WOODY SANDER FORD

Table of Content

  1. Header
  2. Page
    1. WELCOME
    2. OPEN ENROLLMENT IS HERE
    3. ELIGIBILITY
    4. MEDICAL / RX
    5. HSA
    6. DENTAL
    7. VISION
    8. FSA
    9. LIFE
    10. DISABILITY
    11. LEARNING
    12. RESOURCES
    13. PLAN DETAILS
    14. EMPLOYEE ASSISTANCE PROGRAM
    15. WELLNESS HUB
    16. ADDITIONAL BENEFITS
    17. Contact Us
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WELCOME


OPEN ENROLLMENT IS HERE

2023 ENROLLMENT

Open Enrollment runs from 12/01/2022 through 01/31/2023. Any changes you make to your benefits will be effective January 1, 2023.


It is the time of year to review your benefit selections you have made and make any changes that you need. All elections must be submitted before January 31, 2023.

ELIGIBILITY

Current Benefit Period: January 2023 - December 2023


The benefit choices you make during your initial enrollment or annual 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.


Common life events include; Marriage, Divorce, New Dependent, Loss/gain of available coverage by you or any of your dependents.

*A full list of qualifying events can be found in the ‘Required Notice - IRS Code Section 125'

MEDICAL / RX

Humana


PPO

You have the freedom to see any physician, located in any area; however, to receive the maximum benefits under the plan, physicians should be chosen from the network of participating providers. You may also use a doctor that is not in-network and receive reduced, out-of-network benefits. Primary care physicians do not need to be designated, and referrals are not needed to visit specialists.


Preventive Services

Regardless of which plan you choose, preventive services are covered at 100% in-network and copays & deductibles do not apply.


There are 3 sets of free preventive services. See below for see a list of covered services for each group:

  • For all adults
  • For women
  • For children



Online Healthcare

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. Costs must be paid by you at the time of the virtual visit and will apply toward your deductible and out-of-pocket maximum.


Find a Doctor

You pay less out of pocket if you receive care from an In-Network provider. In-Network providers can be found on your provider’s website under “Find a Doctor”. Log in to your account and choose the network based on the plan type you are choosing.


Deductible

The amount of money you are responsible for paying each year before the plan begins to pay for covered services, with the exception of preventive care services, which are covered at 100% In-Network.


Coinsurance

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 Maximum

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.


Common Pharmacy Tiers


Generic | Lowest copay: Most drugs in this category are generic drugs. Members pay the lowest copay for generics, making these drugs the most cost-effective option for treatment. 

Preferred Brand | Higher copay: This category includes preferred, brand name drugs that don't yet have a generic equivalent. These drugs are more expensive than generics, and a higher copay.

Non-Preferred Brand  | Highest Brand copay: In this category are nonpreferred brand name drugs for which there is either a generic alternative or a more cost-effective preferred brand. These drugs have the highest copay. Make sure to check for mail order discounts that may be available.

Preferred Specialty  | Lowest specialty drug copay: Preferred specialty drugs are generally more effective and less expensive than non-preferred specialty drugs.

Non-Preferred Specialty | Highest specialty drug copay: These drugs have the highest copay for specialty drugs, usually because there may be a more cost-effective generic or preferred brand available.


Finding a Drug List

Typically, a full listing of covered drugs is found on your provider’s website. A drug list, also called a formulary, is a list of generic and brand-name drugs covered by a health plan. Although a drug may be on the drug list, it might not be covered under every plan. Review the plan materials for details on specific benefits. You can use drug lists to see if a medication is covered by your health insurance plan. You can also find out if the medication is available as a generic, needs prior authorization, has quantity limits and more.


What is a PPO?

Preferred Provider Organization

What is a PPO?

Preferred Provider Organizatio ...

Prescription Drug Overview

Prescription Drug Overview

Humana Resources

Humana Resources

Humana Summary of Benefits & Coverage

Humana Summary of Benefits & Coverage

Preventive Care Services

Preventive Care Services

DENTAL

Humana

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.


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. 

How Does Dental Insurance Work?

How Does Dental Insurance Work?

Humana Dental Summary of Benefits

Humana Dental Summary of Benefits

VISION

Humana

Under this plan, you may use the eye care professional of your choice. However, when you visit a participating in-network provider, you receive higher levels of coverage. If you choose to receive services from an out-of-network provider, you will be required to pay that provider at the time of service and submit a claim form for reimbursement.


DID YOU KNOW?

  • Eye exams can help detect serious eye and general health conditions sooner: high blood pressure, diabetes, heart disease, high cholesterol
  • Babies should receive their first professional eye exam at 6 months
  • 80% of learning in the first 12 years comes through the eyes





How Does Vision Insurance Work?

How Does Vision Insurance Work?

Humana Vision Summary of Benefits

Humana Vision Summary of Benefits

FSA

BASIC

Health Care FSA

An FSA is an employer-sponsored savings account that allows you to set aside pre-tax contributions that can be used – tax free – for qualified medical expenses ranging from deductibles, medical and prescription copays, dental & vision expenses, and more. In addition, you can use your Health FSA to pay not only for your healthcare expenses, but also for the expenses of your spouse and dependent(s).

  • With a Health Care FSA you can spend up to the full amount of your annual election as soon as your account has been set up.
  • After your initial contribution election, you ordinarily cannot change your election during the plan year. Your elected contribution amount can only be changed if your employer’s FSA plan permits you to change your election because of a qualifying life event.
  • You may elect to deposit up to $3,050 annually in pre-tax dollars.



Dependent Care FSA allows you to pay for eligible dependent care* expenses with tax-free dollars so that you and your spouse can work or attend school full-time.

  • A limited purpose FSA will reimburse you for dental and vision expenses, but you cannot claim the same expense on both the FSA and HSA Accounts.
  • Unlike the Health Care FSA, funds in a Dependent Care FSA are only available once they have been deposited into your account and you cannot use the funds ahead of time.
  • You may set aside up to $5,000 annually in pre-tax dollars, or $2,500 if you are married and file taxes separately from your spouse.
  • If you participate in a Dependent Care FSA, you cannot apply the same expenses for a dependent care tax credit when you file your income taxes.


Qualified Dependent Care ‘Persons’ - A dependent under the age of 13:

  • that has the same principal residence as you for more than half the year;
  • that is your child or step-child (by birth or adoption), or eligible foster child; and,
  • that does not provide more than half of his or her own support for the year.
  • A spouse or dependent who is physically or mentally unable to care for himself or herself and lived with you for more than half the year.


FSA’s operate with the “Use-or-Lose” Rule, meaning “unused” FSA funds do not roll over from year to year. It is very important that participants carefully plan for and decide how much to contribute at the beginning of the plan year.

If you overfund your FSA and don’t use the amount deposited in your account by the last day of the plan year, you’ll lose the funds. However, an employer*, at its option, is permitted to amend its plan document, and provide either a ‘Grace Period’ or ‘FSA Rollover’ to plan participants. An FSA cannot have both a ‘Grace Period’ and ‘FSA Rollover’. It can have one or the other or neither, at the employer’s discretion. See your plan documents for how your plan operates.

Flexible Spending Account (FSA) Overview

Flexible Spending Account (FSA) Overview

Dependent Care FSA Overview

Dependent Care FSA Overview

LIFE

Humana


Basic Life/AD&D

At no cost to you, we provide a benefit on your behalf payable to your designated beneficiary in the event of your death. An additional accidental death & dismemberment benefit (AD&D) is payable to you in the event of a covered dismemberment or to your beneficiary if your death is the result of an accident.


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. If you need to update your beneficiary, please review the "Resources" tab for the Humana beneficiary form.

Life and AD&D Insurance Overview

Life and AD&D Insurance Overview

Humana Life Summary of Benefits

Humana Life Summary of Benefits

DISABILITY

The Hartford

Short Term Disability

At no cost to you, we provide a benefit on your behalf to allow you to continue to receive a portion of your pay in the event you are temporarily disabled or ill and cannot work. The details of the coverage are provided in your summary of benefits below, and are designed to act for a definitive period of time.


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.



Short Term Disability Overview

Short Term Disability Overview

Short Term Disability Summary of Benefits

Short Term Disability Summary of Benefits

LEARNING

RESOURCE CENTER

Benefit Terms Explained

Benefit Terms Explained

What is Preventive Care?

What is Preventive Care?

How To Read An EOB (Explanation of Benefits)

How To Read An EOB (Explanation of Benefits)

RESOURCES

Value Added Benefits & Perks

Looking for the forms you need to make any changes? Look no further! Below is everything you would need to make changes to any current benefits, update elections for the plan year, or update any information, such as a beneficiary. Also included is your Annual Benefits Notices packet - this packet contains important information about the health plans provided by your employer.


Your updated cost per pay is also included in this section, look for "Benefits Cost per Pay".

Humana enrollment form

Humana enrollment form

Humana change form

Humana change form

Hunana Life Beneficiary Form

Hunana Life Beneficiary Form

Annual Benefit Notices

Annual Benefit Notices

Benefits Cost Per Pay

Benefits Cost Per Pay

WELLNESS HUB

What is Go365?


Go365 is a wellness program designed to help employees kick start their health and well-being. Employees take steps to engage in and adopt healthier behaviors and move up in Status level, earning Points and rewards for their progress. A combination of behavioral economics, individualized recommended activities, and an advanced incentive program help motivate members toward positive lifestyle change.


There are a few things members will need to do to get started with the Go365

program. This section outlines the registration process and moving out of Blue Status. It’s important to note that members who have Humana medical insurance will register for Go365 differently than those who do not.


How to register:


For members with Humana insurance:

Members who have Humana medical insurance

will follow the steps below. Once they create an account, they can use the same username and password on Go365.com and the Go365 App to access Go365 moving forward.

1. Visit Humana.com/register and “Get Started.”

2. Enter member ID number (or Social Security

number), date of birth and ZIP code.

3. Create a username, password and security prompt, and click “Next” to finish.


For members without Humana insurance:

There are two ways to register for members who DO NOT have

Humana medical insurance. Even if members register online,

encourage them to download the App for easy access on-the-go.

Via Go365.com

1. Visit Go365.com

2. Click “Register now” from the homepage

3. Complete the registration form and select “Continue.”

4. Create a username and password and click “Submit.”

Contact Us

As you consider your benefit options, please be sure to review all available information: Employee Benefits Guide, Intranet, and other videos and flyers found on this webpage. If you don't understand your benefits or need any assistance, please contact the Human Resources Department.

Account Team Contacts

DS

Deb Shaff

Account Manager

deb.shaff@nfp.com

LS

Lori Shaffer

Account Executive

lori.shaffer@nfp.com

513.725.2315

Additional Contacts

MS

Marlene Schum

mschum@woodysander.com

513-541-5586