Shielded Horizons | Employee Benefits & Section 125 Digital Enrollment

🛡️ Chroma Benefits & Healthcare Tracks

Active Enrollment Period

Chroma Early Learning Academy • Benefits & Healthcare Tracks

Explore your company-sponsored benefits below. Choose between the Employee Healthcare Track, the Employee Wellness Track, or submit a formal waiver if covered elsewhere.

🏥 Employee Healthcare (Cigna HSA VL 1750)

🌿 Employee Wellness (Apex MEC + $50k Life)

🩺 $0 Copay Telehealth 24/7/365 Virtual Care

✨ Zero SSN Required & No Medical Exam

🏥

Employee Healthcare

Major Medical • HSA Qualified

Cigna HSA VL 1750 Policy • High-Deductible Health Plan + HSA Eligibility

Inpatient Hospitalization • Surgical Care • Emergency Trauma • Specialist Network

Comprehensive group major medical under Chroma's sponsored plan: the Cigna HSA VL 1750 Policy. Features nationwide network access, catastrophic protection, and eligibility for a triple-tax-advantaged Health Savings Account (HSA).

Inpatient Hospitalization & Surgery: Full coverage for inpatient room and board, surgical operations, and intensive care units.

Emergency Room & Trauma: Catastrophic financial protection against severe, unexpected medical emergencies.

$1,750 Deductible (VL 1750 Policy): Structured deductible tier with Cigna national network negotiated discount rates.

Health Savings Account (HSA) Eligible: Qualifies for tax-deductible HSA deposits, providing triple-tax-free savings for eligible healthcare costs.

Specialist Consultations & Diagnostics: In-network access to specialists, MRIs, CT scans, and comprehensive outpatient facilities.

Includes Life & Telehealth: Built-in ManhattanLife $50k Life Insurance and unlimited 24/7 virtual telehealth visits.

View Major Medical Schedule →

🌿

Employee Wellness

Wellness Track • Pre-Tax WIMPER

Critical Care • Apex MEC • ManhattanLife Insurance

100% Covered ACA Preventive Care • $0 Copay 24/7 Virtual Telehealth • Zero SSN Required

Administered under the WIMPER program with pre-tax Section 125 payroll rules. Provides comprehensive clinical preventive healthcare with $0 deductible and $0 copay across the nationwide MultiPlan / PHCS network, paired with $50,000 guaranteed-issue life insurance.

Critical Prevention Care (Apex-MEC™): 100% coverage for 63+ statutory ACA § 2713 preventive health screenings, routine annual physicals, immunizations, and preventive diagnostic labs with $0 copay.

24/7/365 Virtual Telehealth ($0 Copay): Unlimited phone and video consults for you and family members with board-certified physicians anytime from your smartphone.

ManhattanLife $50,000 Life Insurance: 100% guaranteed-issue group term life coverage. Zero health questionnaires, zero medical exams, and zero Social Security Number required.

Women's & Pediatric Health: Well-woman exams, mammograms, pap smears, and pediatric well-child visits at 100% coverage with in-network providers.

Pre-Tax Section 125 Protection: Wellness contributions are processed pre-tax under Section 125 cafeteria plan rules, lowering your taxable gross earnings.

Prescription Discount Program: Up to 85% savings on FDA-approved generic medications at 65,000+ national retail pharmacies.

View Preventive Care Schedule →

✋

Waiver and Declaration Protocol

Declination Track

Formal Declination of Group Coverage • For Staff with Outside Healthcare

Zero Payroll Deduction • Preserves Healthcare.gov Individual Subsidies

If you already have healthcare coverage (through a spouse, parent, Medicare, Medicaid, or an individual ACA exchange policy), you can submit a pressure-free digital declination.

⚠️ Protect Your ACA Subsidies: If you currently receive federal premium tax credits on Healthcare.gov, enrolling in employer group coverage can reduce or disqualify your subsidy. Choosing Waiver and Declaration protects your outside subsidized plan!

Preserves Marketplace Tax Credits: Keeps your existing individual exchange policy active without disruption.

30-Day Qualifying Life Event Rights: You retain the legal right to enroll within 30 days if outside coverage terminates.

Retains 30-Day QLE Re-enrollment Rights

📅 Need 1-on-1 Guidance Choosing Your Plan?

Schedule a private 15-minute consultation with Licensed Benefits Advisor Robert Hill to review your specific family needs and benefit tracks.

👔 Director Robert Hill • GA Lic. #19559059 • NPN #839439

(470) 658-3185

Digital Enrollment & Waiver

Complete your election in under 60 seconds. Zero SSN required.

1. Employee Identification

First Name *

Last Name *

Date of Birth * Used strictly for census matching against payroll.

Gender *

Email Address *

Mobile Phone *

Home Zip Code *

Campus / School Location *

Check here if you are currently enrolled in Medicare or Medicaid.
Default is unchecked. Used for coordination of benefits and underwriting guidelines. Does not disqualify you from any benefits.

2. Benefit Plan Election

Track 1: Employee Healthcare — Cigna HSA VL 1750 Comprehensive Major Medical Major Medical • HSA Eligible

Chroma's new group major medical: Cigna HSA VL 1750 HDHP ($1,750 deductible), triple-tax-advantaged HSA eligibility, inpatient hospitalization, surgery, emergency trauma, specialist care + $50,000 Life Insurance.

View Major Medical Coverage Scope ▼

Comprehensive Carrier Coverage:

Inpatient Hospitalization, Surgery & Emergency Room Care
$1,750 Deductible (VL 1750 Policy) with Cigna negotiated discount rates
Health Savings Account (HSA) Eligible with triple-tax-free savings
Specialist Care, Outpatient Clinics, Advanced Diagnostics & Physical Therapy
Includes 100% ACA Preventive Care, ManhattanLife $50,000 Life Insurance, and 24/7 Virtual Telehealth

Track 2: Employee Wellness — Critical Care (Apex MEC) + ManhattanLife $50K Pre-Tax WIMPER • $0 Copay

100% covered ACA § 2713 preventive health screenings, clinical wellness physicals, $0 copay 24/7 virtual telehealth, and $50,000 Guaranteed-Issue Life Insurance with zero medical exams and zero SSN required.

View Included Clinical Preventive & Life Benefits ▼

Complete Clinical Preventive & Insurance Stack:

Critical Care (Apex MEC): 100% coverage for 63+ statutory preventive health screenings, routine annual physicals, immunizations, and preventive diagnostic labs through the nationwide MultiPlan PHCS network with $0 out-of-pocket employee copays.
ManhattanLife $50,000 Group Term Life: 100% Guaranteed Issue (ages 18–69), zero health questions, zero exams, portable coverage under IRC Section 79.
24/7/365 Virtual Telehealth ($0 Copay): Unlimited phone and video consults for you and family members with board-certified physicians anytime from your smartphone.
Pre-Tax Section 125 Protection: Contributions processed pre-tax under Section 125 cafeteria plan rules, lowering taxable gross pay.

*Clinical preventive services administered in compliance with ACA § 2713 via MultiPlan PHCS Network. Life insurance underwritten by ManhattanLife Insurance Company.

Track 3: Waiver and Declaration Protocol Declination Track

I formally decline participation in company-sponsored benefits at this time. Preserves outside individual exchange subsidies (Healthcare.gov) and maintains legal 30-day Qualifying Life Event (QLE) re-enrollment rights.

🛡️ PRIMARY BENEFICIARY DESIGNATION (MANHATTAN LIFE $50,000 LIFE)

IRC § 79 Statutory

Designate the primary person who will receive your $50,000 guaranteed-issue life insurance benefit. You may update this designation anytime through HR.

Beneficiary Full Legal Name *

Relationship to You *

Beneficiary Mobile Phone *

Beneficiary Email Address (Optional)

*Allocation: Primary Beneficiary receives 100% of proceeds. Contingent beneficiaries may be designated via HR.

Coverage Tier *

3. Authorization & Submission

Annual Wellness Activity Agreement (42 U.S.C. § 300gg-4(j)(3)(c)):
I agree to participate in the plan's annual participatory wellness activity (such as completing an annual confidential online health assessment or an annual preventive wellness consultation through Apex-MEC) to maintain my tax-free SIMRP benefit reimbursement status under IRC Section 105(b).

Electronic Signature (Type Full Legal Name) *

I acknowledge that I have watched or reviewed the 3-minute explanation, and hereby confirm my benefit election or waiver under IRS Section 125 regulations.

Securely encrypted • Processed via Shielded Horizons Autonomous Gateway

Choose Your Health Coverage & Pre-Tax Paycheck Protection

Employee Healthcare

Employee Wellness

Waiver and Declaration Protocol

📅 Need 1-on-1 Guidance Choosing Your Plan?

Digital Enrollment & Waiver

Enrollment Confirmed!

📅 Schedule 1-on-1 Benefits Consultation