PowerPoint Presentation2021
Inside This Guide
Your needs, and those of your family, are unique to you.
That’s why LIFE Senior Services provides a
comprehensive and flexible benefits program that you
can customize to fit your personal situation. Our program
offers you and your family important healthcare coverage
and financial security.
Some of the benefits we offer are paid for in full by LIFE
Senior Services. For others, it is a shared contribution
between you and the company. Other benefits are also
available to you at reasonable group rates.
Your benefits are an important part of your total
compensation at LIFE Senior Services. Please take the
time to review and evaluate all the options available to
you and your family.
This guide is not intended to be a complete description of the insurance coverage offered, nor is it a binding contract. Controlling provisions are provided in each benefit plan policy. Should there be a difference between this guide and the official plan documents, the official plan documents will govern.
More information about specific terms and conditions of each plan is included in the Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC).
Welcome to your LIFE Senior Services, January 2021 Benefits!Welcome 2
Benefits Overview 3
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Optional Protection Benefits • Accident & Critical Illness
21-23
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Benefits Overview LIFE Senior Services is proud to offer a comprehensive
benefits package to eligible, full-time employees who work
30 hours per week and have 30 days of service. The
complete benefits package is briefly summarized in this
booklet.
You share the costs of some benefits, and LIFE Senior
Services provides other benefits with reasonable group
rates that you can elect through payroll deductions.
Company Paid Benefits
• Short-term Disability – The Standard / (ER pays 70% of
monthly premium)
• Employee Assistance Program – The Standard
Benefit Options Requiring Employee Contributions
• Medical (Plan Options) – CommunityCare
• HMO CC 2000/80 CR17 = Premier
• HMO CC 3500/80 CR17 = Value
Plans include prescription drug coverage
• Dental –The Standard (Ameritas Network)
• Vision –The Standard (VSP Choice Network)
• Voluntary Life and AD&D – The Standard
• Short-term Disability – The Standard / (EE pays 30%
of monthly premium)
• Healthcare FSA
Transamerica Life Insurance Company
• Accident Insurance – The Standard
• Critical Illness – The Standard
Services benefits.
26, disabled dependents of any age, or LIFE Senior
Services eligible dependents.
enrollment unless you or your family members
experience a qualifying event. If you experience a
qualifying event, you must contact HR within 30 days.
If you work 30 or more hours per week, you are considered
Full-time and you are eligible to enroll in ALL benefits.
If you work 20 or more hours per week, you are considered
Part-time and you are eligible to enroll in the following
benefits:
• Accident Insurance
• Critical Illness
dependent care accounts.
(Advocacy Service / Benefits App / Telemedicine
Services / Behavioral Health Support / RX Cost Saver).
This is regardless of your medical election (either
through LIFE Senior Services or another Medical Plan).
Your eligible dependents may also be enrolled with
you at no additional cost. Registration will be required
for you and your dependents when the App is rolled
out.
You can enroll for benefits:
• On the first of the month following 30 days of
employment
• During the plan year, if you experience a Qualifying
Life Event
When Does Coverage Begin? Benefits for new hires, unless explained otherwise, will
become effective on the first of the month following
30 days.
Open Enrollment
opportunity to review your benefit plan
elections and make adjustments that meets
the needs for you and your family.
Changes made during Open Enrollment will go
into effect January 1, 2021.
If you do not make any changes to your
Medical, Dental, Vision, Vol Life & AD&D,
STD, LTD, Universal Life, Accident, Critical
Illness, Legal, and Identity Protection
benefits, your current 2020 elections will roll
forward to 2021 and all new deductions will be
effective January 1, 20201.
Flexible Spending Accounts (FSA-Healthcare
attention!
2021 as these elections will not roll forward
into the new plan year!
LIFE Senior Services
2021 Benefits Guide
You must actively enroll in the following coverages. All other
coverages will roll over into the next year if you don’t make any
changes.
Dependent Care)
You will be automatically enrolled in all Company paid benefits.
***To enroll (or make changes) to your 2021 benefits, please login into Paycor at: https://hcm.paycor.com/authentication/signin
Termination of Coverage
If you or a covered dependent no longer meet the eligibility
requirements or if your employment ceases, your medical,
dental, vision, and Health Care FSA coverage will end on the
last day of the month in which you become ineligible.
You may be eligible to elect COBRA for yourself and your
eligible dependents for medical, dental, and vision coverage.
Life and AD&D coverage will end on the day you become
ineligible. Your life coverages are convertible.
You are responsible for informing Human Resources within 30
days if any of your dependents become ineligible for benefits.
Making Benefit Changes During the Plan Year
The benefit elections you make during your
initial enrollment period will be in effect through
December 31, 2021.
the change and provide supporting
documentation to Human Resources within 30
days of the event. Proof of life events are subject
to approval by LIFE Senior Services. Changes are
effective retroactive to the date of the event.
Qualifying life events include:
• Birth, adoption or placement for adoption of
an eligible child
• Death of your spouse, or covered child
• Change in you or your spouse’s work status that affects benefits eligibility (for example, starting a new job, leaving a job, changing from part-time to full-time, starting or returning from an unpaid leave of absence, etc.)
• Your spouse’s Open Enrollment
• A change in your child’s eligibility for benefits
• Gain or loss of Medicare or Medicaid during
the year
Other qualifying events may also apply. Please contact Human Resources.
Please Note:
following information during enrollment:
• Social Security numbers for your dependents covered by the medical plan
• Dates of birth and your relationship to your dependents
through CommunityCare with the following features:
• Option to receive care from in-network providers.
• There are NO out Out-of-the-Network benefits paid on HMO plans, except incase of an Emergency
• Preventive care is covered at 100% when using an in-
network provider. Please schedule a “Well Check”
appointment with your Primary Care Provider.
• Includes prescription drug coverage.
a plan year which runs January 1st – December 31st.
• For a comparison of the plans, please refer to the Medical
Plans Comparison Chart on the following page. Specific
benefit levels and limitations can be found in the plan
summaries and Summary of Benefits and Coverage (SBC).
• Always refer to your plan booklet for specific benefit
levels and limitations.
Finding In-Network Providers
To search for in-network medical providers, log onto ccok.com
When prompted to select a plan, click on HMO, then choose the Select Network
Access to Your Healthcare
After you are enrolled in a LIFE Senior Services medical plan, you can login to ccok.com website and register to access self-service tools and resources to help manage your medical benefits.
LIFE Senior Services
2021 Benefits Guide
Insure Oklahoma HMO CC 2000/80 CR17 = Premier
HMO CC 3500/80 CR17 = Value
In-Network Only You Pay You Pay You Pay
Plan Year Deductible (Individual / Family)
$2,000 Ind / $4,000 Fam $2,000 Ind / $4,000 Fam $3,500 Ind / $7,000 Fam
Coinsurance 0% 20% 20%
Plan Year Out-of-Pocket Max1 (Individual /
Family) $3,000 Ind / $6,000 Fam $5,500 Ind / $11,000 Fam $6,000 Ind / $12,000 Fam
Preventive Care 100% 100% 100%
Primary Care Office Visit $35 $25 $20
Specialty Care Office Visit $45 $50 $50
Urgent Care Facility $50 $50 $50
Emergency Room Care $150 (waived if admitted) +
Ded * Ded + 20% * Ded + 20% *
Inpatient Hospital $250 per day
(Max $1,000) + Ded * Ded + 20% * Ded + 20% *
Outpatient Surgery $200 + Ded * Ded + 20% * Ded + 20%*
Routine Radiology / Lab Included in Office Visit 20% 20%
Advanced Radiology (MRI, MRA, CAT, PET Scan)
$200 + Ded * Ded + 20% * $750 / visit
Limitations and maximums may apply. Please refer to the plan summaries and Summary of Benefits and Coverage for more information.
1 Plan Year Out-of-Pocket Maximum includes deductibles, copays and coinsurance
Due to COVID, virtual office visits may be covered
* After Deductible
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Prescription Drugs When you enroll in a medical plan, you receive comprehensive prescription drug coverage through CommunityCare.
Some medications may be subject to prior authorization, quantity limits or step therapy requirements to be approved for
coverage. For a list of approved drugs, log on to ccok.com/pharmacy.
CommunityCare HMO IDEA Plus 5 Lg
Insure Oklahoma HMO CC 2000/80 CR17 = Premier
HMO CC 3500/80 CR17 - Value
Retail (up to 30-day supply) You Pay You Pay You Pay
Preferred Generic $15 copay $15 copay $15 copay
Non-Preferred Generic $70 copay $70 copay $70 copay
Preferred Brand $40 copay $40 copay $40 copay
Non-Preferred Brand $70 copay $70 copay $70 copay
Preferred Specialty $160 copay $160 copay $160 copay
Mail Order (up to 90-day supply) You Pay You Pay You Pay
Tier 1 / Tier 2 / Tier 3 / Tier 4 2x Copay above 2x Copay above 2x Copay above
If a Generic medication is available and you elect to purchase the Brand name medication, you will be responsible to pay the difference in the cost between the Generic and Brand name drugs.
CVS Retail Pharmacy (up to 30-day supply)
Mail Order (up to 90-day supply)
Two Ways to Obtain Prescription Drugs
www.ccok.com
View a list of approved drugs
https://www.ccok.com/pharmacy/mail-order.asp
Use for maintenance drugs such as medication for high blood pressure, arthritis or diabetes
Pay less than retail pharmacy for a 90-day supply
No additional cost for delivery
Emergency Care vs. Urgent Care
When you need help in a hurry, you have choices. Of
course, when it’s a life-threatening problem, you should
call 911 or go straight to the nearest hospital emergency
room (ER).
In the ER, true emergencies are treated first, so unless your
life is in danger, you’ll wait – sometimes for hours. The ER
is also the most expensive option for care.
For non-life-threatening problems, call your doctor, call
Telemedicine or go to an urgent care center.
Go to Urgent Care
• Sprains or strains
• Shortness of breath
• Severe abdominal pain
• Loss of consciousness
• One-sided weakness or numbness
Telemedicine - (Goes live 1/1/21)
24/7/365 days access to board-certified doctors online and
on the phone. For an illness or injury that is not an
emergency, LIFE Senior Services Telemedicine Services are
perfect for on-the-go families, providing a reduction in ER
and Urgent Care costs and a more efficient use of the
healthcare system. Now, a doctor is always just a phone
call away.
healthcare when reaching the doctor is difficult or
inconvenient.
and write short-term prescriptions for minor, non-life-
threatening conditions including, but not limited to:
Covered members may connect with a physician via
telephone or video for medical consultations whenever
they need care.
household members.
• Less interference with child or elder care responsibilities
• No exposure to other potentially contagious patients
• Sinus Infections
• Pink Eye
• Poison Ivy
• Upper Respiratory
Infections
How to Use Telemedicine - (Goes live 1/1/21) 1. Download The Benefits App, through the Google Play or App Store (benefitsapp) or call 866-618-8243.
2. Register and complete your account profile, including a brief medical history, for you and your enrolled family members.
3. Video chat or talk with a doctor from home, work or when traveling.
Rx Cost Saver (Prescription Savings Program)
Our Rx Cost Saver International Prescription Program provides an alternative to the conventional delivery of health plan
prescription benefits that can significantly reduce the impact of escalating drug prices, saving self-insured plan
providers thousands of dollars in the process on brand name maintenance drugs.
Stay tuned as we continue to release more information over the next several weeks regarding your Telemedicine service beginning January 1, 2021.
LIFE Senior Services
2021 Benefits Guide
11
Flexible Spending Accounts (FSA) Flexible Spending Accounts (FSA) allow you to set money
aside for certain eligible expenses (medical, dental and
vision care expenses that aren’t covered by insurance ---
what you pay out of your own pocket) and draw from it
throughout the year to pay for those expenses. The money
is set aside pre-tax, reducing your taxable income.
• Save up to 30% on things like glasses, braces and other
necessities
• Access the full amount of your annual elections on day
one of your plan year
Two types of FSAs are available:
• Health Care & Dependent Care
Money cannot be transferred between the accounts (i.e.,
you cannot use money from your Health Care FSA to pay
for dependent care expenses and vice versa).
Health Care FSA
This FSA allows you to submit eligible medical, dental and
vision expenses for reimbursement. You can deposit up to
$2,750 to the Health Care FSA for the 2021 calendar year.
Health Care FSA Roll Over
If you enroll in a Health Care FSA, you have the option to
carry forward up to $500 to the following plan year. These
funds will not count against your future FSA election plan
contribution limit. Any unused balances in excess of $500
at the end of 2020 will be forfeited.
How the FSA Works
As a new hire (and again during Open Enrollment), you
select the amount of money you wish to deposit into the
Health Care and/or the Dependent Care Account for the
entire plan year. The plan year for the FSA benefit is
January 1 to December 31. The total amount is then
equally divided by the number of pay periods remaining
in that year and that amount is deducted from each
paycheck. The money is set aside in your FSA account(s).
Employees who enroll in the Health Care FSA will receive
an FSA debit card to pay for qualified purchases,
eliminating the need to submit a paper claim and wait
for reimbursement.
account(s), go:
Receipts® mobile app by WageWorks to access your
account from anywhere.
It’s up to you. Simply decide how much to contribute to
your Healthcare FSA, and funds are withdrawn from your
paycheck before taxes. So you’re not paying taxes on
your full income.
Dependent Care FSA
Dependent Care FSAs are used to pay for the costs of
dependent care that enable you to work. This care may be
for a child under age 13 and for older dependents, including
children, spouses and parents who are physically or
mentally unable to care for themselves and who live with
you for more than half the year. Eligible expenses include
daycare, before-school and after-school care, babysitters
and elder daycare. For the 2021calendar year, you can
deposit up to $5,000 to a Dependent Care FSA ($2,500 if
you are married and filing separately).
Note: You can spend your pre-tax medical and /or
dependent care dollars through March 15th of each year.
Receipts for your medical and/or dependent care receipts
should be submitted for reimbursement no later than
April 1st of each year.
COVID-19 – Over the Counter Medications
Due to the Coronavirus Aid, Relief and Economic
Security (CARES) Act, you can use your FSA funds to buy
over-the-counter medications without a prescription, (i.e.
pain relievers, cold and flu medications, antacids, acne
remedies, allergy medications, and more. Menstrual
products such as tampons, pads, liners, cups, sponges, and
more. You can find a more complete listing by visiting
https://www.cvs.com/shop/content/FSA
Virtual Health – (Goes live 1/1/21) The Benefit Plan Strategies Healthcare Advocacy is a
personalize service that helps you navigate the
complexities of the healthcare system.
Dedicated Subject Matter Experts will provide
professional support to you through awareness and
effective engagement tools, and support
improvement with demonstrated, measurable results
via concierge-level services.
understanding Rx benefits, and clarification of
covered services.
opinions and access to transparency tools for
treatment costs and quality ratings.
3. Improvement: Concierge Level Solutions
Using an advocate service helps to shift the tasks
associated with member questions and plan
support.
Reviews, Appeals, Fee Negotiation and unique Rx
Cost Saver programs.
• Finding In-Network Providers, Treatments & Facilities
• Get Second opinions & alternative Care Options
• Schedule Appointments & Transfer Medical Records
• Compare Cost & Quality
• Claims Explanation & Support
• Rx Medication Review
• Cost Savings options
• Case Management Support
• Clarify Covered Services
Mobile App
The Power of Advocacy in the Palm of Your Hand (Goes live 1/1/21)
This tool includes the Benefit Plan Strategies Advocacy Call Line for direct access to one of our Subject Mater Experts,
a place to store individual health plan information, a Telemedicine button to contact a doctor, and savings information
on health procedures, Rx and more!
The Mobile App offers a one-stop solution for employee benefits needs.
• Link to a Concierge Advocate or Telemed provides a
$0 copay and unlimited visits
• Instant alerts to use $0 copay produce when you
walk into an ER, Urgent Care Center or Doctor’s
office!
information in one place.
the doctor.
pharmacies tool
emergency services and much much more!
This concierge-level -- Advocacy service mobile APP will serve as a hub with links to your individual plan information, health plan portals, lab values, Physician contacts, pricing options, Rx information, and much more!!
Behavioral Health Support Behavioral Health Support provides confidential, unlimited telephonic consultation, counseling and referral services for members in their personal times of need.
Stay tuned as we continue to release more information over the next several weeks regarding your Virtual Health services including: Healthcare Advocacy, Telemedicine, Mental Health, Rx Cost Saver. Steps how to Download the Benefits App and more before January 1, 2021.
LIFE Senior Services
2021 Benefits Guide
How To Save $$$! When Using Your Medical and Prescription Plans:
Use In-Network Doctors
pharmacies, you pay the lowest cost for care. On the
HMO plans, unless it is an emergency, expenses are
not covered.
When you need care, know your options. Urgent care
centers, online doctor visits or a call to the medical
plan nurse line can help save time and money.
Use in-network, freestanding imaging centers for
MRIs, CT Scans and other imaging.
Use Your Preventive Care Benefits
Most preventive care services are covered at 100%
when you use in-network providers. Getting regular
exams, screenings and immunizations can save you a
lot of money in the long run by catching problems
early or preventing them altogether.
Use CCOK Rx program
save time by having the medication delivered to your
home.
Through CCOK Rx program, you can also save money
by getting up to a 90-day supply for less than what
you would pay through a retail pharmacy. And
because shipping is free, you’ll also save on gas
money!
Ask Your Doctor for Generic Drugs
The next time you need a prescription, ask your doctor if it
is appropriate to use a generic drug rather than a brand
name drug. Generic drugs contain the same active
ingredients, are identical in dose, form and administrative
method AND are less expensive than their brand name
counterparts.
If you must take a brand name drug, ask your doctor for
samples or coupons. Also check the drug manufacturer’s
website for available rebates and discounts.
Search Good Rx for Cheaper Rx Prices
Drug prices sometimes vary significantly between
pharmacies. GoodRx collects and compares prices for
every FDA approved prescription drug at more than 70,000
pharmacies.
price pharmacy near you and/or print FREE coupons. You
can also get coupons on-the-go through Good Rx’s mobile
app – just show your phone to the pharmacist. https://www.ccok.com/pharmacy/mail-order.asp
Use for maintenance drugs such as medication for high blood pressure, arthritis or diabetes
Pay less than retail pharmacy for a 90-day supply
No additional cost for delivery
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Dental Good oral care enhances overall physical health, appearance and mental well-being. Problems with the teeth and gums are
common and easily treated health problems. Keep your teeth healthy and your smile bright with the LIFE Senior Services
dental benefit plan.
LIFE Senior Services offers one (1) dental plan through The Standard using (Ameritas PPO Network). Your choice of
dentists can determine the cost savings you receive. In-network providers are paid directly by The Standard and agree to
accept negotiated fees as “payment in full” for services rendered when you use The Standard providers. To search for in-
network providers, go to https://www.standard.com/dental / Find a Dentist / Continue to Ameritas.
Note: When utilizing your Dental benefits, please inform your Dentist your Dental plan is through The Standard and the
“Ameritas PPO Network”.
Up to $1,000
Calendar Year Deductible * (applies to Basic and Major Services only)
$100 Individual / $300 Family
Orthodontia (to age 19) 50% to $1,000 lifetime maximum
Reimbursement Type Negotiated Fees 90th percentile
Usual and Customary (U&C)
Important Information!
If you do not enroll in dental benefits when you are first
eligible, become a late entrant and waiting periods may
apply.
Treatment by an out of network dentist may result in
balance billing.
* Plan deductibles and maximums accumulate on a calendar year (January 1 – December 31). These amounts reset on January 1 of each year.
vision and can also provide early warning of other health
conditions. The Standard (with the VSP Choice Network)
vision plan provides coverage for exams, glasses and
contact lenses, as shown below.
In-network coverage is provided when you use VSP Choice
providers. To search for providers, log onto
https://www.standard.com/services / Product and
• Employees pay the full cost of vision coverage.
• No ID card will be provided. To take advantage of
your The Standard / VSP vision benefit, simply
contact a VSP provider and let them know you have
VSP coverage---they handle the paperwork for you.
You may contact the VSP call center at 800-877-7195
The Standard/VSP Choice Network Frequency In-Network Out-of-Network
You Pay Plan Allowance / Reimbursement
Eye Exam Once every 12
months $10 copay Reimbursed up to $45
Frame Once every 24
Lenses
Progressive Lenses (Standard)
$25 Copay – Covered up to the Lined Bifocal Allowance
Reimbursed up to $30 Reimbursed up to $50 Reimbursed up to $65 Reimbursed up to $100
Contacts—instead of Eyeglass Lenses and Frame Benefit
Medical Necessary Elective Disposable
Once every 12 months
100% after $25 Copay Up to $130 Up to $130
Reimbursed up to $210 Reimbursed up to $105 Reimbursed up to $105
As a new hire, you can purchase Voluntary Life insurance
for you, your legal spouse and dependent children without
providing medical information up to certain guarantee
issue (GI) amounts (see chart). If you leave LIFE Senior
Services, this coverage can be taken with you.
Employee and spouse amounts applied for over the GI as a
new hire will require you to provide Evidence of Insurability
(EOI) for review and approval by The Standard.
Benefit amounts reduce at age 65. Please refer to the
benefit summary for details.
If you elect not to enroll within 30 days of your date of hire,
you may elect in certain increments without EOI (see chart).
Any amounts over the guarantee issue are subject to the
EOI requirements provision. If your evidence of insurability
is not satisfactory with The Standard, you will not have
Voluntary Life coverage.
Voluntary AD&D
benefits (see chart) . Employees pay the full cost of
Voluntary Life and Voluntary AD&D insurance on an after-
tax basis.
Basic Life/AD&D
Having appropriate life insurance coverage is a critical part of planning for your family’s current and future financial
needs. Proceeds from life insurance can help with salary replacement, mortgage protection, cost of childcare, debt
repayment and children’s education expenses.
LIFE Senior Services provides Basic Life insurance coverage and Accidental Death and Dismemberment (AD&D) that also
pays in the event of an accidental death and certain other conditions. Basic Life and AD&D insurance is administered by
The Standard and is paid for by LIFE Senior Services. You are automatically enrolled in these benefits.
Voluntary Life/AD&D Amounts Available
Employee
New Hire: Increments of 10,000-$500,000 (Max) Guarantee Issue*: 150,000
Open Enrollment: One (1) or two (2) increments of $10,000 without EOI up to the Guarantee Issue*: $150,000
Spouse
New Hire: Increments of $5,000-$250,000 (Max) Guarantee Issue*: $25,000
Open Enrollment: One (1) or two (2) increments of $5,000 without EOI up to the Guarantee Issue*: $25,000
Child (to age 26)
New Hire: Increments of $2,000-$10,000 (Max) Guarantee Issue*: $10,000
Open Enrollment: Increments of $2,000 without EOI up to the Guarantee Issue*: $10,000
To enroll in Voluntary Spouse and/or Child Life, you must be enrolled in Voluntary Employee Life.
*Guarantee issue is the amount of coverage you or your dependents can elect up to without medical questions. Any additional amount over the Guaranteed Issue will require an Evidence of Insurability.
Class 1 – Directors and above Class 2 – All Others
• Basic Life Coverage: $100,000
• AD&D Coverage: $100,000
• Basic Life Coverage: $50,000
• AD&D Coverage: $50,000
Age Reduction – Basic Life and AD&D insurance coverage amount reduces to 65% at age 70 and to 50% at age 75.
(According to federal law, only the first $50,000 of employer-paid life insurance is not taxable. Premium paid by LIFE Senior Services for coverage levels over $50,000 will be taxable to you and will be included on your year-end W-2 statement.)
LIFE Senior Services
2021 Benefits Guide
Short-term Disability (STD) Insurance
STD benefits become payable when you are unable to work due to an injury or illness unrelated to work. If you remain
disabled and meet the plan’s disability requirements, you will continue to receive a percentage of your weekly earnings
until the benefit duration has ended.
STD benefits integrate with state mandated disability plans.
Long-term Disability (LTD) Insurance
LTD insurance offers a monthly benefit to help replace lost
income if you experience a disability lasting longer than 180
days. Proof of disability is required.
If you were to be out of work due to an injury or illness, could you and your family survive without a paycheck?
Disability insurance is essentially “paycheck” insurance, ensuring you will receive a portion of your income if you
were out of work due to injury or illness. Short-term Disability (STD) provides a weekly benefit, while Long-term
Disability (LTD) pays a monthly benefit after STD insurance has been exhausted.
LIFE Senior Services offers STD and is paying for a portion of the premium as outlined below. Your employer also
offers LTD insurance at no cost to you. Administered by The Standard, you are automatically enrolled in the LTD
benefits.
for illness
Benefit Amount
$2,500 per week
LTD claims for newly covered employees will be denied if
you received medical treatment, medical advice, care or
services or took prescribed drugs or medicines in the last
3 months prior to the effective date of this coverage and
the disability began in the first 12 months after your
effective date of coverage.
Monthly Benefit
monthly predisability earnings,
$1,000 x 0.60 x $0.41 ÷ 10 = $24.60 $11.35 Enter weekly
earnings
per paycheck premium,
multiply the monthly
26.
In addition to being able to use your accrued Sick Time
during the 7-day waiting period, you now will be able to
use your accrued Sick Time to supplement the 60%
Short-term Disability benefit not to exceed 100% of your
normal earnings.
The example below shows you how much you would pay per paycheck for premiums if your weekly income was
$1,000. Use the formula to calculate your own premiums.
Late Enrollment Penalty - The late enrollment penalty applies if you do not apply for this coverage within 31 days of becoming eligible. If you do not apply
within 31 days of becoming eligible, your benefit waiting period for any qualifying disability caused by disease, pregnancy or mental disorder occurring during the
first 12 months of coverage will be 60 days.
LIFE Senior Services
2021 Benefits Guide
Universal Life Insurance with Long Term Care benefits Administered by Transamerica Life Insurance Company
As the events in your life change, so do your needs for life insurance. A universal life policy has the flexibility to adjust to
your needs. You decide what level of insurance is right for you and your family's needs. This policy will have the ability to
build cash value with a guaranteed tax-deferred interest rate of 3%. This policy is fully portable/convertible, allowing you
to keep this policy after retirement or taking another job, as long as you pay the premium.
Enjoy a hassle-free application and claims process Apply by answering a few simple questions. No physicals or blood work required. Our easy to-navigate website allows
you to update your information, keep track of your policies, apply for loans, submit claims and more from your PC or
mobile device.
Use your benefits when you need them most Life is unpredictable. Universal life offers help that goes
beyond traditional life insurance to meet challenging
situations. If you need to borrow against the cash value, you
can pay it back when times get better.
If you’re diagnosed with a terminal illness, you can use a
portion of the policy’s death benefit to make a difficult time
easier. If you’re laid off, monthly deductions are waived for up
to six months so you maintain your policy.
Take our portable, flexible policy with you We let you keep your insurance when changing jobs and adjust premiums, death benefit and cash value amounts to
meet changing personal financial situations like getting married, having a child, buying a house, seeing your child
through graduation or retiring.
Eligibility You can insure your eligible spouse, children and grandchildren with their own policies or purchase protection for your
children through a child level term life insurance rider. The chart below gives the ages at which you and family
members may apply, but all universal life policies can be maintained up to age 100.
SELF Ages 16 through 80 $10,000 - $500,000 benefit, not to exceed 5x base salary
SPOUSE OR EQUIVALENT BY LAW Ages 16 through 65 $10,000 - $100,000 benefit
CHILDREN/GRANDCHILDREN Ages 0 through 25 years $25,000 benefit
CHILDREN UNDER OPTIONAL CHILD TERM RIDER
Ages 15 days through 25 years $10,000 - $20,000 benefit
For any new hires that are newly eligible you may purchase up to $100,000 for yourself, $15,000 for your spouse and $10,000 / $20,000 or $25,000 for your child(ren) without answering any medical questions. During Annual Open Enrollment, an EOI (medical questions ) will be required and you will have to be approved for this coverage.
HOW IT WORKS
• No physicals or blood work • Accumulates Cash Value • Guaranteed 3% interest rate • Loan and withdrawal options • Convenient Payroll Deductions
LIFE Senior Services
2021 Benefits Guide
Universal Life Insurance with Long Term Care Benefits Administered by Transamerica Life Insurance Company
Details
Living Benefit Rider
• Provides an accelerated death benefit for chronic conditions if someone needs assistance with at least 2 out of the 6 Activities of Daily Living (ADLs).
• Guaranteed issue of up to $100,000 with the LBR available based on group size and demographics.
• After a 90-day waiting period, provides a 4%/month benefit (4% of the policy value) up to 25 months.
• The LBR does not require the insured to be institutionalized for a benefit to be paid. Care could be at home, in assisted living, at a nursing home, or hospital.
• No long-term care licensed caregiver requirement. Benefit can be paid to a family member or facility for care.
• No long-term care licensing requirement for the agent to offer our LBR and extension of LBR.
• The 4% benefit is an indemnity cash benefit regardless of the cost of care.
Extension of Benefits Rider*
• Pays an additional 4% monthly benefit (4% of the policy value) for up to an additional 25 months (starting in month 26). With the LBR and extension, the insured can receive up to 50 months of payouts.
• As soon as the first monthly benefit is paid under the Extension of Benefits Rider, we will also issue a paid-up certificate for 25% of the death benefit that was in force on the date the first Living Benefit Rider payment was made on the policy. This paid-up insurance will have no cash or loan values. We will not provide this paid-up life insurance benefit if you elect to receive a one-time lump sum benefit under the Accelerated Death Benefit for Chronic Condition Rider.
• The insured has potential access to up to 225% of the life insurance face amount with the LBR, extension, and 25% restoration of the policy value.
LIFE Senior Services
2021 Benefits Guide
LIFE Senior Services offers additional voluntary benefit plans through The Standard. These plans are not medical
insurance and do not replace your medical coverage, but rather pay cash directly to you in addition to any benefits you
receive from your health plan.
Insurance policies available for purchase (through after-tax payroll deductions) include Accident Insurance and Critical
Illness. These benefits may help fill the gap until you meet your medical plan deductible.
The Standard benefit plans are portable, which means you can take these benefits with you if you leave the company.
Accident Insurance - (Administered by The Standard)
Accident insurance pays a cash benefit when you or your covered
family members suffer injuries sustained in an accident. Covered injuries
include fractures, burns, concussions, tears, lacerations, broken teeth
and eye injuries. Additional benefits may be paid, including ambulance,
emergency care, testing and therapy.
These are actual benefits you could receive in the event of a covered accident. Benefits are paid once per covered accident unless otherwise noted:
LIFE Senior Services
2021 Benefits Guide
Optional Protection Benefits - (Continued)
These are actual benefits you could receive in the event of a covered accident. Benefits are paid once per covered accident unless otherwise noted:
LIFE Senior Services
2021 Benefits Guide
Critical Illness Insurance – (Administered by The Standard)
This insurance pays a lump-sum cash benefit directly to the insured
following the diagnosis of a covered critical illness or event, including (but
not limited to) Alzheimer’s disease, invasive cancer, heart attack, kidney
failure, stroke and major organ transplants. Elect coverage in the amount
of your choosing: $10,000 or $20,000.
Here’s how it works: John has $10,000 of Critical Illness insurance coverage. He makes an
appointment with his doctor after feeling off for the past few weeks.
Diagnosis: cancer, with a good prognosis but a long road ahead. Within
days of making a claim, John receives his Critical Illness insurance benefit
paid directly to him. As John undergoes intensive treatment over the next
few months, he can use the benefit for any purpose, including to pay for
things that his medical insurance does not cover. Things like the deductible,
copays, childcare, certain medications, time away from work, alternative
treatments and a special diet.
Chances are good that a family member, friend or
colleague of yours has endured a critical illness, You
may have even seen that person struggle to pay the
bills. Think of Critical Illness insurance as financial
peace of mind, so you don't have to choose between
paying the medical bills or your car payment.
LIFE Senior Services
2021 Benefits Guide
With Critical Illness insurance you can:
• Update your coverage as needed. As your life circumstances change, increase or decrease your coverage
• Take it with you. If you leave your job, you can take your coverage with you.
• Pick and choose how to spend your benefit. Spend your lump-sum benefit however you want.
• Protect your loved ones. Cover your spouse up to $10,000, as long as it’s not more than your benefit amount.
Your kids are automatically covered at 25% of the amount elected for yourself for the same critical illnesses that
you are. Kids are also covered for 21 additional childhood diseases, including cystic fibrosis, down syndrome,
muscular dystrophy, spina bifida, and cerebral palsy.
• Receive a benefit for taking care of your health. You and your covered loved ones receive a health maintenance
screening benefit of $50 once per calendar year when visiting the doctor for a covered wellness exam.
• Receive additional benefits. If you are diagnosed with a covered illness again after a treatment-free period of 12
months, you will receive 100% of the original benefit amount. If you are diagnosed with a different and
subsequent covered illness at least 90 days after the diagnoses of the first critical illness, you will receive and
additional critical illness insurance benefit.
• Annual health screening benefit $50 per insured per calendar year.
Coverage for: Coverage Amount:
Your Spouse
Flat amount of $5,000 or $10,000, not to exceed 50% of the employee election
Your child(ren) through age 25 Automatically covered at 25% of employee coverage amount
LIFE Senior Services
2021 Benefits Guide
We understand how challenging it can be to balance your
work and personal life, and we are committed to helping you
do just that.
and your family and household members with information
and assistance on a wide range of topics and issues including
work stress, debt problems, family issues, relationship
worries, parenting challenges, anxiety, grief and much more.
Provided at no cost to you, counselors are available for
support by phone 24 hours a day, seven days a week at 888-
293-6948
To help get you started, the program includes up to three free in-person counseling sessions for you and your
household members per issue. Behavioral counselors can help navigate any additional long-term counseling needs.
EAP services can help with:
WorkLife Services
WorkLife Services are included with the Employee Assistance Program. Get help with referrals for important needs
like education, adoption, travel, daily living and care for your pet, child or elderly loved one.
Online resources are also available by logging onto worklifehealth.com/Standard3
LIFE Senior Services
2021 Benefits Guide
Legal (Administered by LegalZoom)
“Live your best life”
By giving you easy access to a suite of financial and legal resources,
LifePlan helps you take care of tomorrow, so you can live your best life
today!
• Goal-setting
• Whatever life throws your way
For the services included, you pay only your monthly premium of $14.99 (or $6.92 per 26 pay) periods through post-tax payroll deductions.
How a year with LifePlan stacks up:
LIFE Senior Services
2021 Benefits Guide
Additional Benefits (continued)
Identity theft is when thieves steal your personal information in order to take over or open new accounts, file fake tax returns,
rent or buy properties or commit other crimes in your name. InfoArmor/Allstate Identity Protection can help you avoid
identity theft and, in the worst-case scenario, get your life back after a breach of your secure personal information.
The most comprehensive identity protection plan available
Digital Footprint™
collection of all the data you’ve left behind that
might expose your identity. Our new tool offers a
simple way for you to see and secure your
information and help stop identity theft before it
starts.
Check your identity health score
View, manage, and clear alerts in real time
Monitor your credit scores and reports for any changes
or errors
and large purchases from any linked bank account
Monitor linked social media accounts for questionable
content and signs of account takeover
Reduce solicitation attempts by opting out of credit
care offers, telemarketing calls, commercial mail and
email, and unrequested coupons
Protect your account with biometric authentication security in iOS and Android
Get reimbursed for stolen 401(k) & HSA funds: we’ll also advance fraudulent tax returns
Enroll in Privacy Armor Plus Get to know us We’re on the job
You’re protected from your effective date. Our auto-on credit monitoring alerts, and support require no additional setup.
Explore additional features in our easy- to-use portal. The more we monitor, the safer you can be.
Our human operatives see more — like when your personal information is sold on the dark web. If you’ve been compromised, we alert you.
We’ll do the heavy lifting We’ve got your back
In the event of identity theft or fraud, Privacy Advocates® are available 24/7. They won’t stop until you’re in the clear
Our $1 million identity theft insurance policy covers out-of-pocket costs associated with identity restoration.†
Identity Protection (Administered by InfoArmor/Allstate Identity Protection)
LIFE Senior Services
2021 Benefits Guide
HMO IDEA Plus 5 Lg Insure Oklahoma Plan
CommunityCare HMO CC 2000/80 CR17 =
Premier
Value
Medical Contributions (Per Pay)
Cost of Coverage Effective January 1, 2021
Contributions made from each paycheck toward your medical, dental and vision benefit elections, as well as contributions
to FSA, will automatically be deducted from your gross pay before Federal Income taxes and Social Security taxes are
calculated. Since these contributions are deducted before your pay is taxed, your taxes will be based on a lower gross pay
and you will end up paying lower taxes on the same salary.
Voluntary Life/AD&D and STD costs are taken from your paycheck after taxes, and the benefits paid are not taxable.
* You may qualify for a lower cost option based on your household income. Please contact Jessica Luong at 405-422-0049 or Jacqueline Thornton at 918-619-4749 to find out if you qualify.
Per Pay (26 Pays) The Standard Dental Plan
(Ameritas Network)
Employee Only $3.72
Employee + Spouse $7.21
Employee + Child(ren) $6.78
Employee + Family $10.27
LIFE Senior Services
2021 Benefits Guide
The Standard Basic Life
The Standard Short-term Disability
Class 2: All Others $50,000
Employee Only / Employer Paid
Employee Only
$1,000 x 0.60 x $0.41 ÷ 10 = $24.60 $11.35 Enter weekly
earnings
per paycheck premium,
multiply the monthly
26.
Employee Only / Employer Paid
0-19 $0.06 $0.06
20-24 $0.06 $0.06
25-29 $0.06 $0.06
30-34 $0.08 $0.08
35.39 $0.09 $0.09
40-44 $0.16 $0.16
45-49 $0.24 $0.24
50-54 $0.39 $0.39
55-59 $0.58 $0.58
60-64 $0.79 $0.79
65-69 $1.27 $1.27
70-74 $2.06 $2.06
Child(ren) $.23 (per $1,000)
Voluntary Life Rates (Per Pay) Vol. AD&D Rates (Per Pay)
Cost of Coverage - Effective January 1, 2021
The Standard Voluntary Life/AD&D
How Much your Coverage Costs
Use the formula below to calculate your premium. If you are buying for a spouse, you will use the same formula that you used for
yourself but use your age and your spouse’s rate.
If you are buying for your dependent child(ren) your monthly rate is the same no matter how many child(ren) you’re covering.
The example below shows you how much you would pay per paycheck for premiums if you purchased $100,000 of additional life insurance. Use the formula to calculate your own premiums.
Vol. AD&D Rates
Employee $.02
Spouse $.02
Child(ren) $.03
To enroll in Voluntary Spouse and/or Child Life, you must be enrolled in Voluntary Employee Life.
$100,000 ÷ 1000.00 = 100 x $0.24 + .02 = $26.00 $12.00
Enter the amount of
coverage you are requesting
table
would pay each month
premium, multiply the monthly premium by 12
and then by 26.
Employee
New Hire: Increments of 10,000-$500,000 Guarantee Issue*: 150,000
Open Enrollment: One (1) or two (2) increments of $10,000 without EOI up to the Guarantee Issue*: $150,000
Spouse
New Hire: Increments of $5,000-$250,000 Guarantee Issue*: $25,000
Open Enrollment: One (1) or two (2) increments of $5,000 without EOI up to the Guarantee Issue*: $25,000
Child (to age 26)
New Hire: Increments of $2,000-$10,000 Guarantee Issue*: $10,000
Open Enrollment: Increments of $2,000 without EOI up to the Guarantee Issue*: $10,000
LIFE Senior Services
2021 Benefits Guide
The Standard – Accident
Employee Only $5.28
Employee + Spouse $8.28
Employee + Child(ren) $9.99
Employee + Family $15.60
Benefits are payable directly to you regardless of other coverage you may have.
Age: $5,000 Benefit Level $10,000 Benefit Level $20,000 Benefit Level
<30 $0.97 $1.94 $3.88
30-39 $1.43 $2.86 $5.72
40-49 $2.95 $5.91 $11.82
50-59 $6.05 $12.09 $24.18
60-70 $11.63 $23.26 $46.52
71-79 $23.45 $46.89 $93.78
The Standard – Critical Illness
Benefits are payable directly to you regardless of other coverage you may have.
You may elect either a $10,000 or $20,000 level. Coverage for your spouse can not exceed 50% of your elected benefit level.
The rates below include coverage for child(ren). Child coverage represents 25% of the employee election.
The $5,000 benefit level below is for spousal coverage only
InfoArmor/Allstate Identity Protection
Financial Advice, Legal Advice, Attorney-Assisted Estate Plan, Tax and Insurance Advice
Employee Only (Includes Family) $6.92 (per 26 pay periods)
Employee Only $4.59 (per 26 pay periods)
Employee + Family $8.28 (per 26 pay periods)
LIFE Senior Services
2021 Benefits Guide
TransAmerica – Universal Life Insurance with Long Term Care
See TransAmerica Rate Tables for Non-smoker and Smoker Rates
Eligible employees are defined as those who work at least 30 hours per week and have been so employed for at least 60
days.
*Guaranteed Issue is only available the first time a person is eligible to apply and is as follows:
Employee – $10,000 – $500,000 (maximum) / not to exceed 5 x base salary
• Guaranteed Issue, $100,000
• Any amount over $100,000, EOI (medical questions) would need to be completed and approved through
underwriting
• Guaranteed Issue, $15,000
• Any amount over $15,000, EOI (medical questions) would need to be completed and approved through
underwriting.
Child(ren) –
• Option 1 – $10,000 – $20,000 – Term Rider (Guarantee Issue)
• Option 2 – $25,000 – Stand alone (Can convert into own policy at age 26) (Guarantee Issue)
**During each “Annual Open Enrollment”, you may apply for amounts up to the maximum limit, however an
Evidence of Insurability (EOI), medical questions will be required for any amount of coverage you may apply for. Your
request will go through an underwriting process and only when you are approved, will your payroll deductions begin.
LIFE Senior Services
2021 Benefits Guide
Medical CommunityCare 800-777-4890 ccok.com
Prescription CommunityCare 877-293-8628 ccok.com
Virtual Health Healthcare Advocacy, Telemedicine, Mobile App, Mental Health, Rx Cost Saver
Benefit Plan Strategies 866-618-8243 www.thebenefitsapp.com/lifess
Dental The Standard
Flexible Spending Accounts (FSA)
Universal Life TransAmerica 888-763-7474 transamericabenefits.com
Accident The Standard 866-851-2439 standard.com
Critical Illness The Standard 866-851-2439 standard.com
Legal LegalZoom 855-787-1909 lifeplan.legalzoom.com
800-789-2720 myprivacyarmor.com
What is a premium?
A premium (also referred to as a contribution) is the bi-
weekly cost you pay for health insurance, whether you
use medical services or not. Premiums are deducted
directly from your paycheck.
What is a deductible?
A deductible is the amount you pay out of your pocket
before your insurance pays.
year. Once you have met that dollar amount, you have
met the requirements for the plan year.
What does a copay pay for?
Copayments, or copays, are pre-set dollar amount you are
expected to pay for office visits, procedures or
prescription drugs under your insurance plan.
Once the copay has been met, the insurance company
pays all remaining costs.
What does coinsurance mean?
Coinsurance is a set percentage of service costs that you
will be expected to pay once you have met your annual
deductible.
When your annual deductible is met, your insurance
provider pays for their portion of the full cost of the
service and you pay the coinsurance, or remaining
percentage.
An out-of-pocket maximum is an annual cap on the
dollar amount you are expected to pay out of your
own pocket for services (including deductibles,
copays, and coinsurance) throughout the plan year.
Once you meet the out-of-pocket amount, your
insurance provider will cover 100% of remaining
medical expenses for the year.
LIFE Senior Services
2021 Benefits Guide
certain employee benefit plans to inform covered
employees and their dependents about
laws/provisions that affect the governance and/or
coverage within those plans.
concerning the following laws/provisions:
• Medicare Part D Notice
(CHIP) Notice
• COBRA Notice
• Women’s Health and Cancer Rights Act
• Summary of Benefits and Coverage
• Mental Health Parity and Addiction Equity Act
(MHPAEA) Notice