HR Policy and Procedure #94 Health Care Plan Credit Revised
Purpose
The University assists employees with a full-time equivalent (FTE) of 0.75 or greater, or who work more than 30 hours per week over a 12 month period, and who are enrolled in the health care plan by crediting an amount toward the health care plan’s premium. This amount is referred to as the health care plan credit (credit).
Policy
1. Certain retirees and surviving spouses of eligible retirees are eligible for the credit. Employees who have been approved for long term disability (LTD) benefits are eligible for the credit for a limited time period.
a. Eligible retirees will receive an amount determined by the date of retirement eligibility or hire date.
b. A surviving spouse or sponsored dependent of a retiree may receive the credit if the following conditions are met:
1. The retiree was eligible for the credit; and
2. The retiree and spouse or sponsored dependent were enrolled in a health plan at the time of the retiree’s death. The surviving spouse/sponsored dependent credit is equal to 50% of the single coverage tier health plan credit, which is applied toward a plan. Surviving spouses and sponsored dependents will become ineligible for the health credit if they remarry. However, they will continue to remain eligible for coverage on the plan.
c. Employees who have been approved for long term disability are eligible to receive the same health credit as regular full-time employees for up to 29 months or the attainment of Medicare parts A & B, whichever occurs first.
2. The employee is responsible for paying the difference between the credit and the cost of the plan selected.
3. Pooling of credits is permissible where both the husband and wife are regular employees with a FTE of 0.75 or greater of the University and both wish to apply their credits toward family coverage. FAQs about FTE and the 0.75 rule can be found here.
4. An employee receiving the credit shall not continue to receive the credit during any month the employee is on leave without pay, with the following exceptions:
a. An employee who
1. Is on an approved Family Medical Leave of Absence,
2. Is on an approved temporary disability leave,
3. Is on an approved Sabbatical Leave,
4. Is receiving temporary total disability (TTD) payments through workers' compensation, or
5. Has an application for benefits under the University's Long Term Disability Plan pending an initial decision.
An eligible employee on leave without pay for part of a month shall receive the credit for that month, if the employee receives a paycheck that month.
Eligible coverage will be determined based on status and the last full premium paid. Generally, employees working part of a month who separate from the university, will have coverage through the last day of that month. Employees should contact the Human Resources Office of Employee Benefits to determine final dates of coverage and deductions necessary for that coverage.
5. An employee who was hired prior to July 1, 1997, and is eligible to retire under the provisions of AR 3:1 as of July 1, 2007, will receive a health credit equal to 90% of the cost of the base health plan single coverage premium for pre-65 (non Medicare eligible) coverage. Employees who are eligible for Medicare will receive a health credit equal to 90% of the Medicare health benefit plan premium or up to the amount which produces a retiree monthly premium of $25, whichever is greater as long as the retiree’s enrollment in a University health plan is continuous and provided the employee
a. Has a minimum of 15 years of regular full time employment, or its equivalent; and
b. Is enrolled in a University health care plan at the time of retirement.
6. An employee who was hired prior to July 1, 1997, and is not eligible to retire under the provisions of AR3:1 as of July 1, 2007, will receive a health credit based on his or her age and service at the time of retirement until age 65 or Medicare eligibility. See attachment A for the percentage of premium employees who retire before age 65 or Medicare eligibility will be responsible for. Upon reaching age 65 or Medicare eligibility, the employee will receive a health credit equal to 90% of the Medicare health benefit plan premium or up to the amount which produces a retiree monthly premium of $25, whichever is greater as long as the retiree’s enrollment in a University health plan is continuous and provided the employee
a. Has a minimum of 15 years of regular full time employment, or its equivalent; and
b. Is enrolled in a University health care plan at the time of retirement.
7. An employee who was hired on or after July 1, 1997, but before January 1, 2006, and is not eligible to retire under the provisions of AR 3:1 as of July 1, 2007, will receive a health credit based on his or her age and service at the time of retirement until age 65 or Medicare eligibility. See attachment A for the percentage of premium employees who retire before age 65 or Medicare eligibility will be responsible for. Upon reaching age 65 or Medicare eligibility, the employee will receive a health credit equal to 90% of the Medicare health benefit plan premium or up to the amount which produces a retiree monthly premium of $25, whichever is greater as long as the retiree’s enrollment in a University health plan is continuous and provided the employee
a. Has a minimum of 15 years of continuous service immediately prior to retirement, and
b. Is enrolled in a University health care plan at the time of retirement.
8. An employee who was hired on or after January 1, 2006, and retires under the provisions of AR 3:1, is not eligible for the health credit. However, the employee is allowed to participate in a University health care plan on an “access only” basis as long as the retiree’s enrollment in a University health care plan is continuous and provided the employee
a. Has a minimum of 15 years of continuous service immediately prior to retirement, and
b. Is enrolled in a University health care plan at the time of retirement.
Note: Retired individuals eligible for University supplemental retirement benefit calculations (referred to as the “old unfunded plan”) are eligible for the credit regardless of their years of service.
9. An employee approved for benefits under the LTD program is eligible to receive the credit for up to 29 months or the attainment of Medicare Parts A & B, whichever occurs first, provided the person
a. Was enrolled in a University health care plan at the onset of disability; and
b. After approval for LTD benefits, remains continuously enrolled in a University health care plan.
10. A regular employee with a FTE of 0.75 or greater who was receiving the credit prior to going on workers' compensation is eligible to receive the credit while on workers' compensation.
Process
The Human Resources Office of Employee Benefits is responsible for the administration of this policy.
Attachment A