The Mountaineer Flexible Benefits Plan is sponsored by the Public Employees Insurance Agency. The premiums for the plans,
except for the Legal Plan, are pre-tax. Review the Mountaineer Flexible Benefits Plan
Booklet each April during Open Enrollment for July 1 changes. Only an IRS “qualifying”
family status change allows plan changes during the plan year.
Note: FSA (Flexible Spending Account) is an IRS approved tax-free account that saves you
money on eligible medical and dependent care expenses. You authorize per-pay-period
deductions from your salary before federal, state, and social security taxes are calculated.
As eligible expenses are incurred, you request tax-free withdrawals from your account
to reimburse yourself. At the end of the plan year a grace period allows you to incur
expenses and submit claims for these expenses.
Plans currently available through this program:
Allows reimbursement for eligible uninsured medical expenses incurred for yourself,
your spouse and your dependents. Eligible expenses include medical and prescription
co-pays and deductibles; dental and vision expenses. Go online for more information:
FBMC Benefits Management
Allows reimbursement for eligible expenses for child or adult and elder care costs
that allow you and your spouse to work.
(PEIA Plan C members only)
A tax free account used to pay health care expenses for enrollees of a High Deductible
health plan. The account is owned by the employee, and can be set up through FBMC
or a local bank. Check the Mountaineer Flexible Benefits booklet for details.
(PEIA Plan C members only)
Funds set aside pre-tax can only be used for dental, vision, and preventive care expenses
not covered by the PEIA high deductible health plan.
Sun Life Dental of WV offers four different plans. Each plan has deductibles and
plan year maximums. Only the Enhanced and Premier plans pay for crowns, bridges and
orthodontia.
Employees will get the best price by using a network dentist. Network dentists will
file your claims; employee will pay a non-network dentist for services, and file their
own claim.
Humana EyeMed Vision Plan offers two plans to help pay for eye care needs. Employees
may select either plan. Full Service Plan pays for glasses and frames or contacts
in the same year. By using a network doctor, the cost will be less. Exam Plus Plan
is a discount plan. However, employees are required to use a Humana EyeMed member
doctor. Go online to Humana Vision Site to find a doctor or call Customer Service: 1-877-398-2980
Note: ID Cards for the Dental and Vision plans are not required to obtain services.
However, instructions to print cards are included in the Mountaineer Flexible Benefits
Plan Booklet. Please retain your Mountaineer Benefits Booklet for plan phone numbers
and addresses.
Plan provides discounts on hearing exam, hearing aid device, batteries, etc.
Provides assistance for employees with legal needs, such as wills, powers of attorney, deed
preparation, sale/purchase of your home. Employees may use either a network attorney
or their own attorney.
Accident Insurance helps protect your finances after a mishap. When you, your spouse,
or child has a covered accident, like a fall from a bicycle that requires medical
attention, you can receive cash benefits to help cover the unexpected costs. While
health plans may cover direct costs associated with an accident, you can use accident
benefits to help cover related expenses like lost income, child care, deductibles,
and co-pays. Benefits are payable directly to you. Accident Insurance can be used
however you want, and it pays in addition to any other coverage you may already have.
There are no health questions or pre-existing conditions limitations. All enrolled
family members on your plan are eligible for a wellness-screening benefit, also paid
directly to you, once each year per covered person up to a maximum of $300 per family
per year.
Hospital Indemnity Insurance helps protect your finances if you, your spouse, or your
child experience a hospital stay. You can receive money to help pay unexpected expenses
like lost income, child care, deductibles, and copays. Hospital Indemnity insurance
payments are paid directly to you and can be used however you want. It pays in addition
to any other coverage you may already have, even if you are enrolled in the HSA.
Benefits are payable for hospital stays due to:
Sickness
Accidents, confinements due to an accident must be within 365 days of the accident
Routine pregnancy
Complications of pregnancy
Newborn complications
Mental and nervous disorders
Substance abuse
This coverage helps protect your finances from an illness. When you, your spouse or
your child is diagnosed with a covered condition, you can receive a cash benefit to
help pay unexpected costs not covered by your health plan. It also helps cover related
expenses like lost income, child care, travel to and from treatment, deductibles,
and co-pays. It pays a cash benefit directly to you, can be used however you want,
and it pays in addition to any other coverage you may already have. All family members
on your plan are eligible for a wellness-screening benefit, also paid directly to
you once each year per covered person.
