Benefits Guide 2016 - Human Resources - EKU [PDF]

MICHAEL T. BENSON PRESIDENT

Dear EKU Faculty and Staff: As I begin my third year at Eastern, I continue to be impressed by and grateful for the commitment and passion I see on a daily basis. I am honored to work alongside faculty and staff members who are eager to enhance the educational experience for our students and to make EKU a truly great place to work. I have long believed that those of us who are fortunate enough to work in higher education – in any capacity – can take great pride in the mission of the institution. I think that’s especially the case for school like EKU, where we maintain a strong focus on our students and their success. I realize the benefits available to you and your dependents are vitally important to you. They also represent a significant component of your total compensation, in addition to programs that provide retirement security, income protection, life insurance, and a generous paid time off practice. We all know that health care costs continue to rise. Businesses and universities alike strive to balance increasing costs on this front with other critical priorities. In our case, the challenge is compounded by reduced state funding. In the coming year, our projections are that EKU will pay $16.6 million for the medical and prescription plan coverage we enjoy. That is in addition to the significant contributions the University pays to the two state retirement programs and other benefits. All of us can make better lifestyle choices. We can exercise more, watch our weight, stop smoking, limit alcohol consumption, and make better choices in our daily diets. The EKU Wellness Program is a great way to move toward a healthier lifestyle and a longer life. I encourage you to study the 2016 Benefits Guide and to review the information with your dependents. If you have questions, please free to contact the HR Department by information on the back cover. EKU is committed to our staff and faculty. Our comprehensive benefits offerings are a clear demonstration of that.

Michael T. Benson President

Coates CP0 1A • 521 Lancaster Avenue • Richmond, KY 40475 • (859) 622-2101 • [email protected]

Table of Contents

2016 Coverage Information & Benefits Enrollment Information ................................................... 3 Important Health Coverage Facts ................................................................................................... 4 Benefits Eligibility Criteria ............................................................................................................... 7 Employee Wellness Program: Healthy You! at EKU........................................................................ 8 Health Plan Summaries ................................................................................................................. 10 Prescription Drug Coverage – Express Scripts .............................................................................. 12 Kentucky Rx/ Know Your Rx Coalition ........................................................................................... 13 Medical Plan Rates ........................................................................................................................ 14 Know Where to Go…………………………………………………………………………………………………………………. 15 Vision Plan Summary & Rates ....................................................................................................... 16 Dental Coverage Summary & Rates .............................................................................................. 17 Sponsored Dependent Rates & Plan Information ........................................................................ 18 Flexible Spending Accounts (FSA) ................................................................................................. 19 Employee Assistance Program …………………………………………………………………………………………………20 Long Term Disability Insurance (LTD) ........................................................................................... 21 Life Insurance Benefits .................................................................................................................. 22 Retirement Plans ........................................................................................................................... 24 Colonial Voluntary Insurance ........................................................................................................ 29 Additional University Benefits ...................................................................................................... 33 EKU Center for the Arts...…………………………………………………………………………………………………..…… 34 Faculty/Staff Tuition Waiver ......................................................................................................... 35 Time Off Benefits .......................................................................................................................... 36 Flexible Work Schedule Program .................................................................................................. 41 Key Terms ...................................................................................................................................... 42 Open Enrollment Checklist ........................................................................................................... 44

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EKU Employee Benefits Guide 2016

2016 COVERAGE INFORMATION HEALTHCARE   

Due to inflation costs and an Anthem administrative rate increase, there is a 2.72% increase to healthcare premiums this year. The Economy plan is still free for employee only coverage. Flexible Spending Account; Maximums increased from $2,500 to $2,550

RATE HOLD ON MOST COVERAGES Through multi‐year contracts and significant negotiating, EKU’s rates will remain the same for the coverages below, which means that employee premiums/contributions will also remain the same for:   

Life insurance, AD&D, and Long‐term disability insurance administered by One America Dental insurance administered by Delta Dental Vision insurance administered by Anthem Blue Cross Blue Shield

EKU’s Healthcare Plan is SELF‐INSURED. This means that EACH dollar paid to health care providers and pharmacies is paid by the University and the participating employees.

ONLINE OPEN ENROLLMENT PROCESS 1. 2. 3. 4. 5.

Log-on https://harmonyenroll.coloniallife.com Your username is EKU + EKU ID Number Your password is the first four characters of your last name + the last four digits of your EKU ID number You will be prompted to change your password for security Enroll in your benefit choices. This will be required even if you don’t intend to make a change to your coverages. 6. Proceed to the last page of the enrollment site. Click LOG OUT on the last page to complete enrollment. If you do not click “Log Out”, your enrollment will be marked as incomplete & you will not be enrolled in your selections.

You will have the opportunity to print or save a copy of your electronic form upon completion of your enrollment. Check your deductions on the first payroll in January 2016. EKU Employee Benefits Guide 2016

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IMPORTANT HEALTH COVERAGE FACTS

FACULTY BENEFIT EFFECTIVE DATES  



Benefits for New Faculty run from August 1st to June 30th in their first year of teaching at EKU. Benefits for non‐returning faculty end on June 30th. o Non‐returning faculty are full‐time faculty who teach in the spring semester but do not return for the following fall semester, regardless of if they teach summer school. o Benefits for these individuals are paid through June 30th by payroll deductions made throughout the academic year, and coverage terminates on that day if they will not be returning to teach full‐time in the fall semester. Returning faculty are covered year‐round and pay for all 12 months of benefits through deductions from their 20 pay periods during the academic year.

COVERAGE FOR SPOUSES BOTH WORKING AT EKU  

Two legally married EKU benefitted employees on the same policy, with no dependents, receive 100% of their coverage paid for by EKU for the STANDARD PLAN. Two legally married EKU benefitted employees on the same policy, with dependents (family coverage), receive 100% of their coverage paid for by EKU for the ECONOMY PLAN.

BENEFIT END DATE WHEN EMPLOYMENT ENDS 



Should you leave employment during the year, your benefits end on the date you terminate employment with EKU. For example: o If you hold a staff position and stop working at EKU on January 12th, your benefits will end on January 12th. o If you hold a faculty position and stop working at EKU on November 1st, your benefits will end on November 1st. When you turn in your resignation/notice to leave EKU, please contact your HR Consultant, information on back cover of this guide, to receive accurate information regarding your benefit termination, your options to continue coverages under COBRA, and to have your benefit questions answered by an expert.

DEDUCTIONS FOR NON‐EXEMPT EMPLOYEES 

In months where bi‐weekly paid employees receive three (3) paychecks, deductions for insurance coverage (other than healthcare) will not be withheld from one (1) of those paychecks.

Page 4 EKU Employee Benefits Guide 2016

BENEFITS ENROLLMENT INFORMATION The choices you make during the Open Enrollment period will be effective for the plan year beginning January 1, 2016 and ending December 31, 2016, unless you have a qualifying event. Annual enrollment must be completed online by October 16, 2015. This applies to both current and new EKU employees. For assistance: Attend the Benefits Expo or contact Human Resources.

CURRENT EKU EMPLOYEES

QUALIFYING EVENTS If you have a “qualifying event”, notification and proper documentation must be provided to the Human Resources Office within 31 days of the qualifying event date. You cannot add or drop coverage until the next Open Enrollment period (for the plan year beginning 2016) unless you have a “qualifying event”. Examples of a “qualifying event” include: Qualifying Event

If you are a current benefit‐eligible employee, each year you have an opportunity to review your benefit elections during the annual open enrollment period and make changes for the upcoming plan year. This year’s enrollment period is October 1‐16, 2015. Benefits selected during this open enrollment period will be effective for the entire 2016 calendar year, unless you have a qualifying event which permits changing of benefits during the year.

NEW EKU EMPLOYEES If you are a newly hired benefit‐eligible employee, you must enroll during your first 30 days of employment. For employees with a benefits eligibility date between the 1st and 14th of the month, insurance benefits will be effective on the fifteenth of that month. If your eligibility date falls between the 15th and the last day of the month, insurance benefits effective date would be the first day of the following month.

Required Documentation

Birth or adoption of a Birth Certificate or court child documentation Marriage

Marriage License

Divorce or Legal Separation

Divorce decree or court documentation

Dependent loss or gain of other coverage

Letter or form regarding Notification of coverage gain or loss

If you remove a dependent due to a qualifying event, you CANNOT change the plan type. If you add a dependent due to a qualifying event, you CAN change the plan type.


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EQUAL OPPORTUNITY/AFFIRMATIVE ACTION STATEMENT Eastern Kentucky University is an Equal Opportunity/Affirmative Action employer and educational institution and does not discriminate on the basis of age (40 and over), race, color, religion, sex, sexual orientation, gender identity, gender expression, pregnancy, ethnicity, national origin, disability, veteran status, and/or genetic information in the admission to, or participation in, any educational program or activity (e.g., athletics, academics and housing) which it conducts, or in any employment policy or practice. Any complaint arising by reason of alleged discrimination should be directed to the Office of Equity and Inclusion, Eastern Kentucky University, Rice House, 244 Summit Street, Richmond, Kentucky 40475‐3102 (859) 622‐8020 (V/TDD), or the Assistant Secretary for Civil Rights, U.S. Department of Education, Office of Civil Rights, Lyndon Baines Johnson Department of Education Building, 400 Maryland Avenue, SW, Washington, DC. 20202, 1‐800‐421‐3481 (V), 1‐800‐877‐8339 (TDD). The Office of Institutional Equity is charged with the University’s compliance with Title IX of the Educational Amendments of 1972. Sexual harassment and sexual assault are forms of sex discrimination that are prohibited by Title IX and may include off campus conduct of such nature. The Office of Equity and Inclusion is charged with the University’s compliance with Title IX and Title VII of the Civil Rights Act of 1964. Inquiries concerning Title VII and Title IX compliance are coordinated through: Joslyn Glover, Director of Institutional Equity and Title IX Coordinator Rice House, 244 Summit Street, Richmond, KY 40475 Phone: (859) 622‐8020 Email: [email protected]

DISCLAIMER All representations contained herein are for general information and illustration purposes. Detailed information regarding specific polices and coverages are available upon request from the employee/member by the carrier/provider.

HIPAA PRIVACY NOTICE Keeping your health information confidential is important to EKU and we have procedures in place to keep it protected. The HIPAA privacy notice is available for your review at: http://www.hr.eku.edu/benefits

HUMAN RESOURCE STATEMENT Human Resource cannot advise you on what benefit coverages to elect, which Retirement or investment options to choose. Human Resource representatives can provide you with information and resources to assist you in making decisions regarding your benefit coverages and providers.

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BENEFITS ELIGIBILITY CRITERIA WHO IS ELIGIBLE FOR COVERAGE?

DEPENDENT COVERAGE

Regular full‐time and regular part‐time employees hired into a position that are scheduled to work at least 25 hours per week are fully benefited positions and are eligible to participate in all EKU offered benefits.

Benefits‐eligible dependents may be covered by the benefit plans including health care, dental, vision, and spouse and dependent life insurance. See table below. Benefits Eligible Dependent

Part‐time employees hired into a non‐exempt position working between twenty and twenty four hours per week are partially benefited employees. Benefits provided to these employees include: participation in the tax deferred plans, prorated vacation & sick time, and holiday pay.

Spouse‐ A person to whom you are legally married. Sponsored Dependent‐ An adult that shares primary residence with the covered EKU employee for at least 12 months prior to the effective date of coverage, is not a relative and is not employed by the EKU employee.

Part‐time employees working less than 20 hours per week, seasonal, intermittent, temporary, student, graduate assistant and other non‐regular positions are not eligible for any EKU benefits.

Employee’s children under age 26‐ regardless of student or marital status or residence. Other qualified children under age 26‐ regardless of student or marital status or residence, including natural born or adopted child of the sponsored dependent and is not a relative of the covered employee.

The full sponsored dependent policy can be found at www.hr.eku.edu/benefits


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Employee Wellness Program All EKU employees are welcome to join Healthy YOU! at EKU. Benefits‐eligible employees and their spouses, sponsored dependents and dependents 18 years or age or older covered under EKU health insurance qualify to earn annual incentives. When creating Healthy YOU! website accounts, family members will use the following letters after the employee’s EKU ID Number: S for spouse, D for dependent and SD for sponsored dependent.

How to Get Started Create an account at healthyyouateku.com Take a video tour Earn points immediately by completing the Personal Health Assessment

Program Highlights The 2015‐16 Annual Incentive Campaign runs from July 1, 2015‐May 15, 2016.

Four annual challenges are designed to help create healthy habits and behavior changes including: Hydrate Well Team Challenge Work Well Individual Challenge Eat Well Individual Challenge Move Well Community Challenge The year‐long challenge is to Breathe Well focusing on our tobacco‐free campus. Page 8


Wellness Programs The employee wellness program is designed to improve employee health through education, intervention and encouragement of healthy lifestyles.             

Blood Pressure Screening Community Garden Cooking Club EAP (Employee Assistance Program) Exercise Classes Farmers Market Fitness Assessment Flu Vaccines at the Benefits Expo Free Fitness Facilities & Swimming Options Health Fair Tobacco Cessation Program Weight Watchers Program 5K Support | Iron Man Support

Annual Wellness Incentives Program participants earn points for completing Healthy YOU! at EKU activities and challenges. These points are redeemed annually: Level 1 (1,000 points) = $50 Value Level 2 (1,200 points) = $100 Value Level 3 (1,400 points) = $150 Value

Incentive Selections include:     

Health Care Premium Reimbursement Flexible Spending Account (Redeemable following January) EKU Campus Rec Gym Membership FitBit Activity Tracker Personal Holiday (only available for level 3)

Information Tammy Cornett or Stacy Groce Jones 106, 859‐622‐7218 Wellness.eku.edu healthyyouateku.com


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HEALTH PLAN SUMMARIES EKU’s Health Plan is self‐insured and is administered by Anthem Blue Cross Blue Shield

HIGH PLAN

In Network Annual Deductible (Single/Family) Out‐of –Pocket Maximum (Single/Family)

$750/ $1,500

STANDARD PLAN

Out of Network

In Network

$1,500/$3,000 $1,000/$2,000

ECONOMY PLAN

Out of Network

In Network

Out of Network

$2,000/ $4,000

$2,000/$4,000

$4,000/$8,000

$2,250/$4,500 $4,500/$9,000 $3,000/$6,000 $6,000/$12,000 $4,000/$8,000 $8,000/$16,000

Physician Office Visit– Primary Care, Online Kiosk

$20 copay

Deductible, then 30%

$25 copay


$35 copay


Physician Office Visit – Specialist Physician

$35 copay


$40 copay


$50 copay


Preventive Care

$0 copay


$0 copay


$0 copay


Medical Nutritional Therapy

$20 copay


$25 copay


$35 copay


$20 copay


$25 copay


$35 copay


Physical/Occupational or Speech Therapy

40 visit limit

30 visit limit

20 visit limit

Chiropractic

20 visit limit

15 visit limit

12 visit limit

Inpatient Services







Outpatient Services







Outpatient Diagnostic Testing, X‐ray and Lab

10% Coinsurance

30% Coinsurance

20% Coinsurance

40% Coinsurance

30% Coinsurance

50% Coinsurance

Maternity Services







Emergency Room

$125 copay per visit




$250 copay $250 copay per per visit visit

Physical Medicine Therapies

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HIGH PLAN

STANDARD PLAN

ECONOMY PLAN

In Network

Out of Network

In Network

Urgent Care

$50 copay per visit


$60 copay per visit

Ambulance Services (Medically Necessary Ground)

Covered in Full

Covered in Full

Covered in Full

Home Care Services

Deductible, then 10%, Unlimited visits

Deductible, then 30%, 30 visit limit

Deductible, then 20%, Unlimited visits

Hospice Services

Covered in Full

Covered in Full

Covered in Full

Durable Medical Equipment







Impatient and Outpatient Mental Health /Substance Abuse







Physician’s Office Mental Health/ Substance Abuse

$20 copay


$25 copay


$35 copay


Out of Network Deductible, then 40%

Covered in Full


Covered in Full

In Network $100 copay per visit Covered in Full Deductible, then 30%, Unlimited visits Covered in Full

Out of Network Deductible, then 50%

Covered in Full


Covered in Full

Important Notes: Payment for all services, accumulate toward the out‐of‐pocket maximum. Deductibles, out‐of‐pocket maximums and therapy visits renew each calendar year. For 2016, there is an out‐of‐pocket maximum for medical services and separate one for prescription drug copays. The combined out of pocket maximums, are determined by The Affordable Health Care Act.

Information provided here is intended to be a summary of benefits only; it does not list all covered services, limitation, or including a Summary of Benefits & Coverage is available on our website at exclusions. Additional information, http://hr.eku.edu/summary‐benefits‐and‐coverage. EKU’s Healthcare Plan is SELF‐INSURED. This means that EACH dollar paid to health care providers and pharmacies is paid by the University and the participating employees.


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PRESCRIPTION DRUG COVERAGE – EXPRESS SCRIPTS Express Scripts is our pharmacy benefit manager.

SAVE MONEY:

The formulary name EKU utilizes is: National Preferred.



Express Scripts benefits include:  Access to a 24‐hour, 365‐day‐a‐year Patient Care Contact Center.  A national network of pharmacies.  Home delivery options for maintenance medications and refills.  Accredo, a division of Express Scripts, is utilized for the effective management of specialty drugs.  Employees will receive an Express Scripts ID card that can be presented at any network pharmacy:







Use generic medications whenever possible. Ask your health care provider if a generic alternative is available for a medicine you already take or any new one being prescribed to you. Use Home Delivery for maintenance medications and get a 3 month supply for the cost of 2 months. Call the KYRx (information on next page) to see if a Copay card is available for your medication, it’s free to you and will save you significantly on select meds. Many pharmacies have $4 medicines for a 30 day supply or $10 for a 90 day supply. This is available at CVS, Walmart, Kroger, Meijer, and many more, regardless of the health coverage you have. Check their websites to see if your medication is on the list for $4.

Prescription Drug Co‐Pays

HIGH PLAN Home Retail Delivery

STANDARD PLAN Home Retail Delivery 10% 10% Generic $10 $20 Min $7 Min $14 Max $20 Max $40 20% 20% 25% 25% Brand/Formulary Min $20 Min $40 Min $25 Min $50 Max $50 Max $100 Max $60 Max $120 45% 45% 40% 40% Min $120 Min $100 Min $60 Non‐Formulary Min $50 Max $100 Max $200 Max $200 Max $400 Out‐of‐Pocket $3,850/ $7,700 $4,600/ $9,200 Maximum per year (single/family)

ECONOMY PLAN Home Retail Delivery 20% 20% Min $10 Min $20 Max $25 Max $50 30% 30% Min $30 Min $60 Max $70 Max $140 50% 50% Min $70 Min $140 Max $300 Max $600 $2,850/ $5,700

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Select Home Delivery through Express Scripts – Save money and time! Select Home Delivery is the preferred way to fill your maintenance medications. Once enrolled in the program, your prescriptions will be delivered directly to your home and you get 3 months of your medications for only 2 months copay. Since this is the preferred way to get your maintenance medications, if you elect not to participate in the home delivery service, you will be contacted by Express Scripts and required to opt‐out. To enroll in Select Home Delivery:  

Call Express Scripts at 877‐697‐7088 or visit www.StartHomeDelivery.com Have your doctor fax your prescription directly to Express Scripts at 800‐636‐9494

KNOW YOUR RX COALITION The Kentucky RX Coalition is changing names to Know Your RX Coalition. This service was launched in July 2011 by University of Kentucky (UK), University of Louisville (UL) and Eastern Kentucky University (EKU). By joining forces, they are helping Universities, college and public sector employers save money on prescription benefits provided to their employees and retirees. The purpose of the Know your Rx Coalition (KYRx) is to facilitate the cost‐effective provision of prescription medications and best practices in prescription benefit plan design, along with improved clinical outcomes. EKU Human Resource staff and Know Your Rx Coalition are here to assist covered employees and their dependents with any issues related to their prescription drug (Rx) benefit. Services include:     

Identification of lower cost prescription alternatives for Employees Direct contact with pharmacists Contacting physician to facilitate seeking authorization for lower cost alternative therapies Assistance working with Express Scripts to fill your prescriptions in a timely and easy manner Drug interaction management

Contact Information: Monday –Friday 8 am to 6 pm eastern time  www.KYRX.org  Toll‐free Phone Number: 1‐855‐218‐5979  Local Phone Number: (859) 218‐5979  Fax Number: (859) 257‐0098

Contact Express Scripts:  When you need ID Cards  Enroll or opt‐out of home delivery  Find an in‐network pharmacy

 Price check a prescription EKU Employee Benefits Guide 2016

Contact Know Your RX Coalition:  When you can’t reach Express Scripts  To find lower cost alternatives  To ask about side effects, drug interactions, and over the counter medications  To ask about Step Therapy Page 13

2016 MEDICAL PLAN RATES High PPO Plan

Total Monthly Premium

EKU Monthly Contribution

EE Monthly Premium

Employee Only

$603.88

$503.88

$100.00

$60.00

$50.00

$46.15

$1,031.59

$600.09

$431.50

$258.90

$215.75

$199.15

$977.80

$592.30

$385.50

$231.30

$192.75

$177.92

Family

$1,593.91

$777.41

$816.50

$489.90

$408.25

$376.85

Two EKU EE's

$1,031.59

$866.59

$165.00

$99.00

$82.50

$76.15

Two EKU EE's + Family

$1,593.91

$1,113.91

$480.00

$288.00

$240.00

$221.54

Standard PPO Plan



EE Monthly Premium

Employee Only

$523.68

$482.56

$41.12

$24.67

$20.56

$18.98

EE + Spouse

$764.06

$527.56

$236.50

$141.90

$118.25

$109.15

EE + Child(ren)

$731.84

$526.34

$205.50

$123.30

$102.75

$94.85

$1,174.70

$702.20

$472.50

$283.50

$236.25

$218.08

$764.06

$764.06

$0.00

$0.00

$0.00

$0.00

Two EKU EE's + Family

$1,174.70

$1,020.60

$154.10

$92.46

$77.05

$71.12

Economy PPO Plan



EE Monthly Premium

Employee Only

$438.84

$438.84

$0.00

$0.00

$0.00

$0.00

EE + Spouse

$570.66

$508.91

$61.75

$37.05

$30.88

$28.50

EE + Child(ren)

$549.66

$508.51

$41.15

$24.69

$20.58

$18.99

Family

$727.13

$598.63

$128.50

$77.10

$64.25

$59.31

Two EKU EE'S + Family

$727.13

$727.13

$0.00

$0.00

$0.00

$0.00

EE + Spouse EE + Child(ren)

Family Two EKU EE's

Faculty (20 Pays)

Semi‐Monthly (24 pays)

Faculty Semi‐Monthly (20 pays) (24 pays)

Faculty Semi‐Monthly (20 pays) (24 pays)

Bi‐Weekly (26 pays)



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When to Know Where to GO! EKU Health Care Plan Administered by Anthem Blue Cross/Blue Shield

Where to GO | Cost When You GO! Online Kiosk Econ Stand $35 $25

High $20

Primary Care Econ Stand $35 $25

High $20

Little Clinic Econ Stand $35 $25

High $20

Specialist Econ Stand $50 $45 Urgent Care Econ Stand $100 $60

High $35

High $50

Emergency Room Econ Stand High $250 $150 $125

Examples

This service is available 24/7.

Sinus Infection/Cold UTI www.livehealthonline.com Migraines Aches & Sprains Schedule appointments for Sinus Infection/Cold Annual Physical and Urinary Tract Infection Wellness Visits. Migraine Aches & Sprains Skin Issues or Infections When Primary Care Doctor is Sinus Infection/Cold unavailable. UTI, Migraines Aches & Sprains Serious medical conditions Diabetes Management that require specialty care Cardiology Issues related to a specific disease Neurologist Needs or body part. Orthopedic Issues Injury or illness that Accidents and Falls requires immediate care but Sprains and Strains does not require emergency Breathing Difficulties care. Fever or Flu Vomiting or Diarrhea Severe Sore Throat/Cough Minor Broken Bones Insurance will NOT cover Traumatic Injury non‐emergency visits to the Heart Attack Symptoms Emergency Room. You may Signs of Stroke be admitted, but will have to Broken Bone pay out of pocket all costs Sudden Disorientation associated with visit. Uncontrolled Vomiting Bite or Puncture Wound

Monthly Cost Employee Pays EKU Pays Economy $0 $438.84 Standard $41.12 $482.56 High $100 $503.88 EKU’s Health Care Plan is Self‐Insured. EACH dollar paid to health care providers and pharmacies is paid by the University and participating employees. EKU Employee Benefits Guide 2016

Page 15

VISION PLAN SUMMARY & RATES EKU’s Vision Plan is administered by Anthem Blue Cross Blue Shield. Coverages and rates are not changing from 2015 levels. For more details of vision plan: Visit hr.eku.edu/benefits/employee resources Please Note: 

The member is responsible for any amounts charged that exceed the maximum allowable amount for any service provided or item purchased Members are not permitted to receive allowances for both frames/lenses and contact lenses in the same plan year Discounts on lens option upgrades are not available out‐of‐network

 

Plan Rates Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

Monthly Premium

Faculty

Staff

(20 pays)

(24 pays)

$7.12 $12.08 $12.80 $19.20

$4.27 $7.25 $7.68 $11.52

$3.56 $6.04 $6.40 $9.60

Plan Coverage Summary

In Network Copay $10 $20 $15 $15

Frequency Once every 12 months Once every 12 months Once every 12 months Once every 12 months

Standard Scratch‐Resistance

$15

Once every 12 months

Standard Polycarbonate

$40


$65


$45


20% off retail


In Network Plan Allowance Frames $130 Contact Lenses $130

Once every 24 months Once every 12 months

Exam Eyeglass Lenses UV Coating Tint (Solid & Gradient)

Standard Progressive (Add‐on to bifocal copay) Standard Anti‐Reflective Coating Other Add‐ons and Services

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DENTAL COVERAGE SUMMARY & RATES EKU offers three optional dental insurance plans for benefit‐eligible employees, which are all administered by Delta Dental. Each plan offers different levels of coverage at different rates.

Rates High Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family Standard Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family Preventive Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family



$37.64 $73.71 $80.13 $128.62

$12.70 $12.70 $12.70 $12.70



$24.84 $50.62 $47.76 $78.52

$12.70 $12.70 $12.70 $12.70



$12.70 $25.88 $24.42 $40.15

$12.70 $12.70 $12.70 $12.70


Employee Monthly Premium $24.94 $61.01 $67.43 $115.92 Employee Monthly Premium $12.14 $37.92 $35.06 $65.82 Employee Monthly Premium FREE $13.18 $11.72 $27.45

Faculty (20 Pays)

Staff (24 Pays)

$14.96 $36.61 $40.46 $69.55

$12.47 $30.51 $33.72 $57.96

Faculty (20 Pays)

Staff (24 Pays)

$7.28 $22.75 $21.04 $39.49

$6.07 $18.96 $17.53 $32.91

Faculty (20 Pays)

Staff (24 Pays)

FREE $7.91 $7.03 $16.47

FREE $6.59 $5.86 $13.73

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SPONSORED DEPENDENT RATES & PLAN INFORMATION EKU offers health, vision, and dental coverage to your Sponsored Dependents and their child(ren). EKU does not contribute to the cost of this coverage and any premiums are deducted post‐tax from your paycheck. In addition, medical expenses incurred by your Sponsored Dependent are not eligible under your Flexible Spending Account. For the full definition of Sponsored Dependent, visit the HR website or the EKU policy page online.

Sponsored Dependent Health Care Premiums High Option Sponsored Dependent SD’s Child(ren) SD + SD’s Child(ren)

Standard Option Sponsored Dependent SD’s Child(ren) SD + SD’s Child(ren)

Economy Option Sponsored Dependent SD’s Child(ren) SD + SD’s Child(ren)

Employee Monthly Premium

Faculty (20 Pays)

Semi‐Monthly (24 Pays)


$527.71 $473.92 $990.03

$316.63 $284.35 $594.02

$263.86 $236.96 $495.02

$243.56 $218.73 $456.94


Faculty (20 Pays)



$281.50 $249.28 $651.02

$168.90 $149.57 $390.61

$140.75 $124.64 $325.51

$129.92 $115.05 $300.47


Faculty (20 Pays)



$131.82 $110.82 $288.29

$79.09 $66.49 $172.97

$65.91 $55.41 $144.15

$60.84 $51.15 $129.53

Sponsored Dependent Dental Premiums High Option Sponsored Dependent SD’s Child(ren) SD + SD’s Child(ren)

Standard Option Sponsored Dependent SD’s Child(ren) SD + SD’s Child(ren)

Preventive Option Sponsored Dependent SD’s Child(ren) SD + SD’s Child(ren)


Faculty (20 Pays)


$36.08 $42.50 $90.98

$21.65 $25.50 $54.59

$18.04 $21.25 $45.49


Faculty (20 Pays)


$25.78 $22.92 $53.68

$15.47 $13.75 $32.21

$12.89 $11.46 $26.84


Faculty (20 Pays)


$13.18 $11.72 $27.46

$7.91 $7.03 $16.48

$6.59 $5.86 $13.73

Sponsored Dependent Vision Premiums Sponsored Dependent SD’s Child(ren) SD + SD’s Child(ren)

Page 18


Faculty (20 Pays)


$4.96 $5.68 $10.64

$2.98 $3.41 $6.38

$2.48 $2.84 $5.32


FLEXIBLE SPENDING ACCOUNTS (FSA) EKU offers two types of Flexible Spending Accounts (FSA) administered through Chard Snyder: Health Care and Dependent Care. You contribute tax‐free dollars to your FSA through payroll deductions. The contributions accumulate in your account until you have an eligible expense, then you are reimbursed from the FSA. Services must be provided or expenses must be incurred during the plan year.

HEALTH CARE SPENDING ACCOUNT (HCSA)

DEPENDENT CARE ASSISTANCE PLAN (DCAP)

The HCSA offers you the opportunity to pay for certain out‐of‐pocket expenses that may not be covered by insurance.

The DCAP offers you the opportunity to pay for certain eligible day care expenses for a dependent child.





Can contribute up to $2,550 annually

Can contribute up to $5,000 annually

Examples of eligible expenses include:

To qualify as a dependent:

     



Medical, dental deductibles and coinsurances Vision exams and hardware Prescription medication Smoking Cessation Programs Adoption Expenses Hearing Devices

 

You will receive a set of 2 “Benny” debit cards to pay for eligible expenses.

To be an eligible daycare provider:  

Account balances MUST be used during plan period (January 1‐December 31, 2016) or balance is FORFEITED. You can check your balance and see the full eligible expense list at www.chard‐snyder.com. Terminated employees have 90 days from termination date to submit claims incurred prior to termination date of that plan year. EKU Employee Benefits Guide 2016

The person must regularly spend at least eight hours a day in your home Be under the age of 13 Or is physically or mentally incapable of taking care of him/herself (including a parent or spouse)



The facility must have a tax I.D. number If an individual caregiver, that individual must be willing to provide a social security number. (This individual can be anyone who is not your dependent under the age of nineteen, or anyone for whom you do not claim an exemption for income tax purposes) Care may be provided inside or outside of your home. The IRS tracks the daycare maximum amounts on a calendar year basis. Keep in mind that any amount deducted in excess of the IRS maximum of $5,000 (single or married filing jointly) or $2,500 (married filing separately) will be considered taxable income. Additionally, participation in DCAP may affect eligibility for the Child and Dependent Care Tax Credit. See your tax advisor for more information.

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EMPLOYEE ASSISTANCE PROGRAM Your Employee Assistance Program (EAP) is provided through ENI (Employee Network, Inc.).

WHY DO WE USE ENI?   



ENI is a national EAP carrier specializing in colleges and universities. ENI has a national provider network with eight counselors in Madison County. ENI offers 24/7 service with phone lines manned by Licensed Mental Healthcare Professionals. ENI provides extensive services, including on‐ site employee training on many topics.

WHAT CAN THE EAP HELP ME WITH? Your EAP can help with problems of daily living, whether it’s with personal or social life, involves family issues, or work‐related issues. Examples of the services they provide include:         

Legal Consultation & Referrals Financial Consultation & Referrals Child and Elder Care Resources & Referrals Substance Abuse Treatment Ask‐a‐Counselor Services – professional advice and emergency behavioral health requests Wellness Resources Stress Management Mental Health Counseling & Referrals Personal Assistant Services – work/life experts to complete personal tasks, such as: trip planning, relocation, event coordination, projects, research, and referrals on everything from travel, childcare, pet care, wedding/event planning, relocation and more.

EAP COVERAGE SUMMARY All EAP services are completely confidential. Your use of this benefit will not be shared with any University Official or other individual except where required by law. The University encourages employees to use the EAP as a helpful resource during times of difficulty. Your EAP coverage is a benefit paid entirely by EKU. EAP access is available to you and any of your family members, regardless of if you enroll in any other University offered benefits. You are eligible for 6 sessions per issue with no limit on number of issues per year. Should additional services be needed over and above the maximum provided through the EAP, ENI will work with you to refer you to a provider covered by EKU’s Health Insurance. For more information or to schedule an appointment, the EAP can be contacted at: (800) 327‐2255 or www.eniweb.com Please identify yourself as an EKU employee or family member of an EKU employee. Use:

Member ID: 59190757 Group ID: 8892

Page 20 EKU Employee Benefits Guide 2016

LONG TERM DISABILITY INSURANCE (LTD) EKU’s Long Term Disability (LTD) carrier is One America. Basic Coverage: The University provides LTD at no cost to benefit eligible full‐time employees. Long Term Disability will be paid out after a 120‐day elimination period for qualified disabilities. The policy will pay 50% of gross monthly earnings up to a maximum of $1,250 per month. Buy‐up Optional Coverage: 

Guaranteed issue for new hires

Eligible employees may increase their coverage amount to 60% of gross monthly earnings up to a maximum of $5,000 monthly by purchasing additional coverage through One America. Buy Up rates are: $0.49 per $100 covered payroll. To calculate your monthly cost, use the following formula: Ann’l salary divided by 12, divided by 100 x .49 = Monthly Prem x 12/# checks per yr=Per Pay Deduction ________________/ 12= _______ / 100 = _________ x $.49 = $_________x12 / (20 or 24) = $_________ Example: If your annual salary is $20,000/12=1666.66/100=16.66 x .49 = $8.17 monthly premium Note: Once employee is vested (with 5 years of completed service in an eligible position) with KERS/KTRS, both retirement systems provide disability coverage without an additional cost and you are no longer eligible for coverage under the EKU Long Term Disability Plan. Optional Retirement Program (ORP) participants and employees that begin participation with KERS after 1/1/2014, will always be covered by EKU’s basic LTD plan.


Page 21

LIFE INSURANCE BENEFITS BASIC LIFE & ACCIDENTAL DEATH&DISMEMBERMENT The Life Insurance carrier for EKU is One America. Basic Coverage: The University provides regular benefited employees, at no cost to the employee, a life insurance policy of 1x base salary up to $50,000 (Age reductions of coverage limits apply beginning at age 70).

SUPPLEMENTAL TERM LIFE Eligible employees have the option to purchase supplemental life insurance. Amounts are in increments of 1x, 2x, 3x, 4x or 5x their annual base salary. (Unless only choosing supplemental AD&D). (Age reductions of coverage limits apply beginning at age 70).    

For new employees there is a guaranteed issue up to 5x annual salary, for a maximum of $300,000. This is only available to new employees within 30 days of first employment with EKU. For amounts over the guaranteed issue amount of $300,000, a medical insurability questionnaire must be completed and approved by One America before it becomes effective. Current employees can start coverage or increase existing supplemental life insurance coverage, subject to One America restrictions, which will include completion of a health questionnaire. Electing supplemental life insurance on yourself gives you the opportunity to also elect supplemental life coverage on your spouse/sponsored dependent and dependent children.

Supplemental Employee Life Rates Age Bands