Benefits Enrollment Guide. Minimum Essential Coverage Hospital Indemnity Dental Vision Disability Life Accident

Transcription

1 Benefits Enrollment Guide Minimum Essential Coverage Hospital Indemnity Dental Vision Disability Life Accident

2 What s Inside Page 1 Page 2 Page 3 Page 4 Page 5 Welcome Your Benefit Choices Enrollment Process Important Notice About Health Care Reform Minimum Essential Coverage Hospital Indemnity Dental Vision About the Plans Accident Universal Life Welcome Welcome to Elwood Staffing! We re happy you re part of our team. As a newly-hired associate, you are now eligible to enroll in our benefit programs. We encourage you to read this guide carefully and review your benefit options with your family. Read on to learn more about your options and how to enroll or visit for additional information. If you provided your address and phone number, you will receive a text message and s with more information. Page 6 Frequently Asked Questions and Answers Rates Back Schedule Your Appointment 1

3 Your Benefit Choices You are now eligible to enroll in a variety of benefits on a voluntary basis. For your convenience, these benefits are paid for pre-tax through payroll deduction. Since they are paid for this way, you do not have to worry about sending in payment each month. A Minimum Essential Coverage (MEC) Plan Dental Three Hospital Indemnity Plans Pharmacy Discounts Term Life & Disability Options Critical Illness Vision Accident Universal Life Keep reading for more information about these plans and how the MEC plan can help you avoid the tax penalty! Enrollment Process You have 30 days from your date of hire to enroll in the benefit programs and can enroll during the first and third week of the month. Should you choose not to enroll at this time, you will not have another opportunity to enroll until the annual open enrollment period or if you experience a qualifying life event. Professional benefit counselors will be available to help you understand your benefits package and help you enroll yourself and your dependents in coverage. Please have your dependent information, including dates of birth and social security numbers available for your meeting with a counselor. Visit to: Get more information about the benefits available Pre-schedule your appointment with a benefit counselor Enroll in the Minimum Essential Coverage and Hospital Indemnity Plans Or call a benefit counselor today at Monday - Friday, 8 a.m. - 6 p.m. MT Important Note About Health Care Reform and the Individual Mandate The Affordable Care Act (ACA), often called Obamacare, requires most individuals to have health insurance. If you do not have health insurance, you may be required to pay a penalty. If you have a family, your family members must also have health insurance. To help you and your family members avoid the penalty, Elwood Staffing is happy to announce that we are now offering a plan that will meet the mandate for Minimum Essential Coverage, meaning that if you choose to enroll in this plan, your coverage will satisfy your requirement for maintaining health coverage under the individual mandate. 2

4 Minimum Essential Coverage (MEC) Plan The Minimum Essential Care (MEC) plan pays 100% for routine physicals, mammograms, well child visits, immunizations, and other preventive services. Visit for more information. MINIMUM ESSENTIAL COVERAGE (MEC) PLAN In-Network Out-of-Network 15 Preventive Services for Adults 100% 40% 23 Preventive Services for Women 100% 40% 26 Preventive Services for Children 100% 40% PPO Network MultiPlan TransChoice Plus Hospital Indemnity Plans We are happy to introduce three new hospital indemnity plans from which you may choose to enroll: the Low, Middle, and High Plans from TransChoice. The amounts shown in the chart below represent the fixed benefit the plan pays for services based on a fee schedule. Enrolling in one of the hospital indemnity plans alone does not meet the minimum essential coverage requirement of the Affordable Care Act (ACA). Depending on the plan you select, you may be able to receive additional benefits, such as critical illness insurance, term life insurance, and short term disability insurance. Important note: critical illness insurance is included in both the Middle and High options. Term life and short term disability are only available if you enroll in any of the three hospital indemnity plans. Please speak with a benefit counselor for more information. Plus, speak with a counselor to learn how taking advantage of the dental, vision, life, and accident plans can help offset non-medical costs. HOSPITAL INDEMNITY PLANS Low Middle High Daily In-Hospital per day benefit, up to 31 days per confinement $100 $500 $800 Surgical and Anesthesia per day benefit, 1 day per year Inpatient Surgery; 1/2 benefit per day, 1 day per year Outpatient Surgery; 1/10 benefit per day, 1 day per year Specified Outpatient Surgery; 20% of surgical benefit for Anesthesia Outpatient Physician Office Visit per day benefit, up to 6 days per year per covered person Outpatient Diagnostic X-Ray/Lab per day benefit, 2 days per year Advanced Studies; 1/4 benefit per day Select Diagnostic, 2 days per year; 1/20 benefit per day Diagnostic Lab Tests, 3 days per year $1,000 $2,000 $2,000 $100 $100 $100 $500 $500 $1,000 Hospital Confinement 1 day per year $500 $1,000 $2,000 Prescription Drug Discount Amount per day a prescription is filled, up to 36 days per year, per covered person Emergency Room per visit, up to 4 days per year, per covered person $10 Generic $20 Brand $10 Generic $20 Brand $30 Generic $60 Brand $100 $100 $100 Ambulance per day; 3x benefit for air ambulance $300 $300 $300 Critical Illness lump sum benefit for initial diagnosis and an additional lump sum of same amount for subsequent and separate covered critical illness Term Life Short Term Disability 6 month max. benefit, 14 day elimination period N/A $10,000 $20,000 $20,000 employee; $10,000 spouse; $2,500 child see a benefit counselor for more information Up to $600 per month available; see a benefit counselor for more information

5 Dental Insurance Because your smile is important, Elwood Staffing offers dental benefits through TransSmile. You have the option to see any provider you wish, but will pay less if you see a network-participating dentist. Visit to locate a provider in your area. DENTAL PLAN FEATURES Deductibles and Maximums Annual Deductible $50 per person Maximum Annual Benefit $1,000 per person Services Diagnostic and Preventive 80% (excluded from deductible) Basic 50% Major 50% Vision Insurance We are proud to introduce Vision Insurance through EyeMed. Although you have the option to see any provider you wish, you will receive the best benefits when you choose an in-network doctor. To locate a provider in your area, please visit or call VISION PLAN FEATURES In-Network Out-of-Network Examination with Dilation every 12 months Eyeglass Lenses every 12 months Single/bifocal/trifocal $10 co-pay $30 $25 co-pay $25/$40/$55 Eyeglass Frames every 24 months Contact Lenses Conventional Disposable Medically Necessary $0 copay, $120 allowance, 20% off balance $0 co-pay, $135 allowance, 15% off balance $0 co-pay $135 allowance, plus balance $0 co-pay, paid in full $60 $108 $108 $210 4

6 About the Plans Because the MEC, Hospital Indemnity, Dental, and Vision plans are paid for pre-tax, you may not cancel or change your coverage outside of the annual open enrollment period or unless you experience a qualifying life event, so please choose your benefits wisely. The TransChoice Plus Hospital Indemnity plans pay a fixed benefit. When you utilize a network provider, the services are discounted first and then the benefit amount is applied. If the cost of service is less than the benefit paid, you will be reimbursed the difference; if the cost of the service is more than the benefit paid, you will pay the difference. Although you have the flexibility to see any provider you wish, you will save money when you use an in-network MultiPlan provider. Get the Most Out of Your Plan. When you choose a MultiPlan in-network provider, you will receive a discount on services provided (typically around 40%). The plans pay a fixed benefit of $100 for office visits, up to six visits per year, per covered person. If the plan pays $100 towards an office visit and the cost of the office visit is $80, you will receive the difference of $20. On the other hand, if the office visit is $120, you will pay the provider $20. Whether you have to pay the difference upfront at the time of the visit or be billed later is based on your provider s billing procedures. Accident Insurance Having an unexpected accident can cause more than physical injury, it can hurt your bank account, too. Since accidents can happen at any time, 24 hours a day, 7 days a week, it s important to prepare for the unexpected. This policy can help you pay for out-of-pocket expenses associated with an accident by paying you a benefit depending on the injuries you receive. You can then use the money as you see fit, whether to pay for expenses associated with your accident, like a trip to the emergency room, or to pay for childcare so you can get to the doctor for a follow up visit. And, since the policy does not coordinate with any other coverage, you can still receive benefits on top of what other plans provide. Plus, the policy will pay you a $60 wellness benefit when you take a covered health screening. The policy includes coverage for events like: ambulance transportation, trips to the emergency room, dislocations and fractures, burns, and more. Universal Life Insurance TransLegacy Universal Life Insurance offers you the financial protection you need. The unique feature of universal life insurance is that you build cash value on a tax-deferred basis (until withdrawn) which may allow your premiums to remain level throughout the life of the contract. Universal life insurance offers flexibility to adjust your benefit amount up or down depending on your current insurance needs. Good News! During your initial enrollment period, you will have the opportunity to get coverage without answering any medical questions! You can get up to $150,000 of coverage for yourself without answering any medical questions. If you elect coverage, you may also receive up to $15,000 in coverage for your spouse without any medical questions. 5

7 We ve Got Answers How Do I? How can I enroll? Enrolling is easy! Benefit counselors are standing by to answer your questions and help you complete the enrollment process. Simply visit to schedule your appointment or call Why should I enroll now? This is your only opportunity to get coverage without answering any medical questions. Plus, if you choose not to enroll now, you ll have to wait until the next open enrollment period. How can I avoid paying the Affordable Care Act (Obamacare) tax penalty? We have chosen to offer the Minimum Essential Coverage (MEC) Plan to help you and your family members satisfy the individual mandate. While choosing additional coverages will provide enhanced financial protection and peace of mind, you must enroll in the MEC plan to avoid the penalty. How can I be sure these benefits are right for me? While each plan can be elected separately, certain enhancements are only available when you elect other coverage. And, because you can pick and choose the benefits that you want, you can be sure that you are only getting the coverage that you need. Plus, that s what the benefit counselors are there for - to help you make the best choices for you and your family. Can I change or cancel my coverage at any time? You may change or cancel your Accident and Universal Life coverage at any time; however, all other changes may only be made if you experience a qualifying life event or during the annual open enrollment period, so please choose your benefit elections carefully. What if I have questions? Log on to for additional information and more answers to other frequently asked questions. Rates MEC AND HOSPITAL INDEMNITY WEEKLY RATES MEC Low Middle High Employee $14.39 $19.17 $28.72 $40.19 Employee + Spouse $20.93 $39.74 $60.02 $85.07 Employee + Child(ren) $35.46 $30.83 $46.02 $66.25 Family $42.00 $47.21 $71.19 $ Ask the benefit counselor about adding term life and short term disability to your medical plan! DENTAL, VISION, AND ACCIDENT WEEKLY RATES Dental Vision Accident Employee $4.62 $1.52 $4.59 Employee + Spouse $8.98 $2.88 $7.13 Employee + Child(ren) $9.75 $3.03 $5.91 Family $15.06 $4.46 $8.60 UNIVERSAL LIFE WEEKLY RATES Please speak with a benefit counselor for a customized quote. Your rate will depend on your level of coverage, age, and tobacco status. 6

8 It s time to enroll in your benefits. Minimum Essential Coverage Hospital Indemnity Dental Vision Disability Life Accident Schedule your appointment today! Call Monday - Friday 9 a.m. 8 p.m. ET/8 a.m. 7 p.m. CT 7 a.m. 6 p.m. MT/6 a.m. 5 p.m. PT Go online Don t miss out! This is your opportunity to avoid the tax penalty! This Benefit Overview is only intended to highlight some of the major benefit provisions of the Elwood Staffing plan and should not be relied upon as a complete, detailed representation of the Plan. Please refer to the Plan s Summary Plan Descriptions (SPD) for further detail. Should this Overview differ from the SPD, the SPD will prevail.