2006 Benefits
2 Comprehensive Health Care Plan Choice of POS or HMO or no coverage Payroll deduction amounts: Qualified change in status - report within 30 days in order to have coverage
3 POS - Point of Service Aetna Open Access Managed Choice POS Network of participating providers Negotiated fees No primary care physician required (no gatekeeper) No referrals
4 POS - Point of Service - cont’d Benefits available for out-of-network care Cost sharing - In-network provider - co-payments and coinsurance - Out-of-network provider - deductible and coinsurance
5 HMO - Health Maintenance Organization Aetna Choice POS Participating providers only Primary Care Physician (PCP) required Referrals not required Lower out-of-network benefits Cost sharing: - In-network care: co-payments - Out-of-network: deductible and coinsurance
6 POS - Pharmacy Benefits Aetna Open Access Pre-certification may be required Retail (up to a 30 day supply) - $15 copay for generic drugs - $25 copay for formulary brand-name drugs - $40 copay for non-formulary drugs Mail Order (up to a day supply) - $30 copay for generic drugs - $50 copay for brand-name drugs - $80 for non-formulary brand-name drugs
7 HMO - Pharmacy Benefits Aetna Choice Pre-certification may be required Retail (up to a 30 day supply at participating pharmacies) - $15 copay for generic drugs - $35 copay for formulary brand-name drugs - $50 copay for non-formulary drugs Mail Order (up to a day supply) - $30 copay for generic drugs - $70 copay for brand-name drugs - $100 for non-formulary brand-name drugs
8 Employee Assistance Program Aetna EAP Counseling sessions (up to face-to-face visits per counselable issue, per year Work/life services (legal, financial) Personal services (health & wellness, daily life) Complementary & alternative medicine resources (discounts on fitness centers, activities, and magazines) 24-hour telephonic access: AETNA-EAP Web access: - Program: Aetna EAP - Company ID: MYMEIEAP
9 Vision One Discount Program Available to all Aetna participants Eyewear discount program administered by Aetna Find participating providers -
10 Dental - PPO Aetna Dental PPO Individual calendar year deductible - $50 for individual - $150 for family Preventative care benefit = 100% Minor restorative care: 80% after deductible Major restorative care: 50% after deductible Annual benefit maximum: $2,000 Orthodontia: - 50% after deductible - Only for children - must apply before age 20 - Lifetime maximum: $2,500
11 Dental - DMO Aetna Dental DMO Primary Care Dentist directs care Diagnostic & preventative care benefit = 100% Restorative care & oral surgery = fixed prices Orthodontia: - Screening Exam = $30 - Diagnostic Records = $150 - Adolescent Treatment = $1,945 - Adult Treatment = not covered - Orthodontic Retention = $275
12 Flexible Spending Accounts Set aside pre-tax dollars Lower your taxable income Two separate accounts - one for Health Care, one for Dependent Care Must enroll within 30 days of hire date Submit claims for reimbursement - processed by ADP (Automated Data Processing) Use it or lose it Changes during the year only within 30 days of a qualifying life event
13 FSA - Cont’d Health Care Account - $5,000 calendar year maximum - Eligible expenses include co-payments, coinsurance, deductibles, and eligible over-the-counter drugs - Health care premiums are not eligible expenses Dependent Care Account - Dependent Care - child care for dependent(s) under 13 while parents work or attend school full time - Care for incapacitated/elderly adults you claim on taxes - $5,000 calendar year maximum (may be less for highly- compensated associates)
14 Life Insurance Non-contributory Life - Company pays for life insurance of 3 times annual eligible earnings Contributory Life - Associate may elect to pay for additional life insurance of up to 2 times annual eligible earnings - Apply within 30 days of hire, no statement of health necessary
15 Retirement Program Company 6% 12% Associate 6% Match 401(k) Vanguard Company contribution based on 100% of base pay Maximum annual contributions subject to IRS limits.
16 Resources Aetna Benefits: POS Member Services: POS Pre-certification: HMO Member Services: Dental Member Services: Prescription Line for Providers: Vision One Customer Service: MEI Retirement Plan: Flexible Spending Accounts:
17 Immediate Next Steps Review your plan summaries Make benefits elections for medical, dental, flexible spending, and life insurance coverages Designate life insurance and retirement plan beneficiaries