Insurance Frequently Asked Questions for McHall Management

Who is eligible for medical benefits?

Medical benefits are available for any employee that is reasonably expected to work 30 or more hours per week. If it cannot be determined at the time of hire if you will regularly work more than 30 hours a week, then we will measure your hours over a 48-week period to determine your eligibility. Your number of hours worked will be re-evaluated every year, so your eligibility one year does not automatically qualify you or disqualify you for subsequent years.

Who is eligible for supplemental benefits?

Supplemental benefits are available for any employee that works 5 or more hours per week. Supplemental benefits include dental, vision, life insurance, short term disability, long term disability, hospital indemnity, accident insurance, and critical illness insurance.

How much will insurance cost me?

The total cost of the medical premium will be shared by both you and us. The most that can be deducted from your pay is 9.96% of your gross (before-tax) wages for the individual level of "Health Plan 1" and we pay the remaining amount for that plan.

Any additional medical coverage above and beyond the individual level of "Health Plan 1" will be paid for entirely by you. Any supplemental benefits will also be paid entirely by you. This means if you choose a higher medical plan; if you choose to cover your spouse, children, or family; or if you add dental, vision, life insurance, short term disability, long term disability, hospital indemnity, accident insurance, or critical illness insurance - these additional costs will be paid entirely by you.

For some job classifications, we will provide a minimum annual contribution to the total insurance premium. We will provide $1,000 for floor supervisors and certified shift leaders, $2,000 for department leaders, $3,000 for restaurant leaders and primary maintenance, and $5,000 for area supervisors. These amounts will be distributed with an equal portion being applied to every payroll throughout the year.

The best way to determine the cost of the premium for any of the options that you choose is to use our Estimated Contribution Worksheet and current Rate Sheet to calculate the cost.

When do I need to sign up for insurance if I qualify?

If you are a new employee and are reasonably expected to work 30 or more hours per week, your benefits would begin on the first day of the month following the date you were hired. You can enroll up to 60 days before or up to 31 days after this date. If you do not complete your enrollment by the end of the 31 days, you will not be able to enroll for benefits until the annual open enrollment cycle.

If you are a new employee and are not reasonably expected to work 30 or more hours per week, then we will measure your hours over a 48-week period to determine your eligibility. If at the end of the measurement period it was determined that you averaged 30 or more hours per week, your benefits would begin on the first day of the month following the end of the measurement period. You can enroll up to 60 days before or up to 31 days after this date. If you do not complete your enrollment by the end of the 31 days, you will not be able to enroll for benefits until the annual open enrollment cycle.

If you are a current employee, every year prior to open enrollment we will recalculate your average hours worked per week over the previous 52 weeks. If you averaged 30 or more hours per week during this time you will be eligible to sign up or make changes to your benefits during open enrollment which occurs in November through mid-December.

When is open enrollment and who's eligible?

Open enrollment occurs every year in beginning in November.

Before open enrollment begins, we will calculate the average weekly hours worked for all employees over the previous 52 weeks. If you averaged 30 or more hours per week during this time, you will be notified that you are eligible for medical benefits for the upcoming year and will be given instructions on how to enroll and how to make modifications to your coverage if you choose to do so.

Can I make changes to my insurance after I've enrolled?

You can cancel benefits at any time. However, you can only add or change benefits during your original 31-day enrollment window or during the annual open enrollment period; or if you've experienced a qualified life event.

You have the option to voluntarily reduce or cancel your benefit coverage at any time. You do not need a qualifying life event to make this change. Any changes you make will take effect on the first day of the month after your request is processed. For example, if you submit a change on February 13, your updated coverage will begin on March 1.

You may use this option to:

If you cancel or reduce coverage, you will not be able to re-enroll until the next Open Enrollment period unless you experience a qualifying life event.

What is an indemnity plan?

An indemnity plan, also known as a reimbursement plan, is an insurance plan that pays a fixed amount for medical events such as hospitalization, accident or diagnosis of a serious health condition.

Can I cover my family under the supplemental or indemnity benefits?

Yes, all supplemental and indemnity plans have the option to add spouse, child(ren) or family - with the exception of the disability plans. Our disability insurance is only offered to our employees.

What is Hospital Indemnity Insurance?

This benefit pays a cash benefit directly to you, in the event of hospitalization. You may elect either the Low Plan ($100/day benefit) or High Plan ($200/day benefit). You can spend the benefit as you choose to cover medical costs or other living expenses.

What is Accident Insurance?

This benefit pays a cash benefit directly to you in the event you are injured in a covered accident. You may choose from the Low Plan or High Plan, with the High Plan offering a greater benefit payment amount. You can spend the benefit as you choose to cover medical costs, physical therapy, rent/mortgage and other living expenses.

What is Critical Illness Insurance?

This benefit pays a cash benefit directly to you in the event you are diagnosed with cancer, heart disease, stroke, or other serious conditions. You can choose either the $10,000 plan ($5,000 for Spouse and Child(ren)) or $20,000 plan ($10,000 for Spouse and Child(ren)). You can spend the benefit as you choose to cover medical costs, groceries and other living expenses.

Do the Indemnity Plans get paid straight to a provider or hospital for my Medical bills?

No, they are paid directly to you and you chose how to spend the reimbursement.

What if I've had a life event such as marriage or birth of a child?

If you've experienced a qualified life event, you will have 31 days from the event to submit an enrollment/change form along with the proof of the lifestyle change.

Some qualifying life events include:

What happens if I receive a promotion?

If you are offered a promotion, regardless if you were previously a part-time or full-time employee, and will be resonably expected to work 30 or more hours per week, you will be eligible to enroll for benefits starting on the date that you receive your promotion. You will have 31 days to enroll in benefits which will become effective beginning on the first day of the following month.

What happens if my hours change in my current position from part-time to full-time status?

If you are a new employee that is still in your 48-week measurement period and will now be reasonably expected to work 30 or more hours per week, then you will be offered coverage at the time of the change in availibility with benefits beginning on the first day of the following month.

If you are an ongoing part-time employee, an increase in hours will not change your status to a full-time employee until the next open enrollment period.

What happens if my hours change in my current position from full-time to part-time status?

If you are a new full-time employee, a decrease in hours will not change your status to a part-time employee until a period of 13 months has elapsed from your hire date.

If you are an ongoing full-time employee, a decrease in hours will not change your status to a part-time employee until the next open enrollment period.

What if I leave the organization and then get rehired?

If your break in service is 13 weeks or more, you will be hired as a new employee and will be subject to the same eligibility requirements as a new employee.

Example: If you stopped working on April 1st and were rehired on September 1st, you will be treated as a new employee upon your rehire since your break in service was more than 13 weeks.

If your break in service is less than 13 weeks, you will be treated as an ongoing employee. For full-time employees that were previously enrolled in an insurance plan and are reasonably expected to work 30 or more hours per week, insurance coverage will be offered on your first day back and any previous benefits will be reinstated beginning on the first day of the following month. For variable hour employees whose hours were being measured for a 48-week period, the measurement will continue upon your resumption of service.

You will also be considered a new employee if your break in service is longer than 4 weeks AND the break in service was longer than your period of employment.

Example: If you worked for 3 weeks and left for 5 weeks before coming back, you will be treated as a new employee upon your rehire.

When will my insurance start and end?

All benefits begin on the first day of the month following the date you were hired. All benefits end on the last day of the month in which benefits are cancelled.

Example: If you were hired on April 14th, all benefits would begin on May 1st.

Example: If you are eligible to enroll for benefits during the annual open enrollment period, all benefits will begin on January 1st.

Example: If you cancel your benefits on October 3rd, all benefits and corresponding premiums will continue until October 31st.

What happens if I take a leave of absence and I'm currently enrolled in insurance?

If you are taking FMLA leave, then your benefits will continue on the same terms as if you had continued to work. If you are making additional contributions to the premiums above the minimum required health insurance plan, you will continue to be obligated to do so. You will have to arrange to pay your additional portion of the premiums in order to maintain coverage.

If your leave is not part of FMLA, then we are not required to maintain any health insurance coverage for extended leaves of absence. You can decide if you will continue making the payments to maintain coverage or if you will discontinue benefits.

Who can I contact for additional help?

If you are having difficulty logging into the McD Health & Welfare Plan Website or need help with enrolling, contact the McDonald's Participant Support line at (866) 962-2303.

For all other questions, you can call the Employee Assistance Program at (800) 327-6260.