Table of Content
- Header
-
Page
- What's New for 2023!
- How To Enroll?
- Medical Benefits
- Pharmacy Updates
- Virtual Visits
- Dental Benefits
- Vision Benefits
- Life/ AD&D
- Disability Benefits
- 401k
- Plan Documents
- Contact Us
- Footer
What's New for 2023!
Pharmacy- SaveonSP with Medical Mutual
How To Enroll?
ENROLLMENT INSTRUCTIONS:
1.You will receive an Email with a link to Ease. Click the blue “login” button with the email message to be directed to the enrollment portal.
2.Enter your User ID and password
3.If you do not remember your User ID and Password, please contact Carolyn Paris with NFP at carolyn.paris@nfp.com.
4.Follow instructions and enroll in your benefits
5.Make sure to sign your forms, save your elections and print your confirmation statement.
Click on the link below to enroll into your benefits
Medical Benefits
Medical: Provided through Medical Mutual of Ohio
•HSA Plan: $5,000/$10,000 Deductible with 100% Coinsurance with underlying Health Reimbursement Arrangement.
- - HRA PLAN: $3,000/$6,000 Deductible In-Network
•NEW ID Cards will be issued for 01/01/2023. MMO is changing their national network from Aetna to Cigna PPO.
HSA Plan
PLAN BENEFITS
In-Network
Out-of-Network
DEDUCTIBLE
Single Deductible
$5,000
$15,000
Family Deductible
$10,000
$30,000
COINSURANCE (applies after deductible is met) & Out of Pocket Max (includes coinsurance and deductible)
Plan Pays
100%
70%
Single Out of Pocket Maximum
$6,900
$20,700
Family Out of Pocket Maximum
$13,800
$41,400
MEMBER COPAYMENTS
Primary Care (PCP) - Office Visit
100% after deductible
70% after deductible
Preventive Services
100% no deductible
70% after deductible
Prenatal Services
100% no deductible
70% after deductible
Specialist - Office Visit
100% after deductible
70% after deductible
OP Lab, X-Ray, MRI/Cat Scan
100% after deductible
70% after deductible
Hospital IP, OP Surgery
100% after deductible
70% after deductible
Urgent Care Facility
100% after deductible
70% after deductible
Emergency Room Visit***
100% after deductible
Only true emergencies will be covered
RX COPAYS after Deductible
Retail 30-Days
Mail Order 90-Days
Tier 1
$10 copay
$25 copay
Tier 2
$40 copay
$120 copay
Tier 3
$70 copay
$210 copay
Tier 4
25% up to $350 (30-day only)
HOW TO FND A PROVIDER IN NETWORK
Click on the white Medical Mutual button below and follow the steps listed.
1. Click on “Find a Doctor”
2. Select “Group” on plan type and click “Next”
3. Select “2023” for the plan year
4. Select Medical
5. Choose “SuperMed PPO” for the network
6. Enter in your location (or zip code)
7. You can now search by specific doctor, location,
or browse a category.
Pharmacy Updates
Medical Mutual is implementing the following pharmacy program enhancements:
SaveonSP – Manufacturers provide savings for certain specialty drugs
•Target specialty drugs across several therapy classes
•Members who enroll in this program will receive a $0 copay amount of these drugs
•Specialty drugs are filled exclusively by these pharmacies:
•Accredo (owned by Express Scripts)
•Gentry Health Solutions (owned by Discount Drug Mart)
•University Hospitals Specialty Program
Home Delivery Active Choice – Member’s choice Mail Order or Retail
•Letters will be sent to members who are currently filling long-term prescriptions at a retail pharmacy 60 days before 01/01/2023
•Select Home Delivery Active Choice requires you to notify ESI of your preference for filling your prescriptions. If you prefer to continue filling your prescriptions at your local retail pharmacy, you need to let ESI know before your fourth fill to ensure that the amount you pay continues to apply to your deductible and maximum out of pocket. Or if you want to switch to home delivery, ESI can help you get started.
•To let ESI know your preference, just call the Rx number listed on member ID card and advise they want to continue to fill prescriptions at their retail pharmacy.
•An example of switching to Home Delivery
Please refer to the Employee Benefit Guide for more Information. Click on the Button below to download the benefit guide.
Virtual Visits
Telehealth, also known as telemedicine, has been gaining popularity with the healthcare providers and patients alike. Telehealth appointments allow you to stay connected with your providers and obtain needed medical care through live video chats using a computer or mobile device.
Are telehealth visits covered under my plan?
As with any health benefit, your plan determines how virtual visits are covered. Generally speaking, virtual visits are covered the same as a standard office visit when you have an existing relationship with the provider. You can use telehealth for routine care for acute conditions such as sore throat, sinus infection, or chronic health conditions, such as diabetes or high blood pressure. Behavioral health visits are also included.
Do I need to make an appointment?
If you have an existing relationship with a healthcare provider, you would need to contact them to set up a telehealth appointment. This is called a scheduled telehealth visit. You can also schedule telehealth visits for behavioral health services once you have had an initial face-to-face visit with the provider.
If you want to speak to a healthcare provider right away, you can use an on-demand telehealth service, if it is covered by your plan. An on-demand telehealth visit is similar to walking into an urgent care center. You do not need to schedule an appointment. You can log in for a telehealth visit anytime and you will be assigned to the first available provider. Behavioral health visits are not covered as on-demand telehealth visits.
Click the bottom below or call Medical Mutual Customer Care at 800-362-4700
Dental Benefits
Dental: Provided through Lincoln with no plan changes
Base Dental
Buy-Up Dental
PLAN FEATURES
In-Network
Out of Network
In-Network
Out of Network
Network Details
Lincoln PPO
N/A
Lincoln PPO
N/A
Benefit Period
Calendar Year
Calendar Year
DEDUCTIBLE
Single $0
Family $0
$0
$0
When receiving Basic and Major services
(Does not apply for Preventive services)
COVERED SERVICES
CLASS I:
Preventive Services
Routine oral exams and cleanings, x-rays (bitewing), sealants & fluoride treatments
Covered at
100%
Covered at
100%
MAC
Covered at
100%
Covered at
100%
UCR
CLASS II:
Basic Services
Periodontics (surgical & non-surgical), endodontics (root canals), oral surgery, fillings, prosthetic maintenance & x-rays (full mouth)
Covered at
50%
Covered at
50%
MAC
Covered at
80%
Covered at
80%
UCR
CLASS III:
Major Services
Prosthodontics, crowns, inlays/onlays,
dentures, implants & bridges
Covered at
30%
Covered at
30%
MAC
Covered at
60%
Covered at
60%
UCR
CLASS IV:
Ortho Services
Lifetime Max - $1,500
Covered at
50%
Covered at
50%
MAC
Covered at
50%
Covered at
50%
UCR
ANNUAL MAXIMUM
Maximum Benefit
Allowed per Benefit Period
$1,000 per covered individual
$1,500 per covered individual
Need help finding a Dentist click on the link below.
Vision Benefits
Vision Exam
$10 copay
Up to $45
COVERED SERVICES – LENSES / FRAMES
Single Lenses
$25 copay
Up to $40
Bifocals
$25 copay
Up to $60
Trifocals
$25 copay
Up to $80
Frames
$130 retail allowance,
plus 30% off remaining balance
Up to $45
COVERED SERVICES
Contact Lenses
$125 retail allowance
Up to $125
Contact Lens Evaluation Fitting
Included in Exam
with covered contact purchase
No discounts
BENEFIT FREQUENCY
Exams
Once every 12 Months
Lenses
Once every 12 Months
Frames
Once every 24 Months
Contacts
Once every 12 Months
(contacts in lieu of frames/lenses)
Life/ AD&D
VOLUNTARY LIFE INSURANCE
Employees have the opportunity to enroll in supplemental Life insurance. If you choose to enroll in employee coverage, this will be in addition to your employer provided Basic Life coverage. Coverage is also available for your spouse and/or child dependents. It is typically required that you elect coverage for yourself in order to be eligible for coverage on your dependents.
Click on the Button below!
Disability Benefits
SHORT-TERM DISABILITY (STD)
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.
LONG-TERM DISABILITY (LTD)
Serious illnesses or accidents can come out of nowhere. They can interrupt your life, and your ability to work for months – even years.
Long Term Disability provides financial protection for you by paying a portion of your income, so you have financial support to manage your disability and your household.
401k
Get Started and Save for the Future!
With EnviroScience, Inc. 401k Plan. This 401k plan is offered by Fidelity Investments
Click on the button below
Plan Documents
Contact Us
Donna Barona
Human Resource Director
(234) 602-0332
Denise Bidgood
Payroll & HR Administrator
(440) 241-4499
Account Team Contacts
Susan Justavick
Account Manager
susan.justavick@nfp.com
(216) 264-2707
Additional Contacts
Carolyn M. Paris
Benefit Coordinator
carolyn.paris@nfp.com
216.816.0010