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

This page was last updated on December 12, 2007.

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Medical and Dental Insurance
Employee Eligibility: Each active full-time employee working a minimum of 20 (twenty) hours per week or 1000 hours within 6 (six) months..

Premium: See premium payment chart provided in the Health/Dental Benefits packet.

Medical Provider: Aetna HMO, Aetna Open Access

Dental Provider: MetLife 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 within 6 (six) months.

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 within 6 (six) months.

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 within 6 (six) months.

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.”

A “full-time” employee is one who regularly works a minimum of 30 (thirty) hours per week for the Employer.  Part-time, 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:

1. Will terminate on the earliest of the following dates.
2. 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:

• IMMEDIATELY contact Human Resources and request a Short Term/Long Term Disability Claim form.
• The Short Term/Long Term Disability Claim Form has three parts, which should be completed as follows.

Step I - Complete the employer’s 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, 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,  CNA 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, CNA 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:
1. Reason(s) for requesting the appeal.
2. 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:

1. Confidentiality.
2. Easy access to services and crisis counseling 24 (twenty-four) hours a day, seven days a week via a toll-free telephone number.
3. No charge for using EAP service.

Your EAP can help you with:

1. Job work stress
2. Family and parenting issues
3. Marital and relationship problems
4. Alcohol, drugs, other substance misuse of abuse
5. Anxiety, stress and depression
6. Anger
7. Legal issues
8. Coping with change
9. Self-esteem problems
10. 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 1-800-523-5668.

Workers Compensation

Policy:  The University will assure that all employees are insured in accordance with the Pennsylvania State Workers’ Compensation statutes and that an acceptable and convenient method is available to record claims an deliver treatment to those individuals suffering from work related illnesses or injuries.

Purpose: Employees injured or suffering an illness as a result of performing their job are entitled to medial and financial assistance.  The conformance to an application of the Pennsylvania Workers’ Compensation statutes to our work force assures our meeting this standard.
If an employee is injured or becomes ill on the job, he/she must inform their supervisor as soon as possible and report to Health Services, for a medical evaluation.  When an illness or injury occurs as a result of performing duties as an employee of Lincoln University, the employee may be eligible for both “Medical Expense” and “Lost Work Time” compensation benefits.  However, to be eligible for such payments/benefits any injury must be reported promptly.

Procedure:

1. Whenever an employee is injured while on duty, he/she should report such an occurrence to their Director or Supervisor immediately.  The Director or Supervisor will then report the incident to Human Resources immediately and refer the employee as follows:
• Between the hours of 8:00am and 4:30pm, Monday through Friday, the injured employee is to report to Health Services.
• At any time, when the injury is so severe that the employee reasonably should not be directed to Health Services, or if Health Services is closed, he/she should be taken directly to our panel of physicians or to the emergency room (follow-up must be completed by a University-selected, panel physician).
2. An incident report form should always be completed detailing how the injury occurred, equipment involved, exact location and time, witnesses, and any other circumstances surrounding the incident.  An incident report is completed by the employee and an injury investigation report is usually completed by the injured employee’s immediate supervisor.  It may also be completed by a member of the Safety Committee.  It is always preferable to have the director or supervisor from the area where the injury occurred complete this form.
3. The general Human Resources Policy governing leaves of absence includes approved worker’s compensation leaves.

In Case of Work-Related Injury or Disease
If you suffer a work-related injury, PMA will pay for reasonable surgical and medical services, medicines, supplies, orthopedic appliances and prostheses, including training in their use. In order to ensure that your medical treatment will be paid for by PMA, you must select from one of the physicians or other health care providers as listed below.

Physician Panel for Worker's Compensation - Main Campus

Emergency/Acute Care:
Jennersville Regional Hospital
Emergency Room Department
1015 West Baltimore Pike
West Grove, PA 19390
(610) 869-1000

 

Initial Care/Occupational Medicine:
Lincoln University Health Services
Cresson Hall
(484) 365-7338

 

Occupational Health Center

830 West Cypress Street

Kennett Square, PA 19348

(610) 444-6214

 

Michael P. Rill, MD

Lanchester Medical Center

381 Gap Newport Pike

Gap, PA 17527

(610) 593-5125

 

Pedro M. Solanet, MD

830 West Cypress Street

Kennett Square, PA 19348

(610) 444-8084

 

Physical Therapy:

Brian Andrews, PT

Nova Care Outpatient Rehab.

One Commerce Boulevard

West Grove, PA 19390

(610) 345-0759

 

Chiropractic:

Douglas A. Fasick, DC

25 North 3rd Street

Oxford, PA 19363

(610) 932-9061

 

Durable Medical Equipment:

Mobility Express

TechHealth

3903 Lincoln Highway

Downingtown, PA 19335

(877) 611-3415

 

Ophthalmology:

James B. Carty

1011 West Baltimore Pike

West Grove, PA 19390

(610) 869-0200

 

Orthopedic Surgery:

John H. Benner, MD

Chester County Ortho Assoc.

402 McFarlan Road

Kennett Square, PA 19348

(610) 444-1344

 

Radiology:

Harris P. Miller, MD

Exton MRI - Raytel Imaging

495 Thomas Jones Way, Ste. 104

Exton, PA 19341

(800) 453-0574

Physician Panel for Worker's Compensation - Graduate Center

Emergency/Acute Care:
Thomas Jefferson University Hospital

Emergency Room Department

201 South 11th Street

Philadelphia, PA 19107
(215) 955-6840

 

Presbyterian Hospital

51 North 39th Street

Philadelphia, PA 19104

(215) 662-8215

 

Initial Care:
Richard Dimonte, DO

7418 Buist Avenue

Philadelphia, PA 19153

(215) 724-7086

 

Vincent E. Baldino, DO

Ritner Medical Associates

1701 Ritner Street

Philadelphia, PA 19145

(215) 336-2145

 

Judith Green McKenzie, MD

University of Pennsylvania Health System

Ground Floor, Silverstein Building

3400 Spruce Street

Philadelphia, PA 19104

(215) 662-2354

 

Physical Therapy:

Matt Gilane, PT

Mercy Workcare

50th and Baltimore Avenue

Philadelphia, PA 19143

(215) 764-8500

 

Durable Medical Equipment:

Logos Medical Supply

5070 Parkside Avenue, Suite 2106

Philadelphia, PA 19131

(215) 452-5701

 

Ophthalmology:

Walter P. Harris, Jr., MD

255 South 17th Street

Philadelphia, PA 19103

(215) 545-5001

 

Orthopedic Surgery:

Craig L. Israelite, MD

University of Pennsylvania

Orthopaedic Institute Presbyterian Med.

51 North 39th Street

Philadelphia, PA 19104

(215) 662-3340

 

Radiology:

Michael Clair, MD - Raytel Imaging

Rittenhouse Square Imaging, P.C.

1705 Rittenhouse Square

Philadelphia, PA 19103

(800) 453-0574

Health Care Options Rate Table - 2007/08

Aetna HMO 15:
 

Coverage	Total Monthly Premium	Univ Pays (Monthly)	Employee Pays (Monthly)	Employee Pays (Bi-Weekly)	Employee Pays (9-Month Contract)	Univ Pays (9-Month Contract)
Single	501.03	486.03	15.00	6.92	20.00	648.04
P/Child(ren)	941.64	564.98	376.66	173.84	502.21	753.31
Emp/Spouse	1098.03	658.82	439.21	202.71	585.62	878.42
Family	1452.39	871.43	580.96	268.13	774.61	1161.91

Aetna HMO 5:
 

Coverage	Total Monthly Premium	Univ Pays (Monthly)	Employee Pays (Monthly)	Employee Pays (Bi-Weekly)	Employee Pays (9-Month Contract)	Univ Pays (9-Month Contract)
Single	509.69	494.69	15.00	6.92	20.00	659.59
P/Child(ren)	957.92	574.75	383.17	176.85	510.89	766.34
Emp/Spouse	1117.02	670.21	446.81	206.22	595.74	893.62
Family	1477.51	886.51	591.00	272.77	788.01	1182.01

Aetna Open Access:
 

Coverage	Total Monthly Premium	Univ Pays (Monthly)	Employee Pays (Monthly)	Employee Pays (Bi-Weekly)	Employee Pays (9-Month Contract)	Univ Pays (9-Month Contract)
Single	526.25	494.69	31.56	14.57	42.08	659.59
P/Child(ren)	987.94	574.75	413.19	190.70	550.92	766.33
Emp/Spouse	1153.32	670.21	483.11	222.97	644.15	893.61
Family	1506.05	886.51	619.54	285.94	826.05	1182.01

MetLife Dental:
 

Coverage	Total Monthly Premium	Univ Pays (Monthly)	Employee Pays (Monthly)	Employee Pays (Bi-Weekly)	Employee Pays (9-Month Contract)	Univ Pays (9-Month Contract)
Single	23.87	20.29	3.58	1.65	4.77	27.05
Family	59.54	20.29	39.25	18.12	52.33	27.05

Flexible Spending Accounts
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 (April - May).

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.

1. Based on past bills, predict what you will spend on eligible expenses in the coming plan year.
2. 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.
3. 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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