City of Wickliffe Benefits

Table of Content

  1. Header
  2. 2025 Benefits Overview
  3. Eligibility
    1. Spousal Waiver and Enrollment
  4. How to Enroll
  5. Medical
    1. Overview
    2. EPO Plan
    3. Lake Blue Plan
    4. MedMutual My Health Plan/Mobile App
    5. Medical Mutual Total Health
    6. 24/7 Nurse Line and Care Navigation
    7. Maternity Management and NICU Management
    8. Transitional Care and Palliative Care
    9. Virtual Physical Therapy
    10. Digital and Telephonic Health Coaching
    11. Preventive Care
  6. Prescription
    1. Overview
    2. ImpaxRX
  7. Health Reimbursement Account
  8. Dental
    1. Overview
  9. Vision
    1. Overview
    2. TruHearing Discount Program
    3. Additional Value Adds through Delta
  10. Life
    1. Overview
    2. Beneficiary Designation
  11. Telemed
    1. Overview
  12. EAP
    1. Ease@Work
  13. NEW! Aflac Coverage
  14. NEW! Pet Insurance
  15. Employee Contributions
  16. Contact Information
  17. Compliance
  18. Footer

2025 Benefits Overview

Medical: Medical Mutual

Prescription: CVS Caremark / RXBenefits

Dental: Delta

Vision: Delta

Basic/Voluntary Life: Reliance Standard

Accident & Critical Illness: AFLAC

Pet Insurance: Nationwide

Telemedicine: First Stop Health

Employee Assistance Program: Ease@Work

Eligibility

The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire year.

EMPLOYEE ELIGIBILITY

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

New Hires: Your coverage will be effective first of the month, following 30 days from your date of hire.

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. 

If your spouse has coverage through his/her employer, they are NOT eligible for City of Wickliffe medical coverage. To enroll your spouse, you must complete the spousal waiver and enrollment form.

You can modify your elections under certain circumstances, called "Qualifying Events" These are events such as marriage, divorce, birth or adoption of a child, or 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.

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 Medical

What is a Qualifying Life Event?

What is a Qualifying Life Event?

If you are enrolling your spouse on the medical plan, please complete both forms below and return to HR no later than 11/18/24.

Spousal Waiver Form

Spousal Waiver Form

Spousal Statement of Coverage

Spousal Statement of Coverage

How to Enroll

open enrollment

**Please note that if you DO NOT go into BenXpress to make elections your current 2024 elections will rollover to 2025, and you will automatically waive the Aflac coverage**

Elections in medical, Aflac and pet insurance benefits must be completed in BenXpress.

During Initial Enrollment, you may:

  • Elect the same coverage with the same dependents.
  • Add or remove coverage for dependents.
    • If adding a dependent, please provide a marriage certificate for spouse and birth certificate for children.
  • Decline benefits.
  • Enroll if you are not currently enrolled in 2024 plans.
  • Update Life Insurance beneficiaries.
  • Enroll in additional Voluntary Life Insurnace (at your expense).

Please note that your Dental, Vision and Life elections are not made BenXpress. To enroll or change these benefits please complete the enrollment forms and submit to HR.

Employee Username: First letter of first name, plus last name, then last two digits of your birth year (example John Doe, Login: jdoe78)

Employee Password: Last four digits of your social security number (example:1876)

To enroll in benefits please use the BenXpress link below.

The City of Wickliffe offers 2 medical plan options through Medical Mutual.

  1. EPO Plan: this plan uses the Medical Mutual MedFlex Network
  2. Lake Blue Plan: This is a 3 Tier Plan that utilizes the MMO SuperMed Plus Network

Reminder:

  • Your Medical Mutual plan covers 1 annual vision exam. You must present your MMO ID card for this visit.
  • All UH Facilities and Providers are Tier 1 on the Lake Blue Plan effective January 1, 2024.
  • Hearing Aid benefits have been added to both medical plans effective January 1, 2024.

Utilizing In-Network providers will allow for the highest level of coverage. In-Network providers agree to accept MMOs contract rate as the final charge and members are not balance billed. Employees who receive care from an Out of Network provider will be responsible for higher costs and can be balance billed.

Please see Summary of Benefits and Coverage (SBC) of your selected medical plan for specific details and exclusions.

EPO Plan

The EPO Plan utilizes the MMO Medflex Network. This network does not include the Cleveland Clinic. This plan offers In Network benefits only. If you see a Non-Network provider, your services will not be covered, and you will be responsible for the cost. It is important to confirm that your providers are Network providers. The below packet can be downloaded and provides more info and instructions on how you can find a MedFlex Network provider near you.

**Please refer to the Summary of Benefits/Certificate of Coverage from Medical Mutual for a full description of benefits and exclusions**

EPO Summary

Lake Blue Plan

The Lake Blue Plan is a 3 Tier Plan. Tier 1 offers additional savings with a lower copay if you use a provider in the Lake Health or UH Facility/Provider. Tier 2 is the standard MMO SuperMed Plus Network, including the Cleveland Clinic. Tier 3 is your non-network providers.

Please remember, deductibles do not accumulate between tiers. (i.e. You met your deductible for Tier 1, but now use a Tier 2 provider. You will still need to meet the Tier 2 deductible)

Reminder:

  • All UH Facilities and Providers are Tier 1 on the Lake Blue Plan effective January 1, 2024.
Lake Blue Summary

MedMutual My Health Plan/Mobile App

MHP

My Health Plan is Medical Mutuals secure website specifically for Medical Mutual members. It makes it easy to manage your plan and your health online. It allows you to compare your healthcare options so you can make better decisions and minimize cost.

On My Health Plan you can:

  • Check your deductible
  • Review your Explanation of Benefits (EOB)
  • Find in network doctors
  • Access your ID Card

To create your account:

  • Visit MedMutual.com/Member
  • Click on "Register for an Account"

Medical Mutual Total Health

The City of Wickliffe 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

Nurse Line

Members have direct access to MMO nurses. Nurses provide easy to understand explanations about tests and results, how to treat minor illnesses at home, and help determine if you or a dependent need to seek further medical care from a doctor, urgent care, or the ER.

There is no charge to use the MMO nurse line. This is a 24/7 support line.

Reminder: have your group number and member ID readily available. This can be found on your MMO ID card.

1-888-912-0636

Care Navigation Program

Members have access to MMO nurses to assist with goals and developing condition specific care plans. A dedicated care navigator will serve as a personal advocate and single point of contact to help manage a member's conditions and overall health, improve the quality of care they receive and control the cost of their care.

24/7 Nurse Line

24/7 Nurse Line

Maternity Management

Maternity Management

Maternity Management

Medical Mutual provides digital resources to help members prepare for babys arival through age 2. During pregnancy members receive weekly updates and have access to tools to look up symptoms and issues.

Once baby arrives members can track feeding, diaper changes, and milestones through age 2.

You can find the app by searching MedMutual Maternity.

There is no cost associated with the app or its tools for members enrolled on the health plan.

NICU Management with Progeny Health

Medical Mutual has partnered with Progeny Health to increase the level of NICU support. Progeny will reach out to members who may need this support to offer care management to babies and their families through the baby's first birthday.

The Transitional Care Program provides nurse-led health coaching and support with home visits after a high-risk hospital stay. Nurses will help members prepare for their hospital release, visit them at home to check on their progress for up to 30 days after release, and connect them with local resources that can help them stay healthy while living at home.

With the Palliative Care Program, members with advanced illness have access to non-hospice community-based in-home support led by physicians, nurses and social workers, to help improve their quality of life as they manage their treatment plan.

These programs are free to Medical Mutual members on the City of Wickliffe Health Plan.

Virtual Physical Therapy

Medical Mutual virtual physical therapy provides guided physical therapy at home with real-time feedback, which can help members avoid injury and surgery, reduce pain, and decrease reliance on medication.


There programs are offered through THRIVE-SWORD and BLOOM.

Medical Mutuals digital coaching is provided through LARK for members with Diabetes and Hypertension.

Digitial health coaching provides smartphone based coaching customized to meet a member's needs. Depending on your health condition, you may receive free supplies, including scale, glucometer, blood pressure cuff, or more, at NO COST.

See attached flyers for more information on each plan for Diabetes and Hypertension.

Telephonic Health Coaching

  • Asthma
  • Heart Disease
  • Type 1 diabetes
  • COPD

MMO nurses help educate and support members, and work with them to set individualized goals and develop condition-specific care plans.

Nurses are available Monday through Friday, 8am-4pm.

1-800-590-2583

Lark Diabetes Prevention

Lark Diabetes Prevention

Lark Diabetes Management

Lark Diabetes Management

Lark Hypertension Management

Lark Hypertension Management

Preventive Care

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 falls 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

City of Wickliffe prescription drug coverage is administered through CVS Caremark and RXBenefits. Please see below guide for detailed information on your plan's prescription coverage.

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.

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.

Prescription Summary

EPO Plan

ImpaxRX

About ImpaxRX

About ImpaxRX

ImpaxRX is a prescription advocacy program that assists employees and their family members with the high cost of certain eligible medications. If the medications you or a family member are taking are identified as eligible under the Medication Under Management (MUM) program, an ImpaxRX advocate will reach out to you to confirm your enrollment in the program and obtain additional information needed to secure the medication at no cost.

Timely participation with ImpaxRX is required to receive these programs for your high-cost medications. Please respond if ImpaxRX contacts you! This will allow them to work on your behalf to obtain your medication at no cost.

There is no cost to you to participate in this program, and there will be no copayments for eligible medications approved by the program. Additionally, by using the program, the cost of these medications is lowered under the City of Wickliffe Health Plan which allows for savings to keep employee premium contributions to a minimum for all.

Please call ImpaxRX at 844-467-2979, option 1 with questions.

Health Reimbursement Account

An HRA, or Health Reimbursement Account, is a kind of health spending account provided and owned by an employer. The money in it pays for qualified expenses, like medical and pharmacy expenses. Your employer decides what your HRA will pay for. HRA is provided on the Lake Blue Plan.

Medical Mutual will administer the HRA that will offset a portion of the employee deductible as follows:

For Employee-Only Coverage

  • The employee will pay the first $150 of the deductible
  • HRA will fund remainder of deductible, up to $2,000.

For Employee plus Spouse,

  • The employee will pay the first $300 of the deductible.
  • HRA will fund remainder of deductible, up to $4,000.

For Employee plus Child

  • The employee will pay the first $250 of the deductible.
  • HRA will fund remainder of deductible, up to $4,000.

For Employee plus Family

  • The employee will pay the first $400 of the deductible.
  • HRA will fund remainder of deductible, up to $4,000.
What is an HRA?

What is an HRA?

City of Wickliffe offers dental benefits through Delta 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.

PREVENTION FIRST!

Your dental health is an important part of your overall health. Make sure you take advantage of your preventive dental visits. Preventive care services are covered at 100% if you visit an In-Network provider. They are also not subject to the annual deductible.

Dental Summary

Enrollment Form

Enrollment Form

The City of Wickliffe offers vision coverage through Delta to help pay for eye exams, prescription glasses and contact lenses. You receive a higher level of benefits when you see a provider in network, however, out-of-network coverage is provided but may only be handled as reimbursements in some situations.

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.

HOW OFTEN CAN I OBTAIN SERVICES?

  • Exams: Once every 12 months
  • Lenses: Once every 12 months
  • Frames: Once every 24 months
  • Elective Contacts: Once every 12 months

Remember you can also use your Medical Mutual coverage for 1 annual vision exam as well.

Vision Summary

Enrollment Form

Enrollment Form

VSP Vision Care members can save up to 60% on brand-name hearing aids. Dependents and extended family members are also eligible for savings.

TruHearing Provides Members with:

  • One year of follow up visits for fittings, adjustments, and cleanings
  • 60-day trial
  • 3-year manufacturer warranty
  • 80 free batteries per hearing aid (if applicable)
  • Access to national network
  • Batteries delivered to your door

See attached flyer for more information on your TruHearing discounts.

TruHearing Flyer

TruHearing Flyer

Laser Vision Care

Laser Vision Care

Premier Edge

Premier Edge

Eyeconic Benefits

Eyeconic Benefits

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 through Reliance - Amount based on job class

A sudden accident or death can leave you or your loved ones in a vulnerable position. The City of Wickliffe provides Basic Life and AD&D benefit to all full-time employees.

Voluntary - Employee Paid Benefit through Reliance

Coverage is also available for your spouse and/or child dependents, but only after you've elected coverage for yourself. A sudden accident or death can leave you or your loved ones in a vulnerable position. Employees have the opportunity to enroll in Term Life and Accidental Death & Dismemberment insurance which will supplement lost income in the event of an accident or death. If you choose to enroll in employee coverage, this will be in addition to your employer provided Basic Life coverage. Review the attached full benefit summary below for details on reductions, portability and conversion options.

Employee: $10,000 increments up to 5x your annual salary, to a maximum of $200,000

Spouse: $5,000 increments up to $100,000

Children: $1,000 increments up to $10,000

Beneficiary Designation

Who's Your Beneficiary?

Naming a beneficiary is a crucial part of electing life insurance. Also, don't forget to update your primary or secondary beneficiary if you experience a life event, such as a divorce or birth of a child.


Primary Beneficiary: Your primary beneficiary receives your benefits in the event of your death.


Contingent Beneficiary: Your contingent beneficiary receives your benefit, in the event that your primary beneficiary cannot.


*Please make sure your beneficiary information is up to date with your HR office*

Beneficiary Form

Beneficiary Form

First Stop Health Telemedicine and the Virtual Primary Care feature will continue to be offered in 2025.

Members have access to convenient and affordable high-quality primary care with First Stop Health's nationwide network of doctors. Using the app, website or phone call you have access to:

  • Urgent Care: 24/7 access to doctors who connect to patients within minutes.
  • Preventive Care: Schedule virtual doctor visits for routine screenings with coordinated care for lab, imaging and procedure orders.
  • Chronic Care: Schedule virtual doctor visits for the management of ongoing health issues and care follow-up.
First Stop Health Telemedicine

First Stop Health Telemedicine

Ease@Work can help you reduce stress, improve mental health, and make life easier by connecting you to the right information, resources, and referrals. All services are free, confidential, and available to you and your family members. This includes access to short-term counseling and a wide range of services.

  • Mental Health Sessions Manage stress, anxiety, and depression, resolve conflict, improve relationships, overcome substance abuse, and address any personal issues.

  • Life Coaching Reach personal and professional goals, strengthen relationships, and build balance.

  • Financial Consultation Build financial wellness related to budgeting, buying a home, paying off debt, managing taxes, preventing identity theft, and saving for retirement or tuition.

  • Legal Consultation Get help with personal legal matters including estate planning, wills, real estate, bankruptcy.

  • Work-Life Resources and Referrals Obtain information and referrals when seeking childcare, adoption, special needs support, eldercare, housing, transportation, education, and pet care.

  • Personal Assistant Save time with referrals for travel and entertainment, seeking professional services, cleaning services, home food delivery, and managing everyday tasks.

  • Medical Advocacy Get help navigating insurance, obtaining doctor referrals, securing medical equipment or transportation, and planning for transitional care and discharge.

  • Wellness Build holistic well-being with wellness coaching.

  • Member Portal and App These digital tools enable you to access your benefits 24/7/365 with online requests and chat options.

Call: 800-521-3273

Visit: easeatwork.com & select Member Portal & App

Portal Code: lakecounty



The City of Wickliffe now offers Accident and Critical Illness coverage through Aflac.

Accident Protection: A serious injury can cost a lot of money - not only in medical bills but income from lost work hours. If you get hurt, accident insurance pays you money that you can use to cover personal expenses, bills, and out-of-pocket medical costs. Accident insurance pays a set benefit amount based on the type of injury you have and the type of treatment you need. It covers accidents that happen both on and off the job.

Critical Illness: A serious illness can affect you physically and emotionally - what's not so obvious is the effect on your personal finances. Major medical plans may pay for a good portion of the cost associated with a critical illness, however there are a lot of expenses that may not be covered. With critical illness coverage you receive a cash benefit directly, giving you the flexibility to help pay for bills for treatment or everyday expenses.

Please see attached benefit summaries for a full list of covered accidents and illness.

**These coverages are elected in BenXpress**

Accident Benefit Summary

Accident Benefit Summary

Critical Illness Benefit Summary

Critical Illness Benefit Summary

City of Wickliffe now offers Pet Insurance through Nationwide. 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.

Enrollment Kit

Enrollment Kit

Employee Contributions

Medical Contributions

Dental

Vision

Contact Information

Terry Ness

Assistant Finance Director

TNess@cityofwickliffe.com

(440) - 943 - 7118

Medical Mutual

Customer Service: 1-844-583-3072

Website: www.medmutual.com

RX Benefits

Customer Service: 800-334-8134

Email: customercare@rxbenefits.com

Delta

Customer Service: 800-524-0149

Website: www.deltadental.com

Reliance

Customer Service: 800-351-7500

Website: www.reliancestandard.com/home/

Aflac

Customer Service: 800-433-3036

Website: www.aflac.com

Nationwide Pet

Customer Service: 1-877-738-7874

Website: benefits.petinsurance.com/lake-county-board-of-commissioners

First Stop Health

Customer Service: 888-691-7867

Website: www.fshealth.com

Ease@Work

Customer Service: 800-521-3273

Website: www.easeatwork.com

ImpaxRX

Customer Service: 844-467-2979 option 1

Website: www.impaxRX.com

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Compliance

2025 Annual Notices

2025 Annual Notices

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