Housestaff Fringe Benefits Summary

July 1, 2005

Eligibility - All full-time and part-time housestaff and clinical post-doctoral associates appointed through a department in the College of Medicine are eligible to receive the College-sponsored fringe benefit program. Premiums are paid by the College. If any leave of absence or unpaid leave is taken during the residency, insurance benefits will be covered by the department for up to two months; after two months, the resident will be responsible for payment of insurance premiums.

Group Health Plan - The following is a brief description of your health plan.

• A copy of your Plan Booklet may be reviewed on the Fringe Benefit website at www.med.ufl.edu/benefits. Where discrepancies exist, the Master contract will apply.  It is your responsibility to notify the Fringe Benefit office of any changes in your family status.
• The College of Medicine self-insured group health plan is administered by Humana Self-Funded Solutions.
  The plan provides coverage for the employee, the spouse of an eligible employee (unless legally separated or divorced), unmarried children under age 19, unmarried children between ages 19 and 25 who are dependent upon the insured for support and are either full time or part time students or who reside in the insured's household.
• Each insured individual is initially covered for a lifetime maximum amount of $5,000,000.
• The calendar year deductible is $1,000 per person/$2,000 per family.
• Coinsurance and copays on covered expenses contribute toward the stop-loss maximum.
• You will pay 20% or $25.00 per visit to a maximum of $2,500 per calendar year if you visit a Humana/ChoiceCare network provider. If utilizing a non-network provider, the loss is stopped at $5,000 of covered expenses, meaning that you are responsible for the 40% and the plan will pay 60%. Charges are discounted according to agreements between the providers.
• No deductibles or coinsurance payments apply to covered inpatient stays at Shands hospital facilities. Deductibles are waived for inpatient stays at network provider hospitals and covered charges are paid at 80% coinsurance. The calendar year deductible applies to inpatient stays at all other non-network hospitals and covered charges are paid at 60% coinsurance. You will also be responsible for the discounted non-eligible expenses.
• Covered Lab and x-ray charges by all others are paid at 80% coinsurance.
• For visits to physicians offices at Shands/UF or Shands/Jax, the UF Faculty Group Practice physicians will waive the deductible and coinsurance payments for covered charges. Deductibles and coinsurance payments will not be waived for non-covered charges. Physician visits to Network Providers are subject to a $25. copayment for outpatient visits. Physician visits to all other providers are subject to the calendar year deductible and are paid at 60% coinsurance for eligible expenses. You are responsible for paying the non-eligible charges and those charges do not apply towards your total stop loss.
• Facility charges for Outpatient Surgery are not subject to the deductible and are paid at 100% at Shands Hospitals and 80% at Network Provider Hospitals. Facility charges for Outpatient Surgery performed at All Other Hospitals will be paid at 60% coinsurance.
  Emergency Room Visits at Shands Provider Hospitals are paid at 100%. Emergency Room Visits to all Hospitals and facilities including out of area emergency visits are paid at 80% coinsurance.
• Your benefits have cost containment features on mental illness and substance abuse, home health care, hospital preadmission tests, weekend hospital confinement, hospice care, birth center benefit, ambulatory surgical facility benefits, second surgical opinion. Outpatient Visits for Mental/Nervous Disorders and Substance Abuse are capped at 52 visits per calendar year. Visits are limited for Physical, Speech and Occupational Therapy; charges are paid according to the same schedule as Outpatient Visits.
• "Well Baby" and " Adult Well Person" care are included as a scheduled benefit and are payable, without deductible, at 80%. "Adult Well Care" is limited to $250 per Calendar Year.
• Pre-Certification is mandatory for in-patient hospitalization.
• A prescription drug plan is included in the benefits. Brand name drugs will require a $35. copayment, Generic drugs will require a $20. copayment. Mail order drugs (90-day supply) will require a $35. Co-payment for brand name drugs and a $20. copayment for generic drugs. Prescriptions written by an insured for self or any family members will not be reimbursable through the drug card nor regular plan benefits.
• COBRA (TitleX of the Consolidated Omnibus Budget Reconciliation Act of 1985) In the event of your termination, you have the option to continue your health insurance policy at the current premium plus 2% for a maximum of 18 months under COBRA. 18-month continuation is also available in the event of reduction in hours or layoff. 36-month continuation is available in the event of divorce, death, retirement and a dependent losing that status because of age. It is your responsibility to notify the Fringe Benefits Office within 30 days of any of the above events. Failure to provide notification could result in forfeiture of COBRA.

Life Insurance

• A copy of your Plan Booklet is located on the Fringe Benefit website at www.med.ufl.edu/benefits. Group Term life insurance of $10,000 is provided. Coverage is through Provident/UNUM Life Insurance Company. For any questions on coverage or claims, please contact the Fringe Benefit Office.

Accidental Death and Dismemberment

• A copy of your Plan Booklet is located on the Fringe Benefit website at www.med.ufl.edu/benefits.
  Coverage is through Provident/UNUM Life Insurance Company. Pays an additional $10,000 on top of $10,000 from life insurance if death is accidental. Dismemberment benefits are paid on a pro-rated basis. For any questions on coverage or claims, please contact the Fringe Benefit Office.

Long Term Disability Insurance

• A copy of your Plan Booklet is located on the Fringe Benefit website at www.med.ufl.edu/benefits.
  All active full-time College of Medicine housestaff members working at least 30 hours a week are provided Long Term Disability insurance. The policy is underwritten by Provident Life and Accident. The monthly benefit is equal to 60% of the first $3,333 monthly salary to a maximum monthly benefit of $2,000 reduced by benefit offsets. The benefits as set forth under this policy will begin after the insured's sixth month of total disability. The maximum benefit period due to sickness and accident is to age 65. For further information, please contact the Fringe Benefit Office. A special Guaranteed Issue Conversion Feature is provided. For information pertaining to this special feature, please contact Holloway Financial, Inc. (352)377-2078 or 800-330-4628.

Social Security (FICA)

• Matching contributions are made on the your behalf in the amount of 7.65% up to a salary cap of $90,000. 1.45% is applied to salary above $90,000.

Professional Liability

• Pursuant to Section 768.28, Florida Statutes, the University of Florida Board of Trustees is exclusively responsible for any civil claims or actions arising from the acts of its employees and agents. The UF BOT is protected for such liabilities by the J. Hillis Miller Health Center Self-Insurance Program (UF SIP), a self-insurance program managed by a governing council created by the Florida Board of Governors that is chaired by the Sr. Vice President for Health Affairs. As an employee of the University of Florida (UF), you are personally immune from civil liabilities which may arise from acts or omissions committed by you in the course of your employment. Personal professional liability protection is afforded you by UF SIP while you act as a Good Samaritan, while you are involved in community service work, which has been pre-approved by your college, or if you are on a job assignment outside of Florida. Defense costs are also provided by UF SIP for certain licensure investigations by the Department of Health. If you have questions regarding professional liability, please contact the UF SIP Director at 352-273-7066.

PLEASE CALL IF YOU HAVE QUESTIONS REGARDING YOUR BENEFITS.