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Benefits Orientation Office of Human Resources Rendleman Hall, Room 3210 650-2190.

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Presentation on theme: "Benefits Orientation Office of Human Resources Rendleman Hall, Room 3210 650-2190."— Presentation transcript:

1 Benefits Orientation Office of Human Resources Rendleman Hall, Room 3210 650-2190

2 Benefits Staff  HR Director – Sherrie Senkfor  Associate Director – Jayne Markus  Benefits Mgr – Debbie Bayne  Benefits Counselors Tayanna Crowder Summer Murphy

3 General Information  Home Address (Banner Self Service)  Pay Schedules – Prorate pay  Earnings Statement (Banner Self Service)  Check Distribution Direct Deposit Check mailed to home address  Tuition Waivers

4 Quality Care Health Plan  Medical Indemnity Plan administered by Cigna  Members may use doctor of choice  No plan year or lifetime maximums  6 month preexisting condition clause (may be waived with certificate of creditable coverage)

5 Quality Care Health Plan (cont’d)  Precertification required for inpatient care and some outpatient services, $800 penalty on claim if precert is not done  QCHP Network (physicians & hospitals) http://provider.healthcare.cigna.com/soi. html or call (800) 962-0051 http://provider.healthcare.cigna.com/soi. html

6 Quality Care Health Plan (cont’d)  Plan year (July 1 –June 30) deductible ranges from $300 - $450 based on salary; Dependents deductible is $300; Family cap ranges from $750 - $1125  General out-of-pocket maximum $1200 per individual, $3000 per family per plan year

7 Quality Care Health Plan (cont’d)  Non-QCHP Hospital Maximum $4400 per individual, $8800 per family per plan year  $400 Emergency Room Deductible  $50 Hospital Deductible  $300 Non-QCHP Hospital Deductible  $100 Transplant Deductible

8 Quality Care Health Plan (cont’d)  RX Program through MedCo $75 rx deductible per individual per yr $11 co-pay Generic $26 co-pay Formulary Brand $52 co-pay Non-formulary Brand Maintenance Medications must be obtained through Maintenance Network Pharmacy, www.benefitschoice.il.gov

9 Quality Care Health Plan (cont’d)  Preventative Services – Not subject to annual deductible (see Benefits Handbook for details)

10 Quality Care Health Plan Member Monthly Costs  Employee Annual Base Salary $29,800 & Below$72.00 $29,801 - $45,000$77.00 $45,001 – $59,900$79.50 $59,901 - $74,900$82.00 $74,901 & Above$84.50

11 Quality Care Health Plan Monthly Costs (cont’d)  Dependent Costs 1 Dependent - $196.00 2 or more dependents - $226.00

12 HMO Coverage  No plan year or lifetime maximums  No preexisting conditions clause  Must use network doctors and hospitals. No benefit if not in network.  $275 Inpatient co-pay  $175 Outpatient surgery co-pay  $200 Emergency co-pay

13 HMO Coverage (cont’d)  $15 Office Visit co-pay for Primary  Referrals are needed to see specialist $20 co-pay for office visit  RX through network pharmacies $10 co-pay for Generic $24 co-pay for Preferred Brand $48 co-pay for Non-Preferred Brand $50 rx deductible per individual per yr  Monthly costs vary according to HMO chosen (see Benefits Choice Booklet)

14 HealthLink Open Access (OAP)  No preexisting conditions clause  Physicians List at www.healthlink.com  Offers 3 benefits levels Tier I HMO Tier II PPO Tier III Out-of-Network Level of Benefits determined by Healthcare Provider chosen Access to all three levels

15 HealthLink Open Access (cont’d)  No Plan year or Lifetime maximums under Tier I and Tier II  $1,000,000 Plan year and Lifetime maximum on Tier III  No Referrals needed to see specialist  Tier I is generally 100% coverage after a co-pay amount according to service, if any

16 HealthLink OAP (cont’d)  Tier I Co-pays $15 office visit co-pay $20 specialist office visit co-pay $275 inpatient co-pay $200 emergency room co-pay $175 outpatient surgery co-pay

17 HealthLink Open Access (cont’d)  Tier II is generally 90% coverage after a $200 deductible and co-pay (if applicable) according to type of service  $325 inpatient admission co-pay  $200 emergency room co-pay  $175 outpatient surgery co-pay

18 HealthLink Open Access (cont’d)  Tier III is generally 80% coverage after a $300 deductible and co-pay (if applicable) according to type of service  $425 inpatient admission co-pay  $200 emergency room co-pay  $175 outpatient surgery co-pay

19 HealthLink Open Access Member Monthly Costs  Employee Annual Base Salary $29,800 & below$47.00 $29,801 - $45,000$52.00 $45,001 - $59,900$54.50 $59,901 - $74,900$57.00 $74,901 & above$59.50

20 HealthLink Open Access Monthly costs (cont’d)  Dependent costs 1 Dependent $105.00 2 or more dependents $149.00  RX through network pharmacies $10 co-pay for Generic $24 co-pay for Preferred Brand $48 co-pay for Non-Preferred Brand $50 rx deductible per individual per yr

21 Dental Coverage  Administered by CompBenefits  Member may use dentist of choice  $125 individual deductible for non- preventative services  Maximum Plan Year Benefits of $2500 per person  May opt out of dental plan as new employee and at Benefits Choice

22 Dental Coverage (cont’d)  $2000 Lifetime Maximum for child orthodontics  Schedule of Benefits at www.benefitschoice.il.gov www.benefitschoice.il.gov  Monthly Costs Member Only $11.00 Member + 1 Dependent $17.00 Member + 2 or more dependents $19.50

23 Vision Coverage  Administered by EyeMed  Coverage for Network and Out-of- Network doctors  Check www.eyemedvisioncare.com Doctor Network and benefit eligibilitywww.eyemedvisioncare.com  Eligible for exam every 12 months, payment on glasses or contacts every 24 months

24 Life Insurance Coverage  Administered by Minnesota Life  State Paid Basic Coverage is equal to basic annual salary (12 months if fiscal, 9 months if academic)  Option to purchase additional units based on age and amount  Automatic issue for 4x as new employee evidence of insurability required for 5x up to 8X

25 Life Insurance (cont’d)  Accidental Death or Dismemberment  Spouse Life $10,000 $6.94 per month  Child Life $10,000 $.52 per month regardless of the number of children

26 Other Benefit Programs  Flexible Spending Dependent Care, $5,000 per year Medical Care, $5,000 per year  Supplemental Retirement Programs Deferred Compensation (457) Tax Deferred Annuity (403b)  Long Term Disability – Prudential  Supplemental Life – ING ReliaStar

27 Other Benefit Programs (cont’d)  Savings Bonds  6 Month Pass to Student Fitness Center In Welcome Packet from VC for Student Affairs  Colonial Life Insurance Cancer Insurance, Critical Illness, Spouse Disability, Accidental Insurance Premiums are collected August thru May

28 General Insurance Information  Opt Out Option Enables members with proof of other major medical coverage to elect not to participate in the health, dental and vision coverage Part-time employees may waive health, dental and vision coverage  Benefits Choice Period May 1-31 of every year, tax exempt premiums

29 General Insurance Info (cont’d)  Summer Premiums Continuing/permanent employees who do not have a summer contract or are off during the summer will be billed by CMS Term employees verified as having a fall contract will be billed by CMS Voluntary deductions will be taken as a lump sum upon return to work

30 General Insurance Info (cont’d)  Dependent Eligibility – documentation Spouses – copy of marriage certificate Children  Birth to 18 – copy of birth certificate  19 to 23 – Verification of full time student at accredited school, copy of birth certificate

31 General Insurance Info (cont’d) Step Children Must reside with member in parent-child relationship at least 50% of the time and member must be married to child’s mother/father – Verification of residency (school records, divorce decree, tax return), birth certificate and marriage certificate

32 General Insurance Info (cont’d)  Adult Child – not eligible for life insurance options Sponsored Adult Child – not a student, not attending school full-time, handicapped, or student military extension dependent (ages 19-25) Veteran Adult Child – have served as a member of the active or reserve branches of Armed Forces (ages 19-29) Student Medical Leave of Absence – student between ages of 19-23 who is on medical leave due to catastrophic illness/injury (can last for 12 months or when child turns 23)

33 General Insurance Info (cont’d) Domestic Partner (same sex)  Effective July 1, 2006, unrelated, same-sex individuals who reside in the same household and have a financial and emotional interdependence, consistent with that of a married couple for a period of not less than one year and continue to maintain such arrangement are eligible for medical, dental and vision benefits through the State of Illinois

34 Benefits Enrollment Deadlines  Long Term Disability 31 Calendar days after employment  Retirement Plan Choice Election is irrevocable; must be chosen within 6 months of employment; election form is returned to SURS; if choosing self manage plan, employers dollars do not go into account until plan is chosen  Flexible Spending Accounts 60 calendar days after employment

35 Benefits Enrollment Deadlines  Tax Deferred Annuities No deadline, paperwork in month before  Deferred Compensation No deadline, paperwork in month before www.benefitschoice.il.gov  Cancer/Critical Illness 30 days after employment


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