City of Maple Heights

Table of Content

  1. Header
  2. Overview of Health Benefits
    1. 2026 Employee Benefits
    2. Open Enrollment Meetings
    3. How To Enroll
    4. Eligibility
    5. NEW! Accident Coverage, Critical Illness, and Hospital Indemnity
    6. NEW - Guardian Benefits
    7. Medical
    8. MMO My Health Plan and Mobile App
    9. Medical Mutual Total Health
    10. 24/7 Nurse Line and Care Navigation
    11. Maternity Management and NICU Management
    12. Transitional Care and Palliative Care
    13. Virtual Physical Therapy
    14. Digital and Telephonic Health Coaching
    15. Preventive Care
    16. Prescription
    17. Prescription 2
    18. Smart90
    19. SaveOnSP (through Medical Mutual)
    20. ImpaxRX
    21. Health Savings Account (HSA)
    22. Medical Mutual HSA with WealthCare Saver Bank
    23. Dental
    24. Dental Maximum Rollover Rewards
    25. Vision
    26. Basic Life AD&D
    27. Voluntary Life AD&D
    28. Beneficiary Designation
    29. PeopleEQ
    30. First Stop Health
    31. AllOne Health
    32. ASPCA Pet Insurance
    33. Carrier Contact Information
    34. Contact Us
    35. Benefits Compliance
  3. Footer

2026 Employee Benefits

NEW! Accident, Critical Illness, and Hospital Indemnity through Voya!

NEW! Basic Life AD&D, Voluntary Life AD&D with Reliance Standard!

NEW! Wellness Platform through PeopleEQ!

Medical: Medical Mutual 

  • HSA plan: $3400/$6800 deductible then 100% coinsurance.

Prescription: Express Scripts and Smart90

Specialty Prescription Assistance: ImpaxRX and SaveOnSP (through Medical Mutual)

 

Dental: Guardian

Vision: Guardian

Health Spending Account (HSA): Wealth Care Bank

Telemedicine: First Stop Health

Employee Assistance Program: AllOneHealth

Pet Insurance: ASPCA

How To Enroll

Action Required for all benefits-eligible employees: 

During Open Enrollment, you may:

  • Elect the same coverage with the same dependents.
  • Add or delete dependents.
    • If adding a dependent, please provide a marriage certificate for spouse and birth certificate for children.
  • Decline benefits and elect to receive a waiver incentive of $200 per month.
  • Enroll, if you are not currently enrolled in 2025 plans.
  • Update Life Insurance beneficiaries.
  • Enroll in additional Voluntary Life Insurance coverage through Reliance Standard at your expense.

Note: In order to comply with Summit County's 2026 Dependent Audit requirements, make sure that you review the Dependent Audit Notice (posted below) and provide the required documents along with your enrollment form (posted below) to HR no later than November 3, 2025.

Every employee who is eligible for benefits must return a 2026 Enrollment Form and required dependent verification documents to HR by November 3, 2025.

After this deadline, you must wait until the 2027 Open Enrollment period or experience a Qualifying Life Event. 

Please view the 2025 Dependent Audit Announcement below for important information related to your benefits!

open enrollment
2026 Open Enrollment Form

2026 Open Enrollment Form

Maple Heights Dependent Audit Notice

Maple Heights Dependent Audit Notice

Eligibility

The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire plan year, January 1, 2026 - December 31, 2026, unless you experience a qualifying life event. If you have a Qualifying Life Event and want to request a mid-year change, you must notify Human Resources and complete your election changes within 30 days following the event. Be prepared to provide documentation to support the Qualifying Life Event.

What is a Qualifying Life Event?

  • Marriage
  • Divorce
  • Birth/Adoption of a child
  • Death of a spouse or other enrolled dependent
  • Change in spouse’s benefits or employment status
  • A dependent becomes eligible for Medicare or Medicaid
What is a Qualifying Life Event?

What is a Qualifying Life Event?

When Does My Coverage Start? 

Open Enrollment: Coverage changes will begin January 1, 2026.

New Hire: Your medical and vision coverage will begin the first of the month following date of hire. Your dental coverage will begin the first of the month following your completion of 30 days of employment.

Qualifying Event: Benefit changes are effective date of event, provided that appropriate documentation is provided to HR within 30 days of the Qualifying Event.

Who is Eligible for Health Care Benefits? 

Regular full-time employees and employees working scheduled for 30 hours or more hours per week are eligible to participate.

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.

NEW! Accident Coverage, Critical Illness, and Hospital Indemnity

Maple Heights offers Accident, Critical Illness and Hospital Indemnity coverage through Voya on a voluntary basis.

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. When you have a covered accident or injury, your health insurance company pays your doctor or hospital, but your accident insurance company pays you.

What is covered?

  • Breaking a limb
  • Loss of a digit or limb
  • Paralysis
  • Burns
  • Lacerations
  • Accidental Death

Accident insurance can help you pay for things like:

  • Emergency helicopter transportation
  • Hosptial admissions
  • Intensive Care and Rehab Unit Care
  • Diagnostic Exams
  • Follow - Up Treatments
  • Physical Therapy

CRITICAL ILLNESS INSURANCE

How would you pay your bills if you were suddenly diagnosed with cancer and couldn’t work? Critical illness insurance doesn't’ pay your medical bills. It pays you if you’re diagnosed with a covered illness. The benefit is paid directly to you and is your choice how to spend it.

What is Covered?

  • Cancer
  • Heart Attack
  • Blindness
  • Loss of Speech
  • End-Stage Renal Failure
  • Deafness
  • Severe Burns
  • Stroke
  • Coma
  • Major Organ Transplant

HOSPITAL INDEMNITY INSURANCE

Hospital indemnity compliments your health insurance to help you pay for costs associated with a hospital stay. The funds can be used to help pay for the out-of-pocket expenses that your medical plan may not cover, such as deductible and coinsurance. When you have a covered inpatient admission, your health insurance company pays your doctor or hospital, but your hospital indemnity insurance company pays you.

For more information on your Voya products visit the employee resource center using the link below or download the attached benefit brochures.

Voya Accident Flyer

Voya Accident Flyer

Voya Critical Illness Flyer

Voya Critical Illness Flyer

Voya Hospital Indemnity Flyer

Voya Hospital Indemnity Flyer

Voya Claim Submission Flyer

Voya Claim Submission Flyer

Medical

The City of Maple Heights offers a High Deductible Health Plan (HDHP) through Medical Mutual.


Utilizing In-Network providers will allow for the highest level of coverage. In-Network providers agree to accept Medical Mutuals contract rate as the final charge and the member is not balanced billed**. Employees who receive care from Out of Network providers may be responsible for higher costs.


**Balance Billing: Some Out of Network Providers bill a patient the difference between the total cost of services and the amount insurance pays.


Please see attached Summary of Benefits and Coverage (SBC) for specific details and exclusions.





Medical Mutual Total Health

The City of Maple Heights is part of Medical Mutual's Total Health Program. (previously known as Chronic Condition Management)

You have access to the below services, at NO COST.

  • Self-Service Wellness tools via My Health Plan
  • 24/7 Nurse Line
  • Maternity Management
  • Care Navigation
  • Palliative Care
  • Transitional Care
  • Progeny Health: NICU Management
  • SWORD Health: Virtual Physical Therapy
  • BLOOM: Virtual Pelvic Health Therapy
  • Digital and Telephonic Health Coaching

Preventive Care

Image

All health plans recognize routine preventive services at 100%, no coinsurance, no deductible if the claim is submitted as routine or preventive and the services performed fall within the approved list of preventive services.

For a complete and updated list of preventive services, please use the link below.

During your wellness visit, proactively let your physician know the reason for the appointment is for a wellness visit and that your physician needs to submit and code the visit as routine or preventive in nature. If your visit is submitted with a diagnosis, the wellness visit will not be paid at 100%, but instead will be subject to deductible and coinsurance. Below are a few examples of services that can be recognized as preventive.

  • Routine wellness exams, including well baby and child routine exams
  • Cholesterol and lipid level screening
  • Pelvic exam, pap test and screening mammograms
  • Colorectal cancer screening, colonoscopies, sigmoidoscopies (age limits apply)
  • Vaccines & immunizations
  • Contraceptives (specific list applies)
  • Diabetes screenings

Prescription

Your prescription drug coverage through Express Scripts is illustrated in the table shown below.



RX

WHERE CAN I FIND A DRUG LIST?

Typically, a full listing of covered drugs is found on your provider’s website. A drug list, also called a formulary, is a list of generic and brand-name drugs covered by a health plan. Although a drug may be on the drug list, it might not be covered under every plan. Review the plan materials for details on specific benefits.

You can use drug lists to see if a medication is covered by your health insurance plan. You can also find out if the medication is available as a generic, needs prior authorization, has quantity limits and more.


TRADITIONAL DRUGS

TIER 1 (GENERIC) Lowest copay: Most drugs in this category are generic drugs. Members pay the lowest copay for generics, making these drugs the most cost-effective option for treatment.

TIER 2 Higher copay: This category includes preferred, brand name drugs that don't yet have a generic equivalent. These drugs are more expensive than generics, and a higher copay.

TIER 3 Highest copay: In this category are nonpreferred brand name drugs for which there is either a generic alternative or a more cost-effective preferred brand. These drugs have the highest copay.

Make sure to check for mail order discounts that may be available.

Health Savings Account (HSA)

Health Savings Account (HSA) is a tax-free savings account that is owned by you, is 100% vested from day one, and lets you build up savings for future needs. The funds may be used to pay for qualifying healthcare expenses not covered by insurance or any other plan for yourself, your spouse, or tax dependents. You decide how much you would like to contribute, when and how to spend the money on eligible expenses, and how to invest the balance.

To have an HSA and make contributions to the account you must meet several basic qualifications.

  • You must have coverage under a qualified High-Deductible Health Plan (HDHP)
  • Participants cannot be covered by any other health insurance plan (this exclusion does not apply to dental, vision, disability or long-term care coverage)
  • Participants cannot participate in a Healthcare FSA or spouse/domestic partner's Healthcare FSA or Health Reimbursement Account (HRA)
  • Participant cannot be enrolled in Medicare or Medicaid
  • You cannot be eligible to be claimed as a dependent on someone else's tax return
  • You have not received Department of Veterans Affairs Medical benefits in the past 90 days. 

 You may contribute as follows: (new 2026 limits)

  • $4,400 for Employee Only
  • $8,750 for a Two-Person or Family
Understanding an HSA

Understanding an HSA

Dental

Your dental coverage is through Guardian. Dental Benefits through Guardian provides 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. 

Employees who receive care from Out of Network providers may be responsible for higher costs and may be balanced billed. 

*Balance Billing: Some Out of Network Providers bill a patient the difference between the total cost of services and the amount insurance pays.

What's Covered?

Preventive: Nearly all dental plans emphasize preventive care. Dental insurance is designed to make it easier for you to prevent serious oral health conditions. Your dental insurance allows 2 preventive cleanings per year. In addition to cleanings your plan offers:

  • Exams, cleanings, fluoride treatments, sealants and X-rays covered at 80%

Basic Care: 

  • Fillings, root canal, scaling and root planing (per quadrant), simple extractions, surgical extractions covered at 80%

Major Care:

  • Anesthesia, bridges, dentures, dental implants, inlays, onlays, veneers, repair of bridges, crowns and dentures covered at 80%

Orthodontia: 

  • Child(ren) covered at 50%

** Please refer to below Dental Summary for more plan details and exclusions. 

** Click the tab below for an overview of you Dental Max Rollover Rewards program with Guardian. 

Guardian Enrollment Form

Guardian Enrollment Form

Dental Summary

Dental Summary

Vision

Vision insurance plans help provide coverage for routine exams and provides discounts on glasses and contacts. Your vision coverage is through Guardian. Your vision network is Davis Vision.


You may use the eye doctor of your choice, however those that are In Network will be more cost effective. Employees who receive care from Out of Network providers may be responsible for higher costs and be balanced billed*.


*Balance Billing: Some Out of Network Providers bill a patient the difference between the total cost of services and the amount insurance pays.


How often can I obtain services?

Exams: once every 24 months (Note: an annual vision exam is also included in your Medical Mutual medical plan)

Frames: once every 24 months

Lenses: once every 24 months


**Please see attached Vision Benefit Summary for more plan details and exclusions.

Vision Enrollment Form

Vision Enrollment Form

Vision Benefit Summary

Vision Benefit Summary

Basic Life AD&D

Life insurance is an important part of your financial security. All life insurance will provide a payout to your beneficiaries if you pass away. 

The City of Maple Heights now offers Basic Life Insurance to employees through Reliance Standard. 

Your Basic Life Benefit:

  • 100% employer paid.
  • Benefit amount dependent on employee class. 
  • Benefits reduced at ages 70 and 75.
  • Convertible: When coverage ends with your plan you can convert your benefit to an individual permanent life policy.
  • Portable: Allows you to take coverage with you if you terminate employment.

There are two classes within the City of Maple Heights that have waiting periods before Basic Life benefits will begin

  • Class 1 - Full-Time Bargaining - First of the month following 1 year of employment
  • Class 2 - Full-Time Non-Bargaining - First of the month following 90 days of employment
Reliance Basic Life/AD&D Flyer

Reliance Basic Life/AD&D Flyer

Voluntary Life AD&D

Voluntary Life Insurance

Employees can enroll in supplemental Life Insurance. This will be in addition to your employer provided Basic Life Insurance. Coverage is also available for your spouse and dependent children. It is required that you enroll in coverage for yourself in order to be eligible for coverage for your dependents.

If you are not a newly hired employee, you are required to complete Evidence of Insurability no matter how much you select. The up to $100,000 offer is a one-time offer to newly hired employees only.

There are two classes within the City of Maple Heights that have waiting periods before Voluntary Life benefits will begin:

  • Class 1 - Full-Time Bargaining - First of the month following your date of hire
  • Class 2 - Full-Time Non-Bargaining - First of the month following your date of hire

 

Voluntary Life Summary

Reliance Voluntary Life/AD&D Flyer

Reliance Voluntary Life/AD&D Flyer

Beneficiary Designation

It is important to designate your beneficiaries to ensure that your assets will be distributed according to your direction.


Primary Beneficiary(ies) receive your life insurance benefits in the event of your death. Contingent Beneficiary(ies) receive your life insurance benefits if the primary beneficiary(ies) cannot. You can change your beneficiaries at any time.


Please make sure your beneficiary designations are up to date with the HR office.

PeopleEQ

The City of Maple Heights now offers the PeopleEQ wellness platform. 

Whether you’re just starting to consider making healthy changes or trying to add new challenges to your wellness routines, you’ll have access to the same great tools and support you need to reach your goals.

You can check out daily wellbeing tips, track Healthy Habits, take small steps with digital coaching, join your friends and coworkers in fun challenges, and so much more. And it’s all available in the easy-to-use app so you always have what you need on the go. Connect devices, apps and activity trackers you already use to sync and automatically track health data like steps, sleep and mindful minutes.

You can earn up to $100 Rewards Cash for your Biometric Screening and Health Risk Assessment. This can be traded in for gift cards or you can shop the PeopleEQ Health store!

 

First Stop Health

No crowded waiting rooms. No driving. See a doctor when you need a doctor. Talk to a doctor 24/7.

When can I use First Stop Health?

  • your doctor is not available.
  • you will become ill when traveling.
  • when you are considering a hospital visit for a non-emergency health condition

What is a non-emergency condition?

  • Bladder infection
  • Bronchitis
  • Diarrhea
  • Fever
  • Rash
  • Seasonal flu
  • Allergies
  • Sore throat

How does it work?

Call (888) 691-7867 or log in to fshealth.com or download the mobile app to request your doctor visit.

Set up your account now so its ready when you need it!

Complete patient registration for medical history, pharmacy preference, primary care physician contact information and insurance information.

Each time you visit you will be asked brief medical questions. If appropriate you will be connected to a doctor using secure live audio and video.

You and your doctor will discuss your medical issue and if appropriate your doctor may write a prescription.

FSH

AllOne Health

All employees and their covered dependents have access to this free Employee Assistance Program through AllOne Health. 

Get support for you and your family from licensed counselors 24/7.

Get help with

  • Family Conflict
  • Work/Life Balance
  • Couples/Relationships
  • Depression
  • Anxiety
  • Parenting
  • Stress

AllOne Health counseling can be done via phone, web portal, mobile app, chat, or video.

Scan the QR code below to access AllOne Health on your mobile phone. 

Your employee code: mapleheights

 1-800.521.3273

EAP Member Portal Flyer

EAP Member Portal Flyer

AllOneHealth Flyer

AllOneHealth Flyer

ASPCA Pet Insurance

City of Maple Heights offers Pet Insurance through ASPCA. This is a voluntary benefit, 100% employee paid, and directly billed to the employee.

Pet Insurance helps cover accidents, illness, hereditary and congenital conditions, alternative therapies, and behavioral issues.

How it Works:

  1. Take your pet to veterinarian of your choice and pay them as usual
  2. Use the app to submit a claim
  3. Receive reimbursement for eligible vet bills by direct deposit or check

Use the link below to get your free pet insurance quote in 2 easy steps!

ASPCA Flyer

ASPCA Flyer

ASPCA Flyer

ASPCA Flyer

Client Contacts

AP

April Perkins

aperkins@mapleheightsohio.com

+1 216-662-6000

LL

Letitia Linker Letitia Linker

llinker@mapleheightsohio.com

+1 216-662-6000

Benefits Compliance

Medicare Part D

Medicare Part D

DOL Exchange Notice

DOL Exchange Notice

2026 Annual Notices

2026 Annual Notices