New Employee Benefits Packet

Transcription

1 New Employee Benefits Packet University Benefits Administration University of Memphis 165 Administration Bldg

2 Contents General Insurance Information... 1 & 3 Dependent Eligibility Definitions & Required Documents... 2 Basic Health Insurance Health Insurance Comparison Chart Health Insurance Premium Chart... 8 Dental Insurance... 9 Dental Insurance Comparison Chart Vision Insurance Vision Insurance Comparison & Premium Chart Basic Term Life/AD&D Insurance Optional Special Accidental Insurance Optional Term Life Insurance Basic Life Coverage and Premiums Chart Optional Special Accidental Premium Chart Long Term Disability (Bi-Weekly Employees) Long Term Disability (Faculty and Administrative Personnel) AFLAC Supplemental Insurance Long Term Care Retirement Tax Deferred Annuity & Deferred Compensation Holidays Annual Leave, Sick Leave, and Sick Leave Banks Longevity Flexible Benefits Plan Educational Assistance Programs Employee Assistance Program Family Medical Leave Act Workers' Compensation COBRA... 28

3 General Insurance Information Effective Date of Insurance The following coverage begins on the first day of the month after one full calendar month of employment from your hire date: Health Dental Vision Basic Term Life and Accidental Death and Dismemberment Optional Special Accidental Death and Dismemberment For example, if your appointment/hire date is August 23, the above insurance coverage begins October 1. Optional Term Life coverage begins after three full calendar months from employment/eligibility. And coverage for Long Term Disability and AFLAC Supplemental insurance begins on the first day of the month after your hire date. Payroll deductions for insurance premiums are made a month in advance for most plans. A few plans, such as long term disability and flexible spending accounts, allow premiums to be paid the same month the coverage is effective. Example: health insurance premiums are deducted from your paycheck in September for October coverage, and long term disability premiums are deducted from your pay in September for coverage in September. Employee Eligibility Full-time employees regularly scheduled to work a minimum of 30 hours a week for a period expected to exceed six months Faculty employed a minimum of 30 hours a week for the full academic year Part-time employees with 24 months of service regularly working a minimum of 1450 hours per year [per state law, will not apply to employees hired on or after July 1, 2015]. Dependent Eligibility Legally married spouse Natural or adopted children Step-children, if you or your spouse has legal/joint custody, or shared parenting Children for whom you are legal guardian Dependent children are eligible for coverage through the last day of the month of their 26 th birthday. PROOF OF ALL DEPENDENT S ELIGIBILITY IS REQUIRED BY THE STATE OF TN. See the list of Dependent Definitions and Required Documents on page 2 for clarification. Dependents must be verified by submitting a copy of the required documentation before they can be enrolled. Please mark/black out any financial information on the copies of your documents. 1

4 DEPENDENT ELIGIBILITY Definitions and Required Documents TYPE OF DEFINITION REQUIRED DOCUMENT(S) FOR VERIFICATION DEPENDENT Spouse A person to whom the participant is legally married You will need to provide a document proving marital relationship AND a document proving joint ownership Proof of Marital Relationship Government issued marriage certificate or license Naturalization papers indicating marital status Proof of Joint Ownership Bank Statement issued within the last six months with both names; or Mortgage Statement issued within the last six months with both names; or Residential Lease Agreement within the current terms with both names; or Credit Card Statement issued within the last six months with both names; or Property Tax Statement issued within the last 12 months with both names; or The first page of most recent Federal Tax Return filed showing married filing jointly (if married filing separately, submit page 1 of both returns) If just married in the current calendar year, a marriage certificate only is acceptable proof of eligibility Natural (biological) child under age 26 A natural (biological) child The child s birth certificate; or Certificate of Report of Birth (DS-1350); or Consular Report of Birth Abroad of a Citizen of the United States of America (FS-240); or Certification of Birth Abroad (FS-545) Adopted child under age 26 Child for whom the participant is legal guardian Stepchild under age 26 Child for whom the plan has received a qualified medical child support order A child the participant has adopted or is in the process of legally adopting A child for whom the participant is the legal guardian A stepchild A child who is named as an alternate recipient with respect to the participant under a Qualified Medical Child Support Order (QMCSO) Court documents signed by a judge showing that the participant has adopted the child; or International adoption papers from country of adoption; or Papers from the adoption agency showing intent to adopt Any legal document that establishes guardianship Verification of marriage between employee and spouse and birth certificate of the child showing the relationship to the spouse; or Any legal document that establishes relationship between the stepchild and the spouse or the member Court documents signed by a judge; or Medical support orders issued by a state agency Never send original documents. Please mark out or black out any social security numbers and any personal financial information on the copies of your documents BEFORE you return them. 2

5 Special Enrollment Process If you do not enroll in medical insurance as a new hire, you or your dependents may apply for coverage by providing supporting documentation that one of the following qualifying events has occurred within the past 60 days and caused loss of coverage: Death of employee s spouse Divorce or legal separation Termination of spouse s employment Reduction in spouse s work hours below number required for benefits Spouse s employer discontinues total contributions to spouse s coverage Loss of TennCare coverage (excluding loss for lack of payment) You may also apply within 60 days of acquiring a new dependent (marriage, birth/adoption) without proving a loss of coverage Annual Enrollment Transfer Period (AETP) Each year in the fall, a 4-week period is designated as the Annual Enrollment Transfer Period. For 2015, September 15 October 15 has been designated as the AETP, and all elections and transfers made during that time will be effective January 1, Following is a partial list of what you can do during the AETP each year: Enroll in or transfer between health options Enroll in or transfer between dental plans Enroll in or transfer between vision plans Increase, decrease, or request Optional Life insurance coverage Add Optional Special Accidental Death and Dismemberment coverage Insurance Handbook The Eligibility and Enrollment Guide includes detailed information related to our insurance plans and a HIPAA information notice. The Guide may be viewed at and a printed copy is available during orientation. You will find links to the Insurance Handbook and all vendor handbooks at the State of TN Benefits Administration web site: 3

6 Basic Health Insurance Choice of two health insurance options: Partnership PPO Standard PPO PPO stands for preferred provider organization. With a PPO, you can see any doctor you want. However, the PPO has a list of doctors, hospitals and other healthcare providers that you are encouraged to use. These providers make up a network, and have agreed to take lower fees for their services. Network providers will always cost you less. You can visit any doctor or facility in the network; referrals by primary care physicians are not required. Both PPO options cover the same services, treatments and products, including the following: In-network preventive care, x-ray, lab and diagnostics at no cost Primary and specialist doctor office visits for a fixed co-pay without having to meet a deductible Prescription drugs for a fixed co-pay without having to meet a deductible Deductibles and co-insurance for certain services such as hospitalization, therapy, durable medical equipment, advanced imaging and ambulance Out-of-pocket maximums to limit your co-insurance costs (There is also a chart of covered services and their associated costs on pages 6-7.) The difference between the Standard PPO and the Partnership PPO There is one important difference between the Partnership PPO and the Standard PPO. If you choose the Partnership PPO, you must agree to a Partnership Promise. The Partnership Promise requires you to take certain steps to get or stay as healthy as you can. In return, you will pay less than you would with the Standard PPO. In general, the Partnership Promise is a commitment to: Know your health history Know your health risks Take actions to get and stay as healthy as you can The Partnership Promise is an annual commitment. In order to remain in the Partnership PPO, you must meet your commitment each year. You and all eligible family members must enroll in the same PPO. If you choose the Partnership PPO, your dependent spouse must also agree to the Partnership Promise. Children are not required to take action. In return for committing to the Partnership Promise, you will have lower premiums, copays, coinsurance, deductibles and out-of-pocket maximums than under the Standard PPO. If you sign up for the Partnership PPO, but do not satisfy the Partnership Promise, you will not be eligible for the Partnership PPO during the next plan year (January through December). 4

7 Choice of two network providers (regardless of whether you choose the Partnership PPO or the Standard PPO): BlueCross BlueShield of Tennessee CIGNA If you choose to enroll in health insurance coverage, you will need to select either BlueCross BlueShield of Tennessee or CIGNA as your network provider. Covered services, deductibles, co-pays and co-insurance amounts are the same for both carriers. There is a difference in premiums, however, by region. If you choose BlueCross BlueShield of TN in West Tennessee, you will pay $20 more per month for employee only coverage, and $40 more per month for all other premium levels. In East and Middle Tennessee, employees pay more for the CIGNA network. See the Health Insurance Premiums chart on page 8 for more information. If both you and your spouse are employees of the State of Tennessee, you have the choice of enrolling in separate plans or having one spouse cover the other. Be sure to discuss this with a Benefits Associate as it will affect the Basic Term Life coverage amount of the dependent spouse. Transferring between health plans You will have an opportunity to transfer between health insurance plans during the Annual Enrollment Transfer Period (AETP) held each year during the fall. Changes made during the AETP become effective January 1 of the following year. Cancellation of health insurance Health insurance premiums are automatically paid on a pre-tax basis. Therefore, cancellations or changes may only be processed with a valid family status change or during the Annual Enrollment Transfer Period. Handbooks and provider directories can be found on the Benefits web site at Additional information is located at the following sites: BlueCross BlueShield of TN Provider directory: (select Network S) Handbook: (Partnership) Handbook: (Standard) CIGNA Provider directory: (select Open Access Plus) Handbook: (Partnership) Handbook: (Standard) 5

8 Comparing the 2015 Partnership and Standard PPOs Services that Require Copays Services in this table ARE NOT subject to a deductible and costs DO APPLY to the annual out-of-pocket maximum, with the exception of in-network pharmacy, which has a separate out-of-pocket maximum. PARTNERSHIP PPO STANDARD PPO Covered Services IN-NETWORK OUT-OF-NETWORK [1] IN-NETWORK OUT-OF-NETWORK [1] Preventive Care Office Visits No charge $45 copay No charge $50 copay Well-baby, well-child visits as recommended by the Centers for Disease Control and Prevention (CDC) Adult annual physical exam Annual well-woman exam Immunizations as recommended by CDC Annual hearing and non-refractive vision screening Screenings including colonoscopy, mammogram and colorectal, Pap smears, labs, bone density scans, nutritional guidance, tobacco cessation counseling and other services as recommended by the US Preventive Services Task Force Outpatient Services Primary Care Office Visit $25 copay $45 copay $30 copay $50 copay Family practice, general practice, internal medicine, OB/GYN and pediatrics Nurse practitioners, physician assistants and nurse midwives (licensed healthcare facility only) working under the supervision of a primary care provider Including surgery in office setting and initial maternity visit Specialist Office Visit $45 copay $70 copay $50 copay $75 copay Including surgery in office setting Behavioral Health and Substance Abuse [2] $25 copay $45 copay $30 copay $50 copay X-Ray, Lab and Diagnostics Including reading, interpretation and results (not including advanced x-rays, scans and imaging) 100% covered after office copay, if applicable 100% covered up to MAC after office copay, if applicable 100% covered after office copay, if applicable 100% covered up to MAC after office copay, if applicable Allergy Injection 100% covered 100% covered up to MAC 100% covered 100% covered up to MAC Allergy Injection with Office Visit $25 copay primary; $45 copay specialist $45 copay primary; $70 copay specialist $30 copay primary; $50 copay specialist $50 copay primary; $75 copay specialist Chiropractors Visits 1-20: $25 copay Visits 21 and up: $45 copay Visits 1-20: $45 copay Visits 21 and up: $70 copay Visits 1-20: $30 copay Visits 21 and up: $50 copay Visits 1-20: $50 copay Visits 21 and up: $75 copay Pharmacy Out-of-Pocket Maximum $2,500 employee only; $5,000 all family tiers none $3,000 employee only; $6,000 all family tiers none 30-Day Supply 90-Day Supply (90-day network pharmacy or mail order) 90-Day Supply (certain maintenance medications from 90-day network pharmacy or mail order) [4] $5 copay generic; $35 copay preferred brand; $85 copay non-preferred brand $10 copay generic; $65 copay preferred brand; $165 copay non-preferred brand $5 copay generic; $30 copay preferred brand; $160 copay non-preferred copay plus amount exceeding MAC copay plus amount exceeding MAC copay plus amount exceeding MAC $10 copay generic; $45 copay preferred brand; $95 copay non-preferred brand $20 copay generic; $85 copay preferred brand; $185 copay non-preferred brand $10 copay generic; $40 copay preferred brand; $180 copay non-preferred Urgent Care Convenience Clinic or Urgent Care Facility $30 copay $35 copay Emergency Room Emergency Room Visit (waived if admitted) * $125 copay $145 copay * Services subject to coinsurance may be extra. copay plus amount exceeding MAC copay plus amount exceeding MAC copay plus amount exceeding MAC

9 Services that Require Coinsurance 2015 Deductibles and Out-of-Pocket Maximums Services in this table ARE subject to a deductible and eligible expenses DO APPLY to the annual out-of-pocket maximum. PARTNERSHIP PPO STANDARD PPO Covered Services IN-NETWORK OUT-OF-NETWORK [1] IN-NETWORK OUT-OF-NETWORK [1] Hospital/Facility Services 10% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance Inpatient care [3] Outpatient surgery [3] Inpatient behavioral health and substance abuse [2] [3] Maternity 10% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance Global billing for labor and delivery and routine services beyond the initial office visit Home Care [3] 10% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance Home health Home infusion therapy Rehabilitation and Therapy Services 10% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance Inpatient [3] ; outpatient Skilled nursing facility [3] Ambulance 10% coinsurance 20% coinsurance Air and ground Hospice Care [3] Through an approved program 100% covered up to MAC (even if deductible has not been met) 100% covered up to MAC (even if deductible has not been met) Equipment and Supplies [3] 10% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance Durable medical equipment and external prosthetics Other supplies (i.e., ostomy, bandages, dressings) Dental Certain limited benefits (extraction of impacted wisdom 10% coinsurance for oral surgeons 40% coinsurance for oral surgeons 20% coinsurance for oral surgeons 40% coinsurance for oral surgeons teeth, excision of solid-based oral tumors, accidental 10% coinsurance non-contracted providers 20% coinsurance non-contracted providers injury, orthodontic treatment for facial hemiatrophy or (i.e., dentists, orthodontists) (i.e., dentists, orthodontists) congenital birth defect) Advanced X-Ray, Scans and Imaging 10% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance Including MRI, MRA, MRS, CT, CTA, PET and nuclear cardiac imaging studies [3] Reading and interpretation 100% covered 100% covered up to MAC 100% covered 100% covered up to MAC Out-of-Country Charges N/A - no network 40% coinsurance N/A - no network 40% coinsurance Non-emergency and non-urgent care Deductible Employee Only $450 $800 $800 $1,500 Employee + Child(ren) $700 $1,250 $1,250 $2,350 Employee + Spouse $900 $1,600 $1,600 $3,000 Employee + Spouse + Child(ren) $1,150 $2,050 $2,050 $3,850 Out-of-Pocket Maximum Employee Only $2,300 $3,500 $2,600 $3,900 Employee + Child(ren) $3,200 $4,600 $3,800 $5,900 Employee + Spouse $3,700 $5,800 $4,500 $7,200 Employee + Spouse + Child(ren) $4,600 $7,500 $5,200 $9,500 No single family member will be subject to a deductible or out-of-pocket maximum greater than the employee only amount. Once two or more family members (depending on premium level) have met the total deductible and/or out-of-pocket maximum, it will be met by all covered family members. Only eligible expenses will apply toward the deductible and out-of-pocket maximum. Charges for non-covered services and amounts exceeding the maximum allowable charge will not be counted. [1] Subject to maximum allowable charge (MAC). The MAC is the most a plan will pay for a service from an in-network provider. For non-emergent care from an out-of-network provider who charges more than the MAC, you will pay the copay or coinsurance PLUS difference between MAC and actual charge. [2] The following behavioral health services are treated as inpatient for the purpose of determining member cost-sharing: residential treatment, partial hospitalization and intensive outpatient therapy. For certain procedures, such as applied behavioral analysis, electroconvulsive therapy, transcranial magnetic stimulation and psychological testing, prior authorization (PA) is required. [3] Prior authorization (PA) required. When using out-of-network providers, benefits for medically necessary services will be reduced by half if PA is required but not obtained, subject to the maximum allowable charge. If services are not medically necessary, no benefits will be provided. (For DME, PA only applies to more expensive items.) [4] Applies to certain antihypertensives; oral diabetic medications, insulin and diabetic supplies; statins.

10 PARTNERSHIP PPO Health Insurance 2015 Monthly Premiums State and Higher Education West Tennessee CIGNA BCBS EMPLOYER SHARE Employee Only $ $ $ Employee + Child(ren) $ $ $ Employee + Spouse $ $ $1, Employee + Spouse + Child(ren) $ $ $1, STANDARD PPO Employee Only $ $ $ Employee + Child(ren) $ $ $ Employee + Spouse $ $ $1, Employee + Spouse + Child(ren) $ $ $1, *For West TN, BCBS is the more costly carrier; therefore, there is a cost differential premium addition of $20 for single coverage and $40 for the family coverage tiers included in the premium above. In Middle and East Tennessee, CIGNA is the more costly carrier. 8

11 Choice of two dental insurance options: State of Tennessee Prepaid Plan Preferred Dental Organization Dental Insurance The State of Tennessee Prepaid Plan (Prepaid Plan), offered through Assurant Employee Benefits, provides dental services at predetermined copayment amounts, which are reduced fees for dental treatments when members receive services from their pre-selected Participating General Dentist or from a Participating Specialist. There are no deductibles, no claims to file, no waiting periods for covered members, and no annual dollar maximum. Pre-existing conditions are covered. The Preferred Dental Organization (PDO), offered through Delta Dental of Tennessee, offers flexibility in that members may choose any dentist; however, members receive maximum benefits when visiting a PDO Network Provider. No referrals are required with the PDO option, and you or your dentist will file claims for covered services. Some services require waiting periods, and limitations and exclusions apply. Please refer to the vendor materials for complete information on coverage, limitations and exclusions. Coverage is available to you and eligible dependents. The chart below depicts the monthly cost of each plan. Assurant Prepaid Plan 2015 Premiums Delta Dental PDO Plan Employee Only $10.13 $21.51 Employee + Child(ren) $21.03 $49.46 Employee + Spouse $17.95 $40.69 Employee + Spouse + Child(ren) $24.68 $79.62 Each year the Annual Enrollment Transfer Period gives you the opportunity to add, change or cancel your dental coverage. Additional information is located at the following sites: Assurant Employee Benefits Provider directory: (choose Tennessee under "DHMO/Prepaid/Managed Care Plans:), or call Handbook: Delta Dental Provider directory: UserSection=subscribers (choose "Delta Dental PPO") Handbook: 9

12 Covered Dental Services Here is a comparison of deductibles, copays and your share of coinsurance under the dental options. Costs represent what the member pays. Assurant PREPAID OPTION Delta PDO OPTION Covered Services General Dentist Specialist Dentist In-Network Out-of-Network Annual Deductible None None $100 single; $300 family, per policy year [5] Annual Maximum Benefit None $1,500 per person, per policy year Pre-existing Conditions Covered Some exclusions Office Visit $10 copay [3] No charge 20% of MAC Periodic Oral Evaluation No charge No charge 20% of MAC Routine Cleaning No charge No charge 20% of MAC X-ray Intraoral, Complete Series No charge $5 copay 20% of MAC 40% of MAC Amalgam (silver) Filling 2 Surfaces Permanent Endodontics Root Canal Therapy Molar (excluding final restoration) Major Restorations Crowns (porcelain fused to high noble metal) $8 copay $10 copay 20% of MAC 40% of MAC $250 copay $600 copay 50% of MAC $275 copay, plus lab fees [1] 50% of MAC [4] Extraction of Erupted Tooth (minor oral surgery) $15 copay $70 copay 20% of MAC 40% of MAC Removal of Impacted Tooth Complete Bony (complex oral surgery) $100 copay $120 copay 50% of MAC Dentures Complete Upper $310 copay, plus lab fees [1] 50% of MAC [4] Orthodontics 25% off participating orthodontist s usual fees 50% of MAC [4] Annual Deductible None None Lifetime Maximum None $1,250 (including any benefits received under a prior dental plan ) [2] Waiting Period None 12 months Age Limit None Up to age 19 MAC Maximum Allowable Charge The benefits listed are a sample of the most frequently utilized dental treatments. Refer to vendor materials for complete information on coverage, limitations and exclusions. [1] Members are responsible for additional lab fees for these services. [2] If an individual had coverage through another dental plan, they may also have had a lifetime maximum for orthodontia. The orthodontia maximum is a lifetime benefit, which means, if an individual enrolls under the PDO, the benefit amount will not start over again. The benefits for orthodontia under the PDO would be adjusted based on the benefits a member may have received previously through another dental plan. [3] A charge of $20 may apply for a missed appointment when the member does not cancel at least 24 hours prior to the scheduled appointment. [4] A 12-month waiting period applies. [5] Does not apply to diagnostic and preventive benefits such as periodic oral evaluation, cleaning and x-ray. 10

13 Choice of two health insurance options: State of Tennessee EyeMed Tennessee Board of Regents VSP Vision Insurance Regular full-time employees at the University of Memphis may enroll in optional vision insurance as a new employee. If you choose not to enroll as a new employee, you may elect coverage for yourself, and dependents, during the Annual Enrollment Transfer Period. Employees may choose between two Vision plans or elect coverage from both. The State of Tennessee (State) offers coverage through EyeMed and the Tennessee Board of Regents (TBR) offers coverage through VSP Vision Care. Each plan offers two coverage plans; a basic plan and a more comprehensive plan. Services and materials must be received from a participating provider to receive the highest benefit. Basic (State)/Bronze (TBR) Plan Free complete eye exam 15% off contact lens exam $50 discount on eyeglass lenses & contact lenses 20% off eyeglass lens options (scratch-resistant, progressives, etc ) $50 discount on frames, then 20% discount on remaining cost Expanded (State)/Gold (TBR) Plan $10 co-pay for complete eye exam Maximum $60 co-pay for contact lens exam (fitting and evaluation) $15 co-pay for eyeglass lenses glass or plastic, single vision, lined bifocal, lined trifocal, or lenticular prescriptions $10-$70 co-pay for various eyeglass lens options (scratch-resistant, antireflective, progressives, etc ) $15 co-pay (State Expanded plan, $0 for TBR Gold plan) for eyeglass frames or contact lenses up to a retail price of $130, 20% discount on remaining cost EYEMED VSP Basic Expanded Bronze Gold Employee Only $3.35 $5.86 $4.42 $9.59 Employee + Spouse $6.35 $11.14 $8.84 $19.21 Employee + Child(ren) $6.69 $11.72 $9.48 $20.54 Employee + Spouse + Child(ren) $9.83 $17.23 $15.15 $32.84 Additional information is located at the following sites: State of Tennessee EyeMed Plan: Tennessee Board of Regents VSP Plan: 11

14 Insurance Enrollment Form Vision Comparison Basic Expanded Bronze Gold Routine Eye Exam $0 copay $10 copay $0 copay $10 copay Eyeglasses Frames EyeMed - State of TN $50 allowance $115 allowance $50 allowance VSP - TBR $130 retail / $50 wholesale allowance, less $15 copay 20% discount after allowance 20% discount after allowance 20% discount after allowance 20% discount after allowance Eyeglass Lenses (glass or plastic) Single, Bifocal, Trifocal & Lenticular $50 allowance; 20% off balance $15 copay $50 allowance $15 copay Eyeglass Lens Options (upgrades) Progressive/No-line $55 copay $55 copay Anti-reflective 20% off all options $45 copay 20% off all options $43 copay Polycarbonate ($0 for children under 18) $30 copay $33 copay Photochromics $70 copay $70 copay Scratch resistance coating $15 copay $17 copay Exam for Contact Lenses (Fitting & Evaluation) Contact Lenses Conventional $50 allowance; 15% off balance $130 allowance; 15% off balance Disposable $50 allowance $130 allowance Lasik/Refractive Surgery Frequency Eye Exam 15% discount 15% off regular price once per calendar year up to $60 copay 15% off regular price once per calendar year 15% discount $50 allowance average 15% off regular price or 5% off promo price once per calendar year up to $60 copay; 15% discount up to $130 allowance average 15% off regular price or 5% off promo price once per calendar year Eyeglass Lenses and Contacts once per calendar year once per calendar year once per calendar year once per calendar year Frames once per two calendar years once per two calendar years once per calendar year once per two calendar years 2015 Monthly Premiums EyeMed - State of TN VSP - TBR Basic Expanded Bronze Gold Employee Only $3.35 $5.86 $4.42 $9.59 Employee + Spouse $6.69 $11.72 $9.48 $20.54 Employee + Child(ren) $6.35 $11.14 $8.84 $19.21 Employee + Spouse + Child(ren) $9.83 $ $15.15 $32.84

15 Basic Term Life and Accidental Death & Dismemberment Insurance All benefit eligible employees are provided a $20,000 basic term and $40,000 basic accidental death and dismemberment life insurance coverage at no cost to the employee. If you are enrolled in the health insurance plan the coverage amounts increase, up to $50,000 term life and $100,000 of accidental death and dismemberment, based on your age and salary. In addition, any dependents enrolled in the health plan receive $3,000 term life insurance. The dependents are also covered for an additional amount of accidental death and dismemberment based on the employee s salary. Please see the chart on page 14 for coverage amounts and premiums. Optional Special Accidental Insurance Optional Special Accidental and Dismemberment Insurance is offered through Minnesota Life Insurance Company. It is offered in addition to the life and accident coverage included in the basic health and life insurance program. A chart of the coverage and monthly premium amounts can be found on page 15. The plan pays 100% of the plan benefits for accidental death and up to 50% for dismemberment. If you and/or your eligible dependents do not elect coverage as a new employee for this plan, you may enroll during the Annual Enrollment Transfer Period with no health questions. Optional Term Life Insurance Employees may enroll in the Optional Term Life Insurance plan available through Minnesota Life Insurance Company. During your first 30 days of employment you may apply for coverage for up to five times your annual salary without proving insurability. And you may apply for up to seven times your salary (maximum $500,000) by completing a health questionnaire. The effective date of coverage will be the first day of the month following three full months of employment. If you terminate employment with the University, you may continue the optional life insurance on a direct billing with Minnesota Life. Optional Term Life is a death benefit only; there is no cash value. The premiums are based on your age and increase over time. You may also insure your eligible dependents. If you do not elect coverage as a new employee, you may apply for coverage during the Annual Enrollment Transfer Period. You would be subject to a health questionnaire at that time. Member Handbook: 13

16 2015 Basic Life Coverage and Premiums Under Age 65 Age Age Age 75+ Salary Term life amount* Under $15,000 $15,000- $17,499 $17,500- $19,999 $20,000- $22,499 $22,500- $24,999 $25,000- $27,499 $27,500- $29,999 $30,000- $32,499 $32,500- $34,999 $35,000 and over $20,000 $22,000 $25,000 $30,000 $33,500 $37,000 $40,500 $44,000 $47,500 $50,000 Employee only Employee + child(ren) EE + spouse and /or EE+sp+child(ren)** Term life amount* $13,000 $14,300 $16,250 $19,500 $21,775 $24,050 $26,325 $28,600 $30,875 $32,500 Employee only Employee + child(ren) EE + spouse and /or EE+sp+child(ren)** Term life amount* $9,000 $9,900 $11,250 $13,500 $15,075 $16,650 $18,225 $19,800 $21,375 $22,500 Employee only Employee + child(ren) EE + spouse and /or EE+sp+child(ren)** Term life amount* $6,000 $6,600 $7,500 $9,000 $10,050 $11,100 $12,150 $13,200 $14,250 $15,000 Employee only Employee + child(ren) EE + spouse and /or EE+sp+child(ren)** *This is the employee term life coverage amount. Employee also receives accidental death and dismemberment for an amount equal to 2 times the employee s term life insurance coverage; $3,000 term life insurance for spouse and each covered dependent; schedule for spouse and eligible dependent accident coverage is listed in the Minnesota Life Member Handbook. ( **If spouse is also a State of TN employee, spouse coverage is $20,000 of term life and $40,000 of accidental death and dismemberment coverage. 14

17 Schedule Number Optional Accidental Death and Dismemberment Insurance Schedule of Benefits and Premiums Effective 1/1/2015 Base Annual Earnings Employee only Spouse, no child Coverage Spouse with children Spouse Each child Single Cost Family 1 Less than $3,000 $6,000 $4,000 $2,000 $1,000 $0.21 $ $3,000 - $3,999 9,000 5,000 3,000 1, $4,000 - $4,999 12,000 7,000 4,000 2, $5,000 - $5,999 15,000 9,000 5,000 2, $6,000 - $6,999 18,000 11,000 7,000 2, $7,000 - $7,999 21,000 13,000 8,000 3, $8,000 - $8,999 24,000 15,000 10,000 3, $9,000 - $9,999 27,000 17,000 11,000 3, $10,000 - $12,499 32,000 19,000 13,000 3, $12,500 - $14,999 38,000 23,000 15,000 4, $15,000 - $17,499 44,000 26,000 18,000 4, $17,500 - $19,999 50,000 30,000 20,000 5, $20,000 and over 60,000 36,000 25,000 5, The Optional Special Accident Insurance is paid totally by the employee. Employees whose spouse works for another State of TN agency must carry family coverage if they wish to cover their dependent children; the spouse is not covered unless he/she is under the single coverage. 15

18 Long Term Disability Bi-Weekly Employees Employees paid bi-weekly may enroll in a long-term disability insurance plan offered by Prudential. The cost is dependent upon your age, salary, and the level of coverage you choose. There are three levels of coverage available: Level #1 replaces 50% of your pre-disability earnings to a maximum of $6,000 per month after 180 days of disability. Your benefit will never be less than $100. Level #2 replaces 60% of your pre-disability earnings to a maximum of $6,000 per month after 120 days of disability. Your benefit will never be less than $100. Level #3 replaces 60% of your pre-disability earnings to a maximum of $6,000 per month after 90 days of disability. Your benefit will never be less than $100. To calculate your cost: 1. Enter your annual earnings: $ 2. Divide by 1,200: $ 3. Enter your rate from the table below: $ 4. Multiply line 2 by line 3. This is your monthly cost. $ *Maximum $144,000 for Level #1; $120,000 for Level #2; $120,000 for Level #3. Age Level #1 Level #2 Level #3 Under 35 $.091 $.140 $ If you decline coverage as a new employee, you may apply for coverage during the Annual Enrollment Transfer Period by completing a special enrollment form and health statement. Your information will be reviewed by the insurance company and approved or denied at that time based on the health questionnaire. The plan booklet may be viewed at 16

19 Long Term Disability Faculty and Administrative Employees Faculty and administrative employees may enroll in a long-term disability insurance plan offered by Prudential. The cost is dependent upon your salary and the level of coverage you wish to carry. A cost-of-living adjustment benefit equal to 3% multiplied by and added to your monthly benefit will be payable every year that you remain totally disabled. The plan offers three levels of coverage: Level #1 replaces 50% of your pre-disability earnings to a maximum of $2,000 per month after 180 days of disability. Your benefit will never be less than $50. Level #2 replaces 60% of your pre-disability earnings to a maximum of $4,000 per month after 120 days of disability. Your benefit will never be less than $75. Level #3 replaces 60% of your pre-disability earnings to a maximum of $7,000 per month after 90 days of disability. Your benefit will never be less than $100. To calculate your cost: 1. Enter your annual earnings*: $ 2. Divide by 1,200: $ 3. Enter your rate from the table below: $ 4. Multiply line 2 by line 3. This is your monthly cost. $ *Maximum $48,000 for Level #1; $80,000 for Level #2; $140,000 for Level #3. Level #1 Level #2 Level #3 $.105 $.148 $.195 If you decline coverage as a new employee, you may apply for coverage during the Annual Enrollment Transfer Period by completing a special enrollment form and health statement. Your information will be reviewed by the insurance company and approved or denied at that time based on the health questionnaire. The plan booklet may be viewed at 17

20 AFLAC Supplemental Insurance AFLAC supplemental insurance plans are designed to help offset certain out-of-pocket expenses associated with injuries and/or illness that traditional insurance does not cover. These plans pay benefits directly to you, not your insurance company, and you may use the money wherever you need. Regular full-time employees of the University of Memphis have several different plans available to them through AFLAC: Group Hospital Indemnity - Provides benefits for hospital inpatient stays as a result of covered accidents and sickness. Examples include: $200/day, up to 180 days $300 per hospital admission $200/day, up to 30 days for ICU stays Group Accident Insurance - Pays a benefit for the treatment of injuries suffered as the result of a covered accident. Benefits are paid regardless of any other health insurance benefits the insured may receive. Examples include: $1,000 hospital admission Leg fracture up to $2,700 Dislocated shoulder up to $2,600 Laceration requiring stitches up to $400 Group Critical Illness - Provides a lump-sum benefit upon the diagnosis of a covered illness. Examples include: $5,000 - $50,000 initial diagnosis of cancer, heart attack, stroke, and more Receive $75 for having a covered health screening (mammogram, colonoscopy ) Personal Sickness Indemnity - Provides benefits for hospitalization, physician visits, surgery and more. Examples include: $20 per physician visit (up to 4 each year) Up to $150/day hospital confinement Up to $2,000 for surgery Cancer Indemnity - Provides benefits for surgical and nonsurgical treatments, hospitalization, and home care related to cancer. Examples include: $1,000 for initial treatment Up to $350/day hospital confinement $250/week during radiation therapy Limitations and exclusions apply to all AFLAC plans; please see the related plan brochures for details. To enroll, contact Debbi Booker at or [email protected] within 31 days of your employment date. Additional information is located at the following site: AFLAC information and brochures: 18

21 Long Term Care Insurance Long-term care insurance benefits cover certain services required by individuals who are no longer able to care for themselves without the assistance of others. When an individual is unable to perform certain tasks defined as activities of daily living, long-term care insurance provides coverage for home care, nursing facility or assisted living facility, and certain community-based services. The program is structured so that you make choices in the amount and duration of coverage. The benefit choices are the ones, other than your age, which will determine the amount of the monthly premium. 1. First, you choose from three daily benefit amount levels: $100, $150 or $200 per day for room and board in an assisted living or nursing home setting and a corresponding benefit for home care, adult day care, hospice and respite care of $60, $90 or $ Next, you decide on the benefit period of either three years (1095 days) or five years (1825 days). This is the duration of time your benefits will last if you spend the daily benefit amount. Should you use less than the daily maximum, your benefits will actually last longer. 3. And, finally, you may choose to add inflation protection, which will increase your daily benefit amount at the compounded inflation rate of five percent annually. If you choose not to include inflation protection, the amounts will remain the same regardless of the impact of the cost of these services due to inflation. Choosing the inflation protection option will result in a higher premium; however, the value of your coverage you purchase today will be increased to offset rising long-term care costs. Employees and their eligible dependents, parents, and parents-in-law may apply for coverage. As an employee, you will not be subject to a health questionnaire if applying within 90 days from your hire date. After the 90 days, you may apply at any time but will be subject to a health questionnaire. All other eligible family members, regardless of when they apply, must provide health information and be approved for coverage by MedAmerica. The plan is offered through MedAmerica Insurance Company. More detailed information may be found at the MedAmerica web site ( or by calling

22 State of TN Retirement Programs effective July 1, 2014 Eligibility All regular full time employees of the University of Memphis are required to participate in a State of TN retirement program. Regular part time employees are eligible, but not required to participate. Employees who are non-us citizens on F-1 or J-1 visas are not eligible for retirement membership. As soon as you gain H-1 visa status or become a permanent resident, you must contact University Benefits Administration to enroll. Employees who have current membership (because of previous State of TN employment) in either TCRS or the ORP may be eligible for the legacy TCRS/ORP programs. Employees paid on an hourly basis will be enrolled in the Hybrid Tennessee Consolidated Retirement System (TCRS). Regular academic, executive, and administrative employees shall have the option of becoming a member of either TCRS or the ORP. Retirement Programs Highlights Hybrid TN Consolidated Retirement System is a combination of a defined benefit plan and a defined contribution plan. The defined benefit portion is managed by TCRS and benefits are defined according to length of service and salary. The defined contribution assets will be deposited into the State s 401(k) plan. Contributions are both employee and employer paid. Defined benefit contributions: o Employee contributes 5% of gross salary o Employer contributes 3.87% of gross salary Defined contribution (the State s 401(k) plan): o Employee contributes 2% of gross salary (with opt-out feature) o Employer contributes 5% of gross salary 5 year vesting for defined benefit portion Defined benefit retirement benefit is based on years of service and average salary Disability benefit available if vested May apply additional service credit for sick leave accruals and military leave Optional Retirement Program is a defined contribution plan. Employees who participate in the ORP may direct contributions to one or more of the three vendors designated under the State's ORP. These companies are VOYA, TIAA-CREF, and VALIC. Auto-enrollment into the State s 401(k) is included with this plan. Contributions are both employee and employer paid. Employee contributes 5% of gross salary Employer contributes 9% of gross salary Auto enrolled into State s 401(k) with employee contribution at 2% (with opt-out feature) Additional information is located at the following sites: TCRS: ORP:

23 Tax Deferred Annuity and Deferred Compensation Plans The University of Memphis offers four long-term savings plans designed to supplement income after retirement. You may enroll at any time in the following programs: Traditional 401(k) a deferred compensation plan ROTH 401(k) a post-tax deferred compensation plan designed as a deferred compensation plan for State government employees 403(b) - designed for educational and nonprofit institutions Contributions Employees may contribute a specified dollar amount to the plans through salary reduction. Amounts contributed do not affect retirement or social security. Contributions and earnings on the plans are not subject to federal income tax until funds are withdrawn (with exception of the ROTH 401(k) plan). Generally, withdrawals are not permitted before age 59 1/2 or retirement. Early withdrawals are subject to taxes and IRS regulations and penalties. The minimum monthly contribution is $20. The table below shows the annual maximum amounts that can be contributed to these programs. 401(k) Traditional/ROTH and 403(b) combination 457 Age/Calendar Year Less than age 50 $18,000 $18,000 Age 50 or older $24,000 $24,000 Traditional 401(k), 401(k) ROTH, and 457 The Traditional 401(k), 401(k) ROTH, and 457 are administered by Empower (formerly Great West). Each program offers the same investment options. With at least the minimum contribution in the 401(k), the State of TN will also contribute a match between $20 and $50 per month. There is not a match in the (b) There are currently 3 companies that are available for investment in the 403(b). Those companies are VALIC,VOYA, and TIAA-CREF. There is not a match in the 403(b). Additional information is located at the following site: University Benefits Administration: 21

24 Holidays The following dates will be observed as University holidays: 2015 Calendar Year Date January 1, 2015 January 19, 2015 May 25, 2015 July 3, 2015 September 7, 2015 Description New Year s Day Martin Luther King, Jr. Day Memorial Day Independence Day Labor Day November 26-27, 2015 Thanksgiving Day & 1 Administrative Closing Day December 24-31, Christmas Day & 5 Administrative Closing Days 2015* *New Year s Day for 2016 will be observed Friday, January Calendar Year Date January 1, 2016 January 18, 2016 May 30, 2016 July 4, 2016 September 5, 2016 November 24-25, 2016 December 23-30, 2016* Description New Year s Day Martin Luther King, Jr. Day Memorial Day Independence Day Labor Day Thanksgiving Day & 1 Administrative Closing Day Christmas Day & 5 Administrative Closing Days *New Year s Day for 2017 will be observed Monday, January 2. 22

25 Annual Leave, Sick Leave And Sick Leave Banks The University of Memphis offers a generous leave program to all regular employees. Employees hired on a temporary appointment are not eligible for these programs. Annual Leave **Executive, administrative, professional, and twelve-month academic personnel, who are regular full-time employees, shall accrue annual leave at the rate of 15 hours (2 days) per month. **Regular full-time clerical and support personnel shall accrue annual leave in accordance with the number of years of service: Years of Service Accrual Rate per Month hours hours hours 20 or more 15.0 hours **Nine, ten, and eleven-month faculty, full or part-time, whether or not compensated over a twelve-month period, are not eligible to accrue annual leave. Sick Leave All regular full-time employees, employed on a twelve-month or nine-month basis, accrue sick leave at the rate of 7.5 hours per month. Sick Leave Banks Staff and Faculty Sick Leave Banks provide sick leave hours to their members for personal illness or injury after all other leave has been exhausted. All regular full and part-time employees are eligible. To join you will be assessed 22.5* hours of sick leave. To use the bank hours, you must have been a member for 30 days and your initial request may not exceed 20 days. Pre-existing conditions will not be covered during the first 12 months of membership. The Sick Leave Bank Trustees have the right to review all requests prior to approval for usage of sick bank time. Employees may enroll any time of the year by contacting the Benefits Administration office. *Prorated for part-time employees 23

26 Longevity The State of Tennessee offers longevity pay for employees who work eighty-two percent (82%) of full time or more as a bonus for years of service. You will begin receiving longevity pay after you have completed three (3) years of employment with the State of Tennessee. Longevity is rewarded at a rate of $100 per year, up to a maximum of $3,000, and is paid on the second pay period of your anniversary month (biweekly) or in your regular pay for that month (monthly). Flexible Benefits Plan The Flexible Benefits Plan, often called a cafeteria plan, allows you to pay for certain benefits on a tax-free basis. The plan, sanctioned under the Internal Revenue Code Section 125, is administered by Payflex. There are four benefit options to this plan. 1. Medical Insurance Premiums - Medical insurance premiums are automatically deducted on a tax-free basis. 2. Dental Insurance Premiums Dental insurance premiums are automatically deducted on a tax-free basis. 3. Medical Expense Flexible Spending Account - You may elect to have an additional reduction of salary made each pay period to an account on a tax-free basis for eligible medical expenses. As eligible expenses (deductibles and copayments are examples) are incurred, tax-free withdrawals from your account may be made to reimburse yourself. This election can be made as a new employee and then must be made again each year during the Annual Enrollment Transfer Period. 4. Dependent Care Expense Flexible Spending Account - You may also elect to have an additional reduction of salary made each pay period to an account on a taxfree basis for dependent care expenses. As the expenses are incurred, tax-free withdrawals from your account may be made to reimburse yourself. This election can be made as a new employee and then must be made again each year during the Annual Enrollment Transfer Period. You do not have to be enrolled in the group health insurance program in order to participate in the medical reimbursement or dependent day care accounts. Elections are effective the first of the month after 1 full calendar month of employment and ends on December 31 of that calendar year. You are locked into your elections for the calendar year unless you have a family status change, such as changes in spouse s employment or acquiring a new dependent. You must re-elect the Medical and Dependent Care Expense options during each Annual Enrollment Transfer Period for the next calendar year. Additional information is located on the following sites:

27 Educational Assistance Programs The University of Memphis, and Tennessee Board of Regents offer two programs, Staff Scholarship and PC-191 Fee Waiver, to assist employees in their educational pursuits. Also offered is a tuition discount program for eligible spouse and/or dependents. All programs may be utilized at the University of Memphis, or any Tennessee Board of Regents (TBR) or University of Tennessee (UT) institution. Staff Scholarship Regular full and part-time employees with at least 6 months of service as of the first day of class are eligible. The program pays for up to six hours per semester for full-time employees and up to three hours per semester for part-time employees. Faculty may only audit or take non-credit job related courses. PC-191 Regular full-time employees are eligible immediately upon employment as of the first day of class. The program will pay for one course per semester, regardless of the number of credit hours. Entrance to classes on a PC-191 Fee Waiver is granted on a space available basis only. For both programs, classes must be outside normal working hours unless the department head approves an altered work schedule (can only be used for one course per semester). Employees may use both the Staff Scholarship and PC-191 Fee Waiver programs to pursue undergraduate and graduate degrees. Spouse/Dependent Discount Regular full time employees dependents and/or spouse receive a 50% discount on undergraduate tuition/maintenance fees at any TBR or UT institution. Dependents and spouses of part-time employees with at least one year of service receive a prorated 50% discount. Dependent children are eligible through age 26. For more information please visit: or contact the University Benefits Administration Office at Additional information is located at: 25

28 Employee Assistance Program The Employee Assistance Program (EAP) is available to all full-time employees and their eligible dependents. You do not have to be enrolled in a health insurance plan to take advantage of this program. It is provided through the State of Tennessee Employee Assistance Program and administered by Magellan Health Services. The EAP can assist with many work-related and personal issues, from advice about financial questions to dealing with a stressful work situation, to overcoming a serious emotional problem. All services are kept confidential in strict accordance with federal and state laws. For mental health/substance abuse situations, you will receive up to five free visits with a Magellan approved counselor. Any time you plan to use a provider for mental health and/or substance abuse, you must first contact Magellan at HERE4TN ( ) to obtain the benefit paid at the highest level. The Magellan specialist will help you in identifying the best resources to assist with your personal situation. Additional information is located at the following site: 26

29 Family Medical Leave Act In compliance with the Family Medical Leave Act of 1993 (FMLA), it is the policy of the University of Memphis to provide eligible employees up to twelve workweeks (450 hours) of job-protected leave during a twelve month period for specified family and medical reasons. For eligibility purposes, an employee must have worked for at least twelve months for the State of Tennessee and must have worked 1250 hours for the University of Memphis during the year preceding the beginning of the leave. Human Resources is responsible for determining these criteria at the beginning of the leave. The FMLA policy includes both regular and temporary employees of the University. In all circumstances, the employee and/or supervisor are responsible for notifying the University Benefits Administration office of any employee who has been off or plans to be off more than five (5) consecutive work days due to family and/or medical reasons. This guideline applies whether or not the employee actually has available sick leave or annual leave, or is on leave without pay. TBR Policy 5:01:01:14 stipulates that any employee who has accumulated sick and annual leave must use this leave during a period of FMLA before going on leave without pay; FMLA shall run concurrently with the paid leave. The Benefits office will provide the employee with the necessary paperwork, and all forms must be completed and returned to the Benefits office within 15 calendar days. Information concerning medical leaves is maintained in a confidential file separate from the employee s Human Resources file. FMLA qualifying events include: birth or adoption of a child; to care for the employee s spouse, son or daughter under age 18, or parent with a serious health condition; or the employee s own serious health condition. For additional information please contact the University Benefits Administration office at Workers' Compensation Any job-related injury should be reported immediately to your supervisor. In a nonemergency situation, contact the Workplace Injury Call Center at and select option 1. In an emergency, you should go to the nearest emergency room and contact Human Resources as soon as possible. Please call for more information. The State of Tennessee Workers Compensation program is administered through CorVel Corporation. 27

30 COBRA COBRA, the Consolidated Omnibus Budget Reconciliation Act, is a federal law that permits eligible employees and dependents whose medical insurance would otherwise terminate, to continue coverage for specific periods of time under certain conditions. If you enroll in family or split contract coverage, it is important that you convey the following information to your dependents: 1. Employees may continue single or family coverage through the State for a maximum of 18 months if: a. Employment is terminated (including lay-offs) for any reason other than the employee's gross misconduct; or b. The employee's work hours are reduced or work status is changed such that the employee is no longer eligible for coverage under the State Plan's eligibility rules. 2. Dependents may continue their coverage through the State for a maximum of 36 months if coverage is terminated: a. Due to the death of the employee; or b. Due to divorce or legal separation of the dependent from the employee; or c. With respect to a dependent child, the child is no longer eligible as a dependent under the State Plan The COBRA notification will be mailed to the employee s home address approximately 7-10 days following the termination of coverage. The person losing coverage will have 60 days from the loss of coverage or the date of the notification letter, whichever is later, to apply for COBRA. 28