Avon Local Schools Benefits

Highlights of your benefit plans include:

  • Medical - Medical Mutual
  • Dental - MetLife
  • Vision - EyeMed
  • Basic Life - MetLife
  • Short Term Disability - UNUM
  • Accident - UNUM
  • Critical Illness - UNUM
  • Whole Life Insurance - UNUM
  • Pet Insurance - Nationwide

To help you gain that strong understanding, please read these virtual benefits guide carefully and consult the Treasurer's Office with any questions.

Thank you for all that you do for us!

How to Enroll

All team members have access to our online benefits enrollment platform 24/7 where you can 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

ENROLLMENT INSTRUCTIONS:

  1. Go to https://www.benxpress.com/Avon
  2. Username: First initial, first 4 letters of last name and last 4 digits of SSN (ex., John Smith = jsmit9876)
  3. Password: First name and birth year (YYYY) (ex. john1975)
  4. Password and Username are all lowercase

Helpful Tips To Consider Before You Enroll

Do you plan to enroll an eligible dependent(s)?

  • If so, make sure to have their social security numbers and birthdates available. You cannot enroll your dependent(s) without this information.

Have you recently been married/divorced or had a baby?

  • If so, remember to add or remove any dependent(s) and/or update your beneficiary designation.

Did any of your covered children reach their age limit for this year?

  • If so, they may no longer be eligible for benefits, unless they meet specific criteria

REMINDER: if you wish to participate in a Flexible Spending Account and/or Health Savings Account, you MUST make an active election each year. Prior elections do not carry over.

The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire year.

QUALIFYING EVENTS

You can, however, modify your elections under certain circumstances, called "Qualifying Events".

Ready to Enroll?

Complete your enrollment on BenXpress.

When Does My Coverage Start?

  • New Hire: Benefits are effective date of hire

  • Open Enrollment: Benefits are effective January 1

  • Qualifying Event: Benefit changes effective date of event

What is a Qualifying 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

Who are my legal dependents?

  • Your legal spouse
  • 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

Open Enrollment (Passive)

Annual enrollment is your opportunity to learn about your benefits, review your current coverage and choose the best options for you and your family. Please review this virtual benefit guide to learn more about our benefits offerings.

This annual enrollment will be a "passive open enrollment", which means if you do not make your benefit elections you will remain in the same plan as your current benefits for this plan year.

Open Enrollment is the one time of year when you can update your elections without experiencing a Qualifying Life Event (QLE). The elections that you make will remain in place unless you notify the Treasurer's Office within 30 days of your QLE to be eligible to make new elections.

REMINDER: if you wish to participate in a Flexible Spending Account and/or Health Savings Account, you MUST make an active election each year. Prior elections do not carry over.

Open enrollment image

Medical & Prescription

Avon Local Schools offers medical coverage through Medical Mutual.

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 the carriers contract rate as the final charge and the member is not balanced billed.


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

ATA/Admin/Exempt - Medical Mutual Summary of Benefits

ATA/Admin/Exempt - Medical Mutual Summary of Benefits

OAPSE - Medical Mutual Summary of Benefits

OAPSE - Medical Mutual Summary of Benefits

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 non-preferred and low-cost generic drugs

TIER 3 | 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 have a higher copay.

TIER 4 | Highest Specialty copay: In this category are nonpreferred brand name drugs for which there is either a generic alternative or a more cost-effective preferred brand including most specialty medications. These drugs have the highest copay. Make sure to check for mail-order discounts that may be available.

Helpful Rx Cost Savings Tools & Tips:

MAIL ORDER - Many drugs are available in a 90-day supply, rather than the 30-day retail supply. Typically, you will pay less if you choose to get a mail-order 90-day supply.

GOOD Rx - There are many tools online that you can use to save on prescription costs. One is GoodRx.com, an online Rx database that allows you to find what pharmacy is the cheapest for your specific prescription. Additionally, you may be able to find a coupon that will greatly reduce your cost. It is important to remember that many of the coupons can only be used outside of your plan (which will not count towards your maximums).

ASK YOUR DOCTOR – Make sure to ask if there are cost-saving alternatives to the prescription they are providing. Many times, there are generic or different manufacturers that will save you money at the pharmacy.

Medical Extras

My Health Plan: Access your MMO information 24/7.

A secure website specifically for Medical Mutual members, My Health Plan makes it easy and convenient to manage your plan and your health online.

  • Search for In-Network doctors, hospitals, and facilities. For example, a less expensive MRI location
  • View your EOB (Explanation of benefits)
  • View plan documents
  • Members that are located outside of Ohio will utilize the Cigna Network - Please visit the My Health Plan website to find a provider.
  • and so much more!!

MedMutual Mobile App

With the Mobile App, you can get access to vital information when you are away from a computer. You can Track Claims and Spending Information, Estimate Costs, Find a Provider, and Access your ID Card. Download the app on the Apple Store or Google Play.

Chronic Management Program

If you suffer from one of the conditions below, this program may be right for you:

  • Asthma
  • Heart Fairure
  • COPD
  • Diabetes
  • Hypertension

Call (800) 590-2583 to learn more or enroll in the Chronic Management Program.

First Stop Health - Telemedicine

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 doctor is not available;​
  • you become ill while traveling; ​
  • When you are considering visiting a hospital emergency room for a non-emergency health condition. ​

*Your covered children may also use Virtual Visits when a parent or legal guardian is present for the visit.

​

Examples of Non-Emergency Conditions:​

  • Bladder infection​
  • Seasonal flu​
  • Sinus​
  • Sore throat​
  • Stomach
  • Rash​
  • Bronchitis​
  • Diarrhea​
  • Fever​
  • Pink eye

Vitality Wellness

Whether you’d like to lose weight, become more active, improve your diet or simply maintain a healthy lifestyle, Vitality is right for you! It’s easy to get started. Before you know it, you’ll begin to make healthy choices a natural part of your everyday life and enjoy the benefits of a healthier lifestyle at work, at home and at play.

You must be enrolled on the medical plan in order to participate in the Vitality program.

Registration is easy

If you haven’t registered yet, go to the PowerofVitality.com and in the middle of your screen click on “First time logging in? Register now.”

1. Complete all the required (*) fields:

*First name

*Last name

*Date of birth

*Email address

*Employee ID

Please note: We encourage you to provide your email address. Our having your email address on file provides our Customer Care team with a way to communicate with you, if necessary, allows us to keep you informed about the program and different events and activities, and contributes to your successful Vitality experience.

2. Once we validate the data you provide, we will ask you to create a username and password.

3. Read and accept our Terms and Conditions.

4. Select and answer a security question.

Here are some of the key things that will help you get started.

Vitality Health Review (Health Assessment)

The Health Assessment is a brief, confidential questionnaire in which we ask you about your current health status, health results, activities, habits, nutrition, lifestyle and work and home lives. Doing so helps us to better understand where you are doing well and where you may need some help. We encourage you to take the Health Assessment as soon as possible once you join the program.

Vitality HRA Rewards

Vitality HRA Rewards

Dental

Dental Benefits through MetLife 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.

NETWORK: Preferred Dental Program (PDP)

How do I find an In-Network Provider? Use the helpful link below!

  • In-Network providers can also be found by visiting your provider’s website below where you can search by location, provider/facility name, or search by specialty.

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.

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.

Looking for more details about how items are covered? Click on the link below to view the formal plan summary.

Dental Summary

Looking for more details about how items are covered? Please refer to the formal Summary below.

Metlife Dental Summary

Metlife Dental Summary

Vision

Vision coverage through EyeMed helps 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. Please note: Members may choose between prescription glasses (lenses and frame) and contact lenses, not both.

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

To find out if your provider is in-network, please visit the website below.

Vision Summary

Looking for more details about how items are covered? Please refer to the formal Summary below.

EyeMed Benefit Summary

EyeMed Benefit Summary

Basic Life

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 - Amount dependent on class

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.

The portability provision allows you to continue Voluntary Term Life Insurance upon loss of eligibility or termination of employment in these situations:

  • Group policy discontinues the eligibility of a class of employees to which you belong
  • You retire
  • You are terminated or change jobs


This Policy will port into a Term policy.

You have 30 days from the loss of eligibility date to port your Voluntary Term Life.

Conversion allows you to convert your Voluntary Term Life Insurance to an individual life insurance policy in these situations:

  • Employment ends
  • You stop being a member of an eligible class of employees
  • Dependent loss of eligibility
  • The policy terminates


This policy will convert to a Permanent Whole Life policy.

You have 30 days from the loss of eligibility date to convert your Voluntary Term Life.

Beneficiary Designation

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.

Primary Beneficiary: Your primary beneficiary receives your benefits in the event of your death.

Contingent Beneficiary: Your contingent beneficiary receives your benefit, in the event that your primary beneficiary cannot.

*Please make sure your beneficiary information is up to date in BenXpress*

Spending 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.

Flexible Spending (FSA) & Dependent Care Accounts (DCARE)

The Health Care and Dependent Care Flexible Spending Accounts (FSA) allow you to set aside pre-tax dollars to pay for eligible expenses. By contributing to one or both of the Flexible Spending Accounts you reduce your taxable income, so you pay less in taxes — which saves you money.

Contributions

The election you make during enrollment is your election for the entire plan year. You may change it only if you have a qualifying life event and the change request must be consistent with the event.

You may contribute as follows:

Health Care FSA

  • Up to $3,400 annually
  • All benefit-eligible can participate unless you or your spouse are contributing to an HSA.
  • Reimbursements allowed for unreimbursed medical, prescription, dental, and vision expenses

The Dependent Care FSA

Allows you to pay for eligible dependent care expenses with tax-free dollars so that you and your spouse can work or attend school Full-time.

Funds in a Dependent Care FSA are only available once they have been deposited into your account and you cannot use the funds ahead of time.

  • You may set aside up to $7,500 annually in pre-tax dollars, or $3,750 if you are married and file taxes separately from your spouse.
  • If you participate in a Dependent Care FSA, you cannot apply the same expenses for a dependent care tax credit when you file your income taxes.

How the Plan Works

Avon Local Schools offers a Health FSA carryover, allowing you to roll over unused Health FSA funds into the next plan year, up to the IRS‑allowed maximum, as long as you enroll in the FSA in the next plan year.

Voluntary Benefits

Avon Local Schools 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 employees. Additional benefits include:

  • Whole Life
  • Critical Illness Insurance
  • Accident Insurance
  • Pet Insurance

Whole Life Insurance

Avon Local Schools offers Whole Life Insurance through UNUM. You can keep Whole Life Insurance as long as you want. Once you’ve bought coverage, your cost won’t increase as you age. The benefit amount stays the same, too — it doesn’t decrease as you get older. That means you get protection during your working years and into retirement. Whole Life Insurance also builds cash value at a guaranteed rate of 4.5%.* You can borrow from that cash value, or you can buy a smaller, paid-up policy — with no more premiums due.

For more information on your Whole Life benefit. Please see attached Benefit Summary.

UNUM Whole Life Summary

UNUM Whole Life Summary

Critical Illness Insurance

Critical Illness Insurance can pay money directly to you when you are diagnosed with certain serious illnesses. Pre-existing conditions will have a 6-month look back; 6 month exclusion period.

What's covered?

  • Critical Illnesses such as heart attack, stroke, and end-stage kidney failure
  • Cancer conditions, such as breast cancer and skin cancer
  • Progressive diseases such as Alzheimer's Multiple Sclerosis and Parkinson's disease

Wellness Benefit

When you enroll in Accident or Critical Illness Insurance you can earn $50 just by getting an annual physical or covered preventive test.

UNUM Critical Illness Summary

UNUM Critical Illness Summary

Accident Insurance

A serious injury can cost you a lot of money – not only in medical bills but in things like income from lost work hours. Some injuries are minor, but others are debilitating and require significant medical care. If you get hurt, accident insurance pays you money that you can use to cover personal expenses, bills, and out-of-pocket medical costs. Accident Insurance can pay a set benefit amount based on the type of injury you have and the type of treatment you need. It covers accidents that occur on and off the job. And it includes a range of incidents, from common injuries to more serious events.

Who Gets Paid? You get paid!

  • When you are paid a benefit from Accident Insurance, your health insurance company pays your doctor or hospital, but your Guardian Accident insurance pays you.
  • You can use the money however you want.

Examples of what's covered

  • Accidental Death coverage for Employee, Spouse, and Child
  • Ambulance
  • Concussions
  • Hospital Admission
UNUM Accident Summary

UNUM Accident Summary

Pet Insurance

Nationwide Pet Insurance is the nation’s oldest and largest provider of pet insurance and provides coverage for cats, dogs, birds and other exotic animals.

Nationwide Pet Insurance policies help pay for medical problems and conditions related to accidental injuries, poisonings and illnesses (even cancer), including diagnosis tests, x-rays, treatments, prescriptions, lab fees, surgeries and hospitalizations.

With Nationwide Pet Insurance, you can take your pet to any licensed veterinarian in the world. Multiple pet discounts are available.

The Nationwide Pet Insurance Policyholder Portal allows you to access to your policy, update contact and payment information, check claim status and history, download forms and renew your policy.

Three plan types are available with premiums based on age, species, and state of residence.

Short Term Disability

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. Your coverage pays 60% of your income up to a specific maximum in your benefit summary.

STD Benefit Features

  • Benefit begins 8th day Accident/8th day Illness
  • Benefit equal to 60% of pay – the benefit is taxable income
  • Pre-existing condition limitations apply for the first 12 months
Short Term Disability Summary

Short Term Disability Summary

MASA

The MASA product was originally offered to provide families protection from non-network charges, and subsequent balance billing, when faced with an emergency ground and air ambulance transport. Due to the No Surprises Act, carriers are no longer able to balance bill for charges associated with these emergency services, eliminating a portion of the potential benefits of the MASA coverage. However, since the vast majority of air ambulance providers are still out-of-network, the MASA coverage does provide benefits to cover non-network charges under the district’s health insurance plan.

MASA protects you and your family from additional cost when receiving emergency transportation services. Not all ambulance expenses could be covered 100% under your health insurance. Even after insurance payments for emergency transportation, you could receive a bill up to $5,000 for ground ambulance an as high as $70,000 for air ambulance.

MASA will provide medical emergency transportation solutions, AND cover your out-of-pocket medical transport cost when your insurance falls short.

A MASA Membership prepares you for the unexpected.

ONLY MASA Medical Transport Solutions provides you with:

  • Coverage ANYWHERE in all 50 states and Canada whether at home or away
  • Coverage for BOTH emergent ground ambulance and air ambulance transport REGARDLESS of the provider
  • Non-emergent transport services, which are frequently covered inadequately by your insurance, if at all

Emergent Plus Membership $14.00 a month

  • Emergent Ground Transportation
  • Emergency Air Transportation
  • Repatriation

Platinum Member $39.00 a month

  • Non-Emergent Air Transportation
  • Emergent Ground Transportation
  • Emergency Air Transportation
  • Repatriation
  • Non-Emergent Air Transportation
  • Escort Transportation
  • Mortal Remains Transportation
  • Visitor Transportation
  • Minor Children/Grandchildren Return
  • Vehicle Return
  • Pet Return
  • Organ Retrieval

Well-being Hub

In today's fast-paced and interconnected world, where stress and mental health issues are on the rise, effective well-being plays a crucial role. We recognize that a healthy, content workforce is not only more productive but also fosters a positive culture. We strive for a supportive and inclusive environment where we encourage and support the improvement of physical, mental, emotional, and social well-being. Whether within a corporate setting, a community, or on a personal level, well-being focuses on fostering awareness, empathy, and support to create a healthier and more balanced workplace and environment for all. Prioritizing employee wellness and wellbeing is not just a policy but a reflection of our commitment to both the individual and collective success of the team.

To access the wellbeing newsletter, which includes resources, tips, recipes, and more, please select the button below.

Wellbeing image
Carrier Contacts

Carrier Contacts

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 to 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, Federal law gives you more choices about your prescription drug coverage.



Client Contacts

EL

Erin Longwill

longwille@avoneagles.org

440-937-4684

SF

Sadie Fox

foxs@avoneagles.org

(440) 937-4680