Title: BENEFITS Plan Year April March
1BENEFITSPlan Year April - March
- TAX SAVINGS PROGRAM Elected premiums will be
sheltered on a before-tax basis under Section 125
of the IRS Tax Code
- You have thirty (30) days from your hire date to
elect these pre-tax benefits (excludes 403b) or
you must wait until open enrollment
- Open Enrollment is once a year in February/March.
You can make changes to your pre-tax benefits
for the following year effective April 1st.
- Coverage is locked for benefit plan year
(April-March) unless there is a qualified status
change. You must make changes to benefits within
thirty (30) days of the status change. See
Changing Coverage during the year on the Benefits
Webpage. - ELIGIBLE DEPENDENTS Include your spouse,
domestic partner, dependent child(ren), and
domestic partner dependent child(ren)
230 DAYS FROM HIRE
NEW HIRE TAX SAVINGS PROGRAM ELECTION FORM For
April 1, 2004-March 31, 2005
ANY APPLICABLE ENROLLMENT FORMS
Health- effective date of hire
Dental-1st of the month after date of hire
Voluntary Life Insurance- effective immediately
under Guaranteed Issue Amounts
Cancer Insurance- determined by insurance
company Heart Care Insurance- - determined by ins
urance company Vision- 1st of the month after dat
e of hire Long Term Care Insurance- - determined
by insurance company
3HEALTH INSURANCE
- Independent College and University Benefits
Association (ICUBA)
- 8 member private schools in Florida
- 501(c) 9 corporation to purchase benefits for
members
- MEWA-multiple employer welfare association
- Four CIGNA PPOs
- No primary care physician required and no
referrals to specialists
- In and out of network coverage available
- Pre-authorization still required on certain
services
- 800-244-6224 www.cigna.com
- College currently subsidizes 63 of the total
premium for employee and eligible dependents
- Three of the plans have college funded Health
Reimbursement Accounts (HRA
- Health Insurance Premiums
- Declining Insurance Now- family status change
- Pre-existing conditions- Need proof of prior
coverage to waive
4HEALTH INSURANCE
- All four plans have same
- Prescription drug copays- 10/25/40
- Same annual wellness benefit
- Same plan rules
- Same network of providers
- Same CIGNA website access
- 24/7 health info line
- ER Urgent Care copays
- Differences are
- Co-pays- small amounts you pay for services such
as office visits
- Deductibles- larger amounts you pay for services
outside of office visits and prescription drugs
- Coinsurance- the cost sharing between you and the
ICUBA plan (example 80/20 means the plan pays 80
and you pay 20 after the deductible)
- Annual Out of Pocket Maximums- your maximum
liability for the benefit plan year (made up of
deductible and coinsurance, not copays)
- HRA Amounts-monthly contribution to your debit
card paid for by College in addition to 63 of
total premium
5In-Network Health Plan Comparison
6Health Plan Comparison (contd.)
7In Network Deductibles/Max with annual HRA
8Health Reimbursement Accounts (HRA)
- US Dept. of Treasury July 2002
- College contributions for faculty/staff on high
deductible medical plans- PPO 80,PPO 70 and
Risk/Reward
- Can be used only by family members on the ICUBA
medical plan
- Two methods of reimbursement Mastercard Debit
or paper reimbursement (within 1 year from date
of service)
- Keep receipts, Explanations of Benefit (EOB), etc
for verification of medical expense
- Unused money rolls over indefinitely in a secure
trust fund separate from ICUBA funds
- Administered by Outsource One- 877-491-5979
- Check Balances at www.mbicard.com (use Internet
Explorer)
9Health Reimbursement Accounts (HRA) contd.
- Eligible Expenses
- out of pocket medical services (ie.
Medical,dental, vision)
- all HCSA eligible expenses except over the
counter drugs
- COBRA,long term care, retiree health premiums
- Non-eligible expenses
- OTC drugs
- life, long term disability, any other pre-tax
premiums
- non-medical expenses, cosmetic or other not
medically necessary
- non-dependent expenses (domestic partners that
are not tax dependents are not eligible)
- dependents that are not enrolled in the ICUBA
plan
10Health Reimbursement Accounts (HRA) contd.
- Money earns interest at the FL Dept of Financial
Services rate on a quarterly basis
- HRA is never taxed
- HRA can never be converted to cash
- Portable with 36 months participation
- HRA available 1st of each month you participate
in high deductible plan
- changing to end of each month in April 2005
11HRA Monthly Funding Schedule
12Highlight Of CIGNA Amenities
- 24 - Hour Health Information Line
- Healthy Rewards
- Healthy Babies
- Well Aware Program- asthma, diabetes, heart,
back, COPD
- MyCIGNA.com- Need to register- 3 days will have
full access
- Access to claims information-Explanation of
Benefits (EOB)
- Provider Look-Up
- Select Quality Care- Hospital Comparisons
- Care Steps - Health Risk Assessment
- Healthwise- Medical Information Resource
- Drug Compare
- Case Management
13DENTAL INSURANCE
- Aetna Dental Insurance - three plans to chose
from
- Indemnity Plan - Any dentist
- PPO Plan In Network or Out of Network
Providers
- DMO Plan Network Providers only
- www.aetna.com/docfind
- Member Services-877-238-6200
14Dental DMO Plan
- Approximately 6,800 available dental office
locations and approximately 17,000 individual
practitioners
- Primary care dentist selection required
- Change dentist by 15th of month effective 1st
the following month
- 5 office visit copayment per visit
- Member pays copayments for all services
- Specialty referral required (except
orthodontists)
- Orthodontia covered for adults and children
- Members receive ID cards
- No deductibles, maximums or claims forms
- Internet access to provider information
DocFind
- In Network Coverage only
- Pre-Determination for anything over 300.00
- One time emergency authorization available
15Dental PPO Max Plan
- Go to a dentist in or out of network- different
benefit levels
- Use Participating PPO Dentist - No Balance
Billing
- Claims are paid based on fee-scheduled amounts
for the Central Florida area
- Non-PPO Dentist can charge above fee-schedule
member can be balanced billed
- Lowest out of pocket costs when using PPO Dentists
16Dental PPO Max Plan
- Annual Deductible
- Individual
50
-
Family 150
- Preventive Services
100 of fee schedule
- Basic Services
80 of fee schedule
- Major Services
50 of fee schedule
- Annual Benefit Maximum 1000
- Orthodontia for adults and children 50
- Orthodontia Lifetime maximum 1000
- No deductible for orthodontia
- Deductible applies to Basic Major services
only
- -Non network claims paid at the fee-scheduled
amount
17Dental PPO Max Examples
- Important Information
- Fee Schedule is based on Contracted Rates with
PPO Dentists NOT Reasonable and Customary
Charges
-
- Example
- John goes to a participating dentist for a
crown
- Scheduled PPO Amount for Procedure 2750 (crown)
551
- Assume Deductible Has Been Met
- Plan pays 50 of Maximum PPO Allowance
275.50
- Member pays 275.50
18Dental PPO Max Examples
- Important Information
- Fee Schedule is based on Contracted Rates with
PPO Dentists NOT Reasonable and Customary
Charges
-
- Example
- John goes to a non-participating dentist for a
crown
- Scheduled PPO Amount for Procedure 2750 (crown)
551
- Non-participating dentist charges
700
- Assume Deductible Has Been Met
- Plan pays 50 of Maximum PPO Allowance
275.50
- Member pays 700.00(Dentist Charge)-275.50(Maxi
mum PPO Allowance) 424.50
19Dental Indemnity Plan
- Go To Any Dentist
- Plan pays at Reasonable Customary (80th
Percentile)
- Deductible 75.00/150 Family
- Preventive Services 100 of R C
- Basic Service 80 of R C
- Major Services 50 of R C
- Annual Maximum 1000
- Orthodontic Services 50
- Orthodontic Lifetime Maximum 1000
20Aetna Dental Navigator
21Vision One Discounts
- 800-793-8616
- Show Aetna Dental Card to receive discounts
- With all Aetna Dental Plans
- Sears, JC Penny,Target and Pearl Optical Centers
- Example of discounts
- 38.00 for eyeglasses exam
- 78.00 for contact exam
- 24.00 for frames up to 60.99
- 44.00 for frames 80-100.99
- 30.00 for single lenses
- 49.00 for bifocal lenses
- 59.00 for trifocal lenses
- 99.00 for standard progressive
- Additional lens option discounts available
- Additional information online
22FLEXIBLE SPENDING ACCOUNTS
- Pre-tax dollars to pay for qualified health
and/or dependent care expenses
- Two types Health and Dependent Care (HCSA
DCSA)
- Two methods of reimbursement Mastercard Debit
or paper reimbursement (within 60 days of end of
plan year)
- Administered by Outsource One- 877-491-5979
- Check Balances at www.mbicard.com (use Internet
Explorer)
- Min and Max (50.00 - 3,000 for health 5,000
for dependent) pro-rated based on date of hire
- Use it or lose it provision for the benefit plan
year
23Health Care Spending Account (HCSA)
- All IRS dependents, even if not on ICUBA medical
plan
- Funds available at the beginning of the plan year
(April)
- Maximum of 3,000 per benefit year pro-rated
based on date of hire
- Keep receipts, Explanations of Benefit (EOB), etc
for verification of medical expense
- Examples of eligible expenses for health
account
- Co-pays- office visits and Rx
- Deductible on PPO and dental
- Eye care Costs
- Over the counter medicines
24Health Care Spending Account (HCSA) vs. Health
Reimbursement Account (HRA)
- HRA
- Employer contributions
- Rolls over while an active employee
- Account will be debited after HCSA is exhausted
- Funds available 1st of each month
- Over the counter medicines not allowed
- May be used for retiree, COBRA, and long term
care premiums
- Balance earns interest quarterly
- May be used ONLY for dependents on the ICUBA
medical plan
- HCSA
- Employee contributions
- Unused funds at end of year cannot be rolled over
into next year
- Account will be debited first
- Funds available at the beginning of the plan year
(April 1st)
- Over the counter medicines allowed
- May not be used for any insurance premiums
- Balance does not earn interest
- May be used for all IRS dependents
25Dependent Care Spending Account (DCSA)
- Dependent care expenses for children under age 13
or elderly parents if they are your IRS tax
dependent so that you and your spouse can work
- Funds available as payroll deductions occur
- Maximum of 5,000 per benefit year pro-rated
based on date of hire
- May be able to use debit card contact Outsource
One
- Documentation of dependent care expense required
26LIFE INSURANCE
- COLLEGE PROVIDED Jefferson Pilot Financial
- 2x annual base salary
- Excess Life Tax- if life insurance amount over
50,000
- Convertible
- VOLUNTARY Jefferson Pilot Financial
- 10,000-500,000 employee
- 10,000 - 250,000 or 3.5x employee earnings for
spouse
- 2,500- 12,500 for children
- Spouse Children coverage available only with
additional voluntary employee coverage
- Guaranteed Issue under age 60-150,000 employee
50,000 spouse
- Portable
- See Rate Sheet for rate per 1,000 per month
27CANCER HEARTCARE VISION
- Cancer Heart Care
- Supplemental- in addition to health insurance
- Portable
- Contact Agent Jan Hunt for details-407-677-8448
- Cancer 16.98 individual 30.32 family
- Heart Care 23.46 individual 45.64 family
- Enrollment Form
- Vision 20/20 Eyecare Plan
- Network Providers
- Eye exam, lenses, and frames every 12 months
- 4 co-pay exam 10 co-pay for supplies In
Network
- 85.00 Frame Allowance
- 119 Contact Lenses Allowance in Lieu of
Eyeglasses
- Premiums/month 5.75 single 10.38 two-person
17.10 family
- Small out of network reimbursement
28LONG TERM CARE INSURANCE
- Nursing home, home health, caregiver, adult day
care
- Employee, spouse, parents, grandparents
- Premiums are after tax and do not increase with
age
- Three levels of benefits- DNB Lifetime Max
- Two plans- Non-Forfeiture Benefit Account
- Life insurance built in
- Guaranteed benefit increase option
- Guaranteed Issue
- Portable
- See Rate Sheet for rates per month
2930 DAYS FROM HIRE
- HEALTH
- DENTAL
- FLEXIBLE SPENDING ACCOUNTS
- VOLUNTARY LIFE INSURANCE
- CANCER
- HEART CARE
- VISION
- LONG TERM CARE INSURANCE
- Return New Hire Tax Savings Form all applicable
enrollment forms
30403b RETIREMENT PLAN
- Voluntary Pre-tax contributions allowed anytime
- Matching from College after 1 year of service
21 yrs old
- Possibly waive 1 year if from another college or
university
- Two core companies TIAA/CREF (800-842-2776)
Fidelity (800-343-0860)
- American Century (800-345-3533) TIAA/CREF SRA
for employee voluntary contributions only
- Loans hardship withdrawals only on TIAA SRA
- 100 Vested
- Employee maximum for 2005 14,000
- Catch up provisions- 50 years old (4,000) and 15
years (3,000)
- Complete Salary Reduction Agreement Account
Application(s)
- Sign up anytime and make changes anytime
31ADDITIONAL COLLEGE PROVIDED BENEFITS
- Long Term Disability
- Travel Accident Insurance
- Vision Discounts Outlook Vision Services, FOCUS