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Employment Packet - Folder #4 - Supplemental Benefits

Voluntary (or Supplemental) Benefits

This IS a lot of information. However, if taken piece by piece as instructed below, it should flow easily. Forms with links are highlighted in blue. Links to additional information are highlighted in gray. Please complete all forms marked "(Required)," even if you are declining coverage.
Coverage will begin on the first of the month - AFTER you have worked one, full calendar month.

  1. Annual Leave Accrual Rate Election Form - (Required) for Academic and Unclassified employees that are earning leave ONLY. If you are a classified employee, do not complete this form.

  2. Dental / Vision / Premiums Only Plan election form - (Required) This form addresses the two dental plan offerings (#3), the vision plan offering (#4) and the Premiums Only plan (#5) all discussed below. After reviewing, please mark your selection or decline coverage for each.

  3. Dental Plans
    Two offerings, the Enhanced Plan (covers more and costs more) and the Basic Plan (covers basic check-ups and offers a discount on any other dental services).
  4. Vision Plan
  5. Premiums Only Plan (POP) - The Premiums Only Plan allows you to tax-shelter your qualified insurance premiums. This means that your premiums for medical, dental, vision and the life insurance offered through the State (the one on the health insurance enrollment form - see Folder 3) can be automatically deducted before taxes from your paycheck. There is no cost or tax liability. Due to the tax advantages under this program, you can only change or cancel this election during Annual Enrollment or if you experience a qualifying event. Make your election on the form linked above, (#2).

  6. Financial Protection Form - (Required) This form addresses Voluntary Life Insurance (through LSU, #7), Critical Illness (#8), Accident Protection (#9), Long-Term Disability (LTD, #10) and Accidental Death and Dismemberment (AD&D, #11). On the second page of the form, you will find premium rates for the Voluntary Life Insurance and the Critical Illness plans. You will also be using that page to designate any beneficiaries for any coverage you elect. A primary beneficiary will receive the money if something happens to you. A contingent beneficiary will receive the money if something happens to both you AND the primary beneficiary.
  7. Voluntary Life Insurance (LSU System Supplemental Life)
    • As a new hire that signs up within the first 30 days, you are Guaranteed Issue up to $500,000 or 5 times your Basic Annual Earnings (whichever is lower) in increments of $10,000. Once enrolled, an application can be made for up to $1,000,000.
    • Your spouse has a Guarantee Issue limit of $100,000, but may only be covered up to 50% of your benefit amount. An application may be made for more coverage, up to $250,000.
    • Children ages 2 weeks to 6 months are covered for $1,000 if selected. Children ages 6 months up to 26 years may be covered at $5,000, $10,000, $15,000 or $20,000. Premium amount is for all included children.
    • An Accidental Death and Dismemberment rider may be elected for employee and/or spouse and/or children. It will be equal to the life election amount. This AD&D rider is separate from the optional stand-alone coverage described below in #11. You may elect neither, one or both of these benefits.
    • Make your election on the form linked above, (#6).

  8. Critical Illness Coverage
  9. Accident Protection
  10. Long Term Disability
  11. Accidental Death and Dismemberment (AD&D) – This plan is a stand-alone election. It is not the same as the AD&D rider on the Supplemental life mentioned in #7, above. You may elect this policy along with that policy or just one or neither. It is an individual decision.
  12. Tax Saver Spending Accounts Election Form - (Required)
    The option to tax-shelter money for the purpose of medical expenses or daycare expenses is available for a small fee each month ($5.10) for one or both accounts.
    • Health Spending Account - The amount elected for the entire plan year will be available in full on the first day that your benefit starts. (You can be reimbursed for qualified medical expenses up to your annual election, even if the money has not yet been deducted from your check.)
    • Dependent (Daycare) Spending Account – You may receive reimbursements only after the service has been rendered and the bill paid, up to what has been deducted from your check at the time of the requested reimbursement. (You have to have the money deducted before you can receive a tax-free reimbursement.)
  13. UNUM Long- Term Care Insurance
    A benefit offering available should you lose 3 daily living activities (example: dressing yourself, feeding yourself, going to the bathroom by yourself…). Rates are locked in at the age in which you enroll. If you choose to enroll during the first 30 days of hire, coverage is Guaranteed Issue. After the first 30 days of employment, you must apply and wait for approval to be granted coverage.
    Informational Sheets:
  14. Forms:
  15. Optional Insurance (Benefits) Election Form (Required)

  16. We also offer Tax-Sheltered Investment Options. 403(b), 403 (b) Roth, 457(b) and 457(b) Roth. Information, instructions and forms for enrollment are located on the Supplemental Retirement Accounts webpage. This is optional and can be done at any time during employment.

  17. STARTStudent Tuition Assistance and Revenue Trust Program
    This is a Louisiana 529 account. Participation is optional and not offered through your employment – we offer the convenience of a payroll deduction, should you wish to participate.

    That’s it for Folder 4!
    (Congratulations for making it this far down!)

Related Files
FilenameDescriptionFile Size
UNUM-LTC-Brochure.pdf 170.75 KB
UNUM-LTC-EOI-Form.pdf 57.83 KB
UNUM-LTC-Form-7606-04.pdf 26.96 KB
UNUM-LTC-Medicare-Disclosure.pdf 17.33 KB
UNUM-LTC-Worksheet.pdf 22.38 KB
UNUM-LTC-Packet.pdf 2,335.14 KB
UHC---Dental-Vision-Enrollment-Form.pdf 661.29 KB
Financial-Protection-Enrollment-Form.pdf 694.07 KB
Last Updated: 7/3/2015 5:58:38 AM

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