McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
Header
1
2023
Benet Guide
McGaw Medical Center
2023 Benet Guide
If you do not receive an insurance card or need to request a
duplicate card, please contact the insurance providers above.
Address Changes
Address changes must be submitted in writing to McGaw Payroll and Benets. Include your name, new address, and eective
date of the change on the correspondence. You may mail, fax, or email this information to McGaw Payroll & Benets.
If you move following completion of your program with McGaw, please notify our oce by December 1. This will assist us in
getting your Form W2 to you next January.
McGaw Payroll and Benefits
866-480-8867 Fax
mcgawpayroll@ey.com
Benet Website: http://mcgaw.northwestern.edu
Payroll Website: https://workforcenow.adp.com
Email mcgawpayroll@ey.com for ADP Registration Code
Blue cross/Blue shield of illinois Medical Plan
GrouP id: s59987/0100
800-346-7072
Call with questions or to request a duplicate ID card.
www.bcbsil.com
Website to select participating providers.
Metlife McGaw dental Plan
GrouP id: 307257
MeMBer id: housestaff ssn
coMPany naMe: McGaw Medical center
800-942-0854
www.metlife.com/mybenets
Call with questions about coverage or claims.
cVs careMark PrescriPtion Plan
id: cardholder ssn
GrouP id: rx4994
rx Bin: 004336
rx Pcn: adV
866-818-6911
Call with questions or to request an ID card.
www.caremark.com
Website to select participating pharmacy or to
download claim forms.
VsP Vision Plan (siGnature)
GrouP id: 12165164
MeMBer id: housestaff ssn
GrouP naMe: McGaw Medical center
800-877-7195
Call to nd a VSP doctor or with general questions.
www.vsp.com
Website to nd a VSP doctor.
fidelity 401(k)/roth: Plan 74471
800-343-0860
Call to set up your account, change your investment
options, change your % invested, rollover funds, or to
inquire on account balance.
Website to manage your account online.
www.delity.com/atwork
Payflex fsas, coMMuter/transit and coBra
800-284-4885
www.payex.com
Call with questions regarding your Flexible Spending
Account (FSA), Commuter/Transit or COBRA.
FSA Member ID is your payroll ID# (nd this on your
electronic paystub).
PaystuBs
https://workforcenow.adp.com
Email mcgawpayroll@ey.com for ADP Registration Code
Benet Contact Information
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
General Open Enrollment Information ............................................................................................................................. 1
Eligibility ................................................................................................................................................................................2
Changing Your Elections Mid-Year .................................................................................................................................... 3
Which Benets Do I Elect and What is My Cost? ............................................................................................................4
Medical Insurance ............................................................................................................................................................... 5
Medical Benet Highlights .................................................................................................................................................6
Dental Insurance ..................................................................................................................................................................9
Prescription Drug Program ...............................................................................................................................................13
Vision Plan ...........................................................................................................................................................................14
Flexible Spending Accounts .............................................................................................................................................15
Commuter/Transit Pre-Tax Benet ..................................................................................................................................17
401(k) Tax Deferred Savings Plan ...................................................................................................................................18
Life Insurance and Accidental Death and Dismemberment .......................................................................................19
Long-Term Disability ..........................................................................................................................................................20
Perspectives (A Housestaff Assistance Program)........................................................................................................22
USMLE Savings Program ...................................................................................................................................................22
Time Off Work .....................................................................................................................................................................23
Vacation Policy ...................................................................................................................................................................23
Sick Policy ...........................................................................................................................................................................23
Short-Term Disability .........................................................................................................................................................24
Family and Medical Leave Policy .....................................................................................................................................25
Workers’ Compensation: Injured on the Job? ................................................................................................................27
Professional Liability Insurance ......................................................................................................................................27
COBRA Continuation Coverage ........................................................................................................................................28
Your Stipend Check Stub/Direct Deposit/Forms W-4 and IL-W-4 ..............................................................................29
Table of Contents
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
1
2023 Benefit Guide and oPen enrollMent inforMation
This guide details the benets oered by McGaw Medical Center of Northwestern
University (McGaw Medical Center) and the process for enrolling in benets.
Please read the enclosed material carefully before determining your 2023 benet
elections. We recommend keeping this guide throughout the year as a quick
reference to phone numbers and benet information.
oPen enrollMent dates
Monday, November 7, 2022 - Monday, November 21, 2022
deadline for enrollinG online
12:00 a.m. midnight, November 21, 2022
Benefit enrollMent weBsite
https://workforcenow.adp.com
Email mcgawpayroll@ey.com for ADP Registration Code
effectiVe date for Benefit chanGes
January 1, 2023
or appointment date for mid-year appointees
General Open Enrollment Information
Disclosure of Information: Ernst & Young, on behalf of McGaw Medical Center, discloses enrollment and disenrollment information to third-party administrators for
purposes of benets administration. Any disclosures will be made consistent with the requirements of the Health Insurance Portability and Accountability Act of 1996,
as amended.
effectiVe dates of coVeraGe
Your coverage will be eective January, 1 2023 through December 31, 2023 for active Housesta at
McGaw the entire year. For new Housesta, benet coverage is eective on their appointment date.
For Housesta completing their program mid-year, insurance will be eective through the last day of
the month in which they are active at McGaw.
After this time, Housesta may be eligible to purchase
COBRA coverage to continue group health plan coverage
at their own expense.
coVeraGe exPansion in 2023
NM Central DuPage Hospital, NM Kishwaukee Hospital, and
NM Valley West Hospital added to medical plan Tier 1 providers.
any Questions?
Email to mcgawpayroll@ey.com with your questions.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
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All active McGaw Housesta are eligible for the Life
Insurance and AD&D and LTD Plans. All active Housesta
and their eligible dependent children may be covered under
the Medical, Prescription, Dental and Vision Plans.
A Housesta’s legally married spouse may be covered under
the Medical, Prescription, Dental and Vision Plans. If you
enroll your legally married spouse, you will be required to
complete the Group Health Plan Spouse Eligibility Form,
on which you must indicate whether your spouse is eligible
for group health plan coverage through his or her employer.
If your spouse is eligible for group health plan coverage
through his or her employer and you elect to enroll your
spouse in the Plans, your cost for coverage will be increased
by an additional amount each payroll period. In 2023, the
cost is unchanged and is $50 per payroll period. This amount
is subject to change in future years, and any changes will be
described in the Benet Guide for the applicable plan year.
Limited exceptions for spouses working part-time (whose
employer does not subsidize premiums) will be granted if
sucient documentation is submitted to McGaw Payroll/
Benets within 30 days. If you are enrolling your legally
married spouse for the rst time, you will be required to
submit a photocopy of your marriage certicate within 30
days of coverage as proof of marital status.
eliGiBle dePendent children
For the Medical, Prescription, Dental and Vision Plans, you
may elect coverage for your child, adopted child, stepchild
or eligible foster child if he or she is under the age of 26
(or any age if the child is dependent on you and incapable
of sustaining employment because of a physical or mental
disability).
If you enroll a grandchild, you may be required to provide
proof that the child satises the dependency requirements
listed above.
Eligibility
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
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Which Benets Do I Elect and What is My Cost?
You will need to make decisions on six benets. Your cost
(your share of the semimonthly premium) is printed on the
enclosed Housesta Insurance Premiums document.
1. Medical and rx insurance
The single contribution rate is $94.17/month and the
family contribution rate is $342.94/month. If you enroll
in the medical plan you will automatically be enrolled for
prescription coverage. See page 5 for medical plan details
and page 13 for prescription plan details.
2. dental insurance
The single coverage is $13.04/month, and $28.24/month for
family coverage. See page 9 for plan details.
3. Vision Plan
Single coverage is $7.21/month, and $18.92/month for family
coverage. See page 14 for plan details.
4. flexiBle sPendinG accounts (fsa)
The annual contribution limit is $2,250 for a Health Care FSA
and $5,000 per family for a Dependent Care FSA. See page 15
for important guidelines.
5.coMMuter/transit Pre-tax Benefit
McGaw oers a pre-tax payroll deduction for your commuter
expenses up to the annual IRS limit. See page 17 for details.
6. 401(k) tax deferred saVinGs Plan
McGaw matches 2% of your per-pay-period gross stipend for
each pay period that you contribute at least 2% to the 401(k)
or Roth. See page 18 for details.
7. life insurance and accidental death and disMeMBerMent
McGaw provides Hartford Life Insurance and AD&D equal
to your annual stipend at no cost to you. You can increase
coverage up to 4 times your annual stipend for a semi-
monthly premium. See page 19 for details.
8. lonG-terM disaBility
Housesta are automatically enrolled in LTD. No action is
required. See page 20 for details.
9. PersPectiVes (a housestaff assistance ProGraM)
A 24-hour, strictly condential service is oered to all
housesta at no cost. No enrollment activity is required.
See page 22 for details.
10. usMle saVinGs ProGraM
McGaw oers a savings program for the United States
Medical Licensing Exam (USMLE). See page 22 for
alternative savings options.
11. short-terM disaBility
Housesta are automatically enrolled in STD. No action is
required. See page 24 for details.
tax iMPlications of housestaff Benefit PreMiuMs
Your medical, dental, vision, life and FSA contributions are
deducted on a pre-tax basis. Please note, since your medical,
dental, vision, life and FSA contributions are paid with pre-
tax dollars, those pre-tax contributions reduce your gross
wages for the purposes of calculating your Social Security
and Medicare taxes and in computing your annual stipend for
Social Security benet purposes. Tax implications of your life
insurance premiums are discussed on page 19 of this guide.
Open enrollmemnt website: https://workforcenow.adp.com Email mcgawpayroll@ey.com for ADP Registration Code
You must participate in Open Enrollment and submit enrollment electronically at https://workforcenow.adp.com
by November 21, 2022 if you want to:
• Elect family coverage
• Elect vision coverage
• Elect a health care or dependent day care FSA
To waive all coverage, you must send an email to mcgawpayroll@ey.com stating your intention
do i need to enroll?
If you are already enrolled and do not participate in online Open Enrollment, your medical, dental, vision, prescription, and
life insurance coverage will not change from 2022 coverage levels. However, the 2023 premium rates and any plan changes
will automatically go into eect. If you want to have a medical or dependent day care FSA account, or change to
family from single coverage or add/delete dental or vision then you must participate in Open Enrollment.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
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Changing Your Elections Mid-Year
Be sure to review your options carefully because the choices
you make during the enrollment period remain in eect for
the entire year. Your benets are eective on a calendar year
(Jan – Dec), not on an academic year. In the event of an
eligible change in status, you may change certain benets.
Examples of changes in status include:
• Marriage, divorce, or legal separation
• Birth or adoption of a child
• Death of your spouse or child
• Spouse’s job change that results in loss of coverage
• Loss of your spouse’s medical coverage dependent status
• Loss or reinstatement of a child’s dependent status
• Loss of eligibility under Medicaid or a state child health
plan.
• Gain eligibility for a premium assistance subsidy
through Medicaid or a state child health plan.
You must submit information in writing (send email to
mcgawpayroll@ey.com) regarding your change in status to
McGaw Payroll and Benets within 30 days of the eligible
change in status (within 60 days of a change in status due
to eligibility for Medicaid or a state child health plan).
Otherwise, your next opportunity to make changes will be
during Open Enrollment next November. Contact McGaw
Payroll and Benets with any questions about changes in
status. You may be required to supply proof of change in
status such as marriage certicate, Group Health Plan Spouse
Eligibility Form, divorce decree, or letter from an employer.
notice of sPecial enrollMent riGhts
If you do not enroll yourself, your spouse, or your dependents
when rst eligible under the Plan because of other health
coverage, you may be eligible to enroll in the Plan without
waiting for the next Open Enrollment. If the other coverage
was COBRA coverage, special enrollment will be available
only if the coverage is lost because the COBRA rights are
exhausted (but not, for example, if you, your spouse, or
dependents simply stop paying premiums).
If the other coverage is non-COBRA coverage, special
enrollment will be available if the employer sponsoring the
other coverage stops contributing towards that coverage,
or if coverage ends because of a loss of eligibility (by, for
example, legal separation, divorce, or loss of dependent
status). Losing coverage for other reasons, including failure
to pay premiums and for cause, such as for ling a false claim
for benets, will not entitle you to special enrollment. Special
enrollment must be requested within 30 days after your
spouse’s or your dependents’ other coverage ends (or after
the employer stops contributing toward the other coverage,
60 days if the coverage is lost due to change in eligibility
under Medicaid or a state child health plan).
If you are participating in the Plan and during the year you
acquire a new dependent by birth, marriage, adoption, or
placement for adoption, your dependent will be eligible for
special enrollment. If you are not participating in the Plan,
but are eligible to do so, and during the year you acquire a
new dependent by birth, marriage, adoption, or placement
for adoption, you, your spouse and your dependents may be
eligible for special enrollment.
Depending on the reason for the special enrollment right, you
may be able to enroll without enrolling your dependents, or
you and your spouse may be able to enroll without enrolling
your dependent children, as long as the enrollment is
consistent with the reason for the special enrollment right. But
your spouse or dependent children may not enroll unless you
do. You must request special enrollment within 30 days of the
relevant birth, marriage, adoption, or placement for adoption.
Enrollments following a birth, adoption, or placement for
adoption will be eective as of the date of the event. Any
other enrollment will be eective as stated in the Plan.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
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McGaw Medical Center oers one medical plan, Blue
Cross/Blue Shield IL PPO. The benet period is January 1
to December 31. Read the following pages and the booklet
titled Your Health Care Benet Program which is available
on the benets website: http://mcgaw.northwestern.edu, to
learn more about your benets.
To identify non-PPO and PPO hospitals and facilities, you
should contact the claim administrator at BCBSIL by calling
the customer service toll-free number on your identication
card (800-346-7072) or online at www.bcbsil.com, click
on provider nder and select participating provider
organization (PPO). To locate a Tier1 physician within the
plan, www.nm.org and lter on Northwestern Medical Group.
Prenatal care
Upon delivery, you must notify BCBSIL by calling Medical
Service Advisory at 800-635-1928 within two business days.
If you call the Medical Service Advisory when you nd out
you are pregnant, the Claim Administrator will provide you
information on support programs to assist you during your
pregnancy.
infertility treatMent
Benets will be provided the same as your benets for any
other condition for Covered Services rendered in connection
with the diagnosis and/or treatment of infertility, including,
but not limited to, in-vitro fertilization, uterine embryo
lavage, embryo transfer, articial insemination, gamete
intrafallopian tube transfer, zygote intrafallopian tube
transfer, low tubal ovum transfer and intracytoplasmic sperm
injection. Please read the Infertility Treatment section under
Special Conditions and Payment of the booklet titled Your
Health Care Benet Program for additional information and
limitations.
reconstructiVe surGery followinG MastectoMy
Benets for Covered Services related to mastectomies are the
same as for any other condition. Mastectomy-related Covered
Services include, but are not limited to:
1. Reconstruction of the breast on which the mastectomy
has been performed;
2. Surgery and reconstruction of the other breast to produce
a symmetrical appearance;
3. Inpatent care following a mastectomy for the length
of time determined by your attending Physician to be
medically necessary and in accordance with protocols and
guidelines based on sound scientic evidence and patient
evaluation and a follow-up Physician oce visit or in-
home nurse visit within 48 hours after discharge; and
4. Protheses and physical complications of all stages of the
mastectomy including, but not limited to, lymphedemas.
5. The removal of breast implants when the removal of
the implants is a Medically Necessary treatment for
a sickness or injury. Surgery performed for removal of
breast implants that were implanted solely for cosmetic
reasons are not covered. Cosmetic changes performed
as reconstruction resulting from sickness or injury is not
considered cosmetic surgery.
Blue Cross/Blue Shield of Illinois (BCBSIL) provided this
benet before it was required and will continue to provide
this coverage, if the procedures are provided by a licensed
physician in accordance with the law and the terms of the
applicable plan. If you receive any of these mastectomy-
related benets, these benets will be subject to the same
deductibles and coinsurance applicable to other medical and
surgical benets provided under the medical plan. Deductible
and coinsurance details are provided in the Medical Benet
Highlights on the following pages.
Your coverage may also include benets for annual
mammograms. See your certicate/benet booklet or call
BCBSIL at the phone number on the back of your ID Card.
Medical Insurance
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
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Your health care benets are highlighted below. However, to fully understand your benets, it is very important
that you read the entire benet booklet: Your Health Care Benet Program available on the benets website:
http://mcgaw.northwestern.edu or request a copy via email at: mcgawpayroll@ey.com
The Utilization Review Program
A special program designed to assist you in determining the course
Lifetime maximum for all benets Unlimited
Individual deductible
Tier 1
Tier 2
Tier 3
$0 per benet period (calendar year)
$225 per benet period (calendar year)
$550 per benet period (calendar year)
Family deductible
Tier1
Tier 2
Tier 3
$0 per benet period (calendar year)
$675 per benet period (calendar year)
$1,650 per benet period (calendar year)
Private duty nursing service
Benet maximum 8 visits per month
Chiropractic and osteopathic
Manipulation benet maximum 15 visits per year
Physical therapy services
Benet maximum 20 visits per year
Occupational therapy
Benet maximum 50 visits per year
Speech therapy
Benet maximum 50 visits per year
Temporomandibular joint dysfunction and related disorders
Benet period maximum Unlimited
hosPital Benefits
When you receive Inpatient Hospital or certain Outpatient Hospital Covered Services from a McGaw Medical Center Hospital,
benets will be provided at 90% of the eligible charge. Coinsurance does apply to Outpatient Hospital Surgery and diagnostic
services. McGaw Medical Center Hospitals include Ann and Robert H. Lurie Children’s Hospital of Chicago, Lake Forest
Hospital, Northwestern Memorial Hospital, Swedish Covenant Hospital, Shirley Ryan AbilityLab, Delnor Hospital, NM
Central DuPage Hospital, NM Kishwaukee Hospital, NM Valley West Hospital and Jesse Brown V.A. Medical Center.
Payment level for Covered
Services from a
Tier 1 (Home Hospital/NMG)
Payment level for Covered
Services from a
Tier 2 (BCBSIL Participating
Provider)
Payment level for Covered
Services from a
Tier 3
(Non-Participating Provider)
Inpatient copay $100 per admission* $275 per admission* $275 per admission*
Inpatient covered services 90% of the eligible charge 80% of the eligible charge 60% of the eligible charge
Inpatient substance abuse
rehabilitation treatment and
inpatient treatment of mental illness
90% of the eligible charge 80% of the eligible charge 60% of the eligible charge
Outpatient covered services 90% of the eligible charge 80% of the eligible charge 60% of the eligible charge
Wellness care 100% of the eligible charge, no
deductible
100% of the eligible charge, no
deductible
100% of the eligible charge, no
deductible
Outpatient treatment of mental
illness and outpatient substance
abuse rehabilitation treatment
90% of the eligible charge 80% of the eligible charge 60% of the eligible charge
*Copay is due until out-of-pocket maximum (OPX) is met
Medical Benet Highlights
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
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McGaw Medical Center of Northwestern University
Lifetime Comprehensive Major Medical Coverage
Unlimited
Tier 1
(Home Hospital/NMG)
Tier 2
(Participating
Provider)
Tier 3
(Non-Participating
Provider)
Deductible (Separate PPO and Non-PPO facilities)
Individual:
Family:
$0
$0
$225
$675
$550
$1,650
Out-of-Pocket Maximum: Single:
Family:
$2,200
$4,400
$4,000
$8,000
10,000
20,000
Hospital
Tier 1
(Home Hospital/NMG)
Tier 2
(Participating
Provider)
Tier 3
(Non-Participating
Provider)
Inpatient Hospital Services
Room allowance is based on the hospital’s most common semi-private
room rate. Pre-Admission Testing, Skilled Nursing Facilities, Hospice
and Coordinated Home Health Care are also paid on the same basis.
90%
$100 copay per
admission
80%
$275 copay per
admission.
60%+
$275 copay per
admission.
90% 80% 60%+
Outpatient Hospital Service
Including Radiation and Chemotherapy.
90% 80% 60%+
Hospital Emergency Medical/Accident Care
Initial treatment in hospital of accidental injuries or sudden and
unexpected medical conditions with severe life-threatening symptoms.
If an inpatient admission occurs, MSA must be contacted within two
business days or benets will be reduced.
100%
$125 copay
100%
$125 copay
100%
$125 copay
Physician Services
(Based on SMA-Schedule of Maximum Allowances)
Tier 1
(NMG)
Tier 2
(Participating Provider)
Non-Participating
Provider
100%
$30*# oce visit
urgent care copay
100%
$30*# oce visit
urgent care copay
60%+
(Including radiologist’s, anesthesiologist’s and surgeon’s charges)
90% 90% 60%+
Physician Services
Participating Provider
Non-Participating
Provider
(Including physical exams, diagnostic tests and immunizations)
100% 100%
80% 60%+
Other Covered Services
• Ambulance
• Blood and blood components
• Leg, arm, and neck braces
• Private duty nursing
• TMJ
• Allergy shots
• Oxygen (includes administration)
• Surgical dressings
• Casts and splints
80%
# Applies to out-of-pocket maximum
* Does not apply to deductible
+ Deductible applies
** Tier I Physicians are only those Physicians that are Participants in Northwestern Medical Group or Pediatric Facility Foundation. Find a list at
www.nm.org (Filter on Northwestern Medical Group) or for Pediatric Faculty Foundation check with the provider.
***$0 copay or deductible for the rst 2 visits during the calendar year, then a $25 copay for the 3rd visit and beyond during the calendar year.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
8
Basic Provisions
Durable Medical Equipment (DME): Covered benet. Please refer to Certicate for details.
Transplant Coverage: Cornea, Kidney, bone marrow, heart valve, heart, heart/lung, pancreas, and pancreas/kidney, muscular-
skeletal or parathyroid human organ or tissues. Transplants are paid as any other condition but must have
prior procedural and facility approval.
Infertility treatment: Covers state mandated services. Four attempts per lifetime.
Dependent Eligibility: To age 26.
Coordination of Benets: This program coordinates benets with other group plans.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
9
The McGaw Dental Plan is administered by MetLife. For
more detailed information about the plan, please consult
the Summary Plan Description (SPD). In addition, you may
contact MetLife at 800-942-0854.
MetLife Preferred Dental Program (PDP) allows members
to see any dentist at any time (full freedom-of-choice),
ID cards are not required or provided. Eligibility and plan
design information can always be veried in real time at the
time of service through multiple customer service systems
(MyBenets, metdental.com, fax, or interactive voice
response system).
Dental Insurance
McGaw Dental Plan — Coverage with freedom of choice and savings!
Benefit suMMary
coVeraGe tyPe PdP in-network out-of-network
Type A – cleanings, oral examinations 100% of PDP Fee* 100% of R&C**
Type B – llings 80% of PDP Fee* 80% of R&C**
Type C – bridges and dentures 50% of PDP Fee* 50% of R&C**
Type D – orthodontia (Dependents until their 18th birthday) 50% of PDP Fee* 50% of R&C**
deductiBle*** in-network out-of-network
Individual $75.00 $75.00
Family $225.00 $225.00
annual MaxiMuM Benefit in-network out-of-network
Per Person $1,000 $1,000
orthodontia lifetiMe MaxiMuM in-network out-of-network
Per Person $1,000 $1,000
* PDP fee refers to the fees that participating PDP dentists have agreed to accept as payment in full, subject to any copayments, deductibles, cost sharing, and
benets maximums.
** R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of: (1) the dentist’s actual charge, (2) the dentist’s usual charge for the
same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.
*** Applies only to type B & C Services.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
10
an exaMPle of saVinGs when you Visit a ParticiPatinG PdP dentist:
This hypothetical example* shows how receiving services from a PDP dentist can save you money.
Your Dentist says you need a crown, a Type C service:
PDP Fee: $670.00 R&C Fee: $1,462.00
Dentist’s Usual Fee: $1,462.00
*Please note: This example assumes that your annual deductible has been met.
in-network
When you receive care from a participating PDP dentist:
Dentist’s Usual Fee is: $1,462.00
The PDP Fee is: $670.00
Your Plan Pays:
50% X $670 PDP Fee: – $335.00
Your Out-of-Pocket Cost: $335.00
out-of-network
When you receive care from a non-participating dentist:
Dentist’s Usual Fee is: $1,462.00
R&C Fee is: $1,462.00
Your Plan Pays:
50% X $1,462 R&C Fee: – $731.00
Your Out-of-Pocket Cost: $731.00
In this example, you save $396.00 ($731.00 minus $335.00) by using a participating PDP dentist.
list of PriMary coVered serVices and liMitations
Type A – Preventive How Many/How Often:
Prophylaxis (cleanings)
Oral Examinations
Topical Fluoride Applications
X-rays
Space Maintainers
Sealants
• Two per calendar year.
• Two exams per calendar year.
• Two uoride treatment per calendar year for dependent children up to 19th birthday.
• Full mouth X-rays and Bitewing X-rays: one set per calendar year.
• Space maintainers for dependent children up to 19th birthday.
• One application of sealant material every 5 years for each non-restored, non-decayed 1st and 2nd molar of a
dependent child up to 19th birthday.
Type B – Basic Restorative How Many/How Often:
Fillings
Simple Extractions
Crown, Denture, and Bridge Repair
Endodontics
General Anesthesia
Oral Surgery
Periodontics
• When dentally necessary in connection with oral surgery, extractions, or other covered dental services.
• Periodontal scaling and root planing once per quadrant, every 12 months.
• Periodontal surgery once per quadrant, every 12 months.
• Total number of periodontal maintenance treatments and prophylaxis cannot exceed 4 treatments in a
calendar year.
Type C – Major Restorative How Many/How Often:
Implants
Bridges and Dentures
Crowns/Inlays/Onlays
• Initial placement to replace one or more natural teeth, which are lost while covered by the Plan.
• Dentures and bridgework replacement: one every 5 years.
• Replacement of an existing temporary full denture if the temporary denture cannot be repaired and the permanent
denture is installed within 12 months after the temporary denture was installed.
• Replacement: once every 5 years.
Type D – Orthodontia How Many/How Often:
• Dependent children are covered until their 18th birthday.
• All dental procedures performed in connection with orthodontic treatment are payable as Orthodontia.
• Payments are on a repetitive basis.
• Benet for initial placement of the appliance will be made representing 20% of the total benet.
• Orthodontic benets end at cancellation of coverage.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
11
coMMon Questions…iMPortant answers
Who is a participating Preferred Dentist Program (PDP) dentist? A participating dentist is a general dentist or specialist who
has agreed to accept MetLife’s negotiated fees as payment in-full for services provided to plan participants. PDP fees typically
range from 15-45%* below the average fees charged in a dentist’s community for the same or substantially similar services.
*Based on internal analysis by MetLife.
How do I nd a participating PDP dentist? There are more than 187,000 participating PDP dentist locations nationwide,
including over 45,000 specialist locations. You can receive a list of these participating PDP dentists online at www.metlife.
com/mybenets or call 1-800-942-0854 to have a list faxed or mailed to you.
What services are covered by my plan? All services dened under your group dental benets plan are covered. Please review
the enclosed plan benets to learn more.
Does the Preferred Dentist Program (PDP) oer any discounts on non-covered services? MetLife’s negotiated fees with PDP
(in-network) dentists may extend to services not covered under your plan and services received after your plan maximum has
been met, where permitted by applicable state law. If you receive services from a PDP dentist that are not covered under your
plan or where the maximum has been met, in those states where permitted by law, you may only be responsible for the PDP
(in-network) fee
May I choose a non-participating dentist? Yes. You are always free to select the dentist of your choice. However, if you choose
a dentist who does not participate in the MetLife PDP, your out-of-pocket expenses may be more, since you will be responsible to
pay for any dierence between the dentist’s fee and your plan’s payment for the approved service. If you receive services from a
participating PDP dentist, you are only responsible for the dierence between the PDP in-network fee for the service provided and
your plan’s payment for the approved service. Please note: any plan deductibles must be met before benets are paid.
Can my dentist apply for PDP participation? Yes. If your current dentist does not participate in the PDP and you’d like to
encourage him or her to apply, tell your dentist to visit www.metdental.com, or call 1-877-MET-DDS9 for an application. The
website and phone number are designed for use by dental professionals only.
How are claims processed? Dentists may submit your claims for you which means you have little or no paperwork. You can
track your claims online and even receive e-mail alerts when a claim has been processed. If you need a claim form, visit www.
metlife.com/mybenets or request one by calling 1-800-942-0854.
Can I nd out what my out-of-pocket expenses will be before receiving a service? Yes. MetLife recommends that you request
a pre-treatment estimate for services in excess of $300. Simply have your dentist submit a request online at www.metdental.
com or call 1-877-MET-DDS9. You and your dentist will receive a benet estimate for most procedures while you’re still in
the oce. Actual payments may vary depending upon plan maximums, deductibles, frequency limits and other conditions at
time of payment.
How can I learn about what dentists in my area charge for dierent procedures? If you have MyBenets you can access the
Dental Procedure Fee Tool provided by go2dental.com where you can learn more about approximate fees for services such as
exams, cleanings, llings, crowns and more. Simply visit www.metlife.com/mybenets and use the Dental Procedure Fee Tool
to help you estimate the in-network (PDP fees) and out-of-network fees* for dental services in your area.
* Out-of-network fee information is provided by go2dental.com, Inc., an industry source independent of MetLife. This site does not provide the benet
payment information used by MetLife when processing your claims. Prior to receiving services, we recommend that you obtain pre-treatment estimates
through your dentist.
Can MetLife help me nd a dentist outside of the US. if I am traveling? Yes. Through international dental travel assistance
services* you can obtain a referral to a local dentist by calling +1-312-356-5970 (collect) when outside the US. to receive
immediate care until you can see your dentist. Coverage will be considered under your out-of-network benets.** Please
remember to hold on to all receipts to submit a dental claim.
*International Dental Travel Assistance services are administered by AXA Assistance USA, Inc. AXA Assistance is not aliated with MetLife, and the
services they provide are separate and apart from the benets provided by MetLife.
** Refer to your dental benets plan summary for your out-of-network dental coverage.
How does MetLife coordinate benets with other insurance plans? Coordination of benets provision in dental benets plans
are a set of rules that are followed when a patient is covered by more than one dental benets plan. These rules determine the
order in which the plans will pay benets. If the MetLife dental benet plan is primary, MetLife will pay the full amount of
benets that would normally be available under the plan. If the MetLife dental benet plan is secondary, most coordination
of benets provisions require MetLife to determine benets after benets have been determined under the primary plan. The
amount of benets payable by MetLife may be reduced due to the benets paid under the primary plan.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
12
exclusions
This plan does not cover the following services, treatments and supplies:
• Services which are not Dentally Necessary, those which do
not meet generally accepted standards of care for treating the
particular dental condition, or which we deem experimental in
nature;
• Services for which you would not be required to pay in the
absence of Dental Insurance;
• Services or supplies received by you or your Dependent before the
Dental Insurance starts for that person;
• Services which are primarily cosmetic;
• Services which are neither performed nor prescribed by a Dentist
except for those services of a licensed dental hygienist which are
supervised and billed by a Dentist and which are for:
• Scaling and polishing of teeth; or
• Fluoride treatments;
• Services or appliances which restore or alter occlusion or vertical
dimension;
• Restoration of tooth structure damaged by attrition, abrasion or
erosion;
• Restorations or appliances used for the purpose of periodontal
splinting;
• Counseling or instruction about oral hygiene, plaque control,
nutrition and tobacco;
• Personal supplies or devices including, but not limited to: water
picks, toothbrushes, or dental oss;
• Decoration, personalization or inscription of any tooth, device,
appliance, crown or other dental work;
• Missed appointments;
• Services:
• Covered under any workers’ compensation or occupational
disease law;
• Covered under any employer liability law;
• For which the employer of the person receiving such services is
not required to pay; or
• Received at a facility maintained by the Employer, labor union,
mutual benet association, or VA hospital;
• Services covered under other coverage provided by the Employer;
• Temporary or provisional restorations;
• Temporary or provisional appliances;
• Prescription drugs;
• Services for which the submitted documentation indicates a poor
prognosis;
• The following when charged by the Dentist on a separate basis
• Claim form completion;
• Infection control such as gloves, masks, and sterilization of
supplies; or
• Local anesthesia, non-intravenous conscious sedation or
analgesia such as nitrous oxide.
• Dental services arising out of accidental injury to the teeth and
supporting structures, except for injuries to the teeth due to
chewing or biting of food;
• Caries susceptibility tests;
• Initial installation of a xed and permanent Denture to replace one
or more natural teeth which were missing before such person was
insured for Dental Insurance;
• Other xed Denture prosthetic services not described elsewhere in
the certicate;
• Precision attachments, except when the precision attachment is
related to implant prosthetics;
• Initial installation of a full or removable Denture to replace one
or more natural teeth which were missing before such person was
insured for Dental Insurance;
• Addition of teeth to a partial removable Denture to replace one
or more natural teeth which were missing before such person was
insured for Dental Insurance;
• Adjustment of a Denture made within 6 months after installation
by the same Dentist who installed it;
• Implants including, but not limited to any related surgery,
placement, restorations, maintenance, and removal;
• Repair of implants;
• Diagnosis and treatment of temporomandibular joint (TMJ)
disorders;
• Repair or replacement of an orthodontic device;
• Duplicate prosthetic devices or appliances;
• Replacement of a lost or stolen appliance, Cast Restoration, or
Denture; and
• Intra and extraoral photographic images
Where two or more professionally acceptable dental
treatments for a dental condition exist, reimbursement is based on the
least costly treatment alternative. If you and your dentist have agreed on
a treatment that is more costly than the treatment upon which the plan
benet is based, you will be responsible for any additional payment
responsibility. To avoid any misunderstandings, we suggest you discuss
treatment options with your dentist before services are rendered, and
obtain a pretreatment estimate of benets prior to receiving certain
high cost services such as crowns, bridges or dentures. You and your
dentist will each receive an Explanation of Benets (EOB) outlining the
services provided, your plan’s reimbursement for those services, and
your out-of-pocket expense. Procedure charge schedules are subject to
change each plan year. You can obtain an updated procedure charge
schedule for your area via fax by calling 1-800-942-0854 and using the
MetLife Dental Automated Information Service. Actual payments may
vary from the pretreatment estimate depending upon annual maximums,
plan frequency limits, deductibles and other limits applicable at time of
payment.
This dental benets plan is made available through a self-funded
arrangement. MetLife administers this dental benets plan, but has not
provided insurance to fund benets.
Like most group benet programs, benet programs oered by MetLife
and its aliates contain certain exclusions, exceptions, reductions,
limitations, waiting periods and terms for keeping them in force.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
13
there are three ways to oBtain your outPatient
PrescriPtion druGs:
1. retail PharMacy
The CVS Caremark retail pharmacy benet allows
you to obtain covered prescriptions for up to a 30-day
supply from a nationwide network of more than 67,000
pharmacies, including CVS, Walgreens, Costco, Kroger,
Target and WalMart. Pharmacies can be identied by
calling CVS Caremark Member Services at 866-818-
6911 or by simply entering your zip code via the website
pharmacy locator at www.caremark.com.
2. hoMe deliVery
You can receive a 90-day supply by using CVS Caremark
Mail Service Pharmacy. CVS Caremark Mail Service
Pharmacy suggests that you request two prescriptions
from your doctor. One prescription is to obtain the
initial 30-day supply from a retail pharmacy. The second
prescription, which you will send to the mail service
facility, should be written for a 90-day supply with 3
rells.
3. retail90
In addition to being able to receive maintenance
medications from CVS Caremark Mail Service Pharmacy,
you will also have the option, choice and convenience
to purchase a 90-day supply at the following select
participating network pharmacies: CVS, Walgreens,
Albertsons, Osco and Sav-on. Your Retail90 co-pays will
be the same as mail service.
other iMPortant inforMation
• You will need to present your ID card to your pharmacy
• Clinical prior authorization monitors medications to
ensure appropriate utilization.
• Specialty prior authorization now through Specialty
Guideline Management (SGM), provides personalized
and dependable support for a variety of complex health
conditions.
• A one-time set-up for CVS Caremark Home Delivery
prescriptions is required. Included in the mailing when
you receive your new prescription drug benet card, you
will receive a brochure-sized form called “Mail Service
Pharmacy-Order Form.” Please follow the directions
provided to get your mail order prescription set up for the
rst time with CVS Caremark Home Delivery.
• Visit www.caremark.com to check drug coverage and co-
pay, nd generic alternatives, review your prescription
history, conrm eligibility, register for CVS Caremark
Home Delivery and order rells, print a temporary ID
card and search for a nearby pharmacy.
CVS Caremark provides your outpatient prescription drug benets. This benet is not part of your BCBS medical PPO
insurance, requires its own prescription identication card, and is provided to all members enrolled in the McGaw medical
plan.
CVS Caremark Customer Care: 866-818-6911
Website effective January 1, 2014: www.caremark.com
Prescription Drug Program
rx co-Pay
• $15 Generic all
• $50 Preferred brand
• $75 Non-preferred brand
• $30 Generic (90-day supply)
• $100 Preferred Brand (90-day supply)
• $150 Non-preferred Brand (90-day supply)
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
14
Vision Plan
01/01/2019
Benefit descriPtion coPay freQuency
• Focuses on your eyes and overall wellness $10 Every calendar year
Prescription Glasses
$20 See Frame and Lenses
Frame
• $130 allowance for a wide selection of frames
• $150 allowance for featured frame brands
• 20% savings on the amount over your allowance
• $70 Costco
®
frame allowance
Included in
Prescription
Glasses
Every other calendar year
Lenses
• Single vision, lined bifocal, and lined trifocal lenses
• Polycarbonate lenses for dependent children
Included in
Prescription Glasses
Every calendar year
Lens Enhancements
• Standard progressive lenses
• Premium progressive lenses
• Custom progressive lenses
• Average savings of 35%-40% o other lens enhancements
$50
$80-$90
$120-$160
Every calendar year
Contacts
(Instead of glasses)
• $130 allowance for contacts; copay does not apply
• Contact lens exam (tting and evaluation)
Up to $60 Every calendar year
Program
• Services related to diabetic eye disease, glaucoma and age-
related macular degeneration (AMD). Retinal screening for
eligible members with diabetes. Limitations and coordination
with medical coverage may apply. Ask your VSP doctor for
details.
$20 As needed
Extra Savings and
Glasses and Sunglasses
• Extra $20 to spend on featured frame brands. Go to vsp.com/specialoers for details.
• 30% savings on additional glasses and sunglasses, including lens enhancements, from the same VSP provider on the
• same day as your WellVision Exam. Or get 20% from any VSP provider within 12 months of your last WellVision
Exam.
• Average 15% o the regular price or 5% o the promotional price; discounts only available from contracted facilities
• After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor
Your Coverage with Out-of-Network Providers
Visit vsp.com for details if you plan to see a provider other than a VSP network provider.
Your Monthly Contribution
Visit vsp.com for more details on your
vision benet and for exclusive savings
and promotions for VSP members
Exam ..........up to $50
Frame .........up to $70
Single Vision Lenses ............ up to $50
Lined Bifocal Lenses ........... up to $75
$7.21 Member Only $18.92 Member + Family
Lined Trifocal Lenses ........ up to $100
Progressive Lenses ............... up to $75
Contact Lenses .........up to $105
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
15
Spending Accounts (FSAs):
• Over-the counter (OTC) drugs and medicines will
be considered ineligible expenses unless you have a
• Healthcare debit cards cannot be used to purchase
OTC
these purchases out-of-pocket and submit a claim to
Please read the PayFlex brochure included in your Open
Enrollment materials titled
Flexible Spending Accounts (also referred to as FSAs) let
you take full advantage of existing laws by allowing you
to pay for certain qualied medical and dependent day care
expenses with pre-tax contributions. Depositing money
throughout the year into a FSA allows you to avoid certain
taxes (federal withholding, state withholding, OASDI and
Medicare) on those amounts.
fsa deBit cards
The debit card is given to Housesta who elect to contribute
to a FSA. Housesta can use their debit card to cover out-of-
pocket health care and dependent day care related expenses. The
debit card can be used only at eligible FSA locations wherever
MasterCard
®
or Visa
®
are accepted. Contact PayFlex at 800-
284-4885 for additional information.
McGaw offers two FSAs — Health Care and Dependent
Day Care
It is advisable not to elect a Flexible Spending Account
unless you are fully aware of the guidelines of the program
and the ramications of not complying. You may review IRS
Publication 502 (Health) and 503 (Dependent Care) for
qualifying expenses.
filinG a claiM
PayFlex administers the FSAs. To le a claim, go to
www.mypayex.com. Submit the claim online or print
a reimbursement form and mail the completed form and
receipts to the address on the form. Keep copies of ALL
documentation you submit in the event it is lost in the mail.
To receive a reimbursement from your 2023 FSA account,
the expenditure must have occurred from January 1, 2023 (or
appointment date for mid-year appointees) through March
15, 2024 (or termination date of your coverage, if earlier).
Expenditures must be incurred only during active Housesta
duty. The deadline for submission of 2023 receipts is
March 31, 2024. To receive a reimbursement from your
2022 FSA account the expenditure must have occurred from
January 1, 2022 (or appointment date for mid-year appointees)
through March 15, 2023 and must be submitted by March 31,
2023. Please make sure you mail the forms well in advance of
the deadline so that you ensure timely receipt. Late receipts
will not be honored
aPProPriate docuMentation for fsa reiMBurseMent
Health Care Claims:
• Proof of expense – Explanation of Benets (EOB) or
physician/hospital invoice describing service
• Proof of payment – Canceled check, receipt, or physician/
hospital invoice indicating patient payment
Dependent Day Care Claims:
• Proof of expense – Day care receipt or canceled check to
individual with SSN and dates of service
• Proof of payment – Day care receipt indicating payment
or canceled check
Flexible Spending Accounts
soMe issues to consider Before siGninG uP for a fsa
1. Health Care and Dependent Care FSAs cannot be
started, stopped, or changed outside of the Open
Enrollment period, unless a qualifying change in status,
or a special enrollment event occurs.
2. The expenditure period for a 2023 FSA is January 1,
2023 – March 15, 2024, unless you are a
mid-year appointee, in which case your expenditure
period begins on your appointment date or your end of
training date.
3. Claim forms for 2023 expenses must be received no
later than March 31, 2024. Funds in your account not
claimed by March 31, 2024, will be forfeited.
4. Appropriate forms of documentation must accompany
the reimbursement claim form.
5. Establishing a FSA will have an impact on your cash
ow, since amounts are deducted from your stipend
before you actually incur (and pay) the expense. You
do not realize the full benet until you get your tax-free
reimbursement.
6. You cannot take a tax deduction for any health care
expense for which you received reimbursement from the
FSA, and you cannot submit to the FSA any expense that
will be reimbursed from another source.
7. Having a Dependent Day Care FSA may oset any tax
credits you may be able to take for childcare expenses.
Check with your personal tax advisor to nd out which
approach is right for you.
8. You cannot transfer money between FSA accounts.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
16
health care fsa
Health Care FSAs are governed by the following rules:
Elections cover a full plan year (January-December).
Housesta must determine the amount to be withheld for
the entire year during Open Enrollment. Estimate carefully
what you expect to spend because changes cannot be made
after the close of the benet enrollment period. The annual
contribution limit is $2,250.00.
Amounts you elect to have contributed to a FSA are subject
to the rule that you “use it or lose it.” Housesta forfeit
any amount in a FSA that remains unused at the end of the
expenditure period. The balance may not be used for the
reimbursement of another benet or carried forward to the
following year. This means Housesta must be very careful
in estimating covered medical care expenses when making a
fund election before the beginning of each plan year.
Claims Substantiation
Medical expenses may be reimbursed only if the Housesta
provides two written statements:
1. From an independent third party (e.g., doctor, hospital)
stating the amount and date expense was incurred and the
services rendered.
2. From the Housesta stating the expense has not yet been
reimbursed and is not reimbursable under any other health
coverage (claim form).
Examples of eligible health care expenses include:
• Medical and dental plan deductibles, co-payments and
other non-covered expenses
• Eye exams, glasses and contacts not covered by
insurance
• Hearing exams and aids
• Prescription drug co-payments
• Certain over-the-counter purchases. Visit the PayFlex
website at: www.payex.com.
Examples of ineligible health care expenses include:
• Cosmetic dentistry (bleaching/bonding)
• Childbirth classes
• Cosmetic medical care (breast augmentation)
• Family counseling
• Massage therapy
dePendent day care fsa
The rules for Dependent Day Care FSAs are similar to those
that apply to the Health Care FSA. The Dependent Day Care
FSA may be used for child care expenses for an eligible
dependent child up to age 13, and other eligible child care or
elder care expenses that allow you (and your spouse) to work,
look for work or for your spouse to attend school full time.
There is a projected IRS annual limit of $5,000 per family
($2,500 for married ling separately) on the amount you can
contribute to a Dependent Day Care FSA. You must provide
the Social Security number or taxpayer identication number
of the provider when you le your income tax return.
Examples of eligible dependent day care expenses include:
• Wages paid to a person who provides care to your
eligible dependents
• Licensed nursery school fees
• Childcare center costs
• Day camp fees
• After-school care – including costs for transportation to
such care furnished by the dependent care provider
• Certain indirect expenses, including day-care application
and agency fees
fsa claiM address:
Payflex systeMs usa, inc.
flex dePt.
P.o. Box 981158
ei Paso, tx 79998-1158
McGaw Payroll and Benets McGawpayroll@ey.com Fax 866-480-8867
Commuter/Transit Pre-Tax Benet
17
McGaw Medical Center of Northwestern University oers a
pre-tax payroll deduction program for your commuter/transit
expenses.
Housesta will need to purchase their Ventra cards in advance
and register their card online at www.payex.com. Then
you’ll be able to place your order by the 10th of the month for
the following month’s commuter/transit expenses. Example,
log-in and place your order by 12/10/22 so that your Ventra
card will be loaded for 1/1/23. Your payroll deduction for
your commuter/transit fees will be withheld from the stipend
payment occurring on the last day of the month prior to the
benet month. In the above example, your stipend will be
reduced on your 12/31/22 stipend deposit for your January
transit pass.
Currently, the IRS limit for pre-tax commuter/transit
expenses is $300.00 per month. This annual limit may be
updated depending on IRS guidance. If you will be ordering
commuter/transit funds of more than the IRS limit, the amount
over the limit must be charged to your credit card; thus $300
would be deducted from your stipend on a pre-tax basis and
anything over $300 would show up as a charge to your credit
card account.
Commuter/Transit benets are not limited to the Open
Enrollment period. Set-up your account and place your order
as needed (by the 10th of the month prior to the month you
want to utilize the benet) or you may place a recurring order
to streamline the process.
iMPortant:
Housesta that will be nishing their training in June must
cancel recurring orders no later than June 10th to avoid
paying for commuter/transit benets for the month of July.
Questions may be sent to mcgawpayroll@ey.com.
contact Payflex for additional inforMation at
800-284-4885 or www.Payflex.coM
MeMBer id is your Payroll id # (see PaystuB)
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
18
You may contribute up to the maximum amount allowable by
law $20,500 in 2022 and projected $22,500 in 2023. If you
will be at least age 50 by the end of the taxable year you may
be able to make additional “catch-up” contributions to the
401(k) plan of up to $7,500 in 2023.
McGaw will match 2% of your earnings each pay period you
contribute at least 2% to the 401(k) or Roth. The McGaw
match continues to be 1% for those contributing 1% per pay
period. If you contribute the IRS maximum before the end of
the year, you will not receive the McGaw match for each pay
period you are not able to contribute.
McGaw end of training:
• Your last 401(k)/Roth deduction, if applicable, will be
on your last stipend check. We strongly encourage you
to contact Fidelity and rollover your existing 401(k)/Roth
balance to your new employer’s plan or an IRA. However,
if you do not rollover your existing balance the following
will apply:
– Your balance is $1,000 or less. You will be required
to take a mandatory distribution. This distribution will
be mailed to your home. If you do not rollover the
distribution to a qualied plan within 60 days you may
incur taxes and penalties.
– Your balance is more than $1,000 but does not exceed
$5,000. Unless you provide instruction otherwise,
your balance will be automatically rolled over to a
Fidelity IRA. You will not incur any taxes or penalties.
Account opening and maintenance fees may apply.
– Your balance is more than $5,000. You may leave your
funds in the McGaw 401(k); however, we strongly
encourage you to rollover to your new employer’s plan
or to an IRA. Account opening and maintenance fees
may apply.
Questions? You may contact Fidelity directly at
800-343-0860 AFTER your nal stipend check to request
rollover paperwork.
401(k) loans
You may take a loan against a portion of your account up to a
maximum dollar amount. Contact Fidelity for limitations and
restrictions. It is your responsibility to ensure your loan is repaid
in full prior to your last day of training at McGaw Medical
Center. All loans not paid in full as of your end of training
date are subject to IRS penalty and taxation. The unpaid loan
becomes an early distribution. If you have taken a loan and you
notice loan repayments are not being withheld from your stipend
check, contact McGaw Payroll and Benets immediately.
401(k) Tax Deferred Savings Plan/Roth Post Tax Savings
freQuently asked Questions
How do I set-up a 401(k)/Roth account?
Contact Fidelity to set-up your 401(k)/Roth account.
The Fidelity Enrollment guide provides more
detailed information on setting up your account and
the 21 investment options you may elect. Follow
the instructions in the guide to set-up your account
directly with Fidelity. Fidelity requires your SSN,
appointment date, and birth date to enroll. If you do
not have a Fidelity Enrollment guide, contact McGaw
Payroll and Benets at mcgawpayroll@ey.com
Can I change my investment options or amount
being deducted during the year?
Yes. Contact Fidelity at 800-343-0860.
How does the McGaw 2% match work on my
Fidelity 401(k) or Roth account?
McGaw matches 2% of your per-pay-period gross stipend
for each pay period that you contribute at least 2% to the
401(k) /Roth plan. The McGaw match continues to be
1% for those contributing 1% per pay period. Therefore,
it is more advantageous to have your deductions withheld
throughout the year, instead of larger deductions in a few
stipend checks.
my account?
Contact Fidelity at 800-343-0860.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
19
Life Insurance and Accidental Death and
Dismemberment
McGaw Medical Center provides Hartford Life Insurance
and AD&D equal to your annual stipend at no cost to you.
You can increase coverage to 2, 3 or 4 times your annual
stipend for a semimonthly premium. Life insurance is available
only to active Housesta and not family members.This plan
is a double indemnity. For example, in the event of death during
an accident and your election is one times your annual stipend
level, your beneciary will receive one times your stipend for
life insurance and one times your stipend for AD&D. In the
event of death during a non-accident, your beneciaries will
receive one times your annual stipend level only.
Life insurance provided by McGaw is a tax-free benet
for amounts up to $50,000 per year. The Internal Revenue
Service requires you to pay taxes on the value of coverage
exceeding $50,000 per year.
Your benet is determined by taking your annual stipend and
then rounding to the nearest thousand. For example, if you
earn $43,595 annually, your benets stipend is $44,000.
choosinG a Beneficiary
You must elect a beneciary to receive the insurance
proceeds in the event of loss of life. If you do not have a
signed and dated beneciary form on le at McGaw Medical
Center, or wish to change beneciary, please contact McGaw
Payroll & Benets at mcgawpayroll@ey.com
eVidence of insuraBility
Current Housesta may increase current coverage levels only
if approved by Hartford Life Insurance. Call or email McGaw
Payroll & Benets for an Evidence of Insurability Form.
Newly appointed Housesta may apply for coverage of 1, 2 or
3 times their annual stipend without evidence of insurability.
If you apply for coverage more than 30 days after your
eligibility date, or change coverage above your previously
elected amount, you will be required to provide evidence of
insurability and be approved by Hartford Life Insurance in
order to qualify for coverage. Call McGaw Payroll & Benets
for an Evidence of Insurability Form.
liMitations/exclusions/terMination of coVeraGe
Life benets for additional life coverage will not be paid for
deaths caused by suicide in the rst 24 months after your
eective date of coverage.
AD&D benets will not be paid for losses caused by, or
resulting from:
1. Anaphylactic shock
2. Any form of auto-erotic asphyxiation
3. Failure to wear a Seat Belt while driving or riding as a
passenger in a Motor Vehicle
4. Intentionally self-inicted Injury
5. Stroke or cerebrovascular accident or event, cardiovascular
accident or event, myocardial infarction or heart attack,
coronary thrombosis or aneurysm
6. Suicide or attempted suicide, whether sane or insane
7. War or act of war, whether declared or not
8. Injury sustained while on full-time active duty as a member
of the armed forces (land, water, air) of any country
or international authority except Reserve or National
Guard Service
9. Injury sustained while taking drugs, including but not limited
to sedatives, narcotics, barbiturates, amphetamines, or
hallucinogens, unless as prescribed by or administered by a
Physician
10. Injury sustained while riding or driving in a scheduled
race or testing any Motor Vehicle on tracks, speedways or
proving grounds
11. Injury sustained while committing or attempting to commit
a felony
12. Injury sustained while Intoxicated
*
13. Injury sustained while driving while Intoxicated
14. Injury sustained by Illegal reworks or the use of any
legal reworks when not following the manufacturer’s
lighting instructions
15. driving and violating any applicable cellular device use or
distracted driving laws
1. the blood alcohol content;
2. the results of other means of testing blood alcohol level; or
3. the results of other means of testing other substances; that
meet or exceed the legal presumption of intoxication, or under
the inuence, under the laws of the state where the accident
occurred. If the accident occurred outside of the United States,
intoxication will be presumed if the person’s blood alcohol level
meets or exceeds .08 grams per deciliter.
Contact McGaw Payroll & Benets for more detailed
information on the plan.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
20
Guardian insures Housesta with a benet of
60% of your stipend up to $3,000 per month for
total disability. Provisions are also available for a
partial disability. This benet is available at no cost
to Housesta. Group No. 426034 • Phone 800-214-7039 •
www.insmedinsurance.com/mcgaw.
A 90-day elimination period between the start of the
disability and the time long-term disability (LTD) payments
(90 continuous days) begin is normally covered by short-
term disability benets. However, if some of these short-
term disability benets were used previously, a leave without
stipend will be required between the end of short-term
disability and the beginning of LTD benets.
definition of disaBility
You may be considered disabled and eligible for benets
because of sickness or injury if:
• You are limited from performing the material and
substantial duties of your regular occupation, as
determined by the plan administrator; and
• You have a 20% or more loss in indexed monthly earnings
due to the same sickness or injury.
Your LTD benet will not be reduced by additional coverage
you purchase on your own. Any disability payments you
receive from the McGaw plan are fully taxable.
liMitations/exclusions/terMination of coVeraGe
Benets are not paid for disabilities caused by, contributed
to, or resulting from:
• Intentionally self-inicted injuries;
• Active participation in a riot;
• War, declared or undeclared, or any act of war;
• Conviction of a crime under state or federal law;
• Loss of professional license, occupational license or
certication;
• Pre-existing conditions.
Pre-existinG condition exclusion
Because LTD insurance is intended to provide payments to
people who become disabled while they are insured rather
than to those whose disabling condition actually started prior
to the insurance coverage, pre-existing condition exclusions/
limitations are applied to insureds upon their eligibility for
LTD coverage.
The pre-existing condition exclusion makes an individual
ineligible for benets for any disability that is due to a pre-
existing condition if the disability begins within a specied
period of time after the insured’s eligibility date, as follows:
• You received medical treatment, consultation, care or
services including diagnostic measures, or took prescribed
drugs or medicines in the 3 months just prior to your
eective date of coverage (appointment date); or
• You had symptoms for which an ordinarily prudent
person would have consulted a health care provider in the
3 months just prior to your eective date of coverage; and
• The disability begins in the rst 12 months after your
eective date of coverage.
Mental and nerVous
LTD benets are paid for up to 24 months per lifetime for
disabilities caused by mental illness that meets the denition
of disability. Mental and nervous benets would continue
beyond 24 months only if you are institutionalized or
hospitalized as a result of the disability.
Contact McGaw Payroll and Benets for more detailed
information on the plan.
Long-Term Disability
Housestaff exceeding 90 days of short-term disability
must personally call McGaw Payroll and Benets
immediately to discuss the application process and
qualications for LTD. Approval/denial of LTD claims and
payments come directly from Guardian.
House sta are automatically enrolled. No action required on your part/for your information only
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
21
Long-Term Disability Plan Overview
McGaw Medical Center of Northwestern University provides you with disability coverage that will pay you a monthly
benet in the event you become disabled due to a sickness or injury and guarantees you the right to maintain coverage
when you complete a residency or fellowship program. This coverage is automatically provided when your residency
begins and does not require enrollment forms. The plan also provides you with important options when you complete your
residency or fellowship.
The following summary is intended to provide general information about your coverage.
Maximum Monthly
Benet During
Residency/Fellowship:
Full Time Housestaff Ofcers: 60% of income up to $3,000 per month. The disability must start
while you are insured and you must satisfy a period of 90 days during which you are disabled
(totally or partially). Benets are provided until you reach Social Security normal retirement age or
recover (whichever occurs rst).
Disability is dened as your inability to perform your own specialty during the rst two years of a
claim. Thereafter, you are insured as a doctor of medicine for the balance of the benet period.
Maternity is covered as an illness.
Restrictions and
Limitations During
the Residency Plan/
Fellowship:
If you are totally or partially disabled due to a mental, nervous or emotional disorder, alcoholism or
drug dependency, but are not hospitalized, a maximum of 24 monthly payments will be paid to you
while the disability continues. During a period of hospitalization, benets will be paid as for any
other disability.
Benets will cease at the end of the maximum benet period (Social Security Normal Retirement
Age), the date your disability ends, the date you die, or the date you fail to give the Insurer proof of
your continuing total disability, whichever occurs rst.
Benets will not be paid for a disability due to war (declared or undeclared) or any act of war,
intentionally self-inicted injuries, or active participation in a riot.
Supplemental Coverage
Opportunity During
Residency/Fellowship:
You are eligible to apply for a supplemental policy that may raise the level of income protection to
more than 100% of your current salary and guarantee the right to obtain up to $15,000 of total
coverage later without additional medical underwriting. This policy is offered with unisex rates
(greatly reducing the cost for women) and does require medical and nancial underwriting.
This is only a general overview. For specic contract language please refer to your Guardian benet booklet. Additional
information is available from your benets ofce or you can contact the plan administrator, InsMed Insurance Agency, Inc.,
at (800) 214-7039, info@insmedinsurance.com, or www.insmedinsurance.com.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
22
McGaw oers a savings program for Housesta to set aside funds to pay for the United States Medical Licensing Exam
(USMLE). The money will be deducted from the Housesta’s stipend check after taxes and maintained by McGaw in a non-
interest bearing account. Housesta may withdraw the full balance of the account by providing McGaw Payroll and Benets
with written notice at least seven business days before any stipend payment date. The requested amount will be included in
the next stipend direct deposit. Housesta may cancel this deduction at any time by notifying McGaw Payroll and Benets in
writing at mcgawpayroll@ey.com.
Alternatively, Housesta may elect to have a portion of their stipend deposited directly into their own savings or other account.
To elect this procedure, please complete a Direct Deposit Authorization form, and submit along with bank documentation stating
the routing number and account number to: mcgawpayroll@ey.com. This program is designed only to assist Housesta with
savings for Step 3 of the USMLE. All paperwork associated with the registering and paying for the exam is the responsibility
of the Housesta member.
Forms to enroll in the USMLE Savings Program are available via email at mcgawpayroll@ey.com.
Perspectives is a Housesta assistance program oered
to all McGaw Medical Center Housesta at no cost to the
Housesta. It is handled in a strictly condential manner
and the program director is not notied if you call or use the
services.
Perspectives provides 24-hour condential service for any
non-medical life issue, such as substance abuse, marriage
problems, nding child care, mental health counseling,
problems with personal or work relationships, legal problems,
nancial problems, moving to a new area, etc. Housesta
can receive up to 3 free counseling sessions without the
use of medical insurance. In addition, with referral from
Perspectives, Housesta may receive a half hour of legal
advice and discounted rates on future visits.
Perspectives Online provides convenient and condential
online access to a vast and continually refreshed library
of articles, self-guided assessments, links, calculators,
information and resources in the following areas:
Perspectives (A Housestaff Assistance Program)
to access PersPectiVes online
1. Go to www.perspectivesltd.com.
2. Click on the Online Services button on the navigation bar at the top of the page.
3. Follow the directions from there by using the username and password.
User Name: MCG501 Password: perspectives
Counselors are available between the hours of 8 AM and 6 PM CST and messages may be left 24 hours a day. The toll-free
phone number is 800-456-6327.
USMLE Savings Program
• Emotional well-being
• Family and care giving
• Health and wellness
• Daily living
• Working well
• Identify child care
options
• Financial stress
• Marital/relationships
• Substances
• Job “burnout”
• Convenience services
House sta are automatically enrolled. No action required on your part/for your information only
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
23
McGaw oers Housesta various paid and unpaid time
o. It is important to remember that individual board
requirements may not allow Housesta to take all of the
time o without having to make-up the time at the end of
an academic year. For instance, if the board governing your
program allows no more than 4 weeks not actively training
during any year and you elect to take 15 vacation days
(3 weeks) and 10 sick days (2 weeks), then one week will
need to be made up at year-end before going to the next PGY
level or before program completion.
Review your board requirements with your program
coordinator in advance of time o so that you and your
program coordinator are aware of the guidelines.
• 15 paid vacation days for PGY-1;
20 paid vacation days for PGY-2 and above
• 10 paid routine sick days
• 90 paid short-term disability (STD at 60%) days
• 6 weeks for birth of a child (combination of parental
leave, sick and STD at 60%)
– see FMLA on page 24
• 2 weeks paid parental leave
• Family Medical Leave Act
• Leave of absence
Time Off Work
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
24
Short-Term Disability
Housesta are allowed 10 routine sick days per academic
year. These are paid at 100% of regular stipend. Housesta
must notify their program coordinator when taking a sick
day. If a Housesta member requires more than 10 sick days,
then the Housesta member will be eligible for short-term
disability (STD). STD is paid at the rate of 60% of regular
stipend. STD requires physician certication prior to or as
quickly as possible following start of leave. Housesta must
personally arrange for STD with McGaw Payroll and Benets.
Failure to personally notify McGaw Payroll and Benets will
result in having to repay all overpaid funds. Additionally,
the Housesta member must personally update McGaw
Payroll and Benets with pending return to work date or
need for additional time o.
Please contact McGaw Payroll and Benets to complete the
required documentation.
Birth of a child:
For a routine birth, a mother is entitled to six weeks o after
delivery. For leave time, she will be paid two weeks parental
leave, then use any remaining sick time for the year, up to
10 days; the balance of the six weeks will be made up with
short-term disability benets providing 60 percent of the
usual stipend. If her physician does not release her to return
to work after six weeks, she remains on short-term disability
until her physician certies that she is capable of returning
to duty. If time o is necessary before delivery, again sick
leave is used rst and, if short-term disability coverage then
is required, a physician’s certication is necessary.
If her physician releases her to return to training after six
weeks but she wishes to extend the leave further, she may
rst use any remaining vacation time for the year and then
request leave of absence without stipend (see Family and
Medical Leave).
A housesta member may choose to use vacation time instead
of short-term disability for maternity leave if she wishes to
receive 100 percent of her stipend, but the duration is limited
to vacation time remaining for the year.
The Payroll/Benets oce must be notied in advance of
an anticipated birth or adoption date, and the actual date
conveyed promptly, so that benets for the infant may
be initiated. A “Request for Family and Medical Leave”
form must be completed and approved by the Program
Director. Request the Family Medical Leave (FML) form at
mcgawpayroll@ey.com.
1. Call the BCBS Medical Services Advisory (MSA) at
1-800-635-1928 within 2 days of delivery.
2. Contact McGaw Payroll and Benets to provide
notication of pending short-term disability and projected
dates of absence.
1. Notify BCBSIL Medical Services Advisory (MSA) within
two business days of delivery at 1-800-635-1928.
2. Email mcgawpayroll@ey.com to add the baby to your
insurance (within 30 days of birth).
3. Email mcgawpayroll@ey.com to nalize the dates of
your leave.
House sta are automatically enrolled. No action required on your part/for your information only
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
25
McGaw Medical Center provides qualied Housesta with
leave pursuant to the federal Family and Medical Leave
Act (FMLA) and applicable state laws which may provide
more generous benets. The FMLA does not supersede any
state or local law which provides greater family or medical
leave protection. Your rights under the federal FMLA are
explained below.
Each Housesta member may be entitled to unpaid leave,
not to exceed 12 weeks in a rolling 12-month period (not
to exceed 26 weeks for military caregiver leave). In order
to qualify for FMLA a second time, housesta must have
participated in training for a minimum of 1,250 hours in the
preceding 12-month period.
The rolling 12-month period is the 12-month period following
the leave. For example, if a Housesta member takes three
weeks of leave beginning on May 1, on May 1 of the next
year the Housesta member will again have the three weeks
of leave available.
Housesta must notify their program coordinator at least 15
days (or if not possible, as soon as practicable) before any
proposed leave is to begin. McGaw reserves the right to delay
the start of any requested leave until appropriate notice is
given. In the event of an emergency, notice must be provided
to the program coordinator no later than three business days
after the commencement of leave. All questions about FMLA
leave should be addressed to McGaw Payroll and Benets.
If a Housesta member suers a program-related injury that
qualies as a serious health condition, the leave provided
under this policy will run concurrently with the leave
required under the workers’ compensation laws. The taking
of leave under this policy will not be used against Housesta
in any educational or program decision, including in the
determination of stipends or discipline; provided, however,
that if such leave prevents a member of the Housesta from
fullling the requirements of the graduate medical education
program in which that Housesta member is enrolled, that
Housesta member shall not be advanced within the program.
A Housesta member on FMLA leave has no greater rights
than if no leave had been taken.
aMount of leaVe aVailaBle
Housesta are generally entitled to a total of 12 training
weeks (26 training weeks for military caregiver leave) of
unpaid leave during a rolling 12-month administrative year,
regardless of the number of events giving rise to the leave
entitlement. Leave may be taken for any one or combination
of the following reasons:
Birth or Placement of a Child
Unpaid leave may be taken by Housesta on the birth or
placement for adoption or foster care of a son or daughter.
Leave must be taken all at once unless McGaw agrees to permit
leave on an intermittent basis. The entitlement to leave for birth
or placement for adoption or foster care ends 12 months after
the birth or placement for adoption or foster care.
Medical Leave
Eligible Housesta may use FMLA leave for their own
“serious health condition” or to care for a child, spouse,
domestic partner or parent with a “serious health condition.”
A serious health condition generally involves inpatient care at
a hospital, hospice or nursing home, or outpatient care which
requires continuing treatment by a health care provider.
To meet the denition of a serious health condition, the
condition must generally exist for more than three calendar
days. Medical leave may be taken all at once or in smaller
increments as medically necessary.
Military Caregiver Leave
Unpaid leave may be taken by Housesta to care for a military
service member who has incurred a serious injury or illness
in the line of active duty, if the military service member is
the Housesta’s spouse, son, daughter, parent or next of kin.
Military caregiver leave may be taken for up to a total of 26
training weeks during a single 12-month period. Housesta
who are eligible for military caregiver leave under the FMLA
are limited to a combined total of 26 training weeks of leave
for any FMLA-qualifying reason during the single 12-month
period (only 12 of the 26 weeks total may be for a FMLA-
qualifying reason other than to care for a covered service
member).
Medical certification
Housesta who wish to take a medical leave of absence for
their own serious health condition or that of an eligible family
member must provide McGaw with a Health Care Provider
Certication completed by the treating health care provider.
This document must be provided to McGaw Payroll and
Benets no more than 15 calendar days after the earlier of the
commencement of leave or the date on which the request for
leave is made. Any requested clarication must be completed
and returned to McGaw Payroll and Benets within ve
calendar days after the request.
After receiving the Health Care Provider Certication,
McGaw may require that a Housesta see a health care
Family and Medical Leave Policy
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
26
provider of McGaw’s choosing in order to verify the
information provided. McGaw will pay the cost of this
examination. If the results of the second examination dier
from the original certication, McGaw may require a third
examination, again at its expense, by a health care provider
which is mutually agreeable to McGaw and the Housesta.
Both McGaw and the Housesta are obligated to cooperate
in selecting a suitable health care provider. The results of this
third examination will be nal and binding on the Housesta
and McGaw as to the classication of the leave.
When a Housesta takes leave because of his/her serious health
condition, McGaw may require the submission of additional
certications periodically during the leave. Recertications
of the Health Care Provider Certication may be requested
every 30 calendar days (or if longer, the stated duration of
the leave) unless the facts and circumstances do not appear to
support the original Certication or McGaw has information
which casts doubt on the stated reason for leave. In such a
case, a recertication of the serious health condition may be
requested at an earlier point in time. McGaw will provide
notice to the Housesta of any recertications which may be
required.
interaction Between fMla and other Paid tiMe off
Housesta granted FMLA leave must rst use any accrued
sick days before taking unpaid leave. However, use of paid
time o will not extend the length of the FMLA leave beyond
12 weeks. In addition, FMLA leave runs concurrently with
all other types of leave, including workers’ compensation and
short and long-term disability. For example, for the birth of
a child, house sta are entitled to 12 weeks of FMLA leave.
McGaw Medical Center oers two weeks paid parental leave
for all house sta. House sta giving birth will follow the two
weeks parental leave with remaining sick days paid @100%
of stipend and short-term disability paid @60% of stipend
for the remainder of the six weeks following delivery date.
Short-term disability is paid at 60 percent of the regular
stipend. Any remaining leave up to the maximum 12 weeks
will be unpaid. Vacation time may be used in lieu of unpaid
time or to supplement short-term disability payments but will
not extend the length of FMLA leave beyond 12 weeks.
Benefits durinG faMily and Medical leaVe
During an approved FMLA leave, McGaw will continue to
make available to Housesta the same insurance benets
which are available to Housesta not on leave. It is the
Housesta member’s responsibility to continue to contribute
his/her portion of any insurance premiums during leave. If
the Housesta member is paid during the leave period, the
premium will be deducted from the pay available. However,
during any unpaid period of leave, the Housesta member
is responsible for making the premium payment in a timely
fashion. The failure to make timely premium payments may
result in the loss of benets.
No Housesta will lose any accrued seniority or benets
while on leave; however, additional seniority and benets
will not accrue during any unpaid family or medical leave.
returninG froM faMily or Medical leaVe
Housesta returning from FMLA leave should, where
possible, give McGaw at least two weeks, but not less than
two work days, written notice of their intent to return to
active status in the graduate medical education program. Any
Housesta who returns from FMLA leave upon or before the
expiration of leave will be reinstated to active status in the
graduate medical education program with equivalent benets,
stipend and other terms and conditions. However, McGaw
cannot guarantee reinstatement to Housesta whose leave
extends beyond 12 weeks (26 weeks for military caregiver
leave) in any 12-month period, except to the extent necessary
to comply with applicable state or federal law.
If a Housesta is on leave because of his/her own serious
health condition, McGaw will require the submission of a
tness-for-duty certicate to his/her program coordinator
before returning to active status in the graduate medical
education program, if the absence was for more than three
work days. A tness-for-duty certicate is a doctor’s note
stating that the Housesta is now able to perform his/her job
and may return to active participation in the graduate medical
education program. If a Housesta member fails to provide
a tness-for-duty certicate by the end of any medical leave,
that person may not be eligible for reinstatement.
failure to Meet Policy reQuireMents
If a member of the Housesta fails to meet the requirements
of this policy, the request for leave may be denied or delayed
until the requirements are met. If you have any questions
regarding the operation or interpretation of this policy, please
contact McGaw Payroll and Benets.
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
27
Contact the legal department of the hospital at which your program is based for information pertaining to your Professional
Liability Insurance.
northwestern MeMorial hosPital
Main phone: 312-926-2000
Dept of Insurance: 630-933-6799 or 312-926-5973
ann and roBert h. lurie children’s hosPital of chicaGo
Main phone: 312-227-4000
Risk Management: 312-227-4204
Va hosPital
Main phone: 312-569-8387
Risk Management: 312-569-6909
shirley ryan aBilitylaB
Main phone: 312-238-1000
Oce of General Counsel: 312-238-1537
Professional Liability Insurance
Have you received a needlestick or other work-related injury? If so, please seek medical assistance immediately and notify
your program director. Shortly thereafter, send an email to mcgawpayroll@ey.com to le a workers’ compensation claim so
your medical bills will be paid.
Failure to report your work-related injury in a timely manner to McGaw Payroll/Benets will result in delay of payment for
services received and could possibly result in a collection agency seeking payment directly from the injured Housesta.
Even if you seek medical assistance from Corporate Health, you are still required to contact McGaw Payroll/Benets to le
a claim.
Workers’ Compensation: Injured on the Job?
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
28
A federal law enacted in 1985 requires most group health plan
sponsors to oer participants and their family members the
opportunity for a temporary extension of health coverage
at group rates in certain instances when coverage under these
plans would otherwise end.
McGaw Housesta who are covered under the McGaw
group health plans at the time of the end of training at
McGaw are eligible for COBRA continuation coverage.
Their current insurance will be terminated at the end of the
month in which they terminate. For example, if you terminate
from McGaw on June 22, your insurance will cease on
June 30.
You are eligible to elect to continue your current medical,
prescription, dental and/or vision insurance. You may
not continue life insurance, long-term disability or your
FSA account, except that under very limited circumstances
you may continue your healthcare FSA on an after-tax basis
for the remainder of the year in which you terminate.
Following the end of your training, you will receive a letter
from PayFlex informing you of the cost and the deadlines for
applying for coverage. Failure to meet the deadlines means
automatic cancellation of insurance and loss of rights under
COBRA. Once you elect coverage, it is your responsibility to
make sure that payments are made in a timely manner. Even
if an invoice is lost in the mail and not received by you, you
must contact PayFlex to arrange for payment by the deadline.
There are no exceptions to this policy.
All questions or inquiries in regards to COBRA should be
directed to PayFlex at 800-284-4885, including:
• How much does COBRA cost?
• How does COBRA work?
• What plans are included in COBRA?
• How to change your home address if you are a current
COBRA participant?
• When are payments due?
• How do I sign-up?
COBRA Continuation Coverage
freQuently asked Questions
following the end of training while I am deciding if I
want COBRA?
No. Your insurance is terminated as indicated above.
If you elect COBRA within the 60-day deadline, the
insurance is eective retroactive back to the date of
lost coverage.
Can I add my newborn to COBRA?
Yes. Contact PayFlex at 800-284-4885 within 30 days
(your window for “Change in Status”) to inform them of
your newborn. If you are currently paying for COBRA at
the single rate, you will owe additional funds to increase
to the family rate.
I never received an invoice from PayFlex and now
coverage if I pay late?
No. It is your responsibility to ensure that payment is
made in a timely manner and to notify PayFlex of any
change in address. If a couple weeks have passed into
the new month and no invoice is received, you should
contact PayFlex immediately to make arrangements for
payment.
coBra PreMiuM address:
Payflex systeMs usa, inc.
P.o. Box 953374
st. louis, Mo 63195-3374
your stiPend check
The top section of your stipend check is a live check. Your
check detail is provided on the stub below.
direct dePosit
Direct Deposit ensures that your stipend is automatically
deposited in your bank account each and every payday.
No more trips to the bank to deposit your check and no
lost checks. Lost checks may take 1-2 payroll cycles to
be reissued.
Paper check stubs are not issued. Electronic check stubs are
available online at:
https://workforcenow.adp.com
Email mcgawpayroll@ey.com for
ADP Registration Code
If you do not remember your user name and password please
click on “forgot user id/password” and follow the prompts.
To sign-up for Direct Deposit, email or fax a completed
Direct Deposit Authorization Form to McGaw with a voided
check. Request the form at: mcgawpayroll@ey.com.
If you close your bank account for any reason you must notify
McGaw Payroll and Benets immediately. Your bank may
hold the Direct Deposit for up to ten days before returning
it to the payroll provider. In other words, it may take 1-2
payroll cycles to rectify the problem and reissue your stipend
check, due to your account closure.
If at anytime you wish to change banks or accounts, notify
McGaw Payroll and Benets approximately 2 weeks prior
to the anticipated switch. You will be asked to provide a new
Direct Deposit Authorization Form and email indicating you
wish to stop Direct Deposit on your current account.
forMs w-4 and il-w-4
Your stipend check stub indicates the amount being
withheld for federal and state taxes as well as deductions for
elected benets.
McGaw Payroll and Benets cannot provide assistance
completing forms W-4, IL-W-4 or IN W-4 (if applicable).
Contact your tax advisor for assistance completing the forms
or for questions regarding your withheld tax.
If you wish to change your taxable marital status or number of
exemptions, submit a new W-4 (federal and/or state) via fax
or mail. Request forms via email at: mcgawpayroll@ey.com.
Forms must be completed in entirety with date and signature
or will not be considered valid.
Your Stipend Check Stub/Direct Deposit/Forms
W-4 and IL-W-4
freQuently asked Questions
How long does it take before the Direct Deposit
starts working?
It depends on when in the payroll cycle the information is
received. If the information is received at least 7 business
days prior to check date, your payroll should be direct
deposited on that check date.
The stipend check never arrived at my house. Can I get
a replacement?
If after 10 days your stipend check has not been received
(not Direct Deposit, but an actual stipend check), we will
ask that you sign an adavit indicating you will not cash
the check if it eventually does arrive. We will then place
a stop payment on the check and reissue you a check on
the next payroll period.
I can’t nd my last stipend check stub. Can you mail
another one?
Stipend check stubs are available online at
https://workforcenow.adp.com.
2022 W-2s will also be available online
at the web address provided above
(https://workforcenow.adp.com).
Email mcgawpayroll@ey.com for
ADP Registration Code
McGaw Payroll & Benets McGawpayroll@ey.com Fax 866-480-8867
29
2110-3894369
