BENEFITS GUIDE
An overview of the wide array of benefits provided by Bunkhouse, to help you enjoy increased well-being and financial security
PREPARED BY BRIO BENEFITS FOR BUNKHOUSE
TABLE OF CONTENTS
▪
Medical Benefits
3
▪ Health Savings Account (HSA)
8
▪
Telemedicine
10
▪
Dental Benefits
11
▪
Vision Benefits
13
▪ Employer Paid Life & Long-term Disability
15
▪ Voluntary Life & Short-term Disability
17
▪
Retirement (401k)
20
▪
Paid Time Off
22
▪ Holiday Policy & Parental Leave
23
▪ Service Hours & Referral Bonus
24
▪
Additional Discounts
25
▪
Online Enrollment
26
▪
Legal Notices
28
▪
Contact Page
39
▪
Notes Page
40
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TABLE OF CONTENTS I
MEDICAL
SUMMARY OF COVERAGE MEDICAL PLAN
Option 1 Bronze Plan $5,000 - 100% - H.S.A.
Option 2 Gold Plan $5,000 - 100%
Option 3 Silver Plan $5,000 - 80%
In-Network
In-Network
In-Network
BlueCross BlueShield
Annual Deductible Individual | Family Out-of-Pocket Max Individual | Family
$5,000 | $10,000
$5,000 | $10,000
$5,000 | $14,700
$5,000 | $10,000
$8,150 | $16,300
$7,350 | $14,700
Primary Care Specialty Care
$35 copay $70 copay
$45 copay $90 copay
0% after deductible
Preventive Care
No Charge
No Charge
No Charge
Diagnostic Lab and X-ray
0% after deductible
0% after deductible
20% after deductible
Complex Radiology
0% after deductible
0% after deductible
20% after deductible
Urgent Care
0% after deductible
$75 copay
$75 copay
0% after deductible
$500 copay
$500 copay
Emergency Room
Hospital Inpatient & Outpatient
0% after deductible
0% after deductible
20% after deductible
Retail Drugs (30 day supply)
Preferred Pharmacy / Non Preferred In-network Pharmacy
Preferred Pharmacy / Non Preferred In-network Pharmacy
Preferred Pharmacy / Non Preferred In-network Pharmacy
$0 / $10
$0 / $10
0% after deductible
Generic Drug
$50 / $70
$50 / $70
0% after deductible
Preferred Brand
$100 / $120
$100 / $120
0% after deductible
Non-Preferred
$150 or 250
$150 or 250
0% after deductible
Specialty Drug
Out of Network Coverage
Annual Deductible Individual | Family
$10,000 / $20,000
$10,000 / $20,000
$10,000 / $29,400
30%
50%
Coinsurance
40%
Out-of-Pocket Max Individual | Family
Unlimited
Unlimited
Unlimited
Bi-Weekly Contribution
$46.38
$57.63
$49.21
Employee Only
Employee and Spouse
$195.64
$246.77
$212.83
$187.92
$237.05
$208.22
Employee and Child
$317.63
$400.06
$351.42
Family
4
Any dependents that are a domestic partner imputed income and after-tax contributions may apply
MEDICAL PLAN I
4
MEDICAL PLAN
KEY TERMS TO REMEMBER
ANNUAL DEDUCTIBLE
OUT-OF POCKET MAXIMUM
The amount you have to pay each year before the plan starts paying a portion of medical expenses. All family members’ expenses that count toward a health plan deductible accumulate together in the aggregate; however, each person also has a limit on their own individual accumulated expenses (the amount varies by plan).
This is the total amount you can pay out of pocket each calendar year before the plan pays 100 percent of covered expenses for the rest of the calendar year. Most expenses that meet provider network requirements count toward the annual out- of-pocket maximum, including expenses paid to the annual deductible*, copays and coinsurance *Except for Grandfathered medical plans
COPAYS AND COINSURANCE
PLAN TYPES
• EPO/PPO – A network of doctors, hospitals, and other health care providers • HMO – A network that requires you to select a Primary Care Physician (PCP) who coordinates your health care • POS – Combines aspects of a PPO and HMO • HDHP – A plan that has higher annual deductibles in exchange for lower premiums.
These expenses are your share of cost paid for covered health care services. Copays are a fixed dollar amount, and are usually due at the time you receive care. Coinsurance is your share of the allowed amount charged for a service, and is generally billed to you after the health insurance company reconciles the bill with the providers.
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MEDICAL PLAN I
5
MEDICAL PLAN
Understanding the full value of covered benefits allows you to take responsibility for maintaining good health and incorporating healthy habits into your lifestyle. Some examples include getting regular physical examinations, mammograms and immunizations. Through the plans offered by Bunkhouse, all covered individuals and family members are eligible to receive routine wellness services like these, at no cost; all copays, coinsurance, and deductibles are waived.
WHICH PREVENTIVE CARE SERVICES ARE COVERED?
The US Preventive Services Task Force maintains a regular list of recommended services that all Affordable Care Act (i.e. Health Care Reform) compliant insurance plans should cover at 100% for in-network providers. Below is a list of common services that are included in the plans offered this year:
“AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE”
• Routine Physical Exam • Well Baby and Child Care • Well Woman Visits • Immunizations • Routine Bone Density Test • Routine Breast Exam • Routine Gynecological Exam • Screening for Gestational Diabetes • Obesity Screening and Counseling • Routine Digital Rectal Exam • Routine Colonoscopy
• Routine Colorectal Cancer Screening • Routine Prostate Test
• Routine Lab Procedures • Routine Mammograms • Routine Pap Smear • Smoking Cessation Programs
• Health Education/Counseling Services • Health Counseling for STDs and HIV • Testing for HPV and HIV • Screening and Counseling for Domestic Violence
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MEDICAL PLAN I
6
HEALTH SAVINGS ACCOUNT (HSA)
BUNKHOUSE IS OFFERING A HEALTH SAVINGS ACCOUNT (HSA) WITH THE OPTION 1 MEDICAL PLAN. THIS IS HOW AN HSA WORKS:
A health savings account (HSA) is a health care account and savings account in one. The main purpose of this account is to offset the cost of a qualifying high deductible health plan (HDHP) and provide savings for your out-of-pocket eligible health care expenses – those you and your tax dependents may have now, in the future, and during your retirement.
This is a “portable” account. You own your HSA! It’s included in your employee benefits package, but after you set up your account, it’s yours to keep, even if you change jobs or retire.
Once your HSA is established, money is contributed to your account by you, Bunkhouse or friends and family, and you can then use your HSA dollars tax-free to pay for eligible health care expenses. You save money on expenses you’re already paying for, like doctors’ office visits, prescription drugs, and much more. Best of all, you decide how and when to use your HSA dollars.
WHY IS IT A GOOD IDEA TO HAVE AN HSA?
HSAs benefit everyone who is eligible to have this account – single individuals, families, and soon- to-be retirees. You save money on taxes in three ways:
Tax-free deposits The money you contribute to your HSA isn’t taxed (up to the IRS annual limit)
Tax-free earnings Your interest and any investment earnings grow tax-free
Tax-free withdrawals Money used toward eligible health care expenses isn’t taxed – now or in the future
Maximum HSA Contributions
Catch-up Contributions Individuals age 55 and older can make additional catch-up contributions in the amounts shown below:
2023 : $3,850; 2024 : $4,150
Single Coverage
2023 : $7,750; 2024 : $8,300
Family Coverage
2020 andafter
$1,000
Refer to your HSA documentation for more information.
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HSA I
7
HEALTH SAVINGS ACCOUNT (HSA)
Qualified medical care expenses are amounts paid for the diagnosis, cure or treatment of a disease, and for treatments affecting any part or function of the body. Below are some examples of Qualified Medical Expenses that HAS Dollars can be used for.
• Acupuncture
• Cold Sore Remedies
• Alcoholism
• Cold / Hot Packs
• Allergy Medicine
• Condoms
• Ambulance
• Contact Lens Solutions / Cleaners
• Annual Physical Examination
• Cotton Balls (sterile)
• Anti-gas, Antacid
• Cough Drops, Cough Suppressants
• Antihistimines
• Crutches
• Artificial Limb
• Decongestants
• Artificial Teeth
• Dental Treatment
• Aspirin
• Diagnostic Devices
• Bandages
• Diaper Rash Treatments
:
• Birth Control Pills
• Disabled Dependent Care Expenses
• Body Scan
• Drug Addiction
• Braille Books and Magazines
• Elastic wraps
• Breast Pumps and Supplies
• Expectorants
• Breast Reconstruction Surgery
• Eye drops (nonmedicated)
• Burn Treatments, OTC
• Eye Exam
• Calamine Lotion
• Eyeglasses
• Capital Expenses
• Eye Surgery
• Chiropractor
• Feminine Hygiene Products
• Contact Lenses
• Fertility Enhancement
• Cold and Flu Medication
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HSA I
8
MEDICAL PLAN
WHICH PREVENTIVE CARE SERVICES ARE COVERED?
CERTAIN VACCINES ■ COVID-19* ■ Diphtheria, Pertussis ("Whooping Cough"), Tetanus ■ Haemophilus Influenzae Type B (Hib) ■ Hepatitis A and B
SCREENINGS FOR ■ Abdominal aortic aneurysm ■ Alcohol abuse and tobacco use ■ Anxiety ■ Breast cancer screening, breast cancer prevention medication, genetic testing and counseling ■ Cardiovascular disease (CVD) including cholesterol screening and statin use for the prevention of CVD ■ Certain contraceptives and medical devices, morning after pill, and sterilization to prevent pregnancy ■ Cervical cancer screening ■ Colorectal and lung cancer ■ Depression ■ Falls prevention ■ High blood pressure, obesity, prediabetes and diabetes ■ Human papillomavirus (HPV) DNA test ■ Osteoporosis screening ■ Prep medication use for the prevention of HIV including baseline and monitoring services ■ Sexually transmitted infections, Chlamydia, gonorrhea, syphilis, HIV, HPV and hepatitis B ■ Tuberculosis
■ Human Papillomavirus (HPV) ■ Inactivated Poliovirus (Polio) ■ Influenza (Flu) ■ Measles, Mumps, Rubella (MMR) ■ Meningitis ■ Pneumococcal ■ Rotavirus ■ Varicella (Chicken Pox) ■ Zoster (Herpes, Shingles) FOR CHILDREN SCREENINGS FOR
■ Anxiety ■ Autism ■ Cervical dysplasia ■ Critical congenital heart defect screening for newborns ■ Depression ■ Developmental delays ■ Dyslipidemia (for children at higher risk) ■ Hearing loss, hypothyroidism, sickle cell disease and phenylketonuria (PKU) in newborns ■ Hematocrit or hemoglobin ■ Lead poisoning ■ Obesity ■ Sexually transmitted infections and HIV ■ Tuberculosis ■ Vision screening ASSESSMENTS AND COUNSELING ■ Alcohol and drug use assessment for adolescents ■ Obesity counseling ■ Oral health risk assessment, dental caries prevention fluoride
FOR ADULTS Annual preventive medical history and physical exam
COUNSELING FOR ■ Alcohol and drug misuse ■ Domestic violence
■ Healthy diet and physical activity counseling for adults who are overweight or obese and have additional cardiovascular disease risk factors ■ Obesity ■ Sexually transmitted infections ■ Skin cancer prevention ■ Tobacco use, including certain medicine to stop ■ Urinary incontinence screening PREGNANCY ■ Aspirin for preeclampsia prevention ■ Breastfeeding support, supplies and counseling ■ Counseling for alcohol and tobacco use during pregnancy ■ Counseling for healthy weight gain during pregnancy ■ Diabetes screening after pregnancy ■ Folic acid supplementation during pregnancy ■ Screenings related to pregnancy, including screenings for anemia, gestational diabetes, bacteriuria, Rh(D) compatibility, preeclampsia and perinatal depression
varnish and oral fluoride supplements ■ Skin cancer prevention counseling ■ Tobacco cessation
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MEDICAL PLAN I
9
TELEMEDICINE
Virtual Visits: Get Cost-Effective, 24/7 Care
With Virtual Visits from MDLIVE ® , the doctor is always in. This Blue Cross and Blue Shield of Texas(BCBSTX)benefit givesyou access to 24/7 non-emergency care from a board-certified doctor or therapist by phone, online video or mobile app from almost anywhere.
Skip expensive ERbills and waiting to see a doctor. You can speak with a Virtual Visits doctor within minutes.
Services are available in both English and Spanish with translation services available in other languages.
Blue Crossand Blue Shield of Texas,a Division of Health CareServiceCorporation, a Mutual Legal ReserveCompany, an Independent Licensee of the Blue Crossand Blue Shield Association
The Virtual Visits benefit is a convenient alternative for treatment of more than 80 health conditions, including:
Why Virtual Visits? • 24/7 access to an independently contracted, board-certified doctor or therapist • Access via phone, online video or mobile app from almost anywhere • Average wait time of less than 20minutes • Doctors can send e-prescriptions to your local pharmacy
• Allergies • Cold/Flu • Fever
• Headaches • Nausea • Sinus infections
Virtual Visits sessions with licensed behavioral health therapists are available by appointment. Get virtual care for:
• Depression • Eating disorders • ADHD
• Substance use disorders • Trauma and PTSD • Autism spectrum disorder
First, call your doctor’s office; they may also offer telehealth consultations by phone or online video. If you have any questions about this or any other BCBSTX benefit, please call the number on the back of your ID card.
Activate your Virtual Visits account today:
• Call 888-680-8646 • Go to MDLIVE.com/bcbstx • Text BCBSTX to 635-483 • Download the app
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TELEMEDICINE I
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DENTAL
DENTAL PLAN
SUMMARY OF COVERAGE
Key Features
Humana Dental Plan
Annual Deductible Individual | Family
$50 | $150
$1,500 per person +30% Extended Annual Maximum
Calendar Year Max
$1,500 per member (adult or child)
Orthodontia Lifetime Max
Preventive Care Benefits
No Charge
Basic Services
20% after deductible
Major Services
50% after deductible
50%
Orthodontia
Bi-Weekly Contribution
Employee Only
$6.18
Employee and Spouse
$17.37
Employee and Child
$22.04
Family
$35.62
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DENTAL PLAN I
12
VISION
VISION PLAN
SUMMARY OF COVERAGE
Vision Benefit
In Network
Out of Network
Frequency
Once every 12 months Once every 12 months Once every 24 months
Examination
$10 copay
Up to $30
Lenses
$15 copay
Up to $25 - $60
Frames
Up to $130
Up to $65
Once every 12 months
Med. Nec. Up to $0 Elective: Up to $130
Med. Nec. Up to $200 Elective: Up to $104
Contacts
Bi-Weekly Contribution
Employee Only
$0.99
Employee and Spouse
$2.46
Employee and Child
$3.05
Family
$4.79
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VISION PLAN I
14
EMPLOYER PAID LIFE & LONG TERM DISABILITY
LIFE & LONG TERM DISABILITY
SUMMARY OF COVERAGE
Bunkhouse provides all active salary and hourly employees who are regularly scheduled (and fulfill) 20 hours or more per week in an eligible class with Life/Accidental Death & Dismemberment Insurance. Coverage is provided by Humana.
Group Term Life/AD&D Benefit
$15, 000
You must designate a beneficiary for this life insurance policy, use Life Event / Open Enrollment instructions to add your beneficiary as a contact.
Employer Paid Long Term Disability Insurance
Bunkhouseprovidesall active salaryand hourlyemployeeswho are regularly scheduled (and fulfill)20 hours or more per week in an eligible class with Long term Disability Insurance. Coverage is provided by Lincoln Financial Group.
Long-Term Disability
Elimination Period
90Days
Benefit Duration
Toage65
Own Occupation Duration
24Months
Monthly Benefit
60%of MonthlyEarnings(up to maximum)
Maximum Benefit
$6,000
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LIFE INSURANCE I
16
VOLUNTARY LIFE & DISABILITY
VOL. LIFE
Bunkhouse provides employees with the excellent opportunity to purchase supplemental term Life/AD&D insurance on a payroll deduction basis.
Employee Benefit Amount
$10,000 increments
Coverage amount
Up to 5X your annual salary (roundedto the next higher $10,000) Maximum of $300,000
Guarantee Issue
$50,000
Spouse/Domestic Partner Benefit Amount
$5,000 increments
Coverage amount
Up to a Maximum of $150,000 (not to exceed 50% of employee coverage)
$10,000forSpousesunder the age of 60 at initial enrollment
Guarantee Issue
Reduction inBenefits
Benefits for both employees and spouse will be reduced 35% upon attainment of age 65.
Dependent Children BenefitAmount
$10,000 fopr children 6 months to 19 years (up to age 25 years if unmarried and a full-time student)
Coverage amount
$250 forchildren 14 days to 6 months
Evidence of Insurability
Voluntary coverages require you to submit an Evidence of Insurability form to Lincoln Financial Group for approval if electedoutside of your initial enrollment periodor if coverage beyond guaranteed issueis elected. See HR for more information.
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DISABILITY – SHORT TERM I
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VOL. DISABILITY PLAN SHORT TERM
SUMMARY OF COVERAGE
Bunkhouse provides employees with the opportunity to purchase group Short-Term Disability Insurance on a payroll deduction basis. Coverage is provided by Lincoln FinancialGroup.
Short-Term Disabilityis intended to protect your income for a short duration in case you become ill or injured.
All activesalaryandhourlyemployeeswhoareregularly scheduled(andfulfill)20 hours or more per week in an eligible class are eligible for coverage on the policy effective date
Eligibility
Maximum Weekly Benefit
60% of weekly salary up to $500 per week
Maximum Benefit Duration
13weeks
Elimination Period
Benefits begin on: 15 days for an accident & 15 days for an illness
You may not be eligible for benefits if you have received treatment for a condition within the past 12 months until you have been covered under this plan for 12 months New Hire: you are able to take advantage of this coverage now without a health examination.Youmay notbe offeredthisopportunity again
Pre-Existing Condition
Enrollment
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DISABILITY – LONG TERM I
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RETIREMENT
401(k)
Plan Highlights Hyatt Corporation Retirement Savings Plan
Eligibility You’re eligibletojointheHyattRetirementSavingsPlan(RSP)onyour30thday ofemploymentonlineatrps.troweprice.comorby calling 1-800-922-9945. Youcanenrollatanytime,butifyoudonotmakeanelection,theHyattRSPisset upsothat you’ll be automatically enrolled after your 30thdayof employment. Onceenrolled,1%ofyourbefore-taxpaywillbedeductedfromyourpaycheck andautomaticallyinvestedinapre-assembled,age- based investment with the target date that is closest to the year you will turn 65. You will receive details about your automatic contributions,includinghowtochangeyour contribution rate, contributiontype(before-taxorRoth),orinvestment election, oropt out of the plan, before payroll deductions are scheduled to begin. Employee Contributions You can contribute up to 75%of your pay in before-taxand/or Roth (after-tax) contributions, up to the IRSannual limits. ▪ Before-taxcontributions:Yourcontributions come out of yourpaycheck beforeincome taxesaretakenout,which reduces yourcurrenttaxable income.Inaddition,you don’t havetopaytaxesonyourcontributionsand associatedearningsuntil you withdraw them from your account. ▪ Rothcontributions:Rothcontributions aremadewithmoneythathas alreadybeentaxed.Unlikebefore-taxcontributions, Roth contributions do not provide a tax break today. The tax benefits come when you takea qualified distribution.* When you take a qualified distribution, you won’t have to pay additional taxes on the money you’ve contributed or on any earnings in your Roth account. *Aqualifieddistributionistax-freeiftakenatleast5yearsaftertheyearofyourfirstRothcontribution AND you’ve reached age 59½,become totallydisabled,ordied.Ifyourdistributionisnotqualified,any earningsfromtheRothportionwillbetaxableintheyearitisdistributed.These rulesapplytoRoth distributionsonlyfromemployer-sponsoredplans.Additionalplandistributionrulesapply. Automatic Increase Yourplan automatically enrollsyou in the T.Rowe Price AutomaticIncrease service. This service gradually increases your contributionamounteachMarch by1%,uptoamaximumof75%.Youcanchangethemonthoftheannual increase,the amountoftheincrease,andthecontributiontype.Oryoucanturn offtheserviceatanytime. You’ll receive more detailed informationaboutthis servicepriortotheeffectivedate. Hyatt Matching Contributions You’re eligiblefortheHyattmatchingcontributionafteroneyearofservice.Hyatt willmatch100%ofthefirst3%youcontributeand 50%onthenext2%.Consider contributingatleast5%toreceivethefullmatchingcontribution.Forexample,if youcontribute5%, Hyatt will add an additional 4%in matching contributions for a total savings of 9%. Vesting You are 100%vested in anycontributions you make,as well as any Hyatt matching contributions. Investing Theplan offersadiverseinvestmentmixforyou tochoose from,including age-based portfolios.
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I
401(k)
21
PAID TIME OFF
Paid Time Off Maintaining abalancebetweenworkandhomelifeisapriorityatBunkhouse.Tofurtherthismis-sion,we provide a generous paid Time Off (PTO) benefit for all full-time employees maintaining 30+ hours/week for 90+ days.
The Guidelines are as follows:
• The table below outlines the PTO accruals which are based on hours worked begin- ning onthe date the employee achieved full-time status (30+ hours per week). PTO hours are not accrued while utilizing paid time-off or for overtime hours worked.
• Tipped employees’ PTO will be paid at their rate or minimum wage, whichever is higher.
• Up to 40 hours ofPTOare eligible forrollover at the end of the benefityear, and these hourswill be reflected on the first paycheck in March.
• Unused PTO balances will be paid out upon separation if the following criteria is met:
Must be employed for One (1) year
Separation must be voluntary
Employee must submit to Management and complete a two weeks’ notice.
An exit survey must be completed and returned to HR prior to the last shift worked.
Yearsof FT
Total Possible Earned PTO Hours
Earned PTO/ Worked Hour
Possible Rollover Hours
Tier
Service
1
.06122
0-3
120
40
2
.07216
3-6
140
40
3
.08333
6-9
160
40
4
.10638
9-19
200
40
5
.13043
19+
240
40
Bereavement Leave
Employeesareentitledtotakeupto3workdays with pay,sotheymaytakecareofpersonalmattersrelated tothedeath of an immediate family member or a spouse’s immediate family member. “Immediate family member” is defined as current spouse, domestic partner, mother, father, sister, brother, child, in-law, grand- parent, grandchild, aunt, uncle, niece,nephew orcousin.All BereavementLeave requests requireManage- ment approval.
Jury Duty Leave
Paid Jury Duty Leave is available forfull-time employees for up to 5 days. Court documentation anda time-off request must be submitted before Jury Leave can be granted.
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PAID TIME OFF
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HOLIDAY POLICY & PARENTAL LEAVE
Holiday Policy All full-time,hourly employeeswhohave fulfilled the 90-day waitingperiod will receive 8 hours of holiday pay in additiontocompensationfor allhours worked. Employeesmust completethe scheduledshifts before and after the holidaytobe eligibleto receivethe additional8 hours of HolidayPay. Full-time tipped employees’ holiday hours will be paid at their rate or minimum wage, whichever is higher.
Part-timeemployeesandfull-timehourly employeeswithintheir90-day waitingperiodwill be paid 1.5xtheir pay rate forhoursworked onrecognizedholidays.
Full-time, salaried employeesrequired to work on a company recognized holiday will be given the opportunityto takeanotherday offinlieu ofthe holiday. This additionalday off mustbe takeninthesame pay period. The list of company recognized holidays is as follows:
New Year’s Day – January1.
•
Memorial Day – Last Monday in May.
•
Juneteenth – June19.
•
Independence Day – July4.
•
LaborDay – First Monday in September.
•
• Thanksgiving – Fourth Thursday in November.
Christmas Day – December 25.
•
Parental Leave Bunkhouse provides eight (8) weeks of paid parental leave to eligible employees. The purpose ofpaid parental leave is to enable the employee to care for and bond with a newborn, newly adopted, or newly placed child in connection with foster care. This policy will run concurrently with Family and Medical leave according to the Family and Medical Leave Act (FMLA), as applicable. This policy will be in effect for births, adoptions or placements of foster children occurring on or after January 1, 2024.
Eligible employees must meet the following criteria:
• Have been employed with the company for at least 12 months (the 12 months do not need to be consecutive). • Have worked at least 1,250 hours during the 12 consecutive months immediately preced- ing the date the leave would begin.
Be a full-time,regularemployee.
•
In addition, employees must meet one of the following criteria:
• Havegivenbirthto achild or have a new childbirthedby spouseordomesticpartner.
• Have adopted a child or have a foster child placed with them (in either case, the childmust be age 17 or younger). The adoptionofa childby a new spouse is excluded fromthispolicy.
***All Paid-Time Off, including Jury Duty, Holiday, Bereavement Leave and Parental Leave will be paid at minimum wage for employees with hourly rates that 3 a 2 resubject to the tip credit .
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HOLIDAY POLICY & PARENTAL LEAVE
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SERVICE HOURS & REFERRAL BONUS
Service Hours Bonus
Service Hours
Bonus
10,000
$500
20,000
$1,000
30,000
$1,500
40,000
$2,000
The guidelines are as follows:
• Actual worked hours are used to determine the Service Hours Bonus calculation.
• Holiday and PTO hours are excluded from the Service Hours Bonus calculation.
• Bonusescan be deposited ona pre-taxbasis into an employee’s 401(k),HSA oranyotherpretax account. • If an employee with accumulated services hour totaling 4,000 to 9,999 hours is subsequently rehiredwithin 12 monthsof termination,thenall service hourswill be reinstated. • If an employee with accumulated service hours totaling 10,000+ is rehired at any future date after termination, then all service hours will be reinstated. Employee Referral Bonus Program Employees referring a candidate who is hired at any Bunkhouse property who then remains employed for the Indicated periodwill be awarded a bonus throughpayroll at the conclusion of the wait period. Candidates must name the referring employee during the application process.
• $500bonus – ($500 after 6 mos) - management position (“Manager” or “Director” intitle).
• $250bonus – ($250 after 90 days) – Housekeeper, NightAuditor,Dishwasher, F&BService Asst / Busser / Runner.
• $100 bonus – ($100 after 90 days) – all other positions.
*Managerswho have hiringprivilegesare exemptedfrom claiming the bonusfortheirown department. Please reference Employee Referral Program guidelines for specific information.
Thanks in advance for helping us grow our team!
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SERVICE HOURS & REFERRAL BONUS I
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ADDITIONAL DISCOUNTS
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ADDITIONAL DISCOUNTS I
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ENROLLMENT
ONLINE ENROLLMENT OVERVIEW BenefitPlan Manager Your benefits are managed through BenefitPlan Manager (BPM), found at www.lyfblox.com. Follow the below instructions to log-in to BPM, where you can: • Complete a new hire or open enrollment – use the below guide for step-by-step instructions! • Submit a life event. • View plan summaries and benefit guides. • View temporary ID cards and request permanent replacements, as applicable. • Add dependents and beneficiaries to your plans. • YOU HAVE 30 DAYS TO ENROLL, AFTER YOUR 2 ND MONTH OF EMPLOYMENT. www.lyfblox.com
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BENEFITS GUIDE
LEGAL NOTICES
LLEEGGAALL NNOOTTI ICCEESS
Health Insurance Portability and Accountability Act of 1996 (HIPAA) The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that addresses the privacy and security of certain individually identifiable health information, called protected health information (or PHI). You have certain rights with respect to your PHI, including a right to see or get a copy of your health and claims records and other health information maintained by a health plan or carrier. For a copy of the Noticeof PrivacyPractices,describinghow your PHI maybe usedand disclosedand how you get accessto the information,contact Human Resources. Women’s Healthand Cancer RightsAct EnrollmentNotice If you have had or are going to have a mastectomy,you maybe entitledto certainbenefits under the Woman’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:
1. All stages of reconstruction of the breast on which mastectomy was performed. 2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; prostheses. 3. Treatment of physical complications of the mastectomy, including lymphedema.
These will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this benefitsplan. Ifyou would likemoreinformationon WHCRAbenefits,callyour plan administrator.
Newborns’ and Mothers’ Health Protection Act Disclosure Group health plans and health insuranceissuers generally maynot, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, fromdischarging the motheror her newborn earlierthan 48 hours (or 96 hours as applicable).In any case,plans and issuers maynot, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Patient Protection Notice Your carrier generally may require the designation of a primary care provider. You have the right to designate any primary care provider who participates in your network and who is available to accept you or your familymembers. Untilyou makethis designation,your carrier may designate one for you. For information on how to select a primarycare provider, and for a list of the participating primary care providers, contact the plan carrier. For children,you maydesignate a pediatrician as the primarycare provider. You do not need prior authorization fromyour carrier or from any other person (including a primary care provider) in order to obtain access to obstetricalor gynecological care from a health care professional in your network who specializesin obstetrics or gynecology. The health care professional, however, maybe required to complywith certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact the plan carrier. HIPAA Special Enrollment Notice If you are declining enrollment foryourself or your dependents (including your spouse) because of other health insuranceor group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. If you or your dependents lose eligibility for coverage under Medicaid or the Children’s Health Insurance Program (CHIP)or become eligible for a premium assistance subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents. You must request enrollment within 60 days of the loss of Medicaidor CHIPcoverage or the determination of eligibilityfor a premiumassistancesubsidy. To request special enrollment orto obtain more information about the plan's special enrollment provisions,contactthe plan administrator.
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PremiumAssistance Under Medicaidand the Children'sHealthInsurance Program (CHIP) If you or your childrenare eligiblefor Medicaid or CHIPand you’re eligible for health coverage from your employer, your state may have a premiumassistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs, but you may be able to buy individual insurance coverage through the Health InsuranceMarketplace. For moreinformation, visitwww.healthcare.gov.
If your or your dependents are already enrolled in Medicaid or CHIP and you livein a State listed below, contact your State Medicaid or CHIP officeto find out if premiumassistanceis available.
If your or your dependents are NOT currentlyenrolled in Medicaidor CHIP, and you think you or any of your dependents might be eligible for either of these programs, contactyour State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that mighthelp you pay the premiumsfor an employer-sponsored plan. If you or your dependents are eligiblefor premiumassistanceunder Medicaidor CHIP,as well as eligibleunder your employerplan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you mustrequest coverage within60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contactthe Departmentof Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list ofstates is current as ofJuly 31, 2024. Contactyour state for more informationoneligibility.
ALABAMA-Medicaid
CALIFORNIA-Medicaid
Website: http://myalhipp.com/ Phone: 1-855-692-5447
Website: Health Insurance Premium Payment (HIPP) Program
http://dhcs.ca.gov/hipp Phone: 916-445-8322 Fax: 916-440-5676 Email: hipp@dhcs.ca.gov
ALASKA-Medicaid
COLORADO-Health First Colorado (Colorado’s Medicaid
Program)&ChildHealth Plan Plus(CHP+)
The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861 Email: CustomerService@MyAKHIPP.com Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx
Health First Colorado Website: https://www.healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1-800-221-3943/State Relay 711 CHP+: https://hcpf.colorado.gov/child-health-plan-plus CHP+ Customer Service: 1-800-359-1991/State Relay 711 Health Insurance Buy-In Program (HIBI): https://www.mycohibi.com/ HIBI Customer Service: 1-855-692-6442
ARKANSAS-Medicaid
FLORIDA-Medicaid
Website: https://www.flmedicaidtplrecovery.com/flmedicaidtplrecovery. c om/hipp/index.html Phone: 1-877-357-3268
Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447)
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GEORGIA-Medicaid
MAINE-Medicaid
GA HIPP Website: https://medicaid.georgia.gov/health- insurance-premium-payment-program-hipp Phone: 678-564-1162, Press 1 GA CHIPRA Website: https://medicaid.georgia.gov/programs/third-party- liability/childrens- health-insurance-program-reauthorization- act-2009-chipra Phone: (678) 564-1162, Press 2
Enrollment Website: https://www.mymaineconnection.gov/benefits/s/?language= en_US Phone: 1-800-442-6003 TTY: Maine relay 711
Private Health Insurance Premium Webpage: https://www.maine.gov/dhhs/ofi/applications-forms
Phone: -800-977-6740. TTY: Maine relay 711
INDIANA-Medicaid
MASSACHUSETTS-Medicaid and CHIP
Healthy Indiana Plan for low-income adults 19-64 Website: http://www.in.gov/fssa/hip/ Phone: 1-877-438-4479 All other Medicaid Website: https://www.in.gov/medicaid/ Phone 1-800-457-4584
Website: https://www.mass.gov/masshealth/pa Phone: 1-800-862-4840 TTY: 711 Email: masspremassistance@accenture.com
IOWA-Medicaid and CHIP (Hawki)
MINNESOTA-Medicaid
Medicaid Website: https://dhs.iowa.gov/ime/members Medicaid Phone: 1-800-338-8366 Hawki Website: http://dhs.iowa.gov/Hawki Hawki Phone: 1-800-257-8563 HIPP Website: https://dhs.iowa.gov/ime/members/medicaid-a-to- z/hipp HIPP Phone: 1-888-346-9562
Website: https://mn.gov/dhs/people-we-serve/children-and- families/health- care/health-care-programs/programs-and- services/other- insurance.jsp Phone: 1-800-657-3739
KANSAS-Medicaid
MISSOURI-Medicaid
Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884 HIPP Phone: 1-800-967-4660
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005
KENTUCKY-Medicaid
MONTANA-Medicaid
Kentucky Integrated Health Insurance Premium Payment Program (KI- HIPP) Website: https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx Phone: 1-855-459-6328 Email: KIHIPP.PROGRAM@ky.gov KCHIP Website: https://kidshealth.ky.gov/Pages/index.aspx Phone: 1-877-524-4718 Kentucky Medicaid Website: https://chfs.ky.gov/agencies/dms
Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084 Email: HHSHIPPProgram@mt.gov
LOUISIANA-Medicaid
NEBRASKA-Medicaid
Website: dhh.louisiana.gov/index.cfm/subhome/1/n/331 or www.ldh.la.gov/lahipp Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618- 5488 (LaHIPP)
Website: http://www.ACCESSNebraska.ne.gov Phone: 1-855-632-7633 Lincoln: 402-473-7000 Omaha: 402-595-1178
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NEVADA-Medicaid
SOUTH CAROLINA-Medicaid
Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900
Website: https://www.scdhhs.gov Phone: 1-888-549-0820
NEW HAMPSHIRE-Medicaid
SOUTH DAKOTA-Medicaid
Website: https://www.dhhs.nh.gov/programs-services/medicaid/health- insurance-premium-program Phone: 603-271-5218 Toll free number for the HIPP program: 1-800-852-3345, ext. 5218
Website: http://dss.sd.gov Phone: 1-888-828-0059
NEW JERSEY-Medicaid and CHIP
TEXAS-Medicaid
Medicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710
Website: Health Insurance Premium Payment (HIPP) Program | Texas Health and Human Services Phone: 1-800-440-0493
NEW YORK-Medicaid
UTAH-Medicaid and CHIP
Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831
Medicaid Website: https://medicaid.utah.gov/ CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669
NORTH CAROLINA-Medicaid
VERMONT-Medicaid
Website: https://medicaid.ncdhhs.gov/ Phone: 919-855-4100
Website:Health Insurance Premium Payment (HIPP) Program | Department of Vermont Health Access Phone: 1-800-250-8427
NORTH DAKOTA-Medicaid
VIRGINIA-Medicaid and CHIP
Website: https://www.hhs.nd.gov/healthcare Phone: 1-844-854-4825
Website: https://coverva.dmas.virginia.gov/learn/premium- assistance/famis-select https://coverva.dmas.virginia.gov/learn/premium-assistance/health- insurance-premium-payment-hipp-programs Medicaid/CHIP Phone: 1-800-432-5924
OKLAHOMA-Medicaid and CHIP
WASHINGTON-Medicaid
Website: http://www.insureoklahoma.org Phone: 1-888-365-3742
Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022
OREGON-Medicaid
WEST VIRGINIA-Medicaid and CHIP
Website: http://healthcare.oregon.gov/Pages/index.aspx Phone: 1-800-699-9075
Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/ Medicaid Phone: 304-558-1700 CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)
PENNSYLVANIA-Medicaid and CHIP
WISCONSIN-Medicaid and CHIP
Website: https://www.dhs.pa.gov/Services/Assistance/Pages/HIPP- Program.aspx Phone: 1-800-692-7462 CHIP Website: Children's Health Insurance Program (CHIP) (pa.gov) CHIP Phone: 1-800-986-KIDS (5437)
Website: https://www.dhs.wisconsin.gov/badgercareplus/p-10095.htm Phone: 1-800-362-3002
RHODE ISLAND-Medicaid and CHIP
WYOMING-Medicaid
Website: https://health.wyo.gov/healthcarefin/medicaid/programs- and-eligibility/ Phone: 1-800-251-1269
Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line)
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To see if any other states have added a premium assistance program since January 31, 2024, or for more information on specialenrollment rights, contact either:
U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565
Paperwork Reduction Act Statement
According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to complywith a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512. The public reporting burden for this collection of information is estimated to average approximately four minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden, to the U.S. Department of Labor, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email ebsa.opr@dol.gov and reference the OMB Control Number 1210- 0137.
OMB Control Number 1210-0137 (expires 1/31/2026)
Genetic Information Nondiscrimination Act (GINA) Disclosures Genetic Information Nondiscrimination Act of 2008
The Genetic Information Nondiscrimination Act of 2008 (“GINA”) protects employees against discrimination based on their
genetic information. Unless otherwise permitted, your Employer may not request or require any genetic information from you
or your family members.
The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II
from requesting or requiring genetic information of an individual or family member of the individual, except as specifically
allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to
this request for medical information. “Genetic information,” as defined by GINA, includes an individual’s family medical hist ory,
the results of an individual’s or family member’s genetic tests, the fact that an individual or an individual’s family member
sought or received genetic services, and genetic information of a fetus carried by an individual or an individual’s family
member or an embryo lawfully held by an individual or family member receiving assistive reproductive services.
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USERRA Notice Your Rights Under USERRA A. The Uniformed Services Employment and Reemployment Rights Act
• USERRA protects the job rights of individuals who voluntarily or involuntarily leave employment positions to undertake military service or certain types of service in the National Disaster Medical System. USERRA also prohibits employers from discriminating against past and present members of the uniformed services, and applicants to the uniformed services. B. Reemployment Rights You have the right to be reemployed in your civilian job if you leave that job to perform service in the uniformed service and: • You ensure that your employer receives advance written or verbal notice of your service; • You have five years or less of cumulative service in the uniformed services while with that particular employer; • You return to work or apply for reemployment in a timely manner after conclusion of service; and • You have not been separated from service with a disqualifying discharge or under other than honorable conditions. If you are eligible to be reemployed, you must be restored to the job and benefits you would have attained if you had not been absent due to military service or, in some cases, a comparable job. C. Right to Be Free from Discrimination and Retaliation If you: • Are a past or present member of the uniformed service; • Have applied for membership in the uniformed service; or • Are obligated to serve in the uniformed service; then an employer may not deny you o Initial employment; o Reemployment; o Retention in employment; o Promotion; or o Any benefit of employment because of this status. In addition, an employer may not retaliate against anyone assisting in the enforcement of USERRA rights, including testifying or making a statement in connection with a proceeding under USERRA, even if that person has no service connection. If you leave your job to perform military service, you have the right to elect to continue your existing employer-based health plan coverage for you and your dependents for up to 24 months while in the military. • Even if you do not elect to continue coverage during your military service, you have the right to be reinstated in your employer's health plan when you are reemployed, generally without any waiting periods or exclusions (e.g., pre-existing condition exclusions) except for service-connected illnesses or injuries. The U.S. Department of Labor, Veterans' Employment and Training Service (VETS) is authorized to investigate and resolve complaints of USERRA violations. For assistance in filing a complaint, or for any other information on USERRA, contact VETS at 1-866-4-USA-DOL or visit its Web site at http://www.dol.gov/vets. An interactive online USERRA Advisor can be viewed at http://www.dol.gov/elaws/userra.htm. • D. Health Insurance Protection • E. Enforcement • If you file a complaint with VETS and VETS is unable to resolve it, you may request that your case be referred to the Department of Justice or the Office of Special Counsel, as applicable, for representation. • You may also bypass the VETS process and bring a civil action against an employer for violations of USERRA. The rights listed here may vary depending on the circumstances. The text of this notice was prepared by VETS, and may be viewed on the Internet at this address: http://www.dol.gov/vets/programs/userra/poster.htm. Federal law requires employers to notify employees of their rights under USERRA, and employers may meet this requirement by displaying the text of this notice where they customarily place notices for employees. U.S. Department of Labor, Veterans' Employment and Training Service, 1-866-487-2365.
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