Annual Benefits Enrollment - Yale University

Annual Benefits Enrollment - Yale University

2012 December

Annual Benefits Enrollment

1 – 15, 2011

2012 Annual Benefits Enrollment Guide • Clerical & Technical | Service & Maintenance | Security Staff

Clerical & Technical, Service &

Maintenance and Security Staff

Welcome to Yale University’s

2012 Annual Benefits Enrollment

Important Information............................................................................................ 2

Employee Contributions..........................................................................................4

Medical and Vision Plan Options.............................................................................. 5

Dental Plan Options................................................................................................ 7

Flexible Spending Account Plans..............................................................................8

Other Benefits Programs........................................................................................11

Contact Information...............................................................................................13

Yale offers excellent benefits as part of a long-standing commitment to the health and well-being

of its faculty and staff.

Annual Benefits


December 1–15, 2011

Flexible Spending


December 1–31, 2011

With a wide array of benefits to choose from, you can select the benefits that meet the needs

of you and your family. Now is the time of year to review your benefits, and take action to

update your medical, dental and vision benefits for 2012.

This year, Annual Benefits Enrollment runs from December 1 through December 15, 2011.

Whether or not you choose to enroll or make changes to your benefits for next year, we strongly

recommend that you review your choices so that you fully understand your options for 2012.

Take Action by December 15, 2011!

n Go online. If you are making changes to your benefits for next year, please select your

2012 benefits online at My Benefits, Yale’s benefits gateway, accessible on the University

portal after logging in at Yale’s health insurance providers also

have a number of tools and resources available through their web sites that can help

support your decision-making process.

n Confirm your dependents. Be sure to check your dependent coverage and remove

any ineligible dependents—you can do so while visiting the My Benefits web site.

n Remember to enroll. Make sure you get the medical, dental and vision coverage that best

suits your needs. If you would like to continue participating in a Flexible Spending

Account plan in 2012, you will need to re-enroll between December 1 and December 31.

n Contact the plan providers. You will find contact information on page 13 of this

guide if you have questions about benefits or available providers.

n Update beneficiary information. If you haven’t already done so, update your life

insurance beneficiary information via the My Benefits web site.

n Keep this guide handy. Refer to the information in this guide to help you make

wise benefits decisions.

If You Don’t Take Action

If you choose not to take action during this Annual Benefits Enrollment period, you

will continue in your existing medical and dental plans with no interruption of coverage.

Exception: You must enroll (or re-enroll) in a Flexible Spending Account plan for

2012 in order to participate.

Highlights of the changes beginning

January 1, 2012 include:

n New EyeMed Vision Plan—effective January 1, 2012, you will have the option of two vision

plans, Basic and Enhanced. See page 5 for details.

■■Yale Advantages—a new voluntary employee discount site that provides easy access to the

already familiar Yale-affliated discounts such as cell phones, computers and travel. The site

can be found on My Benefits (

n Tuition reimbursement–the deadline to submit your 2011 claim reimbursement for 2011

is December 18, 2011.

Please note:

After Annual Benefits

Enrollment ends, changes

to health care benefits can

be made if you experience

a qualifying life event

(such as marriage or the birth

of a child) or at the next

Annual Benefits Enrollment.

(Please see page 3 for a

complete list of qualifying

life events.)

Enroll online at


Important Information

Confirm Your Dependents

Be sure to confirm your eligible dependents between December 1 and December 15, 2011.

Your dependents will be eligible to receive medical coverage until the end of the month in

which they reach age 26.

Dependent children are eligible for dental coverage until the end of the month in which

they reach age 19 (or until the end of the month in which they reach age 25 if they are a

full-time student).

n Eligible dependents are:

■–Child, stepchild, adopted child (including child placed for adoption), foster child

or legal ward

ID Cards and

Benefits Confirmation


In mid-January, you will

receive (if applicable) your

medical, dental and vision ID

cards, a Benefits confirmation

statement and, if you enrolled

in a Flexible Spending

Account, a welcome letter

with useful information.

If neccessary, you may

contact the health care

vendors directly to verify

coverage—see page 13 for

contact information.

■–Same-sex spouse, civil union partner and domestic partnership (on file with Yale

prior to April 2006)

Important Note: If you add dependents, you will be asked to provide documentation, such

as a marriage certificate for a spouse or a birth certificate for your child, within 30 days of

enrollment. For dental coverage, a full-time course schedule will be required if your child is

over the age of 19.

To confirm your eligible dependents and make changes, please go online to My Benefits,

accessible after logging in at


2012 Annual Benefits Enrollment Guide • Clerical & Technical | Service & Maintenance | Security Staff

Changing Your Elections

and Qualifying Life Events

Consider your benefits options carefully before you make your elections. Once you choose

your benefits, including Flexible Spending Account elections, they will be in effect for

the entire calendar year unless you have a qualifying life event during the year, such as:

■■Birth, adoption of a child, acquired legal guardianship or civil court award

■■Marriage, divorce or loss of domestic partnership

■■Death of a dependent

■■Eligibility for Medicare

■■Change to spouse’s benefits/eligibility

■■Change in day care provider rates

■■Change in dependent/child status (e.g., student status changes, age)

■■Change in other coverage (e.g., you or one of your covered dependents gains or loses other

benefits coverage due to a change in employment)

Coverage Options

You can choose from one of the following coverage categories:

■■Employee Only

■■Employee + 1

■■Employee + Family

■■Employee + Same-sex Spouse or Civil Union Partner

A Note for New


If your hire date is

December 2 or later, you

will only be required to

complete enrollment for 2012.

Please note: You must enroll

in most benefits within

30 calendar days of your hire

date. Visit the My Benefits

web site to view all benefits

available to you.

■■Employee + Same-sex Spouse or Civil Union Partner + Child(ren)

You can choose various categories of coverage for different plans. However, you must enroll

yourself in order to enroll your dependents.

Enroll online at


Employee Contributions

Your 2012 Weekly Medical Contributions

Weekly Employee Cost

Yale Health Plan 2012

Single $0.00

2-Person (Employee + spouse or child) $0.00

Family $0.00

Same-Sex Spouse or Partner* $0.00

Aetna Choice POS II 2012

Single $26.77

2-Person (Employee + spouse or child) $39.23

Family $47.54

Same-Sex Spouse or Partner* $12.46

Same-Sex Spouse

or Partner –

Tax Exemption

If you can claim your samesex

spouse, civil union

partner or domestic partner

(on file with Yale prior to

April 2006) as a federal

tax dependent under

Section 152 of the Internal

Revenue Code, you may

apply for an exemption

of federal taxation for the

value of coverage provided

to your spouse or partner.

Contact Employee Services

by e-mail at employee. or call

(203) 432-5552.

Your 2012 Weekly Dental Contributions

Weekly Employee Cost

(18+ months of service)

Weekly Employee Cost

(18 months of service

or less)

Delta Dental 2012 2012

Single $0.00 $0.00

2-Person (Employee + spouse or child) $4.41 $8.82

Family $8.82 $17.64

Same-Sex Spouse or Partner* $4.41 $8.82

CIGNA DMO Dental** (closed to new members) 2012 2012

Single $0.00 N/A

2-Person (Employee + spouse or child) $2.93 N/A

Family $5.93 N/A

Same-Sex Spouse or Partner* $2.93 N/A

Your 2012 Weekly Vision Contributions Basic Enhanced

EyeMed Vision Plan

Single $0.93 $1.56

2-person (Employee + spouse or child) $1.77 $2.98

Family $2.59 $4.38

Same-Sex Spouse or Partner* $0.84 $1.41

Supplemental Life Premium Rate Schedule

Age bracket

Monthly costs per

$1,000 of coverage

Age bracket

Monthly costs per

$1,000 of coverage

less than 30 0.046 55–59 0.329

30–34 0.050 60–64 0.509

35–39 0.059 65–69 0.799

40–44 0.085 70–74 1.200

45–49 0.133 75 and up 1.698

50–54 0.200

* The University only recognizes same-sex spouses, civil union partners and domestic partnerships (on file with

Yale prior to April 2006). Contributions for medical, dental or vision are deducted on a post-tax basis in

accordance with Internal Revenue Code Section 152.

** CIGNA DMO will continue to be available only to employees currently enrolled (2011). Enrollment for 2012 is closed

to new participants; however, Delta Dental will be available as an option for those in the CIGNA DMO plan.


2012 Annual Benefits Enrollment Guide • Clerical & Technical | Service & Maintenance | Security Staff

Medical and Vision Plan Options

Yale Health Plan

Yale Health currently serves three-quarters of Yale faculty and staff, as well as their covered

dependents, in the state-of-the-art new Yale Health Center, which opened in September 2010.

Yale Health has been meeting the needs of the Yale community for nearly 40 years, and its

membership continues to grow.

Care at the Yale Health Center begins with its comprehensive primary care practice, staffed

by experienced professionals in Internal Medicine, Obstetrics and Gynecology, and Pediatrics.

Members also have access to an extensive network of specialists drawn largely from the faculty

of Yale Medical School.

Yale Health offers easy access to services and facilities with limited co-pays and no paperwork.

At the extraordinary new Yale Health Center facility located at 55 Lock Street, members enjoy

on-site, around-the-clock urgent care, a comfortable inpatient care unit, extended hours in

primary care departments, an on-site pharmacy and a full range of services, including lab,

X-ray, CT scan, MRI, ultrasound and endoscopy.

For 2012, your Yale Health Plan benefits remain 100 percent subsidized by the University.

Aetna Choice POS II*

A national Point-of-Service (POS) plan, the Aetna plan gives you a choice each time you need care.

Even though Aetna offers a comprehensive in-network physician base, you are likely to pay more

out of pocket than if you choose Yale Health. This alternative plan is available at a greater cost but,

depending on your circumstances, can be an appropriate choice for you and your family.

* Staff must have three (3) or more years of service to be eligible for this plan

EyeMed Vision

You have the choice of two vision plans: Basic and Enhanced. The Basic option offers allowances

for frames, lenses and contact lenses. In addition to these services, the Enhanced plan also offers

contact lens fittings, polycarbonate lenses for children, frames every 12 months, a yearly eye

exam (in addition to the Yale Health Plan and Aetna exam), and more. If you wish to sign up for

either plan, you will need to enroll during Annual Benefits Enrollment.

Did you know that you can

submit a claim for out-ofnetwork


even if the store (e.g.,

Lencrafters, JCPenney) is

having a sale that is better

than these benefits This

allows you to receive one

reimbursement under the

plan at all times.

Basic Plan

Enhanced Plan

In-Network Member Cost

Exam Not Covered $15

Exam Frequency n/a Once every 12 months

Contact Lens Fitting Not Covered Standard lens fitting up to $40

Frames $0; $130 allowance ; 80% of charge over $130 $0; $130 allowance ; 80% of charge over $130

Frames Frequency Once every 24 months Once every 12 months

Standard Plastic Lenses

Single Vision



Standard Progressive






Lens Options: UV

Treatment, Tint &

$15 each $15 each

Scratch Coating

Standard Polycarbonate


Standard Polycarbonate


(under age 19)


Contact Lenses $0; $130 allowance ; 85% of charge over $130 $0; $130 allowance ; 85% of charge over $130


Disposable $0; $130 allowance ; plus balance over $130 $0; $130 allowance ; plus balance over $130

Laser Vision Correction: $15% off retail price or 5% of promotional price $15% off retail price or 5% of promotional price

Lasik or PRK

Out-of-Network benefits are available; visit for a complete

Benefits summary.

Enroll online at


Here’s a closer look at your medical plan

options for 2012:


The Aetna Alternate

Prescription Drug Plan is

closed to new participants.

If you are currently covered

under this plan, you can

continue to participate

in 2012.

Hearing Aid Discount

Program (AHAA)

AHAA is a discount hearing

aid service provider that

offers discounted hearing

aids to you, your immediate

dependents and extended

family members. Just present

your Yale ID at any of the

participating providers,

including Yale’s own

Hearing & Balance Center,

for a discount.

You may also visit AHAA’s

web site at

to locate a provider.

Benefits & Yale Health Plan Aetna Choice POS II

Services In-Network 1 In-Network Out-of-Network


Deductible 2 None None $250 Individual

$500 2-Person

$750 Family

Office Visits $0 $5 30%


Drugs (up to

1 month)


Hospital Services








Yale Health Plan only provides out-of-area coverage for emergency and urgent care.


The amount of out-of-pocket expenses per calendar year you must pay for service before the plan pays any expenses.


Co-pays apply when purchased at the Yale Health Center pharmacy; your outside pharmacy prescription out-of-pocket expense

is the greater of the co-pay or 20% of the cost.


In-Vitro Fertilization & Advanced Reproductive Technology (ART) covers four (4) cycles of ovulation induction and artificial

insemination. This is a University Lifetime Maximum per contract regardless of insurance carrier chosen.


The maximum amount you have to pay toward the cost of your medical care in the course of the calendar year not including

deductible or co-pays.

$5 Generic 3

$5 Generic

$20 Preferred Brand 3

$30 Non-Preferred Brand 3

$20 Preferred Brand

$30 Non-Preferred Brand

$0 $0 30%

$0 $0 30%


You pay 20%

(not subject to

the deductible)

$50 (waived if admitted)

$0 $0 30%

Routine Physicals $0 $5 (frequency limits

may apply)

Routine Eye





$0 $5 (1 exam

every 12 months)

Physical Therapy: $0

Chiropractic: Up to

12 visits per year, $50

maximum reimbursement

per visit

$5 30%

Not covered

30% (1 exam

every 12 months)



$20,000 University Lifetime Maximum; Pre-authorization Required


Fertilization & Four (4) cycles, University Lifetime Maximum; Pre-authorization Required



Maximum 5 None None $1,000 Individual

$2,000 2-Person

$3,000 Family

This chart is a summary of the benefits provided under each option. For complete details,

refer to the Yale Health Plan and Aetna Plan documents located on the My Benefits web site.

The applicable plan documents govern all questions of interpretation.


2012 Annual Benefits Enrollment Guide • Clerical & Technical | Service & Maintenance | Security Staff

Dental Plan Options

Dental Plans

Delta Dental

Delta Dental will continue as Yale’s dental provider in 2012. Delta Dental offers two networks:

Delta Dental Premier and Delta Dental PPO. Yale’s plan with Delta incorporates both dental

provider networks, which allow employees greater discounts when using the dentists in either

network. There is no annual deductible and no out-of-pocket maximum required.

As always, you will continue to have the flexibility of seeing the dentist of your choice.

The difference will be visible in your out-of-pocket expenses. By receiving care from an

in-network dentist either through the Premier network or PPO network, you will take

advantage of greater savings than if you received care from a non-participating dentist.

Below is a general summary of covered services under the Dental Assistance Plan administered

by Delta Dental. This is a brief summary and the plan documents will prevail.

Service Category Covered Services Percentage Reimbursement

Preventive & Diagnostic

Basic Restorative

Major Restorative


Oral exam


Fluoride treatment








Space maintainers


Emergency treatment to relieve dental pain

when no other definitive dental services are



Amalgam restorations


Composite restorations


Oral surgery/extractions


Endodontics (root canal therapy)


Local anesthetic, analgesic and routine

post-operative care of extractions and other



General anesthetic when medically necessary

in conjunction with oral or dental surgery,

and if the anesthetic agent produces





Inlays, onlays

100% (up to the maximum

allowable amount)

80% (up to the maximum

allowable amount)

50% (up to the maximum

allowable amount)

Protecting Your

Identity Is Important

When you sign up for dental

coverage with Delta Dental,

you will receive an ID card

with a unique number

for use with their plans—you

will not be asked for your

Social Security number

as identification.

Please review a summary of dental benefits online at

CIGNA DMO Dental Care Plan (closed to new enrollments)

Under the CIGNA DMO Dental Care Plan, there are no forms, deductibles, or annual or

lifetime maximums. You are responsible for paying a patient charge directly to the provider

when you or a dependent receives care, and you must see a CIGNA DMO provider in order

to have benefits paid. Covered services include:

■■Preventive care: No patient charges for most preventive procedures

■■Restorative care: Several restorative and specialty procedures are available for low, pre-set fees

■■Oral surgery


Enroll online at 7

Flexible Spending Account (FSA) Plans


You can enroll in an FSA

for 2012 from December 1

through December 31, 2o11.

Go to My Benefits for links

to lists of eligible expenses

under both Flexible

Spending Accounts.

Important Features

of Your Spending

Account (YSA)

The YSA web site helps

you manage your account

balance(s), submit claims

(if necessary), and learn

more about eligible expenses

and merchants. You can

access YSA information

via the My Benefits web

site; click on Access, located

to the right of My Spending

Accounts (under the My

Current Benefits section).

Your Spending Account tm (YSA)—Flexible

Spending Account Plan

To participate, you must enroll every year before the December 31 deadline. Yale Flexible

Spending Account plans give you the opportunity to pay for certain health care and dependent

care out-of-pocket expenses with pre-tax dollars. You can participate in the Health Care

(Medical/Dental/Vision) Expense Reimbursement Account and/or the Child/Dependent Care

Expense Reimbursement Account.

Health Care (Medical/Dental/Vision) Expense

Reimbursement Account

The Health Care (Medical/Dental/Vision) Expense Reimbursement Account helps you

bridge the gap between health care costs covered by your medical, dental and vision plans and

expenses that you pay out of pocket for yourself and your eligible dependents. Reimbursable

expenses include many out-of-pocket costs not covered by the medical, dental and vision

plans, such as deductibles, co-pays, costs that exceed reasonable and customary limits, and

limited over-the-counter medications and supplies, to name a few.

For a complete list of eligible expenses and those that require prescriptions,

please visit My Benefits at

n Log in to the University portal with your Yale NetID and password, then

click on My Benefits.

n Under My Current Benefits on the left side of your screen, click on Access

located to the right of My Spending Accounts.

n At the top of your screen, select the Knowledge Center tab to view the list of

eligible expenses.


2012 Annual Benefits Enrollment Guide • Clerical & Technical | Service & Maintenance | Security Staff

Child/Dependent Care Expense

Reimbursement Account

If you have elder care responsibilities, or are a working parent with dependents, you

can put the Child/Dependent Care Expense Reimbursement Account to work for you.

If you are married, you may contribute to this account if your spouse works, attends

school full time or is disabled. When you participate in the Child/Dependent Care Expense

Reimbursement Account, you not only effectively budget for these predictable expenses,

you also gain real tax savings. Special contribution limits may apply if you are married,

as shown in the following table.

Child/Dependent Care Expense Reimbursement Account Contribution Limits

If you are married, and…

You or your spouse earns less than $5,000

Your spouse also participates in a Child/Dependent

Care Expense Reimbursement Account

You and your spouse file separate federal income

tax returns

Then, your contribution is limited to…

The lower income amount

A combined total contribution of $5,000

$2,500 contributed by you

$2,500 contributed by your spouse

Direct Deposit

If you are re-enrolling in

a Flexible Spending Account

and you have already set up

direct deposit with YSA*,

there’s no need to make any

change; your reimbursements

will continue to be deposited

directly to your bank account

without interruption.

If you qualify, you can contribute to the Child/Dependent Care Expense Reimbursement

Account to pay dependent care expenses for:

n A child under age 13, or

n Other eligible dependents (e.g., a parent or spouse), who spend at least eight hours a day

in your home, require care and are considered dependents for tax purposes.

You can use the account to reimburse the cost of an in-home day care provider, day care

center or similar day care service, or elder care facility. Overnight or evening care is eligible,

if required for business reasons. Overnight camp is not eligible.

Things to Consider Before You Enroll (or Re-enroll)

If you would like to enroll (or re-enroll) in one or both Flexible Spending Account plans,

here’s what to do:

■■Decide how much to contribute—Based upon your anticipated expenses for the year,

decide on the amount to set aside that’s right for you.

Contribute up to a maximum of $12,000 to the Health Care (Medical/Dental/Vision)

Expense Reimbursement Account and/or up to $5,000 to a separate Child/Dependent Care

Expense Reimbursement Account. Your contributions will be deducted from your

paycheck before taxes are calculated.

■■Consider auto-reimbursement of your claims—When you enroll for 2012, you’ll have the

option to choose automatic reimbursement of claims. By enrolling in this feature, you are

authorizing Yale to allow the medical, dental and vision carriers to submit your co-pays,

deductibles and co-insurance information directly to YSA* for reimbursement from your

Health Care Expense Reimbursement Account.

* Yale’s Flexible Spending Account plan is referred to as “Your Spending Account” on the My Benefits web site.

Enroll online at


Things to consider when choosing the

auto-reimbursement option:

■■You can opt in or out of this feature at any time during the calendar year by contacting

Employee Services at 1-203-432-5552; select option #6.

■■Over-the-counter medicine expenses must be submitted to YSA directly at:

Y.S.A., P.O. Box 785040, Orlando, FL, 32878-5040 or 1-888-211-9900 (fax).

■■Do not submit claims for out-of-network medical expenses directly to YSA. These

types of expenses will be sent to YSA via the automatic reimbursement of claims

process (if selected).

■■Do not select this feature if you have a secondary insurance program.

■■Do not select this feature if you are covering a same-sex spouse, civil union or domestic

partner (on file with Yale prior to 2006) under your health insurance or if you are enrolled

in a Health Savings Account as part of a high deductible health insurance plan.


of Your Claims

You must re-enroll in

the claims automatic

reimbursement feature

for 2012. Your 2011 election

will not carry over to 2012.

■■Do not select this feature if you are covering a dependent on your medical insurance

who is not your legal tax dependent as defined by the IRS.

■■Receipt of reimbursements may take up to 60 days based on when the provider submits

the claim to the carrier.

Grace Period Extension

If you are currently enrolled in a 2011 Health Care (Medical/Dental/Vision) and/or

Child/Dependent Care Expense Reimbursement Account, you can incur eligible medical

and dependent care expenses up to March 15, 2012, and still be reimbursed from your 2011

accounts. Be sure to submit these expenses by April 30, 2012.

To continue participating, you must re-enroll online during Annual Benefits Enrollment,

beginning December 1. Remember, the deadline to enroll in a Flexible Spending Account

for 2012 is December 31, 2011.

Please review the following timeline for important deadlines for 2011 and 2012 Flexible

Spending Account participants:

December 1 through

December 31, 2011

Enroll in Flexible

Spending Accounts and


for 2012

March 15, 2012

Last day to incur

eligible Flexible Spending

Account expenses

for 2011

April 30, 2012

Last day to submit

reimbursement requests for

eligible Flexible Spending

Account expenses from

your 2011 accounts


2012 Annual Benefits Enrollment Guide • Clerical & Technical | Service & Maintenance | Security Staff

Other Benefits Programs

Commuter Benefits

Yale’s Commuter Benefits Program can help save you money and help to save the

environment, too! Commuter Benefits accounts provide tax-exempt funds you can

use to pay for eligible transit and off-campus parking services you need every day.

And, funding your account couldn’t be easier—it’s handled through a simple

payroll deduction.

There are two types of accounts:

■■Off-Campus Parking—If you park in a private (non-Yale) parking facility, you can

take advantage of pre-tax savings on your parking expenses up to the IRS limit of

$230 per month.

■■Transit Commuting (by train, bus and van pool)—Purchase your transit pass online

through the My Benefits web site and you will receive a savings on your transit expenses

up to the IRS limit of $230 per month. Your monthly transit ticket/pass will be mailed

directly to you. You will also receive three daily parking permits per month, and can take

advantage of the Guaranteed Ride Home Program.

You may go to the My Benefits web site anytime of the year to enroll in either of these accounts.

Under My Spending Accounts on the left side of the screen, click on Commuter. On the Your

Spending Account landing page, click on the Commuter tab.

Beginning with January 2012 commuting, payroll deductions will process in the month in

which commuting occurs; therefore, your payroll deduction in January will pay for January’s

transportation or off-campus parking expenses.

The monthly pre-tax commuter limits will remain unchanged at $230 for off-campus

parking and transit.

Due to pending legislation, these limits are subject to change. You may find up-to-date

information on the Your Spending Account (YSA) web site, as decisions become finalized.

please NOTE: The American Recovery and Reinvestment Act of 2009, which

increased the monthly transit pre-tax limit to $230, is set to expire on December 31, 2011,

and this limit may change to $125. This change does not apply to Off-Campus Parking.



Important ordering

deadlines to receive

your tickets on time:

Metro North and

Long Island Rail Road

commuters: Order your

tickets online by the

4th of the month.

Shoreline East, Amtrak

and all other train and

bus line commuters:

Order your tickets online

by the 10th of the month.

All riders: Passes are

mailed to your home

address by the 20th to

the 23rd of the month.

NOTE: Payroll deductions

will begin within 1-2 pay

periods following order


Enroll online at


Tuition Reimbursement

Eligible staff may receive tuition assistance for certain degree, non-degree and job-related

courses. Please note the following important updates:

■■The deadline for submission is December 18, 2011 (for your 2011 benefits).

■■While YSA ordinarily requires that you submit proof of your final grades to receive your

reimbursement, at year-end you may instead submit a letter or an e-mail from your

professor with the course name and the grade you will receive. If a final grade has not been

determined, the professor can note that the grade is “pass” or “fail.”

■■Reimbursements for qualified claims will continue to be made via your paycheck.

Yale Advantages

Yale Advantages, a new voluntary employee discount site, is being introduced in December

and will be available via the My Benefits web site. This site will provide easy access to the

already familiar Yale-affiliated discounts such as cell phones, computers and travel.

Visit Yale Advantages mia My Benefits at


2012 Annual Benefits Enrollment Guide • Clerical & Technical | Service & Maintenance | Security Staff

Contact Information

The following table provides important phone numbers and web sites that you may need

when enrolling for your benefits and throughout the year.

Contact Online Telephone


Yale Health Plan




Vision EyeMed 1-866-723-0514


Hearing Aid

Discount Program

Flexible Spending

Accounts (FSAs),

Commuter Benefits

and Tuition


Counseling and

Support Services

403(b) Plans





AHAA 1-800-984-3272


Magellan Health


My Benefits


1-877-352-5552; press 6 1-800-327-9240

Staff Pension Plan 1-877-352-5552 ext. 5

New IRS Limits on Retirement Plans for 2012

Retirement Plan Maximums 2012 2011

403(b) employee contribution $17,000 $16,500

403(b) employee catch-up contribution (age 50 and older

during 2012)

$5,500 $5,500

For General Assistance:

Call Employee Services at 1-203-432-5552. Representatives are available between 8:30 a.m. and

5 p.m., Monday through Friday.

Retirement Plan


Investment may be made

with either one of the

following plan vendors

at anytime. One-on-One

counseling is also available

by request. Go to My

Benefits (

portal) and Click on the

“My Retirement” Tab for a

link to an online reservation

system for the vendor.


The VANGUARD Group at:

Enroll online at


Legal Notices

Women’s Health and Cancer Rights Act (WHCRA)

Under the Women’s Health and Cancer Rights Act of 1998, health plans that provide coverage for mastectomies must also cover reconstructive breast

surgery following the mastectomy, including:

• Reconstruction of the breast on which the mastectomy was performed;

• Surgery and reconstruction of the other breast to produce symmetrical appearances; and

• Prostheses and physical complications at all stages of the mastectomy, including lymphedemas.

Coverage for the procedures will be the same as that for any other medical/surgical benefit under the health plan you have elected, and certain general

coverage limitations may apply, including but not limited to: deductibles, co-insurance, co-payments, reasonable and customary charges, approval of

your primary care physician, etc. Please refer to your group certificate for additional information.

Medicaid and the Children’s Health Insurance Program (CHIP) Offer Free or Low-Cost Health Coverage to Children and Families

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs

that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employersponsored

health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State that participates in the program, you can contact your

State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either

of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or to find out how to

apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is

required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the

employer’s plan.

This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

Early Retiree Reinsurance Program

You are a plan participant, or are being offered the opportunity to enroll as a plan participant, in an employment-based health plan that is certified

for participation in the Early Retiree Reinsurance Program. The Early Retiree Reinsurance Program is a Federal program that was established under

the Affordable Care Act. Under the Early Retiree Reinsurance Program, the Federal government reimburses a plan sponsor of an employmentbased

health plan for some of the costs of health care benefits paid on behalf of, or by, early retirees and certain family members of early retirees

participating in the employment-based plan. By law, the program expires on January 1, 2014.

Under the Early Retiree Reinsurance Program, your plan sponsor may choose to use any reimbursements it receives from this program to reduce

or offset increases in plan participant’s premium contributions, co-payments, deductibles, co-insurance, or other out-of-pocket costs. If the plan

sponsor chooses to use the Early Retiree Reinsurance Program reimbursements in this way, you, as a plan participant, may experience changes that

may be advantageous to you, in the health plan coverage terms and conditions, for so long as the reimbursements under this program are available

and this plan sponsor chooses to use the reimbursements for this purpose. A plan sponsor may also use the Early Retiree Reinsurance Program

reimbursements to reduce or offset increases in its own costs for maintaining your health benefits coverage, which may increase the likelihood that it

will continue to offer health benefits coverage to its retirees and employees and their families.

If you have received this notice by e-mail, you are responsible for providing a copy of this notice to your family members who are participants in this plan.

Grandfathered Health Plan Status

Yale University believes the Aetna POS Choice II Plan is a “grandfathered health plan”, under the Patient Protection and Affordable Care Act (the

Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was

already in effect when that law was enacted. Being a grandfathered health plan means that your Aetna POS Choice II Plan may not include certain

consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services

without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for

example, the elimination of lifetime limits on benefits.

Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to

change from a grandfathered health plan status can be directed to the plan administrator: Yale University, Human Resources Benefits Planning, 221

Whitney Ave, New Haven, CT 06520. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-

3272 or This website has a table summarizing which protections do and do not apply to grandfathered health plans.

Human Resources

221 Whitney Avenue

New Haven, CT 06511


U.S. Postage


New Haven, CT

Permit No. 526

2012 Yale Annual Benefits Enrollment

Yale Annual Benefits Enrollment Guide is a publication of Human Resources, Benefits

Planning, Yale University. © 2011 Yale University. Benefits Planning in conjunction with

Employee Services assists Yale employees and their families in accessing and understanding the

University’s benefits program, one that is competitive, comprehensive and demonstrates the

University’s commitment to the health and well-being of all its employees.

Your Spending Account is a trademark of Hewitt Associates LLC.

Every effort is made to ensure that only those employees who are eligible for the Yale Benefits

Program receive this Annual Benefits Enrollment Guide and other enrollment materials.

Receipt of enrollment materials does not guarantee eligibility or benefit coverage. Eligibility is

determined only by meeting the eligibility and coverage requirements of each plan.

The benefit descriptions in this Annual Benefits Enrollment Guide are brief summaries of the

benefits offered. More detailed information about your benefits can be found on the My Benefits

web site. If anything differs from what is stated in the legal plan documents and insurance

contracts that govern the plans, the legal plan documents will prevail.

Although it is intended that the benefit plans will be continued indefinitely, the University

reserves the right to amend, modify or terminate the plans at any time.

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