EMPLOYEE BENEFITS GUIDE | 2024 PHYSICIANS
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Hughston Benefits Guide
CONTENTS
05
FIND THE LOWEST COST PRESCRIPTION
03
06 DENTAL , VISION & TELEMEDICINE
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WELCOME TO HUGHSTON &
CHOOSE YOUR MEDICAL PLAN
HOW TO ENROLL ON ADP
04
08 LIFE, DISABILITY,
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ELIGIBILITY AND ENROLLMENT
HEALTH SAVINGS ACCOUNT (HSA)
WORKSITE BENEFITS & EMPLOYEE ASSISTANCE PROGRAM (EAP)
Hughston Benefits Guide
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WELCOME TO HUGHSTON’S 2024 BENEFITS GUIDE!
Hughston’s most important asset is our people. That’s why we offer you an exceptional benefits program with many options, designed to meet your needs and the needs of your family. In this booklet you will find summaries of Hughston’s medical, dental, vision, life, disability, HSA,telehealth, EAP and worksite benefits. HOW TO ENROLL ON ADP Go to https://workforcenow.adp.com/workforcenow/login.html .
Step 5: Continue your enrollment by repeating the above steps for all employee paid plans such as Dental, Vision, Health Savings Account (only if High Deductible Health Plan is elected) and Voluntary Life Insurance. Please note that if you want Voluntary Life insurance for spouse or children, you are required to elect coverage for yourself.
Step 1: Log into ADP using your username and password. The Enrollment screen will pop up immediately upon login. Click on Start This Enrollment. Step 2: On the Enrollment screen first review your dependents/ beneficiaries; if you need to add or remove any dependents/ beneficiaries it must be completed prior to electing any benefits. **Please note that your legal spouse and any child(ren) under 26 years of age are eligible for the company paid basic life insurance plan. Step 3: Once the dependents/beneficiaries are updated, scroll down and click on walk me through my benefits options, then click continue. Step 4: In order to elect the plans, start by clicking on Medical (even if you are waiving, you need to click through the screens). Select the plan that best suits you and your
Special Notes:
1. Plans such as Basic Life, EAP and Long-Term Disability are set for automatic enrollment (employees only).
2. For Basic Life Insurance or Voluntary Life Insurance, confirm ALL dependents are enrolled and confirm ALL beneficiaries are designated.
Final Step: Click Review and Complete. Check your email for a Confirmation of Benefits Statement.
family (ex: Premium, Basic, HDHP). Click on enroll in this plan, then choose the level that corresponds with who needs to be included in your benefits. Click Enroll. ***Make sure that all dependents who should be enrolled in the coverage have a checkmark next to their name. ***
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Hughston Benefits Guide
ELIGIBILITY & ENROLLMENT
If enrolling as a new hire, you must complete the enrollment process within 30 days of your hire date.
NEW EMPLOYEES New employee benefits are effective on the first of the month following 30 days for all full-time employees.
Open enrollment refers to your opportunity to: • Change plans
• Enroll in benefits • Cancel benefits
• Add or remove dependents to your benefits. Eligible dependents are your legal spouse and dependent children.
MID-YEAR BENEFITS CHANGES Outside of your annual Open Enrollment period, you may be eligible to make certain benefits changes during the middle of the year. Please refer to your Summary Plan Description (SPD) for specifics, but examples of when you might be able to make mid-year changes are: • Marriage or Divorce
ELIGIBILITY All full-time employees are offered benefits. Spouses and dependent children of the employee are also eligible to participate in our benefits plans. Dependent children include your natural children, legally adopted children and children for whom you have been appointed guardian up to the age of 26.
• Birth, Death, or Adoption • Change in Eligibility Status
MEET YOUR CLIENT ADVOCATES
Contact your Client Advocates to help you get the most from your group insurance plans. Always ensuring confidentiality, your Client Advocates are ready to answer any of your benefits related questions including:
• Need help solving a benefit related problem • Have a question about a benefit • Have questions regarding a bill
• Need further clarification on an insurance matter • Believe that your claim has not been paid properly
Charlie McDaniel Yates LLC Broker cmcdaniel@yatesins.com 706.527.2090
Billy Eissler Yates LLC Broker beissler@yatesins.com 770.778.1978
Resa Carter Yates LLC Account Manager rcarter@yatesins.com 706.323.1600
Cheryl Janis Yates LLC Account Manager cjanis@yatesins.com 404.486.2273
Paige Duckworth Yates LLC Marketing Manager pduckworth@yatesins.com 404.982.2413
Leigh Drawdy Yates LLC Account Manager ldrawdy@yatesins.com 706.323.1600
Hughston Benefits Guide
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FIND THE LOWEST COST PRESCRIPTIONS Did you know that drug prices can drastically vary among different pharmacies? Did you know that purchasing a drug through your company medical plan is not always the lowest cost option? A free, independent third-party solution, GoodRx, is here to help!
• Navigate to www.GoodRx.com or download the free mobile app (search “GoodRx” in your app store).
• Download a free coupon for that pharmacy, or order online when available.
• Type in your prescription name, and then adjust your location, dosage, and quantity.
• Please be aware that any prescriptions purchased outside of your Medical Insurance do not accumulate to your plan deductible and/or out-of-pocket maximum.
• Review the real-time cost of your prescription at various pharmacies around your zip code.
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Hughston Benefits Guide
MEDICAL | ALLIED BENEFIT
Your medical coverage is offered through Allied Benefit for the 2024 plan year. Please review your plan summaries or Summary of Benefits and Coverage (SBC) for coverage information and full plan details. As an Allied member, www.alliedbenefit.com allows you to track your health care benefits and access timely information and tools to help you make better health care decisions. You can view your Personal Health Record, view detailed claims information and reports, find providers and access your ID card.
Remember to tell your providers that your plan utilizes the Aetna Signature Network.
Medical - Allied Benefit (TPA) Aetna Signature Administrators PPO Network Coinsurance (Member pays) Calendar Year Deductible - Individual ( Hughston | In-network) - Family ( Hughston | In-network)
Copay Plan
HSA 1600
In-Network
Out-of-Network
In-Network
Out-of-Network
20%
40%
20%
40%
Embedded $500 | $1,000 $1,000 | $2,000
Embedded $2,000 $4,000
Non-Embedded $1,600 $3,200
Non-Embedded $3,200 $9,600
Out-of-Pocket Maximum (Deductible included) - Individual -Family
$4,000 $8,000
$10,000 $20,000
$4,000 $8,000
$15,000 $30,000
Office Visit -Primary - Specialist - Preventive
$25 Copay $50 Copay 100% Covered
40% after Deductible 40% after Deductible 40% after Deductible
20% after Deductible 20% after Deductible 100% Covered
40% after Deductible 40% after Deductible 40% after Deductible
Emergency Room Services (Copay waived if admitted)
$150 Copay
$150 Copay
20% after Deductible
20% after Deductible
Urgent Care
$60 Copay
40% after Deductible 40% after Deductible 40% after Deductible
40% after Deductible 40% after Deductible 40% after Deductible
20% after Deductible 20% after Deductible 20% after Deductible
Inpatient Services Outpatient Services
20% after Deductible 20% after Deductible
Prescripctions (30 Day Supply) Deductible Tier 1 Tier 2 Tier 3 Tier 4 (Specialty Drugs) Mail Order (90 Day Supply) Tier 1 Tier 2 Tier 3 Medical Rates (Monthly) ** | *** Employee Employee + Spouse Employee + Child(ren) Family
The Prescription Benefit Coverage is Administered by ProAct
$200 Individual / $400 Family $10 Copay $30 Copay after Rx Deductible $60 Copay after Rx Deductible $120 Copay after Rx Deductible
Subject to Medical Deductible $10 Copay after Deductible $30 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible
$20 Copay $60 Copay after Rx Deductible $120 Copay after Rx Deductible
$20 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible
$966.14 $1,736.89 $1,558.98 $2,513.86
$836.43 $1,515.46 $1,358.73 $2,200.01
Hughston Urgent Ortho visits are subject to the primary care physician fee.
Hughston Benefits Guide
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SPOTLIGHT ON URGENT CARE
Is your medical issue a true emergency? While you may encounter urgent issues, they are not always life threatening. In these cases, you can save yourself both time and money by visiting an Urgent Care Center or using the Telemedicine benefit instead of the Emergency Room. Search the Aetna Signature Administrators PPO network for convenient Urgent Care Centers around your home or office, and register with Teladoc today!
Medical - Allied Benefit (TPA) Aetna Signature Administrators PPO Network Coinsurance (Member pays)
HSA 3000
In-Network
Out-of-Network
0%
40%
Calendar Year Deductible - Individual - Family Out-of-Pocket Maximum (Deductible included) - Individual -Family
Non-Embedded $3,000 $6,000
Non-Embedded $10,000 $20,000
$4,000 $8,000*
$15,000 $30,000
SPOTLIGHT ON MAIL ORDER
Office Visit -Primary - Specialist - Preventive
Deductible Deductible 100% Covered
40% after Deductible 40% after Deductible 40% after Deductible
Emergency Room Services (Copay waived if admitted)
Deductible
Deductible
Take regular prescription medications on an ongoing, daily basis?
Urgent Care
Deductible Deductible Deductible
40% after Deductible 40% after Deductible 40% after Deductible
Inpatient Services Outpatient Services
Prescripctions (30 Day Supply) Deductible Tier 1 Tier 2 Tier 3 Tier 4 (Specialty Drugs) Mail Order (90 Day Supply) Tier 1 Tier 2 Tier 3 Medical Rates (Monthly) ** | *** Employee Employee + Spouse Employee + Child(ren) Family *$7,000 per individual in a family plan
The Prescription Benefit Coverage is Administered by ProAct
If so, take advantage of Liviniti’s mail order program! Filling your prescriptions in a 90 day supply may help you stay healthy because having a 90 day supply of your medication on hand typically means you’re less likely to miss a dose. It also means you can make fewer visits to the pharmacy to refill your medication, and depending on your plan, you may be able to save money by filling your prescriptions 90 days at a time.
Subject to Medical Deductible $10 Copay after Deductible $30 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible
$20 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible
$772.91 $1,389.51 $1,247.19 $2,011.09
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Hughston Benefits Guide
HEALTH SAVINGS ACCOUNT | MEDCOM
Who contributes to an HSA? • You
• You will also receive a contribution from Hughston to help grow your balance faster. If you have employee only coverage, Hughston will contribute $250 annually, distributed in a bi- weekly contribution of $9.62. If you have employee plus dependent coverage, Hughston will contribute $750 annually, distributed in a bi-weekly contribution of $28.85 as long as you are benefit eligible. How much can I contribute to an HSA? • Employee only coverage: $4,150 per calendar year. • Employee plus dependent coverage: $8,300 per calendar year. • If you are 55 or older, you can make an additional annual catch-up contribution of $1,000. > Please be aware that the contribution maximums listed above include any employer contribution. You must subtract out the Hughston HSA contribution to determine the maximum amount that you as the employee can contribute. Who cannot contribute to an HSA? • If you are age 65 or older and enrolled in Medicare. • If you have health coverage under another medical plan that is not a high deductible plan. • If you or your spouse has a Full Purpose FSA, you can still enroll in the High Deductible Health Plan, but neither you nor Hughston can contribute money into the HSA.
What is a Health Savings Account?
A Health Saving Account (HSA) is a way for you to save pre-tax dollars that can be used to pay for qualified health care expenses like deductibles, copays, coinsurance, prescriptions, vision and dental expenses. The funds can be taken out via payroll deductions and are deposited into the account for future use. In order to contribute to an HSA, you must be enrolled in Hughston’s High Deductible Health Plan.
SPOTLIGHT ON HSA
Did you know your HSA provides triple tax benefits? All HSA contributions are made pre-tax, qualified healthcare expenses are not taxable, and any interest you may accumulate on the account is also tax-free!
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Hughston Benefits Guide
DENTAL | METLIFE
Premium Plan
Basic Plan
Dental Plan - MetLife
Annual Deductible Individual | Family Preventive Services
$50 | $150 $50 | $150
100%
100%
Your dental coverage is offered through MetLife for the 2024 plan year. Please review your plan summaries or policy for coverage information and full plan details.
Basic Services Major Services
80% 50% 50%
80% N/A N/A
Orthodontia (Child up to age 26) Annual Benefit Maximum Orthodontia Lifetime Maximum Out-of-Network Reimbursement
$3,000 $1,500
$1,500
N/A
90th UCR Premium Plan $41.93 $81.04 $78.58 $123.98
90th UCR
Dental Rates (Monthly)
Basic Plan
Employee Employee + Spouse Employee + Child(ren) Family
$22.51 $40.08 $39.00 $59.37
Out-of-Network Reimbursement
Vision Plan - MetLife
In-Network
Eye Exam Lenses Single Bifocals Trifocals
$10 Copay
Up to $45
$20 Copay $20 Copay $20 Copay
Up to $30 Up to $50 Up to $65
$130 Allowance after $20 Copay*
Frames
Up to $70
VISION | METLIFE
Contacts Electve Medically Necessary
$130 Allowance $20 Copay
Up to $105 Up to $210
Frequency Exam/Lenses or Contacts/Frames 12/12/24 Months Vision Rates (Monthly) Employee $7.38 Employee + Spouse $12.07 Employee + Child(ren) $11.82 Family $19.45
Your vision coverage is offered through MetLife for the 2024 plan year. Please review your plan summaries or policy for coverage information and full plan details.
* Costco, Walmart and Sam’s Club: $70 allowance after $20 eyewear copay.
TELEMEDICINE | TELADOC Telemedicine is an affordable plan that gives you and your family 24/7/365 access to U.S. Board Certified Physicians who can consult, diagnose, and if needed prescribe medication over the phone or via video technology for many common and acute illnesses.
Hughston Benefits Guide
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LIFE, DISABILITY, WORKSITE BENEFITS & EAP
LIFE INSURANCE | METLIFE
LONG TERM DISABILITY | METLIFE
Basic Life and Voluntary Life insurance provides for financial support in the untimely passing of a covered participant. Basic Life and AD&D* • Benefit amount: 1x your Basic Annual Earnings, rounded to the next higher $1,000 - up to $150,000. The spouse benefit amount is $5,000 and $100 for your child from 15 days to 6 months or $2,500 for child 6 months to age 26. • Please be advised that should you reach age 65, your coverage will reduce by 35%. Should you reach age 80, your coverage will reduce by 60%. • Employee Paid – You have the option to decline this benefit. Voluntary Life and AD&D* • Employees can elect Voluntary Life and AD&D for the employee, spouse, and dependent children. • The cost is based on the amount you purchase and your age at the time of purchase, and you can calculate your cost while enrolling in the Hughston’s ADP employee portal. • Physician Paid
Long Term Disability insurance provides partial income replacement in the event of a covered illness or accident. • Benefit begins once you have been out of the office due to your disability for 90 days. • Monthly benefit checks will be 60% of your monthly earnings to a maximum of $10,000 a month. • You can receive these monthly benefit checks up to your normal retirement age if you meet the definition of disability. • Employee Paid – You have the option to decline this benefit.
WORKSITE BENEFITS | AFLAC*
Accident The group accident policy provides a cash benefit for out-of- pocket expenses associated with an accidental injury and can help protect hard-earned savings should an on or off-the-job accident occur. Cancer With an Aflac Cancer Care insurance policy, you can have financial peace of mind if a diagnosis of cancer ever occurs. Short Term Disability Short Term Disability insurance provides partial income replacement in the event of a covered illness or accident that occurs outside of work. Hospital Confinement Hospital Confinement insurance complements your present major medical coverage by providing cash benefits that can be used to help pay out-of-pocket expenses associated with a hospital confinement.
Employee Coverage
Spouse Coverage
Child Coverage
Increments of $10,000 up to a maximum of $500,000, not to exceed 5x your earnings Guarantee Issue $150,000
Increments of $5,000 up to $250,000
Flat amount: $2,500 $5,000 $7,500 $10,000 Guarantee Issue $10,000
Guarantee Issue $50,000
*If your spouse is also a benefits-eligible employee at Hughston, then you may not be eligible to elect spousal coverage for Life insurance, Accident Insurance, Cancer Insurance, and Hospital Confinement. In addition, only one employee can elect life coverage for the child. Please refer to the plan document for details.
EMPLOYEE ASSISTANCE PROGRAM | BHS & METLIFE Hughston provides a confidential Employee Assistance Program (EAP) to you and members of your household. Examples of services provided by the EAP include financial counseling, professional help with drug/alcohol dependence and grief counseling. Services provided are completely confidential and available 24 hours a day, 7 days a week.
CONTACTS
Medical | Allied Benefit (TPA) Tel.: 1.800.288.2078 www.alliedbenefit.com
Employee Assistance Program (EAP) BHS Tel.: 1.800.327.2251
Voluntary Benefits | Aflac Tel.: 1.800.992.3522 www.aflac.com Yates LLC Client Advocates Tel.: 1.404.633.4321
portal.BHSonline.com Company ID: Hughston MetLife Tel.: 1.888.319.7819 metlifeeap.lifeworks.com User Name: metlifeeap Password: eap HSA | Medcom Tel.: 1.800.523.7542 www.medcombenefits.com
Prescription | ProAct Tel.: 1.877.635.9545 www.Proactrx.com Telemedicine | Teladoc
Tel.: 1.800.835.2362 www.teladoc.com Dental, Vision, Life & LTD | MetLife Dental: 1.800.275.4638 Vision: 1.855.638.3931
Life: 1.800.638.5000 LTD: 1.800.858.6506 www.metlife.com
6262 Veterans Parkway Columbus, GA 31908 Phone: 706.324.6661
This booklet is intended as a convenient summary of all major points of your benefits plan. This booklet does not cover all provisions, limitations, and exclusions. The official plan documents, policies, and certificates of insurance govern in all cases and are available for your inspection at any time.
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