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FOR SECRETARIAL/CLERICAL
HOURLY EMPLOYEES |
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| 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 |
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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
- Basic life and long term disability insurance for which the University pays the full cost.
- Health and dental insurance for which the University pays the larger share of the cost.
- Optional life insurance for which faculty and staff pay the full cost.
- Reimbursement accounts that enable faculty and staff to save money by paying for certain uninsured medical, and for certain dependent care, expenses on a pre-tax basis.
- A basic retirement plan to which the University contributes.
- A supplemental retirement plan to which faculty and staff contribute.
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.
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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.
- Begin health or dental insurance coverage.
- Choose a different health plan.
- Change individual or family coverage.
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:
- Your health and dental insurance coverage continues into the following year if you make no change during open enrollment.
- MERA and dependent care accounts do not automatically continue and you must enroll annually during open enrollment if you wish to begin or continue an account
- Supplemental retirement accounts automatically expire each December 31 unless you reenroll.
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CIGNA HealthCare |
| SUMMARY OF BENEFITS Your CIGNA HealthCare Network Open Access plan and Point of Service Open Access plan |
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For Employees of Wesleyan University
Features that Add Value
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Quality Service Is Part of
Quality Care
When you choose CIGNA HealthCare, you can take advantage of our health and wellness programs.
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You Can Depend on CIGNA
HealthCare
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| BENEFIT HIGHLIGHTS |
Network Open Access |
Point-of-Service Open Access |
Point-of-Service Open Access |
| Doctor Office Visit Primary Care Physician (PCP) Office Visit Preventive Care Well Child Care Periodic Physical Exams (Children and Adults) Routine Immunizations and Injections
Adult/Child Medical Care for Illness or Injury |
$10 copay per office visit
$10 copay per office visit $10 copay per office visit |
$10 copay per office visit
$10 copay per office visit $10 copay per office visit |
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 |
$10 for generic drugs $20 for brand-name drugs $35 for non-preferred brand-name drugs $10 for generic drugs |
Not covered Not covered Not covered
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| 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 |
$10 copay per visit $50 per visit, waived if admitted $25 per visit, , waived if admitted
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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 |
Point-of-Service Open Access |
| 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 |
10 copay per visit No charge No charge |
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) |
$10 copay per office visit; No charge for
x-ray/lab if billed by separate facility
No charge No charge |
$10 copay per office visit; No charge for
x-ray/lab if billed by separate facility
No charge No charge |
20% of charges*
20% of charges* |
| Infertility Services
Office Visit (tests, counseling)-PCP or Specialty
Physician Outpatient Surgical Facility |
$15,000 maximum per
lifetime#
$10 copay per office visit
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$15,000 maximum per
lifetime#
$10 copay per office visit
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$15,000 maximum per
lifetime#
20% of charges*
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| 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: ·
Your plan provides coverage for medically necessary services. Your plan does not provide coverage for the following except as required by law:
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
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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 |
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Family Members
The following family members of eligible staff members are eligible for health and dental plan coverage:
- A spouse.
- Dependent children through age 18 or through age 24 if a full-time student.
- An unmarried same or opposite-sex, long-term domestic partner and the partner’s dependent child(ren), if they satisfy eligibility requirements. For eligibility information and an Affidavit of Domestic Partnership, contact Human Resources.
- Widows, widowers, and surviving dependent children of participating faculty, staff, or early retirees may continue health and dental insurance for up to one year after the participant dies.
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:
- Infertility – Procedures that are covered are in-vitro fertilization, gamate intra-fallopian transfer (GIFT), or Zygote intra-fallopian transfer (ZIFT) procedures. More routine testing and treatment is usually covered by the medical plans.
- Maximum payments for adoption and infertility treatment are $4,000 in any single 12-month period and $8,000 in total.
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.
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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.
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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 |
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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 that is fully paid by the University.
- Optional employee, spouse, and dependent children life insurance that is fully paid by the participant.
- A death benefit for the beneficiaries of eligible retirees.
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 |
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| up to 30 |
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| 30-34 |
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| 35-39 |
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| 40-44 |
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| 45-49 |
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| 50-54 |
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| 55-59 |
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| 60-64 |
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| 65-69 |
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| 70-74 |
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| 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.
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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.
- Deductibles and coinsurance not paid by a health or dental plan;
- Vision care, including exams, prescription eyeglasses and contact lenses;
- Hearing examinations and hearing aids;
- Smoking cessation programs and related prescription drugs;
- Weight-loss programs prescribed by a doctor for a specific ailment;
- Installation and operation of a non-permanent air conditioner to relieve an allergy or heart condition, if prescribed by a doctor;
- Vitamins and dietary supplements prescribed by a doctor; and
- Other medical expenses that qualify as federal income tax deductions for federal income tax purposes.
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
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Without Account
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| Annual Base Salary |
$30,000
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$30,000
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| Minus MERA Amount |
2,400
____________ |
0
________________ |
| Sub-total Taxable Income |
27,600
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30,000
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| Minus Estimated Federal Income Tax |
4,140
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4,533
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| Minus Social Security Tax |
2,111
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2,295
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| Minus Health Care Expenses |
0
____________ |
2,400
________________ |
| Net Pay |
$21,349
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$20,722
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| Tax Savings |
$577
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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.
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.
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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
- You must be gainfully employed;
- Expenses must be incurred for a child under age 13 whom you are entitled to claim as a dependent on your federal tax return, or for a dependent physically or mentally incapable of self care who regularly spends at least eight hours each day in your household. (Special rules apply to a child of separated or divorced parents. Please see plan description available from Human Resources.);
- Expenses must be for household services or for outside care of an eligible dependent. (Please note: if you use a dependent care center that provides regular care for at least seven people and receives a fee for such services, the center must comply with all applicable laws and regulations); and
- Expenses must be incurred between January 1 and December 31 of each year and claims for reimbursement must be submitted by the following April 15.
Your account may not exceed $5,000 or any of the following:
Applying for Reimbursement
- $2,500 if you are married but do not file a joint income tax return;
- Your earned income for the calendar year; or
- If you are married and file a joint income tax return, either your earned income or the earned income of your spouse, whichever is less for the calendar year.
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.
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Your dependent children are eligible for Wesleyan’s Neighborhood Preschool scholarship program:The amount of the scholarship is dependent on:
- If your dependent son or daughter is enrolled in Neighborhood Preschool on at least a half time basis;
- If you qualify by working at least three-quarter time (half time for faculty) when you apply for the scholarship and at the beginning and end of each academic term for which the scholarship is granted; and
- If your annual family income (adjusted gross income on IRS form 1040) for the previous calendar year is $75,000 or less.
- Your annual family income;
- Whether a child is enrolled in the infant/toddler or the preschool program; and
- The number of hours a child attends Neighborhood Preschool or, more specifically, the percentage of the monthly full time fee that is paid to NPS.
CHILD CARE SCHOLARSHIP
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FAMILY INCOME |
INFANT/TODDLER |
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SCHOLARSHIP FOR FULL TIME ENROLLMENT |
SCHOLARSHIP FOR FULL TIME ENROLLMENT |
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Applications are available in the Human Resources Office.
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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 |
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| Up to 40 |
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| 40 – 49 |
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| 50 – 59 |
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| 60+ |
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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.
- A TIAA account featuring guaranteed principal, plus earnings; and a TIAA Real Estate account;
- Eight CREF accounts--Bond Market, Equity Index, Global Equities, Growth Account, Inflation-Linked Bond, Money Market, Social Choice, and Stock account; and
- Ten Fidelity funds--Asset Manager; Asset Manager: Growth; Asset Manager: Income; FMMT Retirement Money Market; Growth Fund; Growth and Income Portfolio; Intermediate Bond Fund; Magellan Fund; Overseas Fund; and Short-Term Bond Portfolio.
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.
- A participant may make lump sum withdrawals equal to a maximum of 25% of his or her retirement plan accumulations and only if the participant’s employment has terminated.
- A participant may receive all or part of his or her basic retirement plan accumulations as a lump sum, provided the participant is at least age 59 1/2 and the participant's Wesleyan employment has ended.
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.
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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
- All of the Fidelity funds;
- The Third Century Fund, Inc., similar to CREF's Social Choice Fund, offered by Dreyfus;
- All Vanguard funds; and
- All Scudder funds.
SRA contributions may be started, canceled, or changed as follows:
More information about investment options and about SRA’s are available in Human Resources.
- Changes to an SRA are effective the following January 1, if made during open enrollment. During other times of the year, changes are effective on the first day of the following month.
- Contributions end on December 31 each year unless renewed by the participant.
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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 the dependent son or daughter is enrolled in an accredited undergraduate degree program on a full-time basis;
- If you qualify by working at least three-quarter time when you apply for the scholarship and at the beginning and end of each academic term for which the scholarship is granted; and
- If you have accumulated five or more continuous years of qualifying service at Wesleyan throughout the five years or with comparable prior service at other U. S. colleges and universities generally counting toward the five years.
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.
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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