Benefit Guide
Your benefits overview for you and your family!
2024
Table of Contents
▪ Welcome
3
▪ Eligibility and Enrollment
4
▪ ALEX – Benefits Counselor
6
▪ Medical Benefits
7
▪ Dental Benefits
10
▪ Vision Benefits
12
▪ Basic Life & AD&D Insurance
14
▪ Voluntary Life Insurance
15
▪ Short & Long-Term Disability Coverage
16
▪ Voluntary Worksite Benefits
17
▪ Legal Benefits
19
▪ Spending Accounts
20
▪ Pet Insurance
22
▪ Retirement
23
▪ Contacts Page
24
▪ Legal Notices
25
2
Welcome
At Nordea Bank Abp, New York Branch, we appreciate your commitment and contributions to the Bank’s success. Each year, we strive to offer benefit plans to our employees that not only reward you for your hard work but offer you and your family comprehensive and affordable health and wellness protection. We are confident that you will find our 2024 benefit offerings to be of excellent value to you and to your dependents. In the following pages, you will find a summary of our benefit plans for 2024. Please read this guidebook carefully as you prepare to make your elections to ensure that you select the coverage that is right for you. Our benefit programs continue to remain highly competitive for the 2024 planyear. About this Guidebook This benefit guidebook describes the highlights of Nordea Bank Abp, New York Branch’s benefits program in non-technical language. Your specific rights to benefits under the plan are governed solely, and in every respect, by the official plan documents, and not the information in this guidebook. If there is any discrepancy between the descriptions of the program’s elements as contained in this benefits guidebook and the official plan documents, the language in the official plan documents shall prevail as accurate. Please refer to the plan-specific documents published by each of the respective carriers for detailed plan information. You should be aware that any and all elements of Nordea Bank Abp , New York Branch’s benefits program may be modified in the future, at any time, to meet Internal Revenue Service rules, or otherwise as decided by Nordea Bank Abp, New York Branch.
Nordea Bank Abp , New York Branch’s benefit programs begin on October1 st and end on September 30 th for Medical, Dental, and Vision Benefits Your Plan Year
3
Eligibility & Enrollment
People NY Contact
DLNY-NY-HR@nordea.com
Broker Contact Brio Benefit Consulting
Jillian Brown Jbrown@briobenefits.com
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4
Employee Eligibility
All full-time employees are eligible for company-offered benefit plans immediately, the date of hire. The
voluntary coverages through Unum will only offer one opportunity to enroll during open enrollment each
year.
Dependent Eligibility
Employees who are eligible to participate in the Nordea Bank Abp, New York Branch benefit program
may also enroll their dependents. For the purposes of our benefit plans, your dependents are defined
as follows:
• Your spouse
• Your dependent children to age 26
Changing Your Benefits (Qualifying Life Events)
Per Internal Revenue Service (IRS) rules, employees enrolled in pre-tax benefit plans may only make
elections or changes to their plans once per year with the exception of the following Qualifying Life
Events:
• Marriage
• Birth, adoption or placement for adoption of an eligible child
• Divorce, or annulment of marriage
• Loss of spouse’s job or change in work status
(when coverage is maintained through spouse’s plan)
• A significant change in your or your spouse’s health coverage that is attributable to your spouse’s employment
• Death of spouse or dependent
• Loss of dependent status
• Employer-directed transfers to facilities out of the benefits network
• Becoming eligible for Medicare or Medicaid during the plan year
30 Days – Qualifying Life Events Qualifying Life Events allow you to make plan changes outside of the annual enrollment period. For any allowable changes, you must inform Human Resources within 30 calendar days of the qualifying event. Benefit changes that are requested due to a ‘change of mind’ cannot be allowed until the next annual enrollment period. For additional information concerning plan changes, please contact Human Resources.
5
Alex- Virtual Benefit Counselor
Meet Alex!
Introductio n
WHO IS ALEX AND HOW CAN IT HELP ME?
We understand that making decisions around benefits is important to all of our employees, but at times can be both difficult and confusing.
To enhance your understanding and to make YOUR benefit experience easier, we are excited to offer ALEX, a virtual benefit counselor. ALEX is an interactive decision-making support tool that can help you decide which benefit options are right for YOU! Think of it as your personal guide that helps you make important benefit decisions.
HERE ARE A COUPLE OF IMPORTANT THINGS TO KNOW ABOUT THE ALEX TOOL:
It’s personalized, so you can see which plan makes the most sense for YOU, not your coworkers, or your boss, or even me, your local benefits genius.
It's fun to use. There’s no boring insurance jargon or complicated legal jibber -jabber.
It’s confidential, so you can get the guidance you need without revealing all your fascinating secrets.
It’s available all year! You can find out information about your benefits at any time and your significant other can use it as well!
*Please be aware that Alex is a support tool and NOT where you make your actual benefit elections.
SEE HOW ALEX CAN HELP AT:
https://www.myalex.com/nordea-bank-abp-new-york/2024
Medical Benefits
We all need healthcare that protects our physical health as much as our financial well-being. That is why Nordea Bank Abp, New York Branch believes it is important to invest in quality plans that are cost effective, easy to use and valuable to you. Nordea Bank Abp, New York Branch provides the following 2 medical plan options through Cigna:
Cigna Open Access Plus (OAP) Network- High Plan Cigna Open Access Plus (OAP) Network- Low Plan
Level
OAP – High Plan
OAP – Low Plan
Mid EPO Plan
7
Medical Benefits Plan Comparison
Cigna OAP Plan High Plan
Cigna OAP Plan Low Plan In-Network Only
In-Network
Out-of-Network
Plan pays 80% After Deductible
$20 Copay
$25 Copay
Primary Care Visit
Plan pays 80% After Deductible
$50 Copay
$50 Copay
Specialist Office Visit
$25 Copay /Visit
Urgent Care Visit
$25 Copay / Visit
Prescription Drug Retail
$15/$30/$60
N/A
$20/$30/$60
Prescription Drug Mail Order
$30/$60/$120
N/A
$40/$60/$120
$100 Copay / Visit
Emergency Room
$100 Copay / Visit
Inpatient Services
Plan Pays 100% After Deductible
Plan pays 80% After Deductible
Plan pays 100% After Deductible
Outpatient Services
Plan Pays 100% After Deductible
Plan pays 80% After Deductible
Plan pays 100% After Deductible
Outpatient Lab and X-ray
Plan pays 100% No Deductible
Plan pays 80% After Deductible
Plan pays 100% No Deductible
Advanced Radiology
Plan Pays 100% After Deductible
Plan pays 80% After Deductible
Plan pays 100% After Deductible
Plan Coinsurance
100%
80%
100%
Lifetime Maximum
Unlimited
Deductible (Individual/Family)
$1,000/$3,000
$1,000/$3,000
$1,000/$3,000
Annual Out-of-Pocket Maximum
$5,350/$10,700
$2,000/$4,000
$6,350/$12,700
8
Employee Contributions
The following rates are reflective of your employee contribution for both the Medical Low Plan and the High Plan on a Semi-Monthly and Monthly basis. Employees have NO CONTRIBUTION COST for the Cigna OAP Low Plan
2024 Employee Semi-Monthly Contributions for Medical Benefits
Coverage Tier
OAP – High Plan
OAP – Low Plan
Employee Cost
Employer Cost
Employee Cost
Employer Cost
Employee
$109.79
$487.49
$0.00
$487.49
Employee + Spouse
$256.94
$1,140.73
$0.00
$1,140.73
Employee + Child(ren)
$230.59
$1,023.73
$0.00
$1023.73
Employee + Family
$368.94
$1,637.97
$0.00
$1,637.97
2024 Employee Monthly Contributions for Medical Benefits
Coverage Tier
OAP – High Plan
OAP – Low Plan
Employee Cost
Employer Cost
Employee Cost
Employer Cost
Employee
$219.58
$974.98
$0.00
$974.98
Employee + Spouse
$513.88
$2,281.45
$0.00
$2,281.45
Employee + Child(ren)
$461.18
$2,047.45
$0.00
$2,047.45
Employee + Family
$737.88
$3,275.94
$0.00
$3,275.94
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Good oral care enhances overall physical health, appearance and mental well-being. Problems with the teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with our dental benefit plan. Employees have NO CONTRIBUTION COST for the MetLife Dental PPO Plan Dental Benefits & Employee Cost
2024 Employee Monthly Contributions for Dental Benefits
Coverage Tier
Dental PPO Plan
Employee Cost
Employer Cost
Employee
$0.00
$51.96
Employee + Spouse
$0.00
$107.81
Employee + Child(ren)
$0.00
$133.48
Employee + Family
$0.00
$189.35
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MetLife Dental PPO Plan
Services
In-Network
Out-of-Network
Annual Deductible
$25/$75
Calendar Year
Deductible Accumulation
Annual Maximum Benefit
$3,000
Preventive Dental Services (Deductible is Waived) (cleaning, exams, x-rays)
Plan pays 100%
Plan pays 100%
Once every 6 months
Once every 6 months
Frequency
Plan pays 80% You pay 20%
Basic Dental Services (fillings, root canal)
Plan pays 100%
Full mouth X-rays:
Full mouth X-rays: 1 in
1 in 3 years
3 years
Crowns:
Crowns:
Waiting Period
1 per tooth in 5 years
1 per tooth in 5 years
Plan pays 60%
Plan pays 50% You pay 50%
Major Dental Services
You pay40%
(extractions, crowns, inlays, onlays,
bridges, dentures, repairs, root
Repairs: 1 in 12 months Bridges/Dentures: 1 in 5 years
Repairs : 1 in 12 months Bridges/Dentures: 1 in 5 years
canal)
Waiting Period
Orthodontia Services (Up to age 19)
50% Lifetime Maximum
Orthodontia Lifetime Max
$3,000
Dependent Cut Off Age (Plan)
Up to Age 26
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Vision Benefits
Regular eye examinations can not only determine your need for corrective eye wear but also may detect general health problems in their earliest stages. Protection for the eyes should be a major concern to everyone. Employees have NO CONTRIBUTION COST for the Cigna Vision Plan Coverage Tier Dental PPO Plan
2024 Employee Monthly Contributions for Vision Benefits
Coverage Tier
Coverage Tier
Cigna Vision Plan Cigna Vision Plan
Employee Cost
Employer Cost
Employee
$0.00
$6.48
Employee + Spouse
$0.00
$12.98
Employee + Child(ren)
$0.00
$13.11
Employee + Family
$0.00
$20.92
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Cigna Vision Plan
Services
In-Network
Out-of-Network
Exam (Once Every Calendar Year)
$10 copay
Up to $45 Reimbursement
Lenses (Once Every Calendar Year)
$20 Copay
Single
$20 Copay
Up to $32 Reimbursement
Bifocal
$20 Copay
Up to $55 Reimbursement
Trifocal
$20 copay
Up to $65 Reimbursement
Lenticular
$20 Copay
Up to $80 Reimbursement
Contact Lenses (Once Every Calendar Year)
100% up to $130 Allowance
Up to $105 Reimbursement
Elective
Covered 100%
Up to $210 Reimbursement
Medically Necessary
Frames (Once Every Calendar Year)
Up to $71 Reimbursement
20% off balance over $130 Allowance
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Basic Life & AD&D Insurance
Your family depends on you in many ways and you’ve worked hard to ensure their financial security. But if something happened to you, will your family be protected? Will your loved ones be able to stay in their home, pay bills, and prepare for the future? Life insurance provides a financial benefit that your family can depend on. Nordea Bank Abp, New York Branch pays the entire cost of Basic Term Life Insurance and Basic AD&D for you and you are automatically enrolled upon meeting eligibility. If your basic coverage exceeds the $650,000 Guarantee Issue amount, members will need to complete an Evidence of Insurability Form before the additional Basic Life can be approved
Type
Available Coverage
Basic Term Life
$3x Annual earnings to $1,500,000
Basic AD&D
$3x Annual earnings to $1,500,000
Guarantee Issue
$650,000
Age
Reduction
65 70
35% 50%
Benefit Reductions
We recommend that each employee elects a beneficiary for their life insurance benefit. If you would like additional coverage you can choose to enroll in one of our voluntary options listed on the next page.
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Voluntary Life Insurance
To safeguard your family in the event of your passing, our company offers you the opportunity to purchase additional voluntary life insurance coverage. This plan also allows you to purchase accident death & dismemberment coverage which can pay an additional amount for deaths due to covered accidents and certain serious injuries that may occur.
If you would like to purchase additional benefits, the following options are available:
Type
Available Coverage
$10,000 to $500,000 in $10,000 increments Guaranteed Issue: $100,000
Employee Basic Term Life and AD&D
$5,000 to $500,000 in $5,000 increments Guaranteed Issue: $25,000
Spouse Basic Term Life and AD&D
Increments of $2,000 to a max of 50% of employee or $10,000
Dependent Basic Life and AD&D
Voluntary AD&D Rates- $0.247 per $10k for employee, $0.130 per $5k for spouses, & $0.068 per $2k for children Voluntary Term Life Age Banded Employee Rates per $10,000 and Spouse Rates per $5,000 Age <25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70+ 75 & Over Employee Rates $0.52 $0.60 $0.74 $1.05 $1.51 $2.40 $3.82 $5.88 $9.17 $15.92 $28.41 $55.66
Spouse Rates
$0.33 $0.375 $0.475 $.695 $.995 $1.555 $2.425 $3.720 $6.355 $10.855 $19.340 $38.740
*Members can only enroll in this benefit one time each year during annual open enrollment
15
Short & Long-Term Disability Benefits
You probably have insurance for your car or home, but what about the source of income that pays for it? You rely on your paycheck for so many things, but what if you were suddenly unable to work due to an accident or illness? How will you put food on the table, pay your mortgage or heat your home? Disability insurance can help replace lost income and make a difficult time a little easier. Nordea Bank Abp, New York Branch allowsfor automatic enrollment upon meeting eligibility for the LTD. However, the ability to unenroll within the first 30 days of your start date and during open enrollment is permitted.
Short-Term Disability
Long-Term Disability
70% of weekly earnings to maximum benefit of $2,000/week
60% of monthly earning to maximum benefit of $20,000/month
Coverage Amount
Maximum Payment Period: Maximum length of time you can receive disability benefits.
Up to age 65, standard ADEA
25 weeks
Accident/Illness Benefits Begin:
8 Days
181 Days
The length of time you must be disabled before benefits begin.
Nordea Bank Abp, New York Branch provides a salary continuation that equals 100% of salary while out on STD
Employees pay 100% for their LTD benefit
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Voluntary Worksite Benefits
The following supplemental employee coverage addresses costs associated with injury, illness or hospital costs that are unexpected. These are benefits paid directly to YOU regardless of your other insurance plans. These insurance plans are designed to provide you payments to help offset cost not covered by your insurance plans
Type
Available Coverage
Employee: $5,000-$50,000 ($5k Increments) Spouse: $5,000-$30,000 ($5k Increments) Children: 50% of Employee Coverage Amount
Critical Illness
Pays a lump-sum benefit upon diagnosis of any covered condition
Pre-Existing Condition 6/6 Months
Accident Insurance
Coverage Type: On and Off the Job
Provides payments based on a fee schedule for any covered accident
Fee Schedule: Payment amount varies by service rendered
Accidental Death: Employee - $50,000 Spouse - $20,000 Children - $10,000
Hospital Indemnity
Daily Hospital Confinement: $165 Max of 60 Days per Insured per Calendar Year
Coverage payment for different types of inpatient hospital stays
Hospital Admission: $500 Max of 1 Day per Insured per Calendar Year
Hospital Intensive Care Unit Confinement: $165 Max of 15 Days per Insured per Calendar Year
*Members can only enroll in this benefit one time each year during annual open enrollment
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Long Term Care
Whether it's due to a motorcycle accident or a serious illness, LTC is the type of care you may need if you couldn't independently
perform the basic activities of daily living: bathing, dressing, eating, or if you suffered severe cognitive impairment from a
condition such as Alzheimer's disease. : Nordea Bank Abp, New York Branch pays the entire cost of the Base Plan. Benefits
eligible employees are auto-enrolled upon hire.
Available Base Coverage
Monthly Benefit Amounts
Nursing Facility
Up to $6,000
Assisted Living Facility
Up to 60% of Nursing Facility Benefit
Up to 50% of Nursing Facility Benefit
Total Home Care
3 Years
Benefit Duration
36x The Facility Amount
Lifetime Maximum Benefit
($216,000)
Elimination Period
90 Days
Available Buy-Up Options*
Monthly Benefit Amounts
$7,000 or $8,000
Facility Benefit
6 Years or Unlimited
Benefit Duration
5%
Compound Inflation**
Long Term Care Rates will be based on age. Rates will not increase as you get older. If you separate from Nordea, this benefit is portable and able to be continued on an individual basis directly with Unum .
.
*Evidence of Insurability may be required if applyingfor Buy-Up coverage. **Your Maximum Benefit will be adjusted to include inflation increases, if applicable
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Voluntary MetLife Legal Benefits
The following supplemental employee coverage addresses costs associated with benefits that fit your personal needs. It can be hard to know where to turn to find an attorney you can trust. With MetLife Legal Plans, you have access to the expert guidance and tools you need to navigate a broad range of personal legal needs. The Employee paid cost for this benefit is $18/month.
Money Matters
• Debt Collection Defense • Identity Theft Defense • Identity Restoration 4
• Negotiations with Creditors • Personal Bankruptcy • Promissory Notes • Home Equity Loans • Mortgages • Property Tax Assessments • Refinancing of Home
• Tax Audit Representation • Tax Collection Defense
Home & Real Estate
• Boundary or Title Disputes • Deeds • Eviction Defense • Foreclosure • Codicils • Complex Wills • Healthcare Proxies • Living Wills
• Sale or Purchase of Home • Security Deposit Assistance
• Tenant Negotiations • Zoning Applications
Estate Planning
• Powers of Attorney (Healthcare, Financial, Childcare, Immigration)
• Revocable & Irrevocable Trusts • Simple Wills
Family & Personal
• Adoption • Affidavits
• Juvenile Court Defense, Including Criminal Matters • Name Change • Parental Responsibility Matters • Personal Property Protection • Disputes Over Consumer Goods & Services • Incompetency Defense • Medicaid • Medicare • Notes • Nursing Home Agreements
• Prenuptial Agreement • Protection from Domestic Violence • Review of ANY Personal
• Conservatorship • Demand Letters • Garnishment Defense • Guardianship • Immigration Assistance
Legal Document • School Hearings
Civil Lawsuits
• Administrative Hearings • Civil Litigation Defense
• Pet Liabilities • Small Claims Assistance
Elder-Care Issues
Consultation & Document Review for your parents:
• Powers of Attorney • Prescription Plans • Wills
• Deeds • Leases
Traffic & Other Matters
• Defense of Traffic Tickets 5 • Driving Privileges Restoration
• License Suspension Due to DUI
• Repossession
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*Members can only enroll in this benefit one time each year during annual open enrollment
Flexible Spending Accounts
Health Care FSA A Health Care Flexible Spending Account (FSA) provides you with the ability to save money on a pre-tax basis to pay for any IRS-allowed health expense that is not covered by your health care plan. Examples of these types of expenses include deductibles, co payments, coinsurance payments and uninsured dental and vision care expenses. You may elect a specific annual contribution for each FSA in which you plan to participate. Your annual contribution is then divided by your number of pay periods and that amount will be deducted pre-tax each pay period. The amount you elect may not be changed or revoked during the plan year unless you experience a qualifying life event. Also, you may not transfer funds between a Health Care FSA and a Dependent Care FSA. If you elected to participate in an FSA account last year, you must enroll again and specify your annual contribution if you wish to participate in the upcoming plan year. Your previous elections will not carry over to the new plan year. For the 2023 plan year, the maximum amount that you may contribute to aHealth Care FSA is $3,050. Members will have a grace period that extends 2 ½ months after the end of the plan year. Dependent Care FSA A Dependent Care Flexible Spending Account (FSA) provides you with the ability to set aside money on a pre- tax basis for day care expenses for your child, disabled parent or spouse. Generally, expenses will qualify for reimbursement if they are the result of care for:
• Your children, under the age of 13, for whom you are entitled to a personal exemption on your Federal income tax return. • Your spouse or other dependent, including parents, who are physically or mentally incapable of self-care.
The IRS has set the maximum allowable contribution per calendar year for a Dependent Care Flexible Spending Account as follows:
• $5,000 for a married couple filing jointly • $2,500 for a married couple filing separate
Health Care FSA Debit Card Employees enrolled in a health care FSA will receive a benefits debit card, which allows you to access your FSA account to pay for eligible expenses immediately and conveniently at point of service. Be sure to save your receipts as you may be audited or will need to submit proof of qualified expenses. Commuter Benefits Transportation and Parking Spending Accounts allow employees to use money on a pre-tax basis to pay for qualified work- related commuting and parking expenses. For 2024, the IRS limit is $315 pre-tax per month. 20
Eligible FSA Medical Expenses
• Osteopath • Oxygen and oxygen equipment • Pediatrician • Physician • Physiotherapist • Podiatrist • Postnatal treatments • Practical nurse for medical services • Prenatal care • Prescription medicines • Psychiatrist • Psychoanalyst
• Drugs (prescription) • Elastic hosiery (prescription) • Eyeglasses • Fees paid to health institute prescribed by a doctor • FICA and FUTA tax paid for medical care service • Fluoridation unit • Guide dog • Gum treatment • Gynecologist • Healing services • Hearing aids and batteries • Hospital bills • Hydrotherapy • Insulin treatment • Lab tests • Lead paint removal • Legal fees • Lodging (away from home) • Metabolism tests • Neurologist • Nursing (including board and meals) • Obstetrician • Operating room costs • Ophthalmologist • Optician • Optometrist • Oral surgery • Organ transplant (including donor’s expenses) • Orthopedic shoes • Orthopedist
• Abdominal supports • Abortion • Acupuncture • Air conditioner
(when necessary for relief from difficulty in breathing) • Alcoholism treatment
• Ambulance • Anesthetist
• Arch supports • Artificial limbs
• Autoette (when used for relief of sickness/disability) • Birth Control Pills (by prescription) • Blood tests • Blood transfusions • Braces • Cardiographs • Chiropractor • Christian Science Practitioner • Contact Lenses • Contraceptive devices (by prescription) • Convalescent home (for medical treatment only) • Crutches • Dental Treatment • Dental X-rays • Dentures • Dermatologist • Diagnostic fees • Diathermy • Drug addiction therapy
• Psychologist • Psychotherapy
• Radium Therapy • Registered nurse • Special school costs for the handicapped • Spinal fluid test • Splints • Sterilization • Surgeon
• Telephone or TV equipment to assist the hard-of-hearing • Therapy equipment • Transportation expenses (relative to health care) • Ultra-violet ray treatment • Vaccines • Vasectomy • Vitamins (if prescribed) • Wheelchair • X-rays
*The above list of Eligible FSA Medical Expenses is from IRS Publication 502 and is subject to change by the IRS at any time. To see the full IRS Publication 502 list visit: https://www.irs.gov/pub/irs-pdf/p502.pdf.
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AVAILABLE WISHBONE PLANS Wishbone offers different plan options to fit your budget. Enroll in both for maximum coverage.
Nordea is offering Wishbone Pet Insurance to employees.
Accident & Illness Coverage For the unexpected
90% reimbursement $500 deductible $40,000 annual limit Includes lost pet recovery service and 24/7 pet telehealth
Nobody wants to imagine their pet getting sick or injured - but when it comes to your pet's health, it's best to expect the unexpected. Wishbone Pet Insurance is accepted at any vet in the U.S., including emergency hospitals. Our simple online claims process means you get your money back fast, whether it's for routine care or an accident.
Rates based on your pet’s age, breed & zip code .
Wellness Coverage For regular routine visits
ESSENTIAL PLAN Up to $300 in coverage $14/month
PREMIUM PLAN Up to $575 in coverage $25/month
Protecting your pet's health and your finances has never been easier!
Coverage is based on a schedule of benefits outlined during enrollment
Get a quote & enroll at www.wishboneinsurance.com/nordea
Wishbone Pet Insurance is a pet health insurance program offered by Pet Assure Corp., dba Pet Benefit Solutions, a licensed agency (NJ License Number 1677880). Insurance coverage is administered by Norse Specialty Insurance Company, Inc. and underwritten by Trisura Insurance Company, Clear Blue Insurance Company, or Clear Blue Specialty Insurance Company. Claims
are processed by a third-party administrator, PrimeOne Insurance Co. Please visit https://www.wishboneinsurance.com/terms-and-conditions for more information.
Pet Benefit Solutions | help@wishboneinsurance.com | (800) 887-5708
Fidelity Retirement Plan
There are many benefits to participating in the Nordea Bank Abp, New York Branch Salary Savings and Profit Sharing Plan. One of the primary benefits is that you will receive help reaching your financial goals for retirement. If you haven’t already, enrolling in your plan is the right step towards a more secure retirement.
Here’s how: ● First, go to Fidelity NetBenefits® at www.401k.com. ● Next, set up your password. If you’re already a Fidelity customer, you can use your existing password. Please note, you will be prompted to enter your email address. ● Finally, click on the link to enroll. ● If you have questions or need help before getting started, visit www.401k.com or call Fidelity at 1-800- 890-4015. ● Your plan has an automatic enrollment feature. If the automatic enrollment feature applies to you and you do not take action, you will be automatically enrolled. You will receive a separate notification explaining when the automatic enrollment will occur.
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Need additional information? Have a question about one of your benefits? Keep this brochure handy for a quick reference for all of your benefit needs. If you still have questions, please contact your Human Resources Department. Contacts
Plan
Administrator
Phone #
Website
Medical
Cigna
800-244-6224
www.mycigna.com
Dental
Metlife
800-942-0854
www.metlife.com
Vision
Cigna
800-244-6224
www.mycigna.com
Basic Life Insurance/ AD&D/STD/LTD
Guardian
888-482-7342
www.guardianlife.com
Voluntary Benefits (CI/Accident/ Hospital Indemnity)
Unum
800-635-5597
www.unum.com
Voluntary Life
Unum
800-275-8686
www.unum.com
Legal Plan
MetLife
800-821-6400
www.metlife.com
Health Equity (Formerly WageWorks)
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Spending Accounts
877-924-3967
www.healthequity.com
Notices
Health Insurance Portability and Accountability Act of 1996 (HIPAA) The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that addresses the privacy and security of certain individually identifiable health information, called protected health information (or PHI). You have certain rights with respect to your PHI, including a right to see or get a copy of your health and claims records and other health information maintained by a health plan or carrier. For a copy of the Notice of Privacy Practices, describing how your PHI may be used and disclosed and how you get access to the information, contact Human Resources.
Women’s Health and Cancer Rights Act Enrollment Notice If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Woman’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a
manner determined in consultation with the attending physician and the patient, for: 1.All stages of reconstruction of the breast on which mastectomy was performed. 2.Surgery and reconstruction of the other breast to produce a symmetrical appearance; prostheses. 3.Treatment of physical complications of the mastectomy, including lymphedema.
These benefits will be provided subject to the same deductibles, copays, and coinsurance applicable to other medical and surgical benefits provided under your medical plan. If you would like more information on WHCRA benefits, call your plan administrator. Newborns’ and Mothers’ Health Protection Act Disclosure Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). 60-DAY SPECIAL ENROLLMENT PERIOD In addition to the qualifying events listed in this enrollment guide, you and your dependents will have a special 60-day period to elect or discontinue coverage if: You or your dependent’s Medicaid or Children’s Health Insurance Program (CHIP) coverage is terminated as a result of loss of eligibility; or You or your dependent becomes eligible for a premium assistance subsidy under Medicaid or CHIP HIPAA Special Enrollment Notice If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in Nordea Bank Abp, New York Branch medical plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. If you or your dependents lose eligibility for coverage under Medicaid or the Children’s Health Insurance Program {CHIP) or become eligible for a premium assistance subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents. You must request enrollment within 60 days of the loss of Medicaid or CHIP coverage or the determination of eligibility for a premium assistance subsidy. To request special enrollment or to obtain more information about the plan’s special enrollment provisions, contact your plan administrator.
25
Notices
COBRA
** Continuation Coverage Rights Under COBRA**
Introduction You’re getting this notice because you recently gained coverage under a group health plan (the Plan). This notice has important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan. This notice explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect your right to get it. When you become eligible for COBRA, you may also become eligible for other coverage options that may cost less than COBRA continuation coverage. The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end. For more information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator. You may have other options available to you when you lose group health coverage. For example, you may be eligible to buy an individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-day special enrollment period for another group health plan for which you are eligible (such as a spouse’s plan), even if that plan generally doesn’t accept late enrollees. What is COBRA continuation coverage? COBRA continuation coverage is a continuation of Plan coverage when it would otherwise end because of a life event. This is also called a “qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.
If you’re an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
Your hours of employment are reduced, or Your employment ends for any reason other than your gross misconduct.
If you’re the spouse of an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
Your spouse dies; Your spouse’s hours of employment are reduced;
Your spouse’s employment ends for any reason other than his or her gross misconduct;
Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both);
or You become divorced or legally separated from your spouse.
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Notices
COBRA
Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because of the following qualifying events:
The parent-employee dies; The parent- employee’s hours of employment are reduced; The parent- employee’s employment ends for any reason other than his or her gross misconduct; The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both); The parents become divorced or legally separated; or The child stops being eligible for coverage under the Plan as a “dependent child.”
When is COBRA continuation coverage available? The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred. The employer must notify the Plan Administrator of the following qualifying events: The end of employment or reduction of hours of employment;
Death of the employee;
The employee’s becoming entitled to Medicare benefits (under Part A, Part B, or both).
For all other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days (or enter longer period permitted under the terms of the Plan) after the qualifying event occurs. You must provide this notice to your Plan Administrator. How is COBRA continuation coverage provided? Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children. COBRA continuation coverage is a temporary continuation of coverage that generally lasts for 18 months due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage. There are also ways in which this 18-month period of COBRA continuation coverage can be extended: Disability extension of 18-month period of COBRA continuation coverage: If you or anyone in your family covered under the Plan is determined by Social Security to be disabled and you notify the Plan Administrator in a timely fashion, you and your entire family may be entitled to get up to an additional 11 months of COBRA continuation coverage, for a maximum of 29 months. The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of COBRA continuation coverage. Second qualifying event extension of 18-month period of continuation coverage: If your family experiences another qualifying event during the 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if the Plan is properly notified about the second qualifying event. This extension may be available to the spouse and any dependent children getting COBRA continuation coverage if the employee or former employee dies; becomes entitled to Medicare benefits (under Part A, Part B, or both); gets divorced or legally separated; or if the dependent child stops being eligible under the Plan as a dependent child. This extension is only available if the second qualifying event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred.
27
Notices
COBRA
Are there other coverage options besides COBRA Continuation Coverage? Yes. Instead of enrolling in COBRA continuation coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicaid, or other group health plan coverage options (such as a spouse’s plan) through what is called a “special enrollment period.” Some of these options may cost less than COBRA continuation coverage. You can learn more about many of these options at www.healthcare.gov.
Can I enroll in Medicare instead of COBRA continuation coverage after my group health plan coverage ends? In general, if you don’t enroll in Medicare Part A or B when you are first eligible because you are still employed, after the Medicare initial enrollment period, you have an 8-month special enrollment period to sign up for Medicare Part A or B, beginning on the earlier of
The month after your employment ends; or The month after group health plan coverage based on current employment ends.
If you don’t enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you may have a gap in coverage if you decide you want Part B later. If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan may terminate your continuation coverage. However, if Medicare Part A or Bis effective on or before the date of the COBRA election, COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enroll in the other part of Medicare after the date of the election of COBRA coverage.
If you are enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first (primary payer) and COBRA continuation coverage will pay second. Certain plans may pay as if secondary to Medicare, even if you are not enrolled in Medicare.
For more information visit https://www.medicare.gov/medicare-and-you.
If you have questions: Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under the Employee Retirement Income Security Act (ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit www.dol.gov/agencies/ebsa. (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s website.) For more information about the Marketplace, visit www.healthcare.gov.
Keep your Plan informed of address changes. To protect your family’s rights, let the Plan Administrator know about any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator.
Human Resources Contact: Janet Chin
Janet.chin@nordea.com
212-318-9385
28
Notices
MEDICARE PART D
Important Notice from Nordea Bank Abp, New York Branch About Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Nordea Bank Abp, New York Branch and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. Nordea Bank Abp, New York Branch has determined that the prescription drug coverage offered by the Nordea Bank Abp, New York Branch plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Nordea Bank Abp, New York Branch coverage will not be affected. If you do decide to join a Medicare drug plan and drop your current Nordea Bank Abp, New York Branch coverage, be aware that you and your dependents may not be able to get this coverage back.
29
Notices
MEDICARE PART D
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with Nordea Bank Abp, New York Branch and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information About This Notice Or Your Current Prescription Drug Coverage: Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Nordea Bank Abp, New York Branch changes. You also may request a copy of this notice at any time. For More Information About Your Options Under Medicare Prescription Drug Coverage: More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage:
Visit www.medicare.gov
Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the Medicare & You” handbook for their telephone number) for personalized help
Call 1-800-MEDICARE (H300-633-4227) TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778). Remember, keep this creditable coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
Human Resources Contact: Janet Chin Janet.chin@nordea.com 212-318-9385
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