2015 BENEFITS AT A GLANCE Sinai Non-Union

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1 2015 BENEFITS AT A GLANCE Sinai Non-Union At LifeBridge Health - Sinai Hospital, we are proud of our diverse workforce and we want to make every effort to meet your diverse needs. We are pleased to present our flexible benefits program for eligible employees. Our benefits program responds to your individual and specific needs by offering you options. You choose the benefit options that you want based on your needs. The benefits program outlined here includes all of the perks you enjoy as a LifeBridge employee as well as free parking. As LifeBridge continues to grow and develop, the benefits will evolve. We will keep you informed of all of the updates to benefits under the LifeBridge benefits programs. The chart on this brochure gives an at-a-glance look at your benefit options. Use it as a guide when comparing your choices. A more detailed description of these benefits is included in the Summary Plan Description that will be provided to you when you become a participant in the benefits program. Please contact Employee Services at (410) with any questions that you may have. The Benefits Program is subject to change at any time. If a change does occur, you will be notified. If there is a discrepancy between the plan documents and this chart, the plan documents will govern. Updated January 1,

2 2015 Sinai Non-Union Full-time employees scheduled to work at least 36 hours per week Part-time employees scheduled to work at least 24 hours per week BENEFIT YOUR CHOICES BENEFIT SUMMARY Triple Option BlueChoice Biweekly contributions to the plans are pre-tax dollars Advantage Health Plan & Prescription Plan Waive Coverage Medical and Prescription Drug Full-time bi-weekly rates <$50,000 (78/22) Ind - $60.88 E/C - $91.32 E/S - $ Fam - $ $50,000 - $100,000 (75/25) Ind - $69.18 E/C - $ E/S - $ Fam - $ >$100,000 (70/30) Ind - $83.01 E/C - $ E/S - $ Fam - $ Part-time bi-weekly rates 50/50 Ind - $ E/C - $ E/S - $ Fam - $ Health Plan: The health insurance plan is based on a network of doctors, hospitals and other health care professionals. You have a choice in what providers you wish to use each time you seek medical care. Level 1 LifeBridge Health Providers - you will receive the greatest level of benefits at 100% of allowed benefit after the annual deductible of $100/$300, $25.00 copay for medical visits, $35 copay for specialist, $100 inpatient admission deductible, and $0 copay for preventive care. Mandatory Care Management after second admission into the hospital. Level 2A BlueChoice Advantage Network (care rendered in the service area of MD, DC & Northern VA) plan pays 70% of allowed benefit after $600/$1,000 annual deductible for all covered services and $0 copay for preventive care. Level 2B PPO Provider Network (care rendered outside the service area) plan pays 70% of allowed benefit after $600/$1,000 annual deductible for all covered services and $0 copay for preventive care. Level 3 - Out-of-network Providers - plan pays 60% of allowed benefit after $600/$1,000 annual deductible. Prescription Plan Annual deductible - $25/$75 Mandatory generic Step Therapy Maintenance drugs are only dispensed at LifeBridge Retail pharmacies and ClearScript/NPS mail order at a 3 month supply with 2 co-pays Fertility drugs - $5,000 annual maximum per member Specialty drugs dispensed at Sinai or NW Pharmacies $0 copay Copays LifeBridge Retail Pharmacies: $10 generic, $20 formulary (brand) & $35 non-formulary ClearScript & Other Retail Pharmacies: $10 generic, $30 formulary (brand) & $50 non-formulary Updated January 1,

3 Dental BENEFIT YOUR CHOICES BENEFIT SUMMARY Full-time bi-weekly rates BC/BS PPO Waive coverage Biweekly contributions to the plans are pre-tax dollars. The dental plan pays benefits according to a schedule and based on In-Network or Out-of-Network. Ind - $7.70 E/C - $8.61 E/S - $11.48 Fam $14.93 Part-time bi-weekly rates Ind - $8.62 E/C - $12.92 E/S - $17.21 Fam - $22.40 Vision Eye exam covered through the medical plan Flexible Spending Save pre-tax dollars to Accounts pay for out-of-pocket health care and dependent day care expenses Choose not to participate Participation in a healthcare FSA is only available during annual open enrollment Carebridge Work- Life Services and Employee Assistance Plan ( ) Free core benefit no cost to you In-Network Participating providers in the CareFirst BCBS PPO dental plan. The plan pays 100% for preventative services, 80% for basic/restorative services, and 50% for major services and orthodontics. Out-of-network Non-participating providers in the CareFirst BCBS PPO dental plan. The plan pays 65% for preventative services, 50% for basic/restorative services, and 30% for major services and orthodontics. Calendar year maximum benefit is $1,500 for all services except orthodontics, which has a lifetime maximum benefit of $1,000 for dependent children under age % discount through Krieger Eye at the Quarry Lake & Northwest Hospital You may choose to participate in the health care spending account and/or the dependent care spending account. The annual maximum contribution for the Health Care account is $2,500 and $5,000 for the Dependent Care account. If you would like to take advantage of the tax savings, you decide how many pre-tax dollars to contribute to each account every pay period based on the annual maximum benefit. You must incur the expense by 12/31 & submit receipts by 3/31 of the following year When you pay expenses with pre-tax dollars, you increase your purchasing power by 25% - 30%. $500 carryover. Carebridge is a free core benefit provided by LifeBridge. If you need to talk to a professional about family, financial, job-related, or other matters, call for confidential advice. You can also access a comprehensive online library of information and tools to help with all aspects of your personal and professional life. Updated January 1,

4 BENEFIT YOUR CHOICES BENEFIT SUMMARY Term Life and Accidental Death & Dismemberment Full-time - Free core benefit of 1x salary to a maximum of $250,000 Supplemental term life/ad&d insurance up to 3x salary to a maximum of $400,00 without EOI & up to 5x salary with an EOI to a maximum of $750,000 Part-time Free core benefit of a flat $10,000 Supplemental term life/ad&d insurance up to 3x salary to a maximum of $30,000 without EOI & up to 5x salary with an EOI to a maximum of $50,000 Dependent term life insurance for your spouse and dependent children If you die while employed at LifeBridge Health, your full life insurance benefit will be paid to your beneficiary. If you die in an accident, your full AD&D benefits will also be paid to your beneficiary. If you are injured in an accident, a percentage of your AD&D benefit may be paid to you based on the extent of your injury. Supplemental term life/ad&d coverage is also available for full & part-time employees. You may purchase up to 3 times without providing evidence of insurability or up to 5 times with evidence of insurability. Increase in coverage at a later date will be subject to evidence of insurability. Dependent term life insurance is available for eligible children and your spouse. Coverage for the spouse is $10,000 and $5,000 for each child. Paid Time Off Short Term (STD) and Long Term (LTD) Disability 8 holidays, PTO days depending on position & 5 extended illness days for full-time employees. PTO is prorated for part-time employees. Buy or sell up to 5 additional PTO days during Open Enrollment Free core STD benefit of 60% of pay up to $215/week Free core LTD benefit of 60% of pay up to $3,000/month Buy additional STD coverage and increase your benefit (60% of pay) to a maximum of $700/week Buy additional LTD coverage and increase your maximum monthly benefit to $5,000 PTO and extended leave is accrued during the year. PTO - You may carry up to a maximum of days depending on your position into each new year. All days in excess of will be deposited into your extended illness bank. There is no limit on the number of days in your extended illness bank. You may buy or sell up to 5 additional PTO days during Open Enrollment. All unused purchased days at year end will be paid back to you. Entitled to STD benefits of 60% of pay up to a maximum of $215/week at no cost to you. If you are ill or injured, STD benefits will begin after you have used all your extended leave & PTO or after 30 days, whichever is later for a maximum of 9 weeks. Entitled to LTD benefits of 60% of pay up to a maximum of $3,000/month at no cost to you. If you are ill or injured, LTD benefits will begin after you have used all your extended leave and PTO, or after 90 days, whichever is later. You may increase the maximum STD benefit to 60% of pay up to $700/week if you buy up at time of hire or first open enrollment. You may increase the maximum LTD benefit to 60% of pay up to $5,000/mo. Updated January 1,

5 BENEFIT YOUR CHOICES BENEFIT SUMMARY $5,000 Nursing courses Calendar year $3,500 Non-nursing Tuition expenses only courses Pro-rated for part-time benefit eligible employees Courses must be part of a degree program and from an accredited institution Tuition Reimbursement PensionPlus Retirement Plan Transamerica 403(b) Plan LifeBridge Health Adoption Assistance Automatic participation 5-years vesting Optional participation Employer match 3 year vesting Eligible after one full year of service You become a participant on January 1 st following your date of hire. You will receive a Pay Credit for each year you work at least 1,000 hours. A Pay Credit is the dollar contribution amount made to your account each year and is tied to your years of service: Ø less than 5 years of service = 1.5% of your compensation Ø 5-9 years = 2% Ø years = 3% Ø years = 4.5% Ø 20 plus years = 6% Vesting refers to your ownership of your account. You are 100% vested in the benefit after five years of service with 1,000 hours worked each year Add to your retirement income with pre-tax dollars. Maximum annual contribution is $18,000 with an additional contribution of $6,000 for employees over age 50 years old. Employer match is 50% of the first 4%. 100% vested after 3 years of service with 1,000 hours worked per year. The Adoption Assistance program provides financial assistance to eligible employees who adopt a child under the age of 18. LifeBridge Health will reimburse an employee with at least 1-year of service up to $3,500 for expenses relating to the legal and administrative costs of the adoption. For reimbursement, employees will submit a written request along with supporting documentation of payment of the legal costs, adoption service fees, and proof of the legal adoption. The employee must be currently employed by LifeBridge when the documentation is submitted to Employee Services. Updated January 1,

6 BENEFIT YOUR CHOICES BENEFIT SUMMARY LifeBridge Health Phase-In Retirement To be eligible, an employee must be at least age 60, have a minimum of 5 years of service at LifeBridge Health, and currently be scheduled to work at least 36 hours a week. The employee can reduce their hours with manager approval or transfer to another position that is scheduled for at least 20 hours per week Credit Union Optional to the employees if they wish to participate LifeBridge Health & Fitness Enroll yourself or your family Phase-In Retirement allows employees who are currently working a full-time schedule to reduce their hours as they approach retirement. Since medical coverage is often a barrier for employees to phase into retirement, this program continues the medical, prescription & dental benefits for participants at the subsidized full-time rate for up to 5 years even though the eligible employee is working part-time. The credit union is through First Financial ( ) It offers such benefits as savings & checking accounts, holiday & vacation clubs, all types of loans, etc. Monthly cost is discounted for employees and their family members with payroll deductions. Quick Charge Optional to employees Employees are eligible to set up a Quick Charge account to make purchases throughout LifeBridge Health. Purchases will be payroll deducted. Voluntary Benefits Short Term Disability Universal Life Insurance w/long Term Care Critical Illness with Cancer Rider Accident Insurance Pet Insurance (Dog & Cat) Purchasing Power Motivano Valuable benefits at discounted rates Bi-weekly payroll deductions Call within the first 15 days of the month following date of hire Call the Enrollment Call Center at Monday through Friday 9:00 am 5:00 pm EST There will be an onsite open enrollment period for voluntary benefits in the spring of each year Updated January 1,

7 BENEFITS YOUR CHOICES BENEFIT SUMMARY Voluntary Participation in the LifeBridge Wellness Wellness Program Program results in a savings in your benefits costs. In August, all employees enrolled in the medical plan will receive a wellness program packet that will explain the requirements to receive the premium differential for the following calendar year. For example, if you are not enrolled in the medical plan prior to 9/1, you will not be required to participate in the wellness program and will receive the premium differential for the following calendar year. Surcharges Smoker Spousal $30 bi-weekly surcharge if a smoker. $30 bi-weekly surcharge if spouse is offered employer based health benefits and enrolls in the LifeBridge Health Plan. Mandatory Commitment form required with enrollment form. Updated January 1,