Page 21 - SIH 2022 Re-Enrollment Guide
P. 21
2022
SIH Benefits Re-Enrollment
EMPLOYMENT STATUS HEALTH AND WELFARE
CHANGES AND IMPACT BENEFITS
TO BENEFITS Our Medical Plan Includes the
All beneits drop as of your employment Following Features
Full-Time to Part-Time status change (except medical for X Annual deductible: what you pay directly
Less Than 0.50 FTE
employees still in stability period) to a provider or facility before the plan starts
Full-Time to Part-Time 31 days from employment status change paying a portion of your costs; the deductible
0.80–0.50 FTE to make changes to beneits
31 days from employment status change only applies to services for which you pay a
Part-Time to Full-Time
to enroll in beneits coinsurance
All beneits drop as of your employment
Full-Time to Per Diem status change (except medical for X Annual out-of-pocket maximums: the most
employees still in stability period) any individual or family must pay in any one
All beneits drop as of your employment calendar year for covered services
status change (if enrolled in medical,
Part-Time to Per Diem
coverage may continue if still in stability X Coinsurance: the percentage you pay directly
period)
to a provider or facility for covered services
Call a Beneit Specialist to conirm impact to your after you meet the annual deductible
beneits if making changes to your employment X Contribution: what you pay per paycheck for
status as each individual situation is diferent. coverage
X Copayment: the speciic dollar amount you
pay directly to a provider or facility for covered
services; you pay a copayment when there is no
deductible or coinsurance that applies
Network Access and Cross
Accumulation
Our networks are explained in greater detail on the
following pages. Please pay special attention to the three
in-network providers. These are connected when it comes
to your deductibles and out-of-pocket maximums. Any
expenses you pay for care received in these three networks
will cross accumulate.
This means if you pay a $75 bill in the Collaborative
Partner Network, $75 will not only apply toward the $1,500
deductible for the Collaborative Partner Network, but it will
also accumulate toward the $2,500 deductible which applies
to the Cigna network as well as the $500 deductible which
applies to the QHP network. This will allow you to receive
greater cost savings with the plan while utilizing all three
provider networks.
21
SIH Benefits Re-Enrollment
EMPLOYMENT STATUS HEALTH AND WELFARE
CHANGES AND IMPACT BENEFITS
TO BENEFITS Our Medical Plan Includes the
All beneits drop as of your employment Following Features
Full-Time to Part-Time status change (except medical for X Annual deductible: what you pay directly
Less Than 0.50 FTE
employees still in stability period) to a provider or facility before the plan starts
Full-Time to Part-Time 31 days from employment status change paying a portion of your costs; the deductible
0.80–0.50 FTE to make changes to beneits
31 days from employment status change only applies to services for which you pay a
Part-Time to Full-Time
to enroll in beneits coinsurance
All beneits drop as of your employment
Full-Time to Per Diem status change (except medical for X Annual out-of-pocket maximums: the most
employees still in stability period) any individual or family must pay in any one
All beneits drop as of your employment calendar year for covered services
status change (if enrolled in medical,
Part-Time to Per Diem
coverage may continue if still in stability X Coinsurance: the percentage you pay directly
period)
to a provider or facility for covered services
Call a Beneit Specialist to conirm impact to your after you meet the annual deductible
beneits if making changes to your employment X Contribution: what you pay per paycheck for
status as each individual situation is diferent. coverage
X Copayment: the speciic dollar amount you
pay directly to a provider or facility for covered
services; you pay a copayment when there is no
deductible or coinsurance that applies
Network Access and Cross
Accumulation
Our networks are explained in greater detail on the
following pages. Please pay special attention to the three
in-network providers. These are connected when it comes
to your deductibles and out-of-pocket maximums. Any
expenses you pay for care received in these three networks
will cross accumulate.
This means if you pay a $75 bill in the Collaborative
Partner Network, $75 will not only apply toward the $1,500
deductible for the Collaborative Partner Network, but it will
also accumulate toward the $2,500 deductible which applies
to the Cigna network as well as the $500 deductible which
applies to the QHP network. This will allow you to receive
greater cost savings with the plan while utilizing all three
provider networks.
21
