Dwellworks

Table of Content

  1. Header
  2. Your 2024 Dwellworks Employee Benefits
    1. To Our Employees:
    2. How to Enroll
    3. Open Enrollment
    4. Eligibility & Qualifying Events
  3. Medical & Prescription
    1. Medical Summary
    2. Summary of Benefits and Coverage (SBC)
    3. Prescriptions
    4. Virtual Visits
    5. MMO Resources
    6. MMO Programs
  4. Spending Accounts
    1. Health Savings Account (HSA)
  5. Dental
    1. Dental Summary
  6. Vision
    1. Vision Summary
  7. Basic Life and Voluntary Life
  8. Overview of Short Term & Long Term Disability
  9. New York State Disability & Family Leave
  10. International Travel
  11. Employee Contributions
  12. Understanding your Benefits
  13. Contact Us
  14. Footer

To Our Employees:

To Our Employees: 


Once again this year, we conducted a thorough review of the options available to us and we think we’ve come up with the best possible package. But the process doesn’t stop here—we need you to take an active role in understanding and selecting your benefit options. A strong grasp of the plans available to you will best allow both you and this organization to get the most bang for our buck.  




To help you gain that strong understanding, please read this virtual benefits guide carefully and consult HR with any questions. 


Thank you for all that you do for us!


How to Enroll

All team members have access to our online benefits enrollment platform 24/7 where you have the ability to enroll, select or change your benefits online during the annual open enrollment period, new hire orientation, and for qualifying events.

  • Accessible 24/7
  • View all benefit plan options and your elections
  • View important carrier forms and links
  • Report a qualifying life event
  • Make changes to beneficiary designations and more


Helpful Tips To Consider Before You Enroll


Do you plan to enroll an eligible dependent(s)?

  • If so, make sure to have their social security numbers and birthdates available. You cannot enroll your dependent(s) without this information.

Have you recently been married/divorced or had a baby? 

  • If so, remember to add or remove any dependent(s) and/or update your beneficiary designation.

Did any of your covered children reach their age limit for this year?

  • If so, they may no longer be eligible for benefits, unless they meet specific criteria


REMINDER: if you wish to participate in a Flexible Spending Account and/or Health Savings Account in 2024, you MUST make an active election each year. Prior elections do not carry over.

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


QUALIFYING EVENTS

You can, however, modify your elections under certain circumstances, called "Qualifying Events".


Ready to Enroll?

Complete your enrollment form and hand it into Human Resources.

What is a Qualifying Life Event?

What is a Qualifying Life Event?


When Does My Coverage Start?


If you are a New Hire, you are eligible to participate if you are [full-time and work a minimum of 30 hours per week. Your coverage will be effective 1st of the month following 30 days from your date of hire.]


Open enrollment, your coverage is effective [9/1/2023]

What is a Qualifying 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

Who are my legal dependents?


  • Your legal spouse or domestic partner
  • Your children (up to age 26) including natural children, stepchildren, legally adopted children,

children placed for adoption, children for whom you serve as legal guardian

  • Disabled dependent child(ren) of any age

Medical & Prescription

Dwellworks offers 3 medical plans through Medical Mutual.


A 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. The HDHP is similar to the PPO Plan in that you have the option to choose any provider when you need care. However, in exchange for a lower per-paycheck cost, you must satisfy a higher deductible that applies to almost all health care expenses, including those for prescription drugs. ​ All expenses are your responsibility until the deductible is reached, with the exception of preventive care, which is covered at 100% when you visit a physician in the network. Once the deductible is met, you are responsible for coinsurance for medical expenses and a copay for prescription drug expenses.


Utilizing In-Network providers will allow for the highest level of coverage. In-Network providers agree to accept Medical Mutual's contract rate as the final charge and the member is not balanced billed.


What is a PPO?

What is a PPO?

What is an HDHP with HSA?

What is an HDHP with HSA?


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.

HSA 3000 SBC

HSA 3000 SBC

PPO 1500 SBC

PPO 1500 SBC

PPO 750 SBC

PPO 750 SBC

Prescriptions

TRADITIONAL DRUGS


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 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.


Helpful Rx Cost Savings Tools & Tips:

MAIL ORDER - Many drugs are available in a 90-day supply, rather than the 30-day retail supply. Typically, you will pay less if you choose to get a mail-order 90-day supply.


GOOD Rx - There are many tools online that you can use to save on prescription costs. One is GoodRx.com, an online Rx database that allows you to find what pharmacy is the cheapest for your specific prescription. Additionally, you may be able to find a coupon that will greatly reduce your cost. It is important to remember that many of the coupons can only be used outside of your plan (which will not count towards your maximums).


ASK YOUR DOCTOR – Make sure to ask if there are cost-saving alternatives to the prescription they are providing. Many times, there are generic or different manufacturers that will save you money at the pharmacy.

RX Summary

Managing Prescription Costs

Managing Prescription Costs

Prescription Overview

Prescription Overview

A virtual visit lets you see and talk to a doctor from your mobile device or computer. When you use one of the provider groups in our virtual visit network, you have benefit coverage for certain non-emergency medical conditions. Costs must be paid by you at the time of the virtual visit and will apply toward your deductible and out-of-pocket maximum.


WHEN CAN I USE A VIRTUAL VISIT?  ​

When you have a non-emergency condition and:​

  • your doctor is not available;​
  • you become ill while traveling; ​
  • When you are considering visiting a hospital emergency room for a non-emergency health condition. ​

*Your covered children may also use Virtual Visits when a parent or legal guardian is present for the visit.

​

Examples of Non-Emergency Conditions:​

  • Bladder infection​
  • Seasonal flu​
  • Sinus​
  • Sore throat​
  • Stomach
  • Rash​
  • Bronchitis​
  • Diarrhea​
  • Fever​
  • Pink eye


HOW DOES IT WORK?​

The first time you use a Virtual Visits provider, you will need to set up an account with that Virtual Visits provider group. You will need to complete the patient registration process to gather medical history, pharmacy preference, primary care physician contact information, and insurance information.


Each time you have a virtual visit, you will be asked some brief medical questions, including questions about your current medical concern. If appropriate, you will then be connected using secure live audio and video technology to a doctor licensed to deliver care in the state you are in at the time of your visit. You and the doctor will discuss your medical issue, and, if appropriate, the doctor may write a prescription* for you.


Virtual Visits doctors use e-prescribing to submit prescriptions to the pharmacy of your choice. Costs for the virtual visit and prescription drugs are based on, and payable under, your medical and pharmacy benefit. They are not covered as part of your Virtual Visits benefit.

*Prescription services may not be available in all states.


HOW DO I GET ACCESS?​

Learn more about Virtual Visits and access direct links by downloading the [Virtual Visit App Name] App on your phone.

MMO Resources

Medical Extras

My Health Plan: Access your MMO information 24/7.

A secure website specifically for Medical Mutual members, My Health Plan makes it easy and convenient to manage your plan and your health online. 

  • Search for In-Network doctors, hospitals, and facilities. For example, a less expensive MRI location
  • View your EOB (Explanation of benefits)
  • View plan documents
  • Members that are located outside of Ohio will utilize the Cigna Network - Please visit the My Health Plan website to find a provider.
  • and so much more!!


MedMutual Mobile App

With the Mobile App, you can get access to vital information when you are away from a computer. You can Track Claims and Spending Information, Estimate Costs, Find a Provider and Access your ID Card. Download the app on the Apple Store or Google Play.

Chronic Management Program

If you suffer from one of the conditions below, this program may be right for you:

  • Asthma
  • Heart Fairure
  • COPD
  • Diabetes
  • Hypertension

Call (800) 590-2583 to learn more or enroll in the Chronic Management Program.

MMO Programs

The following MMO programs are offered to all employees at no cost!

Lark

Diabetes Management

Lark

Diabetes Management

LarkHyper

Hypertension

LarkHyper

Hypertension

Lark

Diabetes Prevention

Lark

Diabetes Prevention

SWORD

SWORD

Diabetes Resource

Diabetes Brochure

Diabetes Resource

Diabetes Brochure

Bloom

Women's Health

Bloom

Women's Health

Husk Wellness

Fitness Discounts & Programs Flyer

Husk Wellness

Fitness Discounts & Programs F ...

Spending Accounts

You have the opportunity to contribute to a health savings account on a pre-tax basis which lowers your taxable income. View the information below for important details and guidelines for the various accounts offered by Dwellworks.

A Health Savings Account (HSA) is a tax-free savings account that is owned by you, it is 100% vested from day one, and lets 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 be eligible for an HSA, you must be enrolled in a High Deductible Health Plan (HDHP).


UNDERSTANDING YOUR HSA

  • Pre-tax contributions are deducted through payroll and deposited into your HSA account
  • You can use your HSA available funds to pay for qualified medical expenses tax-free
  • HSA funds can be used for non-eligible expenses but will be subject to regular income taxes and a 20% excise tax penalty
  • Unused funds remain in your account for future use and roll over each calendar year
  • HSAs remain with you even if you change health plans or companies. If you open an HSA and later become ineligible to make contributions, you can still use your remaining funds
  • You can change your HSA contribution at any time during the plan year for any reason.


MAINTAINING RECORDS

To protect yourself in the event that you are audited by the IRS, keep records of all HSA documentation and itemized receipts for at least as long as your income tax return is considered open (subject to an audit), or as long as you maintain the account, whichever is longer.

HSA funds may be used for non-eligible expenses but will be subject to regular income taxes and a 20% excise tax penalty.

Health Savings Account (HSA) Overview

Health Savings Account (HSA) Overview

HSA Contribution Limits

Dental


Dental Benefits through Mutual of Omaha provide comprehensive coverage 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.


NETWORK: Mutually Preferred Dental


How do I find an In-Network Provider? Use the helpful link below!

  • In-Network providers can also be found by visiting your provider’s website below where you can search by location, provider/facility name, or search by specialty.


Did You Know? 

  • You have the freedom to select the dentist of your choice; however, 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.


Pre-treatment Estimate

  • If your dental care is extensive and you want to plan ahead for the cost, you can ask your dentist to submit a pre-treatment estimate. While it is not a guarantee of payment, a pre-treatment estimate can help you predict your out-of-pocket costs.


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.


Looking for more details about how items are covered? Click on the link below to view the formal plan summary.

Dental Insurance Overview Video

Dental Insurance Overview Video

Dental benefit summary

Dental benefit summary

Dental Online Reference for Members

Dental Online Reference for Members

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 summaries provided below.

Dental Summary

Vision


Dwellworks offers vision coverage through Mutual of Omaha 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. Please note: Members may choose between prescription glasses (lenses and frame) and contact lenses, not both.


Did You Know?

Eyes can give doctors a clear picture of overall wellness. That’s why vision care—and vision benefits—can help employees stay healthy. A comprehensive eye exam can detect early signs of serious health problems, such as:

  • Diabetes
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Glaucoma and cataracts


To find out if your provider is in-network, please visit the website below.



Vision Insurance Overview

Vision Insurance Overview

Vision Benefit Summary

Vision Benefit 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 summaries provided below.


Vision Benefit Summary

Basic Life and Voluntary Life

Life/AD&D

Life/AD&D


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 $50,000 Benefit

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.


Voluntary - Employee Paid Life

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 full benefit summary below for additional details.


Employee: $25,000 increments to a maximum of $150,000 ($150,000 GI)

Spouse: $12,500 increments up to $50,000 or 100% of what you elect for yourself ($50,000 GI)

Children: Flat amount of $10,000, one premium covers all of your eligible children


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 the birth of a child.


*Guaranteed Issue (GI) and Evidence of Insurability (EOI)

When you are first eligible (at hire) for Voluntary Life and AD&D, you may purchase up to the Guaranteed Issue (GI) for yourself and your spouse without providing proof of good health (EOI).


Any amount elected over the GI will require EOI. If you elect optional life coverage and are required to complete an EOI, it is your responsibility to complete the EOI and send it to the provider (address will be listed on your form). In addition, your spouse will need to provide EOI to be eligible for coverage amounts over GI, or if coverage is requested at a later date.

Overview of Short Term & Long Term Disability

Short-Term Disability - Employer Paid

Everyday illnesses or injuries can interfere with your ability to work. Even a few weeks away from work can make it difficult to manage household costs. Short Term Disability coverage provides financial protection for you by paying a portion of your income, so you can focus on getting better and worry less about keeping up with your bills. Your coverage pays 60% of your income to a maximum of $750 per week.


Voluntary Long Term Disability

Insurance through Lincoln can pay you a weekly benefit if you have a covered disability that keeps you from working. Long Term Disability insurance can replace part of your income while you recover.


LTD Benefit Features

  • Benefit begins after 90 day elimination period if remain disabled
  • Benefit equal to 60% of pay – the benefit is taxable income
  • The monthly maximum benefit is $6,000; the minimum is $100
  • Pre-existing condition limitations apply for the first 12 months
What is LTD Coverage?

What is LTD Coverage?

What is STD Coverage?

What is STD Coverage?

Short Term Disability Summary

Short Term Disability Summary

Long Term Disability Summary

Long Term Disability Summary

New York State Disability & Family Leave

DBL - PFL flyer image
benefit summary flyer
Lincoln State Disability Summary

Lincoln State Disability Summary

NY State Paid Family Leave Summary

NY State Paid Family Leave Summary

International Travel

Cigna
international travelimage
Welcome Kits and More Information

Username: 05980BMBA Password: Cigna1

Welcome Kits and More Information

Username: 05980BMBA Password: ...

Employee Contributions

Pre-Tax Contributions


You share in the cost of your Medical, Dental, and Vision Benefits. Your employee contributions for these benefits are taken out of your pay on a pre-tax basis as set forth below. In addition, if you elect to contribute to a flexible spending account or a health savings account, those contributions will be taken out of your pay on a pre-tax basis based on your election.


After-Tax Contributions


If you choose to purchase Supplemental Life insurance and Optional AD&D insurance benefits for yourself or your dependents, your contributions will be taken out of your pay on an after-tax basis. You will be able to see the costs for these benefits in the enrollment system when you log in.

Medical Employee Contributions

Dental Employee Contributions

Vision Employee Contributions

What is Preventive Care?

What is Preventive Care?

Benefit Terms Explained

Benefit Terms Explained

How to Read An Explanation of Benefits (EOB)

How to Read An Explanation of Benefits (EOB)

What is Balance Billing?

What is Balance Billing?

What is a Qualifying Event?

What is a Qualifying Event?

Primary Care vs. Urgent Care vs. ER

Primary Care vs. Urgent Care vs. ER

Contact Us

As you consider your benefit options, please be sure to review all available information. If you need further assistance, please reach out to Human Resources.



This is a high-level guide to certain benefits your employer offers. The information in this benefits guide is intended as a general outline of the benefits available under the following welfare benefit programs offered by your employer and should not be considered legal, investment, or other benefits advice. Benefits described are subject to change, amendment, or termination without notice to, or the agreement of, any employee/participant. All protected health information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your benefits guide, contact Human Resources. If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, Federal law gives you more choices about your prescription drug coverage.




Powered By

Insurance services provided through NFP Insurance Services, Inc. (NFPISI), a subsidiary of NFP Corp (NFP). NFP and its subsidiaries do not provide tax or legal advice. This material was created to provide a summary of the subjects covered, but should not be regarded as a complete analysis of these subjects. The services of an appropriate professional should be sought regarding your situation.

Copyright © 2025 NFP Corp. All Rights Reserved.