To Learn More, visit MyVersantBenefits.com

Transcription

1 To Learn More, visit MyVersantBenefits.com

2 TABLE OF CONTENTS Look for the Different Colors at the top of each page to Designate the Section you are Viewing Introduction... 3 Enrollment Process... 4 Open Enrollment Instructions... 5 Changes for the Year... 6 MyVersantBenefits.com... 7 Medical Plan OptiMed GAP Plan Dental Plan Vision Plan Supplemental Plans Hospital Income Plan Critical Illness Plan Term Life, Optional Life, Dependent Life Plans Disability Coverage Plans Rates Legal Notices Affordable Care Act Update Important Phone Numbers Every reasonable effort has been made for the information provided in this booklet to be accurate. It is intended to provide the employees with Versant Supply Chain an overview of the coverages offered. It is in no way a guarantee or offer of coverage. Each carrier has the ability to underwrite based on its contract with Versant Supply Chain or its employees. Each carrier s contract, underwriting, and policies will supersede this document. Please be aware that each carrier may have exclusions or limitations and you must consult your summary plan description and/or policies for details. 2 To Learn More, visit MyVersantBenefits.com

3 Your Versant Supply Chain, Inc. Benefits Package Versant Supply Chain, Inc. takes pride in providing our employees with a competitive, affordable benefit package. Employees enjoy favorable purchasing power due to negotiated discounts as well as a company contribution towards your healthcare coverage. In addition, our Cafeteria Plan allows our employees to pay for certain benefit plans with pre-tax dollars. All of our benefit programs are designed to work cohesively to protect you and your family from catastrophic losses. Keeping our annual healthcare increases year-over-year to a minimum takes a joint effort. We depend on our employees to become educated healthcare consumers and to spend your health care dollars wisely. Visit your primary care physician annually and take advantage of the no cost to you preventive screenings included in all of our medical plan options. When medical tests or surgical procedures are recommended, use United Healthcare s on-line quality and cost comparison tools. This will reduce your out-of-pocket expenses and helps manage the cost to the plan. Full-time benefit eligible employees have an annual opportunity to review your benefit option selections and make any changes in your plan selections. During this annual open enrollment period you can have a one-on-one meeting with an Enrollment Counselor to discuss your personal benefit needs for the upcoming new plan year (6/1/15-5/31/16). If you re confused about putting together a benefit package, this personalized meeting can be a valuable resource for you. Your Benefit Options Medical Plan: 2 choices in medical plans Bronze and Silver. Gap Plan: To aid you with meeting your medical expenses. Dental Plan: Plan covers routine annual cleanings and x-rays at no cost to you. Vision Plan: Save money on eye examinations & materials Hospital Income Plan - Concerned about hospital bills? Critical Illness Plan - What can living with a Critical Illness mean to you? Term Life Insurance - For you and your dependents. Take care of those you love. Disability Coverage - Protect your paycheck. When Does My Coverage Begin as a Full Time Employee? Exempt Employees 1st of the month following 30 days of employment Hourly Employees 1st of the month following 60 days of employment To Learn More, visit MyVersantBenefits.com 3

4 ENROLLMENT PROCESS ENROLLMENT SESSIONS Why is it important to meet with an enrollment counselor during open enrollment? To review and verify your current and upcoming elections and payroll deductions. Has your life changed in the last year? How has it changed? It is important to take a look at your selections and adjust them accordingly to fit your needs and that of your family. To see how much Versant Supply Chain is contributing to your benefits package. Versant values you as an employee and invests many dollars towards your benefits. Benefits are a substantial part of your overall compensation package. To update your beneficiaries. While beneficiary changes can be made outside of open enrollment, open enrollment is a good time to reflect on changes that you may have had throughout the year and determine if you need to make a change. Confirm that your contact information is correct and up-to-date. To enroll in the Hospital Income, Critical Illness or Short Term Disability coverage, you must meet with an enrollment counselor. Enrollment Counselors can help provide you with a better understanding of your benefits and options. ADDING DEPENDENTS If you are adding dependents to the medical, dental or vision plans for the first time during this open enrollment you must present the following verification documentation to your Human Resources Department immediately following your enrollment. If proper documentation is not provided by your effective date of coverage under the plan, these newly added dependents will not be enrolled for coverage during the new plan year unless you experience a change in family status or other specific change event. Dependent Required Documentation Spouse Natural Children Step-Children Dependent Child(ren): Legal guardian, adoption or foster Marriage License & first page of your most recent joint tax return. (financials should be blackened out) Birth Certificate Birth Certificate and Marriage License showing both parent s names Birth Certificate, Final Court Order of legal guardianship with judge s signature and/or final adoption decree with judge s signature 4 To Learn More, visit MyVersantBenefits.com

5 2015 Open Enrollment OPEN ENROLLMENT INSTRUCTIONS This year s open enrollment period will be an ACTIVE enrollment. What does an Active Enrollment mean? You will be required to review and make new benefit elections in order to be covered under the benefit plans offered by Versant Supply Chain. Current elections will not rollover to the new plans or rates. As part of the Active Enrollment process, you will be required to review and update dependent and beneficiary information. Please have your dependent dates of birth and social security numbers handy at time of enrollment. BenefitHelp will be facilitating you individual one-on-one enrollments with the use of experienced Benefit Counselors. Enrolling is easy. Just follow the steps outlined below Schedule your One-on-One Enrollment Meeting Meet with Enrollment Counselor to Review Benefit Offerings Enroll through ebencom with Assistance of Enrollment Counselor You must participate in the enrollment process. You will be notified by your Human Resources Department of the dates and times of the one-on-one enrollment sessions with a BenefitHelp Enrollment Counselor. During your one-on-one enrollment meeting your Enrollment Counselor will: Assist you with using the BenefitHelp ebencom enrollment system. Explain the benefit offerings and answer questions. At the end of your enrollment session, you will be provided with a benefit confirmation and an enrollment survey. Your feedback is important to us so please tell us how we are doing. To Learn More, visit MyVersantBenefits.com 5

6 CHANGES FOR THE YEAR Benefit Plan Changes Effective June 1, Your current medical plan options through BCBS of Tennessee will be replaced with United Healthcare effective June 1, You must either select a United Healthcare plan or waive coverage during this open enrollment. 2 The current dental plan through MetLife will end May 31, Mutual of Omaha will be the new Dental provider effective June 1, Plan design will remain the same, however your provider network may change. 3 The current vision plan through MetLife is being replaced with United Healthcare. Just as with the dental plan, you will need to review the provider network to determine if your current eye health provider is in the United Healthcare Network. 4 Colonial Life will replacing Allstate Benefits as the supplemental coverage provider. Colonial Life was selected for their enhanced benefits and competitive pricing. You may purchase Hospital Income, Critical Illness (with or without cancer coverage) and Short Term Disability coverage with minimal underwriting questions. Allstate Benefit premiums will no longer be payroll deducted as of June 1, Need Help with Enrollment? Contact BenefitHelp at option #2 or service@benefithelp.com for assistance. 6 To Learn More, visit MyVersantBenefits.com

7 MyVersantBenefits.com Watch Videos About Your Benefits. Get Important Phone Numbers & Carrier Information. Search for a Doctor or Dentist Print Important Documents & Forms Have you ever had trouble locating information about your benefits? What about trying to remember how to find a participating doctor or dentist? Problem Solved! It s All Online... One place to go, just an internet connection away. To Learn More, visit MyVersantBenefits.com 7

8 MEDICAL OVERVIEW To fit your specific needs, your benefit package provides you with two options in medical plans. The plan with the lowest deductible has the highest payroll deduction. The plan with the highest deductible has the lowest payroll deduction. Both plans cover the same services, just with different point of service cost. It s up to you to take advantage of everything your health plan offers. To choose the plan that is right for you ask yourself the questions that will help you assess your needs. Think about the ways you use healthcare, the medical needs you can foresee, and how you can balance cost and coverage. To locate a provider or to review the policy details, please visit: Network is Choice Plus Terms and Definitions Deductible This is the amount of money you pay for health services before your medical Insurance begins paying. For some services you have to pay the deductible before the plan pays. Your deductible starts over each January 1 st. Copay This is the amount of money that you pay each time a particular service is utilized. Coinsurance This is the rate that you will essentially be splitting the cost of your healthcare with your insurance provider. For instance, if your health plan has an 80/20 coinsurance rate, your insurance plan pays for 80% of your eligible medical expenses and you re responsible for the remaining 20%. Out-of-pocket Coinsurance Maximum This is the most you will have to pay under your medical plan each year. Includes copays, deductible & coinsurance. This protects you from the financial drain of high medical expenses. Copays do count towards your out-of-pocket maximum and still apply after you meet your maximum. In-Network / Out-of-Network If your medical plan has in and out coverage, this means you can see any provider you wish. However, if you choose to see a provider that is not on the approved in-network list, you will pay a greater share of the cost. Determining whether or not a provider is in-network is your responsibility. Please check with the provider to see if he or she is in the network. before services are rendered, preferably when making the appointment. 8 To Learn More, visit MyVersantBenefits.com

9 Rates Page 22 MEDICAL PLANS Pick the medical plan that best fits your needs... VERSANT SUPPLY CHAIN UNITED HEALTHCARE MEDICAL PLANS (in network benefits) Bronze Plan Silver Plan Physician Office Visit Deductible & Coinsurance $ 25 copay Specialist Office Visit Deductible & Coinsurance $ 50 copay Wellness Benefit (age appropriate screenings apply) 100% Coverage (No Deductible or Coinsurance, No Annual Maximum if in-network) 100% Coverage (No Deductible or Coinsurance, No Annual Maximum if in-network) Urgent Care Center Deductible & Coinsurance $ 75 copay Emergency Room Visit Deductible & Coinsurance $ 250 copay Annual Deductible $ 5,000 Single $ 10,000 Family $ 2,500 Single $ 5,000 Family Coinsurance 80% coverage after deductible 80% coverage after deductible Annual Out-of-Pocket Maximum (Includes Copays, Deductibles and Coinsurance) $ 6,400 Single $ 12,800 Family $ 5,000 Single $ 10,000 Family Need HELP meeting your out of pocket expenses? Find out how supplemental plans can help you on pages To Learn More, visit MyVersantBenefits.com 9

10 PRESCRIPTION DRUG COVERAGE Drugs on the United HealthCare Drug List/Formulary are grouped by tiers. A number of factors are considered when classifying drugs into tiers, including, but not limited to: the absolute cost of the drug; the cost of the drug relative to other drugs in the same therapeutic class; the availability of over-the-counter alternatives; and other clinical and cost-effectiveness factors. To View the United HealthCare Drug List, visit RETAIL PHARMACY MAIL ORDER PHARMACY 31 Day Supply Bronze Plan Silver Plan 90 Day Supply Bronze Plan Silver Plan Tier 1 Deductible & Coinsurance $ 10 Copay Tier 1 Deductible & Coinsurance $ 25 Copay Tier 2 Deductible & Coinsurance $ 35 Copay Tier 2 Deductible & Coinsurance $ Copay Tier 3 Deductible & Coinsurance $ 60 Copay Tier 3 Deductible & Coinsurance $ 150 Copay 10 To Learn More, visit MyVersantBenefits.com

11 Rates Page 22 OPTIMED GAP PLAN To help cover your medical expenses, you are provided with a GAP plan through OptiMed. Whenever you receive medical services you may submit a claim to OptiMed for the amounts not reimbursed by your medical plan. OptiMed in turn will pay up to the plan maximums for Inpatient and Outpatient services. All employees enrolled in the medical plan are provided with a GAP plan that will pay up to $2,500 for Inpatient services and $1,250 for outpatient services (excluding doctor s office co-payments and prescription drugs). Employee only coverage is provided at no cost to you. You may opt to purchase this coverage for your covered dependents as well. You also have the option to enhance your coverage under the OptiMed Gap Plan. The enhanced option would provide up to a $5,000 reimbursement for Inpatient services and $2,500 for outpatient services. The cost for this plan is deducted from your paycheck. Telephonic Doctor Visits and Patient Advocacy Services On-Call Tele Consult: Speak with a licensed physician 24 hours a day, 7 days a week via telephone for non-emergent medical conditions. By Priority Appointment Tele-Consult: Schedule a time to speak with a doctor for a comprehensive consultation. Call back time within an hour. E-Consult: Securely a doctor with your sensitive medical issues. Doctor response time is within 24 hours. Consider using the service for non-emergent medical issues, after-hours, on weekends and holiday or when your primary care physician is not available, when you require medial care and advice without taking the time off work, or while traveling. To Learn More, visit MyVersantBenefits.com 11

12 DENTAL PLAN Rates Page 22 Versant Supply Chain offers dental protection through Mutual of Omaha. With Mutual of Omaha you can receive care from any dentist. However, Mutual of Omaha has contracts with a large network of dentists who have agreed not to charge more than a specified amount for particular services. If you use one of these network dentists, you won t have to worry about being charged for additional amounts above the allowable amount covered by the plan. Preventive Services Oral exams, X-Ray, Cleanings, Brush Biopsy, Topical fluoride, Space maintainers, Sealants 100% Coverage Basic Services - 6 month waiting period Emergency Treatment, Periodontal Maintenance, Fillings, Stainless Steel Crowns, Extractions, Oral Surgery, General Anesthesia, Periodontics 80% Coverage Major Services - 24 month waiting period Endodontics, Full or Partial Removable Dentures, Bridgework, Crowns, Inlays, Onlays, Endosteal Implants 50% Coverage Orthodontia Services - 24 month waiting period For Dependent Child(ren) 50% Coverage Plan Deductible and Maximums Deductible $50 Benefit Maximum $1,250 Orthodontic Lifetime Maximum $1, To Learn More, visit MyVersantBenefits.com

13 Rates Page 22 VISION PLAN Under the United Healthcare Vision Plan you may receive care from any vision care provider. However, UHC has an extensive nationwide network of doctors who provide eye care and eye wear. When you receive care through these vision care providers, you simply pay the appropriate co-payment. If you visit an out-of-network provider, be aware that your out-ofnetwork benefits do not guarantee full payment. Examination Copayment $10 Material Copayment $20 Frames $0 Copayment, up to $130 allowance 20% off balance over allowance Eyeglass Lenses (Includes coverage for standard single vision, bifocal and trifocal lenses) Covered in Full after material copayment (Standard scratch-resistant coating is covered in full. Other optional lens upgrades may be offered at a discount. Discount varies by provider.) Elective Contact Lenses (in lieu of eyeglass benefit) The fitting/evaluation fees, contact lenses, and up to two follow-up visits are covered in full (after copay). If you choose disposable contacts, up to 4 boxes are included when obtained from a network provider. A $125 allowance is applied toward the fitting/ evaluation fees and purchase of contact lenses outside the covered selection. Toric, gas permeable and bifocal contact lenses are example of contact lenses that are outside of the covered contacts. Medically Necessary Contact Lenses (in lieu of eyeglass benefit) No copayment Prior authorization required Benefit Frequency (based on plan year) Vision Exam Eyeglass Lenses Frames Contact Lens Allowance Every 12 months Every 12 months Every 24 months Every 12 months To Learn More, visit MyVersantBenefits.com 13

14 SUPPLEMENTAL PLANS HOW TO FILE CLAIMS GO TO PAGE 23 What exactly are Supplemental Benefits and how can they benefit you? Basically, Supplemental Benefits can help protect your health and savings. What would happen to you if you had a medical catastrophe that you could not afford? When this happens, enormous bills and expenses can add up fast. If you were in the hospital for a few weeks or more, would you have enough money to cover your other expenses that your insurance would not? You may not be able to earn a living which could be devastating. How would you be able to support yourself or your family? The cost of financial misfortune can escalate fast. In fact, recent research shows that medical bills contributed to over 60% of all bankruptcies. But what can you do now to help prevent a crisis? One way is through supplemental benefit plans. Supplemental benefits provide cash directly to you to use as you need it. The amount of cash you would receive and how it is paid out depends on the specific supplemental plan or policy you select. Only you can decide if a supplemental plan is right for you. Some things to consider when deciding if you need supplemental coverage are your health risk factors, your savings, and how much coverage you can afford. Let s take a look at some of the plans available to you. How much does it cost? The per day cost is less than you think... Hospital Income Critical Illness Plan Less than a Postage Stamp Less than a Cup of Coffee 14 To Learn More, visit MyVersantBenefits.com

15 Rates Page 23 HOSPITAL INCOME Concerned about hospital bills? Plans Available from $0.27 / Day What is the need? Colonial Life s Hospital Income Plan helps you fill the gaps when you have unexpected health care expenses. It pays a benefit for each covered hospital confinement. What are the key features? Benefits are paid directly to you. You can take it with you if you change jobs. Coverage is available for you, your spouse and your family. What plans are available? Most Major Medical Plans cover only 38% of direct costs. Choose from a $500 or a $1500 Hospital Confinement Benefit Includes a $50 Wellness Benefit How it Works? Ben elected during his open enrollment period Plan Option 1 Medical and a $1500 Hospital Income Plan. Some time later, he was hospitalized. Ben incurred expenses for services incurred while in the hospital and reached his out of pocket maximum. With Hospital Income Coverage, Ben received $1500 paid directly to him to help with his out of pocket expenses. BILLS When individual hospital confinement coverage is applied for during the enrollment process, each applicant will be asked to attest (acknowledge) that they are currently covered by health insurance that qualifies as minimum essential coverage as defined by federal law. To Learn More, visit MyVersantBenefits.com 15

16 CRITICAL ILLNESS PLANS Rates Page 23 What can living with a Critical Illness mean to you? Plans Available from $0.11 / Day What is the need? Critical illness benefits help families pay off debts and other expenses not covered by medical insurance such as loss of income, childcare services, and travel to treatment centers. What are the key features? With critical illness coverage, employees receive a lump sum benefit after a serious condition such as a heart attack, stroke, coronary artery disease, or cancer occurs. Every 40 seconds, on average, someone in the United States has a stroke. -American Heart Association You can take it with you if you change jobs. Coverage is available for you and your family members. What plans are available? You select the amount of coverage that best meets your needs from $5,000 to $50,000 in coverage. How it Works... John chooses to enroll in a $20,000 Critical Illness plan during his annual enrollment. Some time later, John suffers a heart attack. His prognosis is good and he is expected to make a full recovery. However, John is unable to work during his recovery period and bills continue to pile up. BILLS John can focus on his recovery without worry, because John has a Critical Illness Policy paying him a $20,000 benefit. 16 To Learn More, visit MyVersantBenefits.com

17 TERM LIFE AND AD&D TERM LIFE AND AD&D Versant Supply Chain, Inc provides an employee benefits program that is intended to protect you and your family from catastrophic financial losses. As an employee, you will receive company paid life insurance and AD&D in the amount of $25,000. Coverage is provided through Mutual of Omaha Who depends on you? Term life insurance can help you take care of those you love. How much life insurance do you need? To Learn More, visit MyVersantBenefits.com 17

18 OPTIONAL TERM LIFE Rates Page 24 You have the opportunity to purchase additional life coverage for yourself and your dependents at your expense. How Much Coverage Can You Buy? Employee: You may purchase additional term life insurance in $25,000 increments to a maximum of $300,000 or 5x your annual salary, whichever is greater. Spouse: You may purchase term life insurance for your spouse in increments of $12,500. Coverage for your spouse cannot exceed 50% of the amount that you elect for yourself or $50,000. Coverage for your spouse ends at the age of 70. You must have coverage for yourself under the optional term life plan to have coverage for your spouse. Child/Children: Life insurance coverage for your dependent child(ren) is available in increments of $2,500. Coverage may not exceed 10% of the amount of coverage that you purchase on yourself, to a maximum of $10,000. Guaranteed Issue: Guaranteed issue means that you are guaranteed coverage without having to answer any health questions or provide evidence of good health. Employee: Guaranteed issue up to 5x your annual salary, up to $150,000. Guaranteed Issue for your Spouse is $50,000 and $10,000 for your children. Evidence of Insurability: If you did not elect additional life insurance when you were initially eligible or you are requesting amounts over the Guarantee Issue amount, you will be required to answer health questions on an Evidence of Insurability form. Mutual of Omaha must approve all new applications (following initial eligibility) and coverage amounts above the guarantee issue amount. If you are newly eligible and you elect an amount over Guarantee Issue, you will be covered at the guarantee issue amount until a determination is made by Mutual of Omaha at which point your coverage will increase to the requested amount or will remain at the guarantee issue amount (if denied). In either case, you may receive a request for additional information, if you fail to provide the additional information your application may be denied or in the event of a newly eligible employee you will only be covered for the guarantee issue amount. Reductions in Insurance: By the time you or your spouse reach age 65, chances are that your children will be grown and your mortgage paid. At age 65, providing you are still employed, your coverage will decrease to 65% of the benefit amount. It will decrease to 40% at age 70, 25% at age 75, and 15% at To Learn More, visit MyVersantBenefits.com

19 SHORT & LONG TERM DISABILITY When savings aren t always enough. You and your family rely on your income. But what would happen if you became ill or suffered a serious accident and were unable to work? Who would pay the bills? You may never even think that you could be laid up for an extended period of time. But what if you had a stroke or some other injury that kept you from working? How many months could you continue your standard of living from your savings? The chances of becoming disabled prior to age 65 are 1 in 3, yet the chances of your house burning down are 1 in 1,000. In helping you prepare to meet financial obligations should you face a period of disability, Versant Supply Chain, Inc provides you with Long Term Disability (LTD) coverage and provides the option to purchase Short Term Disability (STD) insurance at competitive rates. Who s at risk? More than 26 million Americans suffer disabling injuries each year. More than two-thirds of disabling injuries suffered by American workers occur off the job and are not covered by workers compensation. Your disability benefits help you cover what matters most. To Learn More, visit MyVersantBenefits.com 19

20 SHORT & LONG TERM DISABILITY Rates Page 24 Voluntary Short Term Disability Insurance (STD) - Colonial Life Short Term Disability is offered through Colonial Life You have the opportunity to purchase insurance that would cover up to 60% of your pre-disability income (minimum coverage amount $400/week). With the Colonial Life Disability plan you select the elimination period, the amount of time you are out of work before the plan begins to pay benefits, based upon your individual needs. You will continue to receive a weekly benefit while disabled for up to 12 weeks. Company Provided Long Term Disability Insurance (LTD) - Mutual of Omaha Your long term disability plan is administered through Mutual of Omaha. The plan includes a 90 day elimination period, that is the amount of time you are disabled by your doctor and unable to work. Once you complete your elimination period the plan will begin paying a monthly benefit equal to 60% of your monthly salary, not to exceed $6,000. If you are disabled prior to the age of 62 the benefit will continue until you are able to return to work or you reach the age of 65, whichever occurs first. If your disability begins at the age of 62 or later, benefits will be paid on a reduced duration schedule. 20 To Learn More, visit MyVersantBenefits.com

21 RATES To Learn More, visit MyVersantBenefits.com 21

22 RATES Review your worksheet prior to your enrollment Pick the Plan that Best Meets Your Needs... Medical Plan - Weekly Payroll Deduction Closest to current plan Who to Cover? Bronze Plan $ 5,000 Deductible Plan Silver Plan $ 2,500 Deductible Plan Employee $ $ Employee + Spouse $ $ Employee + Child(ren) $ $ Family $ $ Medical (pg. 10) Dental Plan - Weekly Payroll Deduction Who to Cover? Employee $ 5.71 Family $ Dental (pg. 13) Vision Plan - Weekly Payroll Deduction Who to Cover? Employee $ 1.38 Employee + One Dependent $ 2.59 Family $ 3.69 Vision (pg. 14) OptiMed GAP Plan Rates - Weekly Payroll Deduction Who to Cover? 5000/2500 Plan 2500/1250 Plan Employee $ 7.62 $ 0.00 Employee + Spouse $ $ Employee + Child(ren) $ $ Family $ $ GAP Plan (pg. 12) NEED HELP? Enrollment Counselors are available to answer questions and assist you with your enrollment. Check with your Human Resources Department to learn when your employee open enrollment meetings are scheduled. 22 Rates

23 RATES Concerned about Hospital Bills? Hospital Income Plan SAMPLE Rates - Weekly Payroll Deduction * most locations Rates for $500 Hospital Confinement, Wellness and Rehabilitation Unit Age Employee Employee + Employee + Family Spouse Child(ren) $ 1.87 $ 4.00 $ 3.20 $ $ 2.58 $ 5.54 $ 3.85 $ $ 3.38 $ 7.34 $ 4.75 $ $ 4.23 $ 9.18 $ 5.94 $ Hospital Income (pg. 17) What can Living with a Critical Illness Mean to You? Critical Illness Plan SAMPLE Rates Weekly Payroll Deduction *most locations Sample Rates are based on a $10,000 policy - non-tobacco user Age Employee Family $ 1.28 $ $ 1.60 $ $ 2.09 $ $ 3.03 $ $ 3.91 $ $ 5.06 $ $ 6.57 $ $ 8.43 $ $ $ $ $ Critical Illness (pg. 18) How to File Claims To file a claim, visit or contact Colonial Life with questions at Rates 23

24 STD Dep. Life RATES Review your worksheet prior to your enrollment Take Care of Those You Love Optional Employee Life Weekly Payroll Deduction AGE 25K 50K 75K 100K 125K 150K 175K 200K 225K 250K Optional Life - Hourly (pg. 20) Dependent Life Child or Children Coverage available in $2,500 increments not to exceed $10,000 in coverage or 10% of employees coverage $ 0.04 per $1,000 of coverage per pay check Short Term Disability SAMPLE Monthly Rates per $100 of Benefit Elimination Period Protecting Your Paycheck... 3 Month Benefit Period 0/7 7/7 0/14 14/14 Age $ 3.75 $ 3.55 $ 2.85 $ 2.50 Age $ 4.50 $ 4.25 $ 3.55 $ 3.15 $ X / $100 = X 12/52 = Coverage amount Rate Monthly cost Per pay cost 24 Rates

25 RATES MY BENEFIT SELECTIONS FOR Benefit Coverage / Election Weekly Deduction Medical Plan $ GAP Plan $ Dental Plan $ Vision Plan $ Hospital Income Plan $ Critical Illness Plan $ Company Provided Life and AD&D $ 25,000 No Cost To You Optional Term Life $ Optional Dependent Life $ Short Term Disability $ Long Term Disability No Cost To You My Total Weekly Payroll Deduction $ NEED HELP? Enrollment Counselors are available to answer questions and assist you with your enrollment. Check with your Human Resources Department to learn when your employee open enrollment meetings are scheduled. Rates 25

26 LEGAL NOTICES 26 To Learn More, visit MyVersantBenefits.com

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33 AFFORDABLE CARE ACT UPDATE As a result of some key parts of the health care law that took effect in 2014, there are now new ways to buy health insurance: the Health Insurance Marketplace. What is the Health Insurance Marketplace? The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace at offers "one-stop shopping" to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Can I Save Money on my Health Insurance Premiums in the Marketplace? You may qualify to save money and lower your monthly premium, but only if your employer does not offer coverage, or offers coverage that doesn't meet certain standards. The savings on your premium that you're eligible for depends on your household income. Does Employer Health Coverage Affect Eligibility for Premium Savings though the Marketplace? Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer's health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the "minimum value" standard set by the Affordable Care Act, you may be eligible for a tax credit. 1 Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution -as well as your employee contribution to employer-offered coverage- is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. 1 Your Responsibility Under Health Care Reform Individual Mandate. The law now requires that most individuals maintain health insurance coverage or otherwise pay a penalty. If you don t have medical coverage in 2015, you ll pay the higher of these two amounts 1 : 2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan. $325 per person for the year ( $ per child under 18 ). The maximum penalty per family using this method is $ Versant Supply Chain s Responsibility Under Health Care Reform Under the Employer Shared Responsibility provisions of Health Care Reform, employers with 50 or more full-time employees must offer affordable health coverage that provides a minimum level of coverage to their full-time employees 2 (and their dependents), or pay a penalty. All of the Versant Supply Chain s medical plans do provide minimum essential coverage and are deemed to be affordable using the IRS federal poverty line safe harbor definition. 2 For purposes of the Employer Shared Responsibility provisions, an employee is a full-time employee for a calendar month if he or she averages at least 30 hours of service per week. To Learn More, visit MyVersantBenefits.com 33

34 WHO TO CONTACT UNITED HEALTHCARE Customer Service OPTIMED GAP Plan MUTUAL OF OMAHA DENTAL Customer Service UHC VISION Customer Service MUTUAL OF OMAHA (to file a life claim) MUTUAL OF OMAHA (to file a LTD claim) COLONIAL Customer Service Need Help with Enrollment? Contact BenefitHelp at option #2 or service@benefithelp.com for assistance. Who Do I Contact after Enrollment? FOR CLAIMS OR BENEFITS QUESTIONS USI USI-6699 Every reasonable effort has been made for the information provided in this booklet to be accurate. It is intended to provide the employees with Versant Supply Chain an overview of the coverages offered. It is in no way a guarantee or offer of coverage. Each carrier has the ability to underwrite based on its contract with Versant Supply Chain or its employees. Each carrier s contract, underwriting, and policies will supersede this document. Please be aware that each carrier may have exclusions or limitations and you must consult your summary plan description and/or policies for details. IMPORTANT PHONE NUMBERS 34 To Learn More, visit MyVersantBenefits.com

35 NOTES To Learn More, visit MyVersantBenefits.com 35

36 IOC FULL TIME v4.2 BenefitHelp 2015 BenefitGuide Versant v3