Q: Outside of annual enrollment, when can I add or drop a spouse/domestic partner or child to health and dental plans?
Q: Are there any waiting periods for dental insurance?
Q: How long do I have to add my child to the dental plan from date of birth or adoption?
Q: Included Health left a voice mail message asking me to call them. Why has Included Health called me unexpectedly as I didn’t call them?
A: Included Health provides personalized care guidance, assistance, and support for healthcare needs. They partner with our medical claims carrier, Meritain, and are able to determine various diagnoses based on the claims received. When a claim reaches Included Health, they can see that a member might benefit from additional services that we offer within our health plan, and they may make an outreach call. Additional services may be available for certain health conditions such as cardiac events and diabetes. Should you receive a call from Included Health, we encourage you to take or return the call.
Q. How do I check to see if my doctor is a participating provider?
Q. What does the health plan offer so that I can improve my health?
- Fitness Reimbursement: Covered programs improve cardiovascular condition, muscular strength/endurance and flexibility (for example, health clubs, gyms, yoga, martial arts, pilates, swim programs). The benefit is administered by the City’s Benefits Division, not by Meritain.
- Smoking Cessation:
- Medication: Prescription medication & over-the-counter (OTC) filled at a pharmacy payable at 100% administered by Meritain.
- Hypnosis: benefits are payable at 100% after a $10 therapy visit copayment administered by the City’s Benefits Division, not by Meritain.
- Smoking Cessation classes: payable at 100% administered by the City’s Benefits Division, not by Meritain.
- Nutrition Counseling: The health plan provides benefits for nutritional counseling when required for a diagnosed medical condition at $0 co-payment.
Q. How long may I keep my child on the health/ dental/vision plan?
Q. When can I add or drop a spouse/domestic partner or child from the health and dental plans?
A. There are two ways this can be done:
- Qualifying Life Event: You have 30 days from the date of the event to make your change(s). The coverage will be effective the first day of the following month. You will need to process a Qualified Life Event through PlanSource and provide documentation of the Life Event.
- Annual Enrollment: Each June for an effective date of July 1st. No qualifying event is needed to make a change during this period.