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Medical & Dental Benefits. Traffic Shoes . Dental and Medical Benefits. Employees working 30 hours or more per week are eligible for medical and dental benefits. Eligible on the first of the following month, after 90 days of trial period. Benefit deductions are twice a month.
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Medical & Dental Benefits Traffic Shoes
Dental and Medical Benefits • Employees working 30 hours or more per week are eligible for medical and dental benefits. • Eligible on the first of the following month, after 90 days of trial period. • Benefit deductions are twice a month. • Assurant Dental Plan Options: • DHMO Plan (Only covered in Florida) • PPO coverage available in every state • Aetna Medical Plan Options: • HMO Open Access • POS Network Option • Open enrollment yearly dates for Dental benefits: • July 1st through July 31st effective on August 1st.unless you experience a Qualified Status Change. • Open enrollment yearly dates for Medical benefits: • August 1st through August 31st effective September 1stunless you experience a Qualified Status Change.
Assurant PPO Plan Design & Benefit Summary Refer to your Medical Summary Plan Description for full benefit description.
Assurant DHMO Plan Design & Benefit Summary Refer to your Medical Summary Plan Description for full benefit description.
Assurant DHMO Vision Discount Services Refer to your Medical Summary Plan Description for full benefit description.
Aetna Medical POS Plan Design & Benefit Summary Benefit summary above is only for the state of Florida, please contact benefits@trafficshoe.com for all other states benefit summary. Refer to your Medical Summary Plan Description for full benefit description.
Aetna Medical HMO Open Access Plan Design & Benefit Summary Benefit summary above is only for the state of Florida, please contact benefits@trafficshoe.com for all other states benefit summary. Refer to your Medical Summary Plan Description for full benefit description.
Saving Tips – Use Your Plan WiselyNo Cost-Network Benefits • Routine Well Child Exams/Immunizations • Routine Mammograms • Routine Eye Exams; 1 routine exam per 24 months • Diagnostic X-ray • Annual Physical • Diagnostic Laboratory • Routine Gynecological Care Exams; 1 exam per 12 months • Pap Tests All covered at 100% NO Deductible FOR THE FOLLOWING in-network SERVICES Therapy OFFICE Visits EMERGENCY ROOM VISITS PHYSICIAN OFFICE VISITS
Pay Only the Contracted Amount of Your Out-of-Pocket Expenses ! • Recently, hospital systems have been purchasing office practices and billing insurance for outpatient hospital visits instead of an office visit. • If billed for a “facility fee” for an office visit OR billed for an annual physical/annual gynecological exam, please advocate on your behalf and contact Aetna Member Services at 1-800-445-5299 and have the claims properly adjusted. • Review Member Health Statements available to you at www.aetna.com , and pay your provider based on the information indicated on the statement.
Definitions • Deductibles: The cumulative amount that you must pay in the Plan Year before benefits will be paid by the Plan. If the Plan has a $1,000 deductible, the Plan begins to pay after you have paid the first $1,000 for services. • Coinsurance: The percentage of a covered expense that you pay after the satisfaction of any applicable deductible. It is a defined percentage of the covered charges for services rendered. For example, the plan may pay for 70% of covered services and you pay 30%.
Contact Information MEDICAL • Aetna Member Services: 1-800-445-5299 • www.aetna.com DENTAL • Assurant Member Services: 1-800-443-2995 • www.assurantemployeebenefits.com
