2002 BENEFITS BOOKLET

FOR

SECRETARIAL/CLERICAL
AND PHYSICAL PLANT

HOURLY EMPLOYEES

This booklet contains brief descriptions of Wesleyan’s group insurance and retirement benefits. More complete plan documents are available in the Human Resources Office. If this booklet differs in any respect from a plan document, the plan document governs. Wesleyan’s benefit plans are subject to change in the future.

 
 
TABLE OF CONTENTS
Introduction and Eligibility
Annual Open Enrollment and Benefit Changes
CIGNA HealthCare
Summary of Insurance Premiums
Selected Coverage Highlights
Medical/Dental Pre-Tax Premium Payment Plan
Dental Plan
Long-Term Disability and Life Insurance
   long-term disability insurance 
   basic life insurance 
   optional employee life insurance
   optional spouse/domestic partner life insurance
   optional dependent children's life insurance 
   termination of coverage and retiree death benefit
Medical Expenses Reimbursement Account
   eligible expenses
   reimbursement
Dependent Care Assistance Account
   eligible expenses 
   reimbursement
Neighborhood Preschool Scholarship
Basic Retirement Plan
Supplemental Retirement Accounts
Tuition Scholarship for Dependent Children
ERISA Rights
Changes made during open enrollment are effective January 1, 2002.
INTRODUCTION

This booklet contains brief descriptions of the group insurance and retirement benefits available to Wesleyan’s Physical Plant and Secretarial/Clerical staff members who are represented by a union; and explains when changes in some of these benefits can be made. More complete plan documents are available in the Human Resources Office. In the event of any differences between this booklet and a plan document, the plan document governs.

Group insurance and retirement benefits include:

ELIGIBILITY

Physical plant and secretarial/clerical staff members may participate in the basic retirement plan if appointed for at least half time on a non-temporary basis, and may participate in most other benefits if appointed for at least three-quarter time on a non-temporary basis. All physical plant and secretarial/clerical staff members, however, are eligible to contribute to supplemental retirement accounts.

Early retirement: Physical plant and secretarial/clerical staff members who retire between ages 60 and 65 with at least 10 years of continuous eligible service may continue to participate in health, dental and life insurance plans until age 65 on the same basis as active staff.
 


 

ANNUAL OPEN ENROLLMENT AND BENEFIT CHANGES

Health and Dental Insurance. During fall open enrollment, you may:

Changes made in health and dental insurance will be effective the following January 1. Changes cannot be made at times other than open enrollment except during the 30 days immediately following certain changes in family status. Examples of such changes in family status are marriage, death of a covered dependent, birth or adoption of a child, divorce or legal separation, loss of coverage through a spouse’s employment, and a dependent’s moving into the state.

Your current health and dental coverage will continue during the next calendar year unless you change coverage during open enrollment. You may, however, drop health or dental insurance at any time.
 

Pre-Tax Reimbursement Accounts.  You may establish a pre-tax medical expenses reimbursement account (MERA) and a pre-tax dependent care reimbursement account during fall open enrollment. IRS regulations do not permit the University to automatically continue a pre-tax reimbursement account from one year to the next and permit changes in an account only during open enrollment or during the 30 days immediately following a change in family status; including, for dependent care accounts, a significant change in the faculty or staff member or spouse’s work hours. A reimbursement account will end on December 31 unless it is reestablished during fall open enrollment.

Supplemental Retirement Accounts. You may open or change a supplemental retirement account during open enrollment, or at any time during the year to be effective on the first day of the following month. In any event, however, contributions to a supplemental retirement account end on December 31 each year unless the participant renews them. You may cancel contributions to a supplemental retirement account at any time.

Life Insurance. An eligible staff member may enroll in optional life insurance without evidence of insurability or increase coverage without evidence of insurability only during the first 30 days of employment or during the 30 days immediately following marriage or the birth or adoption of a child; and, in either case, only to a maximum of $200,000. Optional life insurance can be purchased at other times and for larger amounts only if the faculty or staff member submits evidence of insurability that is satisfactory to the insurance company.
 

Open enrollment checklist:


 

CIGNA HealthCare

SUMMARY OF BENEFITS
Your CIGNA HealthCare Network Open Access plan
and
Point of Service Open Access plan

For Employees of Wesleyan University 

Features that Add Value
  • The convenience of referral-free access to participating specialty physicians, and…
  • The reassurance of having a personal Primary Care Physician (PCP) who is your source for routine care and for guidance when you need more than routine care.  As your needs change, so may your choice of doctors.  That's why you can change your Primary Care Physician for any reason.
  • The CIGNA HealthCare 24-Hour Health Information LineSM connects you to registered nurses and a library of hundreds of recorded programs on important health topics 24 hours a day, 7 days a week, from anywhere in the U.S.
  • CIGNA HealthCare Healthy Rewards® includes special offers for discounts on health-related products and services.  Just call 1.800.870.3470 or visit our web site at www.cigna.com.
  • Prescription drug coverage is a part of your plan.  More than 49,000 pharmacies participate nationwide, so you can have your prescription filled wherever you go.  Mail-order service means quick, convenient delivery of your medications right to your home.
  • Our Guest Privileges program brings your CIGNA HealthCare benefits along when you temporarily relocate or send kids to schools away from home.  Call CIGNA HealthCare Member Services to learn more.
  • CIGNA Behavioral Health offers you access to professional consultation over the phone to help you with problems that affect you, your family, or your work.
Quality Service Is Part of Quality Care
  • Responsive service -- Customer Service representatives have the authority to solve problems on the phone, usually on the first call.
  • www.cigna.com - Visit our interactive Web site to learn more about your plan and get health information, 24 hours a day.
  • We Speak Many LanguagesSM Our Language Line Services means that you can talk with us in 140 different languages.  Just call Customer Service, and ask for an interpreter to assist you.


It's Your Health

When you choose CIGNA HealthCare, you can take advantage of our health and wellness programs.

  • Preventive care services for every covered family member
  • Your PCP serves as your first contact for care, advice and direction.  He/She will recommend specialists and coordinate follow up care.  And, when you need to see a participating specialist - no referral is required.  Just make the appointment and go!
  • The CIGNA HealthCare Well-Aware Program for Better Health® can help you manage certain chronic conditions.
  • The CIGNA HealthCare Healthy Babies® program provides you with education and support to help you have a healthy pregnancy and a healthy baby.  And there's no copayment for prenatal care office visits after the first visit that confirms you're pregnant.
 You Can Depend on CIGNA HealthCare
  • Quality comes first. We select "preferred providers" carefully.  And we make sure you have a wide range of doctors to choose from.
  • Emergency and urgent care are covered wherever you go, worldwide, 24 hours a day.  Urgent care centers can take care of your urgent care needs.


For the Point of Service Open Access Plan:  It's Your Choice

  • You get access to quality care at the lowest out-of-pocket costs available under your plan by having your care coordinated through your Primary Care Physician or participating specialist and by seeing network providers.    You also get the freedom to choose the providers you prefer - even if they aren't part of the network. Your costs are lowest when you see participating providers, but you're still covered for visits to other providers.
 
BENEFIT HIGHLIGHTS

Network Open Access

Point-of-Service Open Access
In-Network

Point-of-Service Open Access
Out-of-Network

Doctor Office Visit
Primary Care Physician (PCP) Office Visit
Preventive Care
Well Child Care
Periodic Physical Exams (Children and Adults)
Routine Immunizations and Injections


Allergy Treatment/Injections

Adult/Child Medical Care for Illness or Injury
Surgery Performed in a Physician's Office

$10 copay per office visit

$10 copay per office visit 
$10 copay per office visit 
Office Visit copayment will be waived when immunizations is the
only service provided
 

$10 copay per office visit  

$10 copay per office visit 
No charge

$10 copay per office visit  

$10 copay per office visit 
$10 copay per office visit 
Office Visit copayment will be waived when immunizations is the only service provided
 

$10 copay per office visit  

$10 copay per office visit 
No charge

20% of charges*  

20% of charges* 
20% of charges* 
20% of charges*



20% of charges*
 

20% of charges* 
20% of charges*

Routine Mammogram, PSA, Pap Test $10 per visit for associated wellness exam; No charge for x-ray/lab if billed by separate facility $10 per visit for associated wellness exam; No charge for x-ray/lab if billed by separate facility 20% of charges*
Specialty Physician Office Visit
Office Visits-Consultant and Physician Services
Surgery Performed in Physician's Office

$10 copay per office visit
No charge

$10 copay per office visit
No charge

20% of charges*
20% of charges*
Second Opinions for Surgery $10 copay per office visit $10 copay per office visit 20% of charges*
Inpatient Hospital Services including:
     
Semi-Private Room and Board
     Physician Services
     Diagnostic/Therapeutic Lab and X-ray
     Drugs and Medication
     Operating and Recovery Room
     Radiation Therapy and Chemotherapy
     Anesthesia and Inhalation Therapy

No charge No Charge 20% of charges*
Precertification required
Outpatient Facility Services includes:
Operating Room, Recovery Room, Procedure
Room and Treatment Room including:
     Physician Services
     Diagnostic/Therapeutic Lab and
     X-rays
    Anesthesia and Inhalation Therapy
No charge per facility use No charge per facility use 20% of charges*
Outpatient Preadmission Testing
Office Visit-Primary Care Physician
or Specialty Physician

Outpatient Facility


$10 copay per office visit
No charge if billed by separate outpatient diagnostic facility
No charge

$10 copay per visit
No charge if billed by separate outpatient diagnostic facility
No charge
20% of charges*  

20% of charges*

Laboratory and Radiology Services
MRIs, MRAs, CAT Scans and PET Scans
Other Laboratory and Radiology Services

No charge
No charge

No charge
No charge

20% of charges*
20% of charges*
Short-Term Rehabilitative Therapy and Chiropractic Services
(includes physical, speech, occupational & chiropractic therapy)
$10 copay per visit
60 visits/days max. per year
$10 copay per visit
60 visits/days max. per year#
20% of charges*
60 visits/days max. per year#
Prescription Drugs
CIGNA Pharmacy Retail Drug Program
Generic Push, Open Formulary Plan - 30-day supply

Mail Order Drug Program - 90-day supply

$10 for generic drugs 
$20 for brand-name drugs 
$35 for non-preferred brand-name drugs
 

$10 for generic drugs 
$40 for brand-name drugs 
$70 for non-preferred brand-name drugs

$10 for generic drugs 
$20 for brand-name drugs 
$35 for non-preferred brand-name drugs
 

$10 for generic drugs 
$40 for brand-name drugs
$70 for non-preferred brand-name drugs

Not covered 
Not covered 
Not covered 


Not covered 
Not covered 
Not covered

Emergency and Urgent Care Services
Physician's Office
Hospital Emergency Room, Participating 
Outpatient Facility
Participating Urgent Care Facility

Ambulance


$10 copay per visit 
$50 per visit, waived if admitted
 

$25 per visit, waived if admitted  

No charge


$10 copay per visit 
$50 per visit, waived if admitted
 

$25 per visit, , waived if admitted  

No charge

Care will be provided at in-network levels if it meets the "prudent layperson" definition of an emergency.  Otherwise 20% of charges*
 
BENEFIT HIGHLIGHTS

Network Open Access

Point-of-Service Open Access
In-Network

Point-of-Service Open Access
Out-of-Network

Maternity Care Services
Initial Office Visit to Confirm Pregnancy
All other office visits
Delivery
    Hospital Charges
    Physician Charges

$10 copay per visit 
No charge
 

No charge 
No charge


10 copay per visit 
No charge
 

No charge
No charge


20% of charges* 
20% of charges*
 

20% of charges* 
20% of charges*

Inpatient Services at Other Health Care Facilities
Skilled Nursing, Rehabilitation and Sub-Acute Facilities
No charge
90 days maximum per candor year#
No charge
90 days maximum per candor  year#
20% of charges*
90 days maximum per calendar year#
Home Health Services No charge No charge 20% of charges*
Family Planning Services  
Office Visits (tests, counseling)-PCP or Specialty Physician
 

Vasectomy/Tubal Ligation (ex reversals) 
Inpatient Facility
 

Outpatient Facility 
Physician's Service

$10 copay per office visit; No charge for x-ray/lab if billed by separate facility  

No charge  

No charge 
No charge

$10 copay per office visit; No charge for x-ray/lab if billed by separate facility  

No charge  

No charge 
No charge

20% of charges* 

 

20% of charges* 
precertification required 
20% of charges*
20% of charges*

Infertility Services  

Office Visit (tests, counseling)-PCP or Specialty Physician 
Treatment/Surgery (includes in-vitro fertilization, artificial insemination, GIFT, ZIFT, etc.) 
Inpatient Facility
 

Outpatient Surgical Facility 
Physician's Service

$15,000 maximum per lifetime#  

$10 copay per office visit 



No charge
 

No charge 
No charge

$15,000 maximum per lifetime#  

$10 copay per office visit 



No charge
 

No charge 
No charge

$15,000 maximum per lifetime#  

20% of charges* 



20% of charges* 
precertification required 

20% of charges* 
20% of charges*

TMJ  

Doctor's Office

Non-Surgical-provided case-by-
case basis
$10 copay per visit; No charge for
x-ray/lab if billed by separate
outpatient facility
Non-Surgical-provided case-by-
case basis
$10 copay per visit; No charge for
x-ray/lab if billed by separate
outpatient facility
Surgical and Non-Surgical  

Not Covered

Mental Health Services  
Inpatient
 

Outpatient

No charge  

$10 copay per visit

No charge  

$10 copay per visit

20% of charges*  

20% of charges*

Substance Abuse Treatment  
Inpatient
 

Outpatient

No charge  

$10 copay per visit

No charge  

$10 copay per visit

20% of charges*  

20% of charges*

Durable Medical Equipment No charge
$3,500 maximum per year
No charge
$3,500 maximum per year#
20% of charges*
$3,500 maximum per year#
External Prosthetic Appliances No charge
$1,500 maximum per year
No charge
$1,500 maximum per year#
20% of charges*
$1,500 maximum per year#
Vision Care
Eye Exam  - one exam every 12 months
Hardware - One pair of eyeglasses or contact lenses in a 12-month period
$5 copay for a routine eye exam. 
Reimbursement allowances: 
Single lens:  $20
Bifocals:  $30
Trifocals:  $40
Contact lenses:  $75
Frames:  $30
$5 copay for a routine eye exam. 
Reimbursement allowances: 
Single lens:  $20
Bifocals:  $30
Trifocals:  $40
Contact lenses:  $75
Frames:  $30
Not covered
OTHER BENEFIT INFORMATION
Annual Deductible
Individual/Family
None/None None/None $250/$500
Annual Out-of-Pocket Maximum
Individual/Family (Includes deductibles)
None/None None/None $1,250/$2,500
Coinsurance Not applicable Not applicable CIGNA HealthCare pays 80% of eligible charges.  You pay 20% of charges.
Precertification (Inpatient) N/A N/A Patient must obtain approval
Lifetime Maximum Unlimited Unlimited Unlimited
Pre-existing Condition Limitation No No No
 

Footnotes: Regarding HMO plan: All services, except for emergency services, must be provided by a provider participating in the CIGNA HealthCare network, or by CIGNA Behavioral Health, Inc. in order to be covered. 

Regarding Point of Service plan: · 

Regarding Point of Service Out-of-Network services: · 


Benefit Exclusions. 
These are examples of the exclusions in your plan. The complete list of exclusions is provided in your Certificate or Summary Plan Description. To the extent there may be differences, the terms of the Certificate or Summary Plan Description control.
 

Your plan provides coverage for medically necessary services. Your plan does not provide coverage for the following except as required by law: 

  1. Services that are not medically necessary, except specifically outlined preventive care.
  2. Charges which the person is not obligated to pay. 
  3. Charges made by a hospital owned by or performing services for the U.S. government if the charges are directly related to a sickness or injury connected to military service. 
  4. Custodial services not intended primarily to treat a specific injury or sickness, or any education or training. 
  5. Experimental, investigational or unproven procedures and treatments. 
  6. Cosmetic surgery, unless: (a) a person receives an injury which results in bodily damage requiring surgery; (b) it qualifies as reconstructive surgery performed on a person following surgery, and both the surgery and the reconstructive surgery are essential and medically necessary; (c) it qualifies as reconstructive surgery following a mastectomy, including surgery and reconstruction of the other breast to achieve symmetry. 
  7. Reports, evaluations, examinations, or hospitalizations not required for health reasons, such as employment, insurance or government licenses and court ordered forensic or custodial evaluations. 
  8. Treatment of the teeth or periodontium, unless such expenses are incurred for: (a) charges made for a continuous course of dental treatment started within six months of an injury to sound natural teeth; (b) charges made by a Hospital for Bed and Board or Necessary Services and Supplies; or (c) charges made by the outpatient department of a Hospital in connection with surgery. 
  9. Reversal of voluntary sterilization procedures. 
  10. Infertility donor charges and services. 
  11. Transsexual surgery and related services. 
  12. Treatment for erectile dysfunction. However, penile implants are covered when an established medical condition is the cause of erectile dysfunction. 
  13. Therapy to improve general physical condition. 
  14. Eyeglasses, hearing aids or examinations and prescription fitting, except as provided in the Certificate or Summary Plan Description. 
  15. Certain internal or external prostheses, or replacement of external prostheses due to wear and tear, loss, theft or destruction. 
  16. Surgical treatment for correction of refractive errors, including radial keratotomy. 
  17. Prescription and non-prescription drugs, except as provided in the Certificate or Summary Plan Description. 
  18. Routine foot care. 
  19. Any injury or sickness arising out of , or in the course of, any employment for wage or profit. 
  20. Charges for over the counter disposable or consumable supplies, except as provided under "Covered Expenses" in the Certificate or Summary Plan Description. 
  21. Charges in excess of reasonable and customary limitations. 
  22. Charges for medical and surgical services intended primarily for the treatment or control of obesity which are not Medically Necessary. 
  23. Speech therapy which is not restorative in nature. 
  24. Artificial aids, including but not limited to orthopedic shoes, arch supports, elastic stockings, dentures and wigs. 
  25. Non-medical ancillary services, including but not limited to vocational rehabilitation, behavioral training, and training or education services for learning disabilities, developmental delays, autism or mental retardation. 

These Are Only the Highlights As you can see, the plan is designed to combine in-depth coverage with affordable prices. This summary contains highlights only and is subject to change. The specific terms of coverage, exclusions and limitations including legislated benefits are contained in the Summary Plan Description or Insurance Certificate. This self-insured and administered by Connecticut General Life Insurance Company, a CIGNA Company.  

"CIGNA HealthCare" refers to various operating subsidiaries of CIGNA Corporation. Products and services are provided by these subsidiaries and not by CIGNA Corporation. These subsidiaries include Connecticut General Life Insurance Company, CIGNA Behavioral Health, Inc., Intracorp, and HMO or service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health, Inc. "CIGNA Tel-Drug" refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C., which are also operating subsidiaries of CIGNA Corporation.  

Catalog Number: BSF48337 (revised 6/20/2002)                   ©2002 CIGNA Health Corporation

 

SUMMARY OF INSURANCE PREMIUMS


 

WESLEYAN UNIVERSITY

Monthly Health/Dental Insurance Premiums

Secretarial/Clerical & Physical Plant Staff


January 1, 2003 to December 31, 2003


                            CIGNA - HMO 

Single 39.25
2 Person 85.59
Family 106.01


                            CIGNA - POS

Single 46.53
2 Person 101.45
Family 125.66

 


 
SOME HEALTH AND DENTAL COVERAGE HIGHLIGHTS

Family Members

The following family members of eligible staff members are eligible for health and dental plan coverage:


Continuing Coverage When Eligibility Is Lost: COBRA

If a faculty or staff member, or a covered family member, becomes ineligible for Wesleyan health and dental insurance--for example, employment ends or because a dependent child is over age—the faculty or staff member may continue coverage by paying the full premium for up to 18 months for the participant or, in some cases, for up to 36 months for a family member.  Please contact Human Resources for details.

Retiree Medicare Supplement

Wesleyan pays the full cost of a plan that supplements Medicare and medigap insurance for eligible retirees up to a lifetime maximum of $25,000. Subject to some required participant co-payments that are subject to change, the plan provides payments for prescription drugs and certain other services, including nursing services, blood transfusions and hospital costs during confinements of 91 days or more.

The plan does not cover any physician or surgeon services or any expenses for mental, emotional, or functional nervous disorders. Please contact Human Resources for details.

Coverage for Family Planning Services, Infertility Treatment and Adoptions

Coverage for birth control prescriptions, legal abortions, tubal ligations, and vasectomies are provided by all five health plan options with the same deductibles and copayments applicable to other physician, hospital, clinic, or pharmaceutical services. Attempts to reverse tubal ligations and vasectomies are not covered.

Wesleyan pays up to $4000 toward expenses involved in adopting a child.

Wesleyan also pays $4,000 towards the treatment of infertility. Benefits for adoption and infertility treatment are subject to the following limitations:


Referral Requirement

Again in 2002, HMO participants seeking treatment from a specialist will be required to get a referral from their primary care physician in order to have the costs covered by insurance.  POS participants will need to get a referral in order to avoid charges for specialist care being subject to deductibles and coinsurance.

Smoking Cessation Programs

IRS regulations now permit expenses incurred for smoking cessation programs and related prescription drugs to be reimbursed from a Medical Expenses Reimbursement Account.
 
 
 


 

MEDICAL/DENTAL PRE-TAX PREMIUM PAYMENT PLAN

A participant in a health or dental plan is deemed to have elected to have his or her salary reduced by an amount equal to the participant’s share of plan costs and to have Wesleyan pay that share on a pre-tax basis. For this reason, health or dental plan coverages cannot be changed (except for ending participation) other than during open enrollment, unless employment terminates or there is a change in family status such as marriage, divorce, death of your spouse/domestic partner or child, birth or adoption of a child, termination or commencement of employment of a spouse, significant change in medical or dental insurance coverage attributable to a spouse’s employment, etc.

The pre-tax premium payment plan does not apply to health/dental plan contributions for a domestic partner or the partner’s dependents unless he or she qualifies as the employee’s dependent for federal income tax purposes.
 


 

DENTAL PLAN

The comprehensive Delta Dental plan is designed to promote dental health by paying the full cost of most routine check-ups, cleanings, and diagnostic x-rays, as well as a substantial portion of the cost of other dental services after a deductible has been satisfied. Most dentists in this area are affiliated with the Delta network whose dentists guarantee not to charge you more than “reasonable and customary” rates for this area. If you go to a dentist who is not affiliated with Delta Dental, your charges may be higher, but your reimbursement is still based on the “reasonable and customary” limits. Below is a summary of the plan.

Delta Dental Group #6507             DENTAL 2
Annual deductible $50 a year for each covered family member (maximum $150 per family). Deductible does not apply to preventive care.
Preventive care (exams, cleanings and x-rays) Plan pays 100%. Limited to two per person, per year.
Basic restorative care (extractions, fillings, root canals, periodontal) Plan pays 80% after deductible is satisfied.
Major restorative (crowns, dentures, bridges) Plan pays 50% after deductible is satisfied.
Annual maximum plan payments $1,200 per person, excluding orthodontia.
Orthodontia Plan pays 50% up to a maximum lifetime payment of $1,500 per person.
Participant’s monthly premium--as of 1/1/03 12.12   single
22.86   two people
43.38   family

Claim forms: Participating dentists get claim forms from Delta, therefore you will not have to bring forms with you; non-participating dentists may use generic forms, which must be mailed to:

Delta Dental of NJ, PO Box 222, Parsippany NJ 07054 Claims 1-800-346-5377

The dental plan is administered and fully insured by Delta Dental.
 
 

DENTAL 1 - Monthly Premiums
Delta Dental Group #6507

One person $2.70
Two people $7.97
Families of 3 or more $7.97


LONG TERM DISABILITY AND LIFE INSURANCE

Long Term Disability Insurance (LTD)

LTD insurance is fully paid by the University and provides disabled participants benefits equal to 60% of salary (maximum $8,000/month) in accordance with the terms and conditions set forth in the plan. LTD benefits are reduced by Social Security and certain other payments. LTD coverage is not available during the first 30 days of service unless the new faculty or staff member submits evidence of similar LTD coverage with the most recent employer.

Group Term Life Insurance

The University’s group term life insurance plan consists of:

Both basic and optional life insurance end when the participant’s Wesleyan employment ends unless the participant is eligible for benefits under the long term disability plan or as an early retiree.

Basic life insurance equals annual base salary up to $50,000. Coverage is automatic and does not require a medical questionnaire or examination. You must, however, designate a beneficiary. As salary increases, basic life insurance automatically increases (on July 1), up to the $50,000 maximum. Basic life insurance reduces to 60% of annual base salary (up to the $50,000 maximum) at age 65, and to $5,000 at age 70.

Optional Employee Life Insurance. Faculty and staff may purchase additional term life insurance equal to 1, 2, 3, or 4 times annual salary, up to a maximum of $750,000, at any time. Evidence of insurability, however, may be required depending on when and how insurance is purchased. No questionnaire or examination is required for the first $200,000 of optional life insurance or less that is purchased during the first thirty days of employment, or during the first thirty days after marriage or birth or adoption of a child. Optional life insurance purchased at other times and all optional life insurance in excess of $200,000 requires medical evidence of insurability satisfactory to the insurance company. This may consist of a medical questionnaire or a medical questionnaire and an examination.

Optional life insurance may be reduced or cancelled at any time by the participant. The amount of optional life insurance an employee may obtain and premiums change on July 1 each year if salary changes.

Rates for optional life insurance are based on age and have not increased for 2001. For each thousand dollars of optional life insurance coverage, the monthly rates are:
 

Age
Monthly rate per $1000
up to 30
.04
30-34
.06
35-39
.07
40-44
.10
45-49
.15
50-54
.23
55-59
.43
60-64
.62
65-69
1.15
70-74
2.06
75+

2.06

(Rates will increase on the July 1 after age increases to the next bracket.)

Example: if you are 43 years old with an annual base salary of $30,000, and you elect optional life insurance equal to three times your annual salary or $90,000, you pay $9.90 a month.

At age 70, optional life insurance reduces to 50% of what it would otherwise be for an actively employed faculty or staff member; and ends at age 68 for faculty early retirees and age 65 for librarian and administrative staff early retirees.
 


Optional Spouse/Domestic Partner Life Insurance. Optional spouse or domestic partner life insurance may be purchased in the amount of $5,000, $10,000, $20,000, $30,000, $40,000, $50,000, $60,000, or $70,000. Medical evidence of insurability is not required for the first $30,000 of spouse/domestic partner life insurance if purchased during the first 30 days of employment or during the first 30 days after marriage or the date on which a domestic partner is first eligible. Medical evidence of insurability satisfactory to the insurance company (a questionnaire or a questionnaire and an examination) is required for spouse/domestic partner insurance in excess of $30,000 or that is purchased at any other time.

Spouse/domestic partner rates are the same as employee optional life insurance rates.

Optional Dependent Children Life Insurance. $5,000 of insurance on the life of each dependent child after the age of 15 days and through age 18 years (through age 24 years if a full-time student) may be purchased without evidence of insurability during the first 30 days of employment or during the first 30 days following the birth or adoption of the child. At other times, medical evidence of insurability satisfactory to the insurance company is required. The total cost is 36¢ a month, regardless of how many dependent children are covered.

Life Insurance Payments and Beneficiary Designation

Participant payments for life insurance are automatically deducted from pay.

A beneficiary must be designated for employee life insurance. The faculty or staff member is assumed to be the beneficiary for spouse/domestic partner and dependent children life insurance unless a different beneficiary is designated.

Life insurance forms are available in Human Resources.

Termination of Coverage and Retiree Death Benefit

Both basic and optional insurance coverage ends when Wesleyan employment ends unless the participant is eligible for benefits under the long-term disability plan or as an early retiree. The designated beneficiary of an eligible retiree who has completed ten years of continuous service will receive a death benefit of $5,000 if the retiree dies after basic and optional insurance coverage has ended.


 

MEDICAL EXPENSES REIMBURSEMENT ACCOUNT (MERA)

Tax Advantage and Effect on other Benefits

You can establish a Medical Expenses Reimbursement Account (MERA) by authorizing a reduction in your taxable salary by an amount up to $7,200 a year. This amount is then used to pay eligible health and dental expenses. Because money goes into a MERA before income or Social Security taxes are withheld, money is saved by paying less in taxes. Depending on where the participant lives, this money may be exempt from state and local taxes as well. The MERA plan is administered by Wesleyan.

Participation in a MERA does not affect other benefits that are based on salary. These other benefits will continue to be calculated on salary before deductions are made.

Eligible Health and Dental Expenses

Any health and dental expenses the Internal Revenue Service considers tax deductible are eligible for reimbursement from a MERA if the participant pays them and does not deduct them on a tax return, and if they are not reimbursable under any insurance plan. Even if a family member is not covered by a Wesleyan health or dental plan, his or her  medical and dental expenses are eligible for reimbursement if they meet the above conditions. Some examples of eligible expenses are:

Any determination of whether a claimed expense is eligible for reimbursement is subject to IRS review.  IRS determinations govern the plan.
 

Establishing or Changing a MERA

If you are eligible to participate in Wesleyan health and dental plans, you may open a  MERA either during your first 30 days of employment or during open enrollment. MERA’s require annual enrollment.  You must enroll annually again during open enrollment--either to continue the same deduction or to increase or decrease it.  IRS regulations prohibit MERA changes at other times except during the 30 days following a change in your family status, e.g. by marriage, divorce, death of a family member, birth or adoption of a child, termination or commencement of spouse's employment, or significant change in spouse's health insurance coverage.

Deciding How Much to Contribute to a Reimbursement Account

You may put any amount between $120 and $7,200 a year in a MERA. The amount should be based on an estimate of eligible expenses likely to be incurred during the year. One-twelfth of this amount will be deducted from your pay each month.

Example of How a MERA Works

The example below shows how the plan would work for someone earning $30,000 a year who set aside $2400 a year and used $2400 for eligible expenses.

With Account 
Without Account 
Annual Base Salary 
$30,000 
$30,000 
Minus MERA Amount 
2,400
____________ 
0
________________ 
Sub-total Taxable Income 
27,600 
30,000 
Minus Estimated Federal Income Tax 
4,140 
4,533 
Minus Social Security Tax 
2,111 
2,295 
Minus Health Care Expenses 
0
____________
2,400
________________ 
Net Pay 
$21,349 
$20,722 
Tax Savings 
$577 
 

Unused Account Amounts

IRS regulations for MERA include a "use-it-or-lose-it" provision. This means you forfeit any MERA funds not used to cover eligible expenses incurred during the plan year. You can reduce your risk of loss by careful planning and by limiting your MERA contributions to predictable health and dental expenses.

Applying for Reimbursement

You will be reimbursed for eligible expenses incurred during the calendar year, regardless of when they are billed or paid, providing reimbursement claims are submitted by the following April 15. Submit reimbursement claims, together with receipts, to Human Resources. Claims can be submitted only for cumulative amounts of $50 or more, except for your last submission of the plan year, when no $50 minimum applies. Claims forms are available from Human Resources or can be printed out in Word format from the Forms section of the Human Resources Web Page.


 

DEPENDENT CARE REIMBURSEMENT ACCOUNT

You can establish a dependent care reimbursement account by authorizing a reduction in your taxable salary by an amount up to $5,000 a year. This amount is then used to pay eligible dependent care expenses. Because this amount goes into the account before income or Social Security taxes are withheld, you save money by paying less in taxes. To be eligible, expenses must satisfy all of the following:

Maximum Account Amount

Your account may not exceed $5,000 or any of the following:

Applying for Reimbursement

Send dependent care expense receipts as you receive them, along with a complete reimbursement request form (available in Human Resources or online at the Human Resources Forms page.) to Human Resources. You will be reimbursed on a monthly basis for expenses up to your accumulated deductions.

Unused Account Amounts

IRS regulations for dependent care reimbursement accounts include a "use-it-or-lose-it" provision. This means you forfeit any funds not used to cover eligible expenses incurred during the plan year. You can reduce your risk of loss by careful planning and by limiting your contributions to predictable dependent care expenses.
 

NEIGHBORHOOD PRESCHOOL SCHOLARSHIP (NPS)
Your dependent children are eligible for Wesleyan’s Neighborhood Preschool scholarship program: The amount of the scholarship is dependent on:


     CHILD CARE SCHOLARSHIP


ANNUAL 
FAMILY
INCOME
INFANT/TODDLER
PRESCHOOL
MONTHLY
SCHOLARSHIP
FOR FULL TIME
ENROLLMENT
MONTHLY
SCHOLARSHIP
FOR FULL TIME
ENROLLMENT
 
0-25,000
$225
$160
26-50,000
$170
$125
51-75,000
$135
$100

Applications are available in the Human Resources Office.






 

BASIC RETIREMENT PLAN FOR PHYSICAL PLANT AND SECRETARIAL/CLERIAL STAFF MEMBERS
WHO ARE REPRESENTED BY A UNION

Eligibility and Plan Contributions

Wesleyan makes basic retirement plan contributions on behalf of eligible staff members who have completed two years of qualifying service. These contributions equal a percentage of base salary as follows:
 

Age 
Contributions 
Up to 40 
5.0% 
40 – 49 
7.5% 
50 – 59 
10.0% 
60+ 
12.5% 

A year of qualifying service is any consecutive twelve-month period during which an eligible staff member has an appointment to work half time or more, or works 910 hours or more, for Wesleyan.  Some periods during which a staff member does not perform any work for Wesleyan may also count as vesting service (e.g., paid vacation, paid holidays, paid sick leave, and jury duty) up to a maximum of 501 hours for any single continuous period during which the staff member performs no work for the University.

Vesting

Contributions and the earnings on them “vest” (are owned by the participant) immediately.

Investment Choices

Participants determine where their plan contributions and the earnings on them are invested from among available investment options. As of January 1, 2001, those options were:

A participant may choose to invest in one or more investment options and may change options--with some restrictions—by calling 1-800-842-2252 for TIAA/CREF or 1-800-343-0860 for Fidelity.

Retirement Date and Retirement Income Options

The "normal" retirement date used by Wesleyan to project a participant’s retirement income under the basic retirement plan is the first day of the month following his or her 65th birthday.  A participant may, however, retire and begin to receive retirement income before or after the normal retirement date.  A participant is not eligible to receive retirement income from the basic retirement plan while actively employed by Wesleyan.

Retirement income options are those offered by the investment vehicle and are described in booklets available in Human Resources. Any lump sum distribution option permitted by the investment vehicle, however, is subject to the following limitation.

Internal Revenue Code requires retired participants to begin receiving a specified amount of retirement income from the Plan no later than April 1 following the calendar year in which the participant reaches age 70 ½.

Lump sum withdrawals before the termination of employment on or after age 55 or before age 59 ½ may be subject to a tax penalty.

Death Benefits

Benefits may be payable to a participant’s spouse or designated beneficiary when the participant dies.  (Special laws protect the rights of a participant’s spouse.  See “Spousal Rights” section below.)  The form and amount of these benefits depend on whether the participant has begun to receive an annuity from the basic retirement plan and what form of annuity was elected.  These benefits are described in booklets available in Human Resources.

Spousal Rights

A married participant must obtain advanced written consent from his or her spouse prior to certain transactions, including lump sum withdrawals.  Also, subject to limited exceptions, a participant must choose an income distribution option that provides a survivor’s annuity to his or her spouse, unless the spouse waives this right in writing.

Under federal law, if a participant is married at the time of death, the participant’s surviving spouse is automatically deemed to be his or her beneficiary for fifty percent of the accumulation (subject to certain limited exceptions), unless prior to the participant’s death the spouse consented in writing to the designation of another beneficiary in the manner required by the law.  The beneficiary for the other fifty percent is deemed to be the participant’s estate.

Booklets containing detailed information about the TIAA/CREF and Fidelity investment and distribution options and more complete information about the basic retirement plan are available in Human Resources. In addition, retirement planning seminars are conducted from time to time by TIAA/CREF, Fidelity or others at which information about investments, distributions and retirement income options is provided.


 

SUPPLEMENTAL RETIREMENT ACCOUNTS

Contributions

IRS regulations allow participants to make tax-deferred contributions from salary to a supplemental retirement account. Wesleyan calls such accounts SRA's (supplemental retirement accounts); another common name is TDA (tax-deferred annuity). Federal and Connecticut income taxes on SRA contributions are deferred until retirement income is paid out.

Vesting

Supplemental retirement contributions vest immediately.

Maximum SRA Contribution

The maximum amount of contributions that can be made to an SRA on a tax-deferred basis is re-calculated each year according to an IRS formula. Human Resources notifies participants of these maximums each year.  The minimum contribution to an SRA is $25 monthly.

Investment Options

In addition to the TIAA/CREF and Fidelity investment options available under the basic retirement plan, supplemental retirement contributions may be invested in:

Starting or Changing SRA Contributions

SRA contributions may be started, canceled, or changed as follows:

More information about investment options and about SRA’s are available in Human Resources.
 
 
 


 

 UNDERGRADUATE TUITION SCHOLARSHIP PROGRAM

Dependent children are eligible for Wesleyan's undergraduate tuition scholarship program:

Each of your dependent sons and daughters qualifies for one scholarship. The award is a payment toward tuition equal to the difference between the school's tuition and any scholarships received from sources other than Wesleyan.  For Physical Plant hourly employees, the maximum award is one-quarter of Wesleyan's tuition. (For the period July 1, 2002 to June 30, 2003, the amount is $6,868.26; the amount changes when Wesleyan tuition changes.)  For Secretarial/Clerical hourly employees, the maximum award is 35% of Wesleyan's tuition.   (For the period July 1, 2002 to June 30, 2003, the amount is $9,615.56; the amount changes when Wesleyan tuition changes.)  The total scholarship to which your son or daughter is entitled will be apportioned equally among the academic terms constituting an academic year and credited to the student's account on that basis. Your dependents will receive scholarships proportionate to your degree of full-time employment if you work three-quarter time or more, but less than full time.

If, before January 1, 1992, you qualified for scholarships for your dependents under terms that were less restrictive, you will not now be required to meet the more restrictive qualifications.
 
 


 

ERISA RIGHTS

The Employee Retirement Income Security Act of 1974 (ERISA) guarantees you certain rights and protection. Please keep in mind that the University itself has established claims review and appeals procedures that can generally respond to your needs quickly and effectively.

Under the law, you are guaranteed the following:

1. Copies of the official plan instruments and other plan documents, such as annual reports and plan descriptions filed with the U.S. Department of Labor, are available in the Human Resources Office.

2. The right to receive a summary of the plan’s annual financial report. This is sent routinely to plan participants.

3. If you do not receive any of the materials to which the law entitles you within 30 days of your request, you may file suit in a federal court, unless the materials were not sent because of matters beyond the control of the administrator. The court may require the administrator to pay you a penalty of up to $100 for each day's delay beyond 30 days until you receive the materials.

4. The right to obtain a statement reporting the amount of funds accumulated to provide benefits.

5. The assurance that the individuals responsible for the operation of these plans act solely in the interest of the plan participants and exercise prudence in the performance of their duties.

6. The assurance that you may not be discharged or discriminated against in order to prevent you from obtaining a benefit or exercising your rights under ERISA.

7. The right to have your claim reviewed and reconsidered if your claim for a benefit is denied in whole or in part.

8. The right to file suit in a federal or state court if your claim is ignored or if you are improperly denied a benefit in full or in part. If you are discriminated against for asserting your rights, you may seek assistance from the Department of Labor or you may file suit in a federal court. If you are successful in a court action, the court may require the other party to pay your legal cost, including attorney's fees. If you lose, the court may require you to pay these costs and fees.

9. The right to contact the U.S. Department of Labor if you have any questions about this statement or your rights under ERISA or problems with these plans which are not answered or settled by the administrator. If you have any questions about this statement or about your rights under ERISA, please contact the nearest office of the Pension and Welfare Benefits Administration, U. S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of Labor, 299 Constitution Avenue, N.W., Washington DC 20210.
 

PLAN ADMINISTRATION

Plan Administrator and Agent for Service of Legal Process

The administrator of Wesleyan benefit plans is WESLEYAN UNIVERSITY. The administrator's representative is the Director of Human Resources. The Human Resources Office will help you with questions about plan provisions, eligibility and participation.

If a legal summons is to be served on a benefit plan, it should be directed to the Agent for Service of Legal Process, the Vice President and Treasurer of the University.

A major responsibility of the administrator's representative is to make sure that the provisions of various benefit plans are applied properly and equitably to you and to all other members.  If you feel that you have been treated unfairly or denied benefits improperly, you are encouraged to seek a review by the administrator.  Any determination by the administrator concerning University benefit plans shall be final and conclusive on all persons in the absence of clear and convincing evidence that the administrator acted arbitrarily and capriciously.  Decisions by the administrator are subject to review by the Vice President and Treasurer to insure that the administrator did not act arbitrarily and capriciously.

Plan Records

Plan applications and claims information are kept on file in the Human Resources Office.

Plan Year

The records of the group insurance and tax-deferred annuity plans are kept on a calendar year basis beginning January 1 and ending December 31. Records for the Retirement Program for Faculty, Professional Librarians and Administrative Staff are kept on a July 1 - June 30 basis.

Names and Plan Identification Numbers

The Employer Identification Number assigned by IRS is: 06-0646959

Under the Internal Revenue Service rules, the following plans are identified by these plan numbers:

Retirement Program for Staff Employees: 002

Tax-Deferred Annuity Plan for Faculty and Staff of WESLEYAN UNIVERSITY: 003

WESLEYAN UNIVERSITY Group Insurance Program: 511

Plan Documents

This booklet describes only the major features of the University's benefit plans. Plan documents are available in the Human Resources Office. In the event of any inconsistency between plan documents and this booklet, the former will govern.

Also available from the Human Resources Office are copies of the latest annual reports and plan descriptions filed with the U.S. Department of Labor.

Amendment and Termination of Plan

It is intended that these plans will be permanent; however, the Employer reserves the right to amend the plans and/or terminate the plans in its sole discretion at any time. Any amendment or termination of the plans shall not adversely affect any benefit provided herein that is owing prior to such amendment or termination.
 
 

ConnectiCare
30 Batterson Park Road, Farmington, CT 06032
Customer Service 1-800-846-8578

Aetna Health Plans
P.O. Box 1111, Middletown, CT 06457
Customer Service 1-800-223-5097

PHS Medical Claims: Physicians Health Services (PHS)
One Far Mill Crossing, P.O. Box 904, Shelton, CT 06484-0944
Customer Service 1-800-959-6210

PHS Mental Health Claims:
PHS Health Plans
c/o ValueOptions, Inc.
P.O. Box 12698
Norfolk, VA  23502

Delta Dental of NJ
P.O. Box 222, Parsippany NJ 07054
Claims 1-800-346-5377

TIAA/CREF
1-800-842-2252

Fidelity
1-800-343-0860

Vanguard
1-800-662-2003

Scudder
1-800-323-6105