Health PlanTexas Biomedical Research Institute is pleased to offer all eligible employees, who work 20 or more hours per week to include dependents up to age 26 and domestic partners the choice of three BlueCross BlueShield medical plans; Mid Plan, High Plan and a High-Deductible HSA Plan. These plans allow the freedom to choose any physician, hospital or medical service provider or to utilize the network of service providers. Texas Biomedical is a tobacco-free campus and tobacco users pay $25 more per pay period for insurance coverage.

Below is a high-level overview of plan similarities and differences.

Plan Details LOW Plan

$3,000 HDHP/HSA

MID Plan

$1,000 PPO

HIGH Plan*

$500 PPO

Calendar Year Deductible (Individual/Family) $3,000/$6,000 $1,000/$2,000 $500/$1,000
Out-of-Pocket Limits (Individual/Family)

Includes copays, coinsurance and deductible charges

 

$4,000/$8,000 $4,500/$9,000 $4,500/$9,000
MEDICAL SERVICES
Network Blue Choice PPO Blue Choice PPO Blue Choice PPO
Preventive Care No charge No charge No charge
Physician Office Visit 0% after deductible $25 copay $25 copay
Specialist Office Visit 0% after deductible $50 copay $50 copay
Urgent Care 0% after deductible $75 copay $75 copay
Virtual Visits (Telephonic) $44 charge towards ded. $25 copay $25 copay
Emergency Room 0% after deductible $250 copay; 20% after ded. $250 copay; 20% after ded.
ER Physician Services 0% after deductible 20% after deductible 20% after deductible
Hospitalization 0% after deductible 20% after deductible 20% after deductible
Out-Patient Procedures 0% after deductible 20% after deductible 20% after deductible
Complex Imaging/Diagnostics 0% after deductible 20% after deductible 20% after deductible
Non-Network Benefits  
Deductible

Coinsurance

Maximum out of Pocket

$6,000/$12,000

70%/50%

$8,000/$16,000

$2,000/4,000

70%/50%

$11,000/$22,000

$5,000/$10,000

70%/50%

$10,000/$20,000

Pharmacy Benefits
RX Deductible Yes, Deductible has to be met prior to copayments No No
Generic $10 $10 $10
Preferred Brand $35 $25 $25
Non-Preferred Brand $60 $50 $50
Mail Order (90 Day Supply) 2.5 x copay 2.5 x copay 2.5 x copay
Choosing Brand over Generic No penalty If member elects brand over generic when not medical necessary, member pays the difference between the cost of the brand and generic plus brand copay. If member elects brand over generic when not medical necessary, member pays the difference between the cost of the brand and generic plus brand copay.

All medical plans offer preventive care covered at 100%.

This applies only when these services are delivered by a network provider. For more details about federally mandated preventive services, visit www.healthcare.gov

Depending on your age, you may have access — at no cost — to preventive services such as:

  • Blood pressure, diabetes, and cholesterol tests
  • Many cancer screenings, including mammograms and colonoscopies
  • Counseling on topics such as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use
  • Regular well-baby and well-child visits
  • Routine vaccinations against diseases such as measles, polio, or meningitis
  • Counseling, screening, and vaccines to ensure healthy pregnancies
  • Flu and pneumonia shots

Texas Biomed also offers a variety of choices where to seek cost effective medical attention.

Telemedicine: The licensed physicians, nurses and physicians assistance can diagnose non-emergency medical problems, recommend treatment, and even call in a prescription to your pharmacy. $44 on the HDHP Plan and $25 on the Mid/High Plan.

Fetch MD: FetchMD allows you to be seen by a medical clinician in the comfort of your home or office. Appointments can be scheduled for same-day via mobile app.  Fetch MD is partnered with HEB, allowing free delivery of prescribed medications. House call is $95 but Texas Biomed pays $50 for all employees including dependents on our medical plan. Your $45 fee is due at time of visit.

Vision

Voluntary vision coverage is provided through VSP (Sun Life) and is offered under the same circumstances as healthcare. Employee and eligible dependents can receive an eye examination ($10 co-pay) and standard lenses ($25 co-pay) annually and frames allowance of $130 every 24 months or contacts every 12 months.

Dental

Dental coverage is provided by SunLife and is offered to employees who work 20 or more hours per week, dependents up to age 26 and domestic partners. The plan allows the freedom to choose any dentist (Buy-Up High plan) or to use a network dentist (Base Low plan). There is a $50 individual and $150 family deductible on basic and major services and a $2,000 lifetime maximum orthodontia for child dependents.

Education

  • Texas Biomed provides reimbursement for covered educational expenses in order to encourage employees to further their education. Policy covers college courses and job related trade, technical or vocational school courses taken either in residence or through distance learning (on-line, etc.) provided the same criteria as residence courses is met.
  • You are eligible for the educational assistance program after 90 days of employment. You must submit your Supervisor approved request for tuition reimbursement to the Human Resources office before your first day of class. The Institute reserves the right to request proof of an institution’s accreditation prior to approval of the application. Proof of course completion and acceptable passing grade must be submitted before reimbursement is paid.
  • Reimbursement for college courses and required materials for full time employees will be up to a maximum of $5,250 per calendar year and part time employees a maximum of $2,625 per calendar year.
  • Courses DO NOT have to be related to your job.
  • You may also attend job-related training programs funded by your department with the approval of your supervisor and department chair/administrative director.

Vacation Time

  • Vacation time is prorated during first calendar year of employment and thereafter earned based on the following schedule:
    • 2 weeks per year during first 3 years
    • 3 weeks per year during 4th-15th years
    • 4 weeks per year during 16th plus years
    1/24 of vacation accrual will be earned each pay period.
  • You cannot carry more than two years’ worth of earned vacation into a new vacation year.

Sick & Emergency Leave

  • Sick leave is accrued each pay period based on hours worked. Leave should be used for personal illness and doctor appointments.
  • Emergency leave is drawn from accrued sick leave. Leave can be used for family member illness, death or other unavoidable short- term emergency. Approved at the discretion of Supervisor.

Retirement

  • Texas Biomed provides a defined contribution through a 403(b) plan (TIAA). The plan is available to all eligible employees immediately upon employment.
  • Texas Biomed contributes an amount equal to 7% of the employee’s gross pay each payday. The contribution increases to 8% after 5 years of service, and 9% after 10 years. Contributions and earnings will be 100% vested after 3 years of eligible service.
  • Texas Biomedical Research Institute Amended Retirement Plan and Trust
  • Supplemental Retirement Annuity is optional for voluntary contributions.

Life Insurance

  • Texas Biomedical provides basic life and AD&D at no cost to you through SunLife.
  • In the event of employee death, the plan would pay beneficiary a benefit of 2x an employee’s basic annual earnings (maximum $500,000) for natural death.
  • Accidental death insurance pays an additional two times an employee’s annual salary (maximum $500,000) for a total accidental death benefit of four times an employee’s salary.
  • Voluntary Life and AD&D is available.
  • Long-term disability is provided by SunLife at no cost. 66.67% of income will be replaced after 90 waiting period, paid monthly.
  • Voluntary short-term disability is optional and available 14 days after doctor places you on medical leave. Benefit duration is 11 weeks.
  • Voluntary Critical Illness, Accident and Home & Auto plans are offered by Sun Life

Holidays

Floating Holiday To be used for personal celebration
New Years Day January 1, 2020
Memorial Day May 25, 20120
Independence Day July 3, 2020
Labor Day September 7, 2020
Thanksgiving Day November 26, 2020
Thanksgiving (Day after) November 27, 2020
Christmas Eve December 24, 2020
Christmas Day December 25, 2020
Winter Recess December 28,2020
Winter Recess December 29, 2020
Winter Recess December 30, 2020
Winter Recess December 31, 2020

Paydays

Employees are paid 24 times a year on the 7th and 22nd.