Your Employee Benefits at Cold Spring Harbor Laboratory (CSHL)
• Definitions • Medical Benefits and Contributions • Dental Benefits and Contributions • Vision Benefits and Contributions • Life and AD&D Benefits and Rates • Other CSHL Benefits • Contacts
Effective January 1, 2024
Contents
Introduction
3
Definitions
4
Benefit Eligibility
4
Your Medical Benefits and Contributions
6
Your Dental Benefits and Contributions
8
Your Vision Benefits and Contributions
9
Your Life and AD&D Benefits
10
Optional Life and Voluntary AD&D Rates
11
Other CSHL Benefits
12
Key Contacts
16
Legal Notices
17
2
Introduction
This employee benefits guide highlights various benefit plans offered at Cold Spring Harbor Laboratory (CSHL). As you look to make decisions regarding medical benefits for you and your family, you should be aware that the available medical plans provide you access to one of the country’s largest provider networks, United Healthcare (UHC). You also have the freedom to select any provider in their network without obtaining a referral. The UHC network includes many top- tier specialist hospitals such as Memorial Sloan Kettering Cancer Center (MSK), St. Francis Hospital, and Hospital for Special Surgery. CSHL remains committed to providing excellent health coverage for our employees. As part of that commitment, we continuously monitor the health plans to ensure an appropriate balance between coverage and cost. In 2023, the operating costs for our health plans were substantially costlier than in previous years that it necessitated our administration to reevaluate and modify the health plans that we currently offer. We have been able to maintain consistent levels of employee cost-sharing (copays, deductible and coinsurance) for many years, at this time we have no other option but to share some of these costs with employees. Following are an example of how the UHC Choice Tiered will be changing.
Type of Procedure
Where Procedure is Performed
Freestanding Facility
Hospital-based Center
In-Network Doctor’s Office
95% after a $250 per occurrence deductible 95% after a $250 per occurrence deductible 20% after satisfying a $400 annual deductible 20% after satisfying a $400 annual deductible
Scopic Procedures Outpatient
5%*
$20/$35 copay, then 100%*
Outpatient Surgery
5%*
$20/$35 copay, then 100%*
Outpatient Lab/ X-Ray
5%*
$20/$35 copay, then 100%*
CT Scans, PET Scans, MRI, MRA & Nuclear Medicine
5%*
$20/$35 copay, then 100%*
*No Deductible
These are difficult but necessary decisions to safeguard the financial strength of the Laboratory while continuing to offer health plans that meet the needs of our employees. As you look to decide which plan best meets your needs, please take the time to review the various plan details and research doctors on the UHC provider network on www.uhc.com. We have included the following definitions section to assist you in understanding the information throughout this guide.
3
Definitions
United Healthcare (UHC) developed the United Health Premium designation program, which recognizes physicians that meet guidelines for providing quality and cost efficient care. These physicians are designated as Premium Tier 1 and are displayed publicly on myuhc.com and in UHC’s physician directory. The program uses national industry standards to evaluate for quality and local market benchmarks for cost efficiency across 25 specialties, including family practice, internal medicine, pediatrics, cardiology, and orthopedics. The fact that a doctor does not have a quality designation does not mean that the doctor does not provide quality health services. All doctors who are part of the UHC network must meet UHC’s standard credentialing requirements. Medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible amount was paid. A cost-sharing arrangement in which a covered person pays a specified charge for a specified service, such as $20 for an office visit. The covered person is responsible for payment at the time the health care is rendered. Our co-payments are fixed amounts for physician office visits, prescriptions, or hospital services for which the patient is responsible to pay. DED is a portion of the benefits, under a policy, that the employee and dependents must satisfy before any reimbursement occurs. This is called the individual deductible. A dental health maintenance organization (DHMO) is a structured type of dental plan. In this type of plan, a set group of dentists provides broad and affordable care at a low monthly pre- mium. The dentists who work with DHMOs receive a fixed fee each month. Most of the work is done at no cost or for a reduced price. You may need to make a copayment for some types of work. You will need to choose a primary dentist to work with and you must let Cigna know if you want to change your dentist. There are no waiting periods, calendar year maximums, deductibles, or claim forms when you have a DHMO plan. Your dependent child can remain covered under your health plan through the end of the month in which s/he turns 26 regardless of marital or student status or if they have access to an employer-sponsored plan. However, under the Dental Plan, your unmarried child can re- main on the plan through the end of the month in which s/he turns 22 or through the end of the month in which s/he ceases being a full-time college student, up to age 26. Each August, you will be required to provide supporting documentation that your unmarried child over age 22 is a full-time student. OOP is the portion of payments for covered health services required to be paid by the member, including co-payments, deductibles, and coinsurance. The OOP maximum is the maximum amount of co-payments, deductibles, and coinsurance that the member will have to pay each calendar year. Once the OOP maximum has been met, the plan will pay 100% of covered medical expenses for the remainder of the calendar year. A primary care physician or primary care provider (PCP) is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. This can be a physician in general practice, family practice, pediatrics, internal medicine, or gynecology. This is a term used to refer to the commonly charged or prevailing fees for health services within a geographic area. A fee is considered to be reasonable if it falls within the parameters of the average or commonly charged fee for the particular service within that specific community. It creates a maximum that is allowed for a particular service based on the geographical area and the charges for the same service within that area. This data is collected and compiled, and an R&C/UCR amount is determined.
Tier 1 Provider
Co-Insurance
Co-Payment
DED: Deductible
Dental Health Maintenance Organization (DHMO)
Dependent Child(ren)
OOP: Out-of-Pocket
PCP: Primary Care Provider
R&C: Reasonable and Customary or
UCR: Usual and Customary and Reasonable:
4
Definitions continued
To help you better understand your health plan, the Affordable Care Act (ACA) requires insurers and group health plans to provide a new way to show benefits and define health care industry terms. These required documents are called the Summary of Benefits and Coverage, or SBC. The goal of the SBC is to help you more easily compare health plans so you can choose the one that’s right for you. SBCs are provided in a standard format, which may only be different based on the specific benefits offered by each plan. The summary plan descriptions (SPDs) are important documents that tell participants what plans provide and how they operate in greater detail. They provide information on when an employee can begin to participate in a plan, how services and benefits are calculated, when and in what form benefits are paid, and how to file a claim for benefits. SPDs can be found on the Human Resources Intranet. If you are unable to print an SPD, please contact the Benefits Office at 516-367-5027 to obtain a free copy of an SPD. A freestanding facility is an outpatient, diagnostic, or ambulatory center or independent laboratory that performs services and submits claims as a freestanding entity and not as a hospital. An alternate facility is a healthcare facility that is not a hospital and that provides one or more of the following services on an outpatient basis, as permitted by law: surgical services; emergency health services; and/or rehabilitative, laboratory, diagnostic, or therapeutic services. An alternate facility may also provide mental health services or substance use disorder services on an outpatient basis or inpatient basis (for example, a residential treatment facility). A place of service that is owned by a hospital and provides services that are billed under the tax idenitifcation number of the hospital. Virtual care visits are interacting with a designated virtual visit network provider using live video, audio, and instant messaging to communicate with their patients remotely.
SBC: Summary of Benefit Coverage
SPD: Summary Plan Description
Freestanding Facility
Alternate Facility
Hospital-based services/facility
Virtual Care Visits
Benefit Eligibility
Eligibility Information As an employee working 30 hours or more per week, you and your eligible dependents qualify for Medical, Dental, Vision, and Life/ AD&D Insurance benefits. If your spouse or domestic partner has access to group coverage through his or her own employer, they are not eligible for CSHL medical/vision and/or dental benefits. Special enrollment rules apply if you are married to another CSHL employee or graduate student. Making Changes During the Year Generally you can only change your benefit elections during the annual benefits Open Enrollment period. A change is permitted when you experience any IRS Qualifying Life Event (QLE), such as marriage, divorce, birth, or adoption. You must notify Human Resources within 31 days of any QLE to make changes. Otherwise, you’ll have to wait until the next Open Enrollment period. Any changes you make to your benefit choices must be directly related to the QLE. Proof of the change will be required (example: a marriage license or birth certificate). When Coverage Ends All benefits end on your last day of work. However, under certain circumstances, you may continue your health care benefits through COBRA Insurance.
5
Your Medical Benefits and Contributions
CSHL health plans are administered by United Healthcare (UHC). Medical Insurance United Healthcare Choice Tiered Plan
Choice Plus Plan
Member pays:
Member pays:
Medical Benefits
In-Network Out-of-Network
In-Network
Out-of-Network
Preventive Services
No charge
No coverage
No charge
30% after DED
PCP/Specialist Office Visit: Tier 1 PCP/Specialist Office Visit: Non-Designated
$20
No coverage
$40
30% after DED
$35
No coverage
$40
30% after DED
Physical Therapy
$20 $50
No coverage No coverage No coverage
$20 $50
30% after DED 30% after DED
Urgent Care Facility
Emergency Room
$150
$150
$150
Deductible (DED) : Single/ Family (calendar year)
$400/$800
No coverage
$600/$1,300
$1,000/$2,400
Coinsurance
See below
No coverage
30%
30%
Inpatient Hospital Outpatient Surgery:
5% - No DED No coverage
$1,000
30% after DED
Alternate Facility
5% - No DED No coverage $250 co-pay per occurrence – 5% No coverage
30% after DED 30% after DED
Hospital Based
30% after DED 30% after DED
Laboratory Services:
Alternate Facility
5% - No DED No coverage 20% after DED No coverage
30% after DED 30% after DED 30% after DED 30% after DED
Hospital Based
Radiology Services:
Alternate Facility Hospital Based
5% - No DED No coverage 20% after DED No coverage
30% after DED 30% after DED 30% after DED 30% after DED
Out-of-Pocket Maximum $3,500/$7,000
No coverage
$3,500/$7,000
$5,000/$10,000
Prescription Drug Benefits – Tier 1 / Tier 2 / Tier 3
Retail (up to 31 days)
$10/$35/$55 $20/$70/$110
No coverage No coverage
$10/$35/$55 $20/$70/$110
$10/$35/$55 No coverage
Mail Order (up to 90 days)
Specialty Drugs
Need to be obtained through OptumRx
Employee Monthly Pre-Tax Contributions Choice Tiered Plan Full-Time Choice Tiered Plan Part-Time
Choice Plus Plan Full-Time
Choice Plus Plan Part-Time
Employee Only
$136.50
$209.50
$320.00
$400.00
Employee+Spouse/Domestic Partner
$266.00
$408.50
$639.50
$799.50
Employee + Child(ren)
$230.00 $401.50
$354.00 $618.00
$611.00 $943.00
$763.50
Employee + Family $1,179.00 For more information on your plan benefits please see your Summary of Benefits Coverage (SBC) and/or Summary Plan Description (SPD) which can be found on the HR Intranet. To locate Tier 1 network providers, or to access the Prescription Drug List, visit www.myuhc.com.
6
Real Appeal: Weight Loss Program Real Appeal is a weight loss and healthy lifestyle program available to employees, spouses/domestic partners and dependents 18 and older enrolled in our UnitedHealthcare insurance with a body mass index (BMI) of 23 or greater. It is available at absolutely no cost to you. You obtain your very own Transformation Coach who guides you through the program step-by-step. Your coach works with you to customize the program to your needs, your personal preferences, your individual goals, and your medical history. Real Appeal’s approach is simple, smart, and helps you make small changes that you can easily live with for lasting weight loss results. Real Appeal puts you on the right track to preventing diseases such as hypertension and type 2 diabetes. By participating, you will receive a Real Appeal Success Kit delivered to your home address containing tools to assist you with your weight loss – all at no cost to you. This Success Kit contains such items as a Real Success guide outlining the program, a nutrition guide, a Real Moves Guide, and DVDs providing you with fitness tips and exercise programs for all fitness levels, an electronic body weight scale, a food scale portion plate and more. You have access to the program for a full 52 weeks. So whether you’re losing, maintaining, or looking to lock in your results, you have all the support and motivation you need. You can join using your smartphone, tablet, or personal computer at http://cshl.realappeal.com. Bend Health Recognizing the importance of having access to quality, supportive mental health care for children and families, Cold Spring Harbor Laboratory has arranged for access to Bend Health to benefits-eligible employees enrolled in one of our United Healthcare plans beginning January 1, 2024. Their unique collaborative care model includes coaches, therapists, and psychiatric providers who work with your entire family to provide comprehensive, personalized care plans that help your child (ages 1 to 26) feel better today, and thrive tomorrow. Bend Health can address mental health issues including but not limited to: parenting support, LGBTQIA+ affirming care & support, sleep issues, behavioral concerns, ADHD, depression, anxiety, OCD, trauma/PTSD, neurodiversity (autism), body image, self-harm, suicidal ideation, substance abuse. One Pass Select As a United Healthcare member you and your eligible family members (18+) have access to One Pass Select, a complete subscription-based fitness and well-being network that supports a healthier lifestyle. There are several membership tiers to choose from starting at just $10.00 per month (digital on-line only), and you can change tiers monthly. Enjoy unlimited multi-location access to gyms and studios, such as Planet Fitness, Pure Barre, Orangetheory Fitness and CrossFit, anywhere in the country within your membership tier. No contracts, pay month to month. Sign-up is easy and convenient – log into your www.myuhc.com profile to create an account. Cancel anytime with 30-days advance notice of the next billing cycle. Hinge Health offers innovative virtual physical therapy programs for back, knee, hip, neck, shoulder, feet, and ankle pain to benefits-eligible employees, graduate students, and 18+ dependents enrolled in a CSHL medical plan. The program takes as little as 45 minutes per week, easily fitting into your schedule anytime and anywhere. Once enrolled in the program, you’ll receive the Hinge Health Welcome Kit, which includes a tablet computer and wearable motion sensors that guide you through exercise therapy. You’ll also be paired with your personal health coach who will be with you every step of the way and will tailor the program to your specific needs. Best of all, Hinge Health’s programs are provided at no cost to you and your eligible dependents. For more information, please visit http://intranet.cshl.edu/administration/human-resources/hinge-health Hinge Health
7
Your Dental Benefits and Contributions
Dental Insurance CSHL Dental coverage is provided by Cigna.
Cigna DENTAL PREFERRED PROVIDER ORGANIZATION (DPPO) $50 (Individual)/ $150 (Family)
DENTAL HEALTH MAINTENANCE ORGANIZATON (DHMO)*
Deductible (Calendar Year)
None
Deductible Waived for Preventative Care
Yes
N/A
Progressive Annual Maximum Benefit
$3,000**
Unlimited
Dental Services
Amount of Coverage
In-Network
Out-of-Network
DHMO* In-Network Copay Range
Preventative (cleanings, x-rays, etc.) Basic Services (fillings, etc.) Major Services (implants, dentures, etc.)
100%
100% of the UCR***
$0
80% 50%
80% of the UCR*** 50% of the UCR***
$0-335.00
$410.00-$875.00
Orthodontia
50% (for dependents up to age 19)
50% of the UCR*** (for dependents up to age 19)
$2,184 (children)**** $2,904 (adults)****
Orthodontia Lifetime Maximum
$2,500
N/A
Employee Monthly Pre- Tax Contributions
DPPO
DHMO
Full-Time
Part-Time
Full-Time
Part-Time
Employee Only
$10.50 $20.00
$11.00 $22.50
$0 $0
$2.00 $5.00
Employee + Spouse/ Domestic Partner Employee + Child(ren) Employee + Family
$22.00 $31.00
$25.00 $37.00
$0 $0
$5.50 $8.50
For more information, or to locate network providers, before you are enrolled in a Cigna dental plan visit www.Cigna.com or call the Cigna dental Pre-Enrollment line at (800) 564-7642. If you utilize a participating Cigna dentist, you just need to provide your Social Security number or your Cigna ID number to the dentist, and the dentist can electronically obtain your eligibility, benefit coverage, and file claims. If you want to obtain a dental ID card or view your claims, register at www.myCigna.com or download the myCigna mobile app. After you are enrolled in a Cigna plan, you can call (800) 244-6224 to gain help in finding an in-network dentist, information on specific plans, and claims questions. Please note: when you enroll in the DHMO plan, you are required to select a primary dentist prior to receiving services and your selected dentist will manage all of your dental care needs. Again, you may visit www.MyCigna.com to select this provider or call Cigna’s 24/7/365 customer service line at (800) 244-6224 *Cigna DHMO provider network is limited. **Regular dental care helps members maintain good oral health and assists in avoiding future major & expensive treatment. DPPO members who go for their annual dental preventive services (oral exam & cleaning), will have $100 added to their Calendar Year Maximum for the following year. This continues year over year, to a maximum increase of $300 per member. ***You are responsible for 100% of the charges that exceed the Usual, Customary and Reasonable (UCR) charges for the geographic and dental services you receive. ****Additional fees may be applied.
8
Your Vision Benefits and Contributions Vision Insurance CSHL Vision coverage is provided by EyeMed. Must be enrolled in a United Healthcare plan to be enrolled in either the Core or the Buy-Up plan.
EyeMed
Core
Buy-Up Vision*
In-Network Member Cost
Out-of-Network Reimbursement
Out-of-Network Reimbursement
Vision Benefits
In-Network Member Cost
Exam (once per 12 months)
$10 copay
up to $35
$10 copay
up to $35
$0 copay, 20% off balance over $175 allowance
Frames (once per 12 months) 35% off retail cost
N/A
up to $75
Lenses (once per 12 months)
Single
$50 copay
N/A
$25 copay
up to $25
Bifocal
$75 copay
N/A
$25 copay
up to $35
Trifocal
$105 copay
N/A
$25 copay
up to $50
Standard Progressive
N/A
N/A
$90 copay
up to $35
$90 copay, 20% off retail cost, less $120 allowance
Premium Progressive
N/A
N/A
up to $35
Contact Lenses (once per 12 months; in lieu of a complete set of glasses)
$0 copay, 15% off balance over $175 allowance $0 copay, 100% of balance over $175 allowance
Conventional
15% off retail cost
N/A
up to $140
Disposable
N/A
N/A
up to $140
Monthly Contributions
Employee Only
$4.85
All United Healthcare enrollees will be covered automatically under the EyeMed Core Plan. The Lab pays 100% toward the cost of this plan.
Employee + Spouse/ Domestic Partner Employee + Child(ren)
$9.46
$9.68
Employee + Family
$15.27
* EyeMed Buy-Up Vision plan includes an annual routine eye exam and allowance toward lenses, contacts and frames once every 12 months with copayment.
For more information, or to locate network providers, visit www.enrollwitheyemed.com and choose “Select” from the provider locator dropdown box.
9
Your Life and AD&D Benefits
Life Insurance
CSHL Life and Accidental Death & Dismemberment (AD&D) coverage is provided by SunLife.
SunLife
Basic Accidental Death & Dismemberment (AD&D) Insurance *
Basic Life Insurance*
Benefit (Full-time employees)
2x your base annual salary, to a maximum of $1,000,000
Benefit (Part-time employees)
1x your base annual salary, to a maximum of $1,000,000
1x your base annual salary, to a maximum of $1,000,000 If you are paid in whole or in part by a grant that is paid directly to you, you will be provided with $50,000 coverage. Age 70 but not age 75: reduced to 65% of your insurance coverage Age 75 but not age 80: reduced to 45% of your insurance coverage Age 80: reduced to 30% of your insurance coverage
Benefit (Post Docs)
Reduction Schedule
Employee Optional Life Insurance
Benefit
1 - 5x base annual salary, to a maximum of $600,000
Guaranteed Issue**
The lesser of 3x salary or $300,000 Spouse/Domestic Partner (DP)/Dependent Child(ren) Optional Life Insurance
$10,000 to $100,000 in $10,000 increments, not to exceed 100% of employee’s Basic Life benefit
Spouse/DP Benefit
Guaranteed Issue**
$20,000 $10,000
Child Benefit
Reduction Schedule
N/A Voluntary Accidental Death and Dismemberment
Employee Only
1 - 10x base salary to a maximum of $600,000
Spouse/DP & Children: Spouse benefit amount would be equal to 40% of your VAD&D benefit and 10% for each child Spouse/DP Only: Benefit amount would be equal to 50% of your VAD&D benefit Children Only: Benefit amount would be equal to 15% of your VAD&D benefit
Family Protection Plus
*Both Basic Life and AD&D insurance plans paid by CSHL. ** The Guaranteed Issue is only available as a new hire or when you become newly benefits eligible. All other enrollments or increases in Optional Life insurance (employee and/or spouse/DP) will require a Statement of Health to be approved by SunLife before increases become effective.
10
Optional Life and Voluntary AD&D Rates Please see the table below for the cost of Optional Life and Voluntary AD&D coverage organized by employee and spouse banded rates and child rates.
Monthly Rates per $1000 of Covered Volume
Optional Life Rates
Age Range
Employee Rate
Spouse Rate
Ages 15-19
$.05
$.04
Ages 20-24
$.05
$.04
Ages 25-29
$.06
$.06
Ages 30-34
$.08
$.07
Ages 35-39
$.09
$.08
Ages 40-44
$.10
$.10
Ages 45-49
$.15
$.15
Ages 50-54
$.23
$.27
Ages 55-59
$.43
$.43
Ages 60-64
$.62
$.76
Ages 65-69
$1.25
$1.29
Ages 70-74
$1.88
$2.15
Ages 75-79
$3.02
$2.15
Ages 80+ Child rate:
$4.89
$2.15
$.85 Voluntary Accidental Death & Dismemberment
Employee Only:
$.016
Family Protection Plus:
$.029
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Other CSHL Benefits Your benefits program offers ways to help you reduce your out-of-pocket expenses. You can set aside pretax dollars from your paycheck to pay for certain health care, dependent care, and transit expenses, reducing your taxable income: • Health Care Flexible Spending Account (HFSA) • Dependent Care Flexible Spending Account (DFSA) -You must re-elect the Health Care and Dependent Care FSA each Open Enrollment • Transitchek Smart Ways to Save
Health Equity/WageWorks Health Care Flexible Spending Account* Annual Minimum Contribution: $240 Annual Maximum Contribution: $3,200 Health Care Eligible Expenses**
• Copayments, deductibles, and coinsurance • Medical, dental, vision, hearing and certain prescription drugs expenses not covered by your plan(s) • Special services and equipment for the disabled Over-the-Counter (OTC) medicines are not eligible FSA expenses unless prescribed by a doctor Dependent Care Flexible Spending Account Annual Minimum Contribution $240 Annual Maximum Contribution: $5,000 Dependent Care Eligible Expenses** • Covers expenses for child(ren) (under age 13) or adult care necessary to allow you and your spouse to work or your spouse to attend school full-time • Child or adult daycare obtained through in-home care centers, before and after school care, or summer day camp programs Transitchek Monthly Contribution Maximum: $315 This program allows you to pay for NY Metro-area commuting costs using pre-tax dollars, to purchase TransitChek cards or MetroCards for use on the LIRR, NYC subway and bus system, PATH, MetroNorth, NJ Transit and more.
*If enrolled in the HFSA, you will receive a health care card from Health Equity/WageWorks which you can use at time of purchase instead of filing a reimbursement claim. **Go to www.wageworks.com for a complete list of eligible health care and dependent care expenses.
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Other CSHL Benefits Continued Retirement Plans
CSHL 401(a) Retirement Plan • Employees who are at least 21 years of age and employed on a regular basis with 1,000 hours of service a year for 2 consecutive years are eligible for participation. • For eligible employees, the Laboratory currently contributes the equivalent of 9.3% of your annual salary up to the social security (FICA) taxable wage base ($168,600 in 2024), and 15% of your annual salary above that figure to an annual salary maximum set by the IRS ($345,000 in 2024). For Postdoctoral and CSHL Fellows, the Laboratory currently contributes the equivalent of 1% of salary. • Participants are 100% immediately vested in the contributions made by the Laboratory. • The retirement plans are administered by Fidelity Investments. Participants may select from a variety of mutual funds in which to invest. You can view or change your investments by contacting Fidelity Investments. CSHL 403(b) Plan You may contribute to the 403(b) Plan with pre-tax contributions, Roth Contributions or a combination of both. Pre- tax contributions are not taxed when you contribute to the Plan but those contributions, and any related earnings, are taxable upon withdrawal. Roth Contributions, on the other hand, are made with after-tax dollars so they are not taxed when you withdraw them from the Plan. Earnings on Roth contributions are also not taxed when they are withdrawn from the Plan provided your withdrawal is a qualified distribution (as long as it has been five tax years since your first Roth 403(b) contribution and after you are age 59½ or on account of you being disabled, or to your beneficiary after your death). The 2024 IRS limit for the 403(b) Plan is $23,000*, and the additional catch-up contribution for employees aged 50 and over is $7,500, which is a cumulative maximum that applies to all employer-sponsored plans (e.g., 401(k), 403(b), 457(b), etc.) to which you contributed in 2024. It should be noted that the limit applies to both pre-tax and Roth contributions. If you decide to change your contribution, you must make the change via ESS. If you do not make any changes, your current contribution amount will carry forward into 2024. You may also change your contribution amount and contribution type (pre-tax, Roth, or both) at any time during the year via ESS. Beneficiaries - Retirement Plans, Life Insurance and AD&D Plans A beneficiary is an individual or entity that will receive all or a portion of the proceeds of an account in the event you should pass away. Naming a beneficiary for your retirement savings and life insurance plan(s) and keeping them up to date is important. Beneficiary designations will bypass other legal documents, such as last will and testament, or divorce decree. Maintaining current beneficiary designations eliminates any question as to whom you wish to be the recipient of your life insurance policy(ies) and retirement account(s), prevents any delay in the transfer of account funds, and helps to ensure the financial security of your loved ones. Remem- ber, major life events, such as marriage, divorce, or the birth of a child are a good time to revisit your benefi- ciary designation. Retirement Plans - You may review and update your beneficiary designation directly with Fidelity Invest- ments and/or TIAA- CREF by simply logging into your profile with the respective provider. Fidelity: https://nb.fidelity.com/public/nb/default/home TIAA: https://www.tiaa.org/public/index.html If you have questions you may contact Fidelity at 1.800.343.0860 or TIAA at 1.800.842.2776.
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Other CSHL Benefits Continued
Life Insurance and Accidental Death & Dismemberment Plans - Click here to download a SunLife Beneficiary Designation Form. Submit the original completed, signed and dated form to Human Resources/Luke Building.
Accident Insurance - The Hartford An accident can happen to anyone, and recovery can be costly. Your medical insurance may pick up most of the tab, but leave you with out-of-pocket expenses that add up quickly. Accident insurance can help ease the unplanned financial burden by complementing other insurance you may have, including medical and disability coverage. As medical costs continue to rise, this additional layer of financial protection may make a difference at a time when you and your family need it most. Accident Insurance provides cash benefit(s) direct to you for a covered injury and related services , which are independent from any claims or coverage provided by your medical insurance. You can use the payment in any way you choose – from expenses not covered by your medical plan to day-to-day costs of living such as the mortgage or your utility bills. Coverage Level Monthly Cost Employee Only $7.94 For more information please visit: Income Protection Cold Spring Harbor Laboratory (CSHL) provides income protection to benefits-eligible employees earning a salary through the Short-Term Disability Salary Continuation Plan, and the Long Term Disability Plan (LTD). The Short- Term Disability Salary Continuation Plan is fully funded by CSHL. You have the option to have CSHL pay for your LTD premiums or you can elect to pay for your own LTD premiums through post-tax payroll deductions. At the time you go out on LTD, there will be a 3-year look back evaluation to determine the % of premium that was paid for by CSHL versus the % of premium that was paid for by you. If in the 3 years prior to the disability you have paid for all the premiums, the LTD benefit will be tax-free. If in the 3 years prior to disability CSHL has paid for all the premiums, the LTD benefit will be taxable. If in the 3 years prior to disability it is a combination of how payments were made. The amount of LTD payments that will be taxable will be determined by the % of premium that was paid for by CSHL.
www.thehartford.com/employeebenefits
Employee and Spouse/Domestic Partner
$12.50
Customer Service: 1-800-523-2233, M-F 8am-8pm ET
Employee and Child(ren)
$13.10
Email: GBD.Customerservice@hartfordlife.com
Employee and Family
$20.65
Identity Theft Protection We offer IdentityForce, an identity (ID) theft protection plan which delivers ongoing monitoring, rapid alerts, and recovery services to help protect against ID theft. For more information, visit https://intranet.cshl.edu/human- resources/benefits/voluntary-benefits/identity-theft-protection/ MSK Direct We have arranged with Memorial Sloan Kettering (MSK) to offer a benefit called MSK Direct – a program that offers guided access to exceptional cancer treatment for all our employees and their family members. The MSK Direct team includes experienced nurses, social workers, and Care Advisors who promptly connect patients with cancer specialists at MSK – one of the top hospitals for cancer care in the country – while providing practical and emotional support along the way. There is no extra charge to use MSK Direct and enrollment in the program is automatic – there is no need to sign up. MSK Direct does not change any of your other health benefits. Patients are responsible only for standard out-of-pocket costs (such as insurance co-pays, coinsurance, and deductibles) for the medical services received from MSK. To speak with an MSK Direct representative, call the dedicated toll-free member line at 1-844-506-0589.
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Other CSHL Benefits Continued
Wellbeats Cold Spring Harbor Laboratory has arranged for all benefits-eligible employees and graduate students free access to Wellbeats. Wellbeats is an on-demand fitness wellbeing benefit to inspire you to stay healthy and feel better than ever. Whatever your goal, Wellbeats fitness and wellbeing challenges can help you reach your goals easier and faster than ever. No matter where you are on your fitness journey, Wellbeats has a starting place for you with exclusive access to 700+ workouts, nutrition and mindfulness classes. Your enrollment in the program is automatic, and is effective the next calendar quarter following your hire date (e.g. If you are hired on 2/14/XX, you will be enrolled in the program 4/1/XX). Once you become eligible, be on the lookout for an email from support@wellbeats.com with your login and password. Your Wellbeats account can be shared at no cost with up to five people in your life (must be at least 14 years of age). Wellness Programs Maternity Support Program -The Maternity Support Program is available to United Healthcare members. The program provides expectant mothers with continuing assistance and advice throughout their pregnancy. If you join the program (Call 1-888-246-7389) within your first trimester and complete the program, CSHL will reimburse you 5% up to a maximum of $500 ($250 for graduate students) towards your in-patient hospital cost. Please provide a copy of your hospital invoice to the Benefits Department in Luke for reimbursement Colonoscopy - Having a colonoscopy can be an inconvenient two day task, which can potentially save your life. CSHL allows you a paid wellness day off for you to have a preventative colonoscopy or for you to take your spouse/domestic partner (covered under your United Healthcare plan) for a preventative colonoscopy. To be eligible for the day off, you will need to provide a note from your doctor with the date of the exam to the Benefits Department in Luke. Mammogram - CSHL provides transportation and arranges appointments each quarter at Zwanger-Pesiri in Plainview for mammograms. Participants who are enrolled in a UHC also receive a $25.00 gift card.
As you go through life, you may be faced with health, personal, family, or work- related challenges. Now there is a resource that can help you sort things out - United Healthcare’s Optum. This service offers information and resources that can help you and your family identify and resolve problems affecting emotional and physical health. Optum is staffed by a team of friendly, registered nurses and Master’s level counselors who can assist with a wide range of problems - all at no cost to you. You may contact Optum at 1-866-248-4094. Optum Behavioral Health has a substance use helpline available for all employees, graduate students, dependents, and even non-members. The substance use treatment helpline is an anonymous channel that provides a direct link to an expert team of licensed Optum Care Advocates who are available 24/7 to listen and provide both information and decision support. The Optum Care Advocate will help you understand substance use disorders (SUDs) and potential interventions/ treatment options available to you and/or your family member. Support is available to you, the member, during the care- and post- care process. The Optum Care Advocates also play an essential role in supporting the families of those in treatment. The Advocates provide guidance for coping with emotional distress, as well as building family participation strategies that will support the long-term recovery of the loved one. Long-term recovery strategies include: a direct channel to skilled clinicians for members or caregivers in need; expert decision support regarding treatment options and risks associated with going out of network for care; facilitation of expedited help for substance abuse disorders within the local community. The Substance Use Treatment Helpline is (855) 780-5955.
Employee Assistance Program (EAP) - Optum
Substance Use Treatment Helpline
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Other CSHL Benefits Continued
Operated by Northwell Health, the Center offers a wide range of services to help ensure your health and well-being. To serve your needs, the Center is staffed five days a week by a nurse practitioner to provide confidential health and wellness services. It is located at Dolan (East Wing, Room 111) and is available to CSHL benefits eligible employees and students for: • Blood pressure, glucose, and cholesterol screenings • Treatment of minor injuries and illnesses • Preventive care services and referrals • Ongoing wellness programs • Prescriptions You may contact the SightMD Center for Health and Wellness at 1-516-422-4422. Operated by Northwell Health, the Center also offers free psychological counseling. Counseling services are provided by NYS licensed behavioral health consultants. Contact the Center at 516-422-4422 for hours and to schedule a confidential appointment. Counseling services are also available after 5 PM Monday through Friday, and 24 hours/day on weekends. Call 1-877-327-4968 and the service will have the on-call consultant contact you. For life threatening emergencies, you should call 911 or go to the nearest emergency room. The MetLife Legal Plan provides you with easy access to a network of more than 9,300 carefully selected, experienced attorneys nationwide who can provide you with a wide range of services. You have unlimited access to our attorneys for all legal matters covered under the plan. For a monthly premium conveniently paid through payroll deduction, an expert is on your side as long as you need them. Employee monthly post-tax rate: $18 AIG provides covered travelers with emergency medical and travel assistance, concierge support and other services 24 hours a day - worldwide. One phone call connects you to our network of multilingual specialists for immediate help with medical, personal, and travel problems when away from home.
The SightMD Center for Health and Wellness
The SightMD Center for Health and Wellness: On-Site And After Hours Counseling Services
MetLife Legal
AIG Travel Assistance
To register visit www.aig.com/us/travelguardassistance and reference policy #9157107.
Key Contacts
The contact list below should help connect you with our providers’ customer service representatives. They can best answer your questions and furnish other information to help you utilize your benefits most effectively. In addition, you can contact the CSHL Benefits Office for further support and assistance as needed. Important Contacts
Benefit Providers Contact Information Medical - United Healthcare
Phone Number
Website/ Email
(866) 633-2446 (844) 506-0589 (800) 244-6224
www.myuhc.com
Bend Health
https://www.bendhealth.com
Dental - Cigna
www.mycigna.com
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Key Contacts (continued)
Vision - EyeMed
(866) 723-0513
www.eyemedvisioncare.com
Flexible Spending Accounts - Health Equity/WageWorks
(855) 774-7441
www.wageworks.com
TransitChek
(800) 622-5000 (800) 343-0860
www.transitchek.com
403(b) and 401(a) - Fidelity Substance Abuse Treatment Helpline - United Healthcare Employee Assistance Plan (EAP) - Optum
www.fidelity.com/atwork
(855) 780-5955
www.myuhc.com
(866) 248-4094
www.myuhc.com
MetLife Legal
(800) 821-6400 (877) 244-6871 (800) 295-0136
www.legalplans.com
AIG Travel Assistance
www.aig.com/us/travelguardassistance
Identity Force
www.identityforce.com
The SightMD Center for Health and Wellness
(516) 422-4422
cshlwellness@northwell.edu
Hinge Health
(855) 902-2777
help@hingehealth.com
Optum Rx
(877) 644-9386
http://www.myuhc.com/
CSHL Benefits Staff
Phone Number
ccava@cshl.edu
Camille Cava
(516) 367-5033
Andres Alarcon
(516) 367-5011
alarcon@cshl.edu
Teri Zagar
(516)-367-5027
tzagar@cshl.edu
Laura Magri
(516)-367-5226
lmagri@cshl.edu
About This Guide
These plans were designed to provide you with a competitive benefit package. We hope to continue the plans indefinitely; however, the Laboratory reserves the right to change, modify, or discontinue these plans at any time, without notice. This guide summarizes important provisions of your benefits, but it does not provide all the details of the plan. These can be found in the official plan documents. The language of the plan documents control in cases requiring a legal interpretation of the plan. If there is any difference between the plan documents (as in effect at the relevant time) and information in this guide, your rights will be based on the provisions of the plan documents. However, changes in applicable law may require operational changes that affect your rights even before a formal amendment to the plan is adopted or this guide is revised; we will make every reasonable effort to apprise employees of any such changes as they become effective. You may obtain a copy of any of the plan documents from Camille Cava, the Senior Benefits Manager.
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Notice of Enrollment Rights
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, as per IRS regulations (under Section 125), you cannot change your benefit choices until the next annual enrollment unless you have a qualifying “Life Event.” You may in the future be able to enroll yourself or your dependents in the CSHL benefit plans, provided that you request enrollment and submit the required paperwork and supporting documentation within 31 days after your other coverage ends. In addition, if you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment and submit the required paperwork and supporting documentation within 31 days after the marriage, birth, adoption or placement for adoption. CSHL will request appropriate documentation to substantiate dependent eligibility. CSHL reserves the right to amend or terminate your benefit elections, seek recovery for overpayments of benefits, as well as applying disciplinary action to the extent information is found to be falsified or incorrect.
Women’s Health and Cancer Rights of 1998 (WHCRA)
As required by the Women’s Health and Cancer Rights Act of 1998 (WHCRA), benefits are provided for mastectomy, including reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy (including lymphedema). If you receiving benefits in connection with a mastectomy, benefits are also provided for the following covered health services, as you determine appropriate with your attending physician: • All stages of reconstruction of the breast on which the mastectomy was performed; • Surgery and reconstruction of the other breast to produce a symmetrical appearance; • Prostheses; and • Treatment of physical complications of the mastectomy, including lymphedema. The amount you must pay for such covered health services (including copayments, coinsurance and any annual deductible) and the benefit coverage limitations are the same as are required for any other covered health service as described in your Summary Plan Description (SPD). Please call the Benefits Office at 516-367-5011, 516-367-5226, 516-367-5027, or 516-367-5033 if you would like more information.
Newborns’ and Mothers’ Health Protection Act
Under Federal law, group health plans and health insurance issuers offering group health insurance coverage generally may not 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 delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g. your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier.
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Also, under Federal law, plans and issuers may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. In addition, a plan or issuer may not, under Federal law, require that a physician or other health care provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours).
Important Notice from United Healthcare 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 United Healthcare and prescription drug coverage available for people with Medicare. It also explains the options you have under Medicare prescription drug coverage and can help you decide whether or not you want to enroll. At the end of this notice is information about where you can get help to make decisions about your prescription drug coverage. 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plans that offer prescription drug coverage. All Medicare prescription 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. United Healthcare has determined that the prescription drug coverage offered by the Cold Spring Harbor Laboratory Welfare Benefit Plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay and is considered Creditable Coverage. Because your existing coverage is on average at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay extra if you later decide to enroll in Medicare coverage. Individuals can enroll in a Medicare prescription drug plan when they first become eligible for Medicare and each year from November 15th through December 31st. Beneficiaries leaving employer/union coverage may be eligible for a Special Enrollment Period to sign up for a Medicare prescription drug plan. You should compare your current coverage, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. If you do decide to enroll in a Medicare prescription drug plan and drop your United Healthcare prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back. In addition, your current coverage pays for other health expenses in addition to prescription drugs. You cannot drop United Healthcare’s prescription drug coverage without dropping the entire medical plan. You should also know that if you drop or lose your coverage with United Healthcare and
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