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TEAM MEMBER BENEFITS
2019 OPEN ENROLLMENT GUIDE
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TABLE OF CONTENTS
Introduction and Eligibility 3
Benefits Summary 4
Medical Plans 5
CDHPs and HSAs 6
Dental Plan 7
Vision Plan 8
Life Insurance 9
Disability 10
Employee Assistance Program 11
How to Enroll in Benefits 12
Contact Information 13
About the Guide 14
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INTRODUCTION AND ELIGIBILITY
Introduction to the Guide At Hulin Health we know how important it is to have a comprehensive and competitive benefits package. That’s why we continue to improve our benefit offerings that can provide protection, peace of mind, and savings. Whether it’s healthcare or income protection we’ve got you covered. This guide provides a general overview of your benefit options and enrollment information to help you select the coverage that’s right for you and your eligible dependents
Who is Eligible All full-time team members regularly scheduled to work at least 30 hours per week are eligible for benefits. As a benefits-eligible team member, you have the opportunity to enroll in or make changes to your benefit plans during our annual open enrollment period. If you’re enrolling as a new team member, you become eligible for benefits on the first of the month following 30 days of employment and must enroll within 31 days to have coverage for the rest of the plan year. You may also need to enroll for the next plan year’s benefits during the open enrollment period. Eligible dependents may also be enrolled for coverage. Eligible dependents include:
Your legal spouse Your child under age 26, regardless of marital or student status. Including your natural child, legally adopted child or
step-child Your child of any age who is medically certified as disabled and dependent on you for support and maintenance
Making Changes for Qualifying Life Events The benefits you choose at hire will be in place through April 2020, unless you have a Qualified Life Event, which includes the following:
Change in marital status, including marriage, legal separation or divorce Birth of a baby, adoption of a child, or placement of a child with you for legal adoption Death of a dependent Eligible dependent(s) gains or loses eligibility due to a change in employment status Eligible dependent child(ren) no longer meets the eligibility requirements. You or your dependent becomes entitled to, or loses, Medicare or Medicaid coverage
If you experience a Qualifying Life Event and choose to make changes to your benefits, you must notify the Hulin Health HR Team and submit a benefit change request within 31 days of the status change (60 days for birth or adoption). If you do not submit the benefits change and necessary documentation in the required timeframe, your coverage will remain unchanged for the remainder of the calendar year.
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BENEFITS SUMMARY
Benefit Enrollment Optional or Automatic Coverage
Medical Optional You and HH share the cost
HH offers two different plans through UnitedHealthcare including one Consumer Driven Health Plan (CDHP) and one Preferred Provider Organization Plan (PPO)
Health Savings Account (HSA)
Optional You and HH contribute
If you elect to participate in a CDHP, you can contribute pre-tax dollars to use for eligible heath care expenses. HH will also contribute money to your HSA. You must open an account through Navia Benefits in order to receive the HH contributions.
Dental Optional You and HH share the cost HH offers comprehensive dental coverage through MetLife.
Vision Optional You pay the cost HH offers a vision plan through EyeMed.
Basic Life / AD&D Automatic HH pays the cost HH pays for basic life and AD&D in the amount of $50,000.
Voluntary Life Optional You pay the cost
You may elect life insurance in $10,000 increments to maximum of $500,000. You can also purchase life insurance for your spouse and child(ren).
Short-Term Disability Optional You pay the cost
You may elect disability coverage in the amount of 60% of your annual base salary to a weekly maximum of $1,000.
Long-Term Disability Automatic HH pays the cost
You are eligible for coverage after 180 days of disability in the amount of 60% of annual base salary to a monthly maximum of $5,000.
Employee Assistance Program
Automatic HH pays the cost
You and your household members have access to free, confidential support to help with personal or professional problems.
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MEDICAL PLANS You may choose from two medical plan options through UnitedHealthcare. One option is a Consumer Driven Health Plan (CDHP) with the option of establishing an HSA account and one option is Preferred Provider Organization (PPO). These options each feature the national Choice Plus network of doctors and specialists who have agreed to provide services at a discounted price.
The information below is a summary of coverage only. Visit myuhc.com or uhc.com, and select “Choice Plus” as your plan to obtain a list of participating physicians. Out-of-network coverage is available, please refer to the Summary of Benefits and Coverage for additional information. You will receive the lowest costs by using in-network benefits.
Base Plan* AF5A $1500 HSA (CDHP)
Buy Up Plan ** AZVZ PPO $1000
Key Features In-Network In-Network Annual Deductible (Based on a Calendar Year) Individual $1,500 $1,000 Family $4,500 $2,000 Out-of-Pocket Maximum Individual $4,000 $6,000 Family $6,850 $12,000 Coinsurance 20% 20% Physician Services
Office Visit 20% after deductible $0 / $40 (over age 19); deductible does not apply
Specialist Visit 20% after deductible $0 / $80 (over age 19); deductible does not apply
Preventative Care 100% covered 100% covered Lab and X-Ray Services 20% after deductible 100% covered Inpatient Hospital Services 20% after deductible 20% after deductible Emergency Treatment Urgent Care 20% after deductible $75; deductible does not apply. Emergency Room 20% after deductible $350; deductible does not apply. Retail Prescriptions (30-day supply) Generic $10, after Medical deductible $10 Preferred brand $35, after Medical deductible $35 Non-preferred brand $60, after Medical deductible $60 Mail Order Prescriptions (90-day supply) Generic $30, after Medical deductible $30 Preferred brand $105, after Medical deductible $105 Non-preferred brand $180, after Medical deductible $180 Employer Contribution to Health Savings Account (HSA) Individual $500
N/A Family $500 Bi-Weekly Payroll Contributions (26 Pay Periods) Team Member Only $42.17 $95.40 Team Member + Spouse $222.79 $317.73 Team Member + Child(ren) $195.70 $284.38 Family $376.32 $506.71 *There is no individual deductible limit within the family deductible. The full $4,500 deductible must be met before
coinsurance applies for any family member.
**All individual deductible amounts will count towards meeting the family deductible, but an individual will not have to pay more than the individual deductible amount.
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CDHPs and HSAs Advantages of a Consumer Driven Health Plan and Health Savings Accounts If you’re enrolled in a Consumer Driven Health Plan (CDHP), you’re eligible to contribute on a pretax basis to a Health Savings Account (HSA). If you’ve had a traditional co-payment plan, you may be wondering how it is different from a CDHP with an HSA.
A Higher Deductible and a Lower Premium - Traditional co-payment plans typically have a lower deductible and higher premiums, so you pay more up front and less when you need care. CDHP’s have the opposite – a higher deducible but lower premiums. A Health Savings Account (HSA) - You open an HSA which is a personal bank account that you own. Here are some advantages of an HSA:
Get triple tax advantages: (1) Contribute pre-tax dollars (2) Grow your account tax-free (3) Use your HSA to pay for
eligible health care expenses tax-free.
Use it today or save for tomorrow. Your HSA is an account in your name; you own it, and you decide how to get the most from it. Lose the worry of having to spend it all before the end of the year. With the HSA, the balance rolls over year after year so you can let it grow over time.
You own the money in the HSA. There is no “use it or lose it” rule. If you choose to leave the company or switch
health care plans, you keep the money.
Employer Contributions. You are required to open an HSA through Navia Benefits Solutions in order to receive the employer contributions into your HSA. You will receive detailed instructions to set up an account once you are enrolled in a CDHP. The company’s contribution to your HSA will be made in two installments, processed in June and December. Mid-year enrollees will receive a pro-rated contribution from the company based on the quarter in which your coverage change is processed
It’s convenient. Contributions are automatically deducted from your paycheck. You can change or stop contributions at any time.
Below are 2019 IRS limits for HSA, which includes employer contributions:
$3,500 for individuals $7,000 for family $1,000 catch-up contributions for individuals who are 55 or older
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DENTAL PLAN Dental coverage is important to your overall health and wellness. You can enroll in dental benefits through MetLife for yourself and your family. The dental plan features a network of dentists and specialists who have agreed to provide services at a discounted price. If you choose to go to a dentist out of the network, you may be balanced billed for any charges over what is considered “reasonable and customary”. The great thing about MetLife is that the reimbursement for what is considered reasonable and customary is in the 90th percentile of fees charged in your area. This helps minimize any balancing billing but remember that the best way to maximize the benefit is by visiting an in-network dentist. The information below is a summary of coverage only. You may go online at www.metlife.com/dental to search for providers, view ID cards and access claims data. Please note, you will not receive an ID card for dental benefits with MetLife
Dental
Key Features In-Network Calendar Year Deductible
Individual $50
Family $150
Calendar Year Maximum Benefit $1,500
Services
Preventative& Diagnostic Services (no deductible) Covered at 100%
Basic Services 20% after deductible
Major Services 50% after deductible
Orthodontia
Appliances and related services 50%
Lifetime maximum $1,000
Age Limitation 19
Bi-Weekly Payroll Contributions (26 Pay Periods)
Team Member Only $5.94
Team Member + Spouse $20.66
Team Member + Child(ren) $23.99
Family $40.31
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VISION PLAN
Vision coverage is through EyeMed and provides an extensive network of vision optometrists and ophthalmologists. Go to www.eyemed.com for a list of participating providers.
Key Features In-Network Out-of-Network (By Reimbursement)
Exam (Once every 12 months) $10 copay Up to $40
Lenses (One pair every 12 months)
Single $25 copay Up to $30
Bifocal $25 copay Up to $50
Trifocal $25 copay Up to $70
Standard Frames (One pair every 12 months) $150 allowance; 20% off balance over $150 Up to $70
Contact Lenses (12-month supply) In lieu of frames and lenses
Conventional $0 Copay, $150 allowance, 15% off balance over $150 Up to $150
Medically Necessary $0 Copay, Paid-In-Full Up to $210
Bi-Weekly Payroll Contributions (26 Pay Periods)
Team Member Only $3.66
Team Member + Spouse $6.95
Team Member + Child(ren) $7.31
Family $10.74
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LIFE INSURANCE
Hulin Health provides life insurance options through MetLife.
BASIC LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) COVERAGE (100% EMPLOYER PAID) Hulin Health provides all eligible team members with a $50,000 Basic Life and AD&D coverage. If you suffer a covered loss due to an accident, AD&D coverage pays you a portion of the full benefit, as specified in the policy.
VOLUNTARY LIFE AND AD&D COVERAGE You can purchase voluntary life insurance for yourself, your spouse and your child(ren). Life insurance is about more than paying for memorial services—it’s about making sure your family can maintain its standard of living if something happens to you. How much your family needs depends on your personal situation (other income, monthly expenses, short and long-term debt such as credit card or mortgage expenses, etc.). By purchasing voluntary life insurance, you also get additional benefits including grief counseling, funeral discounts and planning services, will preparation, and estate resolution services. You may purchase voluntary life coverage for yourself in increments of $10,000 and your spouse in increments of $5,000. To purchase supplemental coverage for either your spouse or child(ren), you must enroll in team member coverage. In addition, your elected spouse coverage cannot exceed 50% of the elected team member coverage. You may elect up to the guarantee issues amounts as a newly-eligible team member. The guaranteed issue is the amount that can be elected without having to complete Evidence of Insurability (EOI). If you enroll or increase your coverage amount after your newly eligible period (such as Open Enrollment), EOI will be required. Below is an overview of how much coverage can be purchase for you and your family, including the guarantee issue.
Team Member Spouse Child(ren)
Minimum $10,000 $5,000 $10,000
Maximum
The lesser of 5 times your basic
annual earnings, or $500,000
$50,000 $10,000
Guarantee Issue $150,000 $30,000 $10,000
The team member and spouse premiums are based on team member’s age as of the effective date of coverage and are subject to increases as the team member enters the next age band of rates.
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DISABILITY
Disability coverage provides income protection in the event that you experience a non-occupational injury or illness that prevents you from working. You have access to Short-Term Disability (STD) and Long-Term Disability (LTD) insurance through MetLife.
SHORT-TERM DISABILITY (STD) If you aren’t able to work after 7 consecutive days of disability due to an eligible injury or illness, this benefit pays 60% of your weekly pay up to a maximum benefit of $1,000 per week, for a maximum of 25 weeks. You pay the full cost of this coverage and rates are based on your age and annual base salary as of the effective date of coverage. If elected, there is a pre-existing limitation in which you will not be covered for any disability beginning in the first twelve months caused by the related medical condition that you were diagnosed and/or treated in the three months prior to the effective date.
If you waive coverage as a newly-eligible team member and choose to elect at a later time (such as Open Enrollment), you will be subject to Evidence of Insurability (EOI) and will be limited to a $100 weekly benefit amount.
LONG-TERM DISABILITY (LTD) - 100% EMPLOYER PAID This benefit pays a portion of your income if you continue to be disabled and your short-term disability benefits end. LTD benefits begin after 180 days of disability and provide you with 60% of your basic monthly earnings up to a $5,000 monthly maximum.
1. Visit http://www.metlife.com/mybenefits
2. Enter your company name and click ‘Submit’ 3. On the Home Page, click on ‘Register Now’ and perform the one-time
registration process.1 Enter your first and last name, identifying data and email address. Create a unique user name and password for future access to MyBenefits.
Once you have filed a claim through your company’s claim submission process and registered on MyBenefits, you can begin to use the site to check claim status and perform tasks, including: Update your claim information: Add and edit key points related to your claim, such as your contact information, any changes in your condition and your expected return to work date. Send messages and attachments to MetLife: Communicate with your MetLife Case Manager by sending messages or questions and uploading required documents to help expedite your claim. Receive alerts about your claim status: You can sign up to be notified via email for a change in your claim status, like approval of your claim.
1 Registration cannot be done from your mobile device.
Reporting your Claim Online:
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EMPLOYEE ASSISTANCE PROGRAM
Expert advice for work, life and your well-being Life doesn’t always go as planned and while you can’t always avoid the twists and turns, you can get help to keep moving forward. MetLife can help you and your family get professional support and guidance to make life a little easier. The program’s experienced counselors provided through LifeWorks – one of the nation’s premier providers of Employee Assistance Program (EAP) services – can talk to you about anything going on in your life, including:
• Family: Going through a divorce, caring for an elderly family member, returning to work after having a baby
• Work: Job relocation, building relationships with co-works and managers, navigating through reorganization
• Money: Budgeting, financial guidance, retirement planning, buying or selling a home, tax issues
• Legal Services: Issues relating to civil, personal and family law, financial matters, real estate and estate planning
• Identity Theft Recovery: ID theft prevention tips and help from a financial counselor if you are victimized
• Health: Coping with anxiety or depression, getting the proper amount of sleep, how to kick a bad habit like smoking
• Everyday Life: Moving and adjusting to a new community, grieving over the loss of a loved one, military family matters,
training a new pet
Expert advice for work, life and your well-being The EAP program includes up to 5 phone or video consultations with licensed counselors for you and your eligible household members, per issue, per calendar year. You can call 1-888-319-7819 to speak with a counselor or schedule an appointment, 24/7/365. When you call, just select “Employee Assistance Program” when prompted. You’ll immediately be connected to a counselor.
If you are simply looking for information, the program offers easy to use educational tools and resources, online and through a mobile app. There is a chat feature so you can talk with a consultant to guide you to the information you are looking for or help you schedule an appointment with a counselor.
Log on to metlifeeap.lifeworks.com, username: metlifeeap and password: eap
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HOW TO ENROLL IN BENEFITS
What do I need to enroll?
Take time to read the entire benefits guide to educate yourself and family members on your options Decide on your benefits with your family, if necessary, prior to starting the enrollment process Gather all social security numbers and dates of birth for you, any covered dependents and elected beneficiaries Once you receive an email from HRconnection, you will need to set up your account in HRconnection (see below for
more information)
How to enroll? You will receive an email from [email protected] titled “Welcome to HRconnection!” This email will contain a link to set up your account and complete your enrollment
1. Select the “Set up account” button in the email. A new page will open with your Profile name pre-filled. 2. Select “Continue” and the homepage of HRc will open up 3. You can begin the enrollment process by clicking on “Enroll Now” in the blue bar towards the top of the page 4. You are required to review and confirm that your demographic information is accurate by selecting the pencil on the
right-hand side under “Actions.” 5. After validating your demographic information, you will then add your spouse and/or child(ren) that you intend to make
a beneficiary and or dependent via the “+ Add Contact” button on the right-hand side. Please note that you will be required to assign a beneficiary for Basic Life and AD&D.
6. Once your demographic information has been validated and family members have been added click on the black “Start Now” button
7. Click the “Select” button to the left of the benefit you want to elect, then select the coverage tier that meets your needs. If you are covering dependents, please be sure to select the check box next to the dependents name to include them in your coverage for each benefit.
8. Click ‘Elect’ to enroll in the benefit or “Waive coverage” if you do not wish to participate in a particular benefit. 9. Once elections have been made, select the “Confirm elections” button.
*Please know that you will not be able to change your elections until the next open enrollment period, unless you have a Qualified Life Event ALL TEAM MEMBERS must access HRconnection to enroll or waive benefits. Questions? If you have questions during the enrollment process, contact the Human Resources Team at [email protected] or call 337-326-5854.
Your current elections will NOT continue if you do nothing. All team members are required to complete an enrollment to continue current coverage and/or participate in any employer paid benefits.
IMPORTANT
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CONTACT INFORMATION
Benefit Plan Carrier Phone Number Website
Medical United Healthcare 1-866-633-2446 www.myuhc.com
Health Savings Account (HSA)
Navia Benefits Solutions 1-800-669-3539
app.naviabenefits.com/app/#/login Questions:
[email protected] Claim Submission
Dental MetLife 1-800-275-4638 www.metlife.com/dental
Vision EyeMed 1-866-723-0513 www.eyemed.com
Life Insurance MetLife 1-800-275-4638 www.metlife.com
Disability MetLife 1-800-275-4638 www.metlife.com
HR Team Hulin Health 337-326-5854 [email protected]
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ABOUT THE GUIDE
This guide gives a brief overview of the benefits available to you. For plan details, including covered expenses,
exclusions, and limitations, please refer to the applicable summary plan description (SPD), certificate of coverage,
or plan document for each plan. These documents can be found on the Team Member Portal. If any information in
this benefits guide conflicts with the plan documents and insurance policies, those plan documents and policies will
govern. Hulin Health, LLC reserves the right to amend, modify or terminate these plans at any time. This Benefits
Guide does not constitute a contract of employment.
All required annual notices are made available via the Team Member Portal.
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