City of Sand Springs

Table of Content

  1. Header
  2. 2024 City of Sand Springs Benefits
    1. Open Enrollment: May 17, 2024 through May 23, 2024
    2. How to Enroll
    3. Eligibility & Qualifying Events
  3. Medical & RX
    1. Summary of Benefits and Coverage (SBC) & Required Notices
    2. Prescriptions
    3. Virtual Visits
    4. CommunityCare Resources
    5. Anthem Resources
    6. UnitedHealthcare Resources
    7. Cigna Resources
  4. HSA
    1. HSA Forms and Resources
  5. FSA
    1. FSA Forms and Resources
  6. Dental
    1. Dental Summary
  7. Vision
    1. Vision Summary
  8. Life and AD&D
  9. Disability
  10. Voluntary Worksite Insurance
  11. Page
    1. Open Enrollment Window: November 21st - December 21st
    2. CommunityCare Resources
    3. Well Being Resources
    4. Benefits Overview
    5. Medical
    6. Dental
    7. Vision
    8. Life & AD&D
    9. Disability
    10. American Benefits Group (ABG)
    11. Cancer Policy
    12. Enrollment Forms
    13. Helpful Benefit Videos
    14. Contact Us
  12. Footer

2024 City of Sand Springs Benefits

Welcome to City of Sand Springs 2024 Open Enrollment. Enrollment begins May 17, 2024 and will last until noon on May 23, 2024. This site houses all our benefit summaries and information required to enroll or make changes to your current benefit elections.


Deadline for enrollment is noon on May 23, 2024. It is important that we all login (even if waiving benefits) and confirm personal details as well as beneficiary information related to our employer provided Life and AD&D insurance.


Online Enrollment through Employee Navigator

If this is your first-time enrolling, you can register by accessing this Registration link. During the registration process, you may be required to enter personal identifying data as well as the following company identifier: CitofSanSpr2024

If you are already registered, start making changes to your insurance elections through the "Enroll Here" link below.


REMINDER: if you wish to participate in a Flexible Spending Account, you MUST make an active election each year. Prior elections do not carry over.




ELIGIBILITY

All full-time employees are eligible to participate in benefits offered by the City of Sand Springs. When you enroll in the benefits program, you may also cover your eligible benefits. Dependents include your legal spouse, child(ren) up to age 26 (regardless of student status, marital status, residence, or financial dependence on you), and an unmarried disabled child incapable of self-support.



QUALIFYING EVENTS

A Qualifying Life Event or QLE, is a significant change in a person's life that allows them to make changes to their health insurance outside of the regular open enrollment period. Examples of qualifying life events include marriage, divorce, the birth of a child, loss of health coverage, and a change in employment status.

You must notify HR within 30 days of a QLE in order to make a change to benefits. If you miss this window you may have to wait until next open enrollment to make your updates/changes to benefits.

Medical & RX

City of Sand Springs offers HMO Medical Plans through CommunityCare. You have three options to choose based on your individual needs.

A Health Maintenance Organization (HMO) is a type of health insurance plan that operates through a network of physicians and healthcare providers. In an HMO, you need to choose a primary care physician (PCP). Your PCP will be your main healthcare professional and coordinate your care. ComnunityCare does not require a referral from your PCP for specialty care, such as see a specialist or getting physical therapy unless you are seeking care out-of-network.

What is a HMO?

What is a HMO?

Summary of Benefits and Coverage (SBC) & Required Notices


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

Idea Plus 6 - Low Plan

$2,500 Individual Deductible

Idea Plus 6 - Low Plan

$2,500 Individual Deductible

Idea Plus 3 - Base Plan

$1,000 Individual Deductible

Idea Plus 3 - Base Plan

$1,000 Individual Deductible

Idea Plus 1 - Buy-Up Plan

$500 Individual Deductible

Idea Plus 1 - Buy-Up Plan

$500 Individual Deductible

07.01.2024-06.30.2025 Required Notices & Federal Mandates

07.01.2024-06.30.2025 Required Notices & Federal Mandates

CommunityCare Resources

www.ccok.com

CommunityCare offers Telemedicine and 24/7 Online Care

This option will provide easy access for some urgent care and behavioral health services to immediately allow member access to a local health care professional. This service is similar to an urgent care visit, but members will only be charged a primary care office visit copay at the time of service. When the 24/7 Online Care option is selected from the CommunityCare website or member portal, the member will need to then select Saint Francis Health System. Once they make their selection, their online visit will begin with a health care professional.

Telemedicine

Telemedicine is accessed through the provider's online patient portal, and members can initiate an online appointment with their provider of choice. The member will be responsible for paying any applicable copay/cost share charged by the provider on the portal and the claim will be sent to CommunityCare.

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

Visit www.saintfrancis.com/mychart/appointment-scheduling.

24-Hour Nurse Line

A free, 24-hour nurse staffed health information line is available for CommunityCare members. You may speak to a registered nurse who can recommend a proper course of treatment for medical conditions or problems. Call 800.777.4890.

Wellness

Visit CommunityCare's wellness page at www.ccok.com/Health-and-Wellness. Get access to health and wellness tools and resources:

  • An online General Health Assessment
  • Information on smoking cessation programs available to CommunityCare members
  • Health Encyclopedia to get information related to medical illnesses and symptoms

Urgent Care vs. Emergency Care

Urgent Care

You may need urgent care if your illness or injury is severe enough to need treatment within 24 hours. To located and in-network urgent care center, please use the provider search found at: www.ccok.com/directory

Emergency Care

If an emergency threatens life or limb, go immediately to the nearest emergency room.

Find a doctor, hospital, pharmacy or search for a prescription? Click the button below.

Medical Extras

FSA

Benefit Resources, Inc. (BRI)

The Health Care and Dependent Care Flexible Spending Accounts (FSA) allow you to set aside pre-tax dollars to pay for eligible expenses. By contributing to one or both of the Flexible Spending Accounts you reduce your taxable income, so you pay less in taxes — which saves you money. The IRS requires you to make new elections every year.

Contributions

The election you make during open enrollment is your election for the entire plan year and will be deducted from payroll throughout the year. You may change it only if you have a qualifying life event and the change request must be consistent with the event.

Health Care FSA

  • Contribute up to $3,200 annually
  • Full election amount is available on July 1
  • Unused balances, over $640 at the end of the plan year, will be forfeited.
  • All benefit eligible employees can participate unless you or your spouse are contributing to an HSA.
  • Fund can be used to pay for out-of-pocket healthcare costs (medical, dental, vision, hearing, prescriptions and some over the counter items)

Dependent Child Care FSA

  • Contribute up to $5,000 annually
  • Limited to $2,500 if you are married and file separate tax returns
  • Funds can only be used once they are deposited into the FSA
  • Pay for out-of-pocket childcare while you are working for children under 13 years old.
  • Unused balances cannot be rolled over and will be forfeited. 

FSA Info Packet

FSA Info Packet

What is an FSA?

What is an FSA?

What is a Dependent Care FSA?

What is a Dependent Care FSA?

Dental


Dental Benefits through Mutual of Omaha 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.


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 button below to view/download the formal dental benefit summary.



Dental Insurance Overview Video

Dental Insurance Overview Video

Dental Summary

Mutual of Omaha

Dental Summary

Mutual of Omaha

Vision


Mutual of Omaha offers vision coverage through EyeMed Providers. Mutual of Omaha Vision helps pay for eye exams, prescription glasses and contact lenses. You receive a higher level of benefits when you see a provider in network.



To find out if your provider is in-network, please visit the website below.



Vision Insurance Overview

Vision Insurance Overview

Vision Summary

Mutual of Omaha

Vision Summary

Mutual of Omaha

Life and AD&D

Life insurance is an important part of your financial security. Life insurance helps protect your family from financial risk and sudden loss of income in the event of your death. Accidental Death & Dismemberment (AD&D) insurance is equal to your Life benefit in the event of your death being a result of an accident and may also pay benefits for certain injuries sustained.

Basic - Employer Paid Life and AD&D | 1x Your annual salary, up to a maximum benefit of $150,000

Provided to all full-time employees by the City of Sand Springs.

Voluntary - Employee Paid Life and AD&D

Coverage is also available for your spouse and/or child dependents, but only after you've elected coverage for yourself. Review the full benefit summary below for additional details.

Employee: $10,000 increments up to 5x your annual salary, to a maximum of $500,000 ($100,000 GI)

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

Children: $1,000 increments, $2,000 minimum up to $10,000 Benefit, one premium covers all eligible dependent children ($10,000 GI - per covered child)

Who's Your Beneficiary?

Naming a beneficiary is a crucial part of electing life insurance. Also, don't forget to update your primary or secondary beneficiary if you experience a life event, such as a divorce or birth of a child.

*Guaranteed Issue (GI) and Evidence of Insurability (EOI)

When you are first eligible (at hire) for Voluntary Life and AD&D, you may purchase up to the Guaranteed Issue (GI) for yourself and your spouse without providing proof of good health (EOI). Annually, you are able to increase elections by $10,000, not to exceed the maximum benefit amount. Amounts over the GI will require evidence of insurability (EOI).

Any amount elected over the GI will require EOI. If you elect optional life coverage, and are required to complete an EOI, it is your responsibility to complete the EOI and send to the provider (address will be listed on your form) or use the link below. 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.

Life/AD&D

Life/AD&D

Basic Life & AD&D Summary

Mutual of Omaha

Basic Life & AD&D Summary

Mutual of Omaha

Voluntary Life & AD&D

Mutual of Omaha

Voluntary Life & AD&D

Mutual of Omaha

Disability

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. Your coverage pays 60% of your income up to a specific maximum in your benefit summary.

STD Benefit Features

  • Benefit begins 15th day Accident/15th day Illness (including pregnancy)
  • Benefit equal to 60% of pay, $1,000 max per week – benefit is taxable income; please consult with your tax advisor. 
  • No Pre-existing condition limitations apply.

Long Term Disability

Insurance through Mutual of Omaha can pay you a weekly benefit if you have a covered disability that keeps you from working. Long Term Disability insurance can replace part of your income while you recover.

LTD Benefit Features

  • Benefit begins after 90-day elimination period if you remain disabled.
  • Benefit equal to 60% of monthly earnings up to $5,000– benefit is taxable income; please consult with your tax advisor.
  • Pre-existing condition limitations apply for the first 3 months prior to your effective date of coverage and the disability begins in the first 12 months after your effective date of coverage.
What is STD Coverage?

What is STD Coverage?

What is LTD Coverage?

What is LTD Coverage?

Short Term Disability Summary

Mutual of Omaha

Short Term Disability Summary

Mutual of Omaha

Long Term Disability Summary

Mutual of Omaha

Long Term Disability Summary

Mutual of Omaha

Long Term Disability Summary

Mutual of Omaha - Police, Fire, EMT

Long Term Disability Summary

Mutual of Omaha - Police, Fire ...

Voluntary Worksite Insurance

Critical Illness benefits are paid directly to you as the employee upon the diagnosis of a critical illness. Additionally, it covers preventative check-ups and early diagnosis for serious conditions.

What's Covered?

  • Heart attack
  • End-Stage Kidney Disease
  • Major Organ Failure
  • Invasive Cancer
  • Skin Cancer
  • $50 Wellness Benefit

Accident Insurance benefits are paid directly to you as the employee upon accidents requiring medical treatment. Also pays you a Wellness Benefit for doing your preventative screenings.

What's Covered? 

  • Dislocations - Hip, Knee, Ankle or bones in the foot
  • Fractures - Hip, thigh, skull-depressed, rib
  • Burns - 2nd and 3rd degree burns
  • Lacerations
  • Hospital Admission
  • Hospital Confinement
  • Ground and Air Transportation
  • $50 Wellness Benefit

Hospital Insurance benefits are paid directly to you as the employee when you, your spouse or child are facing a hospital stay, you can receive a benefit to help pay unexpected expenses not covered by your plan.

 

What's Covered?

  • First Day Hospital Confinement
  • Hospital Confinement up to 30 days
  • First Day of ICU Confinement
  • ICU Confinement up to 15 days
  • $50 Wellness Benefit
Critical Illness Benefit Summary

Sun Life

Critical Illness Benefit Summary

Sun Life

Accident Benefit Summary

Sun Life

Accident Benefit Summary

Sun Life

Hospital Indemnity Summary

Sun Life

Hospital Indemnity Summary

Sun Life

Accident Claim Form

Sun Life

Accident Claim Form

Sun Life

CommunityCare Resources

CommunityCare offers Telemedicine and 24/7 Online Care

This option will provide easy access for some urgent care and behavioral health services to immediately allow member access to a local health care professional. This service is similar to an urgent care visit, but members will only be charged a primary care office visit copay at the time of service. When the 24/7 Online Care option is selected from the CommunityCare website or member portal, the member will need to then select Saint Francis Health System. Once they make their selection, their online visit will begin with a health care professional.

Telemedicine

Telemedicine is accessed through the provider's online patient portal, and members can initiate an online appointment with their provider of choice. The member will be responsible for paying any applicable copay/cost share charged by the provider on the portal and the claim will be sent to CommunityCare.

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

Visit www.saintfrancis.com/mychart/appointment-scheduling

24-Hour Nurse Line

A free, 24-hour nurse staffed health information line is available for CommunityCare members. You may speak to a registered nurse who can recommend a proper course of treatment for medical conditions or problems. Call 800.777.4890.

Urgent Care vs. Emergency Care

You may need urgent care if your illness or injury is severe enough to need treatment within 24 hours. To located and in-network urgent care center, please use the provider search found at: www.ccok.com/directory

If an emergency threatens life or limb, go immediately to the nearest emergency room.

Well Being Resources

Employee Assistance Program (EAP)

When life gets challenging, don't hesitate to reach out. The EAP is here for you and your dependents, offering counseling and consultation services. You can contact OMAG at 800.624.5544 or access resources on the website eap.lucethealth.com. The Company Code is omag.  

CommunityCare Wellness Resources

Visit CommunityCare's wellness page at www.ccok.com/Health-and-Wellness. Get access to health and wellness tools and resources:

  • An online General Health Assessment
  • Information on smoking cessation programs available to CommunityCare members
  • Health Encyclopedia to get information related to medical illnesses and symptoms

Wise & Well Training Center

The Wise & Well Training Center serves as a resource for employees to enhance their well-being and support their mental and physical health. If you're in need of a little uplift, visit the Wise & Well Training Center for additional information.

Employee Assistance Program Flyer

Employee Assistance Program Flyer

Contact Us

Additional Contacts

HW

Holly Wheat

Human Resource Specialist

holly.wheat@sandspringsok.gov

918-245-2506

JT

Jodi Thompson

Account Manager II

jodi.thompson@nfp.com

405-359-0594

KJ

Kristin Johnston

Human Resources Director

kristin.johnston@sandspringsok.gov

918-246-2507

RS

Robyn Setzer

Senior Account Executive

robyn.setzer@nfp.com

918-282-3517

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