Buena Vista University offers you a competitive package of employee benefits. This program is designed to protect and promote your financial, physical and emotional well-being.

Eligibility

You are eligible for benefits as shown below. 

First day of employment	Employee Assistance Program (EAP) Cellular Phone Discount
First of the month following date of employment	Medical* Dental* Vision* Wellness* Disability Benefits Life Insurance Voluntary Life Insurance* Tobacco cessation* Retirement Paid Time Off Flexible Spending Accounts AFLAC Tuition Assistance

*Coverage is available to same sex and opposite sex domestic partners that meet University eligibility requirements.  See Human Resources for eligibility requirements.

Your Medical Benefits - www.firstadministrators.com

Participating Providers

This plan pays greater benefits when you use PPO providers.  See your medical plan ID card for the name of your PPO.  To locate a PPO provider:

States	PPO	Phone	Website
Iowa, South Dakota	SelectFirst	(800) 206-0827	www.firstadministrators.com
Other	PHCS	(866) 680-7427	www.phcs.com

A PPO provider listing is available upon request.

Notification Requirements

• Precertification - You are required to contact Wellmark at (800) 782-9955 for the following services:
• Inpatient Care - Call in advance of a scheduled admission. If you do not call, your benefits will be reduced by $1,000. You are not required to call for maternity stays of less than 48 hours for normal delivery and 96 hours for C-section.
• Case Management - If you decline case management service, your benefits willbe reduced by $2,500 per year, per episode.

Pre-existing Conditions

Participants age 19 and over:

Any condition existing 6 months prior to your eligibility date (or your effective date if you qualify for Special Enrollment) will not be covered until 12 months from your eligibility date. You may receive credit toward this waiting period for your prior coverage by submitting a certificate of creditable coverage from your prior plan.

Filing Your Claims

Participating providers should file your claims for you. You are responsible for filing any claims not filed by your medical providers. Refer to your medical plan ID card for claim filing instructions.

All claims must be received within 12 months of the date of service, or they will be denied.

Your Monthly Cost
Single Coverage
With Wellness	$30.90
Without Wellness	$77.25
Family Coverage
With wellness, faculty/staff and spouse/domestic partner participating	$267.80
With wellness, faculty/staff or spouse/domestic partner participating	$309.00
Without wellness	$360.50
If it is unreasonably difficult due to a medical condition for you to achieve the wellness discount under this program, or it is medically inadvisable for you to attempt to qualify for the discount, contact Human Resources and we will work with you to find another way to qualify.

SimplyWell wellness plan participants receive a $550 per year on single health premiums and $1,200 on family health premiums (over $600 if only the faculty/staff member or spouse/ domestic partner participates)!

Medical	First Administrators, Inc.		Understanding Your Medical Benefits 1Other Providers If your provider is not in the network, covered charges will be limited to the network maximum allowable amount. The provider may bill you for charges over this amount in addition to your deductible and out-of-pocket. 2Deductible You must satisfy a calendar year deductible before certain benefits are payable.  Note: Claims for all family members may be combined to meet the family deductible. Deductible amounts for PPO and Other Providers apply toward the deductible for both PPO and Other Providers.  3Coinsurance This is the percentage paid by the plan after the deductible is met. 4Out-of-Pocket Maximum This is the limit of deductible and coinsurance amounts you must pay in a calendar year. Note: Claims for all family members may be combined to meet the family out-of-pocket maximum. Out-of-pocket amounts for PPO and other providers apply toward the out-of-pocket maximum for both PPO and Other Providers.  5 Annual Maximum This is the maximum available for PPO and Other Providers combined. 6 Copayment (Copay) A copay is a dollar amount or percentage you must pay for certain services. Note: Copayments do not apply to the deductible or out-of-pocket maximum. 7 Specialty Drugs Specialty drugs are typically high- dollar drugs requiring special handling or administration. They are often used to treat cancers, multiple sclerosis, rheumatoid arthritis, psoriasis and other ongoing conditions. Contact the Plan to find out if your drug is considered specialty drug.
	PPO Providers	Other Providers1
Deductible2 per year Individual Family	$1,250 $2,500	$2,500 $5,000
Coinsurance3	80%	60%
Out-of-Pocket Maximum4 Individual Family	$2,500 $5,000	$5,000 $10,000
Annual Maximum5 Lifetime Maximum…	$1,250,000 Unlimited	$1,250,000 Unlimited
Physician Office Services	$30 copay6 up to $400 per visit, then deductible and coinsurance apply	60% after deductible
Prescription Drugs Retail -Generic -Preferred Brand -Nonpreferred Brand -Specialty -Supply Mail Order -Generic -Preferred Brand -Nonpreferred Brand -Supply - Includes tobacco cessation drugs and over-the-counter nicotine replacement. - If you request a brand drug when a generic is available, you will be responsible for the difference in cost.	$10 copay6 $30 copay $50 copay $80 copay 30 days   $25 copay6 $75 copay $125 copay 90 days	- You must use your prescription drug card at a participating pharmacy to receive benefits for drugs covered by the drug plan. - Prescription drugs administered by a physician must be purchased at a participating pharmacy when directed by the plan - Specialty drugs must be purchased at a designated specialty pharmacy when directed by the plan
Emergency Room	80% after deductible	80% after PPO deductible
Cancer Screening Pap smear, Mammogram, and Prostate screening	100%	100%
Preventive Care Colonscopy, Immunizations, Mammogram, Pap smear, Prostate screening, vision/eyewear exams, Well child care Note: Preventive care benefits apply to routine screenings only. Diagnostic services are generally subject to deductible and coinsurance except for the cancer screening services listed above.	100%	100%
Tobacco Cessation… - Tobacco cessation program -Office services     -Prescription drugs and over-the-counter nicotine replacement	100% $30 copay up to $400/visit then deductible and coinsurance apply   See prescription drugs	100% 60% after deductible     NA
Chiropractic Services…20 visits	80% after deductible	60% after deductible
Mental Health/Substance Abuse…  -Inpatient -Outpatient    Office services          Other services	80% after deductible   $30 copay up to $400/visit, then deductible and coinsurance apply                 80% after deductible	60% after deductible   60% after deductible     60% after deductible

Your Dental Benefits - www.firstadministrators.com

Filing Your Claims

You are responsible for filing any claims not filed by your dental providers. Refer to your dental plan ID card for claim filing instructions.

All claims must be received within 12 months of the date of service or they will be denied. 

Your Monthly Cost
Single Coverage	$5.00
Family Coverage	$37.00

Pretreatment Review

A treatment plan for dental services expected to cost $500 or more may be forwarded to First Administrators, Inc. for an estimate of benefits payable. 

Filing Claims

You are responsible for filing any claims not filed by your dental provider.  Refer to your dental plan ID card for claim filing instructions.

All claims must be received within 12 months of the date of service or they will be denied.

Dental	First Administrators, Inc.
Deductible per year Individual Family	$50 $150
Annual Maximum	$1,500
Preventive Services Includes cleanings, exams, fluoride, x-rays, sealants	100% Routine cleanings and oral exams limited to twice per calendar year
Basic Services Includes fillings, gum treatment, root canals, surgery	80% after deductible
Major Services Includes bridges, crowns, dentures (limited to 5 lifetime)	50% after deductible
Orthodontic Services $2,000 lifetime (Adults and children)	50%

Your Vision Benefits - www.avesis.com 

Network Providers

This plan pays greater benefits if you use network providers. To locate a network provider: 

Network	Phone	Website
Avesis	(800) 828-9341	www.avesis.com

A listing of network providers is available upon request. 

Filing Your Claims

Participating providers should file your claims for you. Other claims should be sent to:

Avesis Third Party Administrators, Inc.
Vision Claims Department
PO Box 7777
Phoenix, AZ 85011-7777

All claims must be received within 90 days or as soon as reasonably possible, but in no event greater than 1 year of the date of service, or they will be denied. 

More Information About Your Vision Benefits

• The allowance for lenses is for basic lenses; if you want lineless bifocals, special coatings, tints or other add-ons, a discount will apply (except Wal-Mart).
• The allowance for frames is based on wholesale price, so ask the retailer what your Avesis cost will be (frames at participating Wal-Mart locations are covered up to a $68 retail value.)
• If you use your benefits for contacts and you wish to purchase eyeglasses or vice versa, you may receive a discount on the additional purchase (except Wal-Mart). 

Your Monthly Cost
Single Coverage	$7.12
Single plus Spouse or Domestic Partner	$14.23
Single plus Child(ren)	$13.19
Family Coverage	$18.24

VISION Copayment applies to frames and lenses only	Avesis, Inc.
	Network Providers $15	Other Providers N/A
Frames Each 24 months	Approximate retail value of $100 - $150	Up to $45
Lenses Each 12 months Single vision, bifocal, trifocal	100%	Up to $25/$40/$50
Contacts (Instead of lenses and frames) Each 12 months Includes fitting fee	Up to $130	Up to $130
Laser Surgery One time lifetime INSTEAD OF ALL OTHER SERVICES FOR THE BENEFIT YEAR	Up to $300, plus a 5% - 25% discount	Up to $300

Your Disability Benefits

	Short Term Disability First Administrators, Inc.	Long Term Disability Lincoln Financial Group
Waiting Period	Benefits begin on the first day of disability	180 days of disability
Benefit	60% of earnings up to $2,308/week	60% of earnings up to $10,000/month
Maximum	26 weeks	Social Security Normal Retirement Age

NOTE: You pay 50% of the cost of your long term disability insurance premiums on an after- tax basis so that you may receive 50% of the benefits on a tax-free basis in the event of disability.

Your Life Insurance Benefits - www.lfg.com 

	Basic Life & AD&D  Paid for by your employer Lincoln Financial Group	Voluntary LifE Available through payroll deduction Lincoln Financial Group
For You	200% of annual earnings up to $450,000 1 Includes AD&D2	$10,000 to $500,000 in multiples of $10,000, up to 500% of annual earnings 4
For Your Spouse / Domestic Partner	$2,000	$5,000 to $100,000 in multiples of $5,000, up to 50% of employee amount 5
For Your Eligible Children	$2,000 3	$2,000 to $10,000 in multiples of $2,000 6

¹ Employer-provided amounts greater than $50,000 are subject to tax; benefits reduce at age 70
² AD&D- Accidental death and dismemberment
³ Coverage is provided for eligible children from age 1 day to 19th birthday (26th birthday for full-time students)
⁴ Amounts over $200,000 or 3 times pay require medical questions and coverage may be denied; benefits reduce at age 70
⁵ Amounts over $50,000 require medical questions and coverage may be denied; benefits reduce at age 65 and terminate at employee at age 70
⁶ Coverage is provided for eligible children from age 1 day to 19th birthday (26th birthday for full-time students)
** One monthly premium covers all of your eligible children

Monthly Voluntary Life Costs
Age	For you or your spouse (per $1,000)
<30	$0.06
30-34	$0.07
35-39	$0.09
40-44	$0.13
45-49	$0.23
50-54	$0.39
55-59	$0.61
60-64	$0.96
65-69	$1.72
70-74	$3.08
75-79	$5.08
80+	$10.30
For Your Children ** (per $2,000)
$0.132 (for all eligible children)

Travel Assistance Benefits

The travel assistance benefits provide assistance when you travel for business or personally if you are 100 miles or more from home for 90 days or less.

Pre-Trip Information

• Foreign currency exchange rates
• Weather information

Emergency Medical Assistance

• Medical referrals
• Medical evacuation
• Replacement of eyeglasses/ medical devices

Emergency Personal Services

• Emergency cast
• Translation services
• Lost document assistance

Contact Travel Connect at:
(800) 527-0218 or (410) 453-6330  

Your Flexible Spending Accounts - www.firstadministrators.com 

The Buena Vista University flexible benefit plan save you money by allowing you to pay certain expenses with pre-tax dollars. 

Pre-Tax Premiums. Your medical, dental and vision plan contributions are automatically paid with pre-tax dollars. If you wish to pay your premiums with after-tax dollars, you must notify Human Resources in writing. 

Medical Spending Account. You may set aside up to $7,500 on a pre-tax basis to pay non-covered, qualifying health care expenses. Examples include your deductibles, copays, coinsurance and other out-of-pocket costs. 

Dependent Care Spending Account. You may set aside up to $5,000 on a pre-tax basis for qualifying dependent care expenses. This includes care for your dependents under the age of 13 while you and your spouse are working and/or attending school full-time. 

Filing Your Claims

Send your claims to:

First Administrators, Inc.
Flexible Benefits Department
PO Box 9900
Sioux City, IA 51102-0479
(800) 941-4404
Fax: (712) 279-8479 

• This plan includes a grace period which provides for reimbursement of medical and dependent care expenses incurred through March 15^th of the following year. 
• All claims must be received June 13th of the following year, or they will be denied. 

Your Employee Assistance Program (EAP) - www.lifeworks.com 

The EAP is available to help you and members of your household with:

• Alcohol and drug problems
• Anxiety and depression
• Career and employment issues
• Financial problems
• Legal issues
• Marriage and family problems
• Personal relationship issues
• Stress management  

Tobacco Cessation Program

You and you spouse/domestic partner are eligible for a tobacco cessation program if you participate in the Buena Vista University health plan. The entire cost of this benefit is paid by Buena Vista University. The program includes:

• Up to 5 telephone counseling sessions
• Unlimited phone access to quit counselors
• A personalized action plan
• Interactive Web Site
• Nicotine replacement (gum, patches and/or lozenges) via mail, if appropriate.

The program is provided by Alere Wellbeing.  For more information go to www.quitnow.net.  If you and/or your spouse/domestic partner are interested, contact Human Resources or:

Alere Wellbeing
Quit for Life
(866) QUIT4LIFE (1-866-784-8454) 

Your Wellness Program - www.simplywell.com

The Buena Vista University wellness program features a preventative health screening and wellness education specifically tailored to your needs. Your health is an important factor in your success at work and at home.

Program Services

The wellness program includes:

• Online health risk assessment
• Health screening, including lab tests
• Health coaching by Registered Nurses via phone
• 24-hour nurse line
• Online health education
• Online wellness activity tracking
• Tobacco cessation program

Benefits

The wellness plan offers you the following benefits:

• Reduced premiums for health plan participants
• Free health screening
• Early detection of health issues
• An individualized action plan
• Access to Registered Nurses 24 hours each day
• Access to health education
• Ability to track your progress

Your Membership Cost Per Pay Period
	Health Plan Participants	Other Employees
Employee	Paid by Buena Vista University	Paid by Buena Vista University
Spouse or Domestic Partner	Paid by Buena Vista University	Paid by Buena Vista University
Your Premium Discount
		Annually
Employee		Over $550
Employee or Spouse or Domestic Partner		Over $600
Employee and Spouse or Domestic Partner		Over $1,100

Not only will you receive this benefit free of charge - if you are enrolled in the health plan, you will also receive a discount on your health plan premiums for your wellness program participation!

Participation Requirements 

To participate in the wellness program you must:

• Sign the election form
• Complete the online health assessment
• Complete the health screening (not required if you become eligible after the annual screening conducted in February)
• Record participation in the program via the website each quarter
• Earn SimplyWell points for completion of online education modules and logging your wellness activities online

Action Plan 

• Health risk assessment - 3,500 points
• Health screening - 3,500 points
• Online health education modules 1,000 points (4 at 250 points each)
• Online health trackers 1,000 points (25 at 40 points each)
• Appointments -1,000 points (2 at 500 points each)
• Wellness events - To be announced 

You must complete the health assessment and screening in the first quarter and accumulate a minimum of 10,000 points annually with the above amount in each category. 

Wellness events will be announced throughout the year; wellness event points may be used to satisfy your health education modules and/or health tracker point requirements.  All participants must accumulate the points shown below for each calendar quarter to receive the premium incentive: 

Quarter Ending	Total Points
3/31	7,000
6/30	8,000
9/30	9,000
12/31	10,000

IMPORTANT NOTE:  IF YOU DO NOT EARN THE REQUIRED POINTS BY THE END OF EACH QUARTER, YOU WILL NOT BE ELIGIBLE FOR THE DISCOUNT THE NEXT QUARTER.

Your Retirement Plan - www.tiaa-cref.org 

Company                                 TIAA CREF

Requried Contribution                     5% of gross monthly earnings

Institutional Contribution           8% of gross monthly earnings 

Supplemental Retirement Annuity available through TIAA CREF 

Paid Time Off Plan (PTO) 

Eligibility          Full time staff

Benefit                Paid time off accrues at the rates below with a maximum accrual of 40 days (320 hours)

Exempt (Salaried) Employees

0 - 9 years - 17.33 hrs/month (26 days/yr)

Anniversary of 10^th year - 17.66 hrs/mo (26.5 days/year)

11^th year - 17.99 hrs/mo (27 days/yr)

12^th year - 18.33 hrs/mo (27.5 days/yr)

13^th year - 18.66 hrs/mo (28 days/yr)

14^th year - 18.99 hrs/mo (28.5 days/yr)

15^th year - 19.33 hrs/mo (29 days/yr)

16^th year - 19.66 hrs/mo (29.5 days/yr)

17^th year - 19.99 hrs/mo (30 days/yr)

18^th year - 20.33 hrs/mo (30.5 days/yr)

19^th year - 20.66 hrs/mo (31 days/yr) 

Non-exempt (Hourly) Employees

0 - 5 years - 14 hrs/month (21 days/yr)

Anniversary of 6^th year through 9 years - 17.33 hrs/mo (26 days/yr)

Anniversary of 10^th year - 17.66 hrs/mo (26.5 days/year)

11^th year - 17.99 hrs/mo (27 days/yr)

12^th year - 18.33 hrs/mo (27.5 days/yr)

13^th year - 18.66 hrs/mo (28 days/yr)

14^th year - 18.99 hrs/mo (28.5 days/yr)

15^th year - 19.33 hrs/mo (29 days/yr)

16^th year - 19.66 hrs/mo (29.5 days/yr)

17^th year - 19.99 hrs/mo (30 days/yr)

18^th year - 20.33 hrs/mo (30.5 days/yr)

19^th year - 20.66 hrs/mo (31 days/yr)

For details on an approved Leave of Absence for staff members, see Human Resources.

AFLAC Supplemental Insurance - www.aflac.com

Eligibility

Full time faculty/staff

Benefit

Aflac offers three supplemental insurance policies available to eligible faculty/ staff on a voluntary basis.  All premiums are payroll deducted on a pre-tax basis.  All policies are portable and guaranteed renewable for life.  Annual open enrollment occurs during a specified period each fall.

 Available plans: 

• Cancer Programs
• Personal Recovery Plus
• Personal Accident Protection

Employee Tuition Grant

Eligibility

Full time employee and their dependents who do not possess a Bachelor's Degree are eligible for a tuition grant.  Employees are eligible for this benefit the first day of the month following the date of employment.

Benefit

This benefit includes free tuition at Buena Vista University or other participating schools.  Employee must apply for federal and state aid in order to be eligible for this benefit.

This summary is not intended to be a complete description of your benefits.  Please consult your summary plan description and/or insurance certificate for additional details including plan limitations and exclusions. Buena Vista University reserves the right to change or terminate any benefit at any time.