Benefits Handbook

MMC Benefits Handbook

• Benefits Handbook

• About This Benefits Handbook

• Life Events

• Adding a Domestic Partner

• About the Life Event
• Impact on Benefits

• Making Changes to Benefits
• When to Make Changes
• Pay-related Changes

• Beneficiary Elections
• Employee Assistance Program (EAP)
• Contact

• Becoming Eligible for State Premium Assistance Program

• About the Event
• Making Changes to Benefits

• When to Make Changes
• Pay-related Changes

• Contact

• Child No Longer Eligible for Benefits

• About the Event

• COBRA Coverage
• COBRA Eligibility and Enrollment

• Impact on Benefits

• When to Make Changes
• Pay-related Changes

• Contact

• Death of a Child

• About the Event
• Impact on Benefits

• Making Changes to Benefits
• When to Make Changes
• Pay-related Changes

• Other Things to Think About
• Beneficiary Elections
• Employee Assistance Program (EAP)
• Contact

• Death of a Spouse

• About the Event
• Impact on Benefits

• Making Changes to Benefits
• When to Make Changes
• Pay-related Changes

• Other Things to Think About
• Beneficiary Elections
• Employee Assistance Program (EAP)
• Contact

• Death of an Employee

• Plans That May Pay Survivor Benefits
• Plans That Do Not Pay Survivor Benefits
• Special Death Benefit
• Beneficiary Elections

• COBRA Coverage
• COBRA Eligibility and Enrollment

• Contact

• Getting Divorced

• About the Event

• COBRA Coverage
• COBRA Eligibility and Enrollment

• Impact on Benefits

• Making Changes to Benefits
• When to Make Changes
• Pay-related Changes

• Other Things to Think About
• Beneficiary Elections
• Employee Assistance Program (EAP)
• Contact

• Getting Legally Separated

• About the Event

• COBRA Coverage
• COBRA Eligibility and Enrollment

• Impact on Benefits

• Making Changes to Benefits
• When to Make Changes
• Pay-related Changes

• Other Things to Think About
• Beneficiary Elections
• Employee Assistance Program (EAP)
• Contact

• Getting Married

• About the Event
• Impact on Benefits

• Making Changes to Benefits
• When to Make Changes
• Pay-related changes

• Other Things to Think About
• Beneficiary Elections
• Contact

• Having a Baby / Adopting a Child

• About the Event
• Impact on Benefits

• Making Changes to Benefits
• When to Make Changes
• Pay-related Changes

• Other Things to Think About
• Beneficiary Elections
• Employee Assistance Program (EAP)
• Contact

• CHIP/Medicaid Loss of Eligibility

• About the Event

• Making Changes to Benefits
• When to Make Changes
• Pay-related Changes

• Contact

• Covered Family Member Gains Coverage Elsewhere

• About the Event
• Impact on Benefits

• When to Make Changes
• Pay-related Changes

• Contact

• Covered Family Member Becomes Eligible for Government Insurance

• About the Event
• Impact on Benefits

• When to Make Changes
• Pay-related Changes

• Contact

• Spouse Leaves a Job

• About the Event
• Impact on Benefits

• When to Make Changes
• Pay-related Changes

• Employee Assistance Program (EAP)
• Contact

• Spouse - Loss/Change of Coverage under Another Employer Plan

• About the Event
• Impact on Benefits

• When to Make Changes
• Pay-related Changes

• Employee Assistance Program (EAP)
• Contact

• Termination of a Domestic Partnership

• About the Event
• Impact on Benefits

• When to Make Changes
• Pay-Related Changes

• Employee Assistance Program (EAP)
• Contact

• Glossary

• Work Events

• Authorized Unpaid Leave of Absence

• About the Event
• Impact on Benefits
• Paying for Coverage While on Leave
• Contact

• Leaving the Company

• About the Event
• Pay-Related Information

• COBRA Coverage
• COBRA Eligibility and Enrollment
• COBRA Rates

• Impact on Benefits
• Qualifying Event-Termination of Employment
• Other Things to Think About
• Contact

• Military Leave and Your Benefits

• Your Benefits Coverage
• Will I Lose Coverage?
• Contact

• Newly Hired or Rehired Employee

• Getting Paid
• Benefit-Related Information

• Rehired by the Company

• Enrollment in Before-Tax Benefits
• Available Benefit Plans
• Beneficiary Elections
• Company Policies

• Relocation

• About the Event
• Pay-related information
• Relocation Assistance
• Employee Assistance Program (EAP)
• Transfers
• Glossary

• Healthcare Benefits

• Participating in Healthcare Benefits

• Eligible Employees

• Your Eligibility Date

• Eligible Family Members

• Spouses and Domestic Partners
• Children

• Retiree Plan Participation

• Transfers/Status Changes/Rehires

• Enrollment

• Enrolling/Terminating Retiree Medical Plan Coverage
• Deferring Retiree Medical Plan Coverage

• Costs

• Taxes

• When Coverage Starts
• If You Have Other Coverage
• Changing Levels of Coverage
• When Coverage Ends
• Continuing Coverage

• About COBRA Coverage
• COBRA Eligibility and Enrollment
• COBRA Rates
• COBRA and Flexible Spending Accounts
• Employee Enrollment in COBRA Coverage
• Enrolling a Family Member under COBRA
• Changes While on COBRA
• Paying for COBRA Coverage
• Extending Benefits Due to Disability
• Impact of Medicare Eligibility
• When COBRA Coverage Ends
• Filing a Claim under COBRA
• COBRA Contact

• HIPAA

• How HIPAA Works
• Enrollment
• Pre-existing Conditions and Coverage Information

• Glossary

• Transparency in Coverage - Machine-Readable Files

• Your Rights and Protections Against Surprise Medical Bills

• Medical Coverage Options

• Participating in Pre-65 Retiree Medical Coverage

• Eligibility

• Spouses and Domestic Partners
• Transfers/Status Changes/Rehires

• Enrollment

• Enrolling/Terminating Retiree Medical Plan Coverage
• Deferring Retiree Medical Plan Coverage
• Enrollment Changes

• Paying for Coverage
• When Coverage Begins

• Aetna Medical Plan Options

• The Medical Plan Options at a Glance
• Participating in the Plan

• Enrollment
• Cost of Coverage
• ID Cards

• How the Medical Plan Options Work

• Member Advocacy
• Health Savings Account and Flexible Spending Accounts
• Deductibles
• Out-of-Pocket Maximums
• Networks
• Utilization Review

• What’s Covered

• Preventive/Wellness Care
• Maternity
• Family Planning
• Gender Affirming Surgery
• Inpatient Hospital and Physician Services
• Cardiac Care
• Massage Therapy
• Mastectomy - Reconstructive Surgery
• Musculoskeletal Surgery - Knee, Hip, Spine
• Obesity Surgery
• Occupational Therapy
• Orthognathic Coverage
• Physical Therapy
• Sword Health Virtual Physical Therapy
• Prescription Drugs
• Prescription Drug Programs
• Mental Health/Substance Use
• Speech Therapy
• Temporomandibular Joint (TMJ) Coverage
• Travel and Lodging
• Virtual Medicine
• Detailed List of Covered Services

• What’s Not Covered

• Alternative Treatments
• Comfort or Convenience
• Dental
• Drugs
• Experimental or Investigational Services or Unproven Services
• Foot Care
• Medical Supplies and Appliances
• Mental Health/Substance Use
• Nutrition
• Physical Appearance
• Providers
• Reproduction
• Services Provided under Another Plan
• TMJ
• Transplants
• Travel
• Vision and Hearing
• Work-Related Accident and Illness
• All Other Exclusions

• Filing a Claim

• Appealing a Claim

• Glossary

• Anthem BlueCross BlueShield Medical Plan Options

• The Medical Plan Options at a Glance
• Participating in the Plan

• Enrollment
• Cost of Coverage
• ID Cards

• How the Medical Plan Options Work

• Member Advocacy
• Health Savings Account and Flexible Spending Accounts
• Deductibles
• Out-of-Pocket Maximums
• Networks
• Utilization Review

• What’s Covered

• Preventive/Wellness Care
• Maternity
• Family Planning
• Gender Affirming Surgery
• Gene Therapy Services
• Inpatient Hospital and Physician Services
• Cleveland Clinic Cardiac Concierge
• Massage Therapy
• Mastectomy - Reconstructive Surgery
• Musculoskeletal Surgery - Knee, Hip, Spine
• Obesity Surgery
• Occupational Therapy
• Orthognathic Coverage
• Physical Therapy
• Sword Health Virtual Physical Therapy
• Prescription Drugs
• Prescription Drug Programs
• Mental Health/Substance Use
• Speech Therapy
• Temporomandibular Joint (TMJ) Coverage
• Travel and Lodging
• Virtual Medicine
• Detailed List of Covered Services

• What’s Not Covered

• Alternative Treatments
• Comfort or Convenience
• Dental
• Drugs
• Experimental or Investigational Services or Unproven Services
• Foot Care
• Medical Supplies and Appliances
• Mental Health/Substance Use
• Nutrition
• Physical Appearance
• Providers
• Reproduction
• Services Provided under Another Plan
• TMJ
• Transplants
• Travel
• Vision and Hearing
• Work-Related Accident and Illness
• All Other Exclusions

• Filing a Claim

• Appealing a Claim

• Glossary

• Kaiser Medical Plan Options

• The Medical Plan Options at a Glance
• Participating in the Plan

• Enrollment
• Cost of Coverage
• ID Cards

• How the Kaiser Medical Plan Options Work

• Health Savings Account and Flexible Spending Accounts
• Deductibles
• Out-of-Pocket Maximums
• Networks

• Filing a Claim

• Appealing a Claim

• Glossary

• HMSA’s Health Plan Hawaii Plus HMO

• The Plan at a Glance
• Participating in the Plan

• Enrollment
• Cost of Coverage
• ID Cards

• How the Plan Works
• Filing a Claim
• Glossary

• HMSA’s Preferred Provider Plan (PPP)

• The Plan at a Glance
• Participating in the Plan

• Enrollment
• Cost of Coverage
• ID Cards

• How the Plan Works
• Filing a Claim
• Glossary

• Surest Copay Plan

• The Plan at a Glance
• Participating in the Plan

• Enrollment
• Cost of Coverage
• Imputed Income Rates
• ID Cards

• How the Plan Works

• Flexible Spending Accounts
• Out-of-Pocket Maximums
• Network
• Utilization Review

• What’s Covered

• Preventive/Wellness Care
• Maternity
• Family Planning
• Gender Affirming Surgery
• Inpatient Hospital and Physician Services
• Massage Therapy
• Mastectomy - Reconstructive Surgery
• Musculoskeletal Surgery - Knee, Hip, Spine
• Obesity Surgery
• Prior authorization under the condition of meeting the medical definition of morbid obesity is required.
• Occupational Therapy
• Physical Therapy
• Sword Health Virtual Physical Therapy
• Prescription Drugs
• Prescription Drug Programs
• Mental Health/Substance Use
• Speech Therapy
• Temporomandibular Joint (TMJ) Coverage
• Travel and Lodging
• Virtual Medicine
• Detailed List of Covered Services

• What’s Not Covered

• Alternative Treatments
• Comfort or Convenience
• Dental
• Drugs Administered through Surest (see prescription drugs section for exclusions specific to CVS Caremark®)
• Experimental or Investigational Services or Unproven Services
• Foot Care
• Gender Dysphoria
• Medical Supplies and Appliances
• Mental Health/Substance Use
• Nutrition
• Physical Appearance
• Procedures and Treatments
• Providers
• Reproduction
• Services Provided under Another Plan
• Transplants
• Travel
• Types of Care
• Vision and Hearing
• Work-Related Accident and Illness
• All Other Exclusions

• Filing a Claim

• Appealing a Claim

• Glossary

• Post-65 Retiree Medical Coverage

• Retiree Reimbursement Account (RRA) Plan

• The RRA Plan at a Glance
• Participating in the RRA Plan

• Eligibility
• When Participation Begins
• When Participation Ends

• How the RRA Plan Works
• Using the Benefit Dollars in your RRA
• Required Information for Filing a Claim for Reimbursement of Eligible Healthcare Expenses

• Claim for Reimbursement Denials and Appeals

• What’s Not Covered
• Glossary

• Dental Plan

• The Plan at a Glance
• Participating in the Plan

• Enrollment
• Cost of Coverage
• ID Cards

• How the Plan Works

• About the Network
• Deductible
• Predetermination of Benefits
• Treatment Started Before Coverage Begins
• Treatment Started Before Coverage Ends
• Coordinating with Other Plans

• What’s Covered

• Alternative Benefits
• Covered Service Benefits and ADA Codes

• What’s Not Covered

• General Exclusions
• Diagnostic and Preventive Exclusions
• Restorative Exclusions
• General Services Exclusions
• Orthodontic Exclusions

• Filing Claims

• Appealing Claims

• Glossary

• Vision Care Plan

• Plan at a Glance
• Participating in the Plan

• Enrollment
• Cost of Coverage
• ID Cards

• How the Plan Works

• Finding a VSP Network Doctor
• Non-VSP Doctors
• What to Know About Vision Care
• Coordinating with other plans

• What’s Covered

• More on Covered Services

• What’s Not Covered
• Filing a Claim
• Glossary

• Spending Accounts

• Participating in Spending Accounts

• Health Care Flexible Spending and Limited Purpose Health Care Flexible Spending Accounts

• Eligibility Requirements
• Your Eligibility Date
• Enrollment
• Taxes
• When Participation Starts
• When Participation Ends
• Continuing Participation

• Dependent Care Flexible Spending Account

• Eligibility Requirements
• Your Eligibility Date
• Enrollment
• Taxes
• When Participation Starts
• When Participation Ends
• Continuing Participation

• Health Savings Account

• Eligibility Requirements
• Your Eligibility Date
• Enrollment
• Taxes
• When Contributions Start
• When Contributions End
• Continuing Participation

• Health Savings Account

• The Account at a Glance
• Participating in the Account

• Enrollment
• Contributions
• Contribution Limits
• Investment Options
• When Contributions Start
• When Contributions End
• Taxes

• How the Account Works

• Withdrawals

• Qualified Medical Expenses
• Nonqualified Medical Expenses
• Account Information
• Glossary

• Dependent Care Flexible Spending Account

• The Plan at a Glance
• Participating in the Plan

• Enrollment
• Contributions
• Taxes

• How the Plan Works

• Impact on Benefits
• Reimbursements

• Examples of Eligible Expenses
• Examples of Ineligible Expenses
• About Your Account
• Glossary

• Health Care Flexible Spending Account

• The Plan at a Glance
• Participating in the Plan

• Enrollment
• Contributions
• Taxes

• How the Plan Works

• Reimbursements

• Examples of Eligible Expenses
• Examples of Ineligible Expenses
• About Your Account
• Glossary

• Limited Purpose Health Care Flexible Spending Account

• The Plan at a Glance
• Participating in the Plan

• Enrollment
• Contributions
• Taxes

• How the Plan Works

• Reimbursements

• Examples of Eligible Expenses
• Examples of Ineligible Expenses
• About Your Account
• Glossary

• Insurance Benefits

• Participating in Insurance Benefits

• Eligible Employees

• Your Eligibility Date

• Eligible Family Members

• Spouses and Domestic Partners
• Children

• Enrollment
• Beneficiaries
• Costs
• When Coverage Starts
• Changing Your Coverage
• When Coverage Ends
• Continuing Coverage

• Basic Life Insurance Plan

• The Plan at a Glance
• Participating in the Plan

• Enrollment
• Evidence of Insurability
• Beneficiaries
• Cost of Coverage
• When Coverage Begins
• When Coverage Ends

• How the Plan Works

• Salary
• Accelerated Benefit Option
• Assigning Your Benefit
• Retiree Benefit

• Funeral Discount and Planning Services
• Grief Counseling
• Survivor Assistance
• How Benefits Are Paid
• Filing a Claim
• Glossary

• Group Variable Universal Life (GVUL) Insurance Plan

• The Plan at a Glance
• Participating in the Plan

• Eligible Employees
• Eligible Children
• Eligible Spouse/Domestic Partner
• Enrollment
• Evidence of Insurability
• Beneficiaries
• Cost of Coverage
• When Coverage Begins
• Changing Coverage
• When Coverage Ends

• How the Plan Works
• Spouse/Domestic Partner Coverage - How the Plan Works
• Child Coverage - How the Plan Works

• Salary
• Accelerated Benefit Option
• Investment Feature
• Assigning Your Benefit

• Funeral Discount and Planning Services
• Grief Counseling
• Survivor Assistance
• Will Preparation
• Estate Resolution
• Digital Estate Planning
• How Benefits Are Paid
• Filing a Claim
• Glossary

• Voluntary AD&D Plan

• The Plan at a Glance
• Participating in the Plan

• Eligible Employees
• Eligible Spouses and Domestic Partners
• Eligible Children
• Enrollment
• Cost of Coverage
• When Coverage Begins
• Changing Coverage
• When Coverage Ends
• Beneficiaries

• How the Plan Works

• Spouse and Domestic Partner Benefits
• Dependent Children Benefits
• Coma Benefits
• Dismemberment Benefits
• Additional Benefits
• What Is Not Covered

• How Benefits Are Paid
• Filing a Claim
• Glossary

• Personal Excess Liability Insurance Plan

• The Plan at a Glance
• Participating in the Plan

• Eligible Employees
• Enrollment
• Changing Coverage
• When Coverage Ends
• Underlying Primary Levels of Coverage
• Cost of Coverage

• How the Plan Works

• What’s Covered
• Supplementary Payments

• Exclusions
• Glossary

• Business Travel Accident Insurance Plan

• The Plan at a Glance
• Participating in the Plan

• Eligible Employees
• Eligible Spouses and Domestic Partners
• Eligible Children
• Enrollment
• Cost of Coverage
• When Coverage Begins
• When Coverage Ends
• Beneficiaries

• How the Plan Works

• Spouse and Domestic Partner Benefits
• Dependent Children Benefits
• Coma Benefits
• Dismemberment Benefits
• Additional Benefits

• What Is Not Covered
• How Benefits Are Paid
• Filing a Claim
• Glossary

• Disability Coverage