MEDICAL
Choose from two plan options, administered by Meritain
Dunwoody Village will be offering two medical plan options for the January 1, 2025 plan year.
We’re committed to giving you and your family options by offering a comprehensive medical plan. The Meritain medical plans give you the flexibility to meet the needs of you and your family. To maximize your coverage, it is best to utilize preferred providers that participate within the Aetna Choice Point of Service (POS) II network.
2025 MEDICAL PLANS
Meritain Health: Dunwoody Village is continuing to use Meritain Health as your medical carrier for the January 1, 2025 plan year. You will be receiving new Meritain medical ID card this year. When looking for a participating provider, please select the Aetna Choice Point of Service (POS) II network. The telemedicine benefit offered through the Meritain medical plans will continue to be administered through Teladoc.
Medical Plan Names and Design: Dunwoody Village will now offer two medical plan options: the POS Copay Plan and the Qualified High Deductible Health Plan (QHDHP) with HSA. The POS Copay Plan combines the features of the previous POS Plan and Copay Plan. The QHDHP w/ HSA plan design will remain largely the same. We encourage employees to attend Open Enrollment meetings to learn more about the medical plan offerings for 2025.
Prescription Drug Program: The prescription drug program will continue to be run through SmithRx. SmithRx works hand in hand with Meritain to provide seamless integration between your medical plan and prescription drug program. There are some new features with the SmithRx program that can help lower your drug cost. More information on SmithRx, along with the SmithRx Prescription Drug Formulary, can be found here.
POS Copay Plan
This plan has a deductible of $500 for single and $1,000 for those with dependents that applies to in-network services. The deductible is the first portion that you must pay out-of-pocket. Once your deductible is met, you will have a flat copay for PCP Visits, Specialists Visits, Urgent Care, Emergency Room, Inpatient Hospital stays, and Outpatient Surgery. The deductible does not apply to prescription drugs on the SmithRx formulary, so you will pay a flat copay per Prescription Drug fill without having to meet the deductible first. The deductible also does not apply for preventive care, which is covered at 100%.
This plan is the higher-cost option in terms of the amount that will be deducted from your paycheck. Please see the Employee Contributions page for more details.
Qualified High Deductible Health Plan with HSA
This Medical Plan is a PPO Plan that offers you direct access to any network provider for covered services. Under the QHDHP, preventitive care is covered at 100%. For all other care, you must meet a dedutible before the plan pays.
Employees who enroll in this plan as a single will recevie $750 into their Health Savings Account (HSA) from Dunwoody Village. Those enrolled with dependents will receive $1,500 of funding in their HSA accounts.
This plan is the lowest-cost option in terms of the amount that will be deducted from your paycheck. Please see the Employee Contributions page for more details.
NEED HELP FINDING A PARTICIPATING PROVIDER WITH MERITAIN?
It is always best to receive care In-Network when possible. Providers in the Aetna Choice Point of Service (POS) II network negotiated with Meritain to set rates for health care services. These rates are generally more favorable than what would be found Out-of-Network, so Meritain also provides a greater level of coverage for In-Network care.
Please confirm that your providers are participating in the Aetna Choice Point of Service (POS) II network using this link and enter your zip code. Select or type in Aetna Choice POS II (Open Access) under 'Select a Plan'. The button below also offers a step-by-step guide on finding a participating Meritain provider.
MERITAIN PORTAL
Meritain's Health member portal has an array of tools and resources to help you manage your health benefits. Below are a few things you can do on your Meritain.com member portal.
- Verify eligibility and benefits coverage
- Find the status of claims
- Access your ID card (view, print or request new cards)
- Submit a claim for reimbursement directly to you
- View your Explanation of Benefits (EOB) documents
- And much more!
For more information on the Meritain portal and the tools & resources available to you, click below.
MERITAIN - CVS MINUTECLINIC ACCESS AT NO COST
Through your Meritain medical coverage, you will have access to high-quality care through MinuteClinic at no cost to you. MinuteClinic makes it easy for you to get the care you need, when and where you need it. And now you get access to all covered MinuteClinic services at no cost.
MinuteClinic is a walk-in clinic inside select CVS Pharmacy and Target stores, and is the largest provider of retail health care in the United States - with over 1,100 locations in 33 states and the District of Columbia. MinuteClinic health care providers treat a variety of illnesses, injuries, and conditions. They can also write prescriptions, when medically appropriate. MinuteClinic is open every day, including evenings, and offers both walk-in and scheduled appointment options.
For more information on the no cost MinuteClinic access through Meritain, click below.
