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2012 Employee Benefits




   Presented by:
2012 Benefit Presentation
  •Benefit   Overview
  •How   Do I Choose the Right Medical Plan?
  •Other   Benefits
   Vision, Dental, Life, AD&D & Disability

  •Enrollment Timeframes




                                               2
2012 Benefit Overview
  •   Medical Coverage – Health Plus - ww.healthplus.org
        Cofinity PPO Network - www.cofinity.net
                                                  Cofinity is a large Network
  •   Health Savings Accounts - PNC Bank          of Providers that Health Plus
                                                  offers to PPO Plan
                                                  participants, making it easier
                                                  to stay In-Network when
  •   Flexible Spending Accounts - TASC           obtaining services.


  •   Vision – NVA (National Vision Administrators)

  •   Dental Coverage - Assurant

  •   Life and Disability Coverage - Mutual of Omaha

                                                                                   3
How To Choose the Right Medical Plan?
   e    Cost per pay check (Pre-tax)

   c    Risk (Potential Out-Of-Pocket Cost), Plan Type & Design
        a. Provider Network & Access to Care
               Health Plus (HMO)
               Cofinity (PPO)

        b. Coverage Type & Plan Detail
               HMO (in-network ONLY)
               PPO (in and out-of-network coverage)
               High Deductible Health Plan (w/HSA)
               Standard Plan (w/FSA)

   3.   Health Care Spending Options (Pre-tax)
           HSA (Health Savings Account)
           FSA (Flexible Spending Account)


                                                                  4
How Much Does it Cost?
                        Standard           HSA

                          2012             2012
          Enrollment     Health Plus     Health Plus
  HMO
            Status     Standard HMO    HDHP HMO HSA
                        Cost Per Pay    Cost Per Pay

        Single            $64.49          $21.26
        2 Person         $142.59          $45.33
        Family           $170.94          $54.22


                          2012             2012
         Enrollment     Health Plus      Health Plus
  PPO      Status      Standard PPO    HDHP PPO HSA
                        Cost Per Pay    Cost Per Pay

        Single            $73.91          $42.05
        2 Person         $163.78          $92.10
        Family           $196.36          $110.35




                                                       5
Choosing the Right Plan:
PPO vs. HMO
   PPO Coverage
                                                                                         Find providers at
   Inand Out-of-network benefits available                                              www.cofinity.net
   No primary care physician required
   Higher per pay check cost than HMO




   HMO Coverage                                                                          Find providers at
   In-network                                                                          www.healthplus.org
              benefits ONLY
   Must choose a primary care physician
   Referrals      Required (12 month option)
   Less per pay check cost than PPO
   Large provider network throughout Michigan

   *Preventive care available in all plan options at no cost to the employee (no max; no copay)
   *Adult children up to age 26 can be covered regardless of student, marital or earnings status.
Choosing the Right Plan:
HDHP w/HSA
      2 Options: HMO or PPO

      Plans require deductibles be met in full prior to coverage
       (except for preventive care at 100%)

      Coinsurance & Rx co-pay begin AFTER deductible is met

      All out-of-pocket expenses accumulate to maximum out-of- pocket

      Contracts with two or more MUST meet full Family deductible amount
       before coverage begins (except for preventive care).




                                                                            7
HDHP (w/HSA)                              Plans require copays for Rx, office visits,
                                          ER visits, etc., AFTER Deductible that
PPO or HMO                                DO count to out-of-pocket maximum.

                       HMO (HealthPlus)                                    PPO
                          In-Network                     In-Network               Out-of-Network
                                                           Cofinity
   Deductible             $2000/$4000                    $2,500/$5,000             $10,000/$20,000
   Coinsurance                 80%                            90%                        70%
   Coinsurance            $2,000/$4,000                  $2,500/$5,000             $10,000/$20,000
   Maximum
   Preventive Health          100%                           100%                70% of Reasonable and
   Services                                                                       Customary Charges
   Office Visits           $15 Copay                       $5 Copay                      70%
                         After Deductible               After Deductible           After Deductible
   Specialist Office       $15 Copay                          90%                        70%
   Visits                After Deductible               After Deductible           After Deductible
   Emergency Room          $100 Copay                         90%                        90%
                         After Deductible               After Deductible           After Deductible
   Urgent Care              $50 Copay                         90%                        90%
   Facility Services     After Deductible               After Deductible           After Deductible
   In-Patient                  80%                            90%                        90%
   Hospital              After Deductible               After Deductible           After Deductible
                            *See Details in Access Point                                                 8
HDHP(w/HSA)
PPO or HMO:


   Prescription Drug Coverage
   Prescription   drug coverage is based on the use of a medication
   formulary
   Copays   apply to each prescription you fill (AFTER deductible is met):
      o $15 for Generic drugs
      o $60 for Brand Name drugs

   Contraceptive    drugs and implantable contraceptive drugs are included
   Prescription   Mail Order
      o $30 for Generic drugs/$120 for Brand Name
      o Filled for up to 90 days




                                                                              9
What is a Health Savings Account?
     Two components that work
     together to meet our                                                          HDHP

     personal healthcare needs.                     $$
                                                                                  Member




                                                                                                  Preventive Care 100%
                                                     Deductible & Coinsurance
                                                                                Responsibility
     Health Deductible Health Plan
     (HDHP)                                                                         HSA
        Preventive care covered 100%

     Health Savings Account (HSA)
      Employee allocates to HSA
      Employee controls HSA
      deposit balance to receive Olga’s
You must May roll$1/monthover at year-end                                       2012 HSA Limits
contribution of $20, $40, or $60 /month into your                                Single: $3,100
HSA, based on enrollment status.                                                 Family: $6,250
                                                                                Age 55+: $1,000
                                                                                                                         10
Eligible Expenses with HSA
  Most out-of-pocket health care expenses:

  •Deductibles & Coinsurance
  •Medical, Dental and Vision
  •Prescription drug costs
  •Some over-the-counter medications
          (with prescription)
  •COBRA and Medicare premiums
  •Qualified long-term care insurance and expenses


                         *Remember*
                         What is not used,
                   rolls over to the next year!
                                                     11
HMO or PPO                             Plans require copays for Rx, office visits,
                                       ER visits, etc., that do NOT count toward
                                       maximum out-of-pocket.
Standard Plans
                               HMO (HealthPlus)                               PPO
                                   In-Network               In-Network              Out-of-Network
                                                              Cofinity
    Deductible                      $750/$1,500             $1,500/$3,000             $3,000/$6,000
    Coinsurance                         80%                      80%                       60%
    Coinsurance Maximum            $3,000/$6,000            $3,000/$6,000             $6,000/$12,000
    Preventive Health                  100%                     100%            60% of Reasonable and
    Services                                                                     Customary Charges
    Office Visits                   $20 Copay                $20 Copay                     60%
                                                                                     After Deductible
    Specialist Office Visits        $20 Copay                $40 Copay                     60%
                                                                                     After Deductible
    Emergency Room                  $100 Copay               $100 Copay                    80%
                                                                                     After Deductible
    Urgent Care Facility            $35 Copay                $50 Copay                     60%
    Services                                                                         After Deductible
    In-Patient Hospital                 80%                      80%                       60%
                                  After Deductible         After Deductible          After Deductible
    Prescription Copay                $10/$40                  $15/$50                    $15/$50
    Mail Order 2X, 90 Day                                                           Pay & Receive Reim.
                                  *See Details in Access Point                                            12
Flexible Spending Accounts

     Health Care Reimbursement Account - $4,000
                                                               These are “use it or lose
      Funded with pre-tax payroll deductions
                                                              it” accounts, so please be
      Covers medical, prescription drug, dental and vision.     conservative with your
                                                                      elections.
     Dependent Care Reimbursement Account - $5,000
      Funded with pre-tax payroll deductions




          You must deposit $1/month to receive Olga’s
          contribution of $20, $40, or $60 /month into
          your FSA, based on enrollment status.




                                                                                           13
Vision Summary
National Vision Administrators
                                             In-Network                         Out-of-Network

     Exam                                  Covered 100%                       (Reimbursed Amounts)
     Once Every 12 Months                 After $10 Co-pay                         Up to $52
     Lenses                            Standard Glass or Plastic              Single Vision Up to $55
     Once Every 12 Months                   Covered 100%                         Bi-focal Up to $75
                                           After $25 Copay                      Tri-focal Up to $95
                                                                               Lenticular Up to $125

     Frame                                Covered up to $130                        Up to $80
     Once Every 24 Months                   Retail Allowance
                                (Additional discount on the balance may
                                        apply at some providers)

     Contact Lenses                             Elective:                           Elective:
     Once Every 12 Months        Covered Up to $130 Retail Allowance               Up to $130
                                (Additional discount on the balance may
                                        apply at some providers)              Medically Necessary:
                                                                                      $210
                                       Medically Necessary:
                                         Covered at 100%                    Visit www.e-nva-com

                                              To Find an NVA Provider:
                            https://www.e-nva.com/nva/content/tourist/JSFPEntryTouristPage.jsf
                                     Sample Group/Sponsor Number: 50981000101
                                                                                                        14
Dental – Assurant PPO
  HIGH PLAN                       In-Network                  Non-network
  Deductible                           $0                        $50/$150

  Type I                             100%                  100% after deductible
                           Not Applied to Annual Max   Not Applied to Annual Max

  Type II                             90%                   80% after deductible
  Type III*                           60%                   50% after deductible
  Annual Maximum                     $1000                         $700
  Reasonable & Customary          Fee Schedule                 90th percentile


  LOW MAC PLAN                    In-Network                  Non-network
  Deductible                        $50/$150                    $100/$300

   Type I                           100%                            70%
                                 No Deductible
  Type II                      80% after deductible         50% after deductible

  Type III                     60% after deductible         20% after deductible

  Annual Maximum                      $700                         $500
  Reasonable & Customary        PPO Fee Schedule       45% less than PPO Fee Schedule
                                                                                        15
How Much Does it Cost?


                    2012                           2012
   Enrollment   NVA Vision Plan   Enrollment   Assurant Dental
     Status      Cost Per Pay       Status        High Plan
                                                Cost Per Pay
   Single           $2.75         Single           $8.47
   2 Person         $4.95         2 Person         $17.44
   Family           $7.15         Family           $29.71

                                                   2012
                                  Enrollment   Assurant Dental
                                    Status      Low Mac Plan
                                                Cost Per Pay

                                  Single           $3.10
                                  2 Person         $7.43
                                  Family          $15.43



                                                                 16
Life & Accidental Death &
Dismemberment – Mutual of Omaha

      Core Life & AD&D benefit provided
       by Olga’s at no cost to you.
       ◦ Benefit is 1X annual salary to $50,000


      Voluntary Coverage (Life Only)
       ◦ Up to 5X base annual earnings in increments of $10,000
       ◦ All increases in coverage require evidence of insurability


      Voluntary Dependent Life Available

                                                                      17
Disability
Mutual of Omaha
   Short-Term Disability
   60% of weekly earnings to a maximum of $500
   Payable on the 8th day for up to12 weeks
   Company Paid




   Long-Term Disability
   60% of monthly earnings to a maximum of $5,000
   Payable on the 90th day
   Company Paid




                                                     18
Access Point
 Convenient Online Enrollment




                 ins:
            t Beg re
       men
E nroll te of Hi :
        a          ds
  O n D ent E n s
        llm         k
   Enro n 2 Wee
          i
    With



                        Benefits become active the first of the month following 30
                        days of full time employment.

                        An HR Representative will contact you with enrollment
                        details.
                                                                                     19
Questions?
  Please Contact:
    Roni Pittiglio
    roni.pittiglio@olgaskitchen.com
    (248) 362-9398

    Lisa Procter
    lisa.procter@olgaskitchen.com
    (248) 362-9377



                     Thank You!
                                      20
Carrier Contact Information
       MEDICAL & RX              VISION
                                 NVA – National Vision Administrators
       Health Plus
                                 800-672-7723
       (800) 332-9161            service@e-nva.comwww.e-nva.com
       www.healthplus.org        Claims Adress:
       www.cofinity.net          P.O. Box 2187
                                 Clifton, NJ 07015
       Claims Address:
       P.O. Box 1700             LIFE & DISABILITY
       Flint, MI 48501-1700      Mutual of Omaha
                                 (800) 775-1000
       Mail Order Drugs          www.mutualofomaha.com
       Express Scripts           Claims Address:
       (877) 322-8471            Mutual of Omaha Insurance Company
       www.express-scripts.com   Mutual of Omaha Plaza
                                 Omaha, NE 68175

                                 DENTAL
                                 Assurant Employee Benefits
                                 (800) 733-7879
                                 www.assurantemployeebenefits.com
       HEALTH SAVINGS ACCOUNTS   Claims.dental@assurant.com
       PNC Bank                  Claims Address:
       (866) 622-3946            PO BOX 2940
       www.pnc.com               Clinton, IA 52733

       Claims Address:           FLEXIBLE SPENDING ACCOUNTS
       PO BOX 1234               TASC
       Pittsburgh, PA 52733      (800) 422-4661
                                 www.tasconline.com
                                 Claims Address:
                                 FSA Reimbursement
                                 PO BOX 7308
                                 Madison, WI 53707-7308

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2012 olga's new hire presentation vo

  • 1. 2012 Employee Benefits Presented by:
  • 2. 2012 Benefit Presentation •Benefit Overview •How Do I Choose the Right Medical Plan? •Other Benefits Vision, Dental, Life, AD&D & Disability •Enrollment Timeframes 2
  • 3. 2012 Benefit Overview • Medical Coverage – Health Plus - ww.healthplus.org Cofinity PPO Network - www.cofinity.net Cofinity is a large Network • Health Savings Accounts - PNC Bank of Providers that Health Plus offers to PPO Plan participants, making it easier to stay In-Network when • Flexible Spending Accounts - TASC obtaining services. • Vision – NVA (National Vision Administrators) • Dental Coverage - Assurant • Life and Disability Coverage - Mutual of Omaha 3
  • 4. How To Choose the Right Medical Plan? e Cost per pay check (Pre-tax) c Risk (Potential Out-Of-Pocket Cost), Plan Type & Design a. Provider Network & Access to Care  Health Plus (HMO)  Cofinity (PPO) b. Coverage Type & Plan Detail  HMO (in-network ONLY)  PPO (in and out-of-network coverage)  High Deductible Health Plan (w/HSA)  Standard Plan (w/FSA) 3. Health Care Spending Options (Pre-tax)  HSA (Health Savings Account)  FSA (Flexible Spending Account) 4
  • 5. How Much Does it Cost? Standard HSA 2012 2012 Enrollment Health Plus Health Plus HMO Status Standard HMO HDHP HMO HSA Cost Per Pay Cost Per Pay Single $64.49 $21.26 2 Person $142.59 $45.33 Family $170.94 $54.22 2012 2012 Enrollment Health Plus Health Plus PPO Status Standard PPO HDHP PPO HSA Cost Per Pay Cost Per Pay Single $73.91 $42.05 2 Person $163.78 $92.10 Family $196.36 $110.35 5
  • 6. Choosing the Right Plan: PPO vs. HMO PPO Coverage Find providers at Inand Out-of-network benefits available www.cofinity.net No primary care physician required Higher per pay check cost than HMO HMO Coverage Find providers at In-network www.healthplus.org benefits ONLY Must choose a primary care physician Referrals Required (12 month option) Less per pay check cost than PPO Large provider network throughout Michigan *Preventive care available in all plan options at no cost to the employee (no max; no copay) *Adult children up to age 26 can be covered regardless of student, marital or earnings status.
  • 7. Choosing the Right Plan: HDHP w/HSA  2 Options: HMO or PPO  Plans require deductibles be met in full prior to coverage (except for preventive care at 100%)  Coinsurance & Rx co-pay begin AFTER deductible is met  All out-of-pocket expenses accumulate to maximum out-of- pocket  Contracts with two or more MUST meet full Family deductible amount before coverage begins (except for preventive care). 7
  • 8. HDHP (w/HSA) Plans require copays for Rx, office visits, ER visits, etc., AFTER Deductible that PPO or HMO DO count to out-of-pocket maximum. HMO (HealthPlus) PPO In-Network In-Network Out-of-Network Cofinity Deductible $2000/$4000 $2,500/$5,000 $10,000/$20,000 Coinsurance 80% 90% 70% Coinsurance $2,000/$4,000 $2,500/$5,000 $10,000/$20,000 Maximum Preventive Health 100% 100% 70% of Reasonable and Services Customary Charges Office Visits $15 Copay $5 Copay 70% After Deductible After Deductible After Deductible Specialist Office $15 Copay 90% 70% Visits After Deductible After Deductible After Deductible Emergency Room $100 Copay 90% 90% After Deductible After Deductible After Deductible Urgent Care $50 Copay 90% 90% Facility Services After Deductible After Deductible After Deductible In-Patient 80% 90% 90% Hospital After Deductible After Deductible After Deductible *See Details in Access Point 8
  • 9. HDHP(w/HSA) PPO or HMO: Prescription Drug Coverage Prescription drug coverage is based on the use of a medication formulary Copays apply to each prescription you fill (AFTER deductible is met): o $15 for Generic drugs o $60 for Brand Name drugs Contraceptive drugs and implantable contraceptive drugs are included Prescription Mail Order o $30 for Generic drugs/$120 for Brand Name o Filled for up to 90 days 9
  • 10. What is a Health Savings Account? Two components that work together to meet our HDHP personal healthcare needs. $$ Member Preventive Care 100% Deductible & Coinsurance Responsibility Health Deductible Health Plan (HDHP) HSA  Preventive care covered 100% Health Savings Account (HSA)  Employee allocates to HSA  Employee controls HSA  deposit balance to receive Olga’s You must May roll$1/monthover at year-end 2012 HSA Limits contribution of $20, $40, or $60 /month into your Single: $3,100 HSA, based on enrollment status. Family: $6,250 Age 55+: $1,000 10
  • 11. Eligible Expenses with HSA Most out-of-pocket health care expenses: •Deductibles & Coinsurance •Medical, Dental and Vision •Prescription drug costs •Some over-the-counter medications (with prescription) •COBRA and Medicare premiums •Qualified long-term care insurance and expenses *Remember* What is not used, rolls over to the next year! 11
  • 12. HMO or PPO Plans require copays for Rx, office visits, ER visits, etc., that do NOT count toward maximum out-of-pocket. Standard Plans HMO (HealthPlus) PPO In-Network In-Network Out-of-Network Cofinity Deductible $750/$1,500 $1,500/$3,000 $3,000/$6,000 Coinsurance 80% 80% 60% Coinsurance Maximum $3,000/$6,000 $3,000/$6,000 $6,000/$12,000 Preventive Health 100% 100% 60% of Reasonable and Services Customary Charges Office Visits $20 Copay $20 Copay 60% After Deductible Specialist Office Visits $20 Copay $40 Copay 60% After Deductible Emergency Room $100 Copay $100 Copay 80% After Deductible Urgent Care Facility $35 Copay $50 Copay 60% Services After Deductible In-Patient Hospital 80% 80% 60% After Deductible After Deductible After Deductible Prescription Copay $10/$40 $15/$50 $15/$50 Mail Order 2X, 90 Day Pay & Receive Reim. *See Details in Access Point 12
  • 13. Flexible Spending Accounts  Health Care Reimbursement Account - $4,000 These are “use it or lose Funded with pre-tax payroll deductions it” accounts, so please be Covers medical, prescription drug, dental and vision. conservative with your elections.  Dependent Care Reimbursement Account - $5,000 Funded with pre-tax payroll deductions You must deposit $1/month to receive Olga’s contribution of $20, $40, or $60 /month into your FSA, based on enrollment status. 13
  • 14. Vision Summary National Vision Administrators In-Network Out-of-Network Exam Covered 100% (Reimbursed Amounts) Once Every 12 Months After $10 Co-pay Up to $52 Lenses Standard Glass or Plastic Single Vision Up to $55 Once Every 12 Months Covered 100% Bi-focal Up to $75 After $25 Copay Tri-focal Up to $95 Lenticular Up to $125 Frame Covered up to $130 Up to $80 Once Every 24 Months Retail Allowance (Additional discount on the balance may apply at some providers) Contact Lenses Elective: Elective: Once Every 12 Months Covered Up to $130 Retail Allowance Up to $130 (Additional discount on the balance may apply at some providers) Medically Necessary: $210 Medically Necessary: Covered at 100% Visit www.e-nva-com To Find an NVA Provider: https://www.e-nva.com/nva/content/tourist/JSFPEntryTouristPage.jsf Sample Group/Sponsor Number: 50981000101 14
  • 15. Dental – Assurant PPO HIGH PLAN In-Network Non-network Deductible $0 $50/$150 Type I 100% 100% after deductible Not Applied to Annual Max Not Applied to Annual Max Type II 90% 80% after deductible Type III* 60% 50% after deductible Annual Maximum $1000 $700 Reasonable & Customary Fee Schedule 90th percentile LOW MAC PLAN In-Network Non-network Deductible $50/$150 $100/$300 Type I 100% 70% No Deductible Type II 80% after deductible 50% after deductible Type III 60% after deductible 20% after deductible Annual Maximum $700 $500 Reasonable & Customary PPO Fee Schedule 45% less than PPO Fee Schedule 15
  • 16. How Much Does it Cost? 2012 2012 Enrollment NVA Vision Plan Enrollment Assurant Dental Status Cost Per Pay Status High Plan Cost Per Pay Single $2.75 Single $8.47 2 Person $4.95 2 Person $17.44 Family $7.15 Family $29.71 2012 Enrollment Assurant Dental Status Low Mac Plan Cost Per Pay Single $3.10 2 Person $7.43 Family $15.43 16
  • 17. Life & Accidental Death & Dismemberment – Mutual of Omaha  Core Life & AD&D benefit provided by Olga’s at no cost to you. ◦ Benefit is 1X annual salary to $50,000  Voluntary Coverage (Life Only) ◦ Up to 5X base annual earnings in increments of $10,000 ◦ All increases in coverage require evidence of insurability  Voluntary Dependent Life Available 17
  • 18. Disability Mutual of Omaha Short-Term Disability 60% of weekly earnings to a maximum of $500 Payable on the 8th day for up to12 weeks Company Paid Long-Term Disability 60% of monthly earnings to a maximum of $5,000 Payable on the 90th day Company Paid 18
  • 19. Access Point Convenient Online Enrollment ins: t Beg re men E nroll te of Hi : a ds O n D ent E n s llm k Enro n 2 Wee i With Benefits become active the first of the month following 30 days of full time employment. An HR Representative will contact you with enrollment details. 19
  • 20. Questions? Please Contact: Roni Pittiglio roni.pittiglio@olgaskitchen.com (248) 362-9398 Lisa Procter lisa.procter@olgaskitchen.com (248) 362-9377 Thank You! 20
  • 21. Carrier Contact Information MEDICAL & RX VISION NVA – National Vision Administrators Health Plus 800-672-7723 (800) 332-9161 service@e-nva.comwww.e-nva.com www.healthplus.org Claims Adress: www.cofinity.net P.O. Box 2187 Clifton, NJ 07015 Claims Address: P.O. Box 1700 LIFE & DISABILITY Flint, MI 48501-1700 Mutual of Omaha (800) 775-1000 Mail Order Drugs www.mutualofomaha.com Express Scripts Claims Address: (877) 322-8471 Mutual of Omaha Insurance Company www.express-scripts.com Mutual of Omaha Plaza Omaha, NE 68175 DENTAL Assurant Employee Benefits (800) 733-7879 www.assurantemployeebenefits.com HEALTH SAVINGS ACCOUNTS Claims.dental@assurant.com PNC Bank Claims Address: (866) 622-3946 PO BOX 2940 www.pnc.com Clinton, IA 52733 Claims Address: FLEXIBLE SPENDING ACCOUNTS PO BOX 1234 TASC Pittsburgh, PA 52733 (800) 422-4661 www.tasconline.com Claims Address: FSA Reimbursement PO BOX 7308 Madison, WI 53707-7308

Notas do Editor

  1. Employee Life Insurance: This is TERM insurance. Upon separation from the company, an employees insurance ends the day of separation. Dependent Life Insurance: Coverage includes spouse & child. If you have a spouse and no child, the insurance specifically covered only the spouse at the amount listed for the spouse. Basically the child coverage becomes non-existent if you do not have a child. This is a package deal and no separation is made between the spouse and child coverage's.