NEW HIRE BENEFITS GUIDE - Team Focus Ins€¦ · Tampa. Major Physician Groups Cleveland Clinic Physician Group ... Bethesda Medical HCA Jupiter Medical Center Martin Memorial Medical

NEW HIRE BENEFITS GUIDE July 1, 2017 – June 30, 2018

What’s Inside

New Hire Enrollment Information

Eligibility 2

Medical Insurance

Prescription Drugs

5 Ways To Save

Cigna Telehealth Connection

Health Advocate 9

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance 14

Flexible Spending Account (FSA)

Allstate Supplemental Products

Consumerism Card

Pet Insurance

401(k)

Paid Time Off (PTO) 19

Employee Assistance Program (EAP) 20

Important Contacts 21

Dear Team Members,

Welcome to Team Focus Insurance Group. We look

forward to a long and successful working relationship

with our employees. We recognize that our employees

are our most valuable resource. Therefore, we strive

to provide competitive salaries and a comprehensive

benefits program designed to meet everyone’s

individual needs. This New Hire Benefits Information

Guide provides an overview of the benefits we offer.

We encourage you to take the time to educate

yourself about your options and choose the best

coverage for you and your family. The plans selected

will be effective from your initial eligibility date through

June 30, 2018.

Your HR team is here to answer questions and get you the

information you need so that you can choose the best

coverage for you and your family.

Best Regards,

Laura DeCespedes

Chief Human Resource Officer

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Qualifying Change in Status Examples of qualified family status change events include:

1. Special Enrollment Events (Add coverage).

• Loss of other coverage

• Acquire a new dependent through marriage,

birth or adoption

• Change in eligibility for Medicaid or CHIP

2. IRC Section 125 Status Change Events (Add,

cancel or change coverage).

• Loss or gain of other coverage

• Divorce

• Death of covered dependent

• Change in employment status

• Medicare Entitlement

You should verify the eligible events with Human

Resources. You must notify Human Resources within 30

days of an event (60 days in the case of Medicaid or CHIP

eligibility).

Benefit Election

Under Section 125 of the Internal Revenue Service (IRS)

code, you are allowed to pay for certain group insurance

premiums with tax free dollars. However, you must make

your benefit elections carefully, including the choice to

waive coverage. Your pre-tax elections will remain in

effect until the next annual Open Enrollment period

unless you experience an IRS approved qualifying

change in status.

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How to Enroll

1. Carefully review the plan information in this New Hire

Benefit Guide and all other plan materials included in

your enrollment packet. The insurance carrier’s

websites also provide important information and tools

that can help you make enrollment decisions.

2. Consider the needs of your dependents. If you are

married, review any coverage currently offered through

your spouse’s employer to avoid costly duplicate

coverage.

3. Once you have reviewed all of the options available to

you, log into the UltiPro self-serve system and follow the

simple step-by-step instructions for your online

enrollment.

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Eligibility

Team Member Eligibility

All regular full-time team members working at least 30 hours

per week will be eligible for benefits on the 1st of the month

following date of hire.

Dependent Eligibility You may also elect coverage for your dependents including:

• Your spouse

• A domestic partner

• Your dependent children

Your dependent child’s eligibility varies by line of coverage

as follows:

Proof of Dependency Proof of dependency will be required at time of

enrollment. Examples of acceptable documentation

include:

Proof for Dependent Child

• Birth Certificate

• Document from Hospital with Name and Birth

Date

• Adoption papers

• Legal Guardianship substantiated by a Court

Order

• Medical Support Court Order

Proof for Dependent Spouse or a Domestic Partner

• Proof of common residence (example: utility bill)

• Proof of financial interdependency (example:

shared bank statement)

• Most recent year’s 1040 Married filing jointly

federal tax return that lists the spouse

• Marriage License

• Affidavit

You should verify the acceptable documentation with

Human Resources. Please be sure to submit your

documentation to Human Resources during the

enrollment period.

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Dependent Definitions

A Dependent Child consists of:

The team member’s children or the children of the

team member’s spouse. This includes natural children,

legally adopted children, step children, children placed

for adoption, children under legal guardianship

substantiated by a court order and living with the team

member and children who are entitled to coverage

under a medical support order. Dependent children’s

spouses and/or children are not eligible dependents of

the team member.

Children of a Domestic Partner consist of:

The children of the domestic partner, including natural

children, legally adopted children and children under

legal guardianship substantiated by a court order.

These children are eligible for dependent coverage if

they are primarily dependent on the domestic

partnership for support, reside with the domestic

partners in a regular parent child relationship, meet

the age/school requirements of the benefit plan and

meet the definition of an eligible child under the

Internal Revenue Service Code § 152.

Medical ─ Up to 26 years old

─ Up to 30 years old if the child:

Is unmarried and does not have a

dependent of his or her own;

Is a resident of this state or a full-time or

part-time student; and

Is not provided/offered coverage as a

named subscriber, insured, enrollee, or

covered person under any other group,

blanket, or franchise health insurance policy

or individual health benefits plan, or is not

entitled to benefits under Title XVIII of the

Social Security Act.

Dental & Vision ─ Up to 26 years old

Life ─ Up to age 19

─ Up to age 25 if full-time student

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Medical Insurance

We offer three (3) Cigna medical plan options. All three plans are

Open Access, so referrals from your Primary Care Physician (PCP)

are not required to visit a Specialist.

LocalPlus Open Access Plus In-Network Plan (HMO)

Cigna has developed a local network called LocalPlus in order to offer

members quality and cost-effective health care coverage. The Cigna

LocalPlus network includes all hospitals in the Open Access Plus

network and a select group of local, quality health care professionals.

Refer to the listing of Cigna’s LocalPlus service areas and major

physician groups and hospital systems.

This plan only provides coverage for services performed by providers

in the plan’s network, with the exception of true emergencies. In

service areas where the LocalPlus Network is not available, members

can access doctors and hospitals in Cigna’s national Away From

Home (Open Access Plus) Network and receive coverage at the in-

network level.

Open Access Plus In-Network Plan (HMO)

This plan only provides coverage for services performed by providers

in the plan’s network, with the exception of true emergencies. The

plan utilizes Cigna’s national Open Access Plus network.

Open Access Plus Plan (PPO)

This plan provides In-Network and Out-of-Network benefits. In-

Network services yield the highest level of benefits with the lowest

out-of-pocket expenses because services are paid based on

contracted rates.

LocalPlus

Service Area

Broward, Sarasota, Martin, Miami-Dade, Monroe,

Palm Beach and St Lucie counties

*Also available in Orlando and Tampa

Major Physician Groups Cleveland Clinic Physician Group

Medical Specialists of the Palm Beaches

Miami Children's Physician Group

University of Miami Physicians

Holy Cross Medical Group

VitalMD

Gastro Health, PL

Pediatric Associates

Major Hospital Systems

Baptist Health South Florida

Bethesda Medical

HCA

Jupiter Medical Center

Martin Memorial Medical Center

Memorial Healthcare System

North Broward Hospital District

Tenet System

University of Miami

LocalPlus - Other States

Arizona: Phoenix

California: Northern/Bay Area, Southern

Colorado: Front Range, Mountain, Southwest

Georgia: Atlanta, Augusta, Columbus, Macon,

Rome, Savannah

Illinois: Chicago

Kansas: Butler, Harvey, Kingman, Sedgwick,

Sumner

Massachusetts: Statewide

Missouri: St. Louis (IFP only)

Nevada: Las Vegas

Rhode Island: Statewide

South Carolina: Greenville, Spartanburg

Tennessee: Statewide

Texas: Austin, Brazos, Dallas, Ft Worth, Houston

Find a Provider…

Visit www.cigna.com, and click “Find a Doctor”.

Choose “For plans offered through work or school”

Enter your search criteria

Choose the “LocalPlus” network for the LocalPlus plan

Choose the “Open Access Plus” network for the Open

Access Plus HMO and PPO plans

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http://www.cigna.com/

LocalPlus Open Access Plus

(HMO)

Open Access Plus (HMO)

Open Access Plus (PPO)

In Network Benefits

Calendar Year Deductible (CYD)

Single / Family $1,000 / $3,000

Single / Family $1,000 / $3,000

Single / Family $500 / $1,500

Coinsurance 20% 20% 20%

PCP Visit $20 copay $20 copay $20 copay

Specialist Visit $40 copay $40 copay $40 copay

Express Clinics $20 copay $20 copay $20 copay

Urgent Care $50 copay $50 copay $50 copay

Emergency Room $250 copay $250 copay $200 copay

Inpatient Hospital 20% after CYD 20% after CYD 20% after CYD

Outpatient Surgery 20% after CYD 20% after CYD 20% after CYD

Out-of-Pocket Maximum1

Single / Family $4,000 / $8,000

Single / Family $4,000 / $8,000

Single / Family $4,000 / $8,000

Out of Network Benefits

Calendar Year Deductible (CYD) Not Applicable Not Applicable Single / Family

$1,000 / $3,000

Coinsurance Not Applicable Not Applicable 50%

Out-of-Pocket Maximum1 Not Applicable Not Applicable Single / Family

$8,000 / $16,000

Glossary of Terms

Calendar Year Deductible (CYD) –

The amount each member or family

must pay before Cigna and the member

each pay their portion of the bill.

Coinsurance – The sharing of health

care expenses for covered services

between the member and Cigna.

Copayment – The dollar amount

required to be paid by a member to a

Provider when services are rendered.

Inpatient – A patient who is admitted for

an overnight stay in a medical facility

(i.e. hospital).

Network – The group of Providers who

are approved for services and are

available for treatment under Cigna’s

contract.

Outpatient – A patient who receives

treatment at a hospital or an outpatient

facility without being admitted overnight.

Out-of-Pocket Maximum – The

maximum dollar amount that each

member will pay each plan year. Once

the out-of-pocket maximum is reached,

Cigna will pay 100% for the remainder

of the plan year.

Primary Care Physician (PCP) – A

Physician who provides medical

services to members.

Specialist – A Physician who limits

practice to specific services (i.e.

Surgery, Radiology, Pathology), certain

body systems (i.e. Dermatology,

Orthopedics, Cardiology), or types of

diseases (i.e. Allergy, Oncology).

1Out-of-Pocket Maximum includes deductible, coinsurance, and co-pays, excluding Rx.

Refer to SBC and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.

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(HMO)



Retail (30 day supply)

Tier 1 $15 copay $15 copay $15 copay



Tier 4 20% to $100 max/script 20% to $100 max/script 20% to $100 max/script

Mail Order (90 day supply)

2.5 x retail copay 2.5 x retail copay 2.5 x retail copay

Rx Out-of-Pocket Maximum 1

$2,000 / $4,000 $2,000 / $4,000 $2,000 / $4,000


(HMO)



Team Member Only $27.91 $40.36 $62.95

Team Member + Spouse $115.86 $141.26 $264.41

Team Member + Child(ren) $111.30 $136.03 $259.12

Family $265.38 $312.80 $422.85

1Rx Out-of-Pocket Maximum applies to Rx copays only.

Step Therapy

Step Therapy through Cigna’s

Pharmacy Management involves a two

or three “step” sequence of medication

used to treat certain conditions including

high blood pressure, high cholesterol,

and stomach acid conditions.

Members are required to try a “first

step” medication, generally a generic,

before stepping to a higher cost

medication, if medically necessary.

Physicians can request prior

authorization for a second or third step

medication for the medical necessity by

contacting Cigna directly. Coverage will

be provided for an affected medication

(new and existing prescriptions) for a

60-day grace period. You will then

receive an education letter so you can

speak to your physician to determine if

a more cost-effective prescription is

appropriate and/or discuss how to

submit a request for authorizations.

Future refills of impacted medications

will not be covered unless prior

authorization is obtained. Contact Cigna

for more information.

Mail Order

Cigna’s Home Delivery Pharmacy

Program offers a convenient and cost-

effective way to obtain your medications

without leaving the comfort of your own

home. All maintenance medications,

including contraceptives, must be

purchased through the Cigna Tel-Drug

Home Delivery Pharmacy Program.

Contact Cigna for more information or

log onto www.cigna.com to print an

order form or place an order online.

Prescription Drugs

The prescription drug program is also through Cigna.

We have included information regarding the Step

Therapy Program and Mail Order Program.

Bi-Weekly Cost

Below are your bi-weekly payroll contribution amounts for medical insurance,

depending on the coverage and plan you elect.

Refer to SBC and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.

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4. Use Telehealth, Retail & Urgent Care

Centers for non-emergencies, and the

Emergency Room for true emergencies.

Telehealth Connection.

See page 8.

Retail / Convenience Health Clinic.

While these clinics lack the personal

nature of seeing a family physician who

knows your complete medical history,

their appeal is the temporary relief

when your doctor is not available and

low cost.

Urgent Care Center. If you need

medical care when your regular doctor

is not available, think about going to an

urgent care center rather than a

hospital emergency room. They usually

have a lower copayment and seeking

care is faster than at an emergency

room.

Emergency Room. A visit to the

hospital emergency room is the most

expensive type of outpatient care.

Emergency rooms should only be used

for true emergencies, as they are

staffed, equipped, and best suited for

medical emergencies. Do not return to the Emergency Room for follow-up visits; these visits will not be covered; visit a participating provider for your follow-up care.

5. Use in-network providers. Participating

providers generally charge discounted

rates for plan members. When you go to a

non-participating provider you will likely pay

a higher coinsurance percentage and will

likely have to pay the difference in price

between the participating provider’s

discounted fee and the non-participating

provider’s “regular” fee.

1. Look into discount generic drug programs offered by local

pharmacies.

Publix

5 FREE Antibiotics (up to 14-day supply) FREE Amlodipine (up to 90 day supply) FREE Lisinopril (up to 90 day supply) FREE Metformin (up to 90 day supply)

Wal-Mart 30-day supply for $4 90-day supply for $10

Winn Dixie 30-day supply for $4 90-day supply for $10

Kmart 30-day supply for $5 90-day supply for $10 or $15

2. Research brand name drug rebates online. Many

manufacturers offer discounts/rebates.

3. Look into freestanding surgical and diagnostic centers. If

you need surgery, you might save money by having it

performed at an ambulatory surgical center (a clinic that is not

associated with a hospital.) These sites usually charge less

than hospitals or their outpatient surgical centers. Freestanding

diagnostic centers are also available and tend to charge less for

certain tests like MRIs, CAT scans, X-rays and bone density

scans. Always make sure the facility is in your plan’s network

and that your plan’s benefits cover the service.

- Membership fees may apply - Offers are subject to change

5 Ways To Save

Health care costs continue to increase. This

continuing trend can significantly impact

your budget. Here are some helpful tips on

how to save on your medical and pharmacy

expenses.

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Cigna provides access to two telehealth services as part of your medical

plan – AmWell and MDLIVE.

Cigna Telehealth Connection lets you get the care you need – including

most prescriptions – for a wide range of minor conditions with a $20 copayment. Now you can connect with a board-certified doctor via

secure video chat or phone, without leaving your home or office. When,

where and how it works best for you!

Choose when: Day or night, weekdays, weekends and holidays.

Choose where: Home, work or on the go.

Choose how: Phone or video chat.

Choose who: AmWell or MDLIVE doctors.

The cost savings are clear.

Televisits with AmWell and MDLIVE can be a cost-effective alternative to

a convenience care clinic or urgent care center, and cost less than going

to the emergency room. And the cost of a phone or online visit is the

same as your primary care provider. Remember, your telehealth

services are only available for minor, non-life threatening conditions. In

an emergency, dial 911 or go to the nearest hospital.

How to Use

AmWell and MDLIVE are both quality

national telehealth providers so you

can choose your care confidently.

When you can’t get to your doctor,

Cigna Telehealth Connection is here

for you.

Signing up is easy!

Set up and create an account

with one or both AmWell and

MDLIVE

Complete a medical history using

their “virtual clipboard”

Download vendor apps to your

smartphone/mobile device

If you pre-register on both AmWell

and MDLIVE, you can speak with a

doctor for help with:

Sore throat

Headache

Stomachache

Fever

Cold and flu

Allergies

Rash

Acne

UTIs and more

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Health Advocate

Team Focus Insurance Group provides access to

Health Advocate, at no cost.

Health Advocate is a program that provides you with

your own personal health advocate to help with your

and your entire family’s healthcare needs. Through

this program you can receive assistance to navigate

the healthcare system and maximize your healthcare

benefits.

Clinical services

• Find the best doctors and hospitals

• Locate and research treatments for a medical condition

• Secure second opinions

Health coaching

• Help prepare patients for healthcare appointments

• Help members better understand their conditions

Administrative services

• Resolve insurance claims issues

• Assist with correcting billing mistakes

Personal Health Advocate

• Registered Nurse

• Medical Director Support

To access this program, please contact Health Advocate at (866) 695-8622, and make sure to let the

representative know that you are affiliated with Team Focus Insurance Group.

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DHMO Routine Cleanings 1110/1120 2 per Calendar Year No charge

Routine X-Rays No charge

Resin Based Filling Posterior One Surface 2391 $45 copay

Root Canal – Molar 3330 $530 copay, excludes final restoration

Orthodontics Start-Up 8660 Comprehensive Treatment Retention 8680

$66 copay $2,472 Child / $3,336 Adult

$345 copay

PPO

In-Network Out-of-Network

Calendar Year Deductible (CYD) $50 Individual $150 Family

$50 Individual $150 Family

Calendar Year Maximum $1,500 per member $1,500 per member

Preventive Services Cleanings, Exams, X-Rays

Member 0% Cigna 100%, CYD Waived

Member 0% Cigna 100%,

after CYD

Basic Services Filings, Oral Surgery, Non-routine X-Rays

Member 10%, Cigna 90%, after CYD

Member 20%, Cigna 80%, after CYD

Major Services Crowns, Bridges, Dentures, Root Canals

Member 40% Cigna 60%, after CYD

Member 50% Cigna 50%, after CYD

Orthodontia Not Covered

Wellness Plus Reward Members will receive an additional $250

per year when a preventive service is utilized

DHMO PPO

Team Member Only $3.16 $11.91

Tem Member + Spouse $7.16 $29.84

Team Member + Child(ren) $7.20 $29.98

Family $12.68 $41.28

Bi-Weekly Cost Below are your bi-weekly payroll contribution

amounts for dental insurance, depending on the

coverage and plan you elect.

Find a Provider…

Visit www.cigna.com, and click “Find a Doctor”.

Choose “For plans offered through work or

school”


Choose the “Cigna Dental Care” network for

the DHMO plan

Choose the “Cigna Dental PPO or EPO”

network for the PPO plan

DHMO WAOV9 Plan: The DHMO plan requires

you to select a primary dentist, receive referrals for

specialist care, and seek care exclusively from

participating providers. Services are paid through

copayments. The plan provides you with an

unlimited benefit maximum. Two routine cleanings

and X-Rays are covered every year at no cost to

you. Orthodontic services for children and adults are

covered through copayments.

PPO Plan: The PPO plan allows

you to seek care from participating

and non-participating providers

with no referrals needed. A

calendar year maximum benefit

will apply to In and Out of Network

services. In-Network benefits are

paid based on contracted rates

and Out-of-Network benefits are

paid based on reasonable and

customary rates. Orthodontic

Services are not covered by the

plan.

Refer to Benefit Summary and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.

Dental Insurance

We offer a DHMO plan and a PPO plan through Cigna:

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VSP Vision Plan

In-Network Out-of-Network

Exam Once Every 12 Months $10 copay Up to $45

Lenses Once Every 12 Months Single Bifocal Trifocal

$25 copay

Up to $30 $50 $65

Frames Once Every 24 Months

$25 copay. $130 allowance, then 20% off the amount over your

allowance. Up to $70

Contact Lenses In Lieu of Eyeglasses Once Every 12 Months

$130 allowance Up to $105

Vision

Team Member Only $3.35

Team Member + Spouse $5.36

Team Member + Child(ren) $5.47

Family $8.83

Refer to Benefits Summary and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.

Bi-Weekly Cost

Below are your bi-weekly payroll contribution amounts for

vision insurance, depending on the coverage and plan

you elect.

Find a Provider…

Visit www.vsp.com, and click “Find a Doctor”.


Choose the “Choice” network

Vision Insurance

We offer a vision plan through VSP (Vision Service Plan). Benefits are available every 12 months for exams and

lenses or contact lenses and every 24 months for frames.

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http://www.vsp.com/

Voluntary Life/AD&D: All full-time benefits-eligible team

members may purchase additional Life and AD&D

insurance through CIGNA. During your initial enrollment

period, Evidence of Insurability will not be required if you

are applying for an amount under the Guarantee Issue.

Voluntary Life & AD&D coverage’s are not bundled and

are available on a standalone basis.

Life Coverage AD&D Coverage

Team Member

$25,000 increments to a maximum of $500,000 Guarantee Issue: $200,000 $25,000 increments to a maximum of $500,000

Spouse $5,000 increments to a maximum of $250,000 Guarantee Issue: $25,000 50% of Team Member’s coverage amount

Children

Infant = $500 6 Months – Age 19 = $1,000 increments to a maximum of

$10,000 Guarantee Issue: Full amount

$2,000 increments to a maximum of $10,000

Age Restriction *Only covers dependent children under age 19 (or 25 if full time student) and spouse under age 70.

Voluntary Life Bi-Weekly Rates Team Member or Spouse (not combined)

Age $25,000 $50,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000 0-24 $0.85 $1.71 $2.56 $3.42 $4.27 $5.12 $5.98 $6.83 $7.68 $8.54

25-29 $0.97 $1.94 $2.91 $3.88 $4.85 $5.82 $6.78 $7.75 $8.72 $9.69

30-34 $1.10 $2.19 $3.29 $4.38 $5.48 $6.58 $7.67 $8.77 $9.87 $10.96

35-39 $1.34 $2.68 $4.02 $5.35 $6.69 $8.03 $9.37 $10.71 $12.05 $13.38

40-44 $1.94 $3.88 $5.82 $7.75 $9.69 $11.63 $13.57 $15.51 $17.45 $19.38

45-49 $3.39 $6.78 $10.18 $13.57 $16.96 $20.35 $23.75 $27.14 $30.53 $33.92

50-54 $5.57 $11.15 $16.72 $22.29 $27.87 $33.44 $39.01 $44.58 $50.16 $55.73

55-59 $8.72 $17.45 $26.17 $34.89 $43.62 $52.34 $61.06 $69.78 $78.51 $87.23

60-64 $13.73 $27.46 $41.19 $54.92 $68.65 $82.38 $96.12 $109.85 $123.58 $137.31

65-69 $24.46 $48.92 $73.38 $97.85 $122.31 $146.77 $171.23 $195.69 $220.15 $244.62

70-74 $42.58 $85.15 $127.73 $170.31 $212.88 $255.46 $298.04 $340.62 $383.19 $425.77

75-79 $73.50 $147.00 $220.50 $294.00 $367.50 $441.00 $514.50 $588.00 $661.50 $735.00

80-100 $123.23 $246.46 $369.69 $492.92 $616.15 $739.38 $862.62 $985.85 $1,109.08 $1,232.31

Life Insurance

Basic Life & AD&D – Employer Paid: All full-time benefits-eligible team members will receive Group Life & AD&D

Insurance that will cover 2 times their covered annual earnings up to a maximum of $300,000 through CIGNA. Please

make your beneficiary designations during this initial enrollment. Please see HR for additional information.


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Voluntary Life Bi-Weekly Rates Team Member or Spouse (continued)

Age $275,000 $300,000 $325,000 $350,000 $375,000 $400,000 $425,000 $450,000 $475,000 $500,000 0-24 $9.39 $10.25 $11.10 $11.95 $12.81 $13.66 $14.52 $15.37 $16.22 $17.08

25-29 $10.66 $11.63 $12.60 $13.57 $14.54 $15.51 $16.48 $17.45 $18.42 $19.38 30-34 $12 06 $13 15 $14 25 $15 35 $16 44 $17 54 $18 63 $19 73 $20 83 $21 92 35-39 $14.72 $16.06 $17.40 $18.74 $20.08 $21.42 $22.75 $24.09 $25.43 $26.77 40-44 $21 32 $23 26 $25 20 $27 14 $29 08 $31 02 $32 95 $34 89 $36 83 $38 77 45-49 $37.32 $40.71 $44.10 $47.49 $50.88 $54.28 $57.67 $61.06 $64.45 $67.85 50-54 $61 30 $66 88 $72 45 $78 02 $83 60 $89 17 $94 74 $100 32 $105 89 $111 46 55-59 $95.95 $104.68 $113.40 $122.12 $130.85 $139.57 $148.29 $157.02 $165.74 $174.46 60-64 $151 04 $164 77 $178 50 $192 23 $205 96 $219 69 $233 42 $247 15 $260 88 $274 62 65-69 $269.08 $293.54 $318.00 $342.46 $366.92 $391.38 $415.85 $440.31 $464.77 $489.23 70-74 $468 35 $510 92 $553 50 $596 08 $638 65 $681 23 $723 81 $766 38 $808 96 $851 54 75-79 $808.50 $882.00 $955.50 $1,029.00 $1,102.50 $1,176.00 $1,249.50 $1,323.00 $1,396.50 $1,470.00

80-100 $1,355 54 $1,478.77 $1,602 00 $1,725 23 $1,848 46 $1,971 69 $2,094 92 $2,218 15 $2,341 38 $2,464 62

Voluntary Life Bi-Weekly Rates Child(ren)

$1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 $9,000 $10,000

$0.116 $0.233 $.349 $.465 $.582 $.698 $.814 $.930 $1.047 $1.163

Voluntary AD&D Bi-Weekly Rates Team Member

$25,000 $50,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000

$0.40 $0.81 $1.21 $1.62 $2.02 $2.42 $2.83 $3.23 $3.63 $4.04

$275,000 $300,000 $325,000 $350,000 $375,000 $400,000 $425,000 $450,000 $475,000 $500,000

$4.44 $4.85 $5.25 $5.65 $6.06 $6.46 $6.87 $7.27 $7.67 $8.08

Voluntary AD&D Bi-Weekly Rates Spouse

$12,500 $25,000 $37,500 $50,000 $62,500 $75,000 $87,500 $100,000 $112,500 $125,000

$0.20 $0.40 $0.61 $0.81 $1.01 $1.21 $1.41 $1.62 $1.82 $2.02

$137,500 $150,000 $162,500 $175,000 $187,500 $200,000 $212,500 $225,000 $237,500 $250,000

$2.22 $2.42 $2.63 $2.83 $3.03 $3.23 $3.43 $3.63 $3.84 $4.04

Voluntary AD&D Bi-Weekly Rates Children (One premium rate covers all eligible children)

$2,000 $4,000 $6,000 $8,000 $10,000

$0.03 $0.06 $0.10 $0.13 $0.16

* Rates are subject to change.


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Disability Insurance

Long-Term Disability – Employer Paid: All full-

time benefits-eligible team members receive Long-

Term Disability Insurance through Cigna. The

Long-Term Disability Insurance is designed to

protect your earnings for an extended disability. A

monthly benefit will be paid based on 60% of your

covered monthly earnings up to a maximum benefit

of $10,000 per month. The policy includes a 90 day

elimination period before benefits are payable.

Voluntary Short-Term Disability: All full-time benefits-eligible team members may purchase Short-Term

Disability Insurance through Cigna. A weekly benefit will be paid based on 60% of your covered weekly

earnings up to a maximum benefit of $2,000 per week. Benefits begin on the 8th day of disability. Benefits

are paid for a maximum of 12 weeks During your initial enrollment period, Evidence of Insurability will not

be required.

Voluntary Short-Term Disability Bi-Weekly Rates

Use the calculation below to determine your STD bi-weekly payroll deductions.

____________ X 60% = ___________ X .034 = ____________ X 12 ÷ 26 _____________

Weekly Salary* STD Benefit Monthly Cost Your bi-weekly Cost

(Maximum $2,000)

* Note this is an estimate of premium cost. Actual deductions may vary slightly due to rounding andpayroll frequency. Maximum weekly covered salary is $3,335.


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Please note the following:

• If eligible, you may elect to have both types of FSAs and contribute separate pretax dollar amounts to each.

• Your contributions are deducted from your paycheck in equal installments each pay period.

• “Use It or Lose It” –You must use your contributions or lose them at the end of the plan year.

• Under a Section 125 plan, participant elections generally must be irrevocable until the beginning of the next plan

year. However, when a participant experiences one of several specific recognized events, he or she may be

permitted to make a change in election that is consistent with the event.

Health Care Reimbursement FSA: The maximum annual contribution is $2,600.

With pre-tax dollars, you may use your funds for health care expenses not covered by your insurance.

Eligible expenses include medical, dental and vision. For a complete list of eligible expenses, please

refer to IRC Section 213. Under a rule that went into effect January 1, 2011, claims for over-the-counter

medicine or drug expenses (other than insulin) cannot be reimbursed without a prescription.

Dependent Care FSA: The annual limit a team member may contribute is $5,000 ($2,500 for a married

individual filing taxes separately).

A dependent care FSA allows you to use pretax dollars towards

qualified dependent care; care must be provided by a qualified

dependent care service, not a relative. Funds may be used for the

care of eligible dependent children (under the age of 13 who live with

you) by a babysitter, day care center, or before-school or after-school

program. Care for an eligible disabled spouse, parent or child over the

age of 12 who lives with you, may also be eligible for reimbursement.

Care must be provided to keep you and your spouse gainfully

employed. For a complete list of eligible expenses, please refer to

IRC Sections 21 and 129.

At any given time, Dependent Care FSA distributions are limited to the amount you have in your account.

Dependent care expenses cannot be reimbursed until they are actually incurred.

Flexible Spending Account (FSA)Through a Section 125 Plan, Team Focus Insurance Group offers eligible team members the opportunity to open a

Flexible Spending Account(s) (FSAs). An FSA is a tax-free account, in your name, that pays or reimburses you for

qualified health care or dependent care expenses. Your FSA contributions are made pretax (no employment or

federal income taxes are deducted) through payroll deductions. When you receive a distribution from your FSA, the

reimbursements are tax-free. Eligible expenses must be incurred from July 1, 2017 – September 15, 2018.

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Consumerism Card

The Consumerism Card is offered to compliment your “true”

insurance saving you additional money, which includes the

following:

• Access to discounted services, providers and

products

• Additional savings when you or a family member

reach the maximum annual benefit on your

insurance plan

• Doctors by phone/video and medical bill negotiation

Base Card ($10 per month)

• Teladoc (No Consult fee)

• Dental

• Vision

• Pharmacy

• Travel Assistance

• Vitamins

• Diabetic Supplies

• Hearing Aids

• Lab Testing & Imaging Services

Upgraded Card ($15 per month)

• ALL Benefits from Base Card

• Identity Theft

• Legal Services


Other Supplemental Coverage is available through

Allstate. Critical Illness

Critical Illness helps provide much needed cash

when a catastrophic illness strikes (heart attack,

stroke, renal failure). Benefits are paid directly to

you regardless of other insurance. You may also

add a health screening and/or cancer rider to this

policy.

Accident Care Insurance

Helps you pay unexpected expenses from covered

accidents that result in lacerations, fractures, broken

bones and other injuries. This coverage is also

available for family members.

Hospital Indemnity

Helps you pay unexpected expenses from illness,

injury, or pregnancy where there is a hospitalization.

This coverage is also available for family members.

Cancer

Helps you pay expenses from cancer diagnosis and

treatment of cancer. This coverage is also available

for family members.

If you are interested in obtaining additional

information, please contact Heather Peruzzi at

Benefits Technologies at 561-922-3960.

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Pet Insurance

Team Focus Insurance Group knows that pets are part of your

family, so we are excited to offer the opportunity to purchase pet

insurance through Nationwide, the #1 choice for pet insurance.

You can choose a pet health plan that fits your needs, whether

you are looking for basic wellness coverage or comprehensive

major medical coverage for your pet. It’s easy to use the plan!

Nationwide Pet Insurance Plans offer the following

benefits:

• Members may visit any veterinarian, at anytime,

anywhere in the world

• Never any hassle of membership cards

• Members are free to continue seeing their trusted, long-

time veterinarians

• Visits to any emergency hospital or specialist are covered

• Plans are available in all 50 states, and coverage extends

to treatment received anywhere in the world.

• Members are reimbursed for all covered conditions

Using Your Pet Insurance Policy

1. Pay your vet

Pay for your pet’s treatment at the

time of service

2. Submit your claimMail or email your claim form along

with your vet bill

3. Get reimbursed!

According to your plan, after

meeting the deductible (if any)

To enroll in Pet Insurance, visit Nationwide

at www.petinsurance.com/teamfocusins.

17

http://www.petinsurance.com/teamfocusins

Reasons to Join the

401(k) Plan

• Tax-deferred savings let you

increase your take home pay and

decrease your current taxable

income.

• Team Focus Insurance Group

may offer a discretionary match,

that’s free money. The company

match can help your investments

grow.

• Automatic payroll deductions

make it easy to save. It’s easy to

pay yourself first by setting up

contributions right from your

paycheck.

401(k)

Team Focus Insurance Group offers a 401(k) retirement plan though John

Hancock, a well-established financial services leader serving the financial

needs of millions of customers in 22 countries, as part of our

Comprehensive Benefit Package.

A 401(k) plan allows you to contribute an amount from your income to a

retirement account and to defer taxes until withdrawal.

Full-time regular team members who are over 18 years of age are eligible

to enroll the first of the quarter after a 90 day waiting period.

Quarters begin January 1, April 1, July 1 and October 1.

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Paid Time Off (PTO)

Paid Time Off (PTO) Accrual Rates

Years of Service Days Accrued per Year

Hours Accrued per Year

Hours Accrued per Pay Period

Maximum Accrual Cap

0 through 1 year 13 days 104 hours 4.00 hours 104 hours

1+ Years 15 days 120 hours 4.62 hours 160 hours



The Team Focus Insurance Group Paid Time Off (PTO) benefit program provides you with the flexibility to use your

time off to meet your personal needs, while recognizing your individual responsibility to manage your paid time off. The

information below outlines how the benefit is earned and intended to be used along with the benefit accrual schedule.

Full-time, regular status team members who work at least 32 hours per week, begin accruing PTO on a bi-weekly basis

upon their date of hire. The PTO accrual rates are determined by the team member’s length of service with the

company. Team members can earn and maintain in their PTO Benefit bank up to the maximum accrual cap.

In addition to the PTO benefit, the company also observes 7 holidays: New Year’s Day, Memorial Day, Fourth of July,

Labor Day, Thanksgiving and the day after Thanksgiving, and Christmas Day. Full-time, regular team members will be

paid holiday pay for these observed holidays.

For additional information regarding the Team Focus Insurance Group PTO policy, please visit the UltiPro homepage.

19

Employee Assistance Program (EAP)

Team Focus Insurance Group provides our team members with an Employee Assistance Program

through Cigna that is available at no cost. The program includes three face-to-face sessions with a

behavioral counselor for you and your household members, as well as telephonic and online support.

Legal consultation. Receive a free 30-minute consultation. And up to a 25%

discount on select fees.

Parenting. Get guidance on child development, sibling rivalry, separation

anxiety and much more.

Senior care. Learn how to solve the challenges of caring for an aging loved

one.

Child care. Whether you need care all day or just after school, find a place

that’s right for your family.

Pet care. From grooming to boarding to veterinary services, find what you

need to care for your pet.

Financial Services & Referral. Receive a free 30-minute consultation and

25% discount on select fees with network providers.


20

Important Contacts Need additional information? Have a question about one of your benefits? Keep this brochure handy for a quick reference for all your benefit needs. Below is contact information for each of our providers.

Human Resources Department

Team Focus Insurance Group HR Team Ext. 4411 [email protected]

Medical

Cigna Group #3333453 1-800-244-6224 www.mycigna.com


AMWell MDLIVE

1-855-667-9722 1-888-726-3171

www.AmWellforCigna.com wwwMDLIVEforCigna.com

Health Advocacy

Health Advocate 1-866-695-8622 www.healthadvocate.com

Dental

Cigna Group #3333453 1-800-244-6224 www.mycigna.com

Vision

VSP Group #30020064 1-800-877-7195 www.vsp.com

Life & Disability

Cigna 1-800-362-4462 www.cigna.com

Flexible Spending Account

Diversified 1-954-983-9970 www.div125.com


Benefit Technologies 1-561-922-3960 [email protected]

Consumerism Card

New Benefits 1-800-800-7616 www.mymemberportal.com 401(k)

John Hancock 1-800-395-1113 www.jhancockpensions.com

Employee Assistance Program

Cigna 1-800-538-3543 www.cignabehavioral.com/cgi

Pet Insurance

Nationwide 1-877-738-7874 www.petinsurance.com/teamfocusins www.petnationwide.com

21

mailto:[email protected]

http://www.mycigna.com/

http://www.amwellforcigna.com/

http://www.healthadvocate.com/

http://www.mycigna.com/

http://www.vsp.com/


http://www.div125.com/

mailto:[email protected]

http://www.mymemberportal.com/

http://www.jhancockpensions.com/

http://www.cignabehavioral.com/cgi

http://www.petinsurance.com/teamfocusins

http://www.petnationwide.com/

Documents

NEW HIRE BENEFITS GUIDE - Team Focus Ins€¦ · Tampa. Major Physician Groups Cleveland Clinic Physician Group ... Bethesda Medical HCA Jupiter Medical Center Martin Memorial Medical