2017 Benefits at a Glance
PLAN YEAR:
January 15, 2014 – December 31, 2014
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Our Mission
AMIkids is a non-profit organization dedicated to helping youth develop into responsible and productive citizens. AMIkids’ mission is to protect public safety and positively impact as many youth as possible through the efforts of a diverse and innovative staff. AMIkids works in partnership with youth agencies, local communicates and families.
CONTENTS & CONTACT INFORMATION
Refer to this list when you need to contact one of your benefit vendors. For general information contact the AMIkids Affiliated Programs Benefits Department.
AMIKIDS BENEFITS DEPARTMENT Brandie Holjes & Matt Frye
813-887-3300 bholjes@amikids.org or msf@amikids.org
M.E. WILSON COMPANY - BENEFITS PARTNER Katie Reeves, Cindy Buttrill, or Jeff Lenderman
813-229-8021 kreeves@mewilson.com
MEDICAL & PRESCRIPTION
page 3
Medical : Blue Cross Blue Shield
1-800-830-1501 www.MyHealthToolkitFL.com
Prescription : OptumRX
1-800-334-8134 www.Optumrx.com/myCatamaranrx
HEALTH SAVINGS ACCOUNT page 7 Optum Bank 1-866-234-8913 www.OptumBank.com DENTAL page 8 Blue Cross Blue Shield 1-800-222-7156 www.MyHealthToolkitFL.com
VISION
page 9
Blue Cross Blue Shield (EyeMed network)
1-866-723-0513 www.MyHealthToolkitFL.com
LIFE, SHORT-TERM & LONG-TERM DISABILITY page 10&12 United Healthcare
1-888-299-2070 www.myuhc.com
VOLUNTARY BENEFITS page 14-15 United Healthcare
1-888-299-2070 www.myuhc.com
403(B) page 13 Fidelity (Group #64688) 1-800-343-0860 www.Fidelity.com/atwork EMPLOYEE ASSISTANCE PROGRAM page 11 United Healthcare 1-877-660-3806 www.liveandworkwell.com
HOW TO ENROLL page 17 Web Benefits Design 1-888-639-8077 www.mybensite.com/amikids
DISCLOSURE NOTICES
page 20
BENEFIT INFORMATION
Benefit
Who pays the cost?
Medical Insurance
AMIkids pays roughly 75% towards your cost on Plan 1 / Base H.S.A. Plan.
YOUR BENEFITS PLAN
AMIkids pays about 59% towards your cost on the Base PPO Plan.
Dental Insurance
AMIkids offers a variety of benefits allowing benefit eligible employees the opportunity to customize a benefits package that meets your personal needs. In the following pages, you’ll learn more about the benefits offered. You’ll also see how choosing the right combination of benefits can help protect you and your family’s health and finances – and your family’s future. AMIkids has not raised the employee’s cost for employee coverage on medical, dental or vision for FOUR YEARS IN A ROW!
Vision Insurance
AMIkids offers vision coverage on a voluntary basis.
Basic Term Life Insurance
AMIkids pays 100% of the cost for Basic Term Life coverage.
AMIkids offers you the option to purchase additional term life insurance for yourself, as well as life insurance for your spouse and/or child(ren).
Voluntary Term Life Insurance
Short Term Disability (STD)
See benefits page for more on the voluntary offer of STD and eligibility specifics for the employer sponsored benefit.
Long Term Disability (LTD)
AMIkids offers LTD coverage on a voluntary basis.
Voluntary Benefits
AMIkids offers a variety of voluntary benefits.
AMIkids provides eligible employees entry to the pension plan. As well as the ability to contribute pre-tax dollars into a 403(b) retirement savings account.
Pension and Retirement Plan
ELIGIBILITY
Eligible employees are those averaging 30 hours worked per week. Newly eligible employee’s benefits will become effective on the 1 st of the month following 60 days of eligible employment status.
You may also enroll your dependents in the Benefits Plan when you enroll.
Eligible dependents include:
Your legal spouse
•
• You or your spouse’s child who is under age 26, including natural children, step-children, legally adopted children, a child placed for adoption or any other children for whom you or your spouse are legal guardian • A child who is or becomes disabled and is dependent upon you before reaching age 26 • A child for whom health care coverage is required through a Qualified Medical Child Support Order or other court or administrative order. Please verify all dependents meet the definition of qualified dependent. Initial and periodic audits requesting proof of qualified dependent status may be conducted . You are financially responsible for any claims incurred on the plan by a dependent who does not meet eligibility requirements.
WHEN CAN YOU ENROLL?
You MUST enroll within 60 days of your new hire date. Otherwise you must wait until the next annual open
enrollment period, unless you experience a qualifying event.
If you have a qualifying event, you MUST notify AMIkids of the event within 31 days of a qualified family-status change.
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BENEFIT INFORMATION
?
CHOOSING YOUR BENEFITS
WHY DO I PAY FOR BENEFITS WITH BEFORE-TAX MONEY?
Your portion of the cost of benefits is automatically taken out of your paycheck. There are two ways that the money can be taken out:
There is a definite advantage to paying for some benefits with before-tax money:
• BEFORE YOUR TAXES ARE CALCULATED – Medical, Dental, Vision, H.S.A and 403(b) contributions
Taking the money out before your taxes are calculated lowers the amount of your pay that is taxable. Therefore, you pay less in taxes.
• AFTER YOUR TAXES ARE CALCULATED – Life, Disability and Worksite Benefits
MAKING CHANGES
Generally, you can only change your benefit choices during the annual benefits enrollment period. However, you may be able to change your benefit choices during the plan year if you have a qualifying life event, such as:
Your marriage
• Change in your spouse’s work status that affects his or her benefits
•
Your divorce or legal separation
• Change in your work status that affects your benefits
•
Birth or adoption of an eligible child
• Change in your child’s eligibility for benefits
•
• Death of your spouse or covered child
• Receiving Qualified Medical Child Support Order (QMCSO)
You must enter a life event via www.mybensite.com/amikids and notify AMIkids Benefit Department, in writing, within 31 days of the qualifying event. At this time you will also be required to provide appropriate documentation.
WHEN COVERAGE ENDS
Coverage will stop on the last day of the month in which employment with the company ends, you no longer meet the eligibility requirements, a covered dependent no longer meet the eligibility requirements, the plan ends, and/or failure to make required contributions outside payroll deductions (ex: on leave of absences).
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MEDICAL & PRESCRIPTION INSURANCE
AMIkids offers medical coverage through Blue Cross Blue Shield for the 2017 plan year. The plan year runs from May 1 st , 2017 – April 30 th , 2018. AMIkids contributes about 75% of the cost for employee coverage on Plan 1 / Base H.S.A. You are responsible for the additional cost associated with buying up to another plan and / or adding dependent(s) on the plan. AMIkids has maintained the employee’s cost for employee coverage on Plan 1 / Base H.S.A. for the past 3 years with no increase and is REDUCING premiums for the 2017 plan year (4 years in a row with no increase!) The chart below provides an overview of the medical plan offered This chart is intended only to highlight the benefits available and should not be relied upon to fully determine your coverage. If the below illustration of benefits conflicts in any way with the Summary Plan Description (SPD), the SPD shall prevail. It is recommended that you review the exact description of services and supplies that are covered, those which are excluded or limited, and other terms and conditions of coverage .
Plan 1 HDHP / Base H.S.A (unchanged from 2016)
Plan 2 Copay / Mid Copay (new for 2017)
Plan 3 Copay / Premium Copay (new for 2017)
IN-NETWORK
Embedded *
Embedded *
Embedded *
* Please see bottom of page 4 (next page) for explanation of Embedded
DEDUCTIBLE (your first dollar cost for covered in-network claims) Deductible (Individual / Family) $2,600 / $5,200
$2,500 / $5,000
$1,500 / $3,000
COINSURANCE (your responsibility on claims costs once you’ve met the deductible) 20% 20% OUT OF POCKET MAXIMUM (once met all in-network covered services are covered by the plan) Maximum Out-of-Pocket (Individual / Family) $5,000 / $10,000 $5,000 / $10,000
20%
$4,500 / $6,850
Maximum Includes
Deductible, Coinsurance, Prescription Costs & Copays
PREVENTIVE CARE Wellness, Immunizations, Mammography, Colonoscopy, etc.
Covered 100%, no cost to you
OFFICE VISITS
Referral Required
No
Teladoc Virtual Visits
$25 copay after deductible
$25 Copay
$25 Copay
Office Visits (Illness/Injury)
20% after deductible
$50 Copay
$35 Copay
Specialist Visits
20% after deductible
$75 Copay
$60 Copay
HOSPITAL SERVICES Inpatient Hospital
20% after deductible
20% after deductible
20% after deductible
Outpatient Surgery
20% after deductible
20% after deductible
20% after deductible
Emergency Room
20% after deductible
$350 Copay
$350 Copay
Urgent Care
20% after deductible
$100 Copay
$100 Copay
DIAGNOSTIC TESTING Lab, X-Ray, Advanced Imaging (MRI, CAT, PET, etc.)
20% after deductible
20% after deductible
20% after deductible
PRESCRIPTIONS
Medical deductible first, then
Retail (30 day supply) Tier 1 / 2 / 3 / 4
$10 / $35 / $60
$10 / $50 / $80 / $100
$10 / $35 / $60
Medicare (Part D) Creditable
No
Yes
Yes
OUT-OF-NETWORK 1 Deductible
1 Charges are subject to balance billing
$7,500 / $15,000
$7,500 / $15,000
$3,000 / $6,000
Coinsurance
50%
50%
50%
Out of Pocket Maximum
$15,000 / $30,000
$15,000 / $30,000
$9,000 / $18,000
WHAT ARE TELADOC VIRTUAL VISITS?
They allow you to see and talk to a doctor from your cell phone, tablet or computer regarding non-emergency medical conditions like the flu, pink eye, rashes and fever. These visits are subject to your deductible but are typically at a lesser cost than an office visit. A way to SAVE TIME AND MONEY!
3
HOW TO FIND IN-NETWORK PROVIDERS
To utilize your benefits you want to seek services from in-network doctors and facilities. You can search and locate in- network providers by visiting www.MyHealthToolkitFL.com and following the below instructions.
Go to www.MyHealthToolkitFL.com and click on the highlighted field
Enter the name of the provider you wish to search and/or the desired location and/or the specialty.
Choose “Show me only doctors and hospitals in my Plan” and enter the alpha prefix EQO in the field that pops up.
NEW LAB!?!?! YES!
As of May 1 st , 2017 LabCorp will no longer be your preferred lab.
At this time you should seek services from Quest Diagnostics.
DOES ANYONE UNDERSTAND THIS STUFF?
YOU WILL IN A SECOND….
STARTING WITH THE BASICS (KEY TERMS)
Deductible ? See “deductible”, think DISCOUNT! Once you’re enrolled in medical, you're a Blue Cross Blue Shield member. Because you’re a member you get the discounted rate with all in-network providers and facilities! This discount is typically 50%-70% off the amount charged to someone without insurance. Coinsurance is cost-sharing. The cost-sharing “kicks in” AFTER you meet the deductible. Even though you’ve met your deductible, you still get the discounted rates! On the medical summary chart you can see coinsurance is 20%. When you have coinsurance, you pay 20% of that discounted rate and the plan pays the rest!
Copayment (aka Copay) – A flat fee that you pay for medical services and/or prescriptions. On Plan 1 you do not have copays with the exception of prescriptions and virtual visits, though you must meet your medical deductible prior to having copays for prescriptions and virtual visits.
Out of Pocket Maximum _ drum roll please _ This is the maximum amount you will pay in deductible costs, coinsurance and copays during the policy year.
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YES PLEASE, MORE INFORMATION
To understand how plans work, you can break it down into three phases….
PLAN 1
Phase 1
You’re responsible to pay the first dollar costs for medical services and prescriptions (Rx) until you meet your deductible.
Phase 2
So you’ve met the deductible. Now coinsurance kicks in for all medical services and copays apply to Rx. That’s right, you’ll pay 20% of the cost for medical services and the plan pays the rest! You’ll pay the copay for Rx and the plan pays the rest!
Phase 3
You’ve got a maximum out-of-pocket. This amount is an accumulation of the deductible, coinsurance, and copays. Once all these costs add up to the max out-of-pocket the plan will pay 100% of all in-network, covered medical services and Rx for the rest of the policy year. Yep, you read that right.
PLAN 2 & PLAN 3
You pay the copay amount for day to day services, as stated on page 3. Your deductible applies to these additional services. Once you meet your deductible your coinsurance will “kick in”, you pay 20% of the cost and AMIkids pays 80% of the cost of the claim. The amounts you pay towards your deductible, in coinsurance, copay amounts, and prescription copays apply to your out-of-pocket maximum.
GOT THAT. WHAT NOW?
EMBEDDED V.S. NON-EMBEDDED?
An Embedded plan means that for family coverage, each family member is only responsible for the individual deductible and individual max out-of-pocket. BUT the family as a whole will never exceed the family deductible and family max out-of-pocket.
Yes, this means that if one member reaches the deductible, they will go into coinsurance. If they meet their max out-of- pocket they will be covered 100%, even if no one else in the family has met the deducible.
All three of the AMIkids Medical Plans for 2017 have Embedded deductibles, but just in case you’re interested in what happens in a Non-Embedded plan. . .
On a Non-Embedded plan, if you have one of more covered dependents, either a single family member OR an accumulation of the family is responsible for the family deductible before you have coinsurance. Ultimately, if you have non-embedded plan AND dependent (spouse and/OR child(ren)) coverage, the individual amounts will not apply to you.
Yes, this means that one family member may be responsible for the entire family deductible. Once the family deductible is met all covered members will be covered under coinsurance.
5
ENOUGH INFO, WHAT’S IT GOING TO COST ME?
SALARY RANGE: LESS THAN $35,000
Cost for Coverage Amounts shown are per pay check ( 24 payments/year )
Plan 1 / Base H.S.A
Plan 2 / Mid Copay
Plan 3 / Premium Copay
Employee Only
$ 50.44 $ 141.29 $ 117.85 $ 185.77
$ 104.12 $ 238.93 $ 214.41 $ 338.09
$ 109.62 $ 251.80 $ 225.90 $ 356.23
EE
Employee + Spouse
ES
Employee + Child(ren)
EC
Employee + Family
FAM
SALARY RANGE: MORE THAN $35,000
Cost for Coverage Amounts shown are per pay check ( 24 payments/year )
Plan 1 / Base H.S.A
Plan 2 / Mid Copay
Plan 3 / Premium Copay
Employee Only
$ 59.21 $ 168.39 $ 140.24 $ 221.60
$ 110.14 $ 257.51 $ 229.76 $ 362.66
$ 115.64 $ 270.39 $ 241.25 $ 380.80
EE
Employee + Spouse
ES
Employee + Child(ren)
EC
Employee + Family
FAM
REMINDER: If you sign up for the H.S.A eligible plan (only Plan 1 is H.S.A. eligible) AMIkids WILL GIVE YOU $500, pro-rated, in your open and active H.S.A. Of course you have to open the account and keep it open to get the money!
6
HEALTH SAVINGS ACCOUNT (H.S.A)
When you’re enrolled in a qualified High Deductible Health Plan (HDHP) you and you employer can contribute to your H.S.A account. What are the perks?
ELECTING PLAN 1?
CONGRATS, you’re eligible for an H.S.A! Congrats again because AMIkids is giving you $500 in your H.S.A . This gift will be pro-rated , thus deposited into your account throughout the year. All you have to do is open an H.S.A with Optum Bank and keep it active. Visit their website to open 1 of the 3 account options available.
• Your contributions are pre-tax . • Money rolls over year to year, you never lose it.
• It’s owned by you . The account and money in it are yours to keep whether you retire, come off the group plan, or leave. • It’s easy to use ! Optum Bank sends you a H.S.A card when you open an account. The card is just like a debit card, simply swipe the card when you want to use the funds.
Maximum Contribution Limits* 2016 2017
If you do not open the account and keep it active AMIkids cannot deposit the money for you. Easiest $500 you’ve ever made!
Single Coverage
$3,350
$3,400
Family Coverage $6,650
$6,750
* Individuals who are age 55 or older may contribute an additional $1,000 per year .
ELIGIBLE EXPENSES INCLUDE (but are not limited to):
• Alcohol & drug dependency treatment • Artificial Teeth • Acupuncture & Chiropractic services
• Hearing aids & batteries for use • Hospital, Surgical, lab & X-Ray fees • Long-term care (medical expenses & premiums) & Nursing home • Physical & speech therapies • Smoking-cessation programs & products
• Dental expenses (exams, X-rays, root canals, bridges, etc.) • Diagnostic devices (blood sugar test kits for diabetics) • Prescription drugs • Eyeglasses, exams, laser eye surgery, Contact lenses & solution
• Vasectomy • Wheelchairs
HOW TO GET $500?
OPEN A H.S.A, IT’S SO EASY!
You can choose to enroll in the H.S.A. online or by completing and submitting a paper enrollment form to Optum Bank directly. The form is available on the Benefits Department page on the AMIkids Intranet or from your Business Manager. To enroll online:
• Go to www.optumbank.com • Select “ENROLL NOW” • Scroll down and review the qualifications • If you qualify, select “If you qualify to open an H.S.A you can do so today by clicking here.” • ….And begin!
It will ask you for:
Your Social Security Number An email address, to receive information from Optum Your Group Number: 7160757 IMPORTANT : Under requested contribution please indicate “0”. If you wish to contribute to the HSA as well, please download the HSA contribution form from the Benefits department page of the AMIkids Intranet or contact your Business Manager. Once your enrollment is processed, watch your mail! You’ll receive a Welcome Letter from Optum Bank with your account number H.S.A Debit card (MasterCard). Separately you will receive a Personal Identification Number (PIN) for your debit card. Optum Bank MUST validate your enrollment info prior to activating your account. This process may take up to two weeks. We strongly encourage you enroll as soon as you’re eligible for benefits to ensure you receive your entire prorated gift ($500).
7
DENTAL INSURANCE
AMIkids offers dental coverage through Blue Cross Blue Shield (BCBS). Both plan options are Dental PPOs, which allow you to use in-network or out-of-network benefits. If out-of-network dentists are used, you will be responsible for the balance billed amount (the difference between BCBS’ allowed amount and what the dentist charges). AMIkids has not raised Dental Plan premiums for FOUR years!
The chart below provides a brief overview of the plans. To find in-network providers visit www.MyHealthToolkitFL.com and click on “Find a Dentist” within the right column.
Base PPO Plan (unchanged from 2016)
Premium PPO Plan (unchanged from 2016)
In-Network
Deductible (applies to Basic & Major services)
$50
$50
Individual
$150
$150
Family
Annual Maximum (per covered member)
$1,000
$1,500
Preventive Services
Covered in full
Covered in full
Exams, Cleanings, & Fluoride
Basic Services
Fillings, Simple Extractions, Perio & Endo (other than those listed below) Major Services Crowns, Bridges, Surgical Extractions, Root Canal, Dentures, Osseus Surgery & Endo Molars
20% after deductible
20% after deductible
50% after deductible
50% after deductible
Orthodontia (child only)
40% $2,000 lifetime maximum per person
None
Out-of Network 1
90 th % Usual & Customary Charges
Basis of Payment
Deductible (applies to Basic & Major services)
$50 / $150
$50 / $150
Annual Maximum (per covered member)
$1,000
$1,500
Services Preventive
Covered in full 20% after deductible 50% after deductible
Covered in full 20% after deductible 50% after deductible
Basic Major
Orthodontia (child only)
40% $2,000 lifetime maximum per person
None
1 Subject to balance billing. Please refer to your plan document for specific details.
Cost for Coverage Amounts shown are per pay check ( 24 payments/year )
Base PPO
Premium PPO
Employee Only
$ 4.68 $12.13 $14.78 $24.51
$ 9.35 $21.56 $29.52 $45.26
EE
Employee + Spouse
ES
Employee + Child(ren)
EC
Employee + Family
FAM
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VISION INSURANCE
AMIkids offers vision coverage through Blue Cross Blue Shield (Blue Cross Blue Shield). The Blue Cross Blue Shield vision plan provides you access to the EyeMed network and allows you the flexibility to see any provider, to maximize savings seek services from a EyeMed network provider. If you utilize an out-of-network provider, you’ll pay expenses at the time of service and file a claim for reimbursement. The chart below provides a brief overview of the plan and reimbursement schedule for out- of-network services. AMIkids has not raised Vision Plan premiums for FOUR years!
Your vision is important to your health. Whether your vision is 20/20 or less than perfect, everyone should receive regular vision care.
To find in-network providers visit www.MyHealthToolkitFL.com and hover over on the “Education Center” in the top menu and click on “Enrollment Tools”. Under Healthy Vision you will find a link for “EyeMed Provider Locator”. Get results by entering your location and select the “Access” network.
Vision EyeMed Access Network
Out-of-Network 1
In-Network
Routine Eye Exams
Every 12 months
$20 Copay
Reimbursed up to $35
Lenses 2
Every 12 months
Single Vision Bifocal Trifocal Lenticular
$40 Copay (no cost scratch coating)
Reimbursed $25-$55, depending on type of lenses
Frames
Every 12 months
$40 Copay provides, $130 Allowance PLUS 20% off cost over the allowance
Reimbursed up to $65
Contact Lenses (in lieu of glasses)
Every 12 months
Elective Contact Lenses Conventional
$40 Copay provides, $200 allowance PLUS 15% off cost over the allowance
Reimbursed up to $160
Disposable
$40 Copay provides, $200 allowance
Medically Necessary
Covered in full
Reimbursed up to $210
1 Reimbursable amount, less applicable copay . 2 Lenses benefit listed are for a pair of lenses.
Cost for Coverage Amounts shown are per pay check ( 24 payments/year )
Vision Plan
Employee Only
$ 3.74 $ 7.70 $ 6.50 $10.46
EE
Employee + Spouse
ES
Employee + Child(ren)
EC
Employee + Family
FAM
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LIFE AND AD&D INSURANCE
BASIC LIFE AND AD&D INSURANCE
AMIkids provides all benefit eligible employees with at least a $10,000 Life and Accidental Death & Dismemberment (AD&D) benefit, at NO COST TO YOU! Please be sure to assign your beneficiary at initial eligibility and/or during annual open enrollment and update throughout the year as needed.
Age Reduction Schedule
At age…
The original amount of benefit will reduced to …
65 70
65% 50%
Cost for Coverage Basic Life Insurance and AD&D
Employee Only
$ 0.00 ….. It’s free to you, 100% paid for by AMIkids!
EE
VOLUNTARY LIFE AND AD&D INSURANCE
AMIkids offers you the option to purchase additional Life and AD&D insurance for yourself and your dependents. This coverage is available through United Healthcare.
You may request coverage amounts… as low as… as high as…
$500,000 (not to exceed 5x your annual salary)
1 Cost of Child coverage is same for 1 or more children. 2 Children are eligible from 14 days to 26 years. 3 You must elect voluntary life insurance for yourself to have dependent coverage. The dependent benefit cannot exceed the employee benefit.
$10,000
$10,000
Employee
Spouse 3
$5,000
$150,000
$5,000
Child(ren) 1 2 3
N/A
$10,000
$10,000
What are the GI amounts?
$200,000 (not to exceed 5x your annual salary)
What is Guarantee Issue (GI)? GI is the maximum benefit you can receive without having to provide proof of good health, Evidence of Insurability (EOI). GI is only available at initial eligibility. If you’re requesting coverage outside your initial eligibility, you must submit EOI to United Healthcare for review (form located in myBenSite).
Employee
Spouse 3
$30,000
Child(ren) 1 2 3
$10,000
Cost for Coverage Voluntary Life Insurance and AD&D
Employee Spouse Child(ren)
Check out myBenSite to see your and your dependents personalized rates. The cost for coverage will be taken through payroll deductions.
The Voluntary Life and AD&D plan is portable and also includes the ability to convert should your employment end. These options allow you may have the ability to continue the Life and AD&D. To obtain more information, forms, and confirmation of premium costs contact United Healthcare within 31 days, at 1-877-683-8601 (port) or 1-888-99-4767 (convert).
10
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Sometimes it’s difficult to cope with life’s problems, we often turn to family and/or friends for support. Unfortunately, many times that’s not enough. Sometimes we need the ear of an experienced professional, one who will keep our concerns confidential and help guide us in the right direction. The Employee Assistance Program (EAP) is here for just that! The EAP is available to you and your family, providing you access to highly-trained professionals to help you find solutions to a variety of issues.
WHAT TYPES OF SERVICES AVAILABLE?
• Grief • Balancing work and home • Parenting • Drug and/or alcohol abuse
• Stress and mental health • Resiliency • Depression • Gambling and other addictive behaviors
• Parenting • Financial issues • Life changes • Relationship issues
AMIkids provides you up to 3 face-to-face sessions per calendar year! By contacting a professional though the EAP, they can help you find appropriate resources in your area.
This program is at no cost to you, paid 100% by AMIkids . It’s available to you and your immediate family members through UnitedHealthcare!
EAP staff members are available 24 hours a day, 7 days a week, every day of every year! These professionals may be reached at 1-877-660-3806 or by logging onto www.liveandworkwell.com . You may create an account under “Members: Login or Register” or by using access code “LTDEAP” under Guest Access.
WORLDWIDE TRAVEL ASSISTANCE
AMIkids provides all regular employees with Travel Assistance, provided through United Healthcare (services of UnitedHealthcare Global). This resource is available to you and your dependents for any single trip more than 100 miles from home.
WHAT WILL THEY HELP WITH?
Pre-Trip Assistance
Travel Assistance Services
• Immunization requirements • Passport and visa requirements • Travel/tourist advisories • Embassy/consular referrals • Foreign exchange rates
• Emergency travel arrangements • Document replacement (credit cards, airline tickets, etc.)
Medical Assistance Services • Locating legal services and medical providers • Help with replacing corrective lenses and medical devices
Call collect: 1-410-453-6330
Medical Emergency Transportation
• Emergency evacuation • Coordination of transportation for family to join hospitalized member, return of companion or child(ren)
Visit online: UHCGlobal.com Create an account using the ID #:358231
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DISABILITY INSURANCE
SHORT TERM DISABILITY
Short Term Disability (STD) may provide you a benefit, should you become temporarily disabled because of a non-work related illness, injury or a condition, like pregnancy. Please note, STD does not provide for any job protected status, job protection may be provided for you by the Family Medical Leave Act (FMLA), if applicable. STD leave runs concurrent with family medical leave if an employee is eligible for both STD and FMLA.
See below to determine eligibility for this benefit.
• Benefit eligible employees, employed for less than 2 years are offered Voluntary Short Term Disability through United Healthcare. Elections for STD can be made during the enrollment process, cost for coverage can also be found online. This plan can be purchased on a voluntary basis for those not yet eligible for the company sponsored STD policy. The benefit may pay you 60% of your base earnings, not to exceed $1,500 per week. Benefits begin on the 8 th day from the start of the illness or accident and can pay out up to a 12 week maximum. Please make note of the pre-existing condition limitations, which state disabilities that occur during the first 12 months of coverage (due to pre-existing condition) are excluded if the condition was diagnosed, treated or prescribed for 3 months prior to the effective date of coverage (aka 3/12). • Benefit eligible employees who have completed two full years of continuous employment with no gaps are eligible for employer paid, STD through United Healthcare. That’s STD coverage at NO COST TO YOU ! This benefit may provide you 60% of your weekly base pay, up to 12 weeks. Claims review and benefit amounts / administration is through United Healthcare. There are no pre-existing condition limitations on this policy .
VOLUNTARY LONG TERM DISABILITY
Long Term Disability (LTD) may provide you income protection through monthly benefits should you become unable to work, due to non-work related accident or illness. Benefits under LTD would begin to pay if/when your Short Term Disability benefit is exhausted. AMIkids offers benefit eligible employees the option to purchase Voluntary Long Term Disability through United Healthcare. Claims review and benefit amounts / administration is through United Healthcare. The chart below provides an overview of the plan.
How much does it pay? 60% of monthly base earnings Is there a maximum to the monthly benefit? Yes, 60% of your monthly base earnings cannot exceed $6,000.
What’s the Elimination Period?
Benefits commence after 90 days from disability
If you become disabled prior to age 62, benefits are payable to age 65 or Social Security Normal Retirement Age (SSNRA) Own Occupation. Meaning the disability prevents you from performing at least one of the material duties of your regular occupation during the first 24 months of disability and after 24 months are unable to perform all the material duties of any gainful occupation.
What’s the duration of the benefit?
What’s the definition of disability?
Please make note of the pre-existing condition limitations, which state disabilities that occur during the first 12 months of coverage (due to pre-existing condition) are excluded if the condition was diagnosed, treated or prescribed for 3 months prior to the effective date of coverage.
Cost for Coverage
Voluntary Short Term Disability (STD) &/or Voluntary Long Term Disability (LTD)
Check out myBenSite to see your personalized rates. The cost for coverage will be taken through payroll deductions.
Employee
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THE GIFT THAT KEEPS ON GIVING
PENSION PLAN
After two years of employment, you may be eligible for the company sponsored pension plan. This retirement account is funded 100% by your AMIkids employer. Contributions are made based on years of service, see below for contribution schedule.
Contribution Schedule
Years of service
% of Salary
Less than 10 years
5%
10 years or more
15%
These contributions COST YOU NOTHING , it’s FREE money into a retirement account that you own! Each plan year in which a contribution is made, and in which you are an eligible participant, an allocation will be made into your account.
You have 100% vested interest in your account at all times!
Hardship withdrawals and loans are not permitted from the pension plan. Please contact the payroll department with any questions relating to the pension.
VOLUNTARY 403(b) RETIREMENT SAVINGS PLAN
To help prepare you for the future, AMIkids offers a 403(b) savings retirement plan through Fidelity Investments. This plan is 100% funded by you via PRE-TAX payroll deductions, there is no company match.
Once you enroll directly with Fidelity Investments you must notify your Business Manager or the Benefits Specialist to begin payroll deductions. Per your contribution request, AMIkids will forward these deductions to Fidelity Investments.
With this plan, you can save a portion of your pay on a pre-tax basis (federal and most state income taxes are deferred on amounts contributed), up to $18,000 in 2017. Taxes are also deferred on your investment earnings within the plan.
An additional deferment is available to employees age 50 and over (by December 31 st) . These employees can defer up to $6,000 in addition to their regular contribution amount, for a combined total contribution limit of $24,000 in 2017.
You are always 100% vested in your contributions!
Hardship withdrawals and loans are not permitted from the 403(b) plan. Please contact Fidelity Investments with any questions relating to your 403(b).
WHEN CAN I START CONTRIBUTING?
You are eligible for the 403(b) so long as you’re working 30+ hours per week, you may start contributing immediately and you may sign up at anytime!
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VOLUNTARY BENEFITS
AMIkids offers you the option to enroll in voluntary benefits through United Healthcare. As these benefits are voluntary, you pay 100% of the cost for coverage for yourself and any dependents (spouse and/or child(ren)).
ACCIDENT INSURANCE
The Accident plan helps lessen the financial impact of out-of-pocket medical costs related to an accident by paying you a lump sum benefits for over 50 covered injuries and treatments.
These include, but are not limited to:
• ER visits • Follow-up doctor visits • Broken bones and burns
• Ambulance • Dislocations • Physical therapy
• Emergency dental work • Knee ligament injuries • Chiropractor
There is no total maximum amount for benefits payments! You may file multiple claims for multiple covered incidents and it includes catastrophic accident benefits.
No health questions are required to enroll, meaning this plan is guaranteed issue. Additionally, there are NO pre-existing limitations.
CRITICAL ILLNESS INSURANCE (includes Cancer)
This benefit pays you a lump sum benefit when you, or a covered dependent, experience a covered critical illness. These include but are not limited to following conditions.
• Heart attack or Stroke • Coma • Kidney or major organ failure
• Benign brain tumor • Permanent paralysis • Blindness
• Occupational HIV • Coronary bypass surgery (25%) • Cancer
No health questions are required to enroll, meaning this plan is guaranteed issue. Please note limitations due to pre-existing conditions apply on this plan, conditions are covered on a 6/12 basis.
HOSPITAL INDEMNITY INSURANCE
This plan helps lessen the financial impact of out-of-pocket medical costs related to a covered hospital stay, with pre- defined benefit amounts. Even if the cost of the claim is less than the pre-defined benefit, the full pre-defined benefits will be paid to you directly.
Pre-defined benefits include, but are not limited to:
Hospital Admission
$1,500 per insured person per calendar year
Hospital Confinement
$200 per day per calendar year
Hospital ICU Confinement
$200 per day per calendar year
No health questions are required to enroll, meaning this plan is guaranteed issue. Please note limitations due to pre-existing conditions apply on this plan, conditions are covered on a 12/12 basis.
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MORE VOLUNTARY BENEFITS
LEGAL SHIELD
LegalShield provides their members with immediate, direct, centralized toll-free access to their Provider Law Firm to discuss personal legal matters without worrying about high hourly costs. The network is comprised of lawyers who have practiced a minimum of two years and who are in good standing with their state Bar Association. Any disciplinary actions, even if unfounded, may disqualify an attorney.
LegalShield provides advice or assistance on a variety of legal issues; such as: • Family • Home • Auto • Estate issues • Financial
LegalShield plans provide 24-hour access nationwide for covered emergencies. LegalShield Provider Law Firms adhere to the following service standards:
• Return call from attorney: 8 business hours • Document Review: 3 business days • Letter or Phone Call: 3 business days • Will Preparation: 10 business days • Referrals: 3 business days
You may access the cost for coverage through myBenSite. The cost for coverage will be taken through payroll deductions.
ID SHIELD
Identity theft has been one of the top consumer complaints filed with the FTC for 16 years straight. Victims are spending an exorbitant amount of time and money dealing with it.
Members have unlimited access to the identity consultant services provided by Kroll’s Licensed Private Investigators. The Investigator will advise you on the best practices for identity management, tailored to your specific situation, Consultative services include:
• Address Change Verification • Event-Driven Consultative Support • Alerts and Notifications • Privacy and Security Best Practices
• Credit Monitoring • Payday Loan Monitoring • Dependent Identity Theft Protection
You may access the cost for coverage through myBenSite. The cost for coverage will be taken through payroll deductions.
PET INSURANCE
AMIkids offers you the option to purchase pet health insurance at a discounted rate. This coverage is available through ASPCA ® (the American Society for the Prevention of Cruelty to Animals).
Pet parents may visit any licensed veterinarian or specialist in the US or Canada. This is not a network program.
When purchasing pet health insurance as an employee of AMIkids you will receive 10% off, plus a 10% multiple pet discount for each additional pet.
You may enroll online (information available on myBenSite) or by phone at 1-877-343-5314.
If enrolling by phone please use Priority Code: EBAMIkids
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ENTERPRISE CAR SALES
As an employee of AMIkids you have access to Enterprise Car Sales. They help take the stress out of buying used cars and provide you with the peace of mind that you’re buying a quality certified used vehicle. You'll never haggle with a salesperson. The price you see is the price you pay. Our best car prices are always posted in plain view so you can avoid unpleasant negotiating.
KNOWLEDGE IS POWER
Vehicle Certification Included Enterprise only sell certified used cars and every Enterprise vehicle has passed a rigorous 109-point inspection performed by an ASE-Certified technician.
Free CARFAX® Reports A free CARFAX® Vehicle History Report ™ is available for all certified used cars and trucks we sell.
Trade-Ins Welcome Enterprise will give you Kelley Blue Book® Trade-in Value on your vehicle, when you purchase a certified used vehicle them. Financing Assistance Enterprise Car Sales works with many financial institutions and can help you secure financing along with a competitive used car price.
WORRY FREE OWNERSHIP
Their job doesn't end when you pull off the lot. For your continued driving pleasure, they offer a unique combination of benefits to keep you happy down the road.
•
7-Day Repurchase Agreement If you change your mind, they’ll buy it back – no questions asked. They give you up to seven days or 1,000 miles.
• 12/12 Limited Powertrain Warranty All of their used cars for sale are backed by a Limited Powertrain Warranty for 12 months or 12,000 miles, whichever comes first.
•
Vehicle Service Contracts Vehicle service contracts are available on every Enterprise used car for added protection and peace of mind.
•
12-Month Roadside Assistance Flat tire? Lost key? Out of gas? No problem - because all used car prices include their one-year unlimited mileage roadside assistance program.
Contact your local Enterprise Auto Sales Dealer for more details.
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ENROLLING WITH MYBENSITE
To complete the enrollment process, you will need the following information for yourself and any dependents you would like to cover (spouse and/or child(ren)): • Social Security Number (SSN) • Date of birth • Home address
STEP 1
HOW TO LOGIN
Go to www.mybensite.com/amikids , to login you will need to enter the following information under “Create Account”: • Last name • Date of birth • Last 4 of your social security number (SSN) • Email address • You will also be asked to create your password and confirm it.
In the portal you’ll have the ability to review benefits, summaries, forms, summary plan descriptions, provider search directories and other resources. Be sure you review this site and this guide to ensure you thoroughly understand your benefit options before enrolling.
STEP 2
LAUNCH ENROLLMENT
Click on “Enroll Now”.
STEP 3
You’ll receive the following “welcome” message, click continue to proceed.
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ENROLLING WITH MYBENSITE
STEP 4
PERSONAL & DEPENDENT INFO
Your personal info is already in the system, as are any currently covered dependents. Please review and correct any errors. If you’re unable to make these corrections please contact the Benefits Department or your Business Manager. If you need to add or remove a dependent, the Dependents page is where you can do so.
STEP 5
ENROLLMENT
The bar along the top tracks your progress in the enrollment process. You may also click back to previous pages here.
Please be sure all dependents you wish to cover are checked.
You may view plan costs within the plan option boxes and see plan overviews in the right column. Select a plan by clicking “Select Plan” Click the “Learn More” button for plan documents; such as benefit summary, provider search tools, SBCs, etc)
When plan elections (or waivers) have been confirmed, scroll to the bottom of the screen to continue .
Proceed by electing / waiving additional benefit options. You will also be asked to acknowledge AMIkids Cafeteria Plan and COBRA Initial Notification .
As you select benefits the cost for coverage will reflect in your shopping cart . (located in the top right hand side of the screen)
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ENROLLING WITH MYBENSITE
STEP 6
FINAL REVIEW
After making all benefits elections and acknowledgements you will be asked to review your and your dependents information as well as your benefit elections.
BEFORE you can continue and submit enrollment you must scroll to the bottom of the page to state you have read and agree to the terms and that you completed your selection or wish to discard.
STEP 7
ENROLLMENT SUMMARY
Once you submit the enrollment you will receive a page summarizing your elections with the option to Print/Download the summary, email the summary or close the window (as shown below).
PLEASE BE SURE TO SAVE A COPY OF THIS SUMMARY PRIOR TO CLOSING THE WINDOW.
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REQUIRED ANNUAL EMPLOYEE DISCLOSURE NOTICES
Required Annual Employee Disclosure Notices
THE NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT OF 1996 The Newborns’ and Mothers’ Health Protection Act of 1996 prohibits group and individual health insurance policies from restricting benefits for any hospital length of stay for the mother or newborn child in connection with childbirth; (1) following a normal vaginal delivery, to less than 48 hours, and (2) following a cesarean section, to less then 96 hours. Health insurance policies may not require that a provider obtain authorization from the health insurance plan or the issuer for prescribing any such length of stay. Regardless of these standards an attending health care provider may, in consultation with the mother, discharge the mother or newborn child prior to the expiration of such minimum length of stay. Further, a health insurer or health maintenance organization may not: 1. Deny to the mother or newborn child eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely to avoid providing such length of stay coverage; 2. Provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum coverage; 3. Provide monetary incentives to an attending medical provider to induce such provider to provide care inconsistent with such length of stay coverage;
WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998
The Women’s Health and Cancer Rights Act of 1998 requires AMIkids to notify you, as a participant or beneficiary of the AMIkids Health and Welfare Plan, of your rights related to benefits provided through the plan in connection with a mastectomy. You, as a participant or beneficiary, have rights to coverage to be provided in a manner determined in consultation with your attending physician for:
1. All stages of reconstruction of the breast on which the mastectomy was performed;
2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
3. Prostheses and treatment of physical compilations of the mastectomy, including lymphedema.
These benefits are subject to the plan’s regular deductible and co-pay. For further details, refer to your Summary Plan Description. Keep this notice for your records and call Human Resources for more information.
MICHELLE’S LAW
The law allows for continued coverage for dependent children who are covered under your group health plan as a student if they lose their student status because of a medically necessary leave of absence from school. This law applies to medically necessary leaves of absence that begin on or after January 1, 2010 If your child is no longer a student, as defined in your Certificate of Coverage, because he or she is on a medically necessary leave of absence, your child may continue to be covered under the plan for up to one year from the beginning of the leave of absence. This continued coverage applies if your child was (1) covered under the plan and (2) enrolled as at student at a post-secondary educational institution (includes colleges, universities, some trade schools and certain other post-secondary institutions). Your employer will require a written certification from the child’s physician that states that the child is suffering from a serious illness or injury and that the leave of absence is medically necessary.
4. Require a mother to give birth in a hospital; or
5. Restrict benefits for any portion of a period within a hospital length of stay described in this notice.
These benefits are subject to the plan’s regular deductible and co-pay. For further details, refer to your Summary Plan Description. Keep this notice for your records and call Human Resources for more information.
SECTION 111
Effective January 1, 2009 group health plans are required by Federal government to comply with Section 111 of the Medicare, Medicaid, and SCHIP Extensions of 2007’s new Medicare Secondary Payer regulations. The mandate is designed to assist in establishing financial liability of claims assignments. In other words, it will help establish who pays first. The mandate requires group health plans to collect additional information, more specifically Social Security numbers for all enrollees, including dependents 6 months of age or older. Please be prepared to provide this information on your benefits enrollment form when enrolling into benefits.
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