Benefits Orientation

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Joy Gaines
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1 Benefits Orientation

2 Benefits Enrollment Eligible employees have 30 days from their hire date or qualifying event to elect University benefits As a newly benefit eligible employee you will elect benefits twice during the year: Within 30 days of your start date for the current benefits year (2018) In October during Open Enrollment for next year (2019) Premiums begin on your eligibility date which is your start date Benefits can not be initiated until the online process has been completed and all required documentation is received If you do not elect benefits within 30 days from your hire date you will have to wait for the next open enrollment period in October to elect University benefits. 2

3 Blue MMOH CDHP Medical Mutual of Ohio Tier 1 UTMC/UTP Tier 2 MMO Network Providers Tier 3 Out-of-Network (May be balance billed*) Deductible $1,350 Single $2,700 Family Out-of-Pocket Maximum Includes Deductible $2,200 Single $4,400 Family Co-Insurance Subject to deductible Preventive Care Not subject to deductible UT HSA** Contribution Prorated Per Pay Employee HSA** Contribution 100% 90% / 10% 70% / 30% 100% 90% / 10% 70% / 30% $800 Single $1,600 Family $2,650 Single $5,250 Family ** Heath Savings Account (HSA) is used to pay for qualified medical expenses with tax free dollars and any unused balance carries over year to year. * If you go out-of-network you maybe balanced billed meaning that the provider may send you a bill for the services not covered by your insurance. 3

4 Silver Paramount Employer Select Paramount Employer Select Tier 1 Providers (UTMC/UTP/Plus) Tier 2 Providers Out-of-Network (May be balance billed*) Deductible No Deductible $100 Single $150 Single + 1 $200 Family $500 Single $750 Single + 1 $1,000 Family Out-of-Pocket Maximum (Includes Deductible) $1,000 Single $1,500 Single + 1 $2,000 Family $2,000 Single $3,000 Single + 1 $4,000 Family $4,000 Single $6,000 Single + 1 $8,000 Family Co-Insurance (Subject to Deductible) 100% 90% / 10% 70% / 30% Office Visit Co-Pay $10 $20 70% / 30% Specialist Visit Co- Pay $25 $35 70% / 30% * If you go out-of-network you maybe balanced billed meaning that the provider may send you a bill for the services not covered by your insurance. 4

5 Bronze FrontPath OBA / FrontPath In-Network Providers Out-of-Network (May be balance billed*) Deductible Out-of-Pocket Maximum (Includes Deductible) $100 Single $200 Single + 1 $300 Family $1,100 Single $2,200 Single + 1 $3,300 Family $300 Single $600 Single + 1 $900 Family $4,300 Single $6,600 Single + 1 $8,900 Family Co-Insurance (Subject to Deductible) 90% / 10% 70% / 30% Office Visit Co-Pay $15 70% / 30% Specialist Visit Co-Pay $30 70% / 30% * If you go out-of-network you maybe balanced billed meaning that the provider may send you a bill for the services not covered by your insurance. 6

6 Gold MMOH PPO Medical Mutual of Ohio Deductible Out-of-Pocket Maximum (Includes Deductible) Co-Insurance (Subject to Deductible) Tier 1 UTMC/UTP No Deductible $1,000 Single $2,000 Single + 1 $3,000 Family Tier 2 MMO Network Providers $100 Single $200 Single + 1 $300 Family $1,100 Single $2,200 Single + 1 $3,300 Family Tier 3 Out-of-Network (May be balance billed*) $300 Single $600 Single + 1 $900 Family $4,300 Single $6,600 Single + 1 $8,900 Family 100% 90% / 10% 70% / 30% Office Visit Co-Pay $15 $15 70% / 30% Specialist Visit Co- Pay $30 $30 70% / 30% * If you go out-of-network you maybe balanced billed meaning that the provider may send you a bill for the services not covered by your insurance. 3

7 Healthcare Highways Rx (Prescription Drug) UT Pharmacies (Preferred) Main Campus: (419) Health Science Campus: (419) UT Access (Specialty medications only) (419) AFSCME, CWA, PSA & UTPPA will receive a discount on covered medications if your prescription is written by a UTMC prescriber & filled at a UT Pharmacy Emergency prescriptions may be filled with your HCH Rx drug card, at a network retail pharmacy, (after hours, weekend, out-of-area, etc.) 7

8 2018 Prescription Benefit UT Consumer Driven Health Plan CDHP UT Pharmacy Retail Locations Tier 1 (Generic) $5.00 $10.00 Blue Plan Tier 2 (preferred Brand) 10% ($40 max per RX) 20%($80 max per RX) Tier 3 (non-preferred Brand) 20% 30% day supply Tier 1 (Generic) $10.00 $20.00 Tier 2 (preferred Brand) 20%($100 max per RX) 20% ($200 max per RX) Tier 3 (non-preferred Brand) 20% 30% When you fill prescriptions you will pay the cost of your prescriptions until the deductible has been met. Once the deductible is met or if it is on the preventative med list provided by the pharmacy benefit manager, you pay the copay that is detailed above. Once the out-of-pocket maximum has been met, covered prescriptions will pay at 100%. If the cost of the drug falls below the copayment then you will only pay the cost of the drug at UT Pharmacies. Member will receive a 15% discount until deductible has been met if your prescription is written by a UTMC prescriber & filled at a UT Pharmacy. After deducible has been met, the standard copay/coinsurance will apply and the discount will no longer apply. *Minimum copays may apply to tier 2 and 3 medications at retail

9 2018 Prescription Benefit UT Health Science Campus Non Union and UTP UT Pharmacy Bronze and Silver Retail Locations* 30 day supply 10 day supply only Tier 1 (Generic) $7.26 $7.26 Tier 2 (preferred Brand) $18.15 $18.15 Tier 3 (non-preferred Brand) $36.30 $ day supply Tier 1 (Generic) $18.15 N/A Tier 2 (preferred Brand) $33.88 N/A Tier 3 (non-preferred Brand) $67.21 N/A Member will receive a 15% discount if your prescription is written by a UTMC prescriber & filled at a UT Pharmacy If the cost of the drug falls below the copayment then you will only pay the cost of the drug at UT Pharmacies

10 2018 Prescription Benefit UT Health Science Campus AFSCME UT Pharmacy Bronze and Silver Retail Locations* 30 day supply 10 day supply only Tier 1 (Generic) $7.99 $7.99 Tier 2 (preferred Brand) $19.97 $19.97 Tier 3 (non-preferred Brand) $39.93 $ day supply Tier 1 (Generic/OTC) $19.97 N/A Tier 2 (preferred Brand) $37.27 N/A Tier 3 (non-preferred Brand) $73.93 N/A Member will receive a 15% discount if your prescription is written by a UTMC prescriber & filled at a UT Pharmacy If the cost of the drug falls below the copayment then you will only pay the cost of the drug at UT Pharmacies

11 2018 Prescription Benefit UT Main Campus Bronze and Silver UT Pharmacy Retail Locations* 30 day supply Tier 1 (Generic) $7.26 $11.00 Tier 2 (preferred Brand) $ % AWP Tier 3 (non-preferred Brand) $ % AWP day supply Tier 1 (Generic) $18.15 N/A Tier 2 (preferred Brand) $33.88 N/A Tier 3 (non-preferred Brand) $67.21 N/A Member will receive a 15% discount if your prescription is written by a UTMC prescriber & filled at a UT Pharmacy If the cost of the drug falls below the copayment then you will only pay the cost of the drug at UT Pharmacies

12 2018 Prescription Benefit UT Health Science and Main Campus and Gold Plan UT Pharmacy Retail Locations* 30 day supply Tier 1 (Generic) $7.26 $11.00 Tier 2 (preferred Brand) $ % AWP Tier 3 (non-preferred Brand) $ % AWP day supply Tier 1 (Generic) $18.15 N/A Tier 2 (preferred Brand) $33.88 N/A Tier 3 (non-preferred Brand) $67.21 N/A Member will receive a 15% discount if your prescription is written by a UTMC prescriber & filled at a UT Pharmacy If the cost of the drug falls below the copayment then you will only pay the cost of the drug at UT Pharmacies

13 Spousal Eligibility Required only if Gold, Silver or Bronze plans are selected and spouse is working for another employer. Affidavit must be completed at time of election AND annually during Open Enrollment. For Spouse to be Primary: Unemployed, Self-Employed, Retired or No benefits offered OR makes less than $25,000/year and benefits cost more than $75/month for a single plan Spouse may be Secondary If you and your spouse are both employed by UT and are both eligible for benefit coverage, you may either enroll together on one plan or separately on individual plans, but not both. If this form is not completed and returned annually your spouse will be removed from the plan. 9

14 Dependent Eligibility Medical/Rx o Age (end of calendar year they turn age 26) Not required to be a full-time student or an IRS Dependent Health Savings Account/Flexible Spending Account o Must be IRS dependent Dental, Vision, Life Insurance, Tuition Waiver o Age (end of calendar year they turn age 24) o Must be unmarried, a full-time student and employee s IRS dependent Your dependent children may only be enrolled on one plan, either yours or your spouse s, but not both. 10

15 Gold Dental Plan Coverage is provided through Delta Dental Preventive Services covered at 100% Minor & Major services covered at 80% after deductible $100 annual deductible per person $3,000 annual maximum per person Orthodontia covered for dependents to age 19 Covered at 60% $1,500 lifetime maximum 12

16 Blue Dental Plan Coverage is provided through Delta Dental Preventive Services covered at 100% Basic services covered at 80% after deductible Major services covered at 50% after deductible Crowns, bridges, implants, dentures $50/$150 Annual Deductible $1,500 annual maximum per person Orthodontia covered for dependents to age 19 Covered at 50% $1,500 lifetime maximum 12

17 Gold Vision Plan Coverage is provided through Vison Services Plan (VSP) Eye exam & Lenses: $10 co-pay once every 12 months Frames/Contact allowance Frames $175 every 12 months or Contacts $150 every 12 months 13

18 Blue Vision Plan Coverage is provided through Vison Services Plan (VSP) Eye exam: $10 co-pay once every 24 months Every 12 months for dependents Prescription Glasses: $15 co-pay once every 24 months Every 12 months for dependents Frames/Contact allowance $120 every 24 months Every 12 months for dependents If an exam is needed yearly, on the opposite year you may use Paramount or MMO for Vision Services. 13

19 Flexible Spending Account Must be set-up annually to set aside money on a pretax basis May be used for: Medical FSA Out-of-Pocket Medical Expenses ($2,700 maximum) Dependent Care FSA Out-of-Pocket Childcare/Adult Daycare Expenses ($5,000 maximum) You will be reimbursed for charges incurred once claim form is submitted and reimbursements may be direct deposited Account DOES NOT rollover Medical FSA comes with a debit card If you have Medical Mutual CDHP and have an HSA, you are only eligible for the dependent care flex account 14

20 Life Insurance Basic Life Insurance and Accidental Death & Dismemberment is offered through Sun Life Make elections within 30 days of hire Main Campus Part Time (20+) and Full Time employees receive coverage Health Science Campus Full Time employees receive coverage Benefit determined by employee class Additional (employee) and Dependent (spouse and/or children) available as voluntary coverage 15

21 Employee Assistance Program Impact Solutions offers confidential professional support. All employees, dependents, parents/parent-inlaw are eligible to use any service. Services Include: Unlimited Phone Consultation 24/7 at Face-to-Face Counseling Services Legal Assistance Financial Services Identity Theft Prevention and Recovery Comprehensive Work/life Website 16

22 Retirement Plan Options Ohio Public Employee Retirement System (OPERS) - Automatic Employee Contribution: 10.00% Employer Contribution: 14.00% Phone Number: (800) Auto enrolled with OPERS Full time and part time employees - OR - 403(b) Tax Deferred Account Optional Review list of qualified vendors Contact the representative and set up an account Complete a Salary Reduction Agreement and turn into Benefits University of Toledo will redirect your investment into Tax Deferred Annuity on a pre-tax basis - AND - Alternative Retirement Plan (ARP) 120 Days to Elect Employee Contribution: 10.00% Employer Contribution: 11.56% Choose from a list of approved vendors No state retirement benefits Vested immediately Election is irrevocable when made Full time employees only 457 Optional Tax Deferred Account Optional Available to State of Ohio employees only Set up directly with Ohio Deferred Compensation (877) If you do not elect the Alternative Retirement Plan within 120 days, you will remain in the OPERS plan and you will not pay social security tax. 17

23 Tuition Waiver Employees FT/PT Faculty and Staff are eligible for up to 8.0 undergraduate or graduate credit hours per semester Applies to new student registration fee, application fee, tuition, and general fees. Dependents Eligible spouse, domestic partners and dependents can take undergraduate classes at the University of Toledo after employee s 12 months of service. 12 Credit hour minimum for dependents. Benefit applies to tuition, application and new student registration fee, NOT general fee For additional information, please visit: 18

24 Using Your Benefits Your selected medical plan will mail you an ID card to present each time medical services are received. HCH Rx will issue a separate prescription card. OPTUM HSA Visa Card will also be sent to you to access your Health Savings Account if Blue Plan is elected. Chard Snyder will mail you a debit card for your Medical Flexible Spending Account (FSA) if selected Delta Dental will mail you an ID card VSP does not issue ID cards 20

25 Important Documentation Required Spousal Affidavit (access through online portal and complete hard copy if spouse is employed outside UT) If covering a spouse on the Gold, Silver or Bronze Plans Adult Child Certification (through online portal) If adding a dependent over age 19 Marriage Certificate If adding a spouse to any coverage. Birth Certificate, Court Documents, and/or Adoption Paperwork If adding dependent children to coverage. All documentation is due within 30 days of hire date or qualifying event. If you do not submit your documentation on a timely basis you risk not having coverage for your dependents and a potentially large deduction from your pay when you do. Please keep your new hire benefits enrollment documentation available as you will be asked to supply this information again for open enrollment. 21

26 Enrollment in Benefits Enrollments completed through myut portal ( within 30 days of hire date or qualifying event Plan Overviews/Premiums available at: hr.utoledo.edu Direct questions to: , fax or deliver required New Hire Benefits Enrollment documentation to HRTD no later than 30 days following hire date or qualifying event. 22

27 UT Benefits Contact Information Benefits Team Contact Info Contact Title Ext. Jessica Allar Benefits Specialist 1443 Susan Rahe Benefit Analyst 1459 Kathie George HRIS Coordinator 1461 Kate Johnson Manager, Benefits Planning & Administration 1456 Nate Walker Senior Director, Total Rewards 1475 Please direct employee questions to: (419) or New Hire Benefits Enrollment Document Submissions to HR Benefits via: Secure Fax: (419) In Person: MC: Scott Park, ASC, Suite 1000 HSC: Facility Support Building 24

28 External Benefits Contact Information Benefits Vendors Ohio Benefits Administrators OBA/FrontPath PPO (877) FrontPath PPO (419) Paramount Employer Select (ES) PPO (419) Medical Mutual of Ohio (MMO CDHP) (800) Delta Dental (800) Vision Services Plan (VSP) (800) Chard-Snyder Flexible Spending Accounts (800) Optum (Wells Fargo) Health Savings Account (866) HCH Rx (Prescription) (844)

29 Frequently Asked Questions How do I complete my benefits enrollment? 1.) Review the new hire benefits presentation on the Human Resources Benefits website. 2.) Sign in to myut.utoledo.edu and select the 2018 New Hire/Newly Eligible link under the "Employee" tab. 3.) Determine benefit options that are best for you and your family (all benefit plans and costs are available at the Summary Plan web page). 5.) Complete and return required forms or documentation with 30 days of your date of hire. (i.e., marriage or birth certificates, domestic partner forms, spousal/domestic partner affidavit) 6.) Complete enrollment process within 30 days from your date of hire. What happens if I don t enroll? You will not have University benefits from your date of hire and will have to wait for the regular open enrollment period which begins October 1 st. If you enroll at open enrollment your benefits will be effective January 1, Am I required to turn anything in? a.) If your spouse works outside UT or UTP, the hard copy of the affidavit must be completed by the spouse s employer and returned to HR Benefits. b.) Documentation is required for all dependents. c.) All documentation must be returned within 30 days of your hire date or your dependents will not have benefit coverage. Your next opportunity to elect coverage for your eligible dependents will be with the regular open enrollment which begins October 1 st. If you enroll your eligible dependents at open enrollment their coverage will be effective January 1, Where can I get more information? You can find out more information by ing benefits@utoledo.edu. 26

30 2018 Medical Plan Comparisons

Health Care New Hire Orientation

Health Care New Hire Orientation Health Care Benefits Enrollment 30 days from hire date to elect benefits package 30 days from status change to modify benefits package 30 days from loss of other coverage