Welcome to LSS Benefits !
Lutheran Senior Services (LSS) is committed to providing you with a comprehensive benefits package that’s an important part of your total compensation. These benefits include a wide range of options designed to meet the financial and health care needs of you and your family. Please find all the information you’ll likely need throughout this comprehensive website, including recorded presentations that provide a narrated overview of each benefit. (view all of these presentations here.) If you have any questions, contact your Human Resources department.
Other Benefits Pages
Wondering how you can know which plan is right for you and your family? Good question! Talk to “Alex”. ALEX is a fun, interactive website that can serve as your LSS medical benefits expert 24/7, and help you pick the plan that may be best for you. Visit ALEX at https://www.myalex.com/lss/2020.
Greetings from Your HR Department
Dear LSS Employees,
Without you, Lutheran Senior Services would not be able to live out our mission of Older Adults Living Life to the Fullest. It’s for that reason LSS offers benefits that support you and your family, allowing you to choose what meets your own personal needs. When your own needs are met, you are better equipped for making a positive difference in the lives of others.
This web site will help you and your family to learn about the various components of our benefits package and get answers to your questions 24 hours a day, 7 days a week. The tools you will need for enrolling are available at your fingertips. Be sure to note the information about the Wellness Program, the success of which has been outstanding in increasing the level of wellness for our workforce. According to the data provided by our wellness vendor, we are healthier today than we started the program a few years back. Let’s keep that trend going!
To enroll in our benefits and/or make changes, please visit Workday. If you have any questions or need help, contact your HR representative.
We greatly appreciate all you do for those we serve. Thanks for making our mission come alive!
Director of Benefits and Compensation, LSS Human Resources
On This Page:
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Aligned with our LSS Core Values, the Employee Benefits at LSS are designed to support the recruitment and retention of the talented individuals we need to live out our mission of “Older Adults Living Life to the Fullest”… Talented individuals like YOU.
There are various factors that determine which benefits in the overall LSS Benefits Program you are eligible for… Your employment status (e.g. Full-time, Part-time, PRN, etc.), your length of employment, and/or your number of actual worked/paid hours. Considering your just employment status, here are the benefits you may be eligible for:
All LSS Employees:
- Wellness Program
- Retirement benefits
- Employee Assistance Program (EAP)
- Leaves of Absence
- Pay Advances
- Commuter Benefits
- Some Educational Financial Assistance benefits
- Workers’ Compensation
- Senior Care Network CNA & CMT Training Academy
- Corporate Discounts for External Products/Services
Part-time & Full-Time Employees:
- All of the benefits listed above, plus…
- Time Off Benefits
- Christ Care Fund
Full-Time Employees (including ACA-Eligible Variable Hour Employees):
- All of the benefits listed above, plus…
- Medical insurance
- Insurance Alternative Compensation
- Dental insurance
- Vision insurance
- Flexible Spending Accounts (FSA)
- Life insurance
- Disability insurance
- Voluntary Income Protection benefits
- All Educational Financial Assistance Benefits
Please review the additional sections that follow for more details related to eligibility, dependents, important dates for enrolling and coverage, etc. For additional information, please refer to the LSS HR policy – “Benefits & Insurance Eligibility” (LSS-HR-14) on LSSLink.
Below is a recorded presentation you can watch for an overview of all LSS Benefits.
Below are definitions of the various employment statuses and employee groups within LSS, in regards to benefits-eligibility:
- A full-time employee is someone budgeted for 30 or more hours per week.
- A weekend option employee is someone budgeted to work 32 hours per week but is generally paid for 40 hours per week.
- A part-time employee is someone budgeted for anywhere between 1 and 29 hours per week.
- A variable hour employee is anyone not in a Full-time or Weekend Option status (i.e. Part-time, PRN &/or Casual*), according to the ACA regulations *
- An ACA-eligible variable hour employee is a variable hour employee who averaged 30 or more paid hours per week during their prior “Measurement Period” *
- Chaplains eligible to participate in the Concordia Plan Services benefits must be rostered with the Lutheran Missouri Synod and budgeted to work at least 20 hours per week
- *Some definitions of ACA terms include:
- ACA: “Affordable Care Act”, sometimes referred to as “Healthcare Reform” or “Obama-care”
- Initial Measurement Period (New Hire): LSS will look back over a one-year period (starting on the date of hire or rehire) to determine whether or not a variable hour employee’s paid hours averaged 30+ hours per week.
- Ongoing Measurement Period: Once an employee completes his or her Initial Measurement Period, they become a part of the Ongoing Measurement Period, which is October 5 of the previous year through October 4 of the current year. This time period is used to determine if the employee averaged 30+ paid hours per week.
- Initial Administrative Period: This period allows LSS time to calculate eligibility and identify benefit-eligible employees.
- Ongoing Administrative Period: This time period runs concurrent with annual enrollment and accommodates a larger volume of enrollments and changes. This period allows LSS time to calculate eligibility and identify benefit-eligible employees.
- Initial Stability Period: The LSS initial stability period is 12 months and begins on the day after the initial administrative period ends. Eligible variable hour employees who choose to enroll may remain on the benefit plans through the end of their stability period.
- Ongoing Stability Period: The LSS ongoing stability period is a 12-month time period beginning on January 1 and ending on December 31. Eligible variable hour employees who choose to enroll may remain on the benefit plans through the end of the stability period.
Eligible employees may choose to cover dependents on applicable benefit plans such as our LSS medical insurance, dental insurance, vision insurance, life insurance and voluntary income-protection benefits.
Eligible dependents include:
- A spouse as recognized under the laws of the state where the employee lives.
- Children, including natural children, stepchildren, legally adopted children, children covered under a “Qualified Medical Child Support Order”, and children for whom the subscriber or the subscriber’s spouse is a legal guardian.
- Children may be covered through the end of the month in which they attain the age of 26. They may retain coverage beyond 26 years if the dependent is already enrolled, unmarried, and unable to support him- or herself due to physical or mental disability.
Eligible employees may elect varying coverage levels for different benefit plans. For example, an employee may prefer to elect “employee + children” for medical, “employee + spouse” for dental, and “employee only” for vision, or any other combination of the employee’s choosing.
Enrollment & Coverage Dates
- New Hire: You may enroll for coverage during the annual enrollment period or within a limited time period prior to your initial benefits-eligibility date. Employees are eligible for medical, dental, vision, FSA, short-term disability, and/or life/AD&D coverage to begin the 1st of the month in which they will complete 90 days of full-time/weekend-option employment. Employees' long-term disability coverage does not begin until the first of the month following one consecutive year of full-time employment. Employees may enroll in the LSS Retirement Plan at any time they wish.
- Re-Hire: If you are rehired within one year of leaving LSS, you may enroll for coverage during the annual enrollment period or within a limited time period prior to your initial benefits-eligibility date. Employees are eligible for coverage beginning the 1st of the month following their rehire date (if the rehired employee was benefit-eligible when they recently terminated and they re-enroll).
- Status Change: If you change jobs and move from a non-FT position into a Full-time (or Weekend Option) position, you become eligible for medical, dental, vision, FSA, short-term disability, and/or life/AD&D coverage to begin the 1st of the month in which you will complete 90 days of full-time/weekend-option employment. Employees' long-term disability coverage does not begin until the first of the month following one consecutive year of full-time employment.
- ACA Benefit-Eligible Variable Hour Employees: You may enroll for coverage during your initial or ongoing Administrative Period prior to your benefits-eligibility date. Coverage begins on the 1st of the month following the Administrative Period. Employees' long-term disability coverage does not begin until the first of the month following one consecutive year of ACA Benefit-Eligible employment.
- Chaplains: Chaplains employed by LSS may be eligible for health insurance offered through Concordia Plan Services (CPS). The effective date of coverage for members new to the CHP Plan is the first of the month after employment begins with LSS. For more information regarding Concordia Health Plan, please visit ConcordiaPlans.org.
** Temporary employees are only eligible for coverage while budgeted for 30+ hours/week with a work assignment of 90 days or more.
Termination of Employment & Benefits Coverage
Benefits Coverage: Employees who end their employment with LSS will have benefits coverage continue through either the 15th of the month (if employment ends on the 1st through the 15th day of the month) or the last day of the month (if employment ends on the 16th of the month or later), except for flexible spending accounts (FSA) which end the same day as the employee’s termination date.
COBRA Continuation of Benefits: Employees will be provided the opportunity to continue their coverage of medical, dental and vision insurance as well as healthcare FSA if they choose to elect COBRA. COBRA enrollment forms will be mailed directly to the employee’s home within 14 days of losing coverage. Please note that if one has a healthcare FSA, they may only submit claims for services/expenses dated on or before their termination date (claims must be submitted within 90 days), unless they elect to continue and fund their healthcare FSA through COBRA. For more information on COBRA including rates for coverage, please visit https://lsslife.com/benefits/#benefits and scroll down to the “COBRA Continuation of Health Coverage” section.
Retirement Benefits: Once an employee has received their final paycheck from LSS, they may contact the LSS HR Benefits Department at 314-262-8263 to request their AUL Retirement Distribution paperwork. (If an employee is eligible for the LSS “defined benefit plan” or “pension plan” that was frozen in 2006, they should call 314-446-2487).
Educational Benefits: Any employee who leaves LSS who has received financial educational assistance may owe a balance of the benefit received back to LSS in accordance with that program’s written policy and agreement. If the amount owed exceeds the amount possible to deduct from the employee’s final paycheck(s), the amount or remaining amount will be due and payable to Lutheran Senior Services immediately (or based upon a mutually agreed-upon repayment plan). Employees should contact their HR Director to discuss a repayment plan.
Life Insurance Continuation: If an employee wishes to continue their life insurance benefits, they must complete and submit the application to do so within 31 days of your separation of employment. Please contact Beth Anderson at 314-446-2568 to obtain the application paperwork.
Voluntary Benefits Continuation: If an employee wishes to continue any Hospital, Critical Illness and/or Accident benefits coverage, they should watch for a letter sent to their home from Voya with instructions on how to do so.
If an employee has any questions concerning benefits, they should call the vendors at the numbers below:
- Anthem: 1-833-585-3158 (Group #: 004009901)
- Express Scripts: 1-877-860-9259 (Group #: LSSLVNG)
- Benefit Wallet (HSA): 1-877-472-4200 (Group #: 95009982019777)
- Delta Dental: 1-800-335-8266 (Group #:21731000-1001 basic plan: 21732000-2001 enhanced plan)
- Eye Med Vision Care: 1-866-939-3633 Group# 9797630
- Unum Life and AD&D: 1-800-445-0402 (Group #: 426747-001)
- Unum Short-term and Long-term Disability: 1-800-858-6843 (Group #’s: 423001-001 STD; 426740-001 LTD)
- Voya voluntary benefits: 1-877-236-7564 (Group #: 70587-0)
- Discovery Benefits – Flexible Spending Accounts (& COBRA): 1-866-451-3399
Changing Coverage During the Year
You may change your coverage during the year only when you experience a qualifying event such as a marriage, divorce, birth, adoption, loss of coverage through another plan, or status change to a benefits-eligible position. All changes must be made within 31 days of the qualifying life event and supporting documentation must be provided. (Employees may make changes to their LSS Retirement Plan elections at any time they wish.)
Payment for Elected Benefits
- All premiums for medical, dental, vision, life and voluntary insurance will be deducted from the participant’s payroll twice per month (24 times per year). A participant’s first premium will be deducted on the pay slip for the pay period that ends just prior to their coverage begin date, and a participant’s last premium will be deducted on the pay slip for the pay period that ends just prior to their coverage end date. (Click here for specific coverage begin/end dates and the corresponding deduction begin/end dates.)
- Contributions for the Health Savings Account (HSA), Healthcare Flexible Spending Account (FSA), and/or Dependent Care FSA will be made from the participant's payroll every pay period (26 times per year). A participant’s first premium will be deducted on the pay slip for the pay period that contains their coverage begin date, and a participant’s last premium will be deducted on the pay slip for the pay period that contains their coverage end date.
- Employees are responsible for payment of premiums during times without pay. Failure to pay premiums may result in the retroactive loss of benefits coverage and may result in the denial of submitted claims.
COBRA Continuation of Health Coverage
COBRA provides eligible current and/or former employees, spouses, and dependents the right to temporary continuation of health coverage at group rates if they lose eligibility. This coverage, however, is only available when coverage is lost due to certain specific events. Group health coverage for COBRA participants is typically more expensive than health coverage for active employees, since LSS pays a part of the premium for active employees while COBRA participants pay the entire premium themselves. LSS Benefits for which COBRA continuation is available are medical, dental, vision, and healthcare FSA.
Legally Required Notices
In accordance with ERISA requirements, the following documents and notices may be found and accessed by all LSS employees below. For a printed version of any of these notices, please contact your Human Resources representative.
- Benefits Plan Policy
- Summary Plan Description Lutheran Senior Services Benefits Plan
- Summary Plan Description Lutheran Senior Services Benefits Plan Wrap Document
- Children's Health Insurance Program (CHIP) Notice
- LSS HIPAA Notice
- LSS Medicare Notification
- Marketplace Exchange Notice
- Summary of Material Modifications
- Notice of Special Enrollment Rights
- Women’s Cancer Rights
Summary Annual Reports
Anthem Blue Cross Blue Shield
Express Scripts – Prescription Drugs
BenefitWallet - Health Savings Account
Lutheran Senior Services offers three medical insurance plans through Anthem Blue Cross Blue Shield (BCBS) for all eligible employees to choose from.
Wondering how you can know which plan is right for you and your family? Good question! Talk to “Alex”…
- ALEX is an LSS benefits expert who can help you pick the right plan and explain any terms or concepts you don’t understand.
- ALEX is available online, 24/7, so you can use the tool with your spouse and family members from any computer at any time.
- Using ALEX is easy! ALEX will ask you a few straightforward questions about your needs in order to form a custom recommendation that’s right for you.
- For an expert on health insurance and employee benefits, ALEX is pretty funny. The experience is designed to be light, jargon-free, and helpful.
- Whatever you share with ALEX remains completely private.
LSS Offers three medical plan options:
- Gold Level PPO Plan
- Bronze Level PPO Plan
- Consumer Driven Health Plan with an HSA Option
Two of these plans are “more traditional” PPO (Preferred Provider Organization) plans, and one is a Consumer Driven Health Plan (sometimes referred to as a “high deductible plan”. The Consumer Driven Health Plan is associated with a Health Savings Account (HSA), and is designed to encourage members to spend their healthcare dollars as if they are their own. Not every one of these plans is right for everyone. Each plan has its advantages and disadvantages, and employees should consider their own circumstances (including their families) when choosing the plan that’s best for them.
- All three plans provide coverage for the same medical and prescription drug services.
- How much you pay out of pocket in copays, deductibles, coinsurance, and in premium contributions will be different for each plan.
- Beginning in 2018, if you cover a spouse as a dependent that is eligible to be covered under their own employer-provided health benefits, an additional premium of $50 per month will be charged.
- View the premiums for each of these medical plans.
- View an overview of each of these medical plans’ benefits.
- Anthem Bronze PPO Plan Summary
- Anthem Consumer Driven Health Plan Summary
- Anthem Gold PPO Plan Summary
What is a Health Savings Account (HSA)?
- Only an available option for those enrolled in our Consumer Driven Health Plan
- Members may contribute their own pre-tax money that they may then use on any healthcare costs at any time in their life
- Similar to an IRA in that it’s an account owned by the employee and the employee’s contributions, earnings and distributions are all tax-free (“i.e. triple tax savings!”)
- Similar to a Flexible Spending Account (FSA) but money in the account is never forfeited (Participants in an HSA may NOT participate in a Healthcare FSA.)
- LSS will contribute additional money into the employees’ HSA’s on their behalf – $800 per year ($33.33/pay period) for individual coverage and $1,600 per year ($66.66/pay period) for dependent coverage
- With lower premiums upfront, but higher deductibles, members are encouraged to make contributions to the HSA to help save or prepare for potential expenses down the road (Members are responsible for paying 100% of their higher deductible prior to the plan paying any costs, except for free preventive care)
- If the employee keeps their medical costs down however, the employee keeps this money for future use (never goes away!)
For more information on Health Savings Accounts, please see the resources below:
- Consumer Driven Plan and HSA Overview
- Making HSAs Work for You
- Advantages and Disadvantages
- HSAs – A Healthy Investment
- Frequently Asked Questions
- Member Guide
- Sample Stories
- Mobile Capabilities
- Please visit BenefitWallet’s website by clicking here
For More Details
- Anthem's 360 Condition Care
- Anthem's Case management Fact Sheet
- Hearing Aid Services
- Preventative Care
- Summary Annual Report: Medical Plans
- Summary of Benefits and Coverage (SBC) – Bronze PPO Plan
- Summary of Benefits and Coverage (SBC) – Consumer Driven Health Plan
- Summary of Benefits and Coverage (SBC) – Gold PPO Plan
- Summary Plan Description Bronze PPO
- Summary Plan Description Consumer Driven Health Plan
- Summary Plan Description Gold PPO
- Summary Plan Description Prescription Drug Benefit
Tools & Resources for Patients: Comparing Costs & Quality of Healthcare
Different doctors and hospitals may charge different amounts for the same service, so it pays to shop around and compare costs of available providers…
- Be a smart healthcare shopper – Estimate your costs
- Step-by-step guide to estimating your healthcare costs
In addition, different doctors and hospitals may provide higher (or lesser) quality care when delivering those same services as well. Below are some links to help you find the highest quality of care available to you.
- Guide to Health Care Quality: How to Know It When You See It (This overview of important quality metrics to understand when choosing a medical service or provider was compiled by the Agency for Health Care Quality and Research.)
- Consumer Guide to Hospitals in St. Louis (A report showing variation in hospital readmissions, infection rates and other measures of safety.)
- Your Disease Risk (A free tool developed by researchers at Washington University in St. Louis that can help survey takers understand their risk of developing five of the most important diseases in the United States and get personalized tips for preventing them.
- Choosing Wisely (Some tests and procedures may not be needed. Choosing Wisely, an initiative of the American Board of Internal Medicine Foundation, can help patients and their physicians determine what care evidence suggests is needed and what can cause unneeded worry and cost.)
- Health Finder (A government website with health care information for consumers including a Guide to Healthy Living and Personal Health Tools.)
- Agency for Healthcare Research and Quality (A government website with ways to help patients and families ask questions of physicians and other health care providers.)
Prescription drug coverage is provided to members enrolled in one of LSS' medical plan options. Express Scripts is the Pharmacy Benefits Manager. Prescription drug coverage provides benefits when you and your family have the need for prescription medicine/drugs.
The Express Scripts retail pharmacy network includes more than 64,000 pharmacies across the country, to make accessing your medications very convenient for you and your family. The network includes most chains and some local, independent pharmacies as well. For a complete list of network pharmacies, click here. Also, at Express Scripts, you’ll find the Express Scripts formulary, which lists all prescription drugs covered by the plan. This drug list is sometimes updated and may change throughout the year, as new drugs come to market or if new research becomes available that would impact which drugs are covered. You may also visit http://express-scripts.com or call and speak with a representative.
Beginning in 2018, mail/homedelivery is required for maintenance medications after three fills at a retail pharmacy. For more information, see the below link.
To view the pharmacy/prescription coverage for the 3 medical plans, please visit the link below.
Home Delivery Pharmacy
Home delivery is a great way to save money and it’s convenient too! Home delivery of medications is for members who take medicine on an ongoing basis. LSS’s home delivery pharmacy, Express Scripts, sends you the medicine you need, right to your door, with free shipping and access to pharmacists for drug questions and more.
Not only is home delivery more convenient, but it also saves you money! By switching to home delivery, you will receive a 3-month supply of drugs for less than it would cost you at a retail pharmacy.
Starting home delivery is easy, and you can start by phone or mail. By phone, call Express Scripts at 877.860.9259, or you can mail your order form and send it to Express Scripts, along with your doctor’s prescription.
Switching to home delivery is easy too! If you have existing maintenance prescriptions that are eligible, you can request to have them transferred from a retail pharmacy and delivered to you through the home delivery pharmacy. To review your home delivery opportunities, go to www.express-scripts.com and either register as a new user or sign in. Review your prescriptions available for refill. Any medication that is displayed with the “Transfer to Home Delivery” option can be selected and then click “add to cart.” After you add your retail medication to the cart, you will need to go through the checkout process in order to finalize the transfer to home delivery. Express Scripts will then reach out to your doctor to receive their approval.
Emergency & Urgent Care
When a trip to the doctor is not possible, there are other options besides the emergency Room (ER).
An estimated 14-27% of all emergency department visits in the U.S. could be treated at one of these alternative sites with significant cost savings for everyone. These alternatives can treat conditions that should be looked at right away but aren’t as severe as emergencies (including sprains and strains, animal bites, minor headaches, coughs/sore throats).
For a list of urgent care centers and retail walk-in clinics near you, contact Anthem customer service at 833.585.3158 or the 24-hour Anthem NurseLineSM at 866.647.6117.
Always remember the “Emergency Room Rule of Thumb” though… Always call 911 or go directly to an Emergency Room if you think you could put your health at serious risk by delaying care.
LiveHealth Online (i.e. online telemedicine)
Members may consult a physician via the internet from the comfort of their homes using a computer or smartphone.
- Face-to-face care with a licensed physician
- Request prescriptions for certain conditions
- Save money and time, and avoid getting sick in the doctor’s office!
- With LiveHealth Online, you have a doctor by your side seven days a week, 24 hours a day, 365 days a year.
- LiveHealth Online lets you talk face-to-face with a doctor through your mobile device or a computer with a webcam.
- No appointments, no driving and no waiting at an urgent care center.
- Use LiveHealth Online for common health concerns like colds, the flu, fevers, rashes, infections, and allergies.
- Faster, easier, and more convenient than a visit to an urgent care center.
- To get started, go to LiveHealthOnline.com and register or download the LiveHealth Online mobile app for free on your mobile device by visiting the App Store or Google Play.
- LiveHealthOnline flyer
Waiving Medical Insurance – Insurance Alternative Plan
This benefit allows eligible employees who choose not to elect LSS medical coverage to receive an additional $43.33 of compensation per month (or $21.67 per pay period). To receive this “Insurance Alternative” benefit, the benefits-eligible employee must waive the LSS medical insurance and provide proof that they have health insurance coverage provided through another medical plan outside of LSS, such as a spouse’s plan (excluding Medicare and Medicaid). This benefit may be elected at any time during the year, and supporting documentation must be provided on an annual basis.
LSS Wellness Program
Virgin Pulse - Wellness Program Administrator
(Download the Virgin Pulse App for Apple and Android devices)
Contact Virgin Pulse by phone, live chat, e-mail or the member support page:
Member Services Phone #: 888-671-9395,
Live Chat on member.virginpulse.com
Monday – Friday 2:00am to 9:00pm EST
The LSS Wellness Program is a very important piece of how LSS invests in our staff. Without our staff, we could not deliver on our company mission of “older adults living life to the fullest” and we want you to live your fullest life too. An important part of your living life to the fullest is your health and wellbeing, and this program is designed around providing you the support as well as opportunities to better manage your health and wellbeing.
LSS is recognized year after year by outside organizations such as the St. Louis Business Journal and the American Heart Association for the efforts and financial investments we place in this program. Our program, which evolves year after year, has demonstrated success in helping our workforce become healthier each year they are part of the LSS family. For that we are very proud, and it wouldn’t be possible without the support and focus of everyone across LSS.
2020 is the 12th year for the LSS Wellness Program and it’s administered by our wellness partner, Virgin Pulse. Virgin Pulse, one of the best companies in the employee health industry, is compliant with HIPAA regulations and therefore does not share individual or family members’ health information with LSS.
The LSS Wellness Program is available to all active LSS staff, as well as spouses covered on our medical plans. Whether you participate in the wellness screening or not, please register in the Virgin Pulse portal or app to become engaged with your coworkers and become healthier!
- Visit join.virginpulse.com/lss or download the Virgin Pulse app from the Apple or Google Play store and search for Lutheran Senior Services:
- Provide your First and Last Name
- Enter your identifier:
- Employee: 6-digit Employee Number, including leading zeros (example 012345)
- Spouses: 6-digit Employee Number (including any leading zeros) + ‛S’ (example 012345S)
- Select your State of Residence
- Then follow the prompts to complete registration
- Provide your preferred e-mail address for communications
- Provide your phone number to receive text messages and for coaching calls
For more information, please refer to the “Virgin Pulse User Guide” here.
All employees are invited to complete an annual biometric screening, but only those enrolled in one of our LSS Medical Plans need to screen in order to earn a “Wellness Credit” which lowers your insurance premiums. If an employee covers a spouse on their medical plan, the spouse must also complete an annual biometric screening to receive discounted premiums. (Dependent children do not need to participate in order to receive discounted premiums.) In order to learn how you can earn discounts on your medical insurance premiums (i.e. wellness credits), please review these flyers “It’s Easy to Save Money by Knowing Your Health” and “Wellness Screening for First Time Employees”, and/or visit the section below titled “Earning the Wellness Credit”.
In addition to the screenings and programs, you can also participate in free Health Coaching with a Virgin Pulse health professional. A Health Coach can help you with personal health goals and provide education and motivation to lead a healthier lifestyle! When working with Virgin Pulse and receiving coaching, remember… All programs are confidential and in compliance with the Health Insurance Portability and Accountability Act (or HIPAA). Any information shared with the Virgin Pulse team will not be disclosed, except in accordance with HIPAA laws. Your Protected Health Information (PHI) will not be shared with your employer. You can send a secure message to your coach via your wellness website or by calling toll-free.
All employees are invited to complete an annual biometric screening and the Health Check survey. The Health Check survey is a completely confidential health risk assessment that provides you with a wellness score, and recommendations to improve your health.
Those enrolled in one of our LSS Medical Plans need to screen in order to earn a “Wellness Credit”, which lowers your insurance premiums. If an employee covers a spouse on their medical plan, the spouse must also complete an annual biometric screening and Health Check survey to receive discounted premiums. (Dependent children do not need to participate in order to receive discounted premiums.)
In order to learn how you can earn discounts on your medical insurance premiums (i.e. wellness credits), please review these flyers “It’s Easy to Save Money by Knowing Your Health” and “Wellness Screening for First Time Employees”, and/or visit the section below titled “Earning the Wellness Credit.
In addition to the screenings and programs, you can also participate in free Health Coaching by telephone, with a Virgin Pulse health coach. A Health Coach can help you with personal health goals and provide education and motivation to lead a healthier lifestyle! When working with Virgin Pulse and receiving coaching, remember… All programs are confidential and in compliance with the Health Insurance Portability and Accountability Act (or HIPAA). Any information shared with the Virgin Pulse team will not be disclosed, except in accordance with HIPAA laws. Your Protected Health Information (PHI) will not be shared with your employer. For more information on telephonic coaching review this flyer: Telephonic Coaching Feature Guide
You can schedule a coaching call for a day and time convenient for you on the Virgin Pulse platform from your computer or mobile device, or by calling Member Services at: 888-671-9395
Earning the Wellness Credit (Discounted Premiums)
In order to earn any wellness credit, which translate into discounts on your medical insurance premiums, a biometric screening and a Health Check survey (i.e. a health risk assessment) must be completed.
Biometric screenings can be completed in 3 different ways:
- Off-site at a participating Quest Lab year-round. You may fulfill the screening requirement by visiting a participating Quest Lab (or Diagnostics® Patient Service Center). The venipuncture method will be used to measure both blood work and cotinine test offsite.
- An At Home Screening Kit allows you to self-administer a biometric wellness screening in the comfort of your own home. Log in to the Virgin Pulse platform, go to the Program’s page, on the left click ‘view all’ and navigate to the Quest portal. From there you will be able to select the option to request an at-home screening kit. The materials are mailed to your home, shipped within 3-5 business days, and include everything you need to perform the screening yourself.
You will be given an instructional brochure on how to collect a dried blood sample using the lancet finger stick device provided. When complete, you will mail the screening sample back to Quest Diagnostics in a self-addressed, prepaid envelope. Quest Diagnostics processes the sample and will send email notifications to alert you when your results are ready to be viewed online.
- You may also satisfy this requirement by submitting relevant lab work from your own physician if that’s what you prefer. (Certain restrictions apply to this option and you may also incur out-of-pocket costs that you are responsible for.) If a member prefers to obtain lab results from their own physician, they should request their physician to collect labs for glucose, triglycerides, cholesterol, blood pressure and cotinine, and have their physician document these lab results on the “Physician Results Form”, available in the Virgin Pulse online portal by following the prompts on the under “Programs” tab by “viewing all” then looking for “Quest Biometric Screenings” to download the “Physician Results Form”. The member and their physician must complete and sign the “Physician Results Form”, and then fax the completed forms to Quest for processing.
These screenings provide vital information about your overall health, including cholesterol (total, LDL, and HDL), triglycerides, cardiac risk, glucose, blood pressure, height, weight, Body Mass Index (BMI), waist measurement, and cotinine (nicotine). Biometric screenings must be scheduled online through the Virgin Pulse portal, and fasting for 9-12 hours is required.
The Health Check survey consists of questions about specific lifestyle habits. Your responses are analyzed to show your risk level and generate a health score. You can complete your Health Check survey at join.virginpulse.com/lss or the Virgin Pulse app.
Once you complete your screening and Health Check survey (both pieces are required for any wellness credit), you’ll see your points increase in the Profile section of your Virgin Pulse portal to at least 50 points. This section of the portal shows you an analysis of your Health Check survey responses and Biometric Screening results to help you understand your health risks and your options to improve your results. These first 50 points earn you a partial wellness credit which discounts your medical insurance premiums.
To earn even greater wellness credits or discounts, you’ll need to earn 100 points. If your screening results for all 5 metrics meet the health metric standards or goals (See chart below), you’ll earn the full 100 points needed for the maximum wellness credits. Or if your screening results are improved scores over your last year’s results, you’ll also earn the full 100 points needed for the maximum wellness credits.
|Triglycerides||Less than 150 mg/dL|
|LDL Cholesterol||Less than 130 mg/dL|
|Blood Pressure||Systolic: Less than 141 mmHg
Diastolic: Less than 91 mmHg
|Glucose||Fasting: Less than 100 mg/dL
Non-fasting or Unknown: Less than 140 mg/dL
If your screening results do not earn you the 100 points because they are “out of range” or did not improve compared to your last year’s numbers, there are opportunities to engage with your own healthcare provider to earn those points through the Virgin Pulse appeal process, using the “Physician Engagement Form”. To obtain a “Physician Engagement Form” and instructions on the process, login to your Virgin Pulse portal. Under the Profile tab click "Resources" and then "Forms and Documents" - Print off the document and bring it to your medical provider for completion. Once completed, you’ll submit a copy to Virgin Pulse. Please note: Approvals of appeals may take up to 10 business days, and wellness credits will not be awarded until the points are earned and transmitted to LSS.
Participating in the LSS wellness screening process is valuable. Not only does it mean you’re on the road to improved health, it means you’re saving a lot of money on your employee premiums. When you first become benefits eligible at LSS and enroll in a medical plan, your payroll premiums will automatically include the full wellness credit discount as if you have earned the full 100 points for both you (and your spouse, if applicable). However, based upon when your medical coverage begin date, you will need to complete your Biometric Screening and Health Check survey, and any necessary follow-up steps, within 6 months in order to ensure these same wellness credits continue beyond that 6-month point without any interruption. Below is a table that shows various benefit coverage begin dates, when you’ll be able to screen, and the time frame for which your actions (or lack of actions) will impact your wellness discounts beyond your initial 6-month period of coverage. If you don’t complete your required actions until after the begin-date shown in the 3rd column, don’t worry – it’s not too late. Once you eventually complete the required actions after that date, and LSS receives confirmation from Virgin Pulse that you have, you can begin to earn wellness discounts for the remainder of that time frame going forward.
|If Your Medical Coverage Begins on This Date…||Time Period for Earning Wellness Points for Premium Discounts *||Date Members' Premium Discounts Become Dependent Upon Actions Taken During "Time Period"|
|7/1/2020 or earlier||7/1/2020 - 12/31/2020||1/1/2021|
|8/1/2020||8/1/2020 - 1/31/2021||2/1/2021|
|9/1/2020||9/1/2020 - 2/28/2021||3/1/2021|
|10/1/2020||10/1/2020 - 3/31/2021||4/1/2021|
|11/1/2020||11/1/2020 - 4/30/2021||5/1/2021|
|12/1/2020||12/1/2020 - 5/31/2021||6/1/2021|
|1/1/2021||1/1/2021 - 6/30/2021 **||7/1/2021|
|2/1/2021||2/1/2021 - 7/30/2021 **||8/1/2021|
|3/1/2021||3/1/2021 - 8/31/2021 **||9/1/2021|
|4/1/2021||4/1/2021 - 9/30/2021 **||10/1/2021|
|5/1/2021||5/1/2021 - 10/31/2021 **||11/1/2021|
|6/1/2021||6/1/2021 - 11/30/2021 **||12/1/2021|
|7/1/2021 or earlier||7/1/2021 - 12/31/2021||1/1/2022|
|*Note 1: If member completes action(s) after this time period above, they may still earn wellness premium discounts again once LSS receives confirmation of their actions|
|**Note: no biometric screenings available via Quest in the month of June|
So why does LSS provide these wellness credits? To reward our employees and covered spouses for managing their health. When you manage your health, not only does it help you live your life to the fullest, it also helps contain healthcare costs for all of us on the LSS medical plans. And we all hear all the time on the news how costly healthcare costs can be for individuals and employers. All of us managing our health is a win/win for everyone – better health AND better healthcare costs.
Please contact your Human Resources representative if you have any questions. Virgin Pulse can also be contacted at 888-671-9395.
LSS Wellness Teams
Each LSS community or program has their own local Wellness Team that sponsors wellness events and contests to promote the benefits of an active and healthy lifestyle amongst our staff. All staff are encouraged to take advantage of these fun and healthy programs. To get involved and learn more, contact your community/program Wellness Lead or Human Resources representative.
Disclaimer and Privacy Notice
Lutheran Senior Services’ wellness program, administered by Virgin Pulse, is a voluntary wellness program available to all LSS employees as well as any employee spouses enrolled in an LSS medical plan (including the Concordia Health Plan). The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you will be asked to complete a voluntary Health Check survey (or Health Risk Assessment) that asks a series of questions about your health-related activities and behaviors and whether you have or had certain medical conditions (e.g., cancer, diabetes, or heart disease). You will also be invited to complete a biometric screening, which will test for blood pressure, LDL cholesterol, glucose, triglycerides and tobacco use. You are not required to complete the Health Check survey or to participate in the biometric screening. However, employees who choose to participate in the wellness program will receive an incentive of a wellness credit applied towards their medical insurance premiums. Although you are not required to complete the Health Check survey or participate in the biometric screening, only employees who do so will receive a wellness credit. Additional incentives may be available for employees who achieve certain health outcomes set by Virgin Pulse (i.e. “wellness goal”). If you are unable to achieve any of the health outcomes required to earn an incentive, you may be entitled to a reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative standard by completing the “Program Appeal” process, the form for which may be obtained in the Virgin Pulse portal/app. The information from your Health Check survey and the results from your biometric screening will be used to provide you with information to help you understand your current health and potential risks. You also are encouraged to share your results or concerns with your own doctor. We are required by law to maintain the privacy and security of your personally identifiable health information. Although the wellness program and Lutheran Senior Services may use aggregate information it collects to design a program based on identified health risks in the workplace, Interactive Health will never disclose any of your personal information either publicly or to the employer, except as necessary to respond to a request from you for a reasonable accommodation needed to participate in the wellness program, or as expressly permitted by law. Medical information that personally identifies you that is provided in connection with the wellness program will not be provided to your supervisors or managers and may never be used to make decisions regarding your employment. Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program, and you will not be asked or required to waive the confidentiality of your health information as a condition of participating in the wellness program or receiving an incentive. Anyone who receives your information for purposes of providing you services as part of the wellness program will abide by the same confidentiality requirements. The only individual(s) who will receive your personally identifiable health information is Virgin Pulse in order to provide you with services under the wellness program. In addition, all medical information obtained through the wellness program will be maintained separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellness program will be used in making any employment decision. Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellness program, we will notify you immediately. You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellness program, nor may you be subjected to retaliation if you choose not to participate. If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation, please contact Denis Thien at 314-262-8234.
Concordia Health Plans - Insurance for LSS LCMS Chaplains
Portico Benefit Services - Insurance for LSS ELCA Chaplains
Concordia Plan Services - Insurance for LSS LCMS Chaplains Health Plan & Retirement Benefits Overview
Are you a Chaplain rostered with the LCMS (Lutheran Church Missouri Synod)? If so, and you are budgeted for at least 20 hours per week, you’re eligible for benefits through Concordia Health Plan (CHP). CHP offers insurance plans for ministry workers, and as an eligible LSS employee, you may choose benefits (such as Medical, Dental, Vision, Personal Spending Accounts, Retirement, EAP, Life Insurance, Disability, etc.) available in the CHP “Option D” health plan.
If you choose to enroll in the CHP health plan, you may not also enroll in the comparable LSS benefits. Coverage with CHP begins the first of the month following employment. Please note that your employee premiums for benefits through the CHP plan are eligible for significant discounts if you earn wellness credits in the LSS Wellness program. Go here to learn about the LSS Wellness Program.
For more information on your CHP benefits, please visit the Concordia Health Plan member portal at http://www.concordiaplans.org/. When visiting the CHP member portal for the first time, you’ll need to register using your Last Name, the Last 4 digits of your SSN, and your Date of Birth. If you need help with the CHP member portal, please call 314-965-7580 or 1-888-927-7526.
If you have any questions, please contact your HR Director.
Portico Benefit Services - Insurance for LSS ELCA Chaplains Health Plan & Retirement Benefits Overview
Are you a Chaplain rostered with the ELCA (Evangelical Lutheran Church in America)? If so, and you are budgeted for at least 15 hours per week, you’re eligible for benefits through the Portico health plan. Portico offers insurance plans for ministry workers, and as an eligible LSS employee, you may choose benefits (such as Medical, Dental, Vision, Flexible Spending Accounts (FSA), Retirement, Life Insurance, Disability, etc.) available in the Portico “Gold+” health plan.
If you choose to enroll in the Portico Gold+ health plan, you may not also enroll in the comparable LSS benefits. Coverage with Portico begins the first of the month following employment. Please note that your employee premiums for benefits through the Portico plan may vary based upon the employee’s age, income, and geographical location. The employee cost-share of these premiums can be lowered through significant discounts if you earn wellness credits in the LSS Wellness program... Click here to learn about the LSS Wellness Program.
For more information on your Portico benefits, please visit the “MyPortico for Plan Members” member portal at https://myportico.porticobenefits.org/. If you need help with the Portico member portal, please call 800-352-2876. If you have any questions, please contact your HR Director.
Delta Dental - Dental benefits
Delta Dental Benefit Plan
Strong teeth and gums are an important part of good health, which is why LSS offers you and your eligible dependents comprehensive dental coverage through Delta Dental. The dental plan helps you pay for diagnostic and preventative dental services and supplies (such as exams, cleanings, and x-rays) as well as basic and major restorative services (such as fillings, crowns, and dentures).
For More Details and Downloads:
- 2020 Dental Rates & Plan Comparisons
- Delta Dental Summary Plan Description (SPD) 2020
- Finding a dentist is easy
- Delta Dental Application for Disabled or Handicapped Dependent Children
- Coverage Of In Progress Orthodontic Services
- Presentation: Benefits Orientation - Dental Insurance 2020 (view on Vimeo.com)
Eye Med - Vision benefits
Vision Benefit Rates
|Coverage Level||Per Pay Period|
|Employee & Spouse||$6.67|
|Employee & Dependents||$7.02|
|Employee & Family||$10.31|
For More Details
Flexible Spending Accounts (FSA)
Discovery Benefits - FSA and COBRA administrator
What is a Flexible Spending Account?
A Flexible Spending Account (FSA) allows you to set aside money on a pre-tax basis during the year for anticipated medical and dependent care expenses. You cannot participate in a Healthcare FSA if you’re enrolled in a the CDHP/H.S.A. medical plan.
For eligible medical expenses, you can set aside up to $2,750 annually, and for dependent care expenses you can set aside up to $5,000 annually.
Healthcare Spending Account
Covered expenses include deductibles, coinsurance, vision, hearing care, orthodontia, and other eligible expenses not covered by your health care plan. Expenses are covered for you and your eligible tax dependents. Participants may set aside up to $2,750 per year to cover healthcare expenses. Eligible flexible spending account expenses are listed in IRS Publications 502 and 503, which you can obtain through the IRS Website. You always have until March 31st of the following year to submit claims for expenses incurred in the previous year.
If you elect to renew the FSA for the following year, you will be allowed to continue to use your previous year’s dollars for up to 75 days after January 1st, for dates of service through the 75 days (i.e. March 15th). For new expenses incurred during this 75-day grace period, you may continue using your debit card and Discovery Benefits will automatically use dollars from your previous year’s balance. If you do not elect the FSA for the next year, your benefit ends on 12/31 and you may not take advantage of this 75-day grace period.
*Participants in a Health Savings Account (HSA) may NOT participate in a Healthcare FSA.
Dependent Care Account
Covered expenses include dependent care expenses for your children or other eligible dependents so that you (or you and your spouse, if married) may work. Your spouse must work or attend school full time for your expenses to be eligible. An eligible dependent is a child under the age of 13 or any dependent who is incapable of caring for him- or herself, whom you can claim on your tax return, and who spends at least eight hours a day in your home. Participants may set aside up to $5,000 per year to cover dependent care expenses. Eligible Flexible Spending Account expenses are listed in IRS Publications 502 and 503, which you can obtain through the IRS Website.
The FSA Card
The FSA card is an additional convenience offered to you in conjunction with your Flexible Spending Account. The card is a useful and easy to use tool, similar to a bank debit card that allows you to remove funds from your FSA account with a simple swipe at a merchant payment terminal. By using the FSA debit card to purchase eligible expenses, you avoid paying for a purchase with money out of your pocket. Approximately 95% of all FSA card transactions are approved automatically. In some cases, however, you may be required to substantiate your claim, so you must retain all receipts.
Approximately 5% of all FSA debit card transactions may not be eligible for automatic approval. In this case, you can still get reimbursed by substantiating your claim by submitting a claims form and a receipt or an explanation of benefits (EOB) via fax, website, or mobile upload (see “Mobile Solutions” below).
- 9.15.20 - 2019 Summary Annual Reports
- 9.15.20 - 2018 Summary Annual Reports
- 8.31.18 - September Wellness Screenings are Here!
- 9.17.18 - PayActiv: A New Service Available in Times of Need
- 9.21.18 - Retirement Plan – Annual Fee Disclosure
- 9.24.18 - 2017 Summary Annual Reports
- 10.30.18 - PTO Sellback and Additional Bereavement Pay