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HUMAN RESOURCES Frequently Asked Questions About Benefits General Benefits Information How do our health care benefits compare to those of other Ivy League universities? Overall, 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. Why is Penn adding Independence Blue Cross' Personal Choice network to the PENNCare Plan? Adding 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. Why doesn't the University pay 100 percent of the cost of health care benefits Especially 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. What percentage of my health care costs does Penn pay as part of the cost-sharing arrangement? For 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. Medical Benefits Why are my monthly contributions for medical benefits increasing this year? In 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 coverage. I 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? Both 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. If I switch medical plans, can I continue to see the same doctor Usually, 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. Prescription Drugs Why will I have to pay more for my prescription drugs this year? What can I do to reduce my cost? The 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 www.caremark.com. Why can't I get more than a 34-day supply of pills at a time when I fill my prescription at a drugstore? The 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 program. My doctor says that I can only take the brand name version of my prescription drug. Why do I have to pay more for it? In 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. Dental Benefits I plan on having some expensive dental work done this year. How do our dental plans' annual maximums affect me? If 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. Annual Enrollment How can I find out more about the changes in our health care benefits? Since there are many changes this year, we'll be providing several ways for you to learn more about your benefits:
I 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? Because 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. To 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). What happens if I don't actively enroll? As 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. When is Open Enrollment this year? Open Enrollment will begin on April 22 and end on May 3, 2002. What should I do if I change my address You should advise your Business Administrator so that your mailing address will be updated in the personnel/payroll system. Almanac, Vol. 48, No. 30, April 16, 2002 |
ISSUE HIGHLIGHTS: Tuesday,
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