2018 Pre-Medicare Retiree Annual U.S. Benefits Enrollment ... · PDF fileMore information is also available on the enclosed Health Plan Comparison Charts and on My Health, ... prescription

2018 Pre-Medicare Retiree Annual U.S. Benefits Enrollment Bulletin | 1

Take action before November 10!

Check the enclosed Personalized Fact Sheet for all of the pre-Medicare 2018 coverage options and costs. More information is also available on the enclosed Health Plan Comparison Charts and on My Health, your online centralized resource for plan information. See more information on pages 9‒10 regarding the tools and resources available.

Enroll before the November 10, 2017, benefits enrollment deadline, or any pre-Medicare participant will be assigned coverage based on his or her current 2017 elections with 2018 costs. If changes are needed, go to My Health and click “Enroll now” to make your 2018 elections, or to use the online tools available on the Benefits Web Center. You can access My Health via the Internet at myhealth.jpmorganchase.com.

2018 Annual U.S. Benefits Enrollment Ends November 10, 2017

Welcome to the annual enrollment period for the JPMorgan Chase 2018 U.S. Benefits Program. This bulletin is for pre-Medicare retirees and their eligible covered pre-Medicare family members.

If you are a Medicare-eligible retiree, this bulletin addresses your pre-Medicare dependents’ 2018 coverage elections, which you will continue to make on their behalf through the Benefits Web Center or the accessHR Benefits Contact Center until those dependents become eligible for Medicare and coverage is offered through OneExchange (see page 2 for additional information).

Now is the time to consider and make choices for 2018. You and/or your dependents may be eligible for coverage under the following plans: Retiree Medical, Retiree Dental, Retiree Vision and/or Retiree Life Insurance (Retiree only). Note: JPMorgan Chase Health Care and Insurance Plans do not have a deferral of coverage option. If you choose to waive coverage, you cannot elect coverage at any time in the future.

If you or your covered spouse/domestic partner is Medicare-eligible, medical, prescription drug, dental and vision plan options are offered through OneExchange, the country’s largest and most experienced private Medicare exchange provider. See page 2 for more information, including what happens if one of you is pre-Medicare eligible and the other is Medicare-eligible (split family coverage).

We encourage you to review your current health care and insurance plan options to be sure they continue to meet the needs of you and your covered dependents. Your Enrollment Checklist on page 6 will guide you through making your decisions for 2018.

2018 Pre-Medicare Retiree Annual U.S. Benefits Enrollment Bulletin

WHAT’S INSIDE

When You Turn 65 or Become Eligible for Medicare…………………………………….2

What’s Changing for 2018 .................. 3

Paying for Coverage ............................ 5

Important Steps to Take by Nov. 10: Your Enrollment Checklist .................. 6

Additional Details for Pre-Medicare Retirees ........................ 7

Tools to Help You Choose and Enroll............................................ 9

Now Is the Time to Enroll ................. 11

Benefit Reminders ............................ 13

How to Use “Single Sign-On” ............ 15

OCTOBER 2017

2 | 2018 Pre-Medicare Retiree Annual U.S. Benefits Enrollment Bulletin

When You Turn 65 or Become Eligible for Medicare

When you turn 65 or become eligible for Medicare, you enroll in health care coverage through OneExchange, the country’s largest and most experienced private Medicare exchange. OneExchange offers medical, prescription drug, dental and vision coverage. OneExchange does not provide coverage for you and/or your covered dependents until you and/or your covered dependents become eligible for Medicare.

There are separate elections for Medicare-eligible participants and their Medicare-eligible family members, because the coverage through OneExchange is individualized coverage. As a pre-Medicare retiree or covered dependent, you will receive information from OneExchange approximately 60 days before you become eligible for Medicare.

Medicare-eligible participants who are currently eligible for and receiving a subsidy for medical coverage, based on the rules in effect at the time of their retirement, will continue to be provided a subsidy through an annual contribution to an account called a Health Reimbursement Arrangement (HRA). This account can be used to offset eligible medical, prescription drug, dental and vision premiums, and other eligible medical, dental and vision out-of-pocket costs.

If you have questions, OneExchange can be reached toll-free at 1-844-448-7300, 8 a.m. to 9 p.m. Eastern Time, Monday through Friday. You may also access the OneExchange website for JPMorgan Chase members at www.medicare.oneexchange.com/jpmc.

Having split family coverage

Having split family coverage means one or more family members are Medicare-eligible and one or more family members are not yet eligible for Medicare. When this happens, members of the same family are covered under separate options (i.e., one as pre-Medicare with JPMorgan Chase Retiree Plans and one as Medicare-eligible with health care coverage through OneExchange).

If the pre-Medicare covered family member is eligible for a medical subsidy (based on the rules in effect at the time of retirement), the subsidy will continue to offset the JPMorgan Chase medical premium as long as the pre-Medicare covered family member remains enrolled in JPMorgan Chase medical coverage. Once that covered family member becomes eligible for Medicare, the subsidy will be deposited annually to the HRA with OneExchange as long as that family member enrolls in medical coverage through OneExchange with no lapse in coverage.

Please be sure to review 2018 plan information with your family members. If you (as the former JPMorgan Chase employee) are pre-Medicare, look through this bulletin and choose the right options for you and your pre-Medicare covered dependents, and enroll in JPMorgan Chase benefits using the Benefits Web Center or by calling the accessHR Benefits Contact Center (contact information is on page 11). If you are the former JPMorgan Chase employee and are Medicare-eligible, you need to enroll your pre-Medicare dependents in JPMorgan Chase benefits through the Benefits Web Center or by calling the accessHR Benefits Contact Center, and separately enroll yourself (or continue coverage) through OneExchange.

You will find the Health Plan Comparison Charts for pre-Medicare participants in this package along with their Personalized Fact Sheets; both are also available on the Benefits Web Center via My Health > Enroll now.

http://www.medicare.oneexchange.com/jpmc


What’s Changing for 2018

Medical Plan

Pre-Medicare retirees enrolled in the Consumer Driven Health Plans (CDHP) will continue to have access to CDHP Option 1 and Option 2, offered through Cigna and UnitedHealthcare (UHC). CDHPs encourage participants to become better consumers of health care services and take a more active role in managing and improving their health. To get the most out of these types of plans, participants need to be involved — for example, by researching treatment alternatives and provider quality, and taking part in wellness programs to improve and maintain their health.

Note: The JPMorgan Chase Retiree Medical Plan complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Please refer to the Notice of Nondiscrimination, which we are legally required to provide to you, on page 13 if you have any questions.

2018 Medical Plan Consumer Driven Health Plan (CDHP)

Option 1 and Option 2 under the CDHP continue for 2018. The key difference between CDHP Option 1 and Option 2 is that Option 1 has higher monthly contributions and a lower deductible and coinsurance maximum, while Option 2 has lower monthly contributions and a higher deductible and coinsurance maximum. There are no changes to CDHP Options 1 and 2 for 2018.

2018 Medical Plan Point-of-Service High and Low (POS H/L)

Only retirees who were enrolled in Point-of-Service High and Low (POS H/L) plans as of January 1, 2012, and have remained continuously enrolled in POS H/L may continue that coverage in 2018. There are no changes to the POS plans for 2018.

Prescription Drug Plan changes for pre-Medicare retirees

Your pre-Medicare prescription drug coverage as part of the Retiree Medical Plan is administered by CVS Caremark. Though it is part of the Retiree Medical Plan, it has a different design with separate deductibles and a separate safety net for covered drugs in the form of per-prescription maximums and annual out-of-pocket maximums. While there is an increase in the per-prescription and out-of-pocket maximums in 2018, you’ll continue to have no copayment for preventive generic drugs and no retail deductible for all non-preventive generic drugs. And the deductible remains the same. See chart below:

CHANGES TO PRESCRIPTION DRUG MAXIMUMS

Prescription Drug Benefit Provisions

CVS Caremark Retail Pharmacy Network (up to a 30-day supply)

Maintenance Choice, CVS Caremark Mail Service Pharmacy or CVS Pharmacy (up to a 90-day supply)

Per-Prescription Maximum

Preferred Brand-Name Medications and Specialty Generic Medications

You pay 30% coinsurance after the deductible, up to a maximum of $200 per-prescription payment

You pay 30% coinsurance up to a maximum of $500 per-prescription payment (deductible does not apply)


Non-Specialty and Specialty Lists of Covered and Excluded Drugs Non-Specialty and Specialty Lists of Covered and Excluded Drugs: The Prescription Drug Plan, associated with the CDHP and POS H/L plans, uses CVS Caremark’s lists of covered and excluded drugs. An independent committee made up of pharmacists, physicians and medical ethicists reviews and approves the drug lists (also known as Formularies). These lists are subject to change quarterly by CVS Caremark. If you continue to take a non-covered drug, you will pay the full cost of the drug. You can view the lists on the Caremark website through My Health > 2018 Benefits Resources > CVS Caremark.

CHANGES TO PRESCRIPTION DRUG MAXIMUMS

Prescription Drug Benefit Provisions

CVS Caremark Retail Pharmacy Network (up to a 30-day supply)

Maintenance Choice, CVS Caremark Mail Service Pharmacy or CVS Pharmacy (up to a 90-day supply)

Non-Preferred Brand-Name Medications

You pay 45% coinsurance after the deductible, up to a maximum of $250 per-prescription payment

You pay 45% coinsurance up to a maximum of $625 per-prescription payment (deductible does not apply)

Annual Out-of-Pocket Maximum

(covers copayment/coinsurance expenses for prescription drugs; does not include the deductible)

$1,150 retiree only coverage* $1,750 retiree + spouse/domestic partner coverage, or retiree + child(ren) $2,300 family coverage [retiree + spouse/domestic partner + child(ren)]

*Also serves as the per person maximum. For both the retail deductible and the annual out-of-pocket maximum, the “per person” rule allows the retiree or any covered dependent(s) [e.g., spouse/domestic partner or child(ren)] to reach an individual deductible or out-of-pocket maximum, after which the deductible or out-of-pocket maximum is satisfied for the year for that person. Covered individuals who have not met the deductible or out-of-pocket maximum may combine to meet the remainder of the deductible or out-of-pocket maximum for that particular coverage level. If no one person has met the individual deductible or out-of-pocket maximum, the expenses of all covered individuals can combine to meet the deductible or out-of-pocket maximum for that coverage level.

As a reminder, the plan contains a mandatory generic drug program. This means generic drugs will be substituted for all brand-name prescription drugs with a direct generic equivalent. If you or your doctor requests a brand-name drug when a direct generic equivalent is available, you'll pay the difference in cost between the brand-name and the generic drug, plus the generic copay (i.e., the brand-name drug cost minus the direct generic drug cost plus your generic copay). Note: These cost differences will not be limited by per-prescription maximums or annual out-of-pocket maximum limits.

Retiree Dental and Vision Plans

There are no plan design changes to Retiree Dental or Vision Plans for 2018.


Paying for Coverage

You can pay for your Health Care and Insurance Plans coverage through direct debit from a financial account of your choosing or by check. If your payment (via check or direct debit) is 31 days past due, your coverage will be terminated for non-payment, and you will not be able to re-enroll in coverage for the remainder of the year or at any time in the future. For example, your January 1 payment is past due after January 30. Your February 1 payment is past due after March 2. Therefore, it may be easier for you to set up direct debit.

There are two ways to set up direct debit — either by calling the accessHR Benefits Contact Center (information on page 11) or by electing direct debit during your enrollment event on the Benefits Web Center (My Health > Enroll now). If you do not make a direct debit election during enrollment or through the accessHR Benefits Contact Center, you will automatically continue to receive a direct bill (monthly invoice) for your January 2018 coverage. You will receive your bill for January around December 15 and must pay for that coverage by January 30, 2018. Subsequent monthly bills will be sent in a similar time frame.

A word about dependent eligibility

If you are eligible for retiree benefits, you can cover eligible dependents (e.g., spouse/domestic partner, children) who were part of your family on the date you retired, regardless of whether you covered them under the JPMorgan Chase Medical Plan while you were actively employed. Children are eligible until the end of the month in which they turn age 26. For more on eligibility requirements, access the 2018 Dependent Eligibility Requirements via My Health > 2018 Benefits Resources. If you are adding a dependent to coverage, you will need to provide that dependent’s Social Security number (SSN). IMPORTANT NOTE: If you choose to waive coverage for your eligible dependent(s), you cannot enroll them in JPMorgan Chase plans at any time in the future.


YOUR ELECTIONS LAST ALL YEAR

Elections you make during this annual enrollment period will become effective January 1, 2018, and remain in effect through December 31, 2018. The only time you can make a change during the year is if you have a qualified status change, like getting married or having or adopting a baby. In the event of a status change, any resulting coverage changes must be made within 31 days after the date of the event. If you experience a qualifying event, access the Benefits Web Center or call the accessHR Benefits Contact Center at 1-877-JPMChase (1-877-576-2427) right away.

If you don’t make changes for 2018, generally your elections for 2017 will continue at 2018 rates.

Important Steps to Take by November 10: Your Enrollment Checklist

Review your pre-Medicare Medical Plan options, and elect the coverage that is best for you and your family. Compare your pre-Medicare options both within the JPMorgan Chase Retiree Medical Plan and with any other plans available to you, such as through your spouse’s/domestic partner’s employer or former employer, or other options available to your child(ren). Take everything into consideration when making your choice. Go to My Health and click “Enroll now” to access the Benefits Web Center, where you can review the Health Plan Comparison Charts and compare the costs and coverage provided under each option.

Decide whether your CDHP health care company is still the right fit for you. Both Cigna and UnitedHealthcare (UHC) offer the same CDHP design and monthly contributions to pre-Medicare retirees. Check out the tools, resources and wellness programs each health care company offers, and whether your doctors are in their networks. You can access the health care company websites through My Health or through the Benefits Web Center.

Review the way you pay for health care through your MRA — automatic claim payment or debit card — to see if it’s still the best approach for you. See the Helping You Choose: Automatic Claim Payment vs. Debit Card tip sheet on My Health > 2018 Benefits Resources for details.

Review your Retiree Dental and Vision options, and make sure they are still right for you in 2018.

If you choose to waive coverage in any or all JPMorgan Chase Retiree benefits — medical, dental, vision or life, you cannot re-enroll in the future.

If you are Medicare-eligible, you should review options available to you through OneExchange. Remember: If you have pre-Medicare covered family members, you (the former employee) will enroll them in JPMorgan Chase Retiree plans through the Benefits Web Center.

Consider setting up direct debit from a financial account to pay for your coverage, if you are currently paying by check.

Update your dependent information. Your Personalized Fact Sheet includes the information currently on file for you and your covered dependents. Please review this information carefully, and make sure each dependent’s name, address, date of birth and Social Security number are up to date. This information is important for us to have and is required by the Affordable Care Act (ACA). You can make any necessary changes by visiting the Benefits Web Center via the “Enroll now” link on My Health. To review JPMorgan Chase’s dependent eligibility requirements, please visit My Health > 2018 Benefits Resources.

Take advantage of the online enrollment tools available to you. Visit the Benefits Web Center via the “Enroll now” link on My Health, where you’ll find your monthly cost for coverage, plan details, a comparison of your available options, and links for the health care company websites.

Understand the rules for mid-year changes. If your family situation changes, you may be eligible to make changes to your benefits as follows:

Qualified status changes: The annual benefits enrollment period is the only time you can enroll in or make changes to your benefits during the year, unless you experience a qualified family status change


(such as gaining coverage from another source or in the case of divorce). In the event of a qualified status change, any resulting coverage changes must be made within 31 days after the date of the event. Call the accessHR Benefits Contact Center right away if you experience a qualifying event. (See page 11 for contact information.)

If you or your covered dependent becomes eligible for Medicare: If you or your covered dependent becomes eligible for Medicare due to turning age 65, you will automatically receive information from OneExchange with instructions for enrolling in coverage. You can contact OneExchange if desired for information on their plans at 1-844-448-7300, 8 a.m. to 9 p.m. Eastern Time, Monday through Friday. If you or your covered dependent becomes eligible for Medicare as the result of a disability prior to age 65, please contact the accessHR Benefits Contact Center. (See page 11 for contact information.)

Additional Details for Pre-Medicare Retirees

Your 2018 Consumer Driven Health Plan (CDHP) Medical Plan at a glance

The JPMorgan Chase Retiree Medical Plan is designed to help you manage your health by providing tools and resources that help you make better decisions about your health and the care you and your family receive. The key components of the CDHP, which continue in 2018, include:

In-network age- and gender-appropriate preventive care is covered at 100% with no deductible. This includes physical exams, recommended screenings and immunizations.

Virtual doctor visits with a doctor using a smartphone, tablet or computer for $5 or less per virtual visit (with no deductible).

In-network primary care office visits are covered at 90% with no deductible. This includes visits to a family practice doctor, internist,1 pediatrician and/or OB/GYN, as well as visits to convenience care clinics.

Other in-network medical care has a deductible. The Plan generally pays 80% of costs for other care such as specialist visits, hospital stays, labs and outpatient facilities — after an annual deductible is met.

Out-of-network care does not require a referral. You will pay 100% of the cost for services for out-of-network doctors until you reach a separate, higher out-of-network deductible. After this deductible is met, out-of-network medical services (including services received in an emergency room designated by your health care company as not a true emergency, e.g., colds, earaches, sprains) are covered at 50% up to the reasonable and customary (R&C) limit. The charges are based on average claims data in your area and are determined by your health care company to be appropriate fees for medical services. You are responsible for amounts above the R&C limit.

The Plan’s coinsurance maximum gives you a financial “safety net” that limits the amount you have to pay in coinsurance each year. Note that there are separate coinsurance maximums for in-network and out-of-network charges.

Prescription drug benefits are part of your medical coverage and are provided through CVS Caremark. This benefit has a separate retail deductible for brand-name drugs and a separate safety net for covered drugs in the form of per-prescription maximums and annual out-of-pocket maximums.

– Eligible generic preventive drugs are covered at 100% (no deductibles or copayments/coinsurance). You pay flat copayments for generic drugs and different coinsurance percentages if you use preferred or non-preferred brand-name drugs.

1Internists must be contracted with Cigna or UHC as primary care physicians (PCP). Go to Cigna’s or UHC’s website through

My Health to search for PCPs/primary care.


– There is a mandatory generic drug program whereby generic drugs will be substituted for all brand-name prescription drugs with a direct generic equivalent.

– JPMorgan Chase uses CVS Caremark’s lists of covered and excluded drugs. If you take a non-covered drug, you will pay the entire cost of the drug. More information can be found at the CVS Caremark website through My Health > 2018 Benefits Resources.

– Pharmacy Advisor is a voluntary counseling program offered through CVS Caremark to help members with certain conditions, such as diabetes and heart disease, adhere to their prescription regimen, manage their medications and make sure their medications don’t conflict with each other. When prescriptions are picked up at a CVS pharmacy, the pharmacist will automatically offer to provide onsite counseling.

Learn more about your medical plan and how it works on My Health, where you can access tools and resources, such as the Health Plan Comparison Charts, through the Benefits Web Center at My Health > Enroll now, and/or link to the health care companies’ websites.

Wellness update for pre-Medicare retirees

The health care company you choose (Cigna or UnitedHealthcare) will administer wellness programs such as health coaching and condition management. A health coach can help you manage your health by explaining your Wellness Assessment results, helping you set and reach goals, assessing treatment options for certain conditions or giving you advice on preventive care. If you have a chronic condition such as asthma, diabetes, heart disease or low back pain, the Condition Management Program can provide you with support from a registered nurse to help you manage your personal condition and coordinate treatment with your doctor. Please note: Your health care company may contact you to discuss how you can benefit from these programs. Take the call!

Take the Wellness Assessment

You might be surprised by what you discover. The Wellness Assessment is a simple, online health and lifestyle questionnaire that takes about 15 minutes to complete. It requires you to enter some basic health information — like weight, blood pressure, cholesterol and similar test results — so it’s a good idea to take the Wellness Assessment after you’ve had a health screening at your doctor’s office or neighborhood clinic. Your results will provide you with helpful information about what you’re doing well, recommendations for improving your health, and potential issues to discuss with your doctor.

Your privacy is important

The privacy of your health information is important to you — and to JPMorgan Chase. You can be sure that your personally identifiable health information is protected and secure, and complies with privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA). Any personally identifiable health information, including the Wellness Assessment, is not shared with anyone, including JPMorgan Chase, without your authorization and except as permitted by HIPAA.

Your Medical Reimbursement Account (MRA)

If you participated in the JPMC Medical Plan as an employee and retired, any MRA fund balance will carry over each year and may be used for eligible medical and prescription drug expenses until depleted. As a pre-Medicare retiree, you are no longer eligible to earn new MRA funds. However, you can file claims with your health care company for reimbursement from your remaining MRA fund balance for eligible medical and prescription drug expenses. If you switch health care companies (e.g., Cigna to UnitedHealthcare or vice versa), your MRA balance will transfer with you. Please note: Your MRA will be charged an administrative fee monthly.


If you are not a JPMorgan Chase Retiree

If you are covered as a surviving spouse/domestic partner or dependent child of a JPMorgan Chase retiree and you do not have access to My Health, see page 11 for more details on how to enroll.

If you are a pre-Medicare covered dependent of a Medicare-eligible retiree, the former employee will need to elect coverage for you on the Benefits Web Center even though he or she may have his or her own coverage through OneExchange. (See page 11 for more details on how to enroll.)

Tools to Help You Choose and Enroll

In addition to this Pre-Medicare Retiree Annual Benefits Enrollment Bulletin, several resources are available on My Health to help you during this retiree benefits enrollment, including a link to the Benefits Web Center, where you will make your enrollment choices.

If you want to make changes or use the online tools, you can access My Health via the Internet at myhealth.jpmorganchase.com and select “Retiree” (or “Dependent of Retiree” for your covered family members). Once on My Health, click the green “Enroll now” button.


Important resources

The following chart provides an overview of important resources to help you make your decisions about coverage for 2018:

Enrollment Resource

Where You’ll Find It Details

Personalized Fact Sheet

Mailed with this Enrollment Bulletin

The Personalized Fact Sheet (PFS) highlights your 2018 coverage options and costs under the following benefits plans (if eligible): Retiree Medical, Retiree Dental, Retiree Vision and Retiree Life Insurance.

The Retiree Medical Plan options available are based on home ZIP code.

The Retiree Medical, Retiree Dental and Retiree Vision Plan Comparison Charts included with the enclosed PFS summarize key provisions for each option. You are encouraged to review the full Health Plan Comparison Charts, available through My Health > Enroll now, for the most detailed and up-to-date information, as well as links to the medical, dental and vision companies.

If you are eligible, the Retiree Life Insurance coverage amount in effect for January 1, 2018, is also listed.

Health Plan Comparison Charts on Benefits Web Center

Go to My Health and click “Enroll now”

(Also included in your enrollment package)

Side-by-side comparison of your 2018 Medical, Dental and Vision Plan options and how they compare with current plans.

Provider Search on Benefits Web Center

Go to My Health and click “Enroll now”

Online provider directories show whether your provider is in the health care company networks and let you search for primary care physicians and specialists.

Dependent Eligibility Requirements

Go to My Health > 2018 Benefits Resources

Describes the dependents who are eligible for retiree benefits through JPMorgan Chase.

Tip Sheets Go to My Health > 2018 Benefits Resources

Provides more information regarding:

Dependent Eligibility Requirements

Choosing Your Medical Plan Option and Health Care Company

Covering a Domestic Partner

Prescription Drug Coverage

Beneficiary Designation Form

Access via the Internet:

beneficiary.jpmorganchase.com

Allows you to make changes to your current designations under the Retiree Life Insurance Plan as necessary.


Now Is the Time to Enroll

For former employees (pre-Medicare retiree or Medicare-eligible retiree enrolling

pre-Medicare covered dependents)

Your first stop for enrollment is My Health via the Internet at myhealth.jpmorganchase.com. Click “Enroll now” to access the Benefits Web Center. You will need to enter your Standard ID number, shown on your enclosed Personalized Fact Sheet, and your JPMorgan Chase Single Sign-On password (see How to Use “Single Sign-On” on page 15).

For surviving dependents of a JPMorgan Chase retiree

If you are covered as a surviving spouse/domestic partner or dependent child of a JPMorgan Chase retiree, you do not have access to My Health. You may request any of the information in this bulletin by calling the accessHR Benefits Contact Center at 1-877-JPMChase (1-877-576-2427) or 1-212-552-5100 if calling from outside the United States. You may also enroll through the accessHR Benefits Contact Center; representatives are available to assist you from 8 a.m. to 7 p.m. Eastern Time, Monday through Friday, except certain U.S. holidays.

Confirming your coverage

If you make any changes to your assigned coverage or are newly eligible for coverage in 2018, you must confirm your elections:

Online through the Benefits Web Center; you’ll need to “Confirm” your choices in order to complete your enrollment. Your elections have been saved when you see the “Completed Successfully” screen. Please print a copy of this screen and retain it for your records. You will also be able to view and print your 2018 coverage through the Benefits Web Center. This will serve as your confirmation of your 2018 benefits elections. You will not receive a paper confirmation statement in the mail.

OR

By calling the accessHR Benefits Contact Center, a confirmation of your 2018 benefits elections will be mailed to your home address. Please review it promptly once received.

To reach the accessHR Benefits Contact Center

If you can’t access My Health, need more information or need personal assistance after you’ve been to My Health, call the accessHR Benefits Contact Center at 1-877-JPMChase (1-877-576-2427) or 1-212-552-5100 if calling from outside the United States. Then follow the Quick Path steps:

Enter your Standard ID or Social Security number, and Press 1.

Enter your PIN, and Press 9.

Reminder

If you do not make any changes during your designated enrollment period, the information shown on the “Enroll in Your Benefits” screen on the Benefits Web Center, available through My Health, and the enclosed Personalized Fact Sheet will serve as confirmation of your 2018 retiree benefits elections and costs. You will not receive another confirmation from JPMorgan Chase.

12 | 2018 Retiree Annual U.S. Benefits Enrollment Bulletin

The accessHR Benefits Contact Center representatives are available from 8 a.m. to 7 p.m. Eastern Time, except certain U.S. holidays.

Get additional help with Health Advocate

In addition to your health care company’s support, Health Advocate helps you navigate the complex health care system. You get help:

Understanding your JPMorgan Chase retiree medical, prescription drug, dental and vision benefits;

Evaluating coverage options available through the Health Insurance Marketplace exchanges or understanding other aspects of health care reform;

Resolving benefits claims issues;

Finding quality providers in your network;

Maximizing your health care benefits;

Scheduling appointments with hard-to-reach specialists;

Locating community resources and assistance with non-JPMorgan Chase benefits issues, and more.

To contact Health Advocate, Inc., call 1-866-611-8298, Monday through Friday from 8 a.m. to 9 p.m. Eastern Time. This service is available to eligible covered dependents as well.

Forgot your PIN?

You’ll need your PIN to access the accessHR Benefits Contact Center. If you’ve forgotten your PIN, you can reset it yourself by calling 1-877-JPMChase (1-877-576-2427).

When prompted to enter your PIN, press “0” followed by “#,” and follow the prompts. Once the reset process is complete, you can proceed through the telephone system.


Benefit Reminders

HIPAA privacy rights and protected health information

The Health Insurance Portability and Accountability Act (HIPAA) requires employers to communicate how certain protected health information under employee and retiree health care plans may be used and disclosed, as well as how plan participants can get access to their protected health information.

Accordingly, JPMorgan Chase will distribute once every three years a “Privacy Notice of Protected Health Information Under the JPMorgan Chase Health Care Plans” to you that describes in detail how your personal health information may be used and your rights with regard to this information. (This notice was distributed in December 2014.)

Newborns’ and Mothers’ Health Protection Act

In accordance with the Newborns’ and Mothers’ Health Protection Act, group medical plans and health insurance issuers may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a normal delivery, or to less than 96 hours following a cesarean section. Further, the plan cannot require that any medical provider obtain authorization from the plan or any insurance issuer for prescribing a length of stay less than these periods.

Medical Plan post-mastectomy benefits

All options under the JPMorgan Chase Retiree Medical Plan cover certain breast reconstructive benefits in conjunction with a mastectomy for eligible participants. Coverage is available for:

Reconstruction of the breast on which the mastectomy was performed;

Surgery and reconstruction for the other breast to produce a symmetrical appearance; and

Prosthesis and treatment of physical complications for all stages of mastectomy, including lymphedema.

This coverage is subject to the terms of the Retiree Medical Plan option in which you participate, including relevant deductibles and coinsurance provisions. For more information, please contact your health care company.

Retiree Medical Plan Notice of Nondiscrimination

The Affordable Care Act requires us to inform you that the JPMorgan Chase Retiree Medical Plan (the “Plan”) complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. The Plan does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. The Plan:

Provides free aids and services to people with disabilities to communicate effectively with us, such as:

o Qualified sign language interpreters

o Written information in other formats (large print, audio, accessible electronic formats other formats)

Provides free language services to people whose primary language is not English, such as:

o Qualified interpreters

o Information written in other languages

If you need these services, contact JPMorgan Chase Benefits Delivery & Customer Service.


If you believe that the Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a grievance with:

JPMorgan Chase Benefits Delivery & Customer Service Address: 4041 Ogletown Road, Floor 02, Newark, DE 19713 Phone number: 1 -877-576-2427, option #1 Fax: 1-313-429-8384 Email: [email protected]

You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, JPMorgan Chase Benefits Delivery & Customer Service is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 1-800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

ATTENTION: If you speak languages listed below, language assistance services, free of charge, are available to you. Call 1 -877-576-2427 and select option #1.

Español (Spanish) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1 -877-576-2427 #1.

繁體中文 (Chinese)

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1 -877-576-2427 #1。

Tiếng Việt (Vietnamese) CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1 -877-576-2427 #1

한국어 (Korean)

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1 -877-576-2427

#1번으로 전화해 주십시오.

Tagalog (Tagalog – Filipino) PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1 -877-576-2427 #1.

Русский (Russian) ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1 -877-576-2427 #1.

ية عرب (Arabic) اللحوظة نت إذا :م تحدث ك ر ت غة، اذك ل إن ال ساعدة خدمات ف م ة ال غوي ل ر ال تواف ك ت مجان ل ال صل .ب م ات رق ب1 -877-576-2427 #1.

Kreyòl Ayisyen (French Creole) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. 1-877-576-2427 #1.

http://www.hhs.gov/ocr/office/file/index.html


Português (Portuguese) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1 -877-576-2427 #1.

Français (French) ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1 -877-576-2427 #1.

Polski (Polish) UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1 -877-576-2427 #1.

日本語 (Japanese)

注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。1 -877-576-2427 #1まで

、お電話にてご連絡ください。

Italiano (Italian) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1 -877-576-2427 #1.

Deutsch (German) ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1 -877-576-2427 #1.

سی ار (Farsi) فوجه ر :ت ه اگ ان ب سی زب ار گو ف ت ف يد، می گ ن يالت ک سه ی ت ان صورت زب گان ب رای راي شما ب راهم شد می ف ا ا .ب بماس #1 877-576-2427- 1 د ت يري گ .ب

How to Use “Single Sign-On”

To ensure the security of the Benefits Web Center, available through My Health, a “Single Sign-On” password is required before access can be processed. You’ll know to use the Single Sign-On password when you see this image:

Former employees: How to log on from home using the Internet

Step 1

ENTER YOUR STANDARD ID ON THE SINGLE SIGN-ON SCREEN.

The Standard ID that was in effect at the time you left JPMorgan Chase will remain in effect after you leave.

ENTER YOUR DEFAULT PASSWORD, which is composed of:

The first three characters of your Standard ID;


The last four digits of your Social Security number or national ID number; and

The first letter of your last name.

For example, if Joe Smith’s Standard ID is U123456 and his Social Security number is 123-45-6789; his initial password is: U126789S.

CLICK “LOGIN.”

Step 2 CHANGE YOUR PASSWORD. Re-enter your initial password in the “Current Password” field, and then create and confirm a new password following the rules outlined at the top of the screen. You will need to change your password on your first visit only. Please remember the password you choose for future access.

CLICK “CONTINUE.” You’ll now access the requested website or tool.

Please note: You will be able to create a new password during your initial visit only. You will be unable to reset your password automatically through Single Sign-On during subsequent visits. Please refer to “Contact Information” below for the appropriate telephone number to call in order to reset your password.

Contact information for former employees

To reset your password, ask questions regarding your Standard ID or obtain further assistance, please call the accessHR Benefits Contact Center at 1-877-JPMChase (1-877-576-2427) or 1-212-552-5100 if calling from outside the United States.

For complete plan details, see the Summary Plan Descriptions (SPDs) along with the Annual U.S. Benefits Enrollment Bulletins and Year End Benefits Bulletins which serve as Summary of Material Modifications (SMMs). To view these, go to My Health > Benefit Plan Details (Summary Plan Descriptions).

This Bulletin modifies and changes Your Guide to Retiree Benefits at JPMorgan Chase and is a summary of material modification for certain plans under the JPMorgan Chase U.S. Retiree Benefits Program. It supplements, clarifies, and amends various sections of the Guide and the Summary Plan Descriptions, and should be referred to as part of the Guide and the Summary Plan Descriptions. Please retain this information for your records. The JPMorgan Chase U.S. Benefits Program is available to individuals who met the applicable retiree benefits age and service criteria when their employment terminated with JPMorgan Chase or a heritage organization. This information does not include all of the details contained in the applicable insurance contracts, plan documents, and trust agreements. If there is any discrepancy between this information and the governing documents, the governing documents will control. JPMorgan Chase & Co. expressly reserves the right to amend, modify, reduce, change, or terminate its benefits and plans at any time, including its U.S. Retiree Benefits Program.

© 10/2017 JPMorgan Chase & Co. All rights reserved.

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Documents

2018 Pre-Medicare Retiree Annual U.S. Benefits Enrollment ... · PDF fileMore information is also available on the enclosed Health Plan Comparison Charts and on My Health, ... prescription