2020BENEFITS GUIDE

Enrollment Guidelines…2Enrollment Instructions…3-4Medical Plan OptionsTraditional PPO Plan…5HDHP Plan & HSA….6Dental Summary ….7Working on Wellness…7Vision Summary….8Discounts, Eye Care & Hearing Aids…9Life Insurance & VoluntarySupplemental Term Life…10Dependent Care Flex Account …11Retirement Plans -457(b) & 401(a)… 11Employee Assistance Program &Other Benefits…12 & 13Employee Premium Rates…14Important Contacts…15

This Benefits Guide is an overview of the benefits provided by Sheridan Memorial Hospital. It is not a Summary Plan Description or Certificate of Insurance. If a question arises about the nature and extent of your benefits un-der the plans and policies, or if there is a conflict between the informal language of this Benefits Guide and the contracts, the Summary Plan Description or Certificate of Insurance will govern. Please note that the benefits in your Benefits Guide are subject to change at anytime. The Benefits Guide does not represent a contractual obligation on the part of Sheridan Memorial Hospital.

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ENROLLMENT GUIDELINESWelcome to the 2020 Benefits Guide for Sheridan Memorial Hospital. This Guide provides a quick overview of the benefits program and helps to remove confusion that sometimes surrounds employee benefits. The SMH benefits program is structured to provide comprehensive coverage for you and your family. Benefit programs provide a financial safety net in the event of unexpected and

potentially catastrophic events.

ELIGIBILITYYou are eligible to enroll in the benefits program if you are in a benefits eligible status working at least 32 hours per pay period or part-time, at least 16 hours per week. Benefits for newly hired eligible employees will take effect the first of the month following your date of hire.

Your legal spouse and your dependent children (less than 26 years of age) are eligible for medical coverage. Disabled children over age 26 may be eligible to continue benefits after approval of necessary applications.

OPEN ENROLLMENTOpen enrollment is once a year and benefit elections will take effect January 1st. Participants may switch between the medical plan options at this time. Late entrants (employees or dependents who apply for coverage more than 31 days after the date of individ-ual eligibility) are also provided an opportunity to enroll for coverage during the plan’s open enrollment. The elections you make

stay in effect the entire plan year, unless a qualifying life event occurs.

SPECIAL ENROLLMENT RIGHTSIf you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself or your dependents in this plan if you or your dependents lose eligibility for that other coverage, or if the employer stops contributing towards your or your dependents’ other coverage. Under the med-ical plan, Open Enrollment under your spouse’s group plan will also be considered a qualifying event. However, you must request enrollment within 31 days after you or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).

In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, youmay be able to enroll yourself and your dependents. However, you must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption. (You have 60 days to complete and enter a new enrollment in Infor after coverage under Medicaid or CHIP terminates.)

EMPLOYEE BENEFITS PORTALInfor Employee Space – All benefit elections, changes, and waivers must be made by using the Infor Employee Space Enrollment Portal. Instructions are found on the following page.

Copyright (c) 2017 (Novo Benefits) - All Rights Reserved. This employee guide is intended solely for the use of participants of the employee benefit plan specified herein. It may contain confidential or privileged information. If you are not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited without the written consent of Novo Benefits.

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EMPLOYEE SPACE LOGIN

When accessing from inside SMH:

Access Infor Employee Space from The Pulse (intranet.sheridanhospital.org). Once

on the page, click the Infor icon, then login using your main username and

password.

When accessing from home:

Go to www.sheridanhospital.org - scroll to bottom and click on Staff Portal under

“Other”. Use your hospital username and password to login.

If you are unable to get into your Employee Space, submit an IT help desk ticket with Infor in the subject line. For questions on entering changes through Employee Space, contact the Human Resources department at hr@sheridanhospital.org.

ENTER BENEFIT ELECTIONS

Click on the Life Events Button.On the right side of the screen, you will see the Continue Events box.

Select the Hire Button

The Life Event Details will display with the date you are eligible to begin benefits.

Changes become effective according to the plans policies and display on your confirmation statement.

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ENROLLMENTClick on the Instructions button to review the instructions.

Click on the Dependents and Beneficiaries button to add any of the dependents to cover on insurance or beneficiaries for life insurance plans.

Click on the Enrollment tab. Now click on each benefit section to elect the insurance coverage.

The red circle designates those required to be reviewed. The yellow circle designates items may be missing, i.e. missing beneficiary.

Select the plans in the upper section and the dependents to cover on the plan in the bottom section of the window.

If the dependent does not currently show up in the bottom section, click Add to up-date the list.

PLANS & COVERAGEHealth/Medical – Make selection of benefit plan and dependents to cover.

Health Savings Account – Make contribution amount selection.

Dental – Make selection of benefit plan and dependents to cover.

Vision – Make selection of benefit plan and dependents to cover.

Employee Life – Select coverage and the beneficiaries for the plan.

Spending Accounts – Select whether to contribute to Dependent Care FSA or to waive the spending account.

Dependent Life – Select the life insurance plan and then depen-dents to cover.

Retirement Accounts – Select whether to contribute your retire-ment savings and the beneficiaries for the plan.

REVIEW AND SUBMITIf you missed any steps in the process or had any errors, you will receive a message and can return to the areas to fix.

Otherwise, you can click on Submit to have the changes entered.

A Confirmation window displays. Click OK to continue submitting.

You can print out a confirmation of the plans selected. A Benefit cost summary shows the employer and employee cost.

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TRADITIONAL PPO MEDICAL PLANWHAT YOU PAY AND WHAT THE PLAN PAYSThe below Summary of Benefits shows how much you pay for care, and how much the plan pays. It’s a brief listing of what is includ-ed in your benefits plan. For more detailed information, see your summary plan description.

After you pay your annual deductible and/or any up-front copays, the plan begins to pay a percentage of your provider’s charges, for example 80%. The remaining percentage, for example 20%, is your responsibility – your “out-of-pocket” costs. You’re protected from financial hardship by a maximum out-of-pocket amount each year – the most you’ll have to pay before the plan covers costs at 100% (excluding non-covered expenses and expenses above reasonable and customary charges). (Copays do not apply to the out-of-pocket maximum.)

SAVE WHEN YOU SEE NETWORK PROVIDERSThis plan offers a Preferred Provider Organization (PPO), a network of doctors and other healthcare professionals who have agreed to accept lower amounts than their standard charges. These lower amounts are negotiated and predetermined. That means when you see a PPO provider, your share of costs is based on a lower charge – so your costs are lower, too. PPO providers are conveniently located in both urban and rural areas. Remember: If you go outside the PPO network, you may still have benefits, but your share of costs will be higher, and the amount you pay will not be based on a lower rate.

Benefit Traditional PPO PlanSMH Providers Network Providers Non-Network Providers

Deductible $1,250/single$2,500/family

$1,250/single$2,500/family

$1,250/single$2,500/family

Out-of-Pocket Max* $1,750/single$3,500/family

$2,250/single$4,500/family

$2,750/single$5,500/family

Preventive Care 100%, DW 100%, DW 60%, AD

Office Visit $20 copay $20 copay 60%, AD

Specialist Office visit $20 copay $20 copay 60%, AD

Outpatient Hospital 90%, AD 80%, AD 60%, AD

Inpatient Hospital 90%, AD 80%, AD 60%, AD

Emergency Room 90%, AD 80%, AD 80%, AD

*Includes Deductible AD – After Deductible DW – Deductible Waived

PrescriptionsRetail – 30 day supply

GenericPreferred

Non-PreferredMaximum Out of Pocket Rx

$5 copay, plus 20% DW$10 copay, plus 20% DW$20 copay, plus 50% DW

$2,500

$5 copay, plus 20% DW$10 copay, plus 20% DW$20 copay, plus 50% DW

$2,500

$5 copay, plus 20% DW$10 copay, plus 20% DW$20 copay, plus 50% DW

$2,500

Mail Order – 90 day supply Generic

PreferredNon-Preferred

$10 copay, plus 20% DW$20 copay, plus 20% DW$40 copay, plus 50% DW

$10 copay, plus 20% DW$20 copay, plus 20% DW$40 copay, plus 50% DW

$10 copay, plus 20% DW$20 copay, plus 20% DW$40 copay, plus 50% DW

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HDHP PLAN WITH HSA OPTIONBenefit High Deductible Health Plan (HDHP)

Sheridan Memorial HospitalProviders

Network Providers Non-Network Providers

Deductible $2,250/single$4,500/family

$2,250/single$4,500/family

$2,250/single$4,500/family

Out-of-Pocket Max* $2,750/single$5,500/family

$3,250/single$6,500/family

$4,250/single$8,500/family

Preventive Care 100%, DW 100%, AD 60%, AD

Office Visit 90%, AD 80%, AD 60%, AD

Specialist Office visit 90%, AD 80%, AD 60%, AD

Outpatient Hospital 90%, AD 80%, AD 60%, AD

Inpatient Hospital 90%, AD 80%, AD 60%, AD

Emergency Room 90%, AD 80%, AD 80%, AD

Prescriptions 80%, AD 80%, AD 80%, AD

*Includes Deductible AD – After Deductible DW – Deductible Waived

HEALTH SAVINGS ACCOUNTS (HSA)What is an HSA?An HSA is an account that can be funded by you with pre-tax dollars. The HSA helps pay for eligible medical expenses not covered by an insurance plan, including the deductible, coinsurance, and prescriptions.

How HSAs WorkParticipants make contributions to HSAs up to the allowable IRS limits. The funds can earn interest and be withdrawn at any time to cover qualified medical expenses. Unlike a flexible spending account, there is not a “use-it-or-lose-it” rule. The account will automatically roll over year-after-year. It is an individual account; if you change health plans or jobs, the balance is yours to keep.

When do I use my HSA?After visiting a physician, facility, or pharmacy, request they submit your claim to your Health Plan for payment. You should make sure your provider has your most up-to-date insurance information. Once the claim has been processed, any out-of- pocket expenses will be billed. Always ask that your claim be submitted to the health plan before you seek HSA reimburse-ment. This will ensure provider discounts are applied. Also, remember to keep all medical receipts and Explanation of Benefits (EOBs) to support your personal tax record. You can choose to save your HSA dollars for future medical expenses.

2020 Annual Employer HSA ContributionsFull-Time Part-Time

Individual $300 Individual $225

Family $600 Family $450

2020 IRS Contribution Limits for HSAs (Including Employer Contributions)

Individual $3,550

Family $7,100

Catch-Up Contribution (Age 55+ ) $1,000

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DENTAL AND WELLNESS BENEFITSSheridan Memorial Hospital offers dental benefits through UMR. If you opt out of the medical plan you may elect dental only.

Dental Plan BenefitsDeductible $50/single

$100/two-Party$150/family

Calendar Year Maximum $1,000/person, does not apply to dependent children under age 19

Preventive ServicesOral Exams • X-rays • Cleanings 100%, deductible waived

Basic ServicesFillings • Space Maintainers

General Anesthesia • Palliative Treatment50%, after deductible

Major ServicesCrowns • Inlays & Onlays • Bridgework

Dentures • Complex Surgical Extractions50%, after deductible

At Sheridan Memorial Hospital, we strive to build a “Culture of Health” within ourorganization and to be a wellness role model for our community. The Working On Wellness (W.O.W.) program focuses on supporting the overall health and wellbeing of our employees knowing that being our individu-al best contributes to excellent care for our patients and their families. Throughout the year, the W.O.W. team provides a variety of opportunities for our employees toparticipate in wellness activities supporting healthy habits and attitudes to live healthier, happier, and more fulfilling lives both at work and at home.

For 2020, we are offering wellness incentives to encourage employee participation in the W.O.W. program. This year the incentives are in the form of a cash benefit, to be paid out each quarter (the amount is based on your medical plan election). The program is completely voluntary, but we hope the incentives inspire you to partici-

pate. To take advantage of the incentives, you are required to participate in a Wellness Blood Draw, Online Health Risk Assessment, and Biometrics. You may also participate in an optional Physical Assessment. To join the program, simply select the WELLNESS option in the online employee benefits portal during annual open enrollment or when you become a new employee.

You can always participate in our wellness activities without joining the 2020 Wellness Program, but we hope youdecide to join us in building a culture of health at Sheridan Memorial Hospital. We are excited to focus on our hospital’s most valu-able strength – YOU!

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VISION BENEFITSSheridan Memorial Hospital offers voluntary vision benefits through VSP. The vision plans through VSP provide access to a national network including both private practice and retail chain providers. To find a participating provider, visit www.vsp.com.

VISION PLAN In-Network Basic Plan In-Network Premium PlanVision Exam Frequency $10 copay

Once every 12 monthsRoutine Retinal Screening covered after $39 maximum copay

Frames*Wide Selection

*Featured BrandsAdditional Savings:

Frequency:

$130 allowance$150 allowance

20%Every 24 months

$150 allowance$170 allowance

20%Every 24 months

Lenses (in lieu of contacts)*Single Vision*Lined Bifocal*Lined Trifocal

*Lenticular Frequency:

$25 materials copay$25 materials copay$25 materials copay$25 materials copay

Every 12 months

Lens Enhancements:*Standard Progressive*Premium Progressive*Custom Progressive

*Anti-Reflective Coating*Scratch Resistant Coating

*Tints/Photochromic Lenses

No additional copay Additional $95-$105 copay Additional $150-$175 copay

Additional $41 copay Additional $17 copay

Additional $70-$82 copay

No additional cost No additional cost No additional cost No additional cost No additional cost No additional cost

Contacts (in lieu of lenses) Lens exam (fitting/evaluation)

Frequency:

$130 allowance, no copay 15% discount to a

maximum copay of $60 Every 12 months

$150 allowance, no copay 15% discount to a

maximum copay of $60 Every 12 months

Network Providers VSP Physicians; plus, Eye Masters, Costco, Vision Works, Pearle Vision, Eye Care Centers of America, etc.

Out-of-Network Benefits $45 Exam Allowance$30 Single Vision Lenses/$50 Bifocal Lenses/$65 Trifocal Lenses

$100 Lenticular Lenses/$50 Progressive Lenses$70 Frame Allowance/$105 Elective Contact Lenses

$210 Medically Necessary Contact Lenses

Note: When using a non-network provider, the participant pays the full fee to the provider, and VSP reimburses the customer for services rendered up to the maximum allowance. All receipts must be submitted at the same time. While out-of-network, Sam’s Club and Walmart will file claims to VSP for you.

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VSP DISCOUNTS: EYE CARE & HEARING AIDSVSP PRIMARY EYECAREYou can visit your VSP Doctor as often as needed, paying only a $20 copay for services, which allows for greater savings compared to the specialist copay under your medical plan.

To Find a VSP Doctor, visit vsp.com or call 800-877-7195. At your appointment, tell them you have VSP . There’s no ID card necessary.

Office visit copay includes treatment for:• Eye Pain• Conditions like Pink Eye• Tests to diagnose sudden vison changes• Exams to monitor cataracts

• Retinal screenings• Pictures of your eyes to detect and track conditions for

glaucoma and diabetic eye disease

TruHearing® is making hearing aids affordable by providing exclusive savings to all VSP® Vision Care members.You can save up to $2,400 on a pair of hearing aids with TruHearing pricing. What’s more, your dependents and even extended family members are eligible, too.

In addition to great pricing, TruHearing provides :• Three provider visits for fitting, adjustments, and

cleanings• 45-day money back guarantee

• Three-year manufacturer’s warranty for repairs and one-time loss and damage

• 48 free batteries per hearing aid

Plus, with TruHearing you’ll get:• Access to a national network of more than 4,500 licensed hearing aid professionals• Straightforward, nationally fixed pricing on a selection of more than 90 digital hearing aids in 400 styles• Deep discounts on replacement batteries shipped directly to your door

Best of all, if you already have a hearing aid benefit from your health plan or employer, you can combine itwith this program to maximize the benefit and reduce your out-of-pocket expense.

HOW IT WORKSCall TruHearing. Call 877.396.7194. You and your family members must mention VSP. Schedule exam. TruHearing will answer your questions and schedule a hearing exam with a local provider. Attend appointment. The provider will make a recommendation, order the hearing aids through TruHearing and fit them for you.

Learn more about this VSP Exclusive Member Extra at vsp.truhearing.com or, call 877.396.7194 with questions.

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LIFE INSURANCEGROUP TERM LIFE INSURANCE AND AD&D COVERAGEAll Full-time employees are enrolled in Sheridan Memorial Hospital’s employer sponsored group health plan at no cost to the employee.

Coverage AmountsEmployee Life and AD&D Benefit: 1 times annual salary to a maximum of $300,000.Spouse Life and AD&D Benefit: $2,000Child (ren) Life and AD&D Benefit: $1,000

An employee may have coverage both as an insured and as an insured dependent. Only one eligible spouse may cover the eligible children as insured dependents.

Reduction:Basic Life/AD&D and Supplemental Life benefits will reduce to 50% of the original amountat age 70. No further reductions will occur after age 70.

VOLUNTARY SUPPLEMENTAL TERM LIFE INSURANCECoverage Amounts

Employee:Guarantee Issue:

Maximum:

Benefits are available in increments of $10,000 $80,000

The lessor of 5x Basic Annual Salary or $500,000

Spouse:Guarantee Issue:

Maximum:

Benefits are available in increments of $5,000$25,000

$250,000

Child:Maximum:

Flat amount $10,000$10,000

*Guarantee Issue amount is the maximum amount of coverage that a newly eligible employee can purchase regardless of medical condition. Any purchase or increase in benefits, which does not take place within 31 days of employee’s or dependent’s eligibility date is subject to evidence of insurability. Coverage is subject to approval by Reliance Insurance Company.

Waiver of PremiumIf you become totally disabled while insured; remain disabled for 6 months and continue to pay premiums during that period; and, are less than age 60, your life insur-ance will continue until the day you retire or you reach age 65. If total disability ends, you may exercise the conversion privilege.

ConversionIf your insurance terminates because you are no longer employed full-time, your insurance may be converted to an individual life insurance policy if you apply and include payment of the first premium within 31 days of termination.Conversion does not require proof of medical insurability.

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RETIREMENT & DEPENDENT CARE FSA457(B) RETIREMENT PLANSheridan Memorial Hospital retirement plan offers you a powerful way to save for retirement. Your contributions are pretax, i.e., made directly from your paycheck before income taxes are deducted, and the money grows in your plan tax free until it is with-drawn at retirement. Earnings are not taxable while in the plan, so they have the potential to compound and accumulate sub-stantially over time. Your 457(b) is a great way to establish a disciplined approach to saving. Employees may contribute between 1% and 100% of earnings (limited by IRS regulations). Your contributions to the 457(b) are always yours and are not subject to any vesting or forfeiture provision.

401(A) RETIREMENT PLANTo assist our employees in reaching their retirement savings goals, the Hospital matches employee 457(b) retirement plan contri-butions dollar-for-dollar beginning at 6% (on a per payroll basis). The Hospital’s contribution match grows based on the employ-ee’s years of service (i.e., 0-5 years – 6%; >5 years – 7%;>10 years – 8%; >15 years – 9%; and > 20 years - 10%). Employees are 100% vested at three years of service. If an employee leaves employment before the three year vesting period, all employer contributions in the 401(a) Retirement Plan are forfeited.

DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT – DEBIT CARD INCLUDEDThe Dependent Care account allows you to set aside tax-free income to pay for qualified dependent care expenses, such as day care, that you would normally pay with after-tax dollars. Qualified dependents include children under age 13 and/or dependents who are physically or mentally unable to care for themselves. If your spouse is unemployed or doing volunteer work, you cannot set up a dependent care account. You must meet the following criteria in order to set up this account:• You and your spouse both work;• You are the single head of household; • or• Your spouse is disabled or a full-time student. Each calendar year the IRS allows you to contribute the following amounts, depending on your family status:• If you are single, the lesser of your earned income or $5,000• If you are married, you can contribute the lesser of: • Your (or your spouse’s) earned income; or • $5,000 if filing jointly or $2,500 if filing separately

ONCE ENROLLED, YOU MAY NOT CHANGE YOUR ELECTIONYou cannot change your annual election after the beginning of the plan year. However, there are certain limited situations when you can change your elections if you have a qualifying event such as a change in status.

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OTHER BENEFITSEMPLOYEE ASSISTANCE PROGRAMSheridan Memorial Hospital provides an Employee Assistance Program called LifeMatters® for all employees and their household members. This free and confidential program provides access to resources for maintaining a healthy work/life balance.When you face challenges, LifeMatters can help. Caring professional are available 24/7 every day of the year to help you address concerns both big and small. Call 1-800-634-6433 or visit LifeMatters online (mylifematters.com) to receive expert assistance with:

RelationshipsWellbeing Emotional

DistressLegal/FinancesStress

Substance UseChild and Elder Care Any other concern

SHORT TERM DISABILITYDisability Income protection insurance provides a benefit for ‘short term’ disability resulting from a covered injury or sickness. Bene-fits begin at the end of the elimination period and continue during disability up to a maximum benefit duration. The weekly benefit amount is an amount equal to 60% covered earnings, up to a maximum benefit of $1,500 per week, minimum benefit of $25.

HOSPITAL SERVICES DISCOUNTAll employees and their family members are eligible for a discount up to 40% (including any benefit plan related contractual dis-counts) on all SMH-billed services provided by the hospital and Sheridan Memorial Clinics. The employee is not required to partici-pate in our comprehensive health insurance plan to receive the discount.

PAID TIME OFF (PTO)SMH has a generous time off benefit that is flexible and rewards full-time and part-time employees for using it well. A first year full-time (2080 hours) employee will accrue 20 days, 1 to 5 years 22 days, 6 to 10 years 25 days, and 10+ years 30 days. PTO is available to use for vacation, holidays, and personal time. Employees can accrue up to 320 hours of PTO that carry over from year to year. Effective January 1, 2019 the 90 Day waiting period for new employees to use PTO will be eliminated.

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OTHER BENEFITS

EXTENDED ILLNESS BANK (EIB)In addition to PTO, full-time and part-time employees accumulate .0346 hours per hour worked (up to 720 hours) to be used for your own sick time. To use this time, you must first use one of your PTO days, then you can use your available EIB hours as you need or have accrued. In the event an employee requires a hospital procedure or is hospitalized, accrued EIB may be used immediately.

TUITION REIMBURSEMENTContinuing education is important for individual growth and the growth of the healthcare system. When you are considering working on a degree at an accredited school, check with Human Resources and your manager to complete an education plan and tuition reimbursement request. There are dollars available to help reimburse tuition expenses after you complete one year of full-time service.

ONSITE FITNESS CENTERIn support of a healthy workplace, the Employee Fitness Center is available for employees 24/7. In order to utilize the facility, you need to go through the orientation process with the Wellness Manager and sign an employee waiver for badge access.

GYM MEMBERSHIPEmployees qualify for gym reimbursement paid on a quarterly basis. Simply bring in a copy of your first gym receipt to Human Resources for processing. $20 Reimbursement for initial membership fee and $19 per month.

Employee Bi-Weekly Premiums Effective January 1, 2020 (*NOTE* - 27 pay periods)

Traditional PPO Medical Plan Full-Time Part-Time

Single $ 38.96 $ 182.10

Employee + Spouse $186.06 $361.37

Employee + Child(ren) $129.53 $281.50

Family $248.61 $464.04

2 Full-Time Employees $ 77.93 N/A

High Deductible Health Plan/HSA Full-Time Part-Time

Single $ 36.58 $180.17

Employee + Spouse $174.36 $348.98

Employee + Child(ren) $ 121.45 $273.70

Family $232.76 $447.30

2 Full-Time Employees $ 73.16 N/A

Dental Full-Time and Part-Time

Single $3.50

Employee + Spouse $7.00

Employee + Child(ren) $5.73

Family $8.95

2 Full-Time Employees $6.99

Vision – Basic Plan Full-Time and Part-Time

Single $3.88

Employee + 1 (Spouse or Child) $6.20

Employee + Child(ren) $6.33

Family $10.21

Vision – Premium Plan Full-Time and Part-Time

Single $ 6.86

Employee + 1 (Spouse or Child) $10.97

Employee + Children $ 11.20

Family $18.06

Wellness Credits (for medical plan participants – quarterly cash benefit)

Full-Time Part-Time

Single $37.50 $37.50

Employee + Spouse, Employee + Child(ren) and Family

$75.00 $75.00

Medical Opt Out (quarterly cash benefit)* Full-Time Part-Time

SMH provides a quarterly cash benefit for employees who Opt Out of Medical coverage AND

participate in the WOW Wellness Program *Prorated based on month of hire

$150.00 $75.00

Voluntary Supplemental Term Life See Infor Employee Benefits Portal or Human Resources for age-banded rates

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2020 Benefits GuideImportant Contacts

UMRP.O. Box 30541

SLC, UT 84130-0541

Medical & Dental & Flexible Spending Account Group #76-412618

Eligibility and claims questions

(800) 826-9781 www.UMR.com

Magellan Rx Prescription Benefit Manager (800) 424-6817 www.MagellanRx.com

UMR Care Management Medical ManagementCall before any inpatient stays

(866) 494-4502

UnitedHealthCare Options PPO Network (800) 826-9781 www.UMR.com

VSP Vision Plans (800) 877-7195 www.vsp.com

Reliance Standard LifeJennifer Chassay

Life Insurance (630) 285-4365Jennifer_Chassay@AJG.com

Principal Investments Retirement Plans (800) 547-7754 www.principal.com

D.A. Davidson Retirement Services Facilitator (307) 674-6288

Sheridan Memorial Hospital 1401 W. 5th Street

Sheridan, WY 82801

Sandy Fuller Wellness Coordinator

(307) 675-5846sandyfuller@sheridanhospital.org

Sheridan Memorial Hospital 1401 W. 5th Street

Sheridan, WY 82801

Dixie KansalaHR Benefits Coordinator

Health Savings Account Assistance

(307) 673-4294dixiekansala@sheridanhospital.org