3.3 Análisis de los resultados
3.3.1 Estados financieros
University of Richmond Employee Welfare Benefits Plan Component Programs Available As Of January 1, 2013 Medical Benefits for Active Employees and Eligible Pre-65 Retirees
Component Program: Virginia HealthKeepers HMO
Health Care Reform Status: This Component Program is not a grandfathered group health plan for purposes of health care reform.
Insured by: This Component Program is self-funded by the University. Medical, Vision and Mental Health
and Substance Use Disorder Claims Administered by: HealthKeepers, Inc. Attention: Operations P.O. Box 26623 Richmond, VA 23261-6623 Telephone Number: (800) 421-1880 Prescription Drug Claims
Administered by:
Initial Claims Express Scripts, Inc. P.O. Box 390873
Bloomington, MN 55439-0873 ATTN: Claims Department
Telephone Number: (877) 503-4057 Appeals of Denied Claims
Express Scripts, Inc. Attn: Pharmacy Appeals 6625 West 78th Street Mail Route BL0390 Bloomington, MN 55439 COBRA Administered by: Flores & Associates
P.O. Box 31397
Charlotte, NC 28231-1397
42 Administration Other than Claims
and COBRA: Human Resources University of Richmond 112 Weinstein Hall University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be shared by the University and the employees.
43
Medical Benefits for Active Employees and Eligible Pre-65 Retirees
Component Program: Anthem KeyCare PPO
Health Care Reform Status: This Component Program is not a grandfathered group health plan for purposes of health care reform.
Insured by: This Component Program is self-funded by the University. Medical, Vision and Mental Health
and Substance Use Disorder Claims Administered by:
Anthem Blue Cross and Blue Shield P.O. Box 27401
Richmond, VA 23279
Telephone Number: (804) 358-1551 (in Richmond) or (800) 451-1527
Prescription Drug Claims Administered by:
Initial Claims Express Scripts, Inc. P.O. Box 390873
Bloomington, MN 55439-0873 ATTN: Claims Department
Telephone Number: (877) 503-4057 Appeals of Denied Claims
Express Scripts, Inc. Attn: Pharmacy Appeals 6625 West 78th Street Mail Route BL0390 Bloomington, MN 55439 COBRA Administered by: Flores & Associates
P.O. Box 31397
Charlotte, NC 28231-1397
Telephone Number: (800) 532-3327 Administration Other than Claims
and COBRA: Human Resources University of Richmond 112 Weinstein Hall University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be shared by the University and the employees.
44
Medical Benefits for Active Employees and Eligible Pre-65 Retirees
Component Program: Anthem HealthKeepers High Deductible Health Plan
Health Care Reform Status: This Component Program is not a grandfathered group health plan for purposes of health care reform.
Insured by: This Component Program is self-funded by the University. Medical, Vision, and Prescription
Drug Claims Administered by:
HealthKeepers, Inc. Attention: Operations P.O. Box 26623
Richmond, VA 23261-6623
Telephone Number: (800) 421-1880 COBRA Administered by: Flores & Associates
P.O. Box 31397
Charlotte, NC 28231-1397
Telephone Number: (800) 532-3327 Administration Other than Claims
and COBRA: Human Resources University of Richmond 112 Weinstein Hall University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be shared by the University and the employees.
45
Dental Benefits
Component Program: University of Richmond Voluntary Dental Insurance Program
Health Care Reform Status: Not applicable. Even though the Dental Plan voluntarily complies with certain HIPAA mandates, the Dental Plan is intended to be a HIPAA-excepted benefit, particularly for the purposes of health care reform.
Insured by: Anthem Blue Cross and Blue Shield
Claims Administered by: Anthem Dental P.O. Box 9274 Oxnard, CA 93031
Telephone Number: (800) 453-3622 COBRA Administered by: Flores & Associates
P.O. Box 31397
Charlotte, NC 28231-1397
Telephone Number: (800) 532-3327 Administration Other than Claims
and COBRA: Human Resources University of Richmond 112 Weinstein Hall University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the employees.
46
Vision Benefits
Component Program: University of Richmond Voluntary Vision Insurance Program
Health Care Reform Status: Not applicable.
Insured by: UniCare Life & Health Insurance Company
Claims Administered by: UniView Vision
Attn: Out of Network Claims P.O. Box 8504
Mason, OH 45040-7111
Phone (888)-884-8428 Phone (888)-884-8428
Administration Other than Claims: Human Resources University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the employees.
47
Basic Life and AD&D Benefits
Component Program: Basic Life and Accidental Death & Dismemberment Insurance Plan
Health Care Reform Status: Not applicable.
Insured by: Life Insurance Company of North America
Life Insurance Group Policy FLX-960295 AD&D Group Policy OK-963781
Claims Administered by: Cigna Group Operations Claims
2000 Park Lane Drive, Pittsburgh, PA 15275
Telephone Number: (800) 238-2125 Administration Other than Claims: Human Resources
University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the University.
48
Long-Term Disability Benefits
Component Program: Long-Term Disability Insurance Plan
Health Care Reform Status: Not applicable.
Insured by: Life Insurance Company of North America
Group Policy LK-960276 Claims Administered by: Cigna Group Operations
Claims
2000 Park Lane Drive, Pittsburgh, PA 15275
Telephone Number: (800) 238-2125 Administration Other than Claims: Human Resources
University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the University.
49
Cigna Short-Term Disability Plan for Faculty and Staff
Component Program: Cigna Short-Term Disability Plan for Faculty and Staff
Health Care Reform Status: Not applicable.
Insured by: This Component Program is self-funded by the University. Claims Administered by: Cigna Group Operations
Claims
2000 Park Lane Drive, Pittsburgh, PA 15275
Telephone Number: (800) 238-2125 Administration Other than Claims: Human Resources
University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the University.
50
Employee Assistance Benefits
Component Program: Employee Assistance Program
Health Care Reform Status: This Component Program is not a grandfathered group health plan for purposes of health care reform.
Insured by: Anthem Blue Cross and Blue Shield
Claims Administered by: Anthem Blue Cross and Blue Shield 2015 Staples Mill Road
Richmond, VA 23230
Telephone Number: (800) 346-5484 Website: www.AnthemEAP.com COBRA Administered by: Flores & Associates
P.O. Box 31397
Charlotte, NC 28231-1397
Telephone Number: (800) 532-3327 Administration Other than Claims
and COBRA: Human Resources University of Richmond 112 Weinstein Hall University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the University.
51
Post-65 Retiree Medical Benefits – Open Plan
Component Program: Post-Retirement Medical Benefits Program
Health Care Reform Status: Not applicable.
Insured by: This Component Program is self-funded by the University. Medical Claims Administered by: UMR (on behalf of Hartford Life & Accident Insurance
Company) P.O. Box 826
Onalaska, WI 54650-0826
Telephone Number: (800) 436-3200 Prescription Drug Claims
Administered by:
AARP MedicareRx Preferred (PDP)
P.O. Box 29300
Hot Springs, AR 71903-9300 Telephone Number: (888) 867-5575 www.aarpmedicarerx.com
Administration Other than Claims: Human Resources University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be shared by the University and the employees.
52
Post-65 Retiree Medical Benefits – Closed Plan
Component Program: Closed Retiree Medical Benefits Program
Health Care Reform Status: Not applicable.
Insured by: This Component Program is self-funded by the University. Medical Claims Administered by: UMR (on behalf of Hartford Life & Accident Insurance
Company) P.O. Box 826
Onalaska, WI 54650-0826
Telephone Number: (800) 436-3200 Prescription Drug Claims
Administered by:
Benistar
400 E. Main Street – 2nd Floor Barrington, IL 60010
Telephone Number: (800) 236-4782 [email protected]
Administration Other than Claims: Human Resources University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the University.
53
Disabled Employee Medical Benefits
Component Program: Disabled Employee Medicare Supplement Plan
Health Care Reform Status: Not applicable.
Insured by: Anthem Blue Cross and Blue Shield
Medical Claims Administered by: Anthem Blue Cross and Blue Shield P.O. Box 27401
Richmond, VA 23279
Telephone Number: (800) 451-0361 Administration Other than Claims: Human Resources
University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the University.
54
Supplemental Life Insurance Benefits
Component Program: Voluntary Supplemental Life Insurance Program
Health Care Reform Status: Not applicable.
Insured by: Life Insurance Company of North America
Claims Administered by: Cigna Group Operations Claims
2000 Park Lane Drive, Pittsburgh, PA 15275
Telephone Number: (800) 238-2125 Administration Other than Claims: Human Resources
University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the employees.
55
Medical Reimbursement Benefits
Component Program: Medical Flexible Spending Account Plan
Health Care Reform Status: Not applicable.
Insured by: This option is self-funded by the University. Claims and COBRA Administered
by:
Flores & Associates P.O. Box 31397
Charlotte, NC 28231-1397
Telephone Number: (800) 532-3327 Administration Other than Claims
and COBRA: Human Resources University of Richmond 112 Weinstein Hall University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the employees.
56
Dependent Care Reimbursement Benefits
Component Program: Dependent Care Assistance Program
Health Care Reform Status: Not applicable.
Insured by: This option is self-funded by the University. Claims Administered by: Flores & Associates
P.O. Box 31397
Charlotte, NC 28231-1397
Telephone Number: (800) 532-3327 Administration Other than Claims: Human Resources
University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the employees.
57
University of Richmond Group Legal Services Plan
Component Program: University of Richmond Group Legal Services Plan
Health Care Reform Status: Not applicable.
Insured by: Legal Resources
Claims Administered by: Legal Resources
830 Southlake Blvd., Suite 2B Richmond, VA 23236
Telephone Number: (804) 897-1700 Administration Other than Claims: Human Resources
University of Richmond 112 Weinstein Hall
University of Richmond, VA 23173 Telephone Number: (804) 289-8747
Sources of Contributions: The cost of the benefits will be paid entirely by the employees.
58
ATTACHMENT #1
UNIVERSITY OF RICHMOND MEDICAL PLAN VIRGINIA HEALTHKEEPRS HMO EVIDENCE OF COVERAGE
Evidence of Coverage available at:
http://hr.richmond.edu/benefits/common/2013-Healthkeepers-book.pdf ATTACHMENT #2
UNIVERSITY OF RICHMOND MEDICAL PLAN KEYCARE PPO EVIDENCE OF COVERAGE
Evidence of Coverage available at:
http://hr.richmond.edu/benefits/common/2013-Key-Care-Book.pdf
ATTACHMENT #3
UNIVERSITY OF RICHMOND MEDICAL PLAN HIGH DEDUCTIBLE HEALTH PLAN
Evidence of Coverage available at:
http://hr.richmond.edu/benefits/common/2013-High-Deductible-book.pdf
ATTACHMENT #4
UNIVERSITY OF RICHMOND MEDICAL PLAN PRESCRIPTION DRUG PLAN SUMMARY
(Applies to prescription drug benefits under the HealthKeepers HMO and KeyCare PPO Medical Benefit Options)
Summary available at:
59
ATTACHMENT #5
UNIVERSITY OF RICHMOND VOLUNTARY DENTAL INSURANCE PROGRAM EVIDENCE OF COVERAGE
Evidence of Coverage available at:
http://hr.richmond.edu/benefits/common/10-2800-Prescription-Drug-Benefit.pdf
ATTACHMENT #6
UNIVERSITY OF RICHMOND GROUP LIFE INSURANCE BASIC CERTIFICATE OF COVERAGE
Certificate of Coverage available at:
http://hr.richmond.edu/benefits/common/BasicLifeCert..pdf
ATTACHMENT #7
UNIVERSITY OF RICHMOND GROUP ACCIDENT INSURANCE CERTIFICATE OF COVERAGE
Certificate of Coverage available at:
http://hr.richmond.edu/benefits/common/insurance/AccidentEmployeeCert.pdf
ATTACHMENT #8
UNIVERSITY OF RICHMOND LONG-TERM DISABILITY INSURANCE PLAN CERTIFICATE OF COVERAGE
Certificate of Coverage available at:
60
ATTACHMENT #9
CIGNA SHORT-TERM DISABILITY PLAN FOR FACULTY AND STAFF SUMMARY
Summary available at: Staff: http://hr.richmond.edu/benefits/insurance/2013%20STD%20- %20Staff%20Summary%20Plan%20Description.pdf Faculty: http://hr.richmond.edu/benefits/insurance/2013%20STD%20- %20Faculty%20Summary%20Plan%20Description.pdf ATTACHMENT #10
UNIVERSITY OF RICHMOND EMPLOYEE ASSISTANCE PROGRAM SUMMARY
Description and summary available at:
http://hr.richmond.edu/benefits/employee-assistance/index.html
ATTACHMENT #11
UNIVERSITY OF RICHMOND PRE-65 RETIREE MEDICAL BENEFITS PROGRAM AND POST-RETIREMENT MEDICAL BENEFITS PROGRAM SUMMARY
Summary available at:
http://hr.richmond.edu/retirees/benefits/insurance.html
ATTACHMENT #12
UNIVERSITY OF RICHMOND CLOSED RETIREE MEDICAL BENEFITS PROGRAM SUMMARY
Summary available at:
61
ATTACHMENT #13
UNIVERSITY OF RICHMOND DISABLED EMPLOYEE MEDICARE SUPPLEMENT PLAN
Summary of Coverage available at:
http://hr.richmond.edu/benefits/insurance/long-term-disability.html
ATTACHMENT #14
UNIVERSITY OF RICHMOND VOLUNTARY SUPPLEMENTAL LIFE INSURANCE PROGRAM CERTIFICATE OF COVERAGE
Certificate of Coverage available at:
http://hr.richmond.edu/benefits/common/insurance/VoluntaryLifeEmployeeCert.pdf
ATTACHMENT #15
UNIVERSITY OF RICHMOND VOLUNTARY VISION
Documents available at:
http://hr.richmond.edu/benefits/insurance/medical/vision.html
ATTACHMENT #16
UNIVERSITY OF RICHMOND FLEXIBLE BENEFIT PLAN
Documents available at:
http://hr.richmond.edu/benefits/flexible-spending.html
HSA information available at:
http://hr.richmond.edu/benefits/open-enrollment/health-savings-account.html
ATTACHMENT #17
UNIVERSITY OF RICHMOND GROUP LEGAL SERVICES PLAN
Summary available at:
62
ATTACHMENT #18
UNIVERSITY OF RICHMOND SAME-SEX DOMESTIC PARTNER BENEFITS POLICY
Policy available at: