Full Time Employee. Benefits. At a Glance

Transcription

1 Full Time Benefits At a Glance

2 EXCITING NEWS ABOUT YOUR BENEFITS! At AMG, we have an outstanding benefi t program and it is important for you to understand how your benefi ts work. Th is guide serves as a reference to help you choose the benefi ts that are right for you and your family. Who is eligible to participate? Full-time benefits are available to employees who work at least thirty (30) hours per week and have been employed with AMG for sixty (60) days. These benefits are effective first of the month following sixty (60) days from your date of hire. All employees must either enroll in benefits or waive coverage within sixty (60) days from your date of hire. If you do not have the opportunity to meet with a benefit counselor or have questions regarding these benefits, please call Combined Benefits Administrators: Toll Free: Phone: Fax: OPEN ENROLLMENT 2013 Overview of Benefits Medical Insurance Dental Insurance Short Term Disability Long Term Disability Employer Basic Term Life Cigna Added Value Plans Universal Life Insurance Cancer Insurance Accident Insurance Critical Illness Insurance Wellness claims When You MAy Enroll: 1.)Each year during Annual Enrollment, you have the opportunity to enroll or change your coverage. 2.)Benefits will remain in effect for one full year, unless you experience a qualifying event (such as marriage, divorce, birth or adoption of a child, or loss of spouse s coverage or employment). 3.)You have 30 days from the qualifying event to make changes to your current coverage election. Important to Remember Please have the following information (address, SSN, Date of Birth) for each person/dependent that you will be enrolling in the benefi ts for which they are eligible. Th is will expedite the completion of all enrollment forms. There is an annual open enrollment period which allows employees, who may have previously declined to enroll, the opportunity to enroll in new coverage. Certain restrictions and limitations may apply to employees who initially declined coverage when they first became eligible to enroll. Please note: every attempt has been made to ensure the accuracy of the information contained in this document. If there is any discrepancy between what is written here and what is contained in the insurance booklets, fliers, brochures, policies they take precedence over this guide. Complete details of the plans are contained in the certificates of coverage and policies.

3 Benefit Overview Benefits Plan Overview per pay period cost Medical Insurance See the medical page for details and pricing Benefits Plan Overview Bi-Weekly cost Dental Insurance In Network Calendar year deductible $50 individual/$150 family Annual Maximum $1,000 See dental page for pricing Benefits Plan Overview per pay period cost Short Term Disability Insurance Long Term Disability Insurance Benefits Plan Overview per pay period cost Employer Paid Basic Term Life &AD&D Insurance Company provides $25,000 term life and $25,000 of Accidental Death and Dismemberment Insurance No cost to the employee Additional Term life Benefits Plan Overview Bi-Weekly Cost Voluntary Universal Life Insurance Protection for your pay check It can pay you a % of your income if you become disabled due to a covered illness or off-the-job accident After 90 days of disability it may pay 60% up to monthly maximum of $5,000 to 65 or Social Security normal retirement age If you feel your family needs a higher level of protection than your employer paid basic life insurance provides, you may purchase additional life insurance coverage for you, your spouse, and eligible children Can provide an additional source of financial protection for your working years and provide options for your retirement. You can add a voluntary individual universal life insurance policy in addition to a term life policy. Cancer Insurance Provides benefits for cost associated with cancer treatment Wellness Benefit: Pays $100 per calendar year for covered cancer screening tests for covered employee and spouse Rates depend on age and coverage amount Provided By Employer No Cost To Rates depend on age and coverage amount Rates depend on age and coverage amount $12.60 Single Parent Family $14.34 Family $22.90 Accident Insurance Critical Illness Insurance Provides benefits for cost associated with off the job accidents. Wellness benefit per calendar year for one annual health screening for covered employee and one test for covered spouse Pays a lump sum benefit for first diagnosis for a covered critical illness. only $ Spouse $ Child(ren) $ Family $16.42 Rates depend on age and coverage amount Please see your Human Resources Department for current medical/dental premiums. Medical/dental coverage changes and additions can only be made during medical annual enrollment. You will be notified when you have the opportunity to make medical changes and additions.

4 medical insurance Product & Premiums Medical Insurance Benefits Group Care PPO Plan Doctor's Copay $40 Payroll Deductions Deductible $53.31 Prescriptions Co-Insurance + Spouse $ Generic $7 *OOP Max + Child(ren) Family $ $ Pref. Brand Non Pref. Brand $30 $55 Accident Benefit Maternity Multi-Source Br Injectable Drugs Includes Lead with Generic Step Therapy Program $70 $50 Lifetime Max *Co-Insurance Out-Of-Pocket Maximum does not include the deductible Network Non Network $1500 Individual ($4500 Fly) 60% 40% $3000 Individual ($6000 Fly) $350 per Member Included Unlimited Medical Insurance Blue Saver PPO Plan Network Non Network Payroll Deductions Deductible $1700 Individual ($3450 Fly) $48.50 Prescriptions Co-Insurance 100% 80% + Spouse $ Generic 100% *OOP Max $1650 Individual ($2700 Fly) + Child(ren) Family $ $ Brand Name 80% Maternity Lifetime Maximum Included Unlimited Includes Lead with Generic Step Therapy Program *Co-Insurance Out-Of-Pocket Maximum does not include the deductible Who to call Carrier Name Number Website / Medical, Policy #76441FF2 BCBS of LA Dental, Policy #ACAD314 Always Care We are pleased to provide you with a brief outline of the benefits available to you as our employee. This is a brief summary and does not constitute a contract. Please refer to your Certificate of Insurance for further information. Information last updated 1/29/2014

5 dental insurance Product & Premiums Dental Insurance Benefits Deductible (waived for preventive & Orthodontia Services) $50 (3x) Payroll Deductions + Spouse + Child(ren) Family $2.23 $11.01 $11.44 $23.90 Annual Maximum Preventive (exams, cleanings, sealants, fluoride, bitewing x-rays) Basic (fillings, space maintainers, root canal, periodontics, simple extractions, full mouth x-rays) $1, % 80% Major (crowns, dentures, bridges, surgical extractions) 50% Orthodontia Lifetime Maximum on Orthodontia 50% $1,000 Who to call Carrier Name Number Website / Medical, Policy #76441FF2 Dental, Policy #ACAD314 BCBS of LA Always Care We are pleased to provide you with a brief outline of the benefits available to you as our employee. This is a brief summary and does not constitute a contract. Please refer to your Certificate of Insurance for further information. Information last updated 1/29/2014

6 Disability insurance Disability Coverage Is Insurance For Your Pay Check Short Term Disability paid In the event you become disabled from a non work-related injury, sickness, or pregnancy disability income benefits are provided as a source of income. Long term Disability Employer Paid Provided by Acadiana Management Group at no cost to the employee In the event you become disabled from a long term injury or sickness, disability income benefits are provided as a source of income. Benefit Short Term Disability Long Term Disability Benefits Begin After 30 days of disability After 90 days of disability Percentage of Income Replaced Maximum Benefit 60 % up to weekly maximum of $1,000 9 Weeks 60 % up to monthly maximum of $5,000 To 65 or Social Security Normal Retirement Age Pre- existing condition exclusions Coverage elected at initial eligibility enrollment for STD is subject to a 3/12 pre-existing condition exclusion Coverage elected after initial eligibility is subject to a 12/12 pre-existing condition exclusion for STD. Initial Enrollment:This plan does not pay benefits for any disability resulting from a pre-existing condition unless the disability occurs after you have been insured under this plan for 12 consecutive months. Initial eligibility - Preexisting conditions are those for which you have incurred expenses, taken prescription drugs or medicines, received medical treatment, care or services (including diagnostic measures,) or for which a reasonable person would have consulted a physician during the 3 months immediately prior to recent effective date of insurance. This information is a brief description of the important features of this plan. It is not a contract. Terms and conditions of STD coverage are set forth in Group Policy No. VDT Terms and conditions of the LTD coverage are set forth in Group Policy No. LK963133, issued and subject to its laws The availability of this offer may change. Please keep this material as a reference, and file it with your certificate, should you become insured.

7 CIGNA Basic Term Life/AD&D / Employer paid Coverage Benefit $25,000 Acadiana Management Group provides a $25,000 term life insurance policy, which includes a $25,000 accidental death and dismemberment benefit at no cost to the employee. Cigna Voluntary Term life Insurance employee paid Life insurance can help you protect your family s financial security in case of your death. If you did not elect term life insurance coverage when you were first eligible or you are applying over the guaranteed coverage amount, you will be required to complete an Evidence of Insurability form if you want to apply for coverage. Can select life insurance coverage in units of $10,000. The maximum for any employee is $300,000. The guaranteed coverage amount for you is $200,000 at initial enrollment.(no more than 5 times your salary) Your Spouse You may select coverage for your spouse in units of $5,000 to a maximum of $150,000. Your spouse s benefit cannot exceed 50% of your benefit amount. The cost of coverage will be based on your spouse s age. The guaranteed coverage amount for your spouse is $50,000 at initial enrollment. Your Unmarried Dependent Children You may select coverage for your unmarried, dependent children in the amount of $10,000. The guaranteed coverage amount for your child(ren) is $10,000. One premium will insure all your eligible children, regardless of the number of children you have. ** must elect coverage for spouse and children to enroll **Children are eligible under age 19 (or under age 26 if they are full-time students) TERM LIFE BI-WEEKLY PREMIUMS AGE $20,000 $50,000 $100,

8 Cigna added value plans Whatever life throws at you -Throw it our way! Cigna offers some great value added services available to employees with Cigna Life coverage. These services are either no cost or available as a discount with different vendors. Below is a very brief summary of the different programs available (see actual brochure for additional details). Life Assistance Program , User Name - rewards, Password - savings This program offers assistance in achieving work/life balance. An advocate is ready to help access your needs and develop a solution to help resolve your concerns. They can also direct you to an array of resources. The services available are legal consultation (free 30 minutes consult and 25% discount for further services), guidance for parenting, child care, senior care and pet care assistance. An advocate is available by phone at no cost to assess your needs. You have up to 3 face to face sessions available after getting your referral. Identity Theft Program , Grp #57 - available 24 hrs/day/365 days - theft You can obtain access to free credit reports, help with reporting identity theft to reporting agencies, assist with replacement of lost or stolen documents and many other services to assist regarding identity theft. They also have a helpful website and tips to reduce the risk of identity theft. Healthy Rewards you would print a card to use to access discounts at any Healthy Rewards provider This program offers you a discount on services geared toward health and well being. This includes weight management and nutrition, vision and hearing, tobacco cessation, alternative medicine, mind, body and fitness, vitamins, health and wellness. Will Preparation Call for technical support of the website - You can visit the secure website and create your logon to be able to obtain and complete legal documents for will preparation, health and financial power of attorney, living will and medical authorization for children and estate planning. The website also has access to resources you may need for funeral planning process. Secure Travel Policyholder Name - Acadiana Management Group - Policy OK Available 24 hrs/day days/yr This provides emergency medical evacuation assistance and travel services, as well as pre-trip planning when travelling more than 100 miles from home or work. If in another country travelling and become ill, Cigna can arrange and cover the cost of transportation to get you to a different hospital or facility for treatment comparable to your home country (Cigna does not pay medical expenses). There are many other details Cigna can assist with, please consult the brochure or call Secure Travel. If travelling, especially abroad, this info would be very handy to have with you in case of an emergency. This information was created from multiple Cigna brochures and is presented for illustration purposes. In case of discrepancies, the Cigna brochure will prevail. All information discussed with Cigna is confidential and pursuant to the Health Insurance Portability and Accountability Act of 1996.

9 TransLegacy SM Universal Life insurance paid WHY BUY UNIVERSAL LIFE AT WORK? Portability - Take your coverage with you and pay the same premium if you change jobs or retire. Payroll deduction - No bills to watch for. No checks to mail. A direct bill option is available when you change jobs or retire. One-on-one guidance - You ll get personalized benefit advice and assistance with the application process FEATURES YOU LL APPRECIATE Accelerated Death Benefit for Terminal Illness and waiver of monthly deduction due to layoff rider included. Family Coverage - Apply for your spouse, children, and grandchildren even if you choose not to participate Guaranteed renewable - Guaranteed coverage, as long as your premiums are paid. Your premium may change if the premium for all policies in your class changes. Coverage up to $500,000 Guaranteed 4% Interest Rate Terminal Illness Benefit No Physicals or Blood work Cash Values Level Death Benefit Transamerica Universal Life Benefits Life Benefits units of $10,000 Guaranteed Issue Amount* $100,000 / $15,000 Spouse/ $25,000 Child Maximum Benefit $500,000 Spousal Life Benefit Units of $5,000, Max of $50,000 Child UL Life Benefit $25,000 per child $13/mo. Child Life Benefit-Term Rider One premium covers all children, $10,000 benefit Accelerated Benefit for Terminal Illness 50% or 100,000 Accelerated Benefit for Long Term Care 4% for 25 months Layoff Waiver Up to six months *Guaranteed issue is available only at initial enrollment UNIVERSAL LIFE BI-WEEKLY PREMIUMS AGE $20,000 $50,000 $100,000 Non Tobacco n/a n/a Tobacco n/a This is a brief summary of TransLegacySM Universal Life Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, IA. Policy Form Series CPGLDU00 and CCGL-DU00. Forms and form numbers may vary. Coverage may not be available in all jurisdictions. Limitations and exclusions a apply. Refer to the policy, certificate and riders for complete details. EBD LJFCSD 0813

10 Cancer insurance paid Cancerselect Plus If cancer is the disease you worry about most, you re not alone. The financial costs of cancer care can be a burden on families, and society as a whole. National Cancer care expenditures have been steadily increasing in the United States. Costs also are likely to increase as new, more advanced treatments are adopted as standards of care. With this supplemental benefit your employer is making available, you ll not only have more resources to cope with any future diagnosis of cancer, but you ll also have wellness benefits to help you detect cancer early when it s most treatable. This insurance pays you directly and is not reduced by other insurance. While typical health insurance pays your doctor or hospital, this supplemental insurance pays you directly unless you assign benefits. Some benefits pay by the day or treatment, while others reimburse you for expenses you incur. Either way, it can be a source of financial financial support support just just when when you you and and your your family family need it need most! it most! Hospital Benefits Hospital Confinement Extended Benefits Begin Attending Physician Inpatient Drugs & Medicine Private Duty Nurse Ambulance Extended Care Facility Hospice Care Surgery Benefits Surgery In-Hospital Surgery Outpatient Anesthesia Prosthesis Hair Prosthesis Reconstructive Surgery 2nd Surgical Opinions Ambulatory Surgical Ct Skin Cancer Radiation & Chemotherapy Radiation & Chemotherapy Associated Radiation & Chemotherapy Expenses Blood, Plasma, Bone Marrow/ Stem Cell Transplant Associated Blood, Plasma, Blood Components New or Experimental Treatment Wellness and Miscellaneous Benefits Wellness Magnetic Resonance Imaging Non-Local Transportation Family Member Lodging Physical / Speech Therapy At Home Nursing Waiver of Premium Outpatient Lodging Cancer Maintenance Therapy Hematological, Anti-Nausea, Motility Drugs First Occurrence Benefit $300 per day- Up to 90 Days $600 per day- After 91st Day $60 per day $45 per day $300 per day- Inpatient $300 Maximum $300 per day, within 14 days of discharge $300 per day- 100 day lifetime maximum $2,000 $3,000 25% of Surgery Up to $1,000 Up to $100 $240-$500 (schedule) $200 $300 per day maximum $150 to remove one, $70 each additional $15,000 Annual Maximum $750 Annual Maximum $15,000 Annual Maximum $750 Annual Maximum $15,000 Annual Maximum $100 Per Calendar Year $100 In Addition to Wellness Benefit $.40 per Mile up to 750 miles $100 per day- 50 Day Maximum $50 per session- 1 session per day $100 per day After 60 days of disability $100 per day- 50 Day Annual Maximum In Combination, $3,000 Annual Maximum $ Pay Period + Child(ren) Family Bi-Weekly $12.60 $14.34 $22.90 Semi-Monthly $13.64 $15.53 $24.80 This is a brief summary of CancerSelect Plus, Cancer Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa. Policy form series CP- CAN200 and CCCAN200. Forms and form numbers may vary. Coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details.

11 Benefits Accident Insurance paid AccidentAdvance Accidents and injuries can happen at any place at any time. It is important to protect yourself and make sure you can bounce back from whatever life may throw at you. Pays in addition to any other coverage. Accident Emergency Treatment $125 Major Diagnostic Exam Repair of Dislocations $200 MRI, CT, EEG Examples: Hip - Open-$4000; Closed-$1350 Repair of Fractures Collar Bone -Open-$2150; Closed-$400 Examples: Hip - Open-$5000; Closed-$1700 Nose, Heel or Fingers - Open-$1700; Closed-$350 Treatment of Burns $600-$1500 Repair of Ruptured Disc or Torn Knee Cartilage Eye Injuries $200-$1000 Covered per Schedule Major Surgery, specific type $1500 Accident Follow-Up Treatment $50 per visit, 3 visits Accident Hospital Income $250 per day Accident ICU Benefit $750, max 15 days Ambulance $300 Ground / $1500 Air Medical Appliances $200 Blood, Plasma, Platelets $400 Prosthesis $750-0ne $1500 -two Transportation $600 Family Lodging $150 per day max 30 days Wellness $60 Accidental Death Covered by Plan Accidental Dismemberment Covered by Plan Plan Options Payment of Benefits Paid Directly to Covered EE Portability Plan is Portable Pay Period + Child(ren) + Spouse Family Bi-Weekly $8.45 $11.33 $13.14 $16.41 Semi-Monthly $9.16 $12.28 $14.24 $17.78 Wellness Benefit $60.00 After a 30-day waiting period, benefit is payable per calendar year for one annual health screening test for the covered employee/member and one test for a covered spouse. The following are some of the included wellness tests. Blood test triglycerides Bone marrow testing Breast ultrasound CA 125 CA 15-3 (breast cancer blood test) CEA (colon cancer blood test) Chest X-ray Mammography Pap test PSA Colonoscopy Serum cholesterol test to determine HDL/LDL level Serum Protein Electrophoresis (myeloma blood test) Stress test on a bicycle or treadmill Thermography Riders Included in Coverage Accidental Death and Dismemberment Accident Hospital and ICU Income Expanded Benefits Policy form series CPACC100 and CCACC100. Forms may vary, coverage available where approved. This is a brief summary of AccidentAdvance, 24-Hour Accident-Only Insurance. Limitations and Exclusions apply. Refer to the policy, certificate and riders for complete details. Benefits are payable only once per covered accident, unless otherwise noted. Benefits are not payable for services rendered by immediate family members.

12 Critical Illness Insurance paid CriticalAssistance Plus CriticalAssistance Plus pays a lump sum benefit equal to the Elected Benefit multiplied by the applicable percentage shown below upon the first occurrence of a covered critical illness within each category. Cumulative benefits paid within each category will not exceed 100% of the Elected Benefit. First occurrence means a critical illness that is diagnosed for the very first time after the effective date and is the first critical illness diagnosed within the applicable category. If the total benefit paid in a category is less than 100% of the Elected Benefit, we will pay upon the diagnosis of a different type of critical illness within the same category. Critical Assistance Plus Benefits: Benefit Amount: Select coverage from $10,000 to $50,000 in increments of $5,000 Plan Categories Category Benefits % of Benefit Heart Attack 100% Category 1 Stroke 100% Heart Transplant 100% Coronary Bypass Surgery 25% Angioplasty/Stent 5% Major Organ Transplant (excluding heart) 100% Category 2 End-Stage Renal Failure 100% Paralysis not due to Stroke all 4 limbs 100% Burns (not available in NH) 100% Invasive Cancer 100% Category 3 Cancer Benefit Rider Carcinoma In Situ 25% Prostate Cancer with TNM Classification of T1 25% Skin Cancer 5% Plan Benefit Riders Wellness Benefit Rider $50 This is a brief summary of CriticalAssistance Advance, Critical Illness Insurance. Policy form series CPCI0400 and CCCI0400.Forms and form numbers may vary and this coverage may not be available in all jurisdictions. Limitations and Exclusions apply. to the policy, certificate and riders for complete details. CCA01C(SHH)-0612

13 Wellness Benefit Claims Wellness Benefit included in cancer, critical illness, and accident plans. You must enroll in these plans in order to qualify for the Transamerica wellness benefit. File Wellness Claims Quick and Easy Transamerica s claim filing process for cancer, critical illness and accident wellness benefits is a snap. Insureds can submit claims for cancer, critical illness and accident wellness benefits by phone or fax. No complicated, state-specific forms to fill out. Once the proper documentation is received, the insured should receive the claim check in 5-10 business days. File a Wellness Claim by Phone Contact the Transamerica Claims Department at (800) and press 2. Give the phone representative the following information: 1. Insured s name/ policy number 2. Covered person s name, date of birth and relationship to insured 3. Name of test/ procedure 4. Date of test/ procedure 5. Provider s name, address, and phone number File a Wellness Claim by Fax Fax directly to the Claims Department at (866) Document must include: 1. Insured s name/ policy number 2. Covered person s name, date of birth and relationship to insured 3. Name of test/ procedure who to call CIGNA Short Term Disability, Long Term Disability, Term Life For A Claim Form Call CBA Universal Life, Critical Illness, Cancer, Accident Insurance Customer Service To File A Claim Call CBA For any questions about your benefits or to enroll please call Combined Benefits Administrators at Monday - Friday 8:30 5:00pm CST

14 Election Summary Your Benefit Summary COVERAGE ELECTED DATE Benefit Description Benefit Amount Coverage Type Per pay period Amount Short Term Disability only 30 sickness ELECT WAIVE 30 accidents 9 week benefit Voluntary Term Life ELECT WAIVE Spouse Spouse Child Voluntary Universal Life Child ELECT WAIVE Spouse Child Voluntary Cancer Insurance ELECT WAIVE Voluntary Critical Illness Insurance ELECT WAIVE + Child(ren) Family Voluntary Accident Insurance ELECT WAIVE Spouse Child + Child(ren) Family + Child(ren) Family +Child(ren) and Spouse Family $ $ $ $ $ The above form is for your record only to record your benefit selections while meeting with a benefit counselor.

15 NOTES...

16 DISCLAIMER: This benefit summary is provided for illustrative purposes only and is simply an overview of your benefits. For a detailed explanation of your benefits for each policy you should review a copy of the actual policy on file with the Human Resources Department or you may specifically request a copy of each policy from the insurance carrier.