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Important Terms
As you read this summary of the JPMorgan Chase Vision Plan, you'll come across some important terms related to the plan. To help you better understand the plan, many of those important terms are defined here.
Terms
Definition
Before-Tax Contributions
Contributions that are taken from your pay before federal (and, in most cases, state and local) taxes are withheld. Before-tax dollars are also generally taken from your pay before Social Security taxes are withheld. This lowers your taxable income and your income tax liability. This reduction to taxable income will not affect any other pay-related benefits, such as basic life insurance, long-term disability insurance, and your Retirement Plan benefits. So, your other benefits will continue to be based on your full, unreduced benefits pay.
Keep in mind that before-tax contributions do not count as earnings for Social Security purposes. Therefore, your future Social Security benefit could be slightly reduced if your total earnings for the year are less than the Social Security wage base ($102,000 in 2008). However, this reduction is nominal and may be outweighed by the immediate tax savings resulting from using before-tax dollars to pay for your benefits.
Claims Administrator
The company that provides certain claims administration services for the Vision Plan.
Consolidated Omnibus Budget Reconciliation Act of 1985 as amended (COBRA)
A federal law that allows you and/or your covered dependents to continue Vision Plan coverage on an after-tax basis (under certain circumstances) when coverage would otherwise have ended. The "Plan Administration" section of this Guide provides details on COBRA coverage.
Coordination of Benefits
The rules that determine how benefits are paid when a person is covered by more than one group plan. Rules include:
  • Which plan assumes primary liability;
  • The obligations of the secondary claims administrator or claims payer; and
  • How the two plans ensure that the person is not reimbursed for more than the actual charges incurred.
In general, the following coordination of benefits rules apply:
  • As a JPMorgan Chase employee, your JPMorgan Chase coverage is considered primary for you.
  • For your spouse/domestic partner or dependent child covered as an active employee or employee of another employer, that employer's coverage is considered primary for him or her.
  • For children covered as dependents under two plans, the primary plan is the plan of the parent whose birthday falls earlier in the year (based on month and day only, not year).
Specific rules may vary, depending on whether the patient is an employee in active status (or the dependent of an employee). These rules do not apply to any private insurance you may have. Please see "If You Are Covered by More Than One Vision Plan" for more details.
Copay or Copayment
The amount you pay toward certain vision care services under the Vision Plan when you receive your care from an EyeMed network provider. For example, when you visit a network provider, you will be required to pay a $10 copayment for an eye exam.
Covered Services
Vision procedures that are generally reimbursable by the JPMorgan Chase Vision Plan. While the plan provides coverage for numerous services and supplies, there are limitations on what's covered. For example, contact lenses are not covered under the Vision Plan in the same year you receive benefits for frames and eyeglass lenses. So, while a service or supply may be necessary, it may not be covered under the JPMorgan Chase Vision Plan. Please see "What Is Covered" and "What Is Not Covered" for more details.
Eligible Dependents
Under the Vision Plan, your eligible dependents can include your spouse or domestic partner, and your dependent children.
Please see "Your Eligible Dependents" in the "Medical Plan" section of this Guide for more information.
EyeMed
EyeMed Vision Care, The claims administrator for the JPMorgan Chase Vision Plan.
EyeMed Network Provider/Non-Network Provider
Terms referring to whether a covered service is performed by a provider who is part of the network associated with the Vision Plan ("network provider") or by a provider who is not part of the network ("non-network provider"). When a service is performed through an EyeMed network provider, benefits are paid at a higher level than they are when a service is performed through a non-network provider.
Non-Duplication of Benefits
The Vision Plan does not allow for duplication of benefits. If you and your eligible dependents are covered under more than one group plan, the primary plan (the one responsible for paying benefits first) needs to be determined. You are entitled to receive benefits up to what you would have received under the JPMorgan Chase Vision Plan if it were your only source of coverage, but not in excess of that amount. If you have other coverage that is primary to the JPMorgan Chase Vision Plan, the claims administrator will reduce the amount of coverage that you would otherwise receive under this plan by any amount you receive from your primary coverage. Please see the definition of "Coordination of Benefits" in this section for more information.
Qualified Change in Status
The JPMorgan Chase benefits you elect during each annual benefits enrollment period will generally stay in effect throughout the plan year, unless you elect otherwise due to a qualified change in status (such as marriage, divorce, the birth or adoption of a child, etc.) within 31 days of the event for benefits to be effective on the date of the event. If you miss the 31-day deadline, coverage for certain benefits will be effective as of the date you contact the Benefits Call Center.
Please Note: Any changes you make during the year must be consistent with your qualified change in status. Please see "Qualified Change in Status" for more information.