(Revised 09/08)

Policy

The University provides access to health care coverage for eligible employees.

Eligibility:

Regular full-time and part-time (50-89.9%) faculty, academic staff and University support staff with appointments of nine months or more.

Effective date:

Faculty, Academic Staff and Executive Management: Coverage is immediately available upon hire, provided enrollment occurs within 60 days of employment. If enrollment occurs within the first 60 days of employment, coverage will be retroactive to the date of hire.

Support Staff: Coverage will become effective the first day of the month following date of hire, provided enrollment occurs within 60 days of employment.

Summary of benefit:

Health care coverage is available through one of the following health plans: (Prescription drug coverage is automatic when enrolled in any of the health plans.)
- Community Blue (preferred provider organization);
- Physicians Health Plan (health maintenance organization);
- Blue Cross Blue Shield of Michigan Transition Plan (only available to employees when there is a mix of Medicare and non-Medicare enrolled family members on the plan or when there is a sponsored dependent rider with Medicare); and
- Blue Cross Blue Shield of Michigan (basic benefit plan) with Master Medical benefits (only available to retirees with Medicare or employees with sponsored dependent riders with Medicare).
Coverage may be selected by the employee for self and eligible dependents. Riders for eligible adult dependents may be available at additional cost. Married couples and MSU-recognized same-sex domestic partners who both work at MSU or who are MSU retirees may cover themselves and any eligible dependents under one MSU health plan.
Prescription drug coverage is provided by Caremark with a 4-tier copay structure.

Health Care Waiver:

1. If employees are covered by health care coverage through another health plan, they are eligible to waive their MSU health care coverage during open enrollment and receive up to a $600 cash payment. (Retirees and employees whose spouses or MSU-recognized same-sex domestic partners are employed at MSU are not eligible for the waiver option.) The normal waiver period is July 1 through June 30, with payment to be received the following July.

The cash payment is considered taxable income.
If other coverage is involuntarily discontinued, the employee has 31 days to enroll in an MSU health care plan with the waiver payment prorated.
Individuals newly hired, terminated, going on unpaid leave of absence, or retiring will also receive a prorated payment.

Individuals accrue points based on their employment percent and the number of months they are enrolled in the waiver: 1 point for each month in waiver if full-time; .75 for 3/4-time or .5 if half-time. See chart below.

Points accrued

Waiver payments

Full 12 points

$600

9 through 11.75 points

$450

6 through 8.75 points

$300

3 through 5.75 points

$150

Less than 3 points

$0

Eligible employees who did not have other health care coverage during open enrollment, but have subsequently acquired other health care coverage, can enroll for the waiver option within 31 days of acquiring the other health care coverage. The waiver is effective the first of the month following the date the waiver application is received in MSU Human Resources Benefits.

Access to MSU Health Plan Coverage:

To be covered by an MSU health plan, spouses or MSU recognized same-sex domestic partners of MSU employees who have access to coverage through their employer must purchase single coverage if his/her annual premium contribution toward that coverage is $800 or less.

Premium contribution:

Health care premiums are adjusted annually.
Faculty, Academic Staff and Executve Management:

Faculty, academic staff and executive managment will contribute 14% of the premium cost. Contributions paid through payroll deduction will be taken on a pre-tax basis. For those enrolled in Community Blue, the 14% employee premium contribution plus the difference between PHP and the Community Blue coverage will be deducted.
Support Staff:

Full-time employees (90 - 100%): The University contributes 100% of the monthly premium for the lowest cost health plan.

Part-time employees: The University contributes 50% of the monthly premium for the lowest cost health plan for employees with regular appointments of half-time (50 - 64.9%) and 75% of the amount for employees with regular appointments of 3/4-time (65 - 89.9%) (VARIES: Flexible appointees receive a full-time University contribution).

Procedure

Application for enrollment or waiver:

Enroll or waive coverage within 60 days of initial employment or appointment to an eligible status by accessing the web site at www.hr.msu.edu; click the eHR Services Login link, enter your MSUnetID/Pilot ID and password.
If enrollment does not occur within 60 days of initial employment or appointment to an eligible status, it is necessary to wait for an annual open enrollment period, except as described below.
During annual open enrollment, eligible employees and retirees may:
- waive coverage (retirees are not eligible for waiver);
- enroll in Blue Cross Blue Shield of Michigan with Master Medical, Blue Cross Blue Shield of Michigan Transition Plan, Community Blue, or Physicians Health Plan;
- change carriers; or
- add eligible dependents.
Eligible employees and retirees without Medicare previously covered through another employer group may enroll in either Community Blue or Physicians Health Plan within 31 days of involuntary loss of other group coverage. Employees with dependents covered by Medicare and retirees with Medicare previously covered through another employer group may enroll in either Blue Cross Blue Shield of Michigan with Master Medical or Blue Cross Blue Shield of Michigan Transition Plan.
Eligible dependents may be added within 31 days of gaining dependent status by accessing the web site at www.hr.msu.edu; click the eHR Services Login link, enter your MSUnetID/Pilot ID and password. A copy of the marriage certificate, birth certificate, MSU-recognized same-sex domestic partnership information, etc., is required. If an eligible dependent has not been added within 31 days of gaining dependent status, it is necessary to wait for an annual open enrollment period.
Dependent unmarried children incapable of self-support due to mental or physical disability may remain covered under the basic family contract under Michigan Public Acts 274 and 275, however the disability must be identified by a physician prior to age 19.

Termination date of benefit:

Health care coverage will cease at the end of the month of layoff or termination of employment for reasons other than official retirement from the University.
Employees on unpaid leave of absence receive no University contribution (VARIES: Flexible appointees see Policy and Procedure for flexible appointments; employees on unpaid family and medical leave [FMLA] continue to receive the University contribution).
Employees on unpaid leave of absence who wish to maintain coverage must forward the full premium to MSU Human Resources Benefits. Coverage allowed to lapse, due to non-payment of premiums, will automatically be reinstated to the coverage in effect prior to the leave for employees who return to an eligible status.
Dependent coverage terminates as above. In addition, certain changes to dependent status terminate coverage for dependents.

COBRA continuation of coverage:

In accordance with the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), group health care coverage for eligible employees and their dependents may be continued in the following situations:

Upon termination of employment (except gross misconduct) or transfer to an ineligible status, employees and/or covered dependents may elect to continue group health care coverage for a period of up to 18 months (29 months if disabled and receiving Social Security Disability) by paying the applicable premium plus an administrative fee.
In the event of the employee's death, divorce, legal separation, termination of an MSU-recognized same-sex domestic partner relationship, or a dependent's loss of coverage due to age or loss of IRS dependency, dependents may elect to continue group health care coverage for a period of up to 36 months by paying the applicable premium plus an administrative fee.

COBRA coverage must be elected in writing to MSU Human Resources Benefits by the eligible employee or dependent within 60 days of the qualifying event.

Conversion of coverage:

Blue Cross Blue Shield of Michigan with Master Medical, Blue Cross Blue Shield Transition Plan and Community Blue coverage may be converted to an individual policy by directly contacting the carrier within 31 days of termination of coverage. Physicians Health Plan and Caremark (prescription drug coverage) cannot be converted to an individual policy.
Those who select COBRA coverage may convert to an individual policy after maintaining the COBRA premium for the maximum coverage period (18 or 36 months, 29 months if disabled and receiving Social Security Disability). Coverage may be converted by directly contacting the carrier within 31 days of termination of coverage.

Refer questions to:

MSU Human Resources Benefits (telephone 517-353-4434 or e-mail benefitsinfo@hr.msu.edu)