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Table of Content

  1. Header
  2. Your 2024 Hammontree Benefits
    1. To Our Employees:
    2. Eligibility & Qualifying Events
    3. How to Enroll
    4. Medical
    5. UnitedHealthcare Resources
    6. Virtual Visits
    7. Summary of Benefits and Coverage (SBC)
    8. Prescriptions
    9. Dental
    10. Vision
    11. Basic Life and Voluntary Life
    12. Disability
    13. Hospital Indemnity, Accident and Critical Illness Insurance
    14. Employee Contributions
    15. Understanding your Benefits
    16. Carrier Contacts
  3. Employee Assistance Plan (EAP)
    1. Guardian EAP
  4. Compliance Notices
  5. Questions?
  6. Footer

Your 2024 Hammontree Benefits

To Our Employees: 


Once again this year, we conducted a thorough review of 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.  


This year, we are switching our medical benefits to United Healthcare where we will continue to offer two plans. We also have lowered employee monthly contributions from last year!


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


Thank you for all that you do for us!


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 following 30 days from your date of hire.


Open enrollment, your coverage is effective 9/1/2024

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

Hammontree offers a medical plan through United Healthcare.


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 UHC's contract rate as the final charge and the member is not balanced billed.

Medical Summary

Health Savings Account Contributions

What is a PPO?

What is a PPO?

What is an HDHP with HSA?

What is an HDHP with HSA?

Health Flyer

Health Flyer

Smoking Cessation

Smoking Cessation

Preventive Care

Preventive Care

UnitedHealthcare Resources

Your UHC plan includes additional benefits that can help you become and stay healthy, at no extra cost to you.


myuhc.com

Check out your UHC member website! Myuhc.com is your one-stop resource for all kinds of information to help you manage your health plan benefits and improve your health. The resources listed below can all be accessed through this member website, and after registering on the myUHC website below, you can access a mobile version of the site.


Behavioral Health Virtual Visits

Connect with a provider from your mobile device or computer from the comfort of home. Use a behavioral health virtual visit for needs such as depression, anxiety, ADD/ADHD, addiction or mental health disorders and counseling.


Employee Assistance Program

When life gets challenging, you’ve got caring, confidential help. If you need guidance navigating mental health, financial or legal concerns, take advantage of the Employee Assistance Program (EAP) for 24/7 support — at no extra cost. Call the member phone number on your health plan ID card and ask to speak to an EAP consultant. Or, contact EAP directly 24/7 at 1-888-887-4114.


Tobacco Cessation Program

Quitting tobacco is one of the most beneficial things you can do. The Quit For Life tobacco cessation program uses an evidence-based combination of physical, psychological and behavioral strategies designed to help employees overcome their tobacco addiction.


UnitedHealthcare App

The UnitedHealthcare® app puts your plan at your fingertips. When you’re out and about, you can do everything from managing your plan to getting convenient care. Just download the app to:

  • Find nearby care options in your network
  • Estimate costs
  • Video chat with a doctor 24/7
  • View and share your health plan ID card

Download the app on the Apple Store or Google Play.


Maternity Support Program

Expecting a new arrival? Gearing up to welcome a baby is a great reason to begin some healthy habits. The Maternity Support Program provides comprehensive maternity support before, during, and after pregnancy. You can get support through one-on-one access to a maternity nurse at no additional cost. Enroll by calling the number on your health plan ID card. You may also access the UHC Health Pregnancy app for additional pregnancy support resources.


Diabetes Management

Ongoing one-on-one support from a nurse who may help you manage your diabetes, manage your medications, and improve your diet and exercise. Ongoing one-on-one support from a nurse who may help you manage your diabetes, manage your medications, improve your diet, and exercise.


Real Appeal

Get help losing weight and keeping it off. Real Appeal is an online weight loss program that provides personal coaching to help you and eligible family members lose weight and keep it off. On average, participants lose 10 pounds after attending just 4 online sessions. An online coach leads ongoing group sessions and provides guidance tailored to your unique lifestyle. Real Appeal offers 24/7 online support and a mobile app to help track progress towards reaching your goals. A Success Kit includes scales, recipes, fitness equipment, and more delivered to your door.

Medical Extras

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 UHC App on your phone.

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.

Plan 1 HSA $5000

Plan 1 HSA $5000

Plan 2 PPO $1000

Plan 2 PPO $1000

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 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. These drugs have the highest copay. Make sure to check for mail-order discounts that may be available.

SPECIALTY DRUGS


TIER 4  | Lowest Specialty Drug copay: Tier 4 specialty drugs are generally more effective and less expensive than nonpreferred specialty drugs in tier 5.


WHERE CAN I FIND A DRUG LIST?

Typically, a full listing of covered drugs is found on your provider’s website. A drug list, also called a formulary, is a list of generic and brand-name drugs covered by a health plan. Although a drug may be on the drug list, it might not be covered under every plan. Review the plan materials for details on specific benefits.

You can use drug lists to see if a medication is covered by your health insurance plan. You can also find out if the medication is available as a generic, needs prior authorization, has quantity limits and more.

RX Summary

Managing Prescription Costs

Managing Prescription Costs

Prescription Overview

Prescription Overview

Dental


Dental Benefits through Guardian 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: DentalGuard Preferred


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

Dental Insurance Overview Video

Dental Insurance Overview Video

NAP plan (90th UCR): Under a UCR plan, limits on reimbursement are based upon Usual, Customary, and Reasonable value for your geographic area. UCR value is set at a level where a certain percentage (in this case 90%) of fees charged for a certain procedure in that area are less than the UCR value. Generally, 9 out of 10 dentists accept Guardian’s reimbursement as payment in full.

 

For example, An employee has a filling which is covered at 80% that is billed at $200 and for this procedure, the UCR is set at $180. Insurance will pay 80% of the $180, which is $144. The employee could then be responsible for the additional $20 in balance billing.

Vision


Hammontree offers vision coverage through Guardian 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 Benefit Summary

Vision Insurance Overview

Vision Insurance Overview

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

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.

  • Class 1 (All FT Board of Managers or those w/ 10k Shares of stock) - $50,000
  • Class 2 (All FT Partners & Associates) - $40,000
  • Class 3 (All FT Engineers & Surveyors) - $30,000
  • Class 4 (All other FT Employees) - $20,000


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: $10,000 increments up to a maximum of $500,000 ($50,000 Guaranteed under age $70)

Spouse: $5,000 increments up to $100,000 or 100% of what you elect for yourself ($25,000 Guaranteed under age 65)

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


Annual Election: After You first enroll for Employee Voluntary Term Life Insurance, You may choose to increase Your amount of Voluntary Term Life Insurance by an amount not to exceed an increase of $50,000 as shown above. This option is available once annually during the Voluntary life enrollment period described above. Proof Of Insurability will not be required unless the insurance amount exceeds the amount of Voluntary Term Life Insurance for which Proof Of Insurability is required as shown below.


If Proof Of Insurability is required and has been submitted and approved by Us, Proof of Insurability for additional increases will be required on the second anniversary of the date we approve such coverage.


If Proof Of Insurability is required and has been declined, You will not be eligible for additional annual increases without submitting Proof Of Insurability for them, and then if such increases are approved by Us in writing.


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.


*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 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.

Disability

Overview of Long Term Disability


Long Term Disability

Insurance through Guardian 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 up to a maximum of $5,000 per month – benefit is taxable income
  • Pre-existing condition limitations apply for first 12 months
What is LTD Coverage?

What is LTD Coverage?

Hospital Indemnity, Accident and Critical Illness Insurance

Hospital Indemnity

Hospital indemnity insurance can cover some of the cost associated with a hospital stay, letting you focus on recovery. Being hospitalized for illness or injury can happen to anyone, at any time. While medical insurance may cover hospital bills, it may not cover all the cost associated with a hospital stay.


What Does it Cover?

  • If you are admitted to a hospital for a covered sickness or injury, you'll receive payments that can be used to cover all sorts of costs, including: deductibles and co-pays, travel to and from the hospital for treatment, childcare service assistance while recovering, and much more.


Who Gets Paid? You get paid! 

  • Hospital indemnity insurance is portable and payments are made directly to you- even if you didn't incur any out-of-pocket expenses. You can use the money however you want.

Accident

A serious injury can cost you a lot of money – not only in medical bills but in

things like income from lost work hours. Some injuries are minor, but others are

debilitating and require significant medical care. 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.


Who Gets Paid? You get paid! 

  • When you are paid a benefit from Accident Insurance,

your health insurance company pays your doctor or hospital,

but your Guardian Accident insurance pays you. 

  • You can use the money however you want.


Examples of what's covered

  • Accidental Death - Employee $25,000, Spouse $12,000 and Child $5,000
  • Ambulance - $150
  • Concussions - $75
  • Hospital Admission - $1,000


Critical Illness Insurance

Critical Illness Insurance can pay money directly to you when you are diagnosed with certain serious illnesses. Pre-existing conditions will have a 6-month look back; 6 months exclusion period.


What's covered?

  • Critical Illness such as heart attack, stroke and end-stage kidney failure
  • Cancer conditions, such as breast cancer and skin cancer
  • Progressive disease such as Alzheimer's Multiple Sclerosis and Parkinson's disease


Wellness Benefit

When you enroll in Accident or Critical Illness Insurance you can earn $50 just by getting an annual physical or covered preventive test. 

What is Critical Illness?

What is Critical Illness?

What is Accident Coverage?

What is Accident Coverage?

Accident Plan Summary - OH

Accident Plan Summary - OH

Critical Care Summary - OH

Critical Care Summary - OH

Cancer Care Summary - OH

Cancer Care Summary - OH