Mercy Health Partners, Mercy Service/Support Union
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Health & Welfare
Medical | Dental
| Vision | Life Insurance
Long Term Disability | Flexible
Spending | Legal
New overage dependent child definition for 2010:
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 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
Coming Soon!!!
Effective July 1, 2010 Trinity Health and its Ministry
Organizations will transition from Medco, our existing pharmacy
benefit manager (PBM), to CVS Caremark. This change
applies only to associates and retirees who are covered under
a self-insured medical plan (that is, Blue Cross Blue Shield
of Michigan, Aetna, Priority Health and NGS American). It
does NOT apply to fully insured plans (Blue Care Network (BCN),
Priority Health HMO, etc.).
In preparation for this change, over the coming weeks
you’ll receive more information about the transition
to CVS Caremark. In addition, shortly before the July 1 effective
date you’ll receive new medical and pharmacy ID cards.
Be sure to watch your home mail for these important materials.
Visit www.caremark.com/trinityhealth
for more information.
Medical Plans
You have a choice of two medical plan options - Muskegon
Union PPO and Blue Care Network HMO.
Find a BCBSM Community Blue
Participating Provider
Muskegon
Union PPO SPD | Muskegon
Union PPO Summary
Caremark
Summary of Material Modification - Effective 7/1/2010
Blue Care Network Summary
Dental
You have the option of electing dental coverge through Delta
Dental.
Delta Premier 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 employees have Basic Life Insurance
provided as described in your "Benefits at a Glance."
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
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 2010 calendar year will be eligible
for reimbursement on services incurred from January 1, 2010
through March 15, 2011. The claim submission deadline will
continue to be March 31st. Please consider this extension
when making your 2010 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
|
