FAQ
Who is eligible for medical coverage?
Full-time employees who work at least 30 hours per week. Part time employees working at least 20 hours are eligible for all benefits except for medical.
When can I enroll for coverage?
Eligible employees can enroll during the annual Open Enrollment period and/or within 30 days of experiencing a Qualifying Life Event (QLE).
When will I receive my medical ID card?
Once you have made your benefits elections in your Paycom portal, it takes about two to three weeks to receive your ID cards. If you need to use services in the meantime, you can contact Kempton Group at 800.324.9396. You can also login to www.kemptongroup.com to print a copy of your ID card.
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When will coverage begin?
Eligible employees’ coverage is effective on the following levels:
Salaried Employee: First day of the month following date of hire
Hourly Employee: First day of the month following 60 days of employment
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What is Open Enrollment?
Open Enrollment is the time period each year that you can enroll and/or make changes to your elections. Open Enrollment is the only time each year that you can make changes WITHOUT experiencing a QLE. We will be moving our Plan to a January effective date. You will have the chance again in January 2025 to make changes to your benefit elections.
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What if I miss the Open Enrollment period for benefits?
If you miss the Open Enrollment period, you will not be able to enroll or make changes until the next annual Open Enrollment period unless you experience a QLE that permits you to make benefits changes under IRS rules.
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How do I enroll?
All employee must make their elections online by visiting Paycom.
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What if I do not want coverage?
If you choose to waive coverage, you must still log onto the Paycom website and let us know you are declining coverage and the reason you are not interested.
Who is an eligible dependent?
An eligible dependent is:
Your spouse or domestic partner
Your dependent child(ren) up to age 26
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Can I choose coverage for my family?
You may elect benefits for you and your family. Your dependents become eligible for coverage when you do, provided you have enrolled for coverage yourself.
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How do I pay for my benefits?
Throughout the year, benefit premiums are deducted from each paycheck. Spooner pays a portion of your medical insurance premiums. Most of your benefit deductions are taken on a pre-tax basis thus reducing your taxable income, which in turn lowers the amount of federal and state taxes withheld from your check.
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Who is the Kempton Group?
Kempton administers your health plan. This means they work for you. Kempton Group is your partner to help you make smart healthcare choices, get better health outcomes and lower costs.
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Do I have to see an in-network doctor?
Kempton Group works with all willing providers and does not use a network. You can see any provider you want with the exception of Banner Health. And there are no surprise out-of-network costs to you.
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What if my doctor doesn’t take Kempton Group?
Even though your plan has no network, sometimes doctors don’t know who Kempton Group is and will tell you they don’t “take” the Plan. If this happens, don’t fret, call Kempton Group at 800.324.9396. We will educate the provider and get you the care you need.
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If I reach my medical plan’s out-of-pocket limit, am I still responsible for co-pays?
Your medical plan pays for 100% of all covered expenses once the out-of-pocket limit is reached. Note: Once out-of-pocket limit is reached, the Banner exclusion still applies, and any services or procedures rendered at a Banner facility will not be covered.
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Can I talk to someone at Kempton Group to discuss my personal situation?
Yes. If you have questions about your health plan and your personal situation, please call Kempton's Member Care Team at 800.324.9396.
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Can I have other health coverage?
Yes, you can be covered by another group health plan and still receive benefits under this medical plan. This is called “dual coverage” and Coordination of Benefits (COB) will apply.
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How can I find out which medications are covered on the medical plan?
To view medications and their costs, go www.truescripts.com.
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How do I find an in-network provider for dental care?
For in-network dental providers, visit www.ameritas.com and click on the “Find a Provider” link. You will be able to search for providers based on zip code or city and state.
