Middletown, City of

Table of Content

  1. Header
  2. Page
    1. New for 2023!
    2. Helpful Video Links
    3. Benefits Overview
    4. Enroll and Qualifying Event Changes
    5. BenXpress
    6. Medical
    7. Flexible Spending Account (FSA)
    8. Health Savings Account (HSA)
    9. Dental
    10. Vision
    11. Basic and Voluntary Life
    12. Voluntary Short Term Disability
    13. Accident/Critical Illness/Hospital Indemnity
    14. Norton LifeLock
    15. Nationwide Pet Insurance
    16. Virgin Pulse
    17. Additional Resources
    18. Contact Us
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New for 2023!

Medical Plan changes for 2023


Plan 14 PPO: $600/$1.400 in network deductible

Plan 10 PPO: $1,700/$3,400 in network deductible

Plan 13 HSA: 90% in network coinsurance


Nutrional counseling and weight management benefits have been added to your medical plan.


Virgin Pulse changes for 2023: Spouses now able to win Pulse Cash!

Helpful Video Links

Virgin Pulse Employee Training

Virgin Pulse Employee Training

Anthem Employee Training

Anthem Employee Training

Benefits Overview

No changes to benefit carriers in 2023!


UMR: will continue as your medical carrier

 

CVS Caremark/Optum RX: will continue as your Prescription Drug carriers

 

Anthem: will continue as your Dental, Basic and Voluntary Life, and Short-Term Disability carrier

 

EyeMed: will continue as your vision carrier


Guardian: will continue as your Accident, Critical Illness, and Hospital Indemnity carrier

 

Teladoc through UMR: will continue as your telemedicine virtual health carrier

 

Virgin Pulse: will continue as your wellness program vendor


NortonLife Lock


Nationwide Pet Insurance


Regenexx


Reliance Gap Coverage

Enroll and Qualifying Event Changes

Full-Time Employees

*Employees are eligible for benefits on the date of hire.

 

EMPLOYEE ELIGIBILITY: If you do not enroll during the Open Enrollment period, you must wait until the next Open Enrollment period unless you experience a Qualifying Life Event. If you experience a Qualifying Life Event (i.e., birth or adoption of a child, marriage, divorce, loss of other coverage, etc.) you must enroll within 30 days of the Qualifying Event.

 

DEPENDENT ELIGIBILITY: You may also enroll eligible dependents for benefits coverage. A ‘dependent’ is defined as the legal spouse and/or ‘dependent child(ren)’ of the plan participant or the spouse.

  • Your Legal Spouse: If your legal spouse has coverage at his/her employer, they are not eligible for the City of Middletown's per the spousal waiver policy, if you were hired on or after 1/1/2017. You must submit a copy of your marriage license, if you have submitted documentation previously, you do not need to resubmit.
  • Your Dependent Children: Children are eligible up to the end of the month of 26th birthday regardless of marital or student status. You must submit a copy of each child's birth certificate, if you have submitted documentation previously, you do not need to resubmit.

 

What is a Qualifying Life 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

 

If you have a Qualifying Life Event and want to request a mid-year change, you must notify Human Resources and complete your election changes within 30 days following the event. Be prepared to provide documentation to support the Qualifying Life Event.

Spousal Statement of Coverage

Spousal Statement of Coverage

BenXpress


  • 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

 

Go to: www.benxpress.com/cityofmiddletown

Username: First initial, plus your last name (example John Doe login: joe)

Password: Last four of your social (example: 5811)



This is an active enrollment!

This means that you must log in to BenXpress to enroll yourself and your dependents for benefits. All employees will use BenXpress to confirm or change benefit elections. 

Medical

UMR: will continue as your medical carrier.

 

When you utilize providers that are in the Choice Plus network you will receive higher benefits. Employees who seek care from a provider that is not in UMR's network, will be responsible for higher costs. 


CVS Caremark will administer prescription drug coverage for PPO plans. Optum RX will administer prescription coverage for the HSA and Minimum Value plans.


**Please refer to your Summary of Benefits and Coverage (SBC) or Certificate of Coverage for more complete plan details**



Regenexx

Regenexx procedures use your body's natural healing ability to help repair damage to bone, muscles, tendons and ligaments without surgery. These procedures are performed by highly skilled doctors trained specifically in Interventional Orthopedic procedures to help reduce pain and improve function.


Commonly treated conditions include, ACL tears, hip arthritis, shoulder rotator cuff tears, back/neck pain due to herniated discs, ankle sprains or ligament tears, plantar fasciitis, golfers' elbow, carpal tunnel and more.

Flexible Spending Account (FSA)

BASIC Debit Card

BASIC Debit Card

A Flexible Spending Account (FSA) allows you to pay for your family’s out -of pocket medical and dependent care expenses with pretax income. You can elect to deposit a part of your before-tax income to a personal reimbursement account that you use to pay for qualified expenses incurred during the plan year. Amounts you put into your FSA plan are deducted before federal, state and social security taxes are withheld. Visit www.irs.gov/213d for a listing of services that qualify for FSA.


Your FSA provider: BASIC

Maximum FSA Contribution: $3,050

Grace period: You have until 3/15/22 to use 2022 FSA funds


If you are enrolled in a Health Savings Account (HSA) you are only eligible for a Limited Purpose FSA which includes dental, vision and post deductible medical expenses.

Health Savings Account (HSA)

A Health Savings Account (HSA) is a tax-free savings account that is owned by you, 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, and how to invest the balance.


To be eligible for an HSA:

  • You must be enrolled in a High Deductible Health Plan (HDHP)
  • You cannot be covered by any other health insurance plan that is non-HDHP. i.e. enrolled in a spouses plan that is a PPO
  • Cannot participate in a Healthcare FSA or spouse/domestic partner Healthcare FSA or HRA
  • Cannot be enrolled in Medicare or Medicaid
  • Cannot be eligible to be claimed as a dependent on someone else's tax return
  • Cannot received Tricare, Indian Health Services, or Department of Veterans Affairs Medical benefits in the last 90 days


2023 HSA Contribution Limits:

  • Employee Only: $3,850
  • Two Person/Family: $7,750
Understanding an HSA

Understanding an HSA

Dental

Anthem will remain the carrier for your dental benefits.

  1. Dental Base Plan
  2. Dental Buy Up Plan


You may go to any dentist. However, those who belong to Anthems Dental network will be most cost effective.


**Please refer to attached Benefit Summaries for more complete plan details**

Base Plan Benefit Summary

Base Plan Benefit Summary

Buy Up Plan Benefit Summary

Buy Up Plan Benefit Summary

Vision

EyeMed remains the carrier for your vision benefits. The City of Middletown offers to vision plan options.

  1. Base Plan
  2. Buy Up Vision Plan


You may go to any eye care provider. However, those who are in the EyeMed network will be most cost effective.


**Please refer to attached Benefit Summaries for more complete plan details**

Base Plan Benefit Summary

Base Plan Benefit Summary

Buy Up Plan Benefit Summary

Buy Up Plan Benefit Summary

Basic and Voluntary Life

Anthem remains as the carrier for your Basic and Voluntary Life benefits.


Your Basic Life Benefit

  • 100% company paid benefit, no cost to you
  • Coverage Amount: Based on job class
  • Convertible: To individual life policy when coverage ends under the plan
  • 35% reduction at age 65
  • 55% reduction at age 70
  • 70% reduction at age 75
  • See HR for your job class Benefit Summary


Your Voluntary Life Benefit

  • Available to active full-time employees (40 hours/week)
  • 100% employee paid benefit
  • Spouses and children may also be eligible
  • Convertible: To individual life policy when coverage ends under the plan
  • Portable: continue your term insurance if your employment ends
  • See Plan Summary for Volume Amount details


Vol. Life Class 1-5 Benefit Summary

Vol. Life Class 1-5 Benefit Summary

Vol. Life Class 7

Vol. Life Class 7

Voluntary Short Term Disability

Anthem remains the carrier for your Short Term Disability benefits.


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 Short Term Disability Benefit

  • 100% employee paid
  • Benefits begin on the 1st day of an accident and the 8th day if an illness.
  • Covers 60% of your weekly income up to a max of $1,500
  • Weekly benefit may be reduced or offset by other sources of income
  • Waiver of premium


**Please refer to attached Benefit Summary for more complete plan details**

Short Term Disability Benefit Summary

Short Term Disability Benefit Summary

Accident/Critical Illness/Hospital Indemnity

Guardian remains the carrier for your Accident, Critical Illness, and Hospital Indemnity benefits.


**Please refer to attached Benefit Summaries for more complete plan details**

Critical Illness Benefit Details

Critical Illness Benefit Details

Hospital Indemnity - How to Submit a Claim

Hospital Indemnity - How to Submit a Claim

How Submit an Accident Claim

How Submit an Accident Claim

Hot to Submit a Critical Illness Claim

Hot to Submit a Critical Illness Claim

Accident Benefit Details

Accident Benefit Details

Norton LifeLock

Norton Benefit Plan

Norton Benefit Plan