www.fgks.org   »   [go: up one dir, main page]

                Give Now

Health and Other Benefits

health and wellness

Health and Other Benefits

SMU offers a comprehensive benefits package to help protect you and your family. You need to take an active role in understanding and making thoughtful decisions about your benefits so you can be sure your choices support your needs and goals. To help you make informed benefits choices, SMU provides a number of resources including the Human Resources website, the Benefits Guide, and links to our plan administrators' websites.

  • Click on the tabs above to access additional information. 

  • To determine whether you, your spouse, or dependent children are eligible, please visit the Eligibility page linked to the right.

  • To see if you qualify for benefit changes due to a qualified life event, please visit the Life Events page linked to the right.

Important Health Plan Notices

The University is required by Federal law to make available to faculty and staff enrolled in the SMU Health & Wellness Plan (i.e., the Medical Plan), certain notices related to the Plan.  Below is a brief summary of the information provided in the Required Health Plan Notices.

  • Patient Protection Disclosure:  Explains policies regarding the designation of a Primary Care Provider (PCP) under the Plan.
  • Women's Health & Cancer Rights Act:  Explains the coverage provided, as required by law, for mastectomies.
  • Newborn & Mother Protection Act:  Explains the coverage provided, as required by law, for maternity hospital stays.
  • Medicare Part D Notice:  Provides information about your current prescription drug coverage with SMU and about your options under Medicare’s prescription drug coverage (in the event you are currently eligible for Medicare or are nearing eligibility for Medicare).  If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, Federal law provides additional choices for prescription drug coverage. 
  • COBRA Rights Notice:  Contains important information about your right to COBRA continuation coverage including when COBRA may become available and what you need to do to protect the right to receive it.
  • Special Enrollment Rights Notice:  Explains your right to enroll in the Plan under its “special enrollment provisions.”
  • Notice of Privacy Practices:  Explains how the SMU Health & Wellness Plan protects your personal medical information and outlines your legal rights.
  • Health Insurance Marketplace Notification:  Provides important information about the Health Insurance Marketplace and what the Marketplace means to you.

Health Plans

Medical Plan

SMU's Health and Wellness Plan, administered by Blue Cross/Blue Shield of Texas, includes several deductible options. All of the plans cover a wide variety of medical services, including office visits, prescription drugs, and inpatient and outpatient care.

Prescription Drug Plan

This section provides information on SMU's Prescription Drug Plan, administered by Prime Therapeutics. If participants enroll in one the SMU's Health and Wellness Plan PPO options, prescription drug coverage is included. Participants have the choice of purchasing their prescriptions through local retail pharmacies or through a mail order program.

Dental Plan

Administered by Blue Cross/Blue Shield of Texas, the Dental Preferred Provider Organization gives participants the ability to visit any dentist, without referrals for all of your dental care. If participants select of BCBSTX's network dentists, they will generally pay less for their care. Should they choose a dentist outside of BCBSTX's PPO network, the share of costs will be higher and may need to file their own claims.

Vision Plan

This section provides information on SMU's Vision Plan, administered by VSP. This plan offers access to a large network of participating optometrists and ophthalmologists plus a few select retain chains. Benefits include full examinations and access to lenses, frames, and contact lenses at discounted prices.

Spending Accounts

Flexible Spending Accounts

This section provides information on SMU's Flexible Spending Accounts. A FSA enables participants to pay for out-of-pocket health care or dependent daycare expenses with pre-tax payroll contributions. FSAs are exempt from federal taxes, Social Security (FICA) taxes and, in most cases, state income taxes. Tax savings and the effect on each paycheck will depend on the participant's situation (e.g. household income, tax bracket, and the amount participants contribute to the account), but the tax savings can be significant!

Health Savings Account

This section provides information on SMU's Health Savings Account. If you enroll in either the $2,600 or $5,000 High Deductible Health Plan (HDHP), you will be able to take advantage of a special tax-savings feature called a Health Savings Account (HSA). The HSA is a tax-free bank account used to help pay the cost of eligible out-of-pocket health care expenses.

Life Insurance, AD&D, LTD

Basic Group Life Insurance

This section provides information on SMU's Basic Group Life Insurance.  All regular full-time and part-time faculty and staff are eligible for coverage effective on the first day of active employment. This benefit is paid in full by SMU.

Supplemental Life Insurance

This section provides information on SMU's Supplemental Life Insurance. Employees can purchase Supplemental Life Insurance for themselves, their spouse, and eligible dependent children. Premiums are deducted from the participant's paycheck on a pre-tax basis.

Accidental Death and Dismemberment Plan

This section provides information on how participants can purchase SMU's Accidental Death and Dismemberment (AD&D) Insurance. Administered by Reliance Standard, the cost of AD&D insurance is paid through payroll deductions on an pre-tax basis. The benefit amount the participants receive varies according to the amount of coverage elected and the type of loss incurred.

Long-Term Disability (LTD)

This section provides information on SMU's Long-Term Disability Plan. This benefit are available to all full-time and part-time regular faculty and staff after 3 months of employment, and the cost is paid entirely by SMU.

Business Travel Insurance

This section provides information on SMU's Business Travel Accident Insurance for all full-time staff and faculty who are under age 75 and travel worldwide on business for the University. This benefit is provided at no cost to eligible staff and faculty. For additional information on this benefit contact SMU's Office of Risk Management

Long-Term Care Insurance

We try to plan for the surprises that life may bring in the future but even the most well-thought-out plans may not be enough to prepare us for the unexpected costs associated with long-term care.  According to LongTermCare.gov, a site provided by the U.S. Department of Health and Human Services, at least 70 percent of people 65 and older will need long-term care services at some time in their lives.  On average, eight percent of individuals between ages 40 and 50 have a disability requiring long-term care due to an accident or chronic illness.

Long-term care typically is not medical care, but rather the personal assistance you may need with the “activities of daily living” (i.e., bathing, eating, dressing, toileting, and mobility) as the result of an illness, an accident or the aging process.  It can also include the supervision needed with a cognitive impairment such as Alzheimer’s disease or Dementia. Because these services are not covered by your medical plan, you would have to pay for this care out of your own personal finances. Long-term care insurance (LTCI) is specifically designed to pay for that care so you don’t deplete your financial resources when this care is needed.

  • Medicare covers 100 days in a nursing home if you are recovering from an illness or injury and showing improvement, but does not cover care provided in your home or an assisted living facility.
  • Medicaid pays for care in a nursing home and some in-home assistance but only after you have all but exhausted your savings.

You and your eligible family members should consider applying for LTCI before you need it, as policies become either unavailable or prohibitively expensive once it becomes clear that you need the coverage.  SMU has three long-term care insurance plans, two with CNA and one with LifeSecure.  CNA LTCI is no longer available for new enrollments effective December 31, 2015.  LifeSecure LTCI was made available for new applications in February 2017.

LifeSecure LTCI

Individual policy underwritten by LifeSecure Insurance Company.  New employees interested in purchasing LifeSecure LTCI have 90 days from their hire date to apply for coverage with Simplified Underwriting.  

Visit the LifeSecure Long-Term Care website at  www.groupltci.com/smu to learn more, apply online, and get pricing information for you and your family.  You can also call the long-term care enrollment line at 844-554-7116 to speak with an enrollment counselor.

Resources
LifeSecure LTCI Frequently Asked Questions
LifeSecure LTCI Summary
LifeSecure LTCI Simplified Issue Insurability Questions
LifeSecure Sample LTCI Policy
LongTermCare.gov

CNA LTCI

CNA LTCI is no longer available for new enrollments effective December 31, 2015.  If you or a family member purchased CNA LTCI through SMU prior to this date, you are enrolled in one of the following policies.

  • Policy GLTC2, SMU Account # 9953-TQ, group policy underwritten by Continental Casualty Company: applies to employees and family members enrolled between January 1, 2001 and August 31, 2007.
  • Policy GLTC3, SMU Account # 9953-IS, group underwritten by Continental Casualty Company: applies to employees and family members enrolled between September 1, 2007 and
    December 31, 2015.  Policy may be referred to as Independent Solutions.
If you don’t have a copy of your CNA policy, it is important that you call CNA at 877-838-8508 to request a copy. Be sure to keep a copy with your important records.

Group Legal/Identity Protection

The LegalGUARD and PrivacyArmor plans are available to full-time and part-time benefits-eligible faculty and staff.  Although the plans are administered separately, they are available as a bundled arrangement at a monthly cost of $27.45.  This is a voluntary benefit that participants pay for via after-tax payroll deductions.

LegalGUARD Plan

Administered by LegalEASE and underwritten by Nationwide
(888) 416-4313
LegalGUARD Website

The plan provides access to quality legal services and protection from the high cost of legal fees. Finding the right type of attorney when a need arises can be one of the more stressful tasks when dealing with a legal matter.  LegalEASE uses their experience and relationships with their network attorneys to connect you with the right type of attorney, in the right location.

  • Covered family members include the employee’s spouse and unmarried dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 19, and from age 19 up to 25 years if they are enrolled in an accredited school or college as full-time student(s) and are primarily dependent upon the Member for support.
  • Covers attorney fees, up to plan limits, for:
    • Home:  Purchase, sale, refinancing, tenant dispute
    • Family:  Divorce, adoption, name change
    • Consumer:  Warranty, cell phone contract, bank fees, small claims court
    • Estate Planning:  Will, living will, power of attorney
    • Financial:  Debt, bankruptcy, foreclosure, tax audit
    • Criminal:  Serious traffic matters, misdemeanor defense

PrivacyArmor Plan

Administered by InfoArmor
(800) 789-2720

The plan provides a comprehensive and proactive defense against identity theft, with a focus on identity monitoring.  InfoArmor is capable of identifying anomalies indicative of fraudulent behavior up to 90 days sooner than credit monitoring.

  • Covers employee, spouse, and up to three dependents
  • Monitors data elements from sources such as credit cards, wireless accounts, retail credit accounts, auto/mortgage loans, check/check reorders, utility accounts, change of address requests
  • Provides comprehensive identity restoration services
  • $25K identity fraud reimbursement policy underwritten by Travelers Insurance

Legal & Identity Protection Resources

If you have additional questions, please read the InfoArmor Frequently Asked Questions.

Tuition Benefits Program

The University offers the Tuition Benefits Program to regular full-time faculty and staff employee, their spouse, and their children. This valuable benefit helps expand the horizons of employees and their families through higher education.

Please take the time to review the Tuition Benefits page and the Frequently Asked Questions page.

Affiliated Programs

COBRA

This section provides information on the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA). This allows for continued coverage for a certain period if an employee, spouse, or dependent child loses group Medical, Dental, or Vision coverage due to a qualifying life event.

Employee Assistance Program

This section provides information on SMU's Employee Assistance Program. Administered through Magellan Health Services, EAP is designed to provide confidential counseling and referral services for all full-time and part-time faculty/staff members and their eligible dependents. SMU pays the full cost of providing the EAP and no employee contributions are required for this program.

Leave of Absence and FMLA

This section explains the variety of leaves SMU offers to support employees with their life needs including adoption leave, extended leave (unpaid), maternity leave, military and civil leave, paid medical leave, and qualifying exigency leave. In addition, the Family and Medical Leave Act grants eligible employees the right to take 12 work weeks of job-protected leave over a rolling 12-month period for the qualified reasons.

Tuition Benefits

Southern Methodist University offers tuition benefits to regular, full-time faculty and staff, their spouse, and their dependents.

Unemployment Compensation

This section provides information on SMU's Unemployment Compensation Plan. Should an employee be terminated, they may qualify for weekly Unemployment Compensation payments while they look for a new job.

Workers' Compensation

This section provides information on SMU's Workers Compensation Insurance to protect faculty, staff and students who are injured while working for SMU.