Page 20 - Benefits Summary/New Hire Enrollment Guide

Benefits Eligibility

SUMMARY OF BENEFITS

Benefit Name <20 20-34 35+ Form Required Notes/Exceptions
Hrs/Wk Hrs/Wk Hrs/Wk
RPT RFT

403b EE Contributions N Y Y 403b Enrollment/ EE's @ 20 hrs+ elig. to contribute
Beneficiary Form
403b ER Contributions N Y Y Nationwide Contributions begin upon completion of
Enrollment Form eligibility period
Liberty Mutual Discount N Y Y Direct Contact EE Paid direct to Liberty Mutual
Auto/Home Insurance

Bereavement Leave N Y Y None Required Pro-rated for PT EE's
Dental N Y Y Payroll Deduction and 100% EE paid
Delta Enrollment Form
Direct Deposit Y Y Y Direct Deposit Form EE may request deposit into a max of 3
accounts

The Hartford EAP Y Y Y None Required Administered by The Hartford
EMB N Y Y EMB Request DR's notes to HR

Employer Paid N N Y The Hartford RFT’s ONLY
Life/AD&D/LTD Insurance Beneficiary Form/PPI
csONE Flex Spending Plan N Y Y csONE Flex Enrollment Medical Spending Account
(Section 125 plan) Form Dependent Care Spending Account
Holidays – 11 Paid Y if req Y if req to Y N/A Holiday Compensation Policy
to wk wk
Cigna Medical N Y @ 100% Y @ 30 Payroll Deduction & 30+hr/wk EE's pay by payroll ded; 20-29
prem. (20- hours Cigna Forms hr/wk EE's pay 100% of premium
29 hours)
The Hartford Supp Life N N Y The Hartford RFT ONLY, VOL Benefit only available at
Insurance (VOL) Enrollment Form open enrollment only

DeltaVision N Y Y Payroll Deduction & 100% EE paid
DeltaVision
Enrollment Form
Vacation/Sick Time N Y Y VST Request Form See VST policy for accrual rates

VST Cash In (Non-Exempt N Y Y VST Cash In Form Only applies to Non-Exempt EE's
Staff Only)

Tuition Assistance Suspended as of July 1, 2020 until further notice

Key to abbreviations in above chart:
EE - Employee HR - Human Resources
RFT - Regular Full-Time (employee) RPT - Regular Part-Time (employee)
VST - Vacation/Sick Time EMB - Extended Medical Benefit
LTD - Long Term Disability AD&D - Accidental Death and Dismemberment
EAP - Employee Assistance Program VOL - Voluntary
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