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Werfen Benefits Team
Benefits.na@werfen.com- 2026 Benefits Guide
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Provider Contacts
| Plan | Group Number | Phone Number and Website/Email |
|
Medical
Blue Cross Blue Shield MA Anthem Blue Cross Health Advocate |
4956749 166480 |
1-800-262-2583
bcbsma.com 1-800-700-3351 anthem.com/ca 1-866-695-8622 healthadvocate.com |
|
Dental
Delta Dental MA |
016380 |
1-800-872-0500
deltadentalma.com |
|
Vision
EyeMed |
1061725 |
1-866-939-3633
eyemed.com |
|
Health Savings Account
Health Equity |
1-866-346-5800 healthequity.com |
|
|
Flexible Spending Accounts
Health Equity |
1-877-924-3967 healthequity.com |
|
|
Life and AD&D Insurance
Prudential |
72675 |
1-800-778-4357
prudential.com |
|
Disability
Prudential |
72675 |
1-800-778-4357
prudential.com |
|
Accident, Critical Illness, & Hospital Indemnity Insurance
Prudential |
72675 |
1-800-778-4357
prudential.com |
|
Employee Assistance Program (EAP)
Magellan |
1-800-523-5668 member.magellanhealthcare.com |
|
|
Prepaid Legal Services
Metlife |
1-800-821-6400
legalplans.com/whuenroll |
|
|
Fraud & Identity Protection
Aura |
1-844-931-2872
metlife.com/identity-and-fraud-protection/ |
|
|
Pet Insurance
MetLife Figo |
270667 |
1-800-GET-MET8
metlife.com/getpetquote https://bit.ly/3fHcA7U |
|
Home & Auto
Farmers |
1-833-905-0408
farmers.com/groupselect |
|
|
401(k) Retirement Plan
T. Rowe Price |
1-800-922-9945 rps.troweprice.com |
Common Benefit Terms & Definitions
Annual Benefit Maximum
The maximum dollar amount your insurance plan will pay toward the cost of care within a specific benefit period, usually over the course of the plan year.
Coinsurance
Cost sharing is the amount that you and the insurance plan pay for covered services after the deductible has been met. For example, if the plan pays 80% after the deductible, you would be responsible for the remaining 20% of the eligible expense.
Copay
A fixed amount, determined by your plan, that you will owe at the time you are receiving a covered service.
Deductible
The amount you owe for covered services before your insurance plan pays its portion. For example, if your deductible is $1,000, your plan does not pay anything until you have paid $1,000 out of pocket. Preventive care might be exempt from this deductible.
Explanation of Benefits (EOB)
A statement from your insurance provider that explains what services were provided, the costs, what portion of the cost was covered by the insurance plan, and what portion is your responsibility in addition to how to appeal the decision.
Flexible Spending Accounts (FSAs)
This savings account allows you to deposit pre-tax dollars to pay for eligible out-of-pocket healthcare expenses. Annual contribution limits are set by the IRS every year. FSA funds cannot be carried over, so unused funds will be lost.
- Healthcare FSA – A tax-free savings account used to pay for eligible IRS-qualified medical, dental, and vision care expenses, along with over-the-counter healthcare items, that are not covered by insurance.
- Limited Purpose FSA – A tax-free savings account limited to eligible IRS-qualifying dental and vision care expenses.
- Dependent Care FSA – A tax-free savings account used to pay for eligible IRS-qualified day care expenses for children younger than age 13 and adult dependents who are incapable of caring for themselves.
Health Savings Account (HSA)
Those with a high-deductible health plan (HDHP) can qualify for this savings account, which can be funded with either your own pre-tax dollars or employer-provided funds. HSA funds can be used to pay for eligible IRS-qualified medical, dental, and vision care expenses, along with over-the-counter healthcare items, that are not covered by insurance. Every year, the IRS sets a contribution limit, and unused HSA dollars can be rolled over and moved from job to job.
High-Deductible Health Plan (HDHP)
A plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (also called your deductible). All qualified employee-paid medical expenses count towards your deductible and out-of-pocket maximum, and most preventive care is covered at 100%.
Out-of-Pocket Maximum (OOP)
The maximum amount you must pay during the plan year before your health insurance begins to pay 100% of the allowed amount. It does not include your premiums, out-of-network provider charges beyond Reasonable & Customary, or healthcare services your plan does not cover. Check your plan documents to confirm what is covered.
Premium
The amount that must be paid for an insurance plan by covered employees, by their employer, or shared by both. The employee’s share of the premium will be deducted from their paychecks on weekly, bi-weekly, or semi-monthly basis.
Prescription Medications (Rx)
A doctor’s prescription is required for these medications. The cost is determined by their assigned tier: generic, preferred, non-preferred, or specialty.
- Generic Medicines – Approved by the U.S. Food and Drug Administration (FDA) to be chemically identical to corresponding preferred or non-preferred versions. Usually the most cost-effective version of any medication.
- Preferred Medicines – Brand-name version on your provider’s approved list (also available online).
- Non-Preferred Medicines – Brand-name version not on your provider’s approved list. These medicines are typically newer and have higher copays.
- Specialty Medicines – Brand-name version used to treat complex, chronic, and often costly chronic conditions. Because of the high cost, many insurers require that specific criteria be met before the prescription is covered.
Prior Authorization
A requirement that your physician obtain approval from your health insurance plan before prescribing any medication or undergoing needed medical treatment.
Provider Network
A group of physicians, hospitals, and healthcare providers that have agreed to provide medical services.
- In-Network – Providers that contract with your insurance company to provide healthcare services at the negotiated carrier discounted rates.
- Out-of-Network – Providers that are not contracted with your insurance company. If you choose an out-of-network provider, services will not be covered at the in-network negotiated carrier discounted rates.
- Non-Participating – Providers that have declined entering into a contract with your insurance provider. They may not accept any insurance, and you could pay for all costs out of pocket.
Summary of Benefits and Coverage (SBC)
A summary snapshot of your health plan’s costs, benefits, and covered health care services. SBCs also explain your health plans’ unique features like cost sharing rules, and all significant limits and exceptions to coverage.