Benefits Guide
2019 All Divisions Your Benefits Medical Dental Vision Life & Disability Spending Accounts And more‌
Contents Eligibility and Enrollment
2
Medical Administration (CoreSource)
3
Medical Coverage
4-5
Network Access (Find a Provider)
6
Health Savings Account
7
Dental Coverage
8
Vision Coverage
9
Nurse Support 24/7
10
Life & Disability
11
Voluntary Life
12
Annual Notices
13-23
Eligibility And Enrollment Who Is Eligible All full-time employees who work at least 30 hours per week, and their eligible dependents as described below, are eligible for the benefits outlined in this pamphlet.
When Coverage Begins For New Employees Your coverage begins the first of the month following 30 days of employment. You will need to complete your election prior to your effective date.
When Coverage Ends If your employment with Ladenburg Thalmann ends, your medical, dental and vision coverage will end on the last day of the month of your separation. Depending upon the circumstances of your termination, you may be able to continue coverage under COBRA. Other circumstances which may result in termination of you or your dependents coverage include: • Reduction in your regular hours • Divorce or legal separation • Dependent children who reach age 26
Eligible Dependents • •
Your spouse (unless you are legally separated); Your unmarried or married dependent children up to age 26 (Medical, Dental, and Vision)
Qualifying Events • • •
Change in marital status (divorce, marriage, death, legal separation) Change in number of dependents (birth, death, adoption, child support order or eligibility status) Change in employment status (termination, part-time, full-time status)
The specific terms of coverage, exclusions and limitations are contained in the Plan Documents and insurance certificates. All coverages and the costs for such coverage for all participants are subject to change at any time in the future. If you have any questions about a specific service or treatment, please contact the appropriate insurer or the Human Resources Department.
2019 Benefits Guide
2
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 Custom Content • • •
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.
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.
2019 Benefits Guide
Tailored messages from your employer when needed. Informational articles on website functions, health and wellness and healthcare consumer advice. View links and resources personalized to be relevant to your coverage.
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.
Receive E-mail Alerts • •
When electronic EOBs are available to view. Replies to your Message Center questions.
3
Medical Coverage
Platinum Plan Employee Deductible (Ded) (Non-Embedded) Coinsurance Out-Of-Pocket Maximum (Includes Deductible) Lifetime Maximum Per Family Member
Gold Plan
In-network
Out-of-network
In-network
Out-of-network
$600/Individual
$2,000/Individual
$1,200/Individual
$3,000/Individual
$1,200/Family
$4,000/Family
$2,400/Family
$6,000/Family
100%
80%
90%
70%
$3,500/Individual
$5,000/Individual
$3,500/Individual
$10,000/Individual
$7,000/Family
$10,000/Family
$7,000/Family
$20,000/Family
Unlimited
Unlimited
Unlimited
Unlimited
100% 100% 100%
80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM)
100% 100% 100%
70% (Ded & MM) 70% (Ded & MM) 70% (Ded & MM)
$25 Co-Pay $45 Co-Pay
80% (Ded & MM) 80% (Ded & MM)
$25 Co-Pay $45 Co-Pay
70% (Ded & MM) 70% (Ded & MM)
$20 Co-Pay; $40 Co-Pay 100% (Ded) 100% (Ded) 100%
80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM) 100%
$25 Co-Pay $45 Co-Pay 90% (Ded & MM) 90% (Ded & MM) 100%
70% (Ded & MM) 70% (Ded & MM) 70% (Ded & MM) 70% (Ded & MM) 100%
100% (Ded) 100% (Ded) $150 Co-Pay $20 Co-Pay
80% (Ded & MM) 80% (Ded & MM) $150 Co-Pay 80% (Ded & MM)
90% (Ded & MM) 90% (Ded & MM) $200 Co-Pay $25 Co-Pay
70% (Ded & MM) 70% (Ded & MM) $200 Co-Pay 70% (Ded & MM)
100% (Ded) 100% (Ded)
80% (Ded & MM) 80% (Ded & MM)
90% (Ded & MM) 90% (Ded & MM)
70% (Ded & MM) 70% (Ded & MM)
$20 Co-Pay 100% (Ded) 100% (Ded)
80% (Ded & MM) 100% (Ded) 80% (Ded & MM)
$25 Co-Pay 90% (Ded & MM) 90% (Ded & MM)
70% (Ded & MM) 90% (Ded & MM) 70% (Ded & MM)
Wellness/Preventive Routine Care Physical Examinations Well Child Care (including immunizations) Diagnostic X-Ray & Laboratory
Physician's Office Visits Primary Care Specialist Office
Diagnostic, X-ray, & Lab Physician’s Office Specialist Office Hospital MRI, CAT, & PET Scans Quest Lab (Outpatient Only)
Hospital Benefits In-Patient Out-Patient Emergency Room (Waived If Admitted) Urgent Care Facility
Surgical Benefits In-Patient Out-Patient
Additional Medical Benefits Chiropractic Services (20 Visits) Ambulance Durable Equipment & Supplies
Prescription Drug Card RX Deductible (Cal Yr.) Retail Pharmacy Co-Pay Mail Order Co-Pay
2019 Benefits Guide
N/A $10 Generic $25 Preferred $40 Non-Preferred 2X Retail co-pay for 90 day supply
N/A $15 Generic $35 Preferred $45 Non-Preferred 2X Retail co-pay for 90 day supply
4
Medical Coverage Continued
Silver HSA Plan Employee Deductible (Ded) (Embedded)
Coinsurance (MM) Out-Of-Pocket Maximum (Includes Deductible) Lifetime Maximum Per Family Member
Bronze HSA Plan
In-network
Out-of-network
In-network
Out-of-network
$2,700/Individual
$5,200/Individual
$3,000/Individual
$6,000/Individual
$5,400/Family
$10,400/Family
$6,000/Family
$12,000/Family
100%
60%
80%
60%
$2,700/Individual
$10,400/Individual
$4,900/Individual
$9,800/Individual
$5,400/Family
$20,800/Family
$9,800/Family
$19,600/Family
Unlimited
Unlimited
Unlimited
Unlimited
100% 100% 100%
60% (Ded & MM) 60% (Ded & MM) 60% (Ded & MM)
100% 100% 100%
60% (Ded & MM) 60% (Ded & MM) 60% (Ded & MM)
100% (Ded) 100% (Ded)
60% (Ded & MM) 60% (Ded & MM)
80% (Ded & MM) 80% (Ded & MM)
60% (Ded & MM) 60% (Ded & MM)
100% (Ded) 100% (Ded) 100% (Ded) 100% (Ded) 100% (Ded)
60% (Ded & MM) 60% (Ded & MM) 60% (Ded & MM) 60% (Ded & MM) 60% (Ded & MM)
80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM)
60% (Ded & MM) 60% (Ded & MM) 60% (Ded & MM) 60% (Ded & MM) 60% (Ded & MM)
100% (Ded) 100% (Ded) 100% (Ded) 100% (Ded)
60% (Ded & MM) 60% (Ded & MM) 100% (Ded) 60% (Ded & MM)
80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM)
60% (Ded & MM) 60% (Ded & MM) 80% (Ded & MM) 60% (Ded & MM)
100% (Ded) 100% (Ded)
60% (Ded & MM) 60% (Ded & MM)
80% (Ded & MM) 80% (Ded & MM)
60% (Ded & MM) 60% (Ded & MM)
100% (Ded) 100% (Ded) 100% (Ded)
60% (Ded & MM) 100% (Ded) 60% (Ded & MM)
80% (Ded & MM) 80% (Ded & MM) 80% (Ded & MM)
60% (Ded & MM) 80% (Ded & MM) 60% (Ded & MM)
Wellness/Preventive Routine Care Physical Examinations Well Child Care (including immunizations) Diagnostic X-Ray & Laboratory
Physician's Office Visits Primary Care Specialist Office
Diagnostic, X-ray, & Lab Physician’s Office Specialist Office Hospital MRI, CAT, & PET Scans Quest Lab (Outpatient Only)
Hospital Benefits In-Patient Out-Patient Emergency Room (Waived If Admitted) Urgent Care Facility
Surgical Benefits In-Patient Out-Patient
Additional Medical Benefits Chiropractic Services (20 Visits) Ambulance Durable Equipment & Supplies
Prescription Drug Card Integrated Deductible
Integrated Deductible
Retail Pharmacy Co-Pay
Deductible then Coinsurance
Deductible then Coinsurance
Mail Order Co-Pay
Deductible then Coinsurance
Deductible then Coinsurance
RX Deductible (Cal Yr.)
2019 Benefits Guide
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Network Access
Facts At A Glance Locate health care professionals and facilities using the criteria that’s best suited to your needs. Selecting a doctor and other health care professionals for you and your family is important. Our online directory, available 24 hours a day, 7 days a week, makes it easy. DocFind is the premier online search tool from Aetna. Up-to-date listings of participating doctors, dentists, other medical professionals and facilities are available at your fingertips. With our easy-to-use format, you can search online by name, specialty, gender and/or hospital affiliation.
What Does Docfind Allow Me To Do? •
•
Choose the search option that works for you. Search by using a variety of criteria such as specialty, gender and/or hospital affiliation, or search using the health care professional’s name. Make the informed choice. DocFind gives you easy access to information about health care professionals. This includes information about medical school attended, board certification status and gender, as well as information about the provider’s offices, such as handicapped access. Other features include maps, driving directions and listings (where applicable) of other office locations.
•
Get up-to-date information. DocFind is updated three times per week, giving you access to the latest available information.
•
Review a list of transplant facilities and pediatric congenital heart surgery facilities in our Institutes of Excellence™ network.
Step-by-step Instructions
To access DocFind, simply visit www.aetna.com/asa
Looking To Change Your Primary Care Physician? Need to locate a specialist? DocFind’s “Search by Location” can help: 1. Select the type of health care professional or facility you wish to find, such as primary care physician, specialist, dentist, medical hospital or pharmacy. 2. Enter the geographic information for the area where you wish to find a participating health care professional. Note: Enter your ZIP code information to get the best search results. 3. If you choose to narrow your search by selecting the “Advanced Search” tab, follow the steps above and then select specialty, gender, languages spoken, hospital affiliation and/or name. Or, request a list of all health care professionals who match your geographic and plan requirements. 4. That’s it! You will be presented with a list of health care professionals who match your criteria. You can obtain additional information about each provider by clicking on the “View Details” link.
Know The Name Of The Health Care Professional You’re Looking For? “Search by Name” is your direct route: 1. Select the type of health care professional. 2. Input the name of the individual health care professional you wish to find. 3. Enter the geographic information for the area where you wish to find a participating health care professional. 4. It’s that easy! You will be presented with a list of health care professionals or facilities that match your requirements. You can obtain additional detail about a particular provider by clicking on the “View Details” link. Visit www.aetna.com/asa today for easy access to up-to-date information on participating health care professionals and facilities.
Aetna Signature Administrators is a brand name used for products and services provided by one or more of the Aetna group of subsidiary companies including Aetna Life Insurance Company and its affiliates (Aetna). Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services.
2019 Benefits Guide
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Health Savings Account Health Savings Accounts (HSAs) are tax-advantaged medical savings accounts available to United States taxpayers who are enrolled in a High Deductible Health Plan (HDHP). An HSA is a tax favored account used in conjunction with an HSA-compatible health plan. The funds in the account are used to pay for IRS-qualified medical expenses such as services applied to the deductible, dental, vision, and more.
Employees are eligible to open and fund a Health Savings Account if: • • • • •
They are enrolled in a high deductible medical plan such as an HSA-compatible health plan They are not covered by another health insurance They are not eligible to be claimed as a dependent on someone else’s tax return They are not enrolled in Medicare or TRICARE for Life; and They have not received Department of Veterans Affairs Benefits.
HSA Advantage: • • • • • • • •
An HSA is a unique tax-advantaged account that you can use to pay for current or future IRS-qualified medical expenses. No initial deposits to open an account HSA funds are portable and go with you when you change jobs or retire, you own the account HSA Funds roll over year-to-year; there are tax benefits on contributions, earnings and distributions; and long-term investment opportunities are available. Contributions to your HSA can be made with pre-tax dollars, which reduces your taxable income. Saving for retirement. After age 65, HSA funds can be used for any purpose without penalty (only income tax is assessed) Options for self-directed investments that can potentially grow your savings for healthcare or retirement** You can claim a tax deduction for contributions up to the applicable maximum contribution that you, or someone other than your employer, make to your HSA even if you do not itemize your deductions on Form 1040.
2019 HSA Contribution Limits Individual: $3,500 | Family: $7,000
|
Catch-up (age 55 or older): $1,000
Step 1
Step 2
Step 3
Your Deductible
Your Co-insurance
Your Out-of-Pocket Limit
You pay for all services, including prescriptions until you meet your deductible
After you reach the deductible, you shar the costs with he plan. You can use an HSA to help pay your share
When you reach the limit, you are done paying. The plan pays 100% of covered services for the rest of the coverage year.
Pay with your HSA or pay another way
Your plan pays %
You pay %
You are done paying
Preventive care is covered 100% when you use a network doctor. A list of qualified expenses can be found on IRS Publication 502 at www.irs.gov. Non-healthcare distributions are taxable and subject to the 20% penalty.
2019 Benefits Guide
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Dental Coverage
PPO I Dental Plan
PPO II Dental Plan
In-network
Out-of-network
In-network
Out-of-network
$25/Individual $75/Family
$25/Individual $75/Family
$50 Individual $150 Family
$50 Individual $150 Family
$2,500/Individual
$2,500/Individual
$1,500/Individual
$1,500/Individual
100%
80%
100%
80%
Basic Services
80% After Ded
80% After Ded
80% After Ded
80% After Ded
Major Services
50% After Ded
50% After Ded
50% After Ded
50% After Ded
50%
50%
Not Covered
Not Covered
$2,500
$2,500
N/A
N/A
Employee Deductible (Ded) Annual Maximum Preventative Services
Orthodontic Services*
Orthodontic Lifetime Max
*Orthodontia is only covered for children. Appliances must be placed prior to age 20.
2019 Benefits Guide
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Vision Coverage
VSP Vision Plan In-network
Out-of-network
$10 Co-Pay
Not Applicable
$10 Co-pay
Not Applicable
Plan Options Eye Exam Material Copay (Frames/Lenses or Contact Lenses)
Service Frequency Exams/ Lenses/ Frames/ Contacts
Every 12 months** ** Beginning with the first day of the Benefit Period
Lenses Single Vision
100%
Up to $45
Lined Bifocal
100%
Up to $65
Lined Trifocal
100%
Up to $85
Lenticular
100%
Up to $85
Up to $130
Up to $70
30%
Not Applicable
Up to 4 boxes ($350 Limit)
Up to $105
Up to $105
Up to $105
100%
Up to $210
Standard Scratch-Resistant Coating
Not Applicable
Frames Retail Frame Allowance Discount on Frame Overage at participating providers
Elective Contact Lenses Covered Selection Contacts Non-Selection Contacts Necessary Contact Lenses
Lens Options Covered-in-full Lens Options Non-covered Lens Options Dependent Children Coverage
2019 Benefits Guide
Price Protection available for non-covered lens options ranging from 20-60% off retail pricing at participating providers. To Age 26
9
Nurse Support 24/7 Questions On Everyday Health Issues? We’ve got the answers… Nurse Support 24/7 Thanks to your employer and CoreSource, you have access to medical advice from experienced nurses, 24 hours a day, seven days a week. By calling a tollfree number, you can reach a friendly, registered nurse anytime during the day or night. Our nurse support line, MyNurse 24/7, is your first resource for immediate clinical guidance on everyday health issues.
Avoid Unnecessary Trips To The Doctor With MyNurse 24/7, you get the health information you need, when you need it. One call helps you avoid making an unnecessary and costly trip to the doctor or hospital ER..
Nurses Are Standing By To Help! Dial 866-366-6877 for medical advice in English, Spanish and nearly 150 other languages. Or, visit the CoreSource HealthCenter on our website to chat live with a nurse. The HealthCenter, our personal health management system, also allows you to explore medical information and personal care support tools. Remember, there is no charge for using this valuable service.
Contact MyNurse 24/7 for information on: ▪ Infant care
To call a nurse, dial
866-366-6877 Or visit the HealthCenter at www.coresource.com to chat with a nurse. In case of emergency, call 911.
2019 Benefits Guide
▪ Senior care ▪ Injuries ▪ Disease Symptoms ▪ A new diagnosis ▪ New and emerging health technologies ▪ Any concerns about everyday health issues
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Life & Disability Insurance All Eligible Employees working at least 30 hours per week
Group Term Life/AD&D (Employer Paid) Ladenburg Thalmann Financial Services Inc. provides group term life and accidental death and dismemberment (AD&D) insurance for employees. This group term life insurance provides financial protection for your beneficiaries. The plan features are listed below. • • •
Employee Benefit: 1x annual earnings to a maximum of $500,000 Full Guaranteed Issue amount Life Benefit reduces to 65% of original amount at age 70 and to 50% of the original amount at age 75.
Group Life / AD&D Plan Features • • • • • • • • •
Life Planning Financial and Legal Resources Conversion Privilege Accelerated Benefit Employee Life Insurance Premium Waiver Portability AD&D Education Benefit— 6% or $6,000 AD&D Repatriation Benefit AD&D Seat Belt and Airbag Benefit AD&D Exposure and Disappearance Benefit
Disability Insurance Coverage (Employer Paid) Disability benefits help protect what you work for. Group Short Term Disability (STD) insurance and Group Long Term Disability (LTD) insurance can replace a portion of your salary if you become ill or injured and can’t work. It can help you cover your expenses and protect your finances at a time when you’re not getting a paycheck and have extra medical bills.
Short Term Disability Insurance •
Employee Benefit: 60% of weekly earnings to a maximum of $2,000 per week
•
Definition of Disability: Residual
•
Elimination Period: 0 days injury/7 days sickness
•
Duration of Benefits: 12 weeks
For all New York employees, State statutory plans are still in effect and require no action on your behalf. Should you have any questions regarding these statutory plans, please reach out directly to Unum Contact Department at: 800.275.8686
Long Term Disability Insurance •
Employee Benefit: 60% of monthly earnings to a maximum of $15,000 per month;
•
Definition of Disability:
•
Elimination Period: 90 Days
•
Duration of Benefits: Group LTD Standard Plan Features Include: Rehabilitation and Return to Work Assistance Program ‐ Provides a rehabilitation and return to work assistance benefit for disabled employees who are receiving LTD payments, and who are medically able to participate. Unum will determine eligibility for this program. Work‐life balance employee assistance program ‐ provides a 24‐hour phone line and web resources to help employees and their family members address both everyday issues, such as budgeting or selecting child care, as well as more serious ones, like substance abuse or divorce. This plan includes up to three face‐to‐face sessions for each separate problem an faces, to provide advice and identify resources. Worldwide emergency travel assistance ‐ Emergency medical assistance for employees and their families when traveling 100 miles or more from home, anywhere in the world. Round‐the‐clock phone service provides access to Western‐style medical resources, prescription refills and emergency medical transportation
2019 Benefits Guide
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Voluntary Life Insurance All Eligible Employees working at least 30 hours per week
Voluntary Term Life/ AD&D Insurance Unum’s Group Voluntary Term Life/AD&D Insurance provides employees, spouses and children with the opportunity for an additional safeguard against financial worries
Monthly Rates (Age during calendar year)
Employee Monthly Rate (per $1,000)
Spouse Monthly Rate (per $1,000)
to 5 times your annual earnings to a maximum of $500,000 in increments of $10,000;
15-24
$.052
$.063
•
Spouses can purchase from $5,000 up to 100% of the employee amount in increments of $5,000;
25-29
$.055
$.071
•
Child coverage can be purchased from $2,000 up to $10,000 (not to exceed 100% of the employee amount), in increments of $2,000
30-34
$.073
$.097
•
Guarantee Issue is equal to, $250,000 for an Employee and $25,000 for a Spouse
35-39
$.107
$.14
•
If you purchase at least $10,000 of coverage during your initial enrollment then you will be eligible to increase your benefit at any annual enrollment up to $250,000*.
40-44
$.164
$.212
45-49
$.256
$.329
50-54
$.378
$.489
55-59
$.545
$.718
60-64
$.706
$.99
65-69
$1.00
$1.415
70-74
$1.894
$2.677
75+
$5.854
$8.274
•
As employees, you can purchase from $10,000 up
* If participation requirements are met for the group Delayed Effective Date of Coverage - Insurance will be delayed if you are not in active employment because of an injury, sickness, temporary layoff or leave of absence on the date that insurance would otherwise become effective. Questions? - This plan highlight is a summary provided to help you understand your insurance coverage from Unum. Some provisions may vary or not be available in all states. Please refer to your certificate booklet for your complete plan description. If the terms of this plan highlight summary or your certificate differ from your policy, the policy will govern. If you should have any questions about your coverage or how to enroll, please contact your Plan Administrator.
2019 Benefits Guide
Age
AD&D
$0.03 per $1,000 $0.31 per $1,000
Child Monthly Rates
Life: $0.338 per $1,000 AD&D: $0.035 per $1,000
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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. Ladenburg Thalmann Financial Services Group Health Plan (LTFS) The privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) require the LTFS 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 Employees 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 Cobecon 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 mastectomyrelated 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 employment 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 employee and any other beneficiary will receive COBRA enrollment information.
2019 Benefits Guide
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Medicare Part D Notice Important Notice from Ladenburg Thalmann Financial Services (LTFS) 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 with LTFS and about 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. LTFS has determined that the prescription drug coverage offered by the Platinum and Gold plans 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. If you elect one of these plans your 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. LTFS has also determined that the prescription drug coverage offered by the Silver and Bronze plans is, on average for all plan participants, not expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore not considered Creditable Coverage. This is important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage from the Silver or Bronze plan. This also is important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first become eligible. 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. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) 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 LTFS 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 LTFS 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 coverage with LTFS 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 coverage through LTFS 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 tax credit that lowers your monthly premium right away. Open enrollment for health insurance coverage through the Marketplace begins in October 2019 for coverage starting as early as January 1, 2019. 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 are not eligible for a tax credit through the Marketplace and may 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 costsharing 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, 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. 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)
Ladenburg Thalmann Financial Services
(Available upon request)
Employer Address
Employer Phone Number
4400 Biscayne Blvd
305-572-4100
City
State
Zip Code
Miami
FL
33137
Who can we contact about employee health coverage at this job? Human Resources Phone number (if different from above)
Email Address (Available upon request)
•
Eligible employees are employees that are regularly scheduled to work more than 30 hours each week.
•
LTFS offers dependent coverage - eligible dependents are spouses/domestic partners and children (biological, adopted and stepchildren)
•
Coverage meets the 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.
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Medicare and CHIP Children’s Health Insurance Program (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
Medicare Coordination of Benefits with other Coverage
IF YOU
Are covered by Medicare and Medicaid
SITUATION Entitled to Medicare and Medicaid
PAYS FIRST
Medicare
PAYS SECOND Medicaid, but only after other coverage (such as employer group health plans) have paid
Entitled to Medicare The employer has 20 or more Are 65 or older and covered by a group health plan because you or your spouse is employees still working The employer has less than 20 employees Have an employer group health plan after you retire and are 65 or older
Entitled to Medicare
Group Health Plan
Medicare
Medicare
Group Health Plan
Medicare
Retiree Coverage
Entitled to Medicare Are disabled and covered by a large group The employer has 100 or more Large group health plan employees health plan from your work, or from a family member who is working The employer has less than 100 Medicare employees 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
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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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Notice of HIPAA Privacy Rights • PLEASE REVIEW THIS NOTICE CAREFULLY AS IT DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED. THIS NOTICE ALSO DIRECTS YOU TO HOW YOU CAN ACCESS YOUR MEDICAL INFORMATION.
•Ladenburg Thalmann Financial Services Inc. (“Ladenburg”) is providing you this privacy notice so you understand how we use your health information and when we need to disclose your health information to others. For each obligation and right listed within this notice, the term “we” refers to both the Plan Administrator and the claims administrators for the self-insured group health plan coverage options under the Ladenburg Thalmann Financial Services Inc. Employee Benefit Plan (the “Ladenburg group health plan”)*. • Ladenburg is the Plan Administrator for the Ladenburg group health plan. The claims administrators for the Ladenburg group health plan are listed in the “Claims administrators” section on the last page of this document.
Summary of your privacy rights We may use and give out your health information to:
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Treat you
•
Get paid
•
Run the Ladenburg group health plan
•
Tell you about other health benefits and services
•
Help your family and friends involved in your care
•
Do research
• We may also use and give out health information for:
• This notice is subject to change. You may contact your Human Resources department during normal business hours by telephone or by email anytime to request a copy of the most recent version of this notice. The most recent version of this notice is also available on your company’s intranet, if applicable. The Ladenburg group health plan is required by law to abide by the terms of this notice, which may be amended from time to time. • * Only the listed plan is covered by this Notice of HIPAA Privacy Rights. If you are enrolled in any other benefit plan(s) covered by HIPAA, the insurer or administrator, as applicable, for the plan(s) may also provide a Notice of HIPAA Privacy Rights specifically relating to the coverage under that (those) plan(s).
•
•
Health and safety reasons
•
Organ and tissue donation requests
•
Military purposes
•
Workers’ compensation requests
•
Lawsuits
•
Law enforcement requests
•
National security reasons
•
Coroner, medical examiner, or funeral director use Such other disclosures as may be required by law or further addressed herein
•
•
You have the right to: •
Get a copy of your medical record.
•
Request a change to your medical record if you think it’s wrong.
• •
Ask for an accounting of certain disclosures of your health information. Ask us to limit the information we share.
•
Ask for a copy of our privacy notice.
•
Write a letter of complaint to us if you believe your privacy rights have been violated.
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Notice of HIPAA Privacy Rights The purpose of this document is to outline and inform you about your privacy rights enacted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This privacy notice describes the privacy practices of Ladenburg group health plan. Ladenburg, as the sponsor of the Ladenburg group health plan, the Plan Administrator of the Ladenburg group health plan, and each of the claims administrators that have been hired to administer the Ladenburg group health plan is required by law to protect the privacy of your health information. “Protected health information,” as used in this privacy notice, means any individually identifiable health information that is created or received by a health care provider or the Ladenburg group health plan relating to: •
Your physical or mental health or condition
•
The provision of health care to you
•
The payment for health care
“Protected health information” does not include, among other things, any information maintained on the Ladenburg or a Participating Employer’s1 payroll system or records related to an individual’s enrollment in or coverage level under the Ladenburg group health plan. It also does not include any other information that Ladenburg or a Participating Employer holds in its capacity as “employer” or in connection with plans other than the Ladenburg group health plan. Changes to the Terms of this Notice. Ladenburg reserves the right to change or amend this privacy notice and our privacy practices and to make such changes effective for all protected health information that we maintain, but if we do, we will communicate any material changes to you in a revised privacy notice posted online by the effective date of the material change. We will provide you with the revised notice, or information about the change and how to obtain the revised notice, in the group health plan’s next 1 The
following affiliates or subsidiaries of Ladenburg are employers participating in the Plan as of the effective date of this notice: KMS Financial Services, Inc.; Ladenburg Thalmann & Co.; Highland Capital
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annual mailing to you. For your convenience, the privacy notice is available online on your company’s intranet, if applicable, or from your Human Resources department during normal business hours by telephone or by email anytime.
How we may use or disclose your protected health information We must use and disclose your protected health information to provide information: •
•
•
To you or someone who has the legal right to act for you (your personal representative) To the Department of Health and Human Services, if necessary, to make sure your privacy is protected When it’s required by law
We have the right to use and disclose your protected health information to pay for your health care and to operate and administer the Ladenburg group health plan. Some examples of when we may use your protected health information are: •
• • •
For payment of claims for services received by you and processed by the claims administrators for the Ladenburg group health plan. For treatment, so that doctors, hospitals, or both, can provide you medical care. For coordination of benefits with other covered health plan. For health care operations, to operate and administer the Ladenburg group health plan and to help manage your health care coverage. For example, the Ladenburg group health plan may use your protected health information in connection with: o A disease management or wellness program to improve your health o Underwriting, including but not limited to, soliciting bids from potential insurance carriers
Brokerage, Inc.; Investacorp; Premier Trust; Securities America Financial Corporation; and Securities Service Network, LLC. (collectively, the “Participating Employers”).
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Notice of HIPAA Privacy Rights o o o o o o o
•
(genetic information shall not be used for underwriting purposes) Merger and acquisition activities Determining participant contributions Submitting claims to the plan’s stop-loss (or excess loss) carrier (if any) Conducting or arranging for medical review Legal services Audit services Fraud and abuse detection programs
• •
•
•
•
•
•
•
The Ladenburg group health plan also may use your protected health information for other administrative activities, such as cost management and conducting quality assessment and improvement activities.
•
To provide information on health-related programs or products. For example, the claims administrator might talk to your doctor about health-related products and services, or to suggest an alternative medical treatment or program.
•
Under limited circumstances, we may have to use or disclose your protected health information: •
•
To persons involved with your care, such as a family member, if you are incapacitated, in an emergency, or when permitted by law. For public health activities, such as reporting disease outbreaks. For reporting victims of abuse, neglect, or domestic violence to government authorities, including a social service or protective service agency. For health oversight activities such as governmental audits, fraud, and abuse investigations. For judicial or administrative proceedings, such as responding to a court order, search warrant, or subpoena. For law enforcement purposes, such as providing limited information to locate a missing person.
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To avoid a serious threat to health or safety, such as disclosing information to public health agencies. For specialized government functions, such as military and veteran activities, national security, and intelligence activities. For workers’ compensation, including disclosures required by state workers’ compensation laws for job-related injuries. For research purposes, such as research related to the prevention of disease or disability, but only if the research study meets all privacy law requirements. To provide information regarding decedents, such as providing protected health information to a coroner or medical examiner to identify a deceased person, determine a cause of death, or as authorized by law, or to funeral directors as necessary to carry out their duties. For organ procurement purposes, such as banking or transplantation of organs, eyes, or tissue.
If none of the above reasons apply, then your written authorization is needed to use or disclose your protected health information. Specifically, your written authorization is required to use or disclose any psychotherapy notes, if applicable, and to use or disclose any protected health information for marketing purposes or for which the group health plan receives compensation. If applicable, the group health plan also may contact you to raise funds, but you may elect not to receive any such fundraising communications in the future. If a use or disclosure of protected health information is prohibited or materially limited by other applicable laws, then it is our intent to meet the requirements of the more stringent law to protect your privacy. After we receive authorization from you to release your protected health information, we cannot guarantee that the person to whom the information is provided will not disclose your information. You may revoke your written authorization unless we have already acted based on your authorization. To revoke an authorization, contact the claims administrator for the Ladenburg group health plan in which you are enrolled.
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Notice of HIPAA Privacy Rights Potential impact of State law HIPAA generally does not “preempt” (or take precedence over) state privacy or other applicable laws that provide individuals greater privacy protections. As a result, to the extent state law applies, the privacy laws of a particular state, or other federal laws, rather than HIPAA might impose a privacy standard under which we will be required to operate. For example, where such laws have been enacted, we will follow more stringent state privacy laws that relate to uses and disclosures of protected health information concerning HIV or AIDS, mental health, substance abuse/chemical dependency, genetic testing, reproductive rights, etc.
you about medical matters in a certain way or even at a certain location. An example of this could be that we only contact you at work or by mail. If you have a preference regarding how we communicate with you, please let us know in writing. We are not required to agree to your request, but, if we do agree to it, we will comply with it. •
See and obtain a copy of your protected health information that may be used to make decisions about you, such as claims and cases or medical management records. You may receive a summary of this health information. If your protected health information is maintained electronically in one or more designated record sets, then you have the right to get a copy of this health information in an electronic format. A written request will be needed to inspect and copy your protected health information. In certain limited circumstances, your request to inspect and copy your protected health information may be denied. An access request should be made to the applicable claims administrators as listed within this privacy notice.
•
Ask to amend the protected health information we maintain about you if you believe it is wrong or incomplete. The amendment must be submitted in writing to the claims administrators for the Ladenburg group health plan, along with a reason that supports your request. If your request is denied, you may have a statement of your disagreement added to your protected health information.
•
Appoint a personal representative. You may request that the Ladenburg group health plan disclose your protected health information to your personal representative. A “personal representative” is an individual you designate to act on your behalf and make decisions about your medical care. If you want the Ladenburg group health plan to disclose your protected health information to your personal representative, submit a written
What are your rights to your protected health information? You have the right to: •
•
Ask for restrictions on uses or disclosures of your protected health information for treatment, payment, or health care operations. You also can ask to restrict disclosures to family members or to others who are involved in or make payments for your health care. We may also have policies on dependent access that may authorize certain restrictions. We ask you to understand that while we will try to honor your request and will permit requests consistent with our policies, we are not required to agree to any restriction. A covered entity (such as a health care provider) must comply with a requested restriction if the disclosure is to a health plan for purposes of payment or health care operations and the protected health information relates to a health care item or service for which an individual paid in full, out of pocket. For example, if you receive medical care and choose to pay the provider for the entire amount of care in full, out of pocket, you can request that the provider not disclose such information to the Ladenburg group health plan, and the provider must agree to such request. Choose how we contact you. You have the right to ask that we communicate with
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Notice of HIPAA Privacy Rights
•
statement giving the Ladenburg group health plan permission to release your protected health information to your personal representative and documentation that this individual qualifies as your personal representative under state law, such as a power of attorney authorizing this individual to make health care decisions for you. Submit this request in writing to the applicable claims administrator.
How to exercise your rights
Receive an accounting of disclosures of your protected health information made by the Ladenburg group health plan during the six years before your request. This accounting will not include disclosures of protected health information made:
Filing a complaint
1.
For treatment, payment, and health care operations purposes;
2.
To you or pursuant to your authorization;
3. 4.
To correctional institutions or law enforcement officials; and In connection with other disclosures for which federal law does not require us to provide an accounting.
Your request should indicate in what format you want the list (for example, on paper or electronically). Submit this request in writing to the applicable claims administrator. The first list that you request in a 12-month period will be free and we may charge you for responding to any additional requests. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. • You have the right to a paper copy of this privacy notice anytime. It is posted online on your company’s intranet, if applicable, or you may call your Human Resources department by telephone during normal business hours to request a copy.
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Contact the claims administrators If you have any questions about this privacy notice or want to exercise any of your rights, call the claims administrator for the Ladenburg group health plan coverage option in which you are enrolled. Contact information is listed in the “Claims administrators” section on the last page of this notice.
If you believe your privacy rights have been violated, you may contact Ladenburg’s contact person in writing at the following address: Joseph Giovanniello Senior Vice President – Corporate and Regulatory Affairs Ladenburg Thalmann Financial Services Inc. 277 Park Avenue, 26th floor New York, NY 10172 Tel: 212-409-2544 or by email at: jgiovanniello@ladenburg.com You may also file a complaint with the Secretary of the United States Department of Health and Human Services Office of Civil Rights at: 200 Independence Avenue, SW, Room 509-F HHH Building, Washington, DC 20201, or at the applicable regional office of the HHS Office of Civil Rights, the contact information for which is available at:
http://www.hhs.gov/ocr/aboutus/contact-us/index.html We will not take any action against you for filing a complaint. The Ladenburg group health plan has policies and procedures in place designed to address breaches of unsecured protected health information. The Ladenburg group health plan is obligated to, consistent with HIPAA, notify you if your unsecured protected health information is breached. If your complaint relates to breach notification procedures of the Ladenburg group health plan or compliance with the policies and procedures of the Ladenburg group health plan in general, send the complaint to the Privacy Officer at the address listed above.
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Notice of HIPAA Privacy Rights Restrictions on protected health information Ladenburg (the plan sponsor for the self-insured coverage options under the Ladenburg group health plan) may not use or disclose protected health information for employment-related actions or decisions. Ladenburg may only use or further disclose protected health information as permitted or required by law and will report any use or disclosure of protected health information that is inconsistent with the permitted uses and disclosures.
Plan Administrator and health plan separation Ladenburg team members, classes of team members, or other workforce members of Ladenburg or Participating Employers listed below will have access to protected health information only to perform the plan administrative functions required of the Plan Administrator to administer the Ladenburg group health plan:
P. O. Box 2920 Clinton, IA 52733-2920 866-893-4472 -For prescription drug benefits: Caremark, LLC Attn: Customer Advocate Team 7034 Alamo Downs Parkway San Antonio, Texas 782238 (800) 841-5550 -For vision benefits: VSP Global Attention: Privacy Specialist 3333 Quality Drive MS-163 Rancho Cordova CA 95670 916-858-7432 HIPAA@vsp.com
• Human Resources department team members • Legal counsel • Others identified in the plans’ HIPAA policy This list includes every team member, class of team member, or other workforce member under the control of the individual who may receive protected health information relating to the ordinary course of business. The team members, classes of team members, or other workforce members identified above (and any individual under the control of these team members) may be subject to disciplinary action and sanctions for any use or disclosure of protected health information that is in violation of these provisions. Claims administrators To reach the claims administrator for the benefits provided under the Ladenburg group health plan, please call the applicable number listed below: -For medical and dental benefits: CoreSource, Inc.
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Summary Annual Report Summary Annual Report For Ladenburg Thalmann Employee Benefit Plan This is a summary of the annual report of the Ladenburg Thalmann Employee Benefit Plan, a health, dental and vision plan (Employer Identification Number 65-0701248, Plan Number 501), for the plan year 01/01/2017 through 12/31/2017. The annual report has been filed with the Employee Benefits Security Administration, as required under the Employee Retirement Income Security Act of 1974 (ERISA). Ladenburg Thalmann Financial Services has committed itself to pay certain Medical, Dental and Vision claims incurred under the terms of the plan. Your Rights to Additional Information You have the right to receive a copy of the full annual report, or any part thereof, on request. The items listed below are included in that report: 1.Financial information and information on payments to service providers. To obtain a copy of the full annual report, or any part thereof, write or call the office of Diane Chillemi, who is a representative of the plan administrator, at 4400 Biscayne Blvd, 12 Fl, Miami, FL 33137 and phone number, 631-270-1619. The charge to cover copying costs will be $1.50 for the full annual report, or $0.25 per page for any part thereof. You also have the legally protected right to examine the annual report at the main office of the plan: 4400 Biscayne Blvd, 12 Fl, Miami, FL 33137, and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N-1513, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.
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