VPP Benefit Guide for Plan Year 2025-2026
Employee Benefit Guide 2025-2026
Prepared By Brio Benefits For Veterinary Practice Partners
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Meritain Health Medical Kit
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Pharmacy: RxBenefits & OptumRx
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OptumRx Mobile App
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RxBenefits Online Access
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Member account
Explore Our Employee Benefits Site benefits.vetpartners.com
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Find a doctor
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Teledoc
2
Table of Contents
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Virtual Mental Health
3
Eligibility
Dental and Vision
31
4
Enrollment
Dental & Vision: Overview
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5
2025 Open Enrollment
Dental Plans: Highlights
33
6
AGM Enrollment Service Support
Vision Plan: Highlights
34
7
Qualifying Life Events
Supplemental Coverage
35
8
Understand Your Medical Plans
Supplemental Health
36
9
Key Terms
Critical Illness
37
10
New Medical Plans
Accident
38
11
Medical Plan Highlights
Hospital Care
39
12
Employee Contributions
Short Term Disability
40
13
HSA: Health Savings Account
Voluntary LIFE & AD&D
41
14
Seeking Care: Where to go
Commuter Benefits
42
15
2 43 EAP Employee Assistance Program 44 Employee Perks & Discounts 45 Carrier Contacts 46 Employee Compliance Notices 48 401(K) Retirement
Aetna Medical Kit
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Member account
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Find a Doctor
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CVS Health Virtual Primary Care
AbleTo: Virtual Behavioral Care 20
Eligibility Who Can Enroll
FLEXIBLE SOLUTIONS TO MEET YOUR BENEFIT NEEDS
HOW TO ENROLL
To enroll in benefits, log in to the Employee Self-Service portal in Paycom using your individual Username and Password and the last 4 digits of your Social Security Number. From the home screen, you will have a main menu on your dashboard and one of the options will be “Benefits . ” Please note that this guide applies to VPP’s benefit plans only. If your veterinary hospital sponsors its own employee benefit plans, contact your hospital directly for additional information.
VPP considers our employee benefits program to be one of our most important investments. Because we recognize the value our employees bring to our company, we are committed to providing you with a complete benefits program as part of your total compensation. This guide has been prepared to assist you in making informed decisions regarding your employee benefits. We urge you to read this guide carefully and keep it as a reference. If you are well-informed, you will be better able to make the benefit choices that best meet your needs. When making your choices, you should consider: • The benefits offered • The cost of coverage • Physicians and facilities available • Any ongoing medical needs for you and your family
ELIGIBLE DEPENDENTS
Spouse – An individual to whom you are legally married.
Children – Your or your spouse’s child who is under age 26, including a natural child, stepchild, a legally adopted child, a child placed for adoption or a child for whom you or your spouse are the legal guardian.
Over Age Unmarried Children – Age 26 or older who is disabled and dependent upon you.
WHO IS ELIGIBLE?
VPP may require verification of dependent status for medical, dental and vision coverage for all spouses and dependents under the plans.
All full-time employees working an average of 30 hours per week are eligible to participate in benefits. Your benefits are effective on the first of the month following 30 days after your full time hire date. If you do not enroll during this time period, you will not be eligible for benefits until the next Open Enrollment, unless you have a Qualifying Life Event Change. If you are an employee who is hired into an employment category that may work less than an average of 30 hours per week, VPP will review your average hours following an 11-month lookback policy. Employees changing from part-time to full-time status must work 30 average hours per week during a 12-month measurement period. Benefits will be effective from the 1st of the month following the date they are changed to full- time. Newly full-time employees will have 30 days to enroll from the date of the status change. Employees who average less than 30 hours per week during the measurement periods will generally not be eligible to participate.
DISCLAIMER
To stay in compliance with federal regulations, Veterinary Practice Partners offers medical plans through two different carriers — Aetna and Meritain. The plans have the same design and cost to you, including deductibles, coinsurance, and out-of-pocket limits. Offering two carriers helps us meet legal requirements while ensuring you still receive consistent, high-quality coverage. To review the plan in which you are enrolled, please check your health insurance card or Paycom Benefits.
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Enrollment When To Enroll
NEW HIRES/ NEWLY ELIGIBLE FOR BENEFITS
When you are first hired or become eligible for benefits you have 30 days to enroll. If you do not enroll within this
enrollment period, you will not be eligible for benefits until the next Open Enrollment, unless you have a Qualifying
Life Event.
When you are a new employee or newly eligible your benefits will become effective on the first of the month
following 30 days from your full-time hire date.
OPEN ENROLLMENT
During Open Enrollment, you will have the opportunity to enroll or make changes to your benefit elections. You
must enroll by the Open Enrollment deadline for your benefits to be effective July 1.
You will not be able to change your elections after the Open Enrollment deadline until next year’s Open Enrollment
unless you experience a Qualifying Life Event. All changes are to be made in the Employee Self-Service portal in
Paycom.
WHAT YOU CAN DO TO CONTROL COST
Due to increasing health care costs, there are steps you can take to manage your out-of-pocket health care
expenses. Use the following tips to save time and money:
• Always confirm that your physician, eye doctor, and dentist are In-Network by calling the customer service
number on your ID card or visiting the carrier’s website.
• Check your area for urgent care centers as an alternative to emergency room services. Only visit the
emergency room in the case of a true emergency. You can also use telemedicine to help treat a wide range of
non-emergency medical conditions.
• Use generic prescriptions, if available. Ask your doctor for a generic drug or request the generic equivalent
when having your prescription filled.
Important Notice: Some Americans must have health insurance or be subject to a penalty when filing their state
income tax return. You may obtain insurance from your employer’s plan, spouse’s plan, or the Public/State
Exchange .
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AGM ENROLLMENT SERVICE SUPPORT
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Qualifying Life Event What To Know
What is a Qualifying Life Event (QLE)?
If you experience a Qualifying Life Event (QLE), you may be able to add, change, or drop your benefits before the next Open Enrollment.
❑
Marriage, annulment, legal separation, or divorce.
❑
Medical Child Support Order.
❑
Birth or adoption.
❑
Entitlement to Medicare or Medicaid.
❑
Death of spouse or child.
❑
Reduction in hours.
❑ Change in dependent’s eligibility status (e.g., turns 26 years old). ❑ Change in employment status by you or your spouse. ❑ Change in residence if change affects benefit options.
❑
Enrollment in Marketplace/Exchange.
❑
Loss of coverage under a state insurance program (Children's Health Insurance Program (CHIP) or Medicaid).
When you experience a QLE it triggers a Special Enrollment Period (SEP). You have 30 days from the QLE date to notify Human Resources, act in Paycom, and provide supporting documentation. If your documentation is not submitted within 30 days and/or does not support the change, your request will be denied.
Your benefit changes will be effective as of the QLE date. For example, if you experience a birth, your benefits will be effective on the date of birth.
Options For Processing Your Qualifying Life Event (QLE).
Changes Via AGM | An Enrollment Support Service
Call the AGM Enrollment Service at 1-844-880-6774 or book an appointment for assistance at HTTPS://A.FLEXBOOKER.COM/RESERVE/VPP.
Changes Via Paycom
Log into Paycom Access the Paycom Employee Self-Service portal, either through the web application or the Paycom app.
Navigate to Benefits Locate and click on the "Benefits" tab within the Employee Self-Service portal.
Select Qualifying Events Choose the "Qualifying Events" option from the Benefits menu.
Add Qualifying Event Click on the "Add Qualifying Event" option to initiate the life event submission process.
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Understanding Your Medical Plans
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Key Terms Understand Your Medical Plans
Provider: A provider is a person, doctor, or facility that provides healthcare.
Insurance Carrier: The health insurance company that provides your insurance policy. The terms insurer, carrier, and insurance company are generally used interchangeably.
Insurance Network: A group of doctors, providers and hospitals that have contracted with an insurance carrier. That means they’ve agreed to accept a pre -negotiated rate for medical services or supplies.
In-Network: A provider that has contracted to be a part of your Insurance Network. Seeing an in-network provider for medical services can significantly reduce your medical expenses.
Out-of-Network: A provider that has no contract with your health plan. There are no discounted rates for services and no contracted limits to the amount they can charge you. The general rule is that you will pay more for services if you use out-of-network providers.
Annual Deductible: The amount of money per year that you need to pay for your health care costs (such as doctor’s visits, medication, etc.) The common phrase “meet your deductible” refers to having paid up to that set dollar amount in covered health expenses. The amount varies by plan.
Individual deductible the amount one person needs to meet for coinsurance to kick in. Family deductible is the maximum amount that a family needs to meet for coinsurance to kick in for everyone in the family.
Coinsurance: The percentage of covered health costs you're responsible for paying after you've met your deductible. It's like when friends in a carpool cover a portion of the gas, and you, the driver, also pay a portion.
Copay: A fixed dollar amount you pay for a specific service.
Example: If you have a $20 copay for Primary Care Visits, you will owe a flat fee of $20 for each appointment with a primary care physician.
Out-Of-Pocket Maximum: The most you could pay for covered medical expenses in a year. This amount includes money you spend on deductibles, copays, and coinsurance. Once you reach your annual out-of-pocket maximum, your health plan will pay your *covered medical and prescription costs for the rest of the year.
* Please Note : Out-of- network providers may charge more for “covered medical services” than the maximum amount your Insurance Carrier allows. You will be responsible for paying the difference between the allowed amount and the provider’s bill. This is referred to as “ balance billing .” It is one of the reasons out -of-network coverage is typically more expensive than in-network.
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New Medical Plans Aetna & Meritain Health
To stay in compliance with federal regulations, VPP offers medical plans through two different carriers: Aetna and Meritain . The carriers have different pharmacy coverage as well. Please see the below chart for the details on the RX & Prescription Benefit Manager (PBM) for each carrier. Both carriers will offer the same great benefits including deductibles, coinsurance, and out-of-pocket limits. Offering two carriers helps us meet legal requirements while ensuring you still receive consistent, high-quality coverage.
Medical Carrier
Pharmacy Benefits
plus
How To Confirm Your Carrier
Refer to AGM Enrollment Support.
View your Paycom Benefits account.
Check your health insurance card.
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Medical Plan Highlights
HDHP Core Plan (Bronze)
Choice Plan (Silver)
Choice Plus Plan (Gold)
IN-NETWORK
$1,100 (funded biweekly)
N/A
N/A
VPP Contribution
Aetna Aetna Open Access Plans Meritain Health Broad Medical Networks
Aetna Aetna Open Access Plans Meritain Health Broad Medical Networks
Aetna Aetna Open Access Plans Meritain Health Broad Medical Networks
Network
Deductibles (Individual / Family)
$3,500 / $7,000
$2,000 / $4,000
$5,000/$10,000
Deductible
Embedded
Embedded
Embedded
Preventive Care
100% Covered
100% Covered
100% Covered
Primary Care Visit
$35
$40 after deductible
$50
Specialist Visit
$60
$60 after deductible
$75
Virtual Visit
$35
$40 after deductible
$50
Outpatient Procedure
10% after deductible
10% after deductible
30% after deductible
Inpatient Visit
10% after deductible
10% after deductible
30% after deductible
Lab Tests / Diagnostics**
10% after deductible
10% after deductible
30% after deductible
Urgent Care
$75
$75 after deductible
$75
Emergency Room
10% after deductible
$200 after deductible
30% after deductible
Imaging
$200
$200 after deductible
$200
$10 / $30 / $50 after deductible $25 / $75 / $125 after deductible
Pharmacy / Rx- Retail (31 days) Pharmacy / Rx- Mail Order (90 days)
$15 / $35 / $50 $38 / $88 / $125
$20 / $40 / $60 $50 / $100 / $150
Out-of-Pocket Max (Individual / Family)
$6,550 / $13,100
$7,150 / $14,300
$7,900 / $15,800
Out-of-Pocket
Embedded
Embedded
Embedded
OUT OF NETWORK Deductibles (Individual / Family)
$6,000 / $12,000
$5,000 / $10,000
$10,000 / $20,000
Coinsurance
50% after deductible
50% after deductible
50% after deductible
Out-of-Pocket Max (Individual / Family)
$10,000 / $20,000
$10,000 / $20,000
$15,000 / $30,000
11 **The above plan summaries are for illustrative purposes only. Always check your Aetna and Meritain Health benefit summaries and certificates of coverage for final detailed plan information.
Employee Contributions Medical Plans
HDHP Core Plan
Pre-Tax Monthly Contributions
Pre-Tax Per Pay Period
Employee
$139.07
$64.19
Employee + Spouse
$834.30
$385.06
Employee + Child(ren)
$558.62
$257.82
Family
$1,171.18
$540.54
Choice Plan
Pre-Tax Monthly Contributions
Pre-Tax Per Pay Period
Employee
$196.48
$90.68
Employee + Spouse
$922.47
$425.75
Employee + Child(ren)
$633.41
$292.34
Family
$1,275.72
$588.79
Choice Plus Plan
Pre-Tax Monthly Contributions
Pre-Tax Per Pay Period
Employee
$426.52
$196.86
Employee + Spouse
$1,474.95
$680.75
Employee + Child(ren)
$1,057.51
$488.08
Family
$1,985.08
$916.19
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HSA Health Savings Account
Health Savings Account (HSA) | HDHP Core plan only
A health savings account is used to help offset the cost of a qualifying high-deductible health plan (HDHP) and provide savings for your out-of-pocket eligible health care expenses.
An HSA is portable and it’s yours to keep, even if your employment ends. Once established, money is contributed by yourself and VPP. This allows you to use tax free dollars to pay for eligible health care expenses, like doctors’ visits and prescriptions. Deposits are tax -free, and you get tax-free withdrawals if the money is used toward eligible healthcare expenses. Any unused funds at the end of the plan year will carry over to the next year.
If you elect the HDHP, VPP will contribute $1,100 annually, funded on a biweekly basis ($42.31 per pay period). The VPP contribution is prorated for mid-year enrollees. There is a $1,000 catch up contribution if you are 55 or older.
The 2025 IRS contribution limit is $4,300 for single coverage and $8,550 for family coverage. In addition to the VPPs’ $1,100 contribution, you will be able to contribute up to $3,200 for individual coverage and $7,450 for family coverage.
To be eligible for the HSA account, you must not be a participant in another medical/prescription drug plan that is not a qualified HDHP (such as a spouse’s plan), Medicare, Medicaid, or Tricare. You are also ineligible if you can be claimed on another person’s tax return as a dependent.
How does your HSA work?
When you visit your Aetna or Meritain Health doctor you should never pay at time of service. Your doctor/facility will submit claims on your behalf to Aetna or Meritain Health. If you are seeing an out-of- network provider, those claims are your responsibility. After your claim is processed and the in-network Aetna or Meritain Health discount is applied, your doctor will bill you for your responsibility. You will also receive an Explanation of Benefits (EOB) from Aetna or Meritain Health showing your responsibility.
You can then use your HSA Debit Card to pay your portion. To pay, call the doctor/facility and provide them with your card information. If you receive a paper bill, there is a section on the bill where you may enter your card information to make a payment.
Your HSA account with UMB will automatically be opened for you. If you do not receive a welcome package or card in the mail within 15 business days, please contact UMB:
Customer Service: 866-520-4472. Enrollment Verification Number: 0044008460003
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Seeking Care Where to go?
Your journey to wellness begins with choosing where to start .
Feeling sick?
Telemedicine
Primary Care Center
When would I use this? When you need care for minor illnesses and ailments but would prefer not to leave home.
When would I use this? Your primary doctor knows you and can provide routine care and manage your medications.
What type of issues do they treat?
What type of care do they provide?
✓ Cold & flu symptoms ✓ Allergies ✓ Bronchitis
✓ Urinary tract infection ✓ Sinus problems
✓ Routine checkups ✓ Immunizations
✓ Preventive Services ✓ Manage general health
What are the costs and time considerations? ✓ Requires a copay and/or coinsurance. ✓ Appointment is needed.
What are the costs and time considerations? ✓ Access to care is usually immediate. ✓ Some states may not allow prescriptions through telemedicine or virtual visits.
Do Your Homework What may seem like an urgent care center could be a standalone ER. These newer facilities come with a higher price tag, so ask for clarification if the word emergency appears in the facilities name.
Urgent Care Center
Emergency Room
When would I use this? You need care quickly, but it is not a true emergency. Urgent care centers offer treatment for non-life-threatening injuries or illnesses. What type of issues do they treat?
When would I use this? You need immediate treatment for a serious life- threatening condition. What type of issues do they treat?
✓ Heavy bleeding ✓ Chest pain ✓ Major burns
✓ Spinal injuries ✓ Severe head injury ✓ Broken bones
✓ Strains, sprains ✓ Minor broken bones
✓ Minor burns ✓ X-rays ✓ Minor infections
What are the costs and time considerations? ✓ Often it requires a much higher copay and/or coinsurance. ✓ Open 24/7 but waiting periods may be longer as patients with life-threatening emergencies will be treated first.
What are the costs and time considerations?
✓ Often requires a copay and/or coinsurance. ✓ Walk-in patients welcome but appointments can be made.
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Aetna Medical Kit
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Aetna Member Account
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Aetna Find a Doctor
Why choosing a plan is important.
Pay less if you use a provider that accepts the plan
Find the highest level of coverage from a provider under the plan
Confirm doctors are accepting the plan
How do you use DocFind?
1.
Visit www.aetna.com/docfind.
2.
Enter your zip code, city, state, or county then click search.
3.
Choose AETNA OPEN ACCESS PLANS.
4.
Select MANAGED CHOICE® POS (OPEN ACCESS).
5. Search your provider or select the type of provider you are looking
for (PCP, Specialists, Hospitals).
Quick Facts
DocFind is updated 6 days per week excluding Holidays and Sundays.
If you can’t find your provider, contact Member Services for information on whether a provider is in a network.
The best times to call are early morning or late afternoon Tuesday through Friday.
For assistance with DocFind, please contact Member Services at 800-962-6812.
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CVS Health Virtual Primary Care
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CVS Health Virtual Primary Care
Your care. Your way.
Convenient and affordable virtual care wherever you need it*
From mental health visits to quick care, you can use CVS Virtual Care® in addition to your traditional network of providers. Access is included as part of your medical plan from Aetna®, a CVS Health® company. Because healthier happens together®
CVS Virtual Care®
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Telehealth AbleTo Behavioral Care
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Telehealth AbleTo Behavioral Care
* You may be able to receive AbleTo services with no out-of-pocket cost to you, depending on your employer. With other employers, associated deductibles will apply before your out-of-pocket expenses are covered. Just call the number on your member ID card to learn more about your options. 1 AbleTo Patient Satisfaction Survey, 2019. 2 AbleTo Commercial Outcomes, 2019.
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Meritain Health Medical Kit
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Pharmacy RxBenefits with Optum Rx
Pharmacy with RxBenefits
Administered by OptumRx
Function
OptumRx
RxBenefits
Manages pharmacy benefits for health plans and employers
Optimizes pharmacy benefits for employers and their employees
Role
Negotiates discounts with pharmacies, develops formularies, processes claims
Provides member services, helps members find lower- cost alternatives, assists with transitions of care
Services
Lower prescription drug costs for health plans and employers
Greater discounts, enhanced access, and improved member services for employers and their employees
Benefits
Manages pharmacy benefits for health plans and employers
Optimizes pharmacy benefits for employers and their employees
Role
As part of your NEW pharmacy benefits plan, you will receive: • New pharmacy ID card • Prescription Drug Coverage Statement • Friendly, high-touch service from RxBenefits ’ professional Member Services Team • Commitment to issue resolution Access to My RxBenefits (NEW)
For Questions or Concerns
Members can contact RxBenefits Member Services 800.334.8134 Monday through Friday 7:00 a.m. – 8:00 p.m. Central
•
View pharmacy benefits coverage
•
Download and email ID cards
• View 18 months of pharmacy claims (including claims for eligible dependents) • Establish and manage communications preferences • Access to online PA status (if they have Enhanced Protect and if RxB is the reviewer) Access to OptumRx.com • Review medication tiers, drug pricing, local pharmacies, plan details, and ways to maximize benefits • New Members will need to make an account
customercare@rxbenefits.com
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OptumRx Mobile App
The OptumRx® App makes the online pharmacy experience as simple as possible.
You can easily: • Refill or renew a home delivery prescription • Transfer a retail prescription to home delivery • Find drug prices and lower-cost options • View your prescription claim history or order status • Locate a pharmacy • Access your ID card, if your plan allows Set up refill reminders • Track your order
The OptumRx App: the most convenient way to manage your prescriptions.
Simple You can easily refill a medication or transfer a retail prescription to home delivery. Current Prescription Drug Lists change frequently; the OptumRx App updates automatically, giving you quick access to the most current drug coverage information. Personalized Access a complete profile of your prescriptions when you view your online Medicine Cabinet. You can see all your recent and past prescriptions. Save time and money Compare prescription drug options as well as identify potential cost savings.
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Meritain Health | Member Account
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Meritain Health Find a Doctor
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Teladoc What is it?
Do you ever feel like taking care of yourself is harder than it needs to be? Luckily, with Teladoc Health you can take care of your health needs from home, the airport or from wherever you may be.
Medical Care Teladoc Health is the on-demand health care solution that gives you the medical care you need, when you need it. You can talk to a doctor anytime, anywhere about non-emergent medical conditions, including dermatology and behavioral health.
Common Conditions Treated Include:
Skin irritations & rashes Urinary tract infections Respiratory infections Eye or ear infections
Allergies Sinus infections Migraines Stomachache
What will this service cost? The cost for each virtual visit varies by your medical plan. Please refer to the chart below for the per visit cost according to VPP’s 2025 medical plans.*
Medical Plan
HDHP Core Plan
Choice Plan
Choice Plus Plan
$55 consult fee
$50 copay
$35 copay
Per Visit Cost
*Please note this cost reflects initial cost of a virtual visit. It does not include additional costs that may be accrued for additional \ services during your visit including prescriptions copays, lab tests, or diagnostic services. Please see your plan SBCs for more info.
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Teladoc Where do I start ?
Set up your account online It’s quick and easy! Simply visit the Teladoc Health website at www.teladoc.com.
If you have already registered your account, click Sign in .
To create a new account, click Register now .
More than one way to reach a doctor.
By phone. Just call 1.800.835.2362.
Online. Simply request a video consultation online at www.Teladoc.com.
On-the-go. Download the Teladoc Health mobile app App Store® or Google Play .
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Meritain Health | Virtual Mental Health
Access Mental Well-being Services From Anywhere With telehealth and virtual mental well-being programs, you can easily get help you need from providers who are part of your network. So, whatever you’re facing, you’ll have support, including counseling, medication or help with mental health concerns. Plus, you can see providers when and where it’s convenient for you. However , depending on your plan coverage, some services may not be covered. You’ll want to confirm telehealth eligibility by checking your member website for plan details or calling the number on your ID card, prior to receiving services. Below is a list of providers you can access for a variety of concerns or conditions.
Depression, Anxiety or Mental Well-Being Concerns
Age years
Provider
Contact
Availability
0-18
Brightline
hellobrightline.com/meritain
NY, NJ, CT, MA, WA
5+
Alma Health
helloalma.com/meritain
Nationwide
5+
Rula
rula.com/meritain
Nationwide
5+
Telemynd
1.866.991.2103 or Telemynd.com/meritain
Nationwide
13+
Talkspace
talkspace.com/Meritain
Nationwide
18+
Meru Health
meruhealth.com/sign-up/meritain/
Nationwide
18+
Brightside Health brightside.com/meritainhealth/
Nationwide
18+
CVS MinuteClinic
1.855.417.2486 or CVS.com/mentalhealth
CVS MinuteClinic in select markets
Serious mental health conditions
Age years
Provider
Contact
11 to 34
Charlie Health
1.866.491.5196 or https://CharlieHealth.com/
AK, AZ, CA, CO, DE, FL, GA, ID, IL, IN, IA, MD, MI, MO, MT, ND, NE, NM, NV, NH, NJ, NY, NC, OH, OR, PA, SC, TN, TX, UT, WA, WI, WY
Availability
Chronic Medical Conditions and Mental Health
Age years
Provider
Contact
Availability
18+
AbleTo
1.844.330.3648 or member.ableto.com/meritain/
Nationwide
Eating disorders
Age years
Provider
Contact
Availability
All ages
Equip Health
1.855.387.4378 or https://equip.health
Nationwide
Telehealth (telemedicine) or virtual services: connects you and your provider via a secure televideo platform for counseling, support, education and medication management from the location of your choice.
Availability: specific availability by state is subject to change without notice. To learn more about your benefits or if you have any questions, simply call the number on the back of your medical ID card.
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Dental & Vision
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Dental & Vision Overview
Your Dental Coverage with Principal
Receiving regular dental care can not only catch minor problems before they become major issues and expensive to treat – it may even help improve your overall health. Savings are greater when you visit an In- Network provider as Principal’s contracted dentists have agreed to provide care at a negotiated rate.
Principal PPO Low Plan
The PPO Low plan was designed to help you, and your family maintain oral health, reduce your out-of-pocket costs, and simplify the use of your coverage.
Principal PPO High Plan
The PPO High plan is similar to the low plan but has a higher maximum and includes orthodontia for your dependents. This plan also provides more coverage for out of network dentistry.
Search for participating dentists here: www.principal.com/dentist
Your Vision Coverage With Principal
Principal Mobil As easy as 1,2,3 when accessing your dental, vision, disability and life benefits. This tool can also be used as a mobile ID card for dental. Principal makes it easy. They are designed around their members, so they want to make it easy for you to use your benefits. Principal has one of the largest networks of private practicing optometrists, ophthalmologists, and opticians. In addition to the vision plan benefits provided through your benefits program, Principal offers several non-covered services at a discount.
3 Go to the Group Insurance section.
1 Download Principal Mobil from the App Store or Google Play.
2 Log in using the same username and password as principal.com.
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Dental Plans Highlights
Eligibility
First day of the month after 30 days of employment. Full-time staff only (minimum of 30 hours a week).
Plan Highlights
PPOLOW
PPOHIGH
In-Network
Out-of-Network*
In-Network
Out-of-Network*
Annual Individual Deductible
$0
$300
$50
$50
Annual Family Deductible
$0
$900
$150
$150
Preventative Care
100% Coinsurance
50% Coinsurance after deductible
100% Coinsurance no deductible 80% Coinsurance after deductible 50% Coinsurance after deductible
100% Coinsurance no deductible 80% Coinsurance after deductible 50% Coinsurance after deductible
30% Coinsurance after deductible
Basic Procedures
80% Coinsurance
Major Procedures
40% Coinsurance
25% Coinsurance after deductible
Calendar Year Max Benefit
$1,000 per person
$2,000 per person
Orthodontia
N/A
N/A
$1,500 lifetime maximum for dependents up to age 19
* Additional employee payment responsibility known as ‘Balance Billing’ applies to all out of network services
Employee Contributions
PPOLOWPRE-TAXCOSTS
PPOHIGHPRE-TAXCOSTS
Monthly Cost
Per Pay Period
Monthly Cost
Per Pay Period
Employee
$16.25
$45.36
$7.50
$20.94
Employee + Spouse
$31.95
$83.75
$14.75
$38.65
Employee + Child(ren)
$45.06
$121.81
$20.80
$56.22
Family
$60.90
$169.35
$28.11
$78.16
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Vision Plan | Highlights
Eligibility
First day of the month after 30 days of employment. Full-time staff only (minimum of 30 hours a week).
Plan Highlights
InNetwork
Out ofNetwork
Annual Exam
$10 copay every 12months
$45 allowance
Single Lense
$25 every 12 months
$30 allowance
Bifocal Lense
$25 every 12 months
$50 allowance
Trifocal Lense
$25 every 12 months
$65 allowance
Frames
$150 + 20% off balance every 24months
$70 allowance
Elective Contacts
$150
$105 allowance
Necessary Contacts
$25 per 12 months
$210 allowance
Employee Contributions
Pre-tax Monthly Contribution
Per Pay Period
Employee
$6.94
$3.20
Employee + Spouse
$12.91
$5.96
Employee + Child(ren)
$13.49
$6.23
Family
$20.77
$9.59
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Supplemental Coverage
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Supplemental Health Explained
VPP offers optional supplemental health benefits through Cigna. These plans are not medical insurance and do not replace your medical coverage but rather pay cash directly to you in addition to any benefits you receive from your health plan.
The plans are designed to help offset expenses associated with unexpected injuries, illnesses, and hospital stays, such as deductibles, copays, and lost income.
Insurance policies available for purchase (through after-tax payroll deductions) include insurance for Accidents, Hospital Care, and Critical Illness.
Supplemental Health Plan Types
Accident Insurance
Hospital Care Insurance
Critical Illness Insurance
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Critical Illness Supplemental Health
CRITICAL ILLNESS INSURANCE This insurance pays a lump-sum cash benefit directly to you following the diagnosis of a covered critical illness or event, such as a heart attack, stroke or cancer. The benefit is yours to use however you want, including paying for healthcare expenses, mortgage, rent, or other bills. Coverage Options You can choose from three cash benefit levels for yourself : • $10,000 • $20,000 • $30,000 Coverage is also available for spouses and children, not to exceed 50% of the employee’s benefit.
Covered Illnesses or Events*
100% Benefit
25% Benefit
Invasive Cancer
Coronary Artery Disease
Heart Attack
Carcinoma in Situ
Stroke
Severe Sepsis
Major Organ Failure
Alzheimer’s Disease
End-stage Renal Disease
ALS
Benign Brain Tumor
Parkinson’s Disease
Advanced Heart Failure
Multiple Sclerosis
Child Conditions: includes Cerebral Palsy, Cystic Fibrosis, Muscular Dystrophy, Poliomyelitis, Sickle Cell Anemia
Pulmonary Embolism
Crohn’s Disease
Advanced Obesity
Portability included – allowing you to take the policy with you if you end employment.
WELLNESS BENEFIT Critical Illness Insurance includes an annual benefit of $50 for you and covered spouse when you take a covered health screening test. Over 40 different screenings qualify, including: • Cholesterol screening • Mammogram • Immunizations, e.g., Covid-19
*Please refer to the benefit plan summaries for details and rates on all policies.
Employee Cost for Critical Illness Insurance
Rates for critical illness are based on your age and the benefit level selected. See Paycom for more information.
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Accident Supplemental Health
ACCIDENT INSURANCE
This insurance pays benefits directly to you to help offset the out-of-pocket expenses associated with an unexpected injury requiring medical treatment, such as deductibles or copays. Benefit payments are based on a schedule of injuries and treatments. The benefit is yours to use however you want, including paying for healthcare expenses, mortgage, rent, or other bills.
Over 80 Injuries and Services Covered
Below is a short list of injuries and services that may qualify for a benefit payment: • Ambulance services • Burns & Lacerations (cuts) • Concussions • Emergency room and urgent care • Fractures/dislocations • Hospital admissions and stays • Medical appliances (e.g., crutches, wheelchairs) • Physical Therapy
EXAMPLE CLAIM: Jim crashed his bicycle and was taken to the emergency room for treatment. He was diagnosed with a torn ligament. He required surgery to repair his torn ligament, and he missed several days of work. Fortunately, Jim’s Accidental Injury plan paid him $2,437.50 to help keep him afloat financially while he made a full recovery.
Coverage Options: Coverage is available to employees, spouses and dependent children.
Injuries & Treatment
Plan 1 Benefits
Organized and Personal Sports Benefits
Ambulance
$200
The plan will pay benefits when you or covered family member are injured while participating in an organized sport or personal sporting activity for physical fitness. ▪ Scholastic or amateur athletic competition or supervised practice ▪ Any sport or physical activity with the goal to improve physical fitness ▪ Enhances benefit payout by 25%
Emergency Room
$300
Diagnostic MRI
$300
Surgical repair of ACL
$600
Crutches (medical appliance)
$150
3 Follow Up Visits
$150
Physical Therapy (10 visits)
$250
Sports Injury Benefit Enhancement
+25%
Portability included – allowing you to take the policy with you if you end employment.
Total Benefit
$2,437.50
Please refer to the benefit plan summaries for a full schedule of benefits and more coverage details.
Bi-weekly Cost for Accident Insurance
EE only EE & SP EE & CH FAM
$5.69
$9.30
$9.37
$12.98
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Hospital Care Supplemental Health
HOSPITAL CARE INSURANCE
This insurance pays benefits directly to you to help offset the out-of-pocket expenses associated with an unexpected hospital stay, such as deductibles, copays or lost income. Benefits are paid based on inpatient hospital admissions and confinement. The benefit is yours to use however you want, including paying for healthcare expenses, mortgage, rent, or other bills.
EXAMPLE CLAIM: Laura is admitted the hospital to give birth to her new baby. Her normal delivery kept her in the hospital for a total of three days. Fortunately, Laura’s Hospital Care plan paid her $1,700 to help cover her medical costs – benefits that allowed her to focus on her new baby rather than the financial impact of the hospitalization
Covered Events
Hospital Admissions Hospital Stays
Intensive Care Unit Stays Hospital Observation stays Newborn Nursery Care Hospital Admission for Chronic Conditions
Laura’s Hospital Stay
Benefit Payments
Coverage Options Coverage is available to employees, spouses and dependent children
Hospital Admission
$1.000
2 Additional Days of Confinement
$400
Additional Benefits No pre-existing condition exclusions
Newborn Nursery Care (3 days)
$300
Portability included – allowing you to take the policy with you if you end employment.
Total Benefit
$1,700
Bi-weekly Cost for Hospital Care Insurance
EE Only EE & SP EE & CH FAMILY
$5.48
$11.49
$8.88
$14.89
Please refer to the benefit plan summaries for a full schedule of benefits and more coverage details.
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Short – Term Disability
This benefit is paid for 100% by VPP. There is no cost to you, the employee.
VPP provides employees with group short-term coverage for those unexpected situations that may keep you from performing the daily responsibilities of your job.
Your disability plan is available to help supplement your income when you are not able to continue employment for a certain period of time. Short-term disability benefits may be reduced by benefits received from state disability or temporary worker’s compensation programs. Total benefits received from the policy, state disability, temporary worker’s compensation programs and employers’ Paid Time Off pay may not exceed 100% of your income prior to your disability.
ELIGIBILITY
All Members
Job Class
All active, full-time employees (except seasonal, temporary, or contract workers) who work at least 30 hours per week
Eligible Members
BENEFITS PAYABLE
50% of your pre-disability earnings up to $1,000
Primary Weekly Benefit
Primary Weekly Benefit less other income sources
Benefit Amount
Base wage
Definition of Earnings
BENEFIT QUALIFICATION
Benefits begin on the 8th day for accident and 8th day for sickness
Elimination Period
Up to 12 weeks after the elimination period is satisfied
Benefit Payment Period
Treated the same as any other disability
Maternity
ADDITIONAL BENEFITS
Rehabilitation Incentive Benefit
5% increase in the primary weekly benefit
LIMITATIONS & EXCLUSIONS
There are additional limitations to your coverage. A complete list is included in your booklet.
Other Limitations
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Life and AD&D Coverage Levels
Eligibility
New hires can enroll up to the guaranteed issue amounts listed in the chart below. Any amount beyond the guaranteed issue amount requires Evidence of Insurability (EOI).
At Open Enrollment, employees may make certain increases annually without EOI up to the amounts below. No Statement of Health Required.
Voluntary Term Life Insurance For Purchase
Annual Open Enrollment Increase
Guaranteed Issue (New Hires Only)
Minimum
Maximum
You
$10,000
$200,000
$20,000
$500,000
Spouse
$5,000
$40,000
$10,000
$100,000
Child(ren)
$5,000
All Amounts
$5,000
$20,000
Voluntary Term Life Monthly Rates Per $1,000
Age 1
Employee
Spouse
29 & Under
$0.08
$0.08
30-34
$0.09
$0.09
35-39
$0.14
$0.14
40-44
$0.21
$0.21
45-49
$0.33
$0.33
50-54
$0.54
$0.54
55-59
$0.87
$0.87
60-64
$1.32
$1.32
65-69
$2.25
$2.25
70 & Over
$4.05
$4.05
1 Age band changes are applied on the date of VPP’s policy anniversary (7/1). 2 The spouse is charged based upon his/her individual age on the policy anniversary. 3 Your spouse cannot elect life insurance if you, the employee, choose not to. 4 Benefits begin to reduce at age 65.
Additional Life Benefits
✓ Accelerated benefits if you become terminally ill (Tax consequences may result. Eligibility for public assistance may be affected. Consult your tax advisor.) ✓ Waiver of premium if you become disabled ✓ Ability to take your coverage with you, if you leave your company ✓ Accidental Death & Dismemberment coverage
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Commuter Benefits Wex
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Retirement 401k
Your Retirement Coverage
VPP encourages you to accumulate savings for retirement through convenient 401(k) pre-tax and Roth (after- tax) payroll deductions. As a full time or part time employee, you are eligible to participate in the 401(k) plan on the first pay period of a calendar quarter (Jan 1 April 1, July 1, Oct 1) after you have completed 90 days of service. For example: If you started on January 20, you would be eligible on the first pay period after July 1st. Since your 90th day of employment fell on April 20, you’d have missed the April 1 deadline and would be eligible to start on the next calendar quarter, which would be July 1. New hires are automatically enrolled in the plan with a 3% pre-tax contribution; however, you may make changes at any time. By logging into the Principal, you may modify the auto-enrollment percentage to a higher/lower percentage or flat-dollar amount, and/or enroll in Roth contributions. You can also update your investment funds at any time. You may allocate a portion of your pay (from 1% to 100%) into the plan up to the maximum amounts set by the IRS. Those who are 50 years of age or older are also eligible to make “catch - up” contributions. For 2022, the annual IRS maximum for employee contributions is $23,100 and $7,500 for catch-up.
All your individual contributions are 100% vested immediately.
Years of Service
Vested Percent
0
0%
1
20%
All individual contributions vested 100% immediately.
2
40%
3
60%
4
80%
5 or more 100% Vested percent is based on the employee’s hire date with the hospital and not when they partnered with VPP.
Employer Match
Your Contribution
1%
2%
3%
4%
5%
6%
Company Match
1%
1.50%
2%
2.50%
3%
3.50%
VPP offers 100% employer match on the first 1% of your contributions and 50% match from 2% up to 6% of your contributions. The maximum match is 3.5% if you contribute 6%.
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Employee Assistance Plan EAP EAP Employee Assistance Plan
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Employee Discount Center BenefitHub
Welcome To The VPP Employee Discount Center
The Benefit Hub – exclusive to VPP employees - allows you to access thousands of amazing discounts and deals on travel, restaurants, shopping, family and pet care, car rentals, your favorite local establishments and much more, all through an easy-to-use online marketplace.
Sign Up and Start Saving:
Go to https://vpp.benefithub.com/
Scroll down to 'Create an Account’
Enter your email address & confirm
Complete the registration process and enjoy access to thousands of discounts!
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Carrier Contacts Medical
Medical 800-962-6842 www.aetna.com
Medical 800-925-2272 www.meritain.com
Prescription 800-334-8134 www.rxbenefits.com
Prescription 800-356-3477 www.optumrx.com
AGM | An Enrollment Support Service 844-880-6774 https://a.flexbooker.com/reserve/VPP
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Carrier Contacts Additional Benefits
Health Savings Account 866-520-4472 www.umb.com/hsa
Dental, Vision, Voluntary Life, AD&D, Short Term Disability & 401K 800-986-3343 www.principal.com
Supplemental Health Benefits 800-754-3207 www.myCigna.com
Employee Assistance Program (EAP) 888-881-5462 www.supportlinc.com
Cobra & Commuter Benefits 866-451-3399 www.wexhealth.com
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Employee Compliance Notices
For Information on all employee compliance notifications please scan the QR code below
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