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Summary Annual Report for the University of Pennsylvania Health & Welfare Program
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May 4, 2010, Volume 56, No. 32

This is a summary of the annual report of the University of Pennsylvania Health & Welfare Program, Plan No. 503, sponsored by The Trustees of the University of Pennsylvania, EIN 23-1352685, for the period that began on July 1, 2008 and ended on June 30, 2009. This annual report has been filed with the Employee Benefits Security Administration, as required under the Employee Retirement Income Security Act of 1974 (“ERISA”). Please note that not all employees are eligible to participate in all of the benefits available under the Plan. Please consult your Plan materials for specific eligibility information.

Medical, Prescription Drug, Dental, and Long Term Disability Benefits

The University of Pennsylvania has committed itself to pay certain medical and prescription drug claims, dental benefits and long-term disability benefits incurred under the terms of the Plan on a self-insured basis. In addition, the Plan has a contract with Aetna, Inc. to pay certain medical claims incurred under the terms of the contract. The total premiums paid to Aetna, Inc. for the plan year ending June 30, 2009 were $146,303. The Plan also has a contract with Standard Insurance Company to pay certain long-term disability benefits incurred under the terms of the contract. The total premiums paid to Standard Insurance Company for the plan year ending June 30, 2009 were $718,514.

Vision Benefits

The Plan has a contract with Highmark Blue Shield Vision Plan to pay vision claims incurred under the terms of the contract. The total premiums paid under this contract for the plan year ending June 30, 2009 were $703,326.

Life Insurance Benefits

The Plan has a contract with Aetna Life Insurance Company to pay life insurance, dependent life insurance and accidental death and dismemberment insurance claims incurred under the terms of the contract. The total premiums paid under this contract for the plan year ending June 30, 2009 were $4,957,990.

Long Term Care Benefits

The Plan has a contract with John Hancock Life Insurance Company to pay long term care claims incurred under the terms of the contract. The total premiums paid under this contract for the plan year ending June 30, 2009 were $1,127,524.

Your Rights To Additional Information

You have the right to receive a copy of the full annual report, or any part thereof, on request. Insurance information is included in this annual report. The items listed below are included in that report:

1. financial information and information on payments to service providers;

2. insurance information including sales commissions paid by insurance carriers.

To obtain a copy of the full annual report, or any part thereof, write or call the office of the Plan Administrator, c/o Joanne M. Blythe, Retirement Manager, University of Pennsylvania, 3401 Walnut Street, Suite 527A, Philadelphia, PA 19104-6228, (215) 898-9947. The charge to cover copying costs will be $5 for the full annual report or 25 cents per page for any part thereof.

You also have the legally protected right under ERISA to examine the annual report in the offices of the Employer at the address for the Plan Administrator, above, and at the US Department of Labor in Washington, DC, or to obtain a copy from the US Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N-1513, Employee Benefits Security Administration, US Department of Labor, 200 Constitution Avenue, NW, Washington, DC 20210.

—Division of Human Resources

 

Almanac - May 4, 2010, Volume 56, No. 32