Page 7 - 2022 Penn Engineering Guide

Your 2022 Benefit Offerings

Health Savings Accounts TELEMEDICINE through
You are eligible for a Health Savings Account (H S A) only if you elect the Consumer Driven MDLive®

Health Plan (CDHP) High Deductible PPO Plan. A Health Savings Account is a tax- favored
Independence
account used in conjunction with a qualifying high deductible health plan, as defined by the IRS.
Administrators offers
Telemedicine to all eligible
For 2022, PennEngineering will be funding H S A’s according to the following schedule:
plan members through
Single tier: $ 500.00
MDLive®. Telemedicine
All other tiers: $ 1,000.00 allows for the timely delivery
of high-quality healthcare at
Please see page 7 for important information on Health Savings Accounts for the 2022 Plan year. a lower cost compared to
visiting the emergency room
Preferred Provider Organization (PPO)
or an urgent care center.
A PPO is a group of physicians, hospitals and other providers who form a “network” to provide Plan members access care
quality, comprehensive medical coverage. If you elect the PPO option, a list of participating from a licensed physician by
providers is available online at www.myibxtpa.com. calling a toll-free number,
logging into a secure
You are required to make contributions for coverage. See rate information on page 19. These website, or opening a
premiums will be a pre-tax deduction from your weekly paycheck. You will be subject to mobile app from where it’s
most convenient. $40.00 co-
deductibles and out-of- pocket maximums for most services provided by a network provider.
pay required after
You will also have to make co-payments toward the cost of some covered medical expenses. If
deductible.
you receive medical services from an out-of- network provider, you may receive reimbursement

for your covered expenses, but at a different level of coverage than if the service had been MDLive® makes phone
performed by a network provider. consultations available
24/7/365, including holidays.
Please visit: www.myibxtpabenefits.com and register. Email or print temporary ID cards; Video conferences can be
request additional ID cards; check your cost sharing; view your claims; Download the myibxtpa scheduled 7 days a week.
benefits App. Start to navigate healthcare services. Doctors are U.S. board
certified with an average of
The Myibxtpa Benefit App is also available and offers you the same convenient access from 15+ years’ experience and
can treat a wide range of
your iPhone® or Android™.
conditions. MDLive® is
Vision Plan HIPAA-compliant.

The Vision Plan is provided by Vision Benefits of America (VBA). This PPO Plan covers
Telemedicine is meant for
PennEngineering employees at no cost and allows the employee to add dependents at
non- emergency situations
reasonable weekly rates. See rate information on page 19. only.

Vision Frequency of Service: Please refer to the
• Exam: every 12 months highlights sheet for
• Lenses: every 12 months specifics.
• Frames: Every 24 months
Visit: MDLIVE.com/ibxtpa
• Most In-network expenses are covered at 100% with a $20 co-pay for eyewear.
Phone: 1-888-956-6411

Wholesale allowances for frames and contacts. Visit the VBA website to locate a provider and

request your Benefit Form, by calling: 1-800-432-4966. Visit: www.visionbenefits.com

Please see the detailed VBA packet. If you do not obtain a Benefit form, the Vision charges will

be considered Out-of-Network unless your Provider files vision claims electronically.
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