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1 Tulane’s Wave of Benefits
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2 Eligibility Health Plan Dental Plan Life & Disability Insurance Flexible Spending Retirement Employees Assistance Program (EAP) Tuition Waiver AGENDA
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3 Eligibility Who is eligible Regular Full-Time or Regular Part-Time with Benefits Spouse (same sex domestic partner) Unmarried dependent children, under 21 years of age or under 25 if a full time student or a disabled child. Child is defined as the natural or adopted child, stepchild, foster child, or child whom the employee has legal custody of and resides in the home in a parent child relationship or is required to provide support due to court order.
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4 Benefits Participation Employee Health Coverage Long Term Disability Coverage Basic Life Insurance Dependent Health Coverage Dental Coverage Life Insurance AD&D Insurance Flexible Spending Plans Tax Deferral Plan Tuition Waiver VoluntaryNon-Voluntary
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5 Enrollment Opportunities New Employee Enrollment The date of hire or appointment Annual Open Enrollment You can change plans, add/drop dependent coverage at this time. You will be notified via email and USPS mail of the dates. Qualifying Life Event Changes Career or family life changes may qualify as a qualifying life event change that allows you to make changes outside the annual enrollment period.
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6 Coverage Ends Termination of Employment The last day of work Dependent Ages Out Qualifying Life Event Changes Career or family life changes may qualify as a qualifying life event change that allows you to make changes outside the annual enrollment period.
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7 Ineligible Dependents You must notify Human Resources when a dependent loses eligibility. The deduction will be changed for the next payroll.
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8 HEALTH INSURANCE PROVIDED BY UNITED HEALTHCARE
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9 United HealthCare Insurance Basic, Plan 13 (Low Plan) Basic Plus, Plan 09 (Medium Plan) Basic Choice, Plan 10 (High Plan)
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10 Plan 13 (Low Plan Option) Type of Coverage Physician’s Office Services Specialist Office Visit Emergency Room Services Inpatient Hospital Stay Prescription Drugs Deductible Out-of-Pocket Maximum Plan Maximum Network Benefit $25 $100 copayment 20% after deductible $10/$30/$50 $1000/$2000 $2000/$4000 NA Non-Network Benefit 40% after deductible (preventive in network only) 40% after deductible Covered as network benefit 40% after deductible $10/$30/$50 $2000/$4000 $8000/$16000 $1,000,000 per member
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11 Plan 9 (Middle Plan Option) Type of Coverage Physician’s Office Services Specialist Office Visit Emergency Room Services Inpatient Hospital Stay Prescription Drugs Deductible Out-of-Pocket Maximum Plan Maximum Network Benefit $25 $100 copayment 10% after deductible $10/$30/$50 $500/$1000 $2500/$5000 NA Non-Network Benefit 30% after deductible (preventive in network only) 30% after deductible Covered as network benefit 30% after deductible $10/$30/$50 $1500/$3000 $5000/$10000 $1,000,000 per member
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12 Plan 10 (High Plan Option) Type of Coverage Physician’s Office Services Specialist Office Visit Emergency Room Services Inpatient Hospital Stay Prescription Drugs Deductible Out-of-Pocket Maximum Plan Maximum Network Benefit $25 $100 copayment 10% after deductible $10/$30/$50 $250/$500 $1500/$3000 NA Non-Network Benefit 20% after deductible ( preventive in network only) 20% after deductible Covered as network benefit 30% after deductible $10/$30/$50 $2500/$5000 $5000/$10000 $1,000,000 per member
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13 Plan 13 Low Plan Plan 9 Med Plan Plan 10 High Plan Type of CoverageIn NetworkOut of NetworkIn NetworkOut of Network In NetworkOut of Network Coordinated Vision Care Network Eye exam (Once every 12 months) Co-payments for lenses and frames at CVC plus physician’s office $25 Co-payment 40% of Eligible Expenses – Eye Examinations for refractive errors are not covered No Benefits $25 Co-payment 30% of Eligible Expenses – Eye Examinations for refractive errors are not covered. No Benefits $25 Co-payment $25 Co-payment 20% of Eligible Expenses – Eye Examinations for refractive errors are not covered. No Benefits Optometrist/ Ophthalmologist UHC Network Eye exam (Once every 12 months) No Coverage for Lenses or Frames Vision Benefits Plan Design
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14 Mental Health / Substance Abuse Plan 13Plan 9Plan 10 Type of CoverageIn NetworkOut of Network In NetworkOut of Network In NetworkOut of Network Outpatient Mental Health/Substance Abuse (Visit Maximum per Calendar Year may apply) Prior authorization required $25 Co-payment40% of Eligible Expenses $25 Co-payment30% of Eligible Expenses $25 Co-payment20% of Eligible Expenses Inpatient Mental Health/Substance Abuse ( Day Maximum per Calendar Year may apply) Prior authorization required 20% of Eligible Expenses 40% of Eligible Expenses 10% of Eligible Expenses 30% of Eligible Expenses 10% of Eligible Expenses 20% of Eligible Expenses Benefits Plan Design
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15 COVERAGE TIERS Employee only Employee + spouse (same sex domestic partner) Employee + child(ren) Family
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16 Monthly Health Insurance Rates 2007 Basic Option (Low)Basic Plus (Medium)Basic Choice (High) Employee Only Less than $30,000 $28.63$63.04$143.15 $30,000 to $59,999 $45.96$80.38$160.48 $60,000 to $89,999 $80.38$114.52$194.89 $90,000 & above $109.00$143.15$223.51 Employee + Spouse Less than $30,000 $216.97$283.51$373.78 $30,000 to $59,999 $269.76$329.03$420.37 $60,000 to $89,999 $304.94$396.91$490.52 $90,000 & above $345.99$453.61$548.89 Employee + Child(ren) Less than $30,000 $166.28$219.71$339.46 $30,000 to $59,999 $233.84$290.24$386.31 $60,000 to $89,999 $297.08$389.13$467.16 $90,000 & above $333.54$444.72$522.75 Family Less than $30,000 $242.78$372.71$466.96 $30,000 to $59,999 $310.34$417.74$513.81 $60,000 to $89,999 $378.14$502.38$601.37 $90,000 & above $445.95$569.94$671.25
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17 DENTAL INSURANCE PROVIDED BY METLIFE
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18 Any dentist –Maximized savings when you visit one of the more than 77,000 participating PDP dentists Scheduled fees typically 10-35% below community average charges Lower out-of-pocket expenses for non-covered services –No pre-selecting necessary Any time Anywhere Any specialist No claim forms No referrals needed MetLife Preferred Dentist Program (PDP) Gives You More: Access, Savings and Options
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19 Type A: Preventive Services Exams X-Rays Fluoride Treatment Cleanings SERVICES PROVIDED IN-NETWORK: Percentage of Scheduled PDP Fee OUT-OF-NETWORK: Percentage of Reasonable & Customary (R&C) 100% No Deductible 100% $100 Deductible for single and $300 Deductible for Family Benefits Plan Design *Reasonable & Customary charges are based on the lowest of a dentist's usual, actual or community average charge as determined by MetLife. Type B: Basic Services Most Fillings Simple Extractions Sealants Services Covered at 80% Deductible Applicable Services Covered at 80% Deductible Applicable
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20 SERVICES PROVIDED IN-NETWORK: Percentage of Scheduled PDP Fee OUT-OF-NETWORK: Percentage of Reasonable & Customary (R&C) Benefits Plan Design *Reasonable & Customary charges are based on the lowest of a dentist's usual, actual or community average charge as determined by MetLife. T ype C: Major Services Inlays/Onlays Crowns Bridges/Dentures Root Canal Annual Deductible Annual Benefits Maximum [excluding Orthodontia] Services Covered at 50% Deductible Applicable Services Covered at 50% Deductible Applicable $50 Individual/$150 Family $100 Individual /$300 Family $1,500 per Person$500 per Person
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21 SERVICES PROVIDED IN-NETWORK: Percentage of Scheduled PDP Fee OUT-OF-NETWORK: Percentage of Reasonable & Customary (R&C) Type D: Orthodontia Orthodontic Treatment Orthodontic Appliances Orthodontia Lifetime Benefits Maximum Services Covered at 50% $1,500 per Dependent Child Services Covered at 50% Annual Deductible NONE $500 per Dependent Child Benefits Plan Design Non-covered services: teeth whitening, veneers, implants
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22 Employee Only:$18.48 Employee + Spouse$38.21 Employee + Child(ren)$40.86 Employee + Family$67.12 MetLife Dental Coverage Rates
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23 Financial Security Group Basic Term Life Supplemental Term Life Voluntary Accidental Death & Dismemberment Long Term Disability Death Benefit
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24 Financial Security DEATH BENEFIT PLAN Provides and eligible employee’s beneficiary an amount equal to one month’s salary.
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25 Group Life Insurance PROVIDED BY METLIFE
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26 Basic Term Life Insurance Employer paid Coverage amount 1.5 times base annual salary to maximum of $50,000 For spouse (same sex domestic partner) $2000 Dependent children up to $2000
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27 Supplemental Term Life Insurance Coverage in $10,000 increments up to a maximum of $500,000 Coverage amounts above the lesser of 2 times annual salary or maximum of $100,000 require a Statement of Health form After 31 days of employment, all coverage amounts require a Statement of Health Premium based on age as of October 1 st
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28 Dependent Spouse Term Life Insurance Coverage in $10,000 increments up to a maximum of $150,000 Coverage amounts above $10,000 require a Statement of Health form After 31 days of employment, all coverage amounts require a Statement of Health Premium based on age as of October 1 st
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29 Dependent Child Term Life Insurance $10,000 for children 6 months or older $500 for children under 6 months of age
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30 Voluntary Accidental Death & Dismemberment Life Insurance Coverage amount $10,000 to $500,000 in increments of $10,000.
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31 Long Term Disability PROVIDED BY CIGNA
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32 All eligible employees are automatically enrolled 100% employee paid Premiums based on monthly salary 90 day benefit waiting period Coverage is 66.67% of the monthly salary to maximum of $8000 Benefits received are offset by: Workers Compensation, Social Security, and other sources of income Income received is not taxable Long Term Disability (CIGNA)
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33 Flexible Spending Accounts Benefit Concepts administered by
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34 Health Care Spending Account Enrollment – 31 days of hire or open enrollment period Eligible expenses – vision care, out of pocket deductibles, co-insurance, co-pays, over-the-counter drugs and weight loss programs (excluding food) $4,800 maximum Annual enrollment required All money not used will be forfeited, there are no refunds or credits Additional information including enrollment form in benefits packet
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35 Dependent Care Spending Account Enrollment – 31 days of hire or open enrollment period Regulations $5,000 maximum or $2,500, if married filing separate tax returns or your spouse uses a separate dependent care spending account Children under the age of 13, unless physically or mentally handicapped Disabled or elderly dependent Each parent must work outside the home All money not used will be forfeited, there are no refunds or credits Annual enrollment required Additional information including enrollment form in benefits packet
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36 Tax Deferral Plan Eligible to participate upon hire 403b Plan No company match Pre-taxed which will lower taxable income Contribution does not show in W-2 earnings Refer to the retirement summary in benefits packet Online enrollment Additional information including the Salary Reduction Form is available upon request For more information contact Celeste Wertz at cwertz@tulane.educwertz@tulane.edu Deferred Compensation 457b Plan (based on earnings qualifications)
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37 University Retirement Plan Eligible to participate after 2 years of service 403b Plan Staff- Contribution equals 8% of salary, paid by University No employee contribution required 100% owned by employee Online enrollment For more information refer to the retirement summary in benefits packet
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38 Retirement Plan Investment Options TIAA-CREF www.tiaa-cref.org Fidelity Investmentswww.fidelity.com sponsored by
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39 EMPLOYEE ASSISTANCE PROGRAM Immediate help during a crisis Tips and guidance to help balance work and family Three (3) free in-person counseling sessions Confidential Accessible 24 hours a day, 365 days a year Available to your dependents and all members of your household To access service call CIGNA Behavioral Health at 1-888-371-1125 For more information see brochure in benefits packet
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40 Tuition Waiver Program Employee Waivers Full-time staff are eligible after six months full-time employment Waiver is applied to two classes or six hours which ever is greater Graduate waivers that exceed $5,250 are taxable Dependent Waivers Dependents of staff members are eligible after three years full-time employment Must submit most recent copy of Federal Income Tax Return to prove dependency Waiver applied to tuition and not University fees.
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41 Thank You Human Resources Benefits Section 200 Broadway Street, Suite 120 New Orleans, LA 70118 (504)865-5280
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