Enrolling in Your 2016 Benefits 2016 Open Enrollment is October 26 November 16 Be prepared Visit mydzabenefits.com to learn about your 2016 benefits and view available resources to help you make informed decisions. One of our primary goals is simplification to our medical and pharmacy plan design, and to provide more integrated member tools! All eligible associates MUST actively enroll to receive benefits in 2016. If you do not enroll by November 16, you will not have medical, prescription drug, dental, vision and flexible spending account elections. These 2015 health benefits will not rollover. If eligible, company-provided benefits such as Group Life, Resources for Living and any Voluntary Benefits you may have elected will roll over for 2016. Contents Before You Enroll... 2 Use Your Resources... 2 Gather Your Information... 3 How to Enroll and Email Authentication... 3 When to Enroll... 4 If You Do Not Enroll... 5 Confirm Your Coverage After You Enroll... 6 Life Events/Change in Status... 6
Before you enroll Use your resources We know choosing the right medical plan for you and your family is an important decision Delhaize America is here to help. You have access to several tools and resources to help you learn about your benefit options and make your choices. mydzabenefits.com: A site designed just for you! This site is your one-stop-shop to find personalized health and wellness benefits information. From your home page, you can find notifications for upcoming actions you need to take, see your current benefit elections and access the Resource Guide your complete guide to Delhaize America health benefits, helping you make informed decisions throughout the year. mydzabenefits.com also offers single sign on to your medical carrier and several vendor websites to give you quick and easy access to additional personalized information. That means once you log in to the site, you will always be automatically signed in to participating vendor sites (after you have registered with each vendor) no other logins required! Medical Plan Decision Tool: Estimate you and your family s level of health care use and view a side-by-side cost comparison of the medical options. Enrollment Options: Enroll online anytime during the open enrollment period (24 hours a day!) on mydzabenefits.com. Enrollment Center: If you are unable to enroll online or have questions, please call the Enrollment Center during your assigned enrollment period (see page 4) at 1-855-720-9932, available Monday - Friday, 8 a.m. to 8 p.m. and Saturdays 10 a.m. to 6 p.m., Eastern Time. If you are a newly hired or newly eligible associate, you must enroll prior to your benefit eligibility date. Go to mydzabenefits.com to access all of your benefits information and enroll online, or by calling 1-800-498-3086, Monday Friday (except holidays) 9 a.m. to 6 p.m., Eastern Time. 2
Gather your information Make sure you have all the information you need before you go online to enroll. Have this information ready: Check your current coverage. Not sure what benefits you are currently enrolled in? You can easily view your 2015 elections on your mydzabenefits.com home page. Social Security numbers for any eligible dependents you are enrolling or designating as a beneficiary. Name and provider ID number(s) of the Primary Care Physician for you and your eligible dependents. If you need to choose a PCP, select the Find a Provider link from the home page of mydzabenefits.com. Note: it is important to verify your provider is still innetwork and that their provider ID number has not changed. How to enroll You can easily enroll online anytime during Open Enrollment beginning October 26 and ending November 16 at mydzabenefits.com. It s quick and simple, just follow the steps below: 1. Log in to mydzabenefits.com, or scan the QR code below with your smartphone. 2. From the home page, click Enroll Now for 2016 Benefits under Tools. You ll go straight to the enrollment site no extra log in or passwords necessary! 3. Follow the prompts to enroll. If you ve never logged in to mydzabenefits.com, simply visit the site and follow the instructions on the login page. If you are unable to enroll online or have questions, please call the Enrollment Center at 1-855- 720-9932, available Monday Friday, 8 a.m. to 8 p.m. and Saturdays 10 a.m. to 6 p.m., Eastern Time. 3
When to enroll You can enroll any time during open enrollment on mydzabenefits.com. If you have difficulty enrolling online or have questions, you must call the Enrollment Center at 1-855-720-9932 during your assigned enrollment period (see grid below), which is based on the state in which you live. Representatives are available Monday Friday, 8 a.m. to 8 p.m. and Saturdays 10 a.m. to 6 p.m., Eastern Time. If you do not enroll online by November 16, 2015 or by phone by the end of your assigned enrollment period, you will not have medical, prescription drug, dental, vision or flexible spending account benefits in 2016. State Assigned Enrollment Period Maine, Vermont, New Hampshire, Massachusetts, Connecticut, Rhode Island, New Jersey, New York, Pennsylvania, Delaware, October 26 31, 2015 District of Columbia North Carolina November 9 14 and November 16 All other states November 2 7, 2015 If you are a newly hired or newly eligible associate, you must enroll online or call the Enrollment Center at 1-800-498-3086 to enroll prior to your benefit eligibility date. If you do not enroll prior to your benefit eligibility date, you must wait until the next enrollment period to enroll for these benefits unless you experience a qualifying life event. Full-time and part-time salaried associates will automatically receive basic Group Life, Resources for Living (EAP) and any Voluntary Benefits you may have elected even if you do not enroll for other benefits. If you are a newly eligible associate or have a change due to a classification change, you must call the Enrollment Center to enroll within 31 days. See page 6 for information about qualifying status changes. 4
If you do not enroll All eligible associates MUST actively enroll to receive benefits in 2016. Most of your 2015 health benefits will not roll over, including medical, prescription drug, dental, vision and flexible spending account elections. If you do not enroll, you will not have these health benefits in 2016. Benefit Will NOT carry over to 2016 You must go online or call to enroll for coverage New hire/ newly eligible You must call to enroll for coverage Eligibility for dependent children Medical and ü ü Up to age 26 Prescription Drug Dental ü ü Up to age 26 Disability ü (NE hourly) N/A Vision ü ü Up to age 26 Health Care Flexible ü ü N/A Spending Account Dependent Day Care ü ü N/A Flexible Spending Account Supplemental Life ü Up to age 26 Insurance Company-Provided Benefits Resources for Living Yes EAP Program Group Life Insurance N/A Voluntary Benefits Hyatt Legal ü N/A Universal Life ü Up to age 26 Group Auto and Home ü N/A Insurance Pet Insurance ü N/A Critical Illness ü N/A Insurance Long-Term Disability ü N/A Hospital Indemnity ü N/A 5
Confirm your coverage after you enroll If you enroll online, your personalized benefits confirmation statement will be available immediately. If you are unable to enroll online and have to enroll by phone, your confirmation statement will be available to view online approximately 48 hours after enrolling on mydzabenefits.com. Please review your confirmation statement carefully to be sure your benefits elections are correctly noted. If changes are needed, follow the instructions included on the confirmation statement. If you would like to print your confirmation statement at a later date, you will receive instructions at the end of your enrollment session explaining how to access your statement. Life events/change in status After November 16, 2015, you will not be able to enroll until the next Open Enrollment period unless you have a qualifying status change, such as: Marriage Divorce Birth or adoption of a child Death A change in your spouse/domestic partner s employment status All changes must be made within 31 days of the event. Associates who need to report a status change should open a ticket through the Delhaize America Associate Service Center either online or by calling 1-866-789-HR4U (4748). After you submit the change, you will be required to provide supporting documentation to the Benefits Department. For more information on life events visit the Changing Your Coverage page on mydzabenefits.com. We want you to stay in touch! If your mailing address, phone number, beneficiary designation or email address changes during the year, be sure to log in to Me Online! to update. Don t forget to also update your email address on the mydzabenefits.com portal by clicking on Update Profile on the home page. 6