 |
|
|
|
|
|
|
| Glossary |
|
|
|
|
|
Dependent Care Fund: Through payroll deductions, you can put pre-tax dollars into this flexible spending account that you can use toward care for your children or parents. Using pre-tax funds is like getting a discount—up to 28% depending on your taxable income. You can contribute up to $5,000 to this account.
Health Care Fund: Through payroll deductions, you can put pre-tax dollars into this flexible spending account to use toward medical, drug, vision, and dental expenses. That's like getting a discount on everything you buy using your Health Care Fund—up to 28%, depending on your taxable income. And here's more good news: Now you can contribute up to $5,000 in your Health Care Fund each year.
Health Questionnaire: When you pledge to complete the Health Questionnaire, Alcoa gives you $200 in credits to use toward your benefits costs.
Medical Coinsurance: You pay this percentage when you use your benefits and after you have met your deductible. Your coinsurance amount may depend on what type of physician you see and where you receive services:
- A Primary Care Physician (PCP) is a family, general, or internal practitioner, or a pediatrician.
- Specialist/ER care is received from any other physician or in an emergency room.
- Other services include surgery, hospitalization, laboratory services, X-rays, physical therapy, occupational therapy, speech therapy, durable medical equipment, and more.
Medical Deductible: You pay this amount before Alcoa begins to pay. If you use both in-network and out-of-network providers, you must meet both deductibles.
Medical Network: Your medical claims administrator—either Aetna, CIGNA, Highmark, or UnitedHealthcare—has contracts with network providers that help you save. You pay less when you stay in-network. With Choices, you still have the option to go to an out-of-network provider if you want to. However, you'll pay more.
Medical Out-of-Pocket Maximum: You're protected by this maximum, which is the most you'll pay for covered services in a year. After you pay the maximum amount of out-of-pocket costs through your deductible and coinsurance, Alcoa will pay 100% of your costs for eligible medical expenses.
Opt-Out Credit: If you decide to be covered under your spouse's medical benefits, Alcoa gives you a $1,000 opt-out credit to use toward other benefits costs.
Per-prescription maximum: To protect you from the high costs of some drugs, Alcoa limits the amount you pay per prescription. The most you'll pay for a retail prescription or specialty drug (up to 30-day supply) is $100, and $200 for a mail-order prescription (up to 90-day supply).
Pharmacy Network: Your pharmacy benefit manager is still Caremark. If you use a retail pharmacy, ask if it's part of the Caremark network.
Prescription Drug Coinsurance: You pay this percentage for your prescription drugs after you meet your deductible, if one applies. Your coinsurance amount is based on the type of drug you choose:
- Generic
- Brand 80/20: This coinsurance category typically includes drugs for which there are no or few alternatives in the same drug class. This category also includes asthma drugs, diabetes drugs, and specialty drugs.
- Brand 50/50: This coinsurance category typically includes drugs for which there are a number of alternatives in the same drug class. Therefore, when you choose a Brand 50/50 drug, you pay more. A deductible applies.
Prescription Drug Deductible: You pay your deductible before Alcoa begins to pay a percentage of your prescription drug costs.
|
|
|
