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What is the difference between Aetna and UHC Health Care Plans?
FALSE:
Employees who work at least 30 hours per week are eligible for the benefits described in this guide. Most benefits are effective the first of the month following your date of hire as long as you enroll within 30 days
What is Cobra?
Temporary insurance after employer-based health coverage ends.
Your CE says they dont understand their options, who can they call?
Contractor Care
What is a Deductible?
Deductible – The amount you have to pay for covered services each year before your health plan begins to pay.
How many consulting sessions do our CEs have access to via the SupportLinc Employee Assistance Program?
8!
What events qualify you to being able to make changes to their benefits throughout the year?
Changes to Your Benefits Generally, you may only make or change your existing benefit elections as a new hire or during the annual open enrollment period. However, you may change your benefit elections during the year if you experience an event such as:
• Marriage, divorce, or legal separation
• Birth or adoption of a child
• Loss or gain of other coverage by the employee or dependent
• Eligibility for Medicare or Medicaid
You have 30 days from the qualified life event to make changes to your coverage. Depending on the type of event, you may need to provide proof of the event, such as a marriage license. If you do not make the changes within 30 days of the qualified event, you will have to wait until the next open enrollment period to make changes (unless you experience another qualified life event)
When does insurance coverage end for our CEs post Contract?
When Coverage Ends Aetna:
For the Aetna plan, coverage ends eight days after your last payroll deduction. For example, if you have a deduction on January 19, 2024, coverage will end January 27, 2024.
UnitedHealthcare (UHC):
For the UHC plans, plans, coverage ends at the end of the month. For example, if your employment terminates on January 16, 2024, you will have coverage until January 31, 2024 (end of the month)
My CE needs to file for FMLA, how do I help them do that?
Before CEs go on Medical Leave, they should notify their Recruiter/ Account Manager and Apex’s benefits department: leaverequest@apexsystems.com. to request time off
What is a Co-Pay?
Copay – A fixed amount (for example $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service
What is the cheapest benefits you can enroll in?
Vision! It ranges from $1.59- $5.12 depending on how many people are being covered
Who else can a CE cover on their benefits?
• Your legal spouse or domestic partner*
• Your children up to age 26
*For information about domestic partner coverage, contact Contractor Care
13 weeks! There is good information about how that works in this video: https://www.youtube.com/watch?v=boXTrsHuKMA&list=PLwBmMHZ5GCwyXLhs2DzGb_sw1IB_XURX9&index=12
My CE missed enrollment, who can they talk too?
What is an FSA?
Flexible Spending Account (FSA) – An FSA allows you to pay for eligible health care and dependent care expenses using tax-free dollars. The money in the account is subject to the “use it or lose it” rule which means you must spend the money in the account before the end of the plan year
CEs are NOT offered this plan!
At what age do dependent children lose coverage from their parents?
26
When does coverage begin for a CE?
When Coverage Begins Aetna:
The coverage for the Aetna plan begins the Sunday after your first payroll deduction. Example: If you had a deduction on Friday January 19, 2024; coverage will be effective Sunday, January 21, 2024.
UnitedHealthcare (UHC), Dental, Vision: The coverage for the UHC medical, dental, and vision plans begins the first of the incoming month after you enroll. For example, if enroll on January 20, 2024; coverage will start February 1, 2024.
My CE wanted to retro their insurance while they were between Apex roles, how do they pay for that?
My CE had a baby! How do they get them added to their benefits?
What is an HSA?
Health Savings Account (HSA) – An HSA is a personal savings account for those enrolled in a High Deductible Health Plan (HDHP). You may use your HSA to pay for qualified medical expenses such as doctor’s office visits, hospital care, prescription drugs, dental care and vision care. You can use the money in your HSA to pay for qualified medical expenses now, or in the future, for your expenses and those of your spouse / domestic partner and dependents, even if they are not covered by the HDHP
Please note: CE's are only eligible to enroll in the HSA plan if they enroll in the UHC HDHP ONLY ( the High Deductible Health Plan).
Who is our provider for Prescriptions?
CVS Caremark
When can my CE enroll in our benefits?
- They will have the option to participate in the UnitedHealthCare (UHC) Major Medical Plan options after your one- month orientation period. Coverage will be effective the first of the month following the orientation period plus 54 days of employment, which is 84 days total.
My CE is going back on their parents insurance, but they want to know if they can stay on COBRA for our dental, Can they do that?
My CE got married, and they are taking their spouses benefits. How can they cancel coverage?
What happens when you hit your Out of Pocket Maximum?
The out of pocket max is maximum amount you and your family must pay for eligible expenses each plan year. Once your expenses reach the out-of-pocket maximum, the plan pays benefits at 100% of eligible expenses for the remainder of the year. Your annual deductible is included in your out-of-pocket maximum.