BNY Mellon Benefits Guide
Medical
  • New Prescription Drug Formulary and Benefit Levels
    • Effective January 1, 2018, BNY Mellon will adopt the CVS Value Formulary, which includes a broader selection of generic drugs in place of more expensive brand-name drugs. If you use a prescribed drug that is not on the Value Formulary list, CVS will alert you and your prescribing physician, suggesting alternative drugs included in the Value Formulary. See the "Value Formulary" for more information about.
    • Your coinsurance and copays will change as follows (changes are in italics):
PRESCRIPTION DRUGS
 
PLAN HRA1
Drugs are not subject to the overall plan deductible and follow the traditional 4-tier prescription drug schedule
PLAN HSA1
Non-preventive drugs are subject to the overall plan deductible. Preventive drugs are not subject to the overall plan deductible and are covered under the same traditional 4-tier prescription drug schedule as Plan HRA.
Preventive2
Same as Retail/Mail Order below
Same as Retail/Mail Order under Plan HRA (deductible does not apply)
Retail3
Non-Preventive Drugs
  • Generic: Lesser of $10 or retailer's regular cost
  • Formulary (Preferred) Brand: 25% coinsurance ($50 minimum; $75 maximum)
  • Non-Formulary (or Non-Preferred) Brand: 40% coinsurance ($75 minimum; $100 maximum)
Non-Preventive Drugs
  • Generic: 20% coinsurance after deductible
  • Formulary (Preferred) Brand: 20% coinsurance after deductible
  • Non-Formulary (or Non-Preferred) Brand: 40% coinsurance after deductible5
Mail Order3
Non-Preventive Drugs
  • Generic: Lesser of $25 or regular discount cost
  • Formulary (Preferred) Brand: 25% coinsurance ($125 minimum; $187.50 maximum)
  • Non-Formulary (or Non-Preferred) Brand: 40% coinsurance ($187.50 minimum; $250 maximum)
Non-Preventive Drugs
  • Generic: 20% coinsurance after deductible
  • Formulary (Preferred) Brand: 20% coinsurance after deductible
  • Non-Formulary (or Non-Preferred) Brand: 40% coinsurance after deductible5
Specialty4
  • Generic: $10
  • Formulary (Preferred) Brand: $75
  • Non-Formulary (or Non-Preferred) Brand: $100
  • Generic: 20% coinsurance after deductible
  • Formulary (Preferred) Brand: 20% coinsurance after deductible
  • Non-Formulary (or Non-Preferred) Brand: 40% coinsurance after deductible5
1 Your costs for preventive and non-preventive drugs count toward the out-of-pocket maximum; mandatory generic and step therapy programs apply.
2 Examples of preventive drugs include, but are not limited to, diabetes medications, cholesterol medications, and high blood pressure medications.
3 Maintenance/preventive medication must be filled through mail order or at a CVS (or Target) retail pharmacy after the prescription is filled twice at a retail location.
4 30-days' supply maximum at Retail and Mail Order.
5 Minimums and maximums do not apply.
  • CVS Caremark Accordant Care Program Expanded
CVS Caremark AccordantCare is a voluntary and free service available to employees and their eligible dependents enrolled in the Aetna and UnitedHealthcare health programs. Through this program, individuals with certain complex conditions can work with CVS Healthcare Management Nurses to help ensure the best care. Beginning November 1, 2017, conditions managed under this Program are being expanded to include HIV.
  • Enhanced Institutes/Centers of Excellence Programs
Starting January 1, 2018, Aetna Institutes of Excellence (IOE) and Institutes of Quality (IOQ) and UnitedHealthcare Centers of Excellence (COE) programs are being enhanced to encourage individuals to seek out high-quality facilities for certain complex medical needs. Through these programs, you have access to facilities that must meet the carrier's strict standards for care quality and efficiency, including number of procedures performed, success rates, cost effectiveness of care and low re-admissions and low complication rates. Enhancements include:
    • Joint and Spine Surgeries: Certain complex joint and spinal surgeries will be covered under an enhanced benefit of 100 percent after the deductible if these services are obtained from eligible Aetna IOQ and UnitedHealthcare COE facilities.
    • Transplant Surgery: All transplants must be obtained from a recognized Aetna IOE or UnitedHealthcare COE.
  • Medical Plan Premium Increases
Your medical plan premium contributions will increase in 2018 to address medical cost inflation, more fairly distribute costs based on utilization, reflect transition of the tobacco-free premium reduction to an HRA/HSA deposit based on participation in various points-based activities, and better align with our industry peers.
We're changing contributions for covering dependents in an effort to more fairly distribute costs across our medical plan-enrolled employees as spouse/domestic partner coverage is more expensive for BNY Mellon than employee-only coverage. And, as prescription drug and general medical inflation increases, and as our industry peers move toward a more equitable distribution of costs, we're compelled to change our contributions, and to do so in a fair manner.
By participating in the 2018 Wellbeing Rewards Program, employees and their covered spouse/domestic partner can earn back much of that increase by engaging in a variety of wellbeing activities throughout the year and fund their health accounts to pay for qualified health care expenses that would previously be paid out of pocket. (See "2018 Wellbeing Rewards Program" for more information.)
  • New Contribution Maximums for Your Health Savings Account
In 2018, maximum annual contributions to the Health Savings Account (HSA) will be $3,450 if you cover only yourself (increase of $50 from 2017) and $6,900 if you cover yourself and any dependents (an increase of $150 from 2017). If you are age 55 or older, you may make additional catch-up contributions of up to $1,000 annually (no change from 2017). The maximum annual contribution amount includes contributions made by BNY Mellon, contributions made by you and any health account deposits earned through participation in wellbeing activities.
Important: If you are currently enrolled in any part of Medicare (Part A, Part B, etc.) or Tricare, you may participate in Plan HSA, but you may not contribute to a Health Savings Account. See "Health Savings Account (HSA) Contributions" in the Medical and Prescription Drug section for more information about IRS regulations on Health Savings Accounts.
  • More Preventive Care Services Covered at 100 Percent
Effective January 1, 2018, and in accordance with the Affordable Care Act, at no additional cost to you, you will be able to access an expanded list of in-network preventive care services, which include:
    • Screening for depression (adults, including pregnant and postpartum women) or major depressive disorder (adolescents ages 12-18)
    • Aspirin use as a preventive medication (adults ages 50-59) (you will need a prescription to obtain this benefit)
    • Syphilis screening (asymptomatic, nonpregnant and pregnant adults, and adolescents)
    • Latent tuberculosis infection screening (asymptomatic adults)
    • Breastfeeding support and counseling (women before and after childbirth and their children)
    • Individuals between the ages of 40 and 75, all generic low- and moderate-dose statin medications are covered at $0 cost