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General Benefits Information (Faculty)

Medical Insurance Overview (Christian Brothers Employee Benefit Trust)

Christian Brothers Services, our benefit trust, offers a PPO plan through Blue Cross Blue Shield.

Premium Contributions (Per Paycheck)

• Pre-tax Payment Option.

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Plan Details

Insurance Effective Date:
Coverage begins on the first day of the month following the employee's date of hire.

Plan Type:
PPO (Preferred Provider Organization) through Blue Cross Blue Shield
Employees may seek care outside the network if desired.

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In-Network Coverage

• Deductible: $1,000 individual / $3,000 family (per calendar year)
• Out-of-Pocket Maximum: $3,000 individual / $6,000 family
• Coinsurance: 80% plan / 20% employee (Dr. visits & hospital care)
• Office Visit Co-pay: $25
• Emergency Room Co-pay: $200+ (plus coinsurance)
• Hospitalization: 80% / 20% coinsurance
• Note: Co-pays do not count toward the deductible

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Out-of-Network Coverage

• Deductible: $1,000 individual / $3,000 family (per calendar year)
• Out-of-Pocket Maximum: $6,000 individual / $12,000 family
• Coinsurance: 50% plan / 50% employee (no co-pays)

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Waiving Coverage

Employees may choose to waive insurance coverage. If so, a $500 (gross), one-time payment will be issued after 90 days of employment.

Note: This waiver option is not available to graduate assistants or regular part-time employees.

Transparency in Coverage (TiC)
The Transparency in Coverage Final Rule requires the disclosure of:

• Negotiated rates with in-network providers
• Historically allowed amounts paid to out-of-network providers

This applies to all health plans offered to employees.

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Dependent Coverage

• Employee Contribution: 40%
• University Contribution: 60%
• Current Premium: $1,465.19/month (regardless of number of dependents)
• Per Paycheck Deduction: $270.50 (based on 26 pay periods/year)
• Pre-Tax Payment Option.

Coverage Details:

• Same medical, dental, and prescription benefits as employee
• Effective the first day of the month following hire date
• If enrolled within 31 days of hire:
• No medical records required
• Coverage cannot be denied
• If enrolled after 31 days:
• Six-month waiting period applies
• Dependents are not eligible for life or long-term disability insurance

Important Note: Surgical review, hospital preadmission, and diagnostic authorization are required.

Authorization Phone Number: 1-800-533-5044

Call before:

• Any surgical procedure
• Non-emergency hospital admission
• Diagnostic imaging tests (CT/PET scans, MRIs)

Call within 2 working days after emergency admission.

Failure to comply may reduce benefits.

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Dental Insurance (Christian Brothers Employee Benefit Trust)

• Included with medical coverage (no additional cost)
• $50 individual / $150 family deductible
• $1,500 annual coverage maximum
• 100% coverage for:
• Checkups and cleanings (every 6 months)
• Annual X-rays (before deductible is met)

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Prescription Insurance (Express Scripts)

Retail (30-day supply):

• Generic: $10 or 20% (whichever is greater)
• Preferred Brand: $40 or 20%
• Non-Preferred Brand: $70 or 20%

Mail Order (90-day supply):

• Generic: $25 co-pay
• Preferred Brand: $100 co-pay
• Non-Preferred Brand: $125 co-pay

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Vision Insurance

• No deductible
• $50/year for exams
• $100/24 months for frames
• $50–$100 for lenses (every 12 months) or contact lenses

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Life Insurance & AD&D (Lincoln Financial Group via CBEBT)

• No cost to employee
• Benefit: 1.5× annual salary
• Note: Amount over $50,000/year is considered taxable income

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Long-Term Disability (LTD) Insurance (Lincoln Financial Group via CBEBT)

• No cost to employee
• Benefit: 60% of salary after 90-day qualifying period

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Pension (Christian Brothers Employee Retirement Plan)

• Employees are vested after 4 years and 9 months of service

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Tuition Waiver

Employees

Spouse & Dependents – Undergraduate

Spouse & Dependents – Graduate

Note: Students must maintain satisfactory academic progress as defined in the University catalog.

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Flexible Spending Accounts (FSA)

• Medical FSA: $3,300 annual cap
• Childcare FSA: $5,000 annual cap
• Premiums are pre-tax
• Enrollment: within 30 days of hire or during December open enrollment

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AFLAC Insurance Options

Available Plans:

• Accident
• Cancer
• Specified Health (e.g., stroke, heart attack)
• Intensive Care
• Short-Term Disability
• Premiums are pre-tax
• Enrollment: within 30 days of hire or during December open enrollment

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Employee Assistance Program (Perspectives, Inc.)

Free services for employees and their extended families:

• Counseling
• Care Coordinator Services
• Will & tax assistance
• Childcare support
• More

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Additional Resources

This is a summary. For full details:

• Review the Summary Plan Description (gray booklet)
• Contact Human Resources at SB-104, St. Charles Borromeo
  ext. 5270 | hr@lewisu.edu

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