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APSCUF Benefits
This brochure highlights the Pennsylvania State
System of Higher Education Health Program, Health
and Welfare Fund, Annuitant Health Care Program, and
leave entitlements for State System faculty members
covered by the Association of Pennsylvania State
College and University Faculties (APSCUF) collective
bargaining agreement. The benefits described are
available to most faculty; however, certain
eligibility requirements must be met.
This
brochure is provided for general purposes only.
Legal Plan Documents will govern any discrepancies
that may arise. For additional information
concerning these benefits, contact your human
resource office. Questions on health and welfare
fund benefits should be addressed to the Faculty
Health and Welfare Fund. Benefits, benefit levels,
and eligibility rules are subject to change.
Basic Health Care
and Health and Welfare Fund Benefits
Coverage
If faculty members
reside in a Health Maintenance Organization (HMO)
service area, may choose between Basic, Preferred
Provider Organization (PPO), or HMO Plan coverage;
entitled to Health and Welfare Benefits regardless
of selection of basic health care plan.
Basic Plan
Pennsylvania Blue Shield facility and provider
charges are paid at 100% of the usual, customary and
reasonable charges. Participating providers must
accept payment as payment in full.
Non-participating providers may balance bill.
ClassicBlue Inpatient Facility Services
·
365 days
·
Semi-private
room
·
60 days/12-month
period for mental and nervous disorders
·
Substance abuse
rehabilitation (30 days/year)
ClassicBlue Outpatient Facility Services
·
Emergency
accident and medical
·
Surgery
·
Diagnostic
studies
·
Home care (60
visits/90 day period)
·
Mental illness
·
Substance abuse
rehabilitation (30 visits/year)
ClassicBlue Medical/Surgical Services
·
Surgery
·
Diagnostic
testing
·
Treatment of
mental illness (up to $25/visit)
·
Limited
preventive services and immunizations
ClassicBlueMajor Medical
-
$500
individual/$1,500 family deductible annually
-
80% employer
coinsurance on first $2,000, 100% thereafter up
to $1,075,000 lifetime maximum for general
medical and mental expenses
-
$50 outpatient
mental visit allowance payable at 50% ($25)
Preferred
Provider Organization (PPO) Plan
Most covered services
paid in full if care provided by in-network
physician with no annual deductible or co-insurance;
care not provided by in-network physician is paid at
80% after a $250 individual/$500 family annual
deductible.
Inpatient Facility
Services
·
365 days
·
30 days per
calendar year for mental and nervous disorders
·
30 days per
calendar year for substance abuse rehabilitation
Outpatient Facility
Services
·
Emergency
accident and medical ($50 copayment unless admitted)
·
Home health care
(60 visits/year)
·
Mental health or
substance abuse rehabilitation ($15 copayment – 60
visits per calendar year)
Medical/Surgical
Services
·
Diagnostic
studies
·
Surgery
·
Treatment of
mental illness ($15 copayment)
·
Office visits
($15 copayment)
Preventive Services and
Immunizations
·
Well-baby care,
including testing and childhood immunizations
·
Adult routine
physical examination, including testing
·
Specific
vaccinations
Health
Maintenance Organization (HMO) Plan
Most covered services paid in full if care is
coordinated by primary care physician; care not
coordinated by primary care physician is not
covered.
·
Inpatient
facility services
·
Outpatient
facility services
·
Medical/surgical
services
·
Preventive
services and immunizations
·
Office visits
·
Copayments for
certain services may vary
·
Benefits may
vary by HMO
Prescription Drug Plan
·
$100
individual/$300 family deductible annually
·
Retail
dispensing up to a 30-day supply
·
$5 for generic
drugs
·
$10 for brand
name formulary
·
$20 for brand
name non-formulary
·
Mail service
pharmacy dispensing up to a 90-day supply at twice
the retail copayment ($10, $20, or $40)
·
If brand drug
that has a generic equivalent is dispensed, employee
responsible for brand drug copayment plus difference
in cost between generic and brand drug unless
physician requests brand drug be dispensed (“No
Substitution”)
Health and
Welfare Fund Benefits Program
·
Dental Plan
·
Vision Plan
·
Hearing Aid Plan
·
Wellness
Examination Plan
·
Mammography
Examination Plan
·
Educational
Leave Health Benefits Continuation Plan
Eligibility/Contribution for Active Employees
Basic
Plan/PPO Plan/HMO Plan
Effective
1/1/05
-
Permanent full-time
employees contribute 10% of premiums
for medical and prescription plan on a pre-tax
basis
-
Permanent part-time
employees who work at least 50% time, contribute
50% of premium in addition to the 10%
contribution rate for medical and prescription
plan on a pre-tax basis (Part-time employees are
not eligible for the HMO Plan)
-
Contributions will be based
on selected plan and contract size (single,
two-party or family)
Effective 7/1/05 and after
-
Full-time and part-time employees in the Basic Plan
(indemnity) contribute as outlined above plus
any increase in annual premiums over 12%
Health and Welfare Fund
Benefits Program
Annuitant
Health Care Program
-
For annuitants
retired 7/1/-5 and later
• Annuitants under age 65 - ClassicBule/Major
Medical Coverage ($500 deductible) with
prescription drug card, PPO coverage with
prescription drug card, or HMO coverage with
prescription drug card
•
Annuitant pays same
dollar amount as he/she paid as an active
employee until he/she reaches age 65 - if
annuitant, subsequent to retirement, changes
plans or adds or deletes dependents, the dollar
amount of contribution will change to conform to
the dollar amount of contribution for the most
comparable plan and size of contract that was in
effect on the date the annuitant retired
•
Annuitants age 65 and over - signature-65 and
Major Medical coverage ($500 deductible to
supplement Medicare Part A and B and
prescription drug discount card
• Annuitant pays same flat
percentage amount of Signature-65 premiums paid
by active employees who are enrolled in the PPO
Plan (currently 10%)
-
Annuitant
benefits continue to include coverage for
dependen
-
State System pays
$5 toward cost of coverage for annuitants not
qualifying under eligibility
Eligibility
·
For employees
hired prior to July 1, 1997, when covered employees
retire
·
at age 60 with
at least 10 years of credited service (may include
purchased service)
·
at any age with
at least 25 years of credited service (may include
purchased service)
·
on approved
disability with at least 5 years of credited service
(may include purchased service)
·
For employees
hired July 1, 1997 to June 30, 2004, when covered
employees retire
·
at age 60 with
at least 15 years of Commonwealth/State System
service only
·
at any age with
at least 25 years of Commonwealth/State System
service only
·
on approved
disability with at least 5 years of
Commonwealth/State System service only
·
For employees
hired on or after July 1, 2004, when covered
employees retire
·
at age 60 with
at least 20 years of Commonwealth/State System
service only
·
at any age with
at least 25 years of Commonwealth/State System
service only
·
on approved
disability with at least 5 years of
Commonwealth/State System service only
Flexible Spending
Accounts
Reduces
the amount of taxes paid by designating a portion of
salary to an account for eventual reimbursement of
certain medical and dependent care expenses.
Account balances not used by year’s end are
forfeited.
Medical Reimbursement Account
·
Maximum annual
contribution is $3,500
·
Eligible
expenses for reimbursement include Major Medical
deductibles and amounts in excess of plan allowances
or maximums, prescription drug co-payments, PPO, and
HMO doctor office visit charges, lasik eye surgery,
chiropractic services, most over-the-counter
medications and supplies, etc.
Dependent Care Reimbursement
·
Maximum annual
contribution is $5,000 ($2,500 if you are married
and filing a separate income tax return)
·
Dependent care
must be necessary so that you, and if you are
married, your spouse can work or look for work
·
Eligible
expenses for reimbursement include child care
centers that care for six or more children and that
meet the IRS definition of a qualified day care
center, caregivers for a disabled spouse or
dependent who lives with you, babysitters, nursery
schools, household expenses provided that a portion
of these expenses are incurred to ensure a
dependent’s well-being and protection
Eligibility/Contribution
·
Permanent
full-time faculty members and temporary full-time
faculty members who are employed for one academic
year and their dependents
·
Permanent
part-time faculty members and dependents, if faculty
member works at least 50% time
·
100%
employee-paid
Premium Conversion Plan
Allows
employees to pay health care contributions on
pre-tax basis, resulting in higher take-home pay
Eligibility/Contribution
·
All employees
enrolled in a health care plan and contributing
toward the cost of that plan
Group Life Insurance
Coverage
·
Term life
insurance equal to nearest $1,000 of annual salary
·
Minimum coverage
$2,500; maximum coverage $50,000
·
$20,000
additional work-related accidental death
·
Three-month
waiting period
·
Right to convert
upon termination/retirement
Eligibility/Contribution
·
State System
pays 100% for permanent faculty members
·
Dependents
ineligible
Voluntary Group Life
and Personal Accident Insurance
Coverage
·
Employee term
life and personal accident insurance in increments
of $10,000; maximum coverage $500,000
·
Spouse term life
and personal accident insurance in increments of
$10,000; maximum coverage $100,000
·
Children term
life and personal accident insurance in amounts of
$5,000 or $10,000
Eligibility/Contribution
·
Permanent
full-time faculty members and temporary full-time
faculty members who are employed for one academic
year and their dependents
·
Permanent
part-time faculty members and dependents, if faculty
member works at least 50% time
·
100%
employee-paid
Voluntary Long-Term
Disability Insurance
Coverage
·
Income
protection equal up to 60% of gross annual base
salary
·
Amount offset by
retirement benefits, workers’ compensation, social
security, and paid leave with a guarantee of 10% of
long-term disability benefit amount or $100/month,
whichever is greater
·
Employee may
elect either a 90-day or 180-day
elimination period
·
Cost of living
adjustments
Eligibility/Contribution
·
Permanent
full-time faculty members and temporary full-time
faculty members who are employed for one academic
year
·
Permanent
part-time faculty members working at least 50% time
·
100%
employee-paid
Annual, Sick, and
Personal Leaves
Annual
Leave
·
12-month
administrative faculty members earn leave based on
service as follows:
Less than 12 months of
service 10
days/yr.
12 months to 180 months
of service 15
days/yr.
181 months to 299
months of service 20
days/yr.
300 months of service
or more 25
days/yr.
·
Unused leave may
be carried from one year to the next
·
45 days maximum
accumulation
·
Payment for
unused leave at termination/retirement
·
9-month faculty
members ineligible for leave
Sick Leave (Includes
Bereavement and Sick Family Leave)
·
Permanent
faculty members accrue 15 days leave for each
academic year of service
·
Permanent
part-time faculty members accrue leave on a
pro-rated basis
·
Temporary
faculty members appointed full-time for one academic
year accrue and may use 15 days leave during the
academic year
·
Temporary
faculty members appointed full-time for one academic
semester accrue and may use 7.5 days leave during
the semester
·
Use limited to
90 days per calendar year
·
Unused leave may
be carried from one year to the next
·
Unlimited
accumulation
·
Faculty members
may be absent for up to 3 days for death of
immediate family and no leave will be charged;
faculty members may use up to an additional 2 days
of sick leave for this purpose
·
5 days of leave
may be used for sickness in immediate family
·
Faculty members
with 315 accumulated sick days must contribute 1 day
annually to sick leave bank
·
Payment in
accordance with the following schedule for
accumulated leave at retirement or death if certain
eligibility is met:
Days Accumulated
Maximum Days Paid
0 –
74
10
75 –
149
20
150 –
224
30
225 –
299
40
over
300
50
·
Maximum 50 days
of leave paid to survivor for work-related death
Personal
Leave
·
12-month faculty
members earn 5 days per calendar year
·
9-month faculty
members earn 2 days per calendar year
Holidays
·
12-month
administrative faculty earn 10 paid holidays per
year
·
Observation of
holidays may vary by university
Retirement
·
State Employees’
Retirement System (SERS)
·
6.25% employee
contribution to SERS
·
Public School
Employees’ Retirement System (PSERS)
·
7.5% employee
contribution to PSERS
·
Alternative
Retirement Plan (ARP)
·
5.0% employee
contribution to ARP
·
Participating
ARP companies
·
AIG VALIC
·
ING
·
Met-Life
·
TIAA-CREF
·
Employee may
participate in one or more of the ARP companies at
one time
-
Employer
contribution and benefits vary by plan (view the
Retirement Comparison Chart by visiting
the state System's website at
www.passhe.edu
keywords "Benefits, "Retirement Plans")
-
Selection
of retirement plan must be made within 30 days
of date of hire; if no choice is made, employee
will automatically default to SERS
-
Other Benefits
·
Civil Leave With
Pay
·
Educational
Leave With or Without Pay
·
Family Care
Leave Without Pay
·
Military Leave
With or Without Pay
·
Parental Leave
Without Pay
·
Sabbatical Leave
With Pay
·
Work-Related
Disability Leave
·
Deferred
Compensation/Tax Deferral of Leave Payouts
·
Direct Deposit
of Pay
·
PA State
Employees Credit Union (1-800-435-6500)
·
Savings Bonds
Through Payroll Deduction
·
State Employee
Assistance Program (1-800-692-7459)
·
Social Security
·
Tax-Sheltered
Annuities
·
Tuition Waiver
• Employee (total waiver at any State
System university)
•
Spouse (total waiver at university where
employed to first undergraduate degree)
•
Children (total waiver at university where
employed to first undergraduate degree or until
they reach age 25; 50% waiver at State System
universities other than university where faculty
member is employed)
•
The above provisions may be altered if the
tuition waiver policy of individual university
is greater than those listed
·
Unemployment
Compensation
·
Workers’
Compensation
Revised 7/12/06
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