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>>  Flexible Benefits Program
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  Health Care Insurance

Excerpt from: University of Delaware Policies and Procedures Manual, Section: Personnel

If you choose University medical coverage, you have several level of coverage to choose from:

* Employee only
* Employee and spouse
* Employee and dependent children
* Family
* Waive

The Program
The University provides medical-surgical/health care insurance programs through Blue Cross & Blue Shield of Delaware and Aetna. Full-time and part-time employees, as well as visiting faculty and visiting professional personnel classifications are eligible to participate. (See "Costs" section below.)

When to Apply
Employees must apply for coverage within thirty days of employment, and the benefit goes into effect the first of the following month. If employees do not enroll during the first thirty days of employment, they must wait for the annual enrollment in the month of May to apply for coverage which will be effective July 1.
Exception: You may change your level of coverage upon a "life event" such as marriage, divorce, birth of child, death of spouse.

Costs
The University funds the major portion of health insurance premiums for eligible employees. The cost to each employee depends upon the plan selected and the percentage of time worked. The University contribution is equivelent to the Basic Plan premium (First State Basic Plan premium - Effective July 1, 2007). Should a full-time employee select a basic plan--either Individual Only, Individual & Child, Individual & Spouse or Family--there is no cost. If a higher level of coverage is chosen, the employee pays the difference between the basic plan and the option selected.

Employees with work schedules between 75%-100% time receive a full University contribution. Part-time employees who work less than 75% time (and 50% or more) receive 60% of the University contribution for full-time employees.

Note: Full-time employees whose spouses also work in a full-time capacity for the University of Delaware or the State of Delaware receive University funding in UDollars equal to the total cost of coverage selected. Full funding also applies if spouses have retired from full-time employment from either the State or the University of Delaware.

Options
Insurance options include two traditional plans and two HMO plans. HMO (Health Maintenance plans) differ from traditional plans. These plans require primary care physicians who direct your health care services. In addition, you must obtain all services and supplies from pre-approved health care providers.
See the Comparison of University Health Care Plans for more detailed information on each plan.


Spousal Coordination
All medical plans have a coordination of benefits requirement if your spouse works full-time, is eligible for medical coverage through his/her employer, and does not pay more than 50% of the premium for the lowest benefit plan available (flexible benefits and credits apply towards employer's contribution).

If your spouse is eligible and does not enroll in his/her employer's medical plan, the University coverage will pay only 20% of the eligible expenses normally covered.

Note: If a spouse obtains medical coverage through his/her employer, you may either continue or cancel University coverage for your spouse. You must notify the Office of Human Resources by completion of a Family and Benefit Status Change Form within 30 days of the effective date of the spouse's coverage with his/her employer.

Spousal Coordination does not apply to:
  • Spouses not working full-time
  • Spouses whose employers do not offer medical coverage
  • Spouses whose employers require a contribution of more than 50% of the premium for the lowest benefit plan available
  • Eligible dependent children
For more information, view the Spousal Coordination of Benefits Policy.

Upon Separation
Should an employee separate from the University, he or she may continue membership by paying premiums directly to the Insurance Carrier (under COBRA regulations) or by transferring coverage to another employer.

For more information:
 
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