1 Welcome to the 2019 Open Enrollment period for your health and welfare benefits. Open Enrollment begins Tuesday, November 27th and ends Friday, December 14, 2018. During this time, we encourage you to review your personal information, the benefits offered for 2019, and the plans you are currently enrolled in to determine if you would like to make any changes. Take a fresh look at what EnCore offers to help better life both at home and work as there may be some benefits that you have not taken advantage of in the past but that may help you or your family in 2019.
What is Open Enrollment? Open Enrollment is that annual window when you can make changes to your benefit elections without a qualifying event. During this time, you can: • Add, cancel or change coverage for yourself and your dependents. • Add or remove eligible dependents. • Enroll or re-enroll in Medical Care or Dependent Care Flexible Spending Accounts (FSA). • E lect or make changes to your voluntary supplemental plan elections including Voluntary Long-Term Disability, Supplemental Life Insurance and AD&D, and Accident or Critical Illness plans.
2019 BENEFIT PLAN HIGHLIGHTS This brochure highlights what’s to come for 2019 along with each plan and changes (if applicable). All changes made during this time will become effective January 1, 2019. The EnCore Benefits Program Guide and benefit summaries will be provided during Open Enrollment. The Benefits Program Guide is a detailed booklet describing the options available to you under the EnCore benefits program.
Aetna Medical Benefits The current medical plan options will continue to be offered and provided through Aetna: Open Access Managed Choice POS (PPO) plan, and both HMO AVN (Low) and HMO California (High) plans. Due to a carrier mandate, the Prescription Drug formulary for all the medical plans will be changing from Aetna’s Premier Formulary to the Value Plus Formulary. Certain medications may change copay tiers, be subject to pre-authorization or step therapy requirements or be excluded from the formulary. You are encouraged to visit the Aetna website to verify your current medications at https://www.aetna.com/ individuals-families/find-a-medication/2019-value-plus-plans.html. • Open Access Managed Choice POS | Standard PPO plan option. Does not require designation of a Primary Care Physician. • Deductible - $500 individual/$1500 family; Office Visits - $30 copay; Specialist Visits - $50 copay; Emergency Room $150 copay then 20% after deductible; Urgent Care - $35 copay; Preventative Care - no charge; Coinsurance - 20%; RX - $20/$40/$70 copay. Services rendered by an out-of-network provider are subject to higher deductibles, copays, and coinsurance. • HMO California (High) Plan | Enriched HMO option with larger network of participating providers. Requires designation of a Primary Care Physician. • Deductible $100 individual/$200 family; Office Visits - $30 copay; Specialist Visits - $50 copay; Emergency Room - $150 copay then 10% after deductible; Urgent Care - $35 copay; Preventative Care - no charge; Coinsurance - 10%; RX $20/$35/$60 copay. • HMO AVN (Low) Plan | Lower cost HMO option with higher deductible/coinsurance, and narrow network of participating providers. Requires designation of a Primary Care Physician. •
Deductible $400 individual/$800 family; Office Visits - $30 copay; Specialist Visits - $40 copay; Emergency Room - $200 copay after deductible; Urgent Care - $35 copay; Preventative Care - no charge; Coinsurance - 20%; RX - $20/$30/$50 copay.
2 Aetna Dental Benefits
Unum Life Insurance and AD&D Benefits
The dental insurance provider will be changing from MetLife to Aetna. A PPO and an HMO dental plan option will continue to be offered. The Aetna dental PPO plan will have the same benefits as the MetLife dental PPO plan. The copays on the dental HMO plan will have some changes. You are encouraged to verify your providers under the Aetna Dental Network by visiting https://www.aetna. com/individuals-families/find-a-doctor.html, and search the network for your corresponding plan (listed below).
The Basic Life and AD&D plans will continue to be offered at no cost and the Supplemental Life and AD&D plans will continue to be offered without plan design or employee premium changes (unless you are moving from one age bracket to another or your coverage amount changes). These benefits provide a level of protection to you and your family in the event of death or dismemberment.
• Dental HMO (DMO/DNO Managed Dental) • Requires designation of a Primary Care Dentist. There is no out-of-network coverage. Office Fee $5; No Deductible; Unlimited Calendar Year Maximum; Diagnostic/Preventative service $0-$25; Basic, Major and Orthodontia services - copays vary. • Dental PPO (PDN with PPO II Network) • Does not require designation of a Primary Care Dentist. Calendar Year Maximum is $2,000; Deductible is $50 person/$150 family (waived on preventative); Preventative services (periodic exams, cleanings, x-rays) covered at 100%; Basic services (fillings, root canals, extractions) covered at 80% (in/ out-of-network); Major services (crowns, bridges, dentures), Implants, and Orthodontia covered at 50% (in/out-of-network). Services rendered out-ofnetwork subject to balance billing.
Aetna Vision Benefits The vision insurance provider will be changing from MetLife to Aetna. The in-network benefits will remain the same while the out-of-network allowances are slightly different. The Aetna vision network is comparable to the MetLife vision network and includes retail chains such as Lens Crafters, Sears and Target Optical. You can search for providers by visiting www.aetnavision.com. • Eye Exams covered every 12 months - $10 copay; Lenses/Contacts covered every 12 months; Frames allowed every 24 months (or contact lenses instead of frames every 12 months). Frame allowance is up to $130 (in-network); Contact Lens allowance up to $130 (in-network); Materials - $25 copay. Out-ofnetwork allowances are lower, and copays are higher.
• Basic Life Insurance & AD&D | 1 times your annual base salary up to $200k maximum. • Supplemental Life Insurance & AD&D | Employee/ Spouse - Up to 5 times employee’s base annual salary; $150k guarantee issue (employee)/$30k guarantee issue (spouse); Child(ren) – up to $10k.
Supplemental Benefits through Unum The following three voluntary supplemental benefit plans will continue to be offered without employee premium changes (unless you are moving from one age bracket to another or your coverage amount changes). These benefits provide enhanced protection for you and your family’s physical and financial needs. • L ong Term Disability (LTD) | Replaces 60% of your income up to $8,000 per month if you are unable to work due to a non-work-related illness or injury. • A ccident | Designed to help you meet out-of-pocket expenses and extra bills that can follow an accidental injury, whether minor or catastrophic, that happens off the job. • C ritical Illness | Designed to help you offset the financial effects of a catastrophic illness with a lump sum benefit if an insured is diagnosed with a covered critical illness such as a heart attack, stroke, or major organ failure.
Flexible Spending Accounts through IGOE The Medical Care and Dependent Care FSA plans will continue to be available. • M edical Care FSA | Maximum contribution for 2019 is $2,700. • D ependent Care FSA | Maximum contribution for 2019 is $5,000.
401(k) Retirement Savings Plan through OneAmerica The maximum annual contribution for the 401(k) plan will increase to $19,000 and $6,000 for additional catch-up deferrals for those participants age 50 or greater.
Live Well. Work Well.
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What You Need to Do During Open Enrollment 1
Review the 2019 benefit materials available during Open Enrollment. Attend your reserved Open Enrollment meeting.
Open Enrollment Schedule Date
Location
Tuesday, Nov 27th & Wednesday, Nov 28th
Seal Beach
Thursday, Nov 29th & Friday, Nov 30th
Huntington Beach
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Gather your dependent and beneficiary Social Security numbers and birth dates if you will be adding dependents to your coverage or updating a beneficiary.
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Complete forms and submit to Human Resources by December 14th. Medical | If you are satisfied with your current election, no further action is necessary. Complete the EnCore Enrollment/Change Form if you would like to enroll or make changes. Dental & Vision | Your current election(s) will not carry-over to become your 2019 benefit election(s). You will need to complete the EnCore Enrollment/Change form to enroll for the 2019 plan year. Life, AD&D, LTD, Critical Illness, and Accident Insurance | If you are satisfied with your current election(s), no further action is necessary. Complete the Unum Enrollment/ Change Form if you would like to enroll or make changes. Complete the Unum Beneficiary Form to change your beneficiary designation. Flexible Spending Accounts (FSA) | Complete the 2019 FSA Enrollment Form to participate in the Medical Care and/or Dependent Care FSA for the 2019 plan year; your 2018 election(s) will not carry-over.
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you are enrolling your spouse and/or child(ren) for the first time, you must submit verification documents (e.g., marriage If certificate when adding a spouse, birth certificate when adding a child, and domestic partnership registration when adding a domestic partner) to your HR representative. If you do not provide the required documentation within the enrollment window, your dependent(s) will be considered ineligible and unable to enroll in EnCore’s benefit plans.
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you have any questions or need assistance, please contact Human Resources. Remember to choose your benefits wisely If as you cannot make changes during the year unless you have a qualifying event.
This flyer presents an overview of the EnCore benefits program and is not intended to be all-inclusive, nor is it to be used as a Summary Plan Description. If there is any discrepancy between this flyer and the official plan documents, the official plan documents will prevail. EnCore reserves the right to change or modify its benefit plans as appropriate without notice. Please review the Employee Benefits Program Guide and carrier benefit summaries for full details.