Benefits

How can I get a copy of the Interactive Benefits Guide? 
The new interactive Benefits Guide is now available exclusively online. If you require a printed copy, you may contact the Office of Faculty and Staff Benefits.

Which plans does open enrollment apply to?
Open enrollment applies to medical, dental, vision and flexible spending account benefit 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 life, child life, accident, hospital indemnity, critical illness insurance elections, and enrollment in the MetLaw/Hyatt Legal Plan, 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 gms.georgetown.edu.  Additionally, you will receive a personal benefits summary in your annual open enrollment home mailing.

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 of next year.  You will not be able to change any of your benefit elections after the conclusion of the annual open enrollment period.

Will I receive notice that my elections have been received?
No, not exactly.  You will receive a letter in early December reminding you to review your benefit elections in GMS.

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 medical, dental, vision, supplemental life, dependent life and voluntary AD&D elections will remain the same.  
• You will not be enrolled in the flexible spending accounts the upcoming calendar year.
•  Your contributions will be automatically adjusted to reflect the new 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 UnitedHealthcare.

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. 

For Spouse/LDA:  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.  

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 60 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, CareFirst, or UHC 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, Aetna, 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.

What Is My Effective Date of Eligibility? Is There A Waiting Period?
Medical, dental, vision, flexible spending and supplemental life insurance benefits for those hired into a benefits-eligible position will take effect on the first of the month following – or coinciding with – their date of hire or eligibility date. If you do not enroll by the deadline required of newly hired employees (within the first 30 days of your date of hire/date of eligibility), you must wait until the next “Open Enrollment” period to enroll, unless you experience a qualifying event.

What is Georgetown University’s contribution strategy for medical premiums? 
The University contributes 80% of its core medical plan (Kaiser) in the tier of coverage your elect toward your medical premium. 

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).   

What Is My Effective Date of Eligibility? Is There A Waiting Period? 
Medical, dental, vision, flexible spending and supplemental life insurance benefits for those hired into a benefits-eligible position will take effect on the first of the month following – or coinciding with – their date of hire or eligibility date. If you do not enroll by the deadline required of newly hired employees (within the first 30 days of your date of hire/date of eligibility), you must wait until the next “Open Enrollment” period to enroll, unless you experience a qualifying event. 

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 Delta Dental Enhanced plan.

Do any of the dental plans cover implants?
Delta Denta’s Standard and Enhanced plans both have coverage for implants. The Aetna DMO does not.

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.

Under the Delta Dental plans can I go to any dentist? 
Yes, with your Delta Dental program, you have complete freedom of choice in selecting a dentist. You can select any dentist at any time for any covered service. Your choice of dentist can determine your savings. You likely will save most when you visit a dentist who participates in the Delta Dental PPOSM network. When you must visit a non-PPO dentist, your next best option is a dentist who participates in the Delta Dental Premier network, the largest dentist network in the U.S. Delta Dental Premier dentists usually will save you more money than non-participating dentists will. While Premier dentists’ contracted fees are often slightly higher than PPO dentists’ fees, Premier dentists agree not to balance bill you.

What can I expect to pay when I visit a non-Delta Dental dentist?
You likely will save least when you visit dentists who do not participate with Delta Dental. Non-Delta Dental dentists may balance bill you up their full fees. In other words, they can charge you the difference between the amount of Delta Dental’s payment and their actual fee.

How do I know if my dentist participates with the Delta Dental PPO or Premier networks? 
Delta Dental’s web site at www.deltadentalins.com features an online dentist directory. You can search for dentists by name, address and specialty. You can get directions and maps to dentists’ offices online. You can also call Delta Dental’s toll-free number – 800-932-0783 – and a customer service representative can tell you if your dentist participates with Delta Dental – or your dentist’s office can tell you if your dentist participates with Delta Dental.

Under the Delta Dental plans, how often do the plans allow for me to get my teeth cleaned?
You may receive two cleanings (or two prophylaxis – aka, preventive – procedures) within the same calendar year and they will be covered by your plan.

What if I’m currently having treatments through another plan and elect Delta Dental (either as a new hire or during open enrollment)?
Procedures that are begun (opened or prepared) – such as crowns, root canals, dentures and bridge work – prior to the effective date of Delta Dental’s coverage are considered to be the responsibility of the previous carrier. Delta Dental considers itself liable for a procedure once the procedure irrevocably begins after the effective date of Delta Dental’s coverage.

When enrolled in Delta Dental Standard or Enhanced plans, will I have to submit my own claim form? 
Delta Dental participating dentists take care of all paperwork for you, including submitting your claims. If you visit a dentist who does not participate with Delta Dental, you may need to submit a claim form. Claim forms are available for downloading from Delta Dental’s web site at www.deltadental.com or you can contact Delta Dental at 800-932-0783 to request a form be sent to you.

How do I contact Delta Dental?
Call Delta Dental toll-free at 800-932-0783 from 8 a.m. to 8 p.m. (EST) every business day or visit our web site at www.deltadentalins.com

Where do I submit a claim, should I need to?
All claims are processed at Delta Dental’s regional headquarters in Mechanicsburg, Pennsylvania, regardless of where you live or where you received treatment. Please send your claim form to:
Delta Dental
One Delta Drive
Mechanicsburg, PA 17055

How long will it take to process my claim?
Delta Dental typically processes claims in 10 calendar days or less from the date Delta Dental receives the claim, provided it is complete and eligibility can be verified. If your dental office participates with Delta Dental, you will receive notification that payment was made to your dentist. This notice will advise you of the amount of the bill for which you are responsible. If you have not already paid your dentist your portion of the bill, this is something you should do once you know how much you owe. If your dental office does not participate with Delta Dental, then Delta Dental sends its payment to you.

How can I find out what my benefits are or whether my claims have been approved?
Delta Dental’s web site has a number of services that make it quick and easy to get information about your dental benefits. You can get information about your account online via a secure log-in system. Information includes program benefits, your and your dependents’ eligibility, status of deductibles, maximum usage and claim status. You can also print out an ID card. Just log on to www.deltadentalins.com and follow the links to Online Services. Delta Dental’s web site also has helpful information about how to get the most from your dental coverage, and dental health tips on such topics as caring for children’s teeth, the dangers of mouth piercing, and coping with teeth grinding. You can also download a claim form for those occasions when you may use a non-participating dentist.

Delta Dental can accept customer service inquiries of any nature over the Internet. Our customer service representatives promptly respond to questions and comments on such matters as claim status, enrollee eligibility, and group benefits. You can also call Delta Dental’s toll-free number and a customer service representative will be happy to answer your questions about your benefits and any of your claims.

When is a dentist required to accept Delta Dental’s allowances? When can a dentist balance bill? 
Balance billing occurs when a dentist bills you for the difference between the dentist’s actual charge and the amount benefited by Delta Dental for the service. Delta Dental’s participating dentists are prohibited from balance billing. They agree to accept Delta Dental’s allowances or their fees – whichever is less (the Allowed Amount) – as payment in full. The Allowed Amount is the maximum amount that a participating dentist can charge for a covered service. Delta Dental pays a portion of the Allowed Amount. You are responsible for paying the difference between Delta Dental’s payment and the Allowed Amount. Participating dentists are paid directly by Delta Dental, and by agreement cannot bill you more than the applicable copayment or deductible for covered services. You also may be responsible for charges that exceed your annual benefit maximum or for services that are not covered benefits.

What Is My Effective Date of Eligibility? Is There A Waiting Period? 
Medical, dental, vision, flexible spending and supplemental life insurance benefits for those hired into a benefits-eligible position will take effect on the first of the month following – or coinciding with – their date of hire or eligibility date. If you do not enroll by the deadline required of newly hired employees (within the first 30 days of your date of hire/date of eligibility), you must wait until the next “Open Enrollment” period to enroll, unless you experience a qualifying event.

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?
Ask the provider if he/she participates in the EyeMed Select network.  In addition, you may search the online directory at www.enrollwitheyemed.com/select.

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 Is My Effective Date of Eligibility? Is There A Waiting Period? 
Medical, dental, vision, flexible spending and supplemental life insurance benefits for those hired into a benefits-eligible position will take effect on the first of the month following – or coinciding with – their date of hire or eligibility date. If you do not enroll by the deadline required of newly hired employees (within the first 30 days of your date of hire/date of eligibility), you must wait until the next “Open Enrollment” period to enroll, unless you experience a qualifying event.  

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 flexible spending account and the dependent care reimbursement account.

I currently participate in an FSA and want to continue my contribution amounts in the next calendar year. Do I need to make open enrollment elections? 
Yes. If you wish to participate in any flexible spending account in upcoming calendar year, you must re-enroll during open enrollment.  FSA elections do not carry over from year to year. If you do not take any action during open enrollment, your current FSA participation will end on December 31.

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.  If you are paid monthly, then your deduction will be 1/12 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.

How do I get reimbursed for my out of pocket expenses?
If you pay out of pocket for expenses that can be applied to your Health Care FSA or Dependent Care Account, you can submit claims via the mobile app, online, or by completing the paper claim forms.

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 Account 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 Health Care FSA?
For your health care reimbursement account, you will have access to your total annual election on January 1. 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.

What is the The Benefits Card? 
All FSA participants receive a debit card that allows direct access to Health Care FSA funds for eligible health care expenses.  This means no waiting period for reimbursements.  When you use your card, available funds are deducted from your Health Care FSA account to pay for services or supplies. 

Do I have to use my Benefits card?
No. Use of the card is optional.  You may also pay out of pocket and submit claim forms to be reimbursed.

How do I use the card? 
You can use your card just as you would a debit card to pay for eligible health 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. Check the mobile app or website, or call Connect Your Care to see if any additional supporting documentation is required for your expenditure to be approved.

When I use the card, do I need to submit my receipt?
You may need to submit receipts with additional documentation- check your claims details through Connect Your Care’s website or mobile app to see what, if any, additional information is required for your claim to be considered an approved expense. 

What happens if I use the card and don’t send in my receipts?
If supporting documentation is required, you will receive two friendly reminders from Connect Your Care. If receipts are not received within 21 days of your purchase, you will receive an email (if you have set up an online account with Connect Your Care), then if documentation has not been received withing 42 days of your purchase, you will receive both an email and a letter. After 55 days, your card will be temporarily deactivated.  Connect Your Care 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.

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 Health Care FSA balance is the amount you elect to contribute for the entire year, less any reimbursements that have already been paid. Your Dependent Care Account 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 Connect Your Care at 1-877-292-4040 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 online through Connect Your Care’s website.

What Is My Effective Date of Eligibility? Is There A Waiting Period?
Medical, dental, vision, flexible spending and supplemental life insurance benefits for those hired into a benefits-eligible position will take effect on the first of the month following – or coinciding with – their date of hire or eligibility date. If you do not enroll by the deadline required of newly hired employees (within the first 30 days of your date of hire/date of eligibility), you must wait until the next “Open Enrollment” period to enroll, unless you experience a qualifying event.  

What is the significance of an “initial enrollment” for the supplemental life insurance benefits for new employees?
For newly hired faculty and staff, MetLife offers 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.

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.

How do I initiate a STD or Salary Continuance (AAP) claim?

1. Report your leave of absence to your Manager/Supervisor and maintain contact with him/her throughout your entire leave period.

2. Initiate the Family Medical Leave Act (FMLA) process by completing and submitting an FMLA application to fmla@georgetown.edu. You can learn more about FMLA here.

3. If your absence is scheduled, such as an upcoming hospital stay, call MetLife 30 days prior to your last day of work.
If unscheduled, please call MetLife as soon as possible.

How Do I Contact MetLife?

• Call: 1-866-729-9201
• Visit mybenefits.metlife.com (new window)  (Policy 123529)
• Download the MetLife US app. Downloadable from App Store® or Google PlayTM

What Information Do I Need To Give MetLIfe?
When calling MetLife to report your absence, you should be prepared to provide your:

• Name, address, and other key identification information.
• Name of your department and last day of active full- time work.
• Your HR representative’s name and phone number (Amanda Harris @ 202-687-1319).
• The nature of your claim.
• Your treating physician’s name, address, and phone and fax numbers.
• For Kaiser members only: Please download and have Kaiser complete this Authorization Form to Use and Disclose Protected Health Information. It will need to be provided to Metlife in order to allow them to work directly with your Kaiser team to process your claim.
• Authorizations can also be uploaded online at mybenefits.metlife.com (new window)  or faxed to (800-230-9531).
• If you have any questions regarding the form please do not hesitate to ask Metlife. They will be happy to assist you.

What will MetLife do initially?
MetLife will take the necessary information over the phone.  Unless you are a Kaiser member, no forms are required. Your MetLife representative will walk you through next steps. They will also follow up with you to make sure that you are clear on the process.

What is MetLife’s next step?
MetLife 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. MetLife will notify you when your disability claim/absence is approved and specify the approved duration. If your claim is not approved, MetLife will notify you and state the reasons for denial. MetLife will also advise Georgetown University of the approval/duration or denial.

How long will it take for MetLife to approve or deny my disability request?
MetLife is committed to review claims 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 MetLife to reach a decision. 

How will I be paid while I am out on an approved Short-Term Disability or Salary Continuance leave?
If you’re eligible for Georgetown University STD or Salary Continuance payments and DC Paid Family Leave payments for the same qualifying event, your Georgetown University payment will be offset by your estimated DC PFL payments even if you don’t apply for DC PFL, or apply at a later date.

Short Term Disability and Salary Continuance benefits are paid through the Georgetown University payroll system according to the company’s standard payroll schedule. DC Paid Family Leave benefits are paid directly from the Department of Employment Services (DOES). For additional information you can contact the Office of Faculty and Staff Benefits.

What actions do I need to take in GMS relating to my Short Term Disability?
The only actions you will need to take in GMS are:

• Enter your paid leave (or sick leave if you are 1199SEIU) in order to be paid during the 15 workday elimination period. 
• Enter unpaid leave to record days you will go unpaid during your 15 workday elimination period if applicable.
• Initiate FMLA by first contacting fmla@georgetown.edu. You will then receive guidance on how to proceed in GMS with this process.

What actions do my supervisor/manager and HR Client Services Partner need to take in GMS relating to my Short Term Disability?
No action is required. However, your supervisor will receive an email notifying them of your approval of STD benefits. 

How does Short-Term Disability and Salary Continuance coordinate with Long-Term Disability (LTD)?

For Staff and AAP:
If you are on STD or Salary Continuance for a period that is likely to extend beyond 90 calendar days and you are eligible for LTD coverage, MetLife will coordinate your transition from STD to LTD.

For Faculty:
If you are on Salary Continuance that is likely to extend beyond 90 calendar days and you are eligible for LTD coverage, contact the Office of Faculty & Staff Benefits within 45 days of the start of your Salary Continuance to initiate the LTD claim process.

Who is the insurance company for our disability benefits?
MetLife provides both short term and long term disability benefits. MetLife was selected to provide these services to Georgetown University faculty and staff because of their reputation for efficient short and long term disability claims processing and excellent customer service.

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.

Where will Georgetown University’s contributions to my account be invested? 
You direct how Georgetown University’s contributions and your personal contributions are invested. You decide which investment company(ies) to use. After you have selected your investment company(ies), you will be contacted directly by the company and asked to choose from a variety of fund(s) offered by the company. If you do not make an investment decision, these contributions will be invested in the Plan’s default investment option, until such time as you do make an investment decision. Note that your contribution will be invested in the same manner as Georgetown University contributions.

When will Georgetown University’s contributions be deposited into my account?
Each pay period, Georgetown University remits your contributions, along with Georgetown University contributions, to whichever investment company(ies) you have elected. You may choose from three investment companies:
• Fidelity Investments
• TIAA
• The Vanguard Group

If I leave Georgetown University, what can I do with my Defined Contribution Retirement Plan balance? 
You have several options on what to do with your accrued benefit. You can take your balance with you when you retire or leave employment as a lump sum or monthly annuity. You can also:
• Roll over to a new employer’s plan, if allowed by the new plan
• Roll over the balance to an Individual Retirement Account (IRA)
• Leave the account with Georgetown University and start receiving benefits when you reach retirement age. You must begin taking a minimum distribution in the year after you reach age 72.

If you cash out your account before retirement age, you may be subject to taxes and other financial penalties.

I’m currently in the Defined Contribution Retirement Plan and I was hired before January 1, 1996. What contribution will I receive from Georgetown University?
Those individuals who are currently enrolled in the Defined Contribution Retirement Plan and were hired prior to 1/1/96, will receive (or be eligible to receive) a maximum contribution of 12% of pay to their retirement account from Georgetown University.

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?
No.

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? 
The 120 GU credit hour lifetime TAP maximum applies to all eligible Staff, Faculty and AAPs. There is no impact to your benefit when you change from one TAP-eligible position to another.

My spouse and I both work for Georgetown. May we both receive Dependent TAP benefits for the same child? 
As with all of our benefits, you may only receive one Dependent TAP benefit per child, availing of a maximum of eight undergraduate semesters by age 30. If both parents are TAP-eligible, may submit tuition assistance applications.

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.

If I am enrolled at Georgetown University and I add or drop courses, does my TAP benefit automatically adjust?
Please send an email to tapbenefits@georgetown.edu to alert our office of changes to your student account record so we may adjust your TAP disbursement accordingly.

Please Note: Employees using benefits for non-credit programs at the School of Continuing Studies (SCS) should note that SCS withdrawal and refund policies also apply to TAP recipients. For more information, contact your SCS program administrator or email SCS Certificate Programs at  pdcprograms@georgetown.edu .
 

If I am enrolled at an external 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.

Are TAP benefits taxable to me?
Generally, TAP benefits are not taxable with several important exceptions. TAP benefits are taxable:

• 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 TAP TAX FACTS.

If you are receiving this benefit because your child is attending graduate school at GU there is no exception to the taxability of this benefit. 

What schools or programs are not covered under TAP?

The following schools/programs are not covered under TAP:

• Public schools that offer night programs;
• GED programs, certification exams, or prep classes
• Private high schools, elementary schools, and pre-schools;
• Non-college credit certificate programs, other than Georgetown University’s Center for Continuing and Professional Education (CCPE); 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 Studies (SCS).

Is a temporary study abroad program or four-year enrollment in an international school allowed?
Students temporarily studying abroad as part of their school’s global education offering is allowed under TAP. Four-year enrollment at an international school must be approved in advance. The school and the degree program must be vetted to determine if it meet’s comparable U.S. accreditation standards.  The international school must also be added in Workday and the payment details confirmed in advance. Notify tapbenefits@georgetown.edu  immediately if your child intends to study abroad or enroll full-time at an international school. The required supporting documentation for international enrollment is never waived.
 

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
• Books
• 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? 
Certain leaves of absence are TAP-eligible and some are not. Please contact tapbenefits@georgetown.edu  to discuss your situation.       

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. If you terminate employment, you will may no longer be eligible to receive the future benefits unless a Retiree, but you will not be required to reimburse the University for the benefits you have already used.

What to do if you believe that a fraudulent unemployment claim has been filed using your personal information:

1. Please contact John Williamson in the Department of Human Resources at jlw270@georgetown.edu (new window). You can also request assistance by submitting an HR help ticket (new window) .
2. Call the District of Columbia’s Department of Employment Services (DOES) Fraudulent Claim Department at 1-877-372-8360 to report the incident.

If you receive a debit card from the District of Columbia for payment for a claim that was filed fraudulently, it is very important that you do not use the funds on that card. Instead, contact the DOES at the number above immediately.

For more information on fraudulent unemployment claims or protecting your personal information, please see https://hr.georgetown.edu/fraudulent-unemployment-claims/.