Group Insurance Benefitsfor
New Employees
Your Group Insurance Benefits
• Medical– Prescription Drug
• Dental• Vision• Flexible Spending
Accounts (UT FLEX)– Medical Expense
– Dependent Care
• Life Insurance• Personal Accident
Insurance• Long Term Disability• Long Term Care
Contact information for each Benefit Plan Administrator can be found at http://www.utsystem.edu/egi/contacts.asp#2
Where You Can Find Benefits Information
1) EGI’s website: http://www.utsystem.
edu/egi/employee “Group Insurance Guide for Employee Benefits” and other benefit publications available online
2) Your local Benefits office and website: http://www.utsystem.edu/egi/contacts.asp
You are eligible for benefits if you:
• Work 20 hours per week or more
• For a period of at least 4 ½ months
Or,• Are appointed for at
least 50% of a standard full-time appointment
Your Eligible Family Members and Other Eligible Dependents
• Legally married spouse(or common-law spouse if legal Declaration of Informal Marriage has been filed with the Court)
• Unmarried child under age 25
• An eligible dependent, 25 or older, determined to be medically incapacitated• Unmarried grandchild under age 25(for UT SELECT, parent of the grandchild must also be covered)
Important: To establish the eligibility of certain dependents, you may be asked for documentation.
Period of Initial Eligibility for New Employees
IMPORTANT:
Enroll in benefits during your 31-day period of initial eligibility
The Automatic Coverage Package
The University of Texas System is required by state law to provide benefits-eligible employees with an automatic coverage package. This is provided at no cost to you at the “employee only” level:
• UT SELECT Medical Plan with Prescription Drug Coverage
• $10,000 Basic Life Insurance Coverage
• $10,000 Personal Accident Insurance Coverage
For more information, see http://www.utsystem.edu/egi/employee
You can make future changes to your benefit selections only at these times:
1) Each year, during Annual Enrollment (in July) for the next fiscal year (Sept. 1 through Aug. 31)
2) Within 31 days of a qualified life “status change” such as marriage or birth of a child. Be sure to contact your local benefits office http://www.utsystem.edu/egi/contacts.asp
Eligibility And Enrollment:
Questions And Answers1) What are some examples of dependents who are not eligible for benefits?
Answer: http://www.utsystem.edu/egi/employee/#1
2) What happens if I do not enroll during my period of initial eligibility? Answer: http://www.utsystem.edu/egi/employee/#3
3) What if I have insurance coverage through another state agency, or a public school?
Answer: http://www.utsystem.edu/egi/employee/#2
4) What is Evidence of Insurability?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#5
The Benefit Cost Worksheet
• Here is a link to the Benefit Cost Worksheet. U. T. Austin and U. T. System Administration:http://www.utsystem.edu/egi/pubs/costworksheet720.pdf
All other campuses:http://www.utsystem.edu/egi/pubs/costworksheet.pdf
• Print a hard copy and use this worksheet to help you calculate the approximate monthly premium rate for each benefit plan.
Medical Plans
Medical Plans
1) UT SELECT (Self-Funded PPO/Indemnity Plan)– Administrative Services provided by BlueCross
BlueShield of Texas– Pharmacy Benefit administered by Medco Health
Solutions, Inc.
2) HMO (Fully-Insured Health Maintenance Organization)– Humana HMO – HMO Blue
Medical Plans: Areas Where Available
• UT SELECT is available in all areas, including world-wide
• HMO plan is available in certain areas of Texas
(see link below list of areas).http://www.utsystem.edu/egi/employee/medical.asp
UT SELECT and HMOs: Comparison of Monthly Premium Rates
The first section of the Benefit Cost Worksheet lists the monthly premium rates of each medical plan.
Notice that the premium rate for “Subscriber only” (employee only) is provided at no cost to you.
UT SELECT: General Plan Description
• For basic information on covered benefits see http://www.utsystem.edu/egi/employee/medical.asp#1
• For more details, see the UT SELECT Plan Booklet,http://www.utsystem.edu/egi/pubs/2002utselectplanbooklet.pdf
UT SELECT Prescription Drug Benefit
• For a description of retail pharmacy and mail-order pharmacy copayments, click here: http://www.utsystem.edu/egi/employee/medical.asp#2
• To visit the website of Medco Health Solutions, Inc., click here: http://www.medcohealth.com/
HMOs: General Plan Description
• For basic information, http://www.utsystem.edu/egi/employee/medical.asp#3
• For more details, see the Humana HMO Certificate of Coverage,http://www.utsystem.edu/egi/pubs/2002humanasummary.pdf
• For more details, see the HMO Blue Certificate of Coverage,http://www.utsystem.edu/egi/pubs/2002hmoblueplanbooklet.pdf
HMO Prescription Drug Benefit
• For a description of retail pharmacy and mail-order pharmacy copayments, click here: http://www.utsystem.edu/egi/employee/medical.asp#3a
Health Plan Comparison Chart:UT SELECT and the HMO plan
• See this link for a basic benefits comparison. http://www.utsystem.edu/egi/pubs/2002plancomparison.pdf
Medical Plans: Questions and Answers
1) The UT SELECT plan has a deductible. What is a deductible?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#6
2)The UT SELECT plan has coinsurance. What is coinsurance?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#8
3) Both UT SELECT and the HMO plans have copayments. What is a copayment?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#7
4) How do I find out if my health care providers are in the network for a specific medical plan?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#9
5) If I enroll in an HMO, will I be covered if I have an emergency while traveling outside the service area?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#10
For more details about your medical plans . . .
UT SELECThttp://www.bcbstx.com/ut/(866) 882-2034
Humana HMOhttp://ut.humana.com(866) 394-6648
HMO Bluehttp://www.bcbstx.com/ut/(888) 322-2379
Dental Plans
Dental Plans
• UT DENTAL SELECT (A self-funded Dental plan administered by Delta Dental)http://www.utsystem.edu/egi/employee/dental.asp#1
– For more details, see the UT DENTAL SELECT Plan Booklet, http://www.utsystem.edu/egi/pubs/2002deltaplanbooklet.pdf
• Dental Health Maintenance Organization (Offered by Fortis Benefits)http://www.utsystem.edu/egi/employee/dental.asp#2
– For more details, see the Fortis Dental booklet, http://www.utsystem.edu/egi/pubs/2002fortisplanbooklet.pdf
If you would like dental coverage, you have the option to select one of these plans:
Dental Plans: Comparison of Monthly Premium Costs
See the Benefits Cost Worksheet, page 1.
Dental Plans: Questions and Answers
If I enroll in the Fortis Dental HMO plan, do I have to select a primary dentist?
ANSWER: http://www.utsystem.edu/egi/employee/faq.asp#11
Vision Plan
Vision Plan
• Optional benefit• Offered by Superior Vision• Available in all areas• For basic plan description see http://www.utsystem.edu/
egi/employee/vision.asp
• For more details, see the Superior Vision brochure, http://www.utsystem.edu/egi/pubs/2002svpbrochure.pdf
Vision Plan: Monthly Premium Rates
See the Benefits Cost Worksheet, bottom of page 1.
Vision Plan: Questions and Answers
1) Why can’t I get both eyeglasses and contacts under the Superior Vision Plan?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#12
2) Are refractive surgery procedures covered at a discounted rate, such as radial keratotomy and LASIK surgery?
Answer : http://www.utsystem.edu/egi/employee/vision.asp
(see second paragraph after chart)
UT FLEX
UT FLEX
• Administered by FlexBen• The Internal Revenue Code, Sec. 125, allows you to
pay certain expenses on a pre-tax basis.• Two Types
– Medical Expenses – Dependent Care (such as child day care)
• IMPORTANT: Your UT FLEX elections must be made again during every Annual Enrollment Period.
UT FLEX
• To see a general summary of this plan, click here http://www.utsystem.edu/egi/employee/flex.asp
• To read a more details, see the UT FLEX Flexible Spending Account booklet, http://www.utsystem.edu/egi/pubs/2002utflexplanbooklet.pdf
UT FLEX: Questions and Answers
1) What are some of the eligible expenses that can be reimbursed through UT FLEX?
Answer: http://www.utsystem.edu/egi/employee/flex.asp#1
2) What is the meaning of “Use it or Lose it” regarding the UT FLEX plan?
Answer: http://www.utsystem.edu/egi/employee/flex.asp#2
Life Insurance
Life Insurance
• This plan is available to you from CIGNA• The $10,000 Basic Life Plan is offered to employees
at no cost• You may purchase coverage for all of your eligible
dependents.• For a general description of this plan, click here:
http://www.utsystem.edu/egi/employee/life.asp
• For more details, see the CIGNA Life brochure, http://www.utsystem.edu/egi/pubs/2002lifebrochure.pdf,and the CIGNA Group Insurance Certificate, http://www.utsystem.edu/egi/pubs/2002lifecert.pdf
Life Insurance: Monthly Premium Rates
See Benefit Cost Worksheet pages 2-3 to calculate your approximate monthly premium rate.
Life Insurance:Questions and Answers
1) What are some of the exclusions for the voluntary term life plan?
Answer: http://www.utsystem.edu/egi/employee/life.asp#3
2) How often can I change my beneficiary from my Basic/Voluntary Term Life insurance?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#13
Personal Accident Insurance
Personal Accident Insurance
• Optional plan offered through CIGNA• Provides coverage in the event of your accidental
death and certain bodily injuries that occur as a result of a covered accident
• For a brief summary of this plan, click here: http://www.utsystem.edu/egi/employee/pai.asp
• For more details, see the CIGNA Personal Accident Certificate of Insurance, http://www.utsystem.edu/egi/pubs/2001paicert.pdf
Personal Accident Insurance: Monthly Premium Rates
To calculate the approximate monthly premium rate, see page 2 of the Benefits Cost Worksheet.
Long Term Disability
Long Term Disability
• An optional plan offered by CNA• Provides income protection if you should become
disabled• For a general description of this plan, click here:
http://www.utsystem.edu/egi/employee/ltd.asp
• For more details, see the CNA Group Long Term Disability Certificate, http://www.utsystem.edu/egi/pubs/2000CNALTDcert.pdf
Long Term Disability: Monthly Premium Rate
To calculate the approximate monthly premium rate for Long Term Disability, see the Benefits Cost Worksheet, page 3.
Long Term Disability: Where to find more information
• Call CNA at (800) 303-9744
• Go to CNA’s long term disability website. https://www.cnagroupben2.com/start.asp?u=uni101&p=plan
• Find a more detailed plan description at :<link to LTD publication on EGI website.)
Long Term Care
Long Term Care• This is an optional plan offered through CNA that covers
services needed when people are not capable of caring for themselves. – Examples include: assistance at home with daily activities,
and special attention in a nursing home• You, your spouse, your adult children ages 25 and older, your
parents, your grandparents, parents-in-law, and grandparents-in-law are all eligible to enroll in this plan
• For general information about this plan: http://www.utsystem.edu/egi/employee/ltc.asp
• For additional information, call CNA at (888) 825-0353 or go to their website at http://www.ltcbenefits.com/start.asp?account=521310025&user_id=utsguest
Long Term Care: Monthly Premium Rate
To calculate the approximate monthly premium rate for Long Term Care, see the Benefits Cost Worksheet, page 4.
Long Term Care:Questions and Answers
1) What is the difference between Long Term Disability and Long Term Care?
Answer: http://www.utsystem.edu/egi/employee/faq.asp#14
2) Is the Long Term Care Plan portable if I leave employment at U. T. System?
Answer: Yes, the Long Term Care Plan is portable. This enables your coverage to continue even though you are no longer employed by U. T. The only change would be the method of payment: you would directly pay CNA instead of having the premium rate deducted from your paycheck.
For All Group Insurance Plans: Where To Find Additional Information
Here is a Quick Reference listing the Customer Service website, address, and telephone numbers for each of your group insurance plans.http://www.utsystem.edu/egi/contacts.asp - 2
How to Contact Your Local Benefits Office
You will find the address and telephone number for your local benefits office on this “quick reference” list.
Your local benefits office will be glad to assist you with your benefits and enrollment questions. http://www.utsystem.edu/egi/contacts.asp#1
