Return to flip book view

EMPLOYEE BENEFITSGUIDE2024 - 2025An overview of the wide array of benefits provided byC. W. Williams Community Health Center Inc. to help you enjoy increased well-being and financial security.

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.2024 – 2025 Employee Benefits Guide C. W. Williams Community Health Center Inc.As an employee of C. W. Williams Community Health Center Inc. , enjoying your work and making valuable contributions to business are equally vital. The health, satisfaction and security of you and your family are important, not only to your well-being, but ultimately, in terms of achieving the goals of our organization.For the 2024 – 2025 plan year, C. W. Williams Community Health Center Inc. has worked hard to offer a competitive total rewards package that includes valuable and competitive benefit plans. These programs reflect our commitment to keeping our staff healthy and secure. We understand that your situation is unique, and C. W. Williams Community Health Center Inc. is offering an overall benefits package that can be shaped and molded by you to fit your needs.This benefits booklet is a summary description of your C. W. Williams Community Health Center Inc. benefit plans. If there is a discrepancy between these summaries and the written legal plan documents, the plan documents shall prevail. This booklet and plan summaries do not constitute a contract of employment.We hope this benefits booklet, along with our additional communication and decision-making tools, will help you make the best health care choices for you and your family.INTRODUCTIONEligibility & EnrollmentAs a full-time employee working 30+ hours/week you are eligible for benefits. You can enroll or make changes during our annual enrollment period or within 30 days if you experience a qualifying life event during the year. A Qualifying Life Event includes changes in marital status, employment status, birth or adoption of a child, death of a dependent, entitlement to Medicaid or Medicare, loss of other coverage or eligibility of dependents.Benefits Begin 90 days following date of hireBenefits End Last day of employmentDependents To age 26

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.2024 – 2025 Employee Benefits Guide C. W. Williams Community Health Center Inc.Comparison of PlansCoverage Provided by North Carolina Medical Society (NCMS)In-Network Silver Plan PPO 4000-70 Gold Plan PPO 3500-80Benefit Period Plan Year: 10/1 – 9/30 Plan Year: 10/1 – 9/30Deductibles (Individual / Family) $4,000 / $8,000 $3,500 / $10,500Out-of-Pocket Max (Individual / Family)$8,550 / $17,100 $8,150 / $16,300Preventive Care Covered at 100% Covered at 100%Primary Care Visit $50 Copay* $35 Copay*Specialist Visit $100 Copay $70 CopayTelehealth via Teladoc $50 Copay $35 CopayUrgent Care $100 Copay $100 CopayEmergency Room $1,000 Copay $1,000 CopayOutpatient Procedure 30% after deductible 20% after deductibleInpatient Visit 30% after deductible 20% after deductiblePharmacy / RX (30 Day Supply)Essential Formulary$15/$35/$45/$90/25% ($50 min up to $200 max)$10/$25/$40/$80/25% ($100 max)Lens and Frames Coverage Covered up to $130, then 90% Covered up to $130, then 90%MEDICALThe chart below is an overview of the In-Network benefits. Out-of-Network benefits are available; please review your NCMS plan documents for additional details.*Log in to Blue Connect to select your in-network Primary Care Provider (PCP). Your copay is waived for your first 3 visits to your selected PCP.

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.2024 – 2025 Employee Benefits Guide C. W. Williams Community Health Center Inc.Wellness and Health ManagementUnderstanding the full value of covered benefits allows you to take responsibility for maintaining good health and incorporating healthy habits into your lifestyle. Some examples include getting regular physical examinations, mammograms and immunizations. Through the plans offered by C. W. Williams Community Health Center Inc., all covered individuals and family members are eligible to receive routine wellness services like these, at no cost; all copays, coinsurance, and deductibles are waived.Which Preventive Care Services Are Covered?The US Preventive Services Task Force maintains a regular list of recommended services that all Affordable Care Act (i.e., Health Care Reform) compliant insurance plans should cover at 100% for in-network providers. Below is a list of common services that are included in the plans offered this year:• Routine physical exam• Well baby and childcare• Well women visits• Immunizations• Routine bone density test• Routine breast exam• Routine gynecological exam• Screening for Gestational diabetes• Obesity screening and counseling• Routine digital rectal exam• Routine colonoscopy• Routine colorectal cancer screening• Routine prostate test• Routine lab procedures• Routine mammograms• Routine pap smear• Smoking cessation• Health education/counseling services• Health counseling for STDs and HIV • Testing for HPV and HIV• Screening/counseling for domestic violencePREVENTIVE CARE

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.2024 – 2025 Employee Benefits Guide C. W. Williams Community Health Center Inc.Employees and dependents enrolled in our medical plan have access to telemedicine through Teladoc. Telehealth provides acute and behavioral care 24 hours a day via phone or video by board-certified doctors and behavioral health specialists. Telehealth is a good option for minor health problems when you can’t see your regular doctor. It is also a convenient choice when you want to speak to a counselor or therapist. Some providers will also offer telehealth appointments. Check with your provider on the availability and cost.How Does Telehealth Work?Your virtual visit will take place via phone, video call on a laptop, tablet or cellphone; or through an app. The provider will ask you the same questions you'd be asked at an in-person visit and may recommend treatment based on their findings.What Can’t Telehealth Be Used For?• Life-threatening or emergency situations • Situations in which diagnostic care (e.g., blood work, imaging or lab tests) are required• Situations of severe illness or complex conditionsHow Do I Access Telehealth?There are 3 ways to access Teladoc:• Download the Teladoc mobile app• Go to Teladoc.com and click “Log in/Register”• Call 855-549-2214Refer to your plan documentation for more information.TELEHEALTHWhat Can Telemedicine Be Used For?General, non-life-threatening doctor's visits or consultations for acute care, such as:• Allergies• Cough, cold and flu• Diarrhea, nausea and vomiting• Ear problems• Insect bites• Sinus problems• Urinary problems• And moreBehavioral health issues such as:• Addictions• Anxiety• Depression• Grief and loss• Relationship issues• And more

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.2024 – 2025 Employee Benefits Guide C. W. Williams Community Health Center Inc.Through our partnership with NCMS, enrolled members have access to several additional programs to help support you in achieving a healthy balanced life.Nurse Support Program Condition CareManaging a chronic condition can be complicated. This BCBSNC program connects you to additional tools, resources and care if you have a condition such as:• Asthma• Chronic Obstructive Pulmonary Disease• Congestive Heart Failure• Coronary Artery Disease• Diabetes• HypertensionA Nurse Advocate may call you to provide one-on-one support. If you have not already been contacted by the Nurse Advocate, you can call 1-888-229-8510, Monday through Friday, between 9:00 a.m. and 7:00 p.m.Eat Smart, Move More, Weigh LessEat Smart, Move More, Weigh Less is an online weight management program that uses strategies proven to work for weight loss and maintenance. Each lesson informs, empowers and motivates participants to live mindfully as they make choices about eating and physical activity.Nutrition Counseling Total Nutrition Technology provides members with a custom-built nutrition plan and exercise guidelines to fit each member’s lifestyle and dietary objectives. To get started on your wellness journey, complete and submit this form: https://www.totalnutritiontechnologycharlotte.com/curi-member-form/. Employee Assistance ProgramVITAL WorkLife is available to assist you and your family with life issues which are confronting you., such as grief, anxiety, problems with your children, substance abuse and more. Unlimited phone consultation and website access to articles, assessments, seminars and much more. Face to face counseling is available. Legal, financial and identity theft services can also be accessed. Contact VITAL WorkLife at 800-383-1908 or visit www.vitalworklife.com username: ncmsplan; password: ncmsplan. MEDICAL SUPPORT PROGRAMS

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.2024 – 2025 Employee Benefits Guide C. W. Williams Community Health Center Inc.Coverage Provided by Delta Dental – PPO Plus Premier In-NetworkAnnual Deductibles(Individual / Family)$50 / $150Preventive Care Covered at 100%Basic Procedures (extractions, fillings, etc.)Covered at 80% after deductibleMajor Procedures(crowns, dentures, etc.)Covered at 50% after deductibleChild Orthodontics Covered at 50% Calendar Year Maximum Benefit $2,000Orthodontics Lifetime Maximum $1,000DENTALBelow is a high-level summary of our dental benefits. While Out-of-Network coverage is available, using an In-Network provider will result in less out of pocket expenses. In-Network dentist cannot balance bill you for the amount over the allowable charges. Please review your plan documents for additional details.Please note, late entrant penalties may apply. See policy for more information. VISIONOur vision coverage is provided by BCBSNC. Please review your plan documents for additional details.Coverage provided by BCBSNC – Blue 20/20 Exam Plus In-NetworkVision Exam(once every 12 months)$15 CopayLenses (once every 12 months)$15 CopayFrames (once every 12 months)Up to $300 AllowanceElective Contact Lenses(in lieu of lenses and frames)Up to $300 Allowance

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.2024 – 2025 Employee Benefits Guide C. W. Williams Community Health Center Inc.NCMS Silver Plan PPO 4000-70C. W. Williams Monthly Cost ShareEmployee Monthly Cost ShareEmployee Per Pay Period Cost (26 Deductions)Employee $478.45 $136.17 $62.85Employee + Spouse $478.45 $769.23 $355.03Employee + Child $478.45 $338.99 $156.46Employee + Children $478.45 $609.42 $281.27Employee + Family $478.45 $1,230.19 $567.78MEDICAL PLAN COSTNCMS Gold Plan PPO 3500-80C. W. Williams Monthly Cost ShareEmployee Monthly Cost ShareEmployee Per Pay Period Cost (26 Deductions)Employee $478.45 $318.96 $147.21Employee + Spouse $478.45 $1,140.28 $526.28Employee + Child $478.45 $582.10 $268.66Employee + Children $478.45 $932.96 $430.60Employee + Family $478.45 $1,738.34 $802.31

This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.2024 – 2025 Employee Benefits Guide C. W. Williams Community Health Center Inc.BCBSNC Blue 20/20 Exam PlusC. W. Williams Monthly Cost ShareEmployee Monthly Cost ShareEmployee Per Pay Period Cost (26 Deductions)Employee $16.55 $0.00 $0.00Employee + Spouse $16.55 $14.90 $6.88Employee + Child(ren) $16.55 $16.55 $7.64Employee + Family $16.55 $32.11 $14.82CARRIER RESOURCESBENEFIT CARRIER PHONE NUMBER WEBSITEMedical NCMS/BCBSNC 877-275-9787 www.BlueConnectNC.comDental Delta Dental 800-662-8856 www.deltadentalnc.com Vision BCBSNC Blue 20/20855-400-3641www.BlueConnectNC.comEAP Vital Worklife 800-383-1908www.VITALWorkLife.comUsername & Password: ncmsplanDelta Dental PPO Plus PremierC. W. Williams Monthly Cost ShareEmployee Monthly Cost ShareEmployee Per Pay Period Cost (26 Deductions)Employee $28.07 $18.72 $8.64Employee + Spouse $28.07 $64.39 $29.72Employee + Child(ren) $28.07 $98.52 $45.47Employee + Family $28.07 $146.26 $67.50DENTAL PLAN COSTVISION PLAN COST

EMPLOYEE BENEFITS GUIDEPrepared By Sentinel Benefits Consulting | sentinelra.com2024 - 2025C. W. Williams Community Health Center Inc.