Medical

Important:  Pursuant to the terms of the settlement agreements with the Retiree Committee and LTD Committee (the “Settlement Agreements”) and the bankruptcy court’s orders approving the Settlement Agreements, the U.S. Debtors have terminated the Retiree Welfare Plans and the LTD Plans, as defined under the Settlement Agreements, in their entirety and have discontinued the provision of benefits thereunder as of June 30, 2013.  The information on this site is available solely for purposes of filing claims for the payment or reimbursement of benefits incurred under the Retiree Welfare Plans and the LTD Plans prior to June 30, 2013 in accordance with and subject to the terms of the relevant benefit plans and the Settlement Agreements.  For more information on the Settlement Agreements, please visit the site for “Former Employees.”.

Overview

It’s important that you review and familiarize yourself with the Medical Plan options available to you and your family. While the Company is committed to providing you with tools and education to help you make informed choices, it’s ultimately your health care and your responsibility to make the best decisions during enrollment and throughout the year.

For retirees, learn about your medical benefits in the Retiree Annual Enrollment Guide.

If you elect to cover your spouse/domestic partner under a Nortel Medical Plan option and he or she has access to employer-provided medical coverage elsewhere, you will be required to pay an additional $50 each pay period in addition to the plan premiums unless you experience a qualified status change. Click here for information on qualified status changes. You’ll need to certify each year on your Personalized Enrollment Worksheet that your spouse/domestic partner doesn’t have access to employer-provided medical coverage elsewhere when you enroll to avoid the additional $50 each pay period.

You can recommend that your provider be added to the Anthem or CIGNA network by completing a provider nomination form, which can be requested by calling HR Shared Services toll-free at 1-800-676-4636 and sending it to the address located at the bottom of the nomination form.

Note: Nortel cannot guarantee that nominated providers will choose to participate in either the Anthem or CIGNA networks. As a Nortel employee, you have an out-of-network provision.

If you live in a network area, your options include:

80/60 Preferred Provider Organization (PPO) Option—A managed care option available to those who live in a network area. It generally pays benefits at 80% of covered charges when you see providers within the preferred provider network after the calendar-year deductible is met. If you go to a provider who is not a member of the network, the 80/60 PPO option generally pays 60% of covered charges after the calendar-year deductible (medical) is met. Under this option, you’re not required to have a primary care physician (PCP) coordinate your care, and there are no claim forms for you to fill out (unless you receive services from an out-of-network provider).

This may be a good option for you if you want lower biweekly employee contributions, but are prepared to pay higher out-of-pocket costs. With this option, you’ll pay a $25 primary care physician (PCP) or $30 (specialist) copayment ($0 copayment for preventive care) for in-network office visits without having to first meet a calendar-year deductible. For other in-network and out-of-network benefits, you’ll first have to meet a calendar-year deductible before the plan begins paying benefits.

For complete details on this option, refer to the Medical Plan Summary Plan Description (SPD), which can be found on Explore Plans and Services or by calling HR Shared Services toll-free at 1-800-676-4636.

90/70 Preferred Provider Organization (PPO) Option—The 90/70 PPO option is a type of managed care option available to those who live in a network area. It generally pays benefits at 90% of covered charges when you see providers within the preferred provider network after the calendar-year deductible is met. If you seek care from a provider who is not a member of the network, the 90/70 PPO option generally pays 70% of covered charges after the calendar-year deductible is met. Under this option, you’re not required to have a PCP coordinate your care, and there are no claim forms for you to fill out (unless you receive services from an out-of-network provider).

This option provides a high level of coverage with lower out-of-pocket costs when you receive care. It may be a good choice if you expect to use a lot of medical care and are willing to make higher biweekly employee contributions in exchange for lower out-of-pocket costs when care is received.

For complete details on this option, refer to the Medical Plan Summary Plan Description (SPD), which can be found on Explore Plans and Services or by calling HR Shared Services toll-free at 1-800-676-4636.

No coverage—You can also decide not to participate in a Nortel Medical Plan option. However, if you are planning to retire in 2013, you must be actively enrolled in a Nortel Medical Plan immediately before retirement to be eligible for the Nortel Retiree Medical Plan. For other retiree medical plan eligibility requirements, see the Nortel Networks Retiree Medical Plan Summary Plan Description (SPD), which can be found on Explore Plans and Services or by calling HR Shared Services toll-free at 1-800-676-4636.

Your Personalized Enrollment Worksheet will show all Medical Plan options available in your area.

How to Find Network Providers

To find a provider that participates in your network, you can check the provider directory on the plan administrator’s Web site or call them directly. Click here for plan administrator contact and website information.

Non-Network Area Options

If you live in a non-network area, your options include:

Out-of-Area Comprehensive Option, offered through CIGNA—Available to those who live in a non-network area. There are no in-network or out-of-network benefit levels for the comprehensive option. Generally, this option pays 80% after the calendar-year deductible for most covered expenses, including doctor’s office visits. However, you’ll receive 100% coverage for preventive care, such as routine physicals.

For complete details on this option, refer to the Medical Plan Summary Plan Description (SPD), which can be found on Explore Plans and Services or by calling HR Shared Services toll-free at 1-800-676-4636.

No coverage—You can also decide not to participate in a Nortel Medical Plan option. However, if you are planning to retire in 2013, you must be actively enrolled in a Nortel Medical Plan immediately before retirement to be eligible for the Nortel Retiree Medical Plan. For other retiree medical plan eligibility requirements, see the Nortel Networks Retiree Medical Plan Summary Plan Description (SPD), which can be found on Explore Plans and Services or by calling HR Shared Services toll-free at 1-800-676-4636.

For more information about these plans, review the Summary of Health Benefits.

Your Costs

Here’s a look at your bi-weekly before-tax contributions for the Medical Plan network area options.

2013 Medical Plan Costs—Network Area Options
80/60 PPO Option 90/70 PPO Option
You Only 25.66 41.88
You + Children 55.44 93.78
You + Spouse 76.17 121.13
You + Family 114.28 186.86

*Note: In addition to the costs above, you will pay an additional $50 per pay period to cover your spouse/domestic partner if he or she has access to employer-provided medical coverage elsewhere. Misrepresenting your spouse’s/domestic partner’s access to employer-provided medical coverage is a serious offense and could result in the termination of your health care benefit and disciplinary action.

 

Here’s a look at your biweekly before-tax contributions for the Medical Plan non-network area options.

 

2013 Medical Plan Costs – Non-Network Area Option
Out-of-Area Comprehensive Option
You Only 37.69
You + Children 84.40
You + Spouse 109.01
You + Family 168.17

*Note: In addition to the costs above, you will pay an additional $50 per pay period to cover your spouse/domestic partner if he or she has access to employer-provided medical coverage elsewhere. Misrepresenting your spouse’s/domestic partner’s access to employer-provided medical coverage is a serious offense and could result in the termination of your health care benefit and disciplinary action.