Your
Benefits
Effective November 2023 - October 2024
You must request a change to your benefits
within 30 days of your life event (60 days for
changes involving Medicaid eligibility).
Documentation may be required.
Enroll now
Your benefit plans are in effect November 1 –
October 31 each year. In general, there are three
times you can make benefit selections:
Making benefit selections
Getting started
Eligibility Enrolling in coverage
For you
Covering your family
Medical, dental and vision: until age 26
regardless of student or marital status
Child life insurance: until age 21, or 26 if a
full-time student
You are eligible for benefits as a full-time employee
working at least 30 hours per week.
Covering your family
You may also cover your eligible dependents when
you elect coverage for yourself.
You may cover your legal spouse or domestic
partner.
Dependent children are eligible:
Your Spouse or Partner
Your Children
Your benefits begin on the next day following 90
days of fulltime employment; this is your effective
date. Be sure to submit your selections within your
first 30 days of benefits eligibility/within your first
30 days of employment.
Your benefit selections will be in effect through
October 31.
When you're first eligible
Open Enrollment is your one chance each year to
review your coverage options and make changes to
your benefits.
Your choices are in effect from November 1–
October 31 of the following year unless you have a
qualifying life event.
At Open Enrollment
marriage or divorce,
birth or adoption,
death of a covered dependent, and
a change in eligibility through Medicare,
Medicaid, or a spouse or parent's coverage.
Qualifying life events allow you to change your
coverage during the year outside of Open
Enrollment. These include:
If you have a qualifying life event
Balance billing
When you use an out-of-network
medical or dental provider, they
may bill you the difference between
what they charge and the amount
your insurance pays.
Medical: balance billing is in
addition to – and does not count
towards – your out-of-pocket
maximum.
Coinsurance
After you’ve met your deductible,
you’re sometimes responsible for a
percentage of the cost of the
medical care, dental care, or
prescription medication you
received. This percentage is
coinsurance.
Copay
A flat fee you pay each time you
receive a copay-eligible medical,
dental, or vision service or
prescription medication.
Deductible
The amount you’re responsible for
paying in care expenses before the
medical or dental plan starts paying
deductible-eligible expenses.
In-network
In-network care is always your
lowest-cost option. Networks are
groups of medical, dental, and
vision providers, pharmacies, and
facilities that agree to discount the
cost of their care or service.
Out-of-pocket maximum
The most you’ll pay for covered in-
network medical care in a year. This
includes your deductible, any
coinsurance or copays, and
prescription drugs.
The out-of-pocket maximum does
not include your premium (the
amount you pay for coverage), non-
covered expenses, or out-of-
network care that’s been balance
billed.
Primary care physician
A primary care physician (PCP) is
your main medical doctor – usually
a general practitioner (GP), family
doctor, internist, OB/GYN, or
pediatrician (for children).
Referral/pre-authorization
Some specialty medical providers
and services require a referral from
a primary doctor. These may include
- but are not limited to -
cardiology, psychiatry, orthopedic
surgeons, rheumatology, surgery,
and imaging (CT or MRI).
Have questions?
Your advocate is here to help you
with all things benefits. See their
contact information on the next
page.
How to handle medical
bills (4:46)
Annual Notices
We’re required to tell you about certain
rights and responsibilities you have as an
employee of Fisher Athletic.
You can request a paper copy at no
charge from:
Fisher Athletic
(704)636-5713
Download now
Helpful terms & resources
Getting started
We've removed as much jargon as possible.
But you’ll probably still encounter some terms as you enroll in and use your benefits, and we
want you to be prepared!
Your
Benefits
Effective November 2023 - October 2024