NHTC has an extensive insurance benefit package including health, dental, vision, and life insurance available for all full time employees. The information below is intended to provide general information about each insurance plan available. If you have questions that the information does not fully answer please contact NHTC's insurance agent (Life Security Agency) at 1-800-366-5803 or the specific insurance provider customer support lines and websites listed below.
HEALTH INSURANCE
NHTC's health insurance provider is AVERA Health Plans. Over the last few years NHTC has elected to have higher deductible costs in order to lower the monthly premiums. Understating that this has both positive and negative effects, NHTC established an MRA (Medical Reimbursement Account) that is designed to reduce the cost of deductibles. What this means is that the actual insurance plan will list a higher deductible cost than what our employees will actually pay. To be reimbursed for deductible costs through the MRA account please follow these steps:
1. EOB (Explanation of Benefits) statements regarding services you received that apply toward your deductible must be turned in to Linda Williams, COO. (Please be sure that these EOB statements are for services that apply to the deductible)
2. Linda will then inform our insurance agent (Life Security Agency) and a reimbursement check will be sent you.
DEDUCTIBLES
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NHTC Plan
$500.00 deductible per individual
$1000.00 deductible per family
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AVERA PLAN
$2500.00 deductible per individual
$5000.00 deductible per family
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Please note: Your medical provider will use the Avera Plan deductibles when determining your bill. Please submit copies of your EOB (Explanation of Benefits) statements to Linda Williams, COO for services that qualify toward your deductible.
COINSURANCE
Coinsurance is the split of medical costs between the insurance provider and the insured after the deductible has been met. NHTC's plan has an 80/20 split which means employees pay 20% of medical costs up until the out of pocket maximum has been met.
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NHTC Coinsurance individual
Individual covers 20%
Insurance provider covers 80%
Out of network covers 50%
Out of pocket maximum = $1,000.00
NHTC Coinsurance Family
Family covers 20%
Insurance Provider covers 80%
Out of network covers 50%
Out of pocket maximum = $2,000.00
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AVERA Coinsurance Individual
Individual covers 20%
Insurance Provider covers 80%
Out of Network covers 50%
Out of pocket maximum = $5,000.00
AVERA Coinsurance Family
Family covers 20%
Insurance provider covers 80%
Out of network covers 50%
Out of pocket maximum = $10,000.00
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Once the out of pocket maximum has been met the insurance provider covers 100% of medical costs.
Health insurance is offered to all full-time employees. Please click on the links below to learn more about plan benefits, how to sign up for health insurance, premiums, and effective dates. For more information about your AVERA health plan please go to www.AveraHealthPlans.com . In the top left hand corner of the homepage click on Member and use your group number (SD582A this is also located on your insurance card) to log in. You can also call Avera's customer service line at 1-888-322-2115. For pre-certifications please call 1-888-605-1331.
By signing up for health insurance benefits you are also enrolling in NHTC's life insurance plan. For more information see Life Insurance below.
AVERA HEALTH PLAN BENEFITS
AVERA BENEFIT SUMMARY
HOW TO ENROLL IN HEALTH INSURANCE BENEFITS
Open enrollment for group health insurance benefits is May 1st through May 31st for all full-time employees. You can only sign up for health benefits during this time.
Newly hired full-time employees can enroll for health insurance benefits within 30 days of their hire date. In this case the start date will occur after 30 days and then the 1st of the following month.
If a newly hired employee does not sign up for health insurance within the first 30 days of employment they will have to wait until open enrollment.
PREMIUMS
All monthly insurance premiums are split into the two monthly pay periods. There are two times out of the year when there are three pay periods during the month. In this case one of those pay periods will not have any premiums taken out of your paycheck.
NHTC Health Insurance Premiums
HEALTH INSURANCE EFFECTIVE DATE INFORMATION
- New Hires: 1st of the month following 30 days.
- Part-time to full-time status change: 1st of the month following 30 days.
- Child Birth: effective immediately, but the employee must add the baby to their insurance plan within 30 days following the birth of the child. If the employee does not register the baby they will be considered a late enrollee and subject to pre-existing conditions.
- Marriage: effective date is immediate, but must provide proof of change.
- Resignation or termination from employement: the end date for insurance benefits under these circumstances is at the end of the month in which the termination or resignation took place.
If an employee has a child, gets married, or is adding or removing dependents from the insurance plan they must complete an AVERA Change Form and return it to Dan Cross, SDC or Linda Williams, COO.
Please note: if you desire to add dependents other than birth or marriage to the plan, they must have a qualifying event to do so. This means that the dependent must have lost their coverage due to loss of job, exhaustion of COBRA benefits, or non-eligibility for medicaid or Medicare.
HEALTH INSURANCE APPLICATION MATERIALS
To apply for health insurance benefits you must complete the following paperwork. Please print out these forms, complete, and return to either Dan Cross, SDC or Linda Williams, COO. When you drop these forms off you will be asked to complete the Flexible Benefits Form which needs to be filled out at NHTC. The flexible benefits premium only plan ensures that your premiums are taken out of your paycheck before taxes are taken out, saving you money in the long run.
AVERA Health Insurance Application
Lincoln Mutual and Casualty Insurance Company (Life Insurance)
NHTC Consent Form (Consent forms must be completed with the application. These forms allow NHTC to disclose protected health information in order to carry out treatement, payment, or health care operations.)
Life Security Consent Form (Consent forms must be completed with the application. These forms allow NHTC to disclose protected health information in order to carry out treatement, payment, or health care operations.)
LIFE INSURANCE
The life insurance offered by NHTC is part of the health insurance package of benefits. You cannot only have life insurance and if you enroll in health insurance you will also need to enroll in the life insurance plan. The policy is a $15,000 double indemnity policy. To access the application click on the Lincoln Mutual and Casualty Insurance Company above.
DENTAL AND VISION INSURANCE
NHTC offers a dental and vision insurance package at a group rate and is completely voluntary. This means there is no assistance from NHTC in covering the premium costs of this insurance package. Click on the links below to learn more about the plan benefits, premiums, and how to enroll in the dental and vision insurance benefits.
DENTAL AND VISION APPLICATION MATERIALS
To apply for dental and vision insurance benefits you must complete the following paperwork. Please print out these forms, complete, and return to either Dan Cross, SDC or Linda Williams, COO. When you drop these forms off you will be asked to complete the Flexible Benefits Form which needs to be filled out at NHTC. Visit www.bestlife.com for more information regarding the dental and vision insurance package.
Best Dental and Vision Application
Best Dental & Vision Benefit Summary and Premiums (Deductible is included in the benefit summary)
NHTC Consent Form (Consent forms must be completed with the application. These forms allow NHTC to disclose protected health information in order to carry out treatement, payment, or health care operations.)
Life Security Consent Form (Consent forms must be completed with the application. These forms allow NHTC to disclose protected health information in order to carry out treatement, payment, or health care operations.)
COBRA BENEFITS
COBRA is the acronym for the Consolidated Omnibus Budget Reconcilation Act passed in 1986. The law ammends several other laws and allows for continuation of group health benefit benefit coverage for employees that might otherwise be terminated from coverage. All NHTC employees who resign or have been terminated will receive a COBRA letter explaining what they need to do in order to apply for COBRA benefits. COBRA benefits are temporary. For more information regarding COBRA benefits plese visit the following link.
http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.HTML
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