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Mercy Medical Center - North Iowa, Mason City

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My Health & Welfare

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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 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.

Required Documents

Medical

Please note - Providers/facilities in Rochester, MN or associated with the Mayo Clinc and the University of Iowa Hospitals and Clinics are paid at the non-network level, unless an approved referral has been obtained through Aetna prior to having services at one of these facilities/providers. CLICK HERE FOR MORE INFORMATION.

You have a choice of two medical plan options - Personal Care Account PPO and Standard Option PPO.

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Use the plan comparison tool to Estimate My Plan Costs

Prescription Drug Benefit Changes Effective 8/1/2009

Medical Comparison
Personal Care Account PPO SPD | Personal Care Account PPO Summary
Standard Option PPO SPD | Standard Option PPO Summary
Preventive Care Overview
Preventative Care Summary Modification

Dental

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

Dental Comparison
Delta Standard Summary
Delta 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 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:

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

Short Term Disability

Full and part-time associates are required to use PTO the first week off work to cover the days you were normally scheduled to work. Full-time associates are covered the second week of disability on their regular paycheck at 66 2/3% coverage. After two weeks (starting with the 15th day of disablity), full-time associates are covered through UNUM. UNUM pays at 66 2/3% coverage to a weekly maximum of $2,500.

Short Term Disability Certificate

Long Term Disability

Associates budgeted 32 or more hours per pay are provided LTD coverage at at 60% of your base pay not to exceed a monthly benefit of $10,000. This income replacement benefit begins after being off of work for six months.

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
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.

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.

Streamline Enrollment -If you participate in a medical plan administered by Aetna, you may utilize the streamline enrollment process for any out-of-pocket costs related to your medical claims. Streamline enrollment allows you to receive reimbursement from your Health Care Spending account without submitting a paper claim. To initiate the streamline enrollment process please complete and return the streamline enrollment form to Aetna or sign up through Aenta Navigator.

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
Streamline Enrollment Form
Direct Deposit Authorization Form
Flexible Spending Accounts Summary Plan Description

Legal

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

Hyatt Legal Brochure
Hyatt Legal SPD

Enroll/Review/Change Current Benefits

My Discounts

In addition to the Trinity Health system-wide discounts, Mercy Medical Center associates are eligible to receive various local discounts as described in the attached document.

Mercy Medical Center Discounts - Mercy Club