Understanding Your Benefits - Retirees Service Center
Transcription
Understanding Your Benefits - Retirees Service Center
Understanding Your Benefits 2012 Benefits Summary Information Booklet for Retirees Table of Contents Important Benefit Plan Changes for 2012 3 Medicare Credible Coverage 4 HIPAA Compliance 4 COBRA 4 Pet Insurance 4 Find a Doctor 4 Medical Coverage Options 5 Dental 9 Vision 11 Life and Accidental Death & Dismemberment Insurance 12 Online Benefit Account Information 13 Qualifying Events for Changes 14 Traveling Abroad 15 Vendor Contacts Back Cover Benefits Staff Back Cover Related Links Back Cover NOTE THE SMALL (but important) PRINT: While we make every effort to present this information accurately, this document is a summary overview. That means lots of details, explanations, and qualifiers are left out. It is intended only to provide general guidance, and you should not rely upon it as a complete or binding explanation of Georgia State University’s benefit program. If this summary information differs from the language or intent of the formal published descriptions and/or legal plan documents of these benefit programs, that information prevails. 2 Benefit Plan Changes for 2012 * IMPORTANT * Open Enrollment October 24 – November 18 New Networks for Medical Plans with BlueCross BlueShield of Georgia BOR PPO and HSA (HDHP) PPO will no longer be available. The New Networks are as follows: • BOR PPO becomes Blue Open Access POS • HSA PPO (HDHP) becomes HSA Open Access POS For both POS plans you will receive a new healthcare card for you and any dependents to reflect this change. You do not have to re-enroll for the 2012 plan year unless you wish to change the level of coverage or medical plans. Please be sure to check with your current doctor(s) to ensure membership in this network. The monthly premium will increase by 5.2%. For the HSA Open Access POS plan only the employer/ employee monthly premium contribution will change from 90/10 to 85/15. What is Open Access POS Plan? Blue Open Access POS is a point-of-service plan, which means employees will have the flexibility to choose doctors in or out of network. In-network will of course cost less than out-of-network care. You and your dependents will also have the added bonus of seeing these doctors without the need of a referral. You will need to verify with your current healthcare provider(s) that they are in this network or you will be subject to the out-of-network benefits. Medco Change in prescription plan with Medco’s elimination of quarterly out-of-pocket maximum and moving to an annual out-of-pocket maximum as follows: The following annual out-of-pocket maximum amounts (stop loss) for members who obtain generic and preferred brandname prescription medications will apply: Medco (cont.) • Employee: $1,000 • Employee + Child: (Two (2) covered members): $2,000 • Employee + Spouse: (Two (2) covered members): $2,000 • Family: (Three (3) or more covered members): $3,000 Upon a member reaching the annual out-of-pocket maximum, the prescription drug co-payments will be waived for any additional generic and preferred brand-name medications for the remainder of the calendar year. BlueChoice Healthcare Plan (HMO) will not accept any new enrollments. All current members will be allowed to continue in the plan. The monthly premium will increase by 5.2%. Kaiser Permanente Healthcare Plan (HMO) will not accept any new enrollments. All current members will be allowed to continue in the plan. (Senior Advantage Plan 65+ is still open for new enrollment). The monthly premium will increase by 8.1%. Consumer Choice Option The Consumer Choice Option is eliminated for all medical Healthcare Plans. Board of Regents Dental There is no rate increase for either the BOR Dental Plan or the Georgia State University MetLife Dental Plan. Plan Year 2011 “Reminders” Tobacco Use Surcharge There is no change to the $50 monthly premium surcharge for the use of tobacco. A retiree must self identify. Retirees who turn age 65 after 1/1/2011 Retirees and spouses reaching age 65 have the option to enroll in Medicare B or pay the full cost of the USG system medical insurance (employer and employee portion). 3 Important Notices Coverage Expansion under the Affordable Care Act Medicare Part D— Creditable Coverage (cont.) Medicare Part D— Creditable Coverage COBRA Coverage of Young Adults under Age 26 Under the Affordable Care Act, you can now keep your young adult(s), beginning at age 19, on your medical insurance plan until they turn 26 years old. (See page 15 for dependent coverage details). Medicare eligible covered members must make a decision to continue with their prescription drug coverage offered through the healthcare plans of the Board of Regents or whether to enroll in a Medicare Part D prescription drug plan. If you participate in the Open Access POS healthcare plan, the prescription drug coverage that you currently have with the Board of Regents is deemed to be, on average, at least as good as the standard Medicare Part D coverage. This is called creditable coverage. If you are in HSA Open Access POS, you may want to research a Part D plan. You will find a helpful tool at www.cms.gov. If you are a current Kaiser Permanente Senior Advantage member, Kaiser Permanente will automatically serve as your Medicare Part D provider. The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan. NEW! - Pet Insurance with VPI Accidents and illnesses happen to pets just as readily as they do in children. And though advances in veterinary medicine help treat and cure many conditions, the costs of these treatments are increasing. What would you do if your pet got sick or hurt today? Would you have enough in savings to cover the veterinary costs? VPI Pet Insurance can help you pay for your pet’s veterinary expenses. VPI Pet Insurance is offering Georgia State University students, staff, and retirees a 5% group discount on coverage per pet up to a discount of 15% for three eligible pets. Pet insurance also provides a financial safety net for unexpected veterinary expenses. With pet insurance, you can focus on giving your pet the best care possible, instead of focusing on the cost of treatment. VPI has a variety of plans to choose from with coverage for preventive care, accidents, illnesses and diseases, including cancer. Log on to the site to find out more information about coverage: • www.petsvpi.com • Under “Search for Your Company,” start typing in Georgia State University. Once you see it in the box, click the “Search” button. You can also call 877-PETS-VPI (877-738-7874). Simply mention that you are a retiree of Georgia State University. You will be billed directly for this benefit. 4 Find a Doctor Instructions on how to find a doctor for the: ■HMO ■Open Access POS and ■HSA Open Access POS Plans 1. Go to bcbsga.com/bor. 2. Click on “Find a Doctor.” 3. Click on “Georgia Providers for Individual Plans and Group Plans (through your employer).” 4. On the Basic Information tab select “Doctor & Other Health Professionals.” 5. A search by Name, Specialty or Sub-Specialty is optional. 6. You will be prompted to enter the demographic information for your search. 7. Next click on the Insurance Plan Information tab. 8. Select the state in which you need service (you have the option of entering the alpha prefix as well). 9. Select the type of healthcare/medical plan you are enrolled in. 10. Select the plan type. 11. Click the Additional Options tab to filter your search by gender, language, etc... 12. Click the button at the bottom of page. 5 Medical Open Access POS Calendar year deductible (Individual/family) Out-of-pocket maximum (Individual/family) Office Visits and Services Wellness: routine exams (physical, eye), immunizations, well-child care, PSA and mammograms Illness or injury: physician office visits X-ray, lab, and diagnotic tests; allergy testing; outpatient surgery; urgent care services Maternity care prenatal, delivery, and postnatal Emergency Room Services Emergency room In-Network Out-of-Network $300/$900 $400/$1,200 $1,000/$2,000 $2,000/$4,000 No office co-pay. Plan pays 100% of network rate. Based upon national guidelines for age and gender-appropriate services. Not covered $20 Co-pay per office visit 90% Of network rate; subject to deductible 60% Of network rate; subject to deductible/ balance billing 60% Of network rate; subject to deductible/ balance billing 90% of network rate after an initial visit copayment of $20; not subject to deductible. There will be no copayments charged for subsequent visits 60% Of network rate; subject to deductible/ balance billing 90% Of network rate after a $75 co-pay; copayment is reduced to $50 if referred by 24/7 nurseline; subject to deductible 90% Of network rate after a $75 co-pay; copayment is reduced to $50 if referred by 24/7 nurseline; subject to deductible Inpatient Services Physician services, surgery, anesthesiology, 90% Of network rate; subject to deductible 60% Of network rate; subject to deductible radiology, pathology, maternity/delivery Note: some surgeons and/or hospital physicians, anesthesiologists, pathologists, and/or radiologists may not be a part of the participating physician program/national participating provider network. If you incur services with these non-participating providers, you will be subject to balance billing. See definition of balance billing below. Pharmacy Benefit - Medco 30-Day supply for most prescriptions • Generic $10 Co-pay • Preferred brand name $30 Co-pay • Non-preferred brand name 20% Co-pay (min. $40/Max. $100) Not covered. Up to a 90-day supply - Medco by mail • Generic $25 Co-pay • Preferred brand name $75 Co-pay • Non-preferred brand name 20% Co-pay (min. $100/Max. $250) Definitions Deductible: Amount you pay out of pocket each calendar year prior to any benefits payable by the healthcare plan. Co-payment: Amount you pay per office visit or prescription. UCR: Refers to the usual, customary and reasonable fee as set by Blue Cross Blue Shield of Georgia (BCBSGA). Balance billing is the amount charged over the usual, customary and reasonable (UCR) fee as set by BCBSGA. If you use the participating provider program or national participating provider network you will minimize your out-of-pocket expenses. If you access services outside the networks, you will be subject to balance billing. For the BCBS wellness care guide, please click here or visit www.bcbsga.com/bor. 6 Medical HSA Open Access POS In-Network Out-of-Network Calendar year deductible $1,500/$3,000 (Individual/family) Calendar year maximum out-of-pocket $3,000/$6,000 $6,000/$12,000 (Stop loss) (individual/family) The high deductible amount is significantly offset by your monthly premium savings. You must meet the family deductible before benefits are payable for any family member. Office Visits and Services Wellness: routine exams (physical, eye), immunizations, well-child care, PSA and Plan pays 100% Plan pays 70% subject to balance billing mammograms Physician office visits, laboratory fees, maternity, outpatient surgery, inpatient 90% Of network rate; subject to deductible 70% Of network rate; subject to deductible services Outpatient hospital/ facility — Anesthesiologist, pathologist, or radiologist 90% Of ucr charges; subject to deductible 70% Of network rate; subject to deductible For services/consultations Note: some surgeons and/or hospital physicians, anesthesiologists, pathologists, and/or radiologists may not be a part of the Participating physician program/national participating provider network. If you incur services with these non-participating providers, You will be subject to balance billing. Emergency Room Services Emergency room 90% Of network rate; subject to deductible/ 70% Of network rate; subject to deductible/ balance billing balance billing Behavioral Health Inpatient 90% Of network rate; subject to deductible; Maximum benefit coverage of 60 days per person per plan year; 90 days lifetime Outpatient 90% Of network rate; subject to deductible Maximum benefit coverage of 20 visits per person per plan year. Chiropractic Care Limited to 20 visits — not subject to deductible Pharmacy Benefit - Express Scripts Open formulary Subject to quantity limits and pre-authorization review. Other exclusions apply Rx cost Plan pays 90% Plan pays 90% Definitions Deductible: Amount you pay out of pocket each calendar year prior to any benefits payable by the healthcare plan. Balance billing: is the amount charged over the Usual, Customary and Reasonable (UCR) fee as set by BCBSGA. For the BCBS wellness care guide, visit www.bcbsga.com/bor. 7 Medical - Blue Choice and Kaiser Permanente HMO Calendar year deductible and out-of-pocket maximum Office Visits and Services Wellness routine exams, immunizations, well-child care, PSA and mammograms Illness or injury: physician office visits X-ray, lab, and diagnotic tests; allergy testing; outpatient surgery; urgent care services Maternity care prenatal, delivery, and postnatal Emergency Room Services Emergency room (1) After hours/urgent care (2) Ambulance Inpatient Services Physician services, surgery, anesthesiology, radiology, pathology, maternity/delivery Pharmacy Benefit - Medco 30-Day supply Blue Choice HMO (retiree must be under age 65) Kaiser HMO (contact Kaiser when Medicare eligible) None None No office co-pay No office co-pay $15 Co-pay per office visit $15 Co-pay per office visit 100% Paid by insurance 100% Paid by insurance 100% Paid by ins. After $15 co-pay for initial doctor visit 100% Paid by ins. After $15 co-pay for initial prenatal, delivery and first post-partum visit $75 Co-pay per office visit $30 co-pay Paid at 100% when medically necessary $75 Co-pay per office visit $30 co-pay $75 co-pay 100% paid by insurance; $200 hospital co-pay 100% paid by insurance; $200 hospital co-pay $10 Co-pay for generic $25 Co-pay for name brand Definitions Copayment: 8 Fixed amount you pay per office visit or prescription. Kaiser pharmacy: mail order available $10 Generic/$25 name brand Network pharmacy: $16 Generic/$31 name brand Dental Board of Regents Indemnity The Board of Regents Indemnity dental plan is administered through MetLife. There are many online services on their website, www.metlife.com/mybenefits where you may elect to: • View your personal coverage and claims information • Sign up to receive e-mail alerts each time a dental claim is processed. • Opt to turn off the delivery of paper Explanation of Benefits statements (EOB’s) and utilize • View MyBenefits to access and print future EOB’s. Registration is simple! • Go to: www.metlife.com/mybenefits • Enter “Georgia State University” as company name under Account Sign In • Highlight BOR dental plan or the GSU dental plan, click submit • Click Register Now • Complete steps one through three • Click Register MetLife Board of Regents Indemnity Calendar year deductible: preventive Calendar year deductible: basic/major Annual plan maximum benefit per calendar year Preventive services: two cleanings per year, oral exams, x-rays (limit x-rays to ADA recommended timing). Basic services: fillings, extractions, root canals, crowns, bridge repair Major services: crowns; inlays; dentures; bridges Orthodontia Lifetime Maximum (6 month waiting period) N/A $50 Per member $1200 Per member Paid at 100% of network rate; subject to deductible Paid at 80% of network rate Paid at 80% of network rate; subject to deductible $1000 per member at Network Rate NOTE: Balance billing is the amount charged by your dentist that is more than the plan’s allowed amount for that service. Members who use non-network dental providers will be responsible for any balance billing charged by their dentist Monthly Dental Premiums Retiree Only Retiree + Spouse Retiree + Child Family $30.84 $61.66 $58.58 $98.66 9 Dental Georgia State University MetLife The Preferred Dentist Program (PDP) dental plan is administered through MetLife. There are many online services on their website, www.metlife.com/mybenefits where you may elect to: • View your personal coverage and claims information • Sign up to receive e-mail alerts each time a dental claim is processed. • Opt to turn off the delivery of paper Explanation of Benefits statements (EOB’s) and utilize • Access MyBenefits to access and print future EOB’s. Registration is simple! • Go to: www.metlife.com/mybenefits • Enter “Georgia State University” as company name under Account Sign In • Highlight BOR dental plan or the GSU dental plan, click submit • Click Register Now • Complete steps one through three • Click Register MetLife PDP In-Network Calendar year deductible: preventive Calendar year deductible: basic/major Annual plan maximum benefit per calendar year Preventive services: two cleanings per year, oral exams, x-rays Basic services: fillings, extractions, root canals, crowns, bridge repair Major services: crowns; inlays; dentures; bridges Orthodontia lifetime maximum (6 month waiting period) Out-of-Network N/A $50 Per member/$150 per family $1200 Per member Paid at 100% of PDP fee Paid at 70% of PDP fee Paid at 50% of PDP fee $1000 Per child; paid at 50% of PDP fee $100 Per member/$300 per family $750 Per member/$300 per family Paid at 100% of PDP fee/subject to deductible Paid at 70% of PDP fee/subject to deductible Paid at 50% of PDP fee/subject to deductible $750 Per child; paid at 50% of PDP fee NOTE: Balance billing is the amount charged by your dentist that is more than the plan’s allowed amount for that service. Members who use non-network dental providers will be responsible for any balance billing charged by their dentist. A PDP fee refers to the fees that participating PDP dentists have agreed to accept as payment in full. Monthly Dental Premiums Retiree Only Retiree + Spouse Retiree + Child Family 10 $25.47 $46.10 $58.28 $85.81 Vision UnitedHealthcare Vision The vision plan is administered through UnitedHealthcare. Their network includes the following: • All Georgia Optometry Locations • All UnitedHealthcare Panel Doctors • All UnitedHealthcare Retail Locations (Wal-Mart, For Eyes, Doctors Visionworks) You can go online to print ID cards by visiting www.myuhcvision.com. Benefits Frequency Exam - Provided by a network optometrist or ophthalmologist Lenses and Lens Options • Lined bifocal • Ft35 • Lined trifocal • Scratch coating • Plastic bifocals • Plastic trifocals Frames Option 1 - Materials Only Option 2 - Exam and Materials Lenses once every 12 months Frames once every 12 months Contacts once every 12 months Exam once every 12 months Lenses once every 12 months Frames once every 12 months Contacts once every 12 months Not covered 100% covered after$10 co-pay 100% covered Additional lens options may be available at a discount, please see the provider for details. Receive a $130 frame allowance applied toward the retail price of a frame at any network provider. Your allowance applies to any frame on the market today. If the frame costs less than the allowance, you have no additional out-of-pocket expense, other than applicable co-pay. If the frame costs more than the allowance, you are only responsible for the difference, plus any applicable co-pay. Covered-in-Full Contact Lenses Contacts (including disposables), the fitting/evaluation fees, and up to two follow-up visits are covered in full. If covered disposable contact lenses are chosen, up to four boxes are included when obtained from a network provider. (In lieu of eyeglasses, contacts must be part of the UnitedHealthcare Vision covered selection.) Non-Covered Contact Lenses A $125 allowance is applied toward the fitting/evaluation fees and purchase of contact lenses outside of UnitedHealthcare Vision covered-in-full contacts. The materials co-pay does not apply. Out-of-Network Benefits - Exam Exam not covered Exam: $40.00 (reimbursement amount) Out-of-Network Benefits - Reimbursement Amount Frames: $45.00 Single Vision: $40.00 Bifocal: $60.00 Trifocal: $80.00 Lenticular: $80.00 Contacts (in lieu of glasses): $125.00 Contacts - Medical: $210.00 Vision Premiums Retiree Only Retiree + Spouse Retiree + Child Family Option 1 $5.52 $9.51 $9.05 $13.93 Option 2 $7.11 $12.82 $12.21 $17.83 11 Life Insurance Board of Regents Life Insurance Basic Life and Accidental Death & Dismemberment (AD&D) Insurance - Employee Coverage Only Basic life and AD&D insurance are provided to the employee at no cost. Coverage is provided at 100% through Georgia State University: • Basic Life /AD&D: $25,000 prior to age 70 Your AD&D insurance pays a benefit if you die or suffer certain permanent injuries due to a covered accident. This also includes a Will Preparation Program. Your AD&D coverage ends at age 70. Dependent Life Insurance - Spouse and Child(ren) Dependents of retirees are eligible for life insurance, up to $5,000. Rates are based on the amount of coverage you elect. Supplemental Life and AD&D - Employee Rate per $1,000 of Age coverage <25 $0.09 25 - 29 $0.10 30 - 34 $0.12 35 - 39 $0.13 40 - 44 $0.15 45 - 49 $0.20 50 - 54 $0.30 55 - 59 $0.54 60 - 64 $0.81 65 - 69 $1.58 70+ $2.60 Coverage When You Retire If You Retired After 1/1/88 Dependent Life Coverage Amount Rate per month $5,000 $2.35 $3,500 $1.66 $2,000 $0.94 $1,000 $0.47 Update beneficiary information anytime by logging on to ADP at www.portal.adp.com. Your $25,000 coverage for basic life and AD&D will continue at retirement at no cost to you. AD&D ends at age 70. • If first enrolled in Supplemental Life on or after 11/1/80 - Reduces to 50% in effect immediately before retirement or $15,000, whichever is less. This allows for $40,000 of maximum coverage (Basic plus Supplemental). • If first enrolled in Supplemental Life on or after 1/1/88 - Coverage must be in effect for 10 years immediately prior to retirement. If not, only Basic and Dependent coverage may be continued at retirement. • If first enrolled in Supplemental Life prior to 11/1/80 (closed plan) - If you retired prior to age 67, coverage equals the amount of Basic & Supplemental coverage in force immediately prior to retirement, with a maximum of $125,000. Coverage will reduce at age 67 and 70. After age 70 supplemental life is reduced to $15,000 for a total of $40, 000 basic plus supplemental. AD&D ends at age 70. Go to http://www.usg.edu/hr/benefits_docs/life-ins.pdf to view complete Plan Booklet. 12 Online Access to Benefit Account Information Online Resource ADP Portal Online Benefit Elections (First time users please refer to the enclosed Employee Self Service Registration Guide for instructions). Instructions 1. 2. 3. 4. 5. Go to: https://portal.adp.com/public/index.htm Click on Benefits>My Benefits Key in all demographics on dependents that will be covered Choose desired medical, dental, and/or vision coverage Life Insurance a. Designate Beneficiaries for various life insurance coverage(s) ADP Benefit Services Payment Setup 1. Go to https://www.benedirect.adp.com/ParticipantWeb/login.jsp 2. Click “Click To Register” under Participant Login 3. Enter required information to complete the registration process Blue Choice HMO Member Access 1. 2. 3. 4. • • • • • • Make premium payments Change bank account information Change your PCP on BlueChoice HMO without having to call customer care View and manage your benefits Request a new member ID card Review and print an explanation of benefits (EOB) HSA Open Access POS Prescription Comparison Tool Go to http://www.bcbsga.com/bor/ Select Member Click on “Register Now” Complete the required fields and your username and password will be generated immediately Note: Make sure you have your member ID card handy, because you’ll need your HCID and Group ID numbers. 1. Login to Member Access at www.bcbsga.com/bor/ with existing credentials (or create them, if you do not already have Member Access credentials 2. From “Member Access Overview” page, choose the “Prescriptions” tab 3. From “Prescriptions /overview” page, choose “Pharmacy Member Services” (Note: Do NOT choose “NextRx On-line”) 4. From “Disclaimer Page,” hit ‘continue’ 5. Choose “Price a Drug” (in the Quick Links box). 6. You should now be at the pricing tool. 13 Traveling Abroad Traveling Abroad/Outside Service Areas Open Access POS or HSA Open Access POS To locate in-network providers out-of-country, go to www.bcbsga.com/bor and click on BlueCard WorldWide. This applies to members traveling, or living abroad. Open Access POS All international providers are considered ‘in-network’ and claims are processed under the Georgia network. For members working or traveling abroad, a network of hospitals and physicians is available to offer members services throughout the world. At the physician and outpatient level, the member will need to pay for the services at the time they are performed. The member will then submit an international claim form along with the original bill for the charges to the BlueCard Worldwide® Service Center, where they will be translated and the currency converted to U.S dollars. The claim will then be processed through the Blue Cross and Blue Shield system with payment issued to the member. (Please note: if you use an out-of-network hospital, you will receive a lower level of coverage). Blue Choice HMO Only services for life-threatening injuries or illness will be covered. You will be required to pay the provider at the time medical services are rendered. A paper claim can then be filed to receive reimbursement for services. You must attach an itemized bill (translated to English) to your claim, and the billed amount must be converted to the equivalent U.S. currency rate. Kaiser As a Kaiser Permanente Member, you have 24-hour worldwide emergency coverage. When you travel outside the service area, you are covered for any illness or injury requiring emergency care only; routine and preventive care is not covered outside the service area. 14 Qualifying Events for Changes Qualifying Events for Changes in Medical, Dental, and Vision A retiree will not be permitted to participate in the annual change period unless he/she elected to take healthcare coverage into retirement at the time of his/her separation from employment with the University System of Georgia. During open enrollment, an eligible retired employee may elect to: (1) drop or discontinue healthcare coverage; (2) participate in a different healthcare plan option; and/or (3) reduce his/her level of coverage. During open enrollment, a retiree shall not be permitted to add healthcare coverage, or increase the level of coverage that he/she took into retirement, unless it is the result of one of the following three qualifying events: 1. The addition of a dependent(s) because of marriage, birth, adoption or a Qualified Medical Child Support Order (QMSCO); 2. The loss of a dependent’s health benefit coverage through a change in a spouse’s group coverage, through COBRA coverage, through Medicare, or through Medicaid; and 3. A change in a spouse’s employment status that affects coverage eligibility under a qualified health plan. Documentation Required If you have a qualifying event, documentation must be submitted by fax or mail within 30 days of the event. You are required to log into the ADP portal: www.portal.adp.com and click on tabs: Benefits/My Benefits/Family Status Change. c. The condition existed prior to age 26; and Proof of incapacity is furnished within 30 days of the dependent child’s 26th birthday According to the new regulations, your dependent children are eligible to remain under the Plan without residency and financial support requirements. That means you can cover dependent children up to age 26, who do not live with you, who you do not claim on your tax return, and/or who is no longer a full-time student. If your dependent is disabled and over age 26, you must provide: • A copy of the front page of one of your last two year’s filed federal tax return confirming that you claimed this dependent. You may take out any financial information • Proof of incapacity Dependents turning Age 26: Once your dependent turns age 26, they are no longer eligible to remain covered under the University System of Georgia Healthcare Plan. Your dependent’s coverage will end at the end of the month when they turn 26. ADP will automatically remove them from your plan and mail a COBRA packet to the dependent(s) notifying them of their COBRA enrollment rights. Dependents Effective January 1, 2011, eligible dependents were defined as: • Legal spouse (does not include common law spouse); • Natural or adopted children ages up to age 26 • Children who have been placed for adoption in connection with assumption by the person of a legal obligation for the total or partial support of a child in anticipation of the legal adoption of such child; • Step-children ages up to age 26 • Children up to age 26 for whom the covered employee is the permanent legal guardian if a court has named the employee as the child’s permanent guardian. • Unmarried, disabled children beyond age 26 if: a. They are unable to support themselves; and b. They depend on the employee for support; and 15 Vendor Contact Information Benefits Medical • Open Access POS • Blue Choice HMO • HSA Open Access POS Dental - BOR Dental - GSU Benedirect Self-Service Portal 403(b), 457, ORP 403(b), 457, ORP 403(b), 457, ORP Health Savings Account Medical Prescription Drug Open Access POS Vision Teachers Retirement System Vendor Phone Number Webite BlueCross BlueShield 1-800-424-8950 www.bcbsga.com/bor MetLife MetLife ADP Services GSU Help Desk Fidelity TIAA-CREF Valic U.S. Bank Kaiser Permanente 1-866-832-5759 1-800-438-6388 1-800-770-7981 1-404-413-4357 1-800-343-0860 1-800-842-2003 1-770-395-4717 1-877-470-1771 1-404-261-2590 https://metlife.com/mybenefits https://metlife.com/mybenefits www.benedirect.adp.com www.portal.adp.com www.fidelity.com/atwork www.tiaa-cref.org/georgiastate/ www.valic.com/usg www.healthsavings.usbank.com www.kp.org Medco 1-877-300-5139 www.medco.com UnitedHealthcare Teachers Retirement System of Georgia 1-800-638-3120 1-404-352-6500 www.myuhcvision.com www.trsga.com GSU Benefits Staff Staff Robert Elmore Corrin Sorteberg Valerie Ross Regina Barnett Kizzy Williams Phone Email Address 404-413-3318 [email protected] 404-413-3314 404-413-3323 404-413-3334 404-413-3317 [email protected] [email protected] [email protected] [email protected] Other Important Links State of Georgia website information regarding Agencies and Organizations Board of Regents of the University System of Georgia Employee Self-Service Portal (ESS) through ADP Teachers Retirement System of Georgia (TRS) Social Security Administration Online Medicare Internal Revenue Service Title Director, Payroll, Benefits, HRIS Benefits Manager Benefits Specialist Benefits Assistant Benefits Assistant www.georgia.gov www.usg.edu www.portal.adp.com www.trsga.com www.ssa.gov www.medicare.gov www.irs.gov 2012 Retiree Benefits Booklet revised March 2012 One Park Place South, Suite 330 Mailing Address Benefits Georgia State University P.O. Box 3982 Atlanta GA 30302-3982 Phone (404) 413-3330 (404) 413-3335(fax) Email [email protected]