TO:
FROM:
DATE:
SUBJECT:
UVM Non-Represented Faculty and Staff Members
Greg Brown, Benefits Manager, Human Resource Services
May 2007
FY2008 Benefits Open Enrollment
UVM’s Benefits Open Enrollment period begins May 1 and ends on May 31. Coverage for your
insurance elections will begin July 1, 2007 and end June 30, 2008. The month of May is the only
time that you can make changes to the medical, dental, and disability insurance components of
your benefits package. Please contact the Benefits Office with any family status change you have
during the year.
Human Resource Services provides the following summary benefit information for Open
Enrollment. It is designed to summarize any new benefit features that have been added to the
benefits package during the past 12 months or that will be added on July 1, 2007. It is not
intended to provide full and complete details for each benefit. Full and complete descriptions of
the various insurance benefits and the Flexible Spending Account are contained within
appropriate plan documents or subscriber certificates (in conjunction with the UVM Nonrepresented Faculty Handbook, the UVM Officers’ Handbook, or the UVM Staff Handbook.
Before making any changes, employees are encouraged to familiarize themselves with their
insurance benefits at the above links.
This information regarding the University’s benefits program and the status of related plans is
intended for faculty and staff who are not represented by unions. Collective bargaining unit
employees are subject to the terms and conditions of employment outlined in their union
contracts.
For unionized employees, benefits are bargainable and will be addressed through the collective
bargaining process with union representatives. Represented employees must contact their union
representatives with their questions and comments. All employees, however, may contact their
supervisors or Human Resource Services to seek clarification or ask questions regarding existing
benefits programs.
May is Open Enrollment Month at UVM
The following describes the Open Enrollment period for coverage beginning July 1, 2007 and
ending June 30, 2008.
Take time now to review the benefits you receive as a non-represented University of Vermont
faculty or staff member. During the month of May 2007, you may choose to do the following:
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enroll for the first time in medical or dental insurance plans
change or update your insurance coverage (e.g., make changes within plans, switch plans)
waive coverage
If you missed a 30-day deadline to add a dependent to your medical, dental, or life insurance
coverage during the year, you may add all eligible dependents at this time. The new changes will
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be effective July 1, 2007.
You will continue to designate your cultural holiday and enroll in Flexible Spending in
November for the following year.
What Do I Need To Do?
1. Check what benefits you're enrolled in currently. Consult PeopleSoft Employee SelfService or your paycheck.
2. Attend the Benefits Fair on May 3rd. This is your chance to talk with the benefits experts,
ask questions, and win prizes!
3. Review the available plans and any changes effective July 1, 2007 below.
4. Choose the plan that works best for you. If you are satisfied with your current provider,
coverage will continue without any action on your part.
5. If you wish to switch your plan provider, enroll in the plan of your choice before May 31,
2007.
Changes Effective July 1, 2007
Life Insurance and Long-Term Disability Insurance
No changes.
UVM Retirement Savings Plan
Participants may contribute to the plan a dollar amount up to 100% of their compensation minus
their benefit costs (e.g., FICA and Medicare taxes, health and dental deductions, etc.) to a limit
of $15,500 in calendar year 2007.
The overall employer-employee combined limit per calendar year is $45,000 for 2007, not to
exceed 100% of their compensation minus their benefit costs.
Participants aged 50 and over on December 31, 2007, may contribute an additional $5,000 to the
plan in calendar year 2007.
Medical and Dental Insurance
Medical and dental insurance premiums are increasing for FY 2008 as follows:
Blue Cross Blue Shield Vermont Health Partnership
5.0% increase
Blue Cross Blue Shield Freedom Plan
16.3% increase
MVP
13.0% increase
Delta Dental
no increase this year
Faculty and staff members’ premium payments will change accordingly effective July 1, 2007.
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The Schedule of Monthly Premium Costs attached reflects these premium increases.
Medical Insurance Coverage
As an employee of the University of Vermont, you have three choices for medical insurance:
1. Blue Cross/Blue Shield – See “Blue Cross/Blue Shield Plan” below for information
2. MVP Health Plan – See “MVP Health Plan” below for information.
3. Waiver – The waiver of medical coverage is $1,000 and will be reimbursed over the
fiscal year (July 1, 2007 to June 30, 2008). A new provision requires you to provide
annual certification of coverage in the health plan of a spouse or civil union partner.
If you wish to change coverage, the Open Enrollment period is the only time during the year
when you can switch plans. If you are currently waiving coverage, you may continue to waive
coverage for another year or enroll in one of the medical plans. For detailed information, please
visit the Benefits website.
Premium Payment
Total and employee monthly share of premium costs are available at the Benefits website.
The salary will be the employee’s base salary as of January 1 of each year and will not be
affected by salary changes during the year, unless you have a job or FTE change.
To determine premium payments for medical school faculty, base salary will be defined to
include the combined salary paid under the common paymaster.
Employees with 9-, 10- or 11-month appointments will pay their share of annual premiums over
the term of their appointment. For example, a 9-month employee will pay for their 12-month
coverage over their 9-month term (18 paychecks).
Part-time non-represented faculty and staff employees are eligible to participate and receive
UVM contributions if their full-time equivalency is at least 50%, and they have been employed
for at least four consecutive semesters if faculty, or one year if staff. Premiums are based on the
employee’s full-time equivalency. For example, an employee who works 60% FTE pays 40% of
the cost of coverage. Part-time employees who are at least 50% FTE but do not meet the length
of service requirement may enroll, if they pay the full cost of coverage.
Part-time represented faculty are eligible to participate in the high-deductible plan by paying the
full premium.
Blue Cross/Blue Shield Plan
Your Blue Cross/Blue Shield Plan depends on whether you live in the network service area or
outside of Vermont. If you live in Vermont or Western New Hampshire, you must be enrolled in
the Vermont Health Partnership (VHP). This plan requires the selection of a primary care
physician. BCBS has eliminated the referral system. You may visit any network specialist as
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long as none of the following 16 specific procedures are being performed:
1. Plastic or cosmetic surgery (for example, abdominoplasty, lipectomy, blepharoplasty,
breast reconstruction, otoplasty, panniculectomy, rhinoplasty or septorhinoplasty)
2. Dental surgery (oral surgery, trauma, orthognaltic surgery)
3. Chiropractic care after initial 12 visits in a calendar year
4. Radiology special procedures (MRI, MRA, MRS, PET scans)
5. UPPP/somnoplasty
6. Continuous Passive Motion (CPM) equipment
7. Durable Medical Equipment with a purchase price over $1,000
8. Orthotics/prosthetics
9. Polysomnography (sleep studies)
10. Chondrocyte transplants
11. Home infusion therapy
12. Private duty nursing
13. Transplants
14. TENS units/neuromuscular stimulators
15. Rehabilitation (cardiac/pulmonary/inpatient rehabilitation facility)
16. Services by any out-of-network provider
You pay $10 when you see your primary care physician (PCP) and $20 when you use a
specialist. Emergency hospital care has a $50 co-pay per visit that is waived if followed by
hospitalization. There is a co-pay of $250 for each hospitalization with a maximum of three copays per family per plan year. This co-pay is for an entire course of treatment; if one is
readmitted to the same hospital for the same diagnosis or treatment after a discharge within 21
days, there is no additional co-pay. Out-patient surgical benefits have a co-pay of $100 and
ambulance services have co-pay of $50.
With prior BCBS approval, you may choose to go to an out-of-network doctor or hospital.
However, with this choice you will incur a $500 per person deductible ($1,000 family
maximum), after which you will be reimbursed 70% of expenses. You will pay 30% until you
have met a $2,500 out-of-pocket maximum ($5,000 family out-of-pocket maximum) after which
you will be reimbursed 100%.
If you live outside the network area, you must be enrolled in the Vermont Freedom Plan (VFP),
which does not require selection of a PCP. As long as you use a provider who participates in a
local Blue Cross/Blue Shield Plan, in/out-patient services are reimbursed at 90% of reasonable
and customary charges after an individual deductible of $100 ($300 per family) has been met.
Hospital admissions and surgery require prior authorization and are payable at 90% of
reasonable and customary charges after an individual deductible of $100 ($300 per family) has
been met. The out-of-pocket annual maximum is $1,100 per person plus prescription drug copayments and the plan pays 100% thereafter.
One advantage of the Blue Cross Plan is that you can go to any physician or acute care shortterm general hospital worldwide. However, the plan will pay only reasonable and customary
charges. If the provider does not participate in the local Blue Cross/Blue Shield plan and the
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charges are above reasonable and customary, you must pay the difference.
Mental health and substance abuse benefits under both the VHP and the VFP must be precertified by Magellan Behavioral Health. Outpatient care for VHP has a co-pay of $20. For
VFP, you will be reimbursed at 90% of reasonable and customary charges after an individual
deductible of $100 ($300 per family) has been met. For services pre-approved by Magellan or
UVM’s Employee Assistance Program (EAP), benefits are payable at the same rate (co-pay of
$20) as PCP referrals under the medical portion of the plan.
Prescription drug coverage is provided through a network of retail pharmacies managed by
RESTAT. Under VHP and VFP, after you have met the $100 deductible, you will pay $5 per
generic prescription, $20 per preferred brand prescription or $40 per non-preferred brand
($5/20/40). Prescription drug coverage will have a maximum out-of-pocket of $1,300
individual,
$2,600 two-persons and family of $3,800. A voluntary mail order prescription drug plan is
available for maintenance drugs through IPS. You may purchase a 90-day supply at a cost
equal to two co-pays, (i.e., $10/40/80). There is no deductible on mail-order prescriptions. See
the complete BCBS preferred prescription drug list.
Claims for prescriptions through network pharmacies or IPS mail order are automatically filed
with Blue Cross at the time of purchase. You must submit non-network claims directly to Blue
Cross for processing.
MVP Health Plan
MVP’s Vermont CO-PLAN 15 is an alternative to Blue Cross/Blue Shield. Under this plan, a
PCP must be selected for health care. Office visits such as well-baby, periodic physicals,
OB/GYN, laboratory and testing services, outpatient surgery, mental health, physical therapy,
chiropractic, etc. have a co-pay of $15 per visit. Emergency hospital care has a $50 co-pay per
visit in-area that is waived if followed by hospitalization and no charge for out-of-area
emergency hospital care. There is a co-pay of $240 for each hospitalization. Out-patient surgery
has a co-pay of 20% or $100 whichever is less.
Prescriptions are covered by a $100 deductible and a $5/20/40 formulary drug card program. If
covered under the formulary and you have met the $100 deductible, you will pay $5 per generic
prescription, $20 per preferred brand prescription or $40 per non-preferred brand. If it is not
covered under the formulary, you must pay the entire cost of the prescription. See the complete
MVP prescription drug list online.
One feature of MVP that may be attractive to parents with college-age students is Expanded
College Student Coverage which provides up to $2,500 annually for out-of-area care including
doctors’ visits, lab work, physical therapy, and emergencies.
With MVP, you may not seek care from providers who are not MVP-participating physicians.
You are not free to choose your specialty care. Specialist services are covered only if they are
first authorized by MVP and your PCP.
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Visit www.mvphealthcare.com for more information about MVP’s Vermont CO-PLAN 15.
Waiver of Medical Coverage
The State of Vermont has established the Catamount Health Plan for individuals who are not
covered by their employer. A provision requires annual certification of coverage when an
employee waives medical insurance coverage. Beginning July 1, 2007, if you elect to waive
medical insurance coverage, you are required to complete an annual written certification form
attesting that you are covered with two-person or family coverage by your spouse or civil union
partner. Certification must be returned to the Benefits Office, 228 Waterman Building. Failure
to provide annual certification will make you ineligible for the waiver payment described as
follows.
UVM offers an annual $1,000 payment in lieu of medical coverage. This option is available to:
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An employee who certifies that they and, if applicable, their dependents are covered by
non-UVM medical insurance.
The waiver option is available to full-time employees only. A full-time employee is
defined by UVM as anyone who is employed at 75% full-time equivalency (FTE) or
more on a 12-month basis, or 100% on a 9, 10 or 11-month basis.
This option is not available to an employee whose spouse also works at UVM nor is it available
to an employee formerly retired from UVM with post-retirement benefits. Further, it is not
available if you waive coverage for your eligible dependents but not yourself.
The waiver of $1000 is subject to tax withholding and payments are spread throughout the year.
These payments can be converted to pre-tax dollars through a Flexible Spending Account.
If you lose your non-UVM medical insurance by an event outside your control, you are eligible
to enroll in a UVM medical plan within 30 days of the date of the event.
If you waived coverage for yourself and your dependents, and your spouse loses employment, or
if you lose coverage because of divorce or your spouse’s death, you may enroll in the UVM plan
within 30 days of the date of the event. You may not come back into a UVM plan simply
because your spouse’s employer increases premiums or decreases coverage until the next Open
Enrollment period.
Dental Insurance Coverage
The University offers two dental plans, the Base Plan and the High Option Plan, through
Northeast Delta Dental.
Full-time employees are eligible for coverage after a six-month waiting period. For the Base
Plan, UVM will pay the premium for full-time employees and dependents. For the High Option
Plan, the employee pays the difference between the premium cost for the Base and High Option
Plans.
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Dental coverage for part-time employees is optional after one year of service for staff and four
consecutive semesters for faculty. For the Base Plan, UVM will contribute a percent equal to the
employee’s FTE. For the High Option Plan, in addition to their share of the Base Plan premium,
the employee pays the difference between the premium cost for the Base and High Option Plans.
If you currently have dental insurance coverage, no action is necessary. However if you
previously waived coverage, you may enroll during this Open Enrollment period. Coverage will
be effective on July 1, 2007.
The features of the Base and High Option Plans follow:
Coverage A (Preventive)
Coverage B (Minor Restorative)
Coverage C (Major Restorative)
Deductible/Person/Calendar Year
Deductible/Family/Calendar Year
Base
100%
80%
50%
$25
$75
High Option
100%
80%
60%
$25
$75
Deductible Applied to Coverage A
Maximum/Person/Calendar Year
Coverage D (Orthodontics)
Lifetime Maximum/Person
Base
Yes
$750
50%
$500
High Option
No
$1,500
50%
$1,000
Employee Monthly Cost for Optional Plan:
Employee Only
$ 6.36/month
Employee and Spouse
$12.67
Employee and Child(ren)
$13.28
Employee and Family
$19.52
Please note: The high option maximum per person coverage of $1,500 runs through the
calendar year, not the fiscal year. For further information about dental coverage, visit
www.eligibility.nedelta.com/.
Disability Insurance Coverage
The Standard/TIAA Long-term Disability Plan provides long-term disability coverage.
Eligibility for disability insurance coverage requires that you have completed at least one year of
service and that you are employed 75% FTE on a 12-month basis, or 100% FTE on a 9 or 10month basis. If you do not enroll within 31 days of your eligibility date, you must provide proof
of insurability to enroll at a later date.
If you are currently enrolled, you may increase, decrease, cancel or change your premiums from
after-tax to pre-tax dollars or vice versa. These changes will be effective July 1, 2007 if you are
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actively at work on July 1. If you have previously waived coverage, you must provide proof of
insurability to enroll during Open Enrollment.
You may also request a change in coverage due to a special life event, i.e., a marital status
change, addition or loss of a dependent, or your spouse’s loss of coverage or termination of fulltime employment. You may only request a change in income benefit if you apply within 31 days
of the special life event.
To determine the amount of your disability coverage, visit PeopleSoft Employee Self-Service,
which will indicate whether you have 60% or 70% coverage. If there is no deduction for
disability insurance on your pay stub, you are not covered.
Group Life Insurance
UVM offers you the opportunity to purchase up to seven times your UVM base salary in life
insurance for yourself, up to one half the amount of your coverage for your spouse and $10,000
for each covered child. You may increase your or your spouse’s coverage or add a child if you
haven’t already elected to do so as long as you provide proof of good health to The Standard
Insurance Company. A change in life insurance coverage can only be made during Open
Enrollment.
Flexible Spending Account
There will be no changes to the calendar year 2007 Flexible Spending Account program.
Enrollment for the 2008 Flexible Spending year will be in November.
Questions and Answers
What if I’m happy with the status of my current benefits?
Do nothing if you’d like to maintain your current benefits, unless you are waiving medical
insurance. You must provide certification annually of coverage through your spouse or civil
union partner.
How can I tell which insurance coverage I’ve elected?
Log onto PeopleSoft Employee Self-Service and navigate to the Benefits Summary. You may
also consult the Step-by-Step Guide to Viewing Your Benefits.
What if I don’t change my benefits now? Can I make changes later in the year?
The open enrollment restriction applies only to medical and dental insurance. Changes in
retirement plan contributions can be made any time during the year. In addition, if you want to
increase the amount of your life insurance or if you have not enrolled in the long-term disability
insurance plan, you may do so any time as long as you provide proof to the insurer that you are
insurable. However, this is a good time to review all your benefits to be sure you are taking
advantage of everything that may be beneficial to you and your family.
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Where can I find a description of the various benefit plans?
Check the UVM Benefits website.
What’s the most important thing to remember?
If you need to make changes to your medical and dental insurance, be sure to complete the
necessary paperwork during the Open Enrollment period from May 1, 2007 through May 31,
2007.
Visit the Benefits website for information about:
• Benefits plans
• Benefits eligibility
• Medical and dental premiums
• Long-term disability rates
• UVM Benefits Fair, May 3
• Total compensation
Visit PeopleSoft Employee Self-Service for information about current benefits enrollments.
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