southeast missouri state university benefits orientation
DESCRIPTION
Southeast Missouri State University Benefits Orientation. Your 2010 Benefits. Your benefits are effective on your date of hire Medical Insurance Anthem Blue Cross & Blue Shield Vision Insurance Vision Service Plan Dental Insurance Delta Dental of Missouri Flexible Spending Accounts - PowerPoint PPT PresentationTRANSCRIPT
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Southeast Missouri State UniversityBenefits Orientation
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Your 2010 Benefits
Your benefits are effective on your date of hire
Medical Insurance Anthem Blue Cross & Blue Shield
Vision Insurance Vision Service Plan
Dental Insurance Delta Dental of Missouri
Flexible Spending Accounts Health Savings Account
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Your 2010 Benefits (continued)
Life Insurance Anthem Life
Retirement MOSERS (Faculty & Staff)
CURP (Faculty only)
Educational Benefits Employee Assistance Program
**You will complete enrollment forms during orientation. You are allowed 31 days from date of hire to finalize benefit elections.**
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Medical Insurance Basics Blue Access PPO Network
Nationwide access Worldwide access
Unlimited lifetime maximum
Website: http://www.anthem.com
Pre-existing conditions: 12 months exclusion, can be waived by providing a HIPAA certification (a statement certifying proof of prior coverage)
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Medical Insurance Basics Dependent Coverage
Up to age 25 regardless of student status
If not enrolled at employee’s date of hire – dependents can enroll during annual open enrollment
Dependents can enroll within 31 days of an IRS Qualifying Change in Family Status (e.g., marriage, divorce, birth of child, change in spouse’s coverage status, etc.)
Pre-existing conditions for 12 months unless a HIPAA certification is provided.
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Medical Insurance Basics Coordination of Benefits
Anthem Blue Cross and Blue Shield will coordinate benefits with other group health coverage that you or your covered family members may have.
To ensure that Anthem has up-to-date information they may periodically ask members about other health insurance coverage.
If any information regarding your or your families health insurance changes, please fill out a coordination of benefit form and send to Anthem.
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Medical Insurance Basics Problems with Claims?
Contact Anthem
Call physician’s office
View your claims online at: http://www.anthem.com
Contact the Human Resources Office for further assistance.
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Medical Insurance BasicsHIPAA(Health Insurance Portability and Accountability Act)
HIPAA improves the portability, security and privacy of protected health information.
When obtaining assistance regarding claims issues through the Human Resources Office, employees must sign an authorization for release of information form.
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Medical Insurance BasicsPrescription Drugs Coverage Visiting Network Retail Pharmacies
30-day supply
No RX Copays
Pharmacist processes Rx through Anthem computer system
20% Cost share after deductible
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Medical Insurance BasicsPrescription Drugs Coverage Anthem Mail Services
90-day supply
No RX Copays
Pharmacist processes Rx through Anthem computer system
10% Cost share after deductible
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Medical Insurance BasicsPrescription Drugs Coverage Prior Authorization
Goal: To assist employees with cost control of medications
The process of obtaining approval of benefits before certain prescriptions may be filled.
Must be obtained by your physician in order to receive benefits
To find out which drugs require prior authorization visit: www.anthem.com
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Medical Insurance BasicsMedical Insurance Opt Out Provisions
Employees can decline individual health coverage.
If opting out: Employee’s premium dollars are not available Cannot return to Anthem Blue Cross and Blue
Shield until next annual open enrollment or IRS Qualifying Event
Must sign disclaimer form verifying intention to decline coverage
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Medical Insurance Basics
Health Incentive Accounts (HIA) Allows members to earn health care dollars through
various plan incentives
Features within Medical Plans A and B Medical Plan A – reduces plan deductible Medical Plan B – payable to employee as gift
cards
Unused health incentives carry over
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Medical Insurance Basics Types of Incentives
Health Assessment - $50 Personal Health Coach - $100
$200 incentive when achieving goals through program
Smoking Cessation Program - $50 Weight Management Program - $50
All incentive programs available through the Anthem website: www.anthem.com
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Medical Plan A
Anthem Blue Cross and Blue Shield
Cafeteria Plan Funding for Plan A
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2010 Medical InsuranceMedical Plan A $500 Individual Deductible
$1,000 Family Deductible
20%/80% after deductible met
Full Preventive Care coverage (well woman, PSA, mammogram, annual physical, immunizations, etc.)
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2010 Medical InsuranceMedical Plan A Office Visit Copays:
No Office Visit Copays (employee pays 100% of cost up to the deductible; then cost share applies)
Out of Pocket Maximum: Individual: $3,500/year Family: $7,000/year All deductibles and coinsurance apply
toward the out of pocket maximum including prescription drugs.
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Cafeteria Plan A
Plan Summary
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Medical Plan A Cafeteria Plan Contributions
Employer Cafeteria Plan Funding: $750/year
You must be an employee with the University on December 31 to be eligible to receive the Cafeteria Plan Funding. If you are hired mid year, this benefit will not be available until the next open enrollment period.
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Medical Plan A Cafeteria Plan Funding
Employer Cafeteria Plan Funding = $750/year
Dependent Medical
Dependent Care Assistance (DCAP)
Employee & Dependent Dental
Medical Reimbursement Account (MRA)
Employee & Dependent Vision
Cafeteria Plan A Option
Part-time employee funding prorated by percent of assignment.
The University will use the cafeteria plan dollars first to pay for employee and dependent medical premiums; then vision, dental, MRA and DCAP.
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Medical Plan B
Anthem Blue Cross and Blue Shield
Cafeteria Plan Funding for Plan B
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2010 Medical InsuranceMedical Plan B
$1,500 Individual Deductible
$3,000 Family Deductible
20%/80% after deductible met
Full Preventive Care coverage (well woman, PSA, mammogram, annual physical, immunizations, etc.)
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2010 Medical InsuranceMedical Plan B Office Visit Copays:
No Office Visit Copays (employee pays 100% of cost up to the deductible; then cost share applies)
Out of Pocket Maximum: Individual: $5,000/year Family: $10,000/year All deductibles and coinsurance apply
toward the out of pocket maximum including prescription drugs.
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Cafeteria Plan B
Plan Summary
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Medical Plan B Cafeteria Plan Contributions
Employer Cafeteria Plan Funding: $1,486.32
You must be an employee with the University on December 31 to be eligible to receive the Cafeteria Plan Funding. If you are hired mid-year, this benefit will not be available until the next open enrollment period.
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Medical Plan B Cafeteria Plan Contributions
Employer Cafeteria Plan Funding = $1,486.32/year
Dependent Medical
Dependent Care Assistance (DCAP)
Employee & Dependent Dental
Health Savings Account (HSA)
Employee & Dependent Vision
Cafeteria Plan B Option
Part-time employee funding prorated by percent of assignment.
The University will first fund the HSA; then dependent medical premium, vision, dental and/or DCAP.
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Medical Insurance 2010 Monthly Premiums
Medical Insurance – Anthem Blue Cross and Blue Shield
Medical Plan A Medical Plan B w/MRA option w/HSA option
Cost CostEmployee $512.68* Employee $437.50*Spouse $512.68 Spouse $437.44Children $384.44 Children $328.08Family $897.14 Family $765.56
* Full-time employee premium 100% funded* Effective July 1, 2009, new hire part-time employee premium
funding is prorated by percentage of assignment.
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Medical Plan A or BAn Analysis - Which is right for you?
Medical Plan A - $500 Deductible(w/MRA option)
Medical Plan B - $1,500 Deductible(w/HSA option)
General Office Visits/Rx4 Office Visits ($51/visit) = $ 204 4 Labs ($150/lab) = $ 357 4 Rx purchases ($100/Rx) = $ 80Total Cost = $ 641Less MRA Funding = $ (750)Net Savings (leftover MRA)= $ (109)
General Office Visits/Rx4 Office Visits ($51/visit) = $ 2044 Labs ($150/lab) = $ 6004 Rx purchases ($100/Rx) = $ 400Total Cost = $ 1,204 Less HSA Funding = $(1,486) Net Savings (HSA carryover) = $ (282)
A $50,000 Surgery4 Office Visits ($100/visit) = $ 4004 Labs ($150/lab) = $ 2004 Rx purchases ($100/Rx) = $ 80 Deductible & OOP Maximum = $ 2,820 Total Cost = $ 3,500Less MRA Funding = $ (750)Net Cost = $ 2,750
A $50,000 Surgery4 Office Visits ($100/visit) = $ 4004 Labs ($150/lab) = $ 6004 Rx purchases ($100/Rx) = $ 400Deductible & OOP Maximum = $ 3,600 Total Cost = $ 5,000 Less HSA Funding = $(1,486)Net Cost = $ 3,514
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Vision Insurance
Plan Summary
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Vision Insurance Vision Service Plan (VSP)
Two Plan Options Exam Plus Plan A – Low Option Enhanced Plan B – High Option
Extra Discounts & Savings Laser Vision Correction Prescription Glasses Contacts
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Vision Insurance
Exam Plus Plan A In-Network providers:
Annual eye exam with a $10 copay
20% discount on lenses and frames
15% discount off the contact lens fitting and evaluation exam. This exam is in addition to your vision exam.
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Vision Insurance
Enhanced Plan B In-Network providers:
Annual eye exam with a $10 copay Lenses covered in full–every 12 months Frames – every other plan year (frames of
your choice covered up to $120, plus 20% off any out-of-pocket costs) or
Contact Lens care-every 12 months No copay applies
Prescription glasses-$25 copay
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Vision Insurance 2010 Monthly Premiums
Vision Insurance – Vision Service Plan
Plan A-Exam Plus Plan B-Signature PlanCost* Cost*
Employee $2.88 Employee $10.80Spouse $4.06 Spouse $17.32Children $4.12 Children $17.68 Family $6.10 Family $28.52
*Total premium includes employee only cost.
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Dental Insurance
Plan Summary
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Dental Insurance Delta Dental of Missouri
Two Plan Options Plan A – Low Option Plan B – High Option (with orthodontia) Annual Maximum (per person/year): $1,000 Utilize Delta Premier Network providers
Listing of Network providers can be located at: http://www.deltadentalmo.com
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Dental Insurance Preventive Plan A – Low Option
Coverage A only at 100% of UCR Oral exams – twice in any benefit year Fluoride patients under age 14 – once in any benefit
year Molar sealants for dependent children under age 16 –
once in 5 years Bitewings x-rays: one set in any benefit period
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Dental Insurance Plan B – High Option
Individual Deductible: $50 Waived for Coverage A Dental Services Includes Coverage A, B, C and D
Coverage A Services (100% of UCR) Oral exams – twice in any benefit year Fluoride patients under age 14 – once in any benefit
year Molar sealants for dependent children under age 16 –
once in 5 years Bitewing x-rays: one set in any benefit period
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Dental Insurance Coverage B Services
Fillings, extractions, Full-mouth x-rays at 80% after $50 deductible
Coverage C Services Periodontics, endodontics, surgical
extractions, crowns, complex oral surgery, bridges at the following schedule: 1st year – 10% 2nd year – 25% 3rd year and beyond – 50%
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Dental Insurance Coverage D Services
Orthodontia care for dependent children to age 19 at 50%
Maximum: $1,500, available starting in 3rd year of coverage
Orthodontics is not covered for care started prior to the 3rd year of benefits
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Dental Insurance 2010 Monthly Premiums
Dental Insurance – Delta Dental of Missouri
Plan A-Low Option Plan B-High Option Cost* Cost*
Employee $12.30 Employee $28.42Spouse $26.38 Spouse $56.12Children $40.96 Children $71.14Family $54.22 Family $102.50
*Total premium includes employee only cost.
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Flexible Spending Accounts
Plan Summary
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Flexible Spending Accounts Medical Reimbursement Account (MRA)
Tax-deferred payroll reduction: $5,000 annual maximum
Applicable expenses: Deductibles, copays, coinsurance, Rx, vision, dental, certain over-the-counter items
Dependent Care Assistance Program (DCAP) Tax-deferred payroll reduction: $5,000 annual
maximum Applicable expenses: day care for children and elder
care for adults
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Flexible Spending Accounts PowerGroup Administrators
Account feature Direct Deposit Option for Dependent Care
Print Form from website: www/myflexonline.com
Debit Card for Medical Reimbursement Account
Submitting Claims Expenses incurred through 12/31 of current year Claims filing deadline: 03/31 of upcoming year Claim forms can be faxed or mailed
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Flexible Spending Accounts PowerGroup’s Contact Information
Claims filing email address: [email protected]
Customer Service: (800) 847-0038
Flex Account Hotline: (913) 789-4600
Fax: (913) 491-6379
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Health Savings Account (HSA)
Plan Summary
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Health Savings Account (HSA) Definition
An interest bearing savings account owned by the employee to pay for current and future medical expenses
Offered with a High Deductible Health Plan – Medical Plan B
Works similar to a flexible spending account, yet unused monies roll over year after year and continue drawing interest
Portable
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Health Savings Account (HSA)Account Contributions
Both employer and employee pre-tax contributions are permissible
2010 maximum annual contribution (employer and employee contributions combined)
$3,050 for employee only coverage $6,150 for family coverage
Catch-up Provision at age 55: $1,000 Employee contributions can be changed mid-
year via form completion in Human Resources office
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Health Savings Account (HSA)Who is NOT Eligible?
Employees covered by Medical Plan A
Employees covered by other medical insurance that is a non-high deductible health plan (at least $1,200)
Employees enrolled in Medicare coverage
Employees claimed as a dependent child on someone else’s tax returns
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Health Savings Account (HSA)Account Distributions Tax-free if used for qualified medical expenses Qualified medical expenses incurred on or after
account is established
Withdrawal only for monies in the account at time of distribution
Can apply qualified medical expenses of spouse and children, even if not covered by your medical insurance
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Health Savings Account (HSA)Account Distributions (continued)
Qualified Medical Expenses: Deductibles, cost shares, and out of pocket
costs on medical insurance claims
Over-the-counter medical items
COBRA continuation of coverage premiums
Qualified long term care insurance premiums
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Health Savings Account (HSA)Account Features HSA services through Mellon Bank
Upon electing the Medical Plan B coverage and electing an HSA, Welcome Kits will be mailed to home address
Forms must be completed by the employee and returned to Mellon Bank ASAP
Competitive mutual fund investment options available once account reaches $1,500
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Health Savings Account (HSA)Account Features (continued)
Online management access of personal benefits and HSA details
Monthly account activity statements
MasterCard – a debit card to pay for qualified medical expenses
Checkbook Usage - initial 40 checks supply; free of charge
Setup and monthly fees paid by Southeast
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Health Savings Account (HSA)How to use your money…
If seeing an Anthem provider Provider files insurance claim with Anthem Provider bills the member for out of pocket
responsibility due Member uses HSA account dollars to make payment
to provider via debit card or check
Network Retail Pharmacies/Mail Order Services Pharmacist/Precision Rx processes Rx through
Anthem computer system Member uses HSA account dollars to cover the cost of
prescriptions via debit card or check
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Health Savings Account (HSA)Account Features (continued)
Questions:
Customer Service: (888) 224-4902
www.anthem.com, My Account page
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Life Insurance
Plan Summary
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Life Insurance Anthem Life
Basic Life Insurance The University provides up to 2 ½ x base
salary coverage up to a maximum of $50,000 at no cost to the employee
Term Coverage – ends upon termination of employment
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Life Insurance Supplemental Life Insurance
1x, 2x, or 3x base salary coverage Guarantee issue limit is the lesser of 3x your base
salary or $100,000, without evidence of insurability, if enrolling as a new employee.
Rates<40 $0.06 per thousand/per month40 – 49 $0.15 per thousand/per month50 & over $0.54 per thousand/per month
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Life Insurance Dependent Life Insurance
One price covers all dependents, not per person
Cost $5,000 policy $1.50 per month $10,000 policy $3.00 per month $15,000 policy $4.50 per month
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Long Term Disability
Plan Summary
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Long Term Disability Anthem Life
LTD is for individuals who are certified by a physician as having a disability which does not allow them to continue employment
Works in conjunction with sick leave policy After you have been off work 180 days, you
are eligible to apply for LTD LTD payments are based on 60% of salary,
offset by Social Security disability
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Retirement Benefits
Plan Summary
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Retirement Benefits MOSERS
Missouri State Employees Retirement System Faculty & Staff
CURP College and Universities Retirement Program
Faculty only
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Retirement Benefits MOSERS Southeast contributes:
FY10: 12.75% FY11: 13.81%
Five-year vesting requirement Prior Service Credit
Once you are vested, active military service (or training) or prior public sector service in Missouri may be acquired to increase your MOSERS
Interactive web site – www.mosers.org View personal benefit information Access forms and publications Find “free” educational seminar
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Retirement Benefits CURP Southeast contributes
FY10: 7.71% FY11: 7.77%
TIAA-CREF will automatically... Designate your estate as beneficiary of your contract Invest contributions to TIAA-CREF Lifecycle Funds
(asset allocation)
www.tiaa-cref.org/curp Telephone Counseling Center: (800) 842-2776
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Other Retirement Options Tax Sheltered Annuity Investment
(403(b) Tax Deferred Annuities/457 Deferred Compensation)
Payroll reductions available
Three Easy Steps:
Contact an authorized Broker/Fund Company
Complete Salary Reduction Agreement Form
Submit Salary Reduction Agreement Form to the Benefits Office for processing
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Educational Benefits
Plan Summary
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Educational Benefits Employee Tuition Fee Waiver Program
Credit-bearing courses only
Must earn “C” or better grade
Funding of undergraduate incidental fees: 90%
Funding of graduate incidental fees: 70%
Must apply every semester
Application form can be downloaded and printed from the Human Resources forms website (due no later than the first day of classes for the semester)
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Educational Benefits Dependent Tuition Reimbursement Program
Spouse and eligible dependent children
Undergraduate Courses only
Must earn “C” or better grade
Reimbursement at end of each semester: 50%
Must apply at beginning of academic year (August)
Application form can be downloaded and printed from the Human Resources forms website (due no later than the first day of classes for the semester)
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Educational Benefits Cooperative Graduate Program
Graduate courses offered in partnership between Southeast and another state institution
Masters in Higher Education Administration (University of Missouri – St. Louis)
Doctor of Education in Education Leadership (University of Missouri – Columbia)
Reimbursement for courses with “B” or better grade: 70%
Application form can be downloaded and printed from the Human Resources forms website
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Employee Assistance Program
Plan Summary
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Employee Assistance Program Employee Counseling and Employee Assistance Services
Benefits to you and your immediate family
Provides seven free, confidential counseling Family problems and relationship issues Job conflicts and concerns Grief and loss issues Stress related emotional issues Depression and anxiety Alcohol and drug concerns
Call local office for an appointment: (573) 334-7667 (800) 455-7327
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Additional Benefits… Group Banking Benefit Program
Missouri State Credit Union
M.O.S.T. Program
U.S. Savings Bonds
AFLAC’s Personal Cancer Indemnity Plan
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My Southe@st http://portal.semo.edu
Southeast Key required (Contact IT Department) Extension: HELP (4357) Academic Hall – Room 140
Allows access to: Benefits and Deductions Campus Directory Leave Balances Pay Information Tax Forms (W4 information, W2 Form) Time Sheet
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Any Questions?
Visit our Website: http://www4.semo.edu/humanresources/Benefits/index.htm
Stop by our Office: Human Resources Office Academic Hall, Room 220
Call Us: (573) 651-2206