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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).

Overview Documents

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

2023

Benefits Summary 2023

Benefits Fee Chart 2023

Holiday Schedule 2023

Floating Holiday Schedule 2023

Payroll Schedule 2023

 

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
In Network and Out of Network Coverage

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

PPO Plan Summary 2023

PPO Plan Description 2023

    • Option 2

$5,000 Single Deductible
$10,000 Non-Single Deductible
In Network Coverage – MVP and Cigna
Integrated Debit Card

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

EPO Plan Summary 2023

EPO Plan Description 2023

  • 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).

 

New Health Insurance Marketplace Coverage Options and Your Health Coverage

Marketplace Coverage Form

 

Flexible Spending Account

  • 2023 FSA contributions are $3,050.  Anyone who participates in the FSA must complete the FSA Form for the 2023 calendar year.  Current withholdings for 2022 FSA contributions will end 12/31/22.  Any unused balance from 2022 will carryover to 2023 up to $570.  Carryover limits from 2023 to 2024 have increased to $610.

FSA Enrollment Form

FSA Claim Form

FSA Direct Deposit Form

FSA Eligibility List

 

Dental

Employee Working 20-36 Hours Per Week

Benefit Booklet Including Enrollment/Change Form 2023 – Maximum goes from $1,500 – $2,000 for buyup plan.

Employee Working 36+ Hours Per Week

Benefit Booklet Including Enrollment/Change Form 2023 – Maximum goes from $1,500 – $2,000 for buyup plan.

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

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

Benefit Booklet Including Enrollment/Change Form

Employee Working 36+ Hours Per Week

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

EAP Work Life Matters Overview

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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