Texas 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. 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||Smart Saver Plan HDHP/HSA||Comprehensive PPO Plan||Platinum PPO Plan|
|Calendar Year Deductible (Individual/Family)||$3,000/$6,000||$1,500/$3,000||$500/$1,000|
|Out-of-Pocket Limits (Individual/Family)
Includes copays, coinsurance and deductible charges
|Network||Blue Choice PPO||Blue Choice PPO||Blue Choice PPO|
|Preventive Care||Covered at 100%||Covered at 100%||Covered at 100%|
|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||$50 copay||$50 copay|
|Virtual Visits (Telephonic)||$44 charge towards ded.||$25 copay||$25 copay|
|Emergency Room||0% after deductible||$400 copay; 20% after ded.||$400 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|
Maximum out of Pocket
|RX Deductible||Yes, Deductible has to be met prior to copayments||No||No|
|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.
Web MD/Nurse Line: 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.
Voluntary vision coverage is provided through VSP (MetLife) 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 coverage is provided by MetLife 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.
- 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.
- PTO time is prorated during first calendar year of employment and thereafter earned based on the following schedule:
• 15 days per year during first 3 years
• 20 days per year starting 3rd year through 14th year
• 25 days per year beginning 15th year
- PTO must be taken within 1 1/2 years of accrual and 1 1/2 times can be carried over
Extended Illness Benefit
- Extended Illness Benefit (EIB) is to provide continuation of pay for employees who are unable to work due to an extended illness and/or to care for immediate family (children and/or spouse) due to a long term illness.
- The EIB is paid if the employee is out of work for four (4) or more consecutive days for a long term illness and/or injury.
- Employees accrue 2.33 hours per pay period for a max annual accural of 7 days a year. Total Maximum Accural: 130 days
- Employees may take a maximum of 3 paid workdays off when a death occurs in the immediate family. This is independent of PTO/EIB.
- Immediate family is combined and defined as follows: Employee’s spouse, domestic partner, child, parent, sibling, step-parent, step-child, mother-in-law, father-in-law, brother in-law, sister in-law, son-in-law, daughter-in-law, grandparent, grandchild or uncle/aunt.
- 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 provides basic life and AD&D at no cost to you through Reliance Standard.
- 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 Reliance Standard 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 also offered by MetLife.
|Floating Holiday – To be used for personal celebration within the calendar year|
|New Years Day|
|Thanksgiving (Day after)|
|Winter Recess (Christmas Eve to New Years Day)|
Employees are paid 24 times a year on the 7th and 22nd.