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2012 Employee Benefits Stark Carpet Corp. 2012 Health Benefits Open Enrollment Guide It is time again to review the 2012 Health benefits for you and your.

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Presentation on theme: "2012 Employee Benefits Stark Carpet Corp. 2012 Health Benefits Open Enrollment Guide It is time again to review the 2012 Health benefits for you and your."— Presentation transcript:

1 2012 Employee Benefits Stark Carpet Corp

2 2012 Health Benefits Open Enrollment Guide It is time again to review the 2012 Health benefits for you and your family. Stark Carpet Corp is pleased to announce we will continue to offer Aetna Health Plans as our Medical carrier, but will be making changes to our Dental coverage. The following presentation will outline all your options effective as of February 1, 2012.

3 Effective: February 1, 2012 You Will Continue To Have The Following Medical Plans to Select From Four (4) Options With Aetna Health Plans Plan 1 (High) Open Access MC (NGP) Plan 2 (Medium) Open Access MC (NGP) Plan 3 (Low) Managed Choice POS Plan 4 (Basic Low) Managed Choice POS

4 Plan 1- Open Access MC provided by Aetna Health PlansHIGH BenefitsIn NetworkOut of Network Office Co-pay$30 Primary $50 Specialists Deductible & Coinsurance DeductibleSingle: $500 Family: $1,500 Single: $500 Family: $1,500 Coinsurance % Coinsurance Maximum (Includes Deductible) 100% Single: $500 Family: $1,500 70% / 30% Single: $3,500 Family: $10,500 Hospital Co-pay (I/P) Emergency Room Co-pay $100 Copay after Deductible $50 (Waived If Admitted) $100 Copay; Ded & Coins $50 (Waived If Admitted) Lifetime Maximum UCR Unlimited N/A Unlimited 80 th Percentile Prescription Drug Deductible (Waived for Tier 1) Prescription Drug Co-pay (Mail Order: 2x Co-Pay) $100 Per Person (Ded must be met before copays) Tier 1: $20 Co-pay Tier 2: $35 Co-pay Tier 3: $50 Co-pay Covered at Network Pharmacies Only

5 Plan 2- Open Access MC provided by Aetna Health PlansMEDIUM BenefitsIn NetworkOut of Network Office Co-pay$30 Primary $50 Specialists Deductible & Coinsurance DeductibleSingle: $500 Family: $1,500 Single: $1,000 Family: $3,000 Coinsurance % Coinsurance Maximum (Includes Deductible) 100% Single: $500 Family: $1,500 70% / 30% Single: $6,000 Family: $18,000 Hospital Co-pay (I/P) Emergency Room Co-pay $100 Copay after Deductible $50 (Waived If Admitted) Deductible & Coinsurance $50 (Waived If Admitted) Lifetime Maximum UCR Unlimited N/A Unlimited 80 th Percentile Prescription Drug Deductible (Waived for Tier 1) Prescription Drug Co-pay (Mail Order: 2x Co-Pay) $100 Per Person (Ded must be met before copays) Tier 1: $20 Co-pay Tier 2: $35 Co-pay Tier 3: $50 Co-pay Covered at Network Pharmacies Only

6 Plan 3- Standard Managed Choice provided by Aetna Health PlansLOW BenefitsIn NetworkOut of Network Office Co-pay$30 Primary $50 Specialists Deductible & Coinsurance DeductibleSingle: $500 Family: $1,500 Single: $5,000 Family: $10,000 Coinsurance % Coinsurance Maximum (Includes Deductible) 100% Single: $500 Family: $1,500 70% / 30% Single: $15,000 Family: $40,000 Hospital Co-pay (I/P) Emergency Room Co-pay $500 Copay after Deductible $100 (Waived If Admitted) $500 Ded & Coinsurance $100 (Waived If Admitted) Lifetime Maximum UCR Unlimited N/A Unlimited 80 th Percentile Prescription Drug Deductible (Waived for Tier 1) Prescription Drug Co-pay (Mail Order: 2x Co-Pay) $100 Per Person (Ded must be met before copays) Tier 1: $20 Co-pay Tier 2: $35 Co-pay Tier 3: $50 Co-pay Covered at Network Pharmacies Only

7 Plan 4- Standard Managed Choice provided by Aetna Health Plans BASIC LOW BenefitsIn NetworkOut of Network Office Co-pay$30 Primary $50 Specialists Deductible & Coinsurance DeductibleSingle: $1,000 Family: $3,000 Single: $5,000 Family: $10,000 Coinsurance % Coinsurance Maximum (Includes Deductible) 90% / 10% Single: $2,500 Family: $7,500 70% / 30% Single: $15,000 Family: $40,000 Hospital Co-pay (I/P) Emergency Room Co-pay $500 Copay after Ded & Coins $100 (Waived If Admitted) $500 Ded & Coinsurance $100 (Waived If Admitted) Lifetime Maximum UCR Unlimited N/A Unlimited 80 th Percentile Prescription Drug Deductible (Waived for Tier 1) Prescription Drug Co-pay (Mail Order: 2x Co-Pay) $200 Per Person (Ded must be met before copays) Tier 1: $20 Co-pay Tier 2: $35 Co-pay Tier 3: $50 Co-pay Covered at Network Pharmacies Only

8 We Are Pleased To Announce New Changes To The Dental Plans for Your Dental Plan Will Be Administered By GUARDIAN INSURANCE COMPANY You will continue to have a choice to select either a Pre-Paid DMO Dental Plan ( Network Benefits Only – Must Use A Guardian DMO Provider) Or PPO - NAP 590 QD Dental Plan (Network Benefits – Must Use A Guardian PPO Provider) (Out of Network Benefits – Select A Dentist of your Choice)

9 Dental Benefits provided by Guardian Health Plans Your 2012 Calendar Year Dental Deductible will be…. Pre-Paid DMO : Network Only No Deductibles PPO – NAP590 QD : Network /Out of Network$50 Single / $150 family (Note: Deductible is Waived for Preventive) Your 2012 Calendar Year Dental Maximum will be…. Pre-Paid DMO: Unlimited Benefits PPO - NAP590 QD: Network $2,000 Per Person Out of Network $1,500 Per Person Ortho (Lifetime) Max $1,000 Per Child

10 Dental Benefits provided by Guardian Health Plans (Additional Plan Benefits will be included in Guardian Handbook) Benefits Include….. Pre-Paid DMOPPO – NAP590 QD Network Network Out of Network Preventive & Diagnostic Oral Exams / Cleaning Routine X-rays /Sealants Fluoride Application / Space Maintainers Fee Schedule100% Deductible Waived 100% Deductible Waived Basic Restorative Care Non-Routine X-Rays / Fillings Emergency Care to Relieve Plan Periodontics / Endodontics Oral Surgery - Simple Extractions Fee Schedule 90%80% Major Restorative Care Oral Surgery –except Simple Extractions Surgical Extraction of Impacted Teeth Bridges, Crowns & Inlays/Onlays Dentures / Repairs Fee Schedule60%50% Orthodontia$2500-$2800 ( Adult & Child(ren) 50% For Children

11 Important Information About Your Guardian Dental Plan! If you enroll in the Pre-Paid DMO Dental plan, you will need to select a Guardian DMO Dentist in order to receive care. If you enroll in the Pre-Paid DMO Dental plan, you will need to select a Guardian DMO Dentist in order to receive care. If you enroll in the PPO - NAP590 QD Dental Plan, it is not necessary for you to select a Guardian PPO Dentist in advance. However, by using a PPO dental provider you will be entitled to discounted fees. If you enroll in the PPO - NAP590 QD Dental Plan, it is not necessary for you to select a Guardian PPO Dentist in advance. However, by using a PPO dental provider you will be entitled to discounted fees. If you enroll in the PPO – NAP590 QD Dental Plan and elect to use a dental provider that is not contracted with Guardian, fee payments will be based on Usual & Customary allowances with no discounts. If you enroll in the PPO – NAP590 QD Dental Plan and elect to use a dental provider that is not contracted with Guardian, fee payments will be based on Usual & Customary allowances with no discounts. TO LOCATE A DENTAL PROVIDER IN YOUR AREA, PLEASE VISIT GUARDIAN’S WEBSITE AT

12 Life and AD&D Insurance provided by Guardian Employer PAID Benefit Life Insurance Coverage Levels 2 times Annual Salary – Max of $50,000 Benefits Are Reduce 50% at Age 70 Accidental Death & Dismemberment (AD&D) Levels match Life Insurance coverage Accelerated Life Benefit: Minimum: The Lower of $50,000 or 50% of Death Benefit Maximum: $100,000 Includes Waiver of Premium if Totally Disabled prior to Age 60 Includes Option for Conversion /Portability prior to Age 70

13 Vision Benefits provided by Vision Service Plans (VSP) Benefits Include…Using A VSP ProviderNon-Participating Provider ExamsCovered in Full after $10 CopayReimbursed Up To $50 Lenses Single Lenses Bifocal Lenses Trifocal Lenses Covered in Full after $25 Copay Reimbursed Up To $50 Reimbursed Up To $75 Reimbursed Up To $100 Progressive Lenses (Standard)Covered in Full after $50 CopayReimbursed Up To $75 FramesUp to $120 Allowance after $25 Copay Reimbursed Up To $70 Contact Lenses (Fitting & Evaluation) Up to $120 Allowance Reimbursed Up To $105 Laser Vision Care15% Average Discount or 5% Off Promotional Price Frequency Limits Exams – 1 Every 12 Months Frames or Contacts – 1 Every 24 Months

14 Voluntary Life Insurance provided by Allstate In additional to the Basic Life Insurance, you can also purchase additional Life Insurance through Payroll Deductions. Option 1 - Universal Life: Provides coverage to age 85 with guaranteed cash values. Offers permanent protection with lifetime rate stability. Option to purchase spouse coverage. Option to purchase small amount for children and grandchildren. Policy will pay a portion of the face value to you while you are still living if you are diagnosed with a terminal illness or require long term care. Option 2 - Horizon Term Insurance: Straight death protection with a level death benefit and a premium designed to be level for 20 years. If Interested, please contact Bill Liggan in Human Resources and he will arrange to have an Allstate Representative meet you to review the application process.

15 Voluntary Benefits provided by AFLAC Vol. Short Term DisabilityPersonal Cancer IndemnityAccident Indemnity Advantage Maximum Benefit Duration Choice of 3 / 6 / 12 / 18 Months Benefit Amount: Monthly $500-$5,000 (subject to income requirement) First Occurrence Benefit Pays $2,000 for Insured Pays $2,000 for Spouse Pays $3,000 for Children Accident Emergency Treatment $120 Once per 24-hour period (once per accident / per covered person) Elimination Period for Injury / Sickness Employee will have a choice of electing a 7, 14, 30, 60,90 or 180 day period Hospital Confinement Benefit Pays $300 per day for first 30 days Benefit increases to $600 per day after 31 st day Hospital Confinement Benefit $1000 per period or $1,500 per covered person if admitted to intensive care unit initially. Benefit Includes Total Disability Benefit Partial Disability Benefit Transitional Disability Benefit Policy is Fully Portable Guaranteed Renewable to Age 70 See Brochure for additional benefits Benefit Includes Medical Imaging Radiation & Chemotherapy Immunotherapy Benefit Nursing / Skin Cancer Surgery. See Brochure for additional benefits Benefits Includes X-Rays Accident Follow Up Treatment Accident Hospital Confinement ICU Confinement Major Diagnostic Exams. See Brochure for additional benefits Please contact Bill Liggan in Human Resources for enrollment information.

16 What is an Flexible Spending Account (FSA)? Flexible Spending Accounts provides you with tax relief for un-reimbursed medical and dependent day-care cost. FSAs enable you to utilize pre-tax dollars and save Federal, FICA, and in most cases, State taxes when paying for eligible expenses not covered by the traditional insurance plan. Flexible Spending Account provided by Ameriflex

17 Your Flexible Spending & Dependent Care dollars are deposited through regular payroll deductions. You estimate how much you spend annually on expenses that qualify to be paid from your flex account, then enroll. You May Elect Amounts up to… $5,000 for Flexible Spending (FSA) Expenses The annual amount you elect for the FSA is available on the first day and through-out the plan year. $5,000 ($2,500 if single) for Dependent Care Expenses Dependent Care (DCSA) is available as your contributions are deposited in the account.

18 USE IT… Don’t LOSE IT! Unused balances may not be paid to you in cash or used in a later year. So estimate what you think you will need for your expenses. NOTE: If you were enrolled in the FSA for 2011 and want to continue, you must make a new election for Flexible Spending Account provided by Ameriflex

19 How Are Qualified Expenses Paid? By… using the “AmeriFlex Convenience Card” – this is a Master Card debit card providing electronic access to your FSA Funds. OR… submit a Claim Form – if merchant does not accept the “AmeriFlex Convenience Card”. Note: AmeriFlex may need additional information, including receipts to verify eligibility of the expense and to comply with IRS Rules. Save all receipts, then fax or mail them promptly if requested!.

20 Co-pays, deductibles, and other payments you are responsible for under your medical plan Prescriptions (ONLY PRESCRIBED BY PHYSICIAN) Dental & Eye care expenses Chiropractic treatments Prescribed Weight - Loss Programs Daycare expenses for dependents, so you can work and much more … Expenses That Qualify For Payment With Flex Dollars Flexible Spending Account provided by Ameriflex

21 Online Website Access – Take A Tour Register Your Secure Website For Each Carriers Aetna Medical: Guardian Dental: VSP Vision: Ameriflex FSA: On Your Secure Website, you will find: 24 Hours a day - Access to Your Claims & Benefits Insurance information - To become an informed consumer. Personalized tools - Request Forms & ID Cards – Look for Participating Providers You can do it online - 24 hours a day, 7 days a week - from wherever you have Internet access.

22 Completion of Your Health Benefits Enrollment IMPORTANT INFORMATION THERE ARE TWO WAYS TO MAKE YOUR ENROLLMENT ELECTION FOR HR CONNECTION - ONLINE If you provided a Address (either a Stark or Personal ), you can go online to and make your elections. No Paper Documents will be necessary. (Instruction Sheet will be available)www.hrconnection.com 2.PAPER ENROLLMENT If you do not have an Address, you may complete a Paper Enrollment and submit to Bill Liggan in Human Resources. (Enrollment Packages will be available)

23 If enrolling through HR Connection, please be sure to make your election for each plan and include any addition or changes you may want during this open enrollment. (No paper form will be required if enrolling online) If you will be using a paper form, please print all information clearly. Include All Social Security Numbers. (Yours & Your Dependents) (This is for enrollment process only. You will be assigned a Member Identification Number for Privacy Requirements) Be sure to include all your dependents dates of birth. Sign & Date your application. Return completed enrollment form to Human Resources by January 20, NOTE: ONCE YOU ARE ENROLLED IN THE HEALTH BENEFITS FOR 2012, YOU WILL NOT BE ABLE TO MAKE ANY CHANGES UNTIL THE NEXT PLAN ANNIVERSARY UNLESS YOU HAVE A QUALIFYING EVENT! Completion of Your Health Benefits Enrollment IMPORTANT INFORMATION

24 Service & Advocacy Co-Pilot Benefits Advocacy CoPilot TM is an employee advocacy program from Pilot Employee Benefits designed to assist employees with all aspects of enrollment as well as any claims or coverage issues that may arise. The CoPilot TM service card contains instructions for you to obtain assistance with any of the benefit plans. Pilot works for you and is there to help you receive the benefits of your plans. If you have any questions regarding your benefits, please contact our employee service program, CoPilot TM, Call (800)

25 QUESTIONS?


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