Benefits Enrollment Guide 2025
This document provides information on the benefits enrollment process for Dean McGee Eye Institute in the year 2025.
BENEFITS ENROLLMENT GUIDE 2025
Available Benefits TABLE OF CONTENTS 09 04 08 Flexible Spending Employee PPO Medical Plans Account Premiums 12 11 16 HSA Medical Plan Health Savings Dental Account 17 18 20 Disability Life Insurance Vision 24 22 26 Life Services 401(k) Plan Worksite Toolkit 27 Contacts
Welcome to Your Benefits Eligibility What if I want to make changes to my benefits? Full-time and Part-Time Employees During open Work 20 hours a week or more enrollment, you may Spouse and dependent children (to age 26) make changes to your *Spouses eligible for benefits through their own benefits. However, employer are not eligible for DMEI’s health plan. outside of open enrollment, you can only change your benefit choices if you Enrollment have a qualifying event. These events include New Hires: Enroll within 30 days from date of hire. marriage, divorce, legal Benefits are effective the first of the month following separation, birth or date of hire. adoption, change in a Current Employees: You can enroll or make changes child's dependent annually at Open Enrollment for a January 1st status, death of a effective date. spouse, or change in Be ready to provide address, birthdates, and social employment status. security numbers for you and any eligible dependents You must make changes within 30 days Complete enrollment at of the Qualifying www.workforcenow.adp.com through the employee Event. (Documentation self-service portal. may be required) For Example: If you have a newborn, add them to any Important plan within 30 days of birth. They will not be Benefits will become active on the first of the month automatically added. following your date of hire Please contact HR for more information. You have coverage on the effective date even if the ID card has not yet arrived If you have any problems, please contact your HR team 3
Employee Medical Rates Full-Time Employees: Bi-Weekly Rates $5,000 HDHP Plan $1,500 PPO Plan $500 PPO Plan Tier Total DMEI You Total DMEI You Total DMEI You Cost Pays Pay** Cost Pays Pay** Cost Pays Pay** Regular Annual Salary Up to $50,999 Employee Only $268.88 $284.31 -$15.43 $344.94 $344.59 $0.35 $365.29 $344.59 $20.70 Employee & $537.74 $457.73 $80.02 $689.86 $485.66 $204.20 $730.56 $485.66 $244.90 Spouse Employee & $470.81 $408.89 $61.92 $603.99 $430.72 $173.27 $639.62 $430.72 $208.90 Child(ren) Family $672.18 $569.85 $102.33 $862.33 $612.42 $249.91 $913.21 $612.42 $300.79 Regular Annual Salary $51,000 to $149,999 Employee Only $268.88 $257.16 $11.72 $344.94 $303.89 $41.05 $365.29 $303.89 $61.40 Employee & $537.74 $439.98 $97.76 $689.86 $476.00 $213.86 $730.56 $476.00 $254.56 Spouse Employee & $470.81 $391.00 $79.81 $603.99 $420.45 $183.54 $639.62 $420.45 $219.17 Child(ren) Family $672.18 $542.29 $129.89 $862.33 $592.59 $269.74 $913.21 $592.59 $320.62 Regular Annual Salary $150,000+ Employee Only $268.88 $243.44 $25.44 $344.94 $293.54 $51.40 $365.29 $293.54 $71.75 Employee & $537.74 $412.55 $125.19 $689.86 $444.96 $244.90 $730.56 $444.96 $285.60 Spouse Employee & $470.81 $368.40 $102.41 $603.99 $399.91 $204.08 $639.62 $399.91 $239.71 Child(ren) Family $672.18 $510.69 $161.49 $862.33 $556.37 $305.96 $913.21 $556.37 $356.84 **Includes Flex Credit of $20.00 per pay period Tobacco Use Surcharge: An additional $100 will apply to premiums if you or your eligible dependents use tobacco products. Contact HR to learn more about tobacco cessation options 4
Employee Medical Rates Full-Time Employees: Semi-Monthly Rates $5,000 HDHP Plan $1,500 PPO Plan $500 PPO Plan Tier Total DMEI You Total DMEI You Total DMEI You Cost Pays Pay** Cost Pays Pay** Cost Pays Pay** Regular Annual Salary Up to $50,999 Employee Only $291.29 $308.00 -$16.72 $373.69 $373.31 $0.38 $395.74 $373.31 $22.43 Employee & $582.56 $495.87 $86.69 $747.35 $526.13 $221.22 $791.45 $526.13 $265.31 Spouse Employee & $510.04 $442.96 $67.08 $654.32 $466.61 $187.71 $692.93 $466.61 $226.32 Child(ren) Family $728.20 $617.33 $110.86 $934.19 $663.46 $270.73 $989.31 $663.46 $325.85 Regular Annual Salary $51,000 to $149,999 Employee Only $291.29 $278.59 $12.70 $373.69 $329.22 $44.47 $395.74 $329.22 $66.52 Employee & $582.56 $476.65 $105.91 $747.35 $515.67 $231.68 $791.45 $515.67 $275.78 Spouse Employee & $510.04 $423.58 $86.46 $654.32 $455.49 $198.83 $692.93 $455.49 $237.44 Child(ren) Family $728.20 $587.48 $140.72 $934.19 $641.97 $292.22 $989.31 $641.97 $347.34 Regular Annual Salary $150,000+ Employee Only $291.29 $263.73 $27.56 $373.69 $318.00 $55.69 $395.74 $318.00 $77.74 Employee & $582.56 $446.94 $135.62 $747.35 $482.04 $265.31 $791.45 $482.04 $309.41 Spouse Employee & $510.04 $399.10 $110.94 $654.32 $433.24 $221.08 $692.93 $433.24 $259.69 Child(ren) Family $728.20 $553.25 $174.95 $934.19 $602.73 $331.46 $989.31 $602.73 $386.58 **Includes Flex Credit of $21.67 per pay period Tobacco Use Surcharge: An additional $100 will apply to premiums if you or your eligible dependents use tobacco products. Contact HR to learn more about tobacco cessation options 5
Employee Medical Rates Part-Time Employees: Bi-Weekly Rates $5,000 HDHP Plan $1,500 PPO Plan $500 PPO Plan Tier Total DMEI You Total DMEI You Total DMEI You Cost Pays Pay** Cost Pays Pay** Cost Pays Pay** Regular Annual Salary Up to $50,999 Employee Only $268.88 $251.64 $17.24 $344.94 $253.17 $91.77 $365.29 $253.17 $112.12 Employee & $537.74 $372.97 $164.77 $689.86 $308.04 $381.82 $730.56 $308.04 $422.52 Spouse Employee & $470.81 $337.73 $133.08 $603.99 $275.40 $328.59 $639.62 $275.40 $364.22 Child(ren) Family $672.18 $467.69 $204.49 $862.33 $400.37 $461.96 $913.21 $400.37 $512.84 Regular Annual Salary $51,000 to $149,999 Employee Only $268.88 $88.22 $180.66 $344.94 $49.63 $295.31 $365.29 $49.63 $315.66 Employee & $537.74 $341.20 $196.54 $689.86 $290.24 $399.63 $730.56 $290.24 $440.33 Spouse Employee & $470.81 $305.93 $164.87 $603.99 $257.58 $346.41 $639.62 $257.58 $382.04 Child(ren) Family $672.18 $420.03 $252.15 $862.33 $364.75 $497.58 $913.21 $364.75 $548.46 Regular Annual Salary $150,000+ Employee Only $268.88 $51.90 $216.98 $344.94 $10.00 $334.94 $365.29 $10.00 $355.29 Employee & $537.74 $257.22 $280.52 $689.86 $236.81 $453.05 $730.56 $236.81 $493.76 Spouse Employee & $470.81 $235.53 $235.28 $603.99 $221.94 $382.05 $639.62 $221.94 $417.68 Child(ren) Family $672.18 $319.03 $353.15 $862.33 $302.42 $559.91 $913.21 $302.42 $610.79 **Includes Flex Credit of $10 per pay period Tobacco Use Surcharge: An additional $100 will apply to premiums if you or your eligible dependents use tobacco products. Contact HR to learn more about tobacco cessation options 6
Employee Dental Rates Full-Time Bi-Weekly Rates Base Plan Plus Plan Total DMEI Total DMEI Bi-Weekly Rates You Pay You Pay Cost Pays Cost Pays Employee Only $15.31 $13.31 $2.00 $19.97 $13.31 $6.66 Employee & Spouse $30.64 $22.64 $8.00 $39.95 $22.64 $17.31 Employee & Child(ren) $26.82 $19.82 $7.00 $37.71 $19.82 $17.89 Family $38.29 $28.29 $10.00 $54.73 $28.29 $26.44 Full-Time Semi-Monthly Rates Base Plan Plus Plan Total DMEI Total DMEI Bi-Weekly Rates You Pay You Pay Cost Pays Cost Pays Employee Only $16.59 $14.42 $2.17 $21.63 $14.42 $7.21 Employee & Spouse $33.19 $24.52 $8.67 $43.27 $24.52 $18.57 Employee & Child(ren) $29.05 $21.47 $7.58 $40.85 $21.47 $19.38 Family $41.48 $30.65 $10.83 $59.29 $30.65 $28.64 Part-Time Bi-Weekly Rates Base Plan Plus Plan Total DMEI Total DMEI Bi-Weekly Rates You Pay You Pay Cost Pays Cost Pays Employee Only $15.31 $5.31 $10.00 $19.97 $5.31 $14.66 Employee & Spouse $30.64 $14.64 $14.64 $39.95 $14.64 $25.31 Employee & Child(ren) $26.82 $12.82 $12.82 $37.71 $12.82 $24.89 Family $38.29 $18.29 $18.29 $54.73 $18.29 $36.44 7
Common Insurance Terms Premium: The amount you pay for insurance Medical Copayment (copay): The fixed amount you pay to receive services Deductible: The amount of money you are responsible for before insurance kicks in and starts paying their portion Coinsurance: The percentage of cost that is split between you and the insurance carrier once your deductible is met Out-of-Pocket Maximum: The most you will pay per plan year for health care expenses, including deductibles, flat dollar copays and coinsurance Amounts shown below are your responsibility. This table only shows in-network benefits BCBS BCBS BlueCross BlueShield of Oklahoma $1,500 PPO $500 PPO Plan Network Blue Advantage Blue Advantage After deductible, BCBS pays 80%, After deductible, BCBS pays 80%, Coinsurance employee pays 20% employee pays 20% Primary: $25 Primary: $25 Office Visit Copay Specialist: $25 Specialist: $25 Preventive Care Covered in Full Covered in Full Urgent Care Copay $25 Copay $25 Copay $200 Copay, then Deductible & $200 Copay, then Deductible & Emergency Room Coinsurance Coinsurance Outpatient Hospital Services Deductible & Coinsurance Deductible & Coinsurance Inpatient Hospital Services Deductible & Coinsurance Deductible & Coinsurance Individual: $1,500 Individual: $500 Plan Year Deductible Family: $6,000 Family: $2,000 Individual: $5,000 Individual: $5,000 Medical Out-Of-Pocket .Maximum Family: $10,000 Family: $10,000 Prescription Coverage* Copays OU Health / BCBS Generic $0 / $15 Preferred Brand Greater of: 20% or $40 / 30% or $60 Non-Preferred Brand Greater of: 20% or $60 / 35% or $90 Specialty Greater of: 30% or $100 / 40% or $200 8
FSA What is a Flexible Spending Account? A Flexible Spending Account (FSA) is a savings account filled with a pre-determined, pre-taxed amount from your paycheck to help pay for qualified out-of-pocket medical expenses. FSAs allow you to put aside money tax-free Medical FSA funds are available at the first of the year, so the amount you elect to contribute is available to use any time. When you have an eligible expense, you can use the plan’s debit card to pay for services or you can submit a manual claim and be reimbursed from your account Eligible Expenses: Visit www.optum.com to: Medical and dental deductibles, coinsurance view your account or copays check balances Medical equipment view claims Hearing aids submit claim substantiations Prescription drugs request claim reimbursements. Eye Care Expenses Eligible Claims: Expenses must be incurred during for a complete list, visithttps://fsastore.com the plan year (January 1 thru December 31) Ineligible Expenses: Deadline to Submit of Reimbursement: March Cosmetic surgery 15th of the following year Teeth whitening The IRS does NOT allow you to Fitness club dues contribute to a healthcare FSA and HSA Premiums for a spouse’s health plan at the same time! The FSA is only Over-the-counter medications or drugs that available to employees participating in haven’t been prescribed, except insulin the PPO Plan. Pre-tax benefit that is “Use it or Lose It” Only use for Annual contribution qualifying out of You can rollover up to limit of $3,300 pocket expenses $660, but any additional funds remaining will be lost. For any questions, go to www.optum.com or call 866-234-8913. 9
Dependent Care FSA The Flexible Spending Account for Dependent Care can reimburse your eligible day care expenses for a dependent who lives with you, and who is under the age of 13 (or disabled of any age). You must claim this person as a dependent on your tax return. What is Covered? Can use on a dependent under the age You may be reimbursed only for care that of 13 or dependents who cannot care enables you to work (or look for work) on a for themselves full-time basis. You can’t be reimbursed for care provided by your spouse, your child under age 19, or someone you claim Annual contribution limit of $5,000 per as a dependent. household ($2,500 if married but filing separate) FSA or Tax Credit? A child-care tax credit is available on your federal income tax return. Expenses you pay through the Dependent Care Account Funds can only be used as they are reduce the tax credit you may claim. If you deposited into your account earn less than $25,000, you may benefit more by using the tax credit. Ask a tax advisor which is better for you. Guidelines: Remember! If you enroll in the Dependent Child must be dependent on you for Care Account, the account is funded with over 50% of his or her financial money from each paycheck. Budget support accordingly as the elections cannot be Care may be provided inside or changed until next year’s open enrollment outside your home, but not by or a qualifying event. anyone considered your dependent for income tax purposes, such as one of your older children. For any questions, go to www.optum.com or call If care is provided at a facility that 866-234-8913. cares for more than six children, the facility must be licensed. 10
Common Insurance Terms Premium: The amount you pay for insurance Medical Copayment (copay): The fixed amount you pay to receive services Deductible: The amount of money you are responsible for before insurance kicks in and starts paying their portion Coinsurance: The percentage of cost that is split between you and the insurance carrier once your deductible is met Out-of-Pocket Maximum: The most you will pay per plan year for health care expenses, including deductibles, flat dollar copays and coinsurance Amounts shown below are your responsibility. This table only shows in-network benefits BCBS BlueCross BlueShield of Oklahoma $5,000 HDHP Plan Network Blue Advantage Coinsurance After deductible, BCBS pays 100% Office Visit Copay No charge after deductible Preventive Care Covered in full Urgent Care Copay No charge after deductible Emergency Room No charge after deductible Outpatient Hospital Services No charge after deductible Inpatient Hospital Services No charge after deductible Individual: $5,000 Plan Year Deductible Family: $10,000 Individual: $5,000 Medical Out-Of-Pocket .Maximum Family: $10,000 Prescription Coverage* Copays OU Health / BCBS Generic Preferred Brand No charge after deductible Non-Preferred Brand Specialty 11
HSA A Health Savings Account or HSA is a tax-advantaged medical savings account available to anyone enrolled in a High Deductible Health Plan (HDHP.) HSAs allow you to save money for current and future medical expenses. One of the advantages of an HSA is that funds roll over from year to year. You own the account. Even if your HSA-compatible coverage ends, you can still use your HSA funds tax-free for eligible medical expenses. Please see the chart below for the HSA contribution limits for 2025. Benefits of an HSA: Guidelines to Participate in an HSA: Save Money. HDHPs have lower monthly The HSA plan is only available to employees premiums, meaning less money is taken out of enrolled in the High Deductible Health Plan your paycheck to pay for health insurance Portability. The money in your HSA is carried over from year to year and is yours to keep, even if you leave the company. Tax-Savings. HSA contributions are made with You cannot be covered by any other non-HSA- pre-tax dollars. Since your taxable income is compatible health plan, including Medicare Parts A decreased by your contributions, you’ll pay less and B, a traditional PPO plan or TriCare, or be in taxes. claimed as a dependent on another person’s tax Additional Retirement Savings. After age 65, return. funds can be withdrawn for any purpose without penalty (only income tax is assessed). Investment Opportunities. Once you have a You cannot have accessed your VA medical balance of $1,000 in your HSA account, you can benefits in the past 90 days (to contribute to HSA) self-direct investments that can potentially grow your savings for healthcare or retirement. Contribution Limitations: 2025 IRS 2025 DMEI Annual 2025 Employee Contribution Limit Contribution Contribution Limit Single $4,300 $500 $3,800 Family $8,550 $1,000 $7,550 Age 55+ $1,000 Catch Up For any questions, go to www.hsabank.com or call 800-357-6246. 12
HSA How Does an HSA Plan Work? The elections you make to an HSA are automatically taken from each paycheck throughout the year and deposited in your HSA. You can also contribute to your account anytime throughout the year via the online portal. When you have an eligible expense, HSA Bank offers convenient options to pay for current or future healthcare expenses, including your HSA debit card, online bill pay or manual check. To pay for a service, you must have available funds in your account. HSA Bank Member Resources: Check account balances Enter expenses into Expense Tracker View account activity Request additional debit cards Move money to your HSA Add an authorized signer Schedule an HSA distribution Add a beneficiary Visit www.hsabank.com or download the HSA Bank mobile app to get started! HSA Case Study Justin is a healthy 28-year old who contributes $200 each year to his HSA plan. Justin is enrolled in Employee Only coverage in the $5,000 HDHP, so dean McGee contributes $500 each year to his HSA. Here is a look at the first two years of Justin’s HSA plan. Year 1 Year 2 DMEI Employer Contribution $500 $500 Employee Contribution $200 $200 $700 + Year 1 Rollover of $430 = HSA Balance $700 $1,130 Office Visits: $240 Office Visits: $120 Total Expenses Prescription Drugs: $210 Prescription Drugs: $150 Preventive Care: $0 Total: $170 Total: $450 HSA Rollover to Year 2 $430 $680 Since Justin did not spend all of his HSA dollars in Year 1 or Year 2, he did Year-End Summary not have any additional expenses out-of-pocket and was able to rollover his available funds to the following year. For any questions, go to www.hsabank.com or call 800-357-6246. 13
Medical How do I find in-network providers? In-Network Providers can be found on bcbsok.com under “Find a Doctor.” Select Group Health Plans and choose the BCBS Blue Advantage Network. You can also call 800-942-5837. Preventive Services Did you know that Preventive Services are 100% free under any of the medical plans offered to you? Copays and Deductibles do NOT apply. 1-stop platform for primary S care, urgent care, dermatology, T behavioral health, and employee assistance programs MDLIVE is a leading telehealth C provider, offering solutions designed A F 75+ Net Promoter Score® to increase access to high-quality care, annually since 2019 improve health outcomes, and reduce E V Over 2,500 providers with 5,500+ licenses the total cost of care for patients, I employer groups, and health plans. We L D 24/7/365 coverage in 50 states + Puerto Rico offer best-in-class core virtual care M solutions including primary care, 62M+ eligible members urgent care, behavioral health, Founded in 2009 employee assistance programs, and dermatology. How Do I Create an Account? Cost Per Visit 1.Go to MDLIVE.com Copay on either PPO $25 2.Click on “create my account” Plan 3.Fill in your details to login and schedule an appointment $48 Copay on HDHP Plan Questions? Call 800.400.6354 14
OU Health Pharmacy Why use OU Health Pharmacy? $0 co-pay for generic drugs* Immunizations Weekly delivery to Dean McGee Auto-refill upon request Five convenient locations Chronic disease state expertise Free shipping for remote employees if you Compounding live in Oklahoma Special order over-the-counter Curbside pickup medications upon request Easy to use app for communicating with your pharmacy Switch to OU Health Pharmacy During Open Enrollment, Dean McGee employees are encouraged to transfer their pharmacy services to OU Health Pharmacy to take advantage of lower copays for generic to specialty prescriptions. OU Health Pharmacy offers friendly service, convenient pick-up and free shipping and the highest level of expertise. All locations offer curbside pick- OU Health Pharmacies: up, and the Oklahoma Children’s Generic: $0 Hospital location is open seven Preferred Brand: Greater of 20% or $40 days per week. OU Health — Non-Preferred Brand: Greater of 20% or $60 Nicholson Tower Pharmacy Specialty: Greater of 30% or $100 delivers once weekly to Dean McGee, and if you work remotely in All Other In-Network Pharmacies: Oklahoma, you can take advantage Generic: $15 of free shipping. Preferred Brand: Greater of 30% or $60 Non-Preferred Brand: Greater of 35% or $90 Making the switch to an OU Health Specialty: Greater of 40% or $200 Pharmacy is easy. You can fill out a Transfer Form and fax or return in OU Health has five retail pharmacy locations, including: person to your desired pharmacy - OU Health Physicians Building location. Also, you can ask your - Oklahoma Children’s Hospital OU Health doctor's office (regardless of - Nicholson Tower whether they are an OU Health - Family Medicine Clinic Physician or not) to send your - OU Health Stephenson Cancer Center prescriptions to one of our five OU Health Pharmacy locations. Scan the QR Code to transfer your prescriptions to an OU Health Pharmacy 15
Your dental provider offers an extensive list of network providers Dental that will provide flexibility and savings. We understand how important your health and well-being are and offer this comprehensive Dental Plan to help keep you on the right track. Amounts shown below are your responsibility. This table only shows in-network benefits. Base Plan Plus Plan Network BlueCare DentalSM BlueCare DentalSM $50 per person $50 per person Plan Year Deductible $150 per family $150 per family Covered in full Covered in full Preventive & Diagnostic Care Deductible waived Deductible waived Basic Care 50% 50% Major & Restorative Care 50% 50% Plan Year Maximum Per $1,000 $1,500 Person Orthodontia (Children under 50% after deductible up to Not covered 26) lifetime maximum Orthodontic Lifetime $1,500 per dependent Maximum per Dependent Not covered child Child Preventive Care How do I find in-network providers? Preventive care is covered at In-Network Providers can be found on 100% on both plans available. bcbsok.com under “Find a Dentist.” Choose the BlueCare Traditional Network. You can Studies show that oral health is also call 800-942-5837. closely tied to your overall health. For example, gum disease has connections to diabetes, heart disease, high blood pressure and stroke. Having access to a plan that will cover your preventive visits can go a long way in maintaining your overall health. 16
Vision Amounts shown below are your responsibility. Contact Lens Benefit Employee Only 30% discount Employee’s Spouse / Dependents 30% discount Employee’s Extended Family (parents, siblings, 20% discount children over 26) Sundry Items (non-prescription) 25% discount Fittings Employee: $0 / Spouse & dependents: $35 Optical Shop Benefits Prescription Spectacles: 55% Discount Employee / Spouse / Qualified Dependents Sundry Items: 25% Discount Prescription Spectacles: 25% Discount Employee’s Family or Gifts for Family Sundry Items: 25% Discount Refractive Surgery Benefits Employee’s 25% Discount off current cost Family Service SLC Fee Total Fee Employee / Standard LASIK $925 $925 Spouse / Custom LASIK $925 $925 Qualified Standard PRK $925 $925 Dependents Custom PRK $925 $925 Routine eye exams are free to employees, their spouse and eligible dependents. The employee’s health insurance will be billed for medical services and Dean McGee will accept the insurance reimbursement as payment in full, unless the deductible has not been met. The employee is responsible for the portion of the insurance reimbursement applied to Physician’s the deductible. Services Benefits In the event that an employee or family member is not covered by a health insurance plan, or if they are covered by Medicare/Medicaid, they will be responsible for the insurance reimbursement as set by Dean McGee’s group health plan or by Medicare/Medicaid at the time services are rendered. 17
Employer Paid Because life insurance is important to your Life & AD&D financial well-being, eligible employees are provided this benefit at no cost. You designate your beneficiary when you enroll. This person(s) will receive the benefits from your Life and AD&D coverage in the event of your death. You can change your beneficiaries at Beneficiaries any time during the year. While not always top of mind, making sure that death benefits are directed to the intended beneficiary(ies) is very The Standard important when you have life insurance. Coverage Amount Life Insurance Having an up-to-date beneficiary designation will help ensure payments get to the correct person in the event of 1.5x Salary up to Employee Life your passing. $300,000 Updating a beneficiary is something you Employee Equal to your life can do at any time, so please always keep AD&D amount your beneficiary up to date. Rounding Up to next $1,000 You are a valued part of the Dean McGee team and we are pleased to offer you Age Reduction To 65% at age 65 100% employer paid Schedule To 50% at age 70 Life and AD&D coverage for all employees working 20 hours or more per week only. Please see next page for additional coverage that can include spouse and dependents For further questions and details, see full benefit summary. You can also go to www.standard.com or call 800-368-2859. 18
Should you need additional life insurance, we recommend you enroll upon hire in the Voluntary Life Program which offers competitive pricing and Additional the convenience of payroll deduction. New hires may elect up to the Guarantee Issue (GI) amount. Amounts requested over the GI or outside the Life Coverage New Hire Period may require an EOI (Evidence of Insurability) form. Guarantee Issue (GI) and Evidence of Insurability The Standard Life Coverage Amount (EOI) Insurance 8x Annual Earnings A guaranteed issue amount on Employee Max Life Up to $500,000 in $10,000 life insurance is the amount of and AD&D Amount increments coverage you can elect without having to submit an Evidence of up to $250,000 in Spouse Max Life and Insurability (EOI), a medical AD&D Amount $5,000 increments questionnaire used to determine Dependent Child up to 26 years of if you qualify for coverage. age: Eligible for $10,000 in coverage Child Max Life and AD&D Amount Child under 1 month: Eligible for If you want to elect a coverage $2,000 in coverage amount that exceeds the guaranteed issue, you can but Employee Guarantee $150,000 Issue Amount you will be required to fill out this EOI and go through a Spouse Guarantee $30,000 coverage approval process. Issue Amount Child Guarantee Issue If you do not elect optional life $10,000 Amount insurance as a new hire, any To 65% at age 65 Age Reduction subsequent election will be Schedule To 50% at age 70 subject to Evidence of Insurability. Optional Life Monthly Rates - Per $1,000 of Coverage Employee/ Employee/ Employees enrolled in voluntary life Age Age Spouse Spouse can increase their election by $10k each year at open enrollment, up to
Short-Term The financial consequences of not being able to work due to a sickness or accident off the job can be devastating to Disability both you and your family. We recognize this risk and are pleased to offer a comprehensive disability program. Disability insurances replaces your income for a limited period of time after an accident or injury. Benefits elected paycheck outside the New Hire Period may require an individual protection medical statement. Voluntary Short Term Disability Plan Overview Eligibility Must work at least 20 hours per week Maximum Weekly Benefit $1,000 Maximum Duration 90 Days Weekly Benefit Percentage 60% of your before-tax weekly earnings, not to exceed maximum Benefits begin on the 8th day following an accidental injury, physical Elimination Period disease, pregnancy or mental disorder 60 days for any qualifying disability caused by physical disease, Extended Elimination Period pregnancy or mental disorder occurring during the first 12 months (for late entrants) of coverage If you become disabled and can work part-time (but not full-time), you may be eligible for partial disability benefits, which will help Partial Disability Benefits supplement your income until you are able to return to work full- time. The premium for your short-term disability coverage is waived while Waiver of Premium you are receiving benefits. Use the following calculator to estimate your per pay period premium: Weekly Earnings X 0.60 X $0.85 / 10 = Monthly Premium 8 day waiting period Your disability payments will be combined with, $1,000 maximum per and offset by, any other disability income you week receive (social security, state disability, etc...) so that your monthly payments total your elected C o s t is $0 .85 p er $1 0 o f percentage of your “basic earnings.” w eek l y b en ef it For further questions and details, see full benefit summary. 20 You can also go to www.standard.com or call 800-368-2859.
The financial consequences of not being able to work due Long-Term to a sickness or accident off the job can be devastating to both you and your family. We recognize this risk and are pleased to offer a comprehensive disability program. Disability Disability insurances replaces your income for a limited period of time after an accident or injury. Benefits elected outside the New Hire Period may require an individual paycheck medical statement. protection Voluntary Long Term Disability* Eligibility Must work at least 20 hours per week Maximum Monthly Benefit $8,000 Maximum Duration to Social Security Normal Retirement Age (SSNRA) Elimination Period (Waiting Period 90 days Before Benefits Begin) Own Occupation Period 24 Months Insured Pre-disability Earnings $13,333 Mental & Nervous Limitation 24 Months Substance Abuse Limitation 24 Months Please note: The LTD plan is available to all eligible Employees except Providers Your disability payments will be combined with, and offset by, any other disability income you Age Rate Age Rate receive (social security, state disability, etc...) so that your monthly payments total your elected
Being prepared for the unexpected can make all the difference. An Accident Accident policy can provide you with a solution for those unforeseen accidents that life sometimes delivers. This coverage will pay you a cash benefit for a myriad of injuries, some of which are shown here. The Standard Enhanced Premier Hospital Admission $1,000 $1,500 Ground Ambulance $300 $600 Emergency Room $150 $200 Outpatient Facility $150 $500 Enhanced Premier Deductions Bi-Weekly Semi-Monthly Bi-Weekly Semi-Monthly Employee Only $4.13 $4.47 $6.27 $6.80 Employee & Spouse $6.55 $7.10 $9.83 $10.64 Employee & Child(ren) $7.80 $8.45 $11.86 $12.85 Family $12.21 $13.23 $18.54 $20.08 Additional Features and Benefits for injuries resulting from an accident: Two Plan Options Benefits cover ON or OFF the Job accidents Benefits paid regardless of other coverage Enhanced Benefits pay directly to you Benefits for Emergency Room, Urgent Care, Premier Surgery and Testing Broken Tooth, Eye Injury (removal of substance) Benefit for dislocations and fractures Benefits for Physical, Speech, Vocational, Respiratory and Occupational Therapies Lodging Benefits Benefit for burns Plan is portable For further questions and details, see full benefit summary. You can also go to www.standard.com or call 800-368-2859. 22
Critical Illness coverage pays you in the event Critical Illness that you are diagnosed with a covered illness. This is a cash benefit paid directly to you. The Standard Coverage Amount Employee Amount $5,000 increments up to $30,000 Spouse Amount $5,000 increments up to $15,000 Child Amount 50% of the employee amount Cancer Deafness/Blindness Covered Conditions Include but are Heart Attack Stroke not limited to End Stage Renal Failure Major Organ Transplant $50 per person per year if they receive any eligible Wellness Benefit preventive exam or physical. Monthly Rate per $1,000 of Coverage Additional Features: Covered Critical Illnesses at Age-Band Non-Tobacco Tobacco 100%: Cancer, Heart Attack, Stroke, Coronary Artery 18-29 $0.27 $0.29 Bypass Graft, Kidney Failure, Major Organ Failure 30-39 $0.44 $0.55 Re-Occurrence Benefit 100% of Initial Benefit (after 6 40-49 $0.93 $1.44 months) for above conditions 50-59 $1.88 $3.57 Portability included Spouse covered at 50% of 60-69 $3.35 $7.35 Employee Amount Children covered at 50% of 70+ $5.89 $13.02 Employee amount up to age 26 Children: Automatically included in rate Coverage amounts of $5,000 to $30,000, available in Use the following calculator to estimate your per pay period $5,000 increments premium: Rates based on attained age Employee age used for Coverage Amount/$1,000 X Age Band Rate = Monthly Premium spouse rates Monthly Premium/Number of Pay Periods = Per Pay Period Premium For further questions and details, see full benefit summary. You can also go to www.standard.com or call 800-368-2859. 23
We recognize how important our employees and family members’ work/life balance is as you go through life’s many challenges, and have Life provided an Employee Assistance Program that is available to you and your household family members at no cost. This program offers you someone to talk to and resources to consult whenever and Services wherever you need them. Don’t be afraid to reach out for help as, required by law, issues are kept completely confidential and private from all employers. Toolkit Support Tools Include: 3 face-to-face sessions with a grief counselor Grief Financial Support Counseling initial consult with an attorney online estate planning tools financial counselors to help with Work-Life Legal budget, credit, & debt Services Advisors management experts to help you complete household repairs & chores, find child care/elder care, organize a relocation Confidential Counseling The Standard EAP, Partnering with Stress, anxiety, and depression HealthAdvocate Financial problems Difficulties with children Phone: 866-293-6948 ? Job pressures h t Online: healthadvocate.com/standard3 i Grief and loss w Substance abuse p l Legal Support e When you call the assistance line, h Divorce and family law a highly trained counselor will P Debt and bankruptcy A give you personalized attention Landlord / tenant issues E to determine what services are Real estate transactions y Civil and criminal actions right for you. m Contracts n a Financial Information and Resources c t Getting out of debt a Credit card or loan problems h Tax questions W Retirement planning Estate planning For more information, please Saving for college refer to the carrier packet 24
As a valued Dean McGee Eye Institute Employee, the following travel Travel benefits are included in your employee benefits with The Standard., providing peace of mind while traveling. Visa, currency exchange, weather, inoculation recommendations, and more Missing baggage, emergency cash coordination, credit card/passport Hit the Road! Wheels Up! replacement You & your eligible Assistance replacing prescription dependents are covered medication or prescription lenses through your Group Life Policy with The Standard! Emergency evacuation to the nearest adequate medical facility Connection to local attorneys, interpreter services, and medical care providers Evacuation arrangements in the event of natural disaster, political unrest, and social instability Contact 800.872.1414 U.S., Canada, Puerto Rico, U.S. Virgin Islands, & Bermuda 1.609.986.1234 or text 1.609.334.0807 Everywhere else For more information, please refer to the carrier packet 25
401K Fidelity administers your retirement plan. You can contact the Customer Service Department at 800-835-5097 or visit www.401k.com Accessing your account online Your Employer’s Contributions 1 All employees are able to participate immediately upon hire Dean McGee Eye Institute 2 contributes 3% of your paycheck. 100% vested in contributions 3 May contribute 90% of earnings or the IRS limit From time to time, DMEI’s Board of Directors may elect to make a 4 2025 IRS limit is $23,500 discretionary contribution. These Participants over the age of 50 may elect to make catch-up contributions are meant to 5 enhance a participant’s contributions with the limit of $7,500 retirement savings. Safe harbor contributions are made regardless of a 6 participant’s contribution rate Participants are 100% vested in 7 their contributions and all Safe Contributions increase by 1% each June, unless you Harbor contributions made by decline DMEI. This means the value of your contributions and earnings are yours. Discretionary contributions have a 2-year vesting schedule. 26
Additional Contacts Life, Disability & Medical & Dental Vision EAP 800-368-2859 800-942-5837 405-271-6060 standard.com bcbsok.com dmei.org HSA FSA Fidelity Investments 800-357-6246 866-234-8913 800-835-5097 hsabank.com optum.com 401k.com 27
