University of California Berkeley

1. University of California Berkeley Visiting Scholar Benefit Plan (UCBVSBP) Effective December 1, 2010

2. UCBVSBP • The University of California, Berkeley (UCB) has partnered with Garnett-Powers & Associates to administer the Visiting Scholar Benefit Plan (UCBVSBP) • December 1, 2010 is the effective date whereby all domestic and international Visiting Scholars and Visiting Student Researchers must be provide proof of adequate health insurance coverage • The UCBVSP is available to both domestic and international Visiting Scholars and Visiting Student Researchers at UCB who are affiliates of the Visiting Scholar and Postdoc Affairs (VSPA) Program • The UCBVSBP fully meets the U.S. State Department Exchange Scholar requirements for J-1 scholars and their J-2 dependents

3. UCBVSBPHealthcare Options PPO

4. UCBVSBPHealthcare Options PPO

5. UCBVSBPHealthcare Options PPO

6. UCBVSBP Rates* * Rates are effective September 1, 2016 through August 31, 2017

7. Medical Evacuation & Repatriation Coverage • The UCBVSBP plan includes includes medical evacuation and repatriation of remains benefits that meet the U.S. State Department requirements • International J-1 scholarsand their J-2 dependentsdo not need to purchase supplemental coverage to meet their J Visa requirements

8. UCBVSBP Administrative Process Department staff prepares an affiliate application in the VSPA Gateway VSPA Program confirms approval of affiliate application VSPA sends notification of eligibility to GPA for new and extended appointments Department creates a Human Capital Management (HCM) Contingent Worker Job Organizational Instance .NOTE: Staff can create record up to 3 months in advance of appointment Cal Numerical ID is generated Continued next page…

9. UCBVSBP Administrative Process Affiliate has 31 days from appointment date to visit the GPA website and enroll in VSBP or opt out of the plan When enrollment form is completed and premiums are paid, GPA will notify the scholar. The insurance company will provide an insurance ID card If waiving or opting out: Affiliate must provide proof of comparable coverage to GPA for verification. Upon approval, GPA will notify the affiliate, department staff and VSPA Program that health insurance requirement has been satisfied

10. UCBVSBP Administrative Process • VSPA creates a Person of Interest (POI) record in HCM, which activates the HCM Contingent Worker Job Organizational Instance • If the affiliate’s insurance does not meet the waiver requirements, or if the affiliate drops coverage early, GPA will notify department staff of the deficiency • If the requirements are not satisfied by the affiliate, GPA will inform the VSPA Program and the POI record will be deactivated, resulting in loss of campus services

11. VSPA Affiliate Enrollment Process • Affiliate must enroll online through Garnett-Powers & Associates’ UCVSBP website: www.garnett-powers.com/vs/ucb • Affiliates must follow the enrollment process carefully. To get started, the affiliate clicks on the ‘Enrollment’ link and prints (or reads) the ‘Enrollment/Payment Instructions.’ These instructions are written to guide the affiliate’s completion of the enrollment form. Once the affiliate has filled out the form, the affiliate should print the completed form for record-keeping purposes. • IMPORTANT: Failure to adhere to the recommended enrollment process may result in a long delay in becoming active in the insurance carrier’s system

12. VSPA Affiliate Enrollment Process • Affiliate must provide a current and correct email address because all correspondence between GPA and the affiliate will transacted by email  including confirmation of enrollment and quarterly invoices for subsequent quarterly enrollment. • Enrollment is not complete until GPA receives: 1) confirmation of eligibility from the campus, and 2) initial payment • Health insurance ID cards will be mailed to the affiliate’s U.S. mailing address listed on the enrollment form 7 to 10 business days after the enrollment process is complete • If the affiliate would like to make changes to enrollment in the future, the affiliate must click ‘Making Changes to Your Enrollment’ link and print (or read) the ‘Instructions on Making Changes’ link for detailed instructions.

13. VSPA Affiliate Payment Process • Upon completion of the enrollment form, the affiliate is directed to ‘Submit and Create Printable Enrollment Form’. A reminder that payment is due immediately is issued. • Payment is due for the current quarter (or portion as determined by the affiliate’s insurance start date) at initial enrollment (whole months only  no pro-rated amounts when enrolling after the first of the month) • When the affiliate clicks on the ‘Calculate Premium’ button, the system automatically ‘populates’ both the initial premium owed for the first quarter and premium owed for subsequent quarter(s) on the payment coupon at the bottom of the enrollment form. The affiliate should print this document for record-keeping purposes.

14. VSPA Affiliate Payment Process • The affiliate can pay by debit or credit card or with a check. If the affiliate is paying by check, the affiliate should return the payment coupon with a check to Garnett-Powers & Associates. • After the initial premium has been paid, the GPA billing department will send the affiliate an electronic invoice for subsequent billing(s) prior to the expiration date of the insurance policy. If affiliate’s appointment ends before the end of any quarter, affiliate will only be billed the premium through the end of the last month of appointment.

15. Family Member Eligibility* • Family member categories (including J-2 dependents) are the following: • Spouse • Domestic partner • Same-sex domestic partner • Opposite-sex domestic partner only if one partner is over age 62 • Unmarried natural or adopted children to age 19 or to age 23 if a full-time student who is not self-supporting • NOTE: Other family members (e.g., parents, nieces or nephews) are NOT eligible *See Eligibility and Definitions sections in policy brochure

16. Information Sources • Website: Garnett-Powers’ UCBVSBP website: www.garnett-powers.com/vs/ucb • Toll Free Phone: Garnett-Powers’ UCBVSBP customer service number: 888-441-3719 • Email Address: Garnett-Powers’ email address: UCBVSBP@Garnett-Powers.com