Benefit Fact Sheet - St. Joseph Mercy Ann Arbor Hospital

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2014 SJMHS Benefit Fact Sheet – Graduate Medical Education
Effective Date for Benefits
Your benefit elections become effective on the first of the month following 30 days of service in a benefit eligible
position with the exception of your medical insurance, which becomes effective as of your date of hire. Eligible
dependents include legal spouse and dependent children up to age 26. For more detailed information regarding dependent
eligibility please visit http://mybenefits.trinity-health.org.
Medical (3 Options)
1. Priority Health HealthbyChoice HMO
‣ Priority Health’s HealthByChoice plan rewards you with lower costs for pursuing your wellness goals.
‣ Two levels of benefits: Choice and Standard. You (and your covered spouse) must meet the Choice level
requirements within 90 days of enrollment to remain in Choice level that offers richer benefits.
‣ HMO offers benefits only if you utilize Priority Health participating providers. Members must choose a Primary
Care Physician (PCP).
‣ Please see the Summary of Benefit Changes at http://mybenefits.trinity-health.org for more plan information.
2. BCBS of MI Healthy Blue Solutions PPO
‣ Plan offers more choice and flexibility. Provides both in and out-of-network levels of coverage.
‣ Two levels of benefits: Enhanced and Standard. You (and your covered spouse) must meet the Enhanced level
requirements to remain in the Enhanced level that offers richer benefits.
‣ Members have access to the Community Blue PPO network of physicians and hospitals.
‣ Please see the Summary of Benefit Changes at http://mybenefits.trinity-health.org for more plan information.
3. BCBS of MI PCA PPO
‣ The PCA PPO plan is a consumer-driven medical plan designed to help you take control of your health care
spending by providing comprehensive and cost-effective health care coverage.
‣ Members have access to the Community Blue PPO network of physicians and hospitals.
‣ Please see the Summary of Benefit Changes at http://mybenefits.trinity-health.org for more plan information.
Dental
SJMHS offers Delta Dental Premier High Plan. The dental plan covers preventive services at 100%, basic services at 80%
and major services at 50% after a calendar year deductible, with a calendar year maximum per member of $1,500. Please see
the detailed summary at http://mybenefits.trinity-health.org for more plan information.
Vision (2 Options)
1. United Healthcare Standard
‣ You can receive benefits in-network or out-of-network.
‣ You are eligible for exam, lenses, frames, or contact lenses (in lieu of eye glasses) once every twelve months.
‣ $10 exam co-pay,
‣ Receive up to 6 boxes of disposable contacts.
2. United Healthcare High
‣ You can receive benefits in-network or out-of-network.
‣ You are eligible for exam, lenses, frames, or contact lenses (in lieu of eye glasses) once every twelve months.
‣ No exam co-pay,
‣ Receive up to 8 boxes of disposable contacts,
‣ And enhanced lens options.

20555 VICTOR PARKWAY LIVONIA, MI 48152 p 734-343-1000 newhealthministry.org
Group Legal
Hyatt Group Legal - Provides access to professional legal representation through the Hyatt Legal Services network.
Premium Costs - Listed below are the per pay period rates for full employees.
Plan
Priority Health
HealthByChoice HMO
BCBS of MI
Healthy Blue
Solutions PPO
BCBS of MI
PCA PPO
Delta Dental
United Healthcare
Vision – Standard
United Healthcare
Vision – High
Hyatt Legal
Coverage
Level
Full-Time
72-80 hours per pay
period
Colleague Employer
Colleague $68.96 $186.45
Colleague +Spouse $187.98 $399.45
Colleague + Child(ren) $155.29 $329.98
Colleague + Fam. $261.53 $555.75
Colleague $63.88 $191.63
Colleague +Spouse $153.31 $357.72
Colleague + Child(ren) $114.98 $268.29
Colleague + Fam. $203.13 $473.97
Colleague $47.20 $188.79
Colleague +Spouse $117.99 $353.98
Colleague + Child(ren) $88.50 $265.49
Colleague + Fam. $156.34 $469.03
Colleague $5.00 $10.01
Colleague +Spouse $7.50 $20.65
Colleague + Child(ren) $9.25 $26.38
Colleague + Fam. $10.00 $45.54
Colleague $3.05 $0.00
Colleague +1 $5.13 $0.00
Colleague + Fam. $8.10 $0.00
Colleague $5.09 $0.00
Colleague +1 $9.87 $0.00
Colleague + Fam. $15.60 $0.00
Colleague $5.12 $0.00
Colleague + Fam. $6.97 $0.00

Child(ren) Life
‣ The maximum paid on a death claim for a child 0 – 6 months is $2,000 – you may elect a higher level.
‣ Premium is a flat rate. The online benefit enrollment site will list your individual premium costs.
‣ Child Life Insurance can be purchased in the following amounts of coverage:
‣ $2,000
‣ $5,000
‣ $10,000
‣ $20,000
20555 VICTOR PARKWAY LIVONIA, MI 48152 p 734-343-1000 newhealthministry.org
Healthcare Spending Account
‣ Allows you to reimburse yourself for certain medical, dental and vision expenses not covered under your
insurance plan. You can elect up to $2,500 annually ($192.30 per pay period).
‣ Please review FSA SPD on http://mybenefits.trinity-health.org before you enroll.
‣ Your contribution is deducted each pay on a pre-tax basis and placed into a special account set up for you.
‣ You can incur expenses through March 15, 2015.
‣ By law, any money remaining in your account after you have applied for reimbursement is forfeited and
cannot be returned to you.
Dependent Care Spending Account
‣ Allows you to reimburse yourself for daycare expenses so that you can work full-time.
‣ You can elect up to $5,000 annually ($192.30 per pay period).
‣ Please review FSA SPD on http://mybenefits.trinity-health.org before you enroll.
‣ Your contribution is deducted each pay on a pre-tax basis and placed into a special account set up for you.
‣ You can incur expenses through December 31, 2014.
‣ By law, any money remaining in your account after you have applied for reimbursement is forfeited and
cannot be returned to you.
Employee Basic Life & AD&D
SJMHS pays for 2X annual salary up to a maximum of $1,500,000 with a guaranteed issue amount of $1,500,000.
Cost is paid in full by SJMHS for benefit eligible employees. Please be sure to complete the beneficiary election form.
Supplemental Life
Additional life insurance can be purchased by employees for the following amounts:
‣ 1X annual salary
‣ 2X annual salary
‣ 3X annual salary
‣ 4X annual salary
‣ 5X annual salary
Available up to a maximum of $1,500,000 with a guaranteed issue amount of $1,000,000.
Premium is based on employee’s age and annual salary. The online benefit enrollment site will list your individual
premium costs.
Spouse Life
Spouse Life Insurance can be purchased in the following amounts of coverage:
‣ $10,000,
‣ $20,000,
‣ $50,000
‣ $100,000.
Premium based on employees age and elected amount.
The online benefit enrollment site will list your individual premium costs.
Statement of Health form is required for elections greater than $20,000.

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Short-Term Disability
Under SJMHS Short-Term Disability plan, you may be eligible to receive 66 2/3 percent of your base weekly pay
for up to 24 weeks (following the elimination period) in the event you are absent from work for more than 14 consecutive
days due to a non-work-related injury or illness. Employees are eligible for short-term disability first of the month
following 30 days. Please consult your Summary Plan Description for plan details.
Long-Term Disability
SJMHS provides Long-Term Disability coverage equal to 60 percent of your base pay up to $3,000 at cost to you.
You have the ability to purchase supplemental insurance, long term care provisions or conversion of coverage for portability.
Paid-Time Off
House Officers are provided four (4) weeks of vacation per contract year.
Bereavement
Employees are provided up to 24 paid hours of work to cover regular scheduled work time in the event of a death of
covered family members. Refer to SJMHS Policy 205 for more information. Employees are eligible as of date of hire.
Adoption Assistance
Benefit eligible employees may receive up to $3,000 reimbursement for approved adoption expenses once
the adoption has been finalized.
Employee Assistance Plan
Offers professional help in a strictly confidential manner to individuals who may be having personal problems. The program
is for all employees and members of their immediate family. The EAP offers short-term counseling and referral. These
services are provided at no cost to the employee. If you are referred for professional counseling or other services, you are
responsible for the costs. Most employees and families have health insurance which will cover some of the costs of psychiatric
or substance abuse treatment. For those who do not, the EAP will help contact providers who charge on a sliding-fee scale basis.
403(b) Retirement Savings Plan
Employees may contribute up to 75% of their pay on a pre-tax basis to the plan.
Employees are eligible to contribute as of their date of hire and there is a 3-year vesting period.*
Cash Balance (Pension) Plan
Cash Balance Pension Plan provided by SJMHS. You become active in the plan as of your date of hire. For more information,
Visit http://retirementprogram.trinity-health.org. There is a 5-year Vesting Period.*
*1 year of vesting = 1,000 or more of paid hour per year
For benefit questions, please contact the Associate Resource Center at 734-712-4981, select option 6, then 4.