A COMPLETE GUIDE TO YOUR 2017 EMPLOYEE BENEFITS. 1 / 2017 BENEFITS / Fellowship of Christian Athletes

Transcription

1 A COMPLETE GUIDE TO YOUR 2017 EMPLOYEE BENEFITS 1 / 2017 BENEFITS / Fellowship of Christian Athletes

2 Fellowship of Christian Athletes goal in offering benefits is to add value for you and your family while managing costs for the ministry. A comprehensive and cost effective benefit plan that includes health, dental, vision, life and disability coverages is available to all full time employees. Employees receive benefits on the first of the month following two months of eligible employment. You may cover your spouse and any dependent children up to the age of 26. Dependent Children: This includes your natural child, stepchild, and any child you have adopted or who has been placed for adoption up to age 26. Disabled Dependents: If your dependent child is mentally or physically handicapped, coverage may be extended beyond the age of 26. Please check with your HR representative to obtain forms & information. Examples of INELIGIBLE Dependents: You may not cover a family member other than the ones listed above (for example, parents, grandchildren, nieces, or nephews). Foster children are also not eligible under this plan. FCA reserves the right to audit your dependent information. FCA may request documentation of any of your dependent s status. You may generally elect benefits as a new hire and during annual open enrollment periods. In most cases, you may not change your benefits midyear unless you experience a qualifying event in your life; such as marriage, divorce, birth or adoption of a child, death of a spouse or dependent, loss of employment, or a change in employment status that affects your or your spouse s benefits eligibility. Please notify your HR department within 30 days of the event if you would like to enroll or make a change to your coverage. 2 / 2017 BENEFITS / Fellowship of Christian Athletes

3 MEDICAL FCA offers medical coverage through KC BlueCross Blue Shield. The plan has an individual deductible of $2000 and a family deductible of $4000. All in-network services, including prescription drugs, are covered at 100% at participating providers once the deductible has been met. Members can receive services from any hospital or physician but receive greater benefits when they use the Preferred-Care Blue PPO network. For a complete listing of network hospitals and physicians, please visit Please refer to the benefits chart for more detailed plan information. Preferred-Care Blue/BlueSaver In-Network Out-of-Network Annual Deductible $2,000 Individual / $4,000 Family $2,000 Individual / $4,000 Family Annual Out of Pocket Maximum $2,000 Individual / $4,000 Family $4,000Individual / $8,000 Family Coinsurance Level 100% 80% Lifetime Maximum Unlimited Unlimited Preventive Services Routine Preventive Care Childhood Immunizations Mammograms, Pap Smears & PSA tests No charge No charge No charge Office Visits, Labs and Testing Physician Office Visits Lab Services X-Ray and other Radiology Procedures Hospitalization Inpatient Outpatient facility Prescription Drugs Deductible Generic Preferred Brand Non-Preferred Brand Deductible, then 50% after: $10 copay $50 copay $70 copay Emergency Accident Urgent Care Center Emergency Room In-Network Outpatient Occupational & Physical Therapies (limited # of visits apply) (limited # of visits apply) Outpatient Chiropratic Services Mental Health/Substance Abuse Inpatient Outpatient The content of this chart is for informational purposes only. If there is any conflict between the information in this chart and the official plan document, the official plan document will govern. * No Copayment or Coinsurance AB = Allowed Benefit Allowed Benefit is the amount established for payment of covered In-Network. The Allowed Benefit will generally be lower than the amount charged. You are responsible for copayments, co-insurance and all charges that exceed the Allowed Benefit for services received Out-of-Network. 3 / 2017 BENEFITS / Fellowship of Christian Athletes

4 HEALTH SAVINGS ACCOUNT FCA offers employees a Health Savings Account (HSA) that is administered by Optum Bank. The HSA is used as a vehicle alongside of the Qualified High Deductible Health Plan to help fund the deductible and save money for future medical expenses. Funding for the HSA is done through convenient payroll deductions. Employees can fund any dollar amount per pay period up to $3,400 per year for individual and $6,750 per year for non-individual coverage for Employee s may elect to change their contribution amount at any time throughout the year. FCA currently contributes $42 Individual/$84 Non-Individual per month. Qualified HSA expenses: Deductibles & copays Prescription Costs Dental expenses Vision expenses Long Term Care Premium & Expenses DENTAL FCA offers a dental plan through Humana. Eligible employees can go to any dentist of their choice; however, when utilizing the Humana Traditional/Preferred PPO network, members receive a higher level of coverage and lower out of pocket costs. Humana Traditional Preferred Annual Program Deductible $50 Individual / $150 Family Annual Program Maximum $1,000 Preventive & Diagnostic Services Cleanings, Flouride Treatments, Bitewing Radiographs, Sealants Basic Services Radiographs, Space Maintainers, Simple Extractions, Periodontal Maintenance Major Surgical & Restorative Services Oral Surgery, Endodontics, General Anesthesia, Inlays/Onlays/Crowns, Bridges 100% 80% after deductible 50% after deductible Orthodontia (Covers Children through age 18) Plan pays 50% (no deductible) of covered services Lifetime Orthodontia Maximum $1,000 *Participating dentists accept 100% of the allowed benefit as payment in full for covered services. Members will be responsible for additional balance billing. These are general plan benefits. Any payments, implied or otherwise are subject to all policy provisions and limitations in force at the time services are rendered. Please refer to contract for specific provisions. The content of this chart is for informational purposes only. If there is any conflict between the information in this chart and the official plan document, the official plan document will govern. 4 / 2017 BENEFITS / Fellowship of Christian Athletes

5 VISION FCA offers a Vision plan through Humana. Eligible employees can go to any vision provider of their choice; however, when utilizing the Humana network, members receive a higher level of coverage and lower out of pocket costs. Vision claims due to any medical condition are covered under the medical benefits. HumanaVision In-Network Member Cost Out-of-Network Reimbursement Exam $15 copay $35 allowance Lenses Single Bifocal Trifocal $20 copay $20 copay $20 copay $25 allowance $40 allowance $60 allowance Frames $50 wholesale allowance $40 retail allowance Contact Lenses Elective Medically necessary Frequency Examination Lenses or contact lenses Frame $150 allowance No copay Once every 12 months Once every 12 months Once every 24 months $150 allowance $210 allowance Once every 12 months Once every 12 months Once every 24 months The content of this chart is for informational purposes only. If there is any conflict between the information in this chart and the official plan document, the official plan document will govern. LIFE INSURANCE Life/AD&D Insurance All full time employees are eligible for Life/AD&D coverage. This plan is covered to a maximum of $50,000. This is a company paid benefit. Short-Term Disability (STD) All full-time employees are eligible for STD coverage. The plan covers 60% of base salary to a maximum of $700 per week. Benefits begin 14 days following onset of qualifying injury or illness. Long-Term Disability (LTD) All full-time employees are eligible for LTD coverage. The plan covers 60% of base salary to a maximum of $5,000 per month for a qualifying disability. Benefits begin 3 months after onset of qualifying injury or illness. VOLUNTARY BENEFITS Voluntary Life Insurance All full-time employees are eligible to buy additional Life insurance for themselves and their dependents. Employees can buy $25,000 increments, up to $100,000 guarantee. Spouses are eligible for up to 50% of the employee amounts, dependents are eligible for up to $10, / 2017 BENEFITS / Fellowship of Christian Athletes

6 RETIREMENT PLAN All eligible FCA employees are automatically enrolled with a 5% pre-taxed contribution that is payroll deducted into a personal 401(k) plan. Employees have the option of opting out of contributing to their 401(k) plan at any time. Regular full time and part time employees are eligible to receive an FCA 50% match to their 401(k) contribution up to 10% beginning January or July after one full year of service. FCA match contributions are made into participants 401(k) accounts monthly. Contributions default to pre-tax traditional 401(k) but staff may request their contribution to be after-tax Roth 401(k). EMPLOYER PAID TIME-OFF POLICY Vacation Pay FCA offers paid vacation leave for full time employees based on completion of the fiscal year. This benefit is prorated for incomplete fiscal years. Upon completion of 5th, 10th, and 15th year of service, benefits will be prorated for the remainder of the fiscal year. Use of vacation time begins immediately with supervisory approval. Accrued but unused vacation can be paid upon termination if approved, not in red zone, and not terminated for cause. 0-5 Years of Service = 12 days 6-10 Years of Service = 15 days Years of Service = 18 days Years of Service = 21 days 25+ Years of Service = 24 days Sick Leave FCA offers all full time employees 6 days of paid leave per fiscal year. The sick leave benefit begins immediately. Unused days may be rolled over to the next fiscal year, not to exceed 14 days. Sick leave may be used to care for immediate family members (including doctor/dental visits). Unused sick leave will not be paid upon termination. Personal Days All full time employees receive 3 personal days per fiscal years. This benefit is available upon completion of 12 months of continuous service. Personal days will not be paid upon termination. Holidays FCA offers paid holidays to all full time employees. FCA observes 10 holidays per fiscal year. Please refer to the Employee Handbook for a complete listing of these Holidays. Paid Leave FCA offers paid leave to part time employees, working between 30 to 39 hours per week. This benefit is available upon completion of 12 months of continuous service. Unused part-time paid leave will not be paid upon termination. Please see below for more details. 0-5 Years of Service = 6 days of paid leave 6-10 Years of Service = 8 days of paid leave 11+ Years = 10 days of paid leave 6 / 2017 BENEFITS / Fellowship of Christian Athletes

7 MONTHLY PREMIUMS & DEDUCTIONS Benefit Cost to Your Budget PPO HSA Dental, Vision, Life & Disability Life & Disability Employee $740.00* $150.00** $ Employee + Spouse $ * Employee + Child(ren) $ * Employee + Family $ * *Includes FCA HSA Contribution and Employee only Dental, Employee Vision, Life & Disability in addition to the Medical Level chosen **Includes Employee only Dental, Employee Vision, Life & Disability Cost (or deduction) from your Monthly Paycheck Dental Vision Employee $0.00 $0.00 Employee + Spouse $46.00 $6.00 Employee + Child(ren) $58.00 $7.00 Employee + Family $74.00 $16.00 Further Benefit Information Visit your online portal to view: Summary of Benefits and Coverage Carrier Summaries and Details Marketplace and Subsidy Notice Important Medicare Information about your Prescription Drug Plan And other Legal Notices You may also request a free paper copy of any of these notices by contacting the KELLY Call Center at the phone number listed below. A Final Word In this guide, we describe your employee benefits in a clear, simple, and concise manner. Complete descriptions of the benefits provided through FCA are contained in the corresponding contracts and plan documents. If there is any disagreement between this guide and the wording of the corresponding contract or plan document, the contract or plan document will govern. FCA reserves the right to modify, amend, suspend or terminate any plan, in whole or in part, at any time. This guide does not constitute a guarantee of employment. 7 / 2017 BENEFITS / Fellowship of Christian Athletes

8 KEY CONTACTS For Medical Benefit or Claims Questions Local Kansas City / Outside Kansas City / Blue KC-24 hour nurse line / For Health Savings Account (HSA) Assistance Contact Optum Bank / For Dental & Vision Benefit or Claims Questions Contact Humana Dental / Contact Humana Vision / For Life & Disability Benefit or Claims Questions Contact USABle Life / contact@usablelife.com For Retirement Planning Questions Contact Principal Financial Group / For General Inquiries (ID Cards, Forms, etc) Contact KELLY Customer Service / info@kellyway.com FCA Contacts Joy Cofield; Benefits Manager ; jcofield@fca.org Ken Williams; Chief Administrative Officer ; kwilliams@fca.org A Division of Kelly & Associates Insurance Group, Inc. kellyway.com Kelly & Associates Insurance Group, Inc (KELLY) provides administrative services that include: billing, enrollment and call center service for insurance benefits. The administration of benefits by KELLY does not guarantee coverage. Billing and collecting premiums or sending payroll deduction files, does not constitute coverage being bound. Please refer to specific insurance carrier contract for rules requiring evidence of insurability (EOI) or other underwriting requirements regarding final insurance carrier approval. KELLY is not an insurer and is not responsible for paying insurance benefit claims relative to KELLY's involvement with billing and collecting insurance premiums. *This booklet summary is only intended as a brief summary of your benefits. Benefits are subject to the contractual terms, limitations and exclusions as set forth in the master contracts. 4730FEL