St. Mary Mercy Hospital, Livonia
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My Health & Welfare | Enroll
Now
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 planning
to add family members during annual enrollment, you must submit
dependent verification information to Human Resources within
31 days. 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.
Required Documents
Medical
You have a choice of three medical plan options - Priority
Health HMO, PPO High Option B, Personal Care Account (PCA)
PPO
Find a BCBSM
Participating Provider.
Use the plan comparison tool to Estimate
My Plan Costs.
Medical Comparison
Priority Health HMO
Summary
PPO High Option B SPD - coming 2008 |
PPO High Option Summary
PCA PPO SPD - coming 2008 |
PCA PPO Summary
PPO Preventive Care Overview
> Looking for a
St. Mary Mercy Doctor? Visit the St. Mary Mercy website
and search our Find
a Doctor directory!
Dental
You have a choice of two dental plan options - Delta Dental
Premier Standard and Delta Dental Premier High Option.
Dental Comparison
Premier Standard Summary
Premier High Summary
Delta Premier Certificate
Vision
You have the option of electing vision coverage through Spectera
Vision.
Spectera Vision Summary
Spectera Vision SPD
Life Insurance
Full-time and Part-time associates continue to 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 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
Beneficiary Designation
Form
Short Term Disability
SMMH provides Full-time associates with Short Term Disability
coverage at 66 2/3% of your base pay for a maximum period
of 26 weeks. This income replacement benefit begins after
you have exhausted your fourteen day elimination period.
Short Term Disabililty Certificate
Long Term Disability
Full-time and Part-time associates are provided 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" 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
Evidence of Insurability Form
Flexible Spending Accounts
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 2008 calendar year will be eligible
for reimbursement on services incurred from January 1, 2008
through March 15, 2009. 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 2008 elections.
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.
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 participants can track HCSA
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, review your HCSA balance, sign up for Direct Deposit,
print claim forms, and much more. Once you enroll in an HCSA,
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 for yourself and your family.
Hyatt Legal Brochure
Hyatt Legal SPD
|
