benefits at a glance medical / dental / vision { Insurance a guide for employees 2016 Done once. Done right.

Transcription

1 benefits at a glance medical / dental / vision { Insurance a guide for employees 2016 Done once. Done right.

2 The Conti Group offers a comprehensive benefits program to all eligible employees. Unless otherwise noted, full-time non-union employees are eligible for benefits on their date of hire, within 31 days of a qualified life event, or annually during the open enrollment period. We are confident that you will find this benefit package of great value to you and your family. Should you have any questions regarding the information contained in this benefit summary, including further information on plan details as well as employee costs not listed, please contact HR/Benefits Department. This comprehensive benefits overview will supply you with information regarding: Medical Prescription Drug Dental Vision Life and Accidental Death & Dismemberment (AD&D) Short Term Disability Voluntary Long Term Disability Other Voluntary Products Flexible Spending Accounts (FSA) Work/Life Benefits Important Phone Numbers Benefit Web Links. This benefit overview does not create a contract of employment between The Conti Group and any employee. The Company reserves the right to amend, suspend, or terminate the benefit plans at any time. In all instances, the plan documents and summary plan descriptions will govern the benefit determinations.

3 Medical Plans OPEN ACCESS PLUS Not required to choose a Primary Care Physician No Referrals required CIGNA EXCHANGE PLANS OPEN ACCESS PLUS In-Network Out-of-Network Plan Accumulator Calendar Year Physician s Office Visit $20/$40 70% after the deductible Deductible (Single/Family) $250/$500 $500/$1,000 Coinsurance 90% 70% Out-of-Pocket (Single/Family) $2,000/$4,000 $4,000/$10,000 Lifetime Maximum Unlimited Preventive Care 100% 70% after deductible Inpatient Facility 90% after deductible 70% after deductible Outpatient Facility 90% after deductible 70% after deductible Urgent Care $50 copay/visit $50 copay/visit Emergency Room $100 copay/visit $100 copay/visit Pharmacy Deductible None None Pharmacy OOP $4,350 Individual / $8,700 Family $4,350 Individual / $8,700 Family Retail $15/$35/60% COINS 70% after deductible Home Delivery 2x Retail 70% after deductible benefits at a glance MEDICAL *Rx Out-of-pocket Maximum is separate from Medical Out-of-pocket Maximum. The two do not cross apply. MEDICAL CONTRIBUTIONS - OAP POS Coverage Discount No Discount Employee Only $29.06 $40.60 EE & Spouse* $65.81/$ $77.35/$ EE & Child(ren) $54.85 $66.39 Family* $102.85/$ $125.92/$ Weekly Pre-Tax Contribution Structure (Including Prescription) Conti offers discounted rates to employees (& spouses) who complete an annual physical and Health Assessment in the prior plan year. New hires will recieve the discount for their first plan year. *In order to receive the lower rate for either Employee & Spouse or Family coverage, the employee must sign an affadavit stating that no other coverage is available to their spouse, or must submit proof that available coverage has been elected as primary (making Conti benefits secondary). Please Note: You will receive your medical insurance card(s) within 7-10 business days after enrolling in benefits. While you wait for the hardcopy to arrive by mail, you can access and print out temporary card(s) by registering at Please also note that after registering, you can access your ID cards anytime by downloading the MyCigna app on your smartphone. You can still begin using your benefits on your effective date (day of hire), however if ID cards are not yet available at that time, you will be required to pay out of pocket and then file a claim for reimbursement to the insurance carrier.

4 Medical Plans HSA OPEN ACCESS PLUS Plan Accumulator CIGNA EXCHANGE PLANS HSA 1 HSA 2 In-Network Out-of-Network In-Network Out-of-Network Calendar Year Physician s Office Visit 100% after deductible 70% after deductible 80% after deductible 60% after deductible Deductible (Single/Family) $1,500/$3,000 $2,500/$5,000 $5,000/$10,000 Coinsurance 100% 70% 80% 60% Out-of-Pocket (Single/Family) $2,000/$4,000 $4,000/$10, Lifetime Maximum Unlimited Unlimited Preventive Care 100% 70% after deductible 100% Not Covered Inpatient Facility 100% after deductible 70% after deductible 80% after deductible 60% after deductible Outpatient Facility 100% after deductible 70% after deductible 80% after deductible 60% after deductible Urgent Care (Ded does not apply unless specified) 100% after deductible 100% after deductible 80% after deductible 60% after deductible Emergency Room 100% after deductible 100% after deductible 80% after deductible Pharmacy Deductible Combined with Medical Combined with Medical Pharmacy OOP Combined with Medical Combined with Medical Retail $15/$35/60% coins 70% after deductible $15/$40/$70* Not Covered Home Delivery 2x Retail 70% after deductible $38/$100/$175* Not Covered *Rx Out-of-pocket Maximum is separate from Medical Out-of-pocket Maximum. The two do not cross apply. Conti offers discounted rates to employees (& spouses) who complete an annual MEDICAL CONTRIBUTIONS - HSA 1 physical and Health Assessment in the prior plan year. New hires will recieve the Coverage Discount No Discount discount for their first plan year. Employee Only $3.94 $15.48 EE & Spouse* $8.92/$ $20.46/$78.15 EE & Child(ren) $6.71 $18.24 Family* $17.14/$ $40.22/$ MEDICAL CONTRIBUTIONS - HSA 2 Coverage Discount No Discount Employee Only - $11.54 EE & Spouse* - /$57.69 $11.54/69.23 EE & Child(ren) - $11.54 Family* - /$86.54 $23.08/ *In order to receive the lower rate for either Employee & Spouse or Family coverage, the employee must sign an affadavit stating that no other coverage is available to their spouse, or must submit proof that available coverage has been elected as primary (making Conti benefits secondary). Please Note: You will receive your medical insurance card(s) within 7-10 business days after enrolling in benefits. While you wait for the hardcopy to arrive by mail, you can access and print out temporary card(s) by registering at Please also note that after registering, you can access your ID cards anytime by downloading the MyCigna app on your smartphone. You can still begin using your benefits on your effective date (day of hire), however if ID cards are not yet available at that time, you will be required to pay out of pocket and then file a claim for reimbursement to the insurance carrier.

5 Dental Plans Cigna Deductible (Single/Family) Individual Annual Maximum DIAGNOSTIC/PREVENTIVE Oral Evaluations X-Rays Cleanings, Fluoride Sealants, Space Maintainers BASIC RESTORATIVE CARE Fillings Simple Extractions Root Canal Therapy/ Endodontics CIGNA DPPO B-50 CIGNA DPPO D-50 CIGNA DPPO A-100 In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network $50/$150 $50/$150 $100/$300 $2,000 $1,500 $1,000 Calendar Year Calendar Year Calendar Year 100% 100% 100% 90% 80% 60% 60% 60% 60% 40% 40% Oral Surgery 40% 40% Periodontics 40% 40% MAJOR RESTORATIVE CARE Crowns Inlays/Onlays Bridges/Dentures ORTHODONTIA 60% 50% 40% Lifetime Maximum 50% 50% Not Covered $2,000 for Children and Adults $1,500 for Children only Not Covered *Plan pays out-of-network expenses up to what Cigna deems as Usual and Customary Reimbursement (UCR). Any amount above the UCR amount is the responsibility of the member. DENTAL CONTRIBUTIONS B-50 DENTAL CONTRIBUTIONS D-50 DENTAL CONTRIBUTIONS A-100 Employee Only $29.06 Employee Only $0.99 Employee Only - EE & Spouse $65.81/$ EE & Spouse $1.85 EE & Spouse*\ - EE & Child(ren) $54.85 EE & Child(ren) $2.10 EE & Child(ren) - Family $102.85/$ Family $3.68 Family - Please Note: Dental Insurance Programs are managed by Cigna. To locate a participating Cigna Dentist, search the online directory at For questions, call the toll free number found on your Cigna Dental ID card to talk with a customer representative. To print copies of your Dental ID card and access online member tools, visit

6 Vision Plans Guardian VSP SIGNATURE - HIGH PLAN DAVIS - LOW PLAN Eye Exam (Once per year) Materials $10 Copay $10 Copay (1 pair of lenses per 2 years) $25 Copay $25 Copay Frames $130 Allowance; with 20% off over amount $120 Allowance; with 20% off over amount (1 per 2 years) Out of Network Subject to reimbursement schedule *In Network discounts on non-covered lens options and contact exam costs above allowance VISION CONTRIBUTIONS B-50 VISION CONTRIBUTIONS D-50 Employee Only $1.59 Employee Only $0.84 EE & Spouse $2.68 EE & Spouse $1.41 EE & Child(ren) $2.73 EE & Child(ren) $1.44 Family $4.32 Family $2.28 *In Network discounts on non-covered lens options and contact exam costs above allowance FREQUENCY - VSP SIGNATURE Eye Exam Lenses Frames 12 Months 12 Months 24 Months FREQUENCY - DAVIS Eye Exam Lenses Frames 12 Months 24 Months 24 Months Please Note: Vision coverage from Guardian is paperless. You won t need a card, just your employer name and your Social Security Number. You can also visit Guardian s website at (Group # ) to print out an ID card and obtain specific information on your plan. benefits at a glance DENTAL / VISION If you have an appointment before your coverage is setup with Guardian, you will need to pay out of pocket and submit a claim

7 Life/AD&D insurance Unum Basic Term Life and AD&D Insurance Amount of Life Insurance: Flat $50,000 Amount of AD&D Insurance mirrors Basic Life Conti pays full cost of coverage Short-term disability (STD) Unum Provides financial protection for you by paying a portion of your income while you are disabled. Your payment may be reduced by deductible sources of income. Some disabilities may not be covered under this plan. Maximum period of payment is 26 weeks Elimination period is 7 days for disability due to an accident or sickness Benefits begin the day after the elimination period is completed Weekly benefit is 66 2/3% of weekly earnings to a maximum of $604 Voluntary long term disability (LTD) UNUM Long Term Disability is an income replacement program that protects you and your family in the event you become disabled and are unable to perform the physical and substantial duties of your job. If you are disabled for more than 180 days, you would be eligible to receive 60% of your basic monthly earnings up to a maximum of $8,000. Other provisions apply and are outlined in the summary plan description. Other voluntary products METLIFE As an employee of The Conti Group, you have the opportunity to apply for supplemental insurance through MetLife. These benefits can enhance your current benefits portfolio, and can be customized to fit your individual needs. The following insurance plans are offered: Accident Insurance, Life Insurance, Critical Illness Insurance, and Hospital Indemnity Insurance. MetLife Customer Service Line: Monday-Friday 8:00am-11:00pm EST

8 Flexible spending accounts (FSA) Wage Works The FSA offers programs which provides a means to use pre-tax dollars (Federal and Social Security taxes) to pay for certain out-of-pocket medical and dental expenses, eligible dependent care expenses, as well as work-related transit expenses. By taking advantage of this program, you will ultimately have more disposable income. Monies not used by the end of the year will be forfeited. You must save all receipts from purchases made on your Wage Works Healthcare Card (including prescriptions and physician co-payments). Wage Works will request that you substantiate all of your FSA Health Care purchases made on the Healthcare card. Healthcare FSA Program Employee can annually elect from $100 up to $2,550 to be withheld on a pre-tax basis to be directed into a special account that is to be used to pay for certain unreimbursed medical and dental expenses. NOTE: If you are enrolled in the HSA plan, you can only use the Healthcare FSA Program for qualified non-medical expenses (i.e., eligible dental and vision expenses). Dependent Care FSA Program Employee can annually elect from $100 up to $2,500 (if married; $5,000 if single) to be withheld on a pre-tax basis to be directed into a special account that is to be used to pay for certain expenses relating to childcare and/or eldercare services. Transit/Parking Program Employees can participate in the Qualified Transportation Expenses (QTE) Plan and have money deducted from their pay and set aside for their own QTE. By enrolling in the QTE Plan, you can pay for these expenses tax-free, meaning that you will not have to pay federal income taxes, social security (FICA) taxes, or state income taxes (may vary by state) on these amounts. You can elect up to $255 per month pre-tax towards your Mass Transit expenses and up to $255 per month towards your commuting-related Parking expenses. benefits at a glance INSURANCE Work/life benefits Willis Patient Care Helps members deal with clinical, insurance, and administrative issues involving medical, hospital, dental, pharmacy and other healthcare needs How Can Willis Patient Care Help? Find the best doctors, hospitals and other leading healthcare providers Arrange and schedule appointments with providers, especially with hard to reach specialists Save money on healthcare bills Sort out claim questions, billing and payment arrangements and related administrative issues Navigate within an insurance company to help obtain approval for eligible benefit services Obtain unbiased healthcare information to help make an informed decision Available 24 hours a day / 7 days a week. Services are also available to spouses, children, parents and parents-in-law.

9 Teladoc Teladoc gives you 24/7/365 access to US board-certified doctors through the convenience of phone or video consults. It s an affordable alternative to costly urgent care and ER visits when you need care now. When can I use Teladoc? Teladoc does not replace your primary care physician. It is a convenient and affordable option for quality care. When you need care now If you are considering th ER or Urgent Care Center for a non-emergency issue On vacation, on a business trip, or away from home For short-term prescription refills Get the care you need Teladoc doctors can treat many medical conditions, including: Cold and Flu Symptoms Allergies Bronchitis Respiratory infection Sinus problems And more! Meet Our Doctors Teladoc is simply a new way to access qualified doctors. All Teladoc doctors: Are practicing PCPs, pediatricians, and family medicine physicians Average 15 year experience Are U.S. board-certified and licensed in your state Are credentialed every three years, meeting NCQA standards Speak with a doctor anytime for free. With your consent, Teladoc will provide information about your consult to your primary care physician.

10 ID Watchdog Identity theft occurs when someone uses elements of your personally identifying information, like your name, Social Security Number, or financial information without your permission, to commit fraud or other crimes. While most consumers immediately assume that identity theft is just somebody using a stolen credit card, this should be the last of your concerns. True identity theft is prevalent, and has a much more significant impact than disputing a charge with your credit card company. Why ID Watchdog Identity Monitoring Scans public records searching for new information associated with your Social Security Number. Advanced Identity Monitoring: Scans National Change of Address (NCOA) database identifying new addresses associated with your personal information. Alternative Monitoring*: Today we scan Non-Credit Payday loan databases which provide high-interest, quick cash transactions requiring minimal personal information to obtain. We are expanding our fraud detection network to include monitoring Auto Pawn, Buy-Here-Pay- Here auto dealers, and Rent- To-Own store transactions. This is the most comprehensive alternative credit monitoring in the ID theft protection industry. Proactive Zero Hour Identity Monitoring*: Daily scanning of billions of transactions and data points will provide an early warning alerting customers of high risk transactions. Detects potential fraud as it is happening so our team can help you stop it in its tracks and prevent damage that may occur with ID theft. benefits at a glance INSURANCE Cyber Monitoring: Scans social networking sites, hacker forums, and underground websites that buy, sell and trade personal information. Credit Report Monitoring: Monitors credit and notifies you when changes such as new accounts, delinquent accounts and other credit-related information is recorded. Credit Reports & Scores: Access to your credit reports and scores from the three primary credit reporting agencies; Equifax, Experian and TransUnion.

11 Extended Identity Protection Lost Wallet Online safe box securely stores credit card, driver license information and more. Includes cancellation and request for new credit cards in the event your wallet or purse is stolen. Full Service Identity Restoration*: Dedicated Certified Resolution Specialists work on your behalf to restore your identity by addressing record-keeping and reporting agencies, removing erroneous and fraudulent records that appear in your name. A benefit of our concierge level service is few costs associated with identity restoration. ID Watchdog has a flawless record in restoring victim s identities, however peace of mind is important. All ID Watchdog Plus Protection Plans will include a $25,000 expense reimbursement insurance to cover those rare expenses during a restoration. NPI Monitoring: Monitors National Provider Identifiers (NPI) for healthcare professionals. Identity Theft Protection: You will receive your welcome or letter in the coming weeks to access your account. You can contact ID Watchdog directly at (7:00am-6pm MST; Monday Friday) Legal Plans Program MetLaw Hyatt Legal Plan MetLaw provides you with telephone and office consultations for an unlimited number of matters with the attorney of your choice. During the consultation, the attorney will review the law, discuss your rights and responsibilities, explore your options and recommend a course of action. Estate Planning Money Matters Real Estate Matters Elder Law Matters Family Law Traffic Offenses Document Preparation Immigration Assistance Juvenile Matters Consumer Protection Defense of Civil Lawsuits Personal Property Protection Visit Hyatt Legal Plans online at click on the Employee/Members area to access information about the plan and available services, or call for additional information.

12 Simplee This integrated platform within the portal s homepage allows you to view, manage and pay your insurance plan s expenses in one place. Benefits Organization Simplee keeps your benefits organized and provides a record of provider visits and claims, automatically screening for common billing errors, along with money-saving tips and advice on how to take action. The Simplee services through the portal are free and it s easy to get started on the portal s homepage, just click the button Connect to Simplee to register and set up your account. benefits at a glance INSURANCE

13 The Conti Group Done once. Done right. t f wwwin.conticorp.com