YOUR 2014 BENEFITS ENROLLMENT GUIDE

Transcription

1 YOUR 2014 BENEFITS ENROLLMENT GUIDE

2 Table of Contents New for the 2014 Plan Year... Cover Enrollment Process...1 Who s Eligible?... 2 When Can I Enroll?... 2 Changing Coverage During the Year... 3 Health Care Options... 4 Case Management Program... 6 Vision Coverage for Good Eyesight...6 How Much Do the Plans Cost?...6 Prescription Drug Coverage... 7 Dental Coverage for a Beautiful Smile...8 Stronger You, Stronger Blue Wellness Program...9 Tax-Saving Flexible Spending Accounts for Health and Dependent Care...10 Disability Coverage...12 Life Insurance...12 Required Notices Women s Health and Cancer Rights Enrollment Notice...16 Glossary of Benefit Terms Ask the Experts... Back Cover Notes... Back Cover Enrollment process: Enrollment is easy! Just follow these simple steps to start receiving your benefits coverage for New for the 2014 Plan Year Here are a few features new to our benefits plan: Benefits are effective on your 90th day of employment You must work an average of 30 hours per week to be eligible for benefits Tobacco surcharge TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

3 1. Study Take the opportunity to familiarize yourself with our easy-to-use benefit enrollment guide to decide what plans are best for you and your family. 2. Gather data Gather your dependent and life insurance beneficiary information (e.g. social security number, date of birth, etc.) to enter into the enrollment website. Log on & Enroll 3. Enter the TrueBlue benefits enrollment site here: Add your dependent info and verify your personal info. You can update your enrollment selections anytime, up to the close date. 4. Print It s a good idea to print the Summary Page found at the end of your enrollment process. This will be your only record of this information. 5. submit You re almost done! Press the Submit button once you are satisfied with your choices. Plan ahead so you have plenty of time to meet the deadline. TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 1

4 Eligibility Who s Eligible? If you are a regular full-time employee (working 30 hours or more per week) of a TrueBlue company, you are eligible to enroll in the health and welfare benefits described in this enrollment guide on the 90th day of full-time employment. TrueBlue employees may cover themselves and their dependents. Eligible dependents include a spouse, samesex domestic partner* and children under age 26. *You can view the full domestic partner policy on My Benefits at When Can I Enroll? Current Employees Each year, TrueBlue holds an open enrollment period during which you can choose a new option or make changes to your current benefit coverage for the upcoming plan year. This is a once-a-year opportunity to select the plans that are right for you and your family. It is important to review the options carefully because your choices will remain in effect for the entire plan year. Newly Eligible Employees HOW DO I ENROLL? To enroll, opt out or make changes to your benefits, go to and click on Enrollment Log In. Once you become eligible for benefits, you must enroll for coverage by the date defined in your enrollment packet. An notification will be sent to your work approximately four weeks prior to your enrollment deadline. If you miss this date, you will not be permitted to enroll until either the next open enrollment period or after you experience a qualified change in status (See Changing Coverage During the Year for details). P 2 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

5 Changing Coverage During the Year You can change your coverage during the year only when you experience a qualified change in status, such as: Marriage, divorce or legal separation Beginning or ending a same-sex domestic partnership Birth, adoption, or a child has been placed with you for adoption Start or stop of adoption proceedings Change in your child s dependent status Death of your spouse, same-sex domestic partner or child Change in your spouse s or same-sex domestic partner s benefit or employee status When a qualified change occurs, you must make your benefit choices and provide supporting documentation within 30 days of the event (in most circumstances) and your benefit changes must be consistent with the event. Please contact WebTPA at for specific information. COVERAGE CHANGES TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 3

6 PLAN OPTIONS Health Care Options Nothing is more important than your good health. That is why TrueBlue offers you two different medical plans designed to help you and your family live healthier lives. TrueBlue has selected provider networks that provide access to quality care in each market. To find the network for your area, please go to click on Provider Networks, and review the map for your state. You ll see the provider network chosen for your area and you can use the links below the map to go directly to the provider network website. Affordable Care Act The coverage offered by TrueBlue to its employees and their eligible dependents meets the minimal essential coverage guidelines established by the Affordable Care Act (ACA) as well as the affordability guidelines. Employees that are offered coverage through TrueBlue will not be eligible for subsidized coverage through their state exchange or marketplace. You can find out more about the ACA by visiting the ACA Reference Center. HDHP High Deductible Health Plan Option The High Deductible Health Plan (HDHP) offers bene fits for both in-network and out-of-network services. In return for lower premiums, you share the cost of coverage with co-pays and a higher deductible. Once you reach the plan s annual out-of-pocket maximum, the plan pays 100 percent for covered services (co-pays may still apply). Your out-of-pocket expenses are higher when you use providers who do not participate in the network. There is no deductible or co-pay for preventive care or well-child care services received from in-network providers. EPO Exclusive Provider Option The Exclusive Provider Option (EPO) covers services provided by physicians, facilities or other health care professionals who belong to a network of providers. There is no deductible or co-pay for preventive care or well-child care services received from in-network providers. The EPO does not provide benefits for care received from a non-network provider. You must pay the full cost of your care if you choose to seek care outside the network of providers. How Much Do the Plans Cost? TrueBlue significantly subsidizes the cost of health coverage for you and your covered dependents. The chart on page 5 shows your premium costs, which are determined by your annualized salary. * Includes a spouse or same-sex domestic partner. Bi-weekly premiums for domestic partners will be taken from your paycheck post tax. Employees are responsible for paying imputed income tax on the value of the domestic partner coverage that is paid by TrueBlue. You are strongly encouraged to consult a tax advisor and to view the complete Domestic Partner policy on MyBenefits at ** Includes spouse or same-sex domestic partner and children under age 26. Tobacco surcharge TrueBlue is committed to encouraging our employees to lead a tobacco-free lifestyle. In support of this commitment, beginning January 1, 2014, employees that use tobacco products will pay an additional $50 per month for health benefits. To learn more about this policy, go to P 4 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

7 Medical / Vision / Pharmacy Highlights and Coverage Costs Medical Plan Bi-weekly Premiums HDHP EPO Employees with (annualized) salaries < $40,000 Employee $23.08 $34.62 Employee + Spouse* $90.00 $ Employee + Child(ren) $69.23 $ Employee + Family** $ $ Employees with (annualized) salaries $40,000 Employee $46.15 $69.23 Employee + Spouse* $ $ Employee + Child(ren) $ $ Employee + Family** $ $ PLAN OPTIONS Medical Plan Feature IN-NETWORK OUT-OF-NETWORK IN-NETWORK Annual Deductible Individual $1,500 $4,000 $250 Family $3,000 $8,000 $750 Out-of-Pocket Maximum Includes deductible and co-pays Individual $3,000 $7,500 $2,000 Family $6,000 $15,000 $6,000 Lifetime Benefit Unlimited Unlimited Physician Services Office Visits Deductible then $30 co-pay Routine Preventive 100% Well-Child Care 100% Lab and X-ray Hospital Services Room + Board (pre-certification required: 25% penalty) Outpatient Surgery Emergency Room 80% covered 80% covered 80% covered $150 co-pay, + 80% covered (deductible waived if admitted) $30 co-pay + 50% 50% deductible waived 50% deductible waived 50% covered 50% covered 50% covered $150 co-pay, + 50% covered $30 co-pay 100% 100% 100% covered $500 co-pay per admission 100% after deductible $200 co-pay (co-pay waived if admitted) Vision Services Eye Exam $30 Co-pay $30 Co-pay Frames, Single Vision Lenses, Bifocal Lenses, Trifocal Lenses, Contact Lenses, Prescription Sunglasses Up to $150 combined maximum per calendar year Up to $150 combined maximum per calendar year TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 5

8 Plan Benefits & COSTS Advocating for You: Case Management Program The Case Management program from Web-TPA is designed to help patients who are experiencing catastrophic high-risk or high-cost conditions. The healthcare system can often be difficult to navigate, especially if you are already dealing with a serious illness or injury. A case management nurse will work with you, your family and caregivers as a patient advocate and make sure you receive the care you need at a cost-effective price. The nurse develops a thorough understanding of your condition, needs and concerns, and then works with you to help you become knowledgeable about your medical condition and how you can take a greater role in your own care. Vision Coverage for eye health TrueBlue medical plans also include vision benefits to reduce eye care expenses for you and your family. P 6 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

9 Prescription Drug Coverage If you enroll in a TrueBlue medical plan, prescription drug benefits are included through MedImpact. Through this benefit, you can save money for certain medications you take on a regular basis by purchasing these prescriptions by mail order through MedVantx. With mail order prescriptions, you have the convenience of medication delivered to your home. Your prescription drug coverage is in the form of a three-tier benefit structure based on a formulary, a list of prescription drugs approved by the plan. Your co-pay varies, depending on the type of prescription. Under TrueBlue prescription drug coverage, most medications do not need prior authorization. However, some medications may not be covered until your doctor or pharmacist contacts MedImpact for approval. Your safety and care is our top priority, and our prior authorization program helps you and your doctor choose safe medications that provide you with the best value. DID YOU KNOW? PRESCRIPTIONS Prescription Highlights Annual Deductible Individual Family Retail Pharmacy (30-day supply) $25 $75 Mail Order (90-day supply) $25 $75 Generic Drugs are Safe and Provide the Best Value. A formulary is an approved list of safe and effective brand name and generic drugs covered by the plan. Ask your doctor or pharmacist if your prescription is available in generic form. Tier 1 Generic Drugs Tier 2 Brand name formulary drugs Tier 3 Brand name non-formulary drugs $12 $36 $30 $90 $50 $150 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 7

10 DENTAL Dental Coverage for a Beautiful Smile The plan helps you pay for most necessary dental services and supplies, including diagnostic and preventive care (such as exams, cleanings and x-rays), and basic and major restorative services (such as fillings, crowns and dentures) subject to age and frequency limits. Dental Highlights Dental Plan Feature Calendar Year Maximum Class I, II, and III Expenses Combined Deductible Individual Family Class I Preventive Exams, cleanings, X-rays, fluoride treatments, sealants and space maintainers Class II Basic Fillings, anesthesia, oral surgery, injections, endodontics and periodontics Class III Major Crowns, dentures and bridgework Class IV Orthodontia $1,500 $50 $ % (deductible waived) 80% 50% Not Covered Dental Bi-Weekly Premium COST Employee $12.60 Employee + Spouse* $25.20 Employee + Child(ren) $23.94 Employee + Family** $36.54 * Includes a spouse or same-sex domestic partner. Bi-weekly premiums for domestic partners will be taken from your paycheck post tax. Employees are responsible for paying imputed income tax on the value of the domestic partner coverage that is paid by TrueBlue. You are strongly encouraged to consult a tax advisor and to view the complete Domestic Partner policy at ** Includes spouse or same-sex domestic partner and children under age 26. P 8 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

11 Live well. Take Care of Yourself. Stronger You, Stronger Blue Wellness Program As a TrueBlue employee, you can participate in our Stronger You, Stronger Blue wellness program, designed to help our employees lead healthier, happier lives. Fitness Reimbursment Employees based outside Tacoma are eligible to receive reimbursement for a fitness membership through SnapFitness or 24 Hour Fitness. Reimbursement levels vary based upon utilization. Stronger You, Stronger Blue also offers health and wellness information through WebTPA s Communitas Care Management. Programs offered include: claims administration, case management, personal health assessments, health coaching, early cancer detection and outreach, chronic condition management and healthy beginnings maternity management. For more information, helpme@webtpa.com. Employee Assistance Program Because unresolved personal issues can affect every aspect of a person s life, including work performance, TrueBlue offers U.S. employees and their eligible dependents the Employee Assistance Program (EAP) from Liberty Mutual immediately upon hire. For confidential assistance with nearly any personal matter you may be experiencing, call the EAP at or log on to (password: MLASSIST). Counselors can provide free access to referrals and information on a wide variety of topics such as stress on the job, finding a babysitter, divorce, addiction and recovery, parenting and more. Stronger You. Stronger Blue. TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 9

12 Flex Accounts Tax-Saving Flexible Spending Accounts for Health and Dependent Care You can set aside money in a Flexible Spending Account (FSA) to pay for certain health and dependent care expenses. Because your FSA contribution is deducted before taxes are taken, it lowers your taxable income and increases your take-home pay. You keep track of eligible expenses, which are reimbursed with your own untaxed dollars. TrueBlue offers two FSAs: one for your health care expenses and those of your eligible dependents, and one for dependent care expenses. You may participate in one or both of these FSAs. Only expenses for services incurred during the plan year, while you are actively employed, are eligible for reimbursement from your account(s). DID YOU KNOW? Flexible Spending Accounts (FSAs) for Health and Dependent Care are easy to manage. You will need to keep track of your paperwork, but the reimbursement process especially with the Health FSA Benny card makes it easy. Health Care Flexible Spending Account FSA funds can be used to pay for your eligible medical, dental, vision and prescription drug expenses, including co-pays and deductibles, with pre-tax dollars. Note: Over-the-counter drugs without a prescription are no longer reimbursable under this account. The maximum amount you can contribute is $2,000 per year. When you enroll in a Health Care FSA, you will receive the Benny debit card a pre-paid debit card that works with your Health Care Spending Account (note: it can not be used with the Dependent Care Reimbursement Account). Use the Benny debit card to pay for your eligible out-ofpocket medical expenses at approved merchants and providers; the money is automatically deducted from your spending account. Visit (Flex Plan Services) to learn more about how to use your Benny card and FSA for eligible products and services. You ll also find online tools, including calculators, to help you plan your contributions. Dependent Care Reimbursement Account FSA funds can use pre-tax dollars to reimburse you for dependent care expenses including child care. You (or you and your spouse) must work or attend school full-time for your expenses to be eligible. An eligible dependent is a child under age 13 or any dependent that is incapable of selfcare, spends at least eight hours a day in your home, and whom you claim on your tax return. The maximum amount you can contribute to a dependent care reimbursement account is: $5,000 per year for single employees or those who are married filing jointly; $2,500 per year for married employees filing separately. When estimating your day care expenses, remember you may not have expenses for weeks of vacation, illness, or other times your dependent receives free care. P 10 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

13 IRS Use-It-or-Lose-It Rule FSAs offer sizable tax advantages. The trade-off is that these accounts are subject to strict IRS regulations, including the use-it-or-lose-it rule. According to this rule, you must forfeit any money left in your account(s) after your expenses for the year have been reimbursed. The IRS does not allow the return of unused account balances at the end of the plan year and remaining balances cannot be carried forward to a future plan year. If you are unable to estimate your health care and dependent care expenses accurately, it is better to be conservative and underestimate rather than overestimate your expenses. FLEX ACCOUNTS TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 11

14 Disability & Life Insurance Disability Coverage If you are an employee with full-time status (working 30 hours or more per week) and are benefit eligible, TrueBlue automatically provides you with short-term and long-term disability coverage from Liberty Mutual at no cost to you. Short-Term Disability Short-term disability (STD) replaces a portion of your income if sickness or injury limits or stops you from working for a short period of time. You must also have at least a 20 percent or more loss in your earnings. After 14 consecutive days of disability, you would be eligible for 50 percent of your weekly compensation, up to a weekly maximum of $1,000, for a maximum of 11 weeks. Long-Term Disability Long-term disability (LTD) continues a portion of your income if you are limited or unable to perform your regular job duties for an extended period of time due to illness or injury. If you become disabled, and suffer at least a 20 percent or more earnings loss, the plan begins to pay you a monthly benefit 90 days after the start of your disability. LTD works with Social Security and any other group disability coverage to provide you with a combined monthly benefit equal to 60 percent of your monthly compensation (up to $2,000, $5,000, or $10,000 per month, depending on your class of benefits) for the length of your disability or five years, whichever is less (subject to age limits). Life Insurance Life insurance protects your family or other beneficiary if your death occurs while you are actively employed by TrueBlue. Your coverage amount will be paid to the beneficiary of your choice. Benefits for the loss of a dependent are paid to you. TrueBlue provides all benefit eligible employees with Basic Employee Group Term Life and Accidental Death and Dismemberment (AD&D) Insurance, paid for by TrueBlue, in the amount of $20,000. If your death is due to an accident, your beneficiary will receive an additional amount through AD&D coverage. Your AD&D coverage is equal to your life insurance coverage amount. AD&D benefits may be payable if you pass away, lose a limb, or have a loss of speech, hearing, or eyesight because of a covered accident (either on or off the job) and the loss occurs within one year of the covered accident. The payable amount of your AD&D benefit depends on the type of loss. In the event of death due to an accident, your beneficiary may receive both your life and AD&D benefits. P 12 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

15 Employee-Paid Additional Voluntary Life Insurance You may purchase additional Voluntary Life Insurance for yourself in multiples of $10,000, up to a maximum benefit of $500,000 or five times your annual salary, whichever is less. If you are enrolled, you may also choose coverage for your spouse in multiples of $5,000 (not to exceed 100 percent of your policy coverage) and for your eligible child(ren) in $2,000 increments up to a maximum of $10,000. Note: Death benefits for dependents from live birth to six months of age will be $1,000, if you elect dependent coverage. Any amount of coverage for yourself as an employee greater than $200,000 or spouse coverage greater than $50,000, or any coverage amount if you are applying beyond your initial eligibility period, will require proof of good health and approval by Liberty Mutual prior to that amount of coverage becoming effective. Coverage may not be increased after a reduction. If you reduce the amount of your own life insurance coverage, any coverage for your spouse will be reduced by the same percentage at the same time. Note: It is important to designate a beneficiary or beneficiaries so that any life insurance benefits are paid according to your wishes. A primary beneficiary is the person you name to receive benefits if you die, and a contingent beneficiary is someone you name to receive benefits if the primary beneficiary is deceased. Beneficiary designation forms are available on the Benefits Home Page at webtpa.com. See Life Insurance & Disability Plan section. Life insurance Child Voluntary Life Insurance Age Six months to 19 years (23 if a full-time student) Child Voluntary Life Coverage Amount $2,000, $4,000, $6,000, $8,000, or $10,000 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 13

16 MEdicaid & Chip Assistance Premium Assistance Under and the Children s Health Insurance Program (CHIP) If you or your children are eligible for or CHIP and you are eligible for health coverage from your employer, your State may have a premium assistance program that can help pay for coverage. These States use funds from their or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer. If you or your children are not eligible for or CHIP, you will not be eligible for these premium assistance programs. If you or your dependents are already enrolled in or CHIP and you live in a State listed below, you can contact your State or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in or CHIP, and you think you or any of your dependents might be eligible for either of these pro grams, you can contact your State or CHIP office or dial KIDS NOW or to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under or CHIP, as well as eligible under your employer plan, your em ployer must permit you to enroll in your employer plan if you are not already enrolled. This is called a special enrollment opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your em ployer plan, you can contact the Department of Labor electronically at or by calling toll-free EBSA (3272). State Provider ALABAMA ALASKA ARIZONA CHIP COLORADO FLORIDA GEORGIA IDAHO & CHIP INDIANA IOWA KANSAS KENTUCKY LOUISIANA CONTACT INFORMATION programs/medicaid/ (Anchorage) (elsewhere) (Maricopa County) (elsewhere) (In state) (Out of state) dch.georgia.gov Click on Programs, then, then Health Insurance Premium Payment (HIPP) idaho.gov CHIP CHIP chfs.ky.gov/dms/ MAINE public-assistance/ TTY P 14 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

17 State Provider MASSACHUSETTS & CHIP MINNESOTA MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY & CHIP CONTACT INFORMATION Click on Health Care, then Medical Assistance participants/pages/hipp.htm clientpages/clientindex.shtml dwss.nv.gov/ hippapp.pdf dmahs/clients/medicaid/ CHIP CHIP State Provider PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TEXAS UTAH & CHIP VERMONT VIRGINIA & CHIP WASHINGTON CONTACT INFORMATION rcp-hipp.htm CHIP CHIP premiumpymt/apply.shtm ext MEdicaid & Chip Assistance NEW YORK NORTH CAROLINA medicaid/ WEST VIRGINIA WISCONSIN HMS Third Party Liability pubs/p htm NORTH DAKOTA medicalserv/medicaid/ WYOMING healthcarefin/equalitycare/ OKLAHOMA & CHIP OREGON & CHIP If you live in one of the above States, you may be eligible for assistance paying your employer health plan premiums. The above list of States is current as of July 31, You should contact your State for further information on eligibility. TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 15

18 WOMEN S HEALTH/CANCER RIGHTS Women s Health and Cancer Rights Act Enrollment Notice If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: All stages of reconstruction of the breast on which the mastectomy was performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; Prostheses; and Treatment of physical complications of the mastectomy, including lymphedema. These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under the TrueBlue health plans. If you would like more information on WHCRA benefits, contact the TrueBlue Benefits Department. P 16 TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE

19 Glossary of Benefit Terms There are recurring terms that are mentioned in this enrollment guide and that you may see as you receive invoices from your healthcare provider. For clarity, here is what they mean in context with your health insurance plan. Premium This is the amount you pay out of every paycheck to purchase health coverage, whether or not you go to the doctor or the hospital. For example, an individual employee with an annualized salary of less than $40,000 choosing the EPO option will have $34.62 withheld each paycheck for medical/vision/ pharmacy coverage. Deductible This is the amount you pay out-of pocket when you visit the doctor or go to the hospital before the insurance company pays for covered services. After you have met your deductible, the rest of your expenses are covered (in some instances, co-pays and co-insurance may still apply). For in-network family plans of two or more people, each family member pays for services up to their individual deductible, after which he or she only pays a co-pay and/or co-insurance for the remainder of the calendar year. The rest of the family will continue to pay for services (up to their individual deductible) until the family maximum is met. Family members then only pay co-insurance, up to the out-of-pocket maximum. For example, a family of three is enrolled in the EPO plan which has a $250 individual deductible/$750 family deductible. Mom has a medical procedure that costs $250, so her deductible has been met and she will only pay a $30 co-pay for her office visits for the rest of the year. Later that year, her husband has x-rays and lab work totaling $100, and her daughter has a procedure that costs $150. Their expenses cannot be combined to meet a second individual deductible. They each will need to have additional services applied to their individual deductible before the family deductible is considered met. Out-of-pocket Maximum The annual out-of-pocket maximum refers to the actual amount of money you will pay for your medical costs before an insurance plan pays 100 percent of your bill. Lifetime Benefit This is the maximum total that the insurance company will pay for any one person s claims. An unlimited lifetime benefit means the insurance company will pay their portion of all medical expenses for the life of the policy. Co-pay This is a fixed dollar amount you pay towards the cost of the service a health provider charges. For example, a visit to the doctor could come with a $30 co-pay, which means you pay the doctor s office that much when you visit. There may be additional costs that you ll be billed for later, depending on your coverage. Non-Covered Expenses These are costs for care that are not covered by your plan. Co-Insurance (Co-ins) Co-insurance is the arrangement in which the insurer (TrueBlue and the plan provider) and the insured (you) share costs in a specified ratio. For example, an insurer may cover 80 percent of expenses, leaving you responsible for the remaining 20 percent. In-network Providers When healthcare professionals join an insurer s network of providers, they normally agree to provide their services at a contracted (discounted) rate. The contracted rate includes both the amount the insurer pays, and your portion. Your portion may be in the form of a deductible, co-pay, or co-insurance. Out-of-Network Providers When you use an out-of-network provider, you will likely have significantly higher out-of-pocket costs because the providers have not agreed to a discounted rate. Glossary TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE P 17

20 Ask the Experts If you still have questions after reviewing this guide and your other enrollment materials, you may contact our carriers and administrators directly. For Questions About... Medical/Dental/Vision Claims, Enrollment, Provider Issues, Precertification, Utilization Review, Disease Management, Case Management Web-TPA CONTACT Mail Order Prescriptions MedVantx Retail Pharmacy Flexible Spending Account MedImpact Flex Plan Services, Inc Disability Claims Liberty Mutual Life /AD&D/Premium Waiver Claims Liberty Mutual (k) Plan Employee Stock Purchase Program Employee Assistance Program Principal Financial Group Computershare Bensinger, DuPont & Associates (MyLibertyAssist) Plan # Member Services: Password: MLASSIST Questions? Write them down here and then ask an expert. 001T A Important Note: This brochure is intended to provide you with general information about your benefits under the TrueBlue Benefit Plan; it is not intended to fully describe all of the Plan s features, limits and rules. The Plan is maintained according to comprehensive official plan document(s). In the event that there is a conflict or ambiguity between this brochure and the Plan document(s), the terms of the Plan document(s) will govern. You may request a copy of the Plan document(s) from the Benefits Department. The company reserves the right to amend or terminate the Plan at any time. TRUEBLUE YOUR 2014 BENEFITS ENROLLMENT GUIDE