Benefits Summary doc

Transcription

1 Head Start, Inc. - Employee Benefits Summary* *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination.

2 Employee Benefits Selections Explanation of Benefit* Who is Eligible? EBMS All active eligible employees who work at least 20 hours/week. Head Start may contribute a set amount annually to employees benefit elections. This amount is paid monthly to each employee. Employee pays all remaining contributions to reimbursement accounts with pre-tax dollars. There is a $6 administrative fee per employee per month. Head Start pays $3 of this fee and the employee pays $3. All new employees may enroll after the waiting period for benefits, which is the first of the month following 120 days after your first day of employment. For existing employees (or returning from layoff), enrollment may occur within 30 days of returning back to work after layoff or during Open Enrollment. What is covered? How do I get the money? When can I make changes to my participation levels? What if I don t use the money? Payroll deductions are made on a pre-tax basis and funds may be placed into separate accounts in order to reimburse the employee for: Medical Reimbursement Dependent Care Reimbursement Outside Individual Insurance Premium AE Health Insurance Premium AFLAC Dental Premium AFLAC Personal Accident Expense Plan Premium Claims for the Medical and Dependent Care Reimbursement accounts are submitted by the employee to EBMS and are paid by EBMS. Insurance premium accounts are administered by Head Start. Changes may be made at the Open Enrollment period or when there has been a qualifying change in status as defined by the IRS (such as marriage, birth, death, divorce, or employment). Please see plan documents or the HR Director for a complete explanation. Employees may be given up to two months past the end of the plan year to incur and claim reimbursable expenses. If funds are not claimed by this time, the employee loses the funds. (otherwise known as the use it or lose it rule.) 2

3 Why should I participate? Tax Savings Illustration: Generally speaking, participation in a Cafeteria Plan increases your take-home pay because your taxable income is reduced by the amount of your elections. $2000 monthly income Without Café the remaining take-home would be $ (after paying the expense with after-tax dollars) With Café of $60 health ins. premium, $50 medical exp. and $150 Dependent care, take-home would be $ or $ /year more income. *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination. 3

4 Health Insurance Summary of Benefits* Associate Employers Group Benefit Plan & Trust Who is Eligible? All active eligible employees who work at least 20 hours per week. Head Start may contribute a fixed amount each year to participating employees premiums for the number of weeks that they work each Program Year. The remainder of the premium amount is paid by the employee with pre-tax dollars. All new employees may enroll after the waiting period for benefits, which is the first of the month following 120 days after your first day of employment. For existing employees (or returning from layoff), enrollment may occur within 30 days of returning back to work after layoff or during Open Enrollment. All employees may enroll within 30 days after health insurance coverage ends in another plan and this other plan was the reason for declining AEGBP&T coverage initially. All employees working under their agreement period may enroll any time of year, however preexisting conditions will apply. When does coverage take effect? Coverage will take effect the first of the month following the month of enrollment. For example: Enroll on Sept. 21 and coverage begins on Oct 1. When can I make changes to my coverage levels? Employees may make changes to the level of coverage effective January 1 st of each year, or April in those years in which there is a rate increase. 4

5 Employees participating in the Cafeteria Plan for premium deductions may make mid-year changes to coverage levels if the employee experiences a Change in Status as defined by the IRS (such as marriage, birth, death, divorce, or employment changes). Without a Change in Status, and in most other circumstances, employees may not make changes to coverage midplan year. Level of coverage options Employees may choose a level of coverage from the attached matrix of options. Coverage levels range from $200, $500 or $1500 deductibles, 70/30 or 50/50 split and Choice Care, Choice Care Plus or Select Care networks. Lifetime Maximum Benefit $2,000,000 Pre-Existing condition Deductible 18 consecutive months in the plan. This applies to Late Enrollees only who did not have a Certificate of Creditable Coverage from another healthcare plan previous to enrollment in this plan. Depends upon the plan chosen on the health insurance plan options matrix. May be $200, $500 or $1500/year/individual. Deductible is met based on services provided in a Calendar Year (Jan.-Dec.) Maximum out of pocket For / plans: Yearly maximum of $ deductible per person, with a family maximum of $ deductible. For / Plans: Yearly maximum of $ deductible per person, with a family maximum of $ deductible. Deductible does not apply to maximum out of pocket. Exclusions include but are not limited to: chiropractic, durable medical equipment, prosthetic devices, rehabilitation therapy, and dental. 5

6 Benefit Percentage/Co-Insurance Plan Medical Expenses Benefits and Limitations Prescription Drugs / Plans - Benefit pays 70% and employee pays 30% up to maximum out of pocket amount and then plan pays 100% unless otherwise stated in plan documents. / Plans- Benefit pays 50% and employee pays 50% up to maximum out of pocket amount and then plan pays 100% unless otherwise stated in plan documents. Please see corresponding Plan Summary Book for specific information regarding Health Benefits and Exclusions and General Plan Provisions. Participants receive discounted rates when their ID card is used at participating pharmacies. Participants pay up front for prescriptions and then apply for reimbursement. Plan reimbursement is subject to co-insurance and deductible. A MiRX Mail Order Pharmacy is also available for maintenance medications. Generic drugs are paid at 100% and no deductible applies. Participant must use ID card and Preferred Providers for any benefits to be received. Specialty drugs are obtained through the CVS/Caremark Specialty Pharmacy Program. Please see Summary Plan Description for more details. Add-on Benefit - Life & Accidental Death & Dismemberment $5000/employee if enrolled in the AEGBBP&T health insurance plan. *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination. 6

7 Health Insurance Plan Options and Current Premium Rates* - 70/30 Split Plan: Choice Care Billings Clinic Hospital and Billings Clinic Doctors only Choice Care Billings Clinic Hospital and Billings Clinic Doctors only SelectCare Either Hospital and most all Doctors in Billings $ Deductible $ Deductible $ Deductible Participant Maximum Out-of-Pocket $ deductible; Maximum Family Out-of-Pocket $ deductible Employee Only $ $ Employee + Spouse $ $ Employee + Children $ $ Employee + Family $ $ Participant Maximum Out-of-Pocket $ deductible; Maximum Family Out-of-Pocket 50/50 Split Plan: $ deductible Employee Only $ Employee + Spouse $ Employee + Children $ Employee + Family $ *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination. 7

8 Deaconess Occupational Health & Wellness Explanation of Benefit s, Addresses & Phone Numbers Deaconess Billings Clinic - Occupational Health and Wellness 1020 N. 27 th Street, 3 rd Floor, Billings, MT, Deaconess Billings Clinic Employee Assistance Program (EAP) 1042 N. 29 th Street, Billings, MT Who is Eligible? When am I eligible? What is covered for physical care? All regular and probationary employees Head Start Immediately upon hire for TB, physical exams and Hepatitis B vaccination, and immediately for the EAP All required TB and physical exams as well as Hepatitis B immunizations are available through Head Start at no cost to the employee. Who provides these services? What is covered for emotional and psychological care? A Family Nurse Practitioner and/or a Physician s Assistant The Employee Assistance Program provides assessment for shortterm treatment of: Stress management, anger management, substance use and abuse problems, communication issues, depression, work-related performance issues, and family conflict, and additional more. See the Employee Assistance Program brochure for more information. Who provides these services? Licensed Clinical Social Workers *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination. 8

9 Long Term Disability Insurance Summary of Benefits* Who is Eligible? Unum All active eligible employees who work at least 20 hours per week Employee - voluntary benefit Paid with after-tax dollars. For new employees, the waiting period for enrollment is 120 days after your first day of employment. For existing employees, enrollment may occur during Open Enrollment. A 2 year waiting period for benefits will apply for preexisting conditions. When does coverage take effect? Coverage will take effect the first of the month following the month of enrollment. For example: Enroll on Sept. 21 and coverage begins on Oct 1. When can I make changes to my coverage levels? Level of coverage options Changes may be made during Open Enrollment each year. Employees may increase or decrease levels of coverage at this time. Employees may choose coverage of 25%, 40%, or 50% of monthly earnings. Monthly Maximum Benefit $5000 Elimination Period (waiting period) Duration of coverage Disability Definition Disability payments will begin after 90 days of a continuous disability or illness unless classified as a preexisting condition. Disability payments will continue as long as you meet the definition of disability, up to age 65, but not less than 5 years. If your disability occurs at or after age 65, benefits would be paid for a reduced period of time. You can be classified as having a disability or a partial disability based on certain conditions. Please see the Unum Voluntary Long Term Disability Income Protection Insurance Plan Highlights for

10 additional information. Pre-Existing condition Mental Illness Limitations Rate Guarantee Portability A 12-month look-back period prior to enrollment for any consultations or treatments, and a 24-month waiting period for benefits after enrollment in plan for any pre-existing conditions. 24 months maximum benefit for mental illness rates are guaranteed for 1 year If you leave Head Start, you may take your coverage with you at the group rate for up to 12 months, providing you meet certain conditions. Please see the Unum Voluntary Long Term Disability Income Protection Insurance Plan Highlights for additional information. *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for

11 complete benefit determination. Life Insurance Summary of Benefits* Who is Eligible? Aflac All active eligible employees who work more than 20 hours/week Employee - voluntary benefit Paid with after-tax dollars. For new employees, the waiting period for enrollment is 120 days after your first day of employment. For existing employees (or returning from layoff), enrollment may occur during Open Enrollment. Who is covered? When does coverage take effect? Employees may enroll individually or with a spouse and/or children rider(s). Coverage will take effect the first of the month following the month of enrollment. For example: Enroll on Sept. 21 and coverage begins on Oct 1. Types of Life Insurance Offered Limitations & Exclusions Accidental-Death Benefit Rider Duration of coverage Portability Whole Life, Term Life, and Term Life with Return of Premium Please see the Aflac Life Insurance brochure for additional information. If the primary insured s death meets certain criteria, additional insurance money will be paid out. Please see the Aflac Life Insurance brochure for additional information. - - Year Term and is portable when employment ends If you leave Head Start, you may take your coverage with you. *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a

12 promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination.

13 Dental Insurance Summary of Benefits* Who is Eligible? Aflac All active eligible employees who work more than 20 hours/week Employee pays premium - voluntary benefit. May be paid with pretax dollars through the Cafeteria Plan, or else employee may choose to pay with after-tax dollars. For new employees, the waiting period for enrollment is 120 days after your first day of employment. Current employees may enroll during Open Enrollment. When does coverage take effect? Coverage will take effect the first of the month following the month of enrollment. For example: Enroll on Sept. 21 and coverage begins on Oct 1. When can I make changes to my coverage levels? Level of coverage options Waiting period Duration of Coverage & Portability Employees may make changes to their coverage levels at Open Enrollment. Employees may make mid-year changes to coverage levels if the employee experiences a Change in Status as defined by the IRS (such as marriage, birth, death, divorce, or employment changes). Without a change in status, and in most other circumstances, employees may not make changes to coverage mid plan year. Employees may choose level of coverage that fits their personal needs and budget. See Dental brochures for more information. Based on services performed. Range from 0 to 24 months Available through age 65, should you retire or leave employment you may keep your dental plan at the same payroll rate as long as the premiums are paid with no age limit - guaranteed renewable. *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for

14 complete benefit determination. Short-Term Disability Summary of Benefits* Who is Eligible? Aflac All active eligible employees who work 20 or more hours per week Employee - voluntary benefit Paid with after-tax dollars. For new employees, the waiting period for enrollment is 120 days after your first day of employment. For existing employees (or returning from layoff), enrollment may occur during Open Enrollment. When does coverage take effect? Coverage will take effect the first of the month following the month of enrollment. For example: Enroll on Sept. 21 and coverage begins on Oct 1. When can I make changes to my coverage levels? Pre-existing Conditions Monthly Benefit Employees may increase or decrease levels of coverage during Open Enrollment. 12-month look-back period prior to enrollment. A 12-month waiting period to obtain benefits for pre-existing conditions after enrollment. $500 to $5,000 (subject to income requirements) Benefit Periods 3 or 6 months Elimination Periods (Injury/Sickness) 0/7, 0/14, 14/14, 0/30, 30/30 Portability If you leave Head Start, you may take your coverage with you. *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination.

15 Accident Indemnity Insurance Summary of Benefits* Who is Eligible? Aflac All active eligible employees who work 20 or more hours per week Employee - voluntary benefit Employee portion may be paid with pre-tax dollars through the Cafeteria Plan, or employee may choose to pay with after-tax dollars. For new employees, the waiting period for enrollment is 120 days after your first day of employment. For existing employees (or returning from layoff), enrollment may occur during Open Enrollment. Plan Choices Elimination Period (waiting period) When can I make changes to my coverage levels? Limitations & Exclusions Monthly Benefit Benefit Period Duration of coverage Accident Indemnity Advantage Plan One & Plan Two None Employees may make changes to their coverage levels at Open Enrollment each year. Employees participating in the Cafeteria Plan for premium deductions may make mid-year changes to coverage levels if the employee experiences a Change in Status as defined by the IRS (such as marriage, birth, death, divorce, or employment changes). Without a change in status, and in most other circumstances, employees may not make changes to coverage mid plan year. Please see the Aflac Accident Indemnity Advantage 24-Hour Accident-Only Insurance brochure for complete information. Wellness, Accident-specific benefits, Major diagnostic exam benefits, Physical therapy, Ambulance, Accidental death benefits, and more. See the Aflac Accident Indemnity brochures for more information. No deductible, co-payments, lifetime limits, or network restrictions. Guaranteed renewable *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for

16 complete benefit determination.

17 Vision Now Vision Insurance Summary of Benefits* Who is Eligible? Aflac All active eligible employees who work 20 or more hours per week Employee - voluntary benefit Employee portion may be paid with pre-tax dollars through the Cafeteria Plan, or employee may choose to pay with after-tax dollars. For new employees, the waiting period for enrollment is 120 days after your first day of employment. For existing employees (or returning from layoff), enrollment may occur during Open Enrollment. Three Plan Levels Elimination Period (waiting period) When can I make changes to my coverage levels? Limitations & Exclusions Insurance Benefits When does coverage take effect? Duration of coverage Choose Option, or. See Vision Insurance brochure for additional information. -day waiting period. Other waiting periods apply based on Plan Level. See Vision Now Vision Insurance brochure for additional information. Employees may make changes to their coverage levels at Open Enrollment each year. Please see the Vision Now Vision Insurance brochure for complete information. Specific eye diseases/disorders, Eye surgery, Permanent visual impairment, Eye exams & Vision correction. See the Aflac Vision Now Vision Insurance brochure for more information. Coverage will take effect the first of the month following the month of enrollment. For example: Enroll on Sept. 21 and coverage begins on Oct 1. Guaranteed renewable *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination.

18 Maximum Difference Cancer Indemnity Insurance Summary of Benefits* Who is Eligible? Aflac All active eligible employees who work 20 or more hours per week Employee - voluntary benefit. Employee portion may be paid with pre-tax dollars through the Cafeteria Plan, or employee may choose to pay with after-tax dollars. For new employees, the waiting period for enrollment is 120 days after your first day of employment. For existing employees (or returning from layoff), enrollment may occur during Open Enrollment. Elimination Period (waiting period) When can I make changes to my coverage levels? Limitations & Exclusions Benefits Benefit Period Portability/Duration of Coverage None Employees may make changes to their coverage levels at Open Enrollment each year. Employees participating in the Cafeteria Plan for premium deductions may make mid-year changes to coverage levels if the employee experiences a Change in Status as defined by the IRS (such as marriage, birth, death, divorce, or employment changes). Without a change in status, and in most other circumstances, employees may not make changes to coverage mid plan year. Please see the Aflac Maximum Difference Cancer Indemnity Insurance brochure for complete information. Nonsurgical & surgical treatments, therapy benefits, hospitalization, continuing care, annual mammography, and more. Optional Initial Diagnosis Benefit Rider available. See the Aflac Maximum Difference Cancer Indemnity Insurance brochure for more information. No deductible, co-payments, lifetime limits, or network restrictions. Guaranteed renewable. If you leave Head Start, you may take your coverage with you. *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination.

19 (k) Retirement Plan Explanation of Benefit* Who is eligible? ADP administrates the plan Edward Jones manages the funds Employee may make pre-tax contributions - voluntary benefit. Head Start may make additional discretionary contributions at the end of each program year to those employees who are participating in the plan. These contributions are not guaranteed from year to year. All active eligible employees who work 20 or more hours per week When can I make changes to my contribution levels? How much can I contribute? When am I vested? Employees may make changes to their coverage levels at Open Enrollment each year. All eligible employees working 20 or more hours per week are eligible to enroll at the completion of the 120-day probationary period. Enrollment takes effect the first of the month following the month of enrollment. For example: Enroll on Sept. 21 and participation begins on Oct. 1. Employees may make changes to their contribution levels at any time online at Up to 80% of your salary can be invested pre-tax. Maximum investment amount for under age 50: $17,000. Maximum investment amount for over age 50: $22,500. Contact Lee Humphrey from Edward Jones at for individual retirement strategy advice. You are always 100% vested in your rollover amounts and salary deferral contributions to the plan. You are 100% vested in Head Start s contributions. *The enclosed listed benefits are for summarization purposes only. This summary is not meant to be a promise of benefits nor a complete description of benefits. For official information and description, please refer to plan documents for complete benefit determination.