AUS Self Directed Employee Benefits Plan

The Self Directed Employee Benefits Plan covers faculty and eligible staff employed by the university. The plan empowers eligible employees to design their own benefits package and to apply their allowance in whole or in part to any benefit in the plan. To the extent that available Self Directed Employee Benefits in the package are not utilized by an employee to pay for mandatory and optional benefits provided by the plan, employees are eligible for cash withdrawal at the end of the academic year (paid with the October payroll every year).  Those faculty who have elected to remain on the old plan and staff on “Grandfathered Benefits” are the exception to this plan; they will be joining the Self Directed Employee Benefits Plan in September, 2009.

The self-directed employee benefits plan is calculated at 25% of the annual base salary i.e. the calculation is based on your salary of September 2010 and this amount will not change throughout the 12 month period from September 2010 to August 2011.  Any salary adjustments or merits that occur throughout the year will not be reflected in the allowance until the following September.

Grades 1-6
Effective academic year 2008-2009 employees in grades 1 to 6 qualify for a self-directed benefit of 25 percent of their annual salary.  As with other employees, selection of health insurance and life & disability for the employee is mandatory, unless proof of coverage from another carrier deemed acceptable by the university is provided. 
For eligible staff, not residing on campus, a 45 percent housing allowance is provided.

Grades 7-9
Effective academic year 2008-2009 employees in grades 7 to 9 qualify for a self-directed benefit of 25 percent of their annual salary.  As with other employees, selection of health insurance and life & disability for the employee is mandatory, unless proof of coverage from another carrier deemed acceptable by the university is provided. 
For eligible staff, not residing on campus, a 40 percent housing allowance is provided.

Faculty and Staff Grades 10 and above
Faculty and staff grades 10 and above qualify for a self-directed benefit of 25 percent of their annual salary. Selection of health insurance is mandatory, unless proof of coverage from another carrier deemed acceptable to the university is provided. Faculty who have elected to remain on the old plan and staff on “Grandfathered Benefits” will join the Self Directed Benefits Plan in September 2009.

For eligible staff, not residing on campus, a 35 percent housing allowance is provided.

The following benefits are available within the benefits pool maximum described above. The full annual premium for any coverage elected will be deducted from the benefits pool amount.

Medical insurance
This election is mandatory unless proof of coverage from another carrier deemed acceptable by the university is provided.

Plan I – effective September 1, 2010

Employees covered under this plan may receive medical treatment in the UAE, Arab Countries, Indian Sub Continent and South East Asia. They are also covered for emergency treatment worldwide when on holiday or business trip.

Scheduled benefits under Plan I are:

• Maximum limit per person per year is US$ 200,000. (Equivalent to AED 735,000)
• Maximum outpatient limit per person per year is US$ 15,000. (Equivalent to AED 55,000)
• Inpatient treatment is covered at 100 percent, within the network providers in the UAE.
• Treatment outside UAE is covered with involvement of SOS (within geographical limits).
• Outpatient treatment is covered at 100 percent within the network providers in the UAE, but a co-insurance of 20 percent is applicable for outpatient treatment at Al Zahra hospital networks, and Welcare Hospital Dubai.
• Outside the network providers, outpatient treatment is covered at 80% network rates based on “Reasonable and Customary” charges
• Pharmaceuticals: - Co-insurance of 15 % for pharmaceuticals.
• Deductible: grade 1to 6 – AED 50 per visit, grade 7 to 9 = AED 60 per visit and grade 10 & Faculty =AED 70 per visit  
• Plan I Premium for the period September 1,2010 to August 31,2011     

Plan II – effective September 1, 2010

Employee electing coverage under this plan may receive medical treatment anywhere, i.e., worldwide coverage. However, employees who avail themselves to elective medical treatment or surgeries in the US, Canada or Europe will pay 20 percent (co-insurance) on the total cost of the treatment, inpatient or outpatient.
Scheduled benefits under Plan II are:

• Maximum limit per person per year is US$ 300,000. (Equivalent to AED 1,100,000)
• Maximum outpatient limit per person per year is US$ 15,000. (Equivalent to AED 55,000)
• Inpatient treatment is covered at 100 percent, within the network providers in the UAE but a co-insurance of 20 percent is applicable for bills at American Hospital in Dubai.
• Treatment outside UAE is covered with involvement of SOS.
• Outpatient treatment is covered at 100 percent within the network providers in the UAE, but a co-insurance of 20 percent is applicable for outpatient treatment at American Hospital of Dubai, Welcare Hospital Dubai and Al Zahra hospital networks.
• Outside the network providers, outpatient treatment is covered at 80 percent network rates based on “Reasonable and Customary” charges
• Pharmaceuticals: - Co-insurance of 15% for pharmaceuticals
• Deductible: grade 1to 6 – AED 50 per visit, grade 7 to 9 = AED 60 per visit and grade 10 & Faculty =AED 70 per visit 
• Plan II Premium for the period September 1,2010 to August 31,2011

Plan III – effective September 1, 2010

Employees covered under this plan may receive medical treatment in the UAE, Arab Countries, Indian Sub Continent and South East Asia. They are also covered for emergency treatment worldwide when on holiday or business trip.

Scheduled benefits under Plan III are:

• Maximum limit per person per year is US$ 200,000. (Equivalent to AED 735,000)
• Maximum outpatient limit per person per year is US$ 15,000. (Equivalent to AED 55,000)
• Inpatient treatment is covered at 100 percent, within the network providers in the UAE.
• Treatment outside UAE is covered with involvement of SOS (within geographical limits).
• Outpatient treatment is covered at 100 percent within the network providers in the UAE, including Al Zahra hospital networks without deducting 20% co-insurance, and Welcare Hospital Dubai with 20% co-insurance deduction.
• Outside the network providers, reimbursement at 100% “Reasonable and Customary” charges at the country of treatment
• Pharmaceuticals: - covered 100% based on medical policy limits under the network pharmacies without 15% co-insurance.
• Deductible: grade 1to 6 – AED 50 per visit, grade 7 to 9 = AED 60 per visit and grade 10 & Faculty =AED 70 per visit 
• Plan III Premium for the period September 1,2010 to August 31,2011 

Plan IV – effective September 1, 2010

Employees covered under this plan may receive medical treatment in the UAE, Arab Countries, Indian Sub Continent and South East Asia. They are also covered for emergency treatment worldwide when on holiday or business trip.

Scheduled benefits under Plan IV are:

• Maximum limit per person per year is US$ 300,000. (Equivalent to AED 1,100,000)
• Maximum outpatient limit per person per year is US$ 15,000. (Equivalent to AED 55,000)
• Inpatient treatment is covered at 100 percent, within the network providers in the UAE.
• Treatment outside UAE is covered with involvement of SOS (within geographical limits).
• Outpatient treatment is covered at 100 percent within the network providers in the UAE, including Al Zahra hospital networks without deducting 20% co-insurance.
• Outside the network providers, reimbursement at 100% “Reasonable and Customary” charges at the country of treatment
• American Hospital, Dubai – Direct billing for both In-patient and Out-Patient treatment without 20 % co-insurance
• Pharmaceuticals: - covered 100% based on medical policy limits under the network pharmacies without 15% co-insurance.
• Deductible: grade 1to 6 – AED 50 per visit, grade 7 to 9 = AED 60 per visit and grade 10 & Faculty =AED 70 per visit 
• Plan IV Premium for the period September 1,2010 to August 31,2011 

Plan V – effective September 1, 2010

Employee electing coverage under this plan may receive medical treatment worldwide and need not pay 20% co-insurance for elective treatment in Europe, USA and Canada.

Scheduled benefits under Plan V are:

• Maximum limit per person per year is US$ 500,000. (Equivalent to AED 1,835,000)
• Maximum outpatient limit per person per year is US$ 15,000. (Equivalent to AED 55,000)
• Inpatient treatment is covered at 100 percent, within the network providers in the UAE.
• Treatment outside UAE is covered with involvement of SOS (within geographical limits).
• Outpatient treatment is covered at 100 percent within the network providers in the UAE, including Al Zahra hospital networks without deducting 20% co-insurance.
• Outside the network providers, reimbursement at 100% “Reasonable and Customary” charges at the country of treatment
• American Hospital, Dubai – Direct billing for both In-patient and Out-Patient treatment without 20 % co-insurance
• Pharmaceuticals: - covered 100% based on medical policy limits under the network pharmacies without 15% co-insurance.
• Deductible: grade 1to 6 – AED 50 per visit, grade 7 to 9 = AED 60 per visit and grade 10 & Faculty =AED 70 per visit 
• Plan V Premium for the period September 1,2010 to August 31,2011

Other Benefits

Accidental Damage to natural teeth - Covered in full to policy limits.

International Emergency Medical Assistance

⇒ Emergency Medical Evacuation – USD 1 Million

⇒ Emergency Medical Repatriation and Repatriation of mortal remains – included in above benefit amount

⇒ Compassionate Visit – One Economy Class Return Airfare

⇒ Return of Minor Child – One Economy Class One Way Airfare

⇒ Convalescence Expenses – USD 1,000/- subject to a sub limit of USD 250/- per case

Chronic Conditions - Covered up to Policy Limit

Pre-existing Conditions - Covered up to Policy Limit

Normal Pregnancy and Childbirth – for married females 18 years to 45 years,covered up to a limit of AED 20,000 (sub-limited to normal delivery AED 15,000/-, caesarean delivery AED 20,000/- and legal abortion/ miscarriage AED 5,000/-) with nil waiting period

Maternity Complications including pre-mature birth.( covered up to the applicable sublimit for maternity)

Work Related Accidents for Plan III, IV and V only. Covered over and above WC Policy Limits.

Other Terms andConditions

⇒ Addition of New Born baby from date of birth and all congenital and acute illness covered up to AED 15,000/- for new born children and the cover for such babies to continue as long as they are under the scheme

⇒ Additions and deletions on pro-rata adjustment.

In-PatientTreatment

Covered in full

⇒ Hospital Room and Board

⇒ Diagnostic Procedures

⇒ Operating Theatre charges

⇒ Nursing care, drugs and dressings

⇒ Surgical Appliances used by the medical practitioner during surgery

⇒ Supports, rental of wheel chair (if prescribed by specialist)

⇒ Casts, Splints, Trusses, Braces and Crutches

⇒ Surgeon’s and anaesthetist’s charges including pre and post operative consultations

⇒ Intensive care unit charges

⇒ Consultations and Physiotherapy while admitted for treatment of a medical condition

⇒ Radio therapy and Chemotherapy

⇒ Computerized tomography, magnetic resonance imaging, x-rays and other such proven medical imaging techniques

⇒ Ambulance Services

Out-Patient Treatment

Covered in full

⇒ Specialists Fees per visit per day

⇒ General Practitioner per visit per day

⇒ Surgical procedures

⇒ Drugs and Medicines

⇒ Diagnostic procedures (CT Scan, MRI Scan other such proven medical imaging techniques)

⇒ Physiotherapy as per policy limits.

Click here for Exclusions and Limitations of the Medical Insurance Policy.

"For further details on Medical Insurance, List of Network Medical Providers, List of Network Pharmacies, and Medical Insurance Policy, please reffer to the following link"

Medical insurance does not continue as per UAE government policy and the policy of UAE insurance carriers beyond the age of 70 years for faculty and staff.

Life Insurance
This election is mandatory for staff unless proof of coverage from another carrier deemed acceptable by the university is provided.

• Death benefits:
• 2 times annual base salary in case of natural death
• 4 times annual base salary in case of accidental death
• Benefits are paid per beneficiary designation
• Provided to all full time permanent employees up to age 70 years for faculty and staff.
• Coverage begins on the first day of employment

For further information on Life Insurance, please check the Life Insurance Policy Document.

Long Term Disability Insurance
This election is mandatory for staff unless proof of coverage from another carrier deemed acceptable by the university is provided.

• Applies to employees who are totally and permanently disabled
• Acceptance of a claim under this Rider will automatically terminate the life insurance
• In force from the first day of disability
• Disability must occur before age 65

LIFE AND DISABILITY INSURANCE PREMIUM RATES - PER ANNUM

Annual leave tickets
AUS Day Care Center fees
Benefits provided by AUS in addition to the Self Directed Employee Plan and not included in the 25 percent limitation mentioned above are:

• Faculty housing and utilities (except personal telephone and satellite charges)
• Under Option A, tuition for undergraduate study for up to two dependent children at AUS at any one point of time.
• Indemnity Payment:  The Board of Directors, at their November 2008 meeting, approved an indemnity payment increase, which now reflects 10 percent of the employee’s annual base salary, in lieu of a retirement fund contribution.
• “Patriation”, airline tickets and unaccompanied baggage allowance
• Repatriation, airline tickets and unaccompanied baggage allowance

• School tuition fees for dependent children

Following the AUS Board of Trustees meeting in November 2008, the education benefit has been revised as follows:

A comprehensive study of educational expenses at the elementary and secondary levels was carried out taking into account the hardship that education costs place on lower paid faculty and staff.  As previously decided by the Board, everyone will be placed on the Self Directed Employee Benefit plan effective September 1, 2009, regardless of their date of hire.  However, that plan will be modified so that for all faculty and for staff in grades 10 and above the following education benefit options will be offered:

• Option A – The faculty and staff would remain on the current 25% Self Directed Employee Benefits Plan
• Option B – The faculty and eligible staff (grade 10+) would receive a fixed allocation of $12,500 PLUS school tuition fees for up to two children of AED 30K for primary school (KG2 - grade 8), AED 40K for secondary school (grade 9 - grade 12) and up to 50% of the tuition fee for additional children up to a maximum of AED 20K per child.  This option B does not include university studies, but includes one dependent child attending AUS.