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New Faculty Benefits Presentation. Fall 2011 Presented by Human Resource Services. AGENDA. Web Information Group Health Insurance Other Types of Insurance Types of Leave Retirement Plans Other Payroll Deductions Taxes.
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New Faculty Benefits Presentation Fall 2011 Presented by Human Resource Services
AGENDA • Web Information • Group Health Insurance • Other Types of Insurance • Types of Leave • Retirement Plans • Other Payroll Deductions • Taxes
HRS web site has links to employee policies and procedures, and benefits and payroll information.
Group Health Insurance Terminology • 30-Day Waiting • Pre-Existing Condition - a condition for which medical diagnosis or treatment is recommended or received before the date your coverage begins. • Network – a group of providers that contract with an insurance company that agree to provide services to members of a health plan for a discounted fee.
Group Health InsuranceTerminology • Benefit Description – document that outlines which is covered, under what circumstances and what is excluded from coverage • Exclusions- items for which the plan does not provide coverage • Limitations – services which have limits on coverage. Limitations may be subjective, such as “medically necessary and appropriate.”
Group Health Insurance Terminology • Preventative Care Services – Care designed to prevent, detect and treat conditions early and/or to manage its treatment effectively. These include well-baby care, regular OB-GYN visits, mammograms, routine physical exams and routine eye exams. • Prior Authorization or Pre-Authorization – services that must be approved by the insurance company before treatment is started.
Group Health Insurance Terminology • Premium - the amount deducted from your paycheck for insurance coverage. • Copayment- a flat dollar amount you pay for a specific covered service. Copayments are not applied to coinsurance maximums. • Deductible – the amount the participant must pay each plan year for covered services before the plan will begin to pay. • Coinsurance - a type of cost sharing in which the participate and the plan share payment (usually a specific percentage) of covered services once the deductible is met.
Group Health InsuranceTerminology • Coinsurance Maximum – the maximum amount of coinsurance you pay in a plan year • Out of Pocket Maximum – the maximum amount you pay in a plan year • Lifetime Maximum- the maximum amount the insurance company will pay toward your covered expenses during your lifetime.
Group Health Insurance Terminology • Allowable Charges or Plan Allowance or Usual, Customary & Reasonable (UCR) Charges – the maximum amount a plan will pay for a covered service. • Provider Write Off – the amount a provider will not require you to pay over the plan allowance, usually because of an agreement with the insurance company
Group Health InsuranceMedical Coverage Options • The State Employee Health Plan (SEHP) Benefits Unit negotiates all health care contracts and sets employee and employer premium rates for all State of Kansas employees. • SEHP web site –www.sehbp.org. • Benefit Descriptions • Links to Provider Directories
Group Health InsuranceMedical Coverage Options • All of our medical plans are Preferred Provider Organizations or PPO’s. • The level of reimbursement is based upon the “network status” of the provider of the service. • Network services are provided at a higher plan payment and lower out of pocket costs • Non Network services are paid at lower plan payment percentage and higher out of pocket costs.
Group Health InsuranceMedical Coverage Options There are three Medical Plan Designs and each Plan Design has 3 or 4 Plan Providers to choose from to administer the plan. • Plan A • Blue Cross/Blue Shield • Coventry Health Care • Preferred Health Systems • UMR United Healthcare • Plan B • Blue Cross/Blue Shield • Coventry Health Care • Preferred Health Systems • UMR United Healthcare • Plan C • Coventry Health Care • Preferred Health Systems • UMR United Healthcare
Group Health Insurance Medical Coverage Options • Plan A – Network Benefits • Copayments • $25 Primary Care Providers • $45 Specialists • Deductible • $300 single/$600 family • Coinsurance – 20% • Coinsurance Maximum • $1,400 single/$2,800 family • Voluntary Quest Diagnostics Lab Card Program
Group Health InsuranceMedical Coverage Options • Plan B – Network Benefits • Copayments • Adults - $20 Primary Care Providers • Under 18 - $10 Primary Care Providers • Adults - $40 Specialists • Under 18 - $25 Specialists • Deductible - $150 single/$300 family • Coinsurance – 35% • Coinsurance Maximum • $3,000 single/$6,000 family • Voluntary Quest Diagnostics Lab Card Program
Group Health InsuranceMedical Coverage Options • Plan C “Qualified High Deductible Plan with Health Savings Account”– Network BenefitsDeductible • $1,500 single/$3,000 family • Coinsurance – 20% • Out of Pocket Maximum • $3,000 single/$6,000 family • Health Savings Account with Employer Contribution • Single $900 per year • Family $1,350 per year
Group Health InsuranceDental Coverage • Administered by Delta Dental • Two networks of dentists employees have access to use • Delta Premier - large nationwide network with lower plan payments and higher out of pocket costs • Delta Preferred – small PPO network with higher plan payments and lower out of pocket costs
Group Health InsuranceDental Coverage • Covers 100% for diagnostic and preventative services • Deductible - $50 per person/$150 per family per plan year for some services • Coinsurance • 50% for Basic Restorative Services at Basic Level • 20% to 40% for Basic Restorative Services at Enhanced Level • 50% for Major Restorative Services at Basic and Enhanced Levels
Group Health InsurancePrescription Drug Coverage • The benefits that follow are only available to employees enrolled in Plan A or Plan B. • Employees enrolled in Plan C have a separate prescription benefit that is subject to the deductibles and coinsurance amounts of Plan C. • Administered by Caremark CVS
Group Health InsurancePrescription Drug Coverage • Tiered Coinsurance • Generics – 20% • Diabetes & Asthma Medications • 10% to a maximum of $10 • Preferred Name Brands – 35% • Diabetes & Asthmas Medications • 20% to a maximum of $20 • Non Preferred Name Brands – 60% • Specialty Medications – $75 copayment
Group Health InsuranceVision Service Plan • No employer contribution • Administered by Superior Vision Services • Two levels of coverage – Basic or Enhanced
Group Health InsuranceVision Service Plan • Basic Vision Plan • $50 copayment for eye exam • $25 copayment for 1 pair of eyeglasses or up to $150 of contacts in a plan year • Pays for up to $100 for frames • Pays for basic lenses • Any extra costs for frames or special lenses or coating are not covered by plan • Non-network providers services are reimbursed at a reduced rate
Group Health InsuranceVision Service Plan • Enhanced Plan • $50 copayment for eye exam • $25 copayment for 1 pair of eyeglasses or up to $150 of contacts in a plan year • Pays for up to $100 for frames • Pays for basic lenses plus UV coat, scratch coat, progressive lenses and either high index lenses or polycarbonate lenses. • Must use a Network Provider
Group Health InsuranceKanElect Program • Two components: • Pre-Tax Premium Option • Flexible Spending Accounts • Administered by ASI (www.asiflex.com) • Health Care Accounts – pay for out of pocket medical expenses with pre-tax dollars • Dependent Care Accounts – pay for child care expenses with pre-tax dollars
Group Health InsuranceEnrollment & Changes • Open Enrollment – occurs every year in October. This is your opportunity to review the benefit options available to you and make changes for the next plan year (changes effective January 1) • Mid Year Changes – life changing events that happen during the plan year which will allow you to make changes to your health coverage. These changes become effective on the first of the month following the event. Written notification must be received by HRS within 31 days of the event.
Basic Employer Provided Term Life Insurance • Provided at no cost to employee • Coverage is equal to 150% of employees annual salary • Paid to beneficiary in lump sum • Remember to keep beneficiaries up to date and make changes when you experience a family status change such as marriage, divorce, child birth, adoption, etc. • Basic Employer Provided Term Life Insurance - administered by Minnesota Life Insurance Company
Employee Paid Optional Group Life Insurance • Employees can apply for $5,000 - $250,000 of coverage • Premiums are determined by age and amount of coverage • Premiums deducted from 2nd paycheck of each month • There is no Open Enrollment period. Can apply for coverage at any time but must provide “proof of good health.” • Can apply to increase coverage by $25,000 without providing “proof of good health” within 30 days of a qualified family status change.
Long Term Disability Insurance • There is a 180 day waiting period before disability payments would begin • Pays 60% of annual salary up to $5,000 per month • You will continue to receive benefits for up to 24 months for disability from your occupation. • If you are disabled from any occupation you will continue to receive benefits according to the following limits: • If you become disabled before age 60, you can continue to receive disability benefits until you retire or reach age 65, whichever comes first. • If you become disabled at or after age 60, you can continue to receive disability benefits for five years or until you choose to retire, whichever comes first.
Workers Compensation Insurance and Reporting Accidents at Work • Employees that have Minor / Non-Life Threatening Injuries should seek treatment at the PSU Student Health Center. • Employees that have Serious / Life Threatening Injuries or Incidents that occur after hours or on weekends should seek treatment at the Emergency Department at Mt. Carmel Regional Medical Center. • Employee must complete an Incident Report and the Supervisor must complete an Employer’s Report of Accident within 10 days. • Wage replacement rate is 66 2/3% of salary. • Not eligible to receive wage replacement for the first 7 days unless off work for 21 consecutive days.
Types of LeaveVacation or Annual Leave • Unclassified 12-month Employees • 8 hrs per pay period up to 176 hrs per fiscal year • Do not earn vacation leave on 3rd paycheck of the month or in the month of June • Maximum accumulation of 304 hours • Maximum payout at separation is 176 hours • Maximum payout at retirement is 240 hours
Types of Leave Holidays • New Year’s Day • Martin Luther King Day • Memorial Day • Independence Day • Labor Day • Veterans Day • Thanksgiving – 2 days • Christmas Day • Discretionary Day For detailed information regarding Holidays, reporting time worked on Holidays and eligibility for Holiday pay, see the HRS web page on Holidays.
Types of LeaveSick Leave • Benefits-eligible employees earn 3.7 hours per pay period • Accumulated sick leave is not paid out upon separation from employment • A Sick Leave Bonus is paid upon Retirement only according to the following table Years of Sick Leave Service Accumulation Hours Paid . 8 years 800 hours 240 hours 15 years 1000 hours 360 hours 25 years 1200 hours 480 hours
Types of Leave • Funeral Leave – up to 6 working days of paid leave for the death of a “close relative” defined as spouse, parent, grandparent, sister, brother, child or grandchild, including in-laws. • Jury Duty Leave • Military Leave • Leave without pay for service in the Armed Forces • Up to 15 working days with pay in a 12-month period for service with a reserve component of the Armed Forces. • Leave Without Pay - requested for absences of over 30 days if employee does not have accumulated vacation or sick leave available to use.
Types of Leave • Shared Leave – eligible employees may receive donations of leave if all leave balances have been exhausted for a serious, extreme or life-threatening illness, injury, impairment or physical or mental condition for themselves or an eligible family member.
Family & Medical Leave (FMLA) • Can use up to 480 hours of job protected leave • Can be “leave with pay” or “leave without pay” • Must complete FMLA Leave Request Form and Medical Certification for all conditions except pregnancy • Approved absences cannot be used against you for disciplinary purposes
Retirement Plans Mandatory Plan Regents Mandatory Retirement Plan. • IRS 403(b) Defined Contribution Plan, similar to a 401(k) retirement plan • Employees choose 1 of 2 approved companies to administer their funds - TIAA-CREF or ING. • Contributions are taken out on a pre-tax basis. • Employee contribution is 5.5% • Employer contribution is 8.5% • Plan has immediate vesting • Full retirement at age 55 with 10 years of Regents Service or age 60.
Retirement PlansVoluntary Plans • Deferred Compensation Plan – IRS 457 Plan • Administered by ING • Voluntary Tax Sheltered Annuity Program – IRS 403(b) Plan • Choose from list of approved companies Limit is $16,500 per calendar year May contribute more if age 50 or older - eligible for “catch up” Can do maximum contributions to both plans No employer contribution
Payroll Options & Deductions • Direct Deposit of Paycheck • Mandatory • Up to 6 accounts and/or financial institutions • Can do dollar amounts or percentages • 9 Pay 12 Salary Option 9-month faculty only • Faculty get 20 State of Kansas Regular Payroll Checks and 6 PSU Foundation Reimbursement Checks. • About 25% of the employee’s net pay is deposited into a reimbursement account at the PSU Foundation, and the money is returned to the employee over 6 pay periods in the summer.
Payroll Options & Deductions • Learning Quest Education Savings Plan – IRS 529 Plan • Contributions can be taken out as payroll deductions. • Kansas taxpayers receive an annual adjusted gross income deduction of up to $3,000 ($6,000 if married, filing jointly) for their contributions per student, per year. • Earnings grow on a tax-deferred basis at the federal and Kansas state levels.
Payroll Options & Deductions • Organizational Dues – to KNEA • PSU Foundation • United Way • PSU Parking Deduction – this is a pre-tax deduction taken out on the 2nd paycheck in September and 2nd paycheck in February • PSU Campus Recreation Center Membership Fee – this deduction is taken out on the 2nd paycheck in September and 2nd paycheck in February.
Taxes State and Federal Taxes • K-4 - State Income Tax • W-4 Federal Income Tax A new K-4 and/or W-4 can be completed at any time during the year to change tax withholding. • Social Security - provides retirement income with current contribution rate of 6.2% for both employee and employer. • Medicare - provides health care benefits for social security eligible retirees with current contribution rate is 1.45% for both the employee and employer.