College of Medicine
Clinical Faculty
Summary Plan Document
July 1, 2007 The College of Medicine provides a broad and comprehensive fringe benefit program to eligible faculty members of the University of Florida. The Academic Enrichment Fund finances the program. The insurance programs are designed to protect against the economic effects of total disability, medical expense and death from accidental or natural causes. The retirement programs are planned to provide maximum financial security during retirement years.
Eligibility
Eligible participants for the Group Health, Life and Accidental Death and Dismemberment programs include the following employees who must be appointed at .50 FTE or above: Clinical M.D. and Clinical Ph.D. faculty, ranked Lecturer and above and Associate and Assistant Deans and Vice Presidents as designated by the Fringe Benefit Committee, the Executive Committee, and the Dean of the College of Medicine, Visiting clinical M.D. or Ph.D. faculty, ranked Lecturer and above, appointed for one year or more, and receiving other than OPS salary.
Eligible participants for the Group Disability program include the following employees who must be appointed at .75 FTE or above: M.D. or Ph.D. faculty ranked Lecturer and above, appointed in a clinical or basic science department, Visiting M.D. or Ph.D. faculty ranked Lecturer and above appointed for one year or more, in a clinical or basic science department and receiving other than OPS salary .
Eligible participants for Academic Enrichment Fund (AEF) Retirement Program include any full time, part time or visiting faculty member ranked Lecturer and above, who receive salary from the Academic Enrichment Fund. A biweekly employer contribution will be made to one or more of the approved annuity programs. The rate of contribution will equal the current Optional Retirement Program rate. The total annual contribution may not exceed the I.R.S. maximum. For employees hired after July 1, 1996, no retirement contributions will be made on annual compensation that exceeds limits established by federal law.
Leave of Absence/Reduced FTE Eligibility
Clinical faculty who have been employed by the College of Medicine for one year or more may continue all fringe benefit programs during an approved Leave of Absence, not to exceed one year during an aggregate seven year period. Approved leave of absences include partial disability, FMLA leave, Extension of FMLA leave, Educational Venture or Fellowship, with the recommendation and approval of the Chairman of the Department and signed by the Dean. A recommendation letter must be filed with the Office of the Dean. Upon approval, you will be covered for up to 12 months following the date your approved leave of absence begins. You may be covered for an additional six months of approved leave of absence, subject to the approval of the Dean of the College of Medicine and the insurance provider. Premiums to be paid by the Department.
If you are on any other leave of absence, and if premium is paid, you will be covered through the end of the month that immediately follows the month in which you have used all of your accrued leave and vacation time.
If you are on a temporary layoff, and if the premium is paid, you will be covered through the end of the month that immediately follows the month in which your temporary layoff begins.
Faculty appointed at no less than .75 FTE (30 hours) can retain health insurance, life insurance and long term disability if they pay their pro-rata share of the total monthly premium.
Faculty appointed at .74 FTE and no less than .50 are eligible for the health program; the life insurance program with a reduced benefit of $100,000; the accidental death & dismemberment with a reduced benefit of $50,000. The employee is not eligible for long term disability . The employee will be responsible for payment of their pro rata share of the total monthly premium.
If less than .75 FTE occurs due to partial disability, all benefits can be retained for a period of 24 months with costs incurred by the department, pending certification of the disability by the insurer. After the 24 months have occurred, the partially disabled employee will be eligible for the health plan; the life insurance benefit of $100,000; and the accidental death benefit of $50,000. The employee will be responsible for payment of their pro rata share of insurance premiums. When an employee returns to 1.00 FTE, full benefits will be restored.
In the case of total disability, benefits will be as follows : The disability insurance will continue through the payment of benefits (waiver of premium after the elimination period of 180 days). The life insurance will be continued by waiver of premium, if approved, ** in the full benefit amount of $500,000. Health insurance may be continued through the annual/sick leave, a Leave of Absence and COBRA. An employee may choose to expend all leave balances and then request a Leave of Absence for one year. At the end of the Leave of Absence, under COBRA they will have the opportunity to continue health insurance for a maximum of 29 months. Health insurance will terminate at the end of annual/sick leave, a Leave of Absence or COBRA. If an employee has completed ten or more years of continuous service with the College of Medicine immediately before becoming disabled and was insured as an active employee, he or she may continue major medical insurance upon full time disability under the Post Retirement Health Plan. The policy will be the same as that provided for active employment. When a participant who is disabled becomes eligible for Medicare, the College group health plan will pay only as secondary carrier. The covered participant must pay the entire cost of the insurance.
**"If approved" means that a disabled employee will be approved for a waiver of premium if he meets the requirements of disability for life insurance, (to meet the requirement an employee may not be capable of working in any occupation).
Life Insurance
Level term group life insurance underwritten by Unum Life Insurance Company provides $500,000 of life insurance for all covered employees with an additional $150,000 in the event of accidental death and dismemberment. A copy of your Plan Booklet is located on the Fringe Benefit website at www.med.ufl.edu/benefits. Where discrepancies exist, the Master contract will apply. Coverage begins on the first day of employment. Life insurance premium paid by your employer for coverage over $50,000 is ordinary income to you. The cost of the group term life insurance coverage of more than $50,000 will be included in your income.
Disability Insurance
This policy is underwritten by Unum Life Insurance Company and is designed to offset the economic impact brought about by total or partial long-term disability. A copy of your Plan Booklet is located on the Fringe Benefit website at www.med.ufl.edu/benefits. Where discrepancies exist, the Master contract will apply. The benefits as set forth under this policy will begin after the insured's sixth month of total or partial disability. The maximum benefit period due to sickness is based on your age at the time of disability. The monthly income benefit is equal to 60% of the monthly salary to a maximum of $15,000 per month. There is no offset until benefits from Unum Life Insurance Company, Social Security, Worker's Compensation, the Teacher's Retirement System or any other group disability compensation exceed 70% of the monthly salary, in which case the Unum Life Insurance Company benefit is reduced to a level equal to 70% of the monthly salary. Cost of Living Adjustment rider is included.
Comprehensive Group Health Plan
The following is a brief description of your health plan. A copy of your Plan Booklet is located on the Fringe Benefit website at www.med.ufl.edu/benefits. Where discrepancies exist, the Master contract will apply. It is your responsibility to notify the Fringe Benefit office of any changes in your family status. Humana Insurance Company underwrites and insures the College of Medicine group health plan. The plan provides coverage for the employee, the spouse of an eligible employee (unless legally separated or divorced), qualified domestic partner, unmarried children under age 19, unmarried children between ages 19 and to the end of the 25 th year, who are dependent upon the insured for support and are either full time or part time students or who reside in the insured's household. Each insured individual is initially covered for a lifetime maximum amount of $5,000,000. The calendar year deductible is $1,000 per person/$2,000 per family. Co-insurance on covered expenses contributes towards the coinsurance stop-loss maximum. You will pay 20% coinsurance or a $25.00 co-pay per visit to a maximum of $2,500 per calendar year if you visit a Humana/ChoiceCare network provider. If utilizing a non-network provider, the coinsurance is stopped at $5,000 of covered eligible expenses, meaning that you are responsible for 40% and the plan will pay 60%. Charges are discounted according to agreements between the providers. No deductibles or coinsurance payments apply to covered inpatient stays at Shands Hospital facilities. Deductibles are waived for inpatient stays at network provider hospitals and covered charges are paid at 80% coinsurance. The calendar year deductible applies to inpatient stays at all other non-network hospitals and covered charges are paid at 60% coinsurance. You will also be responsible for the discounted non-eligible expenses. Covered lab and x-ray charges at Shands facilities are paid at 100%. Covered lab and x-ray charges by College of Medicine Faculty Practice Physicians are paid at 80% coinsurance; however, there is no member responsibility for visits to physicians' offices at Shands/UF or Shands/Jax. The UF Faculty Group Practice physicians will waive the deductible and coinsurance payments for covered charges. Deductibles and coinsurance payments will not be waived for non-covered charges. Physician visits to Network Providers are subject to a $25. co-payment for outpatient visits. Physician visits to all other providers are subject to the calendar year deductible and are paid at 60% coinsurance for eligible expenses. You are responsible for paying the non-eligible charges and those charges do not apply towards your total stop loss. Facility charges for Outpatient Surgery are not subject to the deductible and are paid at 100% at Shands Hospitals and 80% at Network Provider Hospitals. Facility charges for Outpatient Surgery performed at All Other Hospitals will be paid at 60% coinsurance. Emergency Room Visits at Shands Provider Hospitals are paid at 100%. Emergency Room Visits to all Hospitals and facilities including out of area emergency visits are paid at 80% coinsurance. Your benefits have cost containment features on mental illness and substance abuse, home health care, hospital preadmission tests, weekend hospital confinement, hospice care, birth center benefit, ambulatory surgical facility benefits, second surgical opinion. Outpatient Visits for Mental/Nervous Disorders and Substance Abuse are capped at 52 visits per calendar year and processed as in-network charges, requiring a 20% Coinsurance Payment. Visits are limited for Physical, Speech and Occupational Therapy; charges are paid according to the same schedule as Outpatient Visits. Durable Medical equipment is available via in-network providers and is payable at 80%; out of network requires the deductible and will be payable at 80%. "Well Baby" and "Adult Well Person" care are included as a scheduled benefit and are payable, without deductible, at 80%. "Adult Well Care" is limited to $250 per Calendar Year. Pre-Certification is mandatory for in-patient hospitalization. Your prescription drug plan allows you to purchase 30-day supply of prescription drugs at retail pharmacies. The retail price is $35.00 name brand drugs and $20.00 generic. RightSource offers a mail-order pharmacy program. Mail order drugs (90-day supply) will require a $35. co-payment for brand name drugs and a $20. co-payment for generic drugs. Prescriptions written by an insured for self or any family members will not be reimbursable through the drug card nor regular plan benefits.
C.O.B.R.A . If a covered employee or dependents' medical insurance terminates due to a Qualifying event (employment termination, work hours reduction, divorce/legal separation, Medicare entitlement, maximum age for child), they may continue their medical insurance under the Consolidated Omnibus Budget Reconciliation Act (C.O.B.R.A.). For additional information, contact Fringe Benefits/Gainesville at 352-273-5077 or Fringe Benefits/Jacksonville at 904-244-8531.
AEF RETIREMENT PROGRAM
This program is designed for those faculty members receiving salary from the Academic Enrichment Fund. The College contributes a percentage of the annual AEF salary to the annuity program(s) of the faculty member's choice. These programs are ING Financial Services, AIG Valic, Merrill Lynch, Fidelity Investments, Jefferson Life, Nationwide, Prudential, Met Life Investors, Smith Barney, and TIAA-CREF. The contribution is not subject to federal income tax until withdrawn.
STATE OF FLORIDA OPTIONAL RETIREMENT PLAN
All Clinical Faculties appointed after July 1, 1989 and who receive state salary are participants in the Optional Retirement Program (ORP). Participation in the ORP continues unless the employee's job status changes such that participation in the FRS becomes mandatory. The administrative cost of this plan will be paid entirely by the State through the University, although you may voluntarily contribute up to the same percentage of your earnings that is contributed to the ORP on your behalf. In addition to the annuity program described above, a variety of voluntary 403b annuity investment options are also available through State of Florida payroll deduction.
VACATION LEAVE
Full time faculty earn 6.769 hours of annual leave per pay period. Part time faculty earn a proportionate amount based on FTE. However, leave accrual is pro-rated proportionate to the amount of time in pay status during each pay period. This leave should be taken when it is necessary for a faculty member to be absent from assigned duties and responsibilities for reasons other than for illness. You may accumulate vacation leave throughout the year. However, any vacation leave hours over 480 that are not used by year-end will convert to sick leave at the end of the pay period in which December 31 fell. Hours converted will also include accruals for that pay period. Upon separation from UF, you will be paid for up to 352 hours of any unused vacation leave. If you transfer to a leave-accruing position within the University of Florida, with no break in service, your vacation leave balance will be transferred to the new department.
SICK LEAVE
Full time faculty members earn four hours of sick leave for each biweekly pay period. Part time faculty accrue leave at a rate directly proportional to the percent of time employed. There is no limitation on total hours to be accrued. Sick leave must be earned before being taken. Additional information may be obtained from your department's business manager or administrator. If you separate from university employment because of retirement, termination in good standing, or death, after you have completed at least ten years of creditable service, you or your beneficiary will be paid for part of your unused sick leave credits. Unused sick leave credits are paid at the rate of 1/4 of unused credits earned, not to exceed an actual payment of 480 hours. If you transfer to a leave-accruing position within the University of Florida, with no break in service, your sick leave balance will be transferred to the new department.
PROFESSIONAL LIABILITY INSURANCE
Pursuant to Section 768.28, Florida Statutes, the University of Florida Board of Trustees is exclusively responsible for any civil claims or actions arising from the acts of its employees and agents. The UF BOT is protected for such liabilities by the J. Hillis Miller Health Center Self-Insurance Program (UF SIP), a self-insurance program managed by a governing council created by the Florida Board of Governors that is chaired by the Sr. Vice President for Health Affairs. As an employee of the University of Florida (UF), you are personally immune from civil liabilities which may arise from acts or omissions committed by you in the course of your employment. UF SIP affords you personal professional liability protection while you act as a Good Samaritan, while you are involved in community service work, which has been pre-approved by your college, or if you are on a job assignment outside of Florida. UF SIP also provides defense costs for certain licensure investigations by the Department of Health. If you have questions regarding professional liability, please contact the UF SIP Director at 352-273-7066.
Fringe Benefits - Gainesville
(352) 273-5077
Fringe Benefits - Jacksonville
(904) 244-8531
Last updated 9/17/07