California TSRI Grad Student Benefit Enrollment SlidesPresentation Transcript
The Scripps Research Institute Welcome to Benefit Enrollment for TSRI Graduate Students
TSRI Grad Student Benefits
Medical, Dental, Prescription, Vision and
Mental Health Plans
Human Resources Department
Benefits Web Site
Claims Questions or Concerns
Paige Gearhart, Sr. Benefits Analyst
New Hire Website
Health Plan Card
Health Plan cards will be mailed to your home address in less than 2 weeks.
Make sure we have your correct address
Your ID# will show on your card and not your SS#
Your name will appear on the health plan card not your dependents.
Principal Financial Group
Preferred Provider Organization (PPO)
Policy Number ASOP90844
Aetna Signature Administrators
Network of Doctors
Medical Plan Service PLAN 7 None None 70% None 100% 100% 100% 100% Other Services Well Baby Care Physical Exam Cancer Screening Immunizations $200 70% $0 100% Inpatient Services Deductible (per admit) Hospital Charges NON-NETWORK $200 70% 70% 70% IN–NETWORK $0 100% 100% 100% Outpatient Services Deductible Office Visit Surgery Lab/X-Ray
Medical Plan Helpful Hints
Chiropractic and Acupuncture coverage
Limited to 20 visits a year
Be sure to keep your Explanation of Benefits (EOB’s)
Delta Dental Insurance
PPO Delta Dental option
Policy # 8593
PPO Delta Dentists
100% coverage for 2 cleanings a year (every 6 months),
$50 deducible is NOT applied.
Premier and All Other Dentists
80% coverage for 2 cleanings a year
After, $50 deductible.
For child dependents up to age 19. (Maximum benefit for orthodontia is $1,500)
Dental Plan Service PPO Delta Dentists Delta Premier Dentists All Other Dentists * Reasonable and Customary Charges $1500 $1500 $1500 Maximum Benefit (Per year per person) 50%* 50% 50% Orthodontic Benefits (Dependents to age 19) 50%* 50% 50% Major Benefits Crowns, Jackets, Implants, and Cast Restorations 80%* 80% 80% Basic Benefits Oral Surgery, extractions & fillings 80%* 80% 100% Diagnostic & Preventative Services Two per 12-month period $50.00 $50.00 $50.00 (Not Applied to Diagnostic and Preventative Services) Deductible (Per Person)
Prescription Benefit Service
Group # K011-0001
Savon, Longs Drugs, Ralph's, Rite Aid…
Generic Co-Pay = $10
Formulary Brand Name Co-Pay = $25
Non-Formulary Brand Name Co-Pay = $50
Medical Eye Services
MES Network of Providers
Must have a Claim Form
One comprehensive exam every 12 months
One standard frame up to $110 every 24 months
One pair of standard lenses every 12 months
(additions such as scratch resistance, UVA protection, ect., are out of pocket expenses)
One pair of contact lens up to $100 every 12 months
Only buy “$100” worth of contacts not a “year’s” worth.
Mental Health Plan
United Behavior Health
Mental Health Network
Call for an in-network provider
100% In-Network Benefit
Maximum of 40 visits a year
50% Out-of-Network Benefit
Maximum of 40 visits a year
Employee and Graduate Student Counseling Department
No cost, confidential, professional counseling services for employees, graduate students, and family members
Jan Hill, LCSW
784-2950 or firstname.lastname@example.org
Daphne Lurie, PhD
784-7915 or [email_address]
Making Changes to your Medical and Dental Plans
Must have a Qualified Status Change
Birth, Marriage, Divorce
Loss of other Coverage, and Obtaining other Coverage (must provide proof)
Coverage Change Form must be filled out and turned into HR within… 31 DAYS!!!
Two weeks in November to make any changes to your medical and dental plans.
Elections are made through a secure web-based system.
All changes will be made effective January 1, 2009.
Voluntary Life Insurance
Adams Group Insurance (AGI)
You may purchase supplementary life insurance during Open Enrollment
Spouses and children are eligible
Rates are based on age
Emergency, Dial 77
Report injury to your Supervisor and
Sharp Rees-Stealy is our Occupational Medical Provider.
Located on Activity Road in Mira Mesa
Directions are posted in all labs
Shiley Health and Fitness Center
24 Hour Fitness
UCSD’s RIMAC Center (Recreation, Intramural, Athletic, Complex)
Memberships for Both Facilities are Paid for by the Graduate Student Office
Contact Marylyn Rinaldi for more details, 4-2877.
Yoga – Pia Weber
Tai Chi – Jesse Tsao
On-Site Seated Massage every other Friday. Contact HR for more info, 4-8487.