Changes for Fiscal Plan Year 2010 - July 1, 2009 through June 30, 2010
It is each member’s responsibility to know their plan benefits in order to make an informed decision regarding coverage elections. See page 4 of the Benefits Choice Options Booklet or page 9 Handbook for a list of your responsibilities.
Health Plan Changes: Health plan contributions increased to $6 per month for employee and $6 per month for each dependent up to two. For HMO plans, office visit for specialist increased to $20 co-payment. For Quality Care Health Plan (QCHP) Co-insurance for out of network physician reduced from 80% to 70%. Out-of-pocket maximums increased to $1200 per individual and to $300 per family. Hospital bill audit program limit on savings eliminated.
Prescription Drugs (HMO's and QCHP): - Annual deductible of $50 per individual per plan year. Co-payments for preferred brand increased by $2 and non-preferred brand $4.
Quality Care Dental Plan (QCDP): - Deductible for non-preventive and non-diagnostic increased to $125 per individual per plan year. Contributions increased by $1 per individual per month.
Benefits Choice Website address: http://www.benefitschoice.il.gov
The following information provides a brief synopsis of benefits and services provided by the Illinois Department of Central Management Services and Governors State University. Employees must review the benefits choice booklet for complete details or contact the Benefits Unit in the Department of Human Resources at GSU prior to making benefit decisions.
Group Insurance
Through the State of Illinois' Group Insurance Program, full-time employees are offered health, and dental insurance coverage; with premiums being deducted before taxes (pre-tax). Vision care and life insurance benefits are also offered. Part-time status employees may purchase the same coverage through the State by paying a proportionate share of the State's cost, based on the percentage of their employment. The same level of coverage is also available for eligible dependents and may be purchased at group rates. To view a copy of the State of Illinois Benefits Handbook, click here.
Health Insurance
The State offers a traditional indemnity plan, which provides a comprehensive range of benefits. Under this health plan, enrollees may:
- Choose any physician for primary care or specialty needs;
- Choose any hospital for general medical services;
- Change physicians or hospitals as desired; and
- Receive enhanced benefits by using a Preferred Provider hospital or doctor after a plan participant meets his/her annual deductible. The annual plan deductible is based on annual salaries as of the first of each April preceding the beginning of the next plan year. This deductible requirement applies to all services unless otherwise noted in the Plan summary document. After the plan deductible has been met, the plan pays its portion of the cost of services or supplies, with the remaining portion (coinsurance) of the cost to be paid by the participant. The participant's portion will most often be a small percentage (coinsurance) on most bills. More information is available at http://provider.healthcare.cigna.com/soi.html.
Cigna Claim Form (PDF)
CIGNA HealthCare PPO Provider Directory
Health Maintenance Organization(s)
As an alternative health plan, the State offers several HMOs from which to choose. HMOs are managed care plans that provide prepaid comprehensive benefits. Coverage levels and co-payments vary among the different HMOs. You must choose a primary care doctor from those participating in the HMO provider network. This doctor becomes your primary care physician (PCP). All routine medical care, hospitalization, and referrals for specialized medical care must be coordinated under the direction of your primary care physician (PCP).
Flexible Spending Accounts
Employee can enroll in Medical Care Assistance Plan (MCAP) only during period January 1, 2009 through Jun 30, 2009. Note: Everyone enrolled in either the Medical Care or Dependant Care Assistant Plans must re-enroll every year to continue to participate every new fiscal year.
The Illinois Department of Central Management Services (CMS) offers the Flexible Spending Accounts Program comprised of the Medical Care Assistance Plan (MCAP) and the Dependent Care Assistance Plan (DCAP). These plans allow state employees to pay for out-of-pocket medical expenses and/or work-related dependent care expenses through the plan year with tax-free dollars. During any given fiscal year, July through June, the program allows, before tax deductions, up to $5,000 ($416.66 per month; $208.33 per pay period)to be set aside for one or both plans for a combined maximum of $10,000 (special limitations may apply). Contact Human Resources for a pamphlet which outlines this program.
Flexible Spending Reimbursement Form and Instructions
Dental Insurance
Eligible employees are offered coverage under the Quality Care Dental Plan (QCDP), which allows enrollees to go to any dentist for treatment and receive a broad range of coverage. Non-preventative services are subject to an annual plan deductible. Preventative and diagnostic services such as cleanings, sealants, and x-rays are not subject to the deductible.
This dental plan reimburses a predetermined or "scheduled amount" Dental Schedule for each covered service. Enrollees are responsible for any amount over the scheduled benefit amount.
Vision Care Benefits
All members and dependents covered by any of the health plans offered by the State Employees' Group Insurance Program are eligible for vision coverage. This benefit is designed to assist with the cost of vision services; to encourage regular eye examinations and to help with vision care expenses when glasses or contact lenses are required. Benefits are available for the following services with the appropriate co-payment:
- Eye Examinations (once every 12 months)
- Spectacle Lenses (once every 24 months)
- Frames (once every 24 months)
- Contact Lenses
- Medically Necessary
- Elective
More information can be found at: Vision Care Benefits Eyemed
If an out-of-network provider is chosen, the member must pay the provider in full. The member can then file for reimbursement by submitting the paid receipts to the plan's administrator.
Out of Network Vision Claim Form
Life Insurance
Group term life insurance coverage is available through the State Employees Group Insurance Program. This coverage is provided automatically by the State at no cost to employees who are working at least 50% time. Each eligible active, non-retired employee is insured for an amount equal to his/her annual base salary.
Employees may purchase optional insurance up to eight (8) times his/her annual base salary (or 4 times without medical underwriting) at the low group term rates. Immediate annuitants may purchase up to four (4) times. Life insurance can be purchased for an eligible spouse and/or children. All premiums for any optional insurance are at the member's expense and deducted from his/her pay after taxes.
Retirement
State Universities Retirement Plan
The State Universities Retirement System of Illinois(SURS) provides retirement, disability, death, and survivors' benefits to eligible SURS participants. Contributions of 8% (9.5% for police officers) are mandatory and are deducted from the employee's paycheck before taxes. The State also provides corresponding contributions, with a five-year vesting requirement for its funds. SURS members must choose from one of the following retirement options:
Traditional Plan
This SURS Defined Benefit retirement plan is designed to provide lifetime retirement benefits with a survivor benefit for the member's eligible spouse at no additional cost. The separation lump sum refund feature does not include any of the State's contributions regardless of the employee's years of service.
Portable Plan
This Defined Benefit retirement plan also provides for a lifetime retirement annuity or a lump sum distribution. This package, however, provides a more generous separation refund when you terminate your employment, but the provisions for survivor benefits require a reduction to the employee's retirement benefit.
Self-Managed Plan
This Defined Contribution plan establishes an account in your name into which you and your employer's contributions are placed; you decide how your account balance will be invested, selecting from a variety of mutual funds and variable annuities. You also decide how your account will be distributed to you at retirement.
When Governors State University notifies SURS that you are a new SURS member, you will receive a choice packet, including an Election form, to help make this one-time, irrevocable election within the first six months of your employment. Because of the importance of this decision, you are advised to carefully review all the materials available to determine which plan best fits your needs. If you fail to make a timely election; SURS will place you in the Traditional Plan automatically after six months.
Voluntary Supplemental Retirement Plans
Governors State University offers voluntary supplemental tax-deferred retirement savings programs under Sections 403(b), 403(b) (7), and 457 of the Internal Revenue Code. Under the Code, employees of certain organizations, including public universities, can enter into salary reduction agreements with their employers. Participation in a tax deferred retirement plan is voluntary. Each employee, who joins any of the current plans made available by GSU, is responsible for making decisions regarding the possible benefits or tax consequences of the options available under the plan.
Tax-Sheltered Annuities 403(b) Plans
Under the agreement, a portion of the employee's compensation (selected by the employee and within the limitations imposed by the Internal Revenue Code) is withheld on a before-tax basis and applied to an investment holding owned by the employee. Under Section 403(b) (7), these contributions can be invested for retirement purposes in custodial accounts holding mutual funds shares. These amounts, together with any investment earnings, are not subject to federal income tax until they are paid to the employee (or beneficiary).
Each employee is responsible for selecting a carrier from one of the available insurance companies, investment companies, accumulation accounts, custodial accounts, and contracts. The following are the Board of Trustees-approved tax shelter annuity companies under 403(b) and 403(b) 7:
Deferred Compensation 457 Plan
The State of Illinois Deferred Compensation Plan, under Internal Revenue Code, Section 457, is also offered by Governors State University on a tax deferred retirement savings option. Each employee is responsible for his/her decisions regarding the type of investment and distribution of it.
For more information, contact your Human Resources benefit representative.
Other
Workers' Compensation
All work related injuries must be reported to Human Resources Benefits Unit. To register a claim with the State of Illinois, we ask that you contact the State of Illinois Case Manager, CareSys, at 1-800-773-3221.
The State self-insures Workers' Compensation benefits to cover employees who sustain job-related injuries or diseases. The amount of the benefit is limited by law. Please note, not all accidents are ruled compensable by the state.
Workers' Compensation Procedures - Forms
Family Medical Leave Act
In accordance with the Family and Medical Leave Act of 1993, eligible employees may be granted up to twelve weeks of paid or unpaid leave per year under particular circumstances that are critical to the life of a family. Leave may be taken for the employee's own serious health condition that makes the employee unable to perform the essential functions of his/her position; or for the birth of the employee's child, or placement of a child with the employee for adoption or foster care; or to care for a family member (child, spouse, or parent) who has a serious health condition.
To be eligible for leave under this act, an employee must have been employed for at least twelve months, and must have worked at least 1250 hours during the twelve month period preceding the commencement of the leave. If you and your spouse are employed by Governors State University, you will be limited to a combined leave of up to twelve weeks in a twelve-month period for the birth, adoption, or placement of a child for foster care, or to care for a sick child, spouse, or parent.
The Family and Medical Leave Act has been amended in January 2009 to provide for leave of a covered service member who is seriously ill or injured in the line of duty or active duty. Family and Medical Leave can be requested due to a qualifying exigency of a covered service member who is on active duty or being called to active duty in support of a continuing operation.
Long-Term Disability (LTD)
Group Voluntary Long-Term Disability Insurance protects your income against the sudden loss that an accident or illness can bring. If you are unable to work, LTD benefits help replace a portion of your salary. Who's eligible? Active, employees with an appointment of 50% or more, for at least eight (8) months.
Employee Assistance Program
When your life is in balance it just feels right. When it's not, call the Employee Assistance Program (EAP)for confidential help with work, family or personal concerns. Call toll-free 24 hours a day, seven days a week. The EAP is a free benefit offered to you by the State of Illinois to help you get the most out of life. The EAP is available to you and your eligible dependents covered under the State Employees Group Insurance Act. For EAP services, call 1-866-659-3848 (TTY 1-800-526-0844) or use the web at http://www.MagellanHealth.com/ and use the toll-free number to register for services.
College Savings Plan - "Bright Start"
Employees may elect to make after-tax contributions to the State of Illinois College Savings Plan under "Bright Start" through payroll deductions, beginning August 1, 2007. This program will enable the employee to begin saving for a college education for his/her self or an eligible family member. Under current law, these contributions (up to certain limitations) can be deducted from the employee's State of Illinois taxable income. Investment results accumulate tax-free unless the money is not used for a college education. Money can be rolled over from one family member to another. More information is available at http://brightstart.com/529-plan.html.
Long Term Care Insurance
Long Term Care Insurance is the protection of your assets against the draining experience of receiving long term care in a nursing home. Coverage is being offered through MetLife Insurance Company on a direct pay basis with the. For more information regarding this coverage, please contract MetLife @ 1-800-438-6388.
Last reviewed 04/28//2009
Contact Human Resources if you have questions about this information.
