2019 benefits guide...finally, the bswift benefit administration system is accessible from any...

California Graduate Students

2019 BENEFITS GUIDE

GETTING STARTED 4 4 Benefits Bird’s Eye View 5 What’s New in 2019 7 Welcome to Open Enrollment

YOUR HEALTH 10 10 Medical 12 Graduate Student Choice POS II Plan 14 Dental Plan 15 Vision Plan

LIFE AND AD&D 16 16 Voluntary Life and AD&D

WORK/LIFE 17 17 Employee Assistance Program (EAP) 18 Perks from Work 19 Even More Coverage Options

COSTS & DIRECTORY 20 20 Cost Breakdown 21 Directory & Resources

REQUIRED NOTICES 22 22 Plan Guidelines and Evidence of Coverage

Scripps Research 2019 Benefits Information Guide 3.

HELLO!Dear Scripps Research Graduate Student:

The annual Open Enrollment period is October 29, 2018 through November 9, 2018. This booklet is provided as a summary of your benefit options for the 2019 plan year. A quick review found on the following pages highlights information regarding each benefit plan. Information regarding 2019 healthcare benefits is also available through bSwift as well as Scripps Research website under Human Resources, Benefits.

The Human Resources Department is very pleased to announce there are minor changes to the benefit premiums and we have added a few enhancements to the health benefit plans. These changes are highlighted on page 5 of this guide.

As a reminder, preventive care is covered at 100% when using in-network providers under the Graduate Student Choice POS II plan. Essentially, this means you will not have to pay any copay, coinsurance or meet a deductible when obtaining care considered and submitted for payment as preventive. Therefore, we encourage you take advantage of free annual exams to maintain your health. The key to keeping health expenses to a minimum is by staying healthy!

NOTE: Voluntary Life, Voluntary Accidental Death & Dismemberment no longer require paper applications. Please plan accordingly and log on to bSwift early when the system opens on October 29 to allow time to complete your enrollment choices and obtain necessary paper applications.

It is important to note too, if you do not log on and make changes, your coverage will remain the same for the 2019 plan year. After the open enrollment period ends, changes to your coverage may only be made if you experience a qualified status change during the plan year.

Finally, the bSwift benefit administration system is accessible from any computer with internet access. If you are traveling during Open Enrollment and will NOT have internet access, please contact Human Resources to make arrangements to complete a paper enrollment by the November 9, 2018 deadline. Benefits Administration is available for questions and if you wish to request hard copy applications, contact us at 858.784.8487 or [email protected].

Sincerely,

Paige Gearhart Director, Benefits

4. Scripps Research 2019 Benefits Information Guide

BENEFITS BIRD’S EYE VIEW

At Scripps Research, we offer a range of options to fit your lifestyle.

BENEFITS PLAN OPTIONS

Medical Aetna Graduate Student Choice POS II

Dental Delta Dental PPO

Vision MES Vision

Life & Disability Prudential Supplemental Life and AD&D

Voluntary Options MetLife Voluntary Benefits – NEW!

GETTING STARTED


WHAT’S NEW IN 2019?

Change is Good

Each year, we carefully evaluate the benefit plans and programs we offer, as well as the insurance companies and vendors we partner with. Our goal is provide you and your loved ones with a comprehensive benefits package designed to cultivate healthy lifestyles and happy individuals.

With that in mind, we are pleased to share some great enhancements, new tools and changes to our program that will take effect in 2019.

Employee Contributions – Employees will see minor changes to employee premiums.

Voluntary Benefits – Scripps Research is introducing Critical Illness, Hospital, and Accident plans through MetLife to assist employees with unexpected healthcare needs.

Dental Annual Maximum – The calendar year maximum will increase from $1,500 to $2,000 per person.

Dental Benefits – In-Network benefits for Basic and Major services will increase. In-Network Preventive/Basic/Major coinsurance will increase from 100% / 80% / 50% to 100% / 90% / 60%.

Dental Adult Orthodontia – Scripps Research will add adult orthodontia to be covered at 50% up to $1,500 per lifetime. Covered services are for orthodontia which begins on or after January 1, 2019.

Vision Frame / Contact Lens allowance – In-network frame allowance will increase from $110 to $150 (every 24 months) and contact lens allowance will increase from $100 to $150 (every 12 months).

Online Benefit Enrollment System – Scripps Research is introducing a new benefit enrollment system, bSwift, where employees can make their benefit elections online during Open Enrollment. Access the site at http://scripps.bswift.com.

GETTING STARTED


ENROLLMENT

Who can Enroll?

If you are a Graduate Student regularly working a minimum of 20 hours per week, you are eligible to participate in the benefits program. Eligible Graduate Students may also choose to enroll family members, including a legal spouse/ registered domestic partner (as legally defined under state and local law) and/or eligible children.

Premiums for state registered domestic partners who do not meet the tax dependent definition of IRC section 152 for the employee, may be considered taxable income (unregistered domestic partners will not meet the relationship test under IRC section 152). Premiums for children / registered Domestic Partners step-children under age 26 are not taxable.

When Does Coverage Begin?

Your enrollment choices remain in effect through the end of the benefits plan year, (January 1, 2019 – December 31, 2019). Benefits for eligible new hires will commence as outlined below:

ELIGIBILITY DATE BENEFIT PLAN You are eligible to be enrolled upon your hire date and benefits are effective immediately

Aetna Graduate Student Choice POS II

Delta Dental PPO

MES Vision

Prudential Supplemental Life/AD&D

MetLife Voluntary Benefits

If you miss the enrollment deadline, you may not enroll in a benefit plan unless you have a change in status during the plan year. Please review details on IRS qualified change in status events for more information.

HOW DO I ENROLL?

bSwift

To enroll, follow these simple steps:

Go to http://scripps.bswift.com Username: first initial and last name (e.g. John Doe would be jdoe) Password: last 4 digits of Social Security Number Click on “Start Your Enrollment” to begin making elections. Click “Complete Enrollment” once finished. You can print or email your final confirmation statement once finished.

You will be prompted to verify your personal and family information before selecting your benefits. A helpful tool to walk you through the process is “Ask Emma.” Emma will guide you through your enrollment and help you decide which plans to enroll in if you are unsure. NOTE: An enrollment guide and instructions will be posted on the Benefits Administration webpages.

TIP

GETTING STARTED GETTING STARTED


WELCOME TO OPEN ENROLLMENT Open Enrollment for Scripps Research benefits program is officially underway. You have from now until October 29, when the online Open Enrollment system opens, to:

Assess your personal coverage needs, including those of your dependents;

Learn about your plans; and

Make your decisions for the upcoming plan year.

The online Open Enrollment system closes at 5:00 p.m. Pacific time on Friday, November 9, 2018.

This booklet highlights your benefit plan options, outlines steps to change your coverage elections for 2019, and informs you of where you can receive more information if you have questions.

MEETINGS & EVENTS The choices you make during Open Enrollment must remain in effect for the full plan year, January 1 through December 31, 2019. Please take this opportunity to review your options and make your decisions with care. If you have questions, please contact Benefits Administration at 858.784.8487 or [email protected].

DATE MEETING / EVENT LOCATION & TIME

October 30th Benefits Informational Meeting Keck Amphitheater 2:00pm – 3:00pm

October 31st Benefits Fair Immunology Galleria / Breezeway

10:00am – 1:00pm

November 1st Benefits Informational Meeting HR Training Room

12:00pm – 1:00pm

November 5th Benefits Informational Meeting MB Committee Lecture Hall

10:00am – 11:00am

November 7th Benefits Informational Meeting IT Training Room

11:00am – 12:00pm

GETTING STARTED


WHAT IF MY NEEDS CHANGE DURING THE YEAR? You are permitted to make changes to your benefits outside of the open enrollment period if you have a qualified change in status as defined by the IRS. Generally, you may add or remove dependents from your benefits, as well as add, drop, or change coverage if you submit your request for change within 30 days of the qualified event. Change in status examples include:

Marriage, divorce or legal separation. Birth or adoption of a child. Death of a dependent. You or your spouse’s/registered domestic partner’s loss or gain of coverage through our organization or another

employer. Change in employment status where you have a reduction in hours to an average below 20 hours of service per week,

but continue to be eligible for benefits, and you intend to enroll in another plan. The plan must provide Minimum Essential Coverage that is effective no later than the first day of the second month following the date of revocation of your employer sponsored coverage.

You enroll, or intend to enroll, in a Qualified Health Plan (QHP) through the State Marketplace or Federal Exchange and it is effective no later than the day immediately following the revocation of your employer sponsored coverage.

Dependents entering or leaving the country.

If your change during the year is a result of the loss of eligibility or enrollment in Medicaid, Medicare or state health insurance programs, you must submit the request for change within 60 days. For a complete explanation of qualified status changes, please refer to the “Legal Information Regarding Your Plans” contents.

DO I HAVE TO ENROLL? Most U.S. citizens and legal residents are subject to a federal tax penalty if they do not have minimum essential health coverage. To avoid paying the penalty, you can obtain health insurance through our benefits program or purchase coverage elsewhere, such as a State or Federal Health Insurance Exchange. However, the Individual Mandate penalty after December 31, 2018 will be $0.

All Scripps Research medical plans meet the minimum essential coverage under the Health Care Reform standards, and therefore, you may not be eligible for any Federal subsidies. The State Health Exchange Notice is available for employees through Scripps Research’s Benefits website at www.scripps.edu/hr/benefits.

For information regarding Health Care Reform and the Individual Mandate, please contact Benefits Administration or visit www.cciio.cms.gov. You can also visit www.coveredca.com to review information specific to the Covered California State Health Insurance Exchange.

You may elect to “waive” medical/dental coverage if you have access to coverage through another plan. To waive coverage, you must log into bSwift, waive your medical and/or dental benefits, and provide Human Resources with your proof of other coverage. It is important to note that if you waive our medical coverage, you must maintain minimum essential health insurance through another source. It is also important to note that if coverage is waived, the next opportunity to enroll in our group benefit plans would be for January 1, 2020, or if a qualifying status change occurs.

GETTING STARTED


Aetna

With Aetna’s mobile app, you can:

Search for a doctor, hospital, or pharmacy. Use the “Urgent Care Finder” tool to quickly find urgent care centers and

walk-in clinics. Register for your secure member site to view claims, coverage details, your

ID card and your personal Health record. Contact Aetna by phone or email.

Search for Aetna’s mobile app in the App Store or Google Play to get started!

GETTING STARTED


MEDICAL

What are my Options?

PPO Aetna

Required to select and use a Primary Care Physician (PCP)

No

Seeing a Specialist No referral required

Deductible Required Yes (Out-of-Network Only)

Finding a Provider

(*remember to disable your pop-up blocker)

Go to www.aetna.com/docfind.

1. Search for a physician by name, provider type, specialty, or location. Once you have made your selections, click on Search. Please remember to turn off pop-up blockers.

2. This will prompt you to select a plan. Under “Aetna Open Access” plans, select Aetna Choice POS II (Open Access). Click Continue.

Other Important Tips You may choose in or out of network care, however in-network care provides you a higher level of benefit.

Emergencies covered worldwide.

Out of network providers will bill the balance to the member for amounts not covered by Aetna

Please note the above examples are used for general illustrative purposes only. Please consult with your Human Resources Department for more specific information as it relates to your specific plan. For a detailed view of your medical plan summaries, visit http://scripps.bswift.com or visit the Benefits Administration webpage at www.scripps.edu.

YOUR HEALTH


WHY PAY MORE? There are a few ways you can save money when using the Prescription Drug Plan:

YOUR HEALTH


GRADUATE STUDENT CHOICE POS II PLAN The Graduate Student Choice POS II Plan is a Preferred Provider Organization (PPO) Plan that utilizes the Aetna Choice POS II (Open Access) Network. It allows you to choose Aetna network or non-network providers each time you need care. Network providers have contracted with the plan to provide services at lower rates, so using these providers will save you money.

With network providers, the plan pays 100% of the cost of all services. With non-network providers, your deductible is $200 per person ($600 maximum per family), and the plan then pays 70% of the cost for most covered services. Preventive care through network providers is covered at 100% and not subject to deductible. Claims are administered by Aetna.

The Graduate Student Choice POS II offers comprehensive coverage, provider choice and complete flexibility. To receive the highest level of benefits you must always use Aetna network providers. Please note that providers include doctors, hospitals, urgent care clinics, laboratory and x-ray facilities. It is important to check that your doctor has referred you to a network facility in order for lab or x-ray services to be considered in-network. Often, doctors will utilize several lab services and you can request to be sent to an in-network facility.

OPTUM RX PRESCRIPTION DRUG COVERAGE The prescription benefit for the Graduate Student Choice POS II Plan is administered through OptumRx. There is a $100 (Individual) / $200 (Family) Annual Deductible applied to brand name drugs before the copay applies. There is also a separate Out-of-Pocket Maximum of $2,000 (Individual) / $4,000 (Family) for prescription drugs.

The following retail copays apply:

Generic is a $10 copay Brand Formulary is a $35 copay Non-Formulary Brand is a $60 copay

A preferred drug list or formulary provides access to quality, affordable prescription drug benefits. Drugs chosen for the formulary have gone through an extensive review process. The drugs listed on the preferred drug list either represent an important therapeutic advance, or are clinically equivalent and possibly more cost-effective than other drugs not on the preferred drug list. The formulary is typically updated every three months to provide a clinically appropriate list of medicines to meet participants’ needs. To determine if your brand name prescriptions are considered formulary or non-formulary and subject to the third tier copay, log onto www.optumrx.com or call OptumRx at 855.395.2022.

What if I want a brand when a generic is available?

In the event that a generic is available but the pharmacy dispenses the brand per the member’s request, the Plan Member will pay the generic copay plus the difference in cost between the brand and the generic. If a physician writes “dispense as written” or “do not substitute” on the prescription, then the applicable brand copay should apply in that instance

For a current version of the prescription drug list(s), please log into your OptumRx online account at www.optumrx.com.

YOUR HEALTH YOUR HEALTH


PLAN HIGHLIGHTS AETNA GRADUATE STUDENT CHOICE POS II

In-network Out-of-network Annual Calendar Year Deductible

Individual None $200 Family None $600

Maximum Calendar Year Out-of-Pocket (1) Individual $2,000 $2,000 Family $4,000 $4,000

Lifetime Maximum Individual Unlimited Unlimited

Professional Services Primary Care Physician (PCP) Covered 100% 30% after deductible Specialist Covered 100% 30% after deductible Preventive Care Exam Covered 100% Cancer screenings only Well-baby Care Covered 100% Cancer screenings only Diagnostic X-ray and Lab Covered 100% 30% after deductible Complex Diagnostics (MRI/CT Scan) Covered 100% 30% after deductible Therapy, including Physical, Occupational and Speech (up to 39 visits per calendar year)

Covered 100% 30% after deductible

Hospital Services

Inpatient Covered 100% 30% after deductible

Additional $200 Copay applies if not pre-authorized

Outpatient Surgery Covered 100% 30% after deductible Emergency Room Covered 100% Covered 100% Urgent Care Covered 100% 30% after deductible

Maternity Care Physician Services (prenatal or postnatal) Covered 100% 30% after deductible Hospital Services Covered 100% 30% after deductible

Mental Health & Substance Abuse Mental Health/Substance Abuse through OptumHealth

Inpatient Covered 100% 30% after deductible

Additional $200 Copay applies if not pre-authorized

Outpatient Covered 100% 30% after deductible Prescription Drugs Prescription Coverage through OptumRx

Prescription Drug Calendar Year Deductible $100/person $200/family

Prescription Calendar Year Out-of-Pocket Maximum $2,000/person $4,000/family

Retail Prescription Drugs (30-day supply) Generic $10 Copay Formulary Brand $35 Copay after Rx deductible Non-Formulary Brand $60 Copay after Rx deductible

Mail Order Prescription Drugs (90-day supply) Generic $20 Copay Formulary Brand $70 Copay after Rx deductible Non-Formulary Brand $120 Copay after Rx deductible

(1) Out-of-pocket maximum is based on the maximum allowable charge the carrier allows. This does not include any balance billing that may occur when using an out-of-network provider.

The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions.

YOUR HEALTH


DENTAL PLAN

Your Dental PPO Plan

This year, you and your eligible dependents have the opportunity to enroll in a Dental Preferred Provider Organization (PPO) plan offered by Delta Dental.

Using the Plan

The Dental PPO plan is designed to give you the freedom to receive dental care from any licensed dentist of your choice. Keep in mind, you’ll receive the highest level of benefit from the plan if you select an in-network PPO dentist versus an out-of-network dentist who has not agreed to provide services at the negotiated rate. Additionally, no claim forms are required when using in-network PPO dentists.

To view a complete plan summary, log on to your bSwift account at http://scripps.bswift.com.

PLAN HIGHLIGHTS DELTA DENTAL PPO

PPO Dentist Delta Premier

Provider All Other Providers

Calendar Year Deductible Individual

----------------------$50 / person*---------------------- Family

Annual Maximum Individual ---------------$2,000 / Calendar Year---------------

Dental Services Preventive 100%

Deductible waived 80% 80%

Basic Services 90% 80% 80% Major Services 60% 50% 50%

Orthodontia Services Child up to age 19 50% 50% 50% Adult 50% 50% 50% Lifetime Maximum ---------------$1,500 / Person / Lifetime---------------

*Deductible does not apply to Orthodontia services.

The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions. Delta Premier Dentist and All Other Provider network charges are based off of reasonable and customary rates.

Choose your Primary Care Dentist

When using a Dental PPO plan, you can receive services from dental providers both in and out of your insurance network. However, you’ll receive better coverage when you use an in-network dentist. To determine whether your dentist is in or out of your insurance network, go to www.deltadentalins.com.

TIP

YOUR HEALTH


VISION PLAN

Your Vision Plan

If you are enrolled in a Scripps Research medical plan (Comprehensive Choice POS II, Select HMO, or HDHP Aetna Choice POS II plans), you receive vision benefits through MESVision.

Using the Plan

As with a traditional PPO, you may take advantage of the highest level of benefit by receiving services from in-network vision providers and doctors. You would be responsible for a copayment at the time of your service. However, if you receive services from an out-of-network doctor, you pay all expenses at the time of service and submit a claim for reimbursement up to the allowed amount.

To view a complete plan summary, log on to your bSwift account at http://scripps.bswift.com. To locate an in-network vision provider, visit www.mesvision.com.

PLAN HIGHLIGHTS MES VISION PPO

In-Network Out-of-Network Copay $10 Copay / Person $10 Copay / Person Exam – Every 12 months Plan pays 100% Up to $40 allowance Lenses – Every 12 months

Single Plan pays 100% Up to $30 Bifocal Plan pays 100% Up to $50 Trifocal Plan pays 100% Up to $65

Frames – Every 24 months Plan pays 100% up to a $150 frame allowance Up to $75

Contacts – Every 12 months, in lieu of lenses & frames Medically Necessary Plan pays 100% Up to $250

Cosmetic Plan pays 100% up to $150,

plus up to $40 for a contact lens fitting fee

Up to $150 allowance, plus up to $40 for a contact lens fitting

fee

The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions.

Five Tips for Superior Vision

Don’t take your eyes for granted! The following pointers can help you keep your vision strong:

Eat lots of leafy greens and dark berries. Get regular eye exams. Give your eyes a rest from staring into the computer screen. Wear sunglasses to protect your eyes from bright light. Wear safety eyewear whenever necessary.

TIP

YOUR HEALTH


VOLUNTARY LIFE AND AD&D Voluntary Life and AD&D coverage for you and your dependents is available for purchase on a payroll deduction basis through Prudential.

Voluntary Life Insurance

For Graduate Students: Increments of $10,000 up to a $500,000 maximum with a guarantee issue benefit of $100,000 if you enroll in the plan upon of your initial eligibility.

For your spouse: Increments of $10,000 up to a $500,000 maximum with a guarantee issue benefit of $50,000 if you enroll in the plan upon your initial eligibility.

For your child(ren): increments of $2,500, up to $10,000 with a guarantee issue benefit of $10,000

Any amounts of insurance over the guarantee issue benefit are subject to review of good health by the insurance company. Insurance amounts subject to review will not be effective until the insurance company approves.

If you do not enroll in the plan within the initial enrollment period, any amount of supplemental life insurance will require proof of good health, which is subject to approval by the insurance company before the insurance is effective. For more information regarding this plan, review the plan summary detail.

Rates and application are available for download via bSwift.

Voluntary AD&D Insurance For Graduate Students: Increments of $50,000 up to a $500,000 maximum with a guarantee issue benefit of

$500,000. For spouse: Coverage amount equal to 50% of Graduate Student amount For your child(ren): Coverage amount equal to 15% of Graduate Student amount Family: Coverage amount for your spouse/domestic partner equal to 40% of Graduate Student amount. Coverage

amount for child(ren) equal to 10% of Graduate Student amount.

You are eligible for this benefit if you are under the age of 70, and work at least 20 hours per week in a benefit eligible position.

Rates and detailed plan summaries are available for download via bSwift.

LIFE AND AD&D


EMPLOYEE ASSISTANCE PROGRAM (EAP) Scripps Research understands that you and your family members might experience a variety of personal or work-related challenges. Through the EAP, you have access to resources, information, and counseling that are fully confidential and no cost to you.

PROGRAM COMPONENT COVERAGE DETAILS Who Can Utilize All Graduate Students, dependents of employees, and members of your household

Topics May Include Childcare. Eldercare. Legal services. Marital, relationship or family problems. Bereavement or grief counseling. Substance abuse and recovery. Educational materials.

Number of Sessions About 10 face-to-face sessions per year per member

How to Access onsite Counseling and Psychological Services Department:

By Phone: 858.784.7297. By Email: [email protected].

TIP

WORK/LIFE


PERKS FROM WORK For information regarding personal time off, sick days, and leaves of absence, please contact Scripps Research’s Graduate Office for guidance.

WORK/LIFE


EVEN MORE COVERAGE OPTIONS

Critical Illness Coverage

Offered by MetLife, critical illness coverage is generally paid in the form of a one-time, lump sum payment, dependent on the illness. This will help reduce expenses associated with life-threatening diseases. Some of the covered medical conditions include:

Cancer. Heart attack. Stroke.

Kidney failure. Organ transplant.

Employees may elect either $10,000, $20,000, or $30,000 for themselves and 50% of employee’s amount for spouse and/or child(ren). Guaranteed issue will be available up to $30,000. This means you will be permitted to enroll and provided this coverage amount regardless of health status, age, gender or other factors. If you’re considering this type of coverage, you must enroll when you first become eligible or during the annual open enrollment period.

Hospital Protection

Although medical insurance may pay for a portion of hospital expenses, deductibles, copayments, and out-of-network costs; the expenses can still add up. Having Hospital Protection through MetLife may help by paying cash to you or your family to offset both medical and non-medical bills when you’re sick, injured, or on maternity leave. The cash benefits can be used to help pay for services or expenses your other medical plan might not cover, such as:

Copayments. Deductibles. Transportation expenses.

Child care. Prescriptions. Lost income.

Coverage is guaranteed issue. This means you will be permitted to enroll and provided this coverage amount regardless of health status, age, gender, or other factors. If you’re considering this type of coverage, you must enroll when you first become eligible or during the annual open enrollment period.

Accident Plan

Accidents happen when you least expect them and can include motor vehicle accidents, sports injuries, slips, falls or just every day mishaps! MetLife’s policy may pay cash to help families offset the expenses associated with accidents or injuries. Benefits may be paid for:

Emergency room and doctor visit. Follow up and physical therapy visits. Hospital admission and confinement.

Ambulance. Medical Equipment (crutches, leg braces, etc.).

If you’re considering this type of coverage, you must enroll when you first become eligible or during the annual open enrollment period.

.

WORK/LIFE WORK/LIFE


2019 BENEFIT PREMIUMS

The monthly rates below are effective January 1, 2019 – December 31, 2019.

COVERAGE LEVEL GRADUATE STUDENT

CONTRIBUTION SCRIPPS RESEARCH

CONTRIBUTION TOTAL MONTHLY

PREMIUM Anthem Graduate Student Choice POS II Plan Graduate Student Only $0 $660 $660 Graduate Student and Spouse / DP $160 $1,160 $1,320 Graduate Student and Child(ren) $100 $1,003 $1,103 Graduate Student and Family $250 $1,513 $1,763

Delta Dental PPO Plan Graduate Student Only $0 $45 $45 Graduate Student and Spouse / DP $20 $69 $89 Graduate Student and Child(ren) $15 $60 $75 Graduate Student and Family $35 $84 $119

Voluntary Benefits (Critical Illness, Hospital, Accident)

Rates and elections are available in bSwift.

Voluntary Life Insurance Premiums

Rates and elections are available in bSwift. Paper applications no longer required.

Voluntary Accidental Death & Dismemberment Insurance Premiums

Rates and elections are available in bSwift. Paper applications no longer required.

COSTS & DIRECTORY


DIRECTORY & RESOURCES

Below, please find important contact information and resources for Scripps Research.

INFORMATION REGARDING GROUP /

POLICY # CONTACT INFORMATION Enrollment & Eligibility Human Resources: • Benefits Administration Online Enrollment Vendor: • bSwift

858.784.8487

contact HR for bSwift

support

[email protected] http://scripps.bswift.com

Medical Coverage Aetna • Graduate Student Choice POS II

805400

877.204.9186

www.aetna.com

Voluntary Benefits Coverage MetLife • Critical Illness • Accident • Hospital

216332 216332 216332

800.GET.MET8 800.GET.MET8 800.GET.MET8

www.mybenefits.metlife.com www.mybenefits.metlife.com www.mybenefits.metlife.com

Dental Coverage Delta Dental • Dental PPO

8593

888.335.8227

www.deltadentalins.com

Vision Coverage MES Vision • Vision PPO

97-005

800.877.6372

www.mesvision.com

Life / AD&D Prudential • Supplemental Life/AD&D

00179

800.842.1718

www.prudential.com

Employee Assistance Plan Onsite Scripps Research Counseling Department 858.784.7297 [email protected]

COSTS & DIRECTORY


PLAN GUIDELINES AND EVIDENCE OF COVERAGE

The benefit summaries listed on the previous pages are brief summaries only. They do not fully describe the benefits coverage for your health and welfare plans. For details on the benefits coverage, please refer to the plan’s Evidence of Coverage. The Evidence of Coverage or Summary Plan Description is the binding document between the elected health plan and the member.

A health plan physician must determine that the services and supplies are medically necessary to prevent, diagnose, or treat the members’ medical condition. These services and supplies must be provided, prescribed, authorized, or directed by the health plan’s network physician unless the member enrolls in the PPO plan where the member can use a non-network physician.

The HMO member must receive the services and supplies at a health plan facility or skilled nursing facility inside the service area except where specifically noted to the contrary in the Evidence of Coverage.

For details on the benefit and claims review and adjudication procedures for each plan, please refer to the plan’s Evidence of Coverage. If there are any discrepancies between benefits included in this summary and the Evidence of Coverage or Summary Plan Description, the Evidence of Coverage or Summary Plan Description will prevail.

REQUIRED NOTICES


Prepared by: Marsh & McLennan Insurance Agency LLC www.MarshMMA.com | CA Insurance Lic: 0H18131

2019 benefits guide...finally, the bswift benefit administration system is accessible from any...

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