What's New for 2022!

ImpaxRX

ImpaxRX is a concierge pharmacy program specifically targeting high-cost drugs by taking advantage of alternate distribution programs.


Income-eligible individuals will qualify to receive their prescriptions at NO COST.

For more information on ImpaxRX, contact your Human Resources department, or call 844-467-2979 (option 1) for ImpaxRX.

Helpful Links

Benefits Overview

Medical Mutual: will continue as your Medical carrier

  1. PPO Plan
  2. MedFlex Plan
  3. HSA Plan

Express Scripts: will continue as your Prescription Drug carrier

SunLife: will continue as your Dental carrier


Medical Mutual: will continue as your Vision carrier


Anthem: will continue as your Basic Life and AD&D carrier


First Stop Health: will continue as your telemedicine and virtual health carrier

EASE@Work: will continue as your employee assistance program vendor


Please contact your Human Resources office with any questions.

Alex Daw: 330-867-5511

Enroll and Qualifying Event Changes

Full-Time Employees (30 hours/week minimum)

**New employees are eligible for benefits 90 days after date of hire.

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

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

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

What is a Qualifying Life Event?

  • Marriage
  • Divorce
  • Birth/Adoption of a child
  • Death of a spouse or other enrolled dependent
  • Change in spouse’s benefits or employment status
  • A dependent becomes eligible for Medicare or Medicaid

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


What is Acceptable Documentation?

  • Marriage: marriage certificate, jointly filed federal tax return, joint mortgage/lease, joint bank account
  • Divorce: divorce decree, legal separation agreement
  • Birth/Adoption: birth certificate, adoption agreement
  • Gain/Loss of other coverage: documentation from employer or carrier with effective date
Election Form

Election Form

Request Spousal Coverage Form

Request Spousal Coverage Form

Spousal Waiver Form

Spousal Waiver Form

Nayya

Personalized enrollment guidance across your benefits.


  • You'll receive a welcome email from Nayya that provides instructions on how to claim your account.
  • Enrollment guidance begins with a personalized assessment
  • Income & Personal Finances
  • Family Structure
  • Lifestyle & Wellness Habits
  • Medical, Pharmaceutical, Vision & Dental Needs
  • Upcoming Life Events

Nayya will provide you with your own custom bundle of recommended benefits.


Need help? Contact customersuccess@nayya.com

BenXpress


All team members have access to your online benefits enrollment platform 24/7 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 24/7View all benefit plan options and your elections
  • View important carrier forms and links
  • Report a qualifying life event
  • Make changes to beneficiary designations


Go To: www.benxpress.com/summit

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

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



This is an active enrollment!

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

Medical

Medical Mutual

  1. PPO Plan
  2. MedFlex Plan
  3. HSA Plan


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


Preventive Services Covered at 100%

All routine preventive services are covered 100% as long as the claim is submitted as routine or preventive, and falls within the approved list of preventive services. Remind your physician that you are visiting for the purpose of a wellness visit and to submit your visit as preventive in nature.


What is considered a preventive service?

  • Routine exams
  • Pelvic exams, pap tests, mammograms
  • Colorectal cancer screenings
  • Vaccines & Immunizations
  • Contraceptives (specific list applies)
  • Diabetes screenings


Your prescription drug coverage is through Express Scripts.



Impax RX will reach out to income eligible employees directly to aid in the payment of high cost prescriptions. (prescription approval and income eligibility required)

Medical Mutual Membership Brochure

See whats included with your benefits

Medical Mutual Membership Brochure

See whats included with your b ...

PPO Summary of Benefits & Coverage

PPO Summary of Benefits & Coverage

HSA Summary of Benefits & Coverage

HSA Summary of Benefits & Coverage

MedFlex Summary of Benefits and Coverage

MedFlex Summary of Benefits and Coverage

Flexible Spending Account (FSA)

BASIC - FSA Guide

What's Covered with you BASIC FSA Card?

BASIC - FSA Guide

What's Covered with you BASIC ...

Flexible Spending Accounts (FSA) allow you to reduce your taxable income by setting aside pre-tax dollars from each paycheck to pay for eligible out of pocket health care and dependent care expenses for yourself, your spouse and your dependent children.


In order to participate in an FSA, you must enroll each year. Your annual contribution stays in effect during the entire year (January 1st through December 31st). The only time you can change your election is during the enrollment period or if you experience a change-in-status event. You must elect this benefit within 30 days of your hire date or first date of benefits eligibility.


Health Care & Limited Purpose FSA

  • Deductibles
  • Medical and prescription copays
  • Dental & Vision expenses

You can spend up to the full amount as soon as your account has been set. Maximum annual contribution is $2,750.


**Health Care FSA's have a $500 rollover limit. These funds can be used for the first 2.5 months of the next year. Any unused funds beyond the 2.5 months will be forfeited**


Dependent Care FSA

  • Eligible dependent care expenses
  • Funds only available once they have been deposited into account
  • Cannot use funds ahead of time
  • Up to $5,000 or $2,500 if you are married and file taxes separately



Health Savings Account (HSA)

A Health Savings Account (HSA) is a tax-free savings account that is owned by you, is 100% vested from day one, and let’s 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 have an HSA and make contributions to the account you must meet several basic qualifications.

  • You must have coverage under a qualified High Deductible Health Plan (HDHP)
  • Participants cannot be covered by any other health insurance plan (this exclusion does not apply to 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)
  • Participant cannot be enrolled in Medicare or Medicaid
  • You cannot be eligible to be claimed as a dependent on someone else's tax return
  • You have not received Department of Veterans Affairs Medical benefits in the past 90 days


Dental

Dental Benefit Summary

Dental Benefit Summary

SunLife remains the carrier for your dental benefits.


You may go to any dentist. SunLife pays all claims (network and non-network) at the 90th percentile. If a dental treatment is expected to exceed $300, SunLife recommends a dental treatment plan be submitted to claims for review, before the treatment begins.



Vision

Medical Mutual remains the carrier for your vision benefits.


You may go to any eye care provider. However, those who belong to the MMO Vision Network will be most cost effective.

Vision (and Hearing) Benefit Summary

Vision (and Hearing) Benefit Summary

Basic Life and AD&D

Basic Life Benefit Summary

Basic Life Benefit Summary

Anthem remains the carrier for your Basic Life benefits.


Your Basic Life Benefit

  • 100% company paid benefit, no cost to you
  • Flat $25,000 benefit
  • 35% reduction at age 65
  • 50% reduction at age 70
  • Benefit ends at retirement


**It is important to designate beneficiaries. The person you designate as your primary beneficiary will receive your life insurance benefits in the event of your death. It is important to designate a contingent beneficiary, who will receive the benefits if the primary beneficiary cannot.


First Stop Health

First Stop Health


No crowded waiting rooms. No driving. See a doctor when you need a doctor. Talk to a doctor 24/7.

When can I use First Stop Health?

  • Your doctor is not available
  • You will become ill when traveling
  • When you are considering a hospital visit for a non-emergency health condition

How does it work?

  • Call (888) 691-7867 or log in to fshealth.com or download the mobile app to request your doctor visit.
  • Set up your account now so its ready when you need it!
  • Complete patient registration for medical history, pharmacy preference, primary care physician contact information and insurance information.
  • Each time you visit you will be asked brief medical questions. If appropriate you will be connected to a doctor using secure live audio and video.
  • You and your doctor will discuss your medical issue and if appropriate your doctor may write a prescription.
How to Access First Stop Health

How to Access First Stop Health

EASE@Work

Ease@work


A program provided by your organization that is available to you, your household members and dependents. 24/7/365 support.

EASE@Work can help you reduce stress, improve mental health, and make life easier by connecting you to the right information and resources.


Contact Us

Client Contacts

AD

Alex Daw

adaw@summitmetroparks.org

330-867-5511

DF

Dale Fobean

dfobean@summitmetroparks.org

330-867-5511