ENROLLMENT 2022 BENEFITS - MARCH 2022-FEBRUARY 2023 - Document Locator
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
MARCH 2022-FEBRUARY 2023 2022 BENEFITS ENROLLMENT YOUR BENEFITS, YOUR STORY Benefits to fit your unique situation 3 TIPS For an easy enrollment ANNUAL ENROLLMENT February 7th- February 15th, 2022
OUR BENEFIT OFFERINGS
How to Choose a Plan Dental & Vision
Medical & Prescription Drug Basic and Voluntary
Life
Flexible Spending Accounts Accident &
Critical Illness
3
1. ENROLL FEBRUARY 7th – 15TH!
TIPS FOR EASY ENROLLMENT
Annual enrollment is your one chance to choose your benefits for the upcoming
plan year. Outside of this enrollment period you will not be able to make any
changes unless you have a qualifying life event, such as getting married or having
a baby. Go to healthcare.gov for a full list of qualifying life events.
2. TO ENROLL OR NOT TO ENROLL?
This year you are required to enroll in and / or waive your benefits.
3. UP YOUR BENEFITS IQ
Have questions about your benefit options? Not sure what is right for you? Make
sure to check out your benefits website at: madisonco.mybenefitportal.com. And
don't forget about the TrueAdvocate Team! They are available from 7:30 a.m. - 5
p.m. CST to answer your benefits questions. Just call 888-655-9980 OR email
trueadvocate@truenorthcompanies.com.
4. Review the Annual notices and SBCs
Got to your benefit portal at madisonco.mybenefitportal.com to review the
Annual Notices and Summary of Benefits and Coverage. (SBCs). If you would
like a paper copy or email of these documents please contact Tessa Prochaska.
The plan information outlined in this enrollment guide is intended to be a snapshot of the benefits and does not provide full plan details. For complete plan information and any
policy restrictions, refer to your plan document. If any discrepancy exists between the summary displayed in this guide and the policy, the policy will govern.
WHAT’S CHANGING?
Annual enrollment for 2022 will begin
February 7th and end February 15th.
There will be changes to your benefits
this year and EVERYONE IS REQUIRED
TO ENROLL OR WAIVE BENEFITS.
• We will be changing the premium contributions to 4 Tier rates. I.E. Single, Employee
Spouse, Employee Child(ren) and Family.
• Wellness and Non Wellness rates will apply. To qualify for the Wellness rates you will need
to get preventive exam and have your doctor complete the required form.
• Adding a second Medical Plan option for more flexibility to meet your health care needs.
• Both plan options will have some small changes changes to the prescription drug
coverage.
• Product selection penalty. If you chose to take a brand name drug when a
generic is available you will be responsible to pay the difference in the cost
between the generic version and the brand name.
• Specialty drugs will be required to be filled by CVS Specialty Pharmacy. If you are
impacted by this change Wellmark will reach out to you to switch over your
prescription.
• New Benefit: We will be adding a flexible spending account for healthcare and
dependent care expenses.
• Specialty Medications must be filled at CVS Specialty Mail
• Product selection penalty for prescriptions. If you take a brand name drug and a
generic is available you will pay the difference in cost from the generic in addition to the
copay.
• Transplant network has been added. Transplants need to performed at a Blue Distinction
Center of Excellence.
• Life and Disability coverage will be moving to Symetra.
• Short Term Disability will be improved with a shorter waiting period before benefit begin to
pay. Disability benefit will now begin on the 15th day, reduced from 30 days.
• New Benefit: Opportunity to purchase Voluntary coverage through Symetra including
Accident and Critical Illness/Hospital.
The plan information outlined in this enrollment guide is intended to be a snapshot of the benefits and does not provide full plan details. For complete plan information and any
policy restrictions, refer to your plan document. If any discrepancy exists between the summary displayed in this guide and the policy, the policy will govern.
Rate Notification
Madison County will be covering a portion of the
cost on the family plan if you enroll in Plan 1
family coverage. You will pay no more than
$200 per month for this coverage. (this includes
medical, dental and vision combined.)
Madison County will be bearing the additional
cost above $200.
The plan information outlined in this enrollment guide is intended to be a snapshot of the benefits and does not provide full plan details. For complete plan information and any
policy restrictions, refer to your plan document. If any discrepancy exists between the summary displayed in this guide and the policy, the policy will govern.
Medical Plan through Wellmark
WELLMARK BCBS: 800-524-9242
WWW.WELLMARK.COM
To help you and your family get the
best care possible, Madison County
provides the option to enroll in
medical coverage. See the
information below for a quick
overview of plan details. For a full
summary of plan details, please view
your Summary of Benefits and
Coverage.
BENEFITS PLAN #1: $1,000 PPO NEW! PLAN #2: $2,000 PPO
$1,000 Single $2,000 Single
Deductible
$2,000 Family $4,000 Family
You pay 10%, You pay 20%,
Coinsurance
plan pays 90% plan pays 80%
$2,000 Single $4,000 Single
Out of Pocket Maximum
$4,000 Family $8,000 Family
$20 PCP $25 PCP
Office Visit Copay $20 Specialist $50 Specialist
$20 Doctor on Demand $25 Doctor on Demand
Preventive
Covered at 100% Covered at 100%
Office Care
Emergency Room Deductible + 10% coinsurance Deductible + 20% coinsurance
Lab / X-Ray /
Advanced Deductible + 10% coinsurance Deductible + 20% coinsurance
Diagnostics
Tier 1: $10 copay
Tier 1: $5 copay
Tier 2: $30 copay
Tier 2: $25 copay
Prescription Tier 3: $45 copay
Tier 3: $40 copay
Drug Specialty: $150 copay
Specialty: $150 copay
Out of Pocket Max: Included with
Out of Pocket Max: $1,000 / $2,000
medical
Plan Rates Wellness / Non-Wellness Wellness / Non-Wellness
Employee: $75.23 / $167.18 $53.95 / $154.14
Employee + Spouse: $154.22 / $342.72 $110.60 / $315.99
Employee + Child(ren) $142.19 / $315.97 $101.96 / $291.33
Family $230.96 (capped at $200) / $513.24 $165.62 / $473.21
For more information refer to the portal OR Contact your TrueAdvocate at 888-655-9980.
Dental Plan
WELLMARK: 800-524-9242
WWW.WELLMARK.COM
SERVICES PPO DENTIST OUT-OF-NETWORK
Preventive Services 100% covered 100% covered
Deductible $25 Single / $75 Family $25 Single / $75 Family
You pay 20% coinsurance You pay 20% coinsurance
Basic Services (after deductible), (after deductible),
plan pays 80% plan pays 80%
You pay 50% coinsurance You pay 50% coinsurance
Major Services (after deductible), (after deductible),
plan pays 50% plan pays 50%
Annual Maximum $1,500 per person per year $1,500 per person per year
You pay 50% coinsurance You pay 50% coinsurance
Orthodontic
(after deductible), (after deductible),
For dependent children
plan pays 50% coinsurance, up to plan pays 50% coinsurance, up to
up to age 19
a lifetime maximum of $1,500 a lifetime maximum of $1,500
EMPLOYEE EMPLOYEE & EMPLOYEE & EMPLOYEE &
PLAN RATES
ONLY SPOUSE CHILDREN FAMILY
Per Pay Period $2.92 $5.47 $6.66 $10.73
For more information refer to the portal OR Contact your TrueAdvocate at 888-655-9980.
Vision Plan
AVESIS: 855-214-6777
WWW.AVESIS.COM
IN-NETWORK OUT-OF-NETWORK
SERVICES
MEMBER COST REIMBURSEMENT
Exam $10 copay Up to $35
1 every 12 months
Materials Copay $25 Up to $45
Contacts • Elective $110 • Elective up to $110
1 every 12 months • Medical necessary covered in full • Medically necessary up to $250
Please note: Contact lenses are in
Please note: Contact lenses are in
place of lenses and frame.
place of lenses and frame.
Frames $50 wholesale allowance (Up to Up to $45
1 every 12 months $150 retail)
Standard Lenses Covered in full after $25 copay Single Lined-Up to $25
1 every 12 months Bifocal Lined-Up to $40
Trifocal-Up to $50
Lenticular-Up to $80
Standard Up to $50, plus 20% off retail Up to $40
Progressive Lenses
EMPLOYEE EMPLOYEE & EMPLOYEE & EMPLOYEE &
PLAN RATES
ONLY SPOUSE CHILDREN FAMILY
Per Pay Period $0.68 $1.19 $1.47 $1.78
For more information refer to the portal OR Contact your TrueAdvocate at 888-655-9980.
FSAs: Healthcare on Sale
www.wexinc.com
IF YOU COULD BUY HEALTH CARE SERVICES DURING A 30% OFF SALE, WOULD YOU?
There are programs available that save you money on health-related expenses, no strings attached.
HEALTH CARE FLEXIBLE SPENDING ACCOUNT (FSA)
Specific health insurance No, BUT if you are enrolled in a High Deductible Health Plan
coverage required to contribute? you can only enroll in a Limited Flexible Spending Account
Pre-tax contributions Yes
Most qualified health care expenses (medical, dental, vision,
Eligible Expenses
prescription drug expenses your plans do not cover)
Be sure to keep your receipts. You may need to submit
these to Wex to validate your expenses. If you do not
Debit Card and Receipts submit a receipt when requested you may be required to
pay back the claim. The best receipt is your EOB
(explanation of benefits) from the carrier.
Healthcare: Available on day 1
Dependent Care: Funds must accumulate before using
Availability of funds in account
Plan starts on March 1, 2022. and ends on February 28th,
2023.
Yes, you lose money you haven’t used or claimed by certain
Use it or lose it
annual deadlines.
2 ½ month grace period. You will have until May 15th to
Grace Period
spend you flex dollars on the Health FSA.
Can take it with you if you leave
No
the company
Healthcare: $2,850
Maximum Contributions
Dependent Care: $5,000
LET’S LOOK AT AN EXAMPLE: NOW YOU TRY:
Use the chart below to calculate YOUR potential savings!!
YOUR CONTRIBUTION:
You contribute the maximum amount Annual
of $2,850 for the year to your FSA Account Tax Bracket Savings
Contribution
YOUR TAXES: FSA
You are in the 30% tax bracket Max. Contribution
Healthcare: $2,750
YOUR SAVINGS: $ _______ x _______% = $_______
Limited Purpose: $2,750
You save $855 on your Dependent Care: $5,000
Life and AD&D Insurance
SYMETRA: 800-796-3872
WWW.SYMETRA.COM
BASIC LIFE AND AD&D BASIC LIFE AND AD&D BENEFIT
Life insurance pays a benefit
(called a death benefit, which is Employee: Flat amount of $20,000
usually a lump sum) to a Life Spouse: Flat amount of $2,000
beneficiary (whomever you choose Child(ren): Flat amount of $2,000
to receive the benefit) after your
death. If you have a life insurance Accidental Death &
Flat amount of $20,000
policy on a family member (such as Dismemberment
your spouse or your child(ren)), you
would receive the money if that
family member died. This money
can help replace your income. VOLUNTARY LIFE AND AD&D BENEFITS
Increments of $10,000 up to $250,000, but
no more than 5 times annual salary
Employee
Guarantee Issue is 5 times annual salary, up
to $100,000 when you are first eligible.
Increments of $5,000, 100% of employee’s
VOLUNTARY LIFE AND AD&D benefit, up to $50,000.
You have the option to purchase a Spouse Guarantee Issue is 100% of employee’s
greater amount of Life and AD&D benefit up to $25,000 when you are first
coverage. Decide whether this extra eligible.
benefit is worth the cost of coverage
for you and your family. To figure 100% of employee’s benefit, up to $10,000
this out, ask a few questions: for children 6 months and older.
Children
How would your family’s finances Guarantee Issue is 100% of employee’s
be affected if you died? benefit up to $10,000.
How much of your paycheck is used
for monthly living expenses? If you wish to increase your life insurance
amounts during this enrollment period or
Evidence of
enroll for the first time you will need to
Insurability
complete health questions for approval
before coverage will begin.
For more information refer to the portal OR Contact your TrueAdvocate at 888-655-9980.Disability Insurance
SYMETRA: 800-796-3872
WWW.SYMETRA.COM
If you are unable to work, disability insurance can help
replace your income so you can pay your bills and protect
your savings.
SHORT-TERM DISABILITY
Short-term benefits pay a weekly benefit when you are
unable to work for a certain amount of time.
LONG-TERM DISABILITY
Long-term benefits usually take over when Short-term
benefits end. This is often a monthly benefit, either a
percentage of your salary or a flat amount.
BENEFITS* SHORT-TERM LONG-TERM
66 2/3% of weekly 66 2/3% of monthly
Coverage amount income to a maximum income to a maximum
of $1,000 of $5,000
Social Security Normal
Maximum payment period 11 weeks
Retirement Age (SSNRA)
Accident benefits begin Day 15 Day 91
Illness benefits begin Day 15 Day 91
3 months /
Pre-existing conditions None
12 months look back
For more information refer to the portal OR Contact your TrueAdvocate at 888-655-9980.Employee Assistance Programs
EMPLOYEE ASSISTANCE
PROGRAM (EAP)
For more information refer to the portal OR Contact your TrueAdvocate at 888-655-9980.Voluntary Coverages
SYMETRA: 800-796-3872
WWW.SYMETRA.COM
PLAN RATES PER PAY PERIOD
Per Pay Period
Base Classic
ACCIDENT Rates
Stay ahead of the medical and out-of-pocket Employee (EE) $4.75 $6.30
expenses that add up so quickly after an
accident. When you have a covered accident, EE & Spouse $7.95 $10.58
you can receive cash benefits to use however
you see fit. Coverage typically includes
ambulance services, emergency room visits, EE & Child(ren) $9.12 $12.22
intensive care unit confinement, etc.
EE & Family $12.95 $17.36
PLAN RATES PER PAY PERIOD
CRITICAL ILLNESS/Hospital Indemnity
Typically pays a lump-sum benefit directly to Per Pay Period
Plan 1 Plan 2
you at the time a covered illness (such as a Rates
stroke, heart attack or cancer) occurs or is
diagnosed. When you are sick, the last thing you Employee (EE) $9.24 $15.57
want to think about is your finances. You can
typically use the money for everyday expenses EE & Spouse $16.76 $27.44
like mortgage payments, utility bills or
childcare. The hospital plan also provides a EE & Child(ren) $11.76 $19.39
benefit if you are hospitalized even for reason
other than a critical illness, for example having a
EE & Family $20.01 $32.37
baby.
For more information on these coverages visit the new benefit portal:
madisonco.mybenefitportal.com
For more information refer to the portal OR Contact your TrueAdvocate at 888-655-9980.YOUR ENROLLMENT BLUEPRINT
Remember, your annual enrollment period is from FEBRUARY 7th – 15TH.
ALL EMPLOYEES MUST ENROLL IN OR WAIVE COVERAGE THIS YEAR!
VISIT YOUR BENEFITS PORTAL STEP
Website: madisonco.mybenefitportal.com
Login: madison 01
SCAN QR CODE
TO ACCESS
ATTEND ENROLLMENT MEETINGS
Meeting #1: February 8th
Time: 1:00 & 2:30
STEP
02
Location: Annex
Meeting #2: February 10th
Time: 2:00 & 3:45
Location: Annex
EVALUATE YOUR OPTIONS STEP
• Review available benefit options
for the year.
• Use carrier resources and tools
03
to make decisions.
STEP
04
NEED HELP ENROLL IN YOUR BENEFITS
ENROLLING? • Complete 2022 Enrollment Form.
Contact • Return to Tessa Prochaska by
Tessa Prochaska February 15th.
515-462-5026Healthcare Hacks
Healthcare Hacks
Still need assistance with
picking a plan or saving
money on healthcare? Don’t
worry, you have all the right
tools at your fingertips!
HEALTHCARE TO GO
Sick but no time to get to the doctor?
Try Doctor on Demand ® instead!
Get connected to a board-certified
doctor anytime, anywhere through
online video chat. Doctors treat non-
emergency conditions like:
• Cold & flu symptoms
• Sinus infections
• Pink eye
How To Register
• Allergies & more
1
For more information, go to
3
DoctoronDemand.com.
EVEN MORE WAYS TO SAVE HAVE WHAT YOU NEED COMPLETE REGISTRATION
Check out these tools from Two ways to register: You will receive an email
If you have your Wellmark ID confirmation. Click on ‘activate my
Wellmark to help you save more
and number: account’ in the email. Do this
and get educated!
• Date of Birth within seven days to prevent your
• myWellmark: Member portal
new registration from expiring.
with customized information on • Last four digits of your
your benefits & claims. Social Security Number After clicking the link, you can
• Blue365: Receive discounts on If you DO NOT have your login to myWellmark.
gym memberships, fitness Wellmark ID and number:
equipment & more! • Date of Birth
• ID Theft Protection: Free • Last name FREE MOBILE APP
protection for members. • Full Social Security Number Manage your healthcare
2
• BeWell 24 / 7: Talk to a real on the go.
person when you have questions 1. Download the app from the
about care navigation or need to START YOUR ACCOUNT App Store or Google Play.
speak with a nurse. 1. Go to welcome.wellmark.com. 2. Sign up for myWellmark.
2. Enter your email address and 3. Gain access to:
password. (make note of these • Your benefits, claims and
for future use) spending
3. Follow the registration process. • Wellness information
• Your Wellmark ID card
• Network Providers
• … and more.Need Help?
Contact these Enrollment VIPs for Assistance!
MEDICAL & PRESCRIPTION DRUGS DENTAL
Carrier: Wellmark BCBS Carrier: Wellmark BCBS
Phone: 800-524-9242 Phone: 800-524-9242
Website: www.wellmark.com Website: www.wellmark.com
VISION FLEXIBLE SPENDING ACCOUNTS
Carrier: Avesis Carrier: WEX
Phone: 855-214-6777 Phone: 866-451-3399
Website: www.avesis.com Website:
www.wexinc.com / solutions / benefits /
BASIC & VOLUNTARY LIFE / DISABILITY ACCIDENT / CRITICAL ILLNESS & HOSPITAL
Carrier: Symetra Carrier: Symetra
Phone: 800-775-6000 Phone: 800-796-3872
Website: www.symetra.com Website: www.symetra.com
This publication has been prepared by TrueNorth Companies, L.C. and is intended for informational purposes only. This
publication does not constitute any type of representation or warranty, and does not constitute, and should not be relied
upon as, legal or medical advice. This publication is not a contract and does not amend, modify or change any insurance
policy you may have with an insurance carrier. © 2022 TrueNorth Companies, L.C. All rights reserved.Notes
You can also read
