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Internal Audit Office

Kansas State University
5 Anderson Hall
Manhattan, KS 66506-0118

 

785-532-7308
785-532-0186
internalaudit@k-state.edu

Insurance Programs

Chapter 4820
Revised February 14, 2008

Table of Contents

.010 Introduction
.020 Eligibility for Participation
.030 Disability Income Benefit
.040 Employment-Connected Accidental Death Benefit
.050 Group Health Insurance
.060 Insured Death Benefit
.070 Supplemental Life Insurance Plans
.080 Deleted
.090 Unemployment Insurance Program
.100 Worker's Compensation Program
.110 Questions
Related Content
.100 Accident/Injury Report (PER-17)
.200 Delta Dental Claim Form
.300 Health Insurance Claim Form (State of Kansas)
.400 Health Insurance Communication Form
.500 Prescription Claim Form
.600 Prescription Drug Program Grievance Form
.700 State of Kansas Health Insurance Information

.010 Introduction

The State of Kansas and Kansas State University provide benefits eligible employees with insurance and related programs as part of their total compensation. Some of these programs are inherent with employee's position and others are optional at the election of the employee. The composition and enrollment periods for these programs change from time to time. Therefore, it is prudent for all employees to stay informed concerning the current status of these programs.

.020 Eligibility for Participation

Eligibility for participation in these programs is dependent upon the employee appointment status:

  1. Unclassified employees (exempt and non-exempt)– appointed to either a full-time (1.0 FTE) or part-time (.5 FTE or more) regular position for at least 90 calendar days or more are benefits eligible for program participation.

  2. Classified employees (exempt and non-exempt)– appointed to either a full-time (1.0 FTE) or part-time (.5 FTE or more) regular position requiring at least 1,000 hours of compensable service per year are benefits eligible for program participation.

Employees appointed to positions with Federal benefits (e.g. retirement plan, health insurance, disability) are not eligible to participate in these programs except for the Teachers and Employees Association (TEA) life insurance program, workers's compensation (effective February 1, 2003), and unemployment compensation (effective February 1, 2003).

.030 Disability Income Benefit

The following information is a summary of that contained in the official disability plan document issued by the Kansas Public Employees Retirement System (KPERS) and its underwriter DCG Resource Options, LLC. The official disability plan document provisions take precedence over any information contained in this policy guidance.

Disability income protection starts with the employee's first day of work. A certificate of disability income benefit coverage is furnished to each employee upon employment as part of their welcome packet of materials.

If an employee, while covered for benefits under this plan, becomes totally disabled, the disability income provider will pay a monthly disability income commencing after the later of the 180 day elimination period or the first day upon which the employee ceases to draw compensation from the employer. The maximum benefit period will be as follows:

  1. employees who become disabled before age 60 can continue to receive disability benefits until they retire or reach age 65, whichever occurs first.

  2. employees who become disabled at or after age 60 can continue to receive disability benefits for five years or until they retire, whichever occurs first.

In no event will any disability income benefit be paid for:

  1. the first 180 days of continuous total disability (elimination period); or

  2. while the employee continues to draw compensation from their employer; or

  3. any period beyond the date the employee withdraws his or her contributions from KPERS or from a Kansas Board of Regents retirement plan provider.

Disability income benefits cease if the employee withdraws his or her contributions from KPERS or from a Kansas Board of Regents retirement plan provider. This includes withdrawals during the 180 day elimination period.

Effective January 1, 2006 the disability income benefit shall be 60 percent of the employee's current annual rate of compensation on the date such disability commenced, payable in equal monthly installments, reduced by the Social Security Administration primary disability or retirement benefit, or any Worker's Compensation benefit, and by any other disability benefit from any other source by reason of employment, subject to a minimum disability income benefit of $100.00 per month and a maximum disability income benefit of $5,000.00 per month.

No disability benefit will be paid for disabilities caused by or contributed to by:

  1. participation in an assault, felony, strike, civil disorder or riot;
  2. an act of war, declared or undeclared;
  3. attempted suicide or intentionally self-inflicted injury, while sane or insane;
  4. visual impairment if the member is in training at and employed by a sheltered workshop for the blind operated by the Secretary of Social and Rehabilitation Services;
  5. the use of an illegal or controlled substance not prescribed by a physician; or
  6. service in the Armed Forces, National Guard, or military reserves of any country or international authority.

The disability plan will not cover any disability that begins during the first 12 months after the employee's effective date of coverage under the plan that is caused or contributed to by a pre-existing condition. Pre-existing condition means any sickness or injury for which the employee, within three (3) months prior to their effective date of coverage under the plan:

  1. was diagnosed by or received treatment from a legally qualified physician; or
  2. had symptoms for which an ordinarily prudent person would have sought treatment.

KPERS retirement plan members approved for disability income benefits will continue to accrue service credit for retirement benefits during the period of total disability.

An employee who is in the 180-day disability elimination period may be placed on leave without pay when all accumulated leave has been exhausted. Time away from work, both paid and unpaid together, may be granted employees for a maximum of one year. If an employee remains totally disabled after the one-year period, the employee must either:

  1. return to work, with or without an accommodation; or
  2. resign their appointment; or
  3. retire, if qualified.

If an employee is totally disabled as defined by the disability plan but accepts rehabilitative employment during a period of total disability for which a monthly disability income is payable, he or she must notify the disability provider. The employee will be entitled to continue to receive the monthly disability income reduced as follows:

  1. during the first four continuous months, the monthly disability income will be reduced by 50 percent of the gross income received from the rehabilitative employment.
  2. during the next five continuous months, the monthly disability income will be reduced by 100 percent of the gross income received from rehabilitative employment.
  3. Rehabilitative employment benefits will not be less than the minimum monthly disability income of $100.00.

The rehabilitative employment benefit will terminate on the earliest of the following dates:

  1. the date the employee completes nine continuous months of rehabilitative employment;
  2. the date the employee resumes full-time gainful employment; or
  3. the date the employee otherwise ceases to be eligible as provided under the plan.

If the monthly disability income is payable under this plan and an employee suffers a recurrence of total disability from the same or related cause or causes while this plan is in force, the subsequent period of total disability will be deemed a continuation of the prior period, unless between such period the employee has been actively at work in any occupation on a full-time basis for at least six consecutive months. In such a case, the recurrence of total disability will be deemed the result of a new sickness or injury and subject to a new elimination period.

The employee's department is to notify the Division of Human Resources when an employee is away from work for more than 30 calendar days due to a medical reason. The Division of Human Resources is responsible for submitting the necessary documents to KPERS to begin the 180-day elimination period. The employee is responsible for applying for Social Security disability benefits during the elimination period.

The disability income benefit provisions for employees participating in the Kansas Police and Firefighter''s (KP&F) retirement plan is different than noted above. Employees participating in KP&F should contact the Division of Human Resources for specific information relating to their disability provisions.

The disability income benefit program is paid for by Kansas State University and underwritten by DCG Resource Options, LLC. A copy of the official disability income benefit certificate is available from the Division of Human Resources, upon request.

Disability coverage for employees on leave without pay (LWOP) is administered as follows:

  1. Classified employees:
    1. Voluntary leave without pay–coverage ceases
    2. Involuntary leave without pay–coverage continues (no cost to the employee)
  2. Unclassified employees:
    1. Voluntary leave without pay–employee has the option to continue coverage by paying the premium or forfeit coverage through non-payment of premium
    2. Involuntary leave without pay–coverage continues (no cost to the employee)
.040 Employment-Connected Accidental Death Benefit

This employment-connected accidental death benefit is provided to employees who, at the time of their death:

  1. are actively participating in the KPERS retirement plan;
  2. classified employees who are in the KPERS one year waiting period;
  3. unclassified employees who are actively participating in the Kansas Board of Regents mandatory retirement plan; and
  4. unclassified employees who are in the Kansas Board of Regents one year waiting period (effective: May 23, 2002).

It does not include employees who are participating in the KP&F retirement plan. There are different employment-connected accidental death benefit provisions for these employees. Employees participating in the KP&F retirement plan should contact the Division of Human Resources for information relating to their employment-connected accidental death benefit provisions.

The Kansas Public Employees Retirement System (KPERS) provides accidental death benefits in the event of the employee's death as a result of an accident arising out of, and in the course of, the employee's actual performance of duty. The accidental death benefit is a lump sum payment of $50,000 and a monthly benefit based on 50 percent of the employee's final average salary (4 year average) less any monies received from Worker's Compensation. The minimum monthly benefit is $100.00.

The accidental death benefit is payable only to a surviving spouse, dependent children or dependent parents, in this order of preference. The spouse's benefit continues until death or remarriage. Upon the spouse's death or remarriage, if there are remaining unmarried children under the age of 18, or 23 if full time students, the benefit is shared equally until the last child marries, dies or reaches 18 or 23, if a full time student, whichever occurs first.

Departments are to notify the Division of Human Resources immediately upon the death of an employee. The Division of Human Resources will assist the surviving spouse, dependent children or dependent parents, as appropriate, in applying for this entitlement.

The employment-connected accidental death benefit program is paid for by Kansas State University.

Accidental death benefit coverage is not available for employees on Leave Without Pay (LWOP) .

.050 Group Health Insurance

Effective: January 1, 2002

The State of Kansas provides benefits eligible employees a number of health care programs. The type of health insurance program available is based upon the negotiated contract between the State of Kansas Health Care Commission and the individual health care provider companies. Generally, these include such programs as: medical care; dental care; pharmaceutical; vision care; and mental health. However, this may vary from year to year as programs are renegotiated. Participation in any of these health care programs is optional for the employee.

Benefits eligibility is as defined in section .020 of this chapter. Student employees and graduate teaching/research assistants are not eligible to participate in the health insurance program.

Benefits eligible employees may enroll in the state sponsored health insurance program at the following times:

  1. within the first 31 calendar days of their date of hire; or
  2. during the annual open enrollment period; or
  3. within 31 calendar days of a family status change.

Once eligibility requirements are met, all benefits eligible employees must select a group health insurance plan provider or waive health insurance coverage within 31 calendar days by properly completing a Group Health Insurance Enrollment Form. The Group Health Insurance Enrollment Form is the application for coverage and an authorization by the employee to deduct from earnings the amount due for the coverage selected. If the employee is enrolling with spouse, child(ren) or full-family coverage, both the employee and dependents must be covered under the same group health insurance program. All Group Health Insurance Enrollment Forms must be completed in full, including the employee's signature, date and attachment of appropriate supporting documents. If a benefits eligible employee does not elect to enroll in the State of Kansas group health insurance program, a Group Health Insurance Enrollment Form must be signed and completed by the employee indicating that they do not wish to enroll. The Group Health Insurance Enrollment Form is to be submitted to the Division of Human Resources during the employee's eligibility period.

Under any of the available health care providers, benefits eligible employees may elect coverage for: themselves; themselves and spouse; themselves and child(ren); or full family. The employee pays for participation in this program through semi-monthly payroll deductions of pretax or after-tax premiums. The University contributes additional amounts, depending on the type of enrollment and employment status/income levels.

The State of Kansas and the insurance providers reserve the right to request documentation to support proof of relationship, dependency, and/or residency. A social security number (SSN) is required for any dependent over 60 days of age.

A newly hired eligible employee becomes eligible for health insurance coverage on the first day of the month following 60 calendar days of employment.

Under certain circumstances, the 60 calendar day waiting period may be waived. The prospective employee will need to complete a request for waiver form. The prospective department head/director must state in a letter to the Division of Human Resources:

  1. that the prospective employee is not eligible for continuation of health insurance coverage through their previous employer; and
  2. that the waiting period will pose an obstacle to recruitment. This should include an explanation of recruitment difficulties.

Both of these criteria must be met before a request for waiver can be honored. The letter and request form are to be submitted to the Division of Human Resources as soon as possible. However, no request for waiver will be entertained after the employee has signed an employment contract with Kansas State University. The approving authority for waivers is the Health Benefits Administrator for the Kansas State Employees Health Care Commission.

During the annual open enrollment period, generally in October each calendar year, the Division of Human Resources, furnishes information to benefits eligible employees concerning changes that will be effective the next health insurance plan year. Employees will be advised of the election options available to them during this open enrollment period. The State of Kansas publishes a comprehensive booklet entitled "Open Enrollment." This booklet is furnished to each benefits eligible employee during the open enrollment period and at the time of the employee's initial employment or eligibility for health insurance participation. This booklet contains information about:

  1. eligibility criteria;
  2. enrollment options;
  3. definition of eligibility for enrollment;
  4. definition of dependent;
  5. effective date of coverage;
  6. health insurance plan providers;
  7. mid-year changes;
  8. semi-monthly premium rates; and

This booklet is available at attachment .700 of this chapter.

Employees on either voluntary or involuntary Leave Without Pay (LWOP) are permitted to continue their health insurance coverage during the LWOP period. The Division of Human Resources will furnish information to the employee concerning this continuation option. Nine month employees, who are placed on involuntary leave without pay during the summer months, also qualify for continuation of their health insurance coverage.

An employee on Leave Without Pay under the Family and Medical Leave Act (FMLA) provisions is allowed to continue their health insurance coverage under the same conditions and at the same level of employee and employer contributions as would have been provided if the employee had been continuously employed. Employees on FMLA leave will be subject to any change in group health insurance plans or benefits that affect all employees. Employees on FMLA leave will be given notice of any opportunity to change plans or benefits that is available to all employees.

Any individual turning age 65 who is actively employed with the State of Kansas or the employee's spouse who is turning age 65, must select either Medicare -Part B or the State of Kansas group health insurance program as their primary carrier. The employee must complete a Tax Equity and Fiscal Responsibility Act (TEFRA) Health Care Selection form, available in the Division of Human Resources.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows certain individuals the right to continue health insurance coverage under the state program. Employees and their dependents who lose health insurance coverage under the State of Kansas group health insurance program have the right to elect to continue coverage by paying the premiums themselves. The type of continuation is based upon the medical, dental, and/or vision care programs the employee was enrolled in at the time of their employment. If an employee goes on leave without pay and then terminates employment and the employee does not continue group health insurance coverage during the leave without pay period, that employee and any dependents would not be eligible for COBRA continuation because they were not participating in the group health insurance program at the time of the leave without pay.

Group health insurance coverage is discontinued at the end of the month in which the employee leaves the payroll.

Retired employees who receive either KPERS or Board of Regents retirement benefits; who are qualified for KPERS disability benefits; or who are a surviving spouse of such deceased employees may voluntarily continue group health insurance coverage by making premium payments directly to the State of Kansas Division of Personnel Services contracted vendor.

Kansas State University will honor, to the extent possible, the provisions of a Qualified Medical Child Support Order (QMCHO), issued by a district court after July 1, 1994, that does not violate the provisions of the group health insurance program. It will be assumed that the child(ren) will meet the definition of dependent for group health insurance purposes.

In most cases the employee only needs to present his or her medical, dental, or pharmaceutical card to the service provider who will submit claims directly to the insurance carrier. If the employee pays for a service, excluding co-payments, deductibles, and coinsurance, a copy of the itemized bill together with a paper claim form (See Attachment .300) should be sent by the employee directly to the insurance carrier.

The Division of Human Resources is responsible for administering the State of Kansas health insurance program to the following extent:

  1. enrolling newly eligible employees;
  2. changing program participation based upon qualifying events;
  3. terminating coverage;
  4. deducting premiums from employee's paycheck;
  5. collecting premium payments from employees, as necessary;

The Division of Human Resources is not responsible for the specific health care plan provisions, such as: selected medical procedures, claims submissions, etc. The individual program provider is responsible for advising employees about these kind of issues. Employees are to contact their particular health insurance carrier for information concerning specific coverage issues. The health insurance carrier's booklet/certificate lists limitation and general exclusions of coverage.

.060 Insured Death Benefit

Upon the death of an employee, regardless of cause, the insured death benefit provides the employee's named beneficiary 150 percent of the employee's annual rate of compensation. The compensation may be paid in a lump sum, or equal monthly payments for one to twenty years. This coverage is provided to benefits eligible classified and unclassified employees, except those participating in the Kansas Police and Firefighter's (KP&F) retirement plan.

Departments are to immediately notify the Division of Human Resources upon the death of an employee. The Division of Human Resources is responsible for submitting the appropriate documents and beneficiary information to the Kansas Public Employees Retirement System (KPERS). The beneficiary information is that contained on the Designation of Beneficiary (KPERS-7/99) form that the employee completes. An employee may submit a new KPERS-7/99 form naming a different primary and/or contingent beneficiary to the Division of Human Resources at any time. The effective date for the new beneficiary is upon receipt of the KPERS-7/99 form in the office of the Kansas Public Employees Retirement System (KPERS) in Topeka.

An employee who terminates their employment at Kansas State University due to resignation or retirement, has the right to convert all or a portion of his or her insured death benefit from term insurance to an individual life insurance policy without submitting proof of insurability. This conversion option must be elected within 31 calendar days of termination of employment. The insurance underwriter will notify the employee as to the premium amounts, payment methods, etc. The Division of Human Resources will provide the employee with the conversion document upon resignation or retirement.

Alternatively, an employee who terminates their employment at Kansas State University due to resignation or retirement, has the right to continue all or a portion of his or her basic term life insurance coverage under portability provisions without submitting proof of good health, if, at the time of termination of employment, the employee is under age 70. Coverage under the portability provision is reduced to 65% at age 65 and terminates at age 70. The conversion option is available after age 70. This portability option must be elected within 31 calendar days of termination of employment. The Division of Human Resources will provide the employee with the portability document upon resignation or retirement.

The insured death benefit program is paid for by Kansas State University and underwritten by Minnesota Life Insurance Company. A copy of the official certificate of insured death benefit is available from the Division of Human Resources, upon request.

Insured death benefit coverage for employees on Leave Without Pay (LWOP) is administered as follows:

  1. Classified employees:
    1. Voluntary leave without pay (for other than health reasons)—coverage ceases. If for employee's personal health reasons—coverage continues (no cost to the employee)
    2. Involuntary leave without pay—coverage continues (no cost to the employee)
  2. Unclassified employees:
    1. Voluntary leave without pay (for other than health reasons)— employee has the option to continue coverage by paying the premium or forfeit coverage through non-payment of premium. If for employee's personal health reasons— coverage continues (no cost to the employee)
    2. Involuntary leave without pay—coverage continues (no cost to the employee)
.070 Supplemental Life Insurance Plans

Benefits eligible employees have the option to purchase supplemental life insurance. There are two supplemental plans available that allow for premium payment through payroll deduction. These are:

  1. KPERS Optional Group Life Insurance (OGLI), and
  2. Teachers and Employees Association (TEA) of Kansas State University.

Both of these life insurance plans are available to the benefits-eligible employee as an election.

The KPERS Optional Group Life Insurance (OGLI) is a term life insurance plan. This insurance plan is underwritten by Minnesota Life Insurance Company who is under contract with the Kansas Public Employees Retirement System (KPERS) for its administration. Effective January 1, 2004, coverage is available from $5,000 to a maximum of $250,000, in $5,000 increments.

Effective January 1, 2004, enrollment is available as follows:

  1. New Hires --the employee must enroll within 30 days of their appointment date. The employee is guaranteed an issue of $50,000 without proof of insurability with coverage effective the first day of the month following receipt of the enrollment form in the Division of Human Resources, 103 Edwards Hall. Amounts over $50,000 will become effective upon approval by Minnesota Life Insurance Company. The employee pays premiums based on their attained age as of January 1 each year and the amount of insurance coverage purchased.

  2. Current Employees --employees who have not reached the plan maximum may enroll or increase coverage at any time with proof of insurability. Coverage will be effective upon approval by Minnesota Life Insurance Company. Employees (who have not reached the maximum) are eligible for an additional $25,000 guaranteed issue if they experience a birth or adoption of a child, marriage, or change in marital status (divorce or death). This election must be done within 30 calendar days of the event with coverage effective the first day of the month following receipt of the enrollment form in the Division of Human Resources, 103 Edwards Hall. The employee pays premiums based upon their attained age as of January 1 each year and the amount of insurance coverage purchased.

This life insurance plan offers coverage for the employee only.

The beneficiary for this KPERS Optional Group Life Insurance plan will be the same as the employee's beneficiary for the KPERS insured death benefit.

Employees may reduce their coverage level or cancel participation at any time by completing a reduction/cancellation form, available from the Division of Human Resources.

This group term life insurance plan includes conversion privileges. Conversion privileges means that upon resignation of employment or retirement, the employee has the privilege of converting this term life insurance plan to an individual policy through Minnesota Life Insurance Company, without evidence of insurability. The Division of Human Resources will provide the employee with the conversion document upon resignation or retirement. This election must be made within 31 calendar days from the last date the employee is on the participating employer's payroll.

Alternatively, an employee who terminates their employment at Kansas State University due to resignation or retirement, has the right to continue all or a portion of his or her supplemental term life insurance coverage under portability provisions without submitting proof of good health, if, at the time of termination of employment, the employee is under age 70. Coverage under the portability provision is reduced to 65% at age 65 and terminates at age 70. The conversion option is available after age 70. This portability option must be elected within 31 calendar days of termination of employment. The Division of Human Resources will provide the employee with the portability document upon resignation or retirement.

Employees approved for long-term disability through DCG Resource Options, LLC are permitted to continue the KPERS Optional Group Life Insurance plan by paying for their coverage at group rates until: (1) age 65, (2) retirement, (3) recovery from disability, or (4) withdrawal of retirement funds.

Effective July 1, 2003, an Accelerated Death Benefit became available. This benefit applies to both the basic and optional group life insurance plans. If the employee is diagnosed by a physician as being terminally ill with a life expectancy of 12 months or less, the employee may request an Accelerated Benefit payment. An Accelerated Benefit is an advance (before death) payment of a part or all of the employee's life insurance benefit. To qualify for an Accelerated Benefit the employee must:

  1. be insured for at least $10,000; and
  2. be terminally ill (life expectancy 12 months or less); and
  3. send proof to Minnesota Life Insurance Company that their life expectancy, because of sickness or accident, is 12 months or less. This must include certification by a physician. Minnesota Life Insurance Company retains the right to have the employee medically examined, at Minnesota Life Insurance Company's expense, to verify the employee's medical condition.

An Accelerated Benefit is not available if the employee is required by law to use this option to meet the claims of creditors, whether in bankruptcy or otherwise, nor is it available if the employee is required by a government agency to use this option in order to apply for, obtain, or keep a government benefit or entitlement.

If the employee qualifies, it may be either a full or partial Accelerated Benefit. The maximum amount available to take as an Accelerated Benefit is the total amount of the employee's basic and optional insurance combined. A partial Accelerated Benefit can only be requested if the remaining death benefit after the Accelerated Benefit payment will be at least $25,000. If the employee chooses a partial Accelerated Benefit, they may reapply for an accelerated payment of the remaining amount of insurance at any time, though further evidence of eligibility may be requested. If a partial Accelerated Benefit is chosen, coverage will remain in force, and premiums will be reduced accordingly. The remaining amount of insurance will be the full amount of insurance minus the amount of insurance that was accelerated. If a full Accelerated Benefit is chosen, coverage will cease.

Benefits received under the Accelerated Benefit provision may be taxable. Employee should seek assistance from a personal tax advisor prior to requesting an accelerated payment of death benefits.

KPERS Optional Life Insurance (OGLI) coverage for employees on voluntary Leave Without Pay (LWOP) is administered as follows:

  1. Non-FMLA qualifying event -

    1. Employee's participation in the Kansas Public Employees Retirement System (KPERS) retirement plan:

      Employees, except those on military leave, have the option of continuing the KPERS Optional Group Life Insurance, on a premium paying basis, for up to 12 months. After the 12 Month limit, the coverage must be converted to an individual whole life policy in order to retain coverage. If coverage is not continued, coverage will be reinstated to the prior coverage amount if the employee returns to work within three months. If return to work is after three months, the employee may apply for coverage when they do return to work, or at any time thereafter, but there is no guaranteed issue available to the employee. The employee must submit evidence of insurability for all coverage amounts.

    2. Employees participating in the Kansas Board of Regents Retirement Plan:

      Employees, except those on military leave, have the option of continuing the KPERS Optional Group Life Insurance coverage, on a premium paying basis, for the entire approve leave of absence (paid or unpaid). If KPERS Optional Group Life Insurance coverage is not continued, coverage will be reinstated to the prior coverage amount if the employee returns to work within three months. If return to work is after three months, the employee may apply for coverage when they do return to work, or at any time thereafter, but there is not guaranteed issue available to the employee. The employee must submit evidence of insurability for all coverage amounts.

  2. Employee's illness as an FMLA qualifying event -

    The employee will be allowed to continue KPERS Optional Group Life Insurance on a premium paying basis until the earlier of:

    1. recovery,
    2. retirement,
    3. age 65, or
    4. termination of employment, or
    5. withdrawal of KPERS or Kansas Board of Regents retirement funds.

    If coverage is not continued, coverage will be reinstated to the prior coverage amount if the employee returns to work within three months. If return to work is after three months, the employee may apply for coverage when they do return to work, or at any time thereafter, but there is no guaranteed issue available to the employee. The employee must submit evidence of insurability for all coverage amounts.

  3. Family member illness as an FMLA qualifying event -

    KPERS Optional Group Life Insurance may be continued on a premium paying basis for up to 12 months. After the 12 month limit, the coverage must be converted to an individual whole life policy in order to retain coverage. If coverage is not continued, coverage will be reinstated to the prior coverage amount if the employee returns to work within three months. If return to work is after three months, the employee may apply for coverage when they do return to work, or at any time thereafter, but there is no guaranteed issue available to the employee. The employee must submit evidence of insurability for all coverage amounts.

    Employees on involuntary LWOP have the option of continuing their KPERS Optional Group Life Insurance policy by paying the premium directly to the Division of Human Resources or canceling their coverage.

  4. Military leave -

    An employee who is on approved military leave without pay has the option of continuing the KPERS Optional Group Life Insurance on a premium paying basis for up to 12 months while on military leave without pay. The employee pays the premium for this coverage directly to the Division of Human Resources, Kansas State University, by personal check or money order. If after the 12 month period, the employee is still on military leave without pay and wishes to keep the KPERS Optional Group Life Insurance coverage, s/he must convert the coverage to an individual policy. The employee pays the premium for this coverage directly to Minnesota Life Insurance Company. Whether or not the employee exercises these options, the employee on military leave without pay is immediately entitled, upon timely return to state employment, to his/her former level of optional coverage. Premiums will be based on the employee's age at the time of return to state employment.

The Teachers and Employees Association (TEA) of Kansas State University offers a term life insurance plan. Member coverage is available from $10,000 to $250,000 in $5,000 increments, not to exceed five times the employee's annual salary. Benefits eligible employees may enroll in TEA for up to $50,000 term life insurance coverage, if elected within 31 days of their hire date, without proof of insurability. Members may enroll or increase their level of coverage up to $20,000, without proof of insurability, within 30 days of marriage, change in marital status, birth or adoption of a child. Applications submitted at any other times will require proof of insurability. Metropolitan Life Insurance Company, the insurance plan underwriter, reserves the right to order medical tests necessary to determine insurability.

This life insurance plan offers coverage for the employee's spouse and children as well as the employee.

TEA life insurance for a spouse has three levels of coverage:

 SpouseChildren
a. Level I
$4,000
scaled by age
b. Level II
$10,000
$5,000 per child
c. Level III
$25,000
$5,000 per child

Note:
Level I coverage requires the employee to be enrolled for at least $10,000 of term life insurance.
Level II coverage requires the employee to be enrolled for at least $20,000 of term life insurance.
Level III coverage requires the employee to be enrolled for at least $50,000 of term life insurance.

The premium is based upon the employee age, the amount of coverage selected, and whether or not spouse and children coverage is selected.

This plan has a continuous open enrollment.

Coverage commences upon acceptance of the enrollment form, payment of the one-time processing fee of $3.00 and approval of the application by Metropolitan Life Insurance Company. If approved, coverage is effective the first day of the month following notification by Metropolitan Life Insurance Company of acceptance.

Employees may reduce their coverage level or cancel participation by submitting a letter stating their intention to the Division of Human Resources.

Effective November 1, 1998, an Accelerated Benefits Option (ABO) became available to the TEA member and spouse, but not the children. This option applies only to those TEA members with insurance coverage of at least $10,000. Under the ABO, a TEA member may receive an accelerated benefit of up to 75 percent of their life insurance coverage (less an 8% administrative fee) if, as a result of an injury or sickness, they are diagnosed as terminally ill, with six months or less to live, and from which there is no reasonable prospect of recovery. This same option and conditions are available to those with spouse coverage. Claims for this provision are subject to an independent medical review and approval by Metropolitan Life Insurance Company. Payment will be made in a lump sum. The remaining life insurance proceeds will be reduced by the amount of the accelerated benefit payment. Premiums will be reduced to correspond with this new, lower face amount. This Accelerated Benefit Option purposely does not allow a full payment of total life insurance coverage before death. This assures that the life insurance coverage continues to serve the function for which it was intended and helps ensure that beneficiaries receive some benefit at the time of death. Accelerated benefit payments can be used to help pay catastrophic health care bills or nursing home expenses that could otherwise deplete a well-planned estate. The payments may also provide funds for necessary living expenses that are lost when income is reduced upon disability.

This group term life insurance plan includes conversion privileges. Conversion privileges means that upon resignation of employment, the member has the privilege of converting this term life insurance plan into an individual, whole life policy through Metropolitan Life Insurance company. Upon retirement, the member has the privilege of continuing this life insurance plan through TEA; however, the face value of the insurance is reduced to a maximum of $10,000 if age 69 and under or $2,000 if age 70 and over. Spouse and children coverage is reduced to $1,000 each.

.090 Unemployment Insurance Program

Unemployment insurance is an insurance program that provides temporary, weekly unemployment checks to qualified unemployed workers. Unemployed workers must meet specific eligibility requirements in order to receive unemployment benefits. Kansas State University, as an employer, participates in this program; however, it is administered by the State of Kansas Department of Human Resources.

The Kansas Employment Security Law was enacted to provide some income during limited unemployment of those individuals who are unemployed due to conditions in the economy or labor market and through no fault of their own. Unemployment insurance pays benefits to qualified unemployed workers until they are recalled by the employer; until they find jobs for which they are reasonably suited in terms of training, past experience, and past wages; or until they reach the maximum benefit payable.

For further information about unemployment insurance, contact:

State of Kansas
Department of Human Resources
401 S. W. Topeka Boulevard
Topeka, Kansas 66603-3182

.100 Worker's Compensation Program

Employees of Kansas State University, including student employees, are provided protection under the Worker's Compensation Act. Employees appointed to positions with Federal benefits are covered by the State of Kansas Worker's Compensation program for any job-related injuries or accidents occurring after February 1, 2003.

The State Self-Insurance Fund office at the State of Kansas Department of Administration is responsible for determining compensability and providing benefits contained within the Worker's Compensation Act for the majority of state agency and Kansas Board of Regents employees. The Division of Human Resources at Kansas State University has been designated as the contact with the Department of Administration for reporting all accidents. Worker's Compensation claims for Kansas State University employees will be submitted to the State Self-Insurance Fund in Topeka, Kansas.

Reporting accidents/injuries— work related accidents, injuries, or occupational diseases must be reported for all faculty, staff, and student employees injured while performing the duties of their employment, regardless of where the situation occurs. All on-the-job accidents and injuries must be reported by the supervisor or other authorized person to the Division of Human Resources during regular business hours or as soon thereafter as possible. This initial reporting must be done by telephone (785-532-1873) or by e-mail to BENEFITS@KSU.EDU Any supervisor who hears or knows of an accident should inquire directly of the employee and make the necessary report.

The following information is required when reporting the accident/injury by telephone or e-mail:

  1. First and last name of person making the report
  2. Business telephone number of person making the report
  3. Department or unit of injured employee
  4. First and last name of injured employee
  5. Employee ID number of injured employee
  6. Date of accident/injury
  7. Medical treatment required: Yes or No
  8. Time loss: Yes or No
  9. Business telephone number of injured employee
  10. Home telephone number of injured employee
  11. Name of injured employee's supervisor
  12. Business telephone number of injured employee's supervisor

The "Accident/Injury Report" (PER-17) form is to be completed by or for the injured employee, signed by the department head or designated official, and submitted to the Division of Human Resources within 3 working days of the accident/injury. Upon receipt of the PER-17 form, the Division of Human Resources will report the accident/injury to the State Self-Insurance Fund. Failure to report work related accidents/injuries within the required time limit may result in denial of benefits.

Medical attention — the Worker's Compensation insurance carrier has the right to select the doctor who will treat the injury. In some areas, the injured employee will be directed to a contracted provider. The following list identifies the medical facilities acceptable by the State Self-Insurance Fund where injured employees are to receive medical attention for on-the-job accidents/injuries:

  1. Manhattan and close surrounding area -
    1. Life threatening injury or illness- call 911 or report directly to the Emergency Room- Mercy Regional Health Center, 1823 College Avenue.
    2. Non-life threatening injury or illness- treated at Occupational Health- Mercy West, 315 Seth Child Road, from 8:00am - 5:00pm, Monday-Friday. For non-life threatening injuries or illnesses occurring on other days of the week or times of day, call the 24-hour Occupational Health Hot Line at 785-323-6000 or toll free at 866-323-6003.
  2. Lawrence and close surrounding area - Lawrence Memorial Hospital;
  3. Kansas City general area - University of Kansas Hospital or KU Med West;
  4. Topeka - St. Francis Hospital and Medical Center;
  5. Winfield and general surrounding area - William Newton Memorial Hospital;
  6. Wichita and close surrounding area - Wichita Clinic and after hours to Wesley Hospital; and
  7. in the rest of the State of Kansas - go to primary care physician or a nearby hospital emergency room.

An injured employee may seek the services of any other provider, but if the claim is determined to be compensable, those services may be considered unauthorized and payment will be limited to a maximum of $500. If an employee is not satisfied with the treatment/diagnosis received by a contracted or authorized provider, they should contact their Worker's Compensation claims adjustor at (785) 296-2364. Direct telephone calls may be made from the employee's department. The State Self-Insurance Fund office will not accept collect telephone calls.

Disability compensation— after being reviewed by a claims adjustor/investigator, if a claim is determined to be compensable and the injured employee's medical restrictions cannot be accommodated by the employer, the injured employee may be entitled to disability benefits. The employee is not entitled to this benefit for the first week they are off work, unless they are off work three consecutive weeks. Thereafter, payments shall be made in a sum equal to 66 2/3% of the employee's gross average weekly wage, but not to exceed the maximum benefit provisions of the Worker's Compensation Act. Payments will be made within the normal biweekly pay periods on or about the regular pay dates. Reimbursement for travel to obtain authorized medical treatment is payable at a mileage rate set by the Worker&'s Compensation Act. Round trips that exceed five miles are reimbursable.

The time away from work for an employee to receive the initial evaluation, care and treatment for a job related injury or illness under the Worker's Compensation Program is not chargeable to the employee's accrued leave credits. Any time away from work after the initial evaluation, care and treatment for a job related injury or illness under the Worker's Compensation Program, including any follow-up appointments, care or treatment, is charged to the employee's accrued leave credits in the following order: sick leave, vacation leave, and holiday compensatory time, unless the employee elects in writing, to use leave credits in a different order or requests to be placed on leave without pay.

Employees who are awarded Worker's Compensation pay are granted, at the employee's election, use of accumulated leave to pay the difference between their regular pay and the Worker's Compensation pay. Normally, leave credits are used in the following order until exhausted: sick leave, vacation leave, and holiday compensatory leave.

The employee may submit a written request to the Division of Human Resources to use their leave credits in a different order or to not use accumulated leave credits to pay the difference between their regular pay and the Worker's Compensation pay. Worker's Compensation hours are credited back to the employee's leave balances in quarter-hour increments.

Family Medical Leave Act (FMLA) - if the work related injury for which the employee is receiving Worker's Compensation meets the criteria of a "serious health condition" as set forth in the KSU Policy and Procedures Manual 4860 (Classified Employee Leaves) and 4865 (Unclassified Employee Leaves) chapters, the time that the employee is off work (i.e. the time covered by Worker's Compensation and any accrued leave) will be counted as part of the employee's 12-workweek FMLA leave entitlement.

Return to work - promptly contact the Division of Human Resources when an employee returns to work from a job-related accident or injury, with or without restrictions, full-time or part-time. This may be done by telephone (785-532-1873) or be e-mail at BENEFITS@KSU.EDU.

Fraud and abuse— the Worker's Compensation Act contains penalties for acts of fraud or abuse. Anyone making false reports, working while drawing disability benefits, or otherwise abusing the Worker's Compensation system, are to be reported by calling 1-800-613-0014.

.110 Questions

Questions regarding these programs should be addressed as follows:

  1. Death benefits, disability, group health insurance, life insurance, long-term care and Worker's Compensation to Benefits Administration at (785) 532-6277.
  2. Unemployment insurance to Payroll and Employment Data at (785) 532-6277.
  3. Federal benefit programs to the Division of Cooperative Extension Operations office at (785) 532-5790.