202 4
Benefits Guide
What’s Inside
WELCOME TO YOUR
2024 Benefits Guide
Thank you for being part of Trinity Health.
You are part of a national Catholic health
system with an enduring legacy and
steadfast Mission to transform and heal
the communities we serve.
Your daily effort makes our long-term
success possible, and because of this,
we are committed to rewarding you with
pay and bene ts that meet your needs
and support our culture.
This 2024 Bene ts Guide outlines the
Total Rewards that Trinity Health proudly
provides. We encourage you to use this
guide to learn about your bene t plan
options, decide on the levels of coverage
that are right for you and your family, and
compare costs. Take the time to review all
the bene ts that Trinity Health offers.
If you have more questions after
reading this guide, refer to the “For
More Information” section to determine
where you can go to get answers.
Trinity Health Total Rewards 2
Who is Eligible 3
How to Enroll 4
Medical Coverage 5
About the Medical Plans 6
Medical and Pharmacy
Plan Highlights 7
Paying for Medical
and Pharmacy Coverage 8
More About the Health
Savings Plan 9
More About the Medical
and Pharmacy Plans 10
Live Your Whole Life
Colleague Well-being 11
Dental Coverage 13
Vision Care Coverage 14
Health Care and
Dependent Care Flexible
Spending Accounts 15
Life Insurance 16
Time Away from Work 17
Retirement 18
Voluntary Benefits 20
Well-being Resources 21
For More Information 22
Important Reminders 23
Additional Notices
1 | MercyOne Northeast Iowa May 31, 2024
Trinity Health Total Rewards
Total Rewards include your compensation, health and well-being benefi ts, retirement plan and voluntary – or
colleague paid – benefi ts. Trinity Health Total Rewards align with our Mission, Core Values and Culture. The Trinity
Health Total Rewards program was created to support and care for the diverse needs of our colleagues, to provide
comprehensive, consistent and market-based rewards, and to offer colleagues meaningful choices. Here is a
summary of key features:
TOTAL REWARDS INCLUDES
HEALTH, WELLBEING & TIME AWAY RETIREMENT COMPENSATION
• 401(k) or 403(b)
Retirement Savings Plan
– Colleague pre-tax and
Roth contributions
– Trinity Health matching
contributions
• Market-based
Compensation
• Trinity Health
Minimum Wage
• Medical and
Prescription Drug
• Dental
• Vision
• Flexible Spending
Accounts (FSAs)
• Basic Life and
AD&D Insurance
• Supplemental
Life Insurance
• Supplemental
AD&D Insurance
• Dependent Life
Insurance
• Short- and Long-term
Disability / Income
Protection
• Time Off - may include
Paid Time Off, Vacation,
Sick Time and Holidays
• Voluntary Benefi ts
• Well-being Initiative
– Adoption Assistance
– Colleague Discounts
– Student Loan Relief
Services
– Tuition Reimbursement
– Mental Well-being Benefi t
– Commuter Benefi ts
Compensation programs offered by Trinity Health
• Market-based compensation
• Established minimum wage
Comprehensive health and well-being benefits
To support the diverse medical, family and fi nancial needs of our colleagues, Trinity Health
provides medical, dental and vision plan options. You are also eligible for Basic Life and
Accidental Loss of Life and Severe Injury insurance (also known as Accidental Death and
Dismemberment (AD&D)) provided by Trinity Health and voluntary (colleague paid) options.
Meaningful retirement benefits
The Trinity Health Retirement Savings Plan is offered to support you in reaching your savings goals
for retirement. Trinity Health will match:
• 100% of your deferred contributions dollar-for-dollar up to 3% of pay, PLUS
• 50% on the next 7% of pay. Trinity Health’s maximum match is 6.5%, subject to IRS limits.
Time away from work and additional benefits
Once you are eligible, Trinity Health provides you with benefi ts to support you when you need
time away from work as well as a comprehensive benefi ts package.
2 | MercyOne Northeast Iowa
Who Is E ligible
Eligible Individual Definition
Colleague Full-time colleagues budgeted for 64 or more hours per pay period or part-time colleagues budgeted for 40 or
more hours per pay period.
Spouse/Eligible Adult You may cover your spouse or Eligible Adult. An Eligible Adult is an adult who resides and has financial
interdependence with the colleague, and is not related by blood, adoption or marriage to the colleague.
If an eligible adult qualifies as a tax dependent, you must complete the Non-Spouse Eligible Adult Dependent
Certification form posted o n the HR4U colleague por tal each year in order to receive pre-tax deductions. If the
form is not submitted, the deductions will be post-tax. For 2024, you must submit the Certification form by the
documentation deadline.
Dependent Children Dependent children are eligible for coverage through the end of the Plan Year in which they turn age 26,
regardless o f marital status, student status, residency, financial dependency or other requirements provided
they meet all of the following cr iter ia.
They are:
•
Your or your spouse/eligible adult’s natural children;
•
Your or your spouse/eligible adult’s legally adopted children or children placed with you or your eligible adult
for adoption; or
•
Children for whom you or your spouse/eligible adult are the court-appointed legal guardian.
•
Not otherwise covered under the Plan or any other group health plan offered by the Employer.
NOTE: Children of eligible adults may be covered only if their eligible adult is covered.
New Hires
New hires are eligible for benefits on the first day of employment, and have 30 da ys from their
start date to enroll in benefits.
To view the complete eligibility rules
and documentation requirements for
you and your family visit
https://hr4u.trinity-health.org
Adding Family Members
If you’re adding eligible family members to your benefit plan during enrollment who have not been on Trinity Health’s benefits
before, you’re required to provide written documentation (for example, marriage certificate or birth certificate) verifying their
dependent status by uploading the appropriate documents to Workday or the HR4U colleague portal by documentation
deadline. If you don’t submit the required documentation by the documentation deadline, your dependents will not be
enrolled in coverage for 2024, and you’ll be required to wait until next year’s open enrollment period to add them to the
plan – provided they remain eligible, and you provide documentation verifying their dependent status at that time. To confirm
who is eligible to be added to cove rage, please see the "Who Is Eligible" section above. Dependents currently enrolled in Trinity
Health benefits do not need to be reverified.
In order for your dependent(s) to be covered, you are required to provide a Social Security Number for each dependent age 45
or older.
Please note, you have the option to purchase coverage for your spouse/eligible adult and dependents. If you and your
spouse/eligible adult or dependent(s) both work for Trinity Health, and are benefits eligible, you cannot elect dual coverage
(enrolled as a colleague and a dependent). In addition, only one of you will be able to elect coverage for your child(ren). If dual
coverage is elected or you both elect Trinity Health coverage for your child(ren), the coverage elected by one of you will not
become effective and any premiums paid for that non-effective coverage are not refundable.
3 | MercyOne Northeast Iowa
Step-by-step instructions
1. Login to Workday. If you are using the mobile app or a personal
computer, you must be enrolled in multi-factor authentication
(MFA). If you haven’t already done so, please follow directions
given when prompted. Otherwise, you will be required to log in
using the Trinity Network.
2.
Enter your network user ID and password and click “sign in”
For problems logging in, contact the Trinity Health IS Service
Desk at 734-712-2288 and select option 2.
3.
Click on the “Inbox” worklet.
4. Choose the enrollment event from your “Actions” list.
5. Proceed to update your benefi ts by following the prompts under
each benefi t icon displayed.
6. After each benefi t, click on “Continue and Confi rm”.
7. After you have reviewed each benefi t, click “Review and Sign”.
A summary of your benefi t elections will be displayed.
8. Once you have reviewed your benefi t elections, click the
“I agree” checkbox at the bottom of the last page to indicate
your electronic signature.
9. Click “Submit” at the end to save all changes/elections.
10.
Click “View 2024 Benefi ts Statement” and be sure to print or
save a copy for your records by clicking on the “print” button
located at the bottom left-hand corner of the screen.
Confi rmation statements will not be mailed to homes.
If you do not change or correct your benefi t elections by your
deadline, IRS regulations require you to remain in your elections
throughout 2024 or until you experience a qualifi ed status change.
For more information on qualifi ed status changes, visit the HR4U
colleague portal.
Job aid available to assist
you in completing enrollment
through Workday
During Open Enrollment, locate the
‘Navigating Open Enrollment’ job
aid for step-by-step instructions for
electing benefi ts and completing
your enrollment. For new hires
or mid-year enrollments, locate
the ‘Benefi t Enrollment’ article for
information on electing benefi ts and
completing your enrollment.
Changing your elections
during open enrollment
Should you need to change your
submitted elections during the
open enrollment period, use the
“Benefi ts” worklet in Workday and
select “change open enrollment.”
Please be sure to submit with your
electronic signature any time you
use this feature whether you make
changes or not.
If you elect the
Health Savings Plan
If you do not plan to contribute any
additional money beyond what Trinity
Health contributes for you, you must
elect the Health Savings Account
with a $0 annual contribution.
How to Enroll
Introducing SmartSelect
Need help deciding which medical plan best meets the needs of you and your family?
SmartSelect provides personalized support to educate and assist you to make better health plan
decisions, recommend a plan based on expected future health care usages, and increases your
understanding of benefi t offerings. To use the SmartSelect tool, click here.
4 | MercyOne Northeast Iowa
Medical Coverage
Trinity Health is offering you three medical plan options during benefits
enrollment: the Traditional Plan, the Health Savings Plan, and the Essential
Plan. All three plans are administered by BlueCross BlueShield of Michigan
and suppor t our clinically integrated network structure.
Each plan offers these two tiers so you can pay less by receiving care from
network providers.
• Tier 1, or the Mercy ACO network providers, are facilities or physicians
aligned with our organization that provide you with the lowest deductibles,
coinsurance and copays. The Clinically Integrated Network includes these
Tier 1 physicians who work to improve the health of our colleagues and the
communities in which they live and work. For services unavailable through
Mercy ACO network providers, select BlueCross BlueShield providers will be
available at the Tier 2 benefit level.
• Tier 2 includes select BlueCross BlueShield providers (facilities and
physicians) not listed under Tier 1. Tier 2 providers can save you money, but
not as much as using our Tier 1 network.
Mayo Clinic and City of Hope Comprehensive Care and Treatment
Centers (formerly Cancer Treatment Centers of America) are not covered
providers.
By using Tier 1 providers, you’re not only reducing your out-of-pocke t
expenses, you’re also supporting Trinity Health as an organization. Since the
cost of medical premiums is shared by you and Trinity Health, using Tier 1
providers helps to minimize the rising cost of health care for all of us.
Please Note
In limited situations where an in-network
provider is not available, please reach
out to your medical plan administrator for
review to see if you qualify for an
exception based on a network deficiency.
For a qualified medical emergency, an
emergency room (ER) visit will be
subject to Tier 1 cost share regardless of
the tier in which you seek care, and the
ER co-pay will be waived if you are
admitted.
Provider Search Tool
Blue Cross Blue Shield of Michigan
• bcbsm.com
• Click Find a Doctor
Selecting the Plan that’s right for you
................................................................................................................................
Review your medical plan options below to find the one that fits your needs.
Traditional Plan Health Savings Plan
High Deductible Health Plan (HDHP)
with Health Savings Account (HSA)
Essential Plan
Assist plan with Health Reimbursement
Account (HRA) if you qualify
P
Pa
y mo
y mor
e each p
e each pay
che
chec
k,
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ut less at the time of se
ut less at the time of ser
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vice
Choose this plan if
Choose this plan if y
ou a
ou ar
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e
in
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est
ed in l
ed in low
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time
time y
ou use insu
ou use insur
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k,
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ut more
ut more
at the time of se
at the time of ser
vice until
vice until y
ou
ou
meet
meet y
our deducti
our deductib
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R
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in an HS
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Choose this plan t
o cont
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the HS
A, and maximi
A, and maximiz
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b
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E
ssential
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Assist plan, including
Assist plan, including
HRA with an
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contribution based on coverage level,
av
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or colleagues who meet
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Choose this plan if y
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oll contributions
5 | MercyOne Northeast Iowa
About the Medical Plans
Access to Care
Trinity Health’s goal with the Tier 1 network is to include adult/pediatric primary care, OB/GYN, hospital-based physicians
(radiologists, pathologists, hospitalists, etc.), and high-volume specialties (cardiology, gastro, ENT, etc.). The majority of
services should be available in Tier 1, however, some services may only be available at the Tier 2 level. Our intent is to
ensure access to all services within Tier 1 or Tier 2 networks.
Medical Terms To Know
• Clinically Integrated Networks – local physicians and health care providers that have partnered with Trinity Health’s
Health Ministries to deliver services to colleagues. They are focused on helping you access the right care, at the r ight
time, in the right setting. All providers are par t of the Tier 1 network, so you pay the lowest cost for the care you receive.
• Premiums – the amount paid for your medical plan. Trinity Health pays a portion of your medical plan premiums and
you pay a portion which is deducted from each of your paychecks.
• Deductibles – the amount you pay for covered health care services before your medical plan starts to pay. Typically,
you pay only a copayment or coinsurance for covered services once you pay your deductible.
• Coinsurance – percentage of costs of a covered health care service you pay after you’ve paid your deductible.
• Copay – the fixed amount you pay for covered health care services.
• Out-of-Pocket Maximum – the most you pay during a plan year before your medical plan starts to pay 100 percent of
covered health benefits.
Understanding your out-of-pocket medical costs
You may be wondering how Trinity Health and you share medical and pharmacy costs each year. The graphic below shows
how costs are shared for both premiums and coverage. Keep in mind, your costs will vary depending on the plan and the
network you access at the time of service.
Your
Cost
Trinity
Health
& You
Shared
Cost
Trinity
Health
Cost
Trinity Health and you
pay for your Medical
and Pharmacy premiums
throughout the year.
Trinity Health and you
pay costs as you receive
care throughout the year.
> Employee Premium
Contributions
> Copays
> 100% of Medical Costs up to
the deductible
> You pay 10%/20%* Coinsurance
> Plan pays 90%/80%* of costs
> Plan pays 100% of Medical
Costs once out-of-pocket
is met
* Dependent on the Trinity Health Medical Plan selected and the cost share for Tier 1 facilities or physicians.
How Trinity Health & You Share Medical & Pharmacy Costs
6 | MercyOne Northeast Iowa
Medical and Pharmacy Plan Highlights
For more information about your medical and phar macy plan options, visit https://hr4u.trinity-health.org.
Medical Plan Network Tier Traditional Plan Health Savings Plan
1
Essential Plan
Highlights
Trinity Health-
funded account N/A HSA: $650 / $1,300 HRA: $1,000 / $2,000
(Individual / Family)
(Essential Assist Plan Only)
Annual deductible Tier 1 $400 / $800 $1,650 / $3,300 $1,150 / $2,300
(Individual / Family)
Tier 2 $900 / $1,800 $2,650 / $5,300 $2,650 / $5,300
Coinsurance
Tier 1 10%* 10%* 20%*
Tier 2 20%* 20%* 30%*
Preventive care
Tier 1 0% no deductible 0% no deductible 0% no deductible
Tier 2 0% no deductible 0% no deductible 0% no deductible
Office visit Tier 1 $20 / $30 10%* 20%*
(PCP/Specialist/
Tier 2 $30 / $40 20%* 30%*
Virtual health
2
)
Urgent care visit Tier 1 and Tier 2 0% after $35 copay 10%* 20%*
Emergency room Tier 1, Tier 2 and 0% after $200 copay 10%* 0% after $200 copay
out-of-network (waive d if admitted) Subject to Tier 1 deductible (waive d if admitted)
Inpatient Tier 1 None* None* None*
admission
Tier 2 $500* $500* $500*
Inpatient
admission Tier 1, Tier 2 and 10% 10% 20%
(thru Emergency
out-of-network Subject to Tier 1 deductible Subject to Tier 1 deductible Subject to Tier 1 deductible
Room)
Outpatient Tier 1 $50* None* $50*
surgical ser vices
Tier 2 $100* $100* $100*
Out-of-pocket Tier 1 $2,500 / $5,000 $2,600 / $5,200 $3,500 / $7,000
maximum
Tier 2 $4,750 / $9,500 $5,000 / $10,000 $5,500 / $11,000
(Individual / Family)
Trinity Health Retail Trinity Health Retail Trinity Health Retail
Owned Pharmacy Pharmacy Owned Pharmacy Pharmacy Owned Pharmacy Pharmacy
Generic $8 $10 $8 $10
Prescription drug Brand formulary 16% ($24 min, 20% ($30 min, 16% after 20% after 20% ($24 min, 25% ($30 min,
34 day supply
$64 max) $80 max) deductible
3
,0% deductible
3
,0% $64 max) $80 max)
after out-of-pocket after out-of-pocket
Brand 32% ($48 min, 40% ($60 min, max max 40% ($48 min, 50% ($60 min,
non-formulary
$80 max) $100 max) $96 max) $120 max)
Obesity 32% ($48 min, 40% ($60 min, 40% ($48 min, 50% ($60 min,
Medications
$320 max) $400 max) $320 max) $400 max)
Trinity Health OptumRx Trinity Health OptumRx Trinity Health OptumRx
Owned Pharmacy Home Delivery Owned Pharmacy Home Delivery Owned Pharmacy Home Delivery
Generic $24 $25 $24 $25
90 day supply Brand formulary 16% ($72 min, 20% ($75 min, 16% after 20% after 20% ($72 min, 25% ($75 min,
$192 max) $200 max) deductible
3
,0% deductible
3
,0% $192 max) $200 max)
after out-of-pocket after out-of-pocket
Brand 32% ($144 min, 40% ($150 min, max max 40% ($144 min, 50% ($150 min,
non-formulary
$240 max) $250 max) $288 max) $300 max)
Obesity 32% ($144 min, 40% ($150 min, 40% ($144 min, 50% ($150 min,
Medications
$960 max) $1,000 max) $960 max) $1,000 max)
Out-of-pocket maximum based on Deductible and out-of-pocket Out-of-pocket maximum based on
Tier 2 based on Tier 1 Tier 2
*Subject to deductible and coinsurance.
1
The individual deductible and individual out-of-pocket maximum only apply to those enrolled in colleague-only coverage for the Health Savings Plan. For family coverage, all
members on the contract can conrtribute to the family deductible and family out-of-pocket; however, a single member will not exceed the individual IRS maximum of $8,150
for Tiers 1 and 2.
2
Virtual visits through your medical plan administrator’s partner are subject to the Tier 2 office visit cost share of your medical plan. If your PCP or other providers offer virtual
visits, these will be covered at the applicable tier level cost share. In-network behavioral health visits, both virtual and in-person, will be subject to the Tier 1 cost share.
3
Select, generic preventive drugs are covered at 100% and are not subject to the annual deductible.
7 | MercyOne Northeast Iowa
Paying for Medical and Pharmacy Coverage
Contribution levels for the medical and phar macy plans are based on the Social Security taxable wage base ($160,200 for
2023, indexed annually) to ensure our benefit plan cost-sharing model is appropriately aligned with our colleagues’ income
levels. The amount you pay for medical and pharmacy coverage is based on your annual base salary (your base rate of pay
times your budgeted hours) and your par ticipation in the Well-Being programs. If at any time during the 2024 plan year, you
earn $160,200 or more, you will pay a higher premium contribution per pay period for your medical insurance.
Full Time Traditional Plan Health Savings Plan Essential Plan
(.8 FTE – 1.0 FTE)
Full 1 - Person No Full 1 - Person No Full 1 - Person No
Your per pay period cost
Incentive Incentive Incentive Incentive Incentive Incentive Incentive Incentive Incentive
For colleagues earning less than the 2023 SSTWB
‡
- Level 1
Colleague only
$103.51 N/A $118.51 $63.55 N/A $78.55 $47.39 N/A $62.39
Colleague plus spouse/ $265.66 $280.66 $295.66 $174.77 $189.77 $204.77 $128.31 $143.31 $158.31
eligible adult
Colleague plus child(ren) $187.17 N/A $202.17 $123.13 N/A $138.13 $90.40 N/A $105.40
Colleague plus family $332.08 $347.08 $362.08 $218.46 $233.46 $248.46 $160.38 $175.38 $190.38
For colleagues earning the 2023 SSTWB or more
‡
- Level 2
Colleague only
$146.63 N/A $161.63 $103.27 N/A $118.27 $83.84 N/A $98.84
Colleague plus spouse/ $360.54 $375.54 $390.54 $262.16 $277.16 $292.16 $208.50 $223.50 $238.50
eligible adult
Colleague plus child(ren) $254.02 N/A $269.02 $184.70 N/A $199.70 $146.90 N/A $161.90
Colleague plus family $450.68 $465.68 $480.68 $327.70 $342.70 $357.70 $260.62 $275.62 $290.62
Part Time Traditional Plan Health Savings Plan Essential Plan
(.5 FTE – .79 FTE)
Full 1 - Person No Full 1 - Person No Full 1 - Person No
Your per pay period cost
Incentive Incentive Incentive Incentive Incentive Incentive Incentive Incentive Incentive
For colleagues earning less than the 2023 SSTWB
‡
- Level 1
Colleague only
$176.82 N/A $191.82 $131.08 N/A $146.08 $98.42 N/A $113.42
Colleague plus spouse/ $407.98 $422.98 $437.98 $314.59 $329.59 $344.59 $232.55 $247.55 $262.55
eligible adult
Colleague plus child(ren) $287.44 N/A $302.44 $221.64 N/A $236.64 $163.84 N/A $178.84
Colleague plus family $509.98 $524.98 $539.98 $393.24 $408.24 $423.24 $290.69 $305.69 $320.69
For colleagues earning the 2023 SSTWB or more
‡
- Level 2
Colleague only
$219.95 N/A $234.95 $170.80 N/A $185.80 $134.87 N/A $149.87
Colleague plus spouse/ $502.86 $517.86 $532.86 $401.97 $416.97 $431.97 $312.75 $327.75 $342.75
eligible adult
Colleague plus child(ren) $354.29 N/A $369.29 $283.21 N/A $298.21 $220.34 N/A $235.34
Colleague plus family $628.58 $643.58 $658.58 $502.47 $517.47 $532.47 $390.93 $405.93 $420.93
‡
The 2023 Social Security taxable wage base (SSTWB) is $160,200 and includes productivity pay, if applicable.
Need help with your medical and prescription drug costs?
You may be eligible for the Essential Assist Plan if you meet certain income requirements. The plan
design is the same as the Essential Plan, but includes a Trinity Health-funded Health
Reimbursement Account (HRA) to help you pay for your medical and/or prescription dr ug
expenses. If you apply and qualify for the Essential Assist Plan, Trinity Health will provide you with
$1,000 for single coverage or $2,000 for family coverage into an HRA*. This contribution is for you
to use for any medical and/or prescription drug expenses you incur for as long as you are eligible
for and enrolled in the Essential Assist Plan.
To participate in the Essential Assist Plan, you must apply and meet specific income and eligibility
guidelines. To learn more, see the Essential Assist information in HR4U and apply by completing
the electronic application within the HR4U portal. Be sure to include a copy of your most recent
Federal Income Tax Form 1040 or 1040EZ by the deadline.
NOTE: We encourage you to enroll in the medical plan you think will be best for you in case you do
not meet the Essential Assist Plan requirements for 2024. If you apply and qualify for the Essential
Assist Plan, you will be moved to the Essential Assist Plan. If you are currently enrolled in the
Essential Assist Plan and you do not re-apply for 2024 coverage, you will be defaulted to the
Essential Plan.
*HRA amounts prorated for mid-year enrollments
How do the
Incentives work?
For more information on how
to achieve Full and 1-Person
incentives, see the Live Your
Whole Life section for more
details.
8 | MercyOne Northeast Iowa
More about the Health
Savings Plan
The Health Savings Plan is a
consumer-dri ven health plan which
gives you the opportunity to participate
in a plan where your health care costs
are more closely determined by your
decisions.
How the Health Savings
Plan works:
First
You p ay the full cost of
medical and prescription
expenses until you reach
the annual deductible.
(Note: preventive care
services and certain
preventive 90-day
generic prescriptions do
not require you to meet
the deductible).
Second
Once you meet the
deductible, you pay
coinsurance until you
reach the out-of-pocket
maximum. A combined
deductible means the full
family deductible must be
met even if only one
person in the family is
receiving care.
Coinsurance begins once
the combined deductible
has been met.
Third
Once you reach the
out-of-pocket maximum,
Trinity Health pays 100%
of all remaining eligible
expenses during the year.
Keep in mind, the plan pays 100% for
certain generic prescription drugs,
diabetes and asthma drugs before your
deductible is met.
For Open Enrollment Only
If you are currently enrolled in the HCFSA for
2023 and you elect the HSA for 2024, you must
utilize your HCFSA funds by Dec. 31, 2023.
If you carry over any HCFSA balance into
2024, you will be unable to receive employer
HSA contributions or your colleague HSA
contributions until April 1, 2024.
How the Health Savings Account (HSA) works
When you enroll in the Health Savings Plan, you automatically have a Health
Savings Account (HSA) administered by HealthEquity to help you pay for
current or future health care costs. Trinity Health will make a contribution to
your account based on the coverage level you elect. In addition, you can also
contribute to this account up to IRS limits:
Coverage Lev el Trinity Health Your Voluntary Total IRS Allowed
Contributions*
†
Contributions**
†
HSA Contributions
Colleague only $650 $3,500 $4,150
All other coverage levels $1,300 $7,000 $8,300
*Prorated based on effective date of coverage.
**If you are 55 or older, you can contribute an additional $1,000 in catch-up contributions to your HSA.
†
May be subject to state taxation.
Questions about the HSA
How do I get an HSA? To be eligible for the HSA, you must enroll in the
Health Savings Plan. In addition, you cannot have coverage under another
non-high deductible health plan, such as Medicare, TRICARE, or coverage
through a spouse’s health plan.
Who can use funds in my HSA? You and your dependents can pay for
medical, dental, vision and pharmacy expenses with funds in your HSA.
Dependents must be claimed on your tax return. (Note: Children under the
age of 26 may not qualify to use HSA funds depending on their annual
income and other factors, see IRS website for details.)
Why would I contribute to my HSA? Contributions to the HSA are a great
way to save on taxes. With the HSA, you do not pay taxes on the amount you
contribute through payroll deductions, the amount you withdraw for medical
expenses, and the interest you ear n in the account (up to amounts set by
federal law)
†
. We encourage you to consult with a tax advisor for IRS rules
and tax implications related to an HSA. Keep in mind that you can change the
amount you contribute to your HSA at any time during the plan year.
How can I use the money in my HSA? You may use the HSA to pay for
qualified medical, dental, vision and phar macy expenses now and during
retirement for you and your qualified dependents.
How do I pay for medical expenses with my HSA? When you receive
eligible health care ser vices, you can pay for those services with your HSA
debit card, or through several online and smartphone app options. You’ll
receive more information about your payment options if you enroll in the
Health Savings Plan with the HSA.
What happens if I don’t use all the money in my HSA each year? Any
money you do not use during the year is carried over, without any limits.
Remember, you own the money in your HSA and it is yours to keep – even
when you change jobs or retire.
Can I enroll in the Health Care Flexible Spending Account (HCFSA) if
I ha ve an HSA?
When you enroll in the Health Savings Plan that includes
the HSA, you will not have access to the health care flexible spending
account (HCFSA). However, the HSA may be seen as having more
advantages over the HCFSA including:
• The opportunity to carry over savings from year to year – you do not forfeit
any amount in your HSA at the end of the plan year.
• Contributions of up to $8,300
†
in tax-free HSA dollars each year (the
HCFSA maximum is $3,050);
• Your HSA dollars are saved in a bank account that may earn interest.
†
May be subject to state taxation.
For more information about the Health Savings Plan, including the Health Savings
Account (HSA), visit www.healthequity.com or https://hr4u.trinity-health.org.
9 | MercyOne Northeast Iowa
More About the Medical and Pharmacy Plans
Choose your Primary Care Physician (PCP)
Maintaining a relationship with your PCP is important
because they are trained to recognize any health problems
you may have. A PCP is the doctor you see for most
services, including annual check-ups. Your PCP can also
help you identify and meet your health goals and help you
prevent serious, long-term health conditions. And, by
following their preventive recommendations, they can help
keep your health care costs low. Trinity Health encourages
you to select and develop a relationship with a PCP. If you
are electing a Trinity Health medical plan for the first
time you and your covered dependents will be required
to select a PCP within the first 30 days from your
effective date of coverage. Be sure to indicate your PCP
through the BlueCross BlueShield online portal. If no PCP is
indicated, the Plan will auto-assign based on claim history,
Tier 1 physician within a 10 mile radius of your home, or Tier
2 physician within a 10 mile radius of your home. To find an
in-network physician or provider, visit www.bcbsm.com.
Be a smar t health care consumer
As you know, the cost of high-quality health care continues
to increase each year. Being a smart consumer means
getting the best price on something you need, whether it’s a
new car or health care.
Being a smart health care consumer doesn’t mean you
should avoid trips to the doctor – it means making the best
decisions about when to go to the doctor. Regular checkups
can improve your health and extend your life. By getting the
recommended exams and tests, you increase your chances
of discovering problems before an illness significantly affects
your health. Plus, preventive care is beneficial not only to
your physical well-being, it also makes sense for your
financial health because generally, it’s covered by your
medical plan. For more information on preventive care
benefits, visit https://hr4u.trinity-health.org.
An easy way to be a smart health care consumer is to
choose a Trinity Health Tier 1 provider when you o r a family
member needs medical care. Besides receiving excellent
care at our own facilities, you receive the highest level of
benefits while paying the lowest available copayment and
coinsurance amounts.
Maintenance Medications
Our prescription drug plan requires that you receive your
maintenance medications* in 90-day supplies through your
Trinity Health owned pharmacy or through OptumRx home
deliver y. Once you reach your plan limit (initial fill and 2
refills) for filling 30-day supplies at a retail phar macy, you will
pay the full cost of your medications if you do not move your
prescription to one of the long-term options listed above.
*A maintenance medication is a long-term medication taken regularly for
chronic conditions or long-term therapy.
Specialty Medications
Specialty medications are required to be filled at either a
Trinity Health owned pharmacy or OptumRx Specialty
pharmacy.
Prescriptions available at a Trinity Health
pharmacy
Remember, purchasing your medications at a Trinity Health
pharmacy may save you money. Also, you can fill
prescriptions for up to a 90-day supply of your medications.
To find a list of Trinity Health pharmacies, please visit the
Pharmacy article in the HR4U colleague portal.
Get help with Medicare
If you or a family member are approaching or have reached
Medicare eligibility, Alight Retiree Health Exchange can offer
access to individual Medicare plans, such a s Medicare
Supplement, Medicare Advantage and Prescription Drug
plans that help pay for ser vices and costs not fully covered
by Original Medicare. Call Alight’s licensed Benefits
Advisors at 877-216-3711 (TTY 711) or use their interactive
plan recommendation tool at retiree.alight.com/trinityhealth.
Refer to the Medicare & You handbook, available at
medicare.gov, for a comprehensive over view of Medicare
Parts A and B. Alight’s services are provided to you at no
additional cost. You only pay for the coverage you select.
10 | MercyOne Northeast Iowa
Mental and Emotional Well-being
Our Trinity Health colleagues and their families continue to be our most valuable resource. While well-being
is multi-dimensional, mental and emotional well-being has emerged as a top priority. Now, more than ever,
it is important to focus on our resilience and ensure that our colleagues have the resources they need to
manage their overall well-being.
Additional Live Your Whole Life Mental and Emotional Well-being Resources
There are a range of tools available, such as virtual support groups, individual counseling, and self-guided video
courses to help you better understand, maintain and improve your health and well-being.
Coverage Under Trinity Health Medical Plan
• Behavioral health care including inpatient and outpatient mental health care and substance abuse care by
Tier 1 & 2 providers is covered at the Tier 1 benefi t level.
Individual Counseling and Coaching
powered by Spring Health
Colleagues and their household members each have
access to six free counseling sessions and six free
coaching appointments per calendar year.
trinityhealth.springhealth.com | 1-855-629-0554
work-life code: trinityhealth
Virtual Support Groups and Educational
Webinars powered by Spring Health
Access virtual support groups that help you work
through life’s challenges together or join a live webinar
to learn about a variety of mental well-being topics.
trinityhealth.springhealth.com
Self-Guided Video Courses
Video courses on Mindfulness and Self-Awareness.
trinity-health.org/lywl
Download the app to your phone at the App Store or
Google Play: search Virgin Pulse
National Suicide Prevention Lifeline
The Lifeline is available nationwide and provides
24/7 free and confi dential support.
Call or text 988. You can also chat with a member of
the Lifeline team by visiting 988lifeline.org
Live Your Whole Life Colleague Well-being
At Trinity Health, we believe that our spiritual, mental,
emotional, physical, financial, social, and vocational
well-being can positively affect quality of life not only for
ourselves, but also for our families and those we serve.
Live Your Whole Life is the integrated well-being strategy
for Trinity Health colleagues and family members and is
comprised of activities, tools, and benefits that support
us in achieving our unique well-being goals.
All colleagues are invited to participate in the well-being
opportunities through Live Your Whole Life. Visit the Live
Your Whole Life Sharepoint Site for the most up-to-date
well-being resources for you and your family. This link
contains monthly highlights, upcoming events and links
to our well-being vendor partners.
To get started, please visit the Live Your Whole Life Sharepoint Site at:
mytrinityhealth.sharepoint.com/sites/SO-LiveYourWholeLife ColleagueWellbeing
11 | MercyOne Northeast Iowa
Need another chance to earn your Full Incentives?
The game resets each quarter with a new opportunity to maintain or regain your Full Incentive amounts. If you do
not complete Level 4 by the Quarter 1 deadline, you will have the opportunity to regain your Full Incentive amounts by
completing Level 4 in Quarter 2, and again in Quarter 3.
If you feel that you are unable to complete the Live Your Whole Life incentive activities by the deadline(s) due to
extenuating circumstances (e.g., medical hardship, military deployment), you may request an exception. For your
exception request to be reviewed, you must complete the form and return it prior to the end of each quarter. You
can
nd exception forms at trinity-health.org/lywl or by calling 855-491-8781.
New hires and colleagues eligible after Jan. 1, 2024
through the remainder of the calendar year.
Colleague Health Plan Well-being Incentive
Each year, medically enrolled colleagues and spouses/eligible adult dependents have an opportunity to earn an incentive to
retain the lower per pay period cost for medical coverage by completing and tracking healthy-living and well-being activities.
The Colleague Health Plan Well-being Incentive is only one component of Live Your Whole Life.
Here’s how the program works:
All colleagues start the plan year with the Full Incentive amounts
(lower per pay cost for medical coverage). Note: See the box to the
right to understand the options for Full and 1-Person Incentives.
Log into or register for your Live Your Whole Life account at
trinity-health.org/lywl or on the mobile app.
Earn points by completing program activities. Points earned within a quarter
accumulate to drive progress to higher levels of the game.
Complete Level 4 of the quarterly game by earning a total of 5,000 points
each quarter to maintain a lower per pay cost for medical coverage in the
following quarter.
Quarter 2024 Dates Premium change date
Q1
Jan. 1 – March 31 Pay including May 1
Q2
Apr. 1 – Jun. 30 Pay including Aug. 1
Q3
Jul. 1 – Sept. 30 Pay including Nov. 1
Q4
Oct. 1 – Dec. 31
Complimentary Quarter – all members
are gifted completion status for Q4
Those who do not complete Level 4 by the quarterly deadline will not
maintain their incentive.
1
2
3
4
5
Incentive Structure
There are separate incentive
amounts for colleagues and
spouse/eligible adult. If both
you and your spouse/eligible
adult complete four levels in
each quarter, you will maintain
the Full Incentive amounts. If
only one of you completes all
four levels in each quarter, you
will only maintain a 1-Person
Incentive amount. (See the
section “Paying for Medical
and Pharmacy Coverage” for
contribution rates with Full
and 1-Person Incentives).
For more information on dates and activities,
please visit the Live Your Whole Life website
at mybene ts.trinity-health.org/lywl or call
1-855-491-8781.
12 | MercyOne Northeast Iowa
Dental Coverage
You h ave a choice between two Delta Dental of Michigan plan options: the High plan and the Standard plan. Our plans utilize
the Delta Premier and PPO networks. Visit www.deltadentalmi.com for providers in your area.
Dental Plan Highlights High Plan Standard Plan
Participating Dentist Nonparticipating Dentist Participating Dentist Nonparticipating Dentist
Annual deductible
Individual/Family $25/$50 $50/$100 $50/$100 $100/$150
Class I - Preventive services 100% covered 100% covered 100% covered 100% covered
($0 colleague cost) (Usual and Customar y ($0 colleague cost) (Usual and Customary
rates apply) rates apply)
Class II - Basic services 20% after deductible 20% after deductible 40% after deductible 40% after deductible
Class III - Major restorative services 40% after deductible 40% after deductible 50% after deductible 50% after deductible
Class IV - Orthodontics 50% after deductible 50% after deductible Not covered
Maximums
Per person annual (non-orthodontics) $1,750 $1,250 $1,500 $1,000
Per person lifetime (orthodontics) $1,500 $1,500 Not applicable Not applicable
Your per pay period cost Full-time Part-time Full-time Part-time
Colleague only
$9.06 $10.51 $5.76 $6.78
Colleague plus spouse/eligible adult $19.94 $22.84 $12.80 $14.84
Colleague plus child(ren) $22.43 $25.69 $14.40 $16.70
Colleague plus family $32.40 $37.11 $20.79 $24.12
NOTE: When you receive services from a non-participating dentist, you will be responsible for the difference between what your
dentist charges and the Delta Dental non-participating dentist fee. Fluoride treatments are covered once every 12 months up to
age 19. Bitewing x-rays are covered once ever y 12 months.
For more information about your
dental plan options or about
Delta Dental, visit
https://hr4u.trinity-health.org.
13 | MercyOne Northeast Iowa
Vision Care Coverage
You have a choice between two UnitedHealthCare vision plan options: the High plan and the Standard plan.
Visit www.myuhcvision.com for providers in your area.
UHC Vision Plan Highlights High Plan Standard Plan
In-network Out-of-network In-network Out-of-network
(reimbursement schedule) (reimbursement schedule)
Benefit frequency Calendar year Calendar year Calendar year Calendar year
Vision exam Coveredinfull Upto$40 $10 copayment Up to $40
Pair of lenses
Single vision Up to $40 Up to $40
Bifocal
$0 copayment Up to $60 $0 copayment Up to $60
Trifocal
Up to $80 Up to $80
Lenticular
Up to $80 Up to $80
Frames $150 retail allowance Up to $45 $150 retail allowance Up to $45
Covered frame
at retail locations at retail locations
Non-covered frame
Contact lenses
(in lieu of eyeglasses) Contact lens coverage is provided under the plan and may vary dependent on the type of contact lenses
Elective
prescribed. Please see the benefit summary on the HR4U colleague portal for additional information.
Necessary
Additional pair of eyeglasses Up to Up to Up to Up to
or contact lenses
20% discount 20% discount 20% discount 20% discount
Additional lens options The following lens
options are covered in
full: standard scratch-
resistant coating, standard
basic and high-end
progressive lenses,
standard polycarbonate
lenses, standard anti-
reflective coating, UV,
tints, photochromic,
Transitions
®
, edge coating
The following lens options
are covered in full:
standard scratch-resistant
coating, standard
polycarbonate lenses
Your per pay period cost
Colleague only $6.24 $3.17
Colleague plus $12.95 $5.81
spouse/eligible adult
Colleague plus child(ren) $13.59 $6.11
Colleague plus family $19.14 $8.43
Children’s Eye Care Program
Dependent children, under the age of 13, are able to receive a second eye exam each calendar year. If a covered child
experiences a prescription change of .5 diopter or greater, the enhanced benefit also provides for an additional pair of
glasses. Copays for the exam and glasses still apply. This benefit ends on the covered child’s 13th birthday.
For more information about your
vision care plan options, visit
https://hr4u.trinity-health.org.
14 | MercyOne Northeast Iowa
Health Care and Dependent Care Flexible Spending Accounts
You have the opportunity to set aside before-tax money to offset eligible health care or dependent care expenses. There are
two different types of Flexible Spending Accounts – a Health Care Flexible Spending Account (HCFSA) and a Dependent Care
Flexible Spending Account (DCFSA).
Health Care Flexible Spending Account (HCFSA) Dependent Care Flexible Spending Account (DCFSA)
How much can I contribute? Before-tax dollars in any amount between $130 and
$3,050 (Trinity Health uses the 2023 IRS limit)
Before-tax dollars in any amount between $130 and
$5,000 if you file your tax return as marr ied filing jointly,
$2,500 limit per spouse if married filing separately
What expenses will it cover? Eligible health care products and services used by you
and/or your eligible dependents. Examples include:
• Vision care, including eyeglasses, contact lenses and
saline solution
• Dental care, both preventive and restorative
• Orthodontia
• Physical therapy, counseling, or psychological
services
• Chiropractic care and acupuncture
• Copayments, coinsurance and deductibles
• Prescribed Over-the-Counter (OTC) medications
For a list of expenses that are eligible for HCFSA
reimbursement, visit https://hr4u.trinity-health.org.
Expenses for the care of your eligible dependents (child
under age 13 or qualifying adult incapable of self-care)
while you work:
• Babysitting or au pair services
• Before and after-school programs
• Day care and nursery school
• Pre-school programs
• Elder care services
When do I have to spend the
money?
Contributions made to the HCFSA during the 2024
calendar year can be used for claims with dates of
service between Jan. 1, 2024* and Mar. 15, 2025.
Contributions made to the DCFSA dur ing the 2024
calendar year can be used for claims with dates of
services between Jan. 1, 2024* and Dec. 31, 2024.
NOTE: You cannot incur dependent care expenses or
submit for reimbursement during a leave of absence.
How do I access my FSA
savings?
You can use a variety of payment options to access your
FSA savings. These include the HealthEquity Health
Card, Pay my Provider, Pay me Back, or by using the
Mobile application.
You can use a variety of payment options to access your
FSA savings. These include the Pay my Provider, Pay
me Back, or by using the Mobile application.
*For mid-year enrollments, this date will be your effective date of coverage.
Reminders:
• If you choose to enroll in the Health Savings Plan medical plan option, you cannot enroll in the HCFSA. The Health
Savings Account (HSA) works just like the HCFSA but offers additional benefits, such as the opportunity to carry over
unused funds, contribute up to $3,500/individual ($7,000/family), plus an additional $1,000 in catch-up contributions if you
are age 55 or over, and ear n interest on your savings.
• You must make HCFSA and/or DCFSA elections for 2024 during open enrollment.
Your prior year elections will NOT carry forward.
• HCFSA and DCFSA claims for the 2024 plan year must be postmarked by Mar. 31, 2025.
• If you choose to contribute to the HCFSA for the first time in 2024, a new HealthEquity
Card will be mailed to your home. Otherwise, you will only receive a new HealthEquity
Card when your current card expires.
• You may contribute to the HCFSA even if you do not elect coverage in a Trinity Health
medical plan.
For more information about your
FSA benefits and to obtain a list
of eligible expenses, visit
https://hr4u.trinity-health.org.
How to use your remaining 2023 HCFSA funds
If you contributed to the HCFSA in 2023 and have funds remaining on Dec. 31, 2023, you can use the funds for claims
incurred between Jan. 1, 2024 and Mar. 15, 2024. Claims must be submitted by Mar. 31, 2024. The only way to use
your remaining 2023 funds during this grace per iod is to pay for the claim at the time of service and submit your claims to
HealthEquity for reimbursement. Do not use your HealthEquity debit card to pay for claims during this period because the
card will access 2024 funds.
15 | MercyOne Northeast Iowa
Life Insurance
Colleague life insurance options
If eligible, you receive employer-provided basic life/Accidental Loss of Life and Severe Injury
Benefits (also known as Accidental Death and Dismemberment (AD&D)) insurance at one
times your annual base salary.
In addition, you have the option to purchase supplemental coverage for yourself in the
increments shown in the table below. If you purchase colleague supplemental life insurance
and you’re approved, the premium contributions will be deducted from your paycheck on an
after-tax basis.
You will be eligible for will preparation services through The Hartford’s EstateGuidance Will
Services at no charge. To get started, access The Hartford’s EstateGuidance Will Services
online at www.estateguidance.com and enter the Trinity Health Web ID "WILLHLF" in the
Promotional Code box. Estate Guidance and Will Services will be available as of the effective
date of your life insurance policy.
Colleague Life Insurance
Plan Highlights (full- and part-time)
Basic life/AD&D One times annual base salar y
(employer-paid)
Supplemental life One to eight times annual base salar y
Supplemental AD&D One to eight times annual base salary
Maximum amounts Basic life: $1.5 million
(Combined: $3 million) Supplemental life: $1.5 million
Personal Health
Applications
NOTE: The Hartford will contact you directly via email or mail if a Personal
Health Application is required for 2024.
Costs for colleague supplemental life are based on your age as of Jan. 1, 2024, and will be available when you
enroll online. Costs will be updated if your birthday moves you into a new age range rate.
Dependent life insurance options
You have the option to purchase coverage for your dependents (including your spouse,
eligible adult or eligible children). You may elect coverage for your dependents without
electing coverage for yourself. If you and your spouse or eligible adult both work for
Trinity Health and are benefit eligible, you cannot elect spouse/eligible adult coverage
for that individual. Also, only one of you will be able to elect coverage for your
child(ren). If your dependent child also works at Trinity Health and is benefit eligible,
you cannot elect child life coverage for that individual. If dual coverag e is elected or
you both elect Trinity Health coverage for your child(ren), the coverage elected by one
of you will not become effective and any premiums paid for that non-effective c overage
are not refundable.
If you have elected dependent life insurance on your child(ren), you must waive dependent life
insurance coverage once your youngest dependent child attains age 26.
Dependent Life Insurance
Plan Highlights (full- and part-time)
Spouse/Eligible Adult life
1
Child(ren) life
2
Coverage amount Coverage amount
$10,000
$20,000
$50,000
$80,000
$100,000
$5,000
$10,000
$20,000
Personal Health
Application
NOTE: The Hartford will contact you directly via email or mail if a Personal Health
Application is required for 2024.
1
Costs for spouse/eligible adult life insurance coverage are based on your age as of Jan. 1, 2024, and will
be available when you enroll online. Costs will be updated if your birthday moves you into a new age
range rate.
2
Child(ren) life insurance costs cover all of your eligible children, and will be available when you enroll online.
Accidental Loss of Life
and Severe Injur y
Benefit (also known as
AD&D)
Accidental Loss of Life and
Severe Injury Benefits covers
youinthecaseofan
accidental loss of motion,
sight, limb, or life.
Are your beneficiaries
up-to-date?
You may want to take a
moment to review the
beneficiary(ies) you have on
file for your life coverage in
Workday. If you haven’t yet
designated beneficiary(ies),
your life insurance benefits
will be paid according to the
plan provisions as outlined in
the Summary Plan
Description.
You may change your
beneficiary(ies) during the
benefits enrollment process
or anytime throughout the
year.
Beneficiary(ies) designated
for Basic Life Insurance apply
to any Employee
Supplemental Life Insurance
elections.
For more information about your
life insurance benefits, visit
https://hr4u.trinity-health.org.
16 | MercyOne Northeast Iowa
Time Away From Work
The Time Away From Work benefit includes paid time off (PTO), holidays, short-term disability and long-term disability. Your
management level deter mines your specific PTO and disability benefits. If you are a physician or resident, please refer to your
employment agreement and/or the HR4U colleague portal for your Time Away From Work benefit.
Paid Time Off/Holidays
(Personal, vacation, sick and holiday)
Years of
Service
PTO
Non-exempt
PTO
Exempt and Advanced Practice Clinicians (APCs)
PTO
VPs, Directors, Managers or Supervisors
Less than
5 years
184 hours 208 hours 224 hours
5-9 years 224 hours 248 hours 264 hours
10-14 years 264 hours 264 hours 288 hours
15+ years 288 hours 288 hours 288 hours
PTO is accrued per pay cycle based on “hours paid”.
Holidays
6 observed holidays per year:
New Year’s Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving, and Christmas.
Holidays are included in a colleague’s PTO accrual.
Time Away From Practice for Physicians
In place of Paid Time Off available to colleagues, each calendar
year a Physician may take, as vacation, holiday, continuing
medical education and any other days absent from work (other
than days absent due to injury or illness or days when Physician
qualifies for temporary disability or long-ter m disability benefits)
(“Days Off”), up to 31 days off from work. Days Off shall be
compensated when on an income guarantee. When a physician is
compensated under the Physician Compensation Plan, the plan
will determine compensation. Days Off not taken within a
calendar year may not be carried over into the next calendar year
and shall not be otherwise reimbursed to Physician. Days Off in
excess of thir ty-one (31) days per calendar year must be
approved by Physician’s department chair and the Administrative
Team (as such term is defined in the Charter of MercyOne
Medical Group – Northeast Iowa).
Anesthesiologists – Each physician member of the Anesthesia
Depar tment will receive eight (8) weeks of paid time off each
calendar year.
Hospitalists – Each physician member of the Hospitalist
Depar tment works a defined number of shifts per year. Time off
as defined in this section has no application.
PTO cash-out
During open enrollment, colleagues who accrue PTO per pay
cycle will have the option to elect to cash-out a certain amount of
unused PTO for the following year.
Howmuchtimeyoucan
cash-out
You can cash-out up to 80 hours. You must
maintain a minimum PTO bank of 40 hours.
Electing to cash-out
Election for 2024 may only be made during
open enrollment to avoid taxation on the value
of your PTO bank. Your election is irrevocable
and cannot be changed.
Payment date for
cash-out
You will receive your cash-out in the fourth
quarter in 2024.
Short-term disability/Income protection
Short-term disability (STD) pays a benefit if you are unable to work
because of a qualified injury or illness. NOTE: this is an employer
provided benefit. No election is required to receive this benefit.
Amount of benefit 60% of base pay (includes Physicians and
APCs)
When benefits
begin
After a 7 calendar day elimination period
following an injury or illness
How long benefits continue Up to 90 days
Use of PTO time
The elimination period must first be covered
by PTO or taken as unpaid time off if PTO is
unavailable.
Long-term disability/Income protection
Long-term disability (LTD) pays a benefit if you are unable to work
for a long per iod of time because of a qualified injury or illness.
NOTE: This is NOT an employer provided benefit and must be
elected during benefit enrollment. You have the option to elect
LTD coverage during benefits enrollment.
Amount of benefit 60% of base pay, not to exceed $17,000 per
month (includes APCs)
Physicians and executives: 60% of base pay,
not to exceed $23,500 per month
When benefits may
begin
After 91 days of disability
How long benefits
continue
Benefits continue until you are able to return
to work, are deemed no longer disabled, or
until social security retirement age or older,
depending on when the disability begins.
For more information about your time away from work,
visit https://hr4u.trinity-health.org.
17 | MercyOne Northeast Iowa
Retirement Benefi t
Saving for Retirement is a partnership. The Trinity Health Retirement Savings Plan is offered to support you
in reaching your savings goals for retirement. Trinity Health will match up to 10% of your voluntary contributions
as follows:
This means if you contribute up to 10% of your eligible pay, Trinity Health will contribute up to 6.5%, up to
IRS contribution and pay limits.
Colleague Example
Colleague earns $50,000 and contributes 7% of pay to the Trinity Health Retirement Savings Plan*
How To Participate
ENROLL
Your Plan account will be established with Fidelity Investments within 7 business days of your hire date
at which point you may enroll and enter your contribution election to begin saving under the Plan by
logging into your account at netbene ts.com or calling Fidelity at 800-343-0860. If you do not make an
election, you will be automatically enrolled in the Plan with a contribution rate of 2%, 35 days after your hire
date. You may change your contribution election at any time.
INVEST
You decide how much to contribute, and you decide where to invest your contributions from the investment
options offered under the Plan. If you do not have an investment election, your future contributions will be
invested in the target date fund that has a target retirement date closest to the year you might retire and
assumes a retirement age of 65.
REVIEW
You may review your online accounts at Fidelity. Remember to review your benefi ciary election. It is important
that you designate your benefi ciary for the assets you save. If you do not have a named benefi ciary at the
time of your death, your benefi ciary will be your spouse. If you do not have a named benefi ciary at the time
of your death and you do not have a spouse, your benefi ciary will default to your estate.
If a colleague
contributes
7%
7%
Trinity Health will match
100%
100% on the fi rst
3% of pay and
50%
50% on the next 4% of pay
Total savings for
retirement annually
(7% x $50,000 of pay) (3% x $50,000 x 100% of pay = $1,500
PLUS 4% x $50,000 x 50% of pay = $1,000)
$3,500 $2,500 $6,000
*For illustrative purposes only. Colleague contributions, and if eligible, employer contributions to the retirement plan are made per paycheck
and are subject to IRS limits. There are no hours requirements to participate in the Plan and make contributions; however, hours requirements
do apply to receive an employer matching contribution.
Match 100%
on the fi rst 3% of eligible
pay you contribute
Plus 50%
on the next 7% of eligible
pay you contribute
18 | MercyOne Northeast Iowa
Eligibility
All colleagues are eligible to participate in the
Trinity Health Retirement Savings Plan.
For questions or more information contact
Fidelity Investments at 1-800-343-0860 or
visit netbene ts.com.
Vesting
Vesting means you have earned a right to the
Plan benefi ts. You earn a year of vesting service
for each calendar year you are credited with at
least 1,000 hours of service. You will be vested in
your Trinity Health employer matching contribution
accounts after you have completed three years
of vesting service or at age 65 while actively
employed at a Trinity Health entity. You are always
fully vested in the money you contribute to the
Plan, and earnings thereon.
Limits
The IRS limits the amount of pay that can be
included in determining your benefi t and the
amount of contributions you can make annually.
2024 IRS limits
$345,000
IRS compensation limit
$23,000
maximum annual employee contribution
$7,500
annual catch-up contribution*
*If you are age 50 or older you may make an additional
catch-up contribution each year.
Don’t forget to complete
your beneficiary election
You may contact Fidelity Investments
to initiate rollovers into the Trinity
Health Retirement Savings Plan and
discuss strategies to consolidate your
retirement accounts.
More about...
Your Contributions
You may defer a portion of your earnings as either pre-tax
or Roth contributions or a combination of both pre-tax and
Roth contributions. All contributions (pre-tax and Roth)
are included in the calculation of the employer matching
contribution. Contribution elections may be changed at
any time during the year.
Automatic Enrollment
Automatic enrollment is a convenient way to assist
you with enrolling in the Plan. The Plan automatically
enrolls you at 2% (pre-tax) if an election is not made
to contribute into the Plan. You are notifi ed at least 35
days in advance of the automatic enrollment period and
have an opportunity to opt out or change contribution
elections at any time. Automatic enrollment occurs when
colleagues are newly hired and annually in January.
Annual Increase Program (AIP)
AIP allows you to gradually increase your savings rate
by 1% each year. You may use the “annual increase”
feature to gradually increase your savings rate and
match opportunity, and grow your account. Once you
sign up, you don’t have to think about it. The annual
increase to your contribution election will happen
automatically. You may choose to opt out of this
program at any time.
Fidelity Tools
Trinity Health is committed to providing a meaningful
retirement benefi t that supports colleagues. Fidelity
offers many tools to help you achieve your retirement
savings goals, short-term savings goals, planning for
unexpected events in life, and managing overall fi nances.
These are just a few of the Fidelity programs available
through the Trinity Health Retirement Savings Plan
• Personalized Planning and Advice,
• Financial Wellness Check-Ups,
• When To Claim Social Security, and
• Improving Your Credit Score
19 | MercyOne Northeast Iowa
Voluntary Benefi ts
Trinity Health provides you with Voluntary Benefi ts to complement your existing benefi ts coverage.
With Voluntary Benefi ts, you can tailor your complete benefi ts package to fi t you and your family’s
needs. The following benefi ts are provided by Farmington, an Aon Company:
Accident Insurance
Pay for accidental injury expenses, like hospital transportation and physical therapy.
Auto/Home Insurance
Protect your possessions so you’re not surprised by coverage gaps or unexpected costs.
Critical Illness Insurance
Ease the impact of a covered illness with cash for medical and non-medical expenses.
Hospital Indemnity Insurance
Supplement your health insurance in case of planned or unplanned hospital services.
Identity/Theft Insurance
Take the stress out of combating identity theft and related fraud.
Legal Services*
Get access to experts who can assist you with a broad range of personal legal needs you
might face throughout your life. *Legal benefi ts are only offered if you are a new hire or during
open enrollment and can only be cancelled during open enrollment.
Pet Insurance
Keep your pets healthy with less worry about the cost of vet bills.
Permanent Life Insurance
Provides fi nancial security for yourself and your loved ones.
NOTE: Voluntary benefi t deductions appear on your paycheck under one deduction code.
To learn more and enroll, call 866-251-9529 and speak to a specialist at Farmington, Trinity Health’s Voluntary
Benefi ts administrator (8:00 a.m. - 5:00 p.m. ET, Monday - Friday) or visit Benefi tsGo.com/TrinityHealth.
20 | MercyOne Northeast Iowa
Adoption Assistance
Reimbursement of eligible expenses up to $4,000 per child
(up to $6,000 if the child has special needs) in accordance with
the Adoption Assistance Program Policy.
Colleague Discounts (Perkspot)
Gain free access for you and your family to exclusive discounts at many national and local
merchants.
Visit trinity.perkspot.com/login.
Mental Well-being Benefit (Spring Health)
Colleagues and household members (age 6+) each have access to six free therapy sessions
per calendar year, six free coaching sessions per calendar year, personalized care, diverse
providers, self-guided wellness exercises, medication management, work-life services, and more.
Visit trinityhealth.springhealth.com (work-life code: trinityhealth)
Student Loan Relief Services (Fiducius)
Colleagues and family members may enroll in the voluntary student loan relief services
program for loan forgiveness, refi nancing, consolidation and lower payments.
Visit trinityhealth.myfi ducius.com/register (registration code: TH1)
Tuition Reimbursement
Reimbursement of tuition and fees, up to annual limits, in accordance with the Tuition
Reimbursement Policy. Union colleagues should refer to the terms of their collective
bargaining agreement for eligibility.
Weight Management Reimbursement Benefit
Reimbursement for behavioral and nutritional counseling services for the purposes of
non-surgical weight loss or weight management. Colleagues and enrolled family members
are eligible.
Commuter Benefits
Commuter benefi ts let you use tax-free money to pay for eligible transit and parking expenses.
Well-being Resources
In addition to the Voluntary Benefi ts provided through Farmington,
Trinity Health also provides these additional well-being options:
21 | MercyOne Northeast Iowa
For More Information
We hope this benefits guide has provided you and your family with the information you need to make your benefit elections. If
you still have questions about your options or the enrollment process you can:
• Visit the HR4U portal by accessing the HR4U icon from your ZENworks window or at https://hr4u.trinity-health.org.
• Create a case in the portal or chat in real time with an HR Service Center representative.
HR Service Center Hours
• Monday through Friday, 7:00 a.m. to 7:00 p.m. ET.
• Extended Open Enrollment Hours: Monday through Friday, 7:00 a.m. to 8:00 p.m. ET.
Enrollment Resources
• For a list of acceptable dependent documents, instructions on how to upload documents, and other open enrollment
related resources, please visit the home page in the HR4U portal at https://hr4u.trinity-health.org.
Benefits Contact Information
Plan Type Contact Phone Website
Medical BlueCross BlueShield of
Michigan
866-917-7537 www.bcbsm.com
Telehealth Teladoc 800-835-2362 www.bcbsm.com/virtualcare
Prescription OptumRx 855-540-5950 www.optumrx.com
Dental Delta Dental of Michigan 800-524-0149 www.deltadentalmi.com/trinityhealth
Life Insurance The Hartford 800-331-7234
Leave of Absence / Disability The Hartford 855-532-7880 www.thehartford.com/mybenefits
https://mytrinityhealth.sharepoint.com/sites/SO-
TH-LOA/SitePages/Home.aspx
Flexible Spending Accounts HealthEquity 877-924-3967 www.healthequity.com
Vision United Healthcare 800-638-3120 www.myuhcvision.com
Health Savings Account HealthEquity 866-346-5800 www.healthequity.com
Voluntary Farmington, an 866-251-9529 https://BenefitsGo.com/TrinityHealth
Aon Company
(Be sure to tell the
representative that you are
a member of Trinity Health)
Mental Well-being Spring Health 855-629-0554 http://trinityhealth.springhealth.com
Medicare Alight Retiree Health
Exchange
877-216-3711
(TTY 711)
www.retiree.alight.com/trinityhealth
Get Answers to Your Benefits
and HR-Related Questions, 24/7
Trinity Health colleagues have 24/7 access to benefits and other HR-related info through
the HR4U online portal. When you log into HR4U you can chat in real time with an
a request for assistance and track the status of your inquiry.
To get started, click on the HR4U icon in your
ZENworks or desktop applications window and
enter your Trinity Health network credentials.
You can also access HR4U on your mobile device at:
https://hr4u.trinity-health.org
c at
ea t
m
me
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y
.
yy
HR representative Monday through Friday, 7 a.m. – 7 p.m. ET. You can also submit
22 | MercyOne Northeast Iowa
Important Reminders
Benefit elections are final for 2024
For more information on qualified
family status changes, visit
https://hr4u.trinity-health.org.
Remember, the benefits you elect will be in effect from Jan. 1 through Dec.
31, 2024. The choices you make now are final for 2024, because open
enrollment is your only opportunity during the year to switch medical, dental
or vision plan coverage unless you experience a qualified family status
change or certain employment status changes.
If you experience a qualified family status change or cer tain employment
status changes and provide any required documentation to the HR Service
Center within 30 days of the event, you will be allowed to make certain benefit
changes that are consistent with the status change. For example, if you get
married during the plan year, you’ll be able to add your spouse to your
coverage within 30 days of the marriage. For more information on qualified
family or employment status changes, visit https://hr4u.trinity-health.org.
HIPAA privacy notice is available online
Trinity Health and the Trinity Health Cor poration Welfare Benefit Plan (Plan)
take the security of colleagues’ and family members’ Protected Health
Information (PHI) ver y seriously. To access a copy of the Plan’s Health
Insurance Portability and Accountability Act (HIPAA) Privacy Notice, visit
https://hr4u.trinity-health.org. If you are unable to access the HIPAA
privacy notice online or would like a paper copy, contact the HR Service
Center to request a paper copy by mail.
Medical plan election notification
When you enroll in a Trinity Health medical plan, the medical plan coverage
provides benefits through a clinically integrated network of hospitals,
physicians, and other health care providers and professionals, including care
coordinators and case managers that monitor and coordinate all aspects of
your medical care. Trinity Health facilities and healthcare providers and
professionals affiliated with Trinity Health facilities participate in cer tain
clinically integrated network. When you and your covered dependents receive
health care services at facilities or by the colleagues of your employer or a
health care provider or professional affiliated with your employer, colleagues
of your employer or a health care provider or professional affiliated with your
employer will have access to and may use and disclose your and your
covered dependents’ personal health information to manage and coordinate
your care. Any access to and use and disclosure of protected health
information will comply with the pr ivacy and security regulations under HIPAA
and any applicable state privacy and security laws.
Plan documents and Summary of Benefits and
Coverage (SBC) are available online
A Summary of Benefits and Coverage (SBC) provides basic information
about a medical plan, comparison examples, and a glossary of terms. To
access the SBCs for the medical plan options, the Summary Plan
Descriptions and certificates of coverage for the Plan benefits available to
you, visit https://hr4u.trinity-health.org. If you are unable to access any
SBC or Plan document online, contact the HR Service Center to request a
paper copy by mail.
Notice: Women’s Health and
Cancer Rights Act of 1998
The Women’s Health and Cancer Rights
Act of 1998 requires all group health
plans that cover mastectomies to
provide certain reconstructive surger y
and other post-mastectomy benefits.
Trinity Health’s medical benefit plan
provisions are as follows:
• The Trinity Health medical benefit
plan will not restrict benefits if you or
your eligible dependent receives
benefits for a mastectomy and elects
breast reconstruction in connection
with the mastectomy.
• Benefits will not be restricted provided
that the breast reconstruction is
performed in a manner determined in
consultation with your (or your eligible
dependent’s) physician, and may
include:
– Reconstruction of the breast on
which the mastectomy was
performed;
– Surger y and reconstruction of the
other breast to produce a
symmetrical appearance; and
– Prostheses and treatment of
physical complications of all
stages of mastectomy, including
lymphedemas.
Benefits for breast reconstruction may
be subject to appropriate plan coverage
provisions and limitations, including
annual deductible, copayment and
coinsurance provisions that are
consistent with those established for
other benefits under the plan.
If you have any questions about your
medical plan provisions relating to the
Women’s Health and Cancer Rights Act
of 1998, contact the HR Ser vice Center.
23 | MercyOne Northeast Iowa
NOTICE REGARDING WELLNESS PROGRAM
The Live Your Whole Life Colleague Health Plan Well-being Incentive Program (the “Well-being Program”) is a voluntary
wellness program available to all colleagues and their spouses/eligible adult dependents enrolled in a participating
medical and prescription drug program (a “group health plan”) offered by your Trinity Health employer. The Well-being
Program is administered according to federal rules permitting employer-sponsored wellness programs that seek to
improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic
Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable,
among others. If you choose to participate in the Well-being Program, you will be able to complete a voluntary health
risk assessment or “HRA” that asks a series of questions about your health-related activities and behaviors and whether
you have or had certain medical conditions (e.g., cancer, diabetes, or heart disease). In addition, certain other activities
that are intended to help colleagues improve their health or prevent disease are offered under the Well-being Program.
You are not required to complete the HRA or participate in any of Well-being Program activities.
However, colleagues who choose to participate in the Well-being Program will receive an incentive of lower-cost group
health plan coverage for completing a voluntary HRA and/or other activities. If a colleague’s spouse/eligible adult
dependent is also enrolled in the Trinity Health group health plan, the colleague will receive the two-person incentive
amount if the spouse/eligible adult also completes the Well-being Program activities. If either the spouse/eligible adult or
the colleague (but not both) complete the Well-being Program activities, the colleague will receive a one-person
incentive amount. Although you (and your spouse/eligible adult dependent, if applicable) are not required to complete
the Well-being Program activities, only colleagues (and their spouses/eligible adult dependents, if applicable) who do so
will receive the incentive of lower-cost group health plan coverage throughout the plan year.
Additional incentives of up to $500 may be available for colleagues and their eligible dependents, enrolled in a standard
Trinity Health group health plan (i.e., the Traditional, Health Savings, or Essential medical and prescription drug plan),
who submit a claim for non-surgical weight loss through HealthEquity. For more information, contact HealthEquity
customer service at 877-924-3967.
NOTE: The requirement to complete Well-being Program activities to receive an incentive of lower-cost group health
plan coverage for a plan year does not apply to colleagues who first become benefits eligible during a plan year.
If you (or your spouse/eligible adult dependent, if applicable) are unable to participate in any of the health-related
activities required to earn an incentive, you (or your spouse/eligible adult dependent, if applicable) may be entitled to a
reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative
standard by contacting the Live Your Whole Life consumer support line at 855-491-8781.
The information from your HRA (if completed) will be used to provide you with information to help you understand your
current health and potential risks and may also be used to offer you services through the Well-being Program, such as
condition management, medical management, case management, and health and well-being coaching. You also are
encouraged to share your results or concerns with your own doctor.
LYWL
Protections from Disclosure of Medical Information
We are required by law to maintain the privacy and security of your personally identifiable health information. Although
the Well-being Program and Trinity Health may use aggregate information they collect to design a wellness program
based on identified health risks in the workplace, the Well-being Program will never disclose any of your personal
information either publicly or to your employer, except as described in the paragraph below, as necessary to respond to
a request from you for a reasonable accommodation needed to participate in the Well-being Program, or as expressly
permitted by law. Medical information that personally identifies you that is provided in connection with the Well-being
Program will not be provided to your supervisors or managers and may never be used to make decisions regarding your
employment.
All Trinity Health group health plans provide care coordination, care management, utilization review, and referral
services to help manage members’ healthcare. By enrolling in a Trinity Health group health plan, you understand that
the plan will provide services to manage care for you and your dependents. These services may be provided through
independent third-party administrators, through clinically integrated networks of hospitals, physicians, and other health
care providers, or through other professionals and healthcare providers, including those affiliated with Trinity Health. The
persons providing these services will have access to your personal health information—including health information you
disclose through wellness programs and well-being activities—not only for treatment purposes but also to manage and
coordinate your healthcare.
Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by
law to carry out specific activities related to the Well-being Program, and you will not be asked or required to waive the
confidentiality of your health information as a condition of participating in the Well-being Program or receiving an
incentive. Anyone who receives your information for purposes of providing you services as part of the Well-being
Program will abide by the same confidentiality requirements. The only individual(s) who may receive your personally
identifiable health information are third-party administrators, members of a clinically integrated network, and other
healthcare providers and professionals, such as registered nurses, doctors, case managers, medical managers, health
coaches, condition managers, and the Well-being Program administrator in order to provide you with services under the
Well-being Program.
In addition, all medical information obtained through the Well-being Program will be maintained separate from your
personnel records, information stored electronically will be encrypted, and no information you provide as part of the
Well-being Program will be used in making any employment decision. Any access to, use, or disclosure of your medical
information obtained through the Well-being Program will comply with the privacy and security regulations under the
Health Insurance Portability and Accountability Act and any applicable state privacy and security laws. Appropriate
precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you
provide in connection with the Well-being Program, we will notify you as soon as possible.
You may not be discriminated against in employment because of the medical information you provide as part of
participating in the Well-being Program, nor may you be subjected to retaliation if you choose not to participate.
If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation,
please contact the Live Your Whole Life consumer support line at 855-491-8781.
LYWL
NOTICE REGARDING THE TRINITY HEALTH RETIREMENT SAVINGS PLANS
This notice includes additional information about the Trinity Health Retirement Savings Plans and supplements the
information provided in the Retirement pages of this Trinity Health Benefits Guide.
x For colleagues covered by a collective bargaining agreement, please contact your union leadership
representative for information about Retirement Plans included in this Benefits Guide and its impact on you.
x Participants contributing in the Sisters of Providence 403(b) PROSPER plan on September 15, 2012, will receive
both the core contribution and service-based matching contribution beginning shortly following the first calendar
year pay period and are not subject to the hours requirements.
x Legacy Trinity Health colleagues (west/mid-west) who were actively employed and vested as of June 30, 2010,
and whose age plus years of benefit service was 60 points or greater as of June 30, 2010, will receive both the
core contribution and service-based matching contribution beginning shortly following the first calendar year pay
period and are not subject to the hours requirements.
The information provided in this summary is designed to assist you with understanding your options under Trinity Health’s welfare bene t
plans and programs. It is only an overview. Please refer to the summary plan descriptions and of cial plan documents for more details
concerning these bene ts. If there is any con ict, the of cial plan and program documents will govern. Trinity Health reserves the right to
modify or terminate its bene t plans and programs at any time.
To view the summary plan descriptions and certi cates of coverage, visit the HR4U colleague portal or, if your Health Ministry has not yet
transitioned to the Trinity Health Human Resources Service Center, the MyBene ts site at trinity-health.org/my-benefi ts. For any plan or
program in which you participate, you may request a printed copy of the summary plan description, any certi cate of coverage, and/or the
of cial plan documents from your employer or from the Trinity Health Human Resources Service Center at 20555 Victor Parkway, Livonia,
MI 48152. There is no charge for printed copies.
All Trinity Health group health plans provide care coordination, care management, utilization review, and referral services to help manage
members’ healthcare. By enrolling in a Trinity Health group health plan, you understand that the plan will provide services to manage care
for you and your dependents. These services may be provided through independent third-party administrators, through clinically integrated
networks of hospitals, physicians, and other health care providers, or through other professionals and healthcare providers, including
those af liated with Trinity Health. The persons providing these services will have access to your personal health information—including
health information you disclose through wellness programs and well-being activities—not only for treatment purposes but also to manage
and coordinate your healthcare. Any access to, use, or disclosure of protected health information will comply with the privacy and security
regulations under the Health Insurance Portability and Accountability Act and any applicable state privacy and security laws.
Our Mission
We, Trinity Health, serve together
in the spirit of the Gospel
as a compassionate and transforming
healing presence within our communities.
Our Core Values
Reverence
We honor the sacredness and dignity of every person.
Commitment to Those Experiencing Poverty
We stand with and serve those experiencing poverty,
especially those most vulnerable.
Safety
We embrace a culture that prevents harm and nurtures
a healing, safe environment for all.
Justice
We foster right relationships to promote the common good,
including sustainability of Earth.
Stewardship
We honor our heritage and hold ourselves accountable
for the human, fi nancial and natural resources
entrusted to our care.
Integrity
We are faithful to who we say we are.
Our Vision
As a mission-driven innovative health organization,
we will become the national leader
in improving the health of our communities
and each person we serve. We will be the
most trusted health partner for life.
THSO W06138-2307-MC ©2023 Trinity Health, All Rights Reserved. 10-23
