How to Enroll

Self-Service Enrollment

Enroll with a Benefit Counselor

Benefits are more important than ever and we encourage you to spend extra time evaluating your benefit options. As such, we have partnered with EOI Service Company so you can enroll with the guidance of a professional benefit counselor.

If you would like additional support, you can speak with a benefit counselor to answer your questions, explain your benefit options, and enroll you and you dependent(s).

Benefit Eligibility ▼

Who is Eligible?

Eligibility depends upon your employment status and your length of service with St. Luke's.

Coverage	Who is Eligible?
Medical, Dental, Vision, Flexible Spending Accounts	Full-time employees who are scheduled, and actually work at least 36 hours per week. Part-time employees who are scheduled, and actually work at least 16 hours per week.
Life Insurance	Full-time and part-time employees as defined above.
Long-Term Disability	Full-time employees as defined above.

Medical Affordable Care Act (ACA) Coverage
Individuals not in a benefit eligible status who meet the ACA full-time status (an average of 130 hours monthly for a total of 1560 hours in a continuous 12-month period, October 1st to September 30th) may be eligible for medical coverage only in the following benefit year. Individuals meeting ACA eligibility criteria will be notified by the Benefits Office if they are able to enroll for medical benefits.

Dependent Coverage

Under the medical, dental and vision plans you can elect to cover your spouse and each of your children until the age of 26. Your children can include your natural or adopted children or your stepchildren. You may cover children age 26 and over who are dependent upon you because of a physical, mental health, or substance use disability and are incapable of self-support.

You must notify the Benefits Office and submit proof of the child’s disability status.

The Plan does not cover grandchildren or spouses of dependents.

You must provide proof of eligibility upon enrolling spouses and dependent children.

Dependent	Proof of Eligibility
Spouse	Marriage certificate
Natural Child	Birth certificate, affidavit of birth or baptismal certificate
Adopted Child	Adoption or placement Papers
Stepchild	Marriage Certificate and Birth certificate
Guardian	Court or Guardianship papers
Disabled Dependent	Physician’s Statement or Social Security Disability
Children of Minor Dependent Children	Court papers for adoption or Guardianship

Making Changes ▼

What Happens If You Decline Coverage?
If you decline coverage for yourself and/or your dependents (including your spouse) because of other health insurance coverage, you may be able to enroll yourself and/or your dependents in the future, as long as you enroll within 31 days (60 days in certain circumstances) of when your other coverage ends or when you experience a change in status/qualifying event. When you are enrolling due to a loss of other coverage, you must supply supporting documentation of loss of other coverage to complete the enrollment.

You always have the ability to enroll yourself and/or your dependents at the next open enrollment period.

Contact the Benefits Office for more information about changing your benefits coverage.

The choices you make during the enrollment period remain in effect for the full plan (calendar) year unless you experience a change in status or a qualifying event.

A change in status / qualifying event includes:

Marriage
Divorce
Birth, adoption, or placement for adoption of a child
Death of a spouse and/or dependent
Loss or gain of coverage due to a change in your spouse's employment status
Change in your employment status from eligible (16 hours or more per week) to ineligible status (less than 16 hours per week) or vice versa
You or your child’s loss of coverage/eligibility because you or your dependent has reached the age of 26
If you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may enroll your dependents.
You or your dependent child losing coverage or becoming eligible for coverage under Medicaid or a state Children’s Health Insurance Program (CHIP)
Medicare eligibility for employee or spouse;
A significant increase or decrease in the cost of coverage; or
Any other change that is permissible under IRS regulations and ruling as determined by St. Luke's.

Any changes to your elections must be consistent with your change in status or qualifying event. For example, if you are married and get divorced mid-year, you may cancel coverage for your ex-spouse but you may not elect no coverage for yourself.

When you experience a qualifying event, you must:

Visit stlukeshospital.bswift.com or use the bswift Mobile App to enter your Qualifying Life Event (QLE) within one month (31 days, provided, however, if the qualifying event is you or your dependent child becoming eligible for or losing coverage under Medicaid or CHIP, then 60 days) from the change in status /qualifying event to change your elections. (For example, if you get married on March 2, 2025, and wish to add your new spouse to your plan, you must return completed paperwork by April 2, 2025).
Provide appropriate documentation, such as a birth certificate or a marriage certificate.

If you fail to do either of these things, you will not be able to change your benefit coverage until the next annual enrollment or until your next qualifying event / change in status.

Once your request to change your benefit elections is approved, the changes and premium amounts will be made effective retroactive to the date of the change in status.

If you experience a change in employment status from full-time to part-time, or part-time to full-time, you may be able to add or drop your coverage consistent with the change in employment status.

How Cost and Coverage Works

While St. Luke's pays the majority of the cost of coverage, you pay a portion of the cost through payroll deduction. Your cost of coverage depends on the option and coverage category you choose, as well as on your employment status. For more information on coverage costs, refer to the monthly contribution rate sheet included in this booklet, distributed at New Hire Orientation or Employee Self Service (ESS). Keep in mind, your portion of the cost for many benefits will be paid with pre-tax dollars, which lowers your taxes and increases your take-home pay.

When coverage begins depends on the type of coverage

Coverage	Who Pays for Coverage	Effective
Medical, Dental, Vision	St. Luke’s and you (on a pre-tax basis)	Immediately (Election must be made online within 31 days of employment)
Life Insurance
Basic Life	St. Luke’s	Immediately
Supplemental Term Life	You (on an after-tax basis)	Immediately (Enrollment must be completed within 31 days of plan eligibility)
Dependent Term Life	You (on an after-tax basis)	Immediately (Enrollment must be completed within 31 days of plan eligibility)
Long-Term Disability	For full-time employees only
Basic	St. Luke’s	Immediately
Premium	You (on a pre-tax basis)	Immediately (An election form must be completed within 31 days of employment or plan eligibility)
Health Savings Accounts	St. Luke’s and You (on a pre-tax basis)	First day of the month following election of HDHP and account set up
Flexible Spending Accounts	You (on a pre-tax basis)	Immediately (Election must be made online within 31 days of employment)

When Coverage Ends :
For You
Generally, your St. Luke’s benefits coverage will end on the earliest of:

Midnight on the last day of the month in which you terminate employment or otherwise cease to be a benefit eligible employee;
The last day of the Plan Year if you cancel coverage during annual enrollment or fail to enroll during an active annual enrollment;
The date you stop making the required plan contribution; or
The date the plan is discontinued.

For Your Dependent
Your dependent’s coverage will end on the earliest of:

Midnight on the date your coverage ends for any reason;
The last day of the month in which the qualified dependent ceases to be eligible;
The date you stop making the required contribution for dependent coverage; or
The date all dependent coverage under the plan terminates.

NOTE:

If you do not notify the plan within thirty-one (31) days (or within sixty (60) days of becoming eligible for or losing coverage under Medicaid or CHIP) of a change in status event that causes your dependent to lose eligibility under the plan, the ineligible dependent’s coverage will still terminate as of the last day of the month in which he or she became ineligible.

If the removal of the dependent results in a lower contribution, contributions will be reduced accordingly moving forward from the first day of the pay period after we were notified. Any prior contributions already paid from the date coverage terminated will not be refunded.

Glossary▼

Allowed Amount – The amount that St. Luke’s determines is the appropriate rate.

Birthday Rule – When both you and your spouse have coverage for your dependents, only one parent’s insurance will pay as primary. This is determined by the birthday rule, which states that the parent who has the first birthday of the year will be the primary insurance carrier.

Coinsurance – The percentage of a covered charge that the plan will pay. For instance, if the coinsurance is 70%, and you have a bill for $100, the plan will pay $70 and you will pay $30 (after you’ve paid your deductible or copay).

Copayment – The set dollar amount you pay for certain services in our medical plans. For instance, when you have an appointment with your physician, you will pay a $20.00 copay at the time of your office visit if you are covered under the Premium medical plan.

Deductible – The amount you must pay for any covered charges before the plan will begin to pay benefits. For instance, if you have a $500 deductible, you’ll be responsible for paying the first $500 of medical expenses you have each year. After that, the plan will begin to pay benefits. Copays do not apply toward the deductible.

Child Dependent Status – Any child, up to age 26. See also section entitled “Benefit Eligibility” for additional information regarding eligibility for dependent status.

Essential Health Benefits – Any medical expense that falls under the following categories, as defined under the Affordable Care Act: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs (excluding all preferred prescription drugs for which there are medically appropriate generic prescription drugs available, all non-preferred prescription drugs and all other non-covered or non-formulary prescription drugs); rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, services including oral and vision care, etc.

Non-Duplication of Benefits – This is the method St. Luke’s uses to coordinate our medical, dental, and vision benefits with other coverage. This means when another plan pays first, St. Luke’s plan pays only the amount needed to bring your total benefits to St. Luke’s plans’ benefit level.

Out-of-Pocket Maximum – The maximum amount you’ll have to pay for covered medical expenses that are identified as Essential Health Benefits in one year. This includes the amount you pay for the plan’s copays, coinsurance and deductible. In addition, the amounts you pay for the plan’s copays, coinsurance, and deductible for any preferred prescription drug for which there is a medically appropriate generic prescription drug available and for non-preferred prescription drugs, as well as all related penalties and additional charges for such drugs, are included in the Out-of-Pocket Maximum for your elected coverage option. 3

Plan Year – The benefit plan year is a calendar year running from January 1st to December 31st. Unless otherwise noted or communicated, benefit elections and plan provision are effective based upon the plan year.

Qualifying Event – When an employee experiences a change that allows the employee to enroll, change, or stop benefits outside the Open Enrollment time period. Qualifying events include marriage, divorce, birth, death, or other changes outlined in the “When You Can Make Changes” section of this book. You must provide appropriate documentation and may only enroll within 31 days of the event.

Spousal Coverage – St. Luke’s provides coverage to employees, spouses and children. If a spouse has other insurance available (for example: through employer or other plans) coverage is still available through St. Luke’s but different premiums will apply. Annually, team members will be asked about the availability of spouse coverage as part of the open enrollment process to determine if the surcharge applies.

Term Life Insurance – The life insurance you automatically receive from St. Luke’s and/or the supplemental coverage you elect “terms” or ends with your employment. You may elect to convert your supplemental life coverage (within 31 days of your termination date) to an individual policy when you leave St. Luke’s. Your premiums would be set by the insurance carrier at the time the coverage is converted.

Medical ▼

Administered through UMR

St. Luke’s has designed a flexible system of electing medical coverage to best suit your personal situation.

Your Options:

Basic Plan Option;
Premium Plan Option;
High Deductible Health Plan (HDHP) with Health Savings Account: or
Decline Coverage

See Schedule of Benefits for each of the plan options for specific plan information.

Basic Plan Option
The Basic Plan offers a flexible 3-tier system. You may choose to receive care from any of the three levels of benefits: however, if you receive care from a Tier 1 provider, you will pay less out of pocket. This plan allows for wellness care to be paid at 100%. This plan provides for lower premiums but requires a higher level of out of pocket expenses. This plan choice is ideal for those who are comfortable with paying more as care is received and prefer to have a lower premium.

Premium Plan Option
The Premium Plan also offers three tiers of care, with the least out of pocket expenses in Tier 1 and 100% wellness care in Tier 1. The Premium Plan has higher monthly premiums, but lower levels of deductibles and co-pays. This plan choice is beneficial for those individuals who would prefer to pay less as care is received and are comfortable with a higher premium.

HDHP with HSA Option
The High Deductible Health Plan (HDHP) presents a different way to manage health care costs and provides an opportunity to save for future or post- retirement medical expenses. The plan offers three tiers of care with the lowest deductible in Tier 1, or the St. Luke’s network. This plan pays for 100% of wellness/preventative care. The HDHP offers the lowest premiums of the three plans. It also has the highest deductible amount, and until the deductible is met, the employee is responsible for the full amount of the bill rather than a co-payment. Along with the HDHP, participants are eligible to enroll in a Health Savings Account (HSA). St. Luke’s will provide an annual contribution to all HSA accounts. An HSA also allows participants to contribute on a tax-advantage basis to this account, and it can be used to cover eligible out of pocket costs or, it can be saved and allowed to grow. This account is vested immediately and can be used for post- retirement eligible medical expenses as well.

NOTE:

Pre-certification is required for inpatient hospitalizations on all plan options. A deductible may be imposed if a hospitalization is not pre-certified (please refer to Pre-certification requirements section in Schedule of Benefits). Care received outside the United States is excluded from coverage under these plans except in an emergency situation.

Sample ID Letter & Card (Basic)

Sample ID Letter & Card (Premium)

Sample ID Letter & Card (HDHP-Family)

Sample ID Letter & Card (HDHP-Single)

Dental ▼

Administered by MetLife

Keep a smile on your face and more money in your pocket with our dental plan. Having a dental plan that covers exams, X-rays, fillings and more can help you save money and live healthier.

Get the care you need with a dental benefits plan featuring MetLife’s Preferred Dentist Program.

There are thousands of general dentists and specialists to choose from nationwide, so you are sure to find one who meets your needs.
Flexibility to visit any dentist you want, in or out-of-network. Your out-of-pocket costs will usually be lower when you visit an in-network dentist.
Negotiated fees that are typically 30-45% less than the average fees charged by dentists in your area for the same or similar covered services

MetLife offers a variety of online tools for you to make the most of your coverage:

The Oral Health Library at www.oralfitnesslibrary.com contains articles and tools that can help you learn more about the importance of oral health and its connection to overall health.
Interactive Dental Risk Assessment tools to help you determine your risk for periodontal disease or tooth decay to then discuss the
results with your dentist during your next appointment.

For plan summaries, rate summaries, ID card and claim filing information:

Vision ▼

Administered by MetLife (VSP Choice network)

Even if you don’t wear glasses, regular visits to your eye doctor are important to your overall health. That’s because a routine eye exam can often detect early signs of serious health conditions like diabetes. A group vision plan makes it easier to get the care you need and lower your costs.

The MetLife Vision Plan features:

Low to no copays for in-network services and materials, including contact lens fittings and evaluations
The freedom to visit any licensed eye care professional or choose from thousands of participating ophthalmologists, optometrists, and opticians/optical retailers. Your out-of-pocket costs will usually be lower when you visit an in-network provider.
Valuable extras – polycarbonate (shatter-resistant) lenses for children up to 18 years of age and ultraviolet coating are covered in full in-network.
Great savings in-network on the latest eyewear and brand name frames.

MetLife offers the Vision Health Library tool at www.visionhealthlibrary.com, which provides valuable information to better manage your vision health.

For rate summaries and ID card:

Flexible Spending Account (FSA) ▼

Administered by Tri-Star

Flexible Spending Accounts allow employee to take advantage of Section 125 of the Internal Revenue Code, by setting aside pre-tax dollars to use for healthcare and dependent care expenses.

Healthcare Flexible Spending Account:

You elect an annual contribution amount (minimum $130, maximum $3,300) that will be deducted from your paycheck on a pre-tax basis. These dollars are available to use for healthcare related expenses like deductibles, copays, coinsurance, prescription drugs, and some over-the-counter medical supplies. You will receive a debit card from Tri-Star (see below for more information on Tri-Star’s debit card program) to use at the time expenses are incurred.

You may incur expenses through the end of the plan year (ex. 2025 Plan Year ends 12/31/2025). Unused funds at the end of the plan year, up to $660, will rollover to the next plan year and continue to be available to you for expenses incurred in the next plan year. Any unused funds above the $660 rollover amount will be forfeited.

Dependent Care Flexible Spending Account:

Similar to the above Healthcare Flexible Spending Account, the Dependent Care Flexible Spending Account allows for you to use pre-tax dollars to pay for daycare expenses, before/after school programs, and some camps. You elect an annual contribution amount (minimum $480, maximum $5,000) that will be deducted from your paycheck on a pre-tax basis. You will receive a debit card from Tri-Star (see below for more information on Tri-Star’s debit card program) to use at the time expenses are incurred.

You may incur and submit expenses up to 90 days after the plan year ends (ex. 2025 Plan Year ends 12/31/2025, incur/submit deadline 3/31/2026), this is called a grace period. Any unused funds after the grace period will be forfeited.

Tri-Star’s FSA Stored Value Debit Card:

To make it even faster and easier for you to access your FSA dollars, Tri-Star offers an FSA Stored Value Debit Cards as a way to pay qualifying expenses directly, without paying out of pocket and waiting for reimbursement. This can also significantly reduce paperwork filing.

The cards are designed to ensure that only qualified expenses, backed by money set aside in an FSA, can be paid with the card.

Cards will work only at physicians, dentists, hospitals, clinics or other medical providers, or merchants who sell prescription drugs or over-the-counter medical supplies
Card balances are synced with your account balance in Tri-Star’s system, and will be restricted to current available funds
Online claims are also synced with the card, preventing over-reimbursement of the FSA balance
You will receive email notification if further documentation is required, and the card will be inactivated if documents are not received or expenses are not qualified

Health Savings Account (HSA) ▼

Administered by Bank of America

A Health Savings Account (HSA) could be for any person, at any stage, or any budget. An HSA allows you to save pre-tax dollars to use for healthcare expenses. You chose how much to contribute each on a pre-tax basis, which investment options to choose from, and when you want to use the money to pay for qualified healthcare expenses. There is no ‘use-it-or-lose’ provision, which means if there are unused funds at the end of the plan you will not lose that money…even if you leave St. Luke’s, any money contributed into your HSA (to include the money St. Luke’s contributes) is yours to take with you.

The IRS sets an annual contribution limit. This means between St. Luke’s employer contribution ($500/single, $1,000/family) and your contribution, your HSA cannot be funded more than $4,300/single or $8,550/family.

Those 55+ can save an additional $1000.

Opening an HSA requires that you have a qualified medical high deductible health plan (HDHP), not enrolled in a traditional PPO medical plan, not enrolled in a government sponsored program (e.g. Medicare, Medicaid, Tricare), not claimed as a dependent on someone else’s tax return, have not received VA benefits in the last three months unless benefits are for a service related disability, and do not have a Flexible Spending Account (FSA) through St. Luke’s or your spouse’s employer.

Disability ▼

Administered by Lincoln Financial Group

Physicians’ Short-Term Disability

What is it?

Short-term disability insurance pays you a portion of your salary while you’re away from work or recovering from a covered illness or injury.

Why is this coverage valuable?

When you’re unable to collect your normal paycheck due to injury or illness, your disability policy provides money that can help you pay your bills.

Long-Term Disability

What is it?

Long-term disability insurance pays you a portion of your salary while you’re away from work or recovering from a covered illness or injury.

Why is this coverage valuable?

When you’re unable to collect your normal paycheck due to injury or illness, your disability policy provides money that can help you pay your bills.

Long-Term Benefit Summary

Life and AD&D ▼

Administered by Lincoln Financial Group

Basic Life and AD&D Insurance

What is it?

Life and accidental death and dismemberment (AD&D) insurance provides cash benefits in the unfortunate event that you or a covered family member passes away or suffers a traumatic injury.

Why is this coverage valuable?

Life and AD&D insurance can offer reassurance that you, or the people you love, will have access to money to help cover expenses during a challenging time.

Basic Life and AD&D Benefit Summaries:

Full-Time Employees
Part-Time Employees
Active Employees On/Before 3/31/2001
President and Vice-President
Physicians

Voluntary Life Insurance

Losing a loved one presents emotional, legal and financial challenges. Lincoln offers employees and their beneficiaries coverage and support at a time when it’s needed most.

What is it?

Life insurance provides cash benefits in the unfortunate event that you or a covered family member passes away or suffers a traumatic injury.

Why is this coverage valuable?

Life insurance can offer reassurance that you or the people you love will have access to money to help cover expenses during a challenging time.

Voluntary Life Benefit Summaries

Evidence of insurability (EOI)

EOI is the information we use to verify your good health when you’re purchasing insurance. We require EOI if you’re:

Buying an insurance amount higher than the guaranteed issue amount for your plan
Already enrolled and want to increase coverage

Critical Illness ▼

Administered by Lincoln Financial

Prepare for the unexpected

No one wants to face an unexpected illness or injury, but it’s important to be prepared so your financial wellness doesn’t suffer. Luckily, different types of insurance coverage can help protect you and your family, providing financial confidence.

What is it?
Critical illness insurance is a supplemental health product that may provide benefits if you or your covered dependent suffers a covered illness.

Why is this coverage valuable?
Unexpected expenses can add up after a critical illness. This coverage provides cash to pay health insurance deductibles, transportation, childcare, and anything else you and your family need while you receive treatment and recover.

Helping you navigate the healthcare system

Take charge of your healthcare with Health Advocate, included with your Lincoln critical illness insurance. You get unlimited confidential support from skilled specialists who will answer your questions, research treatment options, coordinate benefits, and resolve billing and claims issues to ease your coverage concerns. Spouses, dependents, parents, and parents-in-law of the covered employee can also use Health Advocate’s services.

Hospital Indemnity ▼

Administered by Lincoln Financial

What is it?

Hospital indemnity insurance is a supplemental health product that may provide benefits if you or your covered dependent visit a hospital or intensive care unit (ICU) due to a covered illness or injury.

Why is this coverage valuable?

Unexpected expenses can add up after an accident. This coverage provides cash to pay health insurance deductibles, transportation, childcare, and anything else you and your family need while you receive treatment and recover.

Health Assessment Benefit

As the saying goes, an ounce of prevention is worth a pound of cure. Regular health screenings can detect potential medical conditions early when preventive measures can make a big difference. As part of your hospital indemnity coverage, Lincoln pays you for proactively managing your health and
that of your covered family members

Legal Aid ▼

Administered by MetLife Legal Plans

Legal coverage through MetLife Legal Plans means added peace of mind for employees and their dependents.

Having to hire an attorney can be very stressful if you don’t know where to go or how much it will cost. MetLife Legal Plans makes it very simple to get the legal advice and the representation you need without draining your finances. This group benefit features:

Assistance for a wide range of legal needs, including wills and other estate planning documents, real estate matters, traffic offenses, adoptions, debt collection defense and much more
Reasonable monthly cost for unlimited use and no copays when using a Network Attorney for a covered matter
Easy access to more than 18,000 experienced Network Attorneys

Digital estate planning:

Retirement ▼

Will you have the money you need when you retire? Maybe you want to travel or spend more time with family and friends. No matter how you want to spend your retirement, you’ll need the income to do it. St. Luke’s offers you two excellent resources to help you build your retirement income:

Your Personal Pension Account Plan and Your Matched Savings Plan

These retirement plans work together to help you build your retirement income.

Personal Pension Account Plan: Allows you to watch your pension benefits grow – much like watching a savings account grow! St. Luke’s credits the account with a percentage of your pay each year and adds interest credits at a market rate of return.
Matched Savings Plan: You make pre-tax contributions to your account. As long as you work 1,000 hours in the year, St. Luke’s will help you save by matching a portion of the amount you contribute.

These two plans allow you and St. Luke’s to work together for your future with long-term retirement and savings plans.

Medicaid and the Children’s Health Insurance Program (CHIP) Notice	Health Insurance Marketplace Coverage Notice
Notice of Privacy Practices	HIPAA Special Enrollment Rights Notice
Important Notice About Your Prescription Drug Coverage and Medicare	Women’s Health & Cancer Rights Act Notice
Newborns’ and Mothers’ Health Protection Act Notice	Important Health Coverage Tax Documents Notice (Form 1095-C)

2025 Benefits

How to Enroll

Helpful Resources

Benefit Options

How to Enroll

Helpful Resources

Important Notices and Disclosures ▼

bswift Employee Instructions ▼

Benefit Eligibility ▼

Carrier Contacts ▼

Making Changes ▼

Glossary▼

Your 2025 Benefits

Medical ▼

Pharmacy ▼

Dental ▼

Vision ▼

Flexible Spending Account (FSA) ▼

Health Savings Account (HSA) ▼

Disability ▼

Physicians’ Short-Term Disability

Long-Term Disability

Life and AD&D ▼

Basic Life and AD&D Insurance

Voluntary Life Insurance

Group Whole Life ▼

Passport to Wellness ▼

Accident ▼

Critical Illness ▼

Hospital Indemnity ▼

Identity & Fraud Protection ▼

Legal Aid ▼

Employee Assistance Program (EAP) ▼

Retirement ▼

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