The Benefit choices you make during your initial enrollment or annual 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.
You are eligible to participate if you are full-time and work a minimum of 30 hours per week. Your coverage will be effective 1st of the month following 60 days from your date of hire.
Enroll through Employee Navigator (see Orange Button / link below).
If you are enrolling for the first time in Sedera or making a change with Sedera this is a two step process.
In addition to the Employee Navigator enrollment, new Sedera members must complete their enrollment through the Sedera portal before the 19th of the month to ensure an effective date of the 1st of the following month. If you do not do this your enrollment may be pushed to the following month.
Sedera membership will auto-renew unless a change is made on the portal.
Click the following link and enter the Employer code below.
Employer Verification Code: 8103
Current Sedera Members:
Sedera members making changes will need to make theri changes through the Sedera member portal at https://member.sedera.com.
All Sedera memberships will auto enroll unless you log on to the Sedera member portal to make a change.
Option 1 - Sedera (cost sharing) with MEC (Minimum Essential Coverage)
The Sedera combo plan has three parts: Sedera Cost Sharing, a Minimum Essential Coverage (MEC) plan which will cover your preventative care, and a Colonial Accident Plan.
Cost Sharing Plan with Sedera
Sedera is a cost sharing community that will share the cost of the large events in life.* The Sedera plan doesn't have a network. Please reference the Sedera materials and view the video presentations below for details.
There is no ID for this plan and no network. You will present yourself as a cash payer and start a "Need" on the member portal if the total goes over your chosen IUA (Initial Unshareable Amount). See "Sedera Select + Presentation" link below.
Telemedicine is included with your Sedera membership.
Teladoc gives you access 24 hours, 7 days a week to a U.S. board-certified doctor through the convenience of phone, video or mobile app visits.
GET THE CARE YOU NEED
Teladoc doctors can treat many medical conditions, including:
• Cold & flu symptoms
• Pink Eye
• Respiratory infection
• Sinus problems
• Skin problems
• And more!
*Pre-existing limitations apply.
MEC (Minimum Essential Coverage) - Preventative Care through Options Plus
When you enroll in Sedera you are automatically enrolled in this plan.
You will receive an ID for this plan. This plan provides the framework for an HDHP that allows you to open an HSA banking account.
This plan will cover your preventative care at 100% and also provides the framework for an HSA banking account. You do need to stay in network for your preventative care. All preventative care mandated by ACA is covered. You can see a complete list here.
PHCS network search instructions:
● Go to www.multiplan.com
● Click on Find a Provider in the upper right corner
● Click on the green Select Network button & choose PHCS
● Click the green Select Network box
● Choose PHCS in the pop-up box
● Select Preventive Services Only
Colonial Life Accident Plan
Life is full of challenges...
Protecting your way of life shouldn’t be one.
Accident insurance helps offset the unexpected medical expenses that can result from a covered accidental injury.
Choose options your way:
Coverage is available for your spouse and eligible dependents with most products.
Benefits are paid directly to you, unless you specify otherwise.
With most plans, you can continue coverage when you retire or change jobs, with no increase in premiums.
With most plans, you receive benefits regardless of any insurance you may have with other companies.
Option 2 - AllSavers (Self Funded Insurance)
You have two options:
1. PPO Buy Up Plan P5000i100
2. EPO Base Plan E5000i100
These plan are the same with the exception that the EPO has in-network benefits only. They both have a large national network.
You have two dental options to choose from.
Both plans have a $50 deductible on basic and major services. This does not apply for preventative.
Both plans cover preventative care at 100%. The deductible does not apply to preventative care.
With the base plan it is very important that you stay in network. If you go out of network you will almost certainly be balance billed. The base plan has an annual maximum of $1000. Basic services are covered at 80% and major services are covered at 50%. On this plan endodontics and periodontics, root canals and gum disease, are in the major category and paid at 50%.
Buy Up Plan:
The buy up plan pays very well out of network. We typically call this an “Any Dentist Plan.” and it has a higher annual maximum of $2000. It will also pay for endodontics and periodontics, this is root canals and gum disease, in the basic category at 80%.
Even though the plan renews on July 1st, the annual maximum and deductible Are on a calendar year and will reset on January 1st.
As with all Dental carriers, anytime you have procedures that total over $300 we recommend that you get a predetermination of benefits. Dentists do this all the time . They will send the carrier be exact codes that need to be done and will receive back exactly how the plan will pay and what your responsibility will be so that there are no surprises.
Voluntary Vision through Principal
DID YOU KNOW?
Gideon Constracting, LLC offers vision coverage through Prinicpal to help pay for eye exams, prescription glasses and contact lenses. You receive a higher level of benefits when you stay in network. Review your coverage details in your Benefit Guide.