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Ascent Senior Living

Benefit Overview

Effective 11/1/19 - 10/31/2020 • AscentLivingBenefits.com • 844-839-6748


We provide you with a simple online statement once a month – making it easy for you to understand what your doctor billed, what your insurance paid, and what you owe. You can even pay your bill online!

HealthEZ doesn’t serve clients; we serve people. We are here to take care of you.

Welcome!HealthEZ is proud to serve as your benefits administrator. We help companies all over the US provide custom, personalized benefits to their employees. We’re here to make your life easier! We are a family-owned business serving families like yours for over 35 years.

Your employer selected HealthEZ because we are truly a different kind of health care company. We understand health insurance can be very complicated, and it’s our goal to help you navigate the health care maze.

We are here to serve you!

We start by having human beings answer our phones; no computers or phone trees. We are here to listen and help you if you’re sick or just have a simple question about your benefits. You have one dedicated phone number to call-no matter what you need.


Keep an eye out for this HealthEZ mailer containing your ID card!

Personalized Phone numberAscent Living Communities has a dedicated phone number at 844-839-6748 that is answered between the hours of 8 A.M. and 7 P.M. Central Time. No phone trees! After business hours, simply press “3” to reach our 24/7 nurseline.

24/7 nurselineYou have 24/7 access to HealthEZ’s team of experienced nurses and doctors. Have a health related question or need help finding the right doctor? Give us a call at 844-204-3763. We would love to help you!

Personalized benefits WebsiteAscent Living Communities has a dedicated benefits website at AscentLivingBenefits.com where you will be able to view all information relating to your health plan. Everything you need, all in one place!

Before you setup your online account you will be able to view the benefits covered under your plan, pharmacy information, search for a doctor, view the Form Library, and much more!

Once you receive your ID card, you’ll be able to set up your online account. After your account is active, you can view all your information about your benefits, including your statements, account balances, recently processed bills, and your EZpay accounts.


one simPle statementHealthEZ provides all of your expenses in one document. The consolidated monthly statement provides a level of straight forward convenience unique in the industry.

EZPay is a free medical payment service which allows you to pay your medical bills from your own credit card or debit card - simply, easily, and safely. Sign up from your custom benefits site!

1. Login or create an account by clicking “Need to set up online access?” on the login page

2. Click on “HealthEZpay Accounts” located on the left sidebar

3. Click “Add another credit card” (even if it is your first account) and agree to the Terms of Service

4. Fill in your information and click “Submit” to start enjoying the benefits of Auto-Pay with HealthEZ

You will receive an email once a bill is processed, and will be asked to approve payment if you owe money.

EZPay will pay by default if you do not respond in: • 2 business days for claims under $250 • 5 business days for claims over $250

EZPay will combine your payment with any medical plan payments so your provider is paid in full.

Your primary medical network is Cigna.

Your medical network is a group of health care providers. It includes doctors, specialists, hospitals, surgical centers and other facilities. These health care providers provide services at a lower rate, which you will see reflected on your statements as a discount.

There may be times when you decide to visit a doctor who is out-of-network, and those costs are always higher. There are no discounts with these out-of-network services, and you will be responsible for paying the difference between the providers full charge and the amount your plan pays for. This is called balance billing.

To check that your provider is in-network, please visit AscentLivingBenefits.com, and click “Find a Doctor.”


Your pharmacy benefit manager is EHiM. Pharmacy Benefit Managers (PBMs) reduce prescription drug costs and improve convenience and safety for consumers. EHiM administers your prescription drug plan, and offers home delivery of medications and a network of pharmacies offering more affordable medications.

The same prescription rarely costs the same from store to store. Be a savvy consumer and price compare your prescriptions at different pharmacies to get the best price. Check out Wal-mart’s “$4 Prescriptions,” and don’t forget Sam’s Club and Costco - you don’t have to be a member to access their pharmacy! Did you know there are coupon and price comparison sites for prescriptions? Check out these sites and see if you are paying too much:

ghghghTalk to your provider about lower cost alternatives! Generic drugs are important options and offer

the same dosage form, safety, quality, and performance characteristics of brand-name drugs.


Summary of Medical Benefits via HealthEZ

MEC Plan

Plan Year Deductible Employee only Family

In-Network Out-of-Network

$0$0

N/aN/a

Coinsurance 0% N/a

Out-of-Pocket Maximum Employee only Family

$0$0

N/aN/a

Preventive Care 100% Covered No Coverage

Office Visits Primary Services (4 visit limit per year) Specialist Services (4 visit limit per year)

$25 Copay$25 Copay

No CoverageNo Coverage

Hospital Services No Coverage No Coverage

Emergency Services** Emergency Room Emergency Medical Transportation



Urgent Care Services (4 visit limit per year) $25 Copay No Coverage

Chiropractic Services (4 visit limit per year) $25 Copay No Coverage

Mental Health/Chemical Dependency Inpatient Outpatient



Prescription Drug Coverage Generic Preferred brand Non-preferred brand Specialty

Retail 30 Day Supply Mail Order 90 Day Supply

100% Covered Not availableNot availableNot available

100% CoveredNot availableNot availableNot available

NOTES: This serves as a summary of your benefit plan only. Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions.

* After deductible** Covered as in-network in true-emergency



Gold PPO Plan



$1,500$3,000

$5,000$10,000

Coinsurance 20% 50%


$5,500$11,000

$10,000$20,000

Preventive Care 100% Covered 50%*

Office Visits Primary Services Specialist Services

$25 Copay$50 Copay

50%*50%*

Hospital Services 20%* 50%*


20%*20%*

50%*50%*

Urgent Care Services $25 Copay 50%*

Chiropractic Services $25 Copay 50%*


20%*$25 Copay

50%*50%*



100% Covered $35 Copay$70 Copay

$250 Copay

100% Covered $87.50 Copay$175 Copay

Not available





HDHP



$2,700$5,400

$5,000$10,000

Coinsurance 20% 50%


$5,000$10,000

$10,000$20,000

Preventive Care 100% Covered 50%*

Office Visits Primary Services Specialist Services

20%*20%*

50%*50%*

Hospital Services 20%* 50%*


20%*20%*

50%*50%*

Urgent Care Services 20%* 50%*

Chiropractic Services 20%* 50%*


20%*20%*

50%*50%*



100% Covered $45 Copay*$90 Copay*

$250 Copay*

100% Covered $112.50 Copay*

$225 Copay*Not available




rocky mountain reserve

health savings accountThe HSA is a tax-advantaged bank account which can be opened if you are enrolled in a qualified CDHP: HDHP/HSA medical plan and meet all other IRS-regulated eligibility criteria. Deposits can be made on a tax-free basis and the money you deposit has a tax advantaged growth opportunity (triple federal tax benefits).

HSA funds can be used to pay for qualified out-of-pocket medical expenses and qualified dental and vision expenses. You can even pay some insurance premiums, such as long-term care and COBRA premiums with HSA funds. If you do not use the funds in your HSA, the money is yours to keep and rolls forward from year to year. HSA’s are not subject to the ‘use it or lose it’ rule.

2019 Maximum Annual Contribution Amounts: • Employee Only: $3,500 • Family Coverage: $7,000

2020 Maximum Annual Contribution Amounts: • Employee Only: $3,550 • Family Coverage: $7,100

TAX BENEFITS & FLEXIBILITY:• HSA contributions are tax-free• Interest and investment earnings accrued in your

HSA are not taxable• Amounts withdrawn from your HSA for qualified

expenses are tax-free• Open the HSA account at any time• Start or stop contributions at anytime• Increase or decrease the amount you contribute

ELIGIBILITY REQUIREMENTS:• Be enrolled in a qualified CDHP: HDHP/HSA medical

plan• Not be enrolled in any other medical insurance,

except what’s permitted by the IRS• Not be enrolled in Medicare or Tricare• Not be claimed as a dependent on another

individual’s tax return• Not be eligible for a disqualifying Health

Reimbursement Account (HRA)• Not be enrolled in a Standard Flexible Spending

Account (FSA); and your spouse may not be enrolled in a Standard FSA

*Individuals age 55 or older are eligibile to contribute an additional $1,000 per year.


All members have access to doctor consultations with a licensed physician through HealthiestYou telemedicine services. This benefit can save you a trip to the clinic; no need for waiting rooms, travel or time off!

There are 3 services provided by HealthiestYou:• General consultations• Mental health• Dermotology

You can speak to a licensed physician at any time or access via video chat or email no matter where you are. Visit healthiestyou.com or call 866-703-1259.

General consultations are no cost to you, doctors are available 24/7/365 and visits are unlimited! They can consult, diagnose, and prescribe for things like:• Allergies• Upper respiratory infections• Earaches• Pink eye• Urinary tract infections• And more!

With HealthiestYou’s mental health services, a calm mind is just a tap away! Choose your therapist, pick a time that is convenient for you, and then talk to the therapist from the privacy of home or anywhere you feel comfortable.

HealthiestYou therapists can treat:• Anxiety• Depression• Stress/PTSD• Panic disorder• Family & marriage issues• And more!

Therapist: $85/sessionPsychiatrist: $200/evaluationPsychiatrist: $95/ongoing session

If you’re having problems with your skin, HealthiestYou Dermatology can help! Instead of waiting weeks to get an appointment, you can get adiagnosis and treatment plan in just two business days.

HealthiestYou’s board-certified dermatologists treata wide variety of skin conditions, including:• Psoriasis• Acne• Moles• Rosacea• And more!

Consult with a Doctor Today for Only $75.Visit healthiestyou.com or call 866-703-1259.


care managementIf you require medical services like a surgery, hospital stay or are diagnosed with a complex medical condition, you may receive a call from one of the HealthEZ nurses.

The nurse is there to help you understand your treatment options, coordination of services among your doctors, and to make sure you have everything you need for a quick recovery with the right care in the right setting.

chronic care managementWe help members manage chronic conditions like diabetes, hypertension, and high cholesterol. We provide education, diet and exercise tips. We can even provide referrals to providers, make appointments when necessary, and order your medical supplies for you!

HealthEZ’s team of health care professionals believe that partnership and realistic support are the keys to lasting change.

edison healthEdison Healthcare assist employees in getting the best advice to confirm the diagnosis and treatment of complex medical conditions. The program gives employees access to a network of Smart Care Medical Centers which support care through providers with the best quality and outcome metrics.


Preventive care for adults

Aspirin use to prevent cardiovascular disease. Screenings:• Abdominal aortic aneurysm screening.• Alcohol misuse screening.• Blood pressure screening.• Cholesterol screening for adults at high risk.• Colorectal cancer for adults over 50.• Depression screening.• Diabetes (Type 2) for adults at high risk.• Hepatitis B for adults at high risk.• Hepatitis C for adults at high risk.• HIV screening for adults at high risk.• Lung cancer for adults 55 - 80 at high risk.• Obesity screening.• Syphilis screening for adults at high risk.• Tobacco Use screening.

Counseling:• Alcohol misuse counseling.• Diet counseling for adults at high risk.• Obesity counseling.• Sexually transmitted infection (STI) prevention.• Tobacco Use cessation interventions. Immunizations:• Diphtheria• Hepatitis A & B• Herpes Zoster• Human Papillomavirus (HPV) • Influenza (flu shot)• Measles, Meningococcal & Mumps• Pertussis, Pneumococcal & Rubella• Tetanus & Varicella (Chickenpox)

Preventive services

Your health plan covers preventive services and routine health care that includes screenings,check-ups, and patient counseling to preventillnesses, disease, or other health problems. These are meant to prevent health problems and do notinclude tests or treatments. A list of Preventive and Wellness Services can be found at: www.healthcare.gov/preventive-care-benefits.

These are considered preventive and are covered by the Plan when services are rendered at an in-network provider. Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions.


Folic acid supplements for women who may become pregnant.

Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”

Counseling:• Breast cancer genetic test counseling (BRCA) for

women at high risk.• Breast cancer chemoprevention counseling for

women at high risk.• Breastfeeding support and counseling, and access

to breastfeeding supplies for pregnant and nursing women.

• Domestic and interpersonal violence counseling for all women.

• HIV counseling for sexually active women.• Sexually transmitted infections counseling.

Preventive care for Women Well-woman visits to get recommended services for women under 65.

Screenings:• Anemia screening on a routine basis.• Breast cancer mammography screenings.• Cervical cancer screenings.• Chlamydia infection screening.• Domestic and interpersonal violence screening.• Gestational diabetes screening for women 24 to 28

weeks pregnant and those at high risk.• Gonorrhea screenings.• Hepatitis B screening for pregnant women.• HIV screening for sexually active women.• Human Papillomavirus (HPV) DNA test.• Osteoporosis screening over age 60.• Rh Incompatibility screening for all pregnant and

high risk women.• Syphilis for pregnant and high risk women.• Tobacco use screening and interventions.• Urinary tract or other infection screening.


Immunizations:• Diphtheria• Haemophilus influenza type b • Hepatitis A & B• Human Papillomavirus (PVU) • Inactivated Poliovirus• Influenza (flu shot)• Measles• Meningococcal • Pertussis• Pneumococcal• Rotavirus• Tetanus• Varicella (Chickenpox)

Supplements:• Fluoride chemoprevention supplements for

children without fluoride in their water.• Gonorrhea preventive medication for newborns.• Iron supplements for children ages 6 to 12 months

at risk for anemia.

Preventive care for children

Assessments:• Alcohol and drug use assessments.• Behavioral assessments for ages 0 to 17.• Height, weight and body mass index (BMI)

measurements for ages 0 to 17.• Oral health risk assessment for ages 0 to 10.

Screenings:• Autism screening for ages 18 & 24 months.• Blood pressure screening for ages 0 to 17.• Cervical dysplasia screening.• Depression screening.• Developmental screening under age 3.• Dyslipidemia screening for children at higher risk of

lipid disorders ages 1 to 17.• Hearing screening for all newborns.• Hematocrit or hemoglobin screening.• Hemoglobinopathies or sickle cell screening.• Hepatitis B screening for adolescents at high risk

ages 11 – 17.• HIV screening for adolescents at high risk.• Hypothyroidism screening for newborns.• Lead screening for children at high risk.• Obesity screening and counseling.• Phenylketonuria (PKU) screening for newborns.• Sexually transmitted infection (STI) prevention

counseling and screening for adolescents at high risk.

• Tuberculin testing for children at high risk ages 0 to 17.

• Vision screening for all children.


Summary of Dental Benefits via Principal

Calendar Year Benefit Maximum


$1,000 per enrolled member + maximum accumulation

Calendar Year Deducitble $50 per Individual to a maximum of $150 for a Family

Type I: Preventive Care (limits/frequency may apply)

No Cost (Deductible Waived)

Deductible then 20%

Type ll: Basic Care(Includes Endodontics/Periodontics)

Deductible then 20% Deductible then 40%

Type Ill: Major Care Deductible then 50%

Orthodontia (child(ren) to age 19) Not Covered

Maximum Accumulation: • The Maximum Accumulation feature allows for a portion of unused maximum benefit to carry over to next year›s maximum benefit amount.• To qualify, you must have had a dental service performed within the Calendar year and used less than the maximum threshold. The threshold is 50% ($500) of the maximum benefit.• If qualification is met, 50% ($250) of the threshold is carried over to next year›s maximum benefit.• Individuals with fourth quarter effectives will start qualifying for rollover at the beginning of the next calendar year.• You can accumulate no more than four times the carry over amount. The entire accumulation amount will be forfeited if no dental service is submitted within a calendar year.

Summary of Vision Benefits via United HealthCare

Exam (Frequency: 12 month)


$20 Copay

Out-of-Network benefits are available; you must submit a

claim for reimbursement.

Lenses: Single/Bifocal/Trifocal (Frequency: 12 month) $20 Copay

Frames (Frequency: 24 month)$130 Allowance+

30% discount on balance

Contact Lenses (in lieu of lenses) (Frequency: 12 month)Up to 4 boxes for Covered Selection Lenses or up to $130 Allowance for

Non-Selection Lenses


life and ad&d: PrinciPalAll eligible employees are provided basic life and accidental death and dismemberment (AD&D) insurance and your employer pays the full cost of the premjum. Please see Human Resources to update your beneficiary designation.

Employee Benefit: 1x Annual Salary to $75,000, Guarntee Issue: $75,000

voluntary life and ad&d: PrinciPalEligible employees may purchase additional life and AD&D insurance on a voluntary basis. Employees must purchase voluntary life and AD&D for themselves in order to purchase for their spouse or child(ren).

Employee Benefit:Increments of $10,000 to a maximum of $300,000 Guarantee Issue: $70,000 (under age 70)

Spouse Benefit:Increments of $5,000 up to $100,000 Guarantee Issue: $30,000 (under age 70)

Children Benefit (life only):$10,000 benefit for age 14 to age 26 $1,000 benefit for age 14 and under

Evidence of Insurability (EOI): Any purchase or increase in benefits, which does not take place within 31 days of employee’s or dependents original eligibilty effective date is subject to EOI. Cov-erage is subject to approval from the insurance carrier before benefits are effective.

Open Enrollment Provision: If you and your enrolled dependents have exsisting cov-erage you may be able to increase coverage one increment per year during your open enrollment period without evidence of insurability.

voluntary short term disability: PrinciPalAll eligible employees are provided with the opportunity to enroll in the voluntary short term disability benefits.

Employee Benefit: 60% of salary to a maximum of $1,500 per week

Benefit Begins: On 15th day for Accident and Illness

Benefit Duration: Up to 11 weeks

long term disability: PrinciPalAll eligible employees are provided with long term disability benefits and your employer pays the full cost of the premjum. Pre-Existing Condition rule may apply.

Employee Benefit: 60% of salary to a maximum of $6,000 per month

Benefit Begins: After 90 days

Benefit Duration: Up to 5 years

emPloyee assistance Plan (eaP):PrinciPal/magellan healthcareAll eligible employess and their household members have access to 24/7 EAP Program, unlimited telephone counseling, and unlimited online tool.

voluntary suPPlemental benefits:aflacAscent Living Communities provides the option to buy voluntary worksite benefits to all eligible employees through AFLAC. Please refer to your enrollment materials for more detail regarding rates and benefits


eligibilityFull-time employees working 30 or more hours per week are eligible to participate in the benefit program.

Due to IRS regulations, once you have made your enefit elections for this plan year, you may not change your elections until the next Open Enrollment period.

The only exception to this is if you have a qualified status change in your family or employment. Any such changes must be reported within 30 days of the event.

Eligible dependents may include:• Your legally married spouse• Your civil union partner• Your same or opposite gender domestic partner• Dependent child up to age 26 (contracts may vary)

Some qualified status changes are:• Marriage or divorce• Birth/Adoption of a child• Loss of other coverage• Change in work status


2019 / 2020 Bi - Weekly Employee Contributions

Employee Only

MEC Plan Gold PPO Plan HDHP Dental Vision

$20.66 $46.04 $35.08 $5.54 $2.31

Employee + Spouse $30.60 $344.80 $279.98 $19.06 $4.44

Employee + Child(ren) $30.53 $299.31 $235.00 $20.81 $5.22

Family $42.51 $461.54 $369.23 $36.15 $7.38

Other Services and Discounts: Principal

Hearing Aid ProgramThrough American Hearing Benefits Inc. (AHB) and Ear Professionals Internations Corporation (EPIC), employees and their families are eligible for up tp 60% off hearing aids.

Travel Assistance

Employees, their spouses and dependent children (whether traveling together or separately) have access to travel, medical, legal and financial assistance plus emergency medical evacuation benefits provided by AXA Assistance 1 when traveling domestically or internationally more than 100 miles from home for up to 120 consecutive days.

Will & Legal Document Center

Employees and their spouses have free access to resources and tools provided by ARAG2 to create a Will, Living Will, Healthcare Power of Attorney, Durable Power of Attorney and Medical Treatment Authorization for Minors. Estate Planning resources and a Personal Information Organizer are also included.

Identity Theft KitThis valuable resource from ARAG provides employees with information on how to protect their identity and restore it if stolen.

Laser Vision CorrectionThrough the National Lasik Network, administered by LCA-Vision, Inc., employees, their spouses and dependent children receive savings on one of the most frequently performed elective surgeries in America. The discount includes 15% off standard pricing or 5% off promotional pricing.

Contact Information

HR Administrator Pine Grove Crossing - Morgan Graphmen Village at Belmar - Melissa Ludwig

720-370-6427303-351-5455

[email protected]@villageatbelmar.com

Medical: HealthEZ 844-839-6748 AscentLivingBenefits.com

EHiM 800-311-2446 ehimrx.com/index.php

Health Savings Account: Rocky Mountain Reserve 888-772-1223 [email protected]

Dental: Principal - Policy 1069581 800-247-4695 principal.com

Vision: United Healthcare - Policy 02X1269 800-638-3120 myuhcvision.com

Life AD&D: Principal • Policy 1069581 800-843-1371 principal.com

Voluntary Life AD&D: Principal • Policy 1069581 800-843-1371 principal.com

Disbility: Principal· Policy 1069581 800-843-1371 principal.com

Employee Assistance Program: Magellan Healthcare 800-450-1327 magellanhealth.com/member

Voluntary Supplemental Benefits: Aflac 800-462-3522 www.aflac.com


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