2020

Benefits

Open

Enrollment

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What we will cover today

• 2020 Plan Choices

• Medical Plan Comparison

• Cigna Resources

• HRA – Changes for 2020

• FSA

• Contributing to your HSA

• Dental

• Vision

• Voluntary Benefits

• Employee Benefit Center

• Open enrollment 2020

• “Ask Emma” decision making assistance for

medical plans

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Open Enrollment

November 8-20

Your opportunity to make changes to your benefit elections:

• Enroll or drop plans

• Enroll or drop dependents

• Update beneficiary information

• Elect additional HSA dollars

• Elect pre-tax flexible spending dollars

• Action Require: You MUST re-enroll in HSA/FSA/DCA each year.

• No Action is required if you are leaving all benefits as is; strong

encouraged to log in and check your enrollments.

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Benefits Reminders!

If your spouse is offered affordable coverage through their employer, they may not

enroll in the Simon Pearce medical plan.

FORM 1095-C

• All employees will receive Form 1095-C by January 31, 2020

• 1095-C shows the months you were offered coverage or covered under the

medical plan

• It's important because you may need this information to prepare your 2019

taxes

• Watch for this form in your mailbox

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Connect with Cigna

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myCigna.comMy Health

Dashboard

Health

AssessmentFind an in-

network

doctor

Care

Management

Apps & activities

MY PLANS MY HEALTH

Incentives*Explanation

of benefits

Pharmacy

tools

Cost and

quality tools

*If offered by your employer.

SUPPORTING YOUR HEALTH

SUMMARY OF ENGAGEMENT AND RESOURCES

Cigna Telehealth services

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Call 1.800.285.4812 to order by phone

* Availability may vary by location and plan type and is subject to change. See vendor sites for details.

** The downloading and use of any mobile app is subject to the terms and conditions of the mobile app and the online stores from which it is

downloaded. Standard mobile phone carrier and data usage charges apply.

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

AmWellforCigna.com*

855-667-9722

MDLIVEforCigna.com*

888-726-3171

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Cigna Healthy Rewards

Weight management – Jenny Craig®

Smoking cessation programs

Hearing care

Fitness club memberships

Alternative medicine – acupuncture, chiropractic care, massage therapy

Mind/body – Yoga Journal and SpaFinderTM and much more

Find under the My Health Tab, in Programs and Resources

Discounts on a full range of health

and wellness programs and services*

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

*Healthy Rewards is a discount program. Some Healthy Rewards programs are not available in all states and programs may be

discontinued at any time. A discount program is NOT insurance, and the customer must pay the entire discounted charge.

Ckit page- RES20666

Helping you stay healthy

Why it’s important to fill your

medication in a 90-day supply

Less likely to miss a dose**

More likely to stay healthy**

Fewer visits to the pharmacy to refill

your medication

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You now have more choice!

Cigna 90 Now

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

Under your employer’s plan, you can choose to

fill your maintenance medications in either a 30-

day or 90-day supply

• If you choose to fill a 30-day supply, you

can use any retail pharmacy in the plan’s

new network.

• If you choose to fill your prescription in a

90-day supply, you have to use a 90-day

retail pharmacy in the plan’s new network,

or Cigna Home Delivery PharmacySM.*

*Plans vary, so some plans may not include Cigna Home Delivery Pharmacy. Please check your plan materials for more information on what

pharmacies are covered under your plan.

**Internal Cigna analysis performed March 2016, utilizing 2015 Cigna national book of business average medication adherence (customer

adherent > 80% PDC), 90-day supply vs. those who received a 30-day supply taking antidiabetics, RAS antagonist and statins. Individual results will vary.

Your new 90-day benefit and pharmacy network

MyCigna.com Mobile site and app deliver

health information on the go

All customers can access

myCigna via mobile device

using internet browser

myCigna mobile app available

Features:

• Find a doctor, dentist, pharmacy or facility

• View, print, and email ID card information

• Search and view claims

• Drug search

• View plan coverage and authorizations

• Organize and manage personal health

information with the Health Wallet

9Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2015 Cigna

Get help from Cigna now!

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Medical Plans

• Simon Pearce is offering the choice of three (3) plans:

• Gold Level Plan

• Silver Level Plan

• Bronze Level Plan

• You and your dependent must enroll in the same plan.

Because Simon Pearce is offering you affordable coverage that is better

than minimal essential coverage, you are not eligible for a subsidy for

an Exchange plan if you purchase coverage as an individual.

Getting and staying healthy is

important. Most plans include 100%

coverage for designated preventive

care services received in-network,

such as:*

• Screenings for blood pressure,

cholesterol and diabetes

• Testing for colon cancer

• Clinical breast exams and

mammograms

• Pap tests

Preventive care

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Plan Summaries

Gold Plan w/HRA Funding

Enrolled as

an Individual

Enrolled as a EE

+Spouse,

Child(ren) or

Family

$1,800 Deductible

$3,600 Deductible

Simon Pearce

Funding

$750

Simon Pearce

Funding

$1,500

You pay the

next $1,050

You pay the

next $2,100

After the deductible is met, the employee pays 20% of the cost up to a

$2,500 or $5,000 out of pocket max.

All Rx Copays (30-Day Retail) - $5/20/40

How the Gold Plan/HRA Works

at the Doctor’s

Don’t pay at the time of service!

Track your deductible and HRA balance in you myCigna website or

app.

HRA funds may not be used for prescriptions, dental or vision

expenses.

You receive a bill in

the mail for any

coinsurance owed.

Pay bill with your

Cigna issued HRA

card.

• You will receive an HRA debit card from Cigna to pay for expenses in

2020

• Claims will no longer be automatically paid by Cigna; you will need to

use your debit card to pay claims.

• Prescriptions are still not covered by the HRA.

• Any remaining HRA balances (up to $1,125/$2,250) from 2019 will

rollover on January 1st.

• Claims incurred in 2019 but processed in 2020 may be paid with HRA

funds, depending on availability

Changes to the HRA for 2020

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Silver Plan w/ HSA Funding

Enrolled as an

Individual

Enrolled as a

EE +Spouse,

Child(ren) or

Family

$2,800 Deductible

$5,600 Deductible

Simon Pearce

Funding

$520*

Simon Pearce

Funding

$1,040/$1,560*

You pay the

next $2,280

You pay the next

$4,560/4,040

• After the deductible is met, the employee pays 20% of the cost up to a

$5,000 or $10,000 out of pocket max.

• Preventive Rx: Co-Insurance 40%

• Non-Preventive Rx: Deductible, then Co-Insurance 40%

• An employee can also contribute to their HSA. This is a bank account,

so only funds deposited are available for use.

• *HSA funding is prorated for date of hire, funds are deposited per pay

period

• Office visits (primary care and specialist) - $50 copay

• Emergency Room and Urgent Care - $250 copay

• Prescriptions are a $5/$20/$40 copay at a retail pharmacy

• For all other medical claims, pay 40% of the cost up to a

$7,150/$14,300 out of pocket max.

• This plan pairs well with an employee funded Flexible Spending

Account (FSA) which allows for pre-tax contributions to be used

towards qualified expenses.

Bronze Plan

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Ask Emma will ask you a few questions and:

• Help you understand your anticipated medical usage for 2020

• Ask questions about your appetite for out of pocket expense vs.

premium savings

• Weigh the options and decide which plan best suits your specific

benefit and needs

Ask Emma - Decision Support

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HRA vs. HSA – What’s the Difference?

HRA HSA

Gold Plan Silver Plan

Simon Pearce owns the account YOU own the account

Medical onlyMedical, Dental, Vision (or save

it for retirement)

Only SP contributes

$750 and $1,500

Both you & SP can contribute

$20, $40, $60 per paycheck-SP

IRS Limits: $3,550/$7,100

Cap on funds ($1,875/$3,750) All funds rollover, unlimited

No interest Earns interest

Remains with Simon Pearce

if you leave or change medical

plans

Take it with you if you leave

Simon Pearce

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Flexible Spending Account (FSA)

• Administered by HealthEquity in 2020

• You can elect up to $2,700

• Plan Year: 1/1/2020 – 12/31/2020

• Pre-tax money, contributed through payroll deductions

• Up to $500 can roll into 2021, remainder is forfeited if not used

• Eligible expenses:

o Medical & Rx expenses

o Dental Expenses

o Vision Expenses

o Limited Over the Counter

o No medical if you contribute to your H.S.A. in 2020

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FSA vs. LFSA – What’s the Difference?

FSA(Flexible Spending Account)

LFSA(Limited Purpose Flexible

Spending Account)

Medical, Dental, Vision

expensesDental & Vision only expenses

Cannot be used with an HSA Can be used with an HSA

• You need to keep receipts to substantiate your claims

• Match the receipt with your Explanation of Benefits

• You will be asked to show proof that your claim was for a

qualified expense

• You must re-elect this benefit each year - this will NOT

roll-over

Using your FSA

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Dependent Care Account (DCA)

If you have kids under 13:

• Pre-tax money, contributed through payroll deductions

• Pay as you go, can only spend what you have contributed

• “Use it or Lose it”

• Eligible Expenses : Custodial care of dependents while

employee is at work

• Maximum $5,000 annual contribution

• You must re-elect this benefit each year - this will NOT roll-over

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Dental Plan

Plan Coverage Level

Preventive 100%

Cleanings 2

Deductible $25/$75

Basic 80%

Major 50%

Annual max $1,500

Ortho (children) 50%

Ortho Max $1,000

Carryover Yes

• Delta Dental National Network

• Carryover Benefit of $250 per

member

• Maximum of $3,000

• Health through Oral Wellness

(HOW) Program

• Remember, your ID card will

only have the employee’s name

on it

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Vision Insurance

• Employees do not need to be enrolled in the medical plan to enroll in

the Vision coverage in 2020

• Plan includes additional discounts for other eye services and for costs

above the frame allowance

• Low rates, great benefit!

Eye Exam Every Calendar Year

Lenses Every Calendar Year

Frames Every Other Year

Allowance $130

Co-pays for

exams/materials

$10/$25

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100% Company Paid Benefits

• Life Insurance and Accidental Death through Reliance

Standard

o 1x Base + Incentive W2 earnings up to $50,000

o 2x for an accident

• Long Term Disability Insurance through Reliance Standard

o 60% of Base + Incentive W2 earnings up to $5,000

per month

• Employee Assistance Program (EAP) through ACI

o 3 visits for work or non-work issues

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Travel Assistance – 100% Company Paid

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ID Theft – 100% Company Paid

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Employee Voluntary BenefitsLife Insurance enrollment and changes require the approval of an

Evidence of Insurability

Voluntary Life & AD&D Insurance (100% employee funded; age rated premiums)

• Can purchase up to $500,000 of coverage, not to exceed 5x employee earnings, with

evidence of insurability

Dependent Life Insurance (100% employee funded; age rated premiums)

• Can purchase up to $250,000 of coverage, not to exceed 100% of employee’s

coverage, with evidence of insurability

Pre-Ex Clause, no EOI Needed

Short Term Disability Insurance (100% employee funded; age rated premiums)

• Ability to purchase 60% of your weekly earnings, up to $750 per week

• Benefits begin on the 1st day of an accident or injury and the 8th day of a sickness

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Employee Voluntary Benefits

No EOI needed

Critical Illness (100% employee funded; age rated premiums)

• A way to cover deductible or other out of pocket expenses when receiving a major

diagnosis

• Provides a lump sum benefit upon diagnosis of a critical illness such as heart attack,

stroke, cancer, and organ failure

• Purchase, in $5,000 increments, coverage up to $50,000; guarantee issue amount is

$15,000

• Ability to purchase coverage for dependents

• Paid on a post tax basis, so any benefit received is tax-free

• Wellness benefit of $75

Accident Insurance (100% employee funded)

• Pays out a dollar amount based type of injury from an accident and care received

• Another way to cover deductible or out of pocket expenses

• Benefit is paid out tax free

Wellness Benefit

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For employees enrolled on the Accident Insurance

and/or Critical Illness:

Get a preventative screening, file a claim, and

receive a check for $75 from Reliance Standard!

bSwift Open Enrollment

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• Log in to review and make changes to your 2020 benefits

• You must re-elect Flexible Spending and Dependent Care every year.

• Action is necessary for HSA/FSA/DCA enrollment. You must reenroll

in these benefits annually.

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Simon Pearce Employee Benefit Center

• Website contains all the details of your full, comprehensive benefits package and

other great tools and resources

• New URL for the Employee Benefit Center – see your benefit booklet for details

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Questions?