Author: Lothian, Maria

Benefits Overview

Your benefits are an important part of your overall compensation. This overview was designed to answer some of the basic questions you may have about your benefits.
January 1 - December 31, 2018

Eligibility
You are eligible for benefits if you work 30 or more hours per week. You may also enroll your eligible family members under certain plans you choose for yourself. Eligible family members include:
Your legally married spouse
Your Registered Domestic Partner
(RDP and their children, where applicable by state law
Your children who are your natural
children, stepchildren, adopted children, or children for whom you have legal custody (age restrictions may apply). Disabled children age 26 or older who meet certain criteria may continue on your health coverage.

Choose Carefully!
Due to IRS regulations, you cannot change your elections until the next annual Open Enrollment period, unless you have a Qualifying Event during the year. Following are examples of the most common Qualifying Events:
Marriage or divorce
Birth or adoption of a child
Child reaching age 26
Death of a spouse, Registered
Domestic Partner (RDP), or child
Change in child custody
Change in coverage election made
by your spouse/RDP during his/her
employer’s Open Enrollment period
You lose coverage under your
spouse’s/RDP’s plan

Making Changes
To make changes to your benefit
elections, you must contact Human
Resources within 31 days of the qualified event (including newborns). Be prepared to show documentation of the event such as a marriage license, birth certificate, or a divorce decree. If changes are not submitted on time, you must wait until the next Open Enrollment period to make your election changes.
Required Information - when you enroll, you will be required to enter a Social Security number (SSN) for all covered dependents. The Affordable Care Act (ACA), otherwise known as health care reform, requires the company to report this information to the IRS each year to show that you and your dependents have coverage and are not subject to a federal tax penalty. This
information will be securely submitted to the IRS and will remain confidential.

Medical Plans
We are proud to offer you a choice of three medical plans. Following is a high-level overview of the coverage available.

Key Medical Benefits	(Carrier) / Plan name 1	(Carrier) / Plan name 2		(Carrier) / Plan name 3
	In-Network Only	In-Network	Out-of-Network1	In-Network	Out-of-Network1
Deductible (per calendar year)
Individual / Family
Out-of-Pocket Maximum (per calendar year)
Individual / Family
Company Contribution to Your Health Savings Account (HSA) per calendar year: prorated for new/hires/newly eligible
Individual / Family
Covered Services
Office Visits (physician / specialist)
Routine Preventive Care
Emergency Room
Urgent Care Facility
Inpatient Hospital Stay
Prescription Drugs (Tier 1 / Tier 2 / Tier3)
Retail Pharmacy (30-day supply)
Mail Order (90-day supply)

Coinsurance percentages and copay amounts shown in the above charts represent the percentages that the member is responsible for paying.
* Benefits with an asterisk ( * ) require that the deductible be met before the Plan begins to pay.
If you use an out-of-network provider, you will be responsible for any charges above the maximum allowed amount.
If you enroll one or more family members, you must meet the full FAMILY deductible before the plan starts to pay expenses for any one individual.
If you enroll one or more family members, you must meet the full FAMILY out-of-pocket maximum before the plan starts to pay eligible covered services at 100% for any one individual.

Dental Plans
We are proud to offer you a choice of three dental plans. Following is a high-level overview of the coverage available.

Key Dental Benefits	HMO Plan	PPO Plan
	In-Network Only	In-Network	Out-of-Network1
Deductible (per calendar year)
Individual
Family
Benefit Maximum (per calendar year; Preventive, Basic, and Major Services combined)
Per Individual
Covered Services
Preventive Services
Basic Services
Major Services
Orthodontia (Adults & Children)

If you use an out-of-network provider, you will be responsible for any charges above the maximum allowed amount.

Vision Plan
We are proud to offer you a vision plan through
Vision Service Provider (VSP). If you use a Vision Service Provider (VSP) provider, exams are subject to a $10 copay, materials require a N/A copay and frames are covered up to $500. Exams and lenses are covered once every 12 months and frames are covered once every 12 months.

Disability
You are provided Disability Insurance through Anthem at No Cost / an affordable group rate. Disability Insurance provides benefits that replace part of your lost income when you become unable to work due to a covered injury or illness.
Voluntary Short-Term Disability (STD): Benefit amount is equal to 60% of your weekly earnings up to $600. Benefits begin after 7th day of disability.
Voluntary Long-Term Disability (STD): Benefit amount is equal to 60% of your weekly earnings up to $10,000. Benefits begin after 90th day of disability.

Life and AD&D
Basic Life and Accidental Death and Dismemberment (AD&D coverage is provided through Anthem at NO COST. You also have the opportunity to purchase additional Supplemental coverage at affordable group rates through Anthem.
Basic Coverage: 2 times your base salary plus commissions, up to a $500,000 maximum.
Supplemental Coverage: Employee Coverage up to $500,000, spouse/RDP Coverage up to $250,000 (not to exceed 50% of your additional life coverage) and child(ren) Coverage up to $10,000.

Contacts
Medical: [Carrier] - [Phone] - [Website]
Dental: [Carrier] - [Phone] - [Website]
Vision: [Carrier] - [Phone] - [Website]
Life and AD&D: [Carrier] - [Phone] - [Website]
Disability: [Carrier] - [Phone] - [Website]
Call Center: [Carrier] - [Phone] - [Website]
HR: [Phone] - [E-mail]

Cost of Benefits: Your contributions toward the cost of benefits are automatically deducted from your paycheck. The amount will depend upon the plan you select and if you choose to cover eligible family members. Please refer to the separate insert rate sheet for your contributions.

DISCLAIMER: The material in this benefits brochure is for informational purposes only and is neither an offer of coverage or medical or legal advice. It contains only a partial description of plan or program benefits and does not constitute a contract. Please refer to the Summary Plan Description (SPD) for complete plan details. In case of a conflict between your plan
documents and this information, the plan documents will always govern. Annual Notices: ERISA and various other state and federal laws require that employers provide disclosure and annual notices to their plan participants. The Company will distribute all required notices annually.