2016 Benefits Overview For U.S. Hourly Bargaining Employees Group 17
At Packaging Corporation of America (PCA), we recognize the importance of providing competitive benefits benefits that help you achieve a healthy, financially secure future. On the following pages you ll find a broad overview of your benefit options, so you can choose the plans and coverage levels that fit you and your lifestyle.
What you ll find inside... GETTING STARTED... 1 Healthcare Contributions... 1 Enrolling for Health Benefits... 1 HEALTH BENEFITS... 2 Medical Benefits... 2 Prescription Drug Benefits... 3 Dental Benefits... 5 Vision Benefits... 6 Flexible Spending Account... 7 Employee Assistance Program (EAP)... 8 INSURANCE BENEFITS... 9 Life Insurance... 9 Accidental Death and Dismemberment Insurance... 9 Long-Term Disability (LTD) Insurance... 9 OTHER BENEFITS & SERVICES... 10 Health Advocate... 10 Survivor Support Program - AYCO... 10 TOOLS & RESOURCES... 11 Benefit Information... 11 Contacts... 12
GETTING STARTED The health benefits programs for hourly employees are designed to address rising healthcare costs by focusing on prevention and encouraging you to apply the principles of good consumerism to your decisions regarding healthcare from prescription drug choices to annual routine tests to selecting physicians. Healthcare Contributions You help pay for your healthcare benefits in the form of a contribution that is deducted from your paycheck before taxes. Depending on your enrollment elections you pay a percentage of the cost of coverage, and the company pays the balance. Because tobacco use is the number one cause of preventable death in the United States, employees and spouses who are tobacco users and do not enroll in the tobacco cessation program will pay a premium surcharge for medical benefits. You ll find details regarding your contribution rates in your enrollment kit. Enrolling for Health Benefits You may enroll yourself, your spouse, and/or your eligible dependent(s) in a health benefits program within your first 31 days of work orduring your designated enrollment period. Coverage is effective the day following 90 days of employment. If your situation changes through marriage or the birth of a child, for example you can change your coverage by notifying the PCA Benefits Center within 45 days of the qualifying event (within 60 days for special enrollment events related to Medicaid or the Children s Health Insurance Program [CHIP]). Dental and vision benefits are a combined election with one monthly contribution. So, if you elect dental coverage, you will automatically receive vision coverage. Your medical benefits (which include prescription drug) are a separate option. You may choose to elect just medical, just dental/vision, or both. BENEFITS OVERVIEW HEALTH BENEFITS 1
HEALTH BENEFITS Medical Benefits The medical benefits program is designed to enhance your ability to live a healthier life helping you cover the cost of office visits, hospital stays, surgery, and other common medical services. The program is administered by Blue Cross Blue Shield of Illinois (BCBSIL) and it features a Preferred Provider Organization (PPO) network or a group of providers (physicians, hospitals, and other healthcare professionals) who have agreed to provide most medical services at negotiated fees. While you can choose to receive care from out-of-network providers, you will pay more. Medical Benefits at a Glance In-Network (benefit level based on negotiated fees) Out-of-Network (benefit level based on local allowable limits) Deductible Individual $500 Family $1,000 ($500 to be met by two covered family members) Out-of-Pocket Maximum Individual $2,000 Family $4,000 (cumulative for all covered members) Individual $4,000 Family $6,000 (cumulative for all covered members) Covered Services 85% after deductible 65% after deductible Office Visits Physician fee only 100% after a $20 copayment Not subject to deductible Copayment applies to out-of-pocket maximum 65% after deductible Preventive Services Emergency Services Recommended preventive care: 100% (Refer to Preventive Care Benefits sheet for list of services) All other preventive services at 85% Not subject to deductible Coinsurance applies to out-of-pocket maximum 65% after deductible for the following services only: Immunizations + office visit Mammograms (age limits apply) PSAs (age limits apply) PAP smear + office visit Benefit level is 85% of allowable balance after deductible for services in-network or out-of-network To find a PPO provider, view your claims even get a cost estimate: www.bcbsil.com or (888) 979-4516 2 BENEFITS OVERVIEW HEALTH BENEFITS
Prescription Drug Benefits The prescription drug program, administered by CVS Caremark, Inc., features a four-tier structure with a formulary. The amount you pay for your prescription drug depends on the type of drug and how it is classified: Tier I includes the majority of generic drugs and offers the best benefit. Tier II includes preferred brand name drugs at a higher cost than generics. Tier III includes nonpreferred generics and brand name drugs that have a more costeffective alternative in Tier I or Tier II. You will pay more if you choose Tier III drugs. Tier IV includes all noncovered generic and brand name drugs. Mail Order Program CVS Caremark provides a convenient way to obtain long-term, maintenance medications by allowing you to order up to a 90-day supply, delivered directly to your home. Maintenance medications are prescription drugs you take regularly for ongoing conditions, such as high blood pressure, high cholesterol, or depression. BENEFITS OVERVIEW HEALTH BENEFITS 3
Prescription Drug Benefits at a Glance Tier I Tier II Tier III Tier IV General Information Majority of Generic (Formulary) Preferred Brand Name (Formulary) Nonpreferred (Nonformulary) 1 Noncovered Prescription Medications 2 Copayment/Coinsurance Retail (up to a 30-day supply). Individual pays: $5 or 20% of the cost 3, whichever is greater $10 or 30% of the cost 3, whichever is greater 75% of the cost 3 Not covered Copayment/Coinsurance Mail Order (up to a 90-day supply). Individual pays: $10 or 20% of the cost 3, whichever is greater $20 or 30% of the cost 3, whichever is greater 75% of the cost 3 Not covered Annual Tier I and Tier II Out-of-Pocket Maximum $750/covered individual; $1,500/family (cumulative for all covered members) Tier III medications apply only to the cumulative out-of-pocket maximum below Does not apply to the out-of-pocket maximum Annual Cumulative Out-of-Pocket Maximum (applies to Tiers I, II and III) $3,000/covered individual; $6,000/family (cumulative for all covered members) Does not apply to the out-of-pocket maximum 1 Therapeutic alternative is available on the formulary either as a generic or preferred brand name drug. 2 This tier includes generic or brand name medication for which a therapeutic alternative is available over the counter, in which case no benefit is payable for a generic or brand name medication. Examples include Proton Pump Inhibitors (PPIs) which are used to treat conditions such as acid reflux; and Nonsedating Antihistamine (NSA) drugs which are used to treat conditions such as allergies. 3 Cost is the amount charged at the point of sale by a pharmacist or through the mail order program. To view the Primary Drug List or manage your prescription medications: www.cvs Caremark.com or (866) 559-6882 4 BENEFITS OVERVIEW HEALTH BENEFITS
Dental Benefits Your dental benefits are designed to designed to reimburse you for a percentage of your dental expenses. The plan (Traditional Dental Plan + PPO) is administered by CIGNA. You re free to choose any licensed dentist; however, when you choose a dentist who participates in the dental PPO network, you receive the most value, since he/she has agreed on negotiated fees. Dental Benefits at a Glance Provider Choice Annual Deductible Annual Maximum Benefit Preventive Dental Services (exams, x-rays, and cleanings) Minor Restorative Dental Services (periodontal maintenance, scaling, fillings, etc.) Major Restorative Dental Services (bridges, crowns, dentures, etc.) Orthodontics PPO network; You may choose any licensed dentist $50 per covered individual for minor and major restorative services $1,500 per covered individual Benefit is 80% of local allowable limits Deductible is waived Benefit is 80% of local allowable limits Benefit is 50% of local allowable limits Benefit is 50% of local allowable limits up to $1,000 lifetime maximum per covered individual Deductible is waived To find a dental PPO provider or manage claims: www.cigna.com or (888) 336-8258 BENEFITS OVERVIEW HEALTH BENEFITS 5
Vision Benefits Your vision benefits feature a network of providers who offer discounts for your vision care, including routine eye exams, glasses, and contact lenses. The vision plan is administered by Vision Service Plan (VSP). Vision Benefits at a Glance Benefit Frequency Exam $35 Every 12 months Lenses (pair) Single $50 Lined bifocals $70 Lined trifocals $90 Progressive $120 Frames $40 Contact Lenses Elective Up to $90 Medically Necessary Up to $200 (lifetime maximum of $800) Under Age 18: Every 12 months Age 18 or Over: Every 24 months Low Vision Benefit Available to covered individuals who have severe visual problems not correctable with regular lenses. Supplemental testing: In-Network: Covered in full Out-of-Network: Covered up to $125 Supplemental care aids: 75% of the cost Subsequent care aids: 75% of the cost Maximum benefit available is $1,000 (excluding copayment) every 2 years To learn more about VSP member discounts or to find a vision provider: www.vsp.com or (800) 877-7195 6 BENEFITS OVERVIEW HEALTH BENEFITS
Flexible Spending Account An FSA allows you to use tax-free dollars to pay for eligible out-of-pocket healthcare expenses. In the process, you also lower your taxable income. You can enroll in an FSA even if you don t enroll in the health care program. FSAs are administered by WageWorks. Healthcare FSA you can elect up to $2,500 per year to pay for eligible out-of-pocket healthcare expenses. The Healthcare FSA provides you the opportunity to proactively plan and budget for your healthcare expenses annually. How the Program Works When you enroll in an FSA, you estimate your out-of-pocket expenses for the coming calendar year and elect an annual goal amount. The goal amount is then divided into equal amounts that are automatically deducted from each of your paychecks on a pretax basis and deposited into your FSA. (Keep in mind that if you enroll anytime after the first of the year, the goal amount is still dividided equally for the remainder of the calendar year.) You have from January to December to incur eligible out-of-pocket expenses. If you enroll in an FSA, you will receive a welcome kit from WageWorks. The kit will provide more details about WageWorks and how the program works. One important FSA restriction required under IRS regulations is the Use it or lose it rule. This rule states that if you set aside more money in an FSA than you can claim in reimbursements, you will lose any money left in your account. So, estimate your out-of-pocket expenses carefully and take advantage of the savings the FSA has to offer. And Remember: you must elect an FSA each year in order to participate in the program. To learn more about FSAs or to file a claim: www.wageworks.com or (877) 353-9236 BENEFITS OVERVIEW HEALTH BENEFITS 7
Employee Assistance Program (EAP) The Employee Assistance Program (EAP) provides professional, confidential counseling to help you and your eligible family members manage life/work issues, including marital and family problems, drug and alcohol abuse, depression, stress, and anxiety. The program is administered by Magellan and is available to you and your eligible family members at no cost. To access available resources, or find a local provider: www.magellanassist.com or (800) 288-2422 8 BENEFITS OVERVIEW HEALTH BENEFITS
INSURANCE BENEFITS Life Insurance The company automatically provides you company-paid group term life insurance equal to 1 times your annual base earnings. You also have the option to purchase Voluntary life insurance, in an amount equal to 1 or 2 times your annual base earnings. Documentation of your good health may be required for any voluntary or optional insurance coverage. Waiting periods may also apply. Accidental Death and Dismemberment Insurance The company automatically provides you company-paid AD&D coverage that pays a benefit equal to 1 times your annual base earnings if you sustain certain injuries covered under the policy, or if you die as the result of a covered accident. To learn more about Life or AD&D insurance or to file Life or AD&D claims: resources.hewitt.com/pca or (877) 453-0945 Although you receive certain insurance coverage automatically through the company, it is important that you keep your beneficiary information updated at Your Benefits Resource site (link, above). Long-Term Disability (LTD) Insurance The company automatically provides company-paid LTD coverage that will replace up to 50% of your monthly earnings if you experience a disabling illness or injury that prevents you from working. Refer to the eligibility booklet and contract for details about the program. For extended disabilities (more than 3 days), you will be asked to provide a doctor s statement of disability as well as certification to return to work. To learn more about LTD insurance or to file a claim: www.cigna.com or (800) 238-2125 BENEFITS OVERVIEW OTHER BENEFITS & SERVICES 9
OTHER BENEFITS & SERVICES Health Advocate This Service is available to all PCA employees, their spouses, dependents, parents and in-laws. These professionals (nurses, doctors, psychologists, etc.) can help you find doctors, hospitals and specialists, clarify health benefit coverage issues, and answer questions about treatment options, tests and procedures. The service can also help untangle medical bills and claims. To learn more about your Health Advocate: www.healthadvocate.com/members or (866) 695-8622 Survivor Support Program - AYCO PCA employees and their families can use this service to assist them in making certain difficult but necessary financial decisions related to the death of a PCA employee or his/her spouse. To learn more about AYCO: (800) 235-3417 10 BENEFITS OVERVIEW HEALTH BENEFITS
TOOLS & RESOURCES You ll find more detailed information, specific to your particular benefit programs, by logging into the Your Benefits Resources (YBR) site (resources.hewitt.com/pca); you may also go through the PCA portal (PCA portal > PCA benefits). Here s a look at the resources you ll find: Benefit Information The company provides Summary Plan Descriptions (SPDs) to help you understand the details of each benefit program. It s important you read the SPDs to help you understand what is covered under the various programs, and how to use your benefits to gain the most from them. BENEFITS OVERVIEW OTHER BENEFITS & SERVICES 11
Contacts YOUR BENEFITS RESOURCE Administrator Contact info Why you might contact them PCA Benefits Center Aon Hewitt PO Box 563908 Charlotte, NC 28256 (877) 453-0945 M-F 8 a.m. to 5 p.m. CT Your Benefits Resources site resources.hewitt.com/pca Manage benefits Update beneficiaries Get help with benefits including access to expert retirement advice HEALTH BENEFITS YOUR BENEFITS ADMINISTRATORS Benefit / Administrator Contact Why you might contact them Medical Blue Cross Blue Shield of Illinois (888) 979-4516 www.bcbsil.com (800) 772-6896 Call for: Find a PPO provider Request ID cards File/manage a claim Get help with questions or issues Inpatient hospital pre-certification Out-of-network admissions Healthy Expectations program Prescription Drug CVS Caremark Dental CIGNA Vision Vision Service Plan (VSP) Flexible Spending Accounts (FSA) WageWorks (866) 559-6882 www.cvs Caremark.com (888) 336-8258 www.cigna.com (800) 877-7195 www.vsp.com (877) 353-9236 www.wageworks.com Access the primary drug list Manage prescriptions Get help with questions or issues Access plan details Find a PPO provider File/manage a claim Get help with questions or issues Find a VSP provider Access info about VSP discounts Get help with questions or issues Access plan details File/manage a claim Get help with questions or issues 12 BENEFITS OVERVIEW TOOLS & RESOURCES
HEALTH BENEFITS (CONTINUED) Benefit / Administrator Contact Why you might contact them Employee Assistance Program (EAP) Magellan INSURANCE BENEFITS Life and Accidental Death & Dismemberment (AD&D) Insurance PCA Benefits Center Long Term Disability (LTD) CIGNA RETIREMENT BENEFITS 401(k) Retirement Savings PCA Benefits Center OTHER BENEFITS AND SERVICES (800) 288-2422 www.magellanassist.com (877) 453-0945 resources.hewitt.com/pca (800) 238-2125 www.cigna.com (877) 453-0945 resources.hewitt.com/pca Health Advocate (866) 695-8622 healthadvocate.com/members Find a local provider Access tools and resources Get help with questions Access plan details Manage beneficiaries File/manage a claim Get help with questions or issues File/manage a claim Get help with questions or issues Access plan details Manage your investments Get help with healthcare and insurance related issues Survivor Support (AYCO) (800) 235-3417 Get help making financial decisions after an employee death Cobra/Direct Billing For when you leave PCA CONEXIS (866) 206-5751 Get help with questions or issues BENEFITS OVERVIEW OTHER BENEFITS & SERVICES 13
This overview does not include all program rules and details. The terms of your benefit programs are governed by the summary plan descriptions (SPDs) and legal documents, including insurance contracts. The company reserves the right to change or discontinue any or all of its benefits programs at any time. This overview supplements the SPDs for PCA s employee benefits program and should be kept with your other benefits materials. For U.S. Hourly Bargaining Employees of: 650 DeRidder Packaging USW 2016 Benefits Overview Last Update 09/15 IMS# H000165013