ELIGIBILITY
Eligible Associates:
You may enroll in the Meridian Healthcare Benefits Program if you are a full-time employee working at least thirty (30) hours per week.
When Coverage Begins:
The effective date for benefits is July 1, 2024. Newly hired associates hired after July 1, 2024 and their dependents will be effective on the first of the month following date of hire. All elections are in effect for the entire plan year and can only be changed during Open Enrollment, unless you experience a qualifying event.
Who is Eligible:
Medical: Spouses and dependent children. Dependent children are eligible up to the end of the month in which the child attains age 26.
Dental: Spouses and dependent children. Dependent children are eligible up to the end of the month in which the child attains age 26.
Vision: Spouses and dependent children. Dependent children are eligible up to the end of the month in which the child attains age 19 or age 26 if a full-time student.
Life and Disability: Full-time employees, working at least 30 hours per week, are eligible 30 days from date of hire upon completion of application for coverage.
Qualifying Event Change:
A change in family status is a change in your personal life that may impact you or your dependent’s eligibility for benefits. Examples of family status changes include:
- Change of legal marital status (i.e. marriage, divorce, death of spouse, legal separation)
- Change in number of dependents (i.e. birth, adoption, death of dependent, ineligibility due to age)
- Change in employment or job status (spouse loses job, etc.)
When Can You Enroll:
You can sign up for benefits at any of the following times:
- After completing the initial eligibility period
- During the annual open enrollment period
- Within thirty (30) days of a qualifying event
If you do not enroll at the above times, you must wait for the next annual open enrollment period.
Glossary of Terms
Coinsurance: The percentage of the medical or dental charge that you pay after the deductible has been met.
Copayment: A flat fee that you pay for medical services, regardless of the actual amount charged by your doctor or another provider. This generally applies to physicians’ office visits and prescription drugs.
Deductible: The amount you pay toward medical and dental expenses each calendar year before the plan begins paying benefits.
Explanation of Benefits (EOB): A statement you receive after you go to the doctor or hospital that lists the health care treatment you received. It shows the amount the doctor charged, how much Anthem has paid and what you’ll be billed based on your benefits. An EOB is not a bill.
Out of Pocket Maximum: The maximum amount you will pay in deductibles, coinsurance and copays during the calendar year.
Preferred Provider Organization (PPO): A type of health coverage plan that covers services from almost any doctor or hospital. But you’ll almost always pay less for the same level of care when you go to one in your health plan network. You don’t usually need a referral from your main doctor, also called a primary care physician or primary care doctor, to see a specialist.
High Deductible Health Plan (HDHP): Qualified plan as defined by the IRS. No first dollar benefits, all services are subject to the deductible before the plan will pay. Exception is Routine Preventive Care as defined by the IRS. Network Provider: Medical and pharmacy providers that have contracted with the plan to provide lower out of pocket costs for members.
