E ployee Be efit Guide

Transcription

1 Eployee Beefit Guide FOR EMPLOYEE DISTRIBUTION

2 Itodutio As a eploee at FisheBoles ejoig ou ok ad akig aluale otiutios to usiess ae euall ital. The health, satisfatio ad seuit of ou ad ou fail ae ipotat to ou ell eig ad ultiatel, ahieig the goals of ou ogaizatio. Fo the pla ea, FisheBoles has oked had to offe a opetitie total eads pakage that iludes aluale ad opetitie eefits plas. These pogas eflet ou oitet to keepig ou staff health ad seue. We udestad that ou situatio is uiue, ad FisheBoles is offeig a oeall eefits pakage ith a possile hoies oe that a e shaped ad olded ou, to fit ou eeds. This eollet ooklet is a sua desiptio of ou FisheBoles eefit plas. If thee is a disepa etee these suaies ad the itte legal pla douets, the pla douets shall peail. This ooklet ad pla suaies do ot ostitute a otat of eploet. We hope this eollet ooklet, alog ith ou additioal ouiatio ad deisio akig tools, ill help ou ake the est health ae hoies fo ou ad ou fail. UPDATE ON HEALTH CARE REFORM O Jaua,, a ke opoet of the health efo la ae ito effet: Eeoe i the U ith a fe eeptios is o euied to hae health isuae. FisheBoles is offeig health isuae fo eligile staff. This oeage eets all of the health efo la euieets to satisf ou Idiidual Madate euieets ude the la. We hope to keep offeig these eefits as a aluale pat of ou total opesatio i the futue. Hoee, eause e offe ou oeage that satisfies all the health efo euieets, ou ill ot ualif fo a fedeal assistae to puhase a idiidual o fail poli o the ope aket the aketplae.

3 Medial SUMMARY OF COVERAGE Plan Features OAMC 1500 OAMC 3000 OAMC HDHP 6550 IN NETWORK Calendar Year Deductibles $1,500 / $3,000 $3,000 / $6,000 $6,550 / $13,100 (Indiv / Family) Coinsurance 0% 0% 0% Preventive Care 100% 100% 100% Primary Care Visit $25 Copay $30 Copay Deductible Specialist Visit $50 Copay $60 Copay Deductible Outpatient Procedure Deductible Deductible Deductible Inpatient Visit Deductible Deductible Deductible Emergency Room $400 Copay $400 Copay Deductible Urgent Care $75 Copay $75 Copay Deductible Pharmacy / RX (30 Day Supply) $15/ $35/ $65 / 20% Up to $250 Max $20/$45/ $75/ 30% Up to $250 Max Deductible Pharmacy Deductible NA $150 / $300 Medical Deductible Calendar Year Out-of-Pocket Max $6,850 / $13,700 $6,850 / $13,700 $6,550 / $13,100 (Indiv / Family) MONTHLY PRICING Employee $ $ $ Employee + Spouse $1, $1, $ Employee + Child(ren) $1, $1, $ Employee + Family $2, $1, $1, * Mee a e esposile fo a aout oe the alloed aout

4 Medial KEY TERMS TO REMEMBER ANNUAL DEDUCTIBLE The aout ou hae to pa eah ea efoe the pla stats paig a potio of edial epeses. All fail ees epeses that out toad a health pla dedutile auulate togethe i the aggegate; hoee, eah peso also has a liit o thei o idiidual auulated epeses the aout aies pla. OUT OF POCKET MAXIMUM This is the total aout ou a pa out of poket eah aleda ea efoe the pla pas peet of oeed epeses fo the est of the aleda ea. Most epeses that eet poide etok euieets out toad the aual out of poket aiu, iludig epeses paid to the aual dedutile*, opas ad oisuae. *Eept fo Gadfatheed edial plas COPAY AND COIN URANCE These epeses ae ou shae of ost paid fo oeed health ae seies. Copas ae a fied dolla aout, ad ae usuall due at the tie ou eeie ae. Coisuae is ou shae of the alloed aout haged fo a seie, ad is geeall illed to ou afte the health isuae opa eoiles the ill ith the poide. PLAN TYPE EPO/PPO A etok of dotos, hospitals ad othe health ae poides HMO A etok that euies ou to selet a Pia Cae Phsiia PCP ho oodiates ou health ae PO Coies aspets of a PPO ad HMO HDHP A pla that has highe aual dedutiles i ehage fo loe peius.

5 Health Saigs Aout HSA If ou eoll i the HDHP Medial Pla, ou ae eligile to eoll i a H A though ou o fiaial istitutio. A health saigs aout H A is a health ae aout ad saigs aout i oe. The ai pupose of this aout is to offset the ost of a ualifig high dedutile health pla HDHP ad poide saigs fo ou out of poket eligile health ae epeses those ou ad ou ta depedets a hae o, i the futue, ad duig ou etieet. This is a piate ak aout. You o ou H A! Oe ou H A is estalished, ou ae ale to otiute ta fee to ou aout, ad ou a the use ou H A dollas ta fee to pa fo eligile health ae epeses. You sae oe o epeses ou e alead paig fo, like dotos offie isits, pesiptio dugs, ad uh oe. Best of all, ou deide ho ad he to use ou H A dollas. WHY I IT A GOOD IDEA TO HAVE AN H A? H As eefit eeoe ho is eligile to hae this aout sigle idiiduals, failies, ad soo to e etiees. You sae oe o taes i thee as: Ta fee deposits The oe ou otiute to ou H A is t taed up to the IR aual liit Ta fee eaigs You iteest ad a iestet eaigs go ta fee. Ta fee ithdaals The oe used toad eligile health ae epeses is t taed o o i the futue. ettig aside pe ta dollas ito ou H A eas ou pa fee taes ad iease ou take hoe pa ou ta saigs. You sae oe o eligile epeses that ou ae paig fo out of ou poket. The aout ou sae depeds o ou ta aket. Fo eaple, if ou ae i the peet ta aket, ou a sae $ o ee $ spet o eligile health ae epeses. H A fuds oll oe fo ea to ea ad auulate i ou aout. Thee is o use it o lose it ule ith H As, ad ou deide ho ad he to use ou H A fuds, hih a e used fo eligile epeses ou hae o, i the futue, o duig etieet. Ad he ou hae a etai alae i ou H A, iestet oppotuities ae aailale. Refer to your HSA douetatio for ore iforatio.

6 Detal Coerage SUMMARY OF COVERAGE Plan Features Sunlife Dental IN NETWORK Annual Deductible (Individual / Family) $50 / $150 Preventive Care 100% Basic Procedures (Extractions, fillings, etc.) 80% Major Procedures (Crowns, dentures, etc.) 50% Child Orthodontia NA Calendar Year Maximum Benefit $1,500 MONTHLY PRICING Employee $44.86 Employee + Spouse $88.64 Employee + Child(ren) $95.58 Employee + Family $143.89

7 Visio Coerage SUMMARY OF COVERAGE Plan Features Sunlife Vision IN NETWORK Vision Exam $10 Lenses Single $25 Bifocal $25 Trifocal $25 Progressive Frames $130 Allowance Elective Contact Lenses $130 Allowance Medically Necessary Contact Lenses 100% Frequency (Months) Exam Every 12 Months Lenses Every 12 Months Frames Every 24 Months Contacts Every 12 Months MONTHLY PRICING Employee $8.99 Employee + Spouse $17.41 Employee + Child(ren) $18.27 Employee + Family $29.02

8 Disaility Isurae Log Ter SUMMARY OF COVERAGE Plan Name SunLife LTD Benefits Schedule of Benefits Date Effective Elimination Period 90 Duration of Benefits Definition of Earnings Definition of Disability SSRNA Earnings reported by the employer immediately prior to the first date of disability Extended own occupation loss of duties and loss of earnings required Max Salary Amount $200,000 Benefit Rate 60% of Monthly Earnings Maximum Benefits 60% of salary up $10,000 *For personalized rate information, please login to ADP.

9 Teleediie FisherBroyles employees who are covered under the company sponsored health plan have access to FREE around the clock access to a doctor, no matter where they are, through TELADOC. This Telemedicine benefit will connect you to a board-certified doctor by phone or video chat. The monthly cost for this benefit is 100% paid for by FisherBroyles.

10 Olie Erollet Oerie To log on the ADP website : The first time you log on, you must complete the registration process by clicking Register Here. If you are returning to the site, you ll need to enter your user ID and password and click Log In. You will need your registration code before you begin. FisherBroyles code is: FSHBROYLES-1234 Please note if already registered for the Portal; employees need to sign on with their ADP userid and password Please call ADP directly for any enrollment questions or issues: (855)

11 Cotat Iforatio Contact Name Website What do you need help with? Contact Information Cigna One Cigna.com Medical and Claims Questions (888) SunLife Ancillary Benefits (800) ADP Enrollment Assistance (855) The Benefit Company Advocacy (800) or