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Coastal Carolina University

Coastal Carolina University. Candidate Benefits Overview 2011.

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Coastal Carolina University

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  1. Coastal Carolina University Candidate Benefits Overview 2011

  2. This overview is intended to provide an abbreviated description of benefit plans and programs offered at Coastal Carolina University. Plans and eligibility may vary depending on the position. If hired, a complete summary of specific plans and programs will be provided during the orientation process. The language used in this document does not create an employment contract and does not create any contractual rights or entitlements by the candidate. The university reserves the right to revise the content of this summary, in whole or in part, no promises or assurances, whether written or oral, which are contrary to or inconsistent with the terms of this summary create any contract of employment.

  3. Presentation OverviewBenefit Programs Health and Dental Rates Vision MoneyPlu$Life Insurance Disability Insurance Retirement Other Benefits Immigration Contact Information


  5. Health Plan Options State Health Plan Standard Plan Savings Plan HMO Blue Choice Health Plan CIGNA HMO

  6. Enrollment Enroll: Within 31 days of Hire Special eligibility situation During open enrollment as late entrant

  7. Eligibility • For Employee: • Is employed by Coastal Carolina University • Works at least 30 hours per week in a slotted position and receives compensation from Coastal Carolina University • For Dependent Spouse: • A lawful spouse, or • A former spouse who is required to be covered by a divorce decree, but not both spouses • For Dependent Child: • Natural child, step-child, adopted child, foster child, or a child for whom the subscriber has legal custody • Under age 26, unless eligible for other group health coverage (either as an employee or as a spouse) • You may cover an incapacitated child age 19 and over. * Specific documents are required in order to substantiate dependent eligibility. Please contact a University Benefits Administrator for details.

  8. Basics Benefits eligible employees of Coastal Carolina University, can enroll in a health plan and the dental plan(s) within 31 days of the date of hire. Eligible dependents must also be enrolled within 31 days of hire or special eligibility situation. To enroll in a health or dental plan, employees must complete the required forms within 31 days of the date hired. Benefits orientations must be scheduled with the Office of Human Resources within 31 days of the date hired. Benefits become effective on the first day of the month following the date of hire.

  9. Coverage Levels • For health and dental plans, there are four choices of coverage levels: • Employee Only (covers employee only) • Employee Child (covers employee and all eligible children) • Employee Spouse (covers employee and spouse) • Full Family (covers employee, spouse, and all eligible children)

  10. Pre-existing Condition Exclusion Applies to health, basic and supplemental long term disability Waiting period 12 months 18 months (late entrant) May be reduced or eliminated by providing proof of prior coverage (i.e. letter of creditable coverage) Does not apply to children under the age of 18

  11. Coordination of Benefits Health and Dental Plan that covers person as employee is primary to plan that covers person as dependent Children: Plan of parent whose birthday occurs earliest in year is primary Deductible and coinsurance linked for married EIP subscribers enrolled in same health plan If you are eligible for Medicare and are covered as an active employee, your State Health Plan or HMO coverage is primary over Medicare

  12. State Health PlanStandard Plan and Savings Plan Common to Both Worldwide Coverage In and out-of-network benefits Pharmacy network Online access available www.southcarolinablues.com

  13. State Health PlanStandard Plan and Savings Plan Limited Preventive Benefits Routine mammogram Pap test Well child care Routine colonoscopy

  14. Standard Health Plan Annual Deductible $350 Individual $750 Family In-Network Coinsurance Plan pays: 80% Subscriber pays: 20% Out-of-Network Coinsurance Plan pays: 60% Subscriber pays: 40%

  15. Standard Health Plan Per Occurrence Deductibles $10 office visit $75 outpatient facility service $125 emergency room visit

  16. Standard Health Plan Prescription Drug Benefits Network Retail Pharmacy $9 Tier 1 $30 Tier 2 $50 Tier 3 Medco Mail Order $22 Tier 1 $75 Tier 2 $125 Tier 3 $2,500 maximum copayment per person

  17. State Health PlanSavings Plan

  18. SHP Savings Plan Annual Deductible $3,000 Individual $6,000 Family In-network Coinsurance Plan pays 80% Subscriber pays 20% Coinsurance Maximum $2,000 Individual $4,000 Family Out-of-network Coinsurance Plan pays 60% Subscribers pays 40% Coinsurance Maximum $4,000 Individual $8,000 Family

  19. Health Maintenance Organizations (HMOs) BlueChoice Health Plan Annual Deductible $250 Individual $500 Family Network Coinsurance Plan pays 85% Subscriber pays 15% Coinsurance Maximum $2,000 Individual $4,000 Family

  20. Blue Choice Copays Provider $15 PCP $15 OB-GYN $40 Specialist $35 Urgent Care, then plan pays 100% after copay Facility $100 Outpatient, first 3 visits $125 ER $200 Inpatient Plan pays 85% after copay

  21. BlueChoice Pharmacy Network Retail Pharmacy (up to 31-day supply) $8 Lower-cost generic $15 Higher-cost generic $35 Preferred brand $55 Non-preferred brand $80 Preferred brand specialty Pharmaceuticals $125 Specialty Pharmaceuticals Mail Order (up to 90-day supply) $20 Lower cost generic $37.50 Higher cost generic $87.50 Preferred brand $137.50 Non-preferred brand

  22. CIGNA HMO Deductibles and Coinsurance Annual Deductible None In-Network Coinsurance Plan pays 80% Subscriber pays 20% Coinsurance Maximum $2,000 Individual $4,000 Family

  23. CIGNA COPAYS Provider $15 PCP $15 OB-GYN $30 Specialist $100 ER Plan pays 100% after copay Hospital $250 Outpatient $500 Inpatient Plan pays 80% after copay $100 ER, then HMO pays 100%

  24. CIGNA PHARMACY Network Retail Pharmacy (up to 30-day supply) $ 7 generic $25 preferred brand $50 non-preferred brand Mail Order (up to 90-day supply) $14 generic $50 preferred brand $100 non-preferred brand


  26. Tobacco Surcharge $40 per month for tobacco users with subscriber only coverage $60 per month for tobacco users with subscriber plus dependent(s) coverage Automatically charged unless certify no one uses tobacco May certify by completing a Certification Regarding Tobacco Use form Surcharge may be removed if no one has used tobacco within the past 6 months Smoking Cessation program is available to subscribers and their dependents at no charge through: Free & Clear – for subscribers to the State Health and Savings Plans CIGNA Quit Today – for subscribers to CIGNA HMO

  27. State Dental Plan

  28. DENTAL PLAN FEATURES Free to choose dentist No pre-existing condition exclusions Two year plan-may not drop or change until next open enrollment (occurs every October during odd years – ex: next open enrollment period is October, 2011, then October 2013, etc) $1,000 maximum benefit per calendar year

  29. DENTAL PLUS FEATURES Supplement to Basic Dental Higher allowance for services Combined maximum benefit of $2,000 per calendar year May enroll in or cancel coverage during open enrollment Must be enrolled in the basic dental plan and cover the same dependents Does not include orthodontia coverage


  31. STATE VISION PLANAdministered by EyeMed Vision Care

  32. State Vision Plan (EyeMed) Features May enroll within 31 days of date of hire or retirement May enroll in or drop coverage every year during October enrollment

  33. State Vision Plan (EyeMed) Services Eye Exams Frames Lenses Contact lens services and materials Discounts on LASIK and PRK vision correction

  34. State Vision Plan (EyeMed) Providers In-Network No claims to file Pay copayment and charges above the plan’s allowance Out-of-Network Pay provider for service EyeMed will reimburse you for a portion of expenses for certain services

  35. State VisionDiscount Program Features No enrollment or premium Discount program Participating providers only $60 for routine eye exam – excludes contact lens exam 20% discount on eyewear except disposable contact lenses

  36. Supplemental Vision Care Plan United HealthCare Vision Plan • This program offers vision care services for a monthly premium when using a participating Ophthalmologist or Optometrists. Co-pays for office visits and eyewear.

  37. Vision Plan Monthly Premiums


  39. Life Insurance • Basic Life Insurance • Employees enrolled in a health plan automatically receive $3,000 in life insurance. This insurance is provided at no cost to you. • Optional Life Insurance • This programs allows employees to purchase additional life insurance coverage for themselves. Benefit levels range from $10,000 to $500,000. Employees pay the premium for this benefit. • Dependent Life Insurance • Employees can also purchase life insurance for their dependent spouse and dependent children who are between 14 days and 19 years old or up to 25 years old if the dependent is a full-time student. Employees pay the premium with no contribution from Coastal Carolina University. • Lincoln Life • Supplemental life insurance can be purchased for the employee, dependent spouse and eligible child. Employees pay the monthly premium.

  40. Basic Life $3,000 term life insurance to all eligible employees under age 70 Premium paid by employer Employees enrolled in any health plan are covered Accidental death and dismemberment benefits

  41. Optional Life Premium based on amount of coverage and employee’s age Coverage up to three times salary if enrolled within 31 days of employment Medical evidence required for additional coverage Maximum coverage level of $500,000

  42. Dependent Child Coverage $15,000 per child Premiums - $1.24 per month, regardless of number of eligible children covered Can enroll eligible children throughout the year without medical evidence of good health

  43. Spouse Coverage New hire can enroll spouse for $10,000 or $20,000 without medical evidence of good health Premiums based on employee’s age and amount of coverage Employee is beneficiary May enroll in up to 50% of employee’s Optional Life coverage with medical evidence, or a maximum of $100,000

  44. Lincoln Life New Hires may elect $100,000 of themselves and/or $30,000 on their spouse within 31 days of hire without providing medical evidence; after 31 days, medical evidence will be required Premium based on amount of coverage and employee’s age Dependent children age 6 months to age 25, if full-time student, may be covered

  45. Long Term Disability Insurance Basic Long Term Disability Premiums paid by Coastal Carolina University Employee automatically enrolled with enrollment in a health plan Benefit -62.5% of pre-disability earnings, up to $800 per month 90-day waiting period Supplemental Long Term Disability Premiums paid by employee and are based on age and income of employee Provides protection for employee if annual salary exceeds $15,360 Benefit – 65% of pre-disability earnings, up to $8,000 per month Choice of 90-day or 180-day waiting period

  46. Long Term Care Insurance

  47. Long Term Care Insurance Features Benefits paid when subscriber Is unable to perform at least two activities of daily living for at least 90 days or Has severe cognitive impairment requiring ongoing help or supervision Eligible Participants Active full-time permanent employees and their Spouse, parents, parents-in-law, grandparents, grandparents-in-law, siblings, adult children (and their spouses) Premiums Based on age at time of purchase and selected plan Premiums paid directly to Prudential


  49. MoneyPlu$ • Features • Pretax premiums • Medical Spending Account • Dependent Care Spending Account • Health Savings Account • This is a flexible benefits program. It enables employees to save money by using pretax dollars to pay insurance premiums, dependent care expenses, medical and dental bills for which you are not reimbursed. For employees enrolled in the Health Savings Plan, they can contribute to a Health Savings Account. • To enroll in the Medical Spending Account, employees must have been employed by the State of South Carolina for one year.


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