US Benefits Employee Enrollment Guide
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1 US Benefits Employee Enrollment Guide 1
2 Welcome to the Infosys Technologies Benefits Plan Enrollment Infosys Technologies offers you and your eligible family members a comprehensive array of employee benefits that will enable you to provide for your unique life needs. Health Benefits - We understand that a comprehensive health program is the key to maintaining a healthy workforce. We offer comprehensive health coverage including 3 medical plans, a Health Savings Account (if you enroll in the Standard Medical plan), 2 dental plans and vision benefits. Life Insurance Benefits - Our benefits program includes basic life and accidental death & dismemberment insurance coverage to protect you and your family in the event of accidental injury or death. Disability Insurance Benefits - Infosys provides you with Short Term and Long Term Disability Income Insurance benefits that would cover you in the event of an accident or illness resulting in an extended absence from work. Flexible Spending Accounts - Our benefits plan allows you to participate in a dependent care spending account to pay for dependent daycare expenses with pre-tax dollars, reducing your taxable income, resulting in a tax savings. Commuter Benefits You may enroll in the Commuter Benefits if you utilize the train, the bus or pay parking costs for your commute to work. 2
3 Eligibility & Enrollment Guidelines Who is Eligible? Regular full-time employee s working 30 or more hours per week are eligible for benefits. If you enroll in the medical, dental or vision plans you may also enroll your eligible dependents in the same benefits you enroll in. As a new employee, your benefits will become effective on the first day of regular full time employment. 3
4 Eligibility & Enrollment Guidelines Generally, for the purpose of the Infosys benefits program, your eligible dependents are defined as: Legal Spouse or Registered Domestic Partner Dependent Child up to age 26 (disabled children up to any age), regardless of student or marital status. Child includes: Your biological children Your stepchildren; Your legally adopted children Your foster children, including any children placed with you for adoption; Any children for whom you are responsible under court order; Your grandchildren in your court-ordered custody; and Any other child who lives with you in a parent-child relationship. Disabled Children may be covered, regardless of age (no age limit). Requires completion of a disabled child form must be submitted and will require underwriting approval from Aetna. Documentation may be requested to support proof of dependent relationship. 4
5 Eligibility & Enrollment Guidelines How to Enroll: Review the employee benefits enrollment guide; Evaluate your needs; Additional assistance is available if you have questions regarding the benefits plan. You may contact the Benefits Desk by calling (877) (which is a toll free number), or by at Infosys.benefits@hannaglobal.com. Representatives are available 6 am to 6 pm PDT, Monday through Friday. Using our web-based enrollment system, you will select your enrollment elections into the Infosys Health Plan for yourself and your eligible dependents at All employees are required to complete the requested information on this system. You are responsible for logging into the enrollment system and enrolling in the insurance plan within 31 days from the date you are hired in a regular full time position. 5
6 Eligibility & Enrollment Guidelines IRS Qualifying Event How to Make Changes: Your benefits election will be effective for the entire plan year ending in June of each year, unless you experience a qualified status change. Events described in IRS regulations allow you to make a change to your benefit coverage at times other than your initial enrollment or the annual re-enrollment, if you experience any of the following: Marriage or divorce Death Birth or adoption of a dependent Change in employment status Dependent satisfying or ceasing to satisfy the plan s eligibility requirements Loss of or significant change to your current coverage Judgment, decree or court order Enrollment/ceasing to be enrolled in Medicare or Medicaid Ceasing to be enrolled in Children s Health Insurance Program (CHIP) You have 31 days from the date of the event to update your benefits or your dependents benefit election in the Web Based Enrollment System. 6
7 Medical and Prescription Drug Benefits You may choose to enroll in the Standard Medical Plan which provides an option of the Health Savings Account (H.S.A.), the Plus Medical Plan or the Enhanced Medical Plan. If you elect to participate in one of the medical plans, you may also enroll your eligible dependents. An overview comparison shows you a brief outline of the In-Network and Outof-Network benefits for each plan. Please refer to your SPD for a complete list of benefits and any applicable limitations on the plan. The medical plans include the Aetna - Choice POS Network. As a Choice POS participant, you may visit any doctor or specialist of your choice, without a referral. When you use an In-Network provider you will receive benefits at a higher level resulting in less out of pocket expenses. All deductible and out of pocket amounts accumulate on a plan year (from July1 st June 30 th ). 7
8 Medical and Prescription Drug Benefits Plan Features Plan Year Deductible Individual Family (EE + One or More) Standard Plan *HSA Optional In Network *Important note $1,500 single $3,000 family Out of Network *Important note $2,500 single $5,000 family In Network $600 $1,800 Plus Plan Out of Network $2,000 $6,000 Enhanced Plan In Network $100 $300 Out of Network On the Standard Plan, if you cover one or more dependents on the Standard medical plan, then the entire family deductible ($3,000 in network) must be met in full before any one member will receive coinsure or prescription drug copayments under the plan. Member Coinsurance 20% 50% 15% 50% 10% 50% Out of Pocket Maximum Individual Family Does OOP Include Deductible? Does OOP Include Copays? $2,500 (single) $5,000 (family) Yes No $3,500 (single) $7,000 (family) Yes No $1,750 $5,250 Yes No $3,500 $10,500 Yes No $1,100 $3,300 Yes No $250 $750 $2,000 $6,000 Yes No On the Standard Plan, the family out of pocket maximum can be met with a combination of family members or any single individual within the family. Once met, the plan will pay 100% of the family s covered expenses for the rest of the Plan Year. Lifetime Maximum Unlimited Unlimited Unlimited Unless otherwise indicated, any applicable deductible must be met before benefits are paid by the plan. Physician Office Visit 20% 50% $20 Copay 50% $15 Copay 50% Preventive Care Deduct Waived Plan Pays 100% 50% Deduct Waived Plan Pays 100% 50% Deduct Waived Plan Pays 100% 50% 8
9 Medical and Prescription Drug Benefits Plan Features Standard Plan W/HSA Plus Plan Enhanced Plan In Network Out of Network In Network Out of Network In Network Out of Network Hospital Services 20% 50% 15% 50% 10% 50% X-Ray and Lab 20% 50% 15% 50% 10% 50% Emergency Room (Emergency Care) Emergency Room (Non Emergency Care) Deductible Waived Plan Pays 100, You Pay $0 50% In/Out Network For Non Emergency Care in ER Urgent Care Clinics (Non Emergency Clinic) 20% 50% Prescription Drugs Retail Up to 30 Day Supply Generic Preferred Brand Non-Preferred Brand Mail Order More than 30 day supply, up to 90 day supply Generic Preferred Brand Non-Preferred Brand After Deductible Is Met $10 Copay $20 Copay $35 Copay Not Covered After Deductible Is Met $20 Copay $40 Copay $70 Copay Not Covered Deductible Waived $75 Copay, Then 15% of Charges 50% In/Out Network For Non Emergency Care in ER Deduct Waived $20 Copay 50% Deduct Waived $20 Copay $40 Copay $75 Copay Not Covered Deduct Waived $40 Copay $80 Copay $150 Copay Not Covered Deductible Waived $50 Copay, Then 10% of Charges 50% In/Out Network For Non Emergency Care in ER Deduct Waived $15 Copay 50% Deduct Waived $10 Copay $20 Copay $40 Copay Not Covered Deduct Waived $20 Copay $40 Copay $80 Copay Not Covered 9
10 Your Monthly Cost for Medical and Prescription Drug Benefits Standard Medical Plan PL 1 / 2 PL 3 PL 4 / 5 PL 6 PL 7 & TH Single Employee Only $25 $73 $75 $98.75 $ Employee & 1 Dependent $37 $97 $100 $ $ EE & 2 Or More Dependents $43 $109 $110 $ $ Plus Medical Plan PL 1 / 2 PL 3 PL 4 / 5 PL 6 PL 7 & TH Single Employee Only $68 $154 $167 $ $ Employee & 1 Dependent $83 $195 $208 $ $308 EE & 2 Or More Dependents $99 $211 $224 $ $ Enhanced Medical Plan PL 1 / 2 PL 3 PL 4 / 5 PL 6 PL 7 & TH Single Employee Only $147 $292 $292 $ $ Employee & 1 Dependent $195 $361 $361 $ $ EE & 2 Or More Dependents $222 $408 $408 $ $
11 Dental Benefits Infosys offers you a choice to enroll in the Basic Dental PPO plan or the Premium Dental PPO plan through Aetna. If you elect to participate in the dental plan, you may also enroll your eligible dependents. An overview comparison shows you a brief outline of the In-Network and Outof-Network benefits for each plan. Please refer to your SPD for a complete list of benefits and any applicable limitations on the plan. Each plan includes the Aetna Dental PPO. As an Aetna Dental PPO participant, you may visit any dentist you choose. However, if the dentist you choose is out of network, you may experience higher out of pocket costs. 11
12 Dental Benefits Plan Features Basic Plan Premium Plan In Network Out of Network In Network Out of Network Plan Year Deductible Individual Family $50 $150 $50 $150 Annual Maximum (per individual) $2,500 $3,000 Unless otherwise indicated, any applicable deductible must be met before benefits are paid by the plan. Diagnostic & Preventive (Type A Expenses) Deduct Waived Plan Pays 100% Basic Services (Type B Expenses) Plan Pays 80% Major Services (Type C Expenses) Plan Pays 60% Orthodontic Expenses Not Covered Deduct Waived Plan Pays 100% up to ARC Deduct Waived Plan Pays 100% Plan Pays 80% Up To ACR Plan Pays 90% Plan Pays 60% Up to ACR Plan Pays 70% Deduct Waived Plan Pays 100% up to ARC Plan Pays 90% Up To ACR Plan Pays 70% Up to ACR Plan Pays 50% Up To $3,000 Lifetime Employee, Spouse & Dependent Children If your out of network provider charges more than the ACR (Aetna Recognized Charge), you will be responsible for any expenses incurred above the ACR. The ACR is the maximum amount Aetna will pay for a covered expense from an out of network provider. 12
13 Your Monthly Cost for Dental Benefits Basic Dental Plan PL 1 / 2 PL 3 PL 4 / 5 PL 6 PL 7 & TH Single Employee Only $10 $10 $10 $10 $10 Employee & 1 Dependent $15 $15 $15 $15 $15 EE & 2 Or More Dependents $20 $20 $20 $20 $20 Premium Dental Plan PL 1 / 2 PL 3 PL 4 / 5 PL 6 PL 7 & TH Single Employee Only $15 $15 $15 $15 $15 Employee & 1 Dependent $25 $25 $25 $25 $25 EE & 2 Or More Dependents $35 $35 $35 $35 $35 13
14 Vision Benefits Infosys offers you a choice to enroll in a voluntary vision plan through VSP. If you elect to participate in the vision plan, you may also enroll your eligible dependents. An overview comparison shows you a brief outline of the In-Network and Outof-Network benefits for the plan. Please refer to your SPD for a complete list of benefits and any applicable limitations on the plan. The vision plan includes the following discount programs, in addition to the vision benefits: TruHearing Discount program for Hearing Aids»Up to 50% discount»memberplusprogram is free of charge through Dec 2013! ($97 value)»members can enroll up to 4 extended family members for just $71/year. Computer Vision Care Plan Exam, single, bifocal and trifocal covered in full Allowance up to $90 for frames/20% off anything exceeding allowance 14
15 Vision Benefits Infosys offers you a choice to enroll in a voluntary vision plan through VSP. If you elect to participate in the vision plan, you may also enroll your eligible dependents. An overview comparison shows you a brief outline of the In-Network and Outof-Network benefits for the plan. Please refer to your SPD for a complete list of benefits and any applicable limitations on the plan. The vision plan includes the following discount programs, in addition to the vision benefits: TruHearing Discount program for Hearing Aids»Up to 50% discount»memberplusprogram is free of charge through Dec 2013! ($97 value)»members can enroll up to 4 extended family members for just $71/year. Computer Vision Care Plan Separate pair of glasses for computer use only Exam, single, bifocal and trifocal covered in full Allowance up to $90 for frames/20% off anything exceeding allowance 15
16 Vision Benefits Plan Features Comprehensive VSP Vision Plan VSP Provider Any Other Vision Provider Annual Copay Covered in full Covered up to $50 Benefit Frequency Limitations Exam Lenses Frames Once in a 12 month period Once in a 12 month period Once in a 12 month period Plan Benefits VSP Provider Any Other Vision Provider Single Vision Lenses Covered in full Covered up to $50 Bifocal Lenses Covered in full Covered up to $75 Trifocal Lenses Covered in full Covered up to $100 Lenticular Lenses Covered in full Covered up to $125 Frames Covered up to Plan Allowance Covered up to $70 Elective Contact Lenses (instead of glasses) Computer VisionCare $60 Copay, then Covered up to $200 Covered up to $105 This enhancement allows you to obtain corrective eyewear that is designed to meet the specific health and vision needs of computer users. Lenses and frames for those supplemental glasses are available at the same service frequency as your core plan. 16
17 Aetna Vision Discount Program Available to all Aetna members no matter what plan level you enrolled in. Discounts on eye exams, glasses, contact lenses, even Lasik surgery Show your Aetna ID card to a participating Vision provider for immediate savings List of participating providers on the Aetna website No claim forms to file discount given at time of service Do not have to be enrolled in the VSP plan to avail discounts 17
18 Your Monthly Cost for Vision Benefits Aetna Discount Vision Program VSP Vision Plan Single Employee Only $7.69 Employee & 1 Dependent $15.36 EE & 2 Or More Dependents No Cost For Aetna Members $24.74 VSP-Enrollment is required to avail benefits. Aetna Vision Discount Available to all Aetna members/enrollment is not required 18
19 Commuter Benefits The Flexi-Commuter Benefits, provides you access to a network of transit products and parking providers through Flex-Plan Services. You can order commuter products and parking online and have it sent directly to your home you pay for the product with pre-tax salary deductions taken by your employer. Pre-tax saves you money because you do not pay taxes on these amounts. Eligible Transportation Expenses used in connection with travel between your home and your place of employment. A minimum monthly contribution of $75 requires or $3.50 admin fee will be assessed. Purchased are made a month in advance for the following month s transit. Amounts DO NOT ROLL OVER. Mass Transit Expenses (i.e. Train or Bus) - $125/month maximum contribution Parking Expenses - $240/month maximum contribution Registration and order must be completed via the Flex-Plan website by the 8 th of the month for the following month benefit access. Registration is required via Flex-Plan - User ID and Password needed Depending on your commuter order, a transit pass will be mailed to your home address within 10 days of purchase 19
20 Dependent Care FSA The Day Care Flexible Spending Arrangement enables you to pay for out-of-pocket, work-related dependent day-care cost with pre-tax dollars. If you are married, you can use the account if you and your spouse both work or, in some situations, if your spouse goes to school full-time. Single employees can also use the account. An eligible dependent is someone who you can claim expenses on Federal Income Tax Form 2441 Credit for Child and Day Care Expenses : Children under age 13 Disabled children (no age limit) Disabled spouse or parent who lives with you Annual contribution limits: Maximum $5,000 Minimum $900 This plan is for dependent care costs only. THIS IS NOT FOR MEDICAL EX PENSES The IRS mandates that any amount not spent in the plan year, from July through June will be forfeited. Use It Or Lose It 20
21 Qualified Dependent Care FSA Expenses You must use an accredited daycare service that will provide you with either a Tax Identification Number or his/her Social Security Number. Day Care arrangements which qualify include: A Dependent (Day) Care Center, provided that if care is provided by the facility for more than six individuals, the facility complies with applicable state and local laws; An Educational Institution for pre-school children. For older children, only expenses for non-school care are eligible; and An "Individual" who provides care inside or outside your home: The "Individual" may not be a child of yours under age 19 or anyone you claim as a dependent for Federal tax purposes. Eligible Dependent Care Expenses: Before and after school care; Adult daycare Au pair This plan is for dependent care costs only. THIS IS NOT FOR MEDICAL EX PENSES 21
22 Health Savings Account (H.S.A.) If you enroll in the Standard Medical Plan, you may choose to set up an HSA (Health Savings Account) offered through JP Morgan Chase the Aetna HSA vendor partner. A Health Savings Account (HSA) is a special tax-advantaged account that you and your family members can use to pay for all kinds of qualified medical expenses from deductibles and co-insurance to pharmacy bills, dental care, vision care and much more. You can make pre-tax contributions to your HSA via payroll deduction, or mail a check directly to Chase for your contribution. Once deposited, your money grows taxfree year after year, much like an IRA. And it's yours to keep, even if you change jobs. Features of an HSA: $ HSA account is an individually owned account $ HSA contributions are made on a pre-tax basis $ You can withdraw your HSA funds tax-free to pay for qualified medical or save for future expenses $ Funds carry over year after year. You can withdraw the money on a taxable basis for any purpose after age 65 your unused HSA funds can even help fund your retirement $ You can create a balanced HSA portfolio tailored to your specific needs and risk preferences 22
23 Health Savings Account (H.S.A.) Qualified Medical Expenses Each year you may make HSA contributions up to an annual limit specified by the IRS: $ For $3,050 for individual coverage and $6,250 for family coverage $ If you are age 55 or older, you may make additional catch-up contributions of up to $1,000 When you pay for qualified medical expenses with your Health Savings Account (HSA), the funds you withdraw are tax-free, provided they: $ Are qualified medical expenses as generally described in IRS publication 502 titled, Medical and Dental Expenses, Catalog Number 15002Q. You can order the publication by calling (800) TAX-FORM or see it online at $ Have not been compensated or reimbursed by insurance or otherwise. 23
24 Health Savings Account (H.S.A.) Qualified Medical Expenses Examples of Qualified Medical Expenses* Deductibles and coinsurance for medical and dental care Prescription drugs (some over the counter drugs with a prescription) Vision care, including glasses and Lasik eye surgery Smoking cessation treatment and prescriptions Some insurance premiums, such as long-term care, COBRA and health care coverage premiums while receiving unemployment income * For a detailed list, visit the IRS website at: Examples of NON-Qualified Medical Expenses* Air purifiers Cosmetic surgery and related expenses Health club dues (unless prescribed by a physician to treat illness) Illegal operations and treatments Massages for general well-being Transportation, unless specifically for, and essential to, medical care Toothpaste, cosmetics and toiletries Vitamins and nutritional supplements Weight loss programs (unless for a specific illness 24
25 Establishing Your Health Savings Account (H.S.A.) If you enroll in the Standard Medical Plan, you are eligible to establish an HSA (Health Savings Account) offered through JP Morgan Chase the Aetna HSA vendor partner. These plan members will receive a Welcome kit in the mail from JP Morgan Chase with instructions on how to complete the enrollment process. Monthly HSA account fees: $ No fee to establish the HSA account $ Monthly service charge of $3.75 $ A complete list of account fees will be included in the welcome kit and posted on the website 25
26 Disability Income Benefits Infosys Technologies provides eligible employees with Short-Term and Long-Term Disability Income Benefits. There is no cost to the employee. In the event that you become disabled from a non work-related injury or sickness, disability income benefits are provided as a source of income. Plan Features Benefits Begin Benefit Duration Percentage of Income Replaced Short-Term Disability (STD) On the 8 th day of approved claim for illness or injury Up to 13 weeks of Basic Weekly Earnings Long-Term Disability (LTD) On the 91 st day of approved claim for illness of injury Up to age 65 if totally disabled. Limitations for specific conditions % of Basic Monthly Earnings (minus other income benefits) Maximum Benefit $2,000 per week $10,000 per month Eligibility Approved claim paperwork 1 year of US Infosys employment 26
27 Basic Life and AD&D Insurance Infosys Technologies provides eligible employees company-paid group life and (AD&D) accidental death and dismemberment insurance. Infosys pays the full cost of this benefit no cost to employee s. Plan Features Life Benefit Amount $150,000 AD&D Benefit Amount Pays an additional one times the life insurance amount should you die by accidental means Age Reduction Reduce by 50% at age 70 Features Accelerated Death Benefit Conversion Included, up to $25,000 of life benefit if diagnosed with a terminal illness and has a life expectancy of 12 months or less. Included - 31 days to convert to individual policy in most cases Use the online enrollment system to update your beneficiary! 27
28 Insurance ID Cards ID Cards will be mailed to your home address within 30 days of enrollment Providers will be able to verify your coverage with Aetna even if you have not received your ID Card. You will be able to print a temporary ID card from the Aetna Navigator site: There are no ID cards issued for the VSP vision plan. Providers verify eligibility using your SSN which you supply to them. 28
29 Aetna Navigator Register for Aetna Navigator to: Check claim status DocFind / Pharmacy Locator / Hearing Aid Discount Provider View and print temporary ID cards Request replacement Aetna member ID cards Contact Aetna Member Services Utilize tools to manager your health care: Simple Steps Health and Wellness Moms to Babies Program Access expert sources of medical and dental health information 29
30 Employee Assistance Plan EAP is a confidential, employer-offered program that helps active employees, retired employees, members of their households and their adult children up to age 26 balance the demands of work, life and personal issues. EAP can assist with topics such as: Marital distress Relationship issues Substance abuse Workplace conflict Stress Personal and family issues Balancing the demands of work, home and life can lead to improved productivity, increased employee satisfaction and better managed health costs. company code EAP4INFY 30
31 Important Tools Benefits Desk Website Check out our benefits website, where you can review detailed benefits information, compare plans, and access educational materials, including a copy of this presentation Benefits Help Desk available from 6am to 6pm Pacific Time Infosys.benefits@hannaglobal.com Speak with or our benefits representative for assistance with any of your benefits or enrollment questions Benefit Cost Analyzer 31
32 Important Tools Medical/Prescription Drug and Dental Benefits Aetna Choice II POS Group Number: Customer Service: USAETNA ( ) Website Address: VSP available 5am to 8pm Pacific, Mon-Fri and 6am to 5pm Pacific Time on Saturday Find a VSP doctor Review your benefits Flex Plan (Dependent Care FSA & Commuter) Website Address: 32
33 Benefit Cost Analyzer Tool 33
34 Web Based Enrollment System 34
35 Web-Based Enrollment System Instructions Go to: 1) Enter your username and password: Your Username will be your Infosys Employee Number. i.e. INFY_EmpID Your Password has been communicated in the Welcome that you received. 2) You will be prompted to change your password and set up security questions the first time you log in. 3) You will be taken through the Disclosure, Disclaimer and Acknowledgment screens. Please take time to review this information. 35
36 Web-Based Enrollment System Instructions 4) You will follow the onscreen instructions during the enrollment process, which includes: a) Entering your personal information. b) You will enter either your work address or a personal address where you wish to receive electronic correspondence from the enrollment system. c) Once all required personal information is entered, you will be taken through the benefit enrollment screens where you will make your plan choices. d) Screenshots on later slides. 36
37 Web-Based Enrollment System Instructions 5) Helpful Hints: You may view and compare the plan choices by clicking on the Benefits Information Site link located under Enrollment Resources in the enrollment screens. If, during the enrollment process, you wish to exit and return later, you may click on the Save For Later link. Remember, you must complete the enrollment process within 31 days by returning to the system and completing the process. During the New Account Setup, review any information that is pre-populated for accuracy such as your first and last name, gender. 6) Upon completion of the plan selections, you must click on the Submit link on the benefit summary page to complete your enrollment. 7) After submitting your elections, you will receive an that will include your con 37
38 New Employee Enrollment 38
39 New Employee Enrollment 39
40 New Employee Enrollment 40
41 New Employee Enrollment 41
42 New Employee Enrollment 42
43 THANK YOU The contents of this document are proprietary and confidential to Infosys Limited and may not be disclosed in whole or in part at any time, to any third party without the prior written consent of Infosys Limited Infosys Limited. All rights reserved. Copyright in the whole and any part of this document belongs to Infosys Limited. This work may not be used, sold, transferred, adapted, abridged, copied or reproduced in whole or in part, in any manner or form, or in any media, without the prior written consent of Infosys Limited.
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