LTC - Genworth

LTC - Genworth  

Overview

  Basic HSA Plan HSA Plus Plan PPO Plan
HSA-eligible Yes Yes No
Company contribution to HSA $350 for employee-only coverage; $700 for family coverage $600 for employee-only coverage; $1,200 for family coverage None
In-network care: Your costs
Individual/
family deductible
$2,000/$4,000 $1,500/$3,000 $700/$1,400
Individual/
family out-of-pocket maximum
$5,000/$10,000 $4,500/$9,000 $4,500/$9,000
Coinsurance (applies after meeting deductible)
You pay 20%, plan pays 80%
Office visit — Preventive care
Covered at 100% in-network, so you pay nothing*
Office visit — Primary care You pay 20% after deductible
You pay 20% after deductible
You pay $30 copay
Office visit — Specialist 
You pay 20% after deductible You pay 20% after deductible You pay $60 copay
Office visit – Chiropractor
(60 visits per year)
You pay 20% after deductible You pay 20% after deductible You pay $60 copay (services requiring adjustments/manipulation subject to deductible and coinsurance)
Telemedicine Physical Health You pay 20% after deductible up to $59 You pay 20% after deductible up to $59 You pay $15 copay
Telemedicine (Behavioral Health) You pay 20% after deductible You pay 20% after deductible $30
Urgent care visit You pay 20% after deductible You pay 20% after deductible You pay $60 copay
Emergency room visit You pay 20% after deductible You pay 20% after deductible You pay $200 copay
Hospital (inpatient or outpatient) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Mental health and substance abuse (inpatient) You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Mental health and substance abuse (outpatient) You pay 20% after deductible You pay 20% after deductible You pay $30 copay

 

*There is no cost if only a preventive exam is performed. If any other services are provided during the visit for new or ongoing health concerns, the visit may be billed as diagnostic and subject to the applicable charge for your plan.

 

  • Working spouse/domestic partner program

    If your spouse/domestic partner has group medical insurance coverage available elsewhere but chooses our program, $20 will be added to your biweekly premiums each pay period. This helps Masonite to continue to offer comprehensive and affordable coverage for our employees.

    This does not apply to dependent children. You will have to attest to the fact that your spouse/domestic partner is not eligible for group health coverage through his/her own employer. 

  • Non-tobacco rate for all medical plans

    If you and your dependent have been tobacco free for the past six months, you will be able to participate in the medical plan at the lower non-tobacco rate. Once you have been tobacco free for six consecutive months you may contact OSV at 1-855.65.MASON or send an email to MployeeCentralBenefits@onesourcevirtual.com.

FAQ's

Answers about the plan, including eligibility, options, enrollment, customer service and more.

  • Who is the provider?

    Your employer has made arrangements with Mercer Voluntary Benefits to offer you access to a Long-Term Care Insurance program. This program will help you review your needs and offer you options from Genworth Life Insurance Company.
  • How can this help me?

    Long Term Care Insurance helps you offset the costs of care for help with activities of daily living, such as bathing, dressing, eating, toileting, transferring and continence. This coverage will also provide benefits if you suffer from a severe cognitive impairment, which may be the result of diseases (like Alzheimer’s disease) or aging. Long term care services may be at your home, in a nursing home, an assisted living facility, or a hospice facility.

    Why is this coverage necessary? You may need it in three years or three days; it's impossible to predict how long you'll be in good health or if you'll suffer from long term effects of an accident or debilitating disease. And, because long term care insurance rates are based on your age at the time of purchase, the younger you are when you enroll, the less your premiums will be.
  • Who is eligible?

    • Actively-at-work full-time employees
    • Newly hired full-time employees working at least 20 hours per week have the opportunity to apply with reduced medical underwriting depending on their age, during the first 60 days of date of hire.
    • Family members aged 18-75 including:
      • Spouses or domestic partners
      • Parents, Parents-in-law, Step parents and Step parents-in-law
      • Grandparents, Grandparents-in-law, Step grandparents and Step grandparents-in-law
      • Siblings, Siblings-in-law, Step-siblings and Step siblings-in-law
      • Adult children, Step children and adopted children

     

    Eligibility Requirements

     

    All eligible employees and family members must maintain a permanent US residence and have a valid Social Security or Tax Identification number from the US Government.

     

    Please note, this program is not available to residents of Vermont.

  • When can I enroll?

    As a new hire, you can enroll during your employer's designated enrollment period. Once you’ve reached the designated enrollment period you will have a certain number of days to apply with simplified underwriting. After the designated enrollment period, you may enroll with full underwriting.
  • How much will this coverage cost?

    Your cost is based on several factors including your age, any special features you select, and the amount of coverage you want. To get a free, no-obligation online quote, click the "Enroll Now" link.
  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your coverage without interruption as long as you continue to pay your premiums. Although payroll deduction will no longer be available if you retire or leave your company, you can opt for other payment methods such as direct checking or savings account deduction, or home billing.
  • What is the cost of waiting to purchase Long Term Care Insurance?

    If you are thinking of waiting to purchase LTC insurance coverage, consider the impact of waiting:

    • Increases the risk of being ineligible for insurance.
    • Can increase the overall cost of coverage because premium rates increase are based on your age at time of enrollment and the plan design you select, they do not increase with your age.
    • Decreases the overall time you have LTC insurance coverage, leaving you responsible for the cost of care if you need long term care services.
    • Family may sacrifice income by reducing their hours at work to care for you.
    • Without LTC insurance, individuals and families risk exposure to emotional and financial hardships.


    Waiting delays covering your LTC risk can cost you money and deplete savings.

  • Won’t the Federal Government pay for my Long Term Care?

    Medicare provides minimal financial support for LTC services. Medicare was designed to pay for acute medical conditions and post-rehabilitative care; it was not intended to pay for costs associated with LTC. To qualify for nursing home care under Medicare, a three-day hospital stay is required, and care must be rehabilitative in nature. If these conditions are met, Medicare will pay for the first 20 days. Days 21-100 require a co-payment. There is no coverage after day 100.