Asked Questions About Benefits
do our health care benefits compare to those of other Ivy League
Penn's health care benefits are in line with the benefits offered
to faculty and staff at other Ivy League schools and Tier One
Research Institutes. In some areas, our benefits are more generous.
For example, we offer more medical plan choices and our PENNCare
in-network benefits are better than most. We also continue to
subsidize dental benefits whereas some institutions do not subsidize
this benefit at all.
is Penn adding Independence Blue Cross' Personal Choice network
to the PENNCare Plan?
the Personal Choice network gives employees an additional level
of benefits from which to choose. Also, Blue Cross was able to
offer us excellent discounts with providers who participate in
their network. Under the current PENNCare plan, in order to receive
an in-network level of benefits, employees have to see doctors
and go to hospitals that are in the University of Pennsylvania
Health System (UPHS) network. When the Personal Choice network
is added as of July 1, 2002, our employees will be able to utilize
a wider range of providers while still receiving "in-network"
benefits, since most providers in our area participate in the
Personal Choice network.
doesn't the University pay 100 percent of the cost of health care
in these challenging economic times, the University must continually
look for ways to manage its expenses. One of the ways that Penn
can keep benefits costs affordable is by asking employees to share
in the cost of their medical benefits. In general, Penn is well
aligned with what other employers are doing--requiring employees
to share a percentage of the cost of a competitive benefits package.
percentage of my health care costs does Penn pay as part of the
the 2002-2003 benefits, on average, Penn will contribute an average
of 80 percent of the cost of benefits. On average, employees will
be responsible for cost sharing the remaining 20 percent.
are my monthly contributions for medical benefits increasing this
general, health care costs in the United States are increasing
and have been for the past several years. This trend is expected
to continue for the foreseeable future. Almost all employers,
including the University of Pennsylvania, use a cost-sharing approach
whereby both the employer and employee pay the increased costs
based on their sharing arrangement. As a result, the monthly premium
you pay for medical benefits will increase. The most expensive
increases will be for Plan 100 participants; PENNCare participants
(the greatest percentage of Penn employees participate in this
plan) will also experience a significant increase--from $18 more
per month for single coverage to $46 more per month for family
have always been in the PENNCare Plan. Now that I see that costs
are increasing significantly this year, I'm thinking of switching.
What are my other options?
the UPHS POS Plan and the two HMOs provide excellent benefits,
and cost between 65 and 80 percent less than the PENNCare Plan
for a single participant. Additionally, the UPHS POS Plan still
provides some level of benefits if you go out of the network.
If you want to remain with the same physician, you may want to
see if he/she participates in the UPHS POS, Keystone HMO or Aetna
HMO networks. If so, it will certainly be cost-effective for you
to switch. Just be aware that these plans utilize the HMO "gatekeeper"
approach (whereby your primary care physician must authorize visits
to specialists). While some think this approach inconvenient,
it typically isn't difficult in practice once you understand how
to use it.
I switch medical plans, can I continue to see the same doctor
but not always. Because providers sometimes do not participate
in every health plan available, it is possible that your doctor
will not be a network provider for the plan you choose.
With the PENNCare and UPHS POS plans, however, you do receive
some level of benefits if you use a provider that is out-of-network.
So, if you are willing to pay greater out-of-pocket costs to see
an out-of-network provider, you may continue to see your doctor.
You may want to consider browsing a list of the doctors who provide
in-network benefits under your plan. Links to provider directories
are provided on the HR website at: www.hr.upenn.edu/benefits/medical/doctorsearch.asp.
will I have to pay more for my prescription drugs this year? What
can I do to reduce my cost?
cost of prescription drugs is the fastest growing health care-related
expense, and it's projected to grow at 20% to 30% each year over
the next several years. Penn has therefore modified the drug program
to mitigate this expense, and for those who take appropriate steps,
cost changes should be minimal. One of the ways Penn is seeking
to manage the cost of prescription drugs is by encouraging employees
to purchase drugs they take on a regular basis through the mail.
Prescription drug plans offer discounts for prescriptions that
are filled by mail. In addition, think of how much time you'll
save by not having to drive to the drugstore each month to pick
up your prescription. For more information about receiving prescription
drugs through the mail, contact Caremark at 1-800-378-0802, or
visit the Caremark Web Site at
can't I get more than a 34-day supply of pills at a time when
I fill my prescription at a drugstore?
limit on the number of pills is a cost-management measure. Many
times a doctor will write a prescription for three refills even
though you may only need to take the prescription for a month.
If you get the entire three-month supply at once and end up not
using it, these pills go to waste. If your doctor writes a prescription
for a three-month supply and you need to continue taking the drug
after one month, simply call your drugstore to receive another
refill. And, remember that if you take a maintenance drug, you
can have a three-month supply delivered through the mail order
doctor says that I can only take the brand name version of my
prescription drug. Why do I have to pay more for it?
general, brand name drugs are significantly more expensive than
their generic equivalents. This is because brand name drugs are
advertised more extensively, and often marketed directly to consumers
and pharmaceutical companies, and therefore must reflect a portion
of that marketing cost in their price. You should ask your doctor
if you truly need to take the brand name version of your drug.
If not, you will certainly save money by taking the generic equivalent.
plan on having some expensive dental work done this year. How
do our dental plans' annual maximums affect me?
you participate in the MetLife Preferred Dentist Program (PDP),
the plan will cover up to $1,500 worth of eligible dental care
services after you pay your portion of the costs (percentage you
pay depends on the type of dental work done). This is a benefit
increase of $500 from last year. (Orthodontia remains at a $1,000
maximum.) If you participate in the Penn Faculty Practice (PFP)
Plan, there is no annual maximum applied to the services you receive.
Keep in mind, though, that you must receive dental treatment in
a PFP Plan office to receive benefits under that plan.
can I find out more about the changes in our health care benefits?
there are many changes this year, we'll be providing several ways
for you to learn more about your benefits:
normally carry the same coverage over from year to year. In light
of the changes this year, do I need to actively enroll for benefits?
we've made some changes, you will probably want to reevaluate
your coverage. Given the significant cost increases for some of
our plans, you may want to explore other options. For example,
the UPHS POS Plan provides excellent benefits using our own UPHS
providers. You may also want to check out the HMO options.
help offset your out-of-pocket expenses, you may want to consider
contributing to a Health Care Pre-Tax Expense Account. For more
detailed information on the Pre-Tax Expense Accounts, please consult
our website at www.hr.upenn.edu/benefits/pretax.
However, if you decide to keep the same coverage after reviewing
your options, you do not need to actively enroll (unless you need
to recertify an overage student or disabled dependent).
happens if I don't actively enroll?
in past years, if you do not actively enroll for your benefits
(i.e., make a change via the Open Enrollment website or by calling
the Penn Benefits Center), you will continue to receive the same
coverage you had during the previous year. Note that this includes
the PENNCare plan--although there will be significant changes
to the plan this year, it is still essentially the same plan.
is Open Enrollment this year?
Enrollment will begin on April 22 and end on May 3, 2002.
should I do if I change my address
should advise your Business Administrator so that your mailing
address will be updated in the personnel/payroll system.