Summary of Employee Benefits

Transcription

1 Huntsville Memorial Hospital Benefits Program July 2017 June 2018 l ia r o m e M e l il v ts n u H r u Make yo! u o y r o f k r o w s it f e Ho s p it a l be n Eligibility & Enrollment Summary of Employee Benefits Health Care Income Protection And More...

2 At Huntsville Memorial Hospital (HMH), we know how important it is to have good, affordable health and group benefits. That s why we offer competitive benefits that can provide protection, peace of mind, and savings. Whether it s health care, income protection, or other benefits, we ve got you covered. This guide provides a general overview of your benefit choices and enrollment information to help you select the coverage that is right for you. Know Enrollment. Do I Need to Enroll? There are lots of good reasons to enroll. For starters, there are probably changes to your benefits including what you pay for coverage. Also, you may have experienced changes in the past year, so it s a good idea to make sure your benefits still fit you and that you re not paying for more coverage than you need. Take a close look at all the benefits and options Huntsville Memorial Hospital offers you. You must enroll if you want to: Change your medical, dental, or vision coverage for next year. Keep in mind, if electing spouse coverage, you must complete the Spouse Medical Plan Affidavit through the HMH BenefitsNow enrollment system. If you are a tobacco user, or believe you are eligible for the health premium for non-tobacco users, you must confirm your tobacco usage status through the HMH BenefitsNow enrollment system. Specify your Health Savings Account election contributions, if enrolling in the OAP $2,000 with HSA medical plan. Contribute to the Health Care and/or Dependent Care Flexible Spending Accounts (FSAs). Change your optional employee or dependent life insurance. Change your disability elections. If you don t enroll, you may be assigned coverage that won t meet your needs. To enroll, or make changes, be sure to visit the HMH BenefitsNow enrollment site, review your current elections and make changes as necessary, by the enrollment deadline. When Can I Enroll? New Employees As a new employee of Huntsville Memorial Hospital, you become eligible for benefits on the first of the month coinciding with or following your date of hire and you must enroll within 30 days of becoming eligible. Our benefits plan year runs from July 1 through June 30. Annual Enrollment As a benefits-eligible employee, you have the once-a-year opportunity to enroll in or make changes to your benefit plans during our annual benefits enrollment period, unless you experience a qualifying life event. Annual enrollment is typically held in May, with elections effective July 1. Contents Know Enrollment...2 Do I Need to Enroll?... 2 When Can I Enroll?... 2 Know Who is Eligible...3 Who Can I Cover?... 3 What if Things Change During the Year?... 3 Know Your Medical and Prescription Drug Benefits...4 Know Your Dental Benefits...6 Know Your Vision Benefits...6 Know Your Income Protection Benefits...7 Life Insurance... 7 Disability (b) Retirement Savings Plan... 8 Know Your Additional Benefits...9 Health Savings Account (HSA)... 9 Flexible Spending Accounts... 9 Elective Benefits... 9 Wellness Employee Assistance Program Know Your Rights

3 Know Who is Eligible. Who Can I Cover? You can enroll in the benefits listed in this guide as a full-time or part-time benefits-eligible employee working 20 hours or more per week. You can also cover certain dependents (in other words, family members or loved ones) under the plans. Eligible dependents include: Your legal spouse; For medical: your child(ren) up to age 26 regardless of marital or student status for whom you have legal guardianship; or Your child who is 26 or more years old, unmarried, and primarily supported by you and incapable of selfsustaining employment by reason of mental or physical disability that arose while the child was covered as a dependent under this plan. Anyone who is eligible as an Employee will not be considered as a Dependent spouse. A child under age 26 may be covered as either an Employee or as a Dependent child. You cannot be covered as an Employee while also covered as a Dependent of an Employee. For dental and vision insurance: your unmarried child(ren) up to age 25; or Your unmarried child, 25 years of age or older, who is not self-supporting because of mental or physical disability and is chiefly dependent upon you for support and maintenance. Proof must be provided within 31 days of turning age 25. Anyone who is eligible as an Employee will not be considered as a Dependent. No one may be considered as a Dependent of more than one Employee. For optional life and AD&D insurance: your child who is 14 days of age but less than 21 years old or 25 if a full-time student; or Your child who is 21 or more years old, primarily supported by you and incapable of self-sustaining employment by reason of mental or physical disability. Proof must be submitted within 31 days after the date the child ceases to qualify as a dependent. Please refer to the plan summaries or contact the Huntsville Memorial Hospital Human Resources for additional information on benefits and eligibility. What if Things Change During the Year? The benefits you choose will be effective through the end of the plan year. You cannot make changes to your coverage during the year unless you have a qualifying life event, which includes but is not limited to: Marriage, legal separation, or divorce; Birth, legal adoption of a child, or placement of a child with you for legal adoption; or Death of your spouse or dependent child. After a qualifying life event occurs, you must notify and submit any applicable forms and/or documentation to Human Resources within 30 days* of the event. Human Resources will review your request and determine whether the change you are requesting is allowed. Only benefit changes that are consistent with the qualifying life event are permitted. *60 days if you, your spouse, or eligible dependent child loses coverage under Medicaid or a state Children s Health Insurance Program (CHIP) or becomes eligible for state-provided premium assistance. All HMH Medical Plan Options HMH facilities and physicians participating in the Cigna OAP network are eligible for the HMH benefits level. After checking the Cigna OAP network to determine if they are participating with Cigna OAP, review the HMH intranet site for up-to-date information about HMH facilities and physicians participating in the HMH benefits level. Pre-authorization is required for hospital admissions and other outpatient services. Call the customer service number on the back of your ID card for pre-authorization services. All HMH Medical Plan Options Now included in the Participating HMH Benefits Level! Texas Children s Hospital M.D. Anderson - Cancer Treatment St. Luke s Health - The Woodlands and Downtown (Heart, Neurosurgery or other major surgeries not available at HMH) Texas Orthopedic (Orthopedic surgeries not available at HMH) Spousal Surcharge The Working Spouse Surcharge is $100 per bi-weekly pay and is charged to employees who enroll a spouse who has access to other group medical benefits (such as through work or military service) in an HMH medical plan. When considering whether to cover your spouse, compare the cost of your spouse s plan and HMH s plan, including the surcharge. The spousal surcharge does not apply if your spouse: Does not work; Works part time; Is not eligible/has lost coverage as an active employee, but has been offered COBRA; or Is covered by Medicare. If your spouse experiences a qualified change in status (loss of job, etc.) during the year, he or she can be added to your coverage with no surcharge, provided notification and proof is submitted within the time-frame allowed for a qualifying life event. Tobacco User Surcharge If you and/or a family member are tobacco users, a tobacco user surcharge of $23.08 per bi-weekly pay, per each family member who is a tobacco user, will be added to your premium contributions. HMH will require confirmation of your tobacco usage status at the time of enrollment through the HMH BenefitsNow enrollment system. For those participating in Wellness, free tobacco usage cessation resources are available, which may include personal coaching and free nicotine replacement. HMH encourages you to take advantage of this wellness benefit. If you complete the tobacco cessation program, you may be eligible to convert to the non-tobacco premium plan contributions. Contact your Human Resources Representative for more information about changing your tobacco status. 3

4 Know Your Medical and Prescription Drug Benefits. Providing comprehensive and high-quality medical coverage at a reasonable cost is a challenge for all employers. HMH meets this challenge by providing employees with two medical plan options that include prescription drug coverage. The information below is a summary of medical coverage only. Please visit Cigna at or contact Human Resources for plan summaries detailing coverage information, limitations, and exclusions. Any deductibles, copays, and coinsurance percentages shown in the chart below are amounts for which you are responsible. Medical Benefits Summary Key Features Participating HMH Cigna OAP $750 Cigna OAP $1,250 In-Network - Cigna OAP Out-of- Network 1 Participating HMH In-Network - Cigna OAP Out-of- Network 1 Plan Year Deductible Individual Family Plan Year Out-of-Pocket Max Individual Family No member of the family will need to meet more than the individual deductible amount. $750 $2,250 $750 $2,250 $2,500 $7,500 Includes deductible, copay, coinsurance. No member of a family will need to meet more than the individual out-of-pocket maximum amount. $3,250 $3,250 $9,750 $9,750 No member of the family will need to meet more than the individual deductible amount. $1,250 $3,750 $1,250 $3,750 $3,750 $11,250 Includes deductible, copay, coinsurance. No member of a family will need to meet more than the individual out-of-pocket maximum amount. $5,000 $5,000 $12,700 $12,700 Lifetime Maximum Coinsurance (percent you pay) 10% 30% 50% 10% 30% 50% Physician Services Doctor s office visit Specialist Urgent care $25 copay 4 $35 copay 4 $75 copay 4 $45 copay 4 $55 copay 4 $75 copay 4 $75 copay 4 $25 copay 4 $35 copay 4 $75 copay 4 $45 copay 4 $55 copay 4 $75 copay 4 $75 copay 4 HMH Clinics Doctor s office visit Specialist $25 copay 4 $35 copay 4 $25 copay 4 $35 copay 4 Preventive Care No charge No charge No charge No charge Lab and Radiology Services Independent Lab Outpatient Lab and X-ray Advanced Radiology Imaging No charge No charge $150 copay per scan 4 20% 3 30% 3 $1,500 copay per scan, then 30% 3 No charge No charge $150 copay per scan 4 20% 3 30% 3 $1,500 copay per scan, then 30% 3 Hospital Facility Services Inpatient Outpatient surgery Inpatient/Outpatient professional $150 copay, then 10% 2 $150 copay, then 10% 2 10% 3 $1,500 copay, then 30% 3 $1,500 copay, then 30% 3 20% 3 $2,000 copay, then $2,000 copay, then $150 copay, then 10% 2 $150 copay, then 10% 2 10% 3 $1,500 copay, then 30% 3 $1,500 copay, then 30% 3 20% 3 $2,000 copay, then $2,000 copay, then Emergency Room $300 copay, then 20% 2 (copay waived if admitted within 24 hours) $300 copay, then 20% 2 (copay waived if admitted within 24 hours) Retail (30-day supply) 5 Generic Preferred brand Non-preferred brand Not available $7 copay $40 copay $60 copay Retail - 90 day supply available for maintenance medications at 3x retail copay. Prescription Drug Not available $7 copay $40 copay $60 copay Mail Order (90-day supply) 5 Generic Preferred brand Non-preferred brand Not available $18 copay $100 copay $150 copay Not available $18 copay $100 copay $150 copay All Specialty Medications must be obtained through Cigna Specialty Pharmacy. 1 If an out-of-network provider charges more than the allowed amount, you may have to pay the difference. For example, if an out-of-network hospital charges $1,500 for an overnight stay and the allowed amount is $1,000, you may have to pay the $500 difference. This is called balance billing. 2 Coinsurance, deductible is waived. 3 Coinsurance after deductible. 4 Copay no deductible. 5 If you request your prescription be filled with the brand name drug, when there is a generic equivalent available, an additional charge of the difference in cost between the generic and the brand name drug will apply. 4

5 Medical Benefits Summary Continued Key Features Plan Year Deductible Individual Family Plan Year Out-of-Pocket Max Individual Family Lifetime Maximum Cigna OAP $2,000 with HSA Participating HMH In-Network - Cigna OAP Out-of-Network 1 All family members contribute towards the family deductible. An individual cannot have claims covered under the plan coinsurance until the total family deductible has been satisfied. $2,000 $4,000 $2,000 $4,000 $4,000 $8,000 Includes deductible, copay, coinsurance. All family members contribute towards the family out-of-pocket. An individual cannot have claims covered at 100% until the total family out-of-pocket has been satisfied. $4,000 $6,850 $4,000 $6,850 Coinsurance (percent you pay) 10% 30% 50% Physician Services Doctor s office visit Specialist Urgent care HMH Clinics Doctor s office visit Specialist Deductible/20% Deductible/20% Deductible/20% Preventive Care No charge No charge Know How to Choose. When you think about your health care costs, the first thing that comes to mind is probably your premium the amount that comes out of every paycheck for coverage. But to see the total picture, you also have to consider what you re likely to pay out of your pocket, such as when you go to the doctor or get a prescription. Keep this in mind as you review the following health care plan sections. Remember, take what you ll pay for the different coverage options and then add what you think you ll pay for health care services during the year. Estimating your health care costs this way could give you an idea which option will be the best total value for your family. Lab and Radiology Services Independent Lab Outpatient Lab and X-ray Advanced Radiology Imaging Deductible/20% Deductible/30% Deductible then $1,500 per scan and 30% Hospital Services Inpatient Outpatient surgery Outpatient professional Emergency Room Retail (30-day supply) 2 Generic Preferred brand Non-preferred brand Prescription Drug Not available Deductible/30% Deductible/30% Deductible/20% Deductible/20% (not subject to coinsurance) $7 copay after ded. $40 copay after ded. $60 copay after ded. Retail - 90 day supply available for maintenance medications at 3x retail copay. Mail Order (90-day supply) 2 Generic Preferred brand Non-preferred brand Not available (not subject to coinsurance) $18 copay after ded. $100 copay after ded. $150 copay after ded. All Specialty Medications must be obtained through Cigna Specialty Pharmacy. Deductible then $2,000 per admission and 50% 1 If an out-of-network provider charges more than the allowed amount, you may have to pay the difference. For example, if an out-of-network hospital charges $1,500 for an overnight stay and the allowed amount is $1,000, you may have to pay the $500 difference. This is called balance billing. 2 If you request your prescription be filled with the brand name drug, when there is a generic equivalent available, an additional charge of the difference in cost between the generic and the brand name drug will apply. Know Your Terms. Coinsurance: A percentage of costs you pay out of your pocket for covered expenses after you meet the deductible. Copay (Copayment): A fee you have to pay out of your pocket for certain services, such as a doctor s office visit or prescription drug. Deductible: The amount you pay out-of-pocket before the health plan will start to pay its share of covered expenses. Network: Doctors, pharmacists, and other health care providers who make up the plan s preferred providers. When you use in-network providers, you pay less because they have agreed to negotiated pricing. Out-of-Pocket Maximum: The most you pay each year out of your pocket for covered expenses. Once you ve reached the out-of-pocket maximum, the health plan pays 100% for covered expenses. Preventive Care: Services you receive when you are not sick or injured so that you will stay healthy. Preventive care services include annual physicals, wellness screenings, and well-baby care. How do I find out if my doctor is in Cigna s Network? Visit Select Find a Doctor Choose the directory If your insurance plan is offered through work or school Enter your location Select Medical Plan: Open Access Plus, OA Plus, Choice Fund OA Plus Enter your search criteria (Name, Type of Doctor, Hospital, etc.) Select Search Remember to review the HMH intranet site for up-to-date information about HMH facilities and physicians participating in the HMH benefits level. 5

6 Know Your Dental Benefits. Dental coverage is important to your overall health and wellness. You can enroll in dental benefits through Cigna Dental for yourself and your family. HMH offers you a choice of two dental options, Standard and Enhanced, that feature a network of dentists and specialists who have agreed to provide services at a discounted price. So, if you use these in-network providers, you ll pay less. Access Total Network, to locate a participating provider. You can still get care from any providers out of the network, but you ll pay more. The plan covers: Preventive and diagnostic services like routine exams and cleanings, fluoride treatments, sealants, and X-rays Basic services such as simple fillings and extractions, root canals, oral surgery, and gum disease treatment Major services such as crowns and dentures Orthodontia for dependent children The Enhanced dental option includes coverage for implants Key Features Cigna Dental Choice Standard Plan 1 Cigna Dental Choice Enhanced Plan 1 In-Network Out-of-Network 2 In-Network Out-of-Network 2 Plan Year Deductible Individual / Family $50 / $150 $50 / $150 Plan Year Annual Max $1,500 per participant $2,500 per participant Reimbursement Levels Based on Contracted Fees 80th percentile of Reasonable and Customary Allowances Based on Contracted Fees 90th percentile of Reasonable and Customary Allowances Preventive Services No charge 3 No charge 3 No charge 3 No charge 3 Basic Services You pay 20% 4 You pay 20% 4 You pay 20% 4 You pay 20% 4 Major Services You pay 50% 4 You pay 50% 4 You pay 50% 4 You pay 50% 4 Implants You pay 50% 4 You pay 50% 4 Orthodontia child(ren) < 19 You pay You pay You pay You pay Orthodontia Lifetime Max $1,000 $1,000 1 Missing tooth limitation - 12 months for teeth missing prior to coverage with Cigna; review the Cigna benefit summary and certificate for details. 2 If an out-of-network provider charges more than the allowed amount, you may have to pay the difference. 3 Deductible waived. 4 Coinsurance after deductible. Know Your Vision Benefits. Be Ready for the Unexpected Will you need dental services such as a filling, root canal, or crown in the next year? Do you wear glasses or contact lenses? If you answered yes to either of these questions, consider the Health Care Flexible Spending Account (FSA). Learn more about FSAs on page 9. Huntsville Memorial Hospital offers you and your dependents vision coverage through Superior Vision Services. This information is a summary of vision coverage only, refer to the plan document for details regarding the plan. Key Features In-Network Out-of-Network Frequency Exam $10 copay Up to $40 reimbursement Once per plan year Standard Lenses $25 copay Up to $45 - $125 reimbursement Once per plan year Frames $25 copay; up to $130 allowance Up to $63 reimbursement Once every other plan year Contact Lenses Standard Optical Medical Necessity Up to $150 allowance Covered in full Up to $150 allowance Up to $210 allowance Once per plan year 6

7 Know Your Income Protection Benefits. Huntsville Memorial Hospital provides eligible employees with a variety of plans to provide replacement income to you or your beneficiaries in the event of disability, accident, or death. This information is a summary of coverage only. Refer to your certificates of coverage for more detail. Life Insurance Basic Life and Accidental Death and Dismemberment (AD&D) HMH provides full-time and part-time employees with basic life insurance and AD&D coverage in the amount of one times annual salary to a maximum of $200,000 (rounded to the next higher $1,000). Benefits are reduced to 65% at age 70 and to 50% at age 75. Coverage terminates at retirement or employment termination. If you terminate your employment or if you become ineligible for this coverage, you may have the option to convert all or part of the amount of life insurance in force on the date of termination without Evidence of Insurability (EOI). Conversion election must be made within 31 days of your date of the event. Optional Life and AD&D You can also purchase optional life insurance for yourself, your spouse, and child(ren). Remember, life insurance isn t just about paying for memorial services. It s also about making sure your family can maintain its standard of living over the long run. How much your family would need depends on your situation (debts, expenses, etc.). You can elect additional life coverage for: You can elect additional AD&D coverage for: Yourself: Increments of $10,000, up to a maximum of $500,000 Your Spouse: 60% of employee optional AD&D amount (when employee and spouse only) or 50% of the employee optional AD&D amount (when children are covered) Your Child(ren): 20% of employee optional AD&D amount to a maximum of $50,000 (each child) You and/or your spouse will need to submit an Evidence of Insurability (EOI) form to Human Resources for Cigna s review, to elect optional life coverage: 1) in amounts over the guaranteed issue limit; 2) increases during annual enrollment; or 3) if you enroll after your initial eligibility period. Elections requiring EOI will not be active unless approved by Cigna. Age reductions apply to Optional Life and AD&D elections. Optional Life: benefits reduce to 65% at age 70 and to 50% at age 75. Optional AD&D: benefits reduce to 65% at age 65, 50% at age 70 and to 25% at age 75. Yourself: Increments of $10,000, up to a maximum of the lesser of five times your annual salary or $500,000; guaranteed issue limit of $200,000 Your Spouse: Increments of $5,000, up to a maximum of $250,000 and not to exceed 50% of employee life amount; guaranteed issue limit of $50,000 Your Child(ren): $10,000 for each child 14 days to age 21 (or age 25 if a full-time student) 7

8 Know Your Income Protection Benefits. Continued Disability According to the National Safety Council, 490 Americans became disabled in the last 10 minutes. Without disability insurance, those Americans could have no work income for as long as they can t work. You have access to short-term disability (STD) and long-term disability (LTD) insurance through Cigna. Voluntary STD: If you can t work due to an eligible accident or eligible illness, this benefit pays 60% of your weekly pay, up to a maximum benefit of $750 per week, subject to plan requirements. Benefits will begin on the first day of disability resulting from an accident and on the eighth consecutive day of disability resulting from sickness or pregnancy. The maximum benefit period is the earlier of 13 weeks or until you are no longer disabled. You pay the full cost of this coverage at discounted group rates. Voluntary LTD: This benefit pays a portion of your income during periods of total disability lasting more than 90 days resulting from a covered injury, sickness, or pregnancy. LTD benefits provide you with 60% of your monthly salary to a $3,000 monthly maximum. You pay the full cost of this coverage at discounted group rates. Catastrophic Disability Benefit (CDB): If you elect the CDB benefit option, and you are disabled and have a loss of two or more qualified activities of daily living, you will receive an additional benefit equal to 20% of your basic monthly salary, up to a maximum of $2,000. You pay the full cost of this coverage at discounted group rates. Note: Any disability elections made after you re initially eligible require you to complete and submit an Evidence of Insurability (EOI) form to Human Resources for Cigna s review. Elections requiring EOI will not be active unless approved by Cigna. 403(b) Retirement Savings Plan Know how HMH offers you help to save for a secure financial future? Huntsville Memorial Hospital began sponsoring a 403(b) retirement savings plan for our employees in 2011 that is administered by Lincoln Financial Group. Saving for retirement is easy and convenient. Electing to contribute money into the savings plan lowers your taxable income so you pay less in taxes now and take more income home. You do not pay taxes on your savings while your contributions remain in your account. You can contribute between 1% and 75% of your eligible pay on a pretax basis, up to the annual IRS dollar limit of $18,000 for 2017 and $18,500 for If you make the maximum contribution to your 403(b) plan account, and you are age 50 or older during the calendar year, you may also make an additional $6,000 catch-up contribution. You will receive matching contribution of up to 3% of your compensation from HMH into your 403(b) account. HMH matches 50% of your salary deferrals up to 6% of your compensation. Note: You are automatically enrolled in the 403(b) plan at a 3% contribution rate of your pretax eligible earnings and will automatically increase 1% each plan year, to a maximum contribution rate of 10%. If you want to change your contribution rate or discontinue participation, call Lincoln Financial Group. Visit for more information about contribution rates, investments, enrollment, withdraws, loans transfers, as well as for general plan information. 8

9 Know Your Additional Benefits. Health Savings Account (HSA) (for Employees enrolled in the Cigna OAP $2,000 with HSA medical option) A Health Savings Account (HSA) is a great way to save for the future. Just set aside a few dollars from each paycheck now, and then you ll have funds to help cover health care expenses that come up. Plus, it s tax-free so you re actually getting a better deal. The HSA allows you to set aside tax-free money to pay for qualified health care expenses, like your medical, dental and vision copays, deductibles and coinsurance. If you are enrolled in the Cigna OAP $2,000 with HSA medical option, you will be automatically enrolled in a Health Savings Account (HSA) and you may contribute on a pre-tax basis to your HSA. With the Cigna OAP $2,000 with HSA medical option, you will have to meet your deductible for all services other than preventive care, so remember to specify your HSA contributions in the HMH BenefitsNow enrollment system. The balance in your HSA will roll from year to year. Maximum annual contribution limits are determined by IRS guidelines. The HSA is tied to the Cigna OAP $2,000 with HSA. You must be enrolled in the Cigna OAP $2,000 with HSA to participate in the HSA. Your Account, Your Money - You can use your HSA to pay for eligible health care expenses. Money rolls over each year - Lose the worry of having to spend it all before the end of the year. With the HSA, the balance rolls over year after year so you can let it grow over time. Take it with you - Your HSA is yours to keep, even if you retire or leave the company. It s convenient - Contributions are automatically deducted from your paycheck. Important Notice: If you are enrolled in Medicare, Tricare, your spouse s medical plan, or other health coverage, your spouse has a Flexible Spending Account, or you can be claimed on another person s tax return, you are not eligible to open a Health Savings Account. For additional details, review the materials and video links available through the HMH BenefitsNow enrollment system. Flexible Spending Accounts HMH offers three types of Flexible Spending Accounts (FSAs) no matter which medical option you choose that can help you save for out-of-pocket expenses: Employees not enrolled in the OAP $2,000 with HSA: You can use the Health Care FSA for eligible health care expenses, such as deductibles, copays, coinsurance, as well as for prescription drugs, dental, and vision expenses. Employees enrolled in the OAP $2,000 with HSA: You can use the Health Care Limited Purpose FSA for eligible dental and vision expenses. You can use the Dependent Care FSA for eligible child and elder care expenses, so you (and your spouse, if married) can work or go to school. Each year, you can contribute up to $2,600 to the Health Care FSA and up to $5,000* to the Dependent Care FSA. There are tax savings, too, because contributions go from your paycheck into your FSA before taxes are figured. This lowers your taxable income, so you pay less in taxes. Plus, when you have eligible expenses, you pay for them with tax-free money. The plan year is July 1, 2017 June 30, Expenses must be incurred and purchased during the designated plan year. Eligible expenses must be submitted for reimbursement no later than 90 days after the end of the plan year. Any money left in the FSA after the deadline is forfeited, known as the use-it-or-lose-it rule. Elective Benefits HMH is pleased to offer a selection of voluntary benefits. These benefits can enhance your core benefits portfolio and are designed to help protect your finances. The following benefits are available: Benefit Carrier Description Hospital Indemnity Benefits* Group voluntary Critical Illness** Group Accident Kemper Allstate Allstate Supplemental Medical Plan that pays you first dollar benefits with no deductibles should you or one of your family members become ill or suffer an accident and are hospitalized. Group voluntary critical illness coverage from Allstate Benefits provides a lump-sum cash benefit to help you cover the out-of-pocket expenses associated with a critical illness. Group voluntary accident coverage from Allstate Benefits pays cash benefits for expenses associated with accidental injury and can help protect hardearned savings should an off-the-job accidental injury occur. * No health questions when enrolling within the employee s open enrollment period. No late entrant enrollments available. ** Guarantee issue amounts available at your initial enrollment eligibility. Enrolling after your initial eligibility period or increasing your benefit amount will require evidence of insurability. Visit for a current list of eligible expenses, claims filing deadlines, and other information about your accounts. *If you are married and file income taxes separately from your spouse, the maximum you can contribute is $2,500. 9

10 Know Your Additional Benefits. Continued Wellness Huntsville Memorial Hospital is proud to offer an employee wellness program to promote and improve the health and fitness of our staff. Together, we will be encouraging you to learn about healthy lifestyles and the changes we can all make that will allow us to live healthy lives today and prevent health problems tomorrow. July 2017 June 2018: The annual physician exam and dental exam are now required components of the wellness program and will not apply towards points needed for the incentive. You may earn points for using the HMH gym or participating in the HMH exercise classes! Wellness Program All employees are eligible to participate in the wellness program. Each plan year, criteria is established for the Wellness Program. Program criteria includes: Annual exams, educational activities, monthly activities and personal goals that must be completed during the benefit plan year beginning July 1 thru June 30th in order to be eligible for the Wellness Incentive. The Wellness Incentive is available to full-time, benefits eligible staff only. Upon completion of the wellness program activities, employees on the hospital s insurance plan may earn up to $500 off of their insurance premium. Employees not on the hospital s insurance may earn up to $300 flexible spending card upon completion of the wellness program activities. All employees are encouraged to utilize all free onsite fitness classes and the Huntsville Memorial Hospital employee gym! The Wellness Department is responsible for tracking proof of activities. Huntsville Memorial Hospital also offers smoking cessation assistance for staff who want to quit smoking. For additional information on the Wellness Program, call Employee Assistance Program Through the Employee Assistance Program (EAP), you and eligible members of your household have 24/7 access to confidential counseling to help you address issues such as relationships, drug and alcohol abuse, financial hardship, and general stress or depression. Many issues can be addressed directly with an EAP professional; in some cases, you may be referred to other resources. The EAP is available 24 hours, seven days a week by calling or visiting 10

11 Know Your Rights. Women s Health and Cancer Rights Act Federal law requires a group health plan to provide coverage for the following services to an individual receiving plan benefits in connection with a mastectomy: Reconstruction of the breast on which the mastectomy has been performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; and Prostheses and physical complications for all stages of a mastectomy, including lymphedema (swelling associated with the removal of lymph nodes). The group health plan must determine the manner of coverage in consultation with the attending physician and patient. Coverage for breast reconstruction and related services will be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan. Medicaid and the Children s Health Insurance Program Medicaid and the Children s Health Insurance Program (CHIP) offer free or low-cost health coverage to children and families. If you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. Some states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your state Medicaid or CHIP office by calling 877.KIDS.NOW or visiting to find out how to apply. You must request coverage within 60 days of being determined eligible for premium assistance. Additional Notices Please contact Human Resources for additional information about the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Family and Medical Leave Act of 1993, Continuation of Coverage Rights Under COBRA, and the Medicare Part D Creditable Coverage Notice. Termination of Active Service Benefits terminate on the date your active service ends. For more details, please refer to the summary plan description (SPD), plan document or certificate of coverage for each plan. About This Guide This guide highlights your benefits. Official plan and insurance documents govern your rights and benefits under each plan. For more details about your benefits, including covered expenses, exclusions, and limitations, please refer to the individual summary plan description (SPD), plan document, or certificate of coverage for each plan. If any discrepancy exists between this guide and the official documents, the official documents will prevail. Huntsville Memorial Hospital reserves the right to make changes at any time to the benefits, costs, and other provisions relative to benefits. Did you know all the plans cover preventive care? Know How to Stay Well. It s true. In-network preventive care like annual physicals, wellness screenings, immunizations, and well-baby care is 100% covered without having to pay your deductible. So, be sure to schedule your annual preventive screening. 11

12 Updated 1/2018