Employee Benefits Guide for Plan Year: January 1, December 31, 2018

Transcription

1 Employee Benefits Guide for Plan Year: January 1, December 31, 2018 X-FAB takes great pride in offering an excellent selection of benefits to all full-time employees. This guide provides quick access to information about your employee benefit program, which is an important part of your total compensation package. Please take a few moments to familiarize yourself with the benefit programs available to you as part of the X-FAB family.

2 What s Inside Eligibility & Enrollment Guidelines 3 Payroll & Deduction Options Medical Plans 4 X-FAB + 5 Connect your Care Flexible Spending Account 6 Teladoc 7 Dental Plans 8 Vision Plans 9 Basic Term Life and AD&D 10 Voluntary Term Life and AD&D 10 Short & Long Term Disability 11 Cancer & Rare Disease Insurance 11 Legal Shield (k) 13 X-FAB Wellness NEST 13 Common Terms 14 Contacts 15 Carrier Contacts 15 DISCLAIMER: The information in this Enrollment Guide is intended for illustrative and informational purposes only. The information contained herein was taken from various summary plan descriptions, certificates of coverage and benefit information. Every effort was taken to accurately report your benefits however discrepancies and errors are always possible. It is not intended to alter or expand rights or liabilities set forth in the official plan documents or contracts. It is not an offer to contract nor are there any express or implied guarantees. In case of a discrepancy between this information and the actual plan documents, the actual plan documents will prevail. If you have any questions about this summary, please contact Human Resources iaconsulting, a Marsh& McLennan Agency. All Rights Reserved.

3 Eligibility & Enrollment Guidelines Employees are eligible on the first date of hire. If you choose not to enroll during initial eligibility, the employee must wait to enroll during the next Open Enrollment, unless there is a qualifying event. Open enrollment takes place in November and it is the one opportunity during the year to make changes to benefit elections. Qualifying events allow an employee to make coverage election changes within 30 days of the event. These include: Marriage Divorce Court Order Birth or adoption of a child Loss of a dependent Loss of other coverage Significant change in employee s or spouse s employment status The benefit elections you make during open enrollment will be effective January 1, December 31, Payroll & Deduction Options Access employee self-service, review your benefits, check your latest pay stub and more with Paycom s mobile application or online at paycomonline.com. X-FAB has a Section 125 Cafeteria Plan. Participation allows you to pay for health, dental and vision premiums on a pre-tax basis. Employees enrolled in these benefit plans are automatically enrolled in the Cafeteria plan. Employees can opt out in writing to Human Resources prior to the start of coverage each plan year. Visit your Employee Benefit Center (EBC) to access your benefit information and relevant documents such as: Benefit Summaries Plan Documents Claim Forms Contact Information Password: Lubbock1 3

4 Medical Plans Your medical plans are administered by BlueCross BlueShield of Texas. IN-NETWORK BENEFITS 4 Copays Prescription Drugs Primary Care Physician Calendar Year Deductible Specialist Urgent Care Tier 1 Tier 2 Tier 3 20% coinsurance, after deductible 20% coinsurance, after deductible 20% coinsurance, after deductible 5% coinsurance, for generics filled at WalMart or Sam s Club 25% coinsurance, if filled elsewhere 40% coinsurance 50% coinsurance Individual $500 Out of Pocket Limit (Includes Deductible) Member Coinsurance Diagnostic Imaging Family $1,000 Individual $3,000 Family $6,000 Preventive Care Covered at 100% Lab and X-ray (MRI, Pet Scans, CT Scans, etc.) Hospital Services Emergency Services Per Pay Period Employee Contributions Effective 1/1/ % coinsurance, after deductible 20% coinsurance, after deductible 20% coinsurance, after deductible 20% coinsurance, after deductible Wellness Status No Wellness With Wellness* Employee Only $21.88 $12.50 Employee + Children $85.63 $48.93 Employee + Spouse $ $70.73 Employee + Family $ $ Covered Member Tobacco Use Fee $15.00 per user covered by the medical plan *Requires Completion of HRA

5 X-FAB + X-FAB has partnered with Physician Network Services (PNS) to give you access to a special discount on medical services provided at UMC PNS clinics. X-FAB employees and dependents that are covered on the medical plan will have a $5 copay per visit at the following locations: Amigos United Express Clinic N. University 112 N University 9 am - 6 pm United Express Clinic 130 th & Indiana Indiana 9 am - 6 pm United Express Clinic 50 th & Q th 9 am - 7 pm United Express Clinic 82 nd & Boston nd 9 am - 7 pm Express Care Clinic South Plains Mall 6002 Slide Road 9 am - 8 pm Services available at PNS Express Care Clinics Ordinary and routine office visits Chronic illness evaluation Diagnosis of diabetes and referral to PCP for treatment High cholesterol Asthma Acute conditions sore throats, ear, headache, fever, body aches Allergies, cough, sinus Rashes Stomach aches Strains, sprains, musculoskeletal problems Laboratory services including: Urine pregnancy tests included in visit fee Glucose Test (finger stick) included in visit fee Urine Analysis included in visit fee Bloodwork (South Plains Mall location only) charged separately at standard rates Services NOT available at PNS Express Care Clinics Preventive Care Well Checks Radiology Wellness Screenings 5

6 Connect your Care Flexible Spending Account What is a Flexible Spending Account? A Flexible Spending Account (FSA) allows you to use pre-tax dollars to pay for qualified health or dependent day care expenses. There are hundreds of eligible expenses for your FSA funds, including prescriptions, doctor office copays, health insurance deductibles and coinsurance for you, your spouse or eligible dependents, and much more. 1. Health FSA You may contribute up to $2,600 a year to your Health FSA. 2. Dependent Care FSA You may contribute up to $5,000 a year, or up to $2,550 a year if married and filing separately, to the Dependent Care FSA. 24/7 Online/Mobile Access & Support CYC Mobile, our secure mobile app, saves you time by delivering important account information on the go. Download it today! View account balances & payments Request a payment View FAQs or tap to call Customer Service Receive important account alerts Cut the time needed to submit a receipt - take a photo of your receipt and upload it directly to the system Available for Android, ios & Windows devices ConnectYourCare.com

7 Teladoc X-FAB offers Teladoc services to all employees enrolled in the medical plan. Teladoc gives you access to a doctor through the convenience of phone 24 hours a day, 7 days a week, 365 days a year, at no cost to you! Use company code: xft1101 Teladoc gives you 24/7/365 access to U.S. board-certifi ed doctors through phone or video consults. It does not replace your primary care physician but is an affordable option for quality care. STEP 1 SET UP YOUR ACCOUNT We've made it quick and easy to set up your account online. Simply visit the website and click "Set up account". STEP 2 UPDATE YOUR MEDICAL HISTORY Make sure the "My Medical History" tab is updated so the doctor has the information needed to provide an accurate diagnosis. STEP 3 REQUEST A CONSULT Teladoc doctors are available when you need care now. Request a consult anytime online or by phone. With your consent, Teladoc is happy to provide information about your Teladoc consult to your primary care physician. Facebook.com/Teladoc Teladoc.com/mobile 7

8 Dental Plans Your dental plans are administered by BlueCross BlueShield of Texas. BCBSTX DENTAL PLAN Calendar Year Deductible Individual $50 Family $150 Preventive Care (i.e. cleanings) Basic Care (e.g. fillings) Major Care (e.g. crowns, inlays/onlays) Orthodontia (children only) Annual Maximum Benefit Orthodontia Lifetime Maximum Benefits 100%, Deductible waived 80%, After deductible 50%, After deductible 50%, Deductible Waived $3,000 per covered person $3,000 per child under 19 years old Per Pay Period Employee Contributions Employee Only $13.00 Employee + Children $43.55 Employee + Spouse $41.55 Employee + Family $45.64 Dental Plan Highlights Receive two routine cleanings/year at no cost when visiting network providers. You may choose any dentist. However, if you elect to see an out-of-network provider, you may be balance billed for anything over the usual and customary amount allowed by BlueCross. Find innetwork dentists at 8

9 Vision Plans Your vision plan is administered by Superior Vision. SUPERIOR VISION IN-NETWORK OUT-OF-NETWORK Annual deductibles Eye Exam $10 $10 Materials $25 $25 Lenses Single Vision Covered at 100% Up to $25 retail Bifocal Covered at 100% Up to $40 retail Trifocal Covered at 100% Up to $45 retail Lenticular Covered at 100% Up to $80 retail Frames Frames Up to $150 Up to $70 retail Contact Lenses (in lieu of Glasses) Exam and fitting Included in allowance Up to $80 retail Medically Necessary Covered at 100% Up to $150 retail Elective Up to $150 Frequencies Exams Once every 12 months Lenses Frames Once every 12 months Once every 12 months Per Pay Period Employee Contributions Employee Only $7.41 Employee + Family $18.52 Vision Plan Highlights Locate an in-network vision provider at or call If you use an out-of-network provider the benefits will be reduced and you will be required to submit a reimbursement to Superior Vision along with the receipt for your related expenses. 9

10 Basic Term Life and AD&D Your Basic Term Life and Accidental Death & Dismemberment coverage is through Unum. All Active Full-Time Employees are Eligible for the following benefits, at no cost: UNUM AMOUNT Life Benefit $30,000 AD&D Benefit $30,000 Accelerated Death Benefit 50% of benefit amount Age Reduction Schedule: 65 Benefits reduce to 65% 70 Benefits reduce to 50% Voluntary Term Life and AD&D Your Term Life Insurance coverage is through Unum. All active Full-Time Employees are Eligible for the following benefits Please be sure you have a current beneficiary form on file! UNUM EMPLOYEE SPOUSE* CHILD/REN Benefit Amount 5x Annual Earning, Maximum of $500,000 50% of EE Amount, Maximum of $250,000 50% of EE Amount, Maximum of $10,000 Increments $10,000 $5,000 $2,000 Guarantee Issue $150,000** $25,000** $10,000** Accelerated 50% of benefit amount up applicable maximums n/a Age Reduction Schedule: *Spouse benefit not to exceed 50% of employee s coverage 70 Benefits reduce to 65% n/a 75 Benefits reduce to 50% n/a 10

11 Short & Long Term Disability Your short and long term disability coverage is provided through Unum, and is paid for by X-FAB. All Active Full-Time Employees are Eligible for the following benefits, at no cost: UNUM SHORT TERM DISABILITY LONG TERM DISABILITY Benefit Amount 60% of Weekly Earnings 60% of Monthly Earnings Maximum Benefit $1,200/week $6,000/month Elimination Period 14 Days Injury or Illness 90 Days Injury or Illness Benefit Duration 11 weeks To age 65 Please see carrier plan documents for additional details, limitations, and exclusions. Cancer & Rare Disease Insurance Your cancer & rare disease insurance is provided through Allstate. Group Cancer Insurance supplements existing coverage and can help provide cash to cover medical and living expenses. Group Voluntary Cancer coverage from Allstate Benefits pays cash benefits for cancer and 29 specified diseases to help with the costs of treatments and expenses as they happen. 11

12 Legal Shield HAVE YOU EVER? Needed your Will prepared or updated Been overcharged for a repair or paid an unfair bill Had trouble with a warranty or defective product Signed a contract Received a moving traffic violation Had concerns regarding child support Worried about being a victim of Identity theft Been concerned about your child s identity Lost your wallet Worried about entering personal information on-line Feared the security of your medical information Been pursued by a collection agency WHAT IS LEGALSHIELD? LegalShield was founded in 1972, with the mission to make equal justice under law a reality for all North Americans. The 3.5 million individuals enrolled as LegalShield members throughout the United States and Canada can talk to a lawyer on any personal legal matter, no matter how trivial or traumatic, all without worrying about high hourly costs. LegalShield has provided identity theft protection since 2003 with Kroll Advisory Solutions, the world s leading company in ID Theft consulting and restoration. We have safeguarded over 1 million members, provided more than 200,000 identity consultations, and helped restore nearly 10,000 individual identities. 12 Payroll Deduction Monthly LegalShield IDShield Combined Individual $16.95 $8.95 $25.90 Family $18.95 $18.95 $33.90 For more information, please call your independent associate: Abe Abdelhadi abdelhadi85@legalshieldassociate.com This is a general overview and is for illustrative purposes only. Plans and services vary from state to state. See a plan contract for your state of residence for complete terms, coverage, amounts, c o n d i t i o n s a n d exc l u s i o n s.

13 401(k) The X-FAB 401(k) Plan allows you to save for retirement with either pre-tax or post-tax dollars. You may choose between a traditional 401(k) or a Roth 401(k). (Roth 401(k) deferrals are made post-tax.) Eligibility You are eligible to enroll in the 401(k) if you are at least 18 years old and have completed 3 months of continuous service. Enrollment As a new hire, you will be automatically enrolled in the 401(k) plan at the beginning of the quarter following 3 months of continuous employment. This contribution will be 5% of your compensation per pay period, unless you opt out of participation in the plan, and this amount will increase by 1% each year up to 10%. You will have the opportunity to make changes to your contribution amounts, or opt out of participation at the beginning of any quarter as follows: January 1 April 1 July 1 October netbenefits.com Employer Contributions X-FAB will match 100% of the first 3% and 50% of the next 2% of your contributions. X-FAB s matching contributions are NOT subject to the vesting schedule and are 100% vested. For complete plan details, visit your EBC or refer to your plan documents. X-FAB Wellness NEST We are excited to continue to partner with iawellness to bring you a best in class wellness program! Some of the features include: Interactive points system to achieve your insurance premium incentive Team & individual challenges Education opportunities Free health coaching with Registered Nurses, Registered Dietitians, and Certified Personal Trainers Visit the NEST website for more information! xfabwellness.com password: XFABNEST 13

14 Common Terms Allowed Amount: Maximum amount on which payment is based for covered health care services. This may be called eligible expense, payment allowance or negotiated rate. If your provider charges more than the allowed amount, you may have to pay the difference. (See Balance Billing) Annual Maximum Benefit: A cap on the benefits your insurance company will pay in a year while you re enrolled in a particular health insurance plan. These caps are sometimes placed on particular services such as prescriptions or hospitalizations. After an annual limit is reached, you must pay all associated health care costs for the rest of the year. Balance Billing: When a provider bills you for the difference between the provider s charge and the allowed amount. For example, if the provider s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services. Coinsurance: The percentage of costs of a covered health care service you pay (20%, for example) after you ve paid your deductible. Copayment (copay): A fixed amount ($20, for example) you pay for a covered health care service after you ve paid your deductible. Copays can vary for different services within the same plan, like drugs, lab tests, and visits to specialists. Deductible: The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services. Your insurance company pays the rest. Guarantee Issue: A requirement that health plans must permit you to enroll regardless of health status, age, gender, or other factors that might predict the use of health services. Except in some states, guaranteed issue doesn t limit how much you can be charged if you enroll. In-Network: Health care providers who contract with your health insurance or plan. In-network coinsurance and copayments usually cost you less than out-of-network providers Out-of-Network: Health care providers who don t contract with your health insurance or plan. Out-of-network coinsurance and copayments usually costs you more than in-network coinsurance. Out of Pocket Max: The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits. The out-of-pocket limit doesn t include your monthly premiums. It also doesn t include anything you may spend for services your plan doesn t cover. Out-ofpocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren t covered. Prescription Drug Formulary: A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list. Prior Authorization: Approval from a health plan that may be required before you get a service or fill a prescription in order for the service or prescription to be covered by your plan. Preventive Care: Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems. 14

15 Contacts X-FAB Amy Hymel, Benefits & Wellness Manager ext iaconsulting Julie Lawson, Senior Account Manager (toll free) Carrier Contacts MEDICAL/DENTAL BENEFITS BlueCross BlueShield of Texas bcbstx.com FLEXIBLE SPENDING ACCOUNT Connect Your Care connectyourcare.com TELEMEDICINE Teladoc 800-Teladoc teladoc.com VISION BENEFITS Superior Vision superiorvision.com LIFE & DISABILITY BENEFITS Unum unum.com CANCER & RARE DISEASE POLICY Allstate allstate.com 401(k) Fidelity netbenefits.com 15

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