LCR - Wickliffe,City of

Table of Content

  1. Header
  2. Page
    1. 2023 Updates
    2. 2023 Benefits Overview
    3. Enrollment
    4. Eligibility and Qualifying Event Changes
    5. Medical
    6. EPO Plan
    7. Lake Blue Plan
    8. CVS
    9. Dental
    10. Delta Member Portal and ID Cards
    11. Vision
    12. Basic & Voluntary Life
    13. First Stop Health
    14. EASE@Work
    15. Additional Resources
    16. Contact HR
  3. Footer

2023 Updates

New Vision Carrier!

  • Delta Vision will be your vision carrier for 2023.


Medical Mutual

  • New out-of-state network: Medical Mutual out of state network will be moving from Aetna to Cigna.
  • EPO Plan: Network moving from SuperMed Plus to MedFlex effective 1/1/2023. MedFlex plan does not include the Cleveland Clinic.


First Stop Health

  • Virtual Primary Care has replaced the Virtual Mental Health stand-alone platform effective 1/1/2023. This is a more comprehensive virtual visit feature available to all employees enrolled in the health plan.

2023 Benefits Overview

Medical Mutual: will continue as your medical carrier.

  1. EPO Plan - New for 2023: Moving to Medical Mutual MedFlex Network. Network does not include the Cleveland Clinic.
  2. Lake Blue Plan: No changes


CVS Caremark: will continue as your Prescription Drug carrier for retail and mail order prescriptions.


Delta Dental: will continue as your dental carrier with no plan changes.


EyeMed: will continue as your vision carrier for you vision exam only when enrolled in the medical plan.


Delta Vision: NEW CARRIER: Delta will be the new vision buy up carrier for 2023.


Reliance Standard: will continue as your Basic and Voluntary Life benefit carrier.


First Stop Health: will continue as your telemedicine virtual health carrier.


EASE@Work: will continue as your employee assistance program vendor.

Enrollment

To enroll in benefits through your employer, you must log in to BenXpress and make elections for you and your eligible dependents. Please see your HR/Business office to confirm benefits that are not elected through BenXpress.


  • Go To: https://www.benxpress.com/lakecounty
  • Username: First initial, plus your last name, then last 2 digits of birth year
  • Password: Last four of your social security number


Eligibility and Qualifying Event Changes

Eligibility


Employee Eligibility: Employees are eligible when working a minimum of 30 hours per week. Benefits begin 1st of the month following date of hire.


If you do not enroll during the Open Enrollment 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: Eligible employees may enroll their dependents for coverage. Eligible dependents include:

  • Your legal spouse: If your spouse has coverage at his/her employer, they are not eligible for coverage under Lake County per the spousal waiver policy.
  • You MUST submit a copy of your Marriage License. If you have already submitted this documentation previously, you do not need to resubmit.
  • Dependent children: up to the end of the month of 26th birthday (medical only) 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).
  • You MUST submit a copy of each child’s Birth Certificate. If you have already submitted this documentation previously, you do not need to resubmit.


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?

2023 Spousal Waiver

2023 Spousal Waiver

2023 Election Form

2023 Election Form

Medical

The City of Wickliffe offer 2 plan options through Medical Mutual.


  • The EPO Plan and the Lake Blue Plan. The EPO plan through Medical Mutual utilizes the MedFlex network. This is a narrow network of providers but offers a more competitive rate and benefit schedule, such as a lower deductible.

  • The Lake Blue Plan through Medical Mutual utilizes the SuperMed Plus network which is a broader network. For more detail on these two plans, please refer to the EPO and the Lake Blue sections.


For more information on how to access resources with your benefits, please see the attached member guide, as well as the resource on the Medical Mutual app. For specifics on your schedule of benefits, please refer to your benefit guide or summary of benefits and coverages.

EPO Plan

Medical Mutual MedFlex Presentation

Medical Mutual MedFlex Presentation

EPO Plan (MedFlex Network):


The EPO Plan provides In-Network benefits only and has a narrower network. To take advantage of the plan benefits you must utilize providers that are in Medical Mutual's MedFlex Network. The MedFlex network does not include the Cleveland Clinic. If you are choosing this plan, it is highly recommended that you confirm that your provider is in this network. Again, this is a plan that only offers coverage in-network. If you seek care from a provider that is not In-Network, you will be responsible for the cost.


One distinction to the above in-network benefits, is if you are seeking service outside of the MedFlex network while traveling. In this situation, Medical Mutual will cover Out-of-Network convenience clinic and urgent care visits as In-Network.


The below link will take you to the Medical Mutual site where you can look up whether your provider is covered in the MedFlex network. If you have any questions, please don't hesitate to reach out to the customer service number on the back of your Member ID card.

Lake Blue Plan

The Lake Blue Plan is a 3 Tier plan that offers additional saving opportunities if you seek service from a Lake County -based provider (see attached resources):


  • Tier 1 offers savings opportunities with a lower copay if you use a provider that is on the customized Lake Blue Provider Panel; providers that are in the Lake Health or UH System in Lake County.
  • Tier 2 has a slightly higher schedule of benefits, but utilizes the broad SuperMed Plus Network through Medical Mutual
  • Tier 3 is your non-network benefits if you do not use a provider on either the Lake Blue panel of providers (Tier 1) or a provider in the SuperMed Plus network. Please remember that you can be balanced-billed if your provider is not in-network.


Effective January 1, 2023, Beachwood Medical Center located at 25501 Chagrin Blvd. and UH Geneva Medical Center located 870 W Main St. are part of Tier 1 coverage for the Lake Blue Plan effective. These two facilities along with all UH facilities in Lake County will make up Tier 1 beginning in January 2023. Again, please reference the attached panel of providers to confirm they are part of Tier 1.

Lake Blue Tier 1 Provider Panel - A

Lake Blue Tier 1 Provider Panel - A

Lake Blue Tier 1 Provider Panel UH - B

Lake Blue Tier 1 Provider Panel UH - B

CVS

Your prescription benefits are through CVS Caremark. There is a mandatory mail order through Caremark or at a CVS Pharmacy after the third pharmacy fill. All prescription copays are tracked separately from medical. 




Dental

Delta Dental remains the carrier for your dental benefits.


Employees are eligible for benefits on the first of the month following 30 days of employment.


You may go to any dentist. However, those who belong to the Delta Dental PPO network will be most cost effective.


What is covered?

  • Preventive Services: Exams, cleanings, fluoride, space maintainers, sealants, X-rays covered at 100%
  • Basic Services: Fillings, crown repair, root canals, extractions & dental surgery covered at 100%
  • Major Services: Crowns, repairs to prosthetic appliances, bridges, implants, dentures covered at 80%
  • Orthodontic Services: covered at 50% through age 18 and under


**Please refer to attached Benefit Summary for more plan details and exclusions.

Dental Insurance

Dental Insurance

Dental Benefit Summary

Dental Benefit Summary

Visit your Delta Member Portal 24/7 to have access to important information about your benefits. Member Portal can be accessed online or with your mobile device.


1.Visit www.memberportal.com

2.Log in using your existing Toolkit credentials or if you do not have credentials click "sign up"


On your Member Portal you can,

  • See which members are covered on your plan
  • Find In Network dentists
  • Search and compare dental offices to find one that suits your needs. You can safe your preferred dentists to your account for quick access.
  • Access an online ID card
  • Save your card to your device for quick access via the app, or in Apple or Google Wallet.
  • View status of claims for you and your family
  • View and print your Explanation of Benefits (EOB)





Call Toolkit Support at 866-356-0301 or email support@deltadental.com with questions.

How to obtain your Delta ID Card

How to obtain your Delta ID Card

Vision

EyeMed remains the carrier for your vision exam only benefits when you enroll in the medical plan.


NEW CARRIER: Delta will be your new vision Buy-Up plan carrier for 2023.


  1. Basic EyeMed Vision Plan - The City of Wickliffe pays 100% for your basic vision exam when you are enrolled in medical coverage. Provider must be in network. Exam only is covered.
  2. Buy-Up Delta Vision Plan - This is a voluntary plan that provides coverage for exams and materials. In network providers allow for higher coverage.


When enrolled in the Delta Vision Plan you may go to any eye care provider. However, those who belong to the VSP Choice Network will be most cost effective.


How often can I obtain service?

  • Exams: Once every 12 months
  • Lenses: Once every 12 months
  • Frames: Once every 24 months
  • Contact Lenses: Once every 12 months


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

Vision Insurance

Vision Insurance

Delta Vision Benefit Summary

Delta Vision Benefit Summary

Basic & Voluntary Life

Certificate of Coverage (COC)

See whats included with your Reliance benefits

Certificate of Coverage (COC)

See whats included with your R ...

Reliance Standard remains the carrier for your Basic and Voluntary Life Insurance benefits.


All eligible employees are automatically enrolled in Reliance Standard Group Term Life & AD&D insurance through The City of Wickliffe.


Your Basic Life Benefit

  • 100% company paid benefit, no cost to you
  • Flat $30,000 benefit for most employees*
  • Portable
  • Continue your term insurance if your employment ends
  • Convertible
  • To individual life policy when coverage ends under the plan


Your Voluntary Life Benefit

  • Available to active full-time employees
  • 100% employee paid benefit
  • Spouses and children may also be eligible
  • See Plan Summary for Volume Amount details


*Patrolmen, Police Dispatchers, Police Sergeants & Lieutenants receive $50,000. Part-time police and part time fire do not receive the AD&D benefits.

First Stop Health

First Stop Health will continue to be offered in 2023 with the addition of their Virtual Primary Care feature as a replacement to the Virtual Mental Health tool.


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

About Virtual Primary Care

About Virtual Primary Care

EASE@Work

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


EASE@Work Member Portal Flyer

EASE@Work Member Portal Flyer

Additional Resources

Medical Plan - Medical Mutual

Medical Plan Customer Service: 877-730-2221

Website: www.medmutual.com/member


Prescription Plan - CVS Caremark

Customer Service: 800-776-1355

Website: www.caremark.com


Dental and Vision - Delta

Customer Service: 800-524-0149

Website: customerservice@ddpmi.com


Basic Vision Plan - EyeMed

Customer Service: 1-866-723-0513

Website: Vision Benefits (eyemedvisioncare.com)


Basic & Voluntary Life AD&D - Reliance Standard

Customer Service: 800-351-7500 

Website: www.reliancestandard.com/home/


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 HR

Debbie Doles

440-943-7118

ddoles@cityofwickliffe.com