancy $250 Copay then 20% $250 Copay then 40%Prescription Drugs: Generic $10 Copay 50% + $10 Copay Brand Name $25 Copay 50% + $25 Copay Non-Formulary $35 Copay 50% + $35 CopayEmergency Room Visits 20% 40%Routine Physical Exam $20 Copay 40%Mental Health (Non-AB88): Outpatient Amount over the $75 allowance (20 visit max.) Inpatient 20%- 30 days per year 20%-30 days per yearAnnual Maximum Out of Pocket $1,500 Individual $1,500 Individual(Does not include deductible) $4,500 Family $4,500 FamilyDeductible: Individual None $200 Family None $600Lifetime Maximum $1,000,000For more detailed plan design information go to: www.garnett-powers.com/postdoc/ucsf

  12. DENTALINSURANCE

  13. Postdoctoral Scholars’ Dental PPO PlanPrincipal Financial GroupAnnual Maximum $1,500  Principal PPO (In-Network) Principal PPO (Out-of-Network)Postdoctoral Scholar PaysPostdoctoral Scholar PaysCalendar Year Deductible None $50 per person, waived for Diagnostic and Preventative CareDiagnostic and Preventative CareRoutine Exams No charge The amount that the dentist’sRoutine Teeth Cleanings No charge fee exceeds Principal’s Routine X-Rays No charge scheduled allowanceBasic ProceduresFillings 10% 20% of the scheduled allowance,Endodontics 10% after the deductible is met, plus Non-Surgical Periodontics 10% the amount of the dentist’s fee Simple Oral Surgery 10% exceeds Principal’s allowanceMajor ProceduresCrowns 50% 50% of the scheduled allowance,Bridgework 50% after the deductible is met, plus the Dentures 50% amount of the dentist’s fee that Complex Oral Surgery 50% exceeds Principal’s scheduleOrthodontia$1,000 Lifetime Maximum 50% 50% of the scheduled allowance, after the deductible is met, plus the amount of the dentist’s fee that exceeds Principal’s scheduled allowanceFor more detailed plan design information go to : www.garnett-powers.com/postdoc/ucsf

  14. VISIONINSURANCE

  15. Postdoctoral Scholars’ Vision PPO Plan Health Net of California Vision BenefitsHealth Net PPO (In-Network) Health Net PPO (Out of Network) Postdoctoral Scholar PaysPostdoctoral Scholar Allowance Exam with Dilation (if necessary) $0 Copay Up to $40 Standard Plastic Lenses: Single Vision $10 Copay Up to $40 Bifocal $10 Copay Up to $60 Trifocal $10 Copay Up to $80 Lenticular $10 Copay Up to $80 Frames $0 Copay, $120 retail allowance Up to $45 for any frame plus 20% off balance over allowance Lens Options: UV Coating $12 N/A Tint (solid and gradient) $12 N/A Standard Scratch Resistant $15 N/A Standard Polycarbonate $35 N/A Standard Progressive $45 N/A Standard Anti-Reflection $45 N/A Contact Lenses $105 Allowance $105 Allowance Frequency: Examination Once Every 12 Months Lenses or Contact Lenses Once Every 12 Months Frame Once Every 24 Months For more detailed plan design information go to :www.garnett-powers.com/postdoc/ucsf

  16. LIFE AND AD&DINSURANCE

  17. Postdoctoral Scholars’ Life Insurance and Accidental Death & Dismemberment (AD&D) PlanThe 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.

  18. ** NEW BENEFIT**Effective January 1, 2007Repatriation & Medical Evacuation Coverage • International Postdocswill 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 dependentswill 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.

  19. SHORT TERMDISABILITY INSURANCE

  20. Postdoctoral Scholars’Short-Term Disability PlanThe 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.

  21. LONG TERMDISABILITY INSURANCE** Open Enrollment for January 1, 2007 **

  22. Postdoctoral Scholars’Long-Term Disability PlanThe 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.

  23. Long Term DisabilityComposite Rate • As of January 1, 2007 the Long Term Disability Insurance monthly rate will be $6.66 regardless of age or salary.

  24. 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.

  25. 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.

  26. 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

  27. 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.

  28. 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.

  29. Family Member EligibilityFamily 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)

  30. Information Sources GPA: Go to the Garnett-Powers Postdoctoral Scholar Benefits Plan (PSBP) website at www.garnett-powers.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 PSBP@garnett-powers.com 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

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