Table of Content
- Header
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- WELCOME
- ENROLLMENT
- MEDICAL/RX
- HSA
- TELEMEDICINE
- DENTAL
- VISION
- LIFE & DISABILITY
- ADDITIONAL EDUCATION
- CARRIER CONTACTS
- CONTACT US
- Footer
WELCOME
Helping you and your family reach and maintain good health is very important to APhase II. 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.
APhase II 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.
Please review your benefit guide, the remainder of this page, and all of the additional resources for more information regarding APhase II benefit plans.
ENROLLMENT
You are eligible to participate if you are full-time and work a minimum of 35 hours per week. Coverage will be effective the 91st day of active employment for hourly and salaried employees. 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 | Dental | Vision: The last day of the calendar year the child turns age 26
• Voluntary Life: The day the child turns age 19 or age 25 if a full-time student
NEW HIRES! Action Required: You must elect or waive benefits within 30 days of your benefit effective date.
ENROLLMENT INSTRUCTIONS:
1. Review the information in this guide and benefit plan summaries.
2. You must complete and sign an enrollment form, even if you are waiving coverage.
3. You will not be allowed to make changes after the open enrollment window closes, unless you experience a qualifying life event.
The Benefit choices you make will 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
Priority Health Medical/Rx (Group # 78783) | 800.446.5674 | www.priorityhealth.com
Priority Health will administer your medical and prescription drug benefits this year. The plans that will be offered effective January 1, 2023 are as follows:
- HMO HSA 2000
- HMO HSA 5000
- POS HSA 2000
To view participating providers, please visit the Priority Health website below.
HSA
Health Equity HSA | 866.346.5800 | www.healthequity.com
The Health Savings Account (HSA) allow you to set aside pre-tax dollars to pay for eligible expenses. By contributing to a HSA you reduce your taxable income, so you pay less in taxes — which saves you money.
To be eligible to contribute towards an HSA tax-free, you must meet the requirements below:
- Covered by a Qualified High Deductible Health Plan
- You cannot be covered by another health plan (including if your spouse has a Flexible Spending Account)
- You cannot be covered by Medicare or Medicaid
- You cannot be eligible to be claimed as a tax dependent
- You have not received VA benefits in the past 90 days
HSA IRS Maximums are as follows:
$3,850 for a single contract
$7,750 for a two person or family
$1,000 "Catch Up" contribution for those age 55+
Reminder: You can make changes to your HSA elections at any time for any reason. Please contact Human Resources to request a change to your HSA.
TELEMEDICINE
Spectrum Health Now | 844.322.7374
WHEN CAN I USE A VIRTUAL VISIT?
When you have a non-emergency condition and your doctor is unavailable, or if you become ill while traveling .
Examples of Non-Emergency Conditions:
- Bladder infection
- Fever
- Pink Eye
- Rash
- Sore throat
HOW DO I ACCESS CARE?
When you’re in Michigan access virtual care through Spectrum Health Now. How it works:
Connect with Spectrum Health Now one of these ways:
- Log into or create a new member account at priorityhealth.com, click my health care, click get started with Spectrum Health Now.
- Download the Spectrum Health Now app. Log in with your member account credentials.
- Call Spectrum Health Now at 844.322.7374
- Click or ask to schedule your appointment.
- You’ll be asked a few health questions, including a brief description of your current symptoms.
- You’ll be connected to a care provider
When you’re outside of Michigan access virtual care through MDLIVE. How it works:
Connect with MDLIVE one of these ways:
- Log into your member account at priorityhealth.com, click my health care, click get started with MDLIVE.
- Download the MDLIVE app
- Call MDLIVE at 800.400.6354
- Click or ask to schedule your appointment.
- You’ll be asked a few health questions, including a brief description of your current symptoms.
- You’ll be connected to a care provider
How Much Does it Cost?
- HMO HSA 2000: Covered in full after deductible
- HMO HSA 5000: Covered in full after deductible
- POS HSA 2000: Covered in full after deductible
- Prescriptions: If prescribed during a virtual visit, applicable Rx cost sharing will apply based on which medical plan you are enrolled in.
DENTAL
Delta Dental Group # 8233 (EPO) # 1515 (PPO) | 800.524.0149 | www.deltadentalmi.com
APhase II provides comprehensive coverage to help you and your family maintain good dental health. For 2023, the dental carrier will be Delta Dental. The EPO and PPO plan will be offered for 2023. Staying in-network will give you the most cost savings.
To find out if your provider is in-network, please visit the website below.
VISION
NVA Vision (Group # 3211) | 800.672.7723 | www.e-nva.com
DID YOU KNOW?
- Eye exams can help detect serious eye and general health conditions sooner: high blood pressure, diabetes, heart disease, high cholesterol
- Babies should receive their first professional eye exam at 6 months
- 80% of learning in the first 12 years comes through the eyes
APhase II offers vision coverage through National Vision Administrators (NVA) to help pay for eye exams, prescription glasses and contact lenses. You receive a higher level of benefits when you see a provider in network, however, out-of-network coverage is provided but may only be handled as reimbursements in some situations.
To find out if your provider is in-network, please visit the website below.
LIFE & DISABILITY
Sun Life Financial | 800.247.6875 | www.sunlife.com
APhase II provides you with financial protection options for life, accidental death & dismemberment, short term disability and long term disability with Sun Life Financial.
Life/AD&D
A sudden accident or death can leave you or your loved ones in a vulnerable position. Employees have the opportunity to enroll in Term 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.
- Basic Life/AD&D Employer Provided Benefit - No Cost to You
- Flat $10,000
- Voluntary Benefit - Costs are based on Age and Amount of Coverage
- Employee: Choose in $10,000 increments up to the lesser of 5x your annual salary or $100,000. Minimum of $20,000 - Guaranteed Issue: $100,000
- Spouse: Choose Spouse Coverage 50% of employee amount in $5,000 increments up to $50,000 - Guaranteed Issue: $25,000
- Child: $1,000, $5,000, or $10,000 - Guaranteed Issue: $10,000
Evidence of Insurability (EOI): When you are first eligible (at hire) for Voluntary Life and AD&D, you may purchase up to the Guaranteed Issue (GI) for yourself and your spouse without providing proof of good health (EOI). Annually, you are able to increase elections 1 increment up to GI without proof of good heath.
Any amount elected over the GI will require EOI. If you elect optional life coverage, and are required to complete an EOI, it is your responsibility to complete the EOI and send to the provider (address will be listed on your form). In addition, your spouse will need to provide EOI to be eligible for coverage amounts over GI, or if coverage is requested at a later date.
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
Everyday illnesses or injuries can interfere with your ability to work. Even a few weeks away from work can make it difficult to manage household costs. Short Term 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.
- STD Benefit - Employee is responsible for 100% of the cost
- Cover 60% of your weekly earnings up to a maximum benefit of $500 per week (Benefits begin on the 1st day for Accident / 8th day for Illness)
- Benefits last up to 26 weeks
Long Term Disability
Serious illnesses or accidents can interrupt your life, and your ability to work for months – even years. Long Term Disability provides financial protection for you by paying a portion of your income, so you have financial support to manage your disability and your household.
- LTD Benefit - Employee is responsible for 100% of the cost
- Benefit is equal to 60% of your monthly earnings up to a maximum benefit of $5,000 per month
- Benefits begin as soon as 180 days from the date of your disability.
Please consult your Employee Benefits Guide and review the benefit summaries for additional details.
ADDITIONAL EDUCATION
CARRIER CONTACTS
Priority Health Medical/Rx (Group # 78783) | 800.446.5674 | www.priorityhealth.com
Delta Dental (Group #8233 (EPO) #1515 (PPO) I 800.524.0149 I www.deltadentalmi.com
NVA (Group # 3211) I 800.672.7723 I www.e-nva.com
Health Equity HSA | 866.346.5800 I www.healthequity.com
Sun Life Financial | 800.247.6875 I www.sunlife.com
CONTACT US
As you consider your benefit options, please be sure to review all available information.
If you have any questions or need further assistance, please contact:
Human Resources
586-977-0790