YourBenefits2021 it's all about - Northwestern University

 
YourBenefits2021 it's all about - Northwestern University
it’s all about
YourBenefits2021
YourBenefits2021 it's all about - Northwestern University
What’s Inside

The Basics.................................................................. 1
      Eligibility............................................................. 1
        Faculty and Staff.............................................. 1
        Dependents...................................................... 1
      Medical, Dental, and Vision Coverage Tiers.......... 1
      Effective Date of Coverage.................................. 2
      Premium Costs.................................................... 2
For Your Health.......................................................... 3
      Medical............................................................... 3
        Health Savings Account.................................... 6
        Prescription Drug Benefits................................ 9
      Dental............................................................... 10
      Vision................................................................ 11
      Health Care Flexible Spending Account............. 13
For Your Protection................................................... 15
      Extended Sick Time........................................... 15
      Long-Term Disability.......................................... 15
      Life Insurance................................................... 17
For Your Well-being.................................................. 19
      Dependent Care Flexible Spending Account...... 19
      Commuter Benefit............................................. 20
      Tuition Benefits................................................. 21
      YourLife Wellness Benefits................................ 22
      Work/Life & Family Resources........................... 23
For Your Future......................................................... 24
      Retirement Benefits.......................................... 24
      Retiree Benefits & Privileges............................. 25
Glossary................................................................... 26
Directory.................................................................. 28

2 | Benefits Guide 2018 | Northwestern University
YourBenefits2021 it's all about - Northwestern University
The Basics

Eligibility                                         In general, you are eligible to participate in
                                                    the Voluntary Savings Plan if you are an
FACULTY AND STAFF                                   actively-employed faculty or staff member
For Your Health/For Your Protection/                paid by Northwestern. However, if you are a
For Your Wellbeing                                  contractor, leased employee, or nonresident
                                                    alien of the U.S. you may not be eligible to
You are eligible to participate in most of the      participate.                                              To qualify for
Northwestern University benefit plans in these
                                                                                                              benefits coverage,
three categories if you are a:                      DEPENDENTS                                                your Northwestern
  § Faculty member appointed to work                You may include your benefits-eligible Depen-             University salary
    full-time or part-time (half-time or more)                                                                must be sufficient to
                                                    dents under your medical, dental, and vision
    for the entire academic year or on a                                                                      cover any premium
                                                    coverage, as well as under spouse and depen-
    full-time basis for half the academic year.                                                               costs that may be
                                                    dent life insurance. Your benefits-eligible
                                                                                                              deducted from your pay
  § Regular staff member scheduled to work          Dependents can also take advantage of                     based on the choices
    at least 18.75 hours per week (half-time        certain Tuition Benefits. In addition, family             you make during
    or more) for at least 12 months or 37.5         members may access programs and services                  benefits enrollment.
    hours per week (full-time) for at least six     offered through the YourLife Wellness Program
    months.                                         and Work/Life & Family Resources.
                                                    For more information, see Dependent Medical
You are eligible to participate in University-
                                                    Coverage: Proof of Eligibility Required on page 2.           For details regarding
sponsored Tuition Benefits if you are a
full-time faculty or staff member; a service-                                                                    eligibility guidelines
based eligibility guideline also applies to these   Medical, Dental, and Vision                                  for the benefit plans
benefits. These benefits are not available to       Coverage Tiers                                               described in this
part-time faculty and staff.                        If you choose to participate in a medical,                   guide, visit http://
                                                    dental and/or vision plan, you also must                     www.northwestern.
For Your Future                                     choose a Coverage Tier:                                        edu/hr/benefits/.

You are eligible to participate in the                § You Only – coverage for you only
Northwestern University Retirement Plan if            § You + Spouse – coverage for you and
you are a faculty or staff member (as defined           your legal spouse/civil union partner
by the plan) and:                                                                                             Throughout this
                                                      § You + Child(ren) – coverage for you                   booklet, key terms
  § You are at least age 21                             and one or more child(ren)                            appear in initial caps;
  § You are scheduled to work at least 18.75                                                                  definitions of these
                                                      § You + Spouse + Child(ren) – coverage
    hours per week, and                                                                                       terms can be found in
                                                        for you, your legal spouse, and one or
                                                                                                              the Glossary on pages
  § You have completed two years of continu-            more child(ren)                                       26 and 27.
    ous service (24-consecutive months of
    service with the University) as of the first    Remember: You can include adult child(ren)
    anniversary of your employment date or          under your medical, dental, and vision
    any subsequent anniversary of that date.        coverage to age 26 – regardless of their
    Note: Under certain circumstances, prior        educational, marital, tax, or work status.
    service with a tax-exempt educational or
    research organization or a state educa-
    tional organization immediately prior to
    your Northwestern employment date
    may be used to satisfy this service
    requirement.

                                                                                          Northwestern University | Benefits Guide 2021 | 1
YourBenefits2021 it's all about - Northwestern University
The Basics

                                   Effective Date of Coverage
Within the
                                   If you are a:
Northwestern
University benefits                   § Current employee and you enroll for coverage during annual Open Enrollment – any
program, some                           new coverage options you choose will take effect on the following January 1.
benefits provide                      § New hire and you enroll for coverage within 31 days of start date – any coverage options you
automatic cov-                          choose will begin on the first day of the month after your hire date (or on your date of hire if
erage for which                         your hire date is the first of the month), unless otherwise noted in this booklet.
Northwestern pays
the full cost, while               Premium Costs
others provide                     Your cost for any coverage options you elect will be deducted from your pay using Pre-Tax
coverage options                   Contributions or After-Tax Contributions, depending on the coverage for which the premium is
for which you and                  being deducted. 2021 premium costs are included in this booklet; see the appropriate section
Northwestern                       for each benefit.
share the cost (or
for which you pay
the full cost).
Your costs will
                                   Dependent Medical Coverage: Proof of Eligibility Required
be based on the
coverage options                   If you include dependents under your University-sponsored medical coverage, you must
you choose.                        submit proof of eligibility for each dependent and Social Security number (for those who
                                   have one). Coverage for a dependent will not begin until the insurance company accepts
                                   such proof.

                         Benefits-Eligible Dependent                                        Acceptable Documentation
   Spouse – the person to whom you are legally married under the          • Government-issued marriage certificate or
   laws of your state of residence                                        • J-2 or H-4 visa (foreign nationals only)

   Partner – the person to whom you are legally joined in a civil         • Government-issued civil union certificate or
   union; any reference in this guide to a “spouse” also refers to a      • J-2 or H-4 visa (foreign nationals only)
   civil union partner
   Child(ren) – to age 26, regardless of their educational, marital, tax, or work status.
   • Biological child(ren)                                                • Child(ren)’s government-issued birth certificate
   • Other qualified child(ren), including foster children, stepchil-     • See requirements listed at https://www.northwestern.edu/
     dren, legally adopted children or grandchildren, and any child         hr/benefits/eligibility-changes/verify-dependents.html
     for whom you are the legal guardian, as defined by a court order

  2 | Benefits Guide 2021 | Northwestern University
YourBenefits2021 it's all about - Northwestern University
For Your Health

Medical
You can choose a medical plan based on           While enrolling in a medical plan, you should
the protection you and your family need.         assess your needs and those of your family.                All four Northwest-
                                                 You can use the health cost estimator, located             ern-sponsored
Northwestern offers four medical plans:          in the online enrollment site, to estimate the             medical plans pay
  § Premier PPO, Select PPO, and Value PPO       benefits you may receive and what you may                  100% of the cost
    – three preferred provider options (PPOs)    pay in out-of-pocket costs (premiums and                   of Preventive Care
    that offer the flexibility to go to any      Deductible, Coinsurance, and/or Copays                     and will help you
    provider you choose (though you will         combined) under different scenarios.                       and your family
    receive greater benefits and pay lower                                                                  with the costs of
                                                 Whichever plan you choose, you can enroll in
    out-of-pocket costs when you see a                                                                      maintaining good
                                                 coverage just for yourself, or you may include
    provider who is a member of the North-                                                                  health and treating
                                                 one or more eligible family members under
    western Medicine or BlueCross                                                                             disease and injury.
                                                 your coverage (see Medical, Dental, and Vision
    BlueShield PPO Network).
                                                 Coverage Tiers on page 1).
  § HMO Illinois – a health maintenance
    organization (HMO) coverage option that      You and Northwestern share the cost of the
    gives you access to the HMO Illinois         medical coverage you choose. You pay your
    provider Network, but pays no benefits       share through Pre-Tax Contributions, which
    when you see a provider who is not a         will be automatically deducted from your
    member of the Network (except in an          paycheck.
    emergency).

BlueCross BlueShield of Illinois administers
all four medical plans.

The four medical plans differ in:
  § How you and each plan share the cost of
    covered health care services – potential
    out-of-pocket expenses (the amounts
    you may pay in Deductible, Coinsurance
    and/or Copays) vary by plan and, if you
    choose a PPO coverage option, whether
    you receive services from a Northwestern
    Medicine provider, in-Network, or out-of-
    Network (see Medical Plans At-a-Glance
    on page 4).
  § How much you pay in monthly premiums
    – premiums vary by plan based on
    Coverage Tier and salary tier (see Monthly
    Premium Costs: Medical on page 5)

                                                                                     Northwestern University | Benefits Guide 2021 | 3
YourBenefits2021 it's all about - Northwestern University
For Your Health

                                  Medical Plans At-a-Glance

                              Plan Feature             Premier PPO1            Select PPO1              Value PPO2,3          HMO Illinois1
                          Northwestern Medicine Tier 1 Providers
                                                      $250 individual/      $500 individual/          $1,500 individual/
                                Deductible
                                                        $750 family          $1,500 family              $3,000 family
                               Coinsurance                  5%                    10%                       10%
                              Out-of-Pocket          $1,200 individual/    $1,800 individual/         $2,400 individual/
                                                                                                                             Not applicable
                                Maximum                $3,200 family         $4,800 family              $6,400 family
                                                                                                         10% after
                            Office Visit Copay       $10 Primary Care Physician/$20 specialist
                                                                                                         Deductible
                                                     $150 (waived if admitted) + Coinsurance             20% after
                                 ER Copay
                                                     10% Coinsurance        20% Coinsurance              Deductible
                          In-Network Providers
                                                      $400 individual/      $750 individual/          $2,000 individual/
                                Deductible
                                                       $1,200 family         $2,250 family              $4,000 family        Not applicable
                               Coinsurance                  10%                                 20%
                              Out-of-Pocket          $2,400 individual/    $3,000 individual/         $3,000 individual/   $1,500 individual/
                                Maximum                $6,600 family         $8,000 family              $8,000 family        $3,000 family
                                                                                                                               $25 PCP/
                            Office Visit Copay       $25 Primary Care Physician/$35 specialist
                                                                                                         20% after           $35 specialist
                                                     $150 (waived if admitted) + Coinsurance             Deductible               $150
                                 ER Copay
                                                     10% Coinsurance        20% Coinsurance                                (waived if admitted)
                         Out-of-Network Providers
                                                      $800 individual/     $1,500 individual/         $3,000 individual/
                                Deductible
                                                       $2,400 family         $4,500 family              $6,000 family
                               Coinsurance                  30%                       40% after Deductible
                                                                                                                             Not applicable
                              Out-of-Pocket          $4,800 individual/    $6,000 individual/         $7,500 individual/
                                Maximum               $12,800 family        $16,000 family             $20,000 family
                                                         30% after
                            Office Visit Copay                                        40% after Deductible
                                                         Deductible
                                                     $150 (waived if admitted) + Coinsurance             20% after                $150
                                 ER Copay
                                                     10% Coinsurance        20% Coinsurance              Deductible        (waived if admitted)

                                  1 Copays apply toward the out-of-pocket maximums.
                                  2 The in- and out-of-Network Deductibles are tracked separately; a separate out-of-pocket maximum applies.
                                  3 For Value PPO participants who choose You + Spouse, You + Child(ren), or You + Spouse + Child(ren) coverage,
                                    the family Deductible and out-of-pocket rates apply.

 4 | Benefits Guide 2021 | Northwestern University
YourBenefits2021 it's all about - Northwestern University
For Your Health

Monthly Premium Costs: Medical

                            Premier PPO            Select PPO               Value PPO             HMO Illinols
Coverage/Salary Tier   Full-Time   Part-Time   Full-Time   Part-Time   Full-Time   Part-Time   Full-Time    Part-Time
You Only
Under $42,000           $234        $426         $47        $227         $17        $184        $106          $274
$42,001 - $75,000       $277        $453         $86        $253         $37        $196        $139          $296
$75,001 - $128,000      $334        $493        $139        $289         $84        $229        $181          $324
$128,001 - $182,000     $405        $540        $201        $331        $131        $259        $230          $357
$182,001 and above      $511        $611        $293        $391        $199        $305        $307          $409
You + Spouse
Under $42,000           $512        $932        $105        $497         $39        $403        $233          $600
$42,001 - $75,000       $606        $993        $188        $552         $80        $429        $304          $648
$75,001 - $128,000      $731       $1,078       $304        $631        $182        $497        $395          $709
$128,001 - $182,000     $887       $1,182       $443        $722        $285        $568        $503          $781
$182,001 and above     $1,119      $1,338       $640        $855        $432        $666        $673          $895
You + Child(ren)
Under $42,000           $435        $794         $88        $422         $34        $341        $201          $518
$42,001 - $75,000       $516        $848        $159        $468         $68        $365        $262          $559
$75,001 - $128,000      $622        $918        $260        $535        $153        $422        $341          $611
$128,001 - $182,000     $757       $1,009       $376        $614        $242        $481        $433          $673
$182,001 and above      $953       $1,140       $543        $726        $368        $565        $580          $772
You + Spouse + Child(ren)
Under $42,000           $771       $1,400       $156        $745         $57        $602        $350          $903
$42,001 - $75,000       $910       $1,493       $282        $830        $120        $644        $457          $975
$75,001 - $128,000     $1,098      $1,619       $456        $946        $273        $746        $595         $1,067
$128,001 - $182,000    $1,332      $1,777       $664        $1,086      $427        $849        $757         $1,176
$182,001 and above     $1,681      $2,010       $962        $1,285      $648        $997       $1,013        $1,347

The salary tier for current employees is               assigned salary tier, unless you transition from
determined by your salary on September 1st             full-time to part-time or part-time to full-time.
of the year preceding the plan year (e.g.,
premiums starting January 1, 2021 are based            If you are covered by a collective bargaining
on your September 1, 2020 salary). Mid-year            agreement, consult your contract for
changes to salary will not change your                 additional employee contribution information.

                                                                                               Northwestern University | Benefits Guide 2021 | 5
YourBenefits2021 it's all about - Northwestern University
For Your Health

                                   HEALTH SAVINGS ACCOUNT –                         When You Enroll in a Health Savings
                                   FOR VALUE PPO PARTICIPANTS ONLY                  Account for the First Time:

You must renew                     If you choose coverage under the Value PPO       You must activate your HSA upon notification
your election to                   medical plan:                                    from PayFlex. Simply go to www.payflex.com,
                                      § You can open a Health Savings Account       click on “Create Your Profile” and follow the
make Pre-Tax
                                        (HSA) and make Pre-Tax Contributions to     prompts.
Contributions to
                                        this account.                               During the initial set-up of an HSA, the bank
a Health Savings
                                      § You can use the Pre-Tax Contributions in    must fulfill certain obligations to establish
Account each
                                        your HSA to pay for qualified health care   and maintain a Customer Identification
year during Open                        expenses for yourself, your spouse, or      Program (CIP) for each HSA participant, based
Enrollment. If you                      your dependent(s), including Deduct-        on federal laws, including the USA Patriot Act,
don’t, your HSA                         ibles, Copays, Coinsurance, and eligible    the Bank Secrecy Act, the Money Laundering
                                        services that are not covered by your       Control Act and other anti-money laundering
Pre-Tax Contribu-
                                        plan.                                       laws, as they may apply.
tion amount for
                                      § The amount contributed to your HSA is       As part of this process, you may receive a
the next year will
                                        subject to an annual maximum – $2,600       request from the partner bank to submit
default to $0.                          if you elect You Only coverage and          additional information, which may include a
                                        Northwestern will match $1,000; $5,200      copy of your driver’s license or passport, or a
                                        if you elect You + Spouse, You +            recent utility bill. You must provide the re-
                                        Child(ren) or You + Spouse + Child(ren)     quested information; if you don’t, the bank will
                                        coverage and Northwestern will match        not be able to set up your account (and you
                                        $2,000 – and will be equally split          will not be able to receive any contribution
                                        between your own contributions and          from Northwestern).
                                        matching contributions Northwestern
                                        will make on your behalf (see
                                        Contributing to an HSA on page 7).
                                      § Any unused balance in your HSA at
                                        year-end will rollover to the next year.
                                      § If you retire or leave Northwestern you
                                        can take your HSA with you.

                                   Important! Under IRS rules, if you open an
                                   HSA, you cannot participate in a traditional
                                   Health Care Flexible Spending Account (FSA);
                                   however, you can participate in a limited-use
                                   Health Care FSA (see page 13 for details).

  6 | Benefits Guide 2021 | Northwestern University
YourBenefits2021 it's all about - Northwestern University
For Your Health

Contributing to an HSA                                  Enrolled in Medicare?

1 Your own contribution – You can make your             If you will be turning age 65 in 2022 (and will
  own Pre-Tax Contribution of up to $2,600 if           enroll in Medicare), you can choose coverage
  you elect You Only coverage or $5,200 if you          under the Value PPO medical plan, but you will
  elect You + Spouse, You + Child(ren) or You +         not be eligible to make Pre-Tax Contributions
  Spouse + Child(ren) coverage.                         to an HSA – or to receive Northwestern
                                                        matching contributions to an HSA after
2 Northwestern’s matching contribution                  December 31, 2021. However, you may
  – Northwestern will match your Pre-Tax                continue to use any balance you have in an
  Contribution to your HSA up to:                       HSA to pay qualified health care expenses in
  § $1,000 – if you elect You Only coverage, or         2022 and beyond (and this money will remain
                                                        tax-free).
  § $2,000 – if you elect You + Spouse, You +
    Child(ren) or You + Spouse + Family
    coverage.
  If you and Northwestern contribute the                     Any money added to your HSA – including
  maximum allowed, the total contributions                   Northwestern matching contributions – is
  to your HSA for the year will equal the                    your money to keep.
  annual maximum contribution allowed
  under federal regulations.

3 “Catch-up” contribution – If you are age 55
  or older, you can make an annual “catch-up”
  contribution4 (using Pre-Tax Contributions)
  to your HSA each year. This contribution –
  over and above the maximum annual
  contribution – can help you accumulate
  more in your HSA sooner. Northwestern does
  not match any “catch-up” contributions.

                                                                      Northwestern               Annual                         Annual
                                              Your Own                  Matching                Maximum                       “Catch-Up”
 Value PPO Medical Plan Coverage:            Contribution             Contribution             Contribution                  Contribution4
 You Only                                     Up to $2,600            + Up to $1,000             = $3,600                    + Up to $1,000
 You + Spouse, You + Child(ren), or
                                              Up to $5,200            + Up to $2,000             = $7,200                    + Up to $1,000
 You + Spouse + Child(ren)
4 You can make “catch-up” contributions only if you are age 55 or older – or will reach age 55 – in 2021.
  Once eligible, you may continue to make catch-up contributions until the year in which you reach age 65
  or become eligible for Medicare.

                                                                                                  Northwestern University | Benefits Guide 2021 | 7
For Your Health

                                  Qualified Health Care Expenses                    Using Your Health Savings Account

                                  You can use pre-tax dollars from your HSA to      If you participate in an HSA, you’ll receive a
                                  pay qualified health care expenses only.          PayFlex debit card. It’s all you’ll need whenever
                                  Qualified health care expenses – as defined by    you want to use pre-tax dollars from your HSA
                                  the Internal Revenue Service (IRS) – include:     to pay qualified health care expenses. If you
                                     § Deductible, Coinsurance, and Copay           already have an unexpired PayFlex debit card
                                       amounts you pay under your medical           from prior years, you will not receive a new one.
                                       coverage
                                     § Prescription drugs – including over-the-
                                       counter drugs for which you have a
                                       prescription
                                     § Acupuncture and chiropractic services
                                     § Dental care – including orthodontia (after
                                       meeting your medical deductible)
                                     § Vision care – including contact lenses,
                                       prescription sunglasses and LASIK
                                       surgery (after meeting your medical
                                       deductible)
                                                                                    Using the PayFlex website – www.payflex.com.
                                     § Hearing aids – including batteries
                                                                                    – you can:
                                     § Premiums for medical coverage while
                                                                                      § Access your account information, view
                                       receiving federal or state unemployment
                                                                                        transactions, and check the status of
                                       benefits
                                                                                        claims
                                     § COBRA continuation coverage after
                                                                                      § See a complete listing of qualified health
                                       leaving your Northwestern employment
                                                                                        care expenses, and
                                     § Premiums for eligible long-term care, and
                                                                                      § Obtain account-related forms.
                                     § Medicare premiums and out-of-pocket
                                       expenses – including Deductibles,            Important! Be sure to save itemized receipts
                                       Copays, and Coinsurance.                     of all your HSA transactions in case you need
To learn more                                                                       to provide documentation supporting your
about available                   You can use your HSA to pay qualified health      use of the account for qualified health care
HSA investment                    care expenses incurred on or after the date       expenses.
options, visit the                you open your account, and you can use it to
PayFlex website –                 pay qualified health care expenses incurred by    Over time, the balance in your HSA can grow
www.payflex.com.                  your spouse and children even if they are not     through the contributions that you and
                                  enrolled as dependents under your Value PPO       Northwestern make to your account, rollovers
                                  medical plan coverage.                            of your unused account balance from year-to-
                                                                                    year, as well as investment earnings.
                                  For more information about qualified health
                                  care expenses, visit the IRS Web site at          Investing Your HSA for Growth
                                  www.irs.gov.
                                                                                    Once the balance in your HSA exceeds $1,000
                                                                                    you can start investing the excess in one or
                                                                                    more mutual funds managed by Bank of New
                                                                                    York Mellon. You will be able to manage your
                                                                                    investments and track your account growth
                                                                                    online.

 8 | Benefits Guide 2021 | Northwestern University
For Your Health

PRESCRIPTION DRUG BENEFITS

All four Northwestern-sponsored medical plans provide benefits toward the cost of prescription
drugs. Express Scripts – www.express-scripts.com – is the Pharmacy Benefit Manager for all
four plans.
                                                                                                                        Is a Generic
                              Premier PPO, Select PPO, and HMO Illinois                      Value PPO
                                                                                                                        Alternative
                      You pay a copay of:                                                                               Available?
                                                                                      § You pay the full cost of
                         §   $10 for each Generic Drug prescription
                                                                                        all prescription                If a Generic Drug is
                         §   $30 for each Preferred Brand Name Drug
 Retail –                                                                               medications until you           available but you
                             prescription
 1 month supply5                                                                        meet the plan’s                 choose to fill a
                         §   $60 for each Non-Preferred Brand Name Drug                 annual Deductible               prescription with a
                             prescription                                                                               Preferred Brand Name
                                                                                      § After that, you pay
                         §   $90 for each Specialty Drug prescription                   20% of your prescrip-           or Non-Preferred Brand
                      You pay a copay of:                                               tion drug costs                 Name Drug, an ancil-
                                                                                        (Coinsurance) until             lary charge will be
                         §   $20 for each Generic Drug prescription
                                                                                        your total out-of-              added to your cost for
 Home Delivery –         §   $60 for each Preferred Brand Name Drug
                                                                                        pocket expenses                 the medication – even
 3-month supply5             prescription
                                                                                        reach the plan’s                if your doctor checked
                         §   $120 for each Non-Preferred Brand Name Drug                annual Out-of-Pocket            the “dispense as
                             prescription                                               Maximum                         written” box on the
                         §   $180 for each Specialty Drug prescription                                                  prescription form.
                                                                                                                        The ancillary charge
5 If a prescribed medication requires prior authorization, your physician must be consulted before it can be
                                                                                                                        will be 50% of the cost
  dispensed. Physicians should call Express Scripts at 800-417-1764 to provide authorization.
                                                                                                                        difference between the
If you elect coverage under the Premier PPO,              If You Are Prescribed a Specialty Drug:                       brand-name version of
Select PPO, or HMO Illinois medical plans, the                                                                          the drug and the
amount you pay in out-of-pocket costs for                 Prescriptions for all Specialty Drugs must                    generic version. This
                                                          be filled through Accredo mail order; these                   ancillary charge will
prescription drugs each year is subject to an
                                                          prescriptions cannot be filled at a retail                    not apply toward the
annual $1,500 “stop loss.” This annual stop-
                                                          pharmacy.                                                     maximum cost per
loss feature applies separately to you and to
                                                                                                                        prescription or the
each covered family member. If the amount                                                                               annual Out-of-Pocket
                                                          Accredo – a wholly owned subsidiary of
you pay in Copays reaches $1,500 for you or a                                                                           Maximum.
                                                          Express Scripts – is a mail-order pharmacy
covered family member in a calendar year, the
                                                          whose sole purpose is specialty medication
prescription drug Copays noted above will no
                                                          management. Accredo fills prescriptions for
longer apply to prescriptions filled for you or
                                                          Specialty Drugs for oral, injectable, and
that family member for the balance of the year.
                                                          infused medications and provides on-call
Prescription drug costs that exceed the                   nurse and pharmacist support for patients on
approved dispensing limit in any given month              these complex, expensive drugs.
– or that are for medications not covered by
                                                          Because many Specialty Drugs require refrig-
your plan – will not count toward your annual
                                                          eration, Accredo takes precautions to ensure
out-of-pocket expenses.
                                                          product preservation, including using temper-
                                                          ature-controlled packaging and working with
                                                          patients to arrange for safe and secure
                                                          package delivery. For example, if you are
                                                          unable to receive your medications at home,
                                                          you may request delivery to your workplace,
                                                          your doctor’s office, or a family member’s
                                                          home.

                                                                                                    Northwestern University | Benefits Guide 2021 | 9
For Your Health

                                  Dental
                                  Free checkups help maintain good oral health.                  coverage must choose a dentist who is a
Both plans pay                                                                                   member of the Guardian Dental HMO
100% of the cost of               You can choose coverage under one of two                       provider Network as your primary dental
preventive dental                 dental plans:                                                  care provider. The plan pays the full cost
health care and                      § BlueCross BlueShield of Illinois Dental                   of preventive services. For all other
will help you and                      PPO – You and your covered family                         covered services, the plan pays 100% of
your family with                       members can go to any dentist, but you                    the cost after you pay a specified Copay.
the costs of main-                     will generally receive higher benefits (and
taining good dental                                                                      Whichever plan you choose, you can choose
                                       pay less out-of-pocket) for services you
health and treating                                                                      coverage just for yourself, or you may include
                                       receive from a dentist who is a member
dental disease                                                                           one or more eligible family members under
                                       of the BlueCross BlueShield of Illinois
and injury.                                                                              your coverage (see Medical, Dental, and Vision
                                       Dental PPO provider Network. The plan
                                                                                         Coverage Tiers on page 1).
                                       pays the full cost of preventive services
                                       when using an in-Network dental                   You and Northwestern share the cost of the
                                       provider.                                         dental coverage you choose. You pay your share
                                     § Guardian Dental HMO – You and each                through Pre-Tax Contributions, which will be
                                       family member you include under your              automatically deducted from your paycheck.

                                  Dental Plans At-a-Glance
                                                               BlueCross BlueShield of Illinois
Plan Features                                                           Dental PPO                            Guardian Dental HMO
Diagnostic and Preventive Services – oral exams,
                                                           Plan pays 100% – with no Deductible                   Plan pays 100%
x-rays, cleanings, fluoride treatments
Annual Deductible                                                $50 individual/$150 family                             –
Miscellaneous Services – sealants, space main-
                                                               Plan pays 80% of the cost after           Plan pays 100% of the cost after
tainers, pulp vitality tests, palliative treatment to
                                                                     annual Deductible                           specified Copay
relieve dental pain
Restorative Services, Endodontic Services,                     Plan pays 80% of the cost after           Plan pays 100% of the cost after
Periodontal Services, Oral Surgery                                   annual Deductible                           specified Copay
                                                               Plan pays 50% of the cost after           Plan pays 100% of the cost after
Crowns/Inlays/Onlays
                                                                     annual Deductible                           specified Copay
                                                               Plan pays 50% of the cost after
Implants                                                                                                                –
                                                                     annual Deductible
                                                          For dependent children under age 26
                                                                                                        For children and adults – plan pays
Orthodontic Services                                      – plan pays 50%, up to $3,000 lifetime
                                                                                                        100% of cost after specified Copay
                                                                        maximum
Annual Benefit Maximums                                              $3,000 per person                                  –

                                  Monthly Premium Costs: Dental
                                                                 BlueCross BlueShield of Illinois
                                                                          Dental PPO                           Guardian Dental HMO
                                   Coverage Tier                   Full-Time          Part-Time             Full-Time          Part-Time
                                   You Only                           $21                $30                   $7                 $10
                                   You + Spouse                       $45                $64                  $13                 $18
                                   You + Child(ren)                   $51                $72                  $14                 $20
                                   You + Spouse + Child(ren)          $72                $102                 $20                 $28

 10 | Benefits Guide 2021 | Northwestern University
For Your Health

Vision
Don’t underestimate the value of regular           You can choose EyeMed Vision Care Plan
eye exams.                                         coverage just for yourself, or you may include
                                                   one or more eligible family members under
Northwestern’s vision plan through EyeMed
                                                   your coverage (see Medical, Dental, and Vision
offers comprehensive coverage, including eye
                                                   Coverage Tiers on page 1).
exams and allowances for eyewear. With open
access to see any eye care provider, you can       If you choose coverage under the EyeMed
see the one who is right for you. Eye exams are    Vision Care Plan, you pay the full cost of this
an important part of overall health care for you   coverage through Pre-Tax Contributions,
and your entire family                             which will be automatically deducted from
                                                   your paycheck.
If you choose coverage under the EyeMed
Vision Care Plan, you and your covered family      While Northwestern-sponsored medical                         After you pay a
members can go to any optometrist, but you         plans have built-in vision discounts, provided               $10 Copay, the
will generally receive higher benefits (and pay    through the Blue365 Discount Program (see                    EyeMed Vision
less out-of-pocket) for services you receive       Blue365 Discount Program: Overview); you can                 Care Plan will pay
from a vision care provider who is a member of     choose to enroll in the EyeMed Vision Care                   100% of the cost
the EyeMed provider Network.                       Plan, which will provide coverage for vision                 of an annual eye
                                                   care services. Important! You cannot use                     exam performed
EyeMed uses a national Network of more than
                                                   both the Blue365 Discount Program and the                    by an EyeMed
35,000 retail chains and private practice
                                                   EyeMed Vision Care Plan simultaneously to                    Network provider.
providers. To locate an EyeMed Network
                                                   cover the same vision services.
provider near you, go to www.eyemedvision-                                                                      Family members
care.com (choose “Members” and under Find                                                                       you include
a Provider select the “Insight” Network).                                                                       under your Eye-
                                                                                                                Med coverage can
                                                                                                                each receive an
  BLUE365 DISCOUNT PROGRAM: OVERVIEW                                                                            annual eye exam
                                                                                                                 for just $10, as
  Blue365 is a vision services discount              § HMO participants – may be applied to
                                                                                                                   well.
  program sponsored by BlueCross BlueShield            remaining balances for covered vision
  for participants enrolled in the Premier PPO,        care services (including frames,
  Select PPO, Value PPO, and HMO Illinois              contact lenses, and various lens
  medical plans; it is not a vision insurance          options) after the vision coverage
  plan.                                                provided through their HMO Illinois
                                                       coverage has been applied or
  Blue365 discounts for:                               exhausted.
    § PPO participants – may be applied to
      covered vision care services (including      The Blue365 Discount Program is provided
      exams, frames, lenses, contact lenses,       at no additional cost.
      and various lens options). These             For details about how the Blue365 Discount
      discounts are provided through two           Program works and how it can save you
      vision care providers: EyeMed and            money, call BCBS at 800-327-8497 or visit
      Davis Vision. Participants who are also      www.blue365deals.com.
      enrolled in the EyeMed Vision Care
      Plan may take advantage of these
      discounts only after they exhaust their
      EyeMed Vision Care Plan benefits.

                                                                                        Northwestern University | Benefits Guide 2021 | 11
For Your Health

                                  Vision Plan At-a-Glance

                                                                                        EyeMed Vision Plan
Plan Features                                                       In-Network                                Out-of-Network
Annual Eye Exam – once every 12
                                                          After $10 Copay, plan pays 100%                    Plan pays up to $40
months
Exam Options: Contact Lenses
• Standard Fit and 2 Follow-up Visits                     After $10 Copay, plan pays 100%                    Plan pays up to $40
• Premium Fit and Follow-up                      After $10 Copay, plan offers 10% discount on                Plan pays up to $40
                                                   retail prices, then applies $55 allowance
Frames – once every 12 months                           Plan pays 80% of balance over $130                   Plan pays up to $65
Standard Plastic Lenses – once
every 12 months
• Single Vision                                           After $10 Copay, plan pays 100%                    Plan pays up to $40
• Bifocal                                                 After $10 Copay, plan pays 100%                    Plan pays up to $60
• Trifocal/Lenticular                                     After $10 Copay, plan pays 100%                    Plan pays up to $80
• Standard Progressive                                    After $75 Copay, plan pays 100%                    Plan pays up to $60
• Premium Progressive – scheduled                     After $101-$113 copay, plan pays 100%                  Plan pays up to $60
• Premium Progressive – other                         After $75 Copay, plan pays 20% less $120                        –
                                                                     allowance
Standard Lens Options
• UV Coating/Tint (solid and gradient)                                  $15                                           –
• Standard Scratch Resistance/                               No Copay; plan pays 100%                        Plan pays up to $5
  Standard Polycarbonate
• Standard Anti-Reflective Coating                                      $45                                           –
• Polarized                                                 20% discount off retail price                             –
• Photochromic/Transitions Plastic                                      $75                                           –
• Premium Anti-Reflective Coating                                     $57-$68                                         –
  – scheduled
• Other Add-Ons and Services                                80% discount off retail price                             –
Contact Lenses – once
every 12 months
• Conventional                                    No Copay; you pay 85% of balance over $200                 Plan pays up to $160
• Disposable                                     No Copay; you pay 100% of balance over $200                 Plan pays up to $160
• Medically Necessary                                             Plan pays 100%                             Plan pays up to $210

Lasik or PRK – from US Laser                             You pay 85% of retail price (95% of
                                                                                                                      –
Network                                                          promotional price)

                                  Monthly Premium Costs: Vision

                                   Coverage Tier                          EyeMed Vision Care Plan
                                   You Only                                          $12
                                   You + Spouse                                      $24
                                   You + Child(ren)                                  $28
                                   You + Spouse + Child(ren)                         $33

 12 | Benefits Guide 2021 | Northwestern University
For Your Health

Health Care Flexible Spending Account
Save money on eligible health care expenses.            § You can be reimbursed for eligible
                                                          health care expenses up to the full
You can save money when you use tax-free                  value of the Pre-Tax Contributions
dollars from a Health Care Flexible Spending              you’ve agreed to make for the year from
Account (Health Care FSA) to pay eligible                 the first day of the benefit year – even
health care expenses incurred by you, your                before all scheduled contributions for
spouse or your dependent child(ren). Note: You            the year have been made.
do not need to be enrolled in a Northwestern-
sponsored medical plan to participate in a              § You can use the money you contribute
Health Care FSA.                                          to a Health Care FSA each year to pay
                                                          eligible expenses incurred in the
If you choose medical coverage under the:                 calendar year (January 1-December 31)
                                                          in which they are made, as well as
  § Premier PPO, Select PPO, or HMO Illinois                                                                        You must renew
    medical plan – You can open (and contrib-             eligible expenses incurred January
                                                                                                                    your election to
                                                          1-March 15 of the following calendar
    ute to) a traditional Health Care FSA.                                                                          make Pre-Tax
                                                          year (the grace period).
  § Value PPO medical plan – You can open                                                                           Contributions to
    (and contribute to) a limited-use Health            § The deadline for submitting claims is                     a Health Care FSA
    Care FSA.                                             March 31 of the year following the                        each year during
                                                          calendar year in which the contribu-                      Open Enrollment.
Whether you participate in a traditional or               tions are made.                                           If you don’t, your
limited-use Health Care FSA, you can contrib-           § You will forfeit any unused contribu-                     Health Care FSA
ute up to $2,700 a year to your account. The              tions in a Health Care FSA as of the                      Pre-Tax Contribu-
minimum annual contribution is $240.                      claim filing deadline.                                    tion amount for
                                                                                                                     the next year will
If you choose to contribute to a Health Care FSA:       § Funds in your Health Care FSA are                            default to $0.
                                                          not “portable” if you retire or leave
  § Once your enrollment takes effect, you
                                                          Northwestern.
    will not be able to change your Pre-Tax
    Contributions to the account until the
    next Open Enrollment unless you experi-
    ence a qualifying life event.

  Traditional vs. Limited-Use Health Care FSA: What’s the Difference?

  According to IRS rules, if you open a Health Savings Account – which you can do only if
  you choose coverage under the Value PPO medical plan – you cannot contribute to a
  traditional Health Care FSA. However, you can contribute to a limited-use Health Care
  FSA. Here’s how a traditional Health Care FSA and a limited-use Health Care FSA differ:

                    Traditional Health Care FSA                                    Limited-Use Health Care FSA
     For Premier PPO, Select PPO, and HMO Illinois participants               For Value PPO participants with an HSA
    • Use Pre-Tax Contributions to pay eligible health care         • Use Pre-Tax Contributions to pay eligible DENTAL and
        expenses at ANY time within the plan year or grace period      VISION expenses at ANY time
                                                                    • Use Pre-Tax Contributions to pay ALL eligible health care
                                                                       expenses incurred AFTER Value PPO annual Deductible
                                                                       has been met

                                                                                           Northwestern University | Benefits Guide 2021 | 13
For Your Health

                                   Eligible Health Care Expenses                         Using Your Health Care FSA

                                   Eligible health care expenses you can reim-           If you participate in a traditional or limited-use
                                   burse using tax-free dollars from a Health            Health Care FSA, you’ll receive a PayFlex debit
                                   Care FSA include out-of-pocket expenses –             card. It’s all you’ll need whenever you want to
                                   Deductibles, Coinsurance, and Copays under            use pre-tax dollars from your Health Care FSA
For a complete                     your medical coverage – as well as services           to pay eligible health care expenses. However,
list of health care                that may not be covered by your medical,              you can pay eligible health care expenses out
services for which                 dental, and vision plans, including:                  of your own pocket and file a claim using the
you may claim                                                                            Express Claims feature on the PayFlex website
eligible expenses,                    § Acupuncture
                                                                                         – www.payflex.com. Once your claim is
see IRS Publication                   § Chiropractic care                                processed, you will be reimbursed from your
502, available at                     § Dental and orthodontia                           Health Care FSA, up to the amount you have
www.irs.gov.                                                                             elected to contribute to a Health Care FSA for
                                      § Flu shots
                                                                                         the year.
                                      § Laser eye surgery
                                      § Prescription drugs
                                      § Over-the-counter medications and
                                        items for which your doctor provides a
                                        prescription6
                                      § Vision exams, eyeglasses and contact
                                        lenses, and
                                      § Weight loss programs.
                                   6 Costs for over-the-counter medications and items
                                     purchased without a prescription are not eligible
                                     expenses and may not be reimbursed through a
                                     Health Care FSA.

                                   You may use your contributions to a Health            You can also use the PayFlex website to:
                                   Care FSA for eligible expenses incurred during          § Access your account information, view
                                   the calendar year in which the contributions              transactions, and check the status of
                                   were made, as well as those incurred January              claims
                                   1 through March 15 of the following year. The
                                                                                           § Set up direct deposit
                                   deadline for submitting claims for these
                                   eligible expenses is March 31 of that                   § See a complete listing of eligible health
                                   following year.                                           care expenses, and
                                                                                           § Obtain account-related forms, including
                                                                                             claim forms, direct deposit forms, letters
                                                                                             of medical necessity, enrollment forms,
                                                                                             and other IRS publications.

                                                                                         Important! Be sure to keep itemized receipts
                                                                                         of all your Health Care FSA transactions in
                                                                                         case you need to provide documentation
                                                                                         supporting your use of the account for eligible
                                                                                         health care expenses.

  14 | Benefits Guide 2021 | Northwestern University
For Your Protection

Extended Sick Time                                Long-Term Disability
Continuing income if you’re unable to work        Continuing income if you’re unable to work
due to illness or injury for up to six months.    due to illness or injury for more than six
                                                  months.
Extended Sick Time (EST) will provide
continuing income in the event you are unable     Long-Term Disability provides a monthly                       To learn more
to work due to an illness or injury unrelated     benefit if – due to illness or injury – you are               about EST and how
to work.                                          unable to perform:                                            it works – and for a
                                                    § Your regular job – during the first two                   copy of frequently
If you experience an extended illness or injury                                                                 asked questions
                                                      years of your disability, or
and you are approved for EST benefits, you will                                                                 about the program
receive 100% of your hourly rate or monthly         § Any reasonable job – after two years of
                                                                                                                – visit http://www.
salary for up to 25 weeks following completion        disability.
                                                                                                                northwestern.
of an elimination period in which you are                                                                       edu/hr/benefits/
                                                  To receive LTD benefits, you must be absent
absent from work for seven consecutive                                                                          disability-plans/
                                                  from work for six months of continuous
calendar days or five consecutive business                                                                      Extended-Sick-
                                                  disability, then file an LTD claim.
days.                                                                                                              Time.html.
                                                  There are two parts to the LTD plan:
You do not need to enroll to be eligible to
receive EST benefits. Your coverage under this      § Core Plan – This plan provides a monthly
program will begin automatically once you             LTD benefit equal to 50% of your last
complete six months of continuous benefits-           working University salary, up to a maxi-
eligible service with Northwestern.                   mum benefit of $11,500 per month. You
                                                      are automatically enrolled in Core LTD
The EST program is managed by The Hartford            coverage.
Insurance Company. To receive EST benefits,
                                                    § Buy-Up Plan – This plan provides a
you must be absent from work for five
                                                      monthly LTD benefit equal to 60% of your
consecutive business days, then file an EST
                                                      last working University salary, up to a
claim with The Hartford and be approved.
                                                      maximum benefit of $13,800 per month.
Northwestern pays the full cost of your               It also allows for a benefit up to 70% from
coverage under this program; there is no cost         all sources, including Social Security
to you.                                               Disability Income (SSDI). You can enroll in
                                                      Buy-Up LTD coverage during any benefits
                                                      enrollment but you will be required to
                                                      submit a Personal Health Application if
                                                      you choose to enroll in any enrollment
                                                      period other than your first enrollment
                                                      opportunity as a new hire.

                                                  If you are diagnosed or receive care for a
                                                  condition within 26 weeks prior to your
                                                  effective date of LTD coverage, you will not be
                                                  covered by the LTD plan until you have been
                                                  covered under the plan for at least 12 months.

                                                                                        Northwestern University | Benefits Guide 2021 | 15
For Your Protection

                                  The maximum benefit period for which LTD           The LTD program is managed by The Hartford
                                  benefits will be paid depends on your age at       Insurance Company.
Northwestern                      the time you become disabled and your Social
requires faculty                  Security Normal Retirement Age.                    Northwestern pays the full cost of your
and staff who                                                                        Core LTD coverage. If you elect Buy-Up LTD
apply for LTD                     Benefits typically cease at your Social Security   coverage, you will pay the cost of that
benefits to also                  Normal Retirement Age, but may continue            additional 10%. The amount you pay will be
apply for Social                  based on your age at disability according to       based on your age.
Security Disability               the following table.
Income (SSDI).
The Hartford will                  Age at Disability                                        Maximum LTD Benefit Period
offset any LTD                     62 or younger                                 To Normal Retirement Age or 42 months, if greater
benefit payments                   63                                            To Normal Retirement Age or 36 months, if greater
you receive with
                                   64                                                                30 months
any SSDI benefits
                                   65                                                                24 months
for which you are
approved.                          66                                                                21 months
                                   67                                                                18 months
                                   68                                                                15 months
                                   69 or older                                                       12 months

                                                                                     Annual Premium Costs: LTD Buy-Up Plan

                                                                                      Your Age                            Rate
                                                                                      Under 30                           $0.082
                                                                                      30-34                              $0.109
                                                                                      35-39                              $0.123
                                                                                      40-44                              $0.145
                                                                                      45-49                              $0.187
                                                                                      50-54                              $0.243
                                                                                      55-59                              $0.284
                                                                                      60-64                              $0.307
                                                                                      65 older                           $0.287

                                                                                     Note: To calculate your annual premium under the
                                                                                     Buy-Up Plan, divide your annual salary by 100, then
                                                                                     multiply by the rate for your age bracket.

 16 | Benefits Guide 2021 | Northwestern University
For Your Protection

Life Insurance
Financial protection for you and your              SUPPLEMENTAL, SPOUSE, AND                                    Do you know
family.                                            DEPENDENT CHILD TERM LIFE INSURANCE                          who your
                                                                                                                beneficiaries
Northwestern provides a combination of Basic       You can increase your life insurance protection              are?
Term Life Insurance for you and the opportu-       by electing the following types of optional
nity to purchase additional Supplemental,          coverage:                                                    Your Beneficiary
Spouse, and Dependent Child Term Life                                                                           is the person (or
                                                     § Supplemental Term Life Insurance                         persons) who will
Insurance.
                                                       – Additional life insurance coverage for                 receive your Basic
This coverage is provided through Dearborn             yourself in increments of your Annual                    and Supplemental
National.                                              Northwestern Salary, up to a maximum of                  Term Life Insur-
                                                       5x your pay or $2,000,000, whichever is                  ance benefits if
Northwestern pays the cost of your Basic Term          less. Evidence of Insurability is not                    you die.
Life Insurance. You pay the cost of any Supple-        required for Supplemental Term Life
mental, Spouse, and Dependent Child Term               Insurance coverage of up to 3x your                      You can name
Life Insurance you elect based on group                Annual Northwestern Salary (or                           anyone you
insurance rates.                                       $1,000,000, whichever is less) at time                   want as your
                                                       of hire; for Supplemental Term Life                      Beneficiary(ies) –
BASIC TERM LIFE INSURANCE                              Insurance in excess of this amount (or if                and designate as
                                                       adding coverage during Open Enrollment)                  many people as
As a benefits-eligible Northwestern faculty or         Evidence of Insurability is required and                 Beneficiary(ies) as
staff member, you receive Basic Term Life              coverage will be subject to approval by                  you wish – for your
Insurance automatically and at no cost to you.         Dearborn National.                                       Basic and Supple-
You have the choice between Basic Term Life                                                                     mental Term Life
Insurance coverage equal to:                         § Spouse Term Life Insurance – Life                        Insurance. (Note:
                                                       insurance for your spouse in increments                  You may not name
§ $50,000, or                                          of $10,000, up to a maximum equal to                     Northwestern
§ 2.5 x your annual salary up to a                     the value of your total Basic Term Life                  University as a
  maximum of $250,000.                                 Insurance plus Supplemental Term Life                    Beneficiary.) You
                                                       Insurance election or $500,000, which-                   must specify the
If you do not make a selection, you will default       ever is less. Evidence of Insurability is not
to the $50,000 coverage amount.                                                                                 percentage of the
                                                       required for Spouse Term Life Insurance                  benefit to be paid
                                                       coverage of up to $30,000 at time of hire;               to each Beneficiary
Note: Under IRS regulations, the value of
                                                       for Spouse Term Life Insurance in excess                 (up to a maximum
employer-based basic term life insurance in
                                                       of this amount (or if adding coverage                    of 100% for all
excess of $50,000 is considered “imputed” (or
                                                       during Open Enrollment), Evidence of                     allocations).
taxable) income. If you don’t want to incur this
                                                       Insurability is required and coverage will
imputed income, you may elect the $50,000                                                                       You are automati-
                                                       be subject to approval by Dearborn
Basic Term Life Insurance option.                                                                               cally the Benefi-
                                                       National.
                                                                                                                ciary for payment
                                                     § Dependent Child Term Life Insurance                      of any Spouse Term
                                                       – Life insurance for your unmarried                      Life Insurance
                                                       child(ren) who are under age 26 and                      and/or Child Term
                                                       financially dependent on you in incre-                   Life Insurance
                                                       ments of $5,000, up to a maximum of                      coverage you
                                                       $25,000 for each child. Evidence of                        elect.
                                                       Insurability is not required.

                                                                                        Northwestern University | Benefits Guide 2021 | 17
For Your Protection

                                  Monthly Premium Costs: Supplemental, Spouse, and Dependent Child Term Life
                                  Insurance

               Supplemental Term Life Insurance/                                      Supplemental Term Life Insurance/
                  Spouse Term Life Insurance                                             Spouse Term Life Insurance
Per person per $1,000:                       You       Spouse      Per person per $1,000:                You              Spouse
Under age 25                               $0.021       $0.021     Age 55-59                           $0.211             $0.217
Age 25-29                                  $0.021       $0.021     Age 60-64                           $0.280             $0.288
Age 30-34                                  $0.026       $0.026     Age 65-69                           $0.432             $0.445
Age 35-39                                  $0.039       $0.040     Age 70 and older                    $0.691             $0.712
Age 40-44                                  $0.048       $0.049
Age 45-49                                  $0.075       $0.077                     Dependent Child Term Life Insurance
Age 50-54                                  $0.114       $0.117     Per child per $1,000                          $0.128

                                  Does This Coverage Provide Benefits in the
                                  Event of Accidental Injury or Death?

                                  All four types of term life insurance – Basic,        For details regarding circumstances under
                                  Supplemental, Spouse and Child – include              which AD&D benefits will be paid – as well as
                                  accidental death and dismemberment (AD&D)             additional details about AD&D coverage – visit
                                  Insurance. This AD&D coverage will provide a          http://www.northwestern.edu/hr/benefits/
                                  benefit in an amount up to the applicable life        resources/hw_spd.pdf.
                                  insurance if – as the result of an accident –
                                  you or your covered spouse, partner, or child:
                                     § Loses your sight, hearing, or a limb
                                     § Becomes paralyzed
                                     § Dies, or
                                     § Suffers certain other losses.

                                  AD&D coverage will pay a benefit equal to all
                                  or a specified percentage of the corresponding
                                  life insurance coverage amount, based on the
                                  nature of the loss.

 18 | Benefits Guide 2021 | Northwestern University
For Your Well-being

Dependent Care Flexible Spending
Account

Save money on eligible dependent                       § Funds in your Dependent Care FSA
care expenses.                                           are not “portable” if you retire or leave                You must renew
                                                         Northwestern.                                            your election to
You can save money when you use tax-free
dollars from a Dependent Care Flexible               Northwestern Reimbursement                                   make Pre-Tax
Spending Account (Dependent Care FSA) to                                                                          Contributions to a
                                                     If you open and contribute to a Dependent                    Dependent Care FSA
pay eligible dependent care expenses. Your
                                                     Care FSA, Northwestern will reimburse                        each year during
qualified dependents may include your
                                                     to your paycheck an amount equal to a                        Open Enrollment.
children through age 12, or spouse, parents,
                                                     percentage of your contribution if:                          If you don’t, your
in-laws, siblings, or child(ren) over the age of
13 incapable of self-care. Those covered must          § You have full-time status – 100%                         Dependent Care FSA
be declared as a dependent on your tax return.           full-time appointment or scheduled to                    Pre-Tax Contribu-
                                                         work at least 37.5 hours per week                        tion amount for
If you are single or married filing taxes jointly,                                                                the next year will
                                                       § Your spouse is working or studying                       default to $0. If you
you may contribute up to $5,000 per house-
                                                         full-time, and                                           are eligible to re-
hold a year to a Dependent Care FSA. The
minimum annual contribution is $240.                   § Your combined adjusted gross household                   ceive a reimburse-
                                                         income is $130,000 or less.                              ment contribution
If you choose to contribute to a Dependent                                                                        from Northwestern,
Care FSA:                                            Combined                     Reimbursement
                                                     Adjusted Gross                 Percentage/
                                                                                                                  you must re-submit
  § Once your enrollment takes effect, you           Household Income               Maximum7                      your application for
    will not be able to change your contribu-                                                                     this contribution
                                                     Up to $60,000               80% – up to $4,000
    tion to that account until the next Open                                                                         each year, as well.
                                                     $60,001 to $75,000          60% – up to $3,000
    Enrollment unless you experience a
    qualifying life event.                           $75,001 to $100,000         40% – up to $2,000
                                                     $100,001 to $130,000        20% – up to $1,000
  § You can be reimbursed for eligible
    dependent care expenses up to your               7 The maximum reimbursement amount is based on
    current account balance ONLY. Any                  a Dependent Care FSA annual contribution of
    expenses in excess of your current                 $5,000. The reimbursement amount is considered
                                                       taxable income.
    account balance will be reimbursed as
    additional contributions are added to            If you are eligible for – and wish to receive –
    your account throughout the year.                a reimbursement, you must :
  § You can use the money you contribute to            § Complete the online Dependent Care
    a Dependent Care FSA each year to pay                Employer Match Application available
    eligible expenses incurred in the calendar           on myHR (for instructions, see the User
    year (January 1-December 31) in which                Guide), and
    they are made.
                                                       § Provide Benefits a copy of the page from
  § The deadline for submitting claims is                your most recent U.S. income tax Form
    March 31 of the year following the                   1040 showing your tax-filing status and
    calendar year in which the contributions             adjusted gross income (line 37).
    are made. To submit a request for reim-
    bursement, you must complete a PayFlex           If your application is received after the start of
    claim form and submit it to PayFlex.             the calendar year (January 1), Northwestern’s
                                                     reimbursement for the year will be pro-rated.
  § You will forfeit any unused contributions        Important! The enrollment form must be
    in a Dependent Care FSA at year end.             completed each year if you wish to receive
                                                     these funds.

                                                                                          Northwestern University | Benefits Guide 2021 | 19
For Your Well-being

                                   Eligible Dependent Care Expenses                    Commuter Benefit
                                   Eligible dependent care expenses you can            For your convenience, the University has
                                   reimburse using pre-tax dollars from a              partnered with PayFlex to administer our
                                   Dependent Care FSA include:                         Commuter Transit and Parking program.
                                      § Day camp and camp activities                   (The campus parking programs administered
                                                                                       by the Evanston Parking Office and by
                                      § Day care for your child(ren)
For a complete list                                                                    Transportation & Parking for the Chicago
of child and dependent                § Day care for an elderly or disabled            Campus are not included.)
care services for                       dependent
which you may claim                                                                    The program allows you to have the cost of
                                      § Nanny salary and taxes, and
eligible expenses,                                                                     your commuting expenses taken from your
see IRS Publication                   § Summer sports day camp (overnight              check on a pre-tax basis.
503, available at                       camp is NOT an eligible expense).
www.irs.gov.                                                                           See the HR Benefits website for more
                                   When filing a claim for reimbursement with          information.
                                   PayFlex, you will be required to provide a tax ID
                                   number for the individual or facility providing
                                   eligible dependent care services.

                                   Using your Dependent Care FSA

                                   If you participate in a Dependent Care FSA,
Important! Be sure
                                   you will pay eligible dependent care expenses
to save itemized
                                   out of your own pocket and file a claim using
receipts of all your
                                   the Express Claims feature on the PayFlex
Dependent Care
                                   website – www.payflex.com. Once your claim
FSA transactions
                                   is processed, you will be reimbursed for your
in case you need
                                   claim from the available funds in your
to provide
                                   Dependent Care FSA.
documentation
supporting your use                You can also use the PayFlex website to:
of the account for
                                      § Access your account information, view
eligible dependent
                                        transactions, and check the status of
care expenses.
                                        claims
                                      § Set up direct deposit
                                      § See a complete listing of eligible
                                        dependent care expenses, and
                                      § Obtain account-related forms, including
                                        claim forms, direct deposit forms, letters
                                        of medical necessity, enrollment forms,
                                        IRS Form 2441, and other IRS publica-
                                        tions.

  20 | Benefits Guide 2021 | Northwestern University
For Your Well-being

Tuition Benefits
Offering financial assistance for you, your       For classes taken outside of Northwestern:
spouse, and your dependent child(ren)
                                                      § Employee Portable Tuition8 – Reim-
under age 26
                                                        bursement of tuition for undergraduate
Tuition benefits at Northwestern are designed           or graduate university degrees pursued
                                                                                                                    In addition,
to support the ongoing efforts of full-time,            at schools other than Northwestern;
                                                                                                                    Northwestern
benefits-eligible faculty and staff – and their         2021 calendar year reimbursement is
                                                                                                                    offers a 25%
eligible family members – to pursue higher              100%; maximum annual benefit is
                                                                                                                    discount per
education. You can apply for these benefits             $12,000 through 2020 ($5,250 for classes
                                                                                                                    class on tuition
online through the myHR Self-Service portal.            that start on or after January 1, 2021).
                                                                                                                    for non-degree
                                                      § Dependent Portable Tuition – Tuition                        lessons taken
For classes taken at Northwestern:
                                                        assistance for undergraduate university                     at the Music
  § Employee Reduced Tuition – Reduced                  degrees pursued by employees’ depen-                        Academy by
    tuition for undergraduate or graduate               dent children at U.S. accredited schools                    faculty, staff and
    university courses taken at Northwestern:           other than Northwestern after a five-year                   retirees, their
    2021 calendar year discount is 90%;                 service period; 2021 rate is 50% of tuition                 spouses and
    maximum annual discount is $12,000.                 and eligible fees for up to 8 semesters/12                  dependent
  § Enhanced Employee Reduced Tuition –                 quarters lifetime maximum.                                     children.
    Reduced tuition for undergraduate or
                                                  Using the Online Application9
    graduate university courses taken at
    Northwestern after a three-year service       1. Use a Firefox browser.
    period and while earning less than            2. Log into myHR Self-Service at https://
    $100,000 a year; 2021 calendar year              myHR.northwestern.edu with your NetID,
    discount is 90%; there is no limit on the        Password, and Multifactor Authentication.
    annual discount.                              3. Select “Benefits” and choose “My Tuition
  § Employee Northwestern Certificate                Benefit Application.”
    Tuition – Reimbursement of tuition for        4. Select “Submit New Application.”
    non-credit, short duration certificate        5. Select the “Tuition Benefit Year.”
    programs taken at Northwestern; 2021          6. Use the magnifying glass icon to select
    calendar year reimbursement is 100%;             the “Plan ID” (your eligible tuition benefit
    maximum annual benefit is $12,000.               options will appear).
  § Dependent Reduced Tuition – Reduced           7. Follow instructions to complete application
    tuition for undergraduate university             and upload required documentation.
    degrees pursued by employees’ spouses
    and dependent children at Northwestern        For more information, visit http://www.
    – 85% for undergraduate courses in the        northwestern.edu/hr/benefits/tuition. For
    School of Professional Studies (SPS)          information on additional professional devel-
    after a six-month service period; 50% for     opment opportunities, visit http://www.
    all other undergraduate level courses         northwestern.edu/hr/learning/development/
    after a five-year service period; 90% if      index.html.
    hired full-time before January 1, 2000
    – for up to 12 quarters lifetime maximum.

                                                  8   This plan is not available to employees hired on or
                                                      after January 1, 2020.
                                                  9   If you do not have access to myHR Self Service,
                                                      please email tuition-benefits@northwestern.edu.

                                                                                            Northwestern University | Benefits Guide 2021 | 21
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