Table of Content

Header
Your 2025 AMHA (Non-Bargaining Employees) Benefits Page
1. Eligibility
2. Eligibility
3. How to Enroll
4. Instructions
5. NEW! Symetra Coverage
6. Accident
7. Critical Illness
8. Hospital Indemnity
9. Medical
10. Employee Contributions
11. Summary of Benefits and Coverage (SBC)
12. MedMutual My Health Plan/Mobile App
13. NEW! Medical Mutual Total Health
14. 24/7 Nurse Line and Care Navigation
15. Maternity Management and NICU Management
16. Transitional and Palliative Care
17. Virtual Physical Therapy
18. Digital and Telephonic Health Coaching
19. Preventive Care
20. HSA
21. Prescriptions
22. Smart90
23. SaveOnSP (through Medical Mutual)
24. ImpaxRX
25. Dental
26. Dental Summaries
27. Vision
28. Vision Summaries
29. Life
30. Basic Life Insurance
31. Voluntary Life Insurance
32. MetLife Benefit Summaries
33. Beneficiary Designation
34. First Stop Health
35. Ease@Work
36. Contact Information
37. Compliance
Footer

Your 2025 AMHA (Non-Bargaining Employees) Benefits Page

NEW! Accident, Critical Illness, and Hospital Indemnity Coverage through Symetra

Medical: Medical Mutual

**Effective 1/1/25 the EPO and PPO 250 plans will no longer be offered. A new EPO 500 plan will be offered**

Pharmacy: Express Scripts and Smart90

Specialty Pharmacy Assistance: ImpaxRX and SaveOnSP - through Medical Mutual

Dental: MetLife

Vision: MetLife

Basic Life: MetLife

Voluntary Life: MetLife

Telemedicine: First Stop Health

Employee Assistance Program: Ease@Work

Eligibility

The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire plan year, January 1, 2025 - December 31, 2025, unless you experience a qualifying life event.

If you have a Qualifying Life Event and want to request a mid-year change, you must notify Human Resources and complete your election changes within 30 days following the event. Be prepared to provide documentation to support the Qualifying Life Event.

What is a Qualifying Life Event?

Marriage
Divorce
Birth/Adoption of a child
Death of a spouse or other enrolled dependent
Change in spouse’s benefits or employment status
A dependent becomes eligible for Medicare or Medicaid

What is a Qualifying Life Event?

When Does My Coverage Start?

Benefits are effective your 31st day of employment.

Who is Eligible for Benefits?

Regular full-time employees and employees averaging 30 hours per week or more are eligible to participate in the benefit plans.

Who are my legal dependents?

Your legal spouse (with proof of marriage).

Your children (up to age 26) including natural children, stepchildren, legally adopted children,

children placed for adoption, children for whom you serve as legal guardian.

Disabled dependent child(ren) of any age.

How to Enroll

Action Required for all benefits-eligible employees:

To enroll into benefits, you must log in to BenXpress to enroll yourself and your dependents for coverage. All employees will use our new benefits enrollment system to confirm or change benefit elections for 2025.

During Open Enrollment, you may:

Elect the same coverage with the same dependents.
Add or remove coverage for dependents.
- If adding a dependent, please provide a marriage certificate for spouse and birth certificate for children.
Decline benefits and elect to receive a waiver incentive. (with proof of coverage)
Enroll, if you are not currently enrolled in 2024 plans.
Update Life Insurance beneficiaries.
Enroll in additional Voluntary Life Insurance coverage through MetLife at your expense.

Every employee who is eligible for benefits must complete a 2025 enrollment no later than November 15, 2024.

After this deadline, you must wait until the 2026 Open Enrollment period or experience a Qualifying Life Event.

BenXpress Enrollment Guide

NEW! Symetra Coverage

Accident, Critical Illness, Hospital Indemnity

AMHA will offer Accident, Critical Illness and Hospital Indemnity coverage through Symetra effective January 1, 2025.

These coverages are voluntary and are 100% employee paid.

Accident Insurance allows you to be better prepared for the unexpected. Accident insurance can cover out of pocket expenses related to an accidental injury. Benefits are paid for injuries and do not interfere with your medical plan.

When you have an accident, your medical plan pays the hospital or provider, your accident coverage pays you, and you can use that money for out-of-pocket expenses, household bills, or however you see fit while you are recovering.

With Symetra Accident Insurance,

There are no health questions or tests to take
No copays, coinsurance or deductibles to meet
Benefits are paid no matter what other coverage you have
Benefits can be used for anything

Accident Enrollment Guide

How to File a Claim

Accident Benefit Summary

Critical Illness Insurance can provide financial relief during a serious medical condition or event. This benefit pays a lump-sum benefit to you that you can use for anything - medical bills, childcare, household bills - after a covered diagnosis.

Covered conditions include, (see attached benefit summary for full list of covered conditions)

Cancer
Heart Attack
Stroke
Organ Failure
Loss of sight, speech, hearing
Severe burns
Coma

With Symetra Critical Illness insurance,

There are no health questions or tests to take
No copays, coinsurance or deductibles to meet
Benefits are paid no matter what other coverage you have
Benefits can be used for anything

Critical Illness Enrollment Guide

How to File a Claim

Critical Illness Benefit Summary

Hospital Indemnity coverage helps cover the cost of inpatient hospital and ICU stays. It may also cover outpatient services for mental health, skilled nursing and substance abuse.

There are no preexisting condition limitations or health questions to answer. You are paid the full per-day benefit no matter what other insurance you have.

Hospital Indemnity Enrollment Guide

How to File a Claim

Hospital Indemnity Benefit Summary

Medical

AMHA offers 3 medical plans through Medical Mutual.

**Effective 1/1/25 the EPO and PPO 250 plans will no longer be offered. A new EPO 500 plan will be offered**

A PPO option offers the freedom to see any provider when you need care. When you use providers from within the PPO network, you receive benefits at the discounted network cost. Most expenses, such as office visits, emergency room and prescription drugs are covered by a copay. Other expenses are subject to a deductible and coinsurance. The EPO plan only covers In-Network providers.

The HDHP is similar to the PPO Plan in that you have the option to choose any provider when you need care. However, in exchange for a lower per-paycheck cost, you must satisfy a higher deductible that applies to almost all health care expenses, including those for prescription drugs. All expenses are your responsibility until the deductible is reached, with the exception of preventive care, which is covered at 100% when you visit a physician in the network.

If you enroll in the HSA plan you must open a Health Savings Account (HSA).

Notice: IRS guidelines for 2025 have increased the single and family deductible to $3,300/$6,600 for the HDHP plan.

Utilizing In-Network providers will allow for the highest level of coverage. In-Network providers agree to accept Medical Mutual's contract rate as the final charge and the member is not balance billed*.

**Balance Billing: Some Out of Network Providers bill a patient the difference between the total cost of services and the amount insurance pays.

Medical Summary

Employee Contributions

Summary of Benefits and Coverage (SBC)

Looking for more details about how items are covered? Please refer to the formal Medical Mutual Summary of Benefits and Coverage (SBC) below.

NEW! Medical Mutual Total Health

Akron Metropolitan Housing Authority is part of Medical Mutual's Total Health Program. (previously known as Chronic Condition Management)

You have access to the below services, at NO COST.

Self-Service Wellness tools via My Health Plan
24/7 Nurse Line
Maternity Management
Care Navigation
Palliative Care
Transitional Care
Progeny Health: NICU Management
SWORD Health: Virtual Physical Therapy
BLOOM: Virtual Pelvic Health Therapy
Digital and Telephonic Health Coaching

24/7 Nurse Line

Nurse Line

Members have direct access to MMO nurses. Nurses provide easy to understand explanations about tests and results, how to treat minor illnesses at home, and help determine if you or a dependent need to seek further medical care from a doctor, urgent care, or the ER.

There is no charge to use the MMO nurse line. This is a 24/7 support line.

Reminder: have your group number and member ID readily available. This can be found on your MMO ID card.

1-888-912-0636

Care Navigation Program

Members have access to MMO nurses to assist with goals and developing condition specific care plans. A dedicated care navigator will serve as a personal advocate and single point of contact to help manage a member's conditions and overall health, improve the quality of care they receive and control the cost of their care.

Maternity Management

Medical Mutual provides digital resources to help members prepare for babys arival through age 2. During pregnancy members receive weekly updates and have access to tools to look up symptoms and issues.

Once baby arrives members can track feeding, diaper changes, and milestones through age 2.

You can find the app by searching MedMutual Maternity.

There is no cost associated with the app or its tools for members enrolled on the health plan.

NICU Management with Progeny Health

Medical Mutual has partnered with Progeny Health to increase the level of NICU support. Progeny will reach out to members who may need this support to offer care management to babies and their families through the baby's first birthday.

Maternity App Flyer

The Transitional Care Program provides nurse-led health coaching and support with home visits after a high-risk hospital stay. Nurses will help members prepare for their hospital release, visit them at home to check on their progress for up to 30 days after release, and connect them with local resources that can help them stay healthy while living at home.

With the Palliative Care Program, members with advanced illness have access to non-hospice community-based in-home support led by physicians, nurses and social workers, to help improve their quality of life as they manage their treatment plan.

These programs are free to Medical Mutual members on the AMHA Health Plan.

Transitional Care

Palliative Care

Medical Mutual virtual physical therapy provides guided physical therapy at home with real-time feedback, which can help members avoid injury and surgery, reduce pain, and decrease reliance on medication.

There programs are offered through THRIVE-SWORD and BLOOM.

BLOOM

Sword

Medical Mutuals digit coaching is provided through LARK for members with Diabetes and Hypertension.

Digitial health Coaching provides smartphone based coaching customized to meet a member's needs. Depending on your health condition, you may receive free supplies, including scale, glucometer, blood pressure cuff, or more, at NO COST.

See attached flyers for more information on each plan for Diabetes and Hypertension.

Telephonic Health Coaching

Asthma
Heart Disease
Type 1 diabetes
COPD

MMO nurses help educate and support members, and work with them to set individualized goals and develop condition-specific care plans.

Nurses are available Monday through Friday, 8am-4pm.

1-800-590-2583

Diabetes Management

Hypertension Management

Diabetes Prevention

Preventive Care

All health plans recognize routine preventive services at 100%, no coinsurance, no deductible if the claim is submitted as routine or preventive and the services performed fall within the approved list of preventive services.

For a complete and updated list of preventive services, please use the link below.

During your wellness visit, proactively let your physician know the reason for the appointment is for a wellness visit and that your physician needs to submit and code the visit as routine or preventive in nature. If your visit is submitted with a diagnosis, the wellness visit will not be paid at 100%, but instead will be subject to deductible and coinsurance. Below are a few examples of services that can be recognized as preventive.

Routine wellness exams, including well baby and child routine exams.
Cholesterol and lipid level screening
Pelvic exam, pap test and screening mammograms
Colorectal cancer screening, colonoscopies, sigmoidoscopies (age limits apply)
Vaccines & immunizations
Contraceptives (specific list applies)
Diabetes screenings

MMO Preventive Drug Flyer

Preventive Care Guidelines

HSA

Health Savings Account

A Health Savings Account (HSA) is a tax-free savings account that is owned by you, it is 100% vested from day one, and lets you build up savings for future needs. The funds may be used to pay for qualifying healthcare expenses not covered by insurance or any other plan for yourself, your spouse, or tax dependents. You decide how much you would like to contribute, when and how to spend the money on eligible expenses, and how to invest the balance.

To be eligible for an HSA, you must be enrolled in a High Deductible Health Plan (HDHP).

UNDERSTANDING YOUR HSA

Pre-tax contributions are deducted through payroll and deposited into your HSA account.
You can use your HSA available funds to pay for qualified medical expenses tax-free.
If HSA funds are used for non-eligible expenses, they are subject to regular income taxes and a 20% excise tax penalty.
Unused funds remain in your account for future use and roll over each calendar year.
HSAs remain with you even if you change health plans or companies. If you open an HSA and later become ineligible to make contributions, you can still use your remaining balance for qualified medical expenses.
You can change your HSA contribution at any time during the plan year for any reason.

To have an HSA and make contributions to the account, you must meet several basic qualifications.

Participants cannot be covered by any other health insurance plan (this exclusion does not apply to certain other types of insurance, such as dental, vision, disability or long-term care coverage)
Participants cannot participate in a Healthcare FSA elsewhere or spouse/domestic partner’s Healthcare FSA or Health Reimbursement Account (HRA).
Participants cannot be enrolled in Medicare or Medicaid.
You cannot be eligible to be claimed as a dependent on someone else’s tax return.
You have not received Department of Veterans Affairs Medical benefits in the past 90 days, unless the Veteran has a disability rating.

You may contribute as follows. *New maximums for 2025 per IRS guidelines*

$4,300 for Employee Only

$8,550 for a Two-Person or family

MAINTAINING RECORDS

To protect yourself in the event that you are audited by the IRS, keep records of all HSA documentation and itemized receipts for at least as long as your income tax return is considered open (subject to an audit), or as long as you maintain the account, whichever is longer.

HSA Overview

Employer Contributions

Contribution Maximums

Prescriptions

TRADITIONAL DRUGS

TIER 1 (GENERIC) | Lowest copay: Most drugs in this category are generic drugs. Members pay the lowest copay for generics, making these drugs the most cost-effective option for treatment.

TIER 2 | Low copay: This category includes preferred and low-cost generic drugs.

TIER 3 | Higher copay: This category includes non-preferred, brand name drugs that don't yet have a generic equivalent. These drugs are more expensive than generics and have a higher copay.

WHERE CAN I FIND A DRUG LIST?

Typically, a full listing of covered drugs is found on your provider’s website. A drug list, also called a formulary, is a list of generic and brand-name drugs covered by a health plan. Although a drug may be on the drug list, it might not be covered under every plan. Review the plan materials for details on specific benefits.

You can use drug lists to see if a medication is covered by your health insurance plan. You can also find out if the medication is available as a generic, needs prior authorization, has quantity limits and more.

RX Summary

Smart90 Flyer

Akron Metropolitan Housing Authority is enrolled in Smart90 with Medical Mutual. This is a feature to your prescription plan, managed through Express Scripts. With it, you have 2 ways to get up to a 90-day supply of your long-term medications (medications that you take regularly for ongoing conditions). You can conveniently fill these prescriptions either though home delivery from an Express Script Pharmacy or at a retail pharmacy in the Smart90 Network.

By getting up to a 90-day supply of your long-term medication, you’ll make fewer trips to the pharmacy, and you’ll only need to make one payment every three months. Also, there’s usually a savings for getting one 90-day supply vs. three 30-day supplies at retail. You will pay the same copayment for your 90-day supply whether you fill through home delivery from Express Scripts Pharmacy or at a Smart90 network pharmacy.

Please see attached 2024 list of Smart90 Network pharmacies.

Medical Mutual members may be eligible to participate in the SaveOnSP program that helps you pay $0 for your specialty medications.

For any new eligible medications:

Your doctor or health provider will continue to send your new prescription to Accredo or Gentry for filling.
An Accredo/Gentry representative will call you and transfer you to a SaveOnSP customer service representative. The SaveOnSP representative will assist you with the enrollment in the new manufacturer’s assistance program.
The SaveOnSP representative will provide Accredo or Gentry your needed enrollment information.
Accredo or Gentry will process the claim and you will pay $0 for your medication.
After initial enrollment, SaveOnSP will only contact you once a year to ensure you are properly re-enrolled in the manufacturer’s program if needed.

The SaveOnSP service representative will ensure you are enrolled in the appropriate manufacturer program for each SaveOnSP medication you take.

SaveOnSP Flyer

ImpaxRX Info Flyer

ImpaxRX is a prescription advocacy program that assists employees and their family members with the high cost of certain eligible medications. If the medications you or a family member are taking are identified as eligible under the Medication Under Management (MUM) program, an ImpaxRX advocate will reach out to you to confirm your enrollment in the program and obtain additional information needed to secure the medication at no cost.

Timely participation with ImpaxRX is required to receive these programs for your high-cost medications. Please respond if ImpaxRX contacts you! This will allow them to work on your behalf to obtain your medication at no cost.

There is no cost to you to participate in this program, and there will be no copayments for eligible medications approved by the program. Additionally, by using the program, the cost of these medications is lowered under the AMHA Health Plan which allows for savings to keep employee premium contributions to a minimum for all.

Please call ImpaxRX at 844-467-2979, option 1 with questions.

Dental

Non-Bargaining employees of AMHA are offered dental coverage for themselves and their eligible dependents through MetLife. Your dental network is the Preferred Dental Program (PDP) network. To find an In Network dental provider, use the link below and select the PDP Network.

You have the freedom to select the dentist of your choice, however, when you visit and In Network dentist, you will have lower out of pocket costs, no balance billing and claims will be submitted by your dentist on your behalf.

PREVENTION FIRST!

Your dental health is an important part of your overall health. Make sure you take advantage of your preventive dental visits. Preventive care services are covered at 100% if you visit an In-Network provider. They are also not subject to the annual deductible.

Dental Summary

MetLife Dental Summary

How to Access MetLife Site

Vision

Non-Bargaining employees of AMHA are offered vision coverage for themselves and their eligible dependents through MetLife.

Your vision network is the VSP Network. Use the link below to find an In Network vision provider, select Superior Vision.

Vision Summary

MetLife Vision Benefit Summary

Life

Basic Life Insurance and AD&D

Life insurance is an important part of your financial security. Life insurance helps protect your family from financial risk and sudden loss of income in the event of your death. Accidental Death & Dismemberment (AD&D) insurance is equal to your Life benefit in the event of your death being a result of an accident and may also pay benefits for certain injuries sustained.

Basic Life and AD&D - Employer Paid Benefit through MetLife.

All Full-Time Non-Bargaining employees are automatically enrolled in the Life/AD&D insurance with MetLife.

Employee Benefit: 1x annual earnings rounded up to the nearest thousand, up to a maximum of $150,000.
Spouse Benefit: $5,000
Child Benefit: $2,000 (through end of month of 26th birthday)

Voluntry Life Summary

Voluntary Life Insurance

Employees can enroll in supplemental Life Insurance. This will be in addition to your employer provided Basic Life Insurance. Coverage is also available for your spouse and dependent children. It is required that you enroll in coverage for yourself in order to be eligible for coverage for your dependents.

If you are not a newly hired employe, you are required to complete Evidence of Insurability no matter how much you select. The up to $100,000 offer is only upon hire.

Basic Life (Non-Bargaining) Benefit Summary

Voluntary Life Benefit Summary

Voluntary Life Rates

First Stop Health

No crowded waiting rooms. No driving. See a doctor when you need a doctor. Talk to a doctor 24/7 at no cost to you.

When can I use First Stop Health?

Your doctor is not available.
You become ill when traveling.
when you are considering treatment for a non-emergency health condition

What is a non-emergency condition?

Bladder infection
Bronchitis
Diarrhea
Fever
Rash
Seasonal flu
Allergies
Sore throat

How does it work?

Call (888) 691-7867 or log in to fshealth.com or download the mobile app to request your doctor visit.
Set up your account now so its ready when you need it!
Complete patient registration for medical history, pharmacy preference, primary care physician contact information and insurance information.
Each time you visit you will be asked brief medical questions. If appropriate you will be connected to a doctor using secure live audio and video.
You and your doctor will discuss your medical issue and if appropriate your doctor may write a prescription.

Ease@Work

All employees and their covered dependents have access to free Employee Assistance Program through EASE@Work.

Get support for you and your family from licensed counselors 24/7.

Get help with

Family Conflict
Work/Life Balance
Couples/Relationships
Depression/Anxiety
Life Coaching
Parenting
Stress
Wellness
Financial and Legal Consultation

EASE@Work counseling can be done via phone, web portal, mobile app, chat, or video.

Company Code: akronmha

1-800.521.3273

Contact Information

AMHA Contact Information

Mary Lutz

HR Analyst - Benefits and Compensation

330-376-9787

mlutz@akronhousing.org

Mike Gerzeny

Manager of Employee and Labor Relations

330-376-9879

mgerzeny@akronhousing.org

Carrier Contact Information

Medical Mutual

Customer Service: 877-730-2221

Website: www.medmutual.com/member

Express Scripts

Customer Service: 800-282-2881

Website: www.express-scripts.com

ImpaxRX

Customer Service: 844-467-2979, option 1

MetLife

Customer Service: 1-800-638-5433

Website: www.metlife.com

Symetra

Customer Service: 1-800-796-3872

Website: www.symetra.com

First Stop Health

Customer Service: 888-691-7867

Website: www.fshealth.com

Ease@Work

Customer Service: 800-521-3272

Website: www.easeatwork.com

SCR - AMHA

Table of Content

Your 2025 AMHA (Non-Bargaining Employees) Benefits Page

Eligibility

What is a Qualifying Life Event?

What is a Qualifying Life Event?

How to Enroll

BenXpress Enrollment Guide

BenXpress Enrollment Guide

NEW! Symetra Coverage

Accident Enrollment Guide

Accident Enrollment Guide

How to File a Claim

How to File a Claim

Accident Benefit Summary

Accident Benefit Summary

Critical Illness Enrollment Guide

Critical Illness Enrollment Guide

How to File a Claim

How to File a Claim

Critical Illness Benefit Summary

Critical Illness Benefit Summary

Hospital Indemnity Enrollment Guide

Hospital Indemnity Enrollment Guide

How to File a Claim

How to File a Claim

Hospital Indemnity Benefit Summary

Hospital Indemnity Benefit Summary

Medical

Medical Summary

Employee Contributions

Employee Contributions

Summary of Benefits and Coverage (SBC)

MedMutual My Health Plan/Mobile App

NEW! Medical Mutual Total Health

24/7 Nurse Line

24/7 Nurse Line

Maternity App Flyer

Maternity App Flyer

Transitional Care

Transitional Care

Palliative Care

Palliative Care

BLOOM

BLOOM

Sword

Sword

Diabetes Management

Diabetes Management

Hypertension Management

Hypertension Management

Diabetes Prevention

Diabetes Prevention

Preventive Care

MMO Preventive Drug Flyer

MMO Preventive Drug Flyer

Preventive Care Guidelines

Preventive Care Guidelines

HSA

HSA Overview

HSA Overview

Employer Contributions

Contribution Maximums

Prescriptions

RX Summary

Smart90 Flyer

Smart90 Flyer

SaveOnSP Flyer

SaveOnSP Flyer

ImpaxRX Info Flyer

ImpaxRX Info Flyer

Dental

Dental Summary

MetLife Dental Summary

MetLife Dental Summary

How to Access MetLife Site

How to Access MetLife Site

Vision

Vision Summary

MetLife Vision Benefit Summary