inscripcion abierta 2015 4 de noviembre a 25 de noviembre … · 2014-10-31 · inicie sesión en...

101 South Mills Avenue, Claremont, CA 91711 (909) 621-8151 (909) 607-7353

INSCRIPCION ABIERTA 2015 4 de noviembre a 25 de noviembre 2014

¿Qué hay dentro? ¿Qué es la Inscripción Abierta? Lo Que Debe Hacer Durante la Inscripción Abierta Recursos para Inscripción Abierta 2015

Guías de Inscripción Abierta y Beneficios 2015

Su guía a la Cuenta de Ahorros de Salud Anthem Lumenos (HSA)

Cuenta de Gasto Flexibles Limitada (FSA) y la Cuenta de Ahorros de Salud (HSA): Cómo trabajan juntas

Reuniones Informativas y Feria de Salud 2015 Contactos de CUC Administración de Beneficios

¿Qué es la Inscripción Abierta? Inscripción Abierta es su oportunidad anual para realizar cambios en sus opciones de beneficios y agregar o eliminar la cobertura para dependientes. Inscripción Abierta para sus beneficios 2015 tendrá lugar del 04 de noviembre al 25 de noviembre de 2014. Inscripción abierta seguirá siendo una Inscripción Activa. Si usted no toma ninguna acción, usted no tendrá cobertura en 2015. Los beneficios que usted elija durante la Inscripción Abierta serán efectivos el 1 de enero 2015 y permanecerán vigentes hasta el 31 de diciembre de 2015, a menos que tenga un evento de vida calificado que le permitirá hacer un cambio a mitad de año.

2015 Open Enrollment


Lo Que Debe Hacer Durante Inscripción Abierta Todos los empleados deben participar en la Inscripción Abierta para recibir cobertura para el año 2015, con la excepción de algunos de los beneficios que proporciona la compañía. Mientras se prepara para inscribirse en sus beneficios, le animamos a que:

1. Revise el material de Inscripción Abierta proporcionada en este paquete. 2. Revise los guías de Inscripción Abierta y Beneficios 2015 que puede encontrar en el sitio de

web www.cuc.claremont.edu/benefits. 3. Asista a una reunión informativa, vea programa adjunto. 4. Asista a la Feria de Salud 2015, vea el folleto adjunto. 5. Piense en sus beneficios actuales para asegurarse de que sus elecciones se ajusten a sus

necesidades. Si lo hacen, debe volver a inscribirse en estas opciones de beneficios para el próximo ano. Si no lo hacen, decida lo que hay que cambiar para asegurarse de tener la cobertura adecuada en 2015.

6. Tenga en cuenta, el mandato individual requiere que usted tendrá que tener cobertura médica a partir del primero de enero 2015. Si actualmente no tiene cobertura, ahora es el tiempo para considerar cuidadosamente sus opciones, consulte la información sobre La Reforma de Salud adjunta.

7. Inicie sesión en UltiPro utilizando el enlace a través de la página web de su escuela lo más tarde el martes 25 de noviembre para hacer sus elecciones de beneficios para el 2015.

Recursos para Inscripción Abierta 2015 Es importante para The Claremont Colleges que usted este bien informado acerca de los beneficios que se le ofrecen. Le animamos a aprovechar los siguientes recursos para tomar las mejores decisiones sobre beneficios para usted y su familia:

Folleto de Inscripción Abierta 2015: El folleto en este paquete le da información general de los cambios para el 2015, así como las primas para los beneficios.

Guía de Inscripción Abierta 2015: Este guía electrónico está disponible en el sitio de web de CUC. El guía describe los cambios para el 2015, lo que tiene que hacer durante Inscripción Abierta, como inscribirse o hacer cambios y las primas de beneficios para el 2015. Usted puede ver este guía hasta el 25 de noviembre 2014.



Guía de Beneficios 2015: El Guía de Beneficios 2015 está disponible como parte del guía electrónico de Inscripción Abierta que se mencionó anteriormente. Esta guía incluye amplia información sobre todos los beneficios ofrecidos por The Claremont Colleges. El Guía de Beneficios 2015 seguirá a su disposición en el sitio web de CUC durante todo el año de 2015.

Su guía para el Plan de Cuenta de Ahorros Anthem Lumenos (HSA): Esta guía

proporciona los detalles sobre cómo el plan y la cuenta HSA trabajan juntos y cómo puede ahorrar dinero al inscribirse en este plan. Una copia del guía está disponible en la página web de CUC en www.cuc.claremont.edu/benefits.

Cuenta de Gasto Flexibles Limitada (FSA) y la Cuenta de Ahorros de Salud (HSA):

Cómo Funcionan Juntas: Este guía describe cómo funciona una cuenta HSA junto con otra cuenta de ahorro la Cuenta de Gastos Flexibles limitada de Salud (FSA). Una copia del guía está disponible en la página web de CUC en www.cuc.claremont.edu/benefits.

2015 Inscripción abierta Reuniones Informativas y Feria de Salud y Beneficios: La

Administración de Beneficios CUC está ofreciendo numerosas reuniones informativas durante toda la Inscripción Abierta para todos los profesores y el personal. La Feria anual de Salud y Beneficios será el viernes 07 de noviembre 2014 y el bienestar es nuestro principal objetivo. Durante la feria usted podrá hablar con diferentes representantes de nuestros planes y obtener información sobre los servicios de bienestar que se pueden utilizar a través de los diferentes planes para 2015. Las reuniones de información proporcionarán una revisión de los cambios para el 2015 y da tiempo para que usted pueda hacer preguntas. Las reuniones se presentarán en inglés y español.

Acceso a los Recursos Para acceder a estos recursos vaya a www.cuc.claremont.edu/benefits. Si esta acezando estos recursos de una computadora Apple, tendrá que descargar Adobe Acrobat Reader (en lugar de utilizar el programa "preview" de Apple). Uso de Acrobat asegura que todos los enlaces y archivos incrustados en el documento funcionen correctamente. Acrobat Reader se puede descargar de www.adobe.com/downloads.



Contactos de CUC Administración de Beneficios CUC Administración de Beneficios está disponible para ayudarle con sus necesidades de Inscripción Abierta y preguntas. Los representantes de la Administración de Beneficios son:

Carol Saldivar [email protected] 909-607-3195Mónica Villanueva [email protected] 909-607-3684Anna Huerta [email protected] 909-607-9494Claudia Garcia [email protected] 909-607-9493Alicia Silvia [email protected] 909-607-4130

El último día de Inscripción Abierta es el 25 de noviembre 2014 a las 5:00 PM PST.

Inscripción Abierta 2015 Noviembre 04 al 25

Fechas Importantes Martes, 04 de noviembre—Inscripción abierta comienza Viernes, 07 de noviembre—Feria de Salud

Administrative Campus Center Martes, 25 de noviembre—Último día de Inscripción Abierta

Inscripción abierta 2015 04 al 25 noviembre The Claremont Colleges están implementando una inscripción activa para 2015, la inscripción activa significa que los empleadosdeben elegir o declinar los beneficios durante la Inscripción abierta activamente. Si no se inscribe de forma activa en el beneficiodeseado, no estará cubierto en el plan en el 2015.

Inscripción Abierta es su oportunidad de hacer cambios en sus elecciones de beneficios, agregar o quitar dependientes, y realizarcambios en sus cuentas de gastos flexibles. Los beneficios que usted elija durante la inscripción abierta serán efectivos el 01 deenero 2015 y seguirá en vigor hasta el 31 de diciembre de 2015, a menos que tenga un evento de vida calificado.

Este folleto describe algunos de los cambios y las primas para sus beneficios del 2015, más información se puede encontrar en elGuía de Beneficios 2015 en www.cuc.claremont.edu/benefits.

¿Quién es elegible para los beneficios? Usted es elegible para participar en los beneficios de eClaremont Colleges si usted es un empleado regular programadopara trabajar por lo menos 20 horas por semana.Un empleado elegible para beneficios se define como:a. Un profesor que está programado para trabajar por lo menos

medio tiempo durante un semestre, con la excepción deprofesor adjunto en Claremont Graduate University (CGU), o

b. Un miembro de la facultad que tiene previsto enseñar al menos tres clases durante el año académico, o

c. Un miembro del personal en un puesto regular que tieneprevisto a trabajar por lo menos 20 horas a la semana, o

d. Un, empleado basado en donaciones de beneficios-elegibles en CGU1. Un empleado contratado en una posición que es financiado

por una subvención incluyendo específicamente expensasdel empleador por beneficiar a la cobertura, y

2. Empleado cumple el número requerido de las horasprogramadas de trabajo, definidas anteriormente.

Todos los demás empleados no son elegibles para los beneficiosmedicos, a menos que cumplen los requerimientos parabeneficios bajo la ley de Cuidado Asequibles que se define en la Declaración de Elegibilidad de Beneficios para ProgramasAdministrados Centralmente de Beneficios disponibles enwww.claremont.edu/benefits.Dependientes Elegibles Si se inscribe a sí mismo en la cobertura de e ClaremontColleges, también puede inscribir a sus dependientes. Losdependientes elegibles incluyen:� Esposo(a) � Pareja de hecho � Niños hasta 26 años de edad, y los niños de cualquier

edad que están mentalmente o físicamente discapacitados y cumplen con ciertos requisitos

� Hijastros o hijos de su pareja de hecho hasta los 26 añosEvento de Vida* Algunos eventos de vida le permiten hacer cambios a susbeneficios a mediados de año. Para ser elegible usted debe teneruno de los siguientes eventos y enviar la documentación a laAdministración de Beneficios dentro de los 30 días del evento.� Nacimiento/Adopción � Matrimonio/Divorcio � Pérdida de cobertura � Ganancias de cobertura de sus dependientes * Por favor, póngase en contacto con su representante de beneficios para

discutir su evento de vida.

Cómo inscribirse Accede a UltiPro usando su nombre de usuario individuo ycontraseña. Vaya a “Myself ” en la barra de menú y haga clic en“Open Enrollment”. Haga sus elecciones y haga clic en el botón“Submit” en la página de confirmación para completar suselecciones del 2015. Tenga en cuenta que usted tiene ahora lacapacidad de restablecer sus elecciones en cualquier momentodurante el periodo de Inscripción Abierta. Para asistencia con su nombre de usuario y contraseña de UltiPropor favor póngase en contacto con su departamento de RecursosHumanos.Cambios en los beneficios 2015� Anthem Blue Cross HMO (CaliforniaCare)

� Sala de emergencias Copago: El copago de visitas a la sala deemergencia aumentarán de $100 a $150 por visita. Si ustedes admitido en el hospital como consecuencia de su visita deemergencia, entonces el copago de emergencia no se aplica yel copago de hospitalización se aplicará.

� Copago de medicamentos: El copago por medicamentos demarca aumentarán, como sigue. No habrá ningún cambioen los copagos de medicamentos genéricos.� Medicamento de marca: $25 a $30 de copago. � Medicamento de marca fuera del formulario:

$40 a $50 de copago.� MetLife PPO

� Frecuencia de rayos X: Para las personas de 19 años o menos,Los rayos X de aleta de mordida serán cubiertos una vez por año.

� Fluoruro frecuencia de aplicación: Para las personas de edad 14 o menos, la frecuencia de aplicación de flúor serácubierto una vez por año.

� Nuevo Administrador de Cuenta de Gastos Flexibles (FSA)� El 1 de enero de 2015, PayFlex reemplazará Benesyst/TASC

como el administrador de FSA. Las cuentas FSA le ayudan a que su dinero rinda mas, ya que permite ahorrarse susdólares antes de impuestos para pagar los gastos de atenciónmédica fuera de su bolsillo, incluyendo los gastos dentales y de visión.

Planes Médicos

Beneficios Káiser HMO Anthem Blue Cross Anthem Lumenos HSA Anthem Lumenos HSADentro de la Red Fuera de la Red

Deducible por año calendario

Empleado solamente ninguno ninguno $1,500

Empleado + Uno ninguno ninguno $3,000Incluye empleado asegurado y uno o más miembros de la familia del empleado

Máximo de Desembolso (por año calendario) Algunos de los beneficios no se aplican hacia el desembolso máximo.

Empleado solamente $1,500 $1,500 $3,000 $6,000

Empleado + Uno $3,000 $3,000 (dos personas)/ $6,000 $12,000$4,500 (Familia)

Servicios para pacientes hospitalizados

Hospitalización $200 copago $300 copago El Plan paga el 80% El Plan paga el 60%por admisión por admisión después del deducible después del deducible

Rayos X, Laboratorio plan paga el 100% plan paga el 100% El Plan paga el 80% El Plan paga el 60%después del deducible después del deducible

Servicios para pacientes ambulatorios

Visitas al consultorio PCP: $20 copago PCP: $25 copago El plan paga el El plan paga elEspecialista: $30 copago Especialista: $40 copago 80% después 60% después

del deducible del deducible

Cuidado Preventivo El plan paga el 100% El plan paga el 100% El plan paga el 100% El plan paga el 60%después del deducible

Cirugía Ambulatoria $30 copago $100 copago El plan paga el 80% El plan paga el 60%después del deducible después del deducible

Servicios de Emergencia

Sala de emergencia $100 copago; $150 copago; El plan paga el 80% El plan paga el 60%servicios y suministros exonerado si hay exonerado si hay después del deducible después del deducible

admisión admisión

Atencion Hospilataria $200 por admisión $300 por admisión El plan paga el 80% El plan paga el 60%después del deducible después del deducible

Atención Ambulatoria $20 copago $25 copago por visita El plan paga el 80% El plan paga el 60%por visita/terapia ($40 por especialista) después del deducible después del deducibleindividual que$10 copagopor visita de terapia/grupo

Medicamentos recetados- Farmacia (hasta un suministro de 30 días)

Genérico $10 copago $10 copago El plan paga el 80% El plan paga el 60%después del deducible después del deducible

Marca del Formulario $25 copago $30 copago El plan paga el 80% El plan paga el 60%después del deducible después del deducible

Marca No del Formulario $25 copago $50 copago

Medicamentos recetados—Pedido postal

Genérico $20 para un máximo de $10 para un máximo de El plan paga el 80% No Cubierto100 días de suministro 60 días de suministro después del deducible

Marca del Formulario $50 para un máximo de $60 para un máximo de100 días de suministro 60 días de suministro

Marca No del Formulario $50 para un máximo de $100 para un máximo de100 días de suministro 60 días de suministro

Planes Dentales

Planes de Vision

El plan paga el 50% hasta $2,000 beneficio máximo de por vida; deducible no se aplica

MetLife DHMO MetLife PPO MetLife PPOBeneficios Dentro de la Red Dentro de la Red Fuera de la Red

Deducible por año calendario Ninguno Individual $50/ familia $150 Individual $75/ familia $225

Máximo por año Calendario Ilimitado El plan paga hasta $2,000 El plan paga hasta $2,000 por persona/año por persona/año

Preventivo / Diagnóstico

Examen de rutina: $0 copago El plan paga el 100% El plan paga el 90%limpieza una vez cada 6 meses deducible no se aplica deducible no se aplica

Servicios generales

Rellenos: Amalgama $0 a $240 copago El plan paga el 80% El plan paga el 80%compuestas/Resina (dependiendo del número después del deducible después del deducible

de superficies)

Extracciones simples $5 copago El plan paga el 80% El plan paga el 80%($30 para visitas fuera del horario) después del deducible después del deducible

Servicios mayores

Capas, coronas, dentaduras Copagos se enumeran en la El plan paga el 50% El plan paga el 50%lista de servicios cubiertos después del deducible después del deducible

Ortodoncia

Adultos $1,695 copago

Niños Dependientes (hasta 19 años) $1,695 copago

Evaluación y Consulta $100 copago

Plan de Tratamiento y Expedientes $250 copago

Retención $250 copago

Anthem Blue View Anthem Blue View Beneficios Core Plan Buy-Up Plan

Examen de la vista (una vez cada 12 meses)

El plan paga el 100% después El plan paga el 100% después El plan paga hasta $79de $10 de copago de $10 de copago

Marcos (una vez cada 12 meses)

35% descuento El plan paga hasta $130 El plan paga hasta $71recibirá un descuento del 20% en cantidades más subsidio

Lentes (una vez cada 12 meses)

Visión de $50 copago El plan paga el 100% después El plan paga hasta $36

Bifocal alineado $70 copagode $15 de copago

El plan paga hasta $60

Trifocal alineado $105 copago El plan paga hasta $79

Lentes de contacto (una vez cada 12 meses)

Usted recibe un descuento del 15% El plan paga hasta $ 130 subsidio, El plan paga hasta $115en el examen de lentes de contacto usted recibe un descuento del 15% en

honorarios profesionales del médico.Los materiales se pagan a tarifas normales y habituales

Anthem Blue Cross HMO Anthem Lumenos HSAKáiser HMO (California Care)

Empleado solamente $43.39 $53.14 $53.38Empleado más uno $182.23 $223.19 $224.42

Familia $390.49 $477.82 $482.18

Met Life Dental DHMO Met Life Dental PPO

Empleado solamente $5.76 $56.72 Empleado más uno $18.52 $126.80

Familia $30.00 $190.52

Vision Core Vision Buy-Up


Familia $3.05 $12.53

Planes Médicos

Planes Dentales†† Los empleados de RSABG pagan

el 100% de las primas.

Planes de Vision



Familia $180.23 $220.53 $222.54


Empleado solamente $2.66 $26.18Empleado más uno $8.55 $58.52

Familia $13.85 $87.93



Familia $1.41 $5.78

Planes Médicos



Planes de Vision



Familia $195.25 $238.91 $241.09


Empleado solamente $2.88 $28.36Empleado más uno $9.26 $63.40

Familia $15.00 $95.26



Familia $1.53 $6.27

Planes Médicos



Planes de Vision

2015 Primas Mensuales*

2015 Primas Quincenal*

2015 Primas Semi-mensual*

*Impuesto sobre las primas se aplica al momento de inscribir a una pareja de hecho, por favor consulte con su representante de beneficios para obtener información adicional.



Administración de Beneficios ContactosClaremont University Consortium

Carol Saldivar (909) 607-3195 [email protected]

Anna Huerta (909) 607-9494 [email protected]

Claudia Garcia (909) 607-9493 [email protected]

Monica Villanueva (909) 607-3684 [email protected]

Claremont Graduate University

Sarah Verrill (909) 607-8828 [email protected]

Keck Graduate Institute

Cheryl Merritt (909) 607-7853 [email protected]

Para obtener más información, por favor vea el guía de Inscripción Abierta y Beneficios 2015 en www.cuc.claremont.edu/benefits.

Seguro de Vida de Niño(s): $0.50 por familia por $5,000 de cobertura.

Empleado Precios Mensuales Seguro de Vida Suplementario Precios para los empleados y esposo(a)/pareja de hecho se basan en la edad del empleado del 1 de enero de 2015.

Empleado Primas Mensuales Muerte Accidental y Desmembramiento (AD&D) Las cantidades de cobertura de más de 250,000 dólares no podrán excederdiez veces su salario anual básico. Cantidad de cobertura no se puedeaumentar después de 70 años de edad. Cobertura para los niños es el 30% de la cantidad principal, hasta un máximo de $50,000.

Cobertura Solamente CoberturaSuma Principal para Empleado Familiar

$25,000 $0.50 $0.98 $50,000 $1.00 $1.95 $75,000 $1.50 $2.93 $100,000 $2.00 $3.90 $125,000 $2.50 $4.88 $150,000 $3.00 $5.85 $175,000 $3.50 $6.83 $200,000 $4.00 $7.80 $225,000 $4.50 $8.78 $250,000 $5.00 $9.75 $275,000 $5.50 $10.73 $300,000 $6.00 $11.70 $325,000 $6.50 $12.68 $350,000 $7.00 $13.65 $375,000 $7.50 $14.63 $400,000 $8.00 $15.60 $425,000 $8.50 $16.58 $450,000 $9.00 $17.55 $475,000 $9.50 $18.53 $500,000 $10.00 $19.50

Anthem Seguro de Vida Suplementario para esposo(a) o pareja de hecho

Edad Prima mensual (por cada $1,000 de cobertura)

Bajo 30 $0.05 30–34 $0.06 35–39 $0.08 40–44 $0.14 45–49 $0.24 50–54 $0.40 55–59 $0.62 60–64 $0.97 65–69 $1.74 70 + $3.11

cuc ba 10/14

Beneficios pagados 100% por el empleadorSeguro de Vida Básico Toda la facultad y personal elegible para los beneficios seráncubiertos para el Seguro de Vida Básico con un beneficio de una vez su sueldo anual o un mínimo de $20,000 a unmáximo de $50,000.

Discapacidad a largo plazo Facultad y personal elegible para los beneficios que estánprogramados para trabajar 30 horas o más por semana, estáninscritos automáticamente para cobertura de discapacidad alargo plazo en su primer día de trabajo. Excepción: El personalde Rancho Santa Ana Botanic Gardens puede elegir lacobertura y pagar el 50% de la prima.

Programa de Asistencia al Empleado (EAP) Consejos y asesoramiento confidencial está disponible paraprofesores y el personal, sin costo alguno a través de la EAP.Los empleados y sus esposos(a) legales y dependienteselegibles reciben hasta cinco sesiones (5) de orientacióncon un terapeuta certificada por teléfono o en persona, por cada miembro de la familia, cada año. El acceso a EAPestá disponible 24/7 durante todo el año.

Instrucciones de ADP para CGU y KGIIngrese en ADP yendo a https://portal.adp.com, SeleccioneInicio de sesión de usuario, introduzca su nombre de usuarioy contraseña. Para el nombre de usuario y contraseña, porfavor póngase en contacto con Sarah Verrill a (909) 607-8828.� CGU Facultad y Personal utilice el código de registro:

CGU1-91711� KGI Facultad y Personal utilice el código de registro:

cgukgi-91711

The Claremont Colleges Inscripción Abierta 20154 a 25 noviembre, 2014

El Período de Inscripción Abierta Anual Para Seguros Médico, Dental, Visión, Cuentas de Gastos Flexibles y Seguro de Vida está aquí.

Pomona College� Jueves, 06 de noviembreSmith Campus Center, Room 208 HMO 11:00 a.m. (Inglés)� Martes, 11 de noviembreFrank Dining Hall, Blue RoomUnion—No Medica2:00–4:00 p.m. (Inglés/Español)� Miercoles, 12 de noviembreSmith Campus Center, Rose HillsTheatre and LobbyHMO 8:30 a.m. (Inglés)HSA 3:45 p.m. (Inglés)� Miercoles, 19 de noviembreSmith Campus Center, Room 208HMO 9:00 a.m. (Español)

Claremont University Consortium� Miercoles, 12 de noviembreACC, Oak RoomHSA 10:00 a.m. (Inglés)� Miercoles, 19 de noviembreHMO 10:00 a.m. (Inglés)HSA 2:00 p.m. (Inglés)

Scripps College� Martes, 4 de noviembreMalott CommonsHMO 2:30 p.m. (Español)� Jueves, 6 de noviembreVita Nova HallHMO 11:00 a.m. (Inglés)HSA 2:30 p.m. (Inglés)

Claremont Graduate University� Miercoles, 5 de noviembreStauffer AuditoriumHMO 9:00 a.m. (Inglés)� Jueves, 6 de noviembreStauffer AuditoriumHMO 9:00 a.m. (Inglés)� Jueves, 13 de noviembreStauffer AuditoriumHSA 9:00 a.m. (Inglés)Burkle #16HSA 2:00 p.m. (Inglés)

Claremont McKenna College� Martes, 4 de noviembreBauer Center, Founders RoomHMO 11:00 a.m. (Inglés)� Miercoles, 5 de noviembrePickford AuditoriumHSA 1:30 p.m. (Inglés)� Jueves, 6 de noviembre Pickford AuditoriumHSA/HMO 2:00–4:00 p.m.(Inglés/Español)� Martes, 11 de noviembreBauer Center, Founders RoomHSA 12:15 p.m. (Inglés)� Miercoles, 12 de noviembrePickford AuditoriumHMO 1:30 p.m. ( Inglés)

Rancho Santa Ana Botanical Garden� Jueves, 13 de noviembreMain Building, East ClassroomHMO 9:30 a.m. (Inglés)HSA 10:30 a.m. (Inglés)

Harvey Mudd College� Martes, 4 de noviembreShanahan Center, Room 1480HMO 11:00 a.m. (Inglés)� Miercoles, 5 de noviembreHoch Shanahan Dining Commons,

Aviation RoomHMO 2:30 p.m. (Español)� Jueves, 20 de noviembreShanahan Center, Room 1480HSA 11:00 a.m. (Inglés)

Pitzer College� Martes, 18 de noviembreMcConnell Center, Founder’s RoomHSA 10:00 a.m. (Español)HSA 11:00 a.m. (Inglés)HSA 12:00 p.m. (Inglés)� Jueves, 20 de noviembreMcConnell Center, Founder’s RoomHMO 12:15 p.m. (Inglés)HMO 2:15 p.m. (Español)

Keck Graduate Institute� Martes, 4 de noviembreBldg. 535 Watson #152HMO 4:00 p.m. (Inglés)� Miercoles, 5 de noviembreBldg. 535 Watson #152HMO 12:00 p.m. (Inglés)� Miercoles, 12 de noviembreBldg. 535 Watson #152HSA 12:00 p.m. (Inglés)� Viernes, 14 de noviembreBldg. 535 Watson #152HSA 3:00 p.m. (Inglés)

Juntas InformativasEstas reuniones incluyen una presentación sobre los cambios de beneficios para 2015, así como una oportunidadpara hacer preguntas y hablar con un Representante de Beneficios de la Administración de Beneficios CUC. Tenga en cuenta que cada sesión se adapta a mejorar el plan medico HMO o de HSA. Están bienvenidos asistir a una reunión para cada presentación designada.

The Claremont Colleges Feria Anual de Salud y Beneficios

Viernes 07 de noviembre 201410:00 a.m.–2:00 p.m.

Administrative Campus Center

Marque su calendario—no se pierda la oportunidad de hablar con susportadores de seguro, obtengan información divertida y útil acerca de sus planes, y habrá exámenes de salud gratuitos.

101 South Mills Avenue (por First Street)Servicio de transporte disponible, vea el reverso para obtener más información

� American Red CrossAl donar sangre recibira cinco boletos para la rifa

� Exámenes de Salud � Aprenda a sembrar su propio jardín de hierbas—demostración� Demostraciones de jugos verdes y muestras� Masajes de 15 minutos por terapeutas certificados� Regalos gratis� Disfrute de una merienda saludable

Jamba Juice, brochetas de fruta fresca, Subway, Yogurtland� Mercado de Frutas—muestras� Apuntase a la rifa para ganar una bicicleta de la playa o un Fitbit!� Vengan a jugar nuestro juego Spin-the-Wheel, y ganen un premio!

Feria de la Salud

Puntos de Servicio de TransladoLos transportes funcionan aproximadamente cada 15–20 minutos en cada lugar.

The Claremont CollegesFeria Anual de Salud y Beneficios

Viernes 07 de noviembre 201410:00 a.m.–2:00 p.m.

Administrative Campus Center

� Harvey Mudd CollegeKingston Hall Visitors Parking Lot (Platt Boulevard)

� Pomona CollegeFrank Hall (Columbia and Bonita)and Edmunds Ballroom (Sixth and College)

� Scripps CollegeBalch Hall Courtyard (Ninth and Columbia)

� Claremont Graduate UniversityStauffer Hall (Tenth and Dartmouth)

� Claremont McKenna CollegeCollins Dining Hall West Entrance (Eighth and Amherst)

� Pitzer CollegeSanborn Parking Lot (Ninth and Mills)

Comparten sus vehículos al evento y reciban un boleto de rifa adicional.

Ofertas de Bienestar de Sus Portadores

Además de la feria anual de la salud, nuestros portadores de planes médicos también ofrecenuna serie de servicios de salud y bienestar que están cubiertos de forma gratuita en sus planesmédicos. Para obtener más información acerca de estos servicios valiosos póngase en contactocon su proveedor de plan.

Anthem Blue Cross HMO and Lumenos HSAAtención preventiva gratuita (miembros de HMO ydentro de la red para los miembros Lumenos HSA)inmunizaciones gratuitas, como la vacuna contra lagripe anual y la vacuna contra la neumonía.24/7 línea de enfermería ofrece una enfermera deguardia al que puede llamar en cualquier momento,de día o de noche.Programa para futuras madres proporcionadocomo un recurso sin costo a las mujeres embarazadasque desean acceder a las enfermeras y especialistaspara asesoramiento, información de salud, y exámenes de salud.Condition Care proporciona enfermeras paraasesoramiento y otros recursos a los miembrosafectados por los problemas de salud crónicos y de largo plazo como el asma, la diabetes y la insuficiencia cardíaca.LiveHealth Online (LHO) le da rápido y fácil accesoa médicos, incluyendo chats de vídeo privados 24/7.Consultas LHO están cubiertos por su copago regular.MyHealth Record es una característica de la páginaweb de Anthem que mantiene sus registros médicosy vacunaciónes.360°Health ofrece una biblioteca en línea de información y herramientas relacionadas con la salud para ayudar a los miembros con cualquiercosa, desde la gestión de una condición hasta la organización de los registros de salud.Descuentos con los proveedores de atenciónoftalmológica y cuidado de los ojos, tales comoPremier LASIKDescuentos en los programas de salud y gimnasios,tales como Weight Watchers y Gold’s Gym

Kaiser Permanente HMOCuidado preventivo gratuitoInmunizaciones gratuitas, como la vacuna contra la gripe anual y la vacuna contra la neumoníaLos programas de estilo de vida saludables estándisponibles para los miembros; estos programascubren:� Evaluación de la Salud� Maternidad y el embarazo� Manejo del Dolor� Pérdida de peso� Nutrición� Para dejar de fumar� Depresión y manejo del estrés� Insomnio� Gestión de la Diabetes� Gestión condición crónicaCoaching de bienestar anima a los miembros a enfocarse en iniciativas de salud y de mejora su bienestar.My Health Manager mantiene todos los registrosmédicos, recordatorios de salud y permite a losmiembros reservar y/o cancelar citas.ChooseHealthy es un sitio web que ofrecedescuentos en gimnasios de salud y otros recursosque mejoran la salud, tales como libros de salud,videos y ejercicios personalizados y planes de nutrición.Descuentos en servicios de cuidados alternativoscomo acupuntura o terapia de masaje

Reforma de la Atención de la Salud en 2015Como usted sabe, la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act—ACA),también conocida como “Reformas del Sistemade Salud” o “Health Care Reform” fuepromulgada en 2010. Esta ley está destinada a extender el acceso a cobertura médica a lamayoría de las personas en los Estados Unidos,y eliminar restricciones a beneficios claves.

A partir de enero de 2014, la ACA incluye elmandato individual, que requiere que casi todoslos estadounidenses tengan cobertura médicao paguen una multa cuando presenten losimpuestos. Cobertura a través de The ClaremontColleges es probable su mejor opción paracumplir con el mandato individual. Los planes

que se ofrecen a través de The ClaremontColleges son completos y asequibles. Sinembargo, si usted no es elegible para lacobertura a través de The Claremont Colleges,hay varios recursos que puede utilizar paraencontrar cobertura. No se le puede negar la cobertura a través de estos mercados deseguros públicos, y usted puede ser elegiblepara los créditos fiscales que reducen el costo de seguro de salud. Inscripción Abiertapara estos mercados públicos comienza el 15 de noviembre 2014, y la fecha límite parainscribirse en la cobertura efectiva a partir del 01 de enero 2015 es el 15 de diciembre 2014.

GetInsuredA través de GetInsured usted puede compararlos planes de seguro de salud y encontrar el que mejor se adapte a sus necesidades y presupuesto, usted puede averiguar si ustedes elegible para los créditos fiscales quereducirán sus costos de cobertura, y puedeinscribirse en un plan que satisfaceespecíficamente sus necesidades médicas.Cada plan incluye grandes beneficios comovisitas al médico, cuidado preventivo,medicamentos, control de la natalidad

y la atención de emergencia. Con GetInsured,un agente con licencia puede ayudarle anavegar sus opciones de seguro, a determinarsi usted es elegible para créditos de impuestos,y le ayudará inscribirse para que su coberturapueda comenzar el 1 de enero de 2015.

Llame al 877-917-7957O visite www.getinsured.com/mercerpara servicios personalizados

CoveredCAEl estado de California ofrece un mercadoseguro público para los residentes de Californiaque necesitan cobertura de salud. Visitewww.CoveredCA.com para explorar una

variedad de planes de seguro integrales en que se puede inscribirse para la cobertura al partir del 01 de enero 2015.

Important notice from The Claremont Colleges about creditable prescription drug coverage and Medicare Date of this notice: October 2014 The purpose of this notice is to advise you that the prescription drug coverage listed below under The Claremont Colleges medical plan is expected to pay out, on average, at least as much as the standard Medicare prescription drug coverage will pay in 2015. This is known as “creditable coverage.” Why this is important. If you or your covered dependent(s) are enrolled in any prescription drug coverage during 2015 listed in this notice and are or become covered by Medicare, you may decide to enroll in a Medicare prescription drug plan later and not be subject to a late enrollment penalty – as long as you had creditable coverage within 63 days of your Medicare prescription drug plan enrollment. You should keep this notice with your important records. If you or your family members aren’t currently covered by Medicare and won’t become covered by Medicare in the next 12 months, this notice doesn’t apply to you. Please read the notice below carefully. It has information about prescription drug coverage with Claremont and prescription drug coverage available for people with Medicare. It also tells you where to find more information to help you make decisions about your prescription drug coverage. Notice of creditable coverage You may have heard about Medicare’s prescription drug coverage (called Part D), and wondered how it would affect you. Prescription drug coverage is available to everyone with Medicare through Medicare prescription drug plans. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans also offer more coverage for a higher monthly premium. Individuals can enroll in a Medicare prescription drug plan when they first become eligible, and each year from October 15 through December 7. Individuals leaving employer/union coverage may be eligible for a Medicare Special Enrollment Period. If you are covered by one of the Claremont prescription drug plans listed below, you’ll be interested to know that coverage is, on average, at least as good as standard Medicare prescription drug coverage for 2015. This is called creditable coverage. Coverage under the plans listed below will help you avoid a late Part D enrollment penalty if you are or become eligible for Medicare and later decide to enroll in a Medicare prescription drug plan: • Kaiser HMO • Anthem Blue Cross HMO • Anthem Lumenos HSA If you decide to enroll in a Medicare prescription drug plan and you are an active employee or family member of an active employee, you may also continue your employer coverage. In this case, the employer plan will continue to pay primary or secondary as it had before you enrolled in a Medicare prescription drug plan. If you waive or drop Claremont coverage, Medicare will be your only payer. You can re-enroll in the employer plan at annual enrollment or if you have a special enrollment event for the Claremont plan.

You should know that if you waive or leave coverage with Claremont and you go 63 days or longer without creditable prescription drug coverage (once your applicable Medicare enrollment period ends), your monthly Part D premium will go up at least 1% per month for every month that you did not have creditable coverage. For example, if you go 19 months without coverage, your Medicare prescription drug plan premium will always be at least 19% higher than what most other people pay. You’ll have to pay this higher premium as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to enroll in Part D. You may receive this notice at other times in the future – such as before the next period you can enroll in Medicare prescription drug coverage, if this Claremont coverage changes, or upon your request. For more information about your options under Medicare prescription drug coverage More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. Medicare participants will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. Here’s how to get more information about Medicare prescription drug plans: • Visit www.medicare.gov for personalized help. • Call your State Health Insurance Assistance Program (see a copy of the Medicare & You

handbook for the telephone number). • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. For people with limited income and resources, extra help paying for a Medicare prescription drug plan is available. Information about this extra help is available from the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.socialsecurity.gov or call 1-800-772-1213 (TTY 1-800-325-0778). Remember: Keep this notice. If you enroll in a Medicare prescription drug plan after your applicable Medicare enrollment period ends, you may need to provide a copy of this notice when you join a Part D plan to show that you are not required to pay a higher Part D premium amount. For more information about this notice or your prescription drug coverage, contact: The Claremont Colleges CUC Benefits Administration 101 S. Mills Avenue Claremont, CA 91711 909-621-8151

http://www.medicare.gov/

http://www.socialsecurity.gov/

General Notice – Federal Page 1

Initial Notice of COBRA Continuation Coverage Rights The Claremont Colleges – CUC Benefits Administration RETAIN THIS NOTICE WITH 101 S. Mills Avenue, Claremont, CA 91711 (909) 621-8151 YOUR INSURANCE PAPERS

Date of Notice: October 2014 IMPORTANT NOTICE: YOUR RIGHTS UNDER COBRA IN THE EVENT THAT YOU LOSE INSURANCE COVERAGE Employees, spouses and any adult dependents (if applicable) should read this notice carefully. If you have adult dependents covered under benefit plans who reside at a different address, either forward them a copy of this notice or inform PayFlex, our COBRA administrator, in writing of the name and address of the dependent. PayFlex will send them a separate copy of this notice. Federal Law requires that The Claremont Colleges, as a sponsor of group health plans, offer employees and their eligible family members the opportunity for a temporary extension of health coverage called “continuation coverage” at group rates in certain instances where coverage under the plan would otherwise end. This notice is intended to inform you of your rights and obligations under federal law. You may have other rights under applicable state law. Where state law supersedes federal law, The Claremont Colleges and its administrators will make every reasonable effort to apply the appropriate statutes. Under COBRA law if you, as an employee of The Claremont Colleges, have coverage under our group health insurance plans, you have the right to choose continuation coverage equivalent to the eligible insurance in effect on the date you terminated or were laid off from employment if:

1. You have a reduction in employment hours to less than the number of hours per week required to qualify for benefits.

2. Your employment terminates for reasons other than gross misconduct. 3. You retire. 4. Your employer files for reorganization under Chapter 11 (but you are not yet eligible for Medicare). 5. You become disabled under Title II or XVI of the Social Security Act within 60 days of one of the above

events. If you are a Spouse of an employee (or a retiree for reason [5] below,) covered by The Claremont Colleges group health plan(s), you have the right to continue coverage for yourself if you lose our group health insurance coverage(s) for any of the following reasons:

1. The death of your spouse. 2. Termination of your spouse's employment from The Claremont Colleges (for reasons other than gross

misconduct) or reduction in your spouse's hours of employment to less than those required to qualify for applicable benefits.

3. Divorce or legal separation from your spouse, even if coverage was terminated in anticipation of divorce or legal separation. NOTE: Coverage will only be provided from the date of the divorce, and you must inform The Claremont Colleges or its designated agent, PayFlex, of the divorce.

4. Your spouse becomes entitled (that is, covered) under Medicare (but you are not eligible for Medicare). 5. Your spouse’s employer files for Chapter 11 reorganization. Dependent children of employees (or retirees for reason [6] below) covered by The Claremont Colleges group health plan(s) also have the right to continue coverage if group insurance coverage under The Claremont Colleges group health plan(s) is lost for any of the following reasons:

1. The death of a parent who was an employee of The Claremont Colleges 2. The termination of a parent's employment (for reasons other than gross misconduct). 3. A parent's divorce or legal separation. 4. A parent becomes entitled (that is, covered) under Medicare. 5. The parent’s hours have been reduced to less than those required to qualify for benefits. 6. The parent's employer files for Chapter 11 reorganization. 7. The child reaches majority age, or student status expires under the terms of the health plan.

Under the law, the employee or a family member must inform The Claremont Colleges in writing of a “Qualifying Event” such as divorce, legal separation, Social Security determination that the employee was disabled at the time of the employee's termination or reduction in hours, or of a child losing dependent status under The Claremont Colleges group health plan(s) within 60 days. When The Claremont Colleges is notified that one of these events has occurred, The Claremont Colleges or its designated agent will, in turn, notify you (or your eligible dependent) of your continuation coverage options and cost. If you do not choose to continue your coverage, your group health insurance through The Claremont Colleges will end. If you choose to continue coverage, The Claremont Colleges will provide coverage identical to that provided to active, similarly situated eligible employees or their eligible dependents. COBRA continuation law requires that you be allowed the opportunity to maintain continuation coverage for:

General Notice – Federal Page 2

1. 18 months from the date your group health coverage(s) ended for reasons of termination of employment, or a qualifying reduction in hours.

2. 29 months for employees and dependents under Federal Law who have informed The Claremont Colleges or its designated agent in writing, anytime during your 18 months standard COBRA coverage period, that Social Security has determined that you were disabled within the first 60 days your COBRA coverage.

3. 36 months for dependent children ceasing to qualify as dependents under our group health plan(s). 4. 36 months maximum for divorce under Federal continuation law. 5. 36 months maximum (applies to dependents), in cases of retirement from active employment at an age

where you become entitled to Medicare. (See termination of Continuation Coverage below also.). 6. 36 months for retirees and spouses of retirees should the Employer files for Chapter 11 Bankruptcy under

Federal Law. If, during your 18-month continuation period, you experience a second event from the above listed Qualifying Events, which causes a loss of coverage, your coverage may be extended up to a maximum of 36 months of COBRA coverage. The former employee or a family member must notify The Claremont Colleges or its agent when a second event occurs. Note: If state laws supersede federal laws in your situation, The Claremont Colleges will make every reasonable effort to continue coverage in accordance with the applicable statutes. In most, but not all cases the total length of continuation of coverage will range from 18 to 36 months. TERMINATION OF CONTINUATION COVERAGE The law also provides that your continuation may terminate earlier than the period indicated above for any of the following reasons:

1. The Claremont Colleges no longer provides group health coverage to similarly situated employees. 2. The premium for your continuation coverage is not paid in a timely fashion. 3. You become covered under another group health plan that does not include a pre-existing condition clause

that would apply to you or a covered dependent. 4. You become entitled to (that is, covered under) Medicare. NOTE: Medicare coverage in effect prior to

COBRA will not prevent you from electing continuation coverage under COBRA. 5. If you are in the months 19-29 of a disability extension and a final determination has been made that you

are no longer disabled. Termination of coverage is effective in the month that begins after 30 days from the date of the final determination.

You do not have to show that you are insurable to choose continuation coverage. To continue coverage under the law, you will have to pay all of the premium due plus an administrative charge, as permitted by law. You have 60 days to elect COBRA continuation coverage. You will have 45 days from the date you elect COBRA continuation coverage to make your initial premium payment. However, your initial premium payment is required to include all premiums due back to the date coverage would (otherwise) have ceased, in addition to all current premiums due. All initial premiums are to be paid in one lump sum, and thereafter on a monthly basis. Future premiums will be due in advance and by the first of the month for which continuation coverage is desired. After your first premium payment you will have a grace period of 30 days to pay future monthly premiums. The Federal Law also states that, at the end of 18 months, 29 months or three year continuation coverage period you must be allowed to enroll in an individual “conversion health plan” provided under The Claremont Colleges group health plan(s), if The Claremont Colleges plan includes conversion coverage. The person on continuation coverage must submit a written application for the conversion policy within 31 days after applicable continuation coverage ends. Applicants for a conversion policy will not be required to provide evidence of insurability. Read the Summary Plan Description relating to your plan for more detailed information and to determine if conversion is available. If you (as an employee or dependent) have changed marital status or any covered person(s) have changed addresses, please notify The Claremont Colleges in writing at the address below:

The Claremont Colleges CUC Benefits Administration 101 S. Mills Avenue Claremont, CA 91711

If you are eligible for or are currently on Continuation Coverage, please notify our designated agent for continuation coverage administration:

PayFlex

PO Box 2239 Omaha, NE 68103-2239

PRIVACY NOTICE

______________________________________________________________________________

Please carefully review this notice. It describes how medical information about you may be used and disclosed and how you can get access to this information.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on the use and disclosure of individual health information by employer health plans. This information, known as protected health information, includes almost all individually identifiable health information held by a plan – whether received in writing, in an electronic medium, or as an oral communication. This notice describes the privacy practices of these plans: Medical, Prescription Drug, Dental, Vision, Health Savings Account, and Health Care Flexible Spending Arrangement (FSA) benefits. The plans covered by this notice may share health information with each other to carry out treatment, payment, or health care operations. These plans are collectively referred to as the Plan in this notice, unless specified otherwise.

The Plan’s duties with respect to health information about you

The Plan is required by law to maintain the privacy of your health information and to provide you with this notice of the Plan’s legal duties and privacy practices with respect to your health information. If you participate in an insured plan option, you will receive a notice directly from the Insurer. It’s important to note that these rules apply to the Plan, not The Claremont Colleges as an employer – that’s the way the HIPAA rules work. Different policies may apply to the other Claremont Colleges’ programs or to data unrelated to these Plans.

How the Plan may use or disclose your health information

The privacy rules generally allow the use and disclosure of your health information without your permission (known as an authorization) for purposes of health care treatment, payment activities, and health care operations. Here are some examples of what that might entail:

Treatment includes providing, coordinating, or managing health care by one or more health care providers or doctors. Treatment can also include coordination or management of care between a provider and a third party, and consultation and referrals between providers. For example, the Plan may share your health information with physicians who are treating you.

Payment includes activities by this Plan, other plans, or providers to obtain premiums, make coverage determinations, and provide reimbursement for health care. This can include eligibility determinations, reviewing services for medical necessity or appropriateness, utilization management activities, claims management, and billing; as well as “behind the scenes” plan functions such as risk adjustment, collection, or reinsurance.

For example, the Plan may share information about your coverage or the expenses you have incurred with another health plan in order to coordinate payment of benefits.

Health care operations include activities by this Plan (and in limited circumstances other plans or providers) such as wellness and risk assessment programs, quality assessment and improvement activities, customer service, and internal grievance resolution. Health care operations also include vendor evaluations, credentialing, training, accreditation activities, underwriting, premium rating, arranging for medical review and audit activities, and business planning and development. For example, the Plan may use information about your claims to audit the third parties that approve payment for Plan benefits.

The amount of health information used, disclosed or requested will be limited and, when needed, restricted to the minimum necessary to accomplish the intended purposes, as defined under the HIPAA rules. If the Plan uses or discloses Protected Health Information (PHI) for underwriting purposes, the Plan will not use or disclose PHI that is your genetic information for such purposes. The Plan may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you, as permitted by law.

How the Plan may share your health information with The Claremont Colleges

The Plan, or its health insurer or HMO, may disclose your health information without your written authorization to The Claremont Colleges for plan administration purposes. The Claremont Colleges may need your health information to administer benefits under the Plan. The Claremont Colleges agrees not to use or disclose your health information other than as permitted or required by the Plan documents and by law. The benefits staff, payroll and finance are the only employees of The Claremont Colleges employees who will have access to your health information for plan administration functions.

Here’s how additional information may be shared between the Plan and The Claremont Colleges, as allowed under the HIPAA rules:

The Plan, or its insurer or HMO, may disclose “summary health information” to The Claremont Colleges if requested, for purposes of obtaining premium bids to provide coverage under the Plan, or for modifying, amending, or terminating the Plan. Summary health information is information that summarizes participants’ claims information, from which names and other identifying information have been removed.

The Plan, or its insurer or HMO, may disclose to The Claremont Colleges information on whether an individual is participating in the Plan or has enrolled or disenrolled in an insurance option or HMO offered by the Plan.

In addition, you should know that The Claremont Colleges cannot and will not use health information obtained from the Plan for any employment-related actions. However, health information collected by The Claremont Colleges from other sources, for example under the Family and Medical Leave Act, Americans with Disabilities Act, or workers’ compensation is not protected under HIPAA (although this type of information may be protected under other federal or state laws).

Other allowable uses or disclosures of your health information

In certain cases, your health information can be disclosed without authorization to a family member, close friend, or other person you identify who is involved in your care or payment for your care. Information about your location, general condition, or death may be provided to a similar person (or to a public or private entity authorized to assist in disaster relief efforts). You’ll generally be given the chance to agree or object to these disclosures (although exceptions may be made – for example, if you’re not present or if you’re incapacitated). In addition, your health information may be disclosed without authorization to your legal representative.

The Plan also is allowed to use or disclose your health information without your written authorization for the following activities:

Workers’ compensation

Disclosures to workers’ compensation or similar legal programs that provide benefits for work-related injuries or illness without regard to fault, as authorized by and necessary to comply with the laws

Necessary to prevent serious threat to health or safety

Disclosures made in the good-faith belief that releasing your health information is necessary to prevent or lessen a serious and imminent threat to public or personal health or safety, if made to someone reasonably able to prevent or lessen the threat (or to the target of the threat); includes disclosures to help law enforcement officials identify or apprehend an individual who has admitted participation in a violent crime that the Plan reasonably believes may have caused serious physical harm to a victim, or where it appears the individual has escaped from prison or from lawful custody

Public health activities

Disclosures authorized by law to persons who may be at risk of contracting or spreading a disease or condition; disclosures to public health authorities to prevent or control disease or report child abuse or neglect; and disclosures to the Food and Drug Administration to collect or report adverse events or product defects

Victims of abuse, neglect, or domestic violence

Disclosures to government authorities, including social services or protected services agencies authorized by law to receive reports of abuse, neglect, or domestic violence, as required by law or if you agree or the Plan believes that disclosure is necessary to prevent serious harm to you or potential victims (you’ll be notified of the Plan’s disclosure if informing you won’t put you at further risk)

Judicial and administrative proceedings

Disclosures in response to a court or administrative order, subpoena, discovery request, or other lawful process (the Plan may be required to notify you of the request or receive satisfactory assurance from the party seeking your health information that efforts were made to notify you or to obtain a qualified protective order concerning the information)

Law enforcement purposes

Disclosures to law enforcement officials required by law or legal process, or to identify a suspect, fugitive, witness, or missing person; disclosures about a crime victim if you agree or if disclosure is necessary for immediate law enforcement activity; disclosure about a death that may have resulted from criminal conduct; and disclosure to provide evidence of criminal conduct on the Plan’s premises

Decedents Disclosures to a coroner or medical examiner to identify the deceased or determine cause of death; and to funeral directors to carry out their duties

Organ, eye, or tissue donation

Disclosures to organ procurement organizations or other entities to facilitate organ, eye, or tissue donation and transplantation after death

Research purposes

Disclosures subject to approval by institutional or private privacy review boards, subject to certain assurances and representations by researchers about the necessity of using your health information and the treatment of the information during a research project

Health oversight activities

Disclosures to health agencies for activities authorized by law (audits, inspections, investigations, or licensing actions) for oversight of the health care system, government benefits programs for which health information is relevant to beneficiary eligibility, and compliance with regulatory programs or civil rights laws

Specialized government functions

Disclosures about individuals who are Armed Forces personnel or foreign military personnel under appropriate military command; disclosures to authorized federal officials for national security or intelligence activities; and disclosures to correctional facilities or custodial law enforcement officials about inmates

HHS investigations Disclosures of your health information to the Department of Health and Human Services to investigate or determine the Plan’s compliance with the HIPAA privacy rule

Except as described in this notice, other uses and disclosures will be made only with your written authorization. You may revoke your authorization as allowed under the HIPAA rules. However, you can’t revoke your authorization with respect to disclosures the Plan has already made. You will be notified of any unauthorized access, use or disclosure of your unsecured health information as required by law.

Your individual rights

You have the following rights with respect to your health information the Plan maintains. These rights are subject to certain limitations, as discussed below. This section of the notice describes how you may exercise each individual right. See the table at the end of this notice for information on how to submit requests.

Right to request restrictions on certain uses and disclosures of your health information and the Plan’s right to refuse

You have the right to ask the Plan to restrict the use and disclosure of your health information for treatment, payment, or health care operations, except for uses or disclosures required by law.

You have the right to ask the Plan to restrict the use and disclosure of your health information to family members, close friends, or other persons you identify as being involved in your care or payment for your care. You also have the right to ask the Plan to restrict use and disclosure of health information to notify those persons of your location, general condition, or death – or to coordinate those efforts with entities assisting in disaster relief efforts. If you want to exercise this right, your request to the Plan must be in writing.

The Plan is not required to agree to a requested restriction. If the Plan does agree, a restriction may later be terminated by your written request, by agreement between you and the Plan (including an oral agreement), or unilaterally by the Plan for health information created or received after you’re notified that the Plan has removed the restrictions. The Plan may also disclose health information about you if you need emergency treatment, even if the Plan has agreed to a restriction.

Effective February 17, 2010, an entity covered by these HIPAA rules (such as your health care provider) or its business associate must comply with your request that health information regarding a specific health care item or service not be disclosed to the Plan for purposes of payment or health care operations if you have paid for the item or service, in full out of pocket.

Right to receive confidential communications of your health information

If you think that disclosure of your health information by the usual means could endanger you in some way, the Plan will accommodate reasonable requests to receive communications of health information from the Plan by alternative means or at alternative locations.

If you want to exercise this right, your request to the Plan must be in writing and you must include a statement that disclosure of all or part of the information could endanger you.

Right to inspect and copy your health information

With certain exceptions, you have the right to inspect or obtain a copy of your health information in a “designated record set.” This may include medical and billing records maintained for a health care provider; enrollment, payment, claims adjudication, and case or medical management record systems maintained by a plan; or a group of records the Plan uses to make decisions about individuals. However, you do not have a right to inspect or obtain copies of psychotherapy notes or information compiled for civil, criminal, or administrative proceedings. The Plan may deny your right to access, although in certain circumstances you may request a review of the denial.

If you want to exercise this right, your request to the Plan must be in writing. Within 30 days of receipt of your request (60 days if the health information is not accessible onsite), the Plan will provide you with:

the access or copies you requested;

a written denial that explains why your request was denied and any rights you may have to have the denial reviewed or file a complaint; or

a written statement that the time period for reviewing your request will be extended for no more than 30 more days, along with the reasons for the delay and the date by which the Plan expects to address your request.

The Plan may provide you with a summary or explanation of the information instead of access to or copies of your health information, if you agree in advance and pay any applicable fees. The Plan also may charge reasonable fees for copies or postage.

If the Plan doesn’t maintain the health information but knows where it is maintained, you will be informed of where to direct your request.

Effective February 17, 2010, you may request an electronic copy of your health information if it is maintained in an electronic health record. You may also request that such electronic health information be sent to another entity or person, so long as that request is clear, conspicuous and specific. Any charge that is assessed to you for these copies, if any, must be reasonable and based on the Plan’s cost.

Right to amend your health information that is inaccurate or incomplete

With certain exceptions, you have a right to request that the Plan amend your health information in a designated record set. The Plan may deny your request for a number of reasons. For example, your request may be denied if the health information is accurate and complete, was not created by the Plan (unless the person or entity that created the information is no longer available), is not part of the designated record set, or is not available for inspection (e.g., psychotherapy notes or information compiled for civil, criminal, or administrative proceedings).

If you want to exercise this right, your request to the Plan must be in writing, and you must include a statement to support the requested amendment. Within 60 days of receipt of your request, the Plan will:

make the amendment as requested;

provide a written denial that explains why your request was denied and any rights you may have to disagree or file a complaint; or

provide a written statement that the time period for reviewing your request will be extended for no more than 30 more days, along with the reasons for the delay and the date by which the Plan expects to address your request.

Right to receive an accounting of disclosures of your health information

You have the right to a list of certain disclosures of your health information the Plan has made. This is often referred to as an “accounting of disclosures.” You generally may receive this accounting if the disclosure is required by law, in connection with public health activities, or in similar situations listed in the table earlier in this notice, unless otherwise indicated below.

You may receive information on disclosures of your health information for up to six years before the date of your request. You do not have a right to receive an accounting of any disclosures made:

for treatment, payment, or health care operations;

to you about your own health information;

incidental to other permitted or required disclosures;

where authorization was provided;

to family members or friends involved in your care (where disclosure is permitted without authorization);

for national security or intelligence purposes or to correctional institutions or law enforcement officials in certain circumstances; or

as part of a “limited data set” (health information that excludes certain identifying information).

In addition, your right to an accounting of disclosures to a health oversight agency or law enforcement official may be suspended at the request of the agency or official.

If you want to exercise this right, your request to the Plan must be in writing. Within 60 days of the request, the Plan will provide you with the list of disclosures or a written statement that the time period for providing this list will be extended for no more than 30 more days, along with the reasons for the delay and the date by which the Plan expects to address your request. You may make one request in any 12-month period at no cost to you, but the Plan may charge a fee for subsequent requests. You’ll be notified of the fee in advance and have the opportunity to change or revoke your request.

Right to obtain a paper copy of this notice from the Plan upon request

You have the right to obtain a paper copy of this privacy notice upon request. Even individuals who agreed to receive this notice electronically may request a paper copy at any time.

Changes to the information in this notice

The Plan must abide by the terms of the privacy notice currently in effect. This notice takes effect on October 22, 2011. However, the Plan reserves the right to change the terms of its privacy policies, as described in this notice, at any time and to make new provisions effective for all health information that the Plan maintains. This includes health information that was previously created or received, not just health information created or received after the policy is changed. If changes are made to the Plan’s privacy policies described in this notice, you will be provided with a revised privacy notice through your Human Resources Department.

Complaints

If you believe your privacy rights have been violated or your Plan has not followed its legal obligations under HIPAA, you may complain to the Plan and to the Secretary of Health and Human Services. You won’t be retaliated against for filing a complaint. To file a complaint,

The Claremont Colleges’ Plan Administrator c/o CUC Benefits Administration 101 S. Mills Avenue Claremont, CA 91711

Contact

For more information on the Plan’s privacy policies or your rights under HIPAA, contact

The Claremont Colleges’ Plan Administrator c/o CUC Benefits Administration 101 S. Mills Avenue Claremont, CA 91711

inscripcion abierta 2015 4 de noviembre a 25 de noviembre … · 2014-10-31 · inicie sesión en...

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