Answers to Frequently Asked Questions About Your Benefit Options at Unity Health System
Click on the categories below for answers to commonly asked questions about your benefit options and the enrollment process. If you don’t see your question listed here, or would like to speak with a member of our Benefits team, please call the Benefits Hotline at 368-3211 or email email@example.com
Unity Services Discount
Domestic Partner Benefits
EyeMed Vision Plan
Flexible Spending Accounts (FSAs)
Accidental Death and Dismemberment
Short Term Disability
Long Term Disability
Legal Services Plan
Medicare Part D Prescription Coverage
With the new health care reform law, do I have to elect health insurance at Unity?
No, you don't. However, under the Affordable Care Act, all U.S. citizens are required to have health insurance beginning January 1, 2014. If you do not obtain insurance, you will be assessed a tax penalty.
Have any changes been made to the Unity health plans because of Health Care Reform?
Yes. For 2014 both health plans will have an out-of-pocket maximum, which is a positive change for the consumer. This means that all money paid for medical services, including deductibles, co-pays and co-insurance (but not your premium) will count toward the out-of-pocket maxium. Once you reach the maximum, the plan will cover eligible expenses at 100% for the rest of the plan year.
Where can I get more information about the Marketplaces created under Health Care Reform and the insurance plans they offer?
Click here for a quick overview.
You can compare plans offered on the Marketplace by clicking here. Also the government established resources called Navigators to assist you with information on plans offered on the exchange. In Monroe County, contact Coordinated Care Services Inc. or Community Service Society of New York.
What are my health insurance options this year?
You have a choice between two health plans—Unity Basic and Unity Enhanced Health Plans. It’s important to review the plans to make sure you’re enrolled in the one that provides you and your family with the best value and coverage.
What is the difference between the Unity Basic Health Plan and the Unity Enhanced Health Plan?
There are some differences between the plans in co-pays, deductibles and out-of-pockets. In addition, services under the Unity Basic Plan are divided into two categories. Some services, such as physician office visits and emergency room visits, require only a co-pay. Others, such as lab work, diagnostic x-rays and outpatient surgery, require you to reach a deductible before the services are covered; after that, you are responsible for paying a percentage of the remaining cost (co-insurance). Under the Unity Enhanced Plan there are no deductibles or co-insurance. You pay a co-pay for nearly all services. Note that neither plan is “better” than the other—depending on your circumstances, either plan might provide the best coverage and value for you and your family. Click here for more information about selecting your plan.
Who can I cover on my health insurance?
You may insure yourself, your legal spouse or domestic partner, children up to age 26 and disabled adult dependent children. Eligible children can include your children by birth, adoption and legal guardianship, stepchildren, foster children, and children of your domestic partners. Special rules apply to enrollment of domestic partners and the children. Click here for more information.
Do I have to submit eligibility documentation for my dependents?
Yes, if you are enrolling them for the first time. Click here for more information. If your dependent is already enrolled, there is no need to submit additional documents.
What doctors can I see with Unity’s health plans?
You can see any doctor you would like, although you’ll save money if you see a doctor who is employed by Unity. The costs for doctor visits and other services that are listed on the Health Plan Comparison page refer to doctors and services within the BlueCross BlueShield PPO Network. Almost all doctors and services in our local area are part of this network, and many others throughout the United States are also part of this network. (If you want to make sure a local doctor is part of the Blue Cross Blue Shield PPO Network, click here. Click on “Upstate New York Provider Network” and choose Excellus BluePPO Network from the drop-down menu.)
You may occasionally want or need to see a doctor that is not part of the BlueCross BlueShield PPO Network, in which case you will pay a higher cost for services.
What do ‘in-network’ and ‘out-of-network’ mean?
In-network refers to those providers and facilities that have agreed to be part of the BlueCross BlueShield PPO network—the vast majority of doctors in our local area and many throughout the United States. Out-of-network refers to those providers and facilities that are not part of the BlueCross BlueShield Blue PPO network. The service costs listed on our Health Plan Comparison page refer to in-network doctors and services. You will pay more for services provided by out-of-network doctors and facilities.
What is the difference between a “co-pay,” “co-insurance,” “deductibles” and “premiums?”
Health insurance plans typically require participants to pay for medical services either through co-payments or through co-insurance and deductibles.
A co-payment (or co-pay) is the flat dollar amount you pay at the time you receive a service; for example, the amount you are required to pay when you have an office visit with your primary care physician. A co-pay is a fixed amount, such as $40. Unity’s Enhanced Health Plan primarily requires co-pays for services.
A deductible is the annual amount you must pay out-of-pocket for services before the plan begins to cover a portion of the costs. Co-insurance refers to the portion of a bill you are asked to pay for services once the deductible has been met. Co-insurance is expressed in terms of percentages, such as 20%. Many services under Unity’s Basic Health Plan require you to first meet a deductible and then pay co-insurance.
Premiums are the amount deducted from your paycheck to pay for insurance coverage. For more definitions, click here.
Can you show me how deductibles and co-insurance work?
The following example assumes you are covered under the Unity Basic Health Plan, using non-Unity providers.
You Pay: $200
You Pay: $400
You have met your $600 deductible. Co-insurance begins.
You Pay: $1,800 = 20%
You have met your out-of-pocket maximum of $2,400.
You Pay: $0
Once you have met your out-of-pocket maximum, the plan pay 100% of eligible expenses.
If I have family coverage, how do the individual and family deductibles work?
If you decide to cover your family under the Unity Basic Health Plan, you will be required to meet a deductible before the plan will contribute to the cost of certain services. The deductible for each individual family member is $600. However, there is also a total family deductible of $1,800; once this has been met, additional family members are not required to meet an individual deductible. Plus, if you use Unity services, the deductibles are even lower: $200 for each individual and $600 for the family.
I only need to cover myself and one other person in my family. Does the family deductible apply?
The family deductible does not apply to two-person contracts. Each of you must meet your own individual deductible before the Plan will begin paying its portion for services where a deductible applies.
Is there a limit to how much I will have to pay for services if I choose the Unity Basic Health Plan?
Yes, this plan has an annual out-of-pocket maximum of $2,400 for individuals and $7,200 for families. The amount you pay in co-pays, co-insurance and deductible count toward this out-of-pocket maximum. Once any individual in your family has reached the individual out-of-pocket maximum, or any combination of individuals in your family have reached the family out-of-pocket maximum, the Plan will pay 100% of all remaining covered services for the rest of the year.
How do I choose the best plan for me?
Having a good understanding of your 2013 medical expenses can help you plan for 2014. Review the expenses you’ve had so far this year to help predict your needs for the coming year. Compare the costs for these services within each plan to the bi-weekly premium you would pay each pay period. The following tools will assist you with this process:
- Unity Health Plans: A Comparison: a side by side comparison of premiums and many of the services available in our health plans.
- Choosing a Health Care Plan: walks you through some different examples of how to choose a plan.
- Excellus Plan brochure: outlines coverage details for the services offered in both health plans.
- Healthcare Advisor: an online tool that provides information on health conditions and treatment options and compares costs of procedures and medications. (To reach the tool, click on “Get Started Now” and log in or register. You’ll need your insurance ID number to register for the first time.)
Are there any other options available for health coverage?
If you are unable to afford health insurance through Unity’s plans, you may meet the eligibility requirements for the New York State sponsored health plans, Child or Family Health Plus. For more information, call Unity’s Assisted Enrollment Department at 368-4401.
What’s the relationship between individual and family deductible and individual and family out-of-pocket maximums?
If you enroll in the Unity Basic Health Plan for yourself and at least two other dependents, you’ll each have an individual deductible and a combined family deductible, as well as individual and family out-of-pocket maximums that apply to certain services. Any one individual in your family will begin to receive 80% coverage for these services once he or she meets the individual deductible. However, once the first three covered family members’ combined use of these services meets the family deductible, additional family members will begin to receive 80% coverage for services without meeting their own individual deductibles.
Similarly, when an individual reaches his or her annual out-of-pocket maximum ($2,400 for non-Unity doctors), services for that individual are covered at 100% for the remainder of the calendar year. Once three individuals in the family have each reached their individual out-of-pocket maximum, the family out-of-pocket maximum will have been reached ($7,200 for non-Unity doctors), and services for all family members will be covered at 100% for the remainder of the calendar year. Remember, out-of-pocket maximums apply to services that require co-insurance and deductibles; they do not apply to services that require co-pays.
Unity Services Discount
What is the Unity Services Discount?
The Unity Services Discount is the discount you and your eligible dependents receive when you use Unity services and Unity-employed doctors—no matter what your health insurance plan.
Who is eligible to get the Unity Services Discount?
Anyone eligible for one of the Unity Health Plans is eligible for the Unity Services Discount, regardless of whether they are actually enrolled in one of the Health Plans. Click here for more information on eligibility.
How can I find out if a doctor is employed by Unity?
Click here for a list of Unity-employed doctors and Unity Health System Services.
How much can I save with the Unity Services Discount?
Refer to the Unity Services Discount policy on the Unity Intranet for a complete listing of discounts.
How do I receive the Unity Services Discount?
Individuals enrolled in a Unity Health Plan will receive the discount automatically at the time of service. The service representative is able to identify the discount during the insurance verification process. If you are not on a Unity Health Plan, inform the representative at check-in that you are a Unity employee. You may also call Unity's patient accounting department to apply the discount.
How does this work if I get my health insurance elsewhere and am not covered by a Unity Health Plan? Am I eligible for additional discounts?
If you’re covered by any health plan other than Unity's and you go to a Unity-employed doctor or use another Unity Health service, the amount you must pay will be reduced by the standard co-pay amount under the Unity Enhanced Health Plan.
How do I make sure my dependents are able to take advantage of the Unity Services Discount?
If your dependents are not insured by the Unity Health, Dental, or Vision Plan, their names must be on file with Human Resources to receive a Unity Services Discount. You’ll have the opportunity to provide this information during the online Benefits Enrollment process.
Domestic Partner Benefits
Can I cover my domestic partner under Unity’s health and dental plans?
Yes. You can cover a same sex or opposite sex domestic partner, as well as his or her eligible dependents, in Unity’s health, dental, and vision plans.
How do I enroll my domestic partner in benefits?
If you’ve enrolled your domestic partner before, you can simply enroll him or her through online enrollment as you would any other dependent. The first time you enroll a domestic partner, you’ll need to file an Acknowledgement of Domestic Partnership Information, which explains the rules surrounding domestic partner coverage, as well as an Affidavit of Domestic Partnership demonstrating that you and your partner meet the eligibility criteria. Click here for information and forms.
What is the eligibility criteria we must meet to file an Affidavit of Domestic Partnership?
The Affidavit of Domestic Partnership states that you and your domestic partner meet the following criteria:
- You have an exclusive mutual commitment, similar to that of marriage;
- You are each other’s sole domestic partner and intend to remain so indefinitely;
- Neither of you are married to anyone nor has either one of you had a different domestic partner within the most recent 12-month period (except where a prior domestic partner died during that 12-month period);
- You are not related by blood to a degree of closeness which would prohibit legal marriage in New York;
- You are at least (18) years of age and are legally competent to contract;
- You currently reside together and have resided together in a common household for at least 12 months
- You are committed to the physical, emotional, and financial care and support of each other and share with each other the common necessities and tasks of one household and are financially interdependent.
I heard benefits for domestic partners are treated differently for tax purposes. Can you explain?
According to federal tax law, the fair market value of the benefits coverage for a domestic partner must be imputed as income. In other words, you are required to pay taxes on the value of coverage for each non-tax dependent (including your partner’s children) enrolled in your plan. Click here for details.
Is my partner eligible for the Unity Services Discount?
Yes, qualified domestic partners are eligible for the Unity Services discount, even if they are not enrolled in a Unity Health Plan, as long as you file an Affidavit of Domestic Partnership with Human Resources.
If my partner is currently enrolled in Unity’s health coverage, do I need to file an Affidavit of Domestic Partnership?
No. You only have to file the Affidavit once.
What are my dental plan options?
You can choose between two options: Unity Basic Dental and Unity Enhanced Dental.
Why do I see only two coverage options for dental options—“employee” and “employee and family”?
The Unity Dental Plans provide you with two coverage options. Choose “employee and family” to include your spouse or domestic partner, one child, more than one child, or any combination.
How do the two dental plans work?
Both plans offer 100% coverage for preventive and diagnostic services—you do not need to pay a deductible before this coverage begins. You’ll need to pay a small deductible each year for basic and major restorative procedures (such as fillings and oral surgery); after you have reached the deductible, you’ll pay a percentage of the costs of the service. These deductibles and co-insurance costs vary, depending on the plan.
Are braces (orthodontia) covered under the dental plan?
Orthodontia coverage is in the Enhanced Plan only and provides 50% coverage for children under age 19. The lifetime maximum for this benefit is $1,500 (per child).
I was told I won’t be able to change my dental plan until the year after next. Why is that?
If you changed your plan or enrolled for the first time this year, you won’t be able to change your plan or cancel enrollment until the end of next year. Unlike other benefits, once you enroll in dental coverage you are “locked in” to your choice for two enrollment periods. However, if you elected not to enroll in dental coverage last year, you can enroll this year—there is not a two year “lock-out” period.
I’m getting married next spring. Do I still have to wait for next year to elect dental coverage for my spouse?
No. As marriage is a qualifying life event, you can add coverage during the year for yourself and/or your spouse. However, you are unable to cancel coverage due to a qualifying event if you are within your lock-in period.
Why do I have to wait two years to change or cancel my dental coverage?
The lock-in period is a standard precaution used by many employers to ensure employees don’t change dental plans as their dental needs change. Allowing such changes would mean companies couldn’t collect enough in premiums to cover insurance claims. We encourage you to think carefully about your and your family’s potential needs over the next two years, and then choose the best plan you can.
Who can I cover on my dental insurance?
You may insure yourself, your legal spouse, your domestic partner, and your legal dependents up to age 23. Remember, if you wish to cover any dependents for the first time, you must submit documentation verifying their. Click here for information on what documentation is required.
How do I enroll my domestic partner in dental insurance?
Just as with medical insurance, if you have never enrolled your partner in any Unity benefits, you must first file an Affidavit of Domestic Partnership with Human Resources. (If you have already covered your domestic partner under another Unity benefit, you don’t have to file a new Affidavit.) Then simply enroll your domestic partner using the same online enrollment process you use to enroll yourself. As with medical coverage, you are required to pay taxes on the fair market value of your partner's coverage.
How can I find out how much is covered for a specific dental procedure?
It’s best to get an estimate before the procedure is performed. Your dentist can request a “Pre-Determination of Benefits” from Excellus. You will receive a statement detailing the dollar amount the plan will pay.
Where can I find additional coverage information for the dental plans?
Click here for information about the two plans and how they compare.
EyeMed Vision Plan
What does the EyeMed Vision Plan cover?
The vision insurance plan provides coverage for eye exams, glasses, and contact lenses for you and your family.
I thought vision coverage was included in my Unity Health Plan.
Both Unity Health Plans do include some coverage for vision-related services. The EyeMed Vision Plan provides you with an option to purchase additional coverage.
Who can I enroll in vision insurance?
You can enroll yourself, your legal spouse or domestic partner, and your children up to age 26.
How can I find out if my eye doctor is a participating provider?
EyeMed has several networks of providers. Unity’s Plan provides in-network coverage for those providers that participate in EyeMed’s Insight Network. Participating providers include several retail chains such as LensCrafters and Pearle Vision, in addition to local private practitioners. To search for a participating provider, visit EyeMed’s website: www.eyemedvisioncare.com. Click on Find a Provider, select the Insight network or call 866-939-3633.
If my provider does not participate in EyeMed’s Insight Network, can I receive out-of-network benefits?
Yes, you may submit your receipts along with an out-of-network claim form to receive reimbursement for a portion of your expense. Click here for a chart of the out-of-network reimbursement amounts.
Flexible Spending Accounts (FSA)
What are Flexible Spending Accounts?
Flexible Spending Accounts (FSAs) allow you to pay for certain health and/or dependent care expenses with money that is not taxed. Depending on your situation, participating in an FSA can save you hundreds of dollars.
How does an FSA work?
You decide how much you want to set aside for the upcoming year’s health and/or dependent care expenses. A portion of this amount is deducted from each paycheck before your income is taxed, and then is deposited into your FSA. You can pay for eligible expenses using a specially issued debit card (the EBS One Card), which will withdraw money directly from your FSA to pay for services. Or, if you choose, simply pay for services and submit a claim for reimbursement (with receipts) by mail or on-line. If you use the EBS One Card to pay for eligible expenses, be sure to save your receipts; you may be asked to provide copies to EBS-RMSCO as evidence of proper use of the card.
What kinds of expenses can I pay for using my FSA?
The Medical FSA is used to pay for expenses such as health and dental co-pays, deductibles, co-insurance, eyeglasses, hearing aids, and contact lenses. Your bi-weekly health and dental premiums are not reimbursable expenses since they are already taken from your paycheck before taxes.
The Dependent Care FSA is used to pay for child or elder day care that is needed so you can work. Examples of eligible expenses include child care at a center, before-and-after school child care, a regular babysitter who is paying taxes on his or her income, or costs associated with day care for an elderly parent. Living center or nursing home costs are not eligible for reimbursement. For more details about what expenses are eligible to be paid for using your FSA, click here.
Is there a limit to how much money I can put into an FSA?
Yes, the Medical FSA has a maximum contribution of $2,500 per year and the Dependent Care FSA has a maximum contribution of $5,000 per year ($2,500 per parent if you file your taxes separately or each contribute to a Dependent Care FSA).
What is the benefit of participating in an FSA?
You save federal, state, and FICA taxes on the money you contribute to your FSA accounts. The following chart illustrates the potential savings from using FSAs to pay for medical and dependent care expenses:
Participating in FSA
Not Participating in FSA
Annual salary before taxes
Contribution to Medical FSA
Contribution to Dependent Care FSA
Net Bring Home Pay
Health Care Costs
$1,500 in health care expenses covered by the FSA
Dependent Care Costs
$4,000 in dependent care expenses covered by the FSA.
The chart above is only an example. To see how you can save from participating in an FSA, gather your anticipated expenses for next year and try the expense calculator: Click here.
Can I submit expenses for over-the-counter (OTC) drugs?
“Over-the-counter” items classified as “drugs and medicine” (e.g. allergy and sinus medicine, cold and flu products, pain relief remedies) are no longer eligible for reimbursement under medical FSAs without a prescription from a physician. Over-the-counter items considered “not drugs and medicine” (e.g. Band-Aids, contact lens solution and first aid supplies) remain eligible for reimbursement under a medical FSA.
Are expenses incurred by my adult children eligible for reimbursement under my Medical FSA?
Medical and dental expenses incurred by children up to age 26 are eligible for reimbursement through your Medical FSA.
How do I decide how much money to put into an account?
For a Medical FSA, think about what expenses you and your family can reasonably expect to have during the year: consider visits to doctors, dentists and specialists, prescription medicines, eyeglasses, etc. Then calculate your out-of-pocket costs for these services (including co-pays, deductibles, and co-insurance) and total the amounts to obtain your annual out-of-pocket expenses. Divide this figure by 26 pay periods to arrive at your bi-weekly contribution amount.
For a Dependent Care FSA, think about what your family’s costs will be for covered expenses like child care. Divide this figure by 26 pay periods to arrive at your bi-weekly contribution amount.
But be careful - you can only use an FSA for services you've incurred during the given calendar year. IRS rules require any money remaining in an FSA after eligible expenses are claimed will be forfeited.
How do I collect money from my FSA accounts?
Medical FSA: You have two options for paying for services with your Medical FSA funds:
- You can pay for services using the special debit card you’ll be issued as an FSA participant. The “EBS One Card” will withdraw money directly from your FSA to pay for services. Since this payment process is automated, the IRS requires purchases to be verified as eligible expenses. EBS-RMSCO, Inc. will periodically audit your use of the card to verify that it is being used correctly, so be sure to use your card only for eligible expenses and save your receipts. Click here for further information about how the debit card works.
- You still have the option to simply pay for services and submit a claim for reimbursement (with receipts) either by mail or on-line.
Dependent Care FSA: You have two options for paying for care with your Dependent Care FSA funds:
- You can pay for care using the special debit card you’ll be issued as an FSA participant. The card will withdraw money directly from your FSA to pay for care.
- Alternatively, you can simply pay for care and submit a claim for reimbursement (with receipts) either by mail or on-line.
Note: Unlike with the Medical FSA, IRS rules governing the Dependent Care FSA do not allow you to be reimbursed for more than actually exists in your FSA account at any given time. For example, if you elect to contribute $2,000 for the year in your Medical FSA, and you submit a claim for $2,000 in expenses at the end of June, you will be reimbursed the full amount, even though you will have contributed only about $1,000 from your paychecks so far. If you elect to contribute $3,000 for the year to a Dependent Care FSA, and you submit a claim for $2,500 in expenses at the end of June, you will be reimbursed only the approximately $1,500 you have contributed so far that year. You will need to wait until additional contributions are made from future paychecks to be reimbursed the remaining $1,000.
What if I forget to use my debit card or I just don’t want to use it?
If you forget to use your debit card for a purchase or you prefer not to use it at all, you may still submit a claim form with your receipts to EBS-RMSCO, Inc. for reimbursement.
What happens if I don’t use all the money I put in my FSA?
The IRS requires any money remaining in your FSA after all your annual expenses are claimed to be forfeited. So while FSAs can be very beneficial, it is recommended that you estimate your annual expenses conservatively so you don't lose money.
If I have any money left over in my Medical FSA, can I use it to pay for dependent care?
No. Your Medical FSA and Dependent Care FSA are completely separate. You cannot use funds from your medical account to pay for dependent care expenses, and vice versa—nor can you transfer money from one fund to the other.
Is there a deadline to submit expenses?
For both the Medical and Dependent Care FSAs, you have until April 30 following the end of the calendar year to submit claims for expenses incurred during that year. If you terminate employment from Unity during the year, you have 90 days from your last day of employment to request reimbursement for claims incurred prior to your last day of employment.
Can I have my reimbursements deposited directly into my bank account?
Yes. You just need to complete a Direct Deposit Form.
Can I change my FSA deduction at any time?
No. You can change your FSA deduction only during Open Enrollment or at the time of certain Qualifying Events. For more information call the Benefits Hotline at 368-3211.
It’s also important to note that your FSA elections do not automatically roll-over to the next year. You must enroll in FSAs each year in order to participate.
Does Unity offer a life insurance benefit?
Unity provides free, basic term life insurance to employees in an amount equal to your annual salary. The minimum amount of coverage is $15,000 and the maximum is $500,000.
Can I borrow against the policy?
No. Term life insurance does not build up a cash value, and you cannot borrow against it. Term insurance pays out to your named beneficiaries should you die while employed with Unity.
I heard I had an option to buy life insurance that has a cash value?
Employees may enroll in life insurance that builds a cash value (called whole life insurance) through Unity’s Voluntary Benefits Program. New employees can enroll in whole life insurance during their initial enrollment period without having to answer medical questions. The enrollment period is held within several months of an employee’s hire/eligibility date. All other eligible employees may enroll at any time during the year by contacting The Farmington Company’s Client Services Center at (800) 621-0067. Click here for more information.
How is the amount of my free life insurance determined?
Insurance is issued in the amount of your base salary as of October, 2013, or as of your hire date if you are a new employee.
Can I buy more coverage?
Yes. You have the option to purchase additional coverage for yourself in the amounts of 1, 2 or 3 times your salary. You also have the option of purchasing term insurance for your spouse and children. Depending upon your selection, you may be required to provide evidence of insurability, which will be sent to you automatically from our insurer, Liberty Mutual.
Some life insurance policies have a reduced benefit once you reach a certain age. Is that true of Unity’s life insurance benefit?
Yes. Per the terms of our contract with Liberty Mutual, there is an automatic 50% reduction in the amount of coverage for employees who are 70 years of age or older.
How are life insurance premiums calculated?
Employee life insurance premiums are calculated based on your age, salary, and the rates we receive from our insurance carrier. Spouse life insurance premiums are also calculated based on your age and the rate we receive from our insurance carrier. Child life insurance premiums are a set rate charged by our carrier.
Are child life insurance levels changing this year?
No, levels of coverage for children remain at $5,000 and $10,000 this year.
Does the premium for child life insurance listed on the customized benefits information cover all of my children?
Yes, one premium covers all your children up to age 19, or up to age 23 if they are full-time students.
Are there restrictions to purchasing spouse life insurance?
Yes, in New York State employees may not carry more life insurance coverage on their spouse than they have on themselves. For example, your coverage is $25,000, you may elect the $15,000 or $25,000 level for your spouse, but not the $50,000 or $100,000 level.
My spouse and I both work full or part-time at Unity. Can we each purchase spouse life insurance?
You and your spouse are both automatically covered by Unity’s Individual Life Insurance plan in an amount equal to your salary. But our contract prohibits employees from being covered by supplemental insurance both as an employee and as a spouse. So if your spouse opts to purchase supplemental life insurance for him or herself, you cannot purchase spouse life insurance. Conversely, if you wish to purchase spouse life insurance, your spouse must elect to waive the option of purchasing supplemental coverage.
What is “Evidence of Insurability (EOI)”?
Evidence of Insurability refers to the underwriting process our carrier, Liberty Mutual uses to determine if it can insure you for the coverage you have requested. If Evidence of Insurability is required, you will be asked to complete a health questionnaire that assesses your medical status.
What are the circumstances that would require me to complete an Evidence of Insurability?
Liberty Mutual will require you to submit a Personal Health Application in the cases shown below:
Life Insurance Coverage
Requests that Require Approval
Employee Supplemental Life
Increase coverage by more than one level (e.g, going from no coverage to 2x Annual Salary
Request the 3 x Annual Salary option for the first time
Request coverage for the first time other than newly eligible.
Request $100,000 option for the first time
Increase coverage by more than one level (e.g., going from $15,000 to $50,000)
Where do I get an Evidence of Insurability (EOI)?
If your life insurance elections require you to submit a evidence of insurability, The Liberty Mutual will mail information to your home. While your application is being reviewed by Liberty Mutual we will place you in the highest level of insurance permitted without evidence of insurability. Therefore, if the life insurance option you selected requires the completion of a evidence of insurability, you will not see the request reflected on your benefit confirmation form. If your request is approved, we will increase your coverage at that time.
Accidental Death and Dismemberment (AD&D)
What is Accidental Death and Dismemberment Insurance?
AD&D coverage is an optional benefit that provides coverage for accidents that result in death or dismemberment. Full payment is made to your beneficiaries in the event of your accidental death; a portion is payable to you upon accidental dismemberment.
How does AD&D differ from life insurance?
AD&D provides either a benefit to you, if you are involved in an accident that causes dismemberment, or to your beneficiary/beneficiaries should you die as a result of an accident (such as a car accident). Life insurance provides a benefit to your beneficiary or beneficiaries if you die for almost any reason (there is a suicide exclusion in some cases).
Does an accident have to be work-related to collect from AD&D?
No, injuries or deaths do not have to be a result of work.
Where do I indicate my AD&D beneficiary?
You indicate beneficiaries for both life insurance and AD&D during online enrollment.
Can I change my beneficiaries after I elect them?
Yes, you can change beneficiaries at any time throughout the year , simply complete the beneficiary change form found on www.unityhealth.org/BenefitsEnrollment/ or call the Benefits Hotline at 368-3211.
Short Term Disability (STD) Insurance
What is Short Term Disability (STD)?
Short-Term Disability Insurance provides you with partial income protection for up to 26 weeks.
What is the difference between Statutory, Basic and Optional Buy-Up STD Insurance?
All employees, even those not eligible for other benefits (such as per diems) are automatically enrolled in Unity’s Statutory Short Term Disability (STD) Plan. It provides you with 50% of your weekly salary, to a maximum of $170/week. All employees who are eligible for benefits and earn more than $17,680 are also automatically enrolled in the Basic STD Plan. Basic STD provides you with 50% of your salary up to a total maximum of $340/week.
There is no cost to you for the Basic STD Plan and almost no cost to you for the Statutory Plan, as Unity pays for this coverage. However, in accordance with state law, Statutory STD is paid for, in part, by a small tax that is taken from your paycheck—for most employees, this tax amounts to 60 cents per week or $1.20 per paycheck.
Employees who are benefit eligible and earn more than $17,680 annually also have the option of purchasing additional STD through the Optional Buy-Up Plan. The Buy-Up Plan provides you with a benefit of 60% of your salary, up to a maximum of $750/week.
How do the three plans work together?
Coverage under the three disability plans is cumulative. In other words, once the disability period begins, you will be paid each week up to the allotted limit under the Statutory STD Plan. If you are eligible for benefits, you will also receive weekly payment under the Basic STD plan—but the total of the two payments will not be more than 50% of your salary and $340/week. Finally, if you have purchased the Optional STD Buy-Up Plan, you will receive a third weekly payment, but the total of all three payments will not exceed 60% of your salary or $750/week.
Your STD benefit starts after you have been disabled for seven consecutive calendar days with a non-work-related medical condition. Benefits continue up to 26 weeks, should your doctor deem you disabled that long.
I went to the Benefits Enrollment site and didn’t see the Buy-Up option. Why?
The Buy-up option is not available to employees under two circumstances: if your annual salary is $17,680 or less or if you are a director, physician, or administrator.
If I’m on disability, do I have to use my PTO time?
Yes. Your STD benefit, whether Statutory, Basic or Buy-Up, will be supplemented with hours from your Extended Illness Bank (EIB), if you have one, and then your PTO bank. (Only employees who were hired prior to December 31, 1997 will have an EIB.) The idea is to keep you “whole” in salary for as long as you have a balance available in your EIB/PTO banks. Once these banks are depleted, you will receive disability benefits only. Note that you don’t accrue PTO during any period of disability or leave of absence.
Please note: You have the option to retain two work days of PTO time in your bank.
When can I enroll in the Short Term Disability Buy-Up Plan?
You can enroll as a new hire and during Open Enrollment. However, if you elect the benefit at any time other than as a new hire, you will be required to provide an evidence of insurability.
Long Term Disability (LTD) Insurance
What is LTD Insurance?
LTD insurance provides you with partial income protection if you are disabled longer than the 26 weeks you are covered by STD Insurance. Long-term disability insurance coverage is not automatic. If you enroll in it, you are eligible to begin receiving 50% of your earnings, up to a maximum of $5,000/month, after you have been unable to work for more than 26 weeks.
What is the difference between Short Term Disability (STD) Insurance and LTD Insurance?
In general, STD provides partial pay for up to 26 weeks while you are disabled. After 26 weeks, If you continue to be disabled, LTD insurance provides partial pay—assuming you were enrolled in the optional LTD Insurance Plan at the onset of your disability. LTD Insurance continues to provide partial pay until you are no longer disabled or until you reach normal retirement age. Click here for more information.
I don’t get sick very often. Why would I need to elect LTD Insurance?
In the event something unexpected occurs and you become ill or suffer an injury, it helps to have some source of income. While Unity does provide you with some short-term disability coverage, this coverage ends at 26 weeks. If you are still disabled at this time, you will not have any source of income from your benefits with Unity unless you are enrolled in LTD. Keep in mind that it’s best to obtain LTD insurance coverage while you are relatively healthy, as insurance carriers are much less likely to approve requests for coverage if you are experiencing a serious illness or other medical condition.
Why are LTD premiums taken on a post-tax basis?
Taking these premiums from your income after taxes means you won’t have to pay taxes on LTD benefits, should you need to receive them.
PTO Sell (Available during Open Enrollment only)
What is PTO Sell?
PTO Sell is a benefit that allows you to sell your PTO time back to Unity, and have the cash value added to your paychecks during the plan year.
How much can I sell, and how often?
You can only sell PTO time during Open Enrollment. You can sell time in eight hour increments, up to 120 hours, but you must leave at least 40 hours remaining in your PTO bank.
How is the value of my PTO Sell calculated?
The value of your PTO Sell is based on your hourly rate as of the salary lock-in date for the following year's benefits. The numbers of hours you want to sell is multiplied by your hourly rate, then divided by 26 pay periods, which gives you your bi-weekly earnings amount. The value of your PTO Sell is indicated in the Open Enrollment packet you received in the mail.
When will I see the PTO Sell in my paycheck?
The cash value of your sell will be calculated and added to each of your 26 paychecks. On or about January 1st, your PTO bank will be reduced by the number of hours you sold.
Is my PTO Sell considered taxable income?
Yes, the cash you receive from selling PTO becomes part of your taxable income.
I sold some PTO last year. If I make no changes, will I automatically sell the same amount of PTO this year?
No. You must actively select a PTO Sell each year in order to participate.
What happens to the PTO Sell amount I have elected if I leave Unity?
Your PTO Sell balance will be paid out to you at the time of your separation from Unity.
Legal Services Plan
What is the Legal Services Plan?
MetLaw® provides legal advice and representation for you, your spouse and eligible dependents on a variety of personal legal matters, such as will preparation, real estate matters, traffic offenses and more. Click here for details.
What are voluntary benefits?
The Voluntary Benefits Program includes additional benefits that employees can enroll in at any time during the year. Currently, the program includes Accident Insurance, Critical Insurance, Cancer Insurance, and Whole Life Insurance.
Click here for a program summary.
How do voluntary benefits differ from other benefits Unity offers?
There are key advantages to voluntary benefits:
- You can continue the benefits at the same premiums even if you are no longer employed by Unity
- During your initial enrollment period, you can obtain whole life insurance (up to specified limits) without having to answer medical questions. If you request to enroll after the initial enrollment period, your medical status must be reviewed before coverage can be granted.
- Coverage is also available for your family members also, including whole life insurance for eligible children and grandchildren.
How do I enroll?
If you have recently begun working for Unity, you can enroll during your initial enrollment period. The enrollment period will be held within several months of your hire date. Eligible employees will be notified in advance of the enrollment period and a representative from The Farmington Company will contact managers to arrange an on-site visit.
All other eligible employees may enroll at any time during the year by contacting The Farmington Company, our program service provider, at (800) 621-0067.
Medicare Part D Prescription Coverage
Do the Medicare Part D prescription plans affect me as a Unity employee?
This legislation only affects employees, or their dependents, that are eligible for Medicare. Consequently, very few people need to respond to Medicare Part D.
If you are eligible for Medicare and you delayed enrolling in Medicare Part D when it was first available to you, it is important for you to know whether your current prescription coverage is considered to be “creditable.” Click here for more information
Are Unity’s plans “creditable” under Medicare Part D?
Yes, both the Basic Plan and the Enhanced Plan are considered creditable coverage.