ESC of Northeast Ohio Benefits

To Our Employees:

Highlights of your benefit plans include:

  • Medical - MMO
  • Dental - MetLife
  • Vision - Anthem
  • Basic Life - MetLife
  • Voluntary Life - MetLife
  • FSA/DCA - HealthEquity

To help you gain a strong understanding, please review this virtual benefit guide carefully and consult HR with any questions.

Thank you for all that you do for us!

How to Enroll - BenXpress

All team members have access to our online benefits enrollment platform 24/7 where you can 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

ENROLLMENT INSTRUCTIONS:

To enroll in benefits through your employer, you must log in to BenXpress and make elections for you and your eligible dependents.

Go To: https://www.benxpress.com/escneo

Username: first initial and last name

Password: Last 5 digits of your social security number

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

Documents are required to be uploaded to BenXpress for adding a dependent (birth certificate, marriage license, court document).

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

Spousal Waiver

If the employee's spouse is employed and eligible for employer- sponsored health insurance benefits, the spouse is ineligible for the medical insurance offered by the Plan. This requirement does not apply to a spouse that is not employed, retired, or employed with no access to employer-sponsored group health insurance. This provision is for Medical/Prescription Drug coverage only and does not affect Vision or Dental coverage.

Spousal Waiver Forms are now required to be submitted for any spouse who is employed and on the ESC health insurance.

For additional questions, please contact Kim Sperling.

Spousal Waiver Form

Spousal Waiver Form

Eligibility & Qualifying Events

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 on BenXpress.

When Does My Coverage Start?

  • New Hire: Benefits are effective first of the month following date of hire

  • Open Enrollment: Benefits are effective July 1

  • Qualifying Event: Benefit changes effective date of event

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 Medicaid

Who are my legal dependents?

  • Your legal spouse
  • 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 - coverage will terminate for dependents at the end of the calendar month in which the child reaches age 26
  • Disabled dependent child(ren) of any age

Open Enrollment

Annual enrollment is your opportunity to learn about your benefits, review your current coverage and choose the best options for you and your family. Please review this virtual benefit guide to learn more about our benefits offerings.

This annual enrollment will be a "passive open enrollment", which means if you do not make your benefit elections you will remain in the same plan as your current benefits for this plan year.

Open Enrollment is the one time of year when you can update your elections without experiencing a Qualifying Life Event (QLE). The elections that you make will remain in place unless you notify HR within 30 days of your QLE to be eligible to make new elections.

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

Open enrollment image

Medical & Prescription

ESC offers medical coverage 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.

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, except 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.

Annually, The ESC contributes $1,000 ($250 a quarter) for Employee only coverage and $2,000 ($500 a quarter) for Family coverage. These funds are deposited into your Health Savings Account and may be used for your medical, dental, or vision expenses.

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

Summary of Benefits and Coverage (SBC)

The updated 7.1.2026 summary of benefits are coming soon.

Looking for more details about how items are covered? Please refer to the formal Summary of Benefits and Coverage (SBC) below.

Medical Mutual - Skyway

Medical Mutual - Skyway

Medical Mutual - HSA Single

Medical Mutual - HSA Single

Medical Mutual - HSA Family

Medical Mutual - HSA Family

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 | 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 have 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 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.

MMO Resources

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.

Medical Extras

First Stop Health - Telemedicine

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

Spending Accounts

You have the opportunity to contribute to a variety of savings and/or spending accounts on a pre-tax basis which lowers your taxable income. View the information below for important details and guidelines for the various accounts offered.

Health Savings Account (HSA)

If you enroll in the High-Deductible Health Plan, you have the opportunity to enroll in a Health Savings Account (HSA) that 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.

Flexible Spending (FSA) & Dependent Care Accounts (DCARE)

The Health Care and Dependent Care Flexible Spending Accounts (FSA) allow you to set aside pre-tax dollars to pay for eligible expenses. By contributing to one or both of the Flexible Spending Accounts you reduce your taxable income, so you pay less in taxes — which saves you money.

Contributions

The election you make during enrollment is your election for the entire plan year. You may change it only if you have a qualifying life event and the change request must be consistent with the event.

You may contribute as follows:

Health Care FSA

  • Up to $3,400 annually
  • All benefit-eligible can participate unless you or your spouse are contributing to an HSA.
  • Reimbursements allowed for unreimbursed medical, prescription, dental, and vision expenses

The Dependent Care FSA

Allows you to pay for eligible dependent care expenses with tax-free dollars so that you and your spouse can work or attend school Full-time.

Funds in a Dependent Care FSA are only available once they have been deposited into your account and you cannot use the funds ahead of time.

  • You may set aside up to $7,500 annually in pre-tax dollars, or $3,750 if you are married and file taxes separately from your spouse.
  • If you participate in a Dependent Care FSA, you cannot apply the same expenses for a dependent care tax credit when you file your income taxes.

For additional information on FSA, please visit the Health Equity links below.

Dental

Dental Benefits through MetLife 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: Preferred Dental Program (PDP)

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 Summary

Below is a high-level overview of your plan options and in-network benefit information.

ESC Dental Summary

ESC Dental Summary

Vision

Vision coverage through Anthem helps 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 Summary

Below is a high-level overview of your plan options and in-network benefit information.

ESC Vision Summary

ESC Vision Summary

Basic & Voluntary Life

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.

ESC of NE Ohio provides you with an Employer Paid Basic Life Insurance with Accidental Death & Dismemberment, as well as the ability to purchase additional Voluntary Life/AD&D. If you choose to enroll in employee coverage, this will be in addition to your employer-provided Basic Life coverage.

Voluntary - Employee Paid

Cost of Coverage Premiums are based on age-rated tables and paid by the employee every pay period through a payroll deduction. These premiums are post-tax and benefits payable are tax-free. Voluntary life selected after you are first hired will be subject to approval from MetLife.

Coverage Options:

Employee Coverage: Choose in $10,000 increments up to the lesser of 5x your annual salary or $500,000 ($100,000 GI)

Spouse Coverage: Choose in $5,000 increments up to $250,000 or 50% of the employee’s supplemental life insurance amount, whichever is less. ($25,000 GI)

Dependent Coverage: $10,000

*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 child/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 is requested at a later date.

The portability provision allows you to continue Voluntary Term Life Insurance upon loss of eligibility or termination of employment in these situations:

  • Group policy discontinues the eligibility of a class of employees to which you belong
  • You retire
  • You are terminated or change jobs

This Policy will port into a Term policy.

You have 30 days from the loss of eligibility date to port your Voluntary Term Life.

Conversion allows you to convert your Voluntary Term Life Insurance to an individual life insurance policy in these situations:

  • Employment ends
  • You stop being a member of an eligible class of employees
  • Dependent loss of eligibility
  • The policy terminates

This policy will convert to a Permanent Whole Life policy.

You have 30 days from the loss of eligibility date to convert your Voluntary Term Life.

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 in BenXpress*

Rates: July 1, 2026 - June 30,2027

Medical - PPO

Medical - Skyway

Medical - HSA

Dental

Vision

MetLife Resources

MyBenefits member portal: Access your MetLife information 24/7.

A secure website specifically for MetLife members, the MetLife member portal makes it easy and convenient to manage your plan and your health online.

  • Access to all of your plan information and self service capabilities
  • View your EOB (Explanation of benefits) and claims status.
  • View plan documents
  • and so much more!!

Estate Planning Services

Offering unlimited access to create and execute key estate planning documents online by answering a few simple questions, or unlimited face-to-face access with a MetLife Legal Plans’ attorney to prepare or update a will, living will, Power of Attorney and other estate documents. Will preparation services are also available via willscenter.com.

Funeral Discounts and Planning Services

Alleviating the burden of making funeral arrangements from their loved ones. Employees get exclusive access to the largest network of funeral homes and cemeteries to pre-plan with a counselor and receive discounts on funeral services.

Retirement Planning

Helping employees retire with confidence. Employees can attend workshops that offer comprehensive retirement and financial education to help them plan for the future through Retirewise®.

Travel Assistance

Giving financial security while traveling. Employees can access medical, travel, and concierge services— 24 hours a day, 365 days a year, while traveling domestically or internationally.

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AllOneHealth

AllOneHealth (formerly 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.

Well-being Hub

In today's fast-paced and interconnected world, where stress and mental health issues are on the rise, effective well-being plays a crucial role. We recognize that a healthy, content workforce is not only more productive but also fosters a positive culture. We strive for a supportive and inclusive environment where we encourage and support the improvement of physical, mental, emotional, and social well-being. Whether within a corporate setting, a community, or on a personal level, well-being focuses on fostering awareness, empathy, and support to create a healthier and more balanced workplace and environment for all. Prioritizing employee wellness and wellbeing is not just a policy but a reflection of our commitment to both the individual and collective success of the team.

To access the wellbeing newsletter, which includes resources, tips, recipes, and more, please select the button below.

Wellbeing image
Carrier Contacts

Carrier Contacts

Questions?

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.



Client Contacts

KS

Kim Sperling

kim.sperling@escneo.org

216-524-3000