Morningside College Summary of Benefits
Morningside College provides these benefits to full time employees. Please refer to the employee handbook and plan documents or SBC’s for a full description of each benefit or contact the Human Resources Department with any questions.
Medical and Dental Summary
MEDICAL
01/01/17 // PPO Providers / NonPPO Providers /
Deductible (Family)
PPO Plan / $1,000 ($2,000) / $2,000 ($4,000)
Deductible (Family)
PPO Plan / $2,000 ($4,000) / $4,000 ($8,000)
This is the amount you must pay before plan benefits are available. The deductible does not apply to the PPO Office Visit and Prescription Drugs covered under the card and mail order program.
Cost Sharing / 80%
after deductible / 60%
after deductible
This plan will pay the above amount; you are responsible for the remainder after deductible is met.
Out-of-Pocket Maximum (Family) / $2,500 ($5,000) for $1,000 deductible plan / $5,000 ($10,000) for $1,000 deductible plan
$4,000 ($8,000) for $2,000 for $2,000 deductible plan / $5,000 ($10,000) for $2,000 deductible plan
This is the maximum amount of covered charges you will pay. This amount includes the deductible and coinsurance. Office visit copayments, prescription drug copayments, outpatient mental illness/chemical dependency and certification penalties are not included.
Office Visits / 100% after $25 copay / 60% after deductible
Prescription Drugs
Card
(Generic/Brand) / $10,$30,$40, or $75 copay
Specialty Drug $100 copay preferred and $200 copay non preferred / $10,$30,$40, or $75 copay
Specialty drugs not covered
Mail Order (Generic/Brand) / $20, $60, $80 copay
Preventive Care / No Charge / 60% after deductible
Includes no charge for:
· Annual Routine Physical exam ( per benefit period)
· Annual Mammogram (per benefit period)
· Annual Pap smears
· Annual Prostate Exam
· Colonoscopy
· Well child care per mandate to age 7
· X-ray and labs
· Immunizations
Following is paid 100% after $25 copay
· Services for “family history of”
· Outpatient diabetic management education
Mental Illness /Chemical Dependency
Inpatient
Pre-certification required on inpatient MH/CD. / Annual benefit limit per family member is 30 inpatient days. / Annual benefit limit per family member is 30 inpatient days
Outpatient
Office / 80% after deductible
Annual Benefit limit per family member is 30 outpatient/office visits / 60% after deductible
Annual Benefit limit per family member is 30 outpatient/office visits
100% after $25 copay / 60% after deductible
Chiropractic/Spinal Manipulation / 100% after $25 copay / 60% after deductible
Second Surgical Opinion / 100% after $25 copay / 60% after deductible
Pre-existing Conditions / Any condition existing during the 6 months prior to your eligibility date
New hires/special enrollees will not be covered until 12months from your eligibility date. Credit may be given for prior coverage. Late enrollees are not covered. Late enrollee is a member who declines coverage when initially eligible to enroll.
Annual Routine
Vision Exam
(One routine vision exam per benefit period) / No Charge / 60% coinsurance
after deductible
Annual Routine
Hearing Exam
(One routine hearing
Exam per benefit period) / No Charge / 60% coinsurance
after deductible
Preadmission Testing / 100% after $25 copay / 60%
*Wellmark Blue Cross Blue Shield of Iowa is The Medical/Dental insurance carrier.
There is a $25.00 copayment for the following preventive care services: x-ray and labs; immunizations; services for “family history of”; and outpatient diabetic management education as long as using a preferred provider.
Prescription Drugs: The pharmacy copayment is a four tier program, $10, $30, $40, or $75 for retail prescriptions. The mail order copayment is $20, $60, or $80 depending on what tier the drug falls into for a 3-month supply.
Outpatient Mental Health and Chemical Dependency: The benefit for inpatient/outpatient services is 80% after the deductible is met for PPO providers and 60% for NonPPO providers. Office visits are a $25 copayment for PPO providers and 60% after deductible for non PPO providers.
Second Surgical Opinion/Preadmission Testing: The $25 copayment applies to this service of using a PPO provider. If using a NonPPO provider the deductible and coinsurance of NonPPO provider apply.
Outpatient Certification: Participants are not required to contact the plan prior to Outpatient procedures.
High Deductible Health Plan
01/01/17 // PPO Providers / NonPPO Providers /
Deductible (Family)
PPO Plan / $2,000 ($4,000) / $4,000 ($8,000)
This is the amount you must pay before plan benefits are available.
Does not apply to well-child care, routine vision exams and preventive care. The entire family deductible must be satisfied before benefits are available for any family member.
Out-of-Pocket Maximum (Family) / $4,000 ($6,850) / $8,000 ($16,000)
This is the maximum amount of covered charges you will pay.
Office Visits / 20% coinsurance after deductible met / 40% coinsurance after deductible met
Prescription Drugs
Card
(Generic/Brand) / 20% coinsurance / 20% coinsurance
Urgent Care / 20% coinsurance after deductible met / 40% coinsurance after deductible met
Preventive Care: In an effort to promote prevention and early detection of medical conditions, there will be NO charges for annual physicals; annual mammograms; annual pap smears; prostate exams; and annual eye exams as long as using a preferred provider. The College will also continue to offer annual flu shots at a reduced charge.
Health Savings Account (HSA)
If you enroll in the HDHP option, you may be eligible to contribute to a college sponsored Health Savings Account (HSA), administered by Security National Bank.
HSAs offer you the following advantages:
· Tax Savings. You contribute pre-tax dollars to the HSA. Interest accumulates tax-free and funds are tax-free to withdraw for qualified medical expenses—the same expenses that qualify under the Flexible Spending Account (FSA).
· Reduce your out-of-pocket costs. You can use the money in your HSA to pay for eligible medical expenses and prescriptions. The HAS funds you use can help you satisfy your HDHPs annual deductible.
· Invest the funds and take them with you. Unused account dollars are yours to keep even if you retire or leave the company. Additionally, you can invest your HSA funds, so your available health care dollars can grow over time.
· The opportunity for long-term savings. Unlike Flexible Spending Accounts (FSAs), HSAs do not have a “use it or lose it” rule. Unused HSA funds rollover from year to year – money you can use to reduce future out-of-pocket health expenses. You can even save HSA dollars to use after you retire.
What You May NOT Know About HSAs:
· You have to meet the following requirements to be eligible to contribute to the HSA:
- You must be covered by a qualified HDHP
- You cannot be enrolled in Medicare
- You cannot be covered under other non-qualified health insurance
- Your cannot be covered by another “full” medical Flexible Spending Account (FSA) (through a spouse)
- You cannot be claimed as a dependent on someone else’s tax return
· Contributions to the HSA:
- Each year, the IRS sets HSA annual contribution limits, the 2017 limits are as follows:
o $3,400 for individual coverage
o $6,750 for family coverage (includes employee +1 or family tier)
- The employee can contribute to the account up to the IRS max
- If you are over age 55, you can contribute an additional $1,000 over the IRS limit
- Contributions remain in the HSA from year to year until they are used – no use it or lose it!
- You can increase/decrease your contribution to the account throughout the year
· Distributions from the HSA:
- Distributions from you HSA are tax-free if they are taken for “qualified medical expenses.”
- HSA distributions can be taken for qualified medical expenses for the following people:
o The account holder (person covered by the qualified HDHP)
o Spouse of that individual (even if not covered by the qualified HDHP)
o Tax dependents of that individual (even if not covered by the qualified HDHP)
- You may use your HSA dollars even if you are no longer covered by qualified HDHP
- You may use HSA money for non-qualified expenses….BUT…
o You’ll pay income taxes, AND
o A 20% tax penalty
DENTAL
/ 01/01/17 /Deductible (Family) / $50 ($100)
This is the amount you must pay before benefits are available. The deductible does not apply to Preventive Services.
Preventive Services / 100%; deductible waived
Includes:
· Cleanings (2/year)
· Exams (2/year)
· Fluoride to age 16 (2/year)
· Sealants to age 16
· Space maintainers to age 16
· Bitewing x-rays (once a year)
Basic Services / 80%
· Extractions
· Fillings
· Gum Treatment
· Root canals
· Routine Oral Surgery
· Emergency Treatment (Full mouth X-rays-once every 5 years)
Major Services / 50%
· Bridges
· Crowns
· Dentures
· Implants
Annual Maximum / $1,500
Orthodontic Services / 50%
Orthodontic Services apply to dependent children under age 19.
Orthodontic Lifetime Maximum / $1,500
Waiting Periods / Benefits will not be payable prior to the completion of the waiting period shown below:
N/A
Dental: The annual maximum benefit is $1,500. The lifetime orthodontic maximum is $1,500, and there is no waiting period for new employees.
The following monthly employee contributions are effective as of 01/01/17:
Traditional Plan 1 $1,000/$2000 deductible
Plan Type / Medical / Dental / Total CostSingle / $182 / $12 / $194
Employee + 1 / $346 / $23 / $369
Family / $552 / $36 / $588
Traditional Plan 2 - $2,000/$4,000
Plan Type / Medical / Dental / Total CostSingle / $171 / $12 / $183
Employee + 1 / $326 / $23 / $349
Family / $520 / $36 / $556
HDHP
Plan Type / Medical / Dental / Total CostSingle / $144 / $12 / $156
Employee + 1 / $274 / $23 / $297
Family / $437 / $36 / $473
Remember, your contributions are effectively reduced by pre-tax payment through our flexible benefit plan. IRS regulations permit you to change your benefit elections only on January 1st unless you experience a qualifying status change (for example, changes in legal marital status, number of dependents, employment for you or your dependent, number of hours worked, eligibility of your dependent).
Employees who participate in the Wellness program will receive a reduced premium for participation.
The College reserves the right to make changes in benefits and contributions at any time.
This summary is not intended to be a complete description of your benefits. Please consult your summary plan description and/or insurance certificate for additional details including plan limitations and exclusions.
Short Term Disability
Insurer – Self funded.
Waiting Period – Full time administrative and staff employees are eligible after 90 days of service with the College. Faculty members are exempt from the 90 day service requirement.
Morningside provides this program to full time employees, who are medically disabled and unable to perform their duties due to a non-occupational illness or injury. Employees may be eligible for up to six months of paid leave and benefits.
The College provides this benefit at no cost to the employee.
Long Term Disability
Insurer – Unum Provident
Full time employees are eligible for this benefit the first of the month following 30 days of employment.
Waiting Period – 180 days (This is the period of time you must be disabled before long term disability benefits are payable).
The disability benefit is 60% of basic monthly earnings at the time your disability occurred.
The College provides this benefit at no cost to employees.
Life Insurance
Insurer – Unum Provident
Eligible employees will have a life insurance policy equal to 1.5 times their base salary. This coverage goes into effect the first month following thirty days of consecutive service for eligible employees.
The employee’s spouse will have $2,000 of life insurance coverage. Dependents of the employee (over 14 days and less than 19 years old, or if a student, age 23) are covered for $2,000 of life insurance coverage.
Eligible employees also have an Accidental Death and Dismemberment policy.
The College pays the premium.
Retirement Plan
Insurer – TIAA/CREF
After completing one year of service with Morningside, the College will contribute 5% of your base salary through Teachers Insurance & Annuity Association/College Retirement Equities Fund (TIAA/CREF). Vesting is 100%.
The College will continue to contribute 5% of your base salary through your fifth year of employment. During the sixth through ninth years, the college contributes 7% of your base salary, and after completing ten years 9%.
Employees may elect, through payroll deduction, to make pre-tax contributions to their retirement program. The college does not contribute.
Flexible Spending Accounts
Morningside College offers Flexible Spending Accounts to full-time employees. Flexible spending allows employees to take salary, pre-tax to cover Dependent Care Assistance, Group Medical Insurance, Medical Expense Reimbursement, and Individual Medical Insurance expenses. You may enroll within 30 days following employment, 30 days following a change in family status, or during the open enrollment period each December. All claims are processed monthly. An example of possible savings is shown below:
With Without
Cafeteria Plan Cafeteria Plan
Gross Monthly Pay $2,500.00 $2,500.00
Pre-Tax Health Care Expenses Deduction 140.00 -
Taxable Income 2,360.00 2,500.00
Estimated Federal Tax 354.00 375.00
FICA Tax 181.00 191.00
After-Tax Health Care Expense - 140.00
Take Home Pay 1,825.00 1,794.00
Medical FSA covers such expenses not otherwise paid by the group health plan (deductibles, co-pays, etc.), dental related expenses, vision care, hearing expenses, etc.
Dependent Care FSA covers expenses for the care of a dependent such as babysitting, day care centers, IRS eligible elder care, or any other legitimate dependent care charges necessary due to your employment.
A copy of the Summary Plan Description, additional information, and enrollment forms are available from the Human Resources Department.
Tuition Rebates
Morningside College offers Tuition Rebates programs to full-time and part-time employees, their spouses, and their dependents. Full-time employees, their spouses, and their dependents may receive a one-half tuition rebate for graduate or undergraduate credit during the employee’s first three years of service. After the employee begins the fourth year of employment, the employee, spouse and dependents may be eligible to receive a full-tuition rebate. Part-time employees (working at least 20 hours a week), spouse and dependents may receive a one-half tuition rebate for undergraduate or graduate credit. For more information and forms requesting employee rebate, please contact the Office of Student Financial Planning.