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April 21, 2014
Welcome to the April 21th, 2014 edition of HR & Benefit News. After reading these articles, please let us know if you have any questions. Always feel free to send us your comments and questions for future publications.
OEB Administrative Manual Policies
The following policies have been revised and posted in the OEB Administrative Manual on the public OEB website's Forms & Publications page. The highlighted versions showing changes are available on the secure SharePoint website .
- Policy 130 - OEB Terms and Definitions
- Policy 140 - Funding for Group Insurance Coverage
- Policy 141 - Waiting Period for Group Insurance Benefits
Please contact a member of the OEB Benefits Team if you have any questions.
Determine Eligibility for UT Benefits as a Retired Employee
A new interactive tool has been posted to the OEB website to help participants determine if they may be eligible for the University of Texas Group Insurance program as a Retired Employee of a UT System Institution. This tool is a great starting point for anyone who has already retired, is thinking about retiring, or is still an active UT employee who is curious to see where they stand. Using this tool is as simple as answering a few questions. You can access this tool by clicking either the appropriate banner or the 'Getting Ready to Retire' link under 'Insurance Benefits' on the OEB website homepage.
Determine eligibility under varying scenarios by clicking the yellow 'Return to Start' button at any time. A short audio introduction explains how to use the tool and reminds participants that retirement from TRS or under ORP is also a requirement for eligibility for UT Benefits. You will find the tool on the Benefits for Retirees page of the OEB website. Click here to try the tool out for yourself!
What is the Employee Assistance Program (EAP)?
Help your employees learn more about the important resource available through the EAP by directing them to this quick introductory video, a new resource from the cooperative efforts of the wellness and training teams. Please share the below content with your members via email, Human Resource/Benefit website, during new hire orientation or any other communication tools used to reach your members.
Calculation of Creditable Service for UT Group Insurance as a Retired Employee
Question: Are you calculating Creditable Service correctly? What is the correct methodology that a UT institution Benefits Office should use to determine when an individual meets the eligibility requirements for UT group insurance as a Retired Employee?
Here is the language from the governing statute for the UT Uniform Group Insurance Program (Chapter 1601.102(c), Texas Insurance Code):
(c) An individual retiring in the manner described by Subsection (b)(3)(C) is a retired employee only if the individual meets all applicable requirements for retirement, including service and age requirements, adopted by the system comparable to the requirements for retirement under the Teachers Retirement System of Texas .
Therefore, to qualify for a year of creditable service, the Employee must be employed in a benefits-eligible position during the fiscal year (September - August) for at least 4 1/2 months or as determined by TRS.
There are exceptions to these general TRS requirements, including minimum number of work days during the Employee’s last year of employment and a waiting period prior to beginning TRS contributions when employment began in certain previous years (FY 2003-2005). Therefore, you should request that the active or former Employee provide you with a statement from TRS to verify that he/she has a sufficient number of years of UT service credit to be eligible for the UT group insurance program as a Retired Employee. We recommend that you contact TRS if you have any questions about the information on the statement.
The following are good sources from the TRS website to assist you:
Here is an example of an Employee who qualifies for enrollment in the UT group insurance program as a Retired Employee using the TRS calculation methodology but would not qualify using the actual number of months:
- An individual is hired in a benefits-eligible position at UT System Administration on March 1, 2007 at age 56. On November 1, 2015, she celebrates her 65th birthday. In December 2015, she informs her institution HR Office that she is retiring from TRS on January 31, 2016. Since she was hired after 8/31/2003, she must have at least 10 years of creditable service with a UT institution and be age 65, or meet the Rule of 80. Using the TRS calculation methodology, she worked more than 4 1/2 months in FY2007 (6 months) at the beginning of her employment and also more than 4 1/2 months in FY2016 (5 months) at the end of her employment. By allowing these two years, the total years for FY2007 - FY2016 adds up to 10 fiscal years of service credit. Since she is age 65 as of the retirement date, she is eligible for UT Retiree insurance, and the effective date will be February 1, 2016. If this individual’s UT service credit had been incorrectly calculated using the actual number of calendar years and months worked, it would have been only 8 years and 11 months, thus not qualifying for UT Retiree insurance.
We are in the process of revising Policy 220 (Retired Employee Eligibility and Enrollment) of the OEB Administrative Manual to add a new Section 2.4 to describe the correct methodology to be used to calculate a Retired Employee’s eligibility for the UT group insurance program. We will notify you when finalized and posted.
Waiting Period for New UT Retiree
Question: When does the waiting period apply for a newly eligible Retiree to enroll in the UT group insurance plan?
Answer: UT Institution - If the individual’s last place of state agency employment is a UT System institution, there is no waiting period for a newly eligible Retiree to enroll in the UT group insurance program as long as s/he is enrolling without a break in coverage between the last day of Active Employee coverage and the first day of Retiree coverage. However, if there is a break in coverage, a waiting period will apply for enrollment in UT SELECT Medical. The institution may not waive any portion of the waiting period for Retired Employees if there is a break in coverage. There is no waiting period for enrollment in eligible optional coverages.
ERS or Texas A&M - If this individual’s last employment and group insurance coverage was at an agency or higher education institution under the ERS or Texas A&M programs and the individual is not eligible to retire under one of these programs, there is no waiting period to enroll in the UT group insurance program as long as s/he is enrolling without a break in coverage. A new waiting period is not required because these are entities receiving state Premium Sharing monies to fund their employees’ medical coverage.
ISD - If this individual’s last employment and group insurance coverage was at a Texas public Independent School District (ISD) under TRS, a new waiting period will apply because an ISD is not considered a state entity and does not receive state Premium Sharing monies to fund any portion of their group insurance medical coverage.
Voluntary Group Term Life (VGTL) Coverage for Retiree's Spouse
The following issue was identified and resolved as a result of the EOI audit of the VGTL coverage discrepancies between OEB and Dearborn National files:
Question: When a UT Employee retires, can she enroll her spouse with VGTL coverage of $3,000 without Evidence of Insurability (EOI)?
Answer: A new UT Retired Employee may enroll her spouse in $3,000 VGTL without EOI if all of the following conditions are met:
- On her last day of active employment, she must have VGTL of at least 1X annual salary for herself and at least $10,000 of Dependent VGTL coverage; and
- There is no break between the last day of active coverage and the first day of retiree coverage.
If all of these conditions are not met, the Retired Employee must submit an EOI application to the Life carrier, Dearborn National, for the Spouse VGTL coverage.
Life and AD&D Options for a New Retiree When Spouse is a UT Employee
Question: Spouses (John and Mary) are both employed in benefits-eligible positions at a UT System institution. John has no Voluntary Group Term Life (VGTL) coverage, and Mary has 1X VGTL of $40,000 and also Dependent VGTL of $10,000. When John retires, can he enroll in $10,000 Retiree VGTL without EOI since he is currently being covered under Mary’s Dependent VGTL coverage?
Answer: As a new Retiree with no prior VGTL coverage as an Employee, EOI is required for John to enroll in any level of Retiree VGTL coverage. If John is approved through the EOI process, Mary must drop the Dependent VGTL coverage, unless she has other eligible Dependents. If John chooses not to apply or is not approved through the EOI process, then Mary may continue to cover him under her $10,000 Dependent VGTL coverage. Later when she retires, Mary may enroll John with the lower #3,000 Retiree Spouse coverage without EOI.
Question: In the above scenario, can Mary enroll John in Spouse Voluntary AD&D coverage when he retires?
Answer: Because John is not only a UT Retiree but also the spouse of a UT Employee (Mary), Mary may enroll John in Spouse Voluntary AD&D coverage up to 50% of the Voluntary AD&D coverage amount that she is carrying. John could not enroll in his own AD&D coverage upon his retirement because UT Retirees are not eligible for Basic or Voluntary AD&D coverage.