WELCOME VALUED TEAM MEMBER
Helping you and your family reach and maintain good health is very important to Carriage House Children's Center. Your employer is pleased to offer a selection of benefits designed with your health and financial wellbeing in mind. We review our benefit programs each year to ensure we consider the best combination of benefit coverage, network access and affordability for employees.
Eligibility
Employees working at least 30 hours per week are eligible to participate in benefits offered. When you enroll in the benefits program, you may also cover your eligible dependents. Dependents include your legal spouse, child(ren) up to age 26 (regardless of student status, marital status, residence, or financial dependence on you), and an unmarried child incapable of self-support.
OVERVIEW
We offer UPMC’s *Partner Network Plans, which provide access to their award-winning Network facilities.
You have a range of 3 comprehensive options to choose from so you can decide which plan is most beneficial to you & your family financially and medically.
• Option 1 - Base Plan: EPO $6,000 Deductible
• Option 2 - Mid-Level Plan: **First Care Plan: EPO $2,500 Deductible
• Option 3 – Buy-Up Plan: Custom EPO $0 Deductible
Notes:
Partner Network: This is UPMC’s Network that includes only UPMC owned hospitals. By steering members to the UPMC Network owned facilities, this will help control claim costs for the future.
For emergency situations, you should go to the closest hospital, regardless if they are a UPMC HP Network hospital. You have 100% coverage in emergency situations ‘In-Network’ or ‘Out-of-Network, anywhere in the world. It is only for ***non-emergency, or for scheduled services, where you must use a UPMC HP Partner Network provider in order to have coverage by the Health plan.
Please see list of Parter Network hospitals.
Search for providers at www.upmchealthplan.com; Find Care- Filter Network Accepted: Partner.
***Med Express is NOT a Partner Network facility.
First Care: This plan is encouraging members to obtain care when needed by removing costs associated in these situations:
$0 copay for first in-person or virtual primary care and specialist visits
$0 copay for ALL behavioral health visits (either virtual or in-person visits)
$0 copay for urgent care visits using UPMC Anywhere Care
Prescription copays are the same for all 3 plans offered at $15 (Generic) $30 (Brand Name Formulary) $50 (Non-Formulary).
ENROLLMENT
If you are newly hired, you are eligible for benefits on the 1st day of the month following your date of hire. You must complete the appropriate enrollment forms in order to be set up with the coverages. Once completed, please submit them to your employer to sign and to process.
- UPMC HP- Medical & Vision Insurance
- UPMC HP, United Concordia & Sun Life Dental Insurance
- Boston Colonial- Disability, Accident, Cancer or Hospital protection
You can 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.
Refer to your Employee Benefits Guide or contact Human Resources if you have questions about qualifying events.
MEDICAL/RX
UPMC Health Plan will continue to administer your medical and prescription drug benefits this year.
You have the choice between 3 different medical insurance policies offered to suit your own preference of level of coverage:
Buy-Up Option: EPO $0- The richest of all policies offered with $0 Deductible for in-network services and very low doctor copays, and the highest employee contribution from your paycheck.
Mid-Plan Option: EPO $2500 - First Care - This policy has very low doctor copays, but does have a deductible that applies to certain services.
Base Plan Option: EPO $6000- While this policy has a high $6000 in-network deductible, it only applies to certain services. This policy is the most affordable & offers the lowest payroll contribution from your paycheck.
Note, the RX copays are the same for all plans offered.
To find out if your provider is in-network, please visit the UPMC HP website below.
DENTAL
You have the choice between 3 different dental policies to help you and your family maintain good dental health.
- UPMC HP's Premium Dental Advantage Policy: Providers are part of the UPMC HP Dental Advantage/National DentaMax network, or you may see an out-of-network dentist of your choice. Be aware if you go out-of-network, your out of pocket costs will be higher. This plan has the highest payroll contribution, but the most freedom to obtain services.
- United Concordia's Dental HMO Policy: This plan requires that members select a Primary Care Dentist and all services must be obtained by their Primary Care Dentist. The network is more limited that the UPMC HP Dental policy.
- Sun Life's Dental Discount Plan: This plan is the most affordable, and is considered a 'pre-paid' dental plan for all services. It has a limited network of dental providers that are considered part of the network.
To find out if your provider is in-network with any of these policies, please visit the websites noted below.
VISION
DID YOU KNOW?
- Eye exams can help detect serious eye and general health conditions sooner: high blood pressure, diabetes, heart disease, high cholesterol
- Babies should receive their first professional eye exam at 6 months
- 80% of learning in the first 12 years comes through the eyes
Carriage House Children's Center offers vision exam coverage through UPMC HP to help pay for eye exams. The exam is included with all 3 of the medical policies offered.
To find out if your provider is in-network, please visit the UPMC HP website below.
VOLUNTARY BENEFITS
Carriage House Children's Center 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:
- Accident Care
- Critical Illness
- Disability
Wellness Programs
There are wellness programs to help you maintain your emotional wellbeing included with your UPMC HP Benefits.
From an Employee Assistance Program, to Wellness Coaches, there are many resources available to help you take care of any needs.
Whether you are looking for strategies to increase your current physical activity, quit smoking, help resolve financial/credit issues, heal a personal relationship, or looking for assistance for a family member, there is help out there for you, just one call away
Contact Us
As you consider your benefit options, please be sure to review all available information: Employee Benefits Guide, Intranet, & flyers found on this webpage. If you don't understand your benefits or need any assistance, please contact:
Michelle Ruff
(412) 600.2341
michelle.ruff@nfp.com
Client Contacts
Addy Kleinfelter
accounting@carriagehouse.org
(412) 421-0300
Sharon Amick
amick@carriagehouse.org
(412) 421-0300
Account Team Contacts
Michelle Ruff
Producer / Sales Consultant
michelle.ruff@nfp.com
412-600-2341
Additional Contacts
Lynn Kline
Children's Center of Pgh Director
klinel@upmc.edu
(412) 641-1990