2018 BENEFITS NEW EMPLOYEE ORIENTATION FOR - Morehouse ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
HUMAN RESOURCES
NEW EMPLOYEE ORIENTATION FOR
2018 BENEFITS
January 1 – December 31, 2018
* This summary is being provided in accordance with the Employee Retirement Income Security Act
of 1974 (ERISA). If there is a discrepancy between this presentation and the applicable insurance
contract, agreement, or Summary Plan Document (SPD) or plan document, the applicable insurance 11/30/2017 - Supersedes All Previous Versions
contract, agreement, SPD or plan document will prevail.
*Please review your paycheck to ensure appropriate deductions are being withheld.
HUMAN RESOURCES
Agenda
• Healthcare Reform
• MSM Benefits Eligibility
• Medical/Prescription, Dental, Vision, and Flexible Spending Accounts (FSA),
Employee Assistance Program (EAP), Cigna
• Insurance: Life, Accidental Dismemberment (AD&D), Short Term Disability, Long
Term Disability
• MSM Holidays and Vacation
• Retirement Savings Plan – 403(b)
• Cigna Benefits (Travel Protection, Identity Theft Program, Will Preparation,
Bereavement Services, and Healthy Rewards)
• Vendor Contact Information
• Legal Notices
2
HUMAN RESOURCES
Healthcare Reform HUMAN RESOURCES
Medical insurance is required by law
Morehouse School of Medicine (MSM) benefits you because:
MSM pays part of the cost
You get tax savings on your share of the cost (pre-tax payroll deductions)
MSM benefit plans provide greater benefits and include more providers
than Marketplace plans
The value of your medical coverage is reported on your W-2 form (not
taxable to you)
Your will receive a 1095-C form that you will need in order to file your
income taxes
3
HUMAN RESOURCES
MSM Benefits Eligibility HUMAN RESOURCES
You are eligible if you are: Your eligible family members are your:
Employed in a benefits eligible position; Spouse, if not legally separated
and Legal domestic partner (Contact HR for requirements)
Children up to age 26
A full-time or part-time employee
Natural children
scheduled to work at least 18.75 hours per
Unmarried children over the age limit if:
week in a 37.5 hour work week or at least - Dependent on you for primary financial support and
20 hours per week in a 40 hour work week. maintenance due to a physical or mental disability: incapable of self
support; and
- The disability existed before reaching age 19.
If you experience a qualifying life event*, you must do the following with 31 days of the event: (1) request applicable changes and (2)
provide the appropriate documentation. The qualifying life event* also applies to increases/ decreases to your Flexible Spending
Accounts (FSA) elections. Changes are not retroactive.
* Qualifying life events include, but are not limited to marriage/partnership, birth or adoption of a child, death and survivorship, and
employment changes.
*MSM requires original dependent certification documentation (such as marriage license, partnership affidavit, birth certificate, etc.) to add eligible dependent(s). In
most cases coverage for a disabled child continues as long as the child is incapable of self-support, unmarried and fully dependent on you for support.
When adding a dependent you will need to provide their Social Security Number. Centers for Medicare and Medicaid Services (CMS), the agency that monitors the
claims collection from employers for Medicare requires all employers to provide the social security number of any employee and covered dependent covered through
an employer-sponsored medical plan. If you are waiting for a Social Security number of a dependent you are newly adding to benefits, you may initiate the request;
however, contact HR Benefits to update the Social Security number once it arrives.
4
HUMAN RESOURCES
Changing Your Benefits Outside of Open Enrollment
(Qualifying Life Events) HUMAN RESOURCES
The Internal Revenue Service (IRS) states that employees enrolled in pre-tax benefit plans may only make benefit elections
to these plans once a year. As such, your medical, dental, vision and Flexible Spending Account benefit choices are binding
January 1 – December 31. The following special circumstances are generally the only reasons you may change your benefits
during the plan year:
Marriage, divorce, legal separation or annulment
Birth, adoption or placement for adoption of an eligible child
Loss of spouse’s job or change in work status where coverage is maintained through the spouse’s plan; a significant change in your or your
spouse’s health coverage attributable to your spouse’s employment; the reduction or increase in hours of employment or other changes in
employment category for you or your spouse of dependent, including a change between part-time and full-time
Gain or loss of other coverage for your adult child
Death of a spouse or dependent
Loss of dependent status
Change in place of residence that affects eligibility
Becoming eligible for Medicare or loss or gain of Medicaid during the year
Receiving a Qualified Medical Child Support Order (QMCSO)
These special circumstances, often referred to as “Qualifying Life Events” or life even changes, will allow you to make
changes any time during the year in which they occur. For any allowable changes, you must notify Human Resources with 31
calendar days of the event and provide proof of the Qualifying Life Event to avoid a lapse in coverage. Original documents
are required such as marriage license, partnership affidavit, birth certificate, divorce decree, etc.. An election change must
be consistent with the change in status. Changes that are requested due to a “change of mind” are not allowed until the
next annual open enrollment period. Changes (except for newborns) will be effective for the next pay period after all
required documents are received. For additional information concerning plan changes, please contact Human Resources.
5
HUMAN RESOURCES
Medical/Prescription, Dental,
Vision, Flexible Spending,
Employee Assistance Plans
6
HUMAN RESOURCES
Cigna Open Access Plus / OAP – Basic Plan
7
HUMAN RESOURCES
Cigna Open Access Plus / OAP – High Plan
8
HUMAN RESOURCES
Prescription Drugs
In-Network Out-of-Network
30-day supply 90-day supply
(Retail or Home Delivery) (Retail or Home Delivery) Retail Home Delivery
Tier 1 $10 copay $20 copay
Tier 2 $30 copay $60 copay Not Covered Not Covered
Tier 3 $50 copay $100 copay
Notes:
* Retail - up to 90 day supply (except Specialty which is up to a 30-day supply)
* Home Delivery - up to 90-day supply (except Speciality which is up to a 30-day supply)
9
HUMAN RESOURCES
myCigna Telehealth Connection
10HUMAN RESOURCES
Cigna Dental PPO
In-Network Out-of-Network
Benefit Year Maximum $2,000 Overall
Benefits $2,000 Ortho lifetime max
Deductible (Individual/Family) $50 / $150
(Waived for Preventive Services)
• Preventive 100% 100%
• Basic 80% 80%
• Major 50% 50%
• Orthodontia 50% 50%
Basic Endodontics / Basic
Periodontics Covered As
Out-of-Network N/A 85th Percentile of Usual,
Reimbursement Schedule Customary & Reasonable
11HUMAN RESOURCES
Cigna Vision PPO
In-Network Out-of-Network
Vision Exam $10 copay Plan reimburses up to $45
(1x per 12 months)
Materials $10 copay then:
• Eyeglass Lenses Plan pays 100% Plan reimburses $40 - $100
(1x per 12 months) (See Schedule of Vision (See Schedule of Vision
Coverage for lens types) Coverage for lens types)
• Frames Plan pays up to $130 Plan reimburses up to $71
(1x per 24 months)
• Contact Lenses* Elective: Plan pays $130 Plan reimburses up to $115
(1x per 12 months) Therapeutic: Plan pays 100% Plan reimburses up to $250
*Instead of eyeglasses and frames
12HUMAN RESOURCES
2018 Benefits Medical/Rx Premiums
Per
Payperiod
MSM Plan Monthly Cost Cost
Basic Plan Total MSM Employee
Employee $597.61 $533.48 $64.13 $29.60
Employee & Spouse $1,250.20 $970.71 $279.49 $129.00
Employee & Child(ren) $1,165.28 $977.72 $187.56 $86.57
Family $1,824.83 $1,416.88 $407.95 $188.28
High Plan
Employee $660.04 $542.00 $118.04 $54.48
Employee & Spouse $1,380.85 $948.68 $432.17 $199.46
Employee & Child(ren) $1,287.04 $964.79 $322.25 $148.73
Family $2,015.50 $1,384.70 $630.80 $291.14
13HUMAN RESOURCES
Dental & Vision Premiums
Dental
Per
Payperiod
Monthly Cost Cost
Total MSM Employee
Employee $38.98 $34.92 $4.06 $1.87
Employee & Spouse $81.56 $65.33 $16.23 $7.49
Employee & Child(ren) $76.01 $63.77 $12.24 $5.65
Family $119.04 $93.10 $25.94 $11.97
Vision
Per
Payperiod
Monthly Cost Cost
Total MSM Employee
Employee $6.32 $5.71 $0.60 $0.28
Employee & Spouse $11.95 $9.78 $2.17 $1.00
Employee & Child(ren) $11.14 $9.50 $1.64 $0.76
Family $17.44 $13.97 $3.47 $1.60
14HUMAN RESOURCES
Flexible Spending Accounts (FSA)
Healthcare Dependent Care
Spending Account Spending Account
• Set aside up to $2,650 before taxes • Set aside up to $5,000 per calendar
for qualified healthcare expenses year before taxes for dependent care
• Access entire amount on 1st day of expenses
plan year • Access money only once it’s deducted
• $500 Rollover Provision – Participants from your paycheck
are allowed to rollover a maximum of
$500 unused FSA dollars to the next Eligible expenses include
plan year daycare/in-home care for children
• Rollover Provision for Healthcare under 13 years and incapacitated
Spending Account ONLY tax-dependent adults
Claims January 1, 2018 – December 31, 2018 must be submitted by March 31, 2019 or
funds are forfeited except up to $500 from the Healthcare Spending Account.
15HUMAN RESOURCES
Employee Assistance Program
16HUMAN RESOURCES
Life and Disability
Insurance
17HUMAN RESOURCES
Life and Accidental Death & Dismemberment
18HUMAN RESOURCES
Income Protection
Short Term Disability Long Term Disability
Income replacement of up to 60% of pre-disability income*
Employee Paid Employer paid
$2,500 maximum weekly benefit $12,500 maximum monthly benefit
Benefits begin on 15th day of disability after a covered Benefits begin on 180th day of disability
illness/injury occurs
Benefits end at recovery or at 26 weeks If disabled prior to age 60, benefits can be paid up to age 65 or
your Social Security Normal Retirement Age (SSNRA) Disabilities
caused by mental illness or substance abuse have a limited benefit period
of 12 months per disability.
Your spouse or children may receive a lump sum benefit equal Your spouse or children may receive a lump sum benefit equal
to 3 weeks of your gross STD benefit up to $3,000, if you die to 3 months of your gross LTD benefit, if you die while entitled
while entitled to receive STD benefits. to receive LTD benefits.
* These benefits may also be reduced by any other income that you may be receiving (i.e. social security or workers’ compensation,
etc.)
19HUMAN RESOURCES
Time Away From Work
2018 Holidays – MSM provides eleven (11) paid holidays throughout the year.
Please see the Holidays Listing for details.
Vacation – Benefits-eligible employees accrue time or receive an allocation of days starting their first month
of regular employment. There are three employee vacation classifications: Vacation Accrual, Faculty and
Executives Allocation, and Residents Annual Allocation. Note: You are eligible to receive paid vacation time
after successfully completing your 90 day probationary period.
Regular full-time employees and regular part-time employees who are
benefits eligible accumulate vacation time on a prorated basis.
Employees who accrue leave and meet the rollover provisions have the
option to rollover available vacation up to five (5) days or its equivalent in
hours. Vacation time greater than five (5) days that is not used by June
30, will be forfeited.
Faculty, Executive, and Residents who receive an annual vacation
allowance must use their entire vacation allowance by June 30 or it will
be forfeited. The rollover provision does not apply to these employees.
*Time is listed in hh:mm format
20HUMAN RESOURCES
Retirement Savings Plan (403b)
Participating in a retirement savings plan is one of the best investments you can make towards your future.
MSM provides a generous seven (7) percent contribution toward your retirement readiness for employees in certain
employment classifications* and after 90 days of continuous employment (*residents, postdoc fellows and research
scholars do not qualify).
Employee Contributions Can Start Immediately
Start saving for retirement with your first paycheck. You decide how much you want to contribute to the plan,
up to $18,500 annually, and the deduction is automatically taken out of your paycheck on a pre-tax basis.
Changes After Enrollment: Employees may enroll to make employee contributions or makes changes to their
enrollment at any time.
Salary Deferrals: In 2018, employees may defer up to $18,500 - the statutory limitation under IRC Section 415 or
Section 402(g) on a before tax basis.
Vesting: You are always vested in the contributions you make; however, those that you receive from MSM vest after
24 months of continuous employment if you have worked one thousand (1,000) hours or more, during each
twelve(12) month period of the Plan Year.
Catch-up Contributions: Over the age of 50 (or will attain age 50 by the end of the calendar year and have or will
reach the initial maximum deferral limit), you may make additional contributions to the Plan. Please see the 2018
MSM 403(b)/457(b) Salary Reduction Agreement for more information.
21HUMAN RESOURCES
Cigna Benefits
22HUMAN RESOURCES
Cigna Secure Travel
23HUMAN RESOURCES
Cigna Identity Theft Program
24HUMAN RESOURCES
Cigna Will Preparation
25HUMAN RESOURCES
Cignassurance Program for Beneficiaries
26HUMAN RESOURCES
Cigna Healthy Rewards
27HUMAN RESOURCES
Vendor Contact
Information
28HUMAN RESOURCES
myCigna.com
29HUMAN RESOURCES
myCigna Mobile App
30HUMAN RESOURCES
Vendor Contact Information
Cigna
(Medical, Pharmacy, Dental, Vision, 800-244-6224 www.myCigna.com
Flexible Spending Account,
Employee Assistance Program)
Cigna -
(Basic Life, Dependent Life Insurance 800-423-1282 Income Protection
Conversion and Supplemental Life
Insurance)
Aflac 800-433-3036 www.Aflac.com
TIAA www.TIAA-CREF.org/msm
800-842-2776
VALIC / AIG 800-448-2542 www.valic.com
AXA -Equitable 800-628-6673 www.axa.com
31HUMAN RESOURCES
Questions?
This is an overview of the benefits plans in effect on January 1, 2017, generally offered to employees at
Morehouse School of Medicine. It does not contain full details, and should be considered as a “Summary of
Material Modifications” and is not the Summary Plan Description (SPD).
This summary is being provided in accordance with the Employee Retirement Income Security Act of 1974
(ERISA). If there is a discrepancy between this presentation and the applicable insurance contract,
agreement, SPD or plan document, the applicable insurance contract, agreement, SPD or plan document
will prevail. Every effort is made to ensure this presentation contains the most current information
available.
Morehouse School of Medicine reserves the right to change (including, but not limited to, the right to
amend, suspend or terminate) or make exceptions to its policies, procedures and benefit's plans, or to
change contributions at its discretion ant any time with and without prior notice.
If you have additional questions, please contact:
Department of Human Resources
720 Westview Drive, SW
Atlanta, GA 30310
404-752-1600 (Office); 404-752-1639 (Fax)
benefits@msm.edu
32HUMAN RESOURCES
Legal Notices
33HUMAN RESOURCES
Legal Notices
HIPPA Privacy Notice Summary of Benefits and Coverage
The Health Insurance Portability and Accountability Act of The Patient Protection and Affordable Care Act (also known as
1996 (HIPPA) requires health plans to protect the Health Care Reform law) requires that you receive a Summary
confidentiality of your private health information. More of Benefits and Coverage (SBC).
detailed information is provided in the heath’s plan notice of The SBC is designed to help you understand and evaluate your
HIPPA privacy. health plan choices. Copies of MSM’s sponsored medical plans
SBC is located on the MSM portal under Human Resources
Benefits section.
Women’s Health and Cancer Right Act Continuation of Benefits Coverage
If you have had or are going to have a mastectomy, you may be The right to COBRA continuation coverage was created by a
entitled to certain benefits in the Women’s Health and Cancer federal law, the Consolidated Omnibus Budget Reconciliation Act
Rights Act of 1998 (WHCRA). For individuals receiving of 1985 (COBRA). COBRA continuation coverage can become
mastectomy-related benefits, coverage will be provided in a available to you and other members of your family when group
manner determined in consultation with the attending physician health coverage would otherwise end. This notice contains
and the patient, for: important information about your right to COBRA continuation
• All stages of reconstruction of the breast on which the mastectomy
of coverage, which is temporary extension of coverage under the
was performed;
• Surgery and reconstruction of the other breast to produce a
Plan. The COBRA continuation notice is located on the MSM
symmetrical appearance; portal under the Human Resources Benefits section.
• Prostheses and treatment of physical complication of the
mastectomy, including lymphedema.
Genetic Information Nondiscrimination Act
These benefits will be provided subject to the same deductible The Health Insurance Portability and Accountability Act of 1996
and coinsurance applicable to other medical and surgical benefits (HIPPA) requires health plans to protect the confidentiality of
provided under MSM’s medical plans. If you have questions, your private health information. More detailed information is
please contact your medical provider. provided in the heath’s plan notice of HIPPA privacy.
34HUMAN RESOURCES
Health Insurance Marketplace Notice
Health Insurance Marketplace Notice What do I need to do?
Effective January 1, 2014, the Affordable Care Act – also You’re currently eligible to participate in a MSM sponsored
known as “healthcare reform” – requires most Americans medical plan. If you participate in the medical plan, you and
to have health insurance. Individuals who don’t have the Institution share the cost of your coverage. Your share of
coverage by January 1, 2014, will be required to pay a the cost is paid before-tax dollars, unless you
penalty. have elected otherwise.
The Health Insurance Marketplace (”health insurance If you choose not to participate in MSM’s plan and you buy
exchange”) was created to ensure that everyone has access insurance in the Marketplace, you will be responsible for
to affordable health insurance. The Marketplace is an paying the entire premium yourself with after-tax dollars.
option for someone who does not have employer-provided
health coverage or for someone who chooses not to enroll
in employer-provided health coverage. Because you have What is the individual mandate tax?
the option, for employer-provided health coverage, it is Under the ACA, most Americans are required to have health
unlikely that you will be eligible for federal subsidies. insurance or pay a penalty. If you elect coverage through
MSM, you will satisfy this requirement. For more information
Why am I receiving this notice? about the individual mandate, please visit:
https://www.irs.gov/Affordable-Care-Act/Affordable-Care-
This notice provides you with information about the health
Act-Tax-Provisions-Questions-and-Answers
Insurance Marketplace and where you can access more
information about health plans offered to you by either
your state or the U.S. Department of Health and Human Questions:
Services.
Call (800) 318-2596
MSM is required to provide this notice to every employee or visit: https://www.healthcare.gov
to comply with rules under the federal Affordable Care Act
(ACA).
35HUMAN RESOURCES
Prescription Drug Coverage and Medicare Notice
Important Notice about Prescription Drug Coverage and There are two important things you need to know about
Medicare your current coverage and Medicare’s prescription drug
coverage:
Please read this notice carefully and keep it where you can find
it. This notice has information about your current prescription 1. Medicare prescription drug coverage became available
drug coverage with Morehouse School of Medicine (MSM) and in 2006 to everyone with Medicare. You can get this
about your options under Medicare’s prescription drug coverage if you join a Medicare Prescription Drug Plan or
coverage. This information can help you decide whether or not join a Medicare Advantage Plan (like an HMO or PPO)
you want to join a Medicare drug plan. If you are considering that offers prescription drug coverage. All Medicare drug
joining, you should compare your current coverage, including plans provide at least a standard level of coverage set by
which drugs are covered at what cost, with the coverage and Medicare. Some plans may also offer more coverage for
costs of the plans offering Medicare prescription drug coverage a higher monthly premium.
in your area. Information about where you can get help to
make decisions about your prescription drug coverage is at the 2. MSM has determined that the prescription drug
end of this notice. coverage offered by MSM is, on average for all plan
participants, expected to pay out as much as standard
The full notice was sent to the MSM Community email Medicare prescription drug coverage pays and is
distribution list October 9, 2017 and is also located on the therefore considered Creditable Coverage. Because your
Human Resources section under the Benefits section. existing coverage is Creditable Coverage, you can keep
this coverage and not pay a higher premium (a penalty) if
you later decide to join a Medicare drug plan.
36OPEN ENROLLMENT HUMAN RESOURCES
Premium Assistance Under Medicaid and the
Children’s Health Insurance Program (CHIP)
A list of participating states is available at the link below or for more information on special enrollment rights, you can
contact either:
U.S. Department of Labor
Employee Benefits Security Administration
https://www.dol.gov/sites/default/files/ebsa/laws-and-regulations/laws/chipra/model-notice.pdf
(866) 444-EBSA (3272)
37HUMAN RESOURCES
Summary Annual Report 403(b) Plan
(01/01/2016 – 12/31/2016)
38HUMAN RESOURCES
OSHA
39You can also read
