2020 Employee Benefits Summary Overview Plan Year: April 1, 2020 – March 31, 2021
Coronis 2020 Employee Benefits
1
All About Enrollment Employer-Provided Benefits As an eligible employee, Coronis automatically provides you with several benefits. Coronis pays the full cost of life insurance, long term disability coverage, and an employee assistance plan. You are not required to make any contributions for these benefits.
Optional Benefits In addition to the employer-provided benefits, eligible employees may enroll in optional benefits including medical, dental, vision, short-term disability insurance, voluntary life insurance for self, spouse, and dependents and retirement plans. You contribute toward the cost of the optional benefits that you elect.
When Coverage Begins •
New hires/transfers: Coverage will begin on the 1st of the month after 30 days from your date of hire or transfer. You must enroll during your first 30 days of employment with Coronis. If you do not, your coverage will be waived and your next opportunity to enroll in benefits without a qualifying event will be during next year’s annual open enrollment period, typically held in February or March of each year for the upcoming plan year.
•
Current employees: Each year you have an opportunity to review your benefit elections during the annual open enrollment period, typically held in February or March and make changes for the upcoming plan year that begins on April 1st.
When Coverage Ends For most benefits, coverage will end on the last day of the month in which: •
Your regular work schedule is reduced to fewer than 30 hours per week;
•
Your employment with Coronis ends due to resignation, termination, or death;
•
Or if you stop paying your share of the coverage.
Your dependent coverage ends: •
When your coverage ends;
•
The last day of the month in which the dependent is no longer eligible.
•
The end of the month in which dependent children turn 26.
How to Change your Coverage Mid-Year The IRS provides strict regulations about changes to pre-tax elections during the plan year. If you experience a qualified IRS family status change mid-year, you are permitted to make a change within 30 days of the event. If the change request is not completed within 30 days of the event, you will not be able to change your elections until the following annual open enrollment period. Below are some of the more commonly known qualified family status changes: •
Marriage, divorce, or annulment
•
Birth of a child
•
Placement of a foster child or child for adoption with you
•
Obtaining legal guardianship of a child
•
Change in employment status that affects benefits eligibility
•
Return from an unpaid leave of absence
•
Gain or loss of coverage
The change you request must be consistent with the qualifying event. All mid-year changes require documentation, which must also be provided within 30 days of the event. Please contact your HR team if you have questions regarding a Life Event and any documentation that may be needed.
2
Coronis 2020 Employee Benefits
All About Enrollment Who Can Enroll You are eligible for benefits if you are a regular, full-time or part-time prorated employee. If you elect coverage, your dependents are also eligible for medical, dental, vision, and life insurance coverage. Eligible dependents include: •
Your Spouse and legal child(ren)
•
Natural children, adopted children, foster children, step-children, or any child for whom you have legal custody
•
Children up to age 26; through the end of the month of their 26th birthday.
•
Regardless of age, if fully disabled and unmarried, provided they became fully disabled either prior to age 19 or between the ages of 19-26 if the child was covered by the plan when the disability occurred
How to Enroll Signing In
3
•
Go to www.workforcenow.adp.com
•
Enter your User Name.
•
Your user name is the user ID you received when you completed self-registration.
•
Enter your Password.
•
Your password is the one you created during selfregistration.
•
Click Sign In.
•
Once in the system, you will see a welcome note for Open Enrollment
•
You will click on the “start this enrollment” link and the wizard will take you through the enrollment process
•
Once complete, you will click on the “complete enrollment” link
•
The first page you will come to is your Beneficiary and Dependents Page •
Make sure you have all of your dependents in the system if you want to enroll them in any of your benefits.
•
If your dependent is ALSO your beneficiary, you will use the Dependent/Beneficiary option when entering their information into ADP
•
You will need the DOB and SSN for every dependent and beneficiary you enter into ADP in order for the system to save their information.
Coronis 2020 Employee Benefits
Medical Insurance Coronis gives you the option of choosing one of three Trustmark/Cigna plans to best meet your needs. All three plans: •
Use the Cigna PPO network
•
Use CVS CareMark as the administrator for all Pharmacy claims
•
Cover preventive care at 100%,
•
Provide coverage for the same type of services.
Glossary Copay
a fixed fee that you pay at the time you receive services (i.e. $10 for a PCP visit)
Deductible
the set amount you must typically pay before coinsurance starts
Coinsurance
the portion of expense you must pay for care, in most cases, after meeting your deductible
Out-of-Pocket Maximum
the maximum amount you could pay for care within a calendar year, including copays, coinsurance, and deductibles
Preventive Services
routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems
Premiums
your payroll deductions, which are the amounts you pay to belong to a health plan
In-Network
the doctor or health care facility has a partnership with the insurance carrier to bring you lower costs
Providers
a doctor or health care facility
Our Plans High PPO is our richest plan design, which maximizes coverage at the point of service. So if you and your family are looking to pay the least out of pocket at the doctor’s office, then this plan is the right one for you.
Low PPO offers the same rich benefit design as the High PPO, but requires a little more out of pocket at the time of service. It comes with lower premiums than the High PPO. HSA requires the highest cost at the time of service, but comes with the lowest premiums. This plan can be paired with a Health Savings Account.
4
Coronis 2020 Employee Benefits
Trustmark Health Benefits
myTrustmarkBenefits.com Fast, secure online self-service of your benefit plan & healthcare spending anytime. Opt in for electronic communications
Review all your expenses in one place
By opting in, you’ll receive helpful info about your benefits and health via email so you can engage on-the-go. You’ll also receive an email when your electronic explanation of benefits (EOB) is available, which shows your medical claims and payments made by your health benefit plan. Log on and go to the About Me tab to opt in so you can get your info when you need it…and save a few trees along the way!
You can review all your claims, deductible, and out-ofpocket balances with just a few clicks. You can even filter your info to find exactly what you’re looking for!
Access your benefits and claims You can quickly access your benefits and claims for you and your family to help you make smart, informed choices about your health and healthcare spending.
Just log on and go to the My Expenses tab to see all your info.
Connect through the MessageCenter Connect with customer service when you have questions, including the ability to immediately send a question about a claim while viewing its details.
Get a full look at your benefits Click the My Benefits tile to review the details of your plan, including your coverage, your member ID, and your dependents and their information.
Opt in forfast electronic communications Ask a question Review your claims and deductible and out-of-pocket amounts
View your coverage and dependent info
Expect more. Benefit more.
Visit myTrustmarkBenefits.com to login or register.
Self-funded plans areadministeredbyTrustmarkHealth Benefits, Inc. TrustmarkHealthBenefits, Inc. is a subsidiaryofTrustmarkMutualHoldingCompany. 400 Field Drive •Lake Forest,IL 60045 800.832.3332•www.TrustmarkHB.com ©2020TrustmarkHealthBenefits
5
Cigna Network Find a Healthcare Professional Two ways to find what you need There are two ways to find an in-network healthcare professional: 1. If you’re already enrolled, visit mytrustmarkbenefits.com and log in using your User ID and Password 2. Visit Cigna.com and click “Find a Doctor” – Be sure to select the “PPO, Choice Fund PPO” network
Special features allow you to: ✓
Narrow your results by distance, cost efficiency, specialty, and more
✓
Email a copy of your search results
✓
Find doctors in 22 different medical specialties, who meet certain cost and quality measures and have been awarded the Cigna Care Designation
✓
Estimate procedure costs based on Cigna’s historical data
Better Value. Better Together Cigna’s extensive PPO Network gives you access to qualified healthcare professionals. Your good health is important and we’re here to help. With a growing nationwide PPO network of nearly 800,000 healthcare professionals and more than 6,000 facilities, Cigna offers you a range of quality choices to help you stay healthy.
Visit Cigna.com •
Click “I want to: Find a Doctor”
•
On the next page you will be asked to select a directory: “Plans offered through work”
•
Complete your location information and choose a plan
•
Select: “PPO, Choice Fund PPO”
Use the myCigna SM website or app & simplify your search for providers.
6
•
Easily find providers in your plan's network (you'll save money when you stay in-network).
•
Compare costs for hundreds of procedures.
Coronis 2020 Employee Benefits
Medical Insurance Trustmark and Cigna PPO The PPO network allows you to choose any provider you want each time you need care. There are no requirements to choose a primary care physician (PCP) to coordinate your care. When you use in-network providers, your out-of-pocket expenses are kept to a minimum.
High Option PPO Medical Coverage
Low Option PPO
HSA
In-Network
Out-of-Network
In-Network
Out-of-Network
In-Network Only
$500 / $1,500
$1,000 / $3,000
$1,500 / $4,500
$2,000 / $6,000
$2,500 / $5,000
$3,000 / $6,000
$4,500 / $9,000
$5,000 / $10,000
$8,000 / $16,000
$5,000 / $10,000
80%
60%
70%
50%
80%
Preventive Care
No Charge
20% Coinsurance
No Charge
30% Coinsurance
No Charge
PCP Office Visit (No PCP selection required)
$10 copay
Ded, then 20%
$10 copay
Ded, then 20%
Ded, then 20%
Specialist Office Visit (No referral required)
$20 copay
Ded, then 20%
$20 copay
Ded, then 20%
Ded, then 20%
Teladoc (using Teladoc vendor only)
No Charge
Not Covered
No Charge
Not Covered
Ded, then no charge
Outpatient Office Visits
$20 copay
Ded, then 20%
$20 copay
Ded, then 20%
Ded, then 20%
Inpatient Hospital Stays
Ded, then 20%
Ded, then 40%
Ded, then 30%
Ded, then 50%
Ded, then 20%
Mental Health Teledoc
$10 copay
Not Covered
$10 copay
Not Covered
Ded, then $10 copay
Short Term Rehab (PT, OT, Skilled Nursing Facility)
$20 copay
Ded, then 20%
$20 copay
Ded, then 20%
Ded, then 20%
Diagnostic, Lab and X-Ray
No Charge
Ded, then 20%
No Charge
Ded, then 20%
Ded, then 20%
Ded, then 20%
Ded, then 40%
Ded, then 30%
Ded, then 50%
Ded, then 20%
Urgent Care Facility
$50 copay
Ded, then 20%
$50 copay
Ded, then 20%
Ded, then 20%
Hospital Emergency Room (copay waived if admitted)
$150 copay
Treated as In Network
$150 copay
Treated as In Network
Ded, then20%
Inpatient Hospital Facility Services
Ded, then 20%
Ded, then 40%
Ded, then 30%
Ded, then 50%
Ded, then 20%
Outpatient Hospital Facility Services
Ded, then 20%
Ded, then 40%
Ded, then 30%
Ded, then 50%
Ded, then 20%
Durable Medical Equipment
Ded, then 20%
Ded, then 40%
Ded, then 30%
Ded, then 50%
Ded, then 20%
Deductible (Ded) Individual / Family Out-of-Pocket Maximum Individual / Family (Embedded) Coinsurance
Mental Health
Imaging (CT, PET scan, MRIs, Nuclear Scans)
Prescription Coverage Rx Deductible
None
None
Shared with Medical
Shared with Medical
Shared with Medical
Shared with Medical
Tier I
$10 Copay ($20 Copay)
$10 Copay ($20 Copay)
$10 Copay ($20 Copay)
Tier II
$30 Copay ($60 Copay)
$30 Copay ($60 Copay)
$30 Copay ($60 Copay)
Tier III
$50 Copay ($100 Copay)
$50 Copay ($100 Copay)
$50 Copay ($100 Copay)
2 x Retail
2 x Retail
2 x Retail
Rx OOP Maximum
90-Day Maintenance
7
Coronis 2020 Employee Benefits
Health Savings Account A health savings account (HSA) combines high deductible health insurance with a tax-favored savings account. Money in the savings account can help pay the deductible. Once the deductible has been met, the insurance starts paying. If you want tax-free payroll deductions, you must use a Coronis Health offered BRI HSA account. To continue using outside vendors, you will have to make a post-tax contributions and settle that annually when you file taxes. Money left in the savings account earns interest and is yours to keep. So, it’s different from a traditional health insurance package because it adds a new self-funding option — an HSA savings product, which many banks and credit unions offer. Most financial institutions offer a variety of investment options for HSAs, including stocks, bonds, mutual funds and money market funds. Beginning on April 1st, 2020, Coronis Health will be using Benefit Resource, Inc. as its HSA vendor. Deposits will go into BRI HSA Accounts. You can continue to use old HSA accounts, however, the funds will not be deposited pre-tax and you will be responsible for moving funds into those accounts.
2020
HSA Contribution Limits
Individual: $3,550 | Family: $7,100 | Catch-up (age 55+): $1,000
With an HSA, you save in three ways: The money you put in your HSA account is not subject to income tax. • Funds in your account grow tax-free. • You don’t pay taxes on withdrawals (providing they are used for qualified medical expenses) • HSA-Compatible Health Insurance
HSA Advantages Your HSA can help you during certain financial hardships. For example, your HSA funds can be used if you’re between jobs and use them to pay your health insurance premiums without any penalty. You can also use them to pay for qualified long-term care premiums, as well as for Medicare insurance and expenses. An HSA can help add to your retirement funds. That’s because any unused funds are rolled over and after you turn 65, you can withdraw funds from your HSA for any reasons without penalty. It does not have to be for a medical expense and could be for normal living expenses.
What an HSA and an HSA-Compatible Health Plan Pay For Here’s a simple way to look at the way the two products that make up how an HSA works to pay for covered medical expenses during a calendar year. Your Health Plan Pays For:
Your HSA Funds Pay For:
Covered medical expenses after the deductible has been met
Covered medical expenses until your deductible is met
Adult Preventive care
Qualified expenses, such as vision and dental care
Benefits & coverage based on your policy's terms
Copayment, coinsurance, out-of-pocket costs after your deductible is met
8
Coronis 2020 Employee Benefits
Flexible Spending Account Flexible Spending Accounts (FSAs) allow you to be reimbursed for medical and dependent care expenses on a tax-free basis. If you can anticipate your family’s health care and dependent care costs for the next plan year, you may lower your taxable income. Here is how it works: You agree to set aside a portion of your pre-tax salary in the account. The money comes out of your paycheck over the course of the year. The amount you contribute to the FSA is not subject to Social Security (FICA), federal, state, or local income taxes— effectively adjusting your annual taxable salary. Depending on your tax bracket, you may realize significant savings. Beginning on April 1, 2020, Benefit Resource, Inc. will be the Flexible Spending Account vendor.
Important Account Features
Health Care Account
Use It or Lose It Consider your expenses carefully before you decide how much to contribute to each FSA account. If your eligible expenses for the calendar year turn out to be less than the amount you contributed to your FSA account, federal law requires that the unused balance be forfeited (the “Use it or Lose it” rule). You will be able to rollover $500 annually. W hen calculating your amount try to consider any rollover amounts you will have going forward.
Account Rollover
Dependent Care Account
At the end of the plan year, you can rollover up to $500 of unused funds to use in the following plan year.
Claim run-out Period Members have up to 90 days after the plan ends to submit for expenses incurred during the plan year.
Over-the-Counter (OTC) Drugs The IRS requires a doctor’s note or prescription for reimbursement of OTC products under the Health Care FSA. This requirement applies to items such as cough medicines and pain relievers. Submit a doctor’s prescription when you submit your claim.
Status Change Federal regulation prohibits you from changing your enrollment or the amount of your election during the plan year. You are only eligible to change your elections during the year if you have a status change. Only benefit changes consistent with the change in status are permitted. Status Changes that may warrant a change in benefit elections are described elsewhere in this benefit guide, see page 2.
If You Leave the Company Your participation in the Flexible Spending Accounts will end on the last day of the month in which you terminate employment. This means that you may submit for reimbursement any qualified expenses incurred on or before the last day of the month of your termination. You have 90 days after the plan termination to file a claim for reimbursement of these expenses. Please refer to your Human Resource Representative for more details.
9
You may pay for certain IRS approved medical care expenses not covered by your insurance plan with pre-tax dollars e.g. co-pays, deductibles, and other out-of-pocket expenses. Under this FSA, the maximum you may contribute each plan year is $2,750.
The Dependent Care FSA lets you use pre-tax dollars toward qualified dependent care. The annual maximum amount you may contribute to the Dependent Care FSA per calendar year is $5,000 or $2,500 if married and filing separate tax returns. The IRS defines an eligible dependent as: •
A child under the age of 13
•
A dependent over the age of 13 who is physically or mentally incapable of self-care, claimed as a dependent on your income tax return
Only the portion of expenses which enable you to remain employed are eligible. Educational expenses are not eligible. Dependent Care funds are Use It or Lose it and cannot be rolled over. Note: In order for your FSA contributions to be eligible for reimbursement, you must obtain a tax identification or social security number from your provider which will be reported on your federal income tax return.
Coronis 2020 Employee Benefits
Dental Insurance Dental Insurance Coronis offers you a generous dental plan that allows you to see any dentist you choose. You are encouraged to verify that the dentist accepts Met Life dental pricing. Please refer to the chart below for an overview of benefits.
High Plan
In-Network
Out-of-Network**
Plan Year Deductible
$50 Individual / $150 Family
$50 Individual / $150 Family
Annual Plan Year Maximum Benefit
$2,000 per person per year
$2,000 per person per year
Class A - Preventive Care (such as cleaning, exams, and X-rays)
100% Deductible Waived
100% of Allowed benefit Deductible Waived
Class B - Regular Restorative Care (such as fillings & root canals)
90%
80% if Allowed Benefit
Class C - Major Restorative Care (such as dentures, bridgework, crowns)
60%
50%
Class D - Orthodontia (Adults and Children) (such as braces & retainers)
50% up to Lifetime max of $1500 Deductible Waived
Low Plan In-Network
Out-of-Network**
Plan Year Deductible
$50 Individual / $150 Family
$50 Individual / $150 Family
Annual Plan Year Maximum Benefit
$1,500 per person per year
$1,500 per person per year
Class A - Preventive Care (such as cleaning, exams, and X-rays)
100% Deductible Waived
100% of Allowed benefit Deductible Waived
Class B - Regular Restorative Care (such as fillings & root canals)
80%
75% of Allowed Benefit
Class C - Major Restorative Care (such as dentures, bridgework, crowns)
50%
50% of Allowed Benefit
Class D - Orthodontia (Adults and Children) (such as braces & retainers)
Not Covered
* = PLEASE NOTE: When using out-of-network dental providers, your out of pocket costs can be higher due to balance-billing from providers who do not accept the MetLife Allowed Benefit.
10
Coronis 2020 Employee Benefits
Vision Insurance With our vision plan, you’ll get a great value on your eye care and eye wear. Using your vision benefit is easy as well - there is no ID card needed! Remember – your FSA dollars can be used for vision expenses including frames and contacts.
In-Network
Out-of-Network
Eye Exam (once every 12 months)
$10 copay
Plan pays up to $45
Lenses (one pair every 12 months)
$25 Single Vision $25 Bifocal $25 Trifocal
Plan pays up to $30 – Single Plan pays up to $50 – Bifocal Plan pays up to $65 – Trifocal
Frames (one pair every 12 months)
$25 copay up to $100 allowance 20% discount on the balance
Plan pays up to $70
Medically Necessary* (every plan year)
$25 copay
Plan pays up to $210
Elective (every plan year)
Plan pays up to $150
Plan pays up to $105
Contact Lenses in lieu of glasses
*Medically Necessary contact lenses are non-elective contact lenses prescribed when certain medical conditions hinder vision correction through regular eyeglasses. Contact lenses are considered a medical necessity when they are the generally accepted standard of treatment for the condition and not elective in lieu of glasses.
11
Coronis 2020 Employee Benefits
Employee Contributions Plan Year - April 1, 2020 to March 31, 2021
Employee Bi-weekly (26) Premiums High PPO
Low PPO
HSA
Dental High
Dental Low
Vision
Payroll Deductions
Employee Only
$87.75
$79.33
$60.82
$8.68
$6.66
$4.53
Employee + Spouse
$307.15
$250.06
$191.56
$16.88
$12.95
$7.63
Employee + Children
$251.57
$204.82
$156.90
$25.37
$17.17
$7.79
Family
$441.72
$359.62
$275.48
$33.57
$23.47
$12.56
Voluntary Life Rates Age of EE Rate/$1,000 Age of EE Rate/$1,000
Voluntary STD Rates
18-24
$0.05
60-64
$0.68
25-29
$0.06
65-69
$1.27
30-34
$0.08
70-74
$2.06
Age Group
Rates
35-39
$0.09
75-79
$3.86
18-24
$0.75
40-44
$0.11
80-84
$3.86
25-29
$0.88
45-49
$0.18
85-89
$3.86
30-34
$0.61
35-39
$0.36
40-44
$0.32
45-49
$0.33
50-54
$0.31
90-94
$3.86
55-59
$0.53
95-99
$3.86
Rates are Per $10 of Weekly Benefit
50-54
$0.39
Voluntary AD&D - Employees
55-59
$0.45
$.26 per 10,000 increment
60-64
$0.51
65-69
$0.57
70+
$0.63
Voluntary AD&D - Spouses $.13 per $5,000 increment Voluntary AD&D – Children $1,000 $.026
12
$5,000 - $.13
$10,000 - $.26
Coronis 2020 Employee Benefits
Basic Life & AD&D Basic Group Term Life & Accidental Death & Dismemberment Coronis provides full-time permanent and part-time prorated employees with Life and AD&D coverage at no cost to the employee. Coverage eligibility for new employees will become effective the first of the month following 30 days from the date of hire. The benefit provided for each eligible employee is a flat $50,000.
Voluntary Life & Accidental Death & Dismemberment All full-time permanent and part-time prorated employees of Coronis are eligible to purchase Additional Voluntary Life/AD&D coverage. Coverage for new employees will become effective after the first of the month following 30 days from the date of hire. The maximum benefit available for each eligible employee is $500,000 with the initial guaranteed issue amount of $100,000. Guaranteed issue coverage is only available at initial eligibility.
Additional life insurance for spouses can be purchase up to 100% of the employee election up to $250,000 with a guaranteed issues of $30,000. Up to $10,000 can be purchased for a dependent child. See page 12 for costs. Age Reductions: 33% of the pre-age 70 amount at age 70; and an additional 33% of the pre-age 70 amount at age 75.
Short-Term & Long-Term Disability Short-term Disability Coronis also provides full-time permanent and part-time prorated employees with the ability to purchase short-term disability coverage. See page 12 for costs. Long-term disability Coronis pays for the full cost of long-term disability coverage for full-time permanent and parttime prorated employees. Coverage eligibility for new employees will become effective the first of the month after 30 days from the date of hire. In the event you become disabled from a non-work-related injury or sickness, disability income benefits are provided as a source of income.
Short-Term Disability
Long-Term Disability
Benefits Payable
• 8th day of disability due to injury • 1st day of disability due to illness
After 90 days of disability
Benefit Percentage
60% of basic weekly salary
60% of basic monthly salary
Maximum Benefit Amount
$1,000 per week
$5,000 per month
Maximum Benefit Period
13 weeks
Social Security Normal Retirement Age
13
Coronis 2020 Employee Benefits
Accident & Critical Illness Accident Insurance Voluntary accident insurance provides a range of fixed, lump�sum benefits for injuries resulting from a covered accident, or for accidental death and dismemberment (if included). These benefits are paid directly to the insured and may be used for any reason, from deductibles and prescriptions to transportation and child care. Benefits paid range for services like Ambulance Transportation, Inpatient Admission, Surgery Benefits, Physical Therapy, Burns, Fractures to Wellness Screenings, provider follow-ups, diagnosis examinations, etc. Please see the full schedule of benefits for additional payout amounts. Eligibility Employees: Each Full-Time or Part-Time Prorated Employee working 30 or more hours per week, except any person working on a temporary or seasonal basis. Employee must be under age 70 at date of application. Dependents: You must be insured in order for Dependents to be covered. Dependents are: Your legal spouse. Spouse must be under age 70 at date of application. Your dependent children* from birth to 26 years.*Natural, legally adopted, children dependent on Insured during waiting period before adoption, stepchildren, and foster children in your custody.
Monthly Rates: Employee Only: $9.32 Employee & Spouse: $14.00 Employee & Children: $15.34 Family: $20.02
Critical Illness Voluntary critical illness insurance provides a fixed, lump- sum benefit upon diagnosis of a critical illness, which can include heart attack, stroke, paralysis and more. These benefits are paid directly to the insured and may be used for any reason, from deductibles and prescriptions to transportation and child care. Eligibility Employees: Each Active Full-Time Employee working 30 or more hours per week, except any person working on a temporary or seasonal basis. Dependents: You must be insured in order for Dependents to be covered.
Pre-Existing Conditions: Pre-existing condition is any sickness or injury, whether specifically diagnosed or not, for which an insured received treatment, consultation, care or services, including diagnostic procedures, or for which they took prescription drugs or medicines, during the look back period (6 months) before the individual effective date of coverage (or the effective date of an increased in coverage.)Benefits (or an increased benefit) would not be payable due to a preexisting condition unless the Critical Illnesses diagnosed after the coverage period (12 months) from the Insured’s effective date of coverage ( or effective date of an increase.) Benefit Amount Employee: Choose from a minimum $5,000 to a maximum of $10,000 in $5,000 increments. Spouse: Choose from a minimum of $2,500 to a maximum of $5,000 up $2,5000 increments, not exceed 100% of employee amount. Guaranteed Issue: $10,000. Benefits can be reduced based on age.
14
Coronis 2020 Employee Benefits
Employee Assistance Program Reliance Standard Employee Assistance Program (EAP) Life’s not always easy. Sometimes a personal or professional issue can affect your work, health and general well-being. When facing life’s challenges, you often turn to family or friends for support. But sometimes that’s not enough. Sometimes you need an experienced professional to talk with to know you’re not alone. The EAP through Reliance Standard and their partner, ACI Specialty benefits provides useful tools and resources that can guide you through a difficult time. Best of all it is confidential* and at no additional cost to you. You can receive up to 3 face-to-face professional assessments for a range of issues along with unlimited telephonic clinical assessments and referrals for employees.
What can they help with? •
Overcoming stress
•
Crisis at home or work
•
Addiction, depression, & other emotional issues
•
Career goals
•
Management support
•
Work-life balance
•
Stress, relaxation, and personal well-being
•
Personal & family goals
Financial or Legal Questions? Reliance and ACI can help with those as well!
•
Online will preparation
•
Online legal forms library
•
Telephonic financial consultation
•
Online library of legal and financial tools & resources
Your program includes 3 face to face counseling sessions!
To use your EAP Benefit, call toll free 855-RSL-HELP or go online to www.rsli.acieap.com
*Information remains confidential as long as there is no threat to harm yourself or others.
15
Coronis 2020 Employee Benefits
Telemedicine Talk to a doctor anytime… Online: Log into Teladoc.com and click “My Medical History.”
Mobile app: Log into your account and complete the “My Health Record” section. Visit Teladoc.com/mobile to download the app.
Call Teladoc: Complete our medical history
Available 24/7/365
over the phone at 1-800-Teladoc.
Getting Started with Teladoc® Teladoc’s U.S. board-certified doctors are available 24/7/365 to resolve many of your medical issues through phone or video consults. Set up your account today so when you need care now, a Teladoc doctor is just a call or click away.
Copays: • PPO High: $0 copay • PPO Low: $0 copay • HSA: Deductible, then $0 copay. Cost towards deductible is $45 for medical services.
Download the app today, it’s quick and easy! Visit Teladoc.com/mobile or visit your app store. Then follow these 3 easy steps: 1. Create an Account – it only takes a few minutes. After downloading the app, you will provide a brief medical history so the doctors have the information they need to provide you with quality medical care. You can also add family members so they have access to around the clock care. 2. Talk with a Doctor Now – you have the option to speak with the first available Teladoc doctor, or schedule an appointment. Within minutes a doctor will call ready to listen, diagnose, and prescribe medication, if needed. Afterwards you can choose to share the results with your PCP. 3. Pick Up Your Rx – if an Rx is needed, the Teladoc doctor can send it right to your local pharmacy for pickup!
Support services provided for Coronis members and their dependents. The EONE Benefit Advocate Team (BAT) is not affiliated with, nor. Coronis 2020 Employee Benefits 16
EMPLOYEE ONE Benefit Solutions 921 E. Fort Ave., Ste. 325 Baltimore, MD 21230
Telemedicine – Behavioral Health
***ONLY $10.00 Copay in the Low & High Option PPO Plans. For the H S A Plan, deductible first, then $10 Copay***
How to schedule a visit 1. 2. 3. 4. 5.
Register your Teladoc account via web or app or log in to your account if you’re already registered Request a visit Answer a few questions Select your therapist Request a time for your appointment
Support services provided for Coronis members and their dependents. The EONE Benefit Advocate Team (BAT) is not affiliated with, nor. Coronis 2020 Employee Benefits 17
EMPLOYEE ONE Benefit Solutions 921 E. Fort Ave., Ste. 325 Baltimore, MD 21230
ADP 401K Saving for retirement is something you can’t afford to overlook. To get started, log into ADP Workforce Now and navigate to Myself > Benefits > Retirement Savings. You can connect with (K)larity @ Work for Advice. Information is on the homepage of the ADP portal.
(k)LARITY @ WORK™ (k)larity @ Work™ is your primary gateway to leveraging the resources Greenspring Advisors offers as the advisor to your corporate retirement plan.
TO LEARN MORE PLEASE VISIT: greenspringadvice.com
Employees are eligible to contribute on the first of the month after 30 days from date of hire. Employees are immediately 100% vested.
Coronis provides generous matching contributions to any employee contribution made via payroll deduction. Please see the table below to see the matching contributions Coronis provides.
18
Employee Contributes
Coronis Match
1%
1%
2%
2%
3%
3%
4%
3.5%
5%+
4%
Coronis 2020 Employee Benefits
Contacts & Resources Contact information for all of your vendors is included below. For claims and benefit information, please contact the Human Resources department or the Employee One Benefit Advocate Team (BAT Team).
Trustmark
Medical and Pharmacy Claims Administrator
mytrustmarkbenefits.com 800.223.3943
Cigna PPO
Medical Network
Cigna.com/hcpdirectory 800.223.3943
Reliance Standard
Life, Disability, AD&D, and Voluntary Life
Rsli.com 800.351.7500
Reliance Standard ACI Specialty Benefits
Employee Assistance Program (EAP)
Teladoc
Telemedicine
Benefit Resource, Inc.
Health Savings Account (HSA) and Flexible Spending Account (FSA)
Ameritas Life Insurance Corp Coronis Human Resources
EONE Benefits BAT Team
Retirement Account – 401k Human Resources Benefit Advocate Team ID Cards, Eligibility, and Benefits
Rsli.acieap.com 855.775.4357 Teladoc.com 800.Teladoc www.BenefitResource.com 800-473-9595 service.ameritas.com 800.277.9739 hr@coronishealth.com mybenefits@eonebenefits.com 877.719.EMP1
Benefit Advocate Team mybenefits@eonebenefits.com Your EONE Benefit Advocate Team (BAT) is available Monday through Friday 8:30 am to 5:00 pm Eastern Time to provide concierge level support with matters relating to your group health and welfare benefits. Sometimes health insurance can be confusing and stressful if you feel you’re not getting the help you need. The EONE BAT team is familiar with your benefits and can help explain how your plan works.
If you’re experiencing a billing issue, need assistance resolving a claim, or just have general questions about your benefits, email us or give us a call at: 1-877-719EMP1(3671).
> Billing Issues > Claims Resolution > Important Dates > Qualifying Events > General Benefits Information
> Contacts, and more…
Support services provided for Coronis members and their dependents. Benefit Advocate Team (BAT) is not affiliated with, nor represents, the, Coronis 2020 Employee Benefits a 19
EMPLOYEE ONE Benefit Solutions 921 E. Fort Ave., Ste. 325 Baltimore, MD 21230
Continuation of Health Coverage Consolidated Omnibus Budget Reconciliation Act (COBRA) You must notify Human Resources within 30 days of the following COBRA events: •
divorce or legal separation
•
death of an employee
•
dependent child’s loss of dependent status
Individual election rights to continuation of coverage Loss of Coverage due to:
Voluntary or Involuntary loss of employment Max Continuation for covered individuals: You 18 Months Spouse 18 Months Child 18 Months Loss of Coverage due to: When any covered member loses health insurance coverage based on a termination of employment or the occurrence of other qualifying events, the member will be eligible to elect continuation of coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). Once your termination of health insurance coverage is processed you will receive a COBRA packet in mail from Benefit Resources, Inc. You will have 60 days to elect COBRA. Once COBRA is elected your coverage is retroactive to the date you lost coverage. There will be no lapse in coverage. Please contact a Coronis insurance representative for additional information on pricing regarding COBRA coverage. Each individual who is covered by the health plan immediately preceding the member’s COBRA event has independent election rights to continue his or her medical or vision coverage. The right to continuation of coverage ends at the earliest of when: •
you, your spouse or dependents become covered under another group health plan: or,
•
you become entitled to Medicare: or,
•
you fail to pay the cost of coverage: or,
•
your COBRA Continuation Period expires.
For more information visit: www.dol.gov/ebsa/cobra.html
Disability (at the time of event) Max Continuation for covered individuals: You 29 Months Spouse 29 Months Child 29 Months Loss of Coverage due to:
Your Death Max Continuation for covered individuals: You n/a Spouse 36 Months Child 36 Months Loss of Coverage due to:
Your Divorce or Legal Separation Max Continuation for covered individuals: You n/a Spouse 36 Months Child 36 Months Loss of Coverage due to:
You become entitled to Medicare Max Continuation for covered individuals: You n/a Spouse 36 Months Child 36 Months
Support services provided for Coronis members and their dependents. The EONE Benefit Advocate Team (BAT) is not affiliated with, nor Coronis 2020 Employee Benefits 20
EMPLOYEE ONE Benefit Solutions 921 E. Fort Ave., Ste. 325 Baltimore, MD 21230
Annual Notices Right to Rescind Coverage PPACA requires group health plans to provide notice 30 days prior of group health plan termination. The rules prohibit rescissions except in very limited situations such as employees who commit fraud or make intentional misrepresentations. For example, if plan documents require employees enrolling family members to assert that these individuals meet plan eligibility requirements and to immediately notify the employer if their status changes, rescission might be possible for an employee who intentionally misrepresented marital status to obtain coverage for a friend. Prospective terminations of coverage and retroactive terminations for failure to pay premiums or contributions are not rescissions. Coronis Group Health Plan the privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) require the Group Health Plan (the “Plan”) to periodically send a reminder to participants about the availability of the Plan’s Privacy Notice and how to obtain a copy of this notice. The Privacy Notice explains participants’ rights and the Plan’s legal duties with respect to protected health information (PHI) and how the plan may use and disclose PHI. Mothers’ and Newborns’ Act Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and insurers may not, under federal law, require that a provider obtain authorization from the plan or issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Medicare Information Attention Members who are Medicare eligible or who have Medicare eligible dependents—(or those who will soon be eligible). Coordination of benefits between the group plan and Medicare Parts A & B depends on specific criteria and reason for election of Medicare. Please contact the Coronis Insurance Team for more information in regards to these criteria and how the coordination of benefits would be determined.
Uniformed Services Employment and Reemployment Rights Act (USERRA) Health Insurance Protection if you leave your job to perform military service, you have the right to elect to continue your existing employer-based health plan coverage for you and your dependents for up to 24 months while in the military. Even if you don't elect to continue coverage during your military service, you have the right to be reinstated in your employer’s health plan when you are reemployed, generally without any waiting periods or exclusions except for service-connected illnesses or injuries. Women’s Health and Cancer Rights Act of 1998 If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient for: •
All stages or reconstruction of the breast on which the mastectomy was performed;
•
Surgery and reconstruction of the other breast to produce a symmetrical appearance;
•
Prostheses; and
•
Treatment of physical complications of the mastectomy, including lymphedemas.
These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under the plan. COBRA Under the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, COBRA qualified beneficiaries generally are eligible for group coverage during a maximum of 18 months for qualifying events due to award termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage. COBRA coverage is not extended for those terminated for gross misconduct. Upon termination, or other COBRA qualifying event, the former fellows and any other beneficiary will receive COBRA enrollment information.
Support services provided for Coronis members and their dependents. The EONE Benefit Advocate Team (BAT) is not affiliated with, nor Coronis 2020 Employee Benefits 21
EMPLOYEE ONE Benefit Solutions 921 E. Fort Ave., Ste. 325 Baltimore, MD 21230
Medicare Part D Notice Important Notice from the employer about Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage and your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. The employer has determined that the prescription drug coverage offered by the plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. If you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two month Special Enrollment Period (SEP) to join a Medicare drug plan. What Happens To Your Current Coverage If You Decide To Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your group coverage will not be affected. You and your dependents can keep this coverage if part D is elected and the plan will coordinate with Part D. See pages 7- 9 of the CMS Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance (available at http://www.cms.hhs.gov/CreditableCoverage/), which outlines the prescription drug plan provisions/options that Medicare eligible individuals may have available to them when they become eligible for Medicare Part D. If you do decide to join a Medicare drug plan and drop your current coverage, be aware that you and your dependents will be able to get this coverage back but you/they may have to wait until the next open enrollment plan. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current group coverage and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information about This Notice or Your Current Prescription Drug Coverage. Contact your HR Manager for further information. It is always best to discuss your personal situation with a Medicare expert when you are considering your options. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this group coverage changes. You also may request a copy of this notice at any time. More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: Visit www.medicare.gov or call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1- 800-772-1213 (TTY 1-800-325-0778). Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
Support services provided for Coronis members and their dependents. The EONE Benefit Advocate Team (BAT) is not affiliated with, nor Coronis 2020 Employee Benefits 22
EMPLOYEE ONE Benefit Solutions 921 E. Fort Ave., Ste. 325 Baltimore, MD 21230
New Health Insurance Marketplace Coverage Options PART A: General Information What is the Health Insurance Marketplace? The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Open enrollment for health insurance coverage through the Marketplace begins in October 2015 for coverage starting as early as January 1, 2016. Can I Save Money on my Health Insurance Premiums in the Marketplace? You may qualify to save money and lower your monthly premium, but only if your employer does not offer coverage, or offers coverage that doesn’t meet certain standards. The savings on your premium that you’re eligible for depends on your household income. Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace? Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.65% of your household income for the year, or if the coverage your employer provides does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit. Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution (if any) to the employer- offered coverage. Also, this employer contribution – as well as your employee contribution to employer -offered coverage – is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. How Can I Get More Information? For more information about your coverage offered by your employer, please check your summary plan description or contact your HR department. The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.
Part B: Information about Health Coverage Offered by Your Employer This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application. Employer Name Coronis Employer Address 5963 Exchange Drive, Suite 114 Sykesville, MD 21784
Employer Identification Number (EIN)
Employer Phone Number
410-753.3135 City State Zip Code Baltimore MD 21208 Who can we contact about employee health coverage at this job? Carol Miller Phone number (if different from above) Email Address cmiller@coronishealth.com ▪ Eligible members regularly scheduled to work more than 30 hours each week. ▪ Dependent coverage - eligible dependents are spouses/domestic partners and children (biological, adopted and step-children)
▪ Coverage meets minimum value standards and the cost of this coverage is intended to be affordable based on employee wages. ** Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount through the Marketplace. The Marketplace will use your household income, along with other factors, to determine whether you may be eligible for a premium discount. If, for example, your wages vary from week to week (perhaps you are an hourly employee or you work on a commission basis), if you are newly employed mid-year, or if you have other income losses, you may still qualify for a premium discount. *** If you decide to shop for coverage in the Marketplace, HealthCare.gov will guide you through the process. Above is the employer information you’ll enter when you visit HealthCare.gov to find out if you can get a tax credit to lower your monthly premiums.
Support services provided for Coronis members and their dependents. The EONE Benefit Advocate Team (BAT) is not affiliated with, nor Coronis 2020 Employee Benefits 23
EMPLOYEE ONE Benefit Solutions 921 E. Fort Ave., Ste. 325 Baltimore, MD 21230
Medicaid and CHIP Offer Free or Low-Cost Health Coverage to Children and Families If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help you pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has program that might help you pay the premiums for an employer-sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan—as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined for eligible for premium assistance. To view a list of states that offer added premium assistance or for more information on special enrollment rights, you can contact either:
US Department of Labor Employee Benefits Security Administration www.dol.gov/ebsa 1-866-444-ERSA (3272)
US Department of Health and Human Services Centers for Medicare and Medicaid Services www.cms.hhs.gov 1-877-267-2323, Ext. 61565
Coordination of Benefits with other coverage IF YOU
SITUATION
PAYS FIRST
PAYS SECOND
Are covered by Medicare and Medicaid
Entitled to Medicare and Medicaid
Medicare
Medicaid, but only after other coverage (such as employer group health plans) have paid
Entitled to Medicare Are 65 or older and covered by a group health plan because you or your spouse is still working
Have an employer group health plan after you retire and are 65 or older
The employer has 20 or more employees
Group Health Plan
Medicare
The employer has less than 20 employees
Medicare
Group Health Plan
Entitled to Medicare
Medicare
Retiree Coverage
Entitled to Medicare Are disabled and covered by a large group health plan from your work, or from a family member who is working
Have End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant) and group health plan coverage (including a retirement plan)
Have ESRD and COBRA coverage
The employer has 100 or more employees
Large group health plan
Medicare
The employer has less than 100 employees
Medicare
Large group health plan
First 30 months of eligibility or entitlement to Medicare
Group health plan
Medicare
After 30 months of eligibility or entitlement to Medicare
Medicare
Group health plan
First 30 months of eligibility or entitlement to Medicare
COBRA
Medicare
After 30 months
Medicare
COBRA
Support services provided for Coronis members and their dependents. The EONE Benefit Advocate Team (BAT) is not affiliated with, nor Coronis 2020 Employee Benefits 24
EMPLOYEE ONE Benefit Solutions 921 E. Fort Ave., Ste. 325 Baltimore, MD 21230
25
Coronis 2020 Employee Benefits