new hire benefits orientation - university of toledo · 2017-04-26 · new hire benefits...

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

Medical Mutual of Ohio

Tier 1UTMC/UTP

Tier 2MMO Network

Providers

Tier 3 Out-of-Network

(May be balance billed*)

Deductible $1,300 Single$2,600 Family

$1,300 Single$2,600 Family


Out-of-Pocket MaximumIncludes Deductible




Co-InsuranceSubject to deductible 100% 90% / 10% 70% / 30%

Preventive CareNot subject to deductible 100% 90% / 10% 70% / 30%

UT HSA** ContributionProrated Per Pay

$800 Single$1,600 Family



Employee HSA**Contribution




** 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 SelectParamount

Employer SelectTier 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-PocketMaximum (IncludesDeductible)

$1,000 Single$1,500 Single + 1

$2,000 Family


$4,000 Family


$8,000 Family

Co-Insurance (Subject to Deductible)

100% 90% / 10% 70% / 30%

Office Visit Co-Pay $10 / $25 $20 / $35 70% / 30%

Specialist Visit Co-Pay $10 / $25 $20 / $35 70% / 30%


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Service Providers

Tier 1

• 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

• 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

• Paramount Network Providers• View providers at

www.paramounthealthcare.com • Cofinity (Michigan)• PHCS National Wrap Network

Medical Mutual of Ohio

Paramount

Tier 3

• All Other Providers –non network

• All Other Providers –non network

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http://www.mmoh.com/

Ohio Benefit Administrators OBA / FrontPath

OBA / FrontPath In-Network Providers Out-of-Network(May be balance billed*)

Deductible$100 Single

$200 Single + 1$300 Family

$300 Single$600 Single + 1

$900 Family

Out-of-Pocket Maximum(Includes Deductible)


$3,300 Family


$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%


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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 SharingUT Pharmacies MMO CDHP

30-Day / 90-Day

AFSCMEUT

30-Day Supply

AFSCMEUT

90-Day Supply

Other Employees

30-Day Supply

Other Employees

90-Day Supply

Tier 1 (Generic) $5 / $10 $7.99 $19.97 $7.26 $18.15

Tier 2 (Formulary)

10%Up to $40 / $100

max per prescription$19.97 $37.27 $18.15 $33.88

Tier 3 (Non-Formulary) 20% $39.93 $73.93 $36.30 $67.21

Optum Network Retail Pharmacies

MMO CDHP(30-Day / 90-Day Supply)

Paramount/OBA AFSCME

Health Science Campus (HSC) Employees10-Day Maximum

Paramount/OBA Main Campus

Employees30-Day Maximum

Paramount /OBA HSC Non-Union

Employees10-Day Maximum

Tier 1(Generic) $10 / $15 $7.99 $11 $7.26

Tier 2 (Formulary)

20%Up to $80 / $200

Max per prescription$19.97 20% AWP $18.15

Tier 3 (Non-Formulary) 30% 40% AWP 40% AWP $36.30

For a lower prescription cost, utilize our on campus pharmacies (2 locations).

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 co-pays/co-insurance outlined above will be charged. Once the out-of-pocket maximum has been met, all prescriptions will be covered at 100%

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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.

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If this form is not completed and returned annually your spouse/domestic partner will be removed from the plan.

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 Accounto Must be IRS dependent

• Dental, Vision, Life Insurance, Tuition Waivero 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 pre-

tax 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-in-

law 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 OptionsOhio 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• 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

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.

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

457 Optional Tax Deferred Account –Optional

• Available to State of Ohio employees only• Set up directly with Ohio Deferred

Compensation• (877) 644 – 6457• www.ohio457.com

- OR -

- AND -

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http://www.opers.org/

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)• If covering a spouse or domestic partner on the Paramount or OBA/FrontPath plans

• Adult Child Certification (through online portal)• If adding a dependent over age 19

• Marriage Certificate• If adding a spouse to any coverage who has not been previously covered

• Birth Certificate, Court Documents, and/or Adoption Paperwork• If adding dependent children to coverage who have not been previously covered

• Domestic Partner Registration• 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.

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Please keep your new hire benefits enrollment documentation available as you will be asked to supply this information again for open enrollment.

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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http://myut.utoledo.edu/

http://hr.utoledo.edu/

mailto:[email protected]

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Enrollment in Benefits

UT Benefits Contact InformationBenefits Team Contact Info

Contact Title Ext. Jessica Allar Benefits Specialist 1443Kate Johnson Manager, Benefits Planning & Administration 1442 Nate Walker Senior Director, Total Rewards 1475

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 – 1492Email: [email protected] Person: MC: HRTD @ Scott Park, ASC, Suite 1000

HSC: HRTD @ Facility Support Building

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External Benefits Contact Information

Benefits VendorsOhio Benefits Administrators OBA/FrontPath PPO (877) 622-1966FrontPath PPO (419) 891-5206Paramount Employer Select (ES) PPO (419) 887-2525Medical Mutual of Ohio (MMO CDHP) (800) 468-6690Delta Dental (800) 524-0149Vision Services Plan (VSP) (800) 877-7195Chard-Snyder Flexible Spending Accounts (800) 982-7715Optum (Wells Fargo) Health Savings Account (866) 884-7374Optum (Prescription) (800) 325-1810

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Frequently Asked QuestionsHow 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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LegendDW - Deductible WaivedAD - After Deductible

Medical Mutual of Ohio CDHPA 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-pocketmaximum, the plan pays the remainder of your annual medical and prescription drug costs.

Paramount Employer Select PPOA 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 co-pay 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.

OBA/FrontPath PPO(see Paramount Employer Select PPO for a description of a PPO plan)

Deductible:

Out-of-PocketMaximum:

Co-Insurance:

Office Visit:

Specialist Visit:

Emergency Room:

Urgent Care:

Preventative Services:

Diagnostic Services:

Accounts:

Network(s):

Tier 1 $1,300 Single $2,600 Family

$2,200 Single $4,400 Family

100%

100%

100%

100%

100%

100% (DW)

After Deductible

Tier 2 $1,300 Single $2,600 Family


90%

90%

90%

90%

90%

90% (DW)

After Deductible

Tier 3$1,300 Single $2,600 Family


70%

70%

70%

70%

70%

70% (DW)

After Deductible

Tier 1 No Deductible

$1,000 Single $1,500 Single+1 $2,000 Family

100%

$10

$10

$75 (waived if admitted)

Not applicable

Tier 2$100 Single $150 Single+1 $200 Family


90%/10%

$20

$20


Remainder 90% (AD)

$50

Tier 3$500 Single$750 Single+1$1,000 Family

$4,500 Single$6,750 Singe+1$9,900 Family

70%/30%

70/%30% (AD)

70%/30% (AD)


Remainder 90% (AD)

$50

In-Network $100 Single $200 Single+1 $300 Family


90%/10%

$15

$30


Remainder 90% (AD)

$35

Out-of-Network$300 Single$600 Single+1$900 Family

$4,300 Single$6,600 Singe+1$8,900 Family

70%/30%

70/%30% (AD)

70%/30% (AD)


Remainder 90% (AD)

$35

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 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.

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.

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.

2017 Medical Plan Comparison Sheet

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