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2018 AAPL Benefits Guide
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2018 Benefits at a Glance
PLAN YEAR:
January 15, 2014 – December 31, 2014
CONTENTS & CONTACT INFORMATION
Refer to this list when you need to contact one of your benefit vendors. For general information contact Human Resources.
HUMAN RESOURCES Name, Title
Sarah Cammer, Human Resources Generalist
Phone
813-636-2805
BROKER PARTNER – M.E. WILSON COMPANY Broker Contact
Katie Reeves Miller
Phone
813-229-8021 Ext. 132
MEDICAL
page 3
Provider Name
United Healthcare
Provider Phone Number
1-866-633-2446
Provider Web Address
www.myuhc.com
DENTAL
page 5
Provider Name
Guardian
Provider Phone Number
1-800-541-7846
Provider Web Address
www.GuardianAnytime.com
VISION
page 6
Provider Name
Advantica
Provider Phone Number
1-866-425-2323
Provider Web Address
www.advanticabenefits.com
BASIC AND VOLUNTARY LIFE AND AD&D INSURANCE page 7 Provider Name Standard Provider Phone Number 1-800-348-3226 Provider Web Address www.standard.com SHORT TERM AND LONG TERM DISABILITY page 8 Provider Name Standard Provider Phone Number 1-800-348-3226 Provider Web Address www.standard.com
EMPLOYEE ASSISTANCE PROGRAM
page 9
DISCLOSURE NOTICES
page 10
BENEFIT INFORMATION
Benefit
Who pays the cost?
AAPL pays 100% of the employee cost and 50% of the dependent cost for the Base HMO medical plan. You are responsible for the remaining dependent cost. You may also choose to enroll in the PPO medical plan for an additional cost. AAPL pays 100% of the employee only dental cost. You may enroll your eligible dependents for an additional cost, which you will be responsible for. AAPL pays 100% of the employee only vision cost. You may enroll your eligible dependents for an additional cost, which you will be responsible for.
Medical Insurance
YOUR BENEFITS
Dental Insurance
AAPL offers a variety of benefits allowing you the opportunity to customize a benefits package that meets your personal needs. In the following pages, you’ll learn more about the benefits offered. You’ll also see how choosing the right combination of benefits can help protect you and your family’s health and finances – and your family’s future.
Vision Insurance
Basic Life Insurance
AAPL pays 100% of the cost for Basic Life coverage.
AAPL offers you the option to purchase additional life insurance for yourself, your spouse, and/or your child(ren). You are responsible for the cost of coverage for yourself and your dependents.
Voluntary Life Insurance
Short and Long Term Disability Insurance
AAPL pays 100% of the cost for disability coverage.
ELIGIBILITY
All Regular full-time employees are eligible to join the AAPL Benefits Plan on the 1st of the month following 60 days from your date of hire. “Regular Full-Time Employees” must be regularly scheduled and working at least 25 hours per week.
You may also enroll your dependents in the Benefits Plan when you enroll.
Eligible dependents include:
Your legal spouse
•
• Your married or unmarried natural children, step-
children living with you, legally adopted children and any other children for whom you have legal guardianship, who are:
WHEN CAN YOU ENROLL?
You can sign up for Benefits at any of the following times:
► Under 26 years of age;
► A dependent who is older than 26 years of age, but less than 30 years of age may be eligible for medical benefits. To be eligible, a Dependent must: • Be unmarried and not have dependents of his or her own; AND
• After completing your initial eligibility period; • During the annual open enrollment period; • Within 30 days of a qualified family-status change. If you do not enroll at one of the above times, you may enroll during the next annual open enrollment period.
Be a resident of Florida or a student; AND
•
Not have coverage of their own, or covered under any other plan, including Medicare
•
1
BENEFIT INFORMATION
?
CHOOSING YOUR BENEFITS
You are required to actively choose any benefits paid for by AAPL or that you pay for or share in the cost of. Your part of the cost is automatically taken out of your paycheck. There are two ways that the money can be taken out:
WHY DO I PAY FOR BENEFITS WITH BEFORE-TAX MONEY?
There is a definite advantage to paying for some benefits with before-tax money:
• BEFORE YOUR TAXES ARE CALCULATED – Medical, Dental, and Vision
Taking the money out before your taxes are calculated lowers the amount of your pay that is taxable. Therefore, you pay less in taxes.
• AFTER YOUR TAXES ARE CALCULATED – Life and Disability
MAKING CHANGES MAKING CHANGES
Generally, you can only change your benefit choices during the annual benefits enrollment period. However, you may be able to change your benefit choices during the plan year if you have a change in status including:
Your marriage
• Change in your work status that affects your benefits
•
Your divorce or legal separation
• Change in residence or work site that affects your eligibility for coverage
•
• Birth or adoption of an eligible child
• Change in your child’s eligibility for benefits
• Death of your spouse or covered child
• Receiving Qualified Medical Child Support Order (QMCSO)
• Change in your spouse’s work status that affects his or her benefits
If you fail to notify Human Resources within 30 days of a
family status change, you will be required to wait until the
next annual enrollment period to make benefit changes
unless you have another family status change.
WHEN COVERAGE ENDS
Coverage will stop on the last day of the month in which employment with the company ends.
2
MEDICAL INSURANCE
AAPL offers two medical plans through United Healthcare. To find participating providers go to www.myuhc.com and click on “Find a Doctor”. On the following screen select “All United Healthcare Plans.” Select either “Choice HMO” or “Choice”, depending on which plan you are interested in. See chart below for network per plan. Complete the remaining information and click Search.
The chart below provides a brief overview of the medical plans. This chart is intended only to highlight the benefits available and should not be relied upon to fully determine your coverage. If the below illustration of benefits conflicts in any way with the Summary Plan Description (SPD), the SPD shall prevail. It is suggested that you review your exact description of services and supplies that are covered, those which are excluded or limited, and other terms and conditions of coverage.
HMO Plan Choice AUXC
PPO Plan Choice AUW4
IN-NETWORK
Choice HMO
Choice PPO
Deductible (Individual / Family)
$3,500 / $7,000
$2,000 / $4,000
Maximum Out-of-Pocket (Individual / Family)
$7,350 / $14,700
$4,000 / $8,000
Deductible, Coinsurance, & Copays
Deductible, Coinsurance, & Copays
Out-of-Pocket Max Includes
Coinsurance
80% / 20%
90% / 10%
Routine Preventive Services
Wellness
Immunizations
Covered 100%
Covered 100%
Mammography/Colonoscopy
Office Visits & Facility Services
Referral required
No
No
PCP Office Visits
$40 Copay
$25 Copay
Specialist Visits
$80 Copay
$50 Copay
Inpatient Hospital
20% after deductible
10% after deductible
Outpatient Surgery
20% after deductible
10% after deductible
Emergency Room
20% after deductible
$250 copay
Urgent Care
20% after deductible
$50 copay
OUTPATIENT DIAGNOSTIC SERVICES
Lab Services (Freestanding Lab)
20% after deductible
10% after deductible
X-Ray Services (Freestanding Lab)
20% after deductible
10% after deductible
Complex Diagnostic
20% after deductible
10% after deductible
PRESCRIPTIONS
Retail (30 day supply)
$10 / $35 / $60
$10 / $35 / $60
Mail Order (90 day supply)
2.5x retail
2.5x retail
OUT-OF-NETWORK
Deductible
Maximum Out-of-Pocket
Not Available
Not Available
Coinsurance
3
MEDICAL INSURANCE
Employee Payroll Deductions
HMO Plan Choice AUXC
Employer Cost Monthly
Employee Cost Monthly
Employee Cost Bi-Weekly
Employee Only
$ 466.90
$ 0.00
$ 0.00
Employee + Spouse
$ 70035
$ 233.45
$ 107.75
Employee + Child(ren)
$ 665.34
$ 198.44
$ 91.59
Employee + Family
$ 898.79
$ 431.89
$ 199.33
HMO Plan Choice AUW4
Employer Cost Monthly
Employee Cost Monthly
Employee Cost Bi-Weekly
Employee Only
$ 466.90
$ 197.35
$ 91.08
Employee + Spouse
$ 700.35
$ 628.15
$ 289.92
Employee + Child(ren)
$ 665.34
$ 563.53
$ 260.09
Employee + Family
$ 898.79
$ 994.33
$ 458.92
4
DENTAL INSURANCE
AAPL offers dental coverage through Guardian. The Dental PPO Plan allows you to use in-network or out-of-network benefits. If out-of-network dentists are used, you will be responsible to pay the difference between Guardian’s allowed amount and what the dentist may charge, also known as “balance billing”. The charts below provides a brief overview of the plan.
DentalGuard Preferred
In-Network
Out-Of-Network
Deductible
$0
$50
Individual
$0
$150
Family
Annual Maximum (per covered member)
$1,500
$1,000
Preventive Services
Covered in full
Covered in full
Exams, Cleanings, & Fluoride
Basic Services
Fillings, Simple Extractions, Perio & Endo (other than those listed below) Major Services Crowns, Bridges, Surgical Extractions, Root Canal, Dentures, Osseus Surgery & Endo Molars
90% covered after deductible
80% covered after deductible
60% covered after deductible
50% covered after deductible
Orthodontia
Coinsurance Lifetime Maximum
50% covered after deductible $1,000 (combined maximum for in-network and out-of network)
Employer Cost Monthly
Employee Cost Monthly
Employee Cost Bi-Weekly
Dental PPO
Employee Only
$ 41.54
$ 0.00
$ 0.00
Employee + Spouse
$ 41.54
$ 47.88
$ 22.10
Employee + Child(ren)
$ 41.54
$ 73.61
$ 33.97
Employee + Family
$ 41.54
$ 108.76
$ 50.20
1 Subject to balance billing. Please refer to your plan document for specific details.
5
VISION INSURANCE
AAPL offers vision coverage through Advantica. The Advantica vision plan allows you the flexibility to see any provider. To search in-network providers go to www.AdvanticaBenefits.com and search under “future member”. For out-of-network claims you pay expenses at the time of service and file a claim for reimbursement. Below is a list of the reimbursement schedule.
Your vision is important to your health. Whether your vision is 20/20 or less than perfect, everyone should receive regular vision care.
Vision
In-Network
Out-of-Network
Routine Eye Exams
$10 copay
$10 copay
Lenses
Every 12 months
Single Vision Bifocal Trifocal Lenticular
Standard Plastic :
Standard Plastic :
Covered in full after $10 copay
Reimbursed up to $100
Upgraded Materials or Lens types: Polycarbonate Lenses: Covered in full (ages 19 and under)
Upgraded Materials or Lens types: Not covered
Standard Progressives: additional $50 copay Photochromic Lenses: additional $60 copay
Frames
Every 12 months
$150 retail allowance
Reimbursed up to $60
Contact Lenses
Every 12 months
Elective Contact Lenses Medically Necessary
$150 retail allowance $250 retail allowance
Reimbursed up to $80 Reimbursed up to $250
Contact Lens Fitting
$40 allowance
Not covered
• Covered lenses include single vision, bifocal, trifocal and lenticular. • Lenses, Frames & Contacts are limited to either one pair of contacts or frames/lenses per calendar year.
Employer Cost Monthly
Employee Cost Monthly
Employee Cost Bi-Weekly
Vision
Employee Only
$ 7.39
$ 0.00
$ 0.00
Employee + Spouse
$ 7.39
$ 6.46
$ 2.98
Employee + Child(ren)
$ 7.39
$ 8.32
$ 3.84
Employee + Family
$ 7.39
$ 15.50
$ 7.15
6
BASIC LIFE AND AD&D INSURANCE
AAPL provides all benefit eligible employees with Basic Life and AD&D insurance, at no cost to the employee!
Basic Life and AD&D
Benefit Amount
$50,000
At age 65: reduced by 35% At age 70: reduced by 50% At age 75: reduced by 65%
Age Reduction Schedule
AD&D
Included – equal to Basic Life amount
VOLUNTARY LIFE AND AD&D INSURANCE
AAPL offers all employees the opportunity to purchase Voluntary Life and AD&D Insurance.
Voluntary Life and AD&D
Employee Benefit Amount
Increments of $10,000 up to a maximum of $300,000
Guaranteed Issue Amount
$100,000
Spouse Benefit Amount
Increments of $5,000 up to $150,000
Guaranteed Issue Amount
$20,000
Child Benefit Amount
$10,000
Accidental Death & Dismemberment (AD&D)
Equal to Life benefit amount elected
At age 65: reduced by 35% At age 70: reduced by 50% At age 75: reduced by 65%
Age Reduction Schedule
Monthly Cost per $1,000 (includes cost of AD&D)
COST CALCULATION:
Age
Employee/Spouse*
Child(ren)
_____________________ Benefit Amount