Salaried & Hourly Admin Employees Benefits Guide

Transcription

1 Salaried & Hourly Admin Employees Benefits Guide

2 Welcome to your Benefit Enrollment! OK Foods-Albertville Facility offers you and your eligible family members a comprehensive and valuable benefits program. We encourage you to take the time to educate yourself about your options and choose the best coverage for you and your family. What s in the Guide? Open Enrollment 3 Medical 4-5 Dental 6 Vision 7 Voluntary Benefits 8-9 Basic Life & Voluntary Term Life Disability 12 Identity Theft Protection 13 Important Contacts 14 Who is Eligible? Full time W-2 Employees working at least 30 hours each week. When can I Enroll? You may enroll for benefits when you first become eligible, or each year during open enrollment. The benefits you elect will be effective July 1, If you decline coverage or fail to make an election of a coverage during this open enrollment timeframe, you may not be able to make a new or different election until next year s open enrollment, unless you incur an IRS qualifying event including, but not limited to, marriage, birth, divorce, etc. 2 OK Foods-Albertville Facility

3 Enrollment Process STEP 1 Review the Benefit Guide which provides an overview of all benefits being offered for the upcoming plan year. The Benefit Resource Website will also have important forms, brochures and videos. This website is your one-stop place for all benefit related information. STEP 2 Self-Service Visit and move through the enrollment system at your own pace. Review the posted benefit guide and plan summaries to help you with your benefit decisions. If choosing this option, be sure to click submit at the end of the process and make note of your confirmation number. If you do not receive a confirmation number, you have not completed your enrollment. Return to the system anytime and click your confirmation number to view your confirmation statement. REMINDERS Reminders when using any of the above options for enrollment: Be sure to review the Benefit Guide and plan summaries prior to going through the enrollment process Be prepared by gathering dependent and beneficiary information (i.e. collect info such as social security numbers and dates of birth.) OK Foods-Albertville Facility 3

4 Medical At OK Foods-Albertville Facility, we understand that every family has different needs when it comes to medical insurance. That is why we offer the choice amongst medical plans to help you cover the costs associated with a covered illness or injury. These plans allow you to select where you receive your medical services; however, if you use in-network providers, your out-of-pocket costs will be less. NOTE: The Century Healthcare plan is NOT comprehensive health coverage. However, this plan satisfies the Minimum Essential Coverage requirement as specified under the Affordable Care Act. BCBS Bronze Plan In-Network / Out-of-Network BCBS PPO Standard Plan In-Network / Out-of-Network Century Healthcare Limited Fixed Indemnity Plan Deductible (Calendar Year) Individual $2,000 / $4,000 $1,000 N/A Family $4,000 / $8,000 $3,000 N/A Coinsurance 40% / 50% 20% / 50% N/A Out-of-Pocket Maximum (includes deductible) Individual $4,000 $4,000 N/A Family $8,000 $8,000 N/A Doctor s Office Office Visit (PCP) 40% after Ded. / 50% after Ded. $30 copay / 50% after Ded. Office Visit (Specialist) 40% after Ded. / 50% after Ded. $50 copay / 50% after Ded. Preventive Care Services (i.e. routine exams, x- rays/tests, immunizations, well baby care and mammograms) Hospital Services Pays $100 per day (4 days) No Charge / Not Covered No Charge / Not Covered No Charge Emergency Room 40% after Ded. / 40% after Ded. $350 copay / Deductible + $350 copay Pays $200 per day (1 day) Urgent Care Center Services 40% after Ded. / 50% after Ded. $50 copay / 50% after Ded. N/A Inpatient 40% after Ded. / 50% after Ded. $200 copay days 1-5 / 20% after Ded. + $750 per admission Pays $1,500 Plus $500 per day (max of 30 days) Outpatient Surgery 40% after Ded. / 50% after Ded. $200 copay / 20% after Ded. Pays $750 Ambulance Service 40% after Ded. / 50% after Ded. 20% after deductible N/A Other Services Diagnostic Lab/X-ray/Blood 40% after Ded. / 50% after Ded. No Charge / 50% after Ded. No Charge Diagnostic Imaging (CT/PET Scans, MRIs) 40% after Ded. / 50% after Ded. $200 copay / 50% after Ded. Pays $100 per day (4 days) Prescriptions Retail (Tier 1, Tier 2, Tier 3) Mail Order (Tier 1, 2, 3) $15 / $50 / $75 (Not Covered Out-of-Network) $20 / $40 / $60 (Not Covered Out-of-Network) $40 / $80 / $120 (Not Covered Out-of-Network) $10 copay / $50 or 50% of cost, whichever is greater / 100% of cost (Monthly Max: $250 Ind. / $500 Family) *Eligible Dependents to age 26 4 OK Foods-Albertville Facility

5 Medical HEALTHCARE TERMS Co-pay: A specific dollar amount that you must pay for a specific service at the time when you receive the service. Deductible: A dollar amount you are responsible for before the plan will make any benefit payments. Each year, your deductible starts over (January 1st), in addition, you are only responsible for satisfying your deductible one time per year. Coinsurance: A method of cost-sharing between the member and the insurance carrier for your benefit expenses. If you have 30% coinsurance, then you pay 30% of your eligible expenses and the carrier pays the remaining 70%. The coinsurance begins after your deductible has been satisfied. Out-of-Pocket Maximum: The maximum amount you will be required to pay for your benefits, after which the plan will pay 100% of covered expenses. Your deductible, coinsurance and in some instances co-pays apply towards your Out-of-Pocket Maximum. Bi-Weekly Payroll Deductions Tier BCBS Bronze Plan BCBS PPO Standard Plan Century Healthcare Limited Medical Plan Employee $46.36 $73.76 $35.62 Employee & Spouse $ $ $68.24 Employee & Child(ren) $ $ $66.18 Family $ $ $ OK Foods-Albertville Facility 5

6 Dental Good oral care enhances overall physical health, appearance and mental well-being. Problems with teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with the OK Foods-Albertville Facility dental benefit plan through BCBS of Alabama. Preferred Dental In-Network Calendar Year Deductible Individual / Family $50 / $150 Annual Maximum $1,250 per member per year Preventative & Diagnostic Services Exams, Cleanings, X-Rays, etc. Restorative Services Fillings, Simple Extractions, Root Canals, etc. Supplemental Services Oral Surgery and Anesthesia Periodontic Gum Disease Prosthetic Crowns and Dentures Covered at 100%, subject to the deductible Covered at 100%, subject to the deductible Covered at 100%, subject to the deductible Covered at 80%, subject to the deductible Covered at 50%, subject to the deductible Go to to locate a network provider. Please note that your out-of-pocket costs may be more if you choose to go to an out-of-network provider. Bi-Weekly Payroll Employee Family* Deductions $3.74 $10.98 *Dependents can be covered to age 26 regardless of student status. 6 OK Foods-Albertville Facility

7 Vision OK Foods-Albertville Facility offers Vision Insurance through Lincoln Financial Group, utilizing the Spectera network of providers, for all eligible employees and their dependents. You may choose any provider. However, using providers participating in the network should lower your outof-pocket expenses. You may locate a provider at Description In-Network Out-of-Network Every 12 Months Every 12 Months Comprehensive Eye Exam (every 12 mos.) Materials $10 co-pay $25 co-pay Up to $40 Eyeglass Lenses* Every 12 Months Every 12 Months Single Vision Bifocal Trifocal Lenticular 100% 100% 100% 100% N/A Up to $40 Up to $60 Up to $80 Up to $80 Eyeglass Frames Every 24 Months Every 24 Months $130 allowance Up to $45 Contact Lenses (in lieu of glasses) Every 12 Months Every 12 Months Covered Contact Lens Selection All other elective contact lenses 100% Up to $125 Up to $125 Up to $125 Necessary Contact Lenses 100% Up to $210 *Standard scratch resistant coating included Bi-Weekly Payroll Employee Employee & Spouse Employee & Child(ren)* Family* Deductions $3.40 $6.42 $7.54 $10.60 * Dependents may be covered up to age 26. OK Foods-Albertville Facility 7

8 Voluntary Benefits Voluntary Benefits are being offered to strengthen your overall benefits package. You customize the benefit based on need and affordability. Ownership Policies are fully portable and belong to you if you leave your employer, same price and same plan Benefits are payroll deducted If a claim is made the benefits are paid directly to you, not to a hospital or to a doctor Benefits are above and beyond and completely separate from medical insurance and other benefits Level premiums Rates do not increase with age Guaranteed Renewable Voluntary Benefits Designed to provide additional cash flow to assist with out of pocket medical costs and other bills The Voluntary Benefits offered through Lincoln Financial Group are an Accident Plan and Critical Illness Insurance. ACCIDENT PLAN A plan that helps pay for the unexpected expenses that result from an accident On and off the job coverage = 24 hours per day, 7 days a week Family coverage available Sports related injuries covered as well Just a few examples of benefit included in the plan: Emergency Room Visits - $150 Hospitalization - $1,000 admission benefit, $200 per day benefit Fractures - up to $5,600 Dislocations - up to $4,800 Health Assessment Benefit - $50 per insured per year See brochure for a complete list of benefits Bi-Weekly Payroll Deductions Employee Employee & Spouse Employee & Children* Family* $8.42 $12.82 $14.00 $19.58 *Dependents up to age 26 can be covered regardless of student status. 8 OK Foods-Albertville Facility

9 Voluntary Benefits CRITICAL ILLNESS/CANCER PLAN Critical Illness/Cancer is a benefit that will pay you a lump sum of money if you are diagnosed with a critical illness, heart attack, internal cancer or stroke. The cash benefit is provided upon the first diagnosis of a covered condition to help you with associated costs and beyond. Special Underwriting at Initial Offering Only Guaranteed Issue: $20,000 employee / $10,000 spouse / $5,000 children Regardless of other coverage in force, the benefit is paid out in a full lump sum. Examples of covered conditions: (See Brochure for a full list of covered conditions) Heart Attack, Heart Transplant, Stroke, Invasive Cancer, End Stage Renal Failure, Major Organ Transplant, ALS/Lou Gehrig s Disease, Advanced Alzheimer s Disease, Advanced Parkinson s Disease, Cancer In Situ (25%) A Critical Illness Assessment Benefit is included in your Critical Illness/Cancer Policy and $50 for each insured. Each covered person will get one screening test per calendar year. Mammography Pap smear Examples of health screenings: Stress test Serum Cholesterol Colonoscopy Prostate specific antigen Bone Marrow Chest X-ray Also included is an Additional Category Occurrence Benefit that provides a second cash payment in the event a covered person is diagnosed with a different condition or illness. Pays an additional 100% of the original benefit. Issue Age Bi-Weekly $5,000 $10,000 $20,000 EMPLOYEE Payroll Deductions $1.24 $2.42 $ $2.24 $4.40 $ $4.24 $8.42 $ $7.48 $14.90 $ $11.90 $23.74 $47.48 SPOUSE Payroll Deductions Bi-Weekly Issue Age $5,000 $10, $1.24 $ $2.24 $ $4.24 $ $7.48 $14.90 CHILD Payroll Deductions Issue Age Bi-Weekly $5, $ $ $ $ $11.90 $ $0.58 OK Foods-Albertville Facility 9

10 Term Life Insurance Basic Term Life and Accidental Death & Dismemberment OK Foods-Albertville Facility provides Basic Life insurance through Lincoln Financial Group for all eligible employees at no cost to the employee. OK Foods-Albertville Facility also provides Accidental Death & Dismemberment (AD&D) insurance which pays in addition to the Basic benefit when loss occurs as a result of an accident. Voluntary Supplemental Life OK Foods-Albertville Facility employees may elect to purchase additional Life Insurance on a voluntary basis through Lincoln Financial Group via payroll deduction. NOTE: Employee and/or Spouse can increase up to 2 increments if currently covered and not previously declined, withdrawn, or pending, without medical underwriting. Employee You may elect life insurance in increments of $10,000 to the lesser of 5 times your annual salary or $500,000. One Time Guaranteed Issue at Initial Offering Only $200,000 (Not to exceed 5x annual salary) If you elect Voluntary Life Insurance for yourself, you also have the opportunity to elect coverage for your spouse and/or children. Spouse Child(ren) You may elect life insurance in increments of $10,000 not to exceed half of the employee s elected amount up to a maximum of $500,000. One Time Guaranteed Issue Amount at Initial Offering Only $30,000 Coverage in the amount of up to $10,000 can be elected for all children from birth through the age of 19 (25 if a full-time student). One Time Guaranteed Issue Amount at Initial Offering Only $10,000 Employee Spouse 35% at age 65 35% at age 65 Benefits will reduce: Additional 25% of original amount at age 70 Benefits terminate at Employee Age 70 Additional 15% of original amount at age 75 or Retirement, whichever occurs first Additional 15% of original amount at age 80 Benefits terminate at retirement 10 OK Foods-Albertville Facili-

11 Term Life Insurance COSTS FOR TERM LIFE INSURANCE Age Band Employee & Spouse* Monthly Rate per $1,000 Age Band Employee & Spouse* Monthly Rate per $1,000 < *Rates are based on Employee s Age Dependent Children Benefit Amount $2,500 $5,000 $7,500 $10,000 Monthly Rate* $0.50 $1.00 $1.50 $2.00 *Rates cover all dependent children regardless of the number of children Life Example: A 36 year old female, Sally, wants to purchase $50,000 of term life insurance..134 x 50 = $6.70 Monthly rate per $1,000 # of units/$1,000 monthly Voluntary Accidental Death & Dismemberment OK Foods-Albertville Facility employees may elect to purchase additional Accidental Death and Dismemberment Insurance, with or without the purchase of Voluntary Life Insurance, on a voluntary basis through Lincoln Financial Group via payroll deduction. You may also elect this coverage on your Spouse and/or child(ren), spouse is covered up to 50% of the coverage amount on yourself and child(ren) are covered up to 15% of your coverage amount up to a maximum of $10,000. Monthly Rate per $1,000 for AD&D: Employee Only: $0.035 Family: $0.060 AD&D Example: An employee, Sally, wants to purchase $50,000 of AD&D insurance..035 x 50 = $1.75 Monthly rate per $1,000 # of units/$1,000 monthly OK Foods-Albertville Facility

12 Disability Short Term Disability As an employee of OK Foods-Albertville Facility, you are eligible to purchase in Short Term Disability (STD) coverage. STD coverage supplements your lost wages should you be unable to work due to an illness, injury or pregnancy. STD coverage begins following the elimination period below due to a medically certified reason. The benefit is payable up to the specific benefit duration period below. Elimination Period for Sickness, Accident or Pregnancy: 14 days Maximum Benefit Period: 11 weeks Weekly Benefit: 60% of your weekly salary up to $1,000 per week Pre-Existing Condition: You may not be eligible for benefits if you have received treatment for a condition within 3 months prior to your effective date under this policy until you have been covered under the policy for 6 months. Example Bi-Weekly Cost Calculation Example: A 35 year old employee has a weekly salary of $600 and wants to purchase short term disability 1. Weekly Earnings $ Multiply by the premium factor from table at right 3. Your estimate monthly premium 4. Multiply by 12 and divide by 26 to get your bi-weekly premium deduction.0429 $25.74 $11.88 Attained Age Premium Factor Attained Age Premium Factor < Long Term Disability As an employee of OK Foods-Albertville Facility, you are provided, at no cost to you, with Long Term Disability (LTD) coverage. LTD coverage supplements your lost wages should you be unable to work due to an illness, injury or pregnancy. LTD coverage begins following the elimination period below due to a medically certified reason. The benefit is payable up to the specific benefit duration period below. Elimination Period for Sickness, Accident or Pregnancy: 90 days Maximum Benefit Period: To Age 65 Weekly Benefit: 60% of your monthly salary up to $6,000 per month Pre-Existing Condition: You may not be eligible for benefits if you have received treatment for a condition within 3 months prior to your effective date under this policy until you have been covered under the policy for 12 months. 12 OK Foods-Albertville Facili-

13 Identity Theft Protection Identity theft in the United States is a major problem that continues to be on the rise. Professional protection and assistance have become important tools in fighting the identity theft epidemic. Thieves today can get a hold of your personal information from trash cans, dumpsters, stolen mail, and even shoulder surfing. Once thieves have your information, it s a simple matter to open new fraudulent accounts and make purchases in your name. When you enroll in LifeLock, you can be confident knowing that they are available 24 hours a day, 7 days a week, and committed 100% to helping protect your information as if it were their own. LifeLock offers Proactive Protection: LifeLock Identity Alert System Lost Wallet Protection Address Change Verification Black Market Website Surveillance Life Member Service Support LifeLock Privacy Monitor Reduced Pre-Approved Credit Card Offers Identity Restoration Support Offered through payroll deduction at a 15% discount off retail rates Stolen Funds Replacement - up to $100,000 (was up to $25,000) Fictitious Identity Monitoring Court Records Scanning Data Breach Notifications Investment Account Activity Alerts $1 Million Total Service Guarantee LifeLock s proactive approach works to help stop identity theft before it happens. As a LifeLock member, if you become a victim of identity theft because of a failure in their service, they will help fix it at their expense, up to $1,000,000. Bi-Weekly Payroll Employee Employee & Spouse Employee & Children* Family* Deductions $3.92 $7.84 $6.86 $10.78 *Employee & Children and Family Tiers: You may enroll up to 8 children with 4 of those children between the ages of 18 and 26. OK Foods-Albertville Facility

14 Important Contacts Vendor Phone Website Medical & Dental Blue Cross Blue Shield of Alabama Limited Medical Century Healthcare Medical: Pharmacy: Life & STD Lincoln Financial Group Life: Disability: Vision Lincoln Financial Group Voluntary Benefits Lincoln Financial Group Identity Theft Protection Lifelock Lincoln Voluntary Benefits Claims Help Explain My Benefits , Option service@explainmybenefits.biz 14 OK Foods-Albertville Facili-

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16 Benefit Guide Description Please Note: This guide is designed to provide a high-level overview of the employee benefits [Albertville Quality Foods] offers. The guide is not a governing plan document or summary plan description ( SPD ). The official plan and insurance documents govern, including your rights, benefits, eligibility, exclusions, and limitations. Accordingly, if there is any discrepancy between the governing plan document for a particular employee benefit plan and the guide, the plan document shall control. Similarly, if there is a discrepancy between the SPD for an employee benefit plan, the guide, and/or the plan document, the plan document shall control. You should consult the plan documents and SPDs for additional details and information regarding your benefits. Copies of the SPDs and plan documents can be obtained by contacting Human Resources.