Your 2018 Benefits Guide

Transcription

1 Your 2018 Benefits Guide

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3 Table of Contents CEO Letter... 2 Benefit Basics... 3 Benefit Costs... 4 Health Care Coverage... 5 Health Savings Account... 6 Medical Plans... 7 Prescription Drug... 8 Medical/Rx Rates... 9 Dental Plan Vision Plan Flexible Spending Accounts Life Insurance Disability Insurance Supplemental Insurance Additional Benefits Glossary Global Human Resources Enrollment Instructions Contacts

4 CEO Letter Dear Associate: Benefits are an important part of your employment at LifeBridge Health. Enclosed please find a guide to your health care benefits as well as information on how to enroll for your 2018 benefits. Open enrollment will occur October 16 31, You will receive additional information about open enrollment as we get closer to the date. This guide is intended to be a quick reference. You will find more details on our health plans and other benefits on the Hospital intranet pages. You can also learn more about your medical benefits by visiting Please review this information thoroughly and make sure you understand all the benefits that are available to you. If you have questions, please contact Employee Services at , or employee_services@lifebridgehealth.org. As a valued employee, your continued health and well-being is important to us. Take good care of yourself, so that we can continue to care for our communities together. We wish you a happy and healthy 2018! Sincerely, Neil M. Meltzer President and Chief Executive Officer 2

5 Benefit Basics YOUR 2018 BENEFIT GUIDE You have access to a variety of benefits to provide comprehensive coverage for you and your family. Please read this guide to learn more about your benefits. Eligibility You are considered a benefits-eligible Associate* and able to participate in the benefit program if you are: Actively budgeted to work full-time (72-80 hours per pay period), or Actively budgeted to work part-time (48-71 hours per pay period). *Affordable Care Act employer responsibility applies. You will be notified if you are impacted. Medical, dental and vision are effective on the first day of the month following your date of hire. Other benefits are effective the first of the month following 30 days. Your dependents can also enroll for coverage, including: Your legal spouse Your children up to age 26 Open Enrollment The benefits you elect during Open Enrollment will take effect on January 1, 2018 and will remain in effect until December 31, 2018 (as long as you remain benefits eligible). Remember that you may only change coverage if you experience a qualifying life event, as described below. You must enroll by October 31, 2017 or it will be assumed all benefits are waived. Qualifying Life Events Generally, you may only make or change your existing benefit elections during the open enrollment window. However, you may change your benefit elections during the year if you experience an event such as: Marriage Divorce or legal separation Birth of your child Death of your spouse or dependent child Adoption of or placement for adoption of your child Change in employment status of employee, spouse or dependent child Qualification by the Plan Administrator of a child support order for medical coverage New entitlement to Medicare or Medicaid You must notify Human Resources within 30 days of a qualifying life event. Depending on the type of event, you may need to provide proof of the event, such as a marriage license. Human Resources will let you know what documentation you should provide. If you do not contact Human Resources within 30 days of the qualified event, you will have to wait until the next open enrollment window to make changes (unless you experience another qualifying life event). Change in Benefit Eligibility Status If you transfer into a benefits-eligible position for the first time, you can enroll and make your benefit elections. If this occurs, your benefits will change effective the first day of the month following your status change. If you do not complete the enrollment process within 30 days, you will not be able to change your benefits until the next annual open enrollment period. Information needed to complete the enrollment process can be found on pages 18 through 19. New Hires Enrollment should be completed prior to the effective date to ensure that everything is in place once benefits are active. If you fail to complete enrollment within 30 days, you will not be eligible to enroll in benefits again until the next annual enrollment period. Information needed to complete the enrollment process is on page 18. For more information about your benefits: Phone: Online: extra.carrollhospitalcenter.org 3

6 Benefit Costs Your employer pays for some of your benefits and you share the cost for others, as shown below: BENEFIT WHO PAYS TAX TREATMENT Medical Coverage Hospital & Associate Pretax Dental Coverage Hospital & Associate Pretax Vision Coverage Associate Pretax Basic Life and Accidental Death & Dismemberment (AD&D) Insurance Supplemental Life Insurance for You and your Family Disability Coverage Hospital Associate Associate (STD) Hospital (LTD) After-tax After-tax After-tax Flexible Spending Accounts Associate Pretax Employee Assistance Plan Hospital After-tax Retirement Savings Plan (403b) Hospital & Associate Pretax You have access to a variety of benefits to provide health and financial wellness for you and your family. TO YOUR HEALTH Medical Insurance Health Savings Account Prescription Drug Benefits Dental Insurance Vision Insurance TO YOUR WEALTH Flexible Spending Accounts Life Insurance Disability Insurance Voluntary Benefits Retirement Savings Plan 4

7 Health Care Coverage YOUR 2018 BENEFIT GUIDE Your health care coverage includes medical, dental and vision plans. Detailed information about each plan is in this section. If you have questions, please contact Employee Services. Your Medical Plan You have two medical plan options: Health Saver Plan (with HSA) Premium Health Plan Both plans are administered by QualCare, Inc., a Cigna company, so you can choose the coverage level bestsuited to your personal situation. Both medical plans include prescription drug benefits through CVS. In/Out-of-Network Coverage Each medical plan features in- and out-of-network coverage; individual and family deductibles; coinsurance; and out-of-pocket maximums. Some offer a lower monthly cost, a higher deductible, and lower coinsurance amounts, while others cost more each month but offer a lower deductible and higher levels of coinsurance. If you don t understand some of these terms, please refer to the Glossary on page 16. You may use in- or out-of-network providers. You will always pay less if you see a doctor or receive services within the provider network because the plan pays more in-network. Your LifeBridge Health medical benefits include three tiers of coverage, two in-network benefits and one out-of-network benefits. LifeBridge Providers and Cigna OAP are in-network. Deductible You must meet an annual deductible before the medical plan begins to cover a portion of your costs (the Premium Health Plan office visits are covered before the deductible); however, under the Health Saver Plan your HSA may pay for some of those expenses. Once the deductible is met, the medical plan begins to pay for a percentage of covered expenses (this is called coinsurance). Note that with the HDHP, prescriptions are subject to the medical deductible and out-of-pocket maximum. Out-of-pocket maximums Out-of-pocket maximums apply to all of the plans. This is the maximum amount you will pay for health care costs in a calendar year. Once you have reached the out-of-pocket maximum, the plan will fully cover eligible medical expenses for the rest of the benefits plan year (except for any copayments). However, if you see an out-of-network provider, you may be responsible for out-of-pocket costs that are considered above the reasonable and customary fees. You decide which medical plan will work best for you and your family based on the monthly cost of coverage, the annual deductible, the out-of-pocket maximum, and the funding account you will use. 5

8 Health Savings Account Your health care coverage under the Health Saver Plan includes a Health Savings Account, an easy way to save pre-tax money to use on medical expenses. Health Savings Account What is it? A Health Saving Account (an HSA) is a tax-advantaged account similar to a savings or checking account and is usually established with a bank or insurance company. Only individuals enrolled in the Health Saver Plan are eligible to make tax deductible contributions to an HSA. Contributions to HSAs can be made through pretax payroll deductions or directly to the HSA administrator, in which case you receive your tax deduction when you file your federal tax return for the year. In addition, any funds withdrawn from an HSA (including employer contributions) are never taxed as long as they are used to pay for qualified expenses. Health Saver Plan and HSA Working Together Each time you seek medical care under the Health Saver Plan, you can: (1) pay for the services using funds from your HSA, or (2) choose to pay out-of-pocket and let the funds continue to gain tax-free interest or investment return. Once you meet the deductible, services are covered according to the Plan s benefit schedule. After you have incurred a qualified expense, there are several options available for accessing HSA funds. Your HSA administrator may: (1) allow you to draw directly from your account with a debit card, (2) give you the option for automatic withdrawal, or (3) require you to submit a completed claim form. With automatic withdrawal, once your medical claim is processed, your out-of-pocket expenses are automatically processed through your HSA for reimbursement. It s Your Money Unused HSA funds stay in your account and continue to accumulate and earn non-taxable interest or investment return over the life of the account. Your account is portable. You can take your account with you if you retire or leave your employment. All funds in your HSA are your money! HSA Eligibility Requirements In order to be eligible for an HSA account, you must: Be covered by a plan that qualifies as a High Deductible Health Plan (HDHP) Not be claimed as a dependent on another person's tax return Not be covered under another medical plan that is not an HDHP Not be enrolled in Medicare Part A or B (active employees age 65 or over can contribute to an HSA as long as they are not enrolled in either Medicare Part A or Part B) Not be in receipt of VA medical or prescription benefits within the previous three months. IRS guidance states that otherwise eligible individuals are not eligible to make contributions to an HSA in any month if the individual received medical or prescription benefits from the VA at any time during the previous three months. State laws may vary; however, most states follow Federal tax guidelines. Funding Limits For 2018, annual contributions to an HSA are limited to $3,450 for single coverage and $6,900 for family coverage. If you are age 55 or older, you may make a catch-up contribution each year to the HSA. In 2018, the catch-up amount is $1,000. LifeBridge Health also provides a company contribution: $600 for individual coverage or $1,200 for family coverage. Contributions will be made in two installments, with the first pay in January and the second pay in July (if you are employed the full year). This reduces your annual contribution limit. The combined total contribution between the employee and the employer cannot exceed the IRS annual limit. Tax Reporting HSAs have some significant tax advantages because contributions to an HSA are tax favored and earn tax-free interest or investment return. 6

9 Medical Plans Medical Plan Comparisons This chart compares the basic provisions of your two medical plan options. YOUR 2018 BENEFIT GUIDE BENEFITS Annual Deductible Individual Family LBH NETWORK TIER 1 $2,700 $5,200 HEALTH SAVER PLAN (WITH HSA) CIGNA OAP TIER 2 $2,800 $5,600 OUT OF NETWORK TIER 3 $3,000 $6,000 LBH NETWORK TIER 1 $200 $400 PREMIUM HEALTH PLAN CIGNA OAP TIER 2 $600 $1,200 OUT OF NETWORK TIER 3 $1,800 $3,600 Coinsurance 80% 60% 50% 100% 70% 60% Maximum Out of Pocket Individual Family $4,000 $8,000 $5,000 $10,000 $6,600 $13,200 $1,000 $3,000 $4,000 $8,000 $5,600 $11,200 Annual OOP Maximum Includes deductible, copays, coinsurance Includes deductible, copays and coinsurance and prescription - not prescription Hospital Elective, Non- Emergency Admission 80%* 60%* 50%* 100%* $500 copay 70%* $500 copay, 60%* Hospital Physician Elective, Non-Emergency 80%* 60%* 50%* 100%* 70%* 60%* Admission Emergency Room 80%* 80%* 80%* $100 $100 $100 Urgent Care Center 80%* 60%* 50%* $10 70%* 60%* Same Day Surgery Hospital Office Visit Primary Physician 80%* 60%* 50%* 100%* 70%* 60%* 80%* 60%* 50%* $10 70%* 60%* Office Visit Specialist 80%* 60%* 50%* $35 70%* 60%* Routine Wellness Services 100% 100% 50%* 100% 100% 60%* Laboratory 80%* 60%* 50%* 100% 70%* 60%* Radiology 80%* 60%* 50%* 100% 70%* 60%* For all plans: Precertification Penalty: You may be required to obtain pre-certification from the plan prior to receiving certain services. If either you or your physician does not pre-certify care when necessary, plan payments will be reduced or denied. Please review the Plan document for detailed information. *After deductible is met. Deductible Waived. NOTE: This is a summary only of your coverage. In-network services are based on negotiated charges; out-of-network services are based on reasonable and customary (R&C) charges. 7

10 Prescription Drug Prescription Drug Coverage When you enroll in the Health Saver Plan or the Premium Health Plan, you automatically receive prescription drug benefits administered by CVS. HEALTH SAVER PLAN (WITH HSA) PREMIUM HEALTH PLAN PLAN PROVISIONS Retail Mail Order LBH Retail Pharmacies CVS/Other Retail Pharmacies LBH Pharmacies (90-day Supply) CVS Mail Order (90-day Supply) Annual Deductible Annual Out-of- Pocket Maximum Integrated with Medical Integrated with Medical $75 per person/$225 per family $1,000 per person/$2,000 per family Generic 20% 20% $10* $10 $20 $20 Formulary 30% 30% $30 $40 $60 $80 Non-formulary 40% 40% $50 $70 $100 $140 Specialty 50% 50% $0 Not Covered $0** Not Covered * $0 copay for generics to treat high blood pressure, cholesterol, depression and diabetes if the prescription is filled at a LifeBridge Health pharmacy. ** Can only be filled at a LifeBridge Health pharmacy Mail Order and Maintenance Medications This program requires your maintenance medication to be filled by LifeBridge Health Pharmacies, Anchor Pharmacy located in Carroll Hospital or CVS Mail Order after one courtesy fill. By utilizing this benefit, a threemonth supply of medications is received for the cost of two months. Specialty Medications You are required to fill your Specialty medications at a LifeBridge Health Pharmacy. If the medication is filled at a non-lifebridge Health Pharmacy, you will pay the full cost for the drug out-of-pocket. 8

11 Medical/Rx Rates Bi-Weekly Payroll Contributions YOUR 2018 BENEFIT GUIDE RATES* COVERAGE HEALTH SAVER PREMIUM HEALTH Full Time Part Time Full Time Part Time Individual $35.17 $47.64 $75.65 $ Associate and Child $56.27 $76.22 $ $ Associate and Spouse $77.37 $ $ $ Family $98.48 $ $ $ WELLNESS RATES* COVERAGE HEALTH SAVER PREMIUM HEALTH Full Time Part Time Full Time Part Time Individual $33.41 $45.26 $71.86 $ Associate and Child $53.46 $72.41 $ $ Associate and Spouse $73.51 $99.56 $ $ Family $93.55 $ $ $ *There is a nicotine surcharge of $30 per pay period for the Associate, if applicable *There is a spousal surcharge of $30 per pay period for the Associate, if applicable 9

12 Dental Plan Your dental plan provides coverage for routine exams and cleanings and pays for a portion of other services, as shown in the chart below. It s important to have regular dental exams and cleanings so problems are detected before they become painful and expensive. Keeping your teeth and gums clean and healthy will help prevent most tooth decay and periodontal disease, and is an important part of maintaining your medical health. Provider search available on Network: Cigna Advantage DPPO. Your dental plan is the Cigna Preferred Dental Plan. This chart shows what the plan pays: CIGNA PREFERRED DENTAL PLAN PROVISION IN-NETWORK OUT-OF-NETWORK Annual deductible $50 Individual/$150 family $50 Individual/$150 family Annual maximum $1,500 per person $1,500 per person Preventive care** (Does not count towards annual maximum) 100% 100%* Basic services 80% after deductible 60% after deductible* Major services Restorative 80% after deductible 50% after deductible* Major services Surgical 50% after deductible 40% after deductible* Orthodontia Dependents under age 19 ($1,200 maximum lifetime benefit) 50% 40%* * Represents coverage at the usual and customary charge for the services rendered. If your out-of-network provider charges more than the usual and customary limit, those charges will not be covered by the plan and you may be balance billed. ** Additional cleanings covered during pregnancy. DENTAL INSURANCE BI-WEEKLY PREMIUMS LEVEL OF COVERAGE FULL TIME EMPLOYEE PART TIME EMPLOYEE Individual $8.53 $10.10 Associate and Child $10.02 $15.03 Associate and Spouse $13.35 $20.04 Family $18.85 $

13 YOUR 2018 BENEFIT GUIDE Vision Plan Your vision plan provides coverage for routine eye exams and pays for all or a portion of the cost of glasses or contact lenses. BENEFIT IN-NETWORK Exam No copay Hardware No copay Frequency Exam Lenses Frames Frames Lenses Single vision lenses Bifocal lenses Trifocal lenses Medically necessary contact lenses Elective contact lenses in lieu of glasses Once every 12 months No copay; $150 allowance; 20% discount after $150 No copay No copay No copay; $130 allowance $100 allowance for additional pair with adjustment for advanced computer vision. Laser vision correction discounts are available. A list of participating providers can be found at Regular vision care is important for your eye health. An annual exam should be part of your wellness plan. BI-WEEKLY PREMIUMS LEVEL OF COVERAGE FULL OR PART TIME Individual $4.21 Associate and Child(ren) $7.88 Associate and Spouse $7.43 Family (3 or more) $

14 Flexible Spending Accounts A Flexible Spending Account (FSA) is a program that helps you pay for health care and dependent care costs using tax-free dollars. On an annual basis, you decide how much money you would like to contribute to one or both accounts. Your contribution is deducted from your paycheck on a pretax basis and is put into the Health Care FSA, the Dependent Care FSA, or both. When you incur expenses, you can access the funds in your account to pay for eligible health care or dependent care expenses. This chart shows the eligible expenses for each FSA; how much you can contribute to each FSA each year, and how you benefit by using an FSA. ACCOUNT TYPE AND ELIGIBLE EXPENSES HEALTH CARE FSA Most medical, dental and vision care expenses that are not covered by your health plan (such as copayments, coinsurance, deductibles, eyeglasses and doctor-prescribed over the counter medications) LIMITED PURPOSE HEALTH CARE FSA Only dental and vision care expenses that are not covered by your Health Saver Plan (with HSA) DEPENDENT CARE FSA (Covers children to age 13) Dependent care expenses (such as day care, after school programs or elder care programs) so you and your spouse can work or attend school full-time ANNUAL CONTRIBUTION LIMITS Maximum contribution is $2,600 per year Maximum contribution is $2,600 per year Maximum contribution is $5,000 per year ($2,500 if married and filing separate tax returns) BENEFIT Saves on eligible expenses not covered by insurance; reduces your taxable income Saves on eligible dental and vision expenses not covered by insurance; reduces your taxable income Reduces your taxable income Example Here s a look at how much you can save when you use an FSA to pay for your health care and dependent care expenses. ACCOUNT TYPE WITH FSA WITHOUT FSA Your taxable income $50,000 $50,000 Pretax contribution to Health Care and Dependent Care FSA $2,000 $0 Federal and Social Security taxes* $11,701 $12,355 After-tax dollars spent on eligible expenses $0 $2,000 Spendable income after expenses and taxes $36,299 $35,645 Tax savings with the Medical and Dependent Care FSA $654 N/A *This is an example only your actual experience may vary. It assumes a 25% Federal income tax rate marginal rate and a 7.7% FICA marginal rate. State and local taxes vary, and are not included in this example. However, you will also save on any state and local taxes. Important Information about FSAs Your FSA elections are effective from January 1 through December 31. Claims for reimbursement must be submitted by March 31 of the following year. Please plan your contributions carefully. Up to $500 of the money left in your account as of March 31 can be carried over to the next plan year. These plans are governed by Internal Revenue Service regulations. Note that FSA elections do not automatically continue from year to year; you must actively enroll each year. 12

15 Life Insurance What would your family do if your income was lost due to death or disability? Life and disability insurance are important for your financial security. Basic Life and AD&D Insurance Life insurance is an important part of your financial security, especially if you support a family. LifeBridge Health provides basic life insurance to all eligible employees at no cost. Coverage is automatic. YOUR 2018 BENEFIT GUIDE BENEFIT Employer-provided basic life insurance Full-time and part-time coverage is 1x base annual salary o Maximum benefit of $200,000 Accidental Death & Dismemberment Insurance Accidental Death & Dismemberment (AD&D) Insurance provides a benefit in the event of your accidental death or dismemberment. The company provides basic AD&D coverage to all eligible employees at no cost. Coverage is automatic. Disability Insurance Disability insurance provides income replacement should you become disabled and unable to work due to a non-work-related illness or injury. The company provides eligible employees with long-term disability income benefits at no cost. Short-term disability is employee-paid. The underlying plan provisions (pre-existing conditions) apply to longterm and short-term disability. This provision excludes any disability that arises from a condition for which you received treatment three months prior to the effective date. Once you have been insured for 12 months, all covered conditions are insured. COVERAGE AND BENEFITS Short-Term Disability/Salary Continuation 60% of your base weekly earnings, up to a maximum of $1,500 per week Benefits begin on the 22 nd day of disability due to injury or illness, and are payable up to the 89 th day Long-Term Disability Covers 50% of your base monthly pay, up to a maximum of $10,000 per month Benefit begins on the 90 th day and normally continues until: the date you are no longer disabled; the date you reach Social Security age; or the date of your death 13

16 Supplemental Insurance Buy Up Long-Term Disability You may purchase additional long-term disability (LTD) coverage that provides up to 60% of your annual salary, up to a $15,000 maximum monthly benefit. If you are interested in purchasing this coverage, you may do so, without evidence of insurability, at initial eligibility. The underlying plan provisions (pre-existing conditions) apply to the Buy Up Option. This provision excludes any disability that arises from a condition for which you received treatment three months prior to the effective date. Once you have been insured for 12 months, all covered conditions are insured. To elect coverage, please complete the form that you can find on the hospital intranet and return it to Human Resources. Employee earning $80,000 per year: Monthly covered payroll: $6,667 (annual salary divided by 12) Buy Up Rate: $0.382 per $100 of monthly covered payroll x $6,667/$100 = $25.47 per month or $11.76 per 26 pays Employee earning $100,000 per year: Monthly covered payroll: $8,333 (annual salary divided by 12) Buy Up Rate: $0.382 per $100 of monthly covered payroll x $8,333/$100 = $31.83 per month x 12/ 26 or $14.69 per 26 pays If you have any questions, contact Human Resources. Supplemental Life and AD&D Insurance You may choose to purchase additional life and AD&D coverage for yourself and your dependents at affordable group rates. Rates are based on age and the coverage level chosen. Supplemental Life and AD&D Insurance for you You may purchase coverage for yourself through after-tax payroll deductions as follows: Up to 5 x your base annual salary, with a maximum of $2,000,000. Guarantee issue is 3 times salary, up to $500,000. If you are enrolling for the first time and are not a new hire, or if you enrolled in coverage and choose to increase your covered amount by more than 3 x your salary, or $500,000, Evidence of Insurability will be required. Supplemental Life and AD&D Insurance for your dependents You may purchase coverage through payroll deductions as follows: Spouse Increments of $15,000, $25,000, or $50,000 (cannot total more than basic plus supplemental life and AD&D insurance coverage on the Associate) If you are electing $50,000 coverage or increasing coverage, Evidence of Insurability will be required. Child(ren) $10,000 per child Must be added within 30 days of birth, as a new hire or at open enrollment Up to age 26 Dependent Increment Rate Dependent Coverage Bi-weekly Rate Spouse $15,000 $1.29 Spouse $25,000 $2.15 Spouse $50,000 $4.30 Child $10,000 $

17 Additional Benefits YOUR 2018 BENEFIT GUIDE LifeBridge Health offers you and your family additional benefits to enhance your benefits package. Your Employee Assistance Program The EAP through Carebridge provides professional support services to help you, your household members and dependent children cope with a variety of personal and career-related issues. The program is available 24 hours a day, seven days a week, is completely confidential and offered at no cost to you. Turn to the EAP for support with: Marriage and family problems Job-related issues Stress, anxiety and depression Parent and child relationships Legal and financial counseling Identity theft counseling Financial planning Various other related issues PetFirst: Health care for cats and dogs can be very costly, but with pet insurance, you can have coverage for your furry family members. PetFirst Pet Insurance wants pet parents to have peace of mind by offering clear and comprehensive, value-oriented pet insurance plans. As an employee of LifeBridge Health, you have the opportunity to sign up for pet insurance. This voluntary benefit is offered to all employees, and if you are benefits eligible it can be payroll deducted. InfoArmor: Offers identity theft protection, credit monitoring, and full-service identity restoration. This benefit is offered to benefits eligible employees via payroll deductions. Liberty Mutual: Offers comprehensive auto and home insurance coverage at competitive rates. This can also be for all employees but only payroll deducted for benefit eligible employees. The policies are tailored to suit your needs based on the amount of protection needed. If you need help or guidance, call Carebridge at or visit access code KKNH3. They also offer a variety of convenience services including pet care, recreation, household services, transportation, and other pressing life concerns. Voluntary Benefits MetLife Accident Insurance: Accidents can happen at any time and when you least expect them. This benefit can provide you with a payment to use as you see fit if you experience a covered event. This payment can help you focus more on getting back on track and less about the extra expenses accidents can bring. Critical Illness: This benefit provides a lump sum payment if you or a covered family member is diagnosed with certain medical conditions. A payment is made directly to you to use for bills and ongoing expenses. Hyatt Legal: MetLaw, makes things simple for you by providing the attorney you need and representation for a wide variety of legal services. Whole Life Insurance: This benefit provides a great supplement because it provides coverage for your entire life, not just while employed with LifeBridge. Because you own the policy, you can take it with you. 15

18 Glossary Understand the medical terms that are used in your plan. Brand Name Drugs: Drugs that have trade names and are protected by patents. Brand name drugs are generally the most costly choice. Coinsurance: The percentage of a covered charge paid by the plan. Copayment (Copay): A flat dollar amount you pay for medical or prescription drug services regardless of the actual amount charged by your doctor or health care provider. Deductible: The annual amount you and your family must pay each year before the plan pays benefits. Generic Drugs: Generic drugs are less expensive versions of brand name drugs that have the same intended use, dosage, effects, risks, safety and strength. The strength and purity of generic medications are strictly regulated by the Federal Food and Drug Administration. High Deductible Health Plan (HDHP): A medical plan that may be used in conjunction with a health reimbursement account (HRA) or a health savings account (HSA). Health Savings Account (HSA): A fund you can use to help pay for eligible medical costs not covered by your medical plan. Both employers and employees may contribute to this fund; employees may do so through pretax payroll deductions. Equity partners can have monthly contributions charged against their monthly draw account. In-Network (Tier 1 and 2): Use of a health care provider that participates in the plan s network. When you use providers in the network, you lower your out-of-pocket expenses because the plan pays a higher percentage of covered expenses. Out-of-Network (Tier 3): Use of a health care provider that does not participate in a plan s network. Mail Order Pharmacy: Mail order pharmacies generally provide a 90-day supply of a prescription medication for the same cost as a 60-day supply at a retail pharmacy. Plus, mail order pharmacies offer the convenience of shipping directly to your door. Inpatient: Services provided to an individual during an overnight hospital stay. Outpatient: Services provided to an individual at a hospital facility without an overnight hospital stay. Out-of-Pocket Maximum: The maximum amount you and your family must pay for eligible expenses each plan year. Once your expenses reach the out-of-pocket maximum, the plan pays benefits at 100% of eligible expenses for the remainder of the year, except for prescriptions under the Premium plan, which has a separate Rx out-of-pocket maximum. Primary Care Physician (PCP): Physician (generally a family practitioner, internist or pediatrician) who provides ongoing medical care. A primary care physician treats a wide variety of health-related conditions and refers patients to specialists as necessary. Specialist: A physician who has specialized training in a particular branch of medicine (e.g., a surgeon, gastroenterologist or neurologist). Limited Purpose FSA: A medical flexible spending account that you may be able to enroll in when you have a health savings account (HSA). You can use a limited purpose FSA to pay for eligible out-of-pocket dental and vision expenses. 16

19 Global Human Resources The Human Resources team is excited to announce a new system that launches for all employees starting January 1, The new system is called Global Human Resources, or GHR. The new system will allow employees to: view personal information and benefits enrollment data; and submit changes as necessary. In the future, all employees will use GHR to make annual benefits open enrollment selections. (Special Note for 2018 Open Enrollment: Within GHR, Employees will be able to view benefits enrollment statements for the 2018 benefit year toward the end of 2017.) To access GHR, employees will use existing network access credentials this means it will be the same username and password that is used to log in to your computer. Step by step user guides and instructions on how to log in to the new system will be maintained within the Benefits Page on the Extranet. Additional information will be communicated via AllUser s, The Bridge Newsletter, postcards mailed home and Management forums. Stay tuned to learn more about our new system. YOUR 2018 BENEFIT GUIDE 17

20 Enrollment Instructions To enroll in benefits you will meet one-on-one, either over the phone or in person, with a benefit counselor. During the one-on-one meeting, the benefit counselor will educate you on your benefit plans, answer any basic questions that you may have, and enroll you in the benefits of your choice. Active enrollment: 2018 Open Enrollment is October 16 October 31, This is a mandatory enrollment please review your benefits information, take action and enroll through a benefit counselor. New enrollment process: o In order to enroll and learn more about your benefit programs, you must meet one-on-one with a benefit counselor. o During the one-on-one meeting, the benefit counselor will: Confirm dependents (bring covered dependent social security numbers and birth dates to your meeting. We must have birth dates, social security numbers are not mandatory to enroll.) o More information will be posted letting you know when counselors will be at your location. o You also can call the ERG Call Center to enroll by dialing: o Call Center Hours: Monday-Friday 9:00 am 7:00 pm What you need to do to prepare for your one-on-one meeting: o Review your benefits information. o Consider which benefits will best meet your needs; any questions you may have will be answered during your one-on-one session with the counselor. o Watch for postings on the dates and times to meet with a benefit counselor. o Bring covered dependent social security numbers and birth dates (we must have birth dates, social security numbers are not mandatory to enroll.) o Meet one-on-one with a benefit counselor when they are at your location to enroll or call the call center to enroll. How to Enroll: Information Needed 1. You will need the Name, Social Security Number and date of birth for all family members to be covered under medical, dental or vision insurance. 2. Life insurance beneficiary designations require the name of your beneficiary(ies). Remember that we provide a basic life insurance policy; therefore, this information is important in order to complete the enrollment process. 3. Election of dependent or spouse life insurance requires the name and date of birth for each. 18

21 Enrollment Instructions Dependent Verification Any Associate newly enrolling a dependent(s) on the medical, dental or vision plans must complete the steps listed below. As part of our commitment to control health care costs, LifeBridge Health and its affiliates are taking steps to ensure that only eligible dependents are covered under our medical, dental and/or vision plans. To accomplish this, a dependent verification program has been implemented. This process is intended to ensure that each dependent enrolled in the LifeBridge Health medical, dental and/or vision plans is accurately listed and eligible for coverage. Each employee must carefully review the definitions of an eligible dependent and verify that all dependents enrolled for coverage are eligible. Required Documentation Spouse: YOUR 2018 BENEFIT GUIDE A copy of your marriage certificate and One form of documentation establishing current marital status such as a joint household bill, joint bank/credit account, joint mortgage or lease, or front page of your jointly filed federal tax return. Child: A copy of the child s birth certificate, naming you or your legally married spouse as the child s parent, or appropriate court order/adoption decree naming you or your legally married spouse as the child s legal guardian Copy of the Qualified Medical Child Support Order showing you must provide coverage As a reminder, eligible dependents are defined as: Your legally married spouse Your child up to age 26 Your child of any age who is incapable of selfsupport due to a mental or physical disability and who receives more than half of his/her support and maintenance from the Associate A child is defined as your natural child, legally adopted child, a child placed with you for adoption, stepchildren (as long as Associate is still married to the child s natural or adopted parent) and/or a child for whom you are required to provide health insurance by a Qualified Medical Child Support Order. Disabled Dependent (Over age 26): A copy of the child s birth certificate, naming you or your legally married spouse as the child s parent, or appropriate court order/adoption decree naming you or your legally married spouse as the child s legal guardian, and A copy of the front page of the most recently filed federal tax return confirming this child as a dependent, and A medical provider s documentation of disability. Three steps are necessary: Make sure that you have included legible copies of all required documentation (listed below) 1. Write your name and Associate number on each piece of documentation 2. Write Not For Official Use on each document and blacken out the first five digits of any Social Security number and any financial information, if applicable 3. Turn documentation into the Human Resources Department within 30 days or your dependents may not be eligible for coverage 19

22 Contacts PLAN PROVIDER PHONE NUMBERS WEBSITE Auto/Home Insurance Liberty Mutual Credit Union First Financial Credit Union Dental Insurance Cigna CIGNA24 Disability Programs (STD and LTD) Employee Assistance Program (EAP) Flexible Spending Accounts Cigna Carebridge Access Code: KKNH3 WageWorks FMLA Requests FMLA Source Identity Protection InfoArmor Life Insurance MetLife Medical Insurance QualCare, Inc., a Cigna company Pet Insurance PetFirst Pre-Paid Legal Services Prescription Coverage Retirement Savings Plan Hyatt Legal CVS Transamerica Retirement Solutions GET-MET8 Company Access Code: (available 12/15/2017) Vision Insurance VSP Voluntary Benefits (Accident, Critical Illness and Whole Life Insurance) MetLife GET-MET8 20

23 About This Guide This benefit summary provides selected highlights of the Carroll Hospital employee benefits program. It is not a legal document and shall not be construed as a guarantee of benefits nor of continued employment at the company. All benefit plans are governed by master policies, contracts and plan documents. Any discrepancies between any information provided through this summary and the actual terms of such policies, contracts and plan documents shall be governed by the terms of such policies, contracts and plan documents. Carroll Hospital reserves the right to amend, suspend or terminate any benefit plan, in whole or in part, at any time. The authority to make such changes rests with the Plan Administrator.