FAQ

Health Benefits

When can I make changes to my insurance plans?

Additions, changes, or cancellations of enrollment in pre-tax plans may be made during the annual open enrollment period held each fall, or within 31 days of a "Qualifying Status Change" (QSC) event. Examples of QSC events include: a change in employment status of participant or spouse (full-time to part-time, termination of employment), loss of insurance coverage, and a change in personal status (marriage, divorce, birth of child, etc.).

I've had a qualifying event. What do I need to do/what paperwork do I need to turn in?

Fill out the appropriate form (health/dental/vision), checking the box marked "qualifying status change" and add or drop the appropriate dependents. QSC's must be accompanied by documentation of the event (i.e. a marriage certificate for adding a new spouse, birth certificate for adding a new baby, etc). If you have further questions, contact Benefits at 386-822-7058 or email dvega@stetson.edu.

When is my deadline to enroll as a new hire?

You have 30 days from your hire date to enroll in benefits. After 30 days you will have to wait until the next open enrollment period to join.

When is my deadline to make a change in my benefits if I have had a qualifying event?

You have 31 days from the date of the event to make any changes, including added dependents.

My Effective date of coverage is 1/1/2013 and I need to see a doctor on 1/5/2013- what do I need to do?

Although your health insurance is in "effect" on the first, you may not receive your card from the company for up to 6-8 weeks. Until you receive your card, you may ask your doctor's office to delay billing, or you may pay out-of-pocket and file for reimbursement when your card arrives.

If I go on a leave of absence, what happens to my benefits?

The qualifying events pages gives detailed information on what will happen to your benefits if you take a leave of absence.

I'm leaving Stetson University, what do I need to do?

Contact Benefits at 386-822-7058 with any further questions.

How can I receive information on COBRA coverage?

Materials should be sent to you after you leave the university. Please contact Benefits at 386-822-7058.

How is health insurance coverage paid for?

Your health insurance premiums are deducted from your paycheck.

What dependents can be added to my insurance?

Your spouse and natural or adopted children are the only dependents eligible for coverage under your plan.

How long does it take for my pre-existing waiver to be approved/denied?

Pre-existing waiver decisions can take up to 31 days.

Supplemental Insurance

I called my health/dental/vision company and they are stating that I do not have coverage- what do I need to do?

If you have signed up for coverage within the last 4 weeks, the company may not have processed your information yet. If it has been more than four weeks, contact Benefits at 386-822-7058 or email dvega@stetson.edu so we may assist you.

Life Insurance

How much coverage is offered through basic state life insurance?

Basic state life insurance coverage will pay 1 times your salary in the event of your death.

How do I change my beneficiary?

Contact Benefits at 386-822-7058 or email dvega@stetson.edu so we may assist you.

What is Supplemental life insurance?

Stetson University offers you additional life insurance up to 5 times your salary in addition to basic life insurance. Optional life insurance may be elected as a new hire or during open enrollment each year.

Flexible Spending Accounts

How much can I contribute to my reimbursement accounts?

You may contribute up to $5000 per year each in your dependent day care account, and $2,500 in your medical reimbursement account.

How long does it take to for my claim to be filed for FSA's?

Once you send in your reimbursement claim, flexible spending account reimbursements can be expected from our Flex Administrator within 1-2 weeks.

Retirement

What retirement plans are available?

Eligibility for the Retirement Benefits is based on set criteria stated in our policies and procedures. Stetson University contributes five percent or ten percent of an employee's gross base salary to Teachers Insurance Annuity Association-College Retirement Equities Fund (TIAA-CREF) for all full-time employees. Upon notification of eligibility, employees must complete a TIAA-CREF application. A voluntary Supplemental Retirement Account (S.R.A.) is available immediately upon hire for those qualified employees through a salary reduction agreement.

What are the vesting requirements for the retirement plans offered by the university?

Employees are immediately vested and wholly own all contributions.

Can I stop my Pre-Tax contributions at any time or make adjustment at any time?

Yes. You do not have to wait for open enrollment to make changes to your 403(b). To make changes, you have to submit a completed Salary Reduction Agreement Form (S.R.A.).

What should I know about Social Security Benefits?

Social Security benefits are determined by wages reported each year for you. Benefits are calculated on the earnings a person receives during his/her lifetime. The higher the earnings and the number of years worked, the more the monthly benefit will be. Benefits are payable at full retirement age for anyone meeting the minimum criteria for social security credits (with reduced benefits available as early as age 62). A person qualifies for full retirement social security benefits at age 65 if he or she was born before 1938. For individuals born after that date, this qualification age gradually rises until it reaches 67 for persons born in 1960 or later. For more detailed information on social security benefits and eligibility, visit the Social Security Administration's website or call 1.800.772.1213. You may request an estimate of your Social Security benefits on-line at Social Security website.

What is Medicare and how do I enroll in the program?

In order to qualify for Medicare benefits, an individual must reach age 65 and enroll in the program. Medicare is comprised of two parts: Part A (hospitalization) and Part B (medical services). Generally, individuals turning age 65 who already receive social security benefits as well as those who have received social security disability benefits for two years automatically qualify for Medicare. Other individuals must file an application. Part A usually requires no premium, but Part B requires the individual to pay a monthly premium for coverage. If you already are receiving a monthly social security benefit, the Part B premium will be deducted from the monthly benefit each month. You may enroll in Part B without receiving a monthly social security benefit. However, the Social Security Administration will bill you for the premiums.

What happens to my Medicare options if I am 65 or older when I retire from the university?

When an employee retires from the university and either the subscriber or dependent are age 65 or older, Medicare becomes primary. This means the employee's state-sponsored insurance plan will become secondary to Medicare. If an employee has not enrolled in both parts of Medicare, it is important to do so at that time. Visit Medicare's website for more information on coverage, costs, and enrollment, or call 800-633-4227.

What benefits am I eligible to continue?

Employees should contact Benefits for premium costs, coverage and procedures to follow when retiring. Retirees are also eligible to keep their email accounts through the university and keep their library borrowing privileges.

Other Benefits

Employee Assistance Program

Will my supervisor know that I am using the EAP?

Not unless you tell him or her. The university does not receive information about specific employees who utilize the services of the EAP, only demographic information to assist in providing better services.

Do I have to pay for the EAP?

No. The EAP is a university-provided service to employees and their families.

How do I contact the EAP?

Call The Allen Group directly at 800-272-7252. You do not need permission from the university to contact the EAP.

Worker's Compensation

Can I choose my own doctor?

No. If you go to a doctor not authorized by your employer or the insurance carrier, you may be responsible for payment of your medical bills.

What should I do if I am injured in the course of my employment?

If you are injured in the course of your employment, you should report the injury to your supervisor immediately and complete an "Employee Accident Description Form" to be forwarded to the Office of Human Resources as soon as possible. Human Resources will set up a worker's compensation claim with the insurance carrier and assist you in getting authorized treatment with a worker's compensation-approved physician. If you require immediate emergency treatment, you may seek treatment at the Florida Hospital/West Volusia emergency room located in DeLand on Plymouth Avenue. Please notify the emergency room that it is worker's compensation and not health insurance. If you have any questions regarding worker's compensation, please call Terry Gordon at 386-822-7701 or tgordon@stetson.edu.

What if I work after normal office hours or during the weekend and have a worker's compensation injury?

If your injury requires immediate medical attention, you may seek treatment at the Florida Hospital/West Volusia emergency room located in DeLand on Plymouth Avenue. (Tell ER it is worker's compensation and not Health Ins.)Notify your supervisor and the HR Office as soon as possible so a claim can be set up with the worker's compensation insurance carrier.This will avoid billing problems.

If you don't require immediate treatment, you should notify your supervisor as soon as possible & complete an accident form. The HR office will set up a claim and assist you in obtaining authorized medical treatment if needed.

If I need treatment for a worker's compensation injury, can I go to any doctor?

Our worker's compensation insurance program provides us with a preferred medical network specifically developed for injured workers to address occupational injuries.Your HR office or your worker's compensation insurance provider will assist you in obtaining authorized treatment within the worker's compensation network.Seeking treatment with a physician that is not authorized could result in non-payment by the worker's compensation insurance company.

Who pays for my worker's compensation medical costs?

By state law, the Employer pays the premium for employees' worker's compensation insurance coverage.Our worker's compensation provider will pay for any authorized medical treatment or authorized prescriptions directly to the providers.

What if my worker's compensation doctor puts limits on my work duties?

Stetson University is committed to safety and to following an effective return to work program.The university will attempt to provide employees with modified work responsibilities based on the physician's recommendations.Those employees who return to work at modified duties typically do so at their full hourly wages.

What if my physician will not allow me to return to work?

If your worker's compensation physician does not allow you to return to work even at modified duty, after the first seven days missed, the worker's compensation insurance company will make payments directly to you for lost wages based on the current state statutes.This amount is typically approx. 66 2/3% of your average weekly wage.Since the first seven days of missed time are not initially paid by the insurance company, employees may use their sick or vacation time during this period.(Also see the university's policy on worker's compensation under Personnel Policies 4.12.1)

If I am out on worker's compensation for more than seven days, how will my other employee benefit plans get paid?

If you are out of work and receiving a check from the worker's compensation Insurance company instead of a paycheck, the university will not be able to obtain premiums via payroll deduction for your other benefit plans such as Health Insurance, Dental, etc.To avoid cancellation of those policies for non-payment, you should contact Human Resources to make alternative arrangements to pay for those plans. (Also see the university's policy on worker's compensation under Personnel Policies 4.12.1)

HR Benefit Payment Contact: Betty Whiteman: 822-8869

Can my employer terminate my employment if I am unable to work and am receiving workers' compensation benefits?

The law does not permit you to be fired in retaliation because you filed a claim, or attempted to file a worker's compensation claim.However, the workers' compensation law does not require your employer to hold your position while you are injured and unable to work.(Also see the policy on FMLA regarding this under Personnel Policies 4.8)

What can I do if there is suspected fraud involving workers' compensation?

Fraudulent claims contribute to the university's rising worker's compensation insurance costs which can trickle down and affect everyone's budget.Insurance fraud is a third degree felony that can result in fines, civil liability and jail time.The Dept. of Insurance has an anti-fraud program that rewards up to $25,000 to persons providing information that leads to the arrest and conviction of persons committing insurance fraud.If you suspect fraud, please notify the HR Department at 822-7701 and contact the Department of Insurance at: 800-378-0445.

What kinds of medical treatment can I get?

Medical treatment required as a result of your injury or illness must be provided by a health care provider approved by your employer or your employer's insurance carrier. Chiropractic visits may be limited. Surgery; hospital care; dental; prescription drugs; braces and crutches; and any other medical supplies ordered must be approved by your authorized treating physician.

How long after an accident do I have to report it to my supervisor?

You should report it as soon as possible but no later than thirty (30) days or your claim may be denied.

Per Florida Statute 440.185:

An employee who suffers an injury arising out of and in the course of employment shall advise his/her employer of the injury within 30 days after the date of or initial manifestation of the injury. Failure to so advise the employer shall bar a petition under the workers' compensation law, unless:

  • The employer or the employer's agent had actual knowledge of the injury;
  • The cause of the injury could not be identified without a medical opinion and the injured worker advised the employer within 30 days after obtaining a medical opinion indicating that the injury arose out of and in the course of employment;
  • The employer did not put its employees on notice of the requirements of the law by posting notice pursuant to Section 440.055, Florida Statutes.