Berea City Schools Benefits

Highlights of your benefit plans include:

  • Medical - Medical Mutual
  • Prescription - Express Scripts
  • Dental - MetLife
  • Vision - MetLife
  • Basic Life - MetLife
  • Voluntary Life - MetLife
  • Accident - AFLAC
  • Critical Illness - AFLAC

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

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 in ESS.

When Does My Coverage Start?

  • New Hire: Benefits are effective date of hire

  • Open Enrollment: Benefits are effective July 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

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 your benefits offerings.

This annual enrollment will be an active open enrollment, which means you must make your benefit elections if you wish to be enrolled in benefits for the 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 until June 30th unless you notify the Treasurer's Office within 30 days of your QLE to be eligible to make new elections.

Medical & Prescription

Berea City 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.

Berea Medical Mutual Summary of Benefits

Berea 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 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:

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.

Smart90 Walgreens Program

Smart90 Walgreens Program

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

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.

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

Below is a high-level overview of your plan options and in-network benefit information: You can view more details of these plans by accessing the benefit summaries provided above.

Dental Summary - Economy

Dental Summary - Economy

Dental Summary - Premium

Dental Summary - Premium

Vision

Vision coverage through MetLife 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

Below is a high-level overview of your plan options and in-network benefit information: You can view more details of these plans by accessing the benefit summaries provided above.

Vision Benefit Summary

Vision Benefit Summary

MetLife Resources

MyBenefits member portal: Access your MetLife information 24/7.

A secure website specifically for MetLife members, the MetLife member portal makes it easy and convenient to manage your plan and your health online.

  • Get ID Cards
  • Access to all of your plan information and self service capabilities
  • View your EOB (Explanation of benefits) and claims status.
  • View plan documents
  • and so much more!!

To Create Your Account

  • Click on the link below
  • Enter the district name
  • Create login or enter you login information if your account is already created
Ancillary Image

Basic and Voluntary 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

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

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: $10,000 increments up to a maximum of 5x your salary or $500,000 ($300,000 or 3x base earnings GI)

Spouse: $10,000 increments up to $100,000 ($10,000 GI)

Children: $10,000 for each child up to age 26

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 with your Treasurer's office*

*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 it 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.

Voluntary Benefits

Berea City 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:

  • Critical Illness Insurance
  • Accident Insurance

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
AFLAC - Accident

AFLAC - Accident

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
AFLAC - Critical Illness

AFLAC - Critical Illness

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

JR

Jill Rowe

jrowe@bereaschools.org

216-898-8300

SJ

Sarah Jocke

sjocke@bereaschools.org

(216) 898-8300