INSIDE

inside
02 Navigating Benefits
04 Step 1: Set Limits
06 Step 2: Shop Smart
07 Step 3: Kick the Tires
08 Step 4: Consider Alternative Routes
10 Health Plan Comparison Chart
12 Step 5: Drive Communications
14 Step 6: Put Wellness to Work
17 Step 7: Ask for Medicare Directions
20 Road Side Assistance
1 • COSE Update Special Insert • June 2009 (216) 592-2222

Navigating the Winding
Road of Benefits
You’re in the driver’s seat. So here are directions to finding affordable benefits
solutions designed specifically for small businesses.
It’s an employee retention tool, a morale booster and a productivity driver.
Families depend on it—and so do you, the business owner. Health benefits are
a critical part of overall compensation because they protect the bottom line by
“insuring” a company’s greatest asset. People.
Also, benefits and wellness are an investment business owners take seriously
because the stakes are so high. Compromising on health insurance can
inadvertently affect the bottom line. We know that employees who stay well
perform better in the workplace. “An effective benefits plan will not only keep
employees healthy, it will prevent absenteeism, tardiness and turnover,” says
Patty Starr, senior director of health insurance and benefits, COSE.
No business can afford to give benefits less than 100 percent attention.
“In order to retain employees, you have to offer solid benefits,” says Lisa
Logan, executive vice president, Logan Clutch Corp., Cleveland. “When you look
at how layoffs and pay cuts affect the workforce, you don’t want to cut benefits
because that really affects families.”
COSE learned from its 2009 Employer Benefits Survey that more than half
of small business respondents echo Logan’s sentiments. Despite a challenging
economy, 56 percent of Northeast Ohio employers with health insurance cover at
least 80 percent of premium costs for employees. Thirty-eight percent cover 100
percent of premium costs. And only 13 percent reported some decrease in health
insurance coverage due to economic factors.
But according to the 2008 Kaiser Family Foundation Employer Health
Benefits study, large percentages of firms are likely to make changes by increasing
the amount workers contribute to
premiums (40%), increasing deductible
amounts (41%), increasing office visit
cost sharing (45%), or increasing
the amount that employees pay for
prescriptions drugs (41%).
Now, more than ever, small
employers have to take a close look at
how their managing their benefits.
And as employers work to provide
affordable, quality health insurance to
employees, they are also recognizing
that they must educate their workers.
Because the fact is, employers are
much more than the purchaser and
distributor of plans that bundle medical
and wellness solutions, prescription
coverage, vision and dental. They
are also the primary “instructor”
explaining to employees the value and
opportunities benefits offer.
“The business owner is a provider
of information,” Starr explains. “Since
Ask for Directions
Whether you’re considering COSE membership, or
weighing the opportunities of benefits renewal, this is your
chance to get the maximum return on your benefits investment.
For more than 35 years, COSE has provided health benefits
designed exclusively for Northeast Ohio small businesses. We
research, we listen, and we work hard everyday to provide the
best benefit opportunities to Northeast Ohio small employers.
Renewal time is your chance to offer some new options that
could help save money without compromising quality care.
Also consider making your benefits package more attractive
by adding vision, dental and life insurance without adding
significant cost.
But we also go a step further for members than the average
provider. We’ve designed a proven benefits selection process
that includes useful tools and resources that can guide you
toward the best options for your company, including:
Benefits Review Sessions are free, 45-minute, one-onone
sessions with COSE benefits experts that can help you fully
2 • COSE Update Special Insert • June 2009 (216) 592-2222

Survey
benefits are such a large investment, it’s important for
employers to take on the role of educator to help employees
make responsible choices concerning their health and
utilization of the company benefits plan.”
If business owners are the instructors, then COSE is the
experienced curriculum provider.
Staffed with seasoned experts who are accessible for
one-on-one Benefits Review Sessions (visit cose.org/brs for
dates and locations), COSE provides employers with the
tools necessary to make the best benefits decisions for the
company, and to educate employees so they can take full
advantage of company-sponsored plans.
“We know it’s not easy to navigate the world of benefits,
so we actively engage employers in Benefits Review Sessions
and help them customize a plan,” says Starr. “We are here to
help them cut through the red tape and really understand
what their plans offer and what changes they could make to
get the best value and create a quality product.”
The initial selection of plans and the renewal process
does involve some analysis, but we’re here to help with
our seven step process to finding a benefits solution. Sit
down with a COSE expert during one of our scheduled
Benefits Review Sessions or don’t hesitate to call our
Customer Service representatives as you work through all
your options.
The energy you invest in finding the best solution will
pay off for your business.
Have economic conditions changed
employee health insurance coverage?
No change 49%
Asking employees to share more costs 12%
Considering decreasing or discontinuing coverage 11%
Some decreases in coverage 11%
No longer offering coverage 2%
Source: 2009 COSE Employer Benefits Survey
Nationally, businesses are considering changes.
Office visit cost sharing 45%
Deductible amounts 41%
Prescriptions drugs 41%
Amount employees contribute to premiums 40%
Source: 2008 Kaiser Family Foundation Employer Health Benefits study.
Since “ benefits are such a large
investment, it’s important for
employers to take on the role of
educator to help employees make
responsible choices concerning
their health and utilization of the
company benefits plan.”
–Patty Starr, COSE
understand your benefits options and customize those options
to meet the needs of your employees and your bottom line.
Renewal packets are mailed prior to your benefits renewal
period and contain everything necessary to review and make
changes to your current benefits design.
Customer Service Representatives are available
during regular business hours to help you determine the right
mix of benefits for your small business.
(216) 592-2222 or customerservice@cose.org
cose.org/benefits

Set Limits
How much of your budget can you reserve for benefits? The answer to this
question is different for every company, and there is not a one-size-fits-all
solution in the benefits arena. That’s why COSE offers more than 35 base
plans and, ultimately, more than 120 different plan designs.
To determine what type of plan(s) is the best fit for your organization, first
establish an annual benefits limit, which is a fixed amount or percentage of
monthly income that you are willing to contribute to each employee’s benefits plan.
Evaluate employee turnover and realistically consider how you compensate
employees for their hard work. Are you giving back to your staff by providing
them with the benefits they need to maintain a healthy and productive life?
“Evaluate employee wants
and needs so you can
determine whether
you’re offering plan
designs that match your
employee population.”
–Patty Starr, COSE
Benefits Checklist
Establish an annual benefits limit. A fixed amount that an
employer is willing to contribute for each employee’s benefits plan.
Evaluate staff turnover and realistically look at how
you’re paying employees for their services compared to their
benefits structure.
Review what plan characteristics are most important
to your employees. Gather the information through informal
and confidential surveys.
Consider offering a base plan with buy-up, buydown
options. Remember, COSE allows you to offer up to
two different plans plus a Health Savings Account (HSA) or
Health Reimbursement Arrangement (HRA) for a total of three
plan offerings.
Compare apples-to-apples. If you shop around for
benefits, look at the same deductibles, out-of-pocket costs,
copays and prescription drug benefits, and whether there are
monthly administrative fees. Although we believe that COSE is
4 • COSE Update Special Insert • June 2009 (216) 592-2222

Although we believe that
COSE is offering you the best
price, let us know if you find
one that is better. We can
work with the carrier to
better your rate.
What is important to your employees and how do they
really use their benefits? “Evaluate employee wants and
needs so you can determine whether you’re offering plan
designs that match your employee population,” Starr says
Kelly Frye, president of Ten 29 Design in Ohio City, went
through this exercise during a COSE Benefits Review Session
and learned that he could be saving a couple hundred dollars
each month by changing his benefits plan design.
By listing his wife, co-conspirator in the business, as a
dependent rather than an employee, Frye and his family get
the same quality coverage at a lower cost.
“We were educated more during the 45-minute Review
Session than we have ever been,” Frye says. “We are a
healthy family, so we were concerned that we were
spending too much and we wanted to cut costs. We were
able to accomplish that.”
As you review how you and employees use benefits, take
this opportunity to educate your workforce on the true cost
of health insurance. Show them how smart choices
concerning plan utilization can make a difference in your
company’s total cost.
Starr recommends distributing a compensation
breakdown that shows how much an employee truly gets
paid in terms of salary and benefits at least annually.
“Benefits can make up a significant portion of overall
compensation,” she says.
Recently, the Zaremba Group in Lakewood conducted a
staff survey asking employees to estimate benefits costs.
After reviewing the responses, Zaremba crafted a
communication plan to help employees better understand
the true cost of their benefits package.
offering you the best price, let us know if you find one that is
better. We can work with the carrier to better your rate.
Review what’s out there and determine if your benefits
package is competitive in your industry and in the overall
regional marketplace.
Communicate with employees, not only annually about
benefits coverage, but quarterly to help them better understand
their health care options and the costs associated with these
benefits. Also encourage employees to use wellness or
preventive measures available through their health insurance
plan and the COSE Wellness Program. Such efforts can pay big
dividends for workers and for you in terms of improved health,
increased productivity and lower-long-term health care costs.
Think about compensating employees who opt out of
benefits if they can receive them through another plan.
(216) 592-2222 or customerservice@cose.org
cose.org/benefits June 2009 • COSE Update Special Insert • 5

Shop Smart
Health insurance
and wellness
offerings are an
important factor in
employee attraction
and retention.
What type of benefits do other
companies in the region
offer employees?
Compare your benefits plan with
other businesses in your industry.
Also consult with a COSE
representative to find out what other
members provide workers.
Remember, health insurance and
wellness offerings are an important
factor in employee attraction and
retention, so be sure your plan is
relevant and highly valued.
Curious to know what benefits
other companies in this area offer
their employees?
Ask. Talk with other small business
owners at networking events or
health insurance presentations. Or
consider asking competitors and your
accountant for insight while making a
benefits decision.
And most importantly, ask your
employees. They may have knowledge
of what other companies are offering,
and they will definitely provide
feedback on what they prefer in a
health plan—but only if you ask.
Case in point: By adding vision
coverage, Precision Fittings took into
consideration its employees needs.
Precision Fittings employees may
need to wear safety glasses, depending
on an employees’ position. The
company’s benefits plan includes free
eye exams and complete coverage for
safety glasses. Employees who require
prescription glasses get a discount,
explains Renee Pavelko, payroll and
benefits administrator at Precision
Fittings in Wellington.
Lisa Logan, executive vice
president of Logan Clutch Corp.
in Cleveland is careful to consult
with employees every year prior to
benefits renewal. “Since we have a
family-owned business, we are all
working toward the common goal
to get the best product for the
best price,” she says. “We are all in
this together.”
Keep in mind, through COSE you
can offer up to three different plans
including an HSA or HRA option.
Consider the value of offering a base
plan with an employee buy-up to
richer benefits.
6 • COSE Update Special Insert • June 2009 (216) 592-2222

Kick the Tires
With more than 120 benefit
plans configurations available
to COSE members, how do
you compare the plan you have with
others you’re considering? To get the
real story on value and cost, you must
compare apples-to-apples.
If you shop for health care benefits,
at the very least make a list of these
key comparables:
• deductibles
• co-insurance
• copays
• out-of-pocket maximum
• lifetime/annual maximum
• prescription drug benefits
• administrative costs
The area that business owners are
most likely to overlook during a plan
comparison is out-of-pocket
maximums, says Patty Starr, senior
director of health insurance and
benefits for COSE. “You will find a
large variation there, and some really
big surprises,” she says.
Consider this example. You get a
medical procedure with a $10,000
ticket price. Your insurance
deductible is $500. That brings the
invoice down to $9,500. But with an
80/20 plan and an out-of-pocket of
$1,250, you must pay 20 percent of the
cost until your 20 percent reaches
$1,250. So the out-of-pocket expense—
including the deductible—is $1,750. In
this scenario, you will meet your
deductible and out-of-pocket expense
with this single claim.
To get the real story on value and cost, you
must compare apples-to-apples.
But using the same scenario,
compare this out-of-pocket cost under
a different plan that requires paying 50
percent of the cost with an out-ofpacket
of $3,000. Now your total
medical expenditure is $3,500. Here
you will not meet your out-of-pocket
limit, so additional claims during the
benefit period may require 50 percent
payment until you reach your out-ofpocket
limit. Bottom line, this option is
more expensive for employees.
A COSE Benefits Review Session is
an ideal opportunity to hash through
all these details. Judy Seidel, an
independent travel consultant and
owner of Judith A. Seidel, CTC, LLC,
decided four years ago to get a Health
Savings Account (HSA). “I realized
that it would be more beneficial to
decrease my monthly premium and
have the savings for a really big event
rather than paying a higher premium
every month,” she says.
Aside from comparing all of the
numbers, consider the wellness benefits
a plan may provide. “We believe that
wellness program participation will
help avoid costly health issues in the
future,” Seidel says.
What percentage of
premium costs do you
cover for employees?
100 percent coverage 39%
80 percent coverage 19%
50 percent coverage 12%
Less than 50 percent 8%
Source: 2009 COSE Employer Benefits Survey
cose.org/benefits
June 2009 • COSE Update Special Insert • 7

Consider Alternative
Routes
More business owners today are
turning to Health Savings
Accounts (HSAs) to provide
employees with flexibility and control
over their coverage. In fact, 35 percent
of COSE survey respondents reported
offering an alternative health care funding
option, such as an HSA, Health
Reimbursement Arrangement (HRA)
or Flexible Spending Account (FSA).
That’s up from 20 percent from 2008.
Logan Clutch Corp. began offering
HSAs to employees in January. Currently,
the company owners and product line
managers are taking advantage of the
alternative funding solution. Lisa Logan,
executive vice president, says managers
Think of these plans as bank
accounts that provide
employees with unprecedented
control over their earned
health care dollars.
will use their experience to educate
other employees about the plan.
“If we can give our staff a personal
testimony and say, ‘We tried it. It’s O.K.
Here is how it works,’ they might feel
more secure,” Logan says.
While there is some confusion
concerning how these “alternatives”
work, businesses are embracing these
plans because they can give employees
the perk of an insurance fund that is
flexible, portable (they can take it with
them if they switch employers), and
capable of providing tax advantages.
Still not sure how this could work
for your company? Think of these
plans as bank accounts that provide
employees with unprecedented
control over their earned health
care dollars. They can spend it, or
they can save it—but most important,
employees will soon realize the
true cost of health care and it
won’t take long until they are more
informed consumers.
*COSE strongly encourages participants to
consult with both their accountant and attorney
to discover the best option for their business.
Health Savings Account (HSA) Combines a qualified
high-deductible health plan with a tax-advantaged savings
account, allowing employees to save and pay for routine
medical expenses with pre-tax dollars. Employees own their
account and unused dollars roll over year after year.
Who qualifies? Any individual covered by a qualified high
deductible health plan (HDHP) who is not covered by other
health insurance, Medicare, or is claimed as a dependent.
Health Reimbursement Arrangement (HRA)
An employer funded account that provides reimbursement
for specific employee and dependent medical expenses.
Employees lose unused dollars when they switch employers.
Who qualifies? Any employee that meets an employer’s health
benefits eligibility criteria and are not enrolled in an HSA.
Flexible Spending Account (FSA) Section 125 plans
(the name refers to the section of the Internal Revenue Code)
are also called flexible benefits plans or Flexible Spending
Accounts (FSAs). These plans allow employees to save by
paying for health insurance premiums, out-of-pocket medical
expenses, and child-dependent care expenses with pre-tax
dollars. The company saves by paying lower matching Social
Security and Medicare contributions. However, all dollars
placed in the account will be compromised if not spent by the
end of each year.
Who qualifies? Same as an HRA; however self-employed
individuals are not eligible.
8 • COSE Update Special Insert • June 2009 (216) 592-2222

Compare Alternative Funding Solutions for Yourself
Health Savings Account (HSA) Health Reimbursement Arrangement (HRA) Flexible Spending Account (FSA)
Enacting Law/IRS Code Enacting Law: Medicare Modernization Act of 2003 IRS Code: Section 105 IRS Code: Section 125
Who Owns the
Account?
Eligible employee Employer Eligible Employee
Who Funds the
Account?
Eligible employee, employer and/or other individuals
on behalf of eligible employee
Employer
Eligible employee or employers
How is the Account
Funded?
Deposited directly into account
“Zero-balance account.” This is not a true account
but an agreement or “IOU” by an employer
to pay a portion of qualified medical expenses.
Via payroll deduction; claims are
generally paid as they are submitted
by employee.
Is There A Maximum
Contribution
Per Year?
Individual limit increases from $3,000 in 2009 to
$3,050 in 2010. Family limit increases from $5,950 in
2009 to $6,150 in 2010.
No statutory limit. Simply an arrangement where
employer pays medical expenses.
No statutory limit. Employers
generally set annual plan limit.
Is It A Personal
Account?
Does It Accrue
Interest?
Yes Yes Yes
Yes, tax free No No
What Type Of Health
Plan Is Required,
If Any?
The minimum deductible for individual is $1,150 in 2009
and $1,200 in 2010. The minimum for family coverage
is $2,300 in 2009 and $2,400 in 2010. The maximum
annual out-of-pocket amount for individual coverage is
$5,800 in 2009 and $5,950 in 2010 and family coverage
is $11,600 in 2009 and $11,900 in 2010.
No requirements
No requirements
Can Funds Be Used
To Pay For Non-Qualified
Expenses?
No. Funds used for non-medical expenses are taxed
and/or penalized
—Qualified expenses include more than medical.
Funds may not be used for non-qualified
medical expenses.
No. Funds used for non-medical expenses
are taxed and/or penalized.
What Is The Tax
Treatment?
Contributions are 100% tax deductible. Funds spent
on medical expenses are tax free for life. At 65,
funds used to supplement income are tax-deferred.
Funds used to pay for health expenses are not
reported as income.
Contributions are 100% tax
deductible; funds spent on health
expenses are tax-free (no rollover).
Is There A “Catch Up”
Provision?
$1,000 can be contributed and rollovers will be
permitted.
No
No
Advantages
• Affordability—lower health insurance premiums
• Raises employee awareness of the costs of health
care services
• Tax advantages for employer and employees;
account dollars and interest are 100% tax-free
when used for eligible medical expenses
• Portable—employees own the account
• Savings/Growth Opportunity—gives employees
their own account to pay for long-term health care
costs, grows over time
• Reduced insurance premiums to help stabilize
annual increases
• Gradually raises employee awareness of the
cost of health care services
• Tax-advantaged employer-funded accounts help
pay for day-to-day expenses
• Allows ‘employer pay first’ or ‘employee pay
first’ plan designs
• Competitive administration rates
• Reduces taxable payroll by
reducing your employees’ taxable
income and reduced employer
payroll taxes
• Employees increase take-home pay
• Start a Premium Only Plan (POP)
at any time during the year
•First-year tax savings are generally
greater than the cost of plan
implementation
• Competitive administration rates
COSE Offerings
Six Plan Choices:
• COSE HSA SuperMed Plus 1500
• COSE SuperMed Plus 2000/4000
• COSE HSA SuperMed Plus 2500/100
• COSE HSA SuperMed Plus 3000/100
• COSE HSA SuperMed Plus 4000/100
• COSE HSA SuperMed Plus 5000/100
—All have 100% preventive care coverage, not
subject to deductible. All utilize the SuperMed Plus
network of providers.
• COSE HRA SuperMed Plus 1000/3000
• COSE HRA SuperMed Plus 2000/6000
• COSE HRA SuperMed Plus 2500/5000
• COSE HRA SuperMed Plus 3000/9000
—All have 100% preventive care coverage, not
subject to deductible. All utilize the SuperMed
Plus network of providers.
• Premium Only Plan (POP)
• Flexible Spending Accounts
• Daycare (Child and Elder) Accounts
• Adoption Assistance Accounts
• Commuter Benefits Accounts
COSE Services
Provided By:
HSA compatible insurance plans offered through
Medical Mutual of Ohio; HSA accounts held by
financial institution of employee’s choice
Medical Mutual of Ohio
FlexSave provide by
Medical Mutual of Ohio
The information presented is related to the 2009-2010 calendar year.
cose.org/benefits
June 2009 • COSE Update Special Insert • 9

Health Plan Comparison Chart
Medical mutual of ohio (MMO) Plans — COSE groups can simultaneously offer any two standard plans and one Health Savings Account (HSA) or Health Reimbur
Annual
Deductible
Coinsurance
Out-of-Pocket
Maximum
(excluding
deductible)
Office Visits
250/500
**supermed
plus
*Supermed
classic Gold
Network:
$250 single
$500 family
Non-Network:
$250 single
$500 family
500/1000
**supermed
plus
*Supermed
classic Gold
Network:
$500 single
$1,000 family
Non-Network:
$500 single
$1,000 family
Plus: Network: 80% Non-Network: 64%
Classic Gold: Network: 90% Non-Network: 80%
Plus:
Network: $1,250 single;
$2,500 family
Non-Network:
$2,500 single; $5,000 family
Classic Gold:
$1,250 single; $2,500 family
750/1500
**supermed
plus
*Supermed
classic Gold
Network:
$750 single
$1,500 family
Non-Network:
$750 single
$1,500 family
1000/2000
**supermed
plus
*Supermed
classic Gold
Network:
$1,000 single
$2,000 family
Non-Network:
$1,000 single
$2,000 family
Plus:
Network: $1,500 single;
$3,000 family
Non-Network:
$2,500 single; $5,000 family
Classic Gold:
$1,500 single; $3,000 family
Supermed plus
2080 - 250
Network:
$250 single
$500 family
Non-Network:
$500 single
$1,000 family
Network: 80%
Non-network:
60% for most services
Network:
$2,000 single
$4,000 family
Non-Network:
$4,000 single
$8,000 family
Supermed plus
2080 - 500
Network:
$500 single
$1,000 family
Non-Network:
$1,000 single
$2,000 family
Network:
$2,500 single
$5,000 family
Non-Network:
$5,000 single
$10,000 family
SUPERMED PLUS
2080 - 750
Network:
$750 single
$1,500 family
Non-Network:
$1,500 single
$3,000 family
Network: 80%
Non-network: 60%
Network:
$2,500 single
$5,000 family
Non-network:
$5,000
$10,000
$15 copayment then 100% $20 copayment then 100% $20 copayment then 100% $20 copayment then 100%
SUPERMED PLU
2080 - 1000
Network:
$1,000 single
$2,000 family
Non-Network:
$2,000 single
$4,000 family
Diagnostic
services
Excluding MRi’s
and ct scans
Well Baby &
Child Care
100%
$15 copayment then 100% up to
$1,000 per benefit period
$20 copayment then 100% up to
$1,000 per benefit period
100% 100%
$20 copayment then 100% up to
$1,000 per benefit period
$20 copayment then 100% up to
$1,000 per benefit period
Inpatient
Hospital Care
Inpatient
Maternity
Care
Emergency
Room
Coverage
Plus: 80% after deductible
Classic Gold: 90% after deductible
Plus: 80% after deductible
Classic Gold: 90% after deductible
Plus: $150 copayment then 80%
Classic Gold: $150 copayment then 90%
80% after deductible 80% after deductible
80% after deductible 80% after deductible
$150 copayment then 80% $150 copayment then 80%
Inpatient
Mental Health &
Substance
Abuse
Treatment
Plus: 80% after deductible
Classic Gold: 90% after deductible
(Maximum 30 days per benefit period)
80% after deductible
(Maximum 30 days per benefit period)
80% after deductible
(Maximum 30 days per benefit period)
Outpatient
Mental
Health &
Substance
Abuse
Treatment
Prescription
Drugs
(Oral Contraceptives
& Mail Order
included)
$15 copayment then 80%
after deductible
(Maximum 20 visits per benefit period)
Several RX options available
$20 copayment then 80%
after deductible
(Maximum 20 visits per benefit period)
RX treated like
other medical
expenses
$20 copayment
then 80% after deductible
(Maximum 20 visits per benefit period)
Several RX options available
$20 copayment
then 80% after deductible
(Maximum 20 visits per benefit period)
Several RX options available
NOTE: This comparison chart is a general overview of benefits for COSE-sponsored plans. Specific benefits are listed for services received within the network. This is not a certificate of coverage.
*You may receive services from any hospital or physician network. Network and non-network deductibles apply to each other.
**You must receive services from a SuperMed hospital and a SuperMed Plus physician to receive maximum benefits.
*** This plan utilizes the HMO Health Ohio network and requires the selection of a Primary Care Provider.
10 • COSE Update Special Insert • June 2009 (216) 592-2222

sement Arrangement (HRA) compatible plan.
S
SuperMed
Multiple Option
100
SuperMed
Multiple
Option 90
SuperMed
Multiple
Option 80
Supermed plus
1000/3000 HRA
Supermed plus
2000/6000 HRA
Supermed plus
3000/9000 HRA
SUPERMED PLUS
1500
(Aggregate
Deductible)
SUPERMED PLUS
2000/4000
(Aggregate
Deductible)
Network: None
Non-Network:
$250 single
$500 family
Network: None
Non-Network:
$250 single
$500 family
Network:
$100 single
$200 family
Non-Network:
$250 single
$500 family
Network:
$1,000 single
$3,000 family
Non-Network:
$2,000 single
$6,000 family
Network:
$2,000 single
$6,000 family
Non-Network:
$4,000 single
$12,000 family
Network:
$3,000 single
$9,000 family
Non-Network:
$6,000 single
$18,000 family
Network:
$1,500 single
$3,000 Family
Non-Network:
$3,000 single
$6,000 family
Network:
$2,000 single
$4,000 family
Non-network:
$2,000 single
$4,000 family
Network: 100%
Non-Network: 70%
Network: 90%
Non-Network:
70%
Network: 80%
Non-Network: 60%
Network: 100%
Non-Network: 80% for most services
Network: 100%
Non-Network: 60%
Network: 100%
Non-Network: 60%
Network: None
Non-Network:
$1,500 single
$3,000 family
Network:
$1,250 single
$2,500 family
Non-Network:
$3,000 single
$6,000 family
Network: None
Non-Network:
$4,000 single
$12,000 family
Network: None
Non-Network:
$8,000 single
$24,000 family
Network: None
Non-Network:
$12,000 single
$36,000 family
Network: None
Non-Network:
$3,000 single
$6,000 family
Network: None
Non-Network:
$1,500 single
$3,000 family
$15 copayment
then 100%
$20 copayment
then 100%
$20 copayment
then 100%
$20 copayment then 100% 100%
after deductible
100%
after deductible
100% 100% 100% 100%
100%
after deductible
100%
after deductible
$15 copayment
then 100%
$20 copayment
then 100%
$20 copayment
then 100%
$20 copayment then 100% up to $1,000 per benefit period 100% 100%
100% 90% 80% after
deductible
100% after deductible 100%
after deductible
100%
after deductible
100% 90% 80% after
deductible
100% after deductible 100%
after deductible
100%
after deductible
$150 copayment
then 100%
$150 copayment
then 90%
$150 copayment
then 80%
$150 copayment then 100% 100%
after deductible
(Maximum 30 days
per benefit period)
100%
after deductible
(Maximum 30 days
per benefit period)
100%
(Maximum 30 days
per benefit period)
90%
(Maximum 30
days per benefit
period)
80% after
deductible
(Maximum 30 days
per benefit period)
100% after deductible
(Maximum 30 days per benefit period)
100%
after deductible
(Maximum 30 days
per benefit period)
100%
after deductible
(Maximum 30 days
per benefit period)
$15 copayment
then 100%
(Maximum 20
visits per benefit
period)
$20 copayment
then 90%
(Maximum 20
visits per benefit
period)
$20 copayment
then 80%
(Maximum 20
visits per benefit
period)
$20 copayment then 100% after deductible
(Maximum 20 visits per benefit period)
100%
after deductible
(Maximum 20 visits
per benefit period)
100%
after deductible
(Maximum 20 visits
per benefit period)
Several RX options available
RX treated like other
medical expenses
RX treated like other
medical expenses
cose.org/benefits
June 2009 • COSE Update Special Insert • 11

Supermed plus
HSA 2500/100
Supermed plus
HSA 3000/100
Supermed plus
HSA 4000/100
Supermed plus
HSA 5000/100
HMO Health
Ohio***
Network:
$2,500 single
$5,000 family
Non-network:
$3,000 single
$6,000 family
Network:
$3,000 single
$6,000 family
Non-network:
$3,500 single
$7,000 family
Network:
$4,000 single
$8,000 family
Non-network:
$4,500 single
$9,000 family
Network:
$5,000 single
$10,000 family
Non-network:
$5,500 single
$11,000 family
None
Network: 100%
Non-network: 60%
None
Network: None
Non-Network:
$4,500 single
$9,000 family
Network: None
Non-Network:
$4,000 single
$8,000 family
Network: None
Non-Network:
$3,000 single
$6,000 family
Network: None
Non-Network:
Unlimited
None
100% after deductible 100% after
$15 copayment
100% after deductible 100%
100% 100% after
$15 copayment
100% after deductible 100% after
$100 deductible
per admission
100% after deductible 100% after
$100 deductible
per admission
100% after deductible 100% after
$75 copayment
(copayment waived
if admitted)
Network: 100% after deductible
(Maximum 30 days/benefit period)
100% after
$100 deductible
per admission
Network: 100% after deductible
(Maximum 20 visits per benefit period)
100% after $15
copayment
(Maximum 20 visits
per benefit period)
RX treated like other medical expenses
Several RX
options available

Benefits Solution
Shortcuts
Answers to these six questions can help make
plan selection easier.
1. What are you trying to accomplish? Attract and retain employees,
enhance productivity or decrease absenteeism?
2. What did you like and dislike about your plan(s) over the past 12
months? Consider network doctors and hospitals, copays, out-of-pocket
maximums, deductibles, flexibility and service.
3. Do employees utilize network, non-network or a combination of
both providers?
If network, consider any of the SuperMed Plus plans.
If non-network, consider the SuperMed Classic Gold and SuperMed Plus 250,
500, 750, 1000 and 2000/4000 plans.
If combination, consider the SuperMed Plus 250, 500, 750, 1000 and
2000/4000 plans.
4. Would your employees rather pay a fixed cost for doctor’s visits
in the form of a copay, or would they rather pay a discounted rate on
actual services performed?
If copays, consider the SuperMed Plus Multiple Options Plans; SuperMed
Plus 250, 500, 750 and 1000; SuperMed Plus 2080 plans; or SuperMed Plus
1000, 2000 and 3000.
If discounted rate, consider the HSA 1500, 2500, 3000, 4000 or 5000.
5. Do you opt for holistic or alternative care solutions?
If so, consider SuperMed Plus HSA 1500, 2500, 3000, 4000 and 5000.
6. If offering multiple SuperMed Plus plan designs, how do I help
employees select an appropriate plan?
The below chart will help employees determine the best plan based on total
cost. Once completed, the column with the lowest dollar amount should be the
best option.
Plan Description
Option
1
Option
2
A) Annual deductible
B) Total out-of-pocket costs (excluding deductible)
C) Estimated annual copays for prescriptions and/or doctor
office visits
D) Add the deductible, total out-of-pocket costs and copay
costs (A+B+C)
E) Employer contribution to out-of-pocket expenses,
(i.e. Health Savings Account (HSA)) if applicable
F) Total estimated medical out-of-pocket expenses (D-E)
G) Premium contribution (amount withdrawn per paycheck times
the number of paychecks per year)
H) Total estimated health care expenditures per year (F+G)
(Compare the cost difference between option 1 and option 2)

Drive Communications
Employees are often lost when it comes to understanding benefits. Here are three
tactics designed to help you effectively communicate benefits to your employees.
Communications help employees and their
families understand benefits.
As the business owner, you are a distributor of health benefits and wellness
solutions. But much more important, you are the educator who must teach
employees how to use the resources you provide them wisely.
Serving as the instructor is a big responsibility.
So we tapped COSE members and our in-house benefits guru, Patty Starr. They
have the class act down pat and can share a few lessons on how to communicate
benefits information in the workplace.
Tactic 1: Host a casual sit-down to discuss benefits. Use the suggested
talking points (page 13) and consider inviting a COSE representative to answer
questions. Be sure to allow plenty of time for questions and create a way to field
ongoing employee questions. (Not everyone wants to raise a hand in “class.”)
Tactic 2: Show employees the money—that is, the cost of benefits. Create
a total compensation worksheet (or use the one we provided on page 13) that
outlines the cost of the insurance plan with prescription coverage, vision,
dental and other add-ons. If you offer wellness perks, such as gym membership
discounts or free health screening fairs, add up those costs and show your staff
how much these extras are worth.
Tactic 3: Communications help employees and their families understand
benefits. E-mails, face-to-face meetings and mailers all play a role in your lesson
plan. At Precision Fittings, an “insurance corner” gets the word out about wellness
opportunities and changes to benefits
plans. There, employees can view
insurance correspondence, such as
brochures and provider directories; and
posted is a list of hospitals, doctors and
dentists included in the plan.
Employee Communication Copy Guide
“At , we believe that offering a
comprehensive benefits program is one of the most
important advantages we can offer our employees. We take
great pride in our ability to provide you with comprehensive
benefits through COSE.
Health insurance costs over the past several years have
risen three times the average rate of inflation, according to a
recent study from the Kaiser Family Foundation. Heath care
simply costs more today. However, providing you and your
family with quality benefits remains our priority, so we have
taken great strides to accommodate these additional costs.
We have consulted COSE—an organization that
specializes in supporting businesses like ours and has more
than three decades of experience helping businesses choose
the right benefits program. They have provided us with ideas,
strategies and materials and we’ve made all these resources
available to you .
12 • COSE Update Special Insert • June 2009 (216) 592-2222

Sample Meeting
Agenda
1. Health Insurance Industry Trends
Offer insight on the rising cost of benefits and what it means to your
employees.
2. What’s Different This Year?
• Explain the updated plan offerings
• How will the new plan offer staff continued choice and flexibility?
3. COSE-Sponsored Health Insurance Overview
• Explain components of health insurance plan(s)
• Offer information on additional insurance coverage, including:
– Vision through Vision Service Plan (VSP)
– Dental through Medical Mutual of Ohio
– Life or disability through Consumers Life Insurance Company
– Wellness options
– Alternative funding solutions (HSAs, HRAs and FSAs)
4. Striking a Balance
• Explain health insurance increases and what they mean to the company’s
bottom line
• Explain employees’ contribution levels and/or employer-sponsored levels
• Provide employees with a complete benefits summary each quarter
5. Educate Spouses/Family
Encourage employees to discuss information with spouses and families
6. Where to Find More Information
Provide the insurance carrier Web site for specific and secure employee-only
information (medmutual.com)
Total Compensation
Worksheet
Employee name
Title
Home address
Home phone
Mobile phone
Original hire date
This worksheet confirms your 20__ benefits
elections and personal contact information.
Please make any corrections or changes
and return a signed and dated copy to
no later than .
Overview of your
employee benefits package
BASE
SALARY
COMMISSION
BONUS
COMPANY-SPONSORED BENEFITS
Health
INSURANCE
Dental
INSURANCE
Vision
INSURANCE
Life
INSURANCE
Disability
Employer 20__ benefits
contribution per pay
20__ Employee Benefits
contribution per pay
MONTHLY EMPLOYER COST:
(_________%)
We have also scheduled an informal
informational meeting on from
at to provide you a general
overview and give you the opportunity to
get answers to your questions.
In the meantime, if you have any
questions, please contact at or
send an e-mail to .
MONTHLY EMPLOYEE COST:
(_________%)
In addition to your annual salary/hourly wage
of
, you will receive the
above benefits package, which costs our
company $
annually.
Employee Signature
Date
cose.org/benefits

Put Wellness
to Work
“Because medical
costs are going
through the ceiling,
we want to encourage
healthier lifestyles.”
–Barbara Tager,
IDentiphoto
Keeping employees well is a good
business practice, and more
businesses are recognizing that
wellness is an important piece of their
benefits package. A business leader who
understands and supports the concept
of health promotion is the cornerstone
for successful wellness programs.
According to the 2008 Kaiser Family
Foundation Employer Health Benefits
study, more than half (53%) of small firms
with three to 199 workers and 88 percent
of large firms (200 or more workers)
offer at least one wellness program.
Healthy employees are more
productive, safer on the job and less
likely to use the health insurance you
provide. That means lower premiums
over the long-term. Barbara Tager,
president, IDentiphoto, Willoughby,
recognizes that healthier employees
will alleviate health insurance costs in
the long run. “Because medical costs are
going through the ceiling, we want to
encourage healthier lifestyles,” she says.
IDentiphoto received a $1,500
Wellness Mini-Grant from COSE to
help educate their employees about
making choices. The company took
advantage of COSE’s lunch-and-learn
programs—educational sessions
presented by a COSE Wellness
coordinator—that can help jumpstart a
workplace wellness program. From
smoking cessation to health risk
assessments and weight management
through Weight Watchers®, COSE
along with Medical Mutual of Ohio
provides the tools to help employers
craft a valuable low-cost, and
sometimes no-cost, wellness program.
“Now our employees are more aware,
and they are making better choices,”
Tager says, noting that IDentiphoto is
located near a “fast-food” trap that is a
lunch-time lure for many workers.
At Life Equity in Hudson, manager
support is integral in the success of the
company’s annual Healthy Steps
walking program.
“We have significant support from
senior management and that has been
key for us because they actively
participate in the programs,” says
Shelley Keller, human resource
generalist for Life Equity.
Legal Side of the Wellness Road
The Health Insurance Portability and
Accountability Act, or HIPAA, prohibits
employers from denying eligibility for
benefits or charging more for coverage
because of any health factor. There is an
exception to this requirement for wellness
programs that condition a reward on an
individual satisfying a standard related
to a health factor if the wellness program
follows these standards:
14 • COSE Update Special Insert • June 2009
• Reward should not exceed 20 percent
of total cost of the employee’s (or the
employee’s family) coverage.
• Reasonable structures are created to
promote health and prevent disease.
• All employees have the opportunity to
qualify for a reward at least once a year.
• Alternative standards are provided for
participants with medical conditions that
otherwise prevent them from reaching a
goal and receiving a reward, or for whom
it is medically inadvisable to do so.
• The availability of alternatives or
waivers is described in all program
communications.
(216) 592-2222

COSE provided free pedometers to the Healthy Steps participants at Life
Equity, and the program launched with a post-lunch walk around the
company’s business park.
“Our company operates in a competitive environment, so we have a lot of
fun with the walking program and we set a goal every year,” Keller says.
This year, employees set a goal to “walk” to Miami, Fla. They determined
the distance to their location and figured how many steps equals a mile. Every
day, the “red” and “green” teams logged their mileage on a U.S. map.
“Every time we logged our steps, we were surprised to find out how many
miles we had walked as a team,” Keller says.
A Wellness Mini-Grant helped fund prizes for the program, and also a series
of lunch-and-learns on topics that employees expressed interest in via surveys.
Those included nutrition—learning how to read labels, weight loss and exercise.
A variety of programs allow employees to get involved in different ways. “We
have really used the resources available through the COSE Wellness Program,”
Keller says. “In this economy, the free materials and programs are such a
valuable benefit. And we can see that it’s paying off for our employees.”
What wellness initiatives would you consider
to increase productivity and long-term
profitability, or reduce absenteeism and
long-term health insurance premiums?
Preventive health screenings and flu shots 42%
Exercise, nutritional or weight management programs 42%
Smoking cessation 28%
Employee participation incentives 18%
Special company-sponsored challenges 10%
Penalize non-participation in wellness 5%
Source: 2009 COSE Employer Benefits Survey
• All other applicable federal and state
laws, such as the Americans with
Disabilities Act, Title VII, and, in some
cases, state insurance laws, are satisfied.
Employers should work closely with their
insurance providers and legal counsel
when developing and implementing
wellness programs.
Ensure compliance with the short
checklist at cose.org/wellness/
legalchecklist
Wellness
Communication
Tips
Here are some ways to get the word
out to employees about wellness
programs:
• Support the program. When
managers are advocates and
enthusiastic participants in the worksite
health initiative, it is bound to be a
success. Align your organization’s
wellness initiatives with senior
management’s business priorities
and mission.
• Identify champions. Name team
leaders in the organization who will
head up the program, and choose
individuals who are not on the
management team. They will help
encourage all employees to participate
in the company’s wellness programs.
• Gather information. What are your
company’s absenteeism rates? How
many sick days do employees take, on
average? What is the average leave time
for illness or injury? How productive is
your workforce? Answering these
questions will help determine the ‘weak
spots’ in your organization that could
use a dose of good medicine from
wellness programming.
• Survey employees. What matters to
workers? Do they want to quit smoking,
lose weight, eat nutritious meals? Find
out what employees value and center
your wellness initiative around their
interests for the best participation.
• Obtain metrics. How will you measure
the success of your program? By total
pounds lost, or total miles walked during
a walking program? Set goals, track
your progress and celebrate your
collective successes.
• Spread the word. Utilize newsletters,
brochures, e-mail, posters and
education sessions to keep employees
informed of new program offerings.
cose.org/benefits
June 2009 • COSE Update Special Insert • 15

Good Health.
Better Business.
Keeping your employees well is
not just a nice thing to do—it’s
good business. Healthy
employees are more likely to be safe on
the job, more productive and less likely to
incur high health care costs. That’s why
COSE and Medical Mutual of Ohio have
joined forces to help you and your
employees learn to be well, and stay well.
Take Action
free Health Screenings offer blood
pressure, cholesterol, body mass index,
body composition, glucose, height,
weight, waist circumference, and bone
mineral density testing. Employees,
spouses and dependents (18+) enrolled
in the COSE Health Insurance Program
are invited to participate.
(216) 592-2252 to schedule an on-site
screening event or individual appointment
Mini-Grant Program offers a matching
dollar amount of up to $1,500 for
company-sponsored wellness activities.
Complete application on cose.org/
wellness or call (216) 592-2252
In Motion
FREE COSE Y-Days allow COSEmember
businesses, employees and
families to enjoy two free days each
week, and one weekend day each
month, at one of the nine Greater
Cleveland locations. Discounts available
on joiner fees and membership dues,
as well. Locations include downtown
Cleveland, Euclid, Geauga, Hillcrest,
Lakewood, Ridgewood, Southeast, West
Park-Fairview and West Shore.
cose.org/wellness or (216) 592-2222
Members can also take advantage of
discounted rates and flexible membership
options at any GlobalFit fitness club
nationwide (Bally’s, Curves, World Gym
and Ladies Workout Express).
globalfit.com or 1-800-294-1500
Manage
free Lunch and Learn Educational
Sessions are available on a variety
of topics related to managing health.
Encourage employees to bring a brownbag
lunch, or offer a healthy lunch to
increase participation.
cose.org/wellness
free Smoking Cessation Program
provided through Quit Line offers up to
five free telephone counseling sessions
from experienced tobacco cessation
counselors, up to four weeks of Nicotine
Replacement Therapy (NRT) patches,
and a variety of motivational materials.
1-866-845-7702
free Weight Management offers
reimbursement vouchers for Weight
Watchers® at work and community
meetings to help reach personal weight
management goals. Members can
also receive up to $150 back from their
registration fees annually.
cose.org/wellness or 1-866-204-2878
free Online Health Risk Assessment
provides a confidential, personalized report
highlighting risks for heart disease, diabetes,
some cancers, depression or stroke as
well as opportunities for improvement that
can be candidly shared with physicians.
medmutual.com under “My
Health Plan,” then select “Health Risk
Assessment” under “Assess My Health”
free Health Management Programs
through Medical Mutual of Ohio’s Super
Well Disease and Maternity Management
Programs help members that are
pregnant or diagnosed with asthma,
chronic obstructive pulmonary disease,
chronic pain, congestive heart failure,
coronary artery disease, depression or
diabetes. Participants are coached on
ways to control chronic conditions and
prevent complications to achieve optimal
overall health.
medmutual.com under “My Health
Plan” or 1-800-861-4826
Special Seasonal Programs include
Colorful Choices, encouraging
employees to eat more fruits and
vegetables; Walktober, challenging
employees to walk more each day; and
Holiday Weight Maintenance, helping
participants maintain their weight during
the tempting holiday season.
cose.org/wellness or (216) 592-2222
16 • COSE Update Special Insert • June 2009 (216) 592-2222

Ask for Medicare
Directions
The one health insurance stumper
for companies across the board is
Medicare and what it means for
the employer and employees. What
exactly is “Part A and B” and who
should elect “Part D?” Do employees
with Medicare coverage still need
company insurance?
Patty Starr, senior director of
health insurance and benefits,
addressed Medicare questions during
COSE’s regional Benefits Review
Session blitz. Here, she responds to
some Medicare FAQs.
COSE suggests employees
turning 65 enroll in Medicare
Part A and Part B.
Q: What Is Medicare?
A: A federal health insurance plan that
pays for medical services for qualified
senior citizens of the U.S., individuals
who are disabled, or those who have
end-stage renal disease.
Q: Will my employees be
automatically enrolled into Medicare
or do they need to sign up?
A: If an employee is almost 65 years of
age and already receiving Social
Security Benefits, three months prior to
their 65th birthday they should receive
a Medicare package that automatically
enrolls them into Part A and Part B. If
they do not receive a packet, they
should contact Medicare directly. If
they choose to opt out of Part B
coverage, they’ll have to return an
enclosed letter.
If they are almost 65 years of age and
do not receive Social Security Benefits,
they will not be automatically enrolled
in Medicare Part A or B. They will need
to apply 90 days prior to their 65th
birthday to avoid start date delays.
Q: When will Medicare coverage
begin?
A: Medical coverage is available to
begin on the first of the month you
celebrate your 65th birthday, provided
you’re automatically enrolled or have
applied prior to that month.
Q: What is Medicare Part A?
A: A hospital insurance plan provided
by the federal government that pays for
inpatient hospital stays, skilled nursing
facilities, hospice, and some home
continued on page 18
cose.org/benefits
June 2009 • COSE Update Special Insert • 17

continued from page 17
health care services. It does not cover
everything, nor does it cover the total
cost for many of the covered services or
medical supplies. Provided an employee
or spouse has 40 or more quarters of
Medicare-covered employment, there is
no cost associated with Part A.
Q: What is Medicare Part B?
A: A medical insurance provided by the
federal government that covers
Medicare eligible physician services,
outpatient services, certain home
health services and durable medical
equipment. Though many services and
products are covered, Part B is not a 100
percent insurance coverage plan. It
costs $96.40 per month this year,
provided your current income does not
exceed $85,000 (single) or $170,000
(married couple).
Q: If I’m still offering employees
insurance, should they take
Medicare or not?
A: COSE suggests employees turning 65
enroll in Medicare Part A and Part B. If
they do not receive a packet, they
should contact Medicare directly.
If your company has fewer than 20
employees, Medicare is primary. This
means Medicare pays claims first and
the company’s insurance pays
second. If an employee opts out of
Medicare Part B, he or she may incur
large out-of-pocket expenses since they
are now responsible for the amount
Medicare Part B would have paid.
If the company has more than 20
employees, the company insurance
pays first and Medicare pays second.
Q: Do employees need insurance in
conjunction with Medicare?
A: It’s not necessary, but secondary
insurance will help minimize out-ofpocket
expenses. Remember, Medicare
does not cover everything, nor does it
cover the total cost for many of the
covered services or medical supplies.
Q: Do employees have to notify
Medical Mutual of Ohio when they
are turning 65?
A: Yes, employees should call Medical
Mutual of Ohio’s customer service
department when they receive their
Medicare packet.
Q: Will employee coverage remain
the same if enrolled in Medicare
and company insurance plan?
A: As the employer, you need to make a
plan selection for active employees
turning 65. Your choices include
Medifil and Medifil without Rx, which
will change your employee’s coverage.
And Medicare Carve Out, which, in
most cases, will keep an employee’s
coverage the same.
Q: What Is Medicare Part D?
A: Medicare Part D is a stand-alone
prescription drug benefits plan
available to all individuals turning 65
years of age.
Q: Do employees need to elect a
Part D plan?
A: No, however you are responsible for
notifying your employees as to whether or
not the plan elected is considered
creditable by government standards
associated with the Medicare Part D
plan. Visit cms.hhs.gov/creditable
coverage for information on creditable
plans. If not creditable, the employees
need to purchase a Part D plan on their
own so they don’t incur a monthly penalty.
Q: What is the Part D “Doughnut
Hole” or “Gap”?
A: A gap in prescription drug coverage
caused when an employee’s
prescriptions’ total cost reaches $2,700.
Employees then pay the prescriptions’
full price until the total cost reaches
$6,153. Then catastrophic coverage
starts and employees pay
approximately 5 percent of drug costs
until year end.
Benefits Jargon Tune Up
Aggregate deductible: The total family deductible must be
met prior to benefits being paid. The deductible can be satisfied
by one or multiple persons.
Brand-name drug: A drug protected by a patent.
Coinsurance: The cost-sharing percentage that an individual
must pay after the deductible amount has been met.
Copayment (copay): A fixed dollar amount an individual pays
for specific services covered by his or her health plan. The
health plan pays the rest.
Deductible: The fixed dollar amount individuals must pay from
their own funds for covered medical services before insurance
coverage begins. Deductible typically calculates Jan. 1 to Dec. 31.
Embedded deductible: Benefits will begin to pay when one
person meets the single deductible, or when two or more
people satisfy the family deductible.
Formulary: The list of brand name and generic drugs covered
by a health plan.
Generic drug: A drug that is a chemical and therapeutic
equivalent of a brand-name drug where the patent has expired
and is usually less expensive.
Mail order/mail service pharmacy: A pharmacy that
dispenses at least a 90-day supply of maintenance prescription
medications through the mail.
Medicare: A federal health plan that pays for medical services
for qualified seniors, disabled persons, and people with
end-state renal disease.
18 • COSE Update Special Insert • June 2009 (216) 592-2222

8 Common Renewal Questions, Answered
1
Q: How do I change my
benefits plans and where do I
find the forms?
A: Change, add or cancel a plan option
by completing the Alternative Summary
and Benefit Change Request Form
inside your Medical Mutual of Ohio
renewal packet.
2
Q: Can I offer more than one
plan at a time?
A: Yes, enrolled groups can offer up
to two different standard health insurance
plans along with one Health Savings
Account (HSA) or Health Reimbursement
Arrangement (HRA). Groups may also offer
up to two dental plans and one vision plan.
If you’d like to add a plan, send a list
of employees and their selections along
with the Alternative Summary and Benefit
Change Request Form. If you already have
two plans and employees want to change,
please provide written explanation
indicating which employees are changing
and to which new plan.
3Q: How do I submit change
forms?
A: The Alternative Summary and
Benefit Change Request Form can be
faxed to (216) 621-1725 or mailed to
COSE Benefits Administrator, COSE,
The Higbee Building, 100 Public Square,
Suite 210, Cleveland, Ohio, 44113 or
e-mail benefitchanges@cose.org.
4Q: If I decide to make changes,
when will they go into effect?
A: You can make changes in
both the month before and during
your designated renewal period. So if
your renewal is July 1 and you submit
changes on June 30, they will go into
effect July 1. However, if you submit
changes on or after July 1, they will go
into effect August 1.
5Q: What if I don’t want to
change plans?
A: Then no action is necessary.
6Q: I changed my health
insurance plan and my bill
from Medical Mutual still
reflects the old plan. Will I receive a
new invoice for the new plan?
A: No. Medical Mutual bills are prepared
in advance, so your bill may not reflect
the changes. Please pay the current bill
and your next bill will be adjusted.
7Q: What’s the minimum
premium contribution required
for each enrolled employee?
A: Groups must contribute 25 percent
or more to the premium for each
enrolled contract, including both active
and retired employees.
8Q: I need help understanding
all my health care options.
What is available?
A: COSE has harnessed their more than
35 years of health insurance expertise
and designed several resources to help
you maximize your benefits investment.
Try our one-on-one Benefits Review
Sessions or contact a COSE Customer
Service Representatives.
Medicare carve-out: This coverage ensures that the health
care benefits received by individuals over 65 years of age are
equal to the benefits received by individuals of the same group
less then 65 years of age. Medicare carve-out coverage will pay
the difference between the Medicare allowance up to the group’s
contract allowance for the same service. Carve-out coverage
also picks up services that Medicare itself doesn’t cover.
Medicare supplement (Medigap): A private health plan that
supplements Medicare coverage.
Medifill: A group health plan that supplements Medicare coverage.
Network: A group of health care providers under contract to a
health insurance company.
Non-formulary: Medications not listed on a health plan’s
formulary and require additional payments from the individuals.
In some cases, there is a possibility the medication will not be
covered at all.
Non-network: Coverage provided for services obtained
outside of the contracted provider network.
Out-of-pocket maximum: The maximum amount of money
individuals will pay during a period of time (Jan. 1 to Dec. 31). Plans
pay for most covered costs after the maximum has been reached.
Specialty prescription (Threshold prescription): Used
mostly to treat chronic diseases, these medications are equal or
greater than $600 per prescription; injected, infused, oral or
inhaled; and generally require close monitoring as well as
special storage or handling.
cose.org/benefits or (216) 592-2222
cose.org/benefits
June 2009 • COSE Update Special Insert • 19

Road Side Assistance
Fill up on everything you need to know on your way to discovering the best
benefits for your company.
Benefits Review Sessions
From choosing the right health plans, to figuring out how to
share premium costs with your employees, and just about
everything in between, COSE’s benefits experts are available
to sit down with you, one-on-one during a 45-minute
Benefits Review Session.
cose.org/brs or (216) 592-2222
EmployerLink
Customer service at your fingertips—EmployerLink offers
you 24-hour online access to the Medical Mutual of Ohio
customer service system helping you manage your company
benefits like a pro.
medmutual.com/employer under “Accounts” then
“EmployerLink” (members must be registered)
COSE Web Site
Find everything you need to know about health plans,
opportunities and resources available to COSE members.
cose.org/benefits
My Health Plan
Empower employees to manage their health plans through
this dynamic online tool that allows them to appeal claims,
request ID cards and find pharmacy information.
medmutual.com and logon to “My Health Plan” on right
side (members must be registered)
Inside 2009-2010 Benefits
Renewal Packet
Benefits Plan Summaries and
Program Guidelines
This booklet contains detailed descriptions of the COSE Health
Insurance Program provided by Medical Mutual of Ohio. It’s
specifically designed to help you compare and decide which
plan(s) are right for your business.
Health Plan Savings Summary
A dynamic summary that demonstrates how much each of the
health plan options would cost. This form alone will help you
determine if a plan is right for your company or not.
Questions?
General
COSE Customer Service
(216) 592-2222
1-866-553-5427
COSE Membership and
ALL Insurance Sales
(216) 592-2355
1-866-416-5427
Section 125/Flexsave
Inquiries
1-800-525-9252
Billing/Enrollment Medical
Mutual of Ohio Bill Clerk
(216) 687-6600
Medical Mutual of Ohio
Customer Service
(216) 687-7444
1-800-362-7100
Vision Service Plan (VSP)
1-800-877-7195
Consumers Life
1-866-925-2542
20 • COSE Update Special Insert • June 2009 (216) 592-2222