2019 AMIkids Benefits Guide

2019 AMIkids Benefits Guide

2019 Benefits Guide

PLAN YEAR:

January 15, 2014 – December 31, 2014

Our Mission

AMIkids is a non-profit organization dedicated to helping youth develop into responsible and productive citizens. AMIkids’ mission is to protect public safety and positively impact as many youth as possible through the efforts of a diverse and innovative staff. AMIkids works in partnership with youth agencies, local communicates and families.

CONTENTS & CONTACT INFORMATION

Refer to this list when you need to contact one of your benefit vendors. For general information contact the AMIkids Affiliated Programs Benefits Department.

AMIKIDS BENEFITS DEPARTMENT Brandie Holjes & Marie Haskins

813-887-3300 [email protected] or [email protected]

M.E. WILSON COMPANY - BENEFITS PARTNER Katie Miller, Cindy Buttrill, or Jeff Lenderman

813-229-8021 [email protected]

MEDICAL & PRESCRIPTION

page 3

Medical : Blue Cross Blue Shield (Group # 71-60757)

1-800-830-1501 www.MyHealthToolkitFL.com

Prescription : OptumRX

1-800-334-8134 www.Optumrx.com/myCatamaranrx

HEALTH SAVINGS ACCOUNT

page 10

Optum Bank (Group # 71-60757)

1-866-234-8913 www.OptumBank.com

DENTAL

page 12

Blue Cross Blue Shield (Group # 71-60757)

1-800-222-7156 www.MyHealthToolkitFL.com

VISION

__ page 13

Blue Cross Blue Shield (EyeMed network) (Group# 71-60757)

1-866-723-0513 www.MyHealthToolkitFL.com

LIFE, SHORT-TERM & LONG-TERM DISABILITY

page 14

United Healthcare (Group # 305057)

1-888-299-2070 www.myuhc.com

403(B)

page 16

Fidelity (Group #64688)

1-800-343-0860 www.Fidelity.com/atwork

VOLUNTARY BENEFITS

page 17

United Healthcare (Group # 305057)

1-888-299-2070 www.myuhc.com

EMPLOYEE ASSISTANCE PROGRAM

page 19

LifeWorks

1-888-456-1324 www.lifeworks.com User ID: amikids Password: lifeworks

HOW TO ENROLL

page 21

Web Benefits Design

1-888-639-8077 www.mybensite.com/amikids

DISCLOSURE NOTICES

page 24

BENEFIT HIGHLIGHTS

Wage Benefits • Paid time off (PTO) • Paid Holidays (9) • Direct Deposit • Leave of Absences

Wellness Benefits • Employee Assistance Program (EAP) • Real Appeal Weight Loss Program • Rally (BCBS) Wellness Program • Health Coaching • Monthly newsletters • Wellness challenges • Wellness participation incentives • Smoking cessation programs • Stress management programs • Grief and loss care • Caregiving assistance • Chronic Condition Coaching Additional Benefits • Pet Insurance • World Travel Assistance Program • Will and Trust Services • Enterprise Car Sales Program • Enterprise/National Car Rental Program • Verizon Wireless discounts • Gym Membership discounts • AAA membership discounts • Dell product discounts • TicketsatWork Discount Program (diabetes, ADHD, CHF, COPD, etc.) • Healthy Lifestyle Coaching

• Bereavement Leave • Military Leave • Jury Duty • Family Medical Leave Act (FMLA) (Eligibility requirements)

Health Benefits • Medical plan options • Dental plan options • Vision plan option

(maternity, weight management, fitness)

• Prescription Drug plan option • Health Savings Account (HSA)

• Health Reimbursement Account (HRA) • Company paid Life Insurance and AD&D • Supplemental Life Insurance (including spouse & child) • Short and Long Term Disability Insurance • Accident Insurance • Critical Illness and Cancer Insurance

• Hospital Indemnity Insurance • Legal & Identity Theft Insurance • Telemedicine

(theme parks, movies, rentals and more)

Financial Benefits • Employer funded Pension Plan • Voluntary 403(b) Retirement Plan • PNC Bank- Workplace Financial Program (budgeting, saving, reducing debt, etc.) • Eligibility for the Student Loan Forgiveness Program for non-profit employees if meeting the qualifications

*Note* some of these benefits are available to family members as well

For more information on any of these benefits, visit the Benefits page on AMIkids Intranet at intranet.amikids.org under Support Services or contact Brandie Holjes at 813-887-3300 or email at [email protected]

BENEFIT INFORMATION

Benefit

Who pays the cost?

AMIkids shares the cost of your medical premiums no matter what medical plan you choose!

Medical Insurance

YOUR BENEFITS PLAN

AMIkids also shares the cost of your dental premiums regardless of your dental plan choice.

Dental Insurance

AMIkids offers a variety of benefits allowing benefit eligible team members 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

AMIkids offers vision coverage on a voluntary basis.

Basic Term Life Insurance

AMIkids pays 100% of the cost for Basic Term Life coverage.

AMIkids offers you the option to purchase additional term life insurance for yourself, as well as term life insurance for your spouse and/or child(ren).

Voluntary Term Life Insurance

Short Term Disability (STD)

See benefits page for more on the voluntary offer of STD and eligibility specifics for the employer sponsored benefit.

Long Term Disability (LTD)

AMIkids offers LTD coverage on a voluntary basis.

Voluntary Benefits

AMIkids offers a variety of voluntary benefits.

Eligible AMIkids team members are automatically enrolled into the AMIkids pension plan. You can also choose to open a 403(b) retirement savings account using pre-tax dollars.

Pension and Retirement Plan

ELIGIBILITY

Eligible team members are those averaging 30 hours worked per week. Newly eligible team member’s benefits will become effective on the 1 st of the month following 60 days of eligible employment status.

You may also enroll your dependents in the Benefits Plan when you enroll.

Eligible dependents include:

Your legal spouse

•

• You or your spouse’s child who is under age 26, including natural children, step-children, legally adopted children, a child placed for adoption or any other children for whom you or your spouse are legal guardian • A child who is or becomes disabled and is dependent upon you before reaching age 26 • A child for whom health care coverage is required through a Qualified Medical Child Support Order or other court or administrative order. Please verify all dependents meet the definition of qualified dependent. Initial and periodic audits requesting proof of qualified dependent status may be conducted . You are financially responsible for any claims incurred on the plan by a dependent who does not meet eligibility requirements.

WHEN CAN YOU ENROLL?

You MUST enroll within 60 days of your new hire date. Otherwise you must wait until the next annual open enrollment period, unless you experience a qualifying event.

If you have a qualifying event, you MUST notify AMIkids of the event within 30 days of a qualified family-status change.

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BENEFIT INFORMATION

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CHOOSING YOUR BENEFITS

WHY DO I PAY FOR BENEFITS WITH BEFORE-TAX MONEY?

Your portion of the cost of benefits is automatically taken out of your paycheck. There are two ways that the money can be taken out:

There is a definite advantage to paying for some benefits with before-tax money: Taking the money out before your taxes are calculated lowers the amount of your pay that is taxable. Therefore, you pay less in taxes.

• BEFORE YOUR TAXES ARE CALCULATED – Medical, Dental, Vision, H.S.A and 403(b) contributions

• AFTER YOUR TAXES ARE CALCULATED – Life, Disability and Voluntary Benefits

MAKING CHANGES

Generally, you can only change your benefit choices during the annual benefits enrollment period. However, under certain circumstances you may be allowed to make changes to your benefit elections if you or your eligible dependents experience a qualifying life event. An eligible event is determined by the Internal Revenue Service (IRS) Code, Section 125. Examples of Qualifying Events:

Your marriage

• Change in your spouse’s work status that affects his or her benefits

•

Your divorce or legal separation

• Change in your work status that affects your benefits

•

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)

•

You must enter a life event via www.mybensite.com/amikids and notify AMIkids Benefits Department, in writing, within 30 days of the qualifying event. At this time you will also be required to provide appropriate documentation. Failure to make notification within this time period, removes the option to make a changes.

WHEN COVERAGE ENDS – Medical, Dental and/or Vision coverage will end

• On the last day of the month in which employment with the company ends.

• You or a covered dependent no longer meet the eligibility requirements.

• The plan ends, and/or failure to make required contributions outside payroll deductions (ex: on leave of absences).

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MEDICAL & PRESCRIPTION INSURANCE

AMIkids offers medical coverage through Blue Cross Blue Shield for the 2019 plan year. The plan year runs from May 1st, 2019 – April 30th, 2020. AMIkids contributes over 65% of the cost for team member coverage on the Base H.S.A. Plan making this plan one that complies with the affordability rules of the ACA. You are responsible for the additional cost associated with buying up to another plan and / or adding dependent(s) on the plan. The chart below provides an overview of the medical plan offered. 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 recommended that you review the exact description of services and supplies that are covered, those which are excluded or limited, and other terms and conditions of coverage .

Base HDHP H.S.A. Plan

Copay H.R.A. Plan

Copay Premium Plan

IN-NETWORK

PREVENTIVE CARE Wellness, Immunizations, Mammography, Colonoscopy, Annual bloodwork, etc. OFFICE VISITS Referral Required? Teledoc Virtual Visits Office Visits (Illness/Injury) Specialist Visits

Covered 100%, no cost to you.

No Meet deductible, then $25 Copay

No $25 Copay $50 Copay $75 Copay

No $25 Copay $35 Copay $60 Copay

Meet deductible, then 20% Meet deductible, then 20%

HOSPITAL SERVICES Inpatient Hospital Outpatient Surgery Emergency Room Urgent Care Clinic

Meet deductible, then 20% Meet deductible, then 20% Meet deductible, then 20% Meet deductible, then 20%

Meet deductible, then 30% Meet deductible, then 30%

Meet deductible, then 20% Meet deductible, then 20%

$500 Copay $100 Copay

$350 Copay $100 Copay

DIAGNOSTIC TESTING Lab, X-Ray, Advanced Imaging (MRI, CAT, PET, etc.)

Meet deductible, then 20%

Meet deductible, then 30%

Meet deductible, then 20%

PRESCRIPTIONS Retail (30 day supply) Tier 1 / 2 / 3

Meet deductible, then $10 / $35 / $60 Copay

$20 / $50 / $80 Copay

$10 / $35 / $60 Copay

Medicare (Part D) Creditable

NO

YES

YES

DEDUCTIBLE (your cost for covered in-network claims) Deductible (Individual / Family) $3,000 / $6,000

$4,500 / $9,000

$1,500 / $3,000

COINSURANCE (your responsibility on claims costs once you’ve met the deductible) 20% 30% OUT OF POCKET MAXIMUM (once met, all in-network covered services are covered by the plan) Maximum Out-of-Pocket (Individual / Family) $6,000 / $12,000 $6,000 / $12,000

20%

$5,000 / $10,000

Max Out-of-Pocket includes

Deductible , Coinsurance, Prescription Costs, and Copays paid by you during the course of the plan year OUT-OF-NETWORK (charges are subject to balance billing)

Deductible Coinsurance Out of Pocket Maximum

$7,500 / $15,000 50% $15,000 / $30,000

$10,000 / $20,000 50% $15,000 / $30,000

$7,500 / $15,000 50% $15,000 / $30,000

1 Charges are subject to balance billing

WHAT ARE TELADOC VIRTUAL VISITS? They allow you to see and talk to a doctor from your cell phone, tablet or computer regarding non-emergency medical conditions like the flu, pink eye, rashes and fever. These visits are subject to your deductible (or a copay depending upon your plan selection) but are typically at a lesser cost than an office visit. A great way to SAVE TIME AND MONEY! To access Teladoc, visit www.teladoc.com or call 1-800-Teladoc (835-2362)

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HOW TO FIND IN-NETWORK PROVIDERS

To utilize your benefits you want to seek services from in-network doctors and facilities. You can search and locate in-network providers by visiting www.MyHealthToolkitFL.com and following the below instructions.

Go to www.MyHealthToolkitFL.com and click on the highlighted field

Enter the name of the provider you wish to search and/or the desired location and/or the specialty.

Choose “Show me only doctors and hospitals in my Plan” and enter the alpha prefix EQO in the field that pops up.

UNDERSTANDING KEY TERMS

STARTING WITH THE BASICS

Deductible is the amount you have to pay out of pocket for services not covered by a copay before co-insurance starts. Once you’re enrolled in medical, you're a Blue Cross Blue Shield member. Because you’re a member you get the discounted rate with all in-network providers and facilities! This discount is typically 50%-70% off the amount charged to someone without insurance. Coinsurance is cost-sharing. The cost-sharing “kicks in” AFTER you meet the deductible. Even though you’ve met your deductible, you still get the discounted rates! On the medical summary chart you can see coinsurance is 20% or 30% depending upon which plan you choose. When you have coinsurance, you pay 20% or 30% of that discounted rate and the plan pays the rest! Copayment (aka Copay) is a flat fee that you pay for medical services and/or prescriptions. On the Base H.S.A. Plan you do not have copays with the exception of prescriptions and virtual visits, though you must meet your medical deductible prior to having copays for prescriptions and virtual visits. Out of Pocket Maximum is the maximum total amount you will pay in deductible costs, coinsurance and copays during the policy year. Once you meet the Out of Pocket Maximum, the plan pays 100% of your eligible costs on covered medical and pharmacy services.

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UNDERSTANDING HOW THE PLANS WORK

Base HDHP H.S.A. Plan

You’re responsible to pay the first dollar costs for medical services and prescriptions (Rx) until you meet your deductible ($3,000 individual/$6,000 family)

Phase 1

Once you’ve met the deductible, coinsurance kicks in for all medical services and now copays apply to Rx. That’s right, you’ll pay 20% of the cost for medical services and the plan pays the rest! You’ll pay the copay for Rx and the plan pays the rest!

Phase 2

You’ve got a maximum out-of-pocket. This amount is an accumulation of the deductible, Rx, coinsurance, and copays. Once all these costs add up to the total max out-of-pocket ($6,000/$12,000) the plan will pay 100% of all in-network, covered medical services and Rx for the rest of the policy year.

Phase 3

Copay H.R.A Plan & Copay Premium Plan

You pay the copay amount for day to day services, as stated on page 3. Your deductible applies to the additional services not covered by a copay. Once you meet your deductible your coinsurance will “kick in”.

• on the Copay H.R.A. Plan, you pay 30% of the cost and AMIkids pays 70% of the cost of the claim. • on the Copay Premium Plan, you pay 20% of the cost and AMIkids pays 80% of the cost of the claim.

The amounts you pay towards your deductible, coinsurance, copay amounts, and prescription copays apply to your out-of-pocket maximum.

Want to earn some Wellness Incent ives?

Register for one of AMIkids Wellness Programs!

Rally Wellness Program

Team members enrolled in one of the three AMIkids medical plans, have access to the Rally Wellness Program through BlueCross BlueShield at no cost to you year round!

Rally can help you get healthier one step at a time. It will show you how to make simple changes to your daily routine, set smart goals for yourself and stay on target. You’ll get personalized recommendations to get you moving more, eating better, feeling happier and you’ll have FUN doing it!

To get started, login to www.MyHealthToolKitFL.com. Once you register, select Wellness, then Rally.

Once you earn 2,000 coins, contact the Benefits Department to receive a new FitBit (while supplies last).

Real Appeal Weight Loss Program

AMIkids offers a FREE online weight loss program to ALL team members with a BMI of 20 or higher. You do not have to be enrolled in any of the AMIkids benefits to participate. Spouses and dependents over the age of 18 can also participate in Real Appeal as long as they’re enrolled in one of the three AMIkids medical plans. Real Appeal is a free, 52 week online weight loss program that is customized to what works for you! You will learn simple steps to help you transform and earn incentives along the way. You’ll have access to a transformation coach, digital tools, weekly online support group classes and a success kit full of healthy weight management tools.

To get started, login to www.amikids.realappeal.com. Once you complete ten group session, you will receive a FitBit.

(All incentives will be available year round while supplies last and are taxable and subject to federal and state withholdings)

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MEDICAL (SEMI-MONTHLY) RATES

SALARY RANGE: BELOW $35,000

Cost for Coverage Amounts shown are per pay check ( 24 payments/year )

Base HDHP H.S.A Plan

Copay H.R.A. Plan

Copay Premium Plan

Employee Only

EE

$ 56.23

$ 91.73

$ 179.53

Employee + Spouse

ES

$ 153.51

$ 225.84

$ 423.00

Employee + Child(ren)

EC

$ 128.21

$ 192.31

$ 366.07

Employee + Family

FAM

$ 194.00

$ 294.16

$ 564.87

SALARY RANGE: $35,000 TO BELOW $50,000

Cost for Coverage Amounts shown are per pay check ( 24 payments/year )

Base HDHP H.S.A Plan

Copay H.R.A. Plan

Copay Premium Plan

Employee Only

EE

$ 64.67

$ 101.22

$ 192.67

Employee + Spouse

ES

$ 171.22

$ 245.77

$ 450.58

Employee + Child(ren)

EC

$ 144.23

$ 210.34

$ 391.03

Employee + Family

FAM

$ 219.30

$ 322.62

$ 604.28

SALARY RANGE: $50,000 AND OVER

Cost for Coverage Amounts shown are per pay check ( 24 payments/year )

Base HDHP H.S.A Plan

Copay H.R.A. Plan

Copay Premium Plan

Employee Only

EE

$ 73.10

$ 110.70

$ 205.81

Employee + Spouse

ES

$ 188.94

$ 265.69

$ 478.17

Employee + Child(ren)

EC

$ 160.26

$ 228.37

$ 415.99

Employee + Family

FAM

$ 244.60

$ 351.09

$ 643.69

REMINDER : If you sign up for the Base HDHP H.S.A Plan AMIkids WILL GIVE YOU $500, pro-rated, into your open and active Health Savings Account. Of course you have to open the account and keep it open to get the money! If you sign up for the Copay H.R.A. Plan AMIkids WILL GIVE YOU up to the first $500 of any deductible related expenses immediately as the claims are incurred. Your doctor submits the claim to BCBS and they will receive up to $500 from AMIkids.

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2019 Annual Enrollment Elections

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As a current team member , the 2019 Annual Open Enrollment period begins on March 25 th , 2019 and runs through 11:59:59pm on April 8 th , 2019. All benefits eligible team members are strongly encouraged to participate in Annual Open Enrollment by visiting the online benefits administration site at www.mybensite.com/amikids or by calling 1-888-639-8077 and making their benefits selections. Team Members that are currently enrolled in any of the AMIkids benefits will automatically rollover into the new plan year as is unless you make changes. All elections, including optional coverages, will continue if you do not login to make a change. As a recently hired team member , you have a New Team Member Enrollment Period to elect your benefits. The enrollment period starts as soon as you are loaded into the BenAdmin system (usually the week after your first paycheck) and ends on your 60 th day following your date of hire. If you do not make your elections during this window, you cannot enroll in the AMIkids benefit plan until the next annual enrollment unless you experience a qualified change in status (see page 2).

Is participation in the 2019 Annual Open Enrollment Mandatory this year? • No, but participation in your health care decisions is STRONGLY encouraged.

• This is a great opportunity to make

sure your information on file is correct, to include your address, phone number and email and make any updates to your beneficiaries.

HOW DO I DETERMINE WHICH PLAN IS BEST FOR ME AND MY FAMILY?

“Nobody knew health care could be so complicated!”

We know and understand deciding which benefits are right for your situation is a personal choice based on each family’s dynamics. Because of the IRS 125 rules, the decisions you make during annual open enrollment or upon your initial eligibility in the plan year are with you until the beginning of the next plan year.

The next 2 pages provide a couple of scenarios that will assist you in determining which plan makes the most sense for you – if you want assistance with creating your own scenario, you may contact BCBS and they’ll walk through the process.

CHOOSE WISELY! The benefit elections you make will remain in effect until April 30, 2020

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HOW DO I DETERMINE WHICH PLAN IS BEST FOR ME AND MY FAMILY?

SCENARIO 1: TEAM MEMBER AND CHILD(REN) EARNING LESS THAN $35,000

Karl with EE + Ch