...In the Pursuit of Excellence
Employee Benefits 2014
Table of Contents
Company Letter
1
Hatcher Agency Contact Sheet
2
Benefit Overview
3
Medical Benefits
4
Dental Benefits
5
Life Benefits
6
Short Term Disability Benefits
7
Long Term Disability Benefits
8
Vision Benefits
9
Accidental Death and Dismemberment Benefits
10
Cancer & Critical Illness Benefits
11-12
Permanent Term to Age 100 Life Benefits
13-14
Frequently Asked Questions
15-16
Carrier Contacts
17
Disclaimer & Disclosures
18
Welcome to Drew Memorial Hospital...
Drew Memorial Hospital cares about you and your family. We have spent a lot
of time making sure we offer you the best benefit package that is available. We
want you to understand that benefits are a valuable part of your compensation
package. These benefits can help protect important things like your income
and assets if you become sick or injured and cannot work. This will ease the
burden for your family members during difficult times.
We encourage you to take a look at the information in this booklet so you can
make more informed choices about your benefit package plan. As always we
are here to help in any manner possible.
We are also open to questions, comments, and suggestions from YOU, our
STAFF, in order to make our benefit package the best that health care has to
offer.
Sincerely,
Shannon Clark, CFO
Keith Van Dee, HR Director
SIX PILLARS OF OPERATIONAL EXCELLENCE
EMPLOYEE SATISFACTION
CUSTOMER SERVICE
SAFE QUALITY CARE
FINANCIAL GROWTH AND COMMUNITY
1
Voted Best Corporate
Insurance Provider by
Arkansas Business Readers
Nine Years in a Row!!!
2004, 2005, 2006, 2007, 2008, 2009,
2010, 2011, 2012 & 2013.
“The Home of Outrageous Service”
Greg Hatcher
Trish Birch
Cell: (501) 517-4734
Cell: (501) 912-4333
[email protected] [email protected]
Kelsey Hatcher
Cell: (501)258-2566
kelsey@hatcheragency.
Louise Tripp
Cell: (501) 776-7412
[email protected]
The Hatcher Agency is proud to be
the insurance broker for you and
Drew Memorial Hospital. The Hatcher
Agency is an independent agency that
shops the market each year for all of our
clients to get them the very best deal. In
fact it is our promise to find you the lowest
price each and every year with carriers that
are the best in class. In addition to providing
you the very best value for your
coverage it is our goal to deliver
all of you Outrageous Service.
In fact we wrote the book, 55
Steps to Outrageous Service.
Please feel free to contact any
of your representatives shown below if you
ever have customer service questions in
regard to your plan or if we can help you in
any way. Our mission is to work for you and
help you get the most out of your benefits.
310 Louisiana Little Rock, AR 72201
(501) 375-3737 • (800) 359-3748 • (501)375-0446 (f)
www.hatcheragency.com
2
Benefit Overview
BENEFITS
Deduction/Funding
(24 Pay Periods)
$77.75 • Provides benefits for office visits,
$149.94
preventive care, prescription drugs,
$227.77
and hospital services.
$12.91 • Provides benefits for preventive
Dental Benefits by
$24.22
services, restorative care,
Delta Dental
$44.53
periodontics, root canals, and x-rays.
• Life and AD & D insurance amounts
Group Life and AD & D
Employer Paid
are based on each employee’s
Benefits by USAble Life
classification.
Group Short Term Disability
• Benefit can pay 60% of weekly salEmployee Paid
ary up to $2,000 per week.
Benefits by Lincoln Financial
• Benefit can pay 60% of pre-disability
earnings to a maximum of $10,000
Group Long Term Disability
Employer Paid
Benefits by Assurant
per month. Benefit begins after 180
days of disability.
Employee:
$5.96
• Provides benefits for a yearly
Employee/Child(ren): $10.63
Vision Benefits by Delta Vision
eye exam, lenses, frames, and/or
Employee/Spouse:
$10.46
contacts.
Family:
$14.67
• You can purchase in $100,000 units
Accidental Death &
Dismemberment by
Employee Paid
up to $400,000 units of coverage.
Lincoln Financial
• Family coverage is available.
• A lump sum of $20,000 is provided
Cancer & Critical Illness
for the employee, 50% of the amount
Employee Paid
Benefits by Colonial Life
is available for the spouse and/or
children.
• Permanent term life insurance to age
100 for you, your spouse, children or
Permanent Term to Age 100
grandchildren.
Employee Paid
Life Benefits by 5Star Life
• Rates remain the same throughout
policy life and do not increase with
age.
Health Benefits by
Blue Cross Blue Shield
Employee:
Employee + 1:
Family:
Employee:
Employee + 1:
Family:
COVERAGE OPTIONS
3
Health Benefits
Summary of Medical Benefits
Benefit
PPO 204 Grandfathered
In-Network
Out-of-Network
Deductibles and Maximums
Calendar Year Deductible
Individual
$500
$500
Family
$1,500
$1,500
Coinsurance
80%
60%
Deductible Carry Over
Yes
Out of Pocket Calendar Year Maximum (deductible included)
Individual
$2,500
$8,500
Family
$7,500
$25,500
Lifetime Benefit Maximum
UNLIMITED
Covered Services
Office Visits
Deductible+Coinsurance
Primary Care Physician
$35 Co-Pay
Deductible+Coinsurance
Deductible+Coinsurance
Specialist
Emergency Medical Care
Deductible+Coinsurance
Deductible+Coinsurance
Emergency Room
Deductible+Coinsurance
Deductible+Coinsurance
Ambulance
Hospital Services
Deductible+Coinsurance
Deductible+Coinsurance
Inpatient services
Deductible+Coinsurance
Deductible+Coinsurance
Outpatient Services
Prescription Plan
Co-Payments
Generics
$15
Preferred Brands
$45
Non-Preferred Brands
$65
Mail Order Prescriptions
None
Dependents covered to age 26. Please see the FAQ for more information on dependent coverage.
Employee:
$77.75
Rates (24 Pay Periods)
Employee + 1:
$149.94
Family:
$227.77
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
4
Dental Benefits
You have the opportunity to enroll in the Delta Dental plan. This plan provides
a high level of family benefits. You can get discounts on services offered by
dentists who are members of Delta Dental’s panel of dentists.
Summary of Dental Benefits
Coverage
In-Network
Benefit
Deductibles and Maximums
Calendar year deductible
Individual
Annual Benefit Maximum
Individual
Family
Covered Services
$50 (3X)
$1,000
$1,000 per person
Preventive care (cleaning, x-rays, fluoride
treatments, sealants)
100%
Basic services (lab tests, white composite fillings,
extractions, space maintainers, endodontics, oral
surgery, minor emergency treatment)
80%
Major services (crowns, bridges, dentures, inlays,
posts, periodontics, implants, denture repair)
50%
Orthodontic lifetime maximum benefit of $1,000 for
children up to age 19.
Additional Benefits
Carry Over Benefit:
Limitations:
•
•
•
•
•
Member receives annual maximum January 1st.
Member must have one covered dental service during the year.
Paid claims for the benefit year must be less than half of the annual maximum
A quarter of the annual maximum will be carried over for future use.
Carry over benefit maximum is up to $2,000.
The benefit allowance for services of an out of network dentist will be reduced by 10% for
eligible services as determined by Delta Dental after applying the applicable deductibles,
copays, and maximums. This means your out of pocket expense may be greater if you choose
and out of network dentist. There is a 12 month waiting period on the replacement of existing
appliances for employees not covered for 12 months on a previous group dental plan. After 12
months replacement of an existing appliance will be covered if it is more than 5 years old.
Dependents covered to age 26.
Employee Only:
$12.91
Rates (24 Pay Periods)
Employee + 1:
$24.22
Family:
$44.53
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
5
Life Benefits
and AD & D
This benefit is employer paid as an important part of your benefits
compensation package. Your life insurance is $50,000 if you are a
salaried employee and $30,000 if you are an hourly employee.
Life and AD & D benefits will reduce (see age reduction schedule) and terminate at retirement.
Age Reduction Schedule
Age
% Reduction
65
70
75
35%
60%
75%
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
6
Short Term
Disability
Being unable to work should
not hurt your bank account.
Features you will appreciate:
Affordable Coverage– Because Drew Memorial
Hospital has purchased a group plan you will be able
to get absolute best rates available.
You are going to miss work for several weeks
because of an injury, accident, or illness. You may
have a week or two of sick leave or earned time off,
but after that, what happens?
Elimination Period– You are eligible to receive
benefits after you have been unable to work for 7 days
due to covered illness or injury. This is the period of
continuous disability which must be satisfied before
you are eligible to receive benefits.
Fortunately, your employer provides you an
opportunity to purchase individual short term
disability insurance from Lincoln Financial. It can pay
you a percentage of your income if you become
disabled due to a covered illness or off-the-job
accident.
Benefit Duration– Your benefit duration is 25 weeks.
This is the length of time you may be eligible to
receive benefits as long as you are deemed disabled
by your physician.
• During this enrollment period, if you are actively
at work and work a minimum of 30 hours per
week, you can apply for coverage of up to 60% of
your weekly earnings to a maximum of $2,000
per week for up to 25 weeks if deemed disabled
by your physician.
• Because you pay your
premium with post-tax
dollars, your benefit will
not be taxed, under
current tax laws.
Payroll Deduction– Your premiums are automatically
deducted from your paycheck.
Benefit Payment- After you satisfy your 7 day
elimination period your benefit will pay up to 25
weeks as long as you are deemed disabled by your
physician.
No Pre-existing– All employees are covered on
the effective date of coverage with no pre-existing
conditions clause.
Sample Equation for Short Term Disability Rates:
Step One:
your annual salary x 0.60 / 52 = your weekly benefit
Step Two:
your weekly benefit x 0.139 x 12 / 24 = your pay period cost
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
7
Long Term
Disability
What happens if you get sick or seriously hurt?
What would happen if you were seriously injured
Employer Paid!
in a car accident or diagnosed with cancer? You
may eventually get better, but it could take a long
time. It is possible you may never be able to return
to work.
Additional features included in your LTD policy:
Survivor Benefit– Your eligible survivor will
receive a lump sum benefit equal to three months
of your gross disability payment if, on the date of
your death, your disability had continued for 180
or more consecutive days, and you were receiving
or were entitled to payments under the plan.
In addition to dealing with health issues, how
would you make your house and car payments,
buy food, clothing and other essentials? Much
depends on your paycheck and that is why
Drew Memorial Hospital provides long term
disability (LTD) insurance from Assurant.
Partial Residual Disability– Your LTD plan
covers you if you are partially disabled. Please
refer to your plan document for a complete
explanation.
You are eligible for LTD coverage if you are an
active employee working a minimum of 30 hours
per week.
What kind of coverage is provided?
Once you are disabled for 180 days as defined
by the plan (see information at the back of the
booklet), the benefit can pay 60% of your predisability monthly earnings.
It is important to Drew Memorial Hospital that
every employee has the best long term disability
coverage.
How long do payments last?
• Pays a maximum monthly benefit up to $10,000
• Pays 60% of salary
Your LTD benefits are payable for the period
during which you continue to meet the definition
• 180 day elimination period
of disability. Payments continue based on how
(before benefits begin to pay)
old you are when your disability occurs. If your
disability occurs before age 60, benefits would be
• Definition of disability: two year own occupation
paid according to the benefit duration schedule.
• Employer Paid!
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
8
Vision
Benefits
Where will your eyes take you today?
You have the opportunity to enroll with Delta Vision and with them, you will get the
personalized eye care you deserve. Delta Vision will help you see well, stay healthy, and
get the most out of life.
Summary of Vision Benefits
Eye examination
Prescription lenses
Single vision lenses
Lined bifocal vision lenses
Lined trifocal vision lenses
Lenticular lenses
Frames
Progressive lenses
Contacts (in lieu of glasses)
Medically necessary
Elective
In-Network
$10
$25
$25
$25
$25
$10
wholesale cost
$10
up to $130
up to $130
Benefits for frames & lenses or contacts and eye exams are provided
every 12 months.
Employee:
$5.96
Rates (24 Pay Periods)
Employee & Child:
Employee & Spouse:
$10.63
$10.46
Employee & Family:
$14.67
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
9
AD & D
Benefits
All Eligible EmployeesAccidental Death and Dismemberment (24 hour)
Family AD & D
Increments of $100,000, subject to a maximum of
$400,000 but not more than 5 times your
annual earnings
Eligible employees may elect to insure his/her
dependents. The amount of AD & D insurance for depen
dents is equal to a percentage of the employee’s AD & D
insurance, as follows:
Spouse Only:
Children Only:
Spouse and Children:
60%
20% for each dependent child,
not to exceed $50,000
50% for spouse
15% for each dependent child, not to exceed $50,000
Amount Payable
The amount of AD & D insurance will reduce:
Loss of Life
Loss of one Member (Hand, Foot or Eye)
Loss of Thumb and Index Finger
Loss of Two or More Members
Loss of Speech and Hearing in Both Ears
Loss of Either Speech or Hearing in Both
Ears
Loss of Hearing in One Ear
Quadriplegia
Paraplegia
Principal Sum
1/2 Principal Sum
1/4 Principal Sum
Principal Sum
Principal Sum
1/2 Principal Sum
•
•
•
•
35% upon the Person’s attainment age of 70
an additional 20% of the original amount at age 75
1/4 Principal Sum
Principal Sum
an additional 15% of the original amount at age 80
3/4 Principal Sum
an additional 15% of the original amount at age 85
Benefits will terminate upon retirement. For family coverage/spouse coverage
will terminate when the spouse attains age 70 when the insured employee retires, whichever comes first
(1)
(2) an insured person sustains an accidental bodily injury while insured under this provision; and
that injury directly causes one of the following nonfatal losses within 365 days after the date of the accident. The
loss must result directly from the injury and from no other causes.
Lincoln Financial Group will pay the benefit listed below if:
Rates (24 Pay Periods)
$100,000 Coverage
Employee Only $
Employee & Child $
Employee & Spouse$
Family
$
2.00
3.00
3.00
3.00
$300,000 Coverage
Employee Only $
Employee & Child $
Employee & Spouse$
Family
$
$200,000 Coverage
Employee Only $
Employee & Child $
Employee & Spouse$
Family
$
4.00
6.00
6.00
6.00
$400,000 Coverage
Employee Only $ 8.00
Employee & Child $ 12.00
Employee & Spouse$ 12.00
Family
$ 12.00
6.00
9.00
9.00
9.00
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
10
Cancer & Critical
Illness Benefits
Why Purchase Cancer Insurance Coverage?
Colonial Life’s group critical care 1.0 insurance helps your employees and their families maintain financial
security during the lengthy, expensive recovery period of a serious medical event such as cancer, heart
attack or stroke. It provides a lump sum benefit to help with the out-of–pocket medical and/or nonmedical expenses of a critical illness and/or cancer. There are options as well to include ongoing benefits
for the extended treatment and care of cancer (internal or invasive) or carcinoma in situ.
Features
• Benefits are paid in addition to other insurance your employees may have with other insurance
companies.
• Benefits are paid directly to the covered person unless they specify otherwise.
• This product combines cancer and critical illness coverage in a single policy.
• May include an innovative cancer treatment and care benefit which can assist with the extended
costs associated with the treatment and care of cancer (internal or invasive) or carcinoma in situ.
• This product will pay multiple times for the same or different covered conditions.
• Coverage is portable – an employee can continue their coverage if they change jobs or retire.
• Benefits may be used however the covered person chooses. Typical uses include:
• Out-of-pocket medical and/or non-medical expenses
• Home health care needs/home modifications
• Recovery and rehabilitation
• Child care or caregiver expenses
• Travel expenses to and from treatment centers.
• Guaranteed issue for all covered insureds with participation.
• Health Savings Account (HSA) compliant option available.
• Rates are guaranteed for one year.
• The face amount will reduce by 50% on the certificate anniversary date after the named insured’s 75th birthday.
Exclusions apply and there are eligibility
requirements, please refer to the actual plan
documents for full details.
Coverage is available...
Coverage is available to: employee;
employee and spouse; one-parent
family (employee and dependent
children); and two-parent family
(employee, spouse and dependent
children).
A lump sum of $20,000 is provided for the employee, if a spouse is covered under the employee’s plan,
his face amount is 50% of the employee’s coverage. If dependent child(ren) are covered, their face
amount is also 50% of the employee’s coverage.
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
11
Cancer & Critical
Illness Benefits
Cancer Only Plan
$20,000 Lump Sum Benefits
Condition
$100 per year Health Screening Benefit
We will pay:
Cancer (internal or invasive)
100% of face amount
Carcinoma in Situ
25% of face amount
Skin Cancer
$500 flat amount
Cancer Vaccine Benefit
$50 payable if a covered person incurs a charge for and receives any cancer vaccine
approved by the FDA for the prevention of cancer.
Cancer Treatment & Care Benefit ($500/12 months)
Benefit Period (months)
Monthly Benefit
12
$500
Hospice Care
Confinement
Covered Cancer
Treatments
Chemotherapy
Radiation
Surgery
Rates for Ages 16 - 74 (24 Pay Periods) Cancer Only
Named Insured:
$13.89
Named Insured & Spouse:
$22.38
One-Parent Family:
$14.32
Two-Parent Family:
$22.81
Critical Illness Benefit with Subsequent Diagnosis
Critical Illness
We will pay this
percentage of the face
amount:
Heart Attack (Myocardial Infarction)
100%
Stroke
100%
Major Organ Failure
100%
End Stage Renal (Kidney) Failure
100%
Coronary Artery Bypass Graft Surgery (Coronary Artery Disease applicable in lieu of benefit for
Coronary Artery Bypass Graft Surgery when the employer selects the HSA-compliant plan).
25%
Permanent Paralysis due to a Covered Accident
100%
Coma
100%
Blindness
100%
Occupational Infectious HIV or Occupational Infectious Hepatitis B, C, or D
100%
Cancer and Critical Illness Plan Rate Chart
Rates for Ages 16 - 74 (24 Pay Periods) Cancer and Critical Illness
Named Insured:
Named Insured & Spouse:
One-Parent Family:
Two-Parent Family:
$20.25
$31.97
$20.77
$32.49
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator, or team member at The Hatcher
Agency for more information.
12
Term to Age 100
Life Benefits
Term to Age 100 Life Insurance
•
•
•
•
•
•
Rates remain same at issue age (see age rated chart on following page).
Level death benefit to age 100 (based on current assumptions)
No benefit reduction at age 65
4 questions to answer- if all are “NO” then approved on the spot.
Portable (can take with you if you leave employer).
Children & Grandchildren coverage from full-term newborn to age 23 at
enrollment date and will be covered to age 100!
• Employee is not required to take coverage in order to cover spouse or children
and grandchildren.
flexible solutions for
your insurance needs
The Family Protection Plan: Benefit offers a guaranteed level premium to age 100* and a guaranteed level death
benefit for the first 10 years. After the first 10 years the death benefit is projected to remain level to age 100 and we do
not anticipate a reduction. The coverage amount cannot be individually decreased on an insured due to a change in age,
health, or employment status.
Portability: You and your family continue coverage with no loss of benefits or increase in cost should you terminate
employment after the first premium is paid, in which case the insurance company will simply bill you directly. Coverage
can never be cancelled by the insurance company or your employer unless you stop paying premiums.
Family Protection/Children & Grandchildren Plan: Policies can also be purchased for children and grandchildren
ages newborn through 23.
Easy Application Process: The insurance does not require a medical exam or blood profile. Eligibility for coverage is
based on a few simple health questions on the application.
Terminal Illness: This plan pays the insured 30% (25% in CT & MI) of the policy coverage amount in a lump sum
upon the occurrence of a terminal condition that will result in a limited life span of less than 12 months.
This is a brief description of your plan. Please refer to the actual plan documents, plan administrator,
or team member at The Hatcher Agency for more information.
13
Term to Age 100
Life Benefits
rate chart
Rates (24 pay periods)
Available only on children and
grandchildren of employee
Age on
$2.49
$4.98
App. Date
Full-Term
Newborn to
23 Years
semi-monthly
semi-monthly
Coverage
Amount
$10,000
Coverage
Amount
$20,000
This is a brief description of your plan.
Please refer to the actual plan documents,
plan administrator, or team member at
The Hatcher Agency for more information.
14
Frequently
Asked Questions
1.
When does my insurance go into effect?
All full-time employees are enrolled into insurance the 1st day of month following the first 30 days of
employment.
2.
How and when can I add or drop a dependent?
A dependent can only be added or dropped during an open enrollment period, unless you have an
IRS qualifying event (for a listing of qualifying events please see question 9).
3.
How and when do I get my insurance I.D. cards?
Your insurance cards are mailed directly to your home address from all benefit vendors. Most
insurance cards are received within 2 - 4 weeks of effective date.
4.
Can part-time employees carry insurance?
No. Unfortunately, at this time Drew Memorial Hospital does not offer its benefit package to part-time
employees.
5.
Can I carry dependents on voluntary coverages without carrying them on the medical
insurance?
Yes. You do not have to carry medical insurance on dependents to carry them on voluntary benefits
that are offered for family members. You may carry dependent coverage on any benefit you wish
without carrying it on other coverages.
6.
When does the company’s annual enrollment take place?
Drew Memorial Hospital’s annual open enrollment is March 1st - 31st of each policy year. Employees
may make changes to any/all benefit coverages available.
7.
Do we need referrals to see a specialist under our medical plan?
No. BlueCross and BlueShield does not require any referrals to see an in-network provider. Please
note, that some services require prior authorization from BlueCross and BlueShield. Please see
your certificate of coverage for more information.
8.
Can my dependents be denied coverage for pre-existing conditions?
Beginning as early as 2010, employer-based health plans and newly instated individual health plans
will NOT be allowed to deny or exclude coverage for your child dependents (under age 19) due to
pre-existing health conditions including disabilities. Beginning 2014, these same health plans will
NOT be allowed to deny or exclude coverage for any individual.
9.
What are considered qualifying events (make changes to insurance before open enrollments)?
• Change in marital status---marriage, death of spouse, divorce, legal separation, or annulment. Note:
Proof of event is needed when a change is to be made.
• Change in number of dependents---birth, death, or adoption of a child, or placement of a child for
adoption. Note: Proof of event is needed when a change is to be made.
• Change in employment status---commencement or termination of employment, strike or lockout,
commencement or return from an unpaid leave of absence, change in work site, or any of these
15
Frequently
Asked Questions
events that may apply to the employee, the employee’s spouse, or the employee’s dependant(s).
Note: the IRS regulation specify that an employee must actually obtain coverage under the spouse’s
or dependent’s plan for the election change to be consistent. The employee’s certification that he or
she either has or will obtain the coverage is sufficient proof. Note: Proof of event is needed when a
change is to be made.
• Change of residence---change in the place of residence of the employee or the employee’s spouse
or dependent. If, for example, an employee and/or the employee’s family move to another town,
changing their coverage to a plan that provides coverage in the new location would be necessary.
Note: Proof of event is needed when a change is to be made.
• Significant change in coverage---a significant cost increase or reduction in coverage. Under
this reason, however, only the election for plan coverage may be change at midyear; medical
flexible spending accounts (FSAs) may not be changed midyear on account of changes in cost of
coverage. Note: Proof of event is needed when a change is to be made.
• A substantial loss of providers available in a network option may be considered a coverage
decrease: however, the loss of a single physician from a network where there are other physicians
available in the network and in the geographic area covered by the plan would not be considered a
coverage decrease.
• If there is a significant cost decrease for a specific plan, an employee may be allowed to make
a change to participate in that plan if he or she is not a current participant. Similarly, if there
are significant improvements in the plan, employees may be allowed to make an election to
participate.
10.
Why are there different costs on medications?
Under the BlueCross and BlueShield prescription plan there are three tiers of medications.
Generic medications are going to cost you a co-pay of $15, preferred brand medications will cost
you a co-pay of $45 and non-preferred brand medications will cost you a co-pay of $65.
The prescriptions that fall under each tier are listed in a prescription formulary (this can be found
under the health plan link) that is updated as often as every 6 months. The decisions to place
medications in their assigned tiers are done in collaboration among the insurance companies and
the Food and Drug Administration (FDA).
11.
How do I find out if a procedure is covered?
To find out if a particular procedure is covered you may contact the customer service number on
the back of your benefit card(s).
12.
How do the deductibles work on the medical plan?
A deductible is the up front dollar amount that you are responsible for before the insurance starts
paying. The deductibles start over on January 1st each year.
16
Carrier
Contacts
Customer Service
(800) 238-8379
arkbluecross.com
Customer Service
(800) 462-5410
deltadentalar.com
Customer Service
(800) 444-2363
lfg.com
Customer Service
800-283-3636
assuranthealth.com
Customer Service
(800) 325-4368
coloniallife.com
Customer Service
(800) 236-3712
deltadentalar.com/deltavision
Customer Service
(866) 863-9753
5starima.com
Customer Service
(800) 370-5856
usablelife.com
17
Disclosures and
Disclaimer
Active Employment
(applies to group insurance products)
You are considered in active employment, if on the day
you apply for coverage, you are being paid regularly
by Drew Memorial Hospital for the required minimum
hours each week and you are performing the material
and substantial duties of your regular occupation.
Actively at work
(applies to accident insurance and short-term
disability insurance)
Being actively at work means on the day you apply for
coverage, you are working at Drew Memorial Hospital
for the required minimum hours each week. If you
are applying for coverage on a day that is not one of
your scheduled work days, then you’ll be considered
actively at work if you meet this definition as of your
last scheduled workday. Employees are not considered actively at work if their normal duties are limited
or altered due to their health, or if they are on a leave
of absence.
Additional Information
(applies to all individually owned policies)
This material is intended to be a brief description of
the policy. The policy defiitions, exclusions, and limitations will be used to determine actual benefit decisions. Product availability and provisions may vary
by state.
What is next?
Now that you have had the chance to review
the product information, features, and
provisions of your benefit package do not miss
the opportunity to apply.
To enroll or make changes
contact (870) 460-3539.
This benefit booklet was designed to help you better
understand your benefits and benefit choices. The
outlines in this benefit booklet are only benefit
summaries and are designed to provide a brief
overview of your coverages. For a full schedule of
benefits and complete outline of coverage please
review your insurance certificate of coverage, policy,
or summary plan description.