US Benefits ORACLEflex Enrollment Guide 2013 This guide contains highlights of the 2013 benefit options available through Oracle’s US employee benefits program. They are not complete descriptions of the benefits. Oracle may terminate, withdraw or modify any benefits described in this guide, in whole or in part, at any time. The descriptions of the benefits are not guarantees of current or future employment or benefits. We make every effort to ensure the accuracy of the information in this guide. If there is any conflict between this guide and official Plan Documents, the official documents will govern. For full provisions of the benefit plans described in this guide, consult the documentation specific to the plan. You can find our plan documentation on the Oracle US Benefits Website.
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Introduction ................................................................................................. 6
ORACLEflex Benefits .................................................................................. 7
Your ORACLEflex Choices ....................................................................................................................... 7
Your ORACLEflex Effective Date .............................................................................................................. 7
Your ORACLEflex End Date ..................................................................................................................... 7
Your ORACLEflex Credits ......................................................................................................................... 7
Your Annual Benefits Compensation ......................................................................................................... 8
Core Coverage (Minimum Protection Requirements) ............................................................................... 8
Declining Coverage ................................................................................................................................... 9
Who’s Eligible ............................................................................................................................................ 9
How to Enroll ............................................................................................ 11
Online Enrollment System ....................................................................................................................... 11
New Hires/Newly Eligible ........................................................................................................................ 11
Annual US Benefits Open Enrollment ....................................................... 13
Make Your Open Enrollment Elections ................................................................................................... 13
Special Election Consideration for Health Care Reimbursement Account Participants .......................... 14
Qualified Status Change Events ............................................................... 14
Qualified Status Change – Effective Date ............................................................................................... 14
Qualified Status Change – Making Benefit Elections .............................................................................. 15
Beneficiary Designation ............................................................................ 15
Medical Plans ........................................................................................... 15
Eligibility – Geographic Service Area ...................................................................................................... 15
United Healthcare (UHC) Plans .............................................................................................................. 16
UHC Health and Wellness Resources .................................................................................................... 17
Premium Choice Plus PPO Plan ............................................................................................................. 17
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Medium Choice Plus PPO Plan .............................................................................................................. 17
Premium and Medium Out-of-Area Plans ............................................................................................... 18
HSA Medical Plan ................................................................................................................................... 18
Exclusive Provider Organization (EPO) Choice Plan ............................................................................. 18
HPHC Passport Plan ............................................................................................................................... 18
UHC’s Preferred Prescription Drug List (PDL) ........................................................................................ 19
Mail Order Program (Maintenance Medications) .................................................................................... 20
Specialty Medications .............................................................................................................................. 20
Health Maintenance Organizations (HMOs) ........................................................................................... 20
HealthNet HMO ....................................................................................................................................... 21
Kaiser Permanente HMO ........................................................................................................................ 21
Group Health Cooperative (GHC) Washington ....................................................................................... 22
Medical Plan Selection Considerations ................................................................................................... 22
Mental Health Benefits .............................................................................. 22
Employee Assistance Program ............................................................................................................... 22
Mental Health and Substance Abuse Benefits ........................................................................................ 23
Live and Work Well ................................................................................................................................. 23
Dental Plans ............................................................................................. 23
Network and Non-Network Dentists ........................................................................................................ 24
Comprehensive Dental Plan: Pre-Treatment Estimates ......................................................................... 24
Dental Plan Selection Considerations ..................................................................................................... 25
Vision Plans .............................................................................................. 25
Network and Non-Network Eye Care Professionals ............................................................................... 25
Calendar Year Benefits Eligibility ............................................................................................................ 25
How to Use VSP ..................................................................................................................................... 26
Vision Plan Selection Considerations ..................................................................................................... 26
Disability Insurance ................................................................................... 26
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Short Term Disability (STD) Insurance .................................................................................................... 26
Long Term Disability (LTD) Insurance ..................................................................................................... 27
Long Term Disability (LTD): Pre-Tax vs. After-Tax Coverage ................................................................. 27
Long Term Disability (LTD) Selection Considerations ............................................................................. 28
Life Insurance ........................................................................................... 28
Employee Pre-Tax Life Insurance ........................................................................................................... 28
After-Tax Life Insurance .......................................................................................................................... 29
After-Tax Life Insurance Coverage for You ............................................................................................. 29
Life Insurance Coverage for Your Spouse/Domestic Partner ................................................................. 29
Life Insurance Coverage for Your Children ............................................................................................. 29
Changing Your Life Insurance – Annual Open Enrollment ...................................................................... 30
Changing Your Life Insurance – Qualified Status Change ...................................................................... 30
Life Insurance and AD&D Selection Considerations ............................................................................... 30
Accidental Death and Dismemberment (AD&D) Insurance ....................... 31
Changing Your AD&D Insurance – Annual Open Enrollment .................................................................. 31
Health and Dependent Care Reimbursement Accounts ............................ 31
Health Care Reimbursement Account (General Purpose) ...................................................................... 33
Health Care Reimbursement Account (General Purpose) Eligible Expenses ........................................ 33
Health Care Reimbursement Account (General Purpose) Ineligible Expenses ...................................... 33
Health Care Reimbursement Account (Limited Purpose) ....................................................................... 34
Health Care Reimbursement Account Enrollment Considerations ......................................................... 34
Dependent Care Reimbursement Account ............................................................................................. 35
Dependent Care Reimbursement Account Eligible Expenses ................................................................ 35
Dependent Care Reimbursement Account Ineligible Expenses ............................................................. 36
Dependent Care Reimbursement Account Enrollment Considerations .................................................. 36
Group Legal Plans .................................................................................... 36
Financial Planning .................................................................................... 37
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Long Term Care Insurance........................................................................ 39
Personal Insurance (Auto / Home / Renters) ............................................. 39
Health Care Reform .................................................................................. 39
Maximize Your Benefits ............................................................................. 40
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2013 Benefits Enrollment Guide
Introduction
This enrollment guide provides information for employees enrolling in ORACLEflex for the first time and
during the annual Open Enrollment period. This guide is an excellent reference tool to assist you in
making your enrollment decisions. The enrollment criteria may differ between new hire/newly eligible and
Open Enrollment elections and these differences are marked in the document where applicable.
Additional resources to assist in your decision making process includes:
Oracle Benefits Website: Located at www.oraclebenefits.com, this is your best source for benefits
and enrollment information. From this website, you can find direct links to program information on all
Oracle benefit plan offerings. Visit “The Basics” to view general information available outside of the
Oracle firewall. For confidentiality purposes the detailed plan information requires you to log into the
Oracle network to access them. Visit “Full Website and Details” to access the entire site.
Top Picks: The Oracle US Benefits Website is a great place to find information but you may not have
the time to review each and every page or even know where to begin. To help you navigate quickly
and efficiently to key information we’ve pulled together our “Top Picks” to help you enroll.
This Enrollment Guide
Comparison Charts (medical, dental, vision)
Prices and Credits
Vendor Contacts
Family Status Change
Summary Plan Description (SPD)
HSA Medical Plan Resource Center
What’s New: Accessible on the Oracle US Benefits Website this important document highlights key
information about the annual Open Enrollment period including deadlines, enrollment instructions,
information resources, and new plan and prices changes.
Plan Comparison Charts: Side-by-side review of the key features of the medical, dental, and vision
plans. Use these helpful charts to learn more about the benefits that best meet the needs of you and
your family. You can access the information by visiting the Oracle US Benefits Website and selecting
"The Basics”
Summary Benefits Coverage (SBC): There is an individual Summary Benefits Coverage or SBC for
each Oracle medical plan offering and are designed to provide an overview of key plan features and
benefit coverage such as co-pays and coinsurance. You can use the SBCs to view benefits, make
comparisons between the different medical plans, and view cost scenario examples. You can access
the information by visiting the Oracle US Benefits Website and selecting "The Basics”. They are also
available in the online enrollment tool.
HSA Medical Plan Resource Center: This Oracle sponsored website provides information, tools,
tutorials, and FAQs regarding the HSA Medical Plan. You can access the information by visiting the
HSA Medical Plan Resource Center.
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NEW HIRES
Flex credits and deductions for new hires/newly eligible
employees will be retroactive to your eligibility date (e.g. hire
date) and adjusted on your paycheck.
ORACLEflex Benefits
Your ORACLEflex Choices
As an Oracle employee – you are eligible to enroll in the following benefit program choices. This enrollment guide contains additional information about each of the programs.
Medical
Employee Assistance Program (EAP)l
Mental Health & Substance Abuse
Dental
Vision
Long Term Disability (LTD) Insurance
Life/Accidental Death & Dismemberment (AD&D) Insurance
Health (General and Limited Purpose) & Dependent Care Reimbursement Accounts
Group Financial and Legal Services
Long Term Care (LTC) Insurance
Personal Auto/Home/Renters Insurance
Your ORACLEflex Effective Date
Newly Eligible/New Hires Annual Benefits Open Enrollment
All benefits are effective on your eligibility date (e.g.
new hire date). This means you will be retroactively
enrolled in the plans you select. Retroactive payroll
deductions may apply.
Open Enrollment is held each fall. All elections are
effective on January 1 following the enrollment
period
Your ORACLEflex End Date
Your benefits end effective midnight of the day you lose eligibility (e.g. termination date). In the event of
an employee’s death, medical, dental, and vision benefits for covered family members will automatically
continue for an additional 30 days. Eligible dependents may elect COBRA to continue coverage beyond
this 30 day period.
Your ORACLEflex Credits
ORACLEflex allows you to choose the benefit plans and coverage
levels that are right for you and your family. Each pay period,
Oracle provides a specified amount of ORACLEflex credits to
purchase your benefits. Full-time regular employees working 30
hours or more per week receive full flex credits. All regular part-
time employees working an average of 20–29 hours per week
receive 50% of the full-time employee ORACLEflex credits.
Your take-home pay will be affected by the benefit elections that
you make. If the benefits you choose cost less than the amount of
your ORACLEflex credits, the difference will be applied to your paycheck as taxable income. If the
benefits you choose cost more than the amount of your ORACLEflex credits, you pay the difference
through pre-tax or after-tax payroll deductions, depending on the benefit plan. The chart below provides
basic information about your ORACLEflex credits. Login to the ORACLEflex Enrollment System to view
the prices and flex credits applicable to you each pay period.
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NEW HIRES
New hires that DO NOT make an active election during the enrollment period will automatically be assigned
minimum core coverage.
Benefit Type ORACLEflex Credits (Per Pay Period)
Medical Based upon the coverage level you elect
(e.g. employee, employee + children, employee + spouse/DP, family)
Dental $20
Vision $7
Long Term Disability Enough to purchase 66 2/3% of annual benefits compensation*
Accidental Death And Dismemberment Enough to purchase 2x annual benefits compensation*
Life Insurance Enough to purchase 2x annual benefits compensation*
*Note: Credits to purchase LTD and Life/AD&D insurance varies depending on your age and annual benefits compensation. Your flex credits for AD&D coverage are based on your annual benefits compensation only.
Your Annual Benefits Compensation
Your annual benefits compensation is updated annually and is used for purposes of calculating your
Life/AD&D and Long Term Disability benefits. It is also used to determine the amount of your HSA
Medical Plan Oracle seed (if you enroll in the plan).
Your annual benefits compensation is defined as your base salary plus performance based bonus and
commission paid to you between Sept 1st and August 31st of the previous year. Therefore, for 2013 your
annual benefits compensation will include base salary plus performance based bonus and commission
paid between September 1, 2011 and August 31, 2012. Compensation paid outside of the specified time
frame due to payment timing, errors, and/or omissions will NOT be counted in your current annual
benefits compensation – it will be included in your following year annual benefits compensation.
Core Coverage (Minimum Protection Requirements)
ORACLEflex is designed to ensure all employees maintain
a basic level of coverage while offering you flexibility to
choose the benefits and coverage levels that meet your
specific needs. For the most part, you may elect the
benefits you need and waive ones you don’t. To protect
your health and financial security, you must maintain a
minimum level of coverage — called core coverage — as
follows:
UHC Medium PPO Choice Plus medical - Employee Only Coverage*
50% pre-tax Long Term Disability (LTD)
$10,000 Accidental Death & Dismemberment (AD&D)
Employee life insurance
$10,000 (pre-tax) or
one times eligible compensation (after-tax) *You are not required to select this particular medical plan option. You may actively choose any medical plan option you are eligible for and in certain cases you may waive medical coverage altogether. Refer to “Declining Coverage”.
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Minimum core coverage does NOT include:
Coverage for eligible dependents
Dental
Vision
Long Term Care
Group Legal
Financial Services
Declining Coverage
You may decline medical coverage provided you can verify coverage from another source, such as your
spouse/domestic partner’s medical plan. If you choose to decline medical coverage, you will receive a
minimal per pay period waive credit that will offset your total benefits cost. Dental and vision coverage are
not included in core coverage and you are not required to enroll in these plans. If you waive dental or
vision coverage you receive a minimal per pay period credit.
Who’s Eligible
Employees and Dependents
Employees
All regular full-time employees on the Oracle U.S. payroll working 30 hours or more per week and regular
part-time employees working at an average of 20–29 hours per week are eligible to enroll in ORACLEflex
plans. Independent contractors and/or "leased employees" engaged by a staff leasing company are not
eligible for ORACLEflex benefits.
Dependents Your spouse or domestic partner and your children are eligible to enroll in certain ORACLEflex benefits.
The list below provides general information. It is recommended that you review the “Eligibility” section of
the Summary Plan Description for complete details.
Your spouse/domestic partner includes:
Your spouse recognized under federal law
Your qualified same or opposite sex domestic partner
Your children include:
Your natural and/or adopted children
Your children placed with you for adoption
Your domestic partner’s children
Your stepchildren
Your children for whom you are the legal guardian and a federal tax dependent
Your children for whom you are required to provide coverage as the result of a Qualified Medical Child Support Order
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LEARN MORE For more information regarding Domestic Partner coverage visit the Oracle US Benefits Website
A Quick Glance – Your Dependent Enrollment
The table below provides a snapshot of the key plan types and dependent and enrollment ability. “Yes”
signifies you can elect coverage for your dependent and “No” signifies that you cannot.
Plan Type Spouse
Domestic Partner Children
Medical Yes Yes
To age 26
Dental Yes Yes
To age 26
Vision Yes Yes
To age 26
Life Insurance Yes Yes
To age 21 or to age 23 if a
FT student (to age 25 in TX)
Accidental Death & Dismemberment (AD&D)
No No
Long/Short Term Disability No No
Long Term Care Yes No
*Parents and grandparents are also eligible for Long Term Care.
State Tax Implications for Adult Children
Due to regulatory Health Care Reform requirements, your child(ren) are eligible for coverage under the
ORACLEflex medical, dental, and vision plans to age 26 (age 26+ if your child meets certain disability
requirements). Additionally, the portion of the health care premiums paid by Oracle for those child(ren) are
exempt from federal taxes and you can pay your portion of the premiums for such child(ren)’s coverage
on a pre-tax basis for federal tax purposes.
Currently, the state of Wisconsin has not conformed to the federal tax treatment of health care benefits for this expanded group of adult children. As such, if you reside in Wisconsin you are subject to state income taxes if your child does not meet the applicable state’s definition of a qualified tax dependent. Please consult a tax advisor about these requirements and the possible tax implications associated with your child’s insurance coverage. If you reside in Wisconsin and have child(ren) subject to state income taxes, please contact Oracle Benefits.
Same and Opposite Sex Domestic Partners You may choose to enroll your eligible same or opposite sex domestic partner and their children in the medical, dental, vision and dependent life insurance plan. Your domestic partner is also eligible for Long Term Care.
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Employees Who Enroll a Same Sex Domestic Partner
Under ORACLEflex benefits, same sex-spouses who are legally married under state law and partners
who have entered into a valid civil union under state law are treated as an eligible domestic partner.
Applicable benefits and state law protections will be offered to same-sex spouses, civil union partners and
certain state registered domestic partners in the same manner as a spouse. Any special tax treatment
remains the responsibility of the employee and should be addressed when filing your state income tax
return.
Note: Certain portions of ORACLEflex benefits are governed by federal law and do not provide the same
provisions for domestic partners as they do for a legal spouse. In these cases, the federal treatment of
domestic partners is not treated in the same manner as spousal benefits.
California Employees Who Enroll a Same Sex Domestic Partner (CA Only):
Assembly Bill 25 (AB 25) provides the right to receive employer provided health coverage for a domestic
partnership without additional state income taxation. Federal tax still applies. Application of this law
requires registration of the domestic partnership with the State of California. AB 25 may also extend to
opposite-sex domestic partners if one or both partners are over age 62 and one or both partners meet
specified eligibility criteria under the Social Security Act. Any special tax treatment remains the
responsibility of the employee and should be addressed when filing your state income tax return.
When You and Spouse/Domestic Partner Are Oracle Employees If both you and your spouse/domestic partner are employed by Oracle, you may not have “double
coverage” under the ORACLEflex medical, dental and vision plans. This means you may not be covered
as both an Oracle employee and as a dependent of another Oracle employee for these plans. In addition,
you and your spouse/domestic partner may not cover the same child as a dependent for any benefit.
However, you may both elect spouse/domestic partner after-tax life insurance for one another. If one or
both of you choose to “double cover” under the employee and spouse/domestic partner life insurance
options, the combined maximum amount of life insurance coverage you may purchase is $2,050,000.
Rehires
If you leave Oracle and are rehired within 30 days, the benefits you were enrolled in on your termination
date will automatically be reinstated. If you are rehired after 30 days, you must re-enroll for benefits.
Please be advised that if you are a rehire and previously enrolled in the UHC POS Choice Plus plan, it is
no longer an enrollment option for you. Additionally, if you have been on a leave of absence where you
were ineligible for benefits for more than 30 days, you will not be able to re-elect this plan upon your
return to active status.
How to Enroll
Online Enrollment System
Enrolling in ORACLEflex benefits is simple and easy to do. And, the system is accessible outside of
Oracle’s firewall giving you the flexibility to enroll anywhere with internet connection. When accessing
from outside of the Oracle firewall you will be required to login using your Oracle OCS - Single-Sign-On
(SSO) Username and Password. In addition to enrolling in benefits - you may also add or make changes
to your dependents and designate or modify your life insurance, accidental death & dismemberment, and
401(k) plan beneficiaries.
New Hires/Newly Eligible
Newly eligible employees will receive an email approximately one week after your eligibility date (e.g. your
hire date) and a letter will be sent via US mail to your home address approximately two weeks after your
12 | P a g e Rev 06.14.13 cnt1509275
NEW HIRES Avoid Late Enrollment: You are considered a late enrollee if you do not enroll by your specified
deadline. Late enrollees are automatically assigned the minimum core benefit coverage. Core coverage does NOT cover your eligible dependents - nor does it include dental, and vision.
eligibility date. The enrollment email and letter provide you with important information and instructions -
including your enrollment deadline.
Upon receipt of either one of these communications, you can access the ORACLEflex Enrollment System
and make your elections. You can make changes to your enrollment up to your deadline. If you don’t
enroll by the specified deadline, you will automatically be enrolled in the required minimum core benefits.
Refer to the “Core Coverage” section of this document.
System Access
There is a slight delay in your ability to access the enrollment system. If your hire date is a Monday or
Tuesday you will generally be able to make your elections on Wednesday. If your hire date is Wednesday,
Thursday, or Friday you will generally be able to make your elections on the following Monday. You will
be notified via email when you are able to make your elections.
Enrollment Instructions To make your US Benefits elections, visit the ORACLEflex Enrollment System. You may access the
enrollment system in or outside of the Oracle firewall. When accessing from outside of the Oracle firewall
you will be required to login using your Oracle OCS - Single-Sign-On (SSO) Username and Password.
Follow the online instructions to make your benefit elections
You can enter and exit the enrollment application, as many times as needed, up until your election deadline. At that point, your elections are binding
When you have completed your elections, please review your summary of elections for accuracy and keep a copy for your records
The benefits shown on your election summary will remain in effect for the plan year unless you experience a qualified family status change.
Your ORACLEflex Personal Summary Your ORACLEflex Personal Summary is a confirmation of the benefit plans you are electing for the new
plan year. To view your Personal Summary, login to the ORACLEflex Enrollment System and click on any
underlined plan to review or make changes to your elections. Initially, your Personal Summary will reflect
the required core coverage benefits. However, once you make your active elections, your Personal
Summary will reflect your selected coverage.
Your ORACLEflex Personalized Confirmation Statement
After you submit your election, you will receive an e-mail confirming your elections have been recorded.
Upon receipt of this email you can view your Confirmation Statement online. Please review this statement
carefully for accuracy and make any corrections prior to the enrollment date deadline listed in your e-mail.
If you do not make your corrections prior to your deadline, the benefits and enrolled dependent(s)
reflected on your Confirmation Statement will remain in place through the year unless you have a
qualifying status change. Refer to the Oracle US Benefits website “Family Status Change” to learn more
about qualifying events.
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Annual US Benefits Open Enrollment
2013 Open Enrollment Period: October 29 – November 20, 2012 Important: The Open Enrollment end date has been extended from November 16 to November 20. Take advantage of your annual opportunity to review your benefit options and make changes if needed. Be sure to review the “What’s New” document which includes plan and price changes for 2013. This important read can be found on the Oracle US Benefits Website.
The following actions must be completed on or before the deadline - November 20.
Review your benefits
Add/change your current benefit plan elections
Add/cancel coverage for yourself and eligible dependents
Enroll or make changes to your Health/Dependent Care Reimbursement Accounts
Review and update your dependent information and beneficiary designations as needed Note: Dependents removed from coverage during the annual Open Enrollment period is not an IRS qualifying COBRA event and are NOT eligible for COBRA benefits continuation.
Make Your Open Enrollment Elections
Access the ORACLEflex Enrollment System to review, enroll, and/or make changes to your benefits. Any
plan and/or premium changes become effective January 1, 2013 and remain in effect for the entire year.
Your next opportunity to make changes to your benefits is the next annual Open Enrollment period or if
you have a qualifying status change event. For more information about how to enroll - refer to the “How to
Enroll” section of this document.
IMPORTANT
Health and Dependent Care Reimbursement Accounts Automatic Re-Enrollment Health Care and Dependent Care Reimbursement elections will automatically roll-over into 2013, unless you make an election to discontinue, change your contribution amount, or currently have a Health Care Reimbursement Account election greater than $2,500.
Partial Year Election If you enrolled mid-year, your partial year election will carry over and will apply to the entire 2013 calendar year. If you participated in only a portion of the year, you may want to adjust your election accordingly.
Health Care Reimbursement Account – NEW REDUCED MAXIMUM ($2,500) Effective January 1, 2013 Health Care Reform laws require employers to REDUCE the maximum Healthcare Reimbursement Account contribution from $5,000 to $2,500. The Limited Purpose Healthcare and Dependent Care Reimbursement Account maximum amounts will not change.
Plan accordingly and take the appropriate action during Open Enrollment. For more information, refer to section in this document “Special Election Consideration for Health Care
Reimbursement Account Participants”
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Newborns/Newly Adopted Children Coverage is NOT Automatic
You must add your new dependent(s) to your coverage and make any other benefit changes within the established timeframes. Your new child(ren) are NOT automatically enrolled for you.
Special Election Consideration for Health Care Reimbursement Account Participants
If you do not make any changes, all current elections will automatically roll forward into 2013 including
Health/Dependent Care Reimbursement Accounts, unless your current Health Care Reimbursement
Account contribution election is greater than $2,500.
If your current Health Care Reimbursement Account election is greater than $2,500 you should
reduce your election for 2013. If you do not take action during the Open Enrollment period – your
current election will automatically drop to the new maximum of $2,500.
If your current Health Care Reimbursement Account election is equal to or less than $2,500 your
current election will continue in 2013 unless you make a change during the Open Enrollment period.
Qualified Status Change Events
You may be eligible to make changes to benefit elections during the plan year due to a qualifying status change. In general, qualifying status changes include the following:
Your marriage or divorce
Birth or adoption
Children placed with you for adoption
Loss of dependent status
Change of your spouse/domestic partner’s coverage
Spouse/domestic partner's Open Enrollment
Beginning/ending of domestic partnership
Qualified Status Change – Effective Date
The event date and the effective date of coverage are not always the same. For the most part, qualifying
status changes will be effective the day you complete your online status change enrollment, not the date
the event occurred. If you want your new election to be effective on the date of your qualifying status
change, you must submit the change on the qualifying status change event date or contact Oracle
Benefits for assistance prior to the event date.
There are certain qualifying event changes where benefits are retroactive to the event date provided you
make your benefit changes within 62 days (30 days for Kaiser and HealthNet) of the change. Events
include:
Birth or adoption
Ineligible dependents (e.g. divorce, over-aged dependent children)
LEARN MORE
To learn more about qualifying status changes, eligible benefit changes, change effective dates, and
notification requirements defined by the Internal Revenue Service visit the Oracle US Benefits Website
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Qualified Status Change – Making Benefit Elections
Submit your benefit elections by accessing the ORACLEflex Enrollment System. You must make your
changes within 62 days of the status change (30 days for Kaiser and HealthNet). You can make benefit
changes that are directly related to your status change. For example, if you adopt a child, you may add
the child to your current medical plan, but you may not drop your spouse’s medical coverage at that time.
Upon successful submission of your new benefit elections, the online enrollment application will provide
immediate confirmation of the elections you made. If applicable, new medical ID cards will be mailed to
your home address approximately 10 – 15 business days following your election. ID cards are not
required for dental or vision coverage.
Beneficiary Designation
Access the ORACLEflex Enrollment System at anytime to designate, review, or update your life
insurance, accidental death & dismemberment insurance, and 401(k) plan beneficiary information. If you
enrolled in the UHC HSA Medical Plan you must make your Health Savings Account beneficiary
designation directly with the OptumHealth Bank. You may access the form from the OptumHealth Bank
website.
Medical Plans
Eligibility – Geographic Service Area
Your place of residence determines which medical plans you are eligible for. You can enroll in a plan if
your home address zip code falls within the plan’s service area. The chart below identifies each of the
medical plan offerings and provides general geographic availability. The specific medical plans that you
can enroll into are displayed when you access the ORACLEflex Enrollment System.
While plan costs and coverage levels vary from plan to plan – they all provide comprehensive coverage
including preventive exams, screenings, and tests, physician care, hospitalization, prescription drugs,
Medical Plan Geographic Availability
United Healthcare (UHC) Plans UHC EPO Choice All States
UHC EPO (HI) Choice Hawaii HPHC Passport Massachusetts
UHC HSA Medical Plan All States
UHC Medium PPO All States
UHC Premium PPO All States
UHC Medium Out of Area PPO Areas where UHC networks are not available
UHC Premium Out of Area PPO Areas where UHC networks are not available
UHC POS Medical Plan Closed to new members and plan will be
retired effective 1.1.14
Health Maintenance Organizations (HMOs) HealthNet HMO California
Kaiser Atlanta Georgia
Kaiser California (Northern) Northern California
Kaiser California (Southern) Southern California
Kaiser Colorado Colorado
Kaiser Mid-Atlantic Washington DC Kaiser Northwest Oregon and Washington
Washington Group Health Cooperative Washington
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Usual, Reasonable & Customary
When you obtain routine care outside
of your insurance company’s network,
the eligible expense for your benefit is
a portion of the usual, reasonable, and
customary (UCR) charges.
UCR charges are determined by
looking at the fees for medical services
and supplies across the nation and
determining whether your provider’s
fees are in line with those of other
providers in your area. Non-network
services that exceed UCR are not
covered under the UHC plans and you
are required to pay any amount above
UCR.
If your provider’s fees exceed UCR
your Explanation of Benefits (EOB) will
show an amount you must pay over
what the plan pays for services. Any
excess amount you pay does not count
toward your annual deductible or out-
of-pocket maximum. However, these
expenses may qualify for the Health
Care Reimbursement Account (HCRA)
and Health Savings Account (HSA) if
you are an enrolled participant.
You are NOT responsible for charges
in excess of eligible expenses when
you receive covered services within
the network.
emergency care, and mental health/substance abuse intervention. Medical ID cards for all plans are
mailed to your home address approximately 10 – 15 business days after you submit your election.
United Healthcare (UHC) Plans
ORACLEflex offers you a choice of United Healthcare (UHC) medical plans including Choice Plus
Preferred Provider Options (PPOs), a Choice Exclusive Provider Organization (EPO) plan and a Choice
Plus High Deductible Health Plan (HDHP).
The UHC plans are self-insured – which means Oracle pays UHC an administrative fee to pay for things
such as access to provider network, claims processing, customer service, and participation in care
management programs, systems, and tools. Additionally – Oracle pays for ALL of the claims incurred by
you and your family.
All UHC plans utilize the same large nationwide network and
you are encouraged to use network providers whenever
possible. For the most part the provider attrition rate is low
and the network continues to grow. You are encouraged to
verify the network status of your provider before seeking care.
Most of the UHC plans allow you to see any licensed
physician or health care facility – while a few require that you
see only network providers (except in an emergency).
Medical claims for eligible services are discounted as a result
of negotiated contract agreements between the providers and
UHC. This results in lower cost to Oracle and to you. Network
providers will also handle claim submission and any required
authorizations for you (such as hospitalization).
If you obtain care from a non-network provider you will be
responsible for a deductible and the plans will cover a
percentage of the usual, reasonable, and customary (UCR)
charges. UCR charges are generally more than UHC’s
negotiated rates and any expenses exceeding UCR charges
are your responsibility. When you use non-network providers,
you may need to file claim forms and manage authorizations
(if required) to avoid a penalty.
Each of the UHC plans includes a safety net against
catastrophic injury or illness that may result in high cost
claims. The plans’ calendar year out-of-pocket maximum
varies between plans - however each limit the amount you will
be required to pay each year. Should you reach your annual
out-of-pocket maximum the plans will pay 100% of eligible
expenses for the rest of the year.
Eligible services are the same in all UHC plans – however the
plan coverage and your out-of-pocket cost varies by plan. To
review and compare plan features including co-pays,
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DID YOU KNOW Wellness and Prevention Starts with You
ALL Oracle sponsored medical plans cover eligible preventive care services at 100% if received by
network providers. UHC members can visit www.uhcpreventivecare.com for more information about
preventive care services and guidelines. The HMO websites offer similar information.
UHC Medical Plan members have access to a variety of health and wellness resources including preventive care, 24/7 nurseline services, chronic condition, and family planning support. For more
information access the UHC Health & Wellness Resource Guide
deductibles, coinsurance, and out-of pocket maximums you are encouraged to review the Medical
Comparison Chart.
When you enroll in a UHC Plan, prescription drug coverage is included. Your medical ID card also serves
as your prescription drug ID card. For Tier 1 drugs you are responsible to pay the applicable co-pay. Tier
2 and Tier 3 drugs are subject to coinsurance. A minimum and maximum applies which means there is a
minimum amount you will be required to pay – and a maximum amount which limits your financial risk if
you require costly medications. Although coinsurance applies to Tier 2 and Tier 3 medications -
prescription drug coverage DOES NOT require a deductible (The exception is the HSA Medical Plan –
this plan requires you meet the plan deductible before coinsurance applies). For cost savings and
convenience, you may also choose to use the mail-order program for maintenance prescriptions. Review
the Medical Comparison Chart to view prescription drug coverage details.
UHC Health and Wellness Resources
There are a variety of programs and support services to improve the health of you and your family
members. These free services are included automatically when you enroll in one of the UHC plans.
Services and programs include a 24/7 Nurseline, Employee Assistance Program, Healthy Pregnancy, and
dedicated nurse advocates to help manage complex and chronic conditions. An information brochure that
contains ALL of the programs is available in both electronic and pdf format. You may not need any of the
services today – however it is always recommended that you remain informed about the programs
available. Digital Format / PDF Format
Choice Plus Preferred Provider Options (PPOs)
Premium Choice Plus PPO Plan
The rich coverage of the UHC Premium Choice Plus PPO Plan makes this plan attractive. However, due
to the high plan value it is also has the highest per pay period premium of the UHC plans. Network
physician’s office visits are covered at 100% after you pay the applicable co-pay and, most other network
services are also covered at 100% after you pay the annual deductible. The majority of network services
do not require you to meet a deductible – however a deductible is applied to a few services including in-
patient facility and non-preventive laboratory. If you receive care from non-network providers, the plan
pays 80% of UCR charges after you pay the annual deductible. This plan has the richest non-network
coverage.
Medium Choice Plus PPO Plan
The UHC Medium Choice Plus PPO Plan is the most popular UHC option. Its’ comprehensive coverage
and moderate per pay period premium is adequate for most people. This plan is most cost effective when
care is received by network providers. However – it does provide a basic level of non-network coverage.
The plan covers network physician’s office visits at 100% after you pay the applicable co-pay. Most other
network provider services are covered at 90% after you pay the annual deductible. If you receive care
from non-network providers, the plan pays 70% of UCR charges after you pay the annual deductible.
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Health Savings Account (HSA) - Eligibility Requirements
In addition to being enrolled in an IRS qualified HDHP -there are specific eligibility requirements to open
and contribute to a Health Savings Account. Be sure you validate your eligibility by reviewing the criteria
available on the HSA Medical Plan Resource Center
.
Premium and Medium Out-of-Area Plans
If you live outside of UHC’s Choice and Choice Plus service areas, you’re eligible to enroll in the Premium
or Medium Out-of-Area Plans. Because you do not have access to network physicians and facilities – the
plan pays 80% of UCR charges after you pay the annual deductible for all services (except prescription
drugs). There are no gaps in the pharmacy network – therefore prescription drug coverage is accessed in
the same manner as the other UHC plans described in this document.
HSA Medical Plan
The UHC HSA Medical plan is an IRS qualified High Deductible Health Plan (HDHP). All services (except
for eligible preventive care services, which are covered at 100% no deductible) are subject to the plan
deductible and coinsurance. If you receive care from a network provider, the plan pays 90% of UCR
charges after you pay the annual deductible. If you receive care from non-network providers, the plan
pays 70% of UCR charges after you pay the annual deductible. In this plan, all prescriptions (regardless
of Tier) are also subject to the plan deductible and coinsurance. For more information about the HSA
Medical Plan visit the HSA Medical Plan Resource Center.
Aggregate Deductible and Out-of-Pocket Maximum
Unlike the other UHC plans – the annual deductible and out-of-pocket maximum rules are different in this
plan. In the other UHC plans, an individual within a family moves to benefits (coinsurance) once he/she
satisfies the individual deductible. Likewise, an individual within a family isn’t responsible for additional
eligible expenses in the plan year once he/she satisfies the individual OOP maximum.
In the UHC HSA Medical Plan, the plan deductible and out-of-pocket maximum are aggregated. This
means the family deductible must be met before coinsurance applies even if one family member meets
the individual deductible. The same applies to the OOP maximum. The dependent OOP maximum must
be met even if one family member reaches the individual OOP maximum.
Exclusive Provider Organization (EPO) Choice Plan
The Exclusive Provider Organization (EPO) Choice Plan requires you to use EPO Choice physicians and
providers to receive benefits. Non-network benefits are NOT covered except in an emergency,
acupuncture, or ABA Therapy for autism. Most services are covered at 100% after you pay the applicable
co-pay. For the majority of services this plan does not require you to meet a deductible – however a
deductible is applied to a few services including in-patient facility and non-preventive laboratory.
HPHC Passport Plan
UnitedHealthcare’s Harvard Pilgrim Passport Plan (HPHC) network is available to most employees who live in Massachusetts, Maine, New Hampshire and the cities in Vermont and New York that border Massachusetts or New Hampshire. If you enroll in the HPHC Passport Plan you must use the HPHC network. When you are traveling outside of the designated network area you have the flexibility to access the broader UHC Choice network. Non-network benefits are NOT covered except in an emergency. Most services are covered at 100% after you pay the applicable co-pay.
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HMO Drug Lists
HMO plans have their own list of prescription
drugs. If you are enrolled in Kaiser or
HealthNet contact your HMO directly to obtain
the list of drugs covered under the plan.
If you have eligible dependents living outside of the HPHC service area, they are eligible for coverage
provided they utilize the UHC Choice network. Any care obtained outside the HPHC network or UHC
Choice network, except in an emergency, are NOT covered.
United Healthcare (UHC) Health Statements
Each month that UHC processes at least one claim for you or a covered dependent, you will receive a
Health Statement in the mail. Health Statements make it easy for you to manage your family’s medical
costs by providing claims information in an easy-to-understand format and terms. If you prefer not to
receive printed statements go to www.myuhc.com and opt out. You can choose to receive email alerts
when a new statement is generated and monitor and track activity online.
Managing Your Prescription Costs
Prescription drugs are the fastest-growing segment of health care expenses. Drug costs are increasing at
double-digit rates and are outpacing costs for hospital and physician services. Two of the most effective
ways for you to help manage these costs are:
Use lower cost medications when available and appropriate for your condition. Medicines prescribed in the UHC plans fall into one of three drug tiers. You will pay more or less depending on which tier your medication falls in.
Save time and money. Consider purchasing maintenance drugs (those you take on a regular basis for conditions such as asthma or diabetes) using the mail order feature of your prescription benefit. The UHC plans and HMOs all offer mail order programs.
UHC’s Preferred Prescription Drug List (PDL)
A Preferred Drug List (PDL) is a formal list that classifies prescribed medications into different tiers. The
list includes generic, brand name, and compound prescription medications approved by the FDA. When
you choose a medication you and your physician should consult the PDL to help you obtain the most out
value from your benefit. You may obtain the most current tier information on the Oracle US Benefits
Website, www.myuhc.com or calling the UHC member phone number noted on the back of your ID card.
Tier changes generally occur each January and July. You will need to check periodically to be sure you
have the most up-to-date list and print it out and bring it with you when you visit the physician.
UHC’s Prescription Drug Tiers Three Tiers: The UHC medical plan prescription drugs
are categorized into three individual tiers. Each tier has
an associated cost (co-pay or coinsurance). This is the
amount you will pay when you fill a prescription. There
are three tiers – tier 1 is the lowest cost option, tier 2 is
mid-range, and tier 3 is the highest cost option. If you are
currently taking a medication that falls in tier 2 or 3 – you
may want to ask your physician if there is an appropriate medication classified in a lower cost tier.
Compound medications are those with one or more ingredients that are prepared at the pharmacy
location. These types of medications are almost always classified as tier 3 and a lower tier option is not
available. Generally you will find that most generic medications are classified in tier 1 however that may
not always be the case.
Classification Decisions
The UHC PDL Management Committee is responsible for making tier placement decisions. This
committee is made up of senior level UHC physicians and business leaders. The goal of this committee is
20 | P a g e Rev 06.14.13 cnt1509275
to help ensure access to a wide range of medications and at the same time help control costs. Decisions
are made based as new drugs are released and clinical guidelines are updated. Tier changes generally
occur two times per calendar year (January 1 and July 1) and if your current medication(s) move to a
different tier it will result in you paying a lower or higher amount for your medication.
Mail Order Program (Maintenance Medications)
The mail order program is ideal for people who use maintenance medications – such as medicines for
cholesterol and high blood pressure. Using the mail order program saves you money and is also
convenient. You receive a higher quantity of medications at a lower cost and prescriptions are mailed
directly to your home which saves you a trip to the retail pharmacy. When you begin the mail order
program it’s recommended that you obtain two prescriptions from your physician. If you are required to
being your medication immediately – you can obtain your first fill at your local retail pharmacy. The other
prescription can be used to start the mail order program.
Specialty Medications
Specialty medications are critical to improving the health and lives of individuals with complex, serious, or
rare conditions. They are the most expensive medications being used today - usually costing more than
$250 per prescription. These types of prescriptions are typically not available at retail pharmacies and
require additional clinical support for better health outcomes. The majority of medications are not
classified in this special category.
For the small percentage of employees and family members who do require specialty medications, the
program is designed to make them accessible, affordable, and provide you with additional customer
service and clinical support. Therefore, UHC medical plan members are required to use a participating
specialty pharmacy to receive network coverage for all specialty medications. Specialty medications are
dispensed in a 30-day supply only. This is due to the expense and complexity of these medications and
allows physicians to assess the drug’s effectiveness to prevent waste of these very costly medications.
To locate a participating specialty pharmacy visit www.uhcspecialtyrx.com or call the Specialty Pharmacy
Referral Line at 866-429-8177. Representatives are available 24/7 and will answer any questions you
may have about the program and transfer you directly to a participating network specialty pharmacy
based on your medication(s). If you choose to fill your prescription at a non-network pharmacy, you will
be required to pay a higher amount.
Health Maintenance Organizations (HMOs)
ORACLEflex offers you a choice of HealthNet and Kaiser Permanente (Kaiser) HMOs. The HMOs are
available in certain geographic areas only. For more information about service areas – refer to “Eligibility –
Geographic Service Area” section of this document. Additionally, when login to the ORACLEflex
Enrollment System , only the medical plans you are eligible for will be displayed.
The Oracle sponsored HMOs are fully insured – which means Oracle pays HealthNet and Kaiser a
monthly premium for administration and to pay for all claims.
LEARN MORE For more detailed information about Specialty Medications visit
www.uhcspecialtyrx.com or call 1-866-429-8177
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HMOs are managed care plans that require you to use network physicians and facilities. Non-network
benefits are NOT covered except in an emergency. Overall, HMO’s require you to pay a higher per pay
period premium – however services are 100% after the applicable co-pay. As a result, your out-of-pocket
costs for eligible services are predictable and relatively low. Each plan offers similar benefits – but
services and coverage levels vary by plan. To review and compare plan features including eligible
services and co-pays, you are encouraged to review the Medical Comparison Chart.
When you enroll in a HMO prescription drug coverage is included. Your medical ID card also serves as
your prescription drug ID card. There are two categories of prescription drugs – generic, and brand name.
You receive your prescription drugs through the HMO’s pharmacy network and non-network prescriptions
are NOT covered. Each drug category is covered at 100% after you pay the applicable co-pay. For cost
savings and convenience, the HMOs offer a mail-order program for maintenance prescriptions. Review
the Medical Comparison Chart to view prescription drug coverage.
Each of the HMO plans includes a safety net against catastrophic injury or illness. The plans’ calendar
year out-of-pocket maximum varies between plans - however each limit the amount you will be required to
pay each year. Should you reach your annual out-of-pocket maximum the plans will pay 100% of eligible
expenses for the rest of the year.
HealthNet HMO
(Available in California) HealthNet is available to most Oracle employees living in California. If you enroll in HealthNet, you must
choose a Primary Care Physician (PCP) for yourself and enrolled dependents. Your PCP belongs to a
HealthNet affiliated medical group and he/she is responsible for coordinating all of your medical care -
including referring you to specialists, hospitals, and other services within the medical group.
When you enroll for the first time you will be required to designate your selected PCP by entering his/her
10-digit identification number in the ORACLEflex Enrollment System You should visit the HealthNet
website to select a PCP and write down his/her ID number prior to enrolling in ORACLEflex benefits. You
are able to select the same or different PCP for each enrolled family member. Any PCP changes that
occur after your initial enrollment should be handled directly with HealthNet.
The HealthNet HMO requires you to use network physicians and providers to receive benefits. Services
are covered at 100% after you pay the applicable co-pay and there are no deductibles or claim forms to
file. Non-network benefits are NOT covered except in an emergency.
Kaiser Permanente HMO
(Available in California, Colorado, Georgia, Washington DC, Oregon, and Washington) Kaiser Permanente (Kaiser) is available to Oracle employees in certain states across the country. If you
enroll in Kaiser, you receive your care by Kaiser physicians and facilities. Services are covered at 100%
after you pay the applicable co-pay and there are no deductibles or claim forms to file. You must use
Kaiser physicians and facilities to receive benefits. Non-network benefits are NOT covered except in an
emergency.
LEARN MORE To review and compare medical plan features visit the Medical Comparison Chart.
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Employee Assistance Program
Help is Always Available 866-728-8413
www.livenadworkwell.com (enter access code 228485)
Group Health Cooperative (GHC) Washington
An affiliate of Kaiser Permanente
GHC is available to most employees living in Washington. If you enroll in the GHC plan, you receive care
through GHC physicians and facilities. The GHC Plan covers services at 100% after you pay the
applicable co-pay and there are no deductibles or claim forms to file. You must use GHC physicians and
facilities to receive benefits. Non-network benefits are NOT covered except in an emergency.
Medical Plan Selection Considerations
It’s up to you to think about what’s important to you, cost, provider choice and convenience, then decide
and select the medical option that is best for you. Consider the following:
Are your current physicians and facilities in the plan network? You’ll receive higher benefits for
visiting a network physician or facility. And, in some plans benefits are not covered when you use
non-network providers.
How often do you usually require medical care during the year? Some plans make sense if you
have a known condition that requires recurring medical care or have a longstanding relationship
with a non-network provider. Others may be more cost-efficient with lower monthly costs if you
only need routine care during the year.
What are the out-of-pocket costs associated with each plan? Depending on the plan, you may be
required to pay a co-pay for most services while other plans require an annual deductible before
the plan starts paying benefits. And – check out the out-of-pocket maximum which is your
financial safety net in the event of unexpected catastrophic injury or illness.
If you’re choosing between the UHC medical plans, be reminded that the preferred provider network of physicians, facilities, and pharmacies are the same for all plans.
Mental Health Benefits
Your medical plans cover more than just physical care — they also provide assistance when you need counseling to help with emotional and personal wellness.
Employee Assistance Program
The Employee Assistance Program (EAP) provides confidential, personal assessment and referral
services for you and your family members. Enrollment in the EAP is automatic and free of charge to you
and your eligible dependents - even if you are not covered by an Oracle medical plan. United Behavioral
Health (UBH) administers the EAP. You may call UBH 24 hours a day, seven days a week by calling 866-
728-8413. The EAP is available to help with a variety of concerns including:
Stress
Depression
Job Worries
Legal & Financial Concerns
Family & Marital Problems
Alcohol & Chemical Dependency
When you call UBH, a specialist will ask you a few questions to help identify the nature of your issue and
the appropriate resources to address it. The specialist will work with you to find the appropriate clinician
and to satisfy your gender, language, and cultural preferences. The EAP provides 100% coverage for up
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Mental Health / Substance Abuse
UHC medical plan members must call 1.866.728.8413
for referral assistance and to preauthorize treatments
to six (6) in person visits per concern per year with an EAP counselor for each family member. Mental
health outpatient care beyond six (6) visits is managed through Mental Health and Substance Abuse
benefits described in this document.
Mental Health and Substance Abuse Benefits
Care beyond the six free EAP visits
If you enroll in a UHC medical plan, your mental health and
substance abuse coverage will be provided through UHC
and its subsidiary United Behavioral Health (UBH). If you
enroll in an HMO, mental health outpatient care is managed
through the HMO – contact your HMO for more information.
UHC medical plan participants are required to pre-authorize
any mental health and substance abuse outpatient and
inpatient treatment. The UBH network includes a wide range of professionals — psychiatrists,
psychologists, masters-level social workers, and marriage and family counselors — as well as hospitals
and alcohol and substance abuse treatment centers. This applies to both network and non-network
facilities. Please call UBH to pre-authorize services.
When you access care through the UBH mental health network you receive a higher level of benefits than
if you obtain care outside the network. Your benefits vary depending on which plan you’re in and whether
you obtain authorization from UBH. Review the Medical Comparison Chart to view mental
health/substance abuse coverage.
Live and Work Well
Live and Work Well is an interactive website that provides access to benefits and tools to help enhance
your work, health, and life. You may access this online resource center at www.liveandworkwell.com (use
Oracle’s access code 228485). Key features of the website allow you to:
Submit online service requests
Check your benefits information
Search for network clinicians
Participate in interactive and customizable self-improvement programs
Access information and resources related to hundreds of everyday work and life topics such as o Balancing work and personal life o Locating child care and elder care resources o Parenting o Adoption o Selecting schools
Dental Plans
ORACLEflex offers you a choice of two dental plans administered by MetLife:
Preventive Plan: This plan covers preventive care ONLY. This includes services such as routine
exams/x-rays and cleanings. Services such as fillings, oral surgery, implants, dentures, orthodontia,
and periodontal care are NOT covered.
Comprehensive Plan: This plan covers the full spectrum of dental care needs including preventive, basic, major, and orthodontia care for adults and children.
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LEARN MORE Check out what you could save on network and non-network fees.
Visit www.metlife.com/mybenefits and try the Dental Procedure Fee Tool, search for network dentists, view your claims online, and more!
For more detailed information on coverage levels and services provided by each of the dental plans, refer
to the Dental Plan Comparison Chart.
Network and Non-Network Dentists
Both plans allow you to use any licensed dentist. You can choose a dentist from MetLife’s preferred
provider network or any dentist outside of the network. When you obtain services from a network or non-
network dentist, the plan applies the same deductible and coinsurance. However, when you visit a
network dentist your out-of-pocket costs are usually lower. That’s because network providers have
agreed to accept negotiated/discounted fees for dental services. The negotiated fees are usually 15% to
45% less than the average dental fees in the same community. This can help you lower your out-of-
pocket costs and stretch your annual dental benefit maximum..
To illustrate potential cost savings – review the example below.
Cost Saving Example Network Non-Network
Implant – UCR $2,500
Negotiated Contracted Rate $1,868 Not Applicable
Plan Pays $1,494 (80% of contracted rate) $2,000 (80% of UCR)
You Pay $374
$500 Note: If the non-network dentist
charges above UCR – you are also responsible for the additional fees
exceeding UCR.
Savings Using Network Dentist $126 out of pocket cost
$506 less applied to your calendar year benefit maximum
This example assumes the non-network dentist charges UCR amount of $2,500. MetLife Dental Cards
MetLife does not require or issue ID cards for the dental plans. You simply notify your dentist that you are
a MetLife dental participant and the MetLife group number (#300569). The dental office will verify your
eligibility with MetLife.
Comprehensive Dental Plan: Pre-Treatment Estimates
If your dentist recommends treatment that is expected to cost more than $300, ask him or her to complete
a claim form requesting an advance claim review before treatment begins — so you know in advance
what your plan will cover. Your dentist will need to provide MetLife with details about your dental needs,
the proposed course of treatment and the expected charges, as well as copies of your charts and x-rays.
MetLife will then determine which services are covered and estimate how much the Comprehensive Plan
will pay.
Your estimate will be based on the assumption that you will receive services while covered by the plan
and that your treatment plan will not change. In addition, the estimate does not take into consideration
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deductibles or calendar year maximums as there is no way to determine, when the actual claim comes in,
how much of the deductible and calendar year maximum will be met.
Dental Plan Selection Considerations
It’s up to you to think about what’s important to you, cost, provider choice and convenience, then decide
and select the dental option that is best for you. Consider the following:
How often do you usually require dental care during the year? Is your dental care usually limited
to preventive exams, x-ray, and cleanings? Or – do you tend to require additional services such
as fillings?
Do you or your children require orthodontia services?
Are you comfortable paying the Preventive Plan’s lower premium and assume full financial risk
should you need non-preventive services.
Most dental services are eligible Health Care Reimbursement Account and Health Savings
Account (HSA) expenses.
Vision Plans
ORACLEflex offers you a choice of two vision plans, both administered by Vision Service Plan (VSP).
Vision Plan I
Annual Eye Exam
One benefit allowance for lenses or contacts every calendar year
One frame allowance every calendar year. Vision Plan II
Annual Eye Exam
Two benefit allowances for lenses or contacts every calendar year
Two frame allowances every calendar year.
Higher contact lens dollar allowance than Vision I Plan For detailed information on coverage levels and services provided by each of the vision plans, refer to the
Vision Plan Comparison Chart. You may also visit www.vsp.com to search for network physicians, review
plan benefits and allowances, read eye care articles, and more!
Network and Non-Network Eye Care Professionals
You can choose a physician from VSP’s provider network or any provider outside of the network. Benefits
for services performed by VSP network providers are covered at a higher rate and generally, you incur
less out-of-pocket cost for services performed by network providers. The plan pays up to specified dollar
amounts for non-network services. Access the Vision Plan Comparison Chart to view the non-network
allowances.
Calendar Year Benefits Eligibility
Your eligibility for vision benefits is based on the calendar year (January through December) and the
number of benefit allowances provided under the plan in which you are enrolled.
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Examples:
Vision Plan 1: You elect Vision Plan I effective January 1, 2013. This plan provides one frame
allowance each year and you obtain frames in June 2013. You will be eligible for another set of
frames in January 2014.
Vision Plan II: You elect Vision Plan II effective January 1, 2013. This plan provides two frame
allowances each year and you obtain frames in June 2013 and another set of frames in
December 2013. You will be eligible for another set of frames in January 2014.
How to Use VSP
VSP makes it very easy to access care. Simply select a VSP physician and contact the physician to
schedule an appointment. VSP physicians will verify your eligibility, your benefit allowances, and process
any necessary forms. Approval from VSP must be obtained prior to services or the coverage will be
considered out of network. If you receive services from a non-VSP physician, you must first pay the bill in
full and then send your itemized receipt to VSP for reimbursement (paid up to limited allowance only).
VSP Vision Cards
VSP does not require or issue ID cards for the vision plans. You simply notify your physician that you are
a VSP participant and the VSP group number (#12-134446). The provider’s office will verify your eligibility
with VSP.
Vision Plan Selection Considerations
It’s up to you to think about what’s important to you, cost, provider choice and convenience, then decide
and select the vision option that is best for you. Consider the following:
How often do you need to replace your glasses or contact lenses? Do you or your dependents wear glasses or contact lenses? Will you need new ones in 2013?
Have you noticed any changes in your vision?
Do you expect you or any of your dependents will need glasses for the first time?
Even if you do not require corrective lenses – an annual eye examination is a good preventive measure. Medical conditions, such as certain cancers and diabetes, can be identified through a non-invasive eye exam. Medical plans generally cover vision screenings – which is not as comprehensive as a professional exam.
Disability Insurance
Short Term Disability (STD) Insurance
Eligible employees are automatically enrolled in short-term disability insurance at no cost. Employees
who work in California are automatically enrolled in Oracle’s Voluntary Plan - voluntary disability
insurance (VDI), which is a self insured plan as part of a legal alternative in lieu of applying for state
disability insurance. Employees will contribute into the Voluntary Plan through payroll deductions.
Employees may receive VDI benefits up to 365 days of an approved disability. For employees who work
outside of California will receive salary continuation up to 90 days of an approved disability, integrated
with statutory benefits where applicable. Employees that remain disabled greater than 90 days are
eligible to apply for Long Term Disability benefits.
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Pre-Tax or After-Tax Premiums
Paying for your LTD premiums on a pre-
tax basis will result in taxable LTD
benefits. Your LTD benefits will NOT be
taxed if you pay your premium after-tax.
Long Term Disability (LTD) Insurance
Long-Term Disability (LTD) insurance provides income protection if you become totally disabled and
cannot work. You may be eligible for monthly LTD benefits after three months of continuous disability. LTD
picks up where STD ends such that you do not have a gap in your income stream. LTD is a core benefit
— you are required to purchase a minimum amount of LTD insurance coverage for yourself. For more
information - refer to the “Core Coverage” section of this document.
Generally, you are considered totally disabled if, as a result of injury or illness, you cannot perform the
material duties of your occupation in the first 24 months. After the first 24 months, you are considered
totally disabled if you cannot perform the duties of any occupation for which you are reasonably qualified
by education, training or experience, due to the same injury or illness. Your dependent spouse/domestic
partner or child(ren) are not eligible for LTD coverage.
ORACLEflex offers you two levels of LTD coverage:
50% of your annual benefits compensation, up to a maximum benefit of $12,000 per month*
66 2/3% of your annual benefits compensation, up to a maximum benefit of $18,500 per month
*Long Term Disability is a core benefit. At a minimum - you are required to elect coverage of 50% of your
monthly benefits compensation. If you don’t specify a coverage amount or you fail to enroll by your
specified deadline, you will automatically receive pre-tax LTD coverage equal to 50% of your annual
benefits compensation.
The amount of your LTD benefit will be based on the level of coverage you choose and your annual
benefits compensation at the time you initially become disabled. Your monthly benefit will never be less
than the minimum monthly benefit of $50. If you receive benefits for less than a month, you will receive
1/30 of the monthly benefit for each day you were disabled. However, your LTD benefits will be reduced
by any income you receive from other sources, such as Social Security, Workers’ Compensation, State
Disability Insurance (SDI), and Voluntary Disability Insurance (VDI). Your LTD premiums are based on the
coverage level you choose, your age as of January 1 and your annual benefits compensation.
Long Term Disability (LTD): Pre-Tax vs. After-Tax Coverage
You may enroll in either pre-tax or after-tax LTD
coverage. If you enroll in pre-tax LTD, your payroll
deductions are not taxed. However, if you become
eligible to receive LTD benefits, the compensation paid
to you will be fully taxable. If you enroll in after-tax LTD,
your benefits will generally not be taxed in the future
because you’ve already paid taxes on your payroll
contributions. Enrolling in after-tax LTD maximizes the
net benefit amount you receive in the event of a long-
term disability.
An IRS rule known as the "three-year look back" will be used to determine the tax treatment of your LTD Benefits. This provision applies if you switch your election from pre-tax to after-tax, or vice versa, within a three-year period.
28 | P a g e Rev 06.14.13 cnt1509275
Select & Maintain Your Beneficiaries It is important that you select and keep
your beneficiary information current. You may submit or update your beneficiary information online OracleFlex Enrollment System
Long Term Disability (LTD) Selection Considerations
It’s up to you to think about your personal situation including your dependents you support, financial
obligations, and income status, then decide and select which level of coverage will best meet your needs.
Consider the following:
How much income would you and your family need if you were to become disabled and unable to work?
What are your current short/longer term financial resources?
Do you have other insurance outside of Oracle?
Are you prepared to pay income taxes on disability compensation you receive? Choosing pre-tax coverage may reduce the amount of your LTD benefit because they will be taxed.
Life Insurance
ORACLEflex offers you pre-tax and supplemental after-tax
life insurance coverage that pays benefits to help meet
your financial obligations in the event of your death.
Life insurance is a core benefit and you are required to
purchase a minimum amount of coverage for yourself. .
For more information - refer to the “Core Coverage”
section of this document. You also have the option to
purchase after-tax life insurance coverage for your
spouse/domestic partner, your children, and your domestic partner’s children. Premiums for children are
based on a flat rate and the coverage level you choose. Plan premiums for you and your
spouse/domestic partner are based on the insured’s age and the coverage level you choose. Life
insurance rates are broken into five year segments with rates increasing as you age. The cost for you
and eligible spouse/DP will increase when you move from one age band to another so it is recommended
that you review your insurance cost each year during the Annual Open Enrollment period. The age
brackets are listed below.
less than 30 years old
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70 and above
In the event of death, benefits will be paid to your beneficiaries. You are automatically the beneficiary for
your dependents. If your dependent dies while covered by the plan, benefits will be paid to you.
Employee Pre-Tax Life Insurance
ORACLEflex offers you the choice of two levels of pre-tax life insurance coverage:
$10,000 (core coverage)
$50,000
29 | P a g e Rev 06.14.13 cnt1509275
Double Coverage If your spouse or domestic partner is an Oracle employee covered under his or her own employee life
insurance coverage, you may choose to “double cover” him or her under your spousal/domestic partner coverage. The combined maximum amount of coverage is $2,050,000 collectively.
After-Tax Life Insurance
You may elect coverage for yourself and your eligible dependents, including your spouse/domestic
partner, your children/domestic partner’s children from birth to 21 years or to 23 years if they are full-time
students (to age 25 in Texas). Expanded coverage for children to age 26 applicable to medical, dental,
and vision coverage does NOT apply to life insurance. It is your responsibility to remove ineligible
dependents from coverage.
After-Tax Life Insurance Coverage for You
You may choose from the following levels of after-tax life insurance coverage for yourself:
1x your annual benefits compensation
2x your annual benefits compensation
3x your annual benefits compensation
4x your annual benefits compensation
5x your annual benefits compensation
6x your annual benefits compensation The maximum combined pre-tax and after-tax life insurance you may purchase for yourself is
$2,050,000. Upon initial eligibility (e.g. new hire) evidence of insurability is NOT required for any level of
life insurance.
Life Insurance Coverage for Your Spouse/Domestic Partner
You may choose from the following levels of after-tax life insurance coverage for your spouse or domestic partner:
$5,000
$25,000
50% of 1x your annual benefits compensation
50% of 2x your annual benefits compensation
50% of 3x your annual benefits compensation
50% of 4x your annual benefits compensation
50% of 5x your annual benefits compensation
50% of 6x your annual benefits compensation
Life insurance coverage for your spouse/domestic partner is limited to 50% of your after-tax employee life insurance (or pre-tax employee life insurance if you do not elect after-tax) coverage or $500,000; whichever is less. Upon initial eligibility (e.g. new hire) evidence of insurability is NOT required for any level of life insurance.
Life Insurance Coverage for Your Children
You may choose from the following levels of after-tax life insurance coverage for your eligible children:
$2,500
$10,000
25% of 1x your annual benefits compensation
25% of 2x your annual benefits compensation
25% of 3x your annual benefits compensation
30 | P a g e Rev 06.14.13 cnt1509275
25% of 4x your annual benefits compensation
25% of 5x your annual benefits compensation
25% of 6x your annual benefits compensation The election you choose covers all of your eligible children. Life insurance coverage for your children is
limited to 25% of your after-tax employee life insurance (or pre-tax employee life insurance if you do not
elect after-tax) coverage or $250,000; whichever is less. You may elect coverage for your
children/domestic partner’s children from birth to 21 years or to 23 years if they are full-time students (to
age 25 in Texas). Expanded coverage for children to age 26 applicable to medical, dental, and vision
coverage does NOT apply to life insurance. It is your responsibility to remove ineligible dependents from
coverage. Upon initial eligibility (e.g. new hire) evidence of insurability is NOT required for any level of life
insurance.
Changing Your Life Insurance – Annual Open Enrollment
During the annual Open Enrollment period, you can make the following changes to your current Life
Insurance coverage – without evidence of insurability:
Elect $10,000 or $50,000 in employee pre-tax life insurance (if previously waived)
Increase your existing after-tax life insurance coverage by ONE level
Decrease your life insurance to any level
Example: Your current after-tax election is 2 x your annual benefits compensation and you waived pre-tax
coverage. During the annual Open Enrollment period you want to increase your coverage. See below the
allowable increases related to this example. You may:
Increase your coverage by one level – therefore you could increase your current coverage from 2
times to 3 times your annual benefits compensation. You are not eligible to elect 4 times or 5
times your annual benefits compensation
Elect either pre-tax coverage of $10,000 or $50,000.
Changing Your Life Insurance – Qualified Status Change
You are eligible to make changes to life insurance as a result of a qualified status change. The change
rules and options available upon a qualified status change event are the same as those noted above for
Open Enrollment. To learn more about qualifying status changes, eligible benefit changes, change
effective dates, and notification requirements defined by the Internal Revenue Service visit the Oracle US
Benefits Website
Life Insurance and AD&D Selection Considerations
What expenses would your family or other beneficiary have if you were to die or become seriously injured in an accident?
What financial resources would they need on a short- and long-term basis?
What level of protection do you want to provide through your insurance?
What expenses would you or your family incur if your spouse/domestic partner or child(ren) were to die?
What other insurance do you have outside of the Oracle life insurance plan?
31 | P a g e Rev 06.14.13 cnt1509275
Accidental Death and Dismemberment (AD&D) Insurance
ORACLEflex offers you Accidental Death and Dismemberment (AD&D) coverage that pays benefits to
you or your beneficiaries if you die or sustain certain serious injuries in an accident. AD&D insurance is a
core benefit and you are required to purchase a minimum amount of AD&D coverage for yourself. For
more information - refer to the “Core Coverage” section of this document. AD&D Plan premiums are
based on the dollar amount of the coverage level you choose. Your dependent spouse/domestic partner
or child(ren) are not eligible for AD&D insurance coverage.
The plan pays benefits to you or your beneficiaries as shown below.
If You … AD&D Plan Pays
Die 100% of your coverage amount
Lose both hands, both feet, sight in both eyes, or any
combination of the above 100% of your coverage amount
Lose one hand, foot, or sight in one eye 50% of your coverage amount
You may choose from the following AD&D coverage levels for yourself:
$10,000 (core coverage)
$50,000
1x your annual benefits compensation
2x your annual benefits compensation
3x your annual benefits compensation
4x your annual benefits compensation
5x your annual benefits compensation
6x your annual benefits compensation
The maximum AD&D coverage you may purchase for yourself is $2,000,000. Upon initial eligibility (e.g. new hire) evidence of insurability is NOT required for any level of AD&D insurance.
Changing Your AD&D Insurance – Annual Open Enrollment
During the annual Open Enrollment period, you can make the following changes to your current AD&D
Insurance coverage – without evidence of insurability:
Increase your existing AD&D insurance coverage by ONE level
Decrease your AD&D insurance to any level
Example: Your current election is 2 x your annual benefits compensation. During the annual Open
Enrollment period you want to increase your coverage. You may increase your coverage by one level –
therefore you could increase your current coverage from 2 times to 3 times your annual benefits
compensation. You are not eligible to elect 4 times or 5 times your annual benefits compensation.
When you enroll in the AD&D Plan, you must name one or more beneficiaries. You may submit your beneficiary information online in the ORACLEflex Enrollment System
Health and Dependent Care Reimbursement Accounts
ORACLEflex offers you the option to enroll in three pre-tax reimbursement accounts administered by UHC.
32 | P a g e Rev 06.14.13 cnt1509275
General Purpose Health Care Reimbursement Account (HCRA)
Limited Purpose Health Care Reimbursement Account (LPHCRA)
Dependent Care Reimbursement Account (DCRA) Important to Know – Health and Dependent Care Reimbursement Accounts
Separate Accounts: Eligible healthcare expenses for you and your dependents are covered
under the Health Care Reimbursement Account. The Dependent Care Reimbursement account
covers childcare or elder care expenses. The accounts are separate— you cannot transfer money
from one reimbursement account to the other.
Eligible Expenses: Only expenses incurred during the plan year and while you are an active
participant under the plan are eligible for reimbursement. This means you may not submit
expenses that were incurred for the current plan year while not actively participating, even if you
enroll at a later time during the year.
Effective Date: Your benefits begin on your enrollment effective date (e.g. new hire date or
January 1 if enrolled during Open Enrollment). This means that your “annual” reimbursement
account contribution covers expenses incurred on your effective date through December 31.
Should you become ineligible prior to the end of the year (e.g. termination) expenses must be
incurred prior to your ineligibility date.
Ongoing Automatic Enrollment: Any elections you make this year will automatically continue
each successive plan year unless you make a change during a future Open Enrollment period or
through a qualifying status change. Please review your elections each Open Enrollment to
determine if you need to increase or decrease your annual contribution amount.
For example: If you are a new hire as of 7/1/13 and you elected $1,200 for the remaining six
months (at $100 per pay period), $1,200 will be the amount automatically rolled into 2014 for
the entire 12 months (at $50 per pay period). If you intend to increase that amount for a full
year’s participation, you must make a new election.
Medical Plan Changes: If you make a change to your medical plan choice that makes you
ineligible to participate in your current general purpose or limited purpose Health Care
Reimbursement Account your current election will not rollover to the following year.
Use It or Lose It: Plan your expenses carefully! All funds left in your reimbursement accounts at
the end of the calendar year will be forfeited. You may not carry over balances from year to year
or receive a refund of unused amounts. You may submit claims until March 31st of the following
year for expenses incurred during the preceding calendar year ending December 31st.
Tax Implication: You may not claim a tax deduction for any expenses reimbursed from your
Health Care Reimbursement Account. You may use the general purpose HCRA to pay for any
health care expenses considered tax-deductible by the IRS, except for health insurance
premiums in certain circumstances. If you pay for expenses through your general purpose
HCRA, you may not take a tax deduction for those expenses. You’re only eligible for the tax
deduction if your health care expenses exceed 7.5% of your adjusted gross income. Please
consult with your tax advisor for details.
33 | P a g e Rev 06.14.13 cnt1509275
LEARN MORE Click here to review the Frequently Asked Questions developed specific to
Health and Dependent Care Reimbursement Accounts
Health Care Reimbursement Account (General Purpose)
The General Purpose Health Care Reimbursement Account (HCRA) allows you to use pre-tax dollars to
pay for eligible health care expenses incurred by you or any person whom you claim as a dependent on
your federal tax return and who receives more than 50% of financial support from you during the calendar
year. You may contribute up to $2,500 each calendar year to a General Purpose HCRA. The minimum
annual contribution is $120 or $5 per paycheck.
Health Care Reimbursement Account (General Purpose) Eligible Expenses
You may use the Health Care Reimbursement Account to pay for any eligible health care expenses as defined by the IRS. The following is a partial list of expenses eligible for reimbursement. A more comprehensive list of eligible expenses are contained in IRS Publication 502 entitled Medical and Dental Expenses. Read important information at the end of this section called “Plan Carefully - Verify Eligible
Expenses”.
Partial List of Eligible Expenses
Acupuncture
Alcoholism treatment
Ambulance
Artificial limbs
Braille books/magazines
Car controls for the disabled
Chiropractors
Coinsurance
Crutches
Deductibles
Dental
Dentures
Drug/medical supplies
Eyeglasses & Exams
Hearing devices and batteries
Hospital
Insulin
Laboratory
Nurse
Obstetrics
Orthodontia
Orthopedic care
Over the counter drugs (when prescribed by a physician)
Physicians
Psychiatric care
Psychologist care
Radial keratotomy surgery
Non-diagnostic services or treatments
Seeing-eye dog and maintenance
Special education for the blind
Surgical fees
Telephone equipment for the deaf
Therapeutic care for drug and alcohol addiction
Therapy treatments
Tuition at special school for handicapped
Wheelchair
Wigs (for congenital or drug-induced hair loss)
X-rays
Health Care Reimbursement Account (General Purpose) Ineligible Expenses
Expenses that are NOT eligible for reimbursement include but not limited to:
Childcare or elder care expenses
Cosmetic treatment, surgery or supplies (unless to correct a congenital deformity or injury)
Health club dues
Health plan insurance premiums (including COBRA premiums)
Maternity clothes
Over-the-counter drugs (unless prescribed by a physician)
34 | P a g e Rev 06.14.13 cnt1509275
Healthcare Reimbursement Account - Automatic Reimbursement
If you enroll in a UHC medical plan, dental plan, or vision plan and you are also participating in the Health Care
Reimbursement Account, all eligible expenses not paid by the medical, dental, or vision plans will automatically be
processed as a claim and reimbursed to you. If you do not want automatic reimbursement under the Health Care
Reimbursement Account, you must access www.myuhc.com and “opt out” of this feature. You may submit
reimbursement expenses online at www.myuhc.com or print the UHC claim form and submit this form with the
appropriate documentation to UHC.
Plan Carefully - Verify Eligible Expenses
Before enrolling in the Health or Dependent Care Reimbursement Accounts, confirm the expenses you plan to incur are
eligible for reimbursement. Certain information in IRS Publication 502 may not be applicable, since some of the laws
governing health care reimbursement account plans are different from the laws governing medical expense deductibility.
For example, insurance premiums and certain long term care expenses are not eligible for reimbursement from the
Health Care Reimbursement Account or the Limited Purpose Health Care Reimbursement Account even though these
expenses may qualify as deductible medical expenses as explained in IRS Publication 502. If you have any questions
regarding what qualifies as an eligible Health Care Reimbursement Account or Limited Purpose Health Care
Reimbursement Account expense, please contact United Healthcare at 1.866.672.2511.
Social activities, such as dance lessons, even if recommended by a qualified physician
Vitamins
Weight-loss and stop-smoking programs (unless medical necessary as determined by the treating physician and the health plan covering the individual)
Health Care Reimbursement Account (Limited Purpose)
The Limited Purpose Health Care Reimbursement Account (LPHCRA) works similarly to the general
purpose account, however, reimbursements are restricted to eligible dental and vision expenses. It allows
you to use pre-tax dollars to pay for these eligible expenses incurred by you or any person whom you
claim as a dependent on your federal tax return and who receives more than 50% of financial support
from you during the calendar year.
You may contribute up to $2,500 each calendar year to a Limited Purpose HCRA. The minimum annual
contribution is $120 or $5 per paycheck.
IMPORTANT NOTE: You are eligible to contribute to the Limited Purpose Health Care
Reimbursement Account ONLY if you enroll in the UHC HSA Medical plan which consists of a
qualified High Deductible Health Plan (HDHP) and Health Savings Account (HSA).
Health Care Reimbursement Account Enrollment Considerations
How much will you spend in 2013 for eligible health care expenses?
If you’re already participating, will the goal amount you’ve elected this year make sense for 2013? If not, be sure to make a change to your election during Open Enrollment because your elections will automatically continue each year unless you choose otherwise
Remember the “use it or lose it rules” – any unused monies cannot be used in subsequent years. Plan carefully!
HSA Medical Plan enrollees may consider the Limited Purpose Health Care Account as it allows you can use the account for planned dental and vision expenses and reserve your Health Savings Account (HSA) for medical expenses only.
35 | P a g e Rev 06.14.13 cnt1509275
Dependent Care Reimbursement Account
The Dependent Care Reimbursement Account (DCRA) allows you to use pre-tax dollars to pay for eligible
dependent care expenses (childcare or elder care) you incur during the calendar year if you (or you and
your spouse) need these services to allow you to work. You are eligible to enroll if you have an eligible
dependent and if you fall into one of the following categories:
You are a working single parent
You and your spouse both work
Your spouse is a full-time student for at least five months of the plan year
Your spouse is mentally or physically disabled and unable to care for himself or herself or your dependent
The IRS maximum contribution each calendar year is $5,000. The minimum annual contribution is $120 or $5 per paycheck. The actual amount you can contribute to a DCRA depends on your family situation and tax filing status. Dependent Care Reimbursement Account Contributions
If You Are… You May Contribute Up To…
A working single parent $5,000 per year ($208.33 per pay period)
Married and filing a joint tax return, and your spouse does not have access to a Dependent Care
Reimbursement Account $5,000 per year
Married and filing a joint tax return, and your spouse is a student or disabled
$3,000 per year for one dependent or $5,000 per year for two or more dependents
Married and filing separate tax returns $2,500 per year ($104.16 per pay period)
Married and your spouse earns less than $5,000 per year
The amount of your spouse’s annual income
Married to another Oracle employee $5,000 per year combined
You also have the option to take a federal tax credit for dependent care expenses instead of using a DCRA. You may want to consult your tax advisor to determine which method is best for you.
Eligible dependents for the purposes of this account must be claimed as dependents on your federal tax return and be
Under age 13 or;
Mentally or physically unable to care for himself or herself, regardless of age, which may include children over the age of 13, disabled spouse, or older relative or;
Incapacitated elderly adult who lives with you at least eight hours per day
Dependent Care Reimbursement Account Eligible Expenses
The types of care that can be reimbursed include:
Care at a licensed day care facility
Care at an unlicensed facility caring for fewer than seven people
Private school tuition expenses below the first grade when the school can separate the cost of childcare. In this case, only the cost of childcare will be considered
36 | P a g e Rev 06.14.13 cnt1509275
LEARN MORE
For more information including covered services, fees and network attorney directory visit the ARAG website or call ARAG
® toll-free number at 1-800-523-5299
ARAGLegalCenter.com (Access Code 10378ora) Click here to enter website and bypass the Access Code.
In-home baby-sitting services
Day camp
Before-school and after-school care
Practical nursing care for an adult
Dependent Care Reimbursement Account Ineligible Expenses
Expenses that are not eligible for reimbursement from the DCRA include:
Medical or healthcare expenses.
Any amounts paid to provide food, clothing or education
Services outside your home at a camp where your child or disabled spouse or dependent stays overnight
Transportation to and from the place where care is provided
Private school tuition expenses for dependents in first grade or above (after-school care is an eligible expense if this is listed separately from tuition on your bill)
Private school tuition expenses below the first grade when the school can separate the cost of childcare. In this case, only the cost of childcare will be considered reimbursable
Training and travel expenses for childcare provider
If the dependent care provider is your own child or relative, your expenses are eligible for reimbursement only if the provider is at least age 19 before the end of the plan year in which claims are incurred. The provider also cannot be claimed as a dependent on your income tax return.
You are also required to report the name, address and Social Security number or Tax Identification number of your dependent care providers on your federal tax return (IRS Form 2441). Otherwise, the amount of your reimbursements will become taxable income and will be reported on your W-2.
You may submit reimbursement expenses online at www.myuhc.com or print the UHC claim form and
submit this form with the appropriate documentation to UHC.
Dependent Care Reimbursement Account Enrollment Considerations
How much will you spend in 2013 for dependent care expenses? Don’t forget day care, nursery school, after-school programs, and summer care that are likely to come up during the year. Will your dependent child turn 13?
Compare the advantages of the Dependent Care Reimbursement Account with the federal dependent care tax credit and similar tax credits to see which approach provides the greatest tax advantage.
If you’re already participating, will the goal amount you elected this year make sense for 2013? If not, be sure to make a change to your election during Open Enrollment.
Remember that you will lose any money left over in this account from 2013 — it cannot be used for expenses you incur in subsequent years
Group Legal Plans
37 | P a g e Rev 06.14.13 cnt1509275
LEARN MORE
For more information, access the Ayco Financial Service website or contact the toll free number. www.aycofn.com/oracle.mim
1-800-348-2093
You and your eligible dependents may choose to participate in the Group Legal Plan administered by
ARAG to protect you and your eligible dependent(s) from everyday legal issues – and the high cost of
attorney fees. Once enrolled, you and your eligible dependent(s) have access to a wide range of legal
and financial services including:
Legal Representation
Telephone Legal Advice and Consultation
Online Legal Documents, Tools and Resources
Financial Education and Counseling Services
Identify Theft Services
Immigration Assistance
When you work with an ARAG Network Attorney, most covered legal matters are 100% paid-in-full.
Common covered legal matters include:
Wills*
Consumer Protection
Family Law Matters
Property Disputes (Primary Residence)
Property Transfers (Buy/Sell Primary Residence)
* Standalone trust documents can be covered via the 4 hours of in-office attorney time.
For complete coverage details, visit ARAGLegalCenter.com (Access Code 10378).
ARAG Group Legal Plan – Network and Non-Network Attorney Benefits
As a plan member, you can choose to work with any attorney. When you work with an ARAG Network
Attorney, most covered legal services will be 100% paid-in-full (except miscellaneous costs, e.g. court
costs, court reporter’s fees, filing fees, etc.).
When using a Non-Network Attorney for covered matters your attorney will bill you directly. You then
submit a copy of the bill and a completed claim form to ARAG for reimbursement. Claim payment is based
on the Non-Network Attorney Reimbursement schedule.
ARAG Group Legal Plan – Exclusions
Most personal and consumer related legal matters are covered by the Legal Plan. However, any legal
matter that occurs or is initiated before the effective date of your coverage will be excluded and no
benefits will apply. ARAG excludes matters against ARAG and/or Oracle. For a complete listing of
exclusions go to ARAGLegalCenter.com and enter Access Code 10378.
Financial Planning
38 | P a g e Rev 06.14.13 cnt1509275
Oracle is pleased to offer an extensive financial planning benefit to help you with the complexities of
personal financial planning. The program is an employee paid benefit on an after tax basis. Your per pay
period cost is reflected on the Oracle US Benefits Website.
The Money in Motion® Personal Finance Program, provided by The Ayco Company, L.P., a Goldman
Sachs Company, is designed to provide both personalized telephonic and online resources for a variety of
financial issues. You will also have access to Ayco’s Investing in Your Future Guidebook, a
comprehensive planning reference with worksheets, examples, and resources available online. The
Money in Motion® personal finance program includes:
Unlimited access to the Ayco AnswerLine® service
Online planning tools via the Ayco Financial Network Web Site
Personalized reports for retirement, investments and college funding
E-subscriptions to the Updates newsletter and MonthlyMoneyMap action series Ayco’s financial counselors provide you with unbiased information. They do not represent financial
products or investments, and are not paid by commission. Ayco’s counselors are also knowledgeable
about Oracle's benefit plans and can advise you about your benefits as part of your overall financial plan.
The Ayco AnswerLine® service is toll-free and provides direct and confidential access to an experienced
financial planner. It is not an automated response system. One-on-one counseling helps you establish
financial goals and take informed action to reach them. The strategy used on the Ayco AnswerLine® will
most likely resemble the following:
Consultation: The Ayco AnswerLine® counselor can help you establish financial goals, such as a comfortable retirement, college for your children, or a stronger cash flow.
Assessment: Once you’ve identified your goals, the next step is to identify problems and opportunities. You’ll answer a variety of questions that might include how conservative you are with your financial strategy, whether or not you have a good credit rating, whether or not you’re overpaying taxes, or if you’re utilizing your assets in the most productive way.
Action Plan: Following your assessment, Ayco can suggest strategies for you to better reallocate investments, boost 401(k) contributions, establish a 529 plan for education funding, or prioritize spending and reducing debt.
The Ayco Financial Network – Interactive Financial Planning Web Site You can access Ayco’s web site where you’ll find:
Helpful, easy-to-use calculators for financial modeling and projections
A personal financial scorecard to assess your financial health and track your progress
Educational materials on cash flow, debt management, investments, estate planning, insurance, education funding, tax planning and key life events
Answers to frequently asked questions on financial planning issues Updates newsletter online; hotlinks to other finance-related sites
Encryption technologies and password protection to help keep your data secure
Discuss your work on the website with a financial counselor from the Ayco AnswerLine® service, who can help you with practical tips on implementation
39 | P a g e Rev 06.14.13 cnt1509275
LEARN MORE For more information contact Liberty Mutual
800-221-8135
LEARN MORE & ENROLL For more information and to enroll, visit www.ltcbenefits.com (password: oraclegltc)
or call 1-877-777-9072
Long Term Care Insurance
Long-term care is necessary when you are unable to care for yourself because of an injury or a chronic
illness. It can range from assistance at home with activities of daily living such as bathing and dressing,
to skilled nursing care in a facility. Long-Term Care insurance provides reimbursement up to a daily
benefit (which you select) to cover long-term care expenses such as nursing home care, assisted living
facilities or home care.
These services, known as custodial care, are excluded from the Oracle medical plans and Medicare
benefits are limited. Coverage is fully portable – which means if you should leave Oracle you have the
option to continue coverage at the same benefit level and cost.
Upon initial eligibility (e.g. new hire) you may enroll at any level without evidence of insurability. You will
have 60 days from your eligibility date (e.g. hire date) to enroll in the long-term care plan without
providing medical information. If you do not sign up during within 60 days or your hire date, you will not be
allowed to enroll until the next enrollment period. At that time you will be required to answer medical
questions prior to being accepted into the plan.
Enrollment Information Unlike your other benefits – you do not enroll in Long Term Care using the online enrollment system. To
enroll – go to the CNA website at www.ltcbenefits.com (password: oraclegltc) and follow the online
instructions. You, your spouse, same or opposite sex domestic partner, and/or your parents and
grandparents (and parents/grandparents of your spouse/domestic partner) are eligible to participate.
Personal Insurance (Auto / Home / Renters)
Oracle has partnered with Liberty Mutual to offer you a program to purchase personal automobile,
homeowners and renters insurance at a group discount and with the convenience of payroll deduction.
Advantages of the Liberty Mutual Group Savings Plus program include:
Discounts
Convenient payroll deductions for premiums
24-hour roadside assistance as part of auto insurance plan
12 month rate guarantee
Personalized 24-hour claims service
Health Care Reform
Understanding the health care landscape is the key to understanding how Oracle manages your benefits.
Health Care Reform impacts all of us on some level and we understand the importance for all of you to be
informed.
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Visit the Oracle US Benefits Website and check general information regarding Health Care Reform. The
information provided does not include every provision of the law and focuses on key events that directly
impact Oracle sponsored health benefits. The information will change as the Health Care Reform law
develops and policies are established so please check back regularly to obtain the most recent
information.
Maximize Your Benefits
Taking time to learn, make informed selections, and using your benefits wisely are ways you can stay healthy and manage costs for yourself and for Oracle. Making health care decisions today requires many of the same skills you would apply to other purchases, such as:
Understanding your needs and healthcare patterns
Staying informed about plan coverage and new offerings
Comparing your choices and key features
Checking costs
Learning to maximize the plans that you are enrolled in
Healthcare Consumer Tips
There are a number of healthcare consumer tips that can help you obtain necessary care – and at the
same time mitigate your expenses. Check out the list below and start applying them as needed.
Take care of yourself: The best way to keep your healthcare costs down is to stay as healthy as
possible. You can't control heredity, but you can control what you do about your individual risk factors.
Learn what's treatable without a physician: Did you know that the majority of health problems are cared
for in the home? Know how to recognize common health problems, what to do when they occur, when
and where to seek help, and how to prevent them in the first place.
Use provider websites to find answers to your questions: Oracle’s health program vendors host
websites that contains a wealth of health information. Click here to access a list of Oracle’s program
contacts and websites.
Access 24/7 Nurseline services: Utilize the 24/7 Nurseline services available as a starting point for
health care information rather than visiting your physician or the emergency room.
Visit emergency rooms only in true medical/life threatening emergencies: Unless you have a
life/limb threatening condition think about using Urgent Care Centers or your general physician if
acute treatment is not required. Calling the 24/7 Nurseline services is another option to help you
determine suitable treatment options.
Save time and money by using mail order: Buy ongoing maintenance prescription drugs by mail.
Using mail order programs can reduce your cost and provides the convenience of having medications
delivered to your home - saving you a trip to the retail pharmacy.
Consider Tier 1/Generic medications: Instead of automatically purchasing a brand-name
medication, ask your physician if a generic equivalent is available. Generic equivalent medications
contain the same active ingredients and are subject to the same rigid Federal Drug Administration
standards for quality, strength and purity as their brand-name counterparts. Choosing lower cost Tier
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1 or generic medications (if available and appropriate for your condition) can effectively treat your
condition and save you money.
Select network physicians and service providers: Remember, you pay less when you use network
providers. When you and your family use these providers, you save money because network
providers have agreed to accept negotiated rates for their services and you pay a lower portion of
coinsurance.
Take advantage of preventive screenings, check-ups and online wellness resources
information: All of Oracle’s medical plan offerings provide coverage for preventive care. Eligible
network preventive care services are covered at 100%.
Get to know your plan: Become familiar with your plan and use the features that help you prevent
illness or manage your current condition.
Follow through on your physician's prescribed course of treatment: Compliance with your
physician's treatment can help you experience better medical outcomes.
Take advantage of tax savings opportunities: Pay for eligible expenses using pre-tax dollars.
Enroll in the General Purpose Health Care Reimbursement Account (or Limited Purpose Health Care
Account if you elect the UHC HSA Medical Plan).