2015 PLAN YEAR BENEFITS FOR YOU AND YOUR FAMILY

Transcription

1 2015 PLAN YEAR BENEFITS FOR YOU AND YOUR FAMILY 1

2 Dear Fellow Employee, CPSI, the parent company of Evident and TruBridge, is dedicated to providing a comprehensive and competitive benefits package for you and your family. Having the resources and programs available to help you maintain a work/life balance is important to our organization. Our benefit plans have been intentionally designed to provide you a full range of coverage and protection for your short and long-term needs. We offer our employees medical, dental, pharmacy, and vision programs focused on prevention. Our insurance and wellness plans are uniquely designed to cover a full range of services including free preventive care, toprated provider networks and savings accounts to help pay for out-of-pocket expenses. Our insurance programs provide a full range of services to help you get back on track in the event of an illness or injury and help preserve your income. You will have an opportunity to purchase life insurance, accident insurance, critical illness insurance, and a new Hospital Indemnity Plan as your individual circumstances dictate. We are pleased to offer all eligible members one-on-one personal and confidential enrollment meetings with licensed and knowledgeable Benefits Educators from Enrollment Advisors. Please schedule a time to make an appointment with a Benefits Educator at to review your benefit options, ask any questions you may have, and complete your enrollment on the spot. Please take a few minutes to review the guide and the benefit options we proudly offer to you. Sincerely, BOYD DOUGLAS President and Chief Executive Officer SCHEDULE YOUR APPOINTMENT AT 1

3 BENEFITS FOR YOU AND YOUR FAMILY CPSI, the parent company of Evident and TruBridge, is pleased to announce our 2015 benefits program, which is designed to help you stay healthy, feel secure, and maintain a work/life balance. Offering a rich benefits package is just one way we strive to provide our employees with a rewarding workplace. Please read the information provided in this guide carefully. For full details about our plans, please refer to the summary plan descriptions. BENEFITS AVAILABLE DURING OPEN ENROLLMENT Medical Insurance Flexible Spending Account Plan Dental Insurance Hospital Indemnity Plan Vision Insurance Accident Insurance Short-Term Disability Long-Term Disability Life Insurance Optional Critical Illness OTHER CPSI BENEFITS INCLUDED IN THIS GUIDE Symbol Onsite Clinic Virgin Pulse WHO IS ELIGIBLE? All regular employees scheduled to work at least 20 hours per week (30 hours per week for BCBS) are eligible to participate in the CPSI benefits program. Eligible employees may also enroll their legal spouse (as recognized by Alabama statute) and dependent children (married or unmarried). A dependent child may be the natural child, stepchild, legally adopted child, child placed for adoption, or other child for whom the employee has permanent legal custody. WHEN AND HOW DO I ENROLL? We have Benefits Educators with Enrollment Advisors available on site and through the Enrollment Call Center to meet one-on-one with each eligible employee. These knowledgeable, trained Benefits Educators will answer questions about the benefits program, help you choose your benefit options, and assist you with completing the enrollment process. You may schedule your enrollment appointment online or by telephone. To schedule your enrollment appointment online, go to www. enrollappointments.com/cpsi. If you do not have internet access, please contact the Enrollment Advisors Enrollment Center at (877) to schedule your appointment. All eligible employees are required to complete the enrollment process even if you do not wish to make any changes to your benefits. WHEN IS MY COVERAGE EFFECTIVE? Your coverage is effective the first of the month after 30 days of employment. CHANGING COVERAGE DURING THE YEAR You can change your coverage during the year when you experience a qualified change in status, such as marriage, divorce, birth, adoption, placement for adoption, or loss of coverage. The change must be consistent with the event. For example, if your dependent child no longer meets eligibility requirements, you can drop coverage only for that dependent. 1

4 HEALTH REIMBURSEMENT ACCOUNT (HRA) One of your medical plan options is a Health Reimbursement Account (HRA). An HRA has an employer contribution that may be used for deductibles, coinsurance, and copays. In this plan, CPSI will add $250 to your HRA account each year; $500 will be added each year if you have any dependents (spouse and/ or child{ren}) covered. Your HRA gives you the opportunity to manage your health care expenses in partnership with CPSI. If employment ends, you cannot take the balance of your account with you. Your HRA is designed to pay your physician or hospital directly on your behalf. FLEXIBLE SPENDING ACCOUNT (FSA) The Flexible Spending Account (FSA) plan allows you to set aside pre-tax dollars to cover qualified expenses you would normally pay out of your pocket with post-tax dollars. The plan is comprised of a health care spending account and a dependent care account. You pay no federal or state income taxes on the money you place in an FSA. Health Care Flexible Spending Account The health care flexible spending account is available for any team member, spouse or dependent child and may be used for any health, dental, and vision expenses not reimbursed by any other benefit plans. These expenses include deductibles, copays, coinsurance, dental services, eyeglasses, contact lenses, Lasik eye surgery, orthodontics for adults and children, hearing aids, chiropractor, some diabetic supplies, medical equipment, and other out-of-pocket costs. Dependent Care Flexible Spending Account The dependent care flexible spending account allows you to set aside pre-tax dollars for dependent care expenses, such as day care, preschool, after-school care, or elder care for qualified dependents. If you are married, both you and your spouse must be employed full-time in order to participate in this tax savings plan. HOW AN FSA WORKS: Choose a specific amount of money to contribute each pay period, pre-tax, to one or both accounts during the year. Budget according to your and your family s typical health care and dependent care spending. The amount is automatically deducted from your pre-tax pay at the same level each pay period. IMPORTANT RULES TO KEEP IN MIND: The IRS has a strict use it or lose it rule. If you do not use the full amount in your FSA, you will lose any remaining funds. You have until March 15, 2016, to use your FSA funds for services rendered in Once you enroll in the FSA, you cannot change your contribution amount during the year unless you experience a qualifying life event. You cannot transfer funds from one FSA to another. MAXIMUM ANNUAL ELECTION Health Care FSA: $2,550 Dependent Care FSA: $5,000 married filing jointly / $2,500 single or married filing separately SCHEDULE YOUR APPOINTMENT AT 2

5 MEDICAL INSURANCE CPSI offers employees two plan options: The Traditional Plan and Health Reimbursement Account (HRA) Plan. The following chart is a brief outline of the plan. Employees have two levels of benefits with the plan: BCBS In-Network: You receive this level of benefit when the service provider is contracted with BCBS. BCBS Out-of-Network (Non-PPO) Facility or Physician: You receive this level of benefit when using a facility or physician not contracted with Blue Cross. Please refer to the summary plan description for complete plan details. MEDICAL BENEFITS OVERVIEW Benefits Traditional (Blue Cross Blue Shield) HRA (Blue Cross Blue Shield) Lifetime Maximum Unlimited Unlimited Plan Year Deductible $500 ($1,500 per family) In-Network: $500 ($1,000 per family) Out-of-Network: $1,000 ($2,000 per family) Out-of-Pocket Maximum (Includes all copays, deductibles, and coinsurance with the exception of prescriptions) Outpatient Surgery (Including ambulatory surgical centers) Emergency Room Medical Emergency Emergency Room Accident Outpatient diagnostic lab, X-ray, and pathology Outpatient dialysis, IV therapy, chemotherapy, and radiation therapy Services billed by the facility for an emergency room visit when the patient s condition does not meet the definition of a medical emergency (including any lab and X-ray exams and other diagnostic tests associated with the emergency room fee) Outpatient hospital services or supplies not listed above Office visits, consultations, and psychotherapy $900 ($2,700 per family) Certain benefits pay at 100% of the allowed amount thereafter. In-Network: 100% of the allowed amount, subject to a $25 facility copayment In-Network: 100% of the allowed amount, subject to a $25 facility copayment 100% of the allowed amount, no deductible, subject to a $25 facility copayment for mental health and substance abuse Out-of-Network: 100% of allowed amount, no deductible within 72 hours of accident; 80% after 72 hours In-Network: 80% of the allowed amount, subject In-Network: 80% of the allowed amount, subject deductible, subject to a $15 copayment In-Network: $1,000 ($2,000 per family) Out-of-Network: No out-of-pocket maximum Out-of-Network: 90% of the allowed amount, 90% of the allowed amount, subject to the innetwork calendar year deductible for mental health and substance abuse Out-of-Network: 90% of the allowed amount, when services are rendered within 72 hours of the accident; after 72 hours 70% of the allowed amount, deductible, subject to a $30 copayment 3

6 Emergency Room Physician Surgery, second surgical opinion, and anesthesia for a covered service Maternity care Inpatient visits Benefits Traditional (Blue Cross Blue Shield) HRA (Blue Cross Blue Shield) Inpatient consultations by a specialty provider (limited to one consult per specialist per stay) Diagnostic lab, X-rays, and pathology Chemotherapy and radiation therapy Psychological testing Allergy testing and treatment deductible, subject to a $15 copayment 100% of the allowed amount, subject to a $15 copayment for mental health and substance abuse ; 80% of the allowed amount, no deductible or copayment for mental health and substance abuse In-Network:100% of the allowed amount, no ; 80% of the allowed amount, no deductible or copayment for mental health and substance abuse In-Network: 80% of the allowed amount, subject to the calendar year deductible In-Network: 100% of the allowed amount, subject to a $30 copayment 90% of the allowed amount, subject to the innetwork calendar year deductible for mental health and substance abuse Out-of-Network: 100% of the allowed amount,, and a $30 copayment 90% of the allowed amount, subject to the innetwork calendar year deductible for mental health and substance abuse to the calendar year deductible to the calendar year deductible to the calendar year deductible to the calendar year deductible 2015 BI-WEEKLY RATES-TRADITIONAL Tier Amount Employee $60.00 Family $ BI-WEEKLY RATES-HRA PLAN Tier Amount Employee $27.50 Family $70.00 SCHEDULE YOUR APPOINTMENT AT 4

7 Prescription drugs can be dispensed up to a maximum 90-day supply. Refills of prescriptions are allowed after 75% of the allowed amount of the previous prescription has been used (for example, 23 days into a 30-day supply). PRESCRIPTION DRUG PLAN OVERVIEW You automatically receive prescription drug coverage through Medco when you enroll for medical insurance. The chart below is a brief outline of the plan. Please refer to the summary plan description for complete plan details. Traditional (Blue Cross Blue Shield) Service or Supply In-Network Out-of-Network Prescription Generic Drugs Brand Name Drugs Plan pays 80% of the allowed amount Plan pays 80% of the allowed amount, subject to calendar year deductible HRA 80% of the allowed amount, subject to the calendar year deductible 80% of the allowed amount, subject to the calendar year deductible Service or Supply In-Network Out-of-Network Prescription Generic Drugs $5 Copay Not covered Brand Name Drugs $30 Copay ($60 Copay for non-preferred brand) Not covered HOSPITAL INDEMNITY PLAN Unum s Group Hospital Indemnity Insurance can complement your health insurance to help you pay for the costs associated with a hospital stay. It can also provide funds for the out-of-pocket expenses your medical plan may not cover, such as co-insurance, co-pays and deductibles. You may also purchase coverage for your spouse and dependent children. Employees must be a U.S. citizen or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy form GHI-1, or contact your Unum representative. THIS IS A LIMITED POLICY This coverage is a supplement to health insurance. It is not a substitute for comprehensive health insurance and does not qualify as minimum essential health coverage. Underwritten by: Unum Life Insurance Company of America, Portland, Maine Unum complies with state civil union and domestic partner laws when applicable. unum.com 2014 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. CU-9732 (10-14) 5

8 VISION INSURANCE CPSI offers vision insurance through Humana VisionCare. The plan deducts from your pay before any federal income or FICA taxes are withdrawn, which makes your taxable wage base lower so you would pay less tax. Service In-Network Benefits Out-of-Network Lenses - one pair per year -Single -Bifocal -Trifocal -Lenticular Frames - one every two years Contact Lenses Fully covered after $20 Materials Copayment Fully covered after $20 Materials Copayment $150 retail allowance if elective; Covered in full if medically necessary after $20 Materials Copay Allowances per 12 months ($25 Single; $40 Bifocal; $60 Trifocal; $100 Lenticular) $45 allowance every 12 months $150 retail allowance if elective; $210 if medically necessary LASIK Surgery Discounted services available None Coverage Tier Monthly Rate Employee Only $9.40 Employee Only - Exam Only* No Charge Employee + Family $25.10 *This coverage includes one exam every 12 months, but does not include any discounts on frames or lenses ADDITIONAL DISCOUNTS: You also receive a 20% discount on a second pair of glasses and a 15% discount on professional service fees for elective contact lenses when ordering from one of the Humana network eye doctors. DENTAL INSURANCE CPSI offers a dental plan through Blue Cross Blue Shield of Alabama. The chart below is a brief outline of the plan. DENTAL BENEFITS OVERVIEW Plan Feature Dental Benefit Deductible Calendar Year Maximum (1/1-12/31) $1,000 Diagnostic & Preventive Routine oral exams X-rays Cleanings Basic Services Fillings Extractions Oral surgery Periodontal treatment Root canal therapy $25 per member per year (maximum of 3 deductibles per family each year) Covered at 100%, with no deductible Covered at 100%, subject to the deductible SCHEDULE YOUR APPOINTMENT AT 6

9 Major Services Crowns, inlays & onlays Gold fillings Replacement or installation of dentures, partials, or bridgework Periodontic (Gum Disease) Orthodontics Braces Covered at 50%, subject to the deductible Covered at 80%, subject to the deductible Covered at 50%, subject to a per member lifetime deductible of $25. Lifetime maximum of $1,500. Age 19 and under. GROUP LIFE INSURANCE This life insurance plan provides financial protection for you and your beneficiaries by paying a benefit in the event of your death. The amount your beneficiaries receive is based on the amount of coverage in effect just prior to the date of your death according to the terms and provisions of the plan. You also have the opportunity to elect coverage for your dependents. Other features of the Life Insurance Plan: Accelerated Benefit Conversion Portability Employee Maximum Benefits Spouse Maximum Benefits Children Maximum Benefits The lesser of 5x annual earnings or $500,000 The lesser of 100% of your amount of insurance or $100,000* The lesser of 100% of your amount of insurance or $10,000 * Note: The amount of your spouse s life insurance will reduce by the same percentage and at the same time your life insurance reduces. ACCIDENT INSURANCE Unum s Accident Insurance can pay benefits based on the injury you receive and the treatment you need, including emergency-room care and related surgery. The benefit can help offset the out-of-pocket expenses that medical insurance does not pay, including deductibles and co-pays. Family coverage is available. Employees must be a U.S. citizen or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to policy form GA-1 or contact your Unum representative. See schedule of benefits for a full list of covered injuries and treatments. THIS IS A LIMITED POLICY Underwritten by: Unum Life Insurance Company of America, Portland, Maine Unum complies with state civil union and domestic partner laws when applicable. unum.com 2014 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. CU-9732 (10-14) 7

10 GROUP CRITICAL ILLNESS INSURANCE Unum s Group Critical Illness Insurance can help protect your finances from the expense of a serious health problem, such as a stroke or heart attack. Cancer coverage is also available. You choose a lump-sum benefit up to $50,000 that s paid directly to you at the first diagnosis of a covered condition. You can use the benefit any way you choose. You can use this coverage more than once. If you receive a full benefit payout for a covered illness, your coverage can be continued for the remaining covered conditions. The diagnosis of a new covered illness must occur at least 90 days after the most recent diagnosis. Each condition is payable once per lifetime. Employees must be a U.S. citizen or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to policy form CI-1, or contact your Unum representative. THIS IS A LIMITED POLICY Underwritten by: Unum Life Insurance Company of America, Portland, Maine Unum complies with state civil union and domestic partner laws when applicable. unum.com 2014 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. CU-9732 (10-14) SHORT-TERM DISABILITY INSURANCE Unum s Short Term Disability Insurance can pay you a percentage of your gross weekly earnings (up to the maximum allowed by your plan) if you are unable to work for a few weeks or months due to an illness or injury or childbirth. It can help you cover your expenses and protect your finances at a time when you re not getting a paycheck and have extra medical bills. The amount of benefit you receive from the plan may be reduced or offset by income from other sources. You can take advantage of affordable group rates and your cost is conveniently deducted from your paycheck. Employees must be a U.S. citizen or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to policy form C.FP-1 et al., or contact your Unum representative for specific provisions and details of availability. Underwritten by: Unum Life Insurance Company of America, Portland, Maine Unum complies with state civil union and domestic partner laws when applicable. unum.com 2014 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. CU-9732 (10-14) SCHEDULE YOUR APPOINTMENT AT 8

11 EMPLOYER-PAID BENEFIT LONG-TERM DISABILITY INSURANCE CPSI provides Long-Term Disability Insurance to all eligible employees. Unum s Long Term Disability Insurance can pay you a percentage of your gross monthly earnings (up to the maximum allowed by your plan) if you become ill or injured and can t work for an extended period. It can help you pay your bills and protect your finances at a time when you have extra medical costs but don t get a paycheck. The amount of benefit you receive from the plan may be reduced or offset by income from other sources such as Social Security Disability Insurance. The length of time you can receive benefits is based on your age when you become disabled. Employees must be a U.S. citizen or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to policy form C.FP-1 et al., or contact your Unum representative for specific provisions and details of availability. Underwritten by: Unum Life Insurance Company of America, Portland, Maine Unum complies with state civil union and domestic partner laws when applicable. unum.com 2014 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. CU-9732 (10-14) 9

12 CPSI WELLNESS CPSI promotes wellness through offering the Symbol Onsite Clinic and participating in Virgin Pulse. Both benefits are explained in the following two sections. For more information about Symbol Onsite Clinic, visit com/symbol-clinic. SYMBOL ONSITE CLINIC CPSI offers healthcare through the Symbol Onsite Clinic, paid for by CPSI and free for all employees, their spouse, and dependents who are covered under CPSI s BCBS plans. Employees can conveniently make appointments with medical practitioners for a routine checkup or basic care. The onsite clinic offers employees enhanced convenience while promoting employee wellness. The onsite clinic also provides assistance for employees who desire to change and sustain changes in their lifestyle behaviors. VIRGIN PULSE Virgin Pulse is an engaging employee program not only for physical wellness but also for financial security, a healthy family life, and social connections. Virgin Pulse encourages a long-term high quality of life by engaging and inspiring employees to stay active and healthy. Virgin Pulse offers: o Fun, social programs that touch every part of life o Friends and family for support o Daily engagement o Real-time analytics so you know what s going on and what s changing Virgin Pulse: Programs That People Can Love o Competitions o Challenges o Promotions & Contests o Connections with Friends o Recognition o A place for it all to be centralized and simplified to make use easy To create a new account, go to o Gadgets NEXT STEPS Schedule an appointment with a Benefits Educator at enrollappointments.com/cpsi. Please have your dependent & beneficiary information (SSNs, date of birth) with you at your enrollment session. 10 SCHEDULE YOUR APPOINTMENT AT

13 IMPORTANT TELEPHONE NUMBERS & WEBSITES Benefit Carrier Phone Number Website Accident Insurance Unum Critical Illness Insurance Unum Dental Insurance Flexible Spending Account Long-Term Disability Insurance Blue Cross and Blue Shield of Alabama Discovery Benefits Unum Hospital Indemnity Plan Unum Medical Insurance Onsite Clinic Short-Term Disability Insurance Blue Cross and Blue Shield of Alabama Symbol Onsite Clinics Main Campus: Festival Center: Unum Vision Insurance Humana Wellness Program Virgin Pulse The information in this guide should in no way be construed as a promise or guarantee of employment or benefit coverage. Pricing, underwriting, plan specifics and all other product features are solely that of the Insurance Company and not Enrollment Advisors, LLC. If there is a conflict between the information in this guide and the actual plan document or policies, the documents or policies will always govern. Complete details about the benefits can be obtained by reviewing current plan descriptions, contracts, certificates, policies and plan documents available from the Benefits Department. 11

14 6600 Wall Street Mobile, AL Employee Benefits Information IMPORTANT