Frequently Asked Questions About Benefits at SLU

For your 2022 document, go to Workday > Benefits > My ACA Forms.  For records prior to 2020,  please access in Banner Self-Service.

Under the Patient Protection and Affordable Care Act (PPACA), Saint Louis University must report health coverage information to the Internal Revenue Service and provide a statement (Form 1095-C) disclosing health care coverage information to covered employees (medical plan participants) and any other covered individuals, such as COBRA participants, Long Term Disability (LTD) or certain retirees.

The information provided on 1095-C for plan participants will include any dependents covered. Dependents will not receive a separate form. If your dependents file a separate tax return, just copy your Form 1095-C for their records.

Yes, you may reference the information on 1095-C form when completing your federal taxes. You will not submit the 1095-C form, but you should retain it with your tax records.

You do not have to wait to receive the 1095-C form to file your individual income tax return. The IRS has provided more information on the form.

Other forms of documentation that you can use to provide proof of your insurance coverage include:

• Health insurance cards
• Benefits statement from Banner Self-Service
• Explanation of benefits
• W-2 or payroll statement reflecting health insurance deductions
• Any other statements indicating that you, or a member of your family, had health care coverage

Yes, SLU's medical plans meet the minimum essential coverage (MEC) as required by PPACA so you will meet the individual mandate requirement if you were covered by SLU's medical plan for all 12 months of the year. 

If you were employed with a different employer for part of the year and had health care coverage by that employer's medical plan, you should receive a 1095 form from that employer, as well.

If you have questions about the 1095-C form, call the Benefits Office at 314-977-2595, or email benefits@slu.edu.

Benefits become effective on the employee's first day of regular benefit eligible employment, provided online enrollment and dependent verification is submitted in a timely manner. Enrollment must occur within the first 31 days of employment. Members of a collective bargaining unit may have to satisfy a probationary period prior to insurance coverage. Such members should refer to their collective bargaining agreement for specific details.

Your current benefit elections can be found in Workday, by clicking the benefits application, then clicking benefit elections in the view column. 

Changes are generally only permitted during the annual open enrollment period, unless you have a qualifying event during the year. Open enrollment is usually in November of each year, with the requested changes taking effect the following January 1. Open enrollment is the time during which an employee may add or drop dependents to their plans (without a qualifying life change event), as well as change the plan options selected. 

After your initial 31-day enrollment period, the only time to enroll yourself or add a dependent to your plan is during open enrollment, or upon a qualifying event. Such events may, but are not limited to, include birth, adoption, marriage, death or loss of coverage under a different plan. These changes must be made within 31 days of the qualifying life change event. 

Loss of eligibility under another group benefit is a qualifying event in which you can enroll in SLU's health plans. You must provide proof of the loss of coverage documentation in the Workday change benefits event within 31 days of the date your other coverage terminates. Additionally, dependent verification documentation must be included  for any dependents added to your benefits.  

A newly eligible dependent by way of birth, adoption, marriage or court order can be added to an employee's insurance (medical, dental, vision and accident) within 31 days of acquiring the dependent by completing a change benefits event in Workday, and uploading the appropriate dependent verification. 

Supporting documents may be required when requesting coverage for dependents, or for a qualifying event. 

Medical Benefits 

You may only change the medical or dental plan you are enrolled in during the annual November open enrollment. 

Eligible dependents are: 

• Your legal spouse, unless legally separated or divorced
• Each of your children. The term "children" includes any such person related to you by blood or marriage, or for whom you have legally adopted or assumed a legal obligation, or other child, if that child lives in your household in a parent-child relationship and is dependent upon you for support.
• Children are eligible for coverage up until their 26th birthday. *Please note that Workday will automatically remove your ineligible child at the end of the month of your child's 26th birthday. 

After your initial 31-day enrollment period, the only time to remove a dependent from your plan is at open enrollment, or upon a qualifying event, including becoming an ineligible dependent due to gaining coverage elsewhere, divorce, death, or a child reaching 26 years of age. These changes must be made within 31 days of the qualifying event with appropriate documentation and enrollment / change forms. 

You and your eligible dependents are provided the opportunity to continue your medical, dental, vision, and/or flexible spending coverage after the termination of your benefits. You will be notified of your election rights within 30 days of your termination via postal mail sent from the University's third party COBRA vendor; Optum Financial. Questions regarding payment of COBRA premiums should be directed to Optum Financial at 855-687-2021.

Saint Louis University is concerned with the well-being of its staff members and their families. We recognize personal problems arise and having access to professional licensed counselors on a confidential and cost-free basis can be helpful.  To support our faculty and staff, along with members of their household when encountering difficult situations, the University maintains an Employee Assistance Program (EAP). 

 

Learn More

 

The employee does not incur any fees for accessing EAP counseling. Under the SLU EAP benefit, employees and their family members are entitled to eight face-to-face counseling sessions per person, per issue, per year, at no charge to them. If additional counseling sessions are required, the therapist will assist in connecting them with continued care through their health plan or through community resources if they do not have a health plan.

The EAP benefit is paid by SLU for our employees and family members as part of our continued care for your health and well-being. 

Register on United Healthcare's website to print a temporary card or request a card be mailed to your home. You can also request a card by calling member services at 800-382-4259. 

An Explanation of Benefits (EOB) is available online. Register on www.myuhc.com to view EOB's, check on claim status, and other helpful information or call 800-382-4259.

Once you register on www.myuhc.com you can get information on the services and procedures that are covered under our plan. You can view our summary plan description on United HealthCare's website or on our benefits website. Your physician can submit a pre-determination to United Healthcare for the scheduled procedure to determine if the procedure is covered and at what level. 

You can contact United Healthcare and find frequently asked questions on their website.

Some possible reasons for claims not being paid at United HealthCare: 

• A dependent may not be eligible for coverage due to age
• The dependent may not have been added to your coverage in a timely manner
• United HealthCare might not have received a copy of the claim from your provider

Please contact United Healthcare at 800-382-4259 or visit their website to determine if additional information is needed to process your claims.

Our prescription benefit through ESI provides a mail order program. This program offers you a 90-day supply for two co-pays. If you take a maintenance medication, you will be automatically enrolled in the mail order program after three refills at the retail pharmacy. You can opt out of the mail order program if you prefer to visit the pharmacy every 30 days. Failure to opt out of the mail order program may create a disruption in refilling your prescription at a retail pharmacy.

You can initiate your participation in the mail order program by contacting ESI member services at 888-778-8755.

You must contact ESI member services at 888-778-8755 to opt out of the mail order program in order to fill your maintenance prescriptions at the retail pharmacy.

Possible reasons that your prescription isn't covered may be:

• It is a Step Therapy prescription.
• It needs a prior authorization.
• You are filling a maintenance prescription but have not yet opted out of the mail order which will cause a delay in getting a prescription filled.

Contact ESI Customer Service at 888-778-8755 with any additional questions. 

Electing the Flex Option, the highest level of benefits as well as coverage in the PPO network, and out of the PPO network is provided. The Flex option also includes adult and child orthodontia.

However, when electing the Basic Plus Option, a lower level of benefits as well as coverage in the PPO network and out of PPO network is available. The Basic Plus option offers orthodontia for children only up to age 19. 

More Information on Dental Benefits
 

To find out if your dentist is in the Delta Dental PPO Network or to find a Delta Dental participating dentist in your area:

• Visit the Delta Dental website at www.deltadentalmo.com and click on "Looking for a Dentist." Choose Delta Dental PPO Network and locate a list of dentists by zip code or specific dentist name.
• Call Delta Dental at 800-335-8266 or 314-656-3001 to request a dentist directory. 

Yes, although it is not required to obtain services from a participating dentist. Your dentist can verify your coverage by calling Delta Dental and supplying your social security number. Upon enrollment in SLU's dental plan, identification cards will be generated and mailed to your home within seven to 10 business days.

Yes, members simply choose a VSP provider and let them know they have VSP coverage. 

Please visit www.vsp.com and select the "Find a Doctor" option.

VSP does not provide vision insurance ID cards. Members are not required to carry or produce a vision card for services at any of our VSP providers' offices. As an alternative, members can download a member-specific ID cards on www.vsp.com if they would like a card to carry in their wallets. To confirm eligibility in VSP's system, please contact customer service at 800-877-7195.

You may begin your 403(b) contributions after you receive your first paycheck from the University. To start your contributions you must set up your 403(b) account first.  Please watch the mail for information regarding eligibility and registration from TIAA.  You can also access the TIAA website here although you will not have access until the initial communication is received from TIAA.

Yes, after one year of continuous service and working at least 1000 hours, faculty and staff are eligible for the University's contribution, only if the employee is contributing to the 403(b) plan. The University match is based on the employee's 403(b) contribution. 

There are various options available to withdrawal your money from the plan. Please contact TIAA at 800-842-2776 to discuss the options available to you.  

Required Minimum Distributions are distributions that are required to begin no later than April 1 following the end year in which you reach age 70 ½ or terminate employment, whichever is later.  

TIAA, the University's sole approved retirement vendor, allows access to fund balances through a loan provision for active employees. Loans are arranged directly between TIAA and the employee. 

Hardship withdrawals from the 403(b) plan may be available for active employees in very specific circumstances. Please contact TIAA at 800-842-2776 to see if you are eligible.

Once the employee separates employment with the University, he or she may transfer fund balances to another qualified retirement account, including an IRA, or receive a cash distribution. Please consult a tax consultant for tax consequences associated with a cash distribution. 

The life insurance information is available as part of the employee benefit statement in Workday. The employee benefit statement can be accessed by click the benefits application and view benefit elections.

Base coverage, provided by Saint Louis University is equal to one times your annual salary to a maximum of $400,000.

Optional life insurance and accidental death and dismemberment coverage can only be increased during Open Enrollment. Contact the benefits office if you would like to decrease your coverage.

The combined amount of basic and supplemental life insurance cannot exceed $400,000 or four times your annual salary, whichever is less.

Beneficiaries can be changed at any time, and are recommended to be changed after a life event, such as marriage, divorce, death or birth or adoption of a child. This can be changed through a change benefits event in Workday.

 

Your long-term disability benefit becomes effective on the first day of the month following your one-year anniversary with Saint Louis University. 

Benefits under the long-term disability plan begin after three months of disability or the exhaustion of sick leave not to exceed six months.

Before initiating a claim, please be sure to first speak with your HR Consultant to confirm you have exhausted all leave options. To initiate a Long Term Disability claim, please visit the Cigna website and select the “Filing a Claim” option or call 888-842-4462 if you need additional assistance.

Retirement is obtaining age 60 with seven or more years of continuous, full-time service to the University. The benefit of retirement is that you may continue your SLU medical insurance coverage, as long as you pay the premiums for this coverage.

If you are over 65, Medicare is primary and our plan is secondary. If you retire under age 65, your SLU United HealthCare is the primary payer until you reach Medicare eligibility. At that time, if you chose to remain on the SLU United HealthCare health insurance, you must pick up Medicare Part B.

Retirees from SLU are entitled to maintain their tuition remission benefits for themselves and any eligible dependents. The Simon Recreation Center also provides a one year gift membership to retirees as a token of appreciation.