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Benefits Open Enrollment 2011–2012

March 29, 2011, Volume 57, No. 27

Benefits Open Enrollment 2011–2012
Monday, April 4–Friday, April 22

Benefits Open Enrollment, your annual opportunity to make changes to your health care elections, is almost here! There are some important changes to benefit options for the upcoming plan year, so you’re encouraged to review your Open Enrollment materials carefully this year in order to make the right decisions for you and your family.

Open Enrollment runs from Monday, April 4 through midnight on Friday, April 22. You should receive a personalized enrollment packet at your home address in early April. Visit the Human Resources website at www.hr.upenn.edu for more details about Open Enrollment, including what changes you can make during Open Enrollment, how to enroll, when changes go into effect, and more.

Plan Changes as of July 1, 2011

For the 2011–2012 benefits year, we’re making several changes to comply with health care reform legislation and support our commitment to managing costs while maintaining our highly competitive benefits package. These changes are also designed to give you more choice and help accommodate other needs, such as your personal and financial situation, how often you use medical plan services and where you choose to seek medical care.

Medical Plans

Penn will offer four medical plan options: two of these plans are currently offered and two are new. You will still have the option to select from either the Aetna or Independence Blue Cross provider networks, but this new mix of plan options provides greater choice for you and your family.

Plans No Longer Available: UPHS POS and Aetna HMO

As of July 1, 2011, the UPHS Point of Service (POS) and Aetna HMO medical plans will no longer be offered. If you’re currently enrolled in either of these plans, you’ll need to choose a new medical plan during Open Enrollment. If you don’t make an election, you’ll automatically be enrolled in a new plan based on your current coverage. If you’re a UPHS POS participant, you’ll be enrolled in the Aetna Choice POS II plan. If you’re an Aetna HMO participant, you’ll be enrolled in the Keystone/AmeriHealth HMO plan.

New Plans: Aetna Choice POS II and Aetna High Deductible Health Plan with Health Savings Account

The Aetna Choice POS II will replace the UPHS POS plan. The new plan offers more freedom because you do not need to choose a Primary Care Provider or get referrals. You decide which providers you want to use at any time, whether in-network or out-of-network.

In response to faculty and staff requests, Penn will also offer the Aetna High Deductible Health Plan (HDHP) with a Health Savings Account (HSA). This plan is designed to give you more choice and control over how you spend your health care dollars:

• You can see any provider of your choice without a referral, and can choose whether to go in-network or out-of-network each time you need care.

• As the name implies, this plan carries a high deductible and you need to meet that deductible before the plan begins paying benefits. This applies to all services, including prescription drugs and office visits. However, the deductible does not apply to in-network preventive care.

• After you meet the deductible, your out-of-pocket costs are based on whether you use in-network or out-of-network providers.

• This plan has an HSA, a tax savings vehicle that you can use to offset the cost of care. What’s more, Penn will contribute money to the HSA on your behalf—$500 for employee only coverage or $1,000 if you cover any dependents.

You can learn more about the new Aetna High Deductible Health Plan by attending an information session (see the “Information Sessions” section for dates and times).

In Vitro Fertilization Coverage

In Vitro Fertilization (IVF) coverage will be offered under all medical plans for services at the Hospital of the University of Pennsylvania (HUP) only. Coverage will be limited to two cycles per lifetime.

Autism Coverage

The University is expanding coverage for autism under all medical plans. In addition to currently covered services like diagnostic assessments and prescription medications, our plans will also cover applied behavioral analysis.

Out-of-Pocket Costs

Several changes will be made in the PennCare/Personal Choice PPO plan:

• A deductible will be introduced for the PennCare network, and the deductible for the Personal Choice network will increase.

• Some of the existing copays will be replaced with a coinsurance payment, and there will be higher copays and coinsurance amounts for other services.

• The annual out-of-pocket maximum for families will increase for the PennCare network, and the separate copay maximums will be removed from the plan.

For the Keystone/AmeriHealth HMO plan, copays will increase for some services.

MetLife Dental Plan

The MetLife Preferred Dentist Program (PDP) will have a deductible of $50 per person for services. This deductible will not apply to preventive care services that are covered at 100%, such as cleanings and periodic x-rays. The annual maximum benefit for the MetLife plan will increase from $1,500 to $2,000 per person.

Payroll Contributions

There will be an increase in payroll deductions (the amount you contribute through your pay) for the PennCare/Personal Choice PPO and the Keystone/AmeriHealth HMO plans. Penn will continue to fund the majority of the premium costs for all of our health plans; your contribution is a portion of the total cost.

Currently, the premium rates for our medical, dental and vision plans are split into three categories. As of July 1, 2011 there will be four categories. This change allows for a more equitable distribution of the rates across our entire population, and some faculty and staff may actually see lower payroll deductions as a result.

Current Premium Rate Structure

New Premium Rate Structure

Employee Only

Employee Only

Employee + 1

Employee + Child(ren)

Employee + 2

Employee + Spouse/Partner


Employee + Family

Health Care Reform Changes

Federal health care reform legislation sets standards for all employer-sponsored medical plans, and includes a number of provisions that will become effective between now and 2018. Penn is starting to make changes to our benefit plans now in order to comply with these provisions—while still providing affordable, quality care to you and your family.

Dependent Children Covered to Age 26

Penn will extend medical, dental, vision and dependent life insurance coverage to eligible adult children up to the end of the month in which they turn age 26. If you have a child between the ages of 19 and 26 who had previously become ineligible for coverage, you’ll have the opportunity to re-enroll him or her during this year’s Open Enrollment period. Here are additional details:

• Children are eligible for coverage regardless of their student, marital or IRS dependent status.

• Children do not have to live with you or depend on you for financial support to be eligible.

• Children over age 19 no longer have to be full-time college students to remain on coverage.

• Disabled children who are unable to earn a living may be covered beyond age 26, provided the disability began before age 26 and has been certified by your insurance carrier.

• The coverage does not extend to your child’s spouse/partner or children.

• Eligible expenses incurred by children up to age 26 can be reimbursed from your Health Care Pre-Tax Expense Account. However, only expenses for children claimed as dependents on your tax return are eligible for reimbursement under the new Health Savings Account.

No Lifetime Coverage Limits on Essential Plan Benefits

This change only affects the PennCare/Personal Choice PPO plan. There will no longer be a lifetime coverage maximum when you use out-of-network providers in this plan. Please note that some limits do apply to non-essential health benefits, such as in vitro fertilization.

Preventive Care Covered at 100%

In-network preventive care will be covered at 100% with no copay for all medical plans. This includes services such as routine physicals, pediatric immunizations and annual gynecological exams.

Health Care Rates for 2011–2012


Full-Time Weekly-Paid

Full-Time Monthly-Paid



Employee +

Employee +

Employee + Family


Employee +

Employee +

Employee + Family










PennCare Personal Choice







$ 399.84


Aetna Choice









Keystone HMO









Aetna HDHP


















Penn Faculty Practice Plan









MetLife Dental


















Davis Vision









Information Sessions

We’re holding information sessions for this year’s Open Enrollment period so you can learn more and ask questions.

Open Enrollment Information Sessions

The following session will give you a broad picture of the 2011-2012 Open Enrollment period, including plan changes, new premium rates, health care reform changes and more.

Tuesday, March 29, 2–4 p.m.
Bodek Lounge, Houston Hall

Additional sessions will be held in most schools and centers. Because space is limited, these sessions are intended only for the faculty and staff in those areas. Visit www.hr.upenn.edu/benefits/openenrollment.aspx for a schedule.

High Deductible Health Plan Information Sessions
We’re also holding information sessions on the new Aetna High Deductible Health Plan with a Health Savings Account. You’ll have the opportunity to ask questions and learn how the new plan works.

Friday, April 8, 10 a.m.–noon,
3624 Market St., Suite 1B South

Wednesday, April 13, 1–3 p.m.,
3624 Market St., Suite 1B South

Tuesday, April 19, 2–4 p.m.,
3624 Market St., Suite 1B South

To register for any of the sessions above, visit the Human Resources online course catalog at www.hr.upenn.edu/coursecatalog

Open Enrollment Fairs

Tuesday, April 12, 10 a.m.–2 p.m.
Hall of Flags, Houston Hall

Thursday, April 14, 10 a.m.–2 p.m.
Alumni Hall, New Bolton Center

Representatives from Penn’s health care providers and administrators will be onsite to share information and answer questions at our annual Open Enrollment Fairs. At the Houston Hall Fair on April 12, you can also take advantage of free health screenings and wellness information on several topics, including blood pressure, cholesterol and glucose, glaucoma, Body Mass Index, recreation and fitness, women’s health, environmental safety and ergonomics, Employee Assistance Program, occupational and physical therapy, diabetes and heart health, oral and dental care and more.

How Do I Find Out More?

• Attend a Benefits Open Enrollment Fair and Information Session

• Visit the Human Resources website at www.hr.upenn.edu/benefits/openenrollment.aspx

• Call the Penn Benefits Center at 1–888–PENN–BEN (1–888–736–6236), Monday–Friday, 8 a.m.–6 p.m.

• Look for your personalized Benefits Open Enrollment packet at your home address in early April.

• Email HR at benefits@hr.upenn.edu

Almanac - March 29, 2011, Volume 57, No. 27