Department of Human Resources

Medical Mutual and CVS Caremark

To participate in a health plan, benefits-eligible employees may enroll within 31 days from date of hire, qualifying event, or during our annual Open Enrollment period held in October. The date of coverage will be: 

  • Date of Hire - If your DOH is on the 1st of the month - coverage will be effective on your DOH. 
  • Qualifying Event - The 1st of the following month after the date of the qualifying event. 
  • Open Enrollment - January 1st of the next calendar year. 

To change or cancel enrollment outside of our annual Open Enrollment period, a qualifying event, such as loss of coverage, marriage, birth/adoption, divorce, legal separation or annulment, or death must take place. Changes may be made within 31 days from the date of the qualifying event.

The Supreme Court made a ruling that employers and universities can deny contraceptive coverage to their employees and students based on religious objections. Oberlin is making no changes to the health plan coverage regarding reproductive health or rights.

No Surprises Act/Transparency Under the Consolidated Appropriations Act, 2021 - Medical Mutual is committed to full compliance with federal laws and regulations concerning surprise billing and transparency of coverage. They are committed to helping you understand the legislation, its impact to members and employer groups, and what Medical Mutual is doing to be fully compliant with the legislation. Check back often for updates or visit cms.gov for more information. 

Health Plan Highlights 

Benefits Enrollment Form (active employee) 

Cancellation Form (active employee) 

Email documentation to human.resources@oberlin.edu

Our provider network is called SuperMed PPO. For providers outside of Ohio, you will use the Aetna Open Choice PPO network until December 31, 2022.

Effective January 1, 2023, for providers outside of Ohio, you will use the Cigna PPO network. To search for a medical facility, physician or specialty physician, search the provider network. 

New National Network effective January 1, 2023:

Human Resources announced a change to Medical Mutual’s national provider network that will be effective January 1, 2023. Employees and covered dependents will utilize the Cigna PPO network when they travel, reside or access care outside of our SuperMed PPO network. This change allows Medical Mutual to continue providing broad connections to care while managing overall costs. Toward the end of 2022, if you experience a network disruption due to a provider no longer being in-network you will be notified. We expect the impact to be minimal and would like to remind you that continuation of care waivers may be available for those involved in certain forms of active treatment. Directories will be updated starting in fourth quarter 2022 to reflect the change from Aetna Open Choice PPO Network to the Cigna PPO network. At a later date, enrolled employees will receive new identification (ID) cards that show the new national network. 

Dependent Coverage

A spouse or same gender domestic partner of an Oberlin College employee is required to participate in his/her employer sponsored health care plan if: he/she has access to continuous group health coverage through his/her employment, and the employer contributes at least 50 percent of the premium. If these conditions are met, the spouse/domestic partner must enroll in his/her employer’s health care plan.

If your spouse or same gender domestic partner is eligible to participate in our health plan and you cover him/her, a Spousal Coordination of Benefits form must be completed and updated annually during open enrollment.

If you enroll in a medical plan, your ID card from Medical Mutual will include pharmacy benefit information and be mailed to the address we have on file for you. 

Replacement ID cards may be ordered by:

  1. Calling Medical Mutual's Customer Care 1-800-586-4509
  2. Go online My Health Plan
  3. Download the mobile app for free - Apple App Store or Google Play . Search for MedMutual.

Dependents age 18 and older, will be issued an ID card. 

Medical Mutual Customer Care: 1-800-586-4509

Medical Mutual HSA/HRA Account Customer Care: 1-800-522-2037

CVS Caremark: 1-844-283-4674

 


 

All benefit eligible employees have the option to enroll in a Consumer Driven Health Plan (CDHP) with a Health Savings Account (HSA).

CDHP with HSA

Summary of Benefits and Coverage Summary Plan Description

 

  • Single

 

2022 SBC

2022 SPD
  • Employee + Spouse/DP 
   
  • Employee + Child
  • Employee + Children
2022 SBC 2022 SPD
  • Family 
2022 SBC 2022 SPD

All benefit eligible employees who enroll in the Consumer Driven Health Plan (CDHP) and are not eligible for an HSA, you will get a Health Reimbursement Account (HRA).

CDHP with a HRA Summary of Benefits and Coverage Summary Plan Description
  • Single

2022 SBC

2023 SBC

SPD

  • Employee + Spouse/DP 
   
  • Employee + Child
  • Employee + Children
2022 SBC SPD
  • Family
2022 SBC SPD

Traditional OBIR PPO Plan B - OCOPE ONLY

  Summary of Benefits and Coverage Summary Plan Document 
Oberlin College Office and Professional Employees (OCOPE) 2022 OBIR OBIR SPD

 

 

 

 

 

Employees who are eligible to retire and who are covered under Oberlin College’s group health plan while in active service, may continue to participate in the health plan during retirement. 

Benefits coverage for you and your eligible dependents in effect at the time of retirement may continue. Covered dependent children may remain on your plan until they no longer meet eligibility requirements, age 23 for vision and dental insurance, age 26 for health insurance.

Note: A retiree cannot add a dependent during retirement.

Retirees (and covered dependents) under 65 will be enrolled in the Consumer Driven Health Plan with a Health Reimbursement Account (HRA) 

Retirees (and covered dependents) age 65 and over will be enrolled in the Medical Mutual Medicare Advantage Plan with SilverScript (prescription coverage). 

 

HIPAA Privacy Practices - This notice describes how medical information about you may be used and disclosed.

HIPAA Special Enrollment Rights - This notice provides information about your rights and protections as participants in group health plans.

Summary Annual Reports - This gives notice of the annual report summarizing each benefit plan subject to ERISA.

Women's Health and Cancer Rights Act - This notice describes your rights after a mastectomy.

Creditable Coverage Disclosure Notice - This notice is about your prescription drug coverage and Medicare.

USERRA - This notice describes your rights under The Uniformed Services Employment and Reemployment Rights Act.

Drug-Free Workplace Act - This notice informs you about the college policy to maintain a drug-free workplace.