employee benefits 2016 vacati… · • your children 14 days up to age 21 and to age 25 if...

Employee Benefits

2016

Who is Eligible?

Vacation Innovations values the contributions our employees make to the overall success of our organization. In order to recognize this, Vacation Innovations strives to offer challenging and rewarding careers together with a comprehensive benefits package.

To aid you in making the best choices for you and your families, please review the benefits information in this enrollment guide which includes:

Eligibility requirements Enrollment procedures Benefit plans Contact information, should you have questions about your

coverage

Employees who work at least 30 hours per week are eligible to elect benefits following 60 days of employment and are effective the 1st of the following month. Deductions for premiums will begin the first pay period of the month your benefits begin. You may also elect coverage for your dependents as follows:

Medical:

• Your legal spouse or domestic partner (same or opposite sex) • Your children who are less than 26 years old, married or unmarried FLORIDA ONLY: • Your children 26 years old, but less than 30 years; unmarried and do not have dependents of his/her own; and is a resident of Florida or a student and is not covered under any other group or individual health policy; and is not entitled to Medicare. • Your children who are incapable of self-sustaining employment by reason of mental or physical handicap and supported primarily by you.

Dental and Vision:

• Your legal spouse or domestic partner (same or opposite sex)

• Your children up to age 26 living in the household or a FT or PT student. • Your children who are incapable of self-sustaining employment by reason of mental or physical handicap and supported primarily by you.

Voluntary Life:

• Your legal spouse or domestic partner (same or opposite sex) • Your children 14 days up to age 21 and to age 25 if full-time student

Eligibility 1

Section 125 and Benefit Election Changes

2

Medical Benefits 3

MyCigna 4

Generic Medications 5

Dental Benefits 6

Vision Benefits 7

Life and AD&D Insurance

7

Supplemental Life & AD&D Insurance

8

Disability Insurance 9

Contacts 10

Important Information 10

Table of Contents

Health Savings/Flexible Spending/Dependent Care Accounts

9

Section 125 and Benefit Election Changes

Your Health Plan

Page 2 Benefits at a Glance

Under the Section 125 of the Internal Revenue Service (IRS) code, you are allowed to pay for certain group insurance premiums with tax-free dollars. This means your medical, dental and vision premium deductions are taken before federal income and Social Security taxes are calculated. Depending on your tax bracket, your savings could be significant.

However, you must make your benefit elections carefully, including the choice to waive coverage, because your pretax elections will remain in effect until the next plan year, which begins in January of each year, unless you experience an IRS-approved qualifying change in status. Qualifying change in status events include, but are not limited to:

Marriage or divorce

Death of spouse or other dependent

Birth or adoption of a child

A dependent’s eligibility status changes due to age, student status, marital status, or employment

You or your spouse experience a change in work hours that affect benefit eligibility

Relocation into or outside of your plan’s service area.

If you experience a qualifying change in status event, you can make changes to your benefit elections provided your elections are consistent with the event and you notify Human Resources within 30 days of the event.

Vacation Innovations offers three Cigna plans

Before choosing a plan please refer to the “Medical Benefits at a Glance” chart for a comparison of each plans’ major provisions. The chart shows the amount the member is responsible for paying. These plans utilize the Cigna networks of providers and are designed to offer the most cost effective benefits available today.

Web Site: www.myCigna.com

Cigna’s customized web site offers you and your covered dependents personalized benefit information, claims information, and more. Once you register on the secure web site you will be able to print temporary ID cards, find financial tools to help you spend your health care dollars wisely and other great tips.

From the Cigna home page, select the Login tab then click the Register Now button. On the next screen type in your name, date of birth, and address then click Next. That’s all there is to it!

You do not need to select a Primary Care Physician and you won’t need referrals to see a Specialist.

This guide only highlights your benefits. Official plan and insurance documents actually govern your rights and benefits under each plan. It is the employee’s responsibility to request plan documents.

Plans may be subject to exclusions and other limitations.

Medical Benefits

Page 3 Benefits at a Glance

Deductible OAPIN

Low Plan HSA Open Access*

Mid Plan OAP

High Plan

Chart shows Member Responsibility Calendar Year Calendar Year Calendar Year

In Network Individual $2,000 $1,500 $2,000

Out of Network Individual N/A $3,000 $6,000

Family Maximum 2X 2X 3X

Coinsurance

In Network/Out of Network 30% 20% / 40% 20% / 50%

Maximum Out of Pocket (Includes Deductible, Coinsurance, Copays)

In Network Individual $6,350 $4,500 $5,500

Out of Network Individual N/A $9,000 $11,000

Family Maximum 2X 2X 2X

Physician Charges (In Network)

Primary Care / Specialist $35 Copay / $65 copay Deductible + 20% $35 Copay / $65 Copay

Preventive Care $0 Copay $0 Copay $0 Copay

Hospital Admission

In Network $100 + Deductible + 30% Deductible + 20% $100 + Deductible + 20%

Out of Network N/A Deductible + 40% $500 + Deductible + 50%

Outpatient Services

In Network Surgery Deductible + 30% Deductible + 20% Deductible + 20%

Urgent Care / Emergency Room $70 Copay / $300 Copay Deductible + 20% $70 Copay / $300 Copay

Diagnostic Services (In Network)

Diagnostic Laboratory / X-Ray $0 Copay Deductible + 20% $0 Copay

Complex Imaging (Facility) $300 Copay Deductible + 20% $300 Copay

Provider Network

www.MyCigna.com Open Access Plus Open Access Plus Open Access Plus

Prescriptions Deductible +

RX—Tier 1 Generic $10 Copay $10 Copay $10 Copay

RX—Tier 2 Formulary Brand $50 Copay $50 Copay $50 Copay

RX—Tier 3 Non-Form. Brand $80 Copay $80 Copay $80 Copay

RX—Mail Order 3X Copay less $10 2.5X Copay 3X Copay less $10

Low Plan Mid Plan / HSA High Plan

Per Bi-Weekly Paycheck Tobacco Free Tobacco User Tobacco Free Tobacco User Tobacco Free Tobacco User

Employee Only $ 76.74 $143.98 $ 94.15 $167.49 $118.02 $199.72

Employee+Spouse $341.87 $409.11 $383.30 $456.64 $440.13 $521.82

Employee+Child(ren) $238.12 $305.36 $270.16 $343.50 $314.09 $395.78

Employee+Family $484.04 $551.28 $538.36 $611.70 $612.86 $694.55

*The Mid Plan is an HSA plan. All services received (with the exception of preventive care) apply to the deductible. Additionally, for those covering dependents on this plan, the deductible is “aggregate”. This means that in order for

one individual in the family to satisfy their deductible, the entire family deductible of $3,000 must be satisfied.

Benefits at a Glance Page 4

Important Prescription Information

Certain medications require pre-authorization or are subject to quantity limits and/or step therapy treatment. These programs encourage appropriate and cost effective use of prescription medications. A complete list of drugs within these categories can be found at www.MyCigna.com. Your health care provider will need to complete the corresponding forms and submit them to Cigna before you having the prescription(s) filled at the pharmacy. If you have any questions about the medications prescribed to you, you need to contact your physician. For coverage information you should contact Cigna at the number on your ID card.

MyCigna.com

Use the website to access provider networks, claims data, order ID cards, check medication costs and find tools and resources to help you use your benefits more efficiently. Find toolkits and tips for a healthy lifestyle and discounts for Cigna members.

Cigna Mobile App

Benefits on the go! Access at your fingertips to view your ID card, check your claims, find providers in your network and much more. Visit the App Store or Google Play to download this free app and take control of your health care.

Generic Medications An effective way to save on your out-of-pocket healthcare costs is to consider switching to generic drugs when appropriate. Generic medicines are approved to be as safe and effective as their brand-name

counterparts, and on average cost 50 percent less than brand name drugs.

Generic drugs contain the same active ingredients and are available in the same strength and dosage form as their brand-name counterparts. The U.S. Food and Drug Administration (FDA) regulates the manufacturers of all generic drugs, which helps ensure their strength, quality and purity. The FDA also requires generic drugs to be absorbed into the body at the same rate and to the same extent as the branded product, which ensures that generic and branded products provide the same effectiveness in children, adults and the elderly. You can save the most money by choosing generic medicines when

available. Ask your doctor to authorize generic substitutions when medically appropriate.

$4 Generics!! Free Antibiotics!! Shop Around for Medications Another smart way to save on medication costs is to shop around and look for the best price! The cost of a prescription medication can vary greatly from one pharmacy to another, even within the same store chain. For example, your medication at one CVS or Walgreens is not always the same cost at a different CVS or Walgreens, right across the street! Before you drop off

the prescription to be filled, call ahead or check the pharmacy website to find out the cost.

Several pharmacies now offer special prescription programs, including $4 generic drugs and free antibiotics. For a list of the medications included in the programs, please visit the pharmacy’s website.

Wal-Mart, Sam’s Club and Neighborhood Market:

$4 generic medications per 30 day supply


$10 certain women’s medications, including drugs to treat breast cancer and hormone deficiency

www.walmart.com

Target:



www.target.com

Hannaford / Kroger Supermarkets (New Hampshire):



www.hannaford.com

www.kroger.com

Publix Supermarkets (Florida):

FREE– Certain oral antibiotics, including:

Amoxicillin, penicillin, ciprofloxacin and more.

Also free Lisinopril & Amlopidine (HBP) & Metforin (diabetes)

No limits to the # of prescriptions you can have filled

www.publix.com

The Publix Pharmacy Diabetes Management System (Florida)

Publix Pharmacy also offers a Diabetes Management System, which is designed to help you manage your diabetes through several key components, including:

Free Medication- Get your prescriptions for generic immediate-release Metformin (500mg, 850mg and 1000mg) FREE, up to a

30 day supply (up to 90 tablets). There’s no limit to the number of refills of free medication you can receive.

On-line Resources- Take advantage of up-to-date news and health education information, including interactive diabetes management tools, provided by StayWell Custom Communications. Visit this handy on-line resource often to learn the latest developments regarding diabetes. You can also receive monthly e-newsletters with useful information, including

coupons and special offers. Simply click “It’s FREE!” at the top right of the StayWell screen.

http://publix.staywellsolutionsonline.com

This additional information on generic drugs will help facilitate your search for the best deals to lower your prescription drug costs. As you conduct your own research, you may find many other cost-saving alternatives not listed in this benefit guide. The purpose of this article is not to instruct you to utilize these alternatives, but to enlighten you on various options available to you to help decrease costs and improve your health.

Benefits at a Glance

Guardian offers two dental plan – A DHMO plan and a PPO plan. Please see the charts below for an outline of each plans’ major features. A Wait Period applies to Basic (6 months); Major (12 months) & Ortho (24 months) services for those enrolling after their initial eligibility period.

With a PPO Plan you can choose a dentist from the provider list or use an out-of-network provider. With the PPO plan you pay less out of pocket when you choose a Dental Guard Preferred dentist. The DHMO provides negotiated discounts for services within the Managed Dental Guard Florida network.

*To avoid unexpected out of pocket costs for major dental procedures we highly recommend you ask your dentist for a pre-treatment estimate so you will be aware of your financial responsibility before having the procedure done.

Out of Network dentists may balance bill for charges over reasonable & customary.

Dental Benefits

PPO Dental Plan

Deductible In Network (waived for preventive services)

$50 $150 Per Family

Deductible Out of Network (NOT waived for preventive services)

$100 $300 Per Family

Calendar Year Maximum $1,000 (In and Out of Network Combined)

Services In Network Out of

Network*

Preventive & Diagnostic Services Limited to 2X per year

Member pays 0%

Member pays 20%

Basic Services

Member pays 20% After Deductible


Major Services



Orthodontia (Child Only) Member pays 50%

Member pays 50%

Orthodontic Lifetime Max $1,000

Deductions per paycheck

Employee Only $ 2.41

Employee + Spouse $ 9.43

Employee + Child(ren) $ 9.33

Employee + Family $16.35

DHMO Florida Only Dental Plan

Deductions per paycheck

Employee Only $ 8.78

Employee + Spouse $24.40

Employee + Child(ren) $34.63

Employee + Family $43.36

PPO Dental Plan

DHMO (FLORIDA ONLY) Dental Plan

Deductible None

Office Visit $5 Copay

X-Ray (Complete Series) $0 Copay

Prophylaxis (Once per 6 mo) $0 Copay

Amalgam, One Surface $8 Copay

Crown - Full Cast $250 Copay

Root canal - Molar $170 Copay

Gingevectomy (per quadrant) $80 Copay

Extraction of Impacted Tooth (Soft Tissue)

$50 Copay

Orthodontia

Children $2,500 Copay

Adult $2,800 Copay

*Out of Network benefits subject to Reasonable & Customary charge


The Guardian Vision Plan covers annual eye exams as well as eyeglasses or contact lenses. Discounts are also available for LASIK surgery at participating locations. You may choose from a national network of providers or choose to visit an out of network provider. Out of network benefits are on a reimbursement basis.

Vision Benefits

BiWeekly

Deductions

Employee Only $2.99

Employee+Family $8.67

Employee + Spouse $5.53

Employee+Child(ren) $5.80

Vision Plan

Co-payments In-Network Out-of-Network

Eye Exam $10 Copay $50 allowance**

Lenses (every 12 months)

Single $20 Copay $48 allowance**

Bifocal $20 Copay $67 allowance**

Trifocal $20 Copay $86 allowance**

Frames

(every 24 months)

$20 Copay

$130 allowance for frames, then 20% off balance

$48 Allowance**

Contact Lenses You may choose either contact lenses or eyeglass lenses in a 12 month period

$130 allowance $105 allowance

**The amount the plan will reimburse for this benefit less applicable copay.

Life and Accidental Death and Dismemberment (AD&D) Insurance

Basic Life and AD&D Insurance

Eligible employees receive a company-paid Term Life and Accidental Death and Dismemberment

(AD&D) insurance benefit through Mutual of Omaha.

Basic Life and AD&D: $25,000

*On the first of the month following your 65th birthday, your life insurance amounts reduce by 35%; an additional

15% at age 70; and an additional 15% at age 75 and terminate at retirement.

Update Your Beneficiaries

It is important that you keep your beneficiary designations up to date. Your beneficiary is the person you assign to receive your benefit in the event of your death.

Please note, you are automatically the beneficiary of any spouse or child coverage you purchase.


Supplemental Term Life and AD&D Insurance

You may purchase supplemental term life and AD&D insurance coverage through Mutual of Omaha for yourself, your spouse and your child(ren). You pay the total cost of supplemental term life insurance premiums through after-tax payroll deductions. New employees who purchase coverage during their initial enrollment may elect coverage without providing Evidence of Insurability (EOI). Current employees purchasing supplemental life during open enrollment or increasing more than one increment or after a qualifying event must submit EOI for approval.

Supplemental Life Insurance Plan Insurance for... You May Purchase...

Employee Increments of $10,000 up to the lesser of 5x Base Annual Earnings not to exceed $150,000 as of January 1st each year. Guarantee Issue: $100,000

Spouse Increments of $5,000 to a maximum of $75,000 (not to exceed 50% of the employee coverage amount) Guarantee Issue: $20,000

Child(ren) $2,000 increments up to $10,000

Employee must elect coverage for dependents to be eligible.

Employees and Spouses with current coverage may increase one increment up to the GI amount without submitting Evidence of Insurability (EOI).

Employee

Age $10,000

Up to 24 $0.46

25-29 $0.47

30-34 $0.51

35-39 $0.58

40-44 $0.66

45-49 $1.05

50-54 $1.49

55-59 $2.80

60-64 $3.80

$20,000

$0.91

$0.94

$1.02

$1.15

$1.33

$2.10

$2.97

$5.59

$7.61

$30,000

$1.37

$1.41

$1.54

$1.73

$1.99

$3.16

$4.46

$8.39

$11.41

$40,000

$1.83

$1.88

$2.05

$2.31

$2.66

$4.21

$5.94

$11.19

$15.21

$50,000

$2.28

$2.35

$2.56

$2.88

$3.32

$5.26

$7.43

$13.98

$19.02

$60,000

$2.74

$2.82

$3.07

$3.46

$3.99

$6.31

$8.92

$16.78

$22.82

$70,000

$3.20

$3.30

$3.59

$4.04

$4.65

$7.37

$10.40

$19.58

$26.62

$80,000

$3.66

$3.77

$4.10

$4.62

$5.32

$8.42

$11.89

$22.38

$30.42

$90,000

$4.11

$4.24

$4.61

$5.19

$5.98

$9.47

$13.38

$25.17

$34.23

$100,000

$4.57

$4.71

$5.12

$5.77

$6.65

$10.52

$14.86

$27.97

$38.03

Employee/Spouse Voluntary Life and AD&D Bi-Weekly Payroll Deductions

Child(ren) Voluntary Life/AD&D

Bi-Weekly Payroll Deductions

$4,000 $0.22

Child(ren) Flat rate for 1 or more child

$10,000 $0.55


If you enroll in the HSA Mid plan you may open a HSA.

Health Savings Accounts (HSA) are administered by eFlexgroup. The HSA allows you to: • pay for qualified health care expenses using pre-tax dollars through payroll deductions • funds carry over from year to year • the funds remain yours even if you switch employers • IRS Maximums for 2016 Single Coverage: $3,350 / Family Coverage: $6,750

If you enroll in the Low or High plan you are eligible to open a FSA.

Flexible Savings Accounts (FSA) are administered by eFlexgroup. The FSA allows you to: • pay for qualified health care expenses using pre-tax dollars through payroll deductions • funds must be used prior to the end of the plan year. You may roll over up to $500 to the next plan year • maximum annual contribution is $2,550 (not including any rollover amount)

Both the HSA and FSA plans feature: • pay for qualified health care expenses with the eFlex debit card or submit a claim form with receipts to receive a check from eFlex • manage your account online

Health Savings Account (HSA) / Flexible Spending Account (FSA)

Short Term (STD) and Long Term (LTD) Disability

A combination of short-term (STD) and long-term (LTD) disability insurance can help protect you financially in the event of a qualified illness or accident. The Short Term Disability premiums are 100% employee paid while the Long Term Disability premiums are company paid. All new enrollees will be subject to pre-existing condition limitations.

Disability Plan Elimination Period Benefit Maximum Benefit Duration of Benefit

STD (Employee Paid) Accident: 7 Days

Illness: 7 Days

60% of weekly covered

earnings $2,500 per week 25 weeks

LTD (Company paid) 180 Days 50% of monthly

covered earnings $1,000 per month

To SSRA as long as you are

unable to perform your job

Short Term Disability Payroll Deduction Calculation

_________ ÷ 52 = _________ x .60 = $_________ ÷10= _______x____.69__x 12÷26 = $__________________

Annual Salary Weekly Earnings Weekly Benefit STD Rate Payroll Deduction

($2,500 max)

Dependent Care Account (DCA)

A Dependent Care Account (DCA) allows you to set aside pre-tax dollars to pay for child or elder care so that you can go to work. Reimbursement for Dependent Care occurs after you have paid for the service and must be accompanied by acceptable documentation. Acceptable documentation includes but is not limited to: start and end dates of service; dependent’s name and date of birth; provider’s name, address, tax ID or SSN. 2016 Contribution Limits: $2,500

Medical

Cigna 866-494-2111 www.myCigna.com

Dental

Guardian - DHMO 888-618-2016 www.guardiananytime.com

Guardian - PPO 800-541-7846 www.guardiananytime.com

Vision

Guardian 800-627-4200 www.guardiananytime.com

Life Insurance & Supplemental Life Insurance

Mutual of Omaha 800-775-8805 www.mutualofomaha.com

Disability

Mutual of Omaha 800-877-5176 www.mutualofomaha.com

Health Savings Account / Flexible Savings Account (HSA / FSA)

eFlex Group 877-933-3539 www.eflexgroup.com

Supplemental Insurance

Colonial Life 800-325-4368 www.coloniallife.com

Vacation Innovations—Human Resources

Annie Talbot 407-233-1651 [email protected]

Angela DiBari 603-516-0687 [email protected]

Enrollment Rights Under HIPAA If you choose not to participate in the Vacation Innovations Benefit Programs, you will be required to sign a waiver of participation stating your reason for declining coverage. This is required due to future special enrollment considerations if you meet one of the qualified events under the Cafeteria Plan. You may only enroll in benefits during your initial eligibility period and each year at open enrollment unless you experience a qualifying event.

Wallace Welch & Willingham is providing this benefit guide as a service for Vacation Innovations. The information is solely general guidance on the subjects covered and should not be considered as legal advice. This is only a highlight of the benefits provided by Vacation Innovations to be used as

a quick reference for enrollment purposes. Employees should refer to the plan documents or summary plan descriptions for each plan for a more detailed explanation of all plan benefits

including any limitations or exclusions associated with such plan. It is the employee’s responsibility to request copies of plan documents.

Important Information

Page 10

Your Rights Under COBRA If at the time of termination you are an active enrollee in the medical, dental, and/or vision plan, you have the right to continue coverage after you are no longer eligible to participate in our company plans. The Human Resources Department will provide you with additional information regarding your rights upon request.

Contact List

employee benefits 2016 vacati… · • your children 14 days up to age 21 and to age 25 if...

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