Employee Benefits Overview

Transcription

1 2019 Employee Benefits Overview

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3 TABLE OF CONTENTS Who Can You Cover?... 3 Health Savings Account (HSA)... 4 Medical... 5 Prescription Drugs... 7 Find a Doctor / Hospital Where You Live and Work... 9 Dental Vision Life Insurance Disability Insurance Flexible Spending Account (FSA) Cost of Coverage Words You Need to Know Important Plan Notices and Documents Plan Contacts Medicare Part D Notice: If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug. Please see the Annual Notices document for more details. 1

4 Know Your Benefits At The College of New Rochelle, we value your contributions to our success and want to provide you with a benefits package that protects your health and helps your financial security, now and in the future. We continually look for valuable benefits that support your needs, whether you are single, married, raising a family, or thinking ahead to retirement. We are committed to giving you the resources you need to understand your options and how your choices could affect you financially. This guide is an overview and does not provide a complete description of all benefit provisions. For more detailed information, please refer to your plan benefit booklets or summary plan descriptions (SPDs). The plan benefit booklets determine how all benefits are paid. A list of plan contacts is included at the back of this guide. The benefits in this summary are effective: January 1, 2019 December 31,

5 Who Can You Cover? WHO IS ELIGIBLE? In general, full time employees working 30 or more hours per week are eligible for the benefits outlined in this overview. You can enroll the following family members in our medical and dental plans. Your spouse (the person who you are legally married to under state law, including a same-sex spouse.) Your children: o Under age 26 are eligible to enroll in medical. They do not have to live with you or be enrolled in school. They can be married and/or living and working on their own. o Over age 26 ONLY if they are incapacitated due to a disability and primarily dependent on you for support. o Named in a Qualified Medical Child Support Order (QMCSO) as defined by federal law. Please refer to the Summary Plan Description for complete details on how benefits eligibility is determined. WHO IS NOT ELIGIBLE? Family members who are not eligible for include (but are not limited to): Parents, grandparents, and siblings. Any individual who is covered as an employee of The College of New Rochelle cannot also be covered as a dependent. Employees who work fewer than 30 hours per week, temporary employees, contract employees, or employees residing outside the United States. ENROLLMENT PERIODS Coverage for new employees begins on the first of the month following 30 days from date of hire. After that, Open Enrollment is the one time each year that employees can make changes to their benefit elections without a qualifying life event. Notify Human Resources at within 31 days if you have a qualifying life event and need to add or drop dependents outside of Open Enrollment. Life events include (but are not limited to): Birth or adoption of a baby or child Loss of other healthcare Eligibility for new healthcare Marriage or divorce 3

6 Health Savings Account (HSA) Do you want to save money on taxes? A Health Savings Account (HSA) is a tax-advantaged, portable (you own it!) savings account that is offered if you enroll in our Consumer Direct Open Access Plus PPO Plan through Emblem. You contribute pre-tax money to your account to save for out-of-pocket healthcare expenses. Plus, any money that you don't spend grows year after year and can be used in the future, even after you retire. ACCOUNT CONTRIBUTIONS You May Contribute** Employee Employee + Family 1 Up to $3,500 less employer contribution (2019 Federal limit) Up to $7,000 less employer contribution (2019 Federal limit) 1 Includes Employee + Spouse, Employee + Child(ren) **Contribution limits: The IRS has set limits on the total amount you can contribute to a Health Savings Account each calendar year and contributions made by your employer count. In 2019, the limit is $3,500 for an individual and $7,000 for a family. If you're over 55, the IRS allows you to contribute an additional $1,000 this is called a catch-up contribution. USING YOUR MONEY You can use the money in your account to pay for qualified medical expenses that are not paid for by your high health plan (HDHP). For a full list of those expenses, go to irs.gov. When possible, use your HSA debit card to pay for qualified expenses. Make sure that you keep records of your receipts and any over-the-counter (OTC) prescriptions. You will need them to prove that you spent the money on qualified expenses if you are audited by the IRS. ELIGIBILITY You are not eligible to open or contribute to an HSA account if you are: Covered by a non-high health plan Enrolled in a regular healthcare flexible spending account (you or your spouse count) Covered under Medicare or Medicaid Claimed as a dependent on someone else's tax return Non-Qualified Expenses If you use HSA funds for nonqualified expenses before you are age 65, you will owe a 20% penalty tax PLUS income tax on the withdrawal. After age 65, if you use HSA funds for nonqualified expenses, you will owe income tax only. HSA ACCOUNT ACTIVATION If you elect medical under Emblem, you may choose to utilize any bank that has an HSA banking option to open your HSA account. 4

7 Medical Medical provides you with benefits that help keep you healthy, like preventive care screenings and access to urgent care. It also provides important financial protection if you have a serious medical condition. The College s medical plan is administered by EmblemHealth, an insurance carrier that has been serving its members for more than 75 years. Below are some highlights of the medical plan. HIP Prime Medical EPO Plan Option 1 Emblem National Network Consumer Direct Open Access PPO Plan (HSA Eligible) Option 2 In-Network In-Network Out-Of-Network Annual Deductible $0 per individual $2,700 employee $3,000 employee $0 family limit $5,400 family $6,000 family Annual Out-of-Pocket Max $4,500 per individual $9,000 family limit $2,700 employee $5,400 family $6,000 employee $12,000 family Lifetime Max Unlimited Unlimited Unlimited Office Visit Primary Provider $30 copay then plan pays 100% Specialist $30 copay then plan pays 100% Preventive Services Plan pays 100% Chiropractic Care $30 copay then plan pays 100% Lab and X-ray $30 copay then plan pays 100% Inpatient Hospitalization $500 copay then plan pays 100% Outpatient Surgery $250 copay Urgent Care $30 copay then plan pays 100% Emergency Room $200 copay then plan pays 100% (copay waived if admitted) 5

8 Medical, continued Emblem National Network In Balance Open Access PPO Plan Option 3 Emblem National Network Open Access PPO Plan Option 4 In-Network Out-Of-Network In-Network Out-Of-Network Annual Deductible $500 employee $5,000 employee $0 per individual $2,500 employee $1,500 family $15,000 family $0 family limit $7,500 family Annual Out-of-Pocket Max $4,000 employee $10,000 employee $5,000 employee $5,000 employee $8,000 family $30,000 family $10,000 family $15,000 family Lifetime Max Unlimited Unlimited Unlimited Unlimited Office Visit Primary Provider $50 copay then $40 copay then Specialist $50 copay then $40 copay then Preventive Services Plan pays 100% Plan pays 100% Chiropractic Care $50 copay then $40 copay then Lab and X-ray Plan pays 70% after Plan pays 100% after Inpatient Hospitalization Plan pays 70% after $500 copay then Outpatient Surgery Plan pays 70% after Plan pays 100% Urgent Care $50 copay then $40 copay then Emergency Room $200 copay then (waived if admitted) $200 copay then (waived if admitted) $100 copay then (waived if admitted) $100 copay then (waived if admitted) 6

9 Prescription Drugs Prescription drug provides a benefit that is important to your overall health, whether you need a prescription for a short-term health issue like bronchitis or an ongoing condition like high blood pressure. Here are the prescription drug benefits that are included with our medical plans. HIP Prime Medical EPO Plan Option 1 Emblem National Network Consumer Direct Open Access PPO Plan (HSA Eligible) Option 2 In-Network In-Network Out-Of-Network Prescription Drug Deductible Not Applicable Prescriptions subject to medical plan Prescriptions subject to medical plan Annual Out-of-Pocket Limit Not Applicable Not Applicable Not Applicable Pharmacy Generic $15 copay then plan pays 100% Preferred Brand $30 copay then plan pays 100% Non-preferred Brand $50 copay then plan pays 100% Supply Limit 30 days 30 days 30 days Mail Order Generic $37.50 copay then plan pays 100% Not covered Preferred Brand $75 copay then plan pays 100% after Not covered Non-preferred Brand $125 copay then plan pays 100% after Not covered Supply Limit 90 days 90 days Not applicable 7

10 Prescription Drugs, continued Emblem National Network In Balance Open Access PPO Plan Option 3 Emblem National Network Open Access PPO Plan Option 4 In-Network Out-Of-Network In-Network Out-Of-Network Prescription Drug Deductible Annual Out-of-Pocket Limit Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Pharmacy Generic $20 copay then $20 copay then plan pays 50% $15 copay then plan pays 100% Preferred Brand $40 copay then $40 copay then plan pays 50% $30 copay then plan pays 100% Non-preferred Brand $70 copay then $70 copay then plan pays 50% $50 copay then plan pays 100% Supply Limit 30 days 30 days 30 days 30 days Mail Order Generic $50 copay then Not covered $37.50 copay then Not covered Preferred Brand $100 copay then Not covered $75 copay then plan pays 100% Not covered Non-preferred Brand $175 copay then Not covered $125 copay then Not covered Supply Limit 90 days Not applicable 90 days Not applicable 8

11 Find a Doctor / Hospital Where You Live and Work As an EmblemHealth member, you have access to our vast network of leading physicians including many of New York magazine s Top Doctors physician group practices and most acute care hospitals. If you are enrolled in the HIP Prime Medical EPO Plan (Option 1), you can find a provider by following the instructions below: Go to Choose the find a doctor selection Enter your zip code Choose I know the specific plan I am looking for Choose EPO Value Begin your search, click on the zip code to update your location o If you are looking for providers outside of the Tri-State Area, choose the Multiplan circle. You will receive the message redirecting you to the Multiplan website. Click OK to be redirected to the Multiplan website. o Begin your search at the Multiplan website. Click on the Zip Code to update your location. If you are enrolled in either the: Emblem National Network Consumer Direct Open Access PPO Plan (HSA Eligible) (Option 2) Emblem National Network In Balance Open Access PPO Plan (Option 3) Emblem National Network Open Access PPO Plan (Option 4) You can find a provider by following the instructions below: Go to Choose the find a doctor selection Enter your zip code Choose Plan offered through my employer or union Choose More than 100 full-time equivalent employees or members (large group) Choose EmblemHealth National Network GHI PPO / EPO Plans Begin your search, click on the zip code to update your location o If you are looking for providers outside of the Tri-State Area, choose the Multiplan circle. You will receive the message redirecting you to the Multiplan website. Click OK to be redirected to the Multiplan website. o Begin your search at the Multiplan website. Click on the Zip Code to update your location. 9

12 Dental Regular visits to your dentists can protect more than your smile; they can help protect your health. Recent studies have linked gum disease to damage elsewhere in the body and dentists are able to screen for oral symptoms of many other diseases including cancer, diabetes, and heart disease. The College of New Rochelle provides you with comprehensive through Aetna Freedom-of-Choice (FOC) Dental Plan. The FOC plan provides the convenience of two different dental benefits and dental insurance plans in one. Begin by choosing the plan that is right for you. If your needs change during the year, switch to another plan. Each plan gives you and your family the dental that works best for you. It s your choice! If you elect the DHMO plan, you must choose a primary care dentist (PCD) from Aetna s network. Your PCD will help manage your care. There are no s and no claim forms. With this plan, you will generally pay less for covered services. Would you prefer to have the freedom to visit any dentist? Then the PPO plan may be right for you. You can visit any dentist you choose; however, you will obtain better benefits for utilizing a dentist within Aetna s network. Please see below for some plan design features that may assist in your plan selection: Calendar Year Deductible Annual Plan Maximum $0 $0 Aetna DHMO Plan Aetna Dental PPO Plan In-Network In-Network Out-Of-Network $75 per individual $225 per family $75 per individual (combined with in-network) $225 per family (combined with in-network) Unlimited $1,500 $1,500 (combined with innetwork) Waiting Period None None None Diagnostic and Preventive Basic Services Plan pays 100% Plan pays 80% Plan pays 80% Fillings Plan pays 80% Plan pays 60% after Root Canals Plan pays 80% Plan pays 60% after Periodontics Plan pays 80% Plan pays 60% after Major Services Plan pays 60% Orthodontic Services Plan pays 60% after Plan pays 60% after Plan pays 60% after Orthodontia Plan pays 50% Not covered Not covered Lifetime Maximum Unlimited Not applicable Not applicable Dependent Children* Covered Not covered Not covered Full-time Students* Covered Not covered Not covered *Limiting age for Dependents on Dental is the end of the calendar year in which dependent turns

13 Vision Routine vision exams can not only correct vision, but also detect more serious health conditions. Effective February 1 st, 2019, you will be provided with a vision plan through EyeMed. Once you become a member you can register at Eyemed.com and print an ID card. You can also download the member app. However, members don t need an ID card to receive services. A member can simply give the provider their last name and birthdate. EyeMed Vision Plan In-Network Out-Of-Network Examination Benefit $10 copay then Reimbursed up to $40 Frequency 1 x every 12 months from last date of service in-network limitations apply Materials $10 copay then Plan pays 100% (see schedule below) Eyeglass Lenses Single Vision Lens Bifocal Lens Trifocal Lens Frequency Frames Plan pays 100% of basic lens (material copay applies) Plan pays 100% of basic lens (material copay applies) Plan pays 100% of basic lens (material copay applies) 1 x every 12 months from last date of service Reimbursed up to $30 Reimbursed up to $50 Reimbursed up to $70 in-network limitations apply Benefit Up to $150 plus a plan pays 20% discount from the remaining balance Reimbursed up to $105 Frequency Contacts (Elective) 1 x every 24 months from last date of service in-network limitations apply Benefit Up to $130 Allowance Reimbursed up to $130 Frequency 1 x every 12 months from last date of service in-network limitations apply To find a provider, go to Eyemed.com and: Click find a provider Enter in Zip code Choose the INSIGHT network The provider locations will populate 11

14 Life Insurance If you have loved ones who depend on your income for support, having life and accidental death insurance can help protect your family's financial security and pay for large expenses such as housing and education, as well as day-to-day living expenses. LIFE AND AD&D Basic Life Insurance pays your beneficiary a lump sum if you die. AD&D provides another layer of benefits to either you or your beneficiary if you suffer from loss of a limb, speech, sight, or hearing, or if you die in an accident. The cost of is paid in full by the company. Coverage is provided by The Hartford. Basic Life Amount Basic AD&D Amount 1.5 x covered annual earnings ($10,000 minimum benefit) up to a maximum of $600, x covered annual earnings ($10,000 minimum benefit) up to a maximum of $600,000 VOLUNTARY LIFE Voluntary Life Insurance allows you to purchase additional life insurance to protect your family's financial security. Coverage is provided by The Hartford. Employee Voluntary Life Amount Spouse Voluntary Life Amount Child(ren) Voluntary Life Amount (6 months to age 19, age 25 if full-time student) Increments of $10,000 up to Lesser of 5 x covered annual earnings or $500,000 Increments of $5,000 up to Lesser of 50% of employee amount or $250,000 Increments of $2,000 up to $4,000 Voluntary Life Insurance is subject to Guaranteed Issue amounts. Requests for in excess of the Guaranteed Issue Amount(s) will require Evidence of Insurability. Please refer to the Summary Plan Description for more details. 12

15 Disability Insurance If you become disabled and cannot work, your financial security may be at risk. Protecting your income stream can provide you and your family with peace of mind. SHORT-TERM DISABILITY INSURANCE (NYDBL) State Mandated Short-Term Disability is provided to you by the College. Short-Term Disability wait period is 7 days after accident/illness. Benefit equals 50% of base pay, up to a maximum of $170 per week, for 26 weeks. The College pays for 100% of the premium cost. LONG-TERM DISABILITY INSURANCE Long-Term Disability (LTD) pays you a certain percentage of your income if you can't work because an injury or illness prevents you from performing any of your job functions over a long time. It's important to know that benefits are reduced by income from other benefits you might receive while disabled, like workers' compensation and Social Security. If you qualify, long-term disability benefits begin after short-term disability benefits end. Coverage is provided by The Hartford. Monthly Benefit Amount Plan pays 60% of covered monthly earnings Maximum Monthly Benefit $10,000 Benefits Begin After: Accident Sickness Maximum Payment Period* 180 days of disability 180 days of disability Social Security normal retirement age *The age at which the disability begins may affect the duration of the benefits. 13

16 Flexible Spending Account (FSA) A Flexible Spending Account lets you set aside money before it's taxed through payroll deductions. The money can be used for eligible healthcare and dependent day care expenses you and your family expect to have over the next year. The main benefit of using an FSA is that you reduce your taxable income, which means you have more money to spend. You must re-enroll in this program each year. Advanced Benefit Strategies (ABS) administers this program. IMPORTANT CONSIDERATIONS Expenses must be incurred between 1/01/19 and 3/15/20 and submitted for reimbursement no later than 3/31/20. Elections cannot be changed during the plan year, unless you have a qualified change in family status (and the election change must be consistent with the event). If you have a balance in your Dependent Care accounts at the end of 12/31/19, you have a grace period until 3/15/20 to incur claims for reimbursement from the 2019 funds. Claims must be submitted no later than 3/31/20. Unused amounts will be lost at the end of the plan year, so it is very important that you plan carefully before making your election. FSA funds can be used for you, your spouse, and your tax dependents only. You can obtain reimbursement for eligible expenses incurred by your spouse or tax dependent children, even if they are not covered on The College of New Rochelle health plan. You cannot obtain reimbursement for eligible expenses for a domestic partner or their children, unless they qualify as your tax dependents (Important: questions about the tax status of your dependents should be addressed with your tax advisor). HEALTHCARE FSA ACCOUNT This plan allows you to pay for eligible out-of-pocket healthcare expenses with pre-tax dollars. Eligible expenses may be incurred by you or your eligible dependents, as defined by the IRS. You may contribute a minimum of $100 up to $2,700 per year to your Healthcare FSA. WHEN DO I SUBMIT MY CLAIMS? You can submit claims at any time, either by mail or fax directly to Advanced Benefit Strategies: 30 Mill Street, Unionville, CT (phone (877) , fax (860) ). Please refer to the first bullet on the left regarding claims deadlines. HOW DO I USE MY DEBIT CARD? Use your Debit MasterCard the same way you would use your credit card. Instead of paying up front and waiting to be reimbursed, the card debits your account automatically. Keep your receipts you may be asked to substantiate your claims by submitting them to Advanced Benefit Strategies using a debit card claim form. Advanced Benefit Strategies can answer your questions in regards to debit MasterCard or visit us on the web at Keep your receipts. In most cases, you'll need to provide proof that your expenses were considered eligible for IRS purposes. Please refer to the eligible expense listing at 14

17 Flexible Spending Account (FSA) Continued DEPENDENT CARE FSA ACCOUNT This plan allows you to pay for eligible out-of-pocket dependent care expenses with pre-tax dollars. Eligible expenses may include daycare centers, inhome child care, and before or after school care for your dependent children under age 13. Other individuals may qualify if they are considered your tax dependent and are incapable of self-care. It is important to note that you can access money only after it is placed into your dependent care FSA account. All caregivers must have a tax ID or Social Security number. This information must be included on your federal tax return. If you use the dependent care reimbursement account, the IRS will not allow you to claim a dependent care credit for reimbursed expenses. Consult your tax advisor to determine whether you should enroll in this plan. You can set aside up to $5,000 per household for eligible dependent care expenses for the year or $2,500 if married and filing separately. Dependent Care Flexible Spending Account (FSA) lets you pay for eligible expenses such as: Child care Preschool Before and after school care Day camps COMMUTER PROGRAM (TRANSIT AND PARKING) The ABS Commuter program allows you to pay for your work-related parking and transit expenses using pretax dollars. As a month-to-month benefit, you can opt in and opt out of the benefit at any time based on your transit or parking needs for the upcoming month. The ABS Commuter Benefit covers your work-related public transit and parking expenses including, but not limited to: Buses Ferries Parking lots and garages Trains Funds are loaded directly to your ABS Benefit card. You can use your card at transit authorities or parking merchants that accept MasterCard. This includes transit authority websites, kiosks, ticket offices, or parking vendors. Remember, important information regarding this program can be found on the ABS website. The IRS limits for 2019* are: The Transit Account is $265 per month The Parking Account is $265 per month *May be subject to change annually per IRS guidelines MANAGE YOUR ACCOUNT ONLINE Once enrolled, you can manage your Transportation Benefits and you can also order your monthly transit and parking passes directly through 15

18 Cost of Coverage You pay for health before federal, state, and social security taxes are withheld, so you pay less in taxes. The tables below show your bi-weekly contributions. EmblemHealth Medical Plans HIP Prime Network EPO Option 1 Consumer Direct PPO Option 2 In Balance PPO Option 3 OAP PPO Option 4 Employee Only $69.28 $ $ $ Employee + Spouse $ $ $ $ Employee + Child(ren) $ $ $ $ Employee + Family $ $ $ $ Aetna Dental Plan Your Cost CNR DHMO/ PPO Employee Only $14.11 Employee + Spouse $28.60 Employee + Child(ren) $39.44 Employee + Family $42.43 EyeMed Vision Plan Your Cost CNR DHMO/ PPO Employee Only $3.51 Employee + Spouse $6.66 Employee + Child(ren) $7.02 Employee + Family $

19 Cost of Coverage, continued Age Voluntary Life Employee Monthly Rates* Spouse Monthly Rates* Under 25 $0.040 $ $0.040 $ $0.050 $ $0.070 $ $0.100 $ $0.160 $ $0.300 $ $0.510 $ $0.750 $ $1.230 $ $1.920 $ $1.920 $1.860 *Rate is per $1,000 of Dependent Child Rate: $.05 (Per $1,000) Sample Voluntary Life Calculation Example: 30 year old employee (1) Elects $60,000 life insurance (2) $60,000 / $1,000 = 60 (3) 60 x $0.050 = $3.00 per month Sample Spouse Voluntary Life Calculation Example: 50 year old spouse elects 50% of employee amount (1) $30,000 of insurance (2) $30,000 / $1,000 = 30 (3) 30 x $.400 = $12.00 per month 17

20 Words You Need to Know Health insurance seems to have its own language. You will get more out of your plans if understand the most common terms, explained below in plain English. MEDICAL OUT-OF-POCKET COST - A healthcare expense you are responsible for paying with your own money, whether from your bank account, credit card, or from a health account such as an HSA, FSA or HRA. DEDUCTIBLE - The amount of healthcare expenses you have to pay for with your own money before your health plan will pay. The does not apply to preventive care and certain other services. COINSURANCE - After you meet the amount, you and your health plan share the cost of covered expenses. Coinsurance is always a percentage totaling 100%. For example, if the plan pays 70% coinsurance, you are responsible for paying your coinsurance share, 30% of the cost. COPAY - A set fee you pay whenever you use a particular healthcare service, for example, when you see your doctor or fill a prescription. After you pay the copay amount, your health plan pays the rest of the bill for that service. IN-NETWORK / OUT-OF-NETWORK - Network providers (doctors, hospitals, labs, etc.) are contracted with your health plan and have agreed to charge lower fees to plan members, as negotiated in their contract with the health plan. Services from out-of-network providers can cost you more because the providers are under no obligation to limit their maximum fees. With some plans, such as HMOs and EPOs, services from out-of-network providers are not covered at all. OUT-OF-POCKET MAXIMUM - The most you would pay from your own money for covered healthcare expenses in one year. Once you reach your plan's out-of-pocket maximum dollar amount (by paying your, coinsurance and copays), the plan pays for all eligible expenses for the rest of the plan year. PRESCRIPTION DRUG BRAND NAME - A drug sold under its trademarked name. For example, Lipitor is the brand name of a common cholesterol medicine. You generally pay a higher copay for brand name drugs. GENERIC DRUG - A drug that has the same active ingredients as a brand name drug, but is sold under a different name. For example, Atorvastatin is the generic name for medicines with the same formula as Lipitor. You generally pay a lower copay for generic drugs. PREFERRED DRUG - Each health plan has a list of prescription medicines that are preferred based on an evaluation of effectiveness and cost. Another name for this list is a "formulary." The plan may charge more for non-preferred drugs or for brand name drugs that have generic versions. Drugs that are not on the preferred drug list may not be covered. DENTAL BASIC SERVICES - Dental services such as fillings, routine extractions and some oral surgery procedures. DIAGNOSTIC AND PREVENTIVE SERVICES - Generally include routine cleanings, oral exams, x- rays, and fluoride treatments. Most plans limit preventive exams and cleanings to two times a year. MAJOR SERVICES - Complex or restorative dental work such as crowns, bridges, dentures, inlays and onlays. 18

21 Important Plan Notices and Documents CURRENT HEALTH PLAN NOTICES Notices that must be provided to plan participants on an annual basis and are available in a separate Annual Notices packet, along with this Employee Benefits Overview, include: Medicare Part D Notice Describes options to access prescription drug for Medicare eligible individuals. Women's Health and Cancer Rights Act Describes benefits available to those that will or have undergone a mastectomy. Newborns' and Mothers' Health Protection Act Describes the rights of mother and newborn to stay in the hospital hours after delivery. HIPAA Notice of Special Enrollment Rights Describes when you can enroll yourself and/or dependents in health outside of open enrollment. Premium Assistance Under Medicaid and the Children's Health Insurance Program (CHIP) Describes availability of premium assistance for Medicaid eligible dependents. COBRA General Rights Notice Describes your rights should you lose with the company-sponsored plan administrator. Health Insurance Marketplace Notice Describes how you can purchase private individual health insurance. New York State Paid Family Leave Act Notice Describes the law providing eligible New York State employees job-protected, paid leave to bond with a new child, care for a loved one with a serious health condition, or to help relieve pressures when a family member is called to active military service. COBRA CONTINUATION COVERAGE You and/or your dependents may have the right to continue after you lose eligibility under the terms of our health plan. Upon enrollment, you and your dependents receive a COBRA Initial Notice that outlines the circumstances under which continued is available and your obligations to notify the plan when you or your dependents experience a qualifying event. Please review this Notice carefully to make sure you understand your rights and obligations. CURRENT PLAN DOCUMENTS Important documents for our health plan include: Summary Plan Descriptions A Summary Plan Description (SPD) is the legal document for describing benefits provided under the plan as well as plan rights and obligations to participants and beneficiaries. The following Summary Plan descriptions are available: The College of New Rochelle Welfare Benefits Plan Summary of Benefits and Coverage A Summary of Benefits and Coverage (SBC) is a document required by the Affordable Care Act (ACA) that presents benefit plan features in a standardized format. The following SBCs are available along with this Employee Benefits Overview: EmblemHealth Medical Plans Paper copies of these documents and notices are available if requested. If you would like a paper copy, please contact Human Resources at

22 Plan Contacts If you need to reach our plan providers or Human Resources, here is their contact information: Plan Type Provider Phone Number Website Policy/Group # Medical EmblemHealth HIP Prime Medical EmblemHealth TBD Dental Aetna Vision EyeMed TBD Life and AD&D The Hartford GL Voluntary Life The Hartford GL Short-Term Disability (NYDBL) The Hartford LNY Long-Term Disability (LTD) The Hartford GL Flexible Spending Account (FSA) Advanced Benefit Strategies Human Resources The College of New Rochelle

23 Notes 21

24 Rev. 1/3/