Your Benefits Medical & Rx Dental Vision Savings Accounts Life & Disability And More‌
Employee Benefits Guide
2019 Howard Bank
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Baltimore’s Best Business Bank
Introduction Table of Contents Introduction / Eligibility Contacts EONE Benefit Advocacy Team CoreSource Administration Simplicity Cigna Network Medical & Rx Benefit Summaries Plan Comparison Pharmacy Benefits Dental and Vision Employee Contributions Health Savings Account (HSA) Flex Spending Account (FSA) Life and Disability Insurance Additional Benefits COBRA Commonly Used Terms Annual Notices
2 3 4 5 6 7 8-10 11 12 13 14 15 16 17 18-19 20 21 22-25
Employee Eligibility All full-time regular status Employees who work 30 or more hours per week are eligible to enroll in the benefits included in this guide. Howard Bank offers comprehensive, cost effective benefits options. Employees new to Howard Bank are eligible for coverage on the first of the month following date of hire. Part-time regular status Employees who work a minimum of 20 hours may not be eligible for all benefits outlined in this guide. Please refer to the specific plan documents for each benefit to determine eligibility or contact HR@HowardBank.com.
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, Legal Separation, Birth, or adoption of a child.
•
Death of a spouse or 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, even if they’re a student, married or employed.
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Contacts CoreSource
Medical and Dental
myCoreSource.com (800) 223-3943
Cigna
Medical and Dental
cigna.com/hcpdirectory (800) 223-3943
VSP
Vision
vsp.com (800) 223-3943
Howard Bank HSA
Health Savings Account (HSA)
myhsa@howardbank.com 410-988-1860
TASC
Flexible Spending Account (FSA)
tasconline.com/mytasc 800-422-4661
Mutual of Omaha
Group Life and Disability Insurance Voluntary Life Insurance
mutualofomaha.com 800-775-8805
Ability Assist
Employee Assistance Program (EAP)
guidanceresources.com (800) 964-3577
ADP 401k
401(k) Retirement Plan
mykplan.com (866) 269-8268
Howard Bank Human Resources
General HR and Benefits Questions
HR@HowardBank.com
Employee ONE Benefit Solutions
Benefits Advocate Team
mybenefits@employee1.net (410) 719-2222 (410) 719-2221 fax
Medical and Dental Administrator Medical and Dental Network Vision Provider Network
Please Note: This booklet provides a summary of the benefits available, but is not your Summary Plan Description (SPD). Howard Bank reserves the right to modify, amend, suspend, or terminate any plan at any time, for any reason without prior notification. The plans described in this book are governed by insurance contracts and plan documents, which are available for examination upon request. We have attempted to make the explanations of the plans in this booklet as accurate as possible. However, should there be a discrepancy between this booklet and the provisions of the insurance contracts or plan documents, the provisions of the insurance contracts or plan documents will govern.
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EONE Benefit Advocacy Team (BAT Team) 410-719-2222
mybenefits@employee1.net Claims Resolution
Prior to calling the BAT team with questions about a bill or Explanation of Benefits (EOB), please email all relevant documents first (including: bills, EOBs and receipts)
Plan Information & Questions
During open enrollment make sure to take advantage of all group communication materials such as: Benefits Guides, Webinars and Open Enrollment Meetings. If you still have questions about your benefits after open enrollment, we’re here to help!
Provider Search
If you’re having trouble navigating the carrier-specific Provider Search as indicated in this Benefits Guide, please give us a call! Remember to check your Benefits Guide for network information to help narrow your search.
ID Cards
In most cases, you’re able to order and print your ID card (or temporary card) directly from the carrier website; however, the EONE BAT team is here to help. Review your guide for information on how to register online with each carrier – it’s fast and easy!
Note: HIPAA privacy regulations may require the completion of a preauthorization 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.
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CoreSource Administration
A Personal Online Gateway to Your Health Plan
These days, people do their banking, pay utility bills and shop for just about anything online. It’s secure, fast, easy and convenient. At CoreSource, we believe accessing information about your health plan, and managing your accounts should be no different. That’s why we provide myCoreSource.com, a personal online portal to detailed claims data, out-of-pocket expense tracking, dedicated customer service with speedy responses to your important questions, and much more. Better yet, you can visit the portal to your health plan when it fits your busy schedule – at any time of the day or night.
Take advantage of all that myCoreSource.com has to offer: View claim detail •
Use a variety of filtering and sorting capabilities to help you find specific claims faster, including the ability to sort by patient status, type or service date.
View, Print and Order ID Cards •
Log-in to your MyCoreSource portal or member app to view, print, and order copies of your ID cards. Take them everywhere with you on your mobile app.
Online Message Center • • •
Quick, direct access to Customer Service. Immediately send questions about a specific claim while viewing it. Select certain topics so that your important questions are delivered to the appropriate department and answered as quickly as possible.
Receive E-mail Alerts • •
When electronic EOBs are available to view. Replies to your Message Center questions.
2019 Benefits Guide
View Custom Content • •
Informational articles on website functions, health and wellness and healthcare consumer advice. View links and resources personalized to be relevant to your coverage.
Electronic Explanation of Benefits (EOB) • • •
View information on medical claims and payments made by CoreSource with secure electronic EOB. Receive a secure e-mail automatically when electronic EOBs become available. Update the e-mail address receiving secure electronic EOBs at any time.
Site Security and Login • •
Intense security protects members’ information. Create separate logins for family members, and have the ability to block certain information from other members of the household.
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Simplicity CoreSource and Howard Bank have made a new financial benefit available to you called Simplicity. There’s no additional cost to use it, and it will revolutionize the way you manage your healthcare expenses. Participation in this program is completely voluntary.
What is Simplicity? Simplicity gives you flexibility and control to manage healthcare expenses. Here’s how it works:
How can Simplicity help me?
Simplicity gives you control and eliminates confusion by consolidating all your in-network medical bills in one place—just like a credit card bill!
Simplicity gives you the flexibility to spread out your payments by using 12-month interest-free repayment options.
Simplicity gives you rewards in the form of up to 5% SimpleRewardsSM credits on the payments you make.
When you receive a statement from Simplicity, it is legitimate. Simplicity is part of your employee health benefit plan. If you’ve already paid your doctor for the services on this statement, don’t worry, you’re not being double-billed! If you have already paid, you can activate Simplicity online.
Go to www.simplicitypayments.com/Activate. It only takes a few minutes. If you have questions about Simplicity, just call the CoreSource number near the top of your medical ID card.
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Cigna Network Find a Healthcare Professional Two ways to find what you need There are two ways to find a network healthcare professional: 1. If you’re already enrolled, visit myCoreSource.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 myCignaSM website or app & simplify your search for providers.
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Easily find providers in your plan's network (you'll save money when you stay in-network).
•
Compare costs for hundreds of procedures.
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Medical Plan Summary
Option 1
PPO Premium The Premium PPO option uses the Cigna PPO network. There is no deductible for in-network services and low copays for office visits. Out-of-network coverage is lower and providers can balance bill. .
Benefit
In-Network
Out-of-Network
None
$250 Individual $500 Family
$2,500 Individual $5,000 Family
$5,000 Individual $10,000 Family
Physicians Office Visit
$15 Copay
20% of allowed benefit after deductible
Specialists Office Visit
$30 Copay
20% of allowed benefit after deductible
No Charge
No charge after deductible
Lab and X-ray
$15 Copay
20% of allowed benefit after deductible
Inpatient Hospital Facility Services
$250 Copay
20% of allowed benefit after deductible
Outpatient Hospital Facility Services
$250 Copay
20% of allowed benefit after deductible
Annual Deductible Annual Out-of-Pocket Maximum
Preventive Care Services Well-Child Care (exams & immunizations) • Adult Physical Examination (routine GYN) • Breast Cancer Screening • Pap Test • Prostate & Colorectal Cancer Screening
Emergency Room
$100 per visit (waived if admitted)
Urgent Care Prescription Drugs Rx Deductible Rx Out-of-pocket Maximum • Tier I – Generic • Tier II – Preferred Brand • Tier III – Non-Preferred Brand • Tier IV – Specialty Rx • 90 Maintenance Supply Note: The information provided is neither an offer of coverage nor medical advice. It is only a partial, general description of plan or program benefits and does not constitute a contract. In case of a conflict between your plan documents and this information, the plan documents will govern.
2019 Benefits Guide
$30 per visit $0 ($0 family) Combined with medical $10 copay per script $25 copay per script $45 copay per script 50% up to a $75 max 2x Retail Members have access to the Cigna network of providers
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Medical Plan Summary
Option 2
PPO Plus The Plus PPO option uses the Cigna PPO network with a low deductible for innetwork services and copays for office visits. Out-of-network coverage is lower and providers can balance bill. Benefit
In-Network
Out-of-Network
$350 Individual $700 Family
$1,050 Individual $2,100 Family
$4,000 Individual $8,000 Family
$8,000 Individual $16,000 Family
Physicians Office Visit
$20 Copay
30% of allowed benefit after deductible
Specialists Office Visit
$30 Copay
30% of allowed benefit after deductible
No Charge
30% of allowed benefit
Lab and X-ray
10% after deductible
30% of allowed benefit after deductible
Inpatient Hospital Facility Services
10% after deductible
30% of allowed benefit after deductible
Outpatient Hospital Facility Services
10% after deductible
30% of allowed benefit after deductible
Annual Deductible Annual Out-of-Pocket Maximum
Preventive Care Services Well-Child Care (exams & immunizations) • Adult Physical Examination (routine GYN) • Breast Cancer Screening • Pap Test • Prostate & Colorectal Cancer Screening
Emergency Room
$200 per visit (waived if admitted)
Urgent Care
$30 per visit
Prescription Drugs Rx Deductible Rx Out-of-pocket Maximum • Tier I – Generic • Tier II – Preferred Brand • Tier III – Non-Preferred Brand • Tier IV – Specialty Rx • 90 Maintenance Supply Note: The information provided is neither an offer of coverage nor medical advice. It is only a partial, general description of plan or program benefits and does not constitute a contract. In case of a conflict between your plan documents and this information, the plan documents will govern.
2019 Benefits Guide
$50 ($100 family) Combined with medical $10 copay per script $25 copay per script $45 copay per script 50% up to a $75 max 2x Retail Members have access to the Cigna network of providers
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Medical Plan Summary
Option 3
PPO HSA The high deductible plan has the deductible applying to most service except for preventive care.. This plan uses the Cigna PPO network and qualifies for participation in the HSA account. Out-of-network coverage is lower. Providers can balance bill. Benefits
In-Network
Out-of-Network
Annual Deductible*
$1,350 Individual $2,700 Family
$3,900 Individual $7,800 Family
Annual Out-of-Pocket Maximum
$5,000 Individual $10,000 Family
$10,000 Individual $20,000 Family
Physicians Office Visit
10% after deductible
30% of allowed benefit after deductible
Specialists Office Visit
10% after deductible
30% of allowed benefit after deductible
No charge
No charge after deductible
Lab and X-ray
10% after deductible
30% of allowed benefit after deductible
Inpatient Hospital Facility Services
10% after deductible
30% of allowed benefit after deductible
Outpatient Hospital Facility Services
10% after deductible
30% of allowed benefit after deductible
Preventive Care Services Well-Child Care (exams & immunizations) • Adult Physical Examination (routine GYN) • Breast Cancer Screening • Pap Test • Prostate & Colorectal Cancer Screening
Emergency Room Urgent Care
10% after deductible (waived if admitted) 30% of allowed benefit after deductible
10% after deductible
Prescription Drugs Rx Deductible Rx Out-of-pocket Maximum • Tier I – Generic • Tier II – Preferred Brand • Tier III – Non-Preferred Brand • Tier IV – Specialty Rx •
Combined with Medical Deductible Combined with Medical Out-of-pocket Maximum $10 copay per script $25 copay per script $45 copay per script 50% up to a $75 max
90 Maintenance Supply
Note: The information provided is neither an offer of coverage nor medical advice. It is only a partial, general description of plan or program benefits and does not constitute a contract. In case of a conflict between your plan documents and this information, the plan documents will govern.
2019 Benefits Guide
2x Retail Members have access to the Cigna network of providers
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Medical Plan Comparison PPO Premium
PPO Plus
PPO HSA
In-Network
In-Network
In-Network
Individual
$0
$350
$1,350
Family
$0
$700
$2,700
Individual
$2,500
$4,000
$5,000
Family
$5,000
$8,000
$10,000
Preventive Care
No Charge
No Charge
No Charge
PCP Office Visit
$15 Copay
$20 Copay
Deductible then 10%
Specialist Office Visit
$30 Copay
$30 Copay
Deductible then 10%
No
No
No
Diagnostic, Lab and X-Ray
$15 Copay
Deductible then 10%
Deductible then 10%
Urgent Care Facility
$30 Copay
$30 Copay
Deductible then 10%
Hospital Emergency Room (copay waived if admitted)
$100 Copay
$200 Copay
Deductible then 10%
Hospital Facility Services
$250 Copay
Deductible then 10%
Deductible then 10%
Rx Deductible
$0 Individual ($0 Family)
$50 Individual ($100 Family)
Combined with Medical
Rx OOP Maximum
Combined with Medical
Combined with Medical
Combined with Medical
Tier I
$10 copay
$10 copay
$10 copay
Tier II
$25 copay
$25 copay
$25 copay
Tier III
$45 copay
$45 copay
$45 copay
2 X Retail Copay
2 X Retail Copay
2 X Retail Copay
Employee Only
$77.88
$57.06
$48.05
Employee & Child(ren)
$191.04
$160.98
$126.96
Employee & Spouse
$294.05
$238.90
$195.44
Employee & Family
$381.72
$294.08
$261.77
Medical Coverage Deductible
Out-of-Pocket Maximum
Referral required?
Prescription Coverage
90-Day Maintenance
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Pharmacy Benefits Your Benefits. Delivered With Care. At CVS/Caremark we work hard to make sure your prescription benefits work for you. We want you to stay healthy. We also want to help you manage your medicines so you can save time and money on refills. After all, these are your benefits. Shouldn’t they be about you? You may find information on your benefit coverage and search for network pharmacies by logging onto www.caremark.com or calling the customer care number on your ID card. You can also view side-by-side cost comparisons of your medications.
Generic Medications
Preferred Medications
A generic drug is chemically identical to the corresponding preferred or non-preferred versions in dosage, safety, strength, quality and the way it works, the way it is taken and the way it should be used. The additional cost of marketing brand-named drugs is essentially the only difference between brand-name drugs and the generic options. They provide the same benefit, but at a lower price.
Non-Preferred Medications
A generic drug is not always prescribed. However, that shouldn’t stop you from asking for the generic choice every time. In some cases, the prescribed drug will not have an exact generic option, but you can ask for the generic equivalent.
A preferred drug is a brand-name drug that is on your provider’s list of approved drugs. You can check online to see a complete list of preferred drugs. Non-preferred drugs have a higher copayment and are typically newer drugs on the market. Like generic equivalents, you can request a preferred drug equivalent that can offer the same medical effect. You can be a better consumer by doing your research, asking the right questions and buying at the lowest price.
Specialty Medications
Specialty drugs are high-cost drugs used to treat complex or rare conditions.
Quick & Easy Refills
Take advantage of mail service prescriptions: 90-day supply for 2X retail
$0 Copay for prescriptions shipped to your home Over 300 Brand Name medications, including specialty drugs, are available.
CRX International Benefits •
•
Drugs are sourced from Tier I countries like: UK, Australia, New Zealand, and Canada You will receive all drugs in the original manufacturer packaging
2019 Benefits Guide
Monday to Friday 8:30am - 6:30pm Eastern Time Saturday 9:00am - 5:30pmEastern Time
Toll Free 1-866-488-7874
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Dental PPO Regular dental care is essential to good health. Howard Bank provides preferred (PPO) dental coverage through CoreSource with access to the Cigna network of dental providers.
Plan Highlights
• • • •
You can visit in-Network and out-of-network dentists Out-of-network providers can balance bill up to full charges National PPO network Includes Orthodontia In-Network
Plan Year Deductible
Out-of-Network
$50 Individual / $150 Family
Annual Plan Year Maximum Benefit Preventive Care (such as cleanings, exams, and x-rays) Regular Restorative Care (such as fillings, oral surgery, and root canals)
Major Restorative Care
(such as dentures, bridgework and crowns)
Orthodontia – Lifetime maximum of $1200 (such as braces and retainers)
$2,000 No Charge
20% of allowed benefit
20% after deductible
40% after deductible
50% after deductible
65% after deductible
50%
65%
VSP Vision Vision coverage through CoreSource provides access to the VSP network of vision care providers. There are no ID cards for VSP plans, coverage is verified with your Social Security Number.
Eye Exams (every 12 months)
In-Network
Out-of-Network
$10 copay
Up to $40 Reimbursement
$150 Allowance
Up to $45 Reimbursement
$25 Copay $25 Copay $25 Copay
Up to $40 Reimbursement Up to $60 Reimbursement Up to $80 Reimbursement
$150 Allowance No Copay
Up to $105 Reimbursement Up to $210 Reimbursement
Up to 15% off allowed amount or 5% off any advertised special
Up to 15% off allowed amount or 5% off any advertised special
Frames (every 12 months) Collection Lenses (every 12 months) Single Vision Bifocal Trifocal Contact Lenses Conventional Medically necessary Laser Correction Surgery
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.
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Employee Contributions Benefit Rates (Medical, Dental and Vision Insurance) Employee contribution towards premium = Per pay period (26 pays per year)
Medical Employee Only
Employee Child(ren)
Employee Spouse
Employee Family
PPO Premium
$77.88
$191.04
$294.05
$381.72
PPO Plus
$57.06
$160.98
$238.90
$294.08
PPO HSA
$48.05
$126.96
$195.44
$261.77
Employee Only
Employee Child(ren)
Employee Spouse
Employee Family
$5.58
$16.00
$22.46
$29.57
Employee Only
Employee Child(ren)
Employee Spouse
Employee Family
$3.95
$7.10
$8.68
$12.62
Dental
Dental PPO
Vision
VSP Vision
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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 Howard Bank 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.
2019 HSA Contribution Limits
Individual: $3,500 | Family: $7,000 | 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
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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.
Important Account Features 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). Beginning in 2019, you will be able to rollover $500 annually. When calculating your amount try to consider any rollover amounts you will have going forward.
Account Rollover
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.
If You Leave the Company
Health Care Account 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 $2,650.
Dependent Care Account 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. 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.
Your participation in the Flexible Spending Accounts will end on the date of your termination of employment. This means that you may submit for reimbursement any qualified expenses incurred on or before the date of your termination. You have 30 days after the plan termination to file a claim for reimbursement of these expenses. Please refer to your Human Resource Representative for more details. 2019 Benefits Guide
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Life & Disability Insurance Employer Paid Life and AD&D Insurance Howard Bank provides Basic Life and Accidental Death and Dismemberment (AD&D) at no cost to you. • The benefit is equal to 1X your base annual earnings, to a maximum benefit of $200,000 • Benefits would reduce by 50% upon your attainment of age 70 • There is an Accelerated Death Benefit available should you be diagnosed as being terminally ill • This product can be converted to an individual policy should you no longer be employed by Howard Bank
Voluntary Life and AD&D Insurance Howard Bank sponsors a supplemental Life and AD&D plan which allows Employees the opportunity to purchase additional Life and AD&D for yourself, spouse and children at a discounted group rate. Additional Life and AD&D Insurance for you: • Maximum benefit of 5x your salary up to $500,000 (available in $10,000 increments) • Initial guarantee issue amount of 5x salary up to $150,000 • Benefits would reduce by 50% upon your attainment of age 70 • There is an Accelerated Death Benefit available should you be diagnosed as being terminally ill • This product can be converted or ported should you no longer be employed by Howard Bank Additional Life and AD&D Insurance for your spouse and children: • Max benefit of $250,000 ($5,000 increments not to exceed 100% of the Employee amount) • Initial guarantee issue amount of $30,000 • Benefits would reduce by 50% upon your attainment of age 70 • Benefits for your child(ren) are with a minimum of $2,000 and maximum $10,000 • Child benefits available from 6 months to 26 years (benefits limited for children under 6 months) • There is an Accelerated Death Benefit available should your spouse be diagnosed as being terminally ill Rates per $1,000 Life and AD&D insurance benefit per month UNDER 25 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 $0.07
$0.07
$0.08
$0.09
$0.13
$0.21
$0.33
$0.50
$0.77
$1.36
$2.43
75-79
80-100
Child
$3.99
$8.06
$0.16
Employer Paid Short Term Disability Howard Bank provides Short Term Disability Insurance at no cost to you. • This benefit replaces up to 60% of your weekly earnings should you become disabled • The maximum weekly benefit you may receive is $2,500 • Benefits would begin after 8 days for Accidents and Sickness • Benefits may continue for up to 12 weeks
Employer Paid Long Term Disability Howard Bank provides Long Term Disability Insurance at no cost to you. • This benefit replaces up to 60% of your monthly earnings should you become disabled • The maximum monthly benefit you may receive is $15,000 • Benefits would begin after you have been disabled for 90 days • Benefits may continue until your normal Social Security retirement age • Includes a 3 month lump sum survivor benefit • Contains a pre-existing condition limitation for the first 12 months of coverage Note: The information provided is neither an offer of coverage nor medical advice. It is only a partial, general description of plan or program benefits and does not constitute a contract. In case of a conflict between your plan documents and this information, the plan documents will govern.
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Additional Benefits Employee Assistance Program
Employees covered by Mutual of Omaha’s Long Term disability plan have access to an Employee Assistance Program (EAP). Members can call Toll-Free 24/7 help line staffed by Master's and PhD level counselors and can receive up to 3 face-to-face sessions per incident with a counselor and unlimited telephone and web access Services Include: • Emotional and Work/Life concern • Legal Issues • Financial Planning
Beneficiary Assist Counseling Services
Services Include: • Access to counselors through a dedicated toll-free telephone number 24 hours a day, 365 days a year • Beneficiary Assist is offered to Group Life beneficiaries and is included in the contract • Beneficiaries are provided with grief, financial and legal counseling • 5 face-to-face counseling sessions
Travel Assistance
Services Include: • Emergency medical assistance: referrals, evacuation, medication • Emergency personal services: travel, cash, legal assistance • Pre-trip information: visa, passport, immunizations
AFLAC Supplemental Insurance
Supplemental insurance provides an additional level of financial protection in the event of a serious accident or illness. Talk to your AFLAC rep, Drew Skibitsky at (908)358-2552 or drew_skibitsky@us.Aflac.com
ADP Retirement Services
Howard Bank's retirement plan is managed by ADP. All Employees will be automatically enrolled with a 4% contribution the first of the month following 90 days of continuous employment. Howard Bank will provide all Employees with a 100% match on Salary Deferral up to 4% after 90 days of service.
Educational Assistance
If you are a full-time, regular Employee and have completed one year of continuous employment, you are eligible for participation in this program as long as the courses are job-related. Employees on leaves of absence, part-time, term contract, or seasonal Employees are not eligible to participate.
Degree Program
Maximum Reimbursement (Per calendar year)
Undergraduate
$3,000
Graduate Review Courses & Certification Testing
$5,000 $3,000
Parental Leave
This policy is paid leave associated with the birth of an Employee’s own child or the placement of a child with the Employee in connection with adoption. Parental leave is not charged against the Employee’s PTO and the amount of paid days received is a maximum of six weeks. The paid leave is compensated at the following levels (see Parental Leave Policy for more information): • Less than one full year of service – 50% of base salary • After one full year of service – 100% of base salary 2019 Benefits Guide
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Additional Benefits Paid Time Off (PTO) Position
Grant Amount
Full-Time Employees
144 Hours (18 Days)
Full-Time Employees with 5 or more years of service
184 Hours (23 Days)
Officer, AVP, & VP
184 Hours (23 Days)
Officer, AVP, & VP with 5 or more years of service
224 Hours (28 Days)
SVP & Above
200 Hours (25 Days)
SVP & Above with 5 or more years of service
240 Hours (30 Days)
Part Time Employees
Grant amount will be prorated based on the Employee’s regularly scheduled hours in a workweek.
See PTO Policy for eligibility and additional information. *Amounts are pro-rated based on hire date.
Employee Stock Purchase Program (ESPP) Allows Employees of Howard Bank working over 20 hours per week to purchase Howard Bank stock at a 10% discount. •
Employees can make contributions to purchase Howard Bank stock directly through payroll deduction.
•
Employees enroll in the ESPP program during the offering period’s open enrollment period directly through E*TRADE.
•
Stock is purchased at the end of the offering period and held in the employee’s individual brokerage account directly with E*TRADE.
•
2019 Offering Periods: •
Offering Period 1: January 1, 2019 – June 30, 2019
•
Offering Period 2: July 1, 2019 – December 31, 2019
Valuable Banking Benefits • • • • • • •
Relationship Checking Account with Direct Deposit Free ATM usage at any Howard Bank ATM plus rebates of non-Howard Bank ATM surcharges Services that help you manage your account including Online and Mobile Banking with Bill Pay Discounts on loan rates $450 Lender credit on 1st Mortgage settlement Exclusive Howard Bank Employee Credit Card with an extended 0% balance transfer period and a discounted interest rate. Peace of mind – your Employee account is marked private. Balances and history are hidden for privacy purposes.
We want your business!
As Employees of Howard Bank, you are our biggest advocate and we want you to speak first hand about the benefits of banking at Howard. 2019 Benefits Guide
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Continuation of Health Coverage Consolidated Omnibus Budget Reconciliation Act (COBRA)
Individual election rights to continuation of coverage You must notify Human Resources within 30 days of the following COBRA events:
Loss of Coverage due to:
•
divorce or legal separation
• •
death of an employee dependent child’s loss of dependent status
Max Continuation for covered individuals: You 18 Months Spouse 18 Months Child 18 Months
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 CoreSource. 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 Howard Bank 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
2019 Benefits Guide
Voluntary or Involuntary loss of employment
Loss of Coverage due to:
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
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Commonly Used Terms Allowable Charge
Sometimes known as the "allowed amount," or network negotiated amount, this is the dollar amount considered by a health insurance company to be a reasonable charge for services or supplies based on the rates in your area.
Benefit
The amount payable by the insurance company to a plan member for medical costs.
Coinsurance
The amount you pay to share the cost of covered services after your deductible has been paid. The coinsurance rate is usually a percentage. For example, if the insurance company pays 80% of the claim, you pay 20%.
Coordination of benefits
A system used in group health plans to eliminate duplication of benefits when you are covered under more than one group plan. Benefits under the two plans usually are limited to no more than 100% of the claim.
Copayment
One of the ways you share in your medical costs. You pay a flat fee for certain medical expenses (e.g., $15 for every visit to the doctor), while your insurance company pays the rest.
Deductible
The amount of money you must pay each year to cover eligible medical expenses before your insurance policy starts paying.
Medicare
The federal health insurance program that provides health benefits to Americans age 65 and older. Signed into law on July 30, 1965, the program was first available to beneficiaries on July 1, 1966 and later expanded to include disabled people under 65 and people with certain medical conditions. Medicare has two parts; Part A, which covers hospital services, and Part B, which covers doctor services.
Network
The group of doctors, hospitals, and other health care providers that insurance companies contract with to provide services at discounted rates. You will generally pay less for services received from providers in your network.
Out-of-network provider
A health care professional, hospital, or pharmacy that is not part of a health plan's network of preferred providers. You will generally pay more for services received from out-of-network providers.
Out-of-pocket maximum
The most money you will pay during a year for coverage. It includes deductibles, copayments, and coinsurance, but is in addition to your regular premiums. Beyond this amount, the insurance company will pay all eligible expenses for the remainder of the year.
Preferred provider organization (PPO)
Dependent
Any individual, spouse or child, which is covered by the primary insured member’s plan.
A health insurance plan that offers greater freedom of choice than HMO (health maintenance organization) plans. Members of PPOs are free to receive care from both in-network or outof-network (non-preferred) providers, but will receive the highest level of benefits when they use providers inside the network.
Exclusion or Limitation
Provider
Any specific situation, condition, or treatment that a health insurance plan does not cover.
In-Network Provider
A health care professional, hospital, or pharmacy that is part of a health plan’s network of preferred providers. You will generally pay less for services received from in-network providers due to negotiated discounts for services in exchange for the insurance company sending more patients their way.
Any person (i.e., doctor, nurse, dentist) or institution (i.e., hospital or clinic) that is licensed to provide medical care.
Waiting period
The period of time that an employer makes a new Employee wait before he or she becomes eligible for coverage under the company's health plan. Also, the period of time beginning with a policy's effective date during which a health plan may not pay benefits for certain pre-existing conditions
For a complete glossary of healthcare terms visit
www.healthcare.gov/glossary 2019 Benefits Guide
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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. Howard Bank 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 Howard Bank Insurance Team for more information in regards to these criteria and how the coordination of benefits would be determined.
2019 Benefits Guide
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.
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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).
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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 9.5% 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
Employer Identification Number (EIN)
Howard Bank
20-0558805
Employer Address
Employer Phone Number
3301 Boston St.
410-750-3548
City
State
Zip Code
Baltimore
MD
21224
Who can we contact about employee health coverage at this job? Laura Cristofaro Phone number (if different from above)
Email Address lcristofaro@howardbank.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 to you 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.
2019 Benefits Guide
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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 US Department of Health and Human Services Employee Benefits Security Administration Centers for Medicare and Medicaid Services www.dol.gov/ebsa www.cms.hhs.gov 1-866-444-ERSA (3272) 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
2019 Benefits Guide
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
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