2011 heritage employee benefit guide

Benefits Eligibility

OnlineEnrollment

MedicalPlan

DentalPlan

VisionPlan

BasicLifeInsurance

VoluntaryTermLifeInsurance

LongtermDisability

FlexibleSpendingAccount(FSA)

Health&Wellness

Employee Benefits Guide | 2011

Heritage Trust Benefits Guide 20112

online enrollment

OVERVIEW

This year, you will enroll for your benefits via the internet through a secure website designed specifically for Heritage Trust.

Once the enrollment is complete for this year’s benefits, use this website to update your benefit information including address change, child birth, etc.

The enrollment deadline is December 20, 2010.WEbsItE addREsswww.benefitsconnect.net/htfcu

LOgIn:First 6 letters of lastname + First letter of first name + Last 4 digits of SSN

Example1: Mickey Starfish SSN 123456789 Login = starfim6789

Example2: John Smith SSN 987654321 Login = smithj4321

Password: SSN (with no dashes) – You will be asked to change your password with one of at least 6 (six) characters.

EnROLLmEnt pROcEduRE The website will take you step by step, one screen at a time, to enroll in your benefits for the upcoming year. You will be shown information in the following order:

1) Employee Usage Agreement: Acknowledgement of electronic signature use.

2) Password Change: Change to your new password.

3) Personal Information: Enter your name, DOB, address and all other requested information.

4) Dependents: Add spouse and children here. If you do not, your dependents will not be eligible for benefits.

5) Section 6 will walk you through the election of eligible insurance benefits: You may elect the benefits and choose dependents to be covered under the plan or you may waive the benefit indicating that you choose not to elect this plan.

6) Consolidated Enrollment Form: Review your information and print a copy for your records. Once you’ve finished your enrollment and printed the consolidated form, click on the Finished button and you will be directed to the Employee Menu. If you need to make changes to your enrollment you may do so using the selections from the options indicated and follow the instructions listed under MAKING CHANGES to the right.

maKIng cHangEs

To change personal information: Click on the “Personal Information” icon and a drop down list will appear. Click on the appropriate section, change and save your information.

To change dependent information: Click on the “Dependent Information” icon and select to add a spouse or child or click on the dependent you wish to change.

To change your benefit elections: Click on the “Benefit Plan Information”, click on “Benefit Plan Enrollment”, choose from the drop down box the benefit you wish to change and update you enrollment.

If you have any questions regarding your enrollment, please contact your Human Resources department.

Please give great care to your login ID and your password.

Instructions for Online Enrollment

All online enrollments must be completed by December 20, 2010

welcome

Overview

3

We know that your benefits are important to you and your family. Helping you understand the benefits offered by Heritage Trust is important to us. That is why we have created this Benefits Guide. Included in this guide are summary explanations of the benefits, cost information and contact information for each provider.

It is important to remember that only those benefit programs for which you are eligible and have enrolled in apply to you. We encourage you to review each section and to discuss your benefits with your family members. Be sure to pay close attention to applicable co-payments and deductibles, how to file claims, preauthorization requirements, networks and services that may be limited or not covered (exclusions). This guide is not an employee/employer contract. It is not intended to cover all provisions of all plans but rather is a quick reference to help answer most of your questions. Please see your Summary Plan Description for complete details. We hope this guide will give you a clear explanation of your benefits and help you be better prepared for the enrollment process.

Who Is ElIgIblE for bEnEfIts?To determine the benefits for which you may be eligible, please refer to the chart below. You are eligible to participate in these plans upon meeting each plan’s eligibility requirements. You also have the option to enroll your eligible dependents in some of these plans. Eligible dependents may include:

• Your spouse or your children (dependent age limit to 26*)

Individuals whose coverage ended, or who were denied coverage (or were not eligible for coverage), because the availability of dependent coverage of children ended before attainment of age 26 are eligible to enroll in the BlueChoice of SC Healthplan. Employees requesting to enroll eligible dependents will have the opportunity during this open enrollment period. Enrollment will be effective January 1, 2011.

*Certain limitations apply. Please call the Employee Service Hotline for additional information, 1-800-370-2692

Employee benefits hotline: 800-370-2692

2011 PlAn hIghlIghtsEmployee Benefits Hotline: 800-370-2692This service is available during open enrollment and throughout the year. Please call for all your benefits questions, including claims, eligibility, and wellness information. A dedicated customer service team is here to help.

PLAN EMPLOYEES WORKING FULL TIME

NEW HIRE ELIGIBILITY WAITING PERIOD

Medical/Prescription 40 hours per week 90 days

Dental 40 hours per week 90 days

Vision 40 hours per week 90 days

Basic & Voluntary Life 40 hours per week 90 days

Long Term Disability 40 hours per week 90 days

FSA 40 hours per week 90 days

Wellness 40 hours per week 90 days

online Enrollment .............................................................2

highlights .............................................................................3

Medical Insurance .............................................................4

Wellness ................................................................................9

Dental Insurance ............................................................. 12

Vision Insurance .............................................................. 13

basic life Insurance........................................................ 14

long term Disability ...................................................... 14

Voluntary life Insurance .............................................. 15

flexible spending Account ......................................... 16

Medicare ............................................................................ 19

Quick reference Contacts ........................................... 20

BENEFITS IN-NETWORKMEMBER PAYS

OUT-OF-NETWORKMEMBER PAYS

deductible Single Collective Family

$2,750$5,500

$3,500$7,000

maximum coinsurance Single Family

N/AN/A

Plan pays 100% after deductible

$6,500$13,000

physician careOffice services (preventive care)

Office services (all other)

Hospital services (includes inpatient, outpatient & ambulatory care services)

$15 per visitDeductible, $0Deductible, $0

Deductible, then 40%Deductible, then 40%Deductible, then 40%

Other Routine care GYN Exam Routine Screening Mammogram Routine Screening Colonoscopy Routine Physical Exam

$15 Copay, plan pays 100%$0, plan pays 100%$0, plan pays 100%

$15 Copay, plan pays 100%

Deductible, then 40%Deductible, then 40%Deductible, then 40%Deductible, then 40%

Hospital/Facility services (Authorization required)

Inpatient admission (including maternity)Skilled Nursing & Long-term Acute Care Facility - 120 days per Benefit Period

Deductible, then 0%Deductible, then 0%


Outpatient/ambulatory care FacilitiesAll services (including maternity)Emergency room servicesUrgent care

Deductible, then 0%Deductible, then 0%Deductible, then 0%

Deductible, then 40%Same as In-Network

Deductible, then 40%

Other servicesHome HealthPhysical Therapy ($1,000 Maximum)Mental Health (Annual benefit max = 20days In / 20 visits out)

Deductible, 0%Deductible, 0%Deductible, 0%

Deductible, 40%Deductible, 40%

Not Covered

prescriptionsRetail (31 day supply)

Mail Order Prescriptions (90 day supply)

specialty pharmacy Rx

IN NETWORK ONLY Deductible, 0%Deductible, 0%

Deductible, 0%

annual maximum $2,000,000

medical base plan (HDHP/HSA)

hsA is available with the base Plan (see page 5). health Care fsA is not available with this plan but Dependant Care fsA is available.

Summary of Benefits


Mail Claims to:BlueChoice HealthPlan of SC P.O. Box 6170Columbia, SC 29260-6170

Customer Service: 1-800-868-2528

HEAlTH SAvINgS AccOUNT DOllARS ARE AvAIlABlE TO HElP PAY FOR OUT-OF-POcKET MEDIcAl ExPENSES, PlEASE SEE BElOW.

Eligible Employees: Full-time employees working at least 40 hours per week are eligible following 90 days of active employment.

DeductionsEmployee Bi-weekly

Premium

Employee Only $51.79

Employee + Spouse $113.67

Employee + Child(ren) $102.54

Employee + Family $155.22

HSA ContributionWeek of

January 1st

Employee Only $500

Employee + Spouse $1,000

Employee + Child(ren) $1,000

Employee + Family $1,500

CONTRIBUTION*

For those electing the Base Plan, Heritage Trust will continue to allocate funds for medical expenses. The employer paid contributions for 2011 are in the above chart and will be made the first week in January. Employees may also elect to make a contribution to their HSA. The maximum contribution for 2011 (combined employer and employee) is $3,050 for employee only coverage and $6,150 for all family coverages.

Deductions and Eligibility

5Employee benefits hotline: 800-370-2692

ADMINISTERD BY BLUECHOICE HEALTHPLAN

* Please see page 17 for details on eligible hsA/fsA expenses

BENEFITS IN-NETWORKMEMBER PAYS

OUT-OF-NETWORKMEMBER PAYS

deductible Single Family

$1,500$4,500

$3,000$9,000

maximum coinsurance Single Family

$1,500$3,000

$3,000$6,000

primary careOffice services (routine/preventive care)Hospital services

$20 per visit$0


specialty careOffice servicesHospital services (includes inpatient, outpatient & ambulatory care services)Emergency room care

$35 per visitDeductible, then 20%




Other Routine preventive care*GYN ExamRoutine Screening MammogramRoutine Screening ColonoscopyRoutine Maternity Physician Services

$20 per visit$0$0

$35 first visit, then 20%

Deductible, then 40%Deductible, then 40%Deductible, then 40%Deductible, then 40%

Inpatient Hospital/Facility services (Authorization required)Admission (including maternity)Skilled Nursing & Long-term Acute Care Facility - 120 days per Benefit Period


$250 per admission, then 40%Deductible, then 40%

Outpatient/ambulatory care FacilitiesAll services (including maternity)Emergency room servicesUrgent care

Deductible, then 20% $125 per visit, then 20%

$20 per visit

Deductible, then 40%Same as In-Network


Other servicesHome HealthPhysical Therapy ($1,000 Maximum)Mental Health (Annual benefit max = 20days In / 20 visits out)

Deductible, 20%Deductible, 20%

Inpatient = Deductible, 20%Outpatient = $35 per visit

Deductible, 40%Not CoveredNot Covered

chiropractic benefits ($1,000 Max per year) $35 per visit Not Covered

prescriptionsRetail (31 day supply)

Mail Order Prescriptions (90 day supply)

specialty pharmacy Rx

IN NETWORK ONLY $8 (Value Generic) / $15 (Standard Generic) / $35 (Preferred) / $55 (Non-Preferred)$16 (Value Generic) / $30 (Standard Generic) $70 (Preferred) / $110 (Non-Preferred)

$125 co-payment

annual maximum $2,000,000


medical buy up plan (PPO)

Summary of Benefits

*Due to Healthcare Reform legislation, Preventive Care services have been expanded! These services will be available to you with no copayment or cost sharing. Please visit the following link for a list of these services: http://www.healthcare.gov/law/about/provisions/services/lists.html

mental Health:

Mental Health and Substance Abuse Services must be Pre-Authorized by CBA prior to services being rendered.

Call: 1-800-868-1032

pre-authorization:

The following outpatient procedures need pre-authorization: Chemotherapy or Radiation Therapy (one time notification), Hysterectomy, Septoplasty, Sclerotherapy, all Cosmetic procedures, Investigational procedures performed in outpatient or office setting and Durable Medical Equipment over $500.00. All inpatient hospital or skilled nursing facility admissions, home health care, hospice care or inpatient physical rehabilitation, and services and supplies related to human organ and tissue transplants. South Carolina: 1-800-327-3238 Out of State: 800-334-7287.

appeal Rights:

Except in the absence of legal capacity, claims must be filed no later than 15 months from the end of the benefit period in which you or your dependents receive medical services or supplies. You have 60 days from the date you receive an Explanation of Benefits regarding a claim to request a review of all or part of the claim.

mail claims to:

Blue Cross Blue Shield of SC, Columbia Service Center, PO Box 100300, Columbia, SC 29202

Customer Service: 1-800-760-9290 (Medical) / 1-888-963-7290 (Prescription Drugs)


Deductions and Eligibility

Eligible Employees: Full-time employees working at least 40 hours per week are eligible following 90 days of active employment.

DeductionsEmployee Bi-weekly

Premium

Employee Only $77.22





Scenario 1:

Member goes to Primary Care physician for routine physical or preventative screening.(Remember to tell physician about your wellness

benefit and ask them to code it properly)

BASE PLAN:

Member Pays $15 Copay

Plan pays 100% after copay

Member used the $15 from HSA for Copay

(HSA balance is now $485)

BUY UP PLAN:

Member pays $20 Copay

Plan pays 100% after copay

Member paid $20 Out-of-Pocket

Scenario 2:

Member goes to Primary Care Physician or Specialists for diagnostic consult or visit.(Estimated cost $100, Cost based on BlueChoice discounted rate)

BASE PLAN:

Member used the $100 from HSA for Charges

(HSA balance is now $400)

BUY UP PLAN:

Member pays $20 Copay for Primary Care

Member pays $35 Copay for Specialist

Member paid Out-of-Pocket

Scenario 3:

Maternity Care: normal delivery, doctors visit, hospital stay, etc. (Approx. $10,000)BASE PLAN:

First $500 paid from HSA

Member pays remaining $2,250 of deductible

Plan pays 100% of remaining charges

Net Out-of-pocket for member only $2,250

(upon meeting deductible, member is covered

at 100% for the rest of the year)

BUY UP PLAN:

Member pays $1,500 deductible

Member pays 20% coinsurance

(after deductible to $1,500 max)

Total Out-of-pocket for member only $3,000

(upon meeting deductible, member is still

subject to coinsurance)

Scenario 4:

Cardiac Bypass Surgery and hospital stay (Approx. $55,300)BASE PLAN:

First $500 paid from HSA

Member pays remaining $2,250 of deductible

Plan pays 100% of remaining charges

Net Out-of-pocket for member only $2,250

(upon meeting deductible, member is covered

at 100% for the rest of the year)

BUY UP PLAN:

Member pays $1,500 deductible

Member pays 20% coinsurance

(after deductible to $1,500 max)

Total Out-of-pocket for member only $3,000

(upon meeting deductible, member is still

subject to coinsurance)

Scenario 5: PrescriptionsBASE PLAN: Deductible must be met then plan pays 100%. (HSA funds can be used to pay for prescriptions)

BUY UP PLAN: Member pays Copay


medical base plan (HDHP/HSA)

Plan Comparisons based on Single Employees, receiving full HSA contribution only



Wellness Works at Heritage Trust is a fun and innovative way to get employees involved in healthy practices and encourage them to pursue a healthy lifestyle. The wellness website not only offers fun activities and great rewards, it also offers a wealth of information. From recipes to remedies this is your one stop heath shop. Through out the year the wellness program offers exciting quarterly challenges, informative monthly seminars, beneficial healthy living programs and much more.

Heritage Trust wants all employees to participate in the program. Healthier employees are happier employees!

Heritage encourages everyone to get involved by offering fun incentives for challenges completion and earning points. Check out the online bulletin board section of the wellness website for more details.

Go online to learn more about our company’s wellness program.

www.UBAWellnessWorks.com Logon with company access: heritage

1) Click the Login button (top right of navigation bar) 2) enter your personal username and password

wellness www.UBAWellnessWorks.com

Wellness Works

health & wellness value added services

BlueChoice HealthPlan

Discover My Health Toolkit®

Visit BlueChoiceSC.com and select My Health Toolkit on the member homepage.

Be in control of your health care! Our online tools and resources can help you

manage your health!

BlueChoiceSC.com


health & wellnessvalue added services value added services

My Health Toolkit

Use My Health Toolkit to access your claims, health and dental coverage information.

Become a registered member to:

• Review the status of your claims.

• View and print a copy of your Explanation of Benefits.

• Ask Customer Service a question through secure e-mail. View responses in your message center.

• View your benefits booklet, depending on your coverage.

• Request a new ID card.

• Avoid phone calls.

• Access and update Other Health Insurance status.

• And more, with new features and functions being added!

In the Money section, learn about:

Personal Savings AccountsLearn more about Consumer Directed Health Plans and how they can save you money on health spending.

Contribution CalculatorsUse these handy tools to help determine HSA and FSA contributions.

Drug CostsLook up costs and consumer information about a prescription drug.

In the Benefits section, you have access to:

My Pharmacy ManagerSM

Make smart decisions about prescription drugs by comparing costs and searching for generic or preferred brand options. View our preferred drug list, find a network pharmacy, access personal prescription drug history and access a mail-order pharmacy.

Note: If a plan does not have pharmacy benefits, access to My Pharmacy Manager may be limited.

Eligibility and Benefits• Check eligibility for specific procedures

• View deductible and out-of-pocket status

• Contact customer service and more!

In the Health and Wellness section, use these helpful tools:

Personal Health RecordTrack medical history, appointments, doctors, prescriptions and more. Learn about managing conditions, such as diabetes and asthma.

Health LibraryBrowse health topics from A to Z, explore a variety of tools and calculators or find articles on first aid, common illnesses, symptoms and more.

Check Drug InteractionsCheck for possible interactions with other prescriptions, food, alcohol, caffeine and more.

BlueChoice HealthPlan

Doctor and Hospital FinderFind a network health care professional or hospital within South Carolina, outside South Carolina or around the world. Our Doctor and Hospital Finder features information about quality and cost of care.

Quickly find the

health care

professional

you need. You can

even create and

print a directory of

physicians, dentists,

hospitals and urgent

care centers.


Dental DeductionsEmployee Bi-weekly

Premium

Employee Only $4.69





dental

Summary & Deductions

ADMINISTERD BY PRINCIPAL

Your Coverage from a VSP doctor: WellVision Exam¨ focuses on your eye health and wellness • $10 copay...................................................every 12 months

Prescription Glasses • $25 copayLenses..................................................every 12 months • Single vision, lined bifocal and lined trifocal lenses.

• Polycarbonate lenses for dependent children.

Frame................................................... every 24 months

• $130 allowance for frame of your choice.

• 20% off amount over your allowance

~OR~

Contact Lens Care • NO copay............................. every 12 months

$130.00 allowance for contacts and the contact lens exam (fitting and evaluation). This additional exam ensures proper fit of contacts. If you choose contact lenses you will be eligible for a frame 12 months from the date the contact lenses were obtained. Current soft contact lens wearers may qualify for a special program that includes a contact lens evaluation and initial supply of replacement lenses.

Extra Discounts and SavingsGlasses and Sunglasses

•Average 30% savings on lens options like progressives and scratch- resistant and anti-reflective coatings

•20% off additional glasses and sunglasses, including lens options

Contacts*

•15% off cost of contact lens exam (fitting and evaluation)

*Available from any VSP doctor within 12 months of your last eye exam

Laser Vision Correction

•Average 15% off the regular price or 5% off the promotional price from con-tracted facilities

•After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor.

You get the best value from your benefit when you see a VSP doctor. If you see a non-VSP provider, you’ll typically pay more out of pocket. You’ll pay the provider in full and must submit a claim to VSP for partial reimbursement less copays. Before seeing a non-VSP provider, call us at 800.877.7195.

Out-of-Network Reimbursement Amounts:Exam ................................................................................................................................................................................$35.00Single Vision Lenses ...............................................................................................................................................$25.00Lined Bifocal Lenses ...............................................................................................................................................$40.00Lined Trifocal Lenses .............................................................................................................................................$55.00Frame ..............................................................................................................................................................................$45.00Contacts .....................................................................................................................................................................$105.00

VSP guarantees service from VSP doctors only. In the event of a conflict between this informa-tion and your organization’s contract with VSP, the terms of the contract will prevail.

Keep your eyes HEALTHY&Your vision CLEAR

Welcome to VSP Vision Care. We’ll help keep you and your eyes healthy through personal care from a doctor you can trust.

Your eyes say a lot about you and can even tell your doctors about you. During your WellVision Exam, your doctor will look for vision problems and signs of health conditions too.

FIND a doctor that’s right for you. You will have plenty to choose from by visiting www.vsp.com or calling 1-800-877-7195.

ALREADY have a VSP doctor? Make an appoint-ment today and tell them you are a VSP member.

CHECK out your coverage savings. Visit www.vsp.com to see your benefits anytime or to view how much money you have saved with VSP after your appointment.

www.VSP.com1-800-877-7195

Vision DeductionsEmployeeBi-weekly Premium

Employee Only $4.07





vision administered by voluntary vision benefits

Summary & Deductions

ADMINISTERD VOLUNTARY VISION BENEFITS

EMPLOYER PAIDLong Term Disability (LTD)

Eligibility: All employees working 40 or more hours per week Elimination Period: 90 Days Benefit Amount: 66 2/3% of salary, Not to exceed $10,000 per month Maximum Payment Period: Normal Retirement Age

EMPLOYER PAIDLife and AD&D Insurance

Eligibility: All employees working 40 or more hours per week

Benefit Amount: 2 times Salary Maximum of $400,000 with a minimum of $15,000

Maximum Payment Period: Reduces 35% at the age of 65 Reduces 50% at the age of 70

Event Period: AD&D insurance pays a benefit equal to your group term life insurance amount when loss occurs within 365 days of the accident.

Accelerated Death Benefit:If an insured is diagnosed as terminally ill and is expected to die within 12 months, then he or she may take up to75% of the benefit to a maximum of $250,000. The death benefit payable will be reduced by any amount of Accelerated Benefit that has been paid.

EMPLOYER PAID Salary Continuance Plan

This benefit will provide partial income protection for employees in the event of illness or injury. “Disability” is defined for the purpose of salary continuance as one of at least 15 days but not exceeding 90 days duration. Pregnancy will be treated the same as any other disability. Benefits are payable at 60% of the employees’ weekly wages for up to 12 weeks from the date of the disability. An employee must use any available PTO for the first 10 days of illness. If the employee does not have 10 days of PTO available, they may then elect to use available leave under their RSB. The total leave available to an employee where the employee’s job will be held is 12 weeks, except in cases where economic or other conditions make it necessary to reduce the staff of the credit union. Benefits are payable only with a physician’s statement verifying that the employee is unable to work.


basic life & long term disability

Benefit Summaries


EmployEr

paid

EmployEr

paid

EmployEr

paid

employer paid

Group Term Life and AD&DLIFE and AD&D COVERAGE

Employee: Up to 5 times salary in increments of $10,000. Not to exceed $300,000. Guarantee Issue for employee under 70 is $100,000.

Spouse: Up to 100% of employee amount in increments of $5,000. Not to exceed $150,000. Guarantee Issue for Spouse under 70 is $30,000. Benefits will be paid to the employee.

Child: Coverage amount for eligible children 14 days or older of $5,000 or $10,000. Not to exceed $10,000. The maximum death benefit for a child between the ages of live birth and 14 days is $1,000. Benefits will be paid to the employee.

Coverage amount(s) will reduce according to the following schedule: Age: 65 Insurance Amount Reduces to: 35% of original amount Age: 70 Insurance Amount Reduces to: 50% of original amount

Age Employee

<30 .3230-34 .3735-39 .4640-44 .7945-49 1.4350-54 2.2655-59 3.7960-64 6.3765-69 9.2870+ 14.92

Term life coverageSpouse per $5,000

Bi-weekly Rate

Term life coveragechild

Bi-weekly Rate

$5,000= .46

$10,000= .92

Age Spouse

<30 .1630-34 .1935-39 .2340-44 .3945-49 .7250-54 1.1355-59 1.8960-64 3.1965-69 4.6470+ 7.23

For more information contact your Human Resources Department at (843) 832-2622


voluntary life insurance

Benefit Summaries



fsa flexible spending account

Your Flexible Spending Account (FSA)

What is a FSA?

There are two types of Flexible Spending Accounts:

Health Care and Dependent Care

Flexible Spending Accounts (FSA) help you save money by

providing a way to pay for certain types of health care and

dependent care on a pre-tax basis.

How a FSA works

During Open Enrollment you decide how much money you want

to contribute for the year (there are limits). You have only one

opportunity a year to enroll, unless you have a qualified “life

change”. The amount you designate for the year is taken out of

your paycheck in equal installments each pay period and placed

in a FSA account. As you incur medical expenses that are not fully

covered by your insurance, you may submit your expenses for

claims transactions using one of the following options:

1) Explanation of Benefits form from your insurance carrier after a

claim has been paid;

2) Detail claim from the provider of services (ex: physician/dentist)

on the provider of services form with all information related to the

service and expenses;

3) A Prescription form that you receive from the Pharmacy with

the information on each prescription you are submitting;

4) A computer form from a Pharmacy for prescriptions filled

at that Pharmacy with all detail information related to the

prescriptions/date/costs You may submit any one of the above to

evidence claim payment to Blue Water Administrators.

A way to save taxes

Enrolling in a FSA can save you money by reducing your taxable

income. Your total savings will depend upon your family income,

tax status, and expected amount of health and dependent care

costs. The contributions you make to a Flexible Spending Account

are deducted from your pay BEFORE your Federal, State, or

Social Security Taxes are calculated and are never reported to the

IRS. The end result is that you decrease your taxable income and

increase your spendable income. You can save hundreds or even

thousands of dollars a year.

Estimate expenses carefully

To receive the greatest savings, you must carefully estimate the

amount of eligible out-of-pocket expenses you will have for the

year. Once you have estimated the total annual amount, divide

it by 26. That amount is what you may want to have deducted

from your gross pay (before taxes) each pay period to be used

to fund your Flexible Spending Account. If you terminate before

the end of the plan year and have an account balance you may be

eligible to elect Cobra for this benefit. If you do not elect Cobra,

any unclaimed contributions will be forfeited. You have 60 days

from date of termination to file claims for expenses incurred prior

to termination. Please see SPD for complete plan details.

Do not over estimate

Be conservative in your calculations. If you do not incur eligible

expenses for the full amount you elected to put in your FSA, the

remaining balance in your account will be forfeited according to

IRS regulations. Use it or lose it!

Changing your enrollment

You should also remember that once you have made an election

for the plan year, you cannot change it until the next annual Open

Enrollment period unless you have a qualifying life event. If you do

have a qualifying life event and you want to change an FSA, it is

your responsibility to do so within 31 days of the life event.

Eligibility

If you are a full-time employee, you may enroll in a Flexible

Spending Account.

NOTE: Starting January 1, 2011

A closer look at Health Care FSA’s

Health Care Flexible Spending Accounts allow employees to set

aside pre-tax dollars taken through a payroll deduction to pay for

expenses not covered by any medical or dental plan in which you

may be enrolled. These pre-tax dollars are set aside in a personal

flexible spending account until needed. The most you may set aside

for this account is $2,000 per year.

Eligible expenses

According to IRS regulations, the following expenses are eligible

to be claimed against a Health Care FSA. These expenses must

be incurred during the plan year and must not be eligible for

reimbursement from insurance policies or any other source.

Also, expenses can only be incurred by you, your spouse, or any

dependent (if you furnished over one half of the dependent’s

support during the plan year). Please use the list on the next page

to estimate the amount you wish to put in your Health Care FSA.

We encourage you to refer to this list during the year to be sure

you are taking full advantage of your FSA.

Overview


Eligible expenses examples

• artificial limbs, eyes, etc.

• chiropractic care, licensed services/practitioner

• deductibles/co-insurance (if not reimbursed from another source)

• dental fees, including braces, treatments, etc.

• drugs, prescription

• durable medical equipment, wheelchairs, etc.

• eyeglasses (if for medical reasons), contact lenses, solutions, enzymes

• hearing aids and batteries

• maternity (delivery) expenses, midwife

• nursing home, if for medical reasons

• ophthalmologist, optometrist services

• orthodontic expenses

• orthopedic shoes and corrective devices

• physical examinations

• physician fees

• radial keratotomy (PRK, LASIK)

• smoking cessation programs and prescription medication

• transportation, tolls or parking expense for medical care

• vaccinations, immunizations

For more information on eligible and ineligible expenses, visit

www.irs.gov and refer to Publication 502.

Changes to the Over the Counter Eligibility for Reimbursement - January 1, 2011

Healthcare Reform has changed the allowable FSA over the counter

drugs. The list below has been provided in categories of items

that will be removed from the *IIAS list. Please note this is not the

complete listing of items. This list may assist you in determining the

amount that you allow for your Flexible Spending Account election,

and if you have a Health Reimbursement Account that allows all

IRS 213 expenses. These items require a prescription from a medical

doctor to be filled by a pharmacy:

• Acid Controllers • Allergy & Sinus

• Antibiotic Products • Anti-Diarrheal

• Anti-Gas • Anti-Itch - Insect Bites

• Anti-Parasitic Treatments • Baby Rash Ointments/Creams

• Cold Sore Remedies • Cough, Cold, Flu Remedies

• Digestive Aids • Feminine Anti-Fungal/Anti-Itch

• Hemorrhoid Preps • Laxatives

• Motion Sickness • Pain Relief

• Respiratory Treatments • Sleep Aids & Sedatives

• Stomach Remedies

A closer look at Dependent Care FSA’s

Dependent Care Flexible Spending Accounts may be used to pay

for expenses you incur for the care of dependent children under

age 13 or any disabled dependent who lives with you and who you

claim on your taxes. If you use Dependent Care services for a child,

you know how much you need to budget for this expense every

month. With an FSA, you set aside money to pay this expense with

pre-tax dollars.

What’s best for you?

Your total savings will depend upon your family income, tax status,

and total expenses. If you have Dependent Care expenses, you may

choose to claim a tax credit when you file your Federal taxes rather

than contribute to a Dependent Care FSA. Your own circumstances

will determine whether using a Dependent Care FSA or the Federal

income tax credit will be better for you.

Contributions limits

The Dependent Care FSA allows employees to set aside pre-tax

dollars taken through a payroll deduction to pay for work-related

child care expenses (daycare must have a valid Tax ID) or adult

dependent care. Up to $5,000 can be set aside for this purpose.

Checking your FSA balance

To check your balance on the FSA visit the website:

https://employeebwa.lh1ondemand.com

The first time you log onto this site use these credentials:

username: your social security # no dashes password: changeme1

Once you have logged on for the first time you will be prompted

to create a new unique password for future login. Upon login you

will be able to check your FSA account balance. Click on the My

Account button and choose to view your account balance. You may

also check your FSA account balance by contacting the Customer

Service Hotline at 1-800-370-2692.

How to file an online claim

File your claims by logging onto the website:


Click on the FILE CLAIMS link and select the file claim button next to

the appropriate account. Fill out the form and click submit. Print your

confirmation page and send a copy of it along with your claim (detail

claim from provider, explanation of benefits form from insurance

carrier or copy of prescription) to:

Blue Water Administrators FAX#: 843-375-0157

How to file a paper claim

File your paper claims by logging onto the website


Click on the FORMS link and print. Fill out the form and send a copy

of it along with your claim (detail claim from provider, explanation of

benefits form from insurance carrier or copy of prescription) to:

Blue Water Administrators | Attn: Flex

1024 eWall Street, Ste 101 | Mt. Pleasant, SC 29464

FAX: 843.375.0157

[email protected]

Overview

medicare


MEDICArE PArt D CrEDIblE CoVErAgE notICEPrior to November 15, 2007, all employers who offer a medical plan that provides pharmacy coverage are required to send a notice to all plan participants who are eligible for Medicare. Because we do not track which of our employees are eligible for Medicare, we are meeting this obligation by providing this notice to all employees who are eligible for our benefits program. This notice does not apply to you if you or your dependents are not Medicare eligible. If you or a covered dependent are Medicare eligible or will become Medicare eligible in 2010 or 2011, this notice is important to you and contains important, time sensitive information. Please read it carefully and act accordingly to protect your interests.

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Heritage Trust, and prescription drug coverage available for people with Medicare. It also tells you where to find more information to help you make decisions about your prescription drug coverage.

• Medicare prescription drug coverage became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plans that offer prescription drug coverage. All Medicare prescription drug plans provide at least a standard of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

• Heritage Trust has determined that the prescription drug benefit offered through Heritage Trust medical plan is, on average for all plan participants, expected to pay as much as the standard Medicare prescription drug coverage and is considered creditable coverage.

Individuals can enroll in a Medicare prescription drug plan when they first become eligible for Medicare and each year from November 15th through December 31st. However, because you have existing prescription drug coverage that, on average, is as good as Medicare coverage, you can choose to join a Medicare prescription drug plan later. Each year after that, you will have the opportunity to enroll in a Medicare prescription drug plan between November 15th through December 31st. If you do decide to enroll in a Medicare prescription drug plan and want to drop your Heritage Trust prescription drug coverage you will have to drop all of your healthcare coverage with Heritage Trust since prescription drug coverage is a part of your Heritage Trust healthcare plan. Please be aware that you may not be able to get this coverage back should you decide to drop it.

You should compare your current coverage, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Your current coverage pays for other health expenses in addition to prescription drugs. You will be eligible to receive all of your current health and prescription drug benefits even if you choose to enroll in a Medicare prescription drug plan.

You should also know that if you drop or lose your coverage with Heritage Trust and don’t enroll in Medicare prescription drug coverage after your current coverage ends, you may pay more to enroll in Medicare prescription drug coverage later. If you go 63 days or longer without prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage, your monthly premium will go up at least 1% per month for every month that you did not have that coverage. For example, if you go nineteen months without coverage, your premium will always be at least 19% higher than what most other people pay. You’ll have to pay this higher premium as long as you have Medicare coverage. In addition, you may have to wait until the following November to enroll.

For more information about this notice or your current prescription drug coverage, contact our customer service team for further information at 1-800-370-1578. NOTE: You may receive this notice at other times in the future such as before the next period you can enroll in Medicare prescription drug coverage, and if this coverage changes. You also may request a copy at any time.

More detailed information about Medicare plans that offer prescription drug coverage is available in the ’Medicare & You’ handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. You can also get more information about Medicare prescription drug plans from these places:

• Visit www.medicare.gov.

• Call your State Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number) for personalized help.

• Call 1–800–MEDICARE (1–800–633–4227).

TTY users should call 1–877–486–2048

For people with limited income and resources, extra help paying for a Medicare prescription drug plan is available. Information about this extra help is available from the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.ssa.gov, or call them at 1–800–772–1213 (TTY1–800–325–0778).

Remember: Keep this notice. If you enroll in one of the Medicare approved plans offering prescription drug coverage, you may need to provide a copy of this notice when applying for the coverage to show that you are not required to pay a higher premium amount.

lIFETIME lIMIT cHANgE NOTIcEThelifetimelimitonthedollarvalueofbenefitsunderHeritageTrustnolongerapplies.Individualswhosecoverageendedbyreasonofreachingalifetimelimitundertheplanareeligibletoenrollintheplan.FormoreinformationcontactBlueWaterBenefitsat1-800-370-2692.

important notice

CHIP


DEPEnDEnt ChIlDrEn CoVErAgE notICEIndividuals whose coverage ended, or who were denied coverage (or were not eligible for coverage), because the availability of dependent coverage of children ended before attainment of age 26 are eligible to enroll in the Heritage Trust health plan. Individuals may request enrollment for such children during open enrollment. Enrollment will be effective January 1, 2011. For more information contact the Benefits Hotline at 1-800-370-2692.

Your adult children can join or remain on your plan whether or not they are:

• Married; • Living with you; • In school; • Financially dependent on you; • Eligible to enroll in their employer’s plan, with one temporary exception: Until 2014 “grandfathered” group plans do not have to offer dependent coverage up to age 26 if a young adult is eligible for group coverage outside their parents’ plan.

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these

programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

U.S. Department of Labor U.S. Employee Benefits Security Administration www.dol.gov/ebsa 1-866-444-EBSA (3272)

Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Ext. 61565

Medicaid and the Children’s health Insurance Program (ChIP) offer free or low-Cost health Coverage to Children And families

For more information on special enrollment rights, you can contact either:

You should contact your State for further information on eligibilitySOUTH CAROLINA – Medicaid

Website: http://www.scdhhs.govPhone: 1-888-549-0820

important notice

at your service... employee benefits call center

Medical Plan BlueChoice HealthPlan www.bluechoicesc.com Customer Service: 800-868-2528

Dental Plan Principal www.principal.com Customer Service: 800-247-4695

Vision Plan VSP www.vsp.com Customer Service: 800-877-7195

group term life Insurance Principal www.principal.com Customer Service: 800-245-1522

long term Disability Principal www.principal.com Customer Service: 800-245-1522

flexible spending Account Blue Water Administrators https://employeebwa.lh1ondemand.com Customer Service: 800-370-2692

Wellnesswww.UBAWellnessWorks.com

Benefit ContactsWe encourage you to direct all your questions to the Employee Benefits Call Center. For your convenience, we have included a quick reference of your plan’s providers below:

Employee Benefits Call Center

Heritage Trust employees have access to a dedicated employee benefit hotline to answer questions about enrollment, coverage, claims and all other concerns regarding their employee benefit package. Our call center is staffed with trained professionals who understand your benefits plan and are dedicated to providing solutions to your problems. Its easy and its free, just call or email:

1-800-370-2692 (toll-free) Monday - Friday 9am - 5pm EST

email: [email protected]

We are here to help.

2011 heritage employee benefit guide

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