28
1 EMPLOYEE BENEFITS GUIDE PLAN YEAR JULY 1, 2020 – JUNE 30, 2021

EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

  • Upload
    others

  • View
    6

  • Download
    0

Embed Size (px)

Citation preview

Page 1: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

1

EMPLOYEE BENEFITS GUIDE

PLAN YEAR JULY 1, 2020 – JUNE 30, 2021

Page 2: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

2

DENTAL & VISION BENEFITS10

RETIREMENT PLANS

ADDITIONAL EMPLOYEE BENEFITS

ADP ONLINE OPEN ENROLLMENT

REQUIRED NOTICES

CONTACT INFORMATION

NOTES

17

18

19

20

21

22-27

Kentucky State University knows that your employee benefits package is extremely

important to you. We understand benefits should meet the needs of you and your family

as well as be affordable. So we have tools and information to help you make the right

choices. This guide offers a comprehensive overview of your health and welfare benefits

options, including details about eligibility, enrollment, and the plans available to you.

Please take the time to review the guide as you make decisions about your benefits,

and keep it as a reference throughout the next year.

BENEFITS ELIGIBILITY

HELPFUL DEFINITIONS

MAKING A MID-YEAR BENEFITS CHANGE

MEDICAL BENEFITS

PHARMACY BENEFITS

MEDICAL CONTRIBUTIONS

Welcome to Your Benefits Program

Information in this Guide

4

3

5

6

7-8

9

FLEXIBLE SPENDING ACCOUNT

HEALTH SAVINGS ACCOUNT

11-12

13-14

DISABILITY BENEFITS

LIFE INSURANCE

15

16

Page 3: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

3

AD&D - Accidental Death and Dismemberment

COB - Coordination of Benefits

COBRA - Consolidated Omnibus Budget Reconciliation Act

Coinsurance - The amount or percentage that you pay for certain covered health care services under your health plan. This is typically the amount paid after a deductible is met, and can vary based on the plan design.

Copayment - The flat fee that you pay toward the cost of covered medical services.

Deductible - Before benefits are available through a health plan, this is the specific amount you must pay out of pocket.

Dependent - Individuals who meet eligibility requirements under a health plan and are enrolled in the plan as a qualified receiver of medical benefits.

EOB - Explanation of Benefits

GI - Guaranteed Insurability Benefit

High Deductible Health Plan (HDHP) - A qualified health plan that gives you more control over your health care spending by offering lower monthly premiums in exchange for higher deductibles and out-of-pocket limits. These plans are often coupled with an HSA and do not have copays on any services.

In-Network - Care received from your primary care physician or from a specialist within an outlined list of health care practitioners. Visit www.anthem.com to view providers that are in-network.

OTC Drug - Over-the-Counter Drug

Out-of-Network - Care you receive without a physician referral or services received by a non-network service provider. Out-of-network health care and plan payments are subject to deductibles and copayments. In-network and out-of-network claims satisfy different deductibles and do not accumulate toward each other.

Out-of-Pocket Maximum - Once your eligible out-of-pocket expenses reach the maximum, the plan pays 100% of covered expenses for the rest of the plan year. The annual out-of-pocket is the accumulation of both the deductible, the coinsurance and the copays.

Preferred Provider Organization (PPO) - A health plan that offers both in-network and out-of-network benefits. Members must choose one of the in-network providers or facilities to receive the highest level of benefits.

Premium - The amount you pay for a health plan in exchange for coverage. Health plans with higher deductibles typically have lower premiums.

Primary Care Physician (PCP) - The doctor that you select to coordinate your care under your health plan.

SPD - Summary Plan Description

SSNRA - Social Security Normal Retirement Age

Helpful Definitions

Page 4: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

4

You are eligible to participate in the KSU Benefits Program if you are an active, full-time regular employee working 100 hours per month. Eligible employees may elect to cover their spouse and/or dependent child(ren) up to the age limitations specified in each insurance plan. New employees are eligible on the first of the month following 30 days.

Your eligible dependents include:

• Your legally married spouse.

• Dependent child(ren), including stepchildren, legally adopted children, and children placed with you for adoption. The maximum age for dependents is based on the specific benefit and is summarized below.

o Medical, dental, and vision plans: Up to the end of the month in which they reach age 26 (regardless of student or marital status), or up to any age if physically or mentally incapable of self-support.

o Voluntary Life and AD&D plan: From birth to the end of the month in which they reach age 26; up to any age if physically or mentally incapable of self-support prior to age 26.

o Dependent care FSA: Up to age 13 or up to any age if disabled (must be a tax-code dependent).

o Tuition Waiver: Dependent child(ren) up through the end of the term in which they turn age 25.

Dependent Verification of EligibilityWhen you first enroll, or if you change coverage mid-year due to a qualified IRS family status change, you are required to provide documentation substantiation of the eligibility of your dependent(s) within 31 days of the change or enrollment. If documentation is not received within 30 days, a letter will be mailed to you requesting the documentation within a given deadline.

Elections Annual Open Enrollment is your opportunity to review benefits and make changes for the next year. You are encouraged to review this information carefully. If you do not make changes during this open enrollment period, your next opportunity to enroll or make changes will be open enrollment for the 2021 plan year.

Benefits Eligibility

Page 5: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

5

Making a Mid-Year Benefits Change

The University allows you to pay your portion of the medical, dental, and vision plan costs, and fund the flexible spending accounts, on a pre-tax basis. Thus, due to IRS regulations, once you have made your elections for the 2020-2021 plan year, you cannot change your benefits until the next annual enrollment period. The only enrollment exception is if you experience a qualifying life event. Election changes must be consistent with your life event.

Qualifying Life Events• Marriage, divorce, or legal separation• Birth or adoption of an eligible child• Death of your spouse or covered child• Spouse’s open enrollment that affects

your coverage• Change in your spouse’s work status

that affects his or her benefits• Change in your child’s eligibility for benefits• Qualified Medical Child Support Order

This is not an all-inclusive list. If you experience a qualifying life event, contact HR.

Remember, you may only make enrollment changes during the plan year if you experience a qualifying life event. To request an election change, you must submit the appropriate forms to HR within 30 days of the date of the life event. Documentation will be required (e.g., birth certificate, marriage license, divorce paperwork, adoption certificate, proof of new coverage, etc.).

Note: You can change your Health Savings Account election on a monthly basis regardless of whether or not you experience a qualifying life event.

Page 6: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

6

Review your coverage options and determine what is best for your family.

Here are some things to consider:

• What matters most to me – keeping more of my paycheck or paying less when I receive services?• How often do I anticipate needing medical services during the upcoming year?• Am I considering a planned surgery or service that may cause me to reach my out-of-pocket maximum?• Should I cover a spouse or other dependents under my plan, or do my dependents have access

to other coverage options that our family should consider?

New this year: The 2020 ACA Guidelines for HDHPs have a minimum individual deductible of $2,800 for single coverage and the minimum family deductible is $5,600.

Medical Benefits

NOTES: Above referenced benefits are for in-network only; for out-of-network benefits refer to the full benefit summary. Member deductible is first dollar unless the service is copayment eligible. Members must meet the deductible for HDHP $2,800 Plan before coinsurance or copayments apply.

Annual Deductible $1,500 Individual $2,500 Individual $2,800 Individual

(Calendar Year) $3,000 Family $5,000 Family $5,600 Family

Coinsurance 80% 80% 80%

Maximum Out-of-pocket $4,000 Individual $5,000 Individual $5,000 Individual

$8,000 Family $10,000 Family $10,000 Family

Primary Care Office Visit $25 copay $25 copay Deductible + 20%

Specialist Office Visit $40 copay $40 copay Deductible + 20%

Preventive Care Covered in Full Covered in Full Covered in Full

Emergency Room $150 copay $150 copay Deductible + 20%

Urgent Care Deductible + 20% Deductible + 20% Deductible + 20%

Hospital Services Deductible + 20% Deductible +20% Deductible + 20%

Outpatient Services Deductible + 20% Deductible + 20% Deductible + 20%

Prescription Services $10 / $30 / $60 $10 / $30 / $60 Ded then $10 /$35 /$60

SERVICES PPO $1,500 PLAN PPO $2,500 PLAN HDHP $2,800 PLAN

COVERED SERVICES MEMBER COST SHARE

Page 7: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

7

Prescription Medications

Kentucky State University is a member of the Know Your Rx Coalition. Know Your Rx is a governmental purchasing coalition to help reduce costs. Through the coalition, we join other state and regional universities that are also interested in reducing costs, while increasing the level of service to employees.

Members enrolled in Kentucky State University’s health plans are automatically covered under the prescription drug plan and will have access to the services provided by Know Your Rx.

• Personalized support available• Cost-saving strategies offered

Prescription Benefit Resources

Know Your Rx provides personalized support to assist you in making the most of your prescription benefit. The experts at Know Your Rx work together with Kentucky State University and Express Scripts, your pharmacy benefits administrator, to ensure the best possible experience for you and your family. With Know Your Rx, you have access to a dedicated team of pharmacists who can assist you in answering questions regarding prescriptions.

The reference table below reflects the resources available through Kentucky State University’s prescription benefit.

Base Copays/Coinsurances (unchanged from prior year)

Pharmacy Benefits

KSU 1500 PPO KSU 2500 PPO HSA

RETAIL IN-NETWORK IN-NETWORK IN-NETWORK PHARMACIES (up to a 30-Day Supply) (up to a 30-Day Supply) (up to a 30-Day Supply)

Generic $10.00 Copay $10.00 Copay $10.00 Copay (post-Ded)____________________________________________________________________________________________________________________

Formulary Brand $30.00 Copay $30.00 Copay $35.00 Copay (post-Ded)____________________________________________________________________________________________________________________

Non-Formulary Brand $60.00 Copay $60.00 Copay $60.00 Copay (post-Ded)

EXPRESS SCRIPTS IN-NETWORK IN-NETWORK IN-NETWORK HOME DELIVERY (up to a 30-Day Supply) (up to a 30-Day Supply) (up to a 30-Day Supply)

Generic $25.00 Copay $25.00 Copay $25.00 Copay (post-Ded)____________________________________________________________________________________________________________________

Formulary Brand $75.00 Copay $75.00 Copay $88.00 Copay (post-Ded)____________________________________________________________________________________________________________________

Non-Formulary Brand $150.00 Copay $150.00 Copay $150.00 Copay (post-Ded)

Page 8: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

8

If you take medications regularly, prescriptions can add up to a significant part of your overall health care expenses. Knowing how the prescription drug program works and what to do to manage costs can help you make good buying decisions.

The prescription drug program features:

• Convenient mail order program to help you save money on maintenance prescriptions.

• Easy-to-use retail pharmacy program with a broad network of Express Scripts pharmacies, including major pharmacy chains and independent stores.

• Four basic coverage tiers:

1. Generic Formulary (Tier 1) – prescription drug with the same active ingredients and effectiveness as its brand name counterpart, but less expensive.

2. Brand Formulary (Tier 2) – brand-name drug that generally does not have a generic version of the drug available.

3. Generic/Brand Non-Formulary (Tier 3) – brand-name drug that generally either has equally effective and less costly generic equivalents and/or one or more brand formulary alternatives.

4. Specialty (Tier 4) – usually newly approved pharmaceutical drugs, including specialty medications.

Home Delivery Pharmacies are a Great Way to Save Money

Regardless of which medical plan you are enrolled in, you will have the opportunity to use a home delivery pharmacy service. These programs allow you to receive a 90-day supply of your maintenance medication shipped to your home. On the PPO plan, not only will you have the convenience of skipping the drug store, but you will also receive three (3) months’ worth of your medication for what you would normally pay for two (2) months. This saves you one (1) copay or coinsurance amount four (4) times a year and a lot of precious time.

The HDHP plans do not offer the 3 months for the cost of 1 month option, but there may be cost savings based on mail ordering pricing.

Contact Know Your Rx to ...

Get answers to questions about your pharmacy benefit and/or copayments, as well as address any concerns with new or existing prescriptions, such as potential side effects or interactions.

Receive expert guidance on cost-saving strategies, including new generic prescription drug options and/or opportunities to make your prescription refills more cost-effective and more convenient.

Know Your Rx(855) [email protected]

Contact Express Scripts to ...

• Order a replacement prescription benefit ID card.

• Set up automatic mail order prescription refills.

Access an exclusive online resource featuring detailed information on prescription medications, as well as other health and well-being resources.

Express Scripts(877) 647-1519www.express-scripts.com

Page 9: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

9

Medical Contributions

COVERAGE LEVEL

PPO $1,500 PLAN

MONTHLY PREMIUM

EMPLOYEE MONTHLY COST

EMPLOYER MONTHLY COST

EMPLOYEE PER PAY COST

Employee Only $531.74 $149.06 $382.68 $74.53

Employee + Spouse $1,036.87 $514.57 $522.30 $257.29

Employee + Child(ren) $958.19 $437.74 $520.45 $218.87

Employee + Family $1,393.13 $819.27 $573.86 $409.64

COVERAGE LEVEL

PPO $2,500 PLAN

MONTHLY PREMIUM

EMPLOYEE MONTHLY COST

EMPLOYER MONTHLY COST

EMPLOYEE PER PAY COST

Employee Only $503.46 $120.78 $382.68 $60.39

Employee + Spouse $981.73 $459.43 $522.30 $229.72

Employee + Child(ren) $906.58 $386.13 $520.45 $193.07

Employee + Family $1,319.04 $745.18 $573.86 $372.59

COVERAGE LEVEL

HDHP $2,800 PLAN

MONTHLY PREMIUM

EMPLOYEE MONTHLY COST

EMPLOYER MONTHLY COST

EMPLOYEE PER PAY COST

Employee Only $387.68 $5.00 $382.68 $2.50

Employee + Spouse $756.96 $234.66 $522.30 $117.33

Employee + Child(ren) $698.59 $178.14 $520.45 $89.07

Employee + Family $1,015.69 $441.83 $573.86 $220.91

Medical Plan Costs

Page 10: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

10

Dental & Vision Benefits

DENTAL BENEFITS PPO + PREMIER PPO

Annual Deductible – –

Individual $25 Individual $25 Individual

Family $25 Family (per person) $75 Family

Annual Maximum Benefit $1,000 $1,000

Orthodontia Lifetime Maximum Benefit $1,000 No coverage

ANTHEM VISION BENEFITS

COPAYS EOBIN-NETWORK

BENEFITS

Exams $20 copay

Standard Lenses $20 copay

Frames $0 copay

Contacts $0 copay

SERVICE FREQUENCY

Exams Every 12 months

Exams Every 12 months

Frames Every 24 months

Contacts Every 12 months

LENS COVERAGE

Single Vision Lens Paid in full (after copay)

Bifocal Lenses Paid in full (after copay)

Trifocal Lenses Paid in full (after copay)

Frames$130 allowance

+20% off balance over $130

CONTACT LENSES (IN LIEU OF GLASSES)

Elective$130 allowance

+15% off balance over $130

Medically Necessary Covered in full

VISION BI-WEEKLY PAYROLL DEDUCTIONS

Employee $3.06

Employee + Spouse $5.73

Employee + Child(ren) $5.99

Family $9.39

PER PAYROLL DEDUCTIONS PPO + PREMIER PPO

Employee $13.84 $11.22

Employee + Spouse $24.24 $21.48

Employee + Child(ren) $30.02 $24.61

Family $44.40 $31.57

COVERED SERVICES PPO + PREMIER PPO

Preventive/Diagnostic 100% 100%

Basic Restorative 80% 80%

Endodontics 80% 80%

Oral Surgery 50% 80%

Periodontics 50% 80%

Crowns/Bridges/Implants 50% 50%

Orthodontics (end of month of age 19) 50% No coverage

PLEASE NOTE: If you choose an out-of-network provider, you could be balance billed for any amount over and above Delta Dental’s payment.

Staying healthy includes obtaining quality dental care for you and your family. Kentucky State University dental plan is provided through Delta Dental which includes an extensive network of providers and offers flexibility based upon where you choose to access care. You may visit the Delta Dental website at www.deltadentalky.com, or call (800) 955-2030 to locate a provider. Orthodontic benefits are available to dependents up to age 19.

Kentucky State University is pleased to provide access to a comprehensive vision care program through Anthem. The amount you pay or vision services depends upon whether you visit a network or non-network provider. Network providers can be found by visiting www.anthem.com, or by calling (888) 650-4047.

Above referenced benefits are for in-network only; for out-of-network benefits refer to the full benefit summary.

Page 11: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

11

Flexible Spending Account (FSA)

Health Flexible Spending AccountThe Flexible Spending Account allows you to put money aside tax-free to be used for qualified medical, dental, and vision expenses (for example: deductible, coinsurance and copays). All employees are eligible (with exception of those enrolled in the HSA plan). Contributions are deducted from your paycheck in equal installments, however the full annual election amount will be available after the first deduction of the plan year. The elections must be locked in for a year. Any unused funds at the end of the year will be forfeited. The annual maximum contribution is $2,750 per year (minimum contribution is $50/year).

Limited Flexible Spending AccountThe Limited Flexible Spending Account allows you to put money aside tax-free to be used for qualified dental and vision expenses (for example: deductible, copays and coinsurance). All employees who are enrolled in the HDHP are eligible. Contributions are deducted from your paycheck in equal installments, however the full annual election amount will be available after the first deduction of the plan year.

The elections must be locked in for a year. Any unused funds at the end of the year will be forfeited. The annual maximum contribution is $2,750/year (minimum contribution is $50/year).

Dependent Care FSA The Dependent Care Flexible Spending Account allows you to put aside money tax-free to be used for the care of your child(ren) (or disabled dependent adults) while you work. All employees are eligible. This money can only be used as it accumulates. The $5,000 per year ($2,500 if married and filing separately; minimum contribution is $50/year) Health and Dependent Care Flexible Spending Accounts are administered by McGriff Flexible Benefits Services. Any unused funds at end of plan year will be forfeited.

Use It or Lose It!Up to $500 of unused money can roll over to the following year. Any funds in account excess of $500 at the end of claim filing period are forfeited.

TAX SAVINGS 30%-40%

Page 12: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

12

Save Money You can purchase all kinds of products and services using your Health FSA through McGriff Flexible Benefits Service. Some eligible items you may not know about include:

Manage your Flexible Benefits anytime, anywhereThe Benefit Access Mobile App lets you easily and securely manage your Flexible Spending Account and Health Savings Account on your smartphone. You can view account balances, submit health care account claims, and upload pictures of your receipts anytime, anywhere on any iPhone, Android or tablet device.

Get started todayJust download the McGriff Insurance Services Benefit Access App for Android or iPhone (also compatible with iPad® and iPod touch®) and log in using the same password you use to access the Flex website.

• Allergy medication• Bandages• Breastfeeding classes• Cough syrup• Dyslexia treatment• First aid kits• Guide dog• Hearing aids• Humidifier/air filter

• LASIK• Menstrual products • Over-the-counter

medication • Pain relievers• Pregnancy tests• Reading glasses• Smoking cessation drugs• Sunscreen

Flexible Spending Account (FSA)

McGriff Flexible Benefits Service Benefit Consultants

(800) 768-4873

[email protected]

Download the App from App Store or Google Play

Some items may require a doctor’s prescription.

Page 13: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

13

Health Savings Account (HSA)

A tax-free,1 individually owned savings account you can use to pay for qualified medical expenses.

Eligibility: All benefits-eligible faculty, staff and employees who elect the High Deductible Health Plan and who are Exempt, Non-Exempt, who elect the High Deductible Health Plan and who are:

• NOT enrolled in Medicare, Medicaid or any other type health insurance that is not a qualified HDHP.

• NOT being claimed as a dependent on another person’s tax return.

• NOT eligible to receive medical expense reimbursement under a general-purpose health care FSA of a spouse or a parent.

Key benefits of an HSA:

• You can increase or decrease your annual contribution amount any time during the plan year.

• You never pay taxes on your HSA contributions – the account even earns tax-free interest. Tax reporting is minimal.

• When you use the account, your HSA dollars will count toward your annual deductible and out-of-pocket maximums.

• You can take your HSA with you when you leave the plan, change jobs or retire.

• Administration is easier with no stressful submission or substantial deadlines.

• KSU will make a $30 contribution to your HSA each pay period.

Other Considerations:

• Payments are not automatic. You decide when and how to use the money in your HSA. Spend it during the year, save it or open an investment account.

• Consider consulting a tax professional when contributing to an HSA.

• If you will be Medicare eligible in 2020, please contact HSA Authority for guidance.

1. HSA contributions and earnings are not subject to federal taxes and not subject to state taxes in most states. A few states do not allow pre-tax contributions and earnings. Contact your tax advisor for details on your specific location.

Page 14: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

14

At a Glance

Health Savings Account (HSA)

Which medical plan must I elect to participate? HDHP with HSA

Who can contribute to the account?

You, KSU or a third party on your behalf

What is the annual KSU contribution? $720 for individuals

What is the maximum I can contribute?

HSA maximum contribution limits are $3,550 for individuals and $7,100 for families, which includes KSU contribution of $720 – plus an extra $1,000 if you are age 55 and over.

How are contributions taxed?

Your contributions are tax deductible. KSU contributions are excluded from your gross income.

Can funds be carried over from one year to the next?

Yes

Then you pay out

of pocket

YOU PAY WITH YOUR HSA UNTIL

THE FUND IS EXHAUSTED

YOU PAY OUT OF POCKET OR

You or a dependent incurs an eligible health care expense

Sample of how your HSA works

You receive bill for deductible

or coinsurance owed

For more information, visit www.thehsaauthority.com

Page 15: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

15

Disability Benefits

This guide is only intended to provide an outline of benefits. All details and contract obligations of plans are stated in the group contract/insurance documents. In the event of conflict between this guide and the group contract/insurance documents, the group contract/insurance documents will prevail. Please contact your Human Resources Department for further information.

Voluntary Short-Term DisabilityWho is Eligible: All full-time employees working 30 hours per week, first of the month after 30 days.

How much your coverage will cost: This is a 100% employee paid VOLUNTARY benefit. Please contact the OHR for the monthly premium cost.

Coverage: Employees may elect a flat weekly benefit amount from $100 to $1,500 in increments of $100. The employee may not elect an incremental benefit amount that exceeds 60% of their weekly earnings for a 13-week duration. Benefits will begin on the 30th day of an accident or illness.

Long-Term DisabilityWho is eligible: All full-time hourly employees working 30 hours per week.

How much your coverage will cost: This benefit is 100% paid for by KSU.

Coverage: If you become disabled due to illness or injury, you will be able to receive 60% of your basic monthly income to a maximum of $10,000 per month. This benefit becomes payable after you have been disabled for 90 days.

Did you know?Men have a 43% chance

of becoming disabled

during their working

years; women have a

54% chance.

According to the American

Council of Life Insurers,

30% of all Americans

between the ages of 35 and

65 will become disabled for

more than 90 days.

LTD Coverage extends to Social Security Normal Retirement Age

Page 16: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

16

Employer Paid Life / AD&DWho is Eligible: All full-time employees working 30 hours per week.

How much your coverage will cost: This benefit is 100% paid for by Kentucky State University.

Coverage Amounts:• Employee Life Amount: $50,000• AD&D Amount: $50,000

AD&D: While insured under the policy, if the employee has an accident that results in a loss of life or limb, The Hartford will pay a specified amount for such loss. Please refer to your certificate of coverage for more information.

Voluntary LifeWho is Eligible: All full-time employees working 30 hours per week.

Coverage Amounts: • Employee: $10,000 increments up to 5 times

annual salary to a maximum of $500,000. • Your Spouse: You may purchase up to 100%

of employee amount in $5,000 increments to a maximum of $500,000.

Voluntary AD&DWho is Eligible: All full-time employees working 30 hours per week.

Coverage Amounts: • Employee: $10,000 increments up to $500,000. • Your Spouse: You may purchase up to 100% of

employee amount in $5,000 increments.• Your Child(ren): You may purchase a flat

amount of $10,000.

New Hire Guarantee Issue Amounts:• Employee: $150,000• Your Spouse: $25,000• Your Child(ren): $10,000• Elections above Guarantee Issue

Amounts require evidence of insurability

Critical Illness / Accident / VoluntaryCritical Illness insurance pays a lump-sum benefit if you are diagnosed with a covered illness or condition. You can elect a $10,000 or $20,000 benefit amount. CI includes cancer, heart attack, stroke, kidney failure, or coronary artery bypass. After your coverage has been in effect for 30 days, The Hartford will provide an annual benefit of $50 per calendar year for taking one of the eligible screening/prevention measures. (See HR for complete list.)

In the event of a covered off-the-job accident, the Accident Insurance plan pays cash benefits fast to help with the costs associated with out-of-pocket expenses and bills. There is also a health screening wellness benefit of $50 payable 1x per calendar year.

Life Insurance

Page 17: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

17

Are You Planning Retirement Soon?We encourage you to call the Office of Human Resources at (502) 597-6667 to find resources to help you transition smoothly into retirement. Make sure you inform your supervisor, the OHR, and your retirement provider at least 45 days prior to retirement.

Retirement Plans at KSU

Full-time employees of Kentucky State University are required to participate in one of the following retirement plans depending on employment category. Employees may also choose to supplement their retirement savings by contributing to a 403(b), 457, and 401(k) retirement plan on a voluntary basis.

• Kentucky Employees Retirement Systems (KERS) - employees in positions that do not require a bachelor’s degree.

• Kentucky Employees Retirement System-Hazardous (KERS-Haz.) - police department officers and other qualified employees.

For more information regarding KERS and KERS-Haz, please visit the website at https://kyret.ky.gov

Employees in positions requiring a minimum of a bachelor’s degree have the following options:

• Teachers’ Retirement System (TRS) - full-time faculty and staff who meet the eligibility requirements. For more information regarding TRS, please visit the website at https://trs.ky.gov

• Optional Retirement Plan (ORP) - this is available to full-time faculty and staff who would otherwise participate in TRS. The ORP vendors are TIAA and AIG. For more information regarding the ORP plan, please visit the KYSU Human Resources’ website at http://kysu.edu

Voluntary Supplemental Retirement - Supplemental 457(b), 401(k), and 403(b) plans

• For employees wishing to make a voluntary contribution into a supplemental retirement plan. The Supplemental Retirement vendors are TIAA and AIG. The 457(b) vendors are TIAA, KY Deferred Comp, and AIG. The 401(k) vendor is KY Deferred Comp. The 403(b) vendors are NLG (National Life Group), TIAA, and AIG. Please contact Human Resources at (502) 597-6667 for the supplemental retirement vendor contact information.

This guide is only intended to provide an outline of benefits. All details and contract obligations of plans are stated in the group contract/insurance documents. In the event of conflict between this guide and the group contract/insurance documents, the group contract/insurance documents will prevail. Please contact your Human Resources Department for further information.

Retirement Plans

Page 18: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

18

Additional Employee Benefits

Holidays

Wellness

The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will help improve employees’ health and well-being.

You will receive paid holidays in accordance with an approved schedule established each year.

To see the current holiday schedule, visit: https://kysu.edu/administration-governance/finance-business/human-resources/staff-holiday-schedule/

Reference Human Resources Policy and Procedure Manual

Reference Human Resources Policy and Procedure Manual

As part of the Patient Protection and Affordable Care Act (ACA) employers are required to provide information to employees regarding health care coverage. Most employers offer health insurance coverage to full-time employees and their dependents. Due to the new requirements, those employers must send an annual statement, during tax season, to all employees eligible for coverage describing the insurance available to them. The Internal Revenue Service (IRS) created Form 1095-C to serve as that statement.

Kentucky State University full-time employees or their eligible dependent(s) {current spouse, child, or a person for whom you are the legal guardian} are eligible to receive a tuition waiver for a combined maximum of six (6) credit hours per semester including the intersession and summer session; eligible dependent(s) may only utilize this benefit at Kentucky State University; the Internal Revenue Code definition of dependent status shall apply in all cases (under age 19 at the end of the calendar year, or a full-time student under age 25 at the end of the calendar year, or permanently and totally disabled).

Employee Assistance Program (EAP) The Hartford

This program provides confidential counseling resources for all faculty and staff. The EAP includes 3 face-to-face visits per occurrence, as well as support groups, and education to assist you in achieving your personal and professional goals.

The EAP can provide you with confidential support and information for personal and work-life issues.

For more information, call (800) 964-3577.

Annual Leave / Vacation

Sick Days

1095

Tuition Waiver

Page 19: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

19

ADP Online Open Enrollment Instructions

1. Navigate to www.workforcenow.adp.com

2. Click user log in > enter ID and

password > click log in

3. Once you log in to the portal, a pop-up

message will appear. Select start this enrollment. Or navigate to myself > benefits > enrollments > open enrollment

4. Review dependents and beneficiaries, if you

need to add a new dependent or beneficiary

select ADD and enter their information.

5. Start your enrollment by selecting either

Walk me through my benefit options

OR I know what I want to change.

6. If you select I know what I want to change, you can select the benefit options you plan

on changing and hit continue. If you select

Walk me through my benefit options, select

the plans on the left-hand side one by one.

7. To enroll in a plan, click enroll in this plan for

each benefit plan you want to enroll in.

8. Choose a coverage level for the selected plan

(e.g., employee, family, etc.).

9. Choose Enroll next to the dependent’s

name you want to enroll (if applicable).

10. Once you are finished with the enrollment

for the plan, select Enroll at the bottom

of the screen. (Follow these instructions

for each plan you want to enroll in: medical,

dental, vision, etc.)

11. After reviewing all plans and making

selections, click review and complete.

(You cannot click this until all plans

have been reviewed.)

12. Review your benefit elections.

(Select a waive reason for each plan type

you are waiving if applicable.)

13. After reviewing your benefit selections,

do one of the following:

a. Click return to choose plan to

make changes now.

b. Click complete enrollment to finish your enrollment.

Page 20: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

20

Notes

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

Page 21: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

21

Benefits Contact Information

QUESTIONS COMPANY WHO ARE THEY? TELEPHONE URL/EMAIL

General Information

Kentucky State University

Office of Human Resources

HR Office(502) 597-6667

human.resources@ kysu.edu

Medical Information

Anthem BlueCross BlueShield Insurance Company 1 (833) 578-4443 www.anthem.com

Pharmacy Information

Know Your Rx Express Scripts Insurance Company 1 (855) 218-5979 www.kyrx.org

[email protected]

Dental Information Delta Dental Insurance Company (800) 955-2030 deltadentalky.com

Vision Information Anthem Blue View Vision Insurance Company (866) 723-0515 www.anthem.com

Flexible Spending Accounts

McGriff Flexible Benefits Services

Flexible Spending Accounts

(FSA/DCA/LSA)(800) 768-1873 flexclaims@

mcgriffinsurance.com

Life AD&D/Disability Information The Hartford Insurance Company (800) 523-2233 www.thehartford.com/

employee-benefits

Health Savings Account HSA Authority Health Savings

Account Beth Gremaux(888) 472-8697

[email protected]

https://www.oldnational.com/thehsaauthority

Escalated Service Issues

McGriff Insurance Services Account Manager Tish Harris

(859) 422-3776tish.harris@

mcgriffinsurance.com

Retirement

Kentucky Teachers’ Retirement System

Kentucky Teachers’ Retirement

Justin Couch(502) 848-8500

Trs.ky.gov [email protected]

Kentucky Employees Retirement Systems

Kentucky Employees Retirement (800) 928-4646 www.Kyret.ky.gov

TIAA Retirement ORP Chad Seabaugh www.Tiaa.org [email protected]

VALIC Retirement ORP Mark Spinosa (800) 448-2542

[email protected]

Kentucky Deferred Comp

Supplemental Retirement

Amy LeRoy (800) 542-2667

[email protected]

Page 22: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

22

Required Notices

NOTICES TO EMPLOYEES REGARDING HEALTH AND WELFARE PLANS

A. HIPAA Special Enrollment Rights NoticeIf you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or

group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents

lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage).

However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer

stops contributing toward the other coverage).

In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to

enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption,

or placement for adoption.

B. The Women’s Health and Cancer Rights Act of 1998 (WHCRA) Enrollment/Annual NoticeIf you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and

Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner

determined in consultation with the attending physician and the patient, for:

• All stages of reconstruction of the breast on which the covered mastectomy was performed;

• Surgery and reconstruction of the other breast to produce a symmetrical appearance;

• Prostheses; and

• Treatment of physical complications of the mastectomy, including lymphedema.

C. Newborns’ Act DisclosureGroup health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of

stay in connection with childbirth for the mother of the newborn child to less than 48 hours following a vaginal delivery, or less

than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending

provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as

applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan

or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

D. Wellness Program DisclosureIf it is unreasonably difficult due to a medical condition for you to achieve the standards for the reward under this program, or if it

is medically inadvisable for you to attempt to achieve the standard for the reward under this program, contact the individuals listed

at the end of these notices to inquire about a reasonable alternative standard for achieving the reward.

E. Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)If you or your child(ren) are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state

may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs.

If you or your child(ren) aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs, but

you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.

Page 23: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

23

Required Notices

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a state listed below, contact your state

Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents

might be eligible for either of these programs, contact your state Medicaid or CHIP office or dial 1-877-KIDS NOW or visit

www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the

premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your

employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is

called a “special enrollment.”

If you live in one of the following states, you may be eligible for assistance in paying your employer health plan premiums. The following list of states is current as of January 31, 2018. Contact your state for more information on eligibility.

ALABAMA – Medicaid KANSAS – Medicaid

Website: http://myalhipp.com Phone: 1-855-692-5447

Website: http://www.kdheks.gov/hcf Phone: 1-785-296-3512

ALASKA – Medicaid KENTUCKY – Medicaid

The AK Health Insurance Premium Payment Program Website: http://myakhipp.comPhone: 1-866-251-4861Email: [email protected] Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx

Website: http://chfs.ky.gov/dms/default.htm Phone: 1-800-635-2570

ARKANSAS – Medicaid LOUISIANA – Medicaid

Website: http://myarhipp.comPhone: 1-855-MyARHIPP (855-692-7447)

Website: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331 Phone: 1-888-695-2447

COLORADO – Medicaid MAINE – Medicaid

Medicaid Website: http://www.colorado.gov/hcpf Medicaid Customer Contact Center: 1-800-221-3943

Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.htmlPhone: 1-800-442-6003TTY: Maine relay 711

FLORIDA – Medicaid MASSACHUSETTS – Medicaid and CHIP

Website: http://flmedicaidtplrecovery.com/hippPhone: 1-877-357-3268

Website: http://www.mass.gov/MassHealth Phone: 1-800-462-1120

Page 24: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

24

Required Notices

GEORGIA – Medicaid MINNESOTA – Medicaid

Website: http://dch.georgia.gov/medicaidClick on Health Insurance Premium Payment (HIPP) Phone: 404-656-4507

Website: http://mn.gov/dhs/ma/ Phone: 1-800-657-3739

INDIANA – MEDICAID MISSOURI – Medicaid

Healthy Indiana Plan for low-income adults 19-64

Website: http://www.hip.in.govPhone: 1-877-438-4479All other Medicaid Website: http://www.indianamedicaid.com Phone: 1-800-403-0864

Website http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005

IOWA – Medicaid MONTANA – Medicaid

Website: http://www.dhs.state.ia.us/hipp Phone: 1-888-346-9562

Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084

NEBRASKA – Medicaid PENNSYLVANIA – Medicaid

Website:http://dhhs.ne.gov/Children_Family_Services/AccessNebra ska/Pages/accessnebraska_index.aspxPhone: 1-855-632-7633

Website: http://www.dhs.pa.gov/hipp Phone: 1-800-692-7462

NEVADA – Medicaid and CHIP RHODE ISLAND – Medicaid

Medicaid Website: http://dwss.nv.gov Medicaid Phone: 1-800-992-0900

Website: http://www.eohhs.ri.gov Phone: 401-462-5300

NEW HAMPSHIRE– Medicaid SOUTH CAROLINA – Medicaid

Website: http://www.dhhs.nh.gov/oii/documents/hippapp.pdf Phone: 603-271-5218

Website: http://www.scdhhs.gov Phone: 1-888-549-0820

NEW JERSEY – Medicaid SOUTH DAKOTA– Medicaid

Medicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/medicaid/ Medicaid Phone: 609-631-2392CHIP Website: http://www.njfamilycare.org/index.htmlCHIP Phone: 1-800-701-0710

Website: http://dss.sd.gov Phone: 1-888-828-0059

Page 25: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

25

NEW YORK – Medicaid TEXAS – Medicaid

Website: http://www.nyhealth.gov/health_care/medicaid Phone: 1-800-541-2831

Website: http://gethipptexas.com Phone: 1-800-440-0493

NORTH CAROLINA – Medicaid UTAH – Medicaid and CHIP

Website: http://www.ncdhhs.gov/dma Phone: 919-855-4100

Website:Medicaid: http://health.utah.gov/medicaid CHIP: http://health.utah.gov/chipPhone: 1-877-543-7669

NORTH DAKOTA– Medicaid VERMONT – Medicaid

Website: http://www.nd.gov/dhs/services/medicalserv/medicaid Phone: 1-844-854-4825

Website: http://www.greenmountaincare.org Phone: 1-800-250-8427

OKLAHOMA – Medicaid and CHIP VIRGINIA – Medicaid and CHIP

Website: http://www.insureoklahoma.org Phone: 1-888-365-3742

Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm Medicaid Phone: 1-800-432-5924

CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm CHIP Phone: 1-855-242-8282

OREGON – Medicaid WASHINGTON – Medicaid

Website: http://healthcare.oregon.gov/Pages/index.aspxhttp://www.oregonhealthcare.gov/index-es.html Phone: 1-800-699-9075

Website: http://www.hca.wa.gov/free-or-low-cost-health-care/program-ad-ministration/premium-payment-programPhone: 1-800-562-3022 ext. 15473

WEST VIRGINIA – Medicaid WYOMING – Medicaid

Website: http://www.dhhr.wv.gov/bms/Medicaid%20Expansion/Pages/ default.aspxPhone: 1-877-598-5820, HMS Third Party Liability

Website: http://wyequalitycare.acs-inc.com Phone: 307-777-7531

WISCONSIN – Medicaid and CHIP

Website:https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf Phone: 1-800-362-3002

To see if any other states have added a premium assistance program since January 31, 2018, or for more information on special enrollment rights, contact either:

U.S. Department of LaborEmployee Benefits Security Administration: www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)

U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services: www.cms.hhs.gov1-877-267-2323, Menu Option 4, Ext. 61565

Page 26: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

26

Required Notices

F. Medicare Part D Creditable Coverage Notice

Important Notice About Your Prescription Drug Coverage and MedicarePlease read this notice carefully and keep it where you can find it. This notice has information about your current prescription

drug coverage with Kentucky State University, Inc., and about your options under Medicare’s prescription drug coverage. This

information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should

compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering

Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your

prescription drug coverage is at the end of this notice.

There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:

1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you

join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug

coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer

more coverage for a higher monthly premium.

2. Kentucky State University has determined that the prescription drug coverage offered by the Kentucky State University

Health Care Plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug

coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you

can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

When Can You Join a Medicare Drug Plan?You can join a Medicare drug plan when you first become eligible for Medicare and each year

from October 15 through December 7.

However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for

a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens to Your Current Coverage if You Decide to Join a Medicare Drug Plan?If you decide to join a Medicare drug plan, your current Kentucky State University coverage will not be affected unless you elect

to disenroll from the plan.

If you do decide to join a Medicare drug plan and drop your current Kentucky State University coverage, be aware that you and

your dependents will not be able to get this coverage back until the next open enrollment period for Kentucky State University

benefit plan.

When Will You Pay a Higher Premium (Penalty) to Join a Medicare Drug Plan?You should also know that if you drop or lose your current coverage with Kentucky State University and don’t join a Medicare drug

plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare

drug plan later.

Page 27: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

27

Required Notices

If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at

least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example,

if you go 19 months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare

base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug

coverage. In addition, you may have to wait until the following November to join.

For More Information About This Notice Or Your Current Prescription Drug Coverage:Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it before the next

period you can join a Medicare drug plan, and if this coverage through Kentucky State University changes. You also may request

a copy of this notice at any time.

For More Information About Your Options Under Medicare Prescription Drug Coverage:

More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. You’ll

get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.

For more information about Medicare prescription drug coverage:

• Visit www.medicare.gov

• Call your State Health Insurance Assistance Program (see the inside back cover of your copy

of the Medicare & You handbook for their telephone number) for personalized help

• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about

this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

For questions on all of the preceding notices, please contact:Office of Human Resources, 400 East Main Street ASB room 241, Frankfort, KY 40601 (502) 597-6667

Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

Page 28: EMPLOYEE BENEFITS GUIDEAdditional Employee Benefits Holidays Wellness The Thorobred Wellness team will introduce an incentive program that will help employees remain engaged and will

28

This guide is only intended to offer an outline of benefits offered at Kentucky State University. All details and contract obligations of plans are stated in the group contract/insurance documents, including any disclosures (whether regarding “grandfathering” of plans or others) required by the new health reform law, the Patient Protection and Affordable Care Act (PPACA). In the event of

conflict between this guide and the group contract/insurance documents, the group contract/insurance documents will prevail. Please contact the Office of Human Resources for further information.