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Summary of the employee health benefits offered by JBI, Ltd. including information on annual open enrollment, available plans, coverage options, and contribution rates.
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Summary of EMPLOYEE Health Benefits JBI, LTD Effective September 1, 2016
Health Plan Annual Open Enrollment • Open enrollment every August • Changes can be made to health coverage during open enrollment
HEALTH Benefit Resources www.thediamondbenefitgroup.com/unificare User ID: unificare Password: Justice1 Coming Soon! – You will not need a password & user ID and will only include the following URL for the JBI, Ltd. Employee Benefit Website www.thediamondbenefitgroup.com/jbi-ltd
Health Plan Annual Open Enrollment 9/1/2016 • Change Medical Plan at BCBS • Change Vision from RSL/Eye-Med to Vision Service Plan (VSP) • No Plan Changes to Dental, Life/AD&D, LTD, Voluntary Term Life, Accident, Medical/Bridge & Critical Illness insurance policies • New Cancer policy through supplemental insurance – current participants will remain enrolled in current Cancer 1000 policy • Eliminate Grandfather Class –MB will no longer be paid for by the company for employees hired prior to 9/1/2011– MB will continue at Employee cost with pre-tax dollars effective 9/1/2016 based on age at the time of initial enrollment under the MB (unless terminated during open enrollment)
Your Supplemental Insurance Benefits Accident Medical Bridge Cancer Critical Illness
Other Services Available to You at No Cost with RSL • 24-hour Travel Assistance through On Call • Identity Theft Recovery Services through National ID Recovery • Bereavement Counseling services through HMSA
Your Per Paycheck (Bi-Weekly) Contributions Contributions for Medical, Dental, & Vision MedicalBridge is not included but available for purchase with Colonial Life • Employee Only $43.20 • Employee & Spouse $157.75 • Employee & Child(ren) $159.23 • Family $275.62
COBRA Rates for medical, dental, & vision EFFECTIVE 9/1/2016 PER MONTH Employee Only: $636.41 EE & Spouse: $1,269.34 EE & Child(ren): $1,277.48 Family: $1,920.56
Your Medical Plan • Blue Cross Blue Shield (BCBS) • Nationwide more than 720,000 providers and 6,300 hospitals contracted with BCBS • PPO G6521 –BCBS New Benefit Plan Effective 9/1/2016 • BCBS Policy #120534
How do I find a contracting medical provider? • Go to Provider finder at BCBSTX.COM • Log on to your Blue Access for Members (BAM) account • Call Customer Service (number located at back of ID card) • BlueCard Worldwide available for international benefits (800) 810-2583 www.bluecardworldwide.com
Your Medical PlanNetwork Benefits • Calendar Year Deductible - $3,125 (3x family) • Maximum OOP – $3,125 (3x family)
Your Medical PlanNetwork Benefits • Office Visit Copay- $25 • Specialist Visit Copay - $50 • Office visit copay only applies to the doctor office visit • All Copays such as office visit, specialist, prescription, urgent care apply to the Maximum Out of Pocket
Your Medical PlanNetwork Benefits • Urgent Care Center Visit - $75 Copay * *Certain diagnostic procedures are subject to deductible Non-PPO urgent care provider benefits are paid at non-network benefit level • Emergency Room Visit - $400 Copay, then Deductible **Physician charges are subject to the deductible at the ER room
Lab & X-ray • Deductible applies to Routine Lab & X-ray regardless of place of service • Deductible applies for Lab & X-ray performed in the doctor’s office, at a free-standing lab, or an imaging center).
Dependent Children under 19 Pediatric Dental & Pediatric Vision Integrated with Medical Plan Pediatric Dental & Vision benefits are included as part of the Medical Plan in additionto the Dental plan with Dearborn and the Vision plan with VSP For information on Pediatric Dental – please call number on dental ID card For information on Pediatric Vision – please call Davis-Vision at 800/350-1534 Refer to BCBC Medical Booklet for Specific Details
Your Prescription Coverage Generics Plus Formulary List Employer Offered Metallic Small Group – Generics Plus 3 Tier Leaner Formulary List to Encourage Generic Utilization Preferred Retail Pharmacy Network Includes CVS, Walmart, HEB, Brookshire, & Access Health Access Health pharmacies can be located at MyPrime.com Lower Copays through Preferred Pharmacy Network
Your Retail Prescription Coverage (up to a 30 day supply) Preferred Retail Pharmacy Generic $10 Preferred Brand Name $40 Non-Preferred Brand Name $60 Specialty $60 Non-Preferred Retail Pharmacy Generic $15 Preferred Brand Name $50 Non-Preferred Brand Name $70 Specialty $70
Up to a 90 Day Supply Three Times Retail – Available at Preferred Pharmacy or through Mail Order Specialty Medications cannot be filled through Mail Order
PRESCRIPTION plan features Prior Authorization Step Therapy Preferred Drug List Quantity Limits Triessent Specialty Pharmacy Program
BCBS Health & Wellness Resources Blue Care Connection BlueExtras • Personal Health Manager • Condition Management • Weight Management • Tobacco Cessation • Fitness Program • 24/7 Nurseline • Special Beginnings • Online Healthcare Tools • Be Smart – Be Well – Where awareness & prevention meet • Hearing Discount Program • Vision Discount Program • Jenny Craig, Curves, Lifetime Fitness • Seattle Sutton’s Healthy Eating • Life Time Fitness • Complementary Alternative Medicine
Register with BCBS for 24/7 access to your medical claims and account informationBlue Access for Members (BAM) www.bcbstx.com/member/register Prescription Vendor Registration www.myprime.com
Your Dental Benefits • Available through Dearborn National #FG1D1136 • Significant Savings to Utilize PPO Dentists (average discount 28%) • Call phone number on ID card for a list of participating dentists
Your Dental Benefits • Annual Limit - $1,000 • Calendar Year Deductible $50 individual (3x family) • Preventative 100% - deductible waived • Basic 80% & Major 50% • Child Orthodontia - $1,000 lifetime
Features of your dental plan • Two Preventive cleanings per calendar year PLUS Two Professional cleaning, scaling, & polishing cleanings per calendar year • Full Mouth X-rays once every 36 months • Fluoride to Age 19 (two per calendar year) • Sealants to age 16 (one per unrestored permanent molar)
Features of your dental plan • Space Maintainers & Sealants at 100% • Composite (tooth-colored) fillings Once per surface per year • No Missing Tooth Clause • Crown & Bridge replacement Once every 5 years
Register with Dearborn National for 24/7 access to your Dental claims and account information https://accessforindividuals.hcsc.net/registration/
Your Vision Benefits Available through Vision Service Plan Group #30069274 • Choice of Providers -- The decision is yours to make—choose a VSP doctor, a participating retail chain, or any out-of-network provider • The largest network of independent eye doctors • VSP vision insurance is accepted by more than 34,000 doctors nationwide
Your Vision Benefits To find a VSP provider, visit vsp.com or call 800.877.7195 Tell the provider you have VSP – No ID Card is necessary You can print ID card on vsp.com No claim forms to complete when you see a VSP network provider
Your Network Vision Benefits • Routine Eye Exam - $10 Copay • Contacts exam - up to $60 copay (in addition to exam copay) • Materials - $10 Copay Glasses or Contacts
Your Network Vision Benefits • Frame Allowance - $150 • Featured Frame Allowance - $170 • Contact Allowance - $130 • 20% Discount on amounts over allowance or extra pair of glasses within 12 months of exam
Your Network Vision Benefits • Frequency of Vision Benefits Exam – Every 12 Months Lenses – Every 12 Months Frames – Every 24 Month
Your Network Vision Benefits • Minor Eye Medical Condition - $20 Copay • Routine Retina Screening – Up to a $39 Copay
Special Offers through VSP • Select from Extensive List of Featured Brands & receive ADDITIONAL $20 Allowance for Featured Frames • Examples of Featured Brands include Anne Klein, Calvin Klein, Nike, Nautica, & Valentino • Rebates for contact lens, coupons, & other discounts
Register with VSP 24/7 access to your VISION claims and account information www.vsp.com
Your SURVIVOR & DISABILITY BENEFITS • Reliance Standard Life (RSL) • Basic Life/AD&D - $50,000 • Long Term Disability – 60% of salary to $6,000/month after 90 days of disability • Paid for by JBI, Ltd. • Option to Purchase Additional Term Life/AD&D Insurance
Option to Purchase Voluntary Term Life/AD&D Insurance • Available through Reliance Standard Life (RSL) • Choices of life insurance, for Employee and/ORSpouse in increments of $10,000 to $500,000 • Rate based on Age as of Sept. 1st (adjusts once per year)
Option to Purchase Voluntary Term Life/AD&D Insurance • Spouse coverage based on Spouse Age (not EE Age) • Portability Included (at different rates) • Paid by Employee – After Tax Dollars • Child Life Only coverage $10,000 $1.62 per month or $.75 bi-weekly
COLONIAL LIFE SUPPLEMENTAL INSURANCE Colonial pays you directly, in addition to health insurance 30 day waiting period for Cancer, Critical Illness, & Wellness/Health Screenings Colonial benefits are at the same rates if you terminate & wish to continue coverage Guaranteed Renewable
Colonial Supplemental Insurance • Supplemental Policies are Individual Policies • Minimal Underwriting • Duplication of Colonial Policies Not Permissible • Colonial does not Coordinate with your Medical Insurance policy
One Accident Claim can Pay for Entire Year’s Premium ACCIDENT Cost Example for Family Coverage $113.55 Net Annual Cost OR $9.46/Month in 25% Tax Bracket Assuming pre-tax savings & utilizing 4 wellness/health screening
ACCIDENT EXAMPLES OF ELIGIBLE BENEFITSRefer to Outline of Coverage for Complete List
$50 Health Screening benefit per year per person after 30 day waiting period Some Examples of Eligible health screening for Accident policy Blood test for Triglycerides Serum Cholesterol Test for HDL/LDL Levels Mammogram Fasting Blood Glucose Test Pap Smear Blood Test for Colon Cancer Stress test on bike/treadmill PSA Review Hospital Confinement (Medical Bridge) Outline of Coverage Accident Health Screening
Hospital Confinement - $1,000 lump sum per hospital admission – Option to purchase $2,000 admission Outpatient Surgery - $500 or $1,000 per covered procedure (maximum $1,500/year) Same accident or sickness within 90 days – continuation of previous confinement Covers pregnancy (policy must be in force for 10 mos.) Review MB Outline of Coverage for Specific Details Medical Bridge (Hospital Income)
Medical Bridge (HOSPITAL INCOME) Minimal Underwriting Pre-Existing Condition - Not Covered for first 12 Months Special Exception if Enrolling during 9/1/2016 Open Enrollment Period Guarantee Issue / No Medical Underwriting Required for Employee & Spouse Subject to 12 Month Pre-Existing Special Exception for New Employees who Enroll when 1st Eligible Guarantee Issue / No Medical Underwriting Required for Employee & Spouse Pre-existing Exclusion Waived for Employee (not waived for Spouse) Special Exceptions do not apply to dependent children
$50 Wellness benefit per year (2 per family) after 30 day waiting period Some Examples of Eligible Wellness/health screening for MB Colonoscopy, Mammogram, Pap Smear, PSA, Serum, Cholesterol Test for HDL/LDL, Fasting Blood Glucose Test, Blood test for Triglycerides, Ultrasound, CA 15-3, CA 125, CEA, Serum Protein Electrophoresis, Stress test on bike/treadmill, & Chest X-ray Review Hospital Confinement (Medical Bridge) Outline of Coverage Medical Bridge / Hospital Income Wellness