Health Benefits

Health Benefits

Eligibility

Faculty, staff and post-doc employees who work at least 20 hours a week and are classified as regular full-time or part-time are eligible.

Temporary, full-time, benefit eligible employees designated as "greater than a six-month assignment" are eligible.

Coverage begins at date of hire in an eligible position.

Plan Changes for 2012

Tobacco Surcharge

To support the health and wellness of our faculty and staff by discouraging the use of tobacco products, Emory University will implement a $50 per person monthly tobacco use surcharge on medical contributions for employees and their spouses/same sex domestic partners (SSDPs) who use tobacco products. During the Benefits Annual Enrollment period, all faculty and staff covered under Emory’s medical plan will have to certify annually whether or not they and their spouse/SSDP use tobacco.

If you are covered under an Emory sponsored medical plan, you are impacted by this change and must certify annually whether you and your spouse/SSDP use Tobacco products or are Tobacco Free.

If the online certification is not completed, the surcharge will be automatically applied for both you and your covered Spouse/SSDP effective January 1, 2012 and remain in place for the 2012 plan year.

• TOBACCO FREE – To certify as a non-tobacco user, you and your spouse/SSDP must not have used any tobacco products within the last 60 days (from the time of the certification). Complete the certification and the $50 per covered adult/month surcharge will be waived for the 2012 plan year.

• TOBACCO USE – If you and/or your spouse/SSDP are a tobacco user, certify as such and there are still opportunities for you to waive the $50 per covered adult/month surcharge. Complete and return one of the forms below to the Benefits Department prior to 12/31/2011 and the surcharge will be waived for the 2012 plan year.

–– Physician Affidavit – Complete and return a Tobacco Cessation Physician Affidavit Form  if you are medically unable to quit.

–– Tobacco Cessation Program – Enroll in an Emory approved Tobacco Cessation Program and complete and return the Certification Regarding Tobacco Use Form.

Preventive Care Covered at 100%

All routine preventive care under the Aetna POS Value and Aetna POS Plus plans will be available in 2012 for $0 co-pay when received by a provider who is in the EPN or Aetna's National (In-Network). For a complete list of the preventive services where a co-pay is waived click here.

Preventive Care under the HDHP with HSA Plan is also coverd at 100% when received by a provider in the EPN or Aetna National (In-Network).

NEW — Vision Plan with EyeMed Vision Care

Emory is partnering with EyeMed Vision Care to offer you a new voluntary Vision Plan which includes routine eye exams and equipment (lenses, frames, contacts, etc.). EyeMed Vision Care offers a large network of providers including the Emory Eye Center, as well as many private practioners and large name retail locations such as LensCrafters, Pearle Vision, Sears Optical, Target Optical, and more. For a complete list of network providers, visit www.eyemedvisioncare.com (Go to "Locate a Provider", click the "Select Your Network"drop down menu and choose "Select", then enter in your zip code and click the "Submit" button.) or call 855-270-2343. Some details of the plan include:

• Routine Annual Eye Exams - $0 co-pay
• Single, Bifocal, Trifocal, Lenticular lenses — $0 co-pay
• Standard Progressive Lenses — $65 co-pay
• Frames — up to a $150 allowance
• Contact Lenses (Conventional & Disposable) — up to $200 allowance (includes exam and fitting)
• Benefits are provided once every 12 months
• Very affordable rates

Click here PDF to review the details of what the New Vision Plan and Discount covers.

Prescription Drug Changes

What is changing?

 

• For the first time since 2006, prescription drug co-pays are increasing in the Aetna POS Value and Aetna POS Plus medical plans. Tier Zero will remain at a $0 co-pay.
• Tier Changes
• Lansoprozole and Pantoprozole moved from Tier 3 to Tier 1
• Byetta, Symilin and Victoza moved from Tier 2 to Tier 1

 

Am I affected?

Yes, if you are enrolled in the Aetna POS Value or Aetna POS Plus plan, you will see an increase in prescription drug retail and mail order tier co-pays beginning January 1, 2012 (with the exception of Tier Zero).

What do I need to do?

Review and become familiar with the new co-pays for 2012. Plan ahead and order/refill any necessary medications prior to year end. To learn more about Emory’s Prescription Drug benefit, refer to the 2012 Benefits Guide. Here you will find information about Emory’s five-tier structure, Medco (the pharmacy vendor for the POS Plus and POS Value plans) and Aetna (the pharmacy vendor for the HDHP with HSA plan) as well as how you can save money with Tier Zero, Generic drugs and Mail Order.

The new Tier co-pays are:

Tier	2012 Retail	2012 Mail
Zero	$0	$0
1	$15.00	$37.50
2	$30.00	$75.00
3	$55.00	$137.50
4	$85.00	$212.50

* If you are enrolled in the Aetna HDHP, you receive your prescription benefits from Aetna, your pharmacy benefit manager.

For more information click here.

Your Plan Choices

• POS Plus (Aetna) Plan in Detail
• POS Value (Aetna) Plan in Detail
• HDHP (Aetna) Plan in Detail
• Helpful Tools
  • View the Quick Guide Comparison for all Health Plans.
  • View a Guide to the Aetna HDHP HSA Plan
  • Review the Employee Costs for Benefits information to see your costs.
  • Use the Interactive Health Plan Comparison Tool to compare the plans you are considering. (When using this tool the Annual Paycheck Premium Amount is the total of your monthly or bi-weekly contribution costs for one full year. Please be aware the sample charges are for what the physician and facility would typically charge when services are rendered.)

How To Enroll

• Once you select your Healthcare Plan, use the Guide to Benefits Enrollment to assist you in the enrollment process.
• Enroll online through Employee Self Service to submit your choices.
• Documentation is to be provided to the Benefits Department in the event that you and your spouse or dependent have a different last name: Examples are marriage certificate, jointly filed tax return; or a birth certificate for dependents.

How to Make Changes

Changes are only permitted during the annual election period or within 31 days of a Family Status Change.

When You Turn 65

If you are not currently receiving Social Security benefits, you should sign up for Medicare close to your 65th birthday even if you aren't ready to retire.

• If you are already getting Social Security benefits when you turn 65, you are already qualified and Part A starts automatically.
• Part B is an optional program with a monthly cost. Almost anyone who is eligible for Part A (Hospital Insurance) can sign up for Part B (Medical Insurance). If you don't enroll in Part B when you are first eligible, you may pay a penalty to enroll at a later date, unless you are covered by an employer based plan as an active employee.

Vendor Contacts

Plan Information Documents

Guide to the Aetna HDHP HSA Plan	Quick Guide Comparison for all Health Plans.
Healthcare Parttime Rates	Guide to Benefits Enrollment
Healthcare Fulltime Rates	POS Plus Summary Plan Description
Guide to International Travel	HDHP Summary Plan Description
HSA Helpful Contribution Information	POS Value Summary Plan Description
Online Wellness Program Information

Plan Forms

Step Child Certification for Health and Life Insurance	Emory University Appeals Process
Aetna Medical Claim Form

Emory University Benefits

Hours of Operation: Monday through Friday from 8:00 a.m. to 5:00 p.m.
Wed - 8:00am - 3:00pm
1599 Clifton Road, NE
Atlanta, GA 30322
(404) 727-7613 phone
(404) 727-7145 Fax

Disclaimer

Emory reserves the right to terminate, suspend, withdraw, amend or modify the Plan in whole or in part at any time. Further, Emory reserves the right to terminate or modify coverage for any group of employees, active or retired and their dependents or a class of dependents at any time.