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We all have different benefit needs, so instead of giving everyone the same benefits, Flexible Benefits offer a variety of options. Although Human Resources (HR) cannot directly advise you or provide individual counseling on the benefit plans you select, we provide as much information as possible to ensure that you can make an informed decision. Information and details about every benefit program in Flex is contained in this guide in multiple formats for some programs, like medical coverage.
The University provides you with group term life insurance equal to one times your Flexible Benefits Salary and offers the ability to purchase up to four times more coverage if you wish to do so.
If you live in another state, you should contact your own tax advisor to learn of any state tax exemption for FSA deposits. Your Flexible Benefits Salary is your base salary as budgeted at the start of the plan year. For the period January 1 through June 30, your LTD Base Salary is your Flexible Benefits Salary as of January 1. For the period July 1 through December 31, your LTD Base Salary is your base salary as budgeted for the new fiscal year. If you decide to spend some of your salary as pre-tax dollars to pay for the benefits you elect, your taxable income will be reduced by that amount (salary reduction).
You are eligible to participate in Flexible Benefits if you are a full-time (at least 75 percent of a full work schedule) salaried member of Lehigh’s faculty or staff employed in a benefits-eligible position. All benefits included in the Flexible Benefits Plan — flexible spending accounts and medical, dental, life, dependent life, and long-term disability insurances — are available to new staff members on the first of the month following their first work day. Basic life and long-term disability insurances are effective on your first work day for faculty and the first of the month for staff members. If you miss this enrollment deadline, you will be assigned default benefit coverage that consists of individual enrollment in the CMM Plan medical coverage, university-provided basic life insurance, and pre-tax long-term disability coverage.
Benefit elections you make during an annual Flexible Benefits re-enrollment (changes to medical plan, dental coverage, supplemental life insurance, dependent life insurance, and the taxation of the long-term disability insurance premium; or decisions about flexible spending accounts for the next plan year) will be effective on January 1 of the new Flexible Benefits year. Only a qualifying life event (see page 7) or the next open enrollment period will permit you to make changes to default coverage or to the coverage with which you begin a new Flexible Benefits year. To help you, we have organized information about the University’s medical plans into several types of summaries.
The $100 per month surcharge will automatically apply if you do not successfully complete the waiver request by the deadline of November 25, 2015.
If you have dependents covered by Lehigh’s medical insurance plan, you will be asked to complete a Coordination of Benefits Questionnaire.
As is true of the other benefits included in Flexible Benefits, you can change your medical coverage election during the plan year only if you have a Qualifying Life Event. Allowed Charge: That portion of a charge that the plan determines is reasonable for covered services that have been provided to the patient. Balance Billing: Occurs when a provider of services or supplies refuses to accept the payment level determined by a medical plan as payment in full. Coinsurance [CI]: The portion of a covered charge that is paid by both the insured and the plan.
Copayment [CP]: A flat dollar amount paid to the provider by the insured for a covered service or supply at the time it is received.
Covered Charge: An allowed charge for service that the plan is designed to accept and for which the plan will pay, if all other conditions (like deductibles and coinsurance) have been met. Deductible [D]: The total amount of covered charges the insured must pay in full during the plan year before any payment is made by the plan.
Out-of-pocket Maximum: The maximum amount that would be paid by the insured for covered charges during a plan year, usually a combination of deductible and coinsurance. Preventive Care: Any covered medical service or supply that is received in the absence of symptoms or a diagnosed medical condition.
CMM Plan is a Capital BlueCross (CBC) traditional fee-for-service comprehensive major medical plan that allows you to see any health care provider you choose. To speak to a plan representative to ask coverage questions or identify participating doctors or hospitals, call 800-216-9741. Prescription drug (through Express Scripts) and vision care benefits (through Davis Vision) are also provided under the CMM Plan .
PPO 80 is a CBC preferred provider organization (PPO) medical plan with an extensive network of physicians and hospitals across the United States. Magellan Behavioral Health will preauthorize behavioral inpatient care and partial hospitalization benefits. PPO 100 is a CBC preferred provider organization (PPO) medical plan with an extensive network of physicians and hospitals across the United States. To speak to a plan representative — to ask coverage questions or identify participating doctors or hospitals — call 800-216-9741. Behavioral health care benefits for PPO 100 participants are managed by Integrated Behavioral Health (IBH). Prescription drug (through Express Scripts) and vision care benefits (through Davis Vision) are also provided under PPO 100. With Keystone, you must work within the network, use your PCP, and get referrals to see other doctors.
To speak to a plan representative to ask coverage questions, identify participating doctors or hospitals, or to change your existing PCP, call 800-216-9741.
Keystone participants receive behavioral health care benefits through Integrated Behavioral Health (IBH).
Prescription drug (through Express Scripts) and vision care benefits (through Davis Vision) are also provided under Keystone (see Prescription Drug Benefit and Vision Care Benefit). Here is information about Lehigh’s contribution to the cost of the medical plans and your monthly out-of-pocket costs for each of them in 2015.
A prescription plan administered by Express Scripts is available in each of the medical plans. You pay a percentage of the average wholesale price (AWP) for each prescription you fill, and the plan does not limit the number of prescriptions you may receive beyond restrictions of medical necessity, applicable legislation, or plan guidelines. Brand Name: Twenty (20) percent of the AWP up to a maximum of $150 for each brand name prescription.
Remember that your final per prescription cost for mail order prescriptions may be lower than at your local pharmacy because the mail program buys drugs in larger quantities. The Preferred Drug Step Therapy ProgramLehigh’s prescription drug program is based on a two-tiered formulary that determines the amount of coverage you will receive for your drugs. When you are prescribed a drug in one of these twelve classes, Express Scripts will use its Preferred Drug Step Therapy Program (PDST) to determine coverage. What To Do If You Are Prescribed A Non-Preferred DrugIf your doctor prescribes a non-preferred drug, Express Scripts will inform the pharmacist, who will then let you know that the drug isn’t covered. Express Scripts understands that some patients are either allergic to, or receive no benefit from, an equivalent Preferred medication.
The Davis Vision program, offered through Highmark Blue Shield, is part of all medical plans offered by Lehigh. You and each dependent covered under your medical insurance can receive the services or supplies listed in the chart on the next page once every twelve months. You can receive any of the covered services and products as needed more often than once every twelve months if you use network providers or suppliers for all materials and services. Dental insurance is available under United Concordia’s ConcordiaFlex fee-for-service dental plan.
A flexible spending account (FSA) is a cash reimbursement vehicle that allows you to eliminate the payment of federal, FICA, and (in the case of Health Care accounts) Pennsylvania state income taxes on the funds you commit to the account. A Dependent Care FSA can be opened to reimburse yourself for the costs of covered dependent care expenses for individuals who are your tax dependents. Remember that the Internal Revenue Service determines what supplies and services are eligible for reimbursement under FSAs. You can use Health Care and Dependent Care FSAs to pay uninsured health care and dependent care expenses with pre-tax dollars you set aside during the plan year.
Starting January 1, 2011, over the counter medications can only be reimbursed through an FSA if they are prescribed by a doctor. Subject to these conditions and as long as receipts are submitted, your Dependent Care Account reimburses expenses associated with dependent care on a pre-tax basis.
At the beginning of each year, your individual Health Care FSA account will be credited with the amount you designate.
When you have a reimbursable expense, you file a claim for payment from your account with the FSA Administrator (WageWorks).
Claims you submit must be for charges related to qualified services or supplies received during the plan year (January 1 through December 31). The frequency of reimbursements you can receive from your Dependent Care Account will depend on your pay cycle and how often you submit claims.
After March 31, if there is any money left in your Dependent Care FSAaccount, it is forfeited. Your accounts are funded by your setting aside a portion of your salary for deposit in either or both FSAs. In the absence of an FSA, you pay for miscellaneous unreimbursed health and dependent care expenses after you cash your paycheck — after taxes have already been deducted from your earnings. Manage Your Flexible Spending Account OnlineIt’s the fastest and easiest way to manage your Flexible Spending Account. Expenses that have not been and will not be reimbursed by any other health plan may qualify for payment through the Health Care Account. Medical expenses up to the medical deductible limit and the coinsurance amounts you pay after the deductible, as well as medical plan copayments. The cost of over-the-counter supplies that alleviate or treat personal injury or sickness (items that are only beneficial to general good health are not eligible). Eligible expenses that have been incurred by you, your spouse, your tax dependents and any of your adult children under the age of 26 may be reimbursed through your FSA. Other health care services that qualify as medical deductions under IRS rules may be eligible for reimbursement. Housekeepers in your home (including food and lodging) hired to care for an eligible dependent.
You will need to provide proof of payment for your dependent care expenses — a canceled check or a signed statement — as well as the tax identification number of the service provider. The university provides Basic Life Insurance benefits equal to one times your Flexible Benefits Salary at no cost to you. You have the option to purchase Supplemental Life Insurance in increments of one to four times your Flexible Benefits Salary. If you are a new employee at the university, there is no restriction on the amount of coverage you can choose in your initial enrollment in Lehigh’s Flexible Benefits Plan.
In the event that you have been denied additional coverage in the past, or that your Evidence of Insurability is denied now, you will not be able to increase coverage at any time in the future. Providing this evidence of insurability is your responsibility. Neither the University nor the carrier can assume it for you. An accelerated death benefit is available for the Supplemental Life Insurance you purchase. Because the cost of life insurance is paid with pre-tax dollars, some taxable income will result from the value of coverage over $50,000. If your coverage exceeds $50,000, the Internal Revenue Service (IRS) requires the university to include the taxable value of the premium that purchases life insurance in excess of $50,000 on your W-2 form. In evaluating your life insurance needs, it is important to look at the present, plan for the future, and make informed decisions. Full coverage for your children requires that you have at least three times the amount of coverage you elect for them.
The premium you will pay for dependent life insurance is not reduced even if the insurance payment is reduced because of the volume of coverage you carry on your own life. If you are a new employee there is no restriction on the amount of dependent life insurance you select. The increased coverage level becomes effective after the approval of the evidence of insurability from Lincoln Financial. A Tax Issue: Under current law, premiums for dependent life insurance cannot be paid with tax-free dollars. Long-term disability (LTD) insurance provides for the continuation of a percentage of your LTD Base Salary in the event that you experience a qualifying disability and are unable to work for a period longer than six months. Purchasing LTD coverage on a “pre-tax” basis means paying federal income tax on the benefit if you become disabled but paying no federal income tax on the premium.
Purchasing LTD coverage on a “post-tax” basis means paying federal income tax on the premium but paying no federal income tax on the benefit if you become disabled.
Lehigh’s short-term disability plan, as defined in the Faculty and Staff Guides, provides coverage for the first twenty-six weeks (six months) of disability.
LTD insurance assures a certain level of income if you’re unable to work due to a disability that lasts for more than six months.
Whether or not you have elected post-tax disability coverage, other sources of disability income will likely be subject to federal taxation.

The foundation of life insurance is the recognition of the value of a human life and the possibility of indemnification for the loss of that value. It is possible for life insurance policy payouts to be made in order to help supplement retirement benefits; however, it should be carefully considered throughout the design and funding of the policy itself. Life policies are legal contracts and the terms of the contract describe the limitations of the insured events. Protection policies – designed to provide a benefit in the event of specified event, typically a lump sum payment.
Investment policies – where the main objective is to facilitate the growth of capital by regular or single premiums.
There is a difference between the insured and the policy owner, although the owner and the insured are often the same person. When purchasing life insurance coverage, there are several factors that it is important to keep in mind. Just as important as the right amount of life insurance coverage is having the right type of insurance protection. There are a variety of different life insurance coverages to choose from in the marketplace today. While term life insurance can be inexpensive, this type of coverage also comes with an expiration date.
Permanent life insurance differs from term in that it provides both death benefit protection, along with a cash value component.
There are several reasons why a whole life insurance policy may be attractive to a policyholder.
There are numerous different types and variations of whole life insurance that are available today in the market. Another nice advantage is the steady amount of cash value that can be built up over time – with a gain that is tax deferred.
Just as there are different types of permanent life insurance policies, there are further differences in whole life insurance plans. Limited Pay Whole Life – With a limited pay whole life insurance policy, the policyholder can pay for the entire policy over a set time period. Single Premium Whole Life – With a single premium whole life insurance policy, the entire policy will be completely paid off with the payment of just one single premium payment.
Modified Whole Life – A modified whole life insurance policy will require the policyholder to pay his or her premium throughout the entire life of the policy. Indexed Premium Whole Life – An indexed premium whole life policy will allow the face amount of the policy to rise and fall based upon the movements of an underlying market index, provided that the policyholder chooses to accept the increase. When seeking premium quotes for whole life insurance coverage, typically the best way to obtain the most competitive price is to work with either an agency or a company that has access to more than just one insurer. If you pass away before you begin to receive lifetime income or any other annuity payout option, your beneficiaries will typically receive at least the amount you originally invested plus any interest, minus any withdrawals.
Annuities offer the ability to name a beneficiary, which may minimize the expense, delays, and publicity that comes with probate.
Optional living benefits include principal protection, extra withdrawal provisions, and income benefits; sometimes for an additional charge. What if you need to take money from your deferred annuity before you convert it to supplemental retirement income? You are guaranteed an income stream ranging from a specific period of time to your entire life. Representatives of Independent Benefit Solutions, LLC are licensed in RI, MA, CT, FL and ME. To learn more about our services and the products we offer, contact us today for a FREE consultation and quote! And, because your benefit needs may change from year to year, you can always choose what’s best for your personal situation.
You can also visit any benefit vendor Website (see page 2) or contact carriers by telephone for additional information or to discuss specific, detailed coverage issues. All University medical plans include prescription drug coverage and coverage for vision exams and corrective lenses. It is used to determine the coverage you have for life insurance and long-term disability (LTD) insurance. Your benefit coverages, however, will be based on your full, unreduced pay as will any future pay increase. If, for any reason, you voluntarily cease to participate in a given year, IRS rules will not allow us to enroll you again until the next plan year. Active enrollment is required for participation in a medical plan, dental coverage, supplemental life insurance, dependent life insurance, and flexible spending accounts. No dependents will be enrolled in medical coverage; nor will dental insurance, supplemental or dependent life insurance, or flexible spending accounts be available to you or any dependents. In any discrepancy between plan descriptions you may receive and the official plan documents, the plan documents will govern. Lehigh offers three different types of medical coverage plans to meet your needs, and, if applicable, the needs of your family.
A disabled child dependent on you for support may be covered without age limitation and is subject to required certification with the carrier. If your waiver request is accepted, the surcharge will stop, but prior months' charges you paid will not be refunded.
This means that Lehigh’s plan will assume another carrier has processed the claim first and at the level the Lehigh plan would have paid. Otherwise, you will have to wait until the start of the next plan year (during the Open Enrollment period) to make a change. If a QLE occurs, you can add or drop individuals from coverage, but you cannot change your medical coverage option. No one else can assume this responsibility for you, nor can coverage be extended retroactively for any reason.
Each University sponsored medical plan will begin to offer benefits for all covered services and supplies from the first day of coverage. Understanding these terms will make it easier for you to compare the benefits provided under each of the plans. Also known as the “allowance.” Amounts in excess of the allowed charge are not paid by the plan. Charges that are not covered do not affect deductibles, coinsurance, or out-of-pocket maximums. The amount does not include plan copayments, charges for services that are not covered, and charges that are in excess of plan allowable amounts (see Balance Billing).
Preventive care includes preventive health services like physical examinations, certain immunizations, and screening tests.
All other faculty and staff are required to select and pay for one of the medical plans made available by the University. Charges for services are submitted to the plan and the plan determines what it will pay based on defined coverage levels. You may see any provider in the network, including specialists, without selecting a primary care physician or having a referral. Deductibles, coinsurance payments, and out-of-pocket limits similar to those in a fee-for-service plan apply to other in-network services such as tests and hospitalization.
In network, IBH manages the benefits through assessment, referral, case management, and claims payment.
To receive benefits through the plan you are required to select a primary care physician (PCP). It covers medications that require a prescription by either state or federal law and that are prescribed by a licensed practitioner.
In addition, you can receive up to a ninety-day supply of covered medications through the mail order prescription program. In general, Express Scripts considers all ingredients in the medications in each class to be equivalent. At this point, your doctor can either change the prescription to a covered Generic or Preferred drug in the same class, or confirm to Express Scripts’s satisfaction that there is evidence of a medical reason for prescribing the specific medication. If you have questions about coverage for specific medications, please address them to Express Scripts directly at 866-383-7420. Davis Vision has more than 54,000 vision care providers and optical supplier locations across the United States.
When you use a network provider or supplier for additional covered services or supplies, you receive a 20 percent discount off of the provider’s standard charge.
Under ConcordiaFlex you can receive covered dental services from any qualified provider, anywhere in the country.
You can also cover a different set of dependents than the group for which you purchase medical coverage. You can check questions about covered services and supplies with the IRS, or contact the university’s FSA administrator, WageWorks, at 855-774- 7441 or 877-924-3967. A written prescription, on the doctor’s prescription form, will be required to permit reimbursement. Pre-tax reductions are made from your paycheck in equal installments beginning with your first pay after January 1.
If your claim is for medical, vision, or dental expenses, it must be filed first with the medical or dental carrier (if you have these insurances).
You have until March 31 of the following year to submit claims for expenses incurred during the plan year.
As soon as a qualified dependent care claim is received, any reimbursement requested — up to the accrued amount in your account — will be paid out and a check will go out to you the next Thursday. You can carry up to $500 of any unclaimed balance in a Healthcare account into the new year, even if you choose not to participate in an FSA in the new plan year. You may want to consider an FSA if you typically pay (on an after-tax basis) the types of expenses that the FSAs reimburse and would prefer to do so on a pre-tax basis. When prompted to enter a four-digit number, enter the last four digits of your LU ID number (LIN); this will be your ID Code for accessing your account and making claim.
The combined maximum total coverage available for Basic Life Insurance and Supplemental Life Insurance is five times your base salary, up to a limit of $1,500,000. If you are faced with a terminal illness, you will be able to access 50 percent of the value of this Supplemental Life Insurance coverage before your death. The IRS defines the taxable value, and this value may be different from the actual premium paid. Dependent life insurance can cover a child from 15 days of age up to the end of the month in which he or she becomes age 26.
If an increase for your spouse has been denied in the past or if it denied now, no future increase will be permitted. The cost of the dependent life insurance option you choose will be paid through salary deduction on an after-tax basis.
It is necessary to pay for the benefit on a “post-tax” basis for a period of thirty-six months to make the benefit 100 percent free of federal taxation.
In order to qualify for LTD benefits, you need to provide proof of your continued eligible disability. Other sources of disability income are taken into consideration to determine the benefit provided. Depending on the contract, other events such as terminal illness or critical illness may also trigger payment.
Specific exclusions are often written into the contract to limit the liability of the insurer; common examples are claims relating to suicide, fraud, war, riot and civil commotion. For example, if Dr Joe buys a policy on his own life, he is both the owner and the insured. For example, the proper amount of coverage is essential in ensuring that loved ones and survivors will be able to pay off final expenses, estate taxes, or other debts that they are in need of the life insurance proceeds for. This is because there are many different kinds of life insurance to choose from – and each may work a little differently, as well as provide various different features for the policyholder. The cash value is allowed to grow and compound free of taxation – at least until the time it is withdrawn. One reason is that the premium on these plans will typically remain constant for the entire life of the plan. With these types of policies, the insurer assumes all risk of future performance, meaning that if the cost of future claims is underestimated by the insurance company, then the insurer will need to make up for the difference. These can include the fact that the premium remains locked in throughout the entire life of the policy.
Since those who have a whole life insurance policy will never need to re-qualify for their coverage (provided that they keep their coverage in force by paying the premium), then they can always count on having a set amount of death benefit available to their beneficiary.
Even if the policyholder does opt to surrender or cancel the policy, he or she will be able to obtain the cash that has been building up in the policy over time. As an example, if an individual owns a 10-pay policy, then the policy’s premiums would be set up such that the entire policy would be completely paid off after ten years. Due to the large amount of money that is deposited with this one lump sum premium, a single premium whole life insurance policy will usually begin with a significant amount of cash value right from the start.

With these policies, then, the premiums will typically level out higher than that of a straight life policy. Therefore, the actual premium that the policyholder will pay is never more than the maximum premium stated in the policy’s contract. It is important to note that the increase in face amount will also cause an increase in the policy’s premium. This way, you will be able to compare directly multiple policies and premium quotes and in turn determine which will work the best for you and your coverage needs. We work with many of the best life insurance carriers in the marketplace today, and we can assist you in obtaining the important details that you will need in making a well-informed purchase decision. You put money into the contract and in return, accumulate money which later it can provide a lifetime income stream. You have the ability to choose from several different income or annuitization options, including life or for a specific period. Once the interest is credited you are guaranteed that it can never go down based on future market fluctuations. In return for your contribution, the insurance company provides you a pension-like stream of guaranteed, consistent income for your lifetime or for a specified period of time. Flexible Benefits (Flex) let you make new benefit selections each year so your coverage can keep up with your life.
Lehigh also offers an indemnity dental insurance plan for you and your eligible dependents.
Your decision has implications for the taxability of any LTD benefit you might receive if you qualify for it in the future. But after that you are able to use FSAs to pay for the balances with income that is not taxed for federal tax purposes, and in the case of medical FSA expenses, that is also free from Pennsylvania state income tax. However, their coverage does not begin until the day that completed enrollment forms are received in Human Resources.
Coverage for faculty members in these benefits is effective on the date completed enrollment materials are received by Human Resources, provided they are received within thirty (30) days of your first work day. If the services were provided by a participating provider, the amount in excess of the allowed charge is waived by the provider.
Preventive care can also provide specific programs of education, exercise, or behavior modification that seek to manage disease or change lifestyle programs for diabetes management, smoking cessation, childbirth preparation, and the like. The plan is designed to give you access to flat dollar copayments for doctor visits, provide coverage for wellness care, and give you the freedom to receive care without the paperwork hassle of referrals. Services received out of the plan’s network will be subject to higher deductibles, higher coinsurance payments, and are likely to result in balance billing, as well. IBH uses its nationwide network of behavioral health professionals and treatment programs and facilities. Mail order is a time- and money-saving way to get drugs you may be taking for an extended period of time. The doctor will need to fill out and return a fax form with the necessary clinical information.
Even if you aren’t granted an exception at first, there is still another level of appeal possible.
There are more than 2,000 providers and suppliers in Pennsylvania, with more than 200 in the Lehigh Valley area. If you go to non-participating suppliers or providers, there is a specific level of reimbursement for each service or supply the program covers. If you wear both contact lenses and glasses, only one will be covered at the in-network benefit level each year.
However, you will eliminate the possibility of balance billing if you seek services from participating dental providers. Surgery, dental prosthetics, and braces (for children) are covered at 50 percent of the MAC.
You may also be required to submit a “Physician’s Statement Form” to support your reimbursement request.
A copy of the carrier’s explanation of benefits must be filed with your claim to the FSA administrator. For claims that exceed the accrued amount, payments will be made either monthly or semi-monthly (depending on your pay cycle) until the entire claim is paid.
By directing a portion of your salary to an FSA, you actually reduce the amount of salary on which you will pay federal income, FICA, and (in the case of Health Care FSAs) Pennsylvania state taxes. However, not all of the expenses that can be deducted on your tax return are eligible for reimbursement through the Health Care Account.
The difference in the amount of extra taxable income is generally minimal unless you are crossing an age bracket during the plan year. These other sources of disability income can include Social Security benefits and Worker’s Compensation payments. But if Jane, his wife, buys a policy on Dr Joe’s life, she is the owner and he is the insured. The owner can change the beneficiary unless the policy has an irrevocable beneficiary designation. For instance, a term life insurance policy may be 5 years, 10 years, 15 years, 20 years, or 30 years – after which, the policy will expire and if the insured wishes to remain covered, he or she will need to re-apply for coverage at their then-current age and health condition. A par, or participating, policy is one that shares in the excess profits of the life insurance company. However, if the cost of the future claims have been overestimated, then the insurer can keep the difference. This can be a real advantage – especially for those who are on a budget and may have difficulty with rising prices. A straight life policy can also be referred to as either a pure life or a continuous whole life policy. Also, because the premium is all being paid up front with a single premium policy, these types of policies are usually purchased at a substantial discount as compared to the total amount of premium that is paid in throughout the lifetime of a straight life whole life insurance policy. An indeterminate premium whole life insurance policy will also endow when the insured reaches the age of 100. Should the policyholder not take the face amount increase, he or she may not be offered any further increases in face amount in the future. Our experts will help you to ensure that you are making the best coverage decision for your specific life insurance protection requirements.
Money distributed from the annuity will be taxed as ordinary income in the year the money is received. However, it’s important to be aware that withdrawals and other distributions of taxable amounts may reduce the value of the death benefit and any optional benefits. While traditional fixed annuities typically declare interest in advance, an IA’s performance is usually linked to specific market indices (frequently the S&P 500 Index® or other major indices) over a stated period that you can choose on an annual basis. You can be confident that your income amount will never vary because of market performance. Coverage for staff members in these benefits is effective on the first of the month following your start date, provided completed enrollment materials are received within thirty (30) days of your first work day.
In general, dependent children receive primary coverage from the parent whose birthday comes first in the calendar year. If the services were provided by a non-participating provider, the patient may be responsible for paying the additional amount (see Balance Billing).
Medical plans clearly define the types of services, supplies, and programs they offer as wellness benefits, and they provide them based upon protocols established in the medical community with regard to factors like frequency, patient age, and suitability.The Patient Protection and Affordable Care Act also requires particular preventive services for particular individuals to be covered at no cost, provided the covered services are received from a network provider. The plan is designed to pay the cost of treating and caring for participants when they are ill. Prescription drug (through Express Scripts) and vision care benefits (through Davis Vision) are also provided under PPO80. All decisions to cover the non-preferred drug, however, do require clinical evidence to justify the exception. The other will be covered at the out-of-network level when you use a network provider or supplier for all materials and services. Balance billing occurs when a service provider bills you above the Maximum Allowable Charge (MAC) negotiated by the plan. Assuming your annual income is $32,000, the chart below shows how you can reduce your taxes by paying your eligible expenses with these accounts.
Lehigh determines the age-based premium using your age on January 1; the IRS uses your age on December 31. To qualify, you will generally need to be totally disabled and, as a result, unable to work for 180 continuous days. If a policy has an irrevocable beneficiary, any beneficiary changes, policy assignments, or cash value borrowing would require the agreement of the original beneficiary. These types of policies are designed for those who wish to have permanent life insurance protection of whole life, yet do not want to pay a premium for the remainder of their lives. These policies are often purchased by those who wish to have a permanent life insurance policy, however, may initially have a hard time paying the premiums in the beginning.
Yet, the adjustment mechanisms in these plans will also allow the insurance company to continuously fine-tune the policy and keep the cash value competitive in the marketplace.
In addition, withdrawals and other distributions may be subject to income taxes and, if taken prior to age 59?, a 10% federal tax penalty may apply. For example, the interest credit for an IA might be defined as 70% of the rate of increase in the S&P 500 Index® over each one-year period, but none of its downside. You can customize your income to meet your retirement planning needs by choosing from a variety of payment options. To learn more about what is a good retirement income strategy for you, request more information now for a FREE no-obligation consultation. Secondary coverage comes from the medical plan of the other employer, or the other parent, respectively. Such out of network services will be subject to deductibles, coinsurance payments, and are likely to result in balance billing, as well. To check the network, call the number or go to the Website listed at the bottom of the chart. It is important to note that this example is based on 2014 tax rates for a married employee claiming four exemptions. In addition, you’ll pay FICA (Social Security and Medicare) taxes on that amount as well if your pay is less than the Social Security wage base maximum. Once benefit payments begin, they can continue for as long as you are totally disabled and until you reach your Normal Retirement Age (as defined by your access to full Social Security income benefits) or longer if your disability begins after age 60. Your total disability income from all sources will not be less than the amount the plan assures. There is no cash value or investment component that is included with this type of coverage – and because of that, term life insurance is typically the most economical form of life insurance that there is. With this type of coverage, the policy must be renewed each year – and usually the amount of the premium will rise at each renewal date. These dividends are usually not taxed because they are considered to be a return of a portion of the premium.
Guarantees, including interest rates and subsequent income payouts, are backed by the claims-paying ability of the issuing company. Income payments will differ based on several factors, including your age, gender, and the account balance. These are accompanied by a Schedule of Preventive Care Services and description of their Preauthorization Program. Finally, there are summaries and details of the managed behavioral health care plans associated with our medical insurance.
This plan provides you with the greatest freedom of choice but also exposes you to the greatest out-of-pocket cost, including deductibles, coinsurance, and balance billing from physicians who do not participate with the CBC network. This is especially the case for those who are young and in good health at the time of application. Therefore, this can provide yet another tax advantage for the whole life insurance policyholder.
This is because each of the premium payments that are made is more than the amount of the premium payments on a straight life policy. Prior to age 59 ?, early or excessive withdrawals may be subject to surrender charges or a penalty.What are the advantages of an Annuity? The combination of these summaries may make it easier for you to feel comfortable that you’ve chosen the best plan for 2016. Therefore, the cash value component of a limited pay whole life insurance policy will also generally accumulate more quickly than a straight life policy will.
While some immediate annuities do offer you some access to your money, it should be noted that immediate annuities are less liquid than deferred annuities.

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