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The Benefits in Action Program at Winthrop-University Hospital is designed to provide comprehensive, competitive and affordable protection to meet the ongoing needs of our employees and their families.
Flexibility is the key to the Benefits in Action Program. The Program provides employees with certain Hospital-paid benefits and allows them to choose the optional benefits that best meet their needs.
The Hospital provides the following Core Benefits at no cost.
- Basic Life Insurance (1x your base hospital salary up to a maximum of $250,000)
- Accidental Death & Dismemberment
- Pension Plan
- Sick Time
- Tuition Reimbursement
- Vacation, Holidays, and Personal Days
- N.Y. Statutory Disability
- Worker's Compensation
Under the Flexible Benefits Program there are choices you can make from an Optional Benefits group. The Optional Benefits include:
- Medical (3 options)
- Dental (2 options)
- Voluntary Life Insurance (the maximum amount of Basic and Voluntary Life Insurance combined cannot exceed $500,000)
- Voluntary Long Term Disability
- Tax Deferred Annuities (4 Options)
 MEDICAL OPTION A: CHOICE PLUS
The UnitedHealthcare Choice Plus option gives you maximum flexibility each time you require medical services. You have direct access to providers without referrals. You may choose in-network or out-of-network providers each time you need care, although your savings will be greater in-network.
If you choose in-network care, you will receive 100% coverage for most eligible charges. Doctor's office visits require a $20 copayment. The in-
network benefit provides full coverage after a $20 copayment for services such as physicals, well-child care and routine immunizations.
You may choose out-of-network care at any time, at a reduced level of coverage. Out-of-network services are subject to an annual deductible ($300 individual/$450 family maximum). After you satisfy the deductible, most expenses are reimbursed at 75% of Reasonable and Customary (R& C) charges. And, an out-or-pocket maximum ($2,500 individual/$5,000 family) helps to protect you from the financial burden of high medical expenses. Once the maximum is reached, the plan pays 100% of remaining eligible expenses for the rest of the year.
 MEDICAL OPTION B: CHOICE
With the UnitedHealthcare Choice Plan, you have direct access to network providers without referrals.
This option features no claims to file and no deductibles to meet. Most services require only a $20 copayment. Unlike the Choice Plus (POS) option, there is generally no coverage when you receive services outside the network.
MEDICAL OPTION C:
Waiver of Medical Coverage provides cash back. You must submit receipt of proof of other medical coverage to elect this option.
 PRESCRIPTION DRUGS:
Card Plan - 15% co-pay for generic medications and 30% co-pay for brand name medications at local pharmacy. $600 out-of-pocket maximum per individual per calendar year. Medications are covered at 100% at the Winthrop University Pharmacy for the employee and are covered at a discounted rate for eligible dependents.
 VISION CARE BENEFIT
Both the ChoicePlus (POS) and Choice (Network only) options include vision care benefits through Spectera. Features of the Spectera program include eye exams every 12 months, new eyeglass lenses or contacts every 12 months and new eyeglass frames every 24 months. You have a choice of using participating or non-participating providers, although your savings will be greater when you use participating providers.
 YOUR DENTAL OPTIONS
Dental Care is an important part of any health care Program. When you enroll you choose between a "DMO Option" and a "Traditional Option".
OPTION 1 - DMO OPTION
The DMO is a managed dental plan. This means that when you choose a "primary DMO dentist" from those listed in the DMO Directory, he or she can provide all of your routine dental care and arrange for any specialty care which may be required. When you use your primary DMO dentist, there are:
- No deductibles
- annual maximums
- 100% coverage for Preventive Services
- 90% coinsurance for Basic Services
- 60% coinsurance for Major Services
- Scheduled co-payments for specific Specialty Services
- No claims to file
OPTION 2 - TRADITIONAL OPTION
The "Traditional Option" allows you to receive dental services from any
dentist you choose.
- There is a $50 individual deductible ($150 per family) for Basic and Major Services
- There is a $1,500 annual maximum per individual
- The plan will pay 80% of covered UCR - (Usual customary and reasonable) charges on Preventive services, with no deductible
- The plan will pay 80% of covered UCR charges on Basic Services after the deductible.
- The plan will pay 60% of covered UCR charges on Major Services after the deductible.
 INCOME PROTECTION
- Short Term Disability
- Long Term Disability
SHORT TERM DISABILITY:
Employees are covered by short-term non-occupational disability insurance (up to 6 months). To be eligible for disability insurance benefits, you must be on the payroll for a minimum of twenty work days - four consecutive weeks - and be unable to work for more than seven calendar days due to injury or illness.
LONG TERM DISABILITY:
Long Term Disability provides a percentage of your salary up to a maximum of $5,000 per month and begins after the 180th continuous day of disability. The total amount of your Long Term Disability benefits takes into account any benefits that you are entitled to from other sources such as Workers' Compensation, any government benefits, or other program or benefits provided by the hospital.
 SURVIVOR SECURITY
- Basic Life Insurance
- Basic Accidental Death & Dismemberment
- Voluntary Life Insurance
FLEXIBLE SPENDING ACCOUNTS
The "Benefits in Action" Program provides two optional Spending Accounts, a Health Care Spending Account and a Dependent Care Spending Account, that allow you to pay eligible expenses with pre-tax money. By using these options, you can choose an amount of money to be put aside from your pay in before-tax dollars. Then when you have health care expenses that are not covered by your benefit plans or when you have dependent care expenses, you can use the money in your spending account to pay them.
 RETIREMENT PLAN
Regular full-time and part-time employees who are credited with 1,000 hours of service in a plan year become eligible for enrollment in the Hospital's pension plan. You may become eligible for enrollment in the pension plan when you have been employed for one (1) full year and have reached a minimum age of 21.
 TAX DEFERRED ANNUITIES
To assist our employees in saving for Retirement, Winthrop offers the option
of investing in a Tax Deferred Annuity. There are currently four different companies
through which you may direct your Investments:
- Diversified Investment Advisors
- HANYS Mutual Fund Program
- Lincoln Financial Group
- TIAA-CREF
By setting aside as little as $10 per paycheck, you can begin to lower your taxable income, and start on the road toward saving for your retirement.
 TUITION ASSISTANCE
We encourage employees to continue their education and broaden their knowledge. Tuition Assistance is available to eligible employees in order to assist in the furtherance of their education.
To be eligible for Tuition Assistance, you must meet the following criteria:
- Be a regular full-time employee with at least one year of continuous employment at Winthrop-University Hospital
- Course(s) taken must be either job and/or healthcare related
- Only courses receiving a "C" grade or better and/or a "Pass" grade will be eligible
- Have an overall satisfactory performance rating and not be in the progressive discipline process.
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