Health and Insurance Highlights Powering You to Live Well

Transcription

1 Health and Insurance Highlights Powering You to Live Well Eaton recognizes how important health and insurance benefits are in meeting the varying needs of today s employees and their families. Please read the following highlights of the main features of your health and insurance benefits program. Medical Health Savings Account (HSA) Dental Vision Reimbursement Accounts Dental/Vision Reimbursement Account, Dependent Care Reimbursement Account Life Insurance Employee, Spouse/Domestic Partner, Child Accidental Death and Dismemberment (AD&D) Insurance Employee, Spouse/Domestic Partner, Child Disability Work/Life Solutions Employee Assistance Program Adoption Assistance Summary Plan Descriptions, Fidelity NetBenefits Reference Library and EatonBenefits.com Learn More Links Summary Plan Descriptions (SPDs) for your Eaton health and insurance benefits provide greater detail and information. They can be found online in the Fidelity NetBenefits Reference Library. If this packet includes a USB flash drive (jump drive), the SPDs are also available on that drive. Additional information about your benefits is available in various documents located in the Reference Library or in the Eaton Learn More Links section on EatonBenefits.com. Some of these documents are referenced in the following pages. To access Fidelity NetBenefits Reference Library: Go to EatonBenefits.com on the internet or, from JOE, select HR Services > My Benefits (in the list on the left side of the page) > Go to Eatonbenefits.com (in the Eaton Benefits section of the page). Select Eaton Service Center at Fidelity from the list on the left. Log on to Fidelity NetBenefits. From the bottom of the NetBenefits homepage, select the Health & Insurance Reference Library link under the Featured Resources tab. To access Eaton Learn More Links: Go to EatonBenefits.com on the internet or, from JOE, select HR Services > My Benefits (in the list on the left side of the page) > Go to Eatonbenefits.com (in the Eaton Benefits section of the page). Eaton Learn More Links are located at the bottom of the page. If you are accessing EatonBenefits.com from the Internet, you do not have to log on to access the Eaton Learn More Links. Personal Fact Sheet You are eligible for Eaton benefits as of your date of hire or the date you transfer to an eligible group, whichever is later. Your Personal Fact Sheet (PFS) (provided at the front of this booklet) lists all of the benefit options available to you and your eligible family members. The costs (or credits) associated with each benefit option are also listed.

2 Even though you have a 60-day enrollment period to make your benefit elections, you have already been automatically enrolled in the default coverage shown on the PFS. If you don t make any elections within the 60- day enrollment period shown on the PFS, you will continue to be covered by these default benefits through the end of the year. The automatic default benefits include single coverage in the Consumer Health 90 medical plan option. Employee contributions for this coverage will start being deducted from your pay check. Note that this benefit does not include any coverage for your dependents. o You can select a different medical plan option, add your dependents to coverage or elect to have no medical coverage during the 60-day enrollment period. o If you elect not to have medical coverage but have medical plan deductions taken from your pay, contact the Eaton Service Center at Fidelity toll-free at EATON01 ( ). You will not be automatically enrolled in dental or vision coverage. If you do not make a dental or vision plan election within the 60-day enrollment period, you and your dependents will not have dental or vision coverage for the rest of the year. Enrollment in medical, dental and vision can be made separately. For example, you can enroll yourself only in a medical plan, yourself and one eligible dependent in dental, and waive participation in vision coverage. If you elect a coverage option for Employee Accidental Death and Dismemberment (AD&D) Insurance, Employee Life Insurance or Long Term Disability (if you are eligible for this plan) for an amount less that the company-provided amount, you will receive a credit. Who can you cover in the Eaton benefit plans? You can cover your spouse or domestic partner and your eligible children. You can find a Definition of Eligible Dependent document on EatonBenefits.com. Click on the Health & Insurance Benefits the Details link in the Eaton Learn More Links section at the bottom of the page. Then choose 2016 Benefits > Health Care Plans Dependent Coverage in the Using Your Benefits section. The Summary Plan Descriptions (SPDs) also have details on eligible dependents. Pretax Contributions Your contributions will be deducted from your paycheck before taxes are calculated, except for participation in Spouse/Domestic Partner or Child Life Insurance, which is paid for with after-tax money. However, if your domestic partner is not your IRS dependent, then your contributions for your partner s coverage will be deducted from your paycheck on an after-tax basis, and Eaton s contribution to your partner s coverage will be taxable income to you. POWERING YOU TO LIVE WELL EatonBenefits.com Your Benefit Portal Eaton partners with ActiveHealth Management to provide you with quick and easy access all in one place to a broad range of benefit services, resources and health information, including convenient, direct links to the Web sites of Eaton Health Plan Partners, such as Anthem Blue Cross Blue Shield (BCBS) and Express Scripts. Go to EatonBenefits.com from JOE or the Internet to access the tools, information and links that will help you and your spouse or domestic partner manage your personal health. Check out Eaton Learn More Links, connect with Eaton programs and Health Plan Partners directly, and find many more helpful resources by clicking MyActiveHealth. If you access EatonBenefits.com directly from the Internet, you will create a username and password. Please note that this username and password are different from your Fidelity NetBenefits username and password.

3 Spouses and domestic partners who are covered by an Eaton medical plan also have the opportunity to manage their personal health by registering their own usernames and passwords. The tools available through EatonBenefits.com and MyActiveHealth are for their individual use. Logging on ensures that your personal health information remains private and confidential. Eaton does not have access to an individual employee s personal information entered on the site. To Your Health! To help you and your family stay on track with your health, Eaton offers the following services: TOBACCO CESSATION PROGRAM. A tobacco cessation specialist will create a customized plan of one-on-one support and the resources you or your family member (age 18 or over) needs to lead a tobacco-free life. INFORMED CARE MANAGEMENT. A nurse works with you if you have a long-term health condition such as heart disease or diabetes. You can get a better understanding of your condition, answers to medication questions, explanations of test results, and support for making healthy lifestyle changes. COMPLEX CASE MANAGEMENT. A nurse provides extra support if you are hospitalized frequently or for a long time, or if you need extended home health care or specialized services. CANCER MANAGEMENT. An oncology nurse supports you in recognizing the early signs of complications, managing side effects, and understanding your treatment options, whether you ve just been diagnosed with cancer or are in treatment. PATIENT DECISION SUPPORT. A medical professional works with you and your doctor if you face tough treatment decisions for conditions like arthritis, chronic back pain, prostate cancer, obesity, and coronary artery disease. The goal is to reach better-informed decisions in collaboration with your physician. MATERNITY MANAGEMENT. A specially trained nurse guides you through your pregnancy and helps you understand your baby s needs. ACTIVE LIFESTYLE COACHING. Make positive changes to your health with phone support from your personal coach. Quit tobacco, lose weight, get moving, manage stress, eat healthier, or make other healthy lifestyle changes important to you. NURSE LINE. You can get answers 24/7 to troubleshoot medical problems and identify next steps. LIVEHEALTH ONLINE. Consult with a U.S. board certified doctor 24/7 through your computer or mobile device. Doctors can answer questions, make a diagnosis and prescribe medication for issues such as cold and flu symptoms, allergies and sinus infections. Online visits are subject to your medical plan coinsurance and deductible. EXPERT MEDICAL OPINIION. Get access to recognized experts in specific medical fields when you are faced with a medical diagnosis and/or treatment decisions. You work with an Advance Medical physician case manager who answers questions, collect medical documentations, accesses the medical experts, helps you understand the expert s report, and even speaks with your treating physician if requested. You and your immediate family (e.g., spouse/domestic partner and dependent children) can use this service, whether or not you are enrolled in the Eaton Medical Plan. Although Eaton pays the full cost of the program, the cost of medical appointments and treatments remain your responsibility. When you participate in any of the programs described above, Eaton s Health Care Partners ActiveHealth Management (ActiveHealth), Anthem BCBS, Advance Medical and Express Scripts will work together to

4 coordinate your care. To get started with any of the programs, go to EatonBenefits.com and click on the Whom to Contact and More tab in the left-hand side navigation bar. The choice to participate is yours. Medical Plan Eaton offers two managed care medical options administered by Anthem Blue Cross Blue Shield (BCBS). Consumer Health 90 Consumer Health 80 Both options: Use the Anthem BCBS network of doctors and hospitals. Cover eligible in-network preventive care services at 100%. Offer discounts for using in-network providers. Offer prescription drug coverage through Express Scripts. Cover the same services, such as doctor visits, lab work and hospital stays. Protect you from large medical expenses with out-of-pocket maximum spending limits. However, other plan provisions such as deductibles and out-of-pocket maximums differ between the two options. Your PFS lists the options available to you and their costs. The Plan Compare tool on Fidelity NetBenefits provides information about the benefits available under the options. The Consumer Health options provide you with a tax-advantaged opportunity to pay your qualified medical expenses and save for future health care expenses. With both options, you may open a Health Savings Account (HSA). Eaton contributes pretax money to your HSA. (You have the option of making pretax contributions, too.) You decide when to use the HSA, or you can invest your account for future growth. The account is yours to keep, even if you leave Eaton. With the Consumer Health options, Eaton pays 100% (with no deductible) for in-network preventive care and select preventive medications. You pay 100% for other services until you meet your annual deductible. Then, Eaton pays a percentage of covered expenses. The percentage depends on which option you enroll in and whether you use an in-network or out-of-network provider. Get Help Choosing Your Best Plan Option Read through the information below for a brief summary of your options. Go to EatonBenefits.com. o Select Health Plan Choice Tool from the list on the left. o Check out the information available under the Eaton Learn More Links. The Summary Plan Description (SPD) also has details on the plan options. Other helpful documents are located in the Fidelity NetBenefits Reference Library. Health Savings Account You control how and when you spend your HSA. You can use it right away for eligible out-of-pocket qualified medical expenses or invest the account for future growth and use it later. How an HSA Works Eaton contributes pretax money to your account. With either Consumer Health option, when you open an HSA with Fidelity, you ll receive $400 a year for Employee Only coverage, or $800 a year for Employee + Other(s) coverage.

5 In addition, you can choose to contribute to your HSA as well, up to the IRS annual limit of $3,350 for Employee Only coverage or $6,750 for Employee + Other(s) coverage in 2016 (Eaton s contributions apply to the limit). If you are age 55 or over, you can make an additional catch-up contribution of $1,000. You choose how to invest the money in your HSA. Through Fidelity, you will have access to over 4,000 mutual funds and other investments including stocks, bonds and CDs. (Please consult with Fidelity, because some of the mutual funds require a minimum balance.) You own the account, including the contributions Eaton makes. There is no use it or lose it provision, unlike with a Health Care Reimbursement Account (HCRA). All unused funds roll over from year to year. And if you retire or leave Eaton, you take your HSA money with you. While you remain an active employee, Eaton pays the monthly fees associated with maintaining the HSA account. Qualified medical expenses for anyone you claim or could claim on your tax return are eligible to be paid from the HSA, even if you don t cover them under Eaton s medical plan. You don t need to submit receipts every time you withdraw money. However, you will need to reflect HSA expenses on your tax return, so save your receipts. You may NOT establish an HSA if o you participate in a non-consumer medical plan (like Medicare), even as a dependent. o your spouse or qualified domestic partner participates in a health care reimbursement account (also known as a flexible spending account). o you fail to meet other eligibility requirements outlined in IRS publication 969. o Please check IRS publications 969 and 502 for a complete list of eligibility rules and details about limits and eligible expenses. The HSA is Triple-Tax-Advantaged Pretax contributions. Your contributions are made on a pretax basis. You can contribute up to the IRS limit, and Eaton s contribution to your HSA is not taxable. Tax-free earnings. All earnings in your account are tax-free.* Tax-free withdrawals. When you use the money to pay for qualified medical expenses, the withdrawals are tax-free.* *With respect to federal taxation only. Contributions, investment earnings and distributions may or may not be subject to state taxation. See your tax advisor for more information on the state tax implications of HSAs. Prescription Drug Program Both medical plan options include prescription drug coverage through Express Scripts. You ll pay the full cost of prescription drugs until you meet your annual deductible. After that, Eaton starts paying benefits, and you are responsible for 10% (Consumer Health 90) or 20% (Consumer Health 80) of the cost. Plus, you ll pay the difference in cost between a brand-name drug and its generic equivalent, if one is available. Additionally, some preventive medications (mostly generic) are free if acquired through an in-network retail pharmacy or through the Express Scripts mail order pharmacy. Find a list in the medical plan Summary Plan Description (SPD) or in the Eaton Learn More Links. Once you reach the out-of-pocket maximum, Eaton pays 100% of the cost.

6 You can help lower your (and Eaton's) out-of-pocket prescription drug costs by using the mail order drug program for ongoing conditions and purchasing over-the-counter, generic, or formulary brand drugs whenever possible. If you do not use mail order or generic drugs when available, you may pay substantially more, possibly up to 100% of the cost of the drug. However, the choice of drug is always a decision to be made by you and your doctor. Dental Plan Eaton offers a dental plan administered by Delta Dental. Delta Dental has two networks of contracted dentists who offer negotiated fees and will file your claims for you. You may also see any dentist or orthodontist who is not in one of the networks, with no difference in the plan s benefit level. However, you will not receive a discount and may have to file your own claims. For information about the difference in the two networks, go to EatonBenefits.com > Health & Insurance Benefits the Details (in the Eaton Learn More Links section at the bottom of the page) > 2016 Benefits > Plan Summaries and Employee Contributions (in the Choosing Your Benefits section) > Dental/Vision Benefits at a Glance. The following chart provides a high-level summary of the dental plan benefits. Plan Feature Annual Deductible Individual Family Preventive Care (e.g., exam or cleaning) Basic Services (e.g., X-rays or fillings) Major Services (e.g., oral surgery or crowns) Orthodontics (under age 19) Benefit $50 $ %, no deductible 80%, after deductible 50%, after deductible 50%, after deductible $1,500 lifetime maximum per child Annual Benefit Maximum $1,500 Vision Plan EyeMed Vision Care administers the vision plan offered to Eaton employees and eligible dependents. The plan is designed to help you with the cost of routine eye exams and eyewear. Your medical plan may provide additional vision benefits. Refer to your Summary Plan Description (SPD) for details. You must access service through a network of participating providers to receive the highest level of benefits. Fees for services outside the network are generally higher, and the level of benefits is lower. The following chart provides a high-level summary of the vision plan benefits. Vision Service/Supply

7 Eyeglass examination (includes contact lens examination, if desired) Eyeglasses Contact Lenses (in lieu of eyeglasses) Once Each Year In-Network Benefits $10 copayment Frames: Plan pays 100% up to $125 Lenses: $10 copayment* Plan pays 100% up to $105 Out-of-network benefits are available at a lower benefit level. Refer to your SPD for more details. * The plan covers uncoated plastic lenses. If You Need Health Care Before Receiving Your ID Card Call the customer service number of the Health Plan Partners (See your PFS). If the representative confirms you or your family member is covered, do the following: Medical Have your health care provider contact Anthem BCBS customer service number to verify coverage, or you can print a temporary ID card from the Anthem Web site, accessible through EatonBenefits.com. Prescription drug Your Anthem Medical ID card applies to both medical and prescription drug coverage. You can print a temporary ID card from the Anthem Web site, accessible through EatonBenefits.com, or you can provide the pharmacy with the following information: RxBin#: Group#: EATONRX Processor: Express Scripts Dental or vision Have your health care provider contact Delta Dental or EyeMed Vision customer service number to verify coverage. You can also print a temporary ID card from the Delta Dental Web site, accessible through Eaton Benefits.com. If the health plan partner does not show that you or your eligible family member is covered, contact the Eaton Service Center at Fidelity. Explain that you or your family member needs immediate health care and that the claims administrator does not show the coverage. Reimbursement Accounts Eaton offers employees the option to put aside money in order to save for certain health and dependent care expenses that arise throughout the year. There are two types of Reimbursement Accounts available, all administered by Acclaris: The Dental/Vision Reimbursement Account (DVRA) is available for those who participate in the Eaton Consumer Health 80 or Consumer Health 90 medical plan option. It allows you to set aside money up to IRS limits to pay for qualified dental and vision expenses. You cannot use this account for reimbursement of medical expenses. Most employees would choose this account only after contributing the maximum annual allowed amount to a Health Savings Account (HSA). You can receive reimbursements using your Dental/Vision Reimbursement debit card. The debit card is a convenient payment option that deducts directly from your Dental/Vision Reimbursement Account. Be sure to

8 keep your receipts, because in most cases, you will be required to submit receipts for expenses paid with your debit card. The Dependent Care Reimbursement Account (DCRA) allows you to set aside money up to IRS limits to pay for day care (non-medical) expenses for your children or other eligible dependents so that you or if you are married, you and your spouse are able to work. If you are married, generally, your spouse must be working or attending school full-time in order for your day care expenses to be eligible for reimbursement. The Internal Revenue Service (IRS) determines which health and dependent care expenses qualify for reimbursement. For information about eligible expenses, go to EatonBenefits.com > Health & Insurance Benefits the Details (in the Eaton Learn More Links section at the bottom of the page) > 2016 Benefits > Health Savings Account (HSA) & Dental/Vision Reimbursement Account (DVRA) Details (in the Using Your Benefits section). Life and Accidental Death and Dismemberment (AD&D) Insurance Many Eaton benefits focus on keeping you and your family physically healthy. However, Eaton is also concerned about your financial health and security. Part of achieving financial health is ensuring that those close to you are protected financially in the unfortunate event of your death. Therefore, the company provides a basic level of life and AD&D insurance at no cost to you. In addition, you have the opportunity to purchase additional protection through your Eaton benefits program. Benefits are insured by MetLife. Employee Life Insurance The company provides basic life insurance coverage in the amount of 1 times your annual base pay, with a minimum coverage amount of $25,000. You have the option to purchase additional coverage above the company-provided amount, for up to a total coverage of 8 times your annual base pay. You may also elect a coverage amount less than the company provided amount and receive a taxable pay credit for the cost savings. You cannot waive participation in Employee Life Insurance. Refer to your PFS for cost and coverage details. The Internal Revenue Service (IRS) considers a portion of your employee life insurance coverage (basic and supplemental) in excess of $50,000 to be taxable income ( imputed income ). Each pay period, the value of this excess coverage is added to your wages and taxed. Please refer to the Life Insurance Summary Plan Description (SPD) for more information. Spouse/Domestic Partner Life Insurance and Child Life Insurance In addition to Employee Life Insurance, you may elect to purchase Life Insurance for your eligible spouse/domestic partner and/or dependent children by electing coverage under the Spouse/Domestic Partner Life Insurance plan and/or Child Life Insurance plan. The options and costs for this coverage are also listed on your enclosed PFS. Participation in this benefit is voluntary. Accidental Death and Dismemberment Insurance (AD&D) In addition to the Employee Life Insurance described above, Eaton provides AD&D insurance coverage in the amount of 2 times* your annual base pay. This coverage is provided at no cost to you. A benefit is provided to your named beneficiary in the event of your death due to an accident. Additionally, a benefit is available to you in the event of a dismemberment claim resulting from an injury to, or loss of, a covered body part or function. As with life insurance, you have the option to purchase additional coverage above the company-provided amount, for up to a total coverage of 8 times your annual base pay. If you elect a coverage option that is less than the company-provided amount, you will receive a taxable pay credit for the cost savings. Refer to your PFS for cost and coverage details.

9 *If you are represented by a recognized collective bargaining agent, Eaton may only provide coverage in the amount of 1 times your annual base pay. To determine the amount of coverage provided by Eaton, refer to your Personal Fact Sheet provided at the front of this booklet. Spouse/Domestic Partner AD&D Insurance and Child AD&D Insurance You may elect to purchase AD&D insurance coverage for your eligible spouse/domestic partner and/or dependent children by electing coverage under the Spouse/Domestic Partner AD&D Insurance or Child AD&D Insurance plans. The options and costs for this coverage are also listed on your enclosed PFS. Participation in this benefit is voluntary. Disability Eaton also provides other benefits to help you achieve financial health and protect your income in the event that you are unable to work due to a disability. All disability benefits are administered centrally by Sedgwick CMS. Short Term Disability (STD) STD benefits* replace a portion of your pay in the event that you are unable to work because of a short-term illness or injury. This coverage is provided by Eaton, at no cost to you. You do not have to enroll. Benefits generally cover six months of disability. * If you work in a state that provides disability benefits, you may not be eligible for this plan. To determine whether or not you are eligible, refer to your Personal Fact Sheet (PFS) provided at the front of this booklet. If the STD plan shown on your PFS is the State Disability Plan, then you are not eligible for the Eaton STD plan. Long Term Disability (LTD) LTD benefits* continue a portion of your monthly base pay if you are unable to work because of a long-term illness or injury. If you are eligible for the LTD plan, LTD benefits generally begin following the expiration of the six-month STD period during which you have been absent from work for a covered illness or injury. Eaton provides a basic level of benefit at no cost to you. You can also purchase additional levels of coverage to ensure a larger percentage of your pay is protected. Your PFS shows the percentage of income replacement provided by your company-paid benefit, as well as the additional levels of benefit available to you and their costs. You cannot waive participation in LTD. Note: Monthly STD and LTD benefits are reduced by any other disability benefits received, such as Social Security or Workers Compensation. * If you are represented by a recognized collective bargaining agent, you are eligible for LTD benefits only if stated in the collective bargaining agreement. To determine whether or not you are eligible for these benefits, refer to your Personal Fact Sheet provided at the front of this booklet. Counseling and Assistance Programs

10 Work/Life Solutions Employee Assistance Program (EAP) Eaton pays the full cost for this program, which includes confidential services for employees and their dependents who need personal counseling, child and elder care information, and discounted legal and financial services. The Work/Life Solutions program, administered by ValueOptions, also offers concierge services, such as restaurant listings, travel arrangements, home maintenance providers, and tickets for special events. Adoption Assistance You have access to adoption assistance benefits. You do not need to enroll in this program, and it is provided at no cost to you. The adoption assistance benefit provides reimbursement for eligible adoption expenses up to a maximum of $10,000 for each adopted child under the age of 18. Refer to your Summary Plan Description (SPD) for details on eligible expenses. Will Preparation and Estate Resolution Services Will preparation and estate resolution services available to you if you are purchasing additional life insurance for yourself above the one times annual base pay coverage that Eaton provides to you. To access these services call (Company Name: Eaton; Member Number: G and your Social Security Number). Ayco TransitionalSupport for Life-Threatening Illness* Financial counseling services are available to you in the event that you or your spouse or domestic partner is diagnosed with a life-threatening illness. *You are not eligible for this benefit if you are represented by a recognized collective bargaining agent. Ayco SurvivorSupport* Financial counseling services are available to you in the event of the death of your spouse. This benefit is also available to a spouse or domestic partner of a deceased employee, and to the legal guardian of children of a deceased Eaton employee. *You are not eligible for this benefit if you are represented by a recognized collective bargaining agent. Grief Counseling Services Counseling services are available to you and your family in the event of the death of a loved one or major life changes that trigger feelings of grief. Need More Information? The information provided here summarizes some of the key elements of your health and insurance benefits program. More details can be found in the Summary Plan Descriptions (SPDs) and other documents located in the Reference Library or in the Eaton Learn More Links section on EatonBenefits.com. For more information on how to access these documents, see the first page of this Health and Insurance Highlights section. In addition, you can contact the Eaton Service Center at Fidelity online or by phone. Your enrollment questions and many of your general coverage questions can be addressed at the Service Center. You can also call the Health Plan Partners directly for detailed coverage questions, to obtain ID cards, or to process claims. Phone numbers are listed on your PFS. Contact your local Human Resource representative for personal information changes, tuition reimbursement program details, and vacation and holiday schedules.

11 Keep in mind that investing involves risk. The value of your investment will fluctuate over time, and you may gain or lose money. This brochure provides highlights of the Eaton benefit plans. It is not a Plan Document nor part of a Plan Document. If there is any discrepancy between the information provided in this brochure and the official Plan Documents, the official Plan Documents will govern. The information in this brochure was provided by Eaton and is the responsibility of Eaton. The information provided in this brochure is general in nature. It is not intended, nor should it be construed, as legal or tax advice. Since the administration of an HSA is a taxpayer responsibility, you are strongly encouraged to consult your tax advisor before opening an HSA. You are also encouraged to review information available from the Internal Revenue Service (IRS) for taxpayers, which can be found on the IRS Web site at You can find IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans, and IRS Publication 502, Medical and Dental Expenses (including the Health Coverage Tax Credit), online, or you can call the IRS to request a copy of each at Fidelity Brokerage Services LLC, Member NYSE, SIPC 900 Salem Street, Smithfield, RI /24/15 3.EA-H-403A.122