Engineering and Information Services BENEFITS ENROLLMENT

Transcription

1 Engineering and Information Services 2018 BENEFITS ENROLLMENT

2 Welcome to 2018 Open Enrollment We are pleased to continue to offer eligible employees and teir dependents a robust benefits program for Te information in tis document provides you wit a summary of te ealt and welfare plan details and canges effective January 1, Witin tis guide, you will find elpful information to assist you in making benefit decisions and resources to find additional information. PDS makes it a priority to offer a variety of top-notc benefits and programs including excellent ealtcare options, Dental, Life and Disability benefits, and muc more. Remember, te coices you make at tis time will be effective January 1, 2018, and will remain in place until December 31, 2018, unless you experience a qualifying life event during te year. Open Enrollment will run from November 20 troug December 3, Open Enrollment will run from November 20 troug December 3,

3 Benefits Overview Below is a list of te 2018 benefit programs. Te PDS Tec Benefit Plan offers different plan options for Medical, Dental, Vision, and oter voluntary benefits, suc as Life insurance and Prepaid Legal. Tis guide is designed to elp you understand te coices available to you and your family. Eac year during te annual Open Enrollment period, you ave te ability to make certain benefit canges. You can add or drop dependents, cange from one plan to anoter, enroll if you are not currently enrolled, or drop all coverage. Te enrollment website can be accessed at ttps://ess.pdstec.com. Te PDS benefit plan includes: Medical Cigna ¾ Open Access Plus (OAP) Healt Savings Account (HSA) Plan $2,600 ¾ Open Access Plus Plan $1,000 ¾ Open Access Plus Plan $1,200 Teleealt Amwell and MDLIVE Cigna Employee Assistance Program (EAP) Cigna Voluntary Dental DPPO and DHMO (were available) Guardian Voluntary Vision VSP Basic Life/AD&D Guardian Voluntary Life insurance Guardian Voluntary Accidental Deat and Dismemberment (AD&D) Insurance Guardian Prepaid Legal Service Hyatt Legal Long Term Disability Guardian Pre-Tax and After-Tax Payment You pay for Medical, Dental, and Vision coverage on a pre-tax basis; tat is, before federal, Social Security, and most state and local taxes are witeld. Oter voluntary benefits are paid on an after-tax basis; tat is, after federal, Social Security, and most state and local taxes are witeld. Your Cost For te Available Plans Please refer to te separate 2018 Employee Benefit Plan Contributions seet for your cost for eac of te plan offerings. Eligible Dependents You may cover any of your eligible dependents under te PDS Medical, Dental, and Vision plans. Your eligible dependents are: Your legal opposite- or same-sex spouse. Your cildren up to age 26 and cildren older tan 26 wo are not capable of supporting temselves due to a mental or pysical disability, providing te disability began before age 26. IMPORTANT For 2018 Open Enrollment, employees are not required to select new benefits (except annual HSA elections). If you are appy wit your current coverage, your ealt elections will roll over to next year. If you plan to make canges to your current coverage, you will need to enroll by midnigt, December Medical costs are canging; please be sure to review te new premiums. 3 To enroll in, review 2018 premiums, or to make canges to your benefits for 2018, please log on to ttps://ess.pdstec.com.

4 Coverage Categories Te costs of your benefit options are partly determined by te number of dependents you coose to cover. Tese coverage categories are intended to elp you design te most effective benefits package for yourself and your family. For Medical, Dental, and Vision benefits, you can coose from te following coverage categories: Medical Dental Vision Employee Employee Employee Employee + Cild(ren) Employee + Cild(ren) Employee + Cild(ren) Employee + Spouse Employee + Spouse Employee + Spouse Family Family Family Qualifying Canges in Status Once you make your benefit elections, tey remain in effect for te entire calendar year. Tis is wy it is important to consider your coices carefully. However, if one of te following canges in status occurs and causes a gain or loss of coverage, you may be able to cange certain benefit elections during te year: Marriage, divorce, deat, or oter cange in your legal marital status. Birt, adoption, deat, or oter canges in te number of your eligible dependents tat result in loss of coverage. A cange in work ours for you, your spouse, or eligible dependents. Your dependent gaining or losing eligibility for coverage due to canges in age and/or student status. A significant cange in benefit cost or coverage for you, your spouse, or your eligible dependents. A judgment, decree, or court order tat requires coverage of a spouse or eligible dependents. Eligibility for Medicare or Medicaid for you, your spouse, or your eligible dependents. A move in or out of a plan network area for you, your spouse, or your eligible dependents. You must make te cange to your benefits witin 31 days of te event. Te cange must be consistent wit te event. Nonduplication of Benefits If you are covered under two different employers Medical and/ or Dental plans, te two plans coordinate payments. For example, if you are covered under a PDS Medical or Dental plan and under your spouse s employer s Medical or Dental plan as a dependent, te PDS plan is primary for you, wic means tat it is obligated to pay first. Your spouse s plan is secondary. Were cildren are concerned, te primary plan is usually te plan of te spouse wit te earlier birtday during te year. Tis is known as te birtday rule. Wenever te PDS plan is your secondary plan, benefits will be determined according to te nonduplication of benefits rule, wic means tat te PDS plan will pay only up to te amount te plan would normally pay if it were te primary plan, less any benefits paid by te primary plan. Healtcare Reform (Patient Protection and Affordable Care Act) Te Affordable Care Act (ACA) requires most Americans to ave ealt insurance in 2018 or pay an individual income tax penalty. Te penalty is te greater of 2.5% of your yearly ouseold income or te 2017 flat fee penalty of $695 per adult adjusted for inflation. (Te penalty for cildren is alf te amount.) To avoid te penalty, individuals must maintain minimum essential coverage for temselves and teir dependents. Enrolling in a PDS Tec Medical plan will meet te requirements. 4

5 Medical Benefits Te PDS benefit plan offers te following Medical plan options: Cigna OAP HSA $2,600 Cigna OAP $1,000 Cigna OAP $1,200 If your Medical coverage is already provided under anoter plan, you may coose to decline coverage. However, you sould carefully consider te following: Since your Medical plan elections remain in effect for a full year, you will not be able to obtain Medical coverage under te PDS benefit plan during te year unless you ave a qualifying cange in status. If you decline because you ave coverage elsewere, please indicate tis wen completing your declination. As a reminder, if you decline coverage troug PDS Tec and do not ave coverage elsewere, you will be subject to penalties under te individual mandate of te ACA. Find a Pysician Cigna s Open Access Plus network of pysicians and ospitals will replace our current network. You can access to review a complete listing of providers by your ome zip code. Click Find a Doctor at te top. Ten click te orange block FOR PLANS OFFERED THROUGH WORK OR SCHOOL. 5

6 Cigna OAP HSA $2,600 Te OAP HSA plan gives you more control over ow you spend or save your ealtcare dollars. Wit te OAP HSA plan, you get te protection of a Medical benefit plan plus a tax-free Healt Savings Account tat you can use to elp pay for qualified medical expenses. You can witdraw money from your HSA to reimburse your medical expenses (including your deductible), or you can let your HSA grow and earn interest for future or retiree ealt expenses. Best of all, you own your HSA, so you keep it even if you cange ealt plans or jobs. And, at te end of te year, money left in te account rolls over to te next year. From job to job, plan to plan, your HSA goes wit you. Cigna OAP HSA $2,600 BENEFIT IN-NETWORK OUT-OF-NETWORK Annual Deductible Individual $2,600 $5,200 Annual Deductible Family $5,200 $10,400 Coinsurance 80% 50% Out-of-Pocket Maximum Individual (Includes Deductible) $6,500 $13,000 Out-of-Pocket Maximum Family (Includes Deductible) $13,000 $26,000 Office Visit 80% after deductible 50% after deductible Specialist Visit 80% after deductible 50% after deductible Teleealt Connection (AmWell and MDLIVE) 100% after deductible N/A Preventive Care 100% 50% after deductible Inpatient Hospital 80% after deductible 50% after deductible Outpatient Hospital 80% after deductible 50% after deductible Emergency Room 80% after deductible 80% after deductible PRESCRIPTION DRUG BENEFITS* All prescription drug expenses are subject to te calendar year deductible before te copay applies. Once te calendar year deductible as been satisfied, prescriptions will be subject to te copay below and to 50% for out-of-network expenses after te applicable copay. Generic $15 copay 50% Preferred Brand $25 copay 50% Nonpreferred Brand $40 copay 50% Specialty 80% up to $250 50% Mail Order 2 x retail N/A *Tis plan offers 100% coverage for certain preventive maintenance medications (generic and single-source brand), suc as medications for astma, ig colesterol, and ig blood pressure. Te deductible does not apply. Please refer to Cigna s 2018 Preventive List. 6

7 Cigna OAP Cigna offers a $1,000 OAP plan and a $1,200 OAP plan. Tese plans offer in-network and out-of-network benefits depending on wic provider you see. However, if you use an in-network provider, your benefits will be better. You will not need a referral from your primary care pysician to see a specialist. Cigna OAP $1,000 Cigna OAP $1,200 BENEFIT IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK Annual Deductible Individual $1,000 $5,000 $1,200 $2,000 Annual Deductible Family $2,000 $10,000 $3,600 $6,000 Coinsurance 80% 50% 70% 50% Out-of-Pocket Maximum Individual $5,000 $18,000 $6,200 $12,000 (Includes Deductible) Out-of-Pocket Maximum Family (Includes Deductible) $10,000 $36,000 $12,400 $24,000 Office Visit $20 copay 50% after deductible $25 copay 50% after deductible Specialist Visit $30 copay 50% after deductible $35 copay 50% after deductible Teleealt Connection (AmWell and MDLIVE) 100%, copay waived N/A 100%, copay waived Preventive Care 100% 50% after deductible 100% 50% after deductible Inpatient Hospital Outpatient Hospital Emergency Room (Copay Waived if Admitted) 80% after deductible 80% after deductible $250 copay, ten 100%, deductible applies 50% after deductible 50% after deductible $250 copay, ten 100%, deductible applies $250/admission, ten 70% after deductible 70% after deductible $150 copay, ten 70%, deductible applies N/A $500/admission, ten 50% after deductible 50% after deductible $150 copay, ten 70%, deductible applies PRESCRIPTION DRUG BENEFITS Generic $5 copay 50% $20 copay 50% Preferred Brand $40 copay 50% $40 copay 50% Nonpreferred Brand $80 copay 50% $70 copay 50% Specialty 80% up to $250 50% 70% up to $250 50% Mail Order 2 x retail N/A 2 x retail N/A 7

8 Healt Savings Account HSA Bank (a Cigna affiliate) is te designated bank for PDS Tec s Healt Savings Accounts. HSA Eligibility Enrolling in te OAP HSA plan provides you wit a personal HSA tat allows you to set aside pre-tax dollars to pay for out-of-pocket medical expenses. You are able to participate in an HSA if: You are covered by a qualified Hig Deductible Healt Plan, like PDS Tec s OAP HSA plan. You are NOT covered by your spouse s nonqualified traditional ealt plan, Flexible Spending Account, or Healt Reimbursement Account. You are NOT eligible to be claimed as a dependent on someone else s tax return. You are NOT enrolled in Medicare, TRICARE, or TRICARE for Life. (Remember, receiving Social Security benefits automatically enrolls you in Medicare Part A tere is no opting out.) You ave NOT received Veterans Administration benefits. You will receive a ealtcare payment card from HSA Bank to use for your qualified medical or dental expenses. Simply swipe te card, just like a credit card, and te amount is automatically deducted from your HSA. You must ave funds in te account to use te card, just like a bank account. You need to keep your receipts in case you are audited by te IRS. 8

9 Telemedicine Coice Is Good. More Coice Is Even Better. As part of your Medical plan, Cigna provides access to two teleealt services Amwell and MDLIVE. Cigna Teleealt Connection lets you get te care you need, including most prescriptions, for a wide range of minor conditions. Now you can connect wit a board-certified doctor via pone or secure video cat, witout leaving your ome or office, wen, were, and ow it works best for you! Coose wen: Day or nigt, weekday, weekend, or oliday. Coose were: Home, work, or on te go. Coose ow: Pone or video cat. Coose wom: Amwell or MDLIVE doctor. Say it s te middle of te nigt and your cild is sick. Or you re at work and not feeling well. If you preregister bot Amwell and/or MDLIVE, you can speak wit a doctor for elp wit: Sore troat. Fever. Ras. Headace. Cold and flu. Acne. Stomacace. Allergies. UTIs and more! Te Cost Savings Are Clear Televisits wit Amwell and MDLIVE can be a cost-effective alternative to a convenience care clinic or Urgent Care Center visit, and cost less tan going to te Emergency Room. And te cost of a pone or online visit is te same or less tan a visit wit your primary care provider. Remember, your teleealt services are available only for minor, non-life-treatening conditions. In an emergency, dial 911 or go to te nearest ospital. Signing Up Is Easy! Set up and create an account wit one or bot Amwell and/or MDLIVE Register at: AmWell go to or call MDLIVE go to or call Complete a medical istory using teir virtual clipboard Download te vendor app to your smartpone/mobile device Amwell and MDLIVE are available only for medical visits. For covered services related to mental ealt and substance abuse, you ave access to te Cigna Beavioral Healt network of providers. Go to to searc for a video teleealt specialist. Call to make an appointment wit your selected provider. A teleealt visit wit Cigna Beavioral Healt network provider costs te same as an in-office visit. 9

10 Voluntary Dental Benefits Te PDS benefit plan offers te following Dental plan options: Guardian DPPO Guardian DHMO Dental coverage is available on a voluntary basis, wic means tat you can elect Dental coverage witout electing Medical coverage. Te DHMO typically as fewer out-of-pocket expenses and requires using a network provider. Some areas ave a limited network of dentists. Please ceck te availability of dentists before enrolling in tis plan. Te list of providers can be found at Te DPPO offers benefits for any dentist of your coice. However, if you do not use a Guardian dentist, you could be balance-billed for amounts over te allowable amount. Below is a brief summary of benefits: Guardian DPPO Benefit Summary In-Network Out-of-Network Deductible $50 Period Calendar year Family Limit Tree per family Waived Preventive Annual Maximum $1,250 plus maximum rollover* Maximum Rollover Tresold $600 Rollover Amount $300 Account Limit $1,250 Claim Payment Basis Negotiated fee scedule UCR 90t Network DentalGuard Preferred 100% 100% Oral exams (twice/12 mos.) Cleanings (twice/12 mos.) Coinsurance Preventive X-rays (full-mout series once/36 mos.) Fluoride Treatment (to age 19, twice/ 12 mos.) Sealants (to age 16, once/36 mos.) Space maintainers/armful abit appliances 80% 80% Fillings Perio Maintenance Procedure (twice/12 mos.) Periodontal Services (e.g., scaling Coinsurance Basic and root Pplaning) Periodontal surgery Simple extractions Complex extractions Single crowns Endodontic services (e.g., root canal) General anestesia Inlays, onlays, and veneers 50% 50% Coinsurance Major Bridges and Dentures and Repair and Maintenance of Crowns, Bridges and Dentures TMJ Coinsurance Ortodontia 50% for cildren 50% for cildren (Ortodontia in progress covered) (Ortodontia in progress covered) Ortodontia Lifetime Maximum $1,000 $1,000 *If a member submits at least one claim and stays under te claims tresold of $600, a part of te unused maximum will be rolled over for use in future years, up to $300. DON T FORGET You may ave additional dollars to use in 2018 from Guardian s maximum rollover. 10

11 DHMO Managed DentalGuard* Deductible Coinsurance Annual Maximum Benefit DHMO Managed DentalGuard No deductible You pay a copay for eac covered procedure. See Plan Details for more information. Unlimited Office Visit Copay $5 Dependent Age Limits 26 Anestesia Plan Details You Pay Network Only Restrictions apply Bleacing Cosmetic Care $165 Bridges and Dentures $190 $220 Cleaning (Propylaxis) Frequency $0 2 times in 12 monts Fillings $5 Fluoride Treatments Limits $0 No age limits Inlays, Onlays and Veneers $70 $150 Oral Exams $0 Ortodontia Limits Adults and Cild(ren) $1,500 $2,800 Perio Surgery $195 Periodontal Maintenance Frequency $15 2x in 12 monts (standard) Repair and Maintenance of Crowns, Bridges, and Dentures $20 $35 Root Canal $75 $150 Scaling and Root Planing (per quadrant) $30 Sealants (Per Toot) $5 Simple Extractions $10 Single Crowns $180 Surgical Extractions $45 $70 X-Rays $0 *If te DHMO is not available in your area, it will not be an option. IMPORTANT 11 Ortodontia in progress Please note tat ortodontia in progress is not covered under te DHMO plan. If you are currently in treatment for ortodontia, enrolling in te Guardian DHMO does not cange te terms of te contract you signed wit your provider and you may now be responsible for additional costs related to te overall treatment plan. Please consult wit your provider to determine any additional costs for wic you may now be responsible. If you wis to ave any remaining treatment covered, you may consider enrolling in te PPO plan.

12 Voluntary Vision Benefits Te PDS Benefit Plan offers Vision coverage tat provides benefits for you and your family troug Vision Service Plan (VSP). Tis coverage includes a network of providers and a scedule of copays for various vision needs. Vision Service Plan does not issue ID cards. Below is a brief summary of benefits. VSP Voluntary Vision In-Network Out-of-Network Frequency of Service Vision Exam 12 monts 12 monts Eyeglass Lenses 12 monts 12 monts Frames 24 monts 24 monts Contact Lenses 12 monts 12 monts Benefits Plan Pays: Vision Exam $25 copay Up to $45 Lenses (Pair) $25 copay Single Vision 100% Up to $30 Bifocal 100% Up to $50 Trifocal 100% Up to $65 Frame 100% up to $200 Up to $70 Elective Contact Lenses 100% up to $175 Up to $105 Oter Lens Options Up to 20% discount N/A Additional Glasses Up to 20% discount N/A Members will ave a maximum copay, up to $60, for te fitting evaluation. Allowance will be applied 100% toward contacts. Employee Assistance Program For tose enrolled in te Medical plan, Cigna administers te Employee Assistance Program. Te Cigna EAP offers tree faceto-face counseling sessions, teleponic resources, visits wit clinicians, work/life support, time-saving referrals, legal/financial consults, and wellness discussions. Tese are just some of te tools Cigna provides to elp reduce stress and support your overall wellness. You will ave access to elp 24 ours a day, 7 days a week, 365 days a year. Get in touc. Call , or visit and enter your employer ID: pdstec. 12

13 Voluntary Life and AD&D If tis is your first opportunity to enroll in Voluntary Life and AD&D, you may purcase 1, 2, or 3 x your salary up to a maximum of $300,000. Te guaranteed issue amount is $100,000. If you ave already elected coverage, you can increase te amount during Open Enrollment by one increment. For example, if you ave elected 1 x salary, you may increase tis to 2 x salary up to te guaranteed issue amount noted above. Employees wo ave previously been declined, deemed incomplete, or ave witdrawn evidence of insurability will not be eligible. If you elect Voluntary Life insurance for yourself, you may also purcase coverage for your spouse. Spouse coverage can be up to 50% of te employee s coverage in increments of $10,000 up to a maximum of $50,000. Te guaranteed issue amount is $30,000. Dependent cild coverage may also be purcased wit one of te following options: $5,000 or $10,000. Prepaid Legal Plan Fully covered legal service is available for a wide range of personal matters. Te Prepaid Legal Plan provides easy access to professional legal services at an affordable price. Unlimited access to plan attorneys for a wide range of legal matters, including consultation (pone and in person), document preparation, and representation in many common legal matters. Easy access to plan attorneys. Convenient locations and office ours to suit your preferences. Covered Services Wills and Estate Planning Document Preparation Family Matters Wills and Codicils Deeds Uncontested Adoption Powers of Attorney Mortgages Uncontested Guardiansip Living Wills Promissory Notes Name Cange Living Trust Real Estate Matters Sale or Purcase of a Home Refinancing of a Home Tenant Negotiations (as tenant) Debt Collection Defense/Defense of Civil Lawsuits Civil Litigation Defense Administrative Hearings Incompetency Defense Eviction Defense (as tenant) Tere are no limits on usage for covered services. Some exclusions apply. 13

14 Voluntary Long Term Disability Benefits Wat Your Benefits Cover Long Term Disability Coverage amount 60% of salary to maximum $6,000/ mont Maximum payment period: Maximum lengt of time you can receive disability benefits. Social Security Normal Retirement Age Accident benefits begin: Te lengt of time you must be disabled before benefits begin. Day 91 Illness benefits begin: Te lengt of time you must be disabled before benefits begin. Day 91 Evidence of Insurability: A ealt statement requiring you to answer a few medical istory questions. Healt statement may be required Guaranteed Issue: Te guarantee means tat you are not required to answer ealt questions to We Guarantee Issue $6,000 in coverage qualify for coverage up to and including te specified amount, wen you sign up for coverage during te initial enrollment period. Minimum work ours/week: Minimum number of ours you must regularly work eac week to be 30 eligible for coverage. Preexisting conditions: A preexisting condition includes any condition/symptom for wic you, in te specified time period prior to coverage in tis plan, consulted wit a pysician, received treatment, or took prescribed drugs. Premium waived if disabled: Premium will not need to be paid wen you are receiving benefits. Survivor benefit: Additional benefits payable to your family if you die wile disabled. 12 monts look-back; 12 monts after exclusion Yes 3 monts Understanding Your Benefits (Some Information May Vary by State) Disability (Long-Term): For te first two years of disability, you will receive benefit payments wile you are unable to work in your own occupation. After two years, you will continue to receive benefits if you cannot work in any occupation based on training, experience, and education. Earnings definition: Your covered salary excludes bonuses and commissions. Special limitations: Provides a 24-mont benefit limit for specific conditions, including mental ealt and substance abuse. Oter conditions, suc as cronic fatigue, are also included in tis limitation. Refer to your contract for details. Work incentive: Te plan benefit will not be reduced for a specified amount of monts so tat you ave part-time earnings wile you remain disabled, unless te combined benefit and earnings exceed 100% of your previous earnings. 14

15 How to Enroll Employees can enroll witin teir first 90 days online at ttps://ess.pdstec.com/lawson/portal. Te username is your employee ID number, and te password will be te MMYYYY of your date of birt. Questions? Benefits Department You may also visit for furter information. Required Annual Notices PDS Tec, Inc., is required to provide you wit te following Annual Notices, wic will be posted to te website, or you can call te Benefits Department for paper copies. Medicare Part D Creditable Coverage Notice HIPAA Compreensive Notice of Privacy Policy and Procedures Notice of Special Enrollment Rigts Women s Healt and Cancer Rigts Notice Medicaid and te Cildren s Healt Insurance Program (CHIP) Offer of Free or Low-Cost Healt Coverage to Cildren and Families IMPORTANT! Remember tat Open Enrollment is open for two weeks only. Your annual elections or canges must be submitted online by 11:59 p.m. on December 3,

16 2018 PDS Tec Engineering and Information Services Enrollment Guide About tis bulletin: Tis bulletin is publised for te employees of PDS Tec, Inc., and is only a igligt of our benefits. Official plan and insurance documents actually govern your rigts and benefits under eac plan. If any discrepancy exists between tis bulletin and te official documents, te official documents will prevail. KC: 35782