USC Postdoctoral Scholar Benefits Program Enrollment
All postdoctoral scholars will receive similar benefit packages regardless of title code. The postdoctoral scholar benefits package is designed to closely match the benefits offered to faculty and staff and includes health, dental, vision, life, accidental death and dismemberment, short-term and long-term disability insurance plans. Postdoctoral Benefits are managed through the USC Office of Postdoctoral Affairs, except for Disability for Postdoc Research Associates and Postdoc Teaching Fellows, which is managed by USC HR. Partner and family coverage are also available with a variety of plan options. All information about plan types and rates, postdoc contributions, etc. can be found in the plan documents library on the USC Health Benefits Portal below. Enrollment or waiving enrollment is also completed on this portal. To be considered for appointment as a postdoctoral scholar at the University of Southern California, the individual must qualify as a:
- Postdoctoral Scholar – Research Associate
- Postdoctoral Scholar – Teaching Fellow
- Postdoctoral Scholar – Fellowship Trainee
- Postdoctoral Scholar – Visiting Fellow
Period of Initial Eligibility: Postdoctoral Scholars are eligible to enroll 31 days from their appointment start date. Enrollment is not automatic.
Enrollment Start Here: Please visit our benefits and enrollment site.
Please read important topics in Health Care 101 below to learn more about how your insurance plan works and what to expect.
Health Care 101
Important Info regarding your insurance plans
- Your ID number is the first 9 digits of your USC ID. For example, if your USC ID was 1234567890, your Aetna ID would be 123456789.
- Please use your Aetna ID when contacting Aetna regarding claim issues or general questions. Please give Aetna your Aetna ID instead of your Social Security Number. Aetna does not have access to your Social Security Number, and your Aetna ID serves as a pseudo-social security number so Aetna can look up your account. This number also applies when you register for Aetna Navigator ( instructions below ).
- To select or change your Primary Care Physician, please inform Aetna by phone or online using Aetna Navigator.
During your enrollment: How to Find a Provider
For a more comprehensive listing of all facilities, centers, and doctors available to you, please reference the following directories. You may use this directory when prompted to choose a medical provider for HMO plans during the enrollment process.
After you Enroll: Aetna Navigator
After you enroll, you will receive an email from our health benefits administrator to register an account with Aetna Navigator. You may perform a variety of functions, such as changing your PCP, printing temporary ID cards, or checking the status of a claim.
- Register online
- Instead of entering your ‘Member ID Number’ select the ‘Social Security Number’ option
- Enter the first 9 digits your USC ID, instead of an actual Social Security Number
- Fill out all personal information
Once you register for Aetna Navigator, you can immediately access the full benefits and features of the site. Please allow 24-48 hours for Aetna’s system to update with your enrollment before attempting to register.
Postdocs Working/Traveling Outside of the United States
If you are a postdoc working outside of the United States and living abroad for an extended period of time, the medical, dental and vision plans associated with the USC Postdoctoral Scholar Benefit Program are not available for enrollment. You are eligible for the Life/AD&D insurance, Short-Term Disability (for job codes 098219 and 098203) and Long-Term Disability plans regardless of your ability to enroll in the medical, dental and/or vision plans due to being outside of the U.S. This enrollment is performed when you submit your electronic enrollment record through the Gallagher Benefit Services website, and coverage is considered active as of your appointment date.
If you are currently enrolled in either the medical HMO or POS and you travel outside of the U.S., you are only covered for emergency services. This may require you paying for your services while away and then seeking reimbursement from the insurance carrier upon your return.
Emergency services are defined as life-threatening circumstances where you feel you may die if you do not get immediate emergency medical attention.
For information on travel policies and policies that may cover you while living abroad, you may consult an insurance carrier directly, a travel insurance broker in your area, or the U.S. Department of State’s website.
Who to contact for questions and concerns: Gallagher Benefit Services at 1-800-319-9557, e-mail UniversityServices.GBS.email@example.com.
Information regarding open enrollment for the University of Southern California Postdoctoral Scholar Benefit Program can be found on the Postdoctoral Benefits Portal.
Available changes during Open Enrollment are:
- If you are currently enrolled in the POS medical plan, you may switch to the HMO medical plan as long as you reside in California.
- If you are currently enrolled in the HMO medical plan, you may switch to the POS medical plan.
- If you are enrolled in the dental HMO plan, you may switch to the dental POS plan or vice versa.
- Enroll yourself and/or your eligible dependents if you previously waived.
If you are not changing your current enrollment status, no action is necessary.
HMO vs. PPO
What is an HMO Plan?
- The Health Maintenance Organization (HMO) plan offers a broad spectrum of benefit coverage with a higher degree of managed care.
- Under the HMO model, you and your enrolling family members will choose a Primary Care Physician (PCP) contracted with the HMO plan at the time of enrollment.
- The PCP becomes the gatekeeper of your healthcare needs.
- If you are in need of treatment from a Specialist or in need of an In-Patient or Out-Patient procedure, you must obtain a referral from the PCP prior to any type of consultation or treatment. If the referral is not obtained, no benefits will be paid.
- There is no out-of-network benefit.
- In the event of a life/limb-threatening emergency, you should dial 911 and all medical care will be covered. Once you condition is stabilized, the HMO will require that you be transferred to an In-Network facility.
- HMO premiums as well as the out-of-pocket expenses (i.e. deductibles, co-payments, etc.) tend to be lower than their indemnity, POS or PPO counterpart due to the contractual element of capitation. Capitation means that the PCP is compensated by the HMO plan in the form of a monthly capitation fee for each member that signs up with him/her at the time of enrollment. The PCP has agreed to provide all primary care, as well as the cost for most labs and x-rays for that capitated fee. Additionally, in the event that the PCP provides a referral to a Specialist, the PCP will pay the Specialist from that same capitation. There are some hospital charges and lab/x-ray procedures that do fall outside of captitation.
What is a Point of Service Plan (POS)?
- The Point of Service (POS) plan offers much more flexibility and choice than the HMO plan because there is an ‘In-Network’ and ‘Out-of-Network’ choice at the time you seek service from a provider.
- The Aetna POS plan offers you the choice of choosing a Primary Care Physician if you so desire. You are not obligated to choose one.
- The In-Network benefits (copays, coinsurance, etc.) will be greater than the Out-of-Network benefits. You will pay less when you seek your care In-Network. For example, many POS plans offer a copay of $10 for a physician office visit In-Network; that same office visit Out-of-Network can be as much as 50%.
- At the time of service, the member has the ability to seek care from a Specialist, without having to obtain a referral from a Primary Care Physician.
- The contractual agreement between the POS Plan and the Provider is on a “discounted fee for service” basis. This means that the provider who participates in the network has agreed to provide their service on an agreed upon discounted fee. The Provider who is not in the network will not agree to that discounted fee and will typically charge a “Reasonable and Customary” fee.
- There is no capitation in a POS contract.
- POS premiums tend to be higher than the HMO premiums due to the method of reimbursement and contractual agreements with the providers.
In-Network & Out-of-Network
Point of Service Plan (POS)
It’s important to understand that anytime you access the out-of-network benefit on the medical Point of Service (POS) plan, you will pay substantially more out-of-pocket. That is due to there not being any contractual agreement between the insurance carrier and the medical provider to offer services at a discounted rate.
When you seek services in-network, you are accessing physicians and facilities that have agreed to provide services per the provider network discounts outlined in their contracts with the insurance carriers. When you pay 10% for your services in-network on the medical POS plan, you are paying 10% of a contracted, discounted rate.
Below is an example of the difference between in-network and out-of-network services on the medical POS plan. Please keep in mind that this is just an example and does not reflect actualpricing of costs or services:
Aetna Medical POS Example: You are having a baby, normal delivery. We will assume the estimated charges considered to be usual, customary and reasonable for the hospital stay and routine obstetric care amount to $6,000.
Applied deductible: $0 (there is no annual deductible on this plan)
Your percentage of cost in-network: 10% which equals $600
Total estimated cost in-network for these services: $600
Applied deductible: $0 (there is no annual deductible on this plan)
Separate hospital deductible: $500
Your percentage of cost out-of-network: 50% which equals $3,000
Total estimated cost out-of-network for these services: $3,500
By choosing an out-of-network physician or hospital for the normal delivery of your baby, you pay $2,900 more than if you sought these services from an in-network physician and hospital.
There is really no reason to seek services out-of-network unless you already have a relationship with a particular trusted medical professional from whom you’ve received services in the past. Aetna has hundreds of physician choices, including specialists, in the greater Los Angeles area.
DENTAL POS Plan
When you seek services in-network, meaning, from dentists/providers listed in the EPO or PPO networks, you are paying less for services since these dentists/providers have agreed to provide services per the provider network discounts outlined in their contracts with the insurance carriers. When you pay 40% for major services in-network when seeking services from an EPO dentist, you are paying 40% of a contracted, discounted rate.
Below is an example of the difference between in-network and out-of-network services on the dental POS plan. Please keep in mind that this is just an example and does not reflect actualpricing of costs or services:
Principal Dental POS Example: You need a porcelain crown on a molar. We will assume the estimated charge considered to be usual, customary and reasonable is $800.
Applied Deductible: $0. No deductibles apply to any services accessed in the EPO network.
Your percentage of cost in the EPO network is 40%: You pay $320 or less. The EPO network discounts could be deeper, providing you with a lower out-of-pocket cost.
Total estimated cost in-network for the porcelain crown on a molar: $320
Out-of-Network: The out-of-network dentist decides to charge $1,000 for the porcelain crown on a molar. This dentist is not prohibited from charging what he/she feels can be charged for this service.
Applied deductible: $50
Your percentage of cost out-of-network is 40%, and usual, customary and reasonable is considered $800 for this service: You pay $320 AND, you owe the difference between the usual, customary and reasonable amount and what the out-of-network dentist decided to charge you ($1,000 – $800), which is an additional $200.
Total estimated cost out-of-network for the porcelain crown on a molar: $570
There is really no reason to seek services out-of-network unless you already have a relationship with a particular trusted dentist from whom you’ve received services in the past. Principal has a robust EPO and PPO network offering hundreds of dental choices in the greater Los Angeles area.
What’s a ‘Copayment’
Member (postdoc) will be required to make certain Copayments for Covered Benefits as specified in the Schedule of Benefits. Copayments must be paid at the time the Covered Benefits are rendered. The total aggregate amount of Copayments a Member is required to pay per year for basic services is specified in the Schedule of Benefits.
Member will also be responsible for any charges made by Participating Providers for scheduled appointments that are missed without notice to the Participating Providers or without good cause. Personal administrative service costs such as copying Member medical records or completing forms for school, camp, employment, etc. are also Member’s responsibility.
Maximum Out-of-Pocket Limit
If a Member’s Copayments reach the Maximum Out-of-Pocket Limit set forth on the HMO Schedule of Benefits, HMO will pay 100% of the contracted charges for Covered Benefits for the remainder of that calendar year. Covered Benefits must be rendered to the Member during that calendar year.
Emergency or Urgent Care
Protect your health and your wallet. Consider the advantages of your local urgent care center.
It’s second nature for many of us to hit the emergency room if we’re suddenly sick or injured — a sound idea, in many cases. But what if you have an urgent, but non-life threatening, medical issue like a broken arm or ankle sprain? A hefty ER wait time, and even heftier hospital bill might not be your best option. In fact, quicker, more affordable and more convenient treatment is closer than you think: your local urgent care center. Many of these health care spots are open 7 days a week — even nights, weekends and holidays — with no appointments necessary.
That makes them a convenient option for common ailments and accidents you’d typically visit the ER for. Plus, when you opt for care from one of approximately 3,432 Aetna-contracted centers instead of your local ER, your savings can really add up!
Sample services and care offered through Urgent Care:
■ Sports injuries
■ Falls (less than 7 feet)
■ Cuts and minor lacerations
■ Skin lesion removal
■ Burns and rashes
■ Immunizations & vaccinations
If your medical need is more than urgent — for example, characterized by chest pain, trouble breathing, bad bleeding or other symptoms that are serious or put your life at risk — you should go straight to your local ER.
Info for J-1 Postdocs
Medical Evacuation and Repatriation Benefits
All University of Southern California postdoctoral scholars holding J-1 Visa Status, and their dependents holding J-2 Visa status, are automatically covered for medical evacuation and repatriation benefits necessary to satisfy the J Visa Program. It is not necessary to purchase supplemental insurance to satisfy the J-1 and J-2 Visa requirements.
Effective January 1st, 2015, the Department of State Medical Evacuation and Repatriation coverage requirements will change. The Aetna life insurance program will offer both J-1 and J-2 visa holders the newly required insurance coverage of Medical Evacuation of $50,000 and $25,000 of Repatriation of Remains.
You can find more info here.