BENEFITS AT A GLANCE
7.01.21 – 6.30.22
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Contents & Contacts
BROKER Provider Name Broker Contact
M.E. Wilson Company
Amanda Sands
Provider Phone Number Provider Email Address
813-229-8021 Ext. 139 asands@mewilson.com
MEDICAL
page 5
Provider Name
Humana
Provider Phone Number Provider Web Address
1-800-448-6262
www.humana.com
DENTAL
page 8
Provider Name
Humana
Provider Phone Number Provider Web Address
800-448-6262
www.humana.com
VISION
page 9
Provider Name
Humana
Provider Phone Number Provider Web Address
800-448-6262
www.humana.com
BASIC AND VOLUNTARY LIFE
page 10
Provider Name
Lincoln Financial 800-423-2765 www.lfg.com Lincoln Financial 800-423-2765 www.lfg.com
Provider Phone Number Provider Web Address
SHORT TERM AND LONG TERM DISABILITY
page 11
Provider Name
Provider Phone Number Provider Web Address
FLEXIBLE SPENDING ACCOUNT (FSA)
page 12
Provider Name
Discovery Benefits
Provider Phone Number Provider Web Address
866-451-3399
www.discoverybenefits.com
EMPLOYEE ASSISTANCE PLAN (EAP)
page 13
Provider Name
BayCare
Provider Phone Number Provider Web Address
1-800-878-5470 BayCare.org/EAP
PET INSURANCE
page 15
Nationwide
Provider Name
Provider Contact
Amy MacDonald 1-407-283-7963
Provider Phone Number Provider Email Address Provider Web Address
abarton@nationwide.com
www.petinsurance.com/floridaaquarium
RETIREMENT SAVINGS PLAN
page 16
Provider Name
CUNA Mutual
Provider Web Address
www.benefitsforyou.com
PAID TIME OFF
page 18
DISCLOSURE NOTICES
page 19
Your Benefits
Benefit
Who pays the cost?
YOUR BENEFITS PLAN
The Florida Aquarium pays at minimum 90 percent of the employee portion of the medical plan and 50 percent of the spouse & dependent portion. The Florida Aquarium pays 100 percent of the employee portion of the dental plan and you pay the cost for your covered dependents. The Florida Aquarium pays 100 percent of the employee portion of the vision plan and you pay the cost for your covered dependents.
Medical Insurance
The Florida Aquarium offers a variety of benefits allowing you 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.
Dental Insurance
Vision Insurance
The Florida Aquarium pays the entire cost for the employee only.
Basic Life Insurance
You pay the entire cost for you and your dependents.
Voluntary Life Insurance
Short and Long Term Insurance
The Florida Aquarium pays the entire cost for the employee only.
ELIGIBILITY
All Regular full-time employees are eligible to join the Florida Aquarium Benefits Plan on the 1st of the month following 60 days. “Regular Full - Time Employees” must be regularly scheduled and working at least 30 hours per week.
You may also enroll your dependents in the Benefits Plan when you enroll.
Eligible dependents include:
Your legal spouse or domestic partner
•
• Your married or unmarried natural children, step-children living with you, legally adopted children and any other children for whom you have legal guardianship, who are:
Under 26 years of age;
►
WHEN CAN YOU ENROLL?
► A dependent who is older than 26 years of age, but less than 30 years of age may be eligible for medical benefits. To be eligible, a Dependent must: • Be unmarried and not have dependents of his or her own; AND
You can sign up for Benefits at any of the following times:
• After completing your initial eligibility period; • During the annual open enrollment period; • Within 30 days of a qualified life-status change.
Be a resident of Florida or a student; AND
•
Not have coverage of their own, or covered under any other plan; AND
•
If you do not enroll at one of the above times, you must wait for the next annual open enrollment period.
Not entitled to benefits under Medicare
•
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Your Benefits
?
CHOOSING YOUR BENEFITS
You must actively choose any benefit that you pay for or share in the cost with The Florida Aquarium. Your part of the cost is automatically taken out of your paycheck. There are two ways that the money can be taken out:
WHY DO I PAY FOR BENEFITS WITH BEFORE-TAX MONEY?
There is a definite advantage to paying for some benefits with before-tax money: Taking the money out before your taxes are calculated lowers the amount of your pay that is taxable. Therefore, you pay less in taxes.
• BEFORE YOUR TAXES ARE CALCULATED – medical, dental, vision and FSA
• AFTER YOUR TAXES ARE CALCULATED – voluntary life and accidental death & dismemberment, supplemental 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 change in life status including:
If you fail to notify Human Resources within 30 days of a family status change, you will be required to wait until the next annual enrollment period to make benefit changes unless you have another life status change.
Your marriage
•
Your divorce or legal separation
•
Birth or adoption of an eligible child
•
Death of your spouse or covered child
•
WHEN COVERAGE ENDS
• Change in your spouse’s work status that affects his or her benefits
Coverage will stop on the last day of the month in which employment with the company ends.
• Change in your work status that affects your benefits
• Change in residence or work site that affects your eligibility for coverage
• Change in your child’s eligibility for benefits
• Receiving Qualified Medical Child Support Order (QMCSO)
KEY BENEFIT TERMS
COBRA – A Federal law that allows workers and dependents who lose their medical, dental, or vision coverage to continue any of these coverages for a specified length of time by electing and paying for continuation benefits. Copayment – A flat fee that you pay for medical services, regardless of the actual amount charged by your doctor or another provider. This generally applies to physicians’ office visits and prescription drugs. Deductible – The amount you pay toward medical and dental expenses each year before the plan begins paying benefits. Out of Pocket Maximum – The maximum amount you will pay in deductibles and copayments during the year.
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Medical
The Florida Aquarium offers three (3) medical plans through Humana. To find participating providers go to www.humana.com and click on “Find a Doctor”, choose the Premier plan type, and click continue. Then, narrow down your search based on location and provider type.
The chart below provides a brief overview of the medical plans. 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 your exact description of services and supplies that are covered, those which are excluded or limited, and other terms and conditions of coverage.
HMO Premier 2500
HMO Premier 500
PPO 1000
IN-NETWORK:
HMO Premier
HMO Premier
National POS
Plan Year or Calendar Year Basis
Plan Year
Plan Year
Plan Year
Deductible (Individual / Family)
$2,500 / $6,500
$500 / $1,000
$1,000 / $2,000
Coinsurance
100% / 0%
90% / 10%
80% / 20%
Maximum Out-of-Pocket (Individual/Family)
$6,500 / $13,000
$4,000 / $8,000
$5,000 / $10,000
Deductible, Coinsurance & Copayments
Deductible, Coinsurance & Copayments
Maximum Out-of-Pocket Includes
Deductible & Copayments
Lifetime Major Medical Maximum
Unlimited
Unlimited
Unlimited
PREVENTIVE CARE:
Wellness Immunizations Mammography/Colonoscopy Mental/Behavior Health COPAYMENTS: Referral Required
Covered 100%
Covered 100%
Covered 100%
No
No
No
Telemedicine, Office Visits/Consultations for Illness/Injury
$35 copayment
$20 copayment
$35 copayment
Specialist Visits
$60 copayment
$35 copayment
$60 copayment
Deductible, then 10% coinsurance
Deductible, then 20% coinsurance
Inpatient Hospital - Facility Fees
Deductible
Deductible, then 10% coinsurance
Deductible, then 20% coinsurance
Outpatient Surgery - Facility Fees
Deductible
Emergency Room
$250 copayment
$150 copayment
$350 copayment
$35 Copayment
$35 Copayment
$35 Copayment
Urgent Care
OUTPATIENT DIAGNOSTIC SERVICES:
Lab Services (free standing lab)
Covered 100% Covered 100% $300 copayment
Covered 100% Covered 100% $300 copayment
Covered 100% Covered 100% $300 copayment
X-Ray Services (free standing facility)
Complex Diagnostic
PRESCRIPTIONS*:
Retail (30 day supply)
$10 / $30 / $50 / 25% $10 / $30 / $50 / 25% $10 / $45 / $90 / 25%
Mail Order (90 day supply)
2.5x retail
2.5x retail
2.5x retail
OUT-OF-NETWORK: Deductible (Individual / Family)
$3,000 / $6,000
Maximum Out-of-Pocket (Individual/Family)
$15,000 / $30,000
In-Network Only
In-Network Only
Lifetime Major Medical Maximum
Unlimited
Coinsurance
50% / 50%
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Medical Contributions
HMO Premier 2500
Employee Cost Per Pay Period
Employee Only
$ 13.96
Employee + Spouse
$ 264.36
Employee + Child(ren)
$ 180.89
Family
$ 413.15
HMO Premier 500
Employee Cost Per Pay Period
Employee Only
$ 32.51
Employee + Spouse
$ 324.12
Employee + Child(ren)
$ 226.91
Family
$ 497.39
PPO 1000
Employee Cost Per Pay Period
Employee Only
$ 31.32
Employee + Spouse
$ 312.25
Employee + Child(ren)
$ 218.61
Family
$ 479.19
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Know Where to Go
Telemedicine
Convenience Care
Doctor’s office
Urgent care
ER
Access telehealth services to treat minor medical conditions. Connect with a board-certified doctor via video or phone when where and how it works best for you.
Treats minor medical concerns. Staffed by nurse practitioners and physician assistants. Located in retail stores and pharmacies. Often open nights and weekends. › Colds and flu › Rashes or skin conditions › Sore throats, earaches, sinus pain
The best place to go for routine or preventive care, to keep track of medications, or for a referral to see a specialist.
For conditions that aren’t life threatening. Staffed by nurses and doctors and usually have extended hours.
For immediate treatment of critical injuries or illness. Open 24/7. If a situation seems life-threatening, call 911 or go to the nearest emergency room. › Chest Pain › Shortness of Breath › Life Threatening Illness or Injuries › Critical Conditions
› Colds and flu › Rashes › Sore throats › Headaches › Stomachaches › Fever › Allergies
› General health issues › Preventive care
› Muscle Sprains or Strains › Back Pain
› Routine checkups › Immunizations and screenings
› Skin Infections › Broken Bones
› Minor cuts or burns › Pregnancy testing › Vaccines
Terms to Know
When you enroll in coverage you become a Humana Member. A Humana member gets access to their network of providers (doctors and facilities) – these are in-network providers. Humana members receive Discounted Rates with these in-network providers. Discounted Rate
Copays
Copays are set dollar amounts you pay for specific services. These cost are typically collected at the time of service. For example, under the HMO Premier 2500 plan you have a $35 copay for a visit to your primary care physician.
Deductible
Services not subject to a copay are subject to your deductible. You pay first dollar costs for claims subject to your deductible and you receive the Discounted Rate for all covered claims with an in-network provider.
Coinsurance
Coinsurance is the percentage of covered medical expenses you pay after you've met your deductible.
Out-of-Pocket
This amount is the maximum amount you will pay towards covered services on the plan for the calendar year. This amount includes the amounts you pay in deductible, coinsurance, copays, and prescription copays.
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Dental
The Florida Aquarium offers dental coverage through Humana. The Dental DHMO Plan is an in-network plan only, whereas the Dental PPO Plan allows you to use in-network or out-of-network benefits. If out-of-network dentists are used, you will be responsible for paying the difference between Huma na’s allowed amount and what the dentist may charge, also known as “balance billing” . The chart below provides a brief overview of the plans, The Florida Aquarium pays 100% of the employee only dental cost for either selected plan!
Dental
DMO Plan
PPO Plan
In-Network
In-Network
Out-of Network*
Calendar Year Deductible Individual
Not Applicable
$25
$50
Family
Not Applicable
$75
$150
Annual Maximum
Unlimited
$1,500
$1,500
Diagnostic & Preventive Exams Cleanings Fluoride X-Rays Sealants Regular Restorative Services
Refer to Fee Schedule
Covered in full
Covered in full
Amalgam Fillings
Refer to Fee Schedule
Covered 80% after deductible
Extractions - Single Tooth Periodontics (Gum Disease) Endodontics (Root Canal) Major Services Crowns
Covered 90% after deductible
Bridges Dentures
Refer to Fee Schedule
Covered 60% after deductible
Covered 50% after deductible
Basic Child Only $1,000 Lifetime Max
Adult/Child Refer to Fee Schedule
Orthodontia
• Out of network claims are subject to reasonable and customary charges. • If you or your dependents do not enroll when first eligible, there is a 12-month waiting period for Basic (fillings/ 6 months) and a 24 month waiting period for Major and Orthodontia coverage.
BASE DMO Plan (HS205)
PREMIUM PPO Plan
Employee Cost Per Pay Period
Employee Only
$ 0.00 $ 6.66 $ 8.32 $ 17.43
$ 0.00 $ 12.30 $ 21.59 $ 34.41
Employee + Spouse Employee + Child(ren)
Family
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Vision
The Florida Aquarium offers vision through Humana. The Humana vision network consists of optometrists, ophthalmologist opticians and optical retailers. You have the option of visiting any provider, however by choosing a participating provider, you receive the highest level of benefits.
Vision
In-Network
Out-of-Network
Routine Eye Exams
$10 Copayment
$30 Allowance
Lenses Single
$10 Copayment
$25 Allowance
Bifocal
$10 Copayment
$40 Allowance
Trifocal
$10 Copayment
$60 Allowance
Lenticular
$10 Copayment
$100 Allowance
Lens Upgrades
$10 Copayment Tier 1: $75 Copayment Tier 2: $85 Copayment Tier 3: $100 Copayment Tier 4: $120 Allowance 55 Copay + 20% Discount
Standard Progressive Lenses
$40 Allowance
Premium Progressive
$40 Allowance
$150 allowance + 20% discount on amount over allowance*
Frames
$80 Allowance
Contact Lenses Elective Conventional
$150 allowance + 15% Discount
$128 Allowance
$150 allowance
$128 Allowance
Disposable
Covered 100%
$210 Allowance
Medically Necessary
Frequency Exam
Once every 12 months
Lenses or contact lenses
Once every 12 months
Frame
Once every 24 months
Employee Cost Per Pay Period
Employee Only
$ 0.00 $ 2.69 $ 3.14 $ 6.05
Employee + Spouse Employee + Child(ren)
Family
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Basic and Voluntary Life
BASIC LIFE INSURANCE
The Florida Aquarium provides life insurance to all active full time employees, at no cost! The chart below provides an overview of the plan.
Basic Life Insurance
Lincoln
Benefit Outline
Eligible Full Time Employees
$50,000
At age 65 reduce by 35% of original amount, at age 70 reduce by 50% of in force amount
Age Reduction Schedule
AD&D
Included - Equal to basic life
• Please make sure your beneficiary information is up to date and on file with Human Resources. You may change your beneficiary at any time.
VOLUNTARY LIFE INSURANCE
The Florida Aquarium provides all active employees the option to purchase life insurance coverage through a group plan. The chart below provides an overview of the plan.
Voluntary Life Insurance
Lincoln
Increments of $10,000 up to the lesser of $500,000 or 7x annual salary. Minimum of $10,000
Employee Life
Guarantee Issue
$150,000
Increments of $5,000 up to lesser of 50% of employee's amount or $100,000. Guarantee Issue - $30,000 15 days to 6 months old: $1,000 6 months to less than 19 years (26 if full time student): choice of $1,000; $2,000; $4,000; $5,000; $10,000
Spouse Life
Dependent Life
Waiver of Premium Benefit
Included to the earlier of age 65, retirement or recovery
Convertible
Included
Portable
Enrollment Events
Includes annual enrollment period
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Short and Long Term Disability
SHORT TERM DISABILITY
The Florida Aquarium provides short term disability insurance to all active full time employees, at no cost to you! The chart below provides an overview of the plan.
Short Term Disability
Benefit Percentage
60%
Maximum Weekly Benefit
$1,000
15 th day Accident 15 th day Sickness
Elimination Period
Duration of Benefit
11 weeks
LONG TERM DISABILITY The Florida Aquarium provides long term disability insurance to all active full time employees, at no cost to you! The chart below provides an overview of the plan.
Long Term Disability
Benefit % of Monthly Covered Payroll
60%
Monthly Maximum
$6,000
Elimination Period
90 days
Benefit Duration
Normal Social Security Retirement Age (to age 65)
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Supplemental Benefits
Critical Illness Benefit Summary
Benefit Amount
$10,000
Cancer Type I, Heart Attack, Kidney Failure, Organ Transplant, Stroke, Cancer Type II (Non-Invasive), Coronary Artery Bypass Graft
Covered Conditions
100% of employees lump sum benefit *Spouse rate is based on employee age
Spouse Benefit
Child Benefit
25% of employees lump sum benefit
AGE
Deductions Employee – Spouse* $10,000 Benefit
AGE
Deductions Employee - Spouse $10,000 Benefit
Deductions Child $2,500
<24
$ 1.84
50-55
$15.29
$ .49
25-29
$ 2.82
55-59
$18.42
30-34
$ 4.03
60-64
$20.70
35 – 39
$ 5.84
65-69
$23.34
40-44
$ 8.53
70+
$30.78
45 – 49
$11.76
*Spouse Rate will be in addition to the employee rate.
Accident Benefit Summary
Accident Coverage Type
24-Hour
Employee: $25,000 Spouse: $10,000 Child: $5,000
AD&D Benefit Amount
Portability
Included
Emergency Room Visits, Burns, Dental, Stitches, Fractures, Surgeries, and so much more!
Example of Covered Benefits
Hospital & Sickness Rider
Admission ICU Admission Confinement ICU Confinement
$1,000 $1,500
$200 (per day, up to 365 days) $400 (per day, up to 15 days per accident)
Employee Deductions
Accident Coverage
Accident with Hospital/Sickness Coverage
Employee Only
$ 5.64
$11.88
Employee & Spouse
$ 9.21
$23.95
Employee & Child(ren)
$ 9.88
$23.81
Employee & Family
$13.41
$34.59
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Flexible Spending Account (FSA)
What is a Flexible Spending Account? A Flexible Spending Account enables you to set aside a predetermined dollar amount in an account to cover eligible out-of-pocket health care and dependent day care expenses throughout the year. IRS rules allow you to contribute to your account(s) through payroll deduction on a pre- tax basis (before federal income tax & social security) reducing your taxable income. The dollars set aside in a Flexible Spending Account are actually worth more because they are tax-free. As a participant, you pay no taxes on the contributions or the withdrawals. Any unused money left in the account at the end of the year will be forfeited. Please be conservative with your elections.
Health Care Reimbursement FSA This program allows Florida Aquarium employees to use pre-tax dollars to pay for certain IRS-approved medical*, dental and vision expenses to a maximum of $2,750 a year*. Elected funds will be available as of July 1, 2021. Remember to keep receipts for all items purchased through your FSA. The IRS may require you to provide proof of qualified expenses to Discovery Benefits.
Dependent Care FSA The Dependent Care FSA allows Florida Aquarium employees to use pre-tax dollars toward qualified dependent care such as caring for children under the age 13. The annual maximum amount you may contribute to the Dependent Care FSA is $10,500 (or $5,250 if married and filing separately) per calendar year*. Examples include:
• The cost for an individual to provide care either in or out of your house • Nursery schools and preschools (excluding kindergarten)
2021 Flexible Spending Account Maximums
Health Care Reimbursement
Dependent Care
Monies can be put aside for reimbursement for dependent daycare expenses incurred during the upcoming year up to a $10,500 maximum.
Monies can be put aside to pay for certain IRS-approved medical, dental or vision expenses up to a maximum of $2,750. Employees and eligible dependents do not need to participate in the Florida Aquarium medical, dental or vision plans to participate in the healthcare reimbursement account.
Dependent Care Reimbursement Account & the Federal Tax Credit You have the option to take either a tax credit on your federal income tax return for your dependent care expenses or receive pretax reimbursement of expenses through the reimbursement account. You cannot use the reimbursement account and the federal tax credit for the same expenses.
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Employee Assistance Program
What is an Employee Assistance Program?
The Employee Assistance Program (EAP) is free and confidential mental health counseling services provided to you by your employer. Even though your employer is offering you this benefit, your employer will NOT know if you use it.
Why do people use EAP services? Simply put, because life is hard. Employees use EAP benefits to help them better manage the stressors of life: relationships, work, family, school, parenting, moving, and grief. Now more than ever, EAP benefits are being used for life coaching to help employees set goals and create a plan to achieve those goals.
How does the EAP work?
• Call the toll-free helpline 24 hours a day, 7 days a week: 800-878-5470. The helpline is answered by experienced • mental health and/or substance abuse counselors. • After a brief conversation with the helpline counselor, you will be given the contact information for therapists in your area. BayCare has therapists throughout the Tampa Bay area so you can request to see someone in a location that is convenient for you. • If you prefer, BayCare can provide counseling and life coaching sessions over the phone. • You have SIX free visits per year. These visits can be used by you or any of your dependents. • If you need more than your six visits, BayCare can help you use your medical insurance benefits to help cover the cost for additional sessions. • You do NOT have to tell ANYONE that you are using EAP benefits. BayCare does NOT tell your employer or family that you are using the services.
What type of issues does EAP address?
People use EAP benefits to better manage any personal problems which may affect work life, family life, or wellbeing in general. Common issues include:
- Stress
- Divorce
- Building healthy relationships - Managing financial stress
- Anxiety
- Depression -- Parenting
- Grief and loss
- Problems at work - Family problems
- Conflict resolution - Child and adolescent problems
EAP 24-Hour Helpline: (800) 878-5470
BayCare.org/EAP
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No Cost Programs
We are pleased to offer the below programs through Lincoln Financial. These extra services are included as part of your Basic Life/AD&D provided by The Florida Aquarium.
Travel Assistance with ID Theft Protection
The following services are available to all employees through TravelConnect Services: • Medical consultation, evaluation, and referral • Hospital admission • Critical care monitoring • Transportation to return home or to a rehab facility
You and your family (whether traveling together or separately) can activate Travel Connect emergency services with one call to the number below:
Within the U.S.: 1-866-525-1955
Outside the U.S.: 803-628-1955
Your membership number: LFGTravel123
LifeKeys Services
No matter how well you plan your life, you can be sure a few unforeseen challenges will arise. When they do, it’s reassuring to know that help and support are close at hand — thanks to LifeKeys® services from Lincoln Financial Group. If you are enrolled in life and/or AD&D insurance, this program provides access to a wide array of services to help you and your loved ones through life’s ups and downs — and prepare you for whatever lies ahead.
Online will preparation Having a will is important because it allows you to designate who will receive your property and assets when you die. Without one, your state determines how your estate is distributed. EstateGuidance® will preparation is a quick and easy way to create and execute a will. Information on important life matters You have access to GuidanceResources ® Online, where you’ll find articles, tutorials, videos, and “Ask the Expert” advice on a wide range of topics — including legal, financial, family, and career. It’s a way to stay “in the know” on important matters that impact both your personal and professional life. Protection against identity theft Identity theft is widespread, and everyone is vulnerable. LifeKeys includes an online resource for the information you need to recognize and prevent identity theft — and restore your good name. Guidance and support for your beneficiaries The LifeKeys comprehensive program offers resources to help your loved ones address a range of common concerns. Services include grief counseling, advice on financial and legal matters, and help coping with the occasional challenges of day- to-day life.
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You care about your pets and consider them members of your family. So why not give your pets the best health care available? The My Pet Protection plans shown below allow you to cover your dog or cat regardless of the their age! For more information, go to PetsVoluntaryBenefits.com or call 855-874-4944 To enroll, visit: www.petinsurance.com/floridaaquarium Pet Insurance
If you want coverage for your bird, rabbit, reptile or other exotic pets, you’ll find it only with Nationwide. To enroll in the Avian & Exotic Pet Plan, please call 888-899-4874.
My Pet Protection w/ wellness
Employee Cost Per MONTH (based on state of residence)
My Pet Protection
Dog
$84.39
$52.71
Florida
Cat
$50.63
$31.62
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Retirement Savings Plan
If you are interested in participating, please contact Kelly Curington, Plan Administrator, in the Human Resources department for appropriate paperwork and any questions you may have.
PLAN HIGHLIGHTS
Eligibility Employees are eligible to enroll in the plan after meeting the eligibility requirements listed below: Employer Non-Elective (Discretionary) Contributions and Employer Matching Contributions • Completed one year of service, as defined by the Plan • Attained age 21
The Plan does not allow participation by employees who are: • Non-Resident Aliens • Leased Employees
Entry Date Upon meeting the eligibility requirements, you may enroll in the Plan on the following dates: • For Employee Pre-Tax contributions employees are eligible to enter the plan on their date of hire. Employer Non-Elective Contributions and Employer Matching Contributions • January 1 st , April 1 st , July 1 st and October 1 st
Your Contributions Through payroll deduction, you can make pre-tax contributions from your eligible pay. There is no minimum amount that you must elect to contribute. The plan does not limit the amount of compensation that you can elect to contribute. Pre-tax contributions that are deferred from your compensation are subject to the dollar limit for the calendar year as provided by law. The maximum dollar limit applies to the aggregate of all amounts that you contribute to this plan and all other 401(k), 403(b) and SEPs of this employer or any other employer during the calendar year. If you reach age 50 sometime during the calendar year, you are also eligible to make catch-up contributions in addition to the normal maximum dollar limit. These limits may be increased from year to year. Please check with the Plan Representative on the limit for the current calendar year.
Changes to your election to contribute will be governed by either your plan document or your employer’s administrative policy .
Rollovers The plan will accept rollover contributions from other eligible plans.
Distributions Money may be distributed from your Plan account in these events: • Death • Disability • Termination of Service
See your Summary Plan Description for more details about taking a distribution from the Plan. Be sure to talk with your tax advisor before taking a distribution of any money from your Plan account.
Financial Hardship Withdrawals Hardship withdrawals are permitted from this Plan. A hardship can include: • Buying a house • Paying for college tuition and expenses • Paying certain medical expenses • Preventing eviction from or foreclosure on your home • Paying burial or funeral expenses • Paying expenses to repair damage to your home
If you feel you are facing a financial hardship, you should see your Plan Representative on the options available to you as defined in the Plan.
17
Retirement Savings Plan
Loans The Plan is intended to help you put aside money for your retirement. However, your employer has included a Plan feature that lets you borrow money from the Plan. The amount the Plan may loan to you is limited by rules under the tax law. In general, all loans will be limited to the lesser of one-half of your vested account balance or $50,000.
Employer Contributions to the Plan The Plan also provides for your employer to make contributions. • Employer Matching Contributions •
Your employer may make contributions that are based on the amount of employee pre-tax contributions that you elect to contribute. • These matching contributions will be equal to 25% of your contributions up to 3% of compensation.
• Employer Non-Elective Contributions •
The employer may make a discretionary contribution in an amount to be determined each plan year.
Vesting Vesting refers to your “ownership” of a benefit from the Plan. You are always 100% vested in your Plan contributions and you r rollover contributions, plus any earnings they generate. Employer Contributions are vested as follows:
Years of Service
Vesting Percentage
Less than 1
0%
1 2 3 4
20% 40% 60% 80%
5+
100%
Investing Plan Contributions The Plan is intended to be an ERISA Section 404(c) plan. This simply means that you “exercise control” over some or all of th e investments in your Plan account. The fiduciaries of the Plan may be relieved of liability, or responsibility, for any losses that you may experience as a direct result of your investment decisions. As a plan participant, you may request additional investment information from your Plan Representative. Account Information You will receive a personalized account statement quarterly. The statement shows your account balance as well as any contributions and earnings credited to your account during the reporting period.
You will also have access to an automated voice response system designed to give you current information about your Plan account. You can get up-to-date information about your account balance, contributions, investment choices, and other Plan data.
Participant Voice Response System: 844-999-2677
Retirement Plan Website: www.benefitsforyou.com Participant Service Center Email: RetiremenServiceCenter@BenefitsfForYou.com Plan ID: 701846
Investment Professional
Plan Administrator
Gene Melamud Raymond James & Associates (727)-584-8615 Gene.Melamud@raymondjames.com
Kelly Curington Sr. Vice President, Human Resources (813)-367-4046 kcurington@flaquarium.org
Summary of Plan Description The above highlights are only a brief overview of the Plan’s features and are not a legally binding document. You will also receive a Summary Plan Description (SPD) that contains more information. If there are discrepancies between the Plan Highlights and the Summary Plan Description and the Plan Document, the Plan Document will govern. Please read it carefully and contact your Plan Representative if you have any further questions.
The Plan Sponsor reserves the right to amend, modify or terminate this Plan at any time at its sole discretion.
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Paid Time Off Rest, Relax & Recharge!
The Aquarium believes that employees should have opportunities to enjoy time away from work to help balance their lives, and recognizes that employees have diverse needs for time off from work. Our Wellness Leave and Holiday policies give you the chance to take breaks from work to rest, relax, recharge, tend to personal matters, and devote some time to fun, friends, and family! WELLNESS LEAVE Wellness leave is an Aquarium benefit that allows you to get refreshed and take time off when you need it, taking the most common forms of paid time off (vacation and sick leave) and combining them into one account for you to manage. You will be compensated from your wellness leave bank, if time is available, at your base wage when you are absent from work for purposes such as approved vacation, illness, family emergencies, preventive health and dental care, personal time and other authorized absences. The vice president of your department must approve in advance wellness leave requests for more than two consecutive weeks at one time. Eligibility All regular full-time employees are eligible for accruing wellness leave from their first day of employment. You must be employed on a full time basis for three (3) months before being eligible to take paid wellness leave, personal or vacation time. Employees may however, use available wellness leave for illness/sick leave during their first three months of employment. For non-exempt employees, wellness leave days are based on the number of hours actually worked, up to 40 in a workweek. Non- exempt employees can determine how much wellness time they have by multiplying the hours worked percentage factor in the chart below by the actual number of hours worked. For exempt employees, wellness leave days are based on 40-hours per week, regardless of how many hours are actually worked. In instances where you are being paid by a third party or on an unpaid leave of absence, employees will not accrue wellness during this specified unpaid time off. See wellness chart below to determine all accrual rates.
Hours Worked Percentage Factor
Total Maximum Hours/Day Per Year Hours Days
Years of Service
0 < 5
0.077 0.096 0.115 0.135
160 200 240 280
20 25 30 35
5 – 14
15 – 20
20 +
The numbers in this chart have been rounded off to the next highest hours/days per year
Carry Over At the end of each Fiscal Year (September 30), the maximum number of hours or days you may carry over is 200 hours or 25 days. In the event September 30 falls in the middle of a pay period, we will use the end of a pay period closest to September 30 for the wellness cut-off date. All wellness leave remaining in excess of these amounts will be forfeited. HOLIDAYS Do you look forward to spending certain holidays with friends and/or family? The Aquarium observes seven (7) Federal holidays and one (1) mission-based holiday in addition to earned Wellness leave, and provides benefit eligible employees with paid time off to recognize them:
Full-time, non-exempt employees are automatically assigned Holiday pay for all eight observed holidays. If a full-time non-exempt employee works on a designated paid holiday, they will receive payment for the holiday at their regular rate of pay (straight time), in dition to being paid a holiday premium equivalent to one and a half times their regular rate of pay for all hours worked on the holiday. adPart-time and/or seasonal non-exempt employees are not eligible for Holiday pay, but will be paid a holiday premium equivalent to one and a half times their regular rate of pay for all hours worked on any of the eight designated holidays. Please refer to the employee handbook for more detailed information.
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Required Annual Employee Disclosure Notices
Required Annual Employee Disclosure Notices
THE NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT OF 1996
WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998 The Women’s Health and Cancer Rights Act of 1998 requires The Florida Aquarium to notify you, as a participant or beneficiary of the The Florida Aquarium 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.
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;
MICHELLE’S LAW
4. Require a mother to give birth in a hospital; or
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.
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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Required Annual Employee Disclosure Notices continued Required Annual Employee Disclosure Notices
HIPAA PRIVACY POLICY FOR FULLY-INSURED PLANS WITH NO ACCESS TO PHI
PATIENT PROTECTION: If the Group Health Plan generally requires the designation of a primary care provider who participates in the network and who is available to accept you or your family members. For children, you may designate a pediatrician as the primary care provider. You do not need prior authorization from the carrier or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in the network who specializes in obstetrics or gynecology. The health care professionals, however, may be required to comply with 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, or for information on how to select a primary care provider, and for a list of the participating primary care providers, contact the Plan Administrator or refer to the carrier website. It is your responsibility to ensure that the information provided on your application is accurate and complete. Any omissions or incorrect statements made by you on your application may invalidate your coverage. The carrier has the right to rescind coverage on the basis of fraud or misrepresentation. CHILDREN’S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT (CHIPRA) OF 2009 Effective April 1, 2009, a special enrollment period provision is added to comply with the requirements of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009. If you or a dependent is covered under a Medicaid or CHIP plan and coverage is terminated as a result of the loss of eligibility for Medicaid or CHIP coverage, you may be able to enroll yourself and/or your dependent(s). However, you must enroll within 60 days after the date eligibility is lost. If you or a dependent becomes eligible for premium assistance under an applicable State Medicaid or CHIP plan to purchase coverage under the group health plan, you may be able to enroll yourself and/or your dependent(s). However, you must enroll within 60 days after you or your dependent is determined to be eligible for State premium assistance. Please note that premium assistance is not available in all states.
I. No access to protected health information (PHI) except for summary health information for limited purpose and enrollment / dis-enrollment information. Neither the group health plan nor the plan sponsor (or any member of the plan sponsor’s workforce) shall create or receive protected health information (PHI) as defined in 45 C.F.R. § 160.103 except for (1) summary health information for purpose of (a) obtaining premium bids or (b) modifying, amending, or terminating the group health plan, and (2) enrollment and dis- enrollment information. The group health plan is a fully-insured group health plan sponsored by the “Plan Sponsor”. The group health plan and the plan sponsor intend to comply with the requirements of 45 C.F.R. § 164.530 (k) so that the group health plan is not subject to most of HIPAA’s privacy requirements.
II. Insurer for group health plan will provide privacy notice
The insurer for the group health plan will provide the group health plan’s notice of privacy practices and will satisfy the other requirements under HIPAA related to the group health plan’s PHI. The notice of privacy practices will notify participants of the potential disclosure of summary health information and enrollment / dis-enrollment information to the group health plan and the plan sponsor.
III. No intimidating or retaliatory acts
The group health plan shall not intimidate, threaten, coerce, discriminate against, or take other retaliatory action against individuals for exercising their rights , filing a complaint, participating in an investigation, or opposing any improper practice under HIPAAA.
IV. No Waiver
The group health plan shall not require an individual to waive his or her privacy rights under HIPAA as a condition of treatment, payment, enrollment or eligibility. If such an action should occur by one of the plan sponsor’s employees, the action shall not be attributed to the group health plan.
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Required Annual Employee Disclosure Notices - Continued Required Annual Employee Disclosure Notices
When will you pay a higher premium (penalty) to join a Medicare drug Plan? You should also know that if you drop or lose your current coverage with Humana and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For more information about this notice or your current prescription drug coverage… Contact our office for further information (see contact information below). NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Humana changes. You also may request a copy of this notice at any time. For more information about your options under Medicare prescription drug coverage… More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage:
MEDICARE PART D
This notice applies to employees and covered dependents who are eligible for Medicare Part D. Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Humana and about your options under Medicare’s prescription drug Plan. If you are considering joining, you should compare your current coverage including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plan (like an HMO or PPO) that offer prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. Humana has determined that the prescription drug coverage offered by the Welfare Plan for Employees of The Florida Aquarium under the Humana option are, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. You should also know that if you drop or lose your coverage with Humana and don’t enroll in Medicare prescription drug coverage after your current coverage ends, you may pay more (a penalty) to enroll in Medicare prescription drug coverage later. _______________________________________________________
Visit www.medicare.gov
•
• Call your State Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number) for personalized help, • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1- 877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325- 0778).
When can you join a Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 th to December 7 th . However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. What happens to your current coverage if you decide to join a Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Humana coverage will not be affected. You can keep this coverage if you elect part D and this plan will coordinate with Part D coverage. If you decide to join a Medicare drug plan and drop your current Humana coverage, be aware that you and your dependents will be able to get this coverage back.
Remember: Keep this notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show that you are not required to pay a higher premium amount.
Date:
7/1/21
Name of Entity/Sender: Contact--Position/Office:
The Florida Aquarium Kelly Curington 701 Channelside Drive Tampa, FL 33602
Phone Number:
813-367-4046
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