Benefit Guide This publication contains important information about your employee benefit program. Please read thoroughly.

Transcription

1 Benefit Guide This publication contains important information about your employee benefit program. Please read thoroughly.

2 Benefit Guide Table of Contents Additional Information Medical and Drug Coverage Health Savings Account (HSA) mycigna.com AmeriDoc Delta Dental of Tennessee Dental Insurance Vision Company Provided Benefits and Annual Health Plan Notices Contact Information

3 Cornerstone Systems Additional Information Important Information Plan elections are binding for the remainder of the policy year unless you experience a qualifying life event. An IRS qualifying event consists of marriage, divorce, death or legal separation, change in work status, or termination or commencement of your spouse s coverage. A change in family status is a birth, adoption, marriage, divorce, or death. If you experience a change, you will have 31 days from the date of the event to notify Leann Sowell and make adjustments to your elections. 3

4 Benefit Guide Medical and Drug Coverage Cigna Medical and Prescription Drug Coverage Cornerstone Systems offers medical and prescription drug benefits through Cigna. Cornerstone Systems will only offer an IRS qualified High Deductible Health Plan paired with an Health Savings Account (HSA). What You Should Know About High Deductible Health Plans (HDHP) This plan is intended to develop a consumer mind-set regarding medical expenses. In other words, when you use your own money to make a purchase, you normally make a decision based on cost and quality. Here s a brief overview of how the HDHP plan will work: Network: Open Access Plus (OAP) Focus on preventive care: 100% coverage with no out-of-pocket cost for age-appropriate preventive care No copayments: this plan has no copayments for medical services; all services are subject to the deductible and coinsurance, except age-appropriate preventive care using network providers Share the cost: after you meet the deductible, you and the plan share the cost of expenses through coinsurance Added protection: after you meet your out-of-pocket maximum, the plan pays 100% of eligible medical expenses No maximum: the plan s lifetime maximum is unlimited Once you are enrolled in the HDHP, you will have access to enroll in a Health Savings Account (HSA) Medical Payroll Deductions Semi-Monthly Payroll Deductions HDHP Single $45 Associate and Spouse $95 Associate and Child(ren) $90 Family $110 4

5 Cornerstone Systems Health Savings Account (HSA) An HSA is a special tax-advantaged bank savings account you can use to pay for qualified medical expenses including health expenses before your deductible is reached, prescription drugs, coinsurance charges, and non-reimbursed dental and vision expenses. Funds are not taxed when withdrawn for qualified medical expenses. The HSA accounts are tied to the team member and are portable. Pre-tax money put into the account can be used either during the plan year or accumulated in the account to pay for future medical expenses. Money deposited in the HSA earns interest tax-free and can be rolled over year after year. HSA accounts can be rolled over into other HSA accounts. Health Savings Account (HSA) Each team member may contribute up to $3,350 for individual coverage or $6,650 for family coverage on a pre-tax basis for You can fund your account by either paycheck deduction or money can be deposited into the account directly. If you are between the ages of 55 and 65, you can contribute an additional $1,000 in pre-tax contributions to your HSA account. If you do not have an existing HSA, you will need to set one up at Government regulations require that to be eligible to open an HSA, you must first be covered by a High Deductible Health Plan. You cannot have other health insurance coverage. You must not be claimed as a dependent on another person s tax returns. Finally, you may not be enrolled in Medicare. Beginning January 1, 2015 Cornerstone will fund your HSA with $400 if you elect single coverage, and $1,500 if you elect associate and spouse, associate and child(ren), or family coverage. If your date of hire is mid-year, then your Cornerstone HSA funds will be prorated for Limited FSA With an HDHP plan you are eligible to enroll in a limited FSA. A limited FSA eligible expenses are limited to qualifying dental and vision expenses. 5

6 Benefit Guide Schedule of Cigna options for the plan year Plan Components Annual Deductible Collective * (January-December) In-Network HDHP Out-of-Network Single $1,700 $3,500 Family $3,500 $7,000 Coinsurance (plan pays) 80% 60% Out-of-Pocket Maximum (includes deductibles) Single $4,000 $12,000 Family $8,000 $24,000 Maximum Lifetime Policy Benefit Unlimited Unlimited Providers Physician Office Visits 80% after deductible 60% after deductible Specialist Office Visits 80% after deductible 60% after deductible Preventive Services: (includes immunizations, annual physicals, mammogram, pap smear, prostate exams, well-woman/man exams) Facilities 100% 100% Hospital Services 80% after deductible 60% after deductible Urgent Care Services 80% after deductible 60% after deductible Emergency Room 80% after deductible 60% after deductible Inpatient Services Facility charges 80% after deductible 60% after deductible Mental Health and Substance Abuse (in-network prior authorization required by United Behavioral Health) Other Services 80% after deductible 60% after deductible Outpatient Surgery 80% after deductible 60% after deductible Outpatient diagnostic services lab, x-rays, scans, and MRIs 80% after deductible 60% after deductible Durable Medical Equipment 80% after deductible 60% after deductible Home Healthcare limited to 60 visits per calendar year 80% after deductible 60% after deductible Skilled Nursing Facility limited to 60 days per calendar year 80% after deductible 60% after deductible Prescription Drugs Retail Pharmacy (30-day supply) Generic 80% after deductible 60% after deductible Preferred Brand Name 80% after deductible 60% after deductible Non Preferred Brand Name 80% after deductible 60% after deductible Specialty Pharmacy 80% after deductible 60% after deductible * Collective Deductible: Claims are covered under the coinsurance once the family deductible is met by any combination of family members; individual deductibles do not apply. 6

7 Cornerstone Systems How to Get the Most Out of Associates may access online tools by visiting or by registering for a personalized experience by visiting mycigna.com. mycigna.com is completely personalized, so it s easy to quickly find exactly what you re looking for with regards to: mycigna.com Find doctors and medical services Manage and track claims See cost estimates for medical procedures Compare quality of care ratings for doctors and hospitals Access a variety of health and wellness tools My health assessment in just twenty minutes, this confidential, online questionnaire will give you a better understanding of your health today and teach you simple steps for improving your health in the future Condition and wellness resources find information using our interactive medical library cost estimates and quality of care ratings Find a doctor personalized search results make it easy to find the right doctor for you; search by name, specialty, procedure, location, and other criteria Estimate medical costs review estimated costs for specific, in network procedures, treatments, and facilities so there aren t any surprises Compare hospitals and doctors see how they compare by cost, patient outcomes, and more Quality of care quality distinctions and cost-efficiency ratings for doctors appear with every search result, with quality designated doctors appearing at the top of your list Prescription drug price quote tool compare prices between Cigna Home Delivery Pharmacy SM and their network of retail pharmacies to help ensure you re getting the best price possible Manage and track claims quickly search and sort claims, as well as track account balances, like deductibles and out-of-pocket maximums 7

8 Benefit Guide Prescription Drug Plan for Medical Plan Participants With individuals have easy, 24/7 access to the information and services they need most. Chat one on one with a pharmacist Refill and manage prescriptions Track shipments Compare medication pricing With an easy and convenient ordering process better than a retail pharmacy, Cigna Home Delivery Pharmacy makes it easy and convenient for individuals to get the medications they need to stay healthy Customer service associates available 24/7 (800) Free delivery directly to the location of choice Up to a 90-day supply in one fill QuickFill our automated refill reminder service that makes filling prescriptions easy Refilling prescriptions over the phone or through is a snap; their free QuickSwitch service makes it simple for individuals to make the switch from retail to home delivery in just one quick and easy phone call With helpful, personalized support with 24/7 access to a pharmacist online or on the phone individuals can always get their medication questions answered quickly and easily. But often individuals need more proactive, ongoing support to ensure they get the help they need to take their medications as prescribed. Cigna can help there, too. 8

9 Cornerstone Systems AmeriDoc (recently bought by TeleDoc) Cornerstone Systems, Inc. provides employees and their families with AmeriDoc access FREE of charge. AmeriDoc provides you and your family with round-the-clock access to U.S. based licensed physicians via phone, , or online video. Save time and money, avoid a visit to the doctor s office. Use AmeriDoc in the middle of the night, at work, or if you just have a question that doesn t require an in-person consultation. AmeriDoc is a nationwide service provider of consumer-directed telemedicine which provides plan members with round-the-clock access to U.S.-based licensed physicians via online video, telephone and secure using its proprietary telemedicine technology. Regardless of location or time, a member can consult with a U.S.-based licensed physician, who will discuss symptoms, recommend treatment options, diagnose many minor conditions, and prescribe medication when appropriate. AmeriDoc Common Conditions Acid reflux, allergies, asthma, bladder infection, bronchitis, diabetes, fungal infection, gout, headache, hemorrhoids, high blood pressure, infections, nausea, pneumonia (mild), rashes, sinus conditions, sore throat, thyroid conditions, and urinary tract infections Consult with a Doctor by Phone 24/7 (866) All physicians are part of the AmeriDoc Physician Network, LLC, and are credentialed following the guidelines of the NCQA and trained on the AmeriDoc Telemedicine platform. AmeriDoc has two types of medical consultations: 1. Information medical consultation: by telephone or for medical information and general advice 2. Diagnostic medical telephonic consultations: by telephone for evaluation, diagnosis, and prescription medication as appropriate Once you receive your welcome packet and ID card visit to create a username and password. 9

10 Benefit Guide Delta Dental of Tennessee Dental Insurance Delta Dental of Tennessee Dental Insurance Maintaining healthy teeth and gums and seeking professional treatment when dental problems arise is important to your overall health. Associates and their families should maintain good dental habits and seek professional dental care. Our chosen dental provider is Delta Dental of Tennessee. Visit to find a dentist and understand your dental benefits. PPO Dentists Premier/Nonparticipating Dentist Calendar Year Deductible Individual $50 $50 Family $150 $150 Calendar Year Maximum $1,500 $1,500 Coinsurance Preventive 100% 100% Basic 90% 80% Major 60% 50% Orthodontia Coinsurance 50% 50% Lifetime Maximum $1,500 $1,500 Benefit applies to Children (up to age 19) Diagnostic and Preventive Visit for oral examination 100% 100% Fluoride 100% 100% Sealants to prevent decay of permanent 100% 100% teeth X-Rays One set of bite-wing x-rays are covered in a 100% 100% 12-month period Full mouth x-rays are covered once every 100% 100% five years Basic Services Minor restorative services filings 90% 80% Endodontic services root canals 90% 80% Oral surgery services extractions and 90% 80% dental surgery Periodontics services to treat gum disease 90% 80% Major Services Crown repair to individual crowns 60% 50% Major restorative services crowns 60% 50% Prosthodontic services bridges, implants, and dentures 60% 50% 10

11 Cornerstone Systems Vision Insurance Your vision plan provider is VSP. You may elect vision coverage even if you do not elect medical coverage. Please see your summary plan description for the full benefits description and to search for providers visit and select the Choice network. Please note the below benefit summary is for In-Network benefits only. Vision Services Exam (once every 12 months) Lenses (once every 12 months) Frames (once every 24 months) Contact lenses (once every 12 months) In-Network Benefits $10 copay 1 set of lenses (including bifocal, trifocal) covered at 100% after $25 copay 1 set of frames every 2 calendar years covered at 100% up to $130; you pay everything over $130 1 set of contact lenses covered at 100% up to $130; you pay everything over $130 VSP members will receive an additional $20 to spend on featured frame brands like bebe, ck Calvin Klein, Flexon, Lacoste, Michael Kors, Nike, Nine West, and other featured frame brands. At no cost to you, the extra $20 is automatically applied by the VSP doctor. If enrolled in the VSP vision plan, all VSP members and their covered dependent have access to TruHearing Aid discount Program. Learn more about this VSP member offer at vsp.truhearing.com. VSP Voluntary Vision Insurance Per Pay Period Cost Employee $3.69 Employee + 1 $5.90 Employee + Children $6.03 Employee + Family $

12 Benefit Guide Company Provided Benefits and Annual Health Plan Notices Cornerstone System s Company Provided Benefits Through Lincoln Financial Group Basic Life and AD&D As an eligible associate of Cornerstone Systems, you are provided Basic Life and Basic Accidental Death & Dismemberment (AD&D) at no cost to you. The benefit is $15,000, and you are enrolled automatically the first day of the month following your hire date. Long-Term Disability (LTD) Long-term disability (LTD) protects your income should you become disabled. This benefit is 60% of your pre-disability monthly earnings paid to you up until your retirement date, or longer, depending on the age at which you become disabled. This benefit is provided to all eligible associates at no cost Annual Health Plan Notices All employees should review the 2014 Annual Health Plan Notices section located on the company website under the Employee Center tab. The Notices for you to review on this site include: Medicare Part D Creditable Coverage notice HIPAA comprehensive notice of Privacy Policy and Procedure Notice of Special Enrollment Rights The Woman s Health and Cancer Rights Act of 1998 (WHCRA) notice COBRA Coverage notice Medicaid and the Children s Health Insurance Program (CHIP) 12

13 Cornerstone Systems Contact Information Medical Cigna (800) Dental Delta Dental of Tennessee (800) Group # 5201 Voluntary Vision VSP (800) Life and LTD Lincoln Financial Group (800) Policy# (Life) and (LTD) Health Savings Account (HSA) Benefit Wallet (877) Contact Information 13

14 Benefit Guide Notes 14

15 Cornerstone Systems Notes 15

16 This Employee Benefits Newsletter is only intended to highlight some of the major benefit provisions of the Company plan and should not be relied upon as a complete detailed representation of the plan. Please refer to the plan s Summary Plan Descriptions for further detail. Should this newsletter differ from the Summary Plan Descriptions, the Summary Plan Descriptions prevail Lockton, Inc. All rights reserved. Images 2014 Thinkstock. All rights reserved. [Rev 10/02/14] Memphis\EB\CORSY\EE Comm\New Hire Guide\2015\15NH.pdf