St. Mary Mercy Hospital, Livonia
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My Health & Welfare | Enroll
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Medical | Dental
| Vision
Life Insurance | Short
Term Disability | Long Term Disability
Flexible Spending | Legal
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 Healthby Choice 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.
2010 Personal
Care Account PPO SPD | Personal
Care Account PPO Summary
2011 Personal Care Account PPO SPD - Coming Soon!
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 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 HA 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 Complete
Health Appraisal
Healthy
Blue Solutions PPO SPD
Healthy
Blue Solutions Member Guide
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
> 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 one dental plan - Delta Dental Premier
High Option.
Premier High 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 associates continue to have Basic
Life Insurance provided at 2x 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
Enrollment/Beneficiary
Designation 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
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. Please
click here
for directions on how to file your short term disability claim.
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.
Long Term Disability
Certificate
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.
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
|
