Enabling the Success of Others

Office of Human Resources

Benefits PresentationPlan Year 9/1/19 – 8/31/20

Prepared by: Marita M. Yancey, Sr. Director, Benefits and WellnessHR - Employee Benefits Services

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Enrollment/Eligibility Rules

• ORP enrollment deadline – enroll through UT Retirement Manager and submit TRS 28 Form within 90 days from the date of hire or initial ORP eligibility date (one-life-time irrevocable election); complete the ORP Acknowledgement form immediately to the Benefits Office.

• Faculty with .50% FTE (part-time) & .75% FTE (Full-time) with 4.5 service months• New hires/newly eligible – must enroll within 31 days from start date• Annual Enrollment – July 15 – July 31 each year• Family Status (Life Events) - 31 days from event date

– Marriage, divorce, annulment, or spouse’s death– Birth, adoption, medical child support order or dependent’s death– Retirement, separation, end job/assignment– significant change in residence if it changes eligibility;– change of job status affecting eligibility (e.g. FTE changes, non-benefits eligible part-time to full-time, starting or

ending employment, starting or returning from FMLA or LOA, etc.); – change in dependent’s eligibility (e.g., reaching age 26, or gaining or losing eligibility for any other reason); or

significant change in coverage or cost of other benefit plans available to you and your family.

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• Full-time Benefits Eligible Employees-eligible for full premium sharing (30-40)– Full-time (75-1.00% FTE) faculty and staff working at least 4 ½ months

• Part-time Benefits Eligible Employees–eligible for half premium sharing(20-29)– Part-time (50-74% FTE) employees working at least 4 ½ months – Temporary (50-74% FTE) employees working at least 4 ½ months– RA/TA (50% FTE) working at least 4 ½ months (not TRS eligible)

• ACA Eligible Employees – measured working an average of 30 hours per week – Part-time/variable hours employees who worked an average of 30 hours per week

(130/month) during a 12-month measurement period– Seasonal (temporary) employees who worked an average 30 hours per week for the 12-

month measurement period– Student employees (not federally or state funded) who worked an average of 30 hours per

week during a 12-month measurement period – Only eligible for a medical plan and no premium sharing

Note: Employees eligibility may change based on job/assignments changes throughout the year. Changes that will impact benefitseligibility is considered life event and may allow employees to make changes within 31 days.

Eligibility Rules

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Optional Retirement Plan Rules & Eligibility

• Mandatory Retirement Options – Teacher Retirement System or Optional Retirement Program (ORP)• Review the Overview of TRS and ORP available online• ORP Eligibility Rules are available through the UT System OEB Website, the Texas Higher Education

Coordinating Board.Website and the Texas Administrative Code - Chapter 25 – ORP

• UT System ORP-eligible positions are defined under the UT System ORP Policy. • ORP eligible employees have 90 days from the date of first becoming eligible for ORP to make a one-time

irrevocable decision using steps below:• Choose your provider(s) from the currently authorized provider list. You may select more than one

provider.• Log onto UTRetirement Manager and click on the ORP Enroll/Change page.• Complete the appropriate provider application(s) to open an account(s) with that company.• Complete the TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program and/or

Refund) and the ORP Acknowledgement mail or deliver to the UT Dallas HR-Benefits Office.

• Before your first ORP deduction, mail all completed provider applications to the vendor address.

• We encourage you to review your options to ensure you are selecting the best retirement coverage for you.

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Basic Coverage Package

Plans Program Provider

Medical UT Select Blue Cross Blue Shield

Prescription UT Select Express Scripts

Basic Life Insurance $40,000 Dearborn National

Basic AD&D $40,000 Dearborn National

EAP (Confidential) Free Counseling UTSW

Wellness Resources Living Well ProgramCatapult Health (On-site Screening)

Premium Sharing Employee Dependents

Full-time – 30-40 hours 100% 50%

Part-time – less than 30 50% 25%

Waived Medical Coverage $314.03 (FT); $157.01 (PT) None

Tobacco Premium Program(Declaration Required)

$30/person up to $90/family

Charge for Tobacco user (age 16 & over) enrolled in the Medical plan

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Medical Plans Overview

Benefits UT Select-Employee Plan In-Network – 9/1/19

UT Connect Medical*In-Network Only-9/1/19

Plan Year Deductible(Individual/Family)

$ 350 - Individual$ 1,050 - Family

$250/person$750/family

Coinsurance Maximum $ 2,150/person$ 6,450/family

$ 2,150/person$ 6,450/family

Annual Out-Pocket Maximum $ 7,350 - Individual$14,700 - Family

$7,350/person$14,700/family

Coinsurance(Plan pays/Participant pays)

80%/20% of allowable charges 80%/20% of allowable charges

Office Visit Copay $30 Family Care Physician$35 Specialist

$15 Family Care Physician$25 Specialist

Hospital Copay $100/Day up to $500; 80%/20%(waive if admitted)

Deductible then 80% Plan/20% Member

Lifetime Maximum No Limit No Limit

Preventive Care 100% of allowable charges 100% of allowable charges

Prescription Drug Yes Yes – same as UT Select

Monthly Cost $0 – Employee only $0 – Employee only

Dependent Coverage Available Yes Yes

*Coverage limited to SWHR (UT Connect) Network Providers in North Texas Medical Plan Link

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Benefit In-NetworkPlan year medical deductible(individual/family) $350/$1,050

Coinsurance(Plan pays/participant pays) 80%/20%

Plan year medical coinsurance maximum(individual/family) $2,150/$6,450

Plan year out-of-pocket maximum (individual/family; includes all member cost share for allowed medical and prescription drug services covered under the plan, such as deductibles, coinsurance, and copays)

$7,150/$14,300

Office visit copay(network visits covered at 100% after copay)

$30 family care physician$35 specialist

UT Select Medical Plan administered by Blue Cross Blue Shield of Texas

UT Select Medical Plan Overview

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ER, anesthesiology, radiology and pathology provider (-ologists)Care received from an out-of-network anesthesiologist, pathologist, radiologist or emergency room physician will be paid at the out-of-network benefit level and at the non-contracting allowed amount.

Benefit NetworkEmergency room (no deductible applies; copay waived if admitted)

$150 per visit plus 20%

MRI/CT copay(copay waived if member calls Benefits Value Advisor prior to service)

$100 copay per procedure

Inpatient facility(copay limited to $500 per admission)

$100 copay per dayplus 20% after deductible

Outpatient surgery(facility/ambulatory surgery center) $100 per day

plus 20% after deductible

UT Select Medical Plan Overview

Bariatric Surgery(member must be continuously enrolled in the UT SELECT plan for 36 continuous months prior to date of surgery)

$3,000 Deductible

Behavioral HealthOffice visit copay(Maximums removed for inpatient, outpatient and office visits)

$35 specialist

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UT Health Network Tier

• Enhanced benefits from UT System Health Institutions except UT MD Anderson, UTRGV & UTSW.

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PPO – How It Works

Your Choice

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Identity Protection Services

This service is available free to all UT Select Medical Plan participants

Service for adults include:• Experian credit report• Daily one-bureau credit monitoring• Customer support 7 days/week• Online and phone enrollment• Choice of email or mail delivery• $1 million identity theft insurance• Fraud resolution team• Comprehensive educational

resourcesFor minor dependent children:• Monitors children’s personal

information on credit file• Fraud resolution services• Experian report • $2 million product guarantee

To enroll in this free program, you should log into your Blue Access for Members (BAM) account at www.bcbstx.com/ut(for UT SELECT participants) or www.bcbstx.com/utconnect(for UT CONNECT participants). Once logged in, please look for the "Identity Protection" link in the "Quick Links" section on the left side of the page.

NOTE: If you have not previously registered with Blue Access for Members (BAM), you will need to do so in order to access the link to sign up for free Identity Protection services. You will need your BCBSTX Identification number, which is the 8 character after UTS0… as shown below.

You will be required to re-enroll annually.

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BCBS Customer Service

CALL Customer Service

on the back of your ID card

866-882-2034

From your computer OR mobile phone, log on to

bcbstx.com/utand click on

“Doctors and Hospitals”

ORfor Worldwide

Assistance call 1-800-810-BLUE

(2583)

Blue Access for Members• Health Advocates• Claims and coverage • Membership eligibility • Help with online tools• ID card requests• Health education

New for 9/1/19Health Advocate Solutions

MD LiveHinge Health

Omada HealthLivongo

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UT Connect Medical Plan Network

• 4,200+ Physicians and Caregivers Located Throughout North Texas• 1,500+ Primary Care Physicians (PCPS) Available for Adult and Pediatric Care• 80+ Areas of Specialty Care, Including Access to Groundbreaking Treatment Options for Major

Illnesses

UT Southwestern Medical Center Faculty

Texas Health Physicians Group

Affiliated Independent/CommunityPhysicians

UT Southwestern Medical Center

Texas Health Resources Hospital Locations

Children’s Health

Cook Children’s Medical Center

HospitalLocations

Physicians & Caregivers

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Phone number will be on your ID Card.

UT Connect Medical Plan Network

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Members Required to Receive Care from Physicians, Hospitals and Health Care Providers Participating in UT CONNECT Network• No Coverage for Out-of-Network Care in Service Area• Exceptions for Emergencies

True Emergencies: Out-of-Network & Out-of-Area Covered– Examples: Heart Attack, Stroke, Life-Threatening Trauma/Accident – Dallas/Fort Worth Area, Plus Anywhere in Texas or United StatesNot Considered a True Emergency• Finger Cuts, Pediatric Colds and Flu, etc.• No Coverage for ER Visits for These Health Situations and Injuries• Contact PCP, Doctor Office Visits Covered• Additional Support -- 24/7 Nurseline

Travel and College Students• On-campus health clinics usually included in college fees • Continue existing or establish a new relationship with a

DFW PCP– An office visit may not be necessary– Many PCPs can respond by text, call or email

• Urgent care covered– Call Blue Cross Blue Shield of Texas’ Benefit Value Advisor number

to find the closest, in-network urgent care facility • Emergencies covered• Most families choose to bring the family member home if

elective procedures are needed

UT Connect Out-of-Network Coverage

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Medicare & UT Select/Connect

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(888-315-9473)

Health and Wellness

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If you obtain a brand-name drug when a generic equivalent is available, you are responsible for the generic copayment plus the cost difference between the brand-name drug and the generic drug. Chart illustrates benefits when network pharmacies are used. Non-network benefits are also available; see Enrollment Guide for more information.

Effective 9/1/19 – you may obtain 90 day supplies at all Walgreens and UT Pharmacies with same copay as home delivery.

Prescription Drug Benefits

Express Scripts

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Covered Services Dental Select Dental Plus DeltaCare HMOService Area Nationwide Nationwide Areas in TexasAnnual Deductible $25/person $0 N/AOut-of-Network Yes Yes Network onlyAnnual Maximum $1,250 $3,000 N/ADiagnostics & Preventive

100% 100% See schedule of benefits online

Basic Services Fillings

80% Plan20% Member

100% See schedule of benefits online

Major ServicesCrowns, Bridges

50%/50% 80%/20% See schedule of benefits online

OrthodonticAdult and Children

50%/50%Lifetime:$1250

80%/20%Lifetime:$3000

See schedule of benefits

Customer Service 800-893-3582 www.deltadentalins.com/universityoftexas

Dental Benefits Overview

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Delta Dental Networks

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Coverage Basic Plan Plus Plan

Co-paysExam: $35, Materials $0Contact lens Fitting = $35

Exam: $35; Materials $0Contact lens Fitting = $35

Frames $140 retail allowance $165 retail allowance

Lens Standard lenses covered Progressive = trifocal retail amount

Standard lenses covered Progressive $120 allowance

Contact Lens $125 – Elective - allowance$0 - Medically Necessary

$150 – Elective - allowance$0 - Medically Necessary

Plan Frequency All Service – 1 Per Plan Year All Service – 1 Per Plan Year

Superior Vision

CUSTOMER SERVICE (800) 507-3800 https://www.superiorvision.com/openenroll/ut

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UT FLEX – Maestro Health

Enroll in UT Flex to Save on taxes and increase your take home pay!Contributing pre-tax dollars helps reduce your taxable income and increase your take home pay! Two types of UT FLEX accounts

• Health care account – 2019-2020 limit to $2,700 per IRS• Dependent care account – Limit $2,500/$5,000 per IRS• Minimum amount of $15 per month to participate

Note: You (and/or your spouse) don’t need to be covered under UTD health plan to participate.

Debit Card Availablefor Health Care

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Life & Disability Plans

• Basic Coverage $40,000 (No cost to employee)• Employee = 1-10x up to $2M• Spouse = $10/$25/$50K; Child/ren=$10K

Life• Basic Coverage $40,000 (No cost to employee)• Employee=10x up to $2M• Spouse=50% of EE up to $1M; Child/ren=$10K

AD&D• Insuring your Paycheck• Short-term=60% up to $693/wk; 22 wks.• Long-term = 60% up to $12,025/month

Disability

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Basic Life Insurance

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Voluntary Life Insurance

Accelerated Death Benefits: Insured participants may be eligible to receive 50% of the terminally insured’s group term life insurance.

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Accidental Death & Dismemberment

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Short-Term Disability

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Long-Term Disability

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Monthly Insurance Premiums

Employee Only Employee & Spouse Employee & Child(ren) Employee & Family-$ 270.41$ 282.81$ 532.51$ -$ 243.37$ 254.53$ 479.26$

30.00$ 60.00$ 60.00$ 90.00$

Employee Only Employee & Spouse Employee & Child(ren) Employee & Family314.02$ 749.04$ 702.16$ 1,117.45$ 314.02$ 749.04$ 702.16$ 1,117.45$

30.00$ 60.00$ 60.00$ 90.00$

Employee Only Employee & Spouse Employee & Child(ren) Employee & Family28.51$ 54.13$ 59.66$ 84.83$ 61.39$ 116.59$ 128.65$ 183.29$

8.80$ 16.73$ 18.49$ 26.40$

Employee Only Employee & Spouse Employee & Child(ren) Employee & Family5.90$ 9.30$ 9.52$ 15.10$ 9.00$ 14.08$ 15.08$ 21.30$

$314.02 UT Select Medical Plan includes Prescription$157.01 $40,000 Basic Life and $40,000 AD&D Insurance

Medical Plan with PrescriptionCoverage/Tier Level

Medical Plan with Prescription

UT Select Medical

Tobacco Program

Employee Cost

UT Select Dental UT Select Dental Plus

Vision Plan

2019-2020 Insurance Benefits Premium - 12-Month Deduction Rates for Staff/Faculty Paid Over 12 Months & RA/TAEmployee Cost - Full-time (30-40 Hours per week)

*Available in certain areas of the State of Texas.

Basic Coverage Package May be used for Dental, Vision &

Superior VisionSuperior Vision Plus

UT Connect - ACO

UT Connect - ACO

Full-Time Employees: 30-40 hoursPart-Time Employees: 20-29 hours

Premium Sharing for Waived Medical Coverage

Employee Cost - Part-time (20-29 Hours per week)Coverage/Tier LevelUT Select Medical

Tobacco Program

DeltaCare Dental HMO*

Coverage/Tier Level

Dental Plan Employee CostCoverage/Tier Level

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Nine-Month Insurance Premiums

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• Coverage for faculty and RA/TA generally ends on May 31st (end of school) for those who are not appointed during the summer period and no Fall classes

• UTD will offer COBRA coverage if you and your dependents lose coverage

• COBRA notice mailed to home

• Contact vendors for conversion to individual coverage may be available for voluntary insurance, if eligible, and apply within 31 days from coverage end date

• Review UT Cobra Coverage information

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COBRA Coverage

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Teacher Retirement System

Teacher Retirement System of Texas(TRS)• Contribution: Employee: 7.7% Employer: 7.5%• Defined Benefit Plan (Managed by TRS)• Benefit Formula*

• Vested after 5 years of TRS eligible service credit• Death and disability benefits available• Normal Retirement-Age 62 and Rule of 80 (age+Service)• Maximum Salary of $270,000 (subject to IRS changes)

*Average Salary is determined by Tier

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Optional Retirement Program

Optional Retirement Program (ORP)• Contribution: Employee: 6.65% Employer: 8.50%• Defined Contribution Plan – 5 approved vendors & self-directed

investment• One life-time irrevocable election• Must enroll within 90 days of eligibility• No death or disability benefits• Full-time faculty and eligible administrative positions• ORP, 403(b) Roth & TSA Combined limit of $54,000 in 2017 unless

hired before 9/1/96• Vested after 1 year and one day of active participation• Maximum Salary of $280,000 for 2019 (subject to IRS changes)

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Social Security

• Social Security and Medicare Program Mandatory for all Employees

• Social Security Contributions:Contributions (EE & ER) – 6.2% of eligible salary

• Medicare Contribution: Contributions (EE/ER) –1.45% of eligible salary

• Government Pension benefits in addition to TRS

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UT Retiree Benefits

Medical, Dental, Vision, Life Insurance• Must meet the Rule of 80 (age + years of creditable state

service equals 80) or age 65 with 10 years of total state service

• Must have 10 years of service with UT System (3 years if employed in a benefits eligible position at a UT System Institution on 8/31/03)

• Must retire with TRS or ORP• Benefits available if approved for TRS Disability

retirement

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Voluntary Retirement Program

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My Retirement Overview

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Enroll Online

Retirement Program Vendors

Provider Website Telephone Number

Fidelity Investments www.fidelity.com/ut (800) 343-0860

VOYA https://utexas.beready2retire.com/ (866) 506-2199

Lincoln Financial Group www.lfg.com/ut (800) 454-6265 *8

TIAA www.tiaa.org/utexas (800) 842-2776 VALIC www.VALIC.com/utsystem (800) 448-2542

ORP, UT Saver and DCP Approved Providers

Enroll or make changes monthly by the 10th of each month for the following month’s paycheck

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Employee Wellness Program

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Wellness @ UTD

• SPN Employee Wellness Center – membership fees apply• Fitness Classes, YOGA, Zumba• On-site Dietitian/Nutritionist – Taylor Tran• Lunch and Learns – Health, Mind, Body & Wealth• Corporate Challenge• Right This Weigh Challenge• Mammography• Employee Assistance Program (EAP)• Heart Healthy/Heart Walk• Flu Clinics• Health Screenings – Catapult• Naturally Slim• UT System Physical Challenge

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Eligibility Worked at least 12 months (includes State service) Have at least 1,250 hours of service during the 12 months before leave begins 12 weeks of FMLA Leave – employees are required to use vacation, sick, comp time if available 12 weeks may be continuous or intermittent

Qualifying FMLA Leave For the birth or placement of a child for adoption or foster care(both parents eligible for 12 weeks total) To care for a spouse, son, daughter, or parent with a serious health condition For their own serious health condition Military Family Leave

• Because of a qualifying reason arising out of the covered active duty status of a military member who is the employee’s spouse, son, daughter, or parent (qualifying exigency leave)

• To care for a covered servicemember with a serious injury or illness when the employee is the spouse, son, daughter, parent, or next of kin of the covered servicemember (military caregiver leave)

Serious Health Condition definition - Illness, injury, impairment or physical or mental condition involving: a) Inpatient Care, or b) Continuing Treatment by a Health Care Provider

FMLA Triggering events prompting employees and department reporting of FMLA to Human Resources Employee’s absence from work for more than 3 consecutive days due to illness or illness of family

member Employee pregnancy

Family Medical Leave

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Paid Time-Off

Vacation (Annual) Leave (VC) Faculty positions are not eligible

Sick Leave (SL)* - Balances available in Galaxy Faculty & Staff with at least .50% FTE 8 hours accrual or proportionate to FTE% Faculty must report their sick leave usage through Galaxy

Holiday Faculty & Staff with at least .50% FTE; Holiday is proportionate to FTE The number of holidays is authorized by the Legislature. UT Dallas publishes the

approved holiday schedule online each year

Other Paid Time-off, if approved and allowable in the policy Emergency and Funeral Leave Jury Duty or court appearance

Important Reminders: Any authorized paid-time off or leave must be reported through the Time and Labor and Absence Management System.

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Notify supervisor/manager of the absence

Apply for Family and Medical Leave if absence is due to serious health condition and resulted in continuous absence of more than 3 days or ongoing/periodic absences due to treatment of such condition.

Complete/sign the Request for Family and Medical Leave Form and submit to HR – Leave Administrator with supervisor signature

Have the treating physician complete and sign the Certification of Health Care Provider (CHCP) form and send the completed form to the Office of Human Resources directly.

Provide 30 days advance notice of planned leave (i.e. pregnancy and planned surgery)

Notification of leave if foreseeable should be made 30 days in advance; if unforeseeable, as soon as practicable

Provide release to return to work 5 days prior to returning

If leave needs to be extended, contact the Leave Administrator 5 days prior to the expiration of the leave

Follow-up with the Leave Administrator of any changes to the leave status and continuing communication with supervisor

Employee Responsibilities

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Paid Military Leave/Training for up to 15 working days in a federal fiscal year (October 1 through September 30)

National Emergency active duty for members of a reserve branch of the US Armed Forces (will accrue state credit but not vacation or sick leave) = entitled to paid leave of 15 days; then use available leave or be unpaid

Call to National Guard Emergency Leave by the Governor of Texas = leave with full pay and benefits based on duration of emergency assigned duties

Extended Unpaid Military Leave Employee must provide notice to supervisor and inform HR Employee must provide a copy of the military order/assignment Coordination with the Benefits Office for benefits processing Provides job protection under USERRA (Uniform Services and

Reemployment Rights Act of 1994) up to 5 years• Military service must not exceed the five-year cumulative period • Must report back to their previous job within the time limits established by law or submit

an application for reemployment

Military Leave

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What is Next?

• Review your benefit options• Review and watch for your Initial Benefits Enrollment Notice via your UTD email. If you

don’t get in 3 weeks, email benefits@utdallas.edu.• Enroll for Benefits within 31 days from start date through My UT Benefits• Upload all documents needed by deadline date

• Submit evidence of insurability by the deadline• Designate your beneficiary online

• Review your Confirmation Statement• Review benefits deduction from your paychecks on your 1st or 2nd paycheck• Email benefits@utdallas.edu of discrepancies• August new hires/newly eligible may require dual enrollment (Plan Years 2018-2019 and

2019-2020). Review our elections for both years.

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Enroll through

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My UT Benefits Portal

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Resources

• UT Dallas HR-Benefits Page

• UT System Office of Employee Benefits Website – Online Benefits information Resources

• My UT Benefits -Online Enrollment; Benefits Summary; Online Beneficiary Access

• Annual Enrollment and Resources for Employees

• Interactive Benefits Cost Worksheet

• Retirement Overview and Educational Resources

• UT Systems Living Well Health & Wellness Program• Affordable Care Act Information

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Resources and Contacts

• UT Retirement Programs

• Teacher Retirement System of Texas

• Optional Retirement Program and Texas Higher Education Coordinating Board ORP information

• UT Retirement Manager (UTRM) Online Retirement System

• Benefit Vendor Contacts, Group Numbers and Websites

Contact Information

• HR-Benefits Team Members• benefits@utdallas.edu – benefits mailbox• loa@utdallas.edu ; Policies: https://policy.utdallas.edu/utdbp3054• HCM-Timereporting@utdallas.edu

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Please sign and return the ORP Acknowledgement Form given to you at Employment Express.

ORP Acknowledgement

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Office of Human Resources Benefits/ACA Acknowledgement

Please sign and return the Benefits & Retirement Eligibility and ACA Notice Acknowledgement given to you at Employment Express: http://www.utdallas.edu/hr/download/Benefits_New_Hire_Retirement_Eligibility.pdf

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HR-Benefits Team at Your Service!

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• This presentation provides an overview of terms and conditions of the insurance, retirement and wellness programs for The University of Texas System. OEB maintains plan guides, which contain more detailed information. The plan guides can be found online at ww.utsystem.edu/benefits. Please consult the plan guides for specific benefit information.

• The University of Texas System reserves the right to amend, change or terminate the health and welfare benefit plans, any underlying contracts or any other programs, at any time and without notice, at its sole discretion, according to the terms of the applicable plans or programs.

• If any errors occur, the policies and plan guides will prevail.

Disclaimer

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Thank You!

If you need assistance in enrolling or questions about your benefits , please email benefits@utdallas.edu. Just a reminder, you must enroll within 31 days from your date of hire or effective date of employment.

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