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Holy Cross Hospital, Silver Spring

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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

You have the choice of three medical plan options- the PPO Standard Option, the PPO High Option, and the Kaiser HMO.

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Medical Comparison
PPO SPD | PPO Standard Summary | PPO High Summary
PPO Preventive Care Overview
Preventative Care Summary Modification
Kaiser HMO Summary

> Looking for a Holy Cross Hospital Doctor? Visit the Holy Cross Hospital website and search our Find a Physician directory!

Dental

You have the choice of two dental plan options - Delta Dental Premier and Delta Dental Preferred.

Dental Comparison
Delta Premier Summary
Delta Preferred Summary
Delta Premier Certificate
Delta Preferred 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 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

Short Term Disability

Full Time associates are provided with STD coverage at 60% of your base pay. This income replacement begins after you have exhausted your thirty day elimination period.

Short Term Disability Certificate

Long Term Disability

Full Time associates are provided with LTD coverage at 60% of your base pay not to exceed a monthly benefit of $15,000. 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" your LTD coverage to 50% of base pay.

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. Contributions made to the DCSA during the 2009 calendar year will be eligible for reimbursement on services incurred from January 1, 2009 through December 31, 2009. The claim submission deadline will continue to be March 31st.

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

Hyatt Legal Brochure
Hyatt Legal SPD

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My Discounts

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

Holy Cross Health Discounts