Open Enrollment Overview and Summary

Employee Benefits Overview

It is currently open enrollment time. Health Care costs continue to increase, and it is no exception for our group. As a result of these escalating costs, we have spent a significant amount of time analyzing our options in the marketplace and working to negotiate with our current carriers with the help of IFS Benefits, LLC. Below you will find our program options effective June 1, 2014.

SUMMARY OF EMPLOYEE BENEFITS

Aetna will continue to be our medical insurance carrier. You will still have three plans to choose from. Highlights of your new plans include:

HNOption $2500 100/50HNOption $2500 100/50 $40

Primary Care:$2500 ded then 100% covered$40 co-pay

Specialist Care:$2500 ded then 100% covered$60 co-pay

Inpatient Hospital:$2500 ded then 100% covered$2500 ded then 100% covered

Outpatient Surgery:$2500ded then 100% covered$2500 ded then 100% covered

Emergency Room:$2500 ded then 100% covered$200 co-pay

Prescriptions:$10/$50/$75/50% up to $150$10/$50/$75/50% up to $150

HNOption $2500 80/50 H S A

Deductibles: $2500 Individual/ $5000 Family

Most other services:Deductible, then 80% covered

Prescription copays:Deductible, then $10/$50/$75/50% up to $150

Preventive care is covered 100% for all three plans

Please note: the H S A plan allows you to put away monies tax free into a savings account to pay for your deductible. If you do not spend this money you do not lose it – it remains in your tax free savings account earning interest tax free!

*Please refer to your packet for a more detailed benefit description*

Approximate Medical Payroll Deductions:

Employee / Employee +Spouse / Employee+Child(ren) / Family
$2500 100/50 / $76.15 / $422.31 / $292.15 / $603.23
$2500 100/50 $40 / $103.85 / $486.92 / $342.92 / $687.23
$2500 80/50 HSA / $5.08 / $258.46 / $163.38 / $391.38

DENTAL

Delta Dental will continue to be our dental carrier. We will continue to offer two plans to choose from. Highlights of your plans include:

High OptionLow Option

Deductible for Basic & Major Services:$50/$150$50/$150

Preventive Care: 100%100%

Basic Services:80% 50%

Major Services: 50% 50%

Orthodontia: 50% up to $750 max 50% up to $750 max

Annual maximum benefit:$1250$1000

Approximate Dental Payroll Deductions:

Employee / Employee +Spouse / Employee+Child(ren) / Family
High Option / $13.63 / $27.73 / $31.44 / $47.81
Low Option / $11.69 / $23.83 / $27.39 / $43.03

LIFE

People’s Place will continue to pay for a flat $20,000 life and accidental death and dismemberment policy for every full time benefits eligible employee. This coverage will be through Boston Mutual. You may change your beneficiary at any time.

VOLUNTARY SUPPLEMENTAL LIFE & AD&D

All full time employees have the option to purchase extra Life & AD&D insurance from Boston Mutual. See HR for costs.

SHORT TERM DISABILITY

Boston Mutual will be our Disability Insurance carrier. In the event that you become disabled, the Short Term policy will replace67% of your weekly income (max. of $500/week) for 24 weeks after a 14 day wait. This policy is provided to you at no cost by People’s Place.

LONG TERM DISABILITY

Boston Mutual will be our Disability Insurance carrier. In the event that you become disabled, the Long Term policy will replace 60% of your monthly income (max. of $5,000/month) after a 180 day wait. This policy is provided to you at no cost by People’s Place.

FLEXIBLE SPENDING ACCOUNT

We are pleased to continue this benefit again this year. Ameriflexwill remain our FSA provider. This benefit will allow employees to set aside money from their paycheck on a PRE-TAX basis to pay for medical, dental, vision, and dependent care - saving you approximately 25% to 40% on these expenses! Those enrolling in the H S A are not eligible to participate in the FSA. The maximum election amount for medical care is $2500.

Everyone must complete a form to re-enroll or decline participation.

HEALTH ADVOCATE

Health Advocate, Inc. is an advocacy and assistance service company founded to specifically address many of the issues Americans encounter while accessing the healthcare and health insurance systems. Their expertise and relationships in the healthcare industry combined with their in-depth knowledge of health and related insurance policies and procedures, give them the know-how to act on your behalf. This benefit is being provided at no cost to the employees, spouses, dependent children, parents and parents- in-law.

VISION

VSP will continue to be our Voluntary Vision Carrier. Some highlights of the plan are: $ 10 co-pay for exams, $ 25 co-pay for lenses. See benefit sheet for a full description of benefits.

Approximate Vision Payroll Deductions:

Employee / Employee +Spouse / Employee+Child(ren) / Family
$3.47 / $5.54 / $5.66 / $9.12
What do you need to do during the OPEN ENROLLMENT period?
Open Enrollment meetings will be held:
Thursday, April 24th @ 1:00pm & 4:30pm
Monday, April 28th @ 9:00am

Benefit Open Enrollment form – Everyone must complete a plan election form.

AetnaEnrollment forms – These are only required if you are enrolling for the first time or making changes to your coverage such as adding or deleting dependents.

Ameriflex FSA election form – Everyone must complete an Ameriflex FSA election or waiver form.

All Forms are due to HR no later than Friday, May 2nd at noon.
NOTE: After the Open Enrollment Period, you cannot make changes to your coverage during the year unless you experience a change in family status, such as:
Loss or gain of coverage through your spouse
Loss of eligibility of a covered dependent
Death of your covered spouse or child
Birth or adoption of a child
Marriage, divorce, or legal separation
Switch from part-time to full-time
You have 30 days from a change in family status to make changes to your current coverage.
Health Care Reform Reminders
Preventive care covered at100%
No lifetime or annual maximum dollar limits (in-network services)
Dependents can enroll up to age 26
Some over the counter medicines require a written prescription in order to use H S A or FSA funds
Women’s preventive services covered 100% - including FDA approved contraception methods and contraceptive counseling
Pre-existing condition exclusions prohibited
No limits on annual dollar value of essential health benefits
Legislative Updates
Effective January 1, 2012, DE law provides that same-sex couples who enter into a civil union will have the same rights, protections and obligations that exist for married couples.
Effective January 1, 2013, DE law states insurers must provide coverage for screening, diagnosis & treatment of Autism Spectrum Disorder for children under age 21 as well as coverage for Applied Behavior Analysis therapy.
Effective January 1, 2013, DE law states that a member’s out-of-pocket costs for orally administered anticancer medications must be equal to the member’s cost for intravenous or injected anticancer medications.

**This is not a contract or a definitive statement of benefits. It is intended solely to provide you with an overview of your benefits. Complete details of benefits, terms and exclusions are governed by your Group Membership Agreement. The Group Membership Agreement may not cover all of your health care expenses. Read your Group Membership Agreement carefully to determine which health care services are covered.