Plan Year
January 1 - December 31, 2026
What is Open Enrollment?
Open Enrollment is the one time of year that you are able to enroll in or modify your employee benefits for the upcoming plan year. Elections you make at this time will remain in effect until the next Open Enrollment period, unless you have a Mid-Year Election Change Event that allows for a plan change.
What is a Mid-Year Election Change Event?
A Mid-Year Election Change Event (such as marriage, divorce, birth/adoption of a child, or loss of eligibility under another plan) allows you to make plan changes outside of Open Enrollment. If you experience this type of event during the year, you may modify your benefits within 30 days by notifying HR as soon as possible. Learn more.
Who is eligible for benefits?
Full-time employees working 30 or more hours per week, your spouse, and your legal dependents are eligible to participate in the benefit plans.
Who are my legal dependents?
- Your legal spouse
- Your children (up to age 26) including natural, step, legally adopted/placed for adoption, and children for whom you serve as legal guardian
- Disabled dependent children (any age)
When does my coverage start?
Your coverage becomes effective on the first day of the month following 30 days from your date of hire.
How to Enroll
You must complete the enrollment form below in order to be set up with the coverage. Once completed, please submit to your employer to sign and submit to your Human Resource team to process.
- UPMC Health Plan (Medical Coverage): Please complete the UPMC Health Plan Enrollment Form and submit to Sandra Wilkins to process.
- Colonial Life (Accident Insurance)
Understanding Your Benefits
Covered Health Service: A service could be an office visit, test, prescription, or another medical treatment your health insurance covers. Before seeking care, check to make sure the service is covered.
Claim: The request for payment that's sent to your health insurance company after you receive covered care.
Copay: A fixed fee that you must pay for a covered service as outlined in your plan design, usually at the time you receive the service.
Plan Allowance: The set amount your plan will pay for a health service, even if your provider bills for more.
Deductible: The set amount you pay for a covered health service before your plan will begin to pay. Will be outlined within your plan design.
Coinsurance: The percentage of the cost of your covered health care services, that you must pay after you've met your deductible.
Out-of-Pocket Maximum: The most you'd pay for covered care within the plan period. If you hit this amount, your plan pays 100% after it is reached.
Premium: The monthly amount paid (by your employer, a combination of employer and employee or the employee only if voluntary)
In-Network Provider: A doctor, hospital, or other provider in the plan's network. Network providers accept the plan's payment in full. You pay less when you use an in-network provider. With the exception of care for emergent and urgent conditions, if the plan does not offer out of network coverage, you must seek an in–network provider for all covered services.
Out-of-Network Provider: Provider who does not have a contract with your health insurer to provide services to you at a discount. You will generally pay more to see an out-of-network provider. If you have an EPO or HMO plan, you are not covered for out-of-network services (except for emergency and urgent care services).
Formulary: A list of medications covered by your plan sorted by tier. Lower tiers usually mean lower copays.
Medical/Rx
Plan Options
- UPMC Business Advantage EPO - Premium Network
Did you know?
- Preventive services are covered at 100% in-network, and copays and deductibles do not apply.
- You pay less out of pocket if you receive care from an in-network provider.
- You do not need a referral to see a specialist.
Wellness Programs
There are wellness programs to help you maintain your emotional wellbeing included with your UPMC Health Plan benefits. From an Employee Assistance program to wellness coaches, there are many resources available to help you take care of any needs.
Whether you are looking for strategies to increase your current physical activity, quit smoking, help resolve financial/credit issues, heal a personal relationship, or looking for assistance for a family member, help is just a call away.
Voluntary Benefits
City of Beaver Falls provides competitive benefits as part of our total compensation package. Along with our core benefits, we offer these additional voluntary benefits to all employees:
Accident Insurance
A serious injury can cost you a lot of money - not only in medical bills, but in things like 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 can pay a set benefit amount based on the type of injury you have and the type of treatment you need. It covers accidents that occur on and off the job, and it includes a range of incidents, from common injuries to more serious events.
Contacts
As you consider your benefit options, please review all available information and resources found on this site. If you need assistance, please contact:
Michelle Ruff
(412) 600-2341
City of Beaver Falls Contacts
Charles Jones
cjones@beaverfallspa.org
(724) 847-2808
Mayor Dr. Kenya Johns
kjohns@beaverfallspa.org
(724) 847-2808
Paula Durish
pdurish@beaverfallspa.org
(724) 847-2808
Sandy Wilkins
swilkins@beaverfallspa.org
(724) 847-2808 ext.
NFP Contacts
Erica Jones
Account Executive
erica.jones@nfp.com
724-940-9466
Michelle Ruff
Producer / Sales Consultant
michelle.ruff@nfp.com
412-600-2341