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Medical Plan Options Mid-Plan Buy Up Funding Type Benet items Individual Deductible Family Deductible Individual Out-of-Pocket Max Family Out-of-Pocket Max Coinsurance (Policy Holder Portion) Primary Care/Oce Specialist Care Emergency Room Urgent Care Tiers - Mail Order / Retail ' eekly Rates Employee + Spouse+ Child(ren)+ Family 3
My EMI Health AccountGetting StartedFind everything related to your benefits from general plan documents to detailed claims information.Question s?As always, we are here to help. Call customer service at 800- 662- 5851.- Go to emihealth.com.- Click Sign In and select My EMI Health.- Select Register and choose Member as the type of account.- Enter the data to identify yourself and click Continue.*Please note that you will only make an EMI Health account for your family through the plan subscriber. Dependents and spouses will not have their own account.I t''s easy to register and get started !Your Member ID CardYou will receive a Member ID Card in the mail. Please use your Member ID number found on your EMI Health ID card to register your account. emihealth.com | (800) 662- 5851 | 5101 S Commerce Drive Murray, UT 84107EMI.MKTG.REGISTERACCOUNT.1123.1421
Unlock Afford able WellnessWhere you receive services makes a difference on your costs. In general, following the guidelines below will provide you with the best value. Please refer to your specific plan summaries for your costs.EMI.MKTG.HEALTHTURN.0119.1124TeleMed is perfect for minor aches and ailments. Approximately 70% of doctor visits can be handled over the phone. There is no cost for a consult and you can receive a diagnosis and prescription for many common illnesses. Learn more about telemed here. TeleMedZero Cost- Allergies- Asthma- Bronchitis- Cold or Flu- Ear Ache- Fever- Heartburn- Nausea- Rash- Sinus Infection- Sore Throat- Many moreSchedule a visit with a network provider for preventative care, routine care, or non-life-threatening conditions.Sprains, back pain, minor cuts or burns, and minor eye injuries are good examples of conditions where a visit to your primary care provider is your best option. A convenience clinic would also work well with these types of care and cost of services. OfficeVisitVisit an Urgent Care facility for non-life-threatening but urgent care needs.Urgent Care facilities offer the convenience of extended hours and lower costs for many situations. Stitches, x-rays, broken bones, and labs can be handled at most Urgent Care locations. *During business hours, check with your network provider to see if they can handle your condition before going to urgent care.UrgentCareVisit the Emergency Room for serious and/or life-threatening conditions.ERs are not set up to care for routine illness and work on the most serious cases first. You may have to wait longer for your care and costs can be very high.ER VisitYour Guide to High-Value Healthcareemihealth.com | (800) 662-5851 | 5101 S Commerce Drive Murray, UT 84107Visit the ER if you experience:- Trouble Breathing- Sudden, unusual headache- Signs of stroke- Seizure- Head or spine injury- Broken bone- Severe chest pain- Heavy bleeding- Deep woundQuestion s?Call custom er service at 800-662-5851.
PROVIDER NETWORKMental Health mad e easy!Virtual and in- person behavioral health therapy WHEN and WHERE you need it when you use the Lyra Provider Network. Administered by Lyra HealthCombined with your Physician?s therapy plan, management of prescribed medications for symptom monitoring, refills, and follow-up appointments. Medication ManagementMeet with a therapist for diagnosis and treatment of mental health conditions like depression, anxiety, substance use, and more.TherapyFind care with a mental health coach to support you through managing stress, low confidence or self-doubt, relationship issues, and more via video.CoachingScan the QR code to register or go online at emihealth.com/ provider search and get started!emihealth.com | 5101 S Commerce Dr. Murray UT 84107 | (800) 662- 5850N ew!EMI.MKTG.LYRAOVERVIEW.0923.1410EMI members have access to Lyra Health?s provider network of therapists and coaches at no additional cost. Sessions are billed as in- network outpatient, as defined under your mental health benefit.
Dental Benefits Benefit items Individual Deductible Calendar Year Max Benefit Preventive Coinsurance Basic Coinsurance Major Coinsurance Waiting Period - Major Ortho Coinsurance Periodontics / Endodontics Employee + Spouse+ Child(ren)+ FamilyValue Plan MAC Principal In-network Preventive: $10 I Basic & Major: %50 $750 100% 70% 30% (No Waiting Period) N/A Major Weekly Rates $0.00 $2.03 $5.70 $7.12 Plus Plan / 90th Principal In-network $50 $1,500 100% 80% 50% (No Waiting Period) N/A Basic Weekly Rates $4.68 $12.38 $17.95 $27.69 7
Vision Benefits Current Vision Plan Principal VSP Choice Neork + + + Current 8
Group benefitsCheck your benefits when, where, and how you want toIt’s easy to keep track of your benefits from Principal® anytime—online or on your mobile deviceStart by creating your account1 | From your favorite browser, go to principal.com and select Log In. Or, download the Principal app for free from the App Store or Google Play.2 | Select Create an account.3 | Enter personal information such as your date of birth and identification number.4 | Create a username and password, and provide an email address.5 | You’ll receive an email within a few minutes to confirm your account is ready to go. You can access your account information anytime, 24/7, with the username and password you’ve just set.Manage your benefits on Principal.com and the Principal mobile appAfter logging in, you can manage your benefits and other Principal products you have when, where, and how it’s convenient for you. Depending on your coverages, you can:• View and manage claims.• Get a 24-month history of yourexplanation of benefits (EOB).• Access your summary of benefits, as wellas benefit booklets.• Find a list of covered dependents.• View and print your dental ID card.• Search for and contact a network dentist.• Find discounts and services.• Calculate coverage needs and more.Keeping your account safeYour information is important to us. That’s why we use verification codes to prevent others from accessing your account, even if they have your password. The first time you log in—on Principal.com or the mobile app—you’ll need to choose how you’ll receive the codes.If you log in from an unrecognized device, forget your password, or we notice anything out of the ordinary, the codes help us confirm it’s really you accessing your account.
PROVIDER SEARCHPHONECARRIERBENEFIT CONCIERGEWe strive to provide our valued employeeʼs with the most exceptional of benefits. One of the value-added features of our benefit program is that it comes with a Personal Concierge. Our benefits (Medical, Dental and Vision) are now provided to us through a firm called “Primary Care Insurance Solutions" As part of our relationship, they provide a Dedicated Account Manager to assist all our staff with any insurance related issues, questions or concerns. The moment you discover there is any issue or have any questions, please contact them! The sooner we are able to get our account manager involved, the faster the is-sue can be addressed and questions can be answeredPRIMARY CARE INSURANCE SOLUTIONS M: 713-329-6944 - C: 832-380-0911www.primarycareins.comCOVERAGEMEDICALDENTALVISIONNEED HELP FINDING AN "IN-NETWORK" PROVIDER? (DOCTOR / FACILITY / HOSPITAL / PHARMACY / DENTIST, ETC.)NEED TO KNOW HOW OR IF SOMETHING IS COVERED UNDER YOUR MEDICAL, DENTAL OR VISION PLAN?HAVE YOU RECIEVED A MEDICAL/DENTAL/ VISION BILL THAT MAY BE INCORRECT?OR ANY OTHER QUESTION OR CONCERNJordan SpeerSupport to Account Manager D: 832-742-4111Jordan@Primarycareins.comKristi WoodringDedicated Account Manager D: 713-414-4100Kristi@Primarycareins.com800-662-5851www.emihealth.com/providersearchPrincipal FinancialPrincipal Financial800-843-1371800-843-1371https://www.vsp.com/eye-doctorhttps://www.principal.com/find-dentistEMI Healthselect the Aetna Natl PPO from the network drop down menu
Receive a summary of the Plan's annual financial report, if required to be furnished under ERISA. The Plan Administrator is req by law to furnish each participant with a copy of this summary annual report, if any.Coverage is lost under Medicaid or a State CHIP program; orIf you decline enrollment for yourself or eligible dependents (including your spouse) while Medicaid coverage or coverage under a State CHIP program is in effect, you may be able to enroll yourself and your dependents in this plan if:In either case, you must request enrollment within 60 days from the loss of coverage or the date you become eligible for premium assistance.To request special enrollment or obtain more information, contact person listed at the end of this summary. As a participant in the Plan you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 ("ERISA"). ERISA provides that all participants shall beentitled to: Receive Information about Your Plan and Benefits If applicable, you may continue health care coverage for yourself, spouse or dependents if there is a loss of coverage under the plan as a result of a qualifying event. You and your dependents may have to pay for such coverage. Review the summary plan description and the documents govern-ing the Plan for the rules on COBRA continuation of coverage rights. In addition to creating rights for participants, ERISA imposes duties upon the people who are responsible for operation of the Plan. These people, called "fiduciaries" of the Plan, have a duty to operate the Plan pruden ly and in the interest of you and other Plan participants. No one, including the Company or any other person, may fire you or discriminate against you in any way to prevent you from obtaining welfare benefits or exercising your rights under ERISA. You or your dependents become eligible for a premium assistance subsidy from the State.Statement of Erisa RightsExamine, without charge, at the Plan Administrator's office and at other specified locations, thePlan and Plan documents, including the insurance contract and copies of all documents filed by the Plan with the U.S. Department of Labor, if any, such as annual uired reports and Plandescriptions. Obtain copies of the Plan documents and other Plan information upon written request to the PlanAdministrator. The Plan Administrator may make a reasonable charge for the copies.Continue Group Health Plan CoveragePrudent Actions by Plan Fiduciaries
If your claim for a welfare benefit is denied in whole or in part, you must receive a written explana-tion of the reason for the denial. You have a right to have the Plan review and reconsider your claim. Under ERISA, there are steps you can take to enforce these rights. For instance, if you request materials from the Plan Adminis trator and do not receive them within 30 days, you may file suit in federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $152 per day (up to a $1,527 cap per request), until you receive the materials, unless the materials were not sent due to reasons beyond the control of the Plan Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, and you have exhausted the available claims procedures under the Plan, you may file suit in a state or federal court. If it should happen that Plan fiduciaries misuse the Plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose (for example, if the court finds your claim is frivolous) the court may order you to pay these costs and fees. If you have any questions about your Plan, this statement, or your rights under ERISA, you should contact the nearest office of the Employee Benefits and Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits and Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Wash ington, D.C. 20210. Enforce your RightsAssistance with your Questions
This brochure summarizes the benefit plans that are available to Charlie's Plumbing eligible employees and their dependents. Official plan documents, policies and certificates of insurance contain the details, conditions, maximum benefit levels and restrictions on benefits. These documents govern your benefits program. If there is any conflict, the official documents prevail. These documents are available upon request through the Human Resources Department. Information provided in this brochure is not a guarantee of benefits.Contact Ushttps://primarycareins.com/(713) 329 - 6944support@primarycareins.com5920 Star Lane Houston Texas 77057