October 26, 2016 TO: University Insurance Association Members (UIA) The University Insurance Association (UIA) is managed by a nine member Board of Directors elected for three year staggered terms. Elections are held annually for three board members whose terms are expiring. If there are no more than three candidates, an election by the members is not held and the three nominees become members of the Board of Directors. The Board of Directors for 2014-2015 were William Maas (UW-LaCrosse) - President, Kristopher Presler (UW-Eau Claire) Vice President, Hamid Milani (UW-Colleges) - Interim Treasurer, Donna Robole (UW-River Falls) Secretary, Scott Beyer (UW- Oshkosh), Hamid Milani (UW-Colleges), William Ogden (UW-Eau Claire), Matthew Raunio (UW-Colleges) Carey Woodward (UW-Colleges) and one vacant seat. The board determines the proper premium/ benefit relationship based on past plan performance. UIA participation is a condition of employment for Faculty, Academic Staff and Limited Appointees whose initial rate of compensation, when initial eligibility is met, is 45% of the average instructor s salary for the previous year. Detailed information relating to this plan and its features (schedule of benefits, beneficiary designation form, certificate of insurance, bi-laws and annual report) may be viewed at: https://www.wisconsin.edu/ohrwd/benefits/life/uia/. The Annual Meeting for members was held on May 6, 2016. Communications on any issue concerning the activities of UIA may be directed to any board member or by contacting the UIA Board President, William Maas, at wmaas@uwlax.edu. In summary, the UIA began the 2014-15 plan year with a fund balance of $2,655,224. The gross income for the year from premiums collected and interest on cash flow was $584,513. During the 2014-15 plan year, death claims paid totaled $474,915. Plan year expenses, including premium taxes and administrative expenses totaled $82,755. All plan expenses (death claims, taxes, other expenses) did not exceeded the plan year revenues the Premium Deposit Account (plan reserves) did not experience any withdrawals. The plan reserves earned $26,552 in interest during the plan year. The result of these activities allowed for an ending plan year balance of $2,711,096. William Maas, President University Insurance Association Page 1 of 5
The University Insurance Association Report on the 2012-2013 Plan Year SUMMARY PLAN DESCRIPTION The University Insurance Association Group Term Life Insurance Plan provides decreasing term life insurance under a group policy underwritten by the Minnesota Life Insurance Company for the University Insurance Association (UIA). The plan year commences on October 1 and ends the following September 30. The administrator of the plan, the fiduciary, and the agent for service or process is the University Insurance Association. All appeals for redress of claims, which may have been denied in whole or in part, should be directed to the UIA Board. Membership is a condition of employment for persons who hold faculty, academic staff or limited appointments by the Board of Regents of the University of Wisconsin System whose initial rate of compensation was at least the minimum established by the Association. Employees are evaluated annually for eligibility, and the entire cost of the insurance is paid by member premiums and interest of the University Insurance Association, through an annual payroll deduction of $24 from the October payroll or by direct payment from employees who are on a leave of absence.. Employees who do not meet eligibility but had previously are given the opportunity to convert coverage. The Association annually establishes the required minimum salary for initial eligibility at 50% of the average salary for instructors. Membership for persons who are on an approved, unpaid leave of absence continues and the member will be billed for the $24 premium or the premium will be payroll-deducted upon return to work. The University Insurance Association determines the eligibility of individuals for membership in the plan and authorizes the payment of benefits and administrative expenses. The University Insurance Association also determines the benefit schedule in consultation with the Minnesota Life Insurance Company. The Minnesota Life Insurance Company issues the plan certificates, maintains beneficiary information, pays all claims, and manages the plan assets and financial reporting. Requests for payment of a claim should be made directly to the Minnesota Life Insurance Company at P.O. Box 259708, Madison, Wisconsin 53725-9708. Benefits cease for members who fail to remit premiums when due. Administrative support offices for the UIA are located at: University of Wisconsin System Administration, Human Resources & Workforce Diversity, 780 Regent St. Madison, WI 53715. Telephone inquiries may be made by contacting UW System Human Resources & Workforce Diversity at 608-263-7559 or Minnesota Life Insurance Company at 608-277-8690 or 866-295-8690. Page 2 of 5
SUMMARY ANNUAL REPORT FOR UNIVERSITY INSURANCE ASSOCIATION GROUP LIFE INSURANCE PLAN This is a summary of the annual report for the University Insurance Association Group Life Insurance Plan, Employer Identification Number 39-6077530, for the plan year ending September 30, 2015. Insurance Information The plan has a contract with the Minnesota Life Insurance Company to pay all life insurance claims incurred under the terms and conditions of the plan. The total premiums paid for the plan year ending September 30, 2015 were $584513. The value of plan assets was $2,711,096 as of September 30, 2015, as compared to $2,655,244 on September 30, 2014. In summary, the UIA began the 2014-15 plan year with a fund balance of $2,655,224. The gross income for the year from premiums collected and interest on cash flow was $584,513. During the 2014-15 plan year, death claims paid totaled $474,915. Plan year expenses, including premium taxes and administrative expenses totaled $82,755. All plan expenses (death claims, taxes, other expenses) did not exceeded the plan year revenues the Premium Deposit Account (plan reserves) did not experience any withdrawals. The plan reserves earned $26,552 in interest during the plan year. The result of these activities allowed for an ending plan year balance of $2,711,096. Claims Experience During the 2014-15 policy year, the University Insurance Association Group Life Insurance Plan paid 88 death claims for a total amount of $474,915. Age # Claims Age # Claims Age # Claims 53 1 68 3 81 2 55 2 69 2 82 2 56 1 70 1 83 4 57 3 71 3 84 5 58 1 72 7 85 4 59 3 74 1 86 3 60 2 75 1 87 4 41 2 76 5 88 2 61 1 77 1 90 2 64 2 78 3 91 1 65 3 79 2 95 1 66 2 80 3 96 1 67 2 Page 3 of 5
Schedule of Insurance The schedule of insurance determines each members death benefit in any given policy year, based on the member s age at the beginning of the policy year. The policy year began on October 1 and concluded on September 30, 2015. The schedule of benefits for the 2014 15 plan year was as follows: Member's Age at beginning of Policy Year Amount of Death Benefit Member's Age Schedule of Benefits Under Age 28 $101,00 49 51 $22,600 28 30 $98,100 52-54 $17,200 31 33 $90,900 55-57 $13,100 34 36 $78,900 58 60 $10,300 37 39 $65,000 61-63 $8,200 40-42 $50,900 64-66 $6,100 43-45 $39,100 67 69 $4,500 46 48 $30,000 70 + $3,400 Page 4 of 5
Statement of Your Rights Under ERISA (As required by Federal Law and Regulation) As a member of the University Insurance Association, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). You may examine all plan documents, including the insurance contract and annual reports to the U. S. Department of Labor, without charge at any administrative office. You may obtain copies of all plan documents and other plan information upon written requests to the plan administrator. The administrator may make a reasonable charge for the copies. You will receive a summary of the plan s annual financial report, as ERISA requires. You may file suit in a federal court if you do not receive the materials requested within 30 days of your request, unless the materials were not sent because of matters beyond the administrator s control. The court may require the administrator to pay up to $100 a day for each day s delay until the materials are received. ERISA imposes obligations upon the persons responsible for the operation of your plan. These persons, referred to as fiduciaries, must act solely in your interest, and exercise prudence in performing their duties. If they violate ERISA, they may be removed and be required to make good any losses they have caused the plan. Should the fiduciaries misuse the plan s money, you have the right to request assistance from the U. S. Department of Labor, or to file suit in federal court. The court will decide who will pay court costs and legal fees. If you are successful, the court may require the fiduciaries to pay the legal costs, including attorney s fees. If you lose, the court may order you to pay these costs and fees. If you have any questions about this statement or your rights under ERISA, you should contact the plan administrator or the nearest area office of the Labor-Management Service Administration, Department of Labor. The identification number assigned to the Association by the Internal Revenue Service is 39-6077530. The identification number assigned to this group life insurance plan is 501. Your Rights to Additional Information You have the right to receive a copy of the full annual report, or any part thereof, on request. A full copy of this annual report may be printed from the University of Wisconsin System Administration Human Resources website at: https://www.wisconsin.edu/ohrwd/benefits/life/uia/ You also have the right to receive from the University Insurance Association, on request and at no charge, a statement of the assets and liabilities of the plan or a statement of income and expenses of the plan, or both. If you request a copy of the full annual report from the plan administrator, these two statements will be included as part of that report. The charge to cover copying costs given above does not include a charge for the copying of these portions of the report because these portions are furnished without charge. You also have the legally protected right to examine the annual report at the addresses above and at the U. S. Department of Labor in Washington, D.C., or to obtain a copy from the U. S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to Public Disclosure Room, N4677, Pension and Welfare Benefit Programs, U. S. Department of Labor, 200 Constitution Avenue, N. W., Washington, D.C., 20216. Page 5 of 5