Internal - Faculty & Staff

Health and Life

We offer a wide range of benefits to keep you and your family healthy. Your eligibility for these benefits depends upon your employment status (e.g., full-time faculty, part-time staff, etc.).

The following links provide more detail about each of these plans.

Questions?

For any questions, please contact Benefits Department at 617-521-2985 or via email.

Medical

Simmons offers eligible faculty and staff a choice of two medical plans through Harvard Pilgrim Health Care.

Contact Information:

Simmons offers you a choice of two medical plans:

HMO Plan

HDHP/PPO PPO Plan

Pharmacy information for both HMO & PPO

The cost of coverage is shared between you and Simmons, with Simmons paying an average of 76% of the total premiums depending on the plan. The employee-paid premium varies based on the tier of coverage you select (such as employee-only coverage, employee + one dependent, or family coverage) and if you are a full-time or part-time employee.

Finding a provider within the network or a Primary Care Provider (PCP)

If you are looking to find a provider within our network, please visit hphc.providerlookuponlinesearch.com/search, and “Find a Provider” you can find your doctor (without logging in). For HMO plan participants the network to choose the PCP will be the HMO or HMO Open Access. The Provider ID number from this page is required to be populated in Workday.

PPO plan participants will choose providers PPO/ Network.

Forms/Documentation

Machine Readable Files/Federal Transparency Coverage Rule

Visit the Legal Information page for more information on the Machine Readable Files/Federal Transparency Coverage Rule. – Change the link on the Legal Page to this one HarvardPilgrim.org/public/machine-readable-files

Discounts, Programs & Offerings

Health Reimbursement Account (HRA)

Health Equity

Contact Information: 877-826-6882
www.healthequity.com

A health reimbursement arrangement (HRA) is an account funded by Simmons University that helps offset some of the medical  plan deductible.  You are responsible for paying your portion of the deductible responsibility expenses until you have met the Simmons portion of the deductible outlined below.

HMO Blue

Tier Deductible EE Deductible Responsibility First Simmons Deductible Responsibility through the HRA
Single $1,000  $1.00 – $500 $501 – $1,000
EE+1 $2,000 $1.00 – $1,000 $1,001 – $2,000
Family $2,000 $1.00 – $1,000 $1,001 – $2,000

PPO/ HDHP

Tier Deductible
In-Network/
Out-of-Network		 EE Deductible Responsibility First
In-Network/
Out-of-Network		 Simmons Deductible Responsibility through the HRA
Single $2,000 (in network)
$3,000 (out network)		 $1 – $1,500 (in network)
$1 – $2,500 (out network)		 $1,501 – $2,000 (in network)
$2,501 – $3,000 (out network)
EE+1 $4,000 (in-network)
$6,000 (out network)		 $1 – $3,000 (in network)
$1 – $5,000 (out network)		 $3,001 – $4,000 (in-network)
$5,001 – $6,000 (out network)
Family $4,000 (in-network)
$6,000 (out network)		 $1 – $3,000 (in network)
$1 – $5,000 (out network)		 $3,001 -$4,000 (in network)
$5,001 – $6,000 (out network)

How it Works:

  • Visit your provider as you normally would and present your medical ID card
  • Your provider will bill the medical plan who will process the claim in accordance to their contracts
  • Harvard will send these claims to HealthEquity and they will automatically appear in your Health Equity account for reference
  • You are responsible for paying employee deductible responsibility expenses until you have reached the HRA Simmons deductible responsibility outlined above
  • Once you have reached the Simmons deductible, Health Equity will automatically pay your provider for eligible expenses until the HRA funds are used

You may view your claims paid by the Simmons HRA through your Harvard Pilgrim Secure Account. Visit harvardpilgrim.org/login for a direct link to Health Equity, the HRA benefit provider.

Downloads

Health Care Savings Account (HSA)

optum financial

We offer a Health Savings Account to PPO Plan participants (plus read below for exclusions) to set aside pre-tax money for eligible health care expenses now or in the future, through Optum Financial.

Optum Financial
1-877-292-4040
Optum.com/financial-services.html

What is it?
An HSA is an individually held account that allows you to set aside money pre-tax if you are enrolled in a qualified high deductible health plan like our PPO plan. You can use your HSA for eligible health care expenses now or in the future.

Why Choose it?
Your HSA stays with you if you change jobs, you contribute with pre-tax earnings, earn interest on your money depending on how you invest it and can roll over the year-end balance. Simmons makes a contribution to your account: $500 for yourself; $1,000 for yourself and a dependent or $1,000 for family.

Can I receive the employer contribution even if I do not contribute to the HSA?
Yes. If you are enrolled in the PPO plan and in Workday elect the HSA benefit with a “$0” coverage amount, you will receive the employer contribution. Please note that the employer contribution is funded in a lump sum late July for open enrollment elections and during the year for newly benefits eligible faculty and staff.

Friendly Reminder
You must be enrolled in our medical PPO Plan to participate (exclusions apply as noted below). The IRS sets annual maximum contribution limits. For FY25, the total contribution Simmons allows is $4,150 for individuals and $8,300 for families, plus a $1,000 catch-up contribution for individuals over age 55.

Your HSA money comes out of your paycheck pre-tax, and you can use the money for qualified medical expenses tax-free. It’s not treated as income when you take money out for medical bills.

Flexible Spending Accounts (FSA)

optum financial

Optum Financial
1-877-292-4040
Optum.com/financial-services.html

Flexible Spending Accounts (FSAs) allow you to set aside pre-tax dollars to pay for eligible dependent care expenses and/or out-of-pocket health care expenses, reducing your taxable income and saving you money. Simmons offers Health Care FSA, Dependent Care FSA and a Limited Purpose FSA. You cannot be enrolled in both the Health Care FSA and Limited Purpose FSA plans at the same time. So, if you contribute into the Health Care Savings Account (HSA), you can enroll in a Limited Purpose FSA. Optum administers Simmons’s FSA plans.

What are examples of eligible expenses for Dependent Care FSA reimbursement?

Day and after-school care or day camp for a dependent child under age 13, or a disabled child of any age, or daycare for a tax-dependent elder. Both parents must be working or in school full-time to be eligible for this benefit. For a complete listing of eligible expenses, visit IRS Publication 503.

Dependent Care Flexible Spending Account (FSA)

How much can I contribute to the Dependent Care FSA?

You may contribute up to $5,000 per calendar year per IRS regulations ($2,500 if married and filing separately). Please note, your calendar year contribution cannot exceed $5,000 per IRS regulations. Because Simmons’s plan year runs July 1 through June 30, you must plan accordingly when making your election.

Visit Optum.com/financial-services.html for access to planning calculators, FAQs, and information on eligible expenses. You can also manage your FSA account(s) online by submitting claims, viewing the status of claims, viewing the amount you have contributed to your accounts, and what has been paid out to you year-to-date.

Health Care Flexible Spending Account (FSA)

If you participate in the medical HMO plan or do not participate in any of Simmons’s medical plans, you may contribute to the Health Care FSA.

What are examples of eligible expenses for Health Care FSA reimbursement?

Out-of-pocket health care (medical, dental, vision) costs for medically necessary services and treatments. For a complete listing of eligible health care expenses, visit IRS Publication 502.

Per IRS regulations, you may contribute up to $3,200 in FY25.

Optum administers Simmons’s FSA plans and sends out a debit card with your contribution amounts to use at eligible vendors. You may be required to submit receipts for claims incurred and paid with the debit card.

Note: Expenses not incurred between July 1, 2024 and September 15, 2025 as an active employee and submitted for reimbursement by October 31, 2025 will be forfeited into the Plan, so please estimate your Health Care FSA contributions carefully! Please note, should you terminate mid-year you may only claim expenses through your termination date unless you continue under COBRA.

Limited Purpose FSA

If you are a participant in our PPO, IRS regulations allow a limited-purpose FSA to be used alongside a Health Savings Account. This FSA is considered “limited” because you can only be reimbursed for eligible dental, vision and preventive care expenses not covered by any health plan. The maximum that you can contribute into the Limited FSA in FY25 is $3,200. The limited FSA is administered by Optum, who administers our other FSA plans.

Note: Expenses not incurred between July 1, 2024 and September 15, 2025 as an active employee and submitted for reimbursement by October 31, 2025 will be forfeited into the Plan, so please estimate your Health Care FSA contributions carefully! Please note, should you terminate mid-year you may only claim expenses through your termination date unless you continue under COBRA.

Dental

Dental Blue Contact Information:

Simmons offers two dental plans through Blue Cross Blue Shield of Massachusetts and covers a variety of services including orthodontia. The CORE plan is a diagnostic and preventive plan only and the Enhanced is a full service Dental Plan. The CORE plan is free for full-time employees.

Please note, the applicable deductibles and annual maximums listed on the Summary of Benefits are per calendar year.

Participating (in-network) providers charge members Blue Cross’s discounted rates for services. You can see any provider you want, however, non-participating (out-of network) providers are not required to accept the discounted rates and may balance bill for the difference between what the dental provider will reimburse them and what they charge. If you see a non-participating provider, you are responsible for this difference in addition to your cost share under the plan.

Members have access to the PPO providers and the Dental Blue providers through the national DenteMax Network offered through the Dental Blue plan. To get the maximum benefits members can choose a dentist in the PPO network as these dentists accept deeper discounts for their services. If your dentist is in the network, Blue Cross has contracted fees with these dentists, unless the member reaches the calendar year maximum or the benefit is a non-covered procedure.

Rollover Maximum

The Simmons Dental Plans offer Rollover dollars. Please see the below summary for additional information:

Additional Dental Benefits for Members with Specific Diagnosis

Members who have been diagnosed with diabetes, are pregnant, have been diagnosed with oral cancer or have been diagnosed with coronary artery disease, intellectual and/or developmental disabilities and certain mental health conditions are eligible for enhanced dental benefits. To receive your additional dental benefits, please have your physician complete the “Dental Benefit Enrollment Form with Medical Conditions” and return to Blue Cross. This benefit is offered to participants of both dental plans, the Core and the Enhanced.

Vision

VSP Logo

Contact Information:

  • vsp.com
  • 800-877-7195
  • Simmons Group Number: 30026513

We offer a voluntary vision plan through Vision Service Plan (VSP) that provides routine eye exams and eye wear discounts. This benefit is fully paid by enrolled faculty and/or staff members and the plan year is July 1 – June 30.

See vision information below:

For access to additional information, including finding participating providers, please visit https://vsp.com.

Note: VSP does not send out ID cards to its members. All that is necessary to receive services is for the member to provide their name, date of birth and last four digits of their SSN to the service provider. The Simmons Group number is 30026513. If you prefer to carry a member ID card with you, you can print an ID card from the VSP website by clicking on My Benefits and selecting My Member Vision Card. Learn more about VSP vision care

Highlights of Benefits offered through VSP:

  •  Primary Eyecare. VSP doctors can diagnose and often treat urgent or chronic medical eye conditions. This can mean huge cost-savings over emergency rooms, urgent care centers or visits to a primary care physician.
  •  The Open Access difference. VSP members can obtain services at any location they choose – from the vast VSP Preferred Provider network to specialty optical boutiques or retails chains.
  •  Polycarbonate lenses for children. Polycarbonate is considered the material of choice for children’s active lifestyles. These lenses are offered at low national average costs through VSP.
Life Insurance

Unum Logo

  • Life: 800-524-0542
  • Conversion/Portability: 800-421-0344

Group Term Life Insurance and Accidental Death and Dismemberment (AD&D)

Simmons University pays premiums for a group life insurance plan to all benefit eligible full-time and part-time employees. The University pays the premium in full and coverage begins immediately upon the employee’s hire date. The amount of life insurance is equal to 1.5 times the employee’s annual base salary with a minimum benefit value of $75,000 and a maximum $500,000, subject to age reduction in life insurance policies.

Voluntary Life Insurance with AD&D

The University offers voluntary life insurance with accidental death and dismemberment (AD&D) to benefits-eligible full-time and part-time faculty and staff.

If enrolled in the voluntary life insurance benefit, you also have the option to apply for:

  • Life insurance for your spouse and/or domestic partner
  • Life insurance for dependent child(ren), begins at birth and up to 26, up to a maximum benefit amount of $10,000 per child

To learn more about the plan and rate, including the minimum and maximum amounts you can purchase and the reduction in the benefit coverage as you attain different ages, please see the documents below.

To enroll in/change the voluntary life insurance, as a new hire or within 30 days of a qualifying event, please complete the Evidence of Insurability.

Based on your age at termination or retirement, you may be able to convert or port your benefit. If interested, please complete and submit the forms below within 31 days of termination.

Note: The information above is meant to provide a general overview of the benefit offered by the University. Plan provisions and coverage available will be governed by the respective plan document and contracts. Should there be a conflict between this overview and the plan documents/contracts, the official document will govern.

Disability

Unum Contact Information for Simmons-paid STD Benefit:

Colonial Contact Information for Voluntary STD Coverage:

Unum Logo

Short Term Disability (STD) Salary Continuation

Full-time and Part-Time benefits-eligible faculty and staff are covered under the University’s paid Short Term Disability Salary Continuation program upon date of hire at the University. If an eligible faculty or staff becomes disabled due to a covered injury or sickness, with documentation, as you recover, you could be eligible for salary continuation. This benefit generally begins on the 8th day of disability and could continue up to 25 additional weeks of disability. The amount you receive will depend upon the length of your illness and your length of service. Generally, eligible employees hired after July 1, 2000, will receive 60% of their salary during their extended illness, injury, or disability for up to 26 weeks. Employees hired before July 1, 2000 receive a percentage of pay, depending upon their hire date, for the first 8 weeks of disability, then up to 60% of their pay after 8 weeks up to 26 weeks. Short Term Disability benefits are offset by other benefits which faculty and staff receive.

As of January 1, 2021 all Massachusetts workers, with some exclusions, will be eligible for leave through the Simmons Disability Plan or the Massachusetts Paid Family and Medical Leave.

For an overview of the current STD benefits please refer to to the Plan Summary below

To report a short-term disability claim, please email [email protected].

 

colonial life logo

Colonial Supplemental Short-Term Disability Insurance

If you would like to purchase supplemental Short-Term Disability insurance on your own, either to cover your first year of employment at Simmons or after,or to supplement the university-paid benefit, we offer Supplemental Short-Term Disability coverage through Colonial Life. Colonial’s Short-Term Disability Income Protection insurance can help you replace a portion of you income if you were unable to work because of a covered illness or serious accident. You have the option to choose the amount of your disability benefits to meet your needs, subject to income. To learn more, please view the documents below or visit Colonial Life online at www.coloniallife.com or via telephone at 401-596-1510. Call center representatives are available Monday through Friday, 8:00 am – 8:00 pm (ET). Automated service information is available 24/7. Hearing-impaired customers who have TDD (Telecommunications Device for the Deaf), please call 1-800-798-4040.

Additional Documents

Note: The information above is meant to provide a general overview of the benefit offered by the University. Plan provisions and coverage available will be governed by the respective plan document and contracts. Should there be a conflict between this overview and the plan documents/contracts, the official document will govern.

Long Term Disability (LTD)

All full-time and part-time benefits eligible faculty and staff are eligible to participate in the University’s Long Term Disability (LTD) plan. The University fully pays the premiums for this coverage and coverage is effective immediately. Under this plan, a participant who has been disabled and unable to work for six consecutive months (180 days) could receive up to 60% of their base monthly salary, offset by benefits payable from other sources.

For an overview of the LTD benefits please refer to to:

You may select your tax election for your Long Term Disability coverage premiums upon hire or during the annual Open Enrollment period. Electing this benefit is irrevocable until the next annual open enrollment period.

Our plan allows two election options:

1. Faculty and staff can elect to have their Simmons paid long-term disability premiums included on their W-2 as taxable income. This is the taxable option.

OR

2. Faculty and staff can elect not to have their Simmons paid long-term disability premiums included on their W-2 as taxable income. This is the non-taxable option.

If you are paying taxes on the University-paid premiums during the fiscal year in which you become disabled, LTD benefits you receive under the plan would generally not be taxable. You can change your tax election once a year during Open Enrollment.

Note: The information above is meant to provide a general overview of the benefit offered by the University. Plan provisions and coverage available will be governed by the respective plan document and contracts. Should there be a conflict between this overview and the plan documents/contracts, the official document will govern.