Annual Enrollment 2023

Enroll in benefits for 2023 What’s on this page? What’s changing for 2023? Why are these changes being made? New offerings in 2023 Let ALEX help you choose a medical plan 2023 Medical plan changes Questions?

Enroll in benefits for 2023

ACTION REQUIRED!

This year, you MUST complete enrollment in Workday between October 13 and 31 if you are benefits eligible and want to continue, change, add or drop benefits.

Each year, you have the opportunity to enroll in benefits or make changes to your existing choices. This year, elections for our three medical plans with OhioHealthy will NOT carry over for 2023. This is a change from previous years, when benefits carried over without re-enrolling in Workday.

To maintain benefits for 2023, you must go into Workday and submit elections during the enrollment period, October 13 — 31.

What’s on this page?

On this page, you’ll learn what’s changing and what’s new this year.

Don’t forget to explore OhioHealthRewards.com to see all that OhioHealth has to offer. The information on this page reflects benefits coming in 2023, and plan costs. Other information on OhioHealthRewards.com site reflects current (2022) benefits. Unless noted on this page, the plan design described throughout this site will be the same for 2023.

Let’s get started!

What’s changing for 2023?

In 2023 our three medical plan options will have a three-tier provider network. You and your covered family members will choose which tier to use each time you seek care. Depending on what provider and/or facility you use, your out-of-pocket costs may be different. When using Tier 1 providers and facilities, the annual deductibles will not increase or slightly decrease on all three plan options: High Deductible Health Plan (HDHP), Preferred Provider Organization Plan (PPO) or Preferred Provider Organization Assist Plan (PPO Assist). See Provider Tier chart below.
There will be an increase to biweekly premiums for the HDHP and PPO plans.
There will be a premium surcharge of $70 per pay period for spouses who are working and eligible for medical coverage through their employer. This surcharge is in addition to the premium cost for whatever plan you elect that includes a spouse: associate + spouse and family plans. Like many other employers, the working spouse premium surcharge is one way to manage ongoing healthcare costs, now and into the future, so that we can continue to provide affordable coverage for our associates.
For 2023, associates will receive a $30 per-pay medical plan wellness discount without having to complete a Wellness Screening or online Health Assessment in 2022 — but spouses will NOT receive a discount.
OhioHealth Fitness Rewards (gym reimbursement) and Wellness Rewards (CaféWell and cash incentives) will no longer be offered in 2023. This change is due to low associate participation in these programs and recent long-term studies show that these types of wellness programs with incentives do not drive improved health outcomes.
If you’re electing the Permanent Life with Long-Term Care benefit (or making changes to your current coverage), there is a new way to enroll. For information on how to enroll, please read the Selerix Enrollment User Guide.

Why are these changes being made?

Healthcare costs continue to rise year after year, and we are weathering a very challenging economic environment. We have invested significant dollars in staffing and responded to associate feedback by providing benefit enhancements like expanding the Education Benefits program and Student Loan Relief Benefit.

We are committed to providing competitive benefits that meet the needs of our associates while managing the high costs of healthcare. This is so that we can provide choice and flexibility in our benefit offerings and continue providing quality healthcare for our associates, our patients and communities.

New offerings in 2023

Mental and emotional health support is expanding to supplement our current offerings.
New resources are coming to support associates who are starting and raising a family.

Let ALEX help you choose a medical plan

Get help with ALEX, an interactive online tool that will walk you through your benefit options and provide personal assistance in pointing out what choices make the most sense for you. Ask ALEX here.

2023 Medical plan changes

Premiums

Note: Premium charts below do not reflect the additional $70 per pay surcharge for a working spouse who has access to medical coverage through their employer.


Associate cost per pay period (26 pay periods per year) Full-time rates
Coverage type	Without discounts	With discounts
HDHP+HSA
Associate only	$77	$47
Associate + spouse	$218	$188
Associate + child	$136	$106
Associate + children	$154	$124
Family	$235	$205
PPO
Associate only	$106	$76
Associate + spouse	$262	$232
Associate + child	$181	$151
Associate + children	$213	$183
Family	$293	$263
PPO Assist
Associate only	$63.50	$33.50
Associate + spouse	$143	$113
Associate + child	$114.50	$84.50
Associate + children	$133.50	$103.50
Family	$162	$132


Associate cost per pay period (26 pay periods per year) Part-time rates*
Coverage type	Without discounts	With discounts
HDHP+HSA
Associate only	$92	$62
Associate + spouse	$245	$215
Associate + child	$164	$134
Associate + children	$188	$158
Family	$268	$238
PPO
Associate only	$121	$91
Associate + spouse	$289	$259
Associate + child	$209	$179
Associate + children	$249	$219
Family	$327	$297
PPO Assist
Associate only	$76.50	$46.50
Associate + spouse	$169	$139
Associate + child	$140.50	$110.50
Associate + children	$165.50	$135.50
Family	$194	$164
*48–63 scheduled hours per pay period — Per-Pay Amounts

Deductibles & Out-of-pocket Maximums (OOPM)


Tier 1 (In-Network)
Coverage type	Deductible	OOPM
HDHP+HSA
Associate only	$2,000	$4,500
Associate + 1	$3,000	$6,750
Associate + 2 or more	$4,000	$9,000
PPO
Associate only	$500	$3,000
Associate + 1	$750	$4,500
Associate + 2 or more	$1,000	$6,000
PPO Assist
Associate only	$125	$900
Associate + 1	$200	$1,400
Associate + 2 or more	$275	$1,900
Note: your out-of-pocket costs for copays and coinsurance will be the lowest in Tier 1.


Tier 2 (In-Network)
Coverage type	Deductible	OOPM
HDHP+HSA
Associate only	$3,000	$6,500
Associate + 1	$4,500	$9,750
Associate + 2 or more	$6,000	$13,000
PPO
Associate only	$1,500	$5,000
Associate + 1	$2,250	$7,500
Associate + 2 or more	$3,000	$10,000
PPO Assist
Associate only	$150	$1,000
Associate + 1	$225	$1,500
Associate + 2 or more	$300	$2,000
Note: your out-of-pocket costs for copays and coinsurance will be higher than Tier 1, but lower than Tier 3.


Tier 3 (Out-of-Network)
Coverage type	Deductible	OOPM
HDHP+HSA
Associate only	$4,500	Unlimited
Associate + 1	$6,750	Unlimited
Associate + 2 or more	$9,000	Unlimited
PPO
Associate only	$3,000	Unlimited
Associate + 1	$4,500	Unlimited
Associate + 2 or more	$6,000	Unlimited
PPO Assist
Associate only	$1,800	Unlimited
Associate + 1	$2,800	Unlimited
Associate + 2 or more	$3,600	Unlimited
Note: your out-of-pocket costs for copays and coinsurance will be the highest in Tier 3.

Health Savings Account (HSA) Employer Match

	Maximum Annual Match
HDHP
Associate only	up to $250
Associate + 1	up to $375
Associate + 2 or more	up to $500

Medical Plan Network Tiering

To find what Tier your provider is in, go to OhioHealthyPlans.com or call the OhioHealthy Member Advocates at (888) 841.5670.

Tier 1: In-Network You will have the lowest cost and get the highest level of benefits when you receive care or services
About this tier	Included Providers
As compared to Tiers 2 or 3. Lower copays for physician/specialist oﬃce visits (when applicable), Lower deductibles Lower coinsurance and lower out-of-pocket maximums	OhioHealth Physician Group OhioHealth facilities Central Ohio Primary Care Providers Nationwide Children’s Hospital Cleveland Clinic

Tier 2: In-Network

About this tier

Included Providers

Deductible, coinsurance, and copays are lower than when using an out-of-network provider (Tier 3), however they will be higher than services received from Tier 1 network providers and facilities.

Any contracted provider that is not in Tier 1.
The following are some of the providers that are Tier 2
- Fairfield Medical Center
- Licking Memorial Hospital (Newark)
- Holzer Hospital (Athens)
- Genesis Hospital (Zanesville)
All claims for services that are outside of the OhioHealth Preferred Service Area.
Any other network providers and facilities that have agreed to negotiated rates for our plan members.

Tier 3: Out-of-Network
About this tier	Included Providers
You could be billed the difference between what the OhioHealthy Plan pays and what the provider chooses to charge. Seeing providers outside of the Tier 1 and Tier 2 networks will cost you the most out-of-pocket. If you receive care from a provider who is not a part of the networks described above, your services may not be discounted.	Any providers not included in Tier 1 or 2. The following are some of the providers that are out-of-network OSU = Ohio State University MCHS = Mount Carmel Health System Avita = Avita Health System (Galion, Bucyrus and Ontario locations) Adena = Adena Regional Medical Center Marietta Memorial

If you or a covered dependent has an Emergency Medical Condition and receive Emergency Services at an Emergency Facility outside of the Tier 1 network, covered services will be paid according to the Tier 1 benefit.