2023 Annual Enrollment: October 3–21
CHOOSE WELL Healthy decisions start here.
MEDICAL & PRESCRIPTION
HEALTH PLAN PREMIUMS
You have two medical plan options for health care coverage: the Traditional Health Plan (THP) and the High-Deductible Health Plan (HDHP).
WEEKLY PREMIUM
1 TOBACCO-FREE CREDIT
2 TOBACCO-FREE CREDITS
THP
Associate Only
$51.45
$39.45
N/A
Associate + Spouse
$103.95
$91.95
$79.95
Features included in both plans: • One ID card for both medical and prescription coverage • Majority of medical premiums paid by Averitt on your behalf
The Traditional Health Plan (THP) covers many office visits and prescriptions with a flat copay, including labs, X-rays, ultrasounds and surgeries performed and billed by the physician’s office. Simply pay your copay, and the plan will cover the rest of the cost. The High-Deductible Health Plan (HDHP) has a higher deductible and lower weekly rates than the THP. When you enroll in this plan, you can open an HSA and set aside tax- free dollars to pay your out-of-pocket medical, prescription drug, dental and vision expenses. You also receive HSA contributions from Averitt, and any unused HSA funds carry over from year to year.
Associate + Child(ren)
$71.40
$59.40
N/A
Family
$127.05
$115.05
$103.05
WEEKLY PREMIUM
1 TOBACCO-FREE CREDIT
2 TOBACCO-FREE CREDITS
HDHP
• In- and out-of-network coverage • Individual and family deductibles • Coinsurance • Out-of-pocket maximums
Associate Only
$42.00
$30.00
N/A
Associate + Spouse
$85.05
$73.05
$61.05
Associate + Child(ren)
$56.70
$44.70
N/A
Family
$101.85
$89.85
$77.85
• In-network access to the BlueCard PPO network, a group of doctors that BCBS works with to provide care at a discount • Teladoc virtual medical care • Coverage for 30-day and 90-day prescription supplies Both plans are also “embedded,” which means that an individual covered under a family plan will not pay more than the individual deductible and the individual out-of- pocket maximum. However, the family’s medical costs may be combined to meet the family deductible and out-of- pocket maximum.
Weekly premiums are deducted pre-tax , saving you even more money. $12 weekly credit applies to associate and spouse each for non-tobacco use in 2023.
Quick tips to help you continue to choose well, all year long.
Using a provider in the BlueCard network means you’ll pay less for care. If you use an out-of-network provider, you will not only pay the most for care, but you may even receive an additional bill from the provider for the difference between their charge and what the Averitt plan pays (balance billing). Be aware that your network provider might use an out-of-network provider for some services, such as lab work, so check with your provider before you receive services. 90-day prescriptions are often less expensive and can even be delivered straight to your home through Express Scripts. However, keep in mind that certain specialty and brand-name prescriptions may need authorization from your physician before you can fill them.
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HIGH-DEDUCTIBLE HEALTH PLAN (HDHP)
TRADITIONAL HEALTH PLAN (THP)
Benefits at a glance
Benefits at a glance
OUT-OF-NETWORK BENEFITS Annual Individual Deductible
IN-NETWORK BENEFIT Lifetime Maximum
IN-NETWORK BENEFIT Lifetime Maximum
OUT-OF-NETWORK BENEFITS Annual Individual Deductible
$4,000
UNLIMITED
UNLIMITED
$6,000
$11,000
Annual Individual Out-of-Pocket Maximum
$2,000
$3,000
$13,100
Annual Individual Deductible
Annual Individual Deductible
Annual Individual Out-of-Pocket Maximum
$8,000
Annual Family Deductible
$5,500
$6,550
$12,000
Annual Individual Out-of-Pocket Maximum
Annual Individual Out-of-Pocket Maximum
Annual Family Deductible
$22,000
Annual Family Out-of-Pocket Maximum
$4,000
$6,000
$26,200
Annual Family Deductible
Annual Family Deductible
Annual Family Out-of-Pocket Maximum
40% after deductible
$11,000
$13,100
Annual Family Out-of-Pocket Maximum
Annual Family Out-of-Pocket Maximum
40% after deductible
Providers/Facilities
Providers/Facilities
IN-NETWORK COPAYS Teladoc
IN-NETWORK COPAYS Teladoc
PRESCRIPTION BENEFITS**
PRESCRIPTION BENEFITS**
$0
$55
$45
Primary Care Office Visit
Primary Care Office Visit
Retail Prescription (30-Day Supply) Generic
Retail Prescription (30-Day Supply) Generic
$60
Specialist Office Visit
Specialist Office Visit Urgent Care (Clinic) Office Visit Diagnostic X-Ray & Labs IN-NETWORK PHYSICIAN SERVICES Office Services (X-rays, labs, surgeries)*
20% after deductible
$20 copay
$70
Urgent Care (Clinic)
20% after deductible Preferred Brand Nonpreferred Brand Specialty Retail or Mail Order Prescription (90-Day Supply) Generic
$40 copay
Preferred Brand
Office Visit Diagnostic X-Ray & Labs
$0 after copay
$80 copay
Nonpreferred Brand
IN-NETWORK PHYSICIAN SERVICES Office Services (X-rays, labs, surgeries)*
$40 or $80 copay , based on tier
Specialty
included in copay
20% after deductible
$0
Allergy Injections
Allergy Injections Routine/Preventive Care Routine Gynecological Care Mammograms
Retail or Mail Order Prescription (90-Day Supply) Generic $40 copay Preferred Brand $80 copay Nonpreferred Brand $160 copay
$0
Routine/Preventive Care
20% after deductible
Preferred Brand Nonpreferred Brand
$0
Routine Gynecological Care and/or Mammograms
$0
$0 for preventive
20% after deductible (available in 30-day supply only)
$0
Cardiac Stress Test
$0 after deductible
(available in 30-day supply only)
Cardiac Stress Test
Specialty
Specialty
IN-NETWORK HOSPITAL SERVICES Emergency Room Care
IN-NETWORK HOSPITAL SERVICES Emergency Room Care Inpatient Hospital Services Outpatient Diagnostic High-Tech Radiology All Other Outpatient Services
$500
Note: This is a summary of your coverage only. In-network services are based on negotiated charges; out-of-network services are based on reasonable and customary (R&C) charges. *Sometimes not all services performed in a doctor’s office are BILLED by the doctor’s office, so you should always ask at the time of service what charges may be billed separately. **Refer to InsideAveritt.com to see a full list of preventive generic medicines covered at 100%.
Inpatient Hospital Services
Note: This is a summary of your coverage only. In-network services are based on negotiated charges; out-of-network services are based on reasonable and customary (R&C) charges. *Sometimes not all services performed in a doctor’s office are BILLED by the doctor’s office, so you should always ask at the time of service what charges may be billed separately. **Refer to InsideAveritt.com to see a full list of preventive generic medicines covered at 100%.
20% after deductible
Outpatient Diagnostic High-Tech Radiology
20% after deductible
To see how much your prescriptions may cost through either plan, review our list of medications at InsideAveritt.com/benefits and click on the Express Scripts link.
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HEALTH & WELLNESS RESOURCES
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Unlimited phone support Talk to a licensed professional counselor or work/life specialist over the phone. Compassionate professionals are there to listen, help you define your issues and put you in touch with expert resources in your community for additional support. To reach a counselor 24/7, call 800-854-1446 . Three free in-person counseling sessions When phone support isn’t enough, you or a family member can take advantage of three in-person visits per issue with a licensed professional counselor, included at no additional charge with your EAP. Your counselor will provide short- term support and advice and help you find local resources for ongoing care, if necessary.
Health Advocate , provided by Unum, is our EAP benefits manager. EAP services are available to all associates even if you’re not enrolled in our benefits. Our EAP offers free, confidential services to help you and your family members with a wide range of issues, such as: • Relationship and parenting concerns
Virtual Medical Care through Teladoc Teladoc is the newly expanded 24/7 virtual care service that includes phone or video
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appointments available within about 10 minutes. You can use this option for non-emergency health issues, such as sinus problems, respiratory infections, allergies, flu symptoms, cold, cough, sore throat, rashes and many other illnesses. When you access Teladoc through your BCBS plan, it is no cost to you if you’re enrolled in the THP. There is a $55 fee if you’re enrolled in the HDHP. Receive care for non-emergency medical issues when it’s convenient for you: • On nights, weekends and holidays, or any time your doctor or pediatrician is not available • When you are out on the road and need medical care Activate your account at bcbst.com > My Health & Wellness, or call BCBST at 833-377-9371.
• Stress, anxiety and depression • Legal and financial questions • Referrals for child care and elder care • Management of your finances • Substance use • Travel assistance
Healthy discounts with Blue365 Save money on a variety of health and wellness products and services. • Exercise equipment and gym memberships • Healthy eating and nutrition
Tobacco Cessation Program Breaking free from nicotine dependence is not the only reason to quit smoking – cigarette smoke contains more than 7,000 toxic chemicals that can cause serious health problems, numerous diseases and death. When you quit smoking, you can: • Decrease your risk of lung cancer and other cancers, heart attack, stroke, and chronic lung disease • Enjoy a longer life • Reduce your risk of having a low birth weight baby if you are pregnant Remember that chewing tobacco and e-cigarettes present their own health hazards. The best option is to quit altogether!
For online resources or to connect to your EAP, visit healthadvocate.personaladvantage.com.
• Travel and hotels • Clothes and shoes • Hearing and vision services
Blue365 Deals are different than the health care benefits you have with BlueCross BlueShield and can help you maintain a healthy lifestyle. Helping Babies Grow Healthy & Strong If your baby has been admitted to the neonatal intensive care unit (NICU) or the special care nursery, BlueCross BlueShield is there for you. The NICU Management Program can provide support during your hospital stay, after you’re discharged and through your baby’s first birthday.
Access all of these resources by calling 833-377-9371 or visiting bcbst.com.
*For children over the age of 36 months and adults. Teladoc is an independent third-party service provider. Providers are solely responsible for any treatment provided. Teladoc may not be available in all areas. See your plan materials for costs and details of plan coverage.
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FLEXIBLE SPENDING ACCOUNT (FSA)
HEALTH SAVINGS ACCOUNT (HSA)
What is an HSA? If you enroll in the HDHP, you can use a health savings account (HSA) to pay medical, prescription drug, dental and vision expenses not covered by your Averitt plans with tax-free dollars. To be eligible for the HSA, you must not be enrolled in any other insurance coverage except for a qualified HDHP.
Four advantages of an HSA
What is an FSA? A flexible spending account (FSA) allows you to set aside money from your paycheck to pay health care or dependent care expenses with tax-free dollars. If you choose to participate in the Health Care or Dependent Care FSA, you must re-enroll every year. Who is eligible? Associates enrolled in the THP can participate in a Health Care FSA and a Dependent Care FSA. Associates enrolled in the HDHP can participate in the Dependent Care FSA only. Associates not enrolled in either of our medical benefits are eligible for both FSAs. Four advantages of an FSA 1. LOWER TAXES The amount you choose to contribute is deducted from each paycheck before income taxes and Social Security taxes are calculated. This reduces the amount of taxes you pay. 2. ABILITY TO PAY EXPENSES WITH TAX-FREE DOLLARS As you have eligible expenses, you can be reimbursed from your accounts with tax-free dollars. 3. HEALTH CARE FSA FUNDS AVAILABLE IMMEDIATELY The total amount you choose to contribute to your Health Care FSA is available at the beginning of the year. You can spend the dollars in your Dependent Care FSA as they are deposited each pay period. 4. $500 ANNUAL ROLLOVER IN HEALTH CARE FSA You can roll over up to $500 in unused funds in your Health Care FSA at the end of the year if you re-enroll for the following year. The Dependent Care FSA is a use-it-or- lose-it account.
ANNUAL CONTRIBUTION LIMITS
ELIGIBLE EXPENSES
ACCOUNT
1. IT’S FREE MONEY The company will contribute $10 per week if you choose individual coverage or $20 per week if you enroll with family members. 2. IT’S CONVENIENT Use your HSA now, or save it for later – even for health care expenses after you retire. The money in your HSA belongs to you. It rolls over each year, and you can take it with you if you change jobs.
Medical, dental and vision expenses, including glasses, contact lenses, prescription medications and orthodontia Day care for children under age 13 or elder care expenses so you and your spouse can work or attend school full time
• $2,850 per year • Minimum:
Health Care FSA
$5 per week
• $5,000, or $2,500 if
WEEKLY AVERITT CONTRIBUTION
married and filing separate tax returns
Dependent Care FSA*
ASSOCIATE ONLY
$10.00
ASSOCIATE + SPOUSE
$20.00
• Minimum:
3. IT OFFERS TRIPLE TAX ADVANTAGES • Pay no taxes on money you contribute • Pay no taxes on interest you earn • Pay no taxes when you withdraw money
$5 per week
ASSOCIATE + CHILD(REN)
$20.00
EXAMPLE **
With FSA Without FSA
FAMILY
$20.00
$50,000
$50,000
Your taxable income
4. IT ALLOWS YOU TO CONTRIBUTE TOO You can make additional pre-tax contributions to your HSA through payroll deductions. Total Averitt and associate contributions combined cannot exceed these annual IRS limits in 2023: • $3,850 for single coverage • $7,750 for family coverage If you are age 55 or older, you can make an additional $1,000 catch-up contribution.
Pre-tax contribution to the Health Care FSA and the Dependent Care FSA
$2,000
$0
Federal and Social Security taxes*
$15,696
$16,350
After-tax dollars spent on eligible expenses Spendable income after expenses Savings with the Health Care FSA and the Dependent Care FSA
$0
$2,000
$32,304
$31,650
$654
N/A
*The Health Care FSA can be used to pay for eligible medical expenses for yourself, your spouse and any dependents you claim on income taxes. The Dependent Care FSA can be used for nonmedical child care (under age 13) and elder care. **This is an example only and may not reflect your actual experience. It assumes a 25% federal income tax marginal rate and a 7.7% FICA marginal rate. State and local taxes vary and are not included in this example. However, you will save on any state and local taxes as well.
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Dental benefits administered by Delta Dental Regular dental visits certainly play a role in helping you and your family Live Well. Good dental care helps prevent or treat periodontal disease – a primary cause of tooth loss in people of all ages, according to the U.S. Department of Health and Human Services. We offer two dental plans administered by Delta Dental : the Standard Plan and the Maximum Plan. The plans differ in the type of care covered and what you pay for services. You may see any dentist, but when you use a Delta Dental provider, you’ll save money and you won’t have to file any claims. Both plans cover two complete exams annually. DENTAL
Vision benefits administered by VSP Like any other health factor, your vision requires regular care. Our vision plan helps you and your family Live Well by keeping you seeing clearly. We offer two vision plans administered by VSP : the Standard Plan and the Maximum Plan. The plans differ in the type of care covered and what you pay for services. You may see any provider, but when you use a VSP network provider, you’ll save money and you won’t have to file any claims. Both vision plans pay 100% for an annual eye exam. The Standard Plan provides additional benefits for eyeglass lenses and contact lenses. The Maximum Plan also provides benefits for frames. You can get frames once every calendar year on the Maximum Plan, and standard progressive lenses are covered in full on the Standard Plan. Both plans include allowances for contact lenses and full coverage for retinal imaging after a $10 copay. VISION
DENTAL BENEFITS*
STANDARD PLAN MAXIMUM PLAN
VISION BENEFITS*
STANDARD PLAN
MAXIMUM PLAN
DIAGNOSTIC AND PREVENTIVE SERVICES Oral exams and routine cleaning (two per year), X-rays (one bitewing per year, one full mouth every three years), and fluoride treatments (two per year, to age 19) BASIC SERVICES Oral surgery, anesthesia, fillings, extractions, endodontia and periodontia MAJOR SERVICES AND ORTHODONTIA** Crowns, cast restorations, fixed bridgework, dentures and orthodontia (to age 19)
Plan pays 100%*
Plan pays 100%*
EYE EXAM (One exam each calendar year)
Plan pays 100%*
Plan pays 100%*
EYEGLASS LENSES* • Single vision, lined bifocal, lined trifocal lenses • Anti-reflective coating • One pair each calendar year
• $25 copay • Polycarbonate lenses (children only) • Standard progressive lenses
• $15 copay • Polycarbonate lenses (adults and children) • All progressive lenses One pair each calendar year; annual allowance of $180**
Plan pays 50%
Plan pays 80%
FRAMES
No coverage
Plan pays 50%
Plan pays 50%
CONTACT LENSES** • Allowance for contact lenses and contact lens exam (fitting and evaluation) • 15% savings on exam fees (up to $60 copay) • Each calendar year
$150 annual allowance**
$180 annual allowance**
ANNUAL BENEFIT MAXIMUM
$1,500
$2,000
ORTHODONTIA LIFETIME MAXIMUM
$1,500
$2,000
YOUR WEEKLY PAYROLL DEDUCTION
STANDARD PLAN MAXIMUM PLAN
RETINAL IMAGING
$10 copay
$10 copay
ASSOCIATE COVERAGE
$3.45
$5.50
ESSENTIAL MEDICAL EYE CARE Additional exams and services beyond routine care to treat immediate issues from pink eye to sudden changes in vision or to monitor ongoing conditions, such as dry eye, diabetic eye disease, glaucoma and more
ASSOCIATE + SPOUSE COVERAGE
$7.65
$12.40
$20 copay*
$20 copay*
ASSOCIATE + CHILD(REN) COVERAGE
$8.45
$13.20
ASSOCIATE + FAMILY COVERAGE
$11.60
$16.15
YOUR WEEKLY PAYROLL DEDUCTION
STANDARD PLAN
MAXIMUM PLAN
Weekly premiums are deducted pre-tax , saving you even more money. *See Summary Plan Description (SPD) for further details. **New enrollees will be subject to a 12-month waiting period for major services and orthodontia.
ASSOCIATE COVERAGE
$3.00 $3.35 $3.55 $5.10
$4.70 $7.30 $7.50
ASSOCIATE + SPOUSE COVERAGE ASSOCIATE + CHILD(REN) COVERAGE ASSOCIATE + FAMILY COVERAGE
$10.10
Weekly premiums are deducted pre-tax , saving you even more money. *See Summary Plan Description (SPD) for further details. **You may obtain contacts or eyeglasses every year (but not both in the same year).
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LIFE INSURANCE
VOLUNTARY BENEFITS
Averitt provides company-paid basic life Insurance for part-time Flex Force associates. This means that you are covered by a $10,000 policy at absolutely no cost to you! Make sure you keep the beneficiary designation for your life insurance up to date. If you need help or have questions about doing that, contact our Benefits Team at 800-233-9944 , option 3.
In addition to medical, dental and vision coverage, you also have the option to select various voluntary benefits, including whole life, accident, hospital confinement, cancer and critical illness insurance. These options are available through both the online and telephonic enrollment process.
Voluntary benefits offered by
TYPE OF INSURANCE
AVAILABLE TO
AVERITT-PROVIDED LIFE INSURANCE
Provides benefits for injuries resulting from covered accidents, such as fractures, burns and lacerations, as well as for doctor’s office or emergency room visits, ambulance charges, X-rays, and physical therapy. Helps offset the covered out-of-pocket medical and indirect, nonmedical expenses related to cancer, including benefits for diagnosis and treatment. This coverage also provides a benefit for specified cancer- screening tests. Supplements your major medical coverage by providing a lump-sum benefit that you can use to pay the direct and indirect costs related to a covered critical illness, such as heart attack (myocardial infarction), end-stage renal failure, coronary artery bypass surgery, stroke or major organ transplant. Provides an annual health screening benefit for covered tests. Cancer benefit is optional at an additional cost. Provides a lump-sum benefit for a covered hospital confinement or a covered outpatient surgery to help cover copayments and deductibles that are not covered by most major medical plans. Provides death benefit coverage that you can increase or decrease as your needs change. The policy builds cash value on a tax-deferred basis at current interest rates, and premium payments are flexible.
Associate, spouse and children
$10,000
Associate Basic Life Insurance
ACCIDENT INSURANCE
Associate, spouse and children
CANCER INSURANCE
Associate, spouse and children
CRITICAL ILLNESS INSURANCE
Associate, spouse and children Associate, spouse and children
HOSPITAL CONFINEMENT INDEMNITY INSURANCE
WHOLE LIFE INSURANCE
NOTE: Policies have limitations and exclusions that may affect benefits payable. Ask your Colonial Life Benefits Counselor for complete details. In New York, Colonial Voluntary Benefits are underwritten by the Paul Revere Life Insurance Company.
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1415 Neal Street, P.O. Box 3166, Cookeville, TN 38502-3166
This brochure is intended only to be an overview of the Averitt Express benefits plans. The complete details about the plans and how they work are included in the Summary Plan Descriptions (SPDs) and plan documents, which are available upon request. SPDs are also available online at InsideAveritt.com . If there are any inconsistencies between this brochure and the plan documents, the plan documents will govern. Averitt Express is committed to providing competitive benefits programs to its associates. At the same time, we must manage our business carefully and be in a position to change the way we operate, including our benefits plans, when we determine necessary. Therefore, Averitt retains the right to amend, change or end one or more of the benefits plans at any time.
968791-FLEX 08/22
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