Employee Benefits 2023
Here’s where to find... Welcome 3 Who is eligible? 4 Making changes 4 Enrollment deadlines 4 How to enroll 5 Benefits online enrollment support 6 Payroll contributions 7 Medical 9 How to be a smart consumer 10 Health savings account (HSA) 11 Flexible spending account (FSA) 12 Dental 14 Vision 14 Life and disability insurance 15 Additional benefits 16 Glossary of terms 17 Contacts 19
WELCOME TO ANNUAL ENROLLMENT! We appreciate appreciates your commitment to our success. We’re equally committed to providing you with competitive, affordable health and wellness benefits to help you take care of yourself and your family. Please read this guide carefully. It has a summary of your plan options and helpful tips for getting the most value from your benefits plans. We understand that you may have questions about annual enrollment, and we’ll do our best to help you understand your options and guide you through the process. This guide is not your only resource, of course. Any time you have questions about benefits or the enrollment process, you can contact your HR Department representative. Although this guide contains an overview of benefits, for complete information about the plans available to you, please see the summary plan description (SPD) in ADP.
2
2023 Benefits Guide
YOUR BENEFITS FOR 2023 Thank you for being a valued employee of our team! We strive to provide you with a comprehensive benefits package, recognizing each of our employees has unique coverage needs for themselves and their family. This guide is an overview of the plans that are available and can be used to help make your enrollment election for the 2023 Plan Year. Making wise decisions about your benefits requires planning. By selecting benefits that provide the best care and coverage, you can optimize their value and minimize the impact to your budget.
The following are recommended as your evaluating your options:
z Assess your health and the health of your family members before making any selections. For instance, plans with higher monthly premiums and lower copays and deductibles are best for those who will use a lot of health care services over the course of the year. Yet, healthy individuals and families may save a great deal by selecting a plan with low premiums and a high deductible. We offer two plans through Cigna, a High Deductible Health Plan and a Traditional plan option. z Examine how you allocated benefits last year beyond just health care – retirement, dental, flexible spending accounts, etc. If you didn’t invested in some of these benefits in the past, now may be the time to consider adding them. z Review the resources posted on our ADP portal. These electronic resources are avaialble to you 24/7 and can help you determine which plan would be most appropriate in the coming year. z Utilize tax-free benefits such as health savings accounts (HSAs), flexible spending accounts (FSAs) and dependent care spending accounts. These savings vehicles can provide tremendous tax advantages, as contributions are made with before-tax income. Reimbursements from these accounts are also tax-free. They can be used to pay for prescriptions, deductibles and health-related costs that are not covered by your insurance (braces, eye glasses, etc.). HSAs are also a great way to save for future medical costs and if you elect the HDHP, we contribute to your HSA! z Are you saving enough to be comfortable during retirement? If not, change your retirement plan withholdings. Don’t forget to take advantage of your company match in your retirement account. This is free money for the future. For tenured full-time employees, elections made during Open Enrollment will become effective on January 1, 2023. For newly hired full-time employees, plan elections made will become effective 1st of the month following date of hire. We look forward to being a resource for you and your family as you navigate your benefit options.
3
WHO IS ELIGIBLE? Benefits are available to all full-time employees working a minimum of 30 hours per week and their dependents. For those enrolling during Open Enrollment, your benefits will become effective on 01/01/2023. For new hires, your benefits will become effective on the first day of the month following your your hire date.
MAKING CHANGES You may only make changes to your elections during open enrollment each year or during the year if you experience a qualifying event. Qualifying events include, but are not limited to: z Birth, legal adoption, or placement for adoption. z Marital status. z Dependent child reaches age 26. z Spouse gains or loses employment or eligibility with current employer. z Death of a covered dependent. z Spouse or dependent becomes eligible or ineligible for Medicare/Medicaid or SCHIP. z Change in residence that changes eligibility for coverage. z Court-ordered change. Changes to your coverage due to a qualifying life event must be made within 30 days of that life event. Proof of the qualifying life event is required (marriage certificate, divorce decree, birth certificate, or loss of coverage letter).
Eligible dependents include:
Your legal spouse
Your children from birth to age 26
(Including your natural/legally adopted/stepchildren, and/ or your unmarried dependent children of any age who are mentally or physically disabled and who are dependent on you for support) HOW TO ENROLL
To sign up for benefits, visit https://workforcenow.adp.com before the end of your enrollment period.
Note: Any change you make to your coverage must be consistent with the change in status.
ENROLLMENT DEADLINES
Type of Employee/Dependent
Enrollment opportunity
Coverage effective date
Current Employee
Annually during the enrollment period
Start of plan year
Must enroll before last day of month following hire date
First day of month following hire date
New hire
Changes must be made within 30 days of life event
Qualified life event
Date of life event
4
2023 Benefits Guide
HOW TO ENROLL
Employees will receive an email from ADP prompting them to create an account. Once logged into ADP, employees will make benefit elections for the 2023 plan year.
5
ADP REGISTRATION AND OPEN ENROLLMENT SUPPORT
6
2023 Benefits Guide
BI-WEEKLY EMPLOYEE PAYROLL CONTRIBUTIONS
Medical/Rx
HSA Open Access Plus
Open Access Plus
Employee
$103.49
$227.79
Employee + spouse
$217.63
$479.06
Employee + child(ren)
$180.59
$397.51
Family
$225.60
$604.99
Dental
Cigna Dental PPO
Employee
$0.99
Employee + spouse
$2.04
Employee + child(ren)
$2.29
Family
$3.47
Vision
Cigna Vision Plan
Employee
$0.17
Employee + spouse
$0.33
Employee + child(ren)
$0.34
Family
$0.54
Note: Additional rate information can be found in your enrollment portal.
7
WEEKLY EMPLOYEE PAYROLL CONTRIBUTIONS
Medical/Rx
HSA Open Access Plus
Open Access Plus
Employee
$51.75
$113.90
Employee + spouse
$108.82
$239.53
Employee + child(ren)
$90.30
$198.76
Family
$112.80
$302.50
Dental
Cigna Dental PPO
Employee
$0.50
Employee + spouse
$1.02
Employee + child(ren)
$1.15
Family
$1.74
Vision
Cigna Vision Plan
Employee
$0.09
Employee + spouse
$0.17
Employee + child(ren)
$0.17
Family
$0.27
Note: Additional rate information can be found in your enrollment portal.
8
2023 Benefits Guide
MEDICAL CIGNA
mycigna.com 1 (800) CIGNA-24
Your medical benefits are provided by Cigna on their Open Access Plus Network. The High Deductible Healthplan offers in network only coverage, whereas the Traditional Plan has both in and out of network benefits. You will always have stronger benefits when visiting in-network providers.
Medical
HSA Open Access Plus
Open Access Plus
In-network
In-network
Annual deductible (Individual/Family)
$2,500 / $5,000
$1,000 / $2,000
Out-of-pocket maximum (Individual/Family)*
$5,000 / $10,000
$3,000 / $6,000
Preventive care
100%, no deductible
100%, no deductible
Primary physician office visit
$30 copay after deductible
$30 copay
Specialist office visit
$50 copay after deductible
$60 copay
Inpatient hospital services
30% after deductible
20% coinsurance
Outpatient hospital services (lab, x-ray, diagnostic)
30% after deductible
20% coinsurance
Advanced diagnostics
30% after deductible
20% coinsurance
Urgent care
30% after deductible
$75 copay
Emergency room care
30% after deductible
$100 copay
Prescription drugs Retail (30-day supply) Generic
30% after deductible
$20 copay
Brand preferred
30% after deductible
$50 copay
Brand non-preferred
30% after deductible
$70 copay
Mail order (90-day supply) Generic
30% after deductible
$40 copay
Brand preferred
30% after deductible
$100 copay
Brand non-preferred
30% after deductible
$140 copay
This is a summary of coverage; please refer to your summary plan description for the full scope of coverage. In-network services are based on negotiated charges; Out-of-network services are based on a percentage of Medicare charges.
* Includes Deductible and Copayments
9
HOW TO BE A SMART CONSUMER Pharmacy
MyCigna Mobile App The MyCigna app lets you easily access your healthcare information and gives you tools to help estimate costs, manage claims and find providers — anytime and anywhere. It’s built to be your go- to healthcare resource when you’re on the go.
z Find an in-network pharmacy or use the drug cost estimator tool by visiting mycigna.com. z Discount sites like GoodRx and WellRx can help you instantly save (please note: prescriptions acquired under these plans do not go through your insurance). z Ask if a generic/mail order is available. z Generic contraceptives and diaphragms are covered and available at no cost. z See if your drug has a Patient Assistance Program. 24/7 Nurse Line 1 (800) CIGNA-24
mycigna.com
Telemedicine Cigna provides access to telemedicine through MDLive. The program lets you get the care you need — including most prescriptions — for a wide range of minor acute conditions. Now you have access to these board-certified doctors via secure video chat or phone, without leaving your home or office. When, where and how it works best for you.
z Choose appropriate medical care. z Find a doctor or hospital.
z Understand treatment options. z Achieve a healthier lifestyle. z Answer medical questions. Cost Estimator Different doctors and hospitals may charge different amounts for the same service. mycigna.com can help you compare costs based on your own benefits.
Log onto mycigna.com and click on “Talk to a doctor.” or call (888) 726-3171
10
2023 Benefits Guide
HEALTH SAVINGS ACCOUNT (HSA) CIGNA AVAILABLE TO PARTICIPANTS IN THE HSA OPEN ACCESS PLUS PLAN.
1 (800) CIGNA-24 mycigna.com
A health savings account (HSA) is a tax-advantaged savings account that can be used for your qualified healthcare expenses. You own your HSA and can contribute to the account with pre-tax payroll deductions based on your needs. Did you know an HSA provides triple tax benefits? The money you contribute is pre-tax, and the interest that accumulates in the account is tax-free. In addition, money withdrawn from an HSA isn’t taxed, provided you use it for qualified healthcare expenses. Like a savings account, you will only be able to withdraw funds that are in the account. As an added benefit, our company will contribute $1,250 to individual accounts and $2,500 to employee and dependent accounts. If you are paid bi-weekly, expect an employer contribution to your health savings account bi-weekly. If you are on a weekly payroll frequency, you can expect employer contributions to be made weekly. OTHER HSA ADVANTAGES
You can use the account to pay for qualified healthcare expenses.
Unspent dollars roll over each year and are yours to keep if you retire or leave the company.
You can invest your HSA funds, so your available healthcare dollars can grow over time.
You are eligible if:
You are enrolled in the HDHP
You are not covered by a spouse’s plan
No one else can claim you as a dependent
You are not enrolled in Medicare, TRICARE or TRICARE for Life
You have not received VA benefits in the past 3 months
How Do I Access / Make Contributions to My HSA? You can manage your HSA at www.mycigna.com. You’ll set up your payroll contributions during your enrollment period and can make changes at any time throughout the year (although it may take between 1–2 payroll periods for any changes to be processed).
How Much Can Be Deposited into an HSA in 2023?
Up to $3,850 for individual
The maximum contribution increases by $1,000 *Not enrolled in Medicare
z
<55*
55+*
z Up to $7,750 for family *Not enrolled in Medicare
11
FLEXIBLE SPENDING ACCOUNT (FSA) P&A GROUP What is a Flexible Spending Account? A flexible spending account (FSA) is an account that can reimburse you for qualified healthcare or dependent care expenses. You can fund qualified expenses with pre-tax dollars deducted from your paychecks. When electing an FSA, you will set an annual contribution amount. The goal is to choose an amount that will cover medical or dependent care expenses, but that is not so high that the money will be forfeited at the end of the year.
You can choose to participate in one or both accounts, and it’s not necessary to “sign up” specific family members for these accounts.
Healthcare FSA A healthcare FSA reimburses employees for eligible medical expenses, up to the amount contributed for the plan year. Eligible healthcare expenses include many of the out-of-pocket expenses you pay to maintain your health and well-being. Visit irs.gov for a full list of eligible expenses. You may contribute up to $3,050 annually (funds will be available as of the election effective date).
Dependent Care FSA You may use pre-tax dollars from your Dependent Care FSA to pay expenses for the care of a dependent child, spouse or elderly parent inside your home (from a qualified provider), and expenses outside your home, such as baby-sitters, nursery schools, or day care centers. You may contribute up to $5,000 annually (or $2,500 if you are married and file a separate tax return). You can only be reimbursed up to the amount that you have contributed.
12
2023 Benefits Guide
4 WAYS TO SUBMIT YOUR CLAIMS P&A Group Mobile App Download the mobile app and log into your account. Go to the menu and tap Upload Claim/Documentation to submit your claims. QuikClaim from Your Smartphone
(800) 688-2611 www.padmin.com
Capture a picture of your receipt or other supporting documentation of your eligible expense. Log into your account from your account from your mobile device at www.padmin.com by selecting Account Login and follow the prompts on your screen. Electronic Claim Upload from Your Computer Submit claims directly online at P&A’s website www.padmin.com by logging into your P&A account. Select Upload Claim/Documentation under Member Tools. Fax or Mail a Paper Claim Complete a claim form and fax or mail it to P&A Group. Claim forms are available when you log into your account at www.padmin.com.
FAX: (877) 855-7 105 MAIL: P&A Group 17 Court St. Ste 500 Buffalo, NY 14202
When submitting a claim make sure to include proof of service/documentation (itemized receipt, etc). Debit Card FSA participants can request a debit card for payment of eligible expenses. With the card, most qualified services and products can be paid at the point of sale versus paying out-of-pocket and requesting reimbursement. The debit card is accepted at a number of medical providers and facilities, and most pharmacy retail outlets. Here’s How It Works! An employee earning $30,000 elects to place $1,000 into a Health Care FSA. The payroll deduction is $38.46 based on a 26 pay period schedule. As a result, the insurance premiums and health care expenses are paid with tax-free dollars, giving the employee a tax savings of $227.
With a Health Care FSA
Without a Health Care FSA
Salary
$30,000
$30,000
FSA Contribution
-$1,000
$0
Taxable Pay
$29,000
$30,000
Estimated Tax 22.65% = 15% + 7.65% FICA
-$6,568
-$6,795
After Tax Expenses
$0
-$1,000
Spendable Income
$22,432
$22,205
Tax Savings
$227
Please Note: Be conservative when estimating medical and/or dependent care expenses. IRS regulations state any unused funds which remain in the FSA after a plan year ends and after all claims have been filed cannot be returned or carried forward to the next plan year. This rule is known as “use it or lose it.”
13
DENTAL CIGNA
Although you can choose any dental provider, when you use an in-network dentist, you will generally pay less. If you choose an out-of-network provider, you may be billed the difference between what Cigna pays, and what your out-of-network provider charges for the services. If you use a Cigna DPPO Advantage provider (within the Cigna DPPO network), you’ll be responsible for a lower coinsurance amount. To locate an in-network provider, please visit mycigna.com.
Dental
Total Cigna DPPO
Cigna DPPO Advantage Cigna DPPO
Out-of-network
Annual deductible (Individual/Family)
$50 / $150
$50 / $150
Annual maximum (per person)
$1,500, Class I applies
$1,500, Class I applies
Diagnostic and preventive care Includes cleanings, fluoride treatments, sealants and x-rays Basic services Includes fillings, periodontics, scaling and root planning, and oral surgery Major services Includes crowns, bridges and full and partial dentures
100% covered, no deductible 100% covered, no deductible
10% after deductible
20% after deductible
20% after deductible
40% after deductible
50% after deductible
50% after deductible
Orthodontia
50%, no deductible
50%, no deductible
Orthodontia lifetime maximum
$1,500
$1,500
90th percentile of submitted charges
Non-network reimbursement
Based on contracted fees
Plan includes out-of-network benefits, see plan summary for additional details.
VISION CIGNA
Our vision care benefits include coverage for eye exams, lenses and frames, contact lenses, and discounts for laser surgery. The vision plan is built around the Cigna providers, who have higher benefits at a lower cost to you. When you need services, consider using an in-network provider for the most bang for your buck! When you use an out-of-network provider, you will be reimbursed for services according to the grid below. To locate an in-network provider, visit with mycigna.com.
Vision
In-network
Out-of-network
Examination (every 12 months)
$10 copay
$45 allowance
Material
$20 copay
N/A
Lenses (every 12 months) Single
Covered in full
$40 allowance
Bifocal
Covered in full
$65 allowance
Trifocal
Covered in full
$75 allowance
Frames (every 24 months) New frames
$130 allowance
$71 allowance
Contact lenses (every 12 months) Elective
$130 allowance
$105 allowance
Therapeutic
Covered in full
$210 allowance
Employees can elect dental and/or vision regardless of whether they are enrolled in medical.
14
2023 Benefits Guide
LIFE AND DISABILITY INSURANCE NEW YORK LIFE Life Insurance We provide Basic Life and AD&D insurance at no cost to you!
myNYLGBS.com nyl.com/disability-claim (888) 842-4462
Insurance coverage
Benefit
Basic Life and AD&D
1x annual wage or salary including commissions
If you would like additional coverage, Voluntary Life and AD&D insurance is available to you, your spouse and your dependent children. You must enroll in coverage for yourself in order to cover your spouse or children. If you don’t enroll in Voluntary Life when it’s first available to you, or elect an amount over the Guaranteed Issue, you may be required to complete an Evidence of Insurability (EOI) form.
Insurance coverage
Benefit
Voluntary employee life
1 to 2 x annual comp, rounded to nearest $1,000, not to exceed $300,000
Voluntary spouse life
Units of $10,000 to the lesser of $20,000 / 100% of employee’s vol life insurance amt
Birth to 14 days: $500; 15 days to 6 mos.: $1,000; 6 mos. to 26 years: Units of $5,000-$10,000
Voluntary child life
Disability These plans give you income protection in the event you are ill or injured in a non-work related injury, and can’t come to work. If you don’t enroll in Disability coverage when it’s first available, you may be required to complete and an Evidence of Insurability (EOI) form.
Short-term disability benefits
Long-term disability benefits
Elimination period
7 days
Elimination period
90 days
Weekly benefit
60% of weekly earnings
Monthly benefit
60% of monthly earnings
Maximum weekly benefit $2,500
Maximum monthly benefit $10,000
Social Security Normal Retirement Age (SSNRA)
Maximum benefit period 12 weeks
Maximum benefit period
If you reside in a state that provides State Disability and elect the Cigna Voluntary Short Term Disability benefit, your Cigna benefit will be offset by the amount received from the state.
15
ADDITIONAL BENEFITS
Benefit
Description
Contact information
Who pays?
We are pleased to offer an Employee Assistance Program to assist you and your family through difficult times.
ComPsych (800) 344-9752 guidanceresources.com Web ID: NYLGBS
Unlimited access to Master’s-level counselors by phone 24/7.
z
Employer Paid
Employee Assistance Program
z Up to three sessions per issue, per year with a counselor at no cost. z Unlimited access to helpful tools and resources online.
Referrals available.
z
You can gain access to PerkSpot’s exclusive national and local merchants on your Lockton Series shared portal at no cost to you! Big Buys and Everyday Purchases: Exclusive deals from big brands and local favorites. You name it, we’ve got it! Thousands of Discounts: Your employees receive the same offerings as some of the largest employer groups in the country who use PerkSpot. Customer Service Support: No robots here! Real people handle all of our users’ customer service requests.
PerkSpot
locktonsoutheast.perkspot.com N/A
16
2023 Benefits Guide
GLOSSARY OF TERMS COPAYMENT : A copayment (copay) is the fixed dollar amount you pay for certain in-network services on a PPO-type plan. In some cases, you may be responsible for coinsurance after a copay is made. COINSURANCE: Your share of the costs of a healthcare service, usually figured as a percentage of the amount charged for services. You start paying coinsurance after you’ve met the deductible. Your plan pays a certain percentage of the total bill, and you pay the remaining percentage. DEDUCTIBLE: A deductible is the amount of money you must meet before your plan begins paying for services covered by coinsurance. Some services, such as office visits that require copays do not apply to the deductible. For example, if your plan’s deductible is $1,000, you’ll pay 100 percent of eligible healthcare expenses until you have met the $1,000 deductible. After that, you share the cost with your plan by paying coinsurance.
FORMULARY : A list of prescription drugs covered by the plan. Also called a drug list.
IN-NETWORK: A group of doctors, clinics, hospitals and other healthcare providers that have an agreement with your medical plan provider. You pay a negotiated rate for services when you use in-network providers. OUT-OF-NETWORK: Care received from a doctor, hospital or other provider that is not part of the plan agreement. You’ll pay more when you use out-of-network providers since they don’t have a negotiated rate with your plan provider. You may also be billed the difference between what the out-of-network provider charges for services and what the plan provider pays for those services. OUT-OF-POCKET MAXIMUM: This is the most you must pay for covered services in a plan year. After you spend this amount on deductibles and coinsurance, your health plan pays 100 percent of the costs of covered benefits. However, you must pay for certain out-of-network charges above reasonable and customary amounts. HIGH DEDUCTIBLE HEALTH PLAN (HDHP): This is a type of medical plan that requires the member to reach a deductible prior to having services covered by coinsurance. All expenses paid by the member count toward the deductible and out-of-pocket maximum.
17
CONTACTS
Medical Plan(s) Cigna Member services: 1 (800) CIGNA-24 Website: mycigna.com Prescription Services Cigna Member services: 1 (800) CIGNA-24 Website: mycigna.com Dental Cigna Member services: 1 (800) CIGNA-24 Website: mycigna.com Vision Cigna Member services: 1 (800) CIGNA-24 Website: mycigna.com Health Savings Account (HSA) Cigna Member services: (800) CIGNA-24 Website: mycigna.com
Flexible Spending Account (FSA) P&A Group Member services: (800) 688-2611 Website: www.padmin.com Life & Disability New York Life Member services: (888) 842-4462 Website: myNYLGBS.com nyl.com/disability-claim Employee Assistance & Wellness Support ComPsych Member services: (800) 344-9752 Website: guidanceresources.com
Critical Illness Cigna Member services: (800) 754-3207 Website: supphealthclaims.com Hospital Indemnity Cigna Member services: (800) 754-3207 Website: supphealthclaims.com Human Resources Carrie Baumann, Senior HR Coordinator Phone: (914) 779-3500 ext. 208 Email: carrie.baumann@triman.net
Jackie Hart, Sr. Director of HR Phone: (856) 767-7945 ext. 347 Email: jackie.hart@triman.net Hilary Bily, VP of HR Phone: (856) 719-3746 ext. 351 Email: hilary.bily@triman.net
Accident Cigna
Member services: (800) 754-3207 Website: supphealthclaims.com
Annual notices can be found on your ADP Benefits Portal.
18
2023 Benefits Guide
NOTES
19
All changes must be made by December 7, 2022! The descriptions of the benefits are not guarantees of current or future employment or benefits. If there is any conflict between this guide and the official plan documents, the official documents will govern.
SE: 1964289
Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20Made with FlippingBook - Online Brochure Maker