ELIGIBILITY
HOW TO ENROLL
This is an ACTIVE enrollment, which means you must log into Employee Navigator and complete your elections. If no action is taken, your current benefits will end on 5/31/2026.
All team members have access to the Employee Navigator enrollment platform, where you have the ability to enroll, select or change your benefits online during the annual open enrollment period, new hire orientation, and for qualifying events. Please see your employer contact prior to making changes outside of open enrollment.
- 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
Employee Navigator Company Identifier:
NAU
ENROLLMENT INSTRUCTIONS:
- Click the button below to go to your Employee Navigator enrollment portal
- Click the "Login" button located in the top right corner of your screen
- Select "Register as New User" and enter the requested information to verify your account
- Enter your Company Identifier & Pin (Last 4 digits of your SSN)
- After registering your account, click "Start Enrollment"
- You will need to complete some personal & dependent information before making your benefit elections
To get started, click on the link below to head to your Employee Navigator Enrollment Portal!
QUALIFYING LIFE EVENTS
Under certain circumstances, employees may be allowed to make changes to benefit elections during the plan year, if the event affects the employee, spouse, or dependent’s coverage eligibility. Any requested changes must be consistent with and on account of the qualifying event.
Examples Of Qualifying Events:
- Legal marital status (for example, marriage, divorce, legal separation, annulment);
- Number of eligible dependents (for example, birth, death, adoption, placement for adoption);
- Work schedule (for example, full-time, part-time);
- You, your spouse, or other covered dependent become enrolled in Part A, Part B, or Part D of Medicare
- Death of a spouse or child;
- Change in your child’s eligibility for benefits (reaching the age limit);
- Becoming eligible for Medicaid; or
- Your coverage or the coverage of your Spouse or other eligible dependent under a Medicaid plan or state Children’s Health Insurance Program (“CHIP”) is terminated as a result of loss of eligibility and you request coverage under this Plan no later than 60 days after the date the Medicaid or CHIP coverage terminates; or
- You, your spouse or other eligible dependent become eligible for a premium assistance subsidy in this Plan under a Medicaid plan or state CHIP (including any waiver or demonstration project) and you request coverage under this Plan no later than 60 days after the date you are determined to be eligible for such assistance.
A status change from part-time to full-time is not a qualifying event, but it is a change in eligibility that will allow an employee to enroll in insurance.
- Newly eligible employees will have 30 days to enroll in insurance benefits, which will begin on the first day of the month after the employee has completed 60 days of full-time employment.
- Reminder, this means working 30+ hours per week for 60 days.
A status change from full-time to part-time will cause employees to become ineligible for insurance benefits.
- The insurance benefits will end on the last day of the month before the status change becomes effective.
- A termination will also cause an employee to lose their benefit at the end of the month the employment ended.
- Both of these situations will trigger eligibility for continuing coverage under COBRA.
COBRA Customer Service | (210) 659-8100 | www.proficient.com
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families the right to continue their existing group health plan coverage for a limited period of time when they would otherwise lose their coverage through a voluntary or involuntary job loss, a reduction in work hours, death, divorce, or other events.
The cost for coverage under COBRA is usually higher than the cost for employees under a group plan.
- COBRA participants usually pay 100% of the coverage, plus a 2% administrative fee.
- For employees who choose not to re-enroll in benefits during Open Enrollment, the loss of insurance coverage is not a qualifying event for COBRA.
Cobra Qualifying Events
The following are qualifying events for covered employees if they cause the covered employee to lose coverage:
- Termination of the employee's employment for any reason other than gross misconduct.
- Reduction in the number of hours of employment.
The following are qualifying events for the spouse and dependent child of a covered employee if they cause the spouse or dependent child to lose coverage:
- Termination of the covered employee's employment for any reason other than gross misconduct.
- Reduction in the hours worked by the covered employee.
- Covered employee becomes entitled to Medicare.
- Divorce or legal separation of the spouse from the covered employee.
- Death of the covered employee.
In addition to the above, the following is a qualifying event for a dependent child of a covered employee if it causes the child to lose coverage:
- Loss of dependent child status under the plan rules.
- Under the Patient Protection and Affordable Care Act, plans that offer coverage to children on their parents' plan must make the coverage available until the adult child reaches the age of 26.
BCBS MEDICAL
BCBS Customer Service | (800) 521-2227 | www.bcbstx.com
Network: The PPO HDHP plan utilizes Blue Choice network. The HMO plan utilizes the Blue Essentials network. The HMO plan is in-network only.
How do I find an In-Network Doctor?
- Use the link below or visit your provider’s website at www.bcbstx.com under “Find Care”. Select "Find a Doctor or Hospital" and then you can search by provider/facility name or search by specialty.
Did You Know?
- Preventive Services are covered at 100% In-Network and copays & deductibles do not apply.
- You pay less out of pocket if you receive care from an In-Network provider.
- You do not need to designate a primary care physician or need a referral to see a Specialist for the PPO HDHP plan.
- You do need to designate a primary care physician and will need a referral to see a Specialist on the HMO plan.
You have 2 medical plans to choose from. Compare the different plan options in the chart below!
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.
MDLive Customer Service | (888) 680-8646 | www.mdlive.com/bcbstx
With Virtual Visits, the doctor is always in. Get 24/7 non-emergency care from a board-certified doctor by phone, online video or mobile app from the privacy and comfort of your own home. Don’t risk crowded waiting rooms, expensive urgent care or ER bills, or waiting weeks or more to see a doctor, when you can speak with a Virtual Visits doctor within minutes.
Virtual Visits, provided by Blue Cross and Blue Shield of Texas (BCBSTX) and powered by MDLive, are a convenient alternative for treatment of more than 80 health conditions, including allergies, cold, flu, fever, headaches, nausea, sinus infections, etc.
Virtual Visits with licensed behavioral health therapists are available by appointment. Get virtual care for anxiety, depression, stress management, and more.
Having a Virtual Visit
You may want to have a virtual visit:
- Instead of going to the ER or urgent care for non-emergency visits
- If your doctor is booked
- While at home, work or on-the-go
PHARMACY
Pharmacy Customer Service | (833) 715-0942 | www.myprime.com
Prescription drugs are a vital part of your health care coverage. If you have prescription drug coverage through BlueCross and BlueShield of Texas (BCBSTX), this information can help you and your doctor get the most from your prescription drug coverage. The Pharmacy Benefit Manager for BCBS is Prime Therapeutics. That means you will only have one ID card for both medical care and prescriptions. The BCBS plans utilize the Health Insurance Marketplace 6 Tier Drug List. Information on your benefits coverage and a list of network pharmacies is available online at www.bcbstx.com or by calling the Customer Care number on your ID Card.
A formulary drug list specifies which drugs are covered under your prescription drug benefit. How much you pay out of pocket is determined by whether your drug is on the list and at what coverage level, or tier. Your cost is determined by the tier assigned to the prescription drug product. Products are assigned as Generic, Brand Preferred or Brand Non-Preferred. See if your drug is covered by reviewing your formulary drug list using the link below!
Rx Mail Order Customer Service | (833) 715-0942 | express-scripts.com/rx
Express Scripts® Pharmacy, the mail order pharmacy for members with BCBSTX prescription drug coverage, provides safe, fast and cost-effective pharmacy services that can save you time and money. With this program, you can obtain up to a 90-day supply of long-term (or maintenance) medications through Express Scripts® Pharmacy.
Getting Started Online
You have more than one option to fill or refill a prescription online or from a mobile device:
- Visit express-scripts.com and follow the instructions to register and create a profile.
- Download the Express Scripts App on your mobile phone.
Order Over the Phone
- Call (833) 715-0942, 24/7, to refill, transfer a current prescription or get started with home delivery. Please have your member ID card, prescription information and your doctor’s contact information available.
Save up to 80% on your prescriptions with the free GoodRx Mobile App!
How does GoodRx work?
- Prescription drug prices are not regulated. The cost of a prescription may differ by more than $100 between pharmacies across the street from each other! GoodRx gathers current prices and discounts to help you find the lowest cost pharmacy for your prescriptions
How do I find discounts for my drug?
- It’s easy. Just visit www.goodrx.com, type in your drug’s name in the search field, and click the “Find the Lowest Price” button.
What are GoodRx coupons?
- GoodRx coupons will help you pay less than the cash price for your prescription. They’re free to use and are accepted at virtually every U.S. pharmacy.
- Your pharmacist will know how to enter the codes on the coupon to pull up the lowest discount available.
EXTRAS FROM
As a BCBS member, you have access to a plethora of services and resources!
This is only a brief description of some of the plan benefits. For more complete details, including benefits, limitations and exclusions, please login to your BCBS Member Portal.
Blue Access for Members (BAM)
Through Blue Cross Blue Shield our secure member website, you can access health plan information, resources and tools. The information can vary, depending on your plan.
- Review benefits, account balances, claims status and more.
- Order a replacement ID card or print a temporary card.
- View and print an Explanation of Benefits (EOB) for a claim.
Blue Access Mobile
- Blue Access Mobile makes it easy for you to access your information while on the go. You can view coverage details, health and wellness information, check claim status and access member ID card information. You can also sign up to get text or email alerts and tips
Valuable Member Programs
As a BCBSTX member, you have access to a range of programs that can help you get and stay healthy.
- Health and Wellbeing Programs can help you manage your health conditions, get pregnancy support, talk to a nurse 24/7 and more.
- Blue365 Discount Program offers discounts on health-related products, health and fitness clubs, weight-loss programs and much more.
- Well onTarget gives you the tools and resources to create your personal journey — no matter where you may be on your path to wellness.
- AlwaysOn Wellness App has a wide variety of easy-to-use, features that allow you to take your Health Assessment, set personal health and wellness goals and track your progress, take an online educational program, view your Blue Points balance, and track data synced from more than 80 fitness devices and apps.
- Wellness Coaching offers credentialed health experts, including dietitians, nurses, personal trainers and other specialists who can work one-on-one with you to discuss your lifestyle needs. Online trackers can help guide you as you reach your goals. You may sign up for one program at a time.
- Fitness Program Membership Program gives you and your covered dependents (age 16 and older) access to a nationwide network of fitness locations. Choose one location close to home and one near work, or visit locations while traveling.
- Tobacco Cessation Programs consisting of methods to help you learn to quit smoking, with one-on-one coaching and innovative lessons developed using the most current academic and medical research.
offers ongoing support for your health with a plan built around you and all the tools and support you need. All at no cost to you, offered as part of your Blue Cross and Blue Shield of Texas (BCBSTX) health plan. With Omada, you get a dedicated health coach and care team, smart devices, interactive weekly lessons, and long term results through habit and behavior change.
is a health benefit that helps make managing your diabetes easier. Obtain real-time, personalized tips with each blood glucose check, unlimited strip reordering right from your meter, automatic uploads, support and family alerts, and much more. Livongo is offered to you and your family members with diabetes and coverage with BCBSTX.
provides all the tools you need to get moving again from the comfort of your home. You'll get exercise therapy tailored to your needs, technology for instant feedback in the app, personal coach and physical therapist. Hinge Health is 100% covered by BCBSTX for you and eligible family members.
is a weight loss program that is clinically-proven to help you lose weight, sleep better, stress less, and so much more. Wondr will teach you simple skills that are based on behavioral science, so you can enjoy your favorite foods and feel better than ever—at no cost to you.
Getting a health checkup has never been easier! This VirtualCheckup is available at NO COST to eligible employees, spouses, partners and adult dependents (18+) who are covered by our BCBSTX MTBCP007H - PPO HDHP health plan. Your VirtualCheckup home kit even includes a digital blood pressure monitor that’s yours to keep!
HEALTH SAVINGS ACCOUNT (HSA)
A Health Savings Account (HSA) is a tax-advantaged personal savings account that can be used to pay for medical, dental, vision and other qualified expenses now or later in life. To contribute to an HSA, you must be enrolled in the BCBSTX MTBCP007H and your contributions are limited annually.
How It Works
- For 2026, Participants can make an annual election of up to $4,400 for self only HDHP coverage or $8,750 for family High Deductible Health Plan (HDHP) medical coverage.
- You can contribute post-tax contributions (up to the maximum allowed) and recognize the same tax savings by claiming the deduction when filing your annual taxes.
- Eligible healthcare purchases can be made tax-free when you use your HSA. Purchases can be made directly from your HSA account, either by using your debit card, online bill-pay, or check – or you can pay out-of-pocket and then reimburse yourself from your HSA.
- The interest on HSA funds grows on a tax-free basis, and interest earned on an HSA is not considered taxable income when the funds are used for eligible medical expenses.
Why Participate? HSAs save you money!
- It's a tax advantaged vehicle to pay for out-of-pocket healthcare expenses and prepare for your healthcare costs in retirement.
- While your funds can be used to pay for immediate healthcare expenses tax-free, you can also save the money for healthcare expenses later in life.
- You can continue to contribute year after year and withdrawals (provided you are enrolled in an HDHP) can be made at any point in time.
- Whether you withdraw the money tomorrow, five years from now, or in retirement, funds used for qualified healthcare expenses are always tax-free.
Who's Covered?
- An HSA covers qualified out-of-pocket expenses for you, your spouse, your tax dependents, even if they are not covered under an HDHP.
RENAISSANCE DENTAL
Renaissance Customer Service | (800) 894-4532 | www.renaissancebenefits.com
Network: DenteMax Plus
How do I find an In-Network Dentist?
- Use the link below or visit MYRENPROVIDERS.COM.
- If you have any questions regarding the participation of a dentist, please contact Renaissance at (888) 358-9484.
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.
- Research shows there may be a link between oral health and illnesses like heart disease, stroke, diabetes and premature birth.
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.
Looking for more details about how items are covered? Click on the link below to view the formal Dental Plan Summaries.
RENAISSANCE VISION
Renaissance Customer Service | (800) 894-4532 | www.renaissancebenefits.com
Network: VSP Choice
How do I find an In-Network Vision Provider?
- You can choose your vision provider from more than 112,000 access points, including the largest national network of independent doctors and nearly 26,200 participating retail chain access points.**
- Use the link below or find an eye doctor at MYRENPROVIDERS.COM.
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
Looking for more details about how items are covered? Click on the link below to view the formal Vision Benefit Summary.
INCOME PROTECTION
Renaissance Customer Service | (800) 894-4532 | www.renaissancebenefits.com
Voluntary Short-Term Disability
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.
- Elimination Period - Benefits begin on the 15th day of an injury or illness.
- Benefit Duration - Payments may last up to 24 weeks (You must be sick or disabled for the duration of the waiting period before you can receive a benefit payment).
- Coverage Amount - Covers 60% of your weekly income, up to a maximum benefit of $1,500 per week.
What does this mean to you?
- If you are out of work for 14 days due to an illness or accident, you can begin receiving disability benefits on day 15. This is a cash benefit of 60% of your weekly salary to a max of $1,500 when you are out of work. You are able to receive this benefit for up to 24 weeks. A partial cash benefit is available if you can only do part of your job or work part-time.
Looking for more details about how items are covered? Click on the link below to view the formal Short-Term Disability Plan Summary.
Renaissance Customer Service | (800) 894-4532 | www.renaissancebenefits.com
Voluntary Long-Term Disability
Long-Term Disability coverage pays a monthly benefit if you have a covered illness or injury, and you can't work for a few months - or even longer!
You're generally considered disabled if you're unable to do important parts of your job - and your income suffers as a result.
- Elimination Period- Benefits begin on the 180th day of an injury or illness.
- Benefit Duration - Payments may last up to Social Security Normal Retirement Age (SSNRA) (You must be sick or disabled for the duration of the waiting period before you can receive a benefit payment).
- Coverage Amount - Covers 60% of your monthly income, up to a maximum benefit of $5,000 per month.
- 3/12 Pre-existing Condition: A pre-existing condition is a sickness or injury for which you have received treatment within 3 months prior to your effective date. Any disability contributed to or caused by a pre-existing condition within the first 12 months of your effective date will not be covered.
What does this mean to you?
- If you are still unable to work after your Short Term benefit expires, you will have the opportunity to receive a Long Term Disability cash benefit. Starting on the 180th day you are out of work due to an illness or injury, you will receive 60% of your monthly salary to a max of $5,000. You are able to receive these benefits for as long as you remain disabled or reach Social Security Normal Retirement Age (SSNRA).
Looking for more details about how items are covered? Click on the link below to view the formal Long-Term Disability Plan Summary.
SURVIVOR BENEFITS
Renaissance Customer Service | (800) 894-4532 | www.renaissancebenefits.com
Voluntary Life and AD&D
You have the opportunity to enroll in Voluntary Life and AD&D Insurance, which allows you to purchase coverage for yourself, as well as for your spouse and/or dependent children.
Please note that you must first elect coverage for yourself in order to add coverage for any dependents.
You can elect up to the Guarantee Issue (GI) amount, without Evidence of Insurability (EOI). If you elect over the Guarantee Issue (GI) amount you will be required to submit Evidence of Insurability (EOI).
How does it work?
- You choose the amount of coverage that’s right for you, and you keep coverage for a set period of time, or “term.” If you die during that term, the money can help your family pay for basic living expenses, final arrangements, tuition and more. AD&D Insurance is also available, which pays a benefit if you survive an accident but have certain serious injuries. It pays an additional amount if you die from a covered accident.
Looking for more details about how items are covered? Click on the link below to view the formal Voluntary Life and AD&D Plan Summary.
https://renaissancebenefits.com/
Life insurance portability and conversion options allow policyholders to maintain some level of insurance coverage when they might otherwise lose it or wish to change the type of coverage they have.
Portability
- Refers to the ability of an individual to transfer their group life insurance coverage from one employer to another or from a group policy to an individual policy without undergoing new underwriting or providing evidence of insurability.
- This is commonly associated with group term life insurance provided by employers. If you (the employee) leave your job or retire, you may not want to lose your life insurance coverage, especially if there are ongoing health issues. Advantages of porting coverage are that it allows continuity of coverage and there is no need for medical examination or evidence of insurability.
- The application and check for the initial premium must be received within 31 days after Life Insurance terminates or 15 days from the date the Employer signs the application; whichever is later.
Conversion
- The Conversion option allow you to convert your term life insurance policy into permanent (e.g., whole life or universal life) insurance policy without providing evidence of insurability or undergoing new underwriting. Transitions from term to permanent coverage without having to do a new medical exam.
- This option is considered when an individual has ongoing health issues or may be unable to qualify for a new policy.
- An Insured Employee and Dependent(s) may convert Group Voluntary Life Insurance coverage, without evidence of insurability, to an Individual Life Insurance policy during the 31 day period following termination of employment.
How do I port or convert my coverage?
- Contact Equitable's customer service department at (866) 444-6001
It's essential for policyholders to consider the options available to you and request conversion or portability timely, within 30 days of your benefits termination. You will submit the request for conversion or portability directly to the insurance carrier and will set up direct payment for your new individual policy.
IDENTITY THEFT
Renaissance Iris Customer Service | (231) 338-6614 | www.IrisIdentityprotection.com
Renaissance ID Theft - Iris, offers protection beyond identity theft with complete privacy and reputation management services to help keep your online identity and personal information private. Certified identity theft Resolution Specialists provide education on how identity theft occurs and tips to help keep identities safe through access to a multilingual ID Theft Resolution Center
Identity Theft Resolution Services
Help When Identity Theft Happens
Identity theft can be stressful and time‑consuming—but you don’t have to handle it alone. Iris® Identity Theft Resolution Services, powered by Generali, provides 24/7 access to certified specialists who help you take control and restore your identity.
How Iris® Supports You
If you find yourself to be a victim of identity theft, you’ll have 24/7 access to certified identity theft Resolution Specialists who can help restore your identity and prevent further damage in the event of an incident. A Resolution Specialist will assign a personal case manager who will assist with the following:
- Dispute fraudulent activity with creditors, credit bureaus, and authorities
- Place fraud alerts or credit freezes as allowed by law
- Assist with replacing stolen or missing IDs, credit cards, and documents
- Correct insurance or medical records impacted by identity theft
- Provide ongoing follow‑up and status updates until issues are resolved
- Offer emergency assistance if identity theft occurs while traveling
TRAVEL ASSISTANCE
Renaissance General Global Assistance | (231) 338-6614 | www.renaissancebenefits.com
LifeAssist® Travel Assistance
Help Wherever Travel Takes You
Unexpected issues can happen while traveling. LifeAssist® Travel Assistance, powered by Generali Global Assistance, provides 24/7 support for medical, travel, and personal emergencies when you’re away from home—so help is always close by.
What’s Included
When traveling 100+ miles from home or internationally, you have access to:
- Emergency medical evacuation and transportation coordination
- Support locating doctors, hospitals, or dental care
- Help replacing lost medications, travel documents, or personal items
- Emergency travel arrangements and cash advances
- Translation services and legal referrals
- Pre‑trip destination and safety information
FREQUENTLY ASKED QUESTIONS (FAQs)
Why go to an In-network provider?
- Going to an in-network provider means choosing a healthcare professional or facility that has a contract with your health insurance plan. In-network providers have agreed to offer their services at negotiated rates, which are often lower than what you would pay for out-of-network care. By visiting an in-network provider, you can take advantage of your health insurance plan's benefits, which may include lower copayments, coinsurance, and reduced out-of-pocket expenses.
Why should I go for my annual well checkup?
- Annual well checkups are essential for maintaining good health and preventing potential health issues. These visits allow your doctor to assess your overall health, monitor any chronic conditions you might have, and detect early signs of potential health problems. Regular checkups help identify health concerns before they become serious, ensuring timely intervention and a better chance for successful treatment.
What is the difference between generic and brand name drugs?
- Generic drugs are identical or bioequivalent to brand-name drugs in terms of active ingredients, safety, strength, dosage form, and intended use. The main difference is that generic drugs are usually more affordable because they don't have the research and development costs associated with brand-name drugs. The U.S. Food and Drug Administration (FDA) ensures that generic drugs meet the same rigorous standards for quality, safety, and effectiveness as their brand-name counterparts.
How do discount cards work on RX?
- Prescription discount cards provide discounts on medications at participating pharmacies. These cards are often available for free or at a low cost and can be used by individuals without insurance or those with high copayments. When you present the discount card at the pharmacy, it reduces the price of the medication, potentially leading to significant cost savings.
What happens if I go out of network?
- If you go out of network for healthcare services, it means you're seeing a provider or using a facility that doesn't have a contract with your health insurance plan. Out-of-network care typically results in higher out-of-pocket costs, including higher copayments, coinsurance, and potentially higher deductibles. Some health insurance plans may not cover out-of-network care at all, except in emergencies.
What is a SBC (Summary of Benefits and Coverage)?
- A Summary of Benefits and Coverage (SBC) is a document provided by health insurance companies to help individuals understand their health plan's key features and coverage details. It provides a summary of the plan's benefits, costs, coverage limits, and examples of common medical scenarios to help individuals compare different health insurance options and make informed decisions.
What is an EOB (Explanation of Benefits)?
- An Explanation of Benefits (EOB) is a statement sent by the health insurance company to the policyholder after a healthcare claim has been processed. The EOB provides a detailed explanation of the services provided, the amount billed by the healthcare provider, the amount covered by the insurance, and any remaining balance that the insured may be responsible for paying.
What should I ask my doctor?
- When visiting your doctor, consider asking questions related to your health condition, treatment options, medications, potential side effects, and any lifestyle changes you should make. You can also inquire about preventive measures, recommended screenings, and follow-up care. Don't hesitate to ask for clarification if there's anything you don't understand.
What is preventive care?
- Preventive care refers to healthcare services aimed at preventing or detecting health issues before they become more severe or chronic. Examples of preventive care include vaccinations, screenings (e.g., mammograms, colonoscopies), regular checkups, counseling on healthy behaviors, and interventions to manage risk factors.
Where can I get my ID card?
- You can typically get your health insurance ID card from your insurance provider. Many insurers offer electronic versions of the ID card through their mobile apps or member portals. Alternatively, you can request a physical ID card to be mailed to you.
Who do I contact if I have a QLE (Qualifying Life Event)?
- If you experience a Qualifying Life Event (QLE), such as marriage, birth/adoption of a child, divorce, loss of other health coverage, or a change in household income, you should contact your employer's HR department or your health insurance provider promptly. They can guide you through the process of updating your health insurance coverage or enrolling in a new plan if necessary.
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Renaissance Customer Service | (800) 894-4532 | www.renaissancebenefits.com
An Employee Assistance Program (EAP) provides barrier-free access to mental health resources and well-being solutions. EAPs are designed to enhance employee resilience, productivity, and workplace satisfaction by offering confidential support for personal and professional challenges. This helps employees manage stress, improve their overall well-being, and maintain a healthy work-life balance, ultimately benefiting both the individual and the organization.
Your EAP offers you the following!
- Certified Life Coaching & Counseling: Access to expert life coaches and counselors for stress management, career growth, relationship challenges, and personal development.
- Health Advocacy: Support for navigating healthcare, finding providers, resolving billing issues, and making informed insurance decisions.
- Solutions Paths: Personalized, step-by-step guidance and adaptable resources for continuous growth and goal achievement.
- Bree Video Library: Guided meditations, relaxation techniques, educational content, and weekly mood-boosting videos.
- E-Learning Resources: On-demand interactive courses on workplace safety, leadership, and personal development.
- Virtual Concierge Services: Personal assistants to help with everyday tasks such as researching child/elder care, coordinating travel, planning events, and finding local services.
- Entertainment Discounts: Savings on entertainment, travel, shopping, and experiences through partnerships, enhancing satisfaction and work-life balance.
- Legal & Financial Resources: 30-minute legal consultations, 90-minute financial planning sessions, a comprehensive resource library, and preferred rates for ongoing services.
- Professional Health Advocacy Services: One-on-one guidance for claims, billing, benefits, provider research, prescription cost navigation, appeals, and dispute resolution.
- Life Assist Services: Travel assistance, identity theft resolution, and beneficiary companion assistance for support beyond life insurance.
Scan the QR Code below to download the Bree Health App!
Call/Email Bree Health or click the link below!
(888) 868-9790 | hello@breehealth.com
Company Code: 9782
MENTAL HEALTH: ADDITIONAL RESOURCES
Call 911 if you or someone you know is in immediate danger or go to the nearest emergency room.
988 Suicide & Crisis Lifeline
- Dial 988 to be connected with 24/7/365 emotional support.
- Free, confidential crisis counseling, including appropriate follow-up services, is available no matter where you live in the United States.
War Vet Call Center
- Veterans and their families call 877-WAR-VETS (877-927-8387) to talk about their military experience and/or readjustment to civilian life.
MEDICARE ELIGIBLITY
Medicare eligibility is a critical aspect of healthcare planning, particularly for individuals nearing age 65 or those with qualifying disabilities. Here are the key points to keep in mind:
- **Age 65 or Qualifying Disability**: Most individuals become eligible for Medicare at age 65, while those with certain disabilities or medical conditions may qualify earlier.
- **Comprehensive Coverage**: Medicare provides coverage for hospital stays, medical services, prescription drugs, and preventive care, offering essential healthcare benefits.
- **Enrollment Periods**: It's important to understand the various enrollment periods for Medicare, including the initial enrollment period, special enrollment periods, and annual open enrollment periods for making changes to coverage.
- **Supplemental Coverage Options**: Many individuals choose to supplement their Medicare coverage with additional plans, such as Medicare Advantage (Part C) or Medicare Supplement Insurance (Medigap), to enhance benefits and fill gaps in coverage.
As you navigate your benefit elections, be sure to consider your Medicare eligibility and options alongside your employer-provided benefits. Understanding your Medicare coverage can help ensure comprehensive healthcare coverage that meets your needs as you transition into retirement.
- Premium: The amount paid for insurance coverage deducted from your paycheck on a per-pay-period basis.
- Deductible: The amount you must pay out of pocket for covered services before your insurance plan starts to pay.
- Copayment (Copay): A fixed amount you pay for covered services at the time of service, usually for doctor visits or prescription drugs.
- Coinsurance: The percentage of costs you pay for covered services after you've met your deductible.
- Out-of-Pocket Maximum: The maximum amount you'll have to pay for covered services in a plan year, after which your insurance plan pays 100% of covered costs.
- Network: The group of doctors, hospitals, and other healthcare providers contracted with an insurance company to provide services at discounted rates to plan members.
- Preventive Care: Healthcare services aimed at preventing illness or detecting health conditions early when treatment is most effective, often covered at no cost under insurance plans.
- Benefit: The healthcare services or items covered by an insurance plan.
- Preauthorization: The process of obtaining approval from your insurance company before receiving certain medical services or treatments.
- In-Network: Healthcare providers or facilities that have contracted with your insurance company to provide services at lower costs to plan members.
- Exclusion: Specific healthcare services or conditions that are not covered by an insurance plan.
- Lifetime Maximum: The maximum amount of money that an insurance plan will pay for covered services over the entire life of the policy.
- Grace Period: A specified period after the premium due date during which coverage remains in force even though the premium has not been paid.
- Coordination of Benefits (COB): A process used when an individual is covered under more than one health insurance plan to determine which plan pays first and how much each plan will pay.
- Explanation of Benefits (EOB): A statement sent by the insurance company to the insured individual explaining what medical treatments and/or services were paid for on their behalf.
2026 - 2027 REQUIRED NOTICES
Federal regulations require employers to provide certain notifications and disclosures to all eligible employees. If you have any questions or concerns, please contact your HR Department.
If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a Federal law gives you more choices about your prescription drug coverage.
Please see page 4 of the Required Notices packet for more information about your options.