Health Plan
Why was I charged a $15 copay for my routine mammogram or colonoscopy?
Preventive care visits are covered in full at 100% and routine screenings such as a mammogram or colonoscopy may also be covered at 100%. If there is a medical history where you have been treated for a condition, your visit is considered a “follow up” rather than a routine screening and you may be charged a $15 copay. If it is clearly a “routine” screening, mention that to your physician’s office for accurate billing. Once the office bills the insurance carrier, the carrier cannot change the bill and process the claim as “routine”.
Why did I only get reimbursed $40 for my vision exam when it is covered at 100%?
In most cases, employees are covered by both the MMO medical plan and the vision plan through National Vision Administation. The medical plan covers a routine eye exam at 100%. The vision plan covers an eye exam and will reimburse you up to $40 for the exam. To receive the 100% covered exam, make sure you provide your eye doctor with the MMO medical ID card and be sure he/she is in the MMO network. If your provider is not in the medical network, you can use the vision/dental ID card and pay for the exam and submit a claim for the $40 reimbursement.
When does my insurance coverage end when I leave YSU?
Your medical, dental, prescription, and vision coverage ends on the last day of the month in which you stop working at YSU. For example, if you stop working on May 12, your coverage ends on May 31.
I’m recently divorced and I am responsible for my ex-spouse’s insurance coverage, can I leave him/her on my plan with YSU?
If you are no longer married, you cannot cover an ex-spouse as a “dependent” on the health plan. An ex-spouse is eligible to continue coverage under the laws governing COBRA. Notify the Benefits Office at ext. 3748 when your marriage status changes and we will be sure to provide them the continuation option under COBRA.
What is the maximum age limit for my dependent children?
The plan will cover your married or unmarried child through the last day of the month in which he/she reaches age 26.
Other Benefit Questions
How can I update my life insurance beneficiary?
Beneficiary Designation forms are kept in your benefit file in HR. If you need to update your beneficiary, you may download a new form on the Benefits website under “Benefits Resources”, “Forms”. Send the updated form to Human Resources.
What is imputed income for life insurance and how can I avoid it?
Life insurance is a tax-free benefit in amounts up to $50,000. The IRS requires you to pay income tax on the value of any amount exceeding $50,000. The IRS-determined value is called “imputed income” and is calculated from the government’s uniform premium table which is age-based. Although the benefit provided to YSU benefit-eligible employees is 2.5 times their basic annual income, employees may elect to cap the benefit at $50,000 to avoid imputed income. Contact the HR department at ext. 3748.
What is the difference between a 403(b) plan and the 457(b) plan?
Although both plans allow you to save for retirement using tax-free funds, the withdrawal restrictions differ.
403(b) – Less stringent withdrawal restrictions while you are employed, but a 10% early withdrawal federal tax penalty may be applied. Hardship withdrawals may be made for the following reasons: unreimbursed medical expenses, payments to purchase a principal residence, higher education expenses, payments to prevent eviction or foreclosure of a mortgage.
457(b) – More stringent withdrawal restrictions while employed but no 10% penalty after you separate from service. Withdrawals are restricted to an “unforeseeable emergency” such as a sudden and unexpected illness or accident, loss of your property due to casualty, other similar extraordinary circumstances beyond your control.
How can I enroll in a 403(b)?
A current list of the approved 403(b) vendors at YSU is available on the Benefits website, under Benefit Resources. You may contact the vendors to decide which one you wish to use for your retirement savings. Once you have established an account with the vendor you can begin your payroll deductions by logging on the our third party website, MyRetirementManager.com. You will set up a password and then set up your payroll deduction. You will use this site each time you wish to change your deduction or elect a loan or withdrawal. Payroll will receive a file from this site to update our payroll system each pay.
My son/daughter just turned age 25, how long are they eligible for the tuition remission benefit?
Dependent children are eligible for the tuition remission benefit until the end of the academic year in which they reach age 25. The academic year runs from the first day of summer session through the last day of the following spring session. For example, your child reaches age 25 in July, he/she is then eligible through the summer sessions, fall semester and following spring semester.
I have plenty of sick leave available, why do I have to go on FMLA?
The Family and Medical Leave Act (FMLA) is a federal law that requires employers to provide employees job-protected leave for qualified medical and family reasons. The law also states that paid leave provided by the employer will run concurrently with the unpaid FMLA leave.
When am I required to complete a leave request form?
In most cases, employees should complete a leave request with 5 days of absence due to their medical condition or for caring for the family member with the medical condition. The ACE contract requests a notice with 3 days of absence.
Who is eligible to participate in the Wellness Program?
The Wellness program is a benefit for any full-time or benefits-eligible employee. Spouse and domestic partners are invited to participate in some of the special programs offered such as the health screenings and flu shots.
How can I participate in the Wellness programs being offered during my work day?
Typically events are scheduled during the lunch hour so that most employees can use their lunch break to participate. Employees should check with their supervisors to see how they may coordinate their schedules to participate. Currently there is no wellness release time.