Mercy Hospital

Find the latest information here regarding new plan offerings in 2023 for Mercy Hospital caregivers.

Cleveland Clinic Employee Health Plan available to Mercy Hospital caregivers in 2023

Cleveland Clinic’s My Pay + Benefits package is our way of investing in your health and well-being and we are committed to offering comprehensive benefits that empower caregivers to take care of themselves and their families.

The Employee Health Plan provides a rich plan design, comprehensive coverage with minimal out-of-pocket costs (copays, deductibles) while also layering in value added services.  As in previous years, health plan insurance coverage is provided to our caregivers with a premium cost trending below the market.

Starting this fall, Cleveland Clinic Mercy Hospital caregivers will be able to enroll in the Cleveland Clinic Employee Health Plan (EHP) as part of their 2023 benefit offerings.  

The Cleveland Clinic EHP partners with a third party administrator, Aetna, for claims processing, eligibility verification, explanation of benefits, and more.  A partnership that brings you best in class health insurance. Starting Jan. 1, 2023, Cleveland Clinic Mercy Hospital will transition from Medical Mutual of Ohio (MMO) to Aetna for these services.

What does this mean for you?

  • You’ll have health insurance coverage where you are.
    • As our organization grows, it is important to offer our caregivers and their families options for comprehensive, nationwide health coverage. 
    • Two medical plans will be offered during open enrollment this fall: the EHP plan, which includes Cleveland Clinic and Quality Alliance providers; and the EHP Plus plan, which features the EHP network plus Aetna’s national network — providing more than 95% access to healthcare in all 50 states.  
  • The change doesn’t have to be complicated.
    • For the remainder of 2022, MMO will remain the third party administrator for caregivers enrolled in the Mercy Hospital Health Plan. Please continue to use your current health insurance cards through Dec. 31, 2022.
    • We are working closely with Aetna and MMO to ensure a smooth transition for our caregivers.
    • Any discount you earned during the 2022 Simply Healthy Choice program will apply to your health plan premium in 2023.
    • The Catholic religious and ethical directives will carry over onto both EHP Plans for Mercy Hospital and Mercy Professional Care Corporation caregivers.

 

As we approach open enrollment, Oct. 20 – Nov. 4, more information will be available on this site to help you make your health plan selections, including the ability to look up providers and plan costs.

 Cleveland Clinic is invested in your health and well-being, and we look forward to continuing to offer comprehensive healthcare benefits and a competitive My Pay + Benefits package.

Mercy Hospital FAQs

Yes, if you want healthcare benefits through Cleveland Clinic in 2023.

During open enrollment, you will have the choice between two health plans in Workday:

  1. Employee Health Plan (EHP)
  2. Employee Health Plan Plus (includes a national network of providers)


EHP
The EHP offering includes Cleveland Clinic providers, in addition to Quality Alliance providers.

Please note:  Akron Children's Hospital is not included in the EHP network.

EHP Plus
The EHP Plus offering gives members access to the providers available in the EHP plan (above), PLUS Aetna's Open Access Select network, which includes providers nationwide.  Akron Children's Hospital is included in the EHP Plus Network.  

Both plans offer the same benefits and coverage, while premium and network size differ.  The choice is up to you when you make your health plan elections during open enrollment.

You must take action during open enrollment by logging into Workday and electing either the EHP or EHP Plus plan. More details on the health plans, the enrollment process and the Mercy Hospital Benefits/Wellness Fair will be made available as we get closer to open enrollment, Oct 20 - Nov. 4.
 

A provider search will be available online for each network in October for you to see whether current providers will be covered for you in 2023.  

When deciding on which plan to select for 2023, you are strongly encouraged to check all of your current providers to see if they are listed in your new network choice. You are expected to receive all your care from the providers in the network you choose. 
 

No. Services provided by these medical institutions and their affiliates are not covered by either the EHP or EHP Plus health plan in 2023. In case of an emergency, services will be covered and if admitted, will be subject to the notification and transfer requirements outlined in the Summary Plan Description (SPD).

Yes. Participation in the Simply Healthy Choice program will close on Sept. 30, 2022. Beginning in 2023, Mercy caregivers and their spouses will be able to join the Healthy Choice premium discount program provided by the EHP. For more information on the Healthy Choice program, click here. The Healthy Choice portal and other wellness programs will be available to you to join when you have your new health plan ID number, at the beginning of 2023. Note: The Healthy Choice information on the EHP website now is subject to change and may not reflect the complete program requirements for 2023.

Yes.  Any discount you earned during the 2022 Simply Healthy Choice program year will apply to your health plan premium in 2023.  Your Simply Healthy Choice discount will be visible in Workday when you elect benefits during open enrollment. 

As an EHP or EHP Plus member, you will have access to a comprehensive drug benefit program that utilizes a custom EHP formulary and multiple utilization management strategies to drive value, thereby keeping your out-of-pocket health care expenses as low as possible.  

The EHP Prescription Drug Benefit Program is managed by the EHP Pharmacy Management Department and administered by CVS/Caremark. The EHP Prescription Drug Formulary can be found on the EHP website, along with other information related to the EHP Prescription Drug Benefit Program. Medications may be added to the EHP Prescription Drug Formulary four times a year and removed from the EHP Prescription Drug Formulary twice a year, once at the start of the benefit year in January and again at mid-year in July. Caregivers should consult the EHP Prescription Drug Formulary to determine whether their current medications are included in the Formulary, and to discuss alternative options with their healthcare provider if their current medication is not covered. 
 

Yes, the Prescription Drug Benefit Program is the same for both EHP and EHP Plus members.

Yes.  EHP and EHP Plus members are encouraged to use the Cleveland Clinic Mercy Professional Pharmacy or any of the other Cleveland Clinic pharmacies, including the Cleveland Clinic Home Delivery and Specialty pharmacies, to obtain their medications.  You will also receive a lower percentage co-insurance for your prescription medications by using Cleveland Clinic pharmacies, and your annual pharmacy benefit deductible will not be charged if you use a Cleveland Clinic Pharmacy and your prescription is filled with a generic medication.

Unfortunately, no, it will not.  You will need to have your provider re-submit a new prior authorization request to EHP Pharmacy management.  This new request will be evaluated against the coverage determination criteria that have been developed by the EHP Pharmacy Management Team and approved by the EHP Pharmacy & Therapeutics Committee.  Please note that submission of a new prior authorization request does not guarantee approval of the request.

EHP and EHP Plus members can utilize any of the CVS store pharmacies, including those located inside Target stores, to obtain acute need prescription medications.  Please note the charge will apply to your annual pharmacy deductible even if you fill the prescription with a generic medication.

Yes.  Starting in 2023, your vision exams are covered under the EHP and EHP Plus health plans.  You also have the option to enroll in our vision plans, which provide discounts on glasses and contacts.  More information about vision plan coverage will be provided closer to the open enrollment period.

Yes, please look for new medical and pharmacy ID cards in the mail prior to January 2023.  You will also receive new Cigna Dental and EyeMed Vision ID cards in the mail in January 2023.  Please be sure your address is up-to-date in Workday prior to open enrollment. 

In 2023, Mercy Hospital members will still have a religious accommodation with respect to the health plan.  Mercy members will be contacted directly by Aetna and Caremark regarding female contraceptive coverage, as required under the Affordable Care Act.  If coverage is needed, members must take action at that time.  Additional questions can be directed to the Aetna Concierge customer service unit at 1.833.414.2331.

Due to the religious exemption in place at Mercy Hospital, infertility treatments as well as other services are excluded.  If you have specific questions regarding the religious exemption, please contact the Aetna Concierge customer service unit at 1.833.414.2331.

We are building the details of the plan offerings and additional information will be coming soon.  Please bookmark this site for the most current information.  You can also reach out to the following departments with general questions:

  • Workday question:  Contact the ONE HR Service Center at 216.448.2247 or 877.688.2247.
  • Employee Health Plan medical or benefit questions:  Contact an EHP Specialist at 216.986.1050 (option 1) or 888.246.6648 (option 1).
  • EHP Pharmacy Management questions:  Contact the Pharmacy Management Department at 216.986.1050 (option 4) or 888.246.6648 (option 4).  You can also email the department at EHPRxMgmt@ccf.org.