EMPLOYEE BENEFITSGUIDE2024 - 2025HRC Behavioral Health & PsychiatryAn overview of the wide array of benefits provided byHRC Behavioral Health & Psychiatry 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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatryAs an employee of HRC Behavioral Health & Psychiatry, 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, HRC Behavioral Health & Psychiatry 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 HRC Behavioral Health & Psychiatryis 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 HRC Behavioral Health & Psychiatrybenefit 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 1st of month after 30 daysBenefits EndEnd of month following termination**Life & Disability end on date of terminationDependents Up to age 26 (19/26 if FT student for life insurance) Domestic Partner Same and Opposite Sex
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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatryComparison of PlansCoverage Provided by Blue Cross of NCIn-Network Blue Options Gold 2500 HDHP with HSABenefit Period Plan Year: 2/1 – 1/31 Plan Year: 2/1 – 1/31Deductibles (Individual / Family) $2,500/$5,000 $6,000/$12,000Out-of-Pocket Max (Individual / Family)$6,000/$12,000 $8,050/$16,100Preventive Care Covered CoveredPrimary Care Visit$25 Copay (copay waiver for your first 3 visits if your PCP is selected in Blue Connect)30% after deductibleSpecialist Visit $50 Copay 30% after deductibleTelehealth via Teladoc $10 Copay 30% after deductibleUrgent Care $50 Copay 30% after deductibleEmergency Room $750 Copay 30% after deductibleOutpatient Procedure 20% after deductible 30% after deductibleInpatient Visit 20% after deductible 30% after deductiblePharmacy / RX (30 Day Supply)Tiers 1-5Essentials QHP Formulary$4/$15/$35/$50/25% ($100 max per month on tier 5 drugs)30% after deductibleMEDICALThe chart below is an overview of the In-Network benefits. Out-of-Network benefits are available; please review your BCBSNC plan documents for additional details.
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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatryAnnual Deductible - The amount you must pay each year before the plan starts paying a portion of medical expenses. All family members’ expenses that count toward a health plan deductible accumulate together in the aggregate; however, each person also has a limit on their own individual accumulated expenses (the amount varies by plan).Copays and Coinsurance - These expenses are your share of cost paid for covered health care services. Copays are a fixed dollar amount and are usually due at the time you receive care. Coinsurance is your share of the allowed amount charged for a service and is generally billed to you after the health insurance company reconciles the bill with the provider.Out-of-Pocket Maximum - This is the total amount you can pay out of pocket each calendar year before the plan pays 100 percent of covered expenses for the rest of the calendar year. Most expenses that meet provider network requirements count toward the annual out-of-pocket maximum, including expenses paid to the annual deductible, copays and coinsurance. MEDICAL PLAN INFORMATIONWellness 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 HRC Behavioral Health & Psychiatry, 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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatryEmployees 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 1-800-835-2362Refer 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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatryA health savings account (HSA) is a health care account and savings account in one. HSA helps offset the cost of a HDHP while saving for your out-of-pocket eligible health care expenses. The HSA is your personal bank account and can be used for you and your dependents now and in the future.Why Is It A Good Idea To Have An HSA?HSAs benefit everyone who are eligible to have this account, including single individuals, families and soon-to-be retirees. You save money on taxes in three ways:• Tax-Free Deposits: The money you contribute to your HSA isn't taxed (up to the IRS annual limit)• Tax-Free Earnings: Your interest and any investment earnings grow tax-free• Tax-Free Withdrawals: The money used toward eligible health care expenses isn't taxed now or in the futureSetting aside pre-tax dollars into your HSA means you pay fewer taxes and increase your take-home pay by your tax savings. You save money on eligible expenses that you are paying for out of your pocket. The amount you save depends on your tax bracket. For example, if you are in the 30% tax bracket, you can save $30 on every $100 spent on eligible health care expenses.HSA funds roll over from year to year and accumulate in your account. There is no "use-it-or-lose-it" rule with HSAs, and you decide how and when to use your HSA funds, which can be used for eligible expenses you have now, in the future, or during retirement. Also, when you have a certain balance in your HSA, investment opportunities are available.Who is Eligible?You are eligible to contribute to an HSA if:• You are enrolled in a qualified HDHP• You are not enrolled in a copay plan such as a spouse’s non-HDHP, Medicare, Medicaid or Tri-Care• You or your spouse is not enrolled in a full purpose Health Care Flexible Spending AccountRefer to your HSA documentation for more information.HSA Contribution LimitsYou can contribute to your Health Equity HSA on a pre-tax basis through payroll deductions up to the IRS statutory maximums. These maximums include any employer contributions. The IRS has established the following maximum HSA contributions:2024 Tax Year$4,150 Individual / $8,300 FamilyIf you are age 55 and over, you may contribute an extra $1,000 catch-up contribution. HEALTH SAVINGS ACCOUNT (HSA)
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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatrySummary of CoverageCoverage Provided by Delta Dental In-NetworkPlan Year Deductibles(Individual / Family)$50/$150Preventive Care 100%Basic Procedures (extractions, fillings, etc.)80%Major Procedures(crowns, dentures, etc.)50%Plan Year Maximum Benefit $2,000DENTALBelow 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.Summary of CoverageCoverage provided by Blue20/20 In-NetworkVision Exam (Once per 12 months) $15 CopayLenses (once per 12 months) $15 CopayFrames (Once per 12 months) $300 AllowanceContact Lenses (in leu of lenses) $300 AllowanceVISIONOur vision coverage is provided by Blue20/20. Please review your plan documents for additional details.
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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatrySummary of CoverageCoverage provided by UNUMPlan FeaturesEmployee Benefit Amount 1.5 x annual earningsMaximum Benefit Amount $250,000Dependent Benefit AmountSpouse: $2,500 Children: $2,500 (reduced benefit of $1,000 live birth to 6 months)Benefit Reductions begin at age 70Group life insurance coverage is an employer-sponsored safety net in case the worst happens, with no out-of-pocket costs to you. If you believe you need additional coverage, you may wish to enroll in voluntary life insurance as well. Employees must fill out an EOI form if they exceed the guaranteed issue amount.GROUP LIFE and AD&D INSURANCESummary of CoverageLife Benefit Employee Spouse DependentAmount $10,000 increments $5,000 increments $2,000 incrementsMaximum AmountLesser of 5 x annual earnings or $300,000Lesser of 100% of employee amount or $100,000Lesser of 100% of employee amount or $10,000 (reduced benefit of $1,000 live birth to 6 months)Guarantee Issue (Newly Eligible Employees)$50,000 $15,000 $10,000Additional InformationBenefit Reductions begin at age 70Spouse benefits reduce at the same time as employee Up to age 19 or 26 if FT studentVOLUNTARY LIFE and AD&D INSURANCEFor summary of rate sheet, please see carrier summary or Employee Navigator.Cost is age-banded and based on employee’s age.
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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatrySummary of CoverageCoverage provided by UNUMPlan Features Long TermCoverage Paid By HRC Behavioral Health & Psychiatry Taxation Gross up & DeductEmployee Benefit Amount 60% of monthly earningsMaximum Benefit AmountMDs, Providers and Active Management: $15,000/monthAll other Employees: $6,000/monthElimination Period 60 daysBenefit Duration SSNRAPre-Ex 3/12Disability insurance is coverage that provides you with income protection should you be unable to work due to an injury or illness. With disability coverage, you are compensated for a portion of your lost income. Long-Term coverage is available for extended disabilities. DISABILITY INSURANCE
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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatryCarrier ResourcesBENEFIT CARRIER GROUP # PHONE NUMBER WEBSITEMedical BCBSNC 14160806 877-275-9787 www.BlueConnectNC.comDental Delta Dental 10553-0001 1-800-662-8856 www.memberportal.comVision Blue20/20 14160806 1-855-400-3641https://member.eyemedvisioncare.com/bcbsncind/enLife & LTD UNUM 427417 800-275-8686https://www.unum.com/support/employees/contact-usHSA Health Equity 866-346-5800 www.healthequity.comHow to access ID CardsBENEFIT CARRIER HOW TO ACCESSMedical & Vision BCBSNCWill receive an ID Card in the mail. Can also access through the portal: www.blueconnectnc.com Or Mobile App.Dental Delta DentalElectronically through the Delta Dental mobile app or member portal www.memberportal.com
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.Employee Benefits Guide2024 - 2025 HRC Behavioral Health & PsychiatryThis page is intentionally blank
EMPLOYEE BENEFITS GUIDEPrepared By Sentinel Benefits Consulting | sentinelra.com2024 - 2025HRC Behavioral Health & Psychiatry