Welcome to Open Enrollment Saint Joseph s Health System!

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1 Welcome to Open Enrollment Saint Joseph s Health System! Trinity Health and Saint Joseph s Health System are pleased to provide you with the information you will need to enroll in benefits for next year. Throughout the rest of this communication, you will see Trinity Health and Saint Joseph s Health System referred to as simply Trinity Health. If you have more questions after reviewing this guide, refer to the For More Information section to learn where you can get answers. What s Inside What s New for Other Information About 3 Enrolling Who Is Eligible Benefit Hours Requirement Other Medical coverage Dental coverage Regularly scheduled full- or part-time colleague with 40 or more budgeted hours per pay period. Regularly scheduled full- or part-time colleague with 40 or more budgeted hours per pay period. New hires must satisfy the required waiting period New hires must satisfy the required waiting period Health Care Reform Update 4 Medical Coverage 5 Live Your Whole Life 8 Vision coverage Flexible spending accounts Regularly scheduled full- or part-time colleague with 40 or more budgeted hours per pay period. Regularly scheduled full- or part-time colleague with 40 or more budgeted hours per pay period. New hires must satisfy the required waiting period New hires must satisfy the required waiting period Dental Coverage 9 Vision Care Coverage 10 Flexible Spending 11 Accounts Life insurance Short-term disability Regularly scheduled full- or part-time colleague with 40 or more budgeted hours per pay period. Regularly scheduled full- or part-time colleague with 40 or more budgeted hours per pay period. New hires must satisfy the required waiting period Can elect coverage for your spouse, eligible adult, or eligible children. New hires must satisfy the required waiting period Life Insurance 12 Time Away from Work 13 Long-term disability Regularly scheduled full- or part-time colleague with 40 or more budgeted hours per pay period. New hires must satisfy the required waiting period Voluntary Benefits 14 How to Enroll 15 Eligible Adult: You may cover your spouse or Eligible Adult. An Eligible Adult is an adult who resides and has financial interdependence with the colleague, and is not a tax qualified dependent or related by blood, adoption or marriage to the colleague. For More Information 16 Important Reminders 17 St. Joseph s Health System 1

2 What s New for 2016 Due to Health Care Reform, all copayments, coinsurance amounts and deductibles will apply toward meeting your out-of-pocket maximum. Prescription drug costs will also apply. We are pleased to introduce the Trinity Health MyBenefits internet site for You can log on at to find information about the 2016 Open Enrollment process and to learn more about your Trinity Health benefits. If you participate in the Health Care Spending Account (HCSA), you will be able now to contribute up to $2,550 for We are continuing to harmonize who is covered under Trinity Health benefits and programs. For 2016, the definition of Eligible Adult is changing. See the Who Is Eligible section for more information. Starting Jan. 1, 2016, The Hartford will be our new life insurance provider. Any increases or new election to colleague supplemental life coverage or spouse/eligible adult life coverage will require you to submit a Personal Health Application. The Personal Health Application must be sent to The Hartford by Jan. 8, Beginning Jan. 1, 2016, supplemental life insurance can be purchased for eligible adults and their dependents. Beginning Jan. 1, 2016, The Hartford will be providing our disability insurance. Your 2015 elections will carryover. Starting in 2016 your beneficiary designation for life and supplemental life insurance coverage will need to be the same. Beginning in 2016, we will be offering a revised well-being program to help you earn a premium discount on your medical coverage throughout the year. See the Live Your Whole Life page in this guide and the Live Your Whole Life website (mybenefits.trinity-health.org/lywl) for more information. 2 St. Joseph s Health System

3 Other Information About Enrolling Your enrollment requirements Open enrollment is mandatory for This means that you must enroll if you want to choose your own benefit options. If you wish to participate or continue your benefits next year you must complete your enrollment by Nov. 4, 2015 at 12 midnight EST. Benefit elections are effective for the entire year Remember, the benefits you elect during open enrollment will be in effect from Jan. 1 through Dec. 31, Open enrollment is your only opportunity during the year to make elections for your 2016 benefits unless you experience a qualified family status change. If you experience a qualified family status change or certain employment status changes and provide any required documentation to your Human Resources representative within 31 days of the event, you will be allowed to make certain benefit changes as long as they are consistent with the status change. For example, if you get married during the plan year, you ll be able to add your spouse to your coverage within 31 days of the marriage because this is consistent with the status change. For more information on qualified family status changes, visit Adding family members If you re adding family members to your benefit planfor the first time during this year s open enrollment, you re required to provide written documentation (for example, marriage certificate or birth certificate) verifying their dependent status to Human Resources no later than Nov. 11, If you don t submit the required paperwork by the deadline, your dependents will not be enrolled for coverage for 2016, and you ll be required to wait until next year s open enrollment period to add them to the plan provided they remain eligible, and you provide written documentation verifying their dependent status at that time. You are required to provide a Social Security number for each of your dependents over the age of one in order for them to be covered. Please enter the missing Social Security numbers in Lawson ESS. Please note, you have the option to purchase coverage for your spouse/eligible adult and dependents. If you and your spouse/eligible adult or dependent(s) both work for Trinity Health and are benefits eligible, you cannot elect dual coverage (enrolled as a colleague and a dependent). In addition, only one of you will be able to elect coverage for your child(ren). To view the complete eligibility rules and documentation requirements for you and your family members, visit St. Joseph s Health System 3

4 The Affordable Care Act The Affordable Care Act (ACA) was put in place to make sure citizens have access to health insurance they can afford. Since Jan. 1, 2014, the law has required that most U.S. citizens and legal resident aliens have health insurance whether they get it from an employer, a private insurance company or from the government. If they do not have health insurance, they may have to pay a tax penalty. As a colleague at Trinity Health, here is how the law may affect you: Trinity Health will continue to offer health insurance for U.S. colleagues who are benefits eligible. During open enrollment, you can choose the Trinity Health medical plan that works best for you and your family. The law requires employers to offer medical and prescription coverage to employees who work more than 30 hours a week or more than 130 hours per month. Colleagues who work an average of 30 hours a week over a rolling 12-month period are eligible for medical coverage through Trinity Health. A Trinity Health medical plan may be your best option for coverage (if eligible), as long as you re not covered somewhere else. You will probably continue to hear a lot about the health insurance marketplace that has been set up in each state to help people find health insurance. Trinity Health will continue communicating with you about your benefits coverage as weremaincommittedtoprovidingyouwith the latest information. In the meantime, if you have questions, please contact your Human Resources representative. Women s Preventive Care under the Affordable Care Act Part of the Affordable Care Act (ACA) (also known as health care reform) requires employers to cover certain women s preventive care services, including contraception, under health insurance benefits at no charge. As a health ministry of the Catholic Church, we have engaged in extensive advocacy with the support of the Catholic Health Association, to find an acceptable resolution to this issue. The final rules from the U.S. Health and Human Services, Treasury and the Department of Labor give an accommodation to certain religious and religiously-affiliated organizations, like Trinity Health, to provide an exemption from the requirement to provide contraceptive coverage to employees as preventive health services. The intent of the rules is to accommodate the moral perspectives of certain religiously-affiliated employers while also providing for the preventive health care needs of their employees who may not share the employers religious beliefs. In 2016, your medical/pharmacy benefit provider will continue to provide these benefits as mandated by the ACA. Trinity Health colleagues will be provided with access to these benefits, but they will not be paid for by Trinity Health or its health plans. Contact your medical/pharmacy benefit provider for further details. 4 St. Joseph s Health System

5 Medical Coverage You have a choice between two medical plans: the Premier Plus Plan 1 (POS1) and the High Deductible Plan with a HSA. For more information about your medical coverage, visit your benefits website. Saint Joseph s Health System Saint Joseph s Health System Medical Plan Premier Plus Plan 1 High Deductible Plan with HSA Highlights In-network Out-of- In-network Out-ofnetwork network Healthcare $500 $1,000 Savings Acct. Colleague Colleague + Dependents Annual deductible 3 Individual $500 $1,500 $3,000 Family $1,500 $3,000 $6,000 Coinsurance 20% 40% 0% 30% (Colleague responsibility, after deductible is met) Preventive Care 1 $0 40% after $0 30% after deductible deductible Office visits $25 40% after $0 after 30% after copayment deductible deductible deductible Urgent care $75 $75 0% after In-network copayment copayment deductible deductible Emergency Room 2 $200 $200 0% after In-network copayment copayment deductible deductible Inpatient admissions 20% after 40% after 0% after 30% after deductible deductible deductible deductible Outpatient Surgery 3 20% after 40% after 0% after 30% after deductible deductible deductible deductible Out-of-pocket maximums 4 Individual $4,500 $7,500 $1,500 $6,000 Family $9,000 $18,000 $3,000 $12,000 1 Preventive care and wellness benefit paid at 100% - no deductible/no copays apply. 2 Emergency room copay is waived if patient is admitted to hospital. 3 Pre-certification is required for inpatient stays, outpatient diagnostic testing and outpatient surgery. 4 Copayments, coinsurance amounts, and deductibles will apply toward your out-of-pocket maximums. St. Joseph s Health System 5

6 Saint Joseph s Health System Saint Joseph s Health System Medical Plan Premier Plus Plan 1 High Deductible Plan with HSA Highlights In-network Out-of- In-network Out-ofnetwork network Prescription drug copayment/coinsurance 4 Retail/Mail Order Generic $15 copayment / 40% after $0 after 30% after $30 copayment deductible deductible deductible Brand formulary $30 copayment / $60 copayment Brand non-formulary $60 copayment / $120 copayment Your per pay period cost Full-time Part-time Full-time Part-time Reward No Reward Reward No reward Colleague only Colleague plus spouse/eligible adult Colleague plus child(ren) Colleague plus family Please contact your Human Resources representative for medical plan rates. 1 Preventive care and wellness benefit paid at 100% - no deductible/no copays apply. 2 Emergency room copay is waived if patient is admitted to hospital. 3 Pre-certification is required for inpatient stays, outpatient diagnostic testing and outpatient surgery. 4 Copayments, coinsurance amounts, and deductibles will apply toward your out-of-pocket maximums. 6 St. Joseph s Health System

7 Be a smart health care consumer As you know, the cost of high-quality health care continues to increase each year. Being a smart consumer means getting the best price on something you need, whether it s a new car or health care. Being a smart health care consumer doesn t mean you should avoid trips to the doctor it means making the best decisions about when to go to the doctor. Regular checkups can improve your health and extend your life. By getting the recommended exams and tests, you increase your chances of discovering problems before an illness significantly affects your health. Plus, preventive care is beneficial not only to your physical well-being, it also makes sense for your financial health because generally, it s covered by your medical plan. For more information on preventive care benefits, visit An easy way to be a smart health care consumer is to choose an in-network provider when you or a family member needs medical care. Besides receiving excellent care at our own facilities, you receive the highest level of benefits while paying the lowest available copayment and coinsurance amounts. St. Joseph s Health System 7

8 Live Your Whole Life Staying healthy all the way around - in body, mind, and spirit - makes us happier and more productive at home and on the job. At Trinity Health, we believe that an annual Health Assessment and taking part in healthy activities are essential steps in understanding your Well-Being. It s so important that we reward you with a lower premium contribution for medical coverage each pay period when you and your covered spouse or eligible adult complete these steps. Period 1 Getting Started Activities Complete your Health Assessment The Health Assessment is an online questionnaire about your health habits. Your answers are kept secure and confidential; summary data is used to identify areas for future well-being and prevention programs. Note: To maintain your reward of a lower premium contribution on your medical benefits each pay period, the health assessment must be completed by you and your covered spouse or eligible adult in Period 1 (Oct. 1, Feb. 1, 2016.) Log in to your Live Your Whole Life account at mybenefits.trinity-health.org/lywl to review your options or call for help. Periods 2 and 3 Completing Meaningful Choice Activities To continue receiving the reward throughout the year, you and your covered spouse or eligible adult need to complete one meaningful choice activity in Periods 2 and 3. You can choose from a variety of Meaningful Choice Activities that fit your lifestyle. Some examples include talking with a health coach, completing an online journey, tracking physical activity, or participating in a well-being challenge. Period 2 between Feb. 1 and April 30, 2016 You and your covered spouse or eligible adult must complete one Meaningful Choice Activity between Feb. 1 and April 30, Completing this activity will ensure that you continue the reward of a lower premium contribution on the cost of your medical benefits each pay period. Period 3 between May 1 and July 31, 2016 You and your covered spouse or eligible adult must complete one Meaningful Choice Activity between May 1 and July 31, Completing this activity will ensure you continue the reward of a lower premium contribution on the cost of your medical benefits each pay period. Check out the Live Your Whole Life website at mybenefits.trinity-health.org/lywl to learn more about all qualifying Meaningful Choice Activities. Want to learn more? Learn more about the Live Your Whole Life Rewards and Meaningful Choice Activities requirements on the LIve Your Whole Life website. If you feel that you need an exception to one of the requirements in the Live Your Whole Life program, you must complete the Exception Request Form (found on the website). The form must be filed prior to the end of each Period.! For more information on dates and activities, please visit the Live Your Whole Life website at mybenefits.trinity-health.org/lywl. 8 St. Joseph s Health System

9 Dental coverage You have a choice between two Delta Dental Plan options the High Plan and the Standard Plan. Visit for providers in your area. Dental Plan Highlights High Plan Standard Plan Participating Dentist Non-participating Dentist Participating Dentist Non-participating Dentist Annual deductible Individual $25 $50 $50 $100 Family $50 $100 $100 $150 Class I - Preventive services 100% covered 100% covered 100% covered 100% covered ($0 colleague cost) (Usual and Customary ($0 colleague cost) (Usual and Customary rates apply) rates apply) Class II - Basic services 20% after deductible 20% after deductible 40% after deductible 40% after deductible Class III - Major restorative services 40% after deductible 40% after deductible 50% after deductible 50% after deductible Class IV - Orthodontics 50% after deductible 50% after deductible Not covered Maximums Per person annual (non-orthodontics) $1,750 $1,250 $1,500 $1,000 Per person lifetime (orthodontics) $1,500 $1,500 Not applicable Not applicable Your per pay period cost Colleague only Colleague plus spouse/eligible adult Please contact your Human Resources representative for dental plan rates. Colleague plus child(ren) Colleague plus family NOTES: When you receive services from a non-participating dentist, you will be responsible for the difference between what your dentist charges and the non-participating dentist fee. Fluoride treatments are covered once every 12 months to age 14. Bitewing x-rays are covered once every 12 months. For more information about your dental plan options or about Delta Dental, visit St. Joseph s Health System 9

10 Vision care coverage You have a choice between two United Health Care vision plan options: the High Plan and the Standard Plan. Visit for providers in your area. UHC Vision Plan Highlights High Plan Standard Plan In-network Out-of-network In-network Out-of-network (reimbursement schedule) (reimbursement schedule) Benefit frequency Calendar year Calendar year Calendar year Calendar year Vision exam Covered in full Up to $40 $10 copayment Up to $40 Pair of lenses Single vision Up to $40 Up to $40 Bifocal $0 copayment Up to $60 $0 copayment Up to $60 Trifocal Up to $80 Up to $80 Lenticular Up to $80 Up to $80 Frames The preferred price is a The preferred price is a Covered frame $50 wholesale allowance $50 wholesale allowance Non-covered frame at independent locations Up to $45 at independent locations Up to $45 Contact lenses (in lieu of eyeglasses) Elective Necessary or a maximum of $150 or a maximum of $150 of retail allowance at retail locations of retail allowance at retail locations Contact lens coverage is provided under the plan and may vary dependent on the type of contact lenses prescribed. Please see the benefit summary on My Benefits for additional information. Additional pair of eyeglasses 20% discount 20% discount 20% discount 20% discount or contact lenses Additional lense options Your per pay period cost Colleague only Colleague plus spouse/eligible adult Colleague plus child(ren) Colleague plus family The following lense options are covered in full: standard scratchresistant coating, standard basic and high-end progressive lenses, standard polycarbonate lenses, standard antireflective coating, UV, tints, photochromic, Transitions, edge coating The following lense options are covered in full when from a network provider: standard scratch-resistant coating, standard polycarbonate lenses. Please contact your Human Resources representative for vision plan rates. For more information about your vision care plan options, visit 10 St. Joseph s Health System

11 Health care and dependent care flexible spending accounts You have the opportunity to set aside before-tax money to offset eligible health care or dependent care expenses. There are two different types of Flexible Spending Accounts a Health Care Spending Account and a Dependent Care Spending Account. How much can I contribute? What expenses will it cover? When do I have to spend the money? How do I access my FSA savings? Health Care Spending Account (HCSA) Before-tax dollars in any amount between $130 and $2,550 Eligible health care products and services used by you and/or your eligible dependents. Examples include: Vision care, including eyeglasses, contact lenses and saline solution Dental care, both preventive and restorative Orthodontia Physical therapy, counseling, or psychological services Chiropractic care and acupuncture Copayments, coinsurance and deductibles Prescribed Over-the-Counter (OTC) medications For a list of expenses that are eligible for HCSA reimbursement, visit Contributions made to the HCSA during the 2016 calendar year can be used for claims with dates of service between Jan. 1, 2016 and Mar. 15, You can use a variety of payment options to access your FSA savings. These include the WageWorks Health Card; Pay my Provider, Pay me Back; or by using the Mobile application. Dependent Care Spending Account (DCSA) Before-tax dollars in any amount between $130 and $5,000 Expenses for the care of your eligible dependents (child under age 13 or qualifying adult incapable of self-care) while you work: Babysitting or au pair services Before and after-school programs Day care and nursery school Pre-school programs Elder care services Contributions made to the DCSA during the 2016 calendar year can be used for claims with dates of services between Jan. 1 and Dec. 31, You can use a variety of payment options to access your FSA savings. These include the Pay my Provider, Pay me Back; or by using the Mobile application. Reminders: You must make health care and/or dependent care spending account elections for 2016 during open enrollment. Your prior year elections will NOT carry forward. Health Care Spending Account and Dependent Care Spending Account claims for the 2016 plan year must be postmarked on or before Mar. 31, If you are enrolling in the Saint Joseph s Health System High Deductible Plan, the Health Care Spending Account will be limited and can only be applied toward dental and vision expenses. If you choose to contribute to the Health Care Flexible Spending Account for the first time in 2016, a new WageWorks Health Card will be mailed to your home. Otherwise, you will only receive a new WageWorks Health Card when your current card expires. For more information about your FSA benefits and to obtain a list of eligible expenses, visit Take Advantage of WageWorks Mobile Site As the nation s largest independent provider of consumer-directed benefit solutions, WageWorks offers FSA participants the latest technology to make it easier to manage your savings. Their mobile site and new EZ Receipts app offer the following features: Check your current HCSA and DCSA account balances Submit HCSA and DCSA claims Submit WageWorks Health Care card receipts Learn more at or contact your Human Resources representative. St. Joseph s Health System 11

12 Life Insurance Colleague life insurance options If eligible, you receive employer-provided basic life/ad&d insurance at one times your annual base salary. In addition, you have the option to purchase supplemental coverage for yourself in the increments shown in the table below. If you purchase colleague supplemental life insurance and you re approved, the premium contributions will be deducted from your paycheck on an after-tax basis. You will be eligible for will preparation services through The Hartford s EstateGuidance Will Services at no charge. To get started, access The Hartford s EstateGuidance Will Services online at and enter the Trinity Health Web ID WILLHLF in the Promotional Code box. Basic life/ad&d Supplemental life Supplemental AD&D Maximum amounts Personal Health Application Colleague Life Insurance Plan Highlights (full- and part-time) One times your annual pay Onetoeighttimesannualpay One to eight times annual pay $1.5 million Supplemental life: $1.5 million (Combined: $3 million) Any increase in colleague Supplemental life coverage will require you to complete a Personal Health Application form. For more information about your life insurance benefits or to obtain a Personal Health Application form, visit NOTE: Personal Health Application forms should be sent to The Hartford by Jan. 8, Cost for colleague supplemental life insurance rates are based on your age as of Jan. 1, 2016, and will be available when you enroll online. Dependent supplemental life insurance options You have the option to purchase coverage for your dependents (including your spouse, eligible adult or eligible children). You may elect coverage for your dependents without electing coverage for yourself. If you and your spouse or eligible adult both work for Trinity Health and are benefits eligible, you cannot elect both Colleague Supplemental Life and Spouse/Eligible Adult Life coverage for the same person. Also, only one of you will be able to elect coverage for your child(ren). If your dependent child also works at Trinity Health and is benefits eligible, you cannot elect child life coverage for that individual. Are your beneficiaries up-to-date? You may want to take a moment to review the beneficiary(ies) you have on file for your basic life coverage. If some time has passed since you named beneficiaries, are they still appropriate? If you haven t yet designated beneficiaries, your life insurance benefits will be paid according to the plan provisions as outlined in the Summary Plan Description. You ll have an opportunity to review (and change, if you wish) your life insurance beneficiary(ies) during the open enrollment process. Remember, to add or change your beneficiary(ies) you will need to provide their date of birth and Social Security Number. Personal Health Application Dependent Life Insurance Plan Highlights (full- and part-time) Spouse/eligible adult life 1 Child(ren) life 2 Coverage amount $10,000 $20,000 $50,000 $80,000 $100,000 Coverage amount $5,000 $10,000 $20,000 Any increase in spouse/eligible adult supplemental life coverage will require you to complete a Personal Health Application form. NOTE: Personal Health Application forms should be sent to The Hartford by Jan. 8, Costs for spouse/eligible adult supplemental life insurance coverage are based on your age, and will be available when you enroll online. 2 Child(ren) life insurance costs per pay period cover all of your eligible children, and will be available when you enroll online. For more information about your life insurance benefits or to obtain a Personal Health Application form, visit 12 St. Joseph s Health System

13 Time Away from Work At Trinity Health, we are working to harmonize time off benefits across the enterprise. Our goal is to help strengthen and enhance the enterprise and provide our colleagues with meaningful benefits that are competitive and sustainable. Here are some of the benefits you receive as you need time away from work. Short-term disability Short-term disability (STD) pays a benefit if you are unable to work because of a qualified injury or illness. NOTE: this is not an employer-paid for benefit. Amount of benefit When benefits begin How long benefits continue Option 1: 50% of base pay Option 2: 60% of base pay After a 14 calendar day elimination period following an injury or illness Up to 180 days Long-term disability Long-term disability (LTD) pays a benefit if you are unable to work for a long period of time because of a qualified injury or illness. NOTE: this is an employer-paid for benefit. Amount of employer-provided benefit When benefits may begin How long benefits continue 60% of base pay After 180 days of disability Benefits continue until you are able to return to work, are deemed no longer disabled, or until normal retirement age. For more information about your disability benefits, visit St. Joseph s Health System 13

14 Voluntary Benefits In addition to your group benefits, Trinity Health has partnered with Trinity Health Plus Benefits to provide eligible colleagues the opportunity to elect personal insurance plans. Open enrollment for these benefits will be held in the Spring of Individual policy options include: LifeTime benefit term insurance with long- term care Critical illness coverage Individual short-term disability insurance Legal coverage Group accident insurance Additional voluntary benefits available for enrollment all year long include: Auto and home insurance Pet insurance Discount marketplace Long-term care Employee financial solutions ID theft protection For more information, call Be sure to tell the representative that you are a member of Trinity Health and Saint Joseph s Health System. 14 St. Joseph s Health System

15 How to Enroll Annual enrollment is conducted using our web-based tool which you access through your benefits website. It takes only about 10 minutes to make your benefit elections online, and you may not need to fill out any forms. If you don t have a computer with Internet access in your workplace or your home, you can enroll at your local public library. You can enroll any time that s convenient to you during the open enrollment period 24 hours a day, seven days a week. During the two-week open enrollment period, you can make as many changes to your benefit elections as you wish. The last day to modify your choices is Nov. 4, Be sure that your personal information is secure on the enrollment website. Trinity Health has taken extra precautions to ensure the integrity of all confidential records. Step-by-Step instructions 1. Log on to or Use your Lawson User ID and password to log in. 2. Click on Benefits, then Benefits Enrollment Carefully read the Benefits Enrollment Welcome page and continue 3. Verify that your dependent data is up-to-date and accurate. You must actively enroll or decline each benefit offering. You can update dependent information by clicking on Add/Change Dependents. Next you will see the 2016 benefits for which you are eligible and can enroll for. Lawson will then display your current 2015 elections. 4. Review each list of benefits and make changes to your current election You will have the option to keep, add, or change your election. While enrolling in benefits, please do not use the back button. You will encounter election processing problems. To view a previous screen, click the Previous button. 5. Review your confirmation and click CONTINUE, otherwise choose make changes and complete the process over. Important: Print the confirmation page for your records after you enroll. The confirmation statement you print from Lawson will be the only printed record of your 2016 elections. If you can t remember your password, contact the Trinity Health Help Desk at and ask them to reset your password and security questions. St. Joseph s Health System 15

16 For More Information We hope this enrollment guide has provided you and your family with all of the information you need to make your benefit elections for However, if you still have questions, you can: Contact your Human Resources Representatives: Eurana Gracia at or at La Shon Long at or at Attend a benefits meeting where you ll receive additional information and have an opportunity to ask questions regarding your benefit options. Day Time(s) Room Thursday, Oct. 1 9:00 a.m. 11:00 a.m. Mercy Care Decatur Street Board Room Friday, Oct. 2 12:00 p.m. 2:00 p.m. Mercy Care Decatur Street Board Room Friday, Oct. 2 4:00 p.m. 5:00 p.m. Mercy Care Mobile Clinics Board Room Thursday, Oct. 22 3:30 p.m. 4:30 p.m. Mercy Care Clinic at City of Refuge Friday, Oct. 23 9:00 a.m. 10:00 a.m. Mercy Care Foundation Friday, Oct. 23 2:00 p.m. 3:00 p.m. Mercy Care Clinic North Monday, Oct :00 a.m. 12:00 p.m. Mercy Care Rome Get assistance with computer enrollment. Day Time(s) Room Monday Friday during OE 9:00 a.m. 4:00 p.m. HR Department at Ext 8519 or Ext St. Joseph s Health System

17 Important reminders Benefit elections are final for 2016 Remember, the benefits you elect during open enrollment will be in effect from Jan. 1 through Dec. 31, The choices you make now are final for 2016, because open enrollment is your only opportunity during the year to switch medical, dental or vision plan coverage. If you experience a qualified family status change or certain employment status changes and provide any required documentation to your Human Resources representative within 31 days of the event, you will be allowed to make certain benefit changes that are consistent with the status change. For example, getting married is considered a family status change. If you get married during the plan year you ll be able to add your spouse/eligible adult to your coverage within 31 days of the marriage because this is consistent with the status change. For more information on qualified family status changes, visit your benefits website. So before you enroll, be sure to consider what your needs may be for the upcoming year and to choose your benefits accordingly. HIPAA privacy notice is available online Trinity Health takes the security of its colleagues and family members Personal Health Information (PHI) very seriously. To access a copy of the Health Information Portability and Accountability Act (HIPAA) Privacy Notification, visit your benefits website. If you are unable to access the HIPAA notice online, contact your Human Resources representative to request a paper copy by mail. Plan Documents and Summary of Benefits and Coverage (SBC) are available online Health Care Reform legislation requires all employers to provide an easy-to-read summary of each of their medical plan options called a Summary of Benefits and Coverage (SBC). The SBC provides basic information about your medical plan options, comparison examples, and a glossary of terms. To access a copy of the SBC for each of the medical plan options offered by your employer, visit your benefits website. If you are unable to access the SBC s online, contact your Human Resources representative to request a paper copy by mail. Notice: Women s Health and Cancer Rights Act of 1998 The Women s Health and Cancer Rights Act of 1998 ( Act ) requires all employers who provide a medical benefit plan to its employees to communicate the coverage provisions established under the Act. Trinity Health s medical benefit plan provisions are as follows: The Trinity Health medical benefit plan will not restrict benefits if you or your eligible dependent receives benefits for a mastectomy and elects breast reconstruction in connection with the mastectomy. Benefits will not be restricted provided that the breast reconstruction is performed in a manner determined in consultation with your (or your eligible dependent s) physician, and may include: All stages of reconstruction of the breast on which the mastectomy was performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; and Prostheses and treatment of physical complications of all stages of mastectomy, including lymphedemas. Benefits for breast reconstruction may be subject to appropriate plan coverage provisions and limitations, including annual deductible, copayment and coinsurance provisions that are consistent with those established for other benefits under the plan. If you have any questions about your medical plan provisions relating to the Women s Health and Cancer Rights Act of 1998, contact your Human Resources representative. St. Joseph s Health System 17

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