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TRANSCRIPT
Your Health, Your Benefits2013 Benefits Enrollment Guide
UHC
A Message About Your Health Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2013 Benefit Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Eligibility and Enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Medical Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Comparing Your Medical Plan Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
More Resources for Your Better Health from UHC and Express Scripts . . . . . . . . . . . . . . 14
Wellness and Incentives Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Dental Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Vision Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Flexible Spending Accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Income Protection Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Voluntary Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
401(k) Retirement Savings Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Work/Life Balance Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Benefit Contacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Contents
This 2013 Enrollment Guide is a Summary of Material Modifications (SMM) providing information on various SavaSeniorCare benefit plans and outlining changes that take effect January 1, 2013. It is intended to provide an overview of changes and information about some of the benefit plans you are eligible for as an employee of SavaSeniorCare. If any information in this Enrollment Guide conflicts with the plan documents and insurance policies, those plan documents and policies will govern. SavaSeniorCare reserves the right to amend, modify or terminate these plans at any time. This Enrollment Guide does not constitute a contract of employment.
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A Message About Your Health Benefits Our Company is committed to supporting our employees by building a culture of health, one where each of us:• Focusesonwellnessandprevention–takingstepstobeashealthyaswecan
• Makessolid,informedchoicesaboutthehealthplansweelectduringenrollment
• Usestheinformation,toolsandresourcesavailablethroughourCompanyanditshealthplanpartnerstounderstandtreatmentoptionsandrelatedcosts
• Communicateswithourdoctorsandparticipatesinmakingdecisionsaboutourcare
Your Health, Your BenefitsGoodhealthandwellnessareaboutthejourney,notjustthedestination.Becausetobaccousersareatahigherriskforheartdisease,lungcancerandstroke,oneofthewayswe’llcontinuetobuildourorganization’scultureofhealthistointroduceatobaccosurchargeforour2013medicalplans.Simplyput,ifyouandyourspousedon’tusetobacco,you’llpayless.Seepage2formoreinformation.
Also,rememberthatyou’llreceivewellnessincentivesforcompletingtheconfidentialhealthassessment,and,whenyouelectmedicalcoveragethroughSava,theCompanymakesacontributiontoyourHRAtousetowardyoureligiblehealthcareexpenses.
Betterhealthstartswithyou.Andwe’recommittedtogivingyouthetoolstohelpyougetthere.
Pleasereadthroughthisenrollmentguidesoyouhavetheinformationyouneedtomakethebestplanchoicesforyouandyourfamilyfor2013.Theannualenrollmentperiodwilltakeplacefrom October 23 to November 16, 2012. YournewbenefitswillbeeffectiveonJanuary1,2013.
Important Note:IfyouwanttocontinuetoparticipateintheFlexibleSpendingAccount(FSA),youwillneedtoenrollintheHealthCareand/orDependentDayCareFSAduringtheenrollmentperiod.Youmaycontributeupto$2,500intheHealthCareFSAand$5,000intheDependentDayCareFSAfor2013.
WeappreciateallyoudoforourCompanyandourresidentsandtheirfamilies.
ScottBardowell
ExecutiveVicePresident,HumanResourcesandRiskManagement
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2013 Benefit HighlightsRates for medical coverage will increase by approximately 9%, depending on the plan and the coverage level you choose. Based on our plans’ experience from last year, the increase should be much higher, but the Company is absorbing much of the cost increase in an effort to keep the plans affordable for you. Rates for disability and life insurance may increase slightly depending on your coverage. If you don’t elect new benefits for 2013, your current coverage will carry over into next year – with the important exception of your FSAs.BenefitchangesmadeduringtheannualenrollmentperiodwilltakeeffectbeginningJanuary1andwillcontinuethroughDecember31,2013:
• Ifyouandyourspousearenon-tobaccousers,you’llpaylessforyourmedicalcoverage.Youmustbothbenon-tobaccousersinordertoreceivethisdiscount.
• ThemaximumamountyoumaycontributetoyourHealthCareFSAfor2013is$2,500.Thischangeisduetohealthcarereformlaws.
• Asyouprobablyknow,yourin-networkpreventivecareiscoveredat100%,includingcheckups,immunizationsandcancerscreenings.For2013,anexpandedlistofwomen’spreventivecareservicesalsowillbeincluded;thisincludesbreast-feedingsupportandsupplies,contraceptionmethodsandcounseling,andmuchmore.Seetheplan’sSummaryofBenefitsCoverage(SBC)ontheTakeCareBenefitSiteformoreinformation.
Overview of ChoicesYou have the following options. You can choose from:• TwomedicalplanoptionsthroughUnitedHealthcare(UHC):ValueConsumerDirectedHealthPlan(CDHP)andValuePlusCDHP.Whenyouelectcoverage,theCompanymakesacontributiontoyourHRAtousetowardeligibleexpenses–in2013orbeyond.
• TwodentalplanoptionsthroughCignadental:PlanAandPlanB.
• TwovisionplanoptionsthroughUnitedHealthcareVisionandVSP.
In addition, you can choose:• Health Care and Dependent Day Care FSAs.Youmaychoosetomakeyourownpre-taxcontributionstoanFSA.
• Income protection plansincludingaccidentaldeathanddismemberment(AD&D),supplementalanddependentlifeinsurance,accidentinsurance,criticalillnessinsurance,short-termdisabilityandlong-termdisabilitycoverage.
Remember, basic life insurance is provided by our Company at no cost to you.
Your Benefits Enrollment GuideThis enrollment guide includes information you’ll need to enroll in the medical, dental, vision, FSAs and income protection plans. You can also find a Summary of Benefits Coverage (SBC) on the TakeCare Benefit Site.
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Eligibility and EnrollmentKnowing who is eligible for benefits and being aware of enrollment deadlines and requirements can help you make the most of your enrollment opportunity.
Benefits Enrollment YoucancalltheBenefitServiceCenterat1-866-402-4144MondaythroughFriday,8a.m.to8p.m.ESTtohaveaCustomerServiceRepresentativeassistyouwithyourbenefitenrollmentandansweranyquestionsyoumayhaveaboutthebenefitoptionsavailabletoyou.
Youcanenrollonline24/7fromanycomputerwithInternetaccess–fromhome,workoralibrary–duringtheenrollmentperiod.
• From a facility,visitEmployeeExpress,clickonmyBenefitslinkinthemenubarontheleftsideofthescreenandthenclickonthelinktotheTakeCareBenefitSite.
1.Select your location.2.Enter your password.Yourpasswordisbenefits(alllowercase).3.Click on the “Online Access” box. You will need your Novell username and password . (Tip: This is the username
and password you use to access myPay .)
• YoucanalsoaccessEmployeeExpressfromanyexternalcomputerbyusingemployee-express.savasc.com(Note:Donottypewww).
4.Enter your Novell username and password.(Tip:ThisistheusernameandpasswordyouusetoaccessmyPay.)
5. Click on the myBenefits linkinthemenubarontheleftsideofthescreen,andthenclickonthelinktotheTakeCareBenefitSite.
6.Click on the “Online Access” box.
When You Can EnrollGenerally,enrollmentelectionsareonlymadeduringthisenrollmentperiod.Here’sasummaryofotherenrollmentopportunitiesformedical,dental,vision,flexiblespendingaccounts,lifeinsuranceanddisabilitybenefitsduringtheyear.
If you… You can enroll… Your benefits will begin…
Are a new regular, full-time employee
Duringyourenrollmentwindow,whichstartsapproximatelysevendaysafteryourhiredateandextends30 daysbeyondyoureffectivedate
Thefirstdayofthemonthafter:• 30 daysfromyourhiredateifyouarenon-linestaff
• 90 daysfromyourhiredateifyouarelinestaff
Have a qualifying family status change (see page 4 for details on qualifying events) or have a change to regular full-time status
Within60 daysfromyourfamilystatuschange;within60daysforMedicaideligibilitychanges
Basedonthetypeofstatusevent
PleasenotethatanyelectionsandchangesyoumakeduringthisenrollmentperiodwillbeeffectiveJanuary1throughDecember31,2013.
Online Benefits ResourceThe TakeCare Benefit Site makes it easy to enroll in benefits and find the benefit information you need whenever you need it. Visit www.takecarebenefitsite.com for highlights of all your benefits, information about the wellness program and much more! See the enrolling instructions on this page for a step-by-step guide to accessing the site.
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Who Is Eligible for BenefitsPermanent,full-timeemployeeswithstandardworkhoursofatleast30hoursperweekareeligibleforcoverage.Youwillhavea30-or90-dayinitialwaitingperiodbasedonyourjobcode.
Family Members You Can Choose to Enroll in Medical, Dental and Vision • Yourspouse.Notethatyourspouseiseligibleformedicalcoverageaslongasheorshedoesnothaveaccesstoothermedicalcoverage,forexample,throughhisorheremployer.Yourspousecanenrollindentalandvision,regardlessofhavingothercoverageavailable.
• Yourchildbybirthoradoptionwhoisunderage26.
• Thechildofyourspouseordomesticpartner(whoisunderage26,beginningwhenyouhavealegalresponsibilityforthechild).
• Yourchildwhoisphysicallyormentallyhandicapped,dependentonyouforsupportandwascoveredunderthehealthplanbeforeage26orhadpriorcreditablecoveragebeforeage26.Thedisabilitymustoccurbeforeage26.Youwillneedtoprovideproofofdisabilitystatusperiodically.
• Yourdomesticpartnerwhohasbeenlivingwithyouforthepastsixmonths.YouwillneedtocompleteaDeclarationofDomesticPartnership,whichisavailableonline,andprovidesupportingdocumentationtoenrollyourdomesticpartner.Notethatyourdomesticpartneriseligibleformedicalcoverageaslongasheorshedoesnothaveaccesstoothermedicalcoverage,forexample,throughhisorheremployer.Yourdomesticpartnercanenrollindentalandvision,regardlessofhavingothercoverageavailable.
• EmployeeswillneedtocompletetheDependentAuditCertificationofDependentStatusformforallnewlyaddeddependents.AcopyofthisformandthedependenteligibilitychecklistisavailableontheTakeCareBenefitsSite.Notethatbenefitcoveragewillnotstartuntildocumentsaresubmittedandapproved.
Coverage LevelsWhenyouenrollinmedical,dentalorvisioncoverage,youcanchoosefromthesecoveragelevels:
• Employeeonly • Employeeplusspouse/domesticpartner • Employeepluschild(ren) • Family
Benefit Changes During the YearThebenefitelectionsyoumakeduringbenefitsenrollmentwillstayineffectfromyoureffectivedatethroughDecember31,2013.TheInternalRevenueService(IRS)limitschangesyoucanmakethroughouttheyear.TheIRSallowschangeswhenyouhaveaqualifyinglifeeventthatcanaffectyourcoverage.Youmustmakechangeswithin60daysofanyfamilystatuschange(lifeevent).Thisdeadlineisnotflexible.
Anybenefitchangesyoumakemustbeconsistentwiththequalifyinglifeevent.Forexample,ifyouadoptachild,youcanaddthechildtoyourmedicalplan–butyoucannotdropcoverageforyourspouseordomesticpartner.
Youcanchangeyourelectionsforbenefitsthroughouttheyearif:
• Youhaveaqualifyingevent(forexample,lossofcoverage,marriage,divorce,death,birthofchild,aspouse’sbenefitsenrollment).
• Acourtorderrequiresthatyourchildreceiveaccidentorhealthcoverageunderthisplanoraformerspouse’splan.
• You,yourspouseordependentbecomesentitledtoMedicareorMedicaid.
• Yourchildreachesmaximumageforcoverage(age26).
• Thereisasignificantchangeinyourhealthcoverageoryourspouse’scoverageattributabletochangesincostorbenefits.
• Youroryourspouse/domesticpartner’semploymentstatuschanges.
OurCompanyalsoallowsaspecialenrollmentopportunityifyouoryoureligibledependentseither:
• LoseMedicaidorChildren’sHealthInsuranceProgram(CHIP)coveragebecauseyouarenolongereligible,or
• Becomeeligibleforastate’spremiumassistanceprogramunderMedicaidorCHIP.
Forthesetwoenrollmentopportunities,youwillhave60daysfromthedateoftheMedicaid/CHIPeligibilitychangetorequestenrollmentinourCompany’sgrouphealthplan.
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Pre-Existing ConditionsThemedicalplandoesnotcoverpre-existingconditionsforadultsage19orolderforthefirst12monthsoftheircoverage.Alloraportionofthatexclusionmaybeeliminatedifyouhavecreditablecoveragefromanothergrouporindividualhealthplan.Thisexclusiondoesnotapplytopregnancyornewborn/newly-adoptedchildrenwhoenrollasinitialenrollees.
Youmaynotbeeligibleforshort-termdisabilitybenefitsifyouhavereceivedtreatmentforaconditionwithinthepastthreemonthsuntilyouhavebeencoveredunderthisplanforsixmonths.Thelong-termdisabilityplandoesnotcoverpre-existingconditionsforthefirst24monthsyouarecovered.Youmaynotbeeligibleforcriticalillnessbenefitsifyouhavereceivedtreatmentforaconditionwithinthepast12monthsuntilyouhavebeencoveredunderthisplanfor12months.
Paying for CoverageYourcostforcoverageisbasedontheplanoptionandcoveragelevelyouchoose.
• YouandtheCompanysharethecostofyourmedicalcoverage.
• OurCompanyprovidesbasiclifeinsuranceofonetimesyourannualbaseearningsasofJuly1,2012,atnocosttoyou.
• Youpaythecostfordental,vision,supplementalanddependentlifeinsurance,accidentaldeathanddismemberment(AD&D)coverage,short-termandlong-termdisability,accident,cancerandcriticalcarecoverage.
Yourshareofcoveragecostscomesfromyourpayeitherthroughpre-taxorpost-taxcontributions.
Pre-Tax Post-Tax
• Medicalforyou,yourspouse,yourchildrenandyourdomesticpartner’schildren
• Dentalandvisionforyou,yourspouse,andchildren
• HealthCareandDependentDayCareFlexibleSpendingAccounts
• 401(k)
• Medicalforyourdomesticpartnerwhodoesnotqualifyasahealthplantaxdependent
• Dentalandvisionforyourdomesticpartnerandyourdomesticpartner’schildren
• Incomeprotection:Supplementalanddependentlifeinsurance,AD&Dandshort-termandlong-termdisability
• Criticalcarewithcancercoverage
• Accidentinsurance
Pre-tax contributions come from your paycheck before federal income taxes, FICA tax, and most state and local income taxes. Because your taxes are based on a lower amount of income, you pay less in tax and take home more in pay.
Domestic Partner deductions will be separate and post-tax due to IRS regulations.
Note: If your spouse/domestic partner becomes eligible for other medical coverage, for example, through his or her employer, this qualifies as a qualifying life event, and you will be responsible for removing your spouse/domestic partner from medical coverage under our Company’s plan. While our Company allows 60 days to make benefit changes due to a status change event, many employers allow less time. Typically, your spouse or domestic partner will have 30 or 31 days from the loss of coverage to enroll in other coverage with their employer.
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Medical CoverageOur Company offers benefits, programs and resources to help you take control of your health and manage your medical conditions. It starts with medical coverage, including prescription drug coverage. YouhavetwomedicalplanoptionsthroughUnitedHealthcare(UHC)–the Value Consumer Directed Health Plan (CDHP) and Value Plus CDHP.
TheValueandValuePlusConsumerDirectedHealthPlans(CDHP)bothusethesameUHCnetworkofdoctors,hospitalsandmedicalproviders,andcoverthesametypesofservicesandsupplies.
WhiletheValueCDHPpaysbenefitsforin-networkcoverageonly,theValuePlusCDHPpaysbenefitsforcareinandoutsidethenetwork.It’s important to note that if you enroll in the Value CDHP and go outside of the network for care, you will not have coverage, except for life-threatening emergency care.
Both medical plan options offer some covered in-network services without a deductible:• Preventivecare–coveredat100%
• Prenatalcare–coveredat100%
• Emergencyroomcare–copay,thencoveredat100%
• Prescriptiondrugs–youpayacopayforretailandmailorderdrugs
Forallotherservices,youhavetomeetthedeductible–thenyouandtheplansharethecostofcare.Plusyou’reprotectedagainstmajorexpensesthroughanout-of-pocketmax,or“cap”onwhatyoupayoutofpocket.
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Health Reimbursement Arrangement (HRA)BothmedicalplanoptionsincludeaHealthReimbursementArrangementorHRAtohelpyoupayforqualifiedmedicalexpensesduringtheplanyear.
WiththeHRA,ourCompanymakesavailable$550–$1,400whenyouenrollintheValueorValuePlusCDHPmedicalplanandcompletethePersonalHealthAssessment.Youcanearnaddeddollarsforspecificwellnessactivitiesandusethedollarstopayforeligiblemedicalexpenses.YourHRAbalanceisavailablewhenyourcoveragetakeseffect,aslongasyoucompletethePersonalHealthAssessmentwithin30daysofyourenrollmenteffectivedate.
WhenyouenrollintheValueorValuePlusCDHP,here’showdollarsaddupinyourHRA:
Italladdsup!
If you complete the Personal Health Assessment…
If you enroll in a wellness program supported by a Carewise coach…
If you complete a coaching session or online wellness program (or are enrolled for at least 6 months)…
If you complete a biometric screening for key health indicators, like blood pressure, cholesterol and diabetes, and have your doctor validate the results during the plan year…
Total you can earn during the plan year from our Company, up to…
Employeeonly $550 $100 $100 $150 $900Employee+spouse/domesticpartner
$1,400 $100 $100 $150 $1,750
Employee+child(ren)
$1,400 $100 $100 $150 $1,750
Employee+family(spouse/domesticpartnerandeligiblechildren)
$1,400 $100 $100 $150 $1,750
CompleteallincentiveactivitiesandourCompanywillcontributeupto$900foremployeeonlycoverageand$1,750ifyoucoveryourselfanddependents.Onceyoucompleteactivitiesduringtheplanyeartoearnincentives,Carewisewillprocesstheactivity’scompletion.Onceprocessingiscomplete,yourincentivedollarswillbeaddedtotheHRA.
Note: Allincentivesareforanemployeecompletingthelistedtasks.SpousesanddomesticpartnerswhoareenrolledintheValueorValuePlusCDHParewelcometoparticipateinthesewellnessinitiativesbutwillnotearnincentivesfordoingso.
Formoreinformationaboutthewellnessandincentivesprogram,visittakecare.carewisehealth.comorcall1-888-355-7268.YoucanalsolinktothewebsitefromtheTakeCareBenefitSite.
WithanHRA:
• Youcannotmakecontributions.
• Youstillcansetasidepre-taxdollarsinaHealthCareFSAforeligiblehealthcareexpensestax-free;thatisentirelyuptoyou.Seepage21.
• YourunusedHRAdollarsrolloveryearafteryearaslongasyouworkatourCompanyandstayenrolledintheValueorValuePlusCDHP.Ifyoudropcoverage,youforfeityourunusedHRAdollars.
• Ifyouleave,youforfeityourunusedHRAdollars.IfyouelectCOBRA,youretainyourHRA.
YoucanuseyourHRAfor2013medicalandprescriptiondrugexpenses.Forprescriptiondrugexpenses,youchoosewhethertouseyourHRAorpayfromyourpocket.
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UnusedfundsinyourHRAcarryforwardyear-to-yearaslongasyoucontinuetoworkforourCompanyandenrollinaCDHPmedicalplan.
During enrollment• EnrollintheValueorValuePlusCDHPmedicalplanandourCompanysetsupanHRAforyou.
• ParticipateinspecificactivitiestoearnCompanyHRAdollars.• Choosetocontributeextramoneyforeligiblehealthcareexpenses(medical,dentalandvision)toapre-taxHealthCareFlexibleSpendingAccount(FSA).
When your coverage takes effect• OurCompanymakesdollarsavailablewhenyoucompletethePersonalHealthAssessment:$550–$1,400
• Plus,duringtheyearyoucanearnupto$350forparticipatinginotherincentives.Seepage7.
• YourHealthCareFSAannualelectioncontributionisimmediatelyavailable.
When you receive care• UseyouravailableHRAdollarsfirstformedicalcareandprescriptiondrugexpenses.
• IfyourHRArunsout,useyourHealthCareFSAforadditionaleligiblemedicalandprescriptiondrugexpenses.
• AlsouseyourHealthCareFSAfordentalandvisionexpenses.
End of plan year• HRAbalancerollsovertonextplanyearaslongasyouenrollintheValueorValuePlusCDHP.
• YouloseanyFSAdollarsleftinyouraccount.
Using Your HRAWiththeHRA,youcanpayforeligiblemedicalandprescriptiondrugexpenseswiththeADPSpendingAccountVISADebitCard.ItworksjustlikeadebitcardatanyeligibleserviceproviderwhoacceptsVISA,suchasthedoctor’sofficeorpharmacy.
New ADP Spending Account Visa debit cards will be issued for January 1, 2013. Watch for yours if you have an HRA and/or elect to contribute to an FSA!
How the CDHP, HRA and Health Care FSA Work Together
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Comparing Your Medical Plan OptionsThischartmayhelpyouthinkaboutyourplanoptionsfor2013.
Value CDHP Value Plus CDHPPremiums (your payroll contributions for coverage)
Lower Higher
Annual deductible Higher Lower
Annual out-of-pocket maximum Higher Lower
Network preventive care Coveredinfull Coveredinfull
Is everything paid at 100% after you reach out-of-pocket maximum?
No,youstillpayyourshareofallprescriptiondrugcostsandanyrequiredcopays
Health Reimbursement Arrangement
Yes,wemake$550–$1,400availablefor2013whenyoujointheplanandcompletethePersonalHealthAssessment.Youhavetheopportunitytoearnuptoanadditional$350byparticipatinginspecifiedwellness
activities(Seepage7formoredetails.)
Health Care FSA Youcansetasideupto$2,500foreligiblemedical,dentalandvisionexpenses
What happens to your HRA balance? UnusedHRAbalancesarecarriedforwardyear-to-yearaslongasyoustayatourCompanyandenrollintheValueCDHPorValuePlusCDHP
What happens to your Health Care FSA balance?
HealthCareFSAis“useitorloseit”attheendoftheplanyear,andmaybeusedonlyforexpensesyouhaveduringtheyear
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Thischartshowsyourcostformedicalcoverage.
Covered Services
Value CDHPIn-Network Only
Value Plus CDHPIn-Network Out-of-Network
Annual deductible• Individual• Family
• $1,750• $3,500
• $1,250• $2,500
• $2,500• $5,000
Out-of-pocket maximum*• Individual• Family
• $7,500• $10,000
• $4,500• $6,000
• $9,000• $12,000
Your Cost for Covered Services
Preventive care $0(planpays100%) $0(planpays100%) 35%afterdeductible
Office visits 40%afterdeductible 15%afterdeductible 35%afterdeductible
Maternity• Prenatalofficevisits• Hospital
• $0• $200copay,40%afterdeductible**
• $0• $200copay,15%afterdeductible**
• 35%afterdeductible• 35%afterdeductible
Emergency services• Medicalemergencyroom
• Non-emergency
• $200copay(waivedifadmitted)
• Notcovered
• $200copay(waivedifadmitted)
• Notcovered
• $200copay(waivedifadmitted)
• NotcoveredInpatient services• Facility/hospital
• Inpatientphysician
• $200peradmission,40%afterdeductible
• 40%afterdeductible
• $200peradmission,15%afterdeductible
• 15%afterdeductible
35%afterdeductible
Outpatient services• Facility/hospital
• Surgery• Therapy
• $100perservice,40%afterdeductible
• 40%afterdeductible• 40%afterdeductible
• $100perservice,15%afterdeductible
• 15%afterdeductible• 15%afterdeductible
35%afterdeductible
Prescription Drug Coverage (Express Scripts)
Retail• Formularygeneric• Formularybrand• Non-formulary
• $9copay• $40copay• $55copay
• $9copay• $40copay• $55copay
NotCoveredMail order (up to 90-day supply)• Formularygeneric• Formularybrand• Non-formulary
• $22.50copay• $100copay• $137.50copay
• $22.50copay• $100copay• $137.50copay
*Doesnotincludeannualdeductible.
**CopaywaivedifmotherenrollsintheHealthyPregnancyProgram.
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Using Network Providers Oneoftheeasiestwaystomanageyourhealthcarespendingistousenetworkproviderswheneverpossible.Withnetworkprovidersyou:
• Paylessinout-of-pocketexpensesforcare.
• Don’tneedareferralfromaprimarycarephysicianandcanseeanyprovideryouchoose(out-of-networkbenefitsarelower).
• Don’thavetofileclaims–networkprovidersbilltheplanforyou.
IfyouenrollintheValueCDHPorValuePlusCDHP,you’llhaveaccesstotheChoiceandChoicePlusnetworkproviders.TheValueCDHPallowsyoutoseein-networkprovidersonly.Ifyougooutsideofthenetworkforcare,youwillnothavecoverageexceptforlife-threateningemergencycare.WiththeValuePlusCDHP,youcanseebothin-networkandout-of-networkproviders.Keepinmindthatyouwillpaymorewhenyouusenon-UHCproviders.
Ifyouhavequestionsasyou’reconsideringyourplanoptionsorneedtofindaprovider,callUHCat1-800-996-0403,orgoonlinetowww.myuhc.com.Ifyou’renotalreadyenrolledinaUHCplan,gotothepre-memberwebsite,www.myuhc.com/groups/sava.
Paying for Doctor Office Visits Youpayforprimarycarephysicianandspecialistofficevisitsthesameasmostothercoveredservices–coinsuranceafteryoumeettheannualdeductibleforyourplan.Coinsurancemeansyoushareapercentageofthetotalcostofserviceswiththeplan.
Thechartshowsyourcostfordoctorofficevisits.
*Excludespreventivecare,includingwell-babycare,immunizationsandprenatalcarevisits.
For services subject to a deductible and coinsurance like doctor office visits, you should wait until UHC processes the claim before making any payment. While there may be times when you have to make payment up front – for example, at the hospital for expensive services – generally, you should not have to pay at the time of service, including at the doctor’s office.
Why Choose a Primary Care PhysicianHaving a physician who knows you can pay off in better health and lower costs. A primary care physician (PCP) can help reduce your risk of health problems by making sure you get the right preventive care and can offer the peace of mind that comes with getting advice from someone you know and trust.
Keep in mind, when you choose a doctor in the UHC ChoicePlus network, you’ll pay less from your pocket for medical expenses. Investing a little time in yourself – and in selecting and getting to know your doctor – can mean better health for you and more.
Service Before Deductible After DeductibleValue CDHP Value Plus CDHP
Adult PCP visit* $50–$150($93average)
$20–$60 $8–$23
Pediatrician visit* $52–$133($88average)
$21–$53 $8–$20
Specialist visit $50–$160($96average)
$20–$64 $8–$24
Thisexampleshowshowmuchyoucouldexpecttopayforanin-networkdoctor’sofficevisit,basedonnationalaverages:
Value Plus CDHP
In-Network: 15% after deductible
Out-of-Network: 35% after deductible
Value CDHP
In-Network care only: 40% after deductible
For example, if you have an in-network office visit that costs $93, your cost would be $93 before the deductible and $37 after the deductible (Value CDHP) or $13 after the deductible (Value Plus CDHP). If you contribute to a Health Care FSA, you can use contributions you make to your FSA to pay health expenses.
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Manage Your Prescriptions with Express ScriptsWithExpressScripts,youhaveaccesstoeverythingyouneedtomanageyourprescriptiondrugs.Youcanorderrefills,requestprescriptionrenewals,transferprescriptionsfromretailtomailorder,reviewyourprescriptionhistoryorviewandprintrelatedexpenses.Justcall1-866-527-8878orgotowww.express-scripts.comtogetstarted.
IfyouuseExclusiveHomeDelivery,ExpressScriptsoffersBillMeLaterTMwherequalifyingmemberscanpaynoworpaylater.
YouareencouragedtousemailorderthroughExpressScriptstopurchaseanyprescribeddrugsyoutaketotreatanongoingmedicalcondition,suchashighbloodpressure,highcholesterolordiabetes.Toreceiveprescriptiondrugbenefits,youmustusemailorderafterhavingamaintenancemedicationfilledtwotimesataretailpharmacy.Whenyouusemailorderyoucangeta90-daysupplyofyourmedicationatonetimeconvenientlythroughhomedelivery,ratherthanthe30-daysupplyavailableataretailpharmacy,plusyousavemoney!
Use Mail Order and SaveThisexampleshowshowmuchyoucouldsaveannuallybyusingmailordertofillyourmaintenancemedication.
Your Retail Cost (up to 30-day supply)
Your Mail Order Cost (up to 90-day supply)
Your Annual Savings
Formulary generic $9x12=$108 $22.50x4=$90 $18
Formulary brand $40x12=$480 $100x4=$400 $80
Non-formulary $55x12=$660 $137.50x4=$550 $110
It’s easy to order by mail. Choose one of two ways to start receiving your medications at home through Express Scripts:
1.Askyourdoctortowriteyoua90-dayprescription,plusrefillsforuptooneyear,ifappropriate.CompleteaHomeDeliveryorderformavailableontheExpressScriptswebsite.Includeyourprescription,selectyourpaymentoptionandmailittoExpressScripts.
2.GototheExpressScriptswebsiteandloginorregister,ifnecessary.Followtheinstructionsonthesiteto:
• Convertaprescriptiontohomedelivery.
• Fillanewprescriptionusinghomedelivery.
• Refillaprescription.
• Checkthestatusofahomedeliveryorder.
Onceyousubmitaninitialprescription,youcanrequestanyauthorizedrefillsonlineorbycallingthenumberonyourlastmailorderprescription.YourprescriptionwillbedelivereddirectlytoyourhomewithintwoweeksafterExpressScriptsreceivestheorder,withnochargeforstandarddelivery.
ExpressScriptsalsooffersanauto-refillservice,whichmakesiteasiertohaveprescriptionsrefilledbymail.
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UHC Plan Cost EstimatorWhenyouareconsideringmedicalplans,theUHCPlanCostEstimatorcanhelpyoutoestimateyourtotalcost:
• Yourcostofcoverage–whatyoupaythroughpayrolldeductiontobuycoverage.
• Yourcostofcare–alsocalledyourout-of-pocketcost–includingcopays,deductiblesandcoinsuranceamountsfortheoptionyouselectbasedontheservicesyouthinkyouwillreceiveandwhereyoureceiveyourcare.
Findoutyourownbottomlinefor2013:UsethePlanCostEstimatoravailableonthepre-memberwebsite:www.myuhc.com/groups/sava.
Togetstartedclick“PlanCostEstimator”underHealthCareCosts,thenfollowtheinstructions.
Whenyouarefinished,click“calculate”andthetoolwillestimateyourtotalcostforeachoption.Youcanmodelasmanyscenariosasyouneed.Ifyouthinkyoumaywanttorefertotheresultslater,printacopyoftheappropriatescreen,sinceyourPlanCostEstimatorsessionscannotbesavedelectronically.
If you want to compare the price of health care services after enrollment, check out the Treatment Cost Estimator on the UHC site. You can get general information about medical costs for procedures, services and treatments in your area. The tool can help you understand health care costs so you can work with your doctor to plan and budget for an upcoming treatment and participate more fully in managing your health care expenses.
For additional help in estimating the cost of procedures, services and treatments, go to healthcarebluebook.com.
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More Resources for Your Better Health from UHC and Express Scripts When you enroll in a UHC medical plan, you have access to a world of resources to help you find the answers and support you need.
Tools and Resources How Do I Get Started
Myuhc.com UHC’spersonalizedmemberwebsitegivesyouaccesstotoolsandinformationtomanageyourhealth.Youcan:• Comparehealthplancosts.• Chatonlinewitharegisterednurse.• Viewyourclaims.• Searchforhospitalsandphysicians.
Getstartedbyregisteringatwww.myuhc.com.
Click“RegisterNow,”enteryourinformationandbeginusingthesite.
NurseLineSM Getanswerstoyourhealthcarequestions24hoursaday,sevendaysaweekby:• Speakingtoaregisterednursewhocanhelpyoudetermineifthedoctor’soffice,urgentcarecenteroremergencyroomisthebestplacetoseekcarebasedonyourcondition.
• ListeningtoaudiorecordingsinUHC’shealthinformationlibrary.
1-877-643-5141
Healthy Pregnancy
Ifyou’reenrolledinaUHCmedicalplan,youoryourspousecanparticipateinUHC’sprenatalprogramandreceiveeducation,services,supportandincentivesformotherandbabythroughouttheentirepregnancy.Ifyouparticipateintheprenatalprogram,theCompanywillwaivethematernityhospitalcopayandyourshareofprescriptiondrugcostsforprenatalvitamins.
1-800-411-7984www.healthy-pregnancy.com
Treatment Decision Support
Aregisterednursewillhelpyoulearnabouttreatmentoptionsifyou’vebeendiagnosedwith:• Angina• BreastCancer• BenignProstateDisease• BackPain• ABenignUterineCondition• ProstateCancer,or• Ifyouneedahiporkneereplacement
1-888-866-8295
Cancer Support Program
Helpsyouandyourfamilymembersmakeinformeddecisionsaboutcancercare,includingwheretofindqualitytreatmentandhowtodealwiththephysicalandemotionalsideeffectsofcancer.UHCwillpairyouwithacancernurseadvocatewhowill:• Workwithyourtreatingphysician.• Helpyoumanageprescriptiondrugcostsbyreviewingmedicationsandcomparingcosts.
• Providesupportandeducationtohelpyouwiththeservicesyouneed.
Visitwww.optumhealth.com
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Tools and Resources How Do I Get StartedKidney Resource Services (End Stage Renal Disease Program)
ForUHCmembersdiagnosedwithstagefourEndStageRenalDisease,UHC:• Provideseducationandinformationtohelpyouunderstandandmanageyouroptions.
• Encouragesevaluationsforkidneytransplants.• Providessupporttoensurecompliancewithprescriptiondrugs,dietandadditionaltherapies.
• Pairsyouwithnurseadvocateswhoprovidetreatmentsupportandhelpmanagingyourcondition.
Visitwww.optumhealth.com
Emergency Room Decision Support
Ifyouvisittheemergencyroom(ER)fornon-emergencies,UHCwillhelpensurethatyouknowallofyouralternativesforseekingcareby:• Connectingyouwithaprimarycaredoctorforfollowupcare.• ProvidinginformationaboutUHC’sNurseLineSM,urgentcareandconveniencecarecenters.
• OfferingadditionalresourcesifyouvisittheERfrequentlyforachronicconditionorbehavioralhealthneed.
You’llbecontactedbyUHC.
Express Scripts Gethelpmanagingyourprescriptions.Youcan:• Orderrefills.• Requestprescriptionrenewals.• Transferprescriptionsfromretailtomailorder.• Reviewyourprescriptionhistory.
1-866-527-8878Visitwww.express-scripts.com
Employee Assistance Program (EAP) through Bensinger Dupont & Associates (BDA)Youandyourfamilymembershave24/7accesstolicensedprofessionalsprovidingconfidentialsupportandguidancewithpersonalissuesthataffectyourhealth,familylife,worklifeorjobperformance.TheEAPisofferedatnocosttoyou.FormoreinformationabouttheEAP,callBensingerDupont&Associates(BDA)at1-866-757-3271orgotowww.eapadvantage.comandenterthepassword:plus.SeeWork/LifeBalanceBenefitsonpage28fordetails.
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Our Company provides a wellness program, designed to encourage healthy behavior and choices. For 2013, the program will be administered by Carewise Health and will feature incentives.
Complete all incentive activities and our Company will contribute up to $900 for employee only coverage and $1,750 if you cover yourself and dependents . Once you complete activities during the plan year to earn incentives, Carewise will process the activity’s completion . Once processing is complete, your incentive dollars will be added to the HRA .
Note: All incentives are for an employee completing the listed tasks. Spouses and domestic partners who are enrolled in the Value or Value Plus CDHP are welcome to participate in these wellness initiatives but will not earn incentives for doing so.
Wellness and Incentives Program
Here’s how it works:
When you enroll in the Value CDHP or Value Plus CDHP and …
Complete the confidential Personal Health Assessment:• until January 31, 2013 if you enroll during
annual enrollment• within30daysafteryouenrollasanewhire
You earn core incentive dollars to your HRA:• $550ifyoucoveryourselfonly• $1,400ifyoucoveryourselfanddependentsCore incentive dollars will be prorated based on your effective date of coverage.
Enroll in a wellness program supported by a Carewise coach, if you’re identified and invited to participate based on your Personal Health Assessment results
OREnroll in a Carewise online wellness program, if you’re not identified for coaching support
You earn additional incentive dollars to your HRA:
$100
Complete coaching session or online wellness program (or be enrolled for at least six months)
$100
Complete a biometric screening for key health indicators, like blood pressure, cholesterol and diabetes, and have your doctor validate the results during the plan year
$150
For more information about the wellness and incentives program, visit takecare.carewisehealth.com or call 1-888-355-7268. You can also link to the web site from the TakeCare Benefit Site.
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Carewise Health ResourcesCarewiseHealthoffersahostofresourcesthatprovideone-on-onewellnesssupportforouremployeesandspousesordomesticpartnerswithaCarewiseHealthcoach.EveryoneenrolledinaUHCmedicalplanwillbeeligiblefortheresourcesprovidedbyCarewise.
Lifestyle Coaching Support (online or by phone):•Nutritionmanagement
•Smokingcessation
•Stressmanagement
•Weightmanagement
•Physicalactivity
•Cholesterolmanagement
•Bloodpressuremanagement
•Careforyourback
•Overcomingdepression
Condition Management Support: •Asthma
•AtrialFibrillation
•COPD
•CongestiveHeartFailure
•CoronaryArteryDisease
•Diabetes
•HighBloodPressure
•HighCholesterol
•LowBackPain
•Stroke/TIA
Carewisealsoprovidescoachingsupportbyphoneforriskfactorslinkedtodiseases,suchasdiabetes,hyperlipidemia,hypertensionandobesity.To learn more about the resources offered through Carewise Health, visit takecare.carewisehealth.com or call 1-888-355-7268.
Important Legal InformationReconstructive Surgery After a MastectomyIfyouarereceivingmedicalbenefitsinconnectionwithamastectomy,federallawguaranteesyoucoverageforthefollowingprocedureswhendoneinconnectionwithamastectomy:
• Reconstructionofthebreastonwhichthemastectomywasperformed.
• Surgeryandreconstructionoftheotherbreasttoproduceasymmetricalappearance.
• Treatmentofphysicalcomplicationsinallstagesofmastectomy,includinglymphedema.
• Mastectomybrasandexternalprostheseslimitedtothelowestcostalternativeavailablethatmeetsthepatient’sphysicalneeds.
Maternity StaysFederallawrequiresmedicalplanstocovermaternityhospitalstaysofatleast48hoursforthenormaldeliveryofababyandatleast96hoursforacesareansection.Thisappliestocoverageforboththemotherandthenewborn.Motherscangohomesooner,ofcourse,iftheirdoctorsapproveanditissafetodoso–butthepointofthelawisthataninsuranceplancannotrequirethemtobedischargedsooner.
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Your 2013 Per Pay Period Cost for Medical CoverageValue CDHP Value Plus CDHP
TobaccoUser
Non-tobaccoUser
TobaccoUser
Non-tobaccoUser
Employee only $80.00 $67.50 $172.00 $159.50
Employee + spouse $206.50 $181.50 $398.50 $373.50
Employee + child(ren) $178.50 $166.00 $346.00 $333.50
Employee + family $265.00 $240.00 $551.00 $526.00
Domestic partner adult $126.50 $114.00 $226.50 $214.00
New for 2013: Non-tobaccouserswillpayalowerratethantobaccousers.IfyouelectEmployee+SpouseorFamilycoverage,bothadultscoveredbytheplanmustbenon-tobaccouserstoreceivethelowerrate.
Keep in mind that you can enroll your spouse/domestic partner in medical coverage only if he or she does not have access to other medical coverage, for example, through his or her employer’s coverage.
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Find a participating network dentist, get definitions to unfamiliar dental terms and more at www.cigna.com. Once your dental coverage becomes effective, you can register at www.mycigna.com for access to secure, personalized dental benefits information.
Dental CoverageGood dental health is important to your overall health and well-being. Our Company’s dental plans provide coverage for preventive and diagnostic, basic and major dental care. Orthodontia is also covered for eligible children only. Cigna administers the dental plan. You have two coverage options: Plan A and Plan B.
Using Network Dentists Eachtimeyouneeddentalcare,youcanchooseanyprovideryouwant.Theplanspaythesamepercentageofyoureligibledentalexpenseswhetheryouuseanetworkorout-of-networkdentist.WhenyouusetheCignanetworkdentists,however,youbenefitfromlower,discountedcostsforservices.Ifyouusedentistsoutsidethenetwork,youmaybebilledforthedifferencebetweenthepaymenttheyreceiveandtheirusualfees.
How the Plan Pays
ServicesPlan A Plan B
Network Non-Network Network Non-Network
Deductible $50/individual;$150/family $50/individual;$150/family
Plan Year Maximum $1,750/personperplanyear
(combinedin-andout-of-network)
$1,000/personperplanyear
(combinedin-andout-of-network)Covered ServicesPreventive and Diagnostic Care 100%,nodeductible 100%,nodeductible
Basic Care, including fillings and extractions
80%,afterdeductible 80%,afterdeductible
Major Care, including bridges, dentures and crowns
60%,afterdeductible 50%,afterdeductible
Orthodontia 50%,noseparatedeductible,
upto$1,750perpersonlifetimemaximum
100%,noseparatedeductible,
upto$750perpersonlifetimemaximum
Your 2013 Per Pay Period Cost for Dental CoveragePlan A Plan B
Employee only $14.78 $11.80
Employee + spouse $31.21 $23.88
Employee + child(ren) $39.94 $30.56
Employee + family $55.13 $42.18
Domestic partner adult $16.43 $12.08
Domestic partner + child(ren) $25.16 $18.77
Domestic partner adult + family $40.35 $30.38
To find a participating network dentist, go to www.cigna.com and search for providers in Cigna’s Radius network.
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Vision CoverageTo keep you seeing your best, our Company provides coverage for eye exams, frames, lenses and contact lenses. You have two coverage options:• LowOption,offeredthroughUnitedHealthcareVision
• HighOption,offeredthroughVSP
Eachtimeyouneedcare,youarefreetochoosein-networkorout-of-networkproviders,butyoureceivethehighestlevelofbenefitswhenyouuseUnitedHealthcareVisionorVSPproviders.
How the Plan Pays
ServicesIn-Network Out-of-Network
UHC Low Option VSP High Option UHC Low Option VSP High Option
Exam – once every 12 months 100%after$10copayfortheexam;
$25formaterials
$40 $44
Lenses – once every 12 months (glass or plastic, single/multi-vision)
100%aftercopay
• Coveredlensoptions:progressive,polycarbonate,photochromic/transition,solid/gradienttints.Anti-reflectivecoatingforhighoption.
• Otherlensoptions:20%discount
• $40–singlevision• $60–bifocals• $80–trifocals• $80–lenticular
• $32–singlevision• $48–bifocals• $64–trifocals• $100–lenticular
Second pair benefit Notcovered Sameasfirstpairbenefitorcontacts
Notcovered
Frames – once every 24 months
$130allowance $150allowance $45 $38.25
20%discountonoverage
Elective contact lenses $125allowance $150allowance $125 $100
Discounts 15-20%offselectservices N/A
Your 2013 Per Pay Period Cost for Vision CoverageUHC Low Option VSP High Option
Employee $3.15 $8.63
Employee + spouse $5.98 $15.32
Employee + child(ren) $6.28 $16.13
Employee + family $9.65 $28.00
Domestic partner adult $2.83 $6.69
Domestic partner + child(ren) $3.13 $7.50
Domestic partner adult + family $6.50 $19.38
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Take the time to learn more about how FSAs work. Because you lose dollars left in your FSA at the end of the plan year, be sure to use your dollars throughout the year.
Flexible Spending AccountsOur Company offers two accounts that can help you save money on everyday health care and dependent care expenses. FlexibleSpendingAccounts(FSAs)cansaveyoumoneybyallowingyoutousebefore-taxdollarstocovercertainexpenses.YouhaveaccesstotwodifferenttypesofFSAs:
• The Health Care FSAletsyousetasideupto$2,500forspecificeligiblehealthcareexpensesforyouandyoureligibledependents,suchascopays,prescriptionsandmore.Seepage21.
• The Dependent Day Care FSAletsyousetasideupto$5,000forspecificadultorchilddaycareexpenses,suchasdaycare,nurseryschooloreldercare.Seepages23-24.Note:TheDependentDayCareFSAisNOTavailableforyourdependents’healthcareexpenses.
With Both FSAs: • Youdecidehowmuchtocontributeeachyear;participationisvoluntary.YoumakedecisionsabouteachFSAseparately,andyoucancontributetooneorbothFSAsordecidenottoparticipateineitheraccount.
• Thecontributionsaretakenfromyourpayinequalinstallmentsthroughouttheyearanddepositedintoyouraccount.
• ContributionsaretakenfromyourpaybeforefederalincomeandSocialSecuritytaxesaredeductedfromyourpaycheck.Inmanycases,youalsoavoidstateandlocalincometaxes.Before-taxcontributionsloweryourtaxableincomeandreducetheamountyoupayintaxeseachyear.
• Whenyouincureligiblehealthcareanddependentcareexpenses,youcandrawfromyouraccounttocoverthoseexpenses.Yourcostfortheseeligibleexpensesislower,sinceyoucoverthemwithbefore-taxdollars.
Important: As you consider contributing to an FSA, estimate your expenses carefully and keep these rules in mind:
• InexchangeforthetaxbenefitsassociatedwithFSAs,IRSruleslimittheamountoftimeyouhavetousethemoneyinyouraccount.Youforfeitanymoneyleftinyouraccountattheendoftheplanyear–expensesmustbeincurredbetweenJanuary 1 and December 31, 2013,andsubmittedbyFebruary 28, 2014tobereimbursed.
• YoucannotchangeyourFSAcontributionamountsduringtheyearunlessyouexperienceaqualifyingchangeinstatus(seepage4).
• YoumaynottransfermoneybetweentheHealthCareandtheDependentDayCareFSA.MoneyinyourHealthCareFSAcannotbeusedtoreimburseyourselfforDependentDayCareexpenses,andviceversa.
• Toreimburseyourselfforhealthcareexpensesyouhaveduringtheplanyear,youmustbecontributingtoanFSAatthetimeyoureceivetherelatedeligibleservicesandarecoveredundertheplan.
New ADP Spending Account Visa debit cards will be issued for January 1, 2013. Be sure to watch for it if you elect to contribute to an FSA!
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Estimate Your Expenses Carefully: ADP Can Help TheContributionCalculatoronwww.myshps.com/fsa/contributions.stmcanhelpyoudeterminehowmuchtocontributetotheHealthCareFSAsfor2013basedonyourestimatedout-of-pocketexpenses.ThiscalculatordoesnottakeintoaccountwellnessincentiveHRAdollars,somakesuretofactorthatintoyourfinaldecisionforyourHealthCareFSAcontributions.
Managing Your Health Care FSAIf you contribute to an FSA, you can access your benefits account online for instant access to your account statements, activity, balances, claims and payments made. Visit www.takecarebenefitsite.com, click on the link in the Online Access section, enter your user name and password (same as myPay) and then click on the Flexible Spending Account link. By providing ADP with your email address, you’ll automatically receive an email each quarter when your account statement is ready for viewing. If you do not provide your email address, you will receive a quarterly account statement via U.S. mail. In addition, you will also receive a validation request form on a bi-monthly basis if your expenses need to be verified based on the IRS regulations. You will receive more information about your FSA after you enroll.
How the Health Care FSA Works Youcancontributeupto$2,500perplanyear(January1–December31)totheHealthCareFSAthroughpre-taxpayrollcontributions.
• Duringenrollment,youdecidehowmuchtocontributefortheperiod.
• Theentireannualamountyoudecidetocontributeforthisplanperiodisavailableatthestartoftheplanyear.
• Onceyouraccountisopened,you’llreceiveaVISAdebitcardtopayforyoureligiblehealthcareexpensesthroughouttheyear.
Health Care FSA Eligible Expenses YoucanusetheHealthCareFSAtocovereligiblehealthcareexpensesnotcoveredbyyourmedical,dentalorvisionplans.Remember,ifyouenrollintheValueCDHPorValuePlusCDHPandplantoopenaHealthCareFSAaswell,besuretoestimatecarefully,andfactorinanyHRAdollarsyoumayhaveintotheamountyouplantocontributetoyourHealthCareFSA.See ADP Spending Account VISA Debit Card fordetails.
Some Eligible Expenses Some Expenses Not Eligible
Moneycanbesetasidefor:
• Deductibles
• Copayments
• Dental
• VisioncareexpensesincludingLasik
• Orthodontianotcoveredbyadentalplan
• Prescriptiondrugs
• Chiropracticvisits
• Proceduresorexpensesthataremedicallynecessary
• Doctorprescribedweightlossprograms
TheIRSliststhesenon-eligibleexpenses:
• Cosmeticprocedures
• Yourcontributionsforoutsidehealthorlifeinsurance
• Employermedicalpremiumsofanykind
• Proceduresorexpensesnotmedicallynecessary
• Weightlossprogramsnotprescribedbyadoctor
• Medicationswithoutadoctor’sprescriptionotherthaninsulin
Go to www.myshps.com/fsa/contributions.stm for a complete list of eligible expenses for the Health Care and Dependent Day Care FSAs.
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Use It or Lose It TheIRSrequiresthatanyremainingbalanceinanFSAbeforfeitedattheendoftheplanyear.Plancarefullytominimizetheriskofforfeitinganymoney–becarefulofhowmuchyousetasideinthefirstplace,andkeepaneyeonyouraccountbalanceastheplanyeargoesby.
ADP Spending Account VISA Debit CardWhenyouenrollinaHealthCareFSA,youreceiveanADPSpendingAccountVISADebitCardthatworksjustlikeadebitcardtopayforeligibleexpensesatanyeligibleserviceproviderwhoacceptsVISA,suchasthedoctor’sofficeorpharmacy.
WiththeADPSpendingAccountVISADebitCard:
• Youdon’thavetopaydollarsoutofyourpocket.
• Youdon’thavetowaitforreimbursement.
• Youhavenoclaimformstofile–butshouldstillkeepyourreceiptswithyourtaxinformationincaseyouarequestionedbytheIRS.
• Yougetimmediateaccesstoyourspendingaccount.
Claim Submission Is SimpleYoucansubmitspendingaccountreimbursementreceiptsonline.Visitwww.takecarebenefitsite.com,clickonthelinkintheOnlineAccesssection,enteryourusernameandpassword(sameasmyPay)andthenclickontheFlexibleSpendingAccountlink.YouwillbeabletofindFSAreimbursementformshere.Enteryourclaiminformationanduploadscannedimagesofyourreceipts,orselecttoreceiveacompletedclaimformviaemail.Theonlineclaimsubmissionprocessisthemostefficientandquickestwaytogetyourmoneyback.Youcanalsofaxormailyourclaimsto:
ADPSpendingAccountsP.O.Box24700Louisville,KY40232Fax:1-866-643-2219
Remember: You can use your ADP Spending Account VISA Debit Card at any eligible service provider, such as Walgreens. Use your card to pay eligible expenses at the time of service. ADP will automatically pay the expense. Keep your receipt in case you need to provide proof to ADP that the expense was eligible for reimbursement under our Company’s plan.
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How the Dependent Day Care FSA WorksYoumaycontributeupto$5,000ifyouaresingleorifyouaremarriedandfileajointincometaxreturn(ifyouaremarriedandfileseparately,youcancontributeupto$2,500peryear).
• Duringenrollment,youelecthowmuchtocontributefortheyear.
• Theentireamountyouelectwillnotbeavailableup-front,liketheHealthCareFSA.You’llonlyhaveaccesstothefundsastheyaredeductedfromyourpaycheckeachpayperiod.
• LiketheHealthCareFSA,youforfeitanydollarsleftinyouraccountattheendoftheplanyear.
Could the Dependent Day Care FSA Help You?When deciding if the Dependent Day Care FSA is right for you, consider:
• Will my child need day care for 2013?
• Is my parent a dependent for tax purposes, and does he or she attend adult day care?
KeepinmindthatanyexpensespaidthroughtheDependentDayCareFSAreducetheamountyouareeligibletoreceiveunderthefederalchildcaretaxcredit.IfyouareconsideringenrollingintheDependentDayCareFSA,takethetimetocomparethetaxbenefitsoftheFSAandthefederalchildcaretaxcredittodeterminewhichworksbestforyou.
Definition of Eligible Dependents for Dependent Day Care FSAsEligible dependents for Dependent Day Care FSA purposes are determined by the IRS and generally include:
• Any dependent child under age 13 who qualifies as your dependent on your federal income tax return.
• Anyone (including an adult) you claim as a dependent for federal income tax purposes who is physically or mentally unable to care for himself/herself, resides with you for more than half the year.
Dependent Day Care FSA Eligible Expenses YoumayuseyourDependentDayCareFSAtocoveradultorchilddaycare,nurseryschoolorsummercampforyoureligibledependents.Tobeeligibleforreimbursement,thecaremustenableyou(andyourspouse,ifyouaremarried)towork,lookforworkorattendschoolfull-time.Youmustsubmitaclaimforeligibleexpenses,afterwhichyoucanchoosetoreceiveacheckforreimbursementsorhavetheamountsdirectlydepositedintothebankaccountofyourchoice.
Some Eligible Expenses Some Expenses Not Eligible
Moneycanbesetasidefor:
• Paymentstolicenseddaycareproviders.
• Paymentstoindividuals,includingrelatives,whoprovidecareinoroutsideyourhome(otherthanyourdependentsoryourchildrenunderage19).
• Expensestopayforanannywhoprovidesservicesinyourhome.
• Summerdaycamptuition.
TheIRSliststhesenon-eligibleexpenses:
• Careprovidedbyyourspouseordomesticpartner,yourchildrenunderage19oranyotherdependent.
• Careprovidedfornon-workrelatedreasons.
• Expensespaidtoahousekeeper,maid,cook,etc.,unlessspecifictothecareofyourdependent.
• Overnightcamp.
• Medical,prescriptiondrug,dentalorvisionexpensesforyourdependent.
Remember, the Dependent Day Care FSA cannot be used for health care expenses.
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Using Your Dependent Day Care FSAToaccessyourDependentDayCareFSAfunds,youmustfileaclaim–thereisnocardavailableforthisaccount.Youcansubmitspendingaccountreimbursementreceiptsonline.Visitwww.takecarebenefitsite.com,clickonthelinkintheOnlineAccesssection,enteryourusernameandpassword(sameasmyPay)andthenclickontheFlexibleSpendingAccountlink.YouwillbeabletofindFSAreimbursementformshere.Enteryourclaiminformationanduploadscannedimagesofyourreceipts,orselecttoreceiveacompletedclaimformviaemail.Theonlineclaimsubmissionprocessisthemostefficientandquickestwaytogetyourmoneyback.Youcanalsofaxormailyourclaimsto:
ADPSpendingAccountsP.O.Box24700Louisville,KY40232Fax:1-866-643-2219
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Income Protection Plans: Life, Accidental Death and Dismemberment and Disability
To ensure that you have financial protection in the face of unforeseen events, our Company provides basic life insurance, accidental death and dismemberment (AD&D) insurance and long-term disability (LTD) coverage insurance options through Lincoln Financial.
Basic Life Insurance Onceyou’reeligible,youautomaticallyreceivebasiclifeinsuranceatnocosttoyou.Youdonotneedtoenrollforthisbenefit;however,youdoneedtodesignateabeneficiary.Yourbasiclifecoverageisequaltoonetimesyourannualbaseearnings,upto$750,000.
Benefit coverage amounts and premiums for the 2013 plan year are based on your age and salary as of July 1, 2012 for basic life, AD&D, supplemental life and long-term disability coverage. Under federal law, you are taxed on the value of any employer-provided life insurance in excess of $50,000. This taxable income, or “imputed income,” will be shown on your pay stub and on your year-end W-2 form.
Accidental Death and Dismemberment Coverage (AD&D) YoumaypurchaseAD&Dcoverageforyourself,withorwithoutsupplementallifeinsurance.Youcanchooseacoveragelevelofone,twoorthreetimesyourannualbaseearnings.Youpaythecostofcoveragewithpost-taxdollars.Yourcoverageisreducedto50%atage70.
Supplemental Life Insurance For You
Youcanchooseacoveragelevelofone,two,three,fourorfivetimesannualbaseearnings,upto$1,000,000.Themaximumbenefityoucanreceiveissixtimesyourbaseearningsforbasicandsupplementallifeinsurancecombined.Youpaythecostofcoveragewithpost-taxdollars.
Age Rate per $1,000Non-Tobacco Tobacco
<30 $0.095 $0.12030-34 $0.104 $0.13035-39 $0.112 $0.14040-44 $0.149 $0.19045-49 $0.250 $0.31050-54 $0.382 $0.48055-59 $0.570 $0.71060-64 $0.980 $1.23065-69 $1.721 $2.15070-74 $2.870 $3.59075+ $5.770 $7.210
Your Cost for AD&D Coverage
Monthlyrate:$.025per$1,000
Basic life insurance, AD&D and supplemental life insurance coverage amounts are reduced to 50% at age 70. The spouse dependent life coverage amount is also reduced to 50% at age 70.
Note: Tobacco use is defined as using any form of tobacco product within the last 12 months.
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Naming a BeneficiaryBe sure to name a beneficiary for your life and AD&D insurance coverage, review designations periodically and make updates when needed. If you do not name a beneficiary for your company provided coverage combined with any elected supplemental life and AD&D insurance, your benefit will be paid according to applicable insurance rules.
If you choose supplemental life coverage for your family, you will automatically be the beneficiary of that coverage.
For Your FamilyYoucanchoosefromtwooptions:
• Option1withorwithoutsupplementallifeinsuranceforyourself.
• Option2withsupplementallifeinsuranceforyourselfifyouwantdependentcoverage.
You must have supplemental life coverage for yourself if you choose Option 2.
Option 1 Option 2
Spouse/Child Dependent Life Spouse Supplemental LifeCoveryourspouse/domesticpartnerandyourchildren:
• $15,000spouse/domesticpartner
• $10,000foryourchildagesixmonthstoage19(uptoage25,ifafull-timestudent)
• $1,000foryourchildage14daystosixmonths
Monthly rate: $5.00
Coveryourspouse/domesticpartnerand/oryourchildren.Foryourspouse,choosefrom:.5,1,1.5,2and2.5timesyourannualbaseearningsupto$200,000or50%ofyourelection.
Monthly rate: (per $1,000)
<3030-3435-3940-4445-4950-5455-5960-6465-6970-7475+
$0.095$0.104$0.112$0.149$0.250$0.382$0.570$0.980$1.721$2.870$5.770
Rates and coverage amounts are calculated using your spouse’s/domestic partner’s age and your annual base salary as of July 1 of the previous plan year.
And/Or
Child Dependent Life
Foryourchildren:
• $10,000foryourchildagesixmonthstoage19(uptoage25,ifafull-timestudent)
• $1,000foryourchildage14daystosixmonths
Monthly rate: $3.00
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Evidence of Insurability (EOI) EvidenceofInsurability(EOI)willberequiredtopurchasesupplementallifeinsuranceifyouwanttopurchasecoverageover$250,000.NewhiresmustenrollwhenfirsteligibletoavoidEOIatfutureenrollmentevents.Ifyoudon’trespondtotheEOIrequestwithin30days,yourrequestedcoverageamountwillbedeclined.
When Evidence of Insurability (EOI) Is RequiredCoverage for EOI is not required if you EOI is required if you
You • Electcoveragewhenyouarefirsteligibleoryouenrollduringthisannualenrollmentopportunity.
• Wanttoincreasecoverageandtotalcoverageislessthan$250,000.
• Electcoverageafteryourinitialeligibilityperiodorafterthisannualenrollment.
• Wanttoincreasecoverageabove$250,000.• HadapreviouselectiondeclinedbyLincolnFinancial,regardlessofcoverageamount.
Spouse/domesticpartner • Electcoverageunder$50,000 • Electcoverageof$50,000ormore
Child(ren) •EOIisnotrequired.
Short-Term DisabilityLincolnshort-termdisability(STD)insurancereplacesaportionofyourincomewhenyouarerecoveringfromacoveredcondition,includingillness,childbirth,injuryorsurgery.
Benefitsofupto$1,500perweekbeginafterawaitingperiodandlastupto26weeks.Thefollowingoptionsareavailabletoyou:
Amount of pay replaced
When the benefit begins How long the benefit lasts
Option1 40% 7thdayofillnessorinjury 26weeksOption2 40% 14thdayofillnessorinjury 24weeksOption3 40% 30thdayofillnessorinjury 22weeksOption4 60% 7thdayofillnessorinjury 26weeksOption5 60% 14thdayofillnessorinjury 24weeksOption6 60% 30thdayofillnessorinjury 22weeks
ThepremiumyoupaydependsonwhichSTDoptionyouchooseandyourage.Multiplyyourweeklypaybythepremiumfactorshowninthetableabovetogetyourestimatedsemi-monthlypremium.Youpaythecostofcoveragewithpost-taxdollars.
Note: You may be required to provide Evidence of Insurability (EOI) to elect or increase coverage during future enrollments. During this annual enrollment, be sure to evaluate your life insurance needs, and for additional coverage, take advantage of the opportunity to elect or increase coverage without EOI.
Line Employees Non-Line EmployeesUp to Age 49
Ages 50 to 69
Up to Age 49
Ages 50 to 69
Option1 0.03300 0.04100 0.0308 0.0388Option2 0.02420 0.03220 0.0226 0.0300Option3 0.01660 0.02460 0.0154 0.0230Option4 0.04950 0.06210 0.0462 0.0582Option5 0.03630 0.04830 0.0339 0.0450Option6 0.02490 0.03690 0.0231 0.0345
When calculating your premium, your age and salary as of July 1, 2012 will be used.
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Yourdisabilitybenefitsmaybereducedbyothersourcesofincome,suchasSocialSecurityandWorkers’Compensation.Anylong-termdisabilitybenefitsyoureceivearenottaxed.
Youpaythecostofcoveragewithpost-taxdollars.
Evidence of Insurability (EOI) EvidenceofInsurability(EOI)willberequiredtopurchaselong-termdisabilitycoverageifyourenrollmentwaspreviouslydeclinedbyLincolnFinancial.Ifyoudon’trespondtoLincolnFinancial’srequestforEOIwithin30days,yourcoveragerequestwillbedeclined.
Fornewhires,ifyouenrollwhenfirsteligible,youwillnotneedtoprovideEOI.
Your Cost for Long-Term Disability Coverage (Line Staff)
Age Rate per $100 of monthly base salary
<24 $0.22
25-29 $0.27
30-34 $0.42
35-39 $0.50
40-44 $0.53
45-49 $0.61
50-54 $0.79
55-59 $1.07
60-64 $1.15
65-69 $2.06
70+ $2.06
Your Cost for Long-Term Disability Coverage (Non-Line Staff)
Age Rate per $100 of monthly base salary
<20 $0.15
20-24 $0.15
25-29 $0.18
30-34 $0.35
35-39 $0.44
40-44 $0.57
45-49 $0.76
50-54 $1.00
55-59 $1.29
60-64 $0.93
65-69 $0.93
70+ $0.50
Note: You may be required to provide Evidence of Insurability (EOI) to purchase coverage during future enrollments. During this annual enrollment, be sure to evaluate the long-term disability benefit and take advantage of the opportunity to purchase coverage without EOI.
Long-Term Disability Youcanpurchaselong-termdisabilitytohelpreplaceaportionofyourpayifyouareunabletoworkduetoaninjuryorillness.Thefollowingchartshowsyourbenefitamount.Youareeligibleforlong-termdisabilitycoverageifyouareactivelyatworkandworktherequiredhoursforyoureligibilityclassdescription.Coveragewillend90daysfromyourlastdayofwork.Yourdisabilitycoveragemaybeportableorconverted,oryoumayapplyforawaiverofpremium.
Line Staff* Non-Line Staff*Monthlybenefitamount 60%ofyourmonthlybaseearningsupto
$5,00060%ofyourmonthlybaseearningsupto$7,500
Whenbenefitsbegin 181stdayofdisability 181stdayofdisability
Howlongbenefitslast Twoyears UptoSocialSecuritynormalretirementage–age65orlaterdependingonyourbirthdate
*IfyouarenotsurewhetheryouareLineStafforNon-LineStaff,contactyourHRCoordinatortoverifyyourstaffingcategory.
You may not be eligible for benefits if you have received treatment for a condition within the past six months until you have been covered under this plan for 12 months
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Voluntary BenefitsForadditionalcoverage,ourCompanyofferstheopportunitytoenrollinvoluntarybenefitsthroughLincolnFinancial.
Accident InsuranceLincolnAccidentinsurancepayscashifyouorafamilymembersuffersanaccidentalinjury.Youmaychoosefromtwoplans(ChoiceorPreferred)andtwolevelsofcoverage(baseorbuy-up):
Choice Plan Preferred PlanEmergency care• Ambulance/AirAmbulance $150/$600 $250/$1,200• Initialphysicianofficevisit/ERvisit $50/$150 $80/$170• Majordiagnosticcare $100 $200Treatment care• Hospitaladmission $1,000 $1,300• Hospitalcaredailybenefit $200 $250• Intensivecaredailybenefit $400 $600Fractures• Nonsurgical $50–$2,500 $125–$3,000• Surgical $100–$5,000 $250–$6,000Specific injuries or treatments• Transfusions $150 $200• Burns $100–$6,400 $250–$16,000• Skingrafts Additional25% 25%ofburnbenefit• Jointreplacement $1,500–$2,000 $2,500–$3,000• Coma $2,000 $5,000• Concussion $100 $200• Surgery $250–$1,000 $350–$1,300Transitional care benefits• Crutches,wheelchair,walker $25–$350 $50–$700• Prosthesisperlimb/device $500 $1,000
Inadditiontohelpincoveringyourcosts,accidentcoverageincludestelephoneandonlineconfidentialcounselingservicesforpersonalmattersifyousufferanaccident.Theplanalsocomeswithtravelassistancesuchastravelplanningandfreeemergencymedicalhelpwheneveryoutravelmorethan100milesfromhome.
Accident Insurance semi-monthly premium
Choice Plan Preferred PlanAccident base coverageEmployeeonly $8.47 $12.51Employee+spouse $11.86 $17.45Employee+child(ren) $14.35 $21.12Employee+family $18.99 $27.91Accident buy-up coverage to include sickness hospital confinement benefit (premiuminadditiontobasecoverage)Employeeonly $2.05 $2.05Employee+spouse $4.09 $4.09Employee+child(ren) $3.48 $3.48Employee+family $5.71 $5.71
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Critical Illness InsuranceLincolnCriticalIllnessinsuranceprovidesaspecificdollaramounttohelpwithextraexpensesassociatedwithyourrecoveryfromcertaintypesofillnesses,includingheartattack,stroke,invasivecancer,organfailure,Alzheimer’s,Parkinson’sdiseaseandmore.
Employee Spouse Child(ren)Amount of coverage you may purchase
$10,000,$20,000,$30,000,$40,000or$50,000
$10,000,$20,000or$30,000
$10,000
Guarantee Issue (amountyoumaypurchasewithoutevidenceofinsurability)
$30,000 $15,000 $10,000
Benefit reduction at age 70 50%*Whenyouelectemployeecoverage,youautomaticallyreceive$10,000ofcoverageforyourchild(ren).
Premiumsvarydependingontheamountofcoverageyouchoose,yourageasofJuly1,2012,yourspouse’sage(ifyouchoosecoverageforyourspouse)andwhetheryouareatobaccouserornot.
Semi-monthly premium per benefit amount for employeeIssue Age
Non-Tobacco Tobacco$10,000 $20,000 $30,000 $40,000 $50,000 $10,000 $20,000 $30,000 $40,000 $50,000
17–25 $2.63 $5.26 $7.89 $10.52 $13.15 $3.49 $6.98 $10.47 $13.96 $17.4526–30 $3.21 $6.42 $9.63 $12.84 $16.05 $5.43 $10.86 $16.29 $21.72 $27.1531–35 $4.22 $8.44 $12.66 $16.88 $21.10 $7.59 $15.18 $22.77 $30.36 $37.9536–40 $5.69 $11.38 $17.07 $22.76 $28.45 $10.84 $21.68 $32.52 $43.36 $54.2041–45 $8.16 $16.32 $24.48 $32.64 $40.80 $15.47 $30.94 $46.41 $61.88 $77.3546–50 $10.85 $21.70 $32.55 $43.40 $54.25 $21.49 $42.98 $64.47 $85.96 $107.4551–55 $14.27 $28.54 $42.81 $57.08 $71.35 $29.10 $58.20 $87.30 $116.40 $145.5056–60 $18.75 $37.50 $56.25 $75.00 $93.75 $38.06 $76.12 $114.18 $152.24 $190.3061–65 $22.88 $45.76 $68.64 $91.52 $114.40 $47.17 $94.34 $141.51 $188.68 $235.8566–70 $23.96 $47.92 $71.88 $95.84 $119.80 $48.79 $97.58 $146.37 $195.16 $243.95
Semi-monthly premium per benefit amount for spouseIssue Age
Non-Tobacco Tobacco$10,000 $20,000 $30,000 $10,000 $20,000 $30,000
17–25 $2.63 $5.26 $7.89 $3.49 $6.98 $10.4726–30 $3.21 $6.42 $9.63 $5.43 $10.86 $16.2931–35 $4.22 $8.44 $12.66 $7.59 $15.18 $22.7736–40 $5.69 $11.38 $17.07 $10.84 $21.68 $32.5241–45 $8.16 $16.32 $24.48 $15.47 $30.94 $46.4146–50 $10.85 $21.70 $32.55 $21.49 $42.98 $64.4751–55 $14.27 $28.54 $42.81 $29.10 $58.20 $87.3056–60 $18.75 $37.50 $56.25 $38.06 $76.12 $114.1861–65 $22.88 $45.76 $68.64 $47.17 $94.34 $141.5166–70 $23.96 $47.92 $71.88 $48.79 $97.58 $146.37
New hires or employees with qualified life events will have the opportunity to purchase coverage within 30 days of eligibility. Any coverage you elect during the annual enrollment period will be effective January 1, 2013.
Additional information about these benefits can be found on the TakeCare Benefit Site or by calling the Benefit Service Center at 1-866-402-4144.
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Work/Life Balance BenefitsAllemployeesautomaticallyhaveaccesstotheEmployeeAssistanceProgram.Thisbenefitisprovidedatnocosttoyou.
Youandyourfamilymemberscanaccessconfidentialassistance24hoursaday,sevendaysaweek.Licensedprofessionalsprovideconfidentialsupportandguidancerelatedto:
• Family,relationshipandparentingissues.
• Childandeldercareneeds.
• Emotionalandstress-relatedissues.
• Conflictsathomeoratwork.
• Alcoholanddrugdependencies.
• Healthandwellnessresources.
• Face-to-facecounselingwithalicensedmentalhealthprofessional,uptofivesessionsperissueperyear.
• Legalandfinancialservices.
FormoreinformationabouttheEAP,callBensingerDupont&Associates(BDA)at1-866-757-3271orgotowww.eapadvantage.comandenterthepassword:plus.
401(k) Retirement Savings Plan OurCompanyoffersa401(k)plantoallemployees.Youmayenrollinthisplanonthefirstofthemonthfollowingsixmonthsofemployment.
Contributionstotheplancanbefrom1%to30%ofyourCompanyincome,uptoamaximum.*Catch-upcontributionsmaybemadetotheplanforemployeesoverage50,uptoamaximumallowedbythegovernment.
OurCompanymaymatchatitsowndiscretionduringtheplanyear.Thismatchwillbereceivedbyemployeeswhoareactiveonthedatethematchismade.
Anenrollmentkitwillbesenttoyourhomeaddressatsixmonthsofemployment.Ifyouwishtoenroll,pleasecontactFidelityInvestmentsat1-800-835-5091.
*IfyouareconsideredahighlycompensatedemployeebyIRSdefinition,yourcontributionstotheplanarerestrictedbasedontheannualnon-discriminationtestingperformedontheplan.
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For Questions About Contact Call Toll-Free VisitMedical coverage including:• The provider network
(Choice or ChoicePlus)• Getting treatment or
hospital admission authorization
• Behavioral health or substance abuse treatment
UnitedHealthcare 1-800-996-0403(customerservice)
1-877-643-5141
(NurseLine)
www.myuhc.com/groups/sava
(pre-member)
www.myuhc.com(members)
Health Reimbursement Arrangement
ADP 1-866-402-4144 www.takecarebenefitsite.com
Wellness/incentives program
CarewiseHealth 1-888-355-7268 takecare.carewisehealth.com
Prescription drug ExpressScripts 1-866-527-8878 www.express-scripts.com
Dental including Cigna’s Radius network
Cigna 1-800-244-6224 www.cigna.com
Vision UnitedHealthcareVision(Spectera)
VSP
1-800-638-3120
1-800-839-3242
(24hours)
1-800-877-7195
www.myuhcvision.com
www.vsp.comFlexible spending accounts
ADP 1-866-402-4144 www.takecarebenefitsite.com
• Life insurance• Accidental death and
dismemberment (AD&D)• Short-term disability• Accident insurance• Critical Illness insurance• Long-term disability
LincolnFinancial 1-800-423-2765 www.lincolnfinancial.com
401(k) retirement savings plan
Fidelity 1-800-835-5091 www.netbenefits.com
Employee assistance program
BensingerDupont&Associates(BDA)
1-866-757-3271 www.eapadvantage.com
password:plus
Benefit Contacts
If you have a question about plan benefit provisions between now and then, please refer to our plans’ Summary Plan Descriptions, which can be found on our website.
Looking for benefit contact information? Visit the TakeCare Benefit Site – www.takecarebenefitsite.com.
