Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the...

20
2013 Benefits Enrollment Guide For full-time, regular staff and faculty

Transcript of Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the...

Page 1: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013

Benefits Enrollment Guide

For full-time, regular staff and faculty

Page 2: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 1

ENROLLMENT DATE: 1 week after orientation

BENEFITS EFFECTIVE DATE: First of month after hire

This guide will help you make some of the most important decisions you’ll make this year—choosing your benefits.

Enrollment Checklist (PAGE 19) 1. Learn about your options 2. Determine your choices 3. Enroll in your benefits

What Benefits Am I Eligible For? Full-time, regular employees of Champlain College, are eligible to enroll in the following benefits: H E A L T H I N S U R A N C E ( P A G E 2 ) : There are two choices:

o CIGNA Open Access Low Deductible Plan with a deductible of $200 (individual) or $400 (2-person or family)

o CIGNA Open Access High Deducible Health Plan with a deductible of $2,500 (individual) or $5,000 (2-person or family) This plan is associated with a Health Savings Account to help cover the higher deductible

H E A L T H S A V I N G S A C C O U N T S ( P A G E 6 ) : These may only be opened by employees enrolled in the Champlain College CIGNA OAP High Deductible Health Plan

F L E X I B L E S P E N D I N G A C C O U N T S ( P A G E 8 ) :

o Healthcare and/or dependent day care. Change in health care limit D E N T A L I N S U R A N C E ( P A G E 1 0 ) :

o Northeast Delta Dental coverage outline V I S I O N I N S U R A N C E (VSP) ( P A G E 1 1 ) :

o Provides eye exams and discounts on glasses, contacts, etc. o Option of two plans Plan B, basic coverage or Plan C, enhanced coverage

V O L U N T A R Y / S U P P L E M E N T A L T E R M L I F E & A D & D I N S U R A N C E ( P A G E 1 3 ) : o You may purchase additional insurance for yourself at group rates o You may purchase insurance for your spouse, civil union or same-sex marriage partner

D E F I N E D C O N T R I B U T I O N R E T I R E M E N T B E N E F I T S P L A N - 4 0 3 (b ) ( P A G E 1 4 ) : o You may choose to increase or decrease your contributions (you can do this at any time)

WELLBEING (PAGE 15): • Wellbeing options

EMPLOYEE ASSISTANCE PROGRAM (EAP)(PAGE 17):

• EAP benefit options ON-LINE ENROLLMENT (PAGE 18):

o You will need to re-enroll in all your benefits on-line It is not necessary to enroll in the following College-provided benefits:

Sick Leave and Short-Term Disability Insurance Long -Term Disability Insurance Employee Assistance Program Tuition Assistance (submittal process is separate)

Page 3: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 2

2013 Benefits Enrollment Guide

Medical Insurance

You have two choices for medical insurance. Both plans are CIGNA Open Access Plans and provide the same coverage; the difference between the plans is how the coverage is paid.

Learn more about your options – Read about the high deductible plan with a health savings

account in this booklet.

Consider your typical use and expected expenses – Go to www.mycigna.com to look up past expenses incurred and to determine costs of benefits.

Use Plan Cost Calculator – Before you sign up for benefits, compare your options! Log on to use this calculator tool to help determine which plan is best for you based on your health care usage.

http://www.inovius.com/swfhtml/swfhtml_main.cfm?swfID=12497

Employee Premiums (Champlain College’s portion of the total premium is between 70% – 80%)

Low Deductible - OAP (CIGNA Open Access Plan)

High Deductible Plan - HDHP (CIGNA Open Access Plan)

In-network Deductible

Single: $200

2-person/family $400

Single: $2,500

2-person/family $5,000

Coinsurance 80%/20% 90%/10%

In-network out-of pocket maximum

Single: $800

2-person/family $1,600

Single: $3,000

2-person/family $6,000

OAP Employees

Monthly Premiums

OAP Employees Bi-Weekly Premiums

HDHP Employees Monthly

Premiums

HDHP Employees Bi-Weekly Premiums

Single $135.00 $62.31 $77.00 $35.54

Two-person $351.00 $162.00 $208.00 $96.00

Family $522.00 $240.92 $307.00 $141.69

It is important to note that the HDHP deductible is based on the level of coverage you choose. The full deductible must be reached before the plan pays. For example, if you select the HDHP employee + spouse coverage, the total deductible of $5,000 in- network/$10,000 out-of-network must be met, either individually or in conjunction with your spouse, before coverage begins.

Page 4: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 3

Paying for the Difference in Deductibles (see page 7 for more details)

1. There is a $2,300 ($2,500 - $200) difference in the single person deductible between the Low Deductible

and High Deductible plans, how will you cover that amount?

Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings to your HSA, you will have almost enough money in your account to cover the difference between the plans’ deductibles. Contributions will be added to current HSA balances.

$1,500 + $696 = $2,196

College contribution to your account

(annualized)

Your annual premium savings ($135-$77 = $58 per month,

times 12 months = $696)

2. There is a $4,600 ($5,000 - $400) difference in the two-person deductible between the Low Deductible and High Deductible plans, how will you cover that amount?

Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings to your HSA, you will have almost enough money in your account to cover the difference between the plans’ deductibles. Contributions will be added to current HSA balances.

$3,000 + $1,716 = $4,716

College contribution to your account

(annualized)

Your annual premium savings ($351-$208 = $143 per month,

times 12 months = $1,716)

3. There is a $4,600 ($5,000 - $400) difference in the family deductible between the Low Deductible and High Deductible plans, how will you cover that amount?

Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings to your HSA, you will have more than enough money in your account to cover the difference between the plans’ deductibles. Contributions will be added to current HSA balances.

$3,000 + $2,580= $5,580

College contribution to your account

(annualized)

Your annual premium savings ($522-$307 = $215 per month,

times 12 months = $2,580)

Page 5: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 4

CIGNA Plan Comparison – Preventive Care*

Low Deductible - OAP

(CIGNA Open Access Plan) High Deductible Plan - HDHP

(CIGNA Open Access Plan)

Office visit co-pay is $10 for a Primary Care Physician and $20 for a Specialist. The plan pays 100% after the co-pay with an in-network provider.

100 % coverage with in-network providers for well-care/preventive visits.

* Please refer to CIGNA definitions of “preventive care.” Details’ regarding what preventive care is covered is provided on the www.mycigna.com web site as well as on the internal HR web site.

CIGNA Plan Comparison –Prescriptions – The cost for a 90-day supply will continue to be 3 times the monthly cost.

Low Deductible - OAP (CIGNA Open Access Plan)

High Deductible Plan - HDHP (CIGNA Open Access Plan)

In-Network Retail (30-day supply)

Home Delivery (90-day supply)

Retail (30-day supply)

Home Delivery

(90-day supply)

Preventive* Generic & Brand Medications

Covered at 100% (not subject to co-pay or deductible)

Covered at 100% (not subject to co-pay or deductible)

Non-preventive Generics Medications

You pay $10 You pay $30 No charge after deductible No charge after deductible

Non-preventive Brand Medications

You pay $25 You pay $75 No charge after deductible No charge after deductible

Non-preventive Non-preferred Brand Medications

You pay $45 You pay $135 No charge after deductible No charge after deductible

Out-of-network Retail

You pay 50% of charges

Covered in- network only

Covered in-network only Covered in-network only

* Please refer to CIGNA definitions of “preventive prescriptions.” Details regarding which prescriptions are considered “preventive” is covered on the www.mycigna.com web site.

Page 6: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 5

CIGNA Plan Comparison – Behavioral Health Care

Low Deductible - OAP (CIGNA Open Access Plan)

High Deductible Plan - HDHP (CIGNA Open Access Plan)

In-Network Out-of-Network In-Network Out-of-Network

Inpatient Facility

You pay 20% of charges after deductible Unlimited days maximum per year

You pay 30% of charges after deductible Unlimited days maximum per year

You pay 10% of charges after deductible Unlimited days maximum per year

You pay 30% of charges after deductible Unlimited days maximum per year

Outpatient Facility

You pay $10 or $20 co-pay per visit Unlimited visits maximum per year

You pay 30% of charges after deductible Unlimited visits maximum per year

You pay 10% of charges after deductible Unlimited visits maximum per year

You pay 30% of charges after deductible Unlimited visits maximum per year

Group Therapy

You pay $10 or $20 co- pay per visit Unlimited

You pay 30% of charges after deductible Unlimited

You pay 10% of charges after deductible Unlimited

You pay 30% of charges after deductible Unlimited

Intensive Outpatient

You pay $20 per program co-pay and 20% of charge Unlimited

You pay 30% of charges after deductible Unlimited

You pay 10% of charges after deductible Unlimited

You pay 30% of charges after deductible Unlimited

EVERYONE WILL RECEIVE NEW CIGNA CARDS FOR 2013

Other Options:

Employer-Sponsored Insurance (ESI) Premium Assistance through Green Mountain Healthcare

If you are not enrolled in Champlain College’s medical plan, possibly due to cost constraints, you may qualify for health insurance premium assistance if certain criteria are met, including income guidelines. For more information, go to:

www.greenmountaincare.org/vermont-health-insurance-plans/employer-sponsored-insurance

Page 7: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 6

Health Savings Accounts (HSA)

A Health Savings Account/HSA is a tax-free savings account combined with a high deductible health plan (HDHP). HSAs allow anyone not enrolled in Medicare, who enrolls in a compatible “high deductible” health plan (HDHP), to make tax-free contributions to a savings account. Contributions to the HSA may be made by the employee, the employee’s family and Champlain College.

HSA balances are owned by the employee and may be spent or saved by the employee based on his/her preferences. HSA distributions are tax-free if they are used to pay for qualified medical expenses, such as:

• Medical plan costs such as the plan deductible and the out-of-pocket maximum, amounts paid for the diagnosis, cure, treatment or prevention of disease

• Prescription drugs • Qualified long-term care services and long-term care insurance, limited depending on your age • Continuation coverage required by Federal Law (i.e., COBRA) • Health insurance for the unemployed • Medicare Expenses (but not Medigap) • Retiree Health expenses for individuals age 65 and older

Other HSA distributions for other qualified expenses may be tax-free as well. Expenses such as:

• Vision & dental expenses • Family member’s medical/dental/vision expenses, even if they are not covered under your HDHP,

however, they must be considered a dependent per IRS regulations

Distributions made for any non-qualified medical expense are subject to income tax and 20% penalty. The 20% penalty is waived in the case of death or disability or once the individual reaches age 65.

Advantages of a Health Savings Account (HSA)

Control – You can use the HSA to pay for any qualified medical expenses as defined by the IRS. There’s no need for preauthorization of services, unless explicitly stated by the plan.

Savings and Investments – Unlike premiums, unused HSA dollars remain in the HSA for future use.

Flexibility – “Healthcare” dollars can pay for items identified by the health insurance plan, but also a much broader definition as defined by the IRS which includes dental, vision and orthodontia. These may be things individuals are currently paying for using post-tax dollars.

Portability – If you leave Champlain College, you take your HSA (the account) with you. You have a financial stake, because HSA dollars not spent on health care now can be used for eligible medical, dental or vision care expenses, COBRA premiums, long-term care premiums, or carry over into retirement.

Tax Savings – Your contributions to the HSA are made with pre-tax dollars which results in lower income taxes. An HSA does not require third party substantiation for transactions; however, you should keep records of these transactions in the event of an IRS audit.

Page 8: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 7

No Use-it-or-lose-it – Unlike a Flexible Spending Account, balances roll from year to year, so you don’t need a crystal ball to forecast medical expenses in the next year.

Health Advocate – Health Equity offers a Health Advocate service to assist you in understanding your health benefits, locate providers and may assist in claim and billing issues.

Funding Your Health Savings Account

2013 HSA Contribution Maximums (based on IRS regulations): Single coverage: $3,250 Families and 2-person (w/spouse): $6,450* In addition, catch-up contributions of $1,000 per person 55 years of age and older may be made to the account in 2013.

Champlain College will contribute to your HSA Champlain College has committed to help fund your Health Savings Account. Champlain College will fund your HSA with contributions to your HSA every payroll period as follows:

2013 Contributions: Single: 60% of deductible ($1,500.00 annualized - This is prorated based upon date of hire.) Two-person: 60% of deductible ($3,000.00 annualized - This is prorated based upon date of hire.) Family: 60% of deductible ($3,000.00 annualized - This is prorated based upon date of hire.)

You may contribute to your HSA You may also contribute funds to your HSA, either on a pre-tax basis or a post-tax basis. Your funding options include:

No employee contributions to the HSA (not recommended) Contribution of employee premium savings Contributions of more than premium savings (up to IRS maximums)

* If you are a partner in a Civil Union or Same-Sex Marriage and are covered under the Two-person or Family

HDHP, you are an eligible individual under federal guidelines and would be eligible to establish your own HSA account. Your 2013 HSA contribution maximum would be $6,450 since you are eligible and enrolled in the Two-person or Family HDHP.

Page 9: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 8

Flexible Spending Accounts (FSA)

What is a FSA? – A FSA is a flexible spending account, which is authorized by the IRS and available through your employer. This type of account allows you to set aside money for non-reimbursed healthcare and/or dependent day care expenses on a pre-tax basis.

Healthcare - A healthcare Flexible Spending Account reimburses you for out-of-pocket medical, dental, vision, hearing and pharmaceutical expenses such as deductible, co-pays, co-insurance, eligible over-the-counter medications, eyeglasses, contacts, eye care solutions and even laser-vision correction. NEW THIS YEAR - the maximum you may contribute is $2,500 per calendar year per family.

Dependent Care - The Dependent Care Flexible Spending Account reimburses you for dependent day care expenses incurred that enable you and your spouse to work. These dependent day care expenses include day care, before-and-after school programs, nursery school or preschool, summer day camp and even adult day care. The maximum amount you can contribute is $5,000 per calendar year per family.

What happens to the funds left in my account at the end of the plan year? – Any funds left in your account at the end of the year are forfeited. However, because Champlain College does offer a “grace period”, you will be allowed an additional 2 ½ months after the end of your plan year to use your FSA funds. You can avoid forfeitures if you plan carefully by reviewing your prior year’s out-of-pocket expenses to estimate what you will spend in the next year, and make sure to be conservative in planning only for predictable expenses.

Limited Purpose Flexible Spending Account (HDHP participants only) – If you are enrolled in the CIGNA high- deductible plan, you may enroll in a Limited Purpose FSA. You would use these monies to pay for eligible dental and vision expenses, thereby preserving your HSA funds. Money contributed to this account is still subject to the same “use-it-or-lose-it-rule” as with other FSA accounts. However, you may also use your HSA funds for qualified dental or vision expenses and there is not a “use-it-or-lose-it-rule” tied to your HSA.

More information on the IRS guidelines for health care and dependent care can be found in the HR Portal under Benefits Forms, Qualifying Health Care Reimbursement Sheet, or by accessing the IRS website and publication 502 and 503 at www.IRS.gov .

Page 10: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 9

Flexible Spending Accounts (FSA) Access

You may access your FSA balances on-line as well as submit claim information on-line. Our FSA program is administered by Future Planning Associates.

As a participant in the Flexible Spending Account Plan participation in this plan allows you access to the www.myRSC.com website, a password protected website where you can keep up with various benefit news, including your year-to-date claims and payments. You will also have access to online claims. To log in to myRSC for the first time, follow the steps below:

1. Go to www.myrsc.com. 2. Click Register under the First time logging in? paragraph. 3. Click the myRSC Temporary Login ID and Employer Code link in red. 4. Enter your SSN (no dashes or spaces) in the Login ID field and click CONTINUE. 5. Enter 52011599 in the Employer Code field and click CONTINUE. 6. Enter a login ID of your choice that is at least 6 but not more than 100 characters in length. Note: Since

Social Security Numbers are no longer used as the login ID, the login ID you create may not be 9 characters in length.

7. Select an existing e-mail address or enter a new one to be used to e-mail forgotten passwords. 8. Enter a secret question or use a predefined secret question to prompt your memory of your password. 9. Enter the answer to the secret question. 10. Click SUBMIT. 11. Enter a new password in the New Password field. 12. Re-enter the password in the Confirm New Password field. 13. Click CONFIRM PASSWORD. 14. You are now logged into myRSC.

We are pleased to announce a new feature of our web service: On Line Claims. Follow each step carefully to submit your claim. When you go to print your claim, the print may not show due to your security settings. If you click on the screen where it says “internet explorer blocked this site” and allow the program to run you will be able to see the print. With this summary and a copy of your receipts, you will fax the claim to the following toll free fax number: (877) 828-9089.

If you have any questions, please call Linda Hurley at (802) 857-0698 or e-mail: [email protected]

Page 11: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 10

Dental Insurance Our dental plan carrier is Northeast Delta Dental and we utilize the Northeast Delta Dental network of providers. The annual benefit is $2,000 per person and the orthodontia lifetime limit is $2,000. We also cover dependents to age 26 to be consistent with the medical and vision plans.

Employee Monthly Premium Cost

Employee Bi-weekly Premium Cost

Single $12.00 $5.54

Two-person $18.00 $8.31 Family $36.00 $16.62

Deductibles Individual: $25 Family: $75 Annual Maximum Benefit The annual maximum benefit is $2,000 per person.

The orthodontia lifetime maximum benefit for an individual is $2,000 Preventive Care - (Annual deductible is not applied to these services.)

Routine Exam and Cleaning Benefits: 100% of regular and customary fees. (You can have up to four oral cleaning per plan year). Routine X-ray Benefits: plan pays 100% of regular and customary fees. Sealants are covered at 100% of regular and customary fees. Sealants are a covered benefit for dependent children under age 14.

Minor Restorative Care and Oral Surgery – (All services subject to the annual deductible.)

Fillings: Plan pays 80% of cost after the annual deductible. Endodontic (Root Canal): Plan pays 80% of cost after annual deductible Periodontia (Gum Work): Plan pays 80% of cost after annual deductible. Oral Surgery: Plan pays 80% of cost after annual deductible.

Major Care - (All services subject to the annual deductible.)

Bridges, Crowns, Implants, Dentures and Removable Appliances.: Covered at 50% after deductible

Orthodontia - (All services subject to a lifetime limit and annual deductible.)

Orthodontia: For Children & Adults: Covered at 50% after deductible. The lifetime maximum for orthodontia benefits per individual is $2,000. For those currently in a treatment plan and coming onto the College plan in January, payment will be pro- rated up to the new limit.

Refer to the Summary Plan Description for further details. A list of participating providers as well as other helpful information can be found at www.nedelta.com . Requesting a “Pre-determination of Benefits” is an excellent way to determine what your final cost may be for a specific procedure before the procedure begins.

Page 12: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 11

Vision Insurance

You have a choice between two vision plans, both provided by Vision Service Plan (VSP). Plan B is a basic plan and Plan C has enhanced benefits. Review the plans and chose which works best for you.

PLAN B -- Current Plan VSP Network Providers Out-of-Network Routine eye exam Exam paid in full every calendar

year after a $20 co-pay Exam paid up to $50 every calendar year

Prescription glasses, contacts, frames

Lenses, including progressives are covered in full every calendar year after a $20 co-pay

Lenses are covered every calendar year as follows:

Single vision up to $50 Lined bifocal up to $75 Lined trifocal up to $100

Frames covered in full every other calendar year up to $130. Plus, 20% off any out-of-pocket costs

Frames covered every other calendar year up to $70.

For contacts instead of glasses, cost reimbursement is up to $130; Up to $60 co-pay for a contacts and contact lens exam (fitting and evaluations)

For contacts instead of glasses, cost reimbursement is up to $105; allowance applied to cost of contacts and contact lens exams (fitting and evaluations)

Extra Discounts and Savings • Average 30% savings on lens options

• 20% off additional glasses and sunglasses; including lens options

• Average 15% off laser vision correction (or 5% off promotional price) from contracted facilities

• 15% off contact lens exam • (fitting and evaluation)

Employee Premiums - Monthly Employee Premiums – Bi-weekly

Employee only $12.46 $ 5.75 Employee plus one $19.93 $ 9.19 Employee plus children $20.35 $ 9.39 Employee plus family $32.81 $15.14 Go to www.vsp.com for more details and a list of participating vision providers.

Page 13: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 12

Vision Insurance, cont…

PLAN C– Enhanced Plan VSP Network Providers Out-of-Network Routine eye exam Exam paid in full every calendar

year after a $20 co-pay Exam paid up to $50 every calendar year

Prescription glasses, contacts, frames

Lenses, including progressives are covered in full every calendar year after a $20 co-pay

Lenses are covered every calendar year as follows:

Single vision up to $50 Lined bifocal up to $75 Lined trifocal up to $100

Frames covered in full every calendar year up to $150. Plus, 20% off any out-of-pocket costs

Frames covered every calendar year up to $70.

For contacts instead of glasses, cost reimbursement is up to $150; Up to $60 co-pay for a contacts and contact lens exam (fitting and evaluations)

For contacts instead of glasses, cost reimbursement is up to $105; allowance applied to cost of contacts and contact lens exams (fitting and evaluations)

Extra Discounts and Savings • Average 30% savings on lens options

• 20% off additional glasses and sunglasses; including lens options

• Average 15% off laser vision correction (or 5% off promotional price) from contracted facilities

• 15% off contact lens exam • (fitting and evaluation)

Employee Premiums - Monthly Employee Premiums – Bi-weekly

Employee only $16.45 $ 7.59 Employee plus one $26.32 $12.14 Employee plus children $26.84 $12.38 Employee plus family $43.33 $19.99 Go to www.vsp.com for more details and a list of participating vision providers.

Page 14: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

2013 Benefits Enrollment Guide

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 13

Group Term Life and AD&D Insurance

Champlain College provides full-time employees with basic group term life insurance as well as accidental death and dismemberment (AD&D) insurance at no cost to employees. The basic life insurance benefit is two and a half (2.5) times your base annual earnings to a maximum of $700,000; this is also referred to as “principal sum.” Benefit amounts for accidental death or dismemberment are a percentage of the "Principal Sum" amount. Please see the Summary Plan Description for Plan details.

The Group Term Life and AD&D benefit premiums are paid for by Champlain College, however, the benefit is a taxable benefit under federal law. FICA taxes based on the value of the benefit will be deducted from each paycheck. You may choose to reduce the value of the benefit (and therefore the taxes of the benefit) to a flat coverage amount (“principal sum”) of $50,000.

Supplemental Life and AD&D Insurance - In addition to the College-provided benefits summarized above, you may purchase additional or “Supplemental” Life and Accidental Death and Dismemberment Insurance for yourself and your spouse or civil union partner. You pay the full cost of any Voluntary Insurance plan coverage, which is deducted from your paycheck on an after-tax basis. Rates are determined by your age and the amount of coverage you elect. The following rates are your cost per $1,000 of life coverage:

Age Band Employee Rates Spouse/Civil Union Partners Rates

Under 24 $0.061 $0.074 25 - 29 $0.069 $0.085 30 - 34 $0.086 $0.107 35 - 39 $0.122 $0.156 40 - 44 $0.174 $0.224 45 - 49 $0.278 $0.350 50 - 54 $0.442 $0.545 55 - 59 $0.679 $0.837 60 - 64 $1.060 $1.430 65 - 69 $1.840 $2.443 70 - 74 $3.284 $4.353 75+ $6.435 $8.719

The above costs are for life insurance only. Voluntary Accidental Death and Dismemberment (AD&D) insurance premiums are as follows:

Employee only = $0.029 per $1,000 of coverage.

Spouse = $0.031 per $1,000 of coverage.

Again, the costs will be deducted from your paycheck on an after-tax basis.

Note: Rates for Life and AD&D insurance will increase as you move to the next age band. Approval of coverage may be subject to Evidence of Insurability.

Page 15: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 14

2013 Benefits Enrollment Guide

Defined Contribution Retirement Savings Plan

(403(b) Plan)

This self-managed plan is an opportunity to set aside pre-tax income for retirement savings through direct payroll deductions. Employees can defer pre-tax income into the College’s 403(b) Plan. Full and part time employees who are regularly scheduled to work 20 hours per week in the plan year qualify to participate on the first day of work. Champlain College’s match begins the first of the month following the date of hire. Adjunct faculty and qualifying part time employees scheduled to work less than 20 hours per week are eligible to defer pre-tax income into the College's 403(b) Plan without a matching contribution from the College.

You may defer up to $17,500 in 2013 per IRS guidelines (less any “catch-up contributions”) of your compensation* on a pre-tax basis for the 2013 calendar year. Employees over 50 years of age before the end of the calendar year may elect to defer additional amounts (called “catch-up contributions”) to the Plan as of the January1st of that year. The maximum “catch-up contribution” that you can make in 2013 is $5,500.

Champlain College matches employee salary reduction deferrals (excluding “catch-up contributions”) at a rate of 200% of the salary reduction. In applying this matching percentage, however, only salary reductions (less any “catch-up contributions”) up to 5% of your payroll period compensation will be matched. That means that for every dollar you contribute to the Plan (up to 5% of your compensation*), Champlain College will contribute two dollars (a 2:1 match).

Other features include:

• This plan does accept rollovers from other "qualified" plans. • Vesting in the plan is immediate. Employees are 100% vested in all contributions to the plan.

If you would like to change your payroll contributions to the Plan (increase or decrease deferral amount), please complete a Salary Deferral Agreement form. This form can be found in the HR Portal. The form must be received in Human Resources 10 days prior to the pay date to be effective. Please contact Debra Dayman, Benefits Director or Jackie Greer, Assistant Director, Payroll and Benefits with additional questions. Changes to your investment must be done on line at either www.tiaa-cref.org or www.plandestination.com. Beneficiary changes to your TIAA-CREF account must be done online at the TIAA-CREF site. Beneficiary changes to your account with The Newport group require a paper form which can be found in the HR Portal.

*For the purpose of Champlain College’s Defined Contribution Plan, “compensation” is defined as gross wage less severance pay, cell phone allowance, wellness incentive allowance and awards.

Page 16: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 15

2013 Benefits Enrollment Guide

WELLBEING

Champlain College recognizes the importance of health promotion with our employees. We are making a significant investment to support Wellbeing initiatives. The College and Wellness Committee are focused on assisting you in finding your Wellbeing. This is an individual journey and will be very different for everyone. We understand that Wellbeing is not a one-size fits all and we are focusing on offering a diverse array of options. The College provides several avenues for staff and faculty to focus on their individual wellbeing. These include free use of the gym and class participation in the IDX gym on campus. Reduced costs for participation in on-campus wellness initiatives such as Body Resolution, Weight Watchers and Stress Management classes. Full-time staff and faculty also have the option to obtain a membership at the Edge (all five locations) at a reduced rate. Full-time staff and faculty also have access to a $300 Wellbeing Account to use on structured fitness activities. This amount will be prorated based upon your date of hire.

Two current in-house programs that are running in 12-week sessions year round are: Weight Watchers • Program meets on Wednesday’s at 2:00 • Meeting will alternate between Lakeside and Main Campus • Participants also have access to the on-line tools • Your cost for this program is $10 per month

Body Resolution • A twice a week activity/interval training class • Offer kinetic chain evaluations to determine areas of your core to focus on strengthening • There are three levels of classes offered around the lunch hour and will be offered both on the Main

Campus and at Lakeside • Classes are 50 minutes in length • Participants are also eligible for reduced rates for Personal Training and classes held at the Body

Resolution site • Your cost for this program is $15 per month

To enroll in either of these programs please respond to the Wellness Committee at [email protected].

Bio-metric Screening and Heath Assessments We will once again be offering free Bio-metric and Health Assessments in January 2013 for full-time faculty and staff. Watch for sign-up’s in early December. This information is used to develop Wellness programs.

Page 17: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 16

2013 Benefits Enrollment Guide

WELLNESS, continued The Edge Full-time faculty & staff (must be “benefit eligible”) are eligible to join The Edge at any of their locations. The current benefit level is the Active level which includes classes, pools and fitness. The Edge offers a 35% reduction on regular yearly rates for part-timer’s & Retiree’s, and a 50% reduction on regular yearly rates for a Spouse, you will pay the Edge directly for these costs. Children – age 18 and under are free as they are included in the employees’ membership.

There will be a nominal monthly fee of $8 for your membership to the Edge, which will be payroll deducted each pay period. This means for the bi-weekly payroll which occurs 26 times a year, the per-pay deduction will be $3.69 ($8 x 12months = $96 / 26 pay periods = $3.69). Those paid on a monthly basis will see the deduction on the 21st of the month.

Edge memberships are on a monthly basis and cannot be pro-rated. This means if you begin mid-month you will be charged for the entire month.

Wellbeing Account

The Wellbeing Account allows full-time faculty and staff the ability to choose the structured fitness activities that will meet their need while pursuing their own unique Wellbeing. This account is available to all full-time faculty & staff (who are “benefit eligible”). This is a reimbursement program for employees only; this does not include your family members. This program will run from October 1, 2012 through June 30, 2013. This account will be prorated for new hires.

Each employee will have $300 for their use in structured fitness activities from the eligible list below. *Martial Arts *Jazzercise *Yoga *Court fees *Zumba *Personal Trainer *Ski passes * Ice Time *Greens fees * Marathon entry fees *Classes or lessons for dance, golf, tennis, swimming, skiing or climbing *Gym memberships for you, (excluding the Edge, as this is already a discounted rate). If your structured fitness activity is not listed above, please contact Future Planning, the group that processes the reimbursements, or Debra Dayman in Human Resources to determine if an activity is eligible. This account cannot be used to purchase any equipment, such as bikes, shoes, skates, racquets, etc. The account cannot be used to pay for current or future programs and/or events offered through the Wellness Committee that are subsidized. Detailed information on the account and the reimbursement process can be found in the HR Portal.

Page 18: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 17

2013 Benefits Enrollment Guide

EMPLOYEE ASSISTANCE PROGRAM (EAP) Champlain College offers an Employee Assistance Program (EAP) to employees. The program is offered through the Wellness Corporation. The EAP offer several different types of assistance: Confidential Counseling: You are offered up to 4 session of confidential face to face counseling for yourself and household members. Personal issues may include, stress and anxiety, anger or depression issues, substance abuse, relationship issues, parenting issues and grief and loss. Legal Consultations: Through the EAP you will be connected with an attorney for a free 30-minute consultation. Should your legal matter be more complex in nature, you will be referred to an attorney at a 25% discounted rate. Financial Resources: Financial issues leave you feeling stressed and confused. Having someone with whom you can discuss your options can help you feel more in control. The EAP’s financial professionals are available to help you address issues including, budget and debt, estate planning, bankruptcy, credit card issues, tax advice and planning for retirement. Telephonic Health & Wellness Coaching: The health coaching program offers on-line resources and one-on-one coaching for health related issues. You will be offered assistance with, walking/fitness programs, nutrition advice, chronic disease management, weight loss and smoking cessation. Work/Life Resources: The Work/Life program offers both informational resources and referral services. From becoming a new parent, to taking care of an aging relative and more. Specialist will provide you with resources on, new parent coaching, special needs programs, educational programs, child/elder care services, adoption assistance and summer camps. WellnessWorkLife Website and Contact Information: This website is a resource for information on a wide range of issues. Website: www.WellnessWorkLife.com Company Registration Name: Champlain College (not case sensitive) Call 24 hours a day: 1-800-828-6025 Voice/TTY

Page 19: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 18

2013 Benefits Enrollment Guide

On-line Enrollment

You will enroll in your benefits on-line. Go to the my.champlain.edu page and choose webadvisor in the top right hand side of the screen. Once in webadvisor choose employee, then on the next page in the lower right hand corner you will see Benefit Enrollment. You are set to begin enrollment, you will need your dependent names, addresses and social security numbers. Once complete you will see the screen below which will indicate the benefits for which you have enrolled and the dependents covered. You will need to check the box in the lower left hand corner to finalize as well as selecting the ready to sign button. There are still some paper form you need to complete which we will review during your orientation.

Any questions about this process should be sent to Jackie Greer at [email protected] or 865-5431.

Page 20: Benefits Enrollment Guide - Champlain College...Champlain College will contribute 60% of the deductible to your Health Savings Account (HSA). If you contribute your premium savings

The above is a summary only. Always refer to the applicable plan documents, policies or guides before making final decisions. As such, the College reserves the right to alter, amend or suspend the terms of this document at its sole discretion; please refer to the plans and policies posted on the Human Resources intranet site for the most current version. This document does not constitute an employment contract. Page 19

2013 Benefits Enrollment Guide

TO DO CHECKLIST

� Read 2013 Benefits Enrollment Guide

� Enroll on-line – Everyone must enroll in medical, dental, vision, health savings account and the flexible spending accounts on-line.

• Your current benefit option will be displayed once you sign-in to the open enrollment site.

� Medical – If you enroll, choose the plan, the OAP or the HDHP and choose the

coverage level, Single, 2-Person or Family. • If you enroll in the HDHP make a decision if you would like to defer your pre- tax

money into the HSA. Champlain will contribute to the HSA on a per pay schedule – you can choose to defer your money at anytime. You may also need to designate a beneficiary(s) for your HSA account.

� Dental – If you enroll, choose the coverage level, Single, 2-Person or Family.

� Vision – If you enroll, choose the plan, Plan B, the Basic Plan or Plan C, the Enhanced Plan. Then choose the coverage level, Single, 2-Person or Family.

� Flexible Spending Accounts (FSA) – If you enroll choose the plan or both if applicable, healthcare or dependent care. Choose the total amount you wish to defer for 2013. Please note, once you choose an annual amount it cannot be changed unless you have an IRS approved “Change of Status”. Also note that the IRS has decreased the limit on the health care FSA to $2,500 for 2013.

� Life & AD&D Insurance – If you choose Supplemental Life & AD&D insurance you may complete

this on-line You may be required to designate a beneficiary(s) for the College provided insurance as well as the supplemental insurance. You will need to complete a paper form for the College provided insurance, the form is in your packet.

� 403(b) Plan – To enroll you will need to submit a Salary Deferral Agreement form found in the

packet. You will also need to enroll in either or both the Newport group (which is a paper form found in your packet or on-line with TIAA-CREF, the instructions are found in your packet. (Ceridian is actually The Newport Group.) You cannot enroll in the 403(b) unless you have completed the Salary Deferral form and enroll with either the Newport Group or TIAA-CREF.