This section describes the group benefits Rhodes offers to its employees, both faculty and staff. A summary plan description of these benefits are set forth below. To the extent that a benefit plan is governed by a more detailed plan document, it can be reviewed and copies obtained by making an appointment with the Benefits Services Manager in Human Resources. To the extent the summary plan description of a benefit is contrary to the plan document, the plan document controls. Rhodes reserves the right to modify, add, or discontinue the benefits described herein in its sole discretion. 

 

In compliance with the Consolidated Omnibus Budget Reconciliation Act (COBRA), the College offers eligible faculty and staff continuation of the medical benefits coverage. If an employee loses coverage due to termination or reduction in hours, the employee will be offered COBRA coverage for 18 months. An additional 11 months, for a total of 29 months, can be given to a qualified beneficiary who is determined to be disabled by the Social Security Administration at the time of the qualifying event or if the qualified beneficiary becomes disabled during the first 60 days of COBRA coverage. If an enrolled dependent loses coverage due to death of the covered employee, divorce, or legal separation of the employee or a child reaches the age limit for the Plan, the dependent will be offered continuation coverage for 36 months.

It is the employee’s responsibility to notify the College of a divorce, legal separation, or a child reaching the age limit within 60 days of the later of the date of the event or the date on which coverage would be lost because of the event.

Individuals who elect to continue the medical benefits coverage will be required to pay 100% of the total premium plus an administration fee.

HealthSmart will send a notice to the home address on file when an employee is eligible for coverage. The employee may contact the Benefits Services Manager for additional information.

After the 18-month, 29-month, or 36-month period, medical benefits coverage will be terminated.

Plan Administrator. This Dental Plan is administered by Rhodes College, 2000 North Parkway, Memphis, TN 38112 whose Internal Revenue Service Employer Identification Number is EIN620476301. The Plan Number is 504. The Plan year is July through June. This is a full insured plan. Information regarding Plan eligibility, enrollment, cost, and the procedure for applying for benefits is contained in this section. The Certificate of Coverage includes a description of benefits under the Plan and the conditions under which these benefits are available to insured individuals.

Eligible Participants. All full-time employees have the option to purchase dental insurance coverage for themselves, their domestic partner and their dependents.

Date Eligible for Coverage. Each employee becomes eligible for dental coverage under the Plan the first day of the month following the date of employment with Rhodes.

Date Eligible for Dependent Coverage. A dependent shall become eligible for coverage on either (a) the first day that the employee becomes eligible for coverage and satisfies the definition of eligible dependent coverage or (b) the day a covered employee first acquires an eligible dependent.

Benefits Provided. There are four separate Dental Plans available.

MAC Plan In-Network

• $100 lifetime deductible per covered individual (maximum 3 per family)
• Diagnostic and preventive services covered at 100%
• Basic services covered at 80% after deductible has been met
• Major services covered at 50% after deductible has been met
• $1,000 per person maximum benefit per calendar year

MAC Plan Out-of-Network

• $100 lifetime deductible per covered individual (maximum 3 per family)
• Diagnostic and preventive services covered at 100% of the network rate after the deductible has been met
• Basic services covered at 50% after the deductible has been met
• Major services covered at 25% after the deductible has been met
• $1,000 per person maximum benefit per calendar year

PPO Plan In-Network

• $100 lifetime deductible per covered individual (maximum 3 per family)
• Diagnostic and preventive services covered at 100%
• Basic services covered at 100% after deductible has been met
• Major services covered at 60% after deductible has been met
• $2,000 per person maximum benefit per calendar year

PPO Plan Out-of-Network

• $100 lifetime deductible per covered individual (maximum 3 per family)
• Diagnostic and preventive services covered at 100% after the deductible has been met
• Basic services covered at 80% after deductible has been met
• Major services covered at 50% after deductible has been met
• $1,500 per person maximum benefit per calendar year

Plan Premiums. There is a monthly charge for dental insurance coverage that is paid through payroll deduction.

Currently the insurance company is Starmount Life Insurance Company. Request for information concerning Starmount Life Insurance Company contract terms, condition and interpretation thereof, claims thereunder, any requests for review of such claims and service of legal process may be directed in writing to: Starmount Life Insurance Company, 8485 Goodwood Blvd., P.O. Box 98100, Baton Rouge, LA 70898-9100 

The requirements for being covered under this Plan, the provision concerning termination of coverage, a description of Plan benefits (including any limitations and exclusions which may result in reduction or loss of benefits) are explained in the Certificate of Coverage.

Written notice of a claim must be sent within 30 days or as soon as reasonably possible. Typically, the In-Network Dental provider will handle all claims and administrative services for you. Should you need to file a claim from an out of network provider, you must provide the claimant’s name, the policyholder’s name (if different), and the group policy number. You may submit a claim form or an itemized receipt for services to:

Starmount Life Insurance Company
P.O. Box 80139
Baton Rouge, LA 70898-0139

All full-time employees are eligible to participate in the program. The Flexible Benefits Program is an Internal Revenue Code Section 125 sanctioned plan whereby the IRS allows certain benefits to be purchased through the Plan on a tax-free basis. Thus, participating in the flexible benefits program allows employees to pay their medical and dental benefit premiums and their Flexible Spending Accounts (FSA) (Health Care FSA and Child/Dependent Care FSA) through payroll deduction before taxes have been withheld.

Participants must enroll during annual enrollment or submit an enrollment form to elect a tax payment option (i.e., pre-tax or after-tax). FSA participants are required to sign an enrollment form if they elect to participate in the health care or child/dependent care FSA. Participants are then committed to these agreements for the designated plan year (July 1 - June 30). Thus, it cannot be amended during the plan year except as provided by IRS Code Section 125.

Plan Administrator. This Life Insurance and AD&D Plan is administered by Rhodes College, 2000 North Parkway, Memphis, TN 38112 whose Internal Revenue Service Employer Identification Number is EIN620476301. The Plan Number is 503. The Plan year is July through June. This is a fully insured plan.

Information regarding Plan eligibility, enrollment, cost, and the procedure for applying for benefits is contained in this section. The Certificate of Insurance which each insured employee receives includes a description of benefits under the Plan and the conditions under which these benefits are available to insured individuals.

Employees Eligible for the Plan. All active full-time employees are eligible.

When an Employee Becomes Eligible for Insurance. Each employee becomes eligible for insurance under the Plan the first day of the month following the date of employment with Rhodes. If an employee is absent from work on the day they would otherwise become eligible, the employee will become eligible on the day they return to work.

Enrolling in the Plan. An employee will become insured on the first of the month following date of hire. No medical examination is necessary. Enrollment forms, which should be completed promptly, may be obtained from Human Resources. Additional information about enrollment procedures may also be obtained from this office.

Applications, Requests, and Questions Directed to the Plan Administrator. Rhodes College shall be the Administrator for this Plan, and as such, shall have the authority to control and manage the operation and administration of the Plan, subject to the provisions of the Group Insurance Policy. The Administrator has designated the Chief Human Resources Officer to carry out duties under the Plan.

Applications, requests and questions regarding enrollment, participation, or other administrative matters and service of legal process on issues arising from such questions, should be directed to the Chief Human Resources Officer, Rhodes College, 2000 North Parkway, Memphis, TN 38112, (901) 843-3750.

Cost of the Plan. Rhodes currently pays the entire cost of this Plan. Periodically, generally near the end of a plan year, the insurance company reviews the adequacy of premiums charged for the Plan and advises the College whether existing premium rates will be continued or whether adjustments will be made for the coming year.

Covered Schedule (Life and AD&D), maximum benefit is $500,000:

Coverage is determined by a formula using the employee’s age and annual salary:

18 - 64 Years	1.00 x Annual Salary
65 - 69 Years	.65 x Annual Salary
70 - 74 Years	.45 x Annual Salary
75 - 79 Years	.30 x Annual Salary
80 - 84 Years	.20 x Annual Salary
85 - 89 Years	.15 x Annual Salary
90 and over	.10 x Annual Salary

Applying for Benefits. Eligible employees are automatically enrolled in this benefit but must designate at least one (1) beneficiary in Workday.

Notice and proof of claim should be made promptly. Details on the applicable time limits for submitting benefit applications may be found in the Certificate of Insurance which each insured employee receives, as well as in the Group Policy maintained in the office of the Plan Administrator (Human Resources). Upon receipt by the insurance company of the application for benefits and supporting documentation, valid claims will be paid promptly.

If a claim is denied, the insurance company shall within a reasonable period of time (not exceeding 90 days) provide a written denial to the participant. It will include specific reasons for denial, the provisions of the insurance contract on which the denial is based, and how to apply for a review of the denied claim. Where appropriate, it will also include a description of any material which is needed to complete or perfect a claim and why such material is necessary. A participant may request in writing a review of a claim denied by the insurance company and may review pertinent documents and submit issues and comments in writing to the insurance company. The insurance company shall provide in writing to the participant a decision upon such request for review of a denied claim within 60 days of receipt of the request.

If special circumstances require a delay on the initial decision on a claim or a review of a denied claim, the insurance company will notify the participant within 90 days of the date the claim was initially submitted or within 60 days of the date a review was requested. The notice will explain the reasons for the delay and when a decision can be expected. In no event will the decision be provided later than 90 days after the notice is sent for an initial decision on a claim or more than 60 days after the notice is sent for a review of a denied claim.

Currently the insurance company is UNUM. Requests for information concerning UNUM Life Insurance contract and its terms, condition, and interpretations thereof, claims thereunder, any requests for review of such claims, and service of legal process may be directed in writing to UNUM Life Insurance Company, 2211 Congress St., Portland, ME 04122.

Amendment to the Group Life Insurance Plan. Rhodes College shall be the Administrator for this Plan, and as such, shall have the authority to control and manage the operation and administration of the Plan, subject to the provisions of the Group Insurance Policy. The Administrator has designated in writing the Chief Human Resources Officer to carry out duties under the Plan.

For a statement of employees’ rights under the Employee Income Security Act (“ERISA”) see the section below entitled ERISA.

Plan Administrator. This Long-term Disability Plan is administered by Rhodes College, 2000 North Parkway, Memphis, TN 38112 whose Internal Revenue Service Employer Identification Number is EIN620476301. The Plan Number is 501. The Plan year is July through June. This is an insurer administration plan. Information regarding Plan eligibility, enrollment, cost, and the procedure for applying for benefits is contained in this section. The Certificate of Coverage includes a description of benefits under the Plan and the conditions under which these benefits are available to insured individuals.

Employees Eligible for the Plan. All active full-time employees are eligible.

Date Eligible for Insurance. Each employee becomes eligible the first day of the month following the date of employment with Rhodes. If an employee is absent from work on the day they would otherwise become eligible, the employee will become eligible on the day they return to work.

Enrolling in the Plan. An employee will become insured on the first day of the month following hire date. No medical examination is necessary.

Applications, Requests, and Questions Directed to the Plan Administrator. Rhodes College shall be the Administrator for this Plan, and as such, shall have the authority to control and manage the operation and administration of the Plan, subject to the provisions of the Group Insurance Policy. The Administrator has designated the Chief Human Resources Officer to carry out duties under the Plan.

Applications, requests, and questions regarding enrollment, participation, or other administrative matters and service of legal process on issues arising from such questions, should be directed to the Chief Human Resources Officer, Rhodes College, 2000 North Parkway, Memphis, TN 38112, (901) 843-3750.

If a written application or request pertaining to enrollment, participation, or administration of the Plan is denied by the Administrator, the Administrator shall, within a reasonable time, provide a written denial to the participant.

It will include the specific reasons for denial, the provisions of the Plan upon which the denial is based, a description of any material needed to complete the application or request (if appropriate) and why it is necessary, and instructions on review procedures. When the Administrator requires additional time to respond because of special circumstances, an extension of up to 90 days may be obtained by notifying the participant that a decision will be delayed, what circumstances have caused the delay and when a decision can be expected. The Administrator will inform the participant of the delay within 90 days of the date the application or request was submitted.

A participant may request in writing a review of a denied request or application, and may review pertinent documents and submit issues and comments in writing to the Administrator. The Administrator shall provide in writing to the participant a decision upon such request for review within 60 days of receipt of the request. When special circumstances require an extension, the Administrator may obtain an extension of up to 60 days by notifying the participant why the decision on the review will be delayed and when a decision can be expected.

The Cost of the Plan. Rhodes currently pays the entire cost of this Plan. Periodically, generally near the end of a plan year, the insurance company reviews the adequacy of premiums charged for the Plan and advises the College whether existing premium rates will be continued or whether adjustments will be made for the coming year.

Basic Coverage. After six months of total disability and approval by the insurance company, the disabled employee receives monthly income (offset by Social Security and Workers’ Compensation benefits, if applicable) equivalent to 60% of regular monthly salary with a maximum total benefit of $7,500 per month. When an individual begins receiving total disability income protection payments from the insurance company, the College will no longer continue to provide fringe benefits and the employment relationship is terminated.

Applying for Benefits. The appropriate forms for applying for benefits, and assistance in the completion of these forms, may be obtained from Human Resources.

Notice and proof of claim should be made promptly. Details on the applicable time limits for submitting benefit applications may be found in the Certificate of Coverage which each insured employee receives, as well as in the Group Policy maintained in the office of the Plan Administrator (Human Resources). Upon receipt by the insurance company of the application for benefits and supporting documentation, valid claims will be paid promptly.

If a claim is denied, the insurance company shall within a reasonable period of time (not exceeding 90 days) provide a written denial to the participant. It will include specific reasons for denial, the provisions of the insurance contract on which the denial is based, and how to apply for a review of the denied claim. When appropriate, it will also include a description of any material which is needed to complete or perfect a claim and why such material is necessary. A participant may request in writing a review of a claim denied by the insurance company and may review pertinent documents and submit issues and comments in writing to the insurance company. The insurance company shall provide in writing to the participant a decision upon such request for review of a denied claim within 60 days of receipt of the request.

If special circumstances require a delay on the initial decision on a claim or a review of a denied claim, the insurance company will notify the participant within 90 days of the date the claim was initially submitted or within 60 days of the date a review was requested. The notice will explain the reasons for the delay and when a decision can be expected. In no event will a decision be provided later than 90 days after the notice is sent for an initial decision on a claim or more than 60 days after the notice is sent for a review of a denied claim.

Currently the insurance company is UNUM. Requests for information concerning the UNUM Group Total Disability Insurance contract terms, condition, and interpretations thereof, claims thereunder, any requests for review of such claims, and service of legal process may be directed in writing to UNUM, Suite 1700 - Benefits, 3 Ravina Drive, Atlanta, GA 30346.

For a statement of employees’ rights under the Employee Income Security Act (“ERISA”) see the section below entitled ERISA.

Continuation of Medical Benefits Coverage. When an individual begins receiving total disability income protection payments from the insurance company, the College will no longer continue to provide medical benefits coverage and the employment relationship is terminated. Even though an employee will no longer be covered by the College, the employee has the option of electing continuation coverage of their health insurance benefits under the Consolidated Omnibus Budget Reconciliation Act of 1985 (“COBRA”). For more information, consult the section entitled COBRA Coverage.

Amendment to Group Long Term Total Disability Benefits Insurance Plan. Rhodes College shall be the Administrator for this Plan, and as such, shall have the authority to control and manage the operation and administration of the Plan, subject to the provisions of the Group Insurance Policy. The Administrator has designated in writing the Chief Human Resources Officer to carry out duties under the Plan.

The Board of Trustees reserves the right to modify or discontinue the Plan at any time. Such modification or discontinuance must be effected in accordance with the terms of the group insurance contract.

Plan Administrator. This Medical Benefit Plan is administered by Rhodes College, 2000 North Parkway, Memphis, TN 38112, whose Internal Revenue Service Employer Identification Number is EIN620476301. The Plan Number is 501. The plan year is July through June. This is a contract administration plan and the third party administrator (TPA) is HealthSmart Benefits. Information regarding Plan eligibility, enrollment, cost, and the procedure for applying for benefits is contained in this section. The Plan Document, which each covered employee may receive without cost, includes a description of benefits under the Plan and the conditions under which these benefits are available to covered individuals. For a copy of the Plan Document please contact the Benefits Services Manager.

Rhodes College shall be the Administrator for this Plan, and as such, shall have the authority to control and manage the operation and administration of the Plan, subject to the provisions of the Group Insurance Policy. The Administrator has designated the Chief Human Resources Officer to carry out duties under the Plan.

Applications, requests, and questions regarding enrollment, participation, or other administrative matters, as well as service of legal process should be directed to the Chief Human Resources Officer, Rhodes College, 2000 North Parkway, Memphis, TN 38112, 901-843-3750.

Employees Eligible for the Plan. All full-time employees and their dependents are eligible to be enrolled in the Medical Benefit Plan, Part-time employees working an average of 30 hours per week are eligible to enroll in the Medical Benefit Plan. Employees working less than 30 hours per week are not eligible for medical coverage.

Date Eligible for Coverage. Each employee becomes eligible for medical coverage under the Plan the first day of the month following the date of employment with Rhodes.

Date Eligible for Dependent Coverage.  A dependent shall become eligible for coverage on either (a) the first day that the employee becomes eligible for coverage and satisfies the definition of eligible dependent coverage or (b) the day a covered employee first acquires an eligible dependent. New dependents must be added to an employee’s medical coverage within 30 days of the event (i.e., marriage, birth, adoption or placement for adoption). The definition of the dependents eligible for coverage under this Plan appears in the Medical Benefit Plan Document.

Enrolling in the Plan. An employee and their dependents may become enrolled on the date of first eligibility. Enrollment forms, which should be completed promptly, will be processed in Workday. Additional information about enrollment procedures, including special enrollment periods, may also be obtained from the Benefits Services Manager.

Available Plans. Employees may select from the following plans, each of which has a different cost and provides different levels of benefits.

Plan A — PPO Benefits

• 100% coverage after $30 office co-payment on physician’s charges if the employee sees a physician participating in the Partner Solutions PPO network.
• X-ray and lab charges are paid at 80% of PPO rate and the deductible waived for PPO Select providers.
• $500 calendar year deductible per person (family maximum of 3). All eligible expenses apply toward the deductible except the $30 office co-payment, the 20% coinsurance for in-network X-ray and lab charges and prescription drug co-payments if purchased from a network pharmacy.
• 80% coverage for eligible expenses after the deductible has been met.
• 100% coverage on all eligible expenses after $2,500 per covered individual (plus deductible and co-payments) per calendar year has been paid out-of-pocket by the covered person.
• Well baby care and routine exams.
• Pre-admission certification is required for hospital admissions, observation stays, skilled nursing, MRI, CT and chemo/radiation therapy.

Plan A — Non-PPO Benefits

• $600 calendar year deductible per person (family maximum of 3). All eligible expenses apply toward the deductible except prescription drug co-payments if purchased from a network pharmacy.
• 50% coverage on eligible expenses after the deductible has been met.
• Pre-admission certification is required for hospital admissions, observation stays, skilled nursing, MRI, CT and chemo/radiation therapy.

Plan B — PPO Benefits

• $900 calendar year deductible per person (family maximum of 3). All eligible expenses apply toward the deductible except prescription drug co-payments if purchased from a network pharmacy.
• 80% coverage on eligible expenses after deductible has been met.
• 100% coverage on all eligible expenses after $3,500 per covered individual (plus deductible and co-payments) per calendar year has been paid out-of-pocket by the covered person.
• Pre-admission certification is required for hospital admissions, observation stays, skilled nursing, MRI, CT and chemo/radiation therapy.

Plan B — Non-PPO Benefits

• $1,200 calendar year deductible per person (family maximum of 3). All eligible expenses apply toward the deductible except prescription drug co-payments if purchased from a network pharmacy.
• 50% coverage on eligible expenses after deductible has been met.
• Pre-admission certification is required for hospital admissions, observation stays, skilled nursing, MRI, CT and chemo/radiation therapy.

Plan Premiums. Employees are responsible for sharing in the cost of the Medical Benefit Plan through a medical benefit premium payment. At the employee’s option, medical benefit premium payments can be deducted through a flexible benefits program (pre-tax option). For the premium costs for each plan option, contact the Benefits Services Manager.

Plan Amendments. Rhodes shall be the Administrator for this Plan, and as such, shall have the authority to control and manage the operation and administration of the Plan. The Administrator has designated in writing the Chief Human Resources Officer to carry out duties under the Plan. The Board of Trustees reserves the right to modify or discontinue the Plan at any time.

How to Submit a Claim. When a Covered Person has a claim to submit for payment, that person must:

1. Obtain a claim form from the Human Resources Office or the Plan Administrator.
2. Complete the Employee portion of the form. All questions must be answered.
3. Have the Physician complete the provider’s portion of the form.
4. For Plan reimbursements, attach bills for services rendered. All bills must show:
   • Name of Plan
   • Group number of Plan
   • Employee’s name
   • Name of patient
   • Name, address, telephone number of the provider of care
   • Diagnosis
   • Type of services rendered, with diagnosis and/or procedure codes
   • Date of services
5. Send the above to the Claims Administrator at this address:

             Benefit Solutions, Inc.
             P.O. Box 16207
             Lubbock, TX 79490
             (844) 792-4159

When Claims Should Be Filed. Claims should be filed with the Claims Administrator within 90 days of the date charges for the service was incurred. Benefits are based on the Plan’s provisions at the time the charges were incurred. Charges are considered incurred when a treatment or care is given or a procedure performed. Claims filed later than that date may be declined or reduced unless:

• it is not reasonably possible to submit the claim in that time; and 
• the claim is submitted within one year from the date incurred. This one-year period will not apply when the person is not legally capable of submitting the claim.

The Claims Administrator will determine if enough information has been submitted to enable proper consideration of the claim. If not, more information may be requested from the claimant. The Plan reserves the right to have a Plan Participant seek a second medical opinion.

A request for Plan benefits will be considered a claim for Plan benefits, and it will be subject to a full and fair review. If a claim is wholly or partially denied, or if there is any other adverse benefit determination, the Claims Administrator will furnish the Plan Participant with a written notice. The written notice will contain the following information, in addition to any other information required by law:

• the specific reason or reasons for the adverse benefit determination; 
• specific reference to those Plan provisions on which the determination is based; 
• a description of any additional information or material necessary to correct the claim and an explanation of why such material or information is necessary; and 
• appropriate information as to the steps to be taken if a Plan Participant wishes to submit the claim for review.

A Plan Participant will be notified as to the acceptance or denial of a claim within the following time frames:

• Urgent care claims: Within 72 hours of receipt of the claim, unless the Plan Participant fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable under the Plan. In the case of such failure, the Plan Administrator will notify the Plan Participant of the specific information necessary to complete the claim within 24 hours after receipt of the claim by the Plan. The Plan Participant will then have at least 48 hours to provide the specified information. The Plan Administrator will then notify the Plan Participant of the acceptance or denial of the claim within 48 hours of the earlier of the Plan Administrator’s receipt of the specified information or the end of the period afforded the Plan Participant to provide the specified information
• Pre-service claims: Within 15 days of the Plan’s receipt of the claim.
• Post-service claims: Within 30 days of the Plan’s receipt of the claim.

If special circumstances require an extension of time for processing a non-urgent care claim, the Claims Administrator shall send written notice of the extension to the Plan Participant. The extension notice will indicate the special circumstances requiring the extension of time and the date by which the Plan expects to render the final decision on the claim. In no event will the extension exceed a period of 15 days from the end of the initial 15-day period for pre-service claims, or a period of 30 days from the end of the initial 30-day period for post-service claims. If the extension is necessary due to the Plan Participant’s failure to submit the information necessary to decide the claim, the extension notice shall specifically describe the required information, and the Plan Participant will have at least 45 days from receipt of the notice to provide the specified information.

If a Plan Participant is not notified as to acceptance or denial of a claim within the time frames provided above, the claim shall be deemed denied. Note-Failing to respond to the claim within these time periods can have adverse effects on Rhodes. The participant will be free to sue for benefits (rather than follow the administrative appeal process), and the court will be able to review the denial de novo (the standard is typically abuse of discretion when the plan follows the procedural requirements).

Claims Review Procedure. In cases where a claim for benefits payment is denied in whole or in part, or if there is any other adverse benefit determination, the Plan Participant may appeal the denial. This appeal provision will allow the Plan Participant to:

1. Request from the Plan Administrator a review of any claim for benefits. Such request must include: the name of the Employee, their Social Security number, the name of the patient and the Group Identification Number, if any. 
2. File the request for review in writing, stating in clear and concise terms the reason or reasons for this disagreement with the handling of the claim. 

The request for review must be directed to the Plan Administrator or Claims Administrator within 180 days after the claim payment date or the date receipt of the notification of denial of benefits.

A review of the denial or other adverse benefit determination will be made by the Plan Administrator and the Plan Administrator will provide the Plan Participant with a written response as follows:

• Urgent care claims: Within 72 hours of receipt of the Plan Participant’s request for the review of the adverse benefit determination.
• Pre-service claims: Within 30 days of the Plan Participant’s request for review of the adverse benefit determination.
• Post-service claims: Within 60 days of the Plan Participant’s request for review of the adverse benefit determination.

If the Plan Participant is not notified of the plan’s decision within the time frames provided above, the Plan Participant may deem the claim denied. As noted above, failing to respond to the claim within these time periods will permit a reviewing court to review the denial de novo, rather than abuse of discretion.

The Plan Administrator’s written response to the Plan Participant shall cite the specific reason or reasons for adverse determination, the specific Plan provision(s) upon which the determination is based, and any other information required by law.

A Plan Participant must exhaust the claims appeal procedure before filing a lawsuit for benefits.

The Rhodes Prescription Drug Plan is part of the Medical Benefit Plan. Therefore, all full-time employees who participate in the College’s Medical Benefit Plan are eligible to participate in the Prescription Drug Plan. Eligible employees and retirees may obtain prescription drugs at a negotiated price for themselves and their eligible dependents from any participating pharmacy.

Express Scripts, Inc. has a network of pharmacies that participate in our plan. The preferred pharmacies can identify covered persons and the Plan’s coverage provisions. To find out which pharmacies participate, contact Express Scripts, Inc. at 1-800-451-6245.

The covered person must purchase the prescription drugs through a participating pharmacy or the mail order option.

Prescription Drugs – Express Scripts Participating Pharmacy

Retail Store

Generic	$10
Name brand formulary	$30
Name brand non-formulary	$50 or 50% (whichever is greater)

 

Mail Order Program (90 day supply per prescription)

Generic	$20 Generic
Name brand formulary	$60
Name brand non-formulary	$90

 

 

Retiring employees and their eligible dependents that are currently on the active plan, may enroll in the Retiree Medical Benefit Plan upon completion of ten consecutive years of full-time employment after age 50. Employees hired after January 1, 1995 will not be eligible for medical benefits upon retirement.

To participate in the Retiree Medical Benefit Plan, a new enrollment form needs to be completed and returned to the Benefits Services Manager by the first day of the month after the employee’s retirement date. If the retired employee chooses not to enroll or cancels their participation after enrolling in the plan, reenrollment is not allowed. In case of death of the retiree, dependent coverage will continue until the spouse dies, remarries, or has other group medical benefits available to them (excluding Medicare). Employees retiring after June 30, 1989 will be responsible for sharing in the cost of medical coverage through medical benefit premium payments. Employees hired after January 1, 1995 will not be eligible for medical benefits upon retirement.

COBRA medical benefit continuation is also offered to retirees. A retiree may elect either the COBRA coverage or the Retiree Medical Benefit Plan (refer to the “COBRA” policy).

Plan Administrator. The Retirement Plan is available through Rhodes College. The benefits are provided by retirement annuity contracts issued to Participants by TIAA-CREF. The Rhodes Chief Human Resources Officer, 2000 North Parkway, Memphis, Tennessee 38112, (901) 843-3750, is the Administrator of this Plan. The Administrator is responsible for enrolling Participants, forwarding Plan Contributions for each Participant to TIAA-CREF, and performing other duties required for operating the Plan. The Employer Identification Number is 62-047630; the Plan Number is 001.

Information About the Plan. The Rhodes College Retirement Plan (the "Plan") is a Defined Contribution (“Money Purchase”) Plan. The Plan operates under Section 403(b) of the Internal Revenue Code and uses annuity contracts to provide retirement benefits. It was established by the Board of Trustees of Rhodes College as of January 1, 1945 and was amended and restated in its entirety on December 21st, 2002, to comply with certain tax law changes including the General Agreement on Tariffs and Trade (“GATT”), the Uniformed Services Employment and Reemployment Rights Act of 1994 (“USERRA”), the Small Business Job Protection Act of 1996 (“SBJPA”), the Taxpayer Relief Act of 1997 (“TRA’97"), the Internal Revenue Service Restructuring and Reform Act of 1998 (“RRA”) and the Economic Growth and Tax Relief Reconciliation Act of 2001 (“EGTRRA”).

As sponsor of the Plan, Rhodes selects the “Funding Vehicles” into which employer contributions may be paid for the benefit of participants. Funding Vehicles are annuity contracts which meet the requirements of Section 403(b) of the Internal Revenue Code. Currently benefits are provided through annuities issued by the Teachers Insurance and Annuity Association (TIAA). Contributions may be invested in one or more funding vehicles which are currently available under this Plan: TIAA (See web site for available investment options). The College’s current selection of fund sponsors and Funding Vehicles is not intended to limit future additions or deletions of fund sponsors and Funding Vehicles. Employees will be notified of any additions or deletions. 

Information concerning TIAA can be obtained by writing to:
TIAA 
730 Third Avenue
New York, NY 10017

Employees may also contact TIAA at (800) 842-2733 (or the TIAA-CREF telephone counseling center at (800) 842-2776).

TIAA, CREF, and any other insurance, variable annuity or investment company that provides Funding Vehicles available to Participants under the Plan are sometimes referred to herein as “Fund Sponsors.”

As part of its fiduciary duties under ERISA, the College periodically reviews the Funding Vehicles offered to Plan participants.

The Administrator of the Plan is Rhodes College. The Plan Year is the calendar year (January 1 to December 31).

Plan Eligibility. All categories of employees are eligible to participate in this retirement plan except employees who normally work less than 20 hours per week, student employees, employees whose employment is governed by the terms of a collective bargaining agreement and leased employees. However, if an employee’s employment is incidental to the employee’s educational programs at Rhodes College, if the employee is employed by Rhodes College primarily as a music commission teacher or as a consultant, or if the employee is not a regular Rhodes College employee and the employee is employed by or through the College on the basis of grants and/or contracts and/or agency agreements the employee is not eligible to participate. If an individual is treated as an independent contractor, but the Internal Revenue Service subsequently determines that for tax purposes the individual should be treated as an employee, the individual will still not be eligible for the plan despite the reclassification.

Plan Participation. If an individual is an eligible employee, the employee will begin participation in this Plan on the first of the month following completion of a 24-month period that constitutes two Years of Service at the College without a Break in Service. A Break in Service means a 12-month period during which the employee performs less than 501 Hours of Service with the College. If a Break in Service occurs prior to satisfaction of the participation requirements, any “Year of Service” the employee has earned prior to the Break in Service will not be counted for purposes of meeting the participation requirement.

The Plan Administrator will be required to credit the employee with Hours of Service for a maternity or paternity absence. These are absences taken on account of pregnancy, birth, or adoption of a child. No more than 501 Hours of Service shall be credited for this purpose and these Hours of Service shall be credited solely to avoid the employee incurring a Break in Service. The Plan Administrator may require the employee to furnish proof that the employee’s absence qualifies as a maternity or paternity absence.

The appropriate enrollment forms must be completed and returned to the College.

The College will notify the employee when the employee has completed the requirements necessary to participate in the Plan. All determinations about eligibility and participation will be made by the College. The College will base its determinations on its records and the official Plan Document on file with the Plan Administrator.

Counting Years of Service. An employee is credited with a year of service for each 12-month period starting with the employee’s date of employment (or anniversary date of employment) during which the employee completes 1,000 or more hours of service. Year(s) of Service with any educational organization or any organization that meets the eligibility requirements of Code Section 403(b)(1), any teaching institution, any institution of higher education or any nonprofit research institution during the 24-month period immediately preceding the employee’s date of employment with the College will be counted for meeting the participation requirements. However, no credit is given for a period of employment with another institution which does not meet the hours of service requirement for a complete Year of Service.

Participation During An Approved Leave Of Absence. During a paid leave of absence, the College will continue its Plan Contributions on the employee’s behalf. The Plan Contributions will be based on the employee’s compensation during the leave of absence.

Vesting. Employees are immediately vested in the contributions made by Rhodes College for the employee’s benefit under the Plan. Such contributions are non-forfeitable.

How Plan Contributions Are Made. When an employee begins participation in the Plan, contributions will be made by the College automatically to a “Funding Vehicle.” A Funding Vehicle means the financial instrument(s) issued for the purposes of funding benefits under this Plan and specifically approved by the Employer for use under this Plan. The contributions are based on a percentage of the employee’s regular salary in accordance with the following schedule. If the employee participates in the Plan for only a part of a year, the employee’s allocation will be based on the portion of salary applicable to the period in which the employee participates.

Plan Contributions. Rhodes' plan contributions is 8% of the employee's regular budgeted salary. 

For faculty, Regular Salary means the salary stated in the academic year contract or appointment letter. For all other employees, Regular Salary means the basic annual earnings excluding overtime pay, bonuses, and any other forms of supplemental remuneration. In no event will the salary taken into account under the Plan exceed the limits of Internal Revenue Code Section 401(a)(17).

Limitations on Contributions. The total amount of contributions made on the employee’s behalf for any year will not exceed the limits imposed by Sections 402 and 415 of the Internal Revenue Code. These limits may be adjusted from time to time. For more information on these limits, contact the Fund Sponsor.

Rollover of Accumulations. If the employee is entitled to receive a distribution from the employee’s contract which is an eligible “rollover distribution,” the employee may rollover all or a portion of it either directly or within 60 days after receipt into another retirement plan or into an IRA. An eligible rollover distribution, in general, is any cash distribution other than an annuity payment, a minimum distribution payment or a payment which is part of a fixed period payment over ten or more years. The distribution will be subject to a 20 percent federal withholding tax unless it′s rolled over directly into another retirement plan or into an IRA – this process is called a “direct” rollover.

If the employee has the distribution paid to them, then the plan must withhold 20 percent even if the employee intends to roll over the money into another retirement plan or into an IRA within 60 days. To avoid withholding, the employee should instruct the fund sponsor to directly roll over the money for them.

Normal Retirement Age. The normal retirement age under the Plan is the first day of the month on or following the employee’s 65th birthday. 

When Annuity Income Begins

In General. Although income usually begins on the normal retirement age, the employee may begin to receive income at any time after termination of employment, which may be either earlier or later than the normal retirement age. However, the employee may not receive distributions while employed by the College.

Retirement benefits must normally begin no later than April 1 of the calendar year following the year in which the employee attains age 70 ½, or ceases to be an employee of the College, whichever is later. Failure to begin annuity income by the required beginning date may subject the employee to a substantial federal tax penalty.

If the employee dies before the distribution of benefits has begun, the employee’s entire interest must normally be distributed within five years after the employee’s death. Under a special rule, death benefits may be payable over the life or life expectancy of a designated beneficiary (which must be a natural person or eligible trust) if the distribution of benefits begins not later than one year from the date of the employee’s death. If the designated beneficiary is the employee’s spouse, the commencement of benefits may be deferred until the employee would have attained age 70 had the employee continued to live.

The payment of benefits according to the above rules is extremely important. Federal tax law imposes a 50 percent excise tax on the difference between the amount of benefits required by law to be distributed and the amount actually distributed if it is less than the required minimum amount.

Options Available For Receiving Retirement Income. An employee may choose from among several types of income options when the employee retires. If an employee is married at the time the employee elects to begin receiving distributions, the employee’s right to choose an income option will be subject to the employee’s spouse′s right (under federal pension law) to survivor benefits as discussed in the next question, unless this right is waived by the employee and their spouse. A summary of the annuity income options provided under each the current Funding Vehicles are available from the TIAA website.

Receiving Retirement Income While Preserving Accumulation. One or more of the Funding Vehicles may offer such an option. Employees should consult the Income Options section of the TIAA website (depending on which Funding Vehicle the employee has elected for their account) to determine if this option is available to the employee.

Receiving A Portion Of Accumulation In A Lump Sum Upon Retirement. This option may be available depending on the Funding Vehicle the employee has chosen. Please check the appropriate web site.

Lump Sum Payment From The Plan. This option may be available depending on the Funding Vehicle the employee has chosen. Please check the appropriate web site. Employees may not receive any distributions while employed by the College.

Effect of Termination of Employment Before Retirement. An employee’s Retirement Annuities remain in force, including all benefits purchased by the College′s contributions. Employees don’t forfeit any of the benefits that have already been set aside for them.

An employee’s accumulations in the Funding Vehicle the employee has chosen will continue to participate in the earnings (or losses) of the fund as would have been the case had the employee continued contributions.

Effect of Death Occurring Prior to Receipt of Benefits. If an employee dies before beginning retirement benefits, the full current value of the employee’s annuity accumulation is payable as a death benefit. Subject to the special rules for married participants discussed above, employees may choose one or more of the options listed in the employee’s annuity contracts for payment of the death benefit, or the employee may leave the choice to their beneficiary.

Federal tax law puts limitations on when and how beneficiaries receive their death benefits. The Fund Sponsor or annuity company whose Funding Vehicle the employee has chosen will notify the employee’s beneficiary of the applicable requirements at the time they apply for benefits.

An employee should review their beneficiary designation periodically to make sure that the person the employee wants to receive the benefits is properly designated. Employees may change their beneficiary by completing the "Designation of Beneficiary" form available from the Fund Sponsor or appropriate annuity company. If an employee dies without having named a beneficiary, the employee’s spouse will automatically receive half of the employee’s accumulation. The employee’s estate will receive the other half. If there′s no spouse, the employee’s estate receives the entire accumulation.

Spouse’s Rights Under This Retirement Plan. Benefits must be paid to married Participants in the Plan only as described below, unless a written waiver of the benefits by the Participant and a written consent to the waiver by the spouse is filed with the Fund Sponsor. This provision applies to both retirement benefits and pre-retirement death benefits.

If benefits commence before the employee’s death, the employee’s surviving spouse at the employee’s death shall continue to receive income that is at least half of the annuity income payable during the joint lives of the employee and their spouse (joint and survivor annuity). If the employee dies before annuity income begins, the employee’s surviving spouse shall receive a benefit that is at least half of the full current value of the employee’s annuity accumulation (pre-retirement death benefit), payable in a single sum or under one of the income options offered under the Funding Vehicle applicable to the employee.

Married Participants and their spouses may waive the spousal entitlement to a joint and survivor annuity or a pre-retirement death benefit only if a written waiver of the benefit signed by the Participant and the spouse (and notarized) is filed with the Fund Sponsor. The necessary forms will be provided to the Participant by the Fund Sponsor or the annuity company.

For post-retirement survivor benefits (joint and survivor annuity), the waiver may be made only during the 90-day period before the commencement of benefits. The waiver also may be revoked during the same period. It may not be revoked after annuity income begins.

The period during which the employee and the employee’s spouse may elect to waive the pre-retirement survivor death benefit begins on the first day of the plan year in which the employee attains age 35. The period continues until the earlier of the employee’s death or the date the employee starts receiving annuity income. If the employee dies before attaining age 35 – that is, before the employee has had the option to make a waiver – at least half of the full current value of the annuity accumulation is payable automatically to the employee’s surviving spouse in a single sum, or under one of the income options offered under the applicable Funding Vehicle. If the employee terminates employment before age 35, the period for waiving the pre-retirement death benefit begins no later than the date of termination. The waiver also may be revoked during the same period.

If a judgment, decree or order made following a state domestic relations law establishes the rights of another person (the “alternate payee”) to the employee’s benefits under this Plan, and if such an order (hereafter called a "qualified domestic relations order") is for providing child support, alimony or other marital property payments, then payments will be made according to that order. If a court issues a qualified domestic relations order, the order preempts the usual requirements that the employee’s spouse be considered the employee’s primary beneficiary for a portion of the accumulation.

Amending or Discontinuing the Plan. The Board of Trustees of the College reserves the right to modify or discontinue the Plan at any time. The College, by action of its Board, also may delegate any of its power and duties with respect to the Plan or its amendments to one or more officers or other employees of the College. Any such delegation shall be stated in writing. The College will exercise good faith, apply standards of uniform application, and refrain from arbitrary action.

Questions and Further Information. Requests for information concerning eligibility, participation, contributions, or other aspects of operating the Plan should be in writing and directed to the Plan Administrator. Requests for information concerning the Plan and its terms, conditions and interpretations may be directed in writing to: 

Chief Human Resources Officer
Rhodes College 
2000 North Parkway 
Memphis, TN 38112
(901) 843-3750

How to File a Claim

• Filing a claim for benefits. A claim or request for plan benefits is filed when the requirements of a reasonable claim-filing procedure have been met. A claim is considered filed when a written or oral communication is made to the College. 
• Processing the claim. The Plan Administrator must process the claim within 90 days after the claim is filed. If an extension of time for processing is required, written notice must be given to the employee before the end of the initial 90-day period. The extension notice must indicate the special circumstances requiring an extension of time and the date by which the Plan expects to render its final decision. In no event can the extension period exceed a period of 90 days from the end of the initial 90-day period. 
• Denial of claim. If a claim is wholly or partially denied, the Plan Administrator must notify the employee within 90 days following receipt of the claim (or 180 days in the case of an extension for special circumstances). The notification must state the specific reason or reasons for the denial, specific references to pertinent plan provisions on which the denial is based, a description of any additional material or information necessary to perfect the claim, and appropriate information about the steps to be taken if the employee wishes to submit the claim for review. If notice of the denial of a claim is not furnished within the 90/180-day period, the claim is considered denied and the employee must be permitted to proceed to the review stage. 
• Review procedure. The employee or their duly authorized representative has at least 60 days after receipt of a claim denial to appeal the denied claim to an appropriate named fiduciary or individual designated by the fiduciary and to receive a full and fair review of the claim. As part of the review, the employee must be allowed to see all plan documents and other papers that affect the claim and must be allowed to submit issues and comments and argue against the denial in writing. 
• Decision on review. The Plan must conduct the review and decide the appeal within 60 days after the request for review is made. If special circumstances require an extension of time for processing (such as the need to hold a hearing if the plan procedure provides for such a hearing), the employee must be furnished with written notice of the extension, which can be no later than 120 days after receipt of a request for review. The decision on review must be written in clear and understandable language and must include specific reasons for the decision as well as specific references to the pertinent plan provisions on which the decision is based. For a plan with a committee or board of trustees designated as the appropriate named fiduciary, a decision does not have to be made within the 60-day limit if the committee or board meets at least four times a year (about every 90 days). Instead, it must be made at the first meeting after the request is filed, except that when a request is made less than 30 days before a meeting, the decision can wait until the date of the second meeting following the plan′s receipt of request for review. If a hearing must be held, the committee can wait to decide until the first meeting after the hearing. However, it must notify the employee and explain the delay, which can be no later than the third meeting of the committee or board following the plan′s receipt of the request for review. If the decision on review is not made within the time limits specified above, the appeal will be considered denied. If appeal is denied, in whole or in part, the employee has a right to file suit in a state or federal court.

Plan Not Insured By The Pension Benefit Guaranty Corporation (PBGC). Since the Plan is a defined contribution plan, it is not insured by the PBGC. The PBGC is the government agency that guarantees certain types of benefits under covered plans.

Agent For Service Of Legal Process. The agent for service of legal process is: Chief Human Resources Officer, Rhodes College, 2000 North Parkway, Memphis, Tennessee 38112. 

Employees who participate in group retirement and welfare benefit plans such as medical, dental, vision, life insurance, disability benefits, and flexible savings accounts are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all Plan Participants are entitled to:

• Examine, without charge, at the Plan Administrator′s office all documents, including insurance contracts, and copies of all documents filed by the Plan with the U.S. Department of Labor, such as annual reports and Plan descriptions.
• Obtain copies of all Plan documents and other Plan information upon written request to the Plan Administrator. The Administrator may make a reasonable charge for the copies.
• Receive a summary of the Plan′s annual financial report. The Plan Administrator is required by law to furnish the employee with a summary of the Plan′s financial report.
• Obtain a statement telling whether the employee has a right to receive a pension at normal retirement age and if so, what the employee’s benefits would be at normal retirement age if the employee stops working under the Plan now. If the employee does not have the right to a pension, the statement will tell the employee how many more years the employee has to work to get a right to a pension. This statement must be requested in writing and is not required to be given more than once a year. The Plan must provide the statement free of charge.

In addition to creating rights for Plan Participants, ERISA imposes duties upon the people who are responsible for operating the plan. The people who operate the Plan, called "fiduciaries" of the Plan, have a duty to do so prudently and in the interest of employees and other Plan Participants and beneficiaries. 

No one, including the employee’s employer, union, or any other person, may fire the employee or otherwise discriminate against the employee in any way to prevent the employee from obtaining a pension or other welfare benefit or exercising the employee’s rights under ERISA. If the employee’s claim for a pension benefit is denied in whole or in part, the employee must receive a written explanation of the reason for the denial. Employees have the right to have the Plan review and reconsider the employee’s claim. 

Under ERISA, there are steps the employee can take to enforce the above rights. For instance, if the employee requests materials from the Plan and don′t receive them within 30 days, the employee may file a suit in a federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay the employee up to $100 a day until the employee receives the materials, unless the materials were not sent because of reasons beyond the control of the Administrator. If the employee has a claim for benefits that is denied or ignored in whole or in part, the employee may file suit in a state or federal court. If the Plan fiduciaries misuse the Plan′s money, or if the employee is discriminated against for asserting their rights, the employee may seek assistance from the U.S. Department of Labor, or the employee may file suit in a federal court. The court will decide who should pay court costs and legal fees. If the employee is successful, the court may order the person the employee sued to pay these costs and fees. If the employee loses, the court may order the employee to pay these costs and fees, for example, if it finds the claim is frivolous. 

If the employee has any questions about the Plan, the employee should contact the Plan Administrator. If the employee has any questions about this statement or about the employee’s rights under ERISA, the employee should contact the nearest Area Office of the U.S. Pension and Welfare Benefits Administration, Department of Labor.

Plan Administrator. This Vision Plan is administered by Rhodes College, 2000 North Parkway, Memphis, TN 38112 whose Internal Revenue Service Employer Identification Number is EIN620476301. The Plan Number is 504. The Plan year is July through June. This is a full insured plan. Information regarding Plan eligibility, enrollment, cost, and the procedure for applying for benefits is contained in this section. The Certificate of Coverage includes a description of benefits under the Plan and the conditions under which these benefits are available to insured individuals.

Eligible Participants. All full-time employees have the option to purchase vision insurance coverage for themselves and their dependents.

Date Eligible for Coverage. Each employee becomes eligible for vision coverage under the Plan the first day of the month following the date of employment with Rhodes.

Date Eligible for Dependent Coverage. A dependent shall become eligible for coverage on either (a) the first day that the employee becomes eligible for coverage and satisfies the definition of eligible dependent coverage or (b) the day a covered employee first acquires an eligible dependent.

Benefits Provided. All services must be rendered by a provider in the First Look Vision Network.

• $10 annual exam
• $25 materials copay for glasses and lenses every 2 years
  • Single vision lenses, line bifocals or trifocals
  • Frames up to $120
  • Elective contact lenses up to $120
• Average 30% discount for all other materials

Plan Premiums

There is a charge for vision insurance coverage that is paid through payroll deduction. At the employee’s option, vision insurance premium payments may be deducted through the flexible benefits program (pre-tax option).

Currently the insurance company is Starmount Life Insurance Company. Request for information concerning Starmount Life Insurance Company contract terms, condition and interpretation thereof, claims thereunder, any requests for review of such claims and service of legal process may be directed in writing to: Starmount Life Insurance Company, 8485 Goodwood Blvd., P.O. 98100, Baton Rouge, LA 70898-9100.

The requirements for being covered under this Plan, the provision concerning termination of coverage, a description of Plan benefits (including any limitations and exclusions which may result in reduction or loss of benefits) are explained in the Certificate of Coverage.

Written notice of a claim must be sent within 30 days or as soon as reasonably possible. Typically the In-Network Vision provider will handle all claims and administrative services for you. Should you need to file a claim from an out of network provider, you must provide the claimant’s name, the policyholder’s name (if different), and the group policy number. You may submit a claim form or an itemized receipt for services to:

Starmount Life Insurance Company
Attn: Claims
P.O. Box 14389
Baton Rouge, LA 70898-4389

All full-time employees have the option to purchase supplemental AD&D coverage for themselves and their dependents. Coverage is available for employees in increments of $10,000, and for spouses and dependent children in increments of $1,000.

The cost per month for this benefit is $.33 per $10,000 of coverage.

Full-time employees may purchase additional life insurance coverage through UNUM Life Insurance Company. Supplemental life insurance may be purchased through payroll deductions for the employee and their spouse up to $500,000 each or five (5) times the employee’s annual salary, whichever is less.

Dependent children may be covered up to $10,000 per child. The amount of life insurance purchased on a spouse and/or dependent must be equivalent to or less than coverage purchased on the employee. The employee may purchase up to $150,000 of guaranteed coverage within their first 30 days of eligibility. A spouse is guaranteed coverage of $25,000.

If desired coverage is greater than $150,000 or $25,000 respectively, a medical questionnaire must be completed and UNUM must approve the coverage.
Employees should apply for this coverage in Workday.

Monthly Premium Supplemental Life Rates

Age Band	Employee Rate per $10,000 coverage	Spouse Rate per $1000 coverage	Child Rate per $2,000 coverage
			$ .73
15-29	.80	1.10
30-34	.90	1.16
35-39	1.20	1.60
40-44	1.79	2.28
45-49	2.83	3.58
50-54	4.52	5.59
55-59	6.98	8.46
60-64	10.90	14.55
65-69	18.82	24.86
70-74	33.66	44.28
75+	65.79	88.69