Blue Care Network HMO Blue Cross Blue Shield MI PPO Caremark - Rx Delta Dental United Healthcare Vision Hyatt Legal Plans WageWorks

Mercy Health Partners, Union Associates

NOTE: Acrobat Reader is required to view Plan Summaries.

> My Health & Welfare

My Health & Welfare | Enroll Now

Medical | Dental | Vision
Life Insurance | | Long Term Disability | Short 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

You have a choice of two medical plan options - High Option A PPO and Blue Care Network Healthy Blue Living.

BCBSM PPO

Find a BCBSM Community Blue Participating Provider

High Option A PPO Summary
High Option A PPO SPD
Preventive Care Overview

BCN
Healthy Blue Living is an innovative health plan that rewards members with lower costs for pursuing their health goals. The Healthy Blue Living plan has two levels of benefits:

• Enhanced 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 enhanced 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
• If you’re a smoker, join Quit the Nic smoking cessation program within your first 120 days of enrollment, 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.

Healthy Blue Living Summary
Healthy Blue Living HRA Insturctions
Healthy Blue Living Member Checklist
Healthy Blue Living Member Guide
Healthy Blue Living Qualifications Form

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:

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

Please click here for directions on how to file your short term disability claim.

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.

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

Enroll Now