Key Points / Overview: Communicated as an Active Enrollment meaning: All EE need to review the benefits
Who Is Enrolling MUCHO Employees Pay have Retirees 20 deductions
package, make updated elections and beneficiary designations but if EE ends up not acting, current elections roll over Employee EMB Enroll Passwords have been reset to the instructions stated in the BG
No benefit design changes TPA Carrier Change:
EBMS replacing Aither Health • Flexible Spending Accounts • Medical Plan claim handler EMB Call Center # 321-244-7414
Open Enrollment August 8-24 Coverage is effective October 1 st
SDOC Open Enrollment, Coverage Effective October 1
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Good to Know Latasha Aponte Employee Benefits Supervisor Direct # 689-215-3690 Contact onsite if issues or emergency.
Wi-Fi Guest Network Username: enroll-38hh Password: 6Nthb (case-sensitive)
Risk & Benefits Management 407-870-4899 https://www.osceolaschools.net /Page/225 Great site for additional info
SDOC Health Center FAQ www.SDOC-Benefits.com
Open Enrollment August 8-24 Coverage is effective October 1 st
EMB Call Center # 321-244-7414
SDOC Open Enrollment, Coverage Effective October 1
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How Can They Enroll?
Promote the Mobile App
Callback Number 321-244-7414
Callback Queue will have a Spanish Option : Transfer misrouted Spanish Calls to extension
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SDOC Open Enrollment, Coverage Effective October 1
Enrollment System Overview & Instructions Enrollment Live Site: www.EMBENROLL.com Enrollment TEST Site: https://embbenefits.com/presite/ Login ID: initial of first name+last name_sdoc_2022 Ex: bjacobs_sdoc_2022 Password: welcome1 (only if you have not enrolled sdoc) Otherwise: password reset will be available if you do not remember your password
Login to Live site 1 st
Then Login to the Test site to enroll employees in a TEST environment If you previously enrolled SDOC and forgot password, use the NEED HELP link on EMB Enroll Confirm demographic information – SEND EE to benefits dept to discuss any changes. DO NOT send issue form Must enroll or waive each benefit offered & capture beneficiary info as needed VB: any changes to Hospital & ULE must go through EMB Service using smartsheet VB change form. DO NOT touch these benefits if already elected unless EE is 1000% sure wants to decline. Complete enrollment and send confirmation via email
Watch for Autofill Issues Do Not Have 2 Occurrences of PS Open at one time
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Enrollment System Checklist The enrollment system will always jump to a benefit that has not been rolled over or confirmed. This means that when you are done with a benefit most likely the next screen will be a random survey question. Use this checklist to keep the enrollment flowing.
Order
Carrier
Benefit Plans
Checklist
Healthy Essentials
medical medical medical medical medical medical
Healthy Advantage Plus
Healthy Essentials Half Family
1
Healthy Advantage Plus Half Family Healthy Essentials DomPartner Healthy Advantage Plus DomPartner
Humana (dental) Humana (dental) Humana (dental)
DHMO
2
PPO - High PPO - Low
Vision - Standard Vision - Buyup
VSP (vision) VSP (vision) Lincoln (di)
3
4
Disability - STD / LTD Options
CIGNA CIGNA
FSA
5
DCRA
6 7 8 9
Trustmark Trustmark
Accident Hospital
Lincoln
Critical Illness
Trustmark
Universal Life w Long Term Care
10 11
Metlife (life) Metlife (life)
Basic Life
Supplemental Life
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What Employees See Before Log In Page :
Troubleshooting EMB Enroll Login Issues:
Is Username correct?
Password entered correctly?
• Employees can recover their Username via “Need Help?” Link and providing their last name, date of birth and last four of SSN
• Single digit months and days need a zero in front of them .
Temporary password does not work • Did they type in the temp password or paste it? If they pasted it, ask them to carefully type it. Copying & Pasting sometimes causes space to be picked up • Inquiry how many attempts they have made to enter a correct password: If they have made 4-6 attempts the account is likely locked, please refer them to HR to have the account unlocked and a reset. NOTE : a password reset does not resolve an account lock
Reset Not Received
• Inquiry what email address they are checking for the reset. Resets go to email on file. Does the address they are checking match what is on file? • Share reset email comes from plansource.com. They may be looking for something from EMB Enroll. • Ask if they have checked their Spam /Junk folder • Resets can take a few minutes to receive, when did they request the reset?
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Inbound Call Script
You do not have to use this word for word. Though you are welcome to do so. What we are looking for you to do is convey helpfulness, frame the call so the employee know what to expect and key content outlined in the Script.
7 Explain My Benefits © 2021 you believe you are covering. I will quickly go through each benefit and highlight what you are not currently enrolled in and make sure you are aware of what they pricing will be come September 1, we will send you an email confirmation and get you on your way” When reviewing please provide a 1-3 sentence description of the declined benefit “I want to keep everything the same” Absolutely, I can help you make sure you elect to keep the benefits you currently have. To ensure that we have you enrolled in the benefits you believe you currently have, continue to cover the dependents
Greeting
Frame the call (enrollment)
On this call we will verify your demographic information, verify, or add any dependents you will be cover or are considering covering, walk through all your benefit offerings, confirm all your beneficiaries and at the end we will do a review of everything that we have done. As we go through your enrollment, please feel free to stop and ask any questions. My goal is to do exactly what the name of our company says and that is to Explain Your Benefits.
Hello and thank you for calling the EMB Open Enrollment Call Center for the School District of Osceola , my name is [YOUR NAME] how may I help you? May I have your name please? ( if they haven’t provided it already)
Outbound Call Script
You do not have to use this word for word. Though you are welcome to do so. What we are looking for you to do is communicate helpfulness, professionalism and the key content of the Script.
Hello, this is YOUR NAME calling from Explain My Benefits. I am calling for your School District Of Osceola , TIME OF APPOINTMENT enrollment meeting. I am sorry I have missed you. If you still need to enroll, please go to [www.SDOC- Benefits.com] to either schedule a new appointment or to self- enroll through our benefit enrollment system. Additionally, you may contact us at 321-244-7414, Mon. – Fri. from 8am- 5pm to receive enrollment assistance from a benefits counselor. You have till August 24 to enroll. Thank you. On your 3 rd Unsuccessful Call Where Voicemail Answers
Call Answered
Hello. This is [YOUR FIRST NAME] calling from Explain My Benefits for your School District Of Osceola , [ TIME OF APPOINTMENT] open enrollment appointment. Is this still a good time for you? “Yes”: Great. Over the next few minutes, we will walk through your benefits. As we go through your enrollment, please feel free to stop and ask any questions. My goal is to do exactly what the name of our company says and that is to Explain Your Benefits. “No”: I apologize. If you would like a new appointment time, please visit [www.SDOC-Benefits.com] to schedule a new appointment. If you choose to schedule a new appointment, I suggest you do so as soon as you can as appointment availability is on a first come, first serve basis. Also, you have the option to may self-enroll through our benefit enrollment system on [www.SDOC-Benefits.com ] or our Explain My Benefits mobile app. You have through August 24 to enroll.
SDOC Open Enrollment, Coverage Effective October 1
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Important Reminders Ask the caller if it is alright that we record the call for quality assurance purposes
Ask for, do not provide personal data for validation . Example: May I please have the last four digits of your SSN? Instead of are the last four of your SSN are 1234? or “Please confirm the mobile number on file or that we have for you ending in 1243? Instead of “is your mobile number is 123-456-7890?” ***Help us protect against identity theft & HIPPA violations*** Promote the Mobile App . QR Code available on www.SDOC-benefits.com and a 3 minute ‘how to use’ tutorial video are on the Landing Page. NOTE: Company code is case sensitive
Review each plan election taken including per pay period deduction and each declined plan . Example: You elected Medical, you only at $45.00 per pay period and declined “all other plans” instead when you get to declined plans “and you declined Health FSA, Long Term Disability, Voluntary Life, etc. List them all.
Explain you’re sending a confirmation via email . Confirm email address
Remind Coverage elected and payroll deduction amounts are effective October 1 st. .
“ This call is recorded and provides the same authorization as your signature. You confirm that all the information you provided is complete and true to your best knowledge. You confirm that any dependents you have requested to be covered are in fact eligible dependents as defined in the enrollment materials, that the elections we reviewed are correct and you authorize your employer to make deductions for these benefits from your earnings, as appropriate. Do you understand and agree with what I have stated?” WAIT FOR ANSWER Read the Pre-Confirmation Script at the Confirmation page in the system, after reviewing elections SDOC Open Enrollment, Coverage Effective October 1
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QA Key Points
EMB will pull calls randomly or at the request of the client and listen for the following
• Client Accuracy: Did the counselor provide accurate information? (Client Name, OEDates, Landing Page, Effective dates) • Confirmed Demographic Information: Did the counselor confirm the employee and dependent information in the system? • Call Recording Statement: Did the counselor inform the employee the call is being recorded for QA? • Mobile App: (If client has mobile app ) Did counselor ask if the employee has the app downloaded?, mention key features and explain how to download • Pre-Confirmation Statement: Did the counselor: (1) Recite the preconfirmation script? (2) Recap each election including waived benefits? (3) Provide Per pay period deductions and total? Employee gave verbal authorization and confirmed the recapped benefits • Call Quality: Was the call quality clear with no interruptions? (Kids screaming, Music, Static, etc.) • Script: Did the counselor follow the script provided? • Key Points: Did the counselor review the key points provided during training by the client? We understand NOT all calls are the same but following these key points should help keep calls consistent. We take these metrics extremely serious and will consider when selecting enrollers for future telephonic enrollments. Additionally, your training compensation is subject to be withheld based on your review.
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Eligibility
When does child dependent coverage end?
Employees
Plan
When Coverage End End of CALENDAR YEAR in which they attain age 26 regardless of student or marital status
New Hires
Medical
• 15 days to enroll as of their date of hire • Coverage effective 1 st of the month following date of hire. • NEW HIRES NEED TO COMPLETE TWO ENROLLMENTS: (1) effective through 9/30 and (2) for OE
Dependents
Dental & Vision End of the YEAR in which they attain age 26 Universal Life Events Children to age 18 attainment, age 24 if FT student Accident Children up to age 26 attainment or marriage, whichever is earlier. Hospital Staypay
Legal Spouse under Federal Law or Domestic Partner (refer to Benefits Web site for info) Child Dependents
• You or your legal spouse’s natural or legally adopted children • Any child for whom you have been appointed legal guardian, court ordered QMSCO • Child of your currently enrolled dependent(grandchild) – from birth to 18 months IF born on plan. • Extended medical coverage: children 26-30 may be eligible for extended medical coverage if a certain criteria is met. • Refer employee to Benefit Specialist if the employee brings his up.
Critical Illness
Children up to age 26 attainment
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SDOC Open Enrollment, Coverage Effective October 1
Medical, Dental & Vision Rates
SDOC Open Enrollment, Coverage Effective October 1
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SDOC Medical - FAQ
EVOLUTIONS Health Care Systems We have built custom relationships for SDOC with providers and facilities. These relationships will continue to grow. The MAIN hospitals for Evolutions are ALL of the hospitals in the Orlando Health Systems, St Cloud Regional, Nemors, and Lake Nona Medical Center (MAP) Medical Advocacy Program As a service to our members, we offer a nurse concierge service to assist in finding the HIGHEST QUALITY, COST EFFECTIVE, in the BEST TIER available. While this service is available for any claims, it is particularly important in choosing the best facility for any planned procedure. USE MAP!!!! How the MAP plan works for planned procedures and services that require pre-certification:
Member calls MAP and follows their advice:
Deductible is waived
Member calls MAP and DOES NOT follow MAP advice:
Plan pays usual benefits
Member does not call MAP:
Plan pays usual benefits
Direct Cash Pay Program for Tier 2 and Tier 3 Claims:
Prescription Drug Benefits: Developing a Tierred RX Benefit to promote using local / independent pharmacies and retail stores for prescription drugs as they are much more cost effective to the plan, The preferred pharmacies would include Publix, Costco, Walmart and Walmart family of stores (Sam's, Neighborhood Markets) When a member calls MAP for assistance with a pre-planned procedure, the MAP counselor will reach out to the facility to try and negotiate a "cash up front" Arrangement in order to secure the best price.
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Non preferred would be chain pharmacies; IE CVS, Walgreens, Rite Aid
Medical (provider network & ID cards) | 800.308.2748, Mon –Fri. 8:30-6:30pm Email: askehs@ehsppo.com | www.ehsppo.com CLICK HERE TO FIND PROVIDERS • Custom network • ID Card:
Good
BEST!
Better
Tier 1
Tier 2
Tier 3
Most Preferred Relationships
Preferred Relationships
Non-Specified Providers Out-of-network
In-Network (Group: SDOC or 30003
Hospitals
• Orlando Health System • St. Cloud Regional • Ambulatory Surgical Center • Nemors (new) • Lake Nona Medical Center (new) • Osceola Regional (new) • Physicians (Primary Care, Specialist, Pediatricians, OB/GYN, etc
Excluded
• IF enrolling for first time or adding a new dependent(s) to coverage.
• Provider Search Instructions at ehsppo.com • Click on the “FIND A PROVIDER” Box at the top of ehsppo.com website or in the member section. • Type “SDOC” in the Group Name section, click “Continue” & choose your search criteria • Tier 1 Providers will show up as Evolutions Healthcare Systems PRIME Tier 1 Network, All Others that show up in search are Tier 2 • Employees can nominate their provider • Visit the website and complete form (on-line or print and mail /email back) • Evolutions reaches out to your provider but can not guarantee they will want to be part of the network (Tier 1 or Tier 2)
Physicians (Primary Care, Specialist,
Doctors
Pediatricians, OB/GYN, etc
Labs, Imaging, (ancillary services)
• Green Imaging
Note:
Potential for Balance Billing
For non-emergencies it is wise to confirm Provider Tier before scheduling care
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SDOC Open Enrollment, Coverage Effective October 1
Healthy Essentials
Healthy Advantage Plus
Medical
Tier 3 Tier 2
Tier 1
Tier 3
Tier 2
Tier 1
In-Network In-Network ***Follow MAP Recommendation and deductible will be waived for procedures***
Evolutions Network EMBS is the new TPA administering Claims https://mibenefits.ebms.com/auth/login • Same Plans & No Changes in deductible, co- insurance or OPM • Center for Employee Health • 407-483-5757 • SDOCEmployeeHealthCenter.net • Deductible is one bucket • Example: • Both plans offer the freedom to go to any provider but can save $$ via • Utilizing the SDOC Health Center • TeleMedicine • Green Imaging • MAP (procedures, 2 nd options, • Tier 1 providers • Elect Rx (if their Rx meets criteria) • For the premium difference between Healthy Essentials & Health Advantage Plus the employee is essentially purchasing. (depending on tier ) • A $300 / $600 lower deductible • 5% lower co-insurance • A lower OPM • Lower office visit co-pays • A copay for Urgent Care instead of deductible/co-insurance • 5% better co-insurance / $5 lower copay on lab work.
Deductible (Ind./ Family) PlanYear
$1,250 / $2,500
$900 / $1,800
$950 / $1,900
$600 / $1,200
Co-Insurance
30%
25%
$4,000 / $8,000
$3,000 / $6,000
OPM . (includes deductible, coinsurance & copays????) SDOC Center for Employee Health Co-pay TeleMedicine Preventative Care PCP Office Visit (non- SDOC Health Center)
$6,300 /$12,000
$5,700 / $11,400
$0
$40
$20
$30
$25
$15
Deductible / Co-insurance
Specialist Office Visit Emergency Room
$80
$40
$60
$50
$40
Deductible / Co-insurance
Deductible / Co-insurance
Urgent Care
$100
Labwork –Done at Independent Lab
30% No Deductible
30% No Deductible (Ex: Labcorp
$10 (Ex: Quest Diagnostics
25% No Deductible
25% No Deductible (Ex: Labcorp
$5 (Ex: Quest Diagnostics
Labwork – Done elsewhere
Deductible / Co-insurance Deductible / Co-insurance
Advanced Imaging
$0
Advanced Imaging thru Green Imaging
Explain My Benefits © 2021 Health Center, TeleMedicine, MAP along with Green Imaging(when necessary) can save EEs $$$
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Prescription Drug
Healthy Choice
Healthy Advantage
Pharmacy
Non- Preferred (CVS, Walgreens, Rite-Aid) $300 (waived for preferred generics)
Preferred (Independents, Publix, Wal-Mart Family of Stores, Costco )
Non- Preferred (CVS, Walgreens, Rite-Aid) $75 (waived for preferred generics)
Preferred (Independents, Publix, Wal-Mart Family of Stores, Costco )
Deductible
$0
$0
Generics obtained at the SDOC Health Center
$0
$0
$0
$0
Preferred Generics Preferred Brand Non-Preferred Brand
$10
$6
$10
$6
20$ up to $75 50% up to $200
$45
20% up to $50 50% up to $150
$45
50% up to $150 50% up to $200
50% up to $150 50% up to $200
Specialty Elect Rx
No Coverage
No Coverage
$0
$0
$0
$0
Elect Rx
Phone: 1-855-Elect RX (1-855-353-2879) Fax : 1-833-Elect RX (1-833-353-2879) email: info@electrx.com What is Elect Rx? A provider who can obtain a 90-day supply of expensive brand-name prescription medication overseas (countries such as Canada, England and New Zealand) from trustworthy pharmacies and has them delivered to the employee—at no charge to the employee If they indicate / suggest they take a high-cost brand name medication 1. Refer them to ElectRx in order to confirm if any of medication(s) they are taking are on the ElectRx formulary. 2. Let them know if the medication is available through Elect Rx, they should make sure have a 30-day supply on hand for the transition period to Elect Rx AND their doctor will need to send a prescription via fax to ElectRx for a 90-day supply and 3 re-fills. 3) Share with them that once ElectRx has their basic personal information and the prescription, it usually takes 10-15 days, for them to receive the Rx.
Obtaining Generics(when possible), using Preferred Pharmacies and seeing if Elect Rx is a fit for more costly prescriptions are 3 ways for employees to effectively use their Rx benefit
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Half Family (affects medical only) Who / What is “Half Family”?
If you and your spouse work for SDOC, you are both eligible for benefits and if you have children your status is considered “Half-Family . ” Employee who are “Half-Family” have informed Benefits & Risk Management. Who is Primary vs Secondary. They will have an indicator of Primary or Secondary in EMB Enroll ((see screenshot to the right). What does Half Family mean for their health benefits enrollment? The employee who is noted as Primary will enroll the family on their account and have payroll deductions for medical insurance. The spouse designated Primary will have premiums deducted; the employee designated Secondary will be covered under the Primary’s plan For appointments will I know beforehand if the employee is Half Family? We should. We are asking them to tell us but if they don’t you can see in the system. EE claims they are Half Family BUT it does not designate in system – WHAT TO DO? • Enroll the employee and you can quote the HF rate. • Create Issue form so this can then be updated in system. • EMB will resend confirmation What will the medical plan enrollment look like in EMB Enroll for a spouse who is secondary? They should elect you only medical coverage on their EMB Enroll account The coverage will show as being no cost and they can continue with the rest of their elections Half Family is how SDOC addresses couples who both work at SDOC, have children and want medical coverage under one employee
On the Verify information Page in the Open Enrollment Flow, scroll down and look under the Other section --- This will show you who is Primary or Secondary
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SDOC Open Enrollment, Coverage Effective October 1
Opt Out Credit
SDOC Open Enrollment, Coverage Effective October 1
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Opt Out Credit - Cheatsheet
Dental DHMO
Credit
Total Annual (20 pays) Amount left from 750 credit
$ $
12.50 19.33 31.67
$ $ $
250.00 386.60 633.40
$ $ $
500.00 363.40 116.60
PPO Low PPO High
$
Vision
Credit
Total Annual (20 pays) Amount left from 750 credit
Vision care plan $
3.67
$
73.40
$
676.60
*Add total Annual amounts for plans Employee elected, then subtract from the 750 annual credit. This will give you the amount of the credit left that they can use to cover Disabiltiy or put it toward Disability
Example: EE elected the DHMO Dental and vision care plan $250 + 122.40 = $372.40 - $750.00 = $377.60.
Divide this amount by 20 pays $377.60 / 20 = $18.88 per pay that can either cover the cost of Disabilty for the year or go towards the FSA.
Renette’s Opt-Out Calculator can be found in the Smartsheet Attachment: https://app.smartsheet.com/sheets/p3RRpMj2jRHqFxpqwF56G8vFRHFG7gRHpX6r9Xw1
SDOC Open Enrollment, Coverage Effective October 1
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EMBS is the new TPA administering Claims As of 10/1
https://mibenefits.ebms.com
888-326-7240 Aither Health should still be used for any claims through 9/30/22
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Text : 713-524-9190 Call : 844-968-4647 Chat : www.greenimaging.net
What does an employee need to know about Green Imaging? Should they need medical imaging, they can obtain the diagnostic imaging they need at no cost to them by doing the following. 1. Contacting Green Imaging with their prescription Green Imaging will schedule an appointment for them with a network facility that is close to their home and has the right type of equipment for the image their doctor ordered. 1. They will receive a voucher to present at their appointment and then that’s it! Their exam report will be immediately sent to their referring doctor, and they won’t need to worry about your co-pay or after procedure bill If they don’t use Green Imaging’s recommendation, they’ll need to pay the appropriate deductible and coinsurance.
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What does an employee need to know about MAP? MAP is a nurse concierge service that will find the best specialist and highest quality, most cost-effective providers and facilities for any medical procedure an employee may need. They research, provide options and a recommendation, at no cost to the employee. If the employee follows through with the recommendation MAP provides : Their deductible for that procedure will be waived! If they use MAP and don’t follow their advice, their medical plan pays usual benefits.
WHY CALL MAP?
Contacting MAP before a procedure and following through on their recommendation along with using Green Imaging for any medical imaging are 2 more ways for an employee to manage healthcare costs
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Flexible Spending Accounts www.Mibenefits.ebms.com
Healthcare
Dependent Care Pay for qualifying dependent care on behalf of dependent child under 13 or a spouse who is incapable of self care, using pre-tax funds
• Used for eligible medical, dental and vision expense. • Must actively elect each year in order to continue account. • Contributions • Minimum contribution $240 • SDOC Contributions $250 IF employee elects to contribute $750 or more • Can carry over up to $570 into next year. • IMPORTANT : Must make FSA election for the coming plan year for any prior plan year balance to roll over. • EBMS Debit card provided • SDOC Limit
IRS contribution limit: $5,000
Make sure the employee knows • Only the amount you have contributed year to date is available at any one time. .
• 2022: 2,750 • 2023: 2,850
• Includes credit or contribution by SDOC (example if SDOC contributes $250 employee max contribution can only be $2,500 ($2,500 + $250 =$2,750)
SDOC Open Enrollment, Coverage Effective October 1
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Dental Humana / www.humana.com | 800-233-4013 Group #: 830049 • Same Plans & No Changes in deductible, Annual Individual Max or co-insurance percentages or orthodontics • Orthodonita: Only DHMO has adult orthodontia coverage. Child coverage is through age 18. • No ID Cards: • In Network provder look up DHMO is HS195 • For PPO Plans, why does in or out of network matter? While deductible, co-insurance are same for in network vs. out of network. Out-of-pocket cost for care is lower with an in-network because they can only charge what plan allows. Out of network pays what they would if provider was in-network. If the out of network eye doctor charges more you pick up the up the difference (balance billing).
SDOC Open Enrollment, Coverage Effective October 1
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Vision VSP | www.vsp.com | 800.877.7195 Group: 29384 • TWO PPO style plans • What’s The Difference?
While deductible, co-insurance are same for in network vs. out of network. Out-of-pocket cost for care is lower with an in- network because they can only charge what plan allows. Out of network pays what they would if provider was in-network. If the out of network eye doctor charges more you pick up the up the difference (balance billing).
SDOC Open Enrollment, Coverage Effective October 1
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Supplemental Life and AD&D Metlife | www.metlife.com/mybenefits | 800.638.6420 Group: 145776
Basic Life and AD&D Metlife | www.metlife.com/mybenefits | 800.638.6420
• Paid for by SDOC • Amount Varies By Employees: “Trust the System”
• Employees: can elect an additional 1 or 2 x annual earnings • G.I. NEW HIRES ONLY
• Instructional/Professional receive 1x Annual Earnings • Those with 10 years or more of serve receive another 1x Annual Earnings in coverage. • Professional Support Staff (non-instructional)
• EOI
• Employee & Spouse: any increase after NH enrollment • Process: MetLife will Send EE an EOI form post-OE
Annual Earning(contract)
Amount of Basic Life /AD&D
• Other Plan Details
• NO Age reduction
$9,999 or less
$10k
• Employee: ???? • Accelerated death benefit: 12 months or less, up to 80% of coverage to a mx of $500K
$10,000 - $14,999 $15,000 - $19,999 $20,000 or more
15k
$20k
1x Annual Salary rounded to next 1k
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SDOC Open Enrollment, Coverage Effective October 1
Disability Coverage True GI Open Enrollment Every Year • $100 increments • Min Benefit $200 • 3/12 Pre-Ex
Elimination Periods
• 14, 30, 60, 90, and 180 • 1 st Day Hospitalization is associated with 14 or 30 elimination period only
SDOC Open Enrollment, Coverage Effective October 1
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Accident Trustmark | David Roque Special. Pay for Xmas Gifts!!!! Family of 5 should get $200 x 5 = $1,000 Year in Wellness Click Here Accident Brochure
SDOC Open Enrollment, Coverage Effective October 1
Changes can be made in system
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Hospital Staypay Trustmark | https://myvb.trustmarkbenefits.com/login CLICK HERE FOR BROCHURE • Guaranteed Issue on initial offering (no health qualifications) • Rate is locked in and will not increase with age • No pre-ex • No waiting / elimination period • Pregnancy covered • Mental illness and treatment for alcohol or substance abuse are not covered. • Portable • No wellness benefit included
CLICK HERE FOR HOSPITAL STAY PAY TRAINING DECK
Any changes to tier level must be done through an Issue Form
Service /Care Hospital Admission
$1,200 paid once per calendar year
Daily Hospital Confinement Daily Hospital Confinement
$100 per day (pays a max. of 365 days per calendar year $200 per day (pays a max. of 365 days per calendar year
Do NOT decline coverage unless 100% certain that is what employee wants. Once declined in system, an Enrollment Issue Form must be submitted to set up election
Claim Free Return Benefit
$100 every 2 years if claim free
SDOC Open Enrollment, Coverage Effective October 1
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• Coverage levels: 10 -30k in 10k increments • Dependent coverage options • Employee must enroll • Spouse coverages: up to 50% of employee coverage 5K – 15k in 5k increments • Child options: 2.5k -10k in 2.5k increments • $100 health screening (one per calendar year per covered EE/ spouse. • Diagnosis after age 70: Benefits reduced by half. • Pre-ex: No • Reoccurrence Benefit for some covered conditions: • Different illness: • 90 days or more with no reoccurrence Critical Illness Lincoln Financial | CLICK HERE FOR CI BROCHURE CLICK HERE FOR CI TRAINING DECK
Examples of covered condictions
Changes can be made in system
SDOC Open Enrollment, Coverage Effective October 1
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Universal LifeEvents Insurance Trustmark | CLICK HERE FOR BROCHURE CLICK HERE FOR UNIVERSAL LIFE EVENTS TRAINING DECK
Any changes to volume level must be done through an Issue Form
Do NOT decline coverage unless 100% certain that is what employee wants. Once declined in system, an VB Increase Form must be submitted to set up an election
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Appendix
Opt Out Credit – EMB Enroll System New Opt Out Acknowledgement • At top of OE Event Flow • Click ‘I understand’ even if enrolling in medical
Opt Out Medical will be listed as if it was a plan, click ‘View Plan’ to be able to select Opt Out as the employee’s choice for medical
SDOC Open Enrollment, Coverage Effective October 1
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Opt Out Credit – EMB Enroll System New – Proof Of Other Coverage Questionaire • Ask information on person covering employee & the coverage. • Person covering employee’s name and their SSN • Effecive date of coverage, Name of Carrier & Group #
SDOC Open Enrollment, Coverage Effective October 1
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