Southeast Missouri State University Benefits Orientation

Southeast Missouri State UniversityBenefits Orientation

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Your 2010 Benefits

Your benefits are effective on your date of hire

Medical Insurance Anthem Blue Cross & Blue Shield

Vision Insurance Vision Service Plan

Dental Insurance Delta Dental of Missouri

Flexible Spending Accounts Health Savings Account

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Your 2010 Benefits (continued)

Life Insurance Anthem Life

Retirement MOSERS (Faculty & Staff)

CURP (Faculty only)

Educational Benefits Employee Assistance Program

**You will complete enrollment forms during orientation. You are allowed 31 days from date of hire to finalize benefit elections.**

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Medical Insurance Basics Blue Access PPO Network

Nationwide access Worldwide access

Unlimited lifetime maximum

Website: http://www.anthem.com

Pre-existing conditions: 12 months exclusion, can be waived by providing a HIPAA certification (a statement certifying proof of prior coverage)

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Medical Insurance Basics Dependent Coverage

Up to age 25 regardless of student status

If not enrolled at employee’s date of hire – dependents can enroll during annual open enrollment

Dependents can enroll within 31 days of an IRS Qualifying Change in Family Status (e.g., marriage, divorce, birth of child, change in spouse’s coverage status, etc.)

Pre-existing conditions for 12 months unless a HIPAA certification is provided.

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Medical Insurance Basics Coordination of Benefits

Anthem Blue Cross and Blue Shield will coordinate benefits with other group health coverage that you or your covered family members may have.

To ensure that Anthem has up-to-date information they may periodically ask members about other health insurance coverage.

If any information regarding your or your families health insurance changes, please fill out a coordination of benefit form and send to Anthem.

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Medical Insurance Basics Problems with Claims?

Contact Anthem

Call physician’s office

View your claims online at: http://www.anthem.com

Contact the Human Resources Office for further assistance.

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Medical Insurance BasicsHIPAA(Health Insurance Portability and Accountability Act)

HIPAA improves the portability, security and privacy of protected health information.

When obtaining assistance regarding claims issues through the Human Resources Office, employees must sign an authorization for release of information form.

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Medical Insurance BasicsPrescription Drugs Coverage Visiting Network Retail Pharmacies

30-day supply

No RX Copays

Pharmacist processes Rx through Anthem computer system

20% Cost share after deductible

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Medical Insurance BasicsPrescription Drugs Coverage Anthem Mail Services

90-day supply

No RX Copays

Pharmacist processes Rx through Anthem computer system

10% Cost share after deductible

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Medical Insurance BasicsPrescription Drugs Coverage Prior Authorization

Goal: To assist employees with cost control of medications

The process of obtaining approval of benefits before certain prescriptions may be filled.

Must be obtained by your physician in order to receive benefits

To find out which drugs require prior authorization visit: www.anthem.com

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Medical Insurance BasicsMedical Insurance Opt Out Provisions

Employees can decline individual health coverage.

If opting out: Employee’s premium dollars are not available Cannot return to Anthem Blue Cross and Blue

Shield until next annual open enrollment or IRS Qualifying Event

Must sign disclaimer form verifying intention to decline coverage

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Medical Insurance Basics

Health Incentive Accounts (HIA) Allows members to earn health care dollars through

various plan incentives

Features within Medical Plans A and B Medical Plan A – reduces plan deductible Medical Plan B – payable to employee as gift

cards

Unused health incentives carry over

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Medical Insurance Basics Types of Incentives

Health Assessment - $50 Personal Health Coach - $100

$200 incentive when achieving goals through program

Smoking Cessation Program - $50 Weight Management Program - $50

All incentive programs available through the Anthem website: www.anthem.com

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Medical Plan A

Anthem Blue Cross and Blue Shield

Cafeteria Plan Funding for Plan A

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2010 Medical InsuranceMedical Plan A $500 Individual Deductible

$1,000 Family Deductible

20%/80% after deductible met

Full Preventive Care coverage (well woman, PSA, mammogram, annual physical, immunizations, etc.)

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2010 Medical InsuranceMedical Plan A Office Visit Copays:

No Office Visit Copays (employee pays 100% of cost up to the deductible; then cost share applies)

Out of Pocket Maximum: Individual: $3,500/year Family: $7,000/year All deductibles and coinsurance apply

toward the out of pocket maximum including prescription drugs.

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Cafeteria Plan A

Plan Summary

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Medical Plan A Cafeteria Plan Contributions

Employer Cafeteria Plan Funding: $750/year

You must be an employee with the University on December 31 to be eligible to receive the Cafeteria Plan Funding.  If you are hired mid year, this benefit will not be available until the next open enrollment period.

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Medical Plan A Cafeteria Plan Funding

Employer Cafeteria Plan Funding = $750/year

Dependent Medical

Dependent Care Assistance (DCAP)

Employee & Dependent Dental

Medical Reimbursement Account (MRA)

Employee & Dependent Vision

Cafeteria Plan A Option

Part-time employee funding prorated by percent of assignment.

The University will use the cafeteria plan dollars first to pay for employee and dependent medical premiums; then vision, dental, MRA and DCAP.

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Medical Plan B

Anthem Blue Cross and Blue Shield

Cafeteria Plan Funding for Plan B

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2010 Medical InsuranceMedical Plan B

$1,500 Individual Deductible

$3,000 Family Deductible

20%/80% after deductible met

Full Preventive Care coverage (well woman, PSA, mammogram, annual physical, immunizations, etc.)

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2010 Medical InsuranceMedical Plan B Office Visit Copays:

No Office Visit Copays (employee pays 100% of cost up to the deductible; then cost share applies)

Out of Pocket Maximum: Individual: $5,000/year Family: $10,000/year All deductibles and coinsurance apply

toward the out of pocket maximum including prescription drugs.

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Cafeteria Plan B

Plan Summary

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Medical Plan B Cafeteria Plan Contributions

Employer Cafeteria Plan Funding: $1,486.32

You must be an employee with the University on December 31 to be eligible to receive the Cafeteria Plan Funding. If you are hired mid-year, this benefit will not be available until the next open enrollment period.

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Medical Plan B Cafeteria Plan Contributions

Employer Cafeteria Plan Funding = $1,486.32/year

Dependent Medical

Dependent Care Assistance (DCAP)

Employee & Dependent Dental

Health Savings Account (HSA)

Employee & Dependent Vision

Cafeteria Plan B Option

Part-time employee funding prorated by percent of assignment.

The University will first fund the HSA; then dependent medical premium, vision, dental and/or DCAP.

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Medical Insurance 2010 Monthly Premiums

Medical Insurance – Anthem Blue Cross and Blue Shield

Medical Plan A Medical Plan B w/MRA option w/HSA option

Cost CostEmployee $512.68* Employee $437.50*Spouse $512.68 Spouse $437.44Children $384.44 Children $328.08Family $897.14 Family $765.56

* Full-time employee premium 100% funded* Effective July 1, 2009, new hire part-time employee premium

funding is prorated by percentage of assignment.

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Medical Plan A or BAn Analysis - Which is right for you?

Medical Plan A - $500 Deductible(w/MRA option)

Medical Plan B - $1,500 Deductible(w/HSA option)

General Office Visits/Rx4 Office Visits ($51/visit) = $ 204 4 Labs ($150/lab) = $ 357 4 Rx purchases ($100/Rx) = $ 80Total Cost = $ 641Less MRA Funding = $ (750)Net Savings (leftover MRA)= $ (109)

General Office Visits/Rx4 Office Visits ($51/visit) = $ 2044 Labs ($150/lab) = $ 6004 Rx purchases ($100/Rx) = $ 400Total Cost = $ 1,204 Less HSA Funding = $(1,486) Net Savings (HSA carryover) = $ (282)

A $50,000 Surgery4 Office Visits ($100/visit) = $ 4004 Labs ($150/lab) = $ 2004 Rx purchases ($100/Rx) = $ 80 Deductible & OOP Maximum = $ 2,820 Total Cost = $ 3,500Less MRA Funding = $ (750)Net Cost = $ 2,750

A $50,000 Surgery4 Office Visits ($100/visit) = $ 4004 Labs ($150/lab) = $ 6004 Rx purchases ($100/Rx) = $ 400Deductible & OOP Maximum = $ 3,600 Total Cost = $ 5,000 Less HSA Funding = $(1,486)Net Cost = $ 3,514

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Vision Insurance

Plan Summary

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Vision Insurance Vision Service Plan (VSP)

Two Plan Options Exam Plus Plan A – Low Option Enhanced Plan B – High Option

Extra Discounts & Savings Laser Vision Correction Prescription Glasses Contacts

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Vision Insurance

Exam Plus Plan A In-Network providers:

Annual eye exam with a $10 copay

20% discount on lenses and frames

15% discount off the contact lens fitting and evaluation exam. This exam is in addition to your vision exam.

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Vision Insurance

Enhanced Plan B In-Network providers:

Annual eye exam with a $10 copay Lenses covered in full–every 12 months Frames – every other plan year (frames of

your choice covered up to $120, plus 20% off any out-of-pocket costs) or

Contact Lens care-every 12 months No copay applies

Prescription glasses-$25 copay

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Vision Insurance 2010 Monthly Premiums

Vision Insurance – Vision Service Plan

Plan A-Exam Plus Plan B-Signature PlanCost* Cost*

Employee $2.88 Employee $10.80Spouse $4.06 Spouse $17.32Children $4.12 Children $17.68 Family $6.10 Family $28.52

*Total premium includes employee only cost.

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Dental Insurance

Plan Summary

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Dental Insurance Delta Dental of Missouri

Two Plan Options Plan A – Low Option Plan B – High Option (with orthodontia) Annual Maximum (per person/year): $1,000 Utilize Delta Premier Network providers

Listing of Network providers can be located at: http://www.deltadentalmo.com

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Dental Insurance Preventive Plan A – Low Option

Coverage A only at 100% of UCR Oral exams – twice in any benefit year Fluoride patients under age 14 – once in any benefit

year Molar sealants for dependent children under age 16 –

once in 5 years Bitewings x-rays: one set in any benefit period

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Dental Insurance Plan B – High Option

Individual Deductible: $50 Waived for Coverage A Dental Services Includes Coverage A, B, C and D

Coverage A Services (100% of UCR) Oral exams – twice in any benefit year Fluoride patients under age 14 – once in any benefit

year Molar sealants for dependent children under age 16 –

once in 5 years Bitewing x-rays: one set in any benefit period

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Dental Insurance Coverage B Services

Fillings, extractions, Full-mouth x-rays at 80% after $50 deductible

Coverage C Services Periodontics, endodontics, surgical

extractions, crowns, complex oral surgery, bridges at the following schedule: 1st year – 10% 2nd year – 25% 3rd year and beyond – 50%

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Dental Insurance Coverage D Services

Orthodontia care for dependent children to age 19 at 50%

Maximum: $1,500, available starting in 3rd year of coverage

Orthodontics is not covered for care started prior to the 3rd year of benefits

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Dental Insurance 2010 Monthly Premiums

Dental Insurance – Delta Dental of Missouri

Plan A-Low Option Plan B-High Option Cost* Cost*

Employee $12.30 Employee $28.42Spouse $26.38 Spouse $56.12Children $40.96 Children $71.14Family $54.22 Family $102.50

*Total premium includes employee only cost.

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Flexible Spending Accounts

Plan Summary

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Flexible Spending Accounts Medical Reimbursement Account (MRA)

Tax-deferred payroll reduction: $5,000 annual maximum

Applicable expenses: Deductibles, copays, coinsurance, Rx, vision, dental, certain over-the-counter items

Dependent Care Assistance Program (DCAP) Tax-deferred payroll reduction: $5,000 annual

maximum Applicable expenses: day care for children and elder

care for adults

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Flexible Spending Accounts PowerGroup Administrators

Account feature Direct Deposit Option for Dependent Care

Print Form from website: www/myflexonline.com

Debit Card for Medical Reimbursement Account

Submitting Claims Expenses incurred through 12/31 of current year Claims filing deadline: 03/31 of upcoming year Claim forms can be faxed or mailed

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Flexible Spending Accounts PowerGroup’s Contact Information

Claims filing email address: pgaclaimsfaxes@pgcompanies.com

Customer Service: (800) 847-0038

Flex Account Hotline: (913) 789-4600

Fax: (913) 491-6379

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Health Savings Account (HSA)

Plan Summary

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Health Savings Account (HSA) Definition

An interest bearing savings account owned by the employee to pay for current and future medical expenses

Offered with a High Deductible Health Plan – Medical Plan B

Works similar to a flexible spending account, yet unused monies roll over year after year and continue drawing interest

Portable

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Health Savings Account (HSA)Account Contributions

Both employer and employee pre-tax contributions are permissible

2010 maximum annual contribution (employer and employee contributions combined)

$3,050 for employee only coverage $6,150 for family coverage

Catch-up Provision at age 55: $1,000 Employee contributions can be changed mid-

year via form completion in Human Resources office

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Health Savings Account (HSA)Who is NOT Eligible?

Employees covered by Medical Plan A

Employees covered by other medical insurance that is a non-high deductible health plan (at least $1,200)

Employees enrolled in Medicare coverage

Employees claimed as a dependent child on someone else’s tax returns

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Health Savings Account (HSA)Account Distributions Tax-free if used for qualified medical expenses Qualified medical expenses incurred on or after

account is established

Withdrawal only for monies in the account at time of distribution

Can apply qualified medical expenses of spouse and children, even if not covered by your medical insurance

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Health Savings Account (HSA)Account Distributions (continued)

Qualified Medical Expenses: Deductibles, cost shares, and out of pocket

costs on medical insurance claims

Over-the-counter medical items

COBRA continuation of coverage premiums

Qualified long term care insurance premiums

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Health Savings Account (HSA)Account Features HSA services through Mellon Bank

Upon electing the Medical Plan B coverage and electing an HSA, Welcome Kits will be mailed to home address

Forms must be completed by the employee and returned to Mellon Bank ASAP

Competitive mutual fund investment options available once account reaches $1,500

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Health Savings Account (HSA)Account Features (continued)

Online management access of personal benefits and HSA details

Monthly account activity statements

MasterCard – a debit card to pay for qualified medical expenses

Checkbook Usage - initial 40 checks supply; free of charge

Setup and monthly fees paid by Southeast

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Health Savings Account (HSA)How to use your money…

If seeing an Anthem provider Provider files insurance claim with Anthem Provider bills the member for out of pocket

responsibility due Member uses HSA account dollars to make payment

to provider via debit card or check

Network Retail Pharmacies/Mail Order Services Pharmacist/Precision Rx processes Rx through

Anthem computer system Member uses HSA account dollars to cover the cost of

prescriptions via debit card or check

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Health Savings Account (HSA)Account Features (continued)

Questions:

Customer Service: (888) 224-4902

www.anthem.com, My Account page

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Life Insurance

Plan Summary

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Life Insurance Anthem Life

Basic Life Insurance The University provides up to 2 ½ x base

salary coverage up to a maximum of $50,000 at no cost to the employee

Term Coverage – ends upon termination of employment

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Life Insurance Supplemental Life Insurance

1x, 2x, or 3x base salary coverage Guarantee issue limit is the lesser of 3x your base

salary or $100,000, without evidence of insurability, if enrolling as a new employee.

Rates<40 $0.06 per thousand/per month40 – 49 $0.15 per thousand/per month50 & over $0.54 per thousand/per month

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Life Insurance Dependent Life Insurance

One price covers all dependents, not per person

Cost $5,000 policy $1.50 per month $10,000 policy $3.00 per month $15,000 policy $4.50 per month

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Long Term Disability

Plan Summary

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Long Term Disability Anthem Life

LTD is for individuals who are certified by a physician as having a disability which does not allow them to continue employment

Works in conjunction with sick leave policy After you have been off work 180 days, you

are eligible to apply for LTD LTD payments are based on 60% of salary,

offset by Social Security disability

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Retirement Benefits

Plan Summary

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Retirement Benefits MOSERS

Missouri State Employees Retirement System Faculty & Staff

CURP College and Universities Retirement Program

Faculty only

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Retirement Benefits MOSERS Southeast contributes:

FY10: 12.75% FY11: 13.81%

Five-year vesting requirement Prior Service Credit

Once you are vested, active military service (or training) or prior public sector service in Missouri may be acquired to increase your MOSERS

Interactive web site – www.mosers.org View personal benefit information Access forms and publications Find “free” educational seminar

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Retirement Benefits CURP Southeast contributes

FY10: 7.71% FY11: 7.77%

TIAA-CREF will automatically... Designate your estate as beneficiary of your contract Invest contributions to TIAA-CREF Lifecycle Funds

(asset allocation)

www.tiaa-cref.org/curp Telephone Counseling Center: (800) 842-2776

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Other Retirement Options Tax Sheltered Annuity Investment

(403(b) Tax Deferred Annuities/457 Deferred Compensation)

Payroll reductions available

Three Easy Steps:

Contact an authorized Broker/Fund Company

Complete Salary Reduction Agreement Form

Submit Salary Reduction Agreement Form to the Benefits Office for processing

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Educational Benefits

Plan Summary

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Educational Benefits Employee Tuition Fee Waiver Program

Credit-bearing courses only

Must earn “C” or better grade

Funding of undergraduate incidental fees: 90%

Funding of graduate incidental fees: 70%

Must apply every semester

Application form can be downloaded and printed from the Human Resources forms website (due no later than the first day of classes for the semester)

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Educational Benefits Dependent Tuition Reimbursement Program

Spouse and eligible dependent children

Undergraduate Courses only

Must earn “C” or better grade

Reimbursement at end of each semester: 50%

Must apply at beginning of academic year (August)

Application form can be downloaded and printed from the Human Resources forms website (due no later than the first day of classes for the semester)

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Educational Benefits Cooperative Graduate Program

Graduate courses offered in partnership between Southeast and another state institution

Masters in Higher Education Administration (University of Missouri – St. Louis)

Doctor of Education in Education Leadership (University of Missouri – Columbia)

Reimbursement for courses with “B” or better grade: 70%

Application form can be downloaded and printed from the Human Resources forms website

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Employee Assistance Program

Plan Summary

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Employee Assistance Program Employee Counseling and Employee Assistance Services

Benefits to you and your immediate family

Provides seven free, confidential counseling Family problems and relationship issues Job conflicts and concerns Grief and loss issues Stress related emotional issues Depression and anxiety Alcohol and drug concerns

Call local office for an appointment: (573) 334-7667 (800) 455-7327

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Additional Benefits… Group Banking Benefit Program

Missouri State Credit Union

M.O.S.T. Program

U.S. Savings Bonds

AFLAC’s Personal Cancer Indemnity Plan

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My Southe@st http://portal.semo.edu

Southeast Key required (Contact IT Department) Extension: HELP (4357) Academic Hall – Room 140

Allows access to: Benefits and Deductions Campus Directory Leave Balances Pay Information Tax Forms (W4 information, W2 Form) Time Sheet

Any Questions?

Visit our Website: http://www4.semo.edu/humanresources/Benefits/index.htm

Stop by our Office: Human Resources Office Academic Hall, Room 220

Call Us: (573) 651-2206