2024-2025 Benefit Summary
Table of Contents
Welcome_____________________________________ 3
Eligibility & Enrollment__________________________4
Medical Benefits_______________________________7
Dental Benefits________________________________12
Vision Benefits________________________________14
Life Insurance_________________________________16
Disability Benefits______________________________18
EAP_________________________________________19
Long-Term Care_______________________________20 Base & Buy Up Options
Voluntary Legal Benefits________________________21
FSA_________________________________________22
Commuter Benefits____________________________24
Voluntary Benefits_____________________________25
Critical Illness Accident Insurance Hospital Indemnity
Pet Insurance _________________________________ 26
Fidelity Retirement Plan________________________27
Contact Information___________________________28
Notices______________________________________29
2024-2025 Benefit Summary
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Welcome To Your Benefits
At Nordea Bank we appreciate your commitment and contributions to our company’s success. Each year, we strive to provide 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 2024-2025 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 2024-2025. Our benefit programs remain highly competitive for 2024-2025. About this Guidebook This benefits guidebook describes the highlights of Nordea Bank’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’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.
The Nordea Bank benefit programs begin on October 1 st and end on September 30 th . Plan Year
2024-2025 Benefit Summary
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Eligibility & Enrollment
Employee Eligibility All full-time employees working 30 or more hours per week are eligible for company-offered, non- supplemental, benefit plans on their date of hire. Supplemental benefits including Voluntary Life, Accident Insurance, Critical Illness and Hospital Indemnity are offered on the first of the month following their date of hire.
Dependent Eligibility Employees who are eligible to participate in the Nordea Bank benefit program may also enroll their dependents. For the purposes of our benefit plans, your dependents are defined as follows:
• Your spouse or domestic partner • Your dependent children to age 26
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Domestic Partners Domestic partners and children of domestic partners are eligible to enroll as a dependent in some of Nordea Bank plans. You and your partner must meet specific criteria to qualify for domestic partner coverage. Tax consequences of providing health benefits to a domestic partner are subject to the guidelines of the Internal Revenue Code and may result in additional taxable income. An Affidavit will need to be completed. See People NY for more information/paperwork.
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 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.
2024-2025 Benefit Summary
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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.
How Does this Help?
Here are a Couple of Important Things to Know About the Alex Tool:
• It’s personalized - 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 - You can get the guidance you need without revealing all of 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!
• *Important* - Alex is a support tool and NOT where you make your actual benefit elections
See How Alex Can Help: https://www.myalex.com/Nordea-bank-abp-new-york/2024
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The Care You Need. Open Access Plus In-network plan from Cigna
We all need healthcare that protects our physical health as much as our financial well-being. That is why Nordea Bank believes it is important to invest in quality plans that are cost effective, easy to use and valuable to you. Nordea Bank provides the following medical benefits through Cigna: Medical Benefits Cigna OAP High Plan - In and Out of Network ( Note: For provider services provided outside of the Open Access Network, Usual, Customary, Reasonable (UCR) charges will be applied. Member may be responsible for paying the balance of the billed amount above that rate (commonly known as “balance billing”) No-referral specialist care - A primary care provider (PCP) is recommended, but not required. Care coordination - Our robust medical management program provides you and your family a valuable resource for one-onone support. Out-of-pocket costs - Depending on your plan, you may have to pay an annual amount (deductible) before your plan begins to pay for covered health care costs. Offering flexible access to thousands of providers – plus programs and services to support your whole health needs – the Open Access Plus In-network (OAPIN) plan is designed to make it easier for you to get the quality care you need and the savings you want. In-network coverage - When you visit a health care provider who is in the Cigna OAPIN network, you receive in-network coverage and will have lower out-of-pocket costs.
Cigna OAP Low Plan - In Network Only (Providers must participate within the Open Access Plus Network )
Monthly Employee Contributions for Medical Benefits
Level
OAP High Plan
OAP Low Plan
Semi-Monthly (24 Paychecks)
Monthly (12 Paychecks)
Semi-Monthly & Monthly
Frequency
Employee Only
$112.32
$224.64
Employee + Spouse
$262.82
$525.63
$0
Employee + Child(ren)
$235.87
$471.73
Employee + Family
$377.39
$754.77
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Medical Benefits Plan Comparison
Cigna OAP High Plan
Cigna OAP Low Plan
In-Network
Out-of-Network
In-Network Only
Deductible and Coinsurance
Primary Care Visit
$20 Copay
$25 Copay
Deductible and Coinsurance
Specialist Office Visit
$50 Copay
$50 Copay
Deductible and Coinsurance
Urgent Care Visit
$25 Copay
$25 Copay
Prescription Drug Retail
$15/$30/$60
N/A
$20/$30/$60
Prescription Drug Mail Order
$30/$60/$120
N/A
$40/$60/$120
Emergency Room
$100 Copay
$100 Copay
Plan pays 100% after Deductible
Deductible and Coinsurance
Plan pays 100% after Deductible
Inpatient Services
Plan pays 100% after Deductible
Deductible and Coinsurance
Plan pays 100% after Deductible
Outpatient Services
Outpatient Lab and X-ray
Deductible and Coinsurance
Plan pays 100%
Plan pays 100%
Plan pays 100% after Deductible
Deductible and Coinsurance
Plan pays 100% after Deductible
Radiology
Coinsurance
Plan pays 100%
Plan pays 80%
Plan pays 100%
Lifetime Maximum
Unlimited
Annual Out-of-Pocket Maximum
$5,350/$10,700
$2,000/$4,000
$6,350/$12,700
Annual Deductible
$1,000/$3,000
$1,000/$3,000
$1,000/$3,000
2024-2025 Benefit Summary
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How to Find a Provider-MyCigna.com
Member Cigna 90 Choice A pharmacy network designed to boost engagement and avoid surprises.
How it Works Customers choose from two com- plete 30- and 90-day networks, with either CVS Pharmacy or Wal- greens as the main anchor. Every covered member in the household* can choose the phar- macy network that works best for them on an individual level.
Members have access to a large network that includes local pharmacies, grocery stores, retail chains and wholesale warehouse stores, in addition to their preferred anchor pharmacy.
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Enhanced Resources for Cigna Members Cigna member services available 24/7/365 Lifestyle Benefits • Cigna Healthy Rewards® to save money on health and wellness products and services.
• Online coaching programs help you maintain a healthy lifestyle • Personal health coaches to help improve your health and wellness • Programs to help you better manage stress, quit tobacco or lose weight • Simple, online health assessment designed to help you live a healthier life Mental Health Benefits • Talkspace • Headspace (rebrand of Ginger IO) Medical Services • MD Live- Telemedicine service for your convenience Pharmacy • Member Cigna Choice 90 (CVS or Walgreens impact only) Cigna One Guide®
Cigna One Guide service helps you make smarter, informed choices and get health-related recom- mendations based on what matters most to you. It's our highest level of support that combines the ease of a powerful app, the web, and personal service via phone or live chat. One Guide personal sup- port, tools and reminders can help you stay healthy and save money. Help from your One Guide team
is always just a phone call or click away. Know Your Coverage and How it Works
Once you have enrolled, start using the Cigna One Guide service by downloading the enhanced myCigna® App, by phone or live chat by registering on myCigna.com®*
• Get answers to your health care or plan questions • Find an in-network doctor, lab or urgent care center • Connect with health coaches and more • Stay on track with appointments and preventive care • Take advantage of dedicated one-on-one support for complex health situations • Maximize your benefits • Get cost estimates and service comparisons to avoid surprises • Check claim activity to manage expenses
*The downloading and use of the myCigna Mobile App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply.
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View Your Covered Medications Whether you’re a taking medication now or in the future, it’s important to know which medica- tions your plan covers. You can view your drug list 24/7 at Cigna.com/druglist, on the myCigna® App or at myCigna.com®. Before your plan starts: 1. Go to Cigna.com/druglist. 2. Select the Standard 3 Tier drug list from the drop down menu. 3. Choose a search method: Type in your medication name and click “Search” or look for your medication name in the alphabetical list.
Once your plan starts: 1. Log in to the myCigna app1 or myCigna.com. 2. Use the Price a Medication tool to see how your medication is covered and how much it costs.
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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. Dental Benefits
Monthly Employee Contributions for Dental Benefits
Level
Metlife Dental Plan
Frequency
Semi-Monthly & Monthly
Employee Only
$0
Employee + Spouse
$0
Employee + Child(ren)
$0
Employee + Family
$0
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Metlife PPO Plan Services
In-Network
Out-of-Network
$25/$75
$25/$75
Annual Deductible (per person, per calendar year)
Deductible Accumulation
Calendar Year
Calendar Year
Annual Maximum Benefit (per person, per calendar year)
$3,000
$3,000
Preventive Dental Services (cleaning, exams, x-rays)
Plan pays 100%
Plan pays 100%
Frequency
Once every 6 months
Once every 6 months
Plan pays 80% You pay 20%
Basic Dental Services (fillings, root canal)
Plan pays 100%
Full mouth X-rays: 1 in 3 years Crowns: 1 per tooth in 5 years
Full mouth X-rays: 1 in 3 years Crowns: 1 per tooth in 5 years
Waiting Period
Plan pays 60% You pay40%
Plan pays 50% You pay 50%
Major Dental Services (extractions, crowns, inlays, onlays, bridges, dentures, repairs)
Repairs : 1 in 12 months Bridges/Dentures: 1 in 5 years
Repairs: 1 in 12 months Bridges/Dentures: 1 in 5 years
Waiting Period
Plan pays 50% You pay 50%
Plan pays 50% You pay 50%
Orthodontia Services
Orthodontia Lifetime Max
$3,000
$3,000
Dependent Cut Off Age
26 years old
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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. Vision Benefits
Monthly Employee Contributions for Vision Benefits
Level
Cigna Vision
Frequency
Semi-Monthly & Monthly
Employee Only
$0
Employee + Spouse
$0
Employee + Child(ren)
$0
Employee + Family
$0
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Cigna Vision
Benefits
In-Network
Out-of-Network
Eye Exam
$10 copay
n/a
Materials
n/a
Plan pays up to $45
Single Vision Lenses
$20 copay
Plan pays up to $32
Bifocal Lenses
$20 copay
Plan pays up to $55
Trifocal Lenses
$20 copay
Plan pays up to $65
Lenticular Lenses
$20 copay
Plan pays up to $80
Frames
$130 allowance
Plan pays up to $71
Contact Lenses Elective
$130 allowance
Plan pays up to $105
Contact Lenses Medically Necessary
covered in full
Plan pays up to $210
Dependent Cut Off Age
26 years old
Frequency is 1 per calendar year for exams, lenses or contact lenses, and frames.
2024-2025 Benefit Summary
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Life and Accident Death & Dismemberment Insurance, by Guardian
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 pays the entire cost of Basic Term Life Insurance and Basic AD&D for you and you are automatically enrolled upon meeting eligibility. Life Insurance & Accidental Death & Dismemberment (AD&D) Life insurance coverage is a way to protect your family and those who depend on you for financial support. It can provide a large, income tax-free payout to help them carry on if you pass away unexpectedly. Nordea Bank provides basic life insurance up to 3x your annual earnings to a maximum of $1,500,000 at no cost to you. If your Basic Life & AD&D coverage exceeds the $650,000 Guarantee Issue amount, members will need to complete an Evidence of Insurability Form before the additional Basic Life & AD&D can be approved.
If you would like additional coverage you can choose to enroll in our voluntary options listed on the next page.
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0
Voluntary Life and AD&D Insurance
Type
Available Coverage
$10,000 to $500,000 in $10,000 increments Guaranteed Issue: $100,000
Employee Voluntary Life & AD&D
$5,000 to $500,000 in $5,000 increments Guaranteed Issue: $25,000
Spouse Voluntary Life & AD&D
Children Birth to 14 days: Flat $1,000 Children 14 days to age 20 (26 if full time student): $10,000 in Increments of $2,000 to the lesser of 50% of employee’s benefit
Dependent Voluntary Life & AD&D
Voluntary Term Life Rates per $1,000
Age
<30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70+
Rates $0.060 $0.074
$0.105
$0.151
$0.240 $0.382 $0.588 $0.917
$1.592
$2.841
Child
Employee AD&D
Spouse AD&D
Child AD&D
$0.387
$0.025
$0.025
$0.025
Employee Payroll Contributions Will Be Taken Out Once Per Month for Voluntary Life & AD&D. Rates For Voluntary Life & AD&D are a combined benefit.
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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 provides 100% salary continuation while on approved short-term disability.
Short-Term Disability
Long-Term Disability
70% of salary to maximum $2,000/week
60% of total earning to maximum $20,000/month
Coverage Amount
Maximum payment period: Maximum length of time you can receive disability benefits.
To age 65, standard ADEA
25 weeks
Accident benefits begin: The length of time you must be disabled before benefits begin.
Day 8
Day 181
Illness benefits begin: The length of time you must be disabled before benefits begin.
Day 8
Day 181
Minimum work hours/week: Minimum number of hours you must regularly work each week to be eligible for coverage.
30
30
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Employee Assistance Program We all need a little support every now and then. Guardian's Employee Assistance Program gives you and your family members access to confidential personal support, across everything from stress management and nutrition to handling legal or financial issues. The services available include consultations with experienced professionals, as well as access to resources and discounts designed to help you in a variety of different ways.
How it can help Consultative services are available to provide direct support and assistance Work/life assistance that can help you save money and balance commitments Access legal and financial assistance and resources- including Will Prep Services
How to access Visit: worklife.uprisehealth.com Access Code: worklife Call: 800-386-7055 24 Hour Crisis Help Available. Regular office hours: Monday-Friday 6am-5pm PST.
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Long-Term Care 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 pays the entire cost of the Base Plan.
Employer Paid Benefit
Monthly Benefit Amounts
Nursing Facility Assisted Living Facility Total Home Care
Up to $6,000 Up to 60% of Nursing Facility Benefit Up to 50% of Nursing Facility Benefit
Benefit Duration
3 Years
36x The Facility Amount ($216,000)
Lifetime Maximum Benefit
Elimination Period
90 Days
Employee Paid Benefit
Monthly BenefitAmounts
Facility Benefit
$7,000 or $8,000
Benefit Duration
6 Years or Unlimited
Compound Inflation**
5%
Long-Term Care Buy Up Rates will be based on age. Rates will not increase as you get older. This benefit is portable. Evidence of Insurability may be required if applying for Buy-Up coverage.
Long-Term Care does not follow the same anniversary date as our other plans. There will be a separate open enrollment for this benefit.
2024-2025 Benefit Summary
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Voluntary Legal Benefits With MetLife Legal Plans, you have access to the expert guidance and tools you need to navigate a broad range of personal legal needs.
Create an account at members.legalplans.com. Questions? Call the MetLife Legal Plans Client Service Center at 1-800-821-6400. Monday-Friday, 8 a.m. to 8 p.m., ET. *Members can only enroll in this benefit one time each year during annual open enrollment.
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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, copayments, 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. For the 2024 plan year, the maximum amount that you may contribute to a Health Care FSA is $3,200. • Money is deducted pre-tax from your paycheck up to max. benefit of $3,200 (entire amount available day 1) • Can be used to pay for medical copays, deductibles, dental, and/or vision qualified expenses • Employees enrolled in a health care FSA will receive a benefits debit card usually 15 days after enrollment • Benefits are “Use it or Lose it”! • The above FSA requires an active enrollment. You must re-enroll in order to participate for the upcoming plan year or FSA benefit will end on 9/30/24 • The FSA card will NOT work between December 15-31, 2024 for claim submissions, however paper claims can be submitted until Dec 31, 2024. • Grace Period is currently until Dec 15, 2024 and the Run-out period is currently set to Dec 31, 2024 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. • Money is deducted pre-tax from your paycheck up to max. benefit of $5,000 • Used to pay for daycare, after school programs, & more • Eligible for dependents under 13 • The above FSA requires an active enrollment. You must re-enroll in order to participate for the upcoming plan year or FSA benefit will end on 9/30/24 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 single parent filing separately
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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 • Psychologist
• 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
• 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
• Dermatologist • Diagnostic fees • Diathermy • Drug addiction therapy
*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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Commuter Benefits
Commuter benefits allow employees to pay for certain workplace commuting expenses, including mass transit and parking, on a tax-free basis through payroll deductions.
Transit IRS maximum: $315 per month Parking IRS maximum: $315 per month
Transit passes: Including tokens, vouchers, or similar items that entitle you to use mass transit facilities or van pooling services.
Qualified Parking: Includes parking close to work location or at a location from which you commute to work.
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Voluntary Benefits
The following supplemental employee coverage addresses costs associated with injury, illness or hospital costs that are unexpected.
Type
Available Coverage
Cancer: 100% (1st Occurence), 100% (2nd Occurrence) Heart Attack: 100% (1st Occurrence), 100% (2nd Occurrence) Organ Failure: 100% (1st Occurrence), 100% (2nd Occurrence)
Critical Illness
Coverage Type: On and Off the Job Accidental Death: Employee - $50,000
Accident Insurance
Spouse - $20,000 Children - $10,000
Daily Hospital Confinement: $165 per Day, Max of 15 Days per Insured per Calendar Year
Hospital Admission: $500 Per Admission, Limit of 2 Admissions per Insured per Calendar Year Portability: Included
Hospital Indemnity
Contributions/Coverage for Voluntary Benefits per Pay Period
Accident Benefits Employee: $11.94
Critical Illness Coverage Employee: Lump sums of $10,000, $20,000 or $30,000 - GI: $30,000
Employee + Spouse: $19.25 Employee + Children: $22.28 Employee + Family: $29.59 Hospital Indemnity Benefits Employee: $12.75 Employee + Spouse: $26.64 Employee + Children: $21.34 Employee + Family: $35.23
Spouse: Lump sums from $10,000-$30,000 in $10,000 increments - GI: $30,000
Children: 50% of Employee Lump Sum Benefit GI: All Amounts
Employee Payroll Contributions Will Be Taken Out Once Per Month for Accident, Critical Illness, and Hospital Care.
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Pet Insurance 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.
Accident & Illness Coverage For the unexpected
• 90% reimbursement • $500 deductible • $40,000 annual limit • Includes lost pet recovery service and 24/7 pet telehealth
Rates based on your pet's age, breed & zipcode.
Wellness Coverage For regular routine visits Essential Plan Up to $300 in coverage $14/month Premium Plan Up to $575 in coverage $25/month
Coverage is based on a schedule of benefits outlined during enrollment
Get a quote & enroll at www.wishboneinsurance.com/nordea
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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. Fidelity Retirement Plan
23
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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
https://www.metlife.com
Life Insurance/ AD&D/STD/LTD Voluntary Benefits (CI/Accident/ Hospital Indemnity)
Guardian
800-268-2525
www.guardiananytime.com
Guardian
800-268-2525
www.guardiananytime.com
Voluntary Life
Guardian
800-525-4542
www.guardiananytime.com
HSA: 866-346-5800 FSA: 877-924-3967
FSA, DCA, Transit, HSA
HealthEquity/ Wage Works
https://my.healthequity.com/ ClientLogin.aspx
https://www.unum.com/ support/employees/contact-us
Long-Term Care
Unum
866-679-3054
Legal Services
MetLife
800-821-6400
members.legalplans.com
Pet Insurance
Wishbone
800-887-5708
wishboneinsurance.com
Retirement Benefits
Fidelity
800-890-4015
www.401k.com
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Legal 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 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.
2024-2025 Benefit Summary
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COBRA Legal Notices
** 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.
2024-2025 Benefit Summary
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COBRA Legal Notices
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.
2024-2025 Benefit Summary
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COBRA Legal Notices
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.
2024-2025 Benefit Summary
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Legal Notices
MEDICARE PART D
Important Notice from Nordea Bank 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 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 has determined that the prescription drug coverage offered by the Nordea Bank 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 coverage will not be affected. If you do decide to join a Medicare drug plan and drop your current Nordea Bank coverage, be aware that you and your dependents may not be able to get this coverage back.
2024-2025 Benefit Summary
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Legal 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 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 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).
Name of Entity/Sender: Nordea Bank Abp, NY Branch Contact – Position/Office: Janet, Chin, Head of People Address: 1211 Avenue of Americas, 23rd Floor, New York, NY 10036
2024-2025 Benefit Summary
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