2015 Benefits
Re-enrollment Guide
It’s an Individual Choice
Annual
Re-enrollment
November 10-21,
2014
INSIDE THIS ISSUE
2
3
4
5
6
What’s New for
2015
8
Medical Plan
Comparison
12
Spending
Account
Information
How to Re-enroll
Re-enrollment
Checklist
Drop-in Sessions
Benefit Plan
Summaries
13 Individual
Choice Rates
16
Other Benefits
for Your
Consideration
20 Mandated
Notices
A
s an Ithaca College employee,
you have a large variety of benefit
programs available to you. Benefits give
you important financial protection when
you need it most. Please review the
benefit programs offered by IC that are
highlighted in this guide to determine
if your current elections still meet your
individual needs. Annual re-enrollment
is your opportunity to review your
current benefit elections, consider plan
design changes, and make adjustments
for the upcoming plan year. Any changes
made will be effective January 1, 2015.
spending account or a health savings
account. Even if you opt-out of medical
benefits, you must complete the online
re-enrollment process.
If you do not re-enroll, any current
elections for dental, supplemental life,
flexible spending or health savings
accounts will not be carried over. In
addition, should you have any left over
benefit credits, they will be forfeited.
This guide provides you with the
information needed to successfully
complete the re-enrollment process.
It includes details about how to get
questions about your benefits answered,
benefit changes for 2015, summaries of
each of the Individual Choice benefit
plans, and rates.
Completion of the online re-enrollment
process via Parnassus Employee SelfService is required. It allows you to
confirm that you and each of your
eligible dependents are covered under
the benefits you intend, change levels of
coverage, opt for new coverage, review
beneficiaries, and enroll in a flexible
ithaca.edu/hr
Come to the Employee Benefits
& Work/Life Roaring Twenties Gala
J
oin us on Tuesday, November 4, 2014, in the keen Emerson Suites from 10 a.m. - 3 p.m. We
will take you back to a time when getting dolled up and cutting a rug were the cat’s meow.
Jay Gatsby won’t be there, but our swell benefit partners and community resource
representatives will be on hand to spill the beans on all the advantages of Ithaca College
benefits and work/life programs. Because we think you’re the bee’s knees, there will be prizes,
giveaways, refreshments, games, and entertainment. Please bring your employee ID card
with you: it’s your ticket to enter!
Individuals requiring special accommodations
should contact Julie Tinkham at (607) 274-8000
or [email protected] as soon as possible.
What’s New for 2015
ENHANCED LIFE INSURANCE AND ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) BENEFITS
Effective beginning January 1, 2015, each
benefit-eligible employee will receive a flat amount of basic life insurance equal to $50,000 regardless of your salary. The cost of the basic life
insurance will be paid by the college.
• New this year – Your supplemental life insurance plan now allows you to enroll in up to $500,000 of coverage (not to exceed
seven times your salary). This is in addition to the basic life insurance that the college provides and pays for you.
• New this year – The monthly rate that you will pay per $1,000 of life insurance
is based on your age as of January 1 each year. Depending on your age, your
rate will be lower or higher than the rate that you pay for life insurance currently. The age bands and rates are detailed on page 14. It will be important to
review the rates carefully to understand what this means for your specific cost
of supplemental life insurance.
• New for this enrollment period only - You can enroll in supplemental life insurance up to the Guaranteed Issue amount of $200,000 with no medical questions asked, regardless of how much life insurance you currently have through
the college. You may also enroll in AD&D insurance up to the lesser of 10 times
your salary or $300,000 without proving evidence of insurability (that means
there will be no medical questions asked).
2 ithaca.edu/hr
DENTAL INSURANCE
Effective January 1, 2015, the college is partnering with
Delta Dental to provide dental benefits to all eligible
employees.
New this year - Exams, cleanings, and x-rays are covered with no deductible, and there will be a $50 deductible per enrollee (maximum of $150 per family) for all
other covered services. A maximum benefit of $1,500
per member per year continues to apply.
The Delta Dental plan allows you to visit any licensed
dentist. Although you usually save money with a Delta
Dental dentist, there may be reasons why you wish to
visit a non-Delta Dental dentist. The choice is yours! To
find out if your dentist is in the Delta Dental network,
you can check the website at deltadentalins.com or call
customer service at 1-800-932-0783.
HIGH DEDUCTIBLE HEALTH PLAN (HDHP)
AND HEALTH SAVINGS ACCOUNT (HSA)
Effective January 1, 2015, the deductible for employee
only coverage under the HDHP will be $1,300. The deductible for employee and dependent coverage will be
$2,600 as mandated by Internal Revenue Service regulations.
HSA contribution limits will also increase for 2015. The
maximum contribution to an HSA for employee-only coverage is $3,350 and $6,650 for family coverage.
These maximums take into account your contribution
as well as the college’s. The HSA catch-up contribution
for those age 55 or older remains at $1,000. It is your
responsibility to make sure your HSA contributions, including any employer contributions, do not go over the
IRS maximums.
DEPENDENT ELIGIBILITY RULES
Beginning January 1, 2015, no new enrollments in domestic partner benefits will be allowed. Please see “Who
Can Be Enrolled in Your Benefits” for a listing of eligible
dependents.
The nifty sketches in this guide are artwork
from Ithaca College students in the 1920s.
Human Resources
How to Re-enroll
You can enroll online through Parnassus
Employee Self-Service. Step by step instructions
can be found at ithaca.edu/hr/docs/hrforms/
benefitsdocs/2015docs/howtoreenroll.pdf. To
access Employee Self-Service, you will need
your Parnassus password.
If you do not know your password,
simply click the “Forgot your Password?” link
on the Login page and a new password will be
emailed to you.
If you have problems resetting your password,
contact the ITS help desk at 607-274-1000.
Who Can Be Enrolled
in Your Benefits?
Eligible dependents are defined as:
• Your legal spouse/grandfathered qualified domestic
partner (QDP)*
• Your legal children. For medical, dental, vision, and
hearing care this includes your natural, adopted or
foster children, stepchildren, or any child for whom
you have legal custody or are required to provide
health insurance by a Qualified Medical Child Support
Order.
• For dependent life and AD&D insurance this includes
your natural, adopted or stepchildren.
They are eligible:
»» Up to age 19, for all benefits
»» Between ages 19 and 25, for all benefits
provided they are a full-time student
»» Up to age 26, for medical insurance regardless
of student or marital status
»» Age 19 or older, if unmarried and fully
disabled.
* If you and your QDP were enrolled in benefits before
January 1, 2015, your partner is eligible to remain on benefits
for the duration of your eligibility.
Fall 2014 | page 3
Re-enrollment Checklist
BEFORE RE-ENROLLMENT
Before re-enrollment begins, take the time
to educate yourself on all of the benefit options that are available to you. A variety of
tools and resources to help with making
your benefit selections can be found in this
guide and online at ithaca.edu/hr/benefits/
reenrollment2015.
Give extra consideration to deciding which
medical option is right for you. If you have
medical coverage under another plan, you
can decline medical coverage under the
Individual Choice program and receive
$1,250 in separate cashable credits. In order to decline coverage, you must certify
that you have other coverage.
If you are considering electing the high
deductible health plan (HDHP), confirm
whether you are eligible to have a health
savings account. Otherwise, you could face
tax as well as other financial consequences.
See page 7 for important questions to consider.
RE-ENROLLMENT
MUST BE
COMPLETED BY
NOON ON
NOVEMBER 21,
2014!
Verify dependent eligibility and beneficiary information. If you wish to add a dependent who was not previously covered
under any of your benefits, add a new beneficiary, or update full-time student status
for children ages 19 to 25, please complete
the Dependent/Contact Add-Update Form
(ithaca.edu/hr/docs/hrforms/benefitsdocs/
individualchoice/gendocs/depcontactupdate.pdf).The completed form and appropriate supporting documentation should
be returned to the employee benefits and
work/life department. If you prefer to fax
the information, you may send it to 607274-1670. You will not be able to enroll
new dependents or add beneficiaries until
you submit the appropriate paperwork and
it is processed.
Attend the benefits and work/life fair to
get answers to all of your questions. More
information about the fair can be found at
ithaca.edu/hr/benefits/reenrollment2015.
Know your Parnassus password. If you do
not know your password, simply click the
“Forgot your Password?” link on the Login
page and a new password will be emailed
to you. If you have problems resetting your
password, please contact the ITS help desk
at 607-274-1000 for assistance.
DURING RE-ENROLLMENT:
Attend one of the informational sessions
listed on page 5 of this guide to learn more
about the college’s new life insurance offerings and the additional free services that
come along with it.
Re-enroll online between Monday, November 10, and Friday, November 21, at noon!
Instructions are available at ithaca.edu/
hr/docs/hrforms/benefitsdocs/2015docs/
howtoreenroll.pdf. If you prefer to have
personal assistance, stop by one of the
drop-in sessions or call the employee benefits and work/life staff during the dates and
times listed on page 5.
Be sure to check that you are not covering a dependent who is not eligible.
Due to New York State life insurance law
filings, foster children, children for whom
you have legal custody or for whom you
are required to provide health insurance
due to court order, are not eligible to be
covered under dependent life and AD&D
insurance. Therefore, although your child
may be covered under the medical, dental, and/or vision and hearing care plan(s),
they may not be eligible for life insurance.
Claims will not be paid for any child who
is determined to be ineligible for coverage.
Designate your beneficiary(ies) when you
re-enroll. Your current elections will not
be carried over automatically.
Once you have completed your re-enrollment online, save or print a copy of your
confirmation, review it for accuracy, and
retain it for your records. This will be your
only record of your re-enrollment. After
November 21 at noon, most corrections
cannot be made.
4 ithaca.edu/hr
We’re Here to Help!
ONLINE RE-ENROLLMENT DROP-IN SESSIONS
If you prefer to have assistance with the online re-enrollment process, the HR staff will be available on the dates
and times listed below. In addition, if you have questions about your current medical plan or are considering
switching plans, an Aetna representative will be available as indicated below. For added convenience, the HR staff
will also be available during the times listed below by telephone at 607-274-8000. All drop-in sessions will be held
on the garden level of the Peggy Ryan Williams Center.
Tuesday 11
Wednesday 12
Thursday 13
Friday 14
Monday 17
Tuesday 18
Wednesday 19
Thursday 20
Friday 21
Personal Assistance
with Online
Re-enrollment
9:00 a.m. - Noon
1:00 p.m. - 3:00 p.m.
9:00 a.m. - 11:00 a.m.
9:00 a.m. - 12:30 p.m.
12:30 p.m. - 4:00 p.m.
8:30 a.m. - Noon
8:30 a.m. - 4:00 p.m.
8:30 a.m. - 4:00 p.m.
8:30 a.m. - Noon
*Aetna Drop-In
Sessions
9:00 a.m. - Noon
1:00 p.m. - 3:00 p.m.
Not Available
9:00 a.m. - 12:30 p.m.
Not Available
9:00 a.m. - Noon
9:00 a.m. - 3:00 p.m.
9:00 a.m. - 3:00 p.m.
Not Available
*In order to make the most of the resources Aetna has to offer in assisting you with
choosing a health care plan that’s right for you, please bring your Aetna Navigator login
information to the drop-in session. If you do not have an Aetna Navigator account,
please go to aetna.com and follow the easy online instructions to set up an Aetna Navigator account prior to your visit.
LIFE INSURANCE INFORMATIONAL AND DROP-IN SESSIONS
Your life insurance from The Hartford can
help you protect the financial future of your
loved ones. Attend one of the informational
or drop-in sessions listed on the right to learn
more about your life insurance and the additional free services that come with your insurance. Funeral planning and concierge services, beneficiary assist counseling services,
estate-guidance and will services, and travel
assistance services with ID theft protection
and assistance are new offerings you’ll want
to take the time to hear about.
All sessions will be held in the Office of Human
Resources, Peggy Ryan Williams Center.
Human Resources
Tuesday 11
Wednesday 12
Wednesday 19
Thursday 20
8:30 a.m. - 9:30 a.m.
11:00 a.m. - Noon
Drop-ins: 9:30 a.m. - 11 a.m.
Noon - 1:00 p.m.
1:30 p.m. - 2:30 p.m.
Drop-ins: 2:30 p.m. - 3:30 p.m.
8:30 a.m. - 9:30 a.m.
Drop-ins: 9:30 a.m. - Noon
Drop-ins: 1:30 p.m. - 3:00 p.m.
12:15 p.m. - 1:15 p.m.
3:00 p.m. - 4:00 p.m.
9:30 a.m. - 10:30 a.m.
11:00 a.m. - Noon
1:15 p.m. - 2:15 p.m.
3:00 p.m. - 4:00 p.m.
Fall 2014 | page 5
Benefit Plan Summaries
MEDICAL PLANS
You have a choice of three medical plan options: a point of service II (POS II) plan,
a high deductible health plan (HDHP) with a health savings account (HSA) or you
may opt-out of the college’s medical plans.
A general description of how each plan works is below. More specific information
can be found by visiting ithaca.edu/hr/benefits/reenrollment2015.
Point of Service II (POS II) Plan
The POS II plan works more like a traditional medical plan where members pay copays (fixed amount) for some services and co-insurance (a percentage of the expense
you must pay for care, in most cases, after meeting your deductible). With the POS
II plan, your premium is higher than with the HDHP, but your annual deductible is
lower.
HIGHLIGHTS
• Preventive care (annual physical, well woman visit, mammogram, colonoscopy, routine immunizations and other eligible services) received from an in-network Aetna provider is covered at 100% and is not subject to any deductible.
• For most other covered medical services, the plan pays 90% of care received
from an in-network provider after you satisfy your deductible.
• Covered services from an out-of-network provider are subject to a higher deductible and a lower reimbursement rate.
• You cannot have a health savings account with the POS II Plan; however, you
do have the option of enrolling in a health care flexible spending account
(HCFSA), which allows you to set aside pre-tax dollars to help pay for medical
expenses.
• There is a limit to how much you will have to pay out of your pocket for medical care in the event you have significant medical expenses during the year.
• Prescription drugs received at a retail pharmacy or through mail order are not
subject to any deductible. You simply pay a copay.
• If you have family coverage, all family members will be considered as having
met their deductible for the remainder of the calendar year once the family
deductible is met.
High Deductible Health Plan (HDHP) with a Health Savings
Account (HSA)
The HDHP provides comprehensive health benefits and allows you to build savings,
through a health savings account (HSA). Ithaca College contributes to your HSA.
Members in the HDHP pay co-insurance for most medical services received after
satisfying a deductible. The HDHP allows you to pay lower premiums than with the
POS II plan, but your annual deductible is higher.
6 ithaca.edu/hr
HIGHLIGHTS
• Preventive care (annual physical, well woman visit, mammogram, colonoscopy, routine immunizations, and other eligible services) received
from an in-network Aetna provider is covered at 100% and is not subject
to any deductible.
• For most other covered medical services, the plan pays 90% of care received from an in-network provider once you meet the deductible.
• Covered services from an out-of-network provider are subject to a higher
deductible and a lower reimbursement rate.
• The plan has an annual out-of-pocket maximum that limits the amount
you pay in a given year for covered expenses.
• You must meet your annual deductible before any prescription drugs are
covered.
• A list of preventive medications may be found at aetna.com.
• Pre-tax money accumulated in an HSA can be used for current or future
medical expenses. If you don't use up your HSA during the calendar year,
the account balance is rolled over to the following year. It also goes with
you if you leave Ithaca College and ultimately can be used in your retirement.
• The college will make a generous contribution to your HSA for 2015:
$1,000 if you cover yourself only or $1,500 if you have family coverage.
The college’s contribution will be deposited into your account after your
first payroll of the year is processed.
• It is your responsibility to determine if you are eligible to have an HSA.
• If you have family coverage, you must meet the family deductible before
any expenses for any individual are covered.
HSA FEATURES
Your HSA can help you cover your deductible or pay for other qualified medical expenses.
Withdrawals from HSAs for qualified medical expenses are tax-free. If you
withdraw money for any reason other than for qualified medical expenses, you
must pay income tax and a 20% IRS tax penalty.
The maximum you can contribute to an HSA in one year is set by the IRS (in
2015, $3,350 for single coverage and $6,650 for family coverage). If you are age
55 or older, you can contribute additional catch-up contributions. It is your
responsibility to make sure your HSA contributions, including any employer
contributions, do not go over the IRS maximums.
In accordance with IRS regulations, if you are a new enrollee in the HSA
plan for 2015 and you have a balance in a 2014 flexible spending account (as
of December 31, 2014), you are not eligible to contribute funds to an HSA or
receive any funds in your HSA until April 1, 2015. So, make sure your FSA
balance is $0 by December 31, 2014.
Human Resources
Are You Eligible to
Have an HSA?
You are eligible to have a
health savings account ONLY
if you can answer NO to each
of the following questions.
Are you planning to enroll in
the college’s POS II medical
plan?
Are you or any of your dependents already covered by
a flexible spending account
(FSA) or health reimbursement account (HRA)?
Are you or any of your dependents currently enrolled
in or planning to enroll in any
other medical or pharmacy
plan in the coming year? This
would include Medicare Part
A and B or Medicaid.
Are you or any of your dependents enrolled in Tricare
or have any of you received
benefits from the VA in the
last three months?
Will you or your spouse/
grandfathered QDP turn 65
in the coming year?
If you answered YES to any of
these questions, you are ineligible to have a health savings
account.
If you enroll in a HDHP with
an HSA and are NOT eligible,
there are tax implications.
Fall 2014 | page 7
Medical Plan Comparison at a Glance
PLANS
High Deductible Health Plan with HSA
POS II Plan
Yes
No
$1,000 - Individual
$1,500 - Family
Not Applicable
Health Savings Account
IC’s 2015 Contribution to HSA
In-Network
Out-of-Network
In-Network
Out-of-Network
Individual
$1,300
$2,050
$150
$300
Family
$2,600
$4,100
$450
$900
Individual
$2,500
$3,500
$2,000
$3,000
Family
$5,000
$7,000
$4,000
$6,000
Primary Care Office Visits
10% after deductible
30% after deductible
$20 copay, no deductible
30% after deductible
Specialist Office Visits
10% after deductible
30% after deductible
$30 copay, no deductible
30% after deductible
10% after deductible
30% after deductible
10% after deductible
30% after deductible
15% after deductible
30% after deductible
Covered 100%; deductible waived
30% after deductible
Covered 100%;
deductible waived
30% after deductible
Covered 100%;
deductible waived
30% after deductible
Urgent Care Provider
10% after deductible
30% after deductible
10% after $50 copay;
deductible waived
30% after deductible
Emergency Room
10% after deductible
10% after deductible
10% after $100 copay,
waived if admitted.
No deductible
10% after $100 copay, waived
if admitted. No deductible
Not Covered
Not Covered
Not Covered
Not Covered
Inpatient Coverage
10% after deductible
30% after deductible
10% after deductible
30% after deductible
Outpatient Coverage
10% after deductible
30% after deductible
10% after deductible
30% after deductible
Retail (for up to a 30 day
supply)
After deductible, $10
Copay for generic
drugs; $30 copay for
formulary brand-name
drugs; $50 copay for
non-formulary brand
name drugs.
After deductible, 30% of
submitted cost and $10
copay for generic drugs;
$30 copay for formulary
brand-name drugs; $50
copay for non-formulary brand name drugs
$10 copay for generic
drugs; $30 copay for
formulary brand-name
drugs, and $50 copay for
non-formulary brand
name drugs. Deductible
does not apply.
30% of submitted cost after
$10 copay for generic drugs;
$30 copay for formulary
brand-name drugs, and $50
copay for non-formulary
brand-name drugs. Deductible does not apply.
Mail Order (for up to a 31-90
day supply
After deductible, $20
copay for generic drugs;
$60 copay for formulary
brand-name drugs;
$100 copay for non-formulary brand-name
drugs
Not Covered
$20 copay for generic
drugs; $60 copay for
formulary brand-name
drugs, $100 copay for
non-formulary brandname drugs. Deductibe
does not apply.
Not Covered
Annual Deductible
Out-of-Pocket Limit
Physician Services
Diagnostic Procedures
Lab and X-ray
Outpatient Complex Imaging
(CT, MRI, etc.)
Routine Preventive Care
Emergency Care
Non-Emergency care in ER
Hospital Care
Pharmacy
8 ithaca.edu/hr
If you are enrolled in either of our Aetna medical plans,
we strongly encourage you to take advantage of Aetna’s secure member website called Navigator. Navigator provides
resources and tools specific to your health plan at your fingertips. These are just a few of the things you can find on
Navigator:
• Flexible spending account balance(s)
• List of eligible expenses
• HSA balances
• Online bill pay feature that allows you to pay bills out
of your HSA
• List of in-network providers
• Claims information
•
•
•
•
Coverage information (Find out if a service is covered
under your plan)
Prescription drug cost estimator
All Aetna forms
Order a new ID card or print a temporary card
To create a Navigator account simply go to aetna.com and
use your Aetna ID number to create a secure login. Aetna
Navigator is also available on your smart phone. The Aetna mobile app is available for iPhone and Android mobile
devices. This app puts many online features of Navigator at
your fingertips: aetna.com/mobile.
Dental Plan
PLAN HIGHLIGHTS
The dental plan provides coverage for a wide range of dental services:
Benefits and Covered Services
Delta Dental Network
(in-network)
Non-Delta Dental Network
(out-of-network)
100%
(Deductible Does Not Apply)
100% of allowable amount*
(Deductible Does Not Apply)
Basic Services
Fillings, simple tooth extractions, root canals,
etc.
80%
(Subject to Deductible)
80% of allowable amount*
(Subject to Deductible)
Major Services
Crowns, dentures, etc.
50%
(Subject to Deductible)
50% of allowable amount*
(Subject to Deductible)
Diagnostic & Preventive Services (D&P)
Exams, cleanings, x-rays, and sealants
* If you seek care from a dentist who is not in the Delta Dental network (out-of-network), your provider has the option
of having you pay at time of service or submitting the bill to Delta Dental directly and then billing you for the difference
between what was covered by your dental insurance and what the dentist charged. If your dentist does not submit the bill
directly to Delta Dental for you, you will need to complete a claim form, attach the bill, and send it to Delta Dental so that
you can be reimbursed directly.
Your out-of-pocket expenses will be lower if you choose to be treated by a provider in the Delta Dental network.
Find in-network providers at deltadentalins.com.
Late Entrant Rule
Anyone who enrolls during re-enrollment without a qualified life status change is
considered a “late entrant.” For the first 12 months of coverage, late entrants’ benefits are limited to two preventive care cleanings and exams (excluding x-rays), as
well as one fluoride application for children under age 19.
Annual Deductible
Deductible Waived for Diagnostic & Preventive
Services**
$50 per person**/ $150 per family**
Maximum Benefit
$1,500 per person each calendar year
Human Resources
Fall 2014 | page 9
Vision and Hearing Care Plan
VISION CARE PLAN HIGHLIGHTS
Davis Vision benefits are easy to use. Members can access care through the Davis Vision network
of independent, private practice doctors (optometrists and ophthalmologists) or select retail
partners such as Empire Visionworks, Sterling Optical, or Walmart.
Exams: Eye exams are covered every 12 months, after a $10 copayment if you use an in-network
provider.
Frames: Frames are covered every 24 months. If you choose to go to an in-network provider you
have three options for choosing frames:
1. Choose a fashion or designer frame from the Davis Vision Collection and pay nothing for
the frames (value up to $175);
2. Choose a premier frame from the collection and pay only a $25 copayment for the frames;
3. Choose any frame not from the Davis Vision Collection and receive a $130 retail allowance toward the cost of the frames and receive 20% off any balance over $130.
Lenses: Lenses are covered every 12 months. Eyeglass lenses from a participating provider are
covered in full after a $25 copay for standard single-vision, lined bifocal, or trifocal lenses. Discounts apply to other lenses such as standard progressives (no-line bifocal). Contact lenses (in
lieu of eyeglasses) are covered in full once every 12 months if selected from the Davis Vision
Collection. If you select contact lenses that are not in the Davis Vision Collection, you will receive
a $130 allowance toward provider supplied contact lenses, plus 15% off of the balance. For more
details about the plan, log on to davisvision.com and enter 2423 in the Client Code section of the
Open Enrollment box or call 877-923-2847.
Out-of-Network Reimbursement Schedule
Eye Examinations: up to $30
Frames: up to $50
Spectacle Lenses (per pair): up to $25 for single vision; $40 for bifocal; $55 for trifocal; $75 for lenticular
Elective Contacts: up to $100
Medically Necessary Contacts: up to $225
HEARING CARE PLAN HIGHLIGHTS
Hearing Exam Benefit: Members are eligible for up to a $75 allowance per calendar year for
a comprehensive hearing exam.
Hearing Aid Benefit: The plan pays 50% of the hearing aid cost up to the maximum benefit
amount. The benefit amount is progressive, rewarding loyal members with an amount that increases over time based on the patient’s effective date.
Hearing aid maximum benefit is:
Year 1 = up to $500 per ear;
Year 2 = up to $750 per ear;
Year 3+ = up to $1,000 per ear.
Have a question?
Call 877-359-8346
Once plan members use their hearing aid coverage at any level, they become re-eligible for the
benefit at the $1,000 per ear benefit maximum after five years as long as there is no break in coverage. A reduced benefit is available after three years if a member’s hearing suffers deterioration
the current aids can’t correct, as long as there is no break in coverage. Members are eligible for up
to a $40 allowance per benefit period for hearing aid maintenance.
10 ithaca.edu/hr
Employee Life Insurance - New this year!
Basic Life Insurance
The college will provide each benefit-eligible employee with a basic group term life insurance benefit valued at $50,000.
Supplemental Life Insurance
The new supplemental life insurance plan allows you to enroll in up to $500,000 of coverage (not to exceed seven times your
annual salary). For the 2015 re-enrollment period, you can enroll in up to the guaranteed issue amount of $200,000 with no
medical questions asked, regardless of how much life insurance you currently have through the college. If you currently have
$200,000 worth of life insurance coverage and wish to increase above that amount, you will need to provide evidence of insurability (EOI). Please contact the employee benefits and work/life department for more information about the EOI process.
Also, beginning this year, the monthly rate that you will pay per $1,000 of supplemental life insurance is based on your age as
of January 1 each year. Depending on your age, your rate will be lower or higher than the rate that you currently pay for life
insurance. Rates are outlined on page 14 of this guide.
If you are age 65 or older, special provisions apply. Coverage limits are reduced by 35% at age 65; 60% at age 70; and 75% at age 75.
Dependent Life Insurance
PLAN HIGHLIGHTS
This type of insurance pays you a benefit upon the death of an eligible dependent. You may
choose from two levels of coverage. Level 1 allows you to insure your spouse/grandfathered
qualified domestic partner (QDP) for $5,000 and each eligible child for $2,500. Level 2 allows you to insure your spouse/grandfathered QDP for $10,000 and each eligible child for
$4,000. Dependent life insurance coverage is paid for with after-tax dollars.
You are the beneficiary of any dependent life insurance you elect.
Accidental Death & Dismemberment (AD&D) Insurance
PLAN HIGHLIGHTS
Allows you to protect yourself and your family from extra financial burdens in the case of accidental death or serious injury
due to an accident.* Your spouse/grandfathered qualified domestic partner can also receive AD&D insurance for 50% of
your protection level. If you wish to cover your family, your spouse/grandfathered QDP would be insured for 40% of your
coverage level and each child for 10%, with an individual maximum of $10,000 per child. *Limitations and exclusions apply.
Long-term Disability (LTD) Insurance
PLAN HIGHLIGHTS
Once you meet the eligibility criteria, LTD coverage provides important financial protection if you become totally disabled
and unable to work for a period of more than six months. You may choose between two levels of LTD coverage.
Ithaca College benefit credits include an amount sufficient to purchase the 60% option.
LTD Coverage Options
50% Option
This option provides 50% of your base pay up to a maximum monthly amount after 180 days of total disability.
Human Resources
60% Option
This option provides 60% of your base pay up to a maximum monthly amount after 180 days of total disability.
Fall 2014 | page 11
Spending Account Information
HEALTH CARE FLEXIBLE SPENDING ACCOUNT (HCFSA)
An HCFSA allows you to direct a part of your before-tax pay into a spending account
that allows you to pay for qualified health care expenses for you and your eligible dependents with before-tax income or excess benefit credits. It’s a good way to pay for
health care expenses not covered by your medical, dental, and vision plans including
deductibles, co-pays, costs that exceed reasonable and customary limits, and limited
over-the-counter medications and supplies, to name a few.
The maximum amount you can contribute to an HCFSA is $2,500 per calendar year.
You cannot have a HCFSA if you are enrolled in the high deductible health plan. If
you are in the HDHP, you would use a health savings account in place of the HCFSA.
A list of qualified expenses can be found on Aetna’s website at aetnafsa.com.
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT (DCFSA)
A DCFSA provides for the reimbursement of eligible employment-related dependent
day-care expenses. If you are a working parent, or have elder-care responsibilities, a
DCFSA could save you money. If you are married, you may contribute to this account
if your spouse works, attends school full-time or is disabled.
You can contribute to a DCFSA to pay dependent care expenses for: a child under
age 13, or other eligible dependents (for example, a parent or spouse), who spend at
least eight hours a day in your home, require care, and are considered dependents for
tax purposes. You can use the account to reimburse the cost of an in-home day-care
provider, day-care center or similar day-care service, or elder-care facility. Overnight
camps, educational/tuition expenses for a child in Kindergarten or higher grades,
and programs/lessons that are primarily for education or are skill-oriented are not
eligible for reimbursement. A list of qualified expenses can be found on Aetna’s website at aetnafsa.com.
If your spouse also participates in a DCFSA and you file federal taxes jointly, the
contribution limit between the two of you is $5,000. If you and your spouse file separately, you each may contribute up to a maximum of $2,500.
IMPORTANT REMINDER: Contributions to any FSA are “use-it-or-lose-it” funds.
Account balances are not carried over from year to year. This means that if you have any
unused funds at the end of the calendar year, those funds will be forfeited. That’s an IRS
rule. So estimate what you want to direct to your FSA account(s) carefully. March 15,
2015 is the deadline for submitting any reimbursement claims incurred in 2014.
12
Individual Choice Rates
Medical Plan Cost
Annual
Premium
HDHP
Employee Only
Employee + Spouse/
Grandfathered QDP
Employee + Children
Employee + Family
College’s
Employee’s
Benefit
Employee’s
Contribution to
Monthly Increase
Credits
Annual
Health Savings
in Cost from
Provided
Cost
Account
2014
$6,955
$6,535
$1,000
$420
$20
$8,923
$6,535
$1,500
$2,388
$23
$8,815
$10,735
$6,535
$6,535
$1,500
$1,500
$2,280
$4,200
$23
$30
* Only tax dependent grandfathered qualified domestic partners are eligible for the employer’s contribution to the
HSA. Please see plan rules for eligibility.
POS II
Employee Only
Employee + Spouse/
Grandfathered QDP
Employee + Children
Employee + Family
$8,191
$6,535
$0
$1,656
$30
$11,155
$6,535
$0
$4,620
$35
$10,999
$12,655
$6,535
$6,535
$0
$0
$4,464
$6,120
$34
$40
Dental Plan Cost
Employee Only
Employee + Spouse/
Grandfathered QDP
Employee + Children
Employee + Family
Annual Benefit Credits Employee’s Employee’s Monthly Increase
Premium
Provided
Annual Cost
in Cost from 2014
$324
$288
$36
$3
$576
$288
$288
$3
$648
$804
$288
$288
$360
$516
$3
$3
Vision & Hearing Care Plan Cost
Annual
Premium
Benefit Credits
Provided
Employee’s Employee’s Monthly Increase
Annual Cost
in Cost from 2014
Employee Only
Employee + Spouse/
Grandfathered QDP
Employee + Children
$76.68
$36
$40.68
$0
$161.28
$36
$125.28
$0
$125.40
$36
$89.40
$0
Employee + Family
$209.28
$36
$173.28
$0
Human Resources
Fall 2014 | page 13
Basic Life Insurance
$50,000*
Annual Premium
Benefit Credits
Provided
Employee’s Annual
Cost
$120
$120
$0
* Coverage amounts are reduced by 35% at age 65; 60% at age 70; and 75% at age 75.
Supplemental Life Insurance
Age
Benefit Credits
Provided
Monthly Premium Rate Per
$1,000* of Coverage
<25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0.035
$0.035
$0.040
$0.060
$0.090
$0.150
$0.230
$0.390
$0.520
$0.820
$1.435
$2.060
$2.060
$2.060
* Coverage amounts are reduced by 35% age age 65; 60% at age 70; and 75% at age
75.
Maximum amount of coverage is $500,000, but may not exceed seven times annual
salary.
Proof of Evidence of Insurability may apply.
14
Dependent Life Insurance
Annual
Premium
Option 1
Spouse/ Grandfathered QDP = $5,000
Children = $2,500
Option 2
Spouse/Grandfathered QDP = $10,000
Children = $4,000
Benefit Credits Employee’s Monthly Increase
Provided
in Cost from 2014
$23.52
$0
$0
$44.52
$0
$0
Accidental Death & Dismemberment
Annual Premium Benefit Credits Employee’s
per $20,000 Unit
Provided
Annual Cost
Employee Only
Employee + Family
$9.36
$13.68
variable*
variable*
Employee’s Monthly
Decrease in Cost per Unit
from 2014
variable*
variable*
-$1.20
-$1.92
* College provides benefit credits in an amount sufficient to purchase coverage equivalent to one times your base
salary.
Maximum amount of coverage is $300,000, but may not exceed 10 times annual salary.
Long-term Disability
50% Option
60% Option
Human Resources
Annual Premium
Benefit Credits
Provided
Employee’s
Annual Cost
Employee’s Monthly Increase
in Cost from 2014
$213.00
$282.00
$282
$282
$0
$0
$0
$0
Fall 2014 | page 15
Other Benefits for Your Consideration
Ithaca College 403(b) Retirement Plan
If you are eligible to participate in Ithaca College’s retirement plan and receive matching
contributions but haven’t enrolled, you should consider doing so now. Why give away money
that is being offered to you? Provided that you contribute at least 5% of your base salary to the
matching plan, the college will contribute 9% of your base salary. Please contact the employee
benefits and work/life department to determine your eligibility to participate in the plan.
Even if you are not eligible to receive the college’s matching contribution, you can still take
advantage of saving for retirement with pre-tax dollars. All employees of the college, except
for student workers, who receive compensation reportable on an IRS Form W-2 are eligible
to make elective deferrals. A minimum contribution of $200/year is necessary.
Many resources are available to help you assess your savings situation and your goals for
retirement. Becoming a more informed investor will directly affect your chance of reaching
your retirement goals. The TIAA-CREF website found at tiaa-cref.org/ithaca includes several
useful tools and calculators to assist you in improving your financial well-being.
In addition to using the online tools, we encourage you to take advantage of the opportunity to meet with a TIAA-CREF consultant for an individual consultation. To schedule an
appointment, please call 866-843-5640, or visit tiaa-cref.org/schedulenow. All meetings are
held in the Office of Human Resources located on the garden level of the Peggy Ryan Williams Center.
TO CHANGE OR START YOUR RETIREMENT PLAN CONTRIBUTION, you’ll need
to complete a Salary Reduction Agreement (ithaca.edu/hr/docs/hrforms/benefitsdocs/
retirement/SalaryReduction.pdf) and return it to the employee benefits and work/life
department. If you’re not already contributing, you can enroll at tiaa-cref.org/Ithaca.
Important Information about Your Contributions
Employees are alerted that exceeding the legal limit has tax consequences. It is the
employee’s responsibility to check their paycheck to determine if the appropriate amount is being withheld and to report any discrepancies immediately to the Office of Human Resources so that timely corrections can be
made. If you wish to contribute the maximum allowed to your retirement plan each year, please remember that you are responsible for
monitoring your contributions to ensure you will reach the maximum
by the end of the calendar year and that you won’t contribute more
than allowed by law. It is your responsibility to complete a revised Salary
Reduction Agreement when necessary.
IRC Limits on 403(b) Retirement Plan Contributions for 2015:
403(b) employee contribution limit is $18,000.
403(b) employee catch-up contribution (age 50 and older during 2015) is
$6,000.
If you have 15 or more years of service with IC, you may also be eligible for an
additional catch-up contribution. Using the 15 years of service catch-up option
requires a maximum allowed contribution calculation and will not be approved
until that calculation is completed and approved. Please contact the employee benefits and work/life department to request a calculation.
16 ithaca.edu/hr
Emeriti Retiree Health Program
The Emeriti Retiree Health Program provides a way for you
to save for the cost of health care during retirement. Did you
know that Ithaca College makes contributions to an Emeriti
Health Account on your behalf, provided you are at least age
35 and have one year of eligible service in an eligible class?
IC continues to make contributions until they have made 25
years of contributions to your account, the date you cease
employment at the college, or at your death, whichever is
earliest. The college’s contribution is determined on an annual
basis. If you cease employment with the college without having
met the college's criteria for retirement eligibility, assets from
employer contributions will be forfeited.
Equally important to know is that as a benefits-eligible
employee in an eligible class, you may make voluntary contributions to the Emeriti plan if you are age 21 or older and have at
least one year of eligible service. You determine the amount you
want to contribute, and there are no limits on the amount you can
contribute. Your contributions will be made on an after-tax
basis, but all contributions and earnings will accumulate and
be paid out tax-free for qualified medical expenses. If you
leave the college without meeting the college’s criteria for retirement eligibility, you will still have the right to use all of
your own contributions and earnings, starting at age 55, to
pay for qualified medical expenses, including other health insurance.
Contributions are held in tax-advantaged trusts called
VEBAs (Voluntary Employees Beneficiary Association) serviced by TIAA-CREF. You can check your Emeriti Health
Account balance(s) via the TIAA-CREF website at tiaa-cref.
org. If you’ve already set up a log-in and password, you may
use that same information to access the Emeriti Health Accounts on the TIAA-CREF secure website. For new users of
the TIAA-CREF website, just click the link in the Account
Log-in box on the home page that reads “New User? Register
Online.”
Long-Term Care Insurance (LTC)
If you ever have a long-term illness or a chronic condition, you may require extended care at home or in an assisted living
facility or nursing home. Long-term care insurance can help make sure you have the financial resources to cover these costs,
which can be steep. For more information about the college’s long-term care benefit, please call 1-800-416-3624 or visit genworth.com/groupltc. Once on the site, enter the group name as ithacacollege. The access code is groupltc.
For Your Benefiit
Mind, Body, Me Wellness Program
WE INVITE YOU TO JOIN
The MBM wellness program is a holistic approach to
wellness that focuses on YOU, incorporating the mind
and the body, through an individualized plan, all at NO
cost to you. Do it for you! This program already benefits
436 of your colleagues. Flight 11 will roll out in January
2015. Join the program and have access to the following
tools and resources:
•
•
•
•
•
•
Personal Training
Wellness Clinic Membership
Group Exercise Classes
Chair Massages
Monthly Workshops and Lunch-and-Learns
Newsletters and Wellness Tips
Human Resources
• Screenings and Assessments
• Incentive Prizes
• Much more!
If you are interested in joining, email mindbodyme@
ithaca.edu, call 607-274-8000, or stop by the annual
benefits and work/life fair on November 4, 2014, in Emerson Suites. We look forward to starting your wellness
adventure with you!
FOR CURRENT MBM PARTICIPANTS
New year, new you, new MBM options! Look for the
rollout of the new Levels of Engagement. These tracks
are designed to provide you with a path to assist you
with your individual goals. Stay tuned for further information!
Fall 2014 | page 17
Employee Assistance Program (EAP)
Counseling Services
BalanceWorks is your Employee Assistance
Program through eni. BalanceWorks is available 24/7 to help you and your eligible family
members with any issues you may be struggling with. The EAP counselors are licensed
mental health professionals who provide up
to five sessions of free confidential counseling in-person or over the telephone. Here’s
how it works:
• Call 1-800-EAP-CALL (1-800-3272255).
• The EAP counselor will ask you a series of questions designed to assess
your situation to determine the best
level of care.
• Your issue may be resolved over the
telephone or you may be referred to a
counselor in your area (eni will locate
counselors for you).
• If you are referred to a counselor, your
counselor will contact you directly to
set up an appointment.
No-cost Legal and Financial Consultations
Your free, confidential, 24/7 EAP work/life
benefit also includes a free half hour legal
consultation (per issue) with an attorney on
issues such as ID theft, medical malpractice,
traffic tickets, personal injury, small claims,
adoption, collections, and much more! For
more complex issues, you will be provided
legal referrals and discounted attorney’s fees.
Personal Assistant (PA)
Your EAP work/life benefit provides you with
unlimited use of a PA who is a work/life expert who provides you with useful referrals,
research, or information on just about any
topic such as child/eldercare resources, finding pediatricians, babysitters, camps, music
lessons, and assisted living facilities, etc.
Personalized Website
Log in at mybalanceworks.com to access
thousands of work/life articles, self-help
tools, and interactive videos for personal and
professional development. You can submit
and track requests to your personal assistant, chat live, and use the interactive calendar and date reminder. In addition, there is
an Ask-a-Counselor feature you can utilize
to submit a confidential non-emergency
question to a counselor to receive a quick response.
Finally, you can also access your EAP and
work-life services all from your mobile devices by downloading BalanceGo from the
app store. With BalanceGo, you can make
and track personal assistant requests, access
legal and financial services, access a wide variety of wellness and work/life tools and resources, and use the virtual Ask-a-Counselor
feature.
To access your EAP benefit 24 hours per day, seven days per week call:
1.800.EAP.CALL (1.800.327.2255) or LOGIN at mybalanceworks.com.
Robert R. Colbert Sr. Wellness Clinic
The mission of the Ithaca College wellness clinic is to provide quality health and fitness services to the Ithaca College community, while enhancing the practical experiences of exercise and sport science students through genuine guided clinical training.
Services offered through the wellness clinic include group exercise classes, exercise
prescriptions, graded exercise testing, counseling, and supervised exercise sessions.
There is an annual membership fee of $175 for current employees, spouses or significant others of members, and eligible retirees. The membership fee is waived if you are
a member of the Mind, Body, Me wellness program. For more information regarding
the wellness clinic, please contact 607-274-1301 or email [email protected]. You
can also learn more by visiting the website at ithaca.edu/hshp/clinics/wellness.
18 ithaca.edu/hr
Work/Life: It’s about You
Ithaca College believes in the integration of work and life outside of work and has implemented a work/life initiative to help you. We define work/life as education, programs, policies, practices, and services that provide connections between individuals and the college including flexibility, wellness, family care, individual growth and development, and community service. Resources include monthly workshops, flexible work arrangements, Mind, Body,
Me wellness program, informational campaigns, work/life blog, and more. To learn more about the It’s About You
Work/Life program, please visit the website at ithaca.edu/hr/benefits/wrklife.
Sir Alexander Ewing Speech and Hearing Clinic
The speech and hearing clinic provides intervention for individuals suspected of having or demonstrating communication disorders. Faculty and staff can request free clinic services by calling 607-274-3714. Find out more
about the clinic by visiting ithaca.edu/hshp/depts/slpa/clinic.
Fitness Center
The Fitness Center is open to all current members of the campus community which include students, faculty, staff,
and Longview. Whether you are looking to begin a fitness program, participate in group exercise classes, or get a
personal trainer, the Fitness Center can help! Did you know that if you are a member of the Mind, Body, Me wellness program, you can receive free personal training sessions? For more information call them at 607-274-3399
or visit ithaca.edu/sacl/recsports/fitnesscenter.
Faculty/Staff Meal Plan
This meal plan exclusive to Ithaca College faculty and
staff allows access to all dining halls. Meals can be
used for breakfast, lunch, dinner, or late night. The
plan offers meal plans at discounted prices. Payment may be made through payroll deductions,
Visa, MasterCard, check, or cash. To enroll in
the faculty/staff meal plan, please contact Ithaca
Dining Services at 607-274-1187 or go to ithacadiningservices.com/dining_plans.html.
Occupational and Physical Therapy Clinic
The occupational and physical therapy clinic offers comprehensive
rehabilitation services to employees and their families. All services
are provided by New York State licensed physical and occupational
therapists. The clinic is available for the treatment of a variety of
diagnoses and patient populations. Occupational therapy services
require a physician referral in order to be treated. Physical therapy services may be delivered on a limited direct access basis.
All OT/PT clinic services are free! To make an appointment, or get more information, please call 607-274-3740
or visit the website at ithaca.edu/hshp/clinics/otptclinic.
Human Resources
Fall 2014 | page 19
Mandated Notices
HIPAA Special Enrollment Notice:
If you decline enrollment for medical benefits for yourself or your eligible dependents
(including your spouse) in the Ithaca College Medical Plan (“the Plan”) because of other
health insurance or group health plan coverage, you may be able to enroll yourself and
your eligible dependents in the medical benefits provided under the Plan if you or your
eligible dependents lose eligibility for that coverage (or if the employer stops contributing toward you or your eligible dependents’ other coverage). However, you must request
enrollment in the Plan within 60 days after you or your dependents’ other coverage ends
(or after the employer stops contributing toward the other coverage).
In addition, if you have a new dependent as a result of marriage, birth, adoption, or
placement for adoption, you may be able to enroll yourself, your spouse, and your new
eligible dependent children. However, you must request enrollment within 30 days after
the marriage, birth, adoption, or placement for adoption. If you request a change due to a
special enrollment event within the 30-day timeframe, coverage will be effective the date
of birth, adoption, or placement for adoption. For all other events, coverage is effective as
of the event date that makes you eligible.
The Ithaca College Medical Plan must allow a HIPAA special enrollment for employees
and eligible dependents who are not enrolled if they lose Medicaid or CHIP coverage
because they are no longer eligible, or if they become eligible for a state’s premium assistance program. Employees have 60 days from the date of the Medicaid/CHIP event to
request enrollment under the Ithaca College Medical Plan. If you request this change,
coverage is effective as of the event date that makes you eligible. Specific restrictions may
apply, depending on federal and state law. To request special enrollment or obtain more
information, contact the employee benefits and work/life department at 607-274-8000.
Statement of Rights Under the Newborns’ and Mother’s Health
Protection Act:
Under federal law, group health plans and health insurance issuers offering group health
insurance coverage generally may not restrict benefits for any hospital length of stay in
connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a delivery by cesarean section.
However, the plan or issuer may pay for a shorter stay if the attending provider, after consultation with the mother, discharges the mother or newborn earlier. Also, under federal
law, plans and issuers may not set the level of benefits or out-of-pocket costs so that any
later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the
mother or newborn than any earlier portion of the stay.
In addition, a plan or issuer may not, under federal law, require that you, your physician,
or other health care provider obtain authorization for prescribing a length of stay of up to
48 hours (or 96 hours). However, you may be required to obtain precertification for any
days of confinement that exceeds 48 hours (or 96 hours). For information on precertification, contact Aetna at 800-962-6842.
20 ithaca.edu/hr
Mandated Notices
Premium Assistance under Medicaid and the Children’s Health Insurance Program (CHIP):
If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage. These states use funds
from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to
health insurance through their employer. If you or your children are not eligible for Medicaid or CHIP, you will
not be eligible for these premium assistance programs.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a state listed below, you can
contact your state Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your
dependents might be eligible for either of these programs, you can contact your state Medicaid or CHIP office or
dial 1-877-KIDS NOW or insurekidsnow.gov to find out how to apply. If you qualify, you can ask the state if it has
a program that might help you pay the premiums for an employer-sponsored plan.
Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP,
as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if
you are not already enrolled. This is called a “special enrollment” opportunity, and you must request coverage
within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your
employer plan, you can contact the Department of Labor electronically at askebsa.dol.gov or by calling toll-free
1-866-444-EBSA (3272).
New York, Massachusetts, and California are among the states that may offer assistance for paying employer health
plan premiums. You should contact your state for further information on eligibility.
NEW YORK – Medicaid
Phone: 1-800-541-2831
CALIFORNIA – Medicaid
Phone: 1-877-543-7669
MASSACHUSETTS – Medicaid & CHIP
Phone: 1-800-462-1120
To find out more information about premium assistance programs, or for more information on special enrollment rights, you can contact
either the U.S. Department of Labor Employee Benefits Security Administration at dol.gov/ebsa (1-866-444-3272) or the U.S. Department of
Health and Human Services Centers for Medicare & Medicaid Services at cms.hhs.gov (1-877-267- 2323, ext. 61565).
Privacy Notice Reminder:
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires Ithaca College Health Plans,
including but not limited to: The Ithaca College Medical Plans, Pharmacy Plans, Dental Plan, Vision and Hearing
Care Plan, Health Care Flexible Spending Account Plan, Health Savings Account Plan, and the Mind Body Me
Employee Wellness Program (collectively, the “Health Plans”) periodically send a reminder to participants about
the availability of the Plan’s Privacy Notice and how to obtain that notice. The Privacy Notice explains participants’
rights and the Plan’s legal duties with respect to protected health information (PHI) and how the Plan may use and
disclose PHI.
To obtain a copy or more information about the Privacy Notice contact the Benefit Programs and Compliance
Administrator at 607-274-8000. You may also view the Privacy Notice online at ithaca.edu/hr/benefits/SupervisorToolkit/?item=6823.
Human Resources
Fall 2014 | page 21
Mandated Notices
Employee Voting Leave in New York:
If a registered voter in New York State does not have sufficient time outside of working hours to vote at any election, that person may take off the amount of working
time that, when added to voting time outside working hours, will allow enough time
to vote.
Paid Time Off Rules: Of the time taken off to vote, up to two hours may be taken
without loss of pay. Time off to vote must be taken at the beginning or end of the
person’s work shift unless otherwise mutually agreed upon between the employee
and employer.
Advance Notice Requirements: An employee who needs time off to vote shall notify
the employer no more than 10 nor less than two working days before election day
that the time off is required.
Amount of Time Off Allowed: Of the time taken off to vote, up to two hours may
be taken without loss of pay.
When Time Off Not Allowed: If an employee has four consecutive nonworking
hours when the polls are open, the employee has sufficient time outside of work to
vote.
Posting Requirements: Not less than 10 working days before every election, every
employer must post a notice setting forth the provisions of the time-off-to-vote law
in a conspicuous place. The notice must remain posted until the polls close on Election Day.
Employer Penalty for Violation: Fine of $100 to $500 and/or jail up to 1 year (first
offense). Corporations also face forfeiture of charter.
Notice Regarding Women’s Health and Cancer Rights Act:
Under Ithaca College’s health plans, coverage will be provided to a person who is
receiving benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema.
This coverage will be provided in consultation with the attending physician and
patient, and will be subject to the same annual deductibles and coinsurance provisions that apply to the mastectomy. If you have questions about coverage for mastectomies and reconstructive surgery, please contact Aetna at 800-962-6842.
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Mandated Notices
Your Rights under USERRA (Uniformed
Services Employment and Re-employment
Rights Act):
USERRA protects the job rights of individuals who voluntarily or involuntarily leave employment positions to undertake military service or certain types of service in the
National Disaster Medical System. USERRA also prohibits
employers from discriminating against past and present
members of the uniformed services, and applicants to the
uniformed services.
Re-Employment Rights
You have the right to be re-employed in your civilian job if
you leave that job to perform service in the uniformed service and:
• you ensure that your employer receives advance written or verbal notice of your service;
• you have five years or less of cumulative service in
the uniformed services while with that particular employer;
• you return to work or apply for re-employment in a
timely manner after conclusion of service; and
• you have not been separated from service with a disqualifying discharge or under other than honorable
conditions.
If you are eligible to be reemployed, you must be restored to
the job and benefits that you would have attained if you had
not been absent due to military service, or in some cases, a
comparable job.
Freedom from Discrimination and Retaliation
If you: are a past or present member of the uniformed service; have applied for membership in the uniformed service;
or are obligated to serve in the uniformed service; then an
employer may not deny you: initial employment; reemploy-
ment; retention in employment; promotion; or any benefit
of employment because of this status.
In addition, an employer may not retaliate against anyone
assisting in the enforcement of USERRA rights, including
testifying or making a statement in connection with a proceeding under USERRA, even if that person has no service
connection.
Health Insurance Protection
• If you leave your job to perform military service, you
have the right to elect to continue your existing employer-based health plan coverage for you and your
dependents for up to 24 months while in the military.
• Even if you don’t elect to continue coverage during
your military service, you have the right to be reinstated in your employer’s health plan when you are
reemployed, generally without any waiting periods or
exclusions (e.g., pre-existing conditions exclusions)
except for service-connected illnesses or injuries.
Enforcement
The U.S. Department of Labor, Veterans Employment and
Training Service (VETS) is authorized to investigate and resolve complaints of USERRA violations.
For assistance in filing a complaint, or for any other information on USERRA, contact VETS at 1-866-4-USA-DOL
or visit its website at dol.gov/vets. An interactive online USERRA advisor can be viewed at dol.gov/elaws/userra.htm.
If you file a complaint with VETS and VETS is unable to
resolve it, you may request that your case be referred to the
Department of Justice or the Office of Special Counsel, as
applicable, for representation.You may also bypass the VETS
process and bring a civil action against an employer for violations of USERRA.
This guide is meant to provide basic benefit plan information. For additional details and specific
information, please contact the vendor or review the summary plan description (SPD) for each plan. SPDs are available
online at ithaca.edu/hr/securedocs or by contacting the employee benefits and work/life department at 607-274-8000 for a
printed version.
DISCLAIMER: The information in this guide is intended to provide you with an overview of our program; the full texts
of insurance contracts and of other plan documents are the controlling documents. Informational materials are available
upon request. Ithaca College reserves the right to terminate, suspend, withdraw, amend, or modify the plan in whole or in
part at any time. Further, Ithaca College reserves the right to terminate or modify coverage for any group of employees,
active or retired, and their dependents or a class of dependents at any time.
Human Resources
Fall 2014 | page 23
Human Resources
953 Danby Road • Ithaca, NY 14850
24 ithaca.edu/hr