Benefits at a Glance
Plan Year: December 1, 2018 through February 28, 2020
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Please Note:
This Summary of Benefits contains only brief descriptions of the coverages being offered. For more detailed information, please refer to the Coverage Summaries saved on the I Drive:
I:\Employee Information\BENEFITS\Benefit Certificates and Policies\Coverage Summaries
CONTENTS & CONTACT INFORMATION
Refer to this list when you need to contact one of your benefit vendors. For general information contact Human Resources.
BROKER Provider Name
M.E. Wilson Company
Broker Contact
Katie Reeves
Provider Phone Number
813-229-8021 Ext. 132
Provider Email Address
kreeves@mewilson.com
MEDICAL
page 3
Provider Name
Cigna
Provider Phone Number
1-866-494-2111
Provider Web Address
www.cigna.com
HEALTH SAVINGS ACCOUNT (HSA)
page 5
Provider Name
OptumHealth Bank
Provider Phone Number
1-866-234-8913
Provider Web Address
www.optumhealthbank.com
DENTAL
page 6
Provider Name
MetLife
Provider Phone Number
1-800-942-0854
Provider Web Address
www.metlife.com
VISION
page 7
Provider Name
VSP
Provider Phone Number
1-800-877-7195
Provider Web Address
www.vsp.com
FLEXIBLE SPENDING ACCOUNT (FSA)
page 8
Provider Name
Discovery Benefits, Inc.
Provider Phone Number
1-877-765-8810
Provider Web Address
www.discoverybenefits.com/employees
CONTENTS & CONTACT INFORMATION
RETIREMENT – 401(K)
page 8
Provider Name
TransAmerica
Provider Phone Number
1-800-401-8726
Provider Web Address
www.ta-retirement.com
BASIC & VOLUNTARY LIFE AND DISABILITY
page 9
Provider Name
Mutual of Omaha
Provider Phone Number
1-800-877-5176
Provider Web Address
www.mutualofomaha.com
SHORT & LONG TERM DISABILITY
page 11
Provider Name
Mutual of Omaha
Provider Phone Number
1-800-877-5176
Provider Web Address
www.mutualofomaha.com
LONG TERM CARE
page 13
Provider Name
Unum
Provider Phone Number
1-800-343-5406
Provider Web Address
http://unuminfo.com/lsh/index.aspx
VOLUNTARY BENEFITS
page 14
Provider Name
Colonial Life
Provider Phone Number
1-800-325-4368
Provider Web Address
www.coloniallife.com
EMPLOYEE INFORMATION
page 15
DISCLOSURE NOTICES
page 19
BENEFIT INFORMATION
Benefit
Who pays the cost?
M.E. Wilson Company pays 100% of the employee cost of the base medical plan. You may enroll your eligible dependents and/or enroll in a buy-up plan, for an additional cost.
Medical Insurance
YOUR BENEFITS PLAN
M.E. Wilson Company offers a variety of benefits allowing you the opportunity to customize a benefits package that meets your personal needs. In the following pages, you’ll learn more about the benefits offered. You’ll also see how choosing the right combination of benefits can help protect you and your family’s health and finances – and your family’s future.
M.E. Wilson Company pays a portion of the employee cost for the base dental plan. You may enroll your eligible dependents and/or enroll in a buy-up plan, for an additional cost.
Dental Insurance
You may elect vision coverage for yourself and your eligible dependents on a voluntary basis and you will be responsible for the cost.
Vision Insurance
Basic Life Insurance
M.E. Wilson Company pays the entire cost.
Voluntary Life Insurance The employee pays the entire cost.
Short Term Disability
The employee pays the entire cost.
M.E. Wilson company will pay 50% of the cost of coverage (100% if waiving medical coverage)
Long Term Disability
M.E. Wilson Company pays 100% of the base plan. You may enroll in a buy-up plan for an additional cost.
Long Term Care
ELIGIBILITY
All Regular full-time employees are eligible to join the M.E. Wilson Company Benefits Plan on the 1st of the month following date of hire. You may also enroll your dependents in the Benefits Plan when you enroll.
Eligible dependents include:
Your legal spouse
•
• Your married or unmarried natural children, step-children living with you, legally adopted children and any other children for whom you have legal guardianship, who are:
Under 26 years of age;
►
WHEN CAN YOU ENROLL?
► A dependent who is older than 26 years of age, but less than 30 years of age may be eligible for medical benefits. To be eligible, a Dependent must: • Be unmarried and not have dependents of his or her own; AND
You can sign up for Benefits at any of the following times:
Be a resident of Florida or a student; AND
•
• After completing your initial eligibility period; • During the annual open enrollment period; • Within 30 days of a qualified family-status change.
• Not have coverage of their own, or covered under any other plan; AND
Not entitled to benefits under Medicare
•
If you do not enroll at one of the above times, you must wait for the next annual open enrollment period.
1
BENEFIT INFORMATION
?
CHOOSING YOUR BENEFITS
You must actively choose any benefit that you pay for, or share in the cost with M.E. Wilson Company. Your part of the cost is automatically taken out of your paycheck. There are two ways that the money can be taken out:
WHY DO I PAY FOR BENEFITS WITH BEFORE-TAX MONEY?
There is a definite advantage to paying for some benefits with before-tax money:
• BEFORE YOUR TAXES ARE CALCULATED – medical, dental, vision, health savings account (HSA), flexible spending account (FSA)
Taking the money out before your taxes are calculated lowers the amount of your pay that is taxable. Therefore, you pay less in taxes.
• AFTER YOUR TAXES ARE CALCULATED – voluntary life/ accidental death & dismemberment, disability and voluntary products
MAKING CHANGES
Generally, you can only change your benefit choices during the annual benefits enrollment period. However, you may be able to change your benefit choices during the plan year if you have a change in status including:
If you fail to notify Human Resources within 30 days of a family status change, you will be required to wait until the next annual enrollment period to make benefit changes unless you have another family status change.
Your marriage
•
Your divorce or legal separation
•
• Birth or adoption of an eligible child
• Death of your spouse or covered child
WHEN COVERAGE ENDS
• Change in your spouse’s work status that affects his or her benefits
Coverage will stop on the last day of the month in which employment with the company ends. Life insurance ends the last day of employment.
• Change in your work status that affects your benefits
• Change in residence or work site that affects your eligibility for coverage
• Change in your child’s eligibility for benefits
• Receiving Qualified Medical Child Support Order (QMCSO)
KEY BENEFIT TERMS
COBRA – A Federal law that allows workers and dependents who lose their medical, dental, or vision coverage to continue any of these coverages for a specified length of time by electing and paying for continuation benefits. Copayment – A flat fee that you pay for medical services, regardless of the actual amount charged by your doctor or another provider. This generally applies to physicians’ office visits and prescription drugs. Deductible – The amount you pay toward medical and dental expenses each year before the plan begins paying benefits. Out of Pocket Maximum – The maximum amount you will pay in deductibles, copayments and coinsurance during the year.
2
MEDICAL INSURANCE
M.E. Wilson Company offers two medical plans through Cigna. To find participating providers go to www.cigna.com and click on “Find a Doctor”, choose the appropriate plan type, then, narrow down your search based on location and provider type. The plan type you should select is OAP (Open Access Plus).
The chart below provides a brief overview of the medical plans. This chart is intended only to highlight the benefits available and should not be relied upon to fully determine your coverage. If the below illustration of benefits conflicts in any way with the Summary Plan Description (SPD), the SPD shall prevail. It is recommended that you review your exact description of services and supplies that are covered, those which are excluded or limited, and other terms and conditions of coverage.
Low Option HSA OAP Plan
High Option OAPIN Plan
IN-NETWORK:
Plan Year / Contract Year Basis
Calendar Year
Calendar Year
Deductible (Individual / Family)
$1,500 / $3,000
$1,500 / $4,500
Maximum Out-of-Pocket (Individual / Family)
$4,500 / $9,000
$4,500 / $9,000
Deductible, Coinsurance, & Copays
Deductible, Coinsurance, & Copays
Out-of-Pocket Max Includes
Lifetime Maximum
Unlimited
Unlimited
Coinsurance
80% / 20%
80% / 20%
Routine Preventive Services
Wellness
Covered 100%
Covered 100%
Immunizations
Mammography/Colonoscopy
CO-PAYS
Referral required
No
No
Office Visits Consultations for Illness / Injury
Deductible & Coinsurance
$30 copay
Specialist Visits
Deductible & Coinsurance
$55 copay
Inpatient Hospital
Deductible & Coinsurance
Deductible & Coinsurance
Outpatient Surgery
Deductible & Coinsurance
Deductible & Coinsurance
Emergency Room
Deductible & Coinsurance
$250 copay
Urgent Care
Deductible & Coinsurance
$60 copay
OUTPATIENT DIAGNOSTIC SERVICES
Lab Services (Freestanding Lab)
Deductible & Coinsurance
Covered 100%
X-Ray Services (Freestanding Lab)
Deductible & Coinsurance
Covered 100%
Complex Diagnostic
Deductible & Coinsurance
$250 copay
PRESCRIPTIONS
(Once Deductible is Met)
Retail (30 day supply)
$10 / $50 / $80
$10 / $30 / $50
Mail Order (90 day supply)
3 x retail
3 x retail
OUT-OF-NETWORK
Deductible (Individual / Family)
$5,000 / $10,000
Not Available – In Network Only
Maximum Out-of-Pocket (Individual / Family)
$10,000 / $20,000
Not Available – In Network Only
Lifetime Maximum
Unlimited
Not Available – In Network Only
Coinsurance
60% / 40%
Not Available – In Network Only
3
MEDICAL CONTRIBUTION SCHEDULE
Low Option HSA OAP Plan
Bi-Weekly Rates
Employee Only
$ 0.00
Employee + Spouse
$ 240.00
Employee + Child(ren)
$ 100.00
Family
$ 360.00
High Option OAPIN Plan
Bi-Weekly Rates
Employee Only
$ 30.00
Employee + Spouse
$ 337.71
Employee + Child(ren)
$ 190.05
Family
$ 511.98
4
HEALTH SAVINGS ACCOUNT (HSA)
What is a Health Savings Account (HSA)? It is an interest bearing account created to help you pay medical expenses. The funds in your HSA can be used to help pay your deductible, coinsurance and any qualified medical expenses not covered by your health plan (including dental and vision expenses). All of the money you contribute is tax-deductible when used to pay for qualified medical expenses. An HSA is your account. It goes with you if you change jobs or when you retire.
IRS Annual Maximum HSA Contribution Limits (maximums include employer contributions)
2018
2019
Employee Only
$3,450
$3,500
Family
$6,900
$7,000
Additional $1,000 annually
Additional $1,000 annually
Catch-up Amount for employees 55 years or older
Expenses eligible for reimbursement under your HSA include, but are not limited to:
• • Alcohol and drug dependency treatment • Ambulance • Artificial limbs • Artificial Teeth • Breast reconstruction surgery (mastectomy- related) • Chiropractic services • Contact lenses and solution • Dental expenses (exams, cleanings, X-rays, root canals bridges, etc.) • Diagnostic devices (blood sugar test kits for diabetics) • Diagnostic fees • Doctor fees • Prescription Drugs and Over the Counter Drugs (when ordered by a doctor) • Eyeglasses and exams • Eye surgery (laser eye surgery or radial keratotomy) • Acupuncture
Fertility enhancements
• Hearing aids and batteries for use • Hospital fees • Laboratory fees • Long-term care (medical expenses and premiums) • Maternity Expenses • Nursing home • Organ transplants • Physical and speech therapies • Psychiatric care • Smoking-cessation programs and products • Surgical fees • Vasectomy • Weight-loss program (to treat a specific disease diagnosed by a physician) • Wheelchairs • X-rays
• Expenses reimbursed by an insurance provider or a Flexible Spending Account • Babysitting or child care services • Cosmetic Surgery/ Procedures • Diaper Services • Electrolysis or hair removal • Funeral Expenses • Health club dues • Insurance Premiums (except COBRA and for those 65+ other than Medigap coverage) • Nutritional supplements • Personal use items (such as toothbrush, toothpaste) • Teeth whitening Expenses that are not eligible for reimbursement include, but are not limited to:
5
DENTAL INSURANCE
M.E. Wilson Company offers dental coverage through MetLife. The Dental PPO Plans allow you to use in-network or out-of- network benefits. If out-of-network dentists are used, you will be responsible for paying the difference between MetLife’s allowed amount and what the dentist may charge, also known as “balance billing”. The chart below provides a brief overview of the plans.
OPTION 1 - LOW Dental PPO Plan
OPTION 2 - HIGH Dental PPO Plan
In-Network
Out-of Network*
In-Network
Out-of Network*
Calendar Year Deductible Individual
$50
$50
$150
$150
Family
Annual Maximum
$1,250
$1,750
Diagnostic & Preventive
Exams
Cleanings Fluoride X-Rays Sealants Regular Restorative Services Amalgam Fillings Extractions - Single Tooth Endodontics (Root Canal) Periodontics (Gum Disease) Major Services Crowns
Covered in full
Covered in full
Covered in full
Covered in full
Covered 80% after deductible
Covered 60% after deductible
Covered 90% after deductible
Covered 80% after deductible
Covered 50% after deductible
Covered 50% after deductible
Covered 60% after deductible
Covered 50% after deductible
Bridges Dentures Orthodontia Services
Covered 50%
Covered 60%
Children only under the age of 19
Orthodontia Lifetime Maximum
$1,000
$1,000
* Subject to balance billing. Please refer to your plan document for specific details.
** M.E. Wilson contributes $12.14 monthly towards elected dental plan
OPTION 1 - LOW Dental PPO Plan
OPTION 2 - HIGH Dental PPO Plan
Bi-Weekly Rates
Employee Only
$ 5.60
$ 9.12
Employee + Spouse
$ 16.75
$ 23.93
Employee + Child(ren)
$ 20.96
$ 27.86
Family
$ 34.95
$ 46.15
6
VISION INSURANCE
M.E. Wilson Company offers vision coverage through VSP. The VSP vision network consists of optometrists, ophthalmologist opticians and optical retailers. You have the option of visiting any provider, however by choosing a participating provider, you receive the highest level of benefits.
Vision VSP Network
In-Network
Out-of-Network
Routine Eye Exams
$10 Copay
Reimbursed up to $45
Reimbursed from $45 to $125 Depending on type of lenses
Lenses*
Covered in Full
$25 Copay, $150 allowance, then 20% discount
Frames
$70 allowance
Contact Lenses
$150 allowance
Reimbursed up to $105
Frequency Exam
Once every 12 months
Lenses or contact lenses
Once every 12 months
Frame
Once every 24 months
• Covered lenses include single vision, bifocal, trifocal and lenticular.
• Lenses, Frames & Contacts are limited to either contacts or frames/lenses per calendar year.
Bi-Weekly Rates
VSP Vision Plan
Employee Only
$ 3.12
Employee + 1 (spouse or child)
$ 4.98
Employee + Children
$ 5.09
Family
$ 8.20
7
FLEXIBLE SAVINGS ACCOUNT (FSA)
A Flexible Spending Account (FSA) is an employee benefit plan that allows you to set aside a portion of your paycheck, on a pre-tax basis, to pay for non-reimbursable health care and dependent care expenses. All eligible family members are covered under this plan as long as they are claimed on your federal tax return. When you participate in a FSA, you reduce your taxable income and increase your take-home pay!
Two types of FSA plans are available, Health Care FSA (HCFSA) and Dependent Care (DCFSA). These plans were designed by the IRS to provide you with tax relief for non-reimbursable medical expenses and immediate tax savings for dependent care when there are two working parents. Health Care FSA pays for eligible healthcare expenses which generally include those products/services that are not fully covered by your medical, dental or vision insurance plan. A minimum annual contribution of $120 is required with the maximum FSA contribution of $2,650 per plan year (January 1 – December 31). NOTE: If you are enrolled in a qualified HDHP for your medical plan and contribute to a HSA account, your participation in the HCFSA becomes known as a “limited purpose FSA”. Under this plan the FSA reimburses for dental and vision expenses only. Dependent Care FSA pays for eligible child care expenses of dependent children under age 13 (or one who is incapable of self-care) and pays for eligible adult care expenses. A minimum annual contribution of $120 is required with the maximum contribution of $5,000, per household, allowed per plan year (January 1 – December 31). PLEASE NOTE: Dependent Care FSA - you cannot submit for reimbursement unless that prorated election amount has been deducted. This is unlike the Medical FSA whereas funds are available immediately.
401(k) / RETIREMENT BENEFITS
M.E. Wilson offers all eligible employees the opportunity to contribute 1 to 75% of their gross earnings (up to the legal maximum) on a pre-tax basis and invest them in a variety of investment alternatives. Employee contributions to the plan and their earnings are immediately 100% vested. All eligible employees may enroll in the 401k plan January 1, April 1, July 1, or October 1, after your initial 30 day waiting period.
TransAmerica has an automated voice telephone service available 24/7. Call the toll-free line at 1-800-401-8726 to monitor and manage your retirement account as follows:
Check your account balance and the balance of each of the funds in your account Exchange all or part of your current account balance from one fund to another Rebalance your account to its original investment allocation or apply a new investment allocation Redirect how your future contributions are to be allocated among available funds Contact a professional staff member to answer your questions during business hours
Please refer to the Summary Plan Description found on the network shared drive at I:\Employee Information\BENEFITS\Benefit Certificates and Policies\401k
8
BASIC AND VOLUNTARY LIFE INSURANCE
M.E. Wilson Company provides all full-time employees working 30 or more hours per week Basic Life insurance at no cost to the employee, as well as the option to purchase voluntary life insurance coverage through a group plan. The chart below provides an overview of the plan.
Basic Life Insurance
**The Basic Life insurance is paid 100% by M.E. Wilson Company**
$25,000 Life / AD&D
Employee
At age 65, the benefit will be reduced to 65% of the original life insurance amount. At age 70, the benefit will be reduced to 50% of the original life insurance amount.
Spouse
$5,000 Life
Child(ren)
$1,000 Life (birth to 6 months) / $2,500 (6 months to 19 years)
Voluntary Life Insurance
Election for this coverage may be made in increments of $10,000 and cannot exceed 5 times your annual salary or $500,000 (whichever is less). If you elect an amount that exceeds the guarantee issue amount of 5x salary up to $70,000, you will need to provide evidence of good health before the excess can become effective.
Employee
At age 65, the benefit will be reduced to 65% of the original life insurance amount. At age 70, the benefit will be reduced to 50% of the original life insurance amount.
Election for this coverage may be made in increments of $5,000 to a maximum of $250,000 but may not exceed 100% of the employee approved election*. If you elect an amount that exceeds the guaranteed issue amount of 100% of employee’s amount up to $25,000, your spouse will need to provide evidence of good health before the excess can become effective. Election for this coverage may be made for dependent children between the live birth and 19 years (25 years if full-time student). Coverage may be made in the amount of $2,000, $4,000, $6,000 or $10,000 but may not exceed 100% of the employee approved election.* The AD&D benefit, if elected, equals the elected life amount. AD&D provides 24- hour coverage and a benefit in the event of loss of life, limb or eyesight as a direct result of an accident, provided the loss occurs within 365 days of the accident.
Spouse
Child(ren)
Accidental Death & Dismemberment (AD&D)
*In order to purchase voluntary life insurance for a dependent, the employee must be covered.
Refer to the rate chart on the next page for your cost bi-weekly.
9
VOLUNTARY LIFE INSURANCE (continued)
Please note that the premium amounts presented below may vary slightly from the amounts provided on your enrollment form, due to rounding. To select your benefit amount and calculate your premium, do the following: Locate the benefit amount you want from the top row of the employee premium table. Your benefit amount must be in an increment of $10,000. Refer to the Coverage Guidelines section for minimums and maximums, if needed. Find your age bracket in the far left column. Your premium amount is found in the box where the row (your age) and the column (benefit amount) intersect. If AD&D is desired, follow the same steps on the AD&D chart. Note: your AD&D volume must match your Vol Life volume. If the benefit amount you want to select is greater than any amount in the table below, select the benefit amount from the top row that when multiplied by another number results in the benefit amount you want. For example, if you want $150,000 in coverage, you obtain your premium amount by multiplying the rate for $50,000 times 3.
EMPLOYEE VOL LIFE COSTS - BIWEEKLY
Age
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000
$100,000
0-24
$0.12
$0.24
$0.36
$0.48
$0.60
$0.72
$0.84
$0.96
$1.08
$1.20
25-34
$0.24
$0.48
$0.72
$0.96
$1.20
$1.44
$1.68
$1.92
$2.16
$2.40
35-39
$0.36
$0.72
$1.08
$1.44
$1.80
$2.16
$2.52
$2.88
$3.24
$3.60
40-44
$0.46
$0.92
$1.38
$1.85
$2.31
$2.77
$3.23
$3.69
$4.15
$4.62
45-49
$0.69
$1.38
$2.08
$2.77
$3.46
$4.15
$4.85
$5.54
$6.23
$6.92
50-54
$1.06
$2.12
$3.18
$4.25
$5.31
$6.37
$7.43
$8.49
$9.55
$10.62
55-59
$1.98
$3.97
$5.95
$7.94
$9.92
$11.91
$13.89
$15.88
$17.86
$19.85
60-64
$3.05
$6.09
$9.14
$12.18
$15.23
$18.28
$21.32
$24.37
$27.42
$30.46
65-69
$5.86
$11.72
$17.58
$23.45
$29.31
$35.17
$41.03
$46.89
$52.75
$58.62
70-74
$9.51
$19.02
$28.52
$38.03
$47.54
$57.05
$66.55
$76.06
$85.57
$95.08
75-79
$12.97
$25.94
$38.91
$51.88
$64.85
$77.82
$90.78
$103.75
$116.72
$129.69
80+
$26.31
$52.62
$78.92
$105.23
$131.54
$157.85
$184.15
$210.46
$236.77
$263.08
EMPLOYEE MATCHING AD&D COSTS - BIWEEKLY
Age
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000
$100,000
0-80+
$0.05
$0.09
$0.14
$0.18
$0.23
$0.28
$0.32
$0.37
$0.42
$0.46
SPOUSE VOL LIFE COSTS – BIWEEKLY ***Spouse cost is based on EMPLOYEE’S age***
EE Age
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
$40,000
$45,000
$50,000
0-24
$0.06
$0.12
$0.18
$0.24
$0.30
$0.36
$0.42
$0.48
$0.54
$0.60
25-34
$0.12
$0.24
$0.36
$0.48
$0.60
$0.72
$0.84
$0.96
$1.08
$1.20
35-39
$0.18
$0.36
$0.54
$0.72
$0.90
$1.08
$1.26
$1.44
$1.62
$1.80
40-44
$0.23
$0.46
$0.69
$0.92
$1.15
$1.38
$1.62
$1.85
$2.08
$2.31
45-49
$0.35
$0.69
$1.04
$1.38
$1.73
$2.08
$2.42
$2.77
$3.12
$3.46
50-54
$0.53
$1.06
$1.59
$2.12
$2.65
$3.18
$3.72
$4.25
$4.78
$5.31
55-59
$0.99
$1.98
$2.98
$3.97
$4.96
$5.95
$6.95
$7.94
$8.93
$9.92
60-64
$1.52
$3.05
$4.57
$6.09
$7.62
$9.14
$10.66
$12.18
$13.71
$15.23
65-69
$2.93
$5.86
$8.79
$11.72
$14.65
$17.58
$20.52
$23.45
$26.38
$29.31
70-74
$4.75
$9.51
$14.26
$19.02
$23.77
$28.52
$33.28
$38.03
$42.78
$47.54
75-79
$6.48
$12.97
$19.45
$25.94
$32.42
$38.91
$45.39
$51.88
$58.36
$64.85
SPOUSE MATCHING AD&D COSTS - BIWEEKLY
Age
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
$40,000
$45,000
$50,000
0-80+
$0.02
$0.05
$0.07
$0.09
$0.12
$0.14
$0.16
$0.18
$0.21
$0.23
CHILD VOL LIFE COSTS - BIWEEKLY $2,000 $4,000 $6,000 $8,000
$10,000
*Child coverage is for child(ren) up to age 19 or up to age 25 if full-time student
0-19*
$0.17
$0.33
$0.50
$0.66
$0.83
CHILD MATCHING AD&D COSTS - BIWEEKLY $2,000 $4,000 $6,000 $8,000
$10,000
0-19*
$0.01
$0.02
$0.03
$0.04
$0.05
10
SHORT TERM DISABILITY
Short-term disability insurance can help protect your income in the event of a disability by providing you a benefit for injuries and sickness that are not work related. You are eligible to enroll in this plan at your own cost and benefits are payroll deducted.
Plan Features Include:
Weekly benefits are 60% of your basic weekly pay -maximum of $1,000 per week.
Benefits begin on the 8th day of disability for accident, sickness or pregnancy. Pregnancy is covered as any other disability. Benefits are payable to 12 weeks.
Benefits are not subject to federal income tax when premiums are paid with after-tax dollars (post-tax deduction from paycheck).
You may qualify for disability benefits by meeting either an occupation test or an earnings test
Occupation Test: you may qualify under the occupation test if you are under the regular care and attendance of a doctor, and an injury, sickness or pregnancy prevents you from performing at least one of the material duties of your occupation.
Earnings Test: you may qualify under the earnings test if any injury, sickness or pregnancy prevents you from earning more than 99% of your pre-disability pay.
Voluntary Short-Term Disability Monthly Contributions:
$.19 per $10 of weekly benefit
Premium Calculation Worksheet
Weekly Pay
$ _______________
Benefit Amount
X .60
Weekly Benefit
$ _______________
/ 10.00
$ _______________
Rate per $10.00
X .19
Monthly Premium
$ _______________
X 12
Annual Premium
$ _______________
/ 26
Bi-Weekly Rate
$ _______________
11
LONG TERM DISABILITY
Long-term disability insurance provides for income continuation in the event of a disability by providing you a benefit for injuries and sickness that are not work related. Plan highlights our outlined below.
Class II – Producers
Class III – All Other Employees
Monthly Benefit Minimum Maximum
60% of covered earnings $100 $15,000
60% of covered earnings $100 $10,000
Elimination Period
90 days; 0 day residual
90 days; 0 day residual
Maximum Benefit Duration
SS Normal Retirement Age
SS Normal Retirement Age
Dual Definition of Disability Own Occupation Test Earnings Test
Unlimited partial disability To SS Normal Retirement Age 99% Own Occ to age 65
Unlimited partial disability 36 months; any occupation 99% during Own Occ, then 85% thereafter
Benefit Integration
Full Family Direct
Full Family Direct
The pre-existing condition limitation is 3/12. A pre-existing condition is one which an individual has seen a medical practitioner or taken medication in the 3 months prior to his/her effective date. We will not pay benefits for any pre-existing condition until the earlier of 3 consecutive months ending on or after the effective date of coverage during which the individual has not seen a medical practitioner or taken medication for a condition; AND the individual remains insured under this plan for 12 consecutive months.
Pre-existing Condition
Survivor Benefit
3 months
3 months
Premium Calculation Worksheet
Annual Pay
$ _______________
/ 12
M.E. Wilson Company pays 50% of the premium for all employees who enroll in Long-Term Disability. If you waive health coverage, M.E. Wilson Company pays 100% of your Long-Term Disability premium.
Monthly Pay
$ _______________
/ $100
Covered Payroll
$ _______________
X Price (employee cost)
X .32
Monthly Premium
$ _______________
X 12
Annual Premium
$ _______________
/ 26
Bi-Weekly Rate
$ _______________
12
LONG TERM CARE BENEFITS
Long Term Care (LTC) insurance is important for people of all ages if they want to preserve financial security and independence in the event of an extended disability.
Despite popular misconceptions, the need for long term care isn’t restricted by the elderly, because many working age adults have disabling injuries as well as illness.
Because we understand what an important benefit LTC can be, M.E. Wilson pays for 100% of the Plan A premium. If you would like additional coverage, you have the option to “buy up” to Plan B, C or D at your own expense.
Long Term Care Plans
Long term care facility $2000 monthly benefit amount 3 year benefit duration 100% professional home care 90 day elimination period Long term care facility $4000 monthly benefit amount 4 year benefit duration 100% professional home care 90 day elimination period Long term care facility $5000 monthly benefit amount 6 year benefit duration 100% professional home care 90 day elimination period Long term care facility $6000 monthly benefit amount 6 year benefit duration 100% professional home care 90 day elimination period
Plan A
Plan B
Plan C
Plan D
With each plan you also have the option of adding 100% total home care and simple inflation.
100% Total Home Care – provides financial help in the event you need care at home or another similar place due to a chronic illness.
Simple Inflation – non-compounding inflation at 5% annually
For “buy up” options, please refer to the rate grids found on the network shared drive at I:\Employee Information\BENEFITS\2019\UNUM LTC Enrollment Kit
13
VOLUNTARY INSURANCE
Voluntary Insurance Designed to Help Your Benefits Dollars Go Further!
One thing people can count on in life is change. We often fail to consider how these changes affect our current and long-term financial plans. To ensure you are up-to-date with your personal benefits needs, consider this question:
“Do I have the financial resources to help my family maintain their standard of living if I were to become seriously ill, injured or die?”
If you answered “I don’t know”, Colonial insurance could be the answer. As a benefit eligible employee of M.E. Wilson Company, Inc. you can choose from the following insurances that protect you and your family against these financial concerns that are caused from accidents, illnesses and death. Accident Insurance - Do your children play sports? Are you accident prone? This plan pays an emergency room benefit along with a follow up doctor visit. It covers you and your family 24/7 and also includes income for each day you are hospitalized, AD&D and catastrophic benefits with lump sum payments for specific injuries. Cancer Insurance – 62% of cancer related expenses are out-of-pocket costs that major medical plans are not designed to cover such as deductibles, coinsurance, loss of wages, travel expenses, treatment and medications. In addition, there is an annual wellness benefit of $100 for cancer screening tests for each person covered by the policy. Hospital Confinement Insurance - Pays an admission benefit in addition to a daily confinement benefit. This plan can help you budget for any out-of-pocket expenses (deductible and/or coinsurance) that occur when you or a family member is hospitalized. Critical Illness Insurance - Can help fill the gaps created by loss of income or high medical bills. This plan complements your other benefits by adding additional income when needed most. This coverage pays a lump sum benefit, upon diagnosis of a covered critical illness (i.e. stroke, heart attack, organ transplant, and end stage renal failure).
14
PAID TIME OFF BENEFITS
Refer to the M.E. Wilson Handbook for additional information on the following benefits.
Holidays M.E. Wilson Company observes the following holidays each year. All employees are eligible for paid holidays upon hire.
New Year’s Day
Memorial Day
Labor Day
Day after Thanksgiving
Good Friday
Independence Day
Thanksgiving
Christmas Day
Vacation Time M.E. Wilson employees are eligible for paid vacation time on a payroll-calendar year basis as follows:
Length of Employment
Vacation Allotment
Hire date to 1 year of service
3 weeks (pro-rated)*
1 to 4 years of continuous employment
3 weeks (15 days)
5 to 9 years of continuous employment
3 weeks plus 1 day added each year on your anniversary date for the next 5 years, for a maximum of 20 vacation days
10+ years of continuous employment
4 weeks (20 days)
*Please refer to the employee handbook for pro rata details
Personal / Sick Time Personal – each employee is entitled to two (2) days of paid personal time off per payroll-calendar year
Bereavement – each employee is eligible for three (3) paid days for the death of an immediate family member. Members of the immediate family include current spouse, children (in-law), parents (in-law), legal guardian, domestic partner, siblings, grandparents, and grandchildren.
Jury Duty – each employee is paid the difference between their normal rate of pay and the jury duty pay when summoned for jury duty, unless county statute dictates otherwise.
Sick Days – each employee is eligible for seven (7) paid sick days per payroll-calendar year. All employees who are eligible to take sick days are allowed to use this time to care for a spouse or sick child.
Miscellaneous Benefits Education Assistance Program To encourage professional development, our company offers a tuition assistance program to employees who complete job- related courses with a grade of C or better. In addition, all continuing education courses to comply with State requirements for insurance licensed employees are paid 100% by M.E. Wilson.
Employee Discount Program Employees will be reimbursed agency commissions for personal insurance plan written through the agency.
Assist America Worldwide emergency assistance services is provided to any employees traveling more than 100 miles from home through Unum. These assistance services include emergency medical treatment, lost luggage assistance, legal and interpreter referrals, etc. Employee Assistance Program (EAP) Unum’s work-life balance EAP program offers unlimited access to master’s level consultants by telephone, resources and tools online, and up to three face-to-face visits with a consultant for confidential help with a short term problem, including but not limited to: finding child or elder care services, financial advice, attorney referrals and grief counseling.
15
SUMMARY ANNUAL REPORT
SUMMARY ANNUAL REPORT FOR M.E. WILSON CO. 401(K) PLAN
This is a summary of the annual report for the M.E. WILSON CO. 401(K) PLAN (Employer Identification Number 59- 2585447, Plan Number 001) for the plan year 01/01/2017 through 12/31/2017. The annual report has been filed with the Employee Benefits Security Administration, as required under the Employee Retirement Income Security Act of 1974 (ERISA). Basic Financial Statement Plan expenses were $43,883. These expenses included $12,674 in administrative expenses and $31,209 in benefits paid to participants and beneficiaries, and $0 in other expenses. A total of 47 persons were participants in or beneficiaries of the plan at the end of the plan year, although not all of these persons had yet earned the right to receive benefits. The value of plan assets, after subtracting liabilities of the plan, was $4,098,018 as of the end of the plan year, compared to $3,170,528 as of the beginning of the plan year. During the plan year the plan experienced a change in its net assets of $927,490. This change includes unrealized appreciation or depreciation in the value of plan assets; that is, the difference between the value of the plan's assets at the end of the year and the value of the assets at the beginning of the year or the cost of assets acquired during the year. The plan had total income of $971,373, including employer contributions of $50,274, employee contributions of $273,896, other contributions/other income of $124,198 and earnings from investments of $523,005. Information Regarding Plan Assets The U.S. Department of Labor’s regulations require that an independent qualified public accountant audit the plan’s financial statements unless certain conditions are met for the audit requirement to be waived. This plan met the audit waiver conditions for the plan year beginning 01/01/2017 and therefore has not had an audit performed. The plan’s assets were held in individual participant accounts with investments directed by participants and beneficiaries and with account statements from regulated financial institutions furnished to the participant or beneficiary at least annually and loans to participants and other qualifying assets.
General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions."
Your Rights to Additional Information You have the right to receive a copy of the full annual report, or any part thereof, on request. The items listed below are included in that report:
1. Insurance information, including sales commissions paid by insurance carriers.
To obtain a copy of the full annual report, or any part thereof, write or call the office of Karen Martin, who is a representative of the plan administrator, at 300 W. PLATT STREET, SUITE 200, TAMPA, FL 33606 and phone number, 813- 229-8021. The charge to cover copying costs will be $5.00 for the full annual report, or $0.25 per page for any part thereof. You also have the right to receive from the plan administrator, on request and at no charge, a statement of the assets and liabilities of the plan and accompanying notes, or a statement of income and expenses of the plan and accompanying notes, or both. If you request a copy of the full annual report from the plan administrator, these two statements and accompanying notes will be included as part of that report. The charge to cover copying costs given above does not include a charge for the copying of these portions of the report because these portions are furnished without charge. You also have the legally protected right to examine the annual report at the main office of the plan: 300 W. PLATT STREET, SUITE 200, TAMPA, FL 33606, and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N-1513, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.
16
2019 PAYROLL SCHEDULE
Bi-Weekly Payroll:
Pay Period Begin
Pay Period End
Processing Date
Check Date
Notes
12/16/18
12/29/18
12/31/18
01/04/19
Jan 1st Holiday
12/30/18
01/12/19
01/14/19
01/18/19
01/13/19
01/26/19
01/28/19
02/01/19
01/27/19
02/09/19
02/11/19
02/15/19
02/10/19
02/23/19
02/25/19
03/01/19
02/24/19
03/09/19
03/11/19
03/15/19
03/10/19
03/23/19
03/25/19
03/29/19
03/24/19
04/06/19
04/08/19
04/12/19
04/07/19
04/20/19
04/22/19
04/26/19
April 19th Holiday
04/21/19
05/04/19
05/06/19
05/10/19
05/05/19
05/18/19
05/20/19
05/24/19
05/19/19
06/01/19
06/03/19
06/07/19
May 27th Holiday
06/02/19
06/15/19
06/17/19
06/21/19
06/16/19
06/29/19
07/01/19
07/05/19
06/30/19
07/13/19
07/15/19
07/19/19
Jul 4th Holiday
07/14/19
07/27/19
07/29/19
08/02/19
07/28/19
08/10/19
08/12/19
08/16/19
08/11/19
08/24/19
08/26/19
08/30/19
08/25/19
09/07/19
09/09/19
09/13/19
Sep 2nd Holiday
09/08/19
09/21/19
09/23/19
09/27/19
09/22/19
10/05/19
10/07/19
10/11/19
10/06/19
10/19/19
10/21/19
10/25/19
10/20/19
11/02/19
11/04/19
11/08/19
11/03/19
11/16/19
11/18/19
11/22/19
11/17/19
11/30/19
12/02/19
12/06/19
Nov 28th & 29th Holiday
12/01/19
12/14/19
12/16/19
12/20/19
12/15/19
12/28/19
12/30/19
01/03/20
Dec 24th & 25th Holiday
Monthly Payroll: Monthly paid employees are paid on the last business day of each month.
17
2019 TIMESHEET CALENDAR 2019 TIMESHEET CALENDAR
December 2018
PAID HOLIDAYS
Su M Tu W Th F Sa
New Years Day is Jan 1st
Labor Day is September 2nd
1
Good Friday is April 19th
Thanksgiving is Nov 28th & 29th
2 3 4 5 6 7 8
Memorial Day is May 27th
Christmas Eve is Tuesday, Dec 24th
9 10 11 12 13 14 15
Independence Day is July 4th
Christmas Day is Wednesday Dec 25th
16 17 18 19 20 21 22
Bi-Weekly Pay Period End
Bi-Weely Pay Date
23 24 30 31
25 26 27 28 29
Monthly Pay Date is always the last business day of the month
January 2019
February 2019
March 2019
Su M Tu W Th F Sa
Su M Tu W Th F Sa
Su M Tu W Th F Sa
1 2 3 4 5
1 2
1 2
6 7 8 9 10 11 12
3 4 5 6 7 8 9
3 4 5 6 7 8 9
13 14 15 16 17 18 19
10 11 12 13 14 15 16
10 11 12 13 14 15 16
20 21 22 23 24 25 26
17 18 19 20 21 22 23
17 18 19 20 21 22 23 24 29 31 30 25 26 27 28
27 28 29 30 31
24 25 26 27
28
April 2019
May 2019
June 2019
Su M Tu W Th F Sa
Su M Tu W Th F Sa
Su M Tu W Th F Sa
1 2 3 4 5 6
1 2 3 4
1
7 8 9 10 11 12 13
5 6 7 8 9 10 11
2 3 4 5 6 7 8
14 15 16 17 18 19 20
12 13 14 15 16 17 18
9 10 11 12 13 14 15
21 22 23 24 25 26 27
19 20 21 22 23 24 25
16 17 18 19 20 21 22 23 30 24 25 26 27 28 29
28 29 30
26 27
28 29 30 31
July 2019
August 2019
September 2019
Su M Tu W Th F Sa
Su M Tu W Th F Sa
Su M Tu W Th F Sa
1 2 3 4 5 6
1 2 3
1 2 3 4 5 6 7
7 8 9 10 11 12 13
4 5 6 7 8 9 10
8 9 10 11 12 13 14
14 15 16 17 18 19 20
11 12 13 14 15 16 17
15 16 17 18 19 20 21
21 22 23 24 25 26 27
18 19 20 21 22 23 24
22 23 24 25 26 27 28
30
28 29 30 31
25 26 27
28 29
31
29
30
October 2019
November 2019
December 2019
Su M Tu W Th F Sa
Su M Tu W Th F Sa
Su M Tu W Th F Sa
1 2 3 4 5
1 2
1 2 3 4 5 6 7
6 7 8 9 10 11 12
3 4 5 6 7 8 9
8 9 10 11 12 13 14
13 14 15 16 17 18 19
10 11 12 13 14 15 16
15 16 17 18 19 20 21
20 21 22 23 24 25 26
17 18 19 20 21 22 23
22 23 24 25 26 27 28
27 28 29 30 31
24
25 26 27 28 29 30
29 30
31
18
REQUIRED ANNUAL EMPLOYEE DISCLOSURE NOTICES
Required Annual Employee Disclosure Notices
THE NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT OF 1996 The Newborns’ and Mothers’ Health Protection Act of 1996 prohibits group and individual health insurance policies from restricting benefits for any hospital length of stay for the mother or newborn child in connection with childbirth; (1) following a normal vaginal delivery, to less than 48 hours, and (2) following a cesarean section, to less then 96 hours. Health insurance policies may not require that a provider obtain authorization from the health insurance plan or the issuer for prescribing any such length of stay. Regardless of these standards an attending health care provider may, in consultation with the mother, discharge the mother or newborn child prior to the expiration of such minimum length of stay. Further, a health insurer or health maintenance organization may not: 1. Deny to the mother or newborn child eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely to avoid providing such length of stay coverage; 2. Provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum coverage; 3. Provide monetary incentives to an attending medical provider to induce such provider to provide care inconsistent with such length of stay coverage; 5. Restrict benefits for any portion of a period within a hospital length of stay described in this notice. These benefits are subject to the plan’s regular deductible and co-pay. For further details, refer to your Summary Plan Description. Keep this notice for your records and call Human Resources for more information. Effective January 1, 2009 group health plans are required by Federal government to comply with Section 111 of the Medicare, Medicaid, and SCHIP Extensions of 2007’s new Medicare Secondary Payer regulations. The mandate is designed to assist in establishing financial liability of claims assignments. In other words, it will help establish who pays first. The mandate requires group health plans to collect additional information, more specifically Social Security numbers for all enrollees, including dependents 6 months of age or older. Please be prepared to provide this information on your benefits enrollment form when enrolling into benefits. 4. Require a mother to give birth in a hospital; or SECTION 111
WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998
The Women’s Health and Cancer Rights Act of 1998 requires M.E. Wilson Company to notify you, as a participant or beneficiary of the M.E. Wilson Company Health and Welfare Plan, of your rights related to benefits provided through the plan in connection with a mastectomy. You, as a participant or beneficiary, have rights to coverage to be provided in a manner determined in consultation with your attending physician for: 1. All stages of reconstruction of the breast on which the mastectomy was performed; 2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; and 3. Prostheses and treatment of physical compilations of the mastectomy, including lymphedema. These benefits are subject to the plan’s regular deductible and co-pay. For further details, refer to your Summary Plan Description. Keep this notice for your records and call Human Resources for more information. The law allows for continued coverage for dependent children who are covered under your group health plan as a student if they lose their student status because of a medically necessary leave of absence from school. This law applies to medically necessary leaves of absence that begin on or after January 1, 2010 If your child is no longer a student, as defined in your Certificate of Coverage, because he or she is on a medically necessary leave of absence, your child may continue to be covered under the plan for up to one year from the beginning of the leave of absence. This continued coverage applies if your child was (1) covered under the plan and (2) enrolled as at student at a post-secondary educational institution (includes colleges, universities, some trade schools and certain other post-secondary institutions). Your employer will require a written certification from the child’s physician that states that the child is suffering from a serious illness or injury and that the leave of absence is medically necessary. MICHELLE’S LAW
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