Updated Fall, 2012

III.  GROUP BENEFITS

A.  Health Insurance Plans

The University provides two health plan options for Faculty. Premium payments under this plan are partially or totally made by the University with the understanding that increases in the premium are considered as part of the annual discussion concerning faculty compensation increases. The total contributions of all employees will be limited to 10% (or less) of the medical monthly dollar factor on an annual basis (the medical monthly dollar factor includes medical costs, prescription costs, and various administrative fees). Any changes to the employee contribution rates must be presented to the Faculty Senate for approval each year.

Major medical insurance generally provides coverage for the faculty member and his/her eligible dependents. Eligible dependents include the faculty member's spouse, domestic partner, and unmarried children to ages nineteen years, or twenty-three years if the child is a full-time student in an accredited college or university; except that these maximum age exclusions shall not apply with respect to an unmarried child who is mentally or physically incapable of earning his/her own living. Proof of incapacity must be furnished to the insurance company via University Human Resources thirty-one days prior to the handicapped child's nineteenth birthday (twenty-third birthday if a student).

When other contracts for medical benefits are in force, coordination of benefits is provided. Persons with dual hospitalization or medical insurance coverage will not be paid in excess of 100% of a total claim, and, if more than one insurance company is involved in a claim, the University's insurance company will determine primary responsibility according to state law.

Employees can choose between two major medical insurance plans; basic, and open choice PPO. Each plan includes major medical and hospitalization, utilization review, preventive care, prescription, hearing, mental health and substance abuse benefits. Vision Benefits, Dental Benefits, and Flexible Spending Accounts are described separately in the Group Benefits section.

1.  Basic Plan

This noncontributory indemnity plan design includes a $750 individual ($1,500 family) calendar year deductible. after the deductible is met, the plan pays 70% of eligible charges and the employee is responsible for the remaining 30% up to the employee out-of-pocket maximum of $2,500 for individual plans ($5,000 family). After the out-of-pocket limit is met, the plan begins paying 100% of eligible charges. The lifetime maximum for each covered person is $1,000,000.

1. Preventive Care coverage is available and paid at 70% by the plan. The deductible is not applied. See your plan book for a complete description of the preventive care procedures covered.

2. Prescription drugs are covered via a prescription card and a mail order option. The Prescription plan includes a formulary. A formulary is a list of preferred brand name drugs, which, if used, will be made available at a lower copay. The copay using a prescription card or the mail order program is $1 for generic, $15 for brand name formulary, and $25 for brand name non-formulary.

3. Hearing: Every 3 years the plan will pay $40 for an ontological exam and $200 for any combination of audiometric testing, hearing aid evaluation, and hearing aid(s).

4. Mental Health services are paid as follows: inpatient services require precertification, are subject to the deductible, and paid at 70%; outpatient services are limited to 25 visits per year, require precertification after 5 visits, are not subject to the deductible, with network providers paid at 100% for the first 5 visits and 75% for the next 20 visits, and with non-network providers paid at 80% for the first 5 visits and 50% for the next 20 visits.

5. Substance Abuse services are paid as follows: inpatient services require precertification, are subject to the deductible, and are paid at 70%, with a maximum of 1 confinement per lifetime; outpatient services are limited to 25 visits per year, require precertification after 5 visits, are not subject to the deductible, with network providers paid at 100% for the first 5 visits and 70% for the next 20 visits, and with non-network providers paid at 80% for the first 5 visits and 50% for the next 20 visits.

6. Other Features - See latest version of the Benefits Program Handbook.

2.  Open Choice PPO

This is a contributory preferred provider plan. Schedules of rates will be available from the Benefits Office during each annual enrollment period.

The Open Choice PPO plan has two levels of benefits. One when a network provider is used (in-network) and the other when a provider who is not in the network is used (out-of-network). A summary of some of the benefit breakdowns is outlined below. For more information, consult your plan booklet or contact the Benefits Office.

	In-Network Benefits	Out-of-Network Benefits
Deductible	$0	$400/$800 (Ind/Family)
Max. Out-of-Pocket	$500/$1,000 (Ind/Family)	$1,500/$3,000 (Ind/Family)

After the deductible, the percent paid by the plan depends on the type of service rendered.

The out-of-pocket maximum does not include copays for office visits, copays for prescriptions, services for out-patient mental health/substance abuse, or employee contributions. After the out-of-pocket limit is met, the plan begins paying 100% of eligible charges. The lifetime maximum for each covered person is $2,000,000.

	In-Network Benefits	Out-of-Network Benefits
Office Visits	no deduct. $15 co-pay	deduct. applied, 70% paid
Outpatient Services	no deduct. 90% paid (effective 1/1/01)	deduct. applied, 70% paid
Surgery	no deduct. 90% paid	deduct. applied, 70% paid
Hospital services (precertification)	no deduct. 90% paid	deduct. applied, 70% paid
Lifetime Maximum	$2,000,000	$2,000,000

For more claim categories (accidents, transplants, physical therapy, occupational therapy, home health care, etc.) please consult your plan book.

1. Preventive Care coverage is available with a $15.00 co-pay for each office visit and coverage at 100% for procedures pursuant to those office visits for in-network and 70% for out-of-network. The deductible is not applied. See your plan book for a complete description of the preventive care procedures covered.

2. Prescription drugs are covered via a prescription card and a mail order option. The Prescription plan includes a formulary. A formulary is a list of preferred brand name drugs, which if used will be made available at a lower copay. The copay using a prescription card or the mail order program is $1 for generic, $15 for brand name formulary, and $25 for brand name non-formulary.

3. Hearing: Every 4 years the plan will pay $40 for an ontological exam and $600 for any combination of audiometric testing, hearing aid evaluation, and hearing aid(s).

4. Mental Health services are paid as follows: inpatient services require precertification, in-network services are not subject to the deductible and are paid at 90%, out-of-network services are subject to the deductible and paid at 70%, outpatient services are limited to 50 visits per year, require precertification after 5 visits, are not subject to the deductible, with in-network providers paid at 100% for the first 5 visits and 70% for the next 45 visits, and with out-of-network providers paid at 80% for the first 5 visits and 50% for the next 45 visits.

5. Substance Abuse services are paid as follows: inpatient services require precertification, in-network services are not subject to the deductible and are paid at 90%, out-of-network services are subject to the deductible and paid at 70%, with a maximum of 2 confinements per lifetime for both in-network and out-of-network services; outpatient services are limited to 50 visits per year, require precertification after 5 visits, and are not subject to the deductible, in-network providers paid at 100% for the first 5 visits and 70% for the next 45 visits, and with out-of-network providers paid at 80% for the first 5 visits and 50% for the next 45 visits.

6. Other Features - See latest version of the Benefits Program Handbook.

B.  Precertification

Ohio University follows Medical Mutual’s standard predetermination and precertification requirements for both inpatient and outpatient procedures. Some procedures may require authorization prior to services being rendered. Call customer service or check with your provider to determine whether your procedure requires pre-authorization. All inpatient hospital admissions require precertification.

C.  Life Insurance

1. Basic Life Insurance, paid by the University, under this policy provides protection of two and one-half times the base salary. The maximum amount of the basic life insurance benefit is $50,000.

2. Supplemental Life Insurance for faculty, spouses, and dependent children is available on a contributory basis. Information is available from the Benefits Office.

D.  Dental Insurance

1. Employee Dental Insurance is provided, and paid by the University. There is a $25 calendar year deductible. After the deductible is met, the plan pays 80% of eligible charges until the plan has paid $750 per calendar year.

2. Family Dental/Orthodontia Options are available on a contributory basis. Employees can purchase orthodontia coverage for themselves, dental insurance for their family members, or dental and orthodontia insurance for their family members.

   The family dental plan would provide the same coverage as the employee dental plan for each member of the employee's family. The orthodontia plan pays 50% of the first $2,000 in orthodontia expenses per covered person per lifetime.

E.  Vision Insurance

Vision insurance, paid for by the University, is provided for the faculty member and eligible dependents. The plan pays $25 for an exam every 12 months and pays for one of the following every 24 months for adults and children age 19 and older and every 12 months for children: single vision lenses - $45; bifocals - $55; trifocals - $75; contact lens - $45; medically necessary contact lens - $150.

F.  Flexible Spending Account

Eligible faculty may participate in medical and/or dependent care spending accounts. Faculty members wishing to participate in either or both of these plans must enroll during the sign-up period designated by University Human Resources. These accounts allow participants to pay for certain medical and dependent care expenses using tax-sheltered dollars. The accounts are described as follows:

1. Medical Spending Account; the maximum amount that an employee can place in this account is $3000 per calendar year.

2. Dependent Day Care; the maximum amount that an employee can place in this account is $5000 per calendar year.

G.  Major Medical and Life Insurance for Early Retirees

1. Beginning at retirement and continuing to age 70, the University shall provide life insurance under the University's group policy for faculty. The University shall provide the insurance for the total amount that the faculty member would receive with full-time employment.

2. The State Teachers Retirement System provides medical insurance for the retiree at no cost and for spouse and eligible dependents at a low cost (See Policy and Procedure Manual, No. 41.102).

H.  Travel Accident Insurance

The University maintains a travel insurance policy covering loss of life and permanent total disability involving a maximum principal sum of $100,000. It applies to faculty members while traveling outside of the city of employment for official University business or en route to University-approved professional activities, such as conventions and meetings. To minimize possible difficulty in claim processing, the traveling faculty member should ensure that his/her trip is authorized in writing by his/her department head.

I.  Sick Leave Policy - Retirement Benefit

State law entitles retirees to claim up to thirty days of unused sick leave as a retirement benefit. (See Policy and Procedure Manual, No. 40.029.)

J.  Disability Insurance

The University has purchased disability insurance to cover those faculty members who do not qualify for full benefits under the State Teachers Retirement System. Further information concerning this policy is available from University Human Resources.

K.  Ohio University Employees Credit Union

The Credit Union is a full service financial organization that operates for the benefit of all employees of Ohio University, and their immediate families. A variety of savings instruments, in addition to loans, credit and debit cards, checking accounts, direct deposits, and payroll deductions are available.

L.  Retirement

Ohio University offers two retirement plans for Group I Faculty and Group II Faculty with an annual FTE greater than or equal to .67 - the Alternative Retirement Plan (ARP) and the State Teachers Retirement System (STRS). Eligible Faculty have 90 days from the date of employment to select a retirement plan. Eligibility, enrollment guidelines, employee contributions and employer contributions are determined by Ohio state law.

Group II faculty with less than .67 FTE and Group IV faculty are automatically enrolled in the State Teachers Retirement System.

The Alternative Retirement Plan (ARP) is a defined contribution plan. In this type of plan, the faculty member and the university contribute a set percentage of pay to a personal account. The faculty member decides how to invest those contributions among a variety of investment choices. The retirement benefit is determined by the amount of the account balance and the payment option chosen.

The State Teachers Retirement System (STRS) is a defined benefit plan. With this type of plan the faculty member and the university contribute a set percentage of pay to STRS. Contributions made by the faculty member remain in a personal account. Contributions made by the university go into a general fund for all plan participants. The retirement benefit is determined by a mathematical formula that uses age, years of service credit, and final average salary (highest three years of earnings while contributing to STRS) at the time of retirement.

When a faculty member ceases to teach in a state-assisted institution, a refund of the employee's portion of retirement contributions may be refunded to the member upon request; alternatively, a member may leave his/her account on deposit and at age 60 begin receiving a retirement benefit, if his/her Ohio service, or the equivalent, totals five or more years. Faculty members with out-of-state teaching or military service often are able to purchase credit years to be added to the Ohio system in computing retirement benefits.

More detailed information can be obtained by contacting University Human Resources.

M.  Tax Deferred Annuities

Ohio University makes available on a voluntary basis for Group I, II, and IV faculty, and contract employees, a Tax-Deferred Annuity Program. Tax-Deferred Annuities were created by Federal law to allow employees of non-profit organizations to invest monies with certain tax advantages.

Basically, the law allows all contributions to be excludable from current taxable income, thereby providing additional funds that may be invested in this program. Additionally, the earnings on the annuity are not taxable in the year earned. This law does stipulate, however, that money from an annuity is taxed as current income when received.

As the program pertains to employees of Ohio University, it should be noted that it is supplementary to existing state operated retirement systems. The University does not make any contribution toward purchase of the annuities. The reduction in salary does not affect the amount calculated for retirement contributions under the existing state systems.

Additional information and a list of the companies that have been authorized by Ohio University to market their various plans to eligible employees may be obtained by contacting University Human Resources.

N.  Twelve-Month Pay Option

Faculty members may elect to receive their nine-month academic-year contract salaries in twelve equal monthly payments. Those having academic contracts for the full nine months and those on leave are eligible for this option. Part-time faculty in Group I and II, as well as graduate students on salary contracts, are eligible also.

Those who elect this plan will receive one-twelfth of the amount of their regular nine-month contract (adjusted for leave where appropriate) on the first day of each month commencing each October 1 and ending on September 1. In the event they receive a contract for summer session(s), they will receive their summer session check(s) on the last day of classes of the session(s). These will be in addition to the checks received for July, August, and September under the nine-month contract. A form for electing this option and further details regarding scheduled deductions are available in University Human Resources.

O.  Policy Regarding Retirement-System Contribution For Those on Leave

Ohio University provides the University retirement contribution for faculty and staff members while on leave providing:

1. the faculty or staff member is willing and able to contribute his/her normal retirement contribution for the period of leave;

2. that all other avenues of funding the retirement payments through grants or contracts to the University have been exhausted;

3. that the appropriate executive officer deems the leave to be of future benefit to the University and that the appropriate executive officer gives in writing advance approval for said payment prior to the commencement of the leave;

4. the leave has been approved by the State Teachers Retirement System (which usually follows Ohio University approval). (See Policy and Procedure Manual, No. 41.105).

P.  Educational Benefits For Faculty Children

Children of currently employed faculty in Groups I, II, and IV, children of administrative staff, and children of retired or deceased persons whose last employer was Ohio University are entitled to scholarships for undergraduate and graduate tuition charges at Ohio University. For full-time employees the scholarships are equivalent to 100 percent of the instructional fee. For Group II faculty with an FTE of 0.67 or greater (averaged over the academic year rounded to two decimal places) as of the 15th day of classes Fall semester, the scholarships are equivalent to 100 percent of the instructional fee. Benefits for other part-time faculty and administrative staff are prorated. No part of the general fee is covered by this benefit.

These educational benefits are available each academic semester. The rank or tenure of a faculty parent or the high school standing of a faculty child have no bearing on eligibility, except that the student must meet admission requirements. A similar benefit is extended to faculty children who wish to take University courses while still in high school. The criteria for continuation of this benefit are maintenance of good academic standing and continuing eligibility of the parent. Applications are made through University Human Resources. (See Policy and Procedure Manual, No. 40.016.)

Q.  Educational Benefits For Eligible Contract Employees and Their Spouses

Educational benefits are available for Group I, II, and IV faculty, other contract employees and their spouses or domestic partners of same sex or opposite sex. For full-time employees, the benefit is 100 percent of the instructional fee. For Group II faculty with an FTE of 0.67 or greater (averaged over the academic year rounded to two decimal places) as of the 15th day of classes Fall Semester, the scholarships are equivalent to 100 percent of the instructional fee. Benefits for other part-time employees are prorated. No part of the general fee is covered by this benefit.

Eligible contract employees may take one course per semester during regular working hours and an additional course during non-working hours. Spouses or domestic partners of eligible contract employees may take as many courses as academically permissible.

Retirees, spouses or domestic partners of employees who retired while on full-time status, spouses or domestic partners of employees who have been placed on disability termination, and widowed persons whose spouses or domestic partners died while on full-time status shall retain educational benefits. (See Policy and Procedure Manual, No. 40.016.

R.  Early Retirement Policy

General:  A tenured faculty member eligible for retirement under the STRS and wishing to continue to teach part-time may elect to do so under the early retirement policy. Those faculty enrolled in the Alternative Retirement Plan (ARP) will be eligible for the University’s Early Retirement program if they meet the same eligibility requirements as those enrolled in STRS. Faculty enrolled in the ARP are not eligible for those benefits that STRS employees receive from STRS. In this event, an Early Retirement Agreement is signed by the faculty member, department head, dean, and Provost. Such a faculty member will change status from Group I to Group I (retired). The Early Retirement Agreement remains in effect as long as the faculty member wishes to continue part-time teaching and has not reached 70 years of age by August 1 of the upcoming year.

1. Teaching: During early retirement, the faculty member will be permitted to teach a third of an annual teaching load. The distribution of those courses will be determined by the faculty member in discussion with his/her academic department head and after consideration of the needs of the department. For colleges that include summer session as a normal part of a faculty member’s annual contract, the faculty member may, after consulting with his/her department head, choose to fulfill his/her obligation during summer.

2. Compensation: The standard arrangement will be that the faculty member teaches the equivalent of one-third of the specified departmental teaching load for a third of the annual base salary. What constitutes one-third equivalency should be flexible enough for a department to support curricular innovations. The salary amount will be determined according to the following pattern: initially, to determine the salary for the year after retirement, the faculty member’s base salary preceding retirement will be used. Faculty on 10, 11, or 12 month contracts will have their salaries prorated to nine month contracts. In following years, the salary will be adjusted by the average percentage increase afforded the Group I faculty as a whole. An adjustment based upon a similar procedure will be made annually. Any special financial arrangements for a faculty member teaching under this policy must be approved by the Provost.

3. Early retired faculty will have their teaching reviewed annually in accordance with departmental procedures.

4. Insurance: Beginning at retirement and continuing to age 70, the University provides life insurance under the University's group policy for faculty. Medical insurance is provided by STRS. (See Section III.G.) Faculty members enrolled in ARP are not currently provided medical insurance. (See http://www.ohio.edu/hr/benefits/retirement/index.cfm for information.)

5. Special Arrangements: During any academic term when the faculty member is on duty, appropriate office space, parking privileges, use of facilities and similar perquisites will be afforded the faculty member teaching under this policy. During the periods when the faculty member is not on duty, the perquisites as described under Emeritus Status (Section V.F) will be accorded the faculty member.

Updated Fall, 2012