Tulane Medical

Blue Cross Blue Shield 

Tulane University currently offers three medical plans: the High Deductible Health Plan (HDHP), the Health Reimbursement Account Plan (HRA), and the Point of Service Plan (POS) through Blue Cross Blue Shield. Please be aware that all newly hired benefits-eligible or new-eligible employees are automatically enrolled in the HRA plan. Employees have the option of declining, switching, or staying in this plan within thirty days of the new hire or newly eligible status date.

Blue Cross Blue Shield makes it easy to find answers about your benefits. My Health Toolkit App is a one-stop destination for managing those benefits. Check out the flyer below for details.


My Health Toolkit App

Health Toolkit App


Eligibility 

You are eligible to enroll in medical benefits if the below applies:

  • An employee scheduled in HCM to work 18.75 hours or more per week
  • A full-time employee scheduled to work with the university for no less than 7 months
  • A part-time employee working at least 50% of a full-time schedule and expected to work no less than 7 months

These requirements apply to faculty, staff, administrators, librarians, post-doctoral fellows, and expatriates.

Prescription Drug Plan

All three medical plans include the same prescription drug benefits, which are administered through OptumRx Pharmacy. All medical and prescription co-payments, deductibles, and co-insurance payments go towards satisfying your out-of-pocket maximum.

Your copayment and/or coinsurance are determined by the tier to which the drug is assigned on the Prescription Drug List (PDL). To determine tier status and search for network pharmacies, log on to MyHealthToolkitla.com or call the Customer Care number on your medical ID card.

Prescription Drug Plan

Prescriptions Table

    *The HDHP does not have co-pays; you will pay the full price for prescriptions until the deductible is met. Once the deductible is met, you will pay 20% in coinsurance.


     

    Alternative Options 

    To view alternative health insurance options through the Health Insurance Market, click here.


    Tulane Wellness & Annual Health Incentive

    All of Tulane's medical plans are able to earn wellness incentives through the new TU Wellness Program through WellRight. Visit the page for more information on how to earn these rewards now!

    Additionally, the Department of Campus Recreation, in collaboration with TU Wellness and the Living Well Clinic, is thrilled to provide an opportunity for Tulane University employees to reduce health risk factors and enhance overall well-being through a comprehensive Employee Health Improvement Program (EHIP). This 10-week initiative includes three group training sessions per week, led by a certified personal trainer. Click here to learn more. 


    Partnership with Tulane Doctors

    • Tulane Doctors offers Tulane employees a concierge service to help them get same-day or next-day appointments
    • Employees can call 1-504-988-TUMD (8863). The service line is open Monday through Friday, from 9 a.m. to 4 p.m. (CT).
    • Office visit copays for both primary care and specialist providers with Tulane Doctors will be reduced by $20 in both the HRA and POS plans.
    • For those in the HDHP plan, the coinsurance amount will be reduced to 10% after the deductible is met.
    • These lower costs are illustrated under the Medical and Prescription Drug Benefits page.
       

    Meet Some of Your Tulane Doctors

    Tulane Doctors


    Tulane Specialty Pharmacy

    The Tulane pharmacy dispenses highly specialized medications, including those that are hard to find, very expensive, treat complex medical conditions, or have special storage requirements. The pharmacy will help patients manage the coordination of insurance benefits and prior authorizations, as well as reimbursements and/or financial assistance programs. The Tulane pharmacy is open Monday through Friday, from 9 a.m. to 5 p.m., and is located at 1430 Tulane Ave., Suite 1502, New Orleans, LA 70112. For more information, visit www.tulanepharmacy.com


    Insurance Cards

    Scroll to the bottom of this page to view previews of insurance cards.

    Note: Insurance cards are typically mailed out between 7 and 14 business days after your enrollment. You will only receive new medical, dental, vision, and health care FSA cards if you are new to the plans or have changed plans. If you kept the same level of coverage from the previous year, you can continue yo use you existing cards.

    Additional Information

    Explore benefit plan summaries on this webpage.

    Not sure which plan to select for your medical benefits? 

    Try out Blue Cross Blue Shield's Plan Comparison Tool to learn more about what your potential healthcare costs could be over the coming year.

    Please note: This tool is designed only to estimate potential healthcare costs, starting with in-network costs. Several factors, including whether or not your provider is in or out of our network, could impact your actual benefits costs over the course of the year. 

    BCBS Medical Plan Comparison Tool 

    Click below on the tool that corresponds with your salary band:

                                          2024 

                                          2023

     

    Blue Cross Blue Shield (BCBS) Provider Search

    Please see below to search for providers with BCBS.

    BCBS Providers

     

    Prescription Drug Search

     

    Note: Click on "select plan" and enter "TNA" as the first three letters of the member ID. The network will be BlueCard PPO/EPO.

    Blue Cross Blue Shield

    Delta Dental

    Sample Dental Card

    EyeMed

    Eyemed Temp ID

    Accrue Health

    A Qualifying Life Event, or QLE, to change benefits during the plan year is defined as a change in status due to:

    • marriage
    • birth or adoption of child(ren)
    • death of a covered dependent
    • divorce or legal separation
    • loss or gain of insurance by your spouse's employer-sponsored coverage
    • termination of employment
    • dependent children aging out of plans at 26

    When you have a QLE, please alert the Benefits Department as soon as possible. Employees can only initiate the TU Gains Dependent QLE in their self-service account, but everything else must be initiated by a Benefits team member. Even though employees can initiate the TU Gains Dependent QLE, a benefits team member must approve it and see a supporting document. You have 30 days after the date of any qualifying life event to make changes to your benefits and submit supporting documentation to the Benefits Department.


    Moving:
     


    You and Your Family:
     


    You and Your Spouse's Job Status:
     


    Disability:
     

    Understanding Medicare & Social Security Webinar

    Navigating the benefits available to you through Medicare and Social Security can be a challenge. We've compiled some helpful resources to help you learn more about these programs and how to get the most out of them.

    Watch a webinar to learn more.

    We'll periodically be scheduling webinars throughout the year for employees to get their most pressing questions answered. Click here to watch the latest webinar presentation and click here to review the presentation materials.

    What you'll learn in the webinar:

    • When are you eligible to receive retirement benefits?
    • How does early retirement affect your benefits? 
    • Do you qualify for disability, survivors, and spouse benefits?
    • How do you get the most from your benefits?
    • What is the future of Social Security?
    • When should you file for Medicare?

    Access the following sites for more information:

    Be sure to check out the following sites for the latest details on these programs.

    Tulane offers a student employee plan for students that work 30 hours or more per week. Click here for the student-employee medical plan rates.

    As a student employee, you have the option of enrolling in the employer-sponsored plan (Student Worker Health Insurance Plan) or keeping your Student Health Insurance Plan (SHIiP).  Everyone's health care needs are different. It is important to choose carefully which medical plan will work best for you.

    To review the plans side by side, click here to view the student plan offered through Student Health.

    To view alternative health insurance options through the Health Insurance Market, click here.

    Health Insurance Marketplace Coverage Options

    FAQs

    To enroll, visit Employee Self-Service within 30 days of your new hire or newly eligible date:

    1. Go to Employee Self-Service and login with your TU username and password
    2. Make your benefits selections
    3. Print your confirmation statement and keep for your records

    For more detailed instructions, CLICK HERE.

    All benefits-eligible employees are required to have medical coverage. Therefore, if you decide to decline medical coverage for yourself because of other medical coverage, you will be required to submit a Medical Waiver Form and send proof of the other medical coverage. If proof of coverage is not provided within 30 calendar days, you will be defaulted into the HRA plan for single coverage.  To successfully decline medical coverage, follow the steps below:

    1. Login to Gibson Online using your single username and password
    2. Under the Staff or Faculty tab, click on "HCM Self-Service."
    3. Enter your single username and password to access HCM
    4. Under the "Tulane Employee Self-Service" link, click "Benefits."
    5. You will need to "Accept" the Legal Disclaimer and click "Next."
    6. Review your Dependents and beneficiaries; if everything is correct, select "Next."
    7. If you need to add dependents or beneficiaries, click here for instructions.
    8. Select "TU Benefits" and select "Next."
    9. To decline medical coverage or make updates to your benefits, select the "Benefits Enrollment" tab located at the top of the screen, then click "Update Benefits." Select the appropriate option for each plan that you wish to decline or update.
    10. If you are already enrolled in the appropriate option, select "Next." When you have finished making your elections, select "Next" to move on to the next step in the process.
    11. For each dependent you wish to enroll in TU Benefits, select the checkbox for the specific plan in which you want to enroll. Dependents will not be enrolled if you do not complete this step. When you have finished making your elections, click "Next."
    12. For each dependent you wish to designate as a beneficiary, enter a percentage of the benefit that you would like that dependent to receive. You must designate a primary beneficiary if one has not been defaulted on for you. The total percentage per beneficiary type (primary and contingent) needs to equal 0% or 100%.
    13. Review your benefit selections, covered dependents, and beneficiaries. To make changes, select "Back." When you are done, click "Printable Page" to create a confirmation statement for your records, or click "Confirmation Statement" to print or save a PDF copy. Once complete, select "Finish" to complete the process.
    14. Click "Logout," located on the top right corner of the screen, to exit HCM Self-Service
    15. Click under your name on the top right corner of the screen to select "Sign Out" to exit Gibson Online
    16. Complete the Medical Waiver Form and provide proof of other coverage (front and back of your current medical insurance cards)
    17. Email the form and proof of other coverage to TUBenefits@tulane.edu.
    18. Once the information has been received and your coverage has been successfully declined, you will receive a confirmation email.

    Very Important

    If you do not complete all of the steps listed above, you will be defaulted into the HRA plan for single coverage until the annual Open Enrollment period or a qualifying life event, whichever comes first.

    Vendor Information

    Call the Benefits Team

    Phone:

    504-865-HR4U(4748)

    Email:

    TUBenefits@tulane.edu

    Monday-Friday

    8:30am - 5:00 p.m. CST

    Eligibility

    For an employee to be eligible for medical and other benefits, they must be either a Regular-FT employee or a Regular-PT employee who is working 18.75 hours or more a week and working 7 months or longer. Temporary Full-Time employees working less than 7 months are eligible for medical insurance only.

    Who is considered a dependent child?
    For Tuition Waiver: Dependent children are those who are the biological children, adopted children, or stepchildren of an eligible employee at Tulane who are also claimed as a dependent on the qualified parent’s federal tax return; and qualified staff for that purpose include full-time employees scheduled to work with the University for no less than 7 months and have completed three years service. For Full-Time Faculty, there no waiting period.

    All other benefits: Dependent children are those outlined above plus the addition of foster children, and legal custody of grandchildren or other children.  

    What documentation is required to prove dependency?
    Proof of dependency can be acquired by attaching a copy of the most recent federal income tax return to the Office of Human Resources before the waiver can be credited. 

    Who is considered a spouse?
    A spouse is the person to whom the employee is currently and legally married. Spouse does not include divorced, legally separated spouses, or domestic partners.  

    Are opposite gender domestic partners eligible?
    No. Only spouses are eligible. 

    Are registered same-gender domestic partners eligible for medical benefits?
    No. Effective January 1, 2017, Tulane University will no longer recognize or extend benefits to same-gender domestic partners. This change is in response to the 2015 Supreme Court marriage equality ruling, which recognizes the legality of same-sex marriages in all U.S. jurisdictions.

    Medical Plans

    What is the Blue Cross Blue Shield Group Policy Number?

    60865

    Is preventative care free of cost under all three plans?
    Yes.

    Is there a separate prescription drug deductible?
    Not under the HRA or POS plans. Under the new HDHP plan, you will pay 20% coinsurance until you reach your deductible instead of copaying. Using a health FSA (Flexible Spending Account) can help manage this cost. 

    What is the difference between a deductible and an out-of-pocket maximum?
    A deductible is the amount you must pay before your insurance starts to pay its portion of costs for a covered health expense. The deductible could be as low as a few hundred dollars or as high as several thousand dollars. Out-of-pocket maximum is the total cost that would be incurred by the employee, including all deductibles, coinsurance, copays, etc. in a calendar year.

    Do my deductible, coinsurance, and copayments apply to my out-of-pocket maximum?
    Yes. Under the Federal Health Care Reform Act, all payments, including deductibles, coinsurance, and copayments, must be applied to your annual out-of-pocket maximum.

    Do you need a referral from your primary physician to see a specialist?
    No. 

    What if my primary care physician is a specialist? (i.e. Diabetic specialist as the Primary Care Physician) What would be the copay?
    You would pay the specialist-level copay. 

    Are psychologists always considered specialists?
    No. Due to Mental Health Parity Act, psychologists fall under the Primary Care Physician copay. 

    Are physical therapists considered specialists?
    No. Physical therapists would fall under the Primary Care Physician category. 

    Are the out-of-network benefits posted online?
    Yes.


    COBRA

    When will my Tulane benefits be terminated?
    All Tulane benefits will be terminated at midnight on the last day of the month in which separation of employment occurs or the employee is no longer benefits eligible. In addition, all benefits will terminate at midnight on the last day of the month that a dependent(s) attains the age of 26.  

    How can I continue my Medical, Dental, Vision, and Healthcare Flexible Spending Account benefits?
    If you are currently enrolled in any of the above referenced plans, you will have the option to continue benefits under the Consolidated Omnibus Budget Reconciliation Act (COBRA) for 18 months (dependents may be able to continue for 36 months) with the exception of the Healthcare Flexible Spending Account, which can be continued through the end of the current calendar year. There is no tax benefit to continue on this account. However, if you have a large balance or have not incurred expenses, continuing your FSA may be beneficial or you will forfeit funds.  

    Will I need to provide proof of prior coverage?
    Yes. A certificate of group health coverage will be provided by Blue Cross Blue Shield if you were enrolled in one of the University’s medical plans. You may need this certificate for your new group or individual plan to provide evidence of your prior coverage.  

    How much do I have to pay for continuation coverage through COBRA?
    You will be responsible for and required to pay the full COBRA continuation premium. Failure to timely pay any premium for the coverage will result in termination of the coverage. 

    Who is entitled to continuation of coverage under COBRA?
    In order to be entitled to elect COBRA continuation coverage, your group health plan must be covered by COBRA; a qualifying event must occur, such as separation from the university; and you must be a qualified dependent for that event. A qualified dependent is an individual covered by a group health plan on the day before a qualifying event occurred that caused him or her to lose coverage. A qualified dependent must be the employee's spouse or former spouse, or the employee's dependent child.  

    Will I receive a notification stating I am eligible for COBRA?
    Yes. You will receive a notice stating your right to choose to continue benefits provided by the plan from Tulane's COBRA administrator, WageWorks/HealthEquity, by regular mail within 14 days of being notified. This notice is for the employee and all qualified dependents who are currently enrolled in any of the eligible plans.  You can also log onto WageWorks to view your notice online within 14 days, make your election and pay your premium.

    If I choose to not continue benefits provided by the plan from Tulane's COBRA administrator, WageWorks/HealthEquity, do I have other options?
    You should consider all options you may have to get other health coverage before you make your decision. There may be more affordable or more generous coverage options for you and your family through other group health plan coverage (such as a spouse's plan), the Health Insurance Marketplace, Medicare or Medicaid. You also have the ability to review options that may be available to you under the Affordable Care Act at www.healthcare.gov.  

    What steps do I need to take to ensure that I will have benefits coverage?
    The first important step is to elect COBRA by returning the enrollment form provided by WageWorks within 60 days of receiving the enrollment packet. Once you have made your elections, you will receive coupons reflecting the monthly amount that is due to WageWorks. The next important step will be to continue to pay your premiun or the coverage will be terminated.  

    How is the COBRA administrator, WageWorks/HealthEquity, notified to ensure my benefits coverage takes effect?
    WageWorks will receive a file from Tulane of your eligibility change. Within 14 days from being notified WageWorks/HealthEquity will send you a packet outlining what is available to you. You will have 60 days to notify WageWorks/HealthEquity of accepting coverage. Once your payment is received your coverage will be back dated to date of separation. If you do not pay the premium, you will not be covered.

    Flexible Spending Accounts (FSA)

    Will Flexible Spending Accounts (FSAs) still be available?
    Yes, FSAs will still be available and are encouraged in order to help manage costs. If you are currently participating on Flexible Spending Accounts (FSA) and wish to continue the following plan year, you must re-enroll during the open enrollment period. 

    Which types of Flexible Spending Accounts (FSA) are offered at Tulane?
    Healthcare and Dependent care flexible spending accounts. 

    What is a Health Care Flexible Spending Account?
    A Healthcare FSA (HCFSA) reimburses you for eligible, out-of-pocket medical, dental and vision expenses for you and your qualified dependents up to the amount of your annual contribution, even if your dependents are not covered on your Tulane insurance. 

    What is a Dependent Care flexible spending account?
    A Dependent Care FSA (DCFSA) reimburses you for qualified child and adult care incurred so that you (and if married, your spouse) can work. Note: expenses are not claimed on your income tax return, and you are not able to use DCFSA for any healthcare expenses.  

    What is the maximum amount you can contribute to an FSA?
    The maximum amount you can contribute is $3,050 per year to a Healthcare Flexible Spending Account and $5,000 per year to a Dependent Care Flexible Spending Account. 

    Is there a list of eligible healthcare spending?
    Yes, in addition to all medical, dental, vision, you can go to www.fsastore.com. Pharmacy store websites will also inform you of what is covered.

    Tuition Programs

    Are all employees eligible for tuition waivers?
    No. Three types of employees are not eligible for tuition waivers: 

    • Employees whose status is “Part-time” whether Staff, Faculty, or Post Docs
    • Employees whose status is “Temporary Full or Part-time”
    • Student employees, including Residents (while on student payroll employee benefits are not applicable) 

    Are all programs and instances covered by tuition waivers?
    No. Tuition waivers are not available for some programs and instances.

    • Classes previously taken in which you received a grade and credit
    • The Executive Masters of Business Administration
    • Gifted and Talented
    • Project Tulane
    • Tulane Junior Summer Lyric Theatre
    • Freeman Summer School Abroad
    • Executive Masters of Health and Administration
    • Civic and Cultural Management Program
    • Master of Pharmacology
    • Master of Science in Neuroscience
    • Workshops or non-credit seminars
    • Audited courses
    • Graduate-level courses for dependents or spouses

    Are registered same-gender domestic partners eligible for the tuition waiver?
    No, Effective January 1, 2017, Tulane University will no longer recognize or extend benefits to same-gender domestic partners. This change is in response to the 2015 Supreme Court marriage equality ruling, which recognizes the legality of same-sex marriages in all U.S. jurisdictions.  

    If a spouse or dependent child of an employee is hired by Tulane University, are they still eligible for the tuition waiver?
    The spouse or dependent children of employees shall have their eligibility and class limitation for tuition waivers determined exclusively on the basis of their employment. 

    If a person enrolled in classes becomes ineligible for the tuition waiver, will they be charged for the full tuition amount?
    If an employee becomes ineligible or terminated involuntarily, the employee or dependent may finish the semester in which they are enrolled under the tuition waiver. However, the following semester would not be covered under the tuition waiver. 

    After becoming ineligible for the tuition waiver because of the employee’s voluntary termination of employment or due to gross misconduct, the former employee would be charged for the full tuition amount for that semester. 

    Who is eligible for the extended tuition waivers? 

    • Retirees with at least 25 years of full-time service at Tulane.
    • Employees who have been approved as disabled under the Tulane Long Term Disability Plan
    • Faculty members whose tenures are terminated under extraordinary circumstances caused by financial exigencies or by a bona fide discontinuance of a program on a department of instruction.
    • The spouse and dependent children of a retired employee with 25 years of full-time service.
    • The spouse and dependent children of a disabled employee with at least 5 years of service.
    • Dependents and spouses that are enrolled on a tuition waiver basis at the time of an employee's death or disability before completing 5 years of full-time service at Tulane.
    • The spouse and dependent children of an employee who has at least 5 years of full-time service at Tulane and separates from service by reason of death. 

    Is the tuition exchange program available for graduate study?
    No. The tuition exchange program is only available for undergraduate study. 

    As a full-time employee of Tulane, is my dependent child guaranteed a tuition exchange scholarship?
    No. Tuition Exchange scholarships are very competitive and not guaranteed. Students who are sponsored by Tulane are only eligible to compete for Tuition Exchange Scholarships at member institutions and are not guaranteed either admission to a member institution or the award of a Tuition Exchange Scholarship, even if the student is admitted.

    What criteria is used to determine the recipients of the Tuition Exchange Scholarships?
    Host institutions use their own criteria to determine the winners of the Tuition Exchange Scholarships at their institutions, and that the host institutions determine the value of the scholarships that they award.

    Retirement

    What retirement plans does Tulane offer?
    The university currently offers four retirement plans – Tax Deferred Annuity (TDA) Plan, Staff Retirement 403(b) Plan, Faculty and Administrative 403(b) Plan, and the 457(b) Plan. 

    What are my options for investment vendors?
    TIAA-CREF 

    Who is eligible for the Tax Deferred Annuity (TDA) Plan?
    The Tax Deferred Annuity (TDA) plan is a 403(b) employee-funded retirement plan. All employees may enroll in this plan from day one of employment. Contributions are made by you and deducted from your paycheck. 

    Who is eligible for the Staff Retirement Plan?
    The Staff Retirement plan is a 403(b), university-funded retirement plan. Staff employees are eligible to enroll in this plan after 2 years of consecutive service, having worked at least 975 hours in each year. After you become eligible, Tulane will contribute 8% of your base salary. 

    Who is eligible for the Faculty and Administrative Retirement Plan?
    The Faculty and Administrative plan is a 403(b), university funded retirement plan. Faculty and Administrative employees are eligible to enroll in this plan after 2 years of consecutive service, having worked at least 975 hours in each year. After you become eligible, Tulane will contribute up to 10% of your base salary. The percentage depends on your annual base salary amount. 

    Who is eligible for the 457(b) Plan?
    The 457(b) plan is an employee funded retirement plan. All employees currently earning or expected to earn $150,000 during the current year are eligible to participate in this plan. Contributions are made by you and deducted from your paycheck.

    Why is it a 403(b) and not a 401(k)?
    401(k) plans are offered by for-profit companies, 403(b) plans are only available to employees of tax-exempt organizations. The names simply refer to the section of the tax code that outlines these plans.
     

    Eligibility  

    Do I have to open a Staff or Faculty and Administrative Retirement Plan immediately on my 2 year anniversary?
    It is beneficial to be proactive in opening an account in order to receive Tulane’s contributions because the university does not do retroactive payments. 

    I am a rehire; do I have to wait 2 years before Tulane contributes to my Staff or Faculty and Administrative Retirement Plan?
    Rehired employees are eligible immediately if they worked at Tulane for at least 2 consecutive qualifying years. 
     

    Contributions: Employee funded vs. University funded  

    Does the university make contributions to all four retirement plans?
    No. Tulane only makes contributions to the Staff 403(b) Plan and the Faculty and Administrative 403(b) Plan. 

    I would like to make additional contributions to my Staff or Faculty and Administrative Retirement Plan, is this permitted?
    No. The Staff Retirement 403(b) Plan and the Faculty and Administrative Retirement 403(b) Plan are university funded plans. You may not personally contribute additional funds to these plans. However, you may contribute funds to a TDA plan only via payroll deductions. 

    Can I contribute a percentage of my salary to a TDA plan or 457(b) plan? Or must the contributions be flat dollar amounts?
    When contributing funds to a TDA or 457(b) plan, you must express your contributions as flat dollar amounts and not a percentage. 

    Can funds in each of my plans be combined?
    No. Funds accumulated under each plan cannot co-mingle with any of the other plans (TDA, Staff, Faculty and Administrative, and 457(b) plans). 
     

    Taxes and Distributions 

    When will I be taxed on the funds in my Tax Deferred Annuity (TDA) plan?
    Taxes are deferred on both contributions to the plan and any earnings that accumulate in your account until you take a distribution. 

    What are the payment options for receiving my funds?
    There are several payment options for receiving your funds with TIAA-CREF. You may choose different methods of payment from each company. In addition, under certain circumstances, you may be required to begin the receipt of benefits. 

    What happens if I die before I start receiving distributions from my retirement plan(s)?
    If you die before you begin to receive benefits, your beneficiary(ies) will be entitled to the full current value of your benefit accumulation. There are certain rules and restrictions about choosing a beneficiary(ies) other than a spouse. 
     

    How To’s 

    How do I enroll in TIAA-CREF?
    Instructions to enroll in TIAA-CREF may be found here.

    How do I view, update, or enroll in my retirement benefits?
    After you enroll with your elected retirement vendor, you will need to make the necessary updates in HCM. Instructions may be found here

    Where can I find more information on the retirement plans?
    More information on the university’s retirement plans may be found in the Retirement Guide. 

    How do I make an appointment for a one-on-one retirement counseling session with a TIAA-CREF advisor?

    TIAA-CREF
    Representative - Louis Bundy
    1-866-843-5640
    www.tiaa-cref.org/letstalk1

    The Affordable Care Act (ACA) is the major healthcare reform enacted on March 23, 2010. ACA requires large employers like Tulane University to offer health insurance coverage to substantially all (at least 95%) of their full-time employees, which for this purpose is defined as an employee averaging 30 or more hours of work per week. Additionally, the ACA requires the University to complete complex annual IRS reporting. These requirements make it critically important for the University to be able to track hours for all employees.

    The ACA requires employers to report the value of health insurance coverage on employees' W-2 forms. The purpose of the value of health coverage, as stated by the IRS, is to provide employees useful and comparable consumer information on the cost of health care coverage. This amount is not taxable and does not include the value of dental or life coverage.  The IRS also requires the University to include all Social Security Numbers of participants, including dependents, enrolled in the health insurance. 

    The ACA requires employers to send an annual statement (on paper or electronically) to eligible employees describing the health insurance coverage that was offered to them. The IRS Form 1095-C serves as that statement. Tulane works with ADP to make this 1095-C form available each year.