Benefits Guide

Transcription

1 PART-TIME EMPLOYEES Benefits Guide

2 Part-Time Employee Benefits June 1, 2017 May 31, 2018 If you have questions regarding Call Click TeleHealth New Benefits Group #NB84111D (800) Dental Delta Dental (800) Vision VSP (800) Accident & Critical Illness Allstate (800) Payment Information and Enrollment Tall Tree Administrators (801) Questions, General Information Voluntary Benefits Customer Service GBS Benefits, Inc. (801) This communication highlights some of your benefit plans. Your actual rights and benefits are governed by the official plan documents. If any discrepancy exists between this communication and the official plan documents, the plan documents will prevail. We reserve the right to change any benefit plan without notice. Benefits are not a guarantee of employment.

3 What s Inside In response to Part-Time employee feedback, this booklet outlines insurance options that will be available for Part-Time employees. TeleHealth Dental Insurance Vision Insurance Accident & Critical Illness The benefits that will be available for Part-Time employees are a true group product, available at group rates, due to your service with Sorenson Communications and CaptionCall. As such, they are available on an annual basis; meaning, this is an open enrollment opportunity. The elections made will be in effect for 1 year, and will have the same life event options that other group plans have (marriage, divorce, birth of a baby etc). These types of events would all allow employees to make a life event change within 30 days of the event, or within 30 days of the loss or obtaining other coverage. Employees are also able to have COBRA continuation rights for some of these products. These elections will not be made through ADP, they will be made through a system provided by Tall Tree Administrators. You are not required to make an election or to waive the coverage, this is available on a completely voluntary basis. The following booklet contains enrollment instructions, plan information, and direct billing information (the premium is not payroll deducted). Please also note that there is a $4.75 fee that goes to the administration of the plan, this is whether you elect one plan, two plans or all four. It is not an administrative fee for each independent plan. Important Information 4 Enrollment & Eligibility 5 Online Instructions 6 Telehealth 7 Dental 10 Vision 13 Accident & Critical 16 Premiums 19 While TeleHealth is not a substitute for your own Medical plan, we would like to remind you of our partnership with Enroll 365. Enroll 365 is available to assist our part-time employees in navigating the health care landscape. Enroll 365 services are available to our employees at no cost. They are a resource to assist you in finding a medical health plan that best meets your needs and to assist you in the enrollment process in your local insurance marketplace. This is a great resource for helping you find the right plan for you and for your family. Enroll 365 can be contacted at

4 Important Information 4

5 Enrollment & Eligibility Welcome We are committed to providing our employees with quality benefits programs that are comprehensive, flexible and affordable. Giving our employees the best in benefit plans is one way we can show you that as an employee, YOU are our most important asset. Eligible employees have many benefit plans to choose from, so we ask that you read this benefits guide carefully to help you make the benefit elections that are the best fit for you and your family. Know Your Benefits Making wise decisions about your benefits requires planning. By selecting benefits that provide the best care and coverage, you can optimize their value and minimize the impact to your budget. The best thing you can do is shop for benefits carefully, using the same type of decision-making process you use for other major purchases. Take advantage of the tools available to you: That includes this guide, access to plan information, provider directories, and enrollment materials. Be a smart shopper: If you were buying a car or purchasing a home, you would do a lot of research beforehand. You should do the same for benefits Don t miss the deadline & keep record of your enrollment: Pay attention to the enrollment deadline and be sure to make your benefit elections in a timely manner. Remember: Once the enrollment period has ended, you may not make or change your benefit elections, unless you experience a qualified life event. Who is Eligible? If you are a part-time employee, you are eligible for Telehealth, Dental, Vision, Accident and Critical Illness. Coverage will begin on the first day of the month following 60 days. You may also enroll your eligible dependents in the same plans you choose for yourself. Eligible dependents include your legal spouse/domestic partner and your natural, adopted or step-child(ren). The dependent age limit for children on Telehealth, dental and vision plan is age 26, but may vary for other benefits offered. When to Enroll You can enroll for coverage as a new hire, or during our annual open enrollment period. Outside of the annual open enrollment period, the only time you can change your coverage is if you experience a qualifying life event. How to Make Changes Once you enroll in or decline benefits, you will not be able to make any changes to your elections until our next annual open enrollment period, unless you experience a qualified life event. Qualified life events include, but are not limited to: Change in your legal marital status Birth, adoption, placement for adoption or legal guardianship of a child Death of a dependent Change in child s dependent status Qualified life events must be reported to us within 30 days of the event. It is your responsibility to notify us when you have a qualified life event and would like to make changes to your benefit elections. Please do not miss this important deadline! When Coverage Ends Coverage will end on the last day of the month in which your employment ends, or you stop paying for coverage. Your dependent(s) coverage ends when your coverage ends, or the last day of the month in which the dependent is no longer eligible. 5

6 1. L og in to your account a. Finding the open enrollment web page Tall Tree Administrators Open Enrollment Site i. Open your web browser and enter in the following URL ii. Once the web page has loaded, click the red button, located on the left of your screen that is labeled Plan Participants iii. Click the green underlined link that contains the text Tall Tree Enrollment System S S N B N ( ( ( 4 ) S ( 5 ) ( 6 ) ( ( ( 9 ) B S S B b. Enter in your ocial ecurity umber in the Member ID or SSN textbox c. Click Begin Enrollment d. Enter in your Date of irth in the password field using a mmddyyyy ( ) format 2. av ig ating the Tall Tree Administrator s open enrollment site a. Primary s Information i. Contact Info Tab 2) 1. Enter in a valid address and cell phone number ii. Address Tab 3) 1. If your information is already in our system, use the copy buttons to copy addresses. Otherwise, manually enter in your mailing and physical address b. Dependents i. Dependents Tab 1. If your dependents are already in our system, this tab would then be prepopulated with their information. 2. If your dependents are not in our system, click add dependent and enter in the dependent information. c. Cov erag e election i. TelaMedical Tab Dental Tab Vision Tab 7) 1. Choose to Waive, Maintain, or Enroll 2. If enrolling, select cov erag e type ii. Accident Tab 8) Critical Illness Tab 1. Choose to Waive, Maintain, or Enroll 2. If enrolling, select cov erag e type a. eneficiary election i. electing eneficiaries 1. Click and drag a beneficiary from the right column to the a dotted square in ii. iii. iv. the left column Adding Additional B eneficiaries 1. Click the Create A Beneficiary button and fill out the form 2. Click and drag the new beneficiary to an empty slot Adding Additional B eneficiary S lots 1. Click the + sign button at the bottom Allocating B eneficiary Percentag e 1. Use the arrows or manually enter a share percentage in the textboxes located next to the selected beneficiaries. ( B B d. Rev iew Enrollment Tab 10) i. Click Review Enrollment Selections to progress to the Review Enrollment Page e. Rev iew Enrollment Continued i. After reviewing all the information on the screen and confirming its correctness, click the submit enrollment button that is located on both the top and bottom of your screen. 3. Processing Payment Information a. illing Information i. Personal and illing Information 1. Select a payment method 2. Ensure that the displayed information is correct. b. Payment Pag e i. Enter in the req uired information ii. Solve the Captcha iii. Click the confirm payment button 6

7 Telehealth 7

8 It s a WIN-WIN Upgrade your employee benefits with a low-cost non-traditional benefit program. Your employees save time and money - you boost morale and improve employee retention. On demand healthcare - whenever, wherever in the U.S. U.S. board-certified doctors with an average 15 years practice experience Get diagnosis, treatment options and prescription if necessary 24/7 access by phone or online video consult 16 minutes average call back time Consultations for all ages - from children to seniors IMAGINE THIS... You wake up one morning with cold-like symptoms. You don t want to take time off work, but you need care now. What can you do? ER OR URGENT CARE Drive to the nearest office while sick TELEHEALTH Request a consultation from work or home 16 Wait hours before seeing a doctor A doctor calls you back in 16 minutes, on average x$ Pay high ER and urgent care fees per Telehealth consultation WELCOME TO TELEHEALTH! Help employees save time and money with 24/7 access to a doctor by phone or online video consult. 8

9 The time is now. This program was designed specifically to improve productivity, decrease absenteesim, and boost morale... without straining your bottom line! TELEHEALTH 73% of Americans have trouble receiving timely medical care without having to visit the emergency room. Help your members save time and money with 24/7 access to a doctor by phone or online video consult anytime, anywhere in the U.S. with no consultation fee. Doctors offer a diagnosis, treatment options and prescription if necessary. By using Telehealth instead of going to an urgent care clinic or ER, members cut unnecessary out-of-pocket costs and time wasted in crowded waiting rooms. Doctors Online Nurseline Your members have a place to turn to for trusted advice and information when they need it most. Rest assured highly trained registered nurses are on-call 24/7 to answer questions for non-urgent concerns. Nurses can offer self-care tips, direct members to the appropriate care for immediate attention or offer advice on how to ease common problems such as a sore shoulder. Nurseline can help with everything from fevers or flu symptoms to at-home remedies or side effects of medications. Your members have access to a team of medical professionals by or smartphone app. Doctors Online gives members a trustworthy place to get their healthcare questions answered through a secure website 24/7. It s the fast, easy way for members to get health information from a resource they can trust. All of these services are now available to you and your employees! Call us to find out more today: Disclosures: This plan is NOT insurance. The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under the Affordable Care Act or Massachusetts M.G.L. c. 111M and 956 CMR This discount card program contains a 30 day cancellation period. Member shall receive a reimbursement of all periodic membership fees if membership is cancelled within the first 30 days after the effective date. Discount Medical Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box , Dallas, TX , Website to obtain participating providers: MyMemberPortal. com. Telehealth operates subject to state regulation and may not be available in certain states. Consults are not available outside of the U.S. Not available to FL, KS, UT, VT or WA residents. 9

10 Dental Delta Dental 10

11 DELTA DENTAL PPO : YOUR SMILE IS COVERED GO PPO Visit a PPO 1 dentist to maximize your savings. 2 These dentists have agreed to reduced fees, and you won t get charged more than your expected share of the bill. 3 Find a PPO dentist at deltadentalins.com. 4 ACCESS ONLINE SERVICES Get information about your plan anytime, anywhere by signing up for an Online Services account at deltadentalins.com. This free service lets you check benefits and eligibility information, find a network dentist and more. CHECK IN WITH EASE You don t need a Delta Dental ID card when you visit the dentist. Just provide your name, birth date and enrollee ID or social security number. If your family members are covered SAVE WITH A PPO DENTIST PPO 1 In Texas, Delta Dental Insurance Company offers a Dental Provider Organization (DPO) plan. 2 You can still visit any licensed dentist, but your out-of-pocket costs may be higher if you choose a non-ppo dentist. Network dentists are paid contracted fees. 3 You are responsible for any applicable deductibles, coinsurance, amounts over plan maximums and charges for non-covered services. 4 Verify that your dentist is a PPO dentist before each appointment. under your plan, they will need your name, birth date and enrollee or social security number. Prefer to take a paper or electronic ID card with you? Simply sign in to Online Services, where you can view or print your card with the click of a button. If you re covered under two plans, ask your dental office to include information about both plans with your claim, and we ll handle the rest. UNDERSTAND TRANSITION OF CARE Did you start on a dental treatment plan before your PPO coverage kicked in? Multi-stage procedures are only covered under your current plan if treatment began after your plan s effective date of coverage. 5 You can find this date by logging in to Online Services. NEWLY COVERED? Visit deltadentalins.com/welcome. NON-PPO LEGAL NOTICES: Access federal and state legal notices related to your plan at deltadentalins.com/about/legal/index-enrollee.html 5 Applies only to procedures covered under your plan. If you began treatment prior to your effective date of coverage, you or your prior carrier are responsible for any costs. Group- and state-specific exceptions may apply. Enrollees currently undergoing active orthodontic treatment may be eligible to continue treatment under Delta Dental PPO. Review your Evidence of Coverage, Summary Plan Description or Group Dental Service Contract for specific details about your plan. Copyright 2015 Delta Dental. All rights reserved. HL_PPO_2col #92056R (rev. 10/15) E deltadentalins.com/enrollees 11 WE KEEP YOU SMILING

12 Plan Benefit Highlights for: Sorenson Communications - CaptionCall - Part Time Employees Group No: Effective Date: 5/1/2016 Eligibility Deductibles Deductibles waived for Diagnostic and Preventive (D & P)? Maximums D & P counts toward maximum? Waiting Period(s) Primary enrollee, spouse (includes domestic partner) and eligible dependent children to the end of the month dependent turns age 26 $50 per person / $150 per family each plan year Yes $1,000 per person each plan year Yes Basic Benefits None Major Benefits 6 Months Prosthodontics 6 Months Benefits and Covered Services* Delta Dental PPO dentists** Non-Delta Dental PPO dentists** Diagnostic & Preventive Services (D & P) 100 % 80 % Exams, cleanings, x-rays and sealants Basic Services Fillings 80 % 60 % Endodontics (root canals) Covered Under Basic Services 80 % 60 % Periodontics (gum treatment) Covered Under Basic Services 80 % 60 % Oral Surgery Covered Under Basic Services 80 % 60 % Major Services Crowns, inlays, onlays and cast 50 % 40 % restorations Prosthodontics Bridges and dentures 50 % 40 % * Limitations or waiting periods may apply for some benefits; some services may be excluded from your plan. Reimbursement is based on Delta Dental maximum contract allowances and not necessarily each dentist s submitted fees. ** Reimbursement is based on PPO contracted fees for PPO dentists, Delta Dental Premier contracted fees for Premier dentists and the program allowance for non-delta Dental dentists. Delta Dental Insurance Company 1130 Sanctuary Parkway, Suite 600 Alpharetta, GA Customer Service deltadentalins.com Claims Address P.O. Box 1809 Alpharetta, GA This benefit information is not intended or designed to replace or serve as the plan s Evidence of Coverage or Summary Plan Description. If you have specific questions regarding the benefits, limitations or exclusions for your plan, please consult your company s benefits representative. HLT_PPO_2COL_DDIC (Rev. 03/22/2016) 12

13 Vision VSP 13

14 Protect your vision with VSP. Get the best in eye care and eyewear with SORENSON COMMUNICATIONS - CAPTION CALL - PART TIME EMPLOYEES and VSP Vision Care. Why enroll in VSP? We invest in the things you value most the best care at the lowest out-of-pocket costs. Because we re the only national not-for-profit vision care company, you can trust that we ll always put your wellness first. You ll like what you see with VSP. Value and Savings. You ll enjoy more value and the lowest out-of-pocket costs. High Quality Vision Care. You ll get the best care from a VSP provider, including a WellVision Exam the most comprehensive exam designed to detect eye and health conditions. Choice of Providers. The decision is yours to make choose a VSP doctor, a participating retail chain, or any out-of-network provider. Great Eyewear. It s easy to find the perfect frame at a price that fits your budget. Enroll in VSP today. You'll be glad you did. Contact us vsp.com Using your VSP benefit is easy. Register at vsp.com Once your plan is effective, review your benefit information. Find an eye care provider who s right for you. To find a VSP provider, visit vsp.com or call At your appointment, tell them you have VSP. There s no ID card necessary. If you d like a card as a reference, you can print one on vsp.com. That s it! We ll handle the rest there are no claim forms to complete when you see a VSP provider. Choice in Eyewear From classic styles to the latest designer frames, you ll find hundreds of options. Choose from featured frame brands like Anne Klein, bebe, Calvin Klein, Flexon, Lacoste, Nike, Nine West, and more 1. Visit vsp.com to find a VSP provider who carries these brands. 14

15 Your VSP Vision Benefits Summary SORENSON COMMUNICATIONS - CAPTION CALL - PART TIME EMPLOYEES and VSP provide you with an affordable eye care plan. Benefit WellVision Exam Description Your Coverage with a VSP Provider Focuses on your eyes and overall wellness VSP Provider Network: VSP Choice Copay Frequency $10 Every 12 months Prescription Glasses Frame Lenses Lens Enhancements $140 allowance for a wide selection of frames $160 allowance for featured frame brands 20% savings on the amount over your allowance $75 Costco frame allowance Single vision, lined bifocal, and lined trifocal lenses Polycarbonate lenses for dependent children Standard progressive lenses Premium progressive lenses Custom progressive lenses Average savings of 20-25% on other lens enhancements $25 Included in Prescription Glasses Included in Prescription Glasses $55 $95 - $105 $150 - $175 See frame and lenses Every 12 months Every 12 months Every 12 months Contacts (instead of glasses) $140 allowance for contacts; copay does not apply Contact lens exam (fitting and evaluation) Up to $60 Every 12 months Diabetic Eyecare Plus Program Services related to diabetic eye disease, glaucoma and age-related macular degeneration (AMD). Retinal screening for eligible members with diabetes. Limitations and coordination with medical coverage may apply. Ask your VSP doctor for details. $20 As needed Extra Savings Your Monthly Contribution Glasses and Sunglasses Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details. 20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of your last WellVision Exam. Retinal Screening No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam Laser Vision Correction Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities $7.22 Member only $14.43 Member + 1 $15.43 Member + children $20.41 Member + family Your Coverage with Out-of-Network Providers Visit vsp.com for details, if you plan to see a provider other than a VSP network provider. Exam... up to $45 Frame... up to $70 Single Vision Lenses... up to $30 Lined Bifocal Lenses... up to $50 Lined Trifocal Lenses... up to $65 Progressive Lenses... up to $50 Contacts... up to $105 Coverage with a participating retail chain may be different. Once your benefit is effective, visit vsp.com for details. Coverage information is subject to change. In the event of a conflict between this information and your organization s contract with VSP, the terms of the contract will prevail. Based on applicable laws, benefits may vary by location. Contact us vsp.com 1 Brands/Promotion subject to change Vision Service Plan. All rights reserved. VSP, VSP Vision care for life, and WellVision Exam are registered trademarks of Vision Service Plan. Flexon is a registered trademark of Marchon Eyewear, Inc. All other company names and brands are trademarks or registered trademarks of their respective owners. 15

16 Accident & Critical Illness Allstate 16

17 Group Accident Insurance ( O ff- the- Job) Accident insurance can help provide you with a cushion to help cover expenses and living costs when you get hurt unexpectedly. While you can count on health insurance to cover medical expenses, it doesn t usually cover indirect costs that can arise with a serious or even not-so-serious injury. You may end up paying out of your own pocket for things like transportation, over-the-counter medicine, day care or sitters and extra help around the house. With accident insurance, the benefits you receive can help take care of these extra expenses and anything else that comes up. With Allstate Benefits Group Accident Insurance you can have peace of mind knowing Coverage is guaranteed issue no evidence of insurability required at initial enrollment. Benefits are paid directly to you unless assigned to someone else. Benefits are paid in addition to any other coverage. Coverage is portable and may be continued if the employee leaves the group. Employee or Family coverage available. Plan highlights include* - Accidental Death & Dismemberment Cov erag e (Benefit amount payable is multiplied by 5 when accidental death is the result of a Common Carrier) B asic Plan Up to $40,000 Employee; $20,000 Spouse; $10,000 Children Dislocations & F ractures Up to $4,000 Ambulance $200 Regular/$600 Air Accident Physician' s Treatment $100 X - Rays $200 S O B Emerg ency Room erv ices $200 Hospital Confinement $1,500 ($200/day) utpatient Physician' s Treatment enefit $50 Outpatient Physician s Treatment Benefit of $50 available for visiting a doctor on an outpatient basis for any reason (can be claimed up to twice per calendar year, per person or four times with dependent coverage) L O + S + F Monthly Premiums ow Plan Employee nly $11.64 Employee pouse $18.09 Employee Child( ren) $27.45 amily $

18 Group Critical Illness Insurance Critical Illness insurance provides a lump sum benefit to help you cover the out-of-pocket expenses associated with a critical illness diagnosis. With Allstate Benefits Group Critical Illness Insurance you can have peace of mind knowing - Coverage is guaranteed issue no evidence of insurability required at initial enrollment (enrolling after the enrollment period requires evidence of insurability). Benefits are paid directly to you unless assigned. Coverage that supplements your existing medical benefits. Coverage is portable and may be continued if Employee leaves the group. Covered dependents receive 50% of the basic-benefit amount shown in your employer-selected plan, and 100% of the Wellness Benefit. Plan Highlights include* - Coverage for diagnosis of Heart Attack, Stroke, Coronary Artery By-Pass Surgery, Major Organ Transplant, End Stage Renal Failure, Invasive Cancer, and Carcinoma In Situ. Wellness Benefit pays $50 per covered person, per year, for completing a covered wellness exam. Monthly Premiums $10,000 BASIC BENEFIT AMOUNT non-tobacco tobacco Ages EE & EE + CH EE+SP & Family Ages EE & EE + CH EE+SP & Family $5.32 $ $7.79 $ $9.30 $ $14.41 $ $16.85 $ $29.69 $ $29.53 $ $49.74 $ $47.65 $ $81.54 $ $61.71 $ $ $ Allstate Policyholder Contact Information Allstate Benefits - Allstate Benefits Customer Care Center at: For questions regarding Allstate Benefits Claims: or to file electronically 18

19 Premiums 19

20 Premiums Part Time Employees June 1, 2017 May 31, 2018 TeleHealth New Benefits Status Total Premium Per Month Employee & Dependents $5.00 Dental Delta Dental Status Total Premium Per Month Employee Only $32.91 Employee + 1 $58.59 Employee & Family $ Vision VSP Status Total Premium Per Month Employee $7.22 Employee + Spouse $14.43 Employee + Children $15.43 Family $20.41 Accident Allstate Status Total Premium Per Month Employee $11.64 Employee + Spouse $18.09 Employee + Child(ren) $27.45 Family $34.38 Ages Non-tobacco EE & EE + CH Critical Illness Allstate Non-tobacco EE + SP & Family Tobacco EE & EE + CH Tobacco EE + SP & Family $5.32 $8.59 $7.79 $ $9.30 $14.58 $14.41 $ $16.85 $25.90 $29.69 $ $29.53 $44.93 $49.74 $ $47.65 $72.11 $81.54 $ $61.71 $93.18 $ $