Open Enrollment Is October 24th – November 10th

You must enroll in BenefitSolver for medical and spending accounts in order to have coverage in 2024.

Changes for the 2024 Plan Year:

• New benefits administration and enrollment platform: BenefitSolver

• Telehealth services will now be offered through Teladoc and includes Behavioral Health services

• New medical carrier and a total of three plan design options to choose from!

• Now covering reproductive assistance through the new UMR medical plans

• New limits for spending/savings accounts

• Decision-support tool: Sofia, your personal benefits assistant

Helpful Resources!

Here are some helpful resources for you and your dependents to utilize as you complete this year's Open Enrollment.

Enrollment Assistance

Employees will have the opportunity to speak with a Benefits Counselor to experience a personalized educational enrollment session. During your appointment, the Benefits Counselor will:

• Provide core benefits education on your Medical, Dental, Vision, FSA, HSA, Term Life, and Disability plans
• Educate on the Voluntary Benefits with Atlantic American: Permanent Life, Accident, Critical Illness, and Hospital Indemnity
• Answer any questions you may have
• Complete enrollment

How to Navigate 

Use the navigation bar at the top of the page to learn more about each category of benefits.  You can watch videos and view documents provided by the benefit carriers.  If you have questions, we are here! Feel free to submit questions by contacting us using the information listed below. 

Medical Plan Options 

You have the opportunity to choose from three medical plan options from UMR for 2024: the Advantage HDHP, the Standard PPO Plan, or the Premier PPO Plan. Each of these plans utilizes the Choice+ network of providers.

Prescription Drug coverage is provided through OptumRx. Call the Member Services Line at 866.793.7436 or the Specialty Line at 877.838.2907 with formulary questions, coverage and tier inquiries, or help locating a pharmacy.

Review the 2024 Benefits Guide for more information on plan design and cost.

Questions? Chat or Secure Message at www.mysphealth.com or call 877.778.1798.

Telemedicine

You have access to TELADOC! You can speak with a physician via telephone, smartphone, tablet or computer.

When to use Telemedicine

• when it is not an emergency
• when it is not easy to schedule an appointment with your doctor or you are too busy to go
• when you are traveling

Common Conditions Telemedicine Doctors can treat:

Saves You Money!

TELADOC costs less than a trip to urgent care or the ER.

Behavioral Health Visits - TELADOC

TELADOC BH treats issues such as:

The Behavioral Health (BH) program offers members ongoing access to behavioral diagnostic services, talk therapy, and prescription medication management, when appropriate. The following types of BH Practitioners are available under the BH Program:

• Psychiatrists (MD/DO)
• Psychologists (PhD)
• Counselors (Masters)
• Clinical Social Workers (Masters)
• Therapists (Marriage and Family) (Masters)
• Substance Abuse Counselors

Questions? Visit www.teladoc.com or call 800-TELADOC

Quantum Care Coordinators

To help you navigate through your healthcare journey, Surgery Partners offers all medical plan members access to Care Coordinators. These trusted advocates are an expert team of nurses, patient services representatives and benefit specialists who are ready to help you before, during and after any health event. 

Think of Care Coordinators as your personal healthcare team - they fight hard to help you save money and ensure you get the best possible care for you and your family. You'll no longer need to make separate phone calls to your medical carrier, healthcare providers and pharmacy, and you can avoid spending countless hours researching online thanks to your personal team of Care Coordinators. 

For personalized care, contact your Care Coordinators. They will help: 

• Get your ID cards.
• Answer your questions about your benefits plans (after enrollment).
• Find an in-network Primary Care Physician or provider.
• Answer questions about your medical bills.
• Coordinate your care by talking to all your healthcare providers.
• Guide you to various resources that can help you lead a healthier life.
• Ensure you obtain and properly complete pre-certification requests.
• Answer questions regarding your Wellness Credit requirements.

Questions? Visit www.mySPhealth.com or call 877.778.1798.

Wellness

Be rewarded for your health and wellness efforts! UMR medical plan members can maintain lower medical contributions by completing the plan's wellness requirements. 

2024 Plan Year Credit

Members who designated a PCP in the Quantum portal and completed a wellness exam/screening by September 30, 2023, will receive their wellness credit for the 2024 plan year.

Planning Ahead for 2025

To receive your wellness credits in 2025 you must complete the following during October 1, 2023 - September 30, 2024:

• Select a primary care physician (PCP) by calling your Care Coordinators at 877.778.1798 or visiting mySPhealth.com 
• AND Get a preventative screening: Wellness Exam / Annual Physical, Preventative or Diagnostic Mammography, or Preventative or Diagnostic Colonoscopy

If the requirements are not complete by September 30, 2024 your premiums will increase January 1, 2025. The premiums will remain at the increased rate until the end of the 2025 plan year. 

Questions? Visit www.mySPhealth.com or call 877.778.1798.

Dental Plans

Surgery Partners offers two dental plans through Delta Dental of Tennessee. The Base Plan includes the PPO network; the Buy-Up Plan includes both the PPO and Premier networks. The out-of-network covered percentage is the same for both plans.  

Understanding your Dentist’s Rates     

You are free to go to any licensed dentist you choose. We offer two different plan options so that you are able to elect what’s best for you. Researching if your dentist is a member of the Delta Dental PPO or Premier network can save you money.

Basic teeth cleaning and oral exam will be free when you choose a Delta Dental PPO dentist if you are enrolled in the Base plan. If you are enrolled in the Buy Up plan, your Basic cleaning is free if you choose a PPO or Premier dentist. Please note, if you are in the Base plan and choose to see a Premier Provider you might experience larger out-of-pocket expenses. If you choose to see a Non-participating provider, you will experience higher out-of-pocket costs and the dentist can balance bill you (bill you for the difference between what the dentist charges and what the insurance company reimburses).

Questions? Visit www.deltadentaltn.com or call 800.223.3104.

Vision Plan

Whether you have perfect vision or require some type of corrective lenses, preventive eye care is an important part of your overall health.  Superior Vision Insurance can help you offset the expensive costs of exams, frames, contact lenses, corrective surgery and more.   

Superior Vision’s Superior National Network offers a broad provider network of MDs, ODs and national and regional optical retail chains such as Walmart, Costco, LensCrafters, Sam’s Club and Visionworks. 

Questions? Visit portal.superiorvision.com/account/login/member or call 800.507.3800.

Health Savings Account (HSA)

The Health Savings Account (HSA) is designed to help save you money by utilizing funds that have been set aside on a pretax basis. With an HSA, you are never taxed if funds are used to pay for qualified healthcare expenses. In addition, the money in the account earns tax-free interest on investment returns.

There is no 'use it or lose it' rule for an HSA and any unused HSA funds will roll over each year. You must be enrolled in a High Deductible Health Plan (HDHP) with no first-dollar coverage for medical expenses in order to be eligible to contribute to an HSA. You can contribute money toward your HSA through pre-tax payroll deductions. The IRS 2024 HSA Contribution Limits are $4,150 (Individual) and $8,300 (Family). You will have access to your HSA funds with a debit card that you will receive from HSA Bank that you can use at the point of purchase to pay for eligible expenses.

Questions? Email askus@hsabank.com or call 800.357.6246. 

Flexible Spending Accounts (FSAs) offer another way to save by paying certain eligible expenses on a pre-tax basis. You do not pay taxes on the money you put into these accounts. These accounts are administered by HSA Bank. 

Healthcare FSA

(Only available to those NOT enrolled in a Surgery Partners HSA plan) 

You may contribute up to $3,050 per calendar year to pay for out-of-pocket medical, prescription drug, dental, and vision care expenses for yourself and your eligible family members—even if you do not cover your family members under the Surgery Partners medical plans. You can use this FSA to pay for healthcare expenses such as medical, dental and vision plan deductibles and copays; orthodontia expenses not covered by your dental plan, prescription drugs, prescription glasses and contact lenses, and laser eye surgery. Please Note: Due to IRS regulations the Healthcare FSA is not available to employees enrolled in the HSA.

Limited Purpose FSA

The Limited Purpose FSA is a pre-tax account used for eligible dental and vision expenses. Set aside up to $3,050 pre-tax from your paycheck for 2024. You may not use these funds for medical and prescription drug expenses. 

Please Note: The Limited Purpose FSA is only available to those employees enrolled in the Heath Savings Account (HSA) due to IRS regulations.

Dependent Care Spending Account

The Dependent Care Spending Account is a pre-tax account for elder care and childcare expenses. You may set aside up to $5,000 pre-tax to pay for eligible dependent care expenses ($2,500 if you are married filing taxes separately). The child or elder care provider must declare the income on his/her tax return for Dependent Care services provided. You may use the Dependent Care Spending Account only to pay for dependent care that is required to allow you and your spouse to be gainfully employed (note: nursing home care and residential summer camp are excluded). Some examples of eligible expenses include: Before and after school care, daycare, nursery school, preschool, summer day camp, etc.). Certain Highly-Compensated individuals may have their election reduced based upon plan enrollment.

If you enroll, payroll deductions will occur for the prorated amount each pay period. Money that you contribute to your FSAs is considered pre-tax and is not subject to social security, federal, and in most cases, state income taxes. 

Questions? Email askus@hsabank.com or call 800.357.6246. 

Commuter Benefits

With Commuter Benefits, you can make tax-free payroll deductions (up to the IRS limits) and, in certain circumstances, post-tax deductions, to cover mass transit and parking expenses as part of your daily commute to and from work.

Two Account Types

• Tickets, vouchers and passes to ride a subway, train, city bus or ferry
• Transportation in a commuter rideshare vehicle (e.g., Uber, Lyft), for travel to and from home and work

Parking - Covers qualified parking expenses, including:

• Lots or garages at or near where you work
• Train stations, vanpool stops, commuter lots, and anywhere you get transportation to work
• Excludes any parking on or near property at your home

2024 Maximum Contribution

$300 Per Month / Per Benefit

*You must submit all claims within 180 days of receiving the service to get reimbursed for out-of-pocket expenses.

How to use your benefits

Debit card - Use your card to pay for:

• Transit and parking plans at any U.S. terminal
• Transit, rideshare, parking and vanpool expenses

On hsabank.com and the mobile app - Submit claims for cash reimbursement for:

• Parking plans
• Vanpool expenses (where electronic payment method isn't available)
• Any post-tax expenses related to your commute

Basic Life and AD&D Insurance

Life insurance provides financial protection for your family in the event of your death. Surgery Partners offers all benefit-eligible employees life and accidental death & dismemberment (AD&D) insurance through Lincoln Financial in the amount of one times (1x) basic annual earnings up to $500,000. Surgery Partners pays the cost of this benefit. Benefits are payable to your designated beneficiary listed on the employee benefits portal, www.benefitsolver.com. Please ensure a beneficiary is designated.

Supplemental Life and AD&D Insurance

You may elect additional life and AD&D insurance coverage for yourself, your spouse/domestic partner or your dependent children — all at an affordable group rate provided by Lincoln Financial. Whatever you elect for Supplemental Life, you will get an equal amount of Supplemental AD&D for yourself and your dependents. See the benefit summary below for additional details.

*Increases above the current benefit level during this year's open enrollment will be subject to Evidence of Insurability

Questions? Visit www.lincolnfinancial.com or call 800.423.2765.

Disability Insurance

Disability coverage continues a portion of your paycheck if a serious illness, injury, or pregnancy occurs. The goal of the disability plan is to provide you with income replacement should you become disabled and unable to work due to a non work related illness or injury.

Short-Term Disability (STD)

The STD plan provides a weekly benefit if a non-job-related disability (including pregnancy) prevents you from working. If you enroll in the STD plan, you will pay the entire cost of your coverage through payroll deductions. STD coverage is provided through Lincoln Financial. Instructions on how to file a short term disability claim are outlined below by clicking the ‘How to File an STD Claim’ button.

Note: Employees in California, New Jersey and Rhode Island are covered by State Disability Insurance (SDI). You may also purchase Prudential STD insurance to supplement your SDI coverage.

If you’re a new hire or newly eligible for these benefits, you are not subject to Evidence of Insurability upon initial enrollment. However, if you aren’t a new hire or newly eligible and you are enrolling for STD coverage for the first time during this year’s open enrollment, your coverage will be subject to a 3/12 preexisting condition limitation. A 3/12 preexisting condition limitation means that if you file a claim within the first 12 months the policy is in effect, the insurance company will look back 3 months before the policy took effect to see if it was caused by a preexisting condition.

Long-Term Disability (LTD)

The financial consequence of a lengthy disability can be very serious. The LTD plan through Lincoln Financial provides income protection if you become unable to work due to a disabling condition that lasts beyond 90 days. Surgery Partners will provide base LTD coverage, up to 40% of your covered base earnings, at no cost to you. You will also have the option to purchase additional coverage up to a total of 60% of your monthly covered base earnings. 

Instructions on how to file a long term disability claim are outlined below by clicking the ‘How to File an LTD Claim’ button.

Pre-existing Condition Limitation: If you have a medical condition that begins before your coverage takes effect, and you receive treatment for this condition within the three months leading up to your coverage start date, you may not be eligible for benefits for that condition until you have been covered by the plan for 12 months.

*Buy-Up LTD: No Evidence of Insurability is required even if you are electing this coverage for the first time.

Questions? Visit www.lincolnfinancial.com or call 800.423.2765.

Our Voluntary Benefits are offered through Atlantic American. These policies are provided to eligible staff and are designed to offset costs due to Critical Illnesses or Accidental Injuries that are not covered by your existing health insurance. And - Atlantic American will never require Evidence of Insurability for any of these voluntary benefit lines of coverage!

Critical Illness Insurance

The Critical Illness benefit offers comprehensive coverage of illnesses such as strokes and heart attacks.

It pays a lump-sum benefit if you are diagnosed with a covered disease or condition on or after your coverage effective date.  You can use this money however you like, for example:  to help pay for expenses not covered by your medical plan, lost wages, child care, travel, home health care costs, or any of your regular household expenses. Coverage is available at $10,000 and $20,000 Employee Coverage Levels, with your Spouse and Family receiving 50% of the coverage amount.   

Accident Insurance

Accident Insurance pays you benefits for specific injuries and events resulting from a covered accident on or after your coverage effective date.  You can use this money however you like, including deductibles, child care, house cleaning, groceries, or utilities.  

Hospital Indemnity

Hospital Indemnity coverage provides benefits for expenses associated with a stay in the hospital due to a covered accident of sickness.  These benefits can be used to help offset any out-of-pocket medical costs, such as deductibles and co-pays, as well as non-medical expenses incurred during recovery.

Whole Life Insurance

Whole Life Insurance is a permanent life product with living benefits that stands out from the pack.  This coverage not only expands an individual's financial protection but also offers guaranteed benefits to aid surviving family members adjusting to the loss of income and a loved one.

Call the EAP whenever you need help and reference that you are with Surgery Partners to get started.  Your call will be handled confidentially by a professional counselor. The EAP will also cover up to five face-to-face counseling sessions per person, per year for each issue.

Employee Assistance Program

We all need help with life’s challenges now and then. Whether it’s a difficult situation affecting your home life or stress interfering with your work, the Employee Assistance Program (EAP), is there for you and your immediate family members 24 hours a day, seven days a week. 

The EAP is provided by Surgery Partners at no cost to you, and it’s administered by ComPsych. It provides free, strictly confidential counseling to help you resolve a wide range of personal issues, including:

• Stress and depression
• Life transitions
• Grief and loss
• Parenting and child care
• Eldercare referrals
• Domestic violence
• Workplace conflict
• Work/life balance
• Addiction and recovery
• Financial issues
• Legal assistance

Questions? Login to www.GuidanceResources.com, Username: LFGSupport  Password: LFGSupport1 or call 888.628.4824.

Legal And Identity Theft Protection Plan

The MetLife Legal and Identity Theft Protection Plan is an optional benefit that gives you unlimited access to attorneys who can provide advice or assistance on a variety of personal legal issues. Services include assistance with home and financial matters (including home refinancing, collections, and IRS audits), family matters (such as adoption, divorce, and child custody), traffic tickets, car accidents, and estate planning. The plan covers you, your spouse or domestic partner, and your dependents.

This plan also includes Identity Protection Services, which include identity recovery services, privacy monitoring, credit monitoring, assistance with obtaining annual credit reports, and 24-hour live support for covered emergencies. 

Questions? Visit www.members.legalplans.com or call 800.821.6400. 

Employee Discount Program

PerkSpot is an employee discount platform that provides savings on the things that matter most. Discover personalized, exclusive, and private discounts - curated to your interests. PerkSpot partners with 700+ merchants to provide high-quality offers that employees love.

You'll find savings and special offers on everything from home goods to the latest gadgets to monthly bills and big-ticket buys.

Savings Across the Board, Delivered to You

Featured offers span from savings on everyday purchases to larger-ticket items, all organized by category. To save you time, you'll receive a weekly email of certain offers, including the newest specials - right in your inbox. You can access all offers on your portal at any time.

A Perk for Every Aspect of Your Life

• Everyday Essentials
• Local Finds
• Life Events
• Big Buys