Looking Forward to 2021 - 2021 Annual Enrollment starts Monday, October 19 and ends Friday, November 6, 2020
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2021 Benefits Highlights Brochure Looking Forward to 2021 2021 Annual Enrollment starts Monday, October 19 and ends Friday, November 6, 2020
Welcome to 2021
Annual Enrollment!
This year, our attention has been pulled in many directions as we’ve all rapidly adapted
to the many challenges thrown our way.
With the uncertainty caused by the pandemic, the current social and political
environment, the economy and more, we hope you find some relief in knowing your
benefits are here to support you.
We recognize the last thing you need is something else to worry about. That’s why
we’re enhancing your benefits in 2021. With minimal changes and only slight increases
to medical per-paycheck deductions, you can focus your energy on making sure
your coverage fits your and your family’s needs. As you review your 2021 coverage
elections, be sure to consider any life events and family situations that might impact
your benefits decisions.
Visit your-ebenefits.com/prh today for the benefits information you need
to get started, including coverage details, costs, enrollment information, and
decision-making resources.
22021 Annual Enrollment
Annual Enrollment is your once-a-year opportunity to review and change your benefits
elections for the coming year. Any changes you make are effective January 1, 2021, and
remain in effect for the entire year unless you have a qualified life event.
If you do not actively enroll or make changes to your coverage during Annual Enrollment,
your 2020 benefits elections will roll over to 2021 at the same coverage level,
with one exception. If you contribute to a Flexible Spending Account (FSA), your 2020
elections will NOT carry over to 2021. You must re-enroll in FSAs each year.
3What’s Changing for 2021
Dependent Verification Flexible Spending Accounts
Before you enroll your dependents, make sure they’re The Health Care FSA maximum contribution will increase to
eligible! Consova, an independent third party, will review $2,750 ($50 increase from 2020).
your dependents to ensure that they meet the plan’s Note: If you enroll in the Anthem CDHP with HSA, IRS rules
eligibility requirements. You will receive a packet in prohibit you from contributing to a Health Care FSA.
mid-January 2021 with detailed instructions, a list of
required documents, and how to submit them for the
Dependent Eligibility Verification. Documentation is
required even if you’ve provided it in the past. However,
MetLife Voluntary Benefits
if a dependent was verified by Consova within the last If you have accident, critical illness, and/or hospital
24 months, you will not be required to submit indemnity insurance currently or elect it for 2021, visit the
documentation again for this dependent during this MetLife website at mybenefits.metlife.com to designate
verification cycle. Look for additional information from a beneficiary.
Consova after Annual Enrollment.
Per-Paycheck Deductions
Medical and Prescription Drug • The lower two salary bands—$0–$24,999 and $25,000–
The Voluntary Smart90 prescription drug program, which $49,999—will merge into one salary band: $0–$49,999.
allows you to fill a 90-day supply of your maintenance • Medical per-paycheck deductions will increase slightly.
medication at a retail pharmacy for the same price as using See your-ebenefits.com/prh for specific per-paycheck
the mail-order pharmacy, is expanding to include CVS deduction information.
Pharmacy, in addition to Walgreens and Duane Reade.
• There is no change to what you pay for your dental,
vision, or other benefits in 2021 unless changes to your
annual salary or age impact your per-paycheck deduction,
Dental where applicable.
The Cigna Dental Health Maintenance Organization (DHMO)
will use an expanded network of providers: the Cigna
Access Plus network.
Health Savings Account
2021 IRS HSA contribution maximums will increase:
• Individual: $3,600 ($50 increase from 2020)
• Family: $7,200 ($100 increase from 2020)
• If you will be age 55 or older by December 31, 2021, you
can make an additional $1,000 catch-up contribution to
your HSA.
There are no changes to your other 2021 benefits, including vision, disability,
life and AD&D insurance, or voluntary benefits. To learn more about these
benefits, visit your-ebenefits.com/prh.
4What You Need to Know for 2021
Medical
Here’s an overview of how much you will pay under each medical plan option in 2021.
Anthem CDHP with HSA Anthem EPO Anthem PPO* Kaiser HMO
In-Network Out-of- In-Network In-Network Out-of- In-Network
Network ONLY Network ONLY
Annual Deductible
Employee $1,500 $3,000 $250 $250 $1,250 None
Employee + 1 dependent $3,000 $6,000 $500 $500 $2,500 None
Employee + 2 or more $3,000 $6,000 $750 $750 $3,750 None
dependents
Out-of-Pocket Maximum
Employee $2,200 $4,400 $1,100 $1,100 $3,300 $1,500
Employee + 1 dependent $4,400 $8,800 $2,200 $2,200 $6,600 $3,000
Employee + 2 or more $4,400 $8,800 $3,300 $3,300 $9,900 $3,000
dependents
Covered Expenses
Preventive care Plan pays 40% after Plan pays Plan pays 40% after Plan pays
100% deductible 100% 100% deductible 100%
Primary care physician† 20% after 40% after 20% after 20% after 40% after $20 co-pay
deductible deductible deductible deductible deductible
Specialist 20% after 40% after 20% after 20% after 40% after $20 co-pay
deductible deductible deductible deductible deductible
Hospital stay‡ 20% after 40% after 20% after 20% after 40% after $250 co-pay
deductible deductible deductible deductible deductible
Emergency room‡ 20% after 20% after $200 co-pay $200 co-pay $200 co-pay $100 co-pay
deductible deductible
Urgent care‡ 20% after 40% after $40 co-pay $40 co-pay 40% after $20 co-pay
deductible deductible deductible
LiveHealth Online 20% after N/A $10 co-pay $10 co-pay N/A N/A
deductible§
Infertility treatments Covered at appropriate 20% after Covered at appropriate Limited
(includes in- or out-of-network levels; deductible, in- or out-of-network levels; benefits
cryopreservation) $25,000 lifetime maximum, $25,000 $25,000 lifetime maximum,
in- and out-of-network lifetime in- and out-of-network
combinedII maximumII combinedII
Gender confirmation 20% after Not covered 20% after 20% after Not covered Limited
surgery deductible deductible deductible benefits
Annual chiropractic care 20% after 40% after 20% after 20% after 40% after $15 co-pay;
deductible deductible deductible; deductible deductible maximum
maximum of 40 visits
Combined maximum of of 30 visits Combined maximum of per year
30 visits per year per year 30 visits per year
* Must be enrolled as of December 31, 2020, to elect the plan for 2021
† PCP includes outpatient mental health care, convenience care clinics, and non-preventive lab tests
‡ Co-pays and deductibles are included in the out-of-pocket maximum
§ Most LiveHealth Online medical visits cost $59 prior to meeting your deductible
II In addition to the $25,000 lifetime medical maximum on infertility treatments (includes voluntary cryopreservation),
there is a separate $25,000 lifetime maximum on prescription drugs for infertility treatment
5Looking to save money in 2021? Check out the CDHP!
The CDHP has lower per-paycheck deductions than the other plans and offers access to a tax-advantaged
HSA that you can use to pay for eligible health care expenses or invest and use later, such as during
retirement. You control the money in your HSA, and it’s always yours to keep!
Plus, the Company contributes to your HSA on your behalf just for enrolling in the CDHP:
Base Salary as of October 1, 2020 Individual Coverage Employee + 1 or More Dependents
Less than $75,000 $750 $1,500
$75,000 or more $300 $600
Learn more about the benefits of the CDHP on your-ebenefits.com/prh.
Prescription Drugs
If you’re enrolled in an Anthem BCBS medical plan, your prescription drug coverage is provided by Express Scripts. If you’re
enrolled in the Kaiser HMO, your prescription drug coverage is through Kaiser. Here’s an overview of how much you will pay
under each plan.
Anthem CDHP Anthem EPO and PPO Kaiser HMO
Retail (30-day supply)
Generic 20% after deductible* 30% ($15 min./$45 max.) $10 co-pay
Brand name 20% after deductible* 30% ($35 min./$105 max.) $20 co-pay
Specialty 20% after deductible* 30% ($75 min./$225 max.) $20 co-pay
Mail Order (90-day supply) †
Generic 20% after deductible* 25% ($30 min./$90 max.) $20 co-pay
Brand name 20% after deductible* 25% ($70 min./$210 max.) $40 co-pay
Specialty 20% after deductible* 25% ($150 min./$440 max.) $40 co-pay
Out-of-Pocket Maximum
Employee Combined with medical $1,800 Combined with medical
Employee + 1 Combined with medical $3,600 Combined with medical
dependent
Employee + 2 or more Combined with medical $5,400 Combined with medical
dependents
* The deductible is waived for preventive drugs. For all other prescription drugs, you must meet your combined medical and
prescription drug deductible before the plan pays a percentage of your prescription drug cost.
† 100-day supply available for the Kaiser HMO
6What You Should Do Next
It’s simple! Just follow these steps:
1 Learn. Review 2021 changes in this Highlights Brochure, along with additional
information on your-ebenefits.com/prh.
2 Think. Consider whether your current elections will still meet your needs in 2021.
Even if you want to keep the same coverage, it is important to review your options, the
associated costs, and think about any upcoming life events, like the birth of a child, that
may impact your decisions.
3 Compare. Use the Medical Plan Cost Estimator Tool to compare your medical plan
options: bertelsmannmpce.com/PenguinRandomHouse. Enter your and your
dependents’ expected medical and prescription drug usage to view the estimated costs
under each medical plan.
4 Enroll. Log on to the enrollment system, UltiPro: https://e12.ultipro.com/Login.aspx.
For enrollment instructions, including information on your User ID and Password,
visit your-ebenefits.com/prh.
Questions?
If you have a benefits-related question or need assistance during Annual Enrollment,
please contact the Employee Benefits Team:
Email: benefits@penguinrandomhouse.com
Phone: 1-800-726-0600, option 6
For specific questions, see the list of benefits administrators and insurers
on your-ebenefits.com/prh.
7This brochure provides highlights of the Benefits Program. It does not describe many of the
features, provisions, limitations, and exclusions that are contained in the documents and contracts
of which the actual plans are comprised. Although the Company has made every effort to ensure
that this brochure is consistent with the plan documents and contracts, if there is any conflict
or inconsistency between this brochure and those documents or contracts, the documents and
contracts will govern. In addition, while the Company intends to continue these benefits, the
Company reserves the right to change or discontinue these benefits at any time for any reason.
Participation in the Benefits Program does not create or imply an employment contract with the
Company. This brochure outlining benefits features for 2021 is considered a Summary of Material
Modifications (SMM).
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