My Benefits Portfolio
My Health & WelfareMy Retirement ProgramMy DiscountsMy ResourcesHome

My Benefits Portfolio

Planning to add dependents? Click here for a list of required documents.

My Benefits Portfolio

My Resources
Advantage Health HMO
Aetna
Medco Health - Rx
Delta Dental
United Healthcare Vision
Hyatt Legal Plans
Saint Joseph's Regional Medical Center, Indiana

NOTE: Acrobat Reader is required to view Plan Summaries.

> My Health & Welfare | > My Voluntary Options

My Health & Welfare

Enroll/Review/Change Current Benefits

Medical | Dental | Vision | Life Insurance | 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 a choice of three medical plan options -Traditional PPO High Option A plan, Standard PPO Option B, and the Advantage HMO plan.

Find an in-network physician using Aetna Doc Find

Find a Sagamore Provider

Use the plan comparison tool to Estimate My Plan Costs

Choose which coverage level you want - Associate Only, Associate/Spouse, Associate/Child(ren), or Family. Full-time associates may "opt-out" of medical coverage with proof of other coverage and receive $500 annually.

Medical Comparison

Traditional PPO High Option PPO SPD | Traditional PPO High Option A Summary
Standard PPO Option B SPD | Standard PPO Option B Summary
Standard PPO and Traditional PPO Preventive Overview
Preventative Care Summary Modification
Advantage Health HMO Plan Summary
Advantage Health HMO Provider Listing

Dental

You have a choice of two dental plans - Delta Premier Standard Option and Delta Premier High Option.

Dental Comparison
Delta Premier Standard Summary
Delta Premier High Summary
Delta Premier Certificate
Delta Dental ID Card

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. Your employer pays the cost of your Basic Life Insurance..

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 to MetLife Insurance Company during the Enrollment Period.

Life Insurance Certificate
Plymouth Statement of Health Form
South Bend Statement of Health Form
OLP Statement of Health Form
SJRMC, Inc. Statement of Health Form

Long Term Disability

SJRMC provides Full-time associates with LTD coverage at 60% of your base pay not to exceed a monthly benefit of $10,000. This cost is provided in the flexible credits you receive. 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

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 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 Voluntary Options

In addition to your group benefits, Trinity Health has partnered with The Farmington Company to provide eligible associates the opportunity to elect personal insurance plans from a portfolio of products. Individual policy options include:

Universal Life Insurance
Long Term Care Insurance
Cancer Insurance
Critical Illness Insurance
Accidental Death and Dismemberment (AD&D) Insurance
Auto/Home Insurance
Pet Insurance

Enroll Now in My Voluntary Options