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2020 2021 Benefits Book Wyfi Flip Book Fliphtml5

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2020 2021 benefits book wyfi flip book fliphtml5

CHOOSING YOURBENEFIT PATH 2021 Benefit Guide Annual Enrollment 2021: December 1-15, 2020 Effective January 1, 2021TABLE OF CONTENTSINTRODUCTION- CHOOSE YOUR PATH..................................................................3MEDICAL, DENTAL & VISION ELIGIBILITY AND ENROLLMENT.............................4CRACK THE CODE ONBENEFITS TERMS..................................................................5CHANGE IN STATUS......................................................................................................6SECTION 125:... 12EBMS ANYTIME ACCESS..............................................................................................13DENTAL BENEFIT OVERVIEW.......................................................................................14VISION BENEFIT OVERVIEW.........................................................................................15GUARDIAN ONLINE RESOURCES..............................................................................16SUPPLEMENTAL SHORT-TERM DISABILITY INSURANCE..........................................18SUPPLEMENTAL LIFE INSURANCE..............................................................................19RETIREMENT BENEFITS...................................................................................................20PHYSICAL THERAPY TREATMENT BENEFIT................................................................20CONTINUING EDUCATION-THERAPIST ONLY.........................................................20PAID TIME OFF (PTO)....................................................................................................21HOLIDAYS OBSERVED.................................................................................................21NOTES.............................................................................................................................. 22KEY CONTACTS.............................................................................................................23IMPORTANT NOTICEThe Company has made every attempt to ensure the accuracy of the information described in this enrollment guide. Any dis-crepancy between this guide and the insurance contracts or other legal documents that govern the plans of benefits described inthis enrollment guide will be resolved according to the insurance contracts and legal documents. This enrollment guide createsneither an employment agreement of any kind nor a guarantee of continued employment.INTRODUCTIONIn recognition of your work and contribution as a member of our team, we arehappy to be able to... This guide provides an overview ofthe benefit options and enrollment information to assist you as you choose yourbenefits.

If you have questions not answered in this guide or need additionaldetails, please contact Teresa Challans at 406-756-1128, ext. 312.OUR BENEFITS PACKAGE INCLUDES: • Medical Insurance • Health Savings Account (HSA) Option • Retirement Benefits • Paid Time Off • Continuing Education for Therapists & Therapist Assistants • Physical Therapy TreatmentSUPPLEMENTAL BENEFITS INCLUDE:... Eligible dependents include: • A spouse • Any child under the age of 26 • Any child that is disabled and incapable of self-support, regardless of ageIf you are covering dependents, you may be... After you enroll, you will receive all necessary eligibility and documen-tation requirements. Our benefit representative may conduct a dependent eligibilityaudit at any time. Eligible dependents are defined as a lawful spouse and/or child(ren).“Child(ren)” include but are not limited to, natural child(ren), legally adopted child(ren),child(ren) for whom the employee is a court-appointed legal guardian, foster child(ren),and/or stepchild(ren) who...

Benefits for adependent child(ren) will continue until the last day of the calendar month in which thelimiting age is reached.When am I Eligible for Coverage?For medical, dental and vision insurance, the waiting period is... For example, if your first day is January13th, your benefits would start 60 days from February 1st, i.e. April 1st.When Can I Enroll?There are 3 times in which you are able to enroll in benefits:1. At start of employment with the company. If you choose not to enroll at the start ofyour employment, you will be required to wait until the next Open Enrollment to enroll.2. At Open Enrollment.

Open Enrollment occurs in December of each year, at whichtime, full-time employees are given the opportunity to enroll or make benefit electionchanges. During open enrollment eligible employees may add or drop dependents, addor drop coverage, or change current levels of coverage. a. NOTE: Every year prior to Open Enrollment, you will receive an open enrollment fly-er as well as be notified via Fuse, announcing the Open Enrollment session. Additionally,email reminders will be sent to managers. Currently enrolled employees will be auto-matically re-enrolled in the plan closest to their existing coverage, unless they request achange in their coverage during Open Enrollment.3.

Due to a qualifying change in status, which is discussed in the “Change in Status”section of the guide. 4CRACK THE CODE ONBENEFITS TERMSBefore diving into your benefit choices for this year, here are somedefinitions of common health insurance terms. Premium The person’s monthly cost for the insurance. The dollar amount that must be paid by the individual Deductible before the insurance company will begin covering qualified expenses. Network A group of doctors, hospitals, labs, and other pro- viders that the health insurance company contracts Health Savings with. In-network providers are typically encouraged Account (HSA) through improved access or discounted fees.

A personal savings account that can be used for quali- fied health care expenses. For those who enroll in the HSA medical plan with no other first dollar coverage. Copay A predetermined dollar amount paid by the patient when seeing a provider, purchasing prescriptions, or Coinsurance using other healthcare services. In-Network The percentage split, between the insurance company Out-of-Pocket and the patient, paid for covered healthcare services. Maximum This is the maximum amount an individual will pay for covered healthcare services for the year. Once the out of pocket max has been met, the plan will cover the remaining qualified medical expenses at 100%.

All copays, deductibles and co-insurance accumulated to the out of pocket maximum. 5CHANGE IN STATUSOutside of new hire or open enrollment, the only time an individual can change their planbenefits is when a qualifying event occurs. Below is a list of the various qualifying events thatwould allow for a change of status: • A change in your legal marital status (such as marriage, divorce, or death of spouse); • A... For example, a change in residence will only en-title an individual to a change in election if, as a result of the change in residency, an affectedindividual is no longer eligible for a benefit... This rule is named accordingly because itis contained in section 125 of the Internal Revenue Code. (A section 125 plan is also com-monly referred to as a premium plan only or a cafeteria plan.)Our company provides you the opportunity to pay your contributions for medical, dentaland vision with pre-tax dollars...

Those enroll-ing in these benefits will automatically be enrolled in a section 125 benefit unless other-wise instructed. Should you decide not to participate in this benefit, you are responsiblefor notifying our company’s benefit representative in writing. 6MEDICAL PLAN NETWORKINFORMATIONThe next page is a summary of the Medical benefits. Please review this information carefullyso that you can make the choice that best meets the needs of you and your family.NETWORK NAMEOur medical plan is administered by Employee Benefit Member Services (EBMS). The net-work provider, specific to each state, is listed below:• Arizona’s Network Provider is: First Health - www.myfirsthealth.com• Colorado’s Network Provider is: Cofinity - www.cofinity.net• Montana and Washington’s Network Provider is: First Choice -... Ourmedical plans give you access to an extensive network of providers.

For the most currentprovider listing, access the website at www.ebms.com and select “Find a Doctor.” Then enteryour zip code to find an in- network provider nearest to you.This is a summary of benefits only. Please refer to the plan summary and Summary Plan Document (SPD) in theenrollment packet for benefit details. 7MEDICAL PLAN OPTIONSThe employer will pay approximately 75% of the employee only premium. Dependents arenot paid for by the company but can be added to the plan at the employee’s expense.The company provides two options for medical coverage: A traditional plan with a lower de-ductible or a... To assist you in decid-ing which plan option is best for you, a comparison table of the two plans is provided below: 8HEALTH SAVINGS ACCOUNTIn conjunction with our qualified High Deductible Health Plan, a... Your contribution to the HSA is made throughpre-taxed payroll deductions.

In addition to your contribution, the company will match up to$40.00 per month to each eligible employee’s HSA account.An HSA can be used by the individual to pay for any health care expenses that... In addition, the HSA can be used to pay for other qualifiedmedical expenses such as dental, vision, laser eye surgery, hearing aids and over-the-countermedication that are prescribed by a doctor. Please note that over the counter (OTC) medica-tions require a prescription in order to be eligible for reimbursement. For more informationon eligible expenses, please review IRS Publication 502 on www.irs.gov.Maximum contributions to an HSA per Calendar Year are as follows: • $3,600 for Individual • $7,200 for Family • $1000 Catch Up... However, when doing so, be cautious to avoid over funding the account beyond theannual maximums.Key Benefits of an HSA • Deposits into the HSA are exempt from federal and state income tax. • The money deposited into the HSA belongs to the individual regardless of who deposit- ed it.

The money in the HSA stays with the individual even if they change jobs or switch health plans. • HSA funds can be used to pay for current and future qualified medical expenses (there’s no “use it or lose it” rule). • You can use your HSA to pay for qualified medical expenses for your spouse and taxable dependents, even if they are not covered under your high-deductible health plan.HSA Eligibility GuidelinesIRS guidelines state than... • Cannot be claimed as a dependent by another person. • Isn’t covered by any other health coverage except what is permitted (accident, disability, dental care, vision care, and long-term care) or an additional non-HDHP insurance pro- gram such as an HSA plan or... • Is not enrolled in Medicare.

• Following enrollment in Medicare, contributions to HSA must cease. However, the accumulated funds in the HSA up to the point of Medicare enrollment can still be used for expenses as outlined. 9Contributing to Your HSAEstimating your HSA monthly contribution can be somewhat confusing. The below tablehas been created to assist you in calculating your monthly contribution based on estimatedexpenses and expenses from the following year.Annual Expense Actual Expenses Estimated ExpensesEstimate Worksheet Last Year New YearMEDICAL Co-pays /... If you have questions about eligible expenses, the HSA website provides access to a list ofavailable resources www.healthequity.com.2. Plan ahead for major expenses; HSA is a great way to pay for major expenses such as Lasiksurgery or dental work.

10PHARMACY BENEFIT PROGRAMYOUR PHARMACY/PRESCRIPTION BENEFITS THROUGH EBMSYour EBMS medical plan includes pharmacy benefits provided through Nativus HealthSolutions, the chosen pharmacy benefits manager. When you need a prescription filled,present your EBMS ID card at a participating pharmacy. Simply pay the co-payment and getup to a 30-day supply of medication. Visit www.ebms.com to locate a pharmacy and for moredetailed information.PHARMACY BENEFIT PROGRAMAll prescription drugs are divided into tier groups. Generic, Brand Preferred, Brand Non-Preferred and Specialty. The group your prescription falls into will determine your copayment.Generic substitutions are available for many brand-name drugs.Pharmacy benefits are administered by Nativus Health Solutions.

You can obtain informationon plan benefits, locate a participating pharmacy, and access drug information by visiting theEBMS website at www.ebms.com.MAIL ORDER PROGRAMIf you take maintenance drugs that are required on an ongoing basis, we... Using the mail order program is costeffective for both you and your employer. Those savings are passed to you through lowercopays. You also have the added convenience of timely delivery to your home. All mail orderprescriptions are filled by registered pharmacists and are processed and shipped via UPS orUS Mail.Ordering and refill procedures are easy to follow through your choice of Internet access or toll-free telephone assistance. Contact EBMS at [email protected] or toll free at 866-894-1496.When starting a new mail order prescription, remember that processing and delivery timemay take up to ten days.

You may want to ask your doctor to write two prescriptions – one fora one-month supply to fill retail and one for a three-month supply with refills for mail order.DISCOUNTED MEDICATIONSMany retail pharmacies offer... Check the websites of yourfavorite retail pharmacies – they may offer these discounts and can potentially cut the cost ofyour prescription in half.SCRIPT SOURCINGScript Sourcing makes available many name brand medication and specialty medication... Call a Script Sourcing Member Advocates at 410-902-8811 toenroll and find out more information.This is a summary of benefits only. Please refer to the plan summary and Summary Plan Document (SPD) in theenrollment packet for benefit details. 11SCRIPTSOURCING PROVIDES AUNIQUE OPPORTUNITY TO HELP EMPLOYEESSAVE MONEY ON NAME BRAND MEDICATIONS.Enrollment Simply call 410-902-8811, and a Prescription Advocateis simple! will walk you through the enrollment process.

Some of the advantages of joining the ScriptSourcing program are: Employees and Dependents pay $0 Copay for name-brand maintenance medications Prescriptions are shipped directly to your home with no shipping or handling costs No... HEALTHCARE INFORMATIONUtilizing miBenefits, you can obtain REGISTRATION IS EASY!real-time information on any of your,or your dependent’s claims. Addition- • Visit www.ebms.comally, you’ll have access to valuable • Click on the “Log In” link on the top right side ofhealthcare resources that provide the screen.you with the necessary education to • Click... “Register Now”make better healthcare choices. link and complete the simple registration form. • EBMS will immediately validate your eligibilityA new feature just added to the miB- status.

Once verified, you will have instant access toenefits system is EBMS Online Chat. your personal health benefit information.The Online Chat provides instant, on- That’s it! Use your own username and passwordline access to the EBMS Client Service every time you want to visit the miBenefits site!Center for answers to any questions Information Available Within miBenefitsnormally posed to the call... Employees can opt to not enroll in this benefit. An overview of dentalcoverage and monthly premium rates for all employees is listed below.FOR ALL EMPLOYEES Coverage $50 per covered individualBenefits $1,000 per covered person 100%; after deductibleDeductible | Individual 80%Maximum Annual Benefit 50%Preventive... Employees can opt to not enroll in this benefit.

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