Useful Definitions

Dependent Definitions

Who is considered a Dependent for health, dental and life plans?

• Your legal spouse.
• Same-Sex Domestic Partner (SSDP). Another adult of the same sex who is engaged with you in a spouse-like relationship characterized by mutual caring and dependency.
  • Same Sex Domestic Partners coverage and coverage for child(ren) of same sex domestic partners requires completion of the Statement of Same-Sex Domestic Partnership. To receive the Affidavit and to learn more about the eligibility requirements to add a same sex domestic partner, please call 404-727-7613 to speak to a benefits representative.
• Your legal children. Children include your natural or adopted child(ren) or stepchild(ren) or any child(ren) for whom you have legal custody and who live with you in a parent-child relationship as noted. They are eligible if they are:

  - up to age 26 and do not have coverage through their employer.

   

Note:

• Parents, grandparents and siblings are NOT eligible dependents under these plans.
• For the Dependent Care (daycare) FSA, a dependent is defined as a legal child under the age of 13, a disabled child or elderly parents that you can claim as a dependent on your tax returns.

Network Definitions

Each medical plan offers three network options – EPN Network, In-Network and Out-of-Network. Your cost sharing (co-pays, co-insurance, deductibles, etc.) varies based on which network you use.

• EPN Network providers have lower co-pay, co-insurance, and deductibles. The core network includes physicians, hospitals and other health care providers primarily affiliated with Emory HealthCare; however, there may be other providers who are not a part of the Emory Healthcare system but are in the network.
  
  EPN Network hospitals include:
• Emory University Hospital Midtown
• Emory University Hospital
• Emory University Orthopaedic & Spine Hospital
• Emory Johns Creek Hospital
• Emory Adventist Hospital
• Wesley Woods Hospital
• Children's Healthcare of Atlanta (Egleston and Scottish Rite)

EPN Network Physicians include:
Emory physicians
Other participating physicians as specified by each plan

• In-Network providers includes physicians, hospitals and other health care providers that are identified as part of a particular medical plan. At Emory, our medical plans has a defined “network” of providers. If you choose to use an in-network provider instead of an EPN provider, you still have in-network benefits but the deductibles, coinsurance and co-pays are slightly higher.
  
  Contact the appropriate network to find a participating physician or facility:
  

  Aetna POS

  www.aetna.com/docfind/custom/emory

  (800) 847-9026

• Out-of-Network providers are any physicians, hospitals or other health care providers who are not affiliated with either the Emory Core Network or your medical plan in-network providers. If you choose to go to a provider outside the core or in-network, eligible charges will be reimbursed at the usual and customary rate subject to an annual deductible and coinsurance.

Note:

• Your medical and dental plan contributions and your contributions to flexible spending accounts are deducted from your paycheck on a pre-tax basis. These contributions are deducted before federal and most state and local taxes are calculated. The amount you save in taxes helps offset your contributions to these plans.

Emory University Benefits

Hours of Operation: Monday through Friday from 8:00 a.m. to 5:00 p.m.
Wed - 8:00am - 3:00pm
1599 Clifton Road, NE
Atlanta, GA 30322
(404) 727-7613 phone
(404) 727-7145 Fax

Disclaimer

Emory reserves the right to terminate, suspend, withdraw, amend or modify the Plan in whole or in part at any time. Further, Emory reserves the right to terminate or modify coverage for any group of employees, active or retired and their dependents or a class of dependents at any time.