PHYSICIANS BENEFITS GUIDE | 2024
HCO PHYSICIANS
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Hughston Benefits Guide
CONTENTS
05
09
FIND THE LOWEST COST PRESCRIPTION
TELEMEDICINE
03
06
10
WELCOME TO HUGHSTON & HOW TO ENROLL ON ADP
CHOOSE YOUR MEDICAL PLAN
DENTAL, VISION & EMPLOYEE ASSISTANCE PROGRAM (EAP)
04
08
11
ELIGIBILITY AND ENROLLMENT
HEALTH SAVINGS ACCOUNT (HSA)
LIFE, DISABILITY & WORKSITE BENEFITS
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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, telemedicine, EAP and worksite benefits.
HOW TO ENROLL ON ADP Go to https://workforcenow.adp.com/workforcenow/login.html. Step 1 : Log into ADP using your user name 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 family (ex: Premium, Basic, HDHP). Click on enroll in this plan, then choose the level that corresponds
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.
Special Notes:
1. You have the option to decline the Basic Life and Long Term Disability benefits.
2. If electing the 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.
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 check mark 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 Open enrollment refers to your opportunity to: • Change plans • Enroll in benefits • Cancel benefits • Add or remove dependents to your benefits
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
> eligible dependents are your legal spouse and dependent children.
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, step- 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
Paige Duckworth Yates LLC Marketing Manager pduckworth@yatesins.com 404.982.2413
Leigh Drawdy Yates LLC Account Manager ldrawdy@yatesins.com 706.323.1600
Cheryl Janis Yates LLC Account Manager cjanis@yatesins.com 404.486.2273
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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 plans will be 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 $2,000 $4,000
Non-Embedded $1,600 $3,200
Embedded $500 | $1,000 $1,000 | $2,000
Non-Embedded $3,200 $9,600
Out-of-Pocket Maximum (Deductible included) - Individual
$4,000 $8,000
$10,000 $20,000
$4,000 $8,000
$15,000 $30,000
- Family
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
20% after Deductible 20% after Deductible 20% after Deductible
40% after Deductible 40% after Deductible 40% after Deductible
Inpatient Services Outpatient Services
20% after Deductible 20% after Deductible
Prescriptions (30 Day Supply)
Prescription Drug Coverage Administered by Liviniti
Deductible
$200 / $400 $10 Copay
Subject to Medical Deductible $10 Copay after Deductible $30 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible
Tier 1 Tier 2 Tier 3
$30 Copay after Rx Deductible $60 Copay after Rx Deductible $120 Copay after Rx Deductible
Tier 4 (Specialty Drugs) Mail Order (90 Day Supply) Tier 1 Tier 2 Tier 3 Medical Rates (Monthly) Employee Employee + Spouse Employee + Child(ren)
$20 Copay $60 Copay after Rx Deductible $120 Copay after Rx Deductible
$20 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible
$1,127.33 $2,099.77 $1,875.29 $3,080.04
$1,053.26 $1,947.04 $1,740.71 $2,847.99
Family
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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 the Telemedicine vendor today!
Medical - Allied Benefit (TPA) Aetna Signature Administrators PPO Network Coinsurance (Member pays) Calendar Year Deductible - Individual - Family Out-of-Pocket Maximum (Deductible included) - Individual -Family
HSA 3000
In-Network
Out-of-Network
0%
40%
$3,000 $6,000
$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? 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.
Urgent Care
Deductible Deductible Deductible
40% after Deductible 40% after Deductible 40% after Deductible
Inpatient Services Outpatient Services
Prescriptions (30 Day Supply)
Prescription Drug Coverage Administered by Liviniti
Deductible
Subject to Medical Deductible $10 Copay after Deductible $30 Copay after Deductible $60 Copay after Deductible $120 Copay after 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)
$20 Copay after Deductible $60 Copay after Deductible $120 Copay after Deductible
$922.61 $1,752.39 $1,622.54 $2,555.63
Family
*$7,000 out-of-pocket maximum for an individual in a family plan.
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Hughston Benefits Guide
HEALTH SAVINGS ACCOUNT | PINNACLE
Who contributes to an HSA? • You
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. 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 Savings 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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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. TELEMEDICINE | TELADOC
Hughston is pleased to provide you with access to Teladoc, a national network of board certified, state licensed doctors offering medical consultations 24 hours a day, 7 days a week. Teladoc doctors can diagnose acute non-emergency medical conditions and prescribe medications when clinically appropriate. Speak to a doctor within minutes from anywhere – home – work – or while traveling.
WHEN TO USE TELADOC
-Acid reflux - Allergies - Asthma -Bladder infection - Bronchitis - Cold
- Flu - Infections - Nausea -Sinus conditions - UTI - and more…
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Hughston Benefits Guide
DENTAL | METLIFE
Dental Plan
Premium Plan
Basic Plan
Annual Deductible Individual Family Maximum Preventive Service s
$50 $150 100%
$50 $150 100%
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
$3,000 $1,500
$1,500
Orthodontia Lifetime Maximum
N/A
Out-of-Network Reimbursement
90th UCR Premium Plan $41.93 $81.04 $78.58 $123.98
90th UCR
Basic Plan
Dental Rates (Monthly)
Employee Employee + Spouse Employee + Child(ren) Family
$22.51 $40.08 $39.00 $59.37
Vision Plan
In-Network
Out-of-Network Reimbursement
Eye Exam
$10 Copay
Up to $45
Lenses Single Vision
$20 Copay $20 Copay $20 Copay
Up to $30 Up to $50 Up to $65
Bifocals Trifocals
VISION | METLIFE
$130 Allowance after $20 Copay
Frames
Up to $70
Contacts Disposable Medically Necessary
Up to $105 Up to $210
$130 Allowance $20 Copay
Frequency Exam
Once every 12 months Once every 12 months One every 24 months
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.
Lenses or Contacts
Frames
Vision Rates (Monthly) Employee Employee + Spouse Employee + Child(ren)
* Costco, Walmart and Sam’s Club: $70 allowance after $20 eyewear copay.
$ 7.38 $12.07 $11.82 $19.45
Family
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.
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LIFE, DISABILITY & WORKSITE BENEFITS
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%. • Physician Paid . 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 PlanSource employee portal. • Physician Paid .
Long Term Disability insurance provides partial income replacement in the event of a covered illness or accident that occurs outside of work. • 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 $15,000 a month. • You can receive these monthly benefit checks up to your normal retirement age if you meet the definition of disability. • Physician Paid .
WORKSITE BENEFITS | AFLAC**
Accident The 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
Flat amount: $2,500 $5,000 $7,500 $10,000 Guarantee Issue $10,000
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, not to exceed 50% of the employee amount
Guarantee Issue $50,000
AD&D Benefit amount is equal to the Voluntary Life amount. **If your spouse is also a benefits-eligible employee at Hughston, then you may not be eligible to purchase spousal coverage for Voluntary Life, Accident Insurance, Cancer Insurance and Hospital Confinement benefits. Only one employee can elect life coverage for the child. Please refer to plan documents for details.
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.
CONTACTS
Medical | Allied Benefit (TPA) Tel.: 1.800.288.2078 www.alliedbenefit.com Prescription | Liviniti Tel.: 1.800.710.9341 www.liviniti.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
Worksite Benefits | Aflac Tel.: 1.800.992.3522 www.aflac.com Yates LLC Client Advocates Tel: 1.404.633.4321
Employee Assistance Program (EAP) BHS
Tel.: 1.800.327.2251 portal.BHSonline.com Company ID: Hughston MetLife Tel.: 1.888.319.7819 metlifeeap.lifeworks.com User Name: metlifeeap
Password: eap HSA | Pinnacle Tel.: 1.800.264.3613 www.pnfp.com
Life: 1.800.638.5000 LTD: 1.800.858.6506
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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