Benefits & Compensation Phone: 301-877-4567HEALTH CARE BENEFIT PLANS
General Information
Who Is Eligible?
All active employees employed by Southern Maryland Hospital Center or one of its affiliates, other than the Colony South Hotel, who are regularly scheduled to work at least 20 hours per week and who have completed the required waiting period (sixty (60) days of active employment) are eligible to participate in the Southern Maryland Benefit Plans.In addition, participating employees may elect to cover their eligible dependents.
Eligible dependents include:
-your spouse, unless legally separated -your unmarried children under 25 years of agewho are primarily dependent upon you for maintenance & support and are not regularly employed on a full-time basis.(Dependent children include natural children, stepchildren, or legally adopted children)
Plan Features
The programs provided under these plans are as follows: -Medical/Vision Care -Dental Care -Prescription Drug Coverage -Short / Long Term Disability (after 1 year of full-time service) -Basic / Supplemental Life Insurance -401(k) Retirement Savings Plan -Flexible Spending Accounts -Training & Education -Vacation/Sick/Bereavement Leave - Holiday Pay
Medical Care Benefits
CareFirst Blue Choice - Health Maintenance Organization (HMO) Our HMO is designed to be a fully managed care plan, in that all specialty care must be recommended or referred to an CareFirst specialist by your Primary Care Physician (PCP).Office visits rendered by your PCP are covered in full after the $20 co-payment per visit.CareFirst provides an extensive directory of participating physicians and all care must be provided by those listed in the directory.Routine physicals, health assessments and well-baby care are covered after the $20 co-pay.All inpatient care must be pre-certified by CareFirst.All emergency room visits and hospital admissions are covered the same, as long as the facility you visit accepts are CareFirst.
The POS is designed to allow you a little more flexibility.If you select the POS you can utilize the “In Plan” benefits or “Out of Network” benefits.If you stay in network, you will have only co-pays (like the HMO) for your office visits.You will still need to get a referral if using the coverage like an HMO.If you use the out of network, you don’t have to get referrals.However, there is a $300 deductible per person and that maxes out at $600 per family.After you’ve met the deductible, your responsibility would be 20% of the bill, plus anything that is considered over reasonable and customary.“Reasonable & Customary” means any fee that is over the negotiated cost for that particular exam, procedure, etc.
Prescription Drug Coverage
The RX plan has a $100 deductible per family member and once deductible is met you have co-payments of $10 for Tier 1, $30 for Tier 2, and $50 for Tier 3 prescription or refill when using a participating pharmacy.You are responsible for paying the lower of the applicable co-payment or the retail Network Pharmacy’s Usual and Customary charge, or the lower co-payment for the Home Delivery drug costs.With the exception of insulin and injectable contraceptive drugs, there is a 20@ co-payment of pharmacy rate up to $50 for injectables.One (1) co-payment per 31 days consecutive supply for retail drugs and three (3) co-payments per 90 day supply for mail order drugs.Oral contraceptives have 3 co-payments for a 3-cycle supply.
Vision Care Benefits
Davis Vision provides your vision care; it’s a discount plan.There is an insert, which gives you a number to call.They will tell you what optical facilities that participate with CareFirst.
Dental Care Benefits
Dental care benefits are offered through The Southern Maryland Health Group, through DentaQuest.There are three plans you can choose from.
Plan 1- Classic DHMO, which is a Dental Health Maintenance Organization Plan.The DHMO offers low cost, no deductibles, a defined fee schedule, no claim forms, and the only plan that offers child orthodontic benefits.To enroll in this plan, you must select an “open” Participating Dentist from the Classic DHMO directory.This plan does provide the best value.
Plan 2 – Access PPO, which is a Preferred Provider Organization Plan.The Access network is larger than the Classic.This plan does allow you to go in or out of the network.It is a mid-priced plan, and reimburses at a higher percentage for services performed by an In-network provider.
Plan 3 – Choice PPO, is a Preferred Provider Organization Plan.This Choice PPO network is larger than the Access plan.This plan is priced slightly higher, and reimburses In and Out of network at the same percentage.
With either PPO plan you can see ANY dentist.However, you will receive the greatest value when visiting an In-network participating dentist.Participating PPO network dentists have an agreed to accept discounted fees for services provided and will not balance bill you.Furthermore, you will never have to complete claim forms when seeing a participating dentist.
Short Term / Long Term Disability
Short Term Disability Plan is income replacement in the event of an eligible illness or accident.60% or your salary paid up to a $750 weekly maximum.This is a voluntary benefit offered on a payroll deduction basis.Cost is based on age and weekly benefit.You may enroll after 12 months of full-time employment (1.0 or .9).You will be contacted prior to your 1-year anniversary to enroll.
Long Term Disability Plan will provide you with 60% of your monthly earnings after a 6month waiting period in the event of becoming disabled.You are automatically enrolled after 12 months of continuous full-time employment (1.0 or .9).Southern Maryland pays the premium; employees pay 25 cents per pay period for an administrative fee.
Basic / Voluntary Life & AD&D Insurance Basic Life and AD&D is for full and part-time employees (.5 to 1.0FTE). The amount is 1 times your annually salary up to $100,000.Southern Maryland pays the premium for this.You become eligible after 60 days, and the benefits are effective the first of the month following 60 days.
Voluntary Life is for full and part-time employees (.5 to 1.0 FTE).This is group term insurance purchased in increments on you and your dependents.It is age banded – group rates, and you would pay via payroll deductions.The guaranteed issue amount for employees is $200,000, should you elect over that amount you will need to complete a personal health inventory (PHI) and send to the carrier for medical review.The guaranteed issue amount for spouses is $20,000, and you must complete a PHI if you elect over that amount.The maximum amount for children is $10,000.You can only increase the amounts of coverage during our annual open enrollment.
401(k) Retirement Savings Plan (Great West Life)
Employees become eligible after completing 500 hours of service within in the first 6 months.Employees may contribute up to $15,000.Southern Maryland will match 50% of the employee’s contribution up to the first 4%.You elect the deferral amount.Once you meet the criteria, you must complete the election form.Open enrollment periods are only offered in January and July.
Flexible Spending Accounts (FSA)
This is offered to full and part-time employees (.5 to 1.0 FTE).This plan allows employees to allocate pre-tax monies to pay for uncovered medical, dental, vision, over the counter medications, and for dependent care expenses.
Training and Education
Training – This benefit is offered to full and pat-time employees (.5 to 1.0 FTE) for SMHC workshops, In-service training and seminars.Southern Maryland may reimburse paid time off and registration fees.
Education – is offered to full-time employees only (1.0 or .9 FTE).Southern Maryland may reimburse registration fees and tuition is reimbursed at the Bowie State rate.
These benefits are available after 90 days of continuous employment.Forms for reimbursement are located in the HR Department.
Vacation / Sick / Bereavement Leave
Vacation leave is available to full-time, part-time, part-time occasional employees.You begin accruing as of your hire date.You must complete a 90-day probationary period prior to using paid time off.Maximum carryover is 2-½ times annual allotted accrual.
New employees earn up to 10 days per year
After 3 years you can earn up to 15 days per year
After 7 years you earn up to 20 days per year
Part-time employees accrue on a pro-rated basis
Sick leave is available to full-time, part-time, and part-time occasional employees.You begin accruing as of your hire date, but must complete a 90-day probationary period prior to using your sick leave.You can only use sick leave for your illness only.Full-time employees accrue 10 days per year and part-time employees accrue on a pro rated basis on actual hours worked.
Holidays Southern Maryland observes the following holidays:
New Year’s Day
Memorial Day
Independence Day
Labor Day
Thanksgiving Day
Christmas Day
Your Birthday
Full-time employees receive 8 hours of holiday and part-time (.95 - .5) receive 4 hours of holiday.
Applying for Benefits
Eligible employees must turn in their enrollment paperwork (pre-tax forms and applications) within 60 days of being hired.Insurance coverage will be in effect on the first day of the month following your first 60 days of employment.Employees who do not submit the appropriate forms within 60 days will be considered as waiving coverage until they have a status change as defined below.
Changing Your Benefit Selection
Re-enrollment
The Internal Revenue Service regulations pertaining to Pre-Tax Benefit Programs provide plan participants the opportunity to make changes to current benefit selections only during the re-enrollment period.Or during the plan year only if one of the following family status changes takes place:
Family Status Change
You may change your election to participate in the medical or dental plan, change your membership designation, or waive coverage during the year only if you have had a family status change as defined by the Internal Revenue Service.A family status change is defined as: -Marriage, divorce or legal separation -Death of a spouse or other qualified dependent -Birth or adoption of a child -Change in employment status from full-time to part-time (or vice versa) -Change (commencement or termination) in the employment of your spouse -Taking of an unpaid leave by either you or your spouse -Significant change in your spouse's health benefit coverage - Change in eligibility of a dependent child
Election changes, membership designation changes, or waiving coverage must be on account of and consistent with the family status change and made within thirty (30) days of the occurrence of the change in family status and must be accompanied by the proper documentation.
NOTE:Even if you have family coverage, newborn children must be added to the Plan within thirty (30) days of birth/adoption.
Other Benefits Include:
Discount membership to Fitness Center located at Colony South Hotel
Andrews Federal Credit Union Membership
Free Parking
Cafeteria Discounts
BENEFIT SUMMARY
Flexible Scheduling
Shift Differentials
Uniform Ordering – Available through payroll deduction at - discount prices
Medical Benefits – Choose from a Point of Service or HMO (Both include an Rx card, discount dental and vision coverage)
Dental Benefits – Choose from Dental HMO or Indemnity Plan
Life Insurance – 1 times salary, paid in full by the hospital
Supplemental Life – Additional life insurance for you and your dependents
Long Term Disability – Paid in full by the hospital
401(k) Plan – Eligible after 6 months of employment - - - Hospital will match 50% of employees contribution up to 4%
Education and Training Benefits – Includes college tuition and seminars
Vacation and Sick Leave – Accrued each pay period
Paid Holidays – Includes your birthday
Paid Bereavement Leave – Up to 3 days for an immediate family member
Fitness Facility, including pool on hospital grounds – reduced fees for membership
