Culture & Benefits

Our comprehensive benefits program allows you to choose a combination of benefits to best meet your — and your family’s — needs.

  • Health Advocacy & Navigation Services
  • Medical
  • Prescription
  • Dental
  • Vision
  • Life & Accidental Death & Dismemberment
  • Long-Term Care
  • Short-Term & Long-Term Disability
  • Accident, Critical Illness & Hospital Indemnity
  • Identity Theft Protection
  • Pre-Paid Legal Plan
  • Flexible Spending Accounts (FSAs)
  • Health Savings Account (HSA)
  • Income-Eligible Health Reimbursement Account (HRA)
  • Retirement Plans
  • Financial Planning
  • Mortgage Loan Program
  • Wellness
  • Employee Assistance Program
  • Paid & Volunteer Time Off
  • Family-Forming benefits
  • Tuition Reimbursement
  • Travel Assistance

Spousal Advantage Value Incentive (SAVI) Plan

For those who are eligible, SAVI provides you with a unique opportunity to have no out-of-pocket medical costs other than the premium you pay for alternative coverage. If you have access to eligible alternate group medical and prescription drug coverage, SAVI offers 100% coverage with $0 out of pocket for medical. You will be reimbursed for ALL eligible co-pays, co-insurance and deductibles incurred through your alternate medical plan up to the 2024 maximum out-of-pocket limits under the Affordable Care Act ($9,450/single and $18,900/family per year). No premium contribution will be deducted from your Nemours paycheck. You will not be charged the Nemours $300 monthly spousal surcharge if you enroll in SAVI. If you are currently enrolled in the SAVI plan, you are eligible to continue your enrollment into the next plan year. However, you will have to re-enroll using our online benefits system every year.

Please note that the following alternative medical plans are not compatible with SAVI, so you are not eligible if your alternative medical plan is:

  • Medicaid
  • Medicare
  • TRICARE
  • A high-deductible plan with an active HSA contribution (this includes both associate and Nemours contributions)

If you have questions about SAVI, please contact Catilize Health at 877.872.4232, email MERP@catilizehealth.com. You may also reference the SAVI materials available in our Resource Library.

Retirement Plans

Nemours has partnered with Transamerica Retirement Solutions as its record keeper. There is a 403(b) plan for Nemours associates with access to a 457(b) program based on salary requirements.

Full-time, part-time, casual, temporary, and seasonal associates of Nemours are automatically enrolled in the 403(b) plan with a 4% contribution rate. These tax-deferred contributions will begin as soon as administratively possible following 30 days of employment. Associates may opt out of the automatic enrollment or change their contribution rate at any time by contacting Transamerica Retirement Solutions at 800.755.5801 or visit Transamerica.com/portal.

Whether you are automatically enrolled in the 403(b) plan or you actively enroll in the 457(b) plan, please make sure you designate a beneficiary for your account. Taking this step in your estate planning will help give you peace of mind and improve your overall financial wellness.

Retirement Readiness Associate Toolkit

Nemours wants to help you be as prepared as possible as you navigate the path toward a successful retirement. The Retirement Readiness Associate Toolkit contains helpful information about the process of preparing for retirement, as well as checklists, contact lists, resources and frequently asked questions. This toolkit is a first step for you to review as you contemplate retirement.

Paid Time Off (PTO)

Full-time and part-time associates working at least 20 hours per week accrue PTO each pay period, according to position and length of service. For example, full-time associates (40 scheduled hours per week) with less than five completed years of service accrue 25 PTO days. You may carry time over from year to year, however, once the maximum or cap is reached, additional accruals stop until time is used. New associates are eligible to use PTO after 90 days.

Years of Service Accrual Rate Annual Accrual* Maximum
0 through 5 0.0962 per hour paid/worked 25 days (200 hours) 31 days (248 hours)
6 through 15 0.1116 per hour paid/worked 29 days (232 hours) 36 days (288 hours)
More than 15 0.1231 per hour paid/worked 32 days (256 hours) 40 days (320 hours)

* Annual accrual shown is based on a 1.0 FTE.
Note: PTO accrual schedule and usage eligibility may differ for selected associates, for example physicians and residents.

Nemours also offers an annual PTO Buyback option that allows eligible associates to sell a certain number of unused PTO hours.

Paid Holidays

Full-time and part-time associates receive six holidays per year. There is no waiting period for eligibility. Holidays include: New Year’s Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day and Christmas Day.

Volunteer Time Off (VTO)

Full-time associates who have completed the 90-day evaluation period receive eight hours of paid Volunteer Time Off (VTO) each year to use for community service activities (four hours for part-time associates). Please note: VTO plans may vary for physicians and residents.

Mortgage Loan Benefits

Working with Huntington Bank, Nemours is offering assistance to help you become a successful homeowner. In addition to financial education, you can receive a $300 credit toward your mortgage closing costs.

For more information, contact Rob Jones, Mortgage Sales Leader, Huntington Bank at 847.651.6871, rob.jones@huntington.com or huntington.com/mortgage/jones-robert

Frequently Asked Questions

Medical

Where can I find a list of available doctors/hospitals?

To locate participating providers, go to the “Search for Network Providers” tool at www.benefits4nemours.com. Both the homepage and care page have the provider tool. The provider search will link to Aetna POS II (Red, White or Green plans’ network) or Aetna Select (Blue plan’s network) depending on which plan you are enrolled in. You can also call Quantum Health directly to get help with the provider search.

What fertility benefits are being offered in the medical plans and are they available in all four plans?

Nemours provides comprehensive and inclusive fertility benefits and additional pregnancy and parenting support resources. The benefit design allows you and your doctor to pursue the most effective treatment and provides coverage for two Smart Cycles per lifetime. These fertility benefits are available to associates enrolled in any one of the four medical plans (Red, White, Blue or Green). Benefits are subject to the deductible and co-insurance up to the out-of-pocket maximum.

What if my spouse’s employer offers benefits?

If you are currently enrolled in a Nemours plan but have the opportunity to enroll in your spouse’s plan (non-Nemours), you will want to consider our Spousal Advantage Value Incentive (SAVI) plan. Your premium for SAVI is $0, and it will pay 100% of the out-of-pocket costs incurred from your spouse’s medical plan up to the Affordable Care Act (ACA) maximums (2024 limits are $9,450/single and $18,900/family per year).

Note that SAVI is available if you are a new associate and enroll in alternative coverage (except for Medicaid, Medicare, TRICARE and HSA plans) or if you are a current associate enrolled in a Nemours benefit plan and enroll in alternative coverage with the exceptions previously noted. You must waive your current Nemours medical coverage and enroll in SAVI (action must be taken for you and any applicable dependents). You and your spouse should weigh which plan works best for your circumstances.

What is the spousal surcharge for 2024?

The spousal surcharge for 2024 is $300 per month. This surcharge is applicable only when your spouse has access to medical coverage through his/her/their employer and you decide to cover him/her/them through a Nemours medical plan. If your spouse is not covered by Nemours, there is not a spousal surcharge. Note that the spousal surcharge will continue to be waived if you both work at Nemours. If your spouse has access to medical coverage from his/her/their employer, you can avoid the spousal surcharge and lower your out-of-pocket costs by enrolling in the SAVI plan if eligibility requirements are met. Note that you are required to update the status of your spouse’s coverage availability during annual enrollment.

Which of the plans has the greatest tax advantage?

The Green plan includes a health savings account (HSA). An HSA account offers a triple tax advantage to those who enroll in it. Associates can contribute tax free, earn tax-free interest on their investments and use the funds for eligible medical expenses tax free.

Prescription Drug

How do I participate in the mail order drug plan with Express Scripts?

Refer to information available on the Express Scripts website or contact Quantum Health.

How can I find out if the brand name drug that I am taking has a chemical equivalent?

A listing of chemically equivalent drugs is difficult to maintain because as brand name drugs lose their patents, new chemically equivalent generic drugs are manufactured.

You must register on the Express Scripts website; after doing so, you’ll be able to research your options as well as obtain pricing information. At the top right of your prescription, it shows generic and brand name; you can compare each on the site.

How can I avoid paying the difference in cost between a brand name drug and a chemically equivalent generic drug?

You may ask your doctor to circle “Substitution Allowed” on the prescription that he/she/they writes for you. By law, your pharmacist may only substitute a chemically equivalent generic if your doctor has circled “Substitution Allowed” rather than “Dispense as Written.”

There are certain exclusions to this rule as mandated by state law.

The brand name drug I am taking has a chemically equivalent generic drug available. I’ve tried the generic, and I had a bad reaction to the drug. What can I do?

Your physician may file an appeal with Express Scripts. They may provide you with a prior authorization that will allow you to fill your prescription without having to pay the difference in cost.

I use mail order for my prescription drugs. Will the Generics Preferred Program apply to my mail order medications?

Yes, this program will apply to mail order.

How will I be notified by Express Scripts if the cost of my mail order medication increases?

If Express Scripts does not have a credit card on file for you, they will notify you if your order exceeds $150. If Express Scripts has a credit card on file for you, they will notify you if your order exceeds $500.

What happens if my doctor’s request for a prior authorization is denied?

Our pharmacy benefit plan’s guidelines exclude certain drugs from coverage. To learn more about what drugs are excluded under our plan, look in your plan summary.

For a copy of the criteria our plan uses to decide which prior authorizations will be covered, call Quantum Health at 866.920.1929. A representative can send you a copy of the criteria.

OR

If you want to file an appeal to have your prescription drug covered, our plan has an appeals process. Please reach out to Quantum Health to help with appeals.

Dental

What is a participating dentist and how do I locate one?

A general dentist or specialist who meets strict credentialing standards and accepts scheduled fees as payment-in-full for services rendered. To get a list of participating dentists, contact Quantum Health at 866.920.1929 or go to Delta Dental’s online provider search.

How does the Passive PPO Work?

With our plans, you receive a wide range of benefits whether or not you and/or each eligible dependent visit a participating dentist. But, when you visit a participating dentist (an “in-network dentist”), you have the opportunity to make the most of your benefit plan through access to lower out-of-pocket expenses. Out-of-network dental providers can balance bill.

Can I find out how much services will cost and what will be covered prior to treatment?

Delta Dental strongly recommends that you have a dentist submit a pre-treatment estimate for services in excess of $300. While you wait, your dentist can get a real-time pre-treatment estimate online or over the phone in minutes detailing what services the plan will cover and at what payment level. PPO plans pay for the least expensive clinically appropriate course of treatment. Therefore, licensed dental consultants review certain services such as crowns, bridges and periodontics for appropriateness and necessity.

Do I need an ID card?

No, you do not need to present an ID card to prove coverage or confirm that you are eligible. However, Delta Dental does issue ID cards to help identify you as a member of the Nemours Delta Dental program.

How are composite fillings covered?

Composite (or tooth-colored) fillings on posterior teeth are considered an optional service. If you receive an optional service when the alternate benefit of amalgam (silver) fillings are available, Delta Dental will base the benefit on the lower cost of the amalgam filling. Members will be responsible for the difference in cost.

Voluntary Vision

Do I need an ID Card?

No, you do not need to present an ID card to prove coverage or confirm that you are eligible. Identify yourself as a VSP member to your eye care provider.

What will be covered through this benefit?

This vision benefit provides added discounts when services are sought through the preferred provider listing. See the summary of vision care benefits.

What providers are considered in-network?

For the most part, VSP only contracts with private ophthalmologists or optometrists. Most major eye care chains, such as Lenscrafters and Sears Vision are NOT covered as in-network providers by VSP because they do not meet VSP’s quality assurance standards.

However, many of these chains will provide discounts for their eyewear if you identify yourself as a VSP member.

Please note that changes in network status can occur at any time. Check with your provider prior to your next appointment.

My eye care provider is out-of-network. How do I get reimbursed for my expenses?

An out-of-network claim form is available from VSP. To access, click here.

Are my contact lenses “elective” or “necessary”?

If your contact lenses are considered medically necessary (in other words, you can’t wear glasses), they will be reimbursed at 100%.

If you have the option of wearing glasses or contacts, your contact lenses are considered “elective,” and your allowance will be determined by the plan you elect.

What should I do if I need both glasses and contact lenses?

Frames may only be reimbursed one year after filling a prescription for contact lenses. Therefore, we recommend that you fill your prescription for glasses and lenses FIRST, and then, in the following calendar year, fill a prescription for contact lenses.

Contact lenses/glasses lenses are considered interchangeable, so you may EITHER receive your allowance for lenses or for contacts in any given calendar year.

Are disposable contact lenses covered under this plan?

Yes. You may use your elective contact lens allowance toward disposable contact lenses. Use your full allowance at one time as there is no banking this benefit for future use in the same calendar year. Thereafter, you may be eligible for discounts on your disposable lenses.

Are polycarbonate or bicarbonate lenses covered for adults?

Charges for polycarbonate or bicarbonate lenses are not covered under the normal lens co-pay. However, you may elect to pay the extra charge for poly- or bicarbonate lenses.

Term Life Insurance and Accidental Death & Dismemberment

Describe your Evidence of Insurability (EOI) requirements. When would evidence be required (e.g., with change in election, when a salary increase causes an increase in benefit, after initial approval)? How often is EOI required?

EOI is needed for anyone applying for amounts above the guaranteed issue limit, anyone applying after the eligible enrollment period or anyone wanting to increase coverage. This applies to both employee and spouse coverage. We also require EOI when the person does not elect coverage initially.

Disability

What is the most common cause of disability claims delays?

The most common reason that a long-term disability claim is delayed is that the claim form is not complete. To most effectively ensure the processing of a claim, check to be sure that all questions on the form are answered, the policy number is on the form and that the employer portion is completed by the HR Solutions Call Center.

Flexible Spending Accounts

What records do I keep for tax purposes?

Keep receipts for at least a year; the IRS requires auditing of certain debit card transactions. See the FSA debit card section for more information.

Can I use the health care FSA to pay for my spouse’s deductibles and/or co-payments if they are not covered by my group medical plan?

Yes. However, health care premiums deducted from your spouse’s paycheck and premiums for individual insurance policies are not eligible.

To what age may I use the dependent care FSA for daycare expenses incurred for my child?

You may submit expenses incurred for your dependent child before his/her/their 13th birthday, or longer if disabled.

Are expenses for before/after school programs considered eligible expenses?

Yes, but you must separate the cost of such care from the cost of the school. In other words, only the cost of care is covered, not the cost of school.

Are over-the-counter (OTC) medications covered?

Yes, OTC medications and supplies are eligible expenses.

IMPORTANT NOTE FOR DIRECT DEPOSIT OF REIMBURSEMENTS: Each individual bank has its own rules as to when it processes the direct deposit payments it receives. Associates should consult with their bank for details.

Other FAQs

Termination of Employment

What happens to my benefits if I terminate employment with Nemours?

Your benefits options vary depending on what you had in force prior to your termination. Different benefits have different continuation options. For example, medical, dental, vision and health care FSAs may be continued for specified periods of time through COBRA. Term life insurance may be ported or converted, and long-term care may be taken with you at exactly the same rates that you currently pay.

There are limits to the amount of time that you have to make elections to continue terminated coverage. You may find a detailed listing of benefits available upon termination (and information about those benefits) in the Termination of Benefits Summary.

How will my dependent child(ren)’s coverage be impacted by a status change or termination of employment?

Nemours provides coverage for your eligible dependent child(ren) until the end of the month during which they turn 26. You should be aware of how their benefits are impacted by certain circumstances such as turning 26. If you terminate employment with Nemours and are enrolled in COBRA-eligible benefits, you are and your covered dependent children are eligible for COBRA. The COBRA options available to your dependents may vary depending on your status as an active employee (whether you are full-time or part-time), and your dependent’s age as of termination.