City of Vermilion

Table of Content

  1. Header
  2. Your 2026 Benefits
    1. Eligibility
    2. How to Enroll
  3. Medical
    1. Summary of Benefits and Coverage (SBC)
    2. Member Portal
    3. Preventive Care
  4. Prescription
  5. Dental
    1. Dental Summary
  6. Vision
    1. Vision Summary
  7. Life
    1. Beneficiary Designation
  8. Telemedicine
    1. Virtual Mental Health
  9. Employee Contributions
  10. Contact Information
    1. Carrier Contact Information
    2. Vermilion Contact Information
  11. Compliance
  12. Footer

Your 2026 Benefits

Medical: Bywater utilizing Cigna Network

Dental: Lincoln

Vision: Lincoln

Basic and Voluntary Life: Lincoln

Telemedicine: First Stop Health

Eligibility

You are eligible for benefits if you are full-time and work a minimum of 30 hours per week.

New Hire Eligibility: Your coverage will be effective 1st of the month following your date of hire.

Dependent Eligibility: Eligible employees may enroll their dependents for coverage. Eligible dependents include:

  • Your legal spouse
  • Dependent children: up to the end of the month of 26th birthday regardless of student or marital status. The dependent child must meet the carrier’s legal definitions (i.e., child by birth, legal adoption or stepchildren that are required to be covered by court order).

If you do not enroll during your initial enrollment period or the Open Enrollment period, you must wait until the next Open Enrollment period unless you experience a Qualifying Life Event.

Qualifying Life Events

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.

Qualifying events include:

  • 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?

How to Enroll

Complete the below enrollment form if you are,

  • Electing coverage for medical, dental, vision
  • Removing coverage
  • Adding or removing dependents
Enrollment Form

Enrollment Form

Medical

The City of Vermilion offers a PPO Medical Plan through Bywater.

The 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.

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 below.

Medical Summary

Summary of Benefits and Coverage (SBC)

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

Waiting on SBCs

Member Portal

Preventive Care

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

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.

RX Summary

Dental

The City of Vermilion offers dental coverage through Lincoln.

NETWORK: Lincoln Dental Connect

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: Covered at 100% Exams, cleanings, X-rays, fluoride treatments, sealants, space maintainers

Basic: Covered at 80% Fillings, composite fillings, stainless steel crowns, uncomplicated extractions, general anesthesia

Major: Covered at 50% Root canal, scaling and root planing, inlays and onlays, crown lengthening, crown build-up, denture repairs, implants

Orthodontia: Children and adults covered at 50% with a $2,000 lifetime maximum

Individual Deductible: $50

Family Deductible: $150

Calendar Year Maximum Insurance Payout: $1,000 per covered individual

Orthodontic Lifetime Maximum: $2,000

Dental Plan Summary

Dental 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 summary provided below.

Dental Summary

Vision

Vision coverage is through Lincoln. This is a voluntary benefit. The City of Vermilion contributes 100% to the cost of your coverage and 0% toward the cost of your dependent's coverage.

NETWORK: Lincoln Vision Connect

How often can I obtain services?

Exams: once every 12 months

Frames: every 24 months

Lenses: once every 12 months

Elective Contact Lenses: (Instead of glasses) every 12 months

Necessary Contact Lenses: every 12 months

Vision Plan Summary

Vision Plan Summary

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 summary provided above.

Vision Summary

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 Life - Flat $25,000 benefit

City of Vermilion offers Basic Life Insurance through Lincoln.

Voluntary - Employee Paid Life

City of Vermilion offers Voluntary Life Insurance through Lincoln. To elect this coverage please complete the below enrollment form.

Your Voluntary Life Benefit

  • 100% employee paid.
  • Coverage for spouse and children is available.
  • Benefits reduced at age 70.
  • Convertible: When coverage ends with your plan you can convert your benefit to an individual permanent life policy.
  • Portable: If you terminate employment, you can maintain your coverage as an individual plan.

Employee: $10,000 increments up to 5x your annual salary, to a maximum of $500,000

Spouse: $5,000 increments up to $500,000 or 50% of employee amount

Children: Birth to 14 days: $2,000. 14 days to 26 years: $20,000

Life Plan Summary

Life Plan Summary

Who's Your Beneficiary?

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.

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

Please make sure your beneficiary designation is up to date with HR.

Telemedicine

First Stop Health offers employees and their family members quick, convenient and FREE access to care via phone or video for urgent care needs and mental health counseling. Avoiding in-person visits saves patients travel, wait times and keeps them out of germy waiting rooms.

Telemedicine treats non-emergency, common issues like sinus infections, sore throats, earaches, dermatological conditions and more. Doctors can also advise on physical problems and answer medical questions.

First Stop Health members can talk to a doctor 24/7 within 6 minutes (on average) using the mobile app, website or with a phone call. Patients avoid waiting rooms, paperwork and get the quality, convenient care they deserve.

How it Works:

Step 1: Request a visit.

  • Register via mobile app, website or phone call.

Step 2: Talk to a doctor.

  • A doctor will call you directly or join with video on the mobile app or website (typically in under 6 minutes)

Step 3: Get a diagnosis & treatment within minutes.

  • Your doctor will listen to your symptoms, diagnose your issue and provide a treatment plan.

Step 4: Get back to life!

  • If your doctor wrote you a prescription, you'll be able to pick it up at your preferred pharmacy and get back to what matters most.
FSH

Virtual Mental Health

Mental health is about more than whether or not you have a mental illness – it includes the way you think, feel and act. Taking care of your mental health doesn’t just mean self-care Sundays and morning yoga. While those things may be helpful, it’s also normal to need support from a doctor, counselor or other resource.

First Stop Health: Virtual Mental Health Services can help with:

  • Anxiety
  • Depression
  • Stress
  • Greif
  • Work and family concerns
  • Substance Abuse

How it works:

  • Patients initiate consults using the FSH app, website or phone.
  • Members are set up with experienced care representatives, who assess your concerns and schedule you with the appropriate licensed counselor.
  • Consultations occur via phone or video.
  • If appropriate, additional care can be referred and coordinated with mental health specialists.

*All counselors hold a Master's-level degree or above in counseling, social work, psychology or related mental health profession.

*You can request a specific counselor gender

*Members see the same counselor throughout their experience

*$0 cost to employees and their family members (employees can add up to 7 family members to use FSH free of cost)

Employee Contributions

"Contributions are estimated based on current union contract language."

Medical Contributions

Carrier Contact Information

Medical Plan - Bywater

Website: Bywater Benefits - Member Portal

Customer Service: 800-337-0792

Dental, Vision, Life Plan - Lincoln

Website:

Customer Service:

Telemedicine - First Stop Health

Website: First Stop Health | Telemedicine | Virtual Care (fshealth.com)

Customer Service: 888-691-7867

Vermilion Contact Information

Amy Hendricks

Finance Director

440-204-2425

ahendricks@cityofvermilionohio.gov

Beth Williamson

Payroll/Benefits

440-204-2427

bwilliamson@cityofvermilionohio.gov

Compliance

2026 Annual Notices

2026 Annual Notices

2025 Medicare Part D

2025 Medicare Part D

Marketplace Exchange Notice

Marketplace Exchange Notice

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