Save on Medical Care with KISx Card & Accarent Health

You are required to update your Meritain Coordination of Benefits information every year so that they can properly process your claims. Coordination of Benefits information confirms whether you and/or your enrolled dependents have insurance coverage other than your employer's and if so, what that other insurance is, so that they can determine proper payment responsibilities for claims. If your Coordination of Benefits is updated yearly or as requested, your claims will be processed. Click here for the Coordination of Benefits form. If you’d like to complete the Coordination of Benefits online, you can do so once you are registered on the Meritain portal.

Medical: Login to www.meritain.com. Once logged in, you'll have access to print or download an ID card. You may also call Meritain at 800-566-9311 to request a new ID card. Dental: You do not need to present your Delta Dental ID card when receiving services. Notify the provider that your insurance is through Delta Dental of Pennsylvania, give them your name, SSN, Group Number (the DHMO group number is 76293 and the PPO group number is 06472), and state that your employer is Oliver Heating & Cooling. If you would like an ID card, please call Delta Dental at 1-800-932-0783 or register online at www.deltadental.com. Vision: Login to https://member.eyemedvisioncare.com/member/en. Once logged in, you'll have access to print or download an ID card. You may also call EyeMed at 1-866-939-3633 to request a new ID card.

Medical: Click here and select Aetna Choice POS II (Open Access). Dental: Visit www.deltadental.com/us/en/member/find-a-dentist.html to find a dental provider. Choose the following: PPO Provider: Delta Dental PPO DMO Provider: Delta Care USA Primary care dentist in the DeltaCare network will need to be specified. This can be changed through the Delta online portal or by calling 1-800-932-0783, effective for the next month. Please see the plan guide for a full list of services. Vision: Click here for an EyeMed provider (select the Insight Network): https://eyedoclocator.eyemedvisioncare.com/member/en Learn more about potential discounts through PLUS Providers (select the Insight Network): https://eyemed.com/en-us/blog/benefits-101/savings-plus-more-with-plus-providers-22758.

Yes. You can access the Amazon Pharmacy (through SmithRx) to set up your mail order prescriptions: 1-855-206-3605 www.amazon.com/smithrx

When you enroll in one of our healthcare plans, you have access to use telemedicine by using the SwiftMD app. This allows you to speak with a doctor 24/7 by phone, text, or video chat. Click here to learn more.

When you register on the Meritain portal, you will have access to print an ID card, view your claims, or find an in-network doctor. Visit https://account.meritain.com/Portal/Registration and input your Group ID, which is 18510. You will also need your Member ID, which is located on your ID card. If you do not have your ID card, please feel free to contact your Lacher benefits advocate to obtain your Member ID.

You can make changes to your benefit elections during your healthcare and benefits open enrollment OR if you have a qualifying life event (QLE). A QLE is a change in your situation, like a marriage, divorce, or having a baby, for example, which allows you to make changes to your health insurance. Take a look a this document for more information. You have 30 days to submit your changes online through our benefits enrollment system. Here's an overview of qualifying life events from Healthcare.gov. If you have a QLE, contact our Lacher benefits advocate.

First, make sure you compare the bill you received with the EOB from the insurance. If you need to locate an EOB you can find one by logging into your account at www.meritain.com. If the bill does not match the EOB, please contact your Lacher benefits advocate for further assistance.

Take a look at this flyer to learn about your choices when it comes to where you should receive care. High level overview: Primary Care Physician - This is your home base. Your doctor knows your history and is a good place to start. Cost to you: Plan A: After you pay your deductible, there is no cost for this service Plan B: You pay a $30 copay Emergency Room - Go to an ER when you have a life-threatening issue. Cost to you: Plan A: After you pay your deductible, there is no cost for this service Plan B: You pay a $400 copay Urgent Care - Consider an urgent care center for non-life threatening condition. You'll save time and money over the ER. Cost to you: Plan A: After you pay your deductible, there is no cost for this service Plan B: You pay a $87 copay Telemedicine with SwiftMD - Consider using SwitftMD for non-life threatening conditions, and when you need 24/7 care. Cost to you: Plan A: There is no cost for this service Plan B: There is no cost for this service

You can make plan changes and enroll dependents during open enrollment, or if you have a qualifying life event, by visiting the Enroll Now page.

While regular medical care focuses on treating illness, preventive care aims to keep you from getting sick in the first place by focusing on helping you maintain good health. When you visit your doctor for a preventive care service - like a physical exam or a health screening - you should not be billed. However, if you ask your doctor about a specific health concern while you are at your preventive care visit, it may be billed as an office visit, and not a preventive care visit. Here’s how to be sure your preventive care visit is free for you: Mention prevention upfront – When scheduling your appointment, confirm that you are scheduling a preventive care visit. Know what to discuss with your doctor during the visit – During your visit, keep the conversation focused on how you can maintain a healthy lifestyle. Ask your doctor - If you do ask questions about a specific health concern while at your visit, ask your doctor if that will be treated as an office visit or as a preventive visit. Let your doctor know you are expecting this visit to be of no charge to you. For more information about preventive care, contact your Lacher benefits advocate.

After submitting a claim for medical treatment, you may receive an Explanation of Benefits (EOB) from your insurance company. The EOB is a form that insurance companies send to their members to explain what part of a claim was paid by insurance, what part was not paid, and why. It is important to understand what this statement means.

You may contact our Lacher Benefits Advocate, Heather Malik at 215-660-0353 or heather@lacherinsurance.com.

Use the Find My Meds tool, found at https://member.mysmithrx.com/. Click here to learn more.

Many standard prescriptions can be filled at your local retail pharmacy. You can review the national chain options here. Specialty medications are generally filled at Kroger Specialty pharmacy or Senderra Rx. Click here for more information. Do you prefer the convenience and potential cost savings of mail order? You have three options for mail order: Amazon Pharmacy - click here for enrollment instructions Walmart Pharmacy - click here for enrollment instructions Cost Plus Drugs - click here for enrollment instructions

A specialty prescription is for special medicines that may cost more and need extra care, often used for serious health conditions. Follow these required steps to fill a specialty prescription: Initiate the Prescription: Request your doctor to send your prescription to one of the SmithRx specialty pharmacies. Choose between Kroger Specialty Pharmacy or Senderra. Click here for more information and contact details. Kroger Specialty Pharmacy: 888-355-4191 Senderra: 888-777-5547 Prior Authorization: Your physician must complete and submit a prior authorization to SmithRx to obtain approval for your medication under your plan. Connect with Support: Reach out to the SmithRx Connect Team at 1-844-385-7612. They'll assess if you're eligible for any patient assistance programs to help you save on the cost of your medication. If not, they'll guide you through applying for any available manufacturer coupons. This step is required before you can fill your specialty medication.

Click here to determine which medications are covered under your plan and any applicable limitations.

Your doctor will send your mail order script to either Amazon Pharmacy, Walmart Pharmacy, or Cost Plus Drugs. You must first be enrolled in mail order: Amazon Pharmacy - click here for enrollment instructions Walmart Pharmacy - click here for enrollment instructions Cost Plus Drugs - click here for enrollment instructions

When you register for a free account on https://member.mysmithrx.com/, you can look up covered medications new or past-filled medications. You can also find in-network pharmacies from their national network of over 68,000 participating locations. Click here to learn more.

If you are not using mail order pharmacy, tell your doctor to send the scripts to your preferred pharmacy, like CVS or Walgreens, for example.

Did you know your local retail pharmacy may not always be the lowest cost option? SmithRx Connect can help you navigate alternative sources and hold your hand through the process. Click here to learn more.

Covered prescriptions: Click here to determine which medications are covered under your plan and any applicable limitations. Mail order pharmacy information: Click here for enrollment instructions. Other helpful resources from SmithRx, your Prescription provider: Understanding your SmithRx prescription benefits (in English and Spanish) National chain pharmacy listing How to use the SmithRx portal

Medical: Meritain 1-800-925-2272 www.meritain.com Prescription: SmithRx 1-844-454-5201 www.smithrx.com Mail order prescription: Amazon Pharmacy (through SmithRx) 1-855-206-3605 www.amazon.com/smithrx Telemedicine SwiftMD 1-833-794-3863 www.swiftmd.com HSA & FSA The Harrison Group 1-855-222-5727 www.theharrisongrouponline.com

Click here to learn more about the Meritain Cost Estimator Tool.

When you enroll in one of our healthcare plans, you have access to use telemedicine by using the SwiftMD app. This allows you to speak with a doctor 24/7 by phone, text, or video chat. Click here to learn more.

Click here to learn how to register, print an ID card, view your claims, and much more!

KISx (pronounced "Kiss") is a new program that allows you to pay $0 out of pocket for over 400 procedures. So rather than paying your normal copay or deductible on a knee replacement, for example, you could now receive it for free! ​ Click here to learn more.

Click here and select Aetna Choice POS II (Open Access).

Click here to see a side-by-side comparison. Watch a short video below about the DHMO plan:

Delta Dental 1-800-422-4234 (DHMO) 1-800-932-0783 (PPO) www.deltadental.com

Visit www.deltadental.com/us/en/member/find-a-dentist.html to find a dental provider. Choose the following: PPO Provider: Delta Dental PPO DMO Provider: Delta Care USA Primary care dentist in the DeltaCare network will need to be specified. This can be changed through the Delta online portal or by calling 1-800-932-0783, effective for the next month. Please see the plan guide for a full list of services.

Click here for an EyeMed provider (select the Insight Network): https://eyedoclocator.eyemedvisioncare.com/member/en Learn more about potential discounts through PLUS Providers (select the Insight Network): https://eyemed.com/en-us/blog/benefits-101/savings-plus-more-with-plus-providers-22758.

EyeMed 1-866-939-3633 www.eyemed.com

Click here

Contact the Harrison Group to get a new HSA or FSA card or check your balance: The Harrison Group 1-855-222-5727 www.theharrisongrouponline.com

HSAs are a great way to save money and efficiently pay for medical expenses because they are tax-advantaged savings accounts that accompany high deductible health plans, or HDHPs. HSA money can be used tax-free when paying for qualified medical expenses. At the end of the year, you keep any unspent money in your HSA. This rolled over money can grow tax-free. Your HSA and the money in it belongs to you—not your employer or insurance company.

HSA: You may change your HSA contribution any time throughout the year. Visit the Enroll Now page to do so. FSA: You may only change your FSA contribution amount during our annual open enrollment, OR if you have a qualifying life event (QLE). To change your contribution amount because of a QLE, visit the Enroll Now page.

Medicare creditable coverage disclosure notice

Medical Plan A - Summary of Benefits & Coverage Medical Plan B - Summary of Benefits & Coverage ​ Special Enrollments Rights, Marketplace information, Women's Health & Cancer Rights, and CHIP Notices HIPAA Privacy Notice Your Rights and Protections Against Surprise Medical Bills Summary Plan Description Summary Annual Report

Summary plan document

PPO Provider: Delta Dental PPO DMO Provider for PA: Delta Care USA DMO Provider for DE: Delta Care USA Summary Plan Description Enrollee Notices

Coming soon.

Since the KISx Card and Accarent Health programs offer similar benefits for surgeries and imaging procedures, it's important to make sure you're choosing the option that best suits your needs. To do this, we recommend contacting your Lacher Benefits Advocate before scheduling any procedure. They will guide you through the details of each program, ensuring you get the highest quality care at no cost to you. Your advocate is there to provide personalized support, helping you navigate the process with confidence and peace of mind - whether you're preparing for a minor procedure or something more complex. Your Lacher Benefits Advocate Heather Malik 215-660-0353 heather@lacherinsurance.com

No, you don’t need to enroll! When you're ready to use the KISx Card program or Accarent Health, simply reach out to your Lacher Benefits Advocate. They’ll provide all the details you need to make an informed decision.

KISx and Accarent Health have partnered with a network of providers who understand the benefit of you visiting their facility instead of another one. These providers then pass on a discount to KISx or Accarent as a “thank you” for the referral. KISx or Accarent, in turn, pass this discount on to you, through our company.

Use this program for advanced surgery, like complex cancer surgery, bariatric surgery, and cardiac surgeries, for example.​ Accarent offers one of the most robust selections of medical procedures available. They currently have over 130 procedures offered by top-rated hospitals across the country, from common knee and hip replacement, to complex organ transplant.​ And the cost is FREE for you!​ Click here to learn more about this program. Visit https://www.accarenthealth.com/faq#individuals to learn more.

Use this program for orthopedic surgery, general surgery, colonoscopies, and MRI/CT/PET Scans. Click here to learn more! ​ The KISx (pronounced "Kiss") program allows you to pay $0 out of pocket for over 400 surgical and imaging procedures. This benefit is available to you and your dependents if they are covered on our health insurance plan. So rather than paying your normal copay or deductible on a knee replacement, for example, you could now receive it for free! ​ Click here to get a copy of the KISx card. Hang onto it! Whenever you have an upcoming surgery or major imaging procedure, call the phone number on the back of the card to see if it's covered. ​ This benefit is available to you and your dependents, as long as they are covered on our health insurance plan. ​ Talk to a KISx Card Nurse about a procedure: 877-GET-KISX (438-5479). How it works: Member testimonial:

KISx Card Program 1-877-438-5479 www.getkisx.com Accarent Health 1-866-771-0697 www.accarenthealth.com

Yes, the KISx Card program and Accarent Health are only available to employees and their dependents enrolled in one of our medical plans.