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IMPORTANT REMINDERS FOR ENROLLING • You must provide the Date of Birth, Social Security Number, and Residence Address for each dependent you enroll • If you have dependents residing outside the Chattanooga area (for example a child attending school out of state); you must provide their Residence Address in order for them to qualify for Out-of-Area Benefits • You must provide a copy of your certified marriage license; if your spouse has a different last name than you • For any children who have different last names than you; you must provide a copy of their birth certificates • For children whom you have been awarded legal guardianship; you must provide a copy of their birth certificate and court documents signed by the judge naming you legal guardian
IMPORTANT REMINDERS FOR ENROLLING CONTINUED • For step-children you must provide a copy of your marriage license and a copy of their birth certificates. • For children placed with you for adoption; you must provide a birth certificate and court documents signed by a judge placing the children in your care You must provide Human Resources/Benefits Department the required documentation within 31 days of enrollment or your dependents will not be added NO EXCEPTIONS
IMPORTANT REMINDERS FOR ENROLLING CONTINUED Form 1095 -C Per Internal Revenue Service Code, Employers that offer employer-sponsored medical coverage are required to provide employees with Form 1095 -C must accompany Employee’s Tax Filings in 2017 for the 2016 Tax Year. Form 1095 -C includes information about the health insurance offered to employees and their dependents by Erlanger Health System. This form is required in order to avoid tax penalties. Employees need to confirm that their addresses and social security numbers are correct and their dependent’s social security numbers and dates of birth are accurate in People. Soft. Employers are required to furnish Form 1095 -C to the employee only. As the recipient of Form 1095 -C, employees will need to provide copies to any family members requesting the form covered under Erlanger Health System’s employersponsored plan; dependents are listed in Part III of the form.
New Hire, Change in Status & Qualifying Events • • Regular Full-time and Regular Part-time employees have 31 days to apply for eligible benefits. Benefits become effective the 1 st of the month after a full calendar month of employment. (For example: if your start date is March 15 th; your benefits will be effective May 1 st. ) Changes can be made if you experience a qualifying event within 31 days of the event date. A qualifying event includes: – Change in legal marital status (includes marriage, divorce, legal separation as defined by the state or death of a spouse) – Change in number of dependents (includes, birth, death, adoption or placement for adoption and a dependent ceasing to satisfy eligibility requirements) – Change in employment status of employee, employee’s spouse or eligible dependent up to age 26 (You move from a PRN status to a Regular Full-time or Part-time status) – Dependent satisfies or cease to satisfy eligibility requirements (for example, a dependent attains age 26) – Change in coverage of a spouse or eligible dependent up to age 26
New Hire, Change in Status & Qualifying Events Change in Employment Status – if you transfer from a position where you are working less than 19. 50 hours per pay period (temporary below 0. 52 FTE) to a Regular Full-time or Part-time position (0. 52 or above) you have 31 days to enroll from the date of the Status Change. Benefits become effective the 1 st of the month after a full calendar month of employment. (For example: if your start date is March 15 th; your benefits will be effective May 1 st. )
Medical Plan Highlights • Erlanger offers Two Plan Options – – $750 Deductible – $1, 250 Deductible Aetna (Open Access) and VHAN (Vanderbilt Health Associated Network) is the provider network; however, it excludes physician and providers who are employed by other local area healthcare systems. Coverage includes Erlanger physicians or physicians who operate independent practices and accept Aetna (Open Access) and VHAN (Vanderbilt Health Associated Network).
Medical Plan Highlights • Prior approval must be obtained from the Benefits Department for hospital services that cannot be performed at an Erlanger facility; this does not apply to a “true” medical emergency. Please contact the Benefits Department at (423)778 -7969; select option 3. • There is no coverage for services received Out-of-Network; unless it is a “true” medical emergency. Out-of-Network physician claims associated with an ER visit will only be paid up to 100% of the maximum allowable charges. Members could be subject to balance billing.
Medical Plan Highlights • Emergency Services for all plans are covered at a $250 co-payment worldwide if a “true” medical emergency. • When utilizing the Erlanger tier 1 and you are in need of a Advanced Imaging procedure (PET Scan, CAT Scan or MRI, etc. ) in the ER, you will pay the ER co-payment as well as an additional Advanced Imaging co-payment of $350; both copayments will be waived if you are admitted to the hospital. • Advance Imaging procedures (PET Scan, CAT Scan, MRI or etc. ) subject to $350 copayment (includes all scans, read and contrast)
Prescription Drug Benefit 30 Day Supply 90 day supply 30 Day Supply Erlanger Pharmacy Generic $5 Copay Deductible (applies to Preferred and Non. Preferred Brand Name Drugs) 90 day supply Other Pharmacies $10 Copay $15 Copay $125 Deductible N/A $125 Deductible Preferred Brand Name $40 Copay $80 Copay $55 Copay N/A Non-Preferred Brand Name $65 Copay $130 Co-pay $80 Copay N/A Specialty 50% (minimum charge $100 and maximum charge $200) No 90 Day Supply for Specialty Drugs 50% (minimum charge $175 and maximum charge $425) No 90 Day Supply for Specialty Drugs Smoking Cessation Zyban, Wellbutrin & Chantix $0 Copay for 3 months; N/A then Generic Copay for 9 months N/A Nicorette Gum and Nico. Derm CQ Patches Covered 100% for 3 months N/A
Erlanger Pharmacy Benefits You save money on your co-payments when you access an Erlanger Pharmacy (formerly Moore & King). 4 locations including: Medical Mall Dodson Avenue Health Center Erlanger North Erlanger East
$750 Deductible Bi-Weekly Rates Non-Nicotine User Full-time Part-time Employee Only $61. 00 $93. 00 $136. 00 $168. 00 Employee + Spouse $142. 00 $209. 00 $217. 00 $284. 00 Employee + Child(ren) $123. 00 $182. 00 $198. 00 $257. 00 Employee + Family $217. 00 $307. 00 $292. 00 $382. 00 Erlanger is committed to helping its employees achieve their best health. If you think you might be unable to meet the standards for the nicotine free benefit under Erlanger’s wellness program, you may qualify for an opportunity to earn the same benefit by different means. Contact Human Resources/Benefits Department at (423) 778 -7434 and we will work with you (and, if you wish, with your physician) to find a reasonable alternative program with the same reward that is right for you in light of your health status.
$1, 250 Deductible Bi-Weekly Rates Non-Nicotine User Full-time Part-time Employee Only $37. 00 $65. 00 $112. 00 $140. 00 Employee + Spouse $91. 00 $153. 00 $166. 00 $228. 00 Employee + Child(ren) $78. 00 $133. 00 $153. 00 $208. 00 Employee + Family $139. 00 $226. 00 $214. 00 $301. 00 Erlanger is committed to helping its employees achieve their best health. If you think you might be unable to meet the standards for the nicotine free benefit under Erlanger’s wellness program, you may qualify for an opportunity to earn the same benefit by different means. Contact Work. Force at (423) 778 -4800 and they will work with you (and, if you wish, with your physician) to find a reasonable alternative program with the same reward that is right for you in light of your health status.
Dependent Information • • When enrolling dependents, please make sure you enter their correct address. In many instances, you may have a dependent who does not reside at the same address as you; we need this information in order to determine if Out-Of-Area benefits apply. If any dependents have a different last name than yours; you will need to provide the following: – Spouse – marriage license – Child(ren) – birth certificate(s) – Legal Guardianship – birth certificate(s) and copy of the certified court document naming you the legal guardian (must have judge’s signature) – Step-children – marriage license and certified birth certificates – Adopted or Placed for Adoption Child(ren) – birth certificate(s) and certified court document showing the placement or adoption (must have judge’s signature) YOU HAVE 31 DAYS TO PROVIDE THIS PAPERWORK TO HUMAN RESOURCES BENEFITS DEPARTMENT OR YOUR DEPENDENT WILL NOT BE COVERED. NO EXCEPTIONS WILL BE MADE.
DENTAL PLAN HIGHLIGTS Deductible (Applies to Coverage B and C only) Individual $25 Family $75 Annual Maximum $1, 250 (per person Coverage A, B & C) Covered Services Diagnostic and Preventive Services (Coverage A)* 100% Restorative Services (Coverage B)** 80% Prosthetic and Complex Restorative Services (Coverage C)** 60% Orthodontia (Dependent Children up to age 19) Orthodontic Services (Coverage D) 50% Orthodontia Lifetime Maximum $1, 500
Bi-weekly Dental Rates (Regular Full-time and Regular Part-time) Employee + Spouse $14. 00 Employee + Child(ren) $15. 50 Employee + Family • $7. 00 $25. 00 The maximum age for orthodontia is age 19
Vision Plan Highlights Benefit Coverage Frequency Basic Vision Exam $10. 00 Copayment Every 12 months Frame $130. 00 Allowance Every 24 months Lenses Single vision, lined bifocal, and lined trifocal lenses Every 12 months Lens options Standard Progressive – Covered in Full Bifocal – Covered in Full Progressive – Covered at Lined Trifocal Level Laser Vision Correction Although laser vision correction services are not a covered benefit under the medical or vision plans, you can contact Superior Vision help guide you to one of their in-network providers for a significant discount.
Bi-weekly Vision Rates (Regular Full-time and Regular Part-time) Employee $2. 78 Employee + Spouse $5. 76 Employee + Child(ren) $6. 31 Employee + Family $10. 08
Flexible Spending Accounts • Two plan options: Healthcare and Dependent Care (child care and/or elder care) through Discovery Benefits. FSA Dependent Care is available to you upon your date of hire. An employee is only eligible to participate in the Dependent Care FSA if he or she pays dependent care expenses in order to be able to work or go to school. Only dependents under the age of 13 or dependent adults over the age of 13 who are incapable of self-care can be covered; must be listed as a dependent on your income tax return. Our current plan year ends on December 31, 2017. This is a “use it or lose it” plan; any unused funds will be lost. The max contribution in 2017 is $5, 000 for an FSA Dependent Care account.
Flexible Spending Accounts • FSA Health Care is available after you have completed a 12 month waiting period. • FSA Health Care funds can be used to pay for co-pays, deductibles, prescriptions, dental expenses, eyeglasses, contacts, etc. • The maximum contribution in 2017 is $2, 600 for an FSA Healthcare account as set by the IRS. • Our plan allows a $500. 00 carryover for FSA Healthcare only. This means if you do not use up to $500 of your Healthcare FSA funds can you roll them over to the next plan year; 2017. • Plan year ends December 31, 2017. • Per IRS regulation; you must re-enroll for both FSA plans every year; unless you are just carrying over the $500. 00 rollover from 2017 and are not electing additional funds.
Employee Assistance Program (EAP) • EAP is a company paid benefit available to all employees through Magellan Health in partnership with Principal Financial Group to handle work/life issues. • Topics can include, dealing with conflict, depression, stress management, substance abuse, financial advice or locating child care or elder care to name a few. Help is just a click or phone call away… Online: www. Magellan. Health. com/member Toll-Free Phone Number: 1. 800. 450. 1327 TTY for Hearing Impaired: 1. 800. 456. 4006 International Access Only: 1. 800. 662. 4504
Employer Paid Basic Term Life and AD&D • You must be working a minimum of 19. 5 hours per week (0. 52 to 1. 00 FTE) and be classified as a regular employee • Coverage is effective after 6 months of continuous service; for key managers coverage is effective date of hire • Term Life & AD&D Coverage is equal to 1 x your base salary to a maximum of $750, 000 for employees up to age 69 • Double indemnity applies to the AD&D benefit • Enrollment is automatic • Conversion is available (rates will be based on age-banding and amount being converted)
Voluntary Supplemental Group Term Life and AD&D • You must be hired to work a minimum of 19. 5 hours per week (. 52 -1. 00 FTE) and be classified as a regular employee. • You may purchase coverage in the amount of 1 or 2 times your base earnings. • The minimum benefit is $10, 000 and the maximum benefit is $750, 000. Guarantee Issue limit is $750, 000 for employees up to age 69 (meaning no Evidence of Insurability is needed) • The combined benefit maximum for Basic and Voluntary Life for employees is $1, 500, 000 • Cost is $0. 097 per $1, 000 bi-weekly • Conversion available (rates will be based on age-banding and amount being converted)
Voluntary Group Term Life and AD&D for Spouse and Child(ren) • You must enroll in Voluntary Supplemental Group Term Life and AD&D Insurance in order to elect for your spouse and child(ren) • You can elect up to 50% of your Voluntary Supplemental Group Term Life coverage amount on your spouse • The minimum coverage amount for a spouse is $5, 000 and the maximum amount is $375, 000 • Guarantee Issue Limit for a spouse is $50, 000 (meaning no Evidence of Insurability is required for amounts up to $50, 000) • Cost is $0. 097 per $1, 000 bi-weekly
Voluntary Group Term Life and AD&D for Spouse and Child(ren) • For your child(ren), there are two Voluntary Supplemental Group Term Life and AD&D options: Option 1 - $5, 000 …. . $0. 47 per pay period Option 2 - $10, 000…. . $0. 93 per pay period This benefit is available for children age 6 months to age 25. Children age live birth to 6 months of age are covered with an initial benefit of $1, 000 for either option elected.
Hospital Indemnity Group Hospital Indemnity Insurance provides a benefit regardless of any other insurance program. The plan covers injuries and sickness. • Guarantee Issue is available during the initial enrollment period and for newly eligible employees. • Benefits are available for spouse and/or children. • Voluntary benefit, employee paid • Portable benefit – premiums do not increase if you separate service from Erlanger
Accident Insurance • Voluntary Benefit, employee paid • Pays benefits for an injury you or your covered dependent(s) • Accident Insurance helps offset the out-of-pocket expenses that medical insurance does not pay, including deductibles and copayments. • Portable benefit – premiums do not increase if you separate service from Erlanger
Group Legal Insurance Most legal issues are usually accompanied by other personal and/or financial issues. Legal Club of America has a group legal product called the Family Protection Plan (FPP). The FPP, anchored by the Family Legal Plan, provides employees who elect the benefit access to a nationwide network of pre-qualified professionals in many legal areas. • Free & Discounted Legal Services (Group Legal Hourly Rates & Contingency Fees) • Identity Theft Solutions • Tax Preparation & Advice • Financial Education & Credit Counseling Services • Life Events Counseling • Voluntary benefit, employee paid
Pet Insurance Get coverage for your dogs or cats with pet insurance from VPI, you’re free to choose your own vet. • Group Discount • Insured by Nationwide • 877 -PETS-VPI (877 -738 -7874) / www. petsvpi. com • Plan Options (cost varies based on benefit elected): – Pet Wellness Plan Plus everyday care – Major Medical Plan comprehensive + Pet Wellness Plan Plus everyday care
Employer Paid Long Term Disability • You must working a minimum of 19. 5 hours per week (. 52 -1. 00 FTE) and be classified as a regular employee • Coverage is effective after 6 months of employment; for key managers coverage is effective date of hire. • LTD provides a benefit of 60% of your base salary up to a maximum of $15, 000/month. • If you have received treatment for an illness or injury within 3 months prior to being enrolled in the LTD plan, the plan will not cover the treated illness or injury for 12 months • Enrollment is automatic.
Employer Paid Long Term Disability All Employees Elimination Period 180 days (6 months) Monthly Benefit 60% of base monthly earnings to a maximum of $15, 000 per month Pre-existing Clause 3/12
Employee Paid Voluntary Short Term Disability All Employees Elimination Period 8 day injury/illness Weekly Benefit 60% of your base earnings to a maximum of $2, 500 per week Pre-existing Clause 3/12 Evidence of Insurability If you do elect this benefit when first eligible; you will be subject to EOI. Cost $0. 97 per $10 If you elect to participate in the Voluntary Short Term Disability Insurance Plan this will offset the amount of PTO and STD Bank you will be able to use if you go out for an illness/injury. You will only be able to draw 40% of your PTO and STD Bank if you Short Term Disability claim is approved by the carrier.
PTO Accrual Table Years of Service Hourly Employees per pay period Salaried Employees per pay period (Non-Key managers) Maximum Possible Annual Accrual 0 to 5 years 0. 846 6. 34 165 hours 5 to 10 years . 1038 7. 78 202. 5 hours 10 to 20 years . 1231 9. 23 240 hours 20+ years . 1423 10. 67 277. 5 hours Beginning April 1, 2014 the maximum allowed total accrual will be 400 hours, regardless of years of service. Employees may sell unused PTO up to 150 hours per calendar year on any of the 26 pay periods at a per hour rate equal to 90% of the employee’s current base rate of pay. If you enroll in the Voluntary Short Term Disability Plan through Principal Financial Group and your claim is approved; you will only receive 40% of your PTO Bank from EHS.
Short Term Disability Bank • Employees accrue at. 0306 per hour • Maximum of 8 Days (60 hours) earned per year; may be used for illness or injury. You can access your STD Bank immediately if put under sedation or hospitalized; otherwise employees must use PTO for the first 7 calendar days of absence due to illness. • Short Term Disability Bank hours are prorated for part-time employees. • Use of hours from the STD bank will be reviewed for medical necessity by a panel of physicians and HR personnel • Maximum accrual is 400 hours If you enroll in the Voluntary Short Term Disability Plan through Principal Financial Group and your claim is approved; you will only receive 40% of your STD Bank from EHS.
Benefits Department Contact Information Vel Mc. Grady, Sr. Benefits Analyst Phone: 423. 778. 7346 E-mail: Vel. Mc. [email protected] org Lisa Menzia, Benefits Analyst Phone: 423. 778. 7404 E-mail: Lisa. [email protected] org Jody Nix, Director of Benefits Phone: 423. 778. 6609 E-mail: Jody. [email protected] org Location: Human Resources Department, First Floor