Table of Content
- Header
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Page
- Open Enrollment 2025
- WELCOME
- ENROLLMENT
- MEDICAL/RX
- VIRTUAL VISITS
- DENTAL
- VISION
- LIFE & DISABILITY
- Carrier Contacts
- Contact Us
- PROVIDED TO ALL EMPLOYEES
- ADDITIONAL EDUCATION
- HSA
- FSA
- VOLUNTARY BENEFITS
- Footer
Open Enrollment 2025
OPEN ENROLLMENT WINDOW:
Monday November 11th through Monday November 25th for Benefits Effective January 1st, 2025
2025 BENEFITS ARE HERE!
OUR BENEFIT PACKAGE REFLECTS HOW SPECIAL OUR TEAM IS HERE AT WHOLE DENTAL WELLNESS!!
To see what's new, watch the open enrollment video here
WELCOME
Helping you and your family reach and maintain good health is very important to us. We are pleased to offer a selection of benefits designed with your health and financial wellbeing in mind. We review our benefit programs each year to ensure we consider the best combination of benefit coverage, network access and affordability for employees.
We remain committed to providing a competitive, cost-effective benefit program. Each year we take great care and detail in the benefit programs offered to employees. Below are highlights of the benefit options that will be effective January 1st:
MY HEALTH
Medical POS | Blue Care Network
Medical PPO | Blue Cross Blue Shield of MI
Medical HMO | Blue Care Network
Dental | Delta Dental of MI
Vision | Blue Vision/VSP
MY LIFE
Life and AD&D | Principal
Supplemental Life | Principal
Disability | Principal
MY EXTRAS
Virtual Visits | Teladoc
Member Discounts | Blue365
Mobile App | BCBSM
ENROLLMENT
EMPLOYEE ELIGIBILITY
You are eligible to participate in medical if you are full-time and work a minimum of 32 hours per week. You are eligible to participant in dental if you work a minimum of 10 hours per week. Your coverage will be effective on the 91st day of employment.
Children eligibility is as follows:
- Medical, Vision & Dental: End of the year the child turns 26
ENROLLMENT INSTRUCTIONS:
- Review the information in this guide and benefit plan summaries.
- You must complete and sign an election form, even if you are waiving coverage.
- You will not be allowed to make changes after the open enrollment window closes, unless you experience a qualifying life event.
The Benefit choices you make during your open enrollment remain in effect for the entire year. 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.
Contact Human Resources if you have questions about qualifying events.
MEDICAL/RX
Visit the Blues Portal: https://www.bcbsm.com/
Plan Options
- BCN HMO Gold ($2500/$5000) Base Plan
- BCN POS Blue Elect Plus $1000/$2000) Buy Up
- BCBSM PPO Simply Blue Gold ($1500/$3000) Buy Up
You may view participating providers at the link below or consult with your existing providers.
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.
*PPO OUT-OF-NETWORK charges in the above plans are subject to reasonable and customary limitations, which means you are responsible for charges over this amount in addition to separate deductible and coinsurance. Any services received from an out-of-network provider, with the exception of a true emergency, will not be covered
Point of Service | In-Network & Out-of-Network Benefits Available
Blue Elect Plus provides the affordability and managed care benefits of an HMO, layered with provider choice without the need for a referral. Members will have access to BCN’s vast network with the flexibility of provider choice out-of-network. Members living in Michigan must first choose a BCN PCP and have the option to seek care from other physicians and specialists without a referral.
HMO | In-Network Services Only
An HMO gives you access to doctors and hospitals within the HMO network. But unlike PPO plans, care under an HMO plan is covered only if you see a provider within that HMO’s network. You must select a Primary Care Physician, and you must get a referral from your PCP to see other doctors In-Network.
VIRTUAL VISITS
Call: 1-800-835-2362
With BCBSM Virtual Care by Teladoc Health, eligible employees and dependents have access to virtual medical and mental health care from board certified doctors, psychiatrists and licensed therapists 24 hours a day, 7 days a week, 365 days per year.
How Much Does it Cost?
- Same cost as your office visit copay of your medical plan
- Prescriptions: If prescribed during a virtual visit, applicable Rx cost sharing will apply based on which medical plan you are enrolled in.
To get access to these convenient services you may call 1-800-835-2362 or visit: www.bcbsmi.com
DENTAL
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.
The plan is a PPO plan with a $1,000 annual maximum per covered individual. There is a $75 deductible per member on the plan.
Coverage:
- Preventive services - 100% (In) / 80% (Out)
- Basic services - 80% (In) / 60% (Out)
- Major services - 50% (In and Out)
VISION
VSP Vision - VSP Choice Network
Your employer offers vision coverage through BCBSM / VSP to help pay for eye exams, prescription glasses and contact lenses. You receive a higher level of benefits when you see a provider in network, however, out-of-network coverage is provided but may only be handled as reimbursements in some situations. Review your coverage details in your Benefit Guide.
To find out if your provider is in-network, please visit the website below.
LIFE & DISABILITY
Life & Disability
Your employer provides you with financial protection options for life, accidental death & dismemberment, short term disability and long term disability.
Life/AD&D
A sudden accident or death can leave you or your loved ones in a vulnerable position. Employees have the opportunity to enroll in Term Life and Accidental Death & Dismemberment insurance which will supplement lost income in the event of an accident or death. If you choose to enroll in employee coverage, this will be in addition to your employer provided Basic Life coverage.
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.
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.
Long Term Disability
Serious illnesses or accidents 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.
Please consult your Employee Benefits Guide and review the benefit summaries for additional details.
Carrier Contacts
PROVIDER CONTACT INFORMATION
Blue Cross Blue Shield of Michigan
Blue Care Network
(877) 722-6030
(800) 662-6667
Delta Dental
Dental Plan
(800) 524-0149
Blue Vision/VSP
Vision Plan
(800) 877-7195
Principal
Life/STD & LTD
(800) 986-3343
Contact Us
As you consider your benefit options, please be sure to review all available information: Employee Benefits Guide, and other videos and flyers found on this webpage. If you don't understand your benefits or need any assistance, please contact:
Client Contacts
Sandy Pouttu
sandy@wholedental.com
(586) 772-0100