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Employee Handbook - Insurance plans
Payroll deduction and insurance enrollment
The University offers employees many types of insurance. All of these plans will be described to you at Orientation, when you will receive enrollment and informational materials.
Please note:
Payroll deduction is used for most employee insurance premium payments.
Employees must enroll within the first thirty-one (31) days of employment for long-term disability and group life insurance. Employees who wish to enroll in these plans after their first 31 days of employment will need to apply for such coverage and will be subject to medical underwriting and the eligibility requirements of the applicable insurance carrier. In this case, coverage is not guaranteed and the carrier retains the right to approve or decline the application.
Employees must enroll within the first thirty-one (31) days of employment for health insurance. Employees who wish to enroll in health insurance after their first thirty-one (31) days of employment will be able to do so during the next open enrollment period (see "Open Enrollment"). Under certain circumstances, employees may be able to enroll in health coverage at other times under HIPAA provisions (see "Health Insurance—HIPAA").
Health insurance
Regular employees may enroll in the University's Preferred Provider Organization (PPO) plan. During orientation, employees are given details of the coverage.
Cost
WMU pays a portion of the cost for employees' coverage in the PPO Plan. The University also pays a portion of the cost for enrolled employees' dependents.
Dependents
In general, your current spouse, your children, and stepchildren whom you claim as dependents for federal income tax purposes are eligible dependents. Children can normally be covered until age 19 or while attending college full-time until age 26. Please refer to plan provisions for more detail.
Adding and removing dependents
You can add your eligible dependents to your coverage when you enroll. After initial enrollment, you can add newly eligible dependents within 31 days of a qualifying event, such as your marriage or the birth or adoption of a child. Eligible dependents not added to your coverage within 31 days of a qualifying event can be added to your coverage at the next Open Enrollment. You can remove dependents from your health insurance plan at any time. Please contact Human Resources for details and forms.
Open enrollment
An Open Enrollment period is established yearly (usually sometime during the Fall semester). During Open Enrollment, employees may add eligible dependents, whom they have previously opted not to cover, to their health insurance plan.
HIPAA
he Health Insurance Portability and Accountability Act (HIPAA) contains provisions that allow employees/dependents who declined WMU health insurance coverage because they had other coverage to enroll in a WMU health insurance plan within 31 days if the other coverage is terminated under certain conditions. Also, employees who separate from the University will be able to obtain a certificate proving they had health insurance coverage. Future employers may need this certificate to administer the employee's new coverage.
HIPAA also establishes certain privacy rights regarding employees' personal health information. Detailed information is contained in the HIPAA Notice of Privacy Practices, located in the Human Resources Policies and Procedures Manual. The HIPAA Notice of Privacy Practices and related regulations and policies are also available at Human Resources.
See "Medical Reimbursement Flexible Spending Account"
This optional plan allows you to pay for certain expenses not covered under your health insurance using tax-free dollars.
COBRA - Health insurance continuation
Under provisions of the federal Consolidated Omnibus Budget Reconciliation Act (COBRA), insured employees, and the insured dependents of active or retired employees, may apply to continue University group health insurance coverage if they lose normal eligibility for any of these reasons:
- Employee termination.
- Reduction in work hours.
- Divorce or legal separation from the insured employee.
- Cessation of eligibility as a "dependent child" or any situation which results in the loss of benefits eligibility.
The maximum period for continuation depends upon the qualifying event. During the extension period, the insured is required to pay the full cost of the insurance, plus an administration fee. Questions about COBRA should be directed to Human Resources.
Life insurance
The University provides employees a certain amount of group term life insurance, for which the University pays the entire cost. Additional optional life insurance is also available, as shown on the table below.
Life Insurance Plan |
Exempt (Salaried) Employees |
Nonexempt (Hourly-paid) Employees |
| BASIC LIFE provided at no cost to employee. |
$100,000 | $25,000 |
| ADDITIONAL 1 LIFE for which the employee pays 25% of premiums. •Optional |
Not available | $10,000 |
| ADDITIONAL 1 LIFE for which the employee pays 50% of premiums. • Optional |
$50,000 to $5,000, depending on age. • Death benefit decreases as age increases. |
Not available |
| SPOUSE LIFE for which employee pays 100% of premium. • Optional; only available if employee enrolled in Additional 1 Life. |
•Choice of $10,000 increments up to $250,000. |
|
| CHILD LIFE for which the employee pays 100% of premium. • Optional; only available if employee enrolled in Additional 1 Life |
•Choice of $2,000 increments up to $10,000. |
|
| ADDITIONAL 2 LIFE for which the employee pays 100% of premiums. •Optional, but only available if Additional 1 Life has been selected. |
•Employee may select coverage amount, at either one or two times the employee's
base annual wages. |
|
Cost
Your share of premiums is indicated on the above table. The University will continue making its share of premium payments for the selected coverage as long as you are on active pay or approved paid leave status. If you are on an unpaid leave of absence, please contact Human Resources for information.
Taxes
Group life insurance valued at $50,000 or more may create a tax liability. Contact Human Resources for more information.
Beneficiaries
You designate the beneficiary for each policy, and may change your beneficiary at any time by contacting Human Resources.
Retirement
If you retire from the University, a reduced amount of life insurance may be provided to you at no cost, according to the retirement provisions in effect at the time of your retirement.
Converting group life insurance to an individual policy
Upon separation from the University, you do have the option to keep your life insurance policies by converting the policies to individual policies and paying the premiums yourself. If you do not convert the insurance to an individual policy, coverage will cease. The University will not continue to provide life insurance coverage for employees not on the active payroll.
Long-term disability insurance (optional)
The University offers you the opportunity to enroll in a Long-Term Disability Insurance plan. This plan pays qualified disabled employees 66-2/3% of their base annual wages, should they become disabled while their plan is in force. Benefits are payable on the later of (a) the thirty-first (31st) day of disability or (b) the first day after exhaustion of all accrued sick leave. The premium for coverage is determined by a multiple of annual pay, and the University contributes a portion of the premium on employees' behalf; enrolled employees pay the remaining portion of the premium through payroll deduction.
Long-term care insurance (optional)
The University offers you and your immediate family members the option to purchase long-term care insurance. Long-term care coverage is designed to provide you with a range of benefits that will help you meet expenses for potential future long-term care needs. This plan may also provide employees with certain tax benefits. Employees pay the entire premium for long-term care insurance.
Travel accident insurance
Any time employees travel on University-authorized business, they are automatically covered with accidental death and dismemberment insurance. This insurance provides coverage for loss of life or limbs, but does not cover property damage. There is no charge to employees for this coverage and employees do not have to enroll to have this coverage.