BCBSM Medco Health - Rx Delta Dental Spectera Vision Hyatt Legal Plans

Trinity Home Health Services
Mercy Home Care and Mercy Hospice Cadillac/Grayling

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My Health & Welfare

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. 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 electing 2 medical plans: High Option B PPO and Personal Care Account (PCA) PPO.

Find a BCBSM Community Blue Participating Provider

Use the plan comparison tool to Estimate My Plan Costs

High Option PPO SPD | High Option PPO Summary
PCA PPO SPD | PCA PPO Summary
PPO Preventive Care Overview

Dental

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

Delta Premier Summary
Delta Preferred Summary
Delta Premier Certificate
Delta Preferred Certificate

Vision

You have the option of electing vision coverage through Spectera Vision.

Spectera Vision Summary
Spectera Vision SPD

Life Insurance

Full-time employees have Basic Life Insurance provided at 2x annual salary. Part-time employees have Basic Life Insurance provided at 1x annual salary.

In addition, you continue to 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 retrun your Statement of Health during the Enrollment Period.

*New Hires - if you elect spouse life insurance in excess of $20,000 you must complete a Statement of Health.

Life Insurance Certificate
Homecare Statement of Health Form
Hospice Statement of Health Form
Beneficiary Designation Form

Short Term Disability

THHS provides Full-time employees with STD coverage at 66 2/3% of your base pay after your complete your seven calendar waiting period. This Short Term Disability benefit is available to you the first of the month following one year of Full-time benefit eligible employment.

Short Term Disability Certificate

Long Term Disability

THHS provides you with LTD coverage at 60% of your base pay not to exceed a monthly benefit of $10,000. This income replacement benefit begins after you have exhausted your Short Term Disability benefits.

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 2008 calendar year will be eligible for reimbursement on services incurred from January 1, 2008 through March 15, 2009. 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 2008 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 continue to have the choice of electing legal coverage through Hyatt Legal for yourself and your family.

Hyatt Legal Brochure
Hyatt Legal SPD

Contact your Human Resources Department for enrollment forms.