Gateway Regional Medical Center

Table of Content

  1. Header
  2. Welcome
    1. OPEN ENROLLMENT REMINDER!
  3. Eligibility & Enrollment
    1. Eligibility
    2. Enrollment
  4. Medical & Rx
    1. Medical/Rx Plans Overview
    2. Medical Scenarios
    3. Providers & Networks
    4. Virtual Visits
    5. Carrier Resources & Education
  5. Accounts
    1. Health Savings Account (HSA)
    2. Flexible Spending Accounts (FSA)
    3. Dependent Care Reimbursement Account (DCRA)
  6. Dental
    1. Dental Plans Overview
    2. Providers & Networks
  7. Vision
    1. Network & Resources
  8. Financial Protection
    1. Life/AD&D
    2. Disability
    3. Voluntary Benefits
  9. Personal Support & Assistance
    1. Employee Assistance Plan (EAP)
    2. Travel Assistance
  10. Pet Insurance
  11. Legal Shield
  12. Additional Educational Videos
  13. Rates
  14. Have Questions?
  15. Footer

Welcome

Helping you and your family reach and maintain good health is very important to Gateway Regional Medical Center. We are pleased to offer a selection of benefits designed with your health and financial wellbeing in mind. We review our benefit programs each year to ensure we consider the best combination of benefit coverage, network access and affordability for employees. Gateway Regional Medical Center remains committed to providing a competitive, cost-effective benefit program. Each year we take great care and detail in the benefit programs offered to employees. Highlights of the 2024-2025 benefit plans include:

*NEW Medical Carrier - UMR/ United Healthcare Effective 1.1.2025

* New Dental Carrier - Ameritas

*Introducing 4 New Dental Plans

* New Vision Carrier - Ameritas

* Life and Disability Carrier - Blue Cross Blue Shield of IL

* Short Term Disability Carrier - Blue Cross Blue Shield of IL

* Voluntary Benefit Products

*Introducing Critical Illness, Hospital Indemnity, and Accident Plans

Review the remainder of this page and the resources to learn more about your benefit plan offerings for 2024-2025!

OPEN ENROLLMENT REMINDER!

open enrollment

Open Enrollment for MEDICAL ONLY is from December 2, 2024 - December 9, 2024. This open enrollment is for Medical only (and if you need to make changes to your FSA or HSA elections) You may switch between plans and make changes without being required to have a qualifying life event due to a company decision.

  • If you wish to change plan type, add or drop you or dependent coverage, you must take action by Monday, December 9th. If you do not take action to review your benefits or submit your elections during this open enrollment period, your current coverage will default to your existing elections. This means that if you are currently in the PPO Plan, for example, that coverage will automatically transfer to the new PPO Plan with the same dependent coverage unless you make changes. If you are enrolled in either of the existing HSA medical plans, your coverage will automatically transfer to the new HDHP unless you make changes.

  • Online meetings will be held via Microsoft Teams on December 4th at 2:00 CST and 6:00 CST. Please use the links below for the meetings:

Eligibility & Enrollment

Eligibility

All active employees working at least 30 hours per week are eligible to participate in the benefit plans offered by GRMC as of the first of the month following a 30 day waiting period.

When you enroll in the benefits program, you may also cover your eligible dependents. Dependents include your legal spouse and children.


Children eligibility terminates as follows:

·       Medical | Dental | Vision: Last day of the calendar month the child turns Age 26

·       Voluntary Life, Accident, Critical Illness, & Hospital Indemnity: As of the child’s 26th birthday


Should you no longer be employed by GRMC, your coverage will end as of the end of the month of which your termination occurred with the exception of Life and Disability which is the date of your termination.


Enrollment

Log Into ISolved

Make Your Open Enrollment Elections Here

Log Into ISolved

Make Your Open Enrollment Elec ...

ENROLLMENT INSTRUCTIONS:

  1. Review your benefit information included on this site
  2. Log into your ISolved Portal
  3. Follow instructions and enroll in your benefits
  4. Make sure to save your elections and save/print your confirmation statement.

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 & Rx

UMR is your new Medical Administrator using the United Healthcare Choice Plus Network. Prescription benefits are administered through Optum Rx! You have the choice between two plans that will be Effective 1-1-2025. The plan options include a PPO plan and a HDHP PPO plan. View the Providers & Networks area for more information and buttons on how to locate participating providers.

After you enroll in one of the medical plans, please be sure to register through the UMR member portal where you can access important information pertaining to your medical plans with UMR/United Healthcare including participating providers, cost estimates for services, explanation of benefits/claims, and your accumulation amounts for deductibles and out-of-pocket costs.

UMR Member Portal

Your coverage must be active to register

UMR Member Portal

Your coverage must be active t ...

Medical/Rx Plans Overview

Below is a high-level overview of your plan options and in-network benefit information:

Providers & Networks

Instructions and tips for locating participating providers below --

ppo hmo pos

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Virtual Visits

Teladoc

Carrier Resources & Education

HDHP+HSA

HDHP+HSA

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Accounts


You have the opportunity to contribute to a variety of savings and/or spending accounts on a pre-tax basis which lowers your taxable income. View the information below for important details and guidelines for the various accounts offered by ISolved.

Health Savings Account (HSA)

The Health Savings Account (HSA) allows you to set aside pre-tax dollars to pay for eligible medical, dental, and vision expenses. The UMR/Unite Healthcare HDHP Plan is qualified for an HSA. By contributing to an HSA you reduce your taxable income, so you pay less in taxes — which saves you money.

If you enroll in the HDHP, GRMC contributes to your HSA on your behalf as follows:

Employee only = $1,250 Family = $2,250

HSA IRS Maximums are as follows and are on a calendar year basis. The maximums indicated below are a combined maximum for participant and any employer provided funds to the HSA. If you elect the HSA plan mid-year, maximums are prorated based on your effective date in the HSA plan.

$4,150 for a single contract | $8,300 for a two person or family

$1,000 "Catch Up" contribution for those age 55+

If you have an HSA with another bank or custodian, you can transfer your funds to the GRMC HSA with ISolved.

Visit the ISolved HSA page for more information by clicking Customer Logins - isolved Benefit Services

HSA Overview

HSA Overview

HSA Store

HSA Store

Qualified Medical Expenses

Qualified Medical Expenses

Flexible Spending Accounts (FSA)

Plan Details are as follows:

  • You can contribute up to $3,200 annually.
  • At the end of the 2025 plan year (7.31.25), if you have not used all of your FSA funds, they will be forfeited
  • You have 90 days after the end of the plan year (7.31.25) to submit for expenses that occurred on or before 7/31/2025.
  • If you are enrolled in an HSA plan, you will be eligible for the Limited Purpose FSA only which can be used for qualifying dental, vision, and post-deductible medical expenses.
  • You have access to your full annualized election amount on day one (8.1.24).
  • Unused funds will be forfeited. 
Flexible Spending Account

Flexible Spending Account

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How to Optimize your FSA

How to Optimize your FSA

Dental


NEW! High and Low Dental Plan Offering with BCBS of IL


GRMC's dental plans provide comprehensive coverage to help you and your family maintain good dental health. The dental plans do not require you to go to an in network provider, however, your yearly maximum amount of coverage will go farther if you use a contracted provider. Please see the Provider and Networks section for directions on finding a provider.

Dental Plans Overview

Below is a high-level overview of your plan options and benefit information:

What are Preventive Services? Routine oral exams and cleanings, x-rays,, sealants & fluoride treatments

What are Basic Services? Periodontics, endodontics (root canals), oral surgery, fillings, prosthetic maintenance

What are Major Services? Prosthodontics, crowns, dentures, implants & bridges

 You can view more details of these plans by accessing the benefit summaries provided below.

 

Dental Enhanced Network

Dental Enhanced Open Access

Dental Base Network

Dental Base Open Access

Providers & Networks

Network Options

You have access to Ameritas’ Classic PPO network. However, you always have the option to go out-of-network and see any licensed dental provider. But there are financial advantages of staying within the network. You are encouraged to enroll for the Network Only plan if you ONLY want to utilize in-network providers. Let’s look at the differences between plans:

Open PPO: more flexibility to go out-of-network for dental services, but these options have a higher cost per pay period. The out-of-network reimbursement is set at one of the highest Usual & Customary allowances available in the industry.

Network Only: less flexibility for out-of-network services, but lower cost per pay period. The Network Only options pay in-network and out-of-network claims based on negotiated fees accepted by the Ameritas PPO network. Going out-of-network will result in much higher out-of-pocket costs. Enrollees in the Network Only plans should intend to use Ameritas’ Classic PPO network dentists whenever possible.

For a list of network providers: Ameritas - Find a Provider 

Vision

GRMC offers vision coverage through Ameritas to help pay for eye exams, prescription glasses and contact lenses. 

Below is a high-level overview of your plan and in-network benefits:

Ameritas /VSP

Explore Vision

Ameritas /VSP

Explore Vision

Network & Resources

With Ameritas Vision Powered by VSP your vision network is the VSP network. 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 EyeMed for the applicable reimbursement based on the out-of-network reimbursement schedule.

Financial Protection

GRMC understands the importance to you and your family to have strong financial protection. We provide all employees Basic Life/AD&D and Long Term Disability coverage at no cost to you. In addition to these benefits, we offer a variety of insurance you can choose from on a voluntary, employee paid basis so you can select what is best for your family. All of these coverages are provided to protect your income and out of pocket expenses.

Life/AD&D


A sudden accident or death can leave you or your loved ones in a vulnerable position. GRMC provides all eligible employees Basic Life and Accidental Death & Dismemberment (AD&D) coverage up to 2.5 times your salary at a maximum of $500,000 at no cost to you. Employees have the opportunity to enroll in additional Life and Accidental Death & Dismemberment insurance which will supplement lost income in the event of an accident or death. If you choose to enroll in employee coverage, this will be in addition to your employer provided Basic Life coverage.





Supplemental Life Insurance




Disability

GRMC provides Long Term Disability benefits at no cost to you with an option to buy Short Term Disability!


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.







Voluntary Benefits

NEW!!!!


GRMC provides a competitive benefits package for all employees as part of our total compensation package. We realize you make benefit choices based on what’s important to you and the needs of your changing lifestyle. Therefore, along with our core benefits, we offer these additional benefits which help to provide financial support to you. These benefits are paid for through payroll deduction on a post tax basis so that the benefits are tax free.


Accident, Critical Illness, & Hospital coverage is provided through Unum. Hopefully you are never in the position to use it, but if you were to experience an accident, illness, or hospitalization, it could end up costing you a lot of money. With these plans, you will be paid money for qualifying situations/services to cover our of pocket expenses or you may use the funds for whatever you like.























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Personal Support & Assistance

GRMC realizes that your needs go beyond just the standard insurance. This is why we also provide all employees and their families access to personal service and assistance resources at no cost. Here you will find information on our Employee Assistance Program and the Travel Assistance Program to give you peace of mind and support when you need it the most!

Employee Assistance Plan (EAP)


EAP Flyer 2024

EAP Flyer 2024

Travel Assistance


Pet Insurance




Dog = $27.45 per payroll

Cat = $13.83 per payroll


Legal Shield







Rates are $10.96 per payroll

Additional Educational Videos

What is Preventive Care?

What is Preventive Care?

Benefit Terms Explained

Benefit Terms Explained

How to Read an EOB

How to Read an EOB

What is Balance Billing?

What is Balance Billing?

COBRA

COBRA

How to stretch your healthcare dollars

How to stretch your healthcare dollars

FMLA

FMLA

Rates

Have Questions?

As you consider your benefit options, please be sure to review all available information. If you need further assistance, please reach out to Human Resources.



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.


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