Professional Documents
Culture Documents
MEDICAL
Aetna www.aetna.com 1-800-238-6716 Group # 466063 In-Network (Participating Providers) See Options Below See Options Below 70% after your deductible is met See Options Below 70% after your deductible is met See Options on Page 2
Provision Deductible Out-of-Pocket Max (excludes deductibles and copays) Coinsurance Office Visit Copay Emergency Room Prescription Drugs
Out-Of-Network (Non-Participating Providers) See Options Below See Options Below 50% after your deductible is met See Options Below 50% after your deductible is met
Second Choose your office visit copay (Options "D" or "E"): How much do you prefer to pay when you visit your doctor and/or specialist? The lower the office visit copay you select, the higher the payroll deduction will be. Office Visit Copay Office Visit Copay - Primary Care Provider Office Visit - Specialist
"D"
In-Network $10 $25 Out-of-Network 50% after deductible 50% after deductible In-Network $30 $45
"E"
Out-of-Network 50% after deductible 50% after deductible
Hourly
Page 1 of 6
MEDICAL
Dental
Aetna www.aetna.com 1-877-238-6200 Group # 466063
Diagnostic, Preventative, Restorative, Oral Surgery, Crowns & Bridges Flat copay based on procedure Endodontics, Periodontics, Prosthodontics-removable Orthodontia Services Maximum Annual Benefit Maximum Lifetime Benefit $1,045 copay per course of treatment Not applicable Not applicable
Hourly
Page 2 of 6
MEDICAL VISION
SVS Vision Plan www.svsvision.com 1-800-225-3095 Group # 8800 Service Eye Exams Exams for Glasses Exams for Contact Lenses Eyeglass Lenses Single with frames Bifocal with frames Trifocal with frames Eyeglass Frames Standard with lenses Contact Lenses Once every 12 months 100% 100% up to $87.20 One pair every 12 months $5 copay $5 copay $5 copay One pair every 24 months $5 copay $5 copay Aetna www.aetna.com 1-800-238-6716 Group # 466063 Vision Service Plan www.vsp.com 1-800-877-7195 Group # 120818656 2 benefit-year commitment In-Network Out-of-Network Once every calendar year Once every calendar year $10 copay $50 max benefit $50 max benefit Once pair every calendar year $50 max benefit $75 max benefit $100 max benefit One pair every other calendar year $70 max benefit $105 max benefit
Up to $60 copay (evaluation & fitting) Once pair every calendar year $25 copay $25 copay $25 copay One pair every other calendar year $25 copay ($130 max benefit) $130 max benefit
Hourly
Page 3 of 6
Disability Benefits
Unum 1-800-421-0344 Short Term Disability (STD) - up to 26 weeks, eligible for coverage - 1st of the month following 30 days of full-time employment. Benefits begin 1st day of accident, 8th calendar day of illness. STD Options Coverage Contributions Core Option 50% of base pay ($300 maximum benefit per week) Company paid Buy-Up Option 60% of base pay ($1,500 maximum benefit per week) Based on pay Long Term Disability (LTD) - after 26 weeks of STD, eligible for coverage - 1st of the month following one year of continuous full-time employment. LTD Options Coverage Contributions Core Option 50% of base pay ($1,000 maximum benefit per month) Company paid Buy-Up Option 60% of base pay ($3,000 maximum benefit per month) Based on pay
Hourly
Page 4 of 6
401(k) Plan
www.prudential.com/online/retirement 1-877-778-2100 - You can set-aside up to 75% of your pre-tax earnings, (subject to IRS limitation of $17,500 in 2013) - By saving on a pre-tax basis, you can lower both your taxable income and your total tax bill each year - Automatic enrollment (if you choose) starting 1st of the month following 45 days of employment, with a 3% contribution - Roth contributions allow you to save after-tax dollars today for your future - Wide array of investment options enables you to develop a strategy that best suits your needs - Rollover contributions from another qualified account into your new Prudential account - Interactive tools to help you manage your account and access retirement planning education - Make changes to your account on a daily basis - Borrow up to 50% of your account balance to a max of $50,000 of your total account balance
Hourly
Page 5 of 6
MEDICAL Aflac
Aetna www.aflac.com www.aetna.com 248-968-9884 1-800-238-6716 - Policies pay cash benefits directly to you, regardless of any other insurance you may have. Plans are pre-tax and are all payroll deducted. Group # 466063 - Plans are fully portable after 1 month of payroll deductions. - Designed to help with copays, deductibles and other out-of-pocket expenses associated with illness, injury and family expenses. No network of doctors, or rate increases. - Accident Plan: covers emergency treatment, follow-up treatment, initial hospitalization, hospital confinement, physical therapy, accidental death benefit, wellness, and more. - Sickness Plan: covers physican visits, initial hospitalization, hospital confinement, major diagnostic exams, surgical, and more. - Cancer Plan: pays initial treatment, injected or oral chemotherapy, radiation therapy, surgery, hospitalization and experimental treatments.
Hourly
Page 6 of 6