Table of Content
- Header
-
ENROLLMENT
- ELIGIBILITY
- QUALIFYING LIFE EVENTS
- HOW TO ENROLL
- EMPLOYMENT STATUS CHANGES
- LAST DAY OF COVERAGE & COBRA
-
MEDICAL
- Medical Plans
- Summary of Benefits and Coverage (SBC)
- VIRTUAL VISITS
- PHARMACY
- RX COST SAVINGS
- UHC APP
- LEARN MORE
-
SPENDING ACCOUNTS
- HEALTH SAVINGS ACCOUNT (HSA)
- HSA pt.2
- FLEXIBLE SPENDINGS ACCOUNT (FSA)
- LIMITED PURPOSE FSA (LPFSA)
- DEPENDENT CARE FSA (DCFSA)
-
DENTAL
- Dental Plan
-
VISION
- Vision chart
-
SURVIVOR BENEFITS
- VOL LIFE AND AD&D
- PORTABILITY & CONVERSION
-
INCOME PROTECTION
- LTD
-
ASSISTANCE
- EAP
- ADDITIONAL BENEFITS
- ANSEL
- ansel pt2
- INSURCHOICE
- MENTAL HEALTH
-
RESOURCES
- MEDICARE ELIGIBLITY
- GLOSSARY
- FREQUENTLY ASKED QUESTIONS (FAQs)
- REQUIRED NOTICES
- Footer
ELIGIBILITY
QUALIFYING LIFE EVENTS
Under certain circumstances, employees may be allowed to make changes to benefit elections during the plan year, if the event affects the employee, spouse, or dependent’s coverage eligibility. Any requested changes must be consistent with and on account of the qualifying event.
Examples Of Qualifying Life Events (QLEs):
- Legal marital status (for example, marriage, divorce, legal separation, annulment);
- Number of eligible dependents (for example, birth, death, adoption, placement for adoption);
- Work schedule (for example, full-time, part-time);
- You, your spouse, or other covered dependent become enrolled in Part A, Part B, or Part D of Medicare
- Death of a spouse or child;
- Change in your child’s eligibility for benefits (reaching the age limit);
- Becoming eligible for Medicaid; or
- Your coverage or the coverage of your Spouse or other eligible dependent under a Medicaid plan or state Children’s Health Insurance Program (“CHIP”) is terminated as a result of loss of eligibility and you request coverage under this Plan no later than 60 days after the date the Medicaid or CHIP coverage terminates; or
- You, your spouse or other eligible dependent become eligible for a premium assistance subsidy in this Plan under a Medicaid plan or state CHIP (including any waiver or demonstration project) and you request coverage under this Plan no later than 60 days after the date you are determined to be eligible for such assistance.
HOW TO ENROLL
All team members have access to the Employee Navigator enrollment platform, where you have the ability to enroll, select or change your benefits online during the annual open enrollment period, new hire orientation, and for qualifying events.
- Accessible 24/7
- View all benefit plan options and your elections
- View important carrier forms and links
- Report a qualifying life event
- Make changes to beneficiary designations and more
Employee Navigator Company Identifier:
ABoR
ENROLLMENT INSTRUCTIONS:
- Click the button below to go to your Employee Navigator enrollment portal
- Click the "Login" button located in the top right corner of your screen
- Select "Register as New User" and enter the requested information to verify your account
- Enter your Company Identifier & Pin (Last 4 digits of your SSN)
- After registering your account, click "Start Enrollment"
- You will need to complete some personal & dependent information before making your benefit elections
To get started, click on the link below to head to your Employee Navigator Enrollment Portal!
A status change from part-time to full-time is not a qualifying event, but it is a change in eligibility that will allow an employee to enroll in insurance.
- Newly eligible employees will have 30 days to enroll in insurance benefits, which will begin on the first day of the month after the employee has completed 60 days of full-time employment.
- Reminder, this means working 30+ hours per week for 60 days.
A status change from full-time to part-time will cause employees to become ineligible for insurance benefits.
- The insurance benefits will end on the last day of the month before the status change becomes effective.
- A termination will also cause an employee to lose their benefit at the end of the month the employment ended.
- Both of these situations will trigger eligibility for continuing coverage under COBRA.
COBRA Customer Service | (800) 532-3327 | www.flores247.com
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families the right to continue their existing group health plan coverage for a limited period of time when they would otherwise lose their coverage through a voluntary or involuntary job loss, a reduction in work hours, death, divorce, or other events.
The cost for coverage under COBRA is usually higher than the cost for employees under a group plan.
- COBRA participants usually pay 100% of the coverage, plus a 2% administrative fee.
- For employees who choose not to re-enroll in benefits during Open Enrollment, the loss of insurance coverage is not a qualifying event for COBRA.
Cobra Qualifying Events
The following are qualifying events for covered employees if they cause the covered employee to lose coverage:
- Termination of the employee's employment for any reason other than gross misconduct.
- Reduction in the number of hours of employment.
The following are qualifying events for the spouse and dependent child of a covered employee if they cause the spouse or dependent child to lose coverage:
- Termination of the covered employee's employment for any reason other than gross misconduct.
- Reduction in the hours worked by the covered employee.
- Covered employee becomes entitled to Medicare.
- Divorce or legal separation of the spouse from the covered employee.
- Death of the covered employee.
In addition to the above, the following is a qualifying event for a dependent child of a covered employee if it causes the child to lose coverage:
- Loss of dependent child status under the plan rules.
- Under the Patient Protection and Affordable Care Act, plans that offer coverage to children on their parents' plan must make the coverage available until the adult child reaches the age of 26.
MEDICAL
UHC Customer Service | (866) 414-1959 | www.myuhc.com
Network: Choice Plus Network
- All 3 plans offer both in and out-of-network benefits.
- You will pay the least when you utilize a designated in-network provider.
How do I find an In-Network Doctor?
- Use the link below or visit your provider’s website at www.uhc.com and select “Find a Doctor”.
Did you know?
- Preventive Services are covered at 100% In-Network and copays & deductibles do not apply.
- You pay less out of pocket if you receive care from an In-Network provider.
- You do not need to designate a primary care physician or need a referral to see a Specialist.
i
You have 3 medical plans to choose from. Compare the options in the chart below!
i
Summary of Benefits and Coverage (SBC)
Looking for more details about how items are covered? Please refer to the formal Summary of Benefits and Coverage (SBC) below.
VIRTUAL VISITS
UHC Customer Service | (866) 414-1959 | www.myuhc.com
A convenient and faster way to get care
- Doctors can treat a wide range of health conditions - including many of the same conditions as an emergency room (ER) or urgent care - and may even prescribe medications, if needed.
Consider Virtual Visits for these common conditions:
- Allergies, bronchitis, eye infections, flu, headaches/migraines, rashes, sore throats, stomachaches, and more.
Get Started
- Sign in at myuhc.com/virtualvisits
- Call 1 (855) 615-8335
- Download the UnitedHealthcare App
i
PHARMACY
OptumRx Costumer Service | (800) 356-3477 | www.optumrx.com
Pharmacy Network: National
Prescription Drug List: Advantage 3-Tier
Prescription drugs are a vital part of your health care coverage. If you have prescription drug coverage through United Healthcare, this information can help you and your doctor get the most from your prescription drug coverage. OptumRx is your plan's pharmacy services manager and is committed to helping our members find cost-effective ways to get your medications. Be sure to fill your prescriptions at a network (participating) pharmacy, otherwise they may not be covered, or you may pay more. To search for network pharmacies, and member FAQs please view the links below.
Formulary Drug List
- How much you pay out of pocket is determined by whether your drug is on the list and at what coverage level, or tier.
- A generic drug is often at the lower tier. See if your drug is covered by reviewing your 2025 formulary drug list by using the link below!
- Your plans utilize the Advantage 3-Tier PDL
Use the UnitedHealthcare app to help manage their medications! You can use the app to:
- Set up and refill home delivery orders
- Track your prescription history
- Find network pharmacies
- Compare medication prices
i
Save up to 80% on your prescriptions with the free GoodRx Mobile App!
How does GoodRx work?
- Prescription drug prices are not regulated. The cost of a prescription may differ by more than $100 between pharmacies across the street from each other! GoodRx gathers current prices and discounts to help you find the lowest cost pharmacy for your prescriptions
How do I find discounts for my drug?
- It’s easy. Just visit www.goodrx.com, type in your drug’s name in the search field, and click the “Find the Lowest Price” button.
What are GoodRx coupons?
- GoodRx coupons will help you pay less than the cash price for your prescription. They’re free to use and are accepted at virtually every U.S. pharmacy.
- Your pharmacist will know how to enter the codes on the coupon to pull up the lowest discount available.
i
UHC APP
UHC Customer Service | (866) 414-1959 | www.myuhc.com
Get your health info anywhere, anytime!
When you want to easily access your health information anywhere you go, the UnitedHealthcare app is your go-to.
Download it today to get instant access to your health plan details.
Find care
- Find network care options for doctors, clinics and hospitals in your area.
- Talk to a doctor by video 24/7.
- See reviews and ratings for doctors.
Manage your health plan details
- Generate and share digital health plan ID cards.
- View claims and account balances.
- Manage prescription drugs and refills.
Stay on top of costs
- Estimate the costs of common procedures.
- View your copay, annual deductible and out-of-pocket expenses.
- View your Health Savings Account, if applicable.
HEALTH SAVINGS ACCOUNT (HSA)
Flores Customer Service | (800) 532-3327 | www.flores247.com
A Health Savings Account (HSA) is a tax-advantaged personal savings account that can be used to pay for medical, dental, vision and other qualified expenses now or later in life. To contribute to an HSA, you must be enrolled in one of the UHC HSA-Eligible Medical Plans and your contributions are limited annually.
Austin Board of Realtors contributes $175 to your HSA on a per-month basis.
How It Works
- For 2026, Participants can make an annual election of up to $4,400 for self only HDHP coverage or $8,750 for family High-Deductible Health Plan (HDHP) medical coverage.
- Your employer deducts per pay-period the amount you elect on a tax-free basis. You can also contribute post-tax contributions (up to the maximum allowed) and recognize the same tax savings by claiming the deduction when filing your annual taxes.
- Eligible healthcare purchases can be made tax-free when you use your HSA. Purchases can be made directly from your HSA account, either by using your debit card, online bill-pay, or check – or you can pay out-of-pocket and then reimburse yourself from your HSA.
- The interest on HSA funds grows on a tax-free basis, and interest earned on an HSA is not considered taxable income when the funds are used for eligible medical expenses.
Why Participate? HSAs save you money!
- The contributions you make to an HSA are deducted from your paycheck on a pre-tax basis – before federal income, social security, and most state taxes.
- The end results of your HSA contributions is a lower taxable income, and a tax advantaged vehicle to pay for out-of-pocket healthcare expenses and prepare for your healthcare costs in retirement.
- While your funds can be used to pay for immediate healthcare expenses tax-free, you can also save the money for healthcare expenses later in life.
- You can continue to contribute year after year and withdrawals (provided you are enrolled in an HDHP) can be made at any point in time.
- Whether you withdraw the money tomorrow, five years from now, or in retirement, funds used for qualified healthcare expenses are always tax-free.
Who's Covered?
- An HSA covers qualified out-of-pocket expenses for you, your spouse, your tax dependents, even if they are not covered under an HDHP.
i
FLEXIBLE SPENDINGS ACCOUNT (FSA)
Flores Customer Service | (800) 532-3327 | www.flores247.com
A Flexible Spending Account (FSA) is an account your employer sets up so you can pay for a variety of healthcare needs, like insurance co-pays, deductibles, dental, vision, pharmacy and even some over-the-counter medication costs, reimbursed under the Health FSA.
Why Participate?
- Reduce taxable income – FSA Contributions are deducted from your paycheck on a pre-tax basis, so they lower your reported annual income, resulting in lower taxable wages.
- Save on healthcare expenses – Using pre-tax funds to pay out of pocket expenses can save you hundreds!
- Offset rising healthcare costs and individual financial responsibility.
Maximum Annual Contribution
- For plan years beginning in 2026, health FSA and limited purpose health FSA plan year limits are increased from $3,300 to $3,400. The maximum carryover amount is increased from $640 to $680.
Grace Period
- Austin Board of Realtors offers a grace period for FSA spending. You have 2½ months after the plan year ends on December 31, 2026 to incur additional expenses and submit them for reimbursement. Therefore, any remaining balance in the previous plan year that ended December 31, 2026 will be used to pay that grace period expense even though the service was provided in the NEW plan year.
- The grace period applies to both the Dependent Care and Healthcare FSAs.
Eligible Expenses
- A full list of qualified FSA expenses can be found in IRS Publication 502 at www.irs.gov.
- You can learn more about FSA qualified expenses and also make purchases by visiting the FSA Store at www.fsastore.com.
LIMITED PURPOSE FSA (LPFSA)
Flores Customer Service | (800) 532-3327 | www.flores247.com
A LPFSA has the same tax-advantages as a general-purpose flexible spending account (FSA), but it’s used specifically for dental and vision expenses. This allows individuals who are actively contributing to a health savings account (HSA) to enroll in an LPFSA and contribute to both accounts during the same plan year.
Maximum Annual Contribution
- For the 2026 plan year, individuals can contribute a maximum of $3,400. For plan years beginning in 2026, health FSA and limited purpose health FSA plan year limits are increased from $3,300 to $3,400. The maximum carryover amount is increased from $660 to $680.
Eligible Expenses
- A full list of qualified FSA expenses can be found in IRS Publication 502 at www.irs.gov.
- You can learn more about FSA qualified expenses and also make purchases by visiting the FSA Store at www.fsastore.com.
i
DEPENDENT CARE FSA (DCFSA)
Flores Customer Service | (800) 532-3327 | www.flores247.com
A Dependent Care FSA (DCA) is a reimbursement program that allows you to set aside pre-tax funds to help pay for qualified dependent care expenses. Most participants use this program to pay for child daycare and after-school care expenses; however, it can be used to pay for adult daycare expenses as well. It serves as an alternative to using the Dependent Care Tax Credit. Funds can only be used on a dependent child under the age of 13 or dependents who are unable to care for themselves. Unlike a Flexible Spending Account, DCA funds can only be used as they are deposited into your account.
Maximum Annual Contribution
- For the 2026 plan year, you can contribute up to $7,500 ($3,750 if married and filing separately).
Eligible Expenses
- You may be reimbursed only for care that enables you to work, go to school full-time, or look for work on a full-time basis.
- DCA funds can be used on expenses such as tuition for licensed daycare facility, preschool, after-school programs, elder care, summer day camps, and in-home dependent care services.
i
DENTAL
Mutual of Omaha Customer Service | (800) 775-6000 | www.mutualofomaha.com
Network: Mutually Preferred Dental Network
How do I find an In-Network Dentist?
- Use the helpful link below or visit your provider’s website at www.mutualofomaha.com
- You can search by provider/center name or search by location.
Did You Know?
- You have the freedom to select the dentist of your choice; however, 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.
Pre-treatment Estimate:
- If your dental care is extensive and you want to plan ahead for the cost, you can ask your dentist to submit a pre-treatment estimate.
- While it is not a guarantee of payment, a pre-treatment estimate can help you predict your out-of-pocket costs.
Looking for more details about how items are covered? Click on the link below to view the formal Dental Plan Summary.
VISION
Mutual of Omaha Customer Service | (800) 775-6000 | www.mutualofomaha.com
Network: EyeMed Vision Network
How do I use my vision benefit?
- Mutual of Omaha’s affiliation with EyeMed’s vision Network offers access to over 91,000 providers.
To access your vision benefit:
- Locate an in-network provider of your choice by calling the Customer Care Center at (833) 279-4358 or visiting www.mutualofomaha.com/vision and choosing a provider on the provider locator. Or download the EyeMed Members App on your iPhone, iPad or Android to view your benefit details and ID card right when you need it.
- Schedule an appointment. Many of our providers also offer walk-in appointments, in which case, an appointment is not necessary.
- When you arrive, identify yourself as an EyeMed member or present your ID card to receive services. (Vision ID Card is not required to receive services)
- Your in-network provider will file claims on your behalf, so you don’t have to worry about anything!
Did You Know?
- Eyes can give doctors a clear picture of overall wellness. That’s why vision care—and vision benefits—can help employees stay healthy.
- A comprehensive eye exam can detect early signs of serious health problems, such as diabetes, heart disease, high blood pressure, high cholesterol, glaucoma, and cataracts
Hearing Discount Program
- The Hearing Discount Program provides you and your family discounted hearing products, including hearing aids and batteries.
- Call (888) 534-1747 or visit www.amplifonusa.com/mutualofomaha to learn more.
Looking for more details about how items are covered? Click on the link below to view the formal Vision Plan Summary.
This benefit is provided to you at NO COST! This is an employer-paid benefit.
i
SURVIVOR BENEFITS
Mutual of Omaha Customer Service | (800) 775-6000 | www.mutualofomaha.com
Basic Life and Accidental Death & Dismemberment (AD&D) Insurance
i
Life insurance is an important part of your financial security as it helps protect your family from financial risk and sudden loss of income in the event of your death. AD&D (Accidental Death & Dismemberment) insurance is equal to your Life benefit in the event of your death being a result of an accident, and may pay benefits for particular injuries sustained.
i
- Basic Life / AD&D insurance is a company paid benefit, provided to you at no cost.
- You can get a Guaranteed Issue (GI) amount up to $350,000. This is the amount of coverage you can qualify for with no medical underwriting.
- The plan pays a benefit of an amount equal to 2 times your annual salary, but in no event less than $10,000 or more than $500,000.
- Keep in mind, your life insurance benefit amount will reduce to 65% of the original amount at age 65 and to 50% of the original amount at age 70.
i
Looking for more details about how items are covered? Click on the link below to view the formal Basic Life and AD&D Plan Summary.
i
Mutual of Omaha Customer Service | (800) 775-6000 | www.mutualofomaha.com
Voluntary Life and AD&D (Accidental Death & Dismemberment) Insurance
You have the opportunity to enroll in Voluntary Life and AD&D (Accidental Death & Dismemberment) Insurance.
Coverage is also available for your spouse and/or child dependents, however, It is required that you elect coverage for yourself in order to elect coverage for your dependents.
If you have previously elected Voluntary Life but are under the Guarantee Issue (GI) amount, you may increase your amount up to the Guarantee Issue (GI) without Evidence of Insurability (EOI) at Open Enrollment. If you previously waived Voluntary Life you will need to submit Evidence of Insurability (EOI).
How does it work?
- You choose the amount of coverage that’s right for you, and you keep coverage for a set period of time, or “term.” If you die during that term, the money can help your family pay for basic living expenses, final arrangements, tuition and more. AD&D Insurance is also available, which pays a benefit if you survive an accident but have certain serious injuries. It pays an additional amount if you die from a covered accident.
Who can get Voluntary Term Life Coverage?
- Employee: Choose from $10,000 to $500,000 in $10,000 increments, up to 5 times your earnings. You can get a Guaranteed Issue (GI) amount up to $100,000. This is the amount of coverage you can qualify for with no medical underwriting.
- Spouse: Get up to $250,000 of coverage in $5,000 increments. Spouse coverage cannot exceed 100% of the coverage amount you purchase for yourself. Your spouse can get a Guaranteed Issue (GI) amount up to $25,000 with no medical underwriting, if eligible.
- Children: Get up to $10,000 of coverage in $1,000 increments if eligible (see delayed effective date). One policy covers all of your children until their 26th birthday.
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).
- 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. 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.
Looking for more details about how items are covered? Click on the link below to view the formal Voluntary Life and AD&D Plan Summary.
Life insurance portability and conversion options are features that allow policyholders to maintain some level of insurance coverage when they might otherwise lose it or wish to change the type of coverage they have.
Portability
- Refers to the ability of an individual to transfer their group life insurance coverage from one employer to another or from a group policy to an individual policy without undergoing new underwriting or providing evidence of insurability.
- This is commonly associated with group term life insurance provided by employers. If you (the employee) leave your job or retire, you may not want to lose your life insurance coverage, especially if there are ongoing health issues. Advantages of porting coverage are that it allows continuity of coverage and there is no need for medical examination or evidence of insurability.
- The application and check for the initial premium must be received within 31 days after Life Insurance terminates or 15 days from the date the Employer signs the application; whichever is later.
Conversion
- The Conversion option allow you to convert your term life insurance policy into permanent (e.g., whole life or universal life) insurance policy without providing evidence of insurability or undergoing new underwriting. Transitions from term to permanent coverage without having to do a new medical exam.
- This option is considered when an individual has ongoing health issues or may be unable to qualify for a new policy.
- An Insured Employee and Dependent(s) may convert Group Voluntary Life Insurance coverage, without evidence of insurability, to an Individual Life Insurance policy during the 31-day period following termination of employment.
It's essential for policyholders to consider the options available to you and request conversion or portability timely, within 30 days of your benefits termination.
You will submit the request for conversion or portability directly to the insurance carrier and will set up direct payment for your new individual policy.
INCOME PROTECTION
Mutual of Omaha Customer Service | (800) 775-6000 | www.mutualofomaha.com
Short-Term Disability Insurance
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. This employer-paid 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. This benefit is provided to you at no cost.
- Elimination Period - Benefits begin after the 14-day elimination period for injury or illness.
- Benefit Duration - Payments may last up to 24 weeks
- You must be sick or disabled for the entire duration of the waiting period before you can receive a benefit payment.
- Coverage Amount - Covers 60% of your weekly income, up to a maximum benefit of $2,500 per week.
What does this mean to you?
- If you are out of work for 14 days due to an illness or accident, you can begin receiving disability benefits on day 15. This is a cash benefit of 60% of your weekly salary up to a max of $2,500 when you are out of work. You are able to receive this benefit for up to 24 weeks. A partial cash benefit is available if you can only do part of your job or work part-time.
Looking for more details about how items are covered? Click on the link below to view the formal Short-Term Disability Plan Summary.
Mutual of Omaha Customer Service | (800) 775-6000 | www.mutualofomaha.com
Long-Term Disability Insurance
This employer-paid Long-Term Disability coverage pays a monthly benefit if you have a covered illness or injury and you can't work for a few months - or even longer! You're generally considered disabled if you're unable to do important parts of your job - and your income suffers as a result. This benefit is provided to you at no cost.
- Elimination Period- Benefits begin on the 180th day of an injury or illness.
- Benefit Duration - Payments may last up to Social Security Normal Retirement Age (SSNRA)
- You must be sick or disabled for the entire duration of the waiting period before you can receive a benefit payment.
- Coverage Amount - Covers 60% of your monthly income, up to a maximum benefit of $10,000 per month.
- 6/12 Pre-existing Condition: If you have a medical condition that begins before your coverage takes effect, and you receive treatment for this condition within the 6 months leading up to your coverage start date, you may not be eligible for benefits for that condition until you have been covered by the plan for 12 months.
What does this mean to you?
- If you are still unable to work after your Short-Term benefit expires, you will have the opportunity to receive a Long-Term Disability cash benefit. Starting on the 180th day you are out of work due to an illness or injury, you will receive 60% of your monthly salary to a max of $10,000. You are able to receive these benefits for as long as you remain disabled or reach Social Security Normal Retirement Age (SSNRA).
Looking for more details about how items are covered? Click on the link below to view the formal Long-Term Disability Plan Summary.
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Mutual of Omaha Customer Service | (800) 775-6000 | www.mutualofomaha.com
Find professional support when you need it for challenging life events.
Your Mental Health and Wellbeing is very important to Austin Board of Realtors, that's why through your Employee Assistance Program, you have access to many helpful services that address personal life challenges and improve workplace productivity and performance. We are proud to offer our Employee Assistance Program (EAP) in partnership with Mutual of Omaha. Your EAP offers access to personalized support, resources, and no-cost referrals, as well as confidential one-on-one help from a master’s-level EAP specialist.
No-cost, 24/7 access to support in the moments that matter
- EAP helps you and your family with a range of issues, including:
- Identifying resources for managing stress, anxiety and depression
- Offering specialized help in improving relationships at home or work
- Providing guidance on legal and financial concerns
- Finding ways to help you cope with occupational stress and burnout
- Connecting you with care for addressing substance use issues
i
Review plan details and contact information in the Employee Assistance Program Flyer provided in the link below.
ADDITIONAL BENEFITS
Mutual of Omaha Customer Service | (800) 775-6000 | www.mutualofomaha.com
i
Travel Assistance:
Take comfort in knowing that Travel Assistance travels with you worldwide, offering access to a network of professionals who can help you with local medical referrals or provide other emergency assistance services in foreign locations.
For inquiries within the U.S. call 1(800) 856-9947. For inquiries outside the U.S. call collect (312) 935-3658.
i
ID Theft Assistance:
Identity Theft Assistance helps you and your dependents understand the risks of identity theft, learn how to prevent it, and most importantly, assist you if your information is compromised.
Access ID Theft Assistance services by calling AXA Assistance toll-free at (800) 856-9947.
i
Will Preparation Services:
Mutual of Omaha offers a secure account space that allows you to prepare wills and other legal documents.
Create a will that’s tailored to your unique needs from the comforts of your own home.
Visit www.willprepservices.com to learn more about will preparation services provided to you.
i
Hearing Discount Program:
The Hearing Discount Program included in your vision coverage provides you and your family discounted hearing products, including hearing aids and batteries.
In addition to your hearing care benefit, you will have access to complimentary aftercare, administered by Amplifon.
Visit www.amplifonusa.com or call 1(800) 534-1747 to learn more about the hearing discount program.
i
Financial Wellness Tool:
To help you make informed financial decisions, you have access to a financial wellness tool that’s part of your Employee Assistance Program.
The financial wellness tool from Enrich is a convenient, one-stop shop that provides you access to a variety of informational and educational resources designed to help you become financially healthy.
Visit www.mututalofomaha.com/eap/financial-wellness or call (800) 316-2796 to learn more.
i
ANSEL
Ansel Customer Service | (888) 300-5382 | platform.joinansel.com
What is Ansel?
Ansel is supplemental health insurance that pays a lump sum if you are diagnosed with any of 13,000+ covered conditions. Ansel pays cash benefits to help with health care expenses not covered by your major medical insurance or anything else you need on your road to recovery.
How does Ansel work?
Injuries and illnesses come in different shapes and sizes. Some conditions are less serious than others, while some are dangerous or life-threatening. That’s why Ansel was designed as a single plan with three benefit categories that cover a broad spectrum. Covered conditions fall into one of these categories. Each one has a set payout and all three categories are included in your plan.
- MODERATE Condition Benefit: Injuries or illnesses that likely require a short visit to the ER or urgent care.
- Examples: simple fractures, lacerations, dehydration, and kidney stones.
- SEVERE Condition Benefit: Serious conditions that require more intensive medical treatment and attention.
- Examples: compound fractures, appendicitis, pulmonary embolism, and torn ACL.
- CATASTROPHIC Condition Benefit: Life-threatening conditions that require immediate medical intervention.
- Examples: malignant lung cancer, heart attack, stroke, and major organ failure.
Coverage Options
- You may choose one of the pre-configured packages listed in the benefit highlight below If you or an insured dependent is diagnosed with a covered condition, the payout will equal the amount you elected for the benefit category in which the covered condition falls. Your monthly premium costs are listed below.
INSURCHOICE
InsurChoice offers you the ability to personalize your protection program — bringing you quick, convenient, holistic coverage with incredible cost-saving discounts across a variety of top-rated insurance products and carriers.
Our program is simple, fast, and always online. Find coverage in the blink of an eye!
Key benefits include:
- Competitive pricing: One size doesn’t fit all, so you can match yourself with the best rates and coverages from multiple insurance companies.
- Custom-tailored coverage: Select the products that meet YOUR needs.
- Stability: We have relationships with key national carriers who have a proven track record of rate and coverage stability.
- Innovation: With our innovative product delivery platform we are constantly striving to add more benefits and improve your experience.
Click the link below to receive your FREE no obligation quote customized especially for you!
MENTAL HEALTH: ADDITIONAL RESOURCES
Call 911 if you or someone you know is in immediate danger or go to the nearest emergency room.
988 Suicide & Crisis Lifeline
- Dial 988 to be connected with 24/7/365 emotional support.
- Free, confidential crisis counseling, including appropriate follow-up services, is available no matter where you live in the United States.
War Vet Call Center
- Veterans and their families call 877-WAR-VETS (877-927-8387) to talk about their military experience and/or readjustment to civilian life.
MEDICARE ELIGIBLITY
Medicare eligibility is a critical aspect of healthcare planning, particularly for individuals nearing age 65 or those with qualifying disabilities. Here are the key points to keep in mind:
- **Age 65 or Qualifying Disability**: Most individuals become eligible for Medicare at age 65, while those with certain disabilities or medical conditions may qualify earlier.
- **Comprehensive Coverage**: Medicare provides coverage for hospital stays, medical services, prescription drugs, and preventive care, offering essential healthcare benefits.
- **Enrollment Periods**: It's important to understand the various enrollment periods for Medicare, including the initial enrollment period, special enrollment periods, and annual open enrollment periods for making changes to coverage.
- **Supplemental Coverage Options**: Many individuals choose to supplement their Medicare coverage with additional plans, such as Medicare Advantage (Part C) or Medicare Supplement Insurance (Medigap), to enhance benefits and fill gaps in coverage.
As you navigate your benefit elections, be sure to consider your Medicare eligibility and options alongside your employer-provided benefits. Understanding your Medicare coverage can help ensure comprehensive healthcare coverage that meets your needs as you transition into retirement.
- Premium: The amount paid for insurance coverage deducted from your paycheck on a per-pay-period basis.
- Deductible: The amount you must pay out of pocket for covered services before your insurance plan starts to pay.
- Copayment (Copay): A fixed amount you pay for covered services at the time of service, usually for doctor visits or prescription drugs.
- Coinsurance: The percentage of costs you pay for covered services after you've met your deductible.
- Out-of-Pocket Maximum: The maximum amount you'll have to pay for covered services in a plan year, after which your insurance plan pays 100% of covered costs.
- Network: The group of doctors, hospitals, and other healthcare providers contracted with an insurance company to provide services at discounted rates to plan members.
- Preventive Care: Healthcare services aimed at preventing illness or detecting health conditions early when treatment is most effective, often covered at no cost under insurance plans.
- Benefit: The healthcare services or items covered by an insurance plan.
- Preauthorization: The process of obtaining approval from your insurance company before receiving certain medical services or treatments.
- In-Network: Healthcare providers or facilities that have contracted with your insurance company to provide services at lower costs to plan members.
- Exclusion: Specific healthcare services or conditions that are not covered by an insurance plan.
- Lifetime Maximum: The maximum amount of money that an insurance plan will pay for covered services over the entire life of the policy.
- Grace Period: A specified period after the premium due date during which coverage remains in force even though the premium has not been paid.
- Coordination of Benefits (COB): A process used when an individual is covered under more than one health insurance plan to determine which plan pays first and how much each plan will pay.
- Explanation of Benefits (EOB): A statement sent by the insurance company to the insured individual explaining what medical treatments and/or services were paid for on their behalf.
Why go to an In-network provider?
- Going to an in-network provider means choosing a healthcare professional or facility that has a contract with your health insurance plan. In-network providers have agreed to offer their services at negotiated rates, which are often lower than what you would pay for out-of-network care. By visiting an in-network provider, you can take advantage of your health insurance plan's benefits, which may include lower copayments, coinsurance, and reduced out-of-pocket expenses.
Why should I go for my annual well checkup?
- Annual well checkups are essential for maintaining good health and preventing potential health issues. These visits allow your doctor to assess your overall health, monitor any chronic conditions you might have, and detect early signs of potential health problems. Regular checkups help identify health concerns before they become serious, ensuring timely intervention and a better chance for successful treatment.
What is the difference between generic and brand name drugs?
- Generic drugs are identical or bioequivalent to brand-name drugs in terms of active ingredients, safety, strength, dosage form, and intended use. The main difference is that generic drugs are usually more affordable because they don't have the research and development costs associated with brand-name drugs. The U.S. Food and Drug Administration (FDA) ensures that generic drugs meet the same rigorous standards for quality, safety, and effectiveness as their brand-name counterparts.
How do discount cards work on RX?
- Prescription discount cards provide discounts on medications at participating pharmacies. These cards are often available for free or at a low cost and can be used by individuals without insurance or those with high copayments. When you present the discount card at the pharmacy, it reduces the price of the medication, potentially leading to significant cost savings.
What happens if I go out of network?
- If you go out of network for healthcare services, it means you're seeing a provider or using a facility that doesn't have a contract with your health insurance plan. Out-of-network care typically results in higher out-of-pocket costs, including higher copayments, coinsurance, and potentially higher deductibles. Some health insurance plans may not cover out-of-network care at all, except in emergencies.
What is a SBC (Summary of Benefits and Coverage)?
- A Summary of Benefits and Coverage (SBC) is a document provided by health insurance companies to help individuals understand their health plan's key features and coverage details. It provides a summary of the plan's benefits, costs, coverage limits, and examples of common medical scenarios to help individuals compare different health insurance options and make informed decisions.
What is an EOB (Explanation of Benefits)?
- An Explanation of Benefits (EOB) is a statement sent by the health insurance company to the policyholder after a healthcare claim has been processed. The EOB provides a detailed explanation of the services provided, the amount billed by the healthcare provider, the amount covered by the insurance, and any remaining balance that the insured may be responsible for paying.
What should I ask my doctor?
- When visiting your doctor, consider asking questions related to your health condition, treatment options, medications, potential side effects, and any lifestyle changes you should make. You can also inquire about preventive measures, recommended screenings, and follow-up care. Don't hesitate to ask for clarification if there's anything you don't understand.
What is preventive care?
- Preventive care refers to healthcare services aimed at preventing or detecting health issues before they become more severe or chronic. Examples of preventive care include vaccinations, screenings (e.g., mammograms, colonoscopies), regular checkups, counseling on healthy behaviors, and interventions to manage risk factors.
Where can I get my ID card?
- You can typically get your health insurance ID card from your insurance provider. Many insurers offer electronic versions of the ID card through their mobile apps or member portals. Alternatively, you can request a physical ID card to be mailed to you.
Who do I contact if I have a QLE (Qualifying Life Event)?
- If you experience a Qualifying Life Event (QLE), such as marriage, birth/adoption of a child, divorce, loss of other health coverage, or a change in household income, you should contact your employer's HR department or your health insurance provider promptly. They can guide you through the process of updating your health insurance coverage or enrolling in a new plan if necessary.
REQUIRED NOTICES
Federal regulations require employers to provide certain notifications and disclosures to all eligible employees.
If you have any questions or concerns please contact your HR Department.
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.