OPEN ENROLLMENT
Monday, April 22th to Friday, May 10th
Quick Resources:
Click Below to Register for OE Webinar:
Open Enrollment is the one time each year you are able to change benefit plans without a “Change Event.”
Even if you think you will keep your current coverage, take the time to review the Plan changes and understand how those changes will impact your health care and your wallet.
NO CHANGES?
If you are already enrolled in a health plan and do not need to make any changes, you do not need to submit an enrollment form. You will automatically be enrolled in the same coverage.
MAKING A CHANGE?
If you are currently enrolled and want to switch to a different health care plan or add a spouse or dependent, you will need to submit an enrollment form by Friday, May 10, 2024.
In addition to completing an Enrollment/Change Form when adding a new family member to your healthcare plan, you will also be required to provide documents that verify the spouse or child is eligible to be covered. Employees covering a dependent child will need to provide the child’s birth certificate or applicable court/ legal documents. Employees covering a spouse will have to submit a marriage certificate and, as evidence of current status, recent tax returns. When covering a spouse, a completed Working Spouse Employment Verification Form must also be submitted or the $750 per month surcharge will apply.
Note that if you are covered by the MMO PPO or MMO PPO/HSA plan you may enroll in the Everside Health program anytime during the year. If you are eligible for Medicare (for example, age 65) you may elect Medicare coverage and drop your Diocesan plan at anytime.
WAIVING HEALTH INSURANCE?
Are you a newly hired employee or a current employee eligible for health insurance coverage?
If you are waiving health coverage, you must complete a waiver form. Please send completed forms to the Benefits Office.
Note that employees who have already completed a waiver form do not need to complete a new one during each open enrollment period.
YOUR 2024/2025 HEALTH CARE COVERAGE OPTIONS
During the new Plan Year you will again have four plans from which to choose:
- The Medical Mutual PPO (MMO PPO);
- The Medical Mutual PPO/Health Savings Account (MMO PPO/HSA);
- The SkyCare EPO plan (formerly named MetroSelect EPO) plan; and,
- The Medical Mutual MedFlex EPO plan
Remember, when selecting a plan, the most expensive one is not necessarily the best fit for your budget and lifestyle. All four plans also include an option for telemedicine visits.
SPOUSAL SURCHARGE
When covering a spouse, a completed Working Spouse Employment Verification Form must also be submitted or the $750 per month surcharge will apply.
Forms are due to the Benefits Office by May 1, 2024.
| 2024/2025 Plan Options | MMO PPO/HSA | MMO PPO | SkyCare | MMO MedFlex |
| Monthly Employee Contribution Single/Family | ||||
| 0 incentives | $84/$320 | $216/$790 | $181/$665 | $192/$706 |
| 1 incentive | $69/$290 | $201/$760 | $166/$635 | $177/$676 |
| 2 incentives | $54/$260 | $186/$730 | $151/$605 | $162/$646 |
| Out-of-Network Coverage | ||||
| Yes | Yes | No | No | |
| Annual Deductible (In-network) | ||||
| Single | $3,200 | $1,250 | $500 | $750 |
| Family | $6,400 | $2,500 | $1,000 | $1,500 |
| Annual Out-of-pocket Maximum (In-network) | ||||
| Single | $4,000 | $3,250 | $2,000 | $2,500 |
| Family | $8,000 | $6,500 | $4,000 | $5,000 |
| Co-insurance Percentage | ||||
| In-network | 80% | 80% | 90% | 80% |
| Annual Health Care Plan HSA Contribution | ||||
| Single | $500 | N/A | N/A | N/A |
| Family | $1,000 | N/A | N/A | N/A |
MEDICARE AND DIOCESAN HEALTH CARE COVERAGE
If you are a lay person over 65 and still working, you may choose Medicare or one of the Diocesan healthcare plans. If you choose a Diocesan healthcare plan and are also enrolled in Medicare, then Medicare will be the secondary payer of benefits.
Need help deciding? Call the specialists at UROne Benefits for personalized advice at 1-833-605-0901.
THE MMO PPO/HSA PLAN – SAVE FOR YOUR FUTURE
You can save a lot of money when you select the MMO PPO/HSA Plan.
Bear in mind the MMO PPO/HSA covers 100% of preventive care costs, such as your annual physical. Use the chart below to help estimate how much you could save if you select the MMO PPO/HSA option. Select the sample savings that fit your family: single or family coverage. In these examples, covered individuals accrued $500 of medical expenses per person throughout the year.
You can also save on taxes with a Health Savings Account. The total HSA tax-free contribution maximums (including the Diocesan contributions) for 2024 are $4,150/single and $8,300/family.
Do you need the lower deductible and lower out-of-pocket maximums of the more expensive MMO PPO plan?
More than 40% of our health plan participants spend less than $500 annually and more than 90% spend less than $2,000 annually on out-of-pocket medical expenses.
THE EPO PLANS ARE GREAT VALUES
WHAT IS AN EXCLUSIVE PROVIDER ORGANIZATION (EPO) PLAN
An EPO plan means you must receive your healthcare from one of the many in-network facilities and providers. Although the premiums are lower, you still get high-quality health care.
SKYCARE EPO
This plan requires you to receive your healthcare from one of the many SkyWay (formerly MetroHealth) Network facilities and providers. There are several in Cuyahoga County. In Lake County, the LakeHealth hospital system is part of the network.
To find a provider go to www.metrohealth.org/physiciandirectory.
THE MMO MEDFLEX EPO
The providers for this plan include University Hospital system, LakeHealth and Summa. The Cleveland Clinic is not in the network. To find a provider, visit https://providersearch.medmutual.com follow these steps:
- Click on Group and then click Next.
- Select Medical.
- Click on “Don’t See Your Network? View More,” then choose MedFlex and enter your location.
- Click Next.
- Enter the doctor’s name or place you’re looking for, or browse doctors and places by the type of service you desire.
Please note that Cleveland Clinic is not included in the network.
