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Total Rewards frequently asked questions

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I’m enrolling in a tobacco cessation program. When can I get a discount on my insurance premiums?

If you are enrolling in a cessation program, or re-enrolling in a cessation program, you must be tobacco free for at least 3 months or enrolled in a new tobacco cessation program prior to submitting your tobacco attestation.

Please keep in mind that if you begin using tobacco products at any time during the plan year, you must submit a new tobacco attestation to your Campus Benefit Representative or the HR Service Center at the time you begin using the product(s).

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What happens when I return to work from a leave of absence due to active duty?

When you return from a military leave of absence, you will be compensated at the rate of pay you would have received had you continued working during the period of leave. All time spent on a military leave of absence will be counted with previous university experience in calculating seniority and compensation.

If you become physically or mentally unqualified to perform the duties of your former position, you shall be offered employment in a position for which you are qualified.

Use the table below to find out how and when to return to work, based on your type and length of military leave:

Annual training session or emergency mobilization (1-30 days) Emergency mobilizations (31-180 days) Emergency mobilizations (181+ days)

Return to work the first regularly scheduled work day that would fall eight (8) hours after the person returns home.

An application for re-employment must be submitted no later than 14 days after completion of service.

 

An application for re-employment must be submitted no later than 90 days after completion of service; and the employee is qualified to perform the duties of the position.

Learn more about your options when taking a military leave of absence from a university job.

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Who receives a 1099-R?

Anyone who receives a distribution from the Retirement, Disability and Death Benefit Plan (i.e., receives a pension payout) during the tax year, will receive Form 1099-R from the university.

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How should employees with both teaching and non-teaching assignments record hours under PPACA?

For the Patient Protection and Affordable Care Act (PPACA), employees that have both teaching and non‐teaching responsibilities (e.g., a part‐time academic employee who teaches classes and also works in a research lab), use the full-time equivalency (FTE) to determine the hours worked. The FTE should include the credit given using the teaching equivalency(3 1/3 hours worked per credit hour taught), as well as a reasonable estimation of the hours spent doing non‐teaching assignments.

Visit the Patient Protection and Affordable Care Act (PPACA) page for more information.

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Who can apply for development leave?

All regular employees are eligible to apply for development leave for a time period extending up to a full year.

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How should hours for teaching clinical courses be tracked under the Affordable Care Act (PPACA)?

Hours worked in a clinical setting should be tracked in the same manner as a variable-hour, non‐teaching exempt employee by recording actual worked hours using a non‐pay time reporting code in the time reporting system.

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When will I receive Form 1099-R?

If you receive a pension payout, Form 1099-R will be postmarked to you by the end of January (or early February if the end of January falls on a weekend) for delivery by the US Postal Service. Please allow 10 business days for delivery.

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Where can I get information on tobacco cessation programs?

The Total Rewards website has information for each of the campuses regarding cessation programs with local resources.

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Will I get paid if I go on development leave?

It's improtant that you seek external grants or fellowships to help fund your development leave, but whether you receive external fellowships and grants or not, you can receive up to your full salary during development leave.

If you don’t remain employed at the university in full-time status for the same amount of time that you were on development leave, though, you will have to reimburse the university for salary and benefits accumulated during your development leave. You will have three months to make this reimbursement.

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Do I receive holiday pay, sick leave, and vacation while on development leave?

If you are in pay status, you will receive holiday pay. You will also accumulate sick and vacation leave. While on leave, you can also retain your maximum personal days, but you have to use these days before the end of the anniversary year or they will expire.

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If I start using tobacco, when do my contributions change from discount to non-discount?

Contributions would change to the non-discounted rate on the first of the month following the date you submit your revised tobacco attestation.

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I didn’t receive my Form 1099-R. How can I obtain a reprint?

Form 1099-R will be postmarked by the end of January (or early February in year's where the end of January falls on a weekend) for delivery by the US Postal Service. Please allow 10 business days for delivery. If you have not received your 1099-R form by February 16, please contact the HR Service Center to request a reprint via the contact information below.

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What happens if I’m not a tobacco user but I marry a tobacco user mid-year?

 If you begin covering your new spouse on your medical plan, your premiums will change from discounted rates to non-discounted tobacco rates beginning the first of the month following the date of marriage. You will be required to sign a benefit change form, a new attestation, and provide proof of relationship.

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What is the Family and Medical Leave Act?

The Family and Medical Leave Act (FMLA) is a federal law that provides employees the right to take a leave of absence for family, medical reasons, and leave for military families while maintaining job protection. Qualifying absences under FMLA will not be considered in calculating occurrences of absence that may lead to disciplinary action.

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How should hours for teaching clinical courses be tracked under the Affordable Care Act (PPACA)?

For the Patient Protection and Affordable Care Act (PPACA), hours worked in a clinical setting should be tracked in the same manner as a variable-hour, non‐teaching exempt employee: by recording actual worked hours using a non‐pay time reporting code in the time reporting system.

Visit the Patient Protection and Affordable Care Act (PPACA) page for more information.

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What happens if I’m not a tobacco user but my dependent child is?

You will need to mark "tobacco user" on the Tobacco Attestation and pay the non-discounted premium rates.

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Who is eligible to obtain FMLA leave?

Anyone employed by the university for at least 12 months and who  has worked at least 1250 hours in the 12-month period preceding is eligible for a family or medical leave. Special limitations may apply to highly compensated employees.

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I won’t be 62 when I retire; can I continue to work for the university after retirement?

Those who retire before age 62 must execute a “bona fide” termination, as required by the Internal Revenue Service (IRS). If you are younger than age 62 at retirement, you must complete all the necessary paperwork to apply for and initiate your retirement, and you are not eligible to return to work unless meeting certain criteria.

The following factors are key in determining if a “bona fide” termination took place:

  • The employee and the employer did not engage in discussions regarding reemployment before the employee’s separation from service. The IRS has singled out this factor as critical to support the occurrence of a true separation. Therefore, for employees who have not reached normal retirement age, discussions about reemployment are prohibited.
  • The length of the break in service before reemployment is reasonable—at least 90 days.
  • Upon separation from service, the employee surrendered something of value, such as seniority rights or access to benefits available only to active employees.
  • The employer processed the employee as if he or she were separating from service. For example:
    • A COBRA election or information on retiree health insurance coverage was provided to the employee upon separation, or
    • A separation date was entered into the payroll/personnel system.

If you are under age 62 at the time of retirement:

  • There can be no discussion of rehire before your retirement date has passed.
  • You must have a break in service of at least 90 days before returning to work.

If these criteria are met, then at the department’s and university’s discretion, you may return to work, but only on a part-time basis. In other words, you may work at less than 75% full-time equivalency (FTE).

  • The “less than 75% FTE” threshold is measured including all appointments you may hold at any given time.
  • The decision of whether you will be offered employment is at the department’s and university’s discretion.

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I’m in the step therapy program. Why couldn’t I fill my prescription at the pharmacy?

The first time you submit a prescription that isn’t for a front-line drug, your pharmacist should inform you that with step therapy you need to first try a front-line drug if you’d rather not pay full price for your prescription drug.

To receive a front-line drug:

  • Ask your pharmacist to call your doctor and request a new prescription.

OR

  • Contact your doctor to get a new prescription.

Only your doctor can change your current prescription to a first-step drug covered by your program.

 

If you have more questions, you can log in and go to www.StepTherapyFacts.com to watch informative videos or call the Express Scripts Pharmacy at the number on your ID card. (This FAQ answer provided by ExpressScripts.)

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What if I need more than the Employee Assistance Program’s short-term counseling sessions?

The Employee Assistance Program (EAP) is designed help university employees with personal or work-related problems by providing short-term counseling (up to 5 sessions).  EAP practitioners are trained in assessment. If it is determined that more than five sessions are needed, the practitioner will provide employees with a referral within the community. EAP practitioners attempt to ensure sure all referrals are covered by insurance, or if money is a concern, to help employees locate counseling services that are offered at a sliding fee or reduced rate. Visit the Employee Assistance Program webpage for more information.

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What’s the difference between generic and brand-name prescription drugs?

FDA-approved generic drugs must meet the same U.S. Food and Drug Administration (FDA) standards of quality and purity as brand-name drugs. FDA-approved generic versions have the same active ingredients as their brand-name counterparts are equal in strength and dosage. Sometimes drug manufacturers use different inactive ingredients in generic versions, which may affect its shape, color, size or taste.

(This FAQ answer provided by Express Scripts.)

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Whom should I contact with questions about the Wellness Portal hosted by Cerner Health?

For all Healthy for Life Wellness Portal technical questions, if you cannot find your answer among these FAQs, please contact Cerner tech support at (888) 252-8150.

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How can I find out if my doctor or other provider participates in Medicare?

To find out if your provider participates in Medicare, you can ask your provider or can visit the Medicare.gov website at www.medicare.gov/physiciancompare/search.html to search for your doctor. You can find additional information about Medicare, including the CMS “Medicare and You” brochure, on the Medicare.gov website at www.mymedicare.gov or by calling Medicare at 1-800-MEDICARE. TTY users should call 1-877-486-2048, 24 hours a day, seven days a week.

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What can FMLA leave be used for?

There are two types of FMLA leave, as described below:

General (12 weeks within a 12-month period) can be taken for: Covered Service Member Leave (26 weeks in a 12-month period) can be taken for:
  • Birth of an employee's child(ren), adoption of a child, or official placement of a child with the employee for foster care (leaves for birth/adoption must be taken within 12 months of the event).
  • A qualifying exigency** due to a call to active duty in the Reserves or National Guard by an employee’s spouse, son, daughter, or parents who has been notified of an impending call or order to active duty in the Reserves or National Guard.
  • Care of a son, daughter, spouse, or parent (not parent-in-law) having a serious health** condition*.
  • Incapacity of an employee as a result of a serious health condition. 

* Leave for the care of an adult son or daughter (at least 18 years old) is not covered unless required as a result of "mental or physical disability" as defined under the Americans with Disabilities Act. 

**Learn more about what constitutes a qualifying exigency or a serious health condition on the FMLA page Q&A page.

  • Care of a service member who is recovering from a serious illness or injury sustained in the line of duty on active duty and is actively receiving medical treatment.*

* Employee must be the spouse, son, daughter, parent, or nearest blood relative of a covered service member to be eligible.

*Employee must promptly advise their supervisor of the date and probable length of the absence.

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Why must covered dependents be tobacco free? What if only one dependent isn’t tobacco-free?

All dependents covered by the employee’s medical insurance plan must be tobacco free. The goal of this discount program is to encourage healthier living with a reduced risk of cancer and other conditions associated with tobacco use. Also, the university is seeking to reduce the costs of medical insurance for all employees. These goals can best be achieved by encouraging a family-wide cessation of tobacco use – especially because smoking is one of the most common forms of tobacco use and secondhand smoke has health risks just like smoking does. (See the Health Effects of Secondhand Smoke from the Centers for Disease Control and Prevention).

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Can I take FMLA leave if I am on a leave of absence for a work-related injury or illness?

Yes. Either you or the university may choose to have the your FMLA 12-week leave entitlement run concurrently with a Workers’ Compensation absence when your injury is one that meets the criteria for a serious health condition. However, if you have elected to receive worker’s compensation benefits, the university cannot require you to substitute any paid vacation or other leave.

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How can I find out if my doctor or other provider is a member of the UHC Group PPO Network?

To find out if your provider participates in the UHC Group PPO Network, you can ask your provider if they are a UHC Medicare Advantage Provider, or you can also call UHC’s university-dedicated toll-free number at 1-866-899-5903, TTY 711, from 8:00 a.m. – 8:00 p.m. in your local U.S. time zone, seven days a week.

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Is there a specific set of job codes that fall into teaching academics?

There is some work being done on academic titles, so it may be possible in the future, but at this time there is no consistent way to distinguish a teaching academic from a non‐teaching academic by title alone. The same title has been used for both teaching and non‐teaching roles, as well as for both fully benefit-eligible and non‐benefit-eligible positions.

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Can I take intermittent FMLA leave?

Yes. You can take intermittent leave in blocks of time or by reducing your weekly or daily schedule. FMLA leave may be taken intermittently whenever it is medically necessary to care for a seriously ill family member or because you are seriously ill and unable to work a full schedule. Intermittent leave may also be taken for a qualifying exigency or for covered service member leave. If you take such leave, you must make a reasonable effort to schedule such leave so as not to unduly disrupt university operations.

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What happens if I am traveling overseas and need care?

The university-sponsored UHC Group Medicare Advantage plans include worldwide coverage for emergency or urgently needed services, when medical services are needed right away because of an illness, injury, or condition that you did not expect or anticipate, and you can’t wait until you are back in the United States to address it. If you incur expenses for emergent or urgently needed care while traveling outside of the United States, you will have to personally submit your claims to UHC for reimbursement.

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Do I have to prove the necessity of medical leave?

In the case of general FMLA leave, the university requires the health care provider to certify the necessity. In the case of covered service member FMLA leave, the university requires medical certification from the military to certify that the service member is recovering from a serious illness or injury sustained in the line of duty on active duty and is actively receiving medical treatment. Medical leave will be limited to the duration of the serious health condition, as defined by FMLA.

The university may, with a HIPAA compliant authorization, contact your health care provider* to clarify information provided, but not to seek additional information beyond the inquiries permitted on the form. However, your direct supervisor may not contact the health care provider. If the university has reason to doubt the validity of a physician's certification, the university may require you to obtain a second medical opinion at the university’s expense.

* FMLA defines "health care provider" as a doctor of medicine or osteopathy who is authorized to practice medicine or surgery by the state in which the doctor practices; or any other person determined by the Secretary of Labor to be capable of providing health care services.

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Is leave under the FMLA paid or unpaid?

Both. Accrued vacation and personal days must be used when appropriate for any FMLA qualifying purpose. In addition, family sick leave (up to 12 days per year) must be used for a seriously ill immediate family member or service member and accrued sick leave must be used for the employee's own serious health condition. Once this time is exhausted, the employee reverts to unpaid status for the remainder of the FMLA leave. Employees with accrued compensatory leave may not be required to substitute such leave for FMLA leave.

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What info is needed for me to be enrolled in one of the new UHC Group Medicare Advantage plans?

There is certain information you must provide and actions you must take before you can be enrolled in the new university-sponsored Medicare Advantage plans. Although sponsored by the university, because this coverage replaces your current Medicare Part A and Part B coverage, your enrollment must be approved by the Centers for Medicare and Medicaid (CMS) – the federal agency that is responsible for the administration of Medicare Advantage plans – before coverage becomes effective. CMS will approve enrollment into a Medicare Advantage plan if an individual: 

  • Is enrolled in Medicare Parts A and B,
  • Provides a Health Insurance Claim Number (HICN)/Medicare Claim Number,
  • Has a permanent U.S. street address (no P.O. Box) on file, and
  • Is not within the 30-month coordination period for end-stage renal disease.

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Why is “full-time equivalency (FTE)” not an accurate way to determine medical eligibility?

While full-time equivalency (FTE) is currently reported in job data, using FTE does not meet one of the safe harbor methods for tracking hours. The three safe harbor methods are (a) track actual hours, (b) days worked equivalency – credit eight hours worked for any day in which the employee works one hour, or (c) weeks worked equivalency – credit 40 hours worked for any week in which the employee works one hour. Using FTE for teaching academics is appropriate because it is based on an agreed upon documented methodology which is being applied consistently as allowed by the regulations.

Visit the Patient Protection and Affordable Care Act (PPACA) page for more information.

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Why do I need to provide my HICN/Medicare Claim Number and street address when I enroll?

This is a critical step in continuing your university retiree medical coverage. If you have already provided your HICN/Medicare Claim Number to the university and have a current permanent U.S. street address on file with the university, you will not need to provide this information again. For most individuals, the university has the information.

Under CMS rules, individuals must provide the following information before CMS will approve their enrollment in a Medicare Advantage plan such as the university-sponsored UHC Group Medicare Advantage plans:

  • Health Insurance Claim Number (HICN)/Medicare Claim Number
  • Street Address (other than a P.O. Box)

To facilitate the collection of this information, the university will be contacting those Medicareeligible retirees and their covered Medicare-eligible dependents who do not have HICNs/Medicare Claim Numbers and/or street addresses on file with instructions on how to provide that information.

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Will I still receive benefits and accrue vacation and sick leave while on FMLA leave?

The university will continue benefit programs in which you were enrolled at the time of your leave. However, you are responsible for your portion of the cost. 

Vacation and sick leave continue to accrue during any paid leave status of at least 75 percent FTE, but you are not eligible to use accrual until you return to work. Personal days accumulate regardless of paid or unpaid leave status, and are lost at the anniversary date if you are on a leave of absence at that time.

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How can I check if the university has my Health Insurance Claim Number (HICN)/Medicare Claim Number?

The university will send out a letter requesting this information from those retirees or their eligible dependents who do not already have HICNs on file with the university.

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If I go on FMLA leave, do I have to continue to contribute to my retirement?

No. Your contributions to the university’s plan will not be required for periods for which no salary is paid. However, contributions will be required if your leave of absence is recognized as service credit under the plan for which partial or full salary is paid.

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What happens when I return to work from FMLA leave?

Your department will return you to the same position you had before the leave (or an equivalent position). You’ll receive the same level of benefits and seniority as you had before you went on FMLA leave.

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What if I don’t enroll in Medicare Parts A and B?

The Centers for Medicare and Medicaid Services (CMS) require you to be enrolled in Medicare Parts A and B, and that you continue to pay your Part B premium (as you do today if you are already enrolled in Medicare), to participate in a Medicare Advantage plan such as the new university-sponsored UHC Group Medicare Advantage plans. Therefore, to remain eligible for your university retiree medical coverage, you must remain enrolled in Medicare Parts A and B. If you are a pre-1990 university retiree, or retired from the Federal Civil Service or the Missouri State Retirement System and have not previously enrolled in Medicare or are not eligible to enroll in Medicare, please contact that the university to discuss your plan options.

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How do departments ensure time entered by variable-hour, exempt, non-teaching employees is accurate?

Reports are being provided to departments to allow reconciliation of the full-time equivalency (FTE) in the PeopleSoft HR system with the time recorded by variable-hour exempt employees in the time reporting system.

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If I am already enrolled in a Medigap plan, can I still enroll in the Medicare Advantage plan?

Medigap (Medicare Supplement) plans are intended to supplement Medicare parts A&B. Since the university-sponsored Medicare Advantage plans replace Medicare, you would not receive any benefits from your Medigap (Medicare Supplement). Therefore, there may be no value in continuing your Medigap (Medicare Supplement) plan.

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What if I don’t return to work after FMLA leave?

If you don’t return to work, or if you don’t remain at work for at least 30 days, you will have to reimburse the university for the cost of benefits coverage during the leave. If you don’t return due to a continuing serious health condition (your own or a family member’s), or because of other circumstances beyond your control, the reimbursement clause does not apply to you.

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How do I apply for FMLA leave?

If you are interested in applying for Family and Medical Leave, visit the FMLA page. Please note that the university requires a 30-day notice if the leave is foreseeable. For unforeseen circumstances, the university requires as much notice as is practicable.

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If I am enrolled in another Medicare Advantage plan, can I enroll in the university-sponsored plan?

No. CMS does not allow retirees to enroll in two Medicare Advantage plans. You will need to choose between your current plan and the university-sponsored UHC Group Medicare Advantage plans; you cannot be covered under both. 

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How are the Healthy Savings, Custom Network, and PPO plans different?

The Healthy Savings Plan is an IRS-qualified high-deductible health care plan that offers a lower premium with a higher deductible. Because it is qualified by the IRS, it can be paired with a Health Savings Account (HSA) to offset your higher deductible. Plus, the university contributes to your HSA (if you are an active employee) to help pay the higher deductible and eligible out-of-pocket medical, dental, and vision expenses. You may choose to contribute to your HSA, too, up to the IRS maximums, but you do not have to do so to earn the university contribution.

The Custom Network Plan and the PPO Plan are similar to one another in how they are structured. The Custom Network Plan is offered only in specific regions, however. See the Custom Network Plan webpage for information on eligibility. The Custom Network offers a network that is specially selected to keep costs low and offers the mid-level of monthly premiums if you are comparing against the other two plans, but the lowest deductible ($0 for in-network services). The PPO Plan has the same nationwide network as the Healthy Savings Plan and has the highest premium but a lower deductible.

Generally speaking, with both the Custom Network and the PPO Plan, you will pay less per medical service than with the Healthy Savings Plan until you meet the respective deductibles. The Custom Network Plan and the PPO Plan have a higher out-of-pocket maximum than the Healthy Savings Plan.

The Custom Network Plan and PPO Plan can be paired with a Health Care Flexible Spending Account (FSA) to offset out-of-pocket expenses. Any plan can be paired with a Dependent Care FSA.

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I am an LTD recipient enrolled in Medicare, will I need to enroll in the university-sponsored plans?

Long Term Disability (LTD) recipients will not enroll in the University-sponsored UHC Group Medicare Advantage plans for 2017. They will continue to be eligible to remain enrolled in the medical plans offered to active employees: the PPO Plan, Custom Network Plan, and Healthy Savings Plan.

Plan options for LTD recipients in 2018 will be different; stay tuned for more Annual Enrollment information.

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If I miss work due to work-related illness/injury, will my leave be unpaid?

If you accrue an absence due to work-related illness or injury, on the day of the accident or first medical attention, you will be excused from work without loss of pay. This time will not count against vacation time or sick leave. If you are able to return to work, you will continue to be paid during the period of time required to obtain medical attention related to the injury or illness. If unable to return to work, a regular administrative, service, and support staff employee will be granted an unpaid leave of absence.

If attending a Worker’s Compensation conference or hearing, you will be excused from work without loss of pay, vacation time, or sick leave.

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Is women’s preventative health care covered by my insurance plan?

Yes, preventive health care—such as mammograms, screenings for cervical cancer, prenatal care, and other services—is covered at no cost to the employee if you are enrolled in a university medical insurance plan and the visit to your health care provider is not part of a preexisting condition diagnosis or treatment.

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What is ERIP

ERIP stands for Employee Retirement Investment Plan. Learn more on the ERIP webpage.

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