City of Maple Heights
Table of Content
- Header
-
Menu
- 2023 Updates
- Benefits Overview
- Eligibility and Qualifying Events
- Medical
- Health Savings Account (HSA)
- Medical Mutual HSA with Avidia Bank
- Dental
- Vision
- Basic & Voluntary Life
- Wellness
- Employee Assistance Program
- Telemedicine
- Carrier Resources
- Contact Us
- Footer
Benefits Effective 1/1/2023
Benefits Overview
Medical Plan: Medical Mutual is the current medical carrier.
- HSA plan: $2,800/$5,600 deductible then 100% coinsurance.
Dental Plan: Guardian
Vision Plan: Guardian
Basic and Voluntary Life: Guardian
Health Spending Account (HSA): Avidia Bank
Telemedicine: First Stop Health
Employee Assistance: Ease@Work
Wellness: Virgin Pulse
Eligibility and Qualifying Events
EMPLOYEE ELIGIBILITY: If you do not enroll during your initial eligibility waiting period, you must wait until the next Open Enrollment period unless you experience a Qualifying Life Event. If you experience a Qualifying Life Event (i.e., birth or adoption of a child, marriage, divorce, loss of other coverage, etc.) you must enroll within 30 days of the Qualifying Event.
DEPENDENT ELIGIBILITY: You may also enroll eligible dependents for benefits coverage. A ‘dependent’ is defined as the legal spouse and/or ‘dependent child(ren)’ of the plan participant or the spouse.
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
*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.
Video Preview
What is a Qualifying Life Event?
What is a Qualifying Life Event?
Medical
The City of Maple Heights offers an HSA Plan through Medical Mutual.
- $2,800/$5,600 single/family In Network deductible then 100% coinsurance
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.
Please see attached Summary of Benefits and Coverage (SBC) for specific details and exclusions.
Health Savings Account (HSA)
A Health Savings Account (HSA) is a tax-free savings account is owned by you, is 100% vested from day one, and let’s 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
Video Preview
Understanding an HSA
Understanding an HSA
Medical Mutual HSA with Avidia Bank
Medical Mutual HSA with Avidia Bank
Full Access 24/7
Once enrolled, you will have 24/7 online access to your HSA and health benefits through My Health Plan.
After logging in, you’ll be able to:
▪ Track HSA and investment balances
▪ Pay for qualified medical expenses
▪ Invest in mutual fund options
▪ Report and reissue a lost or stolen debit card
▪ Use all the health benefits resources on My Health Plan, including My Care Compare and Find a Provider
AccountLink Mobile App
Access your Medical Mutual HSA on the go with Medical Mutual’s AccountLink mobile app. AccountLink lets you manage your Medical Mutual HSA, view your account balance and profile information; submit a claim; and much more from your mobile device. Download the app today for free from the Apple App Store® or Google Play™ by searching for AccountLink.
Medical Mutual Debit Card
Your HSA comes with a Medical Mutual debit card that can be used to pay for qualified medical expenses, including doctor’s visits, prescriptions and more
For more information, please reach out to the Finance Department.
Dental
Your dental coverage is through Guardian.
You may use the dentist 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 balanced billing.
What's Covered?
Preventive: Exams, cleanings, fluoride treatments, sealants, X-rays 80%
Basic Care: Fillings, root canal, scaling and root planing (per quadrant), simple extractions, surgical extractions 80%
Major Care: Anesthesia, bridges, dentures, dental implants, inlays, onlays, veneers, repair of bridges, crowns and dentures 80%
Orthodontia: Child(ren) 50%
Guardian Maximum Rollover Oral Health Rewards
Vision
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 balanced billing.
How often can I obtain services?
Exams: once every 24 months
Frames: once every 24 months
Lenses: once every 24 months
**Please see attached Vision Benefit Summary for more plan details and exclusions.
Basic & 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.
Your Basic Life Benefit
- 100% employer paid.
- 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.
Your Voluntary Life Benefit
- 100% employee paid.
- Coverage for spouse and children is available.
- 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.
Beneficiary Designation
It is important to designate your beneficiaries to ensure that your assets will be distributed according to your direction.
A beneficiary is the person you designate to receive your life insurance benefits in the event of your death. Your contingent beneficiary will receive the benefits of your life insurance if the primary beneficiary cannot. You can change your beneficiaries at any time.
Wellness
Virgin Pulse
A wellbeing resource offered to all City of Maple Heights employees! Move through levels and earn points for the healthy choices you make each day.
Join in 3 easy steps:
- Join Virgin Pulse by visiting join.virginpulse.com
- Read and Accept your Member Privacy Notice
- Enter your preferred email and create a strong password
Employee Assistance Program
Ease@Work
The City provides all employees and their covered dependents with a free employee assistance program through Ease@Work. Licensed counselors support you and your family through difficult times providing confidential assistance 24/7.
- Licensed counselors support you and your family through difficult times providing confidential assistance 24/7
- Improve mental health, reduce stress and make life easier.
Get help with
- Family Conflict
- Work/Life Balance
- Couples/Relationships
- Depression
- Anxiety
- Parenting
- Stress
Ease@Work counseling via phone, web portal, mobile app, chat, and video.
1-800.521.3273
Your employee code: maplehts
Telemedicine
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.
Carrier Resources
Medical Plan - Medical Mutual
Medical Plan Customer Service: 877-730-2221
Website: www.medmutual.com/member
Dental, Vision, Life - Guardian
Customer Service: 1-888-482-7342
Website: www.guardianlife.com
Telemedicine - First Stop Health
Customer Service: 888-691-7867
Website: www.fshealth.com
Employee Assistance - Ease@Work
Customer Service: 800-521-3272
Website: www.easeatwork.com
Contact Us
Client Contacts
Letitia Linker
llinker@mapleheightsohio.com
+1 216-662-6000
Tinita Tillman
ttillman@mapleheightsohio.com
+1 216-662-6000