Faculty Handbook : V. Benefits (Complete Version)

V. Benefits (Complete Version)

Editor's Note

The information below regarding faculty benefits was originally included in the Faculty Handbook 1999. As this section envisioned, faculty benefits policies and offerings have been changed and modified since 1999. For information regarding the University's current plan offerings, visit the website of the Office of Faculty and Staff Benefits, the faculty Family Care policy, the disability leave policy, and the tuition benefits policy.

OVERVIEW

There are many things faculty members need to know about the University and the benefits available specifically to meet your needs and enhance your work experience at Georgetown University. The Faculty and Staff Benefits Office is dedicated to helping you understand and optimize your benefits. Once you have reviewed this summary, please feel free to call that office at 202-687-3643 with any questions. Details about the costs to the faculty member of specific benefits are available from the Benefits Office.

This summary contains information about paid leave and the benefits currently available to Georgetown University Faculty. The statements made in this summary are accurate but by no means complete in detail. If a conflict arises between this summary and the various plan documents, the master policy or plan document will take precedence.

YOUR BENEFITS PACKAGE

Georgetown University offers a comprehensive benefits package that includes Life, Dependent Life, Disability, Retirement, Health, Dental, Flexible Spending Accounts, U.S. Savings Bonds and Tuition Assistance. The University requires participation in two plans, Group Life and Disability. Your participation is required to ensure that you are protected in times of need.

ELIGIBILITY

You are eligible for the benefits described in this summary, except for the Tuition Assistance Program, if you are a faculty member hired to work at least 75% time. Faculty scheduled to work 90% are eligible for tuition benefits. Part-time faculty and those appointed to full-time positions on a temporary basis (for a period of less than 4 months) including summer appointments are not eligible unless the plan is required by law.

Family members eligible for coverage under the health, dental and Health Care Spending Account plans include your:

legal spouse
dependent children under age 19
dependent children ages 19-26 for Kaiser, or, if they are full-time students, up to age 30 for the Georgetown Health Plan and the dental plans
children who are mentally or physically incapable of self care and are age 19 or older (with proof of disability)

Dependents eligible for coverage under the Dependent Care Assistance Plan include:

children under age 13 qualified as dependents for income tax purposes or dependents who are mentally or physically incapable of self care.

HOW TO ENROLL

You must complete the enrollment forms for each plan you wish to participate in. You must enroll in the benefit plans by the last day of the month following the month of your employment. To complete Enrollment Forms for Health and Dental Insurance, you will need the name(s) and social security number(s) for each family member you wish to cover under these plans.

WHEN COVERAGE BEGINS

Coverage in the Life, Dependent Life, Disability Leave, Long Term Disability, Health and Dental Plans begins on the first day of work, provided you have completed the Enrollment Card and filed it with the Faculty and Staff Benefits Office by the last day of the month following the month of your employment.

YOUR ENROLLMENT DECISIONS

The enrollment choices you make for health, dental, health care and dependent care will be in effect until the next open season. Open enrollment begins in October and goes through the month of November each year. All changes must be made by November 30th. You cannot change your choices unless your needs are affected by a change in family or employment status. If you have a status change, you must notify the Faculty and Staff Benefits Office within 90 days of the change. You will be responsible for any applicable premiums retroactive to the date of the change.

CHANGES IN YOUR FAMILY OR EMPLOYMENT STATUS

According to IRS rules, other than during the annual open enrollment period, you may only change your health, dental, health care and dependent care elections when your status change is a result of a change in family or employment status. This provision covers reasons you might need to change your coverage, such as:

marriage, divorce, legal separation;
birth or adoption of a child;
addition of a dependent;
death of a spouse or dependent;
an employment status change for you or your spouse (i.e., from full-time to part-time or vice versa, employed to unemployed or vice versa, or you go on leave without pay status).

YOUR PREMIUMS

When you enroll, you will be responsible for premiums retroactive to your date of hire. Deductions to cover your portion of the cost of your benefits are taken from each paycheck. If you are hired prior to the fifteenth of the month, you will be responsible for the entire month of premiums.

FAMILY CARE LEAVE

Family Care Leave is a Georgetown University policy that can be used for child care during the first year after the birth, adoption, or foster placement of a child. In the case of a woman giving birth, she first receives paid Disability Leave during the post-partum recovery period, and then she can start Family Care Leave. Family Care Leave can also be used for the serious illness of children, spouses or parents.

Because some faculty members may have close relationships with persons who do not fall exactly within the categories outlined above, but the relationships are very similar in nature to the defined ones, faculty may petition to be granted the Family Care Leave for closely similar circumstances (e.g., the serious illness of an aunt who has been a faculty member's de facto mother). There is no entitlement to such leave, however, and the decision in such cases is left to the discretion of the relevant Executive Vice President.

HOW FAMILY CARE LEAVE WORKS

Under the Family Care Leave policy, you may take up to four months of leave without pay or you may work half-time for up to four months at half pay and be fully reinstated to your position upon your return. Also, if the family care required is periodic in nature, such as for recurring chemotherapy treatments, periodic Family Care Leave may be scheduled.

Health and other insurance benefits may be continued throughout the leave if you pay the employee portion of the premiums.

In certain cases, you may be able to take up to one year of Family Care Leave, but your department head or dean must approve the extended leave. The request for extension may be denied if, in the opinion of your department head or dean, your extended absence would seriously diminish your department's functioning. You may appeal such a denial to the appropriate Executive Vice President.

If you have used less than your four months of Family Care Leave, and a new situation arises requiring use of Family Care Leave, you may ask to use your remaining entitlement. This request may be denied if your absence would seriously diminish your department's functioning. You may appeal such a denial to the appropriate Executive Vice President.

LEAVE OPTIONS FOR TENURE TRACK UNTENURED FACULTY

Tenure track untenured faculty may have any Family Care Leave of a semester or more excluded from the time counted for the tenure probation period. (A semester's leave means that the entire academic year in which that semester occurred will not be counted toward tenure.)

If you are a tenure track untenured faculty member who is in a position to take Family Care Leave but cannot afford the loss of salary, you may apply to extend the 7 year tenure probation period to 8 years.

This will allow you to teach full-time at full salary, fulfill all responsibilities regarding the supervision of students (including the supervision of graduate student research where applicable), and continue committee work, but to reduce your publishing workload for one year.

You must apply for extension of your tenure probation period at the time of your family care circumstance, and not at the time of seeking tenure. The one year probation extension may not be secured retroactively at the time of tenure consideration.

The process of securing a one year extension shall be for the faculty member to submit a statement detailing his or her reason for requesting the extension. The request shall be given to the appropriate Executive Vice President via the Chairman of the Department. The request may be denied only for lack of substantiation of the circumstances.

APPLYING FOR FAMILY CARE LEAVE

You should apply for Family Care Leave as soon as you can before starting the leave. Your application must state when the Family Care Leave will start, your best estimate of how long it will last (if possible), and the reason you are seeking leave. If possible, you should schedule your leave to avoid disruption of courses. Documentation to support your request must accompany your application.

You will be granted leave unless your department head or dean receives permission from a committee composed of the 3 Executive Vice Presidents to deny it. If your department head seeks permission to deny your Family Care Leave, you will get a copy of this request. You have the right to provide the Executive Vice Presidents with a written statement of the hardship to you and your family which would be caused by a denial. You may also suggest ways to alleviate your department's hardship or state why you believe that granting the leave would not cause severe hardship to the department.

For more information on Family and Medical Leave and how to apply for it, contact your Human Resources Department.

FEDERAL AND DISTRICT OF COLUMBIA FAMILY AND MEDICAL LEAVE

Faculty members are also eligible for Federal and District of Columbia Family and Medical Leave after completing one year of employment without a break in service except for holidays or other paid leave, and you have worked at least 1000 hours during the 12 months preceding the request for family or medical leave or at least 50% status, whichever is less. In no case are you entitled to both Federal and District of Columbia Family and Medical Leave and Family Care Leave.

Federal Family and Medical Leave Law provides eligible employees entitlement of a total of 12 weeks of family and medical leave combined during any 12 month period.

District of Columbia Family and Medical Leave Law provides eligible employees entitlement of a total of 16 work weeks of family leave and 16 work weeks of medical leave during any 24 month period.

Federal and District of Columbia Family and medical Leave run concurrently and cannot be used consecutively if leave is covered under both laws.

Federal Family and Medical leave can be used for the following:

The birth of your child and to care for the child (Entitlement expires 12 months after birth.)
The placement of a child with you for adoption or foster care. (Entitlement expires 12 months after placement.)
To care for your spouse, son, daughter, or parent, if the family member has a serious health condition.
If you are unable to perform the functions of your position because of your own serious health condition.

District of Columbia Family Leave can be used for the following:

The birth of your child and to care for the child. (Entitlement expires 12 months after birth.)
The placement of a child with you for adoption or foster care. (Entitlement expires 12 months after placement.)
The placement of a child for whom you permanently assume and discharge parental responsibility. (Entitlement expires 12 months after placement.)
Serious health condition of a person related by blood, legal custody or marriage.
Serious health condition of person or persons with whom you share or have shared within the last year a mutual residence and with whom you maintain a committed relationship.

District of Columbia Medical Leave can be used if you are unable to perform the functions of your position because of your own serious health conditions.

Federal and District of Columbia Family and Medical Leave Law is unpaid except for periods of time that an employee is eligible for paid disability benefits.

The leave period begins on the first work day of an employee's first qualifying leave within the past 12 or 24 month period, as applicable.

LIFE INSURANCE

The University offers a term life insurance policy with six levels of coverage and accidental death and dismemberment (AD&D) benefits. As a full-time staff employee working 30 or more hours per week, you are required to participate in the Core Plan. The Core Plan is equal to $5,000 and is provided at no cost to you. You may elect additional coverage from one to five times your annual salary up to a maximum paid benefit of $400,000, instead of the Core Plan. The Accidental Death and Dismemberment benefit face value is equal to the face value of your life insurance. If you do not enroll when you are first eligible, you will have to submit evidence of insurability to CIGNA, the Life Insurance carrier.

CONTRIBUTION SCHEDULE

The University pays the full cost of the first $5,000 of coverage. You pay $.20 per month per $1,000 of annual pay for coverage from $5,000 to $100,000 and $.30 per month per $1,000 for coverage from $100,000 to $400,000.

To get an exact calculation of your contribution, you should call the Faculty and Staff Benefits Office at 202-687-3643.

BENEFIT REDUCTION

At age 65, there is an automatic benefit reduction of 35% for active employees. Benefits are further reduced by 15% at age 70, for active employees still covered under the GU Group Life Insurance Plan.

CHANGES IN COVERAGE

In determining your need for life insurance, consider all the life insurance coverage sources available to you, including any individual policies you have. You may change your level of coverage at any time. For increases in coverage, you must complete a change form and a form that indicates Evidence of Insurability. Increases in coverage must be approved by CIGNA. For a decrease, you must complete a change form.

DEPENDENT LIFE INSURANCE

If you are insured under the GU Group Life Insurance Plan, you may elect coverage for your dependents under the Dependent Group Life Insurance Plan. A spouse is insured for $2,000. Each dependent child 14 days of age, but less than 6 months of age is insured for $200. Each dependent child 6 months of age but less than 21 years of age is insured for $1,000. You pay $.39 biweekly or $.78 monthly, regardless of how many dependents you insure. Coverage starts on the first day of work, provided you have completed the Enrollment Form and filed it with the Faculty and Staff Benefits Office by the last day of the month following your employment. You are eligible to enroll dependents upon full-time employment or within 90 days of acquiring a spouse or dependent child(ren).

ABOUT DISABILITY BENEFITS

When you are ill or injured, Georgetown's goal is to help you return to work as soon as you are able. If you are disabled, you need to focus your energy on getting well and getting back to work. Georgetown's disability benefits can provide you with replacement income during your illness.

Three options are available: Worker's Compensation, Disability Leave and Long Term Disability.

WORKERS' COMPENSATION

The University has Workers' Compensation insurance for all employees for their protection while performing their assigned duties. Workers' Compensation pays medical bills incurred as a result of a work related illness or injury and replaces lost income in the event of lost time. Work related illnesses or injuries must be reported promptly to the Employee Health Service, ground floor, Hospital, telephone 202-784-3680. In the event of a serious injury, the employee should be taken to Georgetown University Hospital emergency room or to the nearest hospital.

The University takes all practical steps to eliminate or reduce the exposure of employees to accidental injury or to conditions that are injurious to health. You should cooperate by observing established safety regulations and working safely. You should bring allegedly unsafe or unhealthy conditions to the attention of your supervisor or department head and may suggest a resolution to these conditions. Such suggestions should be sent to the Safety and Environmental Management Office, One New South, 202-687-7641.

DISABILITY LEAVE

Your salary can continue for up to three months when you are disabled. Disability Leave benefits begin on the first day you are absent from work due to a medical condition rendering you unable to work, such as illness, recovery from injury, childbirth or medical procedures. Disability Leave benefits do not apply to work-related illness or injury, which is covered under Workers' Compensation. Disability Leave benefits can continue until you are no longer medically disabled, until you reach the recovery limit for your medical condition, or until you have been medically disabled for three months, whichever comes first.

Applying for Disability Leave Benefits

Law Center:

Applications for and notifications of Disability Leave benefits are made through and by the Law Center Personnel & Payroll Officer.

Main Campus:

Applications for and notifications of Disability Leave benefits are made through and by the Office of the Provost.

Medical Center:

Applications for and notifications of Disability Leave benefits are made through and by Medical Center Human Resources.

COST OF PLAN

The entire cost of this plan is paid by the University.

LONG TERM DISABILITY(LTD)

The plan provides a benefit of 60% of your base pay to a maximum paid benefit of $15,000 per month ($300,000 per year). The benefit begins after a 3 month waiting period and coordinates with Disability Leave. The benefit will continue until you are no longer disabled (i.e., unable to perform the duties of your occupation), or for five years, whichever occurs first. Benefits are paid beyond five years if you are unable to engage in any occupation for which you are reasonably trained. LTD benefits are reduced by any wages, benefit collectible under Workers' Compensation, Primary Social Security, or any disability or early benefit received under a University sponsored retirement plan. If you are a participant in another group Disability Plan, your benefit will also be reduced by that benefit. The benefit can continue to age 70, as follows:

AGE AT COMMENCEMENT DURATION OF BENEFIT

OF DISABILITY PERIOD
61 or younger.......................... to age 65 or normal retirement, whichever is first
62............................................... 3.5 years
63............................................... 3 years
64............................................... 2.5 years
65............................................... 2 years
66............................................... 1.75 years
67............................................... 1.5 years
68............................................... 1.25 years, or to age 70, whichever occurs first
69............................................... 1 year, or to age 70, whichever occurs first

PRE-EXISTING CONDITION EXCLUSIONS

Benefits are not payable for disabilities resulting from pre-existing conditions that occur during the first year of participation in the plan. If you do not enroll when first eligible, you will have to submit evidence of insurability satisfactory to UNUM, the insurance carrier.

CONTRIBUTION SCHEDULE

The University pays the full cost of the first $1,000 of monthly base pay. You pay $.50 for each additional $100 of your monthly base pay from $1,000 to $8,333.33, and $.55 for each $100 of monthly base pay from $8333.34 to $25,000.

DEFINED CONTRIBUTION PLAN

The University and Senior Staff employees contribute a defined amount to fund eventual retirement. The amount of the resulting retirement annuity depends on the amount contributed, the earnings on these investments over time, and the form of annuity payment selected. Funds can also be transferred, as a lump sum, to an individual retirement account (IRA).

Retirement contributions may be invested with one insurance company--the Teachers Insurance Annuity Association/College Retirement Equities Fund (TIAA-CREF)--and/or with two mutual fund companies--the Vanguard Group of Mutual Funds and the Fidelity Group of Mutual Funds. Various types of funds are available for investments with each of these companies, including growth, growth and income, fixed income, money market, and balanced funds. More information on the wide variety of funds available for retirement contributions is in the publication Performance of Retirement Investment Alternatives. A copy of this publication is available in the Faculty and Staff Benefits Office.

PARTICIPATION & ELIGIBILITY

Faculty in eligible class codes may elect to join this plan.

VESTING

Vested means you are due a benefit when you retire or leave Georgetown University. You are vested immediately but will not have access to Defined Contribution Plan funds until after you terminate your employment.

ENROLLMENT

You must complete the appropriate contract or account application to enroll in the plan. If you are enrolling in TIAA-CREF, you must provide evidence of your date of birth.

CONTRIBUTION SCHEDULE

Contributions are expressed as a percentage of your salary and are made on a monthly basis while you participate, except for months in which no salary is paid. Your contributions to the plan are made on a before tax or salary reduction basis. By contributing on a salary reduction basis, you lower your current income by the amount you contribute. This means that you pay less in current income taxes. It is important to understand that you are deferring taxes. You will have to pay taxes on any income received from the plan when it is paid to you. Also see the section on Voluntary Retirement Contributions. For further information, contact the Faculty and Staff Benefits Office.

RECEIVING YOUR BENEFITS

Benefits are taxable when they are received. Please consult the Summary Plan Description booklet, or contact a Retirement Specialist in the Faculty and Staff Benefits Office for assistance with understanding your tax options and responsibilities.

An estimated 20% Federal Tax will be withheld from distributions when they are received. If your distribution is rolled directly into an IRA or another employer's plan, you can avoid the 20% withholding.

CONTINUATION OF HEALTH INSURANCE

An important aspect of retirement planning is the continuation of eligibility for health care benefits. Employees who are age 55 and have at least 10 years of continuous service at their termination date may continue their health insurance provided they elect to receive retirement distributions within 90 days following their termination date [35]. A retiree may also elect to continue coverage for their spouse and eligible dependents within 90 days following their termination date. Employees and retirees should contact the Faculty and Staff Benefits Office to determine the cost of this benefit.

VOLUNTARY CONTRIBUTION RETIREMENT PLAN

Voluntary retirement contributions are a way to increase your retirement security and defer taxes on your income. Contributions, which are made on a before tax (salary reduction) basis, lower your current taxable income. This means you pay less in current income taxes.

Contributions can be invested in a wide variety of funds offered by three companies: TIAA-CREF, Vanguard, and Fidelity. You can change your investment choices at any time. For a performance listing of the available funds, contact the Faculty and Staff Benefits Office at 202-687-3643. Or, visit the investment companies on the World Wide Web.

You may contribute as little as $25.00 per month, or as much as the Maximum Exclusion Allowance set out by the IRS.

The Internal Revenue Code limits the amount of pre-tax benefits you may have, including pre-tax retirement contributions in any calendar year. This amount is also affected by pre-tax health premiums and participation in the flexible spending account(s). The Faculty and Staff Benefits Office can assist you in determining the maximum tax deferred contribution you can make under IRS rules. It is your responsibility to remain within these limits and to pay any tax imposed if you exceed them.

When you enroll in the Plan, you should plan on making a long-term investment. Mutual funds may yield impressive gains over a long period of time. Under certain circumstances, loans are available against your contributions. Currently, loans are only available on voluntary contribution accounts with TIAA-CREF. For information, contact the Faculty and Staff Benefits Office at 202-687-3643.

Money deferred to the Voluntary Retirement Plan is not tax-free. You will have to pay taxes on any distribution received from the Plan. When you retire, you may take your benefit in a lump sum or an annuity. One of our Retirement Specialists can help you understand your options. While employed, you may only receive your money as a lump sum as a hardship withdrawal. Contact the Faculty and Staff Benefits Office for details.

More detailed information on the funds offered for tax deferred savings under this Plan is available from the Faculty and Staff Benefits Office.

U.S. SAVINGS BONDS

All employees receiving a Georgetown University paycheck on a regular basis are eligible to participate in this plan. As a participant, you may purchase one series EE savings bond per month through a payroll deduction.

WHEN YOU MAY ENROLL

You may begin purchasing bonds at any time. You will have to provide the Faculty and Staff Benefits Office with: your name and address, the name and Social Security number of your co-owner or beneficiary, and which denomination you wish to purchase. A co-owner has the same rights as you do, including cashing the bonds. A beneficiary becomes the owner of the bonds only at your death.

INTEREST EARNINGS

The interest rate on Series EE Savings bonds is market based. This rate is 85% of the market average on 5 year Treasury securities during the previous 5 year period. The interest rate is recalculated on May 1st and November 1st of each year. Series EE US Savings bonds have a current minimum rate. If your bonds are less than 5 years old when you cash them in, you will receive 4% minimum interest. If your bonds are held five years or longer before you cash them in, you will receive the market based rate if it is greater than 4%.

COST OF PLAN

You may buy one bond per month in one of the following denominations: $100, $200, $500, and $1,000. Bonds cost one half of the bond denomination amount.

HEALTH PLANS

The University offers two options for coverage, the Georgetown Health Plan and Kaiser Permanente Health Maintenance Organization.

NEW DEPENDENTS

If you get married or have a child, you have 90 days after the marriage or birth to enroll your dependents for coverage. If you do not enroll yourself or your dependents when first eligible for coverage, you must wait until the next open enrollment period.

LOSS OF COVERAGE

An exception is made if you are covered by your spouse's plan and that plan terminates due to your spouse terminating employment or becoming ineligible to be covered under that Plan. In this case, you are eligible upon cancellation of that coverage. You must apply within 90 days of the event and coverage must be effective from the cancellation of the other coverage. Written documentation of loss of coverage must be provided.

GEORGETOWN HEALTH PLAN

The plan gives you flexibility in choosing health care services. There are three options available. You select the option you want when you need service. You may select individual coverage for yourself, or family coverage to include your legal spouse, children under age 19, children up to age 30 if they are full-time students, and children who are mentally incapable of self care and are age 19 or older (with proof of disability).

Option 1:

Your Network Primary Care Physician provides and/or arranges for the provision of your health care.

Option 2:

You call a Network Specialist or Designated Provider, without being referred by your Network Primary Care Physician.

Option 3:

You call a physician or other Designated Provider who is not a Network member. You are responsible for any amounts in excess of the network fee schedule that are charged by an out-of-network provider.

To be eligible for all the advantages of the Georgetown Health Plan, each member of your family is strongly encouraged to select a Primary Care Physician. Primary Care Physicians include Internists, Family Practice Physicians and Pediatricians. Females age 16 and over may also select an Obstetrician/Gynecologist for routine OB/GYN care. To select a Primary Care Physician (PCP) or Obstetrician/Gynecologist refer to the Georgetown Health Plan Provider Directory.

The Plan is associated with several hospitals in the Washington Metropolitan and Baltimore area, including Georgetown University Hospital, George Washington University Medical Center, Greater South East Community Hospital and Providence Hospital in Washington, DC; Holy Cross Hospital, P.G. General Hospital, Shady Grove Hospital and Washington Adventist Hospital in Maryland; Arlington Hospital, Fair Oaks Hospital, Fairfax Hospital, Potomac Hospital and Prince William Hospital in Virginia.

PRESCRIPTION DRUG PLAN

Participants in the Georgetown Health Plan automatically participate in the prescription drug plan administered by PCS Health Systems, Inc. The plan provides a separate card just for prescription drugs, which you can present at participating drug stores for prescriptions along with a small copay. The plan features a mail-order option for maintenance drugs. You can receive a 90 day supply of your medication for a small copay.

MENTAL HEALTH/SUBSTANCE ABUSE

The Plan provides inpatient, intermediate and outpatient care with in-network and out-of-network providers.

DENTAL PLANS

The University offers three options for dental insurance, two through Blue Cross/Blue Shield and the Prudential DMO. You may select individual coverage for yourself, or family coverage to include your legal spouse, children under age 19, children up to age 30 if they are full-time students, and children who are mentally incapable of self care and are age 19 or older (with proof of disability).

BLUE CROSS/BLUE SHIELD DENTAL INSURANCE

You may select from two levels of coverage. You must select an option when you enroll in the Blue Cross/Blue Shield Dental Plan.

The annual deductible for Option I and Option II:

$50 for single coverage
$100 for family coverage

OPTION I PAYS:

100% of the Usual and Customary or Reasonable (UCR) fee after the deductible per calendar year for the following services: cleaning, examination, emergency treatment, simple extractions, fillings, x-rays, consultations and recomendations, topical fluoride treatments, repair or removable dentures, endodontia, crowns and simple procedures of oral surgery. The maximum annual benefit is $1,000 per participant.

OPTION II PAYS:

75% of the Usual and Customary or Reasonable (UCR) fee after the deductible per calendar year for the services listed above, plus: complex procedures of oral surgery, fixed bridges, removable dentures, relining of dentures, periodontia; orthodontia. The maximum annual benefit is $1,000 per participant, with a separate $1,000 lifetime maximum for orthodontia.

PRE-EXISTING CONDITIONS

A pre-existing condition is any condition which existed on the date coverage became effective requiring dental treatment, the symptoms of which were present on or before the effective date of coverage, whether or not the participant had knowledge that the symptoms were related to the illness, or any illness for which dental treatment or advice has been rendered within one year prior to the date of which coverage became effective requiring dental care or treatment.

PRE-EXISTING CONDITION EXCLUSIONS

If you do not enroll yourself or your dependents in Blue Cross/Blue Shield when first eligible for coverage, you must wait until the Open Enrollment period to enroll. If you enroll during Open Enrollment, you will have a 10 month waiting period during which benefits are not available for pre-existing conditions. During this time, preventive care (routine cleanings, examinations and x-rays) and dental care needed as a result of an accidental injury are covered. Additionally, the 10 month waiting period applies to dental coverage levels 5 to 8 if you change from Option I to Option II, or the Prudential DMO to Blue Cross Option I or II during Open Enrollment, or if you cancel your coverage with Georgetown University and subsequently re-enroll.

PRUDENTIAL DMO

The Prudential Dental Maintenance Organization (DMO) is a managed care program offering a network of area dentists. If you enroll in the Prudential DMO, you must select a dentist from their network for all of your dental care. The DMO offers 100% coverage for all preventive care and most other services, with a $10 copay per visit. There is no deductible and no annual maximum on benefits.

Orthodontia for eligible participants is covered at 50%. Orthodontia benefits through Prudential are only available for dependent children up to age 19.

FLEXIBLE BENEFITS

The flexible benefit program provides three options for increasing your tax savings. The options are:

Pre-tax Health and Dental Contributions
Health Care Spending Account
Dependent Care Assistance Plan

PRE-TAX HEALTH & DENTAL PREMIUM CONTRIBUTIONS

You may elect to make your health and dental contributions on a tax-exempt basis. This means that contributions for health and dental insurance are deducted from your paycheck before federal, state and Social Security taxes are withheld. These contributions are not included as taxable income on your W-2 form. To elect to have your premiums deducted on a pre-tax basis, check the appropriate space on your health or dental enrollment form.

FLEXIBLE SPENDING ACCOUNTS

By participating in the Flexible Spending Account Plans, you can pay certain health care and/or dependent care expenses with pre-tax money. You designate part of your paycheck to be contributed to your account(s). Contributions are deducted from your paycheck, and your gross taxable pay is reduced by the amount you put into the account(s). Once you make an election in one calendar year, it can only be changed or stopped if you have a change in personal circumstances, such as marriage, divorce, or the birth of a child.

PARTICIPATION

There are two Flexible Spending Accounts: the Health Care Spending Account and the Dependent Care Assistance Plan. Participation in the Health Care Spending Account and Dependent Care Assistance Plan starts on the first day of the month following enrollment, provided you have completed the Enrollment Form(s) and filed it with the Faculty and Staff Benefits Office by the last day of the month following your month of employment. An exception is made under the Dependent Care Assistance Plan when you gain a dependent through birth, adoption or marriage. You must notify the Faculty and Staff Benefits Office and enroll in the Plan within 90 days of acquiring a dependent.

HEALTH CARE SPENDING ACCOUNT

Funds are automatically deducted from your paycheck on a pre-tax basis and are held in your individual account until you submit a claim for un-reimbursed medical expenses. For instance, you can use the Health Care Spending Account for reimbursement of your Georgetown Health Plan deductible and the 20% of covered expenses you have to pay, to an annual maximum of $5,000. In addition, you can receive reimbursement for expenses that are not covered under the health plan, such as eyeglasses, charges over the UCR amount, and dental charges not covered under the GU dental plan.

DEPENDENT CARE ASSISTANCE PLAN

If you have day care expenses for your children or elderly dependents, the Dependent Care Assistance Plan may help you reduce your tax bill. It enables you to pay for certain dependent care expenses with tax-free dollars, which gives you tax savings. You decide how much you wish to contribute per year based on your actual child care or elder care expenses. Once you have designated a contribution amount, the amount is automatically deducted from your paychecks throughout the year on a pre-tax basis. The maximum contribution per year is $5,000. The maximum applies to all eligible dependent care expenses, whether for child care or elder care. The contribution is put in an account in your name.

ANNUAL RE-ENROLLMENT

During Open Enrollment in November, you must re-enroll if you wish to participate in the Flexible Spending Account(s) for the next calendar year.

FILING CLAIMS

You complete a claim form for health and dental expenses, or paid dependent care bills and submit it to the carrier for reimbursement from your account. You must provide receipts, bills that indicate the services rendered, the dates you incurred expenses and the name of the service provider. For dependent care expenses, you must also provide the social security number or tax identification number of the person or organization who provided the care. You have until March 31 of the next year to submit claims for expenses from the plan year.

VISION CARE PLAN

You and your dependents will receive significant discounts when you purchase lenses and frames at area LensCrafters stores.

There are no enrollment forms to fill out, and no restrictions on how often you use the discount. This benefit is automatically extended to you at no cost. The Vision Care benefit with LensCrafters is fully funded by the University. For information on the LensCrafters nearest you, call 1-800-521-3606.

LEAVE OF ABSENCE

If you go on an approved Leave of Absence, through LTD, Worker's Compensation, or Family Care Leave, you are eligible to continue your benefits while on leave. Contact the Faculty and Staff Benefits Office for your rates.

TERMINATION OR INELIGIBILITY

If you terminate employment or transfer to an ineligible group, you may continue participation in the life, dependent life, LTD, health and dental plans through the end of the month in which you terminate employment or change to an ineligible status.

HEALTH AND DENTAL INSURANCE

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) entitles employees (or former employees) and/or their dependents who have lost group health and/or dental coverage to continue the coverage they had with the Georgetown University group on a direct pay basis under certain circumstances.

WHO IS ELIGIBLE FOR COBRA

Employees who terminate employment, change to working less than 30 hours per week, or who otherwise lose group coverage as a result of a qualifying event may continue coverage up to 18 months. These employees are notified of their COBRA rights by ABR, the COBRA carrier. This 18 month period may be extended to 29 months if the employee was disabled at the time of the qualifying event. Disabled employees should contact the GU Faculty and Staff Benefits Office for more detailed information.

Spouses and dependents of employees who lose coverage because of age, divorce or legal separation may continue coverage for up to 36 months. These individuals must notify the Faculty and Staff Benefits Office of such event in order to be certified eligible for COBRA continuation.

HOW TO EXERCISE COBRA RIGHTS

ABR, the carrier will send you a COBRA letter. You have 60 days from the date of the COBRA letter to elect to continue coverage. You must complete the COBRA letter and send it to ABR. If you do not exercise your COBRA rights within the allowed time period or fail to make the required premium payment as scheduled, you will forfeit your right to continue coverage.

COST OF CONTINUED COVERAGE UNDER COBRA

The premium is 102% of the gross monthly contribution in effect at the time of the COBRA qualifying event for the type of coverage purchased. This means you are responsible for the employee portion and the University portion of the premium plus 2% over the total cost.

LIFE INSURANCE

You may convert your group life and dependent life insurance coverage to an individual pay policy with CIGNA, the Life Insurance carrier. Upon termination, the Faculty and Staff Benefits Office will send you a Notice of Life Insurance Conversion Privilege & Verification of Eligibility letter and an application. You have 60 days from the date your coverage ends to elect continued coverage. Such election is accomplished by signing and completing the Notice and application and sending both forms to the Faculty and Staff Benefits Office. When we return the application to you, you must forward it with a check to CIGNA. If you do not exercise your conversion rights within 60 days of the date your coverage ends, you will forfeit your right to continued coverage.

LONG TERM DISABILITY

There is a limited conversion option to an individual insurance policy with UNUM, the LTD carrier. Application for conversion must be submitted to UNUM within 60 days after group coverage stops for the employee to be eligible for conversion without evidence of good health. Upon termination, the Faculty and Staff Benefits Office will send you a Long Term Disability Conversion Privilege and Verification of Eligibility letter. To continue coverage, you must sign and return this letter to the Faculty and Staff Benefits Office. We will send you a Disability Conversion Insurance Application for completion. Once you complete the application, you must forward it to UNUM for approval of continued coverage.

SOCIAL SECURITY

All employees participate in the Social Security program. Social Security provides retirement income, disability income, and Medicare health insurance benefits.

PLAN CHANGES/MODIFICATIONS

This office publishes a summary plan description on each University sponsored benefit plan. Information in this bulletin is subject to change. When plan provisions or contribution rates change, we attempt to notify each affected employee. If a conflict arises between this document and the various plans, the master policy or plan document will take precedence. The master policy or plan document may be examined in the Faculty and Staff Benefits Office. Georgetown University intends to continue its benefit program indefinitely, but reserves the right to modify, suspend or terminate the program, or any part of it, at any time. If such steps are planned, you will receive advance notice which will inform you of the effect that any change will have on your benefits.

TUITION SCHOLARSHIPS

Tuition benefits for study at Georgetown University and other institutions are available for full-time faculty members and academic personnel, and their dependent children, who meet eligibility requirements based on years of continuous full-time employment.

Benefits for Courses Taken in Degree Programs at Georgetown University

The benefit is awarded for pursuit of regular degree programs at the University. Documentation indicating acceptance in the degree program must be submitted with the application for benefits.
Failure to comply with academic regulations of the University is sufficient cause for the termination of the benefit.
In no case will the benefits exceed eight semesters.
Benefits are for tuition only. All other fees must be paid in the semester in which they are incurred.
After the 3 year waiting period, faculty members and academic staff will be eligible for tuition benefits for themselves and their dependent children equal to 33% of Georgetown's tuition; after 5 years, the benefit increases to 67% of Georgetown's tuition. The tuition benefit for dependent children is only available to those individuals enrolled in an undergraduate degree program. [36]

Within the conditions listed above, the following benefits are available:

a. For Faculty Members and Other Academic Personnel:

Tuition benefits for courses toward a degree in all schools of the University. Faculty may use tuition benefits only to pursue a graduate degree. Benefits may not exceed eight semesters.

b. For Children of a Retired or Deceased Faculty Member:

For children of a retired or deceased faculty member who, at the time of retirement or death, had been a full-time faculty member of more than ten years active service, including sabbatical leaves but not other leaves of absence, the same tuition benefits arrangement will apply.

For children of a retired or deceased faculty member who, at the time of retirement or death, had been a full-time faculty member of more than three years but less than ten years active service, provided the child has already begun and is enrolled in a degree program, the same tuition benefits will apply.

Notes:

These benefits may be applied to Georgetown University study abroad programs.
Unofficial Audits: Full-time faculty members and academic personnel may audit courses unofficially with the permission of the instructor on a space available basis; no other permission is required; no credit certificate is issued and no official record of the audit is kept.

Faculty and academic personnel should call the Faculty and Staff Benefits Office for more information about eligibility for benefits for summer course work or for dependents over 30 years of age.

Benefits for Courses Taken in Degree Programs Outside Georgetown University

Academic personnel:

Full-time faculty and academic staff are eligible for tuition benefits for their own use outside of Georgetown University. Georgetown will award limited benefits, with a lifetime maximum cap on benefits. These benefits are available to academic personnel accepted into an undergraduate or graduate degree program, and to faculty accepted into a graduate degree program.

After the three year waiting period, dependent children of full-time faculty members and academic staff are eligible to receive up to 16.5% of Georgetown's undergraduate tuition for an undergraduate degree at another university. After five years, up to 33% of Georgetown's undergraduate tuition will be available.

For full-time faculty and academic staff hired prior to 1996, this benefit is 30% of Georgetown's undergraduate tuition for an undergraduate degree at another university in AY 1999-2000, and 33% thereafter.

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Faculty Handbook