Welcome!

Welcome to your 2025 Annual Open Enrollment

Your Benefit Period is July 1, 2025 – June 30, 2026

For Full-Time Employees Only ​

Richter Healthcare Consultants sponsors the Richter Healthcare Welfare Benefit Plan under plan number 501 and hereby provides notice of the plan changes which are effective on 7/1/2025. If you have any questions about these changes in benefits, please contact, Jessica Stroia at 216-285-0804 or Jessica.Stroia@richterhc.com

​​

Medical/RX: Provided through Medical Mutual with two plan options

Plan 1 - HSA $4,000/$8,000 deductible, then 100%

Plan 2 - PPO $3,000/$9,000 deductible, then 100%

Plan 3 - PPO MOP 80 with $100/$200 deductible (this plan is no longer being offered)

Dental: Provided through Medical Mutual, two plan options with no plan changes

Plan 1 - Basic PPO $75/$225 ded; 100%/50%/50% w/ ortho

Plan 2 - Advantage PPO $75/$225 ded; 100%/100%/50% w/ ortho

Vision: Provided through Anthem BCBS utilizing expanded network Blue View Vision and EyeMed with no plan changes

Basic Life & ADD & Voluntary Life: Provided through Lincoln with no changes

STD & LTD Disability: Provided through Lincoln with no plan changes

Worksite: Provided through Lincoln with 3 offerings

Voluntary through payroll deductions and employee owned

Supplements medical plans as a cash benefit

3 Product Offerings for Critical Illness, Accident, and Hospital Indemnity

Pet Insurance: Voluntary benefit through Pet’s Best. Employee enrolls and pays premiums directly through Pet’s Best.

HSA Contributions: The maximum limit for 2025 increased to $4,300 single / $8,550 family.

The maximum limit for 2026 increases to $4,400 single / $8,750 family.

Those aged 55+ may contribute an additional $1,000 in "catch-up contributions" in 2025 and 2026

COMING SOON - 2024 Open Enrollment Meeting Recording

Common Insurance Terms

A PREMIUM is the amount you pay for insurance, using pre-tax or post-tax dollars.

A DEDUCTIBLE is the amount of money you are responsible for paying each year before the plan begins to pay for covered services. Your plans include two types of deductibles:

Embedded Deductible: One individual must meet the single deductible. A combination of 2 or more members can meet a family deductible.

COINSURANCE This is your share of the expense of covered services after your deductible has been paid when the company plan is paying a percentage. The coinsurance rate is usually a percentage.

OUT-OF-POCKET (OOP) MAXIMUM is the most you pay per Plan Year for health care expenses and applies to deductibles, flat-dollar copays and coinsurance for all covered services – including cost-sharing amounts for prescription drugs. Once this limit is met, the plan will cover all in-network services at 100% until the end of the plan year.

OUT-OF-NETWORK charges are subject to reasonable and customary limitations, which means you are responsible for any charges that exceed the carrier’s contracted amount (often referred to as balance billing). In addition, charges will be paid at the non-network deductible and coinsurance. Call your insurance carrier or refer to your provider’s network directory to verify if the provider is in network – this includes all providers of care: radiologists, pathologist or any referrals from physicians.

PPO HSA | In-Network & Out-of-Network Benefits

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.

Enrolling in this plan allows you to contribute tax free dollars to a health savings account (HSA). Any dollars that you (and your employer) wish to contribute can be used towards any eligible medical, Rx, dental and vision expenses that you may incur while covered under the plan. See HSA section of this guide for additional details.

PPO | In-Network & Out-of-Network Benefits Available

The 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.

Preventive Services | Covered at 100% NO COST SHARE

All plans recognize routine preventive services at 100%, no coinsurance, no deductible as long as the claim is submitted as “routine or preventive” and the services performed falls within the approves list of preventive services. For a complete and updated listing, please go online and search uspstf-a-and-b recommendations or visit https://www.uspreventiveservicestaskforce.org.

During your wellness visit, proactively let your physician know the reason for the appointment is for a wellness visit and that your physician needs to submit and code the visit as routine, preventive in nature. If your visit is submitted with a diagnosis, the wellness visit will not be paid at 100%, but instead, will be subject to deductible and coinsurance. Below are a few examples of services that can be recognized as preventive:

  • Routine Wellness Exams, including well baby & child routine exams
  • Cholesterol and lipid level screening
  • Pelvic exam, pap test and screening mammograms
  • Colorectal cancer screening, colonoscopies, sigmoidoscopies (age limit applies)
  • Vaccines & immunizations: Hepatitis A & B, Influenza, Pneumonia, Shingles
  • Contraceptives (specific list applies) & Diabetes screenings

How To Enroll?

**Action Required**

All team members have access to our online benefits enrollment platform, Ahola, 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.

  • Accessible 24/7
  • View all benefit plan options and your elections
  • View important carrier forms and links
  • Report a qualifying life event
  • Make changes to beneficiary designations and more

ENROLLMENT INSTRUCTIONS:

  1. Log into your Self-Service Portal through Ahola
  2. Click on Benefit Enrollment
  3. Select or change your benefits, dependents, beneficiaries, etc.
  4. Make sure to sign your forms, save your elections, and print your confirmation statement

Eligibility & Qualifying Events

The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire plan year.

EMPLOYEE ELIGIBILITY

You are eligible to participate if you are full-time and work a minimum of 30 hours per week.

New hires are eligible for coverage on the first day of the month following 30 days of employment.

Eligible employees may make their benefit elections between May 27th and June 6th for a July 1, 2025 effective date. If you do not enroll during this Open Enrollment period, you must wait until the next Open Enrollment period unless you experience a Qualifying Life 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.

You can, however, modify your elections under certain circumstances, called "Qualifying Events" These are events such as marriage, divorce, birth or adoption of a child, loss of eligibility under another plan. If you experience a qualifying event, you may make changes to your benefits within 30 days of the event or 60 days if the event is due to birth or adoption of a child.

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

The term ‘child’ refers to any of the following:

  • A natural (biological) child
  • A stepchild
  • A legally adopted child
  • A foster child
  • A child for whom legal guardianship has been awarded to the participant or the participant’s spouse
  • Disabled dependents may be eligible if requirements set by the plan are met.

IMPORTANT

You cannot make changes to these elections during the year unless you experience a qualified family status change, which must be reported to Human Resources within 30 days of the event.

If you separate from employment, COBRA continuation of coverage may be available as applicable by law. COBRA Continuation details can be found in the notices section of this employee benefit guide.

What is a Qualifying Life Event (QLE)?

What is a Qualifying Life Event (QLE)?

Medical

Drug and Alcohol Rehab: Medical Mutual Insurance Coverage

Medical Mutual utilizes the SuperMed Plus network in the State of Ohio and the Cigna network for services provided Out-of-State. Please refer to Medical Mutual’s plan documents for the in and out of network benefit levels, along with plan details.


Below is a link to an Interactive Cost Tool where you can enter estimated medical expenses to see which plan is the best fit for you.

Medical Mutual Member Login

Medical Mutual Member Login

Find a Doctor

Find a Doctor

Preventive Care Services Guide

Preventive Care Services Guide

2025 MMO Basic Prescription Drug Formulary

2025 MMO Basic Prescription Drug Formulary

Plan 1 - HSA 4000

SBC - Summary of Benefits and Coverage

Plan 1 - HSA 4000

SBC - Summary of Benefits and ...

Plan 2 - PPO 3000-9000

SBC - Summary of Benefits and Coverage

Plan 2 - PPO 3000-9000

SBC - Summary of Benefits and ...

Interactive Cost Tool

Interactive Cost Tool

Save Money With 90-Day Supply Options

Save Money With 90-Day Supply Options

HSA - Health Savings Account

A Health Savings Account (HSA) is a tax-free savings account that is owned by you, it is 100% vested from day one, and lets you build up savings for future needs. The funds may be used to pay for qualifying healthcare expenses not covered by insurance or any other plan for yourself, your spouse, or tax dependents. You decide how much you would like to contribute, when and how to spend the money on eligible expenses, and how to invest the balance.

To be eligible for an HSA, you must be enrolled in the HSA 4000 High Deductible Health Plan (HDHP).

UNDERSTANDING YOUR HSA

  • Pre-tax contributions are deducted through payroll and deposited into your HSA account
  • You can use your HSA available funds to pay for qualified medical expenses tax-free
  • HSA funds can be used for non-eligible expenses but will be subject to regular income taxes and a 20% excise tax penalty
  • Unused funds remain in your account for future use and roll over each calendar year
  • HSA's remain with you even if you change health plans or companies. If you open an HSA and later become ineligible to make contributions, you can still use your remaining funds
  • You can change your HSA contribution at any time during the plan year for any reason

You may contribute as follows (2025):

  • $4,300 for Employee Only
  • $8,550 for a two-person or family
  • $1,000 HSA "Catch-Up" Contributions (Age 55 or older)

You may contribute as follows (2026):

  • $4,400 for Employee Only
  • $8,750 for a two-person or family
  • $1,000 HSA "Catch-Up" Contributions (Age 55 or older)

HSA ELIGIBILITY REQUIREMENTS

To have an HSA and make contributions to the account, you must meet several basic qualifications

  • To be eligible to open and contribute to an HSA, you must have coverage under a qualified High Deductible Health Plan (HDHP)
  • Participants cannot be covered by any other health insurance plan that is a non-HDHP plan. i.e. enrolled in spouses plan that is a PPO plan (this exclusion does not apply to certain other types of insurance, such as dental, vision, disability or long-term care coverage)
  • Participants cannot participate in a Healthcare FSA or spouse/domestic partner’s Healthcare FSA or Health Reimbursement Account (HRA)
  • Participants cannot be enrolled in Medicare or Medicaid (including dependents)
  • You cannot be eligible to be claimed as a dependent on someone else’s tax return
  • You have not received Tricare, Indian Health Services or Department of Veterans Affairs Medical benefits in the past 90 days

MAINTAINING RECORDS

  • To protect yourself in the event that you are audited by the IRS, keep records of all HSA documentation and itemized receipts for at least as long as your income tax return is considered open (subject to an audit), or as long as you maintain the account, whichever is longer.
  • HSA funds may be used for non-eligible expenses but will be subject to regular income taxes and a 20% excise tax penalty.

*A full list of qualified expenses can be found in IRS Publication 502 at www.irs.gov OR click the link below to the HSA store.

Health Savings Account (HSA) Overview

Health Savings Account (HSA) Overview

HSA - Setup

Step 1 - If you selected the HSA 4000 plan in Ahola, Medical Mutual will send your card to your home address. An email will be sent to you letting you know that your card has been mailed.

*Please ensure your email address and physical home address are up to date in Ahola

Step 2 - Once you receive your HSA bank card in the mail, you will receive instructions with your card to activate your new HSA card.

Step 3 - Now that your card is activated, download Medical Mutual’s AccountLink app on your phone where you can:

  • Access accounts – Check balances, view transaction history and more.
  • Manage claims and track expenses – Submit new claims, upload receipts, check claims status and track your eligible expenses.
  • Access your Medical Mutual debit card – Manage card details, access your PIN and request a replacement for a lost or stolen Medical Mutual debit card.
  • Receive alerts – View important account messages.

For more information, please refer to the links below to review the HSA Flyer and Member Guide.

MMO Member Flyer - HSA

MMO Member Flyer - HSA

MMO HSA Member Guide

MMO HSA Member Guide

AccountLink Registration Guide

AccountLink Registration Guide

Virtual Visits - Telemedicine

Cleveland Clinic Express Care

No crowded waiting rooms. No Driving. See a doctor when you need a doctor.

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.

Plan 1 - HSA 4000: A $49 copay for Plan (unless the deductible is satisfied then it is covered at 100% for the HSA Plan only)

Plan 2 - PPO 3000-9000: Office visit copay applies.

Payment is required at the time of the virtual visit

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​
  • Bronchitis​
  • Diarrhea​
  • Fever​
  • Pink eye
  • Rash​
  • Seasonal flu​
  • Sinus​
  • Sore throat​
  • Stomach

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 to provider sites by logging into your www.member.medmutual.com or by using the MedMutual app on your phone.​

​For questions regarding online health care, go to: clevelandclinic.org/eco

Virtual Visits | Cleveland Clinic Express Care

Virtual Visits | Cleveland Clinic Express Care

Telemedicine Flyer

Telemedicine Flyer

Mobile App - MedMutual

Download the MedMutual Mobile App

Your Health Plan Benefits at Your Fingertips


Get access to the vital health insurance information you need wherever you are with the MedMutual mobile app. It makes it easy and convenient to manage your health insurance, whether you’re at home, at your doctor’s office or on the go.


Track Your Claims and Spending Information

Review your claims, including details about the total amount billed, what Medical Mutual paid and what you are responsible for paying. You can also view other spending information, like your deductible, out-of-pocket costs and explanation of benefits (EOB) statements.


Find a Provider

You can enter your location to find the nearest doctor, hospital or urgent care facility covered by your plan and get step-by-step directions. You can also view quality and patient ratings for providers.


Access Your ID Card

You always have your ID card with you with our mobile app. View the front and back of your card and call any of the phone numbers listed with just a tap. You can also email or fax your card to your provider.


Securely Log In Without Your Password

You can even use your device’s Facial Recognition or Touch ID feature for a simple, secure and convenient login. This means you don’t have to type in your username and password if these features are enabled.


To download or update the app, visit your device’s App Store (Apple) or Google Play (Android). Make sure your app is set to automatically update, so you don’t miss out on future upgrades and new features.

Mobile App Flyer

Mobile App Flyer

Dental

Drug and Alcohol Rehab: Medical Mutual Insurance Coverage

Your dental coverage is through Medical Mutual who utilizes the Superior Dental Network. Network dentists agree to accept Medical Mutual’s contracted amount and may not balance bill. Non-network dentists may bill you for any difference in cost between the Medical Mutual allowed amount and the dentists’ fees.


COMMON TERMS


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.


DUAL COVERAGE

You might have benefits from more than one dental plan, which is called dual coverage. In this situation, the total amount paid by both plans can’t exceed 100% of your dental expenses. And in some cases, depending on the specifics of the plans, your coverage may not total 100%.


LIMITATIONS AND EXCLUSIONS

Dental plans are intended to cover part of your dental expenses, so coverage may not extend to your every dental need. A typical plan has limitations such as the number of times you can receive a cleaning each year. In addition, some procedures may not be covered under your plan, which is referred to as an exclusion.

Medical Mutual Member Login

Medical Mutual Member Login

Find a Dentist

Find a Dentist

Dental Cert Book

Dental Cert Book

Vision

Anthem Blue Cross Blue Shield Work From Home


You have many choices when it comes to using your benefits. As a Blue View Vision plan member, you have access to one of the nation’s largest vision networks. You may choose from many private practice doctors, local optical stores, and national retail stores including LensCrafters®, Target Optical® and most Pearle Vision® locations. For a complete listing, go to anthem.com/findadoctor. Select Vision for type of care, then select the Blue View Vision network.


Did you know your eyes can tell an eye care provider a lot about you?

In addition to eye disease, a routine eye exam can help detect signs of serious health conditions like diabetes and high cholesterol. This is important, since you won’t always notice the symptoms yourself and since some of these diseases cause early and irreversible damage.

Anthem Member Login

Anthem Member Login

Find an Eye Doctor

Find an Eye Doctor

Anthem Vision

Summary of Benefits

Anthem Vision

Summary of Benefits

Anthem Vision Brochure

Anthem Vision Brochure

Life and AD&D Insurance

Basic Life and AD&D Insurance - Company Paid Benefit, no cost to you!

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. 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.

Benefit Details

  • Coverage Amount: Flat $50,000 Benefit
  • Accidental Death and Dismemberment (AD&D): Amount equal to your Life benefit
  • Benefit Reduction Schedule - Your insurance will reduce to: 50% of the original amount at age 70 and 75% of the original amount at age 75

Additional Provisions

  • Accelerated Death Benefit: Benefits are available if there is less than 12 months life expectancy, up to 75% of Life Benefit
  • Conversion: Application must be made within 30 days following termination

Voluntary Life and AD&D Insurance - Employee Paid Benefit

Employees have the option to purchase additional life insurance at affordable group rates through payroll deduction. This coverage is also available for your spouse and dependent children if you elect coverage. Conversion and Portability are included as long as an application is received within 30 days following termination. An Accelerated Death Benefit is available if less than 12 months life expectancy, (lesser of) $250,000 or 75% of the Life Benefit.

Cost of Coverage

Premiums are based on age-related tables and paid by the employee every pay period through a payroll deduction. These premiums are post-tax and benefits payable are tax-free. The age-related tables and premiums are programmed into the Ahola online enrollment system.

Coverage Options

Employee

  • Choose in $10,000 increments up to the lesser of 5x annual salary or $300,000 (up to age 70)
  • If newly hired, you must enroll for Voluntary Life within 30 days for up to $100,000 on a Guarantee Issue basis. Any amounts in excess of $100,000 will require medical evidence of insurability (EOI)
  • Existing employees may elect up to $10,000 or $20,000 without evidence of insurability as long as not previously declined or enrollment withdrawn, and Guarantee Issue has not been exceeded

Spouse

  • Newly hired spouses can elect in increments of $5,000, not to exceed $150,000
  • Spouse may not exceed 50% of the employee’s elected amount
  • Premiums for spouse will be based on employee’s age
  • Existing employee’s spouse may elect up to $10,000 without evidence of insurability as long as not previously declined or enrollment withdrawn

Children

  • Can elect in flat amount of $250 from 15 days to 6 months and a flat $10,000 from 6 months to age 19 (or age 25 if fulltime student)
  • Age limit – birth to age 14 days – NOT COVERED
  • Note: the premium rate is a flat rate that applies to all eligible children in the family

Plan Provisions

Benefit Reduction Schedule - Your insurance will reduce to: 50% of the original amount at age 70 and 75% of the original amount at age 75

Conversion: Application must be made within 30 days following termination.

Designation of Beneficiary: You must add/update your beneficiary in EASE with any changes in beneficiary designations. You may designate different beneficiaries for your Basic Life/AD&D and Voluntary Life.

*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). Annually, you are able to increase elections up to $10,000 or $20,000 without proof of good heath.

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.

BENEFICIARY(IES)

It’s very important to designate beneficiaries. Taking a few minutes to designate your beneficiaries now will help ensure that your assets will be distributed according to your direction.

A Beneficiary is the person you designate to receive your life insurance benefits in the event of your death. It is important that your beneficiary designation is clear so there is no question as to your intentions.

It is also important that you name a Primary and Contingent Beneficiary. A contingent beneficiary will receive the benefits of your life insurance if the primary beneficiary cannot. You can change beneficiaries at any time.

You should review your beneficiary elections on a regular basis to ensure they are updated as life changes. Even if you are single, your beneficiary can use your Life Insurance to pay off your debts, such as: credit cards, mortgages, and other expenses.

*You designate your beneficiary(ies) when enrolling for your benefits.

WHAT WILL MY BENEFICIARY RECEIVE?

In The Event That Death Occurs:

– Your Basic Life insurance is paid to your beneficiary.

– If death occurs from an accident: 100% of the AD&D benefit would be payable to your beneficiary(ies) in addition to your Basic Life insurance.

Lincoln Member Login

Lincoln Member Login

Funeral Prep Flyer

Funeral Prep Flyer

LifeKeys Services Flyer

LifeKeys Services Flyer

TravelConnect Services Flyer

TravelConnect Services Flyer

Voluntary Disability

VOLUNTARY SHORT-TERM DISABILITY (STD)

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.

Cost of Coverage: Voluntary Benefit - Employee is responsible for 100% of the cost

Elimination Period: Benefits begin on the 1st day of an accident or 8th day of an illness

This is the number of days that must pass between your first day of a covered disability and the day you can begin to receive your disability benefits.

Benefit Duration: Payments may last up to 13 weeks. You must be sick or disabled for the duration of the waiting period before you can receive a benefit payment.

The maximum number of weeks you can receive benefits while you are sick or disabled.

Coverage Amount: Cannot exceed 60% of your salary *see your Certificate of Coverage for details.

What's Covered: A variety of conditions and injuries. Typical claims would include pregnancy, injuries, joint, back and digestive disorders.

Benefit Payment Frequency: Weekly benefit may be reduced or offset by other sources of income.

Cost Calculation: Composite Rate per $10 of Benefit

Waiver of Premium: If you're disabled and receiving benefit payments, you cost may be waived until you return to work.

Pre-Existing Condition Limitation: You have a pre-existing condition if you have received: medical treatment, consultation, care or services including diagnostic measures for the condition, or took prescribed drugs or medicines for it in the 3 months just prior to your effective date of coverage; and the disability begins in the first 12 months after your effective date of coverage.

Certain exclusions and any pre-existing condition limitations may apply. Please refer to the Provider’s detailed benefit summary for details.

VOLUNTARY LONG-TERM DISABILITY (LTD)

Serious illnesses or accidents can come out of nowhere. They can interrupt your life, and your ability to work for months – even years.

Long Term Disability provides financial protection for you by paying a portion of your income, so you have financial support to manage your disability and your household.

Cost of Coverage: Voluntary Benefit - Employee is responsible for 100% of the cost

Elimination Period: Your elimination period is 90 days (if elected, this will be the benefit duration of Short-Term Disability)

This is the number of days that must pass between your first day of a covered disability and the day you can begin to receive your disability benefits.

Benefit Duration: Payments will last for as long as you are disabled, or until you reach Retirement Age (age 65), whichever is sooner. You must be sick or disabled for the duration of the elimination period before you can receive a benefit payment.

The maximum number of weeks you can receive benefits while you are sick or disabled.

Coverage Amount: Covers up to 60% of your monthly income. *see your Certificate of Coverage for details

What's Covered: A variety of conditions and injuries. Typical claims would include cancer, back disorders, injuries and poison, cardiovascular, joint disorders.

Benefit Payment Frequency: Monthly benefit may be reduced or offset by other sources of income.

Cost Calculation: Age Rated Benefit

Waiver of Premium: If you're disabled and receiving benefit payments, you cost may be waived until you return to work.

Pre-Existing Condition Limitation: You have a pre-existing condition if you have received: medical treatment, consultation, care or services including diagnostic measures for the condition, or took prescribed drugs or medicines for it in the 3 months just prior to your effective date of coverage; and the disability begins in the first 12 months after your effective date of coverage.

Certain exclusions and any pre-existing condition limitations may apply. Please refer to the Provider’s detailed benefit summary for details.

Lincoln Member Login

Lincoln Member Login

Long-Term Disability Overview

Long-Term Disability Overview

Short-Term Disability Overview

Short-Term Disability Overview

EAP - Employee Assistance Program

Employees are automatically eligible for an Employee Assistance Program (EAP) and is provided to you at no cost!

EAP Overview

  • Provided through the ComPsych EAP Program that provides consultation for relationship issues, stress, coping with change, grief and loss, family and marital issues, adjustment disorder, depression, anxiety, addiction and domestic violence
  • In-Person sessions that includes up to 5 face-to-face sessions per issue. Per person, per issue, per year.
  • Live, 24/7 access to ComPsych clinicians. All clinicians hold master level degrees with at least 3 years of experience
  • Assists in locating childcare and elder care services.
  • Includes referrals to a local attorney that provides a 30-minute consultation for free.
  • On-staff accredited financial consultants who can assist with credit management, budget analysis, home buying, mortgage/refinancing, retirement planning, basic estate planning.
  • Consumer and Convenience Research—provides consultation, research and referrals on consumer issues, home and appliance repair, pet services, transportation services, house/apartment sitting resources and purchasing large ticket items.
  • Online resources such as, articles, streaming videos and interactive tools.

This is a confidential, voluntary and professional program and is intended to be a short term resource. This EAP is administered and provided by Carrier/Vendor Name and is available to you and your dependents at no additional cost.

ComPSYCH

Call: (888) 628-4824

Visit: www.guidanceresources.com

User ID: LFGsupport

Password: LFGsupport1

EAP Employee Connect Flyer

EAP Employee Connect Flyer

Voluntary Accident Insurance

Accident Insurance can pay a set benefit amount based on the type of injury and the type of treatment. It covers accidents that occur on and off the job. An option benefit, Accident Hospital Daily Confinement Benefit, pays a daily amount if you’re in the hospital for a covered illness. It’s available to each family member who has Accident coverage. You can receive $200 per day.

Who Gets Paid?

You get paid. When you have a covered accident or injury, your health insurance company pays your doctor or hospital, but your accident insurance company pays you. The money is paid directly to you, and you decide how to spend it.

What’s Covered?

Not all accidents are “qualifying injuries.” The kinds of accidents that are covered can vary by plan but accident insurance plans typically cover things like:

  • Nonsurgical Fractures
  • Nonsurgical Dislocations
  • Concussion
  • Lacerations
  • Burns
  • Dental Crown/Extraction
  • Accidental Death

If you have a covered injury, accident insurance can help you pay for things like:

  • Accidental death: employee ($50,000), spouse ($20,000) and child ($10,000)
  • Hospital Admissions (injury): $1,000
  • Hospital confinements: $200/day
  • ICU: $400/day
  • Ambulance Transportation: $300
  • ER initial care visit: $100
  • Surgical repair under general anesthesia: $225
  • Fracture-nonsurgical: $100 to $3,500
  • Laceration: $35 to $400

What it Doesn’t Cover

Accident insurance will not typically cover things like check-ups or hospitalization due to illness. Accident insurance will not cover you for injuries suffered before you purchased the plan.

What is the Cost of Accident Insurance?

Refer to the Ahola self-service portal / benefit enrollment for premium cost.

$50 WELLNESS BENEFIT - Per Covered Individual

You receive a cash benefit every year you and any of your covered family members complete a single covered assessment test.

Accident Insurance Plan Summary

Accident Insurance Plan Summary

Voluntary Critical Illness Insurance

Critical Illness Plan Summary

Critical Illness Plan Summary

How would you pay your bills if you were suddenly diagnosed with cancer and couldn’t work? Critical illness insurance doesn't’ pay your medical bills. It pays you if you’re diagnosed with a covered illness. The benefit is paid directly to you and is your choice how to spend it.

What’s Covered?

Critical illness can vary widely from one another. Some may focus on a single specific diagnosis, while others may provide you with coverage for a range of possible diagnoses, such as:

  • Cancer
  • Heart Attack
  • Loss of Sight
  • Loss of Speech
  • Major Organ Failure
  • Renal (kidney) Failure
  • Arterial/Vascular Disease
  • Severe Burns
  • Stroke
  • Permanant Paralysis
  • Traumatic Brain Injuries

COVERAGE OPTIONS

  • Employee: can choose from $5,000 to $20,000 in increments of $5,000. Coverage is guaranteed up to $20,000.
  • Spouse: can choose from $2,500 to $10,000 in increments of $2,500. Coverage is guaranteed up to $10,000.
  • Children: with your coverage election, your dependent children automatically receive 50% of your coverage amount at no extra cost

What is the Cost of Critical Illness Insurance?

Refer to the Ahola self-service portal / benefit enrollment for premium cost.

Pre-Existing Condition Limitation: During the first 12 of coverage benefits will not be payable for a pre-existing condition. A " pre-existing" condition is one in which you or an insured dependent receive treatment during the 12 months prior to the effective date of coverage. Treatment means consultation, care, and services provided or prescribed by a Physician for which symptoms exist.

If you are a participant in a Critical Illness plan which this plan replaces and are diagnosed with a pre-existing condition, we will consider whether the condition was payable under the prior plan when determining if it will be payable under this plan.

A complete list of benefit exclusions is included in the policy. State variations apply. See plan summary for details.

$50 WELLNESS BENEFIT - Per Covered Individual

You receive a cash benefit every year you and any of your covered family members complete a single covered exam, screening or immunization.

Voluntary Hospital Indemnity Insurance

Hospital indemnity compliments your health insurance to help you pay for costs associated with a hospital stay. The funds can be used to help pay for the out-of-pocket expenses that your medical plan not may cover, such as deductible and coinsurance.

Coverage is available for:

  • Employee
  • Spouse
  • Dependent Children

NOTE: Employee must purchase coverage for themselves in order to purchase spouse or child coverage

Who Gets Paid?

You get paid. When you have a covered inpatient admission, your health insurance company pays your doctor or hospital, but your accident insurance company pays you.

What’s Covered?

Hospital related expenses with plan highlights listed below:

Hospital Admissions: $1,000 per day for 1 day per calendar year

Hospital confinements: $200 per day for 15 days per calendar year starting on 2nd day of confinement

Hospital Intensive Care: $200 per day for 15 days per calendar year starting on the 1st day of confinement

Complications of Pregnancy: Included

Newborn Care: $100 per day for 2 days per calendar year

Portability

If you leave employment for any reason, worksite benefits can be converted to a direct-pay policy. The same benefits and premium rate will apply. Lincoln will send a notice to your home address following your termination from the group plan.

Pre-Existing condition limitation:

A preexisting condition means a covered condition for which treatment was received during the look-back period prior to the effective date of coverage. Treatment means consultation, care, and services provided or prescribed by a physician. It includes diagnostic measures and the prescription, refill, or taking of prescribed drugs or medicines for which symptoms exist.

  • Look-back period: A preexisting exclusion applies to conditions for which the employee received treatment during a 12-month period prior to the employee’s effective date of coverage.
  • Exclusionary period: A preexisting exclusion applies during the first 12 months of an employee’s coverage or increase in coverage. Once this period is satisfied, the exclusion no longer applies.
Hospital Indemnity Plan Summary

Hospital Indemnity Plan Summary

Compliance Notices

Annual Compliance Notices

Annual Compliance Notices

Federal regulations require employers to provide certain notifications and disclosures to all eligible employees. The compliance packet linked is dedicated to those disclosures for your July 1st - June 30th plan year. If you have any questions or concerns, please contact your HR Department.

Contact Information

IMPORTANT CONTACT INFORMATION


Client Contacts

JS

Jessica Stroia

jessica.stroia@richterhc.com

(866) 806-0799