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HIPAA Title I: Health Care Access, Portability, and Renewability Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical.

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Presentation on theme: "HIPAA Title I: Health Care Access, Portability, and Renewability Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical."— Presentation transcript:

1 HIPAA Title I: Health Care Access, Portability, and Renewability Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform

2 HIPAA Title I Limits restrictions for preexisting conditions Provides additional opportunities to enroll in a group health plan

3 HIPAA Title II Covered entities are required by law to maintain the privacy of your health information Covered entities may share health information with each other to carry out treatment, payment, or health care operations Establishes security standards to protect electronic information

4 Additional HIPAA Information Visit our webpage at

5 COBRA Consolidated Omnibus Budget Reconciliation Act of 1985 Allows continuation of medical/dental coverage upon loss of eligibility for employer plan Applies to employee and covered dependents May continue coverage for up to 18 months 102% premium

6 Family Medical Leave Act (FMLA) Provides job protected leave benefits to eligible employees Provides up to 12 work weeks of unpaid leave Gives employee ability to maintain existing medical benefits Employees must have 12 months of service with NMSU (need not be consecutive) and have worked at least 1,250 hours in the previous 12 month period in order to be eligible for FMLA

7 When does FMLA Apply? Birth of a child Placement of an adopted or foster child Serious health condition Care of a child, parent, spouse or recognized domestic partner with a serious health condition Care for a Service Member (only benefit that allows 26 weeks of leave)

8 Additional FMLA Information Benefits Services –Website: – – HR Service Center – –Phone:

9 NMSU Employee Orientation Benefit Overview Benefit Services Department Room 17 Hadley Hall (575) Office hours: M-F 8:00am – 5:00pm

10 General Pay Information Paydays are semi-monthly (on the 15 th and last working day of the month) Non-Exempt (hourly) employees are paid on a 2 week lag Exempt (salaried) employees are paid current Direct deposit is available* and recommended. –It is the responsibility of the employee to set up the direct deposit through my.NMSU.edu * Pay advice notification is sent via and is accessed electronically using a password

11 Time and Leave Reporting All non-exempt (hourly) employees must submit an electronic timesheet through my.NMSU.edu –Timesheets are due 4 business days after the pay period ends Exempt (salaried) employees report leave taken on a monthly basis –Leave reports are due 10 calendar days after the end of the month –Leave reports must be submitted each month even if no leave is taken

12 Holiday Schedule Martin Luther King Jr. Day Spring Holiday Memorial Day Independence day Labor Day Thanksgiving (2 days) Winter Break (Christmas Eve through New Year’s Day)

13 Leave Time Annual Leave  12 month employees earn 22 days per fiscal year*  Fiscal Year = July 1 through June 30  240 hours may be carried forward each July 1*  Pro-rated if working less than 40 hours  Leave time cannot be advanced * excluding non-regular term appt employees & RTW retirees Sick Leave*  12 month employees earn 12 days per fiscal year  Fiscal Year = July 1 through June 30  800 hours may be carried forward each July 1  Pro-rated if working less than 40 hours  Doctor’s note may be requested at any time * excluding non-regular term appt employees & RTW retirees

14 Sick Leave Bank Available to all regular employees with at least 2 years of service Must be enrolled in LTD to participate Donation of 40 hours of personal sick leave to the bank is required Membership in the Sick Leave Bank is optional In the event of a “personal emergency”, a member with insufficient leave balances to cover the 135 day waiting period for LTD is eligible to apply for a donation (maximum of 70 days per request per fiscal year)

15 Insurance Programs Eligibility: Regular employees and Non-regular term appointment employees Medical (pre-tax available) Blue Cross Blue Shield NM (PPO) Blue Cross Blue Shield NM (HMO) Presbyterian Health Plan (HMO) Prescription (included in cost of medical) Express Scripts Dental (pre-tax available) Delta Dental of New Mexico Vision (pre-tax available) Vision Service Plan (VSP)

16 Insurance Programs Eligibility: Regular employees and Non-regular term appointment employees Group Life and AD&D, Voluntary Life and AD&D, Long Term Disability Dearborn National Critical Illness AFLAC Long Term Care Genworth – available to extended family members Eligible Dependents may include spouse, qualified domestic partner, and children (biological, adopted, step, and domestic partner’s children). Supporting documentation must be provided at time of enrollment.Eligible Dependents

17 Deadlines/Rates Deadline for enrollment: Must enroll within 31 days of hire date. Rate splits for Medical/Group Life and AD&D/Long Term Disability: Dental Rates: NMSU 60%, Employee 40% Employee paid benefits: Vision, Voluntary Life and AD&D, Critical Illness, Long Term Care (direct bill) Details on premium amounts can be found on the NMSU Benefits website at Annual SalaryNMSU %Employee % $0 - $26, $26,250 - $31, $31,

18 Flexible Spending Account Enrollment upon hire, at open enrollment in November/December, or with qualifying event Health Care FSA –Eligible expenses include medical, dental, vision and prescription (some OTC included) –Can elect up to $2,550 per plan year –Can file a claim up to the elected amount without money being in the account at the time of filing the claim –Any unclaimed amounts are forfeited Dependent Care FSA –Eligible expenses include childcare payments, camps –Can elect up to $5,000 per plan year or $2,500 if filing joint tax returns –Money must be in the account to file a claim –Any unclaimed amounts are forfeited

19 Retirement Benefits for Retired Employees Retirement Plans Available to Current Employees –NM Alternative Retirement Plan –NM Educational Retirement Plan –Voluntary Retirement (403b/457b) Transitioning to Retirement –http://benefits.nmsu.edu/retirement/preparing/http://benefits.nmsu.edu/retirement/preparing/

20 Tuition Remission Benefits Eligible employees may take 6 credit hours per semester & 8 credits over the summer without a tuition charge –Employees earning degrees may be eligible for pay increase - see NMSU Policy 7.05 Available through Banner Self-Service 10 calendar days prior to start of classes. –Must be an employee as of the first day of classes. –Must be registered for class(es) prior to submitting request. –Must be employed through the census date to be eligible for waiver in that session. Available to the spouse or domestic partner* if the employee does not use all the credit hours Deadlines to submit online waivers: –Summer classes – August 1 –Fall classes – November 1 –Spring classes– April 1 Courses may be subject to taxation. *Domestic Partnership paperwork must be on file in Benefit Services for the domestic partner to have access to this benefit

21 Reduced Tuition for Dependent Children For eligible dependent children under age 25 and unmarried (undergraduate courses only) Student’s status and the employee’s employment status on the NMSU Census Date (third Friday of the semester, or last day to add or register for summer session courses) will determine eligibility. 50% tuition discount for both full-time and part-time students. Employee must submit a request for tuition waiver for each semester in which the dependent will be using the Reduced Tuition Program Available through Banner Self-Service 10 calendar days prior to start of classes. Deadlines to submit online waivers: –Summer classes – August 1 –Fall classes – November 1 –Spring classes– April 1 Students awarded the Lottery Scholarship will not be eligible for this benefit.

22 Additional Benefits Discount Season Tickets for Athletic Events Tennis Center Discount Golf Course Membership Discounts – GM, Verizon, Dell Savings Bonds SmartSavings

23 For Additional Information Plan to attend the Benefit Work Session OR Please contact the Benefit Services Department Contact the HR Service Center for Employment, Payroll and Benefits Questions Phone:


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