THE UNIVERSITY OF CHICAGO 2014 BENEFITS GUIDE

Transcription

1 THE UNIVERSITY OF CHICAGO 2014 BENEFITS GUIDE

2 Table of Cotets 1 Letter from the Executive Director 2 Uderstadig Your Beefits 4 New Hire Erollmet Process 6 Medical Plas 10 Detal Plas 12 Visio Pla 14 Group Life, Busiess Travel Accidet, ad Persoal Accidet Isurace 18 Disability Beefits ad Log Term Care Beefits 21 Flexible Spedig Accouts 23 Adoptio Assistace Program 23 Commuter Beefit 24 Retiremet Plas 30 Other Beefits 33 Cotact Iformatio Dear Uiversity of Chicago Colleague, Welcome to the Uiversity of Chicago commuity. I hope you fid your time with the Uiversity a rewardig experiece. Beefits, icludig health ad welfare ad retiremet programs, are importat for you ad your family s fiacial security ad peace of mid. This guide is desiged to provide you with a summary of health ad welfare ad retiremet beefits for which you are eligible. I additio, to help you compare your medical pla choices before you eroll ad uderstad your coverage after you eroll, a Summary of Medical Beefits ad a Glossary of Medical Terms is available olie at humaresources.uchicago.edu/beefits/healthwelfare. Additioal iformatio is available at humaresources.uchicago.edu to assist you as you make decisios o the beefit programs that best meet your eeds ad the eeds of your eligible depedets. Health care beefits are a importat part of your beefits package at the Uiversity. We focus our efforts o providig the Uiversity commuity access to high quality health care while balacig risig costs. Our goal is to put the Uiversity i the best possible positio to support the health ad welless of our faculty ad staff members while offerig affordable ad comprehesive health pla choices. We also remai dedicated to providig plas that: Offer choice i beefit optios while providig you ad your family fiacial protectio Ecourage ad offer tools to support healthy lifestyles Evaluate our curret pla offerigs ad make ehacemets that beefit our faculty ad staff ad their families Please read ad cosider the iformatio provided i the guide carefully. If you have questios o ay of the pla optios, please do ot hesitate to take advatage of the persoal assistace that our beefit couselors ca provide. Couselors ca be reached Moday through Friday from 8:30 a.m. to 4:30 p.m. by phoe at or at beefits@uchicago.edu. Sicerely, Michael F. Kitter Executive Director Huma Resources The Uiversity of Chicago b The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 1

3 Uderstadig Your Beefits Choosig ad persoalizig your beefits depeds o your specific eeds, prefereces, ad budget. We ve made it easy for you to do your homework, research plas, ad get aswers to your questios. Read this beefits summary ad the pla comparisos o pages 8, 9, ad 11. Visit the Uiversity of Chicago Beefits website at humaresources.uchicago.edu/beefits for additioal pla iformatio, resources, forms, ad erollmet. CONTRIBUTING TO YOUR PLANS You ad the Uiversity of Chicago share the cost of your medical beefits. You pay the full cost for your detal ad visio beefits. Refer to the cotributio charts o the Uiversity of Chicago Beefits website humaresources.uchicago.edu/beefits or see page 7 for medical, page 10 for detal, ad page 12 for visio. UNIVERSITY-PROVIDED BENEFITS The Uiversity of Chicago pays 100% of the cost for: Basic life isurace for you equal to oe times your aual base salary up to a maximum beefit of $50,000 ad Busiess travel accidet isurace for you equal to five times your aual base salary up to a maximum beefit of $500,000. BEFORE-TAX BENEFITS You, as the employee, pay the cost for this coverage through pre-tax payroll deductios. You must eroll i the followig beefits withi 31 days of your hire date or the date you become beefits eligible. Otherwise, you will ot be able to eroll i them util the ext Ope Erollmet period for a effective date of Jauary 1 of the followig year. Medical coverage Detal coverage Visio coverage Health ad depedet care flexible spedig accouts Commuter beefit (see erollmet rules o page 23) Electios for before-tax beefit plas are bidig through December 31, 2014, uless you experiece a qualified life evet. Please visit humaresources.uchicago.edu/lifework/life for more iformatio ad guidace o qualified life evets. AFTER-TAX BENEFITS You, as the employee, pay the full cost for this coverage through after-tax payroll deductios. The followig beefits ca be elected at ay time durig the year. Persoal accidet isurace for you ad your depedets Supplemetal life isurace for you Volutary life isurace for your same ad opposite geder spouse/civil uio or registered same-geder domestic parter ad childre Log-term disability Log-term care Who s Eligible? YOU You are eligible to participate if you work i a positio that is expected to last at least oe year ad are a: Full-time beefits-eligible employee of the Uiversity of Chicago ( the Uiversity ) workig a miimum of 35 hours per week Part-time beefits-eligible employee of the Uiversity workig a miimum of 20 hours per week YOUR FAMILY MEMBERS You ca also cover your eligible depedets, icludig your: Same ad opposite-geder spouse, if ot legally separated Same ad opposite-geder civil uio parter Same-geder domestic parter ( DP ) registered with the Uiversity Child up to age 26 A child is a: Natural child Stepchild Legally adopted child Ward Ay idividual amed i a court order for whom you are legally resposible for providig coverage uder the terms of a qualified medical child support order DP child who depeds o you for support ad lives with you i a regular paret-child relatioship Umarried child beyod age 26 if the child is: Icapable of self-sustaiig employmet due to a metal or physical disability that occurred before attaiig age 26 (proof of disability will be required ad reviewed for approval); Depedet o employee/dp for primary support ad maiteace; ad Covered cotiuously by the pla prior to ad beyod age 26 Military vetera depedet child up to age 30 if the child: Has established residecy i Illiois Has served i the active or reserve compoets of the US Armed Forces Has received a release of discharge other tha a dishoorable discharge Depedet Verificatio Required The Uiversity of Chicago requires verificatio of relatioship for ay depedet to be added to your coverage for the first time. ACCEPTABLE DOCUMENTATION FOR DEPENDENTS Same ad Opposite-Geder Spouse Marriage certificate Same ad Opposite-Geder Civil Uio Parter Certificate of civil uio Same Geder DP Statemet of domestic partership ad Three of the followig items: Domestic parter agreemet Joit mortgage or lease Desigatio of domestic parter as beeficiary for a life isurace policy ad retiremet cotract Desigatio of domestic parter as primary beeficiary i employee s will Durable property ad health care powers of attorey Joit owership of motor vehicle Joit checkig accout Joit credit accout Child A birth certificate Record of birth from hospital Documetatio of adoptio Other appropriate legal documets For military vetera depedets, the Certificate of Release or Discharge from Active Duty documet is also required. Documetatio must be submitted withi 31 days of your hire or beefits eligible date via secure fax to or scaed ad ed to beefits@uchicago.edu. DOES YOUR SPOUSE WORK AT THE UNIVERSITY OF CHICAGO? You may ot elect coverage as a employee ad also receive coverage as the depedet of aother Uiversity of Chicago employee or retiree. Also, oly oe paret may cover eligible depedet childre. Coverage Effective Dates Coverage uder most plas starts o your date of hire or the date you become beefits eligible with the followig exceptios: Flexible Spedig Accouts The first of the moth followig your date of hire or date you become eligible for beefits. Log-Term Disability If coverage is elected withi 31 days of hire or beefits eligible date, beefits automatically begi three moths after your hire or beefits eligible date. If coverage is elected after 31 days of hire or beefits eligible date, beefits begi the date evidece of isurability is approved by Prudetial. Coverage is ot automatic; your applicatio must be approved. For ERIP or CRP participats, coverage begis o the date your retiremet participatio begis. Supplemetal Life Isurace Employee For coverage amouts i excess of $750,000 elected withi 31 days of hire or beefits eligible date, beefits begi the date evidece of isurability is approved by Prudetial. Coverage is ot automatic; your applicatio must be approved. For ay coverage amout elected after 31 days of hire or beefits eligible date, beefits begi the date evidece of isurability is approved by Prudetial. Coverage is ot automatic; your applicatio must be approved. Volutary Life Isurace Spouse or Same Geder Domestic Parter or Civil Uio Parter For coverage amouts i excess of $20,000 elected withi 31 days of hire or beefits eligible date, beefits begi the date evidece of isurability is approved by Prudetial. Coverage is ot automatic; your applicatio must be approved. For ay coverage amout elected after 31 days of hire or beefits eligible date, beefits begi the date evidece of isurability is approved by Prudetial. Coverage is ot automatic; your applicatio must be approved. 2 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 3

4 New Hire Erollmet Process STEPS FOR NEWLY HIRED EMPLOYEES Atted the Uiversity of Chicago Gettig to Kow UChicago orietatio sessio. View the beefits materials you receive at the orietatio sessio ad check out the Beefits website at humaresources.uchicago.edu/beefits for more iformatio ad resources. Visit Employee Self Service (ess.uchicago.edu) to make your beefit electios ad to desigate your depedets ad/or beeficiaries. Please Note: If both you ad your spouse/domestic parter/civil uio parter are Uiversity employees: you may each select employee oly coverage, or oe of you may choose employee plus spouse/ domestic parter/civil uio parter coverage (without a child/childre), or oe of you may choose employee plus child/childre (without a spouse/parter) coverage, or oe of you may choose employee plus family coverage (with a spouse/parter ad child/childre). You may ot elect coverage as a employee ad also receive coverage as a depedet. Oly oe paret may cover eligible depedet childre. Both of you caot choose employee plus spouse/parter, employee plus child/childre or employee plus family coverage. REMEMBER: You have 31 days from your hire date to eroll you ad your eligible depedets i various beefit plas. Proof of relatioship for each depedet you choose to eroll must also be submitted. Refer to the Beefits website for acceptable eligibility documets that must be submitted directly to the Uiversity s Beefits Office withi 31 days of your hire date. Otherwise your depedet(s) will ot be cosidered eligible, ad their erollmet will ot be processed. Your ext opportuity to add your eligible family members will be durig Ope Erollmet or if you experiece a qualifyig life evet. To begi the process, you may access Employee Self Service from ay computer at ess.uchicago.edu ad follow these steps: 1. Work with your hirig maager to claim your CNet ID ad set your password. This is the ID you will use to access all Uiversity systems. 2. Eter your CNet ID ad password. 3. Follow the olie istructios. Note: If you leave the erollmet system before submittig your electios, your choices will ot be saved. 4. Prit the cofirmatio statemet for your records. This is the oly cofirmatio that you will receive. 5. You may eter Employee Self Service ad make chages to your electios ay time durig the first 31 days of employmet. After your electios have bee submitted, you ca view your beefits selectios ad coverage at ay time i ESS. WAIVING HEALTH COVERAGE If you have medical, detal, or visio coverage elsewhere, you ca choose to waive coverage provided by the Uiversity of Chicago. LONG-TERM CARE If you would like to eroll i the log-term care isurace, you will eed to cotact Geworth at or visit geworth.com/groupltc, ad eter group id: UChicago ad code: groupltc. COMMUTER BENEFITS If you would like to eroll i the Commuter Beefits, you will eed to Coexis at or visit mybeefits.coexis.com. WHAT IF I DON T ENROLL? If you do ot eroll withi 31 days of your hire date or the date you become eligible for beefits, you will have to wait util Ope Erollmet or util you experiece a qualified life evet. Qualifyig life evets iclude: Marriage, divorce, legal separatio, or aulmet Registratio or termiatio of a domestic partership Death of a child, spouse, civil uio or domestic parter Birth, adoptio, or placemet for adoptio of a child The start or ed of your spouse s, civil uio or domestic parter s employmet A chage i your spouse s, civil uio or domestic parter s employmet status Loss of status as a depedet Loss of or chage i your spouse s, civil uio or domestic parter s health care coverage A court order which requires that a depedet be covered uder your medical coverage REMEMBER: You have 31 days from the date you experiece a qualified life evet to make your beefit chages or you will have to wait util Ope Erollmet. Chages made at Ope Erollmet will be effective o Jauary 1 of the followig year. Cotact Huma Resources at withi 31 days of the qualifyig evet to eroll. 4 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 5

5 Medical Plas The Uiversity of Chicago offers two differet types of medical plas: a preferred provider orgaizatio (PPO) pla ad three health maiteace orgaizatio (HMO) plas. Mothly Medical Rates for Full-Time Employees If your salary is: Uder $45,000 $45,000 $74,999 $75,000 $99,999 $100,000 $174,999 $175,000 or more Maroo Pla MEDICAL PLANS OFFERED The Uiversity of Chicago offers four medical isurace plas, all which provide coverage for pre-existig coditios, prescriptio drugs, metal health, ad substace abuse. Choosig ad persoalizig your beefits depeds o your specific health care eeds, doctor prefereces, budget, ad the type of pla you prefer. Use the compariso chart o pages 8 ad 9 to determie which of the followig plas best suits your medical eeds. Maroo Pla (PPO) Uiversity of Chicago Health Pla (HMO) HMO Illiois (BlueCross BlueShield) Humaa Illiois Platium (HMO) COST OF COVERAGE You ad the Uiversity of Chicago share the mothly cost for medical coverage. The Uiversity pays the majority of the costs. Your cost is based o The pla you choose; The coverage level you choose (yourself oly; yourself+ spouse/parter; yourself + child(re); yourself + family); Your aual salary; ad Whether you are a full-time or part-time employee. HEALTH MAINTENANCE ORGANIZATION (HMO) A HMO is a maaged care group that provides services ad supplies through its ow etwork of doctors, hospitals, ad other health care facilities. It covers your expeses oly if you go to a health care provider withi its etwork of providers (uless it s a life-threateig emergecy). Whe you eroll i a HMO pla, you will be required to select a primary care physicia (PCP) who maages your care usig the HMO etwork s physicias ad facilities. You will eed approval from your PCP before seeig a specialist. HMOs provide health care withi specific geographic areas called service areas. A HMO s service area may iclude all or part of a particular couty. To be a member of a HMO, you must live i its service area. Except for emergecies, you must use doctors i your HMO s etwork ad withi your service area. With a HMO: There is NO deductible There are NO claims to file You pay a fixed copaymet for each office visit, emergecy room visit, ad hospital stay. PREFERRED PROVIDER ORGANIZATION (PPO) A PPO gives you freedom of choice ad greater flexibility tha a HMO. You are ot required to choose a primary care physicia ad do ot eed a referral to see a specialist. The PPO offers a large etwork of cotractig doctors ad hospitals to choose from whe care is eeded. Whe a cotractig etwork provider is used, the care is cosidered i-etwork, out-of-pocket costs will be less, ad the highest level of beefits is received. If a doctor outside the etwork is used, the care is cosidered out-of-etwork ad coverage is still provided, but the out-of-pocket costs will be sigificatly higher. I additio, PPO members have access to care aywhere they live, work, or travel, across the coutry ad aroud the world. With a PPO: There is a aual deductible ad You pay a percetage of the charge after you have met your deductible for each office visit, emergecy room visit, ad hospital stay. PRE-EXISTING CONDITIONS Noe of the plas offered by the Uiversity has a preexistig coditio clause. This meas if you have a medical coditio prior to erollig i a pla, the treatmet for that medical coditio is covered as log as the pla offers coverage for those particular services ad pla provisios are followed. WHICH PLAN IS RIGHT FOR YOU? The best medical pla for you depeds o a umber of factors: What are your aticipated medical expeses for 2014? What ca you afford to pay out-of-pocket (i terms of deductibles ad copaymets) if you or a covered depedet eeds medical care? Do you have other medical coverage (for example, through your spouse s employer)? Do you have a doctor whom you wat to keep seeig, or would you be willig to switch to a etwork doctor if ecessary to pay less for coverage? Do you travel ofte or are you away from the Uiversity of Chicago ofte? Do ay of your depedets eed routie medical care i a out-of-state locatio? REMEMBER: All medical plas provide emergecy care aywhere i the world. Before you eroll i a ew pla, make sure the doctor you wat is acceptig ew patiets. Yourself Oly $110 $149 $166 $265 $275 Yourself + Spouse/Parter $195 $268 $336 $415 $420 Yourself + Child(re) $191 $265 $310 $340 $390 Yourself + Family $251 $340 $426 $525 $533 UCHP Yourself Oly $43 $68 $96 $110 $117 Yourself + Spouse/Parter $93 $145 $218 $264 $274 Yourself + Child(re) $86 $135 $208 $225 $235 Yourself + Family $117 $178 $258 $315 $325 Humaa Illiois Platium HMO Yourself Oly $44 $71 $104 $132 $137 Yourself + Spouse/Parter $105 $170 $240 $315 $325 Yourself + Child(re) $95 $160 $230 $252 $263 Yourself + Family $133 $206 $301 $375 $387 HMO Illiois Yourself Oly $38 $63 $87 $100 $107 Yourself + Spouse/Parter $90 $139 $190 $255 $260 Yourself + Child(re) $85 $130 $180 $203 $215 Yourself + Family $114 $173 $258 $315 $325 Mothly Medical Rates for Part-Time Employees If your salary is: Uder $45,000 $45,000 $74,999 $75,000 $99,999 $100,000 $174,999 $175,000 or more Maroo Pla Yourself Oly $165 $224 $249 $398 $413 Yourself + Spouse/Parter $293 $402 $504 $623 $630 Yourself + Child(re) $287 $398 $465 $510 $585 Yourself + Family $377 $510 $639 $788 $800 UCHP Yourself Oly $65 $102 $144 $165 $176 Yourself + Spouse/Parter $140 $218 $327 $396 $411 Yourself + Child(re) $129 $203 $312 $338 $353 Yourself + Family $176 $267 $387 $473 $488 Humaa Illiois Platium HMO Yourself Oly $66 $107 $156 $198 $206 Yourself + Spouse/Parter $158 $255 $360 $473 $488 Yourself + Child(re) $143 $240 $345 $378 $395 Yourself + Family $200 $309 $452 $563 $581 HMO Illiois Yourself Oly $57 $95 $131 $150 $161 Yourself + Spouse/Parter $135 $209 $285 $383 $390 Yourself + Child(re) $128 $195 $270 $305 $323 Yourself + Family $171 $260 $387 $473 $488 6 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 7

6 Medical Pla Compariso Chart Your medical-related eeds ad cosideratios are uique, ad so are your family s. That s why the Uiversity offers you the opportuity to select the pla optio that works best for you. Use these charts to help you make a decisio. It s a good idea to thik through how you might use the pla i the comig year. Do you wat a pla that offers you more access to providers? Are you lookig for a pla with lower costs? Do you wat to have oe doctor to coordiate all your care? What kid of coverage do you wat? (BlueCross BlueShield) PLAN FEATURE Maroo Pla Uiversity of Chicago Health Pla Humaa Illiois Platium HMO HMO Illiois Iside BCBSIL (BlueCross BlueShield) Network Outside BCBSIL Network Choice of doctor Limited to BCBSIL etwork Ay provider Limited to etwork Limited to etwork Limited to etwork Deductible Idividual $250 Idividual $250 Noe Noe Noe Family up to $600 Family up to $600 Additioal $200 per hospital admissio Beefit paymet percetage You pay 20%; Pla pays 80% of covered expeses You pay 35%***; Pla pays 65% of the costs You pay othig or a miimal copaymet; Pla pays 100% You pay othig or a miimal copaymet; Pla pays 100% You pay othig or a miimal copaymet; Pla pays 100% Out-of-pocket maximum $2,000/Idividual $4,000/Family Noe $1,500/Idividual $3,000/Family $1,500/Idividual $3,000/Family Claim forms Noe You file your claim Noe Noe Noe Physicia office visits You pay 20%; Pla pays 80% of covered expeses for o-prevetive services. Prevetive services, icludig prevetive office You pay 35%*** ; Pla pays 65% of the costs You pay a $10 copaymet for a PCP* visit ad $20 for a specialist visit; Pla covers the remaider You pay a $10 copaymet for a PCP* visit ad $20 for a specialist visit; Pla covers the remaider You pay a $10 copaymet for a PCP* visit ad $20 for a specialist visit; Pla covers the remaider visits, are covered at 100% Hospital: Ipatiet You pay 20%; Pla pays 80% of covered expeses You pay 35%*** (after $200 deductible); Pla pays 65% of the costs You pay $250 copaymet per admissio; Pla covers the remaider You pay up to $300 copaymet per admissio ($100 per day for up to three You pay $250 copaymet per admissio; Pla covers the remaider days); Pla covers the remaider Hospital: Outpatiet You pay 20%; Pla pays 80% of covered You pay 35%***; Pla pays 65% Provided i full Provided i full Provided i full expeses of the costs Prevetive care/welless No coisurace required $0 copay $0 copay $0 copay Ogoig therapy, occupatioal therapy, physical therapy, ad speech therapy 20 visits maximum per coditio Limit of 60 combied treatmets per caledar year PCP* ad ay cosultig physicia must determie that the member s Limit of 60 combied treatmets per caledar year; $10 copaymet per visit coditio ca improve sigificatly withi 2 moths Hearig services Not covered Exam provided i full; o coverage for hearig aids Exam provided i full; o coverage for hearig aids $10 PCP*/$20 specialist; o coverage for hearig aids Visio services Discouts for care ad supplies are available through the Visio Discout Program offered by Davis Visio. For more iformatio, cotact Davis Visio at Cotact the Pla at Cotact EyeMed Visio Care at Cotact Davis Visio Care at Prescriptios (Geeric/Preferred Brad-Name/ No-Preferred Brad-Name) Covered uder a separate prescriptio drug pla admiistered by CVS Caremark Retail (30-day supply): $8/$20/$35 copaymet Mail Service (90-day supply): $16/$40/$70 copaymet Retail (30-day supply): $5/$15/$30 copaymet; 50% copaymet for maiteace medicatios after 1st refill; Mail service (90-day supply): $10/$30/ $60 copaymet at DCAM** Pharmacy oly; Mail service (90-day supply) with CVS Caremark: $15/$45/$90 copaymet Retail (30-day supply): $5/$15/$30 copaymet; Mail service (90-day supply): $10/$30/$60 copaymet Retail (34-day supply): $5/$15/$30 copaymet; $50 self-ijectables Mail service & select retail pharmacies (90-day supply): $10/$30/$60 copaymet; $50 copay for self-ijectables Lifetime maximum Noe Noe Noe Noe Emergecy room You pay 20%; Pla pays 80% of covered expeses You pay 20%*** ; Pla pays 80% of the costs $75 copaymet; waived if admitted $75 copaymet; waived if admitted $75 copaymet; waived if admitted Metal health: Outpatiet You pay 20%; Pla pays 80% of covered You pay 35%*** ; Pla pays 65% of $10 copaymet per visit $20 copaymet per visit $10 copaymet per visit expeses the costs (waived for iitial visit) Nurse Advice Lie Cotact 24/7 Nurselie at Cotact your PCP* Cotact Humaa First at Cotact your PCP* *PCP = Primary Care Physicia **DCAM = Duchossois Ceter for Advaced Medicie at the Uiversity of Chicago Medicie *** You are also resposible 100% of the charges i excess of the prevailig fee schedule. 8 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 9

7 Detal Plas The Uiversity of Chicago offers two differet types of detal plas: a preferred provider orgaizatio (PPO) pla ad a copay pla. Use this chart to help you make a decisio. It s a good idea to thik through how you might use the pla i the comig year. Although the plas utilize the same provider etwork, your costs associated with the plas will vary. Are you lookig for a pla with lower costs? What kid of coverage do you wat? Which oe best suits your detal eeds? DENTAL PLANS OFFERED The Uiversity of Chicago offers two detal isurace plas, both of which provide coverage for prevetative care, basic care, major care, ad orthodotia. Use the compariso chart o page 11 to determie which of the followig plas best suits your detal eeds. USING YOUR DENTAL BENEFIT IS EASY. To fid a preferred provider, visit metlife.com or call Referece the PDP etwork. At your appoitmet, tell them you have MetLife. There s o ID card ecessary. Detal Pla Compariso Chart PLAN FEATURE METLIFE DENTAL COPAY PLAN I Network Out of Network METLIFE DENTAL PPO PLAN I Network Out of Network MetLife Detal PPO Pla MetLife Detal CoPay Pla Regular visits to the detist may do more tha just brighte your smile they ca be importat to your overall health. May diseases produce oral sigs ad symptoms. Choosig ad persoalizig your beefits depeds o your specific detal care eeds, budget, ad the type of pla you prefer. Uder both plas, you are free to visit ay licesed detist you choose. The detal plas offer a large etwork of cotractig providers to choose from whe detal care is eeded. Whe a cotractig etwork provider is used, the care is cosidered i-etwork, out-of-pocket costs will be less, ad the highest level of beefits is received. If a provider outside the etwork is used, the care is cosidered outof-etwork ad coverage is still provided, but the out-ofpocket costs will be sigificatly higher. COST OF COVERAGE You pay the full cost for your detal coverage. Your cost is based o The pla you choose ad The coverage level you choose (yourself oly; yourself+ spouse/parter; yourself + child(re); yourself + family). WHICH PLAN IS RIGHT FOR YOU? The best detal pla for you depeds o a umber of factors: What are your aticipated detal expeses for 2014? What ca you afford to pay out-of-pocket (i terms of deductibles ad copaymets) if you or a covered depedet eeds detal care? Do you have other detal care (for example, through a spouse s employer)? Choice of detist Limited to etwork providers Ay detist Deductible Noe $75 per covered idividual (waived for orthodotia) $225 per family (waived for orthodotia) Prevetive care You make a copaymet You pay 30%; Pla (approximately 10% of the pays 70% (up to the cost), the Pla pays the aual maximum)*; you remaider (up to the aual pay ay amout over maximum)* up to 2 visits the reasoable ad per year separated by 6 customary charges moths up to 2 visits per year separated by 6 moths Basic care You make a copaymet (approximately 30% of the cost), the Pla pays the remaider (up to the aual maximum)* You pay 60%; Pla pays 40% (up to the aual maximum)*; you pay ay amout over the reasoable ad customary charges Major care You make a copaymet You pay 70%; Pla Limited to etwork Ay detist providers $60 per perso (waived for prevetive care ad orthodotia) Pla pays 100% up to 2 visits per year (o deductible, o coisurace) You pay 20%; Pla pays 80% (up to the aual maximum)* You pay 50%; Pla pays Pla pays 100% of the reasoable ad customary charges up to 2 visits per year (o deductible, o coisurace) You pay 20%; Pla pays 80% (up to the aual maximum)*; you pay ay amout over the reasoable ad customary charges You pay 50%; Pla (approximately 60% of the pays 30% (up to the 50% (up to the aual pays 50% (up to the cost), the Pla pays the aual maximum)*; you maximum)* aual maximum)*; remaider (up to the aual pay ay amout over you pay ay amout maximum)* the reasoable ad over the reasoable customary charges ad customary charges Orthodotia You pay 60%; Pla pays You pay 60%; Pla pays You pay 50%; Pla pays You pay 50%; Pla 40% (up to the lifetime 40% (up to the lifetime 50% (up to the lifetime pays 50% (up to the maximum of $1,500) maximum of $500); maximum of $1,000) lifetime maximum you pay ay amout of $1,000); you pay Mothly Detal Rates over the reasoable ad customary charges ay amout over the reasoable ad customary charges MetLife Detal Copay Pla MetLife Detal PPO Pla Aual maximum beefit* $5,000 per perso $1,000 per perso $1,500 per covered idividual $3,000 per family Yourself oly $25.28 $45.41 Yourself + spouse or domestic/civil uio parter $41.88 $81.35 (without a child/childre) Yourself + child/childre $48.43 $ (without a spouse or domestic/civil uio parter) Yourself + family $66.87 $ (with a spouse or domestic/civil uio parter ad child/childre) Claim forms No Yes No Yes Negotiated fees Yes No Yes No * The aual maximum beefit is the most coverage that the Pla will provide you i oe year. You are resposible for all detal costs after you reach your aual maximum beefit. 10 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 11

8 Visio Pla The Uiversity of Chicago offers a separate visio pla, through VSP. Use this chart to help you decide if your family eeds a separate visio pla. Below is a summary of i-etwork ad out-of-etwork beefit iformatio. VISION PLAN OVERVIEW While all the Uiversity of Chicago s medical plas offer some coverage for visio services (see the chart o pages 8 ad 9), you ca eroll i this separate visio pla for more comprehesive coverage, icludig eye exams ad discouts o eyewear. With ope access to see ay eye care provider, you ca see the oe who is right for you. The Visio Service Pla (VSP) offers a large etwork of cotractig providers to choose from whe visio care is eeded. Whe a cotractig etwork provider is used, the care is cosidered i-etwork, out-of-pocket costs will be less, ad the highest level of beefits is received. If a provider outside the etwork is used, the care is cosidered out-of-etwork ad coverage is still provided, but the out-of-pocket costs will be sigificatly higher. USING YOUR VSP BENEFIT IS EASY. To fid a VSP doctor or a affiliate provider, visit vsp.com or call Review your beefit iformatio. Visit vsp.com to review your pla coverage before your appoitmet. At your appoitmet, tell them you have VSP. There s o ID card ecessary. If you would like a card, you ca visit vsp.com ad prit your persoalized member visio card. COST OF COVERAGE You pay the full cost for this visio coverage. Your cost is based o the coverage level you choose (yourself oly; yourself + spouse/parter; yourself + child(re); yourself + family). Visio Pla Beefit Highlight Chart Beefit Descriptio Copay Frequecy Your Coverage with VSP Doctors ad Affiliate Providers* WellVisio Exam Focuses o your eyes ad overall welless $0 Every caledar year Prescriptio Glasses $25 Frame $150 allowace for a wide selectio of frames $70 allowace at Costco 20% off amout over your allowace Icluded i Prescriptio Glasses Every other caledar year Leses Les Optios Cotacts (istead of glasses) Sigle visio, lied bifocal, ad lied trifocal leses Polycarboate leses for depedet childre Stadard progressive leses Premium progressive leses Custom progressive leses Average 20% 25% off other les optios Cotact les exam (fittig ad evaluatio) $150 allowace for cotacts Icluded i Prescriptio Glasses $55 $95 $105 $150 $175 Up to $60 Copay does ot apply Every caledar year Every caledar year Every caledar year Mothly Visio Rates Yourself oly $7.49 Yourself + spouse or domestic/civil uio parter $14.98 (without a child/childre) Yourself + child/childre $16.44 (without a spouse or domestic/civil uio parter) Yourself + family $26.27 (with a spouse or domestic/civil uio parter ad child/childre) Visio Service Pla Extra Savigs ad Discouts Glasses ad Suglasses 20% off additioal glasses ad suglasses, icludig les optios, from ay VSP doctor withi 12 moths of your last WellVisio Exam Laser Visio Correctio Average 15% off the regular price or 5% off the promotioal price; discouts oly available from cotracted facilities Your Coverage with Other Providers Visit vsp.com for details if you pla to see a provider other tha a VSP doctor. Exam up to $45 Frame up to $70 Sigle Visio Leses up to $30 Lied Bifocal Leses up to $50 Lied Trifocal Leses up to $65 Cotacts up to $105 *Coverage with a retail chai affiliate may be differet. Oce your coverage is effective, visit vsp.com for details. 12 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 13

9 Group Life, Busiess Travel Accidet, ad Persoal Accidet Isurace Whether you re just gettig started or preparig for what s ext i life, someoe is depedig o you. Adequate life isurace protectio meas your loved oes ca pursue their plas ad dreams, eve if somethig happes to you. GROUP LIFE INSURANCE PLANS OFFERED The Uiversity of Chicago offers group life ad accidet isurace plas which provide your family (or beeficiary) with a lump sum paymet i the evet of your death. BASIC LIFE INSURANCE All beefits-eligible employees have a life isurace equal to oe times their aual salary to a maximum beefit of $50,000. If you are a beefits-eligible employee your basic life isurace is effective o your date of hire or beefits eligible date. Erollmet is automatic; as log as you are actively at work o that date. The Uiversity pays the full cost for this beefit. SUPPLEMENTAL LIFE INSURANCE The Uiversity of Chicago offers all beefits-eligible employees the opportuity to purchase additioal life isurace protectio for yourself. Erollmet is volutary ad you decide how much to purchase. Durig the first 31 days of employmet, or durig the first 31 days after you become beefits eligible, you have the optio of selectig supplemetal life isurace coverage equal to a multiple of your base salary (1x, 2x, 3x, 4x, 5x, 6x, 7x, or 8x), up to $750,000 without Evidece of Isurability to a overall maximum of $1,500,000 (basic ad supplemetal combied). After the first 31 days of employmet, or after the first 31 days after you become beefits eligible you have the optio of selectig supplemetal life isurace coverage equal to a multiple of your base salary (1x, 2x, 3x, 4x, 5x, 6x, 7x, or 8x) with Evidece of Isurability to a overall maximum of $1,500,000 (basic ad supplemetal combied). Ay coverage requirig evidece of isurability will ot become effective util approved by The Prudetial Compay of America. You will be cotacted directly by Prudetial through US Mail. You, as the employee, pay the full cost of this beefit. Whe you reach age 65, coverage is oly available at a reduced percetage of your elected coverage amout. The mothly cost is based o your age ad the coverage amouts you elect. Use the chart o page 16 to determie your coverage costs. VOLUNTARY SPOUSE, SAME-GENDER DOMESTIC PARTNER (REGISTERED WITH THE UNIVERSITY), OR CIVIL UNION PARTNER LIFE INSURANCE The Uiversity of Chicago offers you the opportuity to purchase life isurace protectio for your spouse, samegeder domestic parter (who is registered with the Uiversity), or civil uio parter. Erollmet is volutary ad you decide how much to purchase. You may elect coverage for your spouse, same geder domestic parter (registered with the Uiversity), or civil uio parter i $10,000 icremets up to $150,000. Durig the first 31 days of employmet, or durig the first 31 days after you become beefits eligible, you have the optio of selectig up to $20,000 i Life Isurace coverage for your spouse, same-geder domestic parter (registered with the Uiversity), or civil uio parter without evidece of isurability. Electio amouts greater tha $20,000 will require evidece of isurability. After the first 31 days of employmet, or after the first 31 days after you become beefits eligible, evidece of isurability is required for all coverage electios. Ay coverage requirig evidece of isurability will ot become effective util approved by The Prudetial Isurace Compay of America. You will be cotacted directly by Prudetial through US Mail. You, as the employee, pay the full cost for this beefit. The mothly cost is based o the age of your spouse/ same-geder domestic parter/civil uio parter ad the coverage amout you elect. Use the chart o page 16 to determie coverage costs. Whe your spouse, same geder domestic parter, or civil uio parter reaches age 65, coverage is oly available at a reduced percetage of the elected coverage amout. VOLUNTARY DEPENDENT CHILD(REN) LIFE INSURANCE The Uiversity of Chicago offers you the opportuity to purchase life isurace protectio for your child(re). Erollmet is volutary ad you decide how much to purchase. You may elect coverage for your eligible depedet child(re) (up to age 26) i $2,000 icremets up to $10,000. You may cover oe child or multiple childre i your family. You will oly pay premiums o oe level of coverage. So, if you choose the $2,000 level of coverage, you will oly pay premiums based o $2,000, yet you will have $2,000 worth of life isurace coverage o each eligible child i your family. There is o evidece of isurability required for childre. The mothly cost for this isurace is $0.20 for every $2,000 worth of coverage elected. You, as the employee, pay the full cost for this coverage. PERSONAL ACCIDENT INSURANCE (ACCIDENTAL DEATH AND DISMEMBERMENT) The Uiversity of Chicago offers beefits-eligible employees persoal accidet isurace, which provides a beefit that helps protect you ad your family from fiacial hardship if you or a covered family member dies or suffers a serious ijury i a accidet. You may elect to cover oly yourself or yourself ad your family. Participatio is volutary ad you decide how much to purchase. If you are a beefits-eligible employee: You may elect up to $1,000,000 of persoal accidet isurace for you ad your depedets (to a maximum of 10 times your aual salary) without providig evidece of isurability. If family coverage is selected, all eligible depedets will be automatically covered by this volutary persoal accidet isurace beefit. You ca eroll at ay time durig the year. You, as the employee, pay the full cost for this coverage. The mothly cost is based o the coverage amout you elect. Use the chart o page 17 to determie your coverage costs. BUSINESS TRAVEL ACCIDENT INSURANCE The Uiversity of Chicago provides beefits-eligible employees busiess travel accidet isurace, as a beefit i the evet of your death or serious ijury i a accidet while travelig o Uiversity busiess away from Uiversity premises. Erollmet is automatic ad coverage begis o your first day of work. Coverage begis automatically whe you leave your home or office to start a busiess trip. It does ot cover your commute to ad from work. Amout of coverage is geerally five times your aual salary to a maximum of $500,000. The Uiversity pays the full cost for this beefit coverage. 14 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 15

10 Supplemetal ad Volutary Life ad Isurace Rates Whe it comes to life isurace, may families are uderisured. It ca be difficult to kow how much protectio is eeded i the evet of a uexpected death. The Prudetial Easy-to-Use Life Isurace Needs Estimator ca help you estimate how much life isurace makes sese for your curret situatio. To get started, simply visit prudetial.com/ezlifeeeds. Just aswer six questios ad click cotiue to get a estimate of your curret life isurace eeds. How to Calculate Your Mothly Rate for Supplemetal Life Step Oe Take your aual salary ad roud it up to the ext $1,000. Example Sue is 38 ad her aual salary is $34,482. Sue rouds that figure up to $35,000. Persoal Accidet Isurace Rates How to Calculate Your Mothly Rate for Persoal Accidet Isurace Step Oe Example Choose the amout of coverage you wat. Jae wats to kow what it would cost if she chooses coverage equal to $80,000 for herself oly or for herself ad family. Step Two Divide the amout of your total coverage $80,000 $10,000 = 8 (your pricipal amout) by $10,000. Step Two Elect the level of coverage that you wat. Step Three Multiply aual salary times the coverage that you elect. Sue wats to elect three times her aual salary. 3 X $35,000 = $105,000 Step Three Multiply the result by the appropriate rate: $0.14 if you have coverage for yourself oly $0.23 if you have coverage for yourself ad your family This gives you your mothly cotributio rate. 8 x $0.14 = $1.12 Jae will pay $1.12 per moth for coverage for herself. or 8 x $0.23 = $1.84 Jae will pay $1.84 per moth for family coverage. Step Four Divide the result i Step Three by $1,000. Step Five Multiply the result i Step Four by the applicable rate per $1,000. $105,000 $1,000 = X $0.034 = $3.57 per moth The table below shows some examples of mothly Persoal Accidet Isurace cotributio rates for various coverage levels: Pricipal Amout Cost of Idividual Coverage Cost of Family Coverage (Yourself Oly) (Yourself ad Your Family) $50,000 $0.70 $1.15 $100,000 $1.40 $2.30 $150,000 $2.10 $3.45 Employee Spouse, Same-Geder Domestic Parter (Registered with the Uiversity), or Civil Uio Parter Mothly Cost Mothly Cost Your Age per $1,000 of Age per $1,000 of Age Coverage Coverage Child(re) Mothly Factor per $2,000 of Coverage $200,000 $250,000 $300,000 $350,000 $400,000 $450,000 $500,000 $2.80 $3.50 $4.20 $4.90 $5.60 $6.30 $7.00 $4.60 $5.75 $6.90 $8.05 $9.20 $10.35 $11.50 Uder 35 $0.027 Uder 35 $0.027 All Eligible $ $ $0.034 Childre $ $ $ $ $ $ $ $ $ $ * $ * $ * $ * $ ad over* $ ad over* $1.506 * Reductio i coverage applies. 16 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 17

11 Disability ad Log Term Care Beefits The Uiversity of Chicago offers disability coverage uder two plas depedig o the legth ad type of your disability. Short-Term Disability Isurace The Uiversity of Chicago provides short-term disability (STD) isurace to beefits-eligible staff employees who have completed their probatioary period. The STD isurace provides icome replacemet for eligible employees who have a o work-related illess or ijury that makes them uable to work for more tha two work weeks. STD is desiged to allow you to focus o your recuperatio. The Uiversity pays the full cost for this beefit. OPTIONAL PLAN Uder the Optioal Pla, you receive 60% of your mothly base salary, up to a maximum mothly beefit of $20,000, less ay beefits you receive from other sources, such as Social Security. Uder this pla, disability is defied as beig uable to perform the material ad substatial duties of your regular occupatio or you have a 20% or more loss i your mothly earigs, ad you are uder the regular care of a doctor. This pla also provides a aual 5% cost of livig adjustmet. Log-Term Disability Isurace Rates How to Calculate Your Mothly Rate Step Oe Subtract the amout of coverage that the Uiversity pays ($14,000 for full-time employees ad $7,000 for part-time employees) from your aual salary. Step Two Multiply the result by the appropriate factor: if you have elected coverage uder the Base Pla if you have elected coverage uder the Optioal Pla. Example Jae Smith, a full-time employee, ears $25,840 per year. Here is how she calculates her cotributio rate if she is choosig the: Base Pla: $25,840 $14,000 = $11,840 Optioal Pla: $25,840 $14,000 = $11,840 Base Pla $11,840 x = $ Optioal Pla $11,840 x = $ STD BENEFITS STD pays 60% of your regular salary mius all regular deductios for isurace, uio dues, ad retiremet, after a two-week deductible period, for up to 13 weeks from the date of disability. You must use all your accrued sick leave before STD beefits begi or satisfy the two-week deductible period, whichever is loger. Pregacy is a covered disability. STD provides beefits for the balace of six weeks for a regular delivery from the date of birth; the balace of eight weeks are provided for a C-sectio delivery from the date of birth. STD rus cocurret to a leave uder the Family ad Medical Leave Act (FMLA). Log-Term Disability Isurace The Uiversity of Chicago offers beefits-eligible employees log-term disability (LTD) isurace, which provides supplemetal icome to allow you to focus o your recovery whe you suffer a illess, ijury, or disablig coditio that prevets you from workig for more tha three moths. LTD picks up where STD leaves off, providig you with cotiuity i your icome replacemet. You ca choose from the base pla or the optioal pla. BASE PLAN Uder the Base Pla, you receive 60% of your mothly base salary, up to a maximum mothly beefit of $10,000, less ay beefits you receive from other sources, such as Social Security. Uder this pla, durig the first 24 moths, disability is defied as beig uable to perform the material ad substatial duties of your regular occupatio or if you have a 20% or more loss i your mothly earigs ad are uder the regular care of a doctor. After 24 moths, disability is defied as beig uable to perform the duties of ay gaiful occupatio for which you are reasoably fitted by educatio, traiig, or experiece; ad you are uder the regular care of a doctor. LTD PARTICIPATION AND COVERAGE BEGIN DATE Durig the first 31 days of employmet, you may elect to participate i the Base Pla or Optioal Pla without Evidece of Isurability. Participatio is volutary ad coverage automatically becomes effective after three moths of employmet, uless You cotribute to the Retiremet Icome Pla for Employees (ERIP) or the Cotributory Retiremet Pla (CRP), i which case participatio is madatory ad coverage automatically begis o the same date as your retiremet pla participatio date; or You are a member of Local 743, i which case participatio is madatory ad beefits begi after three moths of service. After the first 31 days of employmet, evidece of isurability is required to participate i the Optioal Pla. You will be cotacted by The Prudetial Isurace Compay of America, through US Mail. Coverage will become effective o the date approved by Prudetial. Regardless of whe you eroll (before or after 31 days), you must be actively workig o the date coverage begis. If you are ot, coverage will ot begi util you are actively workig, as determied by the isurace cotract. COST OF COVERAGE The mothly cost for log-term disability coverage is based o your salary ad the pla you elect. You, as the employee, pay the full cost for this coverage. Use the chart o the ext page to determie your coverage costs. Step Three Divide the result by 12. This gives you your mothly LTD cotributio rate. The table below shows some examples of mothly LTD cotributio rates for various salaries (based o full-time employmet): Aual Salary Base Pla Optioal Pla $20,000 $25,000 $35,000 $50,000 $75,000 $100,000 $1.03 $1.89 $3.60 $6.18 $10.47 $14.76 $1.64 $3.01 $5.74 $9.84 $16.67 $23.51 Base Pla $ = $2.03 Optioal Pla $ = $ The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 19

12 Log-Term Care Isurace The Uiversity of Chicago offers beefits-eligible employees log-term care (LTC) isurace to provide support whe eeded due to a log-term illess, recovery from a accidet or illess, or advaced agig. LTC support ca iclude help gettig dressed, eatig, bathig, or self-admiisterig medicatio. Skilled, itermediate, ad custodial care i your home, a adult day care ceter, a assisted livig facility, or a ursig home ca be covered. LTC isurace will provide coverage for services whe they are required for a exteded period of time ad are ot associated with acute care or short-term illess. All beefits-eligible employees actively at work are eligible to apply. Also eligible are the employee s spouse, same-geder domestic parter (registered with the Uiversity), or civil uio parter ad adult childre betwee the ages of 18 ad 79 years. All applicats must maitai a permaet Uited States residece. Erollmet is volutary ad you decide how much to purchase. Evidece of isurability is required for all coverage electios for part-time employees ad all spouses/same-geder domestic parters/civil uio parters ad adult childre. Durig the first 31 days of employmet, full-time beefit-eligible employees may elect to participate without evidece of isurability. After the first 31 days of employmet, evidece of isurability is required to participate. Ay coverage requirig evidece of isurability will ot become effective util evidece of isurability is approved by Geworth. You will be cotacted directly by Geworth. The cost for log-term care isurace is based o your age ad the coverage amouts you select. Premiums are paid directly to Geworth. You choose betwee payroll deductio (for employees ad/or spouses), direct bill or electroic fuds trasfer from checkig or savigs accouts. If you select payroll deductio as your method of paymet, Geworth will commuicate the appropriate deductios to the Uiversity of Chicago. Coverage is portable, so you ca cotiue coverage if you chage jobs, retire, or leave the Uiversity of Chicago as log as you keep payig the premiums. Premiums will ot icrease if you leave the Uiversity of Chicago. If you would like to eroll, you will eed to cotact Geworth at or visit geworth.com/groupltc ad eter group id: uchicago ad code: groupltc. Health ad Depedet Care Flexible Spedig Accouts The Uiversity of Chicago offers beefits-eligible employees flexible spedig accouts (FSA) from which the paymet for certai health ad depedet care expeses ca be made with tax-free dollars. HEALTH CARE FSA The health care FSA offers you the opportuity to pay for certai health care expeses for yourself ad your depedets as log as these expeses are ot covered by your medical, detal, or visio plas. A eligible health care expese icludes: Medical, detal, ad visio deductibles, coisuraces ad office visits Prescriptio medicatio Certai over-the-couter drug expeses Ureimbursed visio expeses. All beefits-eligible employees ca cotribute betwee the aual miimum of $250 ad maximum of $2,500. DEPENDENT CARE FSA The depedet care FSA offers you the opportuity to pay for certai eligible depedet care expeses icurred while you ad your spouse (if married) work. To eroll you must be either sigle with eligible depedets or married with a spouse who is actively employed, a full-time studet, or disabled. No highly compesated employees ca cotribute a aual maximum of $5,000, ad highly compesated employees ca oly cotribute a maximum of $1,900. There is o aual miimum cotributio. HOW THE ACCOUNTS WORK You may eroll i a health care ad/or depedet care FSA withi 31 days of your hire or beefits-eligible date. You elect a aual cotributio, which will be deducted o a pre-tax basis from each of your paychecks i equal amouts. As a pre-tax cotributio, the amout will be deducted from your salary before federal icome tax, Social Security, ad i most cases, state ad local taxes. Your participatio begis o the first day of the moth followig your hire or beefits-eligible date. If you do ot eroll withi 31 days, you must wait util Ope Erollmet to eroll, with a effective date of the followig Jauary 1st. A eligible depedet care expese icludes: Before- ad after-school care Exteded day programs Day care, preschool, or ursery school Summer day camp Elder day care A eligible depedet is: A child uder age 13, who is claimed as a depedet o your icome tax A child age 13 ad older, who Depeds o you for at least half of his/her support, Regularly speds at least eight hours a day i your household, ad Is physically or metally uable to care for himself/herself A disabled spouse A elderly paret Your health ad/or depedet care FSA cotributio electios for 2014 must remai i effect through December 31, IRS regulatios do ot allow you to icrease, decrease, or stop your cotributios durig a pla year uless you have a qualified life evet, such as marriage, divorce, birth, or death. Ad the FSA cotributio chages you make must be cosistet with the type of life evet. Proof of the life evet is required ad must be submitted withi 31 days of the chage effective date. Qualified health ad depedet care expeses icurred o the first day of the moth followig your hire or beefits-eligible date, to December 31, 2014, will be eligible for reimbursemet from your FSA accouts. However, you ca use moey remaiig i your health care ad depedet care FSAs as of December 31, 2014, for qualified expeses icurred from Jauary 1, 2015 through March 15, This meas you have util March 15, 2015 to use your 2014 remaiig accout balace before it is forfeited. All claims must be submitted by Jue 30, Pla carefully. Ay balace ot used by March 15, 2015, will be forfeited; you caot receive the balace ad you caot carry it over to the ext year. 20 The Uiversity of Chicago 2014 Beefits Guide Questios? Cotact Huma Resources at beefits@uchicago.edu humaresources.uchicago.edu 21