We've tried to cover some of the most popular queries we get in the HR office. Click on the question to reveal the answer. If you don't find your particular question, call or email a member of our HR Benefits team.
Enrollment is completed online via the Lehigh Benefits site:
- Log in to Connect Lehigh using SSO at https://connect.lehigh.edu/app/login
- Select Employee
- Select Lehigh Benefits from the drop down menu
- Click the link under Enroll Now
It is your responsibility to complete the enrollment process within your 30 day new hire window, or within 31 days of a Qualifying Life Event. Your failure to do so does not constitute a Qualifying Life Event in itself and will not permit you to dis-enroll from a plan you have initially selected before the next open enrollment period (the following November).
Claims must be filed within twelve (12) months of the date of service for any of the Capital Blue Cross medical plans.
Yes. You can change your Keystone HMO primary care physician by calling Keystone Member Services at 800-216-9741. The change is normally effective the first of the month following the request. Please keep this in mind when scheduling appointments.
You can change to another plan ONLY during the Open Enrollment period, typically held in early to mid-November. If you are dissatisfied with your current coverage, please contact Human Resources. It is important to tell us about any problems you encounter.
You have thirty one (31) days from the date of marriage to add your spouse and/or stepchild(ren) to your health and/or dental coverage, purchase dependent life insurance, increase supplemental life insurance, and/or open or change goal amounts for an flexible spending account. After 31 days, you must wait for the next open enrollment period. If your spouse has access to health insurance through his or her employer, keep the spousal surcharge in mind when considering adding your spouse to your medical plan. To enroll your new spouse and stepchild(ren) you must request benefit changes online in the Lehigh Benefits site and upload required supporting documentation (marriage certificate and stepchildren’s birth certificates).
The process for adding a domestic partner and his/her dependent children to your benefits program is similar to the process of adding any new dependent(s), with one exception. You and your partner will first need to complete an affidavit to document and provide evidence that you are involved in a committed relationship. The affidavit is available in the benefits section of the HR Forms page. The completed affidavit is filed and retained in Human Resources.
Once the affidavit is done, you can complete a Personal Information Change Form, also available in the benefits section of the HR Forms page. On this form you’ll provide the names, dates of birth, and Social Security numbers of your dependents. You will also need to supply dependent verification (birth certificates for your partner’s child(ren)).
To include these dependents during the annual online open enrollment process, all you need to do is indicate your coverage choices on the available screens in the Lehigh Benefits site. For example, if you want life insurance for your partner, you’ll need to elect Dependent Life Insurance and identify the level of insurance you want to purchase. For medical plans, you’ll select your plan choice and then indicate who you wish to cover under the plan.
At any other time during the benefit plan year, you will have 31 days from the beginning of the partnership to add your partner and his or her dependent child(ren) to your health and/or dental coverage. After 31 days, you must wait for the next open enrollment period.
Keep the spousal/partner surcharge in mind when adding your spouse/partner to your medical plan. See page 9 in the Flexible Benefits Enrollment and Reference Guide for additional information.
Also, if you elect medical coverage for a domestic partner and/or the child(ren) of that partner, you will incur a tax liability equal to the value of the benefits provided unless your partner and his/her child(ren) are tax qualified dependents pursuant to section 152 of the Internal Revenue Code. Please see Tax Information On Health Benefits for Domestic Partners on the HR Website. You are also urged to consult with your personal tax advisor or attorney.
You have thirty one (31) days from the date of birth or adoption placement to add a child (under age 26) to your medical and/or dental coverage. You must complete the request to change benefits online in the Lehigh Benefits site and upload proof of birth or adoption. See Qualifying Life Events for more information.
The child must meet certain qualifications to be covered under your health plan. If the child:
- Is under age 26
- Is living in a parent-child relationship with you and economically dependent upon you
- You have legal guardianship of or formally adopted the child,
he or she may be covered under your health plan. The natural parent cannot be living in the same household as the child. If disabled, special rules apply. The dependent must be enrolled within thirty one (31) days from the date of legal custody or during open enrollment. You must contact Human Resources and provide proof of custody.
No. Even if totally dependent on the employee, parents are not eligible for coverage.
Yes, you can submit claims for any person who is financially dependent on you and that you claim as a dependent on your income tax return. You can also submit claims for your adult child(ren) under 26 years of age, regardless of whether they are covered by your medical insurance.
Your dependent or adult children may only remain covered under a university medical, dental, life insurance, or flexible spending account until they reach age 26. Coverage will terminate at the end of the month in which your dependent turns age 26. If your dependent was covered under your plan(s) at that time, he or she will receive an offer to continue his or her coverage under COBRA. COBRA provides coverage continuation for up to 18 months at the COBRA rate. Your dependent will receive a mailing from Wageworks (the University’s COBRA administrator) shortly after coverage ends.
He or she can also visit www.healthcare.gov to see options for purchasing individual medical insurance. If he or she is disabled, special rules apply. Please contact Human Resources for information.
Yes, you can. As a result of The Affordable Care Act, qualifying medical expenses incurred by your adult child (under 26 years old) are eligible for reimbursement through your FSA. The same documentation requirements apply.
The cost of a three-month supply of prescription drugs through Express Scripts is:
- 10 percent of the average wholesale price (AWP) for generic drugs up to a maximum cost of $75
- 20 percent of the AWP for preferred brand names up to a maximum cost of $150
- 30 percent of the AWP for non-preferred brand names up to a maximum of $300
Remember that your final cost may be lower than at your local pharmacy because the mail program buys drugs in larger quantities. You share in the savings larger quantity purchases may produce. Check prescription prices with Express Scripts using the telephone number on your ID card.
The Express Scripts drug card program covers insulin, diabetic tablets, syringes, and diabetic supplies.
Diabetic medications must be ordered in a 3-month supply through a retail Walgreens pharmacy or via the Express Scripts home delivery program.
All university medical plans provide coverage for diabetic supplies (glucose monitors, lancets, test strips, insulin pumps, infusion pumps, injection aids), orthotics, and self-management education programs.
- The High Deductible Health Plan covers these latter supplies (with a valid prescription). You will pay full cost for the supplies until you have satisfied your annual deductible, then subject to coinsurance.
- PPO covers diabetic supplies, subject to deductible and coinsurance (with a valid prescription).
- PPO Plus covers diabetic supplies, subject to coinsurance (with a valid prescription).
- Keystone Health Plan Central (KHP) offers two different levels of coverage — 100 percent at a Durable Medical Equipment (DME) provider (with a referral and prescription) or 50 percent at a retail pharmacy (with a prescription and KHP ID card).
All four of Lehigh's medical coverage plans are administered by Capital BlueCross, which is a member of the BlueCross-BlueShield Association. That affiliation makes the BC/BS Global Core Program (formerly BlueCard Worldwide) available to employees and dependents covered under any Lehigh medical plan. Global Core provides access to an international network of traditional inpatient, outpatient, and professional healthcare providers, as well as participating hospitals around the world.
If you plan to travel outside the United States, you can find information about the program and its services --- including the process for locating a doctor or hospital --- by visiting this page on the Capital Blue Cross website, or by calling 800-810-BLUE. Outside the United States, call the service collect at 804-673-1177.
If you are enrolled in the HDH Plan, PPO, or PPO Plus medical plan --- and receive services or supplies from Global Core providers or facilities --- those charges will be processed as in-network, meaning that you will be responsible only for any co-insurance, deductible, or co-payment imposed by your medical plan. You would be asked to pay only your portion of plan charges at the time of service, and the provider would file a claim with the medical plan on your behalf. Balance billing would not apply.
If you are enrolled in the Keystone HMO --- and receive services or supplies from Global Core providers or facilities --- the plan will cover urgent or emergency care you receive, just as it does when you receive such care in the U.S., but outside of Keystone's twenty-one-county service area. Payment and billing would work just as they do here. You should always contact your primary care physician (PCP) as soon as you reasonably can after receiving out-of-area services or supplies. This will allow your PCP to continue to manage your care, in part, by keeping in touch with the plan about treatment you've received and authorization for further services or supplies. Your PCP's telephone number is printed on the front of your member ID card. Remember that routine medical care is not covered outside of the Keystone plan service area.
Doctors to whom Global Core would refer you meet program quality of care standards, such as speaking English and being acquainted with U.S. treatment practices and standards. That added knowledge could be useful since only medical treatments and supplies approved by the FDA are covered by American medical plans.
If you are traveling on university business outside the U.S., you can use the International SOS program travel services assistance plan. If you become injured or ill while traveling within covered areas, the program will provide medical, personal, travel, and security assistance services to you and accompanying family members. International SOS is not medical insurance, but it is another source of support while on university business outside the U.S. You can learn more about the program --- and other university travel insurance issues --- from the International Programs office (610-758-3351) or the Risk Management office (610-758-3899).
Yes. COBRA continuation coverage provides you the option of continuing your medical and/or dental plan for up to eighteen (18) months. You would be responsible for paying the entire premium amount to Wageworks (Lehigh’s COBRA administrator) plus a two (2) percent administrative fee. Wageworks will mail you a continuation notice shortly after your coverage ends. The provisions of COBRA also apply to dependents who lose coverage. Contact Human Resources for further information. You can also contact Wageworks directly at 1-877-722-2667.
If you experience an eligible disability for a period exceeding six (6) months, you may receive 66-2/3 percent of your pre-disability LTD Base Salary. This benefit is offset by any Worker’s Compensation or Social Security disability benefits, and is provided under a group long-term disability policy with Lincoln Financial.
What is the difference between pre-tax and post-tax long-term disability (LTD) plans?
If you purchase LTD coverage on a pre-tax basis, this means you pay federal income tax on the benefit if you become disabled but you pay no federal income tax on the premium. If you choose the post-tax option, you pay federal income tax on the premium but no federal income tax on the benefit (or income) if you become disabled.
If you're thinking about retirement, it's a good idea to start exploring your options at least six to twelve months in advance. You'll want to find out how your benefits through Lehigh may change with your retirement and you'll need to understand the process for making any necessary adjustments to your benefits elections, initiating payments from your retirement account(s), and signing up for social security and medicare, as appropriate. At least ninety days before your planned retirement date, you should notify your supervisor, submit the appropriate forms and paperwork, contact TIAA and any other investment companies managing your retirement accounts, contact the Social Security Office, and schedule an appointment in HR.