SIMOS EMPLOYEE EDITION 2017 BENEFITS ENROLLMENT GUIDE

Transcription

1 SIMOS EMPLOYEE EDITION 2017 BENEFITS ENROLLMENT GUIDE

2 ELIGIBILITY CHANGES THAT IMPACT YOU THIS YEAR HERE ARE A FEW FEATURES NEW TO OUR BENEFIT PLANS: New HSA provider, Optum Bank (pg 7) New pharmacy benefits manager to provide improved service levels (pg 9) Talk to a doctor on the phone with Teladoc (pg 10) WHO S ELIGIBLE? Benefits-eligible employees working 30 or more hours per week will be eligible for coverage as of the first of the month following a 90-day waiting period. For example, an employee hired on January 15 will be eligible for coverage on May 1. TrueBlue employees may cover themselves and their dependents. Eligible dependents include the employee s spouse and children under age 26. WHEN CAN I ENROLL? CURRENT EMPLOYEES Each year, TrueBlue holds an annual open enrollment period during which you must re-enroll in coverage for the upcoming plan year. This is a once-a-year opportunity to select the plans that are right for you and your family. It is important to review the options carefully because your choices will remain in effect for the entire plan year. NEWLY ELIGIBLE EMPLOYEES Once you become eligible for benefits, you must enroll for coverage by the date defined in your enrollment packet. An notification will be sent to your work approximately three weeks prior to your enrollment deadline. If you miss this date, you will not be permitted to enroll until either the next open enrollment period or after you experience a qualifying change in status. (See Changing Coverage During the Year for details.) CHANGING COVERAGE DURING THE YEAR You can change your coverage during the year only when you experience a qualified change in status, such as: Marriage, divorce, or legal separation Birth, adoption, or a child placed with you for adoption Start or stop of adoption proceedings Change in your child s dependent status Death of your spouse or child Change in your spouse s benefit or employee status When a qualifying change occurs, you must make your benefits choices and provide supporting documentation within 30 days of the event (in most circumstances), and your benefits changes must be consistent with the event. Please contact WebTPA at for specific information. AFFORDABLE CARE ACT The coverage offered by TrueBlue to its employees and their eligible dependents meets the minimum essential coverage guidelines established by the Affordable Care Act (ACA) as well as the affordability guidelines. Employees who are offered coverage through TrueBlue will not be eligible for subsidized coverage through their state exchanges or marketplaces. 2 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE 3

3 HEALTH PLAN OPTIONS QUICK GUIDE TO YOUR HEALTH PLAN OPTIONS Premium PPO 1000 HSA 2000 PPO 3000 Premium Premium No premium Individual Deductible $1,000 $2,000 $3,000 Family Deductible $2,000 $4,000 $6,000 Employer Contribution (pg 6) Savings Options (HSA pg 5, FSA/Limited FSA pg 12) Voluntary Policies (pg 14) $0 $500 $0 FSA Critical illness Accident Hospital HSA Limited FSA Critical illness Accident Hospital FSA Critical illness Accident Hospital FAQ ABOUT HEALTH SAVINGS ACCOUNTS WHAT IS AN HSA? An HSA is a savings account that works in conjunction with HSA-qualified health plans, such as the HSA You can use the funds in your HSA to pay for current and future qualified medical expenses, tax-free. WHAT ARE THE TAX BENEFITS ASSOCIATED WITH AN HSA? The money you contribute to your HSA is tax-deductible and can be used to pay for qualified medical expenses for not only yourself but also your spouse and tax dependents enrolled in an HSA-qualified health plan. You can maximize your tax savings by contributing up to the maximum annual amount allowed by the IRS. Your HSA balance plus investment earnings carry over from year to year, tax-free. State taxes may still apply, so please consult your tax adviser. WHY SHOULD I PARTICIPATE IN AN HSA? The money goes into your HSA tax-free, it grows tax-free, and it comes out tax-free when used for qualified medical expenses. It s like a 401(k) for your health care needs. HOW DO I ENROLL? To enroll or opt out, go to the URL below and click on Enrollment Log In. WHAT IS A PPO? A PPO plan allows you to seek medical care from in- and out-of-network providers. On the PPO 1000 and PPO 3000 plans, you will be responsible for meeting your annual deductible first, and then the plan will pay 80% of your expenses until you reach the out-of-pocket maximum. If you meet your out-of-pocket maximum, the plan pays 100% of your expenses from that point on for the remainder of the year. WHAT IS AN HSA- QUALIFIED HEALTH PLAN? It s an IRS-qualified health plan that allows you to have a health savings account (HSA). It works similar to how a PPO plan works, but all of your medical expenses, including prescriptions, count toward your annual deductible. Once you have met your deductible, the plan will pay 80% of your expenses until you reach your out-of-pocket maximum. If you meet your out-of-pocket maximum, the plan pays 100% of your expenses from that point on for the remainder of the year. HOW MUCH CAN I CONTRIBUTE? The IRS sets limits on how much you can contribute each year. These limits include any money your employer adds to your account Limits Individual Family Annual Contribution $3,400 $6,750 DID YOU KNOW? Generic drugs are safe and provide the best value. A formulary is an approved list of safe and effective brand-name and generic drugs covered by the plan. Ask your doctor or pharmacist if your prescription is available in generic form. 4 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE TRUEBLUE YOUR 2017 SIMOS BENEFITS BENEFITS ENROLLMENT ENROLLMENT GUIDE GUIDE 5 5

4 HEALTH SAVINGS ACCOUNTS HOW MUCH WILL MY EMPLOYER CONTRIBUTE? To get your HSA savings started, TrueBlue will contribute up to $500 per year to your HSA in equal increments over the course of the year $19.23 per biweekly paycheck. WHO IS ELIGIBLE TO CONTRIBUTE TO AN HSA? To contribute to an HSA, you must be enrolled in an HSAqualified health plan, such as the HSA You also can t be enrolled in other comprehensive health coverage that is NOT a qualified high-deductible health plan, be enrolled in Medicare or Tricare, or be a dependent on another person s tax return. If you have specific questions about your eligibility for an HSA, contact the Benefits Department at benefitsdept@trueblue.com. WHAT HAPPENS TO MY HSA IF I AM NO LONGER ENROLLED IN AN HSA-QUALIFIED HEALTH PLAN? You ll no longer be eligible to contribute to the HSA. However, you ll still have access to the HSA and can use the funds as you choose. Withdrawals for qualified medical expenses will still be tax-free. CAN I STILL HAVE A FLEXIBLE SPENDING ACCOUNT? Yes, you can utilize a limited flexible spending account (FSA). See pg 15 for more information on the limited FSA. CAN I HAVE AN HSA WITH THE OTHER PLANS? No. The IRS has strict rules guiding HSAs, and you must be enrolled in an HSA-qualified plan to use this program. WHAT ARE QUALIFIED MEDICAL EXPENSES? To help you determine whether an expense qualifies for tax-free reimbursement under your HSA, Internal Revenue Code Section 213(d) states that eligible expenses must be made for medical care. This is defined as amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. Examples of common qualified medical expenses include: Acupuncture Ambulance services Artificial limb or prosthesis Doctors fees Hearing aids and hearing aid batteries Hospital services Laboratory fees Prescription medicines or drugs X-rays Expenses for over-the-counter (OTC) drugs are no longer eligible for payment or reimbursement from an HSA without a doctor s prescription. Insulin and prescribed drugs will continue to be eligible for payment or reimbursement from an HSA. You should save your receipts and doctors prescriptions for OTC medicines for tax purposes. As the HSA owner, you re ultimately responsible for determining whether a health care expense is eligible for reimbursement from your HSA. Wells Fargo doesn t determine whether claims qualify for tax-free reimbursement and cannot provide tax advice. Please consult your tax adviser if you have questions. CAN I USE FUNDS FROM AN HSA FOR NONQUALIFIED MEDICAL EXPENSES? Yes, but you ll be required to pay income tax and a 20% tax penalty on the amount you use for nonqualified medical expenses. (The 20% penalty doesn t apply to distributions made after your death or disability or after you ve reached age 65.) HOW DO I ACCESS FUNDS IN MY HSA? OPTUM BANK HSA DEBIT CARD You can use your Optum Bank Health Savings Account Debit MasterCard for direct payment at a doctor s office, pharmacy, or any health care facility that accepts MasterCard. ONLINE BANKING AND BILL PAYMENT You can view recent account activity, link to your investment account, and view and download your monthly statements. You can also pay bills for qualified medical expenses directly to your doctor or other health care provider. Set up the names and addresses of your providers to make future payments a snap. PAYING WITH CHECKS You may also request HSA checks to use when paying your medical bills. You can order them online when you log in to your account. MOBILE EXPERIENCE You can easily access your Optum Bank HSA with your smartphone or tablet and manage your account on the go. REIMBURSING YOURSELF You may choose to pay for some or all of your medical expenses out of pocket, saving receipts to track your qualified expenditures. Then you may reimburse yourself for those expenses. Go to optumbank.com, log in, and select Reimburse Yourself. You ll be able to choose to set up an electronic funds transfer from Optum Bank to your savings or checking account at another bank. Or you can ask Optum Bank to send you a check by mail. DISBURSEMENT LIMITS Optum Bank limits your ATM withdrawals to $300 within a 24-hour period. RECEIPT VAULT Optum Bank s receipt vault is an easy online tool that helps you keep track of your receipts and stay organized. It allows you to upload images of receipts for qualified medical expenses and then store them within your HSA. You can easily organize and manage your receipts from your smartphone, tablet, or desktop. WHERE CAN I FIND MORE INFORMATION ABOUT HSAS? 6 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE 7

5 HEALTH PLAN COSTS DENTAL, VISION, AND PRESCRIPTION DRUG COVERAGE MEDICAL / VISION / PHARMACY HIGHLIGHTS AND COVERAGE COSTS Medical Plan Premiums PPO 1000 HSA 2000 PPO 3000 Biweekly Biweekly Biweekly Employees with (annualized) salaries < $40,000 Employee $ $56.27 $39.87 Employee + Spouse $ $ $ Employee + Child(ren) $ $ $ Employee + Family $ $ $ Employees with (annualized) s alaries $40,000 Employee $ $87.42 $39.87 Employee + Spouse $ $ $ Employee + Child(ren) $ $ $ Employee + Family $ $ $ OUT-OF- NETWORK OUT-OF- NETWORK OUT-OF- NETWORK Medical Plan Feature IN-NETWORK IN-NETWORK IN-NETWORK Annual Deductible Individual $1,000 $2,000 $2,000 $4,000 $3,000 $6,000 Family $2,000 $4,000 $4,000 $8,000 $6,000 $12,000 Out-of-Pocket Maximum Individual $2,000 $4,000 $4,000 $8,000 $5,000 $12,000 Family $4,000 $8,000 $8,000 $16,000 $11,000 $24,000 Coinsurance 80% 50% 80% 50% 80% 50% Physician Services Office Visits Routine Preventive 100% Well-Child Care 100% Lab and X-ray Hospital Services Room + Board (precertification required: 25% penalty) Outpatient Surgery Emergency Room Vision Services Eye Exam Frames, Single Vision Lenses, Bifocal Lenses, Trifocal Lenses, Contact Lenses, Prescription Sunglasses then then then then 100% 100% then then then then e 100% 100% then then e $30 copay $30 copay $30 copay Up to $150 combined maximum per calendar year Up to $150 combined maximum per calendar year then then Up to $150 combined maximum per calendar year DENTAL COVERAGE FOR A BEAUTIFUL SMILE The plan helps you pay for most necessary dental services and supplies, including diagnostic and preventive care (such as exams, cleanings, and X-rays), as well as basic and major restorative services (such as fillings, crowns, and dentures), subject to age and frequency limits. DENTAL HIGHLIGHTS Dental Plan Feature Calendar Year Maximum Class I, II, and III Expenses Combined Deductible Individual $1,500 $50 Family $150 Class I Preventive Exams, cleanings, X-rays, fluoride treatments, sealants, and space maintainers Class II Basic Fillings, anesthesia, oral surgery, injections, endodontics, and periodontics Class III Major Crowns, dentures, and bridge work Class IV Orthodontia Dental Premium 100% (deductible ) 80% 50% Not Covered COST Biweekly Employee $13.92 Employee + Spouse $27.84 Employee + Child(ren) $26.44 Employee + Family $40.37 VISION COVERAGE FOR EYE HEALTH TrueBlue medical plans also include vision benefits to reduce eye care expenses for you and your family. PRESCRIPTION DRUG COVERAGE If you enroll in a TrueBlue medical plan, prescription drug benefits are included through WellDyneRx. Through this benefit, you can save money on certain medications you take on a regular basis by purchasing these prescriptions by mail order through WellDyneRx. With mail order prescriptions, you have the convenience of medication delivered to your home. Your prescription drug coverage is in the form of a three-tier benefit structure based on a formulary, a list of prescription drugs approved by the plan. Your cost varies depending on the health plan you choose and the type of prescription. Under TrueBlue s prescription drug coverage, most medications do not need prior authorization. However, some medications may not be covered until your doctor or pharmacist contacts WellDyneRx for approval. Your safety and care are our top priority, and our prior authorization program helps you and your doctor choose safe medications that provide you with the best value. PRESCRIPTION HIGHLIGHTS Deductible $25 individual $75 family Generic Brand Nonformulary PPO 1000 HSA 2000 PPO 3000 $12 $30 $50 Combined with health plan deductible 80% after health plan deductible is met 80% after health plan deductible is met 80% after health plan deductible is met $25 individual $75 family $12 $30 $50 8 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE 9

6 TELADOC STRONGER YOU CONNECTING WITH A DOCTOR WITHIN MINUTES IS EASY WITH TELADOC STRONGER YOU, STRONGER BLUE WELLNESS PROGRAM Request a visit with a doctor 24 hours a day, 365 days a year by web, phone, or mobile app. When you log in to Teladoc, you get access to a national network of board-certified physicians, dermatologists, and therapists. Teladoc will pair you with a doctor licensed in your state. You allow the doctor to review your medical records, which are kept secure through robust encryption methods. You can talk to the doctor as long as you need no limit! If medically necessary, a prescription will be sent to the pharmacy of your choice. Common conditions treated through Teladoc include sinus problems, respiratory infections, allergies, urinary tract infections, cold and flu symptoms, and many other nonemergency illnesses. Teladoc provides a one-time connection with a doctor. Teladoc is not a way to establish an exclusive relationship with a doctor. Teladoc is designed to support your relationship with your existing doctor. Note: Teladoc is designed to handle nonemergency medical problems. You should not use it if you are experiencing a medical emergency. For each consult through Teladoc, you ll pay a $45 copay at the time of service. The copay will count toward your annual deductible. 10 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE As a TrueBlue employee, you can participate in our Stronger You, Stronger Blue wellness program, designed to help our employees lead healthier, happier lives. Stronger You, Stronger Blue also offers health and wellness information through WebTPA s Communitas Care Management. Programs offered include claims administration, case management, personal health assessments, health coaching, early cancer detection and outreach, chronic condition management, and healthy beginnings maternity management. For more information, us at helpme@webtpa.com. TOBACCO SURCHARGE TrueBlue is committed to encouraging our employees to lead tobacco-free lifestyles. In support of this commitment, employees who use tobacco products will pay an additional $100 per month for health benefits. In an effort to encourage our employees to lead tobaccofree lifestyles, TrueBlue has removed all limits or maximums relating to tobacco-cessation prescriptions on our health plan. You can also access our Employee Assistance Program to speak with a licensed counselor to help you become tobacco-free. You can the TrueBlue Benefits Department at benefitsdept@ trueblue.com if you d like more information about TrueBlue s tobacco-cessation benefits. ADVOCATING FOR YOU: CASE MANAGEMENT PROGRAM The Case Management program from WebTPA is designed to help patients who are experiencing catastrophic high-risk or high-cost conditions. The health care system can often be difficult to navigate, especially if you are already dealing with a serious illness or injury. A case management nurse will work with you, your family, and your caregivers as a patient advocate and make sure you receive the care you need at a cost-effective price. The nurse develops a thorough understanding of your condition, needs, and concerns, and then works with you to help you become knowledgeable about your medical condition and how you can play a greater role in your own care. If you are identified as potentially benefiting from a case manager, WebTPA will contact you directly. EMPLOYEE ASSISTANCE PROGRAM Because unresolved personal issues can affect every aspect of a person s life, including work performance, TrueBlue offers U.S. employees and their eligible dependents the Employee Assistance Program (EAP) from Liberty Mutual immediately upon hire. For confidential assistance with nearly any personal matter you may be experiencing, call the EAP at or log on to (password: MLASSIST). Counselors can provide free access to referrals and information on a wide variety of topics, such as stress on the job, finding a babysitter, divorce, addiction and recovery, parenting, and more. TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE 11

7 FLEXIBLE SPENDING ACCOUNTS FLEXIBLE SPENDING ACCOUNTS You can set aside money in a flexible spending account (FSA) to pay for certain health and dependent care expenses. Because your FSA contribution is deducted before taxes are taken, it lowers your taxable income and increases your take-home pay. You keep track of eligible expenses, which are reimbursed with your own untaxed dollars. TrueBlue offers three FSAs: A standard FSA for health care expenses, available to those enrolled in the PPO 1000 or PPO 3000 plan. A limited FSA for eye and dental expenses, available to those enrolled in the HSA 2000 plan. A dependent care reimbursement account. Only expenses for services incurred during the plan year, while you are actively employed, are eligible for reimbursement from your account(s). HEALTH CARE FLEXIBLE SPENDING ACCOUNT FSA funds can be used to pay for your eligible medical, dental, vision, and prescription drug expenses, including copays and deductibles, with pretax dollars. The maximum amount you can contribute is $2,550 per year. When you enroll in a health care FSA, you will receive the Navia Benefits Card a prepaid debit card that works with your health care FSA. (Note: It cannot be used with the dependent care FSA.) Use the Navia Benefits Card to pay for your eligible out-of-pocket medical expenses at approved merchants and providers; the money is automatically deducted from your spending account. Visit (Navia Benefit Solutions) to learn more about how to use your Navia Benefits Card and FSA for eligible products and services. You ll also find online tools, including calculators, to help you plan your contributions. Note: Over-the-counter drugs without prescriptions are no longer reimbursable under this account. LIMITED HEALTH CARE FSA For those who choose the HSA 2000 health care plan, a limited FSA is available to help pay for eligible dental and vision expenses, including copays and deductibles, with pretax dollars. The maximum amount you can contribute is $2,550 per year. When you enroll in the limited health care FSA, you will receive the same Navia Benefits Card as with the standard health care FSA described to the left. Visit (Navia Benefit Solutions) to learn more about how to use your Navia Benefits Card and FSA for eligible products and services. You ll also find online tools, including calculators, to help you plan your contributions. DEPENDENT CARE FSA FSA funds can use pretax dollars to reimburse you for dependent care expenses, including child care. You, or you and your spouse, must work or attend school full time for your expenses to be eligible. An eligible dependent is a child under age 13 or any dependent incapable of self-care who spends at least eight hours a day in your home and can be claimed on your tax return. The maximum amount you can contribute to a dependent care reimbursement account is $5,000 per year for single employees, or those who are married filing jointly, or $2,500 per year for married employees filing separately. When estimating your day care expenses, remember that you may not have expenses for weeks of vacation, illness, or other times your dependent receives free care. IRS USE-IT-OR-LOSE-IT RULE HEALTH CARE FSA & LIMITED HEALTH CARE FSA The IRS allows you to carry over up to $500 into the next plan year. Amounts in excess of $500, after you have submitted all of your final reimbursement requests for the plan year, will be forfeited. Funds carried over from 2016 will be available to you after the claims run out, which is 90 days into the new year. You do not have to be enrolled in the 2017 FSA to have your unused health care FSA dollars carry over. Funds carried over into the next plan year can be used to pay for eligible out-of-pocket expenses incurred in the new plan year. For example: 2016 funds carried over into 2017 can be used to pay for doctor visits incurred at any time in However, you will not be able to submit a reimbursement request until the 91st day of You will be able to use your Navia Benefits Card to access your carried-over health care FSA dollars after the 91st day of You also have the option of submitting a claim form to be reimbursed. DEPENDENT CARE FSA These accounts are subject to strict IRS regulations, including the use-it-or-lose-it rule. According to this rule, you must forfeit any money left in your account(s) after your expenses for the year have been reimbursed. DID YOU KNOW? Flexible spending accounts for health and dependent care are easy to manage. You will need to keep track of your paperwork, but the reimbursement process especially with the Navia Benefits Card makes it easy. You may also submit claims through the MyNavia app. To learn more about the app, go to 12 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE 13

8 DISABILITY, LIFE INSURANCE, AND VOLUNTARY COVERAGE DISABILITY COVERAGE If you are an employee with full-time status (working 30 hours or more per week) and are benefits-eligible, TrueBlue automatically provides you with short-term and long-term disability coverage from Liberty Mutual at no cost to you. SHORT-TERM DISABILITY Short-term disability replaces a portion of your income if sickness or injury limits or stops you from working for a short period of time. You must also have at least a 20% or more loss in your earnings. After 14 consecutive days of disability, you would be eligible for 50% of your weekly compensation, up to a weekly maximum of $1,000, for up to 11 weeks. LONG-TERM DISABILITY Long-term disability (LTD) continues a portion of your income if you are limited or unable to perform your regular job duties for an extended period of time due to illness or injury. If you become disabled and suffer at least a 20% or more earnings loss, the plan begins to pay you a monthly benefit 90 days after the start of your disability. LTD works with Social Security and any other group disability coverage to provide you with a combined monthly benefit equal to 60% of your base monthly compensation (up to $2,000, $5,000 or $10,000 per month, depending on your class of benefits) for the length of your disability or five years, whichever is less (subject to age limits). EMPLOYEE-PAID ADDITIONAL VOLUNTARY COVERAGE VOLUNTARY LIFE INSURANCE You may purchase additional voluntary life insurance for yourself in multiples of $10,000, up to a maximum benefit of $500,000 or five times your annual salary, whichever is less. If you are enrolled, you may also choose coverage for your spouse in multiples of $5,000 (not to exceed 100% of your policy coverage) and for your eligible child(ren) in $2,000 increments (up to a maximum of $10,000). Any amount of coverage for yourself as an employee greater than $200,000 or spouse coverage greater than $50,000, or any coverage amount if you are applying beyond your initial eligibility period, will require proof of good health and approval by Liberty Mutual prior to that amount of coverage becoming effective. Coverage may not be increased after a reduction. If you reduce the amount of your own life insurance coverage, any coverage for your spouse will be reduced by the same percentage at the same time. Note: It is important to designate a beneficiary or beneficiaries so that any life insurance benefits are paid according to your wishes. A primary beneficiary is the person you name to receive benefits if you die, and a contingent beneficiary is someone you name to receive benefits if the primary beneficiary is deceased. CHILD VOLUNTARY LIFE INSURANCE VOLUNTARY LIMITED BENEFIT POLICIES Life s unexpected turns can be stressful enough. Get additional financial protection and help preserve what you value most with these elective policies offered by Voya. Note: These policies are in addition to your primary health plan. You can take advantage of this additional protection whether or not you participate in one of TrueBlue s health plans. Voya insurance products are not health insurance and do not satisfy the requirement of minimum essential coverage under the Affordable Care Act. Pre-existing condition clauses are with these policies through TrueBlue. CRITICAL ILLNESS INSURANCE Pays a lump-sum benefit upon the diagnosis of a covered illness or condition. ACCIDENT INSURANCE Pays you a specified amount for specific injuries resulting from a covered accident. HOSPITAL CONFINEMENT INDEMNITY INSURANCE Pays you a benefit for eligible hospital, critical care unit, or rehabilitation facility stays. WELLNESS BENEFIT You can receive up to a $150 benefit from your policies ($50 from each policy) if you complete an age-appropriate health screening and provide the results to Voya. ACCIDENT Biweekly Employee Only $2.47 Employee + Spouse $4.40 Employee + Children $4.96 Family $6.89 HOSPITAL Employee Only $5.44 Employee + Spouse $11.22 Employee + Children $8.88 Family $14.66 CRITICAL ILLNESS Employee Only Employee + Spouse Employee + Children Rates vary based upon age, tobacco status, and coverage level. LIFE INSURANCE The TrueBlue life insurance benefit is 1x your base salary, up to $50,000. This coverage is provided at no cost to you. Age Six months to 19 years (23 if a full-time student) Child Voluntary Life Coverage Amount $2,000, $4,000, $6,000, $8,000, or $10,000 Note: Death benefits for dependents from live birth to six months of age will be $1,000 if you elect dependent coverage. 14 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE 15

9 GLOSSARY OF BENEFIT TERMS There are recurring terms that are mentioned in this enrollment guide and that you may see as you receive invoices from your health care providers. For clarity, here is what they mean in context with your health insurance plan. PREMIUM This is the amount you pay out of every paycheck to purchase health coverage, whether or not you go to the doctor or the hospital. For example, an individual employee with an annualized salary of less than $40,000 who chooses the HSA 2000 option will have $23.08 biweekly withheld from each paycheck for medical/vision/pharmacy coverage. DEDUCTIBLE This is the amount you pay out of pocket when you visit the doctor or go to the hospital before the insurance company pays for covered services. After you have met your deductible, the rest of your expenses are covered. In some instances, copays and may still apply. For in-network family plans of two or more people, each family member pays for services up to his or her individual deductible, after which each pays only a copay and/or for the remainder of the calendar year. The rest of the family will continue to pay for services (up to each member s individual deductible) until the family maximum is met. Family members then pay only, up to the out-of-pocket maximum. For example, a family of three is enrolled in the HSA 2000 plan, which has a $2,000 individual deductible/$4,000 family deductible. Mom has a medical procedure that costs $2,000, so her deductible has been met and she will pay for her office visits for the rest of the year. Later that year, her husband has X-rays and lab work totaling $200 and her daughter has a procedure that costs $300. Their expenses cannot be combined to meet a second individual deductible. They each will need to have additional services applied to their individual deductibles before the family deductible is considered met. OUT-OF-POCKET MAXIMUM The annual out-of-pocket maximum refers to the actual amount of money you will pay for your medical costs before an insurance plan pays 100% of your bill. LIFETIME BENEFIT This is the maximum total that the insurance company will pay for any one person s claims. An unlimited lifetime benefit means the insurance company will pay its portion of all medical expenses for the life of the policy. COPAY This is a fixed dollar amount you pay toward the cost of the service a health provider charges. For example, a visit to the eye doctor could come with a $30 copay, which means you pay the eye doctor s office that much when you visit. There may be additional costs that you ll be billed for later, depending on your coverage. NONCOVERED EXPENSES These are costs for care that are not covered by your plan. COINSURANCE Coinsurance is an arrangement in which the insurer (TrueBlue and the plan provider) and the insured (you) share costs in a specified ratio. For example, an insurer may cover 80% of expenses, leaving you responsible for the remaining 20%. IN-NETWORK PROVIDERS When health care professionals join an insurer s network of providers, they normally agree to provide their services at a contracted (discounted) rate. The contracted rate includes both the amount the insurer pays and your portion. Your portion may be in the form of a deductible, copay, or. OUT-OF-NETWORK PROVIDERS When you use an out-of-network provider, you will likely have significantly higher out-of-pocket costs because the providers have not agreed to a discounted rate. ASK THE EXPERTS If you still have questions after reviewing this guide and your other enrollment materials, you may contact our carriers and administrators directly. For Questions About... Medical/Dental/Vision Claims, Enrollment, Provider Issues, Precertification, Utilization Review, Disease Management, Case Management Mail Order Prescriptions Retail Pharmacy Flexible Spending Accounts Web-TPA WellDyneRx WellDyneRx Navia Benefit Solutions CONTACT Disability Claims Liberty Mutual Life /AD&D/Premium Waiver Claims Liberty Mutual (k) Plan Employee Assistance Program Health Savings Account Principal Financial Group Bensinger, DuPont & Associates (MyLibertyAssist) Optum Bank Plan TeleTouch@ Password: MLASSIST QUESTIONS? Write them down here and then ask an expert. Important note: This brochure is intended to provide you with general information about your benefits under the TrueBlue benefits plan; it is not intended to fully describe all of the plan s features, limits, and rules. The plan is maintained according to comprehensive official plan document(s). In the event that there is a conflict or ambiguity between this brochure and the plan document(s), the terms of the plan document(s) will govern. You may request a copy of the plan document(s) from the Benefits Department. The company reserves the right to amend or terminate the plan at any time. 16 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE 17

10 18 TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE TRUEBLUE YOUR 2017 SIMOS BENEFITS ENROLLMENT GUIDE 19

11 THE PEOPLE COMPANY