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Employee Benefits

Welcome to the Seiler Instrument Employee Benefits portal! Please select the benefits you are interested in so Human Resources may provide you with more detailed information including plan information, premium pricing, and any additional perks or restrictions. Please note - by selecting the benefits listed below, you are not enrolled in these benefits - you are simply requesting more information.

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First and Last Name*
First Last
Seiler Email Address (or your preferred email)*
Hire Date*
MM slash DD slash YYYY
Benefits Available To You
The following benefits will be presented on the next few pages:
1. Medical Insurance
2. Dental and Vision Insurance
3. Group Life Insurance
4. Voluntary Term Life Insurance
5. Short- and Long-term Disability Insurance

Medical Insurance
Seiler offers two Medical Insurance plans.
A High Deductible Health Plan (HDHP) and PPO Plan, both written by Cigna.

The HDHP offers lower monthly premiums, and a higher deductible ($6,000 for single plans and $12,000 for multi-member plans)

The PPO includes higher monthly premiums, and lower deductibles ($3,000 for single plans and $6,000 for multi-member plans)

Check the provider search at Cigna.com to see if your doctor is in network.

*Please note* Enrollees in the HDHP must first disclose any other active medical coverage, including private insurance, other employer insurance, Medicare and Medicaid.
Health Reimbursement Arrangements and Health Savings Accounts
Seiler's Medical Insurance plan includes a Health Reimbursement Arrangement (HRA).

The second half of the deductible will automatically be paid by Cigna and billed to Seiler.

Seiler's HDHP Medical Insurance plan includes a Health Savings Account. (HSA)

Single plans receive a $50 per month contribution into a personal HSA

Multi-member plans receive a $125 per month contribution into a personal HSA.

Please note that the PPO Plan is not eligible for the HSA.
Are you interested in Medical Insurance through Seiler Instrument?*
- Yes, for myself only
- Yes, for myself and my spouse
- Yes, for myself and my child(ren)
- Yes, for myself, my spouse and my child(ren)
- No, not at this time
Which plan are you interested in?*
- High Deductible Health Plan
- PPO Plan
- Unsure
Spouse Coverage
You have reported that you are interested in covering your spouse on the Seiler Instrument Medical Insurance plan.

Please be aware that during enrollment, you will be asked to complete a form asking whether your spouse is working and is offered medical insurance at his/her workplace.

If he/she is offered coverage at his/her workplace, you may be required to pay a surcharge in order to cover your spouse on Seiler's medical plan.
Child(ren) Coverage
You have reported that you are interested in covering your child(ren) on the Seiler Instrument Medical Insurance plan.

Please be aware that Seiler is able to insure your child(ren) until age 26. Once your child reaches age 26, he/she will be removed from the insurance at the end of the calendar year (December 31st).
Waive Coverage - Medical Insurance
You have reported that you are not interested in Medical Insurance at this time.

You will have the opportunity to enroll each winter for an effective date of January 1st.

If you lose other coverage, you may qualify for a special enrollment period during the year.

Medical Insurance Pricing
If you are interested in seeing pricing for medical insurance, please answer EVERY question below. Otherwise, please click 'next'
Who Will Be Covered?
- Myself only
- Myself and my spouse
- Myself and my child(ren)
- Myself, my spouse, and my child(ren)
Is your spouse offered medical insurance at his/her place of work?
- Yes
- No
Will any smokers be covered on the plan?
- Yes, one or more smokers will be covered by my plan
- No, no smokers will be covered by the plan
Weekly Employee Only, NON-SMOKER (HDHP Plan)
Price:
Weekly Employee Only, NON-SMOKER (PPO Plan)
Price:
Weekly Employee Only, SMOKER (HDHP Plan)
Price:
Weekly Employee Only, SMOKER (PPO Plan)
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Weekly Employee and Spouse, SMOKER (HDHP Plan)
Price:
Spouse is not offered coverage at his/her work place
Weekly Employee and Spouse, SMOKER (PPO Plan)
Price:
Spouse is not offered coverage at his/her work place
Weekly Employee and Spouse, NON-SMOKER (HDHP Plan)
Price:
Spouse is not offered coverage at his/her work place
Weekly Employee and Spouse, NON-SMOKER (PPO Plan)
Price:
Spouse is not offered coverage at his/her work place
Weekly Employee and Spouse, NON-SMOKER (HDHP Plan)
Price:
Spouse IS offered coverage at his/her work place
Weekly Employee and Spouse, NON-SMOKER (PPO Plan)
Price:
Spouse IS offered coverage at his/her work place
Weekly Employee and Spouse, SMOKER (HDHP Plan)
Price:
Spouse IS offered coverage at his/her work place
Weekly Employee and Spouse, SMOKER (PPO Plan)
Price:
Spouse IS offered coverage at his/her work place
Weekly Family, SMOKER (HDHP Plan)
Price:
Spouse IS offered coverage at his/her work place
Weekly Family, SMOKER (PPO Plan)
Price:
Spouse IS offered coverage at his/her work place
Weekly Family, NON-SMOKER (HDHP Plan)
Price:
Spouse IS offered coverage at his/her work place
Weekly Family, NON-SMOKER (PPO Plan)
Price:
Spouse IS offered coverage at his/her work place
Weekly Family, NON-SMOKER (HDHP Plan)
Price:
Spouse is not offered coverage at his/her work place
Weekly Family, NON-SMOKER (PPO Plan)
Price:
Spouse is not offered coverage at his/her work place
Weekly Family, SMOKER (HDHP Plan)
Price:
Spouse is not offered coverage at his/her work place
Weekly Family, SMOKER (PPO Plan)
Price:
Spouse is not offered coverage at his/her work place
Weekly Employee and Child(ren), SMOKER (HDHP Plan)
Price:
Weekly Employee and Child(ren), SMOKER (PPO Plan)
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Weekly Employee and Child(ren), NON-SMOKER (HDHP Plan)
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Weekly Employee and Child(ren), NON-SMOKER (PPO Plan)
Price:

Dental Insurance
Seiler's Dental Insurance is through Cigna and is a national network called Cigna DPPO Advantage.

Preventative care is covered 100% and includes:
1. Cleaning every 6 months
2. Fluoride treatments until age 19
3. Oral exams
4. Sealants
5. X-rays

In-network Basic Care is covered at 90%
In-network Major Care is covered at 60%

Check the provider search at Cigna.com to see if your dentist is in network.
Are you interested in Dental Insurance through Seiler Instrument?*
- Yes, for myself only
- Yes, for myself and my spouse
- Yes, for myself and child(ren)
- Yes, for my family including spouse and child(ren)
- No, not at this time
Weekly Dental Pricing - Employee Only
Price:
Weekly Dental Pricing - Employee Plus Spouse
Price:
Weekly Dental Pricing - Employee Plus Child(ren)
Price:
Weekly Dental Pricing - Family
Price:
Child(ren) Coverage - Dental
You have reported that you are interested in covering your child(ren) on the Seiler Instrument Dental Insurance plan.

Please be aware that Seiler is able to insure your child(ren) until age 26. Once your child reaches age 26, he/she will be removed from the insurance at the end of the calendar year.
Waive Coverage - Dental Insurance
You have reported that you are not interested in Dental Insurance at this time.

You will have the opportunity to enroll each winter for an effective date of January 1st.

If you lose other coverage, you may qualify for a special enrollment period during the year.

Vision Insurance
Seiler's Vision Insurance is through Cigna. The network is called Open Access Plus.

Basic Benefits:
1. $10 standard exam
2. $25 for standard, bi-focal, or tri-focal lenses
3. $130 frame allowance, every other year
4. Discounts on laser surgery, contacts, lens coatings, and more

Check the provider search at Cigna.com to see if your vision provider is in network.
Are you interested in Vision Insurance through Seiler Instrument?*
- Yes, for myself only
- Yes, for myself and my spouse
- Yes, for myself and child(ren)
- Yes, for my family including spouse and child(ren)
- No, not at this time
Weekly Vision Pricing - Employee Only
Price:
Weekly Vision Pricing - Employee Plus Spouse
Price:
Weekly Vision Pricing - Employee Plus Child(ren)
Price:
Weekly Vision Pricing - Family
Price:
Child(ren) Coverage - Vision
You have reported that you are interested in covering your child(ren) on the Seiler Instrument Vision Insurance plan.

Please be aware that Seiler is able to insure your child(ren) until age 26. Once your child reaches age 26, he/she will be removed from the insurance at the end of the calendar year.
Waive Coverage - Vision Insurance
You have reported that you are not interested in Vision Insurance at this time.

You will have the opportunity to enroll each winter for an effective date of January 1st.

If you lose other coverage, you may qualify for a special enrollment period during the year.

Group Life Insurance
Through Mutual of Omaha, Seiler provides life insurance to every current employee at no cost.

Each employee is covered by a minimum of $50,000 and designates any beneficiaries of his/her choosing.

Some professional and managerial positions receive more than $50,000 in coverage. In such cases, the employee pays a very minor weekly tax through payroll.
Group Life Insurance - may include minor tax assessment
Price:
Voluntary Term Life Insurance
Through Mutual of Omaha, Seiler offers additional life insurance, at cost, to the employee.

Employees may also choose to cover their spouse and/or dependents.

Voluntary Term Life Insurance rates vary - you will need to see Human Resources for details.
Are you interested in Voluntary Term Life Insurance through Seiler Instrument?*
- Yes, for myself only
- Yes, for myself and my spouse
- Yes, for myself and my child(ren)
- Yes, for myself, my spouse and my child(ren)
- No, not at this time
Voluntary Term Life - Costs Vary, see HR
Price:
Waive Coverage - Voluntary Term Life Insurance
You have reported that you are not interested in Voluntary Term Life Insurance at this time.

You will have the opportunity to enroll each winter for an effective date of January 1st.

However, you may be required to complete a medical questionnaire if you decide to enroll in the future.

Short- And Long-Term Disability Insurance
Through Mutual of Omaha, Seiler offers Short- and Long-term Disability Insurance, at cost, to the employee.

Both Short- and Long-Term Disability Insurance pay 60% of your weekly base earnings (bonuses and commissions are not included in this calculation).

Short-term Disability begins paying after 1 day for an accident and after 8 days for an illness. Payments continue for 13 weeks.

Long-term Disability beings paying after 13 weeks and continues until you are able to return to work, collect social security disability, or collect another form of disability payment.

Premiums for Disability Insurance vary, you will need to see Human Resources for more information.
Are you interested in Short- or Long-Term Disability Insurance through Seiler Instrument?*
- Yes, Short-term Only
- Yes, Long-term Only
- Yes, Both
- No, Not At This Time
Short-term Disability - Costs Vary, see HR
Price:
Long-term Disability - Costs Vary, see HR
Price:
Waive Coverage - Disability Insurance
You have reported that you are not interested in Disability Insurance at this time.

You will have the opportunity to enroll each winter for an effective date of January 1st.

However, you may be required to complete a medical questionnaire if you decide to enroll in the future.

Thanks for taking the time to help us help you!*
Please use the space below to provide some times you are available to meet with/call Human Resources and complete your enrollment paperwork.

We will contact you shortly to confirm an appointment time and to provide you with information regarding the benefits that interest you.
Phone
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