If a faculty member is covered by one of the health insurance plans, the faculty member can choose to continue coverage if he or she loses group health coverage because of a reduction in hours of employment or the termination of employment (for reasons other than gross misconduct on the faculty member's part).
If a spouse of a faculty member is covered by one of the health insurance plans, he or she can continue coverage if coverage is lost due to: the faculty member's death, termination of employment (for reasons other than gross misconduct), or reduction in hours of employment; divorce or legal separation; or the faculty member becomes entitled to Medicare.
If a faculty member's dependent child is covered by one of the health insurance plans, he or she can continue coverage if coverage under that plan is lost for any of the following reasons: the faculty member's death, termination of employment (for reasons other than gross misconduct) or reduction in hours of employment; parents' divorce or legal separation; the faculty member becomes entitled to Medicare; or the child ceases to be a "dependent child" as that term is defined under the applicable group health plan.
If continuation coverage is chosen, coverage will be given which, as of the time coverage is being provided, is identical to the coverage provided under the group health plan to similarly situated faculty or family members.
Coverage will continue for 36 months unless group health coverage was lost because of a termination of employment or reduction in hours. In that case, the continuation coverage is 18 months. However, the 18-month period may be extended to 29 months when the Social Security Administration determines that you, or another covered family member at the time of termination of employment or reduction of hours, was disabled at any time during the first 60 days of continuation coverage and you inform Saint Joseph’s University before the end of the 18-month period.
Coverage will end for any of the following reasons:
Saint Joseph's University no longer provides group health coverage to any of its employees;
The premium for continuation coverage is not paid by the first of each month; or
The covered individual becomes entitled to (covered by) Medicare.
The person choosing coverage does not have to show that he or she is insurable to continue coverage. To continue coverage, the full premium must be paid, as well as a 2% administration fee. At the end of the 18-month, 29-month or 36-month period, enrollment in an individual conversion health plan will be allowed if such a conversion plan is otherwise provided under the Saint Joseph's University health plan.
Employees may elect to continue participation in the Healthcare Spending Account for the remainder of the Plan Year, which ends December 31 and continue to make any required contributions to the Plan.
If a faculty member, spouse or dependent child wishes to continue coverage, the faculty member will be responsible for notifying the Human Resources Office within 60 days of the loss of group health coverage.
Group dental insurance, through Delta Dental PPO or DeltaCare Dental HMO, is available on the first of the month following 90 days of employment. Thereafter, enrollment is allowed only during the open enrollment period in September of each year with coverage effective November 1. Once enrolled, faculty members may transfer from one dental plan to another only during the open enrollment period. The faculty member and the University share the cost of the premium. Details about these plans are available in the Office of Human Resources.
General Claims, Benefit or Dentist Questions: PPO Plan: 800-932-0783
DeltaCare Questions: 800-422-4234 - Customer Relations Department
NJ DMO Questions: 800-722-3524 if calling from NJ, 800-848-3524 if calling from outside of NJ
A Healthcare Spending Account is a type of Flexible Spending Account that allows employees to pay for qualified out of pocket healthcare expenses on a pre-tax basis. Expenses that qualify include: medical insurance deductibles and co-payments and other expenses not covered by your medical, dental and vision care insurance(s). Enrollment in this plan is optional. Each year or at the start of employment, an employee may elect the amount he/she wishes to contribute to the healthcare spending account. Amounts are deducted each pay period before taxes and deposited into a Healthcare Spending Account. Employees pay for eligible expenses and submit claims to the University’s third party administrator, Payflex. Reimbursement for eligible expenses is made by check or direct deposit. Information and forms for this benefit are available in the Office of Human Resources.
Saint Joseph's University offers a choice of two medical insurance plans: Consumer Driven High Deductible Health Plan (Personal Choice HDHP), and Keystone HMO. Details on these plans are available in the Office of Human Resources.
The University and the faculty member share the cost of the medical premiums. The University’s share will be announced each plan year prior to the open enrollment period in September.
Coverage may begin as soon as the first of the month coincident with or following the date of employment. A faculty member may enroll during the first 30 days after the date of employment. Once enrolled, an employee may transfer from one medical plan to another only during the open enrollment period held in September of each year with coverage effective November 1.
A cash option in lieu of medical insurance is available and cannot be revoked or amended during the plan year unless there is a change in family status.
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment within 30 days after your other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
Personal Choice or Keystone
Member Services: 1-800-ASK-BLUE
Website for Keystone or Personal Choice: www.ibx.com
A vision care program, Davis Vision, is available on the first of the month following 90 days of employment. Thereafter, enrollment is allowed only during the open enrollment period in September of each year with coverage effective November 1. The University and the faculty member share the cost of the vision premium. Details about this plan are available in the Office of Human Resources.
Member Services: 1-800-999-5431 or www.ibxpress.com