2016 Benefits Enrollment Guide

Transcription

1 2016 Benefits Enrollment Guide Make Choices Within 31 Days of Your Hire Date It is important to enroll in benefit plans within 31 days of your date of hire. Otherwise, you will be required to wait until the next open enrollment period in order to be covered by any benefits. There is no auto enrollment for any reason. All materials are also avaliable in The Zone (TheZone.goodmanmfg.com).

2 Welcome to Goodman & Quietflex! We are pleased to offer a comprehensive benefits plan that is competitive in the marketplace. We continue to benchmark our plans against those offered by other employers to ensure that our programs are competitive. Although health care costs have continued to rise, we have worked to maintain increases in employee premiums at levels below the national average and have done so since Cigna will mail personalized ID cards for you and your covered dependents to your home address, within days after completing the enrollment process. Please login and get started today! Kristi Pittman-Director, Benefits & Human Resources Shared Services To make your benefit elections, you will login to our employee portal called The Zone. Directions on how to enroll are included in the back of this package of information. There is additional information on the plans available in The Zone as well. Paid Time Off You will be provided with paid time off for a variety of reasons. The details of these paid time off plans are outlined in our employee handbook available in The Zone under Days Away from Work. Your vacation will begin accruing from your hire date. You may request days away and review your balances in The Zone at any time. Proof of Prior Insurance Coverage The medical insurance plan has a pre-existing condition clause (except for children up to age 19 or for pregnancy) for services performed within the first year of eligibility. A pre-existing condition is a condition (physical or mental) for which medical advice, diagnosis, care or treatment was recommended or received within the 3-month period prior to your enrollment date. If a covered individual has a pre-existing condition, expenses for treatment of this condition will not be covered for 12 months following your enrollment date. After 12 months, normal benefits will be payable. This pre-existing condition exclusion period may be reduced by an equal period of any prior continuous health coverage (credible coverage) as long as there is no break in coverage for 63 consecutive days or more. To reduce the exclusion period, you must provide proof of prior coverage. Your previous employer will be able to provide a Certificate of Coverage that verified the amount of time you and your dependents were insured. This certificate should be submitted to the benefits department. Without this certificate, incurred claims will be placed on hold until after the information is received. 2

3 Getting Started with Enrollment Review Medical & Rx Choices Your Medical & Rx Benefits Your medic al benefits will be provided through Cigna Healthcare and prescription coverage will continue through Catamaran. Plan Selected Your Medical Benefits at a Glance PPO Buy Up Plan Covers: 80% In-Network / 50% Out-of-Network Deductible: Individual $600 / $1500 Family $1,800 / $4,500 Out-of-Pocket Maximum: Individual $2,500 / $5,000 Family $5,000 / $10,0000 Co-pay: $30 Primary Care, $50 Specialist PPO Core Plan Covers: 70% In-Network / 50% Out-of-Network Deductible: Individual $1,200 / $2,500 Family $3,600 / $7,500 Out-of-Pocket Maximum: Individual $5,000 / $10,000 Family $10,000 / $20,0000 Co-pay: $40 Primary Care, $60 Specialist Emergency Room Co-pay: $100 Emergency Room Co-pay: $150 Mental health is covered as any other condition RX Deductible: $100 Individual / $200 Family Rx Co-pay Retail: Gen $10, Brand $30, Non-Pref $50 Rx Mail Order: Gen $20, Brand $60, Non-Pref $100 Monthly Cost* Core Plan Employee Only $36.82 Buy Up Plan Employee Only $92.64 Core Plan Employee + Children $ Buy Up Plan Employee + Children $ Core Plan Employee + Spouse and/or Family $ Buy Up Plan Employee + Spouse and/or Family $ Mental health including Rx is not covered RX Deductible: $100 Individual / $200 Family Rx Co-pay Retail: Gen $20, Brand $40, Non-Pref $60 Rx Mail Order: Gen $40, Brand $80, Non-Pref $120 Both plans have unlimited lifetime maximums, allow for diabetic supplies through Diabetic Sense only and allow for specialty prescriptions to be filled by Catamaran s Specialty Pharmacy, Briova only. For more information or to enroll in Diabetic Sense, call Diabetic Sense directly at The chart above is a summary of the major differences between the two plans only. Please refer to the summary plan descriptions for a complete list of covered expenses and plan specifications. For a complete list of covered providers in your area, please go to or call Cigna at * The monthly cost will be deducted evenly, based upon your appropriate pay period. Check out MyCigna.Com Have you checked out mycigna.com? Mycigna.com is a helpful tool to use for your insurance needs. At mycigna.com you can: Check on claims Print ID Cards Shop for lower cost options on planned procedures Find in-network doctors in your area. Important Notes About Your Prescriptions Generic prescriptions will be substituted for certain brand name prescriptions unless medically necessary. For more information about your specific medication, contact Catamaran/Optum directly at

4 Getting Started with Enrollment Review Medical & Rx Choices Base High Deductible Health Plan & Health Savings Account (HSA) The Base HDHP option offers a base level of medical coverage for members who want protection from catastrophic medical events without paying a monthly premium. The plan also provides access to routine wellness care, not subject to the deductible and covered at 100% when using network providers. This plan is attractive to participants who only require minimal medical care through the year but want to have a level of just in case protection, without the monthly premiums. While there are no monthly premiums, you will pay full price for office visits, prescriptions, medical service, etc., and you will then submit the claim to Cigna so it can be applied to the deductible. Once the deductible has been met, the plan will process eligible charges at 70% up to the appropriate out of pocket maximum. The covered expenses are the same today as on the Buy Up Medical plan and you can use the tools available through Cigna and Catamaran to shop around for the lowest cost options. High Deductible Health Plan (HDHP) In-Network Single/Family Non-Network Single/Family Deductible $3,000 / $9,000 $6,000 / $18,000 Out of Pocket Max $6,600 / $13,200 $13,200 / $26,400 Co-Insurance 70% / 30% 70% / 30% RX Co-Insurance 70% / 30% No Coverage Being covered by a high-deductible health plan also gives you access to the Health Savings Account (HSA) option now available. Here is a quick summary of the HSA: You must be enrolled in the BASE HDHP to contribute to the HSA plan. The annual contribution for single coverage is $3,350; family coverage is $6,750. Something To Consider We understand that a health plan with no monthly premium can be attractive, especially if you re on a tight budget. HOWEVER, the BASE HDHP and HSA option is not designed for everyone. You should carefully consider the impact to your healthcare budget in the event you have an unexpected medical emergency. To put it in perspective, a single trip to the Emergency Room can start at $3,000. Individuals over age 55 can contribute an additional $1,000 per year. There is no time limit on reimbursements as long as the claims occur after the HSA effective date. You can change payroll deductions on the HSA at any time and a family status change is NOT required to do so. Contributions grow tax-free and can be withdrawn tax free if used for qualified medical expenses (as defined by the IRS). Withdrawals for non-qualified expenses are subject to a 20% excise tax. The HSA account is completely portable and the balance rolls over annually without a deadline to use it. Still Have Questions? If you re unsure if this plan is right for you, we encourage you to discuss it further with the Corporate Benefits Dept. before making a change. Throughout 2015, there will be opportunities for you to attend meetings or watch webinars and ask questions about the plans before the next enrollment period in * The monthly cost will be deducted evenly, based upon your appropriate pay period. 4

5 Next Step Review Dental Choices Your Dental Benefits Goodman provides two dental plan options through Cigna to meet your needs. There is no penalty for using a non-cigna provider but the available discounts could lower your out-of-pocket expenses. Plan Selected Monthly Cost* Core Plan Employee Only $7.00 Buy Up Plan Employee Only $19.00 Core Plan Employee + 1 $16.00 Buy Up Plan Employee +1 $59.00 Core Plan Employee + 2 or more $27.00 Buy Up Plan Employee + 2 or more $71.00 Your Dental Benefits at a Glance Buy Up Plan Core Plan Annual Deductible Ind $25 / Fam $75 Ind $50 / Fam $150 Annual Max/Person $2,000 $1,000 Preventive Care 20% No Deductible 20% No Deductible Basic Treatment 80% / 20% 80% / 20% Major Treatment 50% / 50% 50% / 50% Orthodontia 50% / 50% with $50 Deductible & $1,000 Lifetime Maximum Not Covered New cards will NOT be automatically re-issued this year. To replace a card or for a complete list of providers, please visit their website at or call Please refer to the Summary Plan Description for a detailed explanation of covered/ non-covered benefits, plan requirements and applicable co-pays. * The monthly cost will be deducted evenly, based upon your appropriate pay period. 5

6 Next Step Decide on Vision Care Vision Care Employees who enroll in the Davis Vision benefit are eligible for a free pair of safety lenses annually AND upon request at the initial visit. (Brazers may also be eligible for tinted glasses. Please contact Corporate Benefits for additional information). Vision benefits are administered by Davis Vision. There is no ID card. Simply tell the provider that you are covered by Davis Vision when you make the appointment. You may visit any doctor, but if you use an in-network doctor you pay a co-pay for most services. If you visit a doctor outside of the network, you pay the full amount at the time of the visit and submit a claim form for reimbursement. Plan Selected Monthly Premium* Employee Only $0.00 Employee +1 $5.00 Employee +2orMore $8.97 In-Network Co-pay for Exams (Every 12 Months) $10 Co-pay for Frames (Every 24 Months) $5 Co-pay for Lenses (Single/Bifocal/Trifocal) $5 Co-pay for Contacts (Every 12 Months) $24/$45 Out-of-Network Exams & Materials Reimbursement of $50 Important Note The benefit plans you select during the enrollment period will become effective on your date of hire and will remain in effect for the entire calendar year unless you experience a qualified family status change (and make that change within 31 days of the event.) Next Step Consider Flexible Spending Flexible Spending Account You may allocate pre-tax dollars to be set Plan Contribution Limits: aside from each paycheck for medical out-ofpocket expenses. This can include office visit $2,550-Unreimbursed Medical Expenses $5,000-Day Care co-pays, deductibles, vision exams, dental work and prescriptions. For a list of covered & non-covered expenses, please go to Publication 502. You do not have to be enrolled in the health plan to participate. The elected amount will be available immediately and a debit card will be provided. Substantiation for amounts other than co-pays will be required so you ll need to save receipts and insurance statements. You may also allocate pre-tax dollars for daycare expenses. Daycare expenses are reimbursed up to the amount that you contribute each pay period. All charges must be incurred during the Plan Year. Reimbursement will not be allowed for expenses incurred from prior years or for ineligible dependents. Plan wisely unused balances will not be refunded. * The monthly cost will be deducted evenly, based upon your appropriate pay period. Important Note If you would like to participate in flexible spending, you must enroll in the plan(s) each year during open enrollment. 6

7 Next Step Review Additional Information on Voluntary Benefits in The Zone Company Provided Benefits Basic Life Insurance Hourly employees are eligible for one times annual salary, up to $50,000. Salaried employees are eligible for one times annual salary, up to $500,000. This benefit is available to all eligible employees, at no cost. Accidental Death & Dismemberment Insurance In the event of accidental death, your beneficiary will receive two times your annual salary, up to the same maximums as the basic life insurance. Long-Term Disability (LTD) The Company provides long-term benefits at no cost, and employees are automatically enrolled. If needed, LTD benefits begin after 26 weeks of disability and cover 60% of your salary up to $12,000 per month. In most cases, you may receive benefits until you recover or age 65, whichever comes first. LTD also coordinates with Social Security Disability. Other Benefits Voluntary Life and Accidental Death & Dismemberment (AD&D) Insurance For additional financial protection for you and your family, you may purchase voluntary term life insurance. You may choose up to $200,000 of employee life insurance (in increments of $10,000) or family term life insurance to cover a spouse or children. Insurance is subject to a health assessment. AD&D Coverage is also available on this plan for an additional premium. Short-term Disability (STD) This benefit is voluntary and is 100% employee-paid. The disability benefit begins after 7 days of disability and can continue for up to 26 weeks. The weekly income benefit is equal to 60% of your salary up to $1,500 per week. Coverage outside of the original enrollment period is subject to proof of good health. (Continued on next page.) 7

8 (Continued) Identity Theft Insurance Identity Theft Shield protects you before, during and after identity theft occurs (including theft of your social security number, driver s license, credit cards, banking, etc.) By purchasing Identity Theft Shield, you will receive an up-to-date credit report, continuous credit monitoring, identity restoration in the event your identity is stolen, and updates/ alerts. Employees can sign up for Identity Theft Insurance at any time. METLIFE Voluntary Benefit Options For more information about each plan and the rates, go to the Benefits Enrollment Docs tab in The Zone and open the Critical, Accident, Legal document. Accident Insurance This policy helps to cover out-of-pocket expenses associated with an accidental injury, not covered by medical insurance, and helps to protect your savings should an accidental injury occur. This plan replaces the current Allstate Accident plan and re-enrollment is required for coverage in Critical Illness Insurance The Metlife Critical Illness plan protects you and your family from the financial impact of battling cancer, heart attack, stroke, or kidney failure in either a $10,000 or $20,000 increment. Rate information can be found in The Zone under Benefit Enrollment Docs. MetLaw - Discounted Legal Services This plan provides access to legal services and over 12,000 attorneys for Estate Planning, Family Law, Real Estate and many other types of legal needs. Coverage is available for you and your family. 401(k) Retirement Plan Wells Fargo After 90 days of service, full-time employees may contribute up to 50% of their salaries on a pre-tax basis up to the annual maximum of $18,000. If you are age 50 or older, you may contribute additional catch-up contributions. Goodman matches annual contributions up to 6% or a maximum of $3,000. In order to receive a matching contribution you must be employed on December 31. After three years of service, you are 100% vested in the company-matching contribution. At you may enroll, find information about the investment funds, request a loan or hardship withdrawal, change your deferral amount, and designate a beneficiary. Employee Assistance Program Sometimes balancing work and family activities can create stress that is hard to handle on your own. To help you through these times, you can receive confidential counseling and referrals through the EAP at no cost to you. You and your eligible dependents can use the program. No enrollment is necessary and all employees are eligible. Counseling is available through the EAP for personal issues such as: Important Note You must renew annually in 401(k) catch up contributions if you will be 50 or older in 2016 by contacting Karen Gibbs in the Corporate Benefits Dept. 401K Annual Limit Regular contributions are $18,000. Catchup contributions for age 50 and older are $6,000. Family or marital problems Parenting concerns Eating disorders like anorexia or bulimia Conflicts at work Emotional difficulties like depression, anxiety, guilt or grief Crisis situations Drug and alcohol dependency Stress and burnout Questions about legal or financial concerns Questions on child or elder care Counselors are available 24 hours a day and Goodman will pay for up to three onsite counseling sessions per person per year with an EAP counselor. For more information, call Lifeworks at and use the Company Code: GOODMAN GLOBAL or visit user name: goodman / password: eap. 8

9 Wellness Services Quit For Life We are pleased to partner with Quit for Life, a smoking cessation program through the American Cancer Society. Quit for Life is the nation s leading tobacco cessation program and has helped more than One Million members quit to date. The Quit for Life program is completely voluntary for you and your spouse if covered on any of the Goodman Medical Plans. Enrollment and results will be completely confidential. The Plan covers ONE treatment and coaching program for you or your spouse at no charge. Additional programs, if needed, are available at a rate of $ per person. After enrolling, you are matched with a quit coach who helps you develop a personalized quit plan, provides guidance in choosing medicines, and gives ongoing follow-up support. If interested, go to or call Quit4Life ( ). Cigna On-Site Health Coach We are partnering with Cigna to provide an Onsite Coach to help you improve your health outcomes by engagement and awareness using your specific health data. The Onsite Coach will provide you with care recommendations and physician referrals as needed. Sessions with the Onsite Coach are free of charge, voluntary and confidential. In addition to individual sessions, the Onsite Coach will also: Work within our organization to create a culture of health and wellness; Identify and train volunteer wellness coaches at each location; Host wellness education opportunities on general health topics; and Provide training on the Cigna tools to maximize provider discounts and lower your outof-pocket expenses for planned medical treatment. To contact the Onsite Coach, call or Latecia.murphy@cigna.com. 9

10 Next Step Enroll How to Enroll STEP 1 - After reviewing this brochure, begin open enrollment by logging in to THE ZONE ( STEP 2 - Review your dependents and beneficiaries and make appropriate changes under MY DEPENDENTS and MY BENEFICIARIES under the benefits menu. STEP 3 - Select BENEFIT CHANGES under the benefits menu. Enter your hire date under BENEFIT CHANGE DATE. Select NEW HIRES from the BENEFIT CHANGE REASON menu and continue. PRE-TAX BENEFITS MEDICAL & DENTAL - Select the Buy Up, Core, or Base HDHP plan and the level of coverage. VISION - Select level of coverage only. FLEX SPENDING AND HEALTH SAVINGS - Select Health and/or Dependent Care, or HSA Single or Family You will designate the annual amount later (see Step 6). VOLUNTARY BENEFITS Walk through each of the voluntary benefits. Specific details on each are included in the step-by-step instructions available under Benefit Enrollment Docs in the Zone. STEP 4 - Select only those dependents to be covered on each plan. When you are done, press RECALCULATE and, if satisfied, CONTINUE. STEP 5 - Designate beneficiaries for each life insurance plan selected. STEP 6 - If you selected flex spending, you will add the amounts on the savings plan worksheet. Additionally, you will add the weekly premium for Aflac critical illness if appropriate. STEP 7 - Confirm your benefit changes. If you need to make changes use the back button on the screen (not on your browser). You will be able to scan and upload any forms needed at this step. When you are ready to submit, hit the SUBMIT icon. Important Note For detailed step-by-step instructions, see the enrollment instructions posted in the Zone under Benefit Enrollment Docs. Purchasing Power Offers payroll deduction program to purchase brand name computers, electronics, appliances, etc. Payments are made over 12 months Prices include product, warranties, taxes, delivery with no down pmt Employees are eligible after one year of full-time employment Account limits are based on annual income in lieu of a credit check code: GGL2316 VISA Paycards PayChekPLUS Elite Provides employees with a direct deposit without a bank account Access to the full balance at no cost from banks that accept VISA Free ATM at AllPoint ATM locations Online account access and bill pay Reduce worry over lost/stolen checks Immediate access to your paycheck while away on payday Abenity Discount Program Provides a collection of local and national discounts from thousands of companies as well as printable and mobile coupons Company-specific discounts like our Employee Purchase Program or the Whirlpool VIPLink program can be found on the site code: GOODMAN Home & Auto Quotes from up to four insurance companies with just one phone call Special discounts and flexible payment options Discounts available for having a good driving record and safe car Tenure discount based on years of service 10

11 More Details Dependent Children Age 19 thru 25 Once a covered dependent child reaches the age of 19, he/she can remain on the healthcare plan as long as no other coverage options are available until he/she reaches age 26. You will be asked to complete an affidavit that certifies the child has no other coverage options each year. Healthcare Reform The medical plan continues to be grandfathered as defined by the healthcare reform law. Your 2015 W-2 will include the annual portion paid by the Company for your health insurance coverage. This is in compliance with the healthcare reform law. The amount will be listed in Box 12, Code DD Women s Health and Cancer Rights Act Our plans comply with this act by providing coverage for mastectomies and for reconstructive surgery and prostheses following mastectomies. This coverage will be provided in consultation with the patient and the patient s attending physician and will be subject to the same annual deductible, co-insurance and/or co-payment provisions otherwise applicable under the Plan. Making Changes If you have a family status change this year, you will be able to make changes to your elections. Family status changes include, but are not limited to, new marriage, divorce, legal separation, annulment, birth, adoption or placement for an adoption of an eligible child, death of your spouse or covered child, change in your spouse s work status that affects his or her benefits eligibility, or change in your work status that affects your benefits eligibility. If you have a family status change, you must submit a benefit change request through The Zone within 31 days of the event and provide proof of the change (marriage license, birth certificate, etc). Otherwise, you will have to wait until the next annual enrollment period to make benefit changes. About this Guide & Benefits Eligibility Information This guide describes the benefit plans/policies available to Goodman employees. The details of these plans and policies are contained in the official plan and policy documents, including some insurance contracts. This guide is meant only to cover the major points of each plan or policy. It does not contain all of the details that are included in your Summary Plan Description (as described by ERISA)* If there are any questions, or if there is a conflict between the information in this guide and the formal language of the plan or policy documents, the formal wording in the plan or policy documents will govern. Please note that the benefits described in this guide may be changed at any time and do not represent a contractual obligation on the part of Goodman. Regular, full-time employees working 30 or more hours each week are eligible for the following benefits upon date of hire: medical, dental, vision, basic life, voluntary term life, flexible spending, critical illness, identity theft protection, and employee discounts. After 90 days of employment, full-time employees become eligible for the 401(k) retirement plan. After one year, they become eligible for Purchasing Power. Salaried employees are eligible for short and long term disability on the first of the month following 90 days of employment. Hourly employees are eligible on the first of the month following one year of service. Need More Information? Start by going to the Zone ( where there are links to our benefit providers. Cigna (Medical and Dental) Catamaran Rx / Optum or Davis Vision Customer Service or Zions Bank Connect Your Care Flex Spending or Wells Fargo Retirement Plan or Purchasing Power code: GGL2316 Abenity Discount Program code: GOODMAN Your Internal Benefits Contacts Houston, GSD & Dayton Cheryl Guillory Fayetteville & Quietflex Karen Gibbs While you are in the Zone, it is a great time to update your address before W-2s are sent out, make sure your emergency contacts are still correct, and update your address for Company communication. *Summary Plan Descriptions (SPD s) are available in the Zone under Benefit Enrollment Doc. 11