Frequently Asked Benefit Questions
What To Do When ...
Frequently Asked Questions
What To Do When ...
- You will incur an increase in medical related payroll deductions retro to the effective date of the change, if the addition changes your status to "two person" or "family" coverage your biweekly medical insurance premium.
- You may name "My Children" as your beneficiary to cover any current children or future additions to your family.
- The original life insurance beneficiary designation becomes void after a divorce under Michigan law.
- If this changes your coverage from family to two person or from two person to single, then you will see a reduction in your premium on your future check.
Frequently Asked Questions
When can I change from one medical plan to another?
You may change your medical plan election during Open Enrollment or within 30 days of a Section 125 Qualifying event..
When will I receive a medical plan identification card?
After you have completed the medical plan enrollment process with the Total Compensation and Wellness Office (TCW). You should expect to receive your card approximately three weeks after you enroll.
Who is our Dental benefit vendor?
The Delta Dental Plan of Michigan. Delta Dental provides in-network coverage through DeltaPremier. You can find an in-network dentist online at www.toolkitsonline.com.
Will I receive a dental plan card in the mail?
No, dental plan cards are not required for services and are not mailed to subscribers. However, if you prefer to have a dental card for services, you can print one on Delta Dental's web site at www.toolkitsonline.com.
How many routine cleanings are we eligible for in a plan year?
Each enrolled member and their dependents may have two regular cleanings and exams in the plan year. Two additional cleanings will be covered when medically necessary per benefit year for individuals with at-risk conditions such as documented periodontal disease, diabetes, kidney failure, organ or bone marrow transplant recipient, and for individuals receiving dialysis, chemotherapy, radiation treatment, or are HIV positive.)
How are other services paid?
Coverage is dependent on the service provider and what dental service is required by the patient. Please refer to the Dental Plan Benefits Summary and the Dental Plan Summary Plan Description for details.
Who is our Vision Plan Vendor?
EyeMed is The Wayne State University's Vision Plan vendor. The eyemedvisioncare.com web site offers members the opportunity to manage their vision plan benefit through a secure, online account. Members may view vision benefit eligibility for the current plan year, locate network eye doctors and view their member history. You can create your account at www.enrollwitheyemed.com. Click "Member" Follow the on-screen prompts to complete your registration.
Will I receive a vision plan card?
You will not receive a vision plan card in the mail. Tell your provider that you have the EyeMed vision.
Who will have access to my online account?
The primary cardholder is responsible for managing the account for him/her as well as for all covered dependents.
What is a Flexible Spending Account?
A flexible spending account allows you to reimburse yourself (with your own money) for eligible Health Care and/or Dependent Care expenses - tax free. By participating in these accounts, you do not pay federal, state, or city taxes on the money you contribute. Participation is voluntary and employees must sign up during open enrollment or within 31 days of hire.
There are two types of Flexible Spending Accounts you may elect:
Health Care Reimbursement Account (HCRA) – used to reimburse you for out-of-pocket health care expenses not covered under your health insurance plan, including prescription medications for you and your eligible dependents. For a full listing of HCRA eligible expenses, please read IRS Publication 503.
Dependent Care Reimbursement Account (DCRA) – used to reimburse you for out-of pocket expenses for dependent care expenses, whether for a child, a spouse or dependent who is not physically or mentally able to care for themselves, or an elder. This includes expenses for someone else to care for your dependent (under the age of 13 for dependent children) so you may work.
Examples of potentially eligible DCRA expenses include:
- Daycare services
- In-home care
- Nursery and preschool and
- Summer day camps
For a full listing of DCRA eligible expenses, please read IRS Publication 503.
How can I view information on my Flexible Spending Account(s)?
You can view your account balance, claims amounts processed and paid for the current and past plan years at FSA Online.
Can I transfer money from one account to another?
No, you cannot use funds from one account to pay for expenses that apply to the other account.
Can I make changes to the amount of money initially elected?
Changes may only be made if there is a qualifying event. A qualifying event includes marriage, divorce or legal separation, the birth or adoption of a child; a dependent's death, and any changes to your spouse's employment status that results in a loss of benefits coverage. You have 30 days from the date of a qualified status change to make a change to your FSA account.
What happens if I have money left in my FSA at the end of the plan year?
Any unused funds will be forfeited per Internal Revenue Service (IRS) guidelines. The IRS requires that these unused dollars be forfeited as a condition of offering spending accounts. That is why it is very important to plan conservatively.
If you do not apply for reimbursement of your FSA account by April 30 for your previous plan year's dollars, you lose the total amount left in your account.
When are my funds available for reimbursement for my eligible expenses?
Health Care Reimbursement Account (HCRA):
Once you enroll in a Health Care Reimbursement Account, your total pledge is available to you for reimbursement of eligible health care expenses, including prescription medication incurred after the effective date of coverage. You do not have to wait for the contributions to accumulate in your HCRA. You can use it to pay for your eligible health care expenses from your first date enrolled in the account.
Dependent Care Reimbursement Account (DCRA):
Once you enroll in the Dependent Care Reimbursement Account, the funds available to you for reimbursement depend on the actual funds in your account. Unlike the Health Care Reimbursement Account, the entire maximum annual amount is not available during the plan year, but rather after your payroll deductions are made. You must incur services before submitting for reimbursement.
What are important deadlines that I must follow if I am going to participate in a FSA?
Payroll Contribution Period: January 1 – December 31, a 12-month period to make pre-tax payroll contributions
Health Care Account Incurred Expense Period: January 1 – March 15, a 14-1/2 month claim period to incur expenses (excludes DCRA)
Reimbursement Period: January 1 – April 30, a 16-month period to request payment for eligible expenses
All reimbursement requests for the plan year ending at the end of the incurred expense period must be received by April 30 in the Office of Human Resources. Requests received after this date will not be processed and any remaining funds in your account will be forfeited.
How does the extended incurred expense period work?
Claims with dates of service between January 1 and December 31 will be paid using available FSA funds for that plan year.
HCRA Claims with dates of service between January 1 and March 15 of the following calendar year:
– If the claim is incurred in this time period any remaining current plan year FSA funds will be applied to the claim. Once the current plan year funds are exhausted, then the claim will be applied to next plan year funds.
– You will not have to request that current plan year funds be used. If there is a remaining balance and the claim is incurred January 1 – March 15 then the current balance will be used first.
HCRA claims with dates of service after March 15 will be reimbursed from the next plan year FSA funds, if you re-enrolled during the open enrollment period.
How do I submit my expenses for reimbursement?
You will need to complete the FSA Dependent Care Request form for Reimbursement or the FSA Health Care Request form for Reimbursements and provide itemized documentation and receipts of your expense(s).
How is a life insurance claim filed?
Notify TC&W and complete a Beneficiary Statement.
How do I apply for Group Term Life Insurance (GTLI)?
No application is required for enrollment in WSU GTLI; however, you must designate your beneficiary.
How will the GTLI benefit affect my taxes?
Under section 79 of the Internal Revenue Code, the university is required to report the imputed cost of any employer-provided life insurance benefit that exceeds $50,000. Consult your tax advisor for more information.
How do I change my GTLI beneficiary designation?
You may change your beneficiaries anytime by updating the Beneficiary section of the Life Enrollment/Change form.
How can I request coverage for Dependent Group Term Life Insurance (DGTLI)?
You may request coverage at anytime. Coverage may be subject to Evidence of Insurability (EOI) and is effective upon approval by Standard Insurance.
How do I continue my benefits while on a leave?
To continue your benefits while on a leave of absence, either paid or unpaid, you should review the Leave of Absence web page and complete the Benefit Continuation on Unpaid Leave form and return it to TCW.