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2022 Open Enrollment:November 1 – 19, 2021Benefits Effective January 1, 2022Columbia University BenefitsAs a 1199 SEIU United Healthcare Workers East member, youcan take advantage of a comprehensive benefits package. Weare committed to providing valuable benefits and resources tohelp you manage healthcare costs. This brochure is designedto explain your options.Now is the time to review your current enrollment, think aboutchanges to your personal situation, and choose the benefitsthat will best meet your needs in 2022.What’s New for 2022 All UHC medical plan members: Look for new ID cards via U.S. Mail byJanuary 1, 2022. Gender-affirming care services will be enhanced.Go to humanresources.columbia.edu/genderaffirming, or call UHC directly: 800-232-9357with questions. Preventive colonoscopies will now be coveredby the plan starting at age 45. New prescription copay assistance program foreligible specialty medications. This new program,administered by PillarRx in conjunction withOptumRx, leverages available dollars from drugmanufacturers to reduce employee costs. Find outmore at humanresources.columbia.edu/nuss-rx. The full amount of unused Healthcare and/orDependent Care FSA funds can be carried overfrom 2021 to 2022. Be aware: The amount thatcan be carried over from 2022 to 2023 will be 550 for the Healthcare FSA and 0 for theDependent Care FSA. The Child Care Benefit age requirementhas increased to under age 6 and not yet inkindergarten. Voluntary Retirement Savings Plan (VRSP)participants may receive a distribution of up to 5,000 for the birth or adoption of a child, withouta penalty. Contact TIAA and/or Vanguard directlywith questions or to request a distribution. 2022 Open Enrollment Information Forums will bevirtual. Join us. Go to humanresources.columbia.edu/oe-forums for schedule and registration link.
Log in to CUBES to EnrollThe Columbia University Benefits Enrollment System (CUBES) gives you secure access to personalizedinformation about your benefits. The site is available 24/7, which means you can enroll online anytime fromanywhere during the annual benefits Open Enrollment period.To get started:Go to humanresources.columbia.edu and clickthe CUBES logo.Select “Get Started”to make your elections.Be sure to “Checkout”in order to save andsubmit your elections.Log in with your UNI and password; confirm access using multifactor authentication (DUO).You must enroll in your 2022 benefits by November 19, 2021. Remember: The choices you make duringOpen Enrollment will stay in effect all year—unless you experience a Qualified Life Status Change (see page 4for details). What Happens if You Don’t Enroll?You will no longer have coverage for:You will be automatically re-enrolled in yourcurrent 2021: Healthcare FSA Dependent Care FSA Child Care Benefit MedicalDentalTransit/Parking Reimbursement Program (T/PRP)Life and Accidental Death and DismembermentInsurance Voluntary BenefitsYou will also be ineligible to enroll in mostVoluntary Benefits—like Critical Illness andUniversal Life with long-term care insurance—untilthe next Open Enrollment period.QUESTIONS?Contact the ColumbiaBenefits Service Center212-851-7000hrbenefits@columbia.eduOpen Enrollment hours:Monday through Friday9:00 a.m. to 5:00 p.m.2
Important RemindersCHOOSE YOUR COVERAGEElections or changes made during annual benefitsOpen Enrollment will be effective on January 1,2022, and will be in effect for the 2022 calendaryear. If you do not enroll between November 1–19,you must wait until next year’s Open Enrollment toenroll or make changes to your benefits—unless youexperience a Qualified Life Status Change.CONSIDER VOLUNTARY BENEFITSThe University offers eight additional benefit options—Voluntary Benefits—to help you create a customizedbenefits package to meet all your needs. For moreinformation, go to humanresources.columbia.edu/voluntary-benefits. To ask a question or enroll, callFarmington, the University’s Voluntary Benefitsadministrator: 866-494-4498REVIEW BENEFICIARIESUpdate your beneficiary information for life insurance(CUBES) and retirement plans (TIAA/Vanguard).ENROLL IN THE T/PRP PROGRAMYou may enroll in and/or make changes to the Transit/Parking Reimbursement Program (T/PRP) at any timeduring the year. Enrollment and changes made beforethe 20th of a month will be effective the first day ofthe next month. The current IRS contribution limit is 270 per month.*RENEW OR OPEN AN FSAYou may want to consider renewing or opening aFlexible Spending Account (FSA). An FSA allowsyou to set aside money on a pre-tax basis fromeach paycheck to pay for eligible healthcare anddependent care expenses.MAKE CATCH-UP CONTRIBUTIONS TO THE VRSPIf you are age 50 or older (or will turn 50 in 2022), youcan contribute an additional 6,500 pre- or post-taxto your Voluntary Retirement Savings Program (VRSP)account, for a total of 26,000 in 2022.*Current IRS limits are 2,750* for the Healthcare FSAand 5,000* for the Dependent Care FSA (includingthe Child Care Benefit). For both FSAs, you can carryover your entire remaining balance from 2021 to2022. To participate in FSAs for 2022, you must enrollduring annual benefits Open Enrollment.* IRS limits are subject to change.ABOUT THIS COMMUNICATIONThe Benefits Brochure summarizes changes to the benefits programs that are available to benefits-eligible employees of Columbia University. Thiscommunication is intended to be a Summary of Material Modifications (SMM) to the Medical Plans and other benefits programs. It does not include importantinformation about exclusions and limitations. For additional details of benefits coverage, eligibility, limitations and exclusions, you must refer to the SummaryPlan Description (SPD) and the Summary of Benefits and Coverage (SBC) online at humanresources.columbia.edu/benefits. You may also want to request toreceive a paper copy of an SPD, SBC or SMM by contacting the Columbia Benefits Service Center at 212-851-7000. As a requirement of the Patient Protectionand Affordable Care Act, Columbia University must provide a SBC to all participants and their dependents. The SBC is designed to provide you with aneasy-to-understand summary about a health plan’s benefits and coverage and to help you better understand and evaluate your health insurance choices. Youare entitled to receive these Plan documents under the Employee Retirement Income Security Act of 1974 (ERISA). You also have other important rights andprotections under ERISA, which are explained in more detail in the SPDs. If there are any discrepancies between the information in this publication, verbalrepresentations and the Plan documents, the Plan documents will always govern. Columbia University reserves the right to change or terminate these benefitsPlans at any time. This publication is in no way intended to imply a contract of employment. The Columbia University Group Benefit Plan (the “Plan”) complieswith applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.3
Cost of CoverageContributions are the amount you pay toward the cost of medical (includes prescription drugs and vision) anddental coverage through pre-tax payroll deductions.2022 Monthly Pre-Tax Contributions for Medical, Vision & RxChoice In-NetworkFull-TimeYourself OnlyYourself & Child(ren)Yourself & SpouseFamily 0 0 0 02022 Monthly Pre-Tax Contributions for EmblemHealth DentalFull-TimeYourself 0Family* 0*Dependent children can only be covered under EmblemHealth Dental through the end of the calendar year in which they turn 19.QUALIFIED LIFE STATUS CHANGESYou can update benefits elections on CUBES if youexperience a Qualified Life Status Change such asmarriage or divorce, or birth or adoption of a child.You have 31 days from the eligible event to makeupdates. For additional information, including a list ofQualified Life Status Change events, go tohumanresources.columbia.edu/benefits and clickthe “Making Changes to Benefits” icon.REFERENCES AND RESOURCESGo to humanresources.columbia.edu/benefitsfor the Summary Plan Description (SPD) andSummary of Benefits and Coverage (SBC) foreach health plan, legal notices, FAQs, BenefitsVendor Contacts, and our Benefits Glossary.4
Your Medical PlanBelow is an overview of the medical plan, administered by UnitedHealthcare (UHC).UHC Medical Plan Comparison ChartChoice In-NetworkBenefitIn-NetworkOut-of-Network*Annual DeductibleIndividualFamily 0per personN/ACoinsurance100% after deductibleN/AOut-of-pocket MaximumIndividualFamily 3,500 7,000N/AN/APreventive Care100%N/APhysician Office Visits,including specialists 30 copayN/ALaboratory/Radiology Services,including services rendered in aphysician’s office 150 copay if hospital**100% after deductible if non-hospital locationN/AInpatient Hospital Care 500 copay per admission100% after deductible for Inpatient Professional ServicesN/AOutpatient Hospital Care 150 copay (including lab and radiology)**100% after the deductible for hospital professional servicesN/AMental Health and SubstanceAbuse—Inpatient care 500 copay per admissionN/AMental Health and SubstanceAbuse—Outpatient programs 30 copayN/AMental Health and SubstanceAbuse—Outpatient counseling 30 copayN/AEmergency Room 150 copay (Waived if admitted)Basic and ComprehensiveInfertility TreatmentUnlimited benefit for diagnosis and basic medical treatment,including artificial inseminationN/AAdvanced InfertilityTreatment 30,000 lifetime maximum for advanced treatments andAssisted Reproductive Technology including IVF, GIFT and ZIFTN/APrescription Drug coveragewith OptumRx***Retail (30 days) Generic: 10 copay Single-source: 25 copay Multi-source: 45 copayMail-order (90 days) Generic: 15 copay Single-source: 50 copay Multi-source: 90 copayN/A Eligible specialty medications will be processed throughPillarRx with a 30% coinsurance, offset by the manufacturerdiscount. You will be notified in advance if you need to enroll.* Eligible Expenses are determined in accordance with the Claims Administrator's reimbursement policy as described in the Summary Plan Description.** No copay for Lab and Radiology at certain designated New York Presbyterian (NYP) locations. Go to humanresources.columbia.edu/documents and search“New York-Presbyterian (NYP) Outpatient Laboratory Locations” for the list of locations.*** 30,000 lifetime maximum for infertility medication.The Medical Plan Comparison Chart represents highlights of Plan provisions. Clinical medical managementrestrictions and other limits apply. Go to humanresources.columbia.edu; click “Forms & Documents"; search “SPD” to view the Summary PlanDescriptions.! UHC’s Choice network is a national provider network and does not require referrals to see specialists.UHC requires precertification for some services; it is your responsibility to confirm that your provider hasobtained the necessary authorizations from UHC.5
Vision CoverageMembers and their covered dependents who participate in the University’s medical plan are also covered by avision benefit through UnitedHealthcare (UHC).Vision BenefitsChoice In-Network PlanBenefits apply to In-Network onlyRoutine Eye ExamsAdults: One exam every 12 months with a 10 copay.Children:* One exam every 12 months with a 10 copay.LensesAdults:** Every 24 months, 20 allowance for single lenses, 30 for bifocal, 40 for trifocal or 75 for lenticular.Children:* Lenses covered in full every 12 months.More frequently if medically necessary.FramesAdults:** 30 allowance every 24 months.Children:* Up to 100 covered in full every 12 months. More frequentlyif medically necessary. Cost above 100 covered at 60%.Contact LensesAdults:** 75 allowance every 24 months.Children:* Single purchase of a pair of contact lenses or 1 box of contact lensesper eye covered at 100% every 12 months.* Child is defined as a member less than age 19.** Available for either frames and lenses or contact lenses. To search for a vision provider, log in to myuhc.com; click “Coverage & Benefits”, “Vision”, then “Visionbenefit highlights”. You will be taken to the UHC Vision website. Click “Find a Provider” to search.! Provider might require payment in full at the time of service. The patient then submits a claim to UHC forreimbursement.Dental CoverageEMBLEMHEALTH PREFERRED DENTAL BENEFITS PLAN AEmblemHealth Preferred Dental Benefits Plan A covers preventive, basic and major services. You maychoose to use a participating EmblemHealth Preferred Program dentist or go to a nonparticipating dentist.When you receive care from a nonparticipating dentist, you pay the provider up front, and then file a claimfor reimbursement. You’ll be reimbursed up to the allowance on the EmblemHealth Dental fee schedulefor covered services, which is available from EmblemHealth. If you use a participating dentist, no forms arerequired. For EmblemHealth dentists, go to emblemhealth.com/find-a-doctor/directory and select “Dental Preferred”from the menu. For more information, call EmblemHealth: 212-501-4443.6
Benefits Effective January 1, 2022. Columbia University Benefits. As a 1199 SEIU United Healthcare Workers East member, you . can take advantage of a comprehensive benefits package. We . are committed to providing valuable benefits and resources to . help you manage healthcare costs. This brochure is designed to explain your options.
