2012 Benefit Enrollment Guide - Education Management Corporation

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Brought To You By: Vision Your eyes work hard for you every day. Whether you are staring at a computer screen, reading a book or driving home from work, it’s important to have excellent vision. Not only can a regular eye exam uncover vision problems, but vision checkups can offer clues to other underlying health conditions, as well. 1-800-638-3120 www.myuhcvision.com UnitedHealthcare Vision is EDMC’s vision plan provider. With a state-of-the-art optical lab, diversified network, electronic claims system and superior customer care, it’s clear to see the emphasis UnitedHealthcare places on the quality of the materials and services they provide. During enrollment, you have two options to consider: Option 1.… Premium Plan Option 2.… Waive Coverage To help make your decision, determine your usual annual expenses for vision care and compare that against your annual pretax contributions and any coinsurance you might pay throughout the year. Remember that you can also use a health care flexible spending account (FSA) to pay for vision care expenses. Consider this as an alternative if you are not sure whether you want to elect vision benefits or not. See page 27 for more about the tax-advantaged flexible spending accounts (FSAs). Higher level of coverage, better service — when you stay in the network While you are covered at any licensed vision care provider, your coverage is greater if you visit a network provider. See the vision benefits summary on the next page for details. Network providers will also file claims for you. Just show your UnitedHealthcare vision member ID card at the time of your visit and they’ll take it from there. As an enrolled member, if you visit a provider who is not in the network, go to www.myuhcvision.com for instructions on how to file an out-of-network claim. Finding a network provider near you is a quick click or call away Log in to www.myuhcvision.com and select the provider locator option to look up participating vision care providers in your area. No Internet access? Call 1-800-839-3242 — any time, 24/7 — and follow the voice response prompts to find a vision provider near you. 18 Questions? Contact HR One Connect at 1.888.471.3362 (1.888.HR1.EDMC).
Vision Benefits Summary Benefit Benefit Period In Network Premium Plan 12 month period from last date of service Out of Network Vision Exams (one every 12 months) 100% Up to $60 Lenses* (once every 12 months) Single Vision 100% $40 allowance Bifocal 100% $60 allowance Trifocal 100% $80 allowance Lenticular 100% $80 allowance Polycarbonate 100% Not Covered Scratch-Resistant Coating 100% Not Covered Frames (once every 12 months) $130 $50 Contact Lenses (once every 12 months) Elective-covered in full** 100% $150 Elective-specialty*** $150 $150 Medically Necessary**** 100% $250 Laser Vision Correction Access to discounted laser vision correction procedures from numerous provider locations throughout the U.S. To find a participating laser vision correction surgeon in your area, visit www.myuhcvision.com or call 1-877-28-SIGHT. ****One pair of standard single vision, lined bifocal, lined trifocal or standard lenticular lenses is covered in full. Options, such as progressive lenses, tints, UV, and anti-reflective coating may be available at a discount. ****The fitting/evaluation fees, contacts (including disposables) and up to two follow-up visits are covered in full (after the applicable co-pay) for many of the most popular brands on the market. If covered disposable contact lenses are chosen, up to 6 boxes (depending on your prescription) are included when obtained from a network provider. UnitedHealthcare Vision’s covered-in-full contact lenses may vary by provider. ****Toric, gas permeable, and bifocal contacts are examples of contacts that are outside of the “covered-in-full” category. ****Necessary contact lenses are determined at the provider’s discretion for one or more of the following conditions: Following post-cataract surgery without intraocular lens implant, to correct extreme vision problems that cannot be corrected with spectacle lenses and with certain conditions of anisometropia or keratoconus. If your provider considers your contacts necessary, ask your provider to contact UnitedHealthcare Vision concerning the reimbursement that UnitedHealthcare Vision will make before you purchase such contacts. The chart shown above represents an overview of the covered services and plan limitations within each of the vision plan categories. The above overview is not a complete description. The UnitedHealthcare Vision contract and benefit booklet for the plan will govern if any discrepancies exist between this overview and the contract and/or actual benefit booklet. Questions? Contact HR One Connect at 1.888.471.3362 (1.888.HR1.EDMC). 19
Page 1 and 2: Educated Choices 2012 Benefit Enrol
Page 3 and 4: Educated Choices Your Educated Choi
Page 5 and 6: Benefit Costs If you choose to enro
Page 7 and 8: About domestic partner coverage You
Page 9 and 10: When Participation Ends For medical
Page 11 and 12: How the plans work You have the fre
Page 13 and 14: Medical Benefits Summary Benefit Di
Page 15 and 16: Brought To You By: Prescription Dru
Page 17 and 18: Brought To You By: Dental A healthy
Page 19: Dental Benefits Summary Benefit Ind
Page 23 and 24: Brought To You By: Life Insurance L
Page 25 and 26: Life Insurance: Take it with you if
Page 27 and 28: Brought To You By: Disability Insur
Page 29 and 30: Brought To You By: Flexible Spendin
Page 31 and 32: Brought To You By: The Retirement P
Page 33 and 34: Your Wellness EDMC’s benefit prog
Page 35 and 36: Manage your chronic condition Asthm
Page 37 and 38: How The Plan Might Use Or Disclose
Page 39 and 40: If you have limited income and reso

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