WELCOME
Helping you and your family reach and maintain good health is very important to Franklin Hills Country Club. We are pleased to offer a selection of benefits designed with your health and financial wellbeing in mind. Each year we take great care in selecting the benefit programs offered to employees. We review our benefit programs each year to ensure we consider the best combination of benefit coverage, network access and affordability for employees. Franklin Hills Country Club remains committed to providing a competitive, cost-effective benefit program. Highlights of the 2023 benefit plans include:
- No changes to Blue Cross Blue Shield of MI Medical Plan
- Prescription Drug - EHIM
- Health Reimbursement Account - EHIM
- Rx Discounts for Chronic Conditions
Review the remainder of this page and the resources to learn more about your benefit plan offerings for 2023!
OPEN ENROLLMENT REMINDER!
Open Enrollment is from May 19, 2023 through May 24, 2023.
During Open Enrollment you may make changes without being required to have a qualifying event. Please also keep in mind the following when making your elections for 2023:
- Important Reminder: you must complete an Enrollment form, even if you aren't making any changes.
- Open Enrollment meeting:
ELIGIBILITY
All regular employees working at least 30 hours per week are eligible to participate in the benefit plans following 90 days of employment. When you enroll in the benefits program, you may also cover your eligible dependents. Dependents include your legal spouse and children.
Children eligibility is as follows -
- Medical: Coverage ends on the last day of the Calendar Year the Child turns Age 26
- Dental | Vision: Coverage ends on the Child's 26th Birthday
If your employment with Franklin Hills Country Club terminates, your coverage will end on the date of separation.
ENROLLMENT
Action Required: All enrollment forms must be submitted to Rosanne Achtenberg by Wednesday, May 24th!
ENROLLMENT INSTRUCTIONS:
- Review your benefit information included on this site.
- Complete your 2023-2024 election form clearly and legibly.
- Return the form to Human Resources by Wednesday, May 24th, 2023.
The Benefit choices you make during your open enrollment remain in effect for the entire year. You can, however, modify your elections under certain circumstances, called "Qualifying Events" These are events such as marriage, divorce, birth or adoption of a child, loss of eligibility under another plan. If you experience a qualifying event, you may make changes to your benefits within 30 days of the event or 60 days if the event is due to birth or adoption of a child.
Contact Human Resources if you have questions about qualifying events.
MEDICAL
PPO Group #007033159 | (877) 790-2583 | www.bcbsm.com
Blue Cross Blue Shield of MI (BCBSM) will continue to be your medical and prescription carrier. Your plan to consider is a PPO with BCBSM. The PPO plan allows you the flexibility to receive coverage for approved services in and out of network with no requirement to obtain referrals. Although these plans include out of network coverage, if you do go out of network you will experience higher cost sharing in addition to possible balance billing.
Below is a high-level overview of your Medical plan:
Helpful Rx Cost Saving Tools & Tips!
- MAIL ORDER - Many drugs are available in a 90-day supply, rather than the 30-day retail supply. Typically, mail order drugs are subject to two-times the standard 30-day copays noted above, resulting in lower expenses for you. You can get more information on how to start receiving mail order drugs by clicking here.
- GOOD Rx - There are many tools online that you can use in order to save on prescription costs. One being www.goodrx.com an online Rx database that allows you to find what pharmacy is the cheapest for your specific prescription. Additionally, you may be able to find a coupon that will greatly reduce your cost. It is important to remember that many of the coupons can only be used outside of your plan (will not count towards your maximums).
- ASK YOUR DOCTOR – Make sure to ask if there are cost savings alternatives to the prescription they are providing. Many times, there are generic or different manufacturers that will save you money at the pharmacy.
View Participating Providers - Click the link below:
HRA & Rx
(800) 311-3446 | www.ehimrx.com
VIRTUAL VISITS
(844) 606-1608 | www.bcbsmonlinevisits.com
Employees & dependents who are covered by one of the BCBSM/BCN medical plans have access to virtual visits with BCBSM Online Visits. BCBSM Online Visits provide members the opportunity to receive medical and mental health care from the comfort of your own home. With BCBSM Online Visits, eligible employees and dependents have access to board certified doctors, psychiatrists and licensed therapists 24 hours a day, 7 days a week, 365 days per year.
HOW MUCH DOES IT COST?
Medical Visits:
- Standard Plans: Equal to your office visit copay
Mental Health: For both non-HSA and HSA plans, the costs of these services are Subject to your plans normal cost sharing for mental health services, often, deductible & coinsurance. The charges applicable for the type of services, which will apply towards your deductible, are as follows:
- Therapy Visits: $85 (Masters Level) or $99 (Doctorates Level) – Once your deductible is satisfied, coinsurance will apply if applicable
- Psychiatry Visits: $199 for initial visit and $95 for follow up visits –Once your deductible is satisfied, coinsurance will apply if applicable
Prescriptions: If prescribed during a virtual visit, applicable Rx cost sharing will apply based on which medical plan you are enrolled in.
DENTAL
Policy #G000C4LZ | (800) 775-6000 | www.mutualofomaha.com
The dental plan provides comprehensive coverage to help you and your family maintain good dental health. Both in and out of network benefits are included, however, if you go out of network it is likely that you will experience balance billing.
Below is a high-level overview of your Dental plan:
What are Preventive Services? Routine oral exams and cleanings, x-rays, space maintainers, sealants & fluoride treatments
What are Basic Services? Periodontics, endodontics (root canals), oral surgery, fillings, & emergency treatment
What are Major Services? Inlays/onlays, crowns, dentures, implants & bridges
View Participating Providers -- Use the Button Below!
VISION
Policy #GLLV-C4LZ | (800) 775-6000 | www.mutualofomaha.com
Vision coverage is provided through Mutual of Omaha to help pay for eye exams, prescription glasses and contact lenses. You may use the eye care professional of your choice. However, when you visit a participating in-network provider, you receive higher levels of coverage. If you choose to receive services out-of-network, you may be required to pay that provider at time of service and will need to submit a claim to Unum for the applicable reimbursement based on the out-of-network reimbursement schedule.
Below is a high-level overview of your Vision plan:
View Participating Providers -- Use the Button Below!
LIFE & DISABILITY
Policy # GUG-C4LZ | (800) 775-6000 | www.mutualofomaha.com
Life/AD&D
A sudden accident or death can leave you or your loved ones in a vulnerable position. Eligible employees are provided Basic Life and Accidental Death & Dismemberment (AD&D) coverage.
Important Reminder: Who's Your Beneficiary? Naming a beneficiary is a crucial part of electing life insurance. Also, don't forget to update your primary or secondary beneficiary if you experience a life event, such as a divorce or birth of a child.
Short-Term Disability (STD)
Everyday illnesses or injuries can interfere with your ability to work, more serious issues can impact your ability to work indefinitely. Even a few weeks away from work can make it difficult to manage household costs. Disability coverage provides financial protection for you by paying a portion of your income, so you can focus on getting better and worry less about keeping up with your bills.
Please review your plan certificate for additional details, limitations, and exclusions.
EMPLOYEE ASSISTANCE PROGRAM
(800) 316-2796 | mutualofomaha.com/eap
Employee Assistance Plan (EAP) - All employees and their families have access to use the EAP services. Representatives can assist you through work-life balance, stress management, grief, counseling, and much more. They will also help you find resources within your community.
- Includes up to 3 virtual visits
- Unlimited 24/7 online & phone support
- Referrals for personal services and community resources
- Plus much more!
ADDITIONAL EDUCATION
Educación adicional
Contact Us
As you consider your benefit options, please be sure to review all available information.
If you need further assistance, please reach out to Rosanne Achtenberg.
This is a high-level guide of certain benefits your employer offers. The information in this benefits guide is intended as a general outline of the benefits available under the following welfare benefit programs offered by your employer and should not be considered legal, investment or other benefits advice. Benefits described are subject to change, amendment, or termination without notice to, or the agreement of, any employee/participant. All protected health information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your benefits guide, contact Human Resources. If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a Federal law gives you more choices about your prescription drug coverage.