Health & Dental Benefits
The College offers the following health insurance options through Harvard Pilgrim Health Care.
- HP HMO
- HP PPO
- HP PPO Plus HSA (new for 2017)
California employees are eligible for the two PPO plans; not the HMO plan.
Dental insurance is provided through Delta Dental of Massachusetts.
See the tabs below for specific information about these plans.
Enrollment in the medical and dental plans is not automatic. Eligible employees may enroll on the first of the month after their date of hire or during the annual Open Enrollment period with an effective date of January 1. New hire employees have until the last day of the month of their initial eligibility period to enroll.
To enroll at any other time during the year, an eligible employee must have a “change in family status” as defined by the IRS. Employees must notify the Office of Human Resources within 30 calendar days of the change, and must provide appropriate documentation. See Qualifying Events - Benefit Changes for more information.
Provided below are benefit summaries and other information regarding the medical plans offered at Emerson.
- Benefit Summaries and Enrollment Kits
- Harvard Pilgrim Forms (includes Claim forms and Fitness Reimbursement forms)
- Member Savings & Discounts
- Harvard Pilgrim Reimbursement Program for Fitness Centers and Fitness Programs
- Harvard Pilgrim Weight Managment Reimbursement Form
- Harvard Pilgrim Doctor on Demand Program
On Harvard Pilgrim’s website, you can create an account where you can access detailed information about your plan. Included is information on your claims activity, a deductible tracker, a benefits summary, and an option to order ID cards.
- Benefit Summaries and Enrollment Kits
Emerson College also offers the Harvard Pilgrim High Deductible PPO Health Plan (HDHP). This plan is designed to provide comprehensive coverage with in-network and out-of-network benefits. But since the new plan has higher deductibles ($1,500 for individual coverage and $3,000 for family coverage) and higher out-of-pocket maximums, the cost of the new plan is 15% less than the cost of the currently offered PPO plan, based on 2017 rates for both plans.
To help offset the cost of higher plan deductibles, the College will provide funding through a Health Savings Account (HSA) for 2017 of up to $750 annually for HDHP participants under the individual plan, and up to $1,500 annually for HDHP participants under the family plan. Employees who participate in the HSA plan may also make additional contributions to the HSA on a pre-tax basis that will allow them to pay for medical expenses and long-term care insurance premiums (if enrolled) using pre-tax dollars.
Participants in the High Deductible PPO Health Plan may also participate in a Limited Purpose FSA plan.
Information concerning the plans may be found at the following links:
- High Deductible PPO and HSA Presentation
- HP High Deductible PPO Presentation
- WageWorks HSA Presentation
- How it Works - High Deductible PPO Health Plan
- Harvard Pilgrim High Deductible PPO Health Plan Schedule of Benefits
- Harvard Pilgrim High Deductible PPO Summary of Benefits Coverage
- Health Savings Account (HSA) Q&A
- Limited Purpose FSA Plan Information
- Brainshark Video Overview: High Deductible PPO Health Plan (HDHP)
- Brainshark Video Overview: HSA Contributions
- Brainshark Video Overview: HSA Distributions
- How To Complete the HSA Application - BNY Mellon
Additional Harvard Pilgrim Forms and Program Information:
To manage your benefits, log onto the Delta Dental website with your plan information, or contact Delta customer service at 1-800-872-0500.
Emerson College contributes 75% of the health plan premiums for eligible staff and full-time faculty. For eligible part-time faculty, Emerson contributes 50% of the health plan premium.
For the dental plan, Emerson College contributes 100% of the dental premium for individual coverage; for family coverage Emerson contributes the individual rate and the empoyee contributes the difference between the individual and family premium.
For employee contribution information, see the applicable rates sheets below.
2016 Medical and Dental Plan Premiums
- 2016 Full-time Faculty & Staff Premiums
- 2016 Part-Time Faculty Premiums
- 9 Month Employees Insurance Premiums
- 2016 COBRA Insurance Premiums
- 2016 Early Retiree Premiums
2017 Medical and Dental Plan Premiums
If an employee terminates his/her employment with the College, medical and dental coverage ends on the last day of the month in which he/she separates from service.
See below for information on continuing health/dental benefits under COBRA. This information will also be mailed to a terminating employee's home address.The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you when you would otherwise lose your group health insurance. It can also become available to other members of your family who are covered under your health insurance plan when they would otherwise lose their group health coverage.
Qualifying Events for COBRA
If you are an employee of Emerson College covered by one of the medical options maintained by Emerson ("the Plan"), you will become a qualified beneficiary if you lose your group health coverage because either of the following qualifying events happens:
- Your hours of employment are reduced, or
- Your employment ends for any reason other than your gross misconduct.
If you are the spouse of an employee covered by the Plan, you will become a qualified beneficiary if you lose your coverage under the Plan because any one of the following qualifying events happens:
- Your spouse dies;
- Your spouse’s employment ends for any reason other than his or her gross misconduct;
- Your spouse’s hours of employment are reduced;
- You become divorce or legally separated from your spouse; or
- Your spouse becomes entitled to Medicare (under Part A, Part B, or both).
Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because any one of the following qualifying events happens:
- The parent-employee dies;
- The parent-employee’s hours of employment are reduced;
- The parent-employee’s employment ends for any reason other than his or her gross misconduct;
- The parents become divorced or legally separated;
- The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both); or
- The child ceases to be eligible for coverage under the Plan as a “dependent child.”
Obtaining COBRA Coverage
Once the Office of Human Resources receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each qualified beneficiary. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children.
COBRA continuation coverage is a temporary continuation of coverage. When the qualifying event is the death of the employee, the employee’s becoming entitled to Medicare (under Part A, Part B, or both), your divorce or legal separation, or a dependent child’s losing eligibility as a dependent child, COBRA continuation coverage lasts for up to a total of 36 months.
COBRA rates represent 100% of the premium plus a 2% administrative charge.
If you have questions about your COBRA continuation coverage, contact the HR Service Center. You may also contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA).
Click here for Annual Federal Health Insurance Notices for Benefit-Eligible Employees.
This notice has information about your current prescription drug coverage with Harvard Pilgrim Health Care and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Emerson College has determined that the prescription drug coverage offered by Harvard Pilgrim Health Care is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays, and is therefore considered Creditable Coverage. Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
If you are covered under Medicare, you can join a Medicare drug plan when you first become eligible for Medicare and each year from November 15th through December 31st. This may mean that you may have to wait to join a Medicare drug plan and that you may pay a higher premium (a penalty) if you join later. You may pay that higher premium (a penalty) as long as you have Medicare prescription drug coverage. However, if you lose creditable prescription drug coverage, through no fault of your own, you will be eligible for a sixty (60) day Special Enrollment Period (SEP) because you lost creditable coverage to join a Part D plan.
In addition, if you lose or decide to leave Emerson College sponsored coverage, you will be eligible to join a Part D plan at that time using an Employer Group Special Enrollment Period. You should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area.
If you decide to join a Medicare drug plan, your Harvard Pilgrim Health Care coverage will be affected. See below for more information about what happens to your current coverage if you join a Medicare drug plan.
If you do decide to join a Medicare drug plan and drop your Harvard Pilgrim Health Care prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back. You should also know that if you drop or lose your coverage with Harvard Pilgrim Health Care and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage, your monthly premium may go up by at least 1% of the base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without coverage, your premium may consistently be at least 19% higher than the base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to join.
For more information about this notice or your current prescription drug coverage, contact Human Resources.
NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Harvard Pilgrim Health Care changes. You also may request a copy. More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: Visit www.medicare.gov, call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for the telephone number) for personalized help, or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov or call 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).