Frequently Asked Questions
ELIGIBILITY
BENEFITS AND PLAN OPTIONS
ADDITIONAL RESOURCES
General Benefits/Retirement Questions
- How do I change my name with my benefit and retirement provider?
- Name changes are done by providing a copy of your new social security card to the
Data Management Section in Human Resources. Once you have notified Human Resources
of your name changes, it will be communicated to heath, dental, and flexible spending
providers. You will need to contact your retirement vendor to update your new name
with them.
- How do I update my address with my benefit and retirement provider?
- You will need to complete the Employee Address Form and return to Human Resources. Once your address has been updated in Banner, it will
be communicated to health, dental, and flexible spending providers. You will need
to contact your retirement vendor to update your address with them.
- Who is eligible for coverage?
-
- Regular, full-time employees and individuals employed in full-time temporary positions
if employment is expected to continue nine months or longer.
- The employee’s spouse as recognized under the laws of the state where the employee
resides.
- Other Qualified Adult Dependent (OQD) who is financially interdependent, shares primary
residence with the employee, and has done so for the past 12 months.
- The employee’s or the employee’s OQD children from birth up to age 26, including natural
children, stepchildren, newborn or legally adopted children, and as otherwise required
by law. (Children are covered through the end of the year of the 26th birthday.)
- Can I make changes to my benefits throughout the current plan year?
- The choices you make upon hire or during open enrollment remain in place from January
1 current year through December 31 current year. You cannot add or drop coverage until
the next open enrollment period which is typically held in November (for the next
plan year) unless you have a change in family status or experience another qualifying
event with benefit changes related to the specific life event (see below for eligible
qualifying events).
- What is a Qualifying Event?
-
- Birth or adoption
- Marriage
- Divorce
- Employment Status (dependent loses/gains other coverage)
- Dependent no longer meets eligibility criteria
- If I have a qualifying event, how long do I have to make changes to my benefits?
- You must notify the Employee Benefits section within 31 days of your qualifying event
otherwise you will have to wait until the next open enrollment period to make changes
for the next plan year beginning January 1.
- What benefits are offered to eligible employees?
-
- Health/Vision, Dental
- Flexible Spending (health and dependent care)
- Long-Term Care
- Life and Disability (Basic Life/AD&D, Optional Life/AD&D, Spousal Life/AD&D, and Dependent
Child(ren) Life/AD&D)
- Home and Auto
- Employee Assistance
- Where is the Benefits Section located?
- The Benefits Team is located on the ground floor of the Wetherby Administration Building
in Room G-25.
Life Insurance Questions
- How much coverage does the University provide?
- The University provides a $30,000 Basic Life / AD&D policy at no cost to all full-time
employees who work at least 37.5 hours per week and retired former faculty members
who return to work for the University at least 12 hours per semester under the Transitional
Retirement Program.
- Can I purchase additional life insurance?
- Yes, you may elect Optional Life Insurance and AD&D in $10,000 increments up to $500,000.
- Am I guaranteed additional coverage?
- New employees are guaranteed optional life insurance up to $200,000 without completing
an Evidence of Insurability form. Existing employees may elect to increase their optional
life insurance during Open Enrollment by $10,000 without completing an Evidence of
Insurability form up to $200,000. Amounts over $200,000 will require an Evidence of
Insurability form.
- What is Evidence of Insurability (EOI)?
- EOI is a statement or record of you or your dependent’s medical history upon which
acceptance of insurance will be determined by Sun Life.
- Can I elect life insurance on my spouse?
- Yes, you may elect Dependent Spouse Optional Life Insurance / AD&D in $10,000 increments
up to $80,000. However, you must carry optional life insurance in an amount double
what you wish to carry on your spouse.
- Is my spouse guaranteed coverage?
- New employees are guaranteed spouse life up to $10,000 without completing and Evident
of Insurability form. Amounts over $10,000 will require completion of the Evidence
of Insurability form by your spouse. Existing employees may elect to add or increase
spousal life insurance during Open Enrollment; however, an Evidence of Insurability
form will be required regardless of the amount.
- Can I elect life insurance on my children?
- Yes, you may elect Dependent Child(ren) Optional Life Insurance / AD&D in $5,000 increments
up to $10,000. However, you must carry at least $10,000 in optional life insurance
on yourself.
- Is my child(ren) guaranteed coverage?
- Yes, as long as you meet the minimum requirement.
- When will my elections go into effect?
- Coverage will go into effect the first day of the month following your date of hire.
- When can I make changes to my elections?
- New employees have 30 days from their date of hire to make their elections. Existing
employees who have a qualifying event have 31 days from their qualifying event to
make changes or changes can be made during open enrollment for the next plan year.
Disability Insurance Questions
- Do I have disability insurance?
- The University provides a Long Term Disability policy at no cost to all full-time
employees who work at least 37.5 hours per week and retired former faculty members
who return to work for the University at least 12 hours per semester under the Transitional
Retirement Program.
- What is the amount of coverage for Long Term Disability?
- The policy covers 60% of your Total Monthly Earnings, not to exceed the Maximum Monthly
Benefit ($5,000), less Other Income Benefits.
- Is there a minimum monthly benefit?
- Yes, $100 or 10% of your Gross Monthly Benefit, whichever is greater.
- Is there an elimination period for Long Term Disability?
- Yes, 90 days or the end of your Short Term Disability Maximum Benefit Period, whichever
is later.
- What is the Long Term Disability maximum benefit period?
- Your maximum benefit period is based on your age at disability or your normal retirement
age. For further details, please contact a member of your Benefits Department or reference
your SPD.
- Do I automatically have Short Term Disability?
- No, Short Term Disability is an optional benefit offered to all full-time employees
who work at least 37.5 hours per week. Premiums are 100% employee paid and are deducted
on a post-tax basis.
- Do I need to complete an Evidence of Insurability form?
- Employees who elect coverage upon their initial hire are guaranteed coverage; however,
if you do not elect coverage until open enrollment you will be required to complete
the Evidence of Insurability form.
- What is the amount of coverage for Short Term Disability?
- The policy covers 60% of your Total Weekly Earnings, not to exceed the Maximum Weekly
Benefit ($1,250), less Other Income Benefits.
- Is there an elimination period for Short Term Disability?
-
- There is no elimination period for an injury, if your Total Disability occurs within
72 hours after an accident.
- There is a 7-day elimination period for sickness or if you are Total Disability beings
later than 72 hours after an accident.
- What is the maximum benefit period?
- The maximum benefit period is 13 weeks.
- Where can I find the Evidence of Insurability form?
- The EOI form can be found at http://www.wku.edu/hr/documents/lifeeoi.pdf
Health/Vision Benefit Questions
- What type of health plan does the University offer?
- WKU’s health plan is PPO (Preferred Provider Organization) and offers a large selection
of network providers. A provider directory is available online at www.anthem.com.
- Are there different plans to choose from?
- Yes, there are three plans from which to choose when selecting the type and level
of coverage you and your family need. Blue Access High, Standard and Economy all cover
the same services and utilize the same network but differ in the deductible, co-pays,
co-insurance levels, out-of-pocket limits, and prescription co-pays.
- Is prescription included on the health plan?
- Yes, prescription drug coverage is included with your health plan. However, if you
are taking a maintenance type drug (month after month), Mail Order Prescription services
are available. By utilizing mail order services, you will receive a 3-month supply
at the cost of a 2-month supply. You will need to make sure the prescription is written
for a 90-day supply.
- Is vision included as part of the health plan?
- Yes, vision is covered under Anthem Blue View Vision.
- What if I have other coverage and waive the health insurance?
- For employees who waive their rights to health insurance, the University will deposit
$150 per month into a health care flexible spending account to be used for eligible
medical-related expenses as set forth by the Internal Revenue Service. Expenses may
be reimbursed for all eligible dependents of the member. No insurance premiums can
be paid with these funds.
Flexible Spending Accounts
- What is a flexible spending account?
- A flexible spending account is an account used to set aside tax-free money to pay
for eligible health care and/or dependent care expenses.
- What are the types of flexible spending accounts offered by the University?
-
- Health care flexible spending account
- Dependent care flexible spending account
- How does the health care flexible spending account work?
- You may contribute up to $4,000 pre-tax money per plan year to your account to pay
for eligible health, dental, and vision care expenses. If you waive the WKU health
plan the amount you set aside in addition to the money you receive for waiving your
rights to health care cannot exceed $4,000. Any money set aside in the health care
spending account that is not used between January 1 and March 15 is forfeited. Claims
are accepted through March 31.
- What are eligible expenses?
- Eligible expenses include co-pays for doctor visits, prescriptions, dental, and vision
expenses, deductible, and co-insurance payments, orthodontia, and countless other
items.
- How do I use the money set aside?
- You will receive the FlexCard Prepaid MasterCard that makes it fast and convenient.
It can be used to pay for qualified medical expenses not covered by your health insurance
at any provider that accepts Master Card. Just swipe and go… your annual election
is preloaded on your card and will automatically deduct the qualified expense at the
point of sale.
- What if the provider does not accept Master Card?
- Save your receipts and complete the medical reimbursement form. The form can be accessed
at http://www.wku.edu/hr/documents/fsaclaimform.pdf.
- How does the dependent care flexible spending account work?
- You may contribute up to $5,000 pre-tax money per plan year to your account to reimburse
yourself for dependent care expenses.
- What can the dependent care flexible spending account be used for?
- The dependent care flexible spending account is used for the care of eligible dependents,
which include children under the age 13 whom you claim as dependents on your federal
tax return and any other dependents that are mentally or physically disabled and normally
spend at least eight hours in your home each day.
- What qualifies as an eligible expense?
-
- Childcare for child(ren) under age 13 at a day camp or nursery school, or by a private
sitter
- Elder care for an incapacitated adult who lives with you
- Expenses for before school and after-school childcare
Dental Benefit Questions
- What type of dental plan does the University offer?
- WKU offers a core dental plan to eligible employees at no cost for employee only coverage.
The core plan offers preventative dental care as well as limited minor services coverage.
- Can I purchase additional dental coverage that will cover major services?
- Yes, employees have the option to “buy up” to a premier plan with no network restrictions,
which also covers major services and orthodontia in addition to preventative and minor
services.
- Does either plan have a waiting period?
- The core plan does not have a wait period; however, the premier plan has a 12-month
waiting period/missing tooth clause.
Other University Benefits
- Employee Assistance Program
- The Employee Assistance Program is administered by ComPsych. WKU benefits-eligible
employees and their household members with behavioral and mental health issues, as
well as work-life, financial, and legal issues are offered an Employee Assistance
Program (EAP)at no cost to the employee.
- Will ComPsych disclose my call to the University?
- No, it is completely confidential and will not be shared with any University official
or other individual.
- Long-Term Care
- Long-Term Care is a voluntary benefit offered by Prudential on a post-tax basis that
can help preserve your assets and protect your independent way of life in the event
you suffer a chronic illness or disability, which renders you unable to perform two
or more activities of daily living or protect you from threat to health and safety.
- What are activities of daily living?
-
- Bathing
- Continence
- Dressing
- Eating
- Toileting
- Transferring
- What are the coverage options for Long-Term Care?
- There are six plans available that cover that nursing home, assisted living/residential
care facility, and home & community base care. The difference between the plans is
in the daily and lifetime maximum reimbursement.
- 529 College Savings Plan
- The 529 College Savings Plan is a State sponsored, tax advantaged savings plan that
enables families and individuals to save for higher education by setting aside post-tax
money through payroll deduction.
- What are the benefits of a 529 plan?
-
- It offers federal tax-free withdrawals for qualified expenses
- Tax deferral on earnings
- Professional money management
- Flexibility to use proceed at virtually any higher education institution
- Group Home and Auto Discount Program
- The Group Home and Auto Discount Program is administered by Van Meter Insurance and
offers employees discounts up to 10% with the convenience of premium payment through
payroll deduction.
- Am I required to participate in payroll deduction in order to benefit from the program?
- No, payroll deduction is an added benefit designed to be convenient for the employee.
- Can I sign up at anytime for the Group Home and Auto Discount Program?
- Yes, representatives are on campus during open enrollment and periodically throughout
the year to conduct employee meetings and answer questions.