Benefit Guide Template 1
2023 Benefits Guide YOUR BENEFITS JOURNEY
Y O U R J O U R N E Y ENROLLMENT T O STARTS HERE HOWTOUSETHISGUIDE Whenyou seetheiconsbelow,click to link out to websites, downloaddocuments,orlearnmore! Carrier Learn ? Logos More
ENROLLMENT & ELIGIBILITY Employee Eligibility All full-time employees working 30 or more hours per week are eligible for company offered benefit plans after one month following date of hire. Dependent Eligibility Employees who are eligible to participate in the ABC Company benefit program may also enroll their dependents. For the purposes of our benefit plans, your dependents are defined as follows: Enroll • Your spouse or domestic partner • Your dependent children to age 26 Here Mid-Year Changes Once your enrollment window closes, the only time you are allowed to make changes to your benefits elections in the middle of the year is if you experience a qualified mid-year change. Examples may include getting married or divorced, having a baby or adopting, or gaining or losing coverage. You must notify Human Resources within 30 days of the mid-year event to be eligible to change your elections. Your Human Resource Contact: Contact Name [email protected] xxx-xxx-xxxx
MEDICAL Y O U R J O U R N E Y T O HEALTH Medical insurance helps you pay for preventive care, routine health needs, prescriptions, and advanced procedures by cost-sharing with your insurance provider. Hoverovertheinsurancetermsbelowtolearnwhattheymean! PLAN 1 PLAN 2 PLAN 3 Individual: $2,000 Individual: $1,500 Individual: $3,500 DEDUCTIBLE Family: $4,000 Individual with Family: $2,800 Family: $7,000 Family: $3,000 Primary Care: $30 Primary Care: *30% Coinsurance Primary Care: *30% Coinsurance OFFICE VISITS Specialist: $50 Specialist: *30% Coinsurance Specialist: *30% Coinsurance REVIEW Urgent Care: $50 Urgent Care: *30% Coinsurance Urgent Care: *30% Coinsurance Inpatient: *30% Coinsurance Inpatient: *30% Coinsurance Inpatient: *30% Coinsurance PLAN SBC’S PROCEDURES Outpatient: *30% Coinsurance Outpatient: *30% Coinsurance Outpatient: *30% Coinsurance Emergency Room: $200 Emergency Room: *30% Coinsurance Emergency Room: *30% Coinsurance Tier 1: $10 Tier 1: $10 after deductible Tier 1: $15 after deductible PRESCRIPTIONS Tier 2: $35 Tier 2: $35 after deductible Tier 2: $35 after deductible Tier 3: 60 Tier 3: $60 after deductible Tier 3: $60 after deductible OUT-OF-POCKET Individual: $4,000 Individual: $4,000 Individual: $5,000 MAXIMUM Family: $8,000 Family: $8,000 Family: $10,000 RATES PER Employee: $10.00 Employee: $10.00 Employee: $10.00 BIWEEKLY Employee + Spouse: $20.00 Employee + Spouse: $20.00 Employee + Spouse: $20.00 PAY PERIOD Employee + Children: $30.00 Employee + Children: $30.00 Employee + Children: $30.00 Family: $40.00 Family: $40.00 Family: $40.00 *Deductible applies first. The benefits and rates in this guide are for illustrative purposes only. Please refer to the Summary of Benefits and Coverage for specific benefits. To the extent the rates or the benefit plan information summarized herein differs from the underlying plan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlying insurance documents will govern in all cases.
TELEMEDICINE Your life is an adventure, and Telemedicine affords you the convenience of receiving medical care while on the go. Instead of spending your day and dollars at an Urgent Care facility, connect with a board- certified doctor over the phone or video chat to receive immediate and cost-effective care wherever life’s journey may takeyou. Check your plan summary for costs Benefits 101 Telemedicine
EMPLOYEEASSISTANCE PROGRAM (EAP) WELLBEING You encounter more than just health concerns If you think your physical health alone is related to throughout your life. Manage life’s curveballs your overall performance, think again. Total with a confidential and complimentary Wellbeing as a whole is comprised of 5 elements: program designed to provide counseling, physical, financial, communal, emotional, and purpose. support, and resources for a variety of personal To build your overall wellbeing, you have to make issues like stress and anxiety, relationship sure all of these elements are being “exercised”. struggles, substance abuse, eldercare, financial worries, and much more. Scroll over each of the icons below to learn more about wellbeing. Get the support you need today: Company Password: XXXXXXXX
HEALTH SAVINGSACCOUNT(HSA) An HSA allows you to use before tax dollars to reimburse yourself for eligible out-of-pocket medical expenses for you, your spouse and your dependents, which in turn saves you on taxes and increases your spendable income. Both you and your employer can contribute to your HSA. HSA’s have many benefits such as: • An HSA is yours. Funds in your HSA account stay with you, even if you change jobs. • Contribute tax free. An HSA reduces your taxable income. The money is tax free both when you put it in and when you take it out to cover qualified medical expenses. • Grow funds tax free. An HSA grows with you. When your HSA account balance reaches the minimum balance requirement, your funds can be invested in mutual funds yielding tax-free earnings • Spend tax free. Withdrawals used for eligible expenses are tax free. • Funds can be withdrawn anytime for medical expenses. • After age 65, the funds can be used for any purpose, without penalty. 2023 HSAMAXIMUM CONTRIBUTIONS $3,850 Individual ? $7,750 Family YOUR JOURNEYTO SAVINGS
FLEXIBLE SPENDING ACCOUNTS (FSA’s) Health Care FSA A Health Care Flexible Spending Account (FSA) provides you with the ability to save money on a pre-tax basis to pay for any IRS-allowed health expense that is not covered by your health care plan. Examples of these types of expenses include deductibles, co payments, coinsurance payments and uninsured dental and vision care expenses. You may elect a specific annual contribution for each FSA in which you plan to participate. Your annual contribution is then divided by your number of pay periods and that amount will be deducted pre-tax each pay period. The amount you elect may not be changed or revoked during the plan year unless you experience a qualifying life event. Dependent Care FSA A Dependent Care FSA provides you with the ability to save money on a pre-tax basis for day care expenses for your child, disabled parent or spouse. Transportation and Parking FSA Transportation Spending Account allows employees to use money on a pre-tax basis to pay for qualified work-related commuting and parking expenses. 2023 FSA MAXIMUM CONTRIBUTIONS Health Care FSA: $3,050 Dependent Care FSA: $5,000 YOUR JOURNEYTO Transportation: $300 per month Parking: $300 per month SAVINGS
DENTAL Good oral care enhances overall physical health, appearance and mental well-being. Problems with the teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with our dental benefit plan. Hoverovertheinsurancetermsbelowtolearnwhattheymean! DPPO LOW PLAN DPPO HIGH PLAN ANNUAL Individual: $50 Individual: $50 DEDUCTIBLE Family: $150 Family: $150 PREVENTIVE 100% 100% SERVICES BASIC 70% 70% SERVICES MAJOR 50% 50% SERVICES ANNUAL PLAN $1,000 $1,000 MAXIMUM ORTHO 50% 50% SERVICES Children Only Children Only ORTHO LIFETIME $1,000 $1,500 MAXIMUM RATES PER Employee: $10.00 Employee: $10.00 BIWEEKLY Employee + Spouse: $20.00 Employee + Spouse: $20.00 PAY PERIOD Employee + Children: $30.00 Employee + Children: $30.00 Family: $40.00 Family: $40.00 The benefits and rates in this guide are for illustrative purposes only. To the extent the rates or the benefit plan information summarized herein differs from the underlying plan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlying insurance documents will govern in all cases.
VISION Protectyoursightandenjoythosesunsetsevenmore withvision insurance. Receivebothpreventiveandmaterialscoverage. Hoverovertheinsurancetermsbelowtolearnwhattheymean! DPPO LOW PLAN Single: $25 LENSES Bifocal: $25 Trifocal: $25 FRAMES $150 Allowance CONTACT Disposable: $150 Allowance LENSES FREQUENCY Lenses: 1 X 12 months OF SERVICES Frames: 1 X 24 months Contact Lenses: 1 X 12 months RATES PER Employee: $10.00 BIWEEKLY Employee + Spouse: $20.00 PAY PERIOD Employee + Children: $30.00 Family: $40.00 The benefits and rates in this guide are for illustrative purposes only. To the extent the rates or the benefit plan information summarized herein differs from the underlying plan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlying insurance documents will govern in all cases.
LIFE INSURANCE You can't put a price tag on your life, but you can protect your loved ones with life insurance in the event of a premature loss. BASIC LIFE AND AD&D -You are automatically enrolled in this employer-paid coverage. 2.5xyourEarningstoaMaximumof$500,000 VOLUNTARY LIFE AND AD&D -You must submit an application and be approved to be enrolled in this employee-paid coverage. EMPLOYEE Increments of $10,000 up to 5x your earnings; $500,000 Maximum SPOUSE Increments of $5,000 up to 100% of Employee Amount up to $250,000 CHILD Increments of $1,000, maximum benefit of $5,000 Short-Term Disability 101 Long-Term Disability 101
DISABILITY Accidents and illnesses happen and often when we least expect them. Ensure you are financially prepared to stay afloat during a medical condition with disability insurance. SHORT TERM DISABILITY -You are automatically enrolled in this employer-paid coverage. BENEFIT 60% of your Earnings to a Maximum of $1,500 a Week DURATION 13 Weeks for Sickness 13 weeks for Accident WAITING Illness: 7 Days PERIOD Accident: 0 Days LONG TERM DISABILITY -You are automatically enrolled in this employer-paid coverage. BENEFIT 60% of your earnings to a maximum of $12,500 a Month DURATION Up to Social Security Normal Retirement Age Short-Term Disability 101 WAITING 90 Days Long-Term Disability 101 PERIOD
VOLUNTARY BENEFITS Even with medical insurance, you could still be subject to ACCIDENT unexpected out-of-pocket expenses in the form of copays, deductible, and coinsurance. These Voluntary Benefits provide lump sum payments to be used towards your health care expenses, or however you see fit. CRITICAL ILLNESS Hover over the icons to the right to learn more about each of these benefits. HOSPITAL INDEMINITY
ADDITIONAL BENEFITS We offer these additional non-traditional benefit options to help you and your family navigate life’s demands. Hover over the icons below to learn more about each of these benefits. TUITION PET REIMBURSEMENT INSURANCE IDENTITY THEFT FAMILY PROTECTION PLANNING
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RETIREMENT The key to saving for retirement is to start early and stay committed. Making the choice to invest in yourself by contributing to your employer sponsored retirement plan is a decision that may have a big impact on your ability to retire confidently. CONTRIBUTION TYPE EMPLOYER MATCH TAX BENEFITS COMBINE EASE OF TRANSFER SAVINGS COMPOUDNING ACCOUNTS SAVINGS SAVINGS UR YO URNEY O J SAVINGS TO
Contact Information Medical Dental HR Contact Name Name Name Phone Phone Phone Email Email Email web web web Vision Life Broker Name Name Name Phone Phone Phone Email Email Email web web web EAP Disability HSA/FSA Name Name Name Phone Phone Phone Email Email Email web web web
Employee Notices Download Here Please review the following required employee notices detailing your rights and options. You can also request a paper copy of any of these notices at any time.
