Enrollment Procedure

Transcription

1 2017 Benefit Guide Enrollment Procedure Due to Federal Regulations, all benefit eligible employees are REQUIRED to enroll online to confirm their choices. This includes employees who are not making any changes or waiving all benefits. Start enrollment: The elections you make will be effective from March 1, 2017 through February 28, Benefit Plan Support: Explain My Benefits (EMB) ; Option 1 Hours: 9:00 am 5:00 pm EST Online Support: Human Resources Hours: 8:00 am 4:30 pm CST

2 2017 CENERGISTIC 2 MEDICAL & PRESCRIPTION DRUG BlueCross BlueShield: BlueChoice PPO Network Preferred Pharmacy: Walgreens This plan is considered a High Deductible Health Plan which allows you to also enroll in a Health Savings Account BlueChoice PPO Benefits In-Network Out-of-Network Annual Deductible Individual $3,500 $7,000 Family $7,000 $14,000 Coinsurance 20% 40% Annual Out of Pocket Max (Includes deductibles) Individual $5,000 $10,000 Family $10,000 $20,000 Physician Services Primary Physician Office Visit 20% after Deductible 40% after Deductible Specialist Physician Office Visit 20% after Deductible 40% after Deductible Lab, X-rays without Office Visit 20% after Deductible 40% after Deductible Preventive Care Services Covered 100% 30% Emergency Room Services 20% after Deductible 20% after Deductible Inpatient/Outpatient Services 20% after Deductible 40% after Deductible Prescription Drugs 20% after Deductible 20% after Deductible (based on the greater of annualized gross or W-2 income) Employee Only Employee/Spouse Employee/Child(ren) Family Monthly Payroll Deductions <$80,000 $80,000 - $129,999 $130,000 - $179,999 $180,000 or More $69.00 $ $ $ $92.00 $ $ $ $ $ $ $ $ $ $ $1,030.00

3 2017 CENERGISTIC 3 HEALTH SAVINGS ACCOUNT What is a Health Savings Account (HSA)? HSAs are special pre-tax dollar accounts available to individuals enrolled in a High Deductible Health Plan. HSAs allow you to set aside money that is not taxed, and then use that money to pay for health related expenses. Qualified expenses must be incurred to maintain the health of the accountholder or the accountholder s spouse. Who is eligible for a HSA Account? Individuals who are covered by a HSA-compatible health plan are qualified if they are: Not covered by any other non HSA-compatible health plan. Not claimed as a dependent on another person s tax return (excluding spouses per Internal Revenue Code). Not enrolled in Medicare A or B (once your eligible for Medicare you cannot contribute to an HSA but you can still be enrolled in the HDHP). Contributions to your HSA Account Maximum total contributions for 2017 are $3,400 for individuals and $6,750 for those with dependent coverage. An additional $1,000 may be contributed by anyone over the age of 55. You can only withdraw up to the amount in your HSA account but any unused funds roll over from year to year. You do not lose any funds if they are not used by the end of the year.

4 2017 CENERGISTIC 4 FLEXIBLE SPENDING ACCOUNT (FSA) Limited-purpose flexible spending account For those participating in an HSA, a limited-purpose health flexible spending account (referred to as a limited-purpose FSA) is much like a typical, general-purpose health FSA. However, under a limited-purpose FSA, eligible expenses are limited to qualifying dental and vision expenses for you, your spouse, and your eligible dependents. Here s how a limited-purpose FSA works. Money is set aside from your paycheck before taxes are taken out. You can then use your pre-tax FSA dollars to pay for eligible vision or dental expenses throughout the plan year. You save money on expenses you re already paying for, like dental checkups, vision exams, eyeglasses, and much more. If you enroll in the Health Savings Account, the IRS does not permit you to enroll in the Traditional Health Care FSA. All medical reimbursements must be paid through your HSA. The annual maximum that you may contribute to your limited-purpose FSA with Cenergistic is $2,600. Traditional Healthcare FSA The Healthcare FSA is used to reimburse out-of-pocket medical, dental, and vision expenses incurred by you and your tax dependents. This includes your insurance deductibles, co-payments, co-insurance and prescription costs. The maximum that you can contribute to the Traditional Healthcare FSA with Cenergistic is $2,600. NOTE: You will have 90 days after the plan year ends to use any funds left in your healthcare FSA. Any amount remaining will be forfeited. Dependent Care FSA The Dependent Care FSA may be used to reimburse expenses related to the care of eligible dependents while you and your spouse work. The annual maximum that you may contribute to your Dependent Care FSA with Cenergistic is $5,000 if you are a single employee or married filing jointly, or $2,500 if you are married and filing separately.

5 2017 CENERGISTIC 5 DENTAL BlueCare Dental Plan In-Network Deductible (Calendar Year) $50 Individual & $150 Family Preventive Services Cleaning, Exam, X-Rays Fluoride Treatment Basic Services Sealants, Space maintainers, Fillings, Simple Extractions 100% (Deductible waived) 80% (After Deductible) Major Services Root Canal, Gum Disease, Oral Surgery, Crowns, Bridges Annual Maximum Orthodontics 50% (After Deductible) $1,000 Not Covered Your Cost Per Month Employee Only $29.92 Employee + Spouse $59.83 Employee + Child(ren) $74.95 Employee + Family $115.23

6 2017 CENERGISTIC 6 VISION VSP In-Network Exam Copay $10 Prescription Glasses Copay $25 Lenses per pair Single vision Bifocal Trifocal Contact Lenses (in lieu of glasses) Frames Laser Vision Correction Service Frequency Exams Lenses (glasses or contacts) Frames $25 copay $25 copay $25 copay $130 retail allowance Up to $150 & 20% off any amount over allowance Average 15% off regular price or 5% off of promotional price 12 months 12 months 24 months Your Cost Employee Only Employee + Spouse Employee + Child(ren) Family Per Month $7.48 $11.97 $12.22 $19.70

7 2017 CENERGISTIC 7 VOLUNTARY LIFE INSURANCE VOLUNTARY TERM LIFE & DEPENDENT LIFE You may elect additional life insurance in $10,000 increments, not exceeding the lesser of 5 times your annual salary or $500,000. Your spouse may be insured in $5,000 increments not to exceed $250,000 or 50% of the employee life amount. Your eligible dependent children may be insured for $500 from ages 14 days up to 6 months of age. Eligible dependent children ages 6 months to 26 years may be insured for up to $10,000. *Evidence of Insurability (EOI) will be required for any elections made during open enrollment over the guaranteed issue. You will find the Sun Life Enrollment Form, Evidence of Insurability (EOI) Form and Life summary with rates on your ADP home page. Sun Life offers a Portability Privilege, in the event your employment with Cenergistic ends. You may apply for portable coverage on you and your dependents life, up to the amount of coverage currently maintained through Cenergistic. There are certain restrictions that apply, so please consult with Human Resources for more information about this coverage. BENEFICIARY It is IMPORTANT that you check to be sure your beneficiaries are up to date. MONTHLY COST Age Band Employee Life Spouse Life Rate Rate per $1,000 per $1,000 < $0.071 $ $0.080 $ $0.099 $ $0.108 $ $0.117 $ $0.163 $ $0.237 $ $0.421 $ $0.633 $ $1.194 $ $1.922 N/A Child Benefit - $10,000 $2.22 Example: A 36 year old female wants to purchase $50,000 of term life insurance..108 x 50 = $5.40 Monthly rate # of units/ monthly per $1,000 $1,000 premium

8 2017 CENERGISTIC 8 DISABILITY INSURANCE What is STD Insurance? Short Term Disability Insurance helps protect your income for a short duration. If you become disabled and are unable to work, disability insurance can help replace some of your lost income, help you pay bills and protect your long-term savings. STD is voluntary benefit so you would be responsible for 100% of the cost, however premiums are deducted post tax so if you ever have to use your benefit, it will not be taxed at that time. Please refer to the monthly cost breakdown in the chart on the right. Your premium is based on your salary so follow this formula to determine your cost per month: (Annual salary) x.60 / 52 = Your weekly benefit amount THEN (Weekly benefit amount) / 10 x rate = Your cost per month Age Band Voluntary STD Cost Per $10 of Weekly Benefit < 25 $ $ $ $ $ $ $ $ $ $ $0.394 Voluntary Short Term Disability benefits begin after you have been unable to work for a continuous 8 days due to a covered illness or injury. You may receive this benefit up to 12 weeks. See plan documents for full details. What is LTD Insurance? Long Term Disability Insurance benefits are intended to protect your income for a long duration after you have depleted short-term disability or available paid time off. Cenergistic automatically enrolls you in LTD coverage at no cost to you and pays for your premiums. However, if you have a pre-existing condition (you incurred expenses, took prescription drugs, received medical treatment, etc.) during the 3 months just prior to your effective date of insurance, benefits will not be payable for that disability until you have been covered under this plan for 12 consecutive months. Long Term Disability benefits begin after you have been unable to work for 90 days due to a covered illness or injury. Contact your plan administrator for full plan details. NOTE: Other income sources such as Social Security disability, retirement benefits, pension, etc. may reduce your benefits under this plan. Please see your benefit summary for details regarding the effects of other income.

9 2017 CENERGISTIC 9 TRUSTMARK SUPPLEMENTAL INSURANCE TRUSTMARK ACCIDENT INSURANCE While major medical coverage is a significant part of your benefit package, an accident can lead to expenses that may not be covered by medical insurance. Trustmark Accident Insurance benefits are intended to help you with uncovered medical costs, due to a qualified accident, on or off the job. A few examples of benefits included with the accident plan include: Emergency Room Visits - $200 Hospitalization - $2,000 admission benefit, $400 per day benefit Fractures - up to $10,000 Dislocations - up to $8,000 Health Screening Benefit - $100 per insured per calendar year (examples listed on next page) See brochure for a complete list of benefits TRUSTMARK CRITICAL ILLNESS/CANCER INSURANCE Critical Illness/Cancer Insurance is a benefit that will pay you a lump sum of money if you are diagnosed with a critical illness, heart attack, internal cancer or stroke. The cash benefit is provided upon the first diagnosis of a covered condition to help you with associated costs and beyond. The plan also includes a double benefit that provides a second cash payment in the event a covered person is diagnosed with a different condition or critical illness. Critical Illness pays you a lump sum and coverage encompasses illness, such as: Heart attack Invasive cancer Stroke Organ transplant Renal (kidney) failure Advanced Alzheimer s Disease Paralysis And more PRICING AND SUPPORT Employees may speak to a benefit counselor from Explain My Benefits via the call center for any questions regarding the benefits offered, enroll in Trustmark or make changes to your Trustmark Accident or Critical Illness policies. Please call EMB at ; Option 1 to speak with a Benefit Counselor for plan rates. If LAST NAME begins with A - L; Call in Monday February 13 If LAST NAME begins with M - Z; Call in Tuesday February 14 You may also go to the Benefit Information website for additional coverage details.

10 2017 CENERGISTIC 10 ENROLLMENT RIGHTS Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) COBRA requires most employers sponsoring group medical plans to offer employees and their eligible family members the opportunity for a temporary extension of medical and/or dental coverage called continuation coverage. In certain instances where coverage under the plan is lost (referred to as a qualifying event), this coverage is offered at 102% of group rates. Depending on the qualifying event and the eligible participant, coverage can extend up to 18 or 29 months for employees, or 36 months for dependents; 29 months may be granted when the participant is social security disabled at the time of initial COBRA eligibility or within the first 60 days of the COBRA period (additional paperwork required). If you are covered by the group medical or dental plan, you have the right to choose continuation coverage if coverage is lost for the following reasons: resignation, termination (except for gross misconduct), or reduction of hours. If your spouse or dependent child is covered by your group plan, he or she has the right to choose continuation coverage if coverage is lost for the following reasons: your death, your termination, your reduction of hours, divorce, you become entitled to Medicare or your child loses dependent status due to age or marriage. Health Insurance Portability & Accountability Act of 1996 (HIPAA) The legislation of HIPAA is great in scope but its focus is to improve portability of health coverage, reduce health care costs by standardizing the processing of health care transactions, increase the security and privacy of health care information, limit exclusions for preexisting conditions, and allow a special opportunity to enroll in a new plan in certain circumstances. We encourage employees to further educate themselves on HIPAA s portability rules, privacy mandates and special enrollment rights. Additional information is available at pwba or by contacting the U.S. Department of Labor at Family Medical Leave of Absence (FMLA) The Family Medical Leave Act requires covered employers to grant eligible employees up to 12 weeks of unpaid leave each year because of: 1. The birth, adoption, or placement in foster care of a child; 2. The employee s own serious health condition; or 3. The care of a child, spouse, or parent with a serious health condition. The employer must maintain any group health benefits as if the employee had not taken any leave and restore the employee to the same (or an equivalent) position if and when the employee returns to work. Private employers with 50 or more employees within a 75-mile radius of the employer s work site are subject to FMLA. Eligible employees must have worked for the employer for at least 12 months and have worked at least 1,250 hours during the 12-month period immediately preceding the request for leave.

11 2017 CENERGISTIC 11 CHANGES & RESOURCES Keep these things in mind as you have changes in your life. The choices you make during Open Enrollment remain in effect until the next open enrollment period unless you have a qualifying event. RESOURCES Medical & Pharmacy BlueCross BlueShield Policy # Phone: Website: Accident & Critical Illness/Cancer Trustmark Voluntary Benefits Policy # Individual Phone: Website: Life & Short-Term Disability Sun Life Financial Policy # Individual Phone: Website: Vision VSP Policy # Phone: Website: Dental BlueCross BlueShield Policy # Phone: Website: FSA & HSA Discovery Benefits Phone: Website: If you need additional help, contact our Human Resources Department or EMB for support: Cenergistic Human Resources Barbara Coates Phone: benefits@cenergistic.com EMB Call Center ; Option 1 9:00am - 5:00pm EST DISCLAIMER: This is not a summary plan description (SPD) and does not guarantee benefits or payment. This document provides a brief summary of benefits that are available to you. Please refer to your coverage booklets and policies for complete details regarding covered charges, exclusions and plan payments or contact your benefits provider at the numbers located above.