RIT
Human Resources

Employee Assistance Program Summary

Table of Contents

Plan Number: 508
Plan Year: 07/01 - 06/30
Plan Established: 08/01/1997

Key Features of the Employee Assistance Program

Types of Counseling Covered

Benefits Payable

Flexible and Confidential

Introduction

To help employees and their families with personal problems-such as emotional, relationship or substance abuse problems - RIT provides an Employee Assistance Program (EAP) through The Health Association.

To get the help they need, employees can call the EAP 24 hours per day, seven days per week. All counseling is provided on a confidential basis.

This section of the handbook explains the Rochester Institute of Technology's Employee Assistance Program.

General Information

Who Is Covered and When

All regular employees are eligible for the Rochester Institute of Technology Employee Assistance Program (EAP). Coverage begins on your date of hire.

Who Pays for This Protection

RIT pays the total premium of providing employee assistance services to employees.

When Coverage Ends

Coverage under the Employee Assistance Plan ends:

See the section "Continuation of Coverage Under COBRA" for details on extending EAP coverage under certain circumstances for yourself or your dependents if coverage would otherwise end.

How the Program Works

There are three areas of coverage on their website:

  1. counseling benefits
  2. work/life assistance
  3. Information resource benefits

Counseling Benefits

Many complex issues are best resolved with counseling assistance from a behavioral health professional. You will want to consider calling for help if you encounter problems such as:

Counselors are available 24 hours a day, 7 days a week. When you call, you connect immediately with a counselor. Each of the experienced counselors has a Masters or PhD level of training. You have unlimited phone counseling available. If you need to see someone in person, you are eligible for up to six (6) counseling sessions per person per calendar year per issue (number of sessions approved is based on counseling need so it may be less than six). If further sessions are needed, you pay the cost of the visits in full. You may be eligible for coverage under your medical plan; contact your medical insurance carrier directly for further details.

To obtain services, simply contact the EAP directly and the representative will help you over the phone or schedule an appointment for you. There are participating counselors in Monroe and the surrounding counties.

Work/Life Benefits

Assistance for other personal, family, financial and legal issues is available. RIT’s EAP offers a broad range of solutions for your everyday work/life problems. These may include:

Information Resource Benefits

Sometimes the best solution to a problem comes from finding the right information. There are thousands of articles, assessments, trainings, videos, tools, calculators and links to other sites to help solve life problems. You can call or log on to the website to access these benefits. To access the website:

  1. Click on the Employee and Family Login button
  2. Click on the REGISTER HERE link and type in "RIT" in the employer line
  3. Click on the small circle to the left of "RIT" on the employer listing
  4. Click Continue button at the bottom of the page
  5. Complete the registration page; you can choose your own User Name and Password; they should be different than your Oracle User Name and Password
  6. Click Continue button at the bottom of the page

The counselor will assess your situation and, based on this assessment, will either work with you further or refer you to another professional for specialized care.

The local number to call for EAP services is (585) 325-2980 V/TTY, or you may call the toll free number (800) 417-6304 V/TTY Monday through Friday from 9:00 a.m. to 5:00 p.m. After hours emergency services are available by calling Life Line at (585) 275-5151 or (800) 310-1160.

All Treatment Is Confidential

Any information that is discussed in the counseling sessions is strictly confidential; it is not revealed nor communicated to RIT. The only time RIT is informed as to whether an employee is attending counseling is if the employee's supervisor has strongly advised an employee to attend counseling due to his or her work performance, and the employee has signed a "Release of Information Statement." In such a case, the only information released is whether the employee has or has not attended sessions and if the employee has agreed to follow or is following the course of action recommended by the counselor. The nature of the problem and the remedial actions proposed are not disclosed. No other information is released.

Continuation of Coverage under COBRA

See the "Medical Care Plan" section of this handbook for information on COBRA.

Your Rights under ERISA

[The U.S. Department of Labor requires that the following notice be included in all Summary Plan Descriptions.]

As a participant in Rochester Institute of Technology benefit plans, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all plan participants shall be entitled to:

Receive Information About Your Plan and Benefits

Examine, without charge, at the plan administrator's office and at other specified locations, such as worksites, all documents governing the plan, including insurance contracts, and a copy of the latest annual report (Form 5500 Series) filed by the plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Pension and Welfare Benefit Administration.

Obtain, upon written request to the plan administrator, copies of documents governing the operation of the plan, including insurance contracts and collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The administrator may make a reasonable charge for the copies.

Receive a summary of the Plan's annual report. The Plan Administrator is required by law to furnish each Participant with a copy of this summary financial report.

Continue Group Health Care Coverage

Continue health care coverage for yourself, spouse or dependents if there is a loss of coverage under the plan as a result of a qualifying event. You or your dependents may have to pay for such coverage. Review this summary plan description and the documents governing the plan on the rules governing your COBRA continuation coverage rights.

Reduction or elimination of exclusionary periods of coverage for preexisting conditions under your group health plan, if you have creditable coverage from another plan. You should be provided a certificate of creditable coverage, free of charge, from your group health plan or health insurance issuer when you lose coverage under the plan, when you become entitled to elect COBRA continuation coverage, when your COBRA continuation coverage ceases, if you request it before losing coverage, or if you request it up to 24 months after losing coverage. Without evidence of creditable coverage, you may be subject to a pre-existing condition exclusion for 12 months (18 months for late enrollees) after your enrollment date in your coverage. [NOTE: None of the health insurance options presently offered by RIT include a pre-existing condition exclusion.]

Prudent Actions by Plan Fiduciaries

In addition to creating rights for plan participants ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate your plan, called "Fiduciaries" of the plan, have a duty to do so prudently and in the interest of you and other plan participants and beneficiaries. No one, including your employer, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare benefit or exercising your rights under ERISA.

Enforce Your Rights

If your claim for a welfare benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules.

Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of plan documents or the latest annual report from the plan and do not receive them within 30 days, you may file suit in a Federal court. In such a case, the court may require the plan administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or Federal court. In addition, if you disagree with the plan's decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, you may file suit in Federal court. If it should happen that plan fiduciaries misuse the plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If you are successful the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

Assistance with Your Questions

If you have any questions about your plan, you should contact the plan administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the plan administrator, you should contact the nearest office of the Pension and Welfare Benefits Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Pension and Welfare Benefits Administration.

Your Rights under the Newborns' and Mothers' Health Protection Act

Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

Qualified Medical Child Support Orders ("QMCSOS")

A medical child support order shall be filed with the plan administrator as soon as reasonably possible after it has been filed promptly upon the receipt of such order, the plan administrator shall notify the participant and each person eligible to receive benefits under the terms of the order ("alternate recipients") of its receipt and of the procedures set forth in this section 14.04.

The Participant and the alternate recipients may provide comments to the Plan Administrator with respect to the order during the 30 day period commencing as of the date the Plan Administrator sends them notice of receipt of the order. The Plan Administrator shall, within the 60 day period commencing as of the expiration of the 30 day comment period specified in the preceding sentence, determine whether the order is qualified and shall so notify the participant and the alternate recipients in writing of its decision. The parties may waive the 30 day comment period. If they do so, the 60 day period shall commence as of the date all parties have waived their rights to submit comments. The Plan Administrator's determination on the qualified status of an order is final. As soon as reasonably practicable following its notification that an order is "qualified," the Plan Administrator shall take such steps it deems appropriate to implement the order.

The Plan Administrator encourages parties to submit draft orders for "pre-approval" of their qualified status prior to their being submitted to a court for signature as such pre-approval will expedite approval procedures.

An alternate recipient may designate a representative for receipt of copies of notices that are sent to an alternate recipient with respect to a medical child support order.

Claim Procedures

  1. Claims for Benefits - An Employee wishing to present a claim for benefits for himself or his Dependents should obtain a claim form or forms from his Employer or Plan Administrator. The applicable section of such form or forms should be completed by (1) Employee, (2) Employer or Plan Administrator, and (3) attending Physician or Hospital. Claims will only be processed if received within a reasonable time following the date the expense to which the claim relates arises.

    Following completion, the claim form or forms should be submitted to the Plan's representative as indicated on the reverse side of the Employee's Benefit Plan Identification Card. The organization that is authorized by the Plan to process and pay claims (the Plan's Claims Administrator) will compute benefits due, and cause proper claims to be paid. Unless the Employee assigns benefits to a doctor or to a Hospital, draft(s) will be made payable to the Employee.

    A decision will be made by the Claims Administrator no more than ninety (90) days after receipt of due proof of loss, except in special circumstances (such as the need to obtain further information), but in no case more than one hundred eighty (180) days after the due proof of loss is received. The written decision will include specific reasons for the decisions and specific references to the Plan provisions on which the decision is based.

  2. Appealing Denial of Claims - If a claim for benefits is wholly or partially denied, notice of the decision shall be furnished to the Employee. This written decision will:
    1. Give the specific reason or reasons for denial;
    2. Make specific reference to the Plan provisions on which the denial is based;
    3. Provide a description of any additional information necessary to perfect the claim, if possible, and an explanation of why it is necessary; and
    4. Provide an explanation of the review procedure.
    On any denied claim an Employee or his representative may appeal to the Plan Administrator for a full and fair review. The claimant may:
    1. Request a review upon written application within sixty (60) days of receipt of claim denial;
    2. Review pertinent documents; and
    3. Submit issues and comments in writing.

A decision will be made by the Plan Administrator no more than sixty (60) days after receipt of the request for review, except in special circumstances (such as the need to hold a hearing), but in no case more than one hundred twenty (120) days after the request for review is received. The written decision will include specific reasons for the decision and specific references to the Plan provisions on which the decision is based.

Additional information about claims submitted and review procedures may be obtained by contacting the Plan Administrator.

If you have any questions about your Plan, you should contact the Human Resources Department. If you have any questions about this statement or about your rights under ERISA, you should contact the nearest Area Office of the U.S. Labor Management Services Administration, Department of Labor.

Additional Information

Employer
Rochester Institute of Technology

Employer Identification Number
16-0743140

Plan Sponsor
Rochester Institute of Technology
8 Lomb Memorial Drive
Rochester, NY 14623-5604

Plan Administrator
Rochester Institute of Technology
8 Lomb Memorial Drive
Rochester, NY 14623-5604

Business Telephone Number
(585) 475-2424 (voice)

Agent for Service of Legal Process
Associate Director of Human Resources for Compensation and Benefits
Rochester Institute of Technology
8 Lomb Memorial Drive
Rochester, NY 14623-5604