2016 BENEFIT PLANS PDF Print E-mail

IMPORTANT NEWS & BENEFIT UPDATES

Effective January 1, 2017 Target pharmacies, which are now CVS pharmacies, will no longer be participating in the Smart90 Pharmacy program. If you are currently getting 90 day prescriptions filled at a Target pharmacy you will receive a letter from Express Scripts with options on transferring your prescriptions to a participating Smart90 pharmacy.

Aultman Hospital in Medical Mutual Network September 15, 2016

OPEN ENROLLMENT

**2017 EMPLOYEE BENEFIT PROGRAM GUIDE AVAILABLE HERE**

Open Enrollment for the 2016 High Point Summit County Employee Benefit Program will be held October 19th through November 6th.

Open Enrollment is your annual opportunity to review your benefit coverage options. During Open Enrollment employees can enroll for a new benefit, add dependents, drop dependents or drop a benefit.

Please review the 2016 Benefit Program Guide for an overview of the benefit options. The 2016 Employee Benefit Program Guide will provide employees with an overview of the benefits available, updates to the Vitality Program, and instructions on completing the On-line Open Enrollment via BenXpress. Information regarding premiums can be obtained from your benefit coordinator for your department/agency.

Attend an Open Enrollment Benefit meeting on one of the dates list in the Open Enrollment Flyer. If you cannot attend a meeting and want to learn more about Open Enrollment or Vitality, scroll to the bottom of the page for the self-guided presentations that will be available on October 16th.

Between October 19th and November 6th log into BenXpress to make your elections for 2016. Be sure to complete the entire enrollment process, SAVE your changes, and print a confirmation sheet. Click here for the BenXpress Online Enrollment Instruction Guide.

Your elections are effective January 1, 2016 and remain in effect for the entire year unless you have a Qualifying Event.

MEDICAL PLANS

Summit County offers three health plans that are designed to meet your individual needs. Visit the “My Health Plan” section of the Medical Mutual website to set up a personal secure password and order a new ID card, check the status of your claims or print a claim form, reprint an Explanation of Benefits (EOB), view a member handbook or E-mail customer service. Through this site you can also locate a SuperMed Plus hospital or physicians close to where you live and access your prescription information.

Summary of Benefits and Coverage Guide

Benefit Plan Comparison
Summary of Benefits and Coverage-Advantage Plan

Summary of Benefits and Coverage-Plus Plan
Summary of Benefits and Coverage-Minimum Value Plan

MMO Claim Form
MMO Provider Search

Domestic Partner Affidavit
Domestic Partner Frequently Asked Questions (FAQ)

Learn more about continuing coverage through COBRA - contact Greg Hartman, (330) 643-2621, ghartman@summitoh.net

PRESCRIPTION PLANS

Summit County's prescription provider is Express Scripts (administered by Medical Mutual of Ohio).  Your ID card includes both medical and prescription plan information.  Once you receive your ID card you can access your prescription infomation via the Medical Mutual website to locate an in-network pharmacy, review prescription history, view claims, price medications, refill mail orders, check mail order status and update mail order payment information.

Maintenance RX List
Mail Order Form

Preferred RX & Specialty Medication List and Coverage Management Information
Zero Copay Program
SMART 90 Pharmacy Ohio Directory

DENTAL PLANS

Summit County offers you and your eligible dependents a dental program that gives you the choice of three plan options. The PPO plan offers out-of-network benefits and the Value Plan includes increased in-network benefits. Both plans offer Rollover Options. See link below or click on Guardian Dental to register and obtain additional plan information.

GUARDIAN DENTAL-PPO PLAN
With the PPO Plan, you can visit any dentist; but you pay less out-of-pocket when you choose a in-network PPO dentist.

GUARDIAN DENTAL-VALUE PLAN
With the Value Plan, you can visit any dentist; but you pay less out-of-pocket when you choose a in-network PPO dentist. Out-of-network benefits are limited to Guardian's PPO fee schedule.

GUARDIAN DENTAL-DHMO PLAN-NEW PLAN OPTION
With the DHMO Plan employees select a Primary Care Dentist from a select network of providers (see the DHMO Directory link below). There is no annual maximum, and benefits paid are based on a set fee schedule (DHMO FEE SCHEDULE).

Guardian Dental Benefit Summary
Guardian DHMO Directory: Ohio
Guardian Dental Claim Form
Guardian PPO Benefit Book
Guardian Value Plan Benefit Book

Guardian Provider Search

VISION PLAN

Summit County provides you and your eligible dependents a Vision Care Program through Davis Vision. Click on Davis Vision to access network providers.

Davis Vision Benefits Summary
Davis Vision ID Card
Davis Vision Contact Lens Collection (Premium)
Davis Vision Out-of-Network Claim Form

LIFE INSURANCE

The County of Summit provides Life Insurance and Accidental Death and Dismemberment coverage for full time employees. Additional Voluntary Life and AD&D may be purchased in amounts from $10,000 to $300,000 in increments of $10,000 at the employees own expense through payroll deductions.

Anthem Voluntary AD&D Summary
Anthem Voluntary Life Summary
Evidence of Insurability Form
Travel Assist Brochure
Resource Advisor Brochure

You can update your beneficiary during open enrollment, or anytime during the year using the beneficiary forms posted below.  Completed forms should be submitted to Greg Hartman, Insurance Department, Room 103, Ohio Building or email ghartman@summitoh.net

County Provided Life Beneficiary Form

Voluntary Life Beneficiary Form

FLEXIBLE SPENDING ACCOUNTS

Summit County offers employees a Flexible Spending Account (FSA) program. These accounts set aside funds, on a pre-tax basis, through payroll deduction, to pay eligible out-of-pocket medical, dental, and dependent care costs. Participating employees are issued a debit card to make payments for eligible items or employees can file paper claims.

The Flexible Spending Account program is administered by BASIC (Benefit Administrative Services International Corporation).

BASIC Reimbursement Claim Form
BASIC Plan Summary
2016 FSA/HRA Qualified Expenses (Samples)
FSA Registration Instructions

For more information on Flexible Spending Accounts Call Customer Service: 1 (888) 472-0777 (8:00 a.m. - 5:00 p.m. EST) or log on to hrbenefitsdirect.com/Basic

SUMMARY PLAN DESCRIPTION AND CERTIFICATES

Medical/Prescription Plans

Dental Plans

  • Dental Certificate DHMO
  • Dental Certificate PPO
  • Dental Certificate Value Plan

Vision Plans

  • Vision Certificate

Life Insurance

  • The County of Summit provides Life Insurance and Accidental Death and Dismemberment coverage for certain full time employees.  If you would like a copy of this policy, please email you request to ghartman@summitoh.net .

Flexible Spending Accounts

  • Flexible Spending Account Summary Plan Description

 

 

 

 
 
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