Human Resources

Staff Handbook

Group Insurance Plans

Texas A&M University-Kingsville offers several group insurance plans to eligible employees. The employer contribution varies from year to year based on State legislation. This State contribution can only be applied to group medical insurance premiums. Those employees not enrolled in medical insurance or an HMO may use up to ½ the employee's only contribution for dental, basic life, or Accidental Death and Dismemberment (AD&D) insurance and Long Term Disability.

Detailed brochures on coverages and premiums are available from your manager or the Human Resources Office. An eligible employee may change coverage only in the annual open enrollment period, usually July and August, or if there is a change of status in their family. In the event the handbook information conflicts with the actual terms and conditions of coverage, the plan document governs.

Group Health Insurance is available to eligible employees for both themselves and their families in either one of two A&M plans or one HMOs in Kingsville, one of two A&M plans or one HMOs in Palo Alto and only one of two A&M plans in Citrus Center. Out of pocket premiums for employees electing any type of family health coverage will be automatically paid with pre-tax dollars unless the employee specifies otherwise.

Basic Life Insurance will automatically be given to all employees who participate in an HMO or A&M health plan since it is covered by the State contribution. This plan provides the employee with $5,000 of group term life insurance and $5,000 of accidental death and dismemberment coverage. Employees may purchase Basic Life/Basic AD&D coverage even if they are not enrolled in a System health plan. Subject to certain limitations, employees may elect to have $50,000 of Basic Life (or 7 times your salary, whichever is less) and Basic AD&D coverage. Your eligible dependent children will automatically be covered for $2,000 Basic Life.

Optional Life Insurance is available for those wishing to purchase an additional amount of group term life insurance. Eligible employees are limited to those who are participating in an HMO or A&M health plan. The amount of coverage is based on the employee's salary. Employees may elect coverage equal to 1/2, 1,2,3,4,5 or 6 times their 12-month equivalent salary, not to exceed a maximum of $800,000.

Dependent Life Insurance for an eligible employee's family is also available at group rates with three options. Option A, the spouse is covered for 50 percent of the employee's Optional Life insurance amount and eligible children for 10 percent each. Option B, the spouse of an employee is covered for $5,000 or 50 percent of the employee's Basic and/or Optional Life amount, whichever is less, and eligible children for $2,500 each. Optional C, covers your spouse, if enrolled, for 50 percent and each of your enrolled children for 10 percent of your Alternative Basic Life amount.

Long Term Disability (LTD) If an employee becomes disabled, the Long- Term Disability plan pays 65% of his or her base pay minus other disability benefits the employee may be eligible to receive. This means the total disability income from all sources will be at least 65% OF BASE PAY. The maximum monthly benefit is $8,000. The minimum monthly benefit is $100 or 10% of the employees monthly benefits before deductions for other income benefits, whichever is greater. (For employee's age 62 or older, the employer-paid portion of any of these benefits he or she is eligible to receive will reduce the LTD benefit.)

Optional Accidental Death and Dismemberment (AD&D) may be purchased to provide coverage against dismemberment or death from any type of accident, on or off the job. Employees may purchase up to $250,000 in coverage in $10,000 multiples. Coverage between $160,000 and $500,000 may be purchased provided the amount of coverage does not exceed 10 times the employee's annual salary. The employee's family may be included on this policy. The coverage amount available to a spouse is 50 percent of the employee's coverage and each child 10 percent of the employee's coverage. The maximum coverage for each child is $25,000.

A&M Dental (CIGNA) organization network (PPO). If you use a dentist in the PPO network, the dentist’s charges will be discounted up to 20%. While you will pay the same deductible and percentage of the cost as you would at a non-network dentist, your share of the cost will be less because the charges are based on CIGNA’s contracted rate. At non-network dentists, you will also be responsible for any amount over the reasonable and customary charges as determined by CIGNA.

(CIGNA) Dental HMO The CIGNA Dental HMO has lower premiums than A&M Dental, no deductible and no maximum benefit. To receive benefits, you must use your CIGNA Dental HMO general dentist. You must be referred to a network specialist by your network general dentist. CIGNA Dental HMO covers most preventive, basic, major and orthodontic services.

Superior Vision may be purchased and provides coverage for eye exams, eyeglass frames and lenses, and contact lenses as well as discounts on some eye surgeries.

Long Term Care (LTC) may be purchased and is designed to provide a monetary benefit for care provided by skilled nursing and intermediate care facilities. It also pays for custodial care. In addition, LTC provides 50 percent of the daily benefit selected for home health care and adult day care. The daily benefit will be paid in addition to any benefits available from other sources.

Coverage is available for an employee, spouse, parents, parents-in-law, grandparents and grandparents-in-law. Premiums are determined by the age of the individual when coverage takes effect and daily benefit selected. This coverage may not be paid from the State contribution.

This page last updated 21 December, 2004