2019 JL Marine Benefits At A Glance

2019 JL Marine Benefits At A Glance

CONTENTS & CONTACT INFORMATION

Refer to this list when you need to contact one of your benefit vendors. For general information contact Human Resources.

BROKER

Provider Name

M.E. Wilson Company

Broker Contact

Amanda Sands

Provider Phone Number

813-229-8021 Ext. 139

Provider Email Address

[email protected]

MEDICAL

3

Provider Name

Cigna

Provider Phone Number

1-866-494-2111

Provider Web Address

www.cigna.com

DENTAL

7

Provider Name

Guardian

Provider Phone Number

1-800-541-7846

Provider Web Address

www.GuardianLife.com

VISION

8

Provider Name

Guardian

Provider Phone Number

1-800-541-7846

Provider Web Address

www.GuardianLife.com

FLEX SPENDING & HEALTH SAVINGS ACCOUNT

9

Provider Name

Discovery Benefits

Provider Phone Number

1-866-451-3399

Provider Web Address

www.discoverybenefits.com

LIFE AND AD&D AND VOLUNTARY LIFE AND AD&D

10

Provider Name

Mutual of Omaha

Provider Phone Number

1-877-999-2330

Provider Web Address

www.mutualof omaha.com

SHORT -TERM AND LONG -TERM DISABILITY

11

Provider Name

Mutual of Omaha

Provider Phone Number

1-877-999-2330

Provider Web Address

www.mutualof omaha.com

EMPLOYEE ASSISTANCE PROGRAM

12

Provider Name

Mutual of Omaha

Provider Phone Number

1-800-316-2796

Provider Web Address

www.mutualof omaha.com/eap

HOW TO ENROLL

13-14

DISCLOSURE NOTICES

15

BENEFIT INFORMATION

YOUR BENEFITS PLAN

BENEFIT

WHO PAYS THE COST?

JL Marine Systems 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.

Company pays the majority of the employee portion of the Micro plan and a significant amount of the spouse & dependent portion

Medical Insurance

Dental, Vision and Voluntary Life

You pay entire cost

Basic Life Insurance

Company pays entire cost

Voluntary Life Insurance – Employee, Spouse and Dependent Children

You pay entire cost

Short-Term and Long-Term Disability

Company pays entire cost

ELIGIBILITY

All Regular full-time employees are eligible to join the JL Marine Systems Benefits Plan on the 1st of the month following 60 days. “Regular Full-Time Employees” must be regularly scheduled and working at least 30 hours per week.

You may also enroll your dependents in the Benefits Plan when you enroll. Eligible dependents include: • Your Spouse, unless you are legally separated or divorced; • 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: - Under 26 years of age for medical; - To be eligible, a Dependent must: • Be Unmarried and not have dependents of his or her own; AND • Be a Resident of Florida or a Student; AND • Not have coverage of their own, or covered under any other plan; AND • Not entitled to benefits under Medicare

WHEN CAN YOU ENROLL?

You can sign up for Benefits at any of the following times: • After completing 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 must wait for the next annual open enrollment period.

BENEFIT INFORMATION

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

CHOOSING YOUR BENEFITS

?

You must actively choose any benefit that you pay for, or share in the cost with JL Marine Systems. Your part of the cost is automatically taken out of your paycheck. There are two ways that the money can be taken out: • BEFORE YOUR TAXES ARE CALCULATED – medical, dental, vision and flexible spending accounts.

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.

• AFTER YOUR TAXES ARE CALCULATED – voluntary life and accidental death & dismemberment

Generally, you can only change your benefit choices during the annual benefits enrollment period. However, you may be able to change your benefit choices at anytime if you have a change in status including: • Your marriage • Your divorce or legal separation • Birth or adoption of an eligible child • Death of your spouse or covered child • Change in your spouse’s work status that affects his or her benefits • Change in your work status that affects your benefits • Change in residence or work site that affects your eligibility for coverage • Change in your child’s eligibility for benefits • Receiving Qualified Medical Child Support Order (QMCSO)

If you do not notify Human Resources within 30 days of a family status change,

you will have to wait until the next annual enrollment period to make benefit changes unless you have another family status change.

WHEN COVERAGE ENDS

Medical, Dental and Vision Coverage will stop on the last day of the month in which employment with the company ends. All other benefits terminate the day of termination.

COBRA – A Federal law that allows workers and dependents who lose their medical, dental, or vision coverage to continue any of these coverages for a specified length of time by electing and paying for continuation benefits. Coinsurance – The percentage of the medical or dental charge that you pay after the deductible has been met. Copayment – A flat fee that you pay for medical services, regardless of the actual amount charged by your doctor or another provider. This generally applies to physicians’ office visits and prescription drugs. Deductible – The amount you pay toward medical and dental expenses each calendar year before the plan begins paying benefits. Out of Pocket Maximum – The maximum amount you will pay in coinsurance during the calendar year

GETTING MORE FROM YOUR HEALTHCARE DOLLARS

Extras

There are some additional benefits that are available to you as a Cigna member. These products / services offer a variety of discounts at no additional cost to you and your dependents on the plan.

Cigna.com

Register on myCigna.com Once you do, you can log in anytime, anywhere to:  Manage and track claims  View ID card information  Find doctors and compare cost and quality ratings  Review you coverage  Track your account balances and deductibles

Health Information Line

It can be a fever in the middle of the night or a question about a popular medication. Whether you’re looking for general information or have a specific health concern, the health information line is open 24 hours a day, seven days a week. Dial 800.Cigna24 – (800) 244-6224 and you’ll be connected with a nurse who is ready to help answer your health questions.

Register today! Visit myCigna.com or get the myCigna Mobile App.

PRESCRIPTION DRUG BENEFITS AT A REDUCED COST

MyCigna Mobile App

You’re busier than ever. At Cigna, they get that. While they can’t wave a magic wand and make all the frusterating, time-consuming aspects of your life go away, they can give you a tool to help make your life easier. And healthier. The all-new myCigna Mobile App gives you a simple way to personalize, organize and access your important health information – on the go. The app puts you in control of your health, so you can get more out of life.

Q. What should I do if I have a problem getting a claim paid? A. Start by contacting the carrier’s member services number to determine the nature of the problem. If the issue is the way the doctor or other service provider has billed the claim, then contact your doctor or Claims Advocate at MEW. If the insurance company has an eligibility issue, contact Human Resources for assistance. Q. What is the difference between brand formulary, brand non-formulary, and generic drugs? A. Brand formulary is a prescription drug that is listed on the formulary (i.e., a list of prescription drugs covered by the plan). These drugs are protected by a patent issued to the original innovator or marketer. Brand non- formulary drugs are patent protected but are not listed. A generic equivalent drug can become available when the patent protection runs out, and is deemed equal in therapeutic power to the brand name originals. Q. When should I go the Urgent Care vs. Emergency Room? A. For non-life threatening injury/illness after normal doctor’s office hours Did you know you can obtain prescription drugs at local retailers at a reduced cost and sometimes even free? Publix offers a variety of generic Oral Antibiotic medications to you absolutely free. Bring in your prescription for an approved medication and receive it FREE, up to a 14-day supply. Publix recently approved a medication for diabetes. CVS, Target, Walgreens & WalMart also offer over 400 generic prescriptions for $4 and a 90 day supply for approx. $10. Remember DO NOT show your CIgna ID card to receive these benefits, or you will be charged your CIgna drug rate. FAQs

Care Consultants

Here when you need them. Extended Customer Service Hours provides you 24/7 access to a Cigna Care Consultant. Call at your convenience… 866-494-2111

In addition to the network of physicians, hospitals, emergency rooms, and urgent care clinics, you also have the option of going to the convenient care clinics located within some grocery and drug stores, for minor illness such as ear aches, colds, flu and so on. By selecting one of these providers, you pay only the regular office visit copay; a significant savings over the emergency room and urgent care copayments. Please visit the various websites for locations, hours of operations and scope of services.

CVS Minute Clinic: www.cvs.com Walgreen’s Take Care Clinic: www.walgreens.com

MEDICAL INSURANCE

The chart below provides a brief comparison of the 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 your exact description of services and supplies that are covered, those which are excluded or limited, and other terms and conditions of coverage.

JL Marine Systems offers 3 medical plans from Cigna. To find participating providers go to www.cigna.com and click on “Find a Doctor”, choose the appropriate plan type, and click continue. Then, narrow down your search based on location and provider type plans. This chart is intended only to highlight the benefits

v

OAP (HSA)

OAPIN 1000

OAP 250

Plan Options:

Micro with Battery Pak

Sportsman

Pro-Series

IN-NETWORK: Plan Year / Contract Year Basis

Calendar Year

Calendar Year

Calendar Year

Deductible (Individual / Family)

$1,500 / $4,500

$1,000 / $3,000

$250 / $750

Maximum Out-of-Pocket (Individual/Family)

$4,500 / $9,000

$4,000 / $8,000

$3,000 / $6,000

Deductible, Coinsurance, & Copays

Deductible, Coinsurance, & Copays

Deductible, Coinsurance, & Copays

Out-of Pocket Max Includes

Lifetime Major Medical Maximum

Unlimited

Unlimited

Unlimited

Coinsurance

80% / 20%

80% / 20%

80% / 20%

Routine Preventive Services

Wellness Immunizations Mammography/Colonoscopy CO-PAYS PCP Required / Open Access

Covered 100%

Covered 100%

Covered 100%

No

No

No

Telemedicine

Deductible & Coinsurance

$25 Copay

$20 Copay

Office Visits/Consultations for Illness/Injury

Deductible & Coinsurance

$25 Copay

$20 copay

Specialist Visits

Deductible & Coinsurance

$45 Copay

$45 copay

Inpatient Hospital

Deductible & Coinsurance Deductible & Coinsurance

Deductible & Coinsurance

Outpatient Surgery

Deductible & Coinsurance Deductible & Coinsurance

Deductible & Coinsurance

Emergency Room

Deductible & Coinsurance

$250 Copay

$200 copay

Urgent Care

Deductible & Coinsurance

$50 Copay

$50 copay

OUTPATIENT DIAGNOSTIC SERVICES Lab Services (Freestanding Lab)

Deductible & Coinsurance

Covered 100%

Covered 100%

X-Ray Services (Freestanding Lab)

Deductible & Coinsurance

Covered 100%

Covered 100%

Complex Diagnostic

Deductible & Coinsurance

$350 Copay

$200 Copay

PRESCRIPTIONS

(After annual deductible)

Retail (30 day supply)

$10 / $50 / $80

$10 / $50 / $80

$10 / $50 / $80

Mail Order (90 day supply)

3 X retail

3 X retail

3 x retail

OUT-OF-NETWORK:

Deductible (Individual / Family)

$1,000 / $3,000

$5,000 / $9,000

Maximum Out-of-Pocket (Individual/Family)

$9,000 / $18,000

In-Network Only

$6,000 / $12,000

Unlimited

Lifetime Major Medical Maximum

Unlimited

50%

Coinsurance

50%

HEALTH SAVINGS ACCOUNT

What is a Health Savings Account (HSA)?

It is an interest bearing account created to help you pay medical expenses. The funds in your HSA can be used to help pay your deductible, coinsurance and any qualified medical expenses not covered by your health plan (including dental and vision expenses). All of the money you contribute is tax-deductible when used to pay for qualified medical expenses. An HSA is your account. It goes with you if you change jobs or when you retire.

IRS Annual Maximum HSA Contribution Limits

2019

Employee Only

$3,500

Family

$7,000

Catch up amount for employees 55 years or older

Additional $1,000 Annually

JL Marine Systems Tax Free HSA Contributions

Single and Family Coverage

Annual Amount

$250

* Employer contributions: amount and frequency deposited to your Health Savings Account will be determined by JL Marine Systems and will not exceed the plan year contribution amount.

Health Savings Account – Eligible Expenses (partial list)

• Acupuncture • Alcohol and drug dependency treatment • Ambulance • Artificial limbs • Breast reconstruction surgery (mastectomy-related) • Dental expenses (exams, cleanings, X-rays, root canals bridges, etc.) • Diagnostic fees • Doctor fees (including Chiropractic services) • Drugs - prescription and over the counter (when ordered by physician) • Eyeglasses and exams, contact lenses & solutions, laser surgery • Fertility enhancements • Hearing aids and batteries • Hospital and Laboratory fees • Long-term care (medical expenses and premiums) • Nursing home • Physical and speech therapies • Psychiatric care • Smoking-cessation programs and products • Vasectomy • Weight-loss program (to treat a specific disease diagnosed by a physician)

8

MEDICAL INSURANCE

Employee Medical Payroll Deductions

Cigna OAP HSA- Micro with Battery Pak

Weekly Premium

Bi-Weekly Premium

Employee Only

$ 9.27

$ 18.55

Employee + Spouse

$128.13

$256.26

Employee + Child(ren)

$ 84.91

$169.82

Family

$200.16

$400.33

Cigna OAPIN 1000- Sportsman

Weekly Premium

Bi-Weekly Premium

Employee Only

$ 13.45

$ 26.91

Employee + Spouse

$156.11

$312.22

Employee + Child(ren)

$104.24

$208.47

Family

$242.57

$485.14

Cigna OAP 250- Pro Series

Weekly Premium

Bi-Weekly Premium

Employee Only

$ 34.97

$ 69.95

Employee + Spouse

$212.13

$424.26

Employee + Child(ren)

$147.71

$295.41

Family

$319.49

$638.98

9

DENTAL INSURANCE

JL Marine Systems 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.

DENTAL PPO Option 1

DENTAL PPO Option 2

In-Network

Out-of Network*

In-Network

Out-of Network*

CALENDAR YEAR DEDUCTIBLE Individual

$50

$50

$50

$100 $150

Family

$150

$150

$150

ANNUAL MAXMIUM

$1,000

$1,000

$1,500

$1,500

Diagnostic & Preventive

Exams Cleanings Fluoride X-Rays Sealants

Covered in full

Covered in full

Covered in full

Covered in full

Regular Restorative Services

Amalgam Fillings Extractions - Single Tooth Endodontics (Root Canal) Periodontics (Gum Disease) MAJOR SERVICES Crowns

Covered 80% after deductible

Covered 80% after deductible

Covered 80% after deductible

Covered 80% after deductible

Covered 50% after deductible Covered 25% after deductible

Covered 50% after deductible Covered 25% after deductible

Covered 50% after deductible Covered 50% after deductible

Covered 50% after deductible Covered 50% after deductible

Bridges Dentures

Orthodontia (child only)

Orthodontia Lifetime Maximum

$500

$1,500

Subject to balance billing. Please refer to your plan document for specific details.

DENTAL PPO Option 1

EMPLOYEE COST WEEKLY

EMPLOYEE COST BI-WEEKLY

Employee Only

$ 5.50 $12.75 $15.76 $23.06

$11.01 $25.51 $31.52 $46.12

Employee + Spouse

Employee + Child(ren)

Family

DENTAL PPO Option 2

EMPLOYEE COST WEEKLY

EMPLOYEE COST BI-WEEKLY

Employee Only

$ 5.91 $13.71 $18.51 $26.35

$11.83 $27.41 $37.02 $52.70

Employee + Spouse

Employee + Child(ren)

Family

VISION INSURANCE

JL Marine Systems offers vision coverage through Guardian. The Guardian vision network consists of optometrists, ophthalmologist opticians and optical retailers. You have the option of visiting any provider, however by choosing a participating provider, you receive the highest level of benefits.

Vision - Davis Vision

In-Network

Out-of-Network

Routine Eye Exams

$25 Copayment

Allowance up to $50

Allowance from $48 to $126 Depending on type of lenses

Lenses*

$25 Copayment

$150 allowance then 20% discount $150 allowance then 20% discount

Frames

$48 allowance

Allowance from $105 to $210 Depending on type of contacts

Contact Lenses

Frequency

Exam

Once every 12 months

Lenses or contact lenses

Once every 12 months

Frame

Once every 24 months

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.

EMPLOYEE COST WEEKLY

EMPLOYEE COST BI-WEEKLY

Employee Only

$ .90 $2.16 $2.13 $3.48

$1.80 $4.32 $4.27 $6.96

Employee + Spouse

Employee + Child(ren)

Family

11

FLEXIBLE SPENDING ACCOUNT (FSA) DEPENDENT CARE ACCOUNT

TYPICAL ELIGIBLE EXPENSES The following is a partial list of typical expanses eligible for health care FSA reimbursement. A complete list can be found at https://www.irs.gov • Deductible for group health and/or dental plan • Copayments for group health and/or dental plan • Many charges that are not covered by health/dental plan are also eligible for FSA reimbursement, such as: • Eye exams, eyeglasses, contact lenses; • Hearing exams, hearing aids, • Physical exams and mammograms in excess of one per year; • Medical expenses of a dependent not covered by a health plan • Orthodontia YOUR CONTRIBUTION The Internal Revenue service limits the amount you can contribute to a dependent care FSA, up to: • $5,000 per year, if you are married and filing a joint return, or if you are a single parent • $2,500 per year, if married and filing separate federal tax returns Estimate what your daycare expenses will be for the year, and allocate enough from your pay, up to the allowable contribution, to cover those expenses. JUST REMEMBER THIS: FSA dollars are “use-it-or- lose-it” funds. Account balances cannot be carried over from year to year. If you have unused funds at the end of the plan year, or at the end of any applicable grace a period, those funds will be forfeited. That’s an IRS requirement. So estimate the amount you want to contribute to your FSA carefully. • A spouse who is physically or mentally incapable of self-care and has the same principal residence as you • A tax dependent of yours who is under age 13, or • Any other tax dependent of yours, such as an elderly parent, who is physically or mentally incapable of self-care and has the same principal residence as you QUALIFYING DEPENDENT A qualifying dependent is: • Vision corrective surgery (such as Lasik) • Smoking cessation programs an related prescription drugs.

JL Marine Systems offers a both Health Care and Dependent Care Flexible Spending Account to all active employees working 24 or more hours per week. You may elect to have both types of accounts and contribute separate pretax dollar amounts to each. These accounts are kept completely separate; for instance, you could not be reimbursed for dependent care expenses from the health care account. HEALTH CARE ACCOUNTS A health care FSA can reimburse you for eligible medical, dental and vision expenses, up to the amount you elect to contribute for the plan year. Beginning in January 2018, the IRS limits the amount you may contribute to $2,650 per year. This amount will increase in future years to reflect cost-of-living increases. A Dependent Care FSA is a great way to pay dependent care expenses and lower your taxable income. Dependent Care Spending Accounts are pre-tax, payroll deduction accounts established to reimburse employees for out-of-pocket dependent care expenses. To be considered eligible, dependent care expenses must be incurred by an employee who must arrange for care of an eligible dependent in order to work. For married employees, dependent care must be necessary so that both spouses can work YOUR CONTRIBUTION The Internal Revenue service limits the amount you can contribute to a dependent care FSA, up to: • $5,000 per year, if you are married and filing a joint return, or if you are a single parent • $2,500 per year, if married and filing separate federal tax returns Estimate what your daycare expenses will be for the year, and allocate enough from your pay, up to the allowable contribution, to cover those expenses. JUST REMEMBER THIS: FSA dollars are “use-it-or-lose- it” funds. Account balances cannot be carried over from year to year. If you have unused funds at the end of the plan year, or at the end of any applicable grace a period, those funds will be forfeited. That’s an IRS requirement. So estimate the amount you want to • elderly parent, who is physically or mentally incapable of self-care and has the same principal residence as you • A spouse who is physically or mentally incapable of self-care and has the same principal residence as you

BASIC LIFE AND AD&D & VOLUNTARY LIFE INSURANCE

JL Marine Systems provides life insurance to all active full time employees at no cost to the employee. The chart below provides an overview of the plan.

BASIC LIFE INSURANCE

Benefit Outline

Class 1 (Managers): $50,000 Class 2 (All Other Employees): $30,000

Benefit Amount

At age 65 reduce by 33% of original amount At age 70 reduce by 66% of original amount

Benefit Reduction Schedule

AD&D

Included - Equal to basic life

JL Marine Systems provides all active employees working 30 or more hours per week the option to purchase life insurance coverage through a group plan, at the employee’s cost..

VOLUNTARY LIFE INSURANCE

Employee Life

Increments of $10,000 up to $300,000. Minimum of $10,000

Guarantee Issue

$100,000

Increments of $10,000 up to $250,000. GI - $25,000 ($10,000 for spouse aged 65+)

Spouse Life

Dependent Life

Increments of $1,000 up to $10,000

AD&D (Employee Only)

Optional – If elected equal to life amount

Benefit Reduction Schedule

At age 65 reduce by 33% of original amount At age 70 reduce by 66% of original amount

Monthly Voluntary Life and AD&D Rates per $1,000 *Spousal Rates are based on employee age.

Age Table

Employee

Spouse $0.073 $0.080 $0.120 $0.194 $0.299 $0.487 $0.764 $1.061 $1.959 $3.201

Child(ren)