Trinity College Employee Benefits 2018 Benefits Guide... · Trinity College Employee Benefits 2018

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    1

    EFFECTIVE FOR PLAN YEAR: January 1, 2018 through December 31, 2018

    Trinity College

    Employee Benefits 2018 Benefits Guide

    Trinity College offers you and your eligible family members a comprehensive and valuable benefits program. We encourage you to take the time to educate yourself

    about your options and choose the best coverage for you and your family.

  • Page 2 of 28

    __________________________________________________ Whats in this Guide?

    Eligibility Information/How to enroll Page 3

    Medical Insurance Page 4

    Health Savings Account (HSA) Page 6

    Dental Insurance Page 6

    Company Paid Life / AD& D Insurance Page 7

    Supplemental Insurance Page 7

    Voluntary Vision Plan Page 8

    Voluntary Benefit - AFLAC Page 8

    Other Benefit Programs including Flexible Spending Accounts, STD and LTD Insurance

    Page 9

    Benefit Resource Center Page 10

    Important Notices Page 11

    Who to Contact Page 27

    If you (and/or your dependents) have Medicare

    or will become eligible for Medicare in the next 12 months, a Federal

    law gives you more

    choices about your prescription drug coverage.

    Please see page 18 for more details.

    IMPORTANT NOTICE: This document is provided to help employers understand the compliance obligations for Health & Welfare benefit plans, but it may not take into account all the circumstances relevant to a particular plan or situation. It is not exhaustive and is not a substitute for legal advice.

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    Who is Eligible?

    Enrollment is available to all continuing employees with an FTE of .5 or more.

    The following family members are eligible for these benefits: Employee, Legal Spouse, Child(ren) and other legal child guardianship dependents. Any dependents not currently covered will need to provide proof of dependent eligibility (birth certificate, marriage certificate or court papers).

    Dependent Child Eligibility:

    Group Medical: Children are eligible until the end of the calendar month in which they turn 26 regardless of student status.

    Group Dental: Dependent children are covered to age 19 (25 if enrolled as a full-time student in an accredited school or university).

    Coverage for dependent children will terminate at the end of the month in which they attain limiting contract age.

    How to Enroll All employees, regardless of your election, will be required to complete the Flexible Spending

    Account (FSA) Deduction Authorization Form. This is due to health care reform requirements.

    You will need to complete the medical and/or dental and/or voluntary vision enrollment form if you would like to do any of the following: come onto the plan for the first time, change to a different medical/dental plan option, cancel your current plan or make dependent changes.

    You will need to complete a supplemental life insurance form if you are: coming onto the plan for the first time, changing your amount of coverage currently in force, canceling the plan or updating your beneficiary information. If you are enrolling or revising life insurance amounts, you will need to complete an Evidence of Insurability questionnaire for the carrier.

    If you elect benefits, you may only change them during the year if you have a life status change or during open enrollment. The open enrollment period is usually during the month of November. The benefits you elect during open enrollment will be effective on January 1.

    If you have any questions, please contact Wendy Vaillancourt in HR at ext. 2275.

    Please Note: If you elect the FSA Section 125 pretax benefit you cannot make changes to the benefits you elect until the next open enrollment period unless you have a qualified change in status. Qualified changes in status include: marriage, divorce, legal separation, birth or adoption of a child, change in childs dependent status, death of spouse, child or other qualified dependent, change in residence due to an employment transfer for you or your spouse, commencement or termination of adoption proceedings, or change in spouses benefits or employment status. You must notify us in writing within 30 days of a change in status.

    This enrollment guide is intended to be a summary of the benefits offered. Please refer to complete benefit summaries from each insurance carrier for detailed provisions on each benefit program being offered.

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    Medical Insurance being offered by Cigna

    A REVIEW OF YOUR MEDICAL PLAN

    Trinity College understands the importance of benefits for our employees and their dependents. After an extensive review, we have elected to keep the medical coverage, vision and the prescription coverage with Cigna.

    The Cigna plans offer a national provider network. This means that all employees will have access to participating providers in any of the 50 states and services will be covered under the in-network provisions.

    Employees have the option of enrolling in a choice of 2 plans:

    o Cigna Open Access Plus (OAP) Plan: $20 Primary Care and Specialist Copay with a $200 / $400 / $600 deductible on the inpatient and outpatient services. The prescription copays are $15 / $25 / $40 / $100.

    o Cigna HDHP with HSA: $1,350 Single / $2,700 Employee + 1 / $4,050 Family High Deductible Health Savings Account Compatible Plan with a $15 / $25 / $40 / $100 prescription copay after the deductible is reached. (Deductible waived for preventive prescription medications related to hypertension, high cholesterol, diabetes, asthmas, osteoporosis, stroke or prenatal nutrient deficiency).

    Preventive care is covered as follows on all plan options for FREE:

    Infant / Pediatric Physical Exam 100%

    Routine Adult PCP Physical Exam (1 per calendar year) 100%

    Routine GYN Exam 100%

    Routine Mammograms (per schedule) 100%

    Routine Colorectal (per schedule) 100%

    PSA Testing 100%

  • 2018 Cigna Medical Plan Options

    Benefit Feature Cigna Open Access Plus (OAP) Plan Cigna High Deductible Health Plan with

    Health Savings Account

    In Network Out of Network In Network Out of Network

    Annual Deductible Ee / Ee + 1 / Ee + 2 or more

    $200/$400/$600 $400/$800/$1,200 $1,350/$2,700/$4,050 $1,350/$2,700/$4,050

    Plan Coinsurance 100% 70% 90% 70%

    Outofpocket Maximums Ee / Ee + 1 / Ee + 2 or more

    $2,800/$5,550/$8,300 $2,800/$5,550/$8,300 $2,800/$5,550/$8,300 $2,800/$5,550/$8,300

    Preventive Care Covered 100%,

    deductible waived Covered 70% after

    deductible Covered 100%,

    deductible waived Covered 70% after

    deductible

    Routine Eye Exam $20 co-pay,

    deductible waived Covered 60% after

    deductible Covered 100%,

    deductible waived Covered 60% after

    deductible

    Nonpreventive Care PCP / Specialist

    Walkin clinic

    $20 co-pay, deductible waived

    Covered 70% after deductible

    Covered 90% after deductible

    Covered 70% after deductible

    Diagnostic Laboratory and Xray

    Covered 100%, deductible waived

    Covered 70% after deductible

    Covered 90% after deductible

    Covered 70% after deductible

    Maternity Initial confirmation visit

    $20 co-pay, deductible waived

    Covered 70% after deductible

    Covered 90% after deductible

    Covered 70% after deductible

    Global maternity fee for pre and postnatal visits and physicians delivery charges

    Covered 100% after deductible

    Covered 70% after deductible

    Covered 90% after deductible

    Covered 70% after deductible

    Additional visits as required by OB/Gyn or Specialist

    $20 co-pay, deductible waived

    Covered 70% after deductible

    Covered 90% after deductible

    Covered 70% after deductible

    Emergency Care Urgent care not covered for nonurgent services

    $25 co-pay, deductible waived

    Covered 70% after deductible

    Covered 90% after deductible

    Covered 70% after deductible

    Emergency room not covered for nonemergency services

    $50 co-pay, deductible waived

    $50 co-pay, deductible waived

    Covered 90% after deductible

    Covered 70% after deductible

    Ambulance (emergency use) Covered 100%,

    deductible waived Covered 100%,

    deductible waived Covered 90% after

    deductible Covered 70% after

    deductible

    Inpatient Hospital $100 co-pay after

    deductible Covered 70% after

    deductible Covered 90% after

    deductible Covered 70% after

    deductible

    Outpatient Surgery $75 copay after deductible Covered 70% after

    deductible Covered 90% after

    deductible Covered 70% after

    deductible

    Physical/Occupational/Speech Therapy (up to 60 days/year)

    $20 co-pay, deductible waived

    Covered 70% after deductible

    Covered 90% after deductible

    Covered 70% after deductible

    Mental Health Services Inpatient care

    $100 co-pay, after

    deductible

    Covered 70% after

    deductible

    Covered 90% after

    deductible

    Covered 70% after

    deductible

    Outpatient care $20 co-pay,

    deductible waived Covered 70% after

    deductible Covered 90% after

    deductible Covered 70% after

    deductible

    Prescription Drugs (Retail-30 day / Mail-90 day) Tier 1-Generic Tier 2-Preferred Brand Tier 3-Non Preferred Brand Tier 4-Self-Admin. Injectable

    Deductible waived

    $15 / $30 $25 / $50 $40 / $80

    $100 /$200

    Not covered

    Deductible* then, $15 / $30 $25 / $50 $40 / $80

    $100 /$200