Retiree Medical
High Deductible Health Plan |
$120.00 | |||||||||||||
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Supplemental Medical
High Deductible Health Plan |
$120.00 | |||||||||||||
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Retiree Medical HRA
No coverage |
$0.00 | |||||||||||||
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Retiree Dental
DMO Plan |
$20.00 | |||||||||||||
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Retiree Life Insurance
5 x Base Pay, $250,000 |
$17.50 | |||||||||||||
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$17.50 | |||||||||||||
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Retiree AD&D
No coverage |
$0.00 | |||||||||||||
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Plan Options View All Options |
WaivedYou + Family Compare Total Costs |
$0.00 | |
$48.50$110.50 | |
$50.00$114.50 | |
$52.50$120.00 | |
$54.00$182.76 | |
$57.50$198.40 | |
$60.50$208.32 |
Plan Options View All Options |
WaivedYou + Family Compare Total Costs |
$0.00 | |
$48.50$110.50 | |
$50.00$114.50 | |
$52.50$120.00 | |
$54.00$182.76 | |
$57.50$198.40 | |
$60.50$208.32 |
Plan Options View All Options |
WaivedYou + Family |
---|---|
$0.00 | |
$10.00$40.00 | |
$12.50$39.00 |
Plan Options | Coverage Amount | Per-Pay-Period Cost |
No coverage | $0.00 | $0.00 |
1 x Base Pay | $50,000.00 | $0.00 |
2 x Base Pay | $100,000.00 | $7.00 |
3 x Base Pay | $150,000.00 | $10.50 |
4 x Base Pay* | $200,000.00 | $14.00 |
5 x Base Pay* | $250,000.00 | $17.50 |
* Indicates you must complete Evidence of Insurability (EOI) for this level of coverage.
A heart attack, stroke, cancer or other critical illness can strike suddenly and unexpectedly. Even with the best medical care, you or your loved ones may have questions or need additional support. We can help connect you with experts and information to help you manage your current situation and understand where to go from here.
If you or someone you love has been diagnosed with cancer or another serious illness, you may feel like the world has been turned upside down. Take comfort in knowing that Health Advocate has the expertise — and compassion — to help you through this challenging time.
One Call, Complete SupportOne phone call connects you with a dedicated Personal Health Advocate, who will provide ongoing free and confidential support for a wide range of issues.
Your personal advocate can:
Remember...You can call Health Advocate for help with a variety of healthcare and insurance-related issues. Eligible employees, their spouses, dependent children, parents and parents-in-law also can use this free benefit.
Help is Only A Phone Call Away
Phone: 877.776.6211
Email: answers@HealthAdvocate.com
Your employer partners with Cleveland Clinic to provide specialty care for certain heart conditions. To be accepted into this program, you or your covered dependent must be:
If you think you or your covered dependent may be eligible, call WebTPA the program administrator. A trained representative will guide you through the process, answer questions and determine preliminary eligibility.
If WebTPA determines that you or your covered dependent ("the patient") are eligible for the program, Cleveland Clinic will complete a clinical review of the patient's medical records to confirm eligibility. The patient's local physician or specialist also must agree to assume care for the patient at home.
After the patient is accepted into the program, Cleveland Clinic will schedule the procedure and a representative will coordinate travel and lodging for the patient and a companion, with all expenses covered 100% by the program.
Cleveland Clinic Puts Heart Patients FirstCleveland Clinic offers specialty care for certain heart conditions. It is a world renowned, non-profit academic medical center led by doctors who follow the most up-to-date clinical guidelines for treatment, to help ensure top quality heart care.
Their doctors are full-time, salaried employees, which means they get paid the same regardless of how many procedures they perform or patients they see. This practice eliminates incentives to perform unnecessary tests or procedures and encourages physicians to consult with colleagues and spend the time necessary to practice excellent medicine.
Cleveland Clinic puts patients first, and focuses on continual improvement of the patient experience and quality outcomes.
A Leader in Heart CareThe Miller Family Heart & Vascular Institute is the largest cardiovascular practice in the U.S. No hospital in America sees more patients for heart and vascular conditions than Cleveland Clinic.
What does that mean to you? It means that as a patient of Cleveland Clinic, you'll have access to the broadest possible range of solutions from skilled, experienced doctors, nurses and technicians – options you may not have in your home town or anywhere else in America.
When a loved one is diagnosed with a critical illness, it's normal to feel overwhelmed. It's important to find support for yourself, even as you're caring for your loved one. Here are some tips that may help you cope.
Default - If you don't make a different election, you'll receive the highlighted coverage |
|
Medical
Cost is before-tax for you and your covered dependents. Review your Healthcare Plan Summary Plan Description, available in the Resource Materials/Summary Plan Descriptions section of this site, for additional plan coverage information.
When you enroll in medical coverage, you may automatically receive (if eligible) prescription drug coverage for you and your covered dependents. You are also automatically enrolled in the Employee Assistance Program. Please refer to your Medical Plan Profile for plan coverage information.
If your current medical plan option is no longer available, you are automatically defaulted into the coverage listed on this online worksheet.
To be eligible for medical coverage, dependents age 19 - 23 must be full-time students. Additional information for full-time student eligibility is available in the Resource Materials/Plan Guidelines/Eligibility for Coverage section of this site.
IMPORTANT: Employees covering a full-time student as a dependent are required to reaffirm the status of that dependent by the end of the Open Enrollment period (go to the “Verify Full-Time Student" section of the this site to complete the process).
NOTE: If you did not reaffirm your dependents' full-time student status by the end of the Open Enrollment period, their coverage will be discontinued, effective January 1, 2017.
Default - If you don't make a different election, you'll receive the highlighted coverage |
|
Dental
Cost is before-tax for you and your covered dependents. Review your Healthcare Plan Summary Plan Description, available in the Resource Materials/Summary Plan Descriptions section of this site, for additional plan coverage information.
When you enroll in dental coverage, you may automatically receive (if eligible) prescription drug coverage for you and your covered dependents. You are also automatically enrolled in the Employee Assistance Program. Please refer to your dental Plan Profile for plan coverage information.
If your current dental plan option is no longer available, you are automatically defaulted into the coverage listed on this online worksheet.
To be eligible for dental coverage, dependents age 19 - 23 must be full-time students. Additional information for full-time student eligibility is available in the Resource Materials/Plan Guidelines/Eligibility for Coverage section of this site.
IMPORTANT: Employees covering a full-time student as a dependent are required to reaffirm the status of that dependent by the end of the Open Enrollment period (go to the “Verify Full-Time Student" section of the this site to complete the process).
NOTE: If you did not reaffirm your dependents' full-time student status by the end of the Open Enrollment period, their coverage will be discontinued, effective January 1, 2017.
Your Supplemental Life Insurance election requires completion of an Evidence of Insurability (EOI) form and approval from Prudential. Once you complete all your benefit elections, you'll receive further instruction.
Your current coverage elections are highlighted in the sections below
plan options | you only | you + spouse | you + children | you + family |
No Coverage | $0.00 | |||
Premium Plan $500 | $48.50 | $97.00 | $97.00 | $110.50 |
Basic Plan $750 HPN | $52.50 | $113.00 | $113.00 | $181.54 |
Basic Plan $750 | $54.50 | $120.00 | $120.00 | $182.76 |
HRA Plan $1,500 | $57.50 | $131.00 | $131.00 | $198.40 |
HRA Plan $1,500 HPN | $60.50 | $157.00 | $157.00 | $208.32 |
Plan Options | You Only | You + Spouse | You + Child(ren) | You + Family |
No Coverage | $0.00 | |||
Premium Plan $500 | $48.50 | $97.00 | $97.00 | $110.50 |
Basic Plan $750 HPN | $52.50 | $113.00 | $113.00 | $120.00 |
Basic Plan $750 | $54.50 | $120.00 | $120.00 | $182.76 |
HRA Plan $1,500 | $57.50 | $131.00 | $131.00 | $198.40 |
HRA Plan $1,500 HPN | $60.50 | $157.00 | $157.00 | $208.32 |
Plan Options | Per-Pay-Period Cost | |
---|---|---|
Non-Tobacco User | $0.00 | |
Tobacco User | $15.00 |
Plan Options | Per-Pay-Period Cost | |
---|---|---|
No working spouse | $0.00 | |
Spouse not eligible | $0.00 | |
Spouse eligible | $27.00 |
Minimum: $000.00
Maximum: $5,650.00
Multiples: $1.00
Option | Annual Contribution Amount | |
---|---|---|
No Coverage | $0.00 | |
Coverage | $0.00 |
Minimum: $000.00
Maximum: $5,650.00
Multiples: $1.00
Option | Annual Contribution Amount | |
---|---|---|
No Coverage | $0.00 | |
Coverage | $0.00 |
Plan Options | Coverage Amount | Per-Pay-Period Cost |
---|---|---|
1 x Base Pay | $50,000.00 | $0.00 |
2 x Base Pay | $100,000.00 | $2.50 |
3 x Base Pay | $150,000.00 | $4.00 |
Plan Options | Coverage Amount | Per-Pay-Period Cost |
---|---|---|
No Coverage | $0.00 | $0.00 |
1 x Base Pay | $50,000.00 | $3.50 |
2 x Base Pay | $100,000.00 | $7.00 |
3 x Base Pay | $150,000.00 | $10.50 |
4 x Base Pay* | $200,000.00 | $14.00 |
5 x Base Pay* | $250,000.00 | $17.50 |
* Indicates you must complete Evidence of Insurability (EOI) for this level of coverage. |
Plan Options | Per-Pay-Period Cost | |
---|---|---|
No Coverage | $0.00 | |
$10,000 | $5.50 | |
$20,000 | $10.20 | |
$30,000* | $15.75 | |
$40,000* | $20.00 | |
* Indicates you must complete Evidence of Insurability (EOI) for this level of coverage. |
Plan Options | Per-Pay-Period Cost | |
---|---|---|
No Coverage | $0.00 | |
$5,000 | $2.50 | |
$10,000 | $3.50 |
Plan Options | Per-Pay-Period Cost | |
---|---|---|
No Coverage | $0.00 | |
Coverage | $2.50 |
Plan Options | Coverage Amount | Per-Pay-Period Cost |
---|---|---|
No Coverage | $0.00 | $0.00 |
40% of Base Pay | $20,000.00 | $5.00 |
60% of Base Pay | $30,000.00 | $7.50 |
Option | You Only | You + Spouse | You + Child(ren) | You + Family |
---|---|---|---|---|
No Coverage | $0.00 | $0.00 | $0.00 | $0.00 |
$15,000 | $7.22 | $12.36 | $16.13 | $24.76 |
$30,000 | $13.86 | $19.07 | $22.53 | $41.93 |
$50,000 | $22.73 | $36.41 | $43.71 | $68.24 |
Coverage Level | Per-Pay-Period Cost | |
---|---|---|
No Coverage | $0.00 | |
You Only | $10.00 | |
You + Spouse | $15.00 | |
You + Child(ren) | $25.00 | |
You + Family | $40.00 |
Medical
Cost is before-tax for you and your covered dependents. Review your Healthcare Plan Summary Plan Description, available in the Resource Materials/Summary Plan Descriptions section of this site, for additional plan coverage information.
When you enroll in medical coverage, you may automatically receive (if eligible) prescription drug coverage for you and your covered dependents. You are also automatically enrolled in the Employee Assistance Program. Please refer to your Medical Plan Profile for plan coverage information.
If your current medical plan option is no longer available, you are automatically defaulted into the coverage listed on this online worksheet.
To be eligible for medical coverage, dependents age 19 - 23 must be full-time students. Additional information for full-time student eligibility is available in the Resource Materials/Plan Guidelines/Eligibility for Coverage section of this site.
IMPORTANT: Employees covering a full-time student as a dependent are required to reaffirm the status of that dependent by the end of the Open Enrollment period (go to the "Verify Full-Time Student" section of the this site to complete the process).
NOTE: If you did not reaffirm your dependents' full-time student status by the end of the Open Enrollment period, their coverage will be discontinued, effective January 1, 2017.
Dental
Cost is before-tax for you and your covered dependents. Review your Healthcare Plan Summary Plan Description, available in the Resource Materials/Summary Plan Descriptions section of this site, for additional plan coverage information.
When you enroll in medical coverage, you may automatically receive (if eligible) prescription drug coverage for you and your covered dependents. You are also automatically enrolled in the Employee Assistance Program. Please refer to your Medical Plan Profile for plan coverage information.
If your current medical plan option is no longer available, you are automatically defaulted into the coverage listed on this online worksheet.
To be eligible for medical coverage, dependents age 19 - 23 must be full-time students. Additional information for full-time student eligibility is available in the Resource Materials/Plan Guidelines/Eligibility for Coverage section of this site.
IMPORTANT: Employees covering a full-time student as a dependent are required to reaffirm the status of that dependent by the end of the Open Enrollment period (go to the "Verify Full-Time Student" section of the this site to complete the process).
NOTE: If you did not reaffirm your dependents' full-time student status by the end of the Open Enrollment period, their coverage will be discontinued, effective January 1, 2017.
Vision
Cost is before-tax for you and your covered dependents. Review your Healthcare Plan Summary Plan Description, available in the Resource Materials/Summary Plan Descriptions section of this site, for additional plan coverage information.
When you enroll in medical coverage, you may automatically receive (if eligible) prescription drug coverage for you and your covered dependents. You are also automatically enrolled in the Employee Assistance Program. Please refer to your Medical Plan Profile for plan coverage information.
If your current medical plan option is no longer available, you are automatically defaulted into the coverage listed on this online worksheet.
To be eligible for medical coverage, dependents age 19 - 23 must be full-time students. Additional information for full-time student eligibility is available in the Resource Materials/Plan Guidelines/Eligibility for Coverage section of this site.
IMPORTANT: Employees covering a full-time student as a dependent are required to reaffirm the status of that dependent by the end of the Open Enrollment period (go to the "Verify Full-Time Student" section of the this site to complete the process).
NOTE: If you did not reaffirm your dependents' full-time student status by the end of the Open Enrollment period, their coverage will be discontinued, effective January 1, 2017.