State Group Insurance Premium Contribution (SGIP) - #200

The state gives employees in an active pay or Family and Medical Leave Act status and qualified retirees a monthly contribution that can be used to pay A&M System health premiums. This contribution is referred to as the state group insurance premium (SGIP) contribution, employer contribution or state contribution.

Eligibility

  1. Persons eligible for full SGIP are:

    1. Employees as described in Procedure 310, “Definition of Employee” section, working 100% effort, including those on paid leave or on FMLA (Family and Medical Leave Act) leave; and

    2. Retirees, as long as they are eligible for benefit coverages (see Procedures 550).

  2. Persons eligible for one-half SGIP are:

    1. Graduate students;

    2. Employees as described in Procedure 310, “Definition of Employee” section, working at least 50% but less than 100% effort, including those on paid leave or FMLA leave;

    3. Persons covered as a dependent on another state agency policy (certified other - D);

    4. Persons covered as a dependent of a TAMUS member (certified other - S).

    5. Persons covered under another insurance plan NOT through another state agency or institution (certified other – Y)

  3. Persons not eligible for SGIP are:

    1. Employees on leave without pay or Workers’ Compensation leave (except those on FMLA);

    2. Employees who are budgeted for less than 50% effort;

    3. Surviving dependents of deceased employees and retirees;

    4. COBRA participants; and

    5. Person retired from other state agency where they get SGIP from previous employer (certified other - P).

General Information

  1. The SGIP Rate field indicates the level of SGIP payment the employee/retiree may receive and has the following values:

    1. F - full SGIP

    2. P - partial SGIP

    3. N - no SGIP

      If left blank, the 106 screen will calculate the rate based on employment status, percent effort and title code. Retirees should almost always have their SGIP Rate set to F. Graduate students should always have their rate set to P. Otherwise, the rate should be F for those working 100% effort and P for those working at least 50% but less than 100% effort. Nine-month employees will retain the rate they received during the school year, regardless of percent effort in the summer months. The rate should be N for those not eligible for SGIP payments. When employees go on Leave Without Pay, their SGIP Rates can be left at F or P, but the Priority (PRTY) codes should be turned off. The PRTY codes will still control whether employees receive any SGIP applied to a particular premium. When the PRTY codes are numeric, the SGIP Rate flags will dictate the level of SGIP applied to the premiums.

      The SGIP Rate will be set each year at initialization, based on title code (graduate students) and percent effort in the budget. Since the eligibility for full versus partial SGIP can change during the fiscal year, but may not always coincide with percent effort, Human Resource Offices will be able to override the values set at initialization, if necessary, by entering new codes on the 106 screen. If the code entered on 106 does not match the expected SGIP Rate for the employee’s percent effort and title, a warning message will be shown, but the override will be allowed. The SGIP Rate flag will not be automatically changed during the fiscal year, but will be recalculated each September at insurance initialization.

      Throughout the fiscal year, the Human Resources Office will need to check the Budget/Payroll/Personnel (BPP) Budget Changes Potentially Affecting Benefits (BP1606) daily report for percent effort changes. The Human Resources Office is responsible for updating the SGIP Rate flag for employees whose percent effort changes from 100% to less than 100% and vice versa. In this situation, the SGIP flag is changed from partial to full the first of the next month. Any needed payroll corrections must also be entered if the change is made after the first pay calculation for which the employee should be paid at the new rate.

      The month-end Master Error List (BP7009N) will show employees who have SGIP Rate fields that do not match the expected values for their percent effort.

  2. Certified Other Medical Coverage
  3. If an employee has medical coverage through a policy from another state agency, they are already receiving SGIP towards their coverage. Only one full state contribution per individual is allowable. Therefore, a policy holder of a policy from UTS or ERS is not eligible for a state contribution from the A&M System. If an employee/retiree is covered as a dependent on another state insurance policy, their spouse or parent is receiving 1/2 the state contribution for them under that coverage. Therefore, they remain eligible for 1/2 the employee-only contribution to apply to Alternate Basic Life, Dental, Vision, AD&D and/or LTD coverage. Certified Other designation can be done at any time.

    N, blank

    - the individual has TAMUS medical coverage as an employee/retiree (receives SGIP) or has    no TAMUS or other medical coverage (receives no SGIP)

    S - the individual has coverage through a spouse or parent at TAMUS (receives 1/2 SGIP)
    P - the individual has other state provided medical coverage, like University of Texas or ERS      (receives no SGIP)
    D - the individual is a dependent on someone else's state-provided medical plan (receives 1/2    SGIP)
    Y

    - the individual has other medical coverage that is not from another state institution or agency,   this includes TRS Care (receives SGIP)

  4. In most cases, SGIP is applicable only to Basic Life and health coverage. However, if employees or retirees waive health coverage and certify that they have other health coverage, they will receive half the employee-only SGIP amount, based on their percent effort, to apply toward:

    1. Alternate Basic Life (priority code 1)

    2. Optional Accidental Death and Dismemberment (priority code 3)

    3. Dental (priority code 4)

    4. Vision (priority code 5)

    5. Long-Term Disability (priority code 6; employees only)

    The SGIP amount will be applied to coverages in the above order unless the employee does not enroll in a particular coverage. Employees may choose to waive the contribution for Long-Term Disability (LTD). If SGIP is applied to LTD coverage, the employee will have to pay taxes on part or all of any LTD benefits he/she receives. If the employee pays the LTD premiums, the employee will not have to pay taxes on the LTD benefit he/she receives. An employee may change whether SGIP is applied to LTD premiums at any time during the year by completing a Benefit Change Form (http://tamus.edu/benefits/publications/forms/105new.pdf).

  5. No employee or retiree may receive full SGIP from two state institutions or agencies simultaneously. If a Human Resources Office is made aware of this situation, it should contact the other institution involved to verify that the participant is indeed receiving SGIP. In most cases, the initial employer should be responsible for the SGIP payment.

  6. If an individual is retired from the Employee Retirement System (ERS) or University of Texas System (UTS) and comes to work at the A&M System in a benefits-eligible status, he/she may choose our insurance or theirs, but not both. However, if the person chooses ERS or UTS retiree benefits, he/she can still have LTD and/or spending accounts through the A&M System since he/ she would not be able to have these as a retiree with ERS or UTS. All pertinent information should be sent to the Benefit Programs Administration to be imaged into the employee’s master insurance file for reference.

  7. No person may receive SGIP for health coverage as both the dependent of an employee/retiree and as the employee/retiree, even if spouses are employed at two different state agencies or institutions. If a Human Resources Office identifies such a situation, the Human Resources Office should notify the affected employee/retiree immediately, and the employee/retiree must choose between employee, retiree or dependent coverage. Appropriate changes should be made prospectively and no premium refunds should be issued.

  8. If an employee is working part-time for an A&M System member and part-time for another institution of higher education, and the combined effort is 100%, the employer providing benefits should provide the full SGIP. If the A&M System member is paying the full SGIP, the Human Resources Office may wish to contact the other institution to try to recoup some of the expenditure.

SGIP Eligibility Waiting Period

  1. Employees who are hired or move into benefits-eligible positions must complete a waiting period before being eligible for SGIP. The waiting period start date is the date of hire into the benefits eligible position. The SGIP eligibility date is the 1st of the month following the 90th day of the waiting period. A chart of SGIP eligibility dates is included at the end of this procedure.

    1. The 90-day waiting period does not apply in certain circumstances, including when:

      1. Employees transfer from one benefits-eligible position to another without a break in service. The transfer can occur within the same department, from one A&M System member to another or from another Texas state employer to an A&M System member. A list of state agencies (Alphabetical List of Texas State Agencies & Insitutions) (Site of Texas State Agencies and State-Funded Institutions, University of Texas at Austin listing of U.S. Community Colleges WEB), which can be used for verifying a waiver of the SGIP eligibility period but not for transferring longevity and/or vacation accruals, is available on the HR Resources protected site, http://tamus.edu/benefits/hr/login.asp. Employment through a public school district is not considered state employment.

      2. Employees, including adjuncts, complete their A&M System or other Texas state employer nine-month appointments in benefits-eligible positions and expect to return to or begin nine-month appointments with the A&M System in the fall.

      3. Employees terminate their A&M System or other Texas state employer benefits-eligible positions and are hired into A&M System member benefits-eligible positions in the same calendar month or the 1st of the following month. The employees must have remained eligible for insurance and SGIP during their breaks in service to be exempt from the 90-day waiting period.

      4. Employees drop coverage while on leave without pay from their benefits-eligible positions and regain coverage when they return to work.

      5. Employees with separate 4½-month appointments for the fall and spring semesters are not required to complete new-employee paperwork in January and are, therefore, considered to be continuously employed for the duration of both semesters. The 90-day waiting period exemption applies to the time between the fall and spring semesters, not the time between the end of the spring semester and the beginning of the following fall semester.

      6. Employees with separate 4½-month appointments for the fall and spring semesters are placed on leave without pay for the time between semesters and the time between the spring and fall semesters.

      7. Graduate students transfer from one A&M System campus at the end of its semester to another A&M System campus that has a different end date for that semester.

The 90-day waiting period applies when:

  1. Employees with separate 4½-month appointments for the fall and spring semesters are required to complete new-employee paperwork in January for the spring semester. When new-employee paperwork is required in January, the time between the fall and spring semesters is considered a break in service and a 90-day waiting period beginning on the date of hire for the spring semester would be required. Another 90-day waiting period would be required at the beginning of the following fall semester since the time between the end of the spring semester and the beginning of the fall semester is also considered a break in service.

  2. Employees with separate 4½-month appointments for fall and spring semesters are rehired for the following fall semester. The time between the end of the spring semester and the beginning of the fall semester would be considered a break in service, and a 90-day waiting period beginning on the date of hire for the fall semester would be required.

  3. Employees transfer from independent school districts, municipalities or private employers that are not considered Texas state employers or from regional education service centers. Though regional education service centers are Texas state employers, their insurance is through TRS, and they do not receive SGIP.

  4. Former employees who enrolled in COBRA return to work or are hired again by the same or different A&M System members.

SGIP Eligibility Date Field

The SGIP Eligibility Date field (SGIP-Dt) on the 106 screen will automatically determine when new employees are eligible for SGIP, based on the Current Employment Dates when the employees’ insurance coverages are added to the 106 screen. The Human Resources Office will be able to override the dates to match the Employment Dates for those new employees not subject to the waiting period. A value of all 9s in the field will indicate no SGIP eligibility.

  1. New employees subject to the SGIP waiting period who choose to start coverage on their hire date should be entered on the 106 screen with all priority codes set to N, regardless of whether the workstations are supplementing insurance costs for the waiting period. A process will check the SGIP-Dt at the end of each month and reset priority codes and premiums for those employees who will reach their SGIP eligibility date at the 1st of the next month. Any SGIP-eligible employees who have not enrolled in insurance coverage by their SGIP eligibility date will be automatically enrolled in Basic Life and the A&M Care health plan, unless they have elected to waive all insurance coverage (SGIP-ELIG = E).

  2. New employees who choose to delay enrollment until they are eligible for the SGIP contribution should be entered on the 106 screen with Start Dates and premium due dates equal to their SGIP eligibility date. Their priority codes should be set to numeric values rather than “N.” (When the due date is greater than or equal to the SGIP eligibility date, the screen will allow the priority codes to be set to a numeric value.)

Funding

    1. If A&M System members choose to subsidize premium costs with non-General Revenue funds for an employee on a 90-day waiting period, they should do so for all eligible employees. The supplement amount may be based on the category of health coverage (employee only, employee and spouse, employee and family, employee and child).

    2. If local funds used to pay a retiree’s SGIP are no longer available due to termination of a grant, privatization, elimination of an enterprise, etc., the retiree’s SGIP contribution may be paid from Educational and General (E&G) funds. If the original source of revenue still exists, the retiree’s SGIP is generally paid from those funds. However, the benefits proportionality concept applies to retireegroup insurance even though this benefit is no longer tied to an employee's salary. Employees may have worked for multiple employers and may have been paid from various sources throughout theircareers. The equitable way to allocate the retiree insurance cost is to base it on an institution's current salary and benefits calculation and not simply on the last fund from which a retiring employee was paid. The consequence may be that a fund pays a proportional share of a retiree's insurance benefit today when it did not pay the retiree's salary as an active employee. However, it ensures that as aninstitution's funding structure changes over time, no fund ever pays a disproportionate share of theretiree insurance cost.
      (From the Texas Comptroller of Public Accounts, Fiscal Policies & Procedures, Benefits Proportional by Fund (APS 011))

    3. If an employee terminates from a benefits-eligible position, works for another System member in a non-benefits-eligible position and subsequently retires, the System member that last employed the individual in a benefits-eligible position is responsible for the retiree SGIP. Both the PIN and the ADLOC should reflect the System member responsible for paying the SGIP.

     

Date of Hire and SGIP Eligibility Date
FY 2014
Date of Hire 1st of the Month
Following 90-Day Wait
SGIP Eligibility Begins
September 1 – September 2 December 1
September 3-October 3 January 1
October 4 – November 3 February 1
November 4 – December 1 March 1
December 2 – January 1 April 1
January 2 – January 31 May 1
February 1 – March 3 June 1
March 4 – April 2 July 1
April 3 – May 3 August 1
May 4 – June 3 September 1
June 4 – July 3 October 1
July 4 – August 3 November 1
August 4 – August 31 December 1

 

Date of Hire and SGIP Eligibility Date
FY 2013
Date of Hire 1st of the Month
Following 90-Day Wait
SGIP Eligibility Begins
September 1 – September 2 December 1
September 3-October 3 January 1
October 4 – November 3 February 1
November 4 – December 1 March 1
December 2 – January 1 April 1
January 2 – January 31 May 1
February 1 – March 3 June 1
March 4 – April 2 July 1
April 3 – May 3 August 1
May 4 – June 3 September 1
June 4 – July 3 October 1
July 4 – August 3 November 1
August 4 – August 31 December 1

Benefit Procedures Manual • August 2013