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Medical: Bywater utilizing Cigna Network
Dental: Lincoln
Vision: Lincoln
Basic and Voluntary Life: Lincoln
Telemedicine: First Stop Health
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:
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:
Complete the below enrollment form if you are,
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.
Looking for more details about how items are covered? Please refer to the formal Summary of Benefits and Coverage (SBC) below.
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.
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.
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
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.
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
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.
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
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
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.
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.
Step 2: Talk to a doctor.
Step 3: Get a diagnosis & treatment within minutes.
Step 4: Get back to life!
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:
How it works:
*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)
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
Amy Hendricks
Finance Director
440-204-2425
ahendricks@cityofvermilionohio.gov
Beth Williamson
Payroll/Benefits
440-204-2427
bwilliamson@cityofvermilionohio.gov