Employee Benefits Guide - January 1, 2022 - December 31, 2022
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Employee Benefits Guide January 1, 2022 - December 31, 2022
2|Page
TABLE OF CONTENTS
TOPIC PAGE
Introduction 3
Online Enrollment Instructions 4
Key Dates 6
Resources & Contact Information 7
Carrier Information 8
Eligibility & Enrollment Rules 9
COBRA Continuation 10
CIGNA Medical and Prescription Coverage 11
Medical Information 13
Health Savings Accounts (HSA) 14
CIGNA Dental Coverage 19
CIGNA Vision Coverage 20
NEW! CIGNA/NY Life - Life Insurance 21
NEW! CIGNA/NY Life Disability Insurance 22
NEW! CIGNA/NY Life - Accidental Injury Insurance 23
NEW! CIGNA/NY Life - Critical Illness Insurance 25
NEW! CIGNA/NY Life – Hospital Indemnity Insurance 27
PBS Flexible Spending Accounts (FSA) 28
Lifelock Identity Theft Protection 29
Legalease Pre-Paid Legal Protection 30
Required Notices 2022 31
Notice of the Exchange 33
Medicare Part D Creditability Notice 34
Paid Family Medical Leave – CT & MA Notices 35
NEW FOR 2022!
Cigna MotivateMe Program
MotivateMe is an incentive program that helps you change unhealthy behaviors and rewards
you for it. And that’s important, because taking healthy actions will help reduce your risk of
illness, disease and costly medical treatment. With MotivateMe, you’ll work toward achieving
real results that mean a real, healthy change for you.
Human Resources will provide more information about this valuable new program including
how and when to begin, as well as the rewards available.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.
Page |3
INTRODUCTION
Welcome to Annual Enrollment for the 2022 plan year. Our employee benefit plans are a valuable part of your overall
compensation package. The main goal of our benefit program is to help you build financial security for yourself and your
family through a benefit package that offers a broad range of coverage, at reasonable costs.
Our Benefit Program Offers
• Medical and Prescription Drug Coverage • Accidental Injury Insurance
• Health Savings Accounts (HSA) • Critical Illness Insurance
• Dental Insurance • Hospital Indemnity Insurance
• Vision Insurance • Flexible Spending Accounts (FSA)
• Basic Life and AD&D Insurance • Employee Assistance Program (EAP)
• Voluntary Life Insurance • Identity Theft - LifeLock
• Short Term Disability Insurance • Pre-Paid Legal - Legalease
• Long Term Disability Insurance
What’s New This Year?
We are pleased to announce that we will be offering additional CIGNA benefits for the 2022 plan year including Life and
Disability, as well as voluntary benefits – Life Insurance, Accident, and Critical Illness coverage. Moving these core ancillary
benefits under one carrier helps to provide cohesive and complementary coverages for employees.
Making Your Annual Enrollment Selections – Employee Navigator
We will continue to use Employee Navigator this year as our enrollment system. Current employees should log in using their
existing user name and password. Newly eligible employees should register following the instructions in this guide.
Our medical plan offers a Wellness discount on the medical plan premium as part of our “Preventive Care Campaign.” The
Preventive Care Campaign and discounted rates are only available during our Annual Open Enrollment period.
OPEN ENROLLMENT - PREVENTIVE CARE CAMPAIGN
Available to Employees & Spouses who enroll in Medical Coverage January 1, 2022:
Goodwin University and The University of Bridgeport are committed to the health and wellbeing our employees. We have
redeveloped our wellness program where employees and their spouses will receive a credit on their medical plan payroll deductions
for taking the basic step of obtaining a routine wellness exam. We feel that having this routine exam provides an opportunity for
their personal physician to assess their current health situation and create a plan to become their healthiest. This program is only
applicable to employees and spouses enrolled in our health plan; this program does not apply to children.
Employees that enroll in the health plan as of January 1, 2022 and submit their Physician Attestation Forms will be provided a $327
annual credit and a $654 annual credit for employee & spouse. If both employee and spouse are enrolled in the medical coverage,
both must provide the Physician Attestation Form as evidence of a current physical in order to receive the employee & spouse credit
(partial credit will NOT be provided). Those employees and spouses who choose not to submit the Attestation Form(s) will not be
eligible for the credit(s) and will pay a higher medical premium. The credit/surcharge will be provided as follows:
Coverage Level Bi-Weekly Credit
Employee Only $12.58
Employee + Spouse $25.15
Employee + Child(ren) $12.58
Employee + Family $25.15
We encourage all employees and applicable spouses to participate.
The Physician Attestation Form must be submitted to Human Resources no later than January 6, 2022.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.
4|Page
ENROLLMENT INSTRUCTIONS
We conduct benefit enrollment online with Employee Navigator. All benefit eligible employees will be required to
enroll or waive benefits through our new online enrollment system, Employee Navigator.
You are responsible for ensuring all information – including addresses and dates of birth are correct in the
enrollment system.
goodwinuni
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.
Page |5
If you need additional assistance
email: mmurphy1@goodwin.edu
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This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.
6|Page
KEY DATES
2022 Open Enrollment – November 10, 2021 through November 24, 2021
You must complete enrollment even if you are waiving the voluntary benefits. If you do not complete online enrollment,
we will presume that you wish to duplicate your 2021 choices and attempt to match your current elections. However, your
elections for any new benefits (including Voluntary Life Insurance) will be noted as declined. Your ability to change or cancel
these elections will not be possible once the Open Enrollment period has ended.
Benefits “Clinics”
If you have any questions about your benefits options, or need assistance with navigating the PBS enrollment system, please
sign up for one of the on-line ‘ZOOM’ Virtual Benefits Clinics. You will also receive an email from Human Resources with more
information. The HR team will be available to assist you through the enrollment process.
2022 Benefits Annual Meeting
Wednesday, November 10, 2021
11:30AM – 1:00PM
GOODWIN UNIVERSITY
Benefits Clinics – Open Enrollment
Location: Hoffman Family Library Computer Room
Bring with you: Beneficiary(s) information (Name, Address, phone number, date of birth & SSN)
Wednesday, November 10, 2021 10:00AM – 12:00PM
2:00PM – 4:00 PM
Thursday, November 11, 2021 10:00AM – 12:00PM
2:00PM – 4:00 PM
Friday, November 12, 2021 9:30AM – 12:00PM
Monday, November 15, 2021 10:00AM – 2:00PM
Tuesday, November 16, 2021 10:00AM – 12:00PM
2:00PM – 4:00 PM
Monday, November 22, 2021 10:00AM – 1:00PM
Tuesday, November 23, 2021 10:00AM – 1:00PM
Wednesday, November 24, 2021 10:00AM – 1:00PM
UNIVERSITY OF BRIDGEPORT
Benefits Clinics – Open Enrollment
Location: Wahlstrom Library Computer Room (Floor 5)
Bring with you: Beneficiary(s) information (Name, Address, phone number, date of birth & SSN)
Wednesday, November 10, 2021 10:00AM – 12:00PM
2:00PM – 4:00 PM
Thursday, November 11, 2021 10:00AM – 12:00PM
2:00PM – 4:00 PM
Friday, November 12, 2021 9:30AM – 12:00PM
Monday, November 15, 2021 10:00AM – 2:00PM
Tuesday, November 16, 2021 10:00AM – 12:00PM
2:00PM – 4:00 PM
Wednesday, November 17, 2021 9:00AM – 12:00PM
1:00PM – 3:00PM
Thursday, November 18, 2021 9:00AM – 1:30PM
Monday, November 22, 2021 10:00AM – 1:00PM
Tuesday, November 23, 2021 10:00AM – 1:00PM
Wednesday, November 24, 2021 10:00AM – 1:00PM
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.
Page |7
RESOURCES
When you have questions about your insurance coverage, or are experiencing problems with getting claims paid, you have
several resources:
Benefit Guide This guide is a summary of your insurance plans. It also contains benefit rates for all your insurance plans.
While it is a great tool, we recognize that you may need additional information to help you make the best benefit decision.
Therefore, this Benefit Guide contains all of the helpful phone numbers and websites. This benefit guide highlights some of
the main features of your benefit programs, but does not include all plan rules, features, limitations or exclusions. The
terms of your benefit plans are governed by legal documents, including insurance contracts. Should there be any
inconsistencies between this book and the legal plan documents, the plan documents are the final authority.
Insurance Carrier Websites and Phone Numbers These websites are most helpful when you want to review a claim that has
been presented, order additional or replacement ID cards, and other administrative things. The websites are also a valuable
resource for locating in network providers. You can also contact the insurance carriers by phone with any questions about
your coverage. Their phone number(s) is located on your insurance identification care.
The Human Resource Team: can assist you with completing the enrollment process. We are also available to act as a liaison
in your dealings with insurance carriers. If you are having trouble getting claims paid or questions regarding your coverage,
we are here to help.
Goodwin University University of Bridgeport
Terry W. Antoine– Director, Human Resources Cheryl Nyarady – Director, Human Resources
Tantoine@goodwin.edu Cnyarady@bridgeport.edu
Phone: (860) 727-6938 Phone: (203) 576-4731
Meghan Murphy, HR Specialist Alexandra Pisco, HR Assistant
mmurphy1@goodwin.edu Apisco@bridgeport.edu
Phone: (860) 913-2259 Phone: (203) 576-4588
Andrews Benefits is our strategic partner in managing our benefit programs. They work closely with the HR team to ensure
that you have seamless benefits coverage. Andrews Benefits are also a great resource for discussing your 401(k) retirement,
and related questions and concerns.
Andrews Benefits Contacts:
Erica Mitchell – SHRM-CP, Director of Operations Amanda Carlo – Group Account Manager
Emitchell@andrewsbenefits.com Acarlo@andrewsbenefits.com
Phone: (860) 678-8888 Fax: (860) 678-0115
Certificates and Policies documents are required by Health Care Reform. You can find a copy of all Certificates and Policies
on Employee Navigator. If there is a discrepancy between the benefit guide and the Certificates and Policies, the Certificates
and Policies will prevail.
Summary of Benefits and Coverage (SBC) SBC’s is a document required by Health Care Reform. It is a summary of the
insurance plan design. The SBC for your Medical plan is available on Employee Navigator.
Insurance Carrier Websites
These websites are most helpful when you want to review a claim that has been presented, order additional or replacement
ID cards, and other things. They are also the resource for locating in network providers.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.
8|Page
CARRIER INFORMATION
CIGNA: Member Service: 1-800-Cigna-24 /Online: www.cigna.com Group # 00631103
Medical Insurance Company/Employee Paid
Dental Insurance Employee Paid
Vision Employee Paid
Basic Life and AD&D 2x annual salary Company Paid
Voluntary Life Coverage options for employee, spouse, and children Employee Paid
Short Term Disability Coverage of 60% up to a max of $750 per week Company Paid
Long Term Disability Coverage of 60% up to a max of $10,000 per month Company Paid
Accidental Injury Insurance Employee Paid
Critical Illness Insurance Employee Paid
HSA Bank – Health Savings Account Employee Paid
You must open a Health Savings Account with HSA Bank in order to have money payroll
deducted into the account. You can open an account by completing the enrollment
form on Employee Navigator or by enrolling online at www.hsabank.com.
LifeLock: Member Service: 1-800-543-3562 / Online: www.lifelock.com
Identity Theft Protection Employee Paid
Legalease: Member Service: 1-800-562-2929 / Online: www.legaleaseplan.com
Pre-paid Legal Services Employee Paid
Progressive Benefit Solutions: Member Service: 1-888-333-3901 / Online:www.pbscard.com
Flexible Spending Accounts Employee Paid
COBRA Continuation Employee Paid
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.
Page |9
ELIGIBILITY
Open enrollment for eligible employees is the month of November, annually, with the new benefit plan effective
January 1, 2021
• You are eligible if you are a full-time employee, which is defined as:
Faculty - regularly scheduled to work at least 35 hours a week.
Staff – regularly scheduled to work at least 40 hours a week.
If you work an average of 30 hours a week, you are eligible to enroll in the medical insurance plan only.
• New employees are eligible for coverage on “The first of the month, 60 days after their date of hire”.
• If new hires do not enroll for all benefits when first eligible, there could be late entrant penalties and/or
other plan limitations when enrolling later. Be sure to check each benefit’s enrollment rules carefully.
• Open enrollment privileges apply to Medical, Dental, Vision, Accidental Injury, Critical Illness, and
Flexible Spending Accounts (FSA). Individuals may make changes or add dependents without having to
provide proof of insurability during the open enrollment period.
• The open enrollment period is the only time employees may enroll in the above medical or dental coverage
without the occurrence of a qualifying event (see definition below).
Legal Spouse eligibility:
• Employees may cover their spouse under medical, dental, vision, voluntary life, accidental injury, critical illness
plans, Lifelock and Legalease. An eligible spouse may be added to the employee’s medical, dental and vision
plan during the employee’s initial eligibility period, during open enrollment, or due to a qualifying event. For
more information regarding spouse eligibility please contact Human Resources.
Dependent Children eligibility:
• Cigna Medical, Dental, and Vision – dependent children can be covered up to age 26. Coverage will terminate at
the end of the plan year following the 26th birthday.
• Voluntary Life Insurance – children ages 15 days to 26 years old are eligible for coverage. Coverage will
terminate at the end of the policy year following the dependents 26th birthday.
• Accidental Injury & Critical Illness - Dependent children from newborns to age 26 are covered regardless of
their martial or student status. Coverage will terminate on the day the child is no longer eligible.
ENROLLMENT RULES
Special Enrollment Rules
You are eligible to enroll yourself and your eligible dependents in the plans when you meet the eligibility requirements.
Generally, the coverage you elect for yourself and your dependents may only be changed during the next annual open
enrollment period, unless you qualify to make a mid-year change in coverage due to a qualifying event described under
the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Internal Revenue Code § 125. Here is a
partial list of qualifying events:
• A change in your employment status, or your spouse’s employment status that affects eligibility for benefits;
• A change that causes your dependent children to become ineligible, such as age or student status;
• A change in your legal marital status (marriage, civil union, divorce);
• A change in the number of your dependents due to birth, adoption or death; and/or
• Loss of your coverage or your dependent’s coverage under your spouse’s plan due to loss of eligibility under
that plan.
If you wish to request a change in your coverage due to one of the qualifying events outlined above, or as otherwise
described under HIPAA you must submit a written request within 30 days of the date of the event. The change you
request must be consistent with, and on account of, the event listed above. Please contact Human Resources if you
wish to clarify your eligibility to make a mid-year change in your coverage.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.
10 | P a g e
ENROLLMENT RULES
Should Your Employee Coverage Terminate
• Medical, Dental, and Vision coverage will expire the last day of the month in which your final
employment date occurs. You will be sent a COBRA Qualifying Event letter, offering you the opportunity
to continue your current coverage. COBRA coverage will be effective retro back to this same date,
should you elect it.
• Group Life and AD&D, Voluntary life, Short- and Long-Term Disability, and FSA coverages will expire
on the day you are no longer eligible.
• Accidental Injury, Critical Illness, and Hospital Indemnity coverage will terminate with your
last payroll deduction for the policy. Cigna will contact you directly with continuation
options.
• Group Life may offer Conversion and/or Portability options. You will have 30 days to make contact
with the carrier, if you are interested in either of these extensions.
COBRA CONTINUATION
Continuation Under COBRA
If you or your covered dependents lose health coverage under our group plan, you may be eligible for continuation
coverage under Federal COBRA regulations. In certain circumstances – death of a dependent, divorce, or a dependent
child ceasing to be eligible for coverage – it is your responsibility to notify the Human Resources Department of the
qualifying event within 60 days. You are also responsible to keep the Human Resources Department informed of
changes in your address, and your dependents’ address if that is different than yours. If you would like more
information about your rights and responsibilities under COBRA, please contact Human Resources.
Per the Department of Labor (DOL): COBRA requires that continuation coverage extends from the date of the
qualifying event for a limited period of 18 or 26 months. The length of time depends on the type of qualifying event
that gave rise to the COBRA rights. A plan, however, may provide longer periods of coverage beyond the maximum
period by law. When the qualifying event is the end of employment or reduction of the employee’s hours, qualified
beneficiaries are entitled to 18 months of continuation coverage. When the qualifying even is the end of employment
or reduction in the employee’s hours, and the employee became entitled to Medicare less than 18 months before the
qualifying event, COBRA coverage for the employee’s spouse and dependents can last until 36 months after the date
the employee becomes entitled to Medicare.
COBRA Vendor
Progressive Benefit Solutions is our COBRA vendor. All correspondence and payments for COBRA continuation, should
you or a family member be eligible, will be directed to Progressive Benefit Solutions.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.P a g e | 11
CIGNA MEDICAL INSURANCE
Plan 1-Core Plan 2
POS $3,000/30% POS $2,500/20% Buy Up 1
In-Network
Plan Year Deductible $3,000 Individual $2,500 Individual
$6,000 Family $5,000 Family
Coinsurance 30% 20%
Out-of-Pocket Max $5,000 Individual $5,000 Individual
$10,000 Family $10,000 Family
Physician Office Visit
Office Visit $30 Copay $30 Copay
Specialist $45 Copay $45 Copay
Preventive Care No Charge No Charge
Diagnostic Services
Diagnostic X-Ray- PCP Office $30 Copay $30 Copay
Advanced & Diagnostic Radiology $75 Copay $75 Copay
Laboratory
Freestanding Facility No Charge No Charge
Outpatient Hospital 30% After Deductible 20% After Deductible
Hospital Expenses
Inpatient Admission 30% After Deductible 20% After Deductible
Outpatient Surgery 30% After Deductible 20% After Deductible
Emergency Room $150 Copay $150 Copay
Urgent Care Facility $75 Copay $75 Copay
Prescription Drugs
Tier 1- Typically Generic $5 Copay $5 Copay
Deductible RX for Tiers 2 & 3 $100/$200 N/A
Tier 2- Typically Preferred Brand $25 Copay (Retail) $25 Copay (Retail)
Tier 3- Typically Non-Preferred $40 Copay (Retail) $40 Copay (Retail)
Brand
Out-Of-Network
Deductible $5,000 Individual $5,000 Individual
$10,000 Family $10,000 Family
Coinsurance 50% 40%
Out-of-Pocket Max $10,000 Individual $10,000 Individual
$20,000 Family $20,000 Family
Non-Wellness Rates:
Bi-Weekly Cost – NO RATE CHANGE! Plan 1 Plan 2
Employee $125.11 $131.17
Employee & Spouse $581.61 $590.38
Employee & Child(ren) $264.07 $270.73
Employee & Family $621.52 $629.37
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.12 | P a g e
CIGNA MEDICAL INSURANCE
Plan 3 Plan 4
In-Network
Plan Year Deductible $1,500 Individual $2,500 Individual
$3,000 Family $5,000 Family
(Combined deductible in & Out of
Network)
Coinsurance 20% 10%
Out-of-Pocket Max $3,000 Individual $3,275 Individual
$6,000 Family $6,550 Family
Physician Office Visit
Office Visit $20 Copay 10% after deductible
Specialist $40 Copay 10% after deductible
Preventive Care No Charge No Charge
Diagnostic Service
Diagnostic X-Ray- PCP Office $20 Copay 10% after deductible
Advanced & Diagnostic Radiology $75 Copay 10% after deductible
Laboratory
Office $20 Copay 10% after deductible
Freestanding No Charge 10% after deductible
Outpatient Hospital 20% After Deductible 10% after deductible
Hospital Expenses
Inpatient Admission 20% After Deductible 10% After Deductible
Outpatient Surgery 20% After Deductible 10% After Deductible
Emergency Room $150 Copay 10% After Deductible
Urgent Care Facility $75 Copay 10% After Deductible
Prescription Drugs
Tier 1- Typically Generic $5 Copay $5 Copay after deductible
Tier 2- Typically Preferred Brand $25 Copay $25 Copay
Tier 3- Typically Non-Preferred Brand $40 Copay $40 Copay
Out-Of-Network
Deductible $2,000 Individual $2,500 Individual
$4,000 Family $5,000 Family
(Combined deductible in & Out Of
Network)
Coinsurance 40% 30%
Out-of-Pocket Max $6,000 Individual $5,000 Individual
$12,000 Family $10,000 Family
Non-Wellness Rates
Bi-Weekly Cost – NO RATE CHANGE! Plan 3 Plan 4
Employee $149.23 $110.40
Employee & Spouse $629.18 $545.71
Employee & Child(ren) $303.21 $233.32
Employee & Family $678.09 $573.29
Plan 4- The deductible & out-of- pocket max are non-embedded meaning the cost shares of all family members apply to one shared family
deductible and out-of-pocket max.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.P a g e | 13
CIGNA MEDICAL INSURANCE INFORMATION
When you’re a member, your online account gives you access to information about your plan whenever you need it.
Register online to download your member ID, view your benefits, check claims, search prescriptions, and look up
new doctors. You can also download importation plan information including booklet/certificates.
Cigna 90 Now Program: You can choose to fill your medications in a 30- or 90-day supply. If you choose to fill a 30-
day prescription, it can be filled at any network retail pharmacy or Cigna Home Delivery. If you choose to fill a 90-day
prescription, it must be filled at a 90-day network retail pharmacy or Cigna Home Delivery to be covered by the plan.
»» Find a Doctor:
1. Go to https://www.cigna.com/
2. Click on the “Find a Doctor, Dentist, or Facility” link in upper right-hand corner.
3. Then click on “Plans through your employer or school” option.
4. Enter SEARCH LOCATION – city, state, or zip code.
5. Under the SELECT A PLAN option click on the drop-down icon, then click on “Medical Plans” and select your
network. Then press “choose”.
5. Enter into the SEARCH your doctor’s name, or a general term such as “primary care provider”.
»» Print out an ID card:
1. Visit https://www.mycigna.com/
2. If you haven’t already registered for mycigna.com, you’ll need to set up your profile.
3. Once completed, click on the “ID Cards” icon at the bottom of the page.
4. Then Click “Print ID Card” next to the family member for whom a card is needed.
»» Find a Prescription:
1. Go to https://www.cigna.com/
2. Click on “Individuals and Families” link in upper left-hand corner
3. Click on “Member Resources”
4. Click on “Prescription Drug Lists”
5. Click on “Cigna’s Drug List for Plans Offered by Employers”
6. Select a Drug List “Advantage 3 Tier”
7. Enter a Prescription Drug Name and “Search”
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.14 | P a g e
HEALTH SAVINGS ACCOUNTS (HSA)
You are eligible to open a Health Savings Account if you enroll in medical plan 4.
A Health Savings Account is a tax-advantaged medical savings account that is available to employees participating in the High
Deductible Health Plan (HDHP). The money you contribute to your HSA is tax-deductible and can be used to pay for qualified expenses
not only for yourself, but also for your spouse and tax dependents. Once you put money in your HSA, you can use it to pay for qualified
medical, dental and vision expenses now, or save and grow your balance to use later in life or in retirement—all tax-free.
Goodwin University and The University of Bridgeport make it easy for you to deposit your pre-taxed funds directly into your HSA with
HSA Bank. In order to contribute to an HSA you must first open the account by completing the enrollment form on Employee Navigator
or by enrolling on www.HSABank.com.
Annual Limits
Maximum Health Savings Account Contributions Per Year 2022
Self-only coverage $3,700
Family Coverage $7,300
Catch Up (Age 55 & Older) $1,000
Note: If enrolled in Medicare A or B (or any other health plan) you cannot contribute to a health savings account (HSA).
Qualified medical expenses and your HSA Paying for qualified medical expenses such as doctor’s visits and prescription medications is
simple and tax-free. The money you contribute to your HSA is tax-deductible and can be used to pay for qualified medical expenses not
only for yourself, but also for your spouse and tax dependents.
Once you put money in your HSA, you can use it to pay for qualified medical expenses now, or save and grow your balance to use later in
life or in retirement—all tax-free. Remember to contribute up to the maximum annual amount allowed by the IRS to maximize your tax
savings.
HSA Eligibility Any individual who meets the following criteria is eligible for an HSA:
Is covered by an HDHP;
Is not covered by other health insurance;
Is not enrolled in Medicare; and/or
Can’t be claimed as a dependent on someone else’s tax return (children cannot establish their own HSAs).
Important reminders about qualified medical expenses
Items that are merely beneficial to an individual’s general good health, such as vitamins or dietary supplements, are not qualified
medical expenses.
Drugs must be purchased legally.
Remember to save your receipts for OTC medicines for tax purposes.
There may be situations when your doctor recommends a treatment that will be good for your health, but it still may be
considered ineligible, such as a vacation.
As the HSA owner, you are ultimately responsible for determining whether a healthcare expense is eligible for reimbursement
from your HSA.
If an HSA expenditure is not used for a qualified medical expense, you will be required to pay income tax and a 20 percent
penalty on the amount used. (The 20 percent penalty tax does not apply to payments made after your death or disability, or after
you reach age 65).
How do I manage my HSA? Your Health Savings Account (HSA) is your account; the HSA dollars are your dollars. Since you are the account
holder or HSA beneficiary, you manage your HSA account. You may choose when to use your HSA dollars or when not to use your HSA
dollars. HSA dollars pay for any eligible expense. Most commonly, the HSA account holder will use HSA dollars to pay the out-of-pocket
expenses (i.e., deductible and coinsurance) associated with their high deductible health plan.
What expenses are eligible for reimbursement from my HSA? HSA dollars may be used for qualified medical expenses incurred by the
account holder and his or her spouse and dependents. Qualified medical expenses are outlined within IRS Section 213(d). In summary the
IRS Section 213(d) states that “the expense has to be primarily for the prevention or alleviation of a physical or mental defect or illness.”
In addition to qualified medical expenses, the following insurance premiums may be reimbursed from an HSA:
COBRA premiums
Health insurance premiums while receiving unemployment benefits
Qualified long-term care premiums
Any health insurance premiums paid, other than for a Medicare supplemental policy, by individuals ages 65 and over
Are dental and vision care qualified medical expenses under an HSA? Yes, as long as these are deductible under the current rules. For
example, cosmetic procedures, like cosmetic dentistry, would not be considered qualified medical expenses.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.P a g e | 15
HEALTH SAVINGS ACCOUNTS (HSA)
What expenses are NOT eligible for reimbursement from my HSA? The following expenses may not be reimbursed:
Premiums for Medicare supplemental policies
Expenses covered by another insurance plan
Expenses incurred prior to the date the HSA was established
Beginning January 1, 2011, over-the-counter drugs purchased without a prescription will no longer be a qualified medical
expense (except insulin)
What is a coverage gap? This is the gap between total out-of-pocket expenses associated with your high deductible health plan and
your HSA dollars. For example, assume that you have a $2,000 deductible, a $4,000 maximum out-of-pocket, and either you or your
employer has contributed $2,000 to your HSA account. If your medical costs incurred exceed $4,000 for the year, then you are
financially obligated to pay the difference between your total maximum out-of-pocket ($4,000) and your HSA balance ($2,000) -
($4,000 - $2,000 = $2,000).
Can I use my HSA dollars for non-eligible expenses? Money withdrawn from an HSA account to reimburse non-eligible medical
expenses is taxable income to the account holder and is subject to a 20 percent tax penalty - unless over age 65, disabled or upon
death of the account holder.
When can I start using my HSA dollars? You can use your HSA dollars immediately following your HSA account activation and once
contributions have been made.
When do I contribute to my HSA account, and how often can I? You, your employer or others can contribute to your HSA account
through payroll deductions or as a lump sum deposit. You can contribute as often as you like, provided your (and your employer’s)
total annual contributions do not exceed the annual limits. Individuals that are age 55 or older may be eligible to make “catch-up”
contributions up to $1,000.
How do I pay my physician or network facility at time of service with my HSA dollars? You may request that the network provider
submit your claim to your health plan. You should make sure that your provider has your most up-to-date insurance information.
Once the medical claim has been processed, if applicable, out-of-pocket expenses will be billed. At this time you may choose to use
your HSA debit card or HSA check to pay for any out-of-pocket expenses, or you may choose to pay with your own money and
receive reimbursement at a later date. You should always ask that your medical claim be submitted to the health plan before you
seek reimbursement from your HSA. This procedure will ensure that provider discounts are applied. Also, remember to keep all
medical receipts and Explanation of Benefits (EOBs).
What if I have HSA dollars left in my account at year-end? The money is yours to keep. It will continue to earn interest and will be
available for you and your health care costs next year.
How do my remaining HSA dollars rollover at year-end? Any dollars left in your HSA account at year-end will automatically roll
over into next year’s HSA account.
What happens to my HSA dollars if I leave my employer? The funds are yours to keep. You may elect one of the following:
- Leave your funds in the current HSA account
- Transfer your funds to an HSA with your new employer
- Transfer your funds to another qualifying account within 60 days
Can my HSA dollars be used for retirement health care costs? Yes, only for expenses eligible for reimbursement.
Can I use the money in my account to pay for my dependents’ medical expenses? You can use the money in the account to pay
for medical expenses of yourself, your spouse or your dependent children. You can pay for expenses of your spouse and dependent
children even if they are not covered by your HDHP.
Can couples establish a “joint” account and both make contributions to the account, including “catch-up” contributions? “Joint”
HSA accounts are not permitted. Each spouse should consider establishing an account in their own name. This allows you to both
make catch-up contributions when each spouse is 55 or older.
My employer offers an FSA – can I have both an FSA and an HSA? You can have both types of accounts, but only under certain
circumstances. General Flexible Spending Accounts (FSAs) will probably make you ineligible for an HSA. If your employer offers a
“limited purpose” (limited to dental, vision or preventive care) or “post-deductible” (pay for medical expenses after the plan
deductible is met) FSA, then you can still be eligible for an HSA.
Can I shift my IRA funds to my HSA? Owners of individual retirement accounts that are enrolled in a high deductible health plan
can shift IRA funds to an HSA without facing a tax penalty. The IRS allows a one-time transfer that does not exceed your maximum
HSA contribution limit.
Can I borrow against the money in my HSA? No. You may not borrow against it or pledge the funds in it. For more information on
prohibited activities, see Section 4975 of the Internal Revenue Code.
Can the funds in an HSA be invested? Yes, you can invest the funds in your HSA. The same types of investments permitted for IRAs
are allowed for HSAs, including stocks, bonds, mutual funds, and certificates of deposit.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.16 | P a g e
Know Your Health Care FSA Eligible and Ineligible Expenses
Maximize the Value of Your Reimbursement Account | Effective January 1st, 2021
Your Health Care Flexible Spending Account (FSA) dollars can be used for a variety of out-of-pocket health care expenses. The
following is based on a list of eligible and ineligible expenses used by federal employees.
Eligible Expenses
BABY/CHILD TO AGE 13 MEDICAL EQUIPMENT/SUPPLIES MEDICATIONS
• Lactation Consultant* • Air Purification Equipment* • Insulin
• Lead-Based Paint Removal • Arches and Orthotic Inserts • Prescription Drugs
• Special Formula* • Contraceptive Devices
• Tuition: Special School/Teacher for • Crutches, Walkers, Wheel Chairs OBSTETRICS
Disability or Learning Disability* • Exercise Equipment* • Breast Pumps and Lactation Supplies
• Well Baby /Well Child Care • Hospital Beds* • Doulas*
• Mattresses* • Lamaze Class
DENTAL • Medic Alert Bracelet or Necklace • OB/GYN Exams
• Dental X-Rays • Nebulizers • OB/GYN Prepaid Maternity Fees
• Dentures and Bridges • Orthopedic Shoes* (reimbursable after date of birth)
• Exams and Teeth Cleaning • Oxygen* • Pre- and Postnatal Treatments
• Extractions and Fillings • Post-Mastectomy Clothing
• Oral Surgery • Prosthetics PRACTITIONERS
• Orthodontia • Syringes • Allergist
• Periodontal Services • Masks • Chiropractor
• Wigs* • Christian Science Practitioner
EYES • Dermatologist
• Eye Exams MEDICAL PROCEDURES/SERVICES • Homeopath
• Eyeglasses and Contact Lenses • Acupuncture • Naturopath*
• Laser Eye Surgeries • Alcohol and Drug/Substance Abuse • Optometrist
• Prescription Sunglasses (inpatient treatment and outpatient care) • Osteopath
• Radial Keratotomy • Ambulance • Physician
• Fertility Enhancement and Treatment • Psychiatrist or Psychologist
HEARING • Hair Loss Treatment*
• Hearing Aids and Batteries • Hospital Services THERAPY
• Hearing Exams • Immunization • Alcohol and Drug Addiction
• In Vitro Fertilization • Counseling (not marital or career)
LAB EXAMS/TESTS • Physical Examination (not employment-related) • Exercise Programs*
• Blood Tests and Metabolism Tests • Reconstructive Surgery (due to a congenital • Hypnosis
• Body Scans defect, accident, or medical treatment) • Massage*
• Cardiograms • Service Animals • Occupational
• Laboratory Fees • Sterilization/Sterilization Reversal • Physical
• X-Rays • Transplants (including organ donor) • Smoking Cessation Programs*
• Transportation* • Speech
• Weight Loss Programs*
Note: This list is not meant to be all-inclusive, as other expenses not specifically mentioned may also qualify. Also, expenses marked with an
asterisk (*) are “potentially eligible expenses” that require a Note of Medical Necessity from your health care provider to qualify for
reimbursement. For additional information, check your Summary Plan Document or contact your Plan Administrator.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.P a g e | 17
Eligible Over-the-Counter Medicines and Drugs
• Acid controllers • Cough, cold & flu • Medicated nasal sprays, drops,
• Acne medications • Denture pain relief & inhalers
• Allergy & sinus • Digestive aids • Medicated respiratory treatments
• Antibiotic products • Ear care & vapor products
• Antifungal (Foot) • Eye care • Motion sickness
• Antiparasitic treatments • Feminine antifungal & anti-itch • Oral remedies or treatments
• Antiseptics & wound cleansers • Fiber laxatives (bulk forming) • Pain relief (includes aspirin)
• Anti-diarrheals • First aid burn remedies • Skin treatments
• Anti-gas • Foot care treatment • Sleep aids & sedatives
• Anti-itch & insect bite • Hemorrhoidal preps • Smoking deterrents
• Baby rash ointments & creams • Homeopathic remedies • Stomach remedies
• Baby teething pain • Incontinence protection & treatment • Unmedicated nasal sprays,
products drops & inhalers
• Cold sore remedies
• Laxatives (non-fiber) • Unmedicated vapor products
• Contraceptives
• Menstrual Products
Eligible Over-the-Counter Items (Product categories are listed in bold face; common examples are listed in regular face.)
• Baby Electrolytes and Dehydration • Elastics/Athletic Treatments • Hearing Aid/Medical Batteries
• Pedialyte, Enfalyte • ACE, Futuro, elastic bandages, braces, • Home Health Care (limited segments)
• Contraceptives hot/cold therapy, orthopedic supports, • Ostomy, walking aids, decubitis/pressure
• Unmedicated condoms rib belts relief, enteral/parenteral feeding supplies,
• Denture Adhesives, Repair, and Cleansers • Eye Care patient lifting aids, orthopedic
• Contact lens care braces/supports, splints & casts,
• PoliGrip, Benzodent, Plate Weld,
• Family Planning hydrocollators, nebulizers, electrotherapy
Efferdent
products, catheters, unmedicated wound
• Diabetes Testing and Aids • Pregnancy and ovulation kits
care, wheel chairs
• Ascencia, One Touch, Diabetic Tussin, • First Aid Dressings and Supplies
• Incontinence Products
insulin syringes; glucose products • Band Aid, 3M Nexcare, non-sport tapes
• Attends, Depend, GoodNites for
• Diagnostic Products • Foot Care Treatment juvenile incontinence, Prevail
• Thermometers, blood pressure monitors, • Unmedicated corn and callus treatments
• Prenatal Vitamins
cholesterol testing (e.g., callus cushions), devices, therapeutic
• Stuart Prenatal, Nature's Bounty
• Ear Care insoles
Prenatal Vitamins
• Unmedicated ear drops, syringes, • Glucosamine &/or Chondroitin
• Reading Glasses and Maintenance
ear wax removal • Osteo-Bi-Flex, Cosamin D, Accessories
Flex-a-min Nutritional Supplements
• Hand Sanitizer & Hand Wipes
OTC items that are not medicines or drugs remain eligible for purchase with FSAs. You can use your
benefits card for these items.
Ineligible Expenses
• Contact Lens or Eyeglass Insurance • Insurance Premiums and Interest • Personal Trainers
• Cosmetic Surgery/Procedures (FSA Ineligible Only) • Sunscreen (spf less than 30)
• Electrolysis • Long Term Care Premiums • Swimming Lessons
(FSA Ineligible Only)
• Marriage or Career Counseling
Note: This list is not meant to be all-inclusive.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.18 | P a g e
HSA Bank Fees are subject to change – rates last verified 11/4/2021
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.P a g e | 19
CIGNA VOLUNTARY DENTAL INSURANCE
PPO Low Plan With Ortho PPO High Plan
In-Network Out-of-Network In-Network Out-of-
Network
Deductible – Calendar Year
Individual $50 $50
Family $150 $150
Plan Annual Benefit Limit $1,000 $2,000
Preventive Services (deductible waived)
Check-ups 100% 100%
Cleanings 100% 100%
Basic Services
Surgeries 80% 80%
Fillings 80% 80%
Major Services
Crowns 25% 50%
Bridges 25% 50%
Dentures 25% 50%
Orthodontics 50% to $1,000 lifetime max Not Covered
Orthodontics Covers Dependent Children Only (through age 18) None
Out-Of-Network Reimbursement 90th Percentile 90th Percentile
Bi-Weekly Cost: No Rate Change! PPO Low with Ortho PPO High Plan
Employee $16.30 $24.23
Employee & Spouse $37.14 $48.19
Employee & Child(ren) $32.23 $47.93
Family $51.44 $76.38
Register online at www.cigna.com to view claims, print ID Cards, find a doctor, and more!
HOW TO FIND A DENTIST:
• Go to www.Cigna.com, click on “Find a Doctor” at the top of the screen.
• Choose a Directory by clicking “If Your Insurance Plan is offered through Work or School” option.
• Next, click on “Find a…Dentist”
• Enter SEARCH LOCATION – city, state or zip code.
• SELECT A PLAN by clicking on the Pick drop down icon and selecting “Cigna Dental PPO or EPO” for the DPPO. Then
press choose.
• Type DENTIST in the Search Bar to show the dentists in your area.
ID CARDS:
DPPO ID Cards are generic and are not issued. Members have the option of registering on www.cigna.com to print off ID
cards as needed.
• Visit the CIGNA Member Portal website at www.myCigna.com
• Click on the blue box that says, “Register Now”
• Enter your First and Last Name, Date of Birth and Address, and select “Next”
• Select “Option 2” to use the primary plan member’s SSN to verify your identity, and select “Next”
• Create your User ID and Password, and select “Next”
Once you submit all the information, you will be able to log into the member portal. From here, you can view your
benefits, print an ID card, review any pending and approved claims, and more.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.20 | P a g e
CIGNA VOLUNTARY VISION INSURANCE
Network Out-of-Network
Exam Copay $10 Copay N/A
Material Copay $25 Copay N/A
Eye Exam 100% After Copay Up to $42 Reimbursement
Eyeglass Lenses*
Single Lenses 100% After Copay Up to $40 Reimbursement
Bifocal Lenses 100% After Copay Up to $60 Reimbursement
Trifocal Lenses 100% After Copay Up to $80 Reimbursement
Frames Up to $130, then 20% off any Up to $45 Reimbursement
Balance
Elective Contact Lenses**
Elective contact lenses Up to $130 Up to $105 Reimbursement
Up to $105 Reimbusement
Eyeglass Lens Enhancements No allowance when obtained
Transitions Lense(for child under 19) $0 Copay out-of-network
Standard polycarbonate(for child under 19)
Factory scratch coating
Necessary Contact Lenses 100%
Service Frequencies
Exam 12 months
Lenses 12 months
Frames 12 months
* Eyeglass Lenses are provided in lieu of contact Lenses.
**Elective contact lenses are provided in lieu of eyeglasses (lenses and frames).
Bi-Weekly Cost: No Rate Change!
Employee: $2.98 Employee & Spouse: $5.94 Employee & Children: $6.00 Family: $9.58
Find a provider:
There are three ways to find a quality eye doctor in your area:
1. Log into myCigna.com
2. Click “Review My Coverage” and select Vision page
3. Click on Visit Cigna Vision
4. Then select “Find a Cigna Vision Network Eye Care Professional” to search the Cigna Vision Directory
Don’t have access to myCigna.com?
1. Go to Cigna.com, top of the page select “Find A Doctor, Dentist or Facility”
2. Click “Cigna Vision Directory”, under Additional Directories
Prefer the phone?
1. Call Member Services: 1-877-478-7557
2. Talk with a Cigna Vision customer service representative
Print out an ID Card:
Vision ID cards are not provided and are not necessary to receive service. Providers can confirm the
member’s eligibility electronically using the member’s social security number and date of birth. However,
you can print a Vision ID card by logging into the mycigna.com portal.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.P a g e | 21
NEW! CIGNA/NY LIFE - BASIC TERM LIFE AND AD&D
Company Paid
HOW MUCH COVERAGE DOES MY EMPLOYER PROVIDE?
Employer Paid – Term Life and Accidental Death
Your employer pays for a benefit in the amount of:
•
& Dismemberment (AD&D)
2x Base Annual Earnings to a Maximum of $200,000
(benefit is rounded to the next higher $1,000)
Portability/Conversion Reduce your hours or leave your employer, you can take this coverage with you
according to the terms outlined in the contract. If you are interested in either of these
extensions it is your responsibility to contact Human Resources upon termination. All
coverage terminates at retirement.
Additional Information
• Age Reduction Rules: Life coverage amounts will be reduced at age 70 by 50%. Coverage terminates upon
retirement.
• Term Life Insurance and AD&D Coverage Highlights are available on Employee Navigator.
NEW! CIGNA/NY LIFE - VOLUNTARY LIFE INSURANCE
Employee Paid
1/1/2022 ALL EMPLOYEES ARE ELIGIBLE TO TAKE ADVANTAGE OF COVERAGE
UP TO THE GUARANTEE ISSUE AMOUNTS!
AFTER 1/1/2022, GUARANTEE ISSUE WILL ONLY APPLY TO NEW HIRES IN THEIR INITIAL ELIGIBILITY PERIOD.
Employee Spouse Child
$10,000 increments up to $5,000 Increments not to $2,000 Increments not to
5x Salary (rounded to the exceed 50% of the exceed $10,000 the From
Coverage Amounts next higher $10,000). Max employee’s benefit age 15 days to age 26.
amount is $500,000. amount (rounded to the
next higher $5,000)
Guaranteed Issue $150,000 $30,000 $10,000
• Spouse rate is based on employee’s age.
Portability/Conversion Portability and/or conversion options are available upon termination of employment.
It is your responsibility to contact Human Resources if you are interested.
Additional Information
• To apply for amounts over the guarantee issue amount you will have to complete an evidence of insurability
form and will be subject to underwriting’s approval.
• Guaranteed Issue (AFTER THE 1/1/22 OPEN ENROLLMENT)- Applies to new hires within their initial eligibility
period. Employees who elect any amount of new or increased coverage during open enrollment will be
required to complete a Health Statement and coverage will be subject to medical underwriting’s approval.
• Age Reductions Rules:
Voluntary Life will reduce at age 70 by 50% of your life coverage amount.
Voluntary Term Life Insurance Coverage Highlights and Rates are available on Employee Navigator.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.22 | P a g e
NEW! CIGNA/NY LIFE - SHORT TERM DISABILITY
Company Paid
Coverage 60% of salary to a maximum of $750/week
Elimination Period 15th Day Accident
15th Day Illness
Duration 11 Weeks
Definition of a Disability Disability means that, solely because of a covered injury or sickness, you are unable
to perform the material duties of your regular occupation and you are unable to earn
80% or more of your covered earnings from working in your regular occupation. We
will require proof of earnings and continued disability.
Please see the contract for any limitations and/or exclusions.
NEW! CIGNA/NY LIFE - LONG TERM DISABILITY
Company Paid
Coverage 60% of salary to a maximum of $10,000/month
Elimination Period 90 Days
Benefit Duration Later of Age 65 or Social Security Normal Retirement Age (SSNRA)
Pre-existing Conditions 3/12 – a pre-existing condition is a sickness or injury for which the employee received
treatment during the three months prior to his or her effective date. Treatment
means consultation, care or services provided by a physician, including diagnostic
measures and the prescription and/or taking of drugs and medicines.
Your benefit period begins on the first day after you complete your elimination period.
Your benefit amount will be reduced by any amounts payable to you by any other income benefits.
See certificate for long term disability conversion options upon termination.
Please see the contract for any limitations and/or exclusions.
Short Term Disability and Long Term Disability Coverage Highlights are available on Employee Navigator.
This document is intended to provide a brief summary of our benefit plans and is not a guarantee of coverage. For a complete description of plan
features, including eligibility and termination requirements, definitions, limitations and exclusions, please refer to your insurance booklet/certificate
and Summary Plan Description (SPD). The company reserves the right to change plan provisions in whole or in part as it deems necessary.You can also read
