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Presented by Granite Insurance Brokers
-New plan year benefits will be effective 11/1/23
-At this time you can:
-Online Benefits Administration System - Ease!
-After your new hire wait period (refer to your handbook for details) you must have a Qualified Life Event to make changes to your coverage, such as:
You only have 30 days to notify Metcon-TI from the time of event.
This year we are implementing a MERP through East West Administrators.
We have done this to combat high increases to our healthcare costs and to provide a richer benefit plan to our employees.
What is a MERP? - A Medical Expense Reimbursement Plan (MERP) is a plan or arrangement in which an employer reimburses employees for out-of-
pocket medical expenses they or their dependents have incurred.
Kaiser/UHC MERP has Three Parts:
1. Kaiser/UHC High Deductible Plan
2. YOU pay your copays, if any
3. The employer funds the remainder of the coverage through East West Administrators (EWA)
- Two medical plans to choose from:
Type of health plan that limits coverage to care from providers who work for or contract with the HMO. They will generally not cover out-of-network care except for an emergency.
Type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You can use outside providers, but at an additional cost.
Metcon-TI contributes 100% for employees and dependents.
Plan pays 100% after out-of-pocket limit
Out-of-Pocket Limit
$3,000
Company pays difference between MERP & Bronze Plan
You pay copay for service
Deductible
$0
$0 Deductible
$
A copayment is the flat dollar amount you pay each time you receive certain covered health services. Some services will require a copay in lieu of a deductible. Example: $250 ER copay
You go to an out-of-network doctor and the total charge is $250. There is no discount applied. The insurance still only pays $140, you'll have to pay the remainder which is $110.
You go to an in-network doctor and the total charge is $250. A discount is applied to that amount because the doctor has negotiated a rate with the insurance carrier. The discount is $75. The insurance pays $140, you'll have to pay the remainder which is $35.
Key Details
Metcon-TI contributes 100% for employees and dependents.
In-network benefits:
- $130 allowance + 20% discount on amount over
-OR-
- $130 allowance for elective / $25 copay for necessary
- Fitting & Evaluation covered in full with a maximum copay of $60
Employees pay 100% for voluntary coverage.
Key Details
- Enhance your coverage through voluntary supplemental benefits!
- Your options include the following plans that pay you directly when you have a claim:
To enroll in or make changes to existing Colonial Life benefits please contact Lori Laine at (909) 213-0533 or at Lori.Laine@ColonialLifeSales.com
1. You should have received an email from Ease, you will complete your Open Enrollment elections through this portal.
2. Carefully review your benefit selections for this year.
3. Complete your enrollment online between 10/05/23 - 10/12/23
All employees MUST login to the Ease portal and make benefit elections (enroll or waive coverage). If elections are not submitted by 10/12/23, you will not have company provided health benefits (medical, dental and vision) as prior elections DO NOT roll over. The only benefits that will automatically roll over with no changes are the Colonial Life Voluntary Benefits.
Questions? Contact Ally Schiano at Granite Insurance Brokers: aschiano@graniteins.com or (925) 264-5147