Insurance

Eligibility

All regular (non-student), staff and faculty employees that are employed by the university at least .50 FTE (half-time) for a definite period of 4 1/2 months or a full semester of more than 4 months.

An insurance eligible graduate student is defined as one not eligible for participation in the Teacher Retirement System of Texas (TRS), but as a condition of employment must be enrolled in graduate level courses at the university, and employed by the university at least .50 FTE. Eligible graduate students must be appointed with a student job title that has an employee class designation of “GA” which means graduate position.

Dependents Eligible to be Covered

  • Your lawful spouse, including common-law marriage.
  • Any eligible dependent child(ren), up to age 26. Child dependent can be married or unmarried to be covered on health, but must be unmarried to be covered on optional coverage.
  • Any disabled dependent, age 26 and over.

Coverages

Effective Date

Full-time employees health insurance begins on the date of hire; however, part-time employee have a 60-day waiting period for health insurance. Optional coverages for full-time and part-time can begin on date of hire.

Details

  • Health

    Sam Houston State University offers benefits eligible employees a comprehensive health insurance package that includes medical, prescription drug coverage, and a $5,000 basic group term life insurance.

    Cost

    SHSU covers the employee’s medical premium. Employees are responsible for optional selections and family premiums. Currently, the state pays 100% of the health plan premium for eligible full-time employees and 50% of the premium for their eligible dependents. For eligible part-time employees the state pays 50% state contribution for the eligible part-time employee and 25% for their dependents.

    Plans

    HealthSelect of Texas (A network-based point-of-service plan)

    Consumer Directed HealthSelect

    Scott & White Health Plan - HMO

    Coverage Comparison Chart

    HealthSelectShoppERSSM

    HealthSelectShoppERSSM is an incentive program that allows you to save money and rewards when shopping for certain medical services and procedures. This program allows you to

    • compare costs for many health care services and procedures,
    • estimate your out-of-pocket costs and
    • earn incentives for shopping for certain medical services and procedures.

    Program Details
  • Dental

    Sam Houston State University offers optional dental coverage options.

    Cost

    Employees are responsible for the monthly premium.

    Plans

    State of Texas Dental Choice Plan - Delta Dental

    DeltaCare USA DHMO

    Coverage Comparison Chart

  • Vision

    Sam Houston State University offers an optional vision coverage option.

    Cost

    Employees are responsible for the whole premium.

    Plans

    State of Texas Vision – Superior Vision Services

    Coverage Chart

  • Life Insurance

    Sam Houston State University offers basic and optional for eligible employees.

    Cost

    Employees are responsible for the monthly premium. Premium is based on salary and age of the employee.

    Plans

    Basic term life is a $5,000 basic group term life insurance, includes $5,000 of accidental death & dismemberment (AD&D) coverage, is included with health coverage.

    Optional Term Life Insurance provides additional coverage, including AD&D coverage, up to four times your annual salary (Election 1, 2, 3 or 4). Maximum coverage is $400,000. The monthly premium is based on your coverage election, your salary and your age. Coverage begins to decrease when you reach age 70.

  • Disability Insurance

    Sam Houston State University offers optional short-term and long-term disability insurance.

    Cost

    Employees are responsible for the whole premium. Premium is based on the employee’s salary.

    Plans

    Short-term disability provides a maximum benefit of 66% of the employee’s monthly salary up to $10,000 ($6,600 per month (66% of up to $10,000 of salary to a maximum benefit of $6,600). The waiting period is 30 days or sick time, whichever is longest, and is payable up to five months.

    Long-term disability provides a maximum benefit of 60% of the employee’s monthly salary up to $10,000 ($6,000 per month (60% of up to $10,000 of salary to a maximum benefit of $6,000). The waiting period is 180 days or sick time, whichever is longest, and is payable until employee returns to work or reaches the Maximum Benefit Period (based on the age the employee becomes disabled.

    ERS Overview

  • Flex Spending Accounts

    Sam Houston State University offers TexFlex flexible spending accounts for eligible employees.

    Cost

    Employees are responsible for the amount they elect.

    Plans

    TexFlex HealthCare Account can be used to pay for eligible medical, dental, vision, hearing, and prescription drug expenses.

    Dependent Care Account can be used to pay for eligible day care, day camp, sports camp, nursery school, private sitter, and before and after-school care for dependent children under age 13. Tuition is not eligible and must be billed separate from before and after-school care. It may be used to pay for care of dependents of any age who is mentally or physically incapable of caring for himself or herself, and comply with other IRS requirements, including adult custodial care programs for qualifying individuals.

    Limited FSA can be used to pay for eligible vision and dental expenses not covered by insurance. Must be enrolled in Consumer Directed HealthSelect.

    Eligible Expenses

Premium Assistance

Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Premium Assistance With Medicaid and the Children’s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children are not eligible for Medicaid or CHIP, you will not be eligible for these premium assistance programs. If you or your dependents are already enrolled in Medicaid or CHIP, contact your State Medicaid or CHIP office to find out if premium assistance is available.

HIPP is the Texas Medicaid program that helps families pay for employer-sponsored health insurance premiums. It is for families with at least 1 person who gets Medicaid.

Get HIPP 1-800-440-0493

Changing Your Benefits

There are three opportunities to change your insurance benefits; within 31 days as a newly eligible employee, summer enrollment, or within 31 days of a qualifying life event

Summer Enrollment

Our annual benefit election period that occurs during summer months.

Summer Enrollment

Qualifying Life Event

A change in your personal or work life impacts your benefit elections. Qualifying Life Events are

  • Marriage
  • Birth
  • Adoption
  • Death
  • Spouse/dependent loss of other health insurance coverage
  • Gain or loss of legal custody of a dependent

Life Changes

Benefits Questions?

Holly King

Email 4-2637

Christina Munoz

Email 4-2231