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8.2 Optional Benefits (Academic Specialist Handbook)

8.2.1 Accidental Death & Dismemberment (AD&D)

Eligibility

Academic specialists may select the AD&D Program within 60 days of initial appointment. Coverage is provided if death or dismemberment results from accidental cause. All academic specialists appointed full-time or part-time for nine months or more are eligible to participate.

Coverage

Coverage may be selected for the academic specialist and the family, if desired, in one of the varying amounts as shown in the brochure. Beneficiaries are designated by the individual and may be changed at any time.

Cost

Cost of the various coverages offered is described in the brochure available in the Benefits Office.

Academic specialists appointed 50 percent time or more for nine months or more and their eligible dependents may be covered by a dental plan. The benefit can be retroactive to the appointment date if a new employee enrolls within 60 days of the appointment. Failure to enroll during the initial 60-day eligibility period will result in the academic specialist having to wait until the next annual open enrollment period. This coverage is available to official retirees and their eligible dependents or survivors.

Coverage

Dental plan coverage is available under a traditional plan with Delta Dental or the dental maintenance organization Midwestern Dental Plans, Inc. (MDPI).

The Delta Dental Plan covers fifty percent of the usual, customary, and reasonable cost of preventive, diagnostic, restorative, prosthodontics and orthodontic services. The plan provides an individual maximum of $600 per calendar year for covered charges. Orthodontic coverage is limited to those under 19 years of age and is subject to an individual lifetime maximum of $600.

Coverage for MDPI must be provided through one of the eight of Midwestern's participating centers. Benefits are provided with a fixed dollar copay. Some benefits, such as diagnostic, preventive, and minor restorative are covered at no cost to the member. There are no deductibles, annual maximums, or lifetime orthodontic maximums. Orthodontic services are covered if under age 19 with a $750 copay and for persons over age 19 with a $1,300 copay.

Cost

Premiums are fully paid by the University for full-time academic specialists. There may be premium deduction for part-time employees depending on the percent of employment and the number of persons being covered.

An academic specialist may select employee-paid life within 60 days of initial appointment or by furnishing evidence of insurability during Open Enrollment.

Eligibility

Academic specialists appointed 50 percent time or more for nine months or more are eligible to enroll for life coverage.

Coverage

The coverage is decreasing term insurance with no cash or loan value. Coverage may be selected in varying amounts up to $187,500 maximum depending on age and plan selected, as shown in the brochure.

Optional dependent coverage (for spouse or same-sex domestic partner and children, if any) may also be selected.

Benefits are payable to the designated beneficiary in the event of death from any cause while the plan is in force. Beneficiaries are designated by the academic specialist and may be changed at any time.

Cost

Costs vary according to the plan selected; rates are subject to future group experience.

If academic specialists enroll in health plan coverage within 60 days of initial appointment to an eligible status or during an Open Enrollment, academic specialists and their eligible dependents are covered for health plan services. Health plan coverage is available under a preferred provider organization (PPO) or health maintenance organization (HMO). Coverage is currently provided by Community Blue (PPO) or Physicians Health Plan (HMO). Coverage through the traditional Blue Cross Blue Shield of Michigan plan is available only to those enrolling a sponsored dependent with medicare. The benefit can be retroactive to the appointment date if a new employee enrolls within 60 days of the appointment. Specific coverage details under these plans differ. In general, the following apply:

Eligibility

Academic specialists appointed 50% time or more for nine months or more are entitled to enroll themselves and their eligible dependents. Failure to enroll during the initial 60-day eligibility period will result in the academic specialist having to wait until the next annual open enrollment period.

Coverage

The health plans offered through the University provide coverage for semi-private hospital room charges up to 365 days and additional hospital expenses, including intensive care, recovery room, anesthetics, etc. Surgical benefits, diagnostic X-ray and lab tests are provided whether performed in or out of the hospital. The plans provide coverage for office calls subject to either a co-payment and/or satisfaction of an annual deductible amount. Most medically necessary out-of-pocket expenses are also covered subject to a deductible and co-payment. The Health Maintenance Organization (HMO), Physician's Health Plan, is primarily available to employees who live in the service area. Community Blue PPO is a preferred provider organization which offers both in- and out-of-network coverage. Out-of-network services require a higher out-of-pocket cost.

Prescription Drugs

The prescription drug plan is a co-pay plan for generic or brand drugs and is administered through Caremark. Caremark has a large network of over 51,000 participating retail pharmacies, including some of the largest drug store chains. Employees may choose to purchase their prescriptions at a participating retail pharmacy, at an MSU pharmacy (Olin Health Center or the MSU Clinical Center pharmacies) or through Caremark's mail order program:
 

Type of Drug	At a Network Pharmacy  (34-day supply)	Through Mail Order  (90-day supply)	At an MSU Pharmacy  (34-day supply)	At an MSU Pharmacy  (90-day supply)
Generic	$5	$10	$3	$6
Brand name	$10	$20	$8	$16

Cost

The University provides a monthly contribution toward the premium for health coverage for eligible academic specialists. If an additional premium is required, it will be deducted from the academic specialist's paycheck. The University does not make a contribution during periods when an academic specialist does not receive a check.

An academic specialist may elect to waive MSU's health plan coverage in exchange for cash payment if covered by another group health plan (e.g., have health care coverage through their spouse or another employer) that adequately meets health care needs. The waiver period is July 1 through June 30 with payment to be received the following July.

Eligibility

Academic specialists appointed 50% time or more for nine months or more are eligible to waive MSU's health plan coverage within 60 days of appointment or during the annual open enrollment period. A completed form is not required each year during open enrollment to continue the waiver.

Cost

The University provides up to a $600 cash payment the following July to the academic specialist. Individuals accrue points based on their employment percent and the number of months enrolled in the program. The payment is also prorated for those newly hired, going on an unpaid leave of absence, or terminating employment. The payment is considered taxable income.

An academic specialist may participate in a Dependent Care Spending Account (DCSA) to meet their dependent care expenses such as care for a child, disabled spouse or dependent parent.

Eligibility

Full or part-time academic specialists are eligible for the DCSA within 60 days of appointment or during an annual open enrollment period.

Cost

The individual saves money by paying for dependent care expenses in pre-tax dollars. The employee designates an amount of money (up to $5,000 per year) to be set aside from their paycheck. The money is deducted from gross pay before federal, state, city and social security taxes are calculated. The individual pays for actual expenses and requests reimbursement from their account.

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