University of California Berkeley Visiting Scholar Benefit Plan (UCBVSBP) Effective December 1, 2010

UCBVSBP UCBVSBP  The University of California, Berkeley (UCB) has partnered with Garnett-Powers & Associates to administer the Visiting Scholar Benefit Plan (UCBVSBP)  December 1, 2010 is the effective date whereby all domestic and international Visiting Scholars and Visiting Student Researchers must be provide proof of adequate health insurance coverage  The UCBVSP is available to both domestic and international Visiting Scholars and Visiting Student Researchers at UCB who are affiliates of the Visiting Scholar and Postdoc Affairs (VSPA) Program  The UCBVSBP fully meets the U.S. State Department Exchange Scholar requirements for J-1 scholars and their J-2 dependents

UCBVSBP UnitedHealthcare Options PPO Medical BenefitsUHC Options PPO (In-Network) Out-of-Network Scholar PaysScholar Pays Medical BenefitsUHC Options PPO (In-Network) Out-of-Network Scholar PaysScholar Pays Physician Office Visit10%30% Physician Office Visit10%30% Hospitalization: Inpatient10%30% Outpatient10%30% Pregnancy10%30% Hospitalization: Inpatient10%30% Outpatient10%30% Pregnancy10%30% Prescription Drugs: Tier 1$15 CopayNo Out of Network Tier 2$30 CopayNo Out of Network Prescription drug benefit maximum is $700 per Policy year Prescription Drugs: Tier 1$15 CopayNo Out of Network Tier 2$30 CopayNo Out of Network Prescription drug benefit maximum is $700 per Policy year Emergency Room Visits:10% $400 maximum30% $400 maximum Emergency Room Visits:10% $400 maximum30% $400 maximum $400 maximum benefit for each visit (facility charge only) Mental Health (Non-AB88): Outpatient 10% up to $100 (20 visits/yr) 30% up to $100 (20 visits/yr) Inpatient10%30% Mental Health (Non-AB88): Outpatient 10% up to $100 (20 visits/yr) 30% up to $100 (20 visits/yr) Inpatient10%30% Deductible: Each Insured$150$250 Deductible: Each Insured$150$250 Lifetime Maximum:$100,000 lifetime per injury or sickness Lifetime Maximum:$100,000 lifetime per injury or sickness For more detailed plan design information go to:

UCBVSBP Rates * 1.Visiting Scholar/Visiting Student Researcher only: Monthly  $98.67 Quarterly  $ J-2 Spouse Monthly  $ Quarterly  $ Each J-2 Child Monthly – $ Quarterly – $ * Rates are effective September 1, 2010 through August 31, 2011

Medical Evacuation & Repatriation Coverage The UCBVSBP plan includes global emergency medical assistance provided through Scholastic Emergency Services (“SES”) The UCBVSBP plan includes global emergency medical assistance provided through Scholastic Emergency Services (“SES”) See policy brochure for details See policy brochure for details SES includes medical evacuation and repatriation of remains benefits that meet the U.S. State Department requirements SES includes medical evacuation and repatriation of remains benefits that meet the U.S. State Department requirements International J-1 scholars and their J-2 dependents do not need to purchase supplemental coverage to meet their J Visa requirements International J-1 scholars and their J-2 dependents do not need to purchase supplemental coverage to meet their J Visa requirements

UCBVSBP Administrative Process Department staff prepares an affiliate application in the VSPA Gateway Department staff prepares an affiliate application in the VSPA Gateway VSPA Program confirms approval of affiliate application VSPA Program confirms approval of affiliate application VSPA sends notification of eligibility to GPA for new and extended appointments VSPA sends notification of eligibility to GPA for new and extended appointments Department creates a Human Capital Management (HCM) Contingent Worker Job Organizational Instance.NOTE: Staff can create record up to 3 months in advance of appointment Department creates a Human Capital Management (HCM) Contingent Worker Job Organizational Instance.NOTE: Staff can create record up to 3 months in advance of appointment Cal Numerical ID is generated Cal Numerical ID is generated Continued next page…

UCBVSBP Administrative Process Affiliate has 31 days from appointment date to visit the GPA website and enroll in VSBP or opt out of the plan Affiliate has 31 days from appointment date to visit the GPA website and enroll in VSBP or opt out of the plan When enrollment form is completed and premiums are paid, GPA will notify the scholar, department staff and VSPA Program that enrollment is complete When enrollment form is completed and premiums are paid, GPA will notify the scholar, department staff and VSPA Program that enrollment is complete If waiving or opting out: Affiliate must provide proof of comparable coverage to GPA for verification. Upon approval, GPA will notify the affiliate, department staff and VSPA Program that health insurance requirement has been satisfied If waiving or opting out: Affiliate must provide proof of comparable coverage to GPA for verification. Upon approval, GPA will notify the affiliate, department staff and VSPA Program that health insurance requirement has been satisfied

UCBVSBP Administrative Process VSPA creates a Person of Interest (POI) record in HCM, which activates the HCM Contingent Worker Job Organizational Instance VSPA creates a Person of Interest (POI) record in HCM, which activates the HCM Contingent Worker Job Organizational Instance If the affiliate’s insurance does not meet the waiver requirements, or if the affiliate drops coverage early, GPA will notify department staff of the deficiency If the affiliate’s insurance does not meet the waiver requirements, or if the affiliate drops coverage early, GPA will notify department staff of the deficiency If the requirements are not satisfied by the affiliate, GPA will inform the VSPA Program and the POI record will be deactivated, resulting in loss of campus services If the requirements are not satisfied by the affiliate, GPA will inform the VSPA Program and the POI record will be deactivated, resulting in loss of campus services

VSPA Affiliate Enrollment Process Affiliate must enroll online through Garnett-Powers & Associates’ UCVSBP website: Affiliate must enroll online through Garnett-Powers & Associates’ UCVSBP website: Affiliates must follow the enrollment process carefully. To get started, the affiliate clicks on the ‘Enrollment’ link and prints (or reads) the ‘Enrollment/Payment Instructions.’ These instructions are written to guide the affiliate’s completion of the enrollment form. Once the affiliate has filled out the form, the affiliate should print the completed form for record-keeping purposes. Affiliates must follow the enrollment process carefully. To get started, the affiliate clicks on the ‘Enrollment’ link and prints (or reads) the ‘Enrollment/Payment Instructions.’ These instructions are written to guide the affiliate’s completion of the enrollment form. Once the affiliate has filled out the form, the affiliate should print the completed form for record-keeping purposes. IMPORTANT: Failure to adhere to the recommended enrollment process may result in a long delay in becoming active in the insurance carrier’s system IMPORTANT: Failure to adhere to the recommended enrollment process may result in a long delay in becoming active in the insurance carrier’s system

VSPA Affiliate Enrollment Process Affiliate must provide a current and correct address because all correspondence between GPA and the affiliate will transacted by  including confirmation of enrollment and quarterly invoices for subsequent quarterly enrollment. Affiliate must provide a current and correct address because all correspondence between GPA and the affiliate will transacted by  including confirmation of enrollment and quarterly invoices for subsequent quarterly enrollment. Enrollment is not complete until GPA receives: Enrollment is not complete until GPA receives: 1) confirmation of eligibility from the campus, and 2) initial payment Health insurance ID cards will be mailed to the affiliate’s U.S. mailing address listed on the enrollment form 7 to 10 business days after the enrollment process is complete Health insurance ID cards will be mailed to the affiliate’s U.S. mailing address listed on the enrollment form 7 to 10 business days after the enrollment process is complete If the affiliate would like to make changes to enrollment in the future, the affiliate must click ‘Making Changes to Your Enrollment’ link and print (or read) the ‘Instructions on Making Changes’ link for detailed instructions. If the affiliate would like to make changes to enrollment in the future, the affiliate must click ‘Making Changes to Your Enrollment’ link and print (or read) the ‘Instructions on Making Changes’ link for detailed instructions.

VSPA Affiliate Payment Process Upon completion of the enrollment form, the affiliate is directed to ‘Submit and Create Printable Enrollment Form’. A reminder that payment is due immediately is issued. Upon completion of the enrollment form, the affiliate is directed to ‘Submit and Create Printable Enrollment Form’. A reminder that payment is due immediately is issued. Payment is due for the current quarter (or portion as determined by the affiliate’s insurance start date) at initial enrollment (whole months only  no pro-rated amounts when enrolling after the first of the month) Payment is due for the current quarter (or portion as determined by the affiliate’s insurance start date) at initial enrollment (whole months only  no pro-rated amounts when enrolling after the first of the month) When the affiliate clicks on the ‘Calculate Premium’ button, the system automatically ‘populates’ both the initial premium owed for the first quarter and premium owed for subsequent quarter(s) on the payment coupon at the bottom of the enrollment form. The affiliate should print this document for record-keeping purposes. When the affiliate clicks on the ‘Calculate Premium’ button, the system automatically ‘populates’ both the initial premium owed for the first quarter and premium owed for subsequent quarter(s) on the payment coupon at the bottom of the enrollment form. The affiliate should print this document for record-keeping purposes.

VSPA Affiliate Payment Process The affiliate can pay by debit or credit card or with a check. If the affiliate is paying by check, the affiliate should return the payment coupon with a check to Garnett- Powers & Associates. The affiliate can pay by debit or credit card or with a check. If the affiliate is paying by check, the affiliate should return the payment coupon with a check to Garnett- Powers & Associates. After the initial quarter’s premium has been paid, the GPA billing department will send the affiliate an electronic invoice for subsequent quarterly billing(s) prior to the start of each quarter. If affiliate’s appointment ends before the end of any quarter, affiliate will only be billed the premium through the end of the last month of appointment. After the initial quarter’s premium has been paid, the GPA billing department will send the affiliate an electronic invoice for subsequent quarterly billing(s) prior to the start of each quarter. If affiliate’s appointment ends before the end of any quarter, affiliate will only be billed the premium through the end of the last month of appointment.

Family Member Eligibility* Family Member Eligibility* Family member categories (including J-2 dependents) are the following: Family member categories (including J-2 dependents) are the following: Spouse Spouse Domestic partner Domestic partner  Same-sex domestic partner  Opposite-sex domestic partner only if one partner is over age 62 Unmarried natural or adopted children to age 19 or to age 23 if a full-time student who is not self-supporting Unmarried natural or adopted children to age 19 or to age 23 if a full-time student who is not self-supporting NOTE: Other family members (e.g., parents, nieces or nephews) are NOT eligible NOTE: Other family members (e.g., parents, nieces or nephews) are NOT eligible *See Eligibility and Definitions sections in policy brochure

Information Sources Website: Garnett-Powers’ UCBVSBP website: Website: Garnett-Powers’ UCBVSBP website: Toll Free Phone: Garnett-Powers’ UCBVSBP customer service number: Toll Free Phone: Garnett-Powers’ UCBVSBP customer service number: Address: Garnett-Powers’ address: Address: Garnett-Powers’ address: