SIU New Employee Orientation

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SIU New Employee Orientation

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Title: SIU New Employee Orientation


1
SIU New Employee Orientation
  • Employee Benefits

2
Employee Benefits Staff
  • Mary Nippe
  • Employee Benefits/Employee Records Manager
  • Cathy Yeager
  • Benefits Services Supervisor
  • Sherri Thomas-Rich
  • Benefits Counselor
  • Holly Rick
  • Human Resources Representative
  • La Cretia Evans
  • Workers Compensation and Disability Coordinator

3
Session Agenda
  • Important information, Time Limits and
    Responsibilities
  • Retirement Benefits
  • Optional Benefit Programs
  • State Benefit Enrollment Rules and Guidelines
  • Health, Life and Dental Insurance Choices
  • Form Completion

4
Important Information, Time Limits
ResponsibilitiesImportant Information
  • Web sites
  • www.benefitschoice.il.gov
  • www.siu.edu/humres/
  • Forms and State Benefits handbook are on-line

5
Important Information, Time Limits
ResponsibilitiesBenefit Enrollment Time Limits
  • Health, Dental Life
  • 10 calendar days from date of orientation
  • Those who do not make a selection will be
    defaulted into the Quality Care Health, Opted
    into Quality Care Dental and will receive only
    basic life insurance with no optional life units.
  • Flex Spending Accounts
  • 60 days from date of hire
  • Voluntary Supplemental Long Term Disability
    Insurance
  • 60 days from date of hire
  • MetLife Long Term Care Insurance
  • 30 days from date of hire
  • Jefferson Pilot Supplemental Term Life Insurance
  • 30 days from date of hire
  • State Universities Retirement System (SURS)
  • 6 months from certification

6
Important Information, Time Limits
ResponsibilitiesSpecial Notice Regarding Social
Security
  • SIUC and its employees are exempt from Social
    Security participation.
  • Social Security will not be deducted from your
    paycheck.
  • Medicare is deducted from your pay.

7
State Universities Retirement System
  • 1901 Fox Drive
  • Champaign IL 61820
  • 1-800-275-7877

SURS
8
Retirement BenefitsSURS
  • Provides retirement, disability, death and
    survivor benefits.
  • 8 of salary is contributed to SURS
  • deductions begin from hire date
  • Members must choose from one of three retirement
    options plans
  • Traditional
  • Portable
  • Self Managed Plan (SMP)

9
Retirement BenefitsSURS - Plan Election
  • Employees have six months to make a decision.
  • One time, life-time irrevocable choice
  • If enrolled previously, no need to make another
    selection.
  • Default for no election is the Traditional Plan
  • Workbook packet, The Power of Choice will be
    sent to your home address along with enrollment
    form.
  • Keep a copy of the form for your records.
  • Return your election form to SURS in the postage
    paid envelope provided.
  • Call SURS at 1-800-ASK-SURS or visit their
    website at www.surs.com if you have additional
    questions concerning the retirement plan options.

10
Retirement BenefitsSURS - Disability
  • You may qualify for disability benefits if, after
    you have at least two years of service credit,
    you are sick or injured and unable to work for 60
    or more days.
  • If you become disabled due to an accident, there
    is no minimum service credit required to qualify
    for a disability benefit.

11
Retirement Benefits SURS Disability
  • Elimination Period
  • 60 days or through the exhaustion of your sick
    leave whichever is greater
  • Disability Benefit amount
  • 50 of your basic compensation on the day you
    became disabled, or 50 of your average earnings
    for the 24 months prior to the date you became
    disabled
  • Duration of Disability Benefits
  • The maximum you can draw disability is for 50 of
    your total earnings while a participant of SURS.

12
SIU Credit Union
  • 1217 West Main Street
  • P.O. Box 2888
  • Carbondale IL 62920-2888
  • www.siucu.org

13
Optional Benefit ProgramsC U At Work Program
  • As an employee of SIU, you are eligible to join
    the SIU Credit Union. Due to the partnership
    between SIU and the Credit Union, employees
    receive
  • Discounts on vehicle loan rates below the basic
    rate
  • Discounts on fixed rate home equity loans below
    the basic rate
  • Increases on certificate of deposits above the
    basic rate

14
Voluntary Supplemental Long Term Disability Plan
(LTD)
  • The Prudential Insurance Company of America
  • 290 West Mount Pleasant Avenue
  • Livingston, New Jersey 07039
  • 1-800-290-5903

15
Optional Benefit ProgramsPrudential LTD
  • Designed in consultation with SURS as a
    supplement to your disability coverage.

16
Optional Benefit ProgramsPrudential LTD
  • Advantages of participation
  • Economical group rates- typically lower than
    individual rates
  • Convenient payroll deduction
  • Benefits are not subject to income tax
  • Partial income replacement
  • Rates based on age and salary.

17
Optional Benefits ProgramsPrudential LTD Benefits
  • Monthly LTD benefit will be 66.67 of your
    monthly pre-disability earnings
  • If eligible to draw from SURS, LTD will only pay
    a maximum of 16.67 for a combined total of
    66.67
  • Benefits continue to age 65 if you are unable to
    perform any gainful occupation

18
Optional Benefit ProgramsPrudential LTD
  • Certain exclusions apply that are listed in your
    brochure including pre-existing conditions.
  • If you enroll within 60 days of your date of
    hire, there is no medical underwriting.
  • Complete and submit the enrollment form and
    coverage will begin after a 60-day waiting period.

19
Tax Deferred Annuities (TDA)
20
Optional Benefit ProgramsTax Deferred Annuities
  • Supplemental retirement investment, which also
    reduces your taxable income.
  • Defer a dollar amount or a percentage of income
  • Enroll or change at any time
  • Contributions are conveniently payroll deducted
  • Youre in control You can enroll, change
    contributions or cancel at any time

21
Deferred Compensation Program
  • 201 East Madison Street
  • PO Box 19208
  • Springfield IL 62794-9208
  • 1-800-442-1300

22
Optional Benefits ProgramsDeferred Compensation
Plan
  • Supplemental retirement investment plan, which
    also reduces your taxable income.
  • Administered by State of Illinois
  • Defer a dollar amount or a percentage of income
  • Contributions are conveniently payroll deducted
  • Youre in control You can enroll, change
    contributions or cancel at any time
  • www.state.il.us/com/employee/defcom

23
Workers Compensation
  • CareSys
  • 15 River Road, Suite 100
  • Wilton, CT 06897
  • 1-800-773-3221

24
Workers Compensation Program
  • Administered by the Illinois Department of
    Central Management Services Division of Risk
    Management in conjunction with CareSys
  • Steps to take if injured on the job
  • Seek appropriate medical care
  • Report injury to CareSys
  • 1-800-773-3221
  • Notify Supervisor
  • Notify Workers Compensation Coordinator
  • 453-6690

25
Long Term Care Insurance
  • MetLife
  • PO Box 3069
  • Warminster PA 18974-9961
  • 1-800-438-6388

26
Optional Benefit ProgramsLong Term Care Insurance
  • MetLife plan provides benefits that pay for
    long-term care services provided in your own
    home, assisted living facility or a nursing home.
  • What is long-term care?
  • Care needed as a result of injury, illness or
    aging, that prevents an individual from
    performing everyday activities like bathing,
    dressing and eating.

27
Flexible Spending Accounts (FSA)
  • Fringe Benefits Management Company (FBMC)
  • PO Box 1800
  • Tallahassee FL 32302-1800
  • 1-800-342-8017

28
Optional Benefit ProgramsWhat is an FSA?
  • An account that you set up and contribute a
    predetermined amount of money thru payroll
    deductions.
  • Deductions begin when you sign up until the end
    of the fiscal year.
  • This lowers your taxable income which saves in
    federal income taxes.
  • These accounts can be used for medical expenses
    or dependent care expenses.

29
Optional Benefit ProgramsFSA Types
  • Medical Care Assistance Plan (MCAP)
  • Allows eligible out-of-pocket medical, dental and
    vision expenses to be paid by tax-free dollars
    that is not covered by your insurance plan.
  • Dependent Care Assistance Plan (DCAP)
  • Allows eligible child and/or adult day care
    expenses to be paid with tax-free dollars.

30
FSA Account Info
  • MCAP
  • Minimum deposit is 20 per month or 240 a year
  • Maximum deposit is 416.66 per month or 5000 a
    year
  • DCAP
  • Minimum deposit is 20 per month or 240 a year
  • Maximum deposit is 416.66 per month or 5000 a
    year
  • DCAP amount is per family

31
Effective Dates of FSA
  • New hires Effective the first day of the pay
    period following the date the enrollment form was
    signed or the date of the event, whichever is
    later.
  • Mid year enrollments Effective the first day of
    the pay period following the date the enrollment
    form was signed or the date of the event,
    whichever is later.
  • Benefits Choice Effective date is 7/1/xx

32
FSA Plan Year
  • Calculate your expenses wisely. If you do not
    have enough expenses to cover the amount
    deposited into the account, the money left in
    your account will be forfeited.
  • Plan Year July 1 to June 30
  • You have until September 30 to turn in claims for
    the previous years plan. Claims must be in that
    plan year.
  • Grace Period July 1 to Sept 15. Expenses
    incurred through this time may come out of prior
    plan years MCAP account.

33
Getting Answers
  • www.myfbmc.com
  • Check account balance
  • Frequently asked questions
  • General information
  • Forms
  • www.benefitschoice.il.gov

34
MCAP EZ Reimburse Card
  • Can be used for MCAP Expenses only.
  • Annual fee of 20 will be deducted from your
    enrolled amount.
  • Electronically debits funds from your MCAP
    account when an eligible, uninsured medical
    expense is incurred.
  • Can be used for co-pays, deductibles,
    prescription co-pays over the counter items.

35
Enrollment and Reenrollment in FSAs
  • FSA booklets and enrollment forms are available
    at Human Resources.
  • You have 60 days from your date of hire to enroll
    or 60 days from a change in status.
  • If you elect to participate in an FSA,
    reenrollment is not automatic.
  • Re-enrollment packets will be sent to your home
    address during the benefits choice period May 1-
    31st
  • Return the re-enrollment papers to Benefits
    Office.

36
Flex Spending while on a Leave
  • To continue participation in the MCAP Program
    while off payroll, you must complete an MCAP
    COBRA form.
  • Forms may be obtained from the website, but you
    must submit them to the Benefits Office.

37
Flex Spending after Termination
  • You may continue participation in MCAP if you
    complete an MCAP COBRA form, prior to or at the
    time of termination.
  • Contact the Benefits Office for options that are
    available.

38
Prorate
  • To prorate or not to prorate?

39
Prorate Form
  • For employees on a 9-month academic appointment.
  • If your paycheck is not prorated, you will be
    billed by Central Management System (CMS) for
    your coverage over the summer months.
  • Payments are made directly to CMS.
  • Complete and submit prorate form by September 30

40
Insurance Benefits
41
State Of Illinois Employee Benefits
  • Administered by
  • Illinois Department of Central Management
    Services (CMS) - Bureau of Benefits.
  • Plan year
  • July 1 June 30

42
Opt Out
  • Allows employees who are full-time to opt out
    of the State insurance program.
  • Requirements
  • Provide proof of other coverage in another health
    plan
  • Complete Opt Out Election Certificate
  • Note Employees may not Opt Out to become a
    dependent of another member enrolled in a plan
    administer by the Department of Central
    Management System.

43
Waive Insurance Coverage
  • Allows employees who are part-time to waive
    coverage of the State insurance program.
  • Requirements
  • Do not have to show proof of other coverage
  • Must have basic life coverage
  • Note Employees may not waive coverage to be a
    dependent of another member enrolled in a plan
    administer by the Department of Central
    Management System.

44
Employee Eligibility
  • Full-time Employees who work 100 of a normal
    work week with at least a 8-month appointment
  • Part-time Employees who work a schedule of 50 or
    greater and have at least a 8-month appointment
  • Employees who are 50 to 99 pay a portion of
    State rate

45
Dependent Eligibility
  • Spouse
  • Natural child(ren)
  • Adopted child(ren)
  • Step child(ren)
  • Child with legal guardianship
  • Same sex domestic partner

46
Dependent Eligibility Cont.
  • Unmarried child age 19-23 who meet the following
    criteria
  • Enrolled as a full-time student
  • Financially dependent upon the member
  • Eligible to be claimed as a dependent for income
    taxes
  • Copy of class schedule of 12 or more credit
    hours or a letter from the schools registrar
    stating the child is a full-time student

47
Dependent Eligibility Cont.
  • Unmarried child age 19 and older who is mentally
    or physically handicapped and meets all the
    following conditions
  • Continuously disabled as determined by the Social
    Security Administration from a cause originating
    prior to age 19
  • Financially dependent upon the member
  • Eligible to be claimed as a dependent for income
    tax purposes

48
Medicare Eligible
  • Employees must supply a copy of their Medicare
    card for themselves or their dependents who are
    covered under Medicare.

49
Health Insurance Premiums
  • Employee Cost based on annual salary and plan
    selected
  • Dependent Cost based on number of dependents
  • one dependent
  • or 2 or more dependents
  • also on plan selected

50
Insurance Plans
  • Vision
  • Mental Health
  • Dental
  • Life Insurance
  • Health Plans

51
Vision
  • EyeMed Vision Care
  • PO Box 8504
  • Mason OH 45040-7111
  • 1-866-723-0512

52
Vision Coverage
  • Available to all employees and dependents covered
    under any of the state employee health plans.
  • Members choosing to Opt Out are not eligible
    for vision program.
  • Free to employees and dependents

53
EyeMed Benefits Summary
54
EyeMed Vision Care
  • Web www.eyemedvisioncare.com
  • Locate a provider
  • Review benefits available

55
EyeMed Vision Care
  • Providers
  • Private
  • Optical retailers available include
  • JC Penney Optical
  • Lens Crafters
  • Pearle Vision
  • Sears Optical

56
Using EyeMed
  • Schedule an appointment with an in-network
    provider and tell them you are a State of
    Illinois Plan Participant.
  • Provide SSN or ID to vision provider
  • Pay co-pay(s) at the time of visit
  • The provider and EyeMed will take care of the
    rest
  • Note For Lasik or PRK discount, contact the
    U.S. Laser Network at 1-877-5LASER6

57
Mental Health
  • Magellan Behavioral Health
  • Group Number 3181456
  • PO Box 2216
  • Maryland Heights MO 63043

58
Magellan Behavioral Health Employee Assistance
Program
  • Stress
  • Grief
  • Family or parenting issues
  • Alcohol or drug dependencies
  • Marital or relationship issues
  • Adjusting to change
  • Work/life balance
  • Child and elder care
  • Anger
  • Pre and postnatal concerns
  • Access is easy and confidential. Assistance is
    available 24 hours a day, 7 days a week, at no
    cost to you and your eligible dependents.
  • Call 1-800-513-2611 to speak with a trained
    professional on a variety of concerns, including
    but not limited to

59
Magellan - Cont.
  • Referral and authorization needed for seeing a
    counselor face-to-face.
  • www.magellanhealth.com
  • Online screening tools
  • Self-assessments
  • Personalized improvement plans

60
Quality Care Dental Plan
  • CompBenefits
  • Group Number 950
  • PO Box 4677
  • Chicago IL 60680-4677
  • 1-800-999-1669

61
Quality Care Dental Plan
  • Members are eligible to Opt Out
  • Reenrollment is not available until next Benefit
    Choice period
  • Plan Year is July 1 June 30

62
Quality Care Dental Plan
  • Allows member to go to the dentist of their
    choice and receive benefits for an extensive
    range of services
  • QCDP reimburses a predetermined maximum benefit
    amount for each covered service
  • Schedule of Benefits located at
    www.benefitschoice.il.gov or in the BC booklet
  • Members are responsible for any charges over
    scheduled benefit amount

63
Quality Care Dental Plan
  • 100 annual deductible for dental services other
    than diagnostic or preventive
  • Maximum benefit limit - 2,000 per person per
    plan year
  • Orthodontic maximum 1,500 lifetime (children
    under age 19)
  • Claim forms available for reimbursements
  • Cost
  • 10 employee only
  • 15 employee and one dependent
  • 17.50 employee and 2 or more dependents

64
Health Plans
  • Quality Care Health Plan
  • Health Alliance HMO
  • HealthLink OAP

65
Quality Care Health Plan
  • CIGNA HealthCare
  • PO Box 5200
  • Scranton PA 18505-5200
  • 1-800-962-0051

QCHP
66
QCHP
  • QCHP is the medical indemnity plan that offers a
    comprehensive range of benefits.
  • You may choose any physician or hospital for
    medical services.
  • Enhanced benefits by using a Preferred Provider
    Organization (PPO) hospitals, physicians and
    providers.

67
QCHP - Maximums Deductibles
  • Plan Year Maximum Benefit Unlimited
  • Lifetime Maximum Benefit Unlimited
  • Plan Year Deductible is based on the employees
    annual salary

68
QCHP - Deductibles Cont.
  • Deductibles these are in addition to the plan
    year deductible for members and dependents.

69
QCHP Out-Of-Pocket Maximums
  • Deductibles and eligible coinsurance payments
    accumulate toward annual out-of-pocket maximum.
  • Note Prescription drugs, behavior health
    coinsurance or co-payments penalties do not go
    towards out of pocket maximums.

70
QCHP Pre-Existing Conditions
  • New members and dependents are subject to
    possible health benefits limitations based on
    Pre-existing Conditions.
  • A Pre-existing Condition is any disease,
    condition (excluding maternity) or injury for
    which the individual was diagnosed, received
    treatment or services, or took prescribed drugs
    during the three months prior to hire.

71
QCHP Pre-Existing Conditions
  • No benefits are payable for any services relating
    to the Pre-Existing Conditions that are incurred
    during the first 6 months of coverage, unless
  • Proof of prior coverage for the member or
    dependents is provided. This is called a
    Certificate of Creditable Coverage.
  • Pre-Existing may be reduced up to 6 months,
    depending on length of prior coverage.

72
QCHP - Medical Plan Coverage
73
QCHP -Notification Requirements and Penalties
  • Notification is required for the following
  • Elective Inpatient Surgery or Non-Emergency
    Admission (7 days)
  • Maternity (No later than the third month)
  • Skilled Facility, Extended Care Facility or
    Nursing Home (7 days)
  • Emergency or urgent admission (within 2 business
    days following admission)
  • Outpatient Surgery or Procedures/Therapies (prior
    to receiving services)
  • Failure to notify within the required time
    limits will result in an 800 penalty and the
    risk of incurring non-covered charges for
    services not deemed to be necessary.

74
Quality Care Health Plan Prescription Drug Benefit
  • Medco Health Solutions
  • PO Box 14711
  • Lexington KY 405112
  • 1-800-899-2587 www.medco.com

75
QCHP - Pharmacy Coverage
  • Medco Health Solutions
  • Group Number 1400SD3
  • www.medco.com

76
Medco Health Solutions
  • All prescription medications are compiled on a
    formulary list in three levels
  • Note Drug list is subject to change at any time
    during the plan year.

77
Medco Non-Maintenance Medication
  • In-Network Pharmacy retail pharmacies that
    contract with Medco and accept the co-payment
    amount.
  • Kroger
  • Walgreens
  • Schnucks
  • Wal-Mart
  • Out-of-Network Pharmacy retail pharmacies that
    do not contract with Medco.

78
Medco Maintenance Medication Program (MMP)
  • Prescriptions considered maintenance
  • High blood pressure
  • High cholesterol
  • Asthma
  • Birth control
  • Retail Pharmacy Network This network of retail
    pharmacies contracts with Medco to accept certain
    co-payment amounts for maintenance medication.
  • CVS, Kroger, Schnucks, Wal-Mart and CVS
  • Find list of Retail Pharmacy Network providers at
    www.benefitschoice.il.gov
  • Note Receive 3 months of prescription drugs for
    the cost of 2!

79
Medco by Mail
  • Mail Order Prescriptions
  • Medco
  • PO Box 30493
  • Tampa FL 33630-3493
  • Receive a 90 day supply
  • Order refills online, by mail or phone.
  • Refills are delivered within 3 to 5 days.
  • Convenient payment options check, money order,
    credit card or automatic payment program.
  • Standard shipping is free.

80
Medco by Mail Cont.
  • To use Medco By Mail
  • Ask doctor to write a prescription up to a 90-day
    supply for each medication for 1 year.
  • Fill out Medco By Mail order form.
  • Send the completed form, your prescription, and
    payment option to Medco By Mail.
  • Note If you are currently taking a
    medications, be sure to ask your doctor for a
    second prescription for a 14-day supply to fill
    at a participating retail pharmacy while your
    mail-order is being processed.

81
Health Alliance HMO
  • 301 S. Vine Street
  • Urbana IL 61801
  • 1-800-851-3379

HMO
82
Health Alliance HMO
  • Managed care plan that has negotiated rates with
    participating network of physicians, hospitals
    and pharmacies.
  • Cost effective
  • Lower out-of-pocket costs
  • No annual deductible only co-payment
  • No reasonable and customary charges
  • No pre-existing conditions apply.

83
Health Alliance HMO Cont.
  • Member must select a Primary Care Physician (PCP)
    from a network of participating providers.
  • PCP directs health care services and must make
    referrals for specialist and hospitalizations.
  • Every person covered must choose a PCP may be
    changed at any time during the plan year by
    calling Health Alliance.
  • Well woman exams woman do not need a referral
    from their PCP They may go to any OB/GYN of
    their choice if a provider of Health Alliance.

84
Health Alliance HMOSummary of Benefits
85
Health Alliance HMOSummary of Benefits
86
Health Alliance HMO Cont.
  • PAL Patient Advisory Line
  • When you have a health problem that isnt an
    emergency but needs prompt attention, call
    1-800-581-3188 to speak to an experienced
    registered nurse, 24 hours a day.

87
Health Alliance HMOPrescription Drug Benefit
  • MedImpact Healthcare System, Inc.
  • 10680 Treena St., 5th Floor
  • San Diego CA 92131
  • 1-800-966-5772

88
Health Alliance HMO Prescription Drug Benefit
  • Administers their own prescription drug benefits
  • One card for both medical and pharmacy coverage
  • Must utilize a pharmacy in the plans Pharmacy
    Network
  • Carbondale Clinic Pharmacy, CVS Pharmacy, Kroger,
    Schnucks, Wal-mart and Walgreens

89
Health Alliance HMOPrescription Drug Benefit
Cont.
  • All prescription medications are compiled on a
    formulary list in three levels
  • Note Drug list is subject to change at any time
    during the plan year.

90
Health Alliance HMO Prescription Drug Benefit
Cont.
  • Mail order convenience through Walgreens
  • Complete registration form
  • New prescriptions must be mailed to the mail
    service pharmacy or faxed from your doctors
    office.
  • Allow two weeks for delivery
  • For long-term medications ask for two
    prescriptions one for a small supply to fill at
    the pharmacy and one for the mail order.

91
Health Alliance HMOPrescription Drug Benefit
Cont.
  • Choice 90Rx - receive a 90-day supply of
    maintenance medication at your local retail
    pharmacy and get a discount. 2.75 co-payments
    instead of 3 co-payments.
  • First Month Free - Members can receive their
    first month fill of any chronic Tier I
    prescription for Free.
  • Split the Pill, Split the Bill - For most members
    willing to split their pills, Health Alliance
    will split the cost, collecting HALF the normal
    co-payment.

92
HealthLink OAP
OAP
  • 12443 Olive Blvd.
  • St. Louis MO 63141
  • 1-800-624-2356

93
HealthLink OAP
  • Unique plan because it offers three benefit
    levels
  • Tier 1 Participating HMO Doctors and Hospitals
  • Highest level of benefits for covered services
  • Tier 2 Participating PPO Doctors and Hospitals
  • Middle level of benefits for covered services
  • Tier 3 Out-Of-Network Doctors and Hospitals
  • Lowest level of benefits for covered services

94
HealthLink OAP Cont.
  • All three tiers available you do not sign up
    for any level.
  • Members may mix and match providers without
    referrals. No calling needed.
  • Physician or specialist determines Tier and
    charge. Find out before you receive treatment.
  • No pre-existing conditions apply.
  • Large group of providers in St. Louis area under
    Tier I

95
HealthLink OAP - Benefit Overview
96
HealthLink OAP - Hospital Services Cont.
97
HealthLink OAP - Hospital Services
98
HealthLink OAP Cont.
  • MedCall provides medical information by phone 24
    hours a day, seven days a week.
  • National Allergy 15 discount off for products
    such as pillows, mattress, air filtrations.
  • Weight Watchers 10 discount for on-line users
  • VPI Pet Insurance 5 discount for members

99
HealthLink OAPPharmacy
  • Medco Health Solutions
  • PO Box 2080
  • Lees Summit, MO 6463-2080
  • 1-800-899-2587

100
HealthLink - Pharmacy Coverage
  • Medco Health Solutions
  • Group Number 1400SCF
  • www.medco.com

101
HealthLink Pharmacy Coverage
  • All prescription medications are compiled on a
    formulary list in three levels
  • Note Drug list is subject to change at any time
    during the plan year.

102
Medco Maintenance Medications Program (MMP)
  • Prescriptions considered maintenance
  • High blood pressure
  • High cholesterol
  • Asthma
  • Birth control
  • Retail Pharmacy Network This network of retail
    pharmacies contracts with Medco to accept certain
    co-payment amounts for maintenance medication.
  • CVS, Kroger, Schnucks, Wal-Mart and CVS
  • Find list of Retail Pharmacy Network providers at
    www.benefitschoice.il.gov
  • Note Receive 3 months of prescription drugs for
    the cost of 2!

103
Medco Non Maintenance Medications
  • In-Network Pharmacy retail pharmacies that
    contract with Medco and accept the co-payment
    amount.
  • Kroger
  • Walgreens
  • Schnucks
  • Wal-Mart
  • Out-of-Network Pharmacy retail pharmacies that
    do not contract with Medco.

104
Medco by Mail
  • Mail Order Prescriptions
  • Medco
  • PO Box 30493
  • Tampa FL 33630-3493
  • Receive a 90 day supply
  • Order refills online, by mail or phone.
  • Refills are delivered within 3 to 5 days.
  • Convenient payment options check, money order,
    credit card or automatic payment program.
  • Standard shipping is free.

105
Medco by Mail-Cont.
  • To use Medco By Mail
  • Ask doctor to write a prescription up to a 90-day
    supply for each medication for 1 year.
  • Fill out Medco By Mail order form.
  • Send the completed form, your prescription, and
    payment option to Medco By Mail.
  • Note If you are currently taking a
    medications, be sure to ask your doctor for a
    second prescription for a 14-day supply to fill
    at a participating retail pharmacy while your
    mail-order is being processed.

106
State of Illinois Group Life Insurance
  • Minnesota Life Insurance Company
  • One N. Old State Capitol, Suite 305
  • Springfield IL 62701
  • 1-888-202-5525

107
Life Insurance
  • Basic Life
  • Basic term life insurance is provided at no cost
    to members.
  • Coverage is equal to your annual salary
  • Member Optional Life
  • Employees may elect optional life up to 8 times
    the Basic Life coverage amount with a maximum of
    3,000,000 when combined with Basic Life
    coverage.
  • Optional units are in increments of your annual
    salary
  • New employees are eligible to elect 4 times
    salary without medical underwriting
  • Medical underwriting is necessary for units 5 8
  • Cost is determined by age and salary. See page
    12 of Benefit Choice Booklet

108
Life Insurance Cont.
  • Accidental Death and Dismemberment (ADD)
  • Death or dismemberment that results directly and
    independently of disease or bodily infirmity an
    accidental injury which is unexpected and
    unforeseen.
  • See page 13 of State of Illinois Group Life
    Insurance Program Booklet.
  • Cost is .02 per thousand.
  • Can be added at any time with no underwriting.
  • Member may choose the amount to be equal to
    salary or combined amount of basic and optional
    life, up to a total maximum of 5 times salary or
    3,000,000, whichever is less.

109
Life Insurance Cont.
  • Spouse Child Coverage
  • New members may add spouse or child life with no
    underwriting. If added later, medical
    underwriting is needed.
  • Maximum amount of coverage for spouse or children
    is 10,000
  • Cost for spouse 7.14 per month
  • Cost for child(ren) .56 cents per month

110
Life Insurance Cont.
  • Portability
  • If you terminate employment, you can continue
    your life insurance coverage by paying premiums
    directly to Minnesota Life. Premiums will be
    hirer than those paid by active employees.
  • Accelerate Benefits
  • If you are diagnosed with a terminal illness with
    life expectancy of 24 months or less, you can
    accelerate benefits.

111
State of Illinois Group Life Insurance
  • Minnesota Life Insurance Company
  • One N. Old State Capitol, Suite 305
  • Springfield IL 62701
  • 1-888-202-5525

112
Life Insurance
  • Basic Life
  • Basic term life insurance is provided at no cost
    to members.
  • Coverage is equal to your annual salary
  • Member Optional Life
  • Employees may elect optional life up to 8 times
    the Basic Life coverage amount with a maximum of
    3,000,000 when combined with Basic Life
    coverage.
  • Optional units are in increments of your annual
    salary
  • New employees are eligible to elect 4 times
    salary without medical underwriting.
  • Medical underwriting is necessary for units 5
    8.
  • Cost is determined by age and salary. See page
    12 of Benefit Choice Booklet.

113
Life Insurance
  • Accidental Death and Dismemberment (ADD)
  • Death or dismemberment that results directly and
    independently of disease or bodily infirmity an
    accidental injury which is unexpected and
    unforeseen.
  • See page 13 of State of Illinois Group Life
    Insurance Program Booklet.
  • Cost is .02 per thousand.
  • Can be added at any time with no underwriting.
  • Member may choose the amount to be equal to
    salary or combined amount of basic and optional
    life, up to a total maximum of 5 times salary or
    3,000,000, whichever is less.

114
Life Insurance
  • Spouse Child Coverage
  • New members may add spouse or child life with no
    underwriting. If added later, medical
    underwriting is needed.
  • Maximum amount of coverage for spouse or children
    is 10,000
  • Cost for spouse 7.14 per month
  • Cost for child(ren) .56 cents per month

115
Life Insurance
  • Portability
  • If you terminate employment, you can continue
    your life insurance coverage by paying premiums
    directly to Minnesota Life. Premiums will be
    hirer than those paid by active employees.
  • Accelerate Benefits
  • If you are diagnosed with a terminal illness with
    life expectancy of 24 months or less, you can
    accelerate benefits.

116
ING ReliaStar Voluntary Term Life Insurance
  • 20 Washington Avenue South
  • Minneapolis, MN 55401-1900
  • 1-800-955-7736

117
Voluntary Term Life Insurance
  • Member and Spouse Coverage
  • Coverage is available in 5,000 units up to
    200,000
  • Can apply to up to 5 times annual salary for
    member or spouse
  • 35,000 coverage is guaranteed for employee
  • 5,000 coverage is guaranteed for spouse
  • Rates based on employees age
  • Child(ren) coverage
  • 2,500 units to a maximum of 10,000 (Guaranteed)
  • Cost .40 cents per 2,500
  • Coverage continues to age 23 if unmarried and a
    full-time student

118
Benefit Change Periods
  • Annual Changes
  • Mid Year Changes

119
Annual Benefit Change Period
  • Every year during the month of May, employees
    have the option of making changes to their plans.
  • If you sign up for a plan and decide that plan
    is not for you, you have an opportunity to change
    plans. CMS will send to your home address the
    Benefit Choice Option Booklet with the change
    form included. This needs to be submitted during
    the month of May and becomes effective on 7/1/xx.
  • There are no pre-existing changing between
    plans, but if you are in the middle of treatment,
    you need to contact the plan that you are
    changing to, to make sure they will complete the
    services.

120
Annual Benefit Change Period
  • During the Benefit Choice Enrollment Period, you
    may
  • Change health plans, Opt Out, or Opt In
  • Elect to participate or not participate in dental
    plan
  • Increase/decrease optional life Statement of
    Health required
  • Add/drop dependent
  • Enroll/reenroll in Flex Spending Account

121
Mid Year Change
  • If during the year, you experience a change of
    status, you may change your benefits according to
    the status change.
  • See page 28 and 29 of the State of Illinois
    Benefit Handbook for status changes.
  • See page 30 and 31 for documentation
    requirements.
  • You have 60 days after the change to submit your
    benefit change. If you do not come within this
    time period, you will have to wait till the next
    Benefits Choice to make your change.

122
Examples of a Qualifying Change in Status
  • New born/newly acquired dependent
  • Marriage
  • Divorce
  • Death of spouse or dependent
  • Change in your spouses or dependents employment
    status
  • Dependent who no longer meets eligibility
    criteria
  • Change in Public Aid recipient status or Medicare
    status
  • Court order resulting in gaining or losing
    custody
  • Going on or off a Leave of Absence

123
Going on a Leave of Absence?
  • Here is what you need to know!

124
LOA Billing
  • You will be billed for your insurance while you
    are off payroll. You may make changes to reduce
    your premiums. Contact Employee Benefits to
    discuss your options.
  • If you do not pay while you are on a LOA, CMS
    Special Payment Programs Unit will collect
    payment through involuntary withholding. Contact
    CMS to arrange payment arrangements at
    1-800-442-1300.

125
Form Completion
  • Coordination of Benefits Worksheet
  • CMS Beneficiary Designation
  • SIUC HR Employee Benefits Enrollment Form

126
Coordination of Benefits Worksheet
  • Section A
  • Print your first, last name and Social Security
    Number
  • Check either you do not or do have other
    insurance coverage
  • Section B
  • If you checked you do have other coverage,
    complete this section.
  • A copy of your insurance card will be made during
    checkout.
  • Sign and date.
  • This form must be turned in.

127
CMS Beneficiary Designation
  • This form was sent prior to orientation.
  • If you need another form, please raise your hand.
  • Please complete the following
  • First Name, Middle Initial, and Last Name
  • Date of Birth
  • Social Security Number
  • Date Employed
  • Check appropriate box for member status (full
    time or part time employee)
  • Check the Transaction Type - Initial Designation

128
CMS Beneficiary Designation
  • List Primary and Contingent Beneficiaries
  • Provide as much information as possible.
  • Updates to address and social security numbers
    can be made anytime.
  • Minors listed as beneficiaries are not eligible
    to receive life insurance proceeds until age 18.
  • Legal Guardians will receive proceeds unless you
    indicate to hold proceeds until age 18.
  • Sign and date form
  • This form must be turned in.

129
Southern Illinois University CarbondaleGroup
Insurance Initial Enrollment Form
  • SECTION A Member Biographical Information
  • Member SSN ________________ AIS _________
    Hire Date _________/____
  • Last Name _________________ First Name
    __________________ MI _______
  • Marital Status (S/M) _____ Handicapped? (Y/N)
    ____ Birth date _____/_____/_____
  • Sex (M/F) _____ Receiving Medicare? (Y/N)
    _____(If yes, copy of card needed)
  • Member Street Address __________________________
    ___________________________________
  • City ____________________ State ____ Zip
    ________ County ______________
  • Home Phone ( ) ______ - _______ Work
    Phone ( ) ______ - ______

130
Section B Opt Out/Waive Coverage
131
Section C Health Plan Elections
132
Section D Dental Plan Option
133
Section E Life Insurance
134
Section E Life Insurance
135
Section F Dependent Information
136
Member Responsibilities
  • It is each Members responsibility to know their
    benefits and review the information in the State
    of Illinois Benefits Handbook.
  • Notify your Group Insurance Representative when
    any changes occur
  • Life changing event
  • Address Change
  • Loss of Eligibility
  • Leave of Absence
  • Other events (page 28 31)

137
REMINDER Turn in these Forms
  • Coordination of Benefits Worksheet
  • CMS Beneficiary Designation
  • SIUC HR Employee Benefits Form
  • Including documentation for any dependents

138
Completion
  • Please return the completed form to Human
    Resources Employee Benefits Office at
  • 805 S. Elizabeth Street, Carbondale IL 62901
    Mailcode 6520
  • Elections must be made within 10 days of your
    hire date.
  • If you need further explanations of any of these
    plans or any other issues, please contact us at
    the Employee Benefits Office at 618-453-6668.