Personnel Manual: 7.0 Benefits

The University makes available to all full-time employees, effective the first of the month following their date of hire, numerous elective benefits. The University’s benefits for medical, dental and vision are offered under Section 125 cafeteria programs. Employees are able to make choices annually (June 1) at the time of open enrollment or due to a qualifying life event during the plan year. Employees should contact the Office of Human Resources for qualifying event eligibility.

The St. Mary’s Benefits Committee assists in reviewing various benefits, including plan design, and makes recommendations to the Director of Human Resources and the Vice President for Administration and Finance regarding the benefits and plans that best meet the needs of University employees. Several instructional meetings are offered prior to the annual open enrollment period, which ordinarily takes place on, or before June 1.

Medical Insurance

The University offers a choice of plans for employee selection. The University and employees share the cost of these plans. The employee’s share of the premiums is deducted from his/her paycheck before taxes as a participant in the Flexible Benefits Cafeteria Plan. Full-time employees and part-time employees who work a minimum of 30 hours per week, having met the specified waiting period for the benefit, are eligible to participate in the health plans. Employees who are 65 years of age or older may select a plan offered by the University as their primary health insurance or they may choose Medicare.

Dental Insurance

The University offers a choice between two types of dental insurance coverage for the employee and the employee’s family: (1) Dental Maintenance Organization (DMO); or (2) traditional insurance. The employee pays the full premium for coverage selected, and premiums are deducted from pay before taxes, provided the employee participates in the Flexible Cafeteria Benefits Plan.

Disability Insurance

The University provides Disability Insurance for all full-time employees that pays up to two years at 60 percent of base salary. Employees may have the option to purchase additional coverage at their own expense.

Short-term Disability

It is the University’s policy to work closely with full-time employees and their families when disability situations occur. A short-term disability means any condition, whether physical or mental (including conditions resulting from pregnancy and childbirth), which disables the employee from performing the duties assigned in the position by the University or which imposes a risk of infection to other employees. The determination that a short-term disability exists shall be made by the University’s short-term disability carrier, taking into consideration the essential job functions of the position and the employee’s condition.

If approved through the University’s short-term disability carrier, and the employee has successfully completed three months of their introductory period, the employee will be paid for up to 90 calendar days at their full rate of pay. After 90 days of short-term coverage, the employee may be eligible for long-term disability benefits. Employees shall not be paid or otherwise credited for unused short-term disability leave.

The Short-term Disability program may be used while an employee is out on Family and Medical Leave or Non-qualifying Medical Leave.

Life Insurance and Accidental Death and Dismemberment Insurance (Life/AD&D)

The University offers Basic Life/AD&D coverage to all eligible employees, and the University pays 50 percent of the premium.

Employees may purchase one to four times their salary up to $500,000, and spouse coverage up to 50 percent of the employee’s amount for additional voluntary life coverage. The maximum benefit for spouses is $50,000. Without providing proof of good health, the maximum that can be purchased is $100,000 for the employee and $20,000 for the spouse. Employees must be enrolled in basic life to participate in additional coverage. Spouse premiums are based on the employee’s age, not the spouse’s age. Children may be covered up to $500 from age 15 days to six months, and $10,000 for age six months to 25 years.

Voluntary AD&D for employee, spouse, and dependent coverage is available after purchase of Basic AD&D. Minimum coverage is $25,000 and maximum is 10 times the employee’s annual salary.

Retirement

An eligible employee may enter the University retirement plan after completion of one year of service in which the employee has worked at least 1,000 hours. The amount of the matching contribution, if any will be determined each Plan Year and announced to eligible participants.

Employees who have previous full-time, benefits-eligible service with another institution(s) of higher education may be issued credit for completed years of service with the previous institution(s) to waive waiting periods for employer contributions for retirement.

Please refer to the annual Benefits Guide for further details.

Flex Plan

The University offers a cafeteria plan called the Flex Plan. Full-time employees may join the Flex Plan having met the specified waiting period for the benefit. This plan provides a way for employees to take advantage of the special tax benefits made available by current government regulations. Through the Flex Plan, the employee may set aside a portion of his/her pay in a health care or dependent care account to pay medical and dental insurance premiums, dependent care coverage, and other medically related items. If the employee participates in setting up the health and dependent care accounts, the amount the employee sets aside is not included in his/her income for purposes of determining social security and federal taxes. Full information on the Flex Plan is available in the Office of Human Resources.

Liability Insurance

St. Mary’s maintains liability risk coverage for officers and employees in the performance of their duties. Information on this policy, if needed, is available in the Office of the Vice President for Administration and Finance.

Employee Assistance Program

The Employee Assistance Program (EAP) is administered through the Office of Human Resources. Brochures identifying the program coordinator and detailing the services provided are available for employees in the Office of Human Resources.

Employee Education/Tuition Benefits

Dependent Education/Tuition Benefits

Dining Services

Full dining privileges are available to employees in the cafeteria located in the University Center. Employees are eligible to purchase a meal card from the Business Office or pay on a cash basis per meal.

Identification Cards

Employees are issued Identification Cards in the University Center upon presentation of an authorization form, which may be obtained in the Office of Human Resources. This card is necessary for checking out books in the library and for other University activities, such as attendance at on-campus athletic events, and use of recreational facilities. Identification Cards must be returned when employment ends.

Parking

Parking privileges are extended to all employees, except student employees, without charge. Employees are required to observe all University parking and traffic regulations.

Recreational Facilities

University employees may use the Alumni Athletics & Convocation Center’s fitness facilities at no cost. Family members can use the facilities for a reduced annual rate. Arrangements can be made through the Student Development Office.

Workers’ Compensation

Workers’ Compensation insurance is provided for all employees. Medical expenses incurred because of a covered injury and a portion of salary loss are payable through this insurance. Employees are expected to be safety conscious and must report any unsafe conditions to the supervisor. An employee who is injured on the job must report the injury immediately to the supervisor. Every injured employee is encouraged to seek medical attention. A “First Report of Injury” must be completed by the supervisor and filed with the Office of Human Resources immediately or not later than 72 hours after the accident has occurred.

If the employee is absent from work as a result of a work related injury, he/she may be eligible for payments under the Texas Workers’ Compensation Act. The employee will not be paid by the University for periods when the employee is entitled to receive workers’ compensation benefits. An employee must submit a clearance from the treating physician before returning to work following an absence due to a work-related injury.

Unemployment Compensation

St. Mary’s subscribes to the Texas Unemployment Compensation Act. Information about the benefit is available from the Office of Human Resources.

Continuation Health Coverage (COBRA)

Under the federal law, Consolidated Omnibus Budget Reconciliation Act (COBRA), employees and their dependents have the right to temporarily extend coverage under the University’s Group Health Plan in certain circumstances when the coverage would otherwise have been terminated as the result of a “Qualifying Event.” Employees and their dependents that are covered under the University’s Group Health Plan on the day before a Qualifying Event have the right to elect to continue the level of health coverage in effect under the Group Health Plan if such health coverage would otherwise terminate by reason of Qualifying Event. Employees and their dependents do not have to show that they are insurable to choose this continuation coverage. This notice is intended to inform the employee, in summary, of his/her rights and obligation under the continuation coverage provisions of the law. (Both the employee and the employee’s dependents should take the time to read this notice carefully.)

An employee of the University covered by the Group Health Plan has the right to choose this continuation coverage if the employee loses his/her group health coverage due to retirement or other termination of employment (except for gross misconduct), or reduction of work hours.

The spouse of an employee covered by the Group Health Plan has the right to choose continuation coverage for himself/herself if the spouse loses group health coverage under the Group Health Plan for any of the following four reasons: (1) death of spouse; (2) termination of spouse’s employment (for reasons other than gross misconduct) or reduction in spouse’s hours of employment; (3) divorce or legal separation from spouse; or (4) spouse becomes entitled to Medicare.

In the case of a dependent child of an employee covered by the Group Health Plan, he or she has the right to continuation coverage if group health coverage under the Group Health Plan is lost for any of the following: (1) death of a parent; (2) termination of parent’s employment (for reasons other than gross misconduct) or reduction in a parent’s hours of employment with St. Mary’s University; (3) parent’s divorce or legal separation; (4) parent becomes entitled to Medicare; or (5) dependent child ceases to be a “dependent child” under Group Health Plan.

Notification Responsibilities: Under the law, the employee or a family member has the responsibility to inform the University’s Plan Administrator (Director of Human Resources) of a divorce, legal separation, or a child losing dependent status under the University’s Group Health Plan within 60 days of the date of the event. If the employee or his/her dependents do not notify the University within this time period, they may lose their rights to continuation coverage. The University has the responsibility to notify the Plan Administrator of the employee’s death, termination, reduction in hours of employment or Medicare entitlement. Similar rights may apply to certain retirees, spouses, and dependent children if the University commences a bankruptcy proceeding and these individuals lose coverage.

Election Period: When the Plan Administrator is notified that one of the aforementioned events has happened, the Plan Administrator will in turn notify the employee or family member that they have the right to choose continuation coverage. Under the law, the employee or family member has 60 days from the date he/she would lose coverage because of one of the events described above, or the date the notice of the employee’s election rights is sent to him/her, whichever is later, to inform the Plan Administrator that the employee or family member wants continuation coverage. To elect continuation coverage, the employee and/or his/her dependents must notify the Plan Administrator in writing within the election period. If continuation coverage is not so elected, coverage under the University’s Group Health Plan will cease.

Premium Requirements: In order to receive continuation coverage, the employee and/or his/her dependents must pay the required premium. The required premium may be paid in monthly installments. The first premium payment for the initial period of continuation coverage is payable no later than 45 days after the day on which the election of continuation coverage is first made. If the employee and/or his/her dependents elect continuation coverage, they will be informed when the subsequent premium payments are due. Once the employee and/or his/her dependents have elected continuation coverage, they have a 30-day grace period in which to pay subsequent premiums.

Maximum Period of Continuation: Depending on the Qualifying Event, health benefits may be continued for the following maximum periods:

• 18 months upon retirement, termination of employment, or reduction of hours
• 36 months upon death of an employee, divorce or legal separation, Medicare entitlement, or ineligible dependent

The 18 months may be extended to 29 months if an individual is determined to be disabled at the time of termination (for Social Security disability purposes) and the Plan Administrator is notified of that determination within 60 days of the determination and before the end of the original 18-month period. The affected individual must also notify the Plan Administrator within 30 days of any final determination that the individual is no longer disabled. St. Mary’s is permitted to charge 150 percent of the applicable premium for the additional 11 months of coverage provided to disabled beneficiaries.

Second Qualifying Event: If a second Qualifying Event occurs within the first 18 months of continuation coverage (or within the first 29 months of continuation coverage for disabled persons as described above), coverage will be continued for 36 months from the date of the second Qualifying Event.

Continued Medical Child Support: Court orders issued under state domestic relations laws, Qualified Medical Child Support Orders, are intended to ensure children will have coverage under employer-provided plans of their parents.

Termination of Continuation Coverage: The law provides that continuation coverage may be terminated for any of the following reasons:

• The University no longer provides group health coverage to any of its employees;
• The premium for continuation coverage is not paid on time;
• The employee and/or his/her covered dependents becomes covered by another group plan, unless the plan contains exclusions or limitations with respect to a pre-existing condition of the employee or his/her covered dependents;
• The employee becomes entitled to Medicare; or
• The employee extends coverage for up to 29 months due to a disability and there has been a final determination that the employee is no longer disabled.

This law applies to the University’s Group Health Plan beginning annually on June 1. If the employee has any questions about this law, please contact the Plan Administrator (Director of Human Resources). If the employee has changed addresses, please notify the Office of Human Resources