2015 Benefits & Wellness Guide

Transcription

1 2015 Benefits & Wellness Guide HUNTER INDUSTRIES, INC. Built on Innovation Effective January 1, 2015 hunterindustries.com

2 TABLE OF Contents: Hunter Benefits & Wellness Guide This Guide provides an overview of your Total Rewards and a description of the benefits and programs available to Hunter employees. A Message from Shelly Hester 1 Total Rewards at Hunter 2 Hunter Benefits At-a-Glance 3 Eligibility 4 Enrollment 5 Medical 7 Dental 11 Reimbursement Accounts 14 Life Insurance 18 Disability Protection 19 Employee Assistance Program (k) Savings Investment Plan 21 Additional Benefits Employee Contribution Rates 23 Vision 12 Hunter Lifeshift Wellness Program 13 Ask the Experts Back Cover Hunter s Health Care Commitment Hunter Industries recognizes the importance of its benefit programs to employees and remains proud to offer a benefits package that is both comprehensive and competitive within our industry. We offer a variety of integrated health care benefits, programs and tools that encourage and support a healthy lifestyle for our employees and their families. However, the benefits themselves are only part of the story. You also have an important role to play and choices to make such as: Choosing health care options that best fit your needs. Embracing a healthy lifestyle. Making the most of the Hunter Lifeshift Wellness Program. So go ahead and explore all that s available to you through the Hunter Industries Benefits Program on your path to a healthier life. This Guide is intended to provide only an overview of the benefits offered by Hunter Industries. Not all plan provisions, limitations and exclusions are included in this publication. In the event of any conflict between the information contained in this Guide and the plan provisions, the plan documents and insurance contracts will govern. Copies of these documents are available in the HR Service Center. Hunter Industries has the right to change or terminate benefits at any time. i

3 A Message From Shelly Hester Dear Hunter Employee, Each year, Hunter reviews the quality and cost efficiency of our medical plan carriers to ensure they are providing the right care and managing costs to meet our employees needs. With double-digit cost increases for 2015, we decided to discontinue the Cigna HMO, Cigna Open Access Plus and Kaiser Permanente HMO effective December 31. For 2015, we will be introducing two new medical plans: Sharp Health Plan HMO 500 Meritain Health NationCare PPO 1,500 As the only San Diego-based commercial health plan, Sharp Health Plan offers exceptional coverage at an affordable cost right in our own backyard and throughout San Diego County and southern Riverside County. With the Meritain Health NationCare PPO 1,500, you have access to Aetna s Open Access network with significant discounts when you use network providers. In addition to the change in medical plans, we are also initiating different medical contribution rates for those employees with salaries below $50,999 and those with salaries above that amount. The changes to our medical plans will require each of us to make informed choices when it comes to choosing a medical plan and how we use health care services. So, during the 2015 Open Enrollment period (November 17 26), all employees must actively select the medical plan that best meets their needs and budget for the coming year. The 2015 employee contributions can be found starting on page 23 of this Guide. Your participation in our wellness program Hunter Lifeshift will determine your cost share for Hunter medical coverage in If you complete all of the required wellness activities, Hunter will invest more in your medical coverage by picking up a larger portion of the cost share. Take a few minutes to review this Guide. It will help you understand the changes to our medical plans and the differences between the coverage options available so you can make the best decisions for you and your family. You can also call the HR Service Center at (760) with your benefit questions. Sincerely, Shelly Hester Manager, HR Operations 1

4 Total Rewards at Hunter Total Rewards Program At Hunter Industries, Total Rewards represents a broad spectrum of plans and programs designed to reward and motivate you throughout your career. How Total Rewards Benefits You Our Total Rewards program is designed to meet your diverse and evolving needs, as well as to ensure we offer a competitive and attractive package to current and prospective employees. Our Total Rewards program will help you strengthen your financial well-being, develop your skills, help you with health matters and support your time away from work. We offer a comprehensive package that covers everything from traditional pay and benefits along with a variety of unique programs. Total Rewards Are Designed to: Reward you for your performance when company and individual goals are met and exceeded Provide access to tools and resources to help you stay healthy and offer the care needed when you or a dependent is ill or injured Develop your skills and abilities so you can continue to learn and grow Offer programs that give you the flexibility to help balance your time at work and at home COMPENSATION WORK-LIFE Base Pay Profit Share (discretionary) TOTAL REWARDS Paid Time Off (PTO) Employee Assistance Program Adoption Assistance Company Activities BENEFITS Medical, Dental & Vision Hunter Lifeshift Wellness Program Smoking Cessation Program Reimbursement Accounts Long-Term Disability Life and AD&D Insurance 401(k) Savings Investment Plan Onsite Wellness Center (San Marcos) Discounts on irrigation, lighting products/supplies, theme park tickets and more on the Hunter Corporate Portal (HCP) LEARNING & DEVELOPMENT Educational Assistance Training Programs 2

5 HUNTER BENEFITS AT-A-GLANCE Benefit MEDICAL* Pre-tax deduction DENTAL* Pre-tax deduction VISION* Pre-tax deduction HUNTER LIFESHIFT WELLNESS PROGRAM REIMBURSEMENT ACCOUNTS Pre-tax deduction BASIC LIFE AND AD&D INSURANCE Paid by Hunter SUPPLEMENTAL LIFE AND AD&D INSURANCE** Pre-tax deduction Coverage Options Sharp Health Plan HMO 500 Meritain Health NationCare PPO 1,500 United Concordia Dental Davis Vision Program which features personal health assessments, educational tools, on-site activities, wellness challenges, on-site wellness center in San Marcos, health coaching and wellness incentives to promote a healthy lifestyle Health Care Reimbursement Account contribute pre-tax up to $2,550 annually Dependent Care Reimbursement Account contribute pre-tax up to $5,000 annually (or $2,500 annually if married and filing separate tax returns) 1 times annual base salary up to a maximum of $500,000 (paid by Hunter) Choose 1, 2 or 3 times annual base salary up to a maximum of $500,000 DEPENDENT LIFE AND AD&D INSURANCE*** After-tax deduction LONG-TERM DISABILITY (LTD) Pre-tax or after-tax deduction EMPLOYEE ASSISTANCE PROGRAM (EAP) Paid by Hunter 401(K) SAVINGS INVESTMENT PLAN Pre-tax and after-tax deductions Option 1: Spouse/domestic partner $10,000, each child $5,000 ($1,000 for children under 6 months old) Option 2: Spouse/domestic partner $5,000, each child $2,000 ($1,000 for children under 6 months old) Core LTD: 60% of base monthly earnings up to $10,000 per month (paid by Hunter) Assistance with personal, financial, relationship, legal and identity theft issues Invest in your future by saving 1% to 30% of your earnings up to IRS maximums Company matching contribution equal to 100% of first 3% and 50% of next 2% that you contribute Roth 401(k) Feature OTHER BENEFITS Adoption Assistance Smoking Cessation Program Business Travel Accident Insurance Educational Assistance Discounts on a variety of products and theme park tickets on the Hunter Corporate Portal (HCP) * If you enroll a domestic partner, federal tax law may require that deductions for your domestic partner and their dependents you are covering be taken on an after-tax basis. Also, any dependent covered under the plan who is not a qualifying dependent as defined in IRC Section 152 will have deductions taken on an after-tax basis. The company s contribution toward any dependent coverage described above may be included in your taxable income for the year. ** Life insurance premiums over $50,000 will be subject to imputed income tax. *** Dependent life insurance will be subject to imputed income tax in accordance with IRS Table 1 rates. 3

6 Eligibility Employees Regular full-time active employees, working at least 30 hours per week, are eligible for benefits on the first day of the month following one month of employment. DEPENDENTS Eligibility for Spouses/Domestic Partners and Children In general, your eligible dependents include your legallymarried spouse, domestic partner and children up to age 26. Required documentation verifying dependent eligibility (i.e. birth certificate, marriage certificate) must be submitted to the HR Service Center as part of the enrollment process for your dependents. Eligibility for Other Dependents In some circumstances, additional individuals may be eligible for coverage under the Plan as your dependents. An individual who is either your Qualifying Child or Qualifying Relative will generally be eligible to enroll in the Plan on the same basis as your spouse/domestic partner and children. Refer to the table at right for more information. An individual who is not a Qualifying Child or a Qualifying Relative may still be eligible to enroll in the Plan, but you will generally be required to pay any contributions for coverage on an after-tax basis. The rules for determining when someone is eligible to enroll in the Plan as your dependent can be complicated. If you have any questions about whether someone is considered to be your dependent for purposes of the Plan, please contact the HR Service Center for more information. Dependents and the Dependent Care Reimbursement Account Special rules apply for determining when expenses incurred for a dependent are eligible for reimbursement under the Dependent Care Reimbursement Account. This is true even if a dependent is already enrolled in medical or other benefits available through the Plan. In order to get reimbursement through the Dependent Care Reimbursement Account for dependent care expenses, the dependent must (1) be a Qualifying Child under age 13, (2) be a Qualifying Child or a Qualifying Relative who is physically or mentally unable to care for him or herself and who shares the same principal residence with you for more than half the year, or (3) be your spouse and be physically or mentally unable to care for him or herself and share the same principal residence with you for more than half the year. If you have questions regarding how these rules may impact you, please contact the HR Service Center. Is the Person Your Child? To be a child eligible for coverage under the Plan, the person must satisfy both of the following conditions: RELATIONSHIP The person must be your child, stepchild or foster child; and AGE The child is under age 26. Note that your spouse, domestic partner, or grandchild are not eligible for coverage as your child. If the person is not your child, see if he or she is a qualifying child or a qualifying relative instead. Is the Person a Qualifying Child? To be a qualifying child, the person must satisfy all of the following conditions: RELATIONSHIP The person must be your child, stepchild, or foster child (if you are divorced, the child must live with you for the majority of the year); RESIDENCE The child lives with you as his or her primary residence for more than half of the year; AGE The child is under age 19, under age 24 if a fulltime student, or any age if totally disabled due to a physical or mental disability and enrolled in the Plan prior to age 24; SUPPORT The child does not provide more than half of his or her own support; and MARITAL/TAX STATUS The child must not have filed a joint return (other than for a claim of refund) with his or her spouse for the a year. If the person does not satisfy each of these conditions, see if he or she is a qualifying relative instead. Is the Person a Qualifying Relative? To be a qualifying relative, the person must satisfy all of the following conditions: RELATIONSHIP The person must be your relative (e.g., any children who do not meet the age requirements to be a Qualifying Child ); SUPPORT The person does not provide more than half of his or her own support; and STATUS The person cannot be a Qualifying Child 4

7 Enrollment Take action When you are ready to enroll, take action... online and on time. New Hire Enrollment New hires are eligible for benefits the first day of the month following one month of employment. You have 30 days from your eligibility date to enroll in Hunter s benefit plans. Prior to your eligibility date, you will receive information about your benefit options, contribution rates and how to enroll online using the Hunter Employee Self-Service System. It is important to choose your benefits carefully because the choices you make must remain in effect for the entire year unless you experience a Change in Status, as defined by the IRS. If you have any questions, please contact the HR Service Center. See the back cover of this Guide for contact information. Hunter Lifeshift Wellness Program Hunter is committed to providing you with comprehensive health coverage that protects you and your family from the high cost of medical care. However, we cannot do it alone. Your help is needed to preserve the quality and value of our programs while keeping costs under control. We know that wellness and living a healthy lifestyle impacts health care costs, and we want you to join us along the path to a healthier you. Take advantage of Hunter s wellness program Hunter Lifeshift including tools, resources, activities and incentives as well as the Hunter Wellness Center in San Marcos, health club membership discounts for employees and family members outside of San Marcos, and a Smoking Cessation Benefit. See page 13 for more information. Open Enrollment Open enrollment for your benefits is held each fall for a plan year effective January 1 and ending December 31. Prior to open enrollment, you will receive a benefits enrollment package that includes information about your benefit plan options, premium rates and the online enrollment system. It is important to choose your benefits carefully because the choices you make must remain in effect for the entire year unless you experience a Change in Status, as defined by the IRS. Examples of qualified status changes include: Change in the number of your eligible dependents because of marriage, birth, adoption, divorce, or death Change in employment status of you or your spouse or dependents, including commencement or termination of employment or change in work hours Change in residence or worksite for you, your spouse, or dependents You must notify the HR Service Center and submit required documentation if you are adding dependents to verify dependent eligibility within 30 days of the Change in Status to initiate a change in your benefits. Benefit election changes must be consistent with the status change. Also, a change in benefits coverage as it relates to a domestic partnership may be made if you notify the HR Service Center of the change in your domestic partnership and you complete any required documentation within 30 days of the change. 5

8 Easy Online Enrollment Easy to Use With the Hunter Employee Self-Service System, choosing your benefits is convenient, easy and paperless. In order to choose your Hunter benefits, you must log on! You can access the system from home or work. How to Access Employee Self-Service: You may log on from home or from work, at any time, day or night, during your enrollment period to select the coverage that s right for you and your family. Log on from home: Go to Log on from work: Go to the Hunter Corporate Portal (HCP) and double click on Employee Self-Service. Our online system lets you: Elect your benefit coverage Update personal information, such as home address, telephone number and emergency contact information Name beneficiaries for life insurance Access benefit plan information and contact information for providers with links to provider websites Print a confirmation statement after submitting your elections Look up your Paid Time Off (PTO) balance Access your paycheck history and tax withholding election(s) Getting Ready to Enroll Ready to make your benefit selections? Here are a few things to think about to ensure your online enrollment experience is fast, convenient and accurate. Explore All of Your Benefit Choices and Choose Your Benefits Carefully. Remember, you can t change your benefits until the next Open Enrollment period unless you experience a Change in Status as explained on page 5. Have Your Dependents Information Handy. You ll need their date of birth, Social Security number and a few other details. Consider Enrolling in the Reimbursement Accounts. These plans let you pay for health care and dependent care expenses with pre-tax dollars. In short, they can put money back into your pocket. Decide Who You ll Be Covering with Your Life Insurance Benefits. These individuals are called beneficiaries (not to be confused with medical, dental and/or vision dependents). 6

9 HUNTER OFFERS: Medical Hunter s Medical Plans Hunter offers a choice of two medical plans to keep you at your best. Remember to take advantage of the preventive care benefits offered by your plan. It s important to have regular checkups. Sharp Health Plan HMO 500 To enroll in the Sharp Health Plan HMO, you must live or work within Sharp Health Plan s service area for at least nine out of every twelve consecutive months and choose a Primary Care Physician (PCP) from the Sharp Health Plan s service area. Your PCP will manage your care and refer you to specialists as needed; all care except emergency or urgent care must be provided by HMO providers. Covered dependents are not required to live with you, but they must maintain their primary residence or work within Sharp Health Plan s service area unless enrolled as a full-time student at an accredited institution or unless coverage is provided under a medical support order. If a dependent lives outside the service area, he or she must select a PCP within the service area and must obtain all care from HMO providers inside the service area, except for emergency or urgent care. The HMO provides comprehensive benefits, including 100% coverage without a co-pay for preventive care; other services require a co-pay and/or deductible and co-insurance. There are no claim forms to submit. Sharp Health Plan providers are located throughout San Diego and southern Riverside counties. To find providers, go to or call (800) Meritain Health NationCare PPO 1,500 The NationCare PPO plan provides 100% coverage without a co-pay for in-network preventive care. For non-preventive care, you have a choice of using in-network providers and paying a set co-pay and/or co-insurance and deductible, or seeking care from any out-of-network qualified physician or facility and being reimbursed by the plan (usually at 50%), up to the allowable amount*, after any required deductible. Each time you receive care, you have the option to choose between network care and out-of-network care. You will have lower out-of-pocket costs when you use a network provider. NationCare utilizes the national Aetna Open Access provider network. To find providers, visit docfind/custom/mymeritain/. Be sure to click on Open Access Network when prompted for a network in the drop down box. * The allowable amount for out-of-network services under the NationCare PPO is based on the 80th percentile of usual and customary charges. 7

10 Programs & Resources Programs and resources Take advantage of these programs and resources to help guide you on the path to better health. Sharp Health Plan HMO 500 Members Sharp Nurse Connection This telephone service will put you in touch with registered nurses who can provide medical advice and direction regarding health care questions and concerns. Call (800) during regular business hours and (800) after 6 p.m. and on weekends. Best Health Wellness Program Best Health is a comprehensive wellness program available to all Sharp Health Plan members. Best Health provides you with a wealth of resources to reach your own unique wellness goals. You can take an online health risk assessment (HRA ), choose from a variety of multiweek fitness plans, access articles and video clips and choose from a variety of wellness workshops. Get started today at You can also work with a Best Health coach; call (877) or besthealth@sharp.com to learn more. Wellness Discounts You can receive discounts of 15 to 40 percent off suggested retail prices on more than 2,400 health and wellness products including vitamins, herbal supplements, health-related books, fitness products and skin care items. Discounts of up to 25% off standard rates are available on alternative care services from an extensive, credentialed network of chiropractors, acupuncturists, massage therapists and dieticians all of whom you may visit directly, without a physician referral. For more information, contact the Sharp Health Plan at or (877) Chiropractic and Acupuncture Services The Sharp Health Plan HMO has partnered with American Specialty Health (ASH) to provide you access to a national network of licensed and credentialed chiropractors and acupuncturists. You do not need a referral to access chiropractors or acupuncturists for covered services; simply call any in-network chiropractor or acupuncturist whenever you need to access care. You will receive a 25 percent discount off usual provider rates. Go to and click on the Health & Wellness tab to find out more. MinuteClinic As a Sharp Health Plan HMO member, you can access the walk-in medical clinic inside CVS/pharmacy stores. No appointments or prior authorizatio is necessary. Your cost is a $40 co-pay per visit, except for flu vaccinations, which are $10. Present your Sharp Health Plan member ID card when you visit. To locate a participating MinuteClinic near you, go to or call (866) Vision Service Plan (VSP) Benefits As a Sharp Health Plan HMO member, you are entitled to one comprehensive eye exam every 24 months for a $30 co-pay. You also have access to discounted lenses and frames, contact lenses, glasses and sunglasses and laser vision correction. Just call a VSP provider and make an appointment, and provide your name, date of birth and Sharp Health Plan HMO ID number. For more information, call VSP member services at (800) , or visit 8

11 Meritain NationCare PPO 1,500 Members Online tools and resources The Meritain Health member website, is designed to provide a secure, user and family-friendly, one-stop-shop for you to access the information you can use to manage your health and wellness. At you can: Look up health and wellness topics in our online medical library Take a health risk assessment to learn how you re doing and how you can improve your health Benefit from online health coaching Calculate your body mass index Plan a nutritious meal And much more! To register, go to to log in to our secure site. Under Access My Health Tools, select an option. New users, or users of an earlier site name, can create an account by following the easy instructions. Each member of your family can have an account, too. Medical Plans At-a-Glance The table on page 10 highlights some of the benefits available under each plan. A complete description regarding the terms of coverage, exclusions and limitations, including state mandated legislative benefits, are provided in each plan s Summary of Benefits and Coverage (SBC), summary plan description or other documents provided by the insurance carrier. 24 x 7 Nurse Line The 24 x 7 Nurseline helps you find answers to your questions about health care. You and your family can get free and private health information over the phone. This service is available to you 24 hours a day, 7 days a week. You can listen to recorded health topics, or talk to a nurse. The nurse can also put you in contact with community resources in your area. When you have questions about health care, call the toll-free number. You can speak to a live nurse to discuss current health issues. You may also discuss treatments, lifestyle choices and self-care strategies with the nurse. You can also access a topic in the Health Information library by using a four digit code. The nurse can direct you to a specific topic. Call the Meritain 24 x 7 Nurse Line at (866) Hour Customer Service Information Line You have immediate on-demand access to important information regarding benefits, eligibility and claims. The automated features are available 24/7 and Service Center Representatives can assist you Monday through Friday during regular working hours. Use the Automated Customer Service Information Line 24/7 to: Press 1: Obtain faxed verification of eligibility and benefit information Press 2: Get the status of submitted claims or receive a faxed copy of an EOB Press 3: Verify the claims mailing address Press 4: Verify the phone number for precertification of an inpatient hospital admission Press 5: Request a new ID card Press 6: Request a certificate of creditable coverage form Press 8: Speak to a Service Center Representative during normal business hours 9

12 Medical Plans At-a-Glance The chart below provides a brief overview of plan benefits. For additional information, see the Summary of Benefits and Coverage (SBC) for each plan, as well as the summary plan description or other documents provided by the insurance carrier. Plan Feature 10 Sharp Health Plan HMO 500 You Pay Meritain Health NationCare PPO 1,500 In-Network You Pay LIFETIME MAXIMUM Unlimited Unlimited Unlimited ANNUAL DEDUCTIBLE Individual Family Maximum OUT-OF-POCKET MAXIMUM Individual Family Maximum OFFICE VISIT Primary Care Physician (PCP) Specialist $500 $1,000 $3,000 $6,000 $20 co-pay $20 co-pay $1,500 $3,000 $4,500 $9,000 $30 co-pay $30 co-pay $3,000 $6,000 $9,000 $18,000 Out-of-Network You Pay 50% after deductible 50% after deductible HOSPITALIZATION Inpatient Care 20% after deductible 30% after deductible 50% after deductible DIAGNOSTIC X-RAY & LAB TESTS Preventive Diagnostic $0 co-pay $0 co-pay $0 co-pay $30 co-pay 50% after deductible 50% after deductible SURGERY Outpatient 20% after deductible 30% after deductible 50% after deductible PREVENTIVE CARE Routine Physical Well-child Care MATERNITY Outpatient Pre-Natal Hospitalization & Delivery EMERGENCY SERVICES Emergency Room Visit Ambulance (if medically necessary) PRESCRIPTION DRUGS* Retail Supply Generic Brand Name Non-Formulary Mail Order Supply Generic Brand Name Non-Formulary MENTAL HEALTH Inpatient Outpatient SUBSTANCE ABUSE Inpatient Outpatient $0 co-pay $0 co-pay $0 co-pay 20% after deductible 20% after deductible $150 per trip after deductible Participating pharmacies $10 co-pay (up to 30 days) $25 co-pay (up to 30 days) $50 co-pay (up to 30 days) Wellpartner $20 co-pay (up to 90 days) $50 co-pay (up to 90 days) $100 co-pay (up to 90 days) 20% after deductible $20 co-pay 20% after deductible $20 co-pay $0 co-pay $0 co-pay $30 co-pay 30% after deductible $250 co-pay after deductible (co-pay waived if admitted) $250 co-pay after deductible CVS pharmacies $20 co-pay (up to 34 days) $40 co-pay (up to 34 days) $60 co-pay (up to 34 days) Caremark $40 co-pay (up to 90 days) $80 co-pay (up to 90 days) $120 co-pay (up to 90 days) 30% after deductible $30 co-pay 30% after deductible $30 co-pay 50% after deductible 50% after deductible 50% after deductible 50% after deductible $250 co-pay after deductible (co-pay waived if admitted) $250 co-pay after deductible Not covered 50% after deductible 50% after deductible 50% after deductible 50% after deductible DURABLE MEDICAL EQUIPMENT 20% after deductible 20% after deductible 50% after deductible * Name-brand drugs are not covered when a generic is available, unless there is a medical reason why the generic cannot be used.

13 HUNTER OFFERS: Dental Dental Plan There s nothing like a quality dental plan to keep you smiling. Hunter s plan through United Concordia offers you a network of participating dentists who have agreed to provide dental care at special negotiated rates. If you enroll in this plan and use a dentist who belongs to the network, you benefit from these network savings. You also have the freedom to choose any dentist who is not a network provider. If you do, however, your out-ofpocket costs may be higher. Benefit Feature In-Network Dentist 2 You Pay Out-of-Network Dentist 2 You Pay ANNUAL DEDUCTIBLE $0 $50 individual $150 family maximum ANNUAL BENEFIT MAXIMUM Combined in and out-of-network $1,500 $1,000 DIAGNOSTIC & PREVENTIVE 1,3 Exams, cleanings and bite-wing x-rays (2 exams/ cleanings per year; sealants for children to age 14) No charge; no deductible 10% no deductible UC WELLNESS Members (employees or covered dependents) with diabetes must sign up for this feature in My Dental Benefits on UCWellness.com. BASIC SERVICES Oral surgery, restorative-fillings, space maintainers, endodontic/periodontic treatment Covers one additional periodontal maintenance per year covered at no charge Scaling and root planing are covered at no charge Four periodontal surgery procedures are covered at no charge 20% 30% after deductible MAJOR SERVICES Crowns, jackets, cast restorations, prosthodontics (bridges & dentures) 50% 60% after deductible ORTHODONTIA Not covered Not covered 1 Diagnostic and preventive charges do not count toward your annual benefit maximum. 2 The listed percentages represent the portion of United Concordia s maximum allowable charge (MAC) for which the plan will be responsible. Network providers agree to accept United Concordia s MAC for covered services as payment in full and also agree to file claims for you. If you or your family members receive services from a non-network provider, United Concordia will apply the percentages shown to the 90th percentile for covered services and you will be responsible for the difference, up to the provider s charge. United Concordia s standard exclusions and limitations apply. 3 Eligible for three cleanings per year during pregnancy. 11

14 HUNTER OFFERS: Vision Vision Care Whether your vision is 20/20 or less than perfect, routine vision care is important to your overall well-being. Voluntary coverage is available to you through Davis Vision. Davis Vision provides vision care nationwide through a network of national chain stores and private optical practitioners. Through Davis Vision s provider network, you will receive a comprehensive vision examination, as well as materials, if needed. To find out if your current vision provider or retail store is in the Davis Vision network, please call (800) or visit the website at Eye Health Connection Program The Eye Health Connection Program provides enhanced services and benefits to members with a disease that causes serious vision loss and blindness including cataracts, diabetes, macular degeneration or glaucoma. Members having one of the four conditions are entitled to receive one additional eye exam, extra eyewear coverage relevant to their condition and can subscribe to informational s via the Davis Vision website. Visit or call (877) for more information. If you choose an out-of-network provider, you will need to send your itemized receipts to the Davis Vision Care Processing Unit. Davis Vision will reimburse you according to their fee schedule. Benefit Feature Davis Vision Provider You Pay Out-of-Network Vision Provider You Pay EYE EXAM (once every 12 months) $0 co-pay Up to $40 LENSES (once every 12 months) Single vision Bifocal Trifocal Lenticular $25 co-pay $25 co-pay $25 co-pay $25 co-pay Up to $40 Up to $60 Up to $80 Up to $125 FRAMES (once every 24 months) $0 co-pay 1 Up to $50 CONTACT LENSES (once every 12 months) Necessary: $25 co-pay Elective: $130 allowance Necessary: Up to $250 Elective: Up to $105 1 From Davis Vision collection. 12

15 HUNTER OFFERS: The Lifeshift Wellness Program Hunter Lifeshift Wellness Program Hunter Lifeshift is a comprehensive, integrated approach to personal well-being and is available to all Hunter employees and spouses/domestic partners. Hunter Lifeshift provides you with tools, resources and programs required to make healthy lifestyle choices and informed health care decisions. The program features personal health assessments, educational tools and on-site activities, wellness challenges, an on-site wellness center and health coaching to promote healthy lifestyles. Employees can also earn financial incentives and other prizes by participating in wellness activities. WE RE MAKING SOME CHANGES AND ENHANCEMENTS TO OUR WELLNESS PROGRAM FOR WATCH FOR MORE INFORMATION IN DECEMBER

16 Reimbursement Accounts Turn on Tax Savings Reimbursement Accounts allow you to set aside pre-tax dollars to pay for eligible health care and dependent care expenses. Reimbursement Accounts There are two separate accounts you can participate in: Health Care Account Dependent Care Account During enrollment, you decide how much you want to contribute to either or both accounts. You may contribute up to $2,550 per year to the Health Care Account, and/or up to $5,000 per year to the Dependent Care Account (or up to $2,500 if you are married and file separate tax returns). You cannot change your contribution amounts during the plan year unless you have a Change in Status. Your contributions are deducted from your paycheck in equal amounts during the year. Because contributions are made before taxes are withheld, they are not subject to Social Security tax, federal income tax and, in most cases, state and local income taxes, so you save money. To enjoy the tax-saving benefits of the Reimbursement Accounts, you must re-enroll each year. Your elections do NOT carry forward from one year to the next. When you have an eligible expense, you submit a claim for reimbursement. The Health Care Account and Dependent Care Account function separately. This means you cannot use health care funds to pay dependent care expenses and vice-versa. Health care expenses are reimbursed up to the total amount of contributions elected for the calendar year, while dependent care expenses are reimbursed up to the total amount contributed to your account on the date your claim is processed. Note: If you terminate employment, you may submit claims for eligible expenses that are incurred through your date of termination. Health Care Reimbursement Account The Health Care Reimbursement Account (HCRA) gives you a tax break on many health care expenses that are not covered by other plans. By anticipating your expenses and arranging for deductions to be made from your paycheck, you can lower your tax bill. When you incur an eligible expense during the year: You can use the TRI-AD benefit card (see page 15) You can you will file a claim form for reimbursement. You must enclose a copy of the receipt showing the expense has been incurred. Your receipt must include the name and address of the person for whom the expense was incurred, date of service, description of services obtained or product purchased and the amount charged. Important IRS Rules Because the IRS is allowing you to reduce your taxes, certain restrictions apply. When you decide on your contribution to either or both accounts, be conservative in your estimate. Do not contribute more than what you are certain you will use during the plan year for eligible expenses. Any money that is left over after reimbursements are made for claims incurred through March 15 of the following plan year will be forfeited. 14

17 Eligible Health Care Expenses The following is a partial list of expenses that may be reimbursed under the HCRA. You may use the HCRA for yourself and your eligible dependents, as defined under IRC Section 152. To be eligible for reimbursement, the expense cannot be covered by other insurance. If you have questions about eligible expenses, please contact the HR Service Center. Medical Expenses Acupuncture Chiropractor fees Laboratory fees Medical charges over the maximum reimbursable charge Medical deductibles, co-pays and co-insurance Over-the-counter medication if prescribed by a physician (insulin does not require a prescription) Prescription drugs Vaccinations and immunizations X-ray fees Dental Expenses Artificial teeth Cosmetic surgery (only if required to treat an illness, injury, or disfiguring disease) Orthodontia expenses not covered by a dental insurance plan Routine examinations not covered by a dental insurance plan Use the TRI-AD Benefit Card! Vision Care Expenses Contact lenses Contact lens solutions and cleaners Eye examinations Frames Lenses LASIK eye surgery Optometrist charges Prescription eyeglasses Use the TRI-AD BenefitCard Visa debit card for all your eligible health care expenses! The card is recognized nationwide at qualified locations that accept Visa debit cards. It can be used to pay for your TRI-AD health care FSA expenses. Hearing Care Expenses Ear examinations Hearing aids Special telephone for the hearing impaired How to Use Your Card 1. Incur your eligible expense at the doctor, dentist, pharmacy, drugstore, etc. 2. You can swipe the card and select either credit or debit. For debit transactions, your PIN is the last four digits of your card number. For your security, change your PIN by calling (888) Keep receipts and necessary documentation to support your FSA transaction. 4. Submit your documentation to TRI-AD only if it is requested. You can monitor your account on TRI-Ad s website at or through the Benefits by TRI-AD mobile app. 15

18 Reimbursement Accounts (cont d) Health Care Reimbursement Account Worksheet Use the worksheet below to estimate the health care expenses that you and your eligible dependents may incur. You may contribute up to $2,550 annually. MEDICAL Estimated Annual Expense Deductibles $ Co-pays/co-insurance $ Prescription drugs $ Over-the-counter medications prescribed by a physician (insulin does not require a prescription) $ X-ray and lab fees $ Other $ DENTAL Estimated Annual Expense Routine cleanings $ Expected fillings/x-rays $ Bridges/extractions/dentures $ Orthodontia $ Other $ VISION Estimated Annual Expense Eye exams $ Eyeglasses/frames $ Contacts/lens solutions $ LASIK eye surgery $ Other $ HEARING CARE Estimated Annual Expense Ear examinations $ Hearing aids $ Other $ 16

19 Dependent Care Reimbursement Account The Dependent Care Reimbursement Account (DCRA) is a tax-effective way to pay child care or other dependent care services to enable: You and your spouse to work outside the home (this is also true if your spouse is actively looking for work); You to work outside the home and your spouse is a full-time student at least five months of the year; You to work outside the home and your spouse is incapable of self-care. You can use the DCRA to pay eligible expenses of a qualifying dependent (see page 4) under IRC Section 152. If you wish to participate, you must enroll each plan year, as contribution amounts are not carried forward from one plan year to the next. You can set aside up to $5,000 each year on a pre-tax basis to cover the cost of dependent care expenses. The amount you contribute to this account cannot be greater than your income or your spouse s income, whichever is less. If your spouse contributes to a DCRA through his or her employer, your combined contributions may not exceed $5,000. If you are married and file separate tax returns, you can contribute up to $2,500 per year. To receive reimbursement from your DCRA, you will need to file a claim form. You are required to provide the name and address of the service provider on the claim form. You will be reimbursed for the amount of your claim provided the balance of your account is equal to or more than the amount of your claim and the services have already been provided. If you don t have enough money in your account to cover the expense, you ll receive the additional reimbursement when enough money has been deducted from your paycheck and deposited into your DCRA. Dependent Care Expenses You can use the DCRA to be reimbursed for: Dependent care at nursery schools, day camps and licensed day care centers. The day care center must comply with state and local laws and receive a fee for its services. The portion of schooling expenses that is strictly care-related may be eligible; tuition expenses for education are not. Services from individuals who provide day care in your home, except when the provider is the parent of the child, your dependent or your child under age 19. Day care centers that provide nonresidential day care for dependent adults. Household services related to the care of an eligible dependent. FICA and other taxes you pay on behalf of the day care provider. Generally, any other expense that qualifies as dependent care under IRS regulations. Worksheet Calculation Feature Estimated Annual Expense Your weekly day care cost $ Other eligible weekly expenses $ Total $ Number of weeks you will incur expenses in 2015 $ Multiply total by number of weeks $ Other $ 17

20 Life Insurance Peace of mind for you and those who depend on you. Hunter provides you with basic coverage. You can purchase additional protection for yourself and your dependents. Basic Life and AD&D Insurance Life insurance is a way to provide financial security for your family in the event of your death. Hunter provides 1X your annual base salary up to $500,000 of basic life and accidental death and dismemberment (AD&D) insurance as a core benefit. In the event of your death, your designated beneficiary(ies) will receive a benefit of 1X your annual base salary up to $500,000. If your death is the result of a covered accident, your beneficiary(ies) will receive an additional 1X your annual base salary up to an additional $500,000. The accidental death and dismemberment policy also pays a benefit to you in the event of certain bodily injuries resulting in loss of limbs or vision. Insurance values are reduced at age 65 and 70. Supplemental Life and AD&D Insurance If you need more financial protection, you may purchase supplemental life and AD&D coverage for yourself in the amount of 1, 2, or 3 times your annual base salary. Your supplemental life and AD&D insurance coverage may not exceed $500,000. In the event of your death, your designated beneficiary(ies) will receive a benefit equal to your supplemental coverage amount. If your death is the result of a covered accident, your beneficiary(ies) will receive a benefit for AD&D equal to the amount of your supplemental life coverage amount. You will be required to complete an Evidence of Insurability form if you are enrolling when first eligible and requesting coverage greater than $250,000 or if you are requesting coverage or an increase in coverage outside of your initial eligibility period. Premiums for supplemental life will be deducted from your paycheck on a pre-tax basis. Life insurance premiums over $50,000 will be subject to imputed income tax. Insurance values and premiums are reduced at age 65 and 70. Dependent Life and AD&D Insurance You may also purchase life and AD&D insurance for your spouse/domestic partner and/or dependent children in the following amounts: Option 1: Spouse/Domestic Partner $10,000 Child - $5,000 ($1,000 for children under 6 months old) Option 2: Spouse/Domestic Partner $5,000 Child - $2,000 ($1,000 for children under 6 months old) The cost of coverage is deducted from your pay after taxes are withheld. You will be required to complete an Evidence of Insurability form if you are requesting coverage or an increase in coverage after your initial eligibility date. Dependent life insurance will be subject to imputed income tax in accordance with IRS Table 1 rates. Designate Your Beneficiaries Be sure to input your beneficiary designation(s) by accessing the Hunter Employee Self-Service System. 18