Health and Other Benefits

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Email: wellpower@smu.edu
Email: benefitsu@smu.edu
Call: 214-768-3311

51�� offers a comprehensive benefits package to help protect you and your family. You need to take an active role in understanding and making thoughtful decisions about your benefits so you can be sure your choices support your needs and goals. To help you make informed benefits choices, 51�� provides a number of resources including the Human Resources website, the Benefits Guide, and links to our plan administrators' websites.

Click on the tabs above to access additional information.

To determine whether you, your spouse, or dependent children are eligible, please visit the Eligibility page linked to the right.

To see if you qualify for benefit changes due to a qualified life event, please visit the Life Events page linked to the right.

Important Health Plan Notices

The University is required by Federal law to make available to faculty and staff enrolled in the 51�� Health & Wellness Plan (i.e., the Medical Plan), certain notices related to the Plan. Below is a brief summary of the information provided in the Required Health Plan Notices.

Women's Health & Cancer Rights Act: Explains the coverage provided, as required by law, for mastectomies.
Newborn & Mother Protection Act: Explains the coverage provided, as required by law, for maternity hospital stays.
Medicare Part D Notice: Provides information about your current prescription drug coverage with 51�� and about your options under Medicare’s prescription drug coverage (in the event you are currently eligible for Medicare or are nearing eligibility for Medicare). If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, Federal law provides additional choices for prescription drug coverage.
COBRA Rights Notice: Contains important information about your right to COBRA continuation coverage including when COBRA may become available and what you need to do to protect the right to receive it.
Special Enrollment Rights Notice: Explains your right to enroll in the Plan under its “special enrollment provisions.”
Notice of Privacy Practices: Explains how the 51�� Health & Wellness Plan protects your personal medical information and outlines your legal rights.
Health Insurance Marketplace Notification: Provides important information about the Health Insurance Marketplace and what the Marketplace means to you.

Health Plans

Medical Plan

51��'s Health and Wellness Plan, administered by Blue Cross/Blue Shield of Texas, includes several deductible options. All of the plans cover a wide variety of medical services, including office visits, prescription drugs, and inpatient and outpatient care.

Prescription Drug Plan

This section provides information on 51��'s Prescription Drug Plan, administered by Prime Therapeutics. If participants enroll in one the 51��'s Health and Wellness Plan PPO options, prescription drug coverage is included. Participants have the choice of purchasing their prescriptions through local retail pharmacies or through a mail order program.

Creditable Prescription Drug Coverage

Dental Plan

Administered by Blue Cross/Blue Shield of Texas, the Dental Preferred Provider Organization gives participants the ability to visit any dentist, without referrals for all of your dental care. If participants select of BCBSTX's network dentists, they will generally pay less for their care. Should they choose a dentist outside of BCBSTX's PPO network, the share of costs will be higher and may need to file their own claims.

Vision Plan

This section provides information on 51��'s Vision Plan, administered by VSP. This plan offers access to a large network of participating optometrists and ophthalmologists plus a few select retain chains. Benefits include full examinations and access to lenses, frames, and contact lenses at discounted prices.

Caregiving Support Program

This section provides information on Cariloop, 51��'s caregiver support program. This plan offers access to on-demand licensed/certified Care Coaches to assist with caregiving questions and concerns via phone or video chat. Specifically, benefit includes navigating different levels of transition within healthcare, finding providers that accommodate adult or pediatric needs, understanding costs associated with care and etc.

Employee Assistance Program (EAP)

This section provides information on 51��'s Employee Assistance Program. Administered through Magellan Health Services, EAP is designed to provide confidential counseling and referral services for all full-time and part-time faculty/staff members and their eligible dependents. A licensed counselor is available 24-hours a day, 7-days a week.

Life Insurance, AD&D, LTD, Travel

Basic Group Life Insurance

This section provides information on 51��'s Basic Group Life Insurance. All regular full-time and part-time faculty and staff are eligible for coverage effective on the first day of active employment. This benefit is paid in full by 51��.

Supplemental Life Insurance

This section provides information on 51��'s Supplemental Life Insurance. Employees can purchase Supplemental Life Insurance for themselves, their spouse, and eligible dependent children. Premiums are deducted from the participant's paycheck on a pre-tax basis.

Accidental Death and Dismemberment Plan

This section provides information on how participants can purchase 51��'s Accidental Death and Dismemberment (AD&D) Insurance. Administered by Reliance Standard, the cost of AD&D insurance is paid through payroll deductions on an pre-tax basis. The benefit amount the participants receive varies according to the amount of coverage elected and the type of loss incurred.

Long-Term Disability (LTD)

This section provides information on 51��'s Long-Term Disability Plan. This benefit are available to all full-time and part-time regular faculty and staff after 3 months of employment, and the cost is paid entirely by 51��.

Travel Programs

This section provides information on 51��'s Business Travel Accident Insurance and The Standard's Travel Assistance Program for business and personal travel.

Spending Accounts

Flexible Spending Accounts

This section provides information on 51��'s Flexible Spending Accounts. A FSA enables participants to pay for out-of-pocket health care or dependent daycare expenses with pre-tax payroll contributions. FSAs are exempt from federal taxes, Social Security (FICA) taxes and, in most cases, state income taxes. Tax savings and the effect on each paycheck will depend on the participant's situation (e.g. household income, tax bracket, and the amount participants contribute to the account), but the tax savings can be significant!

Health Savings Account

This section provides information on 51��'s Health Savings Account. If you enroll in either the $3,200 or $5,000 High Deductible Health Plan (HDHP), you will be able to take advantage of a special tax-savings feature called a Health Savings Account (HSA). The HSA is a tax-free bank account used to help pay the cost of eligible out-of-pocket health care expenses.

The Standard Voluntary Benefits

Policy #750966
(800) 634-1743
standard.com

Critial Illness Insurance

Accident Insurance

Hospital Indemnity Insurance

LegalGUARD Plan

Administered by LegalEASE and underwritten by Nationwide
(888) 416-4313

The plan provides access to quality legal services and protection from the high cost of legal fees. Finding the right type of attorney when a need arises can be one of the more stressful tasks when dealing with a legal matter. LegalEASE uses their experience and relationships with their network attorneys to connect you with the right type of attorney, in the right location.

$17.90/month via 51�� payroll deduction

Covered family members include the employee’s spouse; unmarried dependent children, including stepchildren, legally adopted children, and foster children, up to age 19, and from age 19 up to 25 years if enrolled full-time in an accredited university; and parents of employee and spouse.

Covers attorney fees, up to plan limits, for:
- Home: Purchase, sale, refinancing, tenant dispute
- Family: Divorce, adoption, name change
- Consumer: Warranty, cell phone contract, bank fees, small claims court
- Estate Planning: Will, living will, power of attorney
- Financial: Debt, bankruptcy, foreclosure, tax audit
- Criminal: Serious traffic matters, misdemeanor defense

LegalGUARD Brochure

Allstate Identity Protection

Administered by Allstate
(800) 789-2720

The plan provides a comprehensive and proactive defense against identity theft, with a focus on identity monitoring. InfoArmor is capable of identifying anomalies indicative of fraudulent behavior up to 90 days sooner than credit monitoring.

Individual Plan: $8.45/month

Family Plan: $12.95/month (covers employee, spouse, and up to three dependents)

Comprehensive tri-bureau identity monitoring; fraud remediation and restoration; identity theft reimbursement

Allstate Identity Protection Brochure

If you have additional questions, please read the Allstate .

51�� offers a variety of leaves to support employees with their life needs.

Adoption Leave

The University will provide paid Adoption Leave to a benefit-eligible staff employee who adopts a child two years (24 months) of age or younger, and is the primary caretaker for the child. Primary caregivers are eligible for a total of three weeks (15 consecutive work days) of paid leave. Adoption Leave takes effect when it becomes necessary for an eligible staff member to be away from work as the result of the adoption.

Benefit-eligible staff, including benefit-eligible part-time staff, may request a paid Adoption Leave after one year of service to the University. During an approved Adoption Leave, a staff member will continue to receive usual wages and elected benefits. In addition, paid medical leave and vacation leave will continue to accrue while the staff member is on approved Adoption Leave.

Staff Educational Leave of Absence

The University recognizes that individual staff members may desire the opportunity to take time off from work without pay to pursue educational interests.

Staff Bereavement Leave

Benefits-eligible employees are entitled to up to three (3) days of paid bereavement leave in the event of the death of a family member. An employee who wishes to take time off due to the death of a family member should notify his or her supervisor as soon as possible.

A family member is defined as the employee's spouse, certified domestic partner, mother, father, stepparent, son, daughter, stepchild, brother, sister, in-laws, grandparent, grandchild, aunt, uncle, niece or nephew.

In a situation where additional time off is warranted and approved, an employee may take two additional days of accrued paid medical leave (sick days). If the employee’s sick days have been exhausted, the employee may use accrued vacation days. If the employee’s accrued vacation days have been exhausted, the employee may request unpaid leave not to exceed a total Bereavement Leave of five days.

In circumstances where concern exists regarding an employee’s attendance record, the Department of Human Resources may require verification of the memorial service or relation to the family member.

Civic Responsibility and Military Leave of Absence

An employee who has an obligation to perform military service will be granted a paid Military Leave of Absence for a period of up to 12 months. Paid Military leave will be converted to unpaid leave if the period of service extends beyond 12 months in duration. No employee or prospective employee will be subjected to any form of discrimination on the basis of that person's membership in or obligation to perform service for any of the Uniformed Services of the United States.

In the spirit of enabling an employee to fulfill his/her civic responsibility, the University will continue an employee's normal scheduled pay for a limited period of time if called for jury duty, subpoenaed to serve as a witness in a court case, or under other specified circumstances.

Extended Leave (Unpaid)

May be granted for a variety of reasons such as government service, a full time educational objective, medical leave if an illness extends beyond a staff member's accumulated medical and vacation leave allowances (including the disability portion of maternity). Upon return, staff member will resume the same position if still available, or another available position at a comparable salary if the staff member is qualified.

All leaves of absence must be approved in writing by

Department Head
Appropriate Vice-President
Human Resources Department

FMLA and Military Caregiver Leave

The Family and Medical Leave Act (FMLA) grants eligible employees the right to take 12 work weeks of job-protected leave over a calendar year for the reasons addressed below. FMLA leave does not eliminate or reduce other University leaves; however, certain leaves must run concurrently with FMLA Leave.

The Department of Labor has produced to provide additional information on FMLA leave.

Eligible employees who are family members of covered service members will be able to take up to 26 work weeks of leave in a "single 12-month period" to care for a covered service member with a serious illness or injury incurred in the line of duty on active duty. This 26 work week entitlement is a special provision that extends FMLA job-protected leave beyond the normal 12 weeks of FMLA leave. This provision also extends FMLA protection to additional family members (i.e., next of kin) beyond those who may take FMLA leave for other qualifying reasons.

Maternity Leave

Eligible staff may request a paid Maternity Leave after one (1) year of service. The staff member will receive her usual wages and benefits. Paid medical leave and vacation leave will continue to accrue while the staff member is on approved Maternity Leave. A total of eight (8) weeks of paid leave may be taken. A completed Staff Leave of Absence form with appropriate approvals is required.

Paid Medical Leave

Medical Leave may be used for:

Illness or injury of staff member, spouse, dependent children, or parents
Occupational injury
Death in immediate family

Unused days may be accumulated to a maximum of 90 work days. Under the Family and Medical Leave Act of 1993 you must use accrued time.

Part-time and partial year employees accrue prorated leave according to scheduled hours.

Qualifying Exigency Leave

The second new military leave entitlement helps families of members of the National Guard and Reserves manage their affairs while the member is on active duty in support of a contingency operation. This provision makes the normal 12 workweeks of FMLA job-protected leave available to eligible employees with a covered military member serving in the National Guard or Reserves to use for “any qualifying exigency” arising out of the fact that a covered military member is on active duty or called to active duty status in support of a contingency operation.

“Qualifying exigency” refers to a number of broad categories for which employees can use FMLA leave:

Short-notice deployment;
Military events and related activities;
Childcare and school activities;
Financial and legal arrangements;
Counseling;
Rest and recuperation;
Post-deployment activities; and
Additional activities not encompassed in the other categories, but agreed to by the employer and employee.

Tuition Benefits Program

The University offers the Tuition Benefits Program to regular full-time faculty and staff employee, their spouse, and their children. This valuable benefit helps expand the horizons of employees and their families through higher education.

Please take the time to review the Tuition Benefits page and the Frequently Asked Questions page.

Other Programs

Employee Assistance Program (EAP)

Paid Medical Absence

The University provides paid medical absence for benefits-eligible staff employees for medical care, personal illness or injury, the care of an ill member of the employee's immediate family, or the death of a member of the employee's immediate family.

Staff Vacation

The University provides paid vacation for benefits-eligible staff employees for rest and relaxation, personal business, or to extend leaves of absence. Vacation eligibility and accrual is based on the employee’s length of employment and other factors.

Floating Holiday

51��’s Floating Holiday is available to benefits eligible Staff and Post Doc employees who are actively employed at the start of each fiscal year (June 1).

COBRA

This section provides information on the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA). This allows for continued coverage for a certain period if an employee, spouse, or dependent child loses group Medical, Dental, or Vision coverage due to a qualifying life event.