the details

HealthPLan

(ALL STATES EXCEPT MD, HI, DE, CA, NM & PR)

(MD, HI, DE, CA, NM & PR)

Association Healthplan details

Open Enrollment Communication TO SHARE with your team!

  • 2023 Open Enrollment Benefits Guide – Click Here
  • LIVEWELL Open Enrollment flyer (English) – Click Here
  • LIVEWELL Open Enrollment flyer (Spanish) – Click Here
  • Open Enrollment Video for your team – Click Here
  • Healthcare Resource Guide – Click Here
  • LIVEWELL enrollment platform – Click Here

OPEN ENROLLMENT HOTLINE:
Team Member Questions: 855-915-3015 Monday to Friday 8amET to 8pm ET

Overview

Anthem Blue Cross Blue Shield is the medical insurer for the GIOA program. There are five (5) medical plan choices that include traditional PPO offerings along with an HSA-qualified plan called the Freedom plan. Detailed plan design information can be found in the sidebar to the right.

As a GIOA Member, our package of offerings includes medical, dental, and vision to all full-time Team Members as well as those who have met the ACA hours requirement. In addition, to these core benefits your team members will also have the option to enroll in a host of supplemental coverages. 

All five (5) Anthem medical plan options will be presented to Team Members at the time of enrollment. Team Members will select the plan that best meets their needs.

Tell Me More

Rates differ by region thus your rates will be based on your region. Click the ‘View My Medical Rates’ button in the sidebar. These rates are for medical coverage only. Dental and vision rates are detailed separately on the site.

If you are an applicable large employer (ALE), to meet affordability guidelines you are required to make contributions for all full-time and ACA-eligible Team Members based on the employee-only rate of the lowest-cost medical plan. If you opt out of contributing towards the cost of medical coverage then applicable ACA fines could apply. 

Your contribution to the cost of coverage must be made in $25 increments. You will have the option of setting your contributions by Team Member group:

  • Tier 1: Other Staff (Executives)
  • Tier 2: Managers
  • Tier 3: Assistant Managers
  • Tier 4: Supervisor/Shift Lead
  • Tier 5: Team Member, Office/Clerical, Restaurant Maintenance Technician, Non-CFA Employee
  • Tier 6: Area Marketing Director, Rest. Marketing Director, Kitchen Director, Training Director, Manager/Training Director, or Hospitality

Use the ACA contribution modeler to help in determining the required contribution amount by Team Member group.

FAQs

Can I select the waiting period as to when Team Members become eligible?

Yes, you will have the option of electing a waiting period of 0 days, 30 days, or 60 days. The waiting period will apply to all newly hired, full-time Team Members regardless of their job title or insurance group. Benefits will be effective the 1st of the month following the completion of their assigned waiting period.

What is the network we use through Anthem?

The Anthem network used is the Blue Card PPO.

Can the medical benefits be offered on a pre-tax basis?

No, given issues with non-discrimination testing, GIOA has decided not to offer benefits on a pre-tax basis.

If I or a Team Member join the Freedom HSA plan, are we able to make contributions to the HSA on a pre-tax basis via payroll deductions?

Contributions to HSAs via payroll deductions will not be supported by the GIOA program at this time. This decision will be revisited however if enrollment in the plan is sufficient enough to warrant the additional administrative expense involved in coordinating this activity.

If GIOA won’t support payroll deductions for HSA contributions, how do I or a Team Member get the tax-free benefits?

You can establish an HSA at any financial institution that provides HSA services. You can make deposits into that account and then take the tax deduction on your annual income tax filings.

Can I contribute to an HSA if I’m enrolled in the Platinum Plan?

No, you can only contribute to an HSA if you are enrolled in the Freedom Plan and you meet other criteria. See the HSA eligibility checklist in the sidebar to determine if you are eligible to make contributions to an HSA.

 

Side by Side Overview
of Medical Options

Platinum Plan Summary
Gold Plan Summary
Silver Plan Summary
Bronze Plan Summary
Freedom Plan Summary
HSA eligibility check list

(To choose your state, download then enable editing.
Includes Affordability Calculator.)

Dental Overview

Anthem Blue Cross Blue Shield is the dental provider for the GIOA program. There are two (2) dental plan choices that cover all basic dental needs. Both Full-time & PT Team Members have the option of enrolling in a High or Low plan. Each option offers the flexibility of in-network or out-of-network dentists. Medical plan participation is not required to enroll in the dental plan. Detailed plan design information can be found in the sidebar to the right.

Both dental plan options will be presented to Team Members at the time of enrollment. Team Members will select the plan that best meets their needs.

Tell Me More

Rates are the same for all regions.

Your contribution to the cost of coverage must be made in $5 increments. You will have the option of setting your contributions by Team Member group:

  • Tier 1: Other Staff (Executives)
  • Tier 2: Managers
  • Tier 3: Assistant Managers
  • Tier 4: Supervisor/Shift Lead
  • Tier 5: Team Member, Office/Clerical, Restaurant Maintenance Technician, Non-CFA Employee
  • Tier 6: Area Marketing Director, Rest. Marketing Director, Kitchen Director, Training Director, Manager/Training Director, or Hospitality Director

FAQs

Can I select the waiting period as to when Team Members become eligible?

Yes, you will have the option of electing a waiting period of 0 days, 30 days, or 60 days. The waiting period will apply to all newly hired, full-time Team Members regardless of their job title or insurance group. Benefits will be effective the 1st of the month following the completion of their assigned waiting period.

Can dental benefits be offered on a pre-tax basis?

No, given issues with non-discrimination testing, GIOA has decided not to offer any benefits on a pre-tax basis.

Will my current orthodontic treatment be covered under the new plan?

Yes, if you select a plan option that covers orthodontia and you are currently receiving treatment from another plan, Anthem will coordinate benefits to determine what is paid under your old coverage and what is paid under your new coverage.

Vision Overview

The GIOA program offers two (2) vision plan options for both Full-time & PT team members, a High & Low option. Medical plan participation is not required to enroll in the vision plan. Detailed plan design information can be found in the sidebar to the right.

All plan options will be presented to Team Members according to their eligibility at the time of enrollment.  Team Members will select the plan that best meets their needs.

Tell Me More

Rates are the same for all regions.

Your contribution to the cost of coverage must be made in $5 increments.  You will have the option of setting your contributions by Team Member group:

  • Tier 1: Other Staff (Executives)
  • Tier 2: Managers
  • Tier 3: Assistant Managers
  • Tier 4: Supervisor/Shift Lead
  • Tier 5: Team Member, Office/Clerical, Restaurant Maintenance Technician, Non-CFA Employee
  • Tier 6: Area Marketing Director, Rest. Marketing Director, Kitchen Director, Training Director, Manager/Training Director, or Hospitality Director

FAQs

Can I select the waiting period as to when Team Members become eligible?

Yes, you will have the option of electing a waiting period of 0 days, 30 days, or 60 days. The waiting period will apply to all newly hired, full-time Team Members regardless of their job title or insurance group. Benefits will be effective the 1st of the month following the completion of their assigned waiting period.

What is the Vision Network called with Anthem?

Blue View Vision is the network in place for the GIOA program. The network provides access to over 36,000 doctors and 27,000 locations nationwide. Employees will have access to retail and online options to take care of their vision needs

Can the vision benefits be offered on a pre-tax basis?

No, given issues with non-discrimination testing, GIOA has decided not to offer any benefits on a pre-tax basis.

Overview

GIOA understands Operators want to support Team Members who work in a reduced schedule capacity. That’s why we are making available new benefit plans designed for your part-time Team Members.

You’ll be able to offer your part-time Team Members a Minimum Essential Coverage (MEC) medical plan with enrollment on the same platform as your full-time employees.

The MEC plan is provided by Essential Benefits Administrators, a leading provider specializing in innovative and flexible employee offerings. The MEC plan is a self-insured guaranteed cost contract.There are no participation and contributions for the Essential Benefits plans. There are three plans: Basic MEC, MEC Plus, and MEC Premium Plus.

The MEC plans are not part of GIOA’s AHP and GIOA makes no assurances regarding their operation. Operators who choose to offer these benefits may enroll their Team Members on the Benefitfocus platform, but will contract directly with Essential Benefits Administrator and assume all liability therein.

Tell Me More

You will also have the opportunity to offer part-time Team Members dental and vision benefits. Anthem will be the dental and vision provider for the part-time coverage. 

  • Dental: The plan design options differ from the full-time plans. The rates are the same as full-time. Part-time employees will have four (4) dental plan designs available to them, Platinum, Gold, Silver and Freedom.
    • There are waiting periods on these plan designs – 6 months for Basic services, 12 months for Major services and 12 months for Ortho – which are noted on the details of each plan.
  • Vision: Only one (1) vision plan will be offered to part-time Team Members. The Gold vision plan will have the same rates as the full-time Team Members.

For more information including plan design, descriptions and rates, see the additional material in the right side bar. 

FAQs

If Operators have to contract directly with the MEC administrator and the benefits aren’t part of the AHP, why select the Essential Benefits offering?

Many Operators are already offering MEC plans “off platform,” meaning they are responsible for managing administration. GIOA is simply facilitating a more efficient means of managing enrollment and other benefit administration responsibilities.

How will the contracting process work for the Essential Benefits offering?

If you elect to offer the Essential Benefits MEC plans, your information will be provided to Essential Benefits Administrator and you will receive the appropriate group application for execution.

Are the dental and vision benefits the same as full-time?

No, the part-time Team Member dental plan design options differ from the full-time plans but the rates remain the same. Part-time Team Members will only have access to the Gold vision plan which will be the same design and rates as full-time Team Members.    

What types of items do the MEC plans cover?

MEC plans are not comprehensive medical coverage. They are designed to provide Team Members with 100% coverage for ACA mandated wellness coverage. The higher level plans provide in-network office visits subject to copays. There is no coverage for outpatient or inpatient services. There is no out of network coverage.

What network does the MEC plan use?

The MEC plans utilize the First Health Network.

MEC Plan Design

Overview

As the benefits landscape continues to change, employers are looking for new ways to provide a well-rounded comprehensive benefits plan to attract and retain talent.  Supplemental Health Benefits provide a low cost way for Team Members to round out their health care coverage whether they are covered by your plan, their parent’s, a spouse’s plan, Military plan, or some other coverage.

You are not required to contribute to the cost of coverage, but if you decide to pay a portion of the cost of coverage, the benefits become even more attractive.

The insurer for the Supplemental Health Benefits is Securian Financial.

Tell Me More

The Supplemental Health Bundle includes Critical Illness, Hospital Indemnity, and Accident Insurance. If you decide to offer this bundle, you and your Team Members will be presented each benefit. You and your Team Members select which benefits you want. Select one, two, three, or none of the options.

Critical Illness Insurance (also called Specified Disease Insurance) provides a lump sum if  the insured is diagnosed with a condition such as cancer or has a heart attack or stroke.

Accident Insurance provides a specified dollar benefit if the insured suffers an accident and has certain injuries or is treated for certain injures.

Hospital Indemnity Insurance provides a lump sump payment if the insured is hospitalized due to sickness or accident.

FAQs

Are Operators required to contribute to the cost of Supplemental Health Benefits?

No, Operators are not required to contribute to the cost of Supplemental Health Benefits.  You may however elect to make a contribution to the cost of coverage.

Do these benefits satisfy any ACA compliance requirements?

No, these benefits are not ACA compliant. They do not meet minimum value (MV) or minimum essential coverage (MEC) requirements.

Are the benefits payments made directly to the insured or to the provider?

All Supplemental Health Benefits are indemnity benefits. Payment is made directly to the insured, not to the provider. The insured first incurs the expense and may be required to pay the provider upfront. The insured then files a claim with Securian and if the claim is for an approved expense, Securian will reimburse the insured directly.

Can spouses and children be covered?

Yes, rates are 4 – tier: employee only, employee + spouse, employee + child(ren) and family. You do not have to select the same tier of coverage for each benefit. You can select different tiers by benefit.

Can these benefits be offered to my part-time Team Members?

Yes, if you decide to offer the Supplemental Health Bundle, your part-time employees working at least 15 hours per week will be presented the option to enroll for these coverages as well.

Critical Illness Plan Summary & Rates
Hospital Indemnity Plan Summary & Rates
Accident Plan Summary & Rates
Value added benefits

Operator Life Insurance

Cigna Group Insurance is the Operator Life Insurance provider for GIOA. GIOA is pleased to announce an expansion of life insurance benefits for Operators – up to $2 million, all guarantee issue. And now, you can purchase life insurance on your spouse (up to $500,000) and child(ren) ($10,000). Your spouse will have to submit proof of good health for amounts over $50,000. All coverage comes with AD&D in equal amounts.

The rates for Operator Life are equal to current rates.

Operator LTD

GIOA’s Operator LTD offering is a multi-level program that provides up to $85,000 in income replacement:

  • Base (The Standard – Group Policy): 60% up to $25,000
  • Buy up Level 1 (UNUM – Individual Policy): 60% up to $10,000
  • Buy up Level 2 (Lloyd’s of London – Individual Policy): 60% up to $50,000

There are two options for base coverage provided by The Standard: (1) the current plan with a 25% rate increase (2) alternate plan with a 8.5% rate increase. See Operator Base LTD Summary and Rates for a comparison of options.

Team Member Life Insurance 

The Hartford is the Team Member Life Insurance provider for GIOA. Team Members can purchase Life Insurance up to $100,000 on themselves, $50,000 on their spouse, and $10,000 on their child(ren). You are not required to contribute to the cost of coverage, but if you select Operator life you must make Team Member life available.

Team Member STD

Team Members will have the option of enrolling for STD benefits. The STD plan will pay a weekly benefit of $200 to $1,500 depending on the Team Members selected benefit amount. You must make Team Member STD available if you select Operator LTD. In states that have a state mandated disability requirement, short term disability coverage may not be available.

FAQs

I notice there are no rates posted for the Buy up Level 1 and Buy up Level 2 of the LTD. Why is that? How do I know the cost of coverage?

The Buy up LTD plans are individual plans. The offerings will be customized to each Operator at the time of enrollment. If you select the Base LTD offering, you’ll automatically receive a customized offer of Buy up LTD prior to annual enrollment. You are only eligible for the Buy up options if you enroll in the Base options.

If I want to keep the Life and Disability insurance amounts I have today, is there something special I need to do?

At annual enrollment, simply select those amounts. There will be no medical underwriting and the coverage will be issued on a no loss/no gain provision.

I have no LTD or Life insurance today. I want to enroll. Do I have to answer medical questions or have an exam?

No, the coverage will be provided during this one time special period without evidence of insurability. That means no medical exams or questions.

If I enroll at a later date or I want to increase coverage amounts, will I have to submit proof of good health?

Yes, any late enrollment or increases in coverage amounts will be subject to evidence of good health requirements.

Operator Buy Up Level 1 Summary – UNUM
Operator Buy Up Level 2 Summary – Lloyd’s of London
Team Member Life Summary & Rates
Team Member STD Summary & Rates

Operator Life Insurance

Cigna Group Insurance is the Operator Life Insurance provider for GIOA. GIOA is pleased to announce an expansion of life insurance benefits for Operators – up to $2 million, all guarantee issue. And now, you can purchase life insurance on your spouse (up to $500,000) and child(ren) ($10,000). Your spouse will have to submit proof of good health for amounts over $50,000. All coverage comes with AD&D in equal amounts.

The rates for Operator Life are equal to current rates.

Operator LTD

GIOA’s Operator LTD offering is a multi-level program that provides up to $85,000 in income replacement:

  • Base (The Standard – Group Policy): 60% up to $25,000
  • Buy up Level 1 (UNUM – Individual Policy): 60% up to $10,000
  • Buy up Level 2 (Lloyd’s of London – Individual Policy): 60% up to $50,000

There are two options for base coverage provided by The Standard: (1) the current plan with a 25% rate increase (2) alternate plan with a 8.5% rate increase. See Operator Base LTD Summary and Rates for a comparison of options.

Team Member Life Insurance 

The Hartford is the Team Member Life Insurance provider for GIOA. Team Members can purchase Life Insurance up to $100,000 on themselves, $50,000 on their spouse, and $10,000 on their child(ren). You are not required to contribute to the cost of coverage, but if you select Operator life you must make Team Member life available.

Team Member STD

Team Members will have the option of enrolling for STD benefits. The STD plan will pay a weekly benefit of $200 to $1,500 depending on the Team Members selected benefit amount. You must make Team Member STD available if you select Operator LTD. In states that have a state mandated disability requirement, short term disability coverage may not be available.

FAQs

I notice there are no rates posted for the Buy up Level 1 and Buy up Level 2 of the LTD. Why is that? How do I know the cost of coverage?

The Buy up LTD plans are individual plans. The offerings will be customized to each Operator at the time of enrollment. If you select the Base LTD offering, you’ll automatically receive a customized offer of Buy up LTD prior to annual enrollment. You are only eligible for the Buy up options if you enroll in the Base options.

If I want to keep the Life and Disability insurance amounts I have today, is there something special I need to do?

At annual enrollment, simply select those amounts. There will be no medical underwriting and the coverage will be issued on a no loss/no gain provision.

I have no LTD or Life insurance today. I want to enroll. Do I have to answer medical questions or have an exam?

No, the coverage will be provided during this one time special period without evidence of insurability. That means no medical exams or questions.

If I enroll at a later date or I want to increase coverage amounts, will I have to submit proof of good health?

Yes, any late enrollment or increases in coverage amounts will be subject to evidence of good health requirements.

Operator Buy Up Level 1 Summary – UNUM
Operator Buy Up Level 2 Summary – Lloyd’s of London
Team Member Life Summary & Rates
Team Member STD Summary & Rates

GIOA’s healthplan offering is designed to be a turn-key solution that frees you from the administrative burden of providing and managing benefits. We’ve partnered with companies that know and understand how we function and the importance of a hands off solution.

As an Operator, you will be fully supported by the GIOA model. Our goal is to take care of most of the day to day activities leaving you free to focus on what matters most to your store and your team. 

Benefit Administration & COBRA

We’ve selected Benefitfocus as our administration partner. They will provide the enrollment system that allows you and your Team Members to select benefits. They will let the insurance companies know who is eligible and who should be terminated from coverage.  They’ll also manage COBRA.

ACA Compliance Support

For ACA Compliance and support we’ve partnered with UnifyHR. They’ll do the ALE tracking, the hours tracking, and 226-J letter response for you.

If you are not participating in a Healthcare option, ACA services are not available – i.e. no GIOA medical and no ACA tracking.

New Technology

As part of the GIOA healthcare program you and your Team Members will have access to an exciting new app that puts your enrolled benefits and program information in the palm of your hands. The tool is called the LiveWell Connect app powered by iNGAGED and you can download it directly to your phone or tablet from the Apple App Store or from Google Play.  It’s customized to each Team Member according to what they have enrolled in so that you see only your relevant information.

You as the Operator will have single sign on to UnifyHR as well.

Health Advocate

Health Advocate will be provided at no cost to you and your Team Members. Have an issue with a claim? Need to research in-network doctors? Want to speak with someone about a health condition? Health Advocate can help you and your Team Members navigate carriers and claims.

Program/ Technology Fees

GIOA charges no additional fees for participating in the healthplan. Similar to today, you will pay fees for benefit administration (Benefitfocus) and ACA compliance (UnifyHR):

  • Benefitfocus: $158.33 per month ($1,900/year)
  • GIOA Insurance Benefits Fee: for UnifyHR and GIOA operations

The UnifyHR fees do not apply if you are not participating in the Healthcare option and there will be no ACA tracking.

Powered by Mercer

As our broker partner, Mercer will provide GIOA with vendor management, compliance support, and all of the oversite needed to make our program a success. This includes working with Corporate to resolve Vender Bridge issues and ensure our data gets to the right place.

Mercer delivers advice and technology-driven solutions that help organizations meet the health, wealth and career needs of a changing workforce. Mercer’s more than 23,000 employees are based in 44 countries and the firm operates in over 130 countries. Mercer is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC), the leading global professional services firm in the areas of risk, strategy and people. With nearly 65,000 colleagues and annual revenue over $14 billion, through its market-leading companies including Marsh, Guy Carpenter and Oliver Wyman, Marsh & McLennan helps clients navigate an increasingly dynamic and complex environment. For more information, visit www.mercer.com. Follow Mercer on Twitter @Mercer.

The Transparency in Coverage final rules from the Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury requires that all health insurers and group plans create machine readable Files (MRFs) that contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers.  This is a first step towards creating consumer friendly tools that will help put healthcare information into the hands of consumers to help make informed health care decisions.  GIOA is committed to complying with all rules and regulations.  Access to the specific files applicable to GIOA can be found here.

Guardian Independent Operator Association (GIOA) in collaboration with Mercer Health & Benefits LLC. has developed a healthcare program that includes comprehensive medical, dental, vision, life and disability benefits coupled with administration, COBRA and ACA compliance services.

As an Operator, GIOA will work in partnership with you supporting the day to day management of your employee benefits offering and associated compliance, leaving you free to focus on what matters most, your store and your team.

Powered by Mercer means leverage to drive the best possible pricing and highest levels of service. Best of all – its built specifically for Operators.

There are no Operator contribution requirements to team member benefits. Additionally, there are no participation requirements during annual enrollment meaning a set number of or percentage of team members is not required to enroll.

You select the waiting period before benefits become effective. Benefits become effective on the 1st of the month on or after Team Members have completed their applicable waiting period.

No waiting period (1st of the month following the date of hire. Team Members hired on the 1st will have benefits effective the 1st of the following month.)

30 day waiting period  (1st of the month following 30 days)

60 day waiting period (1st of the month following 60 days)

A waiting period does not apply to Operators or Team Members that become eligible after measuring full-time.

Coverages are separated so you and your Team Members only purchase what you need. Want Medical only? No problem. Want family medical, employee and spouse dental, and no vision? No problem. You and your Team Members have the flexibility to select what’s right for your own personal needs.

Benefits are offered in bundles. For example, this means if you select the Full-time Healthcare Plan bundle, you will be offering Team Members medical, dental, and vision.

Joining GIOA and GIOA Health Plan

Thank you for your interest in joining GIOA. We are not currently accepting new membership applications for the 2022 Plan Year for existing Operators who have made the decision to leave their current provider. For more information about joining the 2023 Plan Year, contact OperatorsBenefits@gioa.info.

For New Operators graduating from Fundamentals, you may join GIOA if you are expected within two (2) months to have at least one (1) common-law employee. New Operators have 90 days from the completion of Fundamentals to join the GIOA Healthplan. For more information on this process and requirements, contact OperatorsBenefits@gioa.info.

 

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2023 Open Enrollment Communication

Open Enrollment Communication TO SHARE with your team!

  • 2023 Open Enrollment Benefits Guide – Click Here
  • LIVEWELL Open Enrollment flyer (English) – Click Here
  • LIVEWELL Open Enrollment flyer (Spanish) – Click Here
  • Open Enrollment Video for your team – Click Here
  • Healthcare Resource Guide – Click Here
  • LIVEWELL enrollment platform – Click Here

OPEN ENROLLMENT HOTLINE:
Team Member Questions: 855-915-3015 Monday to Friday 8amET to 8pm ET

2023 Anthem Medical

Overview

Anthem Blue Cross Blue Shield is the medical insurer for the GIOA program. There are five (5) medical plan choices that include traditional PPO offerings along with an HSA qualified plan called the Freedom plan. Detailed plan design information can be found in the sidebar to the right.

While the names have changed, the in-network benefits remain virtually unchanged from the prior plan.

If you select the Full-time Healthcare Bundle you will offer medical, dental, and vision to all full-time Team Members as well as those who have met the ACA hours requirement.

All five (5) medical plan options will be presented to Team Members at the time of enrollment. Team Members will select the plan that best meets their needs.

Tell Me More

Rates differ by regions thus your rates will be based on your region. Click the ‘View My Medical Rates’ button in the sidebar. These rates are for medical coverage only. Dental and vision rates are detailed separately on the site.

If you are an applicable large employer (ALE), you are required to make contributions for all full-time and ACA eligible Team Members based on the employee-only rate of the lowest cost medical plan.

Your contribution to the cost of coverage must be made in $25 increments. You will have the option of setting your contributions by Team Member group:

  • Tier 1: Other Staff (Executives)
  • Tier 2: Managers
  • Tier 3: Assistant Managers
  • Tier 4: Supervisor/Shift Lead
  • Tier 5: Team Member, Office/Clerical, Restaurant Maintenance Technician, Non-CFA Employee
  • Tier 6: Area Marketing Director, Rest. Marketing Director, Kitchen Director, Training Director, Manager/Training Director, or Hospitality

Use the ACA contribution modeler to help in determining the required contribution amount by Team Member group.

FAQs

Can I select the waiting period as to when Team Members become eligible?

Yes, you will have the option of electing a waiting period of 0 days, 30 days, or 60 days. The waiting period will apply to all newly hired, full-time Team Members regardless of their job title or insurance group. Benefits will be effective the 1st of the month following the waiting period.

Will we have the same Anthem network as today?

Yes, the same Anthem network as today (Blue Card PPO Network) will be the network in place for the GIOA program.

Can the medical benefits be offered on a pre-tax basis?

No, given issues with non-discrimination testing, GIOA has decided not to offer any benefits on a pre-tax basis.

If I or a Team Member join the Freedom HSA plan, are we able to make contributions to the HSA on a pre-tax basis via payroll deductions?

Contributions to HSAs via payroll deductions will not be supported by the GIOA program at this time. This decision will be revisited however if enrollment in the plan is sufficient enough to warrant the additional administrative expense involved in coordinating this activity.

If GIOA won’t support payroll deductions for HSA contributions, how do I or a Team Member get the tax free benefits?

You can establish an HSA at any financial institution that provides HSA services. You can make deposits into that account and then take the tax deduction on your annual income tax filings.

Can I contribute to an HSA if I’m enrolled in the Platinum Plan?

No, you can only contribute to an HSA if you are enrolled in the Platinum Plan and you meet other criteria. See the HSA eligibility checklist in the sidebar to determine if you are eligible to make contributions to an HSA.

Side by Side Overview
of Medical Options

Platinum Plan Summary
Gold Plan Summary
Silver Plan Summary
Bronze Plan Summary
Freedom Plan Summary
HSA eligibility check list

(To choose your state, download then enable editing.
Includes Affordability Calculator.)

2022/23 Anthem Dental & Vision

Dental Overview

Anthem Blue Cross Blue Shield is the dental provider for the GIOA program. There are four (4) dental plan choices that cover all basic dental needs. Each option offers the flexibility of in-network or out-of-network dentists. Medical plan participation is not required to enroll in the dental plan. Detailed plan design information can be found in the sidebar to the right.

While the names have changed, the in-network benefits remain virtually unchanged from the prior plan.

All four (4) dental plan options will be presented to Team Members at the time of enrollment. Team Members will select the plan that best meets their needs.

Tell Me More

Rates are the same for all regions.

Your contribution to the cost of coverage must be made in $5 increments. You will have the option of setting your contributions by Team Member group:

  • Tier 1: Other Staff (Executives)
  • Tier 2: Managers
  • Tier 3: Assistant Managers
  • Tier 4: Supervisor/Shift Lead
  • Tier 5: Team Member, Office/Clerical, Restaurant Maintenance Technician, Non-CFA Employee
  • Tier 6: Area Marketing Director, Rest. Marketing Director, Kitchen Director, Training Director, Manager/Training Director, or Hospitality Director

FAQs

Can I select the waiting period as to when Team Members become eligible?

Yes, you will have the option of electing a waiting period of 0 days, 30 days, or 60 days. The waiting period will apply to all newly hired, full-time Team Members regardless of their job title or insurance group. Benefits will be effective the 1st of the month following the waiting period.

Will we have the same Anthem network as today?

Yes, the same Anthem network as today (Essential Choice and Complete Network) will be the same network in place for the GIOA program.

Can the dental benefits be offered on a pre-tax basis?

No, given issues with non-discrimination testing, GIOA has decided not to offer any benefits on a pre-tax basis.

Will my current orthodontia treatment be covered under the new plan?

Yes, if you elect a plan option that covers orthodontia and you are currently receiving treatment, Anthem will coordinate benefits to determine what is paid under your old coverage and what is paid under your new coverage.

Vision Overview

The GIOA program offers three (3) vision plan options for Full-time team members – Platinum, Gold and Silver. Medical plan participation is not required to enroll in the vision plan. Detailed plan design information can be found in the sidebar to the right.

While the names have changed, the in-network benefits remain virtually unchanged from the prior plan.

All plan options will be presented to Team Members according to their eligibility at the time of enrollment.  Team Members will select the plan that best meets their needs.

Tell Me More

Rates are the same for all regions.

Your contribution to the cost of coverage must be made in $5 increments.  You will have the option of setting your contributions by Team Member group:

  • Tier 1: Other Staff (Executives)
  • Tier 2: Managers
  • Tier 3: Assistant Managers
  • Tier 4: Supervisor/Shift Lead
  • Tier 5: Team Member, Office/Clerical, Restaurant Maintenance Technician, Non-CFA Employee
  • Tier 6: Area Marketing Director, Rest. Marketing Director, Kitchen Director, Training Director, Manager/Training Director, or Hospitality Director

FAQs

Can I select the waiting period as to when Team Members become eligible?

Yes, you will have the option of electing a waiting period of 0 days, 30 days, or 60 days. The waiting period will apply to all newly hired, full-time Team Members regardless of their job title or insurance group. Benefits will be effective the 1st of the month following the waiting period.

Will we have the same Anthem network as today?

Yes, the same Anthem network as today (Blue View Vision) will be the same network in place for the GIOA program. The network will continue to have access to over 36,000 doctors and 27,000 locations nationwide. Employees will have access to retail and online options to take care of their vision needs

Can the vision benefits be offered on a pre-tax basis?

No, given issues with non-discrimination testing, GIOA has decided not to offer any benefits on a pre-tax basis.

Dental & Vision

2023 Dental & Vision Side by Side Comparison
Platinum Dental Plan Summary
Silver Dental Plan Summary
Platinum Vision Plan Summary
Silver Vision Plan Summary

2022/23 Part-time Healthcare Plans

Overview

GIOA understands Operators want to support Team Members who work in a reduced schedule capacity. That’s why we are making available new benefit plans designed for your part-time Team Members.

You’ll be able to offer your part-time Team Members a Minimum Essential Coverage (MEC) medical plan with enrollment on the same platform as your full-time employees.

The MEC plan is provided by Essential Benefits Administrators, a leading provider specializing in innovative and flexible employee offerings. The MEC plan is a self-insured guaranteed cost contract. There are no participation and contributions for the Essential Benefits plans. There are three plans: Basic MEC, MEC Plus, and MEC Premium Plus.

The MEC plans are not part of GIOA’s AHP and GIOA makes no assurances regarding their operation. Operators who choose to offer these benefits may enroll their Team Members on the Benefitfocus platform, but will contract directly with Essential Benefits Administrator and assume all liability therein.

Tell Me More

You will also have the opportunity to offer part-time Team Members dental and vision benefits. Anthem will be the dental and vision provider for the part-time coverage. 

  • Dental: The plan design options differ from the full-time plans. The rates are the same as full-time. Part-time employees will have four (4) dental plan designs available to them, Platinum, Gold, Silver and Freedom.
    • There are waiting periods on these plan designs – 6 months for Basic services, 12 months for Major services and 12 months for Ortho – which are noted on the details of each plan.
  • Vision: Only one (1) vision plan will be offered to part-time Team Members. The Gold vision plan will have the same rates as the full-time Team Members.

For more information including plan design, descriptions and rates, see the additional material in the right side bar. 

FAQs

If Operators have to contract directly with the MEC administrator and the benefits aren’t part of the AHP, why select the Essential Benefits offering?

Many Operators are already offering MEC plans “off platform,” meaning they are responsible for managing administration. GIOA is simply facilitating a more efficient means of managing enrollment and other benefit administration responsibilities.

How will the contracting process work for the Essential Benefits offering?

If you elect to offer the Essential Benefits MEC plans, your information will be provided to Essential Benefits Administrator and you will receive the appropriate group application for execution.

Are the dental and vision benefits the same as full-time?

No, the part-time Team Member dental plan design options differ from the full-time plans but the rates remain the same. Part-time Team Members will only have access to the Gold vision plan which will be the same design and rates as full-time Team Members.    

What types of items do the MEC plans cover?

MEC plans are not comprehensive medical coverage. They are designed to provide Team Members with 100% coverage for ACA mandated wellness coverage. The higher level plans provide in-network office visits subject to copays. There is no coverage for outpatient or inpatient services. There is no out of network coverage.

What network does the MEC plan use?

The MEC plans utilize the First Health Network.

MEC Plan Design

2022/23 Supplemental Health Plans (All states)

Overview

As the benefits landscape continues to change, employers are looking for new ways to provide a well-rounded comprehensive benefits plan to attract and retain talent.  Supplemental Health Benefits provide a low cost way for Team Members to round out their health care coverage whether they are covered by your plan, their parent’s, a spouse’s plan, Military plan, or some other coverage.

You are not required to contribute to the cost of coverage, but if you decide to pay a portion of the cost of coverage, the benefits become even more attractive.

The insurer for the Supplemental Health Benefits is Securian Financial.

Tell Me More

The Supplemental Health Bundle includes Critical Illness, Hospital Indemnity, and Accident Insurance. If you decide to offer this bundle, you and your Team Members will be presented each benefit. You and your Team Members select which benefits you want. Select one, two, three, or none of the options.

Critical Illness Insurance (also called Specified Disease Insurance) provides a lump sum if  the insured is diagnosed with a condition such as cancer or has a heart attack or stroke.

Accident Insurance provides a specified dollar benefit if the insured suffers an accident and has certain injuries or is treated for certain injures.

Hospital Indemnity Insurance provides a lump sump payment if the insured is hospitalized due to sickness or accident.

FAQs

Are Operators required to contribute to the cost of Supplemental Health Benefits?

No, Operators are not required to contribute to the cost of Supplemental Health Benefits.  You may however elect to make a contribution to the cost of coverage.

Do these benefits satisfy any ACA compliance requirements?

No, these benefits are not ACA compliant. They do not meet minimum value (MV) or minimum essential coverage (MEC) requirements.

Are the benefits payments made directly to the insured or to the provider?

All Supplemental Health Benefits are indemnity benefits. Payment is made directly to the insured, not to the provider. The insured first incurs the expense and may be required to pay the provider upfront. The insured then files a claim with Securian and if the claim is for an approved expense, Securian will reimburse the insured directly.

Can spouses and children be covered?

Yes, rates are 4 – tier: employee only, employee + spouse, employee + child(ren) and family. You do not have to select the same tier of coverage for each benefit. You can select different tiers by benefit.

Can these benefits be offered to my part-time Team Members?

Yes, if you decide to offer the Supplemental Health Bundle, your part-time employees working at least 15 hours per week will be presented the option to enroll for these coverages as well.

Critical Illness Plan Summary & Rates
Hospital Indemnity Plan Summary & Rates
Accident Plan Summary & Rates
Value added benefits

2022/23 Operator Life & Disability Plans (All states)
Operator Life Insurance

Cigna Group Insurance is the Operator Life Insurance provider for GIOA. GIOA is pleased to announce an expansion of life insurance benefits for Operators – up to $2 million, all guarantee issue. And now, you can purchase life insurance on your spouse (up to $500,000) and child(ren) ($10,000). Your spouse will have to submit proof of good health for amounts over $50,000. All coverage comes with AD&D in equal amounts.

The rates for Operator Life are equal to current rates.

Operator LTD

GIOA’s Operator LTD offering is a multi-level program that provides up to $85,000 in income replacement:

  • Base (The Standard – Group Policy): 60% up to $25,000
  • Buy up Level 1 (UNUM – Individual Policy): 60% up to $10,000
  • Buy up Level 2 (Lloyd’s of London – Individual Policy): 60% up to $50,000

There are two options for base coverage provided by The Standard: (1) the current plan with a 25% rate increase (2) alternate plan with a 8.5% rate increase. See Operator Base LTD Summary and Rates for a comparison of options.

Team Member Life Insurance 

The Hartford is the Team Member Life Insurance provider for GIOA. Team Members can purchase Life Insurance up to $100,000 on themselves, $50,000 on their spouse, and $10,000 on their child(ren). You are not required to contribute to the cost of coverage, but if you select Operator life you must make Team Member life available.

Team Member STD

Team Members will have the option of enrolling for STD benefits. The STD plan will pay a weekly benefit of $200 to $1,500 depending on the Team Members selected benefit amount. You must make Team Member STD available if you select Operator LTD. In states that have a state mandated disability requirement, short term disability coverage may not be available.

FAQs

I notice there are no rates posted for the Buy up Level 1 and Buy up Level 2 of the LTD. Why is that? How do I know the cost of coverage?

The Buy up LTD plans are individual plans. The offerings will be customized to each Operator at the time of enrollment. If you select the Base LTD offering, you’ll automatically receive a customized offer of Buy up LTD prior to annual enrollment. You are only eligible for the Buy up options if you enroll in the Base options.

If I want to keep the Life and Disability insurance amounts I have today, is there something special I need to do?

At annual enrollment, simply select those amounts. There will be no medical underwriting and the coverage will be issued on a no loss/no gain provision.

I have no LTD or Life insurance today. I want to enroll. Do I have to answer medical questions or have an exam?

No, the coverage will be provided during this one time special period without evidence of insurability. That means no medical exams or questions.

If I enroll at a later date or I want to increase coverage amounts, will I have to submit proof of good health?

Yes, any late enrollment or increases in coverage amounts will be subject to evidence of good health requirements.

Operator Buy Up Level 1 Summary – UNUM
Operator Buy Up Level 2 Summary – Lloyd’s of London
Team Member Life Summary & Rates
Team Member STD Summary & Rates

Other Services, Program Highlights, & Fees

GIOA’s healthplan offering is designed to be a turn-key solution that frees you from the administrative burden of providing and managing benefits. We’ve partnered with companies that know and understand how we function and the importance of a hands off solution.

As an Operator, you will be fully supported by the GIOA model. Our goal is to take care of most of the day to day activities leaving you free to focus on what matters most to your store and your team. 

Benefit Administration & COBRA

We’ve selected Benefitfocus as our administration partner. They will provide the enrollment system that allows you and your Team Members to select benefits. They will let the insurance companies know who is eligible and who should be terminated from coverage.  They’ll also manage COBRA.

ACA Compliance Support

For ACA Compliance and support we’ve partnered with UnifyHR. They’ll do the ALE tracking, the hours tracking, and 226-J letter response for you.

If you are not participating in a Healthcare option, ACA services are not available – i.e. no GIOA medical and no ACA tracking.

New Technology

As part of the GIOA healthcare program you and your Team Members will have access to an exciting new app that puts your enrolled benefits and program information in the palm of your hands. The tool is called the LiveWell Connect app powered by iNGAGED and you can download it directly to your phone or tablet from the Apple App Store or from Google Play.  It’s customized to each Team Member according to what they have enrolled in so that you see only your relevant information.

You as the Operator will have single sign on to UnifyHR as well.

Health Advocate

Health Advocate will be provided at no cost to you and your Team Members. Have an issue with a claim? Need to research in-network doctors? Want to speak with someone about a health condition? Health Advocate can help you and your Team Members navigate carriers and claims.

Program/ Technology Fees

GIOA charges no additional fees for participating in the healthplan. Similar to today, you will pay fees for benefit administration (Benefitfocus) and ACA compliance (UnifyHR):

  • Benefitfocus: $158.33 per month ($1,900/year)
  • GIOA Insurance Benefits Fee: for UnifyHR and GIOA operations

The UnifyHR fees do not apply if you are not participating in the Healthcare option and there will be no ACA tracking.

Powered by Mercer

As our broker partner, Mercer will provide GIOA with vendor management, compliance support, and all of the oversite needed to make our program a success. This includes working with Corporate to resolve Vender Bridge issues and ensure our data gets to the right place.

About Mercer
Mercer delivers advice and technology-driven solutions that help organizations meet the health, wealth and career needs of a changing workforce. Mercer’s more than 23,000 employees are based in 44 countries and the firm operates in over 130 countries. Mercer is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC), the leading global professional services firm in the areas of risk, strategy and people. With nearly 65,000 colleagues and annual revenue over $14 billion, through its market-leading companies including Marsh, Guy Carpenter and Oliver Wyman, Marsh & McLennan helps clients navigate an increasingly dynamic and complex environment. For more information, visit www.mercer.com. Follow Mercer on Twitter @Mercer.
Transparency in Coverage
The Transparency in Coverage final rules from the Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury requires that all health insurers and group plans create machine readable Files (MRFs) that contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers.  This is a first step towards creating consumer friendly tools that will help put healthcare information into the hands of consumers to help make informed health care decisions.  GIOA is committed to complying with all rules and regulations.  Access to the specific files applicable to GIOA can be found here.
New Member Plan Overview
Guardian Independent Operator Association (GIOA) in collaboration with Mercer Health & Benefits LLC. has developed a healthcare program that includes comprehensive medical, dental, vision, life and disability benefits coupled with administration, COBRA and ACA compliance services.

As an Operator, GIOA will work in partnership with you supporting the day to day management of your employee benefits offering and associated compliance, leaving you free to focus on what matters most, your store and your team.

Powered by Mercer means leverage to drive the best possible pricing and highest levels of service. Best of all – its built specifically for Operators.

There are no Operator contribution requirements to team member benefits. Additionally, there are no participation requirements during annual enrollment meaning a set number of or percentage of team members is not required to enroll.

You select the waiting period before benefits become effective. Benefits become effective on the 1st of the month on or after Team Members have completed their applicable waiting period.

No waiting period (1st of the month following the date of hire. Team Members hired on the 1st will have benefits effective the 1st of the following month.)

30 day waiting period  (1st of the month following 30 days)

60 day waiting period (1st of the month following 60 days)

A waiting period does not apply to Operators or Team Members that become eligible after measuring full-time.

Coverages are separated so you and your Team Members only purchase what you need. Want Medical only? No problem. Want family medical, employee and spouse dental, and no vision? No problem. You and your Team Members have the flexibility to select what’s right for your own personal needs.

Benefits are offered in bundles. For example, this means if you select the Full-time Healthcare Plan bundle, you will be offering Team Members medical, dental, and vision.

Joining GIOA and GIOA Health Plan

Thank you for your interest in joining GIOA. We are not currently accepting new membership applications for the 2022 Plan Year for existing Operators who have made the decision to leave their current provider. For more information about joining the 2023 Plan Year, contact OperatorsBenefits@gioa.info.

For New Operators graduating from Fundamentals, you may join GIOA if you are expected within two (2) months to have at least one (1) common-law employee. New Operators have 90 days from the completion of Fundamentals to join the GIOA Healthplan. For more information on this process and requirements, contact OperatorsBenefits@gioa.info.

 

2022 Anthem Dental & Vision

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Benefits available through this program are administered through an insurance carrier that will vary based on your location.

Questions? Need Help? Send an email to operatorbenefits@gioa.info or call the Operator Call Center at 855-606-3726 Monday-Friday

Services and Marketing Provided by:

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Need Help?

Contact gioa About Membership

Email:                      Mail:

 help@gioa.info                                780 Buford Hwy, Bldg 1, Ste 101
                                                            Suwanee, GA 30024

Contact gioa About your Healthplan

Call:               Email:

855-606-3726                                  operatorbenefits@gioa.info
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8am-6pm EST