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2015 Annual Benefits
Enrollment Guide
2015 Annual Benefits Enrollment
Meeting Schedule
Each year, all benefits-eligible employees have an opportunity to review their benefit elections during the
annual benefits enrollment period and make changes for the upcoming plan year. This year’s annual enrollment
period is Monday, October 20-Monday, November 3, 2014.
2015 Annual Benefits Enrollment Meeting Schedule
DATE
TIME
LOCATION
Saturday, October 11
Monday, October 13**
Tuesday, October 14
Wednesday, October 15
Thursday, October 16
Thursday, October 16
Friday, October 17
Friday, October 17
Monday, October 20
Tuesday, October 21
Tuesday, October 21
Tuesday, October 21
Tuesday, October 21
Wednesday, October 22
Friday, October 24
Friday, October 24
11 a.m.
11 a.m.
12:30 p.m.
7:30 a.m.
8:00 a.m.
2 p.m.
2 p.m.
Noon
7:30 a.m.
9 a.m.
9 a.m.
11 a.m.
11 a.m.
11 a.m.
1 p.m.
2 p.m.
EUH, Classroom A
EUH, Auditorium
EUOSH, 2nd Floor Conference Room
EUHM, Glenn Classroom 2
ESJH, Auditorium
Budd Terrace, Eventide Room
EWWH, AV Conference Room
EJCH, Room 109
EUH, Auditorium
Decatur Plaza, Room 131
Peachtree Center, Room 621
Decatur Plaza, Room 131
Peachtree Center, Room 621
TEC, Building A, Brown Auditorium
ESJH, Auditorium
EUHM, Glenn Classroom 2
**This meeting will be webcast. To view the meeting live, go to http://emory.adobeconnect.com/ae2015 at 11 a.m., October
13.
This session will be recorded and posted on www.ourehc.org/enrollment after October 13.
2015 Annual Benefits Enrollment Assistance
Enrollment assistance is available in Emory Healthcare Human Resources and through the Employee
Resource Center.
To view the list of HR locations, go to www.ourehc.org, Employee Resources and Contact HR.
Employee Resource Center: 404-686-6044
EHC.HR/[email protected]
View our Presentation on the Web!
If you are unable to attend an Annual Benefits Enrollment Meeting in person, the presentation is available on the Web.
Go to www.ourehc.org and Annual Benefits Enrollment to view.
Choices
What’s Inside
Emory Healthcare is proud to be a vital part of the
Benefits Enrollment 2015
Atlanta community. One of the reasons we are an
What’s New for 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
employer of choice is the rich benefits package that
Your Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
we offer our employees. As a part of Emory
Benefits Eligibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
How to Enroll. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Healthcare, you have numerous benefits available to
you. You have a choice of two medical plans for 2015,
each with unique plan design features. In addition,
there are plans that provide coverage for dental,
vision, disability, retirement, long-term care, legal
Enrollment Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Change In Your Coverage Mid-Year. . . . . . . . . . . . . . . . . . . . 9
Health Benefits
Medical Plans. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
- Plan 1: HSA Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
services and more. We encourage you to take a close
- Plan 2: POS Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
look at all of the benefits information provided in this
- Medical Plan Rates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
guide. Our benefit plans are just one of the many
- Medical Plan Comparison Quick Guide . . . . . . . . . . . . . . . 16
ways Emory Healthcare helps you take care of
- Wellness Incentives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
yourself and your family.
Flexible Spending Accounts . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Dental Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Vision Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
The Summary of Benefits and Coverage
Additional Benefits
(SBC) for each health plan and the
Short-Term & Long-Term Disability. . . . . . . . . . . . . . . . . . . . 21
individual health insurance marketplace
Life and Accident Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . 22
exchange notice can be accessed at
Long-Term Care, Home & Auto,
Aflac and Prepaid Legal . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
www.ourehc.org. Click on Employee
Resources and then Your Benefits.
Additional Resources
More Medical Plan Information . . . . . . . . . . . . . . . . . . . . . . . 24
Important Numbers and Websites. . . . . . . . . . . . . . . . . . . . . 25
This guide is meant to provide basic benefit plan information. For additional details and specific information, please contact the vendor or review the
Summary Plan Description (SPD) for each plan. SPDs are available on the Your Benefits website (go to www.ourehc.org and select Employee Resources)
or by contacting the Employee Resource Center at 404-686-6044 or EHC.HR/[email protected] for a printed version.
DISCLAIMER: Emory Healthcare reserves the right to terminate, suspend, withdraw, amend or modify the plan in whole or in part at any time. Further,
Emory Healthcare reserves the right to terminate or modify coverage for any group of employees, active or retired, and their dependents or a class of
dependents at any time.
9/14 2015 Annual Benefits Enrollment Guide
1
What’s New for 2015?
Annual enrollment is your opportunity to review your current benefits and make changes for the upcoming plan year.
Your new benefit selections will be effective on January 1, 2015. Changes for the 2015 plan year are summarized below.
Be sure to take a fresh look at all of the benefits options available to you for the year ahead — and use the tools and
resources Emory Healthcare provides to help you make your decisions.
Medical Plan Changes
For 2015, Emory Healthcare will continue to offer two medical plan options: the HSA Plan and the POS Plan. There will be
an increase in employee biweekly rates for the medical plan. For the 2015 biweekly rates, refer to page 15. If you don’t
make any changes, your medical coverage will carry over.
Other changes for the upcoming year include:
•
Change in Network from EPN to EHN. The Emory Healthcare Network (EHN) will replace the Emory Provider
Network (EPN) as the lowest cost network tier in the medical plan. The EHN comprises providers and facilities that
are owned or affiliated with Emory Healthcare. This means you can count on receiving high-quality, Emory-level
care when you see a physician in the EHN. Services are paid at the maximum benefit available under our plans, so
you will get outstanding value for your health care dollars. The physicians and hospitals in the EHN are required to
meet quality standards and have integrated patient records for better care of their patients. EHN facilities and
physicians are located all across metro Atlanta, giving you great access to exceptional care. Some physicians who
are currently in the EPN will not be in the EHN for 2015. These physicians will continue to be in-network with Aetna,
but because they will not be in the EHN, they won’t be the lowest cost providers for you. It is important to check
Aetna DocFind on www.aetna.com to determine the network tier for your preferred providers. Aetna DocFind will
be updated with 2015 network information by Monday, October 20.
•
Northside Hospital. As previously communicated, Northside Hospital is moving from Aetna In-Network to the
Out-of-Core Network effective January 1, 2015.
•
In-Network Primary Care Co-pay Increase. For the POS plan, Aetna In-Network primary care office visit co-pays
will increase from $25 to $35, with the exception of visits to pediatricians or mental health providers, which will
remain at $25. Emory Healthcare Network primary care visit co-pays will also remain at $25.
Emory Healthcare Network (EHN)
Exclusive network just for you
EHN facilities include:
· Children’s Healthcare of Atlanta (including Egleston and Scottish Rite)
· Emory Johns Creek Hospital
· Emory Rehabilitation Hospital, In Partnership with Select Medical
· Emory Saint Joseph’s Hospital
· Emory University Hospital
· Emory University Hospital Midtown
· Emory University Orthopaedics & Spine Hospital
· Emory Wesley Woods Hospital
· Grady Memorial Hospital (including Hughes Spalding)
· Southern Regional Medical Center
EHN physicians include:
· Emory Clinic physicians
· Private practice physicians who have admitting privileges at either
Emory University Hospital Midtown, Emory Johns Creek Hospital, Emory
Saint Joseph’s Hospital or Emory Wesley Woods Hospital
Locate a participating EHN physician or facility at www.aetna.com/
docfind/custom/emory or call 1-800-847-9026 or the Emory
Healthcare EVIP Appointment Line at 404-778-EVIP.
2
2015 Annual Benefits Enrollment Guide
Aetna National
(In-Network)
Out-of-Core-Network
Providers and facilities are part
of both medical plans through
Aetna National Network.
Co-pays, co-insurance and
deductibles are higher than
with the EHN.
Providers and facilities not
participating with Aetna are
considered Out-of-CoreNetwork. Costs are the highest.
Facilities in the Out-of-CoreNetwork include:
· Newton Medical Center will
remain In-Network for 2015.
· All DeKalb Medical facilities
· All Gwinnett Medical facilities
· All Northside facilities
· All Piedmont Healthcare facilities
· All WellStar facilities
· Atlanta Medical Center
· Cartersville Medical Center
· Eastside Medical Center
· North Fulton Hospital
· Rockdale Medical Center
9/14
What’s New for 2015?
Continued
•
Prescription Drug Administrator Change. Emory Healthcare’s prescription drug administrator will change from
Express Scripts to CVS/caremark, providing you with convenient access to CVS retail pharmacies throughout metro
Atlanta. One very important change to note is that if you take any maintenance prescription medications to treat
certain ongoing medical conditions, you will need to fill your prescriptions in one of three ways: through CVS/
caremark’s mail order service, at a CVS retail pharmacy location (at the mail-service cost) or at an Emory pharmacy
(view page 24 for locations). Please be aware that if you attempt to fill a maintenance drug at a pharmacy other than
CVS or Emory, you will be charged the full retail cost on your third attempt to refill. While this may cause some
inconvenience, it is a necessary measure to help control the overall cost of the plan. More information is available on
the Annual Benefits Enrollment website.
•
Expanded Coverage for Autism. Applied Behavioral Analysis (ABA) and other treatments for autism, such as speech
and occupational therapy, which meet medically necessary guidelines, will now be covered on the medical plan
when provided by an EHN or Aetna In-Network provider. For more information, contact Aetna at 1-800-847-9026.
• Transgender Surgery. The medical plan will be expanded to include coverage for medically necessary
transgender surgery. There will be a per member lifetime cap of $50,000, and employees must have worked at
Emory Healthcare for at least two years to qualify for coverage. Extensive guidelines outlined by Aetna must
also be followed. For more information, contact Aetna at 1-800-847-9026. Note: Emory Saint Joseph’s Hospital
employees are not eligible for this benefit.
Healthy Living Incentives
Incentives will be available again in 2015 to reward healthy living. However, on-site biometric screenings will not be
offered in 2015. You are encouraged to visit a primary care physician (PCP) for an annual checkup and get your important
health numbers. If you visit a PCP for an annual checkup (preventive exam visit), you will receive a $100 incentive.
You can receive another $100 incentive for completing a Healthy Lifestyle Coaching program, and if you have a chronic
condition and complete a Disease Management program, you can earn a $200 incentive. In addition, you will receive a
$25 gift card for completing Aetna’s SimpleSteps online health assessment. Your spouse/SSDP is also eligible for all of
these incentives.
Each of these activities must be completed between January 1, 2015, and November 15, 2015, to be eligible for
2015 incentives. If you enroll in the HSA Plan, your incentives will be a contribution to your HSA. If you enroll in the
POS Plan, your incentives will be a credit against your deductible.
Short-Term Disability
Short-Term Disability (STD) insurance is changing to allow current employees the chance to enroll in or decrease
their waiting period, without having to provide Evidence of Insurability (EOI). Emory Healthcare is making this
change to make enrollment in STD less restrictive for our current staff. It’s very important to know that preexisiting condition limitations apply for those who are enrolling for the first time or decreasing their waiting period.
Please consider this benefit carefully and understand the pre-existing condition limitations. You are considered to
have a pre-existing condition if you received medical treatment, consultation, care or services, including diagnostic
measures; or took prescribed drugs or medicines in the three months prior to your effective date of coverage; and
the disability begins in the first 12 months after your effective date of coverage.
Pregnant or thinking of having a baby? Looking for a great OB/GYN?
Emory Clinic’s OB/GYN department is accepting new patients and can accommodate appointments within
a week, as the department has added several physicians. High-risk pregnancy care consultation can also
be provided by the department’s maternal-fetal medicine specialist. To schedule an appointment with an
Emory Clinic physician, call 404-778-3401.
9/14 2015 Annual Benefits Enrollment Guide
3
What’s New for 2015?
Continued
Dental, Vision & Life Insurance
There are no changes to the Dental Plan and Vision Plan in 2015. Employee rates for dental and vision will also remain
unchanged. Note: You will not receive new dental cards this year.
The Supplemental Life Insurance rates are going up slightly in 2015. View page 22 for more information.
Every Year, You Must Re-certify for the Spouse/SSDP Medical Charge
Emory Healthcare believes all employers should pay their fair share of the health care cost. Emory Healthcare picks
up 80 percent of health care costs for its employees and their families. Picking up the health care cost
responsibilities for other employers adds to the costs paid by Emory Healthcare and our employees. Therefore, all
employees with covered spouses/SSDPs who have access to group health care through their employer and enroll in
our medical plan will incur a $50 per month medical charge.
Emory Healthcare may request supporting documentation at any time to verify your spouse/SSDP is not enrolled in or
eligible to enroll in other health coverage through his or her employer. In addition, Emory Healthcare may periodically
perform an audit of spouses/SSDPs enrolled in the medical benefit plan who do not have access to health insurance
coverage through their employer. As part of this audit, an affidavit will need to be signed by the employee, the spouse/
SSDP and the spouse’s/SSDP’s employer confirming that health insurance coverage is not offered.
All employees who cover their spouse/SSDP must self-certify every year whether their spouse/SSDP “does” or “does
not” have access to group health insurance coverage through his/her employer. If you elect coverage for your
spouse/SSDP, you must re-certify by November 3, 2014, or you will default into the $50 per month medical charge.
Flexible Spending Accounts
Remember that if you want to participate in a Flexible Spending Account (FSA) in 2015, you must actively enroll
during Annual Benefits Enrollment.
IRS Restrictions on the Health Savings Account (HSA) if You Have a 2014 Flexible Spending Account (FSA)
Balance – Use Your Money in 2014!
In accordance with IRS regulations, if you enroll in the HSA Plan for 2015 and have a balance in a 2014 Healthcare FSA (as of December 31,
2014), you are not eligible to contribute funds to an HSA or receive any funds in your HSA until April 1, 2015. This includes Emory
Healthcare’s annual contribution, incentives earned from wellness activities and contributions you make to your HSA.
You will need to consider whether or not you will have an FSA balance on December 31, 2014, when making your decision about enrolling
in the HSA Plan, including making any contributions to an HSA through payroll deduction.
Have a Balance in Your 2014 FSA as of December 31, 2014?
•
The April 1, 2015 date still applies even if your Healthcare FSA account balance reaches $0 at an earlier point during 2015.
•
Any medical expenses incurred prior to April 1, 2015, are not eligible for reimbursement with HSA funds. Expenses
must be incurred after April 1, 2015, to use HSA funds.
Have a $0 Balance in Your 2014 FSA as of December 31, 2014?
4
•
You are HSA eligible on January 1, 2015.
•
You (and Emory Healthcare) can make contributions to the account.
•
Eligible medical expenses can be paid with your HSA funds.
2015 Annual Benefits Enrollment Guide
9/14
Your Benefits
As an Emory Healthcare employee, you are fortunate to have a wide range of benefit programs available to you.
Benefit programs give you important financial protection when you need it most. Enrolling in your benefits is
quick and easy. Spend a few minutes and review the benefit programs that Emory Healthcare offers to make the
choices that are right for you and your family.
Some benefits Emory Healthcare offers are employer
provided, and coverage is automatic if you are eligible.
Other benefits give you choices and require you to
enroll.
Employer-Provided Benefits
As an eligible employee, Emory Healthcare
automatically provides you with several benefits.
Emory Healthcare pays the full cost for basic life
insurance and long-term disability coverage and
provides a basic employer contribution to the 403(b)
retirement plan for eligible employees. For more
information on retirement plan options, view the
Discover Your Retirement Options Guide located on the
Employee Resources site on www.ourehc.org.
Optional Benefits
In addition to employer-provided benefits, eligible
employees may enroll in optional benefits, including
medical, dental, vision, supplemental life insurance,
accidental death and dismemberment, disability,
flexible spending accounts, 403(b) retirement plans and
other voluntary plans. You contribute toward the cost
of the optional benefits that you elect.
For optional benefits other than the 403(b) and
supplemental long-term disability, if you do not enroll
during your first 31 days of employment, you will not
receive coverage. Your next opportunity to enroll in
optional benefits will be during the annual benefits
enrollment period, typically held in the fall of each year
for the upcoming year, or if you experience a qualified
family status change (see page 9 for more information).
Life and long-term care benefits require Evidence of
Insurability (EOI) for late enrollees.
Current Employees: If you are a current, benefitseligible Emory Healthcare employee, each year you
have an opportunity to review your benefit elections
during the annual benefits enrollment period and make
changes for the upcoming plan year.
When Coverage Ends
For most benefits, coverage will end on the last day of
the month in which:
• Your regular work schedule is reduced to fewer than
20 hours per week;
• Your employment with Emory Healthcare ends due
to resignation, termination or death; or
When Coverage Begins
• You stop paying your share of the coverage.
For most benefits, coverage begins on an employee’s
date of hire.
Your dependent(s) coverage ends:
New Hires: If you are benefits-eligible, you must enroll
during your first 31 days of employment with Emory
Healthcare.
• The last day of the month the dependent is no longer
eligible:
9/14 • When your coverage ends, or
–– For Dependent Child(ren) (up to age 26): End of
the month in which they turn 26.
2015 Annual Benefits Enrollment Guide
5
Who Can Enroll (Benefits Eligibility)
You are eligible for benefits if you are a regular full-time
or part-time employee scheduled to work 20 hours or
more per week.
If you elect coverage, your dependents are also eligible
for medical, dental, vision and life insurance coverage.
Eligible dependents include:
If documentation is not received within 31 days, a letter
will be mailed to you requesting the documentation
within a given deadline. Events that require
documentation to support the change include:
• Your legal spouse.
• Spouse with a last name different than yours
• Same-Sex Domestic Partner (SSDP): Another adult of
the same sex who is engaged with you in a spouselike relationship characterized by mutual dependency.
–– Have residence in the same household.
–– Financially responsible for each other’s well-being
and debts to third parties. This means that you
have entered into a contractual commitment
for that financial responsibility or have joint
ownership of significant assets (such as home, car,
bank accounts) and joint liability for debts (such as
mortgages and major credit cards).
–– Neither partner is married to anyone else nor has
another domestic partner receiving benefits.
–– Partners are not related by blood closer than
would bar marriage in the state of their residence.
–– If you choose to cover a same-sex domestic
partner, you will pay the same cost and receive
the same coverage as you would for a spouse.
–– Covering a SSDP will result in additional tax liability
(imputed income). If your relationship ends, you
will need to notify the Employee Resource Center.
• Your legal child(ren): Includes your natural, adopted
or foster child(ren), stepchild(ren), your SSDP’s
child(ren) or any child for whom you have legal
custody. They are eligible:
–– Up to age 26.
–– Regardless of age, if fully disabled and unmarried,
provided he/she became fully disabled prior to
age 19 or between the ages of 19 and 26, if the
child was covered by the plan when the disability
occurred.
Dependent Verification of Eligibility
When you first enroll, or if you change coverage midyear due to a qualified IRS family status change, you are
required to provide documentation substantiating the
6
eligibility of your dependent(s) within 31 days of the
change or enrollment.
2015 Annual Benefits Enrollment Guide
–– Document(s): Marriage certificate OR joint tax
return (current or previous year only).
• Child with a last name different than yours
–– Document(s): Birth certificate or a court document
awarding custody or requiring coverage.
• Dependent child over age 26
–– Document(s): Birth certificate AND a Social
Security Disability Award or letter from a physician
AND the parent’s tax return claiming the child
(current or previous year only).
• Same-Sex Domestic Partner (SSDP)
–– Document(s): Affidavit of Domestic Partnership
and a document validating the partnership,
such as a joint bank account statement, utility
bill or mortgage/lease/rental agreement, or a
marriage/union certificate from another state or
governmental agency that recognizes same-sex
marriages or unions.
• Employee with five dependents who adds a sixth or
more dependents
–– Document(s): Birth certificate AND either a court
document or the tax return from the parent
claiming the child must be submitted (current or
previous year only).
• Employee with a 50+ age difference with dependent(s)
–– Document(s): Birth certificate AND either a court
document or the tax return from the parent
claiming the child must be submitted (current or
previous year only).
REMINDER: You must provide the documents listed above to the Employee
Resource Center within 31 days from your initial election or mid-year family
status change if one of the above situations applies to you and your family.
If documentation is not received in a timely manner, the election/change
requested will not be processed and the affected dependents will not be
covered under Emory Healthcare’s plans. Legible copies of required
documents are acceptable.
9/14
How to Enroll
Steps to Enrolling Online
You must enroll during the annual enrollment period:
Monday, October 20, through Monday, November 3, 2014.
Prior to enrolling, you can attend a Benefits Enrollment
Meeting if you have questions or would like more
information about Emory Healthcare’s medical plans
and benefit programs. Meetings are listed on the first
page of this guide, as well as on our annual enrollment
website on www.ourehc.org. Emory Healthcare offers
numerous tools and resources to help you make your
benefit selections (see the Enrollment Checklist on
page 8). You can also contact the Employee Resource
Center with any questions at 404-686-6044 or EHC.HR/
[email protected].
Enroll Online
Enrolling is easy and available 24 hours a day through
e-Vantage on www.ourehc.org and Self Service. You can
enroll online at any public access computer that has
Internet connectivity. To access e-Vantage, you will need
your network ID and password. If you do not know your
network ID or password, call 8-HELP at 404-778-4357.
1. Once logged in to e-Vantage, click on Self Service,
then Benefits and then Benefits Enrollment.
2. Choose Select to view your current elections and the
new election options.
3. Complete the certification for the Spouse/SSDP
medical charge. Complete the certification for the
tobacco surcharge if you are enrolling for the first
time or need to change your previous response.
4. Change your elections by clicking Edit beside a
particular plan and follow the prompts to view and/
or change your current coverage. You may also
enroll, add or drop eligible dependents.
5. After editing your current coverage in each plan,
your new elections, covered dependents and payroll
deductions will be displayed.
6. You will be prompted at the bottom of the page to
Continue to finalize your elections.
7. Click Submit after reading the Authorize Elections
Statement. Note: You have not enrolled until you
click Submit.
8. Click View/Print to bring up a printable pdf
confirmation page. Make sure to save a copy of your
confirmation page and carefully review it for accuracy.
Don’t have access to a computer? No need to worry! The locations listed below have computers
available Monday through Friday. For times, go to www.ourehc.org, Employee Resources and Contact HR
under Need Help.
• Emory University Hospital
- Learning Resource Center
(2nd Floor, Room E214)
- Human Resources
(2nd Floor, Room D201)
• Emory University Hospital Midtown
- Learning Resource Center
(Glenn Bldg, 2nd Floor, Room 4709)
- Human Resources
W.W. Orr Bldg, 5th Floor)
9/14 • Emory University Orthopaedics & Spine Hospital
- Human Resources
• Emory Johns Creek Hospital
- Human Resources
• Emory Saint Joseph’s Hospital
- Human Resources
• Emory Wesley Woods Center
- Houston Building Main Lobby
2015 Annual Benefits Enrollment Guide
7
Enrollment Checklist
Use this checklist to help you through the enrollment process. Changes are effective on January 1, 2015.
Before Enrollment
During Enrollment
Before enrollment begins, take the time to educate
yourself on all of the benefits options that are available
to you. Emory Healthcare provides the following tools
to help you learn more (each of these tools can be
accessed online at www.ourehc.org, Annual Benefits
Enrollment).
❏❏ Actively enroll between Monday, October 20, and
Monday, November 3, 2014. If you don’t actively
enroll, your plans will stay the same with the
exception of the Flexible Spending Account and the
spouse/SSDP medical certification.
❏❏ Review this 2015 Annual Benefits Enrollment Guide
carefully as you consider your plan choices.
❏❏ Read the HSA Plan Quick Guide which provides a
more detailed overview of the HSA Plan.
❏❏ Watch our video, What’s New in 2015.
❏❏ Use Aetna’s Plan Selection & Cost Estimator Tool,
which allows you to estimate how much each plan
will cost you by using your actual claims data from
the last 12 months.
❏❏ Attend a Benefits Enrollment Meeting to hear
benefits staff explain the details of each plan and
give you an overview of all benefit programs. See
the beginning of this guide for dates, times and
locations. If you can’t attend, you can view a copy of
the presentation online.
❏❏ Decide if you want to enroll in a Flexible Spending
Account (Healthcare and/or Dependent Day Care) or
a Limited Healthcare FSA (for HSA Plan participants).
Remember: You must actively enroll each year. Refer
to page 4 of the Annual Benefits Enrollment Guide
for information if you have a 2014 FSA balance and
want to enroll in the HSA.
❏❏ Complete the Spouse/SSDP Medical Certification.
This certification must be done annually. If you do
not complete this certification, the $50 monthly
charge will be added to your medical plan
contribution automatically.
❏❏ Complete the Tobacco Use Certification if you need
to make changes to your certification. If you don’t
need to make changes, your 2014 certification will
carry over. You do not need to recertify.
❏❏ Review your life insurance beneficiary(ies) and make
changes, if necessary.
❏❏ Once you have completed your enrollment, save
or print a copy of your confirmation, review it for
accuracy and retain it for your records.
After Enrollment
❏❏ Verify your 2015 benefits elections after Thursday,
December 4, by visiting e-Vantage on www.ourehc.
org. Once logged in, select Self Service, then Benefits
and then Benefits Summary. If you notice any errors,
notify the Employee Resource Center immediately
(call 404-686-6044 or email EHC.HR/Benefits@
emoryhealthcare.org). After January 1, 2015, changes
cannot be made.
❏❏ HSA Plan members, decide if you want to make a
contribution to your Health Savings Account.
❏❏ Check to make sure your provider is in the Emory
Healthcare Network using Aetna DocFind after
October 20.
❏❏ Check with CVS/caremark (866-601-6935) to see if
there are any changes to your prescription(s).
8
2015 Annual Benefits Enrollment Guide
9/14
Change in Your Coverage Mid-Year
The IRS provides strict regulations about changes to pretax elections during the plan year. If you experience a
qualified IRS family status change mid-year, you are permitted to make a change within 31 days of the event.
If the change request is not completed within 31 days of the event, you will not be able to change your elections until
the following year’s annual benefits enrollment period, which means the change will not be effective until January 1 of
the following year. Below is a list of some of the more commonly known qualified family status changes:
• Marriage, divorce or annulment, or permanent separation from a same-sex domestic partner
• Birth of a child
• Placement of a foster child or child for adoption with you, or assumption of legal guardianship of a child
• Change in your spouse’s/SSDP’s or dependent’s employment status that affects benefits eligibility, including
termination or commencement of employment or change in worksite
• You or your spouse/SSDP returns from unpaid leave of absence
• You or your dependent becomes eligible or loses eligibility for Medicare or Medicaid
• The death of your spouse/SSDP or dependent
• Court ordered coverage of your child by you or your spouse/SSDP, allowing you to add or drop the child’s coverage
• Change in your employment that affects benefits eligibility (working at least 20 hours per week)
• Loss of eligibility for a dependent
• Change in dependent care provider or cost for Dependent Day Care Flexible Spending Account
The change you request must be consistent with the qualifying event. To make a family status change, go to
www.ourehc.org, log in to e-Vantage and go to Self Service. In most cases, when you enter your family status
change through Self Service and make your elections, the process is complete. However, some mid-year changes
also require documentation to be submitted within 31 days of the event. Please refer to the below section for a list
of events that require documentation.
Family Status Change Event
Documentation to Submit
Dependent loss of the state’s SCHIP plan
A copy of the Certificate of Creditable Coverage or a termination letter
which lists the date your coverage ended
Judgment, Decree or Court Order to add coverage for a dependent child
A copy of the court order awarding custody or requiring coverage
Legally married couples with different last names
Proof of marriage such as marriage certificate or jointly filed tax return
Dependent child with a last name different than yours
A copy of the birth certificate or a court document awarding custody or
requiring coverage
Beginning Same-Sex Domestic Partner Relationship
Statement of Same Sex Domestic Partnership or a civil union certificate
from a state or governmental agency that recognizes civil unions
Ending Same-Sex Domestic Partner Relationship
Complete the Same-Sex Domestic Partnership Termination form
Change of residence that is inside or outside of the plan area
A copy of your visa and/or passport that shows the date of entry or exit
from the plan area
Please contact the Employee Resource Center at 404-686-6044 for more details.
9/14 2015 Annual Benefits Enrollment Guide
9
Medical Plans
Everyone’s health care needs are different. That’s why it’s important to carefully decide which medical plan will work
best for you. In this section, you will find information on the two medical plans that Emory Healthcare offers.
For 2015, you have a choice of two medical plans:
Tier Zero
• Plan 1 — HSA Plan
Both plans offer Tier Zero for prescription drugs. With
Tier Zero, generic forms of birth control and
prescription medications used to prevent and treat
chronic health conditions, such as congestive heart
failure (CHF), diabetes, high blood pressure, high
cholesterol, tobacco addiction and more, are covered at
100%. For Tier Zero medications, you pay $0 for a
30- or 90-day supply.
• Plan 2 — POS Plan
Both plans use the same provider networks; however,
there are key differences in how each plan works,
including deductibles, co-pays and co-insurance.
Network Options
Both plans have three Network options:
• Emory Healthcare Network (EHN): Providers and
facilities that are owned and affiliated with Emory
Healthcare give you the maximum benefit available
under the plans, with lower co-pays, co-insurance
and deductibles. For a list of EHN providers, go to
page 24.
• Aetna National (In-Network): Providers and facilities
are part of both medical plans through Aetna. Copays, co-insurance and deductibles are higher than
with the EHN.
• Out-of-Core-Network: Providers and facilities that
are not participating with Aetna are considered
Out-of-Core-Network. Costs are the highest. Refer
to page 2 for a list of Atlanta-area facilities that are
considered Out-of-Core-Network. To locate an EHN or Aetna National (In-Network)
physician or facility, go to www.aetna.com/docfind/
custom/emory or call 1-800-847-9026. Preventive Care
Routine preventive care is covered at 100% under both
medical plans. Preventive care can help you identify
potential health risks before they become real health
problems. These services include annual physicals,
well-child visits, immunizations, health screenings and
more. (See www.ourehc.org and click on Annual
Benefits Enrollment for a list of services.)
10
2015 Annual Benefits Enrollment Guide
For a complete list of Tier Zero medications, go to www.
ourehc.org and click on Employee Resources and Your
Benefits. Please note that from time to time, this list will
change as medications will be moved off patent
protection (brand) and placed in a generic status. It is
also possible for generic medications to fall off the list as
they become available over-the-counter. For the most
up-to-date information or to request an updated listing,
please contact CVS/caremark at 1-866-601-6935.
What Is the Same in Both Medical Plans?
• Same broad network of physicians in Georgia and
nationally (EHN and Aetna National [In-Network]).
• Routine preventive care is $0 when service is received
within the EHN or Aetna National (In-Network).
• Tier Zero (you pay $0 for certain generic
prescription drugs).
• Neither plan requires you to select a primary care
physician or get a referral to see a specialist.
• Unlimited lifetime maximum applied across both
plans and networks.
• The opportunity to earn incentives for wellness
activities (see page 17 for more details).
9/14
Medical Plans
HSA Plan
Plan 1 – HSA Plan
The HSA Plan, a consumer-driven medical plan with a Health Savings Account, puts you in charge of how your
health care dollars are spent. Features of this plan include:
• The same covered services and network of providers as the POS Plan with a different way to pay and save for
health care expenses.
• A Health Savings Account (HSA) with tax advantages, funded in part by Emory Healthcare. The HSA gives you
the flexibility to choose how to spend your health care dollars.
• 100% coverage for all preventive care when services are in the EHN or In-Network.
Like the POS Plan, the HSA Plan has deductibles, co-insurance and an out-of-pocket maximum to protect you in
the event you have significant medical expenses during the year.
Deductible
Out-of-Pocket Maximum
All eligible expenses incurred by you or your covered
dependents throughout the plan year apply toward
meeting the annual deductible: $1,350 (Employee Only)
or $2,700 (Employee + Spouse/SSDP, Employee +
Children or Family) within the EHN or Aetna National
Network (In-Network). As expenses are incurred,
including ER visits and prescription drugs, you can use
funds that have accumulated in your HSA to cover
these costs. Once your HSA balance is exhausted, any
remaining portion of your deductible that needs to be
met for the year will be an out-of-pocket expense and
your financial responsibility. The annual deductible must
be satisfied before any plan expenses are paid by
co-insurance, with the exception of preventive care and
Tier Zero prescriptions, which are covered at 100%. If
you enroll and elect employee and dependent coverage,
any covered expenses incurred will apply toward
meeting the family deductible of $2,700 (EHN or
In-Network) before any expenses are covered under
co-insurance.
Like a traditional plan, there is a maximum amount that
you are financially responsible for under the plan each
year. Once your out-of-pocket eligible expenses reach
the annual maximum of $3,000 (Employee Only) or
$6,000 (Employee + Spouse/SSDP, Employee + Children
or Family) within the EHN or Aetna National (InNetwork), the plan pays 100% of eligible expenses for
you and your covered dependents for the remainder of
the plan year. If you enroll and elect employee and
dependent coverage, any expenses incurred by a given
individual or combination of individuals that are
covered under the plan will apply toward meeting the
family out-of-pocket maximum. For the remainder of
the plan year, eligible expenses will be covered by the
plan at 100% for all family members.
Co-Insurance
Once the annual deductible is satisfied, the HSA Plan
works like a traditional plan by paying the majority of
expenses through co-insurance. Emory Healthcare
Network (EHN) care is covered at 90% (you pay 10%);
Aetna National (In-Network) care is covered at 80%
(you pay 20%) and Out-of-Core-Network care is
covered at 60% (you pay 40%).
Learn more about this plan by viewing the HSA
Plan Quick Guide posted on the intranet. Go to
www.ourehc.org and Annual Benefits Enrollment.
It is important to note that other than preventive
care, you have to pay 100% of your eligible
medical expenses, including prescription drugs,
until your annual deductible is met.* Once met, the
plan provides coverage through co-insurance. You
need to carefully consider the balance in your HSA
and your ability to meet these financial obligations
in the event of an illness, injury or accident.
* If you elect Employee+Spouse, Employee+Children or Family
level coverage, you must meet the family deductible before the
plan pays.
9/14 2015 Annual Benefits Enrollment Guide
11
Medical Plans
HSA Plan Continued
Prescription Drugs
Prior Authorizations and Quantity Limits
If you are enrolled in the HSA Plan, you must pay all
out-of-pocket costs for prescription drugs until you meet
your annual deductible under the EHN or Aetna National
Network (In-Network), which is $1,350 (Employee Only) or
$2,700 (Employee+Spouse/SSDP, Employee+Children or
Family). You can use your HSA to pay for prescription drugs.
After you meet the deductible, you will pay the applicable
co-insurance amount under the HSA Plan, up to the
30-day retail maximum.
Medications within certain drug categories require
prior authorizations and quantity limits as part of CVS/
caremark’s clinical review program. These clinical
review programs help ensure patient safety by
implementing quantity, dose and effectiveness reviews
prior to medications being prescribed. For a list of drug
categories requiring prior authorization and
medications subject to the clinical review program,
contact CVS/caremark at 1-866-601-6935.
The table below shows what your responsibility is once
your deductible is satisfied. For example, if the table
shows co-insurance is 20%, the plan will pay 80% of
the cost of the prescription drug and you are
responsible for the other 20%. However, there is
financial protection built into the prescription drug
benefit in that you will never pay more than the
30-day retail maximum, outlined in the table below:
Health Savings Account (HSA)
Preventive
Prescription Drugs
(Not Subject to
Deductible)
and
Non-Preventive
Prescription Drugs
(After Meeting
Deductible)
1. Emory Healthcare’s Annual Contribution. If you enroll in:
• Employee-Only coverage — Emory Healthcare
contributes $400 to your HSA.
Tier
Coinsurance
30-Day Retail
Maximum
Co-pay
Zero
0%
$0
–– Emory Healthcare contributes $800 to your HSA.
Note: Emory Healthcare’s contribution is prorated based on your
enrollment date if enrolled after January 1. Your HSA begins on the first
of the month following your election.
1
10%
$25
2
20%
$35
3
30%
$70
4
40%
$100
Prescription drug coverage is administered through
CVS/caremark. To determine your coverage tier, call
1-866-601-6935.
Mandatory Mail Order
If you take any maintenance prescription medications
to treat certain ongoing medical conditions, you will
need to fill your prescriptions in one of three ways:
through CVS/caremark’s mail order service, at a CVS
retail pharmacy location (at the mail-service cost) or at
an Emory pharmacy. Please be aware that if you
attempt to fill a maintenance drug at a pharmacy other
than CVS or Emory, you will be charged the full retail
cost on your third attempt to refill.
12
The HSA is funded in three ways — by Emory
Healthcare’s annual contribution, your participation in
various wellness activities (incentives) and through
optional pretax contributions you make to the HSA.
2015 Annual Benefits Enrollment Guide
• Employee + Spouse/SSDP, Employee + Child(ren) or
Employee + Family level coverage
2. Incentives. In addition to Emory Healthcare’s annual
contribution to your HSA, you can earn up to $400 in
incentives (as well as a $25 gift card) toward your HSA
balance each year by completing various wellness
activities. See page 17 for details on earning incentives.
3. Your Contributions. Finally, if you want a way to save
tax-free for current or future eligible medical expenses,
you can also contribute to your HSA. Contributions to
your HSA have no expiration date — they remain in the
account until you decide to access them or reimburse
yourself for an eligible expense you already paid out-ofpocket. You decide when and how to pay.
To Qualify for a Health Savings Account:
1. You must be enrolled in the HSA Plan.
2. You cannot be claimed as a dependent on someone else’s tax return.
3. You cannot be covered by a spouse’s FSA.
4. You cannot be covered by any other medical plan, including Medicare A and/or B.
5. While you may cover a child up to age 26 or a SSDP under the HSA Plan,
qualified medical expenses are those incurred by you, your spouse and all
dependents you claim on your tax return. Refer to IRS Publication 969 for details.
6. Your 2014 FSA balance must be $0 as of December 31, 2014.
9/14
Medical Plans
HSA Plan Continued
What’s Different About a
Health Savings Account?
1. The Health Savings Account (HSA) is only available
if you participate in the HSA Plan. The money is
yours, is held in an investment account and is
portable — it goes with you to be used for
qualified medical expenses if you leave Emory
Healthcare or when you retire.
2. If you are enrolled in the HSA Plan, you may not
participate in a general Healthcare Flexible Spending
Account (FSA). However, you can participate in the
Limited Aetna Healthcare FSA for dental and vision,
and then for medical expenses once you have met
your deductible. Refer to page 4 for more
information on how your 2014 FSA balance may
affect your 2015 HSA.
3. If you are enrolled in the HSA Plan, you may still
participate in the Dependent Day Care Flexible
Spending Account (FSA).
1
2
Additional HSA Features
• Once your HSA account is open, you will receive a
welcome kit from Aetna/PayFlex. The kit will include
an Aetna/PayFlex MasterCard debit card to pay
eligible expenses.
• Withdrawals from HSAs for qualified medical
expenses are tax-free. If you withdraw money for any
reason other than qualified medical expenses, you
must pay income tax and a 20% IRS tax penalty.
• You must have a balance in your account to make a
withdrawal.
• Money in the HSA will be invested in a money market
fund.
• The maximum you can contribute to an HSA in
one year is set by the IRS (in 2015, $3,350 for single
coverage and $6,650 for family coverage). If you are
age 55 or older, you can contribute additional catchup contributions. It is your responsibility to make
sure your HSA contributions, including any employer
or incentive contributions, do not go over the IRS
maximum. The minimum you can contribute is $200.
9/14 3
HOW THE HSA PLAN WORKS
GET PREVENTIVE CARE FREE
EHN and In-Network preventive care is
covered at 100% with no deductible. You
pay $0 out-of-pocket for your annual
physical, well-woman
visit, mammogram,
colonoscopy, routine
immunizations and
other eligible
services.
PAY FOR OTHER MEDICAL EXPENSES
You pay for additional medical and
prescription drug expenses as you incur them
until your annual deductible is met. Your
deductible amount depends on your
coverage level.
USE YOUR HSA
HSA D
ebit
Card
Your HSA helps
you cover your
HSA
deductible and pay for
other medical costs.
Emory Healthcare will
contribute $400 (employee only) or $800
(dependent or family coverage) to your HSA.
You can also earn additional HSA monies
through wellness incentives. Unused funds
from your HSA roll over to the next year, and
your account balance earns interest (tax-free)
over time.
2015 Annual Benefits Enrollment Guide
13
Medical Plans
POS Plan
Plan 2 – POS Plan
The POS Plan works more like a conventional medical plan where members pay co-pays for some services (copays are fixed fee amounts that you pay at the time you receive services and are not subject to the deductible).
The POS Plan also uses co-insurance for some services (co-insurance is the portion of expense you must pay for
care, in most cases, after meeting your deductible). The deductible is a set amount that typically you must pay
before co-insurance starts. See page 16 for deductible amounts.
The POS Plan allows members to receive services from
a national network of providers and facilities. It is an
open access plan that:
• Provides the flexibility to choose any provider
• Does not require that a Primary Care Physician (PCP)
be identified or selected
• Does not require a PCP referral to see a specialist
With the POS Plan, your biweekly contribution is higher
than with the HSA Plan, but your annual deductible is
lower. You cannot open a Health Savings Account (HSA)
or receive HSA contributions from Emory Healthcare. You
do have the option of enrolling in a Healthcare Flexible
Spending Account (FSA) which allows you to set aside up
to $2,500 pretax dollars to help pay for medical expenses.
See page 18 for more information about the FSA.
EHN and In-Network preventive care is covered at 100%
and is not subject to the deductible. For all other medical
services, the plan pays a portion of your covered expenses
(90% for Emory Healthcare Network (EHN), 80% InNetwork (Aetna National) and 60% (Out-of-CoreNetwork) after you pay the annual deductible. Office visits
are covered with a co-payment. Prescription drugs are
covered through co-insurance.
The POS Plan also has an out-of-pocket maximum to
protect you in the event you have significant medical
expenses during the year. Co-payments, deductibles and
co-insurance count toward the out-of-pocket maximum.
Save on Prescription Drug Costs
If you take prescription medication on an ongoing basis,
you will save money and time by using CVS/caremark
mail orders. No extra charge for shipping. Another great
way to save on drug costs is to buy generic. Always ask
your pharmacist if a generic version is available.
14
2015 Annual Benefits Enrollment Guide
Prescription Drugs
Prescription drug coverage is administered through CVS/
caremark. Emory Healthcare’s prescription drug benefits
for the POS Plan are based on the five-tier co-pay
structure below. You will pay the applicable co-insurance
amount subject to the retail minimum and maximum
cost. You do not have to meet your deductible first.
Prior Authorization & Quantity Limits
Medications within certain drug categories require
prior authorizations and quantity limits as part of CVS/
caremarks’ clinical review program. These clinical
review programs help ensure patient safety by
implementing quantity, dose and effectiveness reviews
prior to medications being prescribed. For a list of drug
categories requiring prior authorization and
medications subject to the clinical review program, call
1-866-601-6935 for more information.
Mandatory Mail Order
If you take any maintenance prescription medications to
treat certain ongoing medical conditions, you will need to
fill your prescriptions in one of three ways: through CVS/
caremark’s mail order service, at a CVS retail pharmacy
location (at the mail-service cost) or at an Emory
pharmacy. Please be aware that if you attempt to fill a
maintenance drug at a pharmacy other than CVS or
Emory, you will be charged the full retail cost on your third
attempt to refill.
Tier
Zero
1
2
3
4
Co30-Day
30-Day
Mail
insurance Retail
Retail
Minimum
Minimum Maximum (up to 90 days)
Mail
Maximum
0%
10%
20%
30%
40%
$0
$62.50
$125
$187.50
$262.50
$0
$10
$30
$55
$85
$0
$25
$50
$75
$105
$0
$25
$75
$137.50
$212.50
(up to 90 days)
9/14
Medical Plan Rates (Biweekly)*
HSA
Plan
Single
Employee+Child(ren)
POS
Full-time**
Part-time***
Full-time**
Part-time***
$13.00
$19.50
$36.00
$54.00
$61.00
$91.50
$119.50
$179.50
$103.00
$157.00
$147.50
$215.00
$221.50
$322.50
Employee+Spouse/SSDP $68.50
Family
$104.50
*Rates do not reflect the Spouse/SSDP Medical Charge and Tobacco Use Surcharge.
** Full-time rates apply for employees scheduled to work 31 or more hours per week.
*** Part-time rates apply for employees scheduled to work 20-30 hours per week.
Spouse/SSDP Medical Charge - $50
Important Notice:
An additional $50 per month medical charge will be
added to your medical plan contribution if your
covered spouse/SSDP has access to group health
insurance coverage through his/her employer. If you
cover a spouse/SSDP, you must certify ANNUALLY
online in e-Vantage whether your spouse/SSDP “does”
or “does not” have access to group health insurance
coverage through his/her employer.
Don’t forget that false statements on the spouse and
tobacco certifications are a violation of Emory
Heathcare’s Standards of Conduct policy as
“falsification of a form” and could lead to disciplinary
action, up to and including an unpaid suspension or
termination of employment without prior warning, at
the sole discretion of Emory Healthcare.
Tobacco Use Surcharge - $50 per person
To support the health and wellness of our staff and
set a positive example for our patients and the
community, Emory Healthcare has implemented a $50
per person monthly tobacco use surcharge on medical
contributions for employees and their spouses/SSDPs
who use tobacco products. If you do not need to make
changes to your certification, you do not need to recertify. Your 2014 certification will carry over to 2015.
Important Reminder!
If the spouse/SSDP medical certification is
not completed, you will automatically incur
the $50 monthly charge for the spouse/SSDP
medical charge. Don’t forget to certify!
Need Help Quitting Tobacco?
Emory Healthcare offers several tobacco cessation resources at no cost to employees. For a listing of
resources, go to www.tobaccofree.emory.edu/cessation.
9/14 2015 Annual Benefits Enrollment Guide
15
Medical Plan Comparison Quick Guide
PLANS
HSA PLAN
POS PLAN
Emory Contribution
$400/$8001
None
Earned Incentives
$400/$8002
$400/$8002
Yes
No
Health Savings Account
(HSA)
Emory Healthcare
Network (EHN)
Aetna National
(In-Network)
Out-of-CoreNetwork3
Emory Healthcare
Network (EHN)
Aetna National
(In-Network)
Out-of-CoreNetwork3
Single
$1,350
$1,350
$2,000
$800
$900
$1,400
Family
$2,7004
$2,7004
$4,0004
$2,400
$2,700
$4,200
Single
$3,000
$3,000
$6,000
$2,300
$2,500
$6,000
Family
$6,000
$6,000
$12,000
$4,600
$5,000
$12,000
Yes
Yes
Yes
Yes
Yes
Yes
Primary Care Physician
Office Visits5
10% after
deductible
20% after
deductible
40% after
deductible
$25 co-pay
$35 co-pay
40% after
deductible
Pediatrician or Mental
Health Physician Visits
10% after
deductible
20% after
deductible
40% after
deductible
$25 co-pay
$25 co-pay
40% after
deductible
Specialist Office Visits
10% after
deductible
20% after
deductible
40% after
deductible
$35 co-pay
$50 co-pay
40% after
deductible
Diagnostic Labs and
X-Ray
10% after
deductible
20% after
deductible
40% after
deductible
10% after
deductible
20% after
deductible
40% after
deductible
Durable Medical
Equipment (DME)
10% after
deductible
20% after
deductible
40% after
deductible
10%
co-insurance (no
deductible)
20%
co-insurance (no
deductible)
40% after
deductible
Routine Preventive Care6
(Eye Exam, Annual
Physical, Flu Shots,
GYN Annual)
Plan Pays
100%
Plan Pays
100%
40% after
deductible
$0 co-pay
$0 co-pay
40% after
deductible
Emergency Room Visits
10% after
deductible
20% after
deductible
20% after
deductible
$150 co-pay7
$150 co-pay7
$150 co-pay
10% after
deductible
20% after
deductible
40% after
deductible
10% after
deductible
20% after
deductible
40% after
deductible
Inpatient Treatment
10% after
deductible
20% after
deductible
40% after
deductible
10% after
deductible
20% after
deductible
40% after
deductible
Outpatient Treatment
10% after
deductible
20% after
deductible
40% after
deductible
$25 co-pay
$25 co-pay
40% after
deductible
Annual Deductible
Out-of-Pocket Maximum
Aggregate
4
4
Hospitalizations
Inpatient/Outpatient
Coverage
Behavioral Health
Benefits
1. $800 is contributed annually to the HSA by Emory Healthcare when Employee+Spouse/SSDP, Employee+Children or Family level coverage is elected.
2. An annual maximum of $800 in incentives can be earned when Employee+Spouse/SSDP or Family level coverage is elected.
3. Amounts applied to deductible and out-of-pocket maximums are limited to the Reasonable and Customary charges.
4. Family deductible applies in the HSA plan when Employee+Spouse/SSDP, Employee+Children or Family level coverage is elected.
5. Includes services of an internist, general physician, family practitioner, dermatologist and allergist.
6. Routine preventive care services ONLY are covered at 100% under the plan. Diagnostic services are subject to the deductible and co-insurance.
7. Co-pay waived if admitted.
DISCLAIMER: Every attempt has been made to ensure the chart and information above accurately reflect the details of the plan. Should there be any errors, the
terms and conditions of the Summary Plan Description (SPD) prevail.
16
2015 Annual Benefits Enrollment Guide
9/14
Wellness Incentives
To encourage you to take an active role in your health and wellness, Emory Healthcare will provide financial
incentives for healthy behavior. You can actually save money on your medical expenses by doing things that help
you live a healthy lifestyle.
Whether you select the HSA Plan or the POS Plan, you
can lower your overall medical costs by participating in
healthy activities. If you enroll in the HSA Plan, your
incentives will be a contribution to your HSA. If you
enroll in the POS Plan, your incentives will be a credit
against your deductible (your deductible will be
lowered by the incentive amount). Refer to the chart
below for incentive amounts. All incentive activities
must be completed between January 1, 2015, and
November 15, 2015, to be eligible for 2015 incentives.
Types of Incentives
Aetna’s SimpleSteps Online Health Assessment
Earn a $25 gift card for completing Aetna’s SimpleSteps
online health assessment. The online health
assessment is a brief online questionnaire to help you
assess your health habits and to provide you with
next steps to a healthier you. Please note that this
incentive activity must be completed before any
other incentives can be received. For example, if you
complete the Healthy Lifetsyle Coaching and get your
annual check-up, but don’t complete the online health
assessment, you will not receive your incentives for
the other two activities. Be sure to complete the online
health assessment early on in 2015 so you can get
credit for all of your incentive activities.
Annual Checkup
One of the most important things you can do for your
health is to schedule an annual checkup (or wellness/
preventive exam visit). With a focus on preventive
care, an annual checkup includes an age- and gender-
2015 Incentive Amounts
For Employee and Spouse/SSDP
Healthy Lifestyle Coaching
100.00
Annual Checkup (preventive exam)
100.00
Disease Management
200.00
Maximum Incentive . . . . . . . . . . . . . . . . . . . . . . . . . . . appropriate history; an examination; a review of risk
factors and plans to reduce them; and the ordering
of appropriate immunizations, screenings, etc. For
women, a well-adult visit or well-women visit will
count for this $100 incentive. If you have an annual
checkup scheduled for late 2014, you may want to
consider rescheduling it for early 2015 so it counts
toward your 2015 incentives. On-site biometric
screenings will not be offered at EHC locations in
2015, but you are encouraged to get “your numbers”
at your annual checkup. If you don’t have a primary
care physician, there are two easy ways to find one:
call Emory HealthConnection at: 404-778-7777 or
1-800-75-EMORY, or go to: www.aetna.com/docfind/
custom/emory.
Aetna’s Healthy Lifestyle Coaching
You will have your own personal, telephonic health
coach to help you reach your health-related goals.
You can work on one or more of the following: weight
management, tobacco cessation, stress management,
nutrition, fitness and preventive health. By
participating, you can receive $100 upon completion
of the third coaching session.
Disease Management Program
If you have a chronic condition, the Disease
Management Program can provide support and
assistance and help you improve your overall health.
Diseases can include diabetes, high blood pressure,
high cholesterol and more. You can be referred to a
disease management program by a physician, through
another program, through Aetna, or you can refer
yourself. The program involves a series of calls with a
nurse who will work with you to effectively manage
your condition. Upon four completed phone calls with
your nurse, you will qualify for a $200 incentive.
$400.00
You and your spouse/SSDP can also receive a $25 gift card for completing
Aetna’s SimpleSteps Online Health Assessment.
9/14 2015 Annual Benefits Enrollment Guide
17
Flexible Spending Accounts (FSAs)
A Flexible Spending Account (FSA) is funded with money you contribute on a pretax basis. You can use FSA
funds to pay for qualified out-of-pocket health care costs for you and eligible dependents or dependent day
care charges. According to IRS regulations, each year you must enroll during your annual benefits enrollment
period if you want to participate in either a Healthcare FSA or a Dependent Day Care FSA. Aetna/PayFlex is
Emory Healthcare’s Flexible Spending Account Administrator. Check your FSA balance online and locate more
information at aetnanavigator.com.
Healthcare FSA for POS Plan
Aetna/PayFlex Card
You can contribute between $200 and $2,500 pretax
annually into the Healthcare FSA. All money you elect to
contribute is accessible immediately. The money you
contribute can be used to cover out-of-pocket costs such as:
New FSA participants will automatically receive an Aetna/
• Medical expenses: co-pays, deductibles, coinsurance
• Dental expenses: deductibles and co-insurance
• Vision expenses: prescription glasses, contact lenses,
co-pays
• Prescription drug costs
• Over-the-counter drugs with a prescription
PayFlex Card in the mail for 2015. Please activate the card
when you receive it. The use of the Aetna/PayFlex Card
is for convenience only. IRS guidelines still require you
to retain receipts for any eligible expense for which you
receive reimbursement. On occasion, Aetna/PayFlex may
request verification of expenses and you will need to submit
appropriate documentation for the expense. If not received,
the card will be deactivated until the expense can be
substantiated as eligible under IRS definitions. Check with
Aetna/PayFlex to determine what supporting documentation
is required.
Limited Healthcare FSA for HSA Plan
HSA Plan members are not eligible for the Healthcare
FSA but do have access to a special Limited Healthcare
FSA administered through Aetna/PayFlex. You may use
the Limited FSA to pay for dental and vision expenses
and then for medical expenses once your deductible
has been met.
18
Use It — Don’t Lose It
The risk of forfeiting money from your Healthcare FSA has
been reduced by a grace period (extra time in the following
year to use your FSA money). You will be able to use any
remaining balance in your Healthcare FSA at the end of
Dependent Day Care FSA
2014 to pay for expenses incurred through March 15, 2015.
Money you contribute into a Dependent Day Care
FSA can be used toward care for a child under age
13, a physically or mentally disabled parent or child,
or elder care for tax-qualified dependents. If you’re
single or married and filing a joint tax return, you can
contribute up to $5,000 into this FSA. If you’re married
and file separately, you can contribute up to $2,500.
If you are a highly compensated employee under the
IRS definition ($115,000 for 2014), you are restricted
to an annual contribution of no more than $2,400.
Unlike the Healthcare FSA, you can only access the
money that is currently in your account. To qualify for
reimbursement, these expenses must be incurred so
that you (and/or your spouse/SSDP) can work or go to
school. HSA Plan members can also participate in the
Dependent Day Care FSA.
will be forfeited. To avoid forfeiture, purchase items such as
2015 Annual Benefits Enrollment Guide
Any 2014 Healthcare FSA funds not used by March 15, 2015,
prescriptions, eyeglasses, contact lenses and other approved
Healthcare FSA expenditures. Reimbursement requests using
your previous year’s remaining Healthcare FSA balance must
be filed by May 15, 2015. Please remember to keep all of your
receipts, as they are required for verification of expenses. If
you have a Dependent Day Care FSA, you do NOT have a grace
period in which to use remaining previous year balances. All
expenses must occur before December 31, 2014, and claims for
the 2014 Dependent Day Care FSA must be filed no later than
March 31, 2015, to receive reimbursement.
Your 2014 FSA balance may affect your
2015 HSA. Refer to page 4 for details.
9/14
Dental
You can choose from two types of dental plans: the Aetna Traditional Dental (PPO) Plan or the Aetna Dental
Maintenance Organization (DMO) Plan.
Plan 1- Aetna Traditional Dental (PPO) Plan
–– Fluoride
This plan is a traditional dental plan that allows you to
see any dental provider. Some services require you to
pay the deductible and applicable co-insurance. The
deductible is a set amount that typically you pay
before co-insurance starts. Co-insurance is the portion
you must pay for services, in most cases, after meeting
your deductible.
–– Sealants (permanent molars only)
Features of this plan include:
• Flexibility to choose any provider. This plan has a
large number of In-Network providers.
• Reimbursements for most Out-of-Network claims.
• Preventive services received by either In-Network or
Out-of-Network providers are covered at 100% up
to reasonable and customary levels. Some examples
of routine preventive services include:
–– Oral examinations
–– Routine, deep cleanings and polishing (Deep
cleanings, or full mouth debridement, CPT 4355,
are covered under preventive services as a
replacement for one of your routine cleanings
once in a 24-month period of time under the
Aetna Traditional Dental (PPO) Plan.)
PLANS
–– Bitewing X-rays
–– Full Mouth Series X-rays
–– Space Maintainers
Plan 2- Aetna DMO Plan
The Dental Maintenance Organization (DMO) Plan
is a managed care plan that contracts with a list of
providers at a set fee schedule. Participants pay copays and do not have to pay co-insurance. This plan
offers a limited network of dentists with low member
contributions, no deductible and low out-of-pocket
co-pays. Out-of-Network coverage is not available.
A Primary Care Dentist (PCD) must be selected and
a referral is required for specialist care. Make sure to
contact the dental provider you select to find out if
they are accepting new patients.
For a list of scheduled services, network providers and to
see what the plan pays, go to www.aetna.com/docfind/
custom/emory.
For the 2015 dental plan rates,
go to page 20.
Aetna Traditional Dental (PPO)
Aetna DMO*
In-Network
Out-of-Network1
In-Network Only
$0
$0
$0
Basic Services (filling, root canal, etc.)
10%2
20%2
Scheduled
Major Restorative (crown, bridge, etc.)
50%2
50%2
Scheduled
$50/person
$150/family
$50/person
$150/family
None
$1,500/person
$1,500/person
None
Deductible
None
None
Co-insurance
50%
50%
$1,500
$1,500
Preventive Services
(routine and deep cleanings, X-rays, etc.)
Calendar Year Deductible3
Annual Plan Payment Maximums
Orthodontia
Lifetime Maximum
$2,000 co-pay,
limited to one
treatment per lifetime
1 Amounts applied to deductible are limited to the Reasonable and Customary charges
2 After deductible
3 Waived for preventive services
* There is no Out-of-Network coverage in the Aetna DMO plan
DISCLAIMER: Every attempt has been made to ensure the chart and information above accurately reflect the details of the plan. Should there be any errors,
the terms and conditions of the Summary Plan Description (SPD) prevail.
9/14 2015 Annual Benefits Enrollment Guide
19
Dental
Continued
Dental Plan Rates (Biweekly)
Plan
Employee Only
2-Person
Family
Aetna Traditional Dental (PPO)
Aetna DMO
Full-time*
Part-time**
Full-time*
Part-time**
$11.50
$23.50
$36.50
$15.71
$31.91
$50.25
$8.50
$15.50
$26.50
$10.47
$21.66
$34.21
* Full-time rates apply for employees scheduled to work 31 or more hours per week.
** Part-time rates apply for employees scheduled to work 20-30 hours per week.
Vision
Emory Healthcare offers an optional vision plan
through EyeMed Vision Care. Features of this plan
include:
• Routine annual eye exam – $0 co-pay.
• Single, bifocal, trifocal, lenticular lenses – $0 co-pay.
• Progressive lenses – $65 co-pay.
• Frames – Up to $150 allowance, 20% off balance
over $150.
• Contact lenses (conventional and disposable) – $0
co-pay up to $200 allowance, 15% off balance over
$200 on conventional lenses.
• Benefits provided once every 12 months for lenses
or contact lenses.
• Contact lens and frame allowance are a one-timeuse benefit. Members are encouraged to use their
full allowance at the time of initial service. Unused
balances are not available for future visits during
the same plan year in which the initial service was
utilized.
• 40% off unlimited additional prescription eyewear
purchases.
• 20% off nonprescription sunglasses.
Providers
EyeMed Vision Care offers a large network of providers,
including the Emory Eye Center, LensCrafters, Pearle
Vision and more. For a complete list of providers, call
1-855-270-2343 or go to www.eyemedvisioncare.com
(click Locate a Provider, then Select Your Network
dropdown menu and choose Select, then enter your
zip code and click Submit). The group number is
9824889.
Vision Coverage Through Your Medical Plan
Employees enrolled in one of Emory Healthcare’s
medical plans receive one vision exam per calendar
year at an optometrist or ophthalmologist. Because an
annual vision exam is considered preventive care, it is
covered at 100%. Locate a participating vision provider
at www.aetna.com/docfind/custom/emory.
Full-time & Part-time
(rates are the same)
Vision Plan Rates (Biweekly)
Employee Only
Employee+Child(ren)
Employee+Spouse/SSDP
Family
$5.08
$10.15
$9.64
$14.94
For a complete list of plan details, go to
www.eyemedvisioncare.com.
Discounts at the Emory Eye Center
All Emory Healthcare employees and their immediate family members are eligible to receive services and discounts at the
Emory Eye Center. For a complete list, visit www.eyecenter.emory.edu. To schedule an appointment, call 404-778-2020.
20
2015 Annual Benefits Enrollment Guide
9/14
Additional Benefits
Short-Term Disability (STD)
Long-Term Disability (LTD)
STD coverage provides you with a portion of your
salary if a temporary illness or injury causes you to be
unable to work. You must first use all of your accrued
comprehensive leave (PTO) and extended illness leave
before receiving STD benefits. Although your
contributions are taken on an after-tax basis, any
benefit you receive is tax free. Coverage begins on the
first of the month following your election.
LTD coverage provides 60% of your base salary after
the 180-day elimination period. Emory Healthcare’s
LTD coverage has a monthly maximum benefit of
$15,000. Emory Healthcare pays 100% of the cost of
LTD coverage. It is automatically provided on the first
of the month after you have completed one year of
service in a benefits-eligible status. If you move to a
non-benefits-eligible status and subsequently return
to a benefits-eligible status, your waiting period will
start over. For LTD coverage, the 60% salary benefit is
taxable.
You can purchase STD coverage to receive 60% of your
base salary for a period of up to 180 days (inclusive of
the waiting period) up to a maximum benefit of $2,500
per week. After 180 days, long-term disability (LTD)
coverage begins. In making this purchase, you can
choose one of three waiting periods. A waiting period
is the length of time you must wait before your STD
benefit starts. Your choices of waiting periods are 15,
30 or 60 days.
If you do not enroll within 31 days of hire or a status
change, you may enroll during the annual benefits
enrollment period. However, pre-existing condition
limitations apply when you enroll or decrease your
waiting period.
Waiting Period
Annual Employee Cost per
$100 Covered Salary
15 days
$.97
30 days
$.47
60 days
$.26
Here is an example of how the costs differ per waiting
period for an employee who earns $40,000 per year.
Waiting
Period
Supplemental LTD
After a year of benefits-eligible service, Emory
Healthcare offers employees the ability to purchase
additional LTD income protection. The supplemental
long-term disability plan benefit allows employees to
insure a higher percentage of income. You can increase
your LTD benefit to 66.67% of your pay for a cost of
$.32 per $100 of your salary. The additional LTD benefit
is tax free. Coverage begins on the first of the month
following your election.
During the annual benefits enrollment period, you will
need to complete a Supplemental LTD form located on
the Employee Resources site on www.ourehc.org in
the benefits section and submit to the Employee
Resource Center. You cannot enroll online.
Pre-existing Condition Limitations
When you first become eligible for STD, LTD and
Supplemental LTD coverage or decrease your waiting
Annual Cost
Cost / Paycheck
15 days
($40,000 ÷ $100) x $.97
= $388
$388 ÷ 24 pay periods =
$16.17
30 days
($40,000 ÷ $100) x $.47
= $188
$188 ÷ 24 pay periods =
$7.83
60 days
($40,000 ÷ $100) x $.26
= $104
$104 ÷ 24 pay periods =
$4.33
period for STD, your eligibility for coverage is subject to
pre-existing condition limitations. Under the terms of
the plans, you have a pre-existing condition if:
• you received medical treatment; consultation; care
or services, including diagnostic measures; or took
prescribed drugs or medicines in the three months
prior to your effective date of coverage; and
• the disability begins in the first 12 months after your
effective date of coverage.
9/14 2015 Annual Benefits Enrollment Guide
21
Additional Benefits
Life and Accident Insurance
Emory Healthcare provides basic life insurance through
The Standard equal to your annual base salary (up to
$50,000) at no cost to you. You don’t need to do
anything to enroll. You will be required to name a
beneficiary.
Supplemental Life Insurance
Employee Coverage
You can elect supplemental life insurance through The
Standard in increments of $10,000 up to $750,000. You
will need to complete evidence of insurability (EOI) for
elections of $500,000 or more.
During the annual benefits enrollment period, you can elect
to increase your existing coverage up to $20,000 without
satisfying evidence of insurability (EOI). If you initially waived
coverage or if you are increasing your existing coverage by
more than $20,000, EOI is required.
2015 Monthly Rates Per
$10,000 Coverage
Employee/Spouse/SSDP
Age
Less than 25
$ .53
25-29
.63
30-34
.84
35-39
.95
40-44
1.05
45-49
1.56
50-54
2.41
55-59
4.99
60-64
6.82
65-69
13.28
70+
21.54
Dependents
Rates per $2,000 coverage
Rates
$.42
Here is an example of how the costs for a
supplemental life insurance policy are calculated for an
employee, age 42, who elects a $100,000 life insurance
policy.
Annual Cost
Cost/Paycheck
($100,000 ÷ $10,000) x
1.05 x 12 = $126.00
$126.00 ÷ 24 pay periods = $5.25
Spouse/SSDP Coverage
Employees can elect spouse/SSDP supplemental life
insurance through The Standard in increments of
22
2015 Annual Benefits Enrollment Guide
$10,000 up to $500,000. They will need to complete
evidence of insurability (EOI) for elections of $100,000
or more.
During the annual benefits enrollment period, you can
elect to increase existing spouse/SSDP coverage up to
$10,000 without satisfying EOI. However, if you initially
waived coverage or if you are increasing your existing
coverage by more than $10,000, EOI is required.
Note: At age 70, supplemental life coverage reduces to
65% of the original face amount; at age 75, it reduces
to 50% of the original face amount.
Child Coverage
Life insurance can be purchased for your eligible
children in increments of $2,000 (up to $10,000). EOI is
not required.
Accidental Death & Dismemberment (AD&D)
Accidental Death & Dismemberment (AD&D) insurance
provides coverage for accidental dismemberment or
accidental death and is provided through The Standard.
You can purchase AD&D for yourself and your spouse/
SSDP in increments of $10,000 (up to $250,000).
Coverage begins on your date of hire.
You can purchase coverage for dependent children at
levels of $5,000, $10,000 or $15,000. No EOI form is
necessary to enroll in this benefit.
The AD&D monthly premium costs $.017 per $1,000
coverage.
Your Beneficiary
Your beneficiary is the person(s) who will receive your
life insurance benefits when you die. Your beneficiary
can be a person or multiple people, charitable
institutions or your estate. Once named, your
beneficiary remains on file until you make a change. If
your family situation changes, you will want to review
the beneficiaries on file and make updates, if
necessary. If you do not name a beneficiary, your life
insurance benefits will automatically go to your estate.
To designate a beneficiary, go to e-Vantage and then
your Benefits Summary on www.ourehc.org.
9/14
Additional Benefits
Emory Healthcare offers a variety of additional benefits for employees and their families. A brief summary is available
below. For more detailed information, access the Emory Healthcare Benefits website on www.ourehc.org, Employee
Resources and Your Benefits.
Long-Term Care Coverage
Aflac
Emory Healthcare offers optional coverage for long-term
care through UNUM. If you do not enroll within 31 days of
hire, you may enroll during the annual benefits enrollment
period and must complete an EOI form and be approved
by UNUM. Guaranteed issue is only available during the
new hire period. Long-term care is designed for people
who need assistance with daily living activities due to an
accident, illness or advancing age. Enrollment kits for you
and/or your spouse/SSDP are available online at http://
w3.unum.com/enroll/emoryhealthcare or in our Employee
Resource Center. For additional information, contact
UNUM at 1-800-227-4165.
Emory Healthcare provides a voluntary coverage
through Aflac for hospital, cancer and accident
insurance. These policies are available at group rates
that are lower than those typically available to
individual policyholders. You have access to a wide
range of policy and rider insurance products through
Aflac. For more information and to enroll, log on to
www.Aflac.com/Emory or call Aflac at 1-877-384-3344.
Group Home and Auto Insurance
Emory Healthcare provides access to this voluntary
coverage through MetLife for home and auto
insurance. This coverage is available at group rates that
are lower than those typically available to individual
policyholders. You have access to a wide range of
personal property and casualty insurance products
through MetLife. You may get coverage for your
automobile, boat, motor home or recreational vehicle.
For more information or to receive a personal quote,
call MetLife at 1-800-GET-MET8 (1-800-438-6388).
Prepaid Legal Plan
Whether you have planned legal expenses or just want
to be prepared for the unexpected, MetLife’s Group
Legal Plan through Hyatt Legal Services is available to
meet your needs. Through the plan, you have access to
more than 4,000 law firms and 9,000 attorneys
nationwide. Attorneys are available for both telephone
and office consultations. For more information, call
MetLife/Hyatt Legal Services at 1-800-821-6400. You
can enroll online in the enrollment tool on e-Vantage.
If you do not enroll within 31 days of hire, you may
enroll during the annual benefits enrollment period.
You can only cancel this benefit during the annual
benefits enrollment period.
For more information on other additional benefits available to you, go to the Your Benefits
site under the Employee Resources tab on www.ourehc.org.
9/14 2015 Annual Benefits Enrollment Guide
23
Additional Resources – Medical Information
The Emory Healthcare Network (EHN)
8-EVIP Emory Employees Appointment Line
Emory Healthcare Network (EHN) facilities include:
Emory Healthcare is committed to the health care
needs of its employees and to meet this commitment,
will facilitate and expedite employee access to Emory
providers. The EVIP Appointment Line was developed
for this purpose.
• Children’s Healthcare of Atlanta (including Egleston
and Scottish Rite)
• Emory Johns Creek Hospital
• Emory Rehabilitation Hospital, In Partnership with
Select Medical
• Emory Saint Joseph’s Hospital
• Emory University Hospital
• Emory University Hospital Midtown
• Emory University Orthopaedics & Spine Hospital
• Emory Wesley Woods Hospital
• Grady Memorial Hospital (including Hughes
Spalding)
• Southern Regional Medical Center
EHN physicians include:
• Emory Clinic physicians
• Private practice physicians who have admitting
privileges at either Emory University Hospital
Midtown, Emory Johns Creek Hospital, Emory Saint
Joseph’s Hospital or Emory Wesley Woods Hospital
Locate a participating EHN physician or facility at
www.aetna.com/docfind/custom/emory or
call 1-800-847-9026.
Out-of-State Coverage
If you or your covered dependents live outside of
Georgia, you may search for providers in Aetna’s
national network at www.aetna.com/docfind/custom/
emory.
International Coverage
If you live or travel outside the U.S., only coverage for
urgent/acute care is provided In-Network. Routine care
will be covered as Out-of-Core-Network. Call Aetna at
1-800-847-9026 for more information.
Emergency Coverage
Emergencies are always covered at the In-Network co-pay
or co-insurance level. Contact Aetna within 48 hours.
24
2015 Annual Benefits Enrollment Guide
EMORY HEALTHCARE EMPLOYEES AND FAMILY
MEMBERS CAN SIMPLY CALL 404-778-EVIP FOR
EXPEDITED ACCESS TO EMORY PHYSICIANS.
Features of the 8-EVIP line include:
• Senior level call agents, answering from 8:00 a.m. to
5:00 p.m., Monday-Friday, can assist you in making
appointments with Emory Clinic providers.
• Assurance that non-urgent appointments will be
scheduled within 14 days with the first available
provider. If your preferred provider is not available,
we will connect you with another well-qualified
Emory Clinic provider or Emory-affiliated practice.
• Assurance that urgent appointments will be
clinically reviewed to secure an appointment within
a medically appropriate time frame. This may
include a referral to Emory Healthcare’s Express Care
Clinic or an Emory-affiliated CVS MinuteClinic.
Emory HealthConnection
Emory HealthConnection is available to assist you in
selecting the right Emory provider to meet your needs.
Emory HealthConnection can be reached at www.
emoryhealthcare.org or by calling 404-778-7777.
Emory Pharmacies
These full-service pharmacies provide the same 90-day
prescription benefits as CVS/caremark.
The Pharmacy at Emory
Emory Clinic Building A, Second Floor
Monday-Friday, 9 a.m.-6 p.m.
Call 404-778-2022 or visit them online at
www.emoryhealthcare.org/pharmacy.
Emory Saint Joseph’s Apothecary
5671 Doctors Building, Second Floor
Monday-Friday, 9 a.m.-5 p.m.
Call 678-843-7400 for more information.
9/14
Important Numbers and Websites
Vendor/Organization
Emory Healthcare Employee Resource Center
Contact
Number
404-686-6044
Aetna:
• Medical
Web Address
www.ourehc.org
Email: ehc.hr/[email protected]
Locate a Provider:
www.aetna.com/docfind/custom/emory
1-800-847-9026
www.aetnanavigator.com
1-866-524-2483
Plan Comparison Tool:
https://www.aetna.com/planselection/mbrDis.jsp?id=339
• Behavioral Health
• Wellness Incentive Programs
• Aetna/PayFlex (Health Savings Account and
Flexible Spending Accounts)
1-888-678-8242
Aetna Dental
1-877-238-6200
www.aetna.com/docfind/custom/emory
Aflac
1-877-384-3344
www.Aflac.com/Emory
CVS/caremark
• Pharmacy Manager - HSA and POS plans
1-866-601-6935
Website available 1/1/2015
EyeMed Vision Care
1-855-270-2343
www.eyemedvisioncare.com
Hyatt Group Legal (MetLife)
1-800-821-6400
www.legalplans.com
MetLife Auto and Home
1-800-GET-MET8
https://mybenefits.metlife.com
The Standard (Life Insurance)
1-866-756-8118
www.standard.com
UNUM (Long-Term Care)
1-800-227-4165
http://w3.unum.com/enroll/emoryhealthcare
UNUM
• Short-Term Disability
• Long-Term Disability
• Supplemental LTD
1-800-858-6843
(Customer Service)
1-866-765-8490
(Claims)
www.unum.com
9/14 www.aetnanavigator.com
2015 Annual Benefits Enrollment Guide
25
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2015 Annual Benefits Enrollment Guide
9/14