Explanation of the
STAFF BENEFITS STATEMENT
THE UNIVERSITY OF WISCONSIN SYSTEM
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Your UW Staff Benefits Statement is produced every April by the UW-Madison, Office of Human Resources. The statement provides an overview of your benefit plan enrollments, level of coverage, projected annual deduction costs, and the projected annual UW contribution. The deduction and UW contribution amounts shown are projected for the calendar year and are based on the assumption that your salary and benefit costs remain the same for the remainder of the year. The statement does not show all deductions; not shown are parking, union dues, charitable contributions, credit union transfers and other miscellaneous deductions.
Review Your Statement
The top section of your statement includes the statement date, your UW System campus, your Unit-Division-Department Number, your name, your Person ID Number, and your birthdate.
The following information will help you check your benefit plan participation and level of coverage: your UW Staff Benefits Statement, your Earnings Statements (found at My UW, under the Work Record tab) and the benefit plan premium tables listed below.
For information about UW-Madison employee benefits plans, visit benefits.wisc.edu
E-mail your questions to the Office of Human Resources at benefits@ohr.wisc.edu
Statement Information
Benefit Plan Participation:
The titles of all benefit plans, organized by category, are displayed in the left text box. Your projected annual deduction and UW contribution amounts are displayed for your active plans in the Contribution columns. Your coverage information is displayed in the left text box and in the Coverage column.
Your Annual Contribution column:
If a benefit plan deduction is active, the amount that you are contributing is annualized by multiplying the April deduction amount by 12. Pending deductions for newly enrolled employees will not appear on the statement.
University Annual Contribution column:
If a benefit plan deduction is active, the amount that the university is contributing is annualized by multiplying the April employer contribution amount by 12.
Coverage column:
If a benefit plan deduction is active, your type or level of coverage is displayed. For most plans, if you are not enrolled in the plan, the Coverage column displays “NONE”. If your spouse is a UW or state employee, and covers you under their benefit plan, your statement will indicate “NONE”.
Your Security TodayHealth Care Benefits
State Group Health Insurance | It’s Your Choice 2009 | Standard Plan
- Health Plan Name: based on your selection (displayed if you are enrolled).
- Coverage column: Single, Family or NONE.
Dental - Excess Medical Insurance (EPIC) | Plan Brochure
- Coverage column: Single, Two Persons, Family or NONE.
Dental Insurance (Union or UW Plans)
- Dental Insurance Name: Union or UW sponsored (displayed if you are enrolled).
- Coverage column: Coverage is in effect unless NONE is printed one the statement.
Dental Insurance-Union
- To determine your coverage use your Earning Statements (found at My UW, under the Work Record tab) and the premium table located at:
Union Represented Dental Monthly Rates
Dental Insurance-UW – Anthem DentalBlue | Plan Brochure
- To determine your coverage use your Earning Statements (found at My UW, under the Work Record tab) and the following premium table:
| Coverage/Annualized Premium* | Dentacare HMO Region 1 |
Dentacare HMO Region 2 |
Preferred PPO Region 1&2 |
Supplemental Plan Region 1&2 |
| Employee | $279.24 | $345.36 | $282.12 | $199.08 |
| Employee & 1 | $558.60 | $690.72 | $564.12 | $398.28 |
| Employee & 2+ | $893.64 | $1105.20 | $930.72 | $597.60 |
Vision Insurance (OptumHealth) | Plan Brochure
- Coverage column: Coverage is in effect unless NONE is printed one the statement.
- To determine your coverage: use your Earning Statements (found at My UW, under the Work Record tab) and the following premium table:
| Coverage/Premium | Monthly | Annualized |
| Employee | $5.83 | $69.96 |
| Employee + Spouse/Domestic Partner | $11.34 | $136.08 |
| Employee + Children | $11.88 | $142.56 |
| Employee + Family | $17.82 | $213.84 |
Income Protection Benefits
Income Continuation Insurance | Plan Brochure
Coverage column: Coverage is in effect unless NONE is printed one the statement.
Classified Staff
- Premium Categories: 1, 2, 3, 4, 5, or 6
Classified premium tables: Standard | Supplemental
Your premium is based on your salary and your sick leave balance as of the end of the previous calendar year. - If you have supplemental coverage, it will be displayed on your statement.
Unclassified Staff (Academic Staff and Faculty)
- Elimination Period: 30, 90, 125 or 180 days
Unclassified premiums tables: Standard | Supplemental
Your premium is based on your salary and your selected elimination period.
If you selected early coverage (prior to the employer contribution; month 7-12), the coverage will not be shown on your statement. - If you have supplemental coverage, it will be displayed on your statement.
Survivor Benefits
State Group Life Insurance | Plan Brochure
- Your premium is determined by your age and the number of units of coverage that you selected.
- Each unit of coverage is based on your highest Wisconsin Retirement System reportable earnings rounded to the next $1,000. Spouse and dependent coverage is combined; you can not select spouse only or dependent only coverage.
- The first line displays the employee’s coverage amount.
- The second and third line displays the spouse and dependent coverage amounts; coverage amounts are displayed for both, even if only one may be applicable.
- If you turn age 70 in April, May, or June, your coverage amount is not displayed.
University of Wisconsin Employees, Inc. | Plan Handout
- Your premium and coverage amount is based on your age as of May 1 of the current calendar year; premium changes are applied in April for May coverage.
- Your premium and coverage amount is displayed.
Individual & Family Group Life Insurance | Plan Brochure
- Your premium and coverage amount(s) is based on your age and the level of coverage that you selected. If you changed your coverage during the annual increase option period, the coverage will be effective on May 1 and therefore will not be reflected on your statement.
- The first line displays the employee’s level of coverage.
- The second and third lines display the level of coverage for your spouse / domestic partner and children, if applicable.
Accidental Death & Dismemberment | Plan Brochure
- Coverage column: The coverage amount is displayed or NONE.
- Your premium is determined by the coverage type (Employee Only or Family Plan), and the coverage amount that you selected.
- Your premium and coverage amount is displayed.
- To determine your coverage type (Employee Only or Family Plan): use your Earning Statements (found at My UW, under the Work Record tab) and the premium table found in the plan brochure.
University Insurance Association | Plan Fact Sheet
- Coverage column: The coverage amount is displayed.
- Participation in this insurance plan is mandatory for all eligible Unclassified employees. Classified employees are not eligible for this plan.
- Your coverage amount is based on your age as of October 1, the beginning of the policy year.
- Your premium and coverage amount is displayed.
Retirement
Wisconsin Retirement System (WRS) | WRS Benefit Summary
- See your WRS Annual Statement of Benefits for detailed information regarding your account. The WRS statement is produced every April by the Department of Employee Trust Funds (ETF).
- Contributions include both employee and employer required contributions. The UW pays both amounts on your behalf. In addition to the WRS contributions, the UW pays a percentage of your salary to pre-fund the Accumulated Sick Leave Conversion Credit and Supplemental Sick Leave Conversion Credit programs to pay for your health insurance premiums upon retirement.
IRS Pension Plan Limitations for 2009
- Employees who started WRS covered employment in 1996 or later, and who are affected by the IRS earning and contribution limits (for 2009, earnings of $245,000 or more), will have their WRS contributions overstated on the UW Staff Benefits Statement.
- For 2009, the annual compensation limit under Sections 401(a)(17) was increased from $230,000 to $245,000.
Social Security
Social Security Administration | Web Site
- You and the UW each contribute to your social security account at the rate of 6.2% of earnings up to a maximum of $106,800. 1.45% of your total income is contributed by both you and the UW to the Medicare program (no earnings maximum).
- See your annual Social Security Statement, mailed to you by the Social Security Administration (for workers aged 25 and older), for detailed information about your account.
- This section displays your active plan participation and the deduction amount by pay period for the following plans:
Employee Reimbursement Accounts | Plan Brochure
Tax Sheltered Annuity 403(b) Plan | Quick Guide
Wisconsin Deferred Compensation | Web Site
IMPORTANT - PLEASE NOTE: While every effort has been made to report information accurately, the legal documents, policies, or certificates pertaining to the benefits would prevail in the event of discrepancy. THIS STATEMENT IS NOT A LEGAL DOCUMENT.
The amounts shown are projected for the calendar year assuming your current salary and benefits will remain the same. If you have elected early coverage in the health or income continuation insurance program, this statement may reflect that you are paying the total cost. However, after you complete the qualifying period, the University will pay part or all of the cost. Future statements will reflect those changes.