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WELCOME
BENEFITS ORIENTATION
EMPLOYEE BENEFITS
Phone: (713) 500-3935 Fax: (713) 500-0342 Address: 10th floor UCT Hours: M-F 8am-5pm Web: www.uth.tmc.edu/finance/benefits Email: [email protected]
Contact Information
KIM LAMNew Hire Benefits Advisor/Orientation Presenter(713) [email protected]
ASHLEY SPANOBenefits Advisor/Orientation Presenter
(713) [email protected]
TERRY CALLOWAYBenefits Advisor/Orientation Presenter(713) [email protected]
CONTACTS
ELIGIBILITY
Full Time Employee At least 40 hours per week Expected to continue for at least 4 ½ months GA / GRA Titles
Part Time Employee At least 20 but not over 40 hours per week Expected to continue for at least 4 ½ months
Cannot be currently insured by another State-sponsored insurance plan. (Applies to covered dependents as well)
Return to Work Retiree
BENEFITS OFFERED Medical Dental Vision Life Accidental Death & Dismemberment Short Term & Long Term Disability Long Term Care Flexible Spending Accounts TRS – Teachers Retirement System Tax Sheltered Annuity – 403B Deferred Compensation Plan – 457B
BASIC PACKAGEBasic Coverage Package
UT Select Health Plan Medical Insurance for Employee
Only (Full-Time) Refer to rate sheet for Part-Time
premiums $10,000 Basic Group Life Insurance
Employee Only Not available if medical waived
$10,000 Accidental Death & Dismemberment Insurance Employee Only Not available if medical waived
Optional Coverage
Dental Vision Voluntary Life Insurance Voluntary AD&D Short Term Disability Long Term Disability Long Term Care UT Flex - Medical Expense UT Flex – Day Care Expense 403B/457B
MEDICAL INSURANCE
Provider - Blue Cross Blue Shield of Texas PPO Plan Only Health insurance available at UT Effective the 1st day of the month following 30
days of service No out-of-pocket cost for employee only (FT) 31 days to elect medical coverage Page 15 (Group Benefits Handbook)
MEDICAL INSURANCE DEPENDENTS
Out-of-pocket cost Semi-monthly pre-tax paycheck deduction 31 days to elect medical coverage
WHO IS ELIGIBLE?
Legally married spouse Unmarried dependent children under 25 Unmarried dependent grandchildren under 25 Submit proof of dependency
Within 31 days of enrollments Page 5 (Group Benefits Handbook)
MEDICAL PLAN SUMMARY
Annual Deductible $250/person
$750/family
Annual Out of Pocket Max $1750 p/person
$5,250 p/family
Hospital –Semi Private Room $100/day copay Max $500/admission
Output/Same Day Surgery $100 copay then 20% member
Physician Office Visits FCP- $30 Specialist - $35
Prenatal/Postnatal Care Visits $25 per visit
Hospital Obstetrical Care Same as Hospital Stay above
Laboratory Services Included in office visit copay
Diagnostic X-Rays Included in office visit copay
Emergency Room $100 copay (waived if admitted)
Ambulance Service 80% plan / 20% member
Immunizations Up to age 6, no charge for injection only
In – Network, Out of Network, Out of Area, Page 22 (GBH)
In – Network
ADDITIONAL WELLNESS BENEFITS
Lifestyle Management-Tobacco Cessation-Weight Management
Health Risk Assessment
Jenny Craig Membership Discounts
Curves Membership Discounts
24/7 Nurseline
Blue Points Incentives Communications
Wellness Discounts:
-Complementary Alternative Medicine
-Vision
-Hearing Aids
Fitness and Weight Centers
Personal Health Manager
-Ask A Features
-Meal Plans
-Fitness Plans
PRESCRIPTION DRUG PLAN
Included with your medical coverage Effective the same day as medical coverage Provider – Medco Health Solutions
In conjunction with Blue Cross Blue Shield PPO Plan
No out-of-pocket premium Retail and Mail Order prescriptions included Page 25 (Group Benefits Handbook)
PRESCRIPTION DRUG PLAN
Retail Max 30-Day Supply $10 Generic $35 Name Brand $50 Non-Preferred
Mail Order Max 90-Day Supply $20 Generic $87.50 Name Brand $125 Non-Preferred
$100 Annual DeductiblePer Person/Per Plan Year
DENTAL INSURANCE
Out-of-pocket cost Semi-monthly pre-tax paycheck deduction 31 days to elect dental coverage Effective date – hire date or 1st of following month
WHO IS ELIGIBLE?
Legally married spouse Unmarried dependent children under 25 Unmarried dependent grandchildren under 25 Submit proof of dependency
Within 31 days of enrollment
DENTAL OPTIONS
Delta Dental PPO
Assurant DMO
Comparison Page 38 (GBH)
DELTA DENTAL - PPO
Self-funded plan Network and Out-of-Network dentists Pre-approvals or referrals not required No primary care dentist needed No claim forms No balance billing Credentialed dentist network $25 annual deductible per person $1,250 maximum annual benefit per person $1,250 maximum lifetime benefit for orthodontics
DELTA BENEFITS SUMMARY
Diagnostic and Preventive (oral exams, x-rays, cleanings and fluoride to age 19)
100%
Basic Restorative (fillings and stainless steel crowns)
80%
Major Restorative (porcelain, resin and gold crowns)
50%
Endodontic (root canals) 80%
Basic Periodontics (scalings, root planing and treatment of gum disease)
80%
Basic Oral Surgery (extractions) 80%
Major Prosthodontics (bridges and dentures) 50%
Orthodontic (braces and retainers) 50% (Max lifetime benefit of $1,250)
Maximum Annual Benefit
Annual Deductible
$1,250
$ 25
In – Network
ASSURANT DENTAL - DMO
DMO Plan Must select a primary care dentist Discount service plan Variable co-payment schedule No claim forms No deductible No coverage for non-participating providers No maximum annual benefit No maximum lifetime benefit for orthodontics Work in progress not covered
ASSURANT BENEFITS SUMMARY
Diagnostic and Preventive (oral exams, x-rays, cleanings and fluoride to age 18)
$0-5
Basic Restorative (fillings and stainless steel crowns)
$8-60
Major Restorative (crowns) $275 (lab fees may also apply)
Endodontic (root canals) $90-175
Basic Periodontics (scalings, root planing and treatment of gum disease)
$0-200
Basic Oral Surgery (extractions) $9-80
Major Prosthodontics (bridges and dentures) $295-350 (lab fees may also apply)
Orthodontic (braces and retainers) Members receive a discount of 25% off of the Dentist Retail Fee. Benefits are available for adults and children with no lifetime maximum benefit.
Maximum Annual Benefit No Annual Maximum
In – Network
VISION
Superior Vision Semi-monthly pre-tax paycheck deduction 31 days to elect coverage Page 43 (Group Benefits Handbook)
VISION BENEFITS SUMMARY
Covered Services Network Benefits Out-of-Network Benefits
Comprehensive eye exam by an ophthalmologist or optometrist
Covered in full after $35 deductible including a contact lens exams or fitting fees
Up to $42 (ophthalmologist)
Up to $37 (optometrist)
Standard lenses (per pair)
Plastic (CR39), clear, uncoated
Covered in full Up to $32 (Single vision)
Up to $46 (Bifocal)
Up to $61 (Trifocal)
Up to $84 (Lenticular)
Frames Covered in full up to $140 Up to $53
Contact lenses (per pair) Covered in full (non-elective)
Up to $125 retail (elective)
Up to $210
(medically necessary)
Up to $95 retail
(cosmetic or elective)
Emp Only Emp/Sp Emp/Child Emp/Fam
UT Select $ 0.00 $169.23 $177.00 $333.28
Delta Dental$29.96 $56.87 $62.69 $89.14
Assurant Dental $10.05 $19.10 $21.11 $30.15
Superior Vision $ 6.80 $10.76 $10.96 $17.40
PREMIUM OVERVIEW
FLEXIBLE SPENDING ACCTS
Pay Flex Systems Set aside tax-free dollars Reduces your taxable income 31 days to elect coverage Page 55 Must re-enroll every year
TWO TYPES Medical Expense Dependent Care Expense
MEDICAL EXPENSE
Reimbursement Account Uses:
Co-payments Deductibles LASIK Over the counter items
Debit Card Available $9 Annual Fee No claim forms to submit Keep receipt copies
DEPENDENT CARE EXPENSE
Reimbursement Account Must have funds set aside prior to submitted a claim Custodial care for qualified dependents up to age 13 Uses:
Before/After School Care Preschool/Nursery School Day Care expenses Nanny Care expenses
Review IRS Guidelines to confirm
expenses are allowable
Contribution Limitations Minimum - $15 per month Maximum - $416 per month
Must have a current SS# to enroll
UNUSED DOLLARS WILL BE FORFEITED AT THE END OF THE PLAN YEAR
(September 1 – August 31)
FLEXIBLE SPENDING ACCTS
www.utflex.com
LIFE INSURANCE
Member Basic Life Plan Voluntary Term Life Plan
Employee $10,000
(provided as part of the Basic Package)
1-6 times Basic Annual Earnings up to a maximum of $1,500,000
1-3 times, within first 31 days of employment (no EOI required)
4-6 times (EOI required)
Spouse N/A $10,000 (no EOI required)
$25,000 or $50,000 (EOI required)
Dependent Children
N/A $10,000 (no EOI required)
Fort Dearborn Life Insurance, Page 45 (Group Benefits Handbook) 31 days to elect additional coverage Employee must have at least 1x in order to elect dependent coverage.
AD&D
Member Basic AD&D Voluntary AD&D
Employee $10,000 (provided as part of the Basic Package)
$0.16 per $10,000 additional
Spouse N/A Cannot exceed 50% of employee’s coverage
Dependent N/A $10,000
Fort Dearborn Life Insurance, Page 47 (Group Benefits Handbook) 31 days to elect additional coverage Employee must have at least $20K voluntary to elect dependent coverage.
Fort Dearborn, Page 49 (Group Benefits Handbook) Provides replacement income in the event you
become disabled due to injury or illness Must satisfy 14 day elimination period Exhaust all sick leave Pays out 60% of weekly income, not to exceed
$693 per week Payable for up to 22 weeks EOI required if not elected at time of hire After-tax paycheck deduction
SHORT TERM DISABILITY
Fort Dearborn, Page 51 (Group Benefits Handbook) Provides replacement income in the event you
become disabled due to injury or illness Must satisfy 90 day elimination period Exhaust all sick leave Pays out 60% of former base income Payable until age 65 or no longer disabled EOI required if not elected at time of hire After-tax paycheck deduction
LONG TERM DISABILITY
LONG TERM DISABILITY
“Catastrophic” accident - additional 10% Catastrophic is defined as:
Not being able to perform two or more Activities of Daily Living.
Ex. bathing, dressing, etc. Pre-Existing Condition – no benefits payable Does not cover if caused by:
War Attempted Suicide Riot Felony Loss of Professional License
LONG TERM CARE
CNA, Page 53 (Group Benefits Handbook) Covers costs associated with long term care May be community based or nursing home facility Available for:
Employees Spouses In-laws Parents Adult children (over age 25) Grandparents
EOI required if not elected at time of hire Must contact CNA directly
TRS
Teacher Retirement System of Texas Mandatory participation for all benefit eligible employees
Excluding Students Withdrawn semi-monthly, pre-tax Employee Contribution – 6.4% Employer Contribution – 6.4% Vested after 5 creditable years of service Vested allows you to receive a monthly annuity upon
retirement Page 63 (Group Benefits Handbook)
TRS DEATH BENEFIT
Beneficiaries will receive a determined amount In addition to Fort Dearborn Life Policy Beneficiary information will be sent in regular mail
by TRS
Contact Info: 1-800-223-8778 www.trs.state.tx.us
UT RETIREMENT BENEFITS
Must be 65 years of age Must have 10 cumulative years of service Insurance Benefits:
Medical Dental Vision Life – up to $50,000
VOLUNTARY RETIREMENT
Tax Sheltered Annuity 403 B
Traditional (Pre-Tax) Roth (After-Tax)
457 B DCP (Pre-Tax)
Contribution limits - $16,500 Over age 50 Catch up Contribution - $5,500 May begin participation at any time Page 65 (Group Benefits Handbook)
RETIREMENT PROVIDERS
AIG Retirement/VALIC Fidelity ING Lincoln Financial MetLife TIAA – CREF Page 70 (GBH)
http://www.utretirement.utsystem.edu/
Turn in: Fort Dearborn Beneficiary Form FT/PT New Hire/Rehire Form
Complete enrollment within 31 days of hire Obtain copies of proof of dependencies if adding
dependents to coverage elections Plan year is Sept 1 – Aug 31 Annual enrollment is in July www.utsystem.edu/benefits
REMINDERS
?
QUESTIONS