2016 Employee Benefits Enrollment Guide

Transcription

1 2016 Employee Benefits Enrollment Guide

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3 Table of Contents Health and Well-Being Additional Resources Medical Aetna/Allied 2 Insurance company contacts 22 Health Savings Account 15 Annual required legal notices 23 Dental 16 Vision 18 Work and Life Savings & Retirement 401(k) PerkSpot This document contains brief summaries of benefits offered as of January 1, 2016, and is not considered "Evidence of Coverage." Please refer to the policy/plan documents for a complete description of the controlling terms, coverages, exclusions, limitations and conditions of coverage. In the case of any discrepancy between the information included in this guide and the policy/plan documents, the policy/plan documents will prevail Benefits Program Page 1

4 Health (Medical Insurance) Aetna & Allied National Costs Weekly Payroll Deduction Aetna Bronze HSA Aetna Silver HSA Aetna Platinum PPO Aetna HMO HMO - National Allied MEC Allied ACP Employee $ $ $ $ $ 9.23 $27.54 Employee + Spouse $ $ $ $ $18.49 $ Employee + Child(ren) $ $ $ $ $29.66 $ Family $ $ $ $ $38.92 $ Page Benefits Program

5 Medical Summary of Benefits Aetna Bronze HSA & Silver HSA Aetna Bronze HSA Signature Administrator Provider Network In-Network Out-of-Network Coinsurance 80% 50% Calendar Year Deductible Individual Family Calendar Year Out-of-Pocket Maximum* Individual Family $2,500 $5,000 $5,000 $10,000 $5,000 $10,000 $10,000 $20,000 Physician Office Visit 80% after deductible 50% after deductible Preventive Care 100%; deductible waived 50% after deductible Emergency Room 80% after deductible 80% after deductible Urgent Care 80% after deductible 50% after deductible Inpatient Services 80% after deductible 50% after deductible Outpatient Services 80% after deductible 50% after deductible Retail Pharmacy** 80% after deductible 80% after deductible Mail Order Pharmacy** 80% after deductible Not Covered Aetna Silver HSA Signature Administrator Provider Network In-Network Out-of-Network Coinsurance 100% 80% Calendar Year Deductible Individual Family Calendar Year Out-of-Pocket Maximum* Individual Family $2,500 $5,000 $2,500 $5,000 $5,000 $10,000 $10,000 $20,000 Physician Office Visit 100% after deductible 80% after deductible Preventive Care 100%; deductible waived 80% after deductible Emergency Room 100% after deductible 100% after deductible Urgent Care 100% after deductible 80% after deductible Inpatient Services 100% after deductible 80% after deductible Outpatient Services 100% after deductible 80% after deductible Retail Pharmacy** 100% after deductible 100% after deductible Mail Order Pharmacy** 100% after deductible Not Covered *Includes deductible **Discount at point of purchase, amount due & paid by member is then applied to deductible and/or out-of-pocket. NOTE: Some benefits require precertification/preauthorization, please see your specific plan booklet for guidelines Benefits Program Page 3

6 Medical Summary of Benefits Aetna Platinum PPO Aetna Platinum PPO Signature Administrator Provider Network In-Network Out-of-Network Coinsurance 90% 70% Calendar Year Deductible Individual Family Calendar Year Out-of-Pocket Maximum* Individual Family $250 $500 $1,250 $2,500 $750 $1,400 $1,750 $3,400 Physician Office Visit 90% after deductible 70% after deductible Preventive Care 100%; deductible waived Not covered Emergency Room Copay waived if admitted $150 copay $150 copay Urgent Care 90% after deductible 70% after deductible Inpatient Services 90% after deductible 70% after deductible Outpatient Services 90% after deductible 70% after deductible Retail Pharmacy $10/$40/$60 $10/$40/$60 Mail Order Pharmacy $20/$80/$120 copay Not Covered Pharmacy Calendar Year Out-of-Pocket Maximum** Individual Family $5,450 $10,900 *Includes deductible **After the Prescription Drug Out-of-Pocket is reached, prescriptions are then covered at 100% in-network. NOTE: Some benefits require precertification/preauthorization, please see your specific plan booklet for guidelines. Page Benefits Program

7 Medical Summary of Benefits Aetna HMO Replacement (In-Network Only Plan) Aetna HMO Replacement (In-Network Only Plan) Signature Administrator Provider Network In-Network Only Coinsurance 100% Calendar Year Deductible Individual Family Calendar Year Out-of-Pocket Maximum* Individual Family Physician Office Visit/Specialist (exam only) $0 $0 $1,500 $3,000 $20 copay/$40 copay Preventive Care 100% Emergency Room Copay waived if admitted $150 copay Urgent Care 100% Inpatient Services 100% Outpatient Services 100% Retail Pharmacy Mail Order Pharmacy Pharmacy Calendar Year Out-of-Pocket Maximum** Individual Family $10/$40/$60 copay $20/$80/$120 copay $4,950 $9,900 HMO Replacement Plan available to all employees nationally! No need to elect a primary care physician No need to secure a referral for services but some services do need to be precertified and preauthorized Utilizes the Aetna Signature Administrator s provider network No benefits will be covered for out of network providers, with the exception of true life threatening emergency care. *Includes deductible **After the Prescription Drug Out-of-Pocket is reached, prescriptions are then covered at 100% in-network. NOTE: Some benefits require precertification/preauthorization, please see your specific plan booklet for guidelines Benefits Program Page 5

8 How do I find an Aetna network medical provider on The contact information for Aetna s network will be listed on the back on your ID card. You may utilize to confirm a provider s network status online or you can call Allied direct at The following details show an illustrated (screenshot) version of the 4 steps that will help you find a provider online at for all of the Aetna Medical plans (Bronze & Silver HSA s, Platinum PPO and HMO). Page Benefits Program

9 Medical Summary of Benefits Allied MEC (Minimum Essential Coverage-Preventive Only Plan) Allied MEC (Minimum Essential Coverage-Preventive Only Plan) MultiPlan Provider Network Coinsurance Calendar Year Deductible Physician Office Visit/Specialist Phone consultations 24/7/365 for diagnosis and treatment of common conditions, prescription charges may apply Emergency Room Urgent Care Inpatient Services Outpatient Services Retail Pharmacy In-Network Only 100% for preventive only 100% for consultation only 100% limited to the following; Routine iron supplements for children, 6-12 months old; Folic Acid for all women; Aspirin for adults age 45-80; Contraception for women approved by the FDA and as required by federal law. NOTE: Some benefits require precertification/preauthorization, please see your specific plan booklet for guidelines Benefits Program Page 7

10 MultiPlan Network and Limited Benefit Plans How do I find a MultiPlan network medical provider on The contact information for MultiPlan s network will be listed on the back on your ID card. You may utilize to confirm a provider s network status online or you can call The following details show an illustrated (screenshot) version of the steps that will help you find a provider online. Step 1. Go to and click on Search for a Doctor or Facility Step 3. Select the type of provider you wish to search (Doctor or Facility) Click on Search for a Doctor or Facility Select provider type and continue Step 2. Indicate that you have the logo shown here on your ID card (found in Front of Card/Other network logos section) Step 4. Enter your search criteria click continue and select a provider (Doctor or Facility) Check the box next to the appropriate logo and then click on Continue Enter your search criteria and click Continue Before Your Appointment It is your responsibility to confirm your providers continued participation in the MultiPlan Network under your limited benefit plan. Please also be sure to follow any preauthorization procedures required by your plan (usually a telephone number on your ID card). To ensure proper handling of your claim, always present your current benefits ID card upon arrival at your appointment. Page Benefits Program

11 Medical Summary of Benefits Allied Affordable Care Plan (ACP) Allied Affordable Care Plan (ACP) ACP Benefits Coinsurance Calendar Year Deductible (waived for physician charges) Individual Family Calendar Year Out-of-Pocket Maximum* Individual Family Physician Office Visit/Specialist (exam only) Phone consultations 24/7/365 for diagnosis and treatment of common conditions, prescription charges may apply Preventive Care Emergency Room Urgent Care Inpatient Services Outpatient Services Retail Pharmacy Mail Order Pharmacy 90% of Medicare Reimbursement Rate $2,000 $4,000 $6,450 $12, % of Medicare Reimbursement Rate, deductible waived 100% for consultation only, deductible waived 100% of Medicare Reimbursement Rate, deductible waived 90% of Medicare Reimbursement Rate 90% of Medicare Reimbursement Rate 90% of Medicare Reimbursement Rate 90% of Medicare Reimbursement Rate 90% after deductible 90% after deductible Important Note: You will be responsible for any charges for services that are billed to you that are over the rates paid by The Affordable Care Plan using the federal government s Medicare Reimbursement Fee Schedule. *Includes deductible NOTE: Some benefits require precertification/preauthorization, please see your specific plan booklet for guidelines Benefits Program Page 9

12 Major Medical Insurance The Affordable Care Plan (Indemnity Plan) Carrier: Allied Effective: 1/1/2016 Website: Phone: The Affordable Care Plan (ACP) simplifies the way that you receive health care benefits. Covered Expenses are covered at specified levels without Preferred Provider Networks that adjust and discount benefit payments. ACP benefits are reimbursed at a flat transparent rate. Specifically, the ACP will reimburse Covered Expenses using the same reimbursement rates as the Federal government under Medicare Fee Schedules. If a Covered Expense does not have a corresponding Medicare Reimbursement Rate, the ACP reserves the right to process that claim at the Reasonable and/or Usual and Customary benefit level. Important Note-You may be responsible for any charges for services that are billed to you that are over the rates paid by The Affordable Care Plan using the federal government s Medicare Fee Schedules. The Affordable Care Plan Benefit Highlight This is a summary of the benefits only. Please refer to your full schedule of benefits for a comprehensive list of covered services. Network None (indemnity) Deductible $2,000/ $4,000 Co Insurance 90% Out of Pocket Maximum Individual Family Physician Services Well Adult / Child Care Physician Office Visit- Exam Charge Only Specialist X-Rays / Lab Diagnostics Allied Affordable Care Plan (ACP) - Q&A/FAQs $6,450 $12, % of Medicare Rate 100% of Medicare Rate 100% of Medicare Rate 100% of Medicare Rate Deductible Waived Is the Affordable Care Plan (ACP) the right plan for me? 1. What does it mean that the Affordable Care Plan uses the Medicare Fee Schedules as the basis for provider payment? The federal government has developed Medicare Fee Schedules as the rates paid to medical professionals to perform certain procedures for nearly 50 million people covered under Medicare. The Affordable Care Plan uses the same pricing methodology however is not affiliated with the federal Medicare program. 2. I m interested in the ACP, how do I know my current provider will accept this plan? Contact your current medical providers (doctors, hospitals, labs, etc.) and ask if they would accept the Affordable Care Plan Medicare Fee Schedule payment structure for services rendered. 3. I ve called my current provider and have been told they won t accept this plan, what happens now? You have the option of looking for another provider who will accept payment at the Medicare allowable or you can elect one of the traditional Aetna network plan options available to you. 4. Is there a network of providers? No. The ACP is considered an indemnity plan. You can utilize any provider you choose however it s at the discretion of the provider to accept the ACP plan and accept as payment in full. 5. How do I find a provider that will accept the ACP? If your current provider will not accept the ACP you have resources available to help you. First, you can search online for providers that currently accept Medicare payments. Once you identify a provider you should call to confirm that they will accept the ACP in advance. Website instructions on the following page. 6. What if I m still having difficulty finding a provider that will accept the ACP? All members of the ACP have access to the Allied Concierge team. The Concierge team is available for enrolled members who need help locating providers who will accept the ACP. 7. What is a balance bill? A balance bill may occur when the provider credits the payment received from the ACP based on the Medicare Fee Schedules but doesn t accept the Medicare rate as payment in full. The provider has the right to bill you the difference between the plan payment and the total billed charges. Emergency Room Services Inpatient Hospitalization Prescription Drug Services Retail (Generic / Brand / Non-Pref Brand) Mail (Generic / Brand / Non-Pref Brand) Lifetime Maximum Page 10 Summary of benefit on the next page. 90% of Medicare Rate 90% of Medicare Rate Subject to Deductible and Coinsurance Unlimited 100% - Deductible Waived 8. What happens if I m balance billed? In the event of a balance bill over $750 you can contact the Allied Patient Advocacy team. They will help work with you and your provider in the event of the balance bill. However there is no guarantee the balance bill will be alleviated. 9. How can I avoid being balance billed? By contacting providers BEFORE utilizing their services. Confirm that they accept the Medicare Fee Schedule payment and that they won t balance bill. You may also want to consider one of the Aetna options instead of the Affordable Care Plan. 10. The Essential Staff Care plan didn t cover hospitalization, does this plan? Yes. The ACP will cover hospitalization up to the Medicare Fee Schedule limits Benefits Program

13 Allied Affordable Care Plan (ACP) - Q&A/FAQs Major Medical Insurance The Affordable Care Plan (Indemnity Plan) Precertification Carrier: Allied Care Phone: Your Plan includes a Pre-Certification program. Certain services and procedures may require you and your doctor to contact Allied Care. Failure to do so may result in a penalty to your benefits. Please refer to your Summary Plan Description for the Pre-Certification requirements. Allied Concierge Service Carrier: Allied Concierge Service Phone: The Concierge Team is a dedicated staff of nurses and social workers that are committed to helping you and your family get the care that you need at an affordable price. Your Allied Concierge will assist you in the event that you have difficulty locating providers who will accept the Affordable Care Plan. Allied Care Solutions Behavioral Health Carrier: Allied Care Solutions Phone: At some point in our lives, each of us faces a problem or situation that is difficult to resolve. When these instances arise, Allied Care Solutions will be there to help. The Allied Care Solutions program is a company-sponsored resource that helps you deal with life s challenges and the demands that come with balancing home and work. The program provides confidential services for a wide array of personal and work-related concerns. Helpful resources for locating providers that may accept the ACP: With access to the internet, you may find the following two websites useful in identifying providers who may be willing to accept the payment from the Affordable Care Plan. Zocdoc.com (Please note this website does offer language options) Step 1: Go to zocdoc.com Step 2: Choose a specialty such as "Primary Care Doctor" Step 3: Enter your preferred zip code Step 4: Choose "Medicare" in the drop down box "Who Participates in" This should provide you with a list of providers currently accepting Medicare within a specified distance of your zip code. Medicare.gov/physiciancompare: Step 1: Go to medicare.gov/physiciancompare Step 2: Enter your zip code in the "Location" box Step 3: Enter "family practice" or "internal medicine" or a specific specialty in the "What are you searching for?" box Step 4: Click on search button to the right and a list of providers and distance from your zip code will appear. IMPORTANT: Providers that are identified are for informational purposes only. This communication does not constitute or imply that the providers listed are known to, recommended by or that they have any relationship or agreement, with the Affordable Care Plan Telemedicine Carrier: Teladoc Phone: Teladoc is an affordable solution to the challenge of healthcare access. We provide you and your family with round-the-clock access to U.S based licensed physicians for telephone consultations. Regardless of your location, you can connect with a doctor in real-time for treatment or diagnosis of common conditions. Allied Patient Advocacy Carrier: Allied Patient Advocacy Team Phone: The Advocacy Team is dedicated to working with you and your family to help you get the quality care you demand at a price that is both fair and appropriate. If you are ever faced with a charge that is not covered by the Affordable Care Plan, your Allied Advocate will personally assist you in resolving billed amounts over $750. Allied Member Portal Carrier: Website: Allied Benefit Systems Your online member account allows easy access to view your Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC). Through your online account, you can also view your Personal Health Record, which provides you with a complete record of all your health care activity under this plan; get answers to medical questions and information on procedures and conditions via Allied s knowledge database; and receive wellness reminders for tests and annual exams. See the examples below outlining how balance billing may impact a medical claim: Example: Provider doesn t agree to not balance bill Procedure: Leg MRI w/contrast Total Billed Charges: $840 ACP Payment (after deductible & coinsurance): $440 Potential member balance bill: $400 Example: Provider accepts ACP and Medicare Fee Schedule as payment in full (confirmation of benefits in advance of service) Procedure: Leg MRI w/contrast Total Billed Charges: $840 ACP Payment (after deductible & coinsurance): $440 Potential member balance bill: $ Benefits Program Page 11

14 Allied Affordable Care Plan (ACP) Allied Concierge Services The Concierge Team is a dedicated unit of highly trained nurses and social workers that are committed to assisting members in securing appointments with providers with highly skilled medical professionals whose services are reasonably priced, affordable, and covered under the plan. Allied Patient Advocacy Services The Advocacy Team has a proven track record of working directly with members and their providers to resolve billing disputes, negotiate settlements of outstanding balances and eliminating patient responsibilities. The Advocacy Team assists members in addressing high cost medical expenses that may not be reimbursable under the Affordable Care Plan. Page Benefits Program

15 How to use Teladoc: 1) Dial Teladoc ( ) to speak with a friendly care coordinator. 2) Access your account online at and click "Set up account" to register. 3) Download the Teladoc member app at Teladoc.com/mobile. NOTE: You must be enrolled in the Allied MEC or ACP medical plans in order to utilize the Teladoc service Benefits Program Page 13

16 -Online Eligibility Status -Online Claim Status -Online Plan/Benefit Information -Healthcare Information Database -Hospital Comparison Tool -Rx Comparison Tool -Search for Network Providers -Custom Wellness Notifications Page Benefits Program

17 Health Savings Account (HSA) HSA Bank What is a Health Savings Account (HSA)? A Health Savings Account (HSA) 1 is a type of savings account funded with pre-tax dollars that is used to pay for eligible health care expenses not covered by the insurance plan. You decide how much to contribute, the amount you want to spend on qualified medical expenses as well as which expenses you will pay out of your account. Withdrawals you make are not taxed as long as they are used for qualified expenses. The account is individually owned which means you take it with you when you change jobs or retire. In order to enroll in an HSA, you must be enrolled in either the Aetna Bronze HSA plan or Aetna Silver HSA plan. How does an HSA work? Part 1 Qualifying High Deductible Health Insurance Plan (HDHP) Intended to cover serious illness or injury after the deductible has been met. How much can I contribute to an HSA? For the 2016 calendar year, the annual contribution limits are equal to: $3,350 for individual coverage or $6,750 for family coverage. Individuals that are age 55 or older may be eligible to make a catch-up contribution of $1,000 in What are the advantages of an HSA? Part 2 Health Savings Account Pays for out-of-pocket expenses incurred before the deductible is met. 1. HSA funds can be used to pay for current and future qualified medical expenses. 2. Contributions use pre-tax dollars or are tax deductible. 3. If the account has a balance at the end of the year, it is rolled over to the following year so you don t have to use the funds by a certain date. 4. The account provides an opportunity to build a significant balance after years of tax-free contributions, interest, and investments. 5. If you terminate employment or retire, you have the option to leave the funds in the HSA or roll them over to another financial institution that is a qualified HSA custodian/trustee. 1. The HSA account is funded by employee contributions. 2. Employee seeks medical services. 3. Medical services are paid by the HDHP subject to a deductible and possible coinsurance. 4. Employee may seek reimbursement from his/her HSA account for amounts paid toward deductible and coinsurance. 5. Deductible and out-of-pocket maximum are fulfilled. 6. Employee may be covered for all remaining eligible expenses. What is a qualified medical expense? A qualified medical expense is a medical care expense that is primarily for the prevention or alleviation of a physical or mental defect or illness. In general, this includes the same services covered by your health plan. It also includes money that goes toward the following: Deductibles and Coinsurance Eyeglasses and Contact Lenses Dental Services Prescription Drugs Certain Services not covered by your health plan 2016 Benefits Program Page 15

18 Dental Summary of Benefits Aetna You may access any licensed dental provider; however, you are eligible to receive discounted dental services if you utilize Aetna providers. Your legal spouse and your unmarried child(ren) up to age 26 are eligible for coverage. To find In-Network Dentists, visit Dental Insurance Low Plan Deductible In-Network Employee $100 $200 Family $300 $600 Out-of-Network** Calendar Year Maximum $1,000 per person $500 per person Preventive Care (not subject to annual deductible; one cleaning every 6 months) Basic Services* (fillings, simple extractions, oral surgery, periodontics, endodontics) Major Services* (crowns, inlays, onlays, dentures) Dental Insurance High Plan Deductible 100% 80% 50% In-Network Employee $50 $50 Family $150 $ % of Usual & Customary fees 70% of Usual & Customary fees 25% of Usual & Customary fees Out-of-Network Calendar Year Maximum $2,000 per person $2,000 per person Preventive Care (not subject to annual deductible; one cleaning every 6 months) Basic Services* (fillings, simple extractions, oral surgery, periodontics, endodontics) Major Services* (crowns, inlays, onlays, dentures) Orthodontic Services* (covers appliances installed prior to age 19) 100% 80% 50% Weekly Employee $ 4.22 Employee + One $ 8.02 Employee + Two or More $12.23 Weekly Employee $11.23 Employee + One $20.71 Employee + Two or More $ % (lifetime max $1,000) Implants* 50% (lifetime max $2,000) 100% of Usual & Customary fees 80% of Usual & Customary fees 50% of Usual & Customary fees 50% of Usual & Customary fees (lifetime max $1,000) 50% of Usual & Customary fees (lifetime max $2,000) * Late entrant waiting periods apply to both plans; 12 months for Basic & Major, 12 months for High Plan Orthodontic benefit. Late entrant means you and/or your dependents declined coverage when first eligible and have elected coverage later. Page Benefits Program

19 How do I find an Aetna network dental provider on The contact information for Aetna s PPO Dental network will be listed on the back on your ID card. You may utilize to confirm a provider s network status online or you can call Allied direct at The following details show an illustrated (screenshot) version of the 4 steps that will help you find a provider online at for both of the Aetna Dental plans (Low & High) Benefits Program Page 17

20 Vision Summary of Benefits EyeMed You may access both In-Network and Non-Network providers for vision care treatment and services. Your legal spouse and your unmarried child(ren) up to age 26 are eligible for coverage. Vision Payroll Deductions Weekly Employee $1.38 Employee + One $2.62 Employee + Two or More $3.85 Vision Summary of Benefits In-Network Out-of-Network Frequency Exam (every 12 months) $10 copay Up to $30 Benefits (every 12 months) Single Vision Lenses Bifocal Lenses Trifocal Lenses Lenticular Lens Options (paid by member) UV Treatment Tint (Solid & Gradient) Standard Plastic Scratch Coating Standard Polycarbonate Standard Polycarbonate Under age 19 Standard Anti-Reflective Coating Premium Anti-Reflective Coating* Tier 1 Tier 2 Tier 3 Photochromic/Transitions Polarized Other Add-Ons & Services $25 copay $25 copay $25 copay $25 copay $15 $15 $15 $40 $0 $45 $57-$68 $57 $68 80% of charge $75 20% off retail price 20% off retail price Up to $25 Up to $40 Up to $60 Up to $60 Up to $55 Frames (every 24 months) Covered up to $130 Up to $65 Contact Lenses (every 12 months) Medically Necessary Disposable Covered in full Covered up to $130 Up to $210 Up to $104 For a list of providers, please visit and search the INSIGHT network or call Additional In-Network Discounts: Additional Pairs Discount Members receive a 40% discount off an additional complete pair of prescription eyeglasses once the funded benefit has been used. Sunglass Discount Members receive 20% off non-prescription sunglasses. Remaining Balance Discount Members receive 20% off any remaining balances beyond the plan coverage. *Premium progressives and premium anti-reflective designations are subject to annual review by EyeMed and are subject to change based on market conditions. Page Benefits Program

21 INSIGHT Provider Search Step 1: Go to to search for a participating vision service provider and get directions on to download the EyeMed Members application from the App Store, Android version not yet available. Click here Click here Step 2: From this page you can enter your zip code and choose the Insight network along with selecting items that may be important to you such as brands, hours, scheduling, etc. Enter your Zip Code Select the Insight network Select additional search options Providers: The Insight network includes a number of retail providers including Lenscrafters, Pearle Vision, Target Optical, For Eyes Optical, Rosin EyeCare, Optical Shop in Meijer, JCPenny Optical, Sears Optical along with many others. Search for the locations near you! 2016 Benefits Program Page 19

22 Savings & Retirement - 401(k) Wells Fargo Bank 401(k) Pre-tax & Roth Save more today for a better tomorrow! You may contribute from 1% to 100% of your salary up to $18,000, the maximum the IRS allows in Advanced Group offers automatic enrollment to all eligible temporary associates based on: Work 12 months from date of hire Work 1,000 hours in the 12 months Actively working and available for assignments Automatic enrollment at 3% contribution will begin the quarter after one year from date of hire. You may contribute to your account with pretax and/or Roth 401(k) contributions. Together, both contribution types are subject to the plan and IRS contribution limits. If you are age 50 or over by the end of the calendar year, you may qualify to make additional catch-up contributions of up to $6,000 in Your plan offers a wide array of investment options; For more investment information, go online at wellsfargo.com to review: Online calculators and a Risk Tolerance Quiz to help you determine your asset allocation and additional plan information. Advanced Group Employee Match For every dollar you put in the plan, pretax or Roth 401(k), Advanced Group will contribute 25 cents, up to the first 8% of your salary. You are always 100% vested in the money you contribute to the plan and the earnings on that money. You are 100% vested in the contributions your employer puts into your plan and the earnings on that money. Page Benefits Program

23 Box, Inc and PerkSpot have partnered to offer you a boxer discount program. PerkSpot is a one-stop shop for exclusive discounts at some of your favorite merchants! Find Deals You Can Use! TRAVEL COMPUTERS TICKETS CELL PHONES FOOD APPAREL AUTOMOTIVE BEAUTY & FRAGRANCES BOOKS, Watch MOVIES for an & MUSIC from Advanced CELL PHONES EDUCATION ELECTRONICS Group with details! FINANCE FLOWERS & GIFTS HEALTH Hundreds & of great WELLNESS merchants like HOBBIES & CREATIVE ARTS HOME & GARDEN HOME SERVICES INSURANCE & PROTECTION SERVICES JEWELRY & WATCHES LIFE EVENTS OFFICE & BUSINESS PETS REAL ESTATE & MOVING and many more! SERVICES SPORTS & OUTDOORS TICKETS & ENTERTAINMENT TOYS, KIDS & BABIES TRAVEL 2016 Benefits Program Page 21

24 Carrier Contact Information Benefit Vendor/Contact Phone Number Website Allied Customer Service (800) Allied/Aetna Customer Service (866) MEC Multiplan Customer Service (888) Medical/Prescription ACP Plan Customer Service Concierge Service Patient Advocacy Allied Care Precertification Care Solutions Behavioral health (855) TelaDoc* (800) Caremark/CVS Customer Service (877) Dental Aetna (866) Vision EyeMed Customer Service Lasik Providers (866) (877) (k) Wells Fargo Bank *You must be enrolled in one of the Allied TelaDoc eligible medical plans offered in order to utilize the Teladoc service. Page Benefits Program

25 Required Legal Notice- Allied MEC Plan Important Notice from The Advanced Group About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the MEC plan and about your options under Medicare s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. The Advanced Group has determined that the prescription drug coverage offered by the MEC plan is, on average for all plan participants, NOT expected to pay out as much as standard Medicare prescription drug coverage pays Therefore, your coverage is considered Non-Creditable Coverage. This is important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage from your Employee Benefit Plan. This also is important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first become eligible. 3. You can keep your current coverage. However, because your coverage is non-creditable, you have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, depending on if and when you join a drug plan. When you make your decision, you should compare your current coverage, including what drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Read this notice carefully - it explains your options. When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 th through December 7 th. However, if you decide to drop your current coverage, since it is employer sponsored group coverage, you will be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan; however you also may pay a higher premium (a penalty) because you did not have creditable coverage. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? Since your current coverage is not creditable, depending on how long you go without creditable prescription drug coverage, you may pay a penalty to join a Medicare drug plan. Starting with the end of the last month that you were first eligible to join a Medicare drug plan but didn t join, if you go 63 continuous days or longer without prescription drug coverage that s creditable, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current coverage may be affected. Moreover, if you do decide to join a Medicare drug plan and drop your current coverage, be aware that you and your dependents may not be able to get this coverage back. For More Information About This Notice Or Your Current Prescription Drug Coverage Contact your Human Resources Department for further information. NOTE: You will get this notice each year. You will also get it before the next period you can join a Medicare drug plan and if your current coverage changes. You also may request a copy of this notice at any time. For More Information About Your Options Under Medicare Prescription Drug Coverage More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. You ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: Visit Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the Medicare & You handbook for their telephone number) for personalized help Call MEDICARE ( ). TTY users should call If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at or call them at (TTY ).

26 Required Legal Notices- Aetna & Allied ACP Plans Important Notice from The Advanced Group About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Aetna and about your options under Medicare s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. The Advanced Group has determined that the prescription drug coverage offered by the Aetna plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 th to December 7 th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, you current Aetna coverage will be affected. See page 7-9 of the CMS Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance (available at which outlines the prescription drug plan provisions / options that Medicare eligible individuals may have available to them when they become eligible for Medicare Part D. If you do decide to join a Medicare drug plan and drop your current Aetna coverage, be aware that you and your dependents may not be able to get this coverage back. When Will You Pay a Higher Premium (Penalty) to Join a Medicare Drug Plan? You should also know that if you drop or lose your current coverage with Aetna and don t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information About Your Options Under Medicare Prescription Drug Coverage: More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. You ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: Visit Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the Medicare & You handbook for their telephone number) for personalized help. Call MEDICARE ( ). TTY users should call

27 Required Legal Notices- Aetna & Allied ACP Plans (continued) If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at or call them at (TTY ). Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty). Date: October 15, 2016 Name of Entity/Sender: Contact: The Advanced Group Mary Gliva Address: 10 Parkway North, Suite 350 Deerfield, IL Phone Number: (847) Women s Health and Cancer Rights Act The Women s Health and Cancer Rights Act of 1998 was signed into law on October 21, The Act requires that all group health plans providing medical and surgical benefits with respect to a mastectomy must provide coverage for all of the following: Reconstruction of the breast on which the mastectomy was performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; and Prosthesis, if necessary, treatment for physical complications of all stages of mastectomy, including lymphedema. This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsurance provisions which apply for the mastectomy. For deductibles and coinsurance information applicable to the plan in which you enroll, please refer to the plan descriptions. Notice of Privacy Practices Availability of Notice of Privacy Practices The Aetna Health Plan (Plan) maintains a Notice of Privacy Practices that provides information to individuals whose protected health information (PHI) will be used or maintained by the Plan. If you would like a copy of the Plan s Notice of Privacy Practices, please contact Human Resources at (847) Genetic Information Title II of the Genetic Information Nondiscrimination Act of 2008 ( GINA ) protects applicants and employees from discrimination based on genetic information in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment. GINA also restricts employers acquisition of genetic information and strictly limits disclosure of genetic information. Genetic information includes information about genetic tests of applicants, employees, or their family members; the manifestation of diseases or disorders in family members (family medical history); and requests for or receipt of genetic services by applicants, employees, or their family members. For further information on GINA, please see the poster Equal Employment Opportunity is The Law, which should be posted in a common area at your employment location. Newborns and Mothers Health Protection Act of 1996 (NMHPA) Statement of Rights Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Premium Assistance Under Medicaid and The Children s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your State may have a premium assistance program that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer. If you or your children are not eligible for Medicaid or CHIP, you will not be eligible for these premium assistance programs. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.

28 Required Legal Notices - Premium Assistance Under Medicaid and the Children s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren t eligible for Medicaid or CHIP, you won t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial KIDS NOW or to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren t already enrolled. This is called a special enrollment opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at or call EBSA (3272). If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, Contact your State for more information on eligibility ALABAMA Medicaid Website: Phone: ALASKA Medicaid Website: Phone (Outside of Anchorage): Phone (Anchorage): COLORADO Medicaid Medicaid Website: Medicaid Customer Contact Center: FLORIDA Medicaid Website: Phone: KENTUCKY Medicaid Website: Phone: LOUISIANA Medicaid Website: Phone: MAINE Medicaid Website: Phone: TTY MASSACHUSETTS Medicaid and CHIP Website: Phone: GEORGIA Medicaid Website: - Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP) Phone: INDIANA Medicaid Website: Phone: IOWA Medicaid Website: Phone: KANSAS Medicaid Website: Phone: NEW HAMPSHIRE Medicaid Website: Phone: NEW JERSEY Medicaid and CHIP Medicaid Website: dmahs/clients/medicaid/ Medicaid Phone: CHIP Website: CHIP Phone: NEW YORK Medicaid Website: Phone: NORTH CAROLINA Medicaid Website: Phone:

29 Required Legal Notices - Premium Assistance Under Medicaid and the Children s Health Insurance Program (CHIP) (continued) MINNESOTA Medicaid Website: Click on Health Care, then Medical Assistance Phone: MISSOURI Medicaid Website: Phone: MONTANA Medicaid Website: Phone: NEBRASKA Medicaid Website: Phone: NEVADA Medicaid Medicaid Website: Medicaid Phone: SOUTH CAROLINA Medicaid Website: Phone: SOUTH DAKOTA - Medicaid Website: Phone: TEXAS Medicaid Website: Phone: UTAH Medicaid and CHIP Website: Medicaid: CHIP: Phone: VERMONT Medicaid Website: Phone: NORTH DAKOTA Medicaid Website: Phone: OKLAHOMA Medicaid and CHIP Website: Phone: OREGON Medicaid Website: Phone: PENNSYLVANIA Medicaid Website: Phone: RHODE ISLAND Medicaid Website: Phone: VIRGINIA Medicaid and CHIP Medicaid Website: Medicaid Phone: CHIP Website: CHIP Phone: WASHINGTON Medicaid Website: index.aspx Phone: ext WEST VIRGINIA Medicaid Website: fault.aspx Phone: , HMS Third Party Liability WISCONSIN Medicaid and CHIP Website: Phone: WYOMING Medicaid Website: Phone: To see if any other states have added a premium assistance program since July 31, 2015, or for more information on special enrollment rights, contact either: U.S. Department of Labor U.S. Department of Health and Human Services Employee Benefits Security Administration Centers for Medicare & Medicaid Services EBSA (3272) , Menu Option 4, Ext OMB Control Number (expires 10/31/2016)