Life University - Benefits Overview PLAN YEAR

Transcription

1 Life University - Benefits Overview PLAN YEAR December 2016 November

2 Our employees are our most valuable asset. That s why at Life University we are committed to a comprehensive employee benefit program that helps our employees stay healthy, feel secure, and maintain a work/life balance. Healthgram/Cigna - Medical Insurance PPO Option $25/$50 $ %/60% PPO Option $25/$50 $ %/60% QHDHP (HSA Option) $ %/70% Transamerica special Voluntary Insurance AccidentAdvance Critical Illness CancerSelect Plus Lincoln Financial Group PPO Dental Vision Life and AD&D Short Term Disability Long Term Disability Voluntary Life and AD&D Assurant DHMO Dental UNUM Long Term Care Legal Shield Legal Services Healthgram Healthconnect 2

3 Medical Insurance Who is Eligible and When: All Full Time Active Employees are eligible for medical insurance. Your coverage begins following completion of your waiting period, or during the next open enrollment in October. Benefits You Receive: Life University medical plans are through Healthgram and they utilize the Cigna PPO, Choice Fund PPO network. They are comprehensive medical plans that meet all the mandates under the Patient Accountability and Affordable Care Act. Medical Maximum age of dependent is 26. 3

4 Medical Insurance Plan 1 (PPO) Benefits You Receive: Life University medical plans are through Healthgram and are comprehensive medical plans that meet all the mandates under the Patient Accountability and Affordable Care Act. Employee Pays Per Paycheck: Employee Only: $ Non-Tobacco / $ Tobacco Family: $ Non-Tobacco / $ Tobacco Plan Feature PPO Deductible Coinsurance* Out-of-Pocket (includes deductible) Office Visit Co-pay: Primary Care Specialist Emergency Services Inpatient Care* Outpatient Care* Prescription Drug Coverage (30 day) Generic or Tier 1 Formulary Brand Drugs or Tier 2 Non-Formulary Brand Drugs or Tier 3 Specialty Drugs or Tier 4 Mail Order (90 day) In-Network Out-of-Network $2,500 Single $7,500 Family 20% $6,350 Single $12,700 Family $2,500 Single $7,500 Family 40% $9,500 Single $19,000 Family $25 Copay $50 Copay 40% After Deductible 40% After Deductible $200 Copay, waived if admitted 20% after Deductible 20% after Deductible 40% After Deductible $15 Copay $30 Copay $60 Copay 10% up to $250 max Copay 2.5 x Copay Not Covered *In-Network - you are responsible for paying the 20% coinsurance; Out of Network you are responsible for paying the 40% coinsurance after you meet your deductible. (see plan certificate for more details) 4

5 Medical Insurance Plan 2 (PPO) Benefits You Receive: Life University medical plans are through Healthgram and are comprehensive medical plans that meet all the mandates under the Patient Accountability and Affordable Care Act. Employee Pays Per Paycheck: Employee Only: $ Non-Tobacco / $ Tobacco Family: $ Non-Tobacco / $ Tobacco Plan Feature PPO Deductible Coinsurance* Out-of-Pocket (includes deductible) Office Visit Co-pay: Primary Care Specialist Emergency Services Inpatient Care* / Outpatient Care* Prescription Drug Coverage (30 day) Generic or Tier 1 Formulary Brand Drugs or Tier 2 Non-Formulary Brand Drugs or Tier 3 Specialty Drugs or Tier 4 Mail Order (90 day) In-Network Out-of-Network $3,000 Single $9,000 Family 20% $6,350 Single $12,700 Family $3,000 Single $9,000 Family 40% $9,500 Single $19,000 Family $25 Copay $50 Copay 40% After Deductible 40% After Deductible $200 Copay, waived if admitted 20% After Deductible 40% After Deductible $15 Copay $30 Copay $60 Copay 10% up to $250 Copay 2.5 x Copay Not Covered *In-Network - you are responsible for paying the 20% coinsurance; Out of Network you are responsible for paying the 40% coinsurance after you meet your deductible. (see plan certificate for more details) 5

6 Medical Insurance Plan 3 (QHDHP HSA) Benefits You Receive: Life University medical plans are through Healthgram and are comprehensive medical plans that meet all the mandates under the Patient Accountability and Affordable Care Act. Employee Pays Per Paycheck: Employee Only: $73.45 Non-Tobacco / $ Tobacco Family: $ Non-Tobacco / $ Tobacco Plan Feature QHDHP (HSA) Deductible Coinsurance* Out-of-Pocket (includes deductible) Office Visit Co-pay: Primary Care Specialist Emergency Services Inpatient Care Outpatient Care In-Network Out-of-Network $3,500 Single $7,000 Family 0% $6,350 Single $12,700 Family $ 7,000 Single $14,000 Family 30% $14,000 Single $28,000 Family 0% After Deductible 0% After Deductible 30% After Deductible 30% After Deductible 0% After Deductible 0% After Deductible 30% After Deductible $10 Copay after Deductible $30 Copay after Deductible $60 Copay after Deductible 1 x Copay Not Covered Prescription Drug Coverage (30-day supply) Generic Formulary Brand Drugs Non-Formulary Brand Drugs Mail Order (90 Day Supply) *Out of Network - you are responsible for paying the 30% coinsurance, after you meet your deductible. (see plan certificate for more details) 6

7 Health Savings Account Life University Employer Contribution: $250/Single; $500/Family this amount will be pro-rated based on your benefits start date for all new hires. Additional employee contributions are made on a pre-tax basis. IRS Total Maximum contributions: Employee Maximum Contribution for 2017 is $3400* (2016 is $3350) Family Maximum Contribution for 2017 is $6750* (2016 is $6650) $1,000 catch-up provision for those age 55 and older by Amounts that remain at the end of the year can be carried over to the next year. *This maximum contribution total will be lowered based on the contribution by Life University. You cannot go over the IRS maximum contribution limit for a plan year. The HSA administration is handled by Mellon Bank. You will not be able to use your own bank for your HSA account. YOUR ADDITIONAL TAX SAVINGS OVER ALTERNATE PLANS: For Singles 2017 Annual H.S.A. Contribution $3,400 x Federal Tax Bracket 35% 33% 28% 25% 15% For Employees with Dependents = Potential Federal Tax Savings $1, $1, $ $ $ Annual H.S.A. Contribution $6,750 x Federal Tax Bracket 35% 33% 28% 25% 15% = Potential Federal Tax Savings $2, $2, $1, $1, $1,

8 Healthgram- Healthconnect 8

9 Healthgram- Healthconnect 9

10 Accident Advance, Critical Illness and CancerSelect Plus With the higher deductibles that are now commonplace for most health plans, an unexpected accident can cause a serious financial burden for even the most well prepared individual or family. The AccidentAdvance Plan: Reduces or eliminates the financial risk if you or a family member suffers a broken or dislocated bone. The money does not replace your health insurance your health insurance will continue to pay the claims incurred. But the money can be used to pay your portion of your health coverage such as your deductible or office visit copays. Or, you can use it to buy that flat screen T.V. to watch while you re recovering! It s paid to you, to use as you see fit. The best part! This plan can be FREE if you get a routine wellness exam or blood test. Transamerica will pay YOU and your SPOUSE $150 each upon receiving proof of a completed wellness exam or test. This can cover most of, or exceed, the cost of the plan premiums! Child physicals are not reimbursed. Semi-Monthly Premiums Individual Single Parent Family Two-Adult Family Family $6.25 $7.26 $9.66 $10.68 Individual only annual premium = $ * Annual Wellness Benefit = $ Annual Cost FREE Two Parent Family annual premium = $ *Annual Wellness Benefit = $ Profit $68.16 Single Parent Family annual premium = $ *Annual Wellness Benefit = $ Annual Cost $24.24 Family annual premium = $ *Annual Wellness Benefit = $ Profit $43.68 *See the plan brochure for additional details 10

11 Last opportunity to enroll with NO HEALTH INFORMATION REQUIRED. Late Entrants will be required to complete Evidence of Insurability and may be declined coverage due to existing health conditions. This plan also has a wellness exam benefit of $50 each for YOU and your SPOUSE to help off-set the plan premiums. Child physicals are not reimbursed. Issue Ages Covered illnesses are: Cancer of any kind, Heart Attack, Stroke, End-stage Renal Failure, Major Organ Transplant Surgery, Carcinoma in Situ* or Skin Cancer*. *limited to 5% of the eligible benefit amount Semi-Monthly Premiums INDIVIDUAL Coverage $10,000 $15, $20, Issue Ages The Critical Illness plan can completely eliminates the financial risk of someone getting one of the serious illnesses covered by this plan. This plan will pay $10,000, $15,000 or $20,000 directly to YOU for a covered illness which you could then use to pay your deductible and other out of pocket expenses. INDIVIDUAL AND CHILD(REN) Coverage $10,000 $15, $20, Issue Ages Accident Advance, Critical Illness and CancerSelect Plus INDIVIDUAL AND SPOUSE PLUS CHILDREN Coverage $10,000 $15,000 $20, * See brochure for additional details 11

12 Accident Advance, Critical Illness and CancerSelect Plus CancerSelect Plus is designed to provide you and eligible family members with benefits for costs associated with cancer treatment. Coverage is 100% portable. Benefits are paid directly to you or anyone you choose in addition to any other insurance.2 Understanding CancerSelect Plus: CancerSelect Plus includes: Hospital Benefits Surgery Benefits Individual $6.98 Cancer Maintenance Therapy Radiation/Chemotherapy Benefits Semi-Monthly Premiums Single Parent Family $8.46 Wellness and Misc. Benefits Family $13.40 This plan also has a cancer screening benefit of $150 each for YOU and your SPOUSE to help off-set the plan premiums see the illustration below. Individual Only annual premium = $ *Annual Wellness Benefit =$ Net Annual Cost $ Single Parent Family annual premium = $ *Annual Wellness Benefit = $ Net Annual Cost $ Family annual premium = $ *Annual Wellness Benefit = $ Net Annual Cost $ Last opportunity to enroll with NO HEALTH INFORMATION REQUIRED. Late Entrants will be required to complete Evidence of Insurability and may be declined coverage due to existing health conditions. *See the plan brochure for additional details 12

13 Accident Advance, CancerSelect Plus and Critical Illness Combined Savings Issue Age: Individual Individual/Child(ren) Individual/Spouse Family Issue Age: Individual Individual/Child(ren) Individual/Spouse Family Issue Age: Individual Individual/Child(ren) Individual/Spouse Family Issue Age: Individual Individual/Child(ren) Individual/Spouse Family Issue Age: Individual Individual/Child(ren) Individual/Spouse Family Accident Premium $6.25 $7.26 $9.66 $10.68 Accident Premium $6.25 $7.26 $9.66 $10.68 Accident Premium $6.25 $7.26 $9.66 $10.68 Accident Premium $6.25 $7.26 $9.66 $10.68 Accident Premium $6.25 $7.26 $9.66 $10.68 Critical Illness $10K Benefit Premium $3.50 $3.85 $6.75 $6.75 Critical Illness $10K Benefit Premium $7.00 $7.70 $13.50 $13.50 Critical Illness $10K Benefit Premium $12.65 $13.90 $24.35 $24.35 Critical Illness $10K Benefit Premium $17.25 $19.00 $33.25 $33.25 Critical Illness $10K Benefit Premium $21.50 $23.65 $41.40 $41.40 CancerSelect Plus Premium *Annual Wellness Benefit Combined **Semi-Monthly out of pocket expense $6.98 $8.46 $13.40 $13.40 $ $ $ $ $2.14 $4.99 $0.64 $1.66 CancerSelect Plus Premium $6.98 $8.46 $13.40 $13.40 *Annual Wellness **Semi-Monthly out of pocket expense Benefit Combined $ $5.64 $ $8.84 $ $7.39 $ $8.41 CancerSelect Plus Premium $6.98 $8.46 $13.40 $13.40 *Annual Wellness Benefit Combined $ $ $ $ CancerSelect Plus Premium $6.98 $8.46 $13.40 $13.40 *Annual Wellness **Semi-Monthly out of pocket expense Benefit Combined $ $15.89 $ $20.14 $ $27.14 $ $28.16 CancerSelect Plus Premium $6.98 $8.46 $13.40 $13.40 *Annual Wellness **Semi-Monthly out of pocket expense Benefit Combined $ $20.14 $ $24.79 $ $35.29 $ $36.31 **Semi-Monthy out of pocket expense $11.29 $15.04 $18.24 $19.26 How much does the Accident, CancerSelect and Critical Illness plans actually cost if I get my physical and/or Cancer Screening? The last column on the right shows your net cost after you received your wellness benefit from all plans. You must have an annual physical and/or cancer screening during the plan year to obtain this benefit. ** This is your net cost after payment of premiums and receipt of wellness benefits, shown on a per paycheck basis for illustrative purposes only. Premiums are deducted each pay period and the wellness benefit reimbursement is received as a lump sum payment. 13

14 Dental Insurance- DMO Prepaid Dental Care Who is Eligible and When: All Full Time Active Employees are eligible for dental insurance. Your coverage begins following completion of your waiting period, or during the next open enrollment in October. Benefits You Receive: Life University s dental plan is through Assurant and underwritten by Union Security DentalCare of Georgia. The employee is responsible for a small portion of the premium cost. Employee Pays Per Paycheck: Employee Only: $1.71 Employee + 1: $5.02 Family: $ Plan Feature Deductible Preventive / Basic / Major Services Orthodontic Services Plan Year Annual Maximum IN NETWORK ONLY No Deductible Copays Apply (See detailed plan summary) 25% Discount on fees Unlimited This plan is a LOW priced dental option for people who do not have a specific provider/dentist. 14

15 Dental Insurance- PPO Who is Eligible and When: All Full Time Active Employees are eligible for dental insurance. Your coverage begins following completion of your waiting period, or during the next open enrollment in October. Benefits You Receive: Life University s dental plan is through Lincoln Financial Group. The employee will be responsible for paying 100% of the premium cost. Employee Pays Per Paycheck: Employee Only: $22.33 Employee + 1: $42.02 Family: $ Network- Lincoln Dental Connect* Network- Lincoln Dental Connect* MAC PLAN** 90% U&C Plan 0% 0% Basic Services 0% After Deductible 20% After Deductible Major Services 40% After Deductible 50% After Deductible $50 Individual / $150 Family $50 Individual / $150 Family Orthodontics (Children) 50% 50% Benefit Period Maximum $1,500 $1,500 Type of Service Preventive Services Deductible Maximum Rollover Benefit $350 with a threshold of $1250 You MUST select the MAC or 90% U&C Plan *Lincoln Financials In-Network provider network is the Lincoln Dental Connect Network. Out of Network benefits are also available but may result in higher out of pocket expenses for you. (See plan summary for details) ** The MAC Plan is the better value & coverage IF your dentist is in the Lincoln Dental Connect Network. Dependent maximum age

16 Voluntary Vision Who is Eligible and When: All Full Time Active Employees are eligible for vision insurance. Your coverage begins following completion of your waiting period, or during the next open enrollment in October. Benefits You Receive: Life University offers employees the opportunity to elect vision coverage which provides benefits for vision exams, lenses and frames, or contacts. The employee will be responsible for paying 100% of the premium cost. Employee Pays Per Paycheck: Employee Only: $ 3.79 Employee/Spouse: $ 7.21 Employee/Child(ren): $ Employee/Spouse/Child(ren): $11.16 Type of Service- SPECTERA VISION NETWORK Amount You Pay In Network1 Routine Eye Exam (one every 12 months) $10 Copay; then covered in full Eyeglass frames (every 12 months) $25 Copay up to $130 Retail Allowance Eyeglass lenses (one pair every 12 months) Standard plastic Single Vision lenses $25 Copay; then covered in full Standard plastic Bifocal lenses $25 Copay; then covered in full Standard plastic Trifocal lenses $25 Copay; then covered in full Contact Lenses (in lieu of glasses) $25 Copay for medically necessary Out of Network benefits also available but may result in higher out of pocket expenses for you. See plan summary for details. Dependent maximum age is 26 16

17 Life and AD&D Insurance Who is Eligible and When: All Full Time Active Employees are eligible for group life and accidental death and dismemberment (AD&D) insurance. Your coverage begins following completion of your waiting period, or during the next open enrollment in October. Basic Life and AD&D Insurance Life University provides full-time employees with group life and accidental death and dismemberment (AD&D) insurance, and pays the full cost of this benefit. Contact HR to update your beneficiary information. Employee Pays: Employee Only: $0 Plan Feature Basic Life and AD&D Insurance Benefit Plan Benefit $50,000 17

18 Voluntary Life and AD&D Insurance Who is Eligible and When: All Full Time Active Employees are eligible for Voluntary Life and AD&D insurance. Your coverage begins following completion of your waiting period, or during the next open enrollment in October. Voluntary Life & AD&D Insurance Life University offers full-time employees with an opportunity to purchase additional life insurance. Employees are responsible for the full cost of this benefit. Employee Pays Per Paycheck: Age Bracket $ 50,000 $100, $1.75 $ $4.00 $ $10.25 $20.50 Child(ren) cost for $10,000 is $0.80 Plan Feature Benefit Guaranteed Issue $200,000 $7.00 $16.00 $ Voluntary Life Coverage 5 x salary or up to $300,000, in $10,000 increments for employees Up to 50% of employee selection for Spouse Up to $10,000 for children Employee up to $200,000 Spouse up to $50,000 *These are sample rates at several age brackets & income levels. All ages and incomes are available on the enrollment system. Age reductions rules apply. You will have to answer medical questions if you didn t enroll last year, or when you were originally eligible as a new hire. 18

19 Life Cost Illustration This is an estimate of premium cost. Actual deductions may vary slightly.

20 Life Cost Illustration This is an estimate of premium cost. Actual deductions may vary slightly.

21 TransElite Universal Life with Long Term Care Insurance In order to enroll for this product you must complete the paper enrollment form and return it to HR. This enrollment is not included in the online benefit portal. 21

22 Long Term Care Plan Benefits are through UNUM. Life University pays $25 towards the cost of monthly coverage. Spouses, parents, grandparents, siblings, and children over 18 are also eligible. Plan covers facility, home care, and community care options with a three year, six year, or unlimited benefit duration. $2,000 to $8,000 monthly benefits are available in $1,000 increments. Inflation protection is also available. 60 day wait period with inability to perform at least two activities of daily living. Your rate is locked in once the policy is purchased. Additional information can be found at Late Entrants will be required to complete Evidence of Insurability and may be declined coverage due to existing health conditions. 22

23 Long Term Care Plan 23

24 Short Term Disability Insurance Who is Eligible and When: All Full Time Active Employees are eligible for short term disability benefits. New Hire coverage begins after completion of your 12 month waiting period. Benefits You Receive: Life University provides short term disability at no cost to regular full time employees. Short-term disability benefits run concurrently with FMLA, LOA, etc. and are available after two weeks of a disability event. Life will pay up to 100% of an employee's wages up to 13 weeks including the use of personal, vacation and banked leave balances. This benefit falls under the same provisions as FMLA and requires proper certification by Lincoln Financial Group. 24

25 Long Term Disability Insurance Long Term Disability Insurance Who is Eligible and When: All Full Time Active Employees are eligible for long-term disability insurance. Your coverage begins following completion of your waiting period. Benefits You Receive: Life University offers full-time employees with long-term disability income benefits at no cost to the employee. In the event you become disabled from a non work-related injury or sickness, disability income benefits are provided as a source of income. Your disability plans do not cover disabilities due to an occupational sickness or injury. Employee Pays: $0 Plan Feature Long-Term Disability Benefits Begin After 90 days Percentage of Income Replaced Maximum Benefit Maximum Period of Payment Pre-existing Condition 60% $5,000 per month Social Security Normal Retirement Age 3 months look back / 12 months after exclusion 25

26 Flexible Spending Account- eflexgroup/tasc The plan is administered by eflexgroup/tasc You deposit the amount you elect in the FSA on a pre-tax basis. Money deposited in the account can be used to reimburse yourself deductibles and co-pays in the medical, dental and vision plans. You can also be reimbursed for a list of IRS approved medical related expenses such as over the counter medications (with a physician prescription) and Lasik surgery. If you are enrolled in the Health Savings Account you can only be reimbursed for dental and vision expenses. You are able to deposit up to $2,500 per year in the medical spending account and $5,000 per year in the dependent spending account. You are now able to rollover $ from one plan year to the next if you do not utilize all of your allocation funds. However, you will no longer be able to file claims after the end of the plan year. 26

27 Employee Assistance Plan EmployeeConnect is offered to you through Lincoln Financial. Employee Support Services include the following: Unlimited telephonic consultation with EAP counselor State of the art web site featuring over 3,400 helpful articles on topics like wellness, training courses, a legal and financial center and more! Referrals to local counselors Estate Guidance will preparation Financial Services Legal Support Support with day-to-day concerns Call Username = LFGsupport Password = LFGsupport1 27

28 Legal Services Legal Shield Life Events Legal Plan The LegalShield Standard Family Legal Plan provides members and their family access to the legal services they need most. Plan benefits include: Preventive Legal Services; phone consultation, letter writing, contract and document review. Motor Vehicle Legal Defense Services. Trial Defense Legal Services. IRS Audit Services. Preferred Member Discount of 25% off legal services not specifically covered by the membership. Attorney assistance for an emergency with a 24-hour toll-free number for certain matters. The description is intended as an overview. See exclusions. for information and Identity Theft Shield Identity theft is the fastest growing crime in America today. Would you know what to do if it happened to you? With the Identity Theft Shield, you ll have experienced private investigators on your side if it does. Plan Benefits include: Current credit report with detailed analysis and credit score Continuous credit monitoring and notification Identity Restoration Services by Kroll licensed investigators. The description is intended as an overview. See exclusions. for information and Plan Options To learn more about the plans and who s covered: Legal Plan Stand Alone : $7.98 per payroll deduction. Legal Plan with Identity Theft Shield: $12.95 per payroll deduction Identity Theft Shield: $7.48 per payroll deduction Contact: Nanette S. Freiman nsfreiman@bellsouth.net 28

29 EMPLOYEE WEB ENROLLMENT PlanSource PlanSource is an employee self-service portal that will allow you to access all the information related to your benefits. You can use any web browser* anywhere in the world to access PlanSource. With PlanSource, you have real time access to all your benefits-related employment information 24 hours a day. Before you begin the enrollment process please make sure you have reviewed the benefit Plan Information provided online. You will need: Benefit Election Decisions All Dependent Information including date of birth and social security number Logging On To access the site, point your web browser to and select Login- PLANSOURCE: BENEFITS ONLY. Employees who have established a login and password will continue to use that same password. Your user name will be your Company Address. Next you will enter your password. The first time you log in to the site your password will be your date of birth in numeric format without any slashes, YYYYMMDD. 29

30 MISCELLANEOUS ITEMS Life Events: Examples of commonly defined Life Status Events may include: Marriage Divorce or legal separation Adoption or birth of a child Employment Status Spouse gains or loses employment Death of a spouse or dependent Eligible for Medicare Leave of Absence To make a change in coverage due to a Life Status Event, documentation is required within 30 days of the qualifying event. The change is most often effective on the date of the event. Voluntary Life Insurance and TransAmerica: EOI (Eligibility of Insurance) and medical history are to be submitted to Human Resources within 30 days, otherwise additional coverage will be denied and removed from PlanSource. FYI to Faculty and Staff: Please do not assume that we get the same correspondence that you receive from the carrier. If you receive information you believe to be in error, please contact HR and forward this information immediately. 30

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32 The information in this Benefits Summary is presented for illustrative purposes and is based on information provided by the employer. The text contained in this Summary was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Benefits Summary and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of If you have any questions about this summary, contact Human Resources. 32