|Monthly Rates||MEC||MEC PLUS||Indemnity w/MEC+||MEC Enhanced||MEC Enhanced + Indemnity||MVP (minimum rates)|
|Employee + Spouse||$105.00||$163.00||$333.00||$436.00||$606.00||$638.00|
|Employee + Child(ren)||$107.00||$144.00||$277.00||$409.00||$542.00||$629.00|
All full-time employees (averaging 30 or more hours/week) are eligible to join.
Due to the federal mandates of the Affordable Care Act, ALL full-time employees must submit a completed enrollment form or declination form through the myTime employee portal.
Coverage will be effective 1/1/18.
Your coverage will be effective on the first of the month following a waiting period of 60 days after your start date.
Your coverage will be effective on the first of the month following a waiting period of 30 days after your start date.
The maximum penalty for 2018 hasn’t yet been determined, but in 2017, any person who does not have Minimal Essential Coverage (MEC) in a qualified health insurance plan will be fined a minimum of $695 per adult, $347.50 per child under 18, or 2.5% of your household income, whichever is greater.
We will deduct your premium on a pre-tax basis through weekly payroll deductions on the first four payrolls of each month. Deductions will start one month prior to your effective date since the plan requires that all monthly premiums be paid in advance. Your weekly deductions will begin the first payroll period of December provided we receive your enrollment form before 12/1/17. If we received your enrollment form in December 2017, payroll deductions will be adjusted for the month of December to cover the monthly premium. Should you work less than 4 weeks in any month, your weekly premium may be adjusted in order to cover your full month’s premium. Overpaid premiums will be reimbursed should your assignment end.
We will deduct your premium on a pre-tax basis through weekly payroll deductions on the first four payrolls of each month. Deductions will start one month prior to your effective date since the plan requires that all monthly premiums be paid in advance. Should you work less than 4 weeks in any month, your weekly premium may be adjusted in order to cover your full month’s premium. Overpaid premiums will be reimbursed should your assignment end.
If your part-time status changes to an average of 30 hours per week or more at any time during your employment, and you are interested in our group insurance plan, you may join by applying within 30 days of your change in status. Your effective date will be the first day of the following month. If you miss this deadline you may still join the plan during our open enrollment period every December.
Once enrolled, you cannot cancel your coverage unless you experience a qualifying event such as recently acquiring other coverage and changes in your family size (marriage, divorce, or birth of a child). You must provide proof of the life-changing event within 30 days of that event.
If you gain a new dependent through birth, adoption, or marriage, you may enroll the new dependent at that time. You must provide proof of the life changing event within 30 days of that event.
Yes, you may enroll if you have a qualifying event such as marriage, divorce, or the birth of a child provided you enroll within 30 days of the qualifying event. If you are covered under another plan but that coverage is lost, you can enroll in our group health plan within 30 days of losing the other coverage.
If your employment ends, your insurance will be discontinued at the end of the month. You may elect to continue your coverage through COBRA.
To locate a specific provider within the PHCS Multiplan Network visit www.multiplan.com.
Refer to the Drug Index for a list of prescriptions covered through the Focus RX network. For information on which pharmacies have a cheaper price you can call Simple Save RX at 1.844.Save4RX.
Refer to the Benefit Handbook for information.
MEC** – covers preventative services only.
MEC Plus** – includes the minimum essential coverage of the MEC plan. Added benefits include three annual office visits, one annual urgent care visit, and prescription coverage.
MEC Enhanced** – includes the minimum essential coverage of the MEC plan with additional benefits including prescription coverage, primary care, specialist visits, diagnostic X-Ray and lab, imaging (CT/Pet Scan and MRI), emergency room, and urgent care.
Hospital Indemnity plan – you may add this benefit to the MEC, MEC Plus, or MEC Enhanced plan for an additional cost. This is a benefit that will pay you for doctor visits, emergency room visit, hospital admission, and inpatient/outpatient surgery.
MVP** – Requires completion of a health questionnaire and a $7,150 (individual) deductible must be met before any services are covered.
**Participation in the MEC, MEC Plus, MEC enhanced, or MVP plan will meet the ACA requirement of minimum essential coverage.
Additional Discounted Coverage:These bundles, by themselves are not ACA compliant; however, when included with a primary plan, offer discounts. Refer to the bundle information packet and visit www.TruBenies.com for additional information to sign up. These bundles are a discount card program where you pay the discounted price at the time of service at a participating dentist.
Dental Advantage Discount Bundle*** – Benefits include dental, chiropractic, vision, lab testing, hearing aids, MRI & Ct Scans, and Diabetic supplies. Monthly cost = $11.50.
Telehealth Plus Discount Bundle*** – Benefits include Teledoc, Doctors online, health wealth connection, health advocate, vitamins, retail health clinics, and pharmacy. Monthly cost = $13.50.
Advantage Plus Discount Bundle*** – Both Telehealth Plus and Dental Advantage bundled together. Monthly cost = $19.95.
Lifestyle Discount Bundle*** – Benefits include ID Sanctuary, Legal Care Direct, Pet care savings, Roadside Assistance, and Global Travel Assistance. Monthly cost = $18.50.
***These bundles are NOT available in FL, KS, UT, VT, and WA. Global Travel Assistance and Discount lab work benefits are also not available in certain states.
Delta Dental – $1,000 calendar year maximum / $50 calendar year deductible per person.
Employee = $39.39/month.
Employee + 1 Dependent = $77.92/month.
Employee + 2 or more Dependents = $120.75/month. Refer to the Delta Dental Information packet and Delta Dental Enrollment Form. Coverage is effective on the first of the month following a 30 day waiting period after your start date. Deductions start on the first pay period after coverage is effective.
Refer to the Pricing Comparison Table.
If you have any questions, please contact our insurance team at 562-284-5333 or email firstname.lastname@example.org.