2012 Nifco Benefit Plan Highlights Medical through Anthem

Transcription

1 2012 Nifco Benefit Plan Highlights Medical through Anthem Benefit Preferred (In-Network) Standard (Non-network) Annual Deductible $300 per covered person $500 per covered person $600 per covered family $ per family per year Lifetime Maximum Benefit Unlimited Unlimited Annual Out-of-Pocket Limit: $1,000 per covered person $2,000 per covered person $2,000 per family per year $4,000 per family per year *Co-payment charges do not apply to annual out-of-pocket limit. Physician Office Care: 100% after $15.00 copay 70% of eligible expenses Physical Exams 100% after $15.00 copay 70% of eligible expenses Well Baby Care 100% after $15.00 copay 70% of eligible expenses Immunizations 100% after $15.00 copay 70% of eligible expenses Cytologic screening 100% after $15.00 copay 70% of eligible expenses Mammograms See SPD See SPD Allergy Testing / injections 90% of eligible expenses 70% of eligible expenses Prescription Drugs $10.00 copay Generic 50% of eligible expenses $25.00 copay Name Brand ($50 minimum) $50.00 copay Non-preferred Name Brand Inpatient Hospital Care Semi-private room & board 90% of Eligible Expenses 70% of Eligible expenses ICU Unit Nursery Other Hospital Services/Supp Transplant Health Services 100% of eligible expenses 50% of eligible expenses Inpatient Physician Care Surgeon 90% of eligible expenses 70% of eligible expenses Physician Visits Outpatient Services Emergency Services 100% after $100 copay Covered as a preferred benefit 90% if admitted to hospital from emergency room Urgent Care Services 100% of eligible expenses after 70% of eligible expenses $35.00 copay

2 Facility Charges for 90% of eligible expenses 70% of eligible expenses Outpatient Surgery Outpatient Diagnostic and 90% of eligible expenses 70% of eligible expenses Therapeutic Services Other medical Services Ambulance Services 90% of eligible expenses Preferred benefits apply Home Health services 90% of eligible expenses 70% of eligible expenses Skilled Nursing Facility 90% of eligible expenses 70% of eligible expenses Hospice Care 90% of eligible expenses 70% of Eligible expenses Dental Injury 90% of eligible expenses 70% of eligible expenses Prosthetics & Med. Equip. 90% of eligible expenses 70% of eligible expenses Medical Supplies This summary only Highlights Nifco Medical Benefit Plan. For a detailed Explanation of Benefits, Please review the Anthem s Summary Plan Description for Group Number

3 2012 Nifco Benefit Plan Highlights Dental through Anthem Deductible: $25.00 per person Yearly Maximum: $ Lifetime Orthodontia Maximum: $ Benefit In-network Out-of-network Preventative 100% 100% Basic 90% 80% Major 60% 50% Orthodontia 50% 50% Preventative Services Basic Services Major Services Orthodontia Services Emergency Treatment Lab Tests Crowns & Fillings Orthodontia Oral Examinations Root Canals Bridgework X-Rays Endodontics Teeth Cleaning Periodontics For Children: Fillings Topical Sealants Amalgam Fluoride Treatment Silicate Cement Space Maintainers Composite Resin This summary only Highlights Nifco s Dental Benefit Plan. For a detailed Explanation of Benefits, Please review Anthem s Summary Plan Description.

4 2012 Nifco Benefit Plan Highlights Vision through Anthem Routine Eye Exam: $15.00 per person co-pay Eyeglass frames: (Once every 12 months) $130 allowance then 20% off any remaining balance. Eyeglass lenses : $15 co-pay, then covered in full Factory Scratch coating included Eyeglass upgrades Lens Options: Member cost for upgrades: UV coating $15.00 Tint (Solid & Gradient) $15.00 Standard polycarbonate $40.00 Transition lenses $75.00 Progressive lenses: Standard $65.00 Premium Tier 1 $91.00 Premium Tier 2 $97.00 Premium Tier 3 $ Contact Lenses (Once every 12 months) $130 allowance then 15% off any remaining balance.

5 Nifco Benefit Plan Highlights Other Benefits Benefit Description Benefit Detail Medical, Dental, Vision Premiums: Employee = $8.00/week Employee plus Child(ren) = $12.00/week Employee plus Spouse = $16.00 Family = $24.00/week Eligibility: Immediate for salaried. 30 days after hire for hourly. Short Term Disability Long Term Disability Flexible Spending Account Life Insurance Eligibility: First of the month following six months of employment and Accident = Immediate Illness = After 7 working days Coverage: Based on length of service with the company Coverage: 66 2/3% of your normal wages up to $4000/month Benefit Waiting Period: 180 days off of work. Provider: Anthem Eligibility: 1 st of the month following 90 days Coverage: Medical and Dependent Care Spending Accounts Eligibility: Date of hire Coverage: 1½ times your average annual salary. Max of $150K. Supplemental Life Insurance available (associate contribution) See SPD for details. AD&D 401K Eligibility: Date of hire Coverage: 1½ times your average annual salary. Max of $150K. Provider: Fidelity Eligibility: First of month following 90 days Benefit: Employer match of 50% up to a maximum of 6%

6 Employee Assistance Program Family and Substance Abuse Counseling, Financial and Legal Counselors as well as a 24 Hour Nurses Line available to all Nifco associates. Tuition Reimbursement Plan Reimbursement up to $5,000 per calendar year. Associate must receive a grade C or better to be reimbursed. Vacation Less than one year Jan.-Mar. 80 hours Apr.-June 60 hours July-Dec. 40 hours 1-3 years 80 hours 4-10 years 120 hours hours hours Amounts are awarded on Jan. 1 of each year. All vacation requests must be given at least 24 hours in advance. Holidays Leaves of Absence The company has 8 paid holidays plus 3 paid floating holidays to be determined at the beginning of each year. Medical A maximum of 12 weeks unpaid leave for a serious medical condition of yourself, spouse, dependent, or parent. Prior authorization required. Associates must have been employed with the company for 12 months and worked 1250 hours to be eligible for this benefit. See Associate Handbook for complete details. Personal - Associates are eligible for a personal leave of absence upon prior authorization by supervisor and General Manager for a maximum of 30 days. This leave is unpaid and all vacation must be exhausted prior to the leave. Workshirts, Safety Shoes, Workshirts: Company paid & Safety Glasses Safety Shoes: Company paid up to $75.00 Safety Glasses: Company paid Automobile Discounts Referral Bonus Discounts with such companies as Honda, Nissan, Mitsubishi Ford and GM. Nifco will pay $ for referring someone that we eventually hire as a non-exempt employee and $500 for someone we hire as an exempt employee. The bonus is paid after 60 days of employment by the new hire.

7 Credit Union Fitness Center Nifco is affiliated with KEMBA credit union. KEMBA offers higher savings rates and discounted loan rates. They can be reached at Associates can receive discounted initiation and membership fees from participating fitness centers by calling Global Fit at