Jade Sterling Steel

Table of Content

  1. Header
  2. Overview of Health Benefits
    1. Open Enrollment
    2. Eligibility & Qualifying Events
    3. Medical & Prescription
    4. Medical Summary
    5. Summary of Benefits and Coverage (SBC)
    6. Prescriptions
    7. Prescription Summary
    8. Virtual Visits
    9. MMO MyHealthPlan
    10. Nurse Line and Care Navigation
    11. Transitional Care and Palliative Care
    12. Digital and Telephonic Coaching
    13. Pivot - Tobacco Cessation
    14. HSA
    15. Dental
    16. Dental Summary
    17. Vision
    18. Vision Summary
    19. Basic Life and Voluntary Life
    20. Summaries
    21. Disability - Short Term & Long Term
    22. Accident Insurance
    23. Critical Illness Insurance
    24. Hospital Indemnity Insurance
    25. MetLife Pet Insurance
    26. Employee Contributions
    27. Contributions 2
    28. How to Enroll
    29. Eligibility & Qualifying Events
    30. Understanding your Benefits
    31. Carrier Contacts
    32. Contact Information
  3. Footer

Overview of Health Benefits

Medical: Medical Mutual

Dental: MetLife

Vision: MetLife

Life: MetLife

Disability: MetLife

Accident: MetLife

Critical Illness: MetLife

Hospital Indemnity: MetLife

Open Enrollment

Annual enrollment is your opportunity to learn about the 2026 Benefits, review your current coverage, and choose the best options for you and your family. Please review this virtual benefit guide and attend our upcoming education session to learn more about our 2026 benefits offerings.

This annual enrollment will be a passive open enrollment, which means if you don't make or change your Ancillary elections for the upcoming 2026 Benefits, you will automatically be enrolled in the same plan to what you currently have. 

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 until the next open enrollment period unless you notify HR within 30 days of your QLE to be eligible to make new elections.

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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".

When Does My Coverage Start? 

New Hire: Benefits are effective 1st of the month following your date of hire.

Open Enrollment: Benefits Effective January 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 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

Jade-Sterling Steel offers three 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.


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


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

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 have 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.

90 Day Supply Flyer

90 Day Supply Flyer

Prescription 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 medical benefit summaries provided under the Medical & Prescription section above.

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

Virtual Visits

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 MedMutual App on your phone.

Telehealth Member Flyer

Telehealth Member Flyer

Telehealth Services Flyer

Telehealth Services Flyer

Express Care Online Flyer

Express Care Online Flyer

MMO MyHealthPlan

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.

Medical Extras

Nurse Line and Care Navigation

Nurse Line

Members have direct access to MMO nurses. Nurses provide easy to understand explanations about tests and results, how to treat minor illnesses at home, and help determine if you or a dependent need to seek further medical care from a doctor, urgent care, or the ER.

There is no charge to use the MMO nurse line. This is a 24/7 support line.

Reminder: have your group number and member ID readily available. This can be found on your MMO ID card.

1-888-912-0636

Care Navigation Program

Members have access to MMO nurses to assist with goals and developing condition specific care plans. A dedicated care navigator will serve as a personal advocate and single point of contact to help manage a member's conditions and overall health; improve the quality of care they receive and control the cost of their care.

Nurse Line Flyer

Nurse Line Flyer

Transitional Care and Palliative Care

The Transitional Care Program provides nurse-led health coaching and support with home visits after a high-risk hospital stay. Nurses will help members prepare for their hospital release, visit them at home to check on their progress for up to 30 days after release, and connect them with local resources that can help them stay healthy while living at home.


With the Palliative Care Program, members with advanced illness have access to non-hospice community-based in-home support led by physicians, nurses and social workers, to help improve their quality of life as they manage their treatment plan.


These programs are free to Medical Mutual members on the health plan.

Transitional Care

Transitional Care

Palliative Care

Palliative Care

Digital and Telephonic Coaching

Medical Mutuals digit coaching is provided through LARK for members with Diabetes and Hypertension.

Digital health coaching provides smartphone-based coaching customized to meet a member's needs. Depending on your health condition, you may receive free supplies, including scale, glucometer, blood pressure cuff, or more, at NO COST.

See attached flyers for more information on each plan for Diabetes and Hypertension.

Telephonic Health Coaching

  • Asthma
  • Heart Disease
  • Type 1 diabetes
  • COPD

MMO nurses help educate and support members, and work with them to set individualized goals and develop condition-specific care plans.

Nurses are available Monday through Friday, 8am-4pm.

1-800-590-2583

Diabetes Prevention

Diabetes Prevention

Diabetes Management

Diabetes Management

Hypertension Management

Hypertension Management

Pivot - Tobacco Cessation

Want to quit the tobacco habit?


MMO has partnered with Pivot to help you quit for good. Pivot is a personalized app that offers content tailored to your goals, direct access to a health coach and nicotine replacement therapy at no charge. Visit the link below to get started.

Pivot Flyer

Pivot Flyer

Dental

Dental Benefits through MetLife, with two plan options, 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: PDP Plus

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 Low Plan Summary

Dental Low Plan Summary

Dental High Plan Summary

Dental High Plan Summary

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 above.

Dental Summary

Vision

Jade-Sterling Steel offers vision coverage through MetLife 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 Plan Summary

Vision Plan 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 above.

Vision Benefit Summary

Basic Life and 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.

Basic - 100% Employer Paid - 1X Salary up to $200,000

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 - 100% Employee Paid

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

Spouse: Choose in $5,000 increments from $10,000 up to $100,000 max (not to exceed 100% of EE amount) ($25,000 GI)

Children: Age Birth to 14 days – N/A; Age 15 days to 6 months - $1,000; Age 6 months and older - $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.

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.

Basic Life and AD&D Summary

Basic Life and AD&D Summary

Voluntary Life and AD&D Summary

Voluntary Life and AD&D Summary

Disability - Short Term & Long Term

Short Term Disability - Employer pays the first $100 of this benefit

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 up to a specific maximum in your benefit summary.

STD Benefit Features

  • Benefit begins 8th day Accident / 8th day Illness
  • Benefit equal to 60% of pay to a maximum amount of $100/week – the benefit is taxable income
  • Employee has the option to buy up to a higher plan of 60% of pay to a maximum amount of $1,000/week
  • Payments may last up to 13 weeks
  • Pre-existing condition limitations apply for the first 12 months with a 3 month look back period

Long Term Disability - 100% Employer paid benefit

Long Term Disability insurance can pay you a monthly 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 a 90-day elimination period if remain disabled
  • Benefit equal to 60% of pay to a maximum amount of $7,500/month – the benefit is taxable income
  • Payments will last for as long as you are disabled, or until you reach retirement age (65), whichever is sooner
  • Pre-existing condition limitations apply for the first 12 months with a 3 month look back period
Short Term Disability Summary

Short Term Disability Summary

Short Term Disability Buy Up Plan Summary

Short Term Disability Buy Up Plan Summary

Long Term Disability Summary

Long Term Disability Summary

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. 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 coverage for Employee, Spouse, and Child
  • Ambulance 
  • Concussions 
  • Hospital Admission 

Wellness Benefit

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

Accident Insurance Summary

Accident Insurance Summary

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 3-month look back; 6 month exclusion period. 

What's covered?

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

Wellness Benefit

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

Critical Illness Summary

Critical Illness Summary

Hospital Indemnity Insurance

Hospital indemnity insurance can cover some of the costs 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 costs 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.
Hospital Indemnity Low Plan Summary

Hospital Indemnity Low Plan Summary

Hospital Indemnity High Plan Summary

Hospital Indemnity High Plan Summary

MetLife Pet Insurance

Pet Insurance Flyer

MetLife offers Pet Insurance to help cover the costs of:

• accidental injuries

• illnesses

• exam fees

• surgeries

• medications

• ultrasounds

• hospital stays

• X-rays and diagnostic tests and more!

See attached flyer for more details. To get a quote or enroll, visit www.metlife.com/getpetquote or call 1-800-GET-METS

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.

See HR for employee contribution rates for Voluntary Life, Disability (Short Term and/or Long Term), and Critical Illness Insurance.

Medical Employee Contributions

Dental Employee Contributions

Vision Employee Contributions

Hospital Indemnity Employee Contributions

Accident Employee Contributions

How to Enroll

Action Required:

Click to download the enrollment form and return to HR or see HR for a copy of the election form to fill out.

Medical Election Form

Medical Mutual

Medical Election Form

Medical Mutual

Ancillary Benefits Election Form

MetLife

Ancillary Benefits Election Form

MetLife

Contact Information

Jade-Sterling Contacts

JS

Jennifer Shebeck

jshebeck@jadesterling.com

(330) 405-2405

NFP Contacts

KL

Kevin Lurie

Producer / Sales Consultant

kevin.lurie@nfp.com

216-410-6751

SG

Samantha Geffert

Account Manager

samantha.geffert@nfp.com

216-260-2401

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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 individual situation.
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