University of Miami
Open Enrollment October 12 through November 2, 2015
It’s time to think about your ’Canes Total Rewards. As a member of the UM family, you have access to the University’s ’Canes Total Rewards package, which is everything offered to you for your contribution and service to UM, including pay, benefits, recognition programs, and training and development.
2
2016 Open Enrollment
October 12 through November 2, 2015 Open Enrollment is the time of the year when you can make changes to your ’Canes Total Rewards package for 2016. This year, Open Enrollment will be done at workday.miami.edu and most of your benefits elections will automatically rollover.
NEW FOR 2016: Voluntary Legal and Vision Plans
We’re excited to announce the launch of the VSP Vision Care and MetLaw Legal plans for 2016. Log in to Workday at workday.miami.edu from October 12 through November 2, 2015 to enroll. Visit miami.edu/benefits for more information.
If You Like What You Have
If you are happy with your current benefits, just sit back and relax. Your current benefits, with the exception of your flexible spending account elections, will roll over to 2016. Monthly premiums for medical plans and the Delta Dental plan will increase slightly next year. To review 2016 premiums, please visit miami.edu/benefits. Note: You will receive a task from Workday as a reminder to review your benefit elections.
If You Want to Enroll in a Flexible Spending Account or Make Changes to Your Coverage
If you would like to enroll in a flexible spending account, or make changes to your medical and/or dental plan (such as electing a new plan or dropping a dependent from coverage), or enroll in the new legal or vision plans, you must do so during Open Enrollment. If you add a dependent, you will be required to provide documentation to substantiate their relationship to you. Log in to Workday at workday.miami.edu from October 12 through November 2, 2015 to make your elections.
A Note About Workday
You will receive a task from Workday as a reminder to review your benefit elections. Additionally, an exclamation point will appear on your Workday Benefits worklet through the end of Open Enrollment, even after you have finalized your elections. YOUR LIFE. YOUR CHOICES. YOUR UM. 3
learn more at miami.edu/benefits
3
Before Electing Your 2016 Benefits 1. Review this guide and visit miami.edu/benefits for tip sheets and information on 2016 Open Enrollment. 2. Attend a benefits fair, a drop-in lab, or a webcast. Find a complete schedule at miami.edu/benefits. 3. Log in to workday.miami.edu between October 12 and November 2, 2015 to elect your benefits for 2016.
Benefits Fairs Campus
Date
Time
Location
Benefits Fairs Coral Gables
Monday, October 12
10 a.m. to 3 p.m.
Foote University Green
RSMAS
Tuesday, October 13
10 a.m. to 2 p.m.
Breezeway
Miller School of Medicine
Wednesday, October 14
10 a.m. to 3 p.m.
Thursday, October 15
8 a.m. to 3 p.m.
Schoninger Research Quadrangle
TABLE OF CONTENTS Save Money On Your Health Care
5
Well ’Canes Free Preventive Care Benefits
5
Understanding Your Medical Options
6
2016 Monthly Medical Premiums
7
2016 Medical Plan Comparison Chart
8
High-End Imaging
11
Prescription Drugs
12
Flexible Spending Accounts
13
UHealth—Your Health Is Our Priority
14
Mental Health, Vision, and Travel
16
Health Care Reform
17
Are You Eligible for Medicare Soon?
17
Well ’Canes
18
Save Now, Enjoy Later
20
Dental Plan Options
23
Additional ’Canes Total Rewards
24
Need help or additional information?
Please contact HR-Benefits at 305-284-3004,visit miami.edu/benefits, or complete the online inquiry form at miami.edu/benefits/ask.
4
Save Money on Your Health Care Learn which medical plan is best for you, ask questions of your doctors, and follow the tips below to save money on health care for you and your family.
Get the most out of your medical plan by taking advantage of the free Well ’Canes in-network preventive care benefits.
Well ’Canes FREE Preventive Care Benefits SERVICE
COVERAGE
Adult Annual Physicals/Labs
Annual exam after age 18.
Well-Child Care
All well-child visits through age 18.
Routine Immunizations
Visit cdc.gov/vaccines/schedules for vaccination guidelines.
• Pay for your eligible health care expenses using pre-tax dollars by enrolling in a health care flexible spending account. See page 13 or visit wageworks.com for details.
Immunizations for Foreign Travel
To view the list, visit cdc.gov/travel.
HPV Vaccine
Three doses (ages 9 to 26).
• Use generic drugs whenever possible. If you receive an Aetna Rx letter regarding brand medications, review it with your doctor to avoid higher costs. See page 12 for details.
Well-Woman Visit
Annual exam and pap smear.
Women’s Coverage
Covers certain oral contraceptives at no cost, along with free breastfeeding supplies.
Breast Cancer Screening
One screening or diagnostic mammogram annually, beginning at age 35. Includes breast ultrasound.
Prostate Cancer Screening
Prostate Specific Antigen and Digital Rectal Examination annually, beginning at age 45.
Osteoporosis Screening
Bone densitometry every two years, beginning at age 60.
Colorectal Cancer Screening
Annual colonoscopy, fecal occult blood test, flexible sigmoidoscopy, or double barium enema beginning at age 50.
Skin Cancer Screening
Annual skin screening exam with a UHealth dermatologist. Call 305-243-6704 to make an appointment.
Annual Eye Exam
Annual eye exam with an Aetna/EyeMed or Bascom Palmer Eye Institute optometrist or ophthalmologist.
• Free annual physicals, well woman exams, and immunizations, as well as $10 visits for minor illnesses at the Healthy ’Canes Employee Clinics. Visit healthycanesclinic.com for details.
• Save on copays by using: • UHealth physicians. Schedule your appointment through UHealth Connect at 305-243-CARE (2273). • CVS or Aetna Rx Home Delivery for your three-month supply of maintenance medications. • If you have a qualifying medical condition, you may be eligible to enroll in the Aetna Health Connections program to receive free or discounted medications. See page 12 for details.
NOTE: The preventive care services listed above are free when using a UHealth or in-network provider. Skin cancer screening is covered only at UHealth. This table is only a summary. Please visit healthcare.gov for a complete list of preventive care services. YOUR LIFE. YOUR CHOICES. YOUR UM. 5 learn more at miami.edu/benefits
5
Understanding Your Medical Options Aetna
Same Benefit Coverage, Different Costs All three medical plans provide the same benefit coverage. The differences in the plans are your monthly premiums and out-of-pocket expenses.
Aetna
Select 1
Monthly Premium Deductible National networks - all 50 states
●
$$$
$$
$
$0
$250 per person
$1,500 per person
Aetna Select (Open Access)
● ● ● ● ● ●
No primary care physician election required No referrals to specialists required Prescription drug coverage included Lower copays when using UM doctors at UHealth facilities Copays apply for most non-preventive services Preventive care services covered at 100 percent High-end imaging services (coverage exceptions apply)
Health Aetna Reimbursement Select 2 Account
●
Covered only at UHealth
●
Aetna Select (Open Access)
●
● ● ● ● ● ●
Covered only at UHealth
Covered through Concordia
Covered through Concordia
Covered through Concordia
Out-of-Pocket maximum includes Rx copays Worldwide emergency coverage
*You have the option of using an out-of-network provider, but your charges will be subject to balance billing.
6
Covered only at UHealth
● ●
(certain services)
(pre-authorization may be required)
●
● ● ● ● ● ●
● ●
Rollover health reimbursement account fund
Behavioral health
Choice POS II (Open Access)
● ● ● ● ●
Out-of-network benefits*
Coinsurance applies
●
● Applies
2016 Monthly Medical Premiums Aetna
Aetna
Aetna
Health Reimbursement Account
Select 1
Select 2
Employee Only
$171
$81
$28
Employee + Child
$348
$174
$119
Employee + Children
$425
$263
$180
Employee + Spouse/Partner
$567
$302
$219
Employee + Family
$630
$330
$254
New Aetna medical ID cards will be mailed in December for new participants/new plan elections.
NOTE: All premiums shown are for non-smokers and for those with spouses/same-sex domestic partners who do not have access to employer-sponsored health insurance. There is a $250 monthly spousal surcharge, which allows you to cover a spouse/same-sex domestic partner who has access to his/her own employer-provided medical plan. During Open Enrollment you may remove your spouse from, or continue their enrollment in, the University’s medical plan. Before making your decision, we encourage you and your spouse to carefully consider the benefits of the University’s plan against your spouse’s own employer-provided plan. There is a $100 monthly smokers’ surcharge, which applies to adult smokers covered under the UM/Aetna medical plan. Through the redesigned BeSmokeFree program, you can get the help you need to quit smoking for free. Visit miami.edu/besmokefree for details.
Healthy ’Canes Employee Clinic Free Flu Shots, Annual Physicals, and Well Woman Exams Available
A Well ’Canes benefit for faculty and staff offering free annual physicals, select immunizations, and convenient access to UHealth medical services for the treatment of minor illnesses. No appointment necessary | Free flu and shingles vaccines | Free annual physicals available on select days | Free Well Woman Exams | $10 visit fee (waived for immunizations and annual physicals) | Staffed by Nurse Practitioners, overseen by UHealth physicians Visit our locations Monday–Friday • 7:30 a.m. to 3:30 p.m. Coral Gables Campus | McKnight Building | 5807 Ponce de Leon Blvd, Ste 109 | 305-284-WELL (9355) Miller School of Medicine Campus | Professional Arts Center | 1150 NW 14 Street, Ste 708 | 305-243-WELL (9355) The Healthy ‘Canes Clinic is not a substitute for your primary care physician. If you have severe abdominal pain, high fever, chest pain, severe headache, trouble breathing, or require immediate assistance due to an accident or injury, please call 911 or proceed to the nearest emergency room.
YOUR LIFE. YOUR CHOICES. YOUR UM. 7
learn more at miami.edu/benefits
healthycanesclinic.com
2016 Medical Plan Comparison Chart AETNA SELECT 1 Network
Aetna Select (Open Access)
Plan Provisions
UM Providers1
In-Network
AETNA SELECT 2
AETNA HRA
Aetna Select (Open Access) UM Providers1
In-Network
Health Reimbursement Account (HRA) Fund Per Member3
Aetna Choice POSII (Open Access) UM Providers1
In-Network
Out-of-Network2
$600 up front per member (up to $1,800 per family). Fund reduces your annual deductible.
Calendar Year Deductible Individual
N/A
$250
$1,500
$3,000
Family
N/A
$750
$4,500
$9,000
Preventive Care Services (see page 5 for details) Preventive Care
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
Not Covered
Primary Care Physician
$15 copay
$20 copay
Deductible, then $20 copay
Deductible, then $25 copay
Deductible, then $15 copay
Deductible, then $20 copay
Deductible, then 30% coinsurance
Specialist
$25 copay
$50 copay
Deductible, then $35 copay
Deductible, then $60 copay
Deductible, then $25 copay
Deductible, then $50 copay
Deductible, then 30% coinsurance
Maternity (Office Services)
$25 copay for first visit, then all office services covered at 100%
$50 copay for first visit, then all office services covered at 100%
Deductible, then $35 copay for first visit, then all office services covered at 100%
Deductible, then $60 copay for first visit, then all office services covered at 100%
Deductible, then $25 copay for first visit, then all office visits covered at 100%
Deductible, then $50 copay for first visit, then all office visits covered at 100%
Deductible, then 30% coinsurance
Allergy Injection (per visit)
$5 copay
$5 copay
Deductible, then $5 copay
Deductible, then $5 copay
Deductible, then $5 copay
Deductible, then $5 copay
Deductible, then 30% coinsurance
$150 copay per day to a maximum of $750 per admission
$250 copay per day to a maximum of $1,250 per admission
Emergency Room5
$100 copay
$100 copay
Urgent Care
$50 copay
$50 copay
Deductible, then $75 copay
Ambulance
N/A
$0 copay
N/A
Physician Expenses
Hospital Expenses
Inpatient
4
8
Deductible, then $200 Deductible, then $300 Deductible, then $100 Deductible, then $200 copay per day to a copay per day to a copay per day to a copay per day to a maximum of $1,000 maximum of $1,500 maximum of $500 per maximum of $1,000 per admission per admission admission per admission Deductible, then $150 Deductible, then $150 copay copay
Deductible, then 30% coinsurance
Deductible, then $100 copay
Deductible, then $100 copay
Deductible, then $100 copay
Deductible, then $75 copay
Deductible, then $35 copay
Deductible, then $35 copay
Deductible, then 30% coinsurance
Deductible, then $0 copay
N/A
Deductible, then 20% coinsurance
Deductible, then 20% coinsurance
2016 Medical Plan Comparison Chart Network Plan Provisions
AETNA SELECT 1
AETNA SELECT 2
AETNA HRA
Aetna Select (Open Access)
Aetna Select (Open Access)
Aetna Choice POSII (Open Access)
UM Providers1
In-Network
UM Providers1
In-Network
UM Providers1
In-Network
Out-of-Network2
Surgery
$100 copay
$150 copay
Deductible, then $100 copay
Deductible, then $250 copay
Deductible, then $50 copay
Deductible, then $150 copay
Deductible, then 30% coinsurance
High-End Imaging (Only available at UHealth6)
$150 copay
Only covered under certain conditions
Deductible, then $150 copay
Only covered under certain conditions
Deductible, then $100 copay
Only covered under certain conditions
Only covered under certain conditions
Low-End Imaging (all other non-invasive services)
$0 copay
$30 copay
Deductible, then $0 copay
Deductible, then $50 copay
Deductible, then $0 copay
Deductible, then $40 copay
Deductible, then 30% coinsurance
Lab Work (Quest or UHealth Laboratories)
$0 copay
$0 copay
Deductible, then $0 copay
Deductible, then $0 copay
Deductible, then $0 copay
Deductible, then $0 copay
Deductible, then 30% coinsurance
$15 copay
$20 copay
Deductible, then $20 copay
Deductible, then $25 copay
Deductible, then $15 copay
Deductible, then $20 copay
Deductible, then 30% coinsurance
Outpatient Services
Other Services Outpatient Therapy (Physical, Speech, and Occupational) per visit
Outpatient Chemotherapy and Radiation Facility
$0 copay
$20 copay
Deductible, then $0 copay
Deductible, then $20 copay
Deductible, then $0 copay
Deductible, then 20% coinsurance
Deductible, then 30% coinsurance
Physician
$0 copay
$0 copay
Deductible, then $0 copay
Deductible, then $0 copay
Deductible, then $0 copay
Deductible, then 20% coinsurance
Deductible, then 30% coinsurance
Medical/Rx Out-of-Pocket Maximum Individual
$3,000
$4,000
$4,000
$8,000
Family
$9,000
$12,000
$12,000
$24,000
1. 2. 3. 4. 5. 6.
A UM physician, UM facility, or Jackson Health System facility. You have the option of using an out-of-network provider, but your charges will be subject to balance billing. The first $600 of eligible medical and Rx expenses are covered by the HRA fund with the exception of Concordia copays. Preventive care services will not be deducted from the $600 HRA fund. Inpatient hospital services include semiprivate room, ancillary service, physician fees/visits, and inpatient surgery. Emergency room copay is waived if admitted to the hospital. Coverage for high-end imaging (MRI, PET, and CT scans) is available exclusively at UHealth. Coverage is available outside of UHealth under certain circumstances: Imaging for children ages 13 and under; imaging performed outside of Miami-Dade/Broward counties, within an emergency room or during an inpatient hospital stay, concurrent with radiation therapy for daily placement, when open or standing MRI is required.
Out-of-Area HRA Plan: If your home address is outside of Miami-Dade/Broward counties, the Out-of-Area HRA option will appear in Workday as an option for you. In the Out-of-Area HRA, you will pay the lower UHealth copay at any Aetna network provider. Contact HR-Benefits at 305-284-3004 for more information.
YOUR LIFE. YOUR CHOICES. YOUR UM. 9
learn more at miami.edu/benefits
9
Understanding the HRA Option The Aetna Health Reimbursement Account (HRA) is a high-deductible, low-premium medical plan that provides cost-effective benefits for you and your family. To help off-set your total deductible, the University provides you with an annual HRA fund of $600 per person, up to $1,800 per family. When medical services are received or prescription drugs are filled, amounts are deducted automatically from your UM-provided HRA fund first. Once the fund is used up, you will make out-of-pocket payments until you meet your individual deductible. If you meet your deductible during the plan year, you pay copays or coinsurance for subsequent services and prescription drugs. If you end up with unused HRA funds, they will roll over to the following year.
UNIQUE PERSON. MEETING YOUR DEDUCTIBLE Once you have used the $600 from the UMUNIQUE provided HRA fundCANCER. and paid an additional $900 to meet your $1,500 deductible, the plan will function like a traditional medical UNIQUE TREATMENT. plan where you pay copays or coinsurance for
MONEY TO PAY MEDICAL EXPENSES UM sets up an HRA fund of $600 per person (max $1,800 per family) to help you pay your eligible medical and pharmacy expenses. Unused funds roll over to the next plan year.
eligible medical and pharmacy expenses until you reach your out-of-pocket maximum for the plan year.
YOUR DEDUCTIBLE, MADE LOWER Your HRA fund helps you meet your annual deductible. Only after the HRA fund is exhausted will you have to pay out-of-pocket for subsequent medical and pharmacy expenses. (In-Network Deductible = $1,500/ individual; $4,500/family max).
Just like no two people are the PAY NOTHING AFTER REACHING YOUR same, neither are their cancers. OUT-OF-POCKET MAXIMUM If you reach your out-of-pocket maximum Today and tomorrow, the team ($4,000 per person, in-network) during the of researchers, cancer physicians plan year, the HRA plan will cover 100 percent and other experts at the Sylvester of your eligible medical and pharmacy Comprehensive Cancer Centerfor the remainder of the plan year. expenses discover, develop and deliver the most precise cancer treatments for your unique cancer. And that leads to faster responses, fewer side effects, better outcomes and more hope. No one is more prepared to fight your cancer.
EXAMPLE: JAN
FEB
HRA FUND: $600 DEDUCTIBLE: $1,500
10
MAR
APR
On March 12 you feel sick and visit your physician. Cost: $250 HRA FUND PAYS: $250 YOU PAY: $0
MAY
JUN
JUL
AUG
OCT
NOV
DEC
S y l vOne sOctober t e r. o g On July 27 you 15 ryou visit a specialist for require additional CORAL SPRINGS DEERFIELD KENDALL treatment. MIAMI HRA medicalBEACH services. HOLLYWOOD FUND: $0 HRA FUND: $0 PLANTATION CORALCost: GABLES COMING 2016 Cost: $350 $900 DEDUCTIBLE: $900 DEDUCTIBLE: $0 HRA FUND PAYS: $350 HRA FUND PAYS: $0 YOU PAY: $0 YOU PAY: $900 YOU HAVE NOW MET YOUR DEDUCTIBLE. •
HRA FUND: $350 DEDUCTIBLE: $1,250
SEPT •
•
•
•
High-End Imaging High-End Imaging Covered Exclusively at UHealth
UHealth Radiology is staffed by experienced, state-certified technologists and highly skilled physicians who are nationally recognized for their clinical care and contributions to radiology. Our health care plan covers high-end imaging services (PET, CT, and MRI) only at UHealth facilities. To schedule a high-end imaging appointment, call 305-243-CARE (2273). MEDICAL PLAN
UHEALTH
AETNA NETWORK
Aetna Select 1
$150
Not covered
Aetna Select 2
Deductible, then $150 copay
Not covered
Aetna HRA
Deductible, then $100 copay
Not covered
UHealth at Coral Gables Opening in late 2016, UHealth
Exceptions
You may be able to receive these services outside of UHealth if you need: • Open or standing MRI • Pediatric high-end imaging services (for children ages 13 and under) • Imaging performed at the time of radiation therapy • Imaging outside of Miami-Dade and Broward Counties • Emergency room/inpatient imaging Contact Aetna at 1-800-824-6411 for more information about receiving imaging services outside of UHealth. RADIOLOGY FACILITIES
ADDRESS
Applebaum Diagnostic Imaging Center
1115 NW 14 Street, Miami, FL 33136
Bascom Palmer Eye Institute, Radiology Department
900 NW 17 Street, Miami, FL 33136
Sylvester Comprehensive Cancer Center
1475 NW 12 Avenue, Miami, FL 33136
University of Miami Hospital
1400 NW 12 Avenue, Miami, FL 33136
UMHC/Sylvester at Deerfield Beach
1192 E Newport Center Drive, Suite 100 Deerfield Beach, FL 33442
UMHC/Sylvester at Kendall
8932 SW 97 Avenue, Kendall, FL 33176
UHealth at Plantation
8100 SW 10 Street Crossroads Business Park, Building 3 Plantation, FL 33324
radiology.med.miami.edu/locations
To schedule a UHealth high-end imaging appointment, call 305-243-CARE (2273)
at Coral Gables in the Lennar Foundation Medical Center will bring the world-renowned expertise of UHealth – the University of Miami Health System, Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute to Coral Gables and surrounding communities. UHealth at Coral Gables will provide primary, extended hours, no-appointment needed, and specialized care for a broad spectrum of health needs including cancer, eye, women’s health, sports medicine, spine, heart, memory disorders, dermatology and more. YOUR LIFE. YOUR CHOICES. YOUR UM. 11
learn more at miami.edu/benefits
11
Prescription Drugs Each UM/Aetna medical plan covers the same prescription drugs. Costs are determined by the fourtier structure below. If the cost of the prescription is less than the copay, you pay the lesser amount. In the HRA plan, copays apply after you have met your deductible.
Rx Step Therapy
Drugs may move up or down a tier in 2016. Visit aetna.com to view an updated list of covered drugs and costs.
Try It and Like It: If you choose to try the lower cost alternative and like it, you may continue to use this new drug, which will help you save money on your prescription drug copay.
Tier
Cost
Description
Tier 1
$10
Covered preferred generic medications (not self-injectable).
Tier 2
$45
Covered preferred brand name medications (not self-injectable).
Tier 3
$75
Covered non-preferred generic and brand-name medications (not self-injectable).
Tier 4
$100
Preferred and non-preferred self-injectable drugs covered by prescription benefits. Insulin is covered under Tiers 1, 2, and 3 (tier depends on type).
The UM/Aetna medical plan covers thousands of medications. Some of these medications have equally effective, but much less expensive, alternatives. The Rx Step Therapy program gives you options regarding these medical conditions.
Try It and Don’t Like It: If you choose to try the lower cost alternative, but it does not work as well for you, your doctor can call Aetna to let them know and you may be able to use the more expensive medication at its regular copay. If you use the more expensive prescription without first trying one of the lower cost alternatives, you will be required to pay the full cost of the medication. Eligible participants and their prescribing physicians will receive a letter from Aetna with additional program information. Visit miami.edu/benefits to view the 2016 Rx Step Therapy drug list.
Generic Choice Incentive Program
12
SAVE MONEY and avoid higher out-of-pocket expenses with generic options in place of brand name medications.
Under the UM/Aetna medical plan, you are encouraged to use generic drugs, when available, to avoid paying more than the cost of your copay. If a generic equivalent is available and you purchase the brand instead, you will pay the copay for the brand name drug, plus the difference in cost between the generic and the brand name. Please review your current medications and visit miami.edu/benefits to review the 2016 Rx list.
Flexible Spending Accounts Aetna Health Connections
UM/Aetna medical plan members taking medications for diabetes, asthma, high cholesterol, or hypertension can save money on prescriptions for these conditions and get personalized medical guidance from an Aetna nurse. Participants will receive generic drugs for their condition at no charge and a 50 percent copay reduction for preferred brand name drugs for their condition. To get started, call Aetna at 1-866-269-4500. To take advantage of these discounts, remember to fill any maintenance medications in 90-day supplies at CVS or through Aetna Rx Home Delivery. (Please allow up to eight weeks from the time you enroll in Aetna Health Connections to see the discount at the pharmacy.)
Maintenance Medications
Save on your copay by filling your 90-day prescription for maintenance medication at your local CVS pharmacy or through Aetna Rx Home Delivery. IMPORTANT: If you fill your maintenance medication monthly (in 30-day increments), your copay will increase by 2½ times after the second filled 30-day prescription. See below.
Your Flexible Spending Account elections will not roll over to 2016. Please log in to Workday to enroll and save up to $25 on every $100 spent on eligible expenses.
Health Care FSA
Set aside pre-tax dollars to pay for your family’s eligible health care expenses; up to $2,550 per year. You will receive a WageWorks Visa card in the mail for use on eligible health care expenses at approved merchants, including pharmacies, physicians’ offices, and hospitals. NOTE: If you are a new participant or your current card has expired, you will receive a new WageWorks Visa card, which will be mailed at the end of December 2015. If you are an existing participant and your card has not expired, you should continue to use your current card.
Dependent Care FSA
Set aside pre-tax dollars to pay for eligible dependent day care (or night care) costs, including care for elderly parents; up to $5,000 per year (based on tax filing status). The maximum election for employees earning $115,000 or more is $2,500 per year. If married, both you and your spouse must be working in order for dependent care expenses to be reimbursable. Eligible dependents include your child or stepchild (under the age of 13); a child of any age who is physically or mentally incapable of caring for themselves; or elderly persons who are financially dependent upon you. Visit wageworks.com to confirm dependent and expense eligibility. 2016 DEADLINES
Tier 2 Rx Example
Local Retail Pharmacy (monthly cost, 30-day supply)
Aetna Rx Home Delivery or Local CVS Pharmacy (average monthly cost, 90-day supply)
First 30-Day Fill
$45.00
$37.50
30-Day Refill #1
$45.00
HEALTH CARE FSA
DEPENDENT CARE FSA
Incur Eligible Expenses By
March 15, 2017
March 15, 2017
Submit Claims By
June 15, 2017
June 15, 2017
$37.50
30-Day Refill #2
$112.50
$37.50
Total Cost
$202.50
$112.50
*
NOTE: Cost increase reflects permanent change in copay for this and all additional refills of the same medication for 30-day supplies at local retail pharmacy. 90-day supplies can only be obtained at CVS or through Aetna Rx Home Delivery. If the cost of your medication is lower than the copay, you pay the lower cost.
Visit miami.edu/benefits for more information.
Enrolling in a health care flexible spending account is a smart way to budget for the upfront expense of using your local CVS or Aetna Rx Home Delivery for your maintenance medications. You can allocate the expense over 12 months and save up to 25 percent because you are paying for medications with pre-tax LIFE. YOUR CHOICES. YOUR UM. 13 dollars. Visit wageworks.com YOUR for more information. learn more at miami.edu/benefits
13
Your Health is Our Priority You have doctors in the family—and UHealth doctors are among the world’s best. Turn to UHealth for high-quality health care that’s convenient and affordable. The expert, dedicated teams of UHealth—University of Miami Health System— include more than 1,000 physicians, as well as about 200 other licensed health providers. You’ll find our care in more than 100 medical specialties and subspecialties at locations in Miami-Dade, Broward, Palm Beach, and Collier Counties. For a comprehensive list of services, visit UHealthSystem.com.
Direct Access to Expert Care
Thanks to a special phone line just for employees, it’s easier than ever to make an appointment with a UHealth provider. Call 305-243-CARE (2273) to schedule care with some of the world’s top physicians in a complete array of medical specialties.
Manage Your Care From Anywhere
With MyUHealthChart, you can access your UHealth medical records securely from any computer, making it easy to stay on top of information such as most lab results, appointment summaries, medications, and immunizations. MyUHealthChart also provides convenient ways to communicate with your doctor’s office. Visit MyUHealthChart.com for details.
UHealth Laboratories
UHealth Laboratories offer routine and complex lab and pathology services at the following locations: UHealth Miami Campus •Bascom Palmer Miami •Diabetes Research Institute •Professional Arts Center •UMHC/Sylvester Miami UHealth Satellite Locations •Deerfield Beach •Kendall •Plantation Services at UHealth Laboratories are covered at 100 percent after deductible (if applicable). No appointment necessary. Visit miami.edu/benefits for more information.
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UHealth
the University of Miami Health System
Bascom Palmer Eye Institute
Sylvester Comprehensive Cancer Center
University of Miami Hospital
UHealth – the University of Miami
Bascom Palmer is recognized
Sylvester is among the nation’s
The only university-owned and
Health System, provides South
as one of the world’s finest and
leading cancer centers and south
operated teaching hospital in
Florida with the best health care
most progressive centers for
Florida’s only Cancer Center of
South Florida, University of Miami
for prevention, detection, diagnosis
ophthalmic care, vision research
Excellence. Sylvester physician-
Hospital provides advanced and
and treatment of routine, chronic,
and education. In 2015, it was
experts and researchers discover,
targeted care in a compassionate
complex and acute diseases and
named the #1 eye hospital in the
develop and deliver the most
environment. Our 560 private room
conditions.
United States by U.S. News &
advanced targeted treatments
hospital is home to a state-of-the-
World Report for the twelfth year
for each patient’s unique cancer.
art cardiac catheterization facility,
No other health system in this
in a row. Bascom Palmer is a
Our comprehensive diagnostics
robotic surgery program, and
region comes close to UHealth
leading destination for excellence
coupled with teams of scientific
acclaimed sports medicine division,
in terms of our groundbreaking
in ophthalmic clinical care.
and clinical experts enable us to
among other innovative services
research, the number of world
better understand each patient’s
and treatments.
class specialists representing
individual cancer and develop
more than 100 areas of advanced
treatments that target the cells and
medicine, and our patient
genes driving the cancer’s growth
outcomes which are among the
and survival.
highest in the nation.
YOUR LIFE. YOUR CHOICES. YOUR UM. 15
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Mental Health, Vision, and Travel Mental Health
FACULTY AND STAFF ASSISTANCE PROGRAM Provides confidential consultations to all UM faculty, staff, retirees, and their dependents. Sessions are conducted by Florida licensed mental health professionals who assess concerns, offer support, and recommend services that can be of help. Call 305-284-6604 or visit miami.edu/fsap for more information. CONCORDIA BEHAVIORAL HEALTH If you are enrolled in a UM/Aetna medical plan, you and your covered dependents are eligible for Concordia Behavioral Health services. Concordia provides mental health and substance abuse outpatient and inpatient treatment, and partial hospitalization. Before accessing these confidential services, authorization may be required. Call 1-800-294-8642 or visit concordiabh.com for more information.
Vision
UM/AETNA VISION COVERAGE (Included in your medical plan) Members receive a free annual routine eye exam with an Aetna/EyeMed or Bascom Palmer optometrist or ophthalmologist. Members are also entitled to discounts on lenses, frames, contacts, and LASIK surgery. Schedule your appointment with Bascom Palmer by calling 305-243-2020 or 305-243CARE (2273). Visit aetna.com for more information about the vision benefit. NOTE: Free annual eye exam does not cover contact lens fitting. If you are interested in contact lenses, please contact the Bascom Palmer Contact Lens Department at 305-326-6095 or any provider in the Aetna/EyeMed network.
NEW!
ADDITIONAL VISION COVERAGE THROUGH VSP VISION CARE If you would like additional vision coverage, consider the new VSP vision program. Every 12 months, VSP plan members can visit a national network of eye care providers and receive an eye exam for a $10 copay, plus lenses and frames each for a $20 copay. Employees who are not enrolled in the UM/ Aetna plan may still elect the VSP vision program. Visit miami.edu/benefits or vsp.com for information and enroll via Workday.
Travel
UM/AETNA EMERGENCY COVERAGE WHILE TRAVELING If you are traveling within the U.S. or anywhere in the world, remember to pack your UM/Aetna medical plan ID card. If you experience a medical emergency and need to visit an emergency room anywhere in the U.S. or around the world, your UM/Aetna plan provides coverage so that your final bill will be the same as your in-network emergency room copay. The same is true for emergency inpatient admissions. TRAVEL IMMUNIZATIONS AND CONSULTATIONS The UHealth Travel Medicine Clinic provides UM employees and their families with country-specific information, travel vaccines, and medications. The clinic is located at University of Miami Hospital and Clinics, 1475 NW 12 Avenue, 3rd Floor, Miami, FL 33136. Call 305-243-TRIP (8747) or visit UHealthTravel.com for clinic hours and additional information.
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Are you eligible for Medicare soon?
Health Care Reform Our medical plans already reflect many of the health care reform requirements—covering adult children through age 26, offering free preventive care, removing lifetime limits on essential health benefits, and limiting health care flexible spending account contributions to $2,550.
As you approach your 65th birthday, you may begin thinking about enrolling in Medicare. Although you’re likely to receive a lot of information in the mail from Medicare and other insurance providers, there are a few important factors to consider:
Health care reform requires all U.S. citizens and legal residents to have minimum essential coverage. As long as you are enrolled in a UM/Aetna medical plan, your coverage will meet (or exceed) this requirement.
You’re not always required to enroll in Medicare at age 65. You may remain covered under the University of Miami’s Aetna medical plan regardless of age, as long as you’re working for UM and are eligible for University benefits. The same is true for your spouse/same-sex domestic partner if they are covered under your plan.
To view the Department of Labor–New Health Insurance Marketplace Coverage Options and Your Health Coverage notice, please visit: miami.edu/benefits. For more information about health care reform, please visit healthcare.gov. For employees not currently eligible for a UM/Aetna medical plan, the University will be offering a new preventive care medical plan in 2016. A separate Open Enrollment will be held for these employees to review this plan.
Short-Term Disability
Will help take care of your bills while you take care of yourself.
The Short-Term Disability Plan is a voluntary program available to staff, administrators,and research personnel that replaces 66 2/3 of your income if you’re unable to work due to an injury, illness, or maternity. In order to submit a claim for STD benefits, you must have been enrolled in the plan for one year. The monthly cost for this benefit is approximately 1% of your pay. New employees can enroll on the first of the month, following date of hire, or during open enrollment. For more information and to view a premiums chart, visit miami.edu/benefits.
You won’t be penalized for delayed enrollment in Medicare because you’re covered by the UM/Aetna medical plan. If you delay enrollment in Medicare, you won’t incur a late enrollment penalty for Medicare Part B or D, as long as you remain employed at the University and covered under the UM/Aetna medical plan. When you retire from the University, you’ll have your own enrollment period for Medicare without late enrollment penalties. Enrolling in Medicare while covered by the UM/Aetna medical plan could increase your costs in some cases. Medicare Parts A and B will become secondary insurance while you’re on active UM/Aetna medical coverage, so they will only pay after your UM/Aetna plan does. Medicare Part A, hospital insurance, does not charge a monthly premium, so there’s no harm in taking Part A when you turn 65, even if you have coverage under the UM/Aetna medical plan. However, Part B, physician and outpatient insurance, charges a minimum monthly premium of $105, and it is not possible to predict whether this extra premium will result in a better benefit. Medicare Part D does not coordinate with employer sponsored coverage, and provides no benefit if you are covered under the UM/ Aetna. When you turn 65, you are eligible to elect Part A and delay Parts B and D until you retire from UM. For more information, please visit miami.edu/benefits and click on Ready to Retire to view the Medicare 101 presentation or contact HR benefits at 305-284-3004.
YOUR LIFE. YOUR CHOICES. YOUR UM. 17
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Stay healthy and well all year with Well ’Canes. The University of Miami is committed to advancing the well-being of its faculty and staff through Well ’Canes.
This wellness program extends beyond physical health
to include psychological, communal, interpersonal,
financial, and occupational wellness.
Enhance your well-being and earn up to $300 with the Well ’Canes Incentives Program
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The Well ’Canes program offers many opportunities to help faculty and staff stay healthy and well all year. Each program is focused on a different wellness dimension.
Be Smoke Free
The BeSmokeFree Program offers free UM-AHEC Quit Smoking Now classes at both on-campus wellness centers. To learn more about this program, visit miami.edu/besmokefree or call 305-243-7606.
Faculty and Staff Assistance Program
The Faculty and Staff Assistance Program provides confidential consultations to all UM faculty, staff, retirees, and their dependents. Sessions are conducted by Florida licensed mental health professionals who assess concerns, offer support, and recommend services that can be of help. Call 305-284-6604 or visit miami.edu/fsap for more information.
Financial Education Seminars
Hosted by Fidelity Investments and TIAA-CREF, these financial education seminars will help you get on the right track to a more secure financial future. Details announced in e-Veritas and eUpdate throughout the year.
Healthy ’Canes Employee Clinic
Conveniently located on the Coral Gables campus and the Miller School of Medicine, the Healthy ’Canes Employee Clinic offers free annual physicals, well woman exams, select immunizations, and convenient access to UHealth medical services for the treatment of minor illnesses. See page 7 for details.
Ready to Retire Workshops
Hosted in the spring and fall, these workshops will help guide UM faculty and staff considering retirement through the necessary steps to retire.
Weight Watchers at Work
This benefit provides first-time attendees with 100 percent reimbursement for complete attendance and continuing participants with 50 percent reimbursement for complete attendance. The cost of the program is $165 for new members and $155 for continuing and lifetime members.
Week of Well-Being
Held every April, the annual Week of Well-Being features five days of events and activities aimed at transforming the lives of faculty, staff, and students through wellness.
Well ’Canes Incentives Program with New Activities for 2016
The Well ’Canes Incentives Program is designed to encourage you to learn about your personal health, motivate you to maintain or improve your overall wellbeing, and allow you to earn up to $300 per year. You can begin earning points by registering and participating in eligible wellness activities. All faculty and staff enrolled in a UM/Aetna medical plan as primary policy holders are eligible to participate in the incentives program. Deadlines to complete wellness activities vary. For more information and to register, please visit miami.edu/wellcanes.
Don’t forget to download the HealthyNow mobile app and manage your Well ’Canes Incentives Program account on the go!
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Save Now, Enjoy Later Your ‘Canes Total Rewards package includes competitive retirement benefits, but it’s always a good idea to contribute money of your own as well. You can more easily reach your retirement savings goals by contributing to the Supplemental Retirement Annuity Plan (for those in the Employees’ Retirement Plan or the Faculty Retirement Plan) or Retirement Savings Plan. Open Enrollment is a great time to begin participating or maximize your current contributions.
Start Saving Today
It’s never too early or too late to start. Start saving today by following the steps outlined below. To enroll in the SRA or RSP:
1. Visit netbenefits.com/um 2. Click on “Register” 3. Follow the on-screen instructions 4. Once in the system, select “Enroll in Your Account” 5. Follow the steps to make your investment elections
To make changes to your voluntary contributions:
1. Visit netbenefits.com/um 2. Click on “Contribution Amount” from the Quick Links pull-down menu 3. Click “Contribution Amount” again 4. Change your desired election 5. Click “Change Contribution Amount” to confirm
Need some help on demand? Contact Fidelity at 1-800-642-7131 | Contact TIAA-CREF at 1-800-842-2252 Want to meet with a Fidelity or TIAA-CREF representative in person? Schedule an appointment at netbenefits.com/um. You can also call them directly at 1-800-642-7131 (Fidelity) or 1-800-842-2252 (TIAA-CREF).
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SAVING TIPS
For maximum benefit, it’s best to save at least 15% of your gross earnings each year, including what the University contributes for you.
By contributing 5% of your pay, you will get even closer to the 15% goal, thanks in large part to the University’s contributions.
YOUR LIFE. YOUR CHOICES. YOUR UM. 21
learn more at miami.edu/benefits
EXPERTS FOCUSED ON YOU. What sets us apart is who we bring together. At UHealth – the University of Miami Health System, you don’t just get a doctor. You have a specialized team of physicians, researchers, nurses and other experts relentlessly focused on you. UHealthsystem.com
MIAMI | BOCA RATON | CORAL SPRINGS | DEERFIELD BEACH | DORAL | FORT LAUDERDALE | HIALEAH | HOLLYWOOD KENDALL | NAPLES | PALM BEACH GARDENS | PLANTATION | CORAL GABLES COMING 2016
Dental Plan Options Cigna (DHMO)
Cigna offers an HMO plan with low copays and no limit on your annual benefit. If you choose this plan, you and your enrolled dependents must select an in-network primary care dentist (PCD) or one will be assigned to you based on your zip code. For maximum flexibility, each enrolled member may select a different in-network dental provider. To locate a PCD, visit cigna.com/dental or call Cigna at 1-800-CIGNA24 (244-6224). You can change your PCD at any time by calling Cigna or going online. Your new PCD designation will be effective the first of the month following the date you make the change.
Delta Dental (PPO)
Delta Dental offers a Preferred Provider Organization (PPO) dental plan with in-network and out-ofnetwork benefits. This plan has an extensive network of dentists and facilities. Once you have met your deductible, the plan pays a percentage of the charges based on the type of service provided. You can take advantage of lower costs by using in-network providers. For more information, including dental plan rate sheets, visit miami.edu/benefits.
UHealth Dental UHealth’s renowned Division of Oral and Maxillofacial Surgery and General Dentistry provides comprehensive general dentistry as well as a full range of oral and maxillofacial care at University of Miami Hospital. Services include routine dental examinations, cleanings, teeth whitening,
MONTHLY PLAN PREMIUMS
CIGNA
DELTA DENTAL
Employee Only
$13.70
$42.80
Employee + Child
$30.72
$104.64
Employee + Children
$34.36
$117.42
Employee + Spouse/Partner
$27.98
$99.70
Delta Dental. To schedule an
Employee + Family
$50.74
$162.91
appointment, please call
evaluations, dental implants, and more. Accepting Cigna and
305-243-CARE (2273).
PLAN FEATURES Primary care dentist required
●
Referrals required
●
National network
●
●
Out-of-network benefits
●
Deductible
●
Two free cleanings per year
●
●
Adult and child orthodontia
●
●
Maximum annual benefit
fillings, dentures, wisdom teeth
● $2,500
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Additional ’Canes Total Rewards Financial Future NEW!
METLAW LEGAL PLAN Covers telephonic and office consultations with legal counsel for a variety of issues, representation, document preparation and more. The monthly $15.75 premium covers employee, spouse and/or same-sex domestic partner, and dependent children. Visit miami.edu/benefits for more information and enroll via Workday. FREE FINANCIAL SECURITY BENEFITS Life Insurance equaling two times your base salary, rounded to the nearest $1,000, to a maximum of $100,000. Coverage begins upon employment. Accidental Death & Dismemberment (AD&D) equaling one time your base salary, rounded to the nearest $1,000, to a maximum of $100,000. Group Life Insurance is offered equaling two times the base salary rounded to the nearest $1,000 to a maximum of $100,000. You are covered immediately upon employment. If you were employed prior to June 1, 2010 and your base salary exceeded $50,000 on May 31, 2010 (May 28, 2010 for bi-weekly staff), your maximum life insurance benefit is the amount of life insurance in effect at that time. Long-Term Disability (LTD). If you become disabled, there is a six-month elimination period before your LTD benefits begin to pay. You will be eligible for a monthly benefit equal to 66 2/3 percent of your base annual salary up to a maximum of $10,000. Faculty are eligible on date of hire, staff are eligible after one year of employment. One Month’s Pay Death Benefit will provide payment equal to one-month’s pay to the named beneficiary of a deceased employee. ADDITIONAL PROTECTION The following may be purchased at the UM group rate at any time. Excess Life Insurance equaling one to six times your base salary, rounded to the nearest $1,000, to a maximum of $1,000,000. Medical evidence of insurability required. Limited coverage available for spouse and children. Voluntary Group Accidental Death & Dismemberment coverage with principal sum ranging from $10,000 to $500,000. Principal sums greater than $150,000 are limited to ten times base annual salary. Limited coverage available for spouse and children. Long-Term Care insurance provides financial resources to receive care at home or in a facility. Available in two plans and five levels of daily benefits ranging from $70 to $200 per day. Coverage available for you, your spouse, and you or your spouse’s parents and grandparents with evidence of insurability.
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Professional Growth TUITION REMISSION The tuition benefit is designed to encourage employee and family participation in higher education and supports the University’s overall interest in the personal and professional development of faculty and staff. Dependents (child or spouse) who are hired at the University as a benefits eligible employee will only be entitled to the employee tuition remission benefit. Employee Tuition Remission Eligibility Full-time faculty and staff are eligible for 100 percent tuition benefits. For eligibility details visit miami.edu/benefits. Part-time faculty and staff are eligible for tuition benefits on a prorated basis depending on their work effort. Benefit Two courses per semester and a maximum of 15 credits per calendar year. Dependent Tuition Remission Eligibility Spouses, same-sex domestic partners, and eligible dependents can take advantage of tuition benefits based on the length of time you have been employed at the University. Dependents (child or spouse) who are hired at the University as a benefits eligible employee will only be entitled to the employee tuition remission benefit. For detailed information, visit miami.edu/benefits. PROFESSIONAL DEVELOPMENT Workforce Engagement and Development has several opportunities available for you to engage in developing new or sharpening existing skills; as well as for teams to work together toward building a stronger, more resilient workforce. These skill building opportunities are available in a variety of formats, from online sessions to live, interactive classes. Visit miami.edu/hr and select Training for more information.
Recognition Programs SERVICE AWARDS The University of Miami annually recognizes faculty and staff who celebrate service milestones and those who have proudly retired from the University. The Long Service Award Program provides special recognition to faculty and staff for their years of service to the University. More than 800 employees who have reached a service milestone are honored each year and recognized with a certificate and a gift based on milestone year. Service levels are recognized in 5-year increments, starting with 10 years of service. Faculty recognition begins with the 20-year milestone. The Retirement Recognition Award recognizes faculty and staff for their retirement from the University of Miami with a gift to mark the University’s appreciation for their service and special contributions. Visit miami.edu/hr and select Recognition for more information.
Just for ’Canes EMPLOYEE DISCOUNT PROGRAM As a University of Miami employee, you are eligible to receive discounts on a number of products and services, including: • Apple • Bank of America • Bascom Palmer Aesthetic Center • Cosford Cinema • Dell • Expedia Cruise Ship Centers • FTD • Lowe Art Museum • Miami Dade Transit • Pearle Vision • Ring Theatre • Tickets at Work • Tri-Rail • UHealth Department of Dermatology and Cutaneous Surgery • UHealth Division of Plastic Surgery • University of Miami Wellness Centers • University of Miami—Miami Hurricanes Sports Visit miami.edu/benefits for a complete list. EMPLOYEE RESOURCE GROUPS The University of Miami’s Employee Resource Groups (ERGs) are voluntary, employeeled groups that serve as a resource for members by fostering a diverse, inclusive workplace aligned with the organizational mission, values, goals, business practices, and objectives. Current ERG’s include groups for people with disabilities, LGBTQ, persons of African/Caribbean descent (UBUNTU), Asians, veterans, and millennials. For more information, visit miami.edu/diversity. NURSING MOTHERS’ ROOMS There are currently nine rooms dedicated for nursing mothers across the University. For more information visit miami.edu/wep.
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Want More Information? Attend a benefits fair or a drop-in lab. Visit miami.edu/benefits to: • Review benefits fair, drop-in lab, and webcast schedules • View tip sheets Ask your Benefits team: • Complete the online inquiry form at miami.edu/benefits/ask • Call 305-284-3004 to speak with a benefits representative
IMPORTANT CONTACTS Aetna • 1-800-824-6411 • aetna.com Cigna • 1-800-CIGNA24 (244-6224)• cigna.com/dental Cigna EAP • 1-800-538-3543 • cignabehavioral.com Concordia Behavioral Health • 1-800-294-8642 • concordiabh.com Delta Dental • 1-800-521-2651 • deltadentalins.com Faculty and Staff Assistance Program (FSAP) • 305-284-6604 • miami.edu/fsap Fidelity Investments • 1-800-343-0860 • netbenefits.com/UM Healthy ’Canes Employee Clinic • 305-284-9355 Gables • 305-243-9355 Medical • healthycanesclinic.com MetLaw • 1-800-821-6400 • legalplans.com (code 1500579) TIAA-CREF • 1-888-488-3420 • tiaa-cref.org/UofMiami UHealth Connect (employee appointment line) • 305-243-CARE (2273) • UHealthSystem.com UHealth Patient Financial Services • 305-243-2900 UHealth Office of Patient Advocacy • 305-243-HELP (4357) • officeofpatientadvocacy@med.miami.edu WageWorks • 1-877-924-3967 • wageworks.com Well ’Canes •305-284-3004 • miami.edu/wellcanes Wellness Centers • 305-284-8500 Gables • 305-243-7600 Medical • miami.edu/wellness Workday Helpdesk • 305-284-6565 (option 9) Gables • 305-243-5999 (option 9) MSOM • miami.edu/workday-hr
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