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2016 Annual Benefits Enrollment 2
What’s New for 2016? 3
Benefits Overview 4
Health Plan 6
Dental Plan 8
Vision Plan 9
Vendor Contact Information 10
TABLE OF CONTENTS
2016 Annual Benefits Enrollment 2
What’s New for 2016? 3
Benefits Overview 4
Health Plan 6
Dental Plan 8
Vision Plan 9
Vendor Contact Information 10
• Marriage, divorce, legal separation or annulment
• Birth or adoption of a child
• Assumption of legal guardianship of a child
• Change in employment status for your spouse or dependent that affects benefit eligibility, including commencement or termination of employment, or change in worksite
• You or your dependent become eligible or lose eligibility for Medicare or Medicaid
• The death of your spouse or dependent
• Court ordered coverage of your child by you or your spouse, allowing you to add or drop the child’s coverage
• Change in your employment that affects benefits eligibility (working at least 20 hours per week)
• Loss of eligibility for a dependent, including graduation or reaching age limitations
QUALIFYING LIFE EVENTS
All employees wishing to make changes to existing coverage levels or enroll/re-enroll in the FSA program must complete the enrollment process during the period referenced above. If you do not, existing health, dental and/or vision coverage will be continued for 2016 and any FSA coverage will be discontinued as of January 1, 2016.
Benefit elections and/or modifications made during the annual enrollment period will be effective January 1, 2016, and will remain in effect for the entire calendar year (January 1st through December 31st). Mid-year changes are not allowed unless you experience a qualified life event and provide timely notification to HR-Benefits (within 30 calendar days of the event).
WHERE:
WHY:Your once-a-year opportunity to:
• Enroll in or change your health, dental and/or vision plan(s)
• Enroll or re-enroll in the Flexible Spending Account (FSA) program
• Enroll or re-enroll in the group legal program (paper enrollment)
• Update and/or verify your personal, covered dependent and emergency contact information
IT Services Help Desk: 8-7799
Password Reset: http://reset.mu.edu or Password Reset link on MyJob login page
Computers available in AMU from 11:00 a.m. - 2:00 p.m. during Employee Assistance Days (10/27, 11/4, 11/12) and outside of HR (Straz Tower #185) during business hours
Helpful Hint: Turn off pop-up blockers!
HELPFULENROLLMENTINFORMATION
On the MyJob website at http://myjob.mu.edu (uses the same username and password as eMarq)
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Monday, October 26 - Friday, November 13, 2015
2016 ANNUAL BENEFITS ENROLLMENT
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HEALTH PLAN • There will be a number of changes made to the EPO and PPO plans:
• Medical and prescription drug expenses will now be integrated under both plans. This means that, rather than a separate prescription drug deductible and out-of-pocket limit, the plan deductible and out-of-pocket limits will be shared between medical and prescription drug expenses.
• Urgent care and emergency room co-pays will be removed. These services will now be subject to deductible and coinsurance.
• In-Network outpatient imaging charges (for CT scans, MRIs, etc.) will now be subject to deductible and coinsurance. Outpatient lab and x-ray charges will continue to be covered under the office visit co-pay.
• There will be increases to premium contributions.
• While there are no plan design changes being made to the HDHP, there will be increases to premium contributions.
• If your spouse is enrolled in Marquette’s health plan, he/she must participate in the HRA process in order for you – the employee – to receive the 10% HRA premium discount. Your spouse’s participation does not affect your discount if he/she is not on your coverage. Covered children are not required to participate in the HRA.
DENTAL AND VISION PLANS • There are no plan design changes being made to the dental plan, only increases to premium
contributions.
• Annual digital retinal screenings will now be covered in full with no co-pay. Premium contributions remain unchanged.
WHAT’S NEW FOR 2016?
Benefit Description Paid by CostHealth Coverage for eligible medical and prescription drug
expensesShared (pre-tax) See Health Plan section
Dental Coverage for eligible dental expenses Shared (pre-tax) See Dental Plan section
Vision Coverage for eligible vision expenses Shared (pre-tax) See Vision Plan section
FSA: Health Care Allows you to set aside pre-tax dollars to reimburse eligible medical, prescription drug, dental and vision expenses
Contributions: You (pre-tax)
Contributions: Up to $2,550 per person per calendar year
FSA: Dependent Care
Allows you to set aside pre-tax dollars to reimburse eligible dependent child care expenses
Contributions: You (pre-tax)
Contributions: Up to $5,000 per household per calendar year
Basic Life/AD&D Insurance
Insurance protection in the event of your death or dismembermentCoverage amount: 1x annual salary rounded up to nearest $1,000
Marquette (for Full-Time employees)You (for Part-Time employees)
$0.145 per $1,000 of coverage
Optional Life Insurance
Insurance protection in the event of your deathCoverage amounts: Choice of an additional 1x, 2x or 3x your annual salary rounded up to nearest $1,000
You (after-tax) Varies based on age and coverage amount selected Note: Calculators included on benefits website
Short-term Disability
Exempt: One 100% pay day accrued for each month worked (up to 130 days); 75% pay after 100% days are exhausted; benefits payable for up to 26 weeks
Non-exempt: Two 100% pay days accrued for each month worked (up to 70 days); Elimination Period of 12 weeks (Sick Pay applies during this time); 0% pay after 100% days are exhausted
Marquette
Long-term Disability (Full-Time only)
Income protection in the event of your disabilityCoverage amount: 65% of pre-disability earnings to maximum of $12,000/month; 180-day Elimination Period; includes retirement contribution and cost of living benefits
Shared (after-tax) $0.48 per $100 of covered earnings (shared equally between you and Marquette)
Long-term Care
Insurance protection in the event you need long-term home health, assisted living or nursing home care
You (after-tax) Varies based on age and option(s) selected
Business Travel Accident
Provides 24-hour worldwide business travel protection
Marquette
EAP 24/7 access to professional counselors to assist with stress, work issues, relationship issues, financial issues, alcohol/drug abuse and/or work/life balance
Marquette
Group Legal Attorney access to assist with various legal matters You (after-tax) $21.00 per month
Retirement Plan After-tax or tax-deferred savings plan for financial needs during your retirement
Contributions: Shared (after-tax or tax-deferred)
Defined Contribution(pre-tax): Upon eligibility,Employee = 5%Marquette = 8%
Marquette University provides a variety of benefits to help protect your health, well-being and income. Upon meeting eligibility requirements, some benefits are provided automatically and at no cost to you while others allow you to elect and contribute – partially or totally – toward the cost. This allows you to choose the benefits that best meet your needs and lifestyle.
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BENEFITS OVERVIEW
The benefits shown on the previous page are offered to all full-time regular, full-time limited term (min-imum of 1-year academic/calendar year contract) and part-time regular employees (working a minimum of 20 but less than 37 ½ hours per week) with the exception of Long-term Disability, which is offered to full-time employees only. Dependents can be covered under the health, dental and vision plans. Eligible dependents include:
BENEFITS OVERVIEW
Health Dental/Vision
• Your legal spouse
• Your legal child(ren): includes your natural or adopted child(ren), stepchild(ren) or any child for whom you have legal custody. They are eligible:
- Until the end of the month in which they turn age 26
- Regardless of age, if fully disabled and unmarried, provided he/she was or became fully disabled while they met the definition of a dependent child under the plan
• Your legal spouse
• Your unmarried, legal child(ren) who meet residency and tax dependency requirements: includes your natural or adopted child(ren), stepchild(ren) or any child for whom you have legal custody. They are eligible:
- Until the end of the month in which they turn age 19
- Until the end of the month in which they turn age 25 or graduate (whichever is earlier) if attending high school or an accredited institution of higher education as a full-time student
- Regardless of age, if fully disabled, provided he/she was or became fully disabled while they met the definition of a dependent child under the plan
CONTINUED
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As a Marquette University employee, you have access to comprehensive health care coverage to protect you and your family from catastrophic medical costs. In this section, you will find information on the three plans that Marquette offers. All plans use the same provider network (UnitedHealthcare Choice Plus) and cover the same services, but there are key differences in the way the cost for services is shared between you and the plan in regard to deductibles, co-pays and coinsurance. Take the time to understand how these plans work, the coverage each provides and how to use them to best meet the needs of you and your family.
EPO Plan PPO Plan HDHPIn-Network Out-of-
Network In-Network Out-of-Network In-Network Out-of-
NetworkYour Deductible Single Employee+1 or Family
$625$1,250
$1,250$2,500
$1,250$2,500
$2,500$5,000
$4,000$8,000
$8,000$16,000
Your Coinsurance Percentage 20% 40% 20% 40% 20% 40%
Your Out-of-Pocket Maximum Single Employee+1 or Family
$3,000$6,000
$6,000$12,000
$4,000$8,000
$8,000$16,000
$5,000$10,000
$10,000$20,000
Preventive Care (Wellness Schedule Applies)
Plan pays 100% Ded/Coins
Plan pays 100% Ded/Coins
Plan pays 100% Ded/Coins
Office Visit Co-Pay Primary Care Specialist
$25$50
Ded/CoinsDed/Coins
$25$50
Ded/CoinsDed/Coins
Ded/CoinsDed/Coins
Ded/CoinsDed/Coins
Urgent Care Co-Pay Ded/Coins Ded/Coins Ded/Coins Ded/Coins Ded/Coins Ded/Coins
Emergency Room Co-Pay (Life and Limb threatening) Ded/Coins
Same as In-Network Ded/Coins
Same as In-Network Ded/Coins
Same as In-Network
Hospital Inpatient (Room and Board) Ded/Coins Ded/Coins Ded/Coins Ded/Coins Ded/Coins Ded/CoinsPrescription Drug Your Deductible Single Employee+1 or Family
Your Coinsurance Generic Formulary Brand Non-formulary Brand Your Out-of-Pocket Maximum Single Employee+1 or Family
Included with MedicalIncluded with Medical
10%30%40%
Included with MedicalIncluded with Medical
Included with MedicalIncluded with Medical
10%30%40%
Included with MedicalIncluded with Medical
Included with MedicalIncluded with Medical
10%30%40%
Included with MedicalIncluded with Medical
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HEALTH PLAN
All (Medical and Prescription Drug) out-of-pocket expenses included in Out-of-Pocket Maximum (Deductible, Coinsurance and Co-Pays).
EPO Plan PPO Plan HDHPCoverage Tier HRA Non-HRA HRA Non-HRA HRA Non-HRASingle $147 $165 $103 $114 $19 $21Employee+1 $342 $380 $238 $263 $51 $57Family $404 $450 $281 $311 $85 $95
2016 FULL-TIME EMPLOYEE MONTHLY CONTRIBUTIONS
BENEFITS COMPARISONPlease refer to rate sheet included in enrollment packet for part-time contributions.
HOW THE HDHP WORKS1. GET PREVENTIVE CARE FREE
In-Network preventive care is covered at 100%. You pay $0 out-of-pocket for your annual physical, routine immunizations and other recommended age- and gender-specific preventive screenings.
2. PAY FOR OTHER HEALTH CARE EXPENSES
You pay the full (discounted) cost for other medical and prescription drug expenses as you incur them until your annual deductible is met. Then, you pay a percentage of eligible expenses until your annual out-of-pocket maximum is satisfied. There are no co-pays under the HDHP.
3. USE YOUR HEALTH SAVINGS ACCOUNT (HSA)
Your HSA helps you cover your deductible and pay for other health care costs. Unused funds from your HSA roll over to the next year, and your account balance may earn interest (tax-free) over time. Please note that setting up an HSA is something you must do on your own, it is not facilitated by Marquette University.
TO QUALIFY FOR AN HSA:1. You must be enrolled in the HDHP.
2. You cannot be covered by Marquette’s FSA or a spouse’s FSA.
3. You cannot be covered by any other medical plan, including Medicare A and/or B.
4. You cannot be claimed as a dependent on someone else’s tax return.
WHAT’S DIFFERENT ABOUT AN HSA? • You are only eligible to open and contribute to an HSA if you participate in the HDHP. The money
you contribute is yours and is portable; it goes with you to be used for qualified medical expenses if you leave Marquette or when you retire.
• If you are enrolled in the HDHP, you may not participate in the Health Care FSA. However, you can pay for eligible medical, prescription drug, dental and vision expenses with your HSA dollars.
• If you are enrolled in the HDHP, you may still participate in the Dependent Care FSA.
ADDITIONAL HSA FEATURES • Withdrawals from HSAs for qualified medical expenses are tax-free. If you withdraw money for
any reason other than qualified medical expenses, you must pay income tax and a 20% IRS tax penalty.
• You must have a balance in your account to make a withdrawal.
• The maximum you can contribute to an HSA in one year is set by the IRS (in 2016, $3,350 for single coverage and $6,750 for family coverage). If you are age 55 or older, you can contribute additional catch-up contributions. It is your responsibility to make sure your HSA contributions do not go over the IRS maximum.
Important: In accordance with IRS regulations, if you are a new enrollee in the HDHP for 2016 (i.e., switching from the EPO or PPO Plan) and you have a balance in a Health Care FSA (as of December 31, 2015), you are not eligible to contribute funds to an HSA until April 1, 2016. Make sure your FSA balance is $0 by December 31, 2015.
HEALTH PLAN CONTINUED
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8
DENTAL PLAN2016 FULL-TIME EMPLOYEE MONTHLY CONTRIBUTIONS
BENEFITS COMPARISON
Single Employee+1 Family$10.30 $25.60 $33.20
Delta Premier or PPO Dentist
Marquette Dental School – Faculty
Marquette Dental School – Student
Individual Annual Maximum $2,500 $2,500 $2,500DeductibleSingleEmployee+1Family
$50$100$150
$0$0$0
$0$0$0
Diagnostic and Preventive ServicesExams 100% 100% 100%Cleanings 100% 100% 100%Fluoride Treatments 100% 100% 100%X-rays 100% 100% 100%Space Maintainers 100% 100% 100%Sealants 100% 100% 100%Emergency Treatment to Relieve Pain 100% 100% 100%Deductible Applies? No No NoBasic and Major ServicesFillings 80% 90% 100%Endodontics 80% 90% 100%Periodontics 80% 90% 100%Extractions 80% 90% 100%Occlusal Guards 80% 90% 100%Crowns, Inlays, Onlays 60% 80% 100%Bridges and Dentures 60% 80% 100%Implants 60% 80% 100%Deductible Applies? Yes No NoOrthodontic ServicesCoverage Co-payment 60% 100% 100%Individual Lifetime Maximum $2,500 $2,500 $2,500Dependents Eligible to Age 19 19 19Full-Time Students Eligible to Age 25 25 25Adult Ortho Yes Yes YesDeductible Applies? Yes No No
Please refer to rate sheet included in enrollment packet for part-time contributions.
Benefits for services received by Out-of-Network providers mirror those of the Delta Premier or PPO dentists but without discounts and the possibility of balance billing.
VISION PLAN
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2016 FULL-TIME EMPLOYEE MONTHLY CONTRIBUTIONS
BENEFITS COMPARISON
Single Employee+1 Family$1.50 $3.40 $4.00
VSP Provider Other Providers FrequencyVision Exam Covered in Full Covered up to $44 Once each Plan Year
Prescription GlassesSingle Vision Lenses Covered in Full Covered up to $32 Once each Plan YearLined Bifocal Lenses Covered in Full Covered up to $48 Once each Plan YearLined Trifocal Lenses Covered in Full Covered up to $64 Once each Plan YearProgressive Lenses Covered in Full after $40
Co-payCovered up to $48 Once each Plan Year
Polycarbonate Lenses for Dependent Children Covered in Full Not Covered Once each Plan Year
Frames Covered in Full up to $170 (featured brands) or $150
(other brands)
Covered up to $38.25 Once Every Other Plan Year
Contact Lens Care (instead of glasses)Contacts Covered in Full up to $150 Covered up to $100 Once each Plan YearContact Lens Exam (fitting and evaluation) Up to $60 Co-pay Not Covered Once each Plan Year
Primary Eye Care
Treatment and Diagnosis of Eye Conditions Covered in Full Not Covered As Needed
Extra Discounts and SavingsGlasses and Sunglasses 20% savings on additional glasses and sunglasses, including lens
enhancements, from any VSP provider within 12 months of your last Vision Exam
Retinal Screening $0 co-pay on annual routine retinal screening as an enhancement to a Vision Exam
Laser Vision Correction Average 15% off regular price or 5% off promotional price; discounts only available from contracted facilities
Please refer to rate sheet included in enrollment packet for part-time contributions.
VENDOR CONTACT INFORMATION
Plan Administrator Website PhoneMedical
• Coverage questions
• Customer service
• ID card request
• Claim information
• Network information
• Pre-authorization
UMR
(UnitedHealthcare Choice Plus network)
www.umr.com 1-800-826-9781
1-800-808-4424
Prescription Drug Express Scripts www.express-scripts.com 1-800-711-0917
Dental Delta Dental www.deltadentalwi.com 1-800-236-3713
Vision Vision Service Plan (VSP) www.vsp.com 1-800-877-7195
FSA EBC www.ebcflex.com 1-800-346-2126
Life/AD&D Insurance MetLife www.metlife.com 1-800-638-6420
Short-term Disability Marquette University www.marquette.edu/hr/benefits 1-414-288-7305
Long-term Disability Northwestern Mutual Life www.nml.com 1-414-271-3242
EAP Aurora Behavioral Health www.aurora.org/eap 1-800-236-3231
MetLaw Group Legal Hyatt Legal Plans www.legalplans.com 1-800-821-6400
403(b) Retirement Plan TIAA CREF www.tiaa-cref.org 1-800-842-2776
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ABOUT THIS GUIDEThis guide describes the benefit plans available to you as an employee of Marquette University. The details of these plans are contained in the official plan documents, including some insurance contracts. This guide is meant only to cover the major points of each plan. It does not contain all of the details that are included in your Summary Plan Description (SPD) (as described by the Employee Retirement Income Security Act).
If there is ever a question about one of these plans, or if there is a conflict between the information in this guide and the formal language of the plan documents, the formal wording in the plan documents will govern.
Please note that the benefits described in this guide may be changed at any time and do not represent a contractual obligation on the part of Marquette University.
Have a question about one of your benefits? Keep this guide handy for a quick reference for all your benefit needs. If you still have questions, please contact the Marquette University Human Resources Department at (414) 288-7305.