2017 Annual Enrollment Guide Make your elections November 14 – 28, 2016 EXCITING NEW CHANGES FOR 2017!
2017 Annual Enrollment Guide
Make your elections November 14 – 28, 2016
EXCITING NEW CHANGES
FOR 2017!
MY HEALTH. MY CHOICE.We realize that the most helpful thing we could do when it comes to your health
is give you more choice. When you can control how you spend on healthcare, you
get the chance to make the choices that are right for you and your family. To help
provide tax incentives and cost savings, we are focusing our efforts on our HSA PPO
plan for next year and into the future.
The HSA PPO is a blend of a traditional PPO plan and a Health Savings Account
(HSA). This tax-advantaged plan lets you save ahead of time for medical expenses.
It gives you all the coverage you need while letting you choose how you spend
on healthcare. By enrolling in this plan you can qualify for a generous VMware
contribution into your personal HSA account! Be sure to learn more about this plan
and all the tax savings you can achieve.
Please review this guide for complete details on all of the benefits available for 2017.
There is a lot of exciting information about our benefit enhancements! We are proud
to deliver quality competitive benefits that give our employees the great choices
they deserve.
MEDICAL PLAN NAME CHANGES FOR 2017New names…but the same great plans and the same Aetna network of Choice POS II.
The medical plan offerings might look different this year — that’s because we’ve
updated the plan names to better reflect what each plan provides. Here’s your new
and improved 2017 plan names:
Aetna HDHP ' HSA PPO
Aetna PPO ' Traditional PPO
WHAT’S INSIDE:
My Health. My Choice. — 1
Benefit Enhancements for 2017 — 2
Health Plan Changes for 2017 — 3
Employee Contributions for 2017 — 5
Choosing My Health Plan — 6
Flexible Spending Accounts — 10
Additional Benefits — 12
Life and AD&D Insurance — 13
Disability and Work/Life Benefits — 14
My Enrollment Checklist — 15
Tools and Resources — 16
Key Benefit Terms — 17
Benefit Contacts — 18
Don’t Forget!This is your once-a-year
opportunity to make
changes to your
medical, dental, vision,
life insurance, voluntary
life, disability, HSA, FSA
and voluntary legal plan
elections. Information
about all of your benefit
options can be found on
benefits.vmware.com.
Paid Interns Eligible for Healthcare CoverageBeginning January 1, 2017, paid interns working more than 30 hours a week are
eligible for the HSA PPO medical plan, Delta Dental and Core Vision coverage.
Interns are not eligible for VMware HSA contributions.
1
BENEFIT ENHANCEMENTS FOR 2017Eligibility Changes
kk You can enroll your foster child(ren) under VMware’s medical, dental and vision programs.
Health Plan Enhancements
Speech Therapykk Currently offered to children with autism, beginning January 1, 2017, speech therapy will be expanded to include all conditions of medical necessity. (The medical plan will make the final determination as to what is a medical necessity.)
Egg Retrievalkk Beginning January 1, 2017, egg retrieval will include preservation of fertility to delay childbearing as part of the $10,000 lifetime infertility benefit maximum.
Transgender Benefitskk Effective January 1, 2017, this benefit will be unlimited.
Surrogacy Benefitkk In 2017 we are enhancing the Adoption Assistance Program to include surrogacy which reimburses 100% of eligible expenses associated with carrying and giving birth using a surrogate, up to a maximum of $5,000 per child with a lifetime maximum of $10,000.
Vision Plan Enhancements
Contact Lens Programkk This covers the contact lens exam (fitting and evaluation) in full, after a co-pay, allowing members to use the total in-network allowance for their contact lenses.
Diabetic Eyecare Plus (DEP+) Programkk This covers additional eyecare services for members with Type 1 and Type 2 diabetes, glaucoma and age-related macular degeneration (AMD).
Added Retail Network kk The VSP network is expanding to include Costco, Pearle Vision, Visionworks, Cohen’s Fashion Optical and others. Go to VSP.com for more information and to find a network provider.
Basic Life and AD&D and Supplemental Life Enhancements
Basic Life and AD&D (Company Paid)kk The maximum is increasing from $800,000 to $1,000,000 for both benefits.
kk The age reduction is changing to 65% at age 70 and 50% at age 75.
Supplemental Life — Employee kk The maximum is increasing from $500,000 to $1,500,000.
kk Guaranteed issue is increasing from $350,000 to $500,000, which means you can enroll in supplemental life up to $500,000 without Evidence of Insurability (EOI).
Supplemental Life — Spousekk The maximum is increasing from $100,000 to $250,000.
kk Guaranteed issue is increasing from $25,000 to $100,000, which means you can enroll in spouse/DP supplemental life up to $100,000 without Evidence of Insurability (EOI).
No EOI is required for new annual enrollment elections in 2017 for Supplemental and Spouse Life.
Key Terms and Definitions: On Demand! When it comes to
benefits, there are a lot of
confusing terms. See page
17 for key benefit terms
and definitions.
2
HEALTH PLAN CHANGES FOR 2017Be sure to review the following changes to the health plans for 2017 before making
your benefit elections.
HSA PPO Plan
Health Savings Account (HSA) PPO Plan Deductible and Out-of-Pocket Maximum
Annual Deductible:kk The annual deductible is increasing to $1,500 for individual coverage and to $3,000 for family coverage.
kk The deductible continues to be an aggregate deductible which means the health plan doesn’t begin paying for the healthcare expenses of anyone in the family until the entire family deductible has been met including prescription drugs.
In Network Out-of-Pocket Maximum (OOPM): kk The out-of-pocket maximum is increasing to $2,500 for individual coverage and to $5,000 for family coverage.
HSA PPO Plan Prescription Drugs
The coinsurance for prescription drugs is changing from 10% for all tiers of drug coverage to the following:
kk Retail (30-day supply) or Mail Order (90-day supply) In-Network
kk Generic: 10% after the deductiblekk Brand: 15% after the deductiblekk Non Formulary: 20% after the deductible
kk Retail (30-day supply) Out-of-Network
kk 50% after deductible
See the comparison chart on page 7 for more details.
Certain preventive drugs are not subject to the deductible and are covered under the coinsurance tiers.
For a full list of covered preventive drugs visit http://benefits.vmware.com/health-wellness/medical/aetna-hdhp/ and click on the preventive drug list link on the page.
HSA Contribution — for current members in the Aetna HDHP in 20161
If you are currently enrolled in the Aetna HDHP plan, and continue in the HSA PPO in 2017, VMware will contribute:
kk $750 (individual)kk $1,500 (family) kk Funding will occur by the end of January, 2017
HSA Contribution — for new adopters to HSA PPO in 2017 Available if you enroll in the HSA PPO Plan1
If you are currently enrolled in the Aetna PPO or Kaiser HMO plans, and decide to enroll in the HSA PPO plan for 2017, VMware will contribute:
kk $1,500 (individual)kk $3,000 (family)kk Funding will occur by the end of January, 2017
This company contribution covers the entire annual deductible for the HSA PPO plan in 2017!
Contribution Limits
HSA Increase in Employee Contribution Limits
For 2017, you can contribute up to $3,400 for an individual and $6,750 for family, less any contributions made by VMware. Catch up contributions remain the same at $1,000 for employees age 55 and over or turning 55 in 2017.
Coming Soon:Rethink — A new program
providing assistance for
employees and families
needing support for
neurodiversity disabilities,
including Autism Spectrum
Disabilities, ADHD, and
Down Syndrome.
Great News!Employee Only paycheck
contributions are free for
the HSA PPO for 2017. See
page 5 for all paycheck
contributions.
1 Interns are eligible for the HSA PPO plan but will not receive the VMware HSA contributions. Interns may contribute their own funds to the HSA if they choose.
3
Traditional PPO Plan
Traditional PPO Plan Deductible, Out-of-Pocket Maximum and Co-pays
Annual Deductible:kk The annual deductible is increasing to $500 for individual coverage and to $1,500 for family coverage.
kk The annual deductible is changing to an aggregate deductible. With an aggregate family deductible, the health plan doesn’t begin paying for the healthcare expenses of anyone in the family until the entire family deductible has been met including prescription drugs.
In Network Out-of-Pocket Maximum (OOPM): kk The out-of-pocket maximum is increasing to $2,350 for individual coverage and to $7,050 for family coverage.
Physician Visit Co-pays: kk Co-pays are increasing to $20 for primary care visits and $30 for specialist visits.
Traditional PPO Plan Prescription Drugs
The pharmacy benefit is changing from a fixed co-pay to a coinsurance plan design.
kk Retail (30-day supply) or Mail Order (90-day supply) In-Network
kk Generic: 10% after the deductiblekk Brand: 25% after the deductiblekk Non Formulary: 40% after the deductible
kk Retail (30-day) Out-of-Network
kk 50% after deductible
See the comparison chart on page 7 for details.
Beginning in 2017, the pharmacy benefit will also be subject to the medical plan deductible. There are certain preventive drugs that are not subject to the deductible and are covered under the new coinsurance tiers. For a full list of covered preventive drugs visit http://benefits.vmware.com/health-wellness/medical/aetna-hdhp/ and click the link for preventive drugs.
Kaiser Hawaii
New Plan: Kaiser Hawaii
To comply with new state regulations, VMware will offer the Kaiser Hawaii HMO Plan. This plan is available to employees who reside in Hawaii.
See the comparison chart on page 7 for details.
See the Updated Traditional PPO Plan in Action!Check out pages 8 and 9
for sample scenarios of
how much the Traditional
PPO Plan might cost you
and why the HSA PPO
Plan might be the better
cost option.
4
Don’t Forget!Contributions are pre-tax
(except for domestic
partner coverage).
EMPLOYEE CONTRIBUTIONS FOR 2017Great news! Employee Only coverage is now free for the HSA PPO, Dental and the
Core Vision plans.
Employee contributions for the HSA PPO plan are lower for all tiers of coverage. Employee
contributions are also lower for most tiers of coverage for the Dental and Vision plans.
Per Paycheck Contributions
Plan Employee Only
Employee + Spouse/Domestic Partner
Employee + Child(ren)
Employee + Family
MEDICAL PLANS
HSA PPO (formerly Aetna HDHP)
$0 $54.02 $38.90 $97.24
Traditional PPO (formerly Aetna PPO)
$57.83 $154.20 $127.22 $231.30
Kaiser N. CA HMO $46.06 $119.76 $101.33 $181.17
Kaiser HI HMO $50.46 $117.74 $104.29 $185.02
DENTAL PLAN
Delta Dental PPO $0 $7.20 $12.68 $20.21
VISION PLANS
VSP Vision — Core $0 $0.37 $0.39 $1.07
VSP Vision — Buy-Up $3.13 $5.00 $5.10 $8.55
Per paycheck contributions are 24 times per year.
WE ALL SHARE THE COST OF COVERAGEManaging healthcare costs is a shared responsibility and we appreciate your
continued efforts to take care of your health and wellness, and to use healthcare
resources wisely and cost-effectively. In 2017, VMware will continue to pay for a
significant portion of your benefits. The pie charts below illustrate the cost-share for
the VMware healthcare plans.
n VMware n You
HSA PPO
Individual Dependent(s)
100%82%
18%
Traditional PPO, Kaiser N. CA, Kaiser HI
Individual Dependent(s)
72%79%
28%21%
Vision (Core)
Individual Dependent(s)
100%
Dental
Individual Dependent(s)
100%33%
67%
23%
77%
5
CHOOSING MY HEALTH PLANBefore you make your health plan election, consider the benefits of the HSA PPO, and
review the medical plan comparison chart and scenarios on the next few pages. Also
check out MyAlex and the plan cost estimator tool! Links can be found on page 16.
MORE ABOUT THE HEALTH SAVINGS ACCOUNT (HSA) The HSA is administered by HealthEquity and may be used to offset your deductible
as well as pay for out-of-pocket medical expenses. Here are several reasons why
people choose to take advantage of the HSA:
kk Triple-tax advantaged. The money you contribute goes in tax-free*, grows with
interest tax-free, and comes out tax-free (as long as you use it to pay for eligible
health care expenses).
kk Watch it grow. Your unused funds roll over from year-to-year and grow with interest
— tax-free. Think of your HSA as your long-term healthcare savings plan to pay for
expenses as they come up or in the future.
kk You own it. VMware’s contribution and your own HSA contributions are yours. You
can take your account with you when you retire or leave VMware for any reason.
Making Contributions to the HSAIn addition to the contributions from VMware, you can make your own pre-tax
contributions to your HSA. Making contributions is easy:
kk Make pre-tax contributions through payroll deductions (simply elect the amount
you want to contribute during annual enrollment).
kk Change your payroll contributions at any time.
kk Make post-tax contributions directly to HealthEquity online or by sending a check.
kk Make contributions any time after your HSA is open.
kk HealthEquity makes it easy to manage your account. You will receive a debit card and
can access and manage your balance online at www.healthequity.com/ed/vmware.
Remember, VMware’s HSA contribution counts towards your maximum IRS HSA limit.
You are eligible to enroll in the HSA if you are:kk Not covered under any other traditional health plan or Health Care FSA.
kk Not enrolled in Medicare.
kk Not currently receiving any health benefits from the Veterans Administration (or
have received any in the last three months).
* Employer and employee contributions to the HSA are tax-free for federal and most state taxes. However, HSA contributions are not tax deductible for AL, CA and NJ.
Not Eligible for the HSA? We’ve Got You Covered!If you are not eligible
for an HSA, you can still
enroll in the HSA PPO.
When enrolling in your
2017 benefits, select “HSA
PPO non HSA Eligible”.
For employees who enroll
in the HSA PPO and are
not HSA eligible, VMware
will provide a taxable
bonus equal to the HSA
contribution for the same
tier of coverage. In order
to qualify for the taxable
bonus, you will need to
submit proof of coverage
within 60 days of your
effective date of coverage.
Examples of proof of
coverage include:
kk Medicare enrollment card
kk Your spouse’s medical plan
enrollment information
(health plan and/or FSA)
kk Tricare coverage/
enrollment card
Yours To KeepYour HSA is a personal savings account — you own your contributions and the
contributions from VMware. If you leave VMware for any reason, you take the
account with you.
6
MEDICAL PLAN COMPARISONHSA PPO1 Traditional PPO1 Kaiser HMO
(N. CA only)Kaiser HMO
(HI only)In-Network Out-of-Network In-Network Out-of-Network
VMware HSA Contribution2
N/A N/A N/Akk Current Enrollees Individual: $750 / Family: $1,500
kk New HSA adopters Individual: $1,500 / Family: $3,000
Annual Deductible Individual: $1,500 / Family: $3,000 Individual: $500 / Family: $1,500 None None
Out-of-Pocket (OOP) Maximum3
Individual: $2,500 Family: $5,000
Individual: $6,000 Family: $12,000
Individual: $2,350 Family: $7,050
Individual: $6,250 Family: $18,750
Individual: $1,500 Family: $3,000
Individual: $1,500 Family: $4,500
Employee Coinsurance
10% after deductible
30% of UCR4, after deductible
10% after deductible
30% of UCR4, after deductible
Applies to certain medical procedures only
Applies to certain medical procedures only
Preventive (Annual Physicals, Well Care Exams)
100% covered, not subject to deductible
30% of UCR4, after deductible
100% covered, not subject to deductible
30% of UCR4, after deductible
100% covered, not subject to co-pay
100% covered, not subject to co-pay
Physician Visit10% after deductible
30% of UCR4, after deductible
Primary Care: $20 Specialist: $30
30% of UCR4, after deductible
$15/visit $15/visit
Lab and X-Ray10% after deductible
30% of UCR4, after deductible
10% after deductible
30% of UCR4, after deductible
None if part of office visit
$10/day; 10% coinsurance for complex imaging
Emergency Room10% after deductible
10% of UCR5, after deductible
$100 co-pay, then 10% of UCR5
$100 co-pay, then 10%
$50/visit $50/visit
Ambulance10% after deductible
30% of UCR4, after deductible
10% after deductible
30% of UCR4, after deductible
$50/trip20% coinsurance
Hospitalization10% after deductible
30% of UCR4, after deductible
10% after deductible
30% of UCR4, after deductible; $500/confinement deductible
$250 co-pay/admit
$250 co-pay/day
Chiropractic Care10% after deductible
30% after deductible
$30 co-pay/visit30% after deductible
$15 co-pay/ visit; up to 30 visits/year
$20 co-pay/visit; up to a combined 30 visits/year
Up to 20 visits/year Up to 20 visits/year
Acupuncture10% after deductible
30% after deductible
$30 co-pay30% after deductible
$15 co-pay/ visit; referral is requiredUp to 12 visits/year Up to 12 visits/year
Speech Therapy5 10% after deductible
30% after deductible
$30 co-pay/visit30% after deductible
$15 co-pay/visit; for covered cases
$15 co-pay/visit; for covered cases
Infertility/Fertility Preservation
50% after deductible up to $10,000 lifetime max ($7,000/$3,000 for med/Rx)
Not covered
50% after deductible up to $10,000 lifetime max ($7,000/$3,000 for med/Rx)
Not covered
50% coinsurance/visit (does not include GIFT, ZIFT, or IVF)7
$15/visit; 20% IVF (1 cycle/lifetime)
Prescription Drugs (Rx)
Retail (30-day supply)6
Generic/Brand/ Non Formulary
10%/15%/20% after deductible
50% after deductible
10%/25%/40% after deductible
50% after deductible
$10/$20/$20 co-pay
$10/$35/$35 co-pay
Mail Order (90-day supply)6
Generic/Brand/ Non Formulary
10%/15%/20% after deductible
Not covered
10%/25%/40% after deductible
Not covered
100-day supply
$20/$40/$40 co-pay
$20/$70/$70 co-pay
1 Individual deductible and OOP maximum only apply to employees enrolled in employee only tier. Members in dependent tiers must satisfy the family deductibles and OOP maximums.
2 All existing employees who switch from another health plan and enroll in the HSA PPO as of January 1, 2017 will receive employer contributions of $1,500/$3,000 (Individual/Family). All new hires will receive employer contributions of $750/$1,500 (Individual/Family) funded on a pro-rated basis after each quarter based on coverage level and employment start date. Interns are not eligible for VMware HSA contributions.
3 Out-of-pocket maximum includes Prescription Rx for all plans.4 Usual, customary and reasonable charges.5 Available to those with conditions of medical necessity.6 Deductible waived for preventive medications.7 GIFT is a gamete intrafallopian transfer; ZIFT is a zygote intrafallopian transfer; IVF is in-vitro fertilization.
7
KAREN’S CHOICEHi, I’m Karen. I’m a 25-year-
old single woman. I don’t have
many medical expenses. In
fact, I probably check in with
the doctor a little less than
I should. But I’m young and
don’t have any pre-existing
conditions. With the HSA PPO, I
get to set aside enough for my
annual check-ups, along with having money saved for an
emergency. And getting $1,5001 from VMware to get started
means I don’t have to worry about what could happen!
With a different healthcare plan, I’d have money taken out
of my paycheck for a service I might not use as much. This
way, I can decide not only how to save and spend on my
health, but what I’d rather put money towards: like jump-
starting my retirement, or helping to pay off student loans.
Plus, when I do decide to add money to my HSA, I can add
it from my pre-tax income and it won’t get taxed when I
use it. So I spend my money on my health. It all rolls over
next year and the account stays with me no matter what.
I own my contributions and the VMware contributions.
I can even take my account with me if I leave VMware
for any reason. Which makes me feel much more secure
when worrying about any accidents or sudden expenses.
VMware’s HSA PPO plan keeps me covered while keeping
me in control of how I spend on my health.
If you’re like me and don’t feel like you have too many
medical needs, the HSA PPO plan helps you put your
money where you really need it. All while making sure
you’re still covered no matter what happens.
HSA PPO Plan vs. Traditional PPO Plan (Individual Coverage)
HSA PPO Traditional PPO
Deductible (includes Rx) $1,500 $500
Co-pay after Deductible 10% $20 / 10%
My Maximum Out-of-Pocket
$2,500 $2,350
VMware HSA Contribution
$1,5002 Not allowed
My Contribution (via payroll deduction)
$0 $1,387.80
My Total Out-of-Pocket
$1,000 $3,737.80
1 $1,500 employer contribution is for new, Employee Only, enrollees only. Previously enrolled, 2017 employer contribution to employee’s HSA is $750.
2 I own my HSA account. My HSA funds roll over year to year and my account is portable if I should leave VMware.
DANNY’S CHOICEHey, I’m Danny. As a father of
two with an 18-month-old and
a newborn, my wife and I might
as well live at the doctor’s
office. When it comes to taking
care of the health of a new
family, the bills pile up faster
than expected. Which is why I
switched to the HSA PPO plan last year.
Last year I enrolled in the HSA PPO plan. The $1,500
VMware gave me to start my HSA helped a lot. And some
of it rolled over! Getting another $1,5001 this year gives me
a lot of peace of mind when I think about the bills we’ll have
to cover with our newborn. Also, it’s nice to know that I’m
adding money to an account that I have control over, and
that goes directly to the care my family needs. The fact that
it doesn’t get taxed when I use it is a great plus too. I own
my contributions and the VMware contributions. I can
even take my account with me when I leave VMware for
any reason. Now if only I could learn the trick to getting
both our kids to sleep at the same time, we’d be set for life.
If you’re like me and have a family — or growing family
— to take care of, then the HSA PPO plan helps you plan
ahead. I know how much money is coming out of my
check and it goes to a place where I can use it, not just a
non-descript health insurance company. And VMware’s
contribution shows that I know that they have my back.
HSA PPO Plan vs. Traditional PPO Plan (Family Coverage)
HSA PPO Traditional PPO
Deductible (includes Rx) $3,000 $1,500
Co-pay after Deductible 10% $20 / 10%
My Maximum Out-of-Pocket
$5,000 $7,050
VMware HSA Contribution
$1,5002 Not allowed
My Contribution (via payroll deduction)
$2,333.76 $5,551.08
My Total Out-of-Pocket
$5,833.76 $12,601.08
1 Previously enrolled, 2017 employer contribution for employees with a family plan HSA is $1,500. New family enrollees earn a one-time HSA $3,000 employer contribution.
2 I own my HSA account. My HSA funds roll over year to year and my account is portable if I should leave VMware.
8
Online Decision SupportIf you want to see your
own real-life scenario,
Aetna offers an interactive
tool that allows you to
estimate your cost of
coverage and your out-of-
pocket costs. Using your
total claims for 2016 as a
starting point simply insert
your expected healthcare
needs and services for
2017. The tool will compare
your costs with the HSA
PPO and the Traditional
PPO. You can use the tool
regardless of your current
health plan — even Kaiser
participants can use it.
If you are a new adopter to
the HSA PPO plan for 2017,
select the New HSA PPO
in the Cost Comparison
Tool. Go to: https://mobile.
aetna.com/planSelect/
kdw?id=871#_frmStart or
use the QR code:
JULIE’S CHOICEHello, I’m Julie. Since my spouse Sarah is a freelance
designer, we both get insurance through VMware. This
year I decided to look closer into the HSA PPO and
realized it is the perfect fit for both of us. Especially since
we want to stay covered, while we are trying to save
money to buy a new home.
Neither of us has any current ongoing medical conditions,
but we both take our health seriously. So we have a few
doctors’ visits throughout the year and we visit specialists like nutritionists every now
and again. With the Health Savings Account, I can put aside money to cover those,
no problem.
A few years ago I had to have my appendix taken out. Since then I’ve been careful
about making sure not only that I’m covered, but that I have money for any
emergencies. The HSA PPO plan gives me piece of mind with its great in-network
coverage. I own my contributions and the VMware contributions. I can even take my
account with me if I leave VMware for any reason. Plus, with VMware contributing
$3,0001 as a new family signing up, I’m not as worried about what could happen.
Knowing that all the money I put in to the HSA is pre-tax and won’t get taxed when I
use it is great, too. And all of it rolls over from year to year. So anything we don’t use
this year helps us stay covered next year. Which helps us save money in the long run.
If you’re like me — married and married to the idea of staying covered without
breaking the bank — then the HSA PPO plan might be right for you and your spouse
or partner. It certainly helps put my mind at ease.
HSA PPO Plan vs. Traditional PPO Plan (Family Coverage)
HSA PPO Traditional PPO
Deductible (includes Rx) $3,000 $1,500
Co-pay after Deductible 10% $20 / 10%
My Maximum Out-of-Pocket $5,000 $7,050
VMware HSA Contribution $3,0002 Not allowed
My Contribution (via payroll deduction) $1,296.48 $3,700.80
My Total Out-of-Pocket $3,296.48 $10,750.80
1 New family enrollees earn a one-time HSA $3,000 employer contribution. Previously enrolled, 2017 employer contribution to employees with a family plan HSA is $1,500.
2 I own my HSA account. My HSA funds roll over year to year and my account is portable if I should leave VMware.
Need More Help?Meet ALEX, your virtual benefits advisor. ALEX will ask you questions
about your personal situation, compare options and help you make
decisions. You can meet ALEX at www.myalex.com/vmware.
9
FLEXIBLE SPENDING ACCOUNTS (FSAS)VMware provides General Purpose, Limited Purpose and Dependent Care FSAs,
which allow you to save money by setting aside pre-tax dollars to pay for approved
expenses. The plan administrator for the FSAs is TRI-AD. If you have an FSA
balance at the end of the calendar year in your General Purpose or Limited Purpose
FSA, your balance, up to $500, will be rolled over into an FSA for next year. For a
complete list of eligible and ineligible expenses set by the federal government see
www.irs.gov/publications/p502.
GENERAL PURPOSE HEALTHCARE FSA (GPFSA)You can use the money in your GPFSA to pay for most healthcare expenses for you
and your eligible dependents, including eligible services and supplies not covered by
your medical, dental or vision plans. When you get care or fill a prescription, you can
use your debit card. Or you can just pay out of pocket and file a claim online. You can
contribute between $25 and $2,550.
LIMITED PURPOSE HEALTHCARE FSA (LPFSA — FOR HSA ENROLLEES)This plan allows you to pay for qualified out-of-pocket dental and/or vision expenses.
Due to IRS regulations, out-of-pocket medical and prescription drug healthcare
expenses are not qualified expenses under the Limited Purpose FSA and can be
reimbursed through your HSA only. You can contribute between $25 and $2,550 to
the LPFSA.
DEPENDENT CARE FSA (DCFSA)The Dependent Care FSA lets you reimburse yourself with tax-free dollars for eligible
out-of-pocket expenses to pay for care for your child 12 years or younger, disabled
spouse, elderly parent or other dependent incapable of self-care while you and/
or your spouse work or go to school full time. You can contribute between $25 and
$5,000 to the Dependent Care FSA. There is no rollover for the DCFSA; any funds
left at the end of the year are forfeited.
If you were previously
enrolled in the Aetna PPO
and/or Kaiser plans and
enroll in the HSA PPO plan
in 2017, your FSA rollover
(up to $500) will be rolled
into a Limited Purpose
FSA which covers dental
and vision expenses.
FSA DatesFor your claims to be reimbursed for the 2017 VMware plan year, here are the
required dates for both the Healthcare and the Dependent Care FSAs:
Expenses Must Be Incurred Through:
Expenses Must Be Submitted For
Reimbursement By:
GPFSA, LPFSA and Dependent Care FSA December 31, 2017 March 31, 2018
10
COMPARE SAVINGS AND SPENDING ACCOUNT OPTIONSVMware offers two types of health saving/spending account options: Health Savings
Account (HSA) and Flexible Spending Account (FSA). Both help you pay for eligible
medical, dental, vision and prescription drug expenses. The type of health account
you are eligible for depends on the plan that you elect. If you enroll in the HSA PPO,
you can participate in the HSA and the Limited Purpose FSA (LPFSA). If you enroll in
one of the other plans, you can participate in the General Purpose FSA (GPFSA).
Here’s a comparison of the options:
HSA Health FSA
Eligibility You must enroll in the HSA PPO to be eligible for the HSA.
General Purpose FSA (GPFSA) eligibility: If you enroll in the Traditional PPO, the Kaiser N. CA or HI HMO, or the HSA PPO non HSA Eligible plan.
Limited Purpose FSA (LPFSA): If you enroll in the HSA PPO.
VMware Contributions1
New HSA adopters: Individual: $1,500 / Family: $3,000
Current HSA enrollees: Individual: $750 / Family: $1,500
No employer contributions.
Your Contributions
You may contribute as little as $100 a year up to the maximum allowed by the IRS ($3,400 employee only, $6,750 for family)2. If you are age 55 or older, you can contribute up to an additional $1,000 per year.
GPFSA and LPFSA: You can contribute any amount between $25 and $2,550 annually.
Paying for Care
The HSA can be used to pay for eligible medical, prescription drug, dental and vision expenses. Or you can save the money in your account for future healthcare expenses.
GPFSA: Reimburses you for eligible medical, prescription drug, dental, and vision expenses.
LPFSA: Reimburses you for eligible dental and vision expenses.
Tax Savings
kk No taxes on contributions.3
kk No taxes on withdrawals for eligible expenses.
kk No taxes on earnings from interest or investments.
kk No taxes on contributions.
kk No taxes on withdrawals for eligible expenses.
Do funds roll over?
Yes. Any funds left over in your HSA will roll over year-to-year. VMware’s contribution and your own HSA contributions are yours. You can take your account with you when you retire or leave VMware for any reason.
GPFSA and LPFSA: Unused funds will roll over but only up to $500.
Account Administration
HealthEquity is the account administrator.
TRI-AD is the account administrator.
1 All existing employees who switch from another health plan and enroll in the HSA PPO as of January 1, 2017 will receive employer contributions of $1,500/$3,000 (Individual/Family). All new hires will receive employer contributions of $750/$1,500 (Individual/Family) funded on a pro-rated basis after each quarter based on coverage level and employment start date.
2 IRS maximums include employer and employee contributions combined for the entire calendar year.3 Employer and employee contributions to the HSA are tax-free for federal and most state taxes.
However, HSA contributions are not tax deductible for AL, CA and NJ.
Why Consider Enrolling in the Limited Purpose FSA?Participants in the HSA
PPO can enroll in an
LPFSA. This allows you
to use the LPFSA first for
dental and vision expenses
before using your HSA
or saving your HSA for
future health expenses.
It’s important to note
that GPFSA and LPFSA
funds are available at the
beginning of the year.
HSA funds are available as
money is deposited into
the account.
11
ADDITIONAL BENEFITSThe following benefits will continue to be offered.
DENTALVMware offers dental coverage through Delta Dental. There are two networks available:
Delta Preferred Provider Organization (PPO) and Delta Premier. You may use any
dental provider you choose, but you save when you use dentists within Delta Dental’s
PPO network. Visit www.deltadentalins.com to see if your dentist is in-network.
Delta PPO Delta Premier Out-of-Network
Annual Deductible Individual: $50 / Family: $150
Annual Maximum Benefit
Non-Orthodontic Services per Individual: $1,500 Orthodontia Lifetime Maximum per Individual: $2,000
Preventive/Diagnostic (exams, cleanings, fluoride, X-rays and sealants)
100% (no deductible)100% (no deductible), up to maximum plan allowance (MPA)
100% (no deductible), up to maximum plan allowance (MPA)
Basic Restorative (fillings, root canal, periodontics and oral surgery)
90% after deductible80% after deductible, up to maximum plan allowance (MPA)
80% after deductible, up to maximum plan allowance (MPA)
Major Restorative (crowns, bridges, dentures, partials, implants, etc.)
60% after deductible50% after deductible, up to maximum plan allowance (MPA)
50% after deductible, up to maximum plan allowance (MPA)
Orthodontia (for adults and children)
60%50% of the maximum plan allowance (MPA)
50% of the maximum plan allowance (MPA)
VISIONVMware offers vision coverage through Vision Service Plan (VSP). There are two plans
to choose from: Core and Buy-Up. The Buy-Up Plan offers a higher level of benefits for
lenses, contacts and frames. To see if your vision provider is in-network, visit VSP.com.
VSP Core1 VSP Buy-Up Out-of-Network
Vision Exam (once every calendar year)
$10 co-pay, then 100% $10 co-pay, then 100%$10 co-pay, then plan reimburses up to $50
Lenses (once every calendar year)
$25 co-pay, then plan pays:
100% for all types (no co-pay)
$25 co-pay for Core Plan2, then plan reimburses up to:
kk Single Vision kk 100% kk $50
kk Lined Bifocal kk 100% kk $75
kk Lined Trifocal kk 100% kk $100
Contact Lenses (once everycalendar year, in lieu of lenses and frame)
Covered up to $120 allowance
Covered up to $200 allowance
Reimbursed up to $105
Frames
kk Covered up to $120 (once every 2 calendar years)
kk Covered up to $65 for Costco frames
kk Covered up to $200 (once every calendar year)
kk Covered up to $110 for Costco frames
Reimbursed up to $70
Diabetic Eyecare Plus Program
$20 for services related to diabetic eye disease
$20 for services related to diabetic eye disease
Not covered
1 Interns are only eligible for Core Vision.2 No co-pay for Buy-Up Plan.
Great News!Employee Only paycheck
contributions are free for
Dental and Core Vision
plans. See page 5 for all
paycheck contributions.
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BASIC LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCEVMware provides you with Basic Life and AD&D insurance at no cost to you. You are
automatically enrolled if you are a regular part time or regular full time employee and
work a minimum of 30 hours per week.
This insurance, underwritten by Cigna, pays your designated beneficiary two times
your annual base salary (to a maximum benefit of $1,000,000) upon your death. If
you are a sales employee, the benefit pays two times your On Target Earnings (OTE)
(to a maximum of $1,000,000). AD&D pays an additional benefit (two times your
annual base salary to a maximum benefit of $1,000,000) to your beneficiary if you
die, or pays a benefit to you if you suffer an injury due to a covered accident. Benefits
for Life and AD&D are reduced to 65% at age 70 and to 50% at age 75.
OPTIONAL LIFE INSURANCEYou can purchase additional life insurance coverage for yourself, your spouse/
domestic partner and your dependent children. Optional Life Insurance premiums are
taken from your paycheck on an after-tax basis.
Optional Life Insurance for yourself: Purchase up to a maximum of $1,500,000
or five times your basic annual earnings (whichever is less) in $10,000 increments.
Evidence of insurability (EOI) is required for amounts over $500,000.
Optional Life Insurance for your spouse or domestic partner: Purchase in $5,000
increments up to $250,000 or 50% of your Optional Life (whichever is less). Evidence
of insurability (EOI) is required for amounts over $100,000.
Optional Life Insurance for your dependent children: Purchase in increments of
$1,000, $2,000, $5,000 or $10,000.
Employee and Spouse/Domestic Partner Optional Life Insurance
Cost per $1,000 of coverage
AgePer Paycheck
Premium
Under 30 $0.038
30 – 34 $0.054
35 – 39 $0.074
40 – 44 $0.091
45 – 49 $0.140
50 – 54 $0.252
55 – 59 $0.483
60 – 64 $0.630
65 – 69 $1.165
70+ $1.890
Child(ren) Optional Life Insurance
OptionPer Paycheck
Premium
$ 1,000 $0.099
$ 2,000 $0.198
$ 5,000 $0.495
$10,000 $0.990
Don’t Forget to Designate Your Beneficiaries!Your beneficiary is the
person who receives the
Life Insurance and AD&D
benefits paid if you die.
Naming your beneficiary
ensures the money will go
to the right person. You
can split up your benefit
among more than one
beneficiary, and you can
change your beneficiaries
at any time. You can also
name a trust, charity or
estate to receive your
benefit. Designate your
beneficiary at login.
vmware.com/adp.
Special Enrollment OpportunityNo EOI is required for new annual enrollment elections in 2017 for Optional Life.
13
SHORT AND LONG TERM DISABILITYVMware provides Short Term and Long Term Disability insurance coverage to you at no
cost. Short Term and Long Term Disability benefits replace a portion of your base pay or
OTE if you become ill, injured or disabled and are unable to work. These plans provide
you valuable income protection and can help you and your dependents when you truly
need it. The disability benefits you receive under the plan are taxable. If you choose, you
can pay the taxes on the company paid premiums, so that disability benefits paid are tax
free. For this option, select the appropriate option box during the enrollment process.
SHORT TERM DISABILITY (STD)Short Term Disability (STD) provides wage replacement benefits of 70% of pay per
week, offset by any state mandated disability plans or Workers’ Compensation, for
your certified medical disability. Benefits begin after seven days following your injury
or illness. During the waiting period, five business days of accrued Sick Time must be
used. STD covers a maximum payment period of 25 weeks.
LONG TERM DISABILITY (LTD)The Long Term Disability (LTD) benefit is provided through Cigna and coverage
begins the date your STD payments end or 180 days following your injury or illness.
LTD provides a benefit equal to 60% of your monthly income. The minimum monthly
benefit is $100 or 10% of your gross disability payment, whichever is more. The
maximum monthly benefit is $15,000
WORK/LIFE BENEFITSARAG GROUP LEGALARAG Group Legal is a voluntary plan which provides legal representation through
a network of attorneys for a variety of services including will preparation, neighbor
disputes, buying a home, traffic tickets and much more. You have access to online
legal tools and resources as well.
When using an attorney in the ARAG network, benefits are paid out at 100%. Please
review eligible services as some may be limited or excluded. For more information,
go to www.ARAGLegalCenter.com.
You can purchase the ARAG Group Legal Plan for $6.53 per paycheck.
EMPLOYEE ASSISTANCE PROGRAM (EAP)CONCERN, VMware’s employee assistance program, is provided at no cost to you.
CONCERN provides up to five free confidential counseling visits per incident for you
and your immediate family members. Counseling services include a broad range of
issues, including:
kk Marital and family problems
kk Emotional distress
kk Parenting and childcare referrals
kk Financial consultations
kk Legal consultations
kk Eldercare resources
CONCERN also provides up to ten free counseling sessions for substance and alcohol
abuse.
You can contact CONCERN 24 hours a day, seven days a week at 1-800-344-4222.
CONCERN also has a website where you have access to work-life resources
and referral information. Visit the CONCERN EAP Resource Center at
www.concern-eap.com (use company code: vmware).
14
MY ENROLLMENT CHECKLIST Step 1: Learn — This is your once a year opportunity to make changes
to your benefit elections. All changes take effect January 1, 2017.
kk Read this guide and understand the changes for 2017.
kk Consider how your health and coverage needs may be different
for 2017.
Step 2: Decide — There are plenty of tools and resources to help you
(see the next page for links and QR codes).
kk Talk to ALEX™ (your virtual benefit advisor) for decision-making
support.
kk Learn how the HSA PPO works.
kk Plan to attend an Annual Enrollment webinar by HealthEquity
on HSA’s during annual enrollment week (dates and times to be
announced).
kk Visit HealthEquity’s website for information and resources for
managing your HSA account.
kk Use Aetna’s interactive Cost Estimator Tool to see the cost of
coverage across medical plans.
ADPStep 3: Enroll
kk To enroll in benefits, visit login.vmware.com/adp and click on the
Benefits Enrollment icon on the right side of the page. Enrollment
begins November 14, 2016.
kk Print out a summary PDF of your elections for your records.
Step 4: Manage your health and benefit dollars year-round
kk You will receive a new ID card in January if you select a new medical
plan and enroll new dependents. Use the Aetna mobile app to
download a copy of your card to your smartphone.
kk Bookmark the US Benefits website at benefits.vmware.com on your
web browser so it’s handy — and make the most of your VMware
benefits.
kk Bookmark Benefits: US Socialcast group to keep up to date on
benefit updates throughout the year.
Don’t Forget! Annual enrollment will
go from November 14 to
November 28, 2016. After
November 28, you will
NOT be able to enroll or
change your elections
unless you have a qualified
life event (such as a birth
or marriage). Elections
made during this annual
enrollment will be effective
on January 1, 2017.
If you do not enroll by
5 p.m. PT, November 28,
2016, your current benefit
elections will carry over to
the next plan year except
for your FSA and HSA
contribution elections.
NEED HELP ALONG THE WAY? Visit the the US Benefits website at benefits.vmware.com for detailed information,
contacts and resources to ensure you make the most out of your VMware benefits.
Contact [email protected] or 1-888-VMware8, Select US Benefits for
enrollment assistance.
15
VMware Benefits Website
Provides detailed information, contacts and resources to ensure you make the most out of your VMware benefits.
benefits.vmware.com
Benefits Advisor Tool
An interactive educational and decision-support tool that provides easy-to-understand guidance on selecting a medical plan option.
www.myalex.com/vmware
HSA PPO
One-stop resource for information about the HSA PPO. Learn how the plan works.
www.aetnavmware.com
Plan Selection and Cost Estimator Tool
An interactive decision-support tool that helps you estimate the cost of coverage and your out-of-pocket costs.
https://mobile.aetna.com/planSelect/kdw?id=871#_frmStart
HealthEquity Health Savings Account (HSA)
Information and resources for managing your HSA.
www.healthequity.com/ed/vmware/
WHAT HAPPENS IF I DON’T ENROLL?If you do not enroll by November 28, 2016, your current benefit plan elections
and coverage will carry over to next year.
Your FSA and HSA annual elections will NOT carry over. You must make new
FSA and HSA elections annually.
QUALIFIED LIFE EVENTSYou may enroll in or make changes to your VMware benefit plans only during annual
enrollment. If you experience a qualified life event (e.g. marriage, divorce, birth
or adoption) you may be allowed to change your elections outside of the annual
enrollment period. If you experience a qualified life event, you must report the change
to VMware Benefits within 30 days of the event in order to make changes to your
current plans.
TOOLS & RESOURCES Choosing a medical plan is an important decision — and sometimes it’s hard to know
which plan is the best for your personal situation. The following tools can help:
16
KEY BENEFIT TERMSAnnual Deductible — The amount you must
pay each year before the Plan begins to pay
for covered healthcare expenses you use. With
an aggregate family deductible, the health plan
doesn’t begin paying for the healthcare expenses of
anyone in the family until the entire family deductible
has been met.
Coinsurance — The percentage of eligible health
care expenses the Plan pays after you meet any
required annual deductible. You are responsible for
paying the remaining difference.
Copayments (Co-pay) — The fixed dollar amount
you pay for certain services.
Evidence of Insurability (EOI) — An application
process where you provide information on the
condition of your health or your dependent’s
health in order to be considered for life insurance
coverage.
Family Coverage — Family coverage is defined
as employee + one or more dependents (e.g.,
employee + spouse/domestic partner, employee +
child(ren), employee + family).
Guaranteed Issue (GI) — Life insurance coverage
that is guaranteed to be issued to applicants
regardless of health status. Evidence of insurability
(EOI) is not required.
Health Maintenance Organization (HMO) — A
health insurance plan that limits coverage to care
from doctors who work for or contract with the
HMO. It generally won’t cover out-of-network care
except in an emergency. An HMO usually requires
you to live or work in its service area to be eligible
for coverage. With an HMO plan, you must choose
a Primary Care Physician (PCP) from a network
of local healthcare providers who will refer you to
in-network specialists or hospitals when necessary.
All your care is coordinated through the PCP.
Health Savings Account (HSA) — A savings
account used in conjunction with a high-
deductible health insurance policy that allows
users to save money tax-free against medical
expenses. HSAs can be used for out-of-pocket
medical, dental, and vision expenses. HSA funds
roll over and accumulate year to year if they are
not spent.
In-Network Provider — A provider who contracts
with a health care plan to offer certain services at
a discounted rate.
Out-of-Network Provider — A provider who does
not have a contract with the health plan and can
charge you over and above what is considered
reasonable and customary.
Out-of-Pocket Maximum (OOPM) — The most
you will pay out of your pocket in a year before
the Plan begins paying 100% of eligible expenses
including prescription drugs.
Paycheck Contributions — The amount deducted
from your pay for the cost of benefits coverage.
The amount deducted is based on which benefit
plan and coverage level (employee only, employee
+ family, etc.) you elect. The amount is deducted
on a semi-monthly basis (24 times a year).
Preferred Provider Organization (PPO) — A
managed care organization of medical doctors,
hospitals, and other health care providers who
have agreed with an insurer to provide health
care at reduced rates to the insurer’s clients. You
generally do not need a referral from a primary
care physician to see a specialist and some
coverage is available for out-of-network care.
Preventive Care — Measures taken for disease
prevention, as compared to a diagnosis or disease
treatment. In most cases, in-network preventive
care (e.g., screenings, immunizations, preventive
medications) are covered at 100%.
Qualified Life Event — Annual enrollment is your
once-a-year opportunity to update dependents
unless you have a qualified life event, such as
marriage, divorce, birth, adoption, death, court
order (Qualified Medical Child Support Order),
change to dependent coverage, or loss or gain of
benefits eligibility.
If you experience a qualified family status change
you must report it to VMware Benefits within 30
days following the qualifying event.
Usual, Customary and Reasonable (UCR) — The
amount paid for a medical service in a geographic
area based on what providers in the area usually
charge for the same or similar medical service.
The UCR amount is used to determine the allowed
amount.
17
Questions?Contact VMware Benefits
at 1-888-VMWARE8,
option “US Benefits”,
Monday through Friday from
5 a.m. to 5 p.m. PT or by
email at hrbenefitadmin@
vmware.com.
BENEFIT CONTACTSTo access VMware Benefits, please go to benefits.vmware.com.
Type of Coverage Insurance Carrier Policy # Contact
HSA PPO (Aetna Choice POS II) (All States)
Aetna 307138
1-877-204-9186 www.aetna.com
24-Hour Nurseline: 1-800-556-1555
Health Equity HSA (All States)
HealthEquity 290201-866-296-2857 www.healthequity.com
Traditional PPO (Aetna Choice POS ll) (All States)
Aetna 307138
1-877-204-9186 www.aetna.com
24-Hour Nurseline: 1-800-556-1555
Kaiser N. CA HMO Kaiser Permanente 39501-00001-800-464-4000 www.kp.org
Kaiser HI HMOKaiser Foundation Health Plan Inc.
09549-001-101-808-432-5955 www.kp.org
PRESCRIPTIONS
Retail (Aetna plans only)
Aetna Pharmacy Management
307138 1-888-792-3862
Mail (Aetna plans only)
Aetna Rx Home Delivery 307138 1-888-792-3862TDD: 1-800-823-6373
Specialty Pharmacy Aetna Specialty Pharmacy 307138 1-866-782-2779
Dental Delta Dental PPO 04221-800-765-6003 www.deltadentalins.com
Vision Vision Service Plan (VSP) 121220741-800-877-7195 www.vsp.com
Short Term Disability Sedgwick CMS N/A 1-866-251-1749
Long Term Disability Cigna Group Insurance LK 9618041-800-362-4462 www.cigna.com
Basic Life Cigna Group Insurance FLX 9624551-800-423-1282 www.cigna.com
AD&D Cigna Group Insurance OK 9640941-800-362-4462 www.cigna.com
Voluntary Life Cigna Group Insurance FLX 9624561-800-423-1282 www.cigna.com
EAP CONCERN 9881-800-344-4222 www.concern-eap.com
FSA TRI-AD VMware1-888-844-1372 https://benefitscentral.tri-ad.com
Legal Plan ARAG 161211-800-247-4184 http://members.ARAGgroup.com/advisor
401(k) Retirement Fidelity Investments 754721-800-835-5095 www.401k.com
Back-up Care Program
Bright Horizons
Username: VMware
Password: backup12
1-877-242-2737 www.backup.brighthorizons.com
VMware Perks Beneplace N/A1-800-683-2886 www.beneplace.com/vmwareus
18
This guide contains basic information about your 2017 VMware Benefits. For more details about your VMware Benefits, check
the Summary Plan Descriptions (SPDs) available online. If there is any difference between the information in this document and
the plan documents, the plan documents will govern. VMware reserves the right to amend or terminate VMware Benefits and
any of its component plans at any time, including specific benefits and the amount of any employee costs. This guide, together
with your other enrollment communications, serves as a summary of material modifications (SMM) to the VMware Benefits
SPDs for 2017. Please keep this information with your SPDs for future reference.