College of Menominee nation Faculty & Staff
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Benefits

 

Health Insurance Summary

 

The College of Menominee Nation participates in the Menominee Indian Tribe (MITW) partially self-funded group medical plan. The claims processor for this plan is Sisco. MITW offers a Point of Services (POS) plan with three different levels of benefits depending upon where you go for services. Services are subject to deductibles and coinsurance.

 

Coverage is effective the first day of the month following the completion of 60 days of employment. The employee contribution for health insurance is $31 per paycheck for single coverage and $67 per paycheck for family coverage. A Section 125 Premium Plan has been established that allows employees to pay for certain voluntary insurance premiums with pre-tax dollars. By reducing your taxable income you are reducing your taxes and increasing your net take-home pay.

 

MITW has a wellness plan included with the PSO plan. Routine services which appear on the schedule of benefits will be covered at 100% at Menominee Tribal Clinic or any participating HealthEOS provider. Routine services received at an “out of network” provider will not be covered. Inpatient treatment of alcohol/drug abuse and mental/nervous disorders are also covered under the plan, subject to a $250 deductible. There is a $100 co-payment for every emergency room visit.

 

The plan has a Pre-existing Clause. Newly eligible employees must serve a 270-day (9-months) waiting period before benefits will be paid for pre-existing conditions. The 270 days starts on the effective date of coverage. If a new hire has previous health care coverage and there has been no lapse in coverage greater than 63 days, all time covered under previous plan will be credited to satisfy the 270-day period (no waiting period).

 

Vision Care

Coverage includes; contact lenses and eye glasses payable at 50%, deductible waived, to a maximum benefit paid of $150 per Covered Person, per Calendar Year on a Reasonable and Customary basis. The vision exam will be covered under the wellness plan. No deductible.

 

Prescription Drugs

Prescription Drugs are paid for through a prescription drug program administered by Clear Scripts. There is a $5 co-payment for generic drugs, $20 co-payment for brand name drugs and $20 co-payment specialty drugs. There is also mail order service available for maintenance drugs subject to two co-pays. The brand name prescription will be $45 for a three month supply. Prescriptions will be charged a double co-payment for anything over a 30 day supply.

 

Contract Health Eligible

(Federal enrolled or descendant Tribal member) employees and dependents will benefit from Medicare Like Rate reimbursement on most hospital UB92 claims. If your hospitalization is eligible for Medicare Like Rate reimbursement, any incurred hospital claims will be paid at 100% and there will not be deductible or coinsurance billed to you.