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Benefits Information & Forms

Benefits

Benefits

Our employees are our biggest asset, so we strive to make working for us a great experience for each employee. To this end, we offer benefits and programs that improve the quality of daily life for our employees now and into the future.

Definition of Employment:

  • Full-time is defined as 36+ hours per week or 1 FTE (Full time Equivalent)
  • Part-time is defined as 20 -36 hours per week or .5 FTE – .9 FTE

Definition of Eligibility:

  • Full-time and Part-time employees (.5 FTE or greater) are eligible for benefits on the 90th day following date of employment.
  • Per Diem and Hospitals part-time employees not eligible on the 90th day of employment, may be eligible for coverage at a latter date in accordance with the Lookback Measurement Period Policy (Notification will be provided if eligible).

 

 Address

  • Check your address in ADP for accuracy as well as other contact information.  This will ensure end of the year items such as W-2’s are properly addressed.

 

2022 Overview Documents

  • Below are documents providing an overview of benefits as well as other pertinent information for 2022.

Benefits Summary

Benefits Fee Chart

Holiday Schedule

Payroll Schedule

 

Health Insurance

  • Anyone NOT participating in ERH’s Health Insurance must complete the Waiver Form.

Health Insurance Waiver Form

  • MVP Forms

Enrollment Form – New enrollments – Changes – Termination of Coverage (otherwise automatically renews)

Claim Reimbursement Form

  • MVP Plan Information
    • Option 1

High Deductible PPO with an Employer Sponsored HRA
$2,500 Single Deductible
$5,000 Non-Single Deductible
Integrated Debit Card

ERH contributes 75% of the Deductible for Full-time employees and a pro-rated amount for Part-time employees.

Plan Summary

Plan Description

    • Option 2

$5,000 Single Deductible
$10,000 Non-Single Deductible

ERH does not contribute to the Deductible for either Full-time or Part-time employees electing this option.
Employees electing this option are not eligible to participate in the FSA Plan.

Plan Summary

Plan Description

  • Eligibility – All full-time employees who work at least thirty six (36) hours per week are eligible for medical coverage following 90 days from their date of hire. Part time employees are eligible after 90 days of service on a pro-rated contribution basis. Eligibility for this benefit is offered in compliance with the Affordable Care Act (ACA).

In the beginning of each policy year some of our employee’s, who have elected our Option #1 Medical Plan, experience issues with the processing of Prescription Drug Claims at their respective pharmacies.

Please note that this issue does not affect employees who elect our Option #2 Medical Plan since after the employee has met the annual deductible Prescription Drug Claims are paid at 100%.

Below we are outlining the issue and the solution under our Option #1 Medical Plan

The ISSUE arises when an employee presents their RX MasterCard for payment at the pharmacy. The pharmacy states that you must pay the Deductible In-Full because MVP states that your deductible is not fully-funded.  This is not accurate, your portion of the deductible, Single ($625) or Family ($1,250) is fully funded via your participation in the FSA Plan. Additionally, Ellenville Regional Hospital fully funds the balance of your deductible, Single ($1,875) or Family ($3,750) via the Health Re-Imbursement Account. The issue is not with you or the hospital, the issue rests with MVP and its Prescription Fulfillment Provider, CVS Specialty. The specific issue is that the MVP and the CVS claim payment systems are not fully integrated. MVP reports up-dated deductible amounts to CVS every 2 weeks.

The SOLUTION to the issue is to ask the pharmacy to call MVP and have the claim manually overridden. This means that MVP tells CVS that your deductible has been met and that you are not responsible for any deductibles.

If for any reason this approach fails to resolve your prescription, please contact the Human Resources or the Payroll office and we will have a representative intervene on your behalf.

Flexible Spending Account

  • FSA contributions have increased to $2,850 in 2022.  Anyone who participates in the FSA must complete the FSA Form for the 2022 calendar year.  Current withholdings for 2021 FSA contributions will end 12/31/21.  Any unused balance from 2021 will carryover to 2022 up to $570.

FSA Enrollment Form

FSA Claim Form

FSA Direct Deposit Form

 

Dental

Employee Working 20-36 Hours Per Week

Plan Summary

Benefit Booklet Including Enrollment/Change Form

Employee Working 36+ Hours Per Week

Plan Summary

Benefit Booklet Including Enrollment/Change Form

Preventive Advantage

  • Eligibility – All Employees, Full-time and Part-time, are eligible 90 days after their date of hire.
  • Benefit Forms

Claim Form

 

Vision

  • Benefit Forms

Plan Summary

Benefit Booklet Including Enrollment/Change Form

Claim Form

  • Eligibility – All Full-time employees are eligible 90 days after their date of hire. Vision is not available to Part-time employees

 

Group Life & AD&D Benefits

Group Life and AD&D premiums are paid by the Hospital.  The Group Life Benefit is the employee’s annual salary + $2000

  • Eligibility – All Employees, Full-time and Part-time, are eligible 90 days after their date of hire.

 

Voluntary Life Benefits

Employee Working 20-36 Hours Per Week

Plan Summary

Benefit Booklet Including Enrollment/Change Form

Employee Working 36+ Hours Per Week

Plan Summary

Benefit Booklet Including Enrollment/Change Form

  • Eligibility – All Employees, Full-time and Part-time, are eligible 90 days after their date of hire.
  • Benefit Forms

Evidence of Insurability Form

Conversion Form

 

College Tuition

Guardian – The College Tuition Benefit

New York 529

New York 529 Payroll Deduction Form

Aflac

Information Flyer

 

Retirement – 403(b)

Diversified Investments

Salary Reduction Agreement

HANYS

Enrollment Form

Beneficiary Form

Salary Reduction Form

Employee Assistance Program

Connect to a counselor for free support services:

Phone: 1-800-386-7055

Available 24 hours a day, 7 days a week

Support and guidance is just a phone call away. Professional counselors are available to assist you with family and personal issues you might be facing or questions you might have.  Such as:

Anxiety
Dependent Care and Care Giving
Depression
Drug & Alcohol
Education
Grief Assistance
Legal & Financial
Lifestyle & Fitness Management
Parenting
Pet Care
Work Issues
And More


 

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