New Hire Benefits Orientation

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New Hire Benefits Orientation
New Hire Benefits
Orientation
Benefits Enrollment
• Eligible employees have 30 days from their hire date or a
qualifying event to elect University benefits
• As a new employee or rehire you will elect benefits twice the
year of your hire:
– Within 30 days of your start date for the current benefits year (2017)
– In October during Open Enrollment for next year (2018)
• 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.
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Medical Mutual of Ohio CDHP
Tier 1
UTMC/UTP
Tier 2
MMO Network
Providers
(May be balance billed*)
$1,300 Single
$2,600 Family
$1,300 Single
$2,600 Family
$1,300 Single
$2,600 Family
$2,200 Single
$4,400 Family
$2,200 Single
$4,400 Family
$2,200 Single
$4,400 Family
100%
90% / 10%
70% / 30%
100%
90% / 10%
70% / 30%
UT HSA** Contribution
Prorated Per Pay
$800 Single
$1,600 Family
$800 Single
$1,600 Family
$800 Single
$1,600 Family
Employee HSA**
Contribution
$2,600 Single
$5,150 Family
$2,600 Single
$5,150 Family
$2,600 Single
$5,150 Family
Medical Mutual of
Ohio
Deductible
Out-of-Pocket
Maximum
Includes Deductible
Co-Insurance
Subject to deductible
Preventive Care
Not subject to deductible
Tier 3
Out-of-Network
** 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.
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Paramount Employer Select
Paramount
Employer Select
Tier 1 Providers
(UTMC/UTP/Plus)
Tier 2 Providers
No Deductible
$100 Single
$150 Single + 1
$200 Family
$500 Single
$750 Single + 1
$1,000 Family
$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
100%
90% / 10%
70% / 30%
Office Visit Co-Pay
$10 / $25
$20 / $35
70% / 30%
Specialist Visit CoPay
$10 / $25
$20 / $35
70% / 30%
Deductible
Out-of-Pocket
Maximum (Includes
Deductible)
Co-Insurance
(Subject to
Deductible)
Out-of-Network
(May be balance billed*)
* 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.
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Service Providers
Tier 1
Medical
Mutual of
Ohio
Paramount
• UT Medical Center (UTMC)
• UT Physicians (UTP)
• UT Medical Center (UTMC)
• UT Physicians (UTP)
• Toledo Hospital, Toledo
Children’s Hospital, Bay
Park, Flower Hospital, St.
Luke’s, Lima Memorial,
Defiance Regional Hospital,
Fostoria Community
Hospital
Tier 2
Tier 3
• Medical Mutual Network
Providers
• St. Anne, St. Vincent, St. Charles,
Toledo/Toledo Children’s, Bay
Park, Flower, St. Luke’s, Mercy
Memorial, Wood County Hospital.
• View providers at
www.mmoh.com and choose
SuperMed PPO (Plus)
• PHCS National Wrap Network
• All Other Providers –
non network
• Paramount Network Providers
• View providers at
www.paramounthealthcare.com
• Cofinity (Michigan)
• PHCS National Wrap Network
• All Other Providers –
non network
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Ohio Benefit Administrators OBA / FrontPath
OBA / FrontPath
In-Network Providers
Out-of-Network
(May be balance billed*)
$100 Single
$200 Single + 1
$300 Family
$300 Single
$600 Single + 1
$900 Family
$1,100 Single
$2,200 Single + 1
$3,300 Family
$4,300 Single
$6,600 Single + 1
$8,900 Family
90% / 10%
70% / 30%
Office Visit Co-Pay
$15
70% / 30%
Specialist Visit Co-Pay
$30
70% / 30%
Deductible
Out-of-Pocket Maximum
(Includes Deductible)
Co-Insurance
(Subject to Deductible)
* 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.
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Optum Pharmacy Plan (Prescription Drug)
• UT Pharmacies (Preferred)
• Main Campus: (419) 530 - 3471
• Health Science Campus: (419) 383 - 3750
• AFSCME, CWA, PSA & UTPPA will receive a
discount if your prescription is written by a UTMC
prescriber & filled at a UT Pharmacy
• Emergency prescriptions may be filled with your
Optum drug card, at a network retail pharmacy,
(after hours, weekend, out-of-area, etc.)
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Prescription Cost Sharing
UT Pharmacies
Tier 1
(Generic)
Tier 2
(Formulary)
Tier 3
(Non-Formulary)
Optum Network
Retail Pharmacies
Tier 1
(Generic)
Tier 2
(Formulary)
Tier 3
(Non-Formulary)
30-Day / 90-Day
AFSCME
UT
AFSCME
UT
Other
Employees
Other
Employees
$5 / $10
$7.99
$19.97
$7.26
$18.15
$19.97
$37.27
$18.15
$33.88
$39.93
$73.93
$36.30
$67.21
(30-Day / 90-Day Supply)
Paramount/OBA
AFSCME
Health Science Campus (HSC) Employees
Paramount/OBA
Main Campus
Employees
Paramount /OBA
HSC Non-Union
Employees
$10 / $15
$7.99
$11
$7.26
$19.97
20% AWP
$18.15
MMO CDHP
10%
Up to $40 / $100
max per prescription
20%
MMO CDHP
20%
Up to $80 / $200
Max per prescription
30%
30-Day Supply
90-Day Supply
10-Day Maximum
40% AWP
30-Day Supply
30-Day Maximum
40% AWP
90-Day Supply
10-Day Maximum
$36.30
For MMO when you fill prescriptions, you will pay the cost of the prescription until you meet the deductible (unless preventive). Once the deductible has been met, the copays/co-insurance outlined above will be charged. Once the out-of-pocket maximum has been met, all prescriptions will be covered at 100%
For a lower prescription cost, utilize our on campus pharmacies (2 locations).
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Spousal/Domestic Partner Eligibility
• Required only if Paramount Employer Select or OBA/FrontPath is
selected and spouse/domestic partner 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, No other 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/domestic
partner will be removed from the plan.
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Dependent Eligibility
•
Medical/Rx
o Age 19 – 26 (end of calendar year they turn age 26)
• Not required to be a full-time student or an IRS Dependent
o Age 26 – 28 (end of month they turn age 28)
•
•
•
•
•
•
•
•
•
Must be unmarried
Not required to be an IRS dependent
Must be State of Ohio resident OR full-time student if out-of-state resident
Must be child, step-child or custodial child of employee
Cannot be eligible for other employer-sponsored coverage, regardless of cost
Cannot be eligible for coverage under any Medicare or Medicaid plan
Cannot be secondary on coverage
Additional post-tax premium will be charged per adult child
Health Savings Account/Flexible Spending Account
o Must be IRS dependent
•
Dental, Vision, Life Insurance, Tuition Waiver
o Age 19 – 24 (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.
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Cost of Adult Child Coverage
• For dependents age 26 – 28, as long as they meet the
requirements, there will be an additional post- tax payroll
deduction of:
• $112.46/pay for each adult child added to the OBA/FrontPath plan
• $88.74/pay for each adult child added to the Paramount Employer
Select 3-tier plan
• $71.51/pay for each adult child added to the Medical Mutual of Ohio
CDHP plan
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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
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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.
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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 ($2,600 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
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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
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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 800-227-6007
5 Face-to-Face Counseling Services
Legal Assistance
Financial Services
Identity Theft Prevention and Recovery
Comprehensive Work/life Website
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Retirement Plan Options
Ohio Public Employee Retirement
System (OPERS) - Automatic
•
•
•
•
•
•
Employee Contribution: 10.00%
Employer Contribution: 14.00%
Phone Number: (800) 222 – 7377
Email: www.opers.org
Auto enrolled with OPERS
Full time and part time employees
Alternative Retirement Plan (ARP) –
120 Days to Elect
•
- OR - •
•
•
•
•
•
- AND -
Employee Contribution: 10.00%
Employer Contribution: 13.23%
Choose from a list of approved vendors
No state retirement benefits
Vested immediately
Election is irrevocable when made
Full time employees only
403(b) Tax Deferred Account –
Optional
457 Optional 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
•
•
Available to State of Ohio employees only
Set up directly with Ohio Deferred
Compensation
(877) 644 – 6457
www.ohio457.com
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.
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Tuition Waiver
Employees
• FT Faculty and Staff are eligible for
up to 8.0 undergraduate or graduate
credit hours per semester (following
probationary period)
• 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
• Benefit applies to tuition, application
and new student registration fee,
NOT general fee
• For additional information, please
visit: http://hr.utoledo.edu
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UT Early Learning Center
• Accredited child care center
• Child Care / Preschool
• 18 months through five years old
• Located just south of Health Science Campus
• Large classrooms, hot lunches, two playgrounds,
full-size gym, summer school-age program
• Contact Caryn Salts, Director of Early Learning
Center, at [email protected] or call
419.530.6710
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Using Your Benefits
• Your selected medical plan will mail you an ID to
present each time medical services are received.
• OPTUM Rx will issue a separate prescription card.
• OPTUM HSA Visa Card will also be sent to you to
access your Health Savings Account if MMO 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
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Important Documentation Required
•
Spousal/Domestic Partner Affidavit (access through online portal and complete hard
copy if spouse is employed outside UT)
•
•
Adult Child Certification (through online portal)
•
•
If adding dependent children to coverage who have not been previously covered
Domestic Partner Registration
•
•
If adding a spouse to any coverage who has not been previously covered
Birth Certificate, Court Documents, and/or Adoption Paperwork
•
•
If adding a dependent over age 19
Marriage Certificate
•
•
If covering a spouse or domestic partner on the Paramount or OBA/FrontPath plans
If registering and/or adding a domestic partner 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 no 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.
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Enrollment in Benefits
• Enrollments completed through myUT portal
(http://myut.utoledo.edu) within 30 days of hire date
or qualifying event
• Plan Overviews/Premiums available at:
hr.utoledo.edu
• Direct questions to: [email protected]
• Email, fax or deliver to HRTD required New Hire
Benefits Enrollment documentation no later than 30
days following hire date or qualifying event
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Enrollment in Benefits
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UT Benefits Contact Information
Benefits Team Contact Info
Contact
Jessica Allar
Kate Johnson
Nate Walker
Title
Benefits Specialist
Manager, Benefits Planning & Administration
Senior Director, Total Rewards
Ext.
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1442
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Please direct employee questions to: (419) 530 – 4747 or [email protected]
New Hire Benefits Enrollment Document Submissions to HRTD Benefits via:
Secure Fax: (419) 530 – 1492
Email: [email protected]
In Person: MC: HRTD @ Scott Park, ASC, Suite 1000
HSC: HRTD @ Facility Support Building
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External Benefits Contact Information
Benefits Vendors
Ohio Benefits Administrators OBA/FrontPath PPO
FrontPath PPO
Paramount Employer Select (ES) PPO
Medical Mutual of Ohio (MMO CDHP)
Delta Dental
Vision Services Plan (VSP)
Chard-Snyder Flexible Spending Accounts
Optum (Wells Fargo) Health Savings Account
Optum (Prescription)
(877) 622-1966
(419) 891-5206
(419) 887-2525
(800) 468-6690
(800) 524-0149
(800) 877-7195
(800) 982-7715
(866) 884-7374
(800) 325-1810
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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 2017 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 1st. If you enroll at open enrollment your benefits will be effective
January 1, 2018.
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 HRTD 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 1st. If you enroll your eligible dependents at open enrollment their
coverage will be effective January 1, 2018.
Where can I get more information?
You can find out more information by going to [email protected]
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2017 Medical Plan Comparison Sheet
Legend
DW - Deductible
Waived
AD - After Deductible
Medical Mutual of Ohio CDHP
Paramount Employer Select PPO
OBA/FrontPath PPO
A CDHP is a high-deductible health plan in which you have greater
control over your medical care. You pay the entire cost of doctor's visits
and other procedures. Once you have met your annual out-of-pocket
maximum, the plan pays the remainder of your annual medical and
prescription drug costs.
A PPO plan is a managed care plan, which means the plan is guided by both
insurance and medical professionals. This type of plan allows you to visit
both in-network and out-of-network practitioners. You'll typically pay a copay or co-insurance when visiting your doctor or undergoing a medical
procedure, but you benefit from the discounted rates that come with
managed care plans. Once you have met your annual out-of-pocket
maximum, the plan pays for the remainder of any service that has
coinsurance.
Deductible:
Tier 1
$1,300 Single
$2,600 Family
Tier 2
$1,300 Single
$2,600 Family
Tier 3
$1,300 Single
$2,600 Family
Tier 1
No Deductible
Tier 2
$100 Single
$150 Single+1
$200 Family
Tier 3
$500 Single
$750 Single+1
$1,000 Family
In-Network
$100 Single
$200 Single+1
$300 Family
Out-of-Network
$300 Single
$600 Single+1
$900 Family
Out-of-Pocket
Maximum:
$2,200 Single
$4,400 Family
$2,200 Single
$4,400 Family
$2,200 Single
$4,400 Family
$1,000 Single
$1,500 Single+1
$2,000 Family
$2,100 Single
$3,150 Single+1
$4,200 Family
$4,500 Single
$6,750 Singe+1
$9,900 Family
$1,100 Single
$2,200 Single+1
$3,300 Family
$4,300 Single
$6,600 Singe+1
$8,900 Family
Co-Insurance:
100%
90%
70%
100%
90%/10%
70%/30%
90%/10%
70%/30%
Office Visit:
100%
90%
70%
$10
$20
70/%30% (AD)
$15
70/%30% (AD)
Specialist Visit:
100%
90%
70%
$10
$20
70%/30% (AD)
$30
70%/30% (AD)
Emergency
Room:
100%
90%
70%
$75 (waived if admitted)
$75 (waived if admitted)
$75 (waived if admitted)
$75 (waived if admitted)
Remainder 90% (AD)
$75 (waived if admitted)
Remainder 90% (AD)
Urgent Care:
100%
90%
70%
$50
$50
$35
$35
Preventative
Services:
100% (DW)
90% (DW)
70% (DW)
Diagnostic
Services:
After Deductible
After Deductible
After Deductible
Remainder 90% (AD)
Not applicable
(see Paramount Employer Select PPO for a
description of a PPO plan)
Remainder 90% (AD)
Accounts:
A Health Savings Account with employer contributions is
available with this plan to offset out-of-pocket expenses. UT
contributes $800/single and $1,600/family. The IRS HSA
contribution limits for 2017 are $3,400/single and $6,750 /
family coverage. Additional $1,000 for age 55 to 64.
A Flexible Spending Account is available with this plan to offset outof-pocket expenses. All expenses incurred in 2017 must be
submitted by March 31,2017 for reimbursement. Whatever is not
used is forfeited. The IRS FSA contribution limits for 2017 are
$2,600. No UT contributions.
A Flexible Spending Account is available with
this plan to offset out-of-pocket expenses. All
expenses incurred in 2017 must be submitted
by March 31,2017 for reimbursement.
Whatever is not used is forfeited. The IRS FSA
contribution limits for 2017 are $2,600. No
UT contributions.
Network(s):
MMO SuperMed (PPO) Plus in Ohio (Mercy & ProMedica),
Cofinity in Michigan and PHCS outside Ohio & Michigan)
Paramount Employer Select PPO: Employer Select in northwest
Ohio (ProMedica only) and PHCS outside of northwest Ohio.
OBA/FrontPath PPO: FrontPath in northwest
Ohio, (Mercy &ProMedica) and PHCS outside
northwest Ohio.
This is a limited highlight of the various medical plans. Please refer to the individual plan summaries and
plan documents for more detailed information.
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