Plan Year BGenefits uide to

Transcription

1 2017 Plan Year Guide to Benefits

2 FROM the LEADERSHIP TEAM The health and well-being of our employees is important to us. Our employees are our greatest asset and the key to our success. You take care of our clients, and our goal is to provide you the benefits and resources you need to take care of you and your family. Our benefit plans are designed to recognize the diverse needs of our workforce. We strive to offer you a comprehensive, competitive benefits package with options that allow you to design your own plan based on your individual needs. This guide is provided to offer you a summary of the benefits available, which include two Medical plans with a robust Wellness program, Dental and Vision coverage, Life insurance, Disability insurance, Tax-savings vehicles, and more. Since 2014, the Patient Protection and Affordable Care Act of Work hard. Play hard. Live well (ACA) or Health Care Reform requires nearly everyone in the United States to have medical coverage or pay a federal income tax penalty (also referred to as an Individual Mandate). Please be assured that by enrolling in any one of the Pond medical plans you will meet this requirement and will not be subject to the tax penalty. If you choose not to enroll in one of the 2017 Pond medical plans beginning January 1, you must obtain coverage from another source, such as your spouse s employer or the Health Insurance Marketplace, to satisfy the Individual Mandate. Dependents up to age 26 may enroll in a parent s plan. Keep in mind that with the Pond medical plans, the company funds a portion of your overall premium, passing on a reduced rate to you which you pay for with before-tax payroll deductions, saving you even more money. We strive to provide our employees with an offering of benefits to meet the needs of you and your family. For your Health and Well-being we offer medical, dental and vision benefits for you and your dependents. We also provide you access to telemedicine through Teladoc and a medical advocate program, (MAP). For your Financial Wellness, we provide a 401(k) qualified plan, life insurance, disability protection, Section 125 Cafeteria Plan and a Flexible Spending Account (FSA) for Health Care and Dependent Care. For your Work/Life Balance, we provide you with access to a confidential Employee Assistance Program (EAP), Flex Time and the option of a Compressed Schedule. We also provide a robust Wellness program along with vacation days, sick days and paid holidays. 1

3 Eligibility You are eligible for benefits if you are a full-time employee, working 30 or more hours a week. Eligible dependents are defined as spouses and/or dependent children to age 26. Employee coverage must be elected in order for dependent coverage to be valid. Employees are eligible for benefits beginning the first day of the month coinciding with or following date of hire. Benefit Basics Once you elect your Pond benefit options, elections remain in effect for the plan year January 1, 2017 through December 31, You may only change coverage due to a qualifying life event and must do so within 30 days of the event. Qualifying Life Events are changes in status as follows: Change in status, which includes: marriage, birth/ adoption of a child, employment changes, changes in residence, dependent satisfies or ceases to satisfy eligibility requirements Dependent s Open Enrollment through their employer Significant cost or coverage changes HIPAA special enrollment rights FMLA special requirements Changes due to a judgment, decree or court order Entitlement to Medicare or Medicaid HEALTH and WELL-BEING Medical After an extensive and thorough review of available plans, it has been determined it is best to remain with UnitedHealthcare for our medical insurance. As an employee of Pond, you will have the opportunity to enroll in one of two medical plans offered. Both plans have in-network as well as out-of-network benefits. However, it will be in your best interest to use an in-network provider (doctor, lab, hospital, etc.). Our Medical Plans Our Base Plan is a traditional copay type of plan. This plan has a significantly higher cost than the Consumer Driven Health Plan (CDHP) which is used in conjunction with a taxadvantaged savings opportunity, the Health Savings Account (HSA). A detailed comparison of the two plans offered follows on page 3. Both plans pay 100% of the cost for annual preventive care (in-network) for each covered member of your family. It is important that your provider properly codes your visit as preventive in order for it to be covered at 100%. About this guide: This document is a summary of the benefits provided under a group insurance plan. The summary is an outline only and is not a contract. This plan contains certain exclusions and limitations as well as terms under which coverage may be continued or discontinued. Please refer to the certificate of insurance for a complete description of actual plan benefits and terms of coverage. 2

4 Medical Plan highlights shown below. See UHC Benefit Summaries for more detail. CHOICE PLUS G7A (HSA Qualified PLAN) CHOICE PLUS G5S (BASE PLAN) PLAN ATTRIBUTES In-Network In-Network Physician Office Visit: PCP / Specialist Plan pays 80% after Deductible $35 / $50 copay Preventive Care Plan pays 100% Plan pays 100% Annual Deductible Individual / Family $2,600 / $5,200 All individual Deductible amounts will count toward the family Deductible, but an individual will not have to pay more than the individual Deductible amount. $2,000 / $6,000 All individual Deductible amounts will count toward the family Deductible, but an individual will not have to pay more than the individual Deductible amount. Member Copayments do not accumulate towards the Deductible. Coinsurance Plan pays 80% after Deductible Plan pays 80% after Deductible Out of Pocket Max Individual / Family Includes Deductible $6,550 / $13,100 Includes Deductible $4,000 / $12,000 Inpatient Services Plan pays 80% after Deductible Plan pays 80% after Deductible Outpatient Services Plan pays 80% after Deductible Plan pays 80% after Deductible Urgent Care Plan pays 80% after Deductible Plan pays 100% after $75 Copay Labs, X-Ray and Diagnostics Plan pays 80% after Deductible Plan pays 100% / No Deductible for Preventive & Non-Major Diagnostic Plan pays 80% after Deductible for Major Diagnostic Emergency Room Plan pays 80% after Deductible Plan pays 100% after $125 Copay Prescription Drugs (Retail) Generic Formulary Brand name Non-Formulary Brand-name Copays apply after Deductible $10 copay $35 copay $60 copay $10 copay $35 copay $60 copay Per Bi-Weekly Pay Period Employee Contributions Employee Only Employee + Child(ren) Employee + Spouse Family HSA Contributions for Employees who elect the HSA/Qualified Plan G7A $0.00 $54.46 $60.00 $90.00 $100 per month EE only $150 per month EE + Dependent(s) GS5 $18.46 $ $ $ N/A 3

5 Health Plan Evaluator Tool Do you need help deciding which plan is best for you and your family? If so, you have access to a plan evaluator tool which is easy to use. Based on your assumptions of plan use, the plan evaluator will show you the cost difference between the two plans, taking into account the premiums, deductibles, copays, etc. attributable to each plan. To access this tool: Username: Password: Pond & Company (case & space sensitive) mybenefits (case sensitive) Your Health Savings Account (HSA) at POND A Health Savings Account (HSA) allows Pond to set aside money to help you pay for your out-of-pocket healthcare expenses (medical, dental and/or vision). You may also make contributions to your HSA, building a savings account that can be used for future healthcare expenses. The HSA is your money (including the contributions from Pond) that you control. Features and Benefits of an HSA Pond will contribute, tax-free, to your HSA $100 per month for employee coverage or $150 per month for employees electing dependent coverage. Plus an additional, one-time contribution of $1,000 for everyone who enrolls in the CDHP Plan January 1, You may also contribute to your HSA, tax-free throughout the year up to the IRS limits established. For 2017 those limits are: $3,400 for employee only, inclusive of the dollars contributed by Pond $6,750 for all other tiers, inclusive of the dollars contributed by Pond If you are age 55 or older, you may contribute an additional $1,000 annual catch-up amount The money in the account is yours! If you decide to leave Pond, the money in your account goes with you. There is NO use it or lose it rule with regard to HSA s; the funds roll over year to year. The funds can be used for dependent medical services even if the dependent is not covered under your health plan. HSA s provide the following tax advantages: Pre-tax or tax-deductible deductions from payroll into your HSA Tax-free earnings through investment income Tax-free withdrawals for Qualified Medical Expense Once you qualify for Medicare (A&B) and purchase supplements, the funds in your HSA can be used to pay these premiums. Such is the case even though you can no longer contribute to your HSA once you have secured Medicare. Medical Advocate Program (MAP) MAP, your own personal healthcare concierge, can help direct you to lower price, high quality options within your existing network of doctors and facilities. Pond provides this valuable resource to you at no cost. Call MAP first for any of the following reasons: Identifying the best physician for your specific needs To obtain a second opinion (surgery, cancer diagnosis, etc.) When you require diagnostic testing Answer your medical questions or concerns To understand your medical alternative treatment options To save money When you want to know more about a particular physician When you receive a balance bill notice from your provider and have questions in that regard Remember, call MAP first!

6 Telemedicine with Teladoc An innovative telemedicine program, Teladoc enables you to be treated for mild illnesses by a licensed physician with no copay or deductible. This service is provided for you by Pond at no cost! No appointments, no waiting, no office visit copays or deductibles! You can and will save time and money by using Teladoc, available 24/7, at the appropriate time: When considering an ER visit for a non-emergency medical need Your family doctor is not available After normal business hours, nights, weekends and holidays Traveling and are in need of medical advice Some of the most common conditions treated include: colds and flu allergies bronchitis sore throat upset stomach sinus congestion back problems muscle or joint pain Remember, use Teladoc and save time and money! You can contact Teladoc at or call 800.Teladoc ( ). DENTAL Pond offers our employees dental coverage through MetLife. This plan covers diagnostic and preventive services (cleanings) at 100%; basic services (fillings) at 80% after deductible; and major services (bridges, crowns) at 50% after deductible. Orthodontics are covered at 50% with a $1,500 lifetime maximum for children under the age of 19. We encourage you to use an in-network provider; utilization of out-of-network providers may result in your paying a higher share of costs. To find an in-network provider, go to or call Plan Attribute Annual Deductible MetLife Dental Benefits In-Network Individual $25 Family $75 Deductible Applies To Basic & Major Annual Benefit Maximum $1,500 Preventive Services Cleaning - 2 treatments per year X-rays - Bitewings & Full Mouth Sealants - To age 16 Space Maintainers - To Age 15 Basic Services Paid at 100% No Deductible Fillings Simple Extractions Endodontics Oral Surgery Deductible Applies; 80% Reimbursement Periodontics Major Services Crowns Implants Bridges Deductible Applies; 50% Reimbursement Dentures Orthodontia (children under age 19) Paid at 50% $1,500 lifetime maximum Employee Contribution Per Bi-Weekly Payroll Dental Employee Only $0.00 Employee + Spouse $19.38 Employee + Children $27.69 Family $

7 VISION Pond offers our employees vision coverage through VSP, one of the largest providers of vision benefits. We encourage you to use an in-network provider for exams as well as glasses and/or contact lenses. You can locate an in-network provider by visiting or by calling Plan Attribute Exams Lenses Single Lined Bifocal Lined Trifocal VSP Vision Benefits In-Network $10 Copay $25 Copay $25 Copay $25 Copay FINANCIAL WELLNESS In addition to providing a complete Health and Well-being package of benefits, Pond recognizes the significant need for our employees to plan for unexpected obstacles you may encounter. The peace of mind that comes with knowing you have a plan in place to replace your income and make sure you and your family can bounce back from whatever life sends you is comforting. This is where the life and disability benefits are invaluable. Pond also provides a 401(k) plan so that you can begin to plan for your financial needs in retirement. In addition to our 401(k) plan, you will have the opportunity to enroll in a Flexible Spending Account (FSA) for healthcare and/or dependent care expenses. Such plans will enable you to pay for qualified medical expenses and dependent care expenses on a pre-tax basis. Our Section 125 Cafeteria plan allows you to pay for medical and dental expenses with pre-tax dollars. Contact Lenses In Lieu of lenses/frames Frames Frequency $130 Allowance Plan pays $130 retail allowance; 20% discount over $130 Exams every 12 months Lenses every 12 months Frames every 24 months Life Insurance Employee Contribution Per Bi-Weekly Payroll Employee Only $3.22 Employee + Spouse $5.25 Employee + Children $5.15 Family $8.46 Pond provides you with a basic life insurance policy of protection equal to two times your annual salary up to a plan maximum of $500,000 (non-medical maximum of $475,000). This insurance includes Accidental Death and Dismemberment (AD&D) in an amount equal to the life insurance amount. This benefit will reduce 35% at age 65, 60% at age 70 and 80% at age 75. This benefit is provided through MetLife. Employees who elect dependent medical or dental coverage will also receive dependent life insurance as follows: Spouse coverage of $5,000 Children age 15 days to 6 months, $100; age 6 months and older, $2,000. Dependent life coverage terminates when a dependent no longer qualifies as a dependent. Vision 6

8 Supplemental Life Insurance For You: You may purchase additional life insurance in increments of $10,000 up to $100,000 maximum with no medical underwriting. An overall maximum of the lesser of five (5) times your annual salary or $500,000. For Your Spouse: You may purchase life insurance for your spouse in increments of $5,000 up to $25,000 maximum with no medical underwriting. An overall maximum of $100,000, not to exceed 50% of employee s coverage. Long-term Disability (LTD) At the end of the STD period (9 weeks), your LTD coverage begins and you receive a monthly benefit, for as long as you remain disabled, up to Normal Social Security Retirement Age. This benefit is 100% paid for by Pond with no cost to the employee. Monthly Benefit 66.67% of monthly salary Maximum Monthly Benefit Up to $10,000 For your Children: Fifteen (15) days to six (6) months $1,000 Over six (6) months you may purchase the amount of $1,000, $2,000, $4,000, $5,000 and $10,000 maximum. Maximum Benefit Duration Benefit Waiting Period Later of age 65 or Normal Social Security Retirement Age 90 days Disability Protection Disability coverage provides income protection if you are unable to work due to an injury or illness, or during maternity leave. Pond provides short-term and longterm disability coverage for all benefit-eligible employees through MetLife at no cost to you. Supplemental Benefits with Liberty National Through Liberty National, accidental, critical illness and hospital indemnity options are available. These plans can provide direct cash replacement benefits designed to meet your family s needs. For more information, please go to Short-term Disability (STD) Short-term disability provides a weekly benefit to replace a portion of your income, for up to nine weeks, if you become disabled due to an accident or illness that is nonwork related. This benefit is 100% paid for by Pond with no cost to the employee. Weekly Benefit 60% of weekly earnings Maximum Weekly Benefit Up to $1,500 Maximum Benefit Duration Benefit Waiting Period 9 weeks 30 days for accident/ sickness Disability 7

9 Flexible Spending Accounts (FSA) An FSA is an IRS-guided plan that enables you to reduce your taxable income by allocating pre-tax dollars to an individual account that will be used to reimburse you for eligible out-of-pocket health and dependent care expenses. Pond offers two types of FSA s, a Dependent Care FSA and a Healthcare FSA. Please note the following: You cannot contribute to a Healthcare FSA the same year you contribute to an HSA; you can, however, contribute to a Dependent Care FSA the same year you contribute to an HSA. You must enroll in the FSA plan(s) each year and determine your deferral amount(s). Plan carefully! The IRS imposes the use it or lose it rule with regard to FSA s. There is a 90 day grace period (March 31, 2018) to submit expenses that were incurred by December 31, Contributions are deducted on a pre-tax basis in equal installments each pay period during the calendar year. Participants in the HSA will be allowed to contribute to a limited FSA for dental and vision expenses only. Members may roll over up to $500 of unused funds to the plan year. Healthcare FSA For plan year 2017, you may contribute up to the maximum IRS limit of $2,600. Examples of eligible expenses include, but are not limited to: Prescription drugs and medicines Chiropractors Hearing aids Optometrists, opticians Dentists, orthodontists Eyeglasses, contacts Copays, deductible & coinsurance Retirement Dependent Care FSA You may contribute as much as $5,000 (if you are married and file a joint return, or you file a single or head of household return). If you are married and file separate returns, you can each elect $2,500 for the calendar year. To qualify, you and your spouse (if applicable) must be employed, or your spouse must be a full-time student. Eligible dependents include children under the age of 13 who are claimed as a dependent for tax purposes or a disabled spouse or disabled dependent of any age. For a comprehensive list of eligible FSA expenses, please visit Pond 401(k) Plan Our 401(k) plan is one of the best ways to help insure the health of your financial future. Our plan is administered by Wells Fargo. Plan highlights include the following: This qualified retirement plans offers both Traditional 401(k) and Roth 401(k) contribution options. Employee contributions between 1% - 4% of compensation will earn a 100% company match. Employee contributions are vested immediately. All full-time employees are eligible to participate in the plan at 21 years of age. You may enter the plan on the first day of the following month after your hire date. The company may, at its own discretion, make a profit sharing match at the end of each fiscal year. For 2017, the maximum deferral amount allowed by the IRS is $18,000. If you are age 50 or older as of December 31, 2017, you may contribute an additional $6,000 catch-up contribution. To enroll or make plan changes, contact Wells Fargo at or Earl Steinmetz, a Wells Fargo Financial Advisor is also available to you or earl.steinmetz@wellsfargo.com 8

10 WORK/LIFE BALANCE Pond recognizes the fact that it is important to balance your professional world with your personal world, your work with rest and peace of mind. Therefore, we are pleased to provide our employees with a confidential Employee Assistance Program (EAP), a comprehensive Wellness program, a generous vacation and holiday policy as well as other perks. Confidential Employee Assistance Program Sometimes life throws you a curve ball; you and your family may have trouble coping at times due to troubled relationships, family concerns, stress, anxiety and depression, drug and alcohol concerns, legal and financial issues, work-related issues and other personal issues. That s why Pond provides an Employee Assistance Program (EAP) that can help you with a variety of issues and give you greater peace of mind. You have 24/7 access to a team of counselors and service professionals who can offer help, all on a strictly confidential level. No matter what you are dealing with, our confidential EAP provided through MetLife is available to you and your dependents to help. Unlimited free phone consultations with an EAP counselor is available to you 24/7 at Referrals to local counselors up to three free sessions Website featuring more than 3,400 helpful articles and topics including wellness, training courses, and a legal and financial center: members.mhn.com Pond Wellness Program We strongly support and encourage a healthy life/work balance and believe that nutrition, physical activity and emotional strength are key components in reducing stress and promoting good health. With this in mind, Corporate Health Partners will continue as our Wellness Advisor and Health Coach. Annually, employees who choose to participate in our Wellness 2017 Initiative will be provided a basic health screening at one of our corporate offices or a designated partner clinic. Biometric screenings, health risk assessments and results coaching sessions will be conducted in January and February. All health information is strictly confidential. At risk individuals will be contacted, confidentially, and encouraged to participate in a voluntary coaching program. Everyone will have access to our Health Coach throughout the year and all are encouraged to participate in our culture of wellness. Look for Lunch n Learns, Healthy Breaks and Wellness Challenges throughout the year! Company Code: metlifeeap1 9

11 ADDITIONAL BENEFITS for POND EMPLOYEES Georgia s Own Credit Union: As an employee of Pond, you will have the option of banking with Georgia s Own Credit Union and will have access to the many features available through a credit union. Those features include interest earning checking accounts, savings accounts, direct deposit, IRA s, CD s, home banking, internet bill paying, telephone access, ATM, competitive vehicle loans, home equity and mortgage loans, VISA credit cards and cost savings opportunities. Employees may work a compressed work schedule; you may compress ten work days over two work weeks (80 hours) into nine (9) work days over two weeks (still maintaining 80 hours). Approved schedules are to remain consistent on an ongoing basis and must be coordinated among the team to maintain productivity such that all employees within a department/team are not out on the same day. Personal time may accrue for salaried personnel up to 40 hours for overtime work. Eight hours personal time is the maximum to be used at one time, unless the supervisor has approved additional hours. Accumulated personal time is not paid at termination. Pond & Company recognizes the following as paid holidays: New Year s Day Memorial Day Independence Day Labor Day Thanksgiving Day Day after Thanksgiving Day Sick pay accumulates at 6 2/3 hours per month (10 days per year). The maximum accumulation permitted is 160 hours. Unused sick pay at year-end may be carried over. Accumulated sick pay is not paid at termination. Vacation time is accrued at 6 2/3 hours per month (10 days per year). Accrued vacation may be taken with supervisor approval. After five (5) years of employment, vacation is accrued at 10 hours per month (15 days per year). After 20 years of employment, vacation is accrued at 20 days per year. A maximum of 40 hours may be carried over at yearend. Accrued vacation is paid upon termination after six months of employment. Flex time is permitted within reason. Our core hours are between 9:00 am and 4:00 pm. Employees may schedule their arrival and departure time to suit their personal needs as long as a full eight (8) hour work day and core hours are maintained. Of course, business needs will at times dictate different hours and professional staff members are expected to spend the time required to get the job done. Christmas Eve (1/2 day; not observed when Christmas Day falls on a Sunday or Monday) Christmas Day 10

12 Carrier Contacts Plan / Provider Telephone Number Web Site Medical United Healthcare Telemedicine Teladoc Health Concierge Medical Advocate Program (MAP) Dental MetLife Vision VSP Life Insurance MetLife Option 4 Claims Status LTD & STD MetLife Option 3 Claims Status 401(k) Provider Wells Fargo Financial Advisor Earl Steinmetz earl.steinmetz@wellsfargo.com