2023
Employee Eligibility
Full-time employees who work 30 or more hours each week at Albers & Associates are eligible for all benefits on the first of the month following date of hire.
Albers & Associates offers comprehensive, costeffective benefits options. You must enroll within 30 days of your eligibility, or you will forfeit your right to enroll until the following annual open enrollment.
Changing Your Elections
It is very important to consider your choices carefully before you make your benefit elections. The benefits you choose will be in place from your eligibility date through the end of the plan year, unless you have a qualifying event during the year such as:
• Marriage, divorce, birth or adoption of a child
• Death of a spouse or covered child
• You or one of your covered dependents gains or loses other benefits coverage due to a change in employment status.
Note: For additional information, Qualified Event Definition is determined by www.IRS.gov guidelines.
Dependent Eligibility
• Legal spouse
• A dependent child under the age of 26 (coverage terminates at the end of the month in which the dependent turns 26).
Note: Under the Patient Protection and Affordable Care Act (PPACA), adult children enrolled under their parent’s medical plan may maintain their coverage until the age of 26.
Table of Contents Introduction 2 Important Information 3 Medical Plan 4 Health Savings Account 5-6 Dental Plan 7 Vision Plan 8 Contacts 9 Introduction 2
Important Information
Enrollment Checklist
Review All Enrollment Materials
Carefully consider your current and future healthcare needs
Complete elections on KTBSonline
Cost of Benefits
Albers & Associates will cover 50% of the employee rate and 10% of any dependents for the Medical Plan and 100% of the employee rate for the Dental & Vision Plans.
Enroll in Benefits
You will be able to complete enrollment online via KTBSonline. Below are the instructions to register and login.
First Time KTBSonline Users
1. Go to https://www.ktbsonline.com (The most recent version of Microsoft Edge, Google Chrome, Safari, or Firefox are recommended)
2. Click on the “Register” link located on the right-hand side of your screen.
3. When promoted, enter your Last Name, Date of Birth, and your Social Security Number. For security purposes you will also be asked to complete a CAPTCHA.
4. Follow the directions provided on the site to complete your registration and setup your online account.
Returning KTBSonline Users
1. Go to https://www.ktbsonline.com (The most recent version of Microsoft Edge, Google Chrome, Safari, or Firefox are recommended)
2. Enter your Username and Password within the Secure Benefits Log In Section and then click “Log In.”
If you have any issues registering, please contact Tech Support at the Kelly Benefits Customer Service Call Center at 1-877-290-9580 Monday – Friday 8:30 am – 5:30 pm.
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Medical
Each plan covers the same services but differs in the amount deducted from your paycheck, your cost when you receive care, and how care is covered - In-network versus out-of-network. Here’s how your plans compare:
Prescription Coverage
with medical Combined with medical Combined with medical
Tier I
Tier II
Tier III
Tier IV
Tier V
90-Day Maintenance
Deductible then $10 $10
Deductible then $45
Deductible then $65
Deductible then 50% up to $100 max
Deductible then 50% up to $150 max
2 X Retail Copay
Deductible then $45
Deductible then $65
Deductible then 50% up to $100 max
Deductible then 50% up to $150 max
2 X Retail Copay
Deductible then $10
Deductible then $45
Deductible then $65
Deductible then $100 max
Deductible then $150 max
2 X Retail Copay
This brochure is intended to convey general information only and does not provide specific claims or coverage advice This is not a guarantee or full description of coverage under the plan Plan participants should contact the plan’s claims department for detailed information regarding benefits provided under the plan and the level at which they will or will not be paid
BlueChoice HMO HSA Silver $2,000 BlueChoice HMO Gold $1,500 BlueChoice Advantage HSA Silver $2,000 In-Network In-Network In-Network Out-of-Network Deductible Aggregate Separate Aggregate Aggregate Individual $2,000 $1,500 $2,000 $4,000 Family $4,000 $3,000 $4,000 $8,000 Out-of-Pocket Max Separate Separate Separate Separate Individual $7,500 $5,900 $7,500 $14.000 Family $15,000 $11,800 $15,000 $28,000 Coinsurance 100% 100% 100% 100% Preventive Care No Charge No Charge No Charge Deductible then $0 PCP Office Visit Deductible then $25 $15 Deductible then $25 Deductible then $70 Specialist Office Visit Deductible then $50 $30 Deductible then $50 Deductible then $70 Labs (LabCorp / Hospital) Deductible then $25 / Deductible then $50 $15 / Deductible then $30 Deductible then $25 / Deductible then $50 Deductible then $75 / Deductible then $150 X-Ray (Non-Hospital / Hospital) Deductible then $50 / Deductible then $100 $30 / Deductible then $60 Deductible then $50 / Deductible then $100 Deductible then $100 / Deductible then $150 Imaging: CT, PET scan, MRIs (Non-Hospital / Hospital) Deductible then $250 / Deductible then $500 $200 / Deductible then $400 Deductible then $250 / Deductible then $500 Deductible then $300 / Deductible then $550 Urgent Care Facility Deductible then $100 $50 Deductible
$100 Treated as In-Network Emergency Room (copay waived if admitted) Deductible then $250 Deductible then $250 Deductible then $250 Treated as In-Network Inpatient Stay Deductible then $500 per day (3-day maximum payment) Deductible then $400 Deductible
$500
Deductible
then
then
per day (3-day maximum payment)
then $600 per day (3-day maximum payment)
Deductible Combined with medical $250 (per person) Combined with medical Rx OOP Maximum Combined
Rx
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Health Savings Account (HSA)
Deposit, Grow, Save and Pay. Extend Your Health Care Dollars.
When you elect medical coverage under the HSA Plans, you can take advantage of a Health Savings Account (HSA) with Further by HealthEquity. An HSA is a pre-tax benefit account used to pay for eligible medical, dental, and vision care expenses that aren’t covered by your insurance plan, or items that apply towards your deductible, copays, and coinsurance. It’s a smart, simple way to save money while keeping you and your family healthy and protected. The money comes out of your paycheck over the course of the year. The amount you contribute to the HSA is not subject to Social Security (FICA), federal, state, or local income taxes, effectively lowering your annual taxable salary.
HSA Advantages
HSAs are owned by the employee. You take the money with you if you were to leave your employer. If you don’t use the money, it simply rolls over to the next year. You do not lose it!
How the Health Plan & Health Savings Account (HSA) work together
Here’s a simple way to breakdown what covered medical expenses the Health Plan pays for vs. what you can use the Health Savings Account (HSA) to pay for.
Your Health Plan Pays For: Your HSA Funds Pay For:
• Preventive Care
• Immunizations
• After deductible and/or copays or coinsurance have been paid:
• Hospitalizations
• Emergency Room Visits
• Diagnostic Services
Are age 55+ and cover dependents*
• All expenses before the deductible has been met
• Copays or coinsurance after the deductible has been met
• Other expenses such as:
• Glasses or Contact Lenses
• Dental services including Orthodontia
• Prescription Drugs
• Qualified expenses for spouse and/or children
Contribution Limits*
$4, 850
$8, 750
* If you do not contribute the maximum, the catch-up contribution won’t be as meaningful because it is meant to allow you to contribute more than the annual limit
* Not everyone is eligible to participate in an HSA You must be enrolled in the HSA Plan. If you are enrolled in TRICARE, Medicare Part A, or another plan that is not a high deductible health plan, you are not eligible to contribute to an HSA
HSA
If you… You may contribute up to…. Have Employee only coverage $3, 85 0 Cover dependents
age 55+ and have and
employee
coverage*
Calendar Year 202 3
$7,750 Are
have
only
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Health Savings Account (HSA)
How to Contribute to your HSA
You can elect how much you want to contribute (up to the IRS Maximum for the 2023 calendar year) while completing your other elections on KTBSonline. These elections will come out of your paycheck pre-tax.
How to Access your HSA
CareFirst BlueChoice BlueShield (CareFirst) wants to make managing your health care easier. As a member with a BlueFund health savings account (HSA), you can submit claims, order debit cards, view account transactions and more through the CareFirst My Account single sign.
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Dental
Regular dental care is essential to good health. Albers & Associates provides dental coverage through CareFirst BlueCross BlueShield. You can see any dentist you choose. However, this plan gives you the option to reduce your out-of-pocket expenses by visiting a dentist who participates in our Preferred Provider Network. It’s your choice!
• You can visit In-Network and Out-of-Network dentists
Plan Highlights
• Out-of-network providers can balance bill up to full charges
• National Preferred Provider Network
How to Find a Dentist
Step 1: Go to carefirst.com/doctor
Step 2: Login or Continue as Guest
Step 3: Enter Zip
Step 4: Click on BlueDental Network
Step 5: Search Names or Specialties
Note: The information provided is only a partial, general description of plan benefits and does not constitute a contract. In case of a conflict between your plan documents and this information, the plan documents will govern.
In-Network Out-of-Network Plan Year Deductible Individual Family $25 $75 $50 $150 Annual Plan Year Maximum Benefit $1,500 Preventive and Diagnostic Care (such as cleanings, exams, and x-rays) No Charge No Charge of Allowed Benefit Basic Restorative & Major Surgical Care (such as fillings, oral surgery, and root canals) 20% after deductible 20% after deductible of Allowed Benefit Major Restorative Care (such as dentures, bridgework, and crowns) 50% after deductible 50% after deductible of Allowed Benefit Orthodontia Care (for eligible children only to age 19) N/A N/A
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Vision
Albers & Associates provides professional vision services including routine eye examinations, eyeglasses and contact lenses through CareFirst BlueCross BlueShield through Davis Vision, Inc. national network of providers.
Eye Exams (every 24 months)
$10 copay Up to $45 Reimbursement
Frames (every 24 months)
Davis Vision Frame Collection: No copay for over 200 frames Non-Collection Frame: Plan pays up to $100
Single: up to $52 Reimbursement
Lenses (every 24 months)
$0 Copay for Single Vision, Bifocal, and Trifocal
Bifocal: up to $82 Reimbursement
Trifocal: up to $101 Reimbursement
Contact Lenses (every 24 months)
How to Find a Provider
Step 1: Go to carefirst.com/doctor
Step 2: Login or Continue as Guest
Step 3: Enter Zip
Step 4: Click on BlueVision Plus
Step 5: Search Names or Specialties
Or call Davis Vision at 800-783-5602
(Identify yourself as CareFirst Member)
Note: The information provided is only a partial, general description of plan benefits and does not constitute a contract. In case of a conflict between your plan documents and this information, the plan documents will govern.
In-Network
Out-of-Network
Up to $45 Reimbursement
Elective Therapeutic
are dispended No copay with prior approval
to $97
Up to $285 Reimbursement
No copay with evaluation if Collection lenses
Up
Reimbursement
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Contact Information
EONE
mybenefits@eonebenefits.com
By emailing mybenefits@eonebenefis.com or calling 1-877-719-EMP1(3671) your employees and their dependents have direct access to the EONE Benefit Advocate Team (BAT). The BAT team is dedicated to providing assistance and answers to day-to-day questions about your group health and welfare benefits. Employees simply reach out to our team when they have an issue and we take it from there. Our team has direct access to the people and systems needed to make life easier, here are just a few examples:
• Resolving claims and provider billing issues
• Locating participating providers
• Explaining benefits coverage
Visit www.carefirst.com/myaccount to:
•
Order ID cards
View claim details and EOB’s Visit CareFirst Online Benefit Phone Website/Email CareFirst Medical 1-855-444-3122 www.carefirst.com CareFirst Dental 1-866-891-2802 www.carefirst.com CareFirst Vision 1-800-783-5602 www.carefirst.com Further by HealthEquity 1-800-932-0783 www.carefirst.com/myaccount Kelly Benefit Customer Service Center 1-877-290-9580 www.ktbsonline.com
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Additional Contacts Need Help? We’ve got you covered…
NOTE: HIPAA privacy regulations may require the completion of a pre-authorization form prior to releasing information regarding deductible amounts or specific medical conditions (once a HIPAA form is submitted, it may take up to 48 hours before information can be released). Bank account information (including: 401(k), HSA, HRA and FSA) is generally considered classified and we recommend you reach out directly to the account holder. BAT Benefit Advocate Team
)
1-877-719-EMP1(3671
View benefits
• Understanding your explanation of benefits (EOB)
Check deductible and out of pocket maximum
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