Luther College is "self-funded" (self-insured) for employee medical and hospital care. Our Third Party Administrator (TPA) processes all medical and hospital claims. Luther College pays the actual incurred claim costs and administration fees. Benefits are designed with annual deductibles, co-insurance, and out-of-pocket maximums.
Pre-certification is required prior to all elective hospital admissions and all admissions to skilled nursing facilities; mental health institutions, hospice and home health care. Pre-certification is required within 24 hours of all emergency and obstetrical admissions.
Annual deductibles are either $500 or $1,000 per covered person with either a $1,000 or $2,000 family maximum, depending on which option you select.
After the deductible is met, the medical/health care plan pays 80 percent and the faculty/staff member pays 20 percent for covered charges until the out-of-pocket maximum of either $1,000 or $1,500 for single coverage; $2,000 or $3,000 for Employee + one; and $2,000 or $3,000 per family is reached. The College pays for most of the cost for coverage.
Luther College offers a "self-funded" (self-insured) dental care program. Premium payments for this benefit can be pre-taxed through the Flexible Benefits Plan.
There is an annual $30 per person deductible (maximum of $90/family/year). The annual benefit limit is $1,000 per person.
The dental care plan pays for covered services based on the number of years enrolled in the plan: 70 percent for the 1st year; 80 percent for the 2nd year; 90 percent for the 3rd year; and 100 percent for the 4th year and beyond. Crowns, bridges, and dentures are covered at 50 percent of approved charges starting the second year you are on the plan.
Spouses who are both Luther employees are eligible to enroll in two single plans.
Please contact Human Resources for additional information on the above plans.