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Insurance 2020

This site contains a summary in English of your plan rights and benefits under the Usui International Cafeteria Plan or Usui International Group Health & Welfare Benefit Plan. If you have difficulty understanding any part of this site, contact Mr. Kyle Shepherd, in human resources at the plan administrator’s office: Usui International Corporation, 88 Partnership Way, Sharonville, OH 45241. Office hours are from 9:00 A.M. to 5:00 P.M, Monday through Friday. You may also call the plan administrator’s office at 513-448-0410, Ext 5607 for assistance.

“यो पुस्तिकामा उसुइ इन्टरन्याशनल ग्रूप हेल्थ एण्डवेलफेयर बेनिफिट प्लान वा उसुइ इन्टरन्याशनल क्याफेटेरिया प्लान  (Usui International Group Health & Welfare Benefit Plan or Usui  International Cafeteria Plan) अन्तर्गत तपाईंको अधिकार तथा सुविधाहरूहरूबारे अङ्ग्रेजी भाषामा एउटा सारांश दिइएको छ। यदि तपाईंलाई यो पुस्तिकाको कुनैपनि भाग बुझ्न गाह्रो भएको छ भने, प्लान एडमिनिस्ट्रेटरको कार्यालयको मानव स्रोतका श्री काइले शेपर्ड (Kyle Shepherd) लाई सम्पर्क गर्नुहोस्: Usui International Corporation, 88 Partnership Way, Sharonville, OH 45241. कार्यालय समय सोमवार देखि शुक्रवार बिहान 9:00 बजे देखि बेलुका 5:00 बजे सम्म हुनेछ। तपाईंले सहायताका लागि प्लान एडमिनिस्ट्रेटरको कार्यालयको 513-448-0410, एक्सटेन्शन 5607 मा पनि कल गर्न सक्नुहुन्छ।”

Ang site na ito ay naglalaman ng buod sa Ingles ng mga karapatan at benepisyo sa plano mo sa ilaim ng Usui International Cafeteria Plan or Usui International Group Health & Welfare Benefit Plan. Kung nahihirapan kang maunawaan ang alinmang bahagi ng site na ito, kontakin si Mr. Kyle Shepherd, sa human resources sa tanggapan ng administrador ng plan: Usui International Corporation, 88 Partnership Way, Sharonville, OH 45241. Ang oras ng opisina ay mula 9:00 A.M. hanggang 5:00 P.M, Lunes hanggang Biyernes. Maaari mo ring tawagan ang opisina ng administrador ng plan sa 513-448-0410, Ext 5607 para sa tulong.

Find a Doctor
Click here to locate a doctor or to see if your doctor works with Blue Cross Blue Shield of Michigan.

Blue Cross Online Visits
Feeling to bad to get out of the house? Try Blue Cross Online Visits and talk to a doctor over the internet from the comfort of your home. There is NO co-pay to use this service on our plans.

Michigan Planners
Need help with a claim. Having trouble understanding your bill. Contact Michigan Planners for assistance.
586-263-9000 or 800-674-9235

General Benefit Plan Information
Summary of Material Modifications

Medical, Dental and Vision Plans

All Medical, Dental and Vision products are offered through:
Blue Cross Blue Shield of Michigan

Benefits Plan Documents

More Plan Information
Benefits Guide eBook
Affordable Care Act Market Place Coverage Options
ACA Market Place Notice

Contact Information
600 E. Lafayette Blvd.
Detroit, MI 48226-2998
Customer Service: 1-888-605-2566
Benefits & Eligibility: 1-800-676-2583
Precertification: 1-800-572-3413

Plan Information
Group Number:
Rx BIN: 610014

Other Information
Certificate(s) of Creditable coverage may be requested in writing or in person from Human Resources. It may take up to 7-10 days for delivery.
Insurance Coverage Change Notices

Medical Insurance Plan Information

Rx – Prescription Drug Plan

How do I know if my plan covers my prescription drug?
Prescription Drug Mandatory Mail Program Info and Frequently Asked Questions
Pharmacy Change Notices
Sam’s Club Removed from Rx Coverage

Dental and Vision Plan Information

Dental Plan

Insurance Plan Documents
Payroll Deductions
Benefits at a Glance
Contact Information
Dental Forms
Claims Reimbursement Form

Vision Plan

Insurance Plan Documents
Payroll Deductions
Benefits at a Glance
Visit Assistance Info Sheet (Give to Your Provider)
Contact Information
Vision Forms
Claims Reimbursement Form
Call VSP Member Services at 800.877.7195
Your Member ID for VSP is on Your Benefits card without the “UIL”

Life, AD&D and Voluntary Life Insurance​

All Life and Disability products are offer through:
Mutual of Omaha Insurance Company
Benefits Plan Documents
Summary Plan Description – SPD

Plan Information
Group ID: G000BGJ7

Voluntary Life Insurance

$20,000 – $300,000 of additional coverage available at discounted rates*
Guarantee issue of $100,000 for employee at enrollment, if elected

Life/AD&D Policy

$20,000 of coverage provided at no cost to every UIC employee

Short Term Disability

Up to 13 weeks of pay at 60% of your normal weekly pay after illness* or injury

Long Term Disability

Additional coverage beyond 13 weeks at 60% of your normal weekly pay until you are able to return from illness or injury

Pricing   (Premium rates for Voluntary Life Insurance are payroll deducted once per month on the first pay of each month)
Evidence of Insurability (EOI) Online Form
Life Claim Form (Please see HR for Information)

Flexible Spending Accounts

All Flexible Spending Account products are offer through:
BASIC – Benefit Administrative Services International Corporation Inc.
Benefits Plan Documents

More Plan Information
BASIC FSA Guide – Your guide to saving and using your FSA Benefit and Prepaid Benefits Card

Medical – FSA

Deduction Limits
Up to $2700.00 per year.

Dependent Daycare – DCA

Deduction Limits
Up to $5000.00 per year if single or married filing jointly or $2500.00 per year if married filing separate.

Employee Assistance Program

Don’t delay if you need help:
Phone Number: 1-800-316-2796

Services Provided by Mutual of Omaha
These consultations and resources are confidential.
Additional Information


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