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Employee Benefit Appointment Date: ________________________ Time: _______________________

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Contents

Subject Page Number

New Employee Checklist 3

CSU Health Plan Provisions 4

United Healthcare Medical Benefits Summary 6

United Healthcare Prescription Drug/ Optium Rx Benefit Summary 6

Prescription Drug Program Information 7

2014 Healthcare Rates 8

Medical Mutual of Ohio/ Vision Benefits Summary 9

Delta Dental of Ohio/ Dental Benefits Summary 10

Chard Snyder/ Flexible Spending Account 12

MetLife/ Group Life and Long Term Disability Insurance 13

Lincoln Financial Group/ Supplemental Life and Accident/ Critical Illness 14

Pension Plans- OPERS/ STRS/ Alternative Retirement Plans 15

Supplemental Retirement Plans- 403b Annuity/ 457 Deferred Compensation 16

Employee Assistance Program 17

Other Benefits 18

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New Employee Action Checklist

Please complete the following tasks within 15 days of your Date of Hire: Complete benefit enrollment paperwork Complete Online Sexual Harassment Training http://training.newmedialearning.com/psh/centralstateu/

Please complete the following tasks as soon as possible: Review CSU Policies and Procedures Review CSU Human Resources website

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Health Plan Provisions The following information relates to enrollment in the university’s medical, dental, and vision plans.

When can I enroll? You may enroll in benefits:

Within 31 days of employment in an eligible appointment

Within 31 days of a qualifying status change

During an annual open enrollment period You must contact the Human Resources department at 937-376-6540 to obtain the appropriate forms.

Whom can I enroll?

Spouse Your legal spouse

Children Your dependent children who have not reached the age limit of 26 (i.e. 26th birthday) and: • Are your biological children, legally

adopted children, stepchildren, children of your same-sex domestic partner, or children for whom you have legal guardianship, legal custody, or an interlocutory order of adoption; and

• Are not eligible to enroll in another employer-sponsored health plan (other than a parent’s plan) if age 19 or over.

Adult Dependent Child

Ages 26–28; eligible if specific criteria are met, as stated in the Dependent Eligibility Requirements online at: http://insurance.ohio.gov/consumer/pages/dependentagecoverageexpansion.aspx.

Coverage Levels • For medical, dental, and vision benefits,

you may choose from four coverage levels: – Employee only – Employee + children – Employee + spouse or partner – Family (employee + spouse or same-sex

domestic partner + one or more dependents)

Domestic Partnership (DP)

Your same-sex or opposite-sex domestic

partner who meets certain criteria as stated

on the required Affidavit of Domestic

Partnership for Health and Life Coverages is

eligible for coverage. You must contact the

Human Resources department at 937-376-

6540 to obtain the appropriate forms.

Ineligible Dependents

Dependents who do not meet the eligibility

requirements outlined in the Dependent

Eligibility Requirements.

When does my coverage begin? Your benefits will be effective on the date of

your eligible appointment or on the date of

your qualifying status change, if you enroll

within 31 days of the event.

When can I make a change to my

benefit coverage? If you experience a qualifying life event, you

have 31 days to make a change to your

benefit coverage. If you miss this deadline,

your next opportunity to change your

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benefit coverage will be during the next

annual open enrollment period.

What is considered a qualifying

life event? Because of federal restrictions, you are

prohibited from dropping, adding, or

changing health plan coverage levels during

the plan year unless a qualifying event

occurs. There are two types of qualifying

events: (1) family status changes and (2)

employment status changes.

Family Status Changes: marriage,

divorce, childbirth, adoption of a

child, death of a spouse/dependent,

or a dependent child reaching the

age limit

Employment Status Changes: the

full-time equivalency (FTE) of your

appointment with the university

changes; your appointment type

changes; or your spouse’s

employment changes and affects

benefit coverage

When a qualifying life event occurs, notify

Evelyn Gordon (937-376-6650) within 31

days to make enrollment changes to your

medical, dental, vision, or health care

flexible spending account.

Moving? Name change? You may update your name or home mailing address at any time by visiting https://www.centralstate.edu/faculty/hr/forms/coa2.php .

Is there a pre-existing condition clause? There is no pre-existing condition limitation applied to benefits when enrolling in the university’s medical, dental, or vision plans.

When does my coverage end? • You may cancel coverage during an annual

open enrollment period or by submitting the appropriate form within 31 days of a qualifying life event. Email Evelyn Adams Gordon at eadams@centralstate.edu for more information.

• Coverage will terminate for the following

covered person(s) when the following events occur: For the covered employee and

his/her dependents, when the employee terminates from the university or is transferred to an ineligible appointment. Coverage will cease on the last day of the pay period in which the employment status change occurs.

For the spouse of the covered employee, upon decree of divorce, dissolution, or legal separation. Coverage will cease on the event date. If appropriate, premiums will be changed the pay period following the event date.

For a dependent child, when the child no longer qualifies as a dependent. Coverage will cease on the event date. If appropriate, premiums will be changed the pay period following the event date.

For a covered dependent who is found to be ineligible through the Dependent Child Certification process.

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United Healthcare

Medical Benefit Summary

United Healthcare/ Optium Rx

Prescription Drug Benefit Summary

Tier Level Retail (31 Day Supply) Mail Order

Tier 1 $10 $20

Tier 2 $30 $60

Tier 3 $50 $100

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Prescription Drug Program

All of the University’s medical plans include

prescription drug benefits through United

Healthcare’s Optium Rx program.

Using This Benefit Optium Rx offers prescription drug benefits through home delivery mail-order service and nationwide retail pharmacy locations. There are three categories of prescription medications: Generic drugs (Tier 1) Generic drugs are federally controlled to meet the same standards of composition, safety, strength, purity, and quality as brand-name drugs. If you receive a generic drug, you will pay a lower amount than for a brand-name drug. Formulary (Tier 2) The medications on the formulary list are chosen based on comparative clinical effectiveness, safety profiles, and opportunities to help contain costs. Non-Formulary (Tier 3) Brand-name medications that are not part of

the formulary list are commonly considered

non-formulary because of safety and/or

efficacy concerns. Every therapeutic class of

drugs has either a generic or formulary

option available. When a new drug comes

onto the market, the Pharmacy and

Therapeutics Committee looks at the drug’s

safety and efficacy compared to similar

drugs already available.

Easy Ways to Reduce Your Prescription Drug Costs

Generic drugs are required by law to have the same active ingredients, dosage form, and strength as their brand-name equivalents, but they generally cost much less. The next time you receive a prescription, ask your doctor or pharmacist whether or not a generic alternative is available and if it would be appropriate for you. Mail Order Service Provides a convenient

and cost-effective way to order a 90-day

supply of medicine you take on a continuing

basis. Through this program, you can get

many of the same maintenance medications

that you have filled at a retail pharmacy

delivered right to your mailbox. Home

delivery can be used for a new maintenance

prescription or refills.

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2014 Healthcare Rates

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Medical Mutual of Ohio/ EyeMed Vision Plan

Vision coverage is available through the Medical Mutual SuperMed Vision EyeMed Access Network. The premium for vision coverage is included in your medical premium.

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Delta Dental of Ohio Dental Plan

The Dental Plan provides coverage for many of the dental services that you and your dependents may need.

Using This Benefit • The plan offers you a choice of network or

non-network coverage. – Delta Dental of Ohio provides network

coverage through Delta Dental PPO or Delta Premier. Search for a provider via http://www.deltadentaloh.com/Find-a-Dentist.aspx

• If you use a network provider:

– Tell the provider’s office that you are covered by Delta Dental when making an appointment, or at the time of service—there is no dental plan identification card.

– No claim forms are necessary for network dental services. Your dental provider should file claims directly with Delta Dental, although you may be required to pay for your portion of the expenses at the time of service.

• If you use a non-network provider:

– The plan pays less for covered services than it does when you utilize a network provider. – Your provider may require you to pay for services in full and be reimbursed from Delta Dental by filing a claim.

Predetermination of Expense Upon your request, Delta Dental will determine benefit coverage prior to your receiving dental service(s) if the course of treatment is expected to be $200 or more. You or your dentist can send a written description of the procedures and the dentist’s proposed charges to Delta Dental before treatment begins.

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Delta Dental Benefit Summary

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Chard Snyder Flexible Spending Account (FSA)

What is an FSA? An FSA allows you to pay for health care and/or dependent care expenses through pre-tax payroll deductions. When enrolling, you determine how much money you want to contribute to each account for the plan year. The money is then withheld from your pay before taxes are calculated. You will be reimbursed from the account as you incur expenses and submit claims for them. FSAs help you save money because they lower your taxable income. Without an FSA, you would still pay for health care and/or dependent care expenses, but you would use money remaining in your pay after taxes were withheld. You do not have to enroll in a medical plan to participate in an FSA. The IRS has placed an annual maximum of $2,500.00 that employees can contribute to the Flexible Spending Account for the 2014 plan year.

FSA Rules and Regulations • The IRS requires that all FSA purchases be verified as eligible expenses. Sometimes, purchases are automatically verified when you use your card. Other times, Chard Snyder will request itemized receipts. Always save your itemized receipts! • You must use all of your FSA funds by the end of your plan year or remaining funds will be forfeited, according to IRS regulations. Use the FSA calculator in this guide to estimate your expenses, so that you contribute the right amount. • The IRS also requires that employers make the full annual FSA election available to employees when an eligible expense occurs, regardless of whether you have deposited enough to cover the full amount at that point in time. For example, you may designate $1,000 per year, equal to a payroll deduction of $83.33 a month. You are eligible for reimbursement up to the full $1,000 in the first month, even though you have only deposited $83.33 in your account.

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MetLife Life/ Long Term Disability Insurance

Life Insurance Central State University offers life insurance to all Full-Time employees through MetLife. Coverage levels will vary depending on classification. Coverage begins 30 days after start date. The University picks up or shares the expense of this benefit with employees depending on their classification. Coverage levels are as listed below.

EMPLOYEE CLASSIFICATION COST TO EMPLOYEE COVERAGE LEVEL

Full-Time Bi-Weekly Employees Free to Employee $25,000.00 + AD&D

Full-Time CSUSA/Police Officers Free to Employee $35,000.00 + AD&D

Full-Time Faculty & Staff 75% of Premiums 2 x Base Salary + AD&D

If an employee wishes to purchase additional life insurance to supplement their university coverage or cover a spouse or dependent children, coverage is available through 5Star Life Insurance Company. Employees can enroll by contacting Evelyn Adams Gordon at eadams@centralstate.edu.

Long Term Disability All Full-Time Faculty and Staff Members are eligible to enroll in the Long Term Disability plan through MetLife. The plan will pay 60% of a member’s monthly salary beginning on the 91St day of work missed. The University shares the expense of this coverage with the employee for Contract and Staff members only.

EMPLOYEE CLASSIFICATION COST TO EMPLOYEE COVERAGE LEVEL

Full-Time Faculty & Staff 48% of Premiums 60% of monthly rate of pay

New employees may enroll in Long Term Disability coverage within 30 days of hire with no questions asked. However, if an employee wishes to enroll after the 30th day of employment, he or she will be required to submit a health questionnaire to MetLife, which they will review. They will then notify that employee in writing as to whether or not they have been enrolled into the program. Please contact Evelyn Adams Gordon at eadams@centralstate.edu for more information.

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Lincoln Financial Supplemental Life Insurance

Accident Insurance/Critical Illness Insurance

Beginning January 1, 2014, Central State University will be partnering with a new provider for Supplemental Life Insurance, as well as Accident/ Critical Illness Insurance: Lincoln Financial.

Please visit their website at https://www.lfg.com/LincolnPageServer?LFGPage=/lfg/lfgclient/index.html For more information.

NOTE: This does not in any way replace the group life insurance policy offered to eligible CSU

employees.

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Pension Plans- OPERS/ STRS/ Alternative Retirement

All Central State University employees are eligible to participate in a pension plan. An employee’s classification will determine which pension plan they are eligible to participate in. The University will

match contributions to all employee pension plans in accordance with the state mandated legislation, which varies between the individual classifications.

EMPLOYEE

CLASSIFICATION EMPLOYEE

CONTRIBUTION

UNIVERSITY MATCH RETIREMENT PLAN

All Bi- weekly

(Except FT Police Officers)

10% of employee’s

gross earnings before taxes

14% of employee’s

gross earnings before taxes OR

9.5% of employee’s gross earnings to ARP and 4.5% to OPERS.

Ohio Public Employees

Retirement System (OPERS) OR

Alternative Retirement Plan

All FT Police Officers

13.0 % of employee’s gross earnings before

taxes

18.1% of employee’s gross earnings before taxes

OR 9.5% of employee’s gross earnings

to ARP and 4.5% to OPERS.

Ohio Public Employees Retirement System Law

Enforcement (OPERS) OR

Alternative Retirement Plan

All Contract (Monthly) Staff

Employees

10% of employee’s gross earnings before

taxes

14% of employee’s gross earnings before

taxes OR 9.5% of employee’s gross earnings to ARP and 4.5% to OPERS.

Ohio Public Employees Retirement System (OPERS)

OR Alternative Retirement Plan

All Faculty Members

11.0% of employee’s gross earnings before taxes

14 % of employee’s gross earnings before taxes OR

9.5% of employee’s gross earnings

to ARP and 4.5% to STRS.

State Teachers Retirement System of Ohio OR Alternative Retirement Plan

Alternative Retirement vs. OPERS or STRSIf an eligible employee opts to enroll in the Alternative Retirement Program instead of STRS or OPERS they must make this election within 120 days of their initial hire date. Once an election to an ARP is made an employee may not return to STRS or OPERS.

With an OPERS/STRS election an employee will receive medical benefits at retirement age providing

they have worked the required period of creditable service at retirement. The ARP does not provide for medical coverage upon retirement.

Upon retirement through STRS or OPERS the employee will have a set monthly retirement benefit. With

the ARP the employee’s retirement benefit will be determined based upon the investment fund value.

Employee and employer contributions to the ARP are immediately 100% vested.

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Supplemental Retirement Plans- 403(b) Tax Sheltered Annuities and

& 457 Deferred Compensation Plans All employees are eligible to participate in any of the 403(b) or 457 plans. These are supplemental retirement plans that are set up in addition to an employee’s mandatory Pension Contribution. Monthly

contributions are deducted from the employee’s payroll on a pre-tax basis and distributed to the

company of their choice. At this time Central State University employees have the option to enroll in the 403(b) and 457 plans with the following companies. Employees may elect to enroll in more than one

company.

Company Monthly Contribution Enrollment Contact

ING No Minimum.

Maximum contribution per year: $17,000.00; $5,500.00 Age 50+ Catch- up Limit

Heather Ashmore

937-436-7475

TIAA- CREF No Minimum. Maximum contribution per year:

$17,000.00; $5,500.00 Age 50+ Catch- up

Limit

1-877-209-3138

Variable Annuity Life Insurance

Company (VALIC)

No Minimum.

Maximum contribution per year: $17,000.00; $5,500.00 Age 50+ Catch- up

Limit

Carrie Cummings 800-892-5558 x. 88823

AXA Equitable

No Minimum.

Maximum contribution per year: $17,000.00; $5,500.00 Age 50+ Catch- up Limit

Fred Fegan 513-207-3488

Ohio Public Employees Deferred

Compensation

No Minimum.

Maximum contribution per year:

$17,000.00; $5,500.00 Age 50+ Catch- up Limit

1-877-644-6457

ING Deferred Compensation

No Minimum.

Maximum contribution per year: $17,000.00; $5,500.00 Age 50+ Catch- up

Limit

Heather Ashmore

937-436-7475

VALIC Deferred Compensation

No Minimum.

Maximum contribution per year: $17,000.00; $5,500.00 Age 50+ Catch- up Limit

Carrie Cummings 800-892-5558 x. 88823

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Employee Assistance Program CSU is pleased to offer an Employee Assistance Program (EAP) from IMPACT Solutions. The IMPACT Employee Assistance (EAP) & Work/Life Program is a benefit available to you and your family offering access to confidential professional support 24 hours a day, 365 days a year. All IMPACT counselors are qualified masters/ doctoral level professionals. This program is available to you free of charge, courtesy of Central State University. Please visit the CSU HR Benefits webpage (http://www.centralstate.edu/faculty/hr/details.php?Benefits-1) and click on the IMPACT Solutions Benefits Summary, or visit the IMPACT Solutions website to gain access to the wealth of information available to CSU Employees and their families. TO LOGIN TO THE IMPACT SOLUTIONS WEBSITE:

Your Member Login: centralstate

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Other Benefits

Vacation Vacation accrual is based on the status and

position of each employee and will be explained individually to each new hire. Once each

employee has met their probationary period requirements they are then able to use vacation

according to the guidelines for their status and position.

Paid Holidays All employees are eligible for the paid holidays as

announced each calendar year by the

administration. If an employee is required to

work on a holiday, they will be paid in

accordance with the applicable union guidelines.

Employees are eligible for holiday pay from the

date of hire. The Paid Holidays are listed on the

CSU website at:

http://www.centralstate.edu/faculty/hr/details01.php?Paid-Holidays-10.

Personal Days (AFSCME Employees ONLY) Each CSU classified employee (AFSCME) is

granted 2 personal days, per calendar year, to use as they wish. These days must be scheduled

in advance through their immediate supervisor and are available after employment. Personal

Days must be used within the calendar year. They will not be carried over to the next calendar

year. Any unused personal days will not be paid

out upon termination or retirement.

Auto/ Home Insurance Plan Employees can take advantage of this comprehensive program from Liberty Mutual Insurance that features auto, home and personal insurance. This program provides an exclusive group discount and convenient payroll deduction payment options. For more information, please visit www.libertymutual.com/tgreenwalt, or call 937-438-1966 x53763.

Direct Deposit All permanent CSU employees may have their

payroll direct deposited to the bank or credit union of their choice. Each employee may have

up to 3 different individual deposits to either a checking or savings account. Direct Deposit

forms may be obtained from the Payroll Department. You should expect your first pay to

be in the form of a check.

Credit Union Your CSU employment makes you eligible to join

the Dayton School Employees Federal Credit

Union or the Wright-Patt Credit Union.

Employees will need to contact the individual

credit unions to join. A current pay stub will be

needed to show eligibility.

ATM Machine At present time Wright-Patt Credit Union has an

ATM machine installed at the Ward Building.

Savings Bonds All employees are eligible to have money deducted from their paychecks each month for

the purchase of U.S. Savings Bonds. Any interested employee will need to contact payroll

to start the deduction for bonds.

Dining Facilities There is a reserved dining room open to faculty

and staff members only in the cafeteria building.

Sodexo manages the dining facilities for an all you can eat buffet, salad bar, drinks and deserts.

Faculty and staff may also frequent the regular cafeteria, Taco Bell located in the Ward Building,

and Grille 55. For more information about Sodexo or the dining facilities you may contact

them at 376-6125.

Education Assistance

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All full time employees and their eligible

dependents are eligible for tuition remission after the employee has successfully completed

their first 90 days of employment and are on good standing with the University.

Employees and their spouses are eligible to take

two classes per term for free. Any classes taken

by the employee are to be done so on their own

time. Individual arrangements will need to be

approved if an employee is to take any class on their lunch hour. Each individual supervisor will

be the approving authority to allow classes to be taken during the lunch period.

Eligible dependents must be claimed on the

employees most recent tax forms or they must

be carried on the employees university

sponsored Health Insurance. The Human

Resources department, on each and every

tuition remission request, will determine the

eligibility of any dependent.

For more information regarding the tuition remission policy you may refer to the on-line policy.

FMLA- Family Medical Leave Act Any employee that has worked for one full year

and has worked a minimum of 1250 hours in the

previous calendar year is eligible for leave under the Family Medical Leave Act. Employees

needing FMLA must see Human Resources for approval. Human Resources is the approving

authority for FMLA leave and any questions

regarding the CSU policy for FMLA should be

directed to the Human Resources Department.

Please note that this is only a summary of the benefits offered

to Central State University Employees. More complete information can be found on the Benefits page of the

CSU HR Website (http://www.centralstate.edu/faculty/hr/details.php?Benefits-1)

or by contacting Human Resources at 937-376-6540 or eadams@centralstate.edu.