EMPLOYEE BENEFITS
House Officers
Effective January 1, 2008
HEALTH INSURANCE: Effective Date of Coverage: Date of hire
The Hospital provides two Health Insurance Plans through MedCost Benefit Services – the Prime Network Plan and Select Options Plan. These plans offer benefits through a network of providers using the MedCost Network and the in-house Network of the Wake Forest University Baptist Medical Center. The Select Options Plan offers the additional option for services out of the network. There is no pre-existing condition exclusion for pregnancy. For information on the network go to www.mbstpa.com
Pre-existing condition exclusion may be imposed for other conditions if you have been without health insurance for more than 63 days and your previous coverage was for less than 18 months.
Prime 80/20 Network Plan – Biweekly Cost for Full Time | | Select 60/40 Options Plan – Biweekly Cost for Full Time |
Coverage | You Pay | Hospital Pays | Total Cost* | | Coverage | You Pay | Hospital Pays | Total Cost* |
Employee Only | $33.00 | $139.79 | $172.79 | | Employee Only | $17.00 | $129.82 | $146.82 |
Employee plus Children | $115.00 | $230.58 | $345.58 | | Employee Plus Children | $62.00 | $231.64 | $293.64 |
Employee Plus Spouse | $124.00 | $238.86 | $362.86 | | Employee Plus Spouse | $67.00 | $241.32 | $308.32 |
Family | $173.00 | $302.17 | $475.17 | | Family | $96.00 | $307.75 | $403.75 |
| Prime 80/20 | Select 60/40 |
| WFUP/NCBH | MedCost | WFUP/NCBH | MedCost |
Individual Deductible | $300 | $600 | $300 | $600 |
Family Deductible | $600 | $1,200 | $600 | $1,200 |
Individual OOP | $2,500 | $4,000 | $4,500 | $6,000 |
Family OOP | $4,500 | $7,500 | $6,500 | $9,500 |
Routine Physical | $ 0 Co-pay | $ 0 Co-pay | $ 0 Co-pay | $ 0 Co-pay |
Well Child Care/Immunization | $ 0 Co-pay (up to age 7) | $ 0 Co-pay (up to age 7) | $ 0 Co-pay (up to age 7) | $ 0 Co-pay (up to age 7) |
Pediatrician | $15 Co-pay | $15 Co-pay | $15 Co-pay | $15 Co-pay |
Primary Care Physician | $15 Co-pay | $30 Co-pay | $15 Co-pay | $30 Co-pay |
Specialist – No referral required | $35 Co-pay | $70 Co-pay | $35 Co-pay | $70 Co-pay |
Inpatient Hospital Care | 20% | $800+40% | 20% | $800+40% |
Outpatient Hospital Care | 20% | 40% | 30% | 50% |
Surgeon/Physician | 20% | 40% | 30% | 50% |
Prescription Drug Program: Individuals covered by these Health Insurance Plans receive prescription drug benefits through a lower co-pay program utilizing the NCBH Outpatient Pharmacy or higher co-pay using a retail pharmacy.
VISION: Effective Date of Coverage: 31st day from date of hire
Eye-exam – Members enrolled in the Health Plan are automatically covered for an eye-exam through Superior Vision or at any out of network provider. There is a $15 co-pay with Superior Vision providers for the eye-exam. The $15 co-pay also applies at out-of-network providers plus the additional cost above what Superior Vision would have paid. For information on the network go to www.superiorvision.com. If you want benefits for lenses and frames you pay the pre-tax cost shown below:
If Enrolled in Health Plan If Not in Health Plan - Includes Eye Exam
Level of Coverage | Employee Cost | | Level of Coverage | Employee Cost |
Employee Only | $2.95 | | Employee Only | $3.48 |
Employee + Children | $4.79 | | Employee + Children | $5.64 |
Employee + Spouse | $6.35 | | Employee + Spouse | $7.48 |
Family | $8.71 | | Family | $10.26 |
DENTAL PLAN: Effective Date of Coverage: 91st day from date of hire
MetLife administers the Dental Plan. This plan provides 100% coverage for preventive services. There is a $50 individual deductible and $150 family deductible for restorative services (fillings, sealants, labs, x-rays) then the plan pays 100% in network and 80% up to the reasonable and customary price out of network. Major restorative and orthodontia are covered at 50% up to the Plan limits. Annual benefit limit per person is $1,250 a year. Orthodontia limit is $1,250 lifetime limit. Orthodontia is available for children and adults. For information on the network go to www.metlife.com/dental. The biweekly cost of dental coverage is below:
Level of Coverage
| Employee Contribution | Hospital Contribution | Total Cost |
Employee Only | $2.15 | $5.53 | $7.68 |
Employee + 1 | $6.91 | $8.45 | $15.36 |
Employee +2 | $11.52 | $11.52 | $23.04 |
Employee +3 | $16.28 | $14.44 | $30.72 |
Employee +4 or more | $21.12 | $17.28 | $38.40 |
PRE-TAX AUTHORIZATION (Section 125): Any monies contributed for Health Insurance, Dental and Vision are not taxed. This means that your taxes will be computed after your premiums are deducted, so you pay less tax.
LONG-TERM DISABILITY: Effective Date of Coverage: 91st day from date of hire.
The hospital provides a long-term disability plan at no cost to you. This plan consists of a group plan, which offers coverage of 66 2/3% of your monthly salary up to a monthly maximum of $2,000 after you have been off work for 90 days due to a disabling condition. There is an additional individual policy also provided by the hospital at no cost to you. This individual policy supplements the group policy.
TERM LIFE INSURANCE: Effective Date of Coverage: 91st day from date of hire
The hospital provides basic term life insurance equal your annual salary rounded to the next highest thousand. This benefit is provided at no cost to you.
ADDITIONAL SUPPLEMENTAL TERM LIFE INSURANCE: Effective Date of Coverage: 91st day from date of hire
Additional life insurance may be purchased for an amount of an additional one, two, three or four times your annual salary.
The bi-weekly deduction cost for this additional life insurance is based on age and amount of coverage.
Dependent life insurance may be purchased for your spouse and dependent children with these options:
Level of Coverage | | Coverage Amount | | Employee Cost |
Spouse | - | $2,500 | = | $ .092/Pay Period |
Spouse | - | $5,000 | = | $ .138/Pay Period |
Spouse | - | $10,000 | = | $ .508/Pay Period |
Spouse | - | $25,000 | = | $1.038/Pay Period |
Child/Children | - | $2,500 Each | = | $ .115/Pay Period |
Child/Children | |