Click on a topic to view the related FAQs.
How can I get a copy of the Open Enrollment Guide?
Contact the Office of Faculty and Staff Benefits at 1-202-687-2500 or the Open Enrollment Call Center at 1-202-687-3300. You can also download a copy by clicking here
Which plans does open enrollment apply to?
Open enrollment applies to medical, dental, vision, and flexible spending account plans. This will be your only opportunity to make changes until the next open enrollment, unless you experience a qualifying event and provide timely notice to the University. Supplemental life, voluntary AD&D, spouse and child life insurance elections are also limited to open enrollment.
Why can we make changes to these plans only once a year?
The Internal Revenue Service (IRS) regulates plans that allow pre-tax contributions for benefits. In exchange for this tax advantage, the IRS permits you to make changes to your coverage only during open enrollment or when you experience certain qualifying events (such as marriage, birth, adoption of a child, etc.).
Why is Supplemental Life insurance being featured as part of open enrollment?
Supplemental life insurance elections and changes (including voluntary AD&D, spouse and child life) are limited to open enrollment to allow the OFSB to improve and streamline the administration of this program.
How can I view my current benefit elections?
To view your current elections, visit Employee Access+. Additionally, you will receive a personal benefits summary included in your Open Enrollment Guide mailing.
How do I make my open enrollment elections?
You can make your open enrollment elections by going to Employee Access + and following the instructions below:
- Log on to Employee Access+ website at www.georgetown.edu/access with your GU NetID and password
- Enter your GU NetID and Password and click Verify
- Click on Faculty & Staff Services
- Click on Employee Services
- Select Open Enrollment on the employee menu screen
- Follow the instructions to make your elections
If you need assistance, contact the Open Enrollment Call Center at 202-687-3300.
What if I made an open enrollment election and then decide that another choice would be better?
During the open enrollment period, you can change your elections online. If you make changes more than once, the last changes you submit will be your elections effective January 1, 2009. You will not be able to change any of your benefit elections after November 15.
Will I receive notice that my elections have been received?
Yes. You will receive a confirmation statement in mid-December. You are also advised to print a summary of your elections from the confirmation screen in Employee Access + when making your elections.
I don’t want to make any changes to my current coverage. Do I need to do anything?
If you don’t take any action during open enrollment:
- Your current elections will remain the same. This includes plan elections for medical, dental, vision, supplemental life (for you), dependent life (spouse/child) and volutary AD&D.
- You will not be enrolled in the flexible spending accounts in 2009.
- Your contributions will be automatically adjusted to reflect the 2009 insurance premiums.
My husband and I both work for Georgetown. How should we cover each other and/or our dependent child/ren under the plans?
Each eligible employee or dependent can be covered only once. For example, you may elect employee and child/ren coverage and your husband may elect employee only
coverage. If you are not covering your children, you and your husband could each choose employee only coverage.
My wife and I both work for Georgetown and we don’t have eligible children. Should I cover my wife as a dependent and have her waive coverage?
Review the employee contribution information available in this guide and at benefits.georgetown.edu to determine if this is your best option or if it is more cost effective for each of you to elect employee only coverage. If you and your spouse elect employee only coverage, you may each elect to be covered by different medical plans. For example, you may elect to enroll in Kaiser and your spouse may choose to enroll in United Healthcare.
Georgetown employees and nearing retirement age, keep in mind that if each of you were to elect “employee only” coverage (as opposed to “employee & spouse”), you would receive a greater total University contribution toward your premiums upon retirement.
What documentation is required to enroll a qualified adult for coverage under the Medical, Dental or Vision plan?
Georgetown reserves the right to require documentation of a dependent’s eligibility status at any time.
Documentation typically includes a marriage certificate or a properly completed LDA enrollment form
Child’s Student Status: Documentation typically includes a copy of the current semester’s tuition bill, official class schedule, and a signed statement from the Registrar or Dean of Students at the accredited school, college or university. The statement must verify that the student attends full-time and is working toward a degree. Full-time student status is generally verified by the insurance company.
Coverage for Legally Domiciled Adults
What coverage is available for my legally domiciled adult (LDA)?
An LDA may be covered under your medical, dental and vision plans.
What is imputed income and why does it apply to benefits for my LDA?
The IRS requires that the value of benefits provided for a person who is not your dependent for federal income tax purposes be subject to taxation. If this applies to your LDA, the value of his/her benefits is considered income to you and is added to your total income for tax purposes. This added “income” is called imputed income.
Who qualifies for coverage as a Legally Domiciled Adult?
A Legally Domiciled Adult is an individual over 18 who has for at least 6 months lived in the same principal residence as the employee and remains a member of the employee's household throughout the coverage period; and who either
(A) has a close personal relationship with the employee (not a casual roommate or tenant), shares basic living expenses and is financially interdependent with the employee, is neither legally married to anyone else nor legally related to the employee by blood in any way that would prohibit marriage, and is neither receiving benefits from an employer nor eligible for any group coverage, or
(B) is the employee's blood relative who meets the definition of his or her tax dependent as defined by Section 152 of the Internal Revenue Code during the coverage period and is neither receiving benefits from an employer nor eligible for any group coverage.
Can I enroll myself, my spouse, and an LDA under the Medical, Dental and Vision Plans?
No. You can elect coverage for a maximum of two adults, in addition to any eligible dependent children. So, if you're legally married, you can elect adult coverage for you plus either your spouse or an LDA.
If I have family coverage now can I also opt for LDA coverage?
Health, dental and vision care coverage is available to two adults - the employee and either a spouse or LDA. If the employee is the only adult now using the family coverage and the other adult meets the eligibility requirements for LDA status, the second adult can be added, provided you have not covered another LDA within the past six (6) months. If, however, you cover your legal spouse under family coverage, you cannot also cover an LDA.
Are children of LDAs eligible for coverage?
A child's eligibility depends on the child's relationship to the employee. A child related to the employee by blood or adoption would, for example, qualify as a dependent.
Can I enroll my mother as an LDA if she is my tax dependent, but we do not live together?
No. To qualify as an LDA an individual must meet all eligibility requirements which include - for both Category A and Category B LDAs - that the adult has lived with you in your principal residence for at least six months before enrollment and continues to live with you during the coverage period.
When can I enroll an LDA for coverage?
You can enroll an LDA in medical, dental or vision plans on or prior to the last day of the month following the date of hire, during open enrollment, or within 90 days of a qualified change in status. After the termination of coverage for an LDA, there is a six month waiting period before a new LDA may be enrolled.
Can I select Kaiser, UHC or CareFirst for medical coverage for an LDA?
Yes. You can enroll an LDA in any of the available medical plans. The LDA must participate in the same plan in which you, the employee, are enrolled.
Will the medical plans provide primary coverage if the LDA is 65 years old?
No. If an LDA is age 65 or older, claims will be processed under UHC, CareFirst or Kaiser as secondary.
How much will these benefits cost me?
Employees who elect LDA coverage will pay the same amount for coverage as employees do for employee + spouse or family coverage. However, there may be other cost implications depending on whether or not the LDA is the employee's tax dependent.
Are there tax or other legal implications of these benefits?
There could be. For example, federal law requires that the value of employer-provided coverage for LDAs who are not tax dependents be imputed and reported as taxable income to the employee. We recommend that you consult with an attorney about the tax and other legal implications of electing LDA coverage.
How much will be imputed as taxable income to the employee?
The amount reported as taxable income for LDA coverage under the medical, dental and vision plans are determined each year. Federal tax laws require employers to report as taxable income the fair value of coverage but the IRS has never issued guidance on how "fair value" should be determined. While Georgetown follows a formula used by many employers, this is not guarantee that the IRS will agree with the amount of taxable income. We recommend that you consult with your attorney or tax professional if you have any questions.
What is Section 152 of the Internal Revenue Code and why is it important?
To qualify for Category B LDA coverage, an individual must meet the definition of "dependent" set forth in Section 152 of the Internal Revenue Code. That section specifies the conditions of financial support, relationship and citizenship necessary to "dependent" status under federal tax law.
As discussed above, the tax treatment of the employer-provided coverage varies depending upon whether or not the LDA is the employee's tax dependent. In addition, federal law prohibits the reimbursement of expenses of an LDA who is not also a tax dependent under a Health Care Reimbursement Account.
To find out more about the specifics of Section 152 go to www.irs.gov
. Given the complexity of the criteria, we recommend that you consult with your attorney or tax professional about the specifics of your particular situation.
Will the Medical, Dental, or Vision Plan require evidence of insurability as an enrollment requirement for the LDA?
No. There are no evidence of insurability rules requirements for any individual under these plans.
When does an LDA become ineligible for coverage?
An LDA's eligibility under the Medical, Dental or Vision Plan will end on the earliest of:
- the end of the month following an employee's date of termination, or
- the end of the month in which the individual no longer satisfies the eligibility criteria for LDA status.
Employees must notify the Faculty and Staff Benefits Office immediately of any changes in eligibility status.
When an adult insured as an LDA loses LDA eligibility, is that individual eligible for COBRA benefits?
No. COBRA coverage applies only to the legal spouse and dependent children of an employee. An LDA who has lost eligibility may not elect continuing coverage under COBRA in his or her own right. If the employee remains an active Georgetown employee and the LDA relationship terminates, the LDA is not eligible for COBRA. Georgetown will extend, however, certain COBRA-like benefits to LDAs. An employee on COBRA may add an LDA in the same manner as is permitted for active employees with spouses. If an employee with an LDA terminates employment and chooses COBRA coverage for 18 months, the employee may continue coverage for his or her LDA for that same 18 month period. If the employee does not elect COBRA coverage, the LDA may not make a separate election to continue his or her coverage. In addition, an employee on COBRA may add an LDA in the same manner as is permitted for active employees with spouses. However, should the employee die or become Medicare entitled or should the LDA relationship end, the LDA may not make an election under COBRA as a second qualifying event.
I’m not sure which medical plan will be the best choice for my family. Where can I get help?
A new online tool has been developed to help you evaluate your medical plan options. Use the Georgetown Medical Plan Chooser to compare plan costs, provider networks, covered services and plan features.
What is Georgetown University's contribution strategy for medical premiums?
Implemented in 2007, the University contributes 80% of the lowest cost medical plan (Kaiser) in the tier of coverage your elect. However, if you elect coverage under United Healthcare, a subsidy will be provided to help offset the cost of the PPO plan. This subsidy is scheduled to be phased out in 2010.
Who can I enroll under the Medical Plan?
You can enroll yourself, one other qualified adult member of your household, and your dependent children under Georgetown' s medical plans. The qualified adult member of your household can be either your legal spouse or a legally domiciled adult (LDA).
I'm changing to the CareFirst plan. What if I want my current PCP to be my BlueChoice PCP?
First, find out if your current doctor participates in the BlueChoice network. This can be done by visiting the CareFirst website, calling CareFirst member services, or calling your doctor’s office. If your doctor does participate in BlueChoice, call CareFirst or use their website to designate him/her as your PCP. If the CareFirst website indicates that your doctor is not currently accepting new patients, call member services at 1-866-520-6099 for assistance in making this designation.
Do I need to select a primary care physician with the new CareFirst BlueChoice plan?
Selecting a BlueChoice PCP is strongly encouraged, but not required. You can receive most care from a network or non-network provider without referral. You can still see any of the doctors within the BlueChoice network without designating a primary care physician.
Why would I designate a PCP if it's not required?
Designating a PCP allows CareFirst to process your claims more efficiently. Additionally, Some doctors within the BlueChoice network are categorized as both a ‘PCP’ and a ‘Specialist’. If you visit a provider who falls into both categories, you will be charged the higher specialist copay ($30) unless that provider is your designated PCP (in which case you’ll pay a $15 copay).
Can I see a BlueChoice network PCP who isn’t my designated PCP?
Yes. You may visit any PCP within the BlueChoice network. However, some doctors are listed as both specialists and PCPs, in which case you will required to pay the higher specialist copay.
How do I designate a PCP with the CareFirst BlueChoice plan?
Once your enrollment in the CareFirst BlueChoice plan has been confirmed, you will be able to either contact CareFirst member services at 1-866-520-6099, or go online to www.carefirst.com
to select your PCP.
Will I be able to change my designated PCP?
Yes, you can change your designated PCP at any time by calling 1-866-520-6099, or by visiting www.carefirst.com. Changes to designated PCPs become effective immediately.
Does everyone covered under my CareFirst BlueChoice plan need to use the same designated PCP?
No. Each member can select his/her own PCP.
What if I have questions about PCPs and the CareFirst BlueChoice plan?
Call CareFirst at 1-866-520-6099 or the Office of Faculty and Staff Benefits at 1-202-687-2500.
Can I see any Aetna dentist with the Aetna DMO plan?
No. You must select a Primary Care Dentist (PCD) who participates in the Aetna DMO network. You must verify that there is a PCD accepting new patients in your service area before selecting the DMO. If you do not select a participating PCD, your coverage may be limited to emergency services only.
How do I designate a PCD with Aetna?
Once you have contacted the PCD to make sure they are accepting new patients, then contact Aetna member services and elect the chosen PCD.
Once I've designated a Primary Care Dentist with the Aetna DMO, when can I make my first appointment?
To be effective on the first of the month, PCD selections must be received by Aetna by the 15th of prior month. In order to schedule an appointment with your PCD, your name must appear on the monthly roster that Aetna sends to PCDs.
If my PCD discontinues his/her participation in the Aetna DMO mid-year, can I drop my dental coverage or switch dental plans?
No. You will remain in the Aetna DMO for the remainder of the plan year. You will need to identify another PCD to receive maximum benefits.
Which dental plans provide orthodontia benefits for adults?
None of the plans offered provide adult orthodontia benefits. Orthodontia for covered dependent children is offered through the Aetna DMO and the CareFirst Enhanced PPO.
How do I find a dentist in either of the CareFirst dental plans?
Both CareFirst PPO plans utilize the Regional Preferred Dental PPO network. You may access non-network providers under either of the CareFirst plans; however, you will receive higher levels of reimbursement when a network provider is used.
What Is My Effective Date of Eligibility? Is There A Waiting Period?
There is no waiting period. You are eligible to participate in the dental plan as of your date of hire, but must enroll in the plan by the last day of the calendar month following the calendar month of your date of hire. Georgetown University does not choose any "default plan" for newly hired employees. If you do not enroll by the deadline required of newly hired employees, you must wait until the next "Open Enrollment" period to enroll, and will not have medical coverage until the following January 1st.
If I don’t elect the new vision plan when I'm first hired or during open enrollment, can I elect it at a later date?
You will not be able to enroll for coverage under the plan until Open Enrollment except as summarized in the Making Changes During the Year section.
I’m currently covered under my spouse’s Eyemed vision plan and just purchased new frames. If I enroll in the Georgetown Eyemed plan, will I have to wait 24 months before I can purchase frames again?
Yes. EyeMed will track your coverage under both plans and apply all frequency limits accordingly. Remember that the frequency limits are: 12 months for the exam, 12 months for lenses, and 24 months for frames.
How do I know if an eye care professional is an EyeMed "Select" network provider?
Flexible Spending Accounts
Who Is Eligible?
You are eligible to participate in the Flexible Spending Accounts if you are
- A staff employee (including members of the Allied International Union and SEIU) hired to work at least 30 hours per week;
- A faculty member or AAP hired to work at least 75% time; or
- A fellow.
What are FSAs?
FSAs are accounts you fund with pre-tax money withheld from your paycheck to pay for eligible health and dependent care expenses that are not reimbursed from any other source. Georgetown offers two accounts: the health care reimbursement account (HCRA) and the dependent care reimbursement account (DCRA).
I currently participate in both HCRA and DCRA and want to continue my contribution amounts in 2010. Do I need to make open enrollment elections?
Yes. If you wish to participate in HCRA and/or DCRA in 2010, you must re-enroll during open enrollment. HCRA and DCRA elections do not carry over from year to year. If you do not take any action during open enrollment, your current HCRA and/or DCRA participation will end on December 31, 2009.
Can I Enroll In The Health Care Reimbursement Plan If I Do Not Choose Medical or Dental Insurance Coverage Through Georgetown University?
Absolutely. There is no requirement that you must participate in our medical insurance plan to enroll in our health care reimbursement plan. For example, you may choose to enroll yourself, your spouse, and your dependent children in the health care reimbursement plan even if your family is enrolled in the medical insurance plan offered through your spouse's employer. Likewise, you can enroll in the health care reimbursement plan to cover out-of-pocket dental expenses for yourself or any of your dependents (including your spouse) if you choose not to participate in any dental plan, choose to participate in the dental plan offered by your spouse's employer, or choose to purchase dental insurance on your own behalf.
Can I Use The Health Care Reimbursement Plan to Reimburse Myself For Medical Insurance Premiums?
No. The IRS specifically disallows medical insurance premiums as an allowable expense for purposes of the health care reimbursement plan. If you are enrolled in one of our health care plans, this is basically a moot point as Georgetown allows for you to pay these premiums with pre-tax dollars. However, if you are paying COBRA premiums for your dependent, or purchase medical insurance elsewhere with post-tax dollars, you cannot use the health care reimbursement plan for those premium payments.
How Do The Deductions Come Out Of My Paycheck?
The payroll system will calculate your deduction, based on your annual election and your pay frequency. If you are paid biweekly, then your deduction will be 1/24 of your annual election. (Remember, when a given month has three biweekly pay dates, benefits deductions are only applicable to the first two pay dates in the month.) If you are paid monthly, 12 months of the year, then your deduction will be 1/12 of your annual election. If you are paid monthly, 10 months of the year, then your deduction will be 1/10 of your annual election. Of course, all deductions for these plans are made on a pre-tax basis.
Can I Change The Timing of the Health Care or Dependent Care Deductions?
No. Participants cannot change the timing of their deductions. For example, participants cannot ask to have their deductions taken out only in the first six months of the plan year, even if they anticipate that they will be terminating employment before the end of the plan year. Likewise, participants cannot request that the deductions be taken out only in the second six months of the plan year either.
Can I Have My Reimbursements Directly Deposited To My Checking or Savings Account?
Yes. You may have your reimbursements directly deposited into your checking or savings account. In order to take advantage of this feature, you simply have to complete a short form
authorizing Colonial HealthCare to directly deposit your reimbursement. Simply download the form, complete it, and return it to Colonial HealthCare. You can also contact them (877-819-9413) to request that they mail or fax a blank form for you to complete. You must return the completed form directly to Colonial HealthCare (do not send the form, or even a copy of the form, to the Benefits Office). Please note that you may elect this direct deposit option at any time; you need not wait until the beginning of a new plan year.
What Happens When I Terminate Employment?
If you terminate employment during the year, special rules apply. Eligible expenses must be incurred on or before your date of termination, and the claim must be filed no later than 90 days from your date of termination, in order for it to be reimbursed by the Plan. You will be reimbursed for the amount of your eligible expenses up to your annual election for the health care reimbursement account (please note for terminated employees this amount can exceed the amount you contributed to the plan). The rule is different for the dependent care reimbursement plan --you will be reimbursed only for the amount you contributed to that plan, which is often less than the annual election for employees terminating during the middle of a plan year.
If I Receive More Than I Contributed to The Health Care Reimbursement Plan, Am I Required to "Repay" This Amount to Georgetown?
No. If you receive a reimbursement for more than you contributed to the health care reimbursement account, you will get to keep the amount you received in excess of the amount you funded. Georgetown will not, and cannot by law, ask for you to pay us back for the excess you receive from the plan. Please note this is not applicable for the Dependent Care Reimbursement Plan because you can never receive a reimbursement in excess of the amount you have funded.
When will I be able to access the pre-tax monies I set aside for my HCRA?
For your health care reimbursement account, you will have access to your total annual election on January 1, 2010. This means that you can spend up to your full balance at any time during year, regardless of whether the money has yet been deducted from your paycheck.
When will I be able to access the pre-tax monies I set aside for my DCRA?
You will have access to your DCRA funds as they accrue throughout the year.
FSA Debit Card - The Benefits Card
What is the The Benefits Card?
All FSA participants receive a debit-style MasterCard that allows direct access to FSA funds for eligible health care and dependent care expenses. This means nno waiting period for reimbursements. When you use your card, availble funds are deducted from your FSA account to pay for services or supplies. You must submit receipts for these purchases to Colonial HeathCare within 10 days in order to comply with IRS rules.
Do I have to use my Benefits card?
No. Use of the card is optional. Traditional claim processing remains available and must be used for purchases from providers who do not accept MasterCard or are not designated as eligible merchants.
When will I receive my debit card?
New FSA participants can expect to receive your card at your home address in mid-January. Each participant will receive one card. If you already have a Benefits card, you will not receive a new card. You may continue to use the card previously issued to you.
In January, may I use my FlexConvenience card to draw on my remaining 2009 FSA balance?
No. Purchases made with cards on or after January 1, 2010, will access funds from your 2010 flexible spending accounts.
How do I use the card?
You can use your card just as you would a debit card to pay for eligible health care and dependent care expenses. Once you’ve ‘swiped’ the card at the point of service, funds are deducted from your FSA account to pay the vendor for goods or services.
How does the card know which expenses are eligible and which are not?
Each merchant or provider accepting MasterCard is assigned a merchant category code. There are over 500 codes and the card accepts only a few of those codes that are related to eligible expenses under HCRA and DCRA. The card will deny merchant category codes that have not been programmed on the card. Although these safeguards are in place, you are fully responsible for ensuring that only eligible expenses are paid using the card. (Using your card for charges other than eligible expenses is considered fraud.) If you are having a problem using your card for eligible expenses with a specific merchant, contact Colonial HealthCare to see whether that merchant’s category code can be added to the card.
When I use the card, do I need to submit my receipt?
Yes. Receipts must be submitted to Colonial HealthCare within 10 days of purchase in order to maintain compliance with IRS rules. Receipts can be faxed, scanned/emailed, or mailed to Colonial HealthCare. Your receipt must include the date of service, the type of service and the amount charged. If you fail to submit receipts when requested, your card will be deactivated.
What happens if I use the card and don’t send in my receipts?
You will receive two friendly reminders from Colonial HealthCare. If receipts are not received within 55 days of your purchase, your card will be temporarily deactivated. Colonial HealthCare will reactivate your card once information is received. Please note that you can still be reimbursed for “manual claims” and receive a check reimbursement during this time.
If I don’t use the card, how do I file a claim?
To receive reimbursement from your account, you complete a claim form
and submit it to Colonial HealthCare. You may download the form and instructions on the link provided. Follow the instructions on the form. Please read above (the section entitled Use It or Lose It!) to for information regarding claim filing deadlines.
When filing a claim, you must specify the Plan Year contributions from which you wish to be reimbursed. If you do not, you will be reimbursed with funds from the plan year in which the claim was incurred (provided you are enrolled for that year).
If your expense is incurred during a grace period, and you specify that you want the claim applied to the prior year's funds, but there are insufficient funds remaining in that year's account, then the prior year's account will be "zeroed out" and the remainder of the claim will be applied to the current year's account.
What will happen if I use my card for an ineligible expense?
If you make a mistake and purchase ineligible items with your card, contact Colonial HealthCare immediately. You will be required to send your receipt and a reimbursement check for the amount of the ineligible expenses to Colonial HealthCare.
Will my transaction be denied if I don’t have enough money in my account to cover the expense?
Yes, your transaction will be denied for any amount that is greater than your allowable balance. Your HCRA balance is the amount you elect to contribute for the entire year, less any reimbursements that have already been paid. Your DCRA allowable balance is the balance in your account at the time your claim is processed (contributions made minus any reimbursements previously paid).
What do I do if my card is lost or stolen?
Immediately call Colonial HealthCare at 1-877-819-9413 to deactivate your card. You may order a replacement card at no additional cost.
Can I request additional debit cards?
Yes, additional debit cards can be obtained for your dependents by submitting a signed request that includes the dependent’s name, date of birth and social security number. Requests can be directed to Colonial HealthCare by mail or fax (1-301-306-2509). You may also submit a request to email@example.com, but it must originate from your Georgetown University email address. One additional card per employee is free, $5.00 for any thereafter.
What is the significance of an "initial enrollment" for the supplemental life insurance benefits for new employees?
For newly hired faculty and staff, MetLife offeris a one-time opportunity to elect supplemental life coverage by one multiple of salary (up to $500,000) without providing evidence of insurability. If you elect supplemental life coverage, you may also elect dependent spouse life insurance up to $30,000 without providing evidence of insurability. Additional increases are subject to a streamlined evdidence of insurability process during this initial offering period only.
Can I increase my supplemental life insurance elections at any time?
No. Life insurance elections can only be increased during open enrollment.
Can I elect dependent spouse or child life insurance if I do not elect supplemental life insurance for myself?
You must elect supplemental life coverage to be eligible to enroll in spouse life. You need not be enrolled in supplemental life coverage to elect child life coverage.
Will my supplemental life insurance rates increase after my birthday?
No. Your rate for the year will be based on your age as of January 1.
Will supplemental life claims be paid out based on my 2009 salary?
No. The benefit will be paid based on your salary at the time the loss occurred.
Do I need to submit evidence of insurability for voluntary AD&D or dependent child life insurance?
No. Evidence of insurability is not required to enroll in either of these plans.
Who is the new insurance company for our disability benefits?
Matrix Absence Management, a Reliance Standard Life company provides both short term and long term disability benefits. Matrix was selected to provide these services to Georgetown University faculty and staff because of their low premium rates and their reputation for efficient short and long term disability claims processing.
Do I need to make open enrollment elections under disability?
No. You are automatically enrolled in both short and long term disability plans. No changes to either plan are permitted.
How do I initiate a STD claim?
First, contact your supervisor and/or the Office of Faculty and Staff Benefits to inform of your absence due to illness, accident or injury.
Next, call Matrix if you will be absent from work for more than 15 working days due to personal non-work related illness, accident or injury. If the absence is planned, such as surgery or maternity, you may call Matrix up to 30 days in advance of your scheduled disability date.
How Do I Contact Matrix?
Contact Matrix by calling 1.866.533.3438. Business hours are Monday through Friday, 7:00 a.m. to 7:00 p.m. Central Standard Time. If you call after hours, your call will be directed to voice mail. Be sure to mention that you are an employee of Georgetown University and leave your name and phone number. Your call will be returned during the next business day.
- You may also file a claim by Contacting Matrix at 1.866.533.3438
- You may also file a claim through Matrix’s secure website, www.matrixefiling.com.
What Information Do I Need To Give Matrix?
When calling Matrix to report your absence, you should be prepared to provide your:
- Phone Number
- Social Security Number
- Type of absence
- Manager’s/Supervisor’s name, phone number, and e-mail address
- Benefits representative’s name, phone number, and e-mail address:
Amanda Harris, 202-687-1319, firstname.lastname@example.org
- Starting date of absence
- Information about your health care provider/physician (name, address, phone number, fax number)
What Will Matrix Do Initially?
Matrix will take the necessary information over the phone. They will send you a Disability Leave Packet – containing:
1. A copy of the “Intake” form they completed with you over the phone;
2. An “Authorization To Obtain Medical Information” form;
3. A “Medical Disability Certification Application for Disability Benefits”;
4. An “Employee Checklist” that explains Actions Required and Your Responsibilities.
At the same time, Matrix will also fax a “Medical/Certification/Work Status Report” directly to your health care provider/physician for completion.
What Do I Need To Do After I Call Matrix?
You need to:
- Review the “Intake” form, and mark any necessary changes. If corrections or changes are made on the form, fax or mail a copy to Matrix as soon as possible.
- Complete the “Medical Disability Certification Application for Disability Benefits” form. Fax or mail form to Matrix as soon as possible.
- Complete and sign the “Authorization To Obtain Medical Information” (you can use either the form included in the packet from Matrix or a copy of the Authorization from the back of your Matrix wallet card). Take, fax or send the signed form to your health care provider/physician as soon as possible.
- Notify your Manager/Supervisor/Benefits representative of your absence (and maintain contact with him/her during your disability leave).
What Is Matrix’s Next Step?
Matrix’s absence management experts will review the information provided by you and your health care provider/physician to determine if your disability claim is approved and to determine the approved duration. Matrix will notify you by mail if your disability claim/absence is approved and specify the approved duration. If your disability claim is not approved, Matrix will notify you by mail and state the reasons for denial. Matrix will also advise Georgetown University of the approval/duration or denial.
How Long Will It Take For Matrix To Approve Or Deny My Disability Request?
Matrix is committed to review requests for disability absences and make decisions as soon as they have all the necessary information. It is critical that you and your health care provider/physician supply all the information necessary for Matrix to reach a decision. If a required health statement is not received, your Georgetown University pay will be suspended until the required health statement is received. (Please note that it is ultimately your responsibility to make sure your health care provider/physician provides Matrix with complete information on a timely basis.)
How Will I Be Paid While I Am Out On An Approved Short-Term Disability?
Short-term disability benefits are paid through the Georgetown University payroll system according to the company’s standard payroll schedule. For additional information on STD benefits you can contact your Supervisor or the Office of Faculty and Staff Benefits.
How Does Short-Term Disability Coordinate with Long-Term Disability (LTD)?
For Staff (including Allied Union):
If you are on STD for a period that is likely to extend beyond 90 calendar days and you are eligible for LTD coverage, Matrix will coordinate your transition from STD to LTD.
For Georgetown Employees represented by SEIU District 1199E-DC:
If you are on STD for a period that is likely to extend beyond 180 calendar days and you are eligible for LTD coverage, Matrix will coordinate your transition from STD to LTD.
For Faculty and Academic Administrative Professionals (AAPs):
If you are on Salary Continuance through Georgetown University that is likely to extend beyond 90 calendar days and you are eligible for LTD coverage, contact Matrix to initiate the LTD claim process.
Tuition Assistance Program
I worked in a benefits-eligible role for 8 years, terminated employment for 13 months, and was recently rehired. Am I eligible for TAP benefits?
Not immediately. You must satisfy the eligibility requirements as if you were a new employee if your employment gap exceeds 12 months.
I worked in a benefits-eligible role for 20 years and am now working part-time in a benefits-ineligible role. Am I eligible for TAP benefits based on my prior, full-time years of service?
No, you must be currently benefits-eligible to receive this benefit.
I worked in a benefits-eligible role for 10 years, switched to a part-time, benefits-ineligible status for 9 months, and then resumed full-time employment. Am I eligible for TAP benefits?
You will be eligible once you have completed 9 months of benefits-eligible service. If you become benefits-ineligible (for any reason) for less than one year, your waiting period for TAP benefits equals the time of your gap.
I worked in a benefits-eligible role for 10 years, switched to a part-time, benefits-ineligible status for 12 months and 1 week, and then resumed full-time employment. Am I eligible for TAP benefits?
Not immediately. You must satisfy the eligibility requirements as if you were a new employee if you become benefits-ineligible for more than 12 months. Note that this answer is the same for employees who terminate employment or switch to a benefits-ineligible status for more than 12 months. (Refer to question #1.)
I worked in a benefits-ineligible role for 3 years, and now work in a benefits-eligible position. Do any of the 3 years of service count for TAP benefits?
I have worked at Georgetown University for 5 years and was eligible for TAP benefits last year, but did not realize it and paid for my child's tuition. Can I apply for TAP benefits retroactively?
Yes, but with several important caveats. We always pay the schools directly, and always require an invoice, even for retroactive payments. We do not abolish the documentation requirements, and you may not always be able to supply the documentation retroactively (in that case, no benefits can or will be paid).
How is my TAP benefit affected if my position changes from Staff to AAP or Faculty?
This type of employment status change triggers the 8-semester TAP limit (a change from the Staff maximum of 120 credit hours) and your record will be reviewed to determine your remaining TAP balance.
The school to which I am applying requires a deposit prior to my registering for classes. Can I submit this deposit to the TAP program for payment?
No, the TAP program will not pay deposits. The TAP program is designed to assist you with your (or your child's) educational expenses. It is not designed to pay for all the expenses associated with attending a college or university. The institution requiring the deposit will credit it to your account and this credit will be applied to the non-tuition portion of your bill. In the unlikely event that the non-tuition expenses exceed your deposit, you should request a refund of the unused portion of the deposit from the educational institution.
If I am enrolled at Georgetown University and I add or drop courses, does my TAP benefit automatically adjust?
Not usually. Please send an email to email@example.com to alert our office of changes to your student account record so we may adjust your TAP disbursement accordingly.
If I am enrolled at an outside institution, and I add or drop classes, how is my TAP benefit affected?
If you add courses, you may submit another tuition invoice and TAP application for the additional charges, as long as they do not exceed your maximum TAP benefit. If you drop courses, most institutions will return the excess TAP payment to our office. For dependents, if any portion of the TAP disbursement is retained by the school, that partial disbursement still counts against the 8 semester maximum. In any event, it is strongly encouraged that you contact the Office of Faculty and Staff Benefits when dropping courses at an outside institution.
Are TAP benefits taxable to me?
Generally, TAP benefits are not taxable with several important exceptions. TAP benefits are taxable:
- if you received this benefit as a MedStar employee in, or prior to, summer semester of 2008;
- if you are receiving benefits for your child's graduate school education; or
- to the extent that these benefits exceed $5,250 for your graduate school education, with very limited exceptions.
To learn more about these exceptions, go to TAPTAXFACTS.
If you are receiving this benefit because your child is attending graduate school at GU, or you are a MedStar employee, there is no exception to the taxability of this benefit. If you are attending graduate school at GU, you can apply for an exception. Please note that you must re-apply for this exception annually.
What schools or programs are not covered under TAP?
The following schools/programs are not covered under TAP:
- Trade schools, including public schools that offer night programs;
- GED programs;
- Private high schools, elementary schools, and pre-schools;
- Non-college credit certificate programs, other than Georgetown University's Center for Professional Development (CPD); and
- Courses that are not part of a degree-granting program and are not job related, except for courses offered through the GU School for Continuing Education (SCS).
- International colleges and universities, with some exceptions. Please contact the Office of Faculty and Staff Benefits for details.
Are study abroad programs covered under TAP?
Students studying abroad as part of their school's study abroad program are covered under TAP as long as the program is approved through a domestic institution and the tuition for the study abroad program is billed by, and paid to, that domestic institution and not the school/program located abroad. An original tuition invoice from the student’s institution reflecting the study abroad tuition must be submitted with the TAP online application
What charges are not covered under TAP?
All non-tuition fees are not covered, such as:
- Mandatory fees
- Lab fees
- Application fees
- Room & board, and meal fees
- Late fees
- Student health fees
- Gym/recreation/activity fees
- Library fees
- Damage fees
- Fines of any type
I meet the eligibility requirements for TAP benefits two days after classes begin for the semester for which I want to apply. Can I be granted an exception to the eligibility requirements due to the fact that I do not meet the service requirements by such a short period of time?
No, to protect the integrity of the program, we do not waive the eligibility requirements, even for participants who miss the service requirements by a short period of time. You must meet the service requirements for eligibility by the first day of classes. If you miss the deadline, even by a small period of time, you can apply for TAP benefits for the next semester of study.
Are there any situations in which Georgetown University will pay the TAP benefit directly to me, instead of paying the school I attend?
No, for IRS-compliance purposes we always pay the school directly, even if you have already paid the tuition bill. If you have already paid the school, you should ask them to reimburse you after we have made payment to them. Please note that we have no control over any other institution's policies with respect to refunds. Therefore, you should verify with the school that they will reimburse you if you choose to pay them directly prior to our processing your TAP benefit.
Can I take a leave of absence and receive TAP for myself or my child?
No, you cannot use TAP if you are on a leave of absence of more than 30 days.
If I have received, or am receiving, TAP benefits, and I resign from my position at the University, would I ever be required to reimburse Georgetown for the value of my tuition benefits?
No. You are not required to remain employed at Georgetown after receiving TAP benefits. Of course, if you terminate employment, you will no longer be eligible to receive the benefit, but you will not be required to reimburse the University for the benefits you have already used. If you resign during a semester during which you or your dependents are using TAP benefits, you will not be required to reimburse Georgetown for that semester, but you will not be eligible for TAP benefits for any subsequent semester.