Effective January 1, 2009
This summary provides a brief description of benefits available through the University of Virginia to all Post-doctorate Staff. For additional information, please contact the Benefits Office at (434) 924-4392, e-mail benefits@virginia.edu
Health Insurance
Medical Insurance
Medical coverage is provided through Optimum Choice, Inc. with Health Maintenance Organization HMO coverage or MAMSI Life and Health Insurance Co. for Preferred Provider Organization (PPO). Information is available on their website at:
http://www.mamsiunitedhealthcare.com.
If you elect the Optimum Choice HMO coverage you must choose an OCI-participating PCP who is open for new patients and be sure this PCP is noted on your card. Failure to select an OCI PCP will result in claims being denied. These visits incur a $15 copayment. You must obtain PCP referrals for specialist visits. If properly referred, you will incur a $15 copayment (no referral needed for OB/GYN or eye refraction services. In addition, if your UVa PCP refers you to another UVa provider, no formal referral is necessary. Services provided by non-network providers are not covered except in emergency. There is a 24/7 Member Services Hotline you can contact at 800-331-2102.
If you elect the MAMSI Life and Health Insurance Co. PPO plan, you must use the MAMSI PPO network of participating providers. PCPs and referrals to specialists are not required. Deductibles are waived for services rendered in a Primary, Wellness or Emergency setting and Primary Services covered incur a $20 copayment.
Covered services rendered by non-network providers are adjudicated under the Non-Preferred Option after deductible. Separate contract year deductibles apply for care rendered under Preferred ($500) and Non-Preferred ($1000) settings. There is a 24/7 Member Service Hotline you can contact at 800-331-2102.
Well Being
Optimum Choice, Inc. and MAMSI Life and Health customers now have access to a no-cost well-being program at the Optimum Choice/MAMSI website
(www.mamsiunitedhealthcare.com). This program, called Health AtoZ offers a number of enhanced capabilities including a health assessment, online health coaching and a live nurse chat. New members can do an easy one time registration to learn more about HealthAtoZ simply by visiting the site.
Premium Costs:
Postdoc premiums changed for the HMO and PPO effective 1/1/09.
Post-Doc single coverage requires no premium payment. Post-Doc Plus One and Post-Doc Plus Family require payment of a monthly premium as follows:
Premium rates for the Optimum Choice HMO:
| Single |
$ 0 |
| Employee + One |
$ 317.66/month |
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| Family |
$ 538.44/month |
Premium rates for the MAMSI PPO:
| Single |
$ 0 |
| Employee + One |
$ 320.73/month |
| Family |
$ 542.60/month |
Copayments, Coinsurance and Deductibles may apply. Please see your Plan’s Benefit Summary for details.
Enrollment:
Enrollment in the Post-Doc health plan must occur within 31 days of your date of hire. Additions, subtractions, changes to coverage can be undertaken during Open Enrollment or within 31 days of a "Life Status" Change such as Birth, Death, Loss of coverage, Marriage or Divorce.
Enrollment applications must be submitted to the University Human Resources Benefits Office , 914 Emmet St. Charlottesville, VA 22904; fax (434) 924-4486.
Do not submit any Optimum Choice or MAMSI health plan applications directly to Optimum Choice/MAMSI.
MAMSI/Optimum Choice Health Plan COBRA Information for Post Doctoral Fellows Under a Federal law called the "Consolidated Omnibus Budget Reconciliation Act" (COBRA), you and your eligible covered dependents may continue your group health benefits under the Plan when your coverage is lost due to a "Qualifying Event." You and your spouse and/or dependent children must apply for coverage under COBRA following the Qualifying Event. Then, you must make monthly payments in order to keep your coverage.
Qualifying Event |
Who May Purchase Continuation Coverage |
Duration of Continuation Coverage |
| Your employment terminates |
You, your spouse and your dependent children who were covered under the Plan when coverage was lost |
18 months |
| Your working hours are reduced, i.e., you become a part-time Employee |
You, your spouse and your dependent children who were covered under the Plan when your status changed |
18 months |
| You experience a termination or reduction in hours while you are disabled (as determined by the Social Security Administration) |
You, your spouse and your dependent children |
29 months (18 months plus an additional 11 months) |
| You divorce, or your marriage is annulled |
Your spouse and your dependent children who were covered under the Plan at the time of divorce, marriage or annulment |
36 months |
| Your dependent child no longer qualifies as a dependent |
Your dependent child |
36 months |
| You die |
Your spouse and your dependent children who were covered under the Plan at the time of your death |
36 months |
MAMSI /Optimum Choice Health Plan COBRA Information for Post-Doctoral Fellows
What You Need to Do
Post Doctoral Fellows enrolled in the MAMSI /Optimum Choice Plans must wait for your COBRA Qualifying Event Notification Letter to come to your home address from Chard Snyder before you can enroll in COBRA. If you are moving, Post docs need to notify the VP for Research and Graduate Studies office of your address change to ensure COBRA documents will be sent to the correct address.
Chard Snyder will send a COBRA Qualifying Event Notification, COBRA Enrollment Form, COBRA Family Member Enrollment Form, and COBRA Premium Computation Form to the MAMSI/Optimum Choice subscriber once your termination is entered by your department. You must complete these forms and return them to Chard Snyder . Enrollment in the COBRA program will not occur unless premium payment accompanies the enrollment forms. Post Doc Fellows have 60 days from the date of the letter of Notification or the date of the Qualifying Event, whichever is greater, to return the COBRA forms. You must pay all back premiums before any COBRA enrollment will take place.
- 2009 COBRA premiums for Post Doctoral Fellows enrolled in Optimum Choice or MAMSI :
Post Doc Fellow Optimum Choice (HMO) monthly rates are:
Single $297.56
Employee + 1 $621.58
Family $846.77
Post Doc Fellow MAMSI (PPO) monthly rates are:
Single $299.04
Employee +1 $624.71
Family $851.02
If you are a Post Doc Fellow currently enrolled in the HMO and are moving out of the Mid-Atlantic area where providers participate with the HMO (Virginia, Maryland, Washington D.C.), you will need to move from the HMO to the PPO to receive COBRA coverage from a national network of providers. You should call Chard Snyder (1-800-982-7715) when you receive your Qualifying Event Notice to let them know you must switch to the PPO.
Dental Insurance
Dental coverage is included with the cost of medical insurance. The dental network is provided by United Concordia. You can use non-participating dentists but the non-participating dentist can balance bill for services above the allowable charge. The benefits when using a network provider include a $1,000 annual benefit per covered person. Major restorative services are not provided except for repair. Orthodontia coverage is not provided.
Prescription Information
For both the Optimum Choice and MAMSI PPO there is a 3-tier plan drug plan with prescription copayments of $10 generic, $20 formulary brand, and $35 non-formulary brand. In addition, for PPO members who access Non-Preferred Pharmacies, there is a 20% copayment.
Reminder about the Specialty Pharmacy Program: Beginning July 1, 2007, Optimum Choice and MAMSI participants were required to obtain specialty medications from select specialty pharmacies to receive in-network benefits. Contact the Specialty Pharmacy Referral Line at 866-429-8177 for more information.
Enrollment:
Enrollment in the Post-Doc health plan must occur within 31 days of your date of hire. Additions, subtractions, changes to coverage can be undertaken during Open Enrollment or within 31 days of a “Life Status” Change such as Birth, Death, Loss of coverage, Marriage or Divorce.
Enrollment applications must be submitted to the Office of Employee Benefits at University Human Resources, 914 Emmet St. Charlottesville, VA 22904; fax (434) 924-4486.
Do not submit any Optimum Choice or MAMSI health plan applications directly to Optimum Choice/MAMSI.Life Insurance
Life insurance is provided for post-doc fellows through The Standard. All active full time post-doc fellows working at least 30 hours per week are eligible. The cost for this benefit is paid 100% by the University of Virginia.
The Guarantee Issue Life Benefit amount is 2 times Annual Earnings to a Maximum Benefit of $150,000. If you become terminally ill with a life expectancy of 12 months or less, you may receive 75% of your life benefits before you die. If a claim occurs while the insured is wearing a seat belt the Plan pays an extra $10,000.
Your life insurance will be continued to age 65 and premiums will be waived if you are totally disabled before the age of 60.
Disability Insurance
Short and Long Term Disability Insurance is provided for post-doc fellows through The Standard. All active full time post-doc fellows working at least 30 hours per week are eligible. The cost for this benefit is paid 100% by the University of Virginia.
Short Term Disability
The Short Term disability insurance provides income replacement benefits in the event you are unable to work due to an accident or sickness. The Short Term coverage provides 60% of weekly earnings to a maximum benefit of $700 per week. There is benefit waiting period of 8 days for accident and sickness. Maternity is covered the same as any other sickness.
The maximum benefit period is 90 days. If you are receiving other types of income such as Workers Compensation, Social Security, or other group disability benefits, these may be considered offsets from the amount The Standard will pay.
Short Term Disability benefits will cease when Long Term Disability becomes payable.
Short Term Disability benefits will not be paid while sick leave is received.
Long Term Disability
The Long Term disability insurance provides income replacement benefits for you and your family in the event you are unable to work due to an accident or sickness. There is a benefit waiting period of 90 days. The Long Term coverage provides 60% of monthly salary with a $3,000 monthly maximum. If you die while receiving Long Term Disability a 3- month lump sum survivor benefit is payable.
If you are receiving other types of income such as Workers Compensation, Social Security, or other group disability benefits, these may be considered offsets from the amount The Standard will pay.
There is a 3/12 pre-existing clause. This is a 3 month look back period to see if you were treatment-free and 12 months continuously covered otherwise.
Accidental Death and Dismemberment
Accidental Death and Dismemberment insurance is provided for post-doc fellows through The Standard. All active full time post-doc fellows working at least 30 hours per week are eligible. The cost for this benefit is paid 100% by the University of Virginia.
Your AD&D insurance benefit is equal to 4 times Annual Earnings to a Maximum Benefit of $300,000. There is a reduction schedule once you reach age 65:
| Age 65-69 | 65% |
| Age 70-74 | 50% |
| Age 75 | 35% |
You may be eligible to continue your Life Insurance at group rates if your employment terminates. You may also be eligible to convert your Life Insurance to a whole-life policy is your employment terminates.
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