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2023 - 2024 Benefits

Metcon-TI, Inc.

Presented by Granite Insurance Brokers

2023 - 2024 Benefits

  • Medical NEW PLAN DESIGN
  • Kaiser (HMO)
  • UnitedHealthcare (PPO)
  • EWA Medical Expense Reimbursement Plan (MERP) NEW!
  • Principal Dental
  • Principal Voluntary Vision
  • Colonial Life Voluntary Supplemental Benefits

Open Enrollment Is Here!

10/05/23 - 10/12/23

-New plan year benefits will be effective 11/1/23

-At this time you can:

  • Enroll without a qualifying life event
  • Change your plan
  • Add/Delete dependents
  • Terminate your coverage

-Online Benefits Administration System - Ease!

Enrolling Outside of Open Enrollment

-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:

  • Marriage
  • Divorce or legal separation
  • Birth, adoption, or placement of a child
  • Change in eligibility of a child
  • Death of a dependent
  • Change in spouse's employment
  • Move outside of network service area

You only have 30 days to notify Metcon-TI from the time of event.

What's Changing This Year?

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.

MERP Through East West Administrators

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)

Medical Options

- Two medical plans to choose from:

  • Kaiser HMO Plan w/ MERP
  • UnitedHealthcare PPO Plan w/ MERP

PPO

HMO

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.

Insurance Crash Course

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

In-Network Providers

  • When you can, use in-network providers. You will pay the least by using the doctors and hospitals that have a contracted rate with the carriers.
  • If you are wondering if your doctor is in-network, the carrier's website will have a provider search function you can use.

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.

Urgent Care vs. Emergency Room

Dental - Principal

Key Details

  • POS plan, gives you the freedom of choice to see any dentist, in or out-of-network
  • $50 per person calendar year deductible up to $150 maximum (waived for preventive services)
  • $2,000 benefit maximum per person per calendar year (combined in and out-of-network)
  • Orthodontics covered for children and adults up to $1,000 lifetime maximum per person

PPO

EPO

Non-Network

Preventive

100%

Basic

80%

Major

50%

Orthodontic

50%

Metcon-TI contributes 100% for employees and dependents.

Voluntary Vision - Principal

In-network benefits:

  • Vision Exam (every 12 months) is $10
  • Prescription Glasses
  • Lenses (every 12 months) are $25
  • Frames (every 24 months)

- $130 allowance + 20% discount on amount over

-OR-

  • Contacts (in lieu of glasses, every 12 months)

- $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.

Voluntary Term Life/AD&D Options

Key Details

  • With this Voluntary product, you can secure Life/AD&D coverage for yourself and choose to cover your dependents as well
  • Employee: $10K increments up to a maximum benefit of $500,000, GI is $100K
  • Spouse: $5K increments up to a maximum of 100% of employee coverage up to $100,000, GI is $30K
  • Children: $10,000 (eligible children under 14 days receive $1,000)
  • Accidental Death & Dismemberment is optional for employee and spouse coverage and must match the voluntary life amounts.
  • You and your enrolled dependents have the option to increase coverage one increment per year during your annual Open Enrollment period without proof of good health.

Voluntary Supplemental Benefits

- Enhance your coverage through voluntary supplemental benefits!

- Your options include the following plans that pay you directly when you have a claim:

  • Disability Insurance
  • Life Insurance
  • Accident Insurance
  • Cancer Insurance
  • Critical Illness Insurance

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

Next Steps

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

Completing Open Enrollment through Ease

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