2018 AAPL Benefits Guide

2018 AAPL Benefits Guide

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

Email

[email protected]

Phone

813-636-2805

BROKER PARTNER – M.E. WILSON COMPANY Broker Contact

Katie Reeves Miller

Email

[email protected]

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