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Saint Mary's Health Care, Grand Rapids

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My Health & Welfare | Enroll or Make Changes Now

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

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 covering any family members, you must submit dependent verification information to Organization and Talent Effectiveness within 31 days of your new hire and/or status change. If you do not submit the required paperwork by the deadline, your dependents will not be enrolled in coverage and you will be required to wait until the next annual enrollment period to enroll dependents in the plan.

Required Document

Medical Plan Contribution Discount Program

This benefit applies to both medical plans offered: Healthy Blue Solutions PPO and Personal Care Account (PCA) PPO. To increase access to health care services for all of our associates, TrinityHealth has developed a medical plan discount program. To participate in this program, associates must complete the form, submit a copy of their most recent Federal Income Tax Form to the Organization and Talent Effectiveness Office and meet specific income and eligibility guidelines. This program makes medical benefits more affordable by reducing the contribution amount for eligible associates enrolled in a Trinity Health medical plan.

Medical Discount Application

Medical

You have the choice of two medical plans - Personal Care Account (PCA) PPO and Healthy Blue Solutions PPO.

Medical Comparison

PCA PPO and Heathy Blue Solutions PPO Preventive Care Overview
Preventative Care Summary Modification

Personal Care Account (PCA) PPO
Is 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 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. Flexibility to see any physician, in or out of network.

PCA PPO Summary
PCA PPO Summary Plan Description


Healthy Blue Solutions PPO
Healthy Blue Solutions Plan A 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. You will automatically enjoy the plan’s enhanced benefit level.

Healthy Blue Solutions Enhanced PPO Summary
Healthy Blue Solutions Plan Requirements
Complete Health Risk Appraisal
Healthy Blue Solutions PPO SPD

Prescription Drug Changes Effective 11/01/2009

Find a Blue Cross Blue Shield MI Participating Provider

Use the plan comparison tools to Estimate My Plan Costs:
Full Time Associate Cost Advisor
Part Time Associate Cost Advisor

If you take prescription medication on an ongoing basis, your prescription drug plan may allow you, for chronic conditions, to order prescriptions from Medco By Mail. Please visit Medco Health - Rx for more information.
Medco By Mail Claim Form
Medco Fax Cover Sheet

> Looking for a Saint Mary's Health Care Doctor? Visit the Saint Mary's Health Care website and search our Find a Physician directory!

Dental

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

Dental Comparison
Delta Dental Premier Standard Option Summary
Delta Dental Premier High Option Summary
Delta Dental 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 associates have Basic Life coverage provided at 1x Annual Salary.

In addition, you have the option to purchase additional coverage for yourself and your dependents in the increments provided below.

Please Note: Some elections may require a Statement of Health. It is your responsibility to complete and return your Statement of Health form.

Life Insurance Certificate
Life Insurance EOI and Maximum Amendments
Statement of Health Form
Beneficiary Designation Form

Short Term Disability

Saint Mary's Health Care provides full-time associates(budgeted 72 hours or more per pay period) with STD coverage at 60% of your base pay. This income replacement benefit begins after you have exhausted your 40 hour elimination period.

Short Term Disability Certificate

Long Term Disability

Saint Mary's Health care provides full and part-time associates (budgeted 40 hours or more per pay period) with LTD coverage at 60% of your base pay (not to exceed a monthly benefit of $10,000). This income replacement benefit begins on the 181st day of disability.

To provide choice and flexibility, there are two additional coverage levels from which you may choose. 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 a Unum Evidence of Insurability Form.

Long Term Disability Certificate
Evidence of Insurability Form

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.

Click here to help estimate your health care and / or dependent care expenses.

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 2009 calendar year will be eligible for reimbursement on services incurred from January 1, 2009 through March 15, 2010. 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 2009 elections. The claim submission deadline is March 31, 2010.

Over-the-counter Medications (OTC) - Certain OTC items qualify as "medical care" and are eligible for reimbursement through an HCSA. Examples of such items include asprin, allergy and sinus medications, antacids and more.

Dependent Care Spending - you may contribute pre-tax dollars in any amount between $130 and
$5,000 annually. Contributions made to the DCSA during the 2009 calendar year will be eligible for reimbursement on services incurred from January 1, 2009 through December 31, 2009. The claim submission deadline is March 31, 2010.

Click here for additional information regarding HCSAs and DCSAs.

Direct Deposit - You can elect to have your reimbursements automatically depositied into your checking or savings account by signing up for direct deposit. Simply complete a Direct Deposit Authorization Form and submit your completed form to Aetna.

Aetna Navigator - HCSA/DCSA participants can track HCSA and DCSA account statuses through Aetna Navigator, Aetna's member self-service website. Navigator is available 24 hours a day, 7 days a week. Through Aetna Navigator, you can check the status of your HCSA or DCSA, review your HCSA or DCSA balance, sign up for Direct Deposit, print claim forms, and much more. Once you enroll in an HCSA or DCSA,, you can register to use Aetna Navigator.

Healthcare Spending Account Claim Form
Dependent Spending Account Claim Form
Over-The-Counter Drug Claim Form
Direct Deposit Authorization Form
Flexible Spending Accounts Summary Plan Description

Legal

You have the choice of electing legal coverage through Hyatt Legal.

Hyatt Legal Brochure
Hyat Legal Brochure - Spanish Version
Hyatt Legal Summary Plan Description

Enroll or Make Changes Now

My Discounts

In addition to the Trinity Health system-wide discounts, Saint Mary's Health Care associates are eligible to receive various local discounts. For a listing, please go to the Saint Mary's Intranet in the Organization & Talent Effectiveness Folder.