Eligibility

All employees who work a minimum of 20 hours per week are eligible for coverage on the 1st day of the month following 28 days of employment.

Summary of Benefits and Coverages

Brattleboro Memorial Hospital offers three medical plans for employees to choose from – Gold, Silver and Bronze. These plans offer varying deductibles, out of pocket maximums, coinsurance and co payments for services depending on which plan is selected and where employees choose to seek treatment.

Participants who choose to seek treatment for certain services at Brattleboro Memorial Hospital, Dartmouth Hitchcock Medical Center and/or Cheshire Medical Center will pay reduced copays and/or coinsurance for these services.

The links provided below outline each plan’s design and features.

Contributions & Rates

Additional Information

Carrier Contact Information

Health Plans Inc: Medical Insurance

Customer Service: 888-335-9400
Website: http://hpitpa.com/your-resources/for-members/

Additional Medical Services

Telemedicine

BMH’s affiliation with Harvard Pilgrim/Doctor on Demand provides you the convenience of attending physician visits from your phone, tablet or computer. In addition to being fast and easy, you are only required to pay your physician office visit co-pay at HPI In-Network (Tier 3) benefit level.

Complementary Medicine

BMH also offers Complementary Medicine to employees enrolled in the Gold or Silver Plans. This benefit reimburses up to $250 to cover employees (and dependents) per calendar year. This benefit offers reimbursement for services such as: Biofeedback, Massage Therapy, Nutrition, Hypno-Therapy, Therapeutic Touch and Healing Touch, Preventative Physical Therapy, Homeopathy, Naturopathy, Oriental Medicine and Reiki.

Diabetes Management

Employees and their dependents enrolled in a BMH medical plan will have a $0 copay for any diabetic drug that is covered n the OptumRx formulary. This includes diabetic testing strips, lancets, insulin, metformin, and more. See the most current OptumRx Formulary List for details.

Prescription Drug Program

RxBenefits manages BMH’s prescription drug program. Prescription drug coverage is provided in 4 tiers – generic, preferred brand, non-preferred brand and specialty. For prescription drug coverage details, please review the medical plan outlines attached below or contact Customer Service.

Specialty medications and mail order prescriptions are administered by Dartmouth Hitchcock Pharmacy. For more information please contact Dartmouth Hitchcock Specialty Pharmacy at 603-653-3737 or by email at specialty.pharmacy@hithccock.org

For Dartmouth Hitchcock Mail Order Pharmacy please call 603-653-3785 or email dh.pharmacy@hitchcock.org 

Carrier Contact Information

RxBenefits: Retail Pharmacy Program

Customer Service: 800-334-8134

Email: RxHelp@rxbenefits.com

Mail Order Pharmacy

Phone: 603-653-3785
email: dhpharmacy@hitchcock.org

Specialty Pharmacy

Phone: 603-653-3737
email: specialty.pharmacy@hitchcock.org

Flexible Spending Accounts

Flexible Spending Accounts provide you with an important tax advantage that can help pay healthcare and dependent care expenses on a pre-tax basis. By anticipating health care & dependent care costs for the next year & setting aside money, employees can lower their taxable income. FSA and DCA accounts are administered by CSONE Benefit Solutions.

Flexible Spending Medical Account (FSA)

• Employees may contribute up to a maximum of $2,750 to the health FSA.
• The program allows employee’s to use the funds for certain IRS-approved expenses such as medical deductibles, copayments/coinsurance, and prescription copays.
• This plan includes a rollover provision that allows employees who elect the FSA to rollover up to $550 of unused funds into the next plan year for the medical FSA only.

Dependent Care Account (DCA)

• Employee may contribute up to a maximum of $5,000 (if single or married filing jointly) or $2,500 (if married filing separately).
• Pre-tax funds can be used to pay for qualified dependent care expenses such as day care for children under age 13 and/or elder care.

Health Savings Accounts

A HSA is a tax-advantaged account that allows employees to save pre-tax dollars to pay for qualified medical expenses. The entire HSA balance rolls over each year and remains yours even if you change health plans, retire or leave employment.

To be eligible to enroll in a HSA, you must meet the following requirements:

• You are enrolled in the Bronze Plan.
• You aren’t enrolled in Medicare.
• You can’t be claimed as a dependent on someone else’s tax return.

Health Savings Account (HSA)

• Employees are eligible to participate in a HSA if they are enrolled in the Bronze Plan.
• In 2021 BMH will contribute the following amounts to employee HSAs (established with Health Equity):
  • Single – $10 per pay period/$240 annual maximum.
  • 2 Person/Family – $20 per pay period/$480 annual maximum.
• Contribution Limits:
  • Single – $3,600
  • Family – $7,200
  • Catch-up contribution (age 55+) – $1,000

Forms and Plan Documents

Contributions

Made By Employees

Carrier Contact Information

CSONE BEnefit Solutions: Flexible Spending Accounts & Dependent Care Accounts

Customer Service: 888-227-9745 (option #1)
Website: www.csone.com

Health Equity: Health Savings Account

Customer Service: 866-346-5800
Website: https://healthequity.com

Employees who work a minimum of 20 hours per week are eligible for coverage on the 1st day of the month following 28 days of employment.

BMH offers dental plan options through Delta Dental. Benefit eligible employees can choose from three different dental plans.

The benefit chart below is only a summary of covered services. Employee premiums vary with plan choice.

Contributions & Rates

Carrier Contact Information

Northeast Delta Dental: Dental Insurance
Customer Service: 800-832-5700
Website: https://www.nedelta.com/Home

Eligibility

Employees who work a minimum of 30 hours per week are eligible for Group Term Life and AD&D coverage on the first day of the month following 180 days of employment.

Employees who wish to elect the Supplemental Term Life and AD&D must work a minimum of 30 hours per week, and are eligible to enroll on the first day of the month following 90 days of employment.

Summary of Benefits and Coverages

BMH provides benefit-eligible employees with the core benefits of life insurance and accidental death & dismemberment insurance. In addition to these core benefits, employees can also chose to purchase supplemental life and accidental death & dismemberment to cover themselves and their families.

Below is an outline of the coverages available under each plan.

Basic Term Life & AD&D Insurance:

• 100% funded by BMH
• The coverage amount is 1.5 times an employee’s annual salary (rounded to the next highest $1,000) up to a maximum of $250,000
• The same coverage amount applies to accidental death & dismemberment
• Base salary is determined by multiplying rate of pay times “scheduled” hours of work per pay period times 26 pay periods
• Please logon to bswift to update you beneficiary information as necessary

Supplemental Term Life & AD&D Insurance:

• 100% Employee funded
• Provides coverage that you can take with you (portable) if you terminate employment
• benefit-eligible employees may enroll during the initial eligibility waiting period and during open enrollment each year
• Eligible employees may purchase from $10,000 up to 5 times their annual salary to a maximum of $500,000
• Employees may purchase coverage for their spouse in $5,000 increments to a maximum of 100% of the employee’s elected voluntary amount
• Employees may purchase from $2,000 up to $10,000 on their dependent children (to age 19 or 26 if financially dependent)
• Employees may select up to $250,000 in voluntary life coverage for themselves (or up to $30,000 for their dependent spouse) within the first 30 days of employment without having to complete a medical history statement (evidence of insurability form). If applying outside of the first 30 days of employment, or for coverage in excess of the guarantee issue amounts, a medical history statement will be required
• AD&D insurance never requires evidence of insurability (medical questionnaire)
• In order to purchase Life or AD&D coverage for your spouse and/or child, you must purchase Life or AD&D coverage for yourself

Carrier Contact Information

Unum: Group and Supplemental Life & AD&D Insurance
Customer Service: 800-421-0344
Website: www.unum.com

Contributions

Basic Life is 100% paid for by BMH.

Supplemental Life is 100% paid for by the employee. Premium costs are based on employee age at time of enrollment and amount chosen; Spouse rates are based on spouse’s age at time of enrollment and amount of coverage chosen. Rates for employee and spouse coverage increase as their age increases. Rates can be found on the bswift online benefits enrollment website.

Supplemental AD&D rates are based upon amount of coverage chosen and coverage on your child(ren) is based upon amount of insurance chosen.

Forms and Plan Documents

Eligibility

Long-Term Disability: Employees who work a minimum of 24 hours per week are eligible for coverage on the first day of the month following 90 days of employment.

Short-Term Disability: Employees who work a minimum of 20 hours per week are eligible for coverage on the first day of the month following 90 days of employment.

Summary of Benefits and Coverages

Long-Term Disability Insurance:

• 100% funded by BMH
• Benefit is 60% of monthly earnings up to a maximum of $10,000
• Payment of benefits begin after 90 days from the start of a qualified disability
• Coverage continues while the employee remains disabled, until the employee reaches normal Social Security Age or as determined by the plan document
• Plan details can also be found in the bswift library

Short-Term Disability (Voluntary) Insurance:

• 100% funded by the employee
• STD insurance provides income protection when an illness or injury prevents you from working
• Employees can choose from different coverage amounts, benefit period durations and elimiation period durations to fit their needs
• STD rates vary based on the employee’s budgeted work hours, the benefit period elected, the coverage amount elected and the elimination period that is chosen
• Plan elections can be made during the bswift benefit enrollment process. Employees will be able to review different plan options at this time

Additional Information

Carrier Contact Information

Unum: Long-Term & Short-Term Disability Insurance
LTD: 800-421-0344/ STD: 800-635-5597
Website: www.unum.com

Contributions

Long Term Disability Insurance is 100% funded by BMH.

Short Term Disability Insurance is a voluntary benefit offered to the employees of BMH and is 100% employee funded. Employee premium rates are based on monthly income range, employment status (20-29 hours per week or 30 hours + per week), elimination period elected and employee’s issue age band. Benefit options and rates can be viewed during the bswift online enrollment process or in the bswift library.

Forms and Plan Documents

Eligibility

All employees who work a minimum of 20 hours per week are eligible for coverage starting on the first day of the month following 90 days of employment.

Summary of Benefits and Coverages

Accident Insurance:

Group Accident Insurance is designed to help employees meet the out-of-pocket expenses and extra bills that can follow an accidental injury, whether minor or catastrophic. Lump sum benefits are paid directly to the covered employee if they sustain a covered injury.

Examples of lump sum benefits payable include: $400 for ambulance (ground); $150 for emergency room treatment; $75 for urgent care facility treatment; $200 for medical imaging testing (MRI, CT, CAT, EEG).

Employees can view rates and enroll in this plan through the bswift benefit enrollment system. Coverage can be elected for an employee, spouse or child. Benefits are paid on a tax-free basis: Employee premiums are deducted on a post-tax basis.

Critical Illness Insurance:

Group Critical Illness is designed to help employees offset the financial effects of a catastrophic illness with a lump sum benefit if an insured is diagnosed with a covered critical illness. Coverage is available for employees, spouses, and children. Coverage levels can be elected from $5,000 – $50,000 (for employee) and from $5,000 – $30,000 (for spouses). Coverage for children is automatically included with employee coverage with a maximum of 25% of the employee coverage amount.

Benefits are paid on a tax-free basis; Employee premiums are deducted on a post-tax basis. Rates are based on age at the date of issue and tobacco usage status. Employees can view the applicable rates for the different levels of coverage and enroll in the plan on bswift.

Additional Information

Carrier Contact Information

Unum: Accident & Critical Illness
Customer Service: 800-635-5597
Website: www.unum.com

Contributions

Accident and Critical Illness Insurance are voluntary and 100% Employee Funded.

Accident Insurance:
Coverage can be elected for an employee, spouse or child.

Critical Illness Insurance:
Rates are based on age at the date of issue and tobacco usage status.

Eligibility

Employees enrolled in the Unum Life , AD&D and LTD plans are eligible for both Worldwide Emergency Travel Assistance and the Unum Identity Theft Program.

Summary of Benefits and Coverages

Worldwide Emergency Travel Assistance 

Emergency travel assistance includes: hospital admission coordination, emergency medical evacuation, medically supervised transportation home, legal & interpreter referral & a variety of other services.

Employees & their families have access to this coverage when traveling 100+ miles from home.

Unum Identity Theft Program

Unum offers free identity theft assistance to BMH employees. The program provides tools and guidance to help with prevention, detection and resolution to identity theft issues.

If you suspect that you are a victim of identity theft, call 1-800-984-6812.

Carrier Contact Information

Unum: Emergency Travel Assistance & Identity Theft
Emergency Travel Assistance: 800-854-1446                      Identity Theft: 800-984-6812
Website: www.unum.com

Forms & Plan Documents

Eligibility

All employees are immediately eligible to participate in the Employee Assistance Program (EAP) offered by BMH.

Program Details

Brattleboro Memorial Hospital’s Employee Assistance Program, provided by KGA,

is a free and confidential benefit for all employees and their adult household members.

This program is designed to help you and your household members deal with a wide range of issues in your personal and work lives. Through KGA, you have free access to confidential counseling, expert consultations and referrals to resources including child care, elder care, legal, financial, nutrition, career, and daily living.

More information about the program and services can be found at www.my.kgalifeservices.com (Company Code: BMH) or by calling 800-648-9557 24 hours a day, 7 days a week.

Some examples of services are:

Counseling: Face-to-face, phone or video session to help resolve emotional issues

Legal Assistance: Legal consultation with an attorney and referrals for most legal issues

Financial Consultation: Help with debt management, budgeting and financial planning

Parenting Resources: Research and referral for all types of child care needs and parenting questions

Work-life Resources: Targeted research and referrals for everything from relocation services to college planning

Nutrition Counseling: Support from a nutritionist on weight management, allergies and other dietary concerns

Career Assessment: Interest testing and career exploration services

EAP Contact Information

KGA: Employee Assistance Program
Phone#: 800-648-9557
Website: my.kgalifeservices.com (Company Code: BMH)

Forms & Plan Documents

Eligibility

Employees may enroll in and begin to make contributions to their retirement plan upon hire.

403(b) Tax -Sheltered Annuity Plan

Plan Details

401(a) Money Purchase Pension Plan

• Designed to provide you with additional income for retirement
• Eligibility requires two years of service with 1,000 hours or more worked; (and 1000 hours worked each plan year thereafter)
• Once you become eligible, you may receive a contribution for each plan year in which you work a minimum of 1,000 hours. BMH will contribute an amount equal to 5% of your annual eligible compensation
• Please contact Human Resources for any questions regarding this plan

403(b) Tax-Sheltered Annuity Plan

• All employees are eligible immediately upon hire to make salary contributions on a pre-tax and/or after-tax (ROTH) basis
• The BMH 403(b) plan offers a variety of investment choices.
• Employees are eligible for an employer matching contribution after two consecutive years of service with 1,000 or more hours worked; (and 1,000 hours worked each plan year thereafter).
• The amount of the match is based on length of continuous employment with the hospital and active employment status at plan year end.
• Employees with 2 to 9 years of service are eligible for a match up to .25% of gross pay
• Employees with 10 to 14 years are eligible for a match up to .50% of gross pay
• Employees with 15 or more years are eligible for a match up to 2.0% of gross pay

How to Enroll

*Retirement plan enrollments and changes are not made through the Bswift benefit enrollment system. Please follow the steps below to enroll in a 403(b) plan. Call Voya Financial at 800-584-6001 with questions.

1.Go to https://enroll.voya.com

2.Enter plan number 664T21

3.Enter Verification number 664T2199

Once enrolled, you can establish an online account by visiting: www.VoyaRetirementPlans.com

Carrier Contact Information

Voya: 403(b) Retirement Plan
Customer Service: 800-584-6001
Website: https;//enroll.voya.com  (Plan # 664T21; Verification # 664T2199)

Retirement Plan Advisors
Steve Burnett
The Richards Group                                                                                                        sburnett@therichardsgrp.com                                                                                   Phone: 802-251-3818

Allisyn Houghton
The Richards Group                                                                                                        ahoughton@therichardsgrp.com                                                                                   Phone: 802-254-6016

Tuition Reimbursement

Brattleboro Memorial Hospital makes available $4,000 per calendar year for employees to pursue continued education through an accredited institution (tuition & fees only, excludes books & other expenses). This benefit is available to any employee scheduled to work *24 or more hours per week and who has been employed by BMH for a minimum of 1 year. The  course must be related to the employee’s position or prepare him/her for a position of greater responsibility at the hospital. The application for tuition reimbursement should be completed and approved prior to taking the course. *As reflected in personnel file

Earned Time

BMH provides employees time off with pay for vacation, holidays, personal days & sick days through the earned time benefit. The amount of earned time accrued is pro-rated, based on hours worked. Employees must work 48 hours or more per pay period to accrue earned time.

Earned time may be accrued to a maximum of 1.5 times the annual accrued allotment. Employees are encouraged to retain some of their accumulated earned time as protection against loss of income in emergency situations when days off with pay are needed and for regularly scheduled holidays.

Contact Information

Brattleboro Memorial Hospital Human Resources

For further information, please reach out to BMH Human Resources:

Phone:  1 (802) 257-3179

Email: hr@bmhvt.org