life insurance program employee basic employee supplemental

dependent

disability insurance program short-term disability long-term disability

child/adult day care FSA

leaves and holidays

qualified tuition reduction

voluntary benefit plans

financial security

2015–2016 benefits guide

Revised 5-25-16

2

Life Insurance Program

Basic Life

The university provides benefits eligible faculty and staff with a group term life insurance policy equal to one times your annual salary (rounded to the next $1,000), up to a maximum of $400,000.

Basic Life (Group Term Life)

BOTH PAID BY ASU

Aetna An ASU Plan

The Hartford A State of Arizona Plan

Coverage Amount One times your annual base earnings (rounded up to the next $1,000) less the $15,000 state-sponsored plan (The Hartford); Minimum coverage $5,000; Maximum coverage $385,000 Age Reductions Coverage reduces by 60 percent of the original amount at age 70 and by 75 percent of the original amount at 75

• Age 70-74 Reduction Formula Annual salary x coverage level, rounded to the nearest $1,000, x .40

• Age 75+ Reduction Formula Annual salary x coverage level, rounded to the nearest $1,000, x .25

Reduced coverage is effective the first day of the pay period in which the 70th or 75th birthday occurs.

$15,000

Accidental Death & Dismemberment

Included only with Employee Supplemental coverage $15,000

Arizona State Statute

Aetna Coverage for a spouse may not be more than 100 percent of the combined Aetna Basic and Supplemental coverages on the life of the faculty or staff member. The Hartford Dependent coverage may not be more than 100 percent of the combined Harford Basic and Supplemental coverages on the life of the faculty or staff member.

Designate Your BeneficiariesYour life insurance plan enrollments must be processed before you can designate a beneficiary.

It is important to designate primary and secondary (contingent) beneficiaries for your life insurance policies. The pri-mary beneficiary is the person, organization or legal entity who will receive the proceeds of your life insurance policy when you die. The secondary (contingent) beneficiary is the person, organization or legal entity who will receive the proceeds of your life insurance policy when you die, if your primary beneficiary predeceases you. LEARN MORE

3

Employee Supplemental Life and Accidental Death and Dismemberment

Within 30 calendar days of your eligibility/hire date, or a qualified life event or during the annual Open Enrollment, you can purchase additional term insurance for yourself through payroll deduction. You can choose to participate in one or both pre-tax plans.

Aetna

You may purchase this group term insurance in increments of 1, 2 or 3 times your annual salary not to exceed $1,000,000. Coverage over $500,000 requires evidence of good health. This coverage includes both accidental death and dismemberment and retiree life benefits and is rounded up to the next $1,000.

After your initial 30-day enrollment period, due to a qualified life event or during Open Enrollment:• If enrolled, you may increase your coverage one level (if less than $500,000) without evidence of good health;

you may increase your coverage a second level with evidence of good health.• If electing for the first time, you may choose 1, 2 or 3 times your annual salary with evidence of good health.

The Hartford

You may purchase this group term insurance in increments of $5,000, not to exceed three times your annual salary or $500,000, whichever is less. This coverage includes an accidental death and dismemberment benefit. Non-smokers will receive an additional $1,000; eligibility is determined when a claim for death benefits is filed.

After your initial 30-day enrollment period, you may elect or increase your coverage up to $20,000 maximum as a result of a qualified life event or during Open Enrollment.

Employee Supplemental Life Insurance premiums are based on your age on Jan. 1 each year and are deducted on a pre-tax basis. Therefore, the value (not the amount) of life coverage you have over $50,000 is taxable as determined by the IRS. Imputed income is the term the IRS applies to the value of any benefit or service that should be considered income for the purposes of calculating federal tax. Even though imputed income adds to your taxable wage base, the increase is normally offset by the benefit of having pre-tax deductions.

Supplemental Life (Group Term Life)

Aetna The HartfordCoverage Options: One, two or three times your annual base earnings (multiplied by coverage level, then rounded up to the next $1,000).

Coverage Limits: $10,000 minimum; $1 million maximum; Guaranteed Issue Amount: $500,000 without evidence of good health

Age Reductions: Coverage reduces by 60 percent of the original amount at age 70 and by 75 percent of the original amount at 75

• Age 70-74 Reduction Formula: Annual salary x coverage level, rounded to the nearest $1,000, x .40

• Age 75+ Reduction Formula: Annual salary x coverage level, rounded to the nearest $1,000, x .25

Reduced coverage is effective the first day of the pay period in which the 70th or 75th birthday occurs.

Coverage Options: Available in $5,000 increments

Coverage Limits: Three times your annual salary or $500,000, whichever is less

Guaranteed Issue Amount: Same as Coverage Limits Above

Designate Your BeneficiariesSee p. 2 for more info

4

Life Insurance Program

Aetna The HartfordAge Rate (per month) Age Rate (per month)< 25

25-29

30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+

$0.056$0.062$0.067$0.077$0.098$0.135$0.198$0.307$0.370$0.689

<3030-3435-3940-4445-4950-5455-5960-6465-6970+

$0.08$0.10$0.11$0.19

$0.26

$0.42$0.60$1.08$1.08

$1.71

Supplemental Life Cost Per $1000 of coverage

Supplemental Life Premium Calculation Example

Aetna An ASU Plan

The Hartford A State of Arizona Plan

Determine Coverage Amount:Base annual earningsMultiply by 1X, 2X or 3X.Round up to the next highest $1000Divide by $1000Multiply by age-based rate.

Example: Age 53Base annual earning = $99,800Multiply by 2x = $199,600Round up to next highest $1,000 = $200,000Divide by $1000 = $200Multiply by monthly premium rate $.198 = $39.60 per monthMultiply by 12 months = $475.20 per yearDivide by 26 pay periods = $18.28 per pay period

Determine Coverage Amount:Determine coverage option (increments of $5,000) Divide by $1,000Multiply by age-based rate

Example: Age 53Coverage option: $100,000Divide by $1,000 = $100Multiply by premium rate $.520 = $52.00 per monthMultiply by 12 months = $624.00 per yearDivide by 26 pay periods = $24.00 per pay period

5

Supplemental Retiree Life Insurance CoverageIf you are enrolled in Aetna Supplemental Life Insurance at the time of your retirement from ASU, you may be eligible for one of the following Aetna Retiree Life Insurance plans:

Aetna An ASU Plan

The Hartford A State of Arizona Plan

If employed at least 10 years but less than 15 years, the retiree can purchase a $5,000 retiree/$2,000 spouse/$1,000 child policy at group rates.

If employed at least 15 years, the retiree will receive a $5,000 retiree/$2,000 spouse/$1,000 child policy paid by the university.

Not Applicable

Accidental Death and DismembermentAetna

An ASU PlanThe Hartford

A State of Arizona PlanAvailability With Supplemental Coverage only With Basic, Supplemental and

Dependent CoverageCoverage Equal to Supplemental

Coverage amountEqual to Basics, Supplemental or Dependent coverage amount

Child Education Benefit √ √Spouse Education Benefit √ √Passenger Restraint and Airbag √ √Passenger Restraint and Airbag √ √Child Care Benefit √ √Coma Benefit √ √

6

Life Insurance Program continued

Dependent Life

Within 30 calendar days of your eligibility/hire date or a qualified life event or during the annual Open Enrollment period, you can purchase additional term insurance for your eligible dependents through payroll deduction. You can choose to participate in one or both after-tax plans. See the plans comparison on the following pages for coverage options and Arizona State statute limitations.

• Married faculty or staff members who both work for an Arizona university or state agency may not elect The Hartford Dependent Life; this restriction does not apply to Aetna Dependent Life.

• You are automatically the beneficiary of your dependent life insurance plan(s).

Aetna

After your initial 30-day enrollment period, due to a qualified life event or during Open Enrollment:• If enrolled, you may increase your coverage one level ($25,000/12,500 maximum) without evidence of good health.

You may increase additional levels or choose the $50,000/$25,000 level with evidence of good health.• If electing for the first time, all coverage levels require evidence of good health.

The Hartford

After your initial 30-day enrollment period, due to a qualified life event or during Open Enrollment, you may elect any level of coverage.

Dependent Life (Group Term Life)

Aetna An ASU Plan

The Hartford A State of Arizona Plan

Coverage Amount Spouse and each child

Rate (Per Pay Period/Per Month

Coverage Amount Spouse and each child

Rate (Per Pay Period/Per Month)

Spouse $5,000Child(ren) $2,500

$1.05/$2.28 $2,000 $0.43/$0.94

Spouse $15,000Child(ren) $7,500

$3.16/$6.84 $4,000 $0.87/$1.88

Spouse $25,000Child(ren) $12,500

$5.26/$11.39 $6,000 $1.30/$2.82

Spouse $50,000Child(ren) $25,000

(Requires evidence of good health)

$10.52/$22.79 $10,000 $2.17/$4.70

$12,000 $2.60/$5.64

$15,000 $3.25/$7.05

$50,000Requires The Hartford

$35,000 Supplemental Life Minimum

$10.85/$23.50

7

Disability Insurance Program | Short-term DisabilityA group short-term disability (STD) insurance plan provides income replacement up to six months if you are out of work for a non-occupational accident or illness. Within 30 calendar days of your eligibility/hire date, a qualified life event or during the annual Open Enrollment period, you have two options for coverage.

UnumAn ASU Plan (Effective 9.1.14)

The HartfordA State of Arizona Plan

(Effective 1.1.15)Maximum Covered Salary Option A: $55,714

Option B: $111,429 Option C: $148,571

$60,000

Weekly Tax-free Benefit Pays 70 percent of your actual salary or the maximum covered salary of your chosen option, whichever is less, up to the maximum of :

• Option A – up to $750• Option B – up to $1500• Option C – up to $2000

Pays 66⅔ percent of base pay, up to a maximum of $769.27 REDUCED by the amount of any paid leave benefit received from ASU Payroll while you are collecting short-term disability benefits

Group Life/Accidental Death and Dismemberment

$5,000 life plus $5,000 AD&D Upon separation from employment, portable or convertible to individual policy

None

Coordination of Benefits IMPORTANT INFORMATION READ CAREFULLY

None, except paid parental leave and compassionate transfer of leaveYou can receive BOTH Unum STD benefit and ASU paid leave benefit

Benefit payment is REDUCED by 100 percent of any paid leave benefit after elimination period. As a result, you may receive only the $57.69 minimum benefit under The Hartford plan

Benefits Begin • First day if hospitalized for 24 hours or more or if outpatient surgery

• 31st day if not hospitalized

MORE INFO Unum STD Document

Unum Life and AD&D Document

• First day if disability is due to an injury • 31st day if due to illness/childbirth

If coverage is elected after the initial new hire/eligibility enrollment period and disability begins during first 12 months of coverage, benefits start on the 61st day if disability is due to illness or pregnancy

MORE INFO The Hartford Plan Document

Pregnancy Benefits • Normal birth: Pays up to six (6) weeks• C-section: Pays up to eight (8) weeks• See Pre-existing Conditions below

Normal birth: Pays from day 31 up to day 42C-section: Pays from day 31 up to day 56

Minimum Weekly Benefit None $57.69Maximum Weekly Benefit 26 weeks Disability due to injury: 26 weeks

Disability due to illness: 22 weeks if benefits start on day 31 or 18 weeks if benefits start on day 61

Pre-existing Condition Exclusion

A pre-existing condition is not covered the first six (6) months after initial election or after option level increaseEXCEPTION: Pregnancy is not considered a pre-existing condition. Can elect while pregnant and collect benefits when baby is born. However, pregnancy complications are considered a pre-existing condition.

None

8

UnumAn ASU Plan (Effective 9.1.14)

The HartfordA State of Arizona Plan

(Effective 1.1.15)Recurring Disability Benefits Periods of disability due to the same

cause count as one (1) period, unless separated by six (6) months or more of full-time active work

Periods of disability due to the same cause count as one period unless separated by 30 days or more

Return-to-work Benefits Benefits will stop if working in any capacity

Partial benefits paid if working less than full-time

Premium Waiver Premiums waived while collecting benefits

Premiums waived while collecting benefits

Premium Cost $.71 per $100 of base pay $.65 per $100 of base payPremium Calculation Examples Option A

Divide your salary or $55,714 (whichever is less) by 100Multiply by x $.71 Divide by 12 (per month) or 26 (per pay period)

Option BDivide your salary or $111,430 (whichever is less) by 100Multiply by $.71Divide by 12 (per month) or 26 (per pay period)

Option CDivide your salary or $148,571 (whichever is less) by 100Multiply by $.71Divide by 12 (per month) or 26 (per pay period)

Divide your salary by 100Multiply by $.65Divide by 12 (per month) or by 26 (per pay period)

Disability Insurance Program | Short-term Disability continued

9

10

Disability Insurance Program | Short-term Disability continued

11

Disability Insurance Program | Long-term Disability

A group long-term disability (LTD) insurance plan provides income replacement if you are out of work for a non-occupational or occupational accident or illness for over six months. Your LTD coverage is included with your mandatory retirement plan: ASRS, ORP or PSPRS.

For ASRS Participants For ORP and PSPRS Participants

Sedgwick CMS The HartfordMaximum Benefit Period Depends on age when disability

occursDepends on age when disability occurs

Monthly Benefit Pays 66⅔ percent of base pay as of date of disability, reduced by Deductible Income*.

Minimum monthly benefit of $50.

Pays 66⅔ percent of base pay as of date of disability, reduced by Deductible Income*

Minimum monthly benefits $100 or 10 percent of your LTD Benefit before reduction by Deductible Income, whichever is greater.

Maximum $10,000 before reduction by Deductible Income.

Benefits Begin Begins on day 181 of a continuous disability

Benefit is paid monthly

50 percent of the claim payment is taxableMORE INFOASRS LTD Plan Document

Begins on day 181 of a continuous disability

Benefit is paid monthly

Claim payments are fully taxable

MORE INFO ORP/PSPRS LTD Plan Document

Pre-existing Condition Exclusion 12-month pre-existing condition limitation

12-month pre-existing conditionlimitation

Recurring Disability Benefits Periods of disability due to the same cause count as one period, unless separated by six (6) months or more of full-time active work

Periods of disability due to the same cause count as one period unless separated by 30 days or more

Return to Work Benefits Partial benefits if working 80 percent or less

Partial benefits if working 80 percent or less

Rates (effective 6.23.14) .12 percent of your gross salary No cost to you

Contact Information Sedgwick CMS1-800-495-9301

The Hartford 1-800-523-2233

*Deductible Income: Social Security Disability benefits paid to employee or to eligible family members; Social Security Retirement benefits paid to employee or spouse; Retirement benefits from a current public service retirement plan; workers’ compensation benefits; ASU sick leave; and any other benefits listed in either the ORP/PSPRS Plan Document or ASRS Plan Document located on the Short- and Long-term Disability Insurance Plans web page.

12

Child/Adult Day Care Flexible Spending Account (FSA)

Within 30 calendar days of your eligibility/hire date or a qualified life event or during the annual Open Enrollment period, you may contribute up to $5,000 per household on a pre-tax basis during your period of participation in the calendar year. This plan covers your eligible child or adult day care expenses necessary to allow you and your spouse, if married, to work, look for work or attend school full-time.

Please refer to page 3 of the Benefits Guide | Administration for more information about coverage effective dates.Eligible dependents are:

• Children under the age of 13 who share the same residence with you, or• Your spouse or qualifying child/relative who is physically or mentally unable to care for him/herself who

shares the same residence with you and has income less than the federal exemption amount.

NOTE: This plan may reimburse you for expenses like day care facilities and pre-schools. The provider’s Tax ID or Social Security Number is required. This plan is not used to pay your dependents “non-reimbursed medical ex-penses.” See the Healthcare Accounts section of the Benefits Guide | Health.

The Use It or Lose It RuleUnused funds do not roll over from year-to-year, so estimate your expenses carefully. Claims must be submitted by April 30 each year for eligible expenses incurred in the previous year.

ELIGIBLE EXPENSES Visit ASIFlex online.

A new annual election is required each year during Open Enrollment for the next calendar (plan) year.

ASIFlex

ASIFlex Mobile App

FSA Store

FSA Frequently Asked Questions

FORMSFSA Forms

PLAN DOCUMENTSFSA Plan Document 2nd Amendment3rd Amendment

FSA Participant Plan Info

Useful Links

13

Leaves and Holidays

The university offers a variety of leave benefits plans (paid time off), paid holidays and paid or unpaid leaves of absence.

Visit Leaves Management online for inforamtion about these leaves of absence:• Birth/Placement for Adoptions or Foster Care/Bonding• Employee Health• Family Member Health• Employee Personal• Employee Military

ASU POLICIES ONLINE Click on the links below to read the policies

SPP Policies Faculty ACD Policies Type of Leave or Leave Benefits701-01 702-02 Sick Leave/Health-related702-01 704-02 Vacation702-04 704-03 Compassionate Transfer703-01 Holidays704-01 Voting704-02 Emergency 704-03 706 Jury Duty/Material Witness Service704-05 702-03 Bereavement704-06 Administrative (with pay)705-01 707 Extended or Regular (without pay)705-02 702-03 Family

706 708 Military708 710 Parental

14

Qualified Tuition Reduction Plan

This program allows a reduced in-state tuition fee for credit courses at any of the Arizona University System institutions (Arizona State University, Northern Arizona University or The University of Arizona).

• Benefits-eligible faculty and staff, their legal spouses and dependent children;• Eligible retirees, their spouses and dependent children who:

• Complete at least five year of continuous, full-time employment in the Arizona University System imme-diately preceding retirement;

• Are at least age 50 (or age 41 if PSPRS member);• Are receiving a retirement annuity under an Arizona university-sponsored retirement program; and• Have not been involuntarily terminated from employment by the university for cause;

• Long-term disability participants who had at least five continuous years of employment immediately preceding separation, their spouses and dependent children; NOTE: Applicable only while receiving LTD benefits.

• Certain employees of affiliated units, their spouses and dependent children;• Eligible spouses and dependent children of deceased employees

Eligibility, Credit Hour Limits and FeesFall/Spring Semesters Winter/Summer Sessions

Eligibility Credit Hours Fee Credit Hours Fees• An employee of at least 50 percent FTE• An employee on approved leave • A retiree• Spouses of above

1 - 9

10 or more

$25

Actual in-state tuition for all hours

over 9

1 - 6

7 or more

$25

Actual in-state tuition for all hours

over 6• Dependent children of above All 25 percent

of actual in-state tuition for all hours

All 25 percent of actual in-state

tuition for all hours

Tuition Reduction Forms

Download a Qualified Tuition Reduction form or pick one up at:OHR Employee Service Center, Tempe University Center (UCNTRA), 1100 E. University Drive.

855-278-5081 | Ask HR

Grandfathered Domestic Partners and their Families

Same-sex and opposite-sex domestic partners and their family members who have been certified by the Provost’s Office prior to Nov.1, 2014, are eligible for the ASU Tuition Program. Elizabeth King in the Provost’s Office can assist you with your inquiries and tuition reduction forms at: elizabeth.ann.king@asu.edu 480-965-7405

15

The waiver amount for undergraduate classes is not taxable if the student is enrolled in an undergraduate degree program.

Employees enrolled in graduate-level programs are subject to taxation on any level of class when the discounted tuition amount exceeds $5,250 within the tax calendar year. The full amount of the tuition discount on any level of classes taken by eligible family members enrolled in graduate-level programs is taxable to the employee. Refer to the bottom of the Qualified Tuition Reduction Program form for more details.

In general:• Spring spouse/dependent waivers are taxed in March, April and May.• Summer spouse/dependent waivers are taxed in August, September and October.• Fall spouse/dependent waivers are usually taxed in October, November and December.

Employee-only waivers exceeding the $5,250 threshold amount within the same tax calendar year are taxed on only the amount that exceeds the $5,250 threshold. It can occur at any point in the year, but most employees do not exceed the threshold until the Fall semester and are taxed in November and December

Taxation

16

Voluntary Benefit Plans

Auto/Home/Other Liability Insurance

MetLife Auto & Home® offers group rates for auto, home, renters, condo, recreational vehicle, boat, fire, mobile home, personal excess and landlord’s rental coverages to all faculty, staff and student employees.

MetLifeGet a quote in two minutes or less 855-975-3329Xcelerate

Customer Service 800-438-6388 More Info

Identity Theft Protection

ASU has two options available for employees: • LifeLock • AllClear ID

LifeLock, an Arizona-based company with a $1 million guarantee, provides services to all faculty, staff and student employees at an exclusive discount of 50 percent off the normal membership rate.

LifeLock 800-543-3562 | Online Promotion Code: ASUEMPLOYEE1 Member ID: Your ASU Employee identification number for information and enrollment.

AllClear ID is a free service that provides automatic identity repair assistance. It is available to all current and retired faculty and staff, as well as students, applicants and their parents. Learn more

AllClear ID855-434-8075 | Online ASU Code: ASU458

Long-term Care Insurance

A long-term care plan is a great way to help preserve your assets, protect your independent way of life and give you peace of mind. This coverage can help you afford the type of care you or someone you love may need some day if you are unable to perform some daily living tasks without assistance. Choices include coverage for assisted living/residential care facilities, adult day care, in-home care and nursing home care. Coverage is available for you and your eligible dependents. Coverage is available to all benefits-eligible faculty and staff and their eligible dependents.

Unum1-800-227-4165