1 tulane’s wave of benefits. 2 eligibility health plan dental plan life & disability insurance...
TRANSCRIPT
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Tulane’s
Wave of Benefits
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EligibilityHealth PlanDental PlanLife & Disability InsuranceFlexible SpendingRetirementEmployees Assistance Program (EAP)Tuition Waiver
AGENDA
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Eligibility
Who is eligibleRegular Full-Time orRegular Part-Time with BenefitsSpouse (same sex domestic partner)Unmarried dependent children, under 21 years of age or
under 25 if a full time student or a disabled child.
Child is defined as the natural or adopted child, stepchild, foster child, or child whom the employee has legal custody of and resides in the home in a parent child relationship or is required to provide support due to court order.
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Benefits Participation
Employee Health CoverageLong Term Disability CoverageBasic Life Insurance
Dependent Health CoverageDental CoverageLife Insurance AD&D InsuranceFlexible Spending PlansTax Deferral PlanTuition Waiver
VoluntaryNon-Voluntary
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Enrollment Opportunities
New Employee EnrollmentThe date of hire or appointment
Annual Open EnrollmentYou can change plans, add/drop dependent coverage at this time. You will be notified via email and USPS mail of the dates.
Qualifying Life Event ChangesCareer or family life changes may qualify as a qualifying life event change that allows you to make changes outside the annual enrollment period.
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Coverage Ends
Termination of EmploymentThe last day of work
Dependent Ages Out
Qualifying Life Event ChangesCareer or family life changes may qualify as a qualifying life event change that allows you to make changes outside the annual enrollment period.
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Ineligible Dependents
You must notify Human Resources when a dependent loses eligibility.
The deduction will be changed for the next payroll.
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HEALTH INSURANCE PROVIDED BY
UNITED HEALTHCARE
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United HealthCare Insurance
Basic, Plan 13 (Low Plan)Basic Plus, Plan 09 (Medium Plan)Basic Choice, Plan 10 (High Plan)
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Plan 13 (Low Plan Option)
Type of CoveragePhysician’s Office ServicesSpecialist Office VisitEmergency Room ServicesInpatient Hospital StayPrescription DrugsDeductibleOut-of-Pocket MaximumPlan Maximum
Network Benefit$25$25$100 copayment20% after deductible$10/$30/$50$1000/$2000$2000/$4000NA
Non-Network Benefit40% after deductible (preventive in network only)
40% after deductibleCovered as network benefit40% after deductible$10/$30/$50$2000/$4000$8000/$16000$1,000,000 per member
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Plan 9 (Middle Plan Option)
Type of CoveragePhysician’s Office ServicesSpecialist Office VisitEmergency Room ServicesInpatient Hospital StayPrescription DrugsDeductibleOut-of-Pocket MaximumPlan Maximum
Network Benefit$25$25$100 copayment10% after deductible$10/$30/$50$500/$1000$2500/$5000NA
Non-Network Benefit30% after deductible(preventive in network only)
30% after deductibleCovered as network benefit30% after deductible$10/$30/$50$1500/$3000$5000/$10000$1,000,000 per member
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Plan 10 (High Plan Option)
Type of CoveragePhysician’s Office Services
Specialist Office VisitEmergency Room Services
Inpatient Hospital StayPrescription Drugs
DeductibleOut-of-Pocket Maximum
Plan Maximum
Network Benefit$25$25
$100 copayment10% after deductible
$10/$30/$50$250/$500
$1500/$3000NA
Non-Network Benefit20% after deductible( preventive in network only)
20% after deductibleCovered as network benefit30% after deductible$10/$30/$50$2500/$5000$5000/$10000$1,000,000 per member
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Plan 13
Low Plan
Plan 9
Med Plan
Plan 10
High Plan
Type of Coverage In Network Out of Network In Network Out of Network
In Network Out of Network
Coordinated Vision Care Network
Eye exam (Once every 12 months)
Co-payments for lenses and frames at CVC plus physician’s office
$25 Co-payment
$25 Co-payment
40% of Eligible Expenses – Eye Examinations for
refractive errors are not covered
No Benefits
$25 Co-payment
$25 Co-payment
30% of Eligible Expenses – Eye Examinations for refractive errors are not covered.
No Benefits
$25 Co-payment
$25 Co-payment
20% of Eligible Expenses – Eye Examinations for refractive errors are not covered.
No BenefitsOptometrist/
Ophthalmologist UHC Network
Eye exam (Once every 12 months)
No Coverage for Lenses or Frames
Vision Benefits Plan Design
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Mental Health / Substance Abuse
Plan 13 Plan 9 Plan 10
Type of Coverage In Network Out of Network
In Network Out of Network
In Network Out of Network
Outpatient Mental Health/Substance Abuse (Visit Maximum
per Calendar Year may apply) Prior authorization required
$25 Co-payment 40% of Eligible
Expenses
$25 Co-payment 30% of Eligible
Expenses
$25 Co-payment 20% of Eligible
Expenses
Inpatient Mental Health/Substance Abuse (Day Maximum
per Calendar Year may apply) Prior authorization required
20% of Eligible Expenses
40% of Eligible
Expenses
10% of Eligible Expenses
30% of Eligible
Expenses
10% of Eligible Expenses
20% of Eligible
Expenses
Benefits Plan Design
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COVERAGE TIERS
Employee only
Employee + spouse (same sex domestic partner)
Employee + child(ren)
Family
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Monthly Health Insurance Rates 2007 Basic Option (Low) Basic Plus (Medium) Basic Choice (High)
Employee Only
Less than $30,000 $28.63 $63.04 $143.15
$30,000 to $59,999 $45.96 $80.38 $160.48
$60,000 to $89,999 $80.38 $114.52 $194.89
$90,000 & above $109.00 $143.15 $223.51
Employee + Spouse
Less than $30,000 $216.97 $283.51 $373.78
$30,000 to $59,999 $269.76 $329.03 $420.37
$60,000 to $89,999 $304.94 $396.91 $490.52
$90,000 & above $345.99 $453.61 $548.89
Employee + Child(ren)
Less than $30,000 $166.28 $219.71 $339.46
$30,000 to $59,999 $233.84 $290.24 $386.31
$60,000 to $89,999 $297.08 $389.13 $467.16
$90,000 & above $333.54 $444.72 $522.75
Family
Less than $30,000 $242.78 $372.71 $466.96
$30,000 to $59,999 $310.34 $417.74 $513.81
$60,000 to $89,999 $378.14 $502.38 $601.37
$90,000 & above $445.95 $569.94 $671.25
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DENTAL INSURANCE PROVIDED BY
METLIFE
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Any dentist – Maximized savings when you visit one of the more than 77,000 participating PDP
dentists• Scheduled fees typically 10-35% below community average charges• Lower out-of-pocket expenses for non-covered services
– No pre-selecting necessary Any time Anywhere Any specialist No claim forms No referrals needed
MetLife Preferred Dentist Program (PDP) Gives You More: Access, Savings and Options
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Type A: Preventive Services Exams X-Rays Fluoride Treatment Cleanings
SERVICES PROVIDEDIN-NETWORK:
Percentage of Scheduled PDP Fee
OUT-OF-NETWORK:Percentage of
Reasonable & Customary (R&C)
100% No Deductible
100%$100 Deductible for single and $300 Deductible for
Family
Benefits Plan Design
*Reasonable & Customary charges are based on the lowest of a dentist's usual, actual or community average charge as determined by MetLife.
Type B: Basic Services Most Fillings Simple ExtractionsSealants
Services Covered at 80%
Deductible Applicable
Services Covered at 80%
Deductible Applicable
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SERVICES PROVIDEDIN-NETWORK:
Percentage of Scheduled PDP Fee
OUT-OF-NETWORK:Percentage of
Reasonable & Customary (R&C)
Benefits Plan Design
*Reasonable & Customary charges are based on the lowest of a dentist's usual, actual or community average charge as determined by MetLife.
Type C: Major Services Inlays/Onlays Crowns Bridges/DenturesRoot Canal
Annual Deductible
Annual Benefits Maximum[excluding Orthodontia]
Services Covered at50%
Deductible Applicable
Services Covered at50%
Deductible Applicable
$50 Individual/$150 Family $100 Individual/$300 Family
$1,500 per Person $500 per Person
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SERVICES PROVIDEDIN-NETWORK:
Percentage of Scheduled PDP Fee
OUT-OF-NETWORK:Percentage of
Reasonable & Customary (R&C)
Type D: Orthodontia Orthodontic Treatment Orthodontic Appliances
Orthodontia Lifetime Benefits Maximum
Services Covered at 50%
$1,500 per Dependent Child
Services Covered at 50%
Annual Deductible NONE NONE
$500 per Dependent Child
Benefits Plan Design
Non-covered services: teeth whitening, veneers, implants
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Employee Only: $18.48Employee + Spouse $38.21Employee + Child(ren) $40.86Employee + Family $67.12
MetLife Dental Coverage Rates
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Financial Security
Group Basic Term Life Supplemental Term LifeVoluntary Accidental Death & DismembermentLong Term DisabilityDeath Benefit
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Financial Security DEATH BENEFIT PLAN
Provides and eligible employee’s beneficiary an amount equal to one month’s salary.
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Group Life Insurance
PROVIDED BY
METLIFE
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Basic Term Life Insurance
Employer paid Coverage amount 1.5 times base annual salary to maximum of $50,000For spouse (same sex domestic partner) $2000Dependent children up to $2000
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Supplemental Term Life Insurance
Coverage in $10,000 increments up to a maximum of $500,000 Coverage amounts above the lesser of 2 times annual salary or maximum of $100,000
require a Statement of Health formAfter 31 days of employment, all coverage amounts require a Statement of HealthPremium based on age as of October 1st
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Dependent Spouse Term Life Insurance
Coverage in $10,000 increments up to a maximum of $150,000 Coverage amounts above $10,000 require a Statement of Health formAfter 31 days of employment, all coverage amounts require a Statement of HealthPremium based on age as of October 1st
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Dependent Child Term Life Insurance
$10,000 for children 6 months or older $500 for children under 6 months of age
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Voluntary Accidental Death & Dismemberment Life Insurance
Coverage amount $10,000 to $500,000 in increments of $10,000.
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Long Term Disability
PROVIDED BY
CIGNA
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All eligible employees are automatically enrolled100% employee paidPremiums based on monthly salary90 day benefit waiting periodCoverage is 66.67% of the monthly salary to maximum of $8000Benefits received are offset by:
Workers Compensation, Social Security, and other sources of income
Income received is not taxable
Long Term Disability(CIGNA)
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Flexible Spending Accounts
Benefit Concepts
administered by
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Health Care Spending Account
Enrollment – 31 days of hire or open enrollment periodEligible expenses – vision care, out of pocket deductibles, co-insurance, co-pays,
over-the-counter drugs and weight loss programs (excluding food)$4,800 maximumAnnual enrollment requiredAll money not used will be forfeited, there are no refunds or creditsAdditional information including enrollment form in benefits packet
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Dependent Care Spending Account
Enrollment – 31 days of hire or open enrollment periodRegulations
•$5,000 maximum or •$2,500, if married filing separate tax returns or your spouse uses a separate dependent care spending account •Children under the age of 13, unless physically or mentally handicapped•Disabled or elderly dependent•Each parent must work outside the home
All money not used will be forfeited, there are no refunds or creditsAnnual enrollment requiredAdditional information including enrollment form in benefits packet
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Tax Deferral Plan
Eligible to participate upon hire403b PlanNo company matchPre-taxed which will lower taxable incomeContribution does not show in W-2 earningsRefer to the retirement summary in benefits packetOnline enrollmentAdditional information including the Salary Reduction Form is available upon request For more information contact Celeste Wertz at [email protected]
Deferred Compensation457b Plan (based on earnings qualifications)
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University Retirement Plan
Eligible to participate after 2 years of service403b PlanStaff- Contribution equals 8% of salary, paid by UniversityNo employee contribution required100% owned by employeeOnline enrollmentFor more information refer to the retirement summary in benefits packet
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Retirement Plan Investment Options
TIAA-CREF www.tiaa-cref.org
Fidelity Investments www.fidelity.com
sponsored by
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EMPLOYEE ASSISTANCE PROGRAM
Immediate help during a crisisTips and guidance to help balance work and familyThree (3) free in-person counseling sessionsConfidentialAccessible 24 hours a day, 365 days a yearAvailable to your dependents and all members of your householdTo access service call CIGNA Behavioral Health at 1-888-371-1125For more information see brochure in benefits packet
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Tuition Waiver Program
Employee Waivers
Full-time staff are eligible after six months full-time employmentWaiver is applied to two classes or six hours which ever is greaterGraduate waivers that exceed $5,250 are taxable
Dependent Waivers
• Dependents of staff members are eligible after three years full-time employment
• Must submit most recent copy of Federal Income Tax Return to prove dependency
• Waiver applied to tuition and not University fees.
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Thank You
Human Resources Benefits Section200 Broadway Street, Suite 120
New Orleans, LA 70118(504)865-5280