Currently the IRS says that if an employee receives employer-paid benefits for anyone who is not the employee’s tax dependent, the value of the coverage is “imputed income” and is taxable.  The additional coverage for your same-sex domestic partner and/or your partner’s children becomes a taxable benefit, unlike medical coverage for other enrolled family members.  Imputed income is separate from, and in addition to, your payroll deduction.  The amount of your imputed income depends on the plan(s) you choose and the level of your coverage.  Imputed income is taxable.  It increases your taxable gross income as well as your FICA (Social Security and Medicare) taxes withheld from your paycheck.  Imputed income is reported on your annual W-2 that you file with the IRS each year.

A health care spending account permits employees to set aside money on a pre-tax basis to pay for qualified uninsured health-related expenses.  By setting aside the money on a pre-tax basis you are reducing your taxable income and the taxes you would pay on that money.  The funds cannot be used to pay for insurance premiums.  The maximum contribution is $5,000 per calendar year.  The funds can be used to pay for medical and dental plan deductibles and co-payments, certain uninsured medical expenses, and other eligible expenses such as contact lenses or eyeglasses for you or your family.  Health care spending accounts can also reimburse expenses for nonprescription or over-the-counter medications and other items such as Claritin, Tylenol, Motrin, band-aids, antacids, and cough medications.  Expenses that are not covered include items that are beneficial to your general health such as vitamins and herbal supplements.

Reimbursement for health care expenses is based on when you had the service (incurred the expense), not on when you paid the bill.  Per IRS regulations, all expenses must be incurred before the end of the calendar year and submitted no later than three months after.

Under IRS regulations, a married employee with a working spouse or a single parent may allocate up to $5,000 in pre-tax dollars to a dependent care account.  Expenses payable through the account are those incurred in order to permit the individual (and if married, the spouse) to work, rather than caring for their dependent full-time.

Dependents who qualify include children up to age 13 and any other dependent (such as a disabled spouse or elderly parent) who is physically or mentally incapable of self-support and who is claimed as a dependent on the employee’s federal tax return.  Reimbursable expenses include care provided inside or outside the home, day care centers that meet state licensing requirements, and preschool tuition.

No. Since your monthly cost is already being deducted from your pay on a pre-tax basis, you do not need to enroll in the Pre-tax Parking Program.

Both life insurance and personal accident insurance protect your family’s financial security in the event of death.  However, there are some basic differences between the plans.  Both pay a benefit if you die; however personal accident only pays if the cause of death was accidental.  Personal accident also pays benefits when an accident results in the loss of a limb or sight.

Long-term care is the type of care received either at home or in a facility when someone needs assistance with the activities of daily living (bathing, dressing, toileting, transferring, continence, or eating).

You can buy policies that will cover yourself, your spouse, parents, grandparents or siblings.  Depending on the type of coverage and when purchased, a completed medical questionnaire may be required.

Drexel does. Drexel adds an amount equal to the cost of Long Term Disability to your regular base pay, and then a corresponding amount for this premium is deducted from your pay.

According to John Hancock, this decision was prompted by the historically low interest rate environment that is expected to continue for an extended period of time.

No.  The decision to cease new enrollments applies to all applicants.

No.  The enrollment application must be postmarked by December 31, 2011, but underwriting activities may take place in early 2012.

No.  The enrollment application must be postmarked by December 31, 2011, but underwriting activities may take place in early 2012.

No.  John Hancock will continue to service all current insureds and any current or future claims will not be affected by this action.  John Hancock continues to be highly rated by the five rating agencies and ratings are a comprehensive measure of the financial strength of an insurance company.

Please call your John Hancock customer service line at 1-800-200-3334.

No. Participation in a Drexel medical plan is voluntary.  However, you must provide proof of other coverage before you decline coverage in Drexel’s medical plans.  Full-time faculty and professional staff who do not enroll and fail to provide proof of other coverage will be defaulted into single coverage under the POS and prescription drug plan with the appropriate payroll deductions. Faculty and professional staff who decline medical and prescription drug coverage and provide the required proof of other coverage will receive a waiver bonus of $100 per month.

In order to receive the highest level of coverage, POS plans require the use of specific plan providers and require the election of a primary care physician (PCP).  This physician serves as the “gatekeeper” for medical services, meaning that you need to consult with your PCP prior to receiving services from most specialist physicians or other providers.  In addition, a POS permits you to seek care outside the network and see an in-network specialist without having to see your PCP, but at a lower level of coverage.

A PPO is a group of hospitals and physicians under contract to an insurance company.  Health care providers in the PPO provide care to members for negotiated fees and co-payments.

When you see a provider who is not part of the POS or PPO network, you are responsible for a greater portion of the cost of your care, and you may also be subject to deductibles and coinsurance.  In addition, you might be subject to “reasonable and customary” limits, which means that you might be responsible for any amount the provider charges above the insurance company’s payment.

A pre-existing condition is an illness for which treatment has been rendered within 12 months preceding the date of enrollment into an insurance plan.  The university’s medical plans do not have a pre-existing conditions clause.

There are several ways in which you might incur medical or dental expenses, some of which can be avoided. Below are definitions of common benefits terms as well as explanations of how they might impact your expenses.

• Deductible: The dollar amount you must pay each year before your medical and/or dental plan begin to pay benefits for certain covered expenses.
• Coinsurance: After you meet the deductible (if applicable), your health plan pays a specified percentage of the charges for covered services. You pay the remaining expenses, and this is called co-insurance. For example, if the plan pays for 90 percent of a covered expense, the other 10 percent, for which you are responsible, is the coinsurance.
• UCR or R&C: Refers to the “Usual, Customary and Reasonable” or “Reasonable and Customary” fees, which physicians, health care facilities, or other health care providers in the same geographic area charge for similar services. Plans that pay 100 percent of UCR or R&C pay 100 percent of the usual, customary, and reasonable fees for that service. If providers have an affiliation with the plan, they are obligated to accept the plan’s UCR or R&C as payment in full. If providers are not affiliated with the plan, they are not obligated to accept the UCR or R&C and you may have to pay charges in excess of the payment made by the plan even if the plan usually covers the service at 100 percent.
• Co-payment or Co-pay: A flat per-service charge that you pay for services such as doctor's visits or prescriptions.
• Out-of-pocket Maximum: The most you have to pay out of your own pocket during the plan year in co-insurance after you meet your deductible, as long as your providers accept your plan's UCR or R&C. Once you reach this limit, the plan pays 100 percent of UCR or R&C.
• Lifetime Maximum: The greatest amount payable by the plan in a subscriber's lifetime.
• Benefit Maximum: The greatest amount payable by the plan for a specific covered service.
• Prior Authorization: Before receiving certain medical procedures or prescription drugs, insurance companies require that you obtain prior authorization or you may be responsible for full payment. Consult your plan’s summary plan description or call the carrier for details.
• Pre-certification: A program that requires a medical review before hospital admissions and surgical procedures are approved. If a procedure requires pre-certification and you do not obtain it, you may be responsible for full payment. Consult your plan’s summary plan description or call the carrier for details.

Medical, prescription drug, dental, vision, and health and dependent care spending account contributions are made on a pre-tax basis.  This reduces your taxable income, therefore reducing the taxes you owe.  However, this also means that once selected, you generally cannot change your coverage until the next open enrollment period.  The exception to this rule is if you have a qualified life event.  Appropriate qualified events include:

• Marriage or divorce
• Death of a spouse, same-sex domestic partner, or dependent child
• Birth or adoption of a child
• Spouse’s termination of employment or new job
• Change of employment status from full-time to part-time or vice versa
• Taking an unpaid leave of absence
• Returning to work after a leave of absence
• Open enrollment of spouse’s plans

See the Qualified Life Event page for more information.

After you have completed your benefits enrollment you can expect to receive insurance cards for plans you enrolled in, a medical spending account MasterCard if enrolled in the medical spending FSA, and a notice of your COBRA rights. Please note you will not receive a dental card from MetLife.

If you are enrolling for the upcoming plan year during open enrollment, your benefit elections go into effect on January 1. If you are newly hired or newly eligible, your benefit elections go into effect the first of the month following your date of hire.

Your benefits will end on the last day of the month you are employed. Once your benefits end, you will receive information on COBRA directly from the Benefits Service Center. COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1986. It's a law that permits you and your eligible dependents to continue your health care coverage for a specific period of time after your employment ends. To continue coverage through COBRA, you are required to pay 102 percent of the actual cost of coverage. Please call the Benefits Service Center at 888-971-0101 with COBRA questions.

A conversion option is available for Basic Life and Long-Term Disability insurance upon termination. Supplemental voluntary life insurance is portable.  Upon termination you may continue this coverage by paying the premiums directly to the insurance company.

Please see the University Policy HR-48, Termination of Employment:

• Drexel Termination of Employment Policy
• DUCOM Termination of Employment Policy