Office of Human Resources
Employee
Benefits
Medical
and Dental Insurance
Basic
Group Life Insurance
Voluntary
Group Term Insurance
403
B Retirement Annuities
Short
Term Disability
Long
Term Disability
Employee
Assistance Program
Workers
Compensation
Health
Care Options Rate Table
Flexible
Spending Accounts
Forms
Aetna
Health Insurance Enrollment/Change Request Form
Delta
Dental Enrollment/Change Request Form
Delta
Dental Student Verification Process
Employee
Report of Occupational Injury or Disease
Health
Insurance Compensation Reduction Agreement
Reliance
Standard Life Insurance Application Form and Informational Brochure
Remission
of Tuition Form
Retirement
Contribution Authorization
Family
Medical Leave (FMLA) Forms / Information
Employee
Rights and Responsibilities Under the FMLA
Certification
of Health Care Provider for Employee's Serious Health Condition
Certification
of Health Care Provider for Family Member's Serious Health Condition
Cert
for Serious Injury/Illness of Covered Servicemember for Military
Family Leave
Certification
of Qualifying Exigency for Military Family Leave
Web
Resources
Organizations
used in Lincoln University's benefits packages:
(Please
click to reach each company's website)
Aetna
US Healthcare
- health insurance carrier
Delta
Dental -
dental insurance carrier
Human
Management Services
- employee assistance program
Username:
Lincoln
Password:
University
TIAA-CREF
-
retirement savings organization
Summary
Plan Description Documents
Aetna
Summary Plan Description
Delta
Dental Summary Plan Description
FSA
Summary Plan Description
Section
125 Summary Plan Description
This
page was last updated on December 10, 2008.
Medical and Dental Insurance
Employee Eligibility: Each active full-time
employee working a minimum of 20 (twenty) hours per week or 1000
hours. Faculty who teach at least 6 credits
per semester.
Premium: See premium payment chart provided
in the Health/Dental Benefits packet.
Medical Provider: Aetna HMO, Aetna Open
Access
Dental Provider: Delta Dental
Plan options: Participating dentist and Non Participating
dentist
Benefit Specifications: Each medical and
dental plan is specifically outlined in detail in the Health/Dental
Benefit package.
If you choose to not participate in the medical
and/or dental benefits under Lincoln University, you must complete
a “Waiver of Medical/Dental Coverage” for provided in the Health/Dental
Benefit package.
Basic
Group Life Insurance
Employee Eligibility: Each active full-time
employee working a minimum of 20 (twenty) hours per week or 1000
hours or a faculty employee teaching 6
credits per semester.
Premium: Employer (Lincoln University):
100%
Employee: 0%
Benefit Amount: I x regular annual
earnings*
*Earnings means basic annual salary as of the day
before the date of loss. Earnings do not include bonus,
commissions or overtime.
Voluntary
Group Term Insurance
Employee Eligibility: Each active full-time
employee working a minimum of 20 (twenty) hours per week or 1000
hours or a faculty employee teaching 6
credits or more per semester.
Premium*: Employer (Lincoln University):
0%
Employee: 100%
*Premiums are based on smoker-nonsmoker rates.
See brochure for premium cost, benefits for dependent rates, imminent
death benefit, disability waiver of premium, exclusions and limitations,
portability, conversion and termination.
403 B
Retirement Annuities
Employee Eligibility: Any regular or permanent
employee who works a minimum of 20 (twenty) hours per week or
1000 hours or a faculty employee teaching
6 credits or more per semester.
5% Mandatory premium: Paid 100% by Lincoln
University
Employee Voluntary Premium*: Paid 100% by
employee to maximum amount allowable by the Internal Revenue Service
guidelines.
*Participating in the voluntary premium allows
you to receive matching funds from Lincoln University to an amount
equal to the 5% mandatory premium.
Short
Term Disability
Employee Eligibility: All active, full-time
employees of Lincoln University who are "actively at work."
Collective Bargaining Agreements should be consulted for
specific union positions regarding eligibility.
A “full-time” employee is one who regularly works
a minimum of 30 (thirty) hours per week for the Employer.
Part-time, casual, seasonal and temporary employees are not eligible.
“Actively at Work” means an employee is at the
usual place of business or on assignment, and performing their
regular job on a full-time basis.
Premium:
Employer (Lincoln University):
100%
Employee: 0%
Certificate:
You will be receiving an insurance
certificate. Please keep this certificate where you can
refer to it as necessary.
Short Term Disability Termination:
-
Will terminate on the earliest of the following
dates.
-
The date the employee is no longer a member
of a class eligible for this insurance, withdraws from the program,
is retired or pensioned, or ceases work because of a leave of
absence, furlough, layoff, or temporary work stoppage due to
a labor dispute, unless Lincoln University has agreed in writing
to continue insurance during such period.
Termination will not affect a covered loss, which
began before the date of termination.
Submitting Disability Claim:
So that you may expect our best service, please read
this section carefully.
Filing a Claim - When an employee becomes disabled
or is expected to become disabled (such as due to pregnancy or
planned surgery) and it is likely that his/her disability will
continue beyond the elimination period for the STD policy, follow
the steps below:
-
The Short Term/Long Term Disability Claim
Form has three parts, which should be completed as follows.
Step I - Complete the employee section of the
claim form. The employee should sign and date this section
of the Short Term/Long Term Disability Claim Form.
Step II - The employee should then give the claim
form to his/her doctor to complete the attending physician section.
The employee must instruct the doctor to return the completed
claim form to either the employee or Human Resources.
Step III - When the disabled employee receives
the completed claim form from his/her doctor, the disabled employee
should send it to Human Resources for completion of Part I.
The submission of the above information will assist
us in processing your claims in a timely fashion and will reduce
the number of requests needed for subsequent information.
Once the elimination period
ends (30 days), claim payments
will be made in accordance with the policy provisions. Claim payments
will be sent directly to the employee unless otherwise specified.
-
If additional information is needed to make the
initial evaluation of the claim, Reliance Standard Life
Insurance Company may contact you, Lincoln
University, or your physician to obtain necessary information.
Continued Claim Processing:
After benefits
begin, additional medical information may be necessary to support
continued disability and to verify that the employee is under
the appropriate regular care and attendance of a physician.
The employee’s condition and the physician’s prognosis determine
how often this information is needed and if there will be utilization
of any additional resources such as nurses, staff physicians,
rehabilitation specialists or independent medical examinations.
Periodically, a claim form may be requested to be completed and
returned.
Long Term Disability
Premium: Employer (Lincoln University): 100%
Employee: 0%
When it appears that the employee’s disability
will extend beyond the Short Term Disability maximum benefit period,
the employee will be notified that benefits will begin to be paid
on a monthly basis and will be paid under the Long Term Disability
(LTD) provisions of the policy.
It will not be necessary to submit a new claim
form. If additional information is needed, Reliance
Standard Life Insurance Company will contact
the employee, Lincoln University, or the attending physician.
Social Security and Other Disability Benefits:
If it is likely that the disability will last for 12 full calendar
months or more, the policy requires that the employee file for
Social Security disability benefits. The claim department will
provide detailed instructions regarding Social Security filing
procedures.
Additional Information:
Specific information
may be requested by correspondence or personal contact from Lincoln
University, disabled employee, or the employee’s attending physician.
Appeal Procedures:
Claim decisions,
including denials or termination of benefits, will be communicated
directly to the claimant with a copy to your claim administrator.
Appeals of claim decisions must be made in writing within 60 (sixty)
days of the date of decision was communicated to the employee
(the date of the denial letter). Appeals should be submitted to
the claim department.
Appeals Should Include the Following:
-
Reason(s) for requesting the appeal.
-
Additional documentation in support of the request.
(This includes medical information relevant to the issues and
time period surrounding the claim.)
Employee
Assistance Program
Premium: Employer (Lincoln University): 100%
Employee: 0%
The Employee Assistance Program (EAP) is a confidential
counseling and referral service that can help you and your family
successfully deal with life’s challenges.
Call whenever you need help sorting through what’s
happening in your life. Call when you need help identifying
options and making an informed choice about what to do next.
The EAP is always there for you—even if it’s in the middle of
the night, over the weekend, or on a holiday.
Key features of the program include:
- Confidentiality.
- Easy access to services and crisis counseling
24 (twenty-four) hours a day, seven days a week via a toll-free
telephone number.
- No charge for using EAP service.
Your EAP can help you with:
- Job work stress
- Family and parenting issues
- Marital and relationship problems
- Alcohol, drugs, other substance misuse of abuse
- Anxiety, stress and depression
- Anger
- Legal issues
- Coping with change
- Self-esteem problems
- Grief or bereavement
Turn to your EAP for help with anything that is interfering
with your job or personal life. This confidential counseling
and referral service for you and your eligible dependents is available
at no charge, 24 hours, 365 days a year. Simply call
1-800-343-2186 or via internet at:
www.hmsincorp.com
username:
Lincoln
password:
University
Health
Care Options Rate Table - 2008/09
Aetna HMO 15:
| Coverage |
Total Monthly Premium |
Univ Pays (Monthly) |
Employee Pays (Monthly) |
Employee Pays (Bi-Weekly) |
Employee Pays (9-Month Contract) |
| Single |
543.91 |
528.91 |
15.00 |
6.92 |
20.00 |
| P/Child(ren) |
1022.23 |
613.34 |
408.89 |
188.72 |
545.19 |
| Emp/Spouse |
1192.01 |
715.21 |
476.80 |
220.06 |
635.74 |
| Family |
1576.70 |
946.02 |
630.68 |
291.08 |
840.91 |
Aetna Open Access:
| Coverage |
Total Monthly Premium |
Univ Pays (Monthly) |
Employee Pays (Monthly) |
Employee Pays (Bi-Weekly) |
Employee Pays (9-Month Contract) |
| Single |
565.99 |
528.91 |
37.08 |
17.11 |
49.44 |
| P/Child(ren) |
1062.54 |
613.34 |
449.20 |
207.32 |
598.93 |
| Emp/Spouse |
1240.40 |
715.21 |
525.19 |
242.40 |
700.25 |
| Family |
1619.77 |
946.02 |
673.75 |
310.96 |
898.33 |
Delta Dental:
| Coverage |
Total Monthly Premium |
Univ Pays (Monthly) |
Employee Pays (Monthly) |
Employee Pays (Bi-Weekly) |
Employee Pays (9-Month Contract) |
| Single |
23.77 |
20.20 |
3.57 |
1.65 |
4.75 |
| Family |
59.28 |
20.20 |
39.08 |
18.03 |
52.10 |
Flexible
Spending Accounts (Reimbursable Medical and Dependant Care)
Overview:
Flexible Spending Accounts are designed to reduce
your costs for certain types of medical and dependent care expenses
by saving you tax dollars. If you are an eligible employee, you
have the opportunity to set up Flexible Spending Accounts during
Open Enrollment during December for calendar year beginning
January.
When you establish a Flexible Spending Account,
you use pretax dollars to pay for certain medical and dependent
care expenses. Pretax dollars come "off the top" of your pay -
before federal income taxes or Social Security taxes are calculated.
When you use pretax dollars, your taxable income is reduced dollar
for dollar. When you lower your taxable income, you pay less in
taxes. The money you save in taxes increases your spendable income.
There are two types of spending accounts that you can set up:
Medical Spending and Dependent Care.
Money left in the spending accounts after the last
day on which you can submit requests for reimbursement will be
forfeited. You have until March 30 of any year (three months after
the end of the plan year) to submit bills for expenses incurred
from January through December 31 of the previous year.
The amount you can contribute to your spending
account(s) is fixed for the entire plan year - unless you experience
a change in family status. A change in status is defined as: marriage
or divorce; death of a spouse or dependent; birth or adoption
of a dependent; or termination of your spouse's or your employment
status.
Contributions to the spending account are not subject
to social security tax; therefore there may be a small reduction
in your social security benefit, depending on the amounts contributed
annually to the spending accounts.
Eligibility:
You will be eligible for this benefit if you are
a full-time employee who is scheduled to work a minimum of 30
hours per week for at least nine (9) months or a part-time employee
who is scheduled to work a minimum of 20 hours per week for at
least twelve (12) months.
Enrollment and Effective Date of Coverage:
Employees may establish an account during December
(to begin January 1) and upon hire. The effective date of coverage
will be January 1, if established during open enrollment or the
first of the month following date of hire, if established within
ten days of hire date.
How Spending Accounts Work:
When you establish your spending account(s), you
need to calculate how much of each paycheck you want to redirect
into one or both accounts. The flexible spending account
worksheets will help you make these calculations, but here's a
quick summary.
-
Based on past bills, predict what you will
spend on eligible expenses in the coming plan year.
-
Divide the total by the number of your pay
periods (faculty and administrative - 9 or 12; support staff
- 26) in the benefit plan year. This is the amount you want
to redirect from each paycheck on a pretax basis to fund your
spending account.
-
Pay for eligible expenses as they occur, and
then submit the bill directly to Human Resources for medical
claims and Benefit Concepts for dependent care claims for reimbursement
from your account.
Benefit Concepts
P.O. Box 60608
King of Prussia, PA 19406-0608
(610) 337-2600
www.bcitpa.com
Reimbursement:
Reimbursement checks drawn on your spending accounts
will be made out to you and sent directly to your home address.
Remember, money left in the spending accounts after
the last day on which you can submit requests for reimbursement
will be forfeited. You have until March 30 of any year (three
months after the end of the plan year) to submit bills for expenses
incurred from January through December 31 of the previous year.
For more information on your Medical Spending Account,
please refer to Internal Revenue Service, Code 213.
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