The PHLEX Plan is a program offering medical, dental, vision, prescription, life insurance coverage and choice. Each Fall you are asked to read a packet of information provided to you and decide which of the options best fit the needs of you and your family. You select from a menu of coverage options and levels of coverage to ensure that you create a benefits package that meets your specific needs. The benefit choices you make will become effective January 1.
For a full description of the Plans and the benefits provided in each, please see the Health Fund section of the website.
How the Plan Works
The Plan uses a point system, called PhlexPoints. Each benefit is assigned a cost. You pay the cost of each benefit option using your PhlexPoints. The Fund gives you 100 PhexPoints to spend on your benefits. You can use these PhlexPoints to buy any combination of benefits.
If the benefits you choose cost less than 100 PhlexPoints, you may use your remaining PhlexPoints to:
- Enroll in a Healthcare Reimbursement Account; and/or
- Enroll in a Dependent Care Reimbursement Account.
If your benefits cost 100 PhlexPoints or more, you will not be eligible to participate in the reimbursement accounts and you will have to contribute towards the cost of your coverage through pre tax deductions.
Options available in the Phlex Plan:
You have the ability to choose between two very different medical plans and an opt out option so it is important to understand the differences between the options and how each works. Both medical options provide coverage for medically necessary care. Both plans require you to elect a Primary Care Doctor (PCP). View The Comparison Chart.
Your Medical Plan Choices:
- High Option Plan – This is a Point of Service Plan
- Basic Plan – This is an HMO Plan.
- Opt out and save – If you have other coverage, for example, through another employer or your spouse, you may choose to opt out of the Fund’s medical plan and spend your PhlexPoints on other benefits.
If you elect either the High Option or the Basic Plan Plan you are automatically enrolled in the prescription Plan.
Your Vision Plan Choices:
- Enhanced vision program – Care is provided through a network of optometrists and ophthalmologists.
- Discount vision program – This program allows you to receive discounted rates for eye exams, eyeglasses and contact lenses.
Enrollment in the Dental Plan is optional. Enroll in the dental plan if you or your dependents need dental coverage. You may enroll in the medical plan even if you waive coverage in the dental plan or enroll in a different level of coverage in each. As an example, you can choose family coverage for the medical plan but elect to cover only you and your spouse in the dental plan. The choice is yours.
Your Dental Plan choices:
- Delta Dental Preferred Provider (PPO) plan
- Opt out