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FAQ's
The virtual benefits website is your primary resource for Open Enrollment details and benefits information. The site is for all benefits-eligible employees and their dependents – anyone who is interested in learning about the Martin Point’s Health Care benefits programs.
Yes! Our site provides you with a comprehensive overview of all the great benefits Martin’s Point Health Care has to offer, so please feel free to visit it as often as you like.
You can enroll or make changes by visiting WorkdaySSO.MartinsPoint.org.
You can access all of your current benefit information by clicking on the ‘All About Me’ icon in Workday.
Every year, we strive to offer our employees and their families a comprehensive selection of benefits. Learn all about new updates and changes by viewing the resources found on the HR Service Center page.
Yes, refer to the Resource Hall page for a full list of each provider’s contact information. You can also contact the Martin’s Point HR Service Center by using the links at the bottom of each booth page.
Failure to elect a PCP when enrolled in the POS medical plan will result in claims being processed incorrectly. You could see increased medical costs and claim denials as well.
To make changes visit Fidelity’s NetBenefits or download the Fidelity mobile app (available for both Apple and Android devices). Note, changes to retirement accounts cannot be made within Workday.
An EOI is a questionnaire used to assess your current health status to determine insurance eligibility.
Failure to complete an EOI will result in reduction of a policy to a guarantee issue amount, or possibly the termination of a policy without a guarantee issue.
Generally, you can only change your benefit elections during the Open Enrollment period, unless you experience a Qualifying Life Event or a change in you or your spouse’s employment status that affects benefits eligibility. You must notify HR within 30 days after a Qualifying Life Event.
These life events include:
- Marriage or divorce
- Birth or adoption of a child
- Death of your spouse or covered child
- Change in your spouse’s employment
- Change in your dependent child’s coverage
- Substantial change in your spouse’s benefit coverage
- Extended unpaid leave of absence by you or your spouse
- Change from part-time to full-time status (or vice versa) by you or your spouse
- Your child no longer qualifying as an eligible dependent under the plan(s)
Yes, you can choose whichever address is most convenient for you.
The email may end up in your junk email box, so please remember to check that.
Common Terms & Definitions
Calendar Year Maximum
The most a plan will pay on your behalf in one year.
Copay
A fixed amount you pay for covered services, typically when you receive the service.
Coinsurance
The cost share that you and the plan pay for covered services after the deductible. For example, if the plan pays 80% after deductible, you would be responsible for the remaining 20% of the eligible expense.
Deductible
An amount you pay out-of-pocket each year before benefits are paid under the plan.
Explanation of Benefits (EOB)
A statement from your insurance carrier that explains which services were provided, their cost, what portion of the claim was paid by the plan, and what portion is your liability, in addition to how you can appeal the insurer’s decision.
Formulary
A list of prescription drugs covered by the health plan, often structured in tiers that subsidize low-cost generics at a higher percentage than more expensive brand-name or specialty drugs.
Flexible Spending Account (FSA)
A bank account where a portion of your paycheck can be contributed on a pre-tax basis to cover certain out-of-pocket health care and dependent care expenses. The Health Care FSA can be used for medical and prescription expenses, such as deductibles and copays. The Dependent Care FSA helps you pay for eligible dependent care expenses so you and your spouse can work – childcare, preschool, after school care, day camps, and eldercare.
Health Savings Account (HSA)
Allows you to set aside pre-tax dollars to cover certain out-of-pocket health care expenses not covered by your plan. If you elect the Aetna HDHP/HSA Plan there is a corresponding HSA to help cover out-of-pocket costs. It is also a savings vehicle which allows unused funds to roll over year to year.
Health Reimbursement Account (HRA)
A health reimbursement account (HRA) is a benefit account your employer funds that you can use to help cover healthcare expenses. It may also reimburse you for qualified expenses from eligible family members, such as qualifying dependents or spouses.
In-Network
Care that is received from a provider who participates in the medical plan network.
Out-of-Network
Care that is received from a provider who does not participate in the medical plan network.
Out-of-Pocket Maximum (OOP)
The maximum amount you will pay before the plan pays at 100% for in-network coverage. The OOP will include the deductible, coinsurance, and copays.
Premium
The amount that must be paid for a health insurance plan by covered employees, by their employer, or shared by both. A covered employee’s share of the annual premium is generally paid periodically, such as monthly, and deducted from his or her paycheck.
The most a plan will pay on your behalf in one year.
Copay
A fixed amount you pay for covered services, typically when you receive the service.
Coinsurance
The cost share that you and the plan pay for covered services after the deductible. For example, if the plan pays 80% after deductible, you would be responsible for the remaining 20% of the eligible expense.
Deductible
An amount you pay out-of-pocket each year before benefits are paid under the plan.
Explanation of Benefits (EOB)
A statement from your insurance carrier that explains which services were provided, their cost, what portion of the claim was paid by the plan, and what portion is your liability, in addition to how you can appeal the insurer’s decision.
Formulary
A list of prescription drugs covered by the health plan, often structured in tiers that subsidize low-cost generics at a higher percentage than more expensive brand-name or specialty drugs.
Flexible Spending Account (FSA)
A bank account where a portion of your paycheck can be contributed on a pre-tax basis to cover certain out-of-pocket health care and dependent care expenses. The Health Care FSA can be used for medical and prescription expenses, such as deductibles and copays. The Dependent Care FSA helps you pay for eligible dependent care expenses so you and your spouse can work – childcare, preschool, after school care, day camps, and eldercare.
Health Savings Account (HSA)
Allows you to set aside pre-tax dollars to cover certain out-of-pocket health care expenses not covered by your plan. If you elect the Aetna HDHP/HSA Plan there is a corresponding HSA to help cover out-of-pocket costs. It is also a savings vehicle which allows unused funds to roll over year to year.
Health Reimbursement Account (HRA)
A health reimbursement account (HRA) is a benefit account your employer funds that you can use to help cover healthcare expenses. It may also reimburse you for qualified expenses from eligible family members, such as qualifying dependents or spouses.
In-Network
Care that is received from a provider who participates in the medical plan network.
Out-of-Network
Care that is received from a provider who does not participate in the medical plan network.
Out-of-Pocket Maximum (OOP)
The maximum amount you will pay before the plan pays at 100% for in-network coverage. The OOP will include the deductible, coinsurance, and copays.
Premium
The amount that must be paid for a health insurance plan by covered employees, by their employer, or shared by both. A covered employee’s share of the annual premium is generally paid periodically, such as monthly, and deducted from his or her paycheck.