IMS Health 2015 Benefits Enrollment Guide

IMS Health 2015 Benefits Enrollment Guide
A guide to help you make the best health care
choices for you and your family
IMS Health offers a menu of benefits to help you and your
eligible family members lead healthier and more active lives.
During Annual Enrollment (November 3 – November 14) all
US benefits-eligible employees may enroll in health care
benefits for 2015.
If you elected coverage in 2014 and you do not enroll
during Annual Enrollment your coverage will continue in
2015. If you wish to contribute to our Flexible Spending
Accounts (FSAs) or Health Savings Account (HSA), you must
make an election during Annual Enrollment (even if you
contributed in 2014).
For More Information: Need help? Have questions?
Just call the Employee Solutions Center at 1-800-467-6130. IMS
Health employees are available Monday through Friday from 9:00
a.m. to 5:00 p.m. Eastern Time to assist you with all your enrollment
and benefits questions. The Employee Solutions Center can also be
reached by email at [email protected].
You can also contact the plan provider directly using the lookup
chart on page 39.
What’s Inside
We are committed to offering competitive benefit programs while
managing costs for you and the company. This Enrollment Guide, along
with available decision making tools, will help you make the best health
care choices for you and your family.
2015 Overview
Ready, Set, Enroll!
Health Plans (Medical, Prescriptions, Dental & Vision)
Flexible Spending Accounts
Other Benefits
Contacts
Important Notices
Inside this Enrollment Guide you will learn about the IMS Health benefit
programs being offered in 2015. These programs reflect our commitment
to focusing on keeping our employees healthy through services such as
preventive care. On the next page, you will find an overview of the modest
changes we are making for 2015. Please review this Enrollment Guide in its
entirety to make informed benefit choices for 2015.
IMS HEALTH 2015 Benefits Enrollment Guide | 2
2015
Overview
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
2015 Overview
A cornerstone of the IMS Health
benefits program is a commitment to
providing competitive and affordable
healthcare coverage as part of our
comprehensive benefits package. In 2015,
no design changes are being made to our
medical or dental plans. This means that
plan deductibles, co-pay amounts, coinsurance percentages and out-of-pocket
maximums for our medical and dental plans
will not increase.
New for 2015, any out-of-pocket
prescription drug expenses you incur
will now count toward your medical plan
out-of-pocket maximum no matter which
medical plan option you choose – enabling
you to reach your out-of-pocket limit earlier
than before.
Premiums will increase moderately
for medical (including prescription
drug) and dental coverage to reflect the
continuing rise in healthcare costs.
Benefit
Category
DESCRIPTION
PPO Medical Plan
Your out-of-pocket eligible prescription drug costs will count towards the out-of-pocket
maximum. Out-of-pocket maximums, which are shown on page 18, are not changing.
New payroll contribution rates (see page 4)
PPO with HSA
Your out-of-pocket prescription drug costs will count towards the out-of-pocket maximum.
Out-of-pocket maximums, which are shown on page 18, are not changing.
The maximum amount you can contribute in 2015 to the HSA has increased to
$3,350/individual or $6,650/family.
New payroll contribution rates (see page 4)
Dental Plans
New payroll contribution rates (see page 4)
Healthcare Flexible
Spending Account
For 2015, the maximum amount you can contribute is increased to $2,550
Note: In compliance with the Affordable Care Act (Health Care Reform), you can access the Summary of Benefits Coverage (SBC) which
provides a detailed overview of IMS Health medical and prescription drug coverage. Go to IMS Now to view or download a copy. If you cannot
access IMS Now, contact the Employee Solutions Center at 1-800-467-6130 to request a copy.
IMS HEALTH 2015 Benefits Enrollment Guide | 3
2015
Overview
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
2015 Overview
2015 Monthly Employee Premiums
Medical – Anthem BCBS
(including prescription drug coverage through Express Scripts)
Dental - Delta Dental
Dental PPO Plan
DentalCare HMO Plan
Employee Only
$18.33
$08.30
PPO Plan
PPO with HSA Plan
Employee Only
$134.17
$069.54
Employee +1
$37.88
$13.91
Employee +1
$282.42
$139.60
Employee +2
$59.05
$23.13
Employee +2
$430.93
$218.22
Employee + 3 or more
$69.65
$28.38
Employee + 3 or more
$485.90
$239.05
Tobacco Surcharge: Your monthly medical contributions will
increase by $25 per month if you or a covered dependent use
tobacco. The tobacco surcharge ($25/month) will only apply
once even if more than one person in your covered family
uses tobacco. Important Note: Once a year, during Annual
Enrollment, employees (and any covered dependents) for
whom it is unreasonably difficult or medically inadvisable to
stop using tobacco due to a medical condition (e.g., nicotine
addiction) may as an alternative, register for a tobacco
cessation program and thereby qualify for a waiver of the $25
tobacco surcharge.
Spousal Surcharge: An additional surcharge (also equal to
$25/month) will apply if you cover a spouse and your spouse
has access to medical coverage through another source.
Life and Disability – Liberty Mutual
Optional
Term Life*
Employee & Spouse
Coverage Rates
Age
Rate per
$1,000
<35
$0.045
35-39
$0.054
40-44
$0.090
45-49
$0.153
50-54
$0.234
55-59
$0.378
60-64
$0.567
65-69
$0.927
70-74
$2.700
Other Plans
Optional Term Life
Child Rates
Rate per
$1,000
$0.120
Voluntary AD&D
Employee Only
Rate per
$1,000
Vision - Eyemed
Employee Only
$05.08
Employee +1
$10.16
Employee +2
$15.24
Employee +3
or more
$20.32
$0.014
Hyatt Legal
Services
Voluntary AD&D
Family
Rate per
$1,000
$0.021
Monthly
Contribution
$13.50
Buy-Up LTD
Rate per $100
$0.198
* Non-grandfathered
IMS HEALTH 2015 Benefits Enrollment Guide | 4
2015
Overview
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
2015 Overview
Pre-Tax or Post-Tax
You will pay your share of the cost of your benefits through either pre-tax or post-tax
contributions. The chart gives you a quick overview of which costs are deducted from
your pay on a pre-tax basis, and which are deducted on a post-tax basis.
Pre-tax contributions are deducted from your pay before federal and Social Security
(FICA) taxes, and in some cases, before state and local taxes are calculated and withheld,
thereby lowering your tax liability. Post-tax contributions come out of your pay after
these taxes are calculated and withheld. The cost calculation is shown on the enrollment
worksheet you’ll see when you enroll through PeopleSoft.
Pre-Tax
Post-Tax
Medical Coverage
(including tobacco and spousal
surcharges)
Employee-Paid
Supplemental Life
Dental Coverage
Buy-Up Long-Term Disability
Vision Coverage
Voluntary Group Accident
Healthcare Flexible
Spending Account
Legal Assistance
Dependent Care Flexible
Spending Account
Long-Term Care*
Health Savings Account
(HSA) additional employee
contributions
401(k)**
401(k)**
*This benefit is closed to new participants.
** Both pre and post tax contributions are available under the 401(k) plan.
IMS HEALTH 2015 Benefits Enrollment Guide | 5
2015
Overview
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Ready, Set, Enroll!
An Important Reminder About Enrollment
Active Employees: You may enroll in your 2015 benefits during Annual Enrollment
from November 3 through November 14. If you do not actively enroll during Annual
Enrollment your 2014 medical, dental, vision, life and disablility coverage will continue
in 2015. Please recall, according to the Affordable Care Act (or “Health Care Reform”)
you must have health coverage as of January 1, 2015 or face a tax penalty. Annual
Enrollment is your only opportunity to enroll for IMS Health-sponsored coverage. If
you do not enroll, you will need to find coverage from another source.
The enrollment process for your
IMS Health-sponsored benefits
varies depending on whether:
• You are an active employee
selecting benefits on an annual
basis; or
• You are a new hire selecting
benefits for the first time; or
As in the past, you will need to re-enroll to continue contributions to your Flexible
Spending Accounts and your Health Savings Account (HSA). All other coverage
elections will be rolled over to 2015 unless you make a change during Annual
Enrollment. Please review the materials provided carefully and be sure to make your
elections no later than November 14.
• You are going through a
change in status or “life event.”
New Employees: You must enroll within 31 calendar days of your hire date. If you do
not enroll you will have no medical, dental or vision coverage until the next Annual
Enrollment or unless you experience a qualified life status change.
IMS HEALTH 2015 Benefits Enrollment Guide | 6
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Ready, Set, Enroll!
Eligibility
Annual Enrollment
You are eligible to enroll if you are an employee of IMS Health
regularly scheduled to work 30 hours or more per week. You
may enroll yourself and your eligible dependents for medical,
dental, life, disability and/or accident insurance coverage.
Eligible dependents include:
You will need to access PeopleSoft to make your Annual Enrollment benefit elections.
To log onto PeopleSoft, visit IMS Now.
• Your legal spouse or, in some instances, a same-sex
domestic partner,
• Your dependent children up to age 26 regardless of
student or marital status.
For complete eligibility requirements, visit the Benefits
Enrollment site on IMS Now.
Go to Our Company > Human Resources >
Benefits > Benefits Enrollment.
Go to Our Company > Human Resources >
Benefits > Benefits Enrollment.
To access your personalized benefits screen in PeopleSoft, you’ll need your
User ID and Password.
• Your User ID and Password is the same as your IMS Health Windows Network
ID and Password
If you have forgotten your User ID and/or password, you can contact the IMS Health
Global Service Desk at 1-800-523-5334, then choose option 1.
How to Make Your Benefit Elections
Once signed onto PeopleSoft, select the following path from the “Main” menu:
• “Self Service,” then
• “Benefits,” then
• “Benefits Enrollment”
This will lead you to the first “Benefits Enrollment” screen, which provides general
enrollment information. After you have read this information, click the “Select”
button to begin your enrollment.
IMS HEALTH 2015 Benefits Enrollment Guide | 7
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Ready, Set, Enroll!
Your personalized Enrollment Summary will be displayed. You
should make a selection (even if you wish to waive coverage)
for each plan listed below. Click on the “Enroll” button in each
of the following plans:
Please submit the appropriate document based on your life
status change to the Employee Solutions Center:
• Photocopy of marriage certificate
• Current income tax return indicating spouse name
• Medical
• Voluntary Group Accident
• Dental
• Buy-Up Long-Term Disability
• Vision
• Legal Assistance Plan
• E mployee-Paid
Optional Term Life
• Health Care Flexible
Spending Account
• E mployee-Paid Spouse Life
• Dependent Care Flexible
Spending Account
• E mployee-Paid Child Life
After completing your selection for each plan, click “Store”
to save your choice until you are ready to submit your final
elections on the Enrollment Summary. Next, click “OK” to
return to the Enrollment Summary page.
Please note that proof of dependent eligibility is required
for any dependent added for the 2015 benefit year who was
not previously covered under the IMS Health benefits plan.
• Photocopy of dependent’s birth certificate. Must be a
complete birth certificate which includes both parents’
names; the short form birth certificate is not acceptable.
• Adoption Placement Order/Petition for Adoption
showing date filed/adoption finalization order
• Legal guardianship award
• Joint custody decree signed by judge
• Photocopy of court order for non-custodial parent to
provide health coverage
• Same sex domestic partnership affidavit for states that
do not recognize same-sex marriage
Coverage is contingent upon verification of eligibility.
Dependent coverage cannot be provided without
appropriate documentation. Documentation may be faxed
to the Employee Solutions Center at 610-997-6521.
IMS HEALTH 2015 Benefits Enrollment Guide | 8
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Ready, Set, Enroll!
Important Reminder: During
the enrollment process you will
be asked to indicate whether you
and any of the dependents you
elect to enroll in an IMS Health
medical plan use tobacco. If you
or a covered family member use
tobacco (or, if it is unreasonably
difficult or medically inadvisable
to stop using tobacco due to a
medical condition, fail to enroll
in a tobacco cessation program
during enrollment) then you will
incur the tobacco surcharge of
$25/month.
Let’s Keep in Touch
Printing Your Enrollment Summary
Don’t forget to update your
contact information during
Annual Enrollment. It is very
important to have the most
up-to-date phone numbers
and address information on file.
You can update your contact
information in PeopleSoft
though “Self Service.” The path to
update your contact information
in PeopleSoft is:
Before submitting your elections you should print the Enrollment
Summary, which will serve as confirmation of your choices for 2015.
Before clicking the “Submit” button, use the “Print” function on
your browser to print the Enrollment Summary page on the Annual
Enrollment screen.
Home > Self Service >
Personal Information >
Home > Mailing Address
or Phone Number.
Submitting Your Enrollment Elections
After printing your Enrollment Summary, you are ready to submit your
final elections. From the Annual Enrollment screen, click “Submit.”
If you have any errors or warnings in your submission, you will be
instructed on what steps you need to take. Once any errors have been
corrected and/or warnings have been reviewed, click “Continue.” Then
from the Submit Benefit Choices screen, click “Submit.”
If you do not have any errors or warnings, you will go directly to the
Submit Benefits Choices screen. After you submit your final choices,
you will be at the Submit Confirmation screen. At this point, your
choices have been successfully submitted. Look for an email confirming
your submission. You may want to print out this email for your records.
To log off, go to the upper right hand corner of the window and click
on “Sign out.”
Please contact the Employee Solutions Center at 1-800-467-6130 if you
have any questions.
IMS HEALTH 2015 Benefits Enrollment Guide | 9
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Ready, Set, Enroll!
Making Your Elections – New Hires
As a newly hired IMS Health employee, you received this
Guide along with a generic enrollment worksheet. More
details about your benefits, including medical, dental,
disability and life insurance plans are available on IMS Now,
our global intranet. You will have access to the Intranet
on the first day of work. Your coverage will be effective
retroactive to your first day of work as long as you enroll
within 31 calendar days of your start date.
If you do not enroll within 31 days of your start date or
change in status event, for whatever reason, you will not be
able to enroll until the next Annual Enrollment or until you
have a “qualified change in status.”
To enroll, you’ll need the New Hire packet that was mailed
to you by the Employee Solutions Center. If you did not
receive a New Hire packet, call the Employee Solutions
Center at 1-800-467-6130. The four steps to follow for
enrollment are found on the Benefits Enrollment site
on IMS Now. Go to Our Company> Human Resources>
Benefits> Benefits Enrollment. Detailed instructions on how
to enroll can be found on pages 7 through 9 of this Guide.
During your 31 calendar day enrollment window, the
enrollment system is available 24 hours a day, 7 days a
week, but must be accessed through IMS Now. If you
encounter problems or difficulties using the enrollment
system, contact the Employee Solutions Center at
1-800-467-6130 or [email protected].
Life Status Change Enrollment
Once you have enrolled, all of your elections remain in
effect through the end of the calendar year. However,
you may be able to make changes during the year if
you have a qualified change in status as designated
by the Internal Revenue Service. For a list of qualifying
changes, visit the Benefits Enrollment site on IMS Now,
or contact the Employee Solutions Center.
You must make your changes within 31 calendar days
of the qualified change in status. To initiate your benefit
changes please contact the Employee Solutions Center
at 1-800-467-6130. Your coverage will be effective
retroactive to the date of the change in status as long
as you enroll within 31 calendar days of the event.
You will be required to provide documentation as to
the change, and all changes in coverage will be on
hold until the appropriate documentation has been
received by the Employee Solutions Center.
If you Do Not Enroll
You will receive the following
company-paid health &
welfare benefits:
• Short-Term
Disability coverage
• Long-Term Disability
benefit of 40% monthly
income replacement up to
$5,000 a month
• Life Insurance benefit of
1x annual insurable base
up to $200,000
• Business Travel
Accident Insurance
• Participation in the
Employee Assistance
Program (EAP)
IMS HEALTH 2015 Benefits Enrollment Guide | 10
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans - Anthem BCBS
At IMS Health, we remain committed to meeting your
health care needs by giving you choices, flexibility and
the resources to become a better consumer of health
care. Of course, managing your health also requires a
commitment from you.
As with any other major purchase, educating yourself about your options
and which best meets your needs and your budget makes you a wise
consumer. Taking an informed, active role in your own health care can help
you to stay healthy and it can also help you get better treatment when you
need it. This saves you and IMS Health money – in direct medical expenses,
and in costs related to lost productivity.
It is important that you carefully review your medical plan options for
2015. With the PPO Plan with Health Savings Account, you will pay less in
monthly contributions but pay more when you require medical care during
the year. With the PPO Plan, you will pay more in monthly contributions
but will pay less when you require medical care during the year.
IMS Health’s commitment to you starts with your medical coverage. So,
along with an enhanced focus on preventive care and wellness, IMS Health
offers plans and programs that will make it easy to get informed and to get
the most from your medical coverage.
IMS HEALTH 2015 Benefits Enrollment Guide | 11
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans
Medical Options
The medical options include
the following choices offered by
Anthem BCBS:
• PPO with HSA Plan
• PPO Plan
Regardless of which plan you
enroll in, all plans use the same
provider network, the Blue Card
PPO Network.
2015 Plan
How the Plan Works
• You can contribute your own pre-tax contributions to your HSA, which will
be deducted from your paycheck. Your annual pre-tax contributions are
subject to a maximum of $3,350 for individuals and $6,650 for families.
• You choose how you want to pay for medical expenses.
• Once you meet the annual deductible, your health plan provides coverage.
You pay the actual cost of the service, minus a network discount if you use
an in-network provider. When you reach the applicable deductible your
health plan covers 75% of the cost for in-network, and 55% of the cost for
out-of-network eligible services. For details, see the table to the right as
well as the Health Plan Comparison Chart on pages 18 and 19.
The PPO with HSA Plan represents
a very different and innovative
approach to health care. The plan
is designed to give you:
• More control over how your
benefit dollars are spent.
• A tax-advantaged, interestbearing way to save for health
care expenses.
Family:
• In-Network: $5,000
•Out-of-Network: $10,000
Annual Out-of-Pocket Maximum*
Single:
• In-Network: $4,500
•Out-of-Network: $9,000
Family:
• In-Network: $9,000
•Out-of-Network: $18,000
• Preventive Care covered at 100%.
PPO with Health
Savings Account
(HSA) Plan
Deductibles*
Single:
• In-Network: $2,500
•Out-of-Network: $5,000
• Preventive Drugs covered at 75%, with deductible waived.
There are several ways to pay for qualified medical expenses in the HSA.
• Anthem BCBS ACS/BNY Mellon MasterCard. This debit card draws money
directly from your Health Savings Account.
• Anthem BCBS ACS/BNY Mellon Checkbook. This works the same as your
personal checkbook, only it draws from your Health Savings Account.
• Your personal money. Because unused dollars remain in your HSA year after
year, you may want to use it as a tax-sheltered savings tool. Unused dollars
accrue interest and grow tax-deferred. So, you may choose to pay your
qualified medical expenses up to your deductible out of your own pocket,
and use your account to save for medical expenses in future years, even
after retirement.
*Includes both medical and prescription drug
eligible out-of-pocket expenses.
Physician and Specialists After
Deductible is Met:
• Plan pays 75% of in-network costs;
you pay 25% of discounted cost
• Plan pays 55% of out-of-network
costs; you pay 45%
Preventive Care
• In-Network: Plan pays 100%,
no co-pay
• Out-of-Network: Plan pays 55%
after deductible; you pay 45%
IMS HEALTH 2015 Benefits Enrollment Guide | 12
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans
You may use your HSA to pay for medical services not covered by your plan. However, these payments do
not count toward your deductible. You can find covered expenses on www.anthem.com/imshealth.
Note on HSA Bank Account
If you enrolled in the PPO with HSA last year, you do not need to set up another account. Please keep your
card and use it again for eligible medical expenses for 2015.
For new enrollees and new hires, Anthem BCBS partners with ACS/The Bank of New York (BNY) Mellon. A
welcome kit will be sent to PPO with HSA Plan participants with everything you need to open an account,
transfer existing balances, etc. but you don’t have to wait for it to activate your ACS/BNY Mellon account.
You can activate your ACS/BNY Mellon HSA account online as soon as you make your election by logging
on to Anthem BCBS’s HSA Advantage website at https://hsamember.com/HSA/anthem.adv.
Questions?
Information about Anthem BCBS’s
plans is available on IMS Now. You
can also contact Anthem BCBS
directly by visiting www.anthem.
com/imshealth, or by calling
Anthem BCBS at 877-403-4424.
IMS HEALTH 2015 Benefits Enrollment Guide | 13
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans
Using Your PPO with HSA:
Two Examples
How might the Anthem BCBS HSA work for you?
Year One
How you decide to use your new HSA plan
may depend on the size of your family and
your medical expenses. The following are
two examples of how the HSA can work for
different types of users.
$1,500
Your annual HSA contribution
-$0
You see your doctor for your physical
-$720
A minor accident sends you to the emergency room
-$0
You use Express Scripts “Price a Drug” tool to evaluate an allergy medication that
you need (this online tool lets you analyze up to 10 medications at once to better
understand side effects, drug interactions and alternatives)
Single and Healthy
You’re a single, healthy, active 30-year old,
who sees a primary care physician for annual
physical exams. With the exception of allergy
treatment and mild asthma, you rarely need to
visit a specialist or fill prescription drugs.
You make an initial $1,500 pre-tax deposit
to your HSA and you have a $2,500
individual deductible.
Cost/Contributions
-$350
You fill your regular allergy medications (not considered a “preventive” drug)
Your HSA account balance
$430
plus interest
Year Two
Cost/Contributions
$430
Your HSA account balance
Your annual contribution (you decide to contribute less this year because you have a
balance from last year)
$1,070
You see your doctor for a sprained knee
-$160
You start taking a “preventive” drug
for asthma (covered at 75%, deductible waived)
-$120
You refill your regular allergy medications (not considered a “preventive” drug)
-$350
Your HSA account balance
$870
plus interest
IMS HEALTH 2015 Benefits Enrollment Guide | 14
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans
Year One
Cost/Contributions
$3,500
Your annual HSA contribution
Your daughter visits an asthma specialist twice a year. She takes a
“preventive” drug for asthma (covered at 75%, deductible waived)
-$320
-$120
Your children visit the doctor for an ear infection and take antibiotics
(not “preventive”)
-$180
-$50
Your son goes to the emergency room with a broken arm
-$850
$0
You use Anthem BCBS’s online Care Comparison tool to research the
best physicians and hospitals for upcoming knee surgery
-$1,980
(from the remaining balance in your HSA plan)
Your wife is hospitalized for knee surgery that costs $7,200
Married with Two Children
You are a father of two and you, your spouse
and children are covered under the PPO with
HSA Plan. Your daughter has asthma and your
wife needs knee surgery later in the year.
-$3,600
The remaining cost of the surgery
$900
(25% of the remaining cost of surgery;
you pay out-of-pocket)
Your co-insurance amount
Your HSA account balance
You make an initial pre-tax deposit of $3,500
to your account, in anticipation of the cost
of your wife’s surgery and you have a $5,000
family deductible.
$0
Year Two
Cost/Contributions
$0
Your HSA account balance
$2,500
Your initial contribution (you contribute less than last year because
you do not anticipate major Medical events, like surgery)
-$0
Your family members receive annual physicals
Your daughter visits an asthma specialist twice. She takes a
“preventive” drug for asthma (covered 75%, deductible waived)
-$320
-$120
Your children visit the doctor for ear infections and take antibiotics
(not “preventive”)
-$180
-$50
Your HSA account balance
$1,830
plus interest
IMS HEALTH 2015 Benefits Enrollment Guide | 15
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans
Helpful HSA Tips
In many plans, you pay co-pays
or co-insurance at the time of
service. However, the process works
differently for the PPO with Health
Savings Account (HSA) Plan.
• Your in-network doctor will not
collect any money from you at
the time of visit. Instead, your
doctor will send the claim directly
to Anthem BCBS. The claim also
will reflect a network discount,
if applicable. You will not need
to pay the doctor at the point of
service.
• You may pay your doctor with your
Anthem BCBS ACS/BNY Mellon
MasterCard or checkbook, or your
personal funds.
• If you receive a bill from your doctor,
make sure the claim has been sent to
Anthem BCBS before you pay the bill.
You can do this by:
~ Reading your monthly statement
from ACS/BNY Mellon.
~ Calling Member Services to find
out the status of your claim.
Health Savings and Health
Care Flexible Spending – Two
Very Different Accounts
~ If your plan covers the services
you received; and if so, what
part of the covered services
your plan pays.
Many people confuse Health Savings
Accounts (HSAs) with Health Care
Flexible Spending Accounts (FSAs).
While they are both accounts that can
help you pay for your health care, there
are some important differences.
Health Care
Flexible Spending
Account (FSA)
What is the
Your HSA pays for eligible health
account used for? care expenses with pre-tax money
(if you’ve contributed)
Your FSA pays for eligible health
care expenses with your pre-tax
contributions. You must use all of
your annual contributions in the
elected plan year or you lose them
under the “use it or lose it” rule.
Who funds the
account?
You can fund the account up
to IRS allowed limits. For 2015,
the maximum amount you can
contribute is $3,550/individual or
$6,650/family.
You can fund the account up
to IRS allowed limits. For 2015,
the maximum amount you can
contribute is $2,550.
Can the funds be
carried over from
year to year?
Yes. You can carry HSA funds
with you indefinitely during your
lifetime.
No. You forfeit unused FSA fund
balances at the end of the plan
year.
Are the funds
portable?
Yes. You may take the funds with
you if you leave IMS Health.
No. You forfeit unused FSA
balances if you leave IMS Health.
Do the funds
earn interest
or investment
gains?
Yes. Any dollars in your savings
account earn interest. This interest
is calculated daily and posted to
your account monthly. Once your
account balance reaches $1,500,
you will have access to investment
options through ACS/BNY Mellon,
which administers the savings
account and investment portions
of the Anthem BCBS HSA.
No. Your funds do not earn interest
or investment gains.
Can I use a
HSA and a FSA
together?
Yes. You may use both a Health Savings Account (HSA) and a Health
Care Flexible Spending Account (FSA), however, HSA participants who
want to take advantage of the FSA will only be allowed to enroll in a
“Limited FSA.” This Limited FSA will allow for vision and dental service
reimbursements at any time, but reimbursements for medical expenses
will only be allowed after your medical deductible has been met.
~ Checking your fund activity on
www.anthem.com/imshealth.
•A
nthem BCBS will process the
claim and send you an Explanation
of Benefits (EOB) that will tell you
~ How much you owe the doctor
Health Savings
Account (HSA)
IMS HEALTH 2015 Benefits Enrollment Guide | 16
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans
PPO Plan
Don’t Forget to Pre-Certify
With Anthem BCBS’s PPO Plan you have the flexibility to
go to any doctor or to any hospital you wish, and no
referral is required.
How it works:
• S tay “In-Network”: You pay a co-payment for your
care (e.g., office visits); for ancillary services such as
lab tests and x-rays and for hospitalization, there is
an annual deductible. The plan pays 80% once you
meet the deductible.
•G
o “Out-of-Network”: The plan pays 60% of the
reasonable and customary cost for eligible expenses
after you meet the annual deductible and file claim
forms for reimbursement.
For more details, see the Health Plan Benefits
Comparison Chart on page 18.
If you require inpatient hospital care or
certain outpatient tests, all plans require
you to call Case Management prior to
admittance. If you have an emergency
admittance to the hospital, you must
call by the second business day after
you are admitted.
Hospital pre-certification is designed to
confirm that a hospital stay is the best
course of treatment, and if so, how long
it should last. Regardless of whether
or not you go In- or Out-of-Network, if
you do not follow the pre-certification
procedures, claims could be subject to
non-payment.
Remember that pharmacy benefits for PPO Plan
participants are provided through Express Scripts
(ESI). You will receive separate ESI ID cards to access
pharmacy benefits.
2015 Plan
Deductibles
Single:
• In-Network: $500
•Out-of-Network: $1,000
Family:
• In-Network: $1,000
•Out-of-Network: $2,000
Annual Out-of-Pocket Maximum*
Single:
• In-Network: 2,750
•Out-of-Network: $5,500
Family:
• In-Network: $5,500
•Out-of-Network: $11,000
Physician Co-pay
• In-Network: $25
• Out-of-Network: 60%
after deductible
Specialist Co-pay
• In-Network: $40
• Out-of-Network: $60
after deductible
Preventive Care
• In-Network: 100%, no co-pay
• Out-of-Network: 60%
after deductible
*Includes both medical and prescription drug
eligible out-of-pocket expenses.
IMS HEALTH 2015 Benefits Enrollment Guide | 17
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans
Health Plan Benefits
Comparison Chart
The Health Plan Comparison Chart
includes a high-level summary of
the benefits provided by Anthem
BCBS plans. For a detailed summary
of the Health Plan benefits, visit
www.anthem.com/imshealth.
Features
PPO with HSA Plan
PPO Plan
In-Network
Out-of-Network
In-Network
Out-of-Network
$2,500 individual
$5,000 family
(Combined medical and
pharmacy)
$5,000 individual
$10,000 family
(Combined medical and
pharmacy)
$500 individual
$1,000 family
(Medical only)
$1,000 individual
$2,000 family
(Medical only)
100%, no co-pay
55% after deductible
100%, no co-pay
60% after deductible
Primary Care/Specialist
Office Visits
Pay network discounted
cost until deductible is met.
Once deductible is met, plan
pays 75% of discounted cost
55% after deductible
100% after $25 primary
care physician co-pay; $40
specialist co-pay
60% after deductible
Hospitalization
Pay network discounted
cost until deductible is met;
Once deductible is met plan
pays 75% of discounted cost
55% after deductible
80% after deductible
60% after deductible
$4,500 individual
$9,000 family
$9,000 individual
$18,000 family
$2,750 individual
$5,500 family
$5,500 individual
$11,000 family
Annual Deductible
Preventive Care
Annual Out-of-Pocket
Maximum (including
deductibles, as well
as eligible medical
and prescription drug
expenses)
Lifetime Maximums
No limit
IMS HEALTH 2015 Benefits Enrollment Guide | 18
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Health Plans
Prescription Drugs
PPO with HSA Plan
PPO Plan
Express Scripts (ESI)
For details about your prescription
drug benefits, see pages 27 and 28
Pay ESI discounted pricing until combined medical and
prescription drug deductible is met.
Retail:
Generic: $10 co-pay
Brand: Member pays 25%; $25 minimum and $75
maximum per prescription; no deductible applies
In-Network: Once the deductible is satisfied plan will
pay 75% of covered prescription drug costs.
Please note that the deductible is waived for preventive Mail Order/Online:
drugs. See the Benefits Enrollment Page on IMS Now
Generic: $20 co-pay
for a listing of preventive drugs that are not subject to
Brand: Member pays 25%; $50 minimum and $150
the deductible.
maximum per prescription; no deductible applies
Women’s Health: Oral Contraceptives and Emergency
Contraception: No charge in network for generic; coinsurance applies for brand.
Out-of-Network: Not covered.
Certain prescription drugs that
have alternative uses outside of
medical necessity will require
pre-authorization. To view or
print a list of the medications
requiring pre-authorization go
to IMS Now.
Mandatory Generic Program: Please note that if a
generic is available, you will automatically have the
generic filled at the generic co-pay. If you still elect to
receive the brand drug, you will pay the brand name coinsurance plus the difference in cost between the brand
name and the generic drug. For more information on this
program, see page 27.
Women’s Health: Oral Contraceptives and Emergency
Contraception: No charge in network for generic; coinsurance applies for brand.
Select Home Delivery: This allows you to order 90-day
prescription drug supplies to be delivered to your home
at a price lower than retail. See page 28 for more details.
Out-of-Network: Not Covered
IMS HEALTH 2015 Benefits Enrollment Guide | 19
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
FIND OUT IF YOUR DOCTOR IS IN THE ANTHEM
BCBS NETWORK
To find out if your doctor is in the Anthem BCBS
network, visit www.anthem.com/imshealth and
select “Find a Doctor.”
• Select “Search the National BlueCard Directory.”
• Enter your identification prefix from your ID
card or Select “PPO” as the plan type as a guest.
• Follow prompts to search by location, provider
type, or provider name.
Check it out…Mobile Provider Finder is also
available via your Web-enabled cell phone,
Blackberry, or PDA. From your Web-enabled device
visit www.anthem.com/mobile and click on the
“Anthem Mobile Provider Finder” link.
• Select “National” from the state selection drop
down box.
• Select “National Blue Card” from plan selection
drop down box.
• Enter your identification prefix from your ID
card or Select “PPO” as the plan type as a guest.
Online Tools for Good
Decision Making
Before you Enroll
Anthem BCBS and Express Scripts (ESI) provide online tools that are helpful both
before and after you enroll.
Anthem BCBS Online Tools
Anthem BCBS’s website www.anthem.com/imshealth provides tools to help you
with enrollment decisions regarding your medical plan options. This useful website
enables employees to compare the potential out-of-pocket cost of various Anthem
BCBS health plans, without having to enter relevant plan information (plan design,
premium contributions).
Benefits of this tool include:
• Employee support during the Annual Enrollment period by providing
IMS Health-specific information when choosing the best Anthem BCBS plan
for you and your family;
• Easy-to-use calculation tools that provide a net-cost comparison of the plans
offered by IMS Health; and
• A side-by-side summary of the benefits, employee-specific costs and features
of the plans.
IMS HEALTH 2015 Benefits Enrollment Guide | 20
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Online Tools
use the prescription drug plan website to better manage your benefits
Visit www.express-scripts.com to make filling and tracking your prescriptions easier, including:
• Self-service tools that explain your benefit
•C
omparison tools that help you shop for lower cost medications
• Automatic prescription renewal
• E nhanced privacy features – including individual accounts for every member of your
household (over 18 years old)
• “Worry-Free®Fills” – Home delivery
Certain Prescriptions Require
Pre-Authorization
Certain prescription medications that
have other uses beyond medical necessity
will require pre-approval before they are
covered. To determine if a medication you
are using currently is on that list, go to IMS
Now, in the Prescription Drugs tab in the
Benefits Section.
• Enhanced communications
In addition to this website, you can download the “Express Scripts” app for your smartphone
(replacing the “Express Rx” app). Use the “Express Scripts” app to refill, renew and track your
prescriptions on-the-go!
For more information, visit www.express-scripts.com!
IMS HEALTH 2015 Benefits Enrollment Guide | 21
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Online Tools
After You Enroll
Anthem BCBS and Express Scripts (ESI) provide online tools that are
helpful both before and after you enroll.
• Women’s and men’s health centers
Anthem BCBS Online Tools
• Medical reference encyclopedia of health topics from A to Z
Anthem BCBS’s website www.anthem.com/imshealth is a convenient
resource that offers access to a wide range of interactive online health
tools.
Plans & Benefits – provides a wealth of information about your benefits
through a secure site that is password-protected to ensure privacy. Check
the status of a claim, order a new ID card, view your benefits, learn which
services need prior approval, view deductibles and maximums.
Health & Wellness – a suite of interactive online health-related tools and
resources.
• Health assessment
• Health news, including a searchable library
• Condition Centers
• Personal Health Record
• Secure Message Center and Personal Health News
• F itness: LEAP, the Lifetime Exercise Adherence Program
• Pregnancy and child health planners
Care Comparison – find hospitals that match your location, situation, and
preferences.
Find a Doctor
• Find a doctor, specialist, hospital or urgent care facility
• Search based on name, specialty or location
MyHealth Record – organize your health information in a simple and
confidential online environment. Keep track of medical appointments,
preventive care, claims, medications and more.
SpecialOffers@Anthem – access discounts on products and services that
help promote better health and well-being. Discounts available on a wide
selection of products and services such as: American Baby Magazine, Jenny
Craig, Weight Watchers, Barnes & Noble.com, drugstore.com, and many
others.
Healthy Lifestyles – a free online program that offers IMS Health members
support and incentives to maintain or improve their overall health.
IMS HEALTH 2015 Benefits Enrollment Guide | 22
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Online Tools
ESI Online Tools
Express Scripts’ website features round-the-clock assistance, convenience,
savings opportunities and important health information.
Convenience
At www.express-scripts.com, there are no lines and no waiting; the store is
always open. You can quickly refill and request renewal of Home Delivery
prescriptions online, and check the status of your orders at any time. If you
need to find a local pharmacy, you can easily locate one near you using the
“Find a Pharmacy” tool.
Savings
With Express Scripts’ “Price a Drug” online feature, you can tell what you will
pay for a specific drug, and find out how to save money by choosing Home
Delivery and lower cost alternatives. The “Save on My Prescriptions” feature
alerts you when you have an opportunity to save.
Control
www.express-scripts.com lets you view all the details of your pharmacy
plan and review your prescription claims history. You don’t have to
search your benefits documents every time you have a question about a
co-payment or a medication.
Get more from your prescription benefit. Register today at
www.express-scripts.com to access savings, convenience and service.
• See what you’ll pay for a specific drug.
• Discover ways to save.
• Order refills and track the status of your order.
• Locate participating retail pharmacies near you.
• Check your benefit coverage.
• Verify coverage for eligible dependents.
IMS HEALTH 2015 Benefits Enrollment Guide | 23
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Other Health and Wellness Resources
360º Health
Condition Care
Anthem BCBS and IMS Health want to change the way you
think about your health plan. 360º Health is health care for
people who need a partner, not a typical health plan. The goal
is for you to feel helped, not helpless, proactive, not frustrated.
Here is an overview of the resources available to make that
happen.
When you have an ongoing health condition it is important to have the support and
guidance you need to live your life fully. As part of the medical plans being provided,
you have access to your own personal registered nurse who will work with you to help
develop a personal action plan to manage your condition, help you avoid or minimize
complications, and generally improve the quality of your life. Anthem BCBS’s Condition
Care nurses help IMS Health members of all ages manage the symptoms of asthma and
diabetes, and they work closely with adults who are dealing with chronic obstructive
pulmonary disease (COPD), heart failure and coronary artery disease. When you join
Condition Care you’ll get:
24/7 Nurse Line
When you have a health question – any time of the day or
night, whether you are at home or away – and you’re not
sure what to do next, call the 24/7 Nurse Line to talk with a
registered nurse who can help you make informed decisions
about your health and the care of your family.
The 24/7 Nurse Line nurses cannot diagnose conditions but
can provide information and guidance on your health related
questions and concerns. All calls to the 24/7 Nurse Line are
strictly confidential.
Call the toll-free number for Nurse Line at 866-670-6694.
• 24 hour toll-free access to registered nurses who’ll answer your questions and
support you in making lifestyle changes that can improve your health.
• An initial health evaluation and follow-up calls, if needed. Anthem BCBS’s nurses also
consult with pharmacists, dietitians, doctors and other medical professionals to bring
you the very latest information.
• Care guides, prevention reminders and other helpful tools.
Information and encouragement are as close as your phone. Sign up for Condition Care
at no additional cost by calling toll-free 866-670-6694.
Find more information about your condition online at
www.anthem.com/imshealth > 360Health > HealthTopics
IMS HEALTH 2015 Benefits Enrollment Guide | 24
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Other Resources
Future Moms
Healthy Lifestyles
Research shows that mothers-to-be who are well-informed make good
choices that often result in healthier pregnancies. That’s why IMS Health
offers their members Anthem BCBS’s Future Moms, a program designed
to help you have a safe delivery and a healthy child.
A free online program that offers IMS Health members support and
incentives to maintain or improve their overall health. Through the
program, members can access:
As soon as you know you’re expecting, just pick up the phone and call
one of Anthem BCBS’s experienced, registered nurses. They’ll send
everything you need to participate right to your home. You’ll get:
• A toll-free number you can call for answers to your questions about
important topics such as pregnancy, labor, nursing and postpartum
depression. The line is staffed by registered nurses 24 hours a day,
seven days a week.
• A helpful prenatal care book – Your Pregnancy Week by Week.
• Educational materials to help you handle any unexpected events.
• Useful tools to help you, your doctor and Future Moms nurse, keep
track of your pregnancy and spot possible risks.
• Nutrition and fitness trackers
• Healthy recipes
• Educational articles
• A smoking cessation program
• Community and online forums
• Discounts on massages, gym memberships, spa services,
and more
Log on to www.anthem.com/imshealth and click on the Health and
Wellness tab.
Expecting? Answers and support are just a phone call away. Register
for the Future Moms program at no additional cost by calling toll-free
866-670-6694.
IMS HEALTH 2015 Benefits Enrollment Guide | 25
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Other Resources
Behavioral Health
Employee Assistance Program (EAP)
It’s no secret that mental health and physical well-being go hand in
hand. Anthem BCBS’s Behavioral Health Program offers a total-health
solution for you and your loved ones who need help dealing with:
IMS Health wants to provide access to the support you need. Through
Anthem BCBS’s Employee Assistance Program you have 24/7 access to no
cost services to help you with:
• Anxiety
• Depression
• Drug or alcohol dependency
• Eating disorders
•O
ther pressures affecting your day to day quality of life
Just one call can connect you to the right care at the right time. Call
24/7 at 877-419-1659.
• Relationship and family concerns
• Financial and legal concerns
• Child care and elder care needs
• Stress management
• Alcohol and drug issues
• Care kits
• Support in times of loss or grief
• Concierge services
• Marital concerns
• Pet care
• Assistance with depression
and anxiety
• Identity theft
Your participation is voluntary and confidential.
Call your EAP at 877-419-1659. Visit online at www.anthemeap.com
(employee ID: ims).
IMS HEALTH 2015 Benefits Enrollment Guide | 26
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Certain prescription
drugs that have alternative
uses outside of medical
necessity will require
pre-authorization. Please
check the ESI website
or IMS Now for a list of
medications requiring
pre-authorization.
Please Note –
Your
Prescription
Drug ID Card
s
If you are a
PPO member,
you need to us
e
Express Scrip your
ts ID card at
the pharmacy.
If you are an
HSA member,
you will use
your Anthem/
BCBS ID card
.
New for 2015: Out-of-pocket
expenses for prescription
drugs count towards your
medical plan out-of-pocket
maximum each year no matter
which IMS Health medical plan
you choose.
Prescription Drugs - Express Scripts
Regardless of the medical plan you choose, all IMS Health covered members will have two ways to buy prescription
drugs; at a retail pharmacy, or through a convenient mail order service.
1. At a Pharmacy – if you are enrolled in the PPO Plan, you will receive a separate ID card to access your prescription
drug benefit through ESI. Please present your ESI card at the pharmacy to receive benefits. Employees enrolled
in the PPO with HSA Plan will not receive a prescription card from ESI. You should use your Anthem BCBS card for
both medical and prescription drug.
2. Through the mail or online (if you or your dependents use maintenance prescription drugs) – the Mail Order
Drug Program allows you to buy up to a 90-day supply of medications you take on an ongoing basis, such as high
blood pressure medicine, insulin or contraceptives. You can order refills online at www.express-scripts.com
Prescription
Drugs
PPO with HSA Plan
PPO Plan
At a pharmacy
(34-day supply or less)
Member pays 25% for “Preventive Drugs” with the deductible
waived. You pay the negotiated discount cost of other drugs,
up to the plan deductible limits, then 25% thereafter. For details
about the Preventive Drugs classification, please see page 28.
Generic - $10 co-pay
Mail Order/Online
(90-day supply –
maintenance medication)
Member pays 25% for “Preventive Drugs” with the deductible
waived. You pay the negotiated discounted cost of other drugs,
up to the plan deductible limits, then 25% thereafter. For details
about the Preventive Drugs classification, please see page 28.
Generic - $20 co-pay
Brand name – Member pays 25%; $25
min and $75 max; no deductible applies
Brand name – Member pays 25%; $50
minimum and $150 maximum per
prescription; no deductible applies.
Mandatory Generic Program for PPO Plan members: We want to encourage our employees to take advantage
of cost-saving alternatives to brand name prescription drugs. If you fill a brand name prescription that has a direct
chemical equivalent generic available, you will automatically have the generic filled at the generic co-pay. However,
you may still request the brand name drug be filled, but you will incur an additional ancillary charge equal to the
brand name co-insurance plus the difference in cost between the brand name and the generic drug. This additional
cost will apply even if your doctor has indicated “DAW” (“Dispense as Written”) on the prescription. Please review the
example on page 28 for more cost details.
IMS HEALTH 2015 Benefits Enrollment Guide | 27
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Prescriptions
Women’s Health
Oral and emergency contraception
are covered 100% in-network with no
co-payment for generic medication.
Co-insurance applies for brand medications.
Select Home Delivery
Express Scripts’ Home Delivery program
allows you to order 90-day prescription
drug supplies to be delivered to your
home at a price lower than retail. You will
receive a letter after your 1st fill and 2nd
fill of a maintenance drug; at the 3rd fill of
your maintenance drug, if you have not
yet taken advantage of the Select Home
Delivery Program, you will be required to
make a decision to enroll in the program
or opt out. If you choose to enroll in this
program, ESI will contact your doctor for
you to get the process started, or you can
complete a form and send your prescription
and co-pay to ESI. If you choose to opt out
of home delivery, you will need to notify
ESI of your decision, or going forward you
will be required to pay the full price of your
prescription drugs at retail.
Preventive Drugs Featured
in the PPO with HSA Plan
Mandatory Generic Program For PPO
Plan Members
The following includes drug classes that are
considered “preventive” by ESI. Please check
the ESI website or the IMS Now site to view
a complete list of drugs. When you take
covered drugs in these categories, the PPO
with HSA Plan will cover 75% of your costs
with no deductible.
If there is a generic drug available and you
choose to purchase the brand name drug, your
co-pay will be the brand name co-pay plus the
difference in costs between the brand name
drug and the generic drug.
• Cholesterol and blood pressure
lowering agents
• Blood thinners
For example:
At the pharmacy, you choose the brand name
that costs $100 when there is an available
generic that costs $40. Your cost share will be:
• Diabetes
• Asthma
Total cost of the brand name drug $100
• Osteoporosis medications
Total Cost of the generic substitute
• Vitamins
Difference $ 60
Brand name co-insurance
• Vaccines
– $ 40
+ $ 25 (25% of $100)
Member brand name cost $ 85
(brand co-insurance + difference is
total cost of generic and brand)
• Some anticancer agents
vs. Member generic cost (generic co-pay) $ 10
IMS HEALTH 2015 Benefits Enrollment Guide | 28
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
HOW TO SEARCH FOR A
DENTIST IN THE PPO AND
PREMIER NETWORKS
• Visit www.deltadentalins.com.
• Under “Find a Dentist,” select a
Plan from the drop down.
Dental - Delta Dental
Delta Dental provides you with access to the largest dentist networks in the U.S. For 2015, you will still be able
to choose between two dental plan options: Dental PPO and DeltaCare HMO. Continue reading to see which
plan will meet you and your family’s needs best.
Delta Dental PPO Plan
• Select your state.
PPO participants will have access to two dental networks within Delta Dental. You do not need to select a
network, and you can use dentists from both networks. The multiple networks simply give you the best of
both worlds. The opportunity to access dentists that will help you save money by providing services at deeply
discounted rates and access to one of the nation’s largest network of providers.
• Click “Submit” and fill in the
rest of your search criteria.
As a PPO participant, you can use providers in the Delta Dental Premier network, as well as the Delta Dental
PPO network dentists that are willing to provide services at even greater discount rates.
• To search the PPO, select the
“Delta Dental Premier.”
Once you have your list of
dentists in the network, look for
dentists who are in the PPO to
find the best discounts.
When searching for a dentist, you may want to begin by looking at the larger of the two networks, the Premier
network. This network is most likely to have your existing provider, as well as a great number of providers in
your area. Premier network dentists have agreed to accept the Delta Dental discount rate for full payment. This
search will also include an indicator if the dentist participates in the PPO network as well. If so, you will be able
to benefit from even greater discounts and save even more money!
This design gives IMS Health employees greater flexibility and multiple opportunities for savings.
IMS HEALTH 2015 Benefits Enrollment Guide | 29
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Delta Dental
How to use the Plan
The plan is easy to use! Simply provide the dental office with your ID card,
which you will receive in the mail. The office will take care of submitting
your claims.
You can also speak with a customer service representative by calling
1-800-932-0783, Monday – Friday from 8:00 a.m. to 8:00 p.m. (ET).
*Reimbursement is based on PPO contracted fees for PPO dentists. Premier contracted fees for Premier
dentists and 90th percentile for non-Delta Dental dentists
DeltaCare Dental HMO Plan
Dental ID Cards
When you receive your ID cards in the mail, you will automatically
receive two, no matter how many dependents you have enrolled. Also,
the employee’s name will appear on the card, not the name of the
dependent(s).
Contacting Delta Dental
about the PPO Plan
Visit the website anytime at www.deltadentalins.com. On the
website you can:
The DeltaCare Dental HMO Plan is designed to encourage you and your
family to visit the dentist regularly to maintain your dental health. The
DeltaCare network consists of private practice dental facilities that have
been carefully screened by Delta Dental for quality. When you enroll, you
MUST select a primary dentist to provide services. But if you live in CT, LA,
ME, NH, OK or VT, you do NOT have to select a primary dentist. If you live
in MA, MN, NE, NC, ND, or VA, you are not eligible for the DeltaCare Dental
HMO Plan and must enroll in the PPO Plan.
How the DeltaCare HMO Plan Works
Your selected primary dentist will take care of your dental care needs. If you
require treatment from a specialist, your primary dentist will handle the
referral for you.
• Find a dentist in our online directory
• Review benefits
• Check claim status
• Print an ID card and much more
To access some services, you’ll need to log in: simply enter your user name
and password in the designated boxes and submit. If you are visiting
the website for the first time, you’ll need to complete a quick one-time
registration process by clicking the “Register Today” link.
After you have enrolled, you will receive a membership packet including
an ID card and an Evidence of Coverage that fully describes the benefits of
your dental program. Also included in this packet are the name, address
and phone number of your primary dentist. Simply call the dental facility to
make an appointment.
IMS HEALTH 2015 Benefits Enrollment Guide | 30
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Delta Dental
HOW TO SEARCH FOR A
DELTACARE DENTIST
Under the DeltaCare HMO Plan, many services are covered at no cost, while others have co-payments for certain
benefits. Please note that dental services not performed by your selected primary dentist, or that are not covered
under provisions of emergency care, must be preauthorized by Delta Dental to be covered under your DeltaCare
HMO plan.
• Visit www.deltadentalins.com
Changing your Primary Dentist
• Under “Find a Dentist,” select a
Plan from the drop down
You may change primary dentists by notifying Delta Dental either by phone or in writing, or by visiting the website
(www.deltadentalins.com/deltacareusa). If you contact Delta Dental by the 21st of the month, the change will
become effective the first of the following month.
• To search the HMO, select the
“DeltaCare USA”
Dental ID Cards
• Select your state
• Click “Submit” and fill in the
rest of your search criteria
When you receive your ID cards in the mail, you will automatically receive two, no matter how many dependents
you have enrolled. Also, the employee’s name will appear on the card, not the name of the dependent(s).
Contacting Delta Dental about the DeltaCare HMO Plan
You can call a customer service representative at 1-800-422-4234 Monday – Friday from 8 a.m. to 9 p.m. (ET).
Information about your plan is also available by visiting www.deltadentalins.com/deltacareusa.
Dental Insurance
PPO In-Network and Out-of-Network
(PPO and Premier)
DeltaCare
HMO Plan
$75 per person | $150 per family
None
$1,500 per person
None
100% covered
See schedule on IMS Now
Basic Services
80% after deductible
See schedule on IMS Now
Major Services
50% after deductible
See schedule on IMS Now
50% after deductible | $1,500 lifetime max
See schedule on IMS Now
Annual Deductible
Calendar Year Maximum Coverage
Diagnostic & Preventive Services
Orthodontia (adults and dependent children)
IMS HEALTH 2015 Benefits Enrollment Guide | 31
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Life & Disability
Benefits - Liberty Mutual
IMS Health realizes the important role
Life and Disability insurance plays in
protecting you financially.
Disability Insurance
Company-Paid
Long-Term Disability*
• IMS Health will provide to all benefits eligible employees at no cost.
• 40% monthly income replacement; maximum benefit of $5,000 a month.
Buy-Up Long-Term
Disability
• 66.67% monthly income replacement; maximum benefit of $15,000 a month.
Short-Term Disability
•B
enefits begin after sixth consecutive day of illness or injury.
•A
ll employees will receive 70% weekly income replacement.
*Please note that benefits paid under the Company-Paid Long-Term Disability coverage will be subject to applicable taxes.
Life & Accident Insurance
Company-Paid Life
Insurance
• IMS Health will provide to all benefits eligible employees at no cost.
• Benefit level: 1 x Salary up to $200,000.
Employee-Paid
Optional Life Insurance
• Coverage may be purchased for you, your spouse, and your children.
• Benefit level: 1 to 5x your annual insurable base.
• Combined maximum for Company-Paid Life Insurance and Employee-Paid
Optional Life Insurance is $1 million.
• Evidence of insurability required for current employees electing coverage for
the first time, for employees who are increasing coverage, and for new hires
electing coverage beyond the lesser of $250,000 or 2x annual insurable base.
Voluntary Group
Accident
(VGA) Insurance
• Coverage may be purchased for you, your spouse, and your children.
• Benefit level: Up to 10x your annual insurable base in $10,000 increments
(up to $1 million).
• No evidence of Insurability required.
Business Travel
Accident Insurance
• Automatic company-paid benefit for employee only.
• Benefit level: 5x annual insurable base (up to $2 million).
IMS HEALTH 2015 Benefits Enrollment Guide | 32
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Wellness Program
IMS Health recognizes that keeping you healthy
will go a long way toward minimizing healthcare
costs – and our Wellness Program is a major part
of our commitment to helping you minimize
health risks and improve your lifestyle.
Practicing healthy behaviors, including preventive care, can lower the rate of
serious illness and, through early detection and treatment, can reduce the severity
of illnesses that occur. Your commitment to healthy behaviors will help IMS Health
more effectively manage health cost increases – saving both IMS Health and
employees in the long run – and enabling the company to continue providing
employees with a high degree of coverage at competitive rates.
Our Wellness Program includes an annual reimbursement of 50%, up to an annual
maximum of $250. Benefits-eligible employees and their spouses may receive
reimbursement for participation in the following programs:
• Smoking Cessation
• Nutrition and Weight Reduction
• Exercise
• Stress Management
To learn more about the IMS Health Wellness Reimbursement Plan, you can go to
the Wellness Page in the Benefits Section on the IMS Now Intranet.
IMS HEALTH 2015 Benefits Enrollment Guide | 33
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Vision - EyeMed
The EyeMed Vision program
is a voluntary program
available to employees
and eligible dependents
regardless of whether you
participate in an IMS Health
medical plan.
In-Network Benefits
Out-of-Network Benefits
Eye Exams
Covered in full, once yearly after $10 co-pay
Service
Reimbursement
Pair of Lenses*
(once every
calendar year)
UV Coating
Tint (Solid or Gradient)
Standard Scratch Resistance
Standard Polycarbonate
Standard Anti-Reflective Coating
Standard Progressive (Add-on to Bifocal)
Exam
Optometrist/Opthalmologist –
up to $40
Lenses
Single vision – up to $40*
Bifocal – up to $60*
Trifocal – up to $80*
Lenticular – up to $80*
Frames
Up to $45
Contact Lenses
in Lieu of
Eyeglasses
(lenses and
frames)
Elective – Conventional up to $105
Disposable up to $105
Medically necessary up
to $210
Please note: The allowance must
be used for a single purchase. We
encourage members to use the
allowance when ready to purchase a
supply of contacts to ensure the full
benefit is received.
$15 co-pay
$15 co-pay
$ 0 co-pay
$40 co-pay
$45 co-pay
$65 co-pay
Standard Scratch-Resistance is covered in full. Other lens
options such as progressive lenses, polycarbonate lenses,
tints, UV and antireflective coating are available at an
additional co-pay. Other Add-ons and services may be
available at a discount.
Frames*
(once every
calendar year)
Receive a $130 retail frame allowance at retail chain
providers and a 20% discount off balance for frames
above $130
Contact Lenses
in Lieu of
Eyeglasses*
(once every
calendar year)
Contact lenses – The fitting/evaluation fees and up to
two follow-up visits are covered in full (after co-pay)
Contact lenses – A $125 allowance is applied toward
the purchase of contact lenses. Please note: The contact
lens allowance must be used for a single purchase; we
encourage members to use the allowance when ready to
purchase a supply of contacts to ensure the full benefit
is received
Refractive
(Laser)
Eye Surgery
Discounts available through participating surgeons
Visit www.eyemedvisioncare.com to find a participating
surgeon
Retinal Imaging
In-Network: Member cost is up to $39
Out-of-Network: No coverage
*Reimbursement for these items are $15 higher in AK, CA, HI, OR,
and WA.
*Please note, your benefit allows for either one pair of eyeglasses or the purchase of
contact lenses during one calendar year.
IMS HEALTH 2015 Benefits Enrollment Guide | 34
Health
Plans
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Flexible Spending Accounts
IMS Health offers two types of Flexible Spending Accounts (FSAs)
to help you use pre-tax money to pay for qualified expenses:
IMPORTANT NOTE FOR PPO
WITH HSA PARTICIPANTS:
• Healthcare Flexible Spending Account
HSA participants who want to take
advantage of the Healthcare Spending
Account will only be allowed to enroll
in a “Limited FSA,” per IRS regulations.
This Limited FSA will allow for vision
and dental service reimbursements
at any time, but reimbursements for
medical expenses will only be allowed
after your medical deductible has
been met. All eligible FSA expenses
must be incurred during the plan
year (January 1 - December 31 for
the limited FSA and January 1 to
March 15 of the following year for
the non-limited FSA).
• Dependent Care Spending Account
IMS HEALTH 2015 Benefits Enrollment Guide | 35
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Flexible Spending Accounts
Healthcare Flexible Spending Account
Eligible Spending Account Expenses
The Healthcare Flexible Spending Account allows you to set aside
money from your pay on a pre-tax basis to reimburse yourself for
eligible healthcare expenses. Here’s how the plan works:
Eligible expenses are determined by the IRS and include charges such as:
• Deductibles and co-pays
• You decide how much you want to contribute to the account. The
minimum each year is $250; the maximum is $2,550.
• Your contribution is deducted from your pay before taxes are
calculated, reducing your current tax liability.
• Charges in excess of reasonable and customary expenses
• Any vision (including laser surgery) and hearing care services and
supplies not covered by your medical plan
• Services in excess of plan limits
• To be reimbursed for eligible expenses, just submit a Spending
Account Claim Form along with your receipts. Claim forms can be
found in the Benefits site under Resource Library Materials on IMS
Now, or by calling the Employee Solutions Center at 1-800-4676130. Reimbursement will be made with the tax-free dollars from
your account.
• You may submit eligible healthcare expenses incurred by anyone
you claim as a dependent on your federal income tax return (e.g.,
dependent children or elderly parents).
Ineligible Expenses
These types of expenses cannot be reimbursed through the Spending
Account:
• Premium payments for group health coverage, including COBRA
• Cosmetic surgery, unless needed to correct an injury, disfiguring disease
or congenital abnormality
• Fees for health club programs
Employees may use the website http://hcet.ebia.com/ims to look up
specific products eligible for reimbursement. The access code to sign into
the website is ims2006. This website should be used as a guideline and
does not guarantee reimbursement. If you have any questions regarding
reimbursement, please call the Employee Solutions Center at
1-800-467-6130.
IMS HEALTH 2015 Benefits Enrollment Guide | 36
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Flexible Spending Accounts
Estimate Carefully
Be sure to estimate your expenses for the year as accurately as
possible. An expense is considered incurred when the service is
provided, not when you receive or pay the bill. The IRS requires
that any contributions left in your account at the of the plan year
be forfeited. In others words, “use it or lose it.”
• F or the Healthcare Flexible Spending Account, the deadline
for submission of eligible expenses for reimbursement
depends on the type of FSA in which you participate. If you
participate in the PPO with HSA, you will only be allowed to
enroll in a “Limited FSA,” per IRS guidelines. For the Limited
FSA the deadline for submitting expenses for reimbursement
is March 31 following the end of the plan year for expenses
incurred during the preceding January 1 – December 31.
For the regular (meaning, non-Limited) Healthcare Flexible
Spending Account, the deadline for submitting expenses
for reimbursement is June 15 for expenses incurred from
Jan 1 of the preceding year to March 15 of the current year.
For example, you will have until June 15, 2016 to submit a
claim for reimbursement as long as that claim was incurred
between January 1, 2015 and March 15, 2016.
• For the Dependent Care Spending Account, dependent
day care expenses must be incurred during the plan year
(January 1- December 31) and claims must be filed by
March 31 of the following year.
Dependent Care Spending Account
The Dependent Care Spending Account allows you to set aside money on
a pre-tax basis to reimburse yourself for eligible dependent care expenses.
You can use the account to cover expenses for your children under age 13,
a disabled spouse, or a dependent of any age (including a parent) who lives
with you and is at least 50% dependent on you for financial support.
Expenses eligible for reimbursement range from wages paid to a care
provider, nursery school or day care center. They also include expenses paid
for household services, such as preparing meals, and even FICA or other
taxes you pay on behalf of a service provider.
Please note that the IRS finalized regulations making kindergarten and
overnight camps no longer eligible for reimbursements.
You can set aside between $250 and $4,500 each year. Remember, IMS
Health will match 50% of the first $1,000 you contribute. Your contributions
are deducted from your pay before taxes are calculated, reducing your
current tax liability, and reimbursements are made with tax-free dollars from
your account.
Please note: FSA limits are per household and if both spouses are working
the combined maximum contribution is $5,000. Additionally, it is important
to note that the Dependent Care FSA is designed to allow a family with two
working parents to pay for a portion of dependent care expenses using tax
free dollars. Employees whose spouses do not work outside the home are
not eligible to participate.
IMS HEALTH 2015 Benefits Enrollment Guide | 37
Flexible Spending
Accounts
Other
BEnefits
Contacts
Important
Notices
Other Benefits
IMS Health offers comprehensive health
and insurance benefits, with a wide array
of choices to meet all of your needs.
Review this summary chart for a high-level
understanding of what other benefits you
have, and then refer to the sites and contact
numbers listed for more information. You
can find more detailed information about
these plans by visiting IMS Now. Go to Our
Company>Human Resources>Benefits.
Benefit
Coverage
Personal Insurance Coverage
•D
iscounted rates for auto, homeowners, rental and other
insurance policies.
• Direct payroll deduction available.
Employee Assistance Program
•C
ounseling services and support for personal and family
concerns.
•U
p to 5 free visits per episode for yourself and each covered
dependent.
• Work/Life and concierge service.
• Life Care kits.
Legal Plan
•C
overs legal advice, document preparation (wills, living wills,
powers of attorney), financial and family matters.
• Administered by Hyatt Legal Plans, Inc.
•P
articipants may use both participating Hyatt (in-network) and
out-of-network attorneys; benefits vary accordingly.
Tuition Assistance
• Reimbursement for undergraduate and graduate degree costs.
•U
p to IRS annual maximum of $5,250 undergraduate; $9,000
graduate.
• Additional one-time lump sum awarded upon receipt of degree.
•O
nly available to full-time employees with acceptable
performance.
Adoption Assistance
• Reimbursement for covered adoption expenses.
• $3,000 per adoption; two adoptions per family.
Matching Contribution Program
•C
ompany match for employee contributions to primary and
secondary schools and colleges or universities.
Working Advantage Employee
Discount Program
•N
ational program with employee discounts on tickets, travel and
shopping.
Commuter Benefits Program
• Pre-tax reimbursement for transit/commuting costs
IMS HEALTH 2015 Benefits Enrollment Guide | 38
Other
BEnefits
Contacts
Important
Notices
Information at
Your Fingertips
For more information on the
benefits not covered in this Guide,
you can access the Health View site
on IMS Now. You also can contact
the Employee Solutions Center
at 1-800-467-6130 or by emailing
[email protected].
Plan
Administrator
Phone Number
Website
Medical
Anthem BCBS
877-403-4424
www.anthem.com/imshealth
Prescription Drugs
Express Scripts
866-790-8276
www.express-scripts.com
Mental Health/Chemical
Dependency Benefits
Anthem BCBS
877-419-1659
www.anthem.com/imshealth
Vision Plan
EyeMed
800-521-3605
www.eyemedvisioncare.com
Dental – PPO Plan
Delta Dental
800-932-0783
www.deltadentalins.com
Dental – DeltaCare
HMO Plan
Delta Dental
800-422-4234
www.deltadentalins.com/deltacareusa
Flexible Spending Accounts
IMS Health
IMS Health Employee Solutions
Center: 800-467-6130
http://hcet.ebia.com/ims
Access Code: ims2006
Disability Insurance
Liberty Mutual
800-713-7384
www.mylibertyclaim.com
Life Accident Insurance
Liberty Mutual
IMS Health Employee Solutions
Center: 800-467-6130
Personal Insurance Coverage
Metropolitan Life
Insurance Company
1-800-GET-MET1
Provide Company Code OKU
www.metlife.com/mybenefits
Provide Company Code OKU
New Jersey Manufacturers
Insurance
PA/NJ residents only:
1-800-232-6600 Provide
IMS Health Code (51130)
when prompted
PA/NJ residents only:
www.njm.com (New Jersey
Manufacturers Insurance); Provide IMS
Health Code (51130) when prompted
Employee Assistance Program
Anthem BCBS
877-419-1659
www.anthemeap.com
Employee ID: ims
Legal
Hyatt Legal
800-821-6400
www.legalplans.com
Password: 3060010
Long-Term Care Insurance
Prudential
800-732-0416
www.prudential.com/gltc
Group Name; ims; password: imsltc
Employee Discount Program
Working Advantage
800-565-3712
www.workingadvantage.com
IMS Health Company Code: 410228316
Commuter Benefits Program
Wage Works
877-924-3967
www.wageworks.com
Savings Plan
Charles Schwab
800-724-7526
www.schwabplan.com/workplace
IMS HEALTH 2015 Benefits Enrollment Guide | 39
Contacts
Important
Notices
Important Notices
Women’s Health and Cancer Rights Act Notice
The Women’s Health and Cancer Rights Act is a federal law. It protects
breast cancer patients who elect breast reconstruction surgery due to a
mastectomy. Health care plans must cover reconstructive surgery following
a mastectomy, as determined in consultation with the attending physician
and the patient.
Reconstructive benefits must include coverage for:
•R
econstruction of the breast on which the mastectomy has
been performed;
• S urgery and reconstruction of the other breast to produce a
symmetrical appearance; and
•P
rosthesis and physical complications at all stages of mastectomy,
including lymphedemas.
Medicaid or CHIP, you will not be eligible for these premium assistance
programs but you may be able to buy individual insurance coverage
through the Health Insurance Marketplace. For more information, visit
www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you
live in a state where eligible, contact your state Medicaid or CHIP office to
find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP
and you think you or any of your dependents might be eligible for either
of these programs, you can contact your state Medicaid or CHIP office or
dial 1-877-KIDS-NOW or go to www.insurekidsnow.gov to find out how to
apply. If you qualify, you can ask the state if it has a program that might
help you pay the premiums for an employer-sponsored plan.
Premium Assistance under Medicaid and the Children’s Health
Insurance Program (CHIP)
If you or your dependents are eligible for premium assistance under
Medicaid or CHIP, as well as eligible under your employer plan, your
employer must permit you to enroll in your employer plan if you are not
already enrolled. This is called a “special enrollment” opportunity, and
you must request coverage within 60 days of being determined eligible
for premium assistance. If you have questions about enrolling in your
employer plan, you can contact the U. S. Department of Labor at
www.askebsa.dol.gov or by calling toll-free 1-866-444-EBSA (3272).
If you or your children are eligible for Medicaid or CHIP and you are eligible
for health coverage from your employer, your state may have a premium
assistance program that can help pay for coverage, using funds from their
Medicaid or CHIP programs. If you or your children are not eligible for
If you live in one of the states with a program, you may be eligible for
assistance paying your employer health plan premiums. The list of states is
available at www.insurekidsnow.gov and is current as of July 31, 2014. You
should contact your state for further information on eligibility.
These benefits are subject to IMS plans’ regular copayments
and deductibles.
Employer Children’s Health Insurance Plan (CHIP)
IMS HEALTH 2015 Benefits Enrollment Guide | 40
Important
Notices
Amendment and Termination, and Governing Documents. This guide describes benefits currently offered by IMS
Health as of the date of publication. The Company reserves the right to change or terminate any benefits described in this
guide, or any underlying benefit option, at any time. In addition, if descriptions in this document conflict with the terms of
any governing plan document, then the terms of the governing plan document will control.
©2014 IMS Health Incorporated and its affiliates. All rights reserved. Trademarks are registered in the
United States and in various other countries.
2015
Overview
Ready, Set,
Enroll!
Health
Plans
Flexible Spending
Accounts
IMS HEALTH 2015 Benefits Enrollment Guide | 41
Other
BEnefits
Contacts
Important
Notices