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Planning to add dependents? Click here for more information

For more information on Health Care Reform, click here.

For more information on the Collection of Medicare Health Insurance Claim Numbers (HICNs), Social Security Numbers (SSNs) and Employer Identification Numbers (EINs)(Tax Identification numbers), click here

My Benefits Portfolio

My Resources
Priority Health HMO
BCBSM
Caremark - Rx
Delta Dental
United Healthcare Vision
WageWorks
Hyatt Legal Plans
Trinity Health Corporate Office - Southeast Michigan

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Medical | Dental | Vision
Life Insurance | Short Term Disability | Long Term Disability
Flexible Spending
| Legal

2012 Open Enrollment Booklet and Plan Highlights

Dependent child definition:

Your dependent child may be eligible to be on your health coverage through the end of the year they turn 26. Please click here for more information.

Planning to add dependents?

In order for new family members to be eligible for coverage under any Trinity Health benefit plan, you are required to provide proof of their dependent status. If you are planning to add family members you must submit dependent verification information to Human Resources within 30 days of your new hire or status change date. If you do not submit the required paperwork by the deadline, your newly added dependents will not be enrolled in coverage and you will be required to wait until the next annual enrollment period to enroll new dependents in the plan. Click here for a listing of required documents.

Social Security Numbers Required When Adding Dependents

To remain compliant with federal regulations, all associates must provide Social Security numbers for any dependent age one year and over enrolled in any health or welfare plan offered by Trinity Health. This mandate is outlined in the Medicare, Medicaid and State Children's Health Insurance Program Extension Act of 2007. Social Security numbers are used to coordinate Medicare payments with other insurance and workers' compensation benefits. For more information on the collection of Social Security Numbers for dependents, click here.

Medical

Medical Plans

You have a choice of three medical plan options - Priority Health HealthbyChoice HMO, Healthy Blue Solutions PPO, Personal Care Account (PCA) PPO

Use the plan comparison tool to Estimate My Plan Costs

Personal Care Account PPO
A high deductible (PPO) plan using Blue Cross and Blue Shield Community Blue Network, with a personal care account funded by Trinity Health. The Personal Care Account (which is funded by Trinity Health) is used to fund a portion of the deductible. Once the PCA is exhausted, the remaining amount of the deductible must be met before the regular co-insurances and co-pays apply. Preventative services are 100% covered. Unused PCA funds may be carried over from year to year.

If you and your spouse (if you insure them) go online to bcbsm.com and complete a BlueHealthConnection® health appraisal you will be given a $25 incentive for each employee and spouse with a $50 max per year that will be credited toward your PCA account.

Personal Care Account PPO Summary
Personal Care Account PPO SPD
Preventive Care Overview

Healthy Blue Solutions PPO
Healthy Blue Solutions rewards your decision to actively adopt a healthier lifestyle by reducing your copayments and deductibles. It combines quality PPO health care benefits with effective wellness and care management features. The Healthy Blue Solutions plan offers two levels of benefits:

  • Enhanced offers lower co-payments and deductibles to members who adopt a healthy lifestyle.
  • Standard has higher co-payments and deductibles for members who choose not to participate in the health appraisal and in designated wellness and disease management interventions.

You will automatically enjoy the plan’s enhanced benefit level for the first 120 days of coverage if you and your spouse:

  • Go online to bcbsm.com and complete a BlueHealthConnection® health appraisal by 1/31/2012, and
  • Based on your health appraisal results, attend the first of four appointments with a BCBSM health coach by 4/15/2012.

If you and your spouse do not commit to the above, you will be dropped to the standard benefit level on your 121st day of coverage.

Healthy Blue Solutions Enhanced PPO Summary | Healthy Blue Solutions Standard PPO Summary
Healthy Blue Solutions PPO SPD
Healthy Blue Solutions Member Guide
Complete Health Appraisal
Preventive Care Overview

Find a BCBSM Participating Provider.

HealthybyChoice HMO
Priority Health - HealthbyChoice HMO is a health plan combined with a wellness program encouraging members to make healthier choices. The HealthbyChoice plan has two levels of benefits:

  • Choice offers lower co-payments and deductibles to participants who adopt a healthy lifestyle.
  • Standard has higher co-payments and deductibles for participants who choose not to participate in designated wellness and disease management interventions.

You automatically will enjoy the Choice benefit level of for the first 90 days of coverage if you and your spouse:

  • Complete a Health Risk Appraisal
  • Meet with your primary care physician(s) to complete a Qualification form, and
  • Adopt a healthy lifestyle

If you and your spouse do not commit to the above within your first 90 days of coverage, you will be dropped to the standard benefit level.

HealthbyChoice HMO Summary
HealthbyChioce FAQ
HealthbyChoice Brochure
HealthbyChoice Qualifications Form
Complete Health Risk Appraisal

Dental

You have a choice of two dental plan options - Delta Dental Premier High and Delta Dental Premier Standard.

Delta Premier High Summary
Delta Premier Standard Summary
Delta Premier Certificate

Vision

You have the option of electing two vision benefits through United Healthcare(UHC) Vision.

UHC High Vision Summary
UHC Standard Vision Summary
UHC Vision Benefit Booklet
UHC High Vision SPD
UHC Standard Vision SPD

Life Insurance

Full-time and Part-time benefit eligible associates have Basic Life Insurance provided at 2x annual salary with the option to "buy down" to 1x annual salary.

In addition, you have the option to purchase additional coverage for yourself (up to 5x your annual salary) and your dependents in the following increments:

For Yourself For Your Spouse For Your Child(ren)
1x annual salary
2x annual salary
3x annual salary
4x annual salary
5x annual salary
$10,000
$20,000
$50,000
$100,000
$2,000
$5,000
$10,000
$20,000

Please Note: some elections may require a Statement of Health. It is your responsibility to complete and return your Statement of Health during the Enrollment Period.

Life Insurance Certificate
Statement of Health Form
Life Insurance Enrollment Brochure
Guaranty Association Notices (To be delivered to residents of the applicable states) – Certain state guaranty association laws require that a notice be provided to their residents. The notice explains the protections, subject to limitations and exclusions, available to residents in the event that the insurer becomes financially impaired or insolvent. If the client covers residents in any of the following states, the client must provide the applicable state notice when distributing certificates: Alaska, Arkansas, California, Colorado, District of Columbia, Hawaii, Illinois, Indiana, Kansas, Louisiana, Maryland, Minnesota, Missouri, Mississippi, Montana, North Carolina, North Dakota, New Hampshire, New Jersey, Nevada, Ohio, Oklahoma, Rhode Island, South Dakota, Tennessee, Texas, Utah, Washington, West Virginia, and Wyoming.
Will Preparation Information
- If you elect supplemental life insurance you qualify for free will preparation through Prudential.

Short Term Disability

Please click here for directions on how to file your short term disability claim.

Long Term Disability

Trinity Health provides you with LTD coverage at 60% of your base pay not to exceed a monthly benefit of $10,000. This income replacement benefit begins after you have exhausted your Short Term Disability benefits.

You have the option to "buy-up" your LTD coverage to 66 2/3% of base pay, or "buy-down" your LTD coverage to 50% of base pay.

If you currently have a 50% benefit and elect up to a 66 2/3% benefit, you must complete an Evidence of Insurability Form.

Long Term Disability Certificate

Flexible Spending

A Flexible Spending Account (FSA) gives you a way to pay for your out-of-pocket health care and / or dependent care expenses with before-tax dollars.

Health Care Spending:
You may contribute pre-tax dollars in any amount between $130 and $5,000 annually. Contributions made to the HCSA during the 2012 calendar year will be eligible for reimbursement on services incurred from January 1, 2012 through March 15, 2013. The claim submission deadline will continue to be March 31st. This 2-½ month extension is allowed under new IRS guidelines. Please consider this extension when making your 2012 elections. .

Dependent Care Spending:
You may contribute pre-tax dollars in any amount between $130 and $5,000 annually.

Direct Deposit:
You can elect to have your reimbursements automatically deposited into your checking or savings account by signing up for direct deposit. This can be done by going on www.wageworks.com or by calling WageWorks customer service at 1-877-WageWorks (1-877-924-3967).

Health Care Debit Card:
Associates enrolled the HCSA will receive a debit card that can be used for many health care purchases including prescription co-pays, dental and vision expenses.

Wageworks.com:
HCSA/DCSA participants can track HCSA/DCSA account statuses through www.wageworks.com. This is available 24 hours a day, 7 days a week. With wageworks.com, you can check the status of your HCSA/DCSA, review your HCSA/A balance, sign up for Direct Deposit, print claim forms, and much more. Once you enroll in an HCSA/DCSA, you can register to use www.wageworks.com.

Additional Flexible Spending Account Information
Healthcare Spending Account Claim Form
Dependent Spending Account Claim Form

Flexible Spending Accounts Summary Plan Description-Coming Soon!

Legal

You have the choice of electing legal coverage through Hyatt Legal for yourself and your family.

Hyatt Legal Brochure
Hyatt Legal SPD

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