2016 pre-65 benefits guide - mympcbenefits.com · every pre-65 retiree currently covered under...
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Marathon Petroleum
2016 BENEFITS OPEN ENROLLMENT GUIDE
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Pre-65 Retirees
Your Internal Benefits ResourceNeed help? No problem. We understand that the numerous benefit options available to you can be confusing. Marathon Petroleum’s Benefits Service Center is an internal team of benefit experts that are ready to help you navigate all the benefit options available to you and your family.
The Benefits Service Center can help you:
• Before you enroll by providing details on benefit options and cost-saving resources.
• During enrollment as you work to make your benefit elections or review your Benefits Confirmation.
• After enrollment and throughout the year. Do you have questions about your benefits or need help making life event changes?
Simply call 1-888-421-2199 Monday through Friday, 7 a.m. to 5 p.m., Eastern Standard Time, or send an email to [email protected]. After-hours callers can leave a message along with their phone number and, in most cases, can expect to receive a response within one business day.
Benefits Open EnrollmentNovember 1 – 20
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Marathon Petroleum Benefits Open Enrollment Guide
Benefits Open Enrollment is HereIt’s Time to Make a Change!Benefits Open Enrollment is here, and you have some important decisions to make for next year. In the past, some retirees have taken advantage of the opportunity to change and make updates to their benefit elections during open enrollment, while others have simply let their elections roll over from year to year. This year, however, is going to be a little different in terms of your involvement!
EVERY PRE-65 RETIREE CURRENTLY COVERED UNDER MPC’S HEALTH PLAN IS REQUIRED TO SELECT A NEW HEALTH PLAN OPTION FOR NEXT YEAR!
What’s Changing?
• Your current Health Plan options: Marathon Petroleum is offering two new options, and every retiree who wishes to have health coverage for 2016 MUST select one of these options.
• How you pay for eligible health care expenses with pre-tax dollars: If you select the Saver HSA Health Plan option, you have the opportunity to participate in a Health Savings Account.
• The Health Reimbursement Account: If you have a balance in your account as of January 1, 2016, it will be converted to a Limited-Purpose HRA. This means it can no longer be used for medical expenses, but it can be used to reimburse yourself for out-of-pocket dental and vision expenses. Your balance also can be used for premiums associated with the Retiree Health Plan, Pre-65 Retiree Dental Plan or Pre-65 Retiree Vision Plan.
• Pre-65 Retiree Vision Plan: Your premiums will increase slightly.
What’s NOT Changing?
• Pre-65 Retiree Dental and Pre-65 Retiree Vision Plan benefits, also Pre-65 Retiree Dental Plan premiums will remain the same for 2016.
You have some important decisions to make, and we’re committed to giving you the resources you need to understand your options for next year.
• We’re providing information on www.myMPCbenefits.com and have extended Benefits Open Enrollment for five extra days; this year it will run November 1 – 20.
• Finally, don’t forget about the Benefits Service Center. Please contact them if you have any questions — they’re only an email or phone call away.
Don’t miss your opportunity to actively enroll this year and make the elections that will best meet your health care needs!
Sincerely,
Rod Nichols Senior Vice President Human Resources and Administrative Services
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2016 Benefits Open Enrollment ..................................................... 3
Electing Changes — Just Three Easy Steps .................................. 4
Need Assistance? ....................................................................... 6
After You Complete Your Enrollment ........................................... 6
Same Sex Spousal Coverage ..................................................... 6
What’s Changing ............................................................................ 7
Health Plan Updates for 2016 ..................................................... 7
Health Savings Account (HSA) .................................................. 11
Pre-65 Retiree Dental Plan ........................................................ 13
Pre-65 Retiree Vision Plan......................................................... 14
Useful Contacts ............................................................................ 15
Important Notices ......................................................................... 16
Summaries of Benefits and Coverage .......................................... 17
Table of Contents
The Company’s policies, plans, practices and procedures may be amended, terminated or changed at any time at the sole discretion of the Company. If that should occur, the material in this document will be superseded and the provisions of the official plan documents will be followed. If there are discrepancies between this document and the official plan documents, the official plan documents will always govern.
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2016 Benefits Open EnrollmentBenefits Open Enrollment is November 1 – November 20. You MUST ENROLL in a new Health Plan option during this time in order to have these benefits be effective January 1, 2016:
✔✔ Health Plan options — Saver HSA or Classic
✔✔ Health Savings Account (HSA), if you elect the Saver HSA Health Plan option
Your 2015 elections for the following Plans will stay the same in 2016 if you make no changes:
✔✔ Pre-65 Retiree Dental Plan*
✔✔ Pre-65 Retiree Vision Plan*
This 2016 Benefits Open Enrollment Guide offers more detail about what’s changing with Marathon Petroleum’s benefit plans so you can make the most of your 2016 benefits coverage.
* This Plan is not open to new enrollment.
Marathon Petroleum Benefits Open Enrollment Guide
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Electing Changes — Just Three Easy Steps
STEP 1 Before you make your elections …Review your Benefits Open Enrollment material. Be sure to:
✔✔ Read this guide to find out what’s changing for 2016.
✔✔ Review the enclosed “Personalized Benefits Summary.”
✔✔ Contact Marathon Petroleum’s Benefits Service Center, your internal team of benefit experts, to assist you with any questions you may have.
✔✔ Access detailed information about all of Marathon Petroleum’s benefit plans at www.myMPCbenefits.com.
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STEP 2 Decide on your 2016 coverage …• Select your NEW Health Plan option. Every
retiree currently covered under MPC’s Health Plan is REQUIRED to select a new Health Plan option this year!
• Decide on tax-saving options. Choose to pay out-of-pocket health care expenses with pre-tax dollars through a Health Savings Account with the Saver HSA Health Plan option.
REMEMBER: In order to have health benefits in 2016 that best meet your needs, you MUST actively enroll during Benefits Open Enrollment.
STEP 3 Make your 2016 benefit plan elections …You have three ways to enroll or make changes to your benefit plan elections.
1 Paper:
• Mark any desired changes on the Personalized Benefits Summary and return in the enclosed envelope. You can also scan and email your summary to [email protected] or fax to 419-421-3057.
• The Benefits Service Center will enter your information into SAP and return a confirmation to you.
2Email:
• Email the Benefits Service Center at [email protected] with detailed information about your benefit elections/changes for 2016. Please include your full name and former employee number.
• The Benefits Service Center will enter your information into SAP and send a confirmation to you.
Marathon Petroleum Benefits Open Enrollment Guide
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HOW WILL I KNOW IF MY PERSONALIZED BENEFITS SUMMARY FORM WAS RECEIVED?
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After You Complete Your Enrollment✔✔ Review Your Benefits Confirmation: Your Benefits Confirmation for 2016 elections will be printed and mailed daily, to reflect changes entered that day. If you make additional changes and receive multiple confirmations, be sure to keep the one with the most recent date.
Review it carefully and if it does not reflect the changes you want to make for 2016, call the Benefits Service Center immediately at 1-888-421-2199 or send an email to [email protected].
Same Sex Spousal CoverageIf you are legally married and are covering your same sex spouse in MPC’s benefit plans as a domestic partner you may provide MPC with a copy of your marriage certificate (valid in the state where you were married) and MPC will no longer be required to treat coverage for your spouse as imputed income to you for federal tax purposes. Note that you may still be subject to state taxes depending on your current state of residence and state law recognition of your marriage.
It is each retiree’s responsibility (in accordance with the administrative rules and terms of each benefit plan) to advise MPC of your marital status, or any changes to your marital status, so that your benefits, taxes, and any other matters can be appropriately administered in accordance with your marital status and the applicable plan terms and legal requirements.
PHONE TIPS
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3 Phone: If you’re unable to complete your
benefit elections by paper or email enrollment, contact the Benefits Service Center at 1-888-421-2199 and speak with a Benefits Service Center counselor Monday – Friday, 7 a.m. to 5 p.m., Eastern Standard Time.
Need Assistance?If you have a question, please call 1-888-421-2199 and follow the prompts to speak with a Benefits Service Center counselor.
You can also email questions to [email protected]. Please include your full name and former employee number in your email.
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Marathon Petroleum Benefits Open Enrollment Guide
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What’s ChangingHealth Plan Updates for 2016In 2016, Marathon Petroleum will be eliminating the current Health Plan options and introducing two completely new options: Saver HSA and Classic. Both options will be administered by Anthem BlueCross BlueShield for medical and Express Scripts for prescription drug coverage. In-network preventive care will continue to be covered at 100% with no deductible.
The primary difference between the two options is how you pay for your health care expenses, so the Saver HSA and Classic options will have different premiums, deductibles and out-of-pocket maximum limits. The following chart offers a side-by-side comparison of the Saver HSA and Classic options.
Comparing the Two New Health Plan Options
Key Health Plan Option Features
Saver HSA“Pay as you go”
Classic“Pay up-front”
Premiums and Deductibles (see page 9 for more information)
• Lower monthly premiums, but higher deductibles and out-of-pocket maximums.
• With Retiree + Dependents* coverage, once any combination of covered family members reaches the annual deductible, the Health Plan starts paying coinsurance for all family members.
• Qualifies as a High Deductible Health Plan (HDHP).
• Higher monthly premiums, but lower deductibles and out-of-pocket maximums.
• With Family coverage, until the family deductible is met, each covered family member must meet the individual deductible before the Health Plan starts paying coinsurance.
Copays and Coinsurance (see pages 9 and 10 for more information)
No copays; only coinsurance. Includes copays instead of coinsurance for office visits and prescription drugs.
Prescription Drug Coverage (see page 10 for more information)
• Annual deductible includes both medical and prescription drug expenses.
• Certain generic preventive drugs covered at 100%. (The list of these drugs can be found on www.myMPCbenefits.com.)
• You pay all your medical and prescription drug costs in full until you reach your deductible (with the exception of preventive care and certain generic preventive medications).
• You pay 20% after deductible for retail and mail-order drugs.
• Plan pays 100% for medical and prescription drug costs once you reach the out-of-pocket maximum.
• Separate deductibles for medical and retail prescription drugs.
• Prescription drugs have copays (retail drugs are subject to a smaller, separate deductible that must be met before copays apply).
(continued)* Retiree + Dependents covers Retiree + Spouse, Retiree + Child(ren) and Retiree + Family.
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MARATHON PETROLEUM HEALTH PLAN AND HEALTH CARE REFORM
QUALIFYING LIFE EVENTS
Key Health Plan Option Features
Saver HSA“Pay as you go”
Classic“Pay up-front”
Health Savings Account (see pages 11 and 12 for more information)
• Offers a portable Health Savings Account (HSA) that includes triple-tax advantages.
• Company contributes $350 for Retiree Only coverage or $700 for Retiree + Dependents coverage*.
Not available.
Out-of-Pocket Maximums (see page 9 for more information)
Both Health Plan options have in-network out-of-pocket maximums. So whichever option you choose, the most you’ll pay for covered in-network medical (including prescription drug) expenses out of your own pocket in a calendar year is the out-of-pocket maximum for your selected Health Plan option. With Family coverage, until the family out-of-pocket maximum is met, each covered family member must meet the individual out-of-pocket maximum for the Plan to begin paying at 100% for that individual.
* Retiree + Dependents covers Retiree + Spouse, Retiree + Child(ren) and Retiree + Family.
Marathon Petroleum Benefits Open Enrollment Guide
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2016 Health Plan Monthly Retiree Contributions
Monthly contribution amounts for the Saver HSA and Classic Health Plan options shown below are for retirees with 100% of the Company subsidy. A complete list of accrual rates can be found on your “Personalized Benefits Summary” or at www.myMPCbenefits.com.
Monthly Contributions (pre-tax payroll deductions)
Saver HSA Option Classic Option
Retiree Only $ 103 $ 151
Retiree + Spouse $ 205 $ 302
Retiree + Children $ 205 $ 302
Family $ 308 $ 453
Company Contribution to Health Savings Account
Saver HSA Option Classic Option
HSA Funding$350 Retiree Only/
$700 Retiree + Dependents**None
2016 Health Plan Options Comparison
Health Plan (includes Medical, Surgical, Mental Health and Chemical Dependency)
Saver HSA OptionIn-network benefits
Classic OptionIn-network benefits
Deductible$1,350 Retiree Only $500 Individual
$2,700 Retiree + Dependents** $1,000 Family
Out-of-Pocket (OOP) Maximum*
$5,000 Individual $3,000 Individual
$10,000 Family $6,000 Family
Coinsurance You pay 20% after deductible You pay 20% after deductible
Office Visit You pay 20% after deductible$20 for primary care;
$50 for specialist and urgent care
Preventive Services
Plan covers at 100% (no deductible) Plan covers at 100% (no deductible)
ER ChargeDeductible, then $150 charge,
then 20% coinsurance$150 charge, then deductible
plus 20% coinsurance
* Medical and prescription drug expenses will apply toward meeting the out-of-pocket maximum.** Retiree + Dependents covers Retiree + Spouse, Retiree + Child(ren) and Retiree + Family.
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Prescription Drugs (Rx)
Marathon Petroleum’s prescription drug coverage for both Health Plan options is administered by Express Scripts. You will automatically receive prescription drug coverage if you enroll in either Health Plan option. Your prescription drug costs will depend on the Health Plan option you elect, whether you purchase at a retail pharmacy or through mail order, and the type of prescription drugs you buy (i.e., generic or brand name).
All prescription and specialty drugs MUST be purchased through Express Scripts Mail Order or at a Participating Network Pharmacy, or there will be no coverage from the Plan.
Saver HSA Option Classic Option
Out-of-Pocket Maximum Combined with medical
Prescription Annual Deductible Combined with medicalRetail Only —
$100 Individual; $200 Family
Retail (30-day supply):• Generic Drugs• Preferred Brand Drugs• Non-Preferred Brand Drugs
You pay 20% after deductible*$10 after deductible$30 after deductible$60 after deductible
Mail Order (90-day supply):• Generic Drugs• Preferred Brand Drugs• Non-Preferred Brand Drugs
You pay 20% after deductible*$25$75$150
* Certain generic preventive drugs under the Saver HSA option are covered at 100%. A list of these drugs can be found at www.myMPCbenefits.com.
GENERIC DRUGS — YOU AND THE COMPANY SAVE MONEY
Always Verify In-Network Providers
You are responsible for determining whether or not your providers are in the Anthem BlueCross BlueShield (Anthem BCBS) network and if your pharmacy is in the Express Scripts network. Please note that Walgreens is not a participating pharmacy within the Marathon Petroleum Express Scripts network.
To search for Anthem BCBS in-network providers, call Anthem BCBS at 1-855-698-5676 or go to www.Anthem.com. Express Scripts information is available at 1-877-207-1357 or www.express-scripts.com.
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Marathon Petroleum Benefits Open Enrollment Guide
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Health Savings Account (HSA)New for 2016: The Health Savings Account, administered by Fidelity, is a triple-tax-advantaged account that you can use to pay for qualified health-related expenses, including copays, coinsurance and deductibles for medical, prescription drug, dental and vision expenses. You are eligible to open an HSA only if you enroll in the Saver HSA option of the Health Plan.
If you open an HSA, Marathon Petroleum contributes $350 for Retiree Only coverage or $700 for Retiree + Dependents coverage to your HSA. You can also contribute to your HSA with pre-tax contributions, up to the IRS limits. For 2016, the IRS limits are:
• $3,350 for Retiree Only coverage ($350 MPC contribution + $3,000 retiree contribution).
• $6,750 for Retiree + Dependents coverage ($700 MPC contribution + $6,050 retiree contribution).
• Plus an additional $1,000 in catch-up contributions if you’re over age 55.
You manage this account. You can choose to save and invest the money with tax-free earnings or use it to pay eligible expenses during the year, up to your current balance. If you had an HSA with a previous health plan, you can transfer it to your Fidelity HSA.
Your HSA has a triple-tax advantage because:
• The contributions you make are pre-tax.
• Any investment earnings are tax-free.
• Payments from the account for qualified health care expenses are tax-free.
At any time, you may make an after-tax contribution to your Fidelity HSA online, by transferring money online into your HSA from another Fidelity account or from an outside bank using electronic funds transfer (EFT), or by check. You may also call a Fidelity Representative to transfer money. You then
report all contributions to your HSA on Form 8889 and file it with your Form 1040 or Form 1040NR.
HSA funds roll over from year to year and belong to you so you will always have access to these funds. You do not need to submit receipts for reimbursement. However, it’s recommended you save receipts and records in case the IRS requests proof that these funds were used for qualified health care expenses.
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Notice for Marathon Petroleum Health Reimbursement Account (MPHRA) ParticipantsIf you are a Marathon Petroleum Health Reimbursement Account (MPHRA) participant, and you have an available balance as of January 1, 2016, your account will be converted to a Limited-Purpose Health Reimbursement Account. As a Pre-65 Retiree, the balance can be used to reimburse yourself for out-of-pocket dental and vision expenses (no medical), as well as premiums for the Retiree Health Plan, Pre-65 Retiree Dental Plan or Pre-65 Retiree Vision Plan. This is available only if you have a remaining MPHRA balance from 2015. You can continue to access these HRA funds regardless of which Health Plan option you choose for 2016. The administrator for this account has changed from ADP to PayFlex.
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2016 Account Comparisons
HSA Limited-Purpose HRA
Who is eligible? Saver HSA option participants Retirees with a balance in their MPHRA on 1/1/2016
Who may contribute? MPC and Retiree MPC only; however, as of 2016, MPC no longer contributes
Who is the administrator? Fidelity PayFlex
Maximum Annual Contribution (Cap)*
$3,350 (Retiree Only); $6,750 (Retiree + Dependent(s))
As of 2016, MPC no longer contributes
Can I invest the money? Yes No
Tax Treatment Tax-Free Tax-Free
Medical Expenses Allowed IRC 213(d) Expenses No (Dental and Vision only)
MPC Contributes to the Account
Yes As of 2016, MPC no longer contributes
Balance Carries Over Year to Year
Yes Yes
* Maximum amounts include Company contribution.
The HSA account is used to reimburse eligible health care expenses. To view a list of eligible HSA expenses for this account, refer to IRS Publication 502, which you can obtain through your local IRS office or from the IRS’s website at www.irs.gov. Please be aware that the rules governing IRS-qualified health care expenses are subject to change from year to year.
DOCUMENTATION REQUIREMENTS
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Marathon Petroleum Benefits Open Enrollment Guide
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Pre-65 Retiree Dental PlanMarathon Petroleum’s Pre-65 Retiree Dental Plan is administered by Cigna Dental. Under this Plan, you can receive care from any licensed dentist. However, you can save more when you receive care from a dentist in the Cigna Dental Preferred Provider Organization (DPPO) Advantage Network, since these dentists have agreed to give Plan members the largest discounts. To find a Cigna Advantage Network provider, call Cigna at 1-800-244-6224 or go to www.cigna.com. This Plan is not open to new enrollment.
2016 Pre-65 Retiree Dental Plan Monthly Contributions
Contribution amounts for the Pre-65 Retiree Dental Plan will remain the same for 2016.
Retiree Only
Retiree + Spouse
Retiree + Children
Retiree + Family
Cigna Dental PPO $23 $46 $50 $79
Pre-65 Retiree Dental Plan Overview
There are no Plan changes for 2016.
Cigna Dental PPO
Calendar Year Maximum (Individual) $1,000
Calendar Year Deductible• Individual Maximum• Family Maximum
$50 per personN/A
Preventive & Diagnostic Care:• Oral Exams• Cleanings• Routine and Non-Routine X-Rays• Fluoride Application• Sealants• Space Maintainers (limited to non-orthodontic treatments) • Emergency Care to Relieve Pain
Plan covers 100% (no deductible)
Basic Restorative Care:• Fillings• Oral Surgery • Surgical Extraction of Impacted Teeth• Anesthetics• Major and Minor Periodontics• Root Canal Therapy/Endodontics• Relines, Rebases and Adjustments• Repairs: Bridges, Crowns and Inlays• Repairs: Dentures
You pay 20% after deductible is met
Major Restorative Care:• Crowns/Inlays/Onlays• Dentures• Bridges
You pay 50% after deductible is met
Orthodontic Care Not covered
Claims ID cards are not issued for the Pre-65 Retiree Dental Plan. You or your provider files a claim
form for reimbursement.
The Pre-65 Retiree Dental Plan details and claim form can be found at www.myMPCbenefits.com.
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Pre-65 Retiree Vision PlanThe Marathon Petroleum Vision Plan is administered by Anthem Blue View Vision. Vision coverage includes regular eye exams and the opportunity to purchase glasses and contact lenses at discounted rates. You can receive care from any licensed eye care professional, but if you see an Anthem in-network provider, you receive a higher level of benefits and there are no claim forms to file.
If you see an out-of-network provider, you receive a lesser discount on services and must file a claim for reimbursement. For a list of in-network providers, call Anthem at 1-866-723-0515 or visit www.Anthem.com. This Plan is not open to new enrollment.
2016 Pre-65 Retiree Vision Plan Monthly Contributions
Contribution amounts for the Pre-65 Retiree Vision Plan will increase slightly for 2016.
Retiree Only
Retiree + Spouse
Retiree + Children
Retiree + Family
Vision Plan $7 $12 $13 $20
Pre-65 Retiree Vision Plan Overview
There are no Plan changes for 2016.
Plan Features In-Network Out-of-Network
Frequency of Service • Exams• Lenses/Contacts• Frames
Once every calendar yearOnce every calendar yearOnce every other calendar year
Once every calendar yearOnce every calendar yearOnce every other calendar year
Exams
Frames
Lenses• Single Vision• Bifocal• Trifocal
No copay
No copay (Up to $130 retail)
$10 copay$10 copay$10 copay
Up to a maximum allowance of $35
Up to a maximum allowance of $45
Up to a maximum allowance of $25Up to a maximum allowance of $40Up to a maximum allowance of $55
Contact Lenses (in lieu of prescription eyeglass lenses)
Up to a maximum allowance of $130
This benefit applies to one order of contact lenses per calendar year
Up to a maximum allowance of $105
This benefit applies to one order of contact lenses per calendar year
The Pre-65 Retiree Vision Plan details and the out-of-network claim form can be found at www.myMPCbenefits.com.
THAT’S ALL THE CHANGES FOR 2016
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Marathon Petroleum Benefits Open Enrollment Guide
Useful ContactsPlan or Service Online Phone
Marathon Petroleum Benefits Service Center
Online access to Plan documents, forms and updates
Email: [email protected]
http://www.myMPCbenefits.com
1-888-421-2199
Health Care
Saver HSA and Classic Health Plan Options
Anthem BlueCross BlueShield Find Providers, Claims and ID Cards Pre-Certification
http://www.anthem.com Group #: 003329993
1-855-698-5676 1-866-776-4793
Prescription Drug Program Express Scripts
http://www.express-scripts.com Group #: MARAPET
1-877-207-1357
Billing/Premiums PayFlex
http://www.payflex.com
1-844-PAYFLEX (1-844-729-3539)
Pre-65 Retiree Dental Plan Cigna Dental PPO
http://www.cigna.com Group #: 2499499
1-800-244-6224
Pre-65 Retiree Vision Plan Anthem Blue View Vision
http://www.anthem.com
1-866-723-0515
Health Savings Account (HSA)
Fidelity http://www.netbenefits.com/marathonpetroleum
1-866-602-0595
Limited-Purpose Health Reimbursement Account (HRA)
PayFlex www.payflex.com 1-844-PAYFLEX (1-844-729-3539)
CHANGES THROUGHOUT THE YEAR
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Important Notices
Marathon Petroleum is required by law to provide you with certain notices that inform you about your rights regarding eligibility, enrollment and coverage of health care plans.
Special Enrollment Notice/Medicaid and State Children’s Health Insurance Program (S-CHIP)Special enrollment events allow you and your eligible dependents to enroll for health coverage outside of the Benefits Open Enrollment period under certain circumstances if you lose eligibility for other coverage, become eligible for state premium assistance under Medicaid or the State Children’s Health Insurance Program (S-CHIP), or acquire newly eligible dependents. This is required under the Health Insurance Portability and Accountability Act (HIPAA).
If you decline enrollment in a medical plan for you or your dependents (including your spouse/domestic partner) because of other health insurance coverage, you or your dependents may be able to enroll in a medical plan without waiting for the next Benefits Open Enrollment period if you:
• Lose other coverage. You must request enrollment within 60 days after the loss of other coverage.
• Gain a new dependent as a result of marriage, birth, adoption or placement for adoption. You must request enrollment within 60 days after the marriage, birth, adoption or placement for adoption.
• Lose Medicaid or Children’s Health Insurance Program (S-CHIP) coverage because you are no longer eligible. You must request enrollment within 60 days after the loss of such coverage.
In addition, you may enroll in a medical plan if you become eligible for a state premium assistance program under Medicaid or S-CHIP. You must request enrollment within 60 days after you gain eligibility for such coverage. To request special enrollment or obtain more information, contact the Benefits Service Center at 1-888-421-2199.
PLEASE NOTE: Patient Protection NoticeMarathon Petroleum generally allows the designation of a primary care provider for its Health Plan options. You have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members. For information on how to select a primary care provider, and for a list of the participating primary care providers, contact the Plan Administrator.
For children, you may designate a pediatrician as the primary care provider.
You do not need prior authorization from Marathon Petroleum or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals.
Women’s Health and Cancer Rights Act of 1998 NoticeThe Women’s Health Act requires the publication of the following notice annually:
The Plan provides mastectomy coverage and also provides for reconstructive surgery in a manner determined in a consultation with the attending physician and the patient. Coverage includes reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prostheses and treatment of physical complications at all stages of the mastectomy, including lymphedemas.
This notice is made solely to satisfy the Act’s requirements. The Health Plan has always covered such procedures and in no way does this reflect a change in plan provisions.
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Marathon Petroleum Benefits Open Enrollment Guide
Summaries of Benefits and Coverage
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Notes
Marathon Petroleum Benefits Open Enrollment Guide
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Pre-65 Retirees