ROSE MANAGEMENT GROUP
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1 ROSE MANAGEMENT GROUP Employee Benefit Summary 7/01/2014 6/31/2015 Dear Employee, Rose Management Group is pleased to provide you and your family with a comprehensive, market competitive benefits package that protects your personal health and financial well being. Rose Management believes that our success is due, in large part, to the efforts of our employees. We continually keep this in mind every year when evaluating our employee benefit programs. It is important to emphasize that we always work hard to strike a balance the increasing costs of employee benefits, and controlling employee out-of-pocket costs. Effective 7/1/2014, the Rose Academy benefits package will include the following benefits available to all eligible employees: Medical Plan through Health Net of Arizona Supplemental Gap coverage with included Critical Illness coverage from Transamerica Dental Plan from United Healthcare Vision Plan through SightCare AFLAC Supplemental Benefits Remember... The best decisions are based on a thorough understanding of each plan and the plan options. This guide is an overview of the benefit plans and should not be construed as a Summary Plan Description, Certificate of Coverage or Plan Document. It should not be relied upon to fully determine coverage. For each benefit elected, you will receive a Certificate of Coverage containing more detailed information from the insurance carrier. If differences exist between this overview and the Certificate of Coverage, the Certificate governs. If you are uncertain about any provisions specified in this guide, please refer to the Certificate of Coverage or contact Human Resources.
2 Benefit Plan Eligibility Employees must be considered benefits eligible to enroll in the medical and dental plans. New employees become eligible for coverage on the first of the month following 30 days of employment.. All forms must be returned to Human Resources by the enrollment deadline for any of your coverage changes to be effective for the new plan year. You can enroll the following dependents in your benefit plans: Your legal spouse or Domestic Partner Your dependent children: Medical Plan: dependent children are covered up to age 26. Dental Plan: dependent children are covered up to age 26. Important Information Regarding Plan Changes Each year during the annual open enrollment, you have the opportunity to make new benefit elections for the coming year. All eligible employees who wish to make any benefit changes must complete and return an enrollment form by the due date. Changes to your medical and dental benefits are allowed only during the annual open enrollment each year. Per IRS rules, employees cannot drop or add coverage for yourself or your dependents mid-plan year unless you have a qualifying change in family status such as loss of benefits under another plan, marriage, divorce, legal separation, birth, adoption or placement for adoption, or a HIPAA qualifying special event. If you have a qualifying change in family status, or HIPAA qualifying event, and want to drop, add or make any changes to your coverage, you must request this change within 31 days of the qualifying event (e.g. within 31 days of marriage or divorce, within 31 days of date of birth, within 31 days of the date you lose coverage under another plan) by completing a new enrollment form and giving it Human Resources. It is your responsibility to notify Human Resources of a qualifying or special enrollment event. Per IRS rules, if you waive or terminate coverage during your annual open enrollment period, you will not be able to enroll in Rose Management s plans until 7/1/2015 unless you have a qualifying change in family status. Deductible and out-of-pocket maximums are administered on a calendar year basis. It is important that employees enrolled in the medical benefits see providers in the Health Net network. If you see providers outside of the Health Net network, you will pay considerably more. To find providers in the Health Net network, you can go to GAP Plan Coverage Transamerica Effective 7/1/2014, all employees who enroll in the medical plan with Health Net will also be enrolled in our Gap Plan. This Plan coverage will help offset plan costs for inpatient hospital care and out-patient procedures. These payments are per person enrolled in your medical plan. You will be issued a separate ID card that should be carried and presented in combination with your Health Net Id card when receiving in-patient hospital services, or out-patient medical procedures. Providers are able to file claims to Trans America on your behalf. Providers will be paid the benefit directly therefore reducing your member responsibility.
3 Major Medical Deductible NEW MEDICAL PLANS FROM UNITED HEALTHCARE Only In Network Benefits Shown Here CORE OPTION HMO PLAN 4 $2,500 single $5,000 family Coinsurance 100% Maximum Out-of-Pocket Includes deductible $2,500 single $5,000 family Gap Plan Coverage Transamerica Physician Office Visits Out Patient Surgery Inpatient Hospitalization Emergency Room Urgent Care $15 PCP / $30 Specialist Covered 100% after deductible Covered 100% after deductible $250 copay Waived if admitted $50 copay Gap Plan Pays: First $1,250 * Gap Plan Pays: First $2,500 * Prescription Drugs $20 / $40 / $60 / $120 Critical Illness Benefit This policy will pay a lump sum benefit when initially diagnosed with cancer, heart attack, stroke, end stage renal failure, and major organ transplants. Employee Cost per Paycheck Employee Only $85.23 Employee Plus Spouse $ Employee Plus Child(ren) $ Employee Plus Family $ * Some Limitations, exclusions, or other provisions apply. For Actual benefits please refer to the policy or certificate of coverage. $5,000 lump sum
4 United Dental Plan Options Effective 7/1/2014, Rose Management will continue to offer our current dental benefit through United Dental. Please see the specific plan information in your enrollment materials for more detailed plan information. UNITED DENTAL Annual Maximum Per Calendar Yr. Deductible (Must be met before plan benefits will be paid) PPO Dental In Network Out-of-Network $1,500 per person $50 individual $150 family max Deductible Waived for Preventive Yes No Preventive (Limited to 2 exams per year) Basic (See Summary of Benefits for applicable procedures) Major (See Summary of Benefits for applicable procedures) 100% 100% 80% 80% 50% 50% Employee Cost per Paycheck Employee Only $13.22 Employee Plus Spouse $26.62 Employee Plus Child(ren) $26.34 Employee Plus Family $41.38
5 Pre-Tax Premiums The Flexible Benefit Plan allows for your healthcare premiums to be automatically deducted from your paychecks on a pre-tax basis. If you enroll in Rose Management s medical, dental, or supplemental plan benefits, you are able save money with every paycheck because your premiums are deducted on a pre-tax basis and it reduces your taxable income. You must notify Human Resources in writing during the annual open enrollment period, if instead, you elect to have your medical, dental or supplemental plan premiums deducted on a post tax basis. Employer Paid Life/AD&D Insurance UNITED HEALTHCARE Every benefits eligible employee will continue to have a Basic Life Insurance plan provided and 100% paid for by Rose Management Group. Accidental Death and Dismemberment (AD&D) - UNITED HEALTHCARE All employees enrolled in the basic life plan also have included AD&D coverage and are eligible to receive double the life benefit should a death occur as part of an accident. Employer Paid Basic Life Benefit Employee Coverage $15,000 AD&D Coverage $30,000
6 Vision Plan SightCare More choices means it s easier for you to find the eye care provider who is best for you. SightCare s Vision Plan offers you one of the broadest eyewear and eye care programs available with a large network of qualified eye doctors and optical retailers. Routine vision exam (including refraction) paid in full after copay Preferred pricing offered by network providers on frames, lenses and lens options Routine Vision Network of credentialed private practice providers and retail optical providers Access to discounts on laser vision correction through a nationwide network of more than 300 laser vision correction specialists 24-hour access to benefit information through myuhc.com and toll-free automated information line No claim forms Routine Exam each year Frames each year Lenses single focal plane Contact Lenses in lieu of glasses Sight Care Vision Plan $20 In Network $25 allowance out of network $125 allowance in network $80 allowance out of network 100% covered in network $25 allowance out of network $120 allowance in network $80 allowance out of network Employee Cost per Paycheck Employee Only $3.01 Employee Plus Spouse $6.02 Employee Plus Child(ren) $5.41 Employee Plus Family $8.42
7 Voluntary Supplemental Plans AFLAC Rose Management will offer AFLAC voluntary benefit plans to all benefit eligible employees. AFLAC policies help to cover unexpected medical bills, co-payments, deductibles, out of pocket expenses and more. We highly encourage you to consider enrolling in the AFLAC plans to ensure you have adequate insurance protection for all of life s unexpected health care expenses and disability issues. AFLAC voluntary benefit plans are available to you, your spouse and children with most products The premiums for these voluntary benefit plans are paid by you via payroll deductions AFLAC insurance benefits pay cash benefits directly to you, unless you choose otherwise AFLAC pays benefits regardless of any other insurance coverage. Therefore, these benefits are paid in addition to the benefits provided under your Rose Management UHVC medical plan, if you are enrolled in the UHC benefits With most plans, you can continue benefits when you retire or change jobs, with no increase in premiums. Policyholders can keep coverage for a lifetime as long as they continue to pay premiums. Short Term Disability Insurance Replaces a portion of your income to help make ends meet if you become disabled from a covered accident or covered sickness. Accident Insurance Helps offset the unexpected medical expenses, such as emergency room fees, deductibles and copayments that can result from a fracture, dislocation or other covered accidental injury. Cancer Insurance Helps offset the out of pocket medical and indirect, non-medical expenses related to cancer that most medical plans don t cover. This coverage also provides a benefit for specified cancerscreening tests. Included in this plan is the option to also purchase a Critical illness rider which provides a lump-sum benefit that you can use to pay the direct and indirect costs related to a covered critical illness, which can often be expensive and lengthy. Hospital Confinement Insurance Provides a lump-sum benefit for a covered hospital confinement and a covered outpatient surgery to help offset the gaps caused by higher deductibles and coinsurance amounts that are not covered by most major medical plans.
8 Contact Information WHO WHAT PHONE WEBSITE - HEALTH NET Medical Plan (800) WWW. HEALTHNET.COM UNITED DENTAL & LIFE Dental & Life Plan (877) SIGHTCARE Vision Plan (480) TRANSAMERICA GAP PLAN (866) Insurance Broker Chris Gordon or Heather Rivera Benefits & enrollment (520) cgordon@crestins.com hrivera@crestins.com. This document was prepared by: CREST Insurance Group 5285 East Williams Circle #4500 Tucson, AZ / (520)
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