Presentation on theme: "Benefits Focused on You! Health and Welfare Benefits 2012 - 2013."— Presentation transcript:
Benefits Focused on You! Health and Welfare Benefits 2012 - 2013
Page 2 OUR COMMITMENT TO YOU | a plan designed for your needs Benefit Basics Elections you make now will remain in effect through December 31 st, 2013 You can only make changes if there is a qualified Life Event Changes must be made within 30 days of experiencing a qualifying event Review benefits-make selections wisely Designed to recognize diverse needs Competitive and comprehensive benefits Provides plans based on individual needs Offer plans that provide long-term financial security for you and your family
Page 3 YOUR BENEFITS | what are qualifying events? Qualifying Events Change in status including marital, employment, number of dependents and residence Dependents employers Open Enrollment Significant cost or coverage changes HIPAA special enrollment rights FMLA special requirements Changes due to a judgment, decree or court order Entitlement to Medicare or Medicaid
Page 4 MEDICAL BENEFITS | cost-effective peace of mind BENEFITIn-NetworkOut-of-Network Annual Deductible Single Family $1,000 $3,000 $2,000 $6,000 Out-of-Pocket Maximum Single Family $2,500 $5,000 $4,000 $6,000 Office Visit (PCP/Specialist)$25 / $50 Copay40% after deductible Preventive Care Well-Child/Adult Preventive Care Mammograms/PAP Tests/Physicals 100% 40% after deductible Emergency Room$200 Copay Urgent Care$75 Copay40% after deductible Inpatient Hospital Services (Room/Board & Surgery) 20% after deductible40% after deductible Prescription Drugs Retail (up to 31-day supply) Generic Preferred Brand Non-Preferred Brand Mail Order (up to 90-day supply) Generic Preferred Brand Non-Preferred Brand * NOTE: If you purchase prescription drugs from an out- of-network pharmacy, you are responsible for any difference between the out-of-network pharmacy charges and the amount paid for the same prescription drug dispensed by an in-network pharmacy. $10 $30 $50 $25 $75 $125 $10 $30 $50 N/A UHC MEDICAL MONTHLY DEDUCTIONS Employee$140.00 Employee & Spouse $659.45 Employee & Child(ren) $607.51 Family$1282.78
Page 5 DENTAL BENEFITS | keeping you healthy The dental plan allows you to use any dentist you want, although there is a network that can be accessed for enhanced benefits. Visit www.guardianlife.com to locate a participating dentist.www.guardianlife.com BENEFIT GUARDIAN (In Network) GUARDIAN (Out-of-Network) Annual Deductible – Single Annual Deductible – Family $25 $75 $50 $150 Preventive Treatment100% Basic Treatment100%80% Major Treatment60%50% OrthodontiaNot Available Calendar Year Maximum Benefit $2,500 Guardian DENTAL MONTHLY DEDUCTIONS Employee$16.72 Employee & Spouse$67.27 Employee & Child(ren)$53.38 Family $103.93
Page 6 VISION BENEFITS | keeping you healthy BENEFIT GUARDIAN (In Network) GUARDIAN (Out-of-Network) Exams (every 12 months)$10 Copay Glasses Frames (every 24 months) Single Vision Lenses (every 12 months) Bifocal Lenses (every 12 months) Trifocal Lenses (every 12 months) Lenticular (every 12 months) $120; 20% discount on amount over $120 $25 copay Up to $47 Up to $66 Up to $85 Up to $125 Contacts (every 12 months) Elective & Conventional Medically Necessary Up to $120 $25 copay Up to $105 Up to $210 Guardian VISIONMONTHLY DEDUCTIONS Employee$7.06 Employee & Spouse $12.85 Employee & Child(ren) $12.59 Family $20.32
Page 7 LIFE & DISABILITY BENEFITS / there when you need it BENEFITCOVERAGE Short Term DisabilityBenefit begins on the 1 st day of injury and 8 th day of illness The benefit pays 50% of your weekly base salary up to a maximum of $1,250 per week Long Term DisabilityBenefit begins after 180 days of disability The benefit pays 40% of your monthly base salary to a monthly maximum of $3,500 Disability (Short Term and Long Term) - Unum ScripNet provides coverage for basic life, accidental death and dismemberment, short term and long term disability. Once you meet the eligibility requirements, you are automatically enrolled in these benefits at no cost to you. Basic Life and AD&D - Unum BENEFITCOVERAGE Life Benefit1 times your annual salary Accidental Death and Dismemberment 1 times your annual salary
Page 8 FLEXIBLE SPENDING ACCOUNTS & OTHER BENEFITS Flexible Spending Accounts Flexible Spending Accounts (FSA) allow you to set aside pre-tax money from each paycheck to reimburse yourself for eligible healthcare or dependent care expenses. Reimbursements can be requested by completing a claim form and providing proper documentation (e.g., pharmacy receipts, explanation of benefits [EOB]). Other Company Benefits 401(K) Savings Plan AFLAC Benefits Fitness Center Membership & Weight Programs ACCOUNTUSE FORCONTRIBUTION Health Care SpendingMost medical, dental and vision care expenses (e.g., copayments, deductibles, eyeglasses) $2,500 annual maximum Dependent Care Spending Dependent care expenses such as after-school programs and elder care programs $5,000 annual maximum
Page 9 Need additional information? Have a question about one of your benefits? PLANADMINISTRATORWEBSITEPHONE NUMBER Medical BenefitsUnitedHealthcarewww.myuhc.com866-633-2446 Dental BenefitsGuardianwww.guardianlife.com888-600-1600 Vision BenefitsGuardianwww.guardianlife.com888-600-1600 Life/AD&DUnumwww.unumprovident.com888-857-0157 Short Term DisabilityUnumwww.unumprovident.com888-857-0157 Long Term DisabilityUnumwww.unumprovident.com888-857-0157 Flexible Spending AccountsOptumHealthwww.optumhealthfinancial.com866-898-4584 Benefits BrokerWilliswww.willis.com800-874-2244 If there is ever a question about one of these plans, or if there is a conflict between the information in this guide and the formal language of the plan documents, the formal wording in the plan documents will govern. Please note that the benefits described in this guide may be changed at any time and do not represent a contractual obligation on the part of ScripNet, Inc.
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