Health & Welfare

Chuze offers a variety of benefits to eligible employees. Our health and welfare benefits go beyond just medical, dental and vision. We offer employer-paid life insurance, extra life insurance if you want to increase your amount, short-term disability, and supplemental plans to help you with those out-of-pocket costs that you may find with your regular medical insurance. Want to check out all of the benefits Chuze offers? Please click on the Chuze Benefits Guide below!

BENEFITS GUIDE

Click below for cost, how to find a doctor, and full plan details!

Benefits Eligibility

An employee who is classified as Full-Time is considered to be a benefit eligible employee and able to participate in the company sponsored health and welfare plans. An employee who is classified as Part-Time is considered to be a non-benefit eligible employee and unable to participate in the company sponsored health and welfare plans, but may still be eligible for medical coverage if their stability period, as defined by the Affordable Care Act, is Full-Time. For more information, please refer to appendix B in the plan document.

Coverage Start

Coverage will start after the following: Insurance plans selected during your New Hire window will be effective 1st of the month following 60 days of employment. Selections made during Open Enrollment are effective on September 1st of that plan year. Coverage effective dates for mid-year entries due to Qualifying Events vary.

Selections and Changes​

Eligible employees can make benefits election and changes only during the following: Within 30 days of your hire date as a full-time employee Within 30 days of your status change to full-time During the annual Open Enrollment period Within 30 days of a qualifying life or family status event (applies only to certain changes)

Aetna (Medical)

Find Care and Costs - Search for in-network providers, procedures, cost estimates, and more. View Claims - See a list of your most recent claims, their status, and reimbursements.

MyCigna (Dental and Vision)

Find Care and Costs - Search for in-network providers, procedures, cost estimates, and more. View Claims - See a list of your most recent claims, their status, and reimbursements.
Qualifying Life Events

Qualifying life events are those situations that cause a change in your life that has an effect on your health insurance options or requirements. The IRS states that a qualifying event must have an impact on your insurance needs or change what health insurance plans that you qualify for. In either case, the qualifying life event triggers a special enrollment period that would make you eligible to select or drop coverage.

Category

Examples of Qualifying Life Events

Loss of health-care coverage

    • Losing health insurance for any reason except not paying premiums
    • Losing eligibility (Medicaid, Medicare or a Children’s Health Insurance Program)
    • Turning 26 and losing coverage through a parent’s plan
    • Loss of job-based coverage (quit or fired)

Changes in household

    • Marriage, divorce or legal separation
    • Pregnancy, adoption of a child or any adding of dependents
    • Losing coverage due to a death in the family

Other qualifying events

    • Your spouse retires, which forces you to lose coverage
    • Your spouse changes jobs

Qualifying Life Events are evaluated on a case-by-case basis and require documentation related to the QLE

Per the IRS (Section 125 regulations), employees may not alter their plan selections mid-year without a valid Qualifying Life Event (QLE). This is not a Chuze policy, this is an IRS regulation that we must follow.

 

  1. Log in to ADP
  2. Click on Myself > Benefits > Enrollments
  3. Click Report a Life Change > Report a change
  4. Select the life event reason
  5. Fill in required fields

You will be required to provide documentation to prove the date of the QLE. Please note all qualified life events (QLE) must be completed within 30 days of the event. Proof documents are official documents directly related to the event.

  1. Submit.

Benefits will review your elections and documentation. If your QLE has been accepted and approved you will receive a benefits confirmation email. If your QLE is rejected or further information is needed you will receive an email.  

  1. Log in to ADP
  2. Click on Myself > Benefits > Enrollments
  3. Click Report a Life Change > Report a change
  4. Select the life event reason
  5. Fill in required fields

You will be required to provide documentation to prove the date of the QLE. Please note all qualified life events (QLE) must be completed within 30 days of the event. Proof documents are official documents directly related to the event.

  1. Submit.

Benefits will review your elections and documentation. If your QLE has been accepted and approved you will receive a benefits confirmation email. If your QLE is rejected or further information is needed you will receive an email.  

  1. Log in to ADP
  2. Click on Myself > Benefits > Enrollments
  3. Click Report a Life Change > Manage

Adding dependents and beneficiaries does not automatically add them to benefit plans.  If you need to add dependents to your plan please see “Add insurance coverage after a valid Qualifying Life Event (QLE) occurs”

BASIC LIFE INSURANCE PAID BY CHUZE 100%

Chuze Fitness provides basic Life Insurance of 1x salary up to a maximum of $200,000 with a minimum of $50,000 to all eligible Full-Time employees, at no cost to you. You may purchase Life and AD&D in addition to the company-provided coverage. Note: Benefit amounts over $50,000 are subject to imputed income and may be taxable. *if you do not wish to get free life insurance and have imputed income please decline during your enrollment*

September 1, 2023 - August 31, 2024 Health and Welfare Policy Documents

Previous Years Health and Welfare Policy Documents

Your Benefits Advocate!
Questions about Chuze Benefits? Need help picking a plan? Claim Problems? Talk to a Benefits Advocate!

Your Benefits Advocates Center (BAC) can help you navigate the healthcare system and make the most of your health benefits. Use the BAC service to help you understand your coverage, assistance with picking a plan and support with billing and claims.

The Benefits Advocates Center service is in addition to the Chuze Benefits Team! BAC for Chuze employees is brought to you by our benefits broker Gallagher

 

Contact Information

Chuze Benefits Advocate Center (BAC)

FAQ's

    • Click HERE for the Aetna OAMC (ALL STATES) network.
    • Click HERE for the Aetna HMO (CA ONLY) network.
    • Continue as a guest: Enter a 5-digit zip code or city.
    • Click “Medical Doctors & Specialists”.
    • Click “All Primary Care Physicians,” and the provider listing will appear.
    • Your provider listing will include specific providers currently accepting your Aetna Health Plan. You must call and check with the provider before scheduling your appointment or receiving services to confirm if they are still participating in Aetna’s network.
  • Member Service phone numbers for Aetna plan
    • HMO CA ONLY – (800) 445-5299
    • OAMC 1000 & 3000 –  (877) 204-9186

CALIFORNIA ONLY - HMO FAQ's

A Health Maintenance Organization (HMO) health plan offers a local and sometimes limited network of doctors and hospitals for you to choose from.

HMO plan important key features:

  • You will need to select an in-network primary care provider (PCP) for yourself and your covered dependents. You can change your PCP at any time.
  • The PCP you choose will coordinate your health care needs and refer you to specialists as needed, except for OB/GYN (OB/ GYN and PCP must be in the same medical group) and chiropractic services.
  • You do not need a referral from your PCP to see a mental health provider; however, you can call Aetna directly to speak with a mental health team member 877.204.9186 who will refer you to an in-network mental health provider or confirm if your specific mental health provider is in-network.
  • Aetna may need to pre-certify hospitalizations and other outpatient care, but there’s no paperwork for you when using in-network providers.

Yes, you and your covered dependents can only see a provider within the AETNA HMO network.  

If you get medical care outside of the plan’s network (such as a physician, hospital, clinic or pharmacy), those out-of-network services will only be covered if the treatment is considered an emergency or urgent care as defined by your health plan documents.

HMO CALIFORNIA ONLY:

    • Click HERE for the Aetna HMO network.
    • Continue as a guest: Enter a 5-digit zip code or city.
    • Click “Medical Doctors & Specialists”.
    • Click “All Primary Care Physicians,” and the provider listing will appear.
    • Your provider listing will include specific providers currently accepting your Aetna Health Plan. You must call and check with the provider before scheduling your appointment or receiving services to confirm if they are still participating in Aetna’s network.

Most HMO plans are very attractive because of their inexpensive costs for the participant. Most services can be paid with a small copay and there is usually no deductible or a very small deductible. It is important to know the difference between an HMO and a traditional PPO plan to determine if the HMO plan is right for you and your family.

One of the differences between an HMO and a traditional PPO is how service/care is provided or managed. With an HMO, you are not able to be seen by specialists or other service providers without seeing your primary care provider first. Your primary care provider must refer you to see a specialist. HMO plans may also have to pre-approve certain hospital and out-patient care as well. With a traditional PPO, you are able to see any provider you would like without having to go through your primary care provider first.

Another difference is the access to care. With traditional PPOs, they usually have a bigger network which means more access to in-network providers and hospitals/clinics. There is a better chance that your current provider is covered under a PPO network. An HMO plan generally has a much smaller network which means access to a provider of your choice or hospital/clinic is much more limited and sometimes not available in your area. 

When comparing the HMO plan and the PPO plan to determine if the HMO plan is right for you, an HMO may be right for you if the cost savings is more valuable to you and your family and you do not mind taking extra steps to access specialty care along with maybe having to choose a new primary care provider.