Employee Insurance Benefits Guide 2019-2020
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 1-877-342-5855 Revision Date: 11/05/2019
Table of Contents Your Benefits
Employee Benefits Overview _____________________ 3
Runk & Pratt offers a Comprehensive Benefits Package that includes:
Key Things You Should Know_____________________ 4 Medical Insurance Plans__________________________ 5
Medical Insurance
Voluntary Dental & Vision Insurance ______________ 6 Medical, Dental & Vision Plan Costs_______________ 7
Voluntary Dental Insurance
Voluntary Term Life/Short-Term Disability__________8
Voluntary Vision Insurance
Voluntary Permanent Life Insurance_______________ 9
Voluntary Short-Term Disability
Voluntary Accident Insurance_____________________ 10
Voluntary Term Life Insurance
Voluntary Critical Illness Insurance________________ 11
Voluntary Critical Illness Insurance
Additional Employee Benefits_____________________12
Voluntary Accident Insurance Voluntary Permanent Life Insurance
Important Contact Information ______________________ 13
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 1-877-342-5855 2
Employee Benefits Overview Dependent verification requirements Runk & Pratt provides an array of quality benefits to full-time eligible employees. To keep benefit plans affordable, eligibility of dependents is restricted to your spouse and your children who meet the age and financial support requirements. When initially enrolling a spouse or your child(ren) in one of the benefit plans, you may be required to provide proof of eligibility such as a copy of your marriage license or a copy of the child’s birth certificate. Dependent children can be covered under your plan up to age 26.
When You Can Enroll You can sign up for benefits or change your benefit elections at the following times: • Prior to your benefits effective date as a newly hired employee. • During the annual benefits open enrollment period November 1st - November 30th for a December 1st effective date. • Within 30 days of experiencing a qualifying life event (See Changing Your Benefits below). If you do not sign up for benefits during your initial eligibility period or during the open enrollment period, you will not be able to elect coverage until the following plan year unless you experience a qualifying life event.
Changing Your Benefits During the Year Runk & Pratt allows you to pay your portion of the medical, dental and vision on a pre-tax basis. Thus, due to IRS regulations, once you have made your elections for the plan year, you cannot change your benefits until the next annual open enrollment period. The only exception is if you experience a qualifying life event. Election changes must be consistent with your life event. Please contact Beneficial Associates Resource Center to notify them of the qualifying life event and provide supporting documentation. Change requests submitted after 30 days cannot be accepted.
Qualifying life events include, but are not limited to: 3 4 4 5 5
• Marriage, divorce, or legal separation. • Birth or adoption of an eligible child. • Open Enrollment at a spouse’s job. • Death of your spouse or covered child. • Change in your spouse’s work status that affects his or her benefits. • Change in your child’s eligibility for benefits. • Qualified Medical Child Support Order. • Loss or gain of other coverage.
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If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 1-877-342-5855 3
Key Things You Should Know Deductible
The amount you must pay for medical expenses before the insurance plan will begin to pay.
Coinsurance A form of cost-sharing where you and the insurance plan share expenses in a specified ration after you meet your deductible (until you reach the out-of-pocket maximum).
Out-of-Pocket Maximum The maximum amount of money you will pay during the plan year. The out-of-pocket maximum is the sum of your deductible, coinsurance payments, and medical copays.
Preventive Care The Piedmont Medical plans cover in-network preventive care at 100%. This includes routine screenings and checkups, as well as counseling to prevent illness, disease, or other health problems. You won’t have to pay anything - no deductible, copay, or coinsurance - for preventive services when: • You get them from a doctor or other health care provider in the Piedmont Medical network. • The main purpose of your visit is to get preventive care.
Talk to your primary care physician to find out which screenings, tests, and vaccines are right for you, when you should get them, and how often. Please be aware that you will be responsible for the cost of any non-preventive care services you receive at your preventive care exam. Learn more about preventive care www.pchp.net
Copays The flat dollar amount you pay for certain services such as office visits and prescription drugs.
Dependent Coverage If you elect dependent coverage, the individual deductible and out-of-pocket maximum (OOP) will apply to each individual. If only one person in the family uses the plan they will only be subject to the individual deductible and OOP. The OOP maximum for the entire family is two times the individual and can be obtained by a combination of family members. (Once the family out-of-pocket maximum is met, expenses are paid 100% by the plan for the entire family).
Picking Your Plan- The difference between PPO and HMO Plans PPO (Preferred Provider Organization) PPO plans give you flexibility. You don’t need a primary care physician. You can go to any health care professional you want without a referral—inside or outside of your network. Staying inside your network provides the best benefit including office visit copays and lower out-of-pocket costs, as well as protecting you from balanced billing. If you choose to go outside your network, you'll have higher out-of-pocket costs, and not all services may be covered.
HMO (Health Maintenance Organization) With an HMO plan, you pick one primary care physician. All your health care services go through that physician. Visits to health care professionals outside of your network typically aren’t covered by your insurance.
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 4 1-877-342-5855
Medical Insurance Plans Runk & Pratt offers Health Insurance plans through Piedmont Community Health Care. Locate a Piedmont network provider at www.PCHP.net. Please refer to the official Plan Documents and the Summary Benefits of Coverage (SBC), available on the Runk & Pratt Benefit Administration Online Portal, Paycom. for additional information on coverages and exclusions. You may also refer to the Piedmont packet provided with summary information.
Summary of Covered Benefits Plan Year Deductible
Individual/Family Out-of-Pocket Maximum Individual/Family
R&P Silver PPO Piedmont Basic 5000/30/50 CBOP
R&P Bronze HMO Consumers Complete 5000 CBOP (limited network)
$5,000 / $10,000
$5,000 / $10,000
$7,000 / $14,000
$5,000 / $10,000
No Charge
No Charge
Includes deductible, CoInsurance, & Copays
Preventive Care Physicians Services Primary Care Physician Specialist Urgent Care Tele Med Services
$30 $50 $50 $25
Lab / X-Ray Diagnostic Lab / X-Ray High-Tech Services MRI, CT, PET
No Copay for PCP and Specialist (subject to ded)
0% AD* 0% AD* 0% AD* $49
30% AD*
0% AD*
Hospital Services Inpatient / Outpatient
30% AD*
0% AD*
Emergency Room
30% AD*
0% AD*
$15 $40 $55 $125
$15 $40 $55 $125
Prescription Drugs (30-Day Supply) Generic Perferred Brand Non-Prefered Brand Specialty
AD* After Deductible The above plan descriptions are in-network benefit outlines.
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 5 1-877-342-5855
Voluntary Dental & Vision Insurance Runk & Pratt offers Dental & Vision Insurance plan options through Companion Life Insurance Company. These plans offer in-network and out-of-network benefits paying at the 90th percentile giving you the freedom to choose any provider. The tables below summarizes the key features of the Dental & Vision plans. Please refer to the official plan documents, available on the Runk & Pratt Benefit Administration Online Portal, Paycom, for additional information on coverages and exclusions.
Companion Life Dental Insurance - (Network - DentalMax) Plan Year Maximum
$1,000
Plan Year Deductible Per Individual
$50 Deductible For Each Covered Individual
Type I - Diagnostic & Preventive Exams Cleanings (2 per 12 Months) Bitewing X-Rays (1 per 12 Months)
Covered at 100% (Deductible Waived)
Type II - Basic Services Fillings, Space Maintainers, Pain Treatment, Sealants, Full Mouth X-Rays
Covered at 80% *AD
Type III - Major Services Anesthesia, Endodontics, Simple & Surgical Extractions, Oral Surgery, Periodontics, Crowns, Inlays, Onlays, Dentures, Bridges, Implants
Covered at 50% *AD (12 Month Waiting Period)
AD* After Deductible
Companion Life Vision Insurance - (Network - EyeMed) Copayment Eye Exam Materials
$10 $10
Once Every 12 Months
Base Lenses Single Vision Lenses Lined Bifocal/Trifocal Lenses OR Contact Lenses (up to $120)
100%
Once Every 12 Months
Frames
$130 Retail Allowance Once Every 24 Months
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 6 1-877-342-5855
Medical, Dental & Vision Plan Costs (Rates are Semi-Monthly 24 Times Per Year) Piedmont Medical Insurance
Coverage Level
R&P Silver PPO Piedmont Basic 5000/30/50 CBOP
Employee Only
$114.13
$85.11
Employee + Child
$202.45
$160.71
Employee + Children
$325.69
$266.07
Employee + Spouse
$346.22
$283.63
Employee + Family
$510.55
$424.10
R&P Bronze HMO Consumers Complete 5000 CBOP (limited network)
*Due to ACA, some employees may receive additional employer contribution amounts towards medical insurance based on your compensation.
Companion Life Voluntary Dental Insurance Coverage Level Employee Only
$14.04
Employee + Child(ren)
$31.21
Employee + Spouse
$28.08
Employee + Family
$45.95
Companion Life Voluntary Vision Insurance Coverage Level Employee Only
$4.65
Employee + One
$8.79
Employee + Two
$10.40
Employee + Three or >
$13.84
If you have any questions about your beneďŹ ts please contact BeneďŹ cial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 7 1-877-342-5855
Voluntary Term Life Insurance Runk & Pratt provides you the option to purchase Voluntary Term Life and AD&D Insurance for yourself, your spouse, and your dependent children through Companion Life. You must purchase coverage for yourself in order to purchase coverage for your spouse and/or dependents. Voluntary Term Life rates are based on age.
Plan Highlights: • Employee: $5,000 increments up to $150,000 Guarantee issue: $150,000 • Spouse: $5,000 increments up to 50% of the employee’s election to a maximum amount of $25,000 Guarantee issue: $25,000 • Dependent children: Option of $2,500, $5,000 or $10,000 Employee Coverage Required (Available Age 14 Days - 26 Years old)
Voluntary Short-Term Disability Insurance Runk & Pratt offers employees the opportunity to purchase Short-Term Disability Insurance through Companion Life. Short-Term Disability Insurance helps replace your income if a doctor deems you unable to work due to an off the job injury or sickness.
Plan Highlights: GUARANTEED ISSUE no health questions asked first time offered Waiver of Premium while receiving Short-Term Disability benefits Pregnancy is covered same as any other illness Claim Payments & Amounts paid on a weekly basis Non-Occupational Coverage off the job only Pre-Existing Conditions - 12/12 waiting period
Elimination Periods: 7 Days Injury / 7 Days Sickness Benefit Period: 13 Weeks Benefit Amounts: Employees can choose from $150-$1,250 per week, not to exceed 66% of their salary.
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 8 1-877-342-5855
Voluntary Whole Life Insurance
WL
values, as well as the option to insure your entire family, Life changes … so it may be time to review how much coverage you have and consider what your family might need if something should happen. Whether t, whole life insurance
Just like Boston Mutual has always been there for our policyholders, whole life coverage will always be there to provide you and your family protection and security for the future.
HIGHLIGHTS
$
Flexible
Worldwide coverage
Portable
Guarantees Available for you, your spouse, children, and grandchildren. Guaranteed coverage with no medical questions, up to certain amounts.
Premium – As long as you continuously pay your premiums, the cost of your life insurance policy can never go up.
You select the amount of insurance you need and
Cash Value – The cash value illustrated at the time of purchase are guaranteed as long as your coverage stays in force*.
Payroll deduction makes payment easy.
Interest Rate – This policy provides a 3% guaranteed credited interest rate on accruing cash values.
Your payment amount will stay the same, even if you change employment or retire.
Portability – Even if your employer changes, you can arrange to pay us directly and keep your coverage.
Builds cash value.
Coverage Issued – Employees and their spouses who are actively at work for a minimum of 20 hours per week can purchase this insurance up to certain limits, despite past or present health problems.
Annual statements provide current policy value information. Paid up options, based on accrued cash values. Our Whole Life workplace insurance is an endowment at age 95 policy, which means the face value would be paid to the insured, if living, at age 95.
Additional Purchase – If you buy a minimum amount of coverage, you guarantee yourself the right to purchase any remaining portion of the guaranteed issue limit at future approved enrollments (subject to product and payroll deduction availability). * The actual cash value may be decreased by loans or withdrawals.
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 1-877-342-5855 9
Voluntary Accident Insurance Runk & Pratt provides you the option to purchase Voluntary Group Accident Insurance through Boston Mutual. Accident Insurance helps with out-of-pocket costs that arise when you have a covered accident such as fracture, dislocation, or laceration. Listed below are examples of some conditions that would qualify under the Voluntary Group Accident Insurance. Please refer to the official plan documents for a full list of covered injuries and expenses. $50 health screening benefit per insured (paid upon completion of a preventative health exam - 30 Day waiting period from effective date to participate)
HOSPITAL CARE Hospital Admission: Within 6 months after the covered accident. Amount will be doubled if placed in a Hospital Intensive Care Unit within the first 24 hours of admission. Hospital Confinement: Per day up to 365 days. Within 6 months after the covered accident.
$2,000
Hospital Intensive Care Unit Confinement: Per day up to 30 days. Within 30 days after the covered accident
$1,000 $200
Lodging: Per day up to 30 days per covered accident for companion. Hospital must be more than 100 miles.
$500
EMEREGENCY ROOM $200
Emergency Room Treatment: Within 72 hours after a covered accident.
DIAGNOSTIC IMAGING Medical Imaging: For CT scan, MRI or EEG as the result of a covered accident.
$200
X-Rays: Payable for diagnosis and treatment of injuries received as the result of a covered accident.
$50
CONTINUING CARE Physician Follow-Up Care: Within 180 days of the covered accident. Payable twice per covered accident.
$100
MAJOR INJURY Accidental Death: Within 90 days from the date of a covered accident. $100,000 $100,000 $20,000
Employee Spouse Children
FRACTURES: Diagnosed by a physician within 90 days after the covered accident
Closed
Open
Skull - depressed fracture (except Bones of Face or Nose) Hip, Thigh (Femur) Leg Shoulder blade or Collarbone (Scapula, Clavicle, Sternum)
$5,000
$10,000
$3,000
$6,000
$1,600 $600
$3,200 $1,200
Coverage Level
Semi-Monthly Rates
Employee Only
$4.44
Employee + Spouse
$8.10
Employee + Child(ren)
$11.20
Employee + Family
$14.86
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Voluntary Critical Illness Insurance Runk & Pratt provides you the option to purchase Voluntary Group Critical Illness Insurance through Boston Mutual. Group Critical Illness Insurance can help with the treatment costs of covered critical illnesses upon initial diagnosis. This plan provides a lump sum benefit paid upon the diagnosis and treatment of a covered illness. Please refer to the official plan documents for a full list of covered conditions and benefits.
Plan Benefits: Initial Occurrence Benefit: Lump Sum Benefits payable upon initial diagnosis of a covered illness or condition. Employee benefit amounts are available from $5,000 to $25,000
Additional Occurrence Benefit: In an insured collects benefits for a Critical Illness under the plan and later has one of the remaining covered illnesses/procedures, then we will pay the benefit amount for each additional illness provided the occurrences are seperated by at least 6 months.
Re-Occurrence Benefit: In an insured collects benefits for a covered condition and is later diagnosed with the same condition, we will pay the benefit again provided that the two dates of diagnosis are seperated by at least 6 months. (12 months treatment free for Cancer/Carcinoma in situ). Covered Specified Critical Illnesses
Percent of Benefit
Cancer Carcinoma in situ Skin Cancer Heart Attack (Myocardial Infarction) Coronary Artery Bypass Surgery Angioplasty & Stent Insertion Stroke (Apoplexy or Cerebral Vascular Accident) Coma Paralysis Severe Burns Major Organ Transplant Alzheimer’s Disease ALS (Lou Gehrig’s Disease) Loss of Sight/Speech/Hearing End Stage Renal Disease Benign Brain Tumor
100% 30%
$300 one-time (lifetime) 100% 30% 30% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
All covered conditions are subject to the definitions found in the employee’s certificate
Prior History of Cancer: No benefits are payable for Cancer or Carcinoma in Situ if the Insured was previously diagnosed before this Coverage was in force and, after the previous diagnosis, the Insured has not gone 12 months without Treatment before a new diagnosis of Cancer/Carcinoma in situ is made.
Health Screening Benefit: Boston Mutual will pay a $50 benefit if an insured has a covered screening test after the 30 day waiting period. This benefit is paid only once per calendar year, regardless of the number of tests. This benefit is paid regardless of the results of the test. Payment of this benefit will not reduce the amount payable for the diagnosis of a critical illness. This benefit is payable for the covered employee (and spouse if spouse coverage is included). This benefit is not paid for dependent children.
Employee Monthly Premium Employee $5,000 Issue Age Benefit
$10,000 Benefit
18-29 30-39 40-49 50-59 60-69
$3.92 $6.63 $11.62 $19.52 $32.94
$2.41 $3.77 $6.26 $10.21 $16.92
This coverage contains a 30 day Waiting Period. This means no benefits are payable for any Insured who has been diagnosed with a Specified Critical Illness during the Waiting Period.
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 1-844-743-7575 11
Additional Employee Benefits!
Benefit eligible Employees of Runk & Pratt have local benefits available to help save money on medical costs, dining, and leisure activities at no additional cost! Free Doctor services with Dr. Guzen (Available for all R&P Employees, subject to Dr. availability, located at Liberty Ridge)
Membership at Carilion Wellness at Smith Mountain Lake - (Free for Runk & Pratt Smith Mountain Lake Employees) 20% off R&P Golf Cafes 20% off Pool Memberships at all R&P Golf Clubs 20% off all Merchandise, Apparel & Accessories (some exclusions may apply; cannot be combined with other discounts) Opportunity for Continuing Education Kirkley Hotel - special room rate for employees (subject to availability, blackout dates may apply) Employee Assistance Program - professional counseling and referral service to help you with your personal, job or family problems. Tickets to Liberty University Sporting Events including - Football, Basketball, Baseball, & Hockey (on request when available)
*Subject to Change
Revision Date: 11/5/2019
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Important Contact Information If you have any questions regarding your benefits or the material contained in this guide, please contact your Human Resources Representative. Insurance Carrier/Plan
Contact Number
Website
Piedmont Medical Insurance:
1-800-400-7247
www.pchp.net
Companion Life Dental Insurance:
1-800-753-0404
www.Companionlife.com
Companion Life Vision Insurance:
1-800-753-0404
www.Companionlife.com
Companion Life Short-Term Disability:
1-800-753-0404
www.Companionlife.com
Companion Life Voluntary Term Life:
1-800-753-0404
www.Companionlife.com
Boston Mutual Permanent Life:
1-800-669-2668
www.BostonMutual.com
Boston Mutual Accident:
1-800-669-2668
www.BostonMutual.com
Boston Mutual Critical Illness:
1-800-669-2668
www.BostonMutual.com
Runk & Pratt Resource Center:
1-877-342-5855
admin@beneficialassociates.com
This summary of benefits is not intended to be a complete description of the terms of Runk & Pratt’s insurance benefit plans. Please refer to the plan document(s) for a complete description. Each plan is governed in all respects by the terms of its legal plan document, rather than by this or any other summary of the insurance benefits provided by the plan. In the event of any conflict between a summary of the plan and the official document, the official document will prevail. Although Runk & Pratt maintains its benefit plans on an ongoing basis, Runk & Pratt reserves the right to terminate or amend each plan, in its entirety or in any part, at any time.
If you have any questions about your benefits please contact Beneficial Associates Resource Center 115 Goldenrod Place, Lynchburg, Virginia 24502 1-877-342-5855 13