Benefits Summary
Employee Benefits Management Group (EBMC)- 2010 |
WHV Health Insurance Plan(Medical Mutual Network) |
Benefits |
Network |
Benefit Period |
1/1/10 – 12/31/10 |
Dependent Age |
19/23 Student |
Pre-Existing Condition Waiting Period |
12 Months |
Office Visit Co-Pay |
$20If the employee visits Bexley Primary Care; the cost can be reimbursed through payroll. |
ER Co-Pay |
$150 |
Benefit Period Deductible (Single) |
$1,000 |
Benefit Period Deductible (Family) |
$2,000 |
Co-insurance |
80% |
Maximum Out-of-Pocket (Single) |
$2,500 |
Maximum Out-of-Pocket (Family) |
$5,000 |
Urgent Care Office Visit |
$30 |
Prescriptions Retail |
$10/$35/$55 |
Prescriptions Mail Order |
$30/$70/$110 |
Lifetime Maximum |
$1,000,000 |
Hospital Services (Room & Board) |
80% after deductible |
Emergency Room* |
100% after co-payment |
NOTE: Employees whose spouses are eligible and entitled to insurance elsewhere are not eligible for our health insurance, but are eligible for the Medical Expense Reimbursement Plan (MERP), see MERP section below.
Associate Bi-weekly Contribution:
|
|
Non-Smoker |
Smoker |
Dental |
Employee (EE) |
$29.00 per pay |
$46.00per pay |
$10.00 per pay |
EE + Children |
$55.00 per pay |
$78.00 per pay |
$18.00 per pay |
EE+ Spouse |
$60.00 per pay |
$86.00 per pay |
$18.00 per pay |
Family |
$87.00 per pay |
$118.00 per pay |
$26.00 per pay |
Important Points:
- 90day prescriptions will now be mandatory for all maintenance drugs or no coverage will apply
- Emergency room visits will only be covered for true emergencies
- Pre-certification will be required for hospitalizations, substance abuse treatments, skilled nursing facility stays, home health care, hospice, cardiac rehab, outpatient surgical procedures, chemotherapy, radiation therapy & dialysis
Insurance Benefits are eligible the first of the month, following 90 days of employment. Pre-existing conditions not covered if proof of prior insurance not provided.
Dental Insurance
- All Preventative Care is paid 100% of Usual and Customary Rate (UCR)
- Deductible $100/$300
- Restorative procedures to include items such as fillings, root canals – 80/20, after deductible
- Major procedures to include items such as crowns, on-lays, dentures – 50/50, after deductible
- Max per year benefit: $1000
- Orthodontia coverage 50% paid, up to lifetime maximum $1500
Short Term Disability Insurance – Prudential Insurance Company
- Waiting period for illness or injury is 14 consecutive calendar days
- Weekly benefit is 50% of an associate’s weekly pay with a maximum benefit of $350 per week
- Maximum benefit period is 11 weeks for any period of disability
- Maximum benefit period for maternity leave with no complications is 6 weeks
- THERE IS NO COST TO THE ASSOCIATE FOR 50% COVERAGE
Long Term Disability – Prudential Insurance Company
- Waiting period for illness or injury is 90 consecutive calendar days
- Benefit is 60% of basic monthly earnings not to exceed the maximum monthly benefit of $5,000
- THERE IS NO COST TO THE ASSOCIATE FOR 60% COVERAGE
Life Insurance –Prudential Insurance Company
- Benefits will be provided on a non-contributory basis equal to two times the associate’s annual income, rounded the nearest $1,000. The maximum benefit is $250,000 and the minimum benefit is $15,000
- AD&D coverage included with the amount being the same as the life coverage
- Effective date on Plan: 1st of month following six months of service
- THERE IS NO COST TO THE ASSOCIATE
Additional Benefits:
- 403 B Retirement Plan –$ .50 match on each dollar contributed up to 3% of salary, plus annual discretionary profit sharing match up to dollar for dollar up to 6% of salary. Matching is available after one year of service
- Supplemental insurance is available to include additional life, vision, cancer, disability and accident insurance (AFLAC)
- Memberships to either Telhio Credit Union or First Service Credit Union
- Mandatory Direct Deposit to any bank or credit union
- Paid Time Off (PTO)-Accrued biweekly based on hours worked per pay
- Seven paid holidays a year
- Flexible Medical and Dependent Care Spending Account
Medical Expense Reimbursement Plan (MERP)
If your spouse is entitled to and eligible for health insurance elsewhere, you are not eligible for Wexner Heritage Village health insurance; however you are eligible for the MERP Plan.
The MERP Plan will allow you the following:
- Deduction reimbursement to add you to your spouse’s plan, up to certain maximum limits
- Reimbursement for copays, deductibles and coinsurance


