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Benefits Program

Benefits Program

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Benefits Program

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  1. Benefits Program 2013 – 2014 Plan Year

  2. Benefits Offered • Health Insurance • Flexible Reimbursement Accounts • Virginia Retirement System • Optional Retirement Plan • Basic Life Insurance • Optional Life Insurance • Leaves • Family and Medical Leave Act • Virginia Sickness and Disability Plan • Traditional Sick Leave Plan • Annual Leave • School Assistance and Volunteer Service Leave • Military Leave • Long-Term Care • Deferred Compensation and Cash Match Program • Commonwealth of Virginia Provider Listing • 529 Plan

  3. Health Insurance - Eligibility • Full-time salaried classified employees (40-32 hours) • Full-time Faculty

  4. Health Insurance – Membership Levels • Single – Employee Only • Dual – Employee and one dependent (spouse or child) • Family – Employee and two or more eligible dependents

  5. Health Insurance – Eligible Dependents • Legally married spouse • Biological and legally adopted children • May be covered until the end of the year they turn age 26 • Stepchildren • May be covered until the end of the year they turn age 26 • Unmarried children of whom you have permanent sole custody • Principal place of residence is with the employee; • Member of employee’s household; • Receive over one-half of their support from the employee and; • Custody was awarded prior to the child’s 18th birthday • Unmarried incapacitated dependents age 26 and older • Reside full-time with the employee (or the other natural/adoptive parent) • Employee provides more than half of the dependent’s support • Documentation required to enroll any eligible dependent in health coverage!!

  6. Health Insurance – Enrollment Periods • Newly Eligible • Open Enrollment • Qualifying Mid-Year Events (QMEs)

  7. Health Insurance – Effective Dates of Coverage Newly Eligible coverage begins on the first of the month coinciding with or following the date of employment if enrollment form is received within 30 calendar days of employment Example: hired 2/10, submitted enrollment on 2/18 = 3/1 effective date Example: hired 2/25, submitted enrollment on 3/5 = 3/1 effective date Example: hired 2/1, submitted enrollment within 30 days = 2/1 effective date 9 month faculty members – coverage continues through August 31 even if contract ends May 15 and not re-employed on a full-time basis for the next year as long as employee portion of premiums are paid for the summer months

  8. Health Insurance – Enrollment Periods • If newly eligible employee does not enroll within 30 calendar days of employment, then s/he may enroll during the next annual open enrollment period or with a qualifying mid-year event

  9. Health Insurance – Open Enrollment • During the spring of each year • Allows you to change plan and/or membership selections • Enroll or cancel coverage • Changes effective July 1

  10. Health Insurance – Qualifying Mid-Year Events • Within 60 calendar days of qualifying event • Allows for consistent changes • Events include • Marriage • Birth/Adoption • Divorce • Termination or commencement of spouse’s employment • Death of a dependent • Dependent loses eligibility • Going on or returning from an unpaid leave of absence • Spouse’s open enrollment period differing • Normally changes will be effective the first of the month following receipt of the enrollment action

  11. Health Insurance – Plan Options • COVA Care • COVA HealthAware • COVA HDHP • TRICARE Supplement Plan

  12. Health Insurance – COVA Care • No PCP requirement • No referrals • Blue Card PPO Network • Out-of-network defined by providers not a geographical region • Out-of network coverage for true emergencies

  13. Health Insurance – COVA Care • Co-payments • PCP - $25 • Specialist - $40 • Inpatient hospital - $300 • Outpatient hospital and ER - $150 • Deductible • $225 – individual • $450 - family • Co-insurance • Out-of-pocket expense limit • $1,500 per person • $3,000 per family • Wellness visits covered at 100% - no co-pay, no co-insurance

  14. Health Insurance – COVA Care • Prescription Drug Program • Mandatory generic • Tier System • Mail Order for Maintenance Rx • Co-pays • Retail pharmacy – up to 34 day supply • $15 – Tier 1 • $25 – Tier 2 • $40 – Tier 3 • $50 – Tier 4 (Specialty drugs) • Mail order – 90 day supply • $30 – Tier 1 • $50 – Tier 2 • $80 – Tier 3 • $100 – Tier 4 (Specialty drugs)

  15. Health Insurance – COVA Care • Dental Basic Services • Diagnostic and preventive services • Twice a year • Paid at 100% • Dental Maximum • $2,000 annually

  16. Health Insurance – COVA Care • Options • Out-of Network • Access to providers outside Anthem/Blue Card PPO network • Plan pays 75% - you pay 25% • Expanded Dental • Adds primary dental service coverage at 80% after deductible (fillings, root canals, periodontal, etc.) • Adds complex restorative service coverage at 50% after deductible (crowns, dentures, and bridgework) • Adds orthodontic services coverage at 50% up to a $2,000 lifetime maximum • Provides $2,000 dental maximum annually • Deductible - $50 single, $100 dual, or $150 family • Vision and Hearing • 1 eye exam every 12 months - $40 co-pay • Provides allowance for lenses, frames, and contacts every 12 months • 1 hearing exam every 48 months - $40 co-pay • Provides hearing aids and other hearing aid related services up to $1,200 every 48 months

  17. Health Insurance – COVA Care • Vendors – • Anthem (medical, prescription drugs, and behavioral health benefits) • Delta Dental of Virginia (dental)

  18. COVA Care Monthly Premiums

  19. Health Insurance – COVA HealthAware • Consumer driver health plan that includes deductible, co-insurance, and Health Reimbursement Arrangement (HRA) • The Commonwealth will fund an HRA of $600 for employees or $1,200 for employees and enrolled spouses to help offset family out-of-pocket costs. • Employees and spouses may each receive up to $150 by completing certain healthy activities called “do rights” • If you add the “do right” rewards to the Commonwealth’s initial HRA funding, you can save half of the cost of your plan deductible • Wellness and preventive services covered at 100% - including an annual vision and hearing exam at no cost to members

  20. Health Insurance –COVA HealthAware • Deductible • Individual $1,500 • Family $3,000 • Out-of-Pocket Maximum • Individual $3,000 • Family $6,000 • Health Reimbursement Arrangement • $600 Employee • $1,200 Employee & Spouse • Co-insurance – plan pays 80% and you pay 20%, after deductible • Out-of-Network – Plan pays 60% and you pay 40%

  21. Health Insurance –COVA HealthAware • How Does an HRA Work? • The Commonwealth contributes to the HRA - no employee contributions to the account • HRA automatically pays expenses first • Out-of-pocket plan costs such as the deductible and coinsurance for medical, pharmacy and behavioral health expenses can be paid from the HRA • Money in the account rolls over into the next plan year if not used by June 30th • There is no need to file claims – HRA funds are automatically dispersed for eligible out-of-pocket amounts not paid by the health plan

  22. Health Insurance – COVA HealthAware • Options • Expanded Dental • Adds primary dental service coverage at 80% after deductible (fillings, root canals, periodontal, etc.) • Adds complex restorative service coverage at 50% after deductible (crowns, dentures, and bridgework) • Adds orthodontic services coverage at 50% up to a $2,000 lifetime maximum • Provides $2,000 dental maximum annually • Deductible - $50 single, $100 dual, or $150 family • Vision • Provides allowance for lenses and frames every 12 months

  23. COVA HealthAware Monthly Premiums

  24. Health Insurance - HDHP • Special health insurance plan for employees who want to open a Health Savings Account (HSA) – employees enrolled in COVA are not eligible for HSA • $1,750/$3,500 Deductible • 80/20% Coinsurance • $5,000/$10,000 Out-of-pocket expense limit • 100% wellness coverage • Out-of-network – emergency only • Blue Card PPO Network • Dental Benefits • $50/$100/$150 Deductible • 100/80/50% Co-insurance • $2,000 Plan year maximum • $2,000 orthodontic lifetime maximum • Claims administrator for all services - Anthem

  25. COVA HDHP Monthly Premiums

  26. TRICARE Supplement Plan • TRICARE-eligible employees who are eligible for the state health benefits program and are in one of the following categories may enroll in this supplement plan: • Military retirees with 20 years of creditable military service and entitled to retired pay and their spouses/surviving spouses who are NOT eligible for Medicare • Retired Reservists and National Guardsmen between the ages of 60 and 65 with 20 years of creditable service and their spouses/surviving spouses who are not eligible for Medicare • Retired Reservists and National Guardsmen under age 60 and enrolled in TRICARE Retired Reserves (TRR) and their spouses/surviving spouses who are not eligible for Medicare • Military retirees and their spouses/surviving spouses who reside outside the U.S. or its territories • Military retirees and their spouses/surviving spouses age 65 or older but ineligible for Medicare (all must have received a Statement of Disallowance from Social Security Administration

  27. TRICARE Supplement Plan • No medical examination required for enrollment • No pre-existing condition clause • Guaranteed issue • Works with all three TRICARE options (Standard, Extra, and Prime) • Complete TRICARE Supplement Plan enrollment form to enroll and provide documentation if covering dependents

  28. TRICARE Supplement Monthly Premiums

  29. Health Insurance • Premium Conversion • Health insurance premiums are automatically deducted pre-tax

  30. Behavioral Health Benefits • Employee Assistance Program (EAP) • 4 free visits per person, per occurrence, per plan year • Mental health, alcohol, and substance abuse coverage – inpatient or outpatient

  31. Commonhealth • Wellness program for Commonwealth of Virginia employees • Includes health check screenings, programs, fitness center discounts, and challenges

  32. Health Insurance – Enrollment Options • Enrollment Form • Employee Direct • Quick, easy, and available 24 hours a day from any computer with internet access • Permits review and changes to health benefits and flexible reimbursement accounts in the Commonwealth’s Benefits Eligibility System Remember, you have 30 calendar days from your date of hire to enroll in coverage! ID Cards arrive 3-4 weeks after enrolling

  33. Flexible Reimbursement Accounts (FRA) • Allows employees to use pre-tax dollars to pay for certain medical and dependent care expenses • Cannot claim these expenses on your taxes and utilize the FRA • Medical Reimbursement Account – may claim expenses not covered by your health benefits plan • Dependent Care Reimbursement Account – may claim expenses for the care of your eligible dependent • You can enroll in one or both the accounts even if you are not enrolled in a state health insurance plan

  34. Flexible Reimbursement Accounts (FRA) • Funds cannot be transferred between the accounts • “Use it or Lose it” rule • May claim reimbursement for expenses incurred during the plan year (July 1 – June 30) • Must submit all claims for reimbursement by September 30th of each year • Must re-enroll in FRAs each year – your election does not roll over from one plan year to another • Availability Rule • Medical – entire election amount available at the beginning of the plan year • Dependent Care – funds must be posted to the account in order to be claimed (available after payroll deductions)

  35. Flexible Reimbursement Accounts (FRA) • Minimum contribution - $10 per pay period • Maximum contribution • Medical - $2,500 • Dependent Care - $2,500 if married filing separately or $5,000 if married filing jointly • Contributions must be made in whole dollar increments • Monthly pre-tax administrative fee of $3.65 taken from paycheck on the 16th

  36. FRA – Enrollment Periods(Same as Health Insurance) • Newly Eligible • Open Enrollment • Qualifying Mid-Year Events (QMEs)

  37. FRA – Enrollment Periods • If newly eligible employee does not enroll within 30 calendar days of employment, then s/he may enroll during the next annual open enrollment period or with a qualifying mid-year event

  38. Flexible Reimbursement Accounts (FRA) • Anthem is the claims administrator • Additional FSA details may be found at • Online account access at • Elite Visa Benefit Card is available for the Medical Reimbursement Account

  39. EmployeeDirect Available 24 hours a day Step 1: Verify your registered e-mail address and date of birth Contact a member of the Employee Benefits team if your information is incorrect. It will need to be corrected before you can use EmployeeDirect Step 2: Create a password Step 3: Sign-up Step 4: Click and follow prompts Step 5: Ask questions if you need help

  40. Virginia Retirement System (VRS) • Full-time Classified employees are automatically enrolled in VRS • Full-time Faculty may elect to participate in VRS or the Optional Retirement Plan – if no election is made within 60 days of eligibility, then automatically enrolled in VRS • If employed on a full-time basis with another VRS employer, you will need to complete a form to designate which employer you choose to report your retirement • myVRS • Defined Benefit Plan • Five years of service to be vested • Retirement benefit calculated based on age at retirement, number of years of service, and average final compensation • Members hired before July 1, 2010 who have not taken a refund are covered under VRS Plan 1 • Members hired or rehired on or after July 1, 2010 are covered under VRS Plan 2 • Members contribute 5% of salary to the plan

  41. Virginia Retirement System (VRS) – Purchase of Prior Service • Once you are an active member of VRS, you may be eligible to increase your benefit, or qualify for retirement at an earlier age by purchasing prior service credit • Prior service is a period of service that has not been credited to your VRS service record because it was not covered by VRS or it was covered service for which you previously took a refund

  42. Virginia Retirement System (VRS) – Purchase of Prior Service • Types of service you may purchase include • Military leave of absence • Birth or Adoption leave of absence • Educational leave of absence • Non-covered service with a Participating employer (part-time service, temporary service, etc) • Public service • Civilian service in the federal government • VRS refunded service • Active duty military service • Better to buy sooner rather than later • Salary increases have cost implications • Window to buy the time is short

  43. Optional Retirement Plan • Defined contribution plan available to faculty only • Immediately vested • Retirement benefit is based on employer contributions and the investment gains and losses on those contributions • Employer contributes 10.4% of creditable compensation under Plan 1 • Employer contributes 8.5% of creditable compensation and employee contributes 5% under Plan 2 • You choose investments from a range of funds offered under the plan and assume all risks associated with those choices • May begin receiving benefits at termination of employment regardless of age • Pay out options vary according to provider chosen • Provider choices for the ORP are TIAA-CREF and Fidelity

  44. Optional Retirement Plan • If you choose the ORP you must • Complete an Election to Participate in Optional Retirement for Higher Education (VRS-65) • Select the investment provider to which you want your contributions sent and enroll with that provider • Designate the beneficiaries you wish to receive your account in the event of your death • You can change ORP providers during Open Enrollment which occurs in October each year effective the following January

  45. Basic Life Insurance • Provided to all full-time classified and faculty staff in VRS or ORP • Natural death benefit equal to 2 times your annual salary • Annual salary rounded to next highest thousand and multiplied by 2 • Accidental death benefit equal to 4 times your annual salary • No cost to you! • Minnesota Life Insurance Company is the carrier

  46. Optional Life Insurance • You may purchase additional life insurance coverage for yourself, spouse, and dependents • You may purchase one, two, three, or four times your annual salary not to exceed $700,000 • You pay premiums through payroll deduction • Premiums for coverage for yourself and spouse are based on the coverage amount and your age • Premiums for dependent children are flat amounts and based on the coverage amount • You cannot cover your spouse and dependents without being enrolled in optional coverage for yourself • Evidence of insurability is required when electing coverage amounts greater than $350,000 for yourself, or electing Options 2, 3, or 4 for your spouse • Evidence of insurability is also required when electing coverage AFTER your 31 day initial eligibility period • Minnesota Life Insurance Company is the carrier

  47. Designation of Beneficiary • Order of precedence established by law for payment of Basic and Optional Group Life Insurance and retirement benefits • Spouse • Children and descendants of deceased children, per stirpes • Parents equally or surviving parent • Duly appointed executor or administrator of your estate • Next of kin

  48. Family and Medical Leave Act • Provides 12 workweeks of job-protected leave during a calendar year (26 weeks if using caregiver leave) • Eligible employees: • 1 year of State service • Worked 1,250 hours in the 12 months immediately preceding the leave • Leave granted for • Birth/Adoption of Child • To care for an immediate family member (child, parent, spouse) • Employee’s own illness/injury • Qualifying exigency arising out of the fact that your spouse, child, or parent is on active duty or call to active duty status in support of a contingency operation as a member of the National Guard or Reserves • To care for your spouse, child, parent or next of kin who is a covered service member with a serious injury or illness

  49. Virginia Sickness and Disability Program (VSDP) • Covers full-time classified employees and full-time faculty members who are active members of the VRS • VSDP does NOT cover employees who elect the ORP • Administered by Unum • Return to Work Policy

  50. Virginia Sickness and Disability Program (VSDP) • Sick Leave • Credited on January 10 based on your first date of employment • May not be carried from one calendar year to the next • No payment of unused sick leave when you terminate employment • Used for absences due to personal illness, injury or pregnancy and for doctor visits when disability benefits are not payable • May use up to 33% of your sick leave for immediate family illness • Leave amount increases based on years of service (5 yrs = 72 hours; 10+ years = 80 hours for full-time and 10+ years = 40 hours for part-time)