Summary of Plans. Flex Choice PPO 2000 Cigna Network. 25th of month Prior to Effective date
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2 Summary of Plans Benefits Flex Choice PPO 1000 Flex Choice PPO 2000 Flex Choice PPO 2500 Flex Choice PPO 3500 Flex Choice PPO 5000 $125 Processing Fee Referrals Req'd No No No No No Plan Anniversary November 30, 2015 November 30, 2015 November 30, 2015 November 30, 2015 November 30, 2015 Wellness Not subj to Ded / No Copay Not subj to Ded / No Copay Not subj to Ded / No Copay Not subj to Ded / No Copay Not subj to Ded / No Copay Enrollment Deadline Rx Card In Network Deductible Out of Network Deductible $ 1,000 Single $ 2,000 Family $ 2,000 Single $ 4,000 Family $ 2,000 Single $ 4,000 Family $ 4,000 Single $ 8,000 Family $ 2,500 Single $ 5,000 Family $ 5,000 Single $ 10,000 Family $ 3,500 Single $ 7,000 Family $ 7,000 Single $ 14,000 Family $ 5,000 Single $ 10,000 Family $ 10,000 Single $ 20,000 Family 80% / 20% In 80% / 20% In 0% In 0% In 0% In Max In Network No Responsibility No Responsibility No Responsibility Max Out of Network $5,000 Single $10,000 Family $5,000 Single $10,000 Family Office Co Pay Dependents Hospital Co Pay ER Co Pay $150 (not subj to ded) $150 (not subj to ded) $150 (not subj to ded) $150 (not subj to ded) $150 (not subj to ded) Lab $35 Copay $35 Copay $35 Copay $35 Copay $35 Copay Rates include Medical Contribution, PEO Fees, & Administrative costs Single $ $ $ $ $ Employee + Spouse $1, $1, $1, $1, $1, Employee + Child(ren) $1, $1, $1, $1, $1, Family $1, $1, $1, $1, $1,220.00
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4 Program Highlights Who is Idilus? Idilus is a national PEO with administrative offices in Chicago and the NY Metropolitan Area. They specialize in serving smaller high end service businesses that expect white glove service. They are most often characterized in the industry as a "Boutique PEO". Idilus is a PEO that is a co- employer organization that has the capability of AGGREGATING hundreds of small employers including sole proprietors allowing each small businessperson to purchase better, more cost effective employee benefits while receiving services that are reserved for Fortune 100 companies. Who is Employers Network Association (E.N.A.)? E.N.A. is the membership association providing additional benefits & the billing administrator. Who is this program available to? This program is being rolled out to the New York Metropolitan area with enhanced benefit options. It will cover all businesses from one employee (sole proprietor) to one hundred. How does it work? Idilus responsibilities under their agreement with the employer include the setting up of a payroll relationship with each business and their employees even if there is only one employee, a sole proprietor. The small business employees (including sole props) are also W-2 employees of Idilus, a PEO. Each small business owner (sole props included) will determine the payroll frequency they wish to utilize. The payroll frequency could be weekly, bi-weekly, semi-monthly, monthly, quarterly, or semiannually. Idilus will at each pay date deduct from the business account the gross payroll and all taxes associated with the payroll being paid. This is the same procedure that payroll companies such as ADP and Paychex utilize, they deduct the employee and employer taxes with each payroll. The taxes will then be forwarded on, lessening or eliminating the need for sole proprietors to have to file estimated quarterly taxes (they should check with their accountant). The pay check will be net of all taxes due for that pay period. The actual EMPLOYEE pay check will be direct deposited back into the account the now employee has chosen, seventy two (72) hours after the payroll encumbrance. Idilus as stated earlier will be deducting both the employer portion as well as the employee portion of the taxes due. Idilus, once they receive the paperwork and applications fully completed, will contact each new employer group to set up their payroll & enroll them in the medical benefits plan. The PEO fees as well as the Dues will be billed directly by Idilus on the fifteenth of each. The Health Plan & Optional Riders will be billed by ENA of Valhalla, NY each month via EFT.
5 Idilus' PEO Products & Services Idilus does not have management responsibility for your employees; they merely provide benefits and payroll expertise along with HR support. Idilus is not interested in running their clients business only advising as needed. *Workers Compensation Insurance; is provided to most member firms as part of the basic package charge. This is a benefit for sole proprietors who currently can t carry workers comp. The AMTRUST is the workers comp carrier. State Disability Insurance (DBL); is provided to all employers, down to one life, Deducted and remitted by Idilus to the carrier. Unemployment Insurance; with Idilus is being extended to Sole Proprietors. Sole Props will be covered for unemployment insurance benefits. They will be eligible for them upon separation of service form Idilus. *Tax & Payroll services; is provided as part of the basic package. Payroll frequencies are: Sole Props: Monthly, Quarterly Groups: Weekly, Bi-weekly, Semi-monthly, monthly Each employer will choose the frequency that best fits their situation. *Employee Assistance Program (EAP); Idilus sponsors an EAP and it is available to all employee groups down to one life. *Employers Practice Liability Insurance; Idilus provides to all member employers as part of the basic package an Employees Practice Liability policy, and Human Resource consulting as needed. The minimum annual payroll for sole proprietors is $15,000 annually for a single and $15,000 annually for a family employee. Federal, State and local Tax Services are processed as part of the basic package. Sole proprietors will now be able to budget their tax payments with their payroll frequency, not having to file estimated quarterly taxes. Sole proprietors will receive Unemployment Benefits & Workers Compensation. FUTA and SUTA payments will be deducted and remitted as the Federal, State, and local taxes are. *Included in basic services. (There is no additional charge for these products and services)
6 Idilus Optional Benefit Services and Products Life Insurance provided on a guaranteed issue basis. $13.00 per month) Dental Insurance provided on a guaranteed issue basis. (2 plans: PPO $1500 Max with Orthodontia or $1,000 Max, No waiting periods on any services) Group Long Term Disability Insurance on a guaranteed issue basis. (90 Day wait, 5 Year payout, up to $10,000 benefit, Own Occupation) The benefit is determined by the salary amount set by the employer or sole proprietor. The disability insurance benefit payable is coordinated with the social welfare programs. Accident Indemnity Insurance on a guaranteed issue basis. Lump Sum Critical Illness Insurance with simplified underwriting. ($10,000 $25,000 $35,000) Medical Plan: Idilus offers a Fully Funded health plan. Fully funded means no risk for the employer and a health plan that utilizes the nation s largest PPO Network, accepted by 90% of all physicians in the United States. The Medical plan has 6 different options with low deductible and out of pocket maximums; the plan then pays covered charges at 80%. Plan has in and out of network benefits. The plan has a full drug card. The plan summary follows, for specific plan details. The Plan has been around for close to a decade and is reinsured by A rated international reinsurance companies and has over 40,000 plan members All applications need to be submitted by the 25th of the month for the following month start. *Idilus-HR is an outsourced Human Resources provider. In a global marketplace filled with companies trying to get your payroll business, Idilus-HR offers you a team of professionals who are more personal, more adaptable to custom solutions, more local, you re more complete choice. We really will make your entire Human Resources process easier for you to manage. When you bring Idilus HR on board, you will not be just outsourcing payroll, you will be hiring your own dedicated Human Resources and Payroll Departments. We offer customized one-of-a-kind Human Resources solutions for your unique business needs. We believe, as you do, that if you invest in your human resources, the returns will be limitless. We know you don t have time to do it all, you re running a business. Yet, you still want a professional team to turn to that will take your employees concerns as seriously as you do. You don t want to hire additional employees and train them in areas in which you are not an expert. Your evenings and weekends should be yours not spent with complex employee issues.
7 Total Solution FAQ s 1. Q: What is a Professional Service Organization (PEO)? A: A PEO (Professional Employer Organization) is an organization that administers payroll, provides human resource support and allows companies to access its benefit portfolio by coemploying a company s employees. 2. Q: What is co employment? A: Co employment means that Idilus will employ your company s employees and pay them through its TIN allowing the company to access Idilus s benefit portfolio and cover that company under its Workers Compensation insurance. 3. Q: Does the company give any managerial control up to Idilus if they participate in the PEO? A: No. Idilus runs payroll, administers benefits and provides Human Resource support as needed by its clients. Idilus has no management responsibility or any control on the operations of the company. 4. Q: If I don t like the PEO relationship can I separate from the PEO? A: Yes. You can leave the PEO with 60 day written notice. All benefits terminate upon separation from the PEO. 5. Q: Can I enroll in the health plan without being a member of the Idilus Professional Services Organization (PEO)? A: No. In order to access the plan the employer must be a member of the PEO and all employees must receive a W2. 6. Q: How does payroll work? A: Idilus is very flexible and can run your group payroll weekly, Bi weekly, Semi monthly or monthly. Direct deposit is the preferred method of payment. 7. Q: When is renewal for Health plan and when can we expect new rates? A: Renewal is December 1 and we have new rates the last week of October. 8. Q: When is renewal for Guardian plan benefits and when can we expect new rates? A: Renewal is January 1 and we have new rates the last week of November. 9. Q: Who will handle open enrollment? A: Idilus will send out open enrollment packets to existing clients. 10. Q: Does the $96 administrative fee apply to employees not on the benefit plans? A: Yes. The Administrative fee applies to all employees participating in the PEO.
8 11. Q: When is the deadline for submission of my application for enrollment? A: All application paperwork for the PEO must be submitted by the 25 th of each month to start the 1 st of the following month. No exceptions. 12. Q: If Idilus runs my payroll how do I account for that on my taxes? A: Generally, funds drawn by Idilus for the purpose of payroll should be shown as payroll expense on your corporate tax return. 13. Q: Once I fill out an application for the PEO and submit it, what happens next? A: A representative from Idilus will contact you to complete the enrollment process and answer any additional questions. 14. Q: How do I get Idilus my funds to administer my payroll? A: Idilus will set up an ACH with your operating account for your business. You will report your payroll 5 business days prior to the pay date. Idilus will send a preprocess register to you for approval. Once approved, Idilus will draw the funds 72 hours prior to the pay date and issue the direct deposits/ checks on the pay date you specify. 15. Q: Is there a minimum amount of annual payroll or employees that a Group must have to qualify for the PEO? A: No. 16. Q: Can a 1099 employee (schedule C filer) receive W 2 wages? A: Yes. They will receive a year end W 2 from Idilus which they would file (using a 1040 IRS form) along with their Schedule C. 17. Q: I have a Defined Contribution plan (example 401K or a SEP plan). Can I participate in the Idilus PEO? A: Yes. You can keep your current plan in force and still contribute the same %. Or participate in the Idilus 401K (Transamerica). 18. Q: I have a Defined Benefit plan. Can I participate in the Idilus PEO? A: Consult your plan, plan administrator and or Accountant for guidance. 19. Q: Can any size groups participate in the Idilus PEO? A: Yes, Idilus works well with groups of all sizes. ( to 500) 20. Q: Does Idilus offer an FSA? A: Yes, Idilus offers an FSA (at no extra charge). With the recent changes due to the ACA effective 1/1/14 you can roll over $500 in your FSA annually. Funds are not portable from one company to another. Employer determines maximum contribution. Maximum contribution for2014 is limited to (TBA). ($2,500 in 2013) Source of funding is both employer and employee. If funds attributable to employee are pre tax salary reductions, the plan owns (in the case of an ERISA plan). Employee Contributions are made pre tax. Reimbursements for eligible expenses are excluded from income. Allows otherwise unreimbursed Code 213(d) medical expenses, excluding premiums on qualified long term care services. Employer may restrict scope of reimbursements by plan design. If participant also has an HSA, FSA must be limited to dental expenses, vision expenses and expenses constituting preventive care. Over the counter drugs and medicines (except insulin) are not eligible unless prescribed by a medical provider. Prescription co pays are an allowable expense.
9 21. Q: Does Idilus offer an HRA (Health Reimbursement Account)? A: Yes, Idilus offers an HRA at $10 per employee per month administration charge. Employer determines maximum contribution. Key Features: HRA Funds can be used for IRS approved expenses as long as funds available in HRA were incurred by employee/dependent during period of HRA eligibility; Funds cannot be reimbursed by any other source, example: other insurance plan. HRA Funds roll-over from year to year. If employee terminates, HRA funds are no longer available. Funds are refunded to the Employer at the end of the year for any employee who terminates employment and does not choose continuation of the HRA, in accordance with COBRA provisions. Employee has the right to continue paying monthly HRA contribution, including administration fee to Idilus, in order to access funds in accordance with COBRA provisions.
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