Open Enrollment Benefit Decision Guide
California
2012 Open Enrollment
Open Enrollment 2012 Your benefits choices for next yeaR
JT3 is pleased to offer a generous benefits package for you and your family. As you’ve probably heard by now, it’s time to consider your benefits choices for next year. This guide highlights the 2012 benefits package. Although there are no major plan design changes for 2012, please carefully evaluate your options. The medical comparison chart is included within this booklet. We’ve also enclosed your customized enrollment worksheet showing your current coverage options and the estimated 2012 costs. JT3 shares the costs of benefits coverage for you and your covered dependents. Because we have a Section 125 plan, also known as a cafeteria plan, your costs for many of your benefits are deducted from your paycheck before federal income, Social Security, and state (if applicable) taxes are withheld. This lowers the amount of your taxable pay, which in turn lowers the taxes you pay from your paycheck and keeps more in your wallet. Due to increasing health care costs, there will be some changes in the monthly premiums and deductibles next year. Fortunately, our wellness programs and cost controls have kept these increases at minimum levels. We’re scheduling Open Enrollment briefings in your area in October. Please watch for announcements with dates and times. If you’re not able to make a briefing, please contact your local HR representative. Thank you for your hard work for JT3 and dedication to serving our customer. Sincerely,
Familiar faces Thanks to Phil Culver, Kimberly Ferris, Susan Hymas, Lynette Pavilcek, Dawn Ryan, Carmel Salgado, and Brent Smith for letting us use their photos for this year’s Open Enrollment campaign.
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Bob Donovan JT3 Director of Human Resources
Table of contents Your Choices, Points, and Eligibility. . . . . . . . . . . . . . . . 3 How to Enroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Your Medical Benefits. . . . . . . . . . . . . . . . . . . . . . . . 5–8 Dental. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Vision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Personal Paid Leave. . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Flexible Spending Accounts . . . . . . . . . . . . . . . . . . 12–13
Benefit Decision Guide
Life Insurance, Disability Insurance, and AD&D. . . . Additional Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Benefits Any Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enrollment Confirmation. . . . . . . . . . . . . . . . . . . . . . . . Helpful Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Important Contacts . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Choices, points, and eligibility Make the most of your benefits in 2012
Choices Some of your benefits will automatically carry over into 2012. Some will not. You will need to re-enroll in the following benefits to continue coverage next year: • Flexible spending accounts -H ealth care - Dependent care
NOTEs:
• Purchased paid leave - Dollars* - Points
• Legal plan (Hyatt)
If you do not elect these benefits, your coverage for them will be terminated at the end of 2011. For your convenience, we’re keeping the enrollment system at jt3benefits.com available 24 hours a day, seven days a week, during Open Enrollment, Oct. 26–Nov. 16, 2011.
Health tIPs
* Unused hours from PPL-Dollars in 2011 will roll over to 2012. If you would like to acquire additional hours in 2012, you must make that election during Open Enrollment.
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Points to purchase your benefits Our cafeteria plan provides eligible employees with certain employer-paid benefits and the option to exchange unused points for cash. Each employee is given points valued at $1,700. You can use these points to purchase benefits, including: • Medical insurance • Dental insurance • Vision insurance • Additional paid leave time (i.e., PPL-Points) Who’s eligible? All full-time JT3 employees are eligible to participate in the company’s benefits programs, including medical, dental, and vision coverage. In addition, your spouse/domestic partner and minor dependents (regardless of student status) through the month they turn 26, including children, stepchildren, and children for whom you have legal guardianship, may be enrolled in medical coverage. Medical coverage is also available for your unmarried children who have mental or physical disabilities and who are not capable of supporting themselves. Your spouse/domestic partner and minor dependents up through age 19 and full-time students through the month they turn 26 can enroll in vision and dental plans.
Don’t need medical? If you waive medical coverage, we’ll give you an extra $1,000 for you to use toward other benefits and/or purchased personal leave (PPL-Points).
2012 Open Enrollment
How to enroll Enroll online in five easy steps
Follow these steps to enroll in your 2012 benefits.
NOTEs:
Step 1 Carefully review this benefits decision guide.
Step 2
Step 3 Use the enclosed customized worksheet to evaluate the costs of your current elections and make your selections for 2012. Don’t forget that most costs listed are on a per-pay-period basis.
Step 4 From your home or office computer, go to the enrollment site at jt3benefits.com. • Log in using your employee identification number. • Review your 2011 benefits summary. • Add/update your spouse/domestic partner and child(ren)’s information, even if you are not electing benefits for them. • Select your 2012 elections.
Collect the following information so your enrollment process goes more smoothly: • Your employee identification number (i.e., your “J” number) • Your password for the enrollment system* • Your spouse/domestic partner and child(ren)’s birth dates and Social Security numbers
Step 5 Print your enrollment confirmation. • Review your confirmation to make sure what you’ve selected is what you want. You may make changes until Nov. 16, 2011, when Open Enrollment ends. • Keep your enrollment confirmation for your records.
Health tIPs
* If you forgot your password, just click “Forgot Password” on the screen. After answering a series of questions, you’ll be prompted to pick a new password.
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Benefit Decision Guide
Dependent eligibility verification If you are adding a dependent to your coverage, you must verify that dependent’s eligibility by providing a birth certificate, marriage certificate, or 2011 tax return listing the dependent(s) to your local HR representative before the end of Open Enrollment.
Your medical benefits Choices to keep you and your family healthy
Since medical plans and carriers vary from state to state, we’ve provided a state-specific comparison table for you to evaluate the plan that best meets your family’s needs. Cost information is also available on the benefits worksheet that came with this booklet. JT3’s California-based employees can select from three plan types from Kaiser and Aetna. They include the following options:
NOTEs:
Health maintenance organization (HMO) through Kaiser or Aetna An HMO is an insurance provider that combines a range of health insurance coverage on a group basis. These plans attempt to control costs and ensure quality care by encouraging preventive care. A group of doctors and other medical professionals offer care through the HMO, normally requiring a copayment at the time of service. However, only visits to professionals within the HMO network are covered by the policy. Your primary care physician handles referrals to specialists and outside services. In addition, all visits, prescriptions, and other care must be cleared by the HMO in order to be covered. Point of service (POS) through Aetna With most POS plans, you are required to select a primary care physician who will coordinate your access to medical services through referrals. However, in Aetna’s POS plan, you can self-refer yourself or your dependents to primary care physicians or specialists as you wish. Keep in mind that there are incentives for choosing in-network providers, including lower in-network copays, coinsurance, and deductibles than out-of-network coverage. Preferred provider organization (PPO) through Aetna A PPO is a plan design that offers a network of physicians, hospitals, and other medical providers that have agreed to provide health care at discounted fees. If you are covered under a PPO plan, you do not need referrals to receive care from in-network or out-of-network physicians, nor must participants select primary care physicians. A PPO plan provides both in-network and out-of-network benefits, with incentives for in-network care. Incentives to use preferred providers include offering lower in-network copays, coinsurance, and deductibles than out-of-network coverage. Please carefully review your options and the costs associated with them to make the best coverage choices for you and your family.
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2012 Open Enrollment
Medical comparison chart Review your choices
Kaiser HMO
Aetna HMO** — In Network Only
Calendar-Year Deductable (individual/family)
$0
$0
Coinsurance
N/A
N/A
Individual $1,500 Family $3,000
$2,500/$5,000
$500/admit
$500
Out-of-Pocket Maximum (individual/family) Inpatient Surgery
$100/procedure
$200
$30/visit
$20/visit
Yes
Yes
$30/visit
$35/visit
Routine Lab
$10
$0
Routine X-Ray
$10
$35
$10/visit for 30 visits/year with a $50 CYD
$35/visit
Outpatient Surgery PCP Office Visits Referral Required? Specialist Office Visits
Chiropractic Care
$0
$35
Urgent Care
$30/visit
$75/visit
Emergency Room (waived if admitted)
$100/visit
$150/visit
$100
$0
$30/visit
$35/visit
Prescription Drug Copays
Generic: $15 Brand name: $30 (100-day supply)
Generic: $15 Formulary brand: $35 Nonformulary brand: $50
Prescription Drug Copays (mail order with 90-day supply)
Generic: $15 Brand name: $30 (100-day supply)
Generic: $30 Formulary brand: $70 Nonformulary brand: $100
Routine Eye Exam
Ambulance Outpatient Rehabilitation Therapy (e.g., speech, physical, occupational therapies)
EME: eligible medical expenses CYD: calendar-year deductible
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Benefit Decision Guide
JT3’s California employees have four options for coverage. In addition, a TRICARE supplement is offered through ASI for all eligible JT3 employees (see Page 8).
More detailed information about each policy is contained in the provider’s summary plan documents, which are available at jt3benefits.com.
Aetna Managed-Choice POS Open Access
Aetna Open-Choice PPO
In Network
Out of Network
In Network
Out of Network
$500/$1,000
$1,500/$4,500
$1,000/$2,000
$2,000/$4,000
100% of EME
70% of EME
80% of EME
60% of EME
$1,000/$2,000
$2,000/$4,000
$3,000/$6,000
$6,000/$12,000
80% after $250 copay
70%
80% after $250 copay
60%
90%
70%
80%
60%
$20/visit
70% after CYD
$30/visit
60% after CYD
No
No
No
No
$30/visit
70% after CYD
$40/visit
60% after CYD
90%/visit after CYD
70% after CYD
80% after CYD
60% after CYD
90%/visit after CYD
70% after CYD
80%/visit after CYD
60%/visit after CYD
$30
70%
$40/visit
60%
$30
70%
$40
60%
$75/visit
70% after CYD
$50/visit
$50/visit
$150/visit
$150/visit
$150/visit
$150/visit
90%
70%
80%
60%
90%
70%
80%
60%
Generic: $15 Formulary brand: $35 Nonformulary brand: $50
Not covered
Generic: $30 Formulary brand: $70 Nonformulary brand: $100
Not covered
Generic: $15 Formulary brand: $30 Nonformulary brand: $50 Generic: $30 Formulary brand: $60 Nonformulary brand: $100
70%
* This table highlights available plan coverages. If the information in this table is inconsistent with the plan documents and insurance contacts or state/federal regulations, the latter will prevail.
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2012 Open Enrollment
ASI TRICARE supplement Review additional options for those who served our nation
JT3 employees who served in the military may be eligible to receive medical coverage through TRICARE. If you elect TRICARE coverage, you may enroll in TRICARE supplemental coverage through JT3 (as a pretax benefit) or directly from ASI. The ASI summary plan document at jt3benefits.com has further details. For TRICARE Standard/Extra Members
TRICARE Supplement Plan Deductible of $100 per Person / $200 per Family
Standard Fee-for-Service Option
TRICARE Category Eligible Children
(unmarried)
For TRICARE PRIME Members
TRICARE Supplement Plan Deductible of $100 per Person / $200 per Family
Extra Preferred-Provider Option
Out-of-Network Point-of-Service (POS) Option
In-Network HMO
Up to age 21: up to age 23 if full-time student (unless disabled and continues to have TRICARE)
Up to age 21: up to age 23 if full-time student (unless disabled and continues to have TRICARE)
None
None
Pre-existing Condition Limit Outpatient Deductible
TRICARE standard outpatient deductible of $150 per person / $300 per family1
Lifetime Benefit Maximum
Unlimited
Unlimited
Annual Enrollment Fee
None
The TRICARE Prime enrollment fee is not covered by the supplement plan
PreCert Requirements
Only as required by TRICARE
Only as required by TRICARE
(fiscal year: Oct. 1 - Sept. 30)
None
TRICARE Prime POS deductible of $300 per person / $600 per family
The Plan pays the following Benefits after the Plan Deductible and the TRICARE Outpatient Deductible have been met The daily subsistence fee
Inpatient Military Hospital Care *
The daily subsistence fee
Inpatient Civilian Hospital Care*
Your eligible cost share (the lesser of the daily per diem charge or 25% of billed amount, not to exceed TRICARE standard DRG amount) PLUS 100% of covered excess charges up to legal limit
Your eligible cost share (the lesser of the daily per diem charge or 25% of TRICARE Extra contracted rate); 20% of professional fees
Your eligible TRICARE Prime copayments and cost shares
Your 50% POS cost share PLUS 100% of covered excess charges up to legal limit
Outpatient Hospital Services (surgery, X-ray, lab,
50% of your TRICARE outpatient deductible amount and your 25% cost share PLUS 100% of covered excess charges up to legal limit
50% of your TRICARE outpatient deductible and your 20% cost share
Your eligible TRICARE Prime copayments and cost share
TRICARE POS Deductible amount of $75 per person, $150 per family and your 50% POS cost share PLUS 100% of covered excess charges up to the legal limit
Civilian network/mail-order pharmacy: Your copayment ($3 generic/ $9 brand/$22 nonformulary). Civilian non-network Pharmacy: Your TRICARE outpatient deductible plus $9 or 20% of the total cost, or $22 or 20% of the total cost, whichever is greater.
Civilian network/mail-order pharmacy: Your copayment ($3 generic/$9 brand/$22 non-formulary)
Civilian non-network pharmacy: TRICARE POS deductible amount of $75 per person, $150 per family, and your 50% POS cost share
office visits, well baby care, accident, emergency care, home health care)
Prescription Drugs
Mail order: 90-day supply Civilian network: 30-day supply Civilian non-network: 30-day supply
Outpatient Mental Health
Up to $500 per person per fiscal year
Up to $500 per person per fiscal year
Inpatient Mental Health
Limited to 30 days for adults 19 or older, or 45 days for children under 19, per fiscal year. If TRICARE approves benefits beyond these daily limits, supplemental coverage is limited to the lesser of the number of days TRICARE pays or 90 inpatient days per fiscal year.
Limited to 30 days for adults 19 or older, or 45 days for children under 19, per fiscal year. If TRICARE approves benefits beyond these daily limits, supplemental coverage is limited to the lesser of the number of days TRICARE pays or 90 inpatient days per fiscal year.
* 1
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For military retirees and dependents. Amount applied is reimbursed only if the deductible is incurred after the effective date of coverage. After you have satisfied your plan deductible and 50% of the TRICARE outpatient deductible, your benefits will be paid.
Benefit Decision Guide
Note
Benefits are payable for covered cost share amounts up to the TRICARE catastrophic cap. See plan brochure for exclusions and limitations, which may vary by state and underwriter. See your certificate for complete details.
Dental
Choose your Guardian coverage JT3 offers employees dental coverage through Guardian. If you enroll, you can choose to cover yourself, your spouse/domestic partner, your children, and your spouse/domestic partner’s child(ren). You may elect from three different plans or waive coverage. Base PPO
Buy-Up PPO
Premier PPO
In Network
Out of Network
In Network
Out of Network
In Network
Out of Network
$50
$50
$25
$25
$0
$0
100%
100%
100%
100%
100%
100%
50%
50%
80%
80%
90%
90%
(e.g., bridges and dentures, dental implants, inlays/onlays/ veneers,1 and single crowns
50%
50%
80%
80%
90%
90%
Orthodontia 2
50%
50%
50%
50%
50%
50%
$1,000
$1,000
$1,500
$1,500
$2,000
$2,000
Calendar-year deductible
(waived for preventive care)
Preventive care
(e.g., cleaning every three months, fluoride treatments for kids under age 14, oral exams, sealants, X-rays)
Basic care
(e.g., anesthesia, one-surface fillings, perio surgery, periodontal maintenance, repair/maintenance of bridges/crowns/dentures, root canals, scaling and root planing, and simple and surgical extractions)
Major care
Maximum calendaryear benefit Maximum rollover 3
Yes $500 $250 $350 $1,000
Rollover threshold Rollover amount Rollover in-network amount Rollover account limit
Lifetime orthodontia maximum
$1,000
1
Yes $700 $350 $500 $1,250
$1,000
Crowns, inlays, onlays, and labial veneers are covered only when needed because of decay or injury and only when the tooth cannot be restored with amalgam or composite filling material.
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$1,500
2
Yes $800 $400 $600 $1,500
$1,500
Orthodontic coverage is for children only. The appliance must be placed prior to the age of 19. See summary plan document for details and restrictions.
$2,000
3
$2,000
If a member submits at least one claim and stays under the claims threshold, a part of the unused maximum will be rolled over for use in future years.
2012 Open Enrollment
Vision
Select the right plan for your family from Davis Vision JT3 offers vision coverage from Davis Vision for you and your eligible dependents. If you elect vision benefits, you may choose basic coverage or a buy-up option as described below. Please note that the calendar year begins Jan. 1.
Vision Plan In Network Eye examinations • One per calendar year
• Copayment $10 • Covered after copayment Spectacle lenses • One set every calendar year
• Copayment $10 • Covered after copayment
Frames • One set every other
calendar year • Copayment $10 • $55 wholesale allowance toward provider frames Contact lenses • Contact lens fittings (elective)
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Vision Plan Buy-Up Out of Network
• One per calendar year • Reimbursed up to $40
In Network
• One per calendar year • Copayment $10
• One set every calendar year • One set every calendar year • Reimbursed up to $40 • Copayment $10 for single vision • Covered after copayment • Reimbursed up to $125 for lenticular lenses • Bifocals reimbursed up to $60 • Trifocals reimbursed up to $80 • One set every other calendar year • Reimbursed up to $45
Out of Network
• One per calendar year • Reimbursed up to $40 •O ne set every calendar year • Reimbursed up to $40 for single vision • Reimbursed up to $125 for lenticular lenses • Bifocals reimbursed up to $60 • Trifocals reimbursed up to $80
• One set every calendar year • O ne set every calendar year • Reimbursed up to $45 • Copayment $10 • $60 wholesale allowance toward provider frames
•C ontact lens fittings •C ontact lens fittings • Contact lens fittings every calendar year every calendar year every calendar year every calendar year • Copayment $10 •R eimbursed up to $105 for • Copayment $10 • Reimbursed up to $105 elective contact lenses for elective contact lenses • Standard, soft, daily-wear • Standard, soft, daily-wear disposable OR $105 disposable OR $115 allowance plus additional allowance plus additional 15% discount on overage 15% discount on overage from provider's own supply from provider's own supply
Benefit Decision Guide
Personal paid leave Use your extra points for paid time off
You can use your cafeteria points to purchase additional paid leave (better known as PPL-Points) during Open Enrollment. Leave acquired through PPL-Points will be added to your leave balance as they’re awarded with each pay period and loaded on the business day following each paycheck. For example, if you elect to purchase five additional days of leave using your points, that time will not be available all at once. It’ll become available for use with each paycheck as it is awarded. In addition, JT3 offers the PPL-Dollars program, where you can also pay out of pocket for even more personal paid leave. Leave purchased with PPL-Dollars is loaded into your leave balance in January 2012. Here’s how the two options work:
NOTEs:
PPL-Points • As part of JT3’s cafeteria plan, points are automatically awarded to you as credits to be applied toward medical, dental, and vision coverage, as well as for personal leave. • These are issued each pay period on a pretax basis using available cafeteria points. • Changes in medical, dental, and vision coverage will require an adjustment of your PPL-Points credit balance. • IRS regulations require any unused portion of PPL-Points to be paid no later than Dec. 31 of that year.
PPL-Dollars • You can purchase leave based on your rate of pay as of the end of Open Enrollment (Nov. 16, 2011). • If you purchase leave, it must be a minimum of four hours and can be no more than 40 hours. • The dollars are banked and available for you to use throughout the year (except in the blackout period). • Unused dollars are rolled over into the next year. • If you leave JT3, those dollars will be paid out to you.
JT3 tIPs
• The withdrawal amount will be deducted from your first check in 2012. If the amount is more than 50 percent of your net pay, it will be spread over two paychecks.
For example Here’s a hypothetical example of how the PPL-Dollars program works: As of Nov. 16, your current rate of pay is $10/hour and you want to buy 40 hours of leave. Your first check in January will have $400 ($10 x 40 hours) deducted for your PPL-Dollars. That $400 will stay in your leave “bank” until you use it or leave JT3. If you take a day off, JT3 will deduct $80 ($10 x 8 hours) from your bank. Later in the year, you get a raise to $10.50 per hour. Now when you use the PPL-Dollars in your leave bank, $84 ($10.50 x 8 hours) will be deducted, reflecting your new pay rate.
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2012 Open Enrollment
Flexible spending accounts Set aside pretax funds for medical and/or dependent care
Health and dependent care flexible spending accounts (FSAs) let you set aside pretax money to help you budget for large health care and dependent care expenses by spreading the costs over a year. Please use the helpful worksheets on the next page to calculate how much you should set aside for your FSAs. You can contribute up to $2,500 toward your health care FSA and up to $5,000 toward your dependent care FSA, all on a pretax basis. You can get reimbursed for medical expenses up to your elected limit at any point in the plan year. In contrast, with the dependent care FSA, you can’t take out more than you’ve contributed at the time of your claim.
NOTEs:
JT3 tIPs
Use it or lose it If you do not use all of the funds you contributed, you will forfeit them at the end of 2012. Be sure to review all of the items covered by your FSAs so you can be reimbursed. You can keep track of your account online at flexdirect.adp.com. In addition, please consult with your tax professional about properly accounting for your FSAs on your annual tax return.
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Benefit Decision Guide
Get a prescription Remember, many over-the-counter medications are no longer eligible for reimbursement unless you have a prescription.
FSA worksheet Estimate your expenses and plan your deductions
We’ve developed this worksheet to help you estimate your annual expenses and plan for your 2012 FSA contributions. Please keep in mind that when you enroll at jt3benefits.com, you need to enter the total amount you want to contribute in 2012, not the amount per paycheck (as is the case with your other benefits). The enrollment system will calculate for you how much will come out of each paycheck.
NOTEs:
Contribution Worksheet — Health Care Eligible Expenses
Expected Annual Expense
Deductibles or copayments under your or your spouse’s benefit plans. . . . . . . . . . $ Vision care expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Dental expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Medical equipment or supplies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Health care professional services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Medical treatment such as acupuncture and healing services. . . . . . . . . . . . . . . . . $ Other eligible medical expenses not covered by your medical plan . . . . . . . . . . . . . $ Total estimated eligible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Contribution Worksheet — Dependent Care Eligible Expenses In-home care provider expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Day care expenses for a dependent adult or child. . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Preschool expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Wages paid to a housekeeper for providing care for an eligible dependent . . . . . . $ Dependent adult care expenses (usually a parent cared for in the home), as long as the adult dependent lives with you for more than 50 percent of the year. . . . . . . . . $ Total estimated eligible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
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Expected Annual Expense
2012 Open Enrollment
Just in case
Select life insurance, disability insurance, and AD&D options to protect your family No one plans to get hurt or sick. However, making sure your life insurance and disability insurance are up to date is critical to ensuring your family’s health and well-being.
NOTEs:
It’s your life JT3 provides basic life insurance coverage (at no cost to you) in the amount of your annual base salary (rounded up to the nearest $1,000) or a minimum of $50,000, whichever is greater, up to a maximum of $200,000. You can purchase supplemental life insurance coverage from $10,000 to five times your salary, up to $500,000 (in increments of $10,000).
JT3 tIPs
Add the family If you’ve enrolled in supplemental life insurance for yourself, you may also elect to purchase supplemental life insurance coverage for your spouse/domestic partner up to $50,000 (in increments of $10,000). Coverage cannot exceed 50 percent of the amount of the combined total of your basic life insurance coverage and the supplemental life insurance coverage that you purchase for yourself. Coverage for your child(ren) is available at $2,000, $5,000, and $10,000 levels.
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Benefit Decision Guide
Things happen In addition to basic life insurance coverage, you receive basic accidental death and dismemberment (AD&D) insurance coverage at JT3’s expense. The basic coverage is the amount of your annual base salary or a minimum of $50,000, whichever is greater, up to a maximum of $200,000. You can purchase supplemental AD&D insurance coverage of between $10,000 and 10 times your salary, up to $500,000 (in increments of $10,000). Short-term disability (STD) insurance JT3 provides STD insurance for you. If you experience a qualified nonoccupational disabling illness or injury and are unable to work, the plan will pay 70 percent of your base weekly pay for 25 weeks, up to a maximum of $2,000 per week. Please be sure to check each policy at jt3benefits.com for specific rules regarding your coverage.
Personal health applications Please contact your local HR representative to fill out a personal health application (PHA) if you are enrolling in supplemental life insurance for the first time, increasing your coverage, adding a spouse/domestic partner, and/or enrolling in long-term disability for the first time. Payroll deductions and coverage will not begin until your application is approved.
Additional benefits Income protection and legal coverage
At JT3, we care about the long-term health and well-being of you and your family. That’s why we’re pleased to offer these additional benefits for you to enroll in during Open Enrollment.
NOTEs:
JT3 tIPs
AD&D insurance for your dependents You may add AD&D insurance for your spouse or domestic partner unless he or she is already covered as an employee under JT3’s policy. You may also cover your minor/student dependents as long as you elect coverage for yourself as well. You may choose AD&D insurance for your spouse or domestic partner in the following amounts: • 50 percent of the amount you select for yourself if you do not have any children you cover under this AD&D policy. • 40 percent of the amount you select for yourself if you have children you cover under this AD&D policy. You may choose guaranteed AD&D insurance for each child through age 19 (age 26 for students) in the following amounts: • 15 percent of the amount you select for yourself if you do not have a spouse or domestic partner you cover under this AD&D policy. • 10 percent of the amount you select for yourself if you have a spouse or domestic partner you cover under this AD&D policy.
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Long-term disability insurance You may elect to enroll in long-term disability insurance, which pays you a portion of your earnings if you cannot work due to a disabling illness or injury. The plan covers approved disability claims and provides a payment of 60 percent of your earnings, which begins when your short-term disability insurance ends. The maximum benefit is $8,000 per month. Legal Hyatt Legal offers complete representation for many personal legal needs. You may receive telephone advice and office consultations. While there are some specifically excluded matters, there are no restrictions on the number of times per year you may use the service. Go to legalplans.com for more information, or call 800-821-6400. Be sure to thoroughly read the summary plan documents and policy information on jt3benefits.com.
Update your beneficiaries If something should happen to you, we want to make sure your benefits are distributed according to your wishes. Help us help your loved ones by contacting your local HR representative to make sure your beneficiary listing is up to date. If you’re enrolled in our retirement savings program, be sure to check with Fidelity (401k.com) as well.
2012 Open Enrollment
Benefits any time More options directly through providers
There are a number of other benefits available for you to enroll in during Open Enrollment, but you’ll need to contact the benefits providers directly to sign up. The benefits providers will coordinate the payroll deductions, which will begin in 2012.
NOTEs:
Long-term care insurance JT3 provides basic long-term care insurance, which covers 100 percent of eligible nursing home care or hospice care expenses, up to $50 per day, with a lifetime maximum benefit of $36,500. You may choose to increase your coverage to a daily benefit of $100, $150, or $200 at your own expense. Even if you don’t enroll for additional coverage for yourself, you may enroll your spouse, parents, and/or grandparents. Please note that additional coverage for you or your family members may require that you submit evidence of insurability. You can call CNA at 800-266-2904 for more information or see your local HR representative for the proper forms. Auto, home, property, renters, and boat insurance Would you like to have your payments for auto, home, and other types of property insurance deducted directly from your paycheck? JT3 has contracted with MetLife to provide group insurance for a variety of coverages, allowing many employees to save through MetLife. Auto insurance quotes are available at metlife.com. You can also call 800-438-6388 for more information and quotes on all available coverages. Pet insurance JT3’s employees can get coverage for their animal companions. The basic plan covers office visits, treatments, lab fees, X-rays, and covered medical problems and conditions. A “superior plan” with higher coverage levels is offered, as is a well-care plan to help offset costs for annual physicals, vaccinations, teeth cleanings, and more. Coverage, through VPI, is also available for birds, rabbits, ferrets, reptiles, and other exotic pets. Costs and coverage options are determined based on the pet type, age, and other factors. Contact VPI for more information and a quote at petinsurance.com or 888-899-4VPI. Accident, intensive care, and cancer coverages Through Aflac, you can add personal accident indemnity coverage, personal hospital intensive care coverage, and cancer indemnity coverage. For more information, call 800-992-3522. You can also follow the link from jt3benefits.com.
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Benefit Decision Guide
Enrollment confirmation Print a copy for your records
Once you’ve completed your enrollment at jt3benefits.com, be sure to print the enrollment confirmation for your records. An additional confirmation will be mailed to your home address after Open Enrollment in November or December.
NOTEs:
Cards If you enrolled for medical coverage for the first time or if you switched plans, new cards will be issued to you after Open Enrollment. If you signed up for your first FSA with JT3, you will receive a card as well. If you are already enrolled and your card has not expired, your current card will still be valid in 2012. (FSA cards are good for three years.) If you’re enrolling in dental benefits for the first time, please see your local HR representative to obtain a card.
Health tIPs
JT3 tIPs
Changes after Open Enrollment After Open Enrollment, you will be able to change your elections only if you have a qualifying event in your immediate family (e.g., a marriage, divorce, birth, and/or adoption, and/or your dependent gains or loses coverage). If you have a qualifying event, please contact your local HR representative to file a family-status change.
Prevention saves money
( and possibly your life)
Each provider offers a number of preventive care programs for little to no cost, including well checks, immunizations, and more. In addition, JT3’s Healthy Roads program offers free phone-based coaching to employees and spouses looking for help with weight loss, smoking cessation, and stress management.
Happy birthday If you’re celebrating your 65th birthday this year, be sure to contact your local Social Security office to sign up for Medicare benefits.
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2012 Open Enrollment
Key terms
Defining important terminology about your benefits Coinsurance Coinsurance is the amount that a covered person must pay for covered health care during a benefit year after meeting the deductible.
NOTEs:
Copayment A copayment is a cost-sharing arrangement under a health plan in which a participant pays a specified dollar amount for a service, such as $15 for a prescription or $25 for a doctor’s office visit. Copayments are generally not included in the out-of-pocket maximum. Deductible The amount paid by the plan participant for covered expenses in a group medical plan before the plan pays benefits. Formulary A formulary is a list of medications that are covered by your health insurance plan. Formularies can include both generic and brand-name drugs. They are often organized into “tiers” that indicate how much your copayment will be for each drug. If a drug is not on your plan’s formulary, you will have to pay the full cost of the medication out of pocket or through your FSA. In network The option for a plan participant to utilize providers who have agreed to provide services at a set rate. Health plans negotiate reimbursement fees with the providers.
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Benefit Decision Guide
Maximum rollover amount (MRA) Some health care coverage providers, allow a portion of unused annual maximum benefits to roll over into the next plan year, accumulating to a maximum cumulative total. The MRA can be used in future years if a member reaches the plan’s annual maximum. This benefit is enhanced if a member exclusively uses preferred providers. In many cases, a plan participant must submit a claim and not exceed the paid-claims threshold during the benefit year. Out of network The option for a plan participant to utilize providers who have not agreed to provide services at a set rate. Typically, amounts charged by physicians and hospitals are higher and plan participants pay higher deductibles, copayments, and coinsurance. Out-of-pocket limits The maximum amount of covered medical and surgical expenses the employee and his or her dependents are responsible for each year. Summary plan description (SPD) An SPD is an easy-to-read document that describes a plan’s benefits, eligibility provisions, employee rights, and appeal procedures.
Important contacts For quick reference
Here are some helpful contact numbers for benefits providers and your local HR staff. You can cut this out and keep it handy for whenever you need to talk to someone about your benefits. JT3 Employee Service Center (ADP)
866-743-2142
jt3benefits.com
California HR staff Name/location
Phone
Fax
Kim Flowers /AFFTC
661-277-9191
661-277-4806
kim.flowers@jt3.com
Jo Newman/AFFTC
661-277-9234
661-277-4806
josephine.newman@jt3.com
Debbie Dragovich/ECR
760-939-9325
760-939-9155
debbie.dragovich@jt3.com
Contact
Phone
Website/e-mail
Aetna HMO/POS
877-402-8742
aetna.com
Aetna PPO
888-416-2277
aetna.com
Aflac
800-992-3522
aflac.com
ASI (TRICARE)
800-638-2610, ext. 255
asicorporation.com
CNA
800-266-2904
cnagroupben2.com (user ID JT3, password gltc)
Davis Vision
800-999-5431
davisvision.com
Guardian
800-541-7846
guardiananytime.com
The Hartford (estate guidance)
866-854-5429
hartfordlifeconversations.com (promotional code WILLHLF)
The Hartford (Everest funeral planning)
866-854-5429
hartfordlifeconversations.com (enrollment code HFEVLC)
The Hartford (general information)
800-523-2233
hartfordlifeconversations.com
The Hartford (life insurance)
888-563-1124
hartfordlifeconversations.com
The Hartford (travel assistance)
800-243-6108 OR 202-828-5885 n/a
Healthy Roads
877-330-2746
healthyroads.com
Hyatt Legal
800-821-6400
legalplans.com
Kaiser Permanente Health Plans
800-464-4000
kaiserpermanente.org
Lifeworks Employee Assistance Program
888-267-8126
lifeworks.com (user ID jt3, password llc)
MetLife
800-438-6388
metlife.com
VPI
877-738-7874
petinsurance.com
The Work Number
866-743-2142, opt. 5
theworknumber.com
Benefits providers
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California 65373 This guide provides an overview of your benefits options. If the information in this guide is inconsistent with the plan documents and insurance contracts or state and federal regulations, the plan documents, insurance contracts, and state and federal regulations will prevail. This guide is not intended as a contract of employment or a guarantee of current or future coverage. The plan sponsor reserves the right to amend or terminate each plan at any time and from time to time.