FAQs

Basic Dental insurance option for 2025:

• $50 per covered person annual deductible
• $150 annual family deductible
• $1,000 yearly maximum per person on dental treatment
• The Basic option does not cover orthodontia

High Dental insurance option for 2025:

• $25 per covered person annual deductible
• $75 annual family deductible
• $2,000 yearly maximum per person on dental treatment
• The High option also covers orthodontia with an additional $25 per covered person deductible and a separate lifetime maximum of $1,500 for orthodontia services per person. Implants are covered at 50% after deductible under the High option. 

To locate an in-network provider, CLICK HERE.

For help determining which network service area you are in, see the 2025 HSHS Benefits Guide.

If you have a dependent that does not live in the Prevea360 service area, such as a child attending college, you can register your dependent with Dean Health Plan after you receive your Dean Health Plan ID card.

Call Dean Health Plan to get started. Once your dependent is registered, the First Health network will apply for your dependent’s medical plan coverage.

The HSHS benefit plan offers two flexible spending accounts:

• Health Care FSA
• Dependent Care FSA

FSAs are like a sale. Money you set aside in the accounts is taken off the top of your pay before taxes are withheld. You contribute to the account(s) with pre-tax dollars deducted from your paycheck. This lowers your taxable income, and you don’t pay taxes on the money you use from your account(s). When you enroll, you decide how much to set aside in your account(s) during the 2025 calendar year for:

• Health care expenses for services you or your dependents receive between January 1, 2025, and March 15, 2026.
• Dependent day care expenses for services you receive between January 1, 2025, and December 31, 2025.

When you have an eligible expense, you file a claim to reimburse yourself from your account. For the Dependent Care FSA, it’s important to compare the tax savings you might have under the FSA to what you might save using the federal dependent day care tax credit.

HSHS provides basic life insurance with built-in accidental death & dismemberment (AD&D) coverage at no cost to you.

• You automatically receive 1 ½ times your annual salary up to a maximum of $50,000. No evidence of insurability is required.
• Basic life insurance is provided to all active colleagues of an HSHS facility who are regularly scheduled/budgeted to work 32 or more hours per biweekly pay period.
• Temporary or leased colleagues are not eligible for life insurance.

Benefit eligible colleagues may purchase additional supplemental life insurance through Securian for yourself, your spouse, and/or your dependent children who are under age 26.

• Supplemental life insurance for you is one to eight times your annual salary up to a maximum of $1 million.
• Supplemental life insurance for your spouse is in $5,000 increments up to a maximum of $50,000.
  • Note: As required by law, you cannot carry more life insurance on your spouse than you carry for yourself (Basic life and supplemental life combined).
• Supplemental life insurance for your eligible dependent children in the amount of $20,000. When you select supplemental children’s life insurance, each child from live birth is covered for the same amount.

Long Term Disability (LTD) Insurance is insurance that provides 60% of your salary, up to a monthly maximum of $10,000, in the event you become disabled due to illness or injury.
This is money that you can use to pay your expenses while you are disabled and unable to work.

Note: The amount you receive from LTD insurance is adjusted if you receive benefits or disability income from other sources such as Social Security or Worker’s Compensation. However, regardless of the benefits you receive from other sources, the minimum benefit payable from LTD insurance is 10% of your gross benefit or $100, whichever is greater.

• The Short Term Disability Income Protection Plan (STD) is sponsored by HSHS to replace a portion of your income (70%) in the event you are unable to work due to an illness or injury.
• The STD benefit does not provide benefits for occupational (work related) illness or injury or to care for an ill or injured family member.
• You are eligible for STD benefits if you are a regular active colleague of an HSHS facility and regularly scheduled/budgeted to work 32 or more hours per biweekly pay period.
• Temporary or leased colleagues are not eligible for STD benefits.
• Coverage in the Short Term Disability Income Protection Plan will begin after you complete 90 days of active employment.

The VSP Vision Plan provides coverage for eye exams, lenses, frames and contact lenses plus discounts on many vision services and products. No deductible applies to VSP vision benefits. Click here to see a chart that highlights some commonly used services and shows the vision plan’s benefits.

New Vision Plan Enhancements for 2025!
Enhancements include:

• Increased allowances for frames and contacts up to $180 and featured frames up to $200.

• Introduction of VSP LightCare – You can now use your frame allowance, in lieu of prescription glasses, towards your choice of ready-made, non-prescription sunglasses or blue light filtering glasses.

• Colleagues who are regularly scheduled to work 32 hours or more per biweekly pay period are eligible for PTO.
• Temporary and PRN colleagues are not eligible for the program.

The LiveWELL wellness program is designed to empower you to live a life that’s healthy, active and rewarding, so you can be a better role model for our patients and set a higher standard for the future of health care at HSHS.

You will have the opportunity to complete activities to earn FastCash rewards to improve your physical, emotional, financial and work well-being. 
 

The HSHS Discount Program is a one-stop shop for exclusive discounts at some of your favorite merchants in travel, computers, tickets and more! All HSHS colleagues will now have access to thousands of exclusive discounts. Visit hshs.perkspot.com to register.

• While it is important that you register using your six digit HSHS colleague ID number, you may use any email address you prefer. 
• After you complete the registration process, your access to great discounts and savings will begin!

To find more information about the program, please contact PerkSpot customer service at [email protected] or (866) 606-6057.
 

Click here to access the HSHS Student Loan Repayment Program FAQs.

OptumRx is your plan’s pharmacy care services manager. Our commitment is to help you get the most out of your prescription medication benefit. We provide safe, easy and cost-effective ways for you to get the medication you need.

HSHS Colleagues who are actively employed and budgeted at least 32 hours per pay period are eligible to participate in the program. Colleagues must also be in good standing and have no formal performance corrective action plan or counseling within the last 12-months.  

There is no waiting period before eligible colleagues may apply for HSHS Education Assistance.
 

To locate an in-network provider, CLICK HERE. 

For help determining which network service area you are in, see the 2025 HSHS Benefits Guide. 

If you have a dependent who lives outside of the network area, such as a child attending college, you  can register your dependent with UMR after you receive your ID card. Call UMR to get started (1-800-221-6346). Once your dependet is registered, they will receive the HSHS Extended benefit level for all in-network services.

The HSHS Retirement Program has multiple elements that reflect both the HSHS commitment to make significant employer contributions to your retirement savings and the opportunity for you to meet your own savings goals. 

The HSHS retirement program includes the:

• HSHS Employer Contribution Retirement Plan (“401(a) Plan”), consisting of HSHS employer contributions only. In this plan, HSHS contributes to your retirement savings whether you are able to or not. Your participation/enrollment in the 401(a) Plan is automatic. The HSHS employer contribution ranges from 3%-7% of your eligible pay based on your years of service. 
• HSHS 403(b) Retirement Savings Plan (“403(b) Plan”) with matching contributions from HSHS. You can elect to contribute to your own retirement savings and HSHS will match 50¢ for every $1 you save on the first 4% of your eligible pay. 

You direct how your accounts in the plans are invested by choosing from the investment options offered by Fidelity Investments, the recordkeeper and investment provider.

The HSHS Employer Contribution Retirement Plan (401(a) Plan) is an important source of your overall retirement income – funded entirely by HSHS. It rewards your service with higher contributions as your years of service increase and forms the foundation of the retirement income you build. If eligible, you are automatically enrolled.

Your 401(a) Plan account grows through:

• HSHS contributions of 3% to 7% of your eligible pay, depending on your years of service.
• Investment earnings.

You are fully vested (100%) in all contributions after three years of vesting service. HSHS service prior to becoming a participant in the 401(a) counts towards your contribution percentage and your vesting service. 

How HSHS Contributions Work
You earn a year of service for both vesting and your contribution percentage for each calendar year you are paid for at least 1,000 hours. To receive the annual contribution, you must be actively employed by HSHS on December 31 of the plan year and have worked at least 1,000 hours during the plan year, unless you terminate with HSHS after reaching normal retirement age (65), die or become disabled (as defined by the plan).

HSHS full time (regularly scheduled/budgeted to work  36 or more hours a week) Registered Nurses, Advanced Practice Nurses, Physician Assistants and Certified Registered Nurse Anesthetists (CRNA) starting January 1, 2019.
RNs are limited to the following job codes:
2410:  RN
2412: RN/Clinic
2413: RN/Critical Care
2464:  RN/Telehealth
2561: RN/License Pending
2493: Facilitator/Clinical RN
2522: RN/Flight Nurse
2560: RN/First Assist
2697: RN/Physician Practice
2781:  RN/Float
2911:  Facilitator/Clinical Nursing
2100: RN/Occ. Health



 

Under the HSHS Education Assistance policy, colleagues can receive up to $4,000 of educational assistance each calendar year.  The maximum annual allowance will be based on budgeted biweekly hours at the time of application. 
 

Hours	Max Annual Allowance
72-80	$4,000
48-71	$3,000
32-47	$2,000

You will have access to OptumRx® home delivery and a large network of retail pharmacies, including large national chains and many local pharmacies. Go online or call us to help find a network pharmacy. You can also fill your prescription at an HSHS pharmacy.

You will be able to fill a 90-day supply of non-specialty prescription drugs using Walgreens, in addition to HSHS pharmacies and the OptumRx mail order service.

You are able to opt out of email communications either by clicking “Unsubscribe” at the bottom of PerkSpot emails, or by going into “My Account” once you have completed registration and updating your email preferences.

• You begin accumulating PTO on your first day of employment.
• Accrual of PTO is based upon length of continuous service and actual hours paid, up to 2080 hours per payroll calendar year.
• Part-time colleagues accrue PTO on a pro-rated basis, based on hours paid per year.
• PTO is accrued on: straight time, overtime, premium pay, on call time worked, bereavement, PTO, OWB, and Jury Duty.
• Upon reaching a PTO balance of two times the annual accrual rate, the colleague stops accumulating PTO hours until some PTO is used.
• For more information on PTO accrual, CLICK HERE. 

LiveWELL is available to all HSHS benefit-eligible colleagues (scheduled/budgeted to work 16 or more hours per week).

The claim submission process for STD is telephonic.

• Contact Unum at 866-295-3007 and provide the requested information to start your claim.
• The STD policy # is 92707.
  • Unum will send a packet of information to your home address. 
  • Follow the directions on each form contained in the packet.
  • If you are unable to report for work, you must also notify your supervisor as soon as possible, prior to the start of your shift.

• The duration of benefits is based on your age when you become disabled.
• Your LTD benefits are payable for the period during which you continue to meet the definition of disability.
• If your disability occurs before age 60, benefits will be paid to a maximum of age 65.
• If you become disabled at or after age 60, benefits would be paid according to a benefit duration schedule found in the LTD insurance summary plan description booklet.

You must complete the EOI form if, as a newly eligible colleague, you elect coverage that exceeds three times your pay or $350,000 or elect coverage for your spouse that exceeds $20,000.

• Securian will send an email to your personal email directing you to Securian Financial’s website to complete your EOI. If you do not have a personal email on file a EOI form will be mailed to our home address. 
• Elected coverage will become effective only if you complete the EOI online process or form and Securian has approved the coverage.

If you are a late entrant (previously waived coverage) and want to elect coverage, increase your current coverage more than one level, or add or increase spouse coverage, you will be required to complete the EOI process via online or form if you wish to make these changes during annual enrollment.

• Securian will send an email to your personal email directing you to Securian Financial’s website to complete your EOI. If you do not have a personal email on file a EOI form will be mailed to our home address. 
• Elected coverage will become effective only if you complete the EOI online process or form and Securian has approved the coverage.

Note:
Occasionally, during annual enrollment there may be an opportunity to choose employee supplemental life insurance coverage that is one level higher than your current coverage (e.g., from five to six times pay), you will not be required to provide Evidence of Insurability (EOI) to Securian. You will be notified of this opportunity when annual enrollment information is sent out.

Evidence of insurability (EOI) is not required to enroll dependent children in supplemental life insurance.
 

• The minimum contribution amount is $5 per biweekly pay period.
• The maximum contribution for the dependent care (DCRA) FSA is $5,000 per year. If you file your federal income tax as “married filing separately,” the maximum amount that you may deposit into the dependent care FSA is $2,500 per year.
• The maximum contribution amount for the health care (HCRA) FSA is $3,300 for 2025.

Your coverage will begin on the 1st of the month on or after your hire date. This applies if you are a newly hired colleague or have transferred from a PRN position to a benefits-eligible position. Coverage for your dependents begins on the same day as your coverage as long as you have enrolled them for health insurance. 

Your coverage will begin on the 1st of the month on or after your hire date. This applies if you are a newly hired colleague or have transferred from a PRN position to a benefits-eligible position. Coverage for your dependents begins on the same day as your coverage as long as you have enrolled them for health insurance. 

• The HSHS Dental Insurance Plan provides coverage for up to two exams and up to two cleanings in a calendar year.
• You are not required to wait six months between dental cleanings.

The high option of the HSHS Dental Insurance Plan includes coverage for orthodontia services.

Under the high option:

• Orthodontia services are covered at 50% after deductible with a lifetime maximum of $1,500 per covered member.
• This lifetime maximum does not apply towards your yearly maximum benefits for all other dental services under this option.
• Provides for a preliminary study which includes x-rays, diagnostic costs and a treatment plan.
• The first month of active treatment and retention appliances are also covered.

If you are a new hire and you do not enroll by your enrollment deadline, you will have the following coverage by default:

• Basic Life and AD&D insurance
• Short-Term Disability Coverage
• Long-Term Disability Coverage

If you are a new hire and you do not enroll by your enrollment deadline, you will have the following coverage by default:

• Basic Life and AD&D insurance
• Short-Term Disability Coverage
• Long-Term Disability Coverage

Based on IRS regulations, you must use all the money in your Dependent Care FSA by December 31, 2025. For the Health Care FSA, HSHS offers a grace period that lets you use your 2025 FSA for expenses incurred up to March 15, 2026. Keep in mind that these time limits apply based on the date of service, not the date billed. For both accounts, you have until May 1, 2026, to claim reimbursement. If you do not, the money left in your account(s) is forfeited.

Beneficiary information for life insurance and accidental death insurance is maintained within Workday. 

You may review and update your beneficiary information during the annual open enrollment period or at any time during the year by access Workday. 

• Once you log in, click the Benefits tile within the Application section on your Home page.
• Click on Beneficiaries in the Change section to view your current beneficiary elections.
• To update your beneficiaries, click on the Benefit event in the Change section.
• Select the Change Life Insurance Beneficiaries and follow the prompts to update.
• Check your math. Make certain that your primary beneficiary designations total 100%.

You should begin the LTD claim process in the fifth month of your disability.

• Contact Unum at 866-295-3007 who will advise you of the information necessary for submitting a claim.
• UNUM will also supply you with any required claim forms.

• The elimination period is a period of continuous disability which must be satisfied before you are eligible to receive STD or EIB benefits.
• The elimination period is seven (7) consecutive calendar days of absence and applies to both STD and EIB.
• You are required to use PTO for any regularly scheduled work days that fall within these seven (7) consecutive calendar days of absence due to your disability, if you have PTO available.
• See the Short Term Disability SPD for more information.

• The VSP network has more than 86,000 locations nationwide and includes vision care providers who participate in the Prevea network. To find a VSP Vision Plan provider, visit www.vsp.com.
• Remember, the VSP network includes Prevea vision providers for the HSHS VSP option.

There is no enrollment required. Visit the LiveWELL portal (https://hospitalsisters.sharepoint.com/sites/LiveWell/) to review the many resources and see what FastCash opportunities are avaible. 

• A 403b tax deferred annuity is a retirement savings program that allows eligible HSHS colleagues to set aside a portion of their income on a pre-tax basis.
• It is also known as a Tax Sheltered Annuity (TSA).
• This reduces current federal income taxes, and, in most states, state income tax.
• The 403b retirement plan is a convenient way to save for retirement through payroll deduction and offers flexible options for receiving your money when you retire.

• The purpose of PTO is to give you maximum flexibility in scheduling time away from work.
• You may use PTO for illness, vacation, holidays, family emergencies, preventive health and dental care, personal business, etc.
• You should schedule your use of PTO in advance whenever possible.

• HSHS will contribute $100 per month directly to your student loan servicer for approved and eligible loans.
• The loan must be a qualified education loan in your name and in good standing.
• Lifetime maximum benefit is $18,000.

You can contact PerkSpot Customer Services either by email at [email protected] or by phone at (866) 606-6057.

The program will offer reimbursement for expenses relative to books, fees and tuition less any grants/scholarships.  

Courses must be taken for credit through an accredited school or institution and must relate to the completion of a degree program in a discipline that supports the operations of the System, such as healthcare, business, or management to allow for succession planning, talent management, and growth strategies.  Certification programs are not eligible under the program.  

Proof of costs, including detailed tuition bill and book receipts, are required at the time of application. 
 

When an application is completed it will automatically route to colleague’s direct manager for approval.  Once the manager has approved the application will then route to the HR Service Center for review. 
 
Leader approval ensures that the colleague is in good standing and provides an opportunity for the colleague and their leader to discuss if the courses relate to the completion of a degree program in a discipline that supports the operations of the System, such as healthcare, business, or management to allow for succession planning, talent management, and growth strategies. 

The program is available to eligible colleagues who have completed two full bi-weekly pay periods of active employment. An email invitation will be sent to your HSHS business email account to notify you that you are eligible to participate.

All regular colleagues budgeted to work at least 32 hours per pay are eligible for holidays. You will use accrued PTO on any holiday you would normally be assigned to work. HSHS observes the following holidays:

• New Year’s Day (January 1st)
• Easter (for the purpose of Holiday Premium only)
• Memorial Day (the last Monday in May)
• Independence Day (July 4th)
• Labor Day (the 1st Monday in September)
• Thanksgiving Day (the 4th Thursday in November)
• Christmas Day (December 25th - begins 3:00 pm Christmas Eve)

For areas that are normally closed on Saturday and Sunday, legal holidays falling on Saturday will be observed on Friday and legal holidays falling on Sunday will be observed on Monday. 

For areas open on weekends, the legal holiday will be observed on the actual holiday.  Non-exempt colleagues working on any of these holidays will be compensated at a premium for the number of hours worked on that holiday (11:00pm – 11:00pm).

• There’s no ID card needed.
• If you’d like a card as a reference, you can print one on www.vsp.com.
• At your appointment, simply tell the provider you have VSP insurance.

• The maximum period that you may receive STD benefits for the same period of disability is 26 weeks.
• The Short Term Disability Income Protection Plan will not pay more than 26 weeks of STD benefits for a single period of disability.

Contact the HSHS HR Service Center at 855-394-4747 to initiate your claim.  Please have the following information available prior to calling:

• Colleague name and ID number
• Name of deceased and relationship to colleague
• Deceased’s date of birth, date of death, and social security number

The HR Service Center will report this information to Securian who will then contact the colleague or beneficiary.

In the event you and/or your covered dependents have both health insurance and dental insurance coverage, expenses for the extraction (removal) or excision (surgical removal) of impacted teeth are covered first under the HSHS Healthy Plan (health insurance).

• Ask that your oral surgeon or dentist first submit claims for this service to UMR if you reside in Illinois/outside of Wisconsin or Dean Health Plan if you reside in Wisconsin.
• Once your claim for the removal of impacted teeth has been processed by UMR or Dean Health Plan, your oral surgeon or dentist’s office should then submit any expenses not paid by the health insurance plan to Cigna for processing by the dental insurance plan.

You will have a $100 copayment for emergency services. This is in addition to your deductible and coinsurance for the medical plan option you select.

A Roth contribution to your retirement savings plan allows you to make after-tax contributions and take any associated earnings completely tax free at retirement - as long as the distribution is a qualified one. A qualified distribution, in this case, is one that is taken at least five tax years after your first Roth 403(b) contribution and after you have attained age 59½, or become disabled or die. Through automatic payroll deduction, you can contribute between 0% and 100% of your eligible pay as designated Roth contributions, up to the annual IRS dollar limits.

There are several options available to you to confirm coverage.

1. Contact Cigna’s customer service at 800-244-6224. Cigna customer service agents may be able to verify coverage.
2. Refer to the Dental Insurance Plan summary plan description (SPD). The SPD contains detailed information about the Plan including covered services and Plan exclusions and limitations.
3. Ask your dental provider to contact Cigna and request a pre-determination of benefits. Provider offices are often experienced with confirming coverage with insurance companies.

Portability allows you to continue your Basic Life, Supplemental Group Term Life (SGTL) insurance, and Accidental Death & Dismemberment insurance for yourself and any covered family members when coverage is lost due to retirement, termination of employment, layoff, non-medical leave, or loss of eligibility. You pay the total cost of premiums directly to Securian (formerly known as Minnesota Life). You may continue your total amount of insurance coverage that was in effect on the date your coverage ended, up to a maximum of $500,000. If you are age 65 or older, the amount you may “port” will be 65% of the amount of insurance in force on the date your coverage ended. Portability ends at age 70.

Conversion allows you to continue your Basic and/or Supplemental Group Term Life (SGTL) insurance coverage as an individual insurance policy for yourself only when coverage is lost due to retirement, termination of employment, layoff, leave of absence (including medical leave), or loss of eligibility. You pay the total cost of premiums directly to Securian (formerly known as Minnesota Life). There is no age reduction of coverage at age 65 and there is no age limitation for the conversion option.

The basic differences between portability and conversion of life insurance are:

• Portability has an age limit of 70. There is no age limit with conversion.
• Portability has a reduction in coverage at age 65. There is no reduction of coverage based on age with conversion.
• Portability is coverage under the group term life contract. Conversion is a new individual life insurance policy.
• Portability is not allowed for a medical leave of absence (disability). Conversion does not have this restriction.
• Portability allows for continuing life insurance coverage for family members. Conversion is limited to coverage for the colleague only.
• Coverage cannot be increased with the portability option. Coverage may be increased with evidence of insurability (EOI) with the conversion option.
• Coverage can be decreased if you choose either portability or conversion.

Yes, if you have PTO available, you may choose to use some of your PTO hours, so that in combination with your STD benefit, you receive 100% of your base pay.

• For example, if you receive STD benefits for a week and you are regularly scheduled (budgeted) to work 40 hours a week, the STD plan would pay 70% of pay; that equates to 28 hours. You could use 12 hours of PTO that week to bring your pay to 100%.

 

For calendar year 2025, the maximum elective contributions are projected to be:

• For a participant who is under age 50, the maximum contribution is $23,500.
• For a participant who is age 50+, the maximum contribution is $31,000.

For those colleagues enrolled in the Cigna Dental Plan
Answer: Cigna Healthy Rewards. Present your Cigna dental card at time of service for applicable discount.

• To find a Cigna Healthy Rewards vision provider, click here or call 1-800-870-3470.
• For help on registering on the Cigna site, call 1-800-853-2713.
• For more information on Cigna’s vision discount program through Cigna’s Healthy Rewards program, click here. 

If you transfer to another HSHS facility, you have the option of transferring all of your accumulated PTO hours (and EIB hours if applicable) to the receiving organization or you may receive payment for your accumulated PTO and transfer only the EIB hours if applicable, or a combination of some PTO hours paid out and some transferred.

Applications must be received by the 10th of the month to be considered for HSHS contributions starting the following month.

• Example: When an application is submitted and approved by December 10, 2024, the first HSHS contribution will take place in January 2025.

Fully completed and approved applications must be received on or before the course start date to be considered for education assistance.  Proof of costs is also required at time of application.   

Reimbursement will only be made upon completion of a course.  Proof of grades must be submitted within 3 weeks of completing the course(s).

Education Assistance payments will be issued through payroll within 3 pay periods of receipt and verification of final grades.  

Payments will be treated as non-taxable income to the colleague.  The amount may be reported on the colleague's Form W-2 as educational assistance in Box 14.  This does not denote taxable income, but rather is provided for informational purposes. 
 

Yes, you can have your prescription filled at an HSHS pharmacy for a 90-day supply.

No. However, if you leave employment with HSHS or become ineligible for the program your monthly contributions will cease immediately.

Yes! Your personal health information is important and should be kept confidential. That is why HSHS has a strict policy in place to protect your privacy rights. Your individual information is held in strict confidence between you and Limeade. The only information HSHS can receive is collective data about its population as a whole, not any individual health information. Your privacy is ensured, in compliance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996, which prohibits anyone at your company from receiving your personal health information without your permission. For more information on the Privacy Policy, please login at http://hshs.limeade.com.

• HSHS contributes 50 cents for every dollar you contribute on the first 4% of your eligible pay (pay shown on your W-2 statement plus any pre-tax contributions you make for benefits, including the 403(b) Plan; subject to IRS limits, $350,000 in 2025). 
• Contributions that are made in each calendar year in which you are paid for at least 1,000 hours are matched, as long as you are actively employed on December 31 of that year.
• The maximum match you can receive in a calendar year is 2% of eligible pay.
• Colleagues terminating employment during the year due to death, disability, or after reaching age 55 are also eligible to receive matching contributions.

Out-of-network services will not be covered unless you first obtain a referral from your network provider and prior authorization from Dean Health Plan. Your network provider will need to submit a referral request to Dean Health. If you have questions about the referral process, contact Dean Health Plan at 1-888-895-1188.

You will have a $100 copayment for emergency services. This is in addition to your deductible and coinsurance for the medical plan option you select.

Out-of-network services will not be covered unless you first obtain a referral from your provider and prior authorization from URM. Your provider will need to submit a referral request to UMR. If you have questions about the referral process, contact UMR at 1-800-221-6346.

The HealthEquity Visa Health Account card works like a debit card for eligible health care FSA expenses. Use it to pay for eligible expenses at the pharmacy, including OptumRx for maintenance medications, hospital or your doctor or other health care provider’s office. Through the card, you access money you have elected to set aside each pay period in your health care FSA. 

When you pay for eligible health care expenses with this card, you do not have to use your own money up front and then wait for reimbursement. The card also gives you the ability to purchase qualified over-the-counter items such as nicotine gum or patches that are not eligible for reimbursement through manual claim submission.

It’s important to keep all documentation related to each expense you have in case the documentation is requested by the IRS or HealthEquity s to substantiate your claims.  

Only use the debit card for expenses that have not and will not be paid by the HSHS Medical Plan, HSHS Dental Plan, and/or VSP Vision Plan by the option(s) in which you are enrolled.

The formulary is a list of commonly prescribed medications covered by your plan. It also:

• Identifies medications for certain conditions and organizes them into cost levels called tiers
• Lets you know if any medications require prior authorization or step therapy, which may affect how they are covered
• Includes additional information about (medications that may have quantity/supply limits or be considered specialty

To see if your medication is covered under OptumRx, check the current formulary, by clicking HERE. 

In the event a colleague terminates employment (voluntarily or involuntarily), reduces his/her hours less than 32 hours per pay period or transfers to PRN status within one year of receiving Education Assistance, the colleague agrees to repay a prorated amount of the education assistance paid by HSHS. 

If you have not already selected your beneficiaries, or if you have experienced a life-changing event such as a marriage, divorce, birth of a child, or a death in the family, it’s time to consider your beneficiary designations. Fidelity’s Online Beneficiaries Service offers a straightforward, convenient process that takes just minutes. To make your elections, click HERE, then click on the “Profile” link, then select “Beneficiaries” and follow the online instructions.

Process 

Step 1: Policy Review 

• Review HSHS Education Assistance policy available on HSHS intranet. 
• Review discounts available at colleges/universities participating in the HSHS Discount Program/PerkSpot. 

Step 2: Application, Supporting Documentation Submission, and Approval*

• Complete the Education Assistance Application, found on MyHR, in its entirety.
• Gather required documents which include course schedule and tuition bill and, if applicable, detailed receipts for required textbooks.

• If applicable, gather required documentation for grants, scholarships or other financial assistance being received that do not require repayment.
• Submit fully completed application and required documents prior to beginning the courses.
• Upon submission, your application will be routed to your leader for approval.
• Once your application is approved by your leader, it will be sent to the HR Service Center for review and processing. Processing updates will be sent to your HSHS email and available in MyHR.

 
IMPORTANT: Completed applications and all required supporting documentation must be received by the HSHS HR Service Center on or prior to the course start date to be considered for payment.
 
Step 3: Final Grades*

• Submit Education Assistance Reimbursement request, found on MyHR, attaching final and verifiable grade report that includes your name, course(s), and grade(s) within 21 days of course completion

Step 4: Receive Payment* 

• Education Assistance payments will be issued through payroll and treated as non-taxable income. 
• Payments will be issued within 3 pay periods of receipt and verification of final grades. 
• The maximum benefit amount allowed under the Education Assistance policy is based on payments made in the calendar year, which may/may not be the same calendar year in which coursework is completed. 

 
*does not apply to Partnership Program
 

• Medications will be delivered directly to your door, which means fewer trips to the pharmacy.
• You will receive up to a 90-day supply, which may save you money on copays
• Pharmacists will be available by phone 24 hours a day, 7 days a week to answer questions.
• You can set up automatic reminders to help you remember when to take your medication and refill your prescriptions.
• Enroll in our Hassle-Free FillSM program and we’ll automatically refill and deliver your eligible maintenance medications to you.

• Access Fidelity NetBenefits NetBenefits.com/atwork to review all the information provided to assist you in making your investment decisions.
• You may also contact Fidelity at 800-343-0860 and ask to speak to an investment representative.
• You can also research the funds on your own or with your financial advisor.

The IRS requires proof that the expense was qualified for reimbursement through a health care FSA. Receipts/proof will be need to submitted to Health Equity. They will request documentation from you in order to substantiate your claim.
 

• To encourage early investing and simplify the 403(b) Plan enrollment process, all eligible HSHS colleagues hired or rehired with HSHS on or after July 1, 2014 are enrolled automatically at a 4% of pay contribution level after 60 days of employment.
• Unless you choose otherwise, your contribution level will continue to increase by 1% each year until you’re eventually contributing 8% of your pay.
• These automatic contributions will be invested in the Vanguard Target Retirement Funds based on your date of birth, unless you choose different investment options.
• You can increase, decrease, or stop your contributions at any time.

If you are leaving HSHS you may still submit claims for both the health care and/or the dependent care FSA.

Health Care FSA:

• Claims for services received through your employment end date are eligible for reimbursement.
• Qualifying health care claims must be filed with Health Equity by May 1 of the year following the plan year in which you contributed to the spending account.
• Your debit card will be automatically canceled on your employment end date.
• You will need to submit claims directly to Health Equity for reimbursement.

Dependent Care FSA:

• Claims may be submitted for dependent care expenses up to the amount in your account at your employment end date and must be incurred prior to your employment end date.
• Qualifying dependent care claims must be filed with Health Equity by May 1 of the year following the plan year in which you contributed to the spending account.
• If you did not have any qualifying dependent care expenses as of the day your employment ends, you are not eligible to file any claims for reimbursement per IRS regulations.

You are permitted to roll over eligible pretax contributions from another 401(k) plan, Roth 401(k) plan, 401(a) plan, 403(b) plan, Roth 403(b) plan, governmental 457(b) retirement plan, or a Roth 457(b) retirement plan account or eligible pretax contributions from conduit individual retirement accounts (IRAs). A conduit IRA is one that contains only money rolled over from an employer-sponsored retirement plan that has not been mixed with regular IRA contributions.

Additional information can be obtained online, or by calling the Fidelity Retirement Benefits Line at 1-800-343-0860.

You can fill your prescription at Optum® Specialty Pharmacy. Our patient care coordinators and pharmacists are trained to understand your special therapy needs.

• By e-prescribe. Your doctor can send an electronic prescription to OptumRx
• Go online. Visit the website on your member ID card
• By mobile app. Open the OptumRx app, which you can download from the Apple® App Store® or Google Play™
• By phone. Call the toll-free number on your member ID card

Specialty medications treat chronic conditions such as cancer, multiple sclerosis and rheumatoid arthritis. It can be an injectable, oral or inhaled medication with one or more of the following characteristics:

• May require ongoing clinical oversight and additional education for best management
• Have unique storage or shipping requirements
• May not be available at retail pharmacies