Artech Information Systems 2016 Benefits Summary New Hire Enrollment

26 Pages·2016·1.71 MB·English

Artech Information
Systems
2016 Benefits Summary
New Hire Enrollment
2016 Benefits Snapshot
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New Medical Plan
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Aetna
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Dental (Two Plan Options)
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∗ Voluntary Long Term Disability
Assurant
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Cigna
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High Plan
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Low Plan
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New AD&D Coverage
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Vision ∗
Cigna
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VSP
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Employee Assistance Program (EAP)
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Voluntary Life/AD&D
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∗ Cigna
Cigna
(cid:1) Voluntary Short Term Disability (cid:1) Value Add Programs & Services
∗ Cigna ∗ Cigna
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Kemper Worksite Benefits
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Accident Expense, Critical Illness & Whole Life
New Medical Plan
In-Network Benefits
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Plan deductible of $5,000 Single / $10,000 Family
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Coinsurance 100%
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Primary Care Physician $30 co-pay
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Specialist $50 co-pay
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Emergency Room $250 co-pay
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Urgent Care Clinic $75 co-pay
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Inpatient Hospital Services covered at 100% after deductible
(cid:1) *Prescription card $15/$35/$60
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Mail-order -90 day supply for 2 co-pays
(cid:1) 100% Coverage for Preventive Services
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Maximum out of pocket (deductible & coinsurance) $5,000 Single / $10,000 Family
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Non-gatekeeper plan (no referrals needed to see specialists)
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Unlimited lifetime maximum
*Refer to benefit summary for specialty drugs
New Medical Plan
Out-of-Network Benefits
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Deductible $10,000 Single /$20,000 Family
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Coinsurance 80% / 20%
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Maximum out of pocket (deductible & coinsurance) $20,000 Single /$40,000 Family
*Maximum out-of-pocket is based on a percentage of the Medicare schedule for contracted in-network providers. Visiting non-participating providers
may result in significant balance billing.
New Medical Plan
Aetna Medical Plan
Bi-Weekly Rates:
Employee Only $77.89
Employee/Spouse $230.27
Employee/Child(ren) $198.12
Family $351.89
Who is eligible to enroll?
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All full-time employees working 30 or more hours per week are eligible to
participate and their benefits will be effective from 1st of the following month
after 60 days of employment and they can enroll their dependents. Your eligible
dependents are your lawful spouse or domestic partner and your children
from birth until age 26, through any age if handicapped and unable to
earn a living, or until they can no longer be legally declared as
dependents. Dependent age and status requirements may vary by state.
Dental - Assurant High Plan
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$50 Single /$150 Family Calendar Year deductible for Basic & Major services
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$1,500 annual maximum benefit (per covered member)
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Large national network - Find Assurant PPO providers at www.dha.com under
Assurant Employee Benefits
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Insurance Covers:
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100% Preventive Services (exams & cleanings; 1 time in any 6-month period, x-
rays, etc.)
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90% Basic Services (fillings, endodontics, periodontics, oral surgery)
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80% (out-of-network)
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60% Major Services (crowns, dentures, implants)
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50% (out-of-network)
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50% Orthodontia (Adult and Child) with a lifetime maximum of $1,500
Dental - Assurant Low Plan
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$50 Single /$150 Family Calendar Year deductible for Basic & Major services
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$1,000 annual maximum benefit (per covered member)
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Large national network - Find Assurant PPO providers at www.dha.com under
Assurant Employee Benefits
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Insurance Covers:
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100% Preventive Services (exams & cleanings; 1 time in any 6-month period, x-
rays, etc.)
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80% Basic Services (fillings, oral surgery, anesthesia)
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80% (out-of-network)
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50% Major Services (endodontics, periodontics, crowns, dentures)
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50% (out-of-network)
Dental - Assurant Rates
High Plan
Bi-Weekly Rates:
Employee Only $25.99
Employee/Spouse $52.18
Employee/Child(ren) $63.58
Family $89.76
Low Plan
Bi-Weekly Rates:
Employee Only $16.62
Employee/Spouse $33.32
Employee/Child(ren) $44.30
Family $61.00
Vision Plan - VSP
VSP has the largest national vision network - Find VSP “Choice”
network providers at www.vsp.com
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Vision Exam: $20 co-pay (Every 12 months)
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Frames: $20 co-pay - up to $130 allowance on wide variety of frames (Every 24
months)
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Lenses: Single Vision, Lined Bifocal, Lined Trifocal and Polycarbonate lenses for
dependent children included in prescription glasses (Every 12 months)
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Contacts (instead of glasses): Up to $60 co-pay - up to $130 allowance - includes
exam, fitting and evaluation (Every 12 months)
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Other discounts available on Sunglasses, Retinal Screening and Lasik Vision
Correction
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Out-of-network services paid up to plan allowance