Upcoming UROne Medicare Webinar:
April 16 | 12:00 p.m.
Welcome to Your Employee Benefits
Your benefits are an important part of your overall compensation. We are pleased to offer a array of valuable benefits to protect your health, family and way of life. This guide answers some of the basic questions you may have about your benefits. Please read it carefully, along with any supplemental materials you receive.
Important Information
Eligibility
You are eligible for benefits on the 1st day of the month following 60 days of employment. You may also enroll your eligible family members under certain plans you choose for yourself. Eligible family members include:
- Your legally married spouse
- Your biological children, stepchildren, adopted children or children for whom you have legal custody (age restrictions may apply). Disabled children age 26 or older who meet certain criteria may continue on your health coverage.
When Coverage Begins
- New Hires: You must complete the enrollment process within 30 days
of your date of hire. If you enroll on time, coverage is effective on the first day of the month following 60 days employment. - If you fail to enroll on time, you will NOT have benefits coverage (except for company-paid benefits) until you enroll during our next annual Open Enrollment period.
- Open Enrollment: Changes made during Open Enrollment are effective January 1, 2025 – December 31, 2025.
Choose Carefully!
Due to IRS regulations, you cannot change your elections until the next annual Open Enrollment period, unless you have a qualifying life event during the year. Following are examples of the most common qualifying life events:
- Marriage or divorce
- Birth or adoption of a child
- Child reaching the maximum age limit
- Death of a spouse or child
- You lose coverage under your spouse’s plan
- You gain access to state coverage under Medicaid or The Children’s Health Insurance Program
Making Changes
To change your benefit elections, you must contact Human Resources within 30 days of the qualifying life event. Be prepared to show documentation of the event, such as a marriage license, birth certificate or a divorce decree. If changes are not submitted on time, you must wait until the next Open Enrollment period to change your elections.
Paycom Employee Self Service
To login, visit paycom.com and select “employee” from the login drop down in the top right corner. You can also download the Paycom app. Reach out to HR if you need your username or password.
Employees can complete the following through the Paycom Employee Self Service.
- Direct Deposit account changes
- Edit federal and state tax withholdings
- Access pay stubs and year end tax forms
- Request 401k contribution changes
- Update your home address and contact information when needed
- Hourly and salary non-exempt employees can request timecard punch changes
MEDICAL
We are proud to offer you a choice of medical plans that provide comprehensive medical and prescription drug coverage. The plans also offer many resources and tools to help you maintain a healthy lifestyle. Following is a brief description of each plan.
Employee Contributions (Semi-Monthly)
| Employee Only | Employee & Spouse | Employee & Child(ren) | Employee & Family | |
| PPO plan 1 | $161.88 | $438.70 | $273.58 | $513.17 |
| PPO plan 2 | $137.30 | $372.08 | $232.03 | $435.23 |
| HSA plan | $65.44 | $282.78 | $176.38 | $330.84 |
RESOURCES
Gravie (Aetna) PPO
These plans give you the freedom to seek care from any provider of your choice. However, you will maximize your benefits and lower your out-of-pocket costs if you choose a provider who participates in the network.
- The plans pay the full cost of qualified in-network preventive health care services.
- You pay the full cost of non-preventive health care services until you meet the annual deductible. You may also have to pay a fixed dollar amount (copay) for certain services.
- Once you meet the deductible, you pay a percentage of certain health care expenses (coinsurance) and the plans pay the rest.
- Once your deductible, copays and coinsurance add up to the out-of-pocket maximum, the plans pay the full cost of all qualified health care services for the rest of the year.
PPO #1
| In-Network | Out-of-Network | |
| Deductible per calendar year |
$2,000 Individual / $4,000 Family | $10,000 Single / $20,000 Family |
| Out of Pocket Limit Maximum per calendar year |
$4,000 Individual / $8,000 Family | N/A |
| Office Visits (physician/specialist) | $15 / $50 copay | 50%* |
| Routine Preventive Care | No charge | 50%* |
| Outpatient Diagnostic (lab/X-ray) | 20%* | 50%* |
| Complex Imaging | 20%* | 50%* |
| Emergency Room | $500 copay | $500 copay |
| Urgent Care Facility | $25 copay | 50%* |
| Inpatient Hospital Stay | 20%* | 50%* |
| Outpatient Surgery | 20%* | 50%* |
*Benefits with an asterisk ( * ) require that the deductible be met before the plan begins to pay.
Prescription Drugs
| PPO #1 | In-Network (Tier 1 / Tier 2 / Tier 3) |
Out-of-Network (Tier 1 / Tier 2 / Tier 3) |
| Retail Pharmacy (30-day supply) | $0 / $30 / $100 | N/A |
| Mail Order (90-day supply) | $0 / $60 / $200 | N/A |
| Specialty | $250 | N/A |
PPO #2
| In-Network | Out-of-Network | |
| Deductible per calendar year |
$4,500 Individual / $9,000 Family | $10,000 Single / $20,000 Family |
| Out of Pocket Limit Maximum per calendar year |
$6,000 Individual / $12,000 Family | N/A |
| Office Visits (physician/specialist) | $15 / $50 copay | 50%* |
| Routine Preventive Care | No charge | 50%* |
| Outpatient Diagnostic (lab/X-ray) | 20%* | 50%* |
| Complex Imaging | 20%* | 50%* |
| Emergency Room | $500 copay | $500 copay |
| Urgent Care Facility | $25 copay | 50%* |
| Inpatient Hospital Stay | 20%* | 50%* |
| Outpatient Surgery | 20%* | 50%* |
*Benefits with an asterisk ( * ) require that the deductible be met before the plan begins to pay.
Prescription Drugs
| PPO #2 | In-Network (Tier 1 / Tier 2 / Tier 3) |
Out-of-Network (Tier 1 / Tier 2 / Tier 3) |
| Retail Pharmacy (30-day supply) | $0 / $30 / $100 | N/A |
| Mail Order (90-day supply) | $0 / $60 / $200 | N/A |
| Specialty | $250 | N/A |
Gravie (Aetna) HDHP HSA
The High-Deductible Health Plan (HDHP) works similarly to a traditional PPO:
- You may see any health care provider and still receive coverage, but will maximize your benefits and lower your out-of-pocket costs if you see an in-network provider.
- The plan pays the full cost of qualified in-network preventive health care services.
- You pay the full cost of non-preventive health care services until you meet the annual deductible. NOTE: If you enroll one or more family members, each covered family member is only required to meet the INDIVIDUAL IN A FAMILY deductible (up to the family limit) before the plan starts to pay expenses for that individual.
- Once you meet the deductible, you pay a percentage of your health care expenses (coinsurance) and the plan pays the rest.
- Once your deductible and coinsurance add up to the out-of-pocket maximum, the plan pays the full cost of all qualified health care services for the rest of the year.
NOTE: If you enroll one or more family members, each covered family member is only required to meet the INDIVIDUAL IN A FAMILY out-of-pocket maximum (up to the family limit) before the plan starts to pay covered services at 100% for that individual.
| In-Network | Out-of-Network | |
| Deductible per calendar year |
$6,000 Individual / $12,000 Family | $10,000 Single / $20,000 Family |
| Out of Pocket Limit Maximum per calendar year |
$6,000 Individual / $12,000 Family | N/A |
| Office Visits (physician/specialist) | 0%* | 50%* |
| Routine Preventive Care | 0% | 50%* |
| Outpatient Diagnostic (lab/X-ray) | 0%* | 50%* |
| Complex Imaging | 0%* | 50%* |
| Emergency Room | 0%* | 50%* |
| Urgent Care Facility | 0%* | 50%* |
| Inpatient Hospital Stay | 0%* | 50%* |
| Outpatient Surgery | 0%* | 50%* |
*Benefits with an asterisk ( * ) require that the deductible be met before the plan begins to pay.
Prescription Drugs
| In-Network (Tier 1 / Tier 2 / Tier 3) |
Out-of-Network (Tier 1 / Tier 2 / Tier 3) |
|
| Retail Pharmacy (30-day supply) | 0%* | N/A |
| Mail Order (90-day supply) | 0%* | N/A |
| Specialty | 0%* | N/A |
Coinsurance percentages and copay amounts shown in the above chart represent what the member is responsible for paying.
*Benefits with an asterisk ( * ) require that the deductible be met before the plan begins to pay.
To be eligible for the HSA, you cannot be covered through Medicare Part A or Part B or TRICARE programs. See the plan documents for full details.
1. If you use an out-of-network provider, you will be responsible for any charges above the maximum allowed amount.
HEALTH SAVINGS ACCOUNT
The HDHP comes with a type of savings account called a health savings account (HSA). The HSA lets you set aside pre-tax dollars to help offset your annual deductible and pay for qualified health care expenses.
RESOURCES
Here’s how the HSA works:
- You contribute pre-tax funds to the HSA through automatic payroll deductions.
- Your contributions may not exceed the annual IRS limits listed below. HSA Contribution Limit 2025 Employee Only $4,300
- You can withdraw HSA funds, tax free, to pay for qualified health care expenses now or in the future. Unused funds roll over from year to year and are yours to keep, even if you change medical plans or leave your employer.
| HSA Contribution Limit | 2025 |
| Employee Only | $4,300 |
| Family (employee + 1 or more) | $8,550 |
| Catch-up (age 55+) | $1,000 |
Important Notes:
- You must meet certain eligibility requirements to have an HSA: You must a) be at least 18 years old, b) be covered under a qualified HDHP, c) not be enrolled in Medicare and d) cannot be claimed as a dependent on another person’s tax return. For more information, visit www.irs.gov/forms-pubs/about-publication-969.
- For a complete list of qualified health care expenses, visit www.irs.gov/forms-pubs/about-publication-502.
- Adult children must be claimed as dependents on your tax return for their medical expenses to qualify for payment or reimbursement from your HSA.
DENTAL
This plan offers you the freedom and flexibility to use the dentist of your choice. However, you will maximize your benefits and lower your out-of-pocket costs if you choose a dentist who participates in the Guardian network.
Employee Contributions (Semi-Monthly)
| Employee Only | Employee & Spouse | Employee & Child(ren) | Employee & Family | |
| Dental plan | $4.94 | $9.83 | $11.26 | $17.68 |
RESOURCES
The following is a high-level overview of the coverage available.
| Guardian DPPO | In-Network | Out-of-Network1 |
| Annual Deductible | $50 Individual $150 Family |
$50 Individual $150 Family |
| Annual Maximum per calendar year; preventive, basic and major services combined |
$1,250 Per individual | $1,250 Per individual |
| Preventive Services | 10%* | 10%* |
| Basic Services | 30%* | 30%* |
| Major Services | 50%* | 50%* |
Coinsurance percentages shown in the above chart represent what the member is responsible for paying.
*Benefits with an asterisk ( * ) require that the deductible be met before the Plan begins to pay.
1. If you use an out-of-network provider, you will be responsible for any charges above the maximum allowed amount.
VISION
This plan gives you the freedom to seek care from the provider of your choice. However, you will maximize your benefits and lower your out-of-pocket costs if you choose a provider who participates in the Guardian network.
Employee Contributions (Semi-Monthly)
| Employee Only | Employee & Spouse | Employee & Child(ren) | Employee & Family | |
| Vision plan | $1.35 | $2.28 | $3.67 | $4.28 |
RESOURCES
The following is a high-level overview of the coverage available.
| Guardian | In-Network | Out-of-Network Reimbursement |
| Exam – once every 12 months | $10 | Up to $39 |
| Lenses – once every 12 months Single vision Bifocal lenses Trifocal lenses |
$25 | Up to $23 Up to $37 Up to $49 |
| Frames – once every 12 months | $130, then 20% discount | Up to $46 |
| Contact Lenses – once every 12 months; in lieu of glasses | $130 | Up to $100 |
LIFE AND AD&D
Life insurance provides your named beneficiary(ies) with a benefit after your death.
Accidental death and dismemberment (AD&D) insurance provides specified benefits to you in the event of a covered accidental bodily injury that directly causes dismemberment (i.e., the loss of a hand, foot or eye). In the event that your death occurs due to a covered accident, both the life and the AD&D benefit would be payable.
RESOURCES
Basic Life/AD&D (Company-paid)
This benefit is mostly company-paid, and is offered to you at a low cost.
Benefit Amount
Employee: $50,000
DISABILITY
Disability insurance provides benefits that replace part of your lost income when you become unable to work due to a covered injury or illness.
RESOURCES
Voluntary Short-Term Disability
Provided at an affordable group rate through Anthem.
| Guardian | In-Network |
| Benefit Percentage | 60% |
| Weekly Benefit Maximum | $600 |
| When Benefits Begin | 1st day for accident, 8th day for illness |
| Maximum Benefit Duration | 13 weeks |
Voluntary Long-Term Disability
Provided at an affordable group rate through Anthem.
| Guardian | In-Network |
| Benefit Percentage | 60% |
| Weekly Benefit Maximum | $5,000 |
| When Benefits Begin | After the 90th day of disability |
| Maximum Benefit Duration | Normal Social Security retirement age |
EMPLOYEE ASSISTANCE PROGRAM
No matter where you are on your journey, there are times when a little help can go a long way toward achieving your goals. From checking off daily tasks to working on more complex issues, your program offers a variety of services, resources and tools to help make your life a little easier. Best of all, because your employer has covered the cost of services, there is no cost to you. Best of all, because your employer has covered the cost of services, there is no cost to you.
Key Features
- Provided at no cost to you and your household members
- Includes up to 5 counseling sessions
- Completely confidential service provided by a third party
RESOURCES
CONTACTS
| Benefit | Provider | Website | Phone Number |
| Medical/Rx | Gravie (Aetna) | member.gravie.com/login | (866) 863-6232 |
| Dental | Guardian – Group# 59927 | www.guardiananytime.com | (888) 600-1600 |
| Vision | Guardian – Group# 59927 | www.guardiananytime.com | (888) 600-1600 |
| Life/AD&D | Anthem | www.anthem.com | (800) 331-1476 |
| STD | Anthem | www.anthem.com | (800) 331-1476 |
| LTD | Anthem | www.anthem.com | (800) 331-1476 |
| Supplemental | Allstate | www.allstate.com | (800) 521-3535 |
| HSA | MedCom | www.medcombenefits.com | (800) 523-7542 |
| Retirement | Nationwide | [email protected] | (833) 268-7080 |