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Helping you and your family reach and maintain good health is very important to Apollo Manufacturing. We are pleased to offer a selection of benefits designed with your health and well-being 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.
Eligibility
Regular employees working at least 30 hours per week are eligible to participate in benefits offered by Apollo Manufacturing. When you enroll in the benefits program, you may also cover your eligible dependents. Dependents include your legal spouse and child(ren) up to age 26.
The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire year.
EMPLOYEE ELIGIBILITY
You are eligible to participate if you are full-time and work a minimum of 30 hours per week. Your coverage will be effective 90 days from your date of hire.
***Reminder:
You have up to 30 days after your benefit effective date to make your elections. If you wait until the 31st day, you will need to wait until Open enrollment or a qualifying event.
DEPENDENT ELIGIBILITY
You may also enroll eligible dependents for benefits coverage. A ‘dependent’ is defined as the legal spouse and/or ‘dependent child(ren)’ of the plan participant or the spouse.
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.
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 Medical
Ready to Enroll?
Apollo Manufacturing offers 1 plan option through NEW carrier United Healthcare
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.
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 balanced billed.
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 | Higher copay: This category includes preferred, brand-name drugs that don't yet have a generic equivalent. These drugs are more expensive than generics, and a higher copay.
TIER 3 | Highest copay: In this category are nonpreferred brand name drugs for which there is either a generic alternative or a more cost-effective preferred brand. These drugs have the highest copay. Make sure to check for mail-order discounts that may be available.
SPECIALTY DRUGS
TIER 4 | Lowest Specialty Drug copay: Tier 4 specialty drugs are generally more effective and less expensive than nonpreferred specialty drugs in tier 5.
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.
The differences in prescription drug costs are summarized here:
A virtual visit lets you see and talk to a doctor from your mobile device or computer. When you use one of the provider groups in our virtual visit network, you have benefit coverage for certain non-emergency medical conditions. Costs must be paid by you at the time of the virtual visit and will apply toward your deductible and out-of-pocket maximum.
WHEN CAN I USE A VIRTUAL VISIT?
When you have a non-emergency condition and:
*Your covered children may also use Virtual Visits when a parent or legal guardian is present for the visit.
Examples of Non-Emergency Conditions:
HOW DOES IT WORK?
The first time you use a Virtual Visits provider, you will need to set up an account with that Virtual Visits provider group. You will need to complete the patient registration process to gather medical history, pharmacy preference, primary care physician contact information, and insurance information.
Each time you have a virtual visit, you will be asked some brief medical questions, including questions about your current medical concern. If appropriate, you will then be connected using secure live audio and video technology to a doctor licensed to deliver care in the state you are in at the time of your visit. You and the doctor will discuss your medical issue, and, if appropriate, the doctor may write a prescription* for you.
Virtual Visits doctors use e-prescribing to submit prescriptions to the pharmacy of your choice. Costs for the virtual visit and prescription drugs are based on, and payable under, your medical and pharmacy benefit. They are not covered as part of your Virtual Visits benefit.
*Prescription services may not be available in all states.
HOW DO I GET ACCESS?
Learn more about Virtual Visits and access direct links by downloading the United Healthcare app on your phone or by clicking on Myuhc.com
Dental Benefits through Guardian provide comprehensive coverage to help you and your family maintain good dental health. Your coverage will be greater when you visit a participating 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.
A comparison of the options is below:
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.
Guardian (Group # 00477765) | 800-775-6000
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 - Employer Paid $20,000 Benefit
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.
Voluntary - Employee Paid Life
Coverage is also available for your spouse and/or child dependents, but only after you've elected coverage for yourself. 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. Review the full benefit summary below for additional details.
Employee: You can elect $25,000, $50,000, $100,000, $150,000 or $200,000 ($100,000 GI)
Spouse: 50% of what you elect for yourself to a maximum of $50,000 ($30,000 GI)
Children: 10% of what you elect for yourself to a maximum of $10,000
Annual Increase (Applies to Employees only, Spouses are subject to EOI):
You may request to increase the amount of insurance once a year, provided the new amount of insurance does not exceed the maximum benefit amount shown above. You may increase your amount of insurance by up to $10,000. If the amount of insurance requested exceeds the Guarantee Issue Amount, Evidence of Insurability will be required.
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.
*Guaranteed Issue (GI) and 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 up $50,000 not to exceed the GI without proof of EOI. ]
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.
Long Term Disability
Insurance through Unum can pay you a weekly benefit if you have a covered disability that keeps you from working. Long Term Disability insurance can replace part of your income while you recover.
LTD Benefit Features
Pre-Tax Contributions
You share in the cost of your Medical, Dental Benefits. Your employee contributions for these benefits are taken out of your pay on a pre-tax basis as set forth below. In addition, if you elect to contribute to a flexible spending account or a health savings account, those contributions will be taken out of your pay on a pre-tax basis based on your election.
After-Tax Contributions
If you choose to purchase Supplemental Life insurance and Optional AD&D insurance benefits for yourself or your dependents, your contributions will be taken out of your pay on an after-tax basis. You will be able to see the costs for these benefits in the enrollment system when you log in.
The resources below are provided by Chase Properties to all eligible, full-time employees at no additional cost.
Employees who are enrolled in Guardian Life benefits are eligible for an Employee Assistance
Program (EAP) at NO COST.
EAP Overview:
Contact information: worklife.uprisehealth.com
Access Code: Worklife
Call at (800) 386-7055
Anthem (Group #SO5468 | 1 (844) 290-7584
Guardian (Group # 000400001000) | 1 (877) 275-5462
As you consider your benefit options, please be sure to review all available information. If you don't understand your benefits or need any assistance, please contact Human Resources.
Lisa Weaver
lisaw@apollo-mfg.com
(440) 951-9972