Sentry Electrical Group 12.1.2023 EMPLOYEE BENEFITS AT A GLANCE GLANCE
**New for 12.1.2023** Sentry will be changing carriers for all lines of coverage. United Healthcare / Surest will be our new Health Insurance Carrier and MetLife will be our new carrier for Dental, Vision, Life and Disability.
MEDICAL INSURANCE | UNITED HEALTHCARE / SUREST In Network – Choice Plus
In-Network
Out-of-Network
Coinsurance
100%
100%
Deductible Employee | Family
None
None
Out of Pocket Maximum Employee | Family
$8.000 | $16,000
$16,000 | $32,000
Preventive Care
Covered in Full
$225
No Charge $45 to $150 copay $45 to $150 copay
Not Covered $450 copay $450 copay
Emergency Treatment ER (waived if admitted) Urgent Care
$1,000 copay $100 copay
$1,000 copay $300 copay
Inpatient Services
$400 - $5,500
$13,000
Outpatient Services
$75 - $5,500
Up to $13,000
Prescription Copays Tier 1 | 2 | 3 | 4
$10 / $25 / $90 / $200
Not Covered
Office Visit Virtual Care PCP (Primary Care Provider) Specialist
Employee Cost per Weekly Pay Period (52) Employee Only
$45
Employee + Spouse
$110
Employee + Child(ren)
$85
Family
$155
DENTAL INSURANCE | METLIFE In-Network Coverage Annual Deductible: Employee | Family Annual Maximum per Person Preventive Services (Cleanings, X-Rays, Exams, Sealants)
$50 | $150 $1,000 100% (Deductible Waived)
Basic Services (Simple Extractions, Fillings)
80%
Major Services (Endo, Perio, Crowns, Dentures, Bridges, Implants)
50%
Out of Network Claims Payments
90th Percentile of Usual and Customary
Employee Cost per Weekly Pay Period (52) Employee Only
$3.71
Employee + Spouse
$7.32
Employee + Child(ren)
$9.67
Family
$14.31
12.1.2023 EMPLOYEE BENEFITS AT A GLANCE
VISION INSURANCE | METLIFE In-Network Coverage – VSP Network Eye Exam (1x per 12 mos)
$10 Copay
Prescription Lenses (1x per 12 mos)
$25 Copay
Frame Allowance (1x per 24 mos)
$130 allowance + 20% off of balance
Contact Lenses (in lieu of frames) Elective Necessary Standard or Premium Fitting
$130 allowance Plan pays 100% Up to $60
Employee Cost per Weekly Pay Period (52) Employee
$1.25
Employee + Sprouse
$2.50
Employee + Child(ren)
$2.57
Family
$3.82
LIFE INSURANCE | METLIFE Company Paid Basic Life | AD&D Employee Benefit Amount
$100,000
Accidental Death & Dismemberment
Included
Age Reduction Schedule Cost
35% at age 65; 60% at age 70; 75% at age 75; 85% at age 80 100% Employer Paid
DISABILITY INSURANCE | METLIFE Company Paid Short Term Disability Weekly Benefit Amount
60% of Weekly Earnings up to $1,000
Benefit Waiting Period
14 days for Accident or Illness
Benefit Duration Cost
24 Weeks 100% Employer Paid
Company Paid Long Term Disability Monthly Benefit Amount
60% of Monthly Earnings up to $5,000
Benefit Waiting Period
180 days or until the end of short term disability
Benefit Duration
Social Security Normal Retirement Age
Pre-Existing Conditions Limitation
3 month look-back; 12 month exclusion
Cost
100% Employer Paid
12.1.2023 EMPLOYEE BENEFITS AT A GLANCE HOW TO ENROLL
We will be using Employee Navigator to assist with your benefit elections. All employees are required to login to Employee Navigator and make elections, even if you are declining coverage. To begin, visit www.employeenavigator.com and click Login. • Returning Users: Log in with the username and password you selected. Click “Reset a forgotten password” if necessary. • First Time Users: Click “Register as a new user”. • Create your account by entering: First and last name as they appear in payroll. Sentry’s company identifier is SEGGA. The last 4 digits of your SSN. Your date of birth.
ELECTION CHANGES DURING THE PLAN YEAR
Once you elect coverage in a Sentry Electrical Group plan, you are NOT eligible to change or drop coverage until the next Open Enrollment period unless you have a qualifying event. If you experience a qualifying life event, you must contact the Human Resources Department within 30 days of your qualifying event. If you fail to do so, you will have to wait until the next open enrollment period to make any changes to your coverage. Qualifying life events include, but are not limited to: • • • •
Marriage/Divorce Birth/Adoption Employment changes from Part-time to Full-time Change in dependent status (i.e. Dependent child reaches age 26 limit)
HELPFUL WEBSITES / SMARTPHONE APPLICATIONS • • •
Benefits.surest.com – Health Plan ID Cards, Cost for Care, Provider Search, Track Deductible/Claims, Drug Pricing Metlife.com/mybenefits – Dental and Vision ID Cards, Provider Search, Claim Tracking Dowload the United Healthcare Surest App to your Smartphone using the QR Codes Below:
NEED HELP?
Please reach out to your dedicated team at Sterling Seacrest Pritchard for assistance with coverage and claims. Client Service Executive Steven Katcoff stevenk@sspins.com
678-426-1572
Claims Assistance Darlene Moorman dmoorman@sspins.com
770-635-0439