Open Enrollment
Active Employee: Monday, October 9th - Friday, October 27th
Retiree: October 15th - December 7th
Changes made will be effective January 1, 2024
Oberlin College has a passive open enrollment period, meaning if no changes are made to medical, vision, dental, and/or life and ad&d, the benefit you are enrolled in will continue into the next calendar year.
Enrollment/Changes are available for Medical, Dental, Vision, Flexible Spending Dependent Care Account (DCFSA), Health Savings Account (HSA), Life Insurance, Accidental Death & Dismemberment (AD&D), and Charitable Deductions.
Online Open Enrollment may be completed online by going to OberView. Click here to access a guide that will help you navigate your way around. NOTE: Click, "Complete" even if you do not make any changes. If you are unsure about your choices, view your January 1, 2024 Benefit Summary.
Retiree's and active employees may complete paper forms. Send all forms with applicable documentation to Human Resources. Original documents are not required if they are sent to Human Resources electronically.
Email: Human.Resources@oberlin.edu
Box Folder: click here
Fax (440) 775-8630
US MAIL: Human Resources 173 West Lorain Street, Suite 205 Oberlin, OH 44074
Campus Mail: Service Building 205
Office: 8 am to 5 pm, Monday through Friday (after hours secure drop box available)
Important Reminders
- Do you cover your Spouse on your health plan?
- If so, a Spousal Coordination of Benefits Form must be completed.
- Deadline to complete 10/27/2023
- Do you have a Dependent Flex Spending Account?
- If so, you must re-enroll to continue this benefit option in 2024.
- Do you contribute to your Health Savings Account through payroll deduction?
- If so, you must re-enroll to continue this option in 2024.
- Do you donate to Oberlin College or Charitable organization through payroll deduction?
- If so, you must re-enroll to continue this option in 2024.
Active Benefit Eligible Employee Open Enrollment Letter
Retiree Open Enrollment letter, forms and resources
- Medical Mutual Directory and Evidence of Coverage Requests 2023
- Medical Mutual Directory and Evidence of Coverage Requests 2024
- MedMutual Annual Notice of Changes 2023
- MedMutual Annual Notice of Changes 2024
- MedMutual Evidence of Coverage 2023
- MedMutual Evidence of Coverage 2024
- MedMutual Summary of Benefits 2023
- MedMutual Summary of Benefits 2024 -
- Click, here for a copy of the PowerPoint Presentation about the MedMutual Medicare Advantage Plan.
- Medicare Advantage Welcome Kit 2023
- Medicare Advantage Welcome Kit 2024 - coming soon!
Group Medicare Advantage PPO Plan - Providers
- In-network, full-benefit coverage for services incurred anywhere in the US or US territories.
- Must use providers that accept Medicare.
- No travel restrictions.
- Providers that accept Medicare or MedMutual Advantage plans can be found using search tools.
- https://www.medicare.gov/
- https://providersearch.medmutual.com/
SilverScript - Medicare Prescription Drug Plan (PDP)
- SilverScript Summary of Benefits 2023
- SilverScript Summary of Benefits 2024
- SilverScript Formulary List of Covered Drugs 2023
- SilverScript Formulary List of Covered Drugs 2024
- SilverScript Evidence of Coverage 2023
- SilverScript Evidence of Coverage 2024
- SilverScript Annual Notice of Changes 2024
Medicare Supplement transition plan - Medical Mutual COMP
CDHP Plan with HRA (less than age 65) | Summary of Benefits and Coverage | Summary Plan Description |
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CDHP with HRA Single SBC | CDHP with HRA - SPD |
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CDHP with HRA Retiree + Spouse/DP SBC | CDHP with HRA - SPD |
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CDHP with HRA Retiree + Child (ren) SBC | CDHP with HRA - SPD |
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CDHP with HRA Family SBC | CDHP with HRA - SPD |
Medical Mutual of Ohio (MMO) will remain our health insurance carrier.
Our provider network is called SuperMed PPO. For providers outside of Ohio, you will use the Cigna PPO network. To search for a medical facility, physician or specialty physician, search the provider network.
NEW - Medical Mutual Advocacy Program - Beginning January 1, 2024 we are excited to share a new resource that can help you make the most of your health plan. Medical Mutual's Health Advocacy Program gives you access to a designated team of experts to guide you through your healthcare journey. This team is familiar with the Oberlin College plan and can connect you with vital resources when you need extra support. They will serve as a single point of contact for you.
Call 1-888-636-3622 Medical Mutual Health Advocates are available Monday through Thursday from 7:30 a.m. to 7:30 p.m. (ET), Friday from 7:30 a.m. to 6 p.m. (ET), and Saturday from 9 a.m. to 1 p.m. (ET).
Visit My Health Plan to register for a secure member website. Find doctors in the network, estimate costs, check claims, receive your Explanation of Benefits (EOB), and more!
Download the Mobile App for free from the Apple App Store or Google Play by searching MedMutual.
Employer ID: MTL10590467
Do you cover your Spouse on your health insurance policy?
If so, a Spousal Coordination of Benefits Form must be completed and sent to HR by Friday, October 27, 2023. Email completed form to human.resources@oberlin.edu
CDHP with HSA | Summary of Benefits and Coverage | Summary Plan Description |
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CDHP with HSA - SPD | |
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CDHP with HSA Employee + Spouse/DP SBC | CDHP with HSA - SPD |
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CDHP with HSA Employee + Spouse/DP SBC | CDHP with HSA - SPD |
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CDHP with HSA Family SBC | CDHP with HSA - SPD |
NOTE: If you are not qualified for an HSA, your plan will be paired with an employer-funded Health Reimbursement Arrangement (HRA) instead of an HSA.
CDHP with a HRA | Summary of Benefits and Coverage | Summary Plan Description |
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CDHP with HRA Single SBC | CDHP with HRA - SPD |
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CDHP with HRA Employee + Spouse/DP SBC | CDHP with HRA SPD |
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CDHP with HRA Employee + Spouse/DP SBC | CDHP with HRA - SPD |
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CDHP with HRA Family SBC | CDHP with HRA - SPD |
Additional Information and Resources
- FAQ - Medical Mutual Member Guide
- Preventive Care Services
- Colorectal Cancer Awareness
- Make the Most of Your Benefits
- Explanation of Benefits (EOB) Guide
- Fitness Discounts
- Disease Management Programs
- LifeStyle Coaching
- My Care Compare
- Nurse Line - Just a phone call away
- Online Tools
- Quit Line - Enjoy life without tobacco
- WW - Wellness that Works
- Take control of your Diabetes
- Know Your Risks of Diabetes
CVS Caremark will continue to administer the college’s prescription drug benefits.
Caremark Cost Saver, a new enhancement to lower out-of-pocket drug costs for members will be available. Cost Saver provides automatic access to GoodRx's prescription pricing that allows lower prices, when available, on generic medications. When you visit the pharmacy to collect a prescription, you only need to present your ID card to your preferred in-network pharmacy. The amount paid will automatically be applied to the deductible and out-of-pocket thresholds. No action is required by you.
To make accessing your prescription benefits easier and more convenient, register your account at Caremark.com. Many tools and resources are available.
Plan participants are not required to manage their prescription benefits at a CVS pharmacy. Find a network pharmacy. CVS Caremark’s national network includes more than 68,000 pharmacies including retail chains.
The ID card from Medical Mutual will include prescription benefit information.
List of Medications
Formulary changes happen from time to time when drugs are: recalled from the market; replaced by a new generic drug; or, Clinical restrictions are added, including, but not limited to, prior authorization, quantity limits or step therapy.
- 2024 updates to Non Specialty Medications
- 2024 updates to Specialty Medications
- Preferred Non-Specialty Formulary Chart January 2024
- Specialty Formulary Chart January 2024
- Non Specialty Formulary List of Medications October 2023
- Specialty Formulary List of Medications October 2023
- No Cost ACA Preventive Services and Drug List October 2023
- Preventive Drug List - CDHP plan (Generic and Name Brand Drugs) October 2023
Do you want to see the cost of your prescription under the CDHP plan before you meet your deductible, and price lower cost options?
The Drug Price Comparison Tool links below will help. The default pharmacy will be CVS. There is an option for you to change the pharmacy. If the prescription is a maintenance medication, it will show the 90 day option.
- PRE - Deductible - To estimate the cost under the CDHP plan before you meet your deductible.
- POST- Deductible - To estimate the cost under the CDHP plan before after you have met your deductible.
Additional Information
To be eligible for an HSA, the IRS requires that you not be enrolled in secondary insurance (such as through your spouse) that provides first-dollar coverage such as a traditional PPO. You also cannot be enrolled in Medicare or be claimed as a dependent on someone else’s tax return and make or receive contributions into an HSA account.
If you are not qualified to make or receive contributions into an HSA, you may still sign up for the College’s CDHP medical plan; however, it willbe paired with an employer-funded Health Reimbursement Arrangement (HRA) instead of an HSA.
Employees who have the HSA, also have the option to fund your account with pre-tax dollars through payroll deduction. If HSA dollars remain at year-end, they roll over for you to use in the future. The HSA account is owned by you and is also portable; you take it with you if you leave the plan or the college.
Oberlin College will fully fund the employer contribution to your HSA/HRA account in January 2024.
HSA/HRA dollars can be used to cover eligible expenses.
An HRA is an employer-funded group health plan from which employees are reimbursed tax-free for qualified expenses. The College will contribute the same annual funding amounts into HRA accounts. Unused HRA funds will roll over into subsequent years. NOTE: HRAs can only be funded by employers and you will not be taxed on the contributions. Also, employers are not permitted to cash out the balance to employees when they leave employment including retirement.
Medical Mutual HSA and HRA self-service phone access 24/7, 365 days a year. Call the appropriate phone number and you will be prompted to enter your debit card number or social security number.
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HSA: 1.800.522.2037
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HRA: 1.800.384.0859
- Email: MySpendingAccounts@MedMutual.com
HSA Contribution Form
- Health Savings Account (HSA) Employee Contribution Form 2023
- Health Savings Account (HSA) Employee Contribution Form 2024
Additional Information
Superior Dental Care (SDC) will continue to administer our dental insurance.
There are no changes to the rates or plan design in 2024.
What is new? Beginning, January 1, 2024, a covered employee’s married or unmarried child (ren) may be covered up to the age of 26. Previosuly the age limit was 23.
SDC’s network offers over half a million access points throughout the United States! Find a Participating Dentist
Go online to Superior Direct Connect or download the mobile app, which is available through the Apple App Store or Google Play Store. You will have the ability to securely access plan information, view claims, print ID cards, and more.
Dental ID card:
- If you enroll in a new dental option, you will receive a new ID card.
- If you change your option, you will receive a new ID card.
- If you do not make any changes, you will not receive a new ID card.
Information and Forms
- Evidence of Coverage
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For specific plan coverage, select one of the following:
- SDC Mobile App
- SDC Value Added Benefits
- SDC Evidence of Coverage
Medical Mutual partners with EyeMed Vision Care, one of the largest optical retailers of eyewear products and optometry services in the U.S., to give you comprehensive vision coverage at the right price and with less hassle.
There are no changes to the plan options or rates in 2024.
What is new? Beginning, January 1, 2024, a covered employee’s married or unmarried child (ren) may be covered up to the age of 26. Previosuly the age limit was 23.
EyeMed offers eye exams, eyeglass lenses and frames, and contact lens benefits through an expansive network of providers, including Pearle Vision®, LensCrafters®, Target Optical®, Sears OpticalSM and JCPenney Optical®.
Accessing your vision benefits is easy — simply visit one of the many participating network optical providers and show your health plan identification card. The provider will verify your eligibility, plan benefits and any fees that apply. There are:
- No prior authorizations or referrals needed
- No claim forms to fill out
- No waiting for reimbursement
And if you exhaust your regular benefit, you can still get savings on vision services through discount arrangements.
For help finding an EyeMed Vision Care provider, click on our Provider Search tool and select the Vision provider type or visit EyeMedVisionCare.com. The provider network is called Access.
- Vision Plan Highlights and Rates
- Summary Plan Description
- Vision Claim Form
- Out-of-Network Claim Form
Unum will continue to administer our Optional Life and Accidental Death & Dismember ment benefits.
There are no changes to the plan options, or rates in 2024.
All benefit-eligible employees will have the opportunity to enroll in valuable coverage, with benefits beginning on January 1, 2024. Read more, by clicking here to see how this can help protect you, your family, and your finances.
If you currently have coverage and would like to make changes you may go online or complete the Optional Life/AD&D form below.
If you elect or increase your amount over the guarantee issue amount, you will need to Sign in to complete your Statement of Health (Evidence of Insurability) online with Unum.
Access Code: SUHYWHB
Before you start, review the Statement of Health Checklist so you have necessary information to complete this process.
The effective date of coverage for all amounts over the guarantee issue amount is determined when you are approved. All amounts up to the guarantee issue about will begin January 1, 2024.
- Optional Life AD&D Rate Sheet
- Optional Life AD&D Insurance Brochure
- Optional Life AD&D Enrollment Form - Email form to HR by October 27th
- Life Insurance Beneficiary Form
Have questions regarding your status of your pending application? Unum is here to help. Call: (800) 421-0344; hours are 8 a.m. to 8 p.m., Monday through Friday
WageWorks will continue to administer our Dependent Care Flexible Spending Account (FSA-DC)
All 2023 Dependent Care FSA accounts will terminate on December 31, 2023.
If you have money left in your Dependent Care FSA account at the end of the year, you will have until March 31, 2024, to get reimbursed for expenses incurred up through December 31, 2023. If not action is taken by March 31, 2024, amounts will be forfeited.
- Dependent Care FSA (for children under the age of 13 or for elderly dependents who reside with you) reimburses the participant for eligible dependent care expenses such as day care, preschool, before/after school care programs, summer camps, and Nanny expenses attributed to dependent care.
- FSA Dependent Care Enrollment Form 2024
- QuickStart Guide to Managing Your FSA
- WageWorks EZ Receipts® mobile app
- Examples of Eligible Expenses
- FAQ's - FSA Online Store
- FSA Payment Options
- Questions and Answers
Maximize Your Impact by Making a Gift to Oberlin.
Oberlin College is committed to supporting and investing in the local community. Employees have the option to donate through payroll deduction.
If you are enrolled in this benefit - you must re-enroll - to continue your donation in 2024.
Enroll online or complete our Charitable Donation Form.
Our 2024 charities will be:
- Diversity Center of NEO
- Greater Cleveland Community Shares
- Oberlin College Gift
- Oberlin Community Services
- Oberlin Early Childhood Center
- Northern Ohio Youth Orchestra
- Youth Opportunities Unlimited
- United Way of Lorain County
All employees and retirees are responsible for notifying HR of any changes in personal status that change benefits enrollment or contact information on a timely basis.
Relevant changes in status include:
- Name Change
- Address and/or Phone Number
- Change in Marital Status (history of dependents cannot be deleted)
- Emergency Contact Information
- Change in Life Insurance Beneficiary
- Change in Dependents (history of dependents cannot be deleted)
- Change in Tax Withholding
You will be limited to updating only specific information, including your preferred name, gender identity, personal pronouns, personal phone number(s), personal mailing address (es), and emergency contact(s). Other information, including legal name, will be displayed without update capability.
Online updates will reduce the need to fill out a form and will also allow for more consistent collection of cell phone numbers which may be used for health safety survey text messages. Please note, it is still your responsibility to submit a complete Ohio IT-4 form to HR when changing your address. This will ensure your school district tax is accurately updated.
To log in, launch the My Self Service Profile task in OberView and click the Start button in the upper right. We encourage you to log in to review your personal information and enter an up-to-date cell phone number. Entering a cell phone number does not automatically opt you in to receive text messages, but makes it possible for you to opt in for text message reminders when they become available and for the college to send you text messages if necessary.
HIPAA Privacy Practices - This notice describes how medical information about you may be used and disclosed.
HIPAA Special Enrollment Rights - This notice provides information about your rights and protections as participants in group health plans.
Summary Annual Reports - This gives notice of the annual report summarizing each benefit plan subject to ERISA.
Women's Health and Cancer Rights Act - This notice describes your rights after a mastectomy.
Creditable Coverage Disclosure Notice - This notice is about your prescription drug coverage and Medicare.
USERRA - This notice describes your rights under The Uniformed Services Employment and Reemployment Rights Act.
Drug-Free Workplace Act - This notice informs you about the college policy to maintain a drug-free workplace.
Mercy Allen Hospital in Oberlin has exclusively reserved appointment slots for our employees, spouses, and retirees to schedule a mammogram screening. Mercy is committed to having a minimal wait time. If you cannot attend one of these appointments, you may make your own appointment at a location and time convenient for you. An order from a physician must be obtained before a mammogram can be performed.
The scheduled days are Tuesday 10/24, Wednesday 10/25 and Thursday 10/26
- Appointments are as follows
- Morning: 8:00, 8:15, 8:30, 8:45, 9:00, 9:30, 9:45, 10:00, 11:00, 11:15
- Afternoon: 1:00, 1:15, 1:30, 1:45, 2:00, 2:15, 2:30, 3:00, 3:15, 3:30
- Your Medical Mutual health insurance through Oberlin College will cover a 3D mammogram, so every mamogram will be 3D unless you specify you want a 2D.
- If you do not have health insurance through the College, please check with your insurance provider to see which option they cover and if Mercy Hospital is in your network.
- Please request an order from your physician so you will be well prepared in advance.
- You cannot receive a mammogram without a physician's order.
- The order does not need to specify 2D or 3D.
To schedule an appointment, please send an email to human.resources@oberlin.edu or call 440-775-8430 with your preferred date and time. Once scheduled, you will receive additional information and instructions. You will need:
- A physician's order
- A copy of your insurance card
- Registration paperwork
- An appointment