Welcome to Luther College

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Benefits

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Your Benefits in a NutshellBenefit Full-

TimePart-Time

100% paid by Luther College

Employee Shared

Premium

100% paid by Employee

Health Care Yes Prorated Group Term Life(employees must work minimum of 20 hrs/wk to be eligible) Yes Yes Disability Yes No Dental Plan Yes Yes Flexible Benefit Plan Yes Yes Retirement Annuity--See details for effective date of eligibility. Yes Yes Tax Deferred Annuity (TDA) or Roth 403b Yes Yes Education Benefit--See plan for terms Employee Education Benefit

Yes No

1 crs/sem. 8 credits per year

Faculty & Administrative Staff Spouse Yes No Support Staff Spouse Yes No Dependents Yes NoEmployee Assistance Program (EAP) Yes No

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Health Care Coverage BasicsOne health care plan with two deductible

options:$500 deductible/$1,000 out-of-pocket$1,000 deductible /$1,500 out-of-pocket

One provider network:Midland’s Choice Network (includes Gundersen

Health System, Mayo, Winneshiek Medical Center Clinic, Franciscan Skemp and others)

Three levels of coverage: SingleEmployee plus one other personFamily

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Health Care Providers

In-network services are covered at 80/20 after the deductible has been met

Out-of-network services are covered at 60/40 after the deductible has been met

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Office Visits

$50 per visit will be paid for office visits for new or existing patients for which patient history and medical decision making are fairly straightforward

50% per visit will be paid for office visits requiring a more complex medical history and medical decision making

$500 out-of-pocket limit for office visits per person, not a part of the medical deductible or OOP

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Prescription CoveragePrescription Co-pays:

Generic $10 + 20%Formulary $20 + 20%Non-Formulary $35 + 20%90-Day Maintenance Double co-pay + 20%

The +20% coinsurance is applied to the remaining cost of the Rx

Once your out-of-pocket cost for prescriptions reaches $1,500/calendar year, the 20% coinsurance stops

Co-pays continue until your total out-of-pocket for prescriptions reaches $2,000/calendar year. Prescriptions are then paid at 100%

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2014 Preventive Care(Jan. 1 – Dec. 31, 2014)

Routine physical exam paid 100% by plan in 2014$45 blood panel screening thru Luther health

service or $45 Winneshiek Medical Center (WMC) Walk-In Wellness clinic paid 100% by plan in 2014

$40 PSA for men ages 40 and above thru Luther health service or WMC will be paid 100% by plan in 2014

Completion of Health Risk AssessmentParticipants that join after July 1 will not be

charged an additional $25 in 2015 if they don’t complete the steps

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2014 Preventive Care Continued

Routine vision exam-plan pays up to $50 for employee, spouse, and dependent children in 2014

Benefit regardless of whether it is an even or odd year:

One baseline mammogram for female employee/spouse ages 35-39

Routine mammogram paid at 100% for women 40 and above

Colonoscopy for employee/spouse age 50 and above: Plan pays first $1,200 with balance at 80% after deductible has been met, etc. (once very 10 years)

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Monthly RatesPlan Option 1/

$500 DeductiblePlan Option 2/

$1,000 Deductible July 1, 2014 

DeductibleOut-of-Pocket Deductible

Out-of-Pocket

Plan 1 vs. Plan 2 Annualized Difference

Single $500 $1,000 $1,000 $1,500  Employee + 1 $1,000 $2,000 $2,000 $3,000  Family $1,000 $2,000 $2,000 $3,000         Single Premium $528 $498  Employee Contribution:      

Salary Tier 1 < $35,000 $84 $54 $360

Salary Tier 2 $35,000 - $58,000 $92 $62 $360

Salary Tier 3 > $58,000 $102 $72 $360        Employee + 1 Premium $1,370 $1,300  Employee Contribution:      

Salary Tier 1 < $35,000 $238 $168 $840

Salary Tier 2 $35,000 - $58,000 $318 $248 $840

Salary Tier 3 > $58,000 $397 $327 $840        Family Premium $1,398 $1,328  Employee Contribution:      

Salary Tier 1 < $35,000 $283 $213 $840

Salary Tier 2 $35,000 - $58,000 $372 $302 $840

Salary Tier 3 > $58,000 $456 $386 $840

Affordable Care Act

You should have received a Summary of Benefits and Coverage for each of the two health care plans

Health coverage options are also available through the new Health Insurance Marketplace

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Dental InsuranceDeductible: $30/year with maximum or $90/family/yearAnnual benefit limit: $1,000/personCoverage for exams, x-rays, cleanings, fillings,

surgery, root canals, gum disease treatments and denture repairs.Percentage paid by plan for above services:

70% 1st year (September – December 2014), coverage percentage increases by 10% each year until by your 4th year in the plan you have 100% coverage

Crowns-bridges-dentures covered at 50% of approved charges starting second year on plan

Monthly premium pre-tax:$32/single + $73/familyOnce enrolled, participants may only opt out at the end

of December each year 12

Flexible Spending AccountMoney placed in this account is not subject to

federal/state income tax and FICA/Social Security tax

Funds in the account are returned to you as non-reimbursed medical, dental and dependent care expenses are incurred

Once enrolled, you may not make additions, changes, or cancellations during the calendar year unless you experience a qualifying event

Your initial plan year will be September –December.

Maximum account contribution is $2,500 for health and $5,000 for dependent care 13

Personal InfoPersonal Info

Elect dollar

amount

Elect dollar

amount

Remember to sign

Remember to sign

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Life Insurance

The college provides basic life insurance in the amount of twice the annual basic salary at no cost to the employee

Accidental death and dismemberment (AD&D) coverage is also offered at twice the basic salary at no cost to the employee

Optional supplemental life insurance is available for new employees without a health screening

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Disability InsuranceLong term disability insurance (LTD) is

provided for faculty teaching at least 4 classes Salary continuation is provided for the first 6

months of leave equal to ½ annual salaryLong term disability benefits pay 60% of pay

after the initial 6 months of leaveLTD benefits are off-set by other pay receivedBenefits can continue until retirement agePension contributions are continued if eligible

for contributions when disability commences

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Luther’s Retirement Programwith TIAA-CREF

After completing 1-year of eligible employment, the college remits 10% of an employee’s base salary to TIAA-CREF

The 1-year waiting period may be waived if you met your 1-year of eligibility with another employer

All faculty, regardless of course load, are eligible to participate in a tax-deferred annuity (TDA) or a Roth 403(b) with TIAA-CREF

Complete the eligibility form and return to the Office of Human Resources

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Employee Assistance Program (EAP)

Luther’s employee assistance program is provided at no additional charge for confidential counseling services for concerns including:

PersonalFinancialLegal needsGuidance resources are available online

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Travel Assistance ProgramOur emergency travel assistance includes:

Medical evacuationRepatriationTraveling companion assistanceDependent children assistanceVisit by a family member or friendEmergency medical paymentsReturn of mortal remainsMedication and eyeglass assistanceMedication referrals and monitoring

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Funeral Planning

Life InsuranceWhy do you need it? How much do you need?

Estate PlanningConversation starters - calculators

Funeral Concierge Services24/7 funeral planning from licensed funeral

directorsFamily Support

Legal, emotional & family counseling to help cope with a loss with Beneficiary Assist

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Confidential Reporting Hotline

Occasionally, an employee has a concern that he or she would like to express anonymously. These concerns might include ethical concerns, theft, sexual harassment, etc. For these occasions, the college participates in a service called the In Touch Hotline.

This system is available for your use around the clock, seven days a week. Because the hotline is operated by an independent organization, any calls made through this hotline are completely confidential.

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Non-Discrimination

It is the policy of Luther College to provide equal educational opportunities and equal access to facilities for all qualified persons. The college does not discriminate in employment, educational programs, and activities on the basis of age, color, creed, disability, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, veteran status, or any other basis protected by federal or state law. Sexual harassment and sexual assault are prohibited forms of sex discrimination.

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Non-Discrimination, Continued

Questions regarding this policy or Title IX  of the Education Amendments should be directed to:

Marsha WentholdInterim Director of Human Resources and Title IX Coordinator(563) 387-1415, Main 28mwenthold@luther.edu

 Questions regarding Title IX of the Education Amendments of 1972 may also be referred to the U.S. Department of Education’s Office for Civil Rights.

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These forms are necessary to process your payroll:

A. I-9 Employment Eligibility VerificationB. Federal W-4C. Iowa W-4D. Direct Deposit Form

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Complete Section 1 of I-9

Iowa W-4 – 1st Part

The Iowa W-4 has

two sections

that need to be

completed

2nd Part…

Employee completes personal

information

Federal W-4Employee completes personal

information

Be sure to sign

Direct Deposit Form

Include a Voided Check!

Luther requires direct deposit

Luther College

FACULTY/STAFF DIRECT DEPOSIT AUTHORIZATION

NAME (please print) ______________________________________ ID# _____________________

This form authorizes Luther College to deposit your payroll earnings and your accounts payable payments directly to your checking or savings account. An e-check advice will be emailed to your Luther email to indicate a direct deposit has occurred. A payroll direct deposit advice will be sent via campus mail to indicate a direct deposit has occurred. By signing this form, I also authorize Luther College to direct my bank to return any funds to which I was not entitled and debit my account. IMPORTANT: For checking accounts, please attach a voided check. For savings accounts, please attach a form that shows your account number. Inaccurate bank account information will result in a delay of payment. PAYROLL PRIMARY DEPOSIT (Net earnings) Bank Name ________________________________________ Bank Phone Number _____________________ Bank City & State ___________________________________ Checking or Savings______________________ Account Number ____________________________________ Routing Number ________________________

Accounts Payable Deposit

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PAYROLL ADDITIONAL DEPOSIT (optional) Bank Name ________________________________________ Bank Phone Number ______________________ Bank City & State ___________________________________ Checking or Savings_______________________ Account Number ____________________________________ Routing Number _________________________ Amount to be deposited in this account _______________________________________ ACCOUNTS PAYABLE DEPOSIT (please check appropriate box) Use Payroll Primary Account OR Use Bank information provided below Bank Name ________________________________________ Bank Phone Number _____________________ Bank City & State ___________________________________ Checking or Savings ______________________ Account Number ____________________________________ Routing Number _________________________ Signature (required) ______________________________________ Date _____________________

Please return completed form to the Human Resources Office.

Your pay advice is online!

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Where you can find us

Human Resources and Payroll are located in the lowest level of Main (Main 25 + 28). We are here to assist you.

Marsha Wenthold, Interim/Associate Director, 387-1415

Sheryl Sievert, Administrative Assistant, 387-1134

Korrine Jackson, Payroll Specialist, 387-1135HR website: http://www.luther.edu/hr/

Please call us any time32