Employee Benefits Enrollment Guide January 1, 2018 to December 31, 2018
Welcome to Open Enrollment for your employee benefits! Republic Health Resources offers you and your family members a comprehensive and valuable benefits program. Our employees are our most valuable asset that is why we are committed to an employee benefit program that helps our employees stay healthy, feel secure, and maintain a work/life balance. Every effort is made to provide you with a thorough plan of benefits while still keeping costs fair and manageable for both the company and our employees. We encourage you to take the time to educate yourself about your options and choose the best coverage for you and your family.
Enrollment Guidelines Who is Eligible? If you are a full-time employee (working 30 or more hours per week) you are eligible to enroll in the benefits described in this guide. The following family members are eligible for the benefits in this summary: spouse and/or dependent children (up to age 26). How to Enroll? The first step is to review your plan options in this Benefits booklet. Once you review the benefits, you will go to the TBX website to select your benefits for the next plan year. Once you have made your elections, you will not be able to change them until the next open enrollment period, unless you have a qualified change in status. When to Enroll? New Hires If you are hired on the 25th or the month or after, you will become eligible for benefits on the 1 st of the month following your date of hire. If you are hired before the 25th of the month, you will have benefits as of your date of hire. ALL new hire elections MUST be made within 30 days of your hire date or you will have to wait until the next Open Enrollment period. How to Make Changes? You cannot make changes to the benefits you elect until the next open enrollment period unless you have one of the following events: - Marriage, divorce, legal separation - Birth/Adoption of child, change in child s dependent status - Death of spouse, child, or other qualified dependent - Commencement or termination of adoption proceedings - Change in spouse s benefits or employment status You must notify HR within 30 days of a qualifying event in order to make changes.
How To Login Click the link below or open your internet browser and go to www.thebenefitsexpert.com/login/rhr Enter your Social Security Number or your employee ID Enter the last 4 digits of your Social Security Number and the last 2 digits of your birth year John Doe s Social Security Number is 123-45-6789 and he was born on June 1st, 1980. His PIN is 678980 *NOTE: The home screen of your login page will look similar to the one above. This image is an example only. 2013-2016 TBX Employee Benefits, LLC. All Rights Reserved. The Benefits expert, TBX and the Benefits Enhancer Bundle are the marketing brands of TBX Employee Benefits, LLC. 3
Medical Insurance Medical H.S.A. Plan This is a summary of the Medical H.S.A. Plan benefits. For a list of in-network providers, claims information, and full plan details, please register at www.bcbstx.com. Plan Features H.S.A Plan - MTBCP609 Blue Choice Network In-Network Benefits Deductible (Individual / Family) Coinsurance Out-of-Pocket Max (Individual / Family) $6,000 / $12,000 0% after Deductible $6,000 / $12,000 Preventive Care Office Visit Primary Care or Specialist Outpatient Therapy Urgent Care Emergency Room Visit In-Patient & Out-Patient Services Prescription Drugs Mail-Order Prescriptions Lifetime Maximum Out-of-Network Benefits Covered 100%, No Deductible Deductible Deductible (Limits Apply) Deductible Deductible Deductible Deductible Deductible Unlimited Separate Deductible Applies Please see Plan Summary for more details
Health Savings Account There are several advantages of choosing to participate in the high-deductible health plan (HSA): 1. You can set aside money in a Health Savings Account (HSA) before taxes to pay for eligible medical, dental and vision expenses. An HSA is similar to a flexible spending account in that you are allowed to pay for eligible expenses with pre-tax dollars. Certain items such as cosmetic procedures are not eligible. Refer to the IRS Publication 501 for a list of covered expenses. 2. Unused money in an HSA account is NOT forfeited at the end of the year and is carried forward. There is NO use it or lose it policy, therefore providing incentive to save and grow your money! 3. The HSA account is yours to keep which means that you can take it with you if you change jobs or retire. If you have any money remaining in your HSA after retirement, you may withdraw the money as cash (after age 65) with no penalty. If you should choose not to participate in an HSA plan again next year, you can still use the funds in the account for qualified expenses. However, you are no longer eligible to put money in the account if you do not have a high deductible health plan that meets the IRS requirements, such as the HSA plan offered by your employer. 4. You can use the HSA funds for any immediate family member, even if they are not covered on your medical plan. However, if you have a spouse or dependents covered on a plan with copays they can NOT be enrolled as a dependent on the HSA plan. 5. Per IRS regulations, you are NOT eligible to contribute to an HSA pre-tax if you are currently enrolled in a traditional Flexible Spending Account (FSA) or if you are eligible for or enrolled in Medicare. Further, if an individual s spouse is enrolled in a general purpose health FSA (with spouse s employer), then the individual is not eligible to receive or make contributions to an HSA. HSA Limits for 2018 The following Health Savings Account (HSA) limits apply: 2018 HSA Maximum Contribution Amount Individual $3,450 Family $6,900 Catch-Up Contributions (age 55 and older) $1,000
Medical Insurance Medical Base Plan This is a summary of the Medical Base Plan benefits. For a list of in-network providers, claims information, and full plan details, please register at www.bcbstx.com. Plan Features PPO MTBC813 Blue Choice Network In-Network Benefits Deductible (Individual / Family) Coinsurance Out-of-Pocket Maximum (Individual / Family) Preventive Care Office Visit / Specialist Visit Outpatient Therapies Urgent Care $5,000 / $14,700 30% after Deductible $5,600 / $14,700 Covered 100%, No Copay $45 Copay / $90 Copay Deductible then 30% (Visit Limits Apply) $75 Copay Emergency Room $500 Copay + Deductible then 30% Out-Patient Facilities/Surgeries Deductible then 30% In-Patient Facilities/Surgeries Deductible then 30% Prescription Drugs Copays listed are for non-preferred pharmacies. You can receive lower copays at preferred pharmacies. Mail-Order Prescriptions Lifetime Maximum Out-of-Network Benefits Preferred Drug / Non-Preferred Drug Generic $10 Copay / $20 Copay Brand $70 Copay / $120 Copay Specialty $150 Copay / $250 Copay 3X Copay (90 Day Supply) Unlimited Separate Deductible Applies Please see Plan Summary for more details
Medical Insurance Medical Buy Up Plan This is a summary of the Medical Buy Up Plan benefits. For a list of in-network providers, claims information, and full plan details, please register at www.bcbstx.com. Plan Features PPO MTBC808 Blue Choice Network In-Network Benefits Deductible (Individual / Family) Coinsurance Out-of-Pocket Maximum (Individual / Family) Preventive Care Office Visit / Specialist Visit Outpatient Therapies Urgent Care $2,500 / $7,500 20% after Deductible $5,500 / $14,700 Covered 100%, No Copay $30 Copay / $60 Copay Deductible then 20% (Visit Limits Apply) $75 Copay Emergency Room $500 Copay + Deductible then 30% Out-Patient Facilities/Surgeries Deductible then 30% In-Patient Facilities/Surgeries Deductible then 30% Prescription Drugs Copays listed are for non-preferred pharmacies. You can receive lower copays at preferred pharmacies. Mail-Order Prescriptions Lifetime Maximum Out-of-Network Benefits Preferred Drug / Non-Preferred Drug Generic $10 Copay / $20 Copay Brand $70 Copay / $120 Copay Specialty $150 Copay / $250 Copay 3X Copay (90 Day Supply) Unlimited Separate Deductible Applies Please see Plan Summary for more details
Virtual Visits Getting sick is never convenient, and finding time to get to the doctor can be hard. Blue Cross and Blue Shield of Texas (BCBSTX) provides you and your covered dependents access to care for non-emergency medical issues and behavioral health needs through MDLIVE. Whether you re at home or traveling, access to a board certified doctor is available 24 hours a day, seven days a week. You can speak to a Doctor immediately or schedule an appointment based on your availability. Virtual visits can also be a better alternative than going to the emergency room or urgent care center. MDLIVE doctors or therapists can help treat the following conditions and more: General Health Pediatric Care Behavioral Health Allergies Asthma Nausea Sinus Infection Cold/Flu Ear Problems Pinkeye Anxiety/Depression Child behavior/learning issues Marriage problems Get connected today! To register, you ll need to provide your first and last name, date of birth, and BCBSTX member ID number
Benefits Resources www.goodrx.com Use GoodRx s drug price search to compare prices (just like you do for travel or electronics on other sites) for your prescription at pharmacies near you. GoodRx does not sell the medications, they tell you where you can get the best deal on them. GoodRx will show you prices, coupons, discounts, and savings tips for your prescription at pharmacies near you. Download GoodRx s iphone or Android app to get drug prices and coupons on the go. Please note if you use Good RX Coupon you will not be able to use your medical insurance to receive deductible/out of pocket credit. www.healthcarebluebook.com Join the Fair Price Revolution Find out what you should expect to pay for healthcare services in your area with Healthcare Bluebook s free search tool. Did you know that the cost for the same innetwork procedure can vary by over 400%? Healthcare Bluebook levels the playing field with cost and quality transparency that makes shopping for healthcare services simple and straight forward. From Fair Price Comparison to industry leading quality rankings, Healthcare Bluebook gives you everything you need to quickly find and connect with Value Certified Providers. It is our responsibility to be the best consumers we can be. This is a quick and easy tool to help us make the right medical decisions for ourselves and our families.
Dental & Vision Insurance This is a summary of your dental plan benefits. Please see benefit summary for more detail, or visit www.humana.com Dental Benefits Annual Plan Maximum Deductible Preventive Basic Services Major Services Traditional Plan PPO Network Unlimited $50 employee/ $150 family 100% (i.e. cleanings) 80% after Ded (i.e. fillings, endo, perio) 50% after Ded (i.e. crowns, dentures) Orthodontia 50% Ortho LIFETIME Maximum $2,000 This is a summary of your vision plan benefits. Please see benefit summary for more detail, or visit www.humana.com. Vision Benefits Exams VSP Network $10 Copay Covered once every 12 months Glass Lenses Frames Contact Lenses Lens Limit $15 Copay (for Basic lenses) - Covered once every 12 months $130 Allowance + 20% off remaining balance Covered once every 24 months $130 Allowance + 15% of remaining balance Covered once every 12 months Benefits include glass lenses or contact. NOT both in the same year.
Life and AD&D Basic Life Insurance Republic Health Resource provides all full-time active employees with Group Life and Accidental Death (AD&D) policies through Humana. The Life policy will provide $25,000 in Life and AD&D benefits. The AD&D policy will pay your beneficiary double the benefit, if you were to pass away as a result of an accident. Republic Health Resources pays the full cost of these benefits. Please use the TBX enrollment system if you need to update your beneficiary at any time.
Important Notices The following notices applies to all benefits eligible employees: Notice Regarding Availability of Health Insurance Marketplace Coverage Options (Employer Exchange Notice) Summary of Benefits and Coverage (SBC) and Uniform Glossary Notice of Special Enrollment Rights Women s Health and Cancer Rights Act (WHCRA) Notices Employer CHIP Notice HIPAA Notice of Privacy Practices for Protected Health Information General Notice of COBRA Rights Plan Document Summary Plan Description (SPD) This booklet is a summary of plan highlights only. Please consult the carrier s contract for full information on covered charges, limitations, and exclusions. This is not a binding contract. In the event of a discrepancy, the carrier s contract will prevail. If you have further questions, please contact your Human Resources representative or Gus Bates Insurance & Investments.
Contact Information Refer to this list when you need to contact one of your benefit vendors. For general information contact Human Resources or Gus Bates Insurance & Investments. Blue Cross Blue Shield of Texas: Medical Benefits (800) 521-2227 www.bcbstx.com Humana: Dental Benefits (800) 233-4013 www.humana.com Vision Benefits (866) 995-9316 www.humana.com Group Life Benefits (800) 233-4013 www.humana.com Gus Bates Insurance & Investments 3221 Collinsworth Street Fort Worth, TX 76107 Phone: (817) 335-9547 Fax: (817) 529-5341 Justin Phipps Sales justin@gusbates.com (817) 529-5311 Olivia Cummings Account Manager olivia@gusbates.com (817) 529-5319 Megan Lewis Account Manager megan@gusbates.com (817) 529-5327