NEW - IRS Forms for 2016

Form 1095 for the Affordable Care Act is often called the “W-2 of benefits”.

Updated January 2016: On December 28, 2015, the IRS extended the due date for the 2015 form 1095-C reporting requirements. This means that the original deadline for issuing form 1095-C to employees has moved from February 1, 2016 to March 31, 2016. You will receive your 2015 form 1095-C prior to the revised deadline of March 31, 2016.

You will only receive this form if you are a benefit-eligible employee with the University. These forms are similar to your W-2 and while not required to file your 2015 tax return, they will be required when filing your taxes with the IRS in future years. The 1095-C will be mailed to your home address from Equifax, Penn State’s partner in 1095 form administration.

Eligibility

Regular full-time faculty and staff members are eligible to enroll in Penn State’s Health Care Plan. Highmark Blue Shield is responsible for administering the health plan.

If you have any children, they are eligible for coverage on your insurance up to the age of 26. Eligibility is regardless of student status, marital status, or ability to have insurance through their employer.

NOTE: If the adult dependent child of the employee is married, only the adult dependent child of the employee is eligible for coverage.

Notification is sent to the employee from Highmark approximately 45 days prior to a dependent child turning age 26.  This notification includes information concerning a dependent child who may be eligible to continue coverage if that dependent is mentally or physically handicapped, so as to be incapable of earning a living when coverage would normally terminate due to age.  After your dependent child is no longer eligible, your dependent child will receive information from Lifetime Benefit Solutions regarding continuing benefits under COBRA.  Additional information regarding COBRA benefits can be found at the following website: http://ohr.psu.edu/benefits/insurance/cobra/.

Highmark Network Rules for Laboratories

Network rules for labs are differerent than other in-network providers.  Laboratories are considered in-network if they participate in the local Blue Cross and/or Blue Shield network IN THE SERVICE AREA OF THE PHYSICIAN WHO ORDERED THE LAB WORK.  This means that when a physician orders labwork, you need to make sure you are using a laboratory in the same state as the ordering physician.  For example, if you live in Pennsylvania, but see a doctor in New Jersey, you need to make sure the labwork is performed in New Jersey, or the laboratory claim will be processed as out-of-network, and the higher deductible and coinsurance would apply.  Contact Highmark directly at 800-914-4384 if you need help finding network providers. 

University Health Services Student Health Center Update

As of August 2014, University Health Services (UHS) Student Health Center located at the University Park campus, will accept the following insurances for STUDENTS ONLY:

  • Highmark Blue Shield
  • Aetna
  • Cigna
  • United Health Care
  • UPMC
  • PA Medical Assistance
  • Tri Care

University employees who participate in either the PPO Blue plan or the PPO Savings Plan, who have student dependents attending Penn State, should encourage their children to present their Highmark medical ID card when seeking services at UHS. Please be aware that Penn State FACULTY AND STAFF may continue to use the UHS pharmacy for prescriptions, but they will not have access to MEDICAL services at UHS.  
 
Questions regarding this change should be directed to University Health Services at uhs-info@psu.edu.

Employee Medical Plans Used at Other Penn State Student Health Clinics

All other Penn State campuses also have a student health clinic that is the primary treatment center for its students.  Therefore, it is reasonable to expect that dependent students may try to seek treatment from one of these clinics.  Unfortunately, these student clinics are unable to contract with insurance providers.  The cost of dealing with so many insurance companies for those clinics would drive up the current discounted rate for services provided there.

Therefore, if you have dependents who are also students at Penn State campuses, other than University Park, we suggest that they continue to utilize their family physician or search for a participating provider through the Highmark Provider Directory.  In most cases, the student health clinics available to Penn State students will be considered an out-of-network provider with our Highmark employee health plan.  Should your dependent student decide to visit a student clinic regardless, it is the patient (or employee) responsibility to submit claims to Highmark for reimbursement.

If your dependent student attends University Park campus, please review the information in the section above, “University Health Services Student Health Center Update,” regarding the use of their Highmark health insurance coverage.

Faculty & Staff Premiums

Payroll contributions will be determined based on your annual base salary as of October 31, 2015. Your new payroll contribution amount is effective January 1, 2016 and will remain the same for the entire year.

If both the employee and spouse/same-sex domestic partner are employed at Penn State, they have the ability to choose which employee will carry the health benefits and have the corresponding salary-indexed payroll deduction; changes of this nature must by made in ESSIC during Open Enrollment only.

The below grid(s) are sample contribution amounts only. Your own specific, salary-based payroll contribution for 2016 is reflected in ESSIC.

2016 PPO Blue Plan (Faculty & Staff)
Plan Type
$30,000$40,000$50,000$60,000$75,000$85,000$100,000$140,000
Individual
(1.81% of Salary)
$45.28 $60.37 $75.47 $90.56 $113.20 $128.30 $150.94 $211.31
2-Person
(4.40% of Salary)
$110.05 $146.74 $183.42 $220.11 $275.13 $311.82 $366.84 $513.58
Parent/Child(ren)
(4.08% of Salary)
$101.98 $135.97 $169.97 $203.96 $254.95 $288.95 $339.94 $475.91
Family
(5.61% of Salary)
$140.37 $187.16 $233.95 $280.74 $350.93 $397.72 $467.91 $655.07
2016 PPO Savings Plan (Faculty & Staff)
Plan Type
$30,000$40,000$50,000$60,000$75,000$85,000$100,000$140,000
Individual
(0.52% of Salary)
$12.94 $17.25 $21.56 $25.87 $32.34 $36.66 $43.12 $60.37
2 Person
(1.25% of Salary)
$31.31 $41.75 $52.18 $62.62 $78.27 $88.71 $104.36 $146.11
Parent/Child(ren)
(1.16% of Salary)
$28.98 $38.64 $48.30 $57.96 $72.45 $82.11 $96.60 $135.24
Family
(1.60% of Salary)
$40.11 $53.47 $66.84 $80.21 $100.27 $113.63 $133.69 $187.16

Teamsters Bi-Weekly Premiums

Payroll contributions will be determined based on your annual base salary as of October 31, 2015. Your new payroll contribution amount is effective January 1, 2016 and will remain the same for the entire year.

If both the employee and spouse/same-sex domestic partner are employed at Penn State, they have the ability to choose which employee will carry the health benefits and have the corresponding salary-indexed payroll deduction; changes of this nature must by made in ESSIC during Open Enrollment only.

The below grid(s) are sample contribution amounts only. Your own specific, salary-based payroll contribution for 2016 is reflected in ESSIC.

2015 PPO Blue Plan (Teamsters)
Plan Type
$25,000$30,000$35,000$40,000$45,000$50,000$60,000
Individual
(2.26% of Salary)
$21.73 $26.08 $30.42 $34.77 $39.12 $43.46 $52.15
2-Person
(4.88% of Salary)
$46.92 $56.31 $65.69 $75.08 $84.46 $93.85 $112.62
Parent/Child(ren)
(4.55% of Salary)
$43.75 $52.50 $61.25 $70.00 $78.75 $87.50 $105.00
Family
(6.10% of Salary)
$58.65 $70.38 $82.12 $93.85 $105.58 $117.31 $140.77
2016 PPO Blue Plan (Teamsters)
Plan Type
$25,000$30,000$35,000$40,000$45,000$50,000$60,000
Individual
(2.37% of Salary)
$22.79 $27.35 $31.90 $36.46 $41.02 $45.58 $54.69
2-Person
(5.12% of Salary)
$49.23 $59.08 $68.92 $78.77 $88.62 $98.46 $118.15
Parent/Child(ren)
(4.78% of Salary)
$45.96 $55.15 $64.35 $73.54 $82.73 $91.92 $110.31
Family
(6.42% of Salary)
$61.73 $74.08 $86.42 $98.77 $111.12 $123.46 $148.15
2016 PPO Savings Plan (Teamsters)
Plan Type
$25,000$30,000$35,000$40,000$45,000$50,000$60,000
Individual
(1.04% of Salary)
$10.00 $12.00 $14.00 $16.00 $18.00 $20.00 $24.00
2 Person
(1.81% of Salary)
$17.40 $20.88 $24.37 $27.85 $31.33 $34.81 $41.77
Parent/Child(ren)
(1.71% of Salary)
$16.44 $19.73 $23.02 $26.31 $29.60 $32.88 $39.46
Family
(2.17% of Salary)
$20.87 $25.04 $29.21 $33.38 $37.56 $41.73 $50.08

Part-Time Employee Premiums

Individuals who became eligible on or before December 31, 2014, for the part-time health care plan will continue to be eligible for such provisions provided:

  1. There is no involuntary or voluntary separation from University employment, for example if you leave University employment for any period of time;
  2. You continue to be enrolled in the part-time health care plan, with applicable payment of health care plan premiums, with no drop of coverage; or
  3. You transfer into a full-time benefits eligible position.

See Policy HR103 Employment Conditions for Part-Time, Intermittent/Short-Term & Full-Time Student Employees for established criteria for those grandfathered under discontinued Policy HR05 prior to December 31, 2014.

2016 Part-Time Employee Contributions Per Pay
Plan TypeMonthly RateBi-Weekly Rate
Individual $281.66 $130.00
Family $765.97 $353.52

PLEASE NOTE: During the part-time employee healthcare open enrollment period held in November and December 2014, it was communicated that due to this healthcare plan closing there would be no future open enrollment periods held. Future changes to your part-time employee healthcare plan will only be granted in the event of a qualifying life status change (e.g. marriage, divorce, birth of a child, adoption of a child, loss of coverage, etc.).

Postdoctoral Scholar Eligibility

Postdoctoral scholars interested in participating in the Penn State employee healthcare plan according to postdoctoral scholar eligibility, the per pay contribution rates follow the same salary-based schedule as faculty and staff. Sample contribution rates are located under Faculty & Staff Premiums. To determine the best plan option for you and your family, please use the Health Plan Comparison and the Health Plan Decision Tool. For additional information regarding the benefits available to postdoctoral scholars, please contact or visit the Office of Postdoctoral Affairs.

Summary of Benefits and Coverage (SBC)

As part of Health Care Reform, Penn State has made available to you a Summary of Benefits and Coverage (SBC) for each of the plan types available to benefit-eligible employees for review. These documents summarize important information about the healthcare coverage options that are offered under the group PPO Blue Plan, PPO Savings Plan, and Value Based Benefit Design at Penn State. A paper copy is also available, free of charge, by contacting the Employee Benefits Division.

How To Delete Your WebMD Account and Wellness Profile

  1. Visit Highmark Blue Shield and log in at the top left of your screen
  2. Click on the Health & Wellness tab at top of webpage under Highmark logo
  3. Click on the Wellness Profile WebMD link from the list on the left-hand side of screen
  4. In the upper right side of the page, click on the triangle to the right of your name
  5. Click on "Settings"
  6. Click "Account Deletion"
  7. Click the checkbox beside "I agree to the deletion of my data as described above."
  8. Click "Delete My Account"
  9. Type "DELETE" in the box, then click "Confirm Deletion"

Upon completing the steps outlined above, your WebMD account (and Wellness Profile) will be deleted.

Please note that members cannot "delete" their Wellness Profile from WebMD and still have access to other WebMD functionality. If you wish to delete your responses to the Wellness Profile you will need to delete your WebMD account.

Additional Resources

Forms

Please use the following link for the most up-to-date versions of Highmark's medical, prescription, and spending account reimbursement claim forms. If you need help finding a Highmark form, please contact Highmark directly at (800) 914-4384.

Medical, Prescription, and Spending Account Forms for Highmark Members