Employee BAG 09indd by ps94506

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									                       Benefits At A Glance 2009




Revised January 2009
Benefit               Description                                   Eligibility         Cost
Direct                Your earnings are transferred
                      directly into your checking or savings
                                                                   All employees.      No cost to employees.

Deposit               account via electronic transfer.


For information
call Mary Anderson
at ext. 8118




Benefit               Description                                   Eligibility         Cost
                                                                   All employees.      Cost and eligibility
Additional           • Credit Union
                       – DESCO
                                             • Unemployment
                                               Insurance           Varies by benefit.   of these additional
Benefits              • Holiday Savings
                        Account
                                             • Off Site Parking
                                               Incentives
                                                                                       benefits vary. Please
                                                                                       contact Human
                       – DESCO               • Employee                                Resources for further
For information      • Payroll deduction       Emergency Relief                        information.
call Ellen Devins      - cafeteria meals       Fund
at ext. 8380           - various sales       • Annual Service
                       - Gift Gallery          Awards Banquet
                     • Discounted            • Reward and
                        LIFE Center            Recognition
                        Membership             Programs
                     • Discounted AAA        • Christmas Buffet
                        Membership           • Paid Time Off
                     • Sam’s Club            • PTO Sick Days
                        Membership           • Donation of PTO
                     • Weight Watchers       • Healthy Partners
                     • Shift Differential      Discount
                     • Jury Duty/Military    • AT&T Discount
                        Leave                  (84509)
                     • Bereavement Leave     • Sprint Discount
                     • Employee Health         (0018717214)
                        Services             • Local Merchant
                     • Individualized          Rewards Program
                        Orientation          • VPI Pet Insurance
                     • Free Parking          • Adoption
                     • Cafeteria Discounts     Reimbursement
                     • Worker’s              • Continuing
                        Compensation           Education Units




                                                         13
Benefit                 Description                               Eligibility                 Cost                                               Table of Contents

Employee               A confidential assessment, treatment
                       and referral service offering help
                                                                 All employees and
                                                                 their dependents.
                                                                                             No cost to employees.

Assistance             to employees and members of
                       their immediate families who have
Program (EAP)          psychosocial problems that may disrupt
                       family, job and overall well being.
                                                                                                                     Benefit Description                               Page
For information
contact EAP                                                                                                          403(b) Retirement Savings                        9
at ext. 8425                                                                                                         529 College Savings Plan                         10
                                                                                                                     Additional Benefits                               13
                                                                                                                     AFLAC Insurance Products                         8
                                                                                                                     Auto and Home Insurance                          11
Benefit                 Description                               Eligibility                 Cost                    Basic Life, Accidental Death and Dismemberment   7
                                                                                                                     Cash Balance Retirement Plan                     9
                       Comprehensive plan that offers members
Prepaid                the ability to contact an attorney
                                                                 All employees.              Pre-paid Legal          Dental                                           4
                                                                                             $7.88 per pay
Legal and              to assist them with legal questions,
                       document review, traffic violations
                                                                                                                     Direct Deposit                                   13
Identity               and similar issues 24-hours a day,                                    Identity Theft          Education Assistance                             10
                       7-days a week. Includes preparation of
                                                                                             $ 6.48 per pay          Eligibility                                      2
Theft Shield           a will for employee and their spouse.
                                                                                                                     Employee Assistance Program (EAP)                12
                       Identity theft protection may be                                      Pre-paid Legal
For information        purchased separately or in addition                                                           Events that Effect Your Benefits                  2
contact                to the pre-paid legal services.
                                                                                             and Identity
Wendell Beculheimer                                                                                                  Flexible Spending Accounts                       7
                                                                                             Theft
877-624-4470                                                                                 $12.85 per pay          Healthy Partners Program                         6
or call Tonya Messer                                                                                                 In the Event You Decide to Leave SOMC            2
at ext. 8745                                                                                                         Leave of Absence                                 3
                                                                                                                     Long-Term Disability                             8
                                                                                                                     Medical Insurance                                4
                                                                                                                     Medical Plan Design                              5
Benefit                 Description                               Eligibility                 Cost                    Online Homework Help—Tutor.com                   11
                                                                                                                     Paid Time Off                                    12
Paid Time              Paid Time Off (PTO) provides time away
                       from your work responsibilities for
                                                                 All regular full-time,
                                                                 part-time, and contingent
                                                                                             No cost to employees.   Pharmacy Services                                6
Off                    vacations, holidays and personal needs.   employees are eligible
                                                                 for paid time off.
                                                                                                                     Pre-Paid Legal Services                          12
                       PTO is accrued per each hour                                                                  Savings Bonds                                    9
For information        worked and varies depending
call Ken Applegate
                                                                                                                     Scholars Program                                 10
                       upon years of service according
at ext. 8594           to the following schedule:                                                                    Short-Term Disability                            8
                       Years of Service    Max Annual Accrual
                                                                                                                     Sick Child Care “TLC” Program                    11
                       Hourly                                                                                        SOMC Select Plan                                 4
                       0–4                152 hours
                       5 – 13             192 hours                                                                  SOMC Standard Plan                               4
                       14 – 19            232 hours
                       20+                272 hours                                                                  Stipend Program                                  10
                       Salary/Supervisory
                       1–9                192 hours
                                                                                                                     Supplemental Life Insurance                      7
                       10 – 19            232 hours                                                                  UMRmD                                            6
                       20+                272 hours
                       Directors                                                                                     Vision Coverage                                  6
                       20+ years          272 hours
                                                                                                                     Workers’ Compensation                            3


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                                                                                                                           Benefit                      Description                                   Eligibility                Cost
Overview
                                                                                                                                                       Online Homework Help provides live
This document provides you with an overview of the various benefits available at Southern                                   Online                      tutoring assistance, in many subjects,
                                                                                                                                                                                                     All employees and their
                                                                                                                                                                                                     children.
                                                                                                                                                                                                                                SOMC provides this
                                                                                                                                                                                                                                benefit at no cost
Ohio Medical Center. Due to space limitations, it is impossible to list complete details for
each benefit. For additional information concerning a particular benefit plan, consult your
                                                                                                                           Homework                    to students in kindergarten through
                                                                                                                                                       the first year of college. Subject experts
                                                                                                                                                                                                                                to employees and/
                                                                                                                                                                                                                                or their children.
Summary Plan Document or you may call the contact number listed for that benefit.                                           Help                        will assist students in a variety of ways,
                                                                                                                                                       including charts, graphs and referrals
                                                                                                                                                       to other Internet resources, to find
                                                                                                                           Tutor.com
                                                                                                                                                       answers to their questions and make
                                                                                                                           http://somc.org/employee/
Eligibility                                                                                                                                            learning easier and more enjoyable.
Eligibility varies for each benefit plan. Be sure to review the eligibility for each benefit or call Ellen                   For more information
                                                                                                                                                       Assistance is available from both
                                                                                                                           call Ellen Devins
Devins at ext. 8380 for further information. Enrollment forms, where required, must be completed and                                                   English- and Spanish-speaking
                                                                                                                           at ext. 8380
returned to Human Resources within 30 days from your date of hire or the date you become eligible.                                                     tutors from 2 to 10 p.m., seven days
                                                                                                                                                       a week (excluding holidays).


Events that Effect Your Benefits
In order to properly maintain your benefit plans, it is imperative that your personal
information on file in Human Resources is current and accurate. It is your responsibility
to notify HR immediately in the event of any of the following changes/events:

       •   Employment status (i.e., part-time to full-time)                                                                Benefit                      Description                                   Eligibility                Cost
       •   Marital status (marriage or divorce)
       •   Birth or adoption of a child
       •   Death of a dependent
                                                                                                                           Sick Child                  Daycare services for your sick children are
                                                                                                                                                       provided in the Pediatrics Department.
                                                                                                                                                                                                     All employees.             Only sick children will
                                                                                                                                                                                                                                be accepted. Services
       •   Ineligibility of a dependent (i.e., age, marriage, student status, etc.)                                        Care “TLC”                  Availability is determined by patient
                                                                                                                                                       census, on a first/come, first/serve basis.
                                                                                                                                                                                                     Employees must pre-
                                                                                                                                                                                                     register their children.
                                                                                                                                                                                                                                cost $1 per hour.
       •   Address/phone number/name
       •   Loss of, or becoming newly eligible for, other coverage (through spouse, parent, etc.)
                                                                                                                           Program                                                                   Forms are available
                                                                                                                                                                                                     in Human Resources
       •   Beneficiary                                                                                                                                                                                and/or Pediatrics.
                                                                                                                           For information
       •   Banking institution or account number (direct deposit)                                                          call Pediatrics
                                                                                                                           at ext. 8341
Note: For most changes, notification to Human Resources must be completed
within 30 days of the change/event in order to make the change effective.



In the Event You Decide to Leave SOMC
If for any reason you decide to end your employment relationship with SOMC, please notify Human
Resources at ext. 7231 as soon as possible. HR will schedule an exit interview with you to discuss all
your benefits and answer any questions you may have regarding the status of each benefit.
                                                                                                                           Benefit                      Description                                   Eligibility                Cost
                                                                                                                                                       Special group rates and discounts
                                                                                                                           SOMC                        available for auto and home insurance.
                                                                                                                                                                                                     All full-time and part-
                                                                                                                                                                                                     time employees.
                                                                                                                                                                                                                                Plan cost varies
                                                                                                                                                                                                                                depending upon
                                                                                                                           Employee                    Convenient payment options available
                                                                                                                                                       including payroll deduction.
                                                                                                                                                                                                                                coverage selected.

                                                                                                                           Auto & Home
                                                                                                                           Insurance
                                                                                                                           For information
                                                                                                                           contact
                                                                                                                           Travelers Insurance
                                                                                                                           888-695-4640

                                                                                                                           or call Tonya Messer
                                 The information contained in this document is subject to change with or without notice.   at ext. 8745



                                                          2                                                                                                                                11
Benefit                 Description                               Eligibility                  Cost
                                                                                                                       Leave of Absence
Educational            SOMC provides selected applicants
                       with educational assistance
                                                                 Regular full-time, part-
                                                                 time, contingent or flex
                                                                                              A work commitment,
                                                                                              based on hours worked,
                                                                                                                       Southern Ohio Medical Center recognizes that occasionally employees need
                                                                                                                       extended time away from work due to special circumstances or needs. To
Assistance             (books and late fees excluded) for
                       approved courses of study.
                                                                 employees who have
                                                                 successfully completed
                                                                                              following completion
                                                                                                                       accommodate those needs, SOMC provides the following types of leave:
                                                                                              of degree/course
                                                                 the 90-day introductory      work is required.
For information        Must be pursuing a degree or education    period. Graduate degrees                                      • FMLA (Family and Medical Leave Act)
call Mary Anderson     in a position defined as “hard to fill.”    eligible after one year
at ext. 8118                                                                                                                   • Maternity
                                                                 of continuous services                                        • Personal
                       One-hundred percent tuition assistance
                       is available for RN, BSN, MLT, RT,                                                                      • Educational
                       LPN and MSW degrees (limitations                                                                        • Military
                       and/or maximums may apply).                                                                             • Others as approved at the hospital’s sole discretion
                       Other courses may be eligible for
                       50 percent reimbursement.                                                                       While on an approved leave of absence, your seniority and benefits are protected.



                                                                                                                       Your Responsibilities While On a Leave
                                                                                                                         •   Notify your supervisor of your need for a leave of absence
Benefit                 Description                               Eligibility                  Cost                       •   Provide beginning and ending dates
                                                                                                                         •   Complete the appropriate leave request form (Request for Leave or Employee Status Change)
                                                                                                                         •   Provide medical certification and periodic updates (at least every 30 days) for all FMLA
Scholars               Educational assistance is available to
                       children, step-children and spouses of
                                                                 Children, step-children
                                                                 and spouses of current
                                                                                              A work commitment,
                                                                                              based on hours worked,
                                                                                                                             requests
                                                                                                                         •   Questions regarding FMLA should be directed to Human Resources (ext. 8745)
Program                current SOMC employees. 100 percent
                       tuition assistance is available for RN,
                                                                 SOMC employees.              following completion
                                                                                                                         •   Continue to pay your normal medical/dental insurance premium by the first of each
                                                                                              of degree/course
For information        MLT, RT, US and LPN, up to $5,200 per     Employee must                work is required.              month during your leave of absence to maintain coverage
call Mary Anderson     year (based on available funding).        have completed one                                      •   Contact Matt Nelson at Great West regarding 403(b) loan arrangements at 1-800-284-0444
at ext. 8118                                                     year of service.                                        •   Contact HR (ext. 8380) regarding your other payroll deductions
                                                                                                                         •   Notify HR (ext. 8380) immediately of any change effecting your benefits
                                                                                                                         •   Enrollment of new dependents must be completed within 30 days of the event (birth, adoption,
                                                                                                                             marriage)
Benefit                 Description                               Eligibility                  Cost                       •   Consult with SOMC Personnel Policies and Procedures manual, located on the SOMC Intranet or contact
                                                                                                                             HR (ext. 8745) for complete details of all leaves of absence

Stipend                Approved programs may qualify
                       for payment of tuition, room and
                                                                 Eligibility is determined
                                                                 on a case-by-case basis.
                                                                                              A work commitment,
                                                                                              based on hours worked,
Program                board and limited living expenses
                       while attending school.
                                                                                              following completion     When You Return From Leave
                                                                                              of degree/course
                                                                                                                         • You must provide a fitness-for-duty certificate from your physician to Human Resources
                                                                                              work is required.
For information                                                                                                          • If you are released for duty with restrictions (i.e., hours, duties, etc) you must consult
call Mary Anderson                                                                                                         Employee Health before returning.
at ext. 8118
                                                                                                                         • Provide HR and your department with as much advance notice as possible
                                                                                                                           of your return to work date


Benefit                 Description                               Eligibility                  Cost
                                                                                                                       Worker’s Compensation
                                                                                                                       SOMC provides protection for employees injured at work through the Workers’ Compensation
529 College            The College Advantage 529 College
                       Savings Plan allows employees to
                                                                 All employees are eligible
                                                                 to participate on the
                                                                                              Minimum contribution
                                                                                              of $15 per month.
                                                                                                                       Program. If you are injured at work, regardless of how minor the injury is, you must
                                                                                                                       notify your supervisor immediately and complete an employee incident report. Questions
Savings Plan           set aside funds, through payroll
                       deduction for future education needs.
                                                                 first day of hire.
                                                                                                                       regarding Workers’ Compensation should be directed to Safety Services at ext. 8568.
Edward Jones Contact   Five different savings funds are
Barry Rodbell at       available, based on the investment
740-353-0363           strategy that fits your comfort level.

                                                                                                                                                                                                                  Revised January 2009

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Benefit                       Description                                                      Eligibility              Cost                        Benefit                  Description                              Eligibility                      Cost
                                                                                                                                                                           The Cash Balance Plan is a retirement
Medical                       Comparing the Features                                          Eligibility begins on
                                                                                              the first day of the
                                                                                                                       Employee premiums
                                                                                                                       are deducted from each
                                                                                                                                                   Cash Balance            plan fully funded by SOMC. Employees
                                                                                                                                                                                                                    All employees are eligible.
                                                                                                                                                                                                                    Must be 21 years of age with
                                                                                                                                                                                                                                                     SOMC provides to
                                                                                                                                                                                                                                                     employees at no cost.
Insurance                                                Standard      Select                 month after hire date.   pay on a pre-tax basis:     Retirement              earn 100% vesting after 3 years of
                                                                                                                                                                           service. Normal retirement at age
                                                                                                                                                                                                                    1,000 hours of service.
                                                                                                                                                                                                                                                     Service credits accrued
                              Choice                Freedom to         Freedom to
SOMC Standard
                              of provider:          choose any
                                                    doctor or
                                                                       choose any
                                                                       doctor or
                                                                                              Annual open enrollment
                                                                                              held November 1—30.      SOMC Standard               Plan                    65 with at least 3 years of vesting
                                                                                                                                                                           service, or early retirement at age
                                                                                                                                                                                                                    SOMC Contribution Schedule
                                                                                                                                                                                                                    Years of Service  Contribution
                                                                                                                                                                                                                                                     each year are based
                                                                                                                                                                                                                                                     on wages up to the
SOMC Select                                         hospital either    hospital either                                                                                     55 with at least 3 years of service.     0-4               2%             2009 IRS maximum
                                                                                                                       FT Single     $25.17/pay    For information                                                  5-9               2.5%
                                                    in or out of       in or out of           Regular full-time and                                                                                                                                  recognizable pay
                                                                                                                       FT EE+Ch      $46.34/pay    call Ellen Devins                                                10-14             3%
                                                    the network        the network            regular part-time                                                            Benefit grows during the course of                                         limit of $245,000.
                                                                                                                       FT EE+Sp      $50.75/pay    at ext. 8380                                                     15-19             4%
For claims and benefit                                                                         employees (approved                                                          employment through service and
                              Use of                No referral        No referral                                     FT Family     $59.02/pay                                                                     20-24             5%
coverage contact                                                                              for 32 hours/pay).                                                           interest credits. Service credits are    25-29             6%
                              specialists:          required           required                                        PT Single     $33.69/pay
UMR                                                                                                                                                                        a percent of pay and increase with       30+               7%
800-950-4867                                                                                                           PT EE+Ch      $63.27/pay                            years of service. Interest credits are
                              Services out          Reduced            Reduced
umr.com                       of network:           benefits            benefits                                         PT EE+Sp      $67.68/pay                            applied each year a balance is in the
                                                                                                                       PT Family     $81.60/pay                            fund. A Lump Sum option is available
To find out if your                                                                                                                                                         upon retirement or termination.
physician or a hospital is    Office visit           $20 PCP            $15 PCP                                         SOMC Select
in the network, contact       (co-pay):             $40 specialist     $30 specialist
Provider Network                                                                                                       FT Single     $39.05/pay
HealthReach                                                                                                            FT EE+Ch      $71.44/pay
                              ER co-pay:            $100               $100
800-455-4460                                                                                                           FT EE+Sp      $77.64/pay
ohiohealthgroup.com           Urgent Care           $25                $25                                             FT Family     $123.91/pay   Benefit                  Description                              Eligibility                      Cost
                              co-pay:                                                                                  PT Single     $51.32/pay
If not in the HealthReach                                                                                              PT EE+Ch      $97.32/pay
Network, contact                                                                                                                                                                                                                                     Employees may
                                                                                                                                                                           Employees are automatically enrolled
Beechstreet                   Pharmacy Benefit (same)                                                                   PT EE+Sp
                                                                                                                       PT Family
                                                                                                                                     $106.52/pay
                                                                                                                                     $164.98/pay
                                                                                                                                                   403(b)                  in the plan with contributions of
                                                                                                                                                                                                                     All employees, except
                                                                                                                                                                                                                     temporary, are eligible.
                                                                                                                                                                                                                                                     contribute up to $16,500
                                                                                                                                                                                                                                                     during 2009, with an
800-432-1776
beechstreet.com
                                                   SOMC                Other                                                                       Retirement              2% of starting base pay made on a
                                                                                                                                                                           pre-tax basis via payroll deduction.      Contributions begin
                                                                                                                                                                                                                                                     additional $5,000 catch-
                                                                                                                                                                                                                                                     up contribution allowed
                                                                                                                       Rates effective 01/01/09
For Pharmacy
                             Generic:              $5/prescrpt.        $15/prescrpt.
                                                                                                                                                   Savings Plan            Great West Life administers the plan.
                                                                                                                                                                           Several investment options with
                                                                                                                                                                                                                     with first pay.                  for employees age 50 and
                                                                                                                                                                                                                                                     older. SOMC will match,
information contact          Preferred             $20/prescrpt.       $30/prescrpt.                                                                                       varying degrees of risk are available.                                    dollar for dollar, up to
Pharmacy Services            name brand:                                                                                                           Great West Contact                                                                                2% of your pay (based on
800-997-3784                                                                                                                                       Matt Nelson                                                                                       the 2009 IRS maximum
                                                                                                                                                                           SOMC provides matching contributions
                             Non-                                                                                                                  gwrs.com                                                                                          recognizable pay limit
catalystrx.com                                                                                                                                                             immediately, with 100 percent vesting
                             preferred             $35/prescrpt.       $45/prescrpt.                                                                                                                                                                 of $245,000) if you are
                                                                                                                                                   800-284-0444            earned after three years of service.
                             name brand:                                                                                                                                                                                                             contributing to the plan.*
or call Ellen Devins at
ext. 8380                    • Generic mandate will be applied                                                                                     or call Ellen Devins    Current information regarding                                             *Matching contributions
                             • 90-day supply of maintenance drugs                                                                                  at ext. 8380            investment options may be                                                 are subject to annual
                               available for two times the normal co-pay                                                                                                                                                                             discrimination testing
                                                                                                                                                                           viewed at www.gwrs.com.
                             • Maintenance drugs available through SOMC                                                                                                                                                                              which may result in a
                               Pharmacy only                                                                                                                                                                                                         portion of the matching
                             • Restricted Pharmacy Network Applies                                                                                                                                                                                   contribution being
                                                                                                                                                                                                                                                     taxable income.



Benefit                       Description                                                      Eligibility              Cost

                             Plan Benefits
                                                                                                                                                   Benefit                  Description                              Eligibility                      Cost
Dental                                                                                        Eligibility begins on
                                                                                              the first day of the
                                                                                                                       Dental
                                     Calendar                                                 month after hire date.   Premiums
For information contact
UMR
                                       Year       Co-pay    Max.
                                                                                                                       FT Single     $2.78/pay
                                                                                                                                                   Savings                 Employees may purchase Series EE US
                                                                                                                                                                           Savings Bonds of various denominations
                                                                                                                                                                                                                    All employees are
                                                                                                                                                                                                                    eligible to participate
                                                                                                                                                                                                                                                     Bonds are available
                                                                                                                                                                                                                                                     in denominations of
                             Service Deductible Percentage Benefits                            Annual open enrollment
800-950-4867
                             Preventative/                                                    held November 1—30.
                                                                                                                       FT EE+Ch      $6.35/pay     Bonds                   through payroll deduction.               on first day of hire.             $100, $200, $500 and
umr.com                      diagnostic treatment NONE           0%           2 cleanings                              FT EE+Sp      $6.35/pay                                                                                                       $1,000. The bonds cost
                                                                              per cal. year
                                                                                                                       FT Family     $6.35/pay     For information         Bonds are mailed to employee’s home                                       1/2 of the face amount.
                                                                                              Regular full-time and
or call Ellen Devins at      Basic treatment    $50 per person   20%          $1,000
                                                                                                                       PT Single     $3.54/pay     contact                 from the Federal Reserve Bank.                                            Bonds are purchased
                             Major treatment    $50 per person   50%          per year        regular part-time
ext. 8380                                                                                     employees (approved      PT EE+Ch      $8.90/pay     usbonds.gov                                                                                       with after-tax funds.
                             Orthodontic
                                                                                              for 32 hours/pay).       PT EE+Sp      $8.90/pay
                             treatment          NONE             40%          $1,500
                                                                              lifetime                                 PT Family     $8.90/pay     or call Mary Anderson
                                                                                                                                                   at ext. 8118
                                                                                                                       Rates effective 01/01/09


                                                                              4                                                                                                                               9
                                                                                                                                                                                   Medical Plan Design
                                                                                                                                                                                 Medical Plan Design 2009
Benefit                 Description                                  Eligibility                 Cost
                                                                                                                                                                                           SOMC STANDARD                                                                SOMC SELECT
Short Term             Disability protection in the event you are
                       unable to work due to a non-work related
                                                                    Regular full-time
                                                                    employees only.
                                                                                                No cost to employees.

                                                                                                                                 Type of Service                          SOMC              In-Network Out-of-Network SOMC                                            In-Network Out-of-Network
Disability             medical condition.
                                                                    Coverage begins after six                           Deductible                                       $350/indiv.            $700/indiv.                $1,500/indiv.         $150/indiv.             $200/indiv.
                                                                                                                                                                                                                                                                          $300/indiv.              $1,000/indiv.
                       Hourly: Benefit pays 60 percent of your                                                                                                           $700/family            $1400/family               $3,000/family         $300/family              $400/family
                                                                                                                                                                                                                                                                         $600/family              $2,000/family
                                                                    months of continuous
For information        weekly salary up to $400 per week.           full-time employment.                               Annual out-of-pocket maximum                    $2,500/indiv.          $2,500/indiv.              $3,500/indiv.          $1,500/indiv.           $1,500/indiv.            $2,000/indiv.
                                                                                                                                                                                                                                                                         $2,000/indiv.            $2,500/indiv.
call Tonya Messer      Begins the seventh day of illness or                                                             (deductible not included)                      $5,000/family          $5,000/family               $7,000/family         $3,000/family           $3,000/family
                                                                                                                                                                                                                                                                        $4,000/family            $4,000/family
                                                                                                                                                                                                                                                                                                 $5,000/family
at ext. 8745           injury. Maximum of 26 weeks.                                                                     Primary Care office visit (incl. OB/GY N )           N/A                 $20/visit               60% after deduct.            N/A                   $15/visit           60% after deduct.
                                                                                                                        Specialist office visit                              N/A                 $40/visit               60% after deduct.            N/A                  $30/visit            60% after deduct.
                       Salary: paid according to chart below:
                                                                                                                        P r eventive Care
                       Service            Full Pay   60% Pay                                                            Routine physical                                    N/A                $20/visit                   Not Covered*              N/A                  $15/visit               Not Covered*
                       Less than 1 year   2 weeks    24 weeks                                                           Routine GYN exam                                    N/A                $20/visit                   Not Covered*              N/A                  $15/visit               Not Covered*
                       1 year-less
                                                                                                                        Routine Pap                                      100% (lab)         70% after deduct.              Not Covered*           100% (lab)          80% after deduct.           Not Covered*
                       than 2 years       4 weeks    22 weeks
                       2 years-less                                                                                     Well-child checkups                                  N/A          100% up to 24-months             Not Covered*               N/A           100% up to 24-months          Not Covered*
                       than 3 years       6 weeks    20 weeks                                                                                                                             $20/visit 24-months - 19                                                  $15/visit 24-months - 19
                       3 years-less                                                                                     Allergy Immunizations                                N/A                 $20/visit               60% after deduct.            N/A                   $15/visit           60% after deduct.
                       than 5 years       10 weeks   16 weeks                                                           Allergy Testing                                      N/A            70% after deduct.            60% after deduct.            N/A             80% after deduct.         60% after deduct.
                       5 years-less                                                                                     P SA                                                100%            70% after deduct.              Not Covered               100%             80% after deduct.           Not Covered
                       than 7 years       14 weeks   12 weeks
                                                                                                                        Routine Immunizations                                N/A          100% up to 24-months             Not Covered*               N/A           100% up to 24-months          Not Covered*
                       7 years-less
                                                                                                                                                                                          $20/visit 24-months - 19                                                  $15/visit 24-months - 19
                       than 10 years      18 weeks   8 weeks
                       Over 10 years      26 weeks   0 weeks                                                            Mammography screening                               100%            70% after deduct.              Not Covered*              100%             80% after deduct.            Not Covered
                                                                                                                        Inpatient Hospital
                                                                                                                        Unlimited days                                     100%             70% after deduct.            60% after deduct.          100%              80% after deduct.         60% after deduct.
                                                                                                                                                                       no deductible                                                            no deductible
                                                                                                                        Outpatient Hospital
Benefit                 Description                                  Eligibility                 Cost                    Diagnostic Serv i ce s
                                                                                                                        Surgery
                                                                                                                                                                      80% after deduct.     70% after deduct.            60% after deduct.      90% after deduct.     80% after deduct.         60% after deduct.

                                                                                                                        Inpatient                                          100%             70% after deduct.            60% after deduct.          100%              80% after deduct.         60% after deduct.
                                                                                                                                                                       no deductible                                                            no deductible

Long Term              Disability coverage for long term
                       conditions. Benefits begin after
                                                                    Regular full-time
                                                                    employees only.
                                                                                                No cost to employees.   Outpatient
                                                                                                                        Office-based
                                                                                                                                                                      80% after deduct.
                                                                                                                                                                            N/A
                                                                                                                                                                                            70% after deduct.
                                                                                                                                                                                            70% after deduct.
                                                                                                                                                                                                                         60% after deduct.
                                                                                                                                                                                                                         60% after deduct.
                                                                                                                                                                                                                                                90% after deduct.
                                                                                                                                                                                                                                                      N/A
                                                                                                                                                                                                                                                                      80% after deduct.
                                                                                                                                                                                                                                                                      80% after deduct.
                                                                                                                                                                                                                                                                                                60% after deduct.
                                                                                                                                                                                                                                                                                                60% after deduct.

Disability             initial 26 weeks of disability.
                                                                    Coverage begins after six
                                                                                                                        Maternity/GY N
                                                                                                                        Prenatal and postpartum office visits               N/A           70% of the global fee          60% after deduct.           N/A      80% of the global fee             60% after deduct.
                                                                                                                        Delivery (vaginal/cesarean)                        100%             70% after deduct.            60% after deduct.          100%         after deduct.                  60% after deduct.
                       Benefits equal 60 percent of your             months of continuous                                                                                                                                                                       80% after deduct.
For information                                                                                                                                                        no deductible                                                            no deductible
                       base annual salary (up to a maximum          full-time employment.
call Tonya Messer                                                                                                       Infe rtility treatment                          Not covered             Not covered                Not Covered           Not covered     Not covered                       Not covered
                       of $3,500 per month) less any social                                                             Mental Health
at ext. 8745           security or other applicable benefits                                                             Inpatient (30/calendar year max.)                    N/A            70% after deduct.            60% after deduct.            N/A             80% after deduct.         60% after deduct.
                       you and your family are eligible
                       to receive. Benefits continue until                                                               Outpatient (20 visits/calendar year max.)            N/A               $40 per visit             60% after deduct.            N/A                $30 per visit          60% after deduct.
                       recovery or age 65, whichever is first.                                                           S u b s t a n ceAbuse
                                                                                                                        Inpatient (30/calendar year max.)                    N/A            70% after deduct.            60% after deduct.            N/A             80% after deduct.         60% after deduct.

                                                                                                                        Outpatient (20 visits/calendar year max.)       N/A           $40 per visit                      60% after deduct.            N/A                $30 per visit          60% after deduct.
                                                                                                                        Miscellaneous

Benefit                 Description                                  Eligibility                 Cost                    Urgent Care Ce n t e r
                                                                                                                        Emergency Room
                                                                                                                                                                      $25/visit
                                                                                                                                                                      $75/visit
                                                                                                                                                                    $100 per visit      $75/visit
                                                                                                                                                                                      $100 per visit
                                                                                                                                                                                                                     60% after deduct.   $25/visit
                                                                                                                                                                                                                                         $75/visit
                                                                                                                                                                                                                     60% after deduct. $100 per visit                     $75/visit
                                                                                                                                                                                                                                                                       $100 per visit
                                                                                                                                                                                                                                                                                               60% after deduct.
                                                                                                                                                                                                                                                                                               60% after deduct.
                                                                                                                        Ambulance                                       N/A         80% no deductible                80% no deductible      N/A                      80% no deductible         80% no deductible
                                                                                                                        Hospice                                   80% after deduct. 70% after deduct.                60% after deduct. 90% after deduct.             80% after deduct.         60% after deduct.
AFLAC                  AFLAC offers a variety of supplemental
                       insurance products through payroll
                                                                    Eligibility begins on the
                                                                    first day of the month
                                                                                                Plan cost varies
                                                                                                according to the
                                                                                                                        Durable Medical Equipment
                                                                                                                        Dialysis
                                                                                                                                                                        N/A         80% after deduct.
                                                                                                                                                                      80% after deduct.     70% after deduct.
                                                                                                                                                                                                                     80% after deduct.
                                                                                                                                                                                                                         60% after deduct.
                                                                                                                                                                                                                                            N/A
                                                                                                                                                                                                                                                80% after deduct.
                                                                                                                                                                                                                                                                     80% after deduct.
                                                                                                                                                                                                                                                                      80% after deduct.
                                                                                                                                                                                                                                                                                               80% after deduct.
                                                                                                                                                                                                                                                                                                60% after deduct.
Insurance              deduction plans such as cancer coverage,
                       disability, life, long-term care and
                                                                    after hire date.            coverage selected.      Home Health
                                                                                                                        Gastric Bypass
                                                                                                                                                                      80% after deduct.
                                                                                                                                                                        not covered
                                                                                                                                                                                            70% after deduct.
                                                                                                                                                                                              not covered
                                                                                                                                                                                                                         60% after deduct.
                                                                                                                                                                                                                           not covered
                                                                                                                                                                                                                                                90% after deduct.
                                                                                                                                                                                                                                                 not covered
                                                                                                                                                                                                                                                                      80% after deduct.
                                                                                                                                                                                                                                                                        not covered
                                                                                                                                                                                                                                                                                                60% after deduct.
                                                                                                                                                                                                                                                                                                  not covered
Products               accident coverage are available.             Annual open enrollment
                                                                                                                        Physical Therapy (30 visits/cal. year max.)   80% after deduct. 70% after deduct.             60% after deduct.         90% after deduct.     80% after deduct.         60% after deduct.
                                                                    held November 1—30.
                                                                                                                        Occ. Therapy (30 visits/cal. year max.)       80% after deduct. 70% after deduct.             60% after deduct.         90% after deduct.     80% after deduct.         60% after deduct.
For information                                                                                                         Speech Therapy (20 visits/cal. year max.)     80% after deduct. 70% after deduct.             60% after deduct.         90% after deduct.     80% after deduct.         60% after deduct.
                                                                    Regular full-time and
call Ramona Ingram                                                                                                      PRE-EXISTING COND ITION                        Does not apply         Does not apply            Does not apply          Doesn’t apply           Doesn’t apply             Doesn’t apply
                                                                    regular part-time
1-800-452-8631                                                                                                          POLICY MA XI MUM (combined)                       $1,000,000           $1,000,000                $1,000,000              $1,000,000              $1,000,000                $1,000,000
                                                                    employees (approved
                                                                                                                        DEPENDENT COV E RAGE                             To age 19; full- To age 19; full-time stu- To age 19; full-time stu-    To age 19;full-    To age 19; full-time stu- To age 19; full-time stu-
                                                                    for 32 hours/pay).                                                                                 time students to dents to 24 (end of           dents to 24 (end of       time students         dents to 24 (end of       dents to 24 (end of
or call Tonya Messer
at ext. 8745                                                                                                                                                          24 (end of month)           month)                    month)                to 24 (end of             month)                    month)
                                                                                                                                                                                                                                                    month)



                                                           8                                                                                                                                                         5
Benefit                  Description                                   Eligibility                Cost                    Benefit                 Description                                Eligibility                   Cost
                                                                                                                                                Flexible Spending Accounts offer savings
Pharmacy                Employees may have their prescriptions
                        filled at the outpatient pharmacy
                                                                      All employees and their
                                                                      dependents are eligible.
                                                                                                 Co-pays are             Flexible               through pretax contributions to cover
                                                                                                                                                                                           Eligibility begins on
                                                                                                                                                                                           the first day of the
                                                                                                                                                                                                                         Contribution amounts
                                                                                                                                                                                                                         are determined by
                                                                                                 determined by the
Services                window at the SOMC Pharmacy, Monday
                        - Friday, 9 a.m. t0 5:30 p.m; pick-up only
                                                                                                 type of drug.           Spending               eligible medical or dependent care
                                                                                                                                                expenses. Expenses may be paid with
                                                                                                                                                                                           month after hire date.        individual employee.


For information
                        5:30 - 6 p.m. Saturday - 9 a.m. - 5:30 p.m.                                                      Accounts               the FSA debit card, or by submitting
                                                                                                                                                receipts for reimbursement.
                                                                                                                                                                                           Annual open enrollment
                                                                                                                                                                                           held November 1—30.
                                                                                                                                                                                                                         Annual maximums:
                                                                                                                                                                                                                         Medical $2,600
call ext. 8101                                                                                                           (FSA)                  Benefit is administered by AFLAC.           Regular full-time and
                                                                                                                                                                                                                         Dependent Care $5,200

                                                                                                                         For information                                                   regular part-time
                                                                                                                         call Ramona Ingram                                                employees (approved
                                                                                                                                                                                           for 32 hours/pay).
Benefit                  Description                                   Eligibility                Cost                    1-800-452-8631

                                                                                                                         or call Ellen Devins
                                                                                                                         at ext. 8380
Healthy                 Employee Wellness Plan.
                        Involves initial consultation and
                                                                      All employees.             No cost to employees.

Partners                assessment, establishing health
                        related goals and progress review
Program                 with a Wellness Specialist.

                        HPP members can earn a free SOMC LIFE
For information
                        Center membership through the program.
contact Regina Tipton
at ext. 7510                                                                                                             Benefit                 Description                                Eligibility                   Cost

                                                                                                                         Basic Life,            Hourly employees may elect coverage        Regular full-time             No cost to employees.
Benefit                  Description                                   Eligibility                Cost                                           equal to one time their annual salary      employees only.
                                                                                                                         Accidental             up to $50,000. Salaried employees are
                                                                                                                                                may select coverage equal to two times     Coverage begins on the first
                        UMRmD is a wellness program that              All employees and their                            Death and              their annual salary up to $100,000.        day of the month after hire
UMRmD                   focuses on your health and well being.
                                                                                                 No cost to employees                                                                      date. Coverage ends when
                        Services include assistance with any
                                                                      family members who
                                                                      are enrolled in SOMC’s
                                                                                                 or dependents.          Dismember-             AD&D coverage is provided at               FT employment ends.
                                                                                                                                                the same level as Basic Life.
For information
contact
                        health care issues, smoking cessation,
                        tools and resources for lowering
                                                                      medical insurance plan.                            ment
UMRmD                   blood pressure and cholesterol and
800-950-4867            diet and exercise information.                                                                   For information
or ext. 3045                                                                                                             call Ellen Devins
                                                                                                                         at ext. 8380



Benefit                  Description                                   Eligibility                Cost
                        Vision coverage is available through
Vision                  VSP (Vision Service Plan). Two coverage
                                                                      Eligibility begins on
                                                                      the first day of the
                                                                                                 Employee premiums
                                                                                                 are deducted from
Coverage                options are available; both offer a           month after hire date.     each pay on an          Benefit                 Description                                Eligibility                   Cost
                        $130 frame allowance or up to $120                                       after-tax basis:
                        for contact lenses, $10 co-pay per            Annual open enrollment
For information
contact
                        exam and $10 co-pay for materials:            held November 1—30.
                                                                                                 Plan 1                  Supplemen-             Supplemental life offers employees an
                                                                                                                                                economical means of increasing their
                                                                                                                                                                                           Regular full-time
                                                                                                                                                                                           employees only.
                                                                                                                                                                                                                         Employees pay 100
                                                                                                                                                                                                                         percent of the cost.
                                                                                                 Single    $4.95/pay
Vision Service Plan
1-800-877-7195
                        Plan 1                                        Regular full-time and
                                                                      regular part-time
                                                                                                 Family    $10.38/pay    tal Life               basic life coverage provided by SOMC.
                                                                                                                                                                                           Coverage begins on the
                                                                                                                                                                                                                         Rate is based on age
                         • Eye exam once every 12 months                                                                                                                                                                 and annual salary.
vsp.com                                                               employees (approved                                                       Hourly employees may elect coverage        first day of the month after   Contact Human
                         • Lenses and frames once every 24
                                                                      for 32 hours/pay).         Plan 2                  For information        equal to one time their annual salary      hire date. Coverage ends      Resources for specific
or call Mary Anderson      months                                                                Single    $8.07/pay     call Ellen Devins      up to $50,000. Salaried employees are      when FT employment ends.      rate information.
at ext. 8118                                                                                     Family   $16.91/pay     at ext. 8380           may select coverage equal to two times
                        Plan 2                                                                                                                  their annual salary up to $100,000.        Conversion to individual
                         • Eye Exam once every 12 months                                                                                                                                   plan available.
                         • Lenses and frames once every 12
                           months


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