2016-2017 Employee Open Enrollment Guide SCA EMPLOYEES
ProForce, Inc. strives to provide employees with a comprehensive and competitive benefit package that is among the best in our industry. Employees are our greatest asset and we consider the investment we make in our benefit offerings as an investment in the health and well-being of our employees and their eligible dependents. Welcome to Your Benefits What are the Health Care Reform Law Requirements and How Will it Impact Me? Please see the Required Notices packet available on ProForce, Inc. Intranet site for more information. The HR department will post all benefit-related documents on the intranet site. Please note: The Employee Open Enrollment Guide contains important information to help you make informed decisions during the open enrollment period. We encourage all employees to carefully review the material contained in this guide. This guide is a summary of the employee benefits provided by ProForce, Inc. If there is a discrepancy between the benefits illustrated in this guide and the official plan document, the plan document will always govern. v. 10.16 Each year, ProForce, Inc. reviews a variety of benchmark surveys and evaluates the benefit offerings of others within our industry. We also review the company s benefit spending trends, vendor performance, and new benefit options. Our goals for 2016/2017 are to continue offering a comprehensive benefits package to our employees in an era of rising health care costs, expand the medical and dental options for eligible employees, and enhance employee services across the company. In order to continue to keep providing our employees with high quality health benefits, we need your help. The companies that most successfully control their costs engage their employees as health care consumers, and provide them with information, resources and support they need to get the most value out of their health care plan. If we all work together to be smart health care consumers, will all reap the rewards of lowered health care costs. Our employees are our greatest asset, and we consider the investment we make in our benefit package as an investment in the health and wellbeing of our employees. Table of Contents Eligibility and Enrollment 2 Medical Benefits 3 Medical Benefit Resources 4 Dental Benefits 5 Vision Benefits 6 Life and AD&D Benefits 7 Disability Benefits 8 Employee Assistance Program 9 Payroll Deductions 10 Carrier Contact Information 11 1
Eligibility and Enrollment Eligibility Employees and dependents are eligible to participate in the benefit programs on the 1st day of the month following the date of hire if you work at least 30 hours per week. Your dependents generally include: When to Enroll A spouse to whom you are legally married or; A dependent child under age 26 (including children, stepchildren and legally adopted children) You must enroll for benefits during the designated annual Open Enrollment period. When Can I Make Changes To My Benefits Open Enrollment occurs once each calendar year, usually in October for the new plan year beginning November 1. You may change your benefit elections during the Open Enrollment period. Once you have made your selection, you may not change benefit elections until the next Open Enrollment, unless you have a Qualifying Life Event in employment or family status. Qualifying Life Events include: Marriage, divorce or legal separation Adding a dependent child through birth, adoption or court-ordered custody Death of a spouse or child Change in your work schedule affecting benefits, i.e. full-time to part-time or part-time to full-time Your dependent loses eligibility for coverage Your spouse involuntarily loses health coverage through his/her employer You and/or your spouse and dependents become eligible for COBRA You and/or your spouse and dependents gain or lose Medicaid or CHIP coverage You receive a Qualified Medical Child Support Order (QMCSO) If you experience a Medicaid or CHIP Qualifying Life Event, you have 60 days to notify the Benefits Department and make any desired benefit changes. If you experience any other of the above Qualifying Life Events, you have 30 days to notify the benefits department. Otherwise, elections you make during Open Enrollment will remain in effect for the entire plan year. 2016/2017 Benefit Elections Helpful Hints 1. Review your current enrollment information by logging on to the CareFirst website. 2. Ensure your dependent satisfies and continues to satisfy the definition of eligible dependent, 3. Complete your enrollment form and return to Human Resources department. 4. All changes to your benefits must be submitted online by midnight. When Coverage Stops Employee and dependent medical, dental and vision coverage stops when your employment or your status as a regular full-time employee ends. The effective date for loss of coverage will be the end of the month in which termination of employment occurs, or your full-time employment status ends. At this time you and your covered dependents may elect to continue their medical, dental, vision or flexible spending account coverage for up to eighteen (18) months through the Consolidated Omnibus Budget Reconciliation Act (COBRA) provisions. A COBRA notice will be mailed to you. All other benefits end the day after your employment with ProForce, Inc. ends. 2
Medical Benefits Medical Coverage Our medical plans are Preferred Provider plans administered by the CareFirst BlueCross BlueShield network. Network providers are available in all states throughout the country. Out-of-Network medical benefits are significantly reduced due to their increased costs. See the column title Out-of-Network in the following tables for more detailed information on the medical benefits. Additional Available Services For the following information, register and/or login to your account at CareFirst at www.carefirst.com; Get information about savings opportunities, learn about medications and ask a pharmacist questions you may have. For questions regarding coverage, eligibility or claims. To reach customer service call 855-258-6518 or login to your personal portal online at www.carefirst.com Rewards program that offers incentive for getting healthy and staying healthy. Quick and Easy Ways to Find a Doctor To locate in-network physicians, specialists, and hospitals in the CareFirst area (Maryland, DC, Virginia) go to https://member. carefirst.com. For all other areas of the US use the BlueCross BlueShield National Doctor and Hospital Finder website http:// provider.bcbs.com/. Our plans are the BlueCard PPO/EPO network. HealthyBlue Advantage HSA BluePreferred Traditional Member Responsibility In-Network Out-of-Network In-Network Out-of-Network Deductible - Ind. / Family $2,000 / $4,000 $4,500 / $9,000 $2,000 / $4,000 $4,000 / $8,000 Out-of-Pocket Max. - Ind. / Family $4,500 / $6,550 $6,000 / $12,000 $6,350 / $12,700 $7,500 / $15,000 Coinsurance $0 $0 AD 100% 80% Office Visit - Physician $0 AD $50 AD $20 copay Ded., then 20% Office Visit - Specialist $30 AD $50 AD $20 copay Ded., then 20% Emergency Room $200 per visit AD $200 per visit AD $0 per visit AD $0 per visit AD Urgent Care $50 AD $50 AD $20 copay Ded., then 20% Inpatient Hospital Ded., then $300 Ded., then $500 $0 AD Ded., then 20% per day ($1,500 max) per day ($2,500 max) Outpatient Hospital Ded., then $300 Ded., then $500 $0 AD Ded., then 20% Outpatient Surgery Center Ded., then $100 Ded., then $500 $0 AD Ded., then 20% Labs (Non-Hospital) Ded., then $0 Ded., then $50 $0 AD Ded., then 20% X-Ray (Non-Hospital) Ded., then $50 Ded., then $50 $0 AD Ded., then 20% Complex Imaging (Non-Hospital) Ded., then $100 Ded., then $200 $0 AD Ded., then 20% Prescription Drugs Generic Brand / Preferred Brand / Non-Preferred Brand Generic Brand / Preferred Brand / Non-Preferred Brand Retail Participating Pharmacy $0 / $25 / $45 after deductible $15 / $35 / $60 50% to max $200 Mail Order $0 / $50 / $90 after deductible $30 / $70 / $120 AD = After Deductible 3
Medical Benefits Resources Resources available through CareFirst Register Today! www.carefirst.com/myaccount provides a wealth of resources to aid you and your family members in improving your overall health, managing your costs and understanding your medical benefits. CareFirst Mobile Application The CareFirst app provides instant access to you and your family s critical health information anytime/anywhere. Whether you want to find physicians near you, check the status of a claim or download a copy of your ID card. The mobile application is your go-to resource for everything related to your CareFirst medical benefit. CareFirst Blue Rewards Blue Rewards is an incentive program where you can earn up to $600 per adult and $1,500 per family for taking an active role in getting healthy and staying healthy. Follow the 4 steps within 120 days from the date your coverage begins and earn your reward: 1. Select a primary care provider (PCP) who participates in CareFirst s Patient-Centered Medical Home (PCMH) program. 2. Agree to receive electronic wellness communications 3. Complete an online health assessment. 4. Visit your selected PCP and complete a health evaluation. CareFirst Health & Wellness Discounts and Blue365 Program www.carefirst.com/wellness offers access to health and wellness information and deals exclusive to CareFirst BlueCross and BlueShield members. Search recipes, research medical conditions and treatments, receive discounts on alternative therapies, as well as health and wellness resources such as fitness centers, acupuncture, massages, chiropractic care, laser vision correction and more. 4
Dental Benefits United Concordia Dental Plan ProForce, Inc. is happy to provide a comprehensive dental plan through United Concordia. This plan allows you to visit any dental provider. When you use an in-network dentist, you will not be billed for any amount above the Usual and Customary Fees (UCF). If you go to an out-of-network provider, you may be responsible for any amounts above the Usual and Customary fees, which United Concordia refers to as maximum allowable charges (MAC) and may result in balance billing to the employee. Please review the option from United Concordia in the chart below. A pre-treatment estimate is recommended for any service estimated to cost over $500; please consult your dentist. Dental Plan Benefits In-Network Out-of-Network Annual Deductible (Ind/Fam) $50 / $150 $50 / $150 Plan Maximum $1,500 per person $1,500 per person Preventive Care Oral Exams, Cleanings, X-Rays, Floride Treatment, Sealants, Simple Extractions 100% 100% Basic Services Fillins, Perio Maintenance, Complex Extractions, Endodontic Services 80% 80% Major Services Crowns, Bridges, Dentures, Peridontal Surgery,, Inlays, Onlays, Veneers 50% 50% Orthodontia Orthodontia covered for Child (age 26) and Adult; Orthodontia in Progress covered Lifetime Maximum $1,000 50% 50% 5
Vision Benefits EyeMed Vision Plan ProForce, Inc. offers a Vision plan through EyeMed. Every plan year, you are eligible for an eye exam, contact lens or lenses / frames. You can go to www.eyemed.com to locate participating providers. If you see a non-participating provider, you will be responsible for 100% of the cost at the time of service. To obtain direct reimbursement according to your plan design, you can print a claim form from www.eyemed.com. Vision Plan Option One Benefits In-Network Out-of-Network Services & Materials Exam Copay $10 $40 Frequencies Exams Lenses Frames 12 months 12 months 24 months Annual Eye Exam $10 copay $40 Standard Contact Lense Fit Up to $55 N/A Premium Contract Lense Fit 10% of Retail N/A Eyeglass Lenses Single Lenses $25 copay $30 Bifocal Lenses $25 copay $50 Trifocal Lenses $25 copay $70 Lenticular Lenses $25 copay $70 Retail Frame Benefit $130 / 20% off over amount $130 Allowance $91 Contact Lenses - Elective $130 Allowance $130 6
Life / AD&D Benefits Guardian Life Insurance Company Basic Life and AD&D Insurance Coverage ProForce, Inc. provides both group Life Insurance and Accidental Death & Dismemberment (AD&D), through Guardian Life Insurance Company for all benefits eligible employees. These benefits are 100% company paid via Health & Welfare. Benefit Description Basic Life Insurance: Life insurance that is provided to your designated beneficiary should you die. ProForce, Inc. provides $50,000 of Basic Term Life Coverage for all full-time employees. Accidental Death and Dismemberment (AD&D): Benefit that is paid in an event that you are seriously injured or killed as a result of an accident. The accident death benefit is equal to one times the employee s life benefits. The dismemberment benefit will depend on the injuries sustained. Coverage Ends upon separation from the company or when you are no longer eligible to participate in the benefits. Continuation of this benefit is available. Contact Guardian Life Insurance Company at (888) 600-1600 within 31 days of your date of separation. Additional benefits under this plan include: Conversion Option If you terminate your employment or become ineligible for this coverage, you have the option to convert all or part of the amount of coverage in force to an individual life policy on the date of termination without evidence of insurability. Beneficiary Designation: All employees should designate a beneficiary for these plans. You may do this in Ultipro or by written request to the Human Resources Department. 7
Disability Benefits Short-Term Disability (STD) Benefits ProForce, Inc. provides short-term disability (STD) income protection through Guardian Life Insurance Company for all benefits-eligible employees. In the event you are disabled because of a non-work related accident or illness and are unable to perform your job duties, you will be eligible to receive 60% of your weekly salary, up to a $1,500 maximum weekly benefit. Benefits begin on the 8th day for an accident and on the 8th day for an illness. Benefits are payable for up to 12 weeks. The benefit is paid in full by ProForce, Inc. and all employees are automatically enrolled in this benefit. Long-Term Disability (LTD) Benefits ProForce, Inc. also provides long-term disability through Guardian Life Insurance Company for all benefits-eligible employees. Benefits begin on the 91st day of disability (usually after STD has been exhausted) and the benefit payable is equal to 50% of your monthly salary, to a maximum of $5,000 per month. The benefit is paid in full by ProForce, Inc. and all employees are automatically enrolled in this benefit. Tax Choice option for long-term disability insurance is available during open enrollment. Please select whether you will pay taxes on the value of the premium. If you opt to pay taxes and go out on long-term disability, you will receive your benefits tax-free. Pre-Existing Condition Clause states benefits will not be paid for a total disability caused by or resulting from a preexisting condition. This does not apply to a total disability after 12 consecutive months from the date you became insured. Pre-existing condition means any existing sickness or injury for which you received medical treatment, consultation, care or services (including diagnostic procedures), or took prescribed drugs/medicines, during the three months immediately prior to your effective date of insurance. Eligibility for Coverage Under Both Benefits Begins on the first day of the month following your start date. If your start date is the first of the month, your eligibility will begin that day. The STD benefit begins on the 8th day for an accident and the 8th day for illness and the LTD benefit begins on the 91st day, after the STD benefit has been exhausted. Coverage Ends upon separation from the company or when you are no longer eligible to participate in the benefits. New claims cannot be filed on or after the date coverage ends. As described in the Plan document, pending claims remain in effect until a final determination is made by Guardian Life Insurance Company. 8
Employee Assistance Program (EAP) WorkLifeMatters WorkLifeMatters offers a variety of services to promote well-being and help enhance the quality of life for you and your family, at every stage of life. From family support, legal assistance, fitness, mental health resources, and work-related help, the WorkLifeMatters Employee Assistance Program (EAP) provides access to solutions and support for the challenges of daily living. You can access benefits by logging into www.ibhworklife.com or calling (800) 386-7055. Education Admissions testing & procedures Adult re-entry programs College planning Financial aid resources Dependent Care & Care Giving Adoption assistance Before/after school programs Day care & elder care In-home services Parenting support Senior housing options Legal & Financial Basic tax planning Credit & debt Immigration Legal forms and will making Personal legal Retirement planning Working Smarter Balancing work and home life Career & training development Effective managing Relocation Lifestyle & Fitness Management Anxiety and depression Divorce and separation Relationship issues Drugs and alcohol Health and well-being Grief & loss Pet care Contact Information Log into www.ibhworklife.com User name: Matters Password: wlm70101 OR Call (800) 386-7055 9am - 8pm, M-F (EST) Emergency access 24/7. 9
Payroll Deductions Payroll Deductions and Section 125 ProForce, Inc. has established a Section 125 plan that will enable you to make payroll contributions for certain benefits, on a pre-tax basis. That is, the contribution will be deducted from your pay before federal, state and social security taxes are withheld. Medical, dental, vision, life/ad&d, STD and LTD costs are deducted from your pay on a pre-tax basis. Pre-Tax Health Deductions for eligible, full-time Non-Exempt SCA Employees (Plan B Employees) Coverage/Tier Per Pay Period Medical - CareFirst HealthyBlue Advantage HSA BluePreferred Traditional Employee N/A $ 0 Employee/Child(ren) $103.00 $298.00 Employee/Spouse $212.00 $455.00 Family $380.00 $677.00 Dental and/or Vision United Concordia Dental EyeMed Vision Employee $18.34 $3.27 Employee/Child(ren) $40.95 $6.53 Employee/Spouse $36.84 $6.21 Family $64.72 $9.60 Life & Disability - Guardian Life/AD&D Short-Term Disability Long-Term Disability 100% Company Paid 100% Company Paid 100% Company Paid Important Plan Information: Plan B (Non-Exempt SCA) Employees: Are eligible for Health & Welfare (H&W) benefits up to $4.27 per hour paid (up to 40 hours per week). However, company-provided H&W benefits currently exceed the H&W amount. All Plan B Employees are automatically enrolled into the company healthcare BluePreferred PPO plan which includes medical, life, short and long-term disability insurance, unless a more comprehensive company plan is selected. Employees with either TRICARE or spousal coverage via the spouse s employer are permitted to opt out of the company medical plan by providing written proof. Proof of coverage must be submitted no later than within ten (10) days of date hired and verified during each open enrollment thereafter. Employees may choose to purchase additional family member coverage for their spouse, dependents and/or family. Insurance cost will be on a pre-tax basis. Employees who opt out of the medical plan by providing written proof of either TRICARE coverage or spousal coverage via the spouse s employer have the option to enroll in dental and/or vision coverage for themselves and/or dependents. Employees who are permitted to opt out of automatic enrollment in the company plan by providing written proof of TRICARE or employer sponsored spousal coverage will be enrolled in the company paid life insurance, short-term disability and longterm disability. The cost of this insurance is a fringe benefit and part of the H&W benefit. Excess H&W funds will be provided as a contribution to the employee s retirement account as a qualified non-elective contribution. 10
Contact Information Carrier Name Group Number Telephone Website Medical - CareFirst https://member.carefirst.com Medical and Prescription Drug Plan 1VAZ (866) 452-2217 http://provider.bcbs.com/ Dental - United Concordia Dental Plan 919479-000 (800) 332-0366 www.unitedconcordia.com Vision - EyeMed Vision Plan 1003712 (866) 800-5457 www.eyemed.com Life & Disability - Guardian Life Insurance Co. Life/AD&D Insurance 519281 (800) 627-4200 www.guardiananytime.com Short-Term & Long-Term Disability 519281 (800) 627-4200 www.guardiananytime.com EAP - Guardian Life Insurance Co. Employee Assistance Program 519281 (800) 386-7055 www.ibhworklife.com Let our Personal Benefit Advocates assist you and your family with your benefit questions and claim issues. Benefit Resource Center Your one-call benefits information hotline Call for assistance with: Benefit Elections Benefit Plan/Policy Questions Eligibility Claim Issues with Carriers Change in Family Status Plan Contact Information CONTACT INFORMATION Hours: Monday - Friday 8:00 AM - 5:00 PM EST Phone: 855-874-6699 (Toll-Free) Email: BRCEast@usi.biz This guide is a summary of the employee benefits provided by ProForce, Inc. If there is a discrepancy between the benefits illustrated in this guide and the official plan document, the plan document will always govern. ProForce, Inc. reserves the right to change or terminate these plans at any time. This guide is in no way an attempt to constitute a contract of employment. Responsibility for making your benefit elections is yours alone. No one at ProForce, Inc. is authorized to give you advice. Therefore, please give careful consideration to all benefit elections. v.10.16 11