Welcome, Chariot Automotive Employees
Welcome, Chariot Automotive Employees
Our Employee Benefits And Wellness Program
Table Of Contents
To make your life easier, click on the topics below to go directly to that information:
Annual Notices: Under federal law, we are required to provide or have available specific benefit notices for your review. All annual notices are available on our benefit administration platform or from Human Resources. If you would like to review the Annual Notices now, please CLICK HERE.
Disclaimer: This benefit guide provides highlights of the benefits available. Please request a copy of the plan certificate for additional coverage details, limitations, exclusions and restrictions. If any conflict shall arise between this document and the plan certificate, the plan certificate will govern in all cases.
OPEN ENROLLMENT VIDEO
Welcome to our employee benefits program. We have designed a personalized video for you and your family to better understand all of the benefits offered to you.
At the same time, you’ll have an opportunity to meet the team from AHW that will be working with you. In addition to the video, we have designed the following benefit highlights to be user-friendly.
You can click on any topic you’re interested in vs having to scroll through the entire booklet.
ELIGIBILITY
Eligibility
Eligibility Definitions
Employee:
A full-time employee who is scheduled to work at least 30 hours per week
Dependent:
New Employees
As a new, full-time employee (working 30 or more hours per week), your benefits will become effective: the first of the month, after 60 days, following the date you start working.
Dependents are eligible to stay on a parent’s medical until the day they turn age 26, regardless of student status, employment status or marital status.
Spousal Exclusion
Our medical plan does have a spousal exclusion meaning that If you have a spouse that is able to obtain coverage through his/her employer or other means, they are not eligible to participate in our group health plan.
Qualifying Life Events
When one of the following events occurs, you have 30 days from the date of the event to notify human resources and/or request changes to your coverage:
Your change in coverage must be consistent with your change in status. Please direct questions regarding specific life events and your ability to request changes to human resources.
HOW TO ENROLL
ANNUAL OPEN ENROLLMENT
If you would like to make a change to your plan, you may do so during your open enrollment
12/8/2021 – 12/16/2021
HOW TO ENROLL
ANNUAL OPEN ENROLLMENT
If you would like to make a change to your plan, you may do so during your open enrollment.
12/8/2021 – 12/16/2021
We are using an online benefit administration system to capture your benefit elections. Our online enrollment systems is with Employee Navigator. It is simple, secure and can be done in a few minutes from any computer or smart device with internet access. After enrolling online, you will have access to your benefit information anytime, from any computer.
To get started, you will need:
Use your computer, smart phone or device to enroll using this company identifier:
ChariotAuto
Log On To Enroll
You will receive an email from noreply@employeenavigator.com that provides your registration link and company identifier code. To access employee navigator, you will need to enter the credentials you used when you originally registered with Employee Navigator. If you cannot remember your credentials, use the forget password or forgot username option on the login screen, then follow the prompts. An email will be sent to the email address you originally provided during your registration. Keep in mind, it could be your work email OR your personal email account.
Go to (or click) https://www.employeenavigator.com/benefits/Account/Login to login to Employee Navigator
MEDICAL BENEFITS
Choose the Plan that is Best for You and Your Family
We will continue to offer four medical plans to provide choice for you and your family.
Cigna Network
Cigna Network option will utilize the Cigna national network of providers. If you use an out-of-network provider your financial responsibility for the deductible, coinsurance and out-of-pocket maximum will be higher.
Also, we are very pleased to continue our wellness program in 2022. Our program is designed to give you choices, so it fits your lifestyle and includes your family. The health coaching team from American Health & Wellness will continue to provide support with weight management, nutrition, wellbeing, exercise and more.
Also, we are very pleased to continue our wellness program in 2022. Our program is designed to give you choices, so it fits your lifestyle and includes your family. The health coaching team from American Health & Wellness will continue to provide support with weight management, nutrition, wellbeing, exercise and more.
MEDICAL PLAN OPTIONS
Your employer offers 2 medical options:
Plans: (Scroll sideways to see all 2 plans)
| Network Benefits 1/1/2023 - 12/31/2023 | High Deductible Health Plan Core Your Responsibility | Traditional Plan Buy-Up Your Responsibility |
|---|---|---|
| Network Benefits 1/1/2023 - 12/31/2023 | High Deductible Health Plan Core Your Responsibility | Traditional Plan Buy-Up Your Responsibility |
| Annual Deductible (embedded) Individual | $4,000 | $2,000 |
| Annual Deductible (embedded) Family | $8,000 | $4,000 |
| Out-of-Pocket Maximum (including deductible, copays & coinsurance) - Individual | $4,000 | $4,000 |
| Out-of-Pocket Maximum (including deductible, copays & coinsurance) - Family | $8,000 | $8,000 |
| Coinsurance In | 0% | 30% |
| Office Visit Copays - Primary (PCP) | Deductible | $35 Copay |
| Office Visit Copays - Specialist | Deductible | $35 Copay |
| Prescription Drugs Retail/Mail Order Supply: 30/90 day - Tier 1: generic | Deductible | Deductible |
| Prescription Drugs Retail/Mail Order Supply: 30/90 day - Tier 2: brand | Deductible | Deductible |
| Prescription Drugs Retail/Mail Order Supply: 30/90 day - Tier 3: formulary | Deductible | Deductible |
| Medicare Part D Creditable Status (Creditable means the Rx plan is as good as Medicare Part D | Creditable | Creditable |
| Preventive Care (Routine Exams, Screening Colonoscopies, X-rays/Tests, Immunizations, Well Baby Care & Mammograms) | Covered at 100% | Covered at 100% |
| Emergency Room (Charges outside of the facility could be billed separately) | Deductible | Deductible, then 30% |
| Urgent Care (Charges outside of the facility could be billed separately) | Deductible | Deductible, then 30% |
| Inpatient Hospital | Deductible | Deductible, then 30% |
| Outpatient Surgery | Deductible | Deductible, then 30% |
| Network Benefits 1/1/2023 - 12/31/2023 | High Deductible Health Plan Core Your Responsibility | Traditional Plan Buy-Up Your Responsibility |
|---|---|---|
| Network Benefits 1/1/2023 - 12/31/2023 | High Deductible Health Plan Core Your Responsibility | Traditional Plan Buy-Up Your Responsibility |
| Annual Deductible (embedded) Individual | $4,000 | $2,000 |
| Annual Deductible (embedded) Family | $8,000 | $4,000 |
| Out-of-Pocket Maximum (including deductible, copays & coinsurance) - Individual | $4,000 | $4,000 |
| Out-of-Pocket Maximum (including deductible, copays & coinsurance) - Family | $8,000 | $8,000 |
| Coinsurance In | 0% | 30% |
| Office Visit Copays - Primary (PCP) | Deductible | $35 Copay |
| Office Visit Copays - Specialist | Deductible | $35 Copay |
| Prescription Drugs Retail/Mail Order Supply: 30/90 day - Tier 1: generic | Deductible | Deductible |
| Prescription Drugs Retail/Mail Order Supply: 30/90 day - Tier 2: brand | Deductible | Deductible |
| Prescription Drugs Retail/Mail Order Supply: 30/90 day - Tier 3: formulary | Deductible | Deductible |
| Medicare Part D Creditable Status (Creditable means the Rx plan is as good as Medicare Part D | Creditable | Creditable |
| Preventive Care (Routine Exams, Screening Colonoscopies, X-rays/Tests, Immunizations, Well Baby Care & Mammograms) | Covered at 100% | Covered at 100% |
| Emergency Room (Charges outside of the facility could be billed separately) | Deductible | Deductible, then 30% |
| Urgent Care (Charges outside of the facility could be billed separately) | Deductible | Deductible, then 30% |
| Inpatient Hospital | Deductible | Deductible, then 30% |
| Outpatient Surgery | Deductible | Deductible, then 30% |
Employee Payroll Contributions
Wellness Program
If you meet the Wellness Program goals, you will continue with lower payroll contributions.
Employee Weekly Payroll Contribution
Your weekly medical premium will be adjusted by the following amount:
Plans: (Scroll sideways to see all 4 plans)
| Description | High Deductible Health Plan or Traditional Plan NO Wellness Credit | High Deductible Health Plan or Traditional Plan With 1 Wellness Credit | High Deductible Health Plan or Traditional Plan With 2 Wellness Credits | High Deductible Health Plan or Traditional Plan With 3 Wellness Credits |
|---|---|---|---|---|
| Employee Only | +$20.00/week | -$3.50/week | -$7.00/week | -$20.00/week |
| Employee + Spouse | +$20.00/week | -$3.50/week | -$7.00/week | -$20.00/week |
| Employee + Child(ren) | +$20.00/week | -$3.50/week | -$7.00/week | -$20.00/week |
| Employee + Family | +$20.00/week | -$3.50/week | -$7.00/week | -$20.00/week |
| Description | High Deductible Health Plan or Traditional Plan NO Wellness Credit | High Deductible Health Plan or Traditional Plan With 1 Wellness Credit | High Deductible Health Plan or Traditional Plan With 2 Wellness Credits | High Deductible Health Plan or Traditional Plan With 3 Wellness Credits |
|---|---|---|---|---|
| Employee Only | +$20.00/week | -$3.50/week | -$7.00/week | -$20.00/week |
| Employee + Spouse | +$20.00/week | -$3.50/week | -$7.00/week | -$20.00/week |
| Employee + Child(ren) | +$20.00/week | -$3.50/week | -$7.00/week | -$20.00/week |
| Employee + Family | +$20.00/week | -$3.50/week | -$7.00/week | -$20.00/week |
Medical Resources GPA Support & Mobile App
You have questions about your benefits
Need help with a claim
Need to find a provider
One Number To Call
Our Member Care Team is ready to assist you no matter what you’re inquiring about: benefits information; assistance finding a doctor; or questions about a claim or bill. Your time is valuable, and we are committed to helping you get the most out of your health plan with just one call.
Complete Healthcare Guidance (Live & Digital Resources)
Get expert support to find the right provider for your needs. Compare providers based on quality metrics, cost and other information so that you can make an informed choice. Finally, no more random Internet searches – get real-time industry-leading data.
Health & Clinical Support
We will take care of your throughout your entire healthcare journey. Our team of experts will answer your questions and provide education regarding your treatment plan, diagnosis care options and medications. We can also assist you with scheduling appointments and obtaining your medical records.
GPATPA.com Website
Go to gpatpa.com and click on “Members” in the upper right hand corner of the homepage. You can then sign in or create an account to access all of your benefit information.
GPA provides an easy-to-navigate online portal and mobile app that gives you access to all of your key benefits information.
GPA Mobile App
Download the GPA Mobile App today through the Google Play Store or the Apple Store. Search for “Group Mobile Pension”, download the app for free, register and set up a user Id and password. It’s that simple!
Find A Cigna Provider
If you are choosing the Cigna Network option, you can find a provider at www.myCigna.com or call 1-800-716-2852 and GPA will help you.
BILLING SUPPORT
FIND A PROVIDER
My provider is stating that they don’t recognize my ID card. What do I do?
Explain that you have health benefits and request they call the number on your ID card to verify your eligibility status. You can call the same number if you have any difficulties.
What if a provider asks me to pay for my procedure upfront?
The only out-of-pocket expense you should pay, at the time of service, is a copay or deductible (if applicable). Please call the number on the back of your ID card to confirm amounts or if the facility will not perform treatment without additional funds.
Why is an Explanation of Benefits (EOB) so important?
When a claim is processed, an Explanation of Benefits or EOB will be sent to you and the provider. This EOB explains how your claim was processed. The most important area on the EOB is the Patient Responsibility.
Healthcare providers can have excessive markups, often way beyond what their actual costs are. A detailed audit will be performed to review your medical claims for any errors and overcharges to eliminate these excessive mark-ups and ensure you pay only what is allowed within your plan.
This helps save you money.
If a provider bills you for more than the amount they are sent, it is called a balance bill. To be clear, the provider is asking you to pay more than what the plan allows. If you receive a balance bill, call the phone number on your benefits ID card.
Telemedicine
Call 1-844-484-7362 or go to www.goseesam.com.
Included with all medical plans
Your health plan has partnered with United Concierge Medicine (also known as UCM) to provide you access to Emergency Medicine providers 24/7/365. These services can save you and your family valuable time and money by avoiding unnecessary trips to the doctor’s office, urgent care and ER. You and your covered dependents will have unlimited access to Emergency Medicine, Board Certified, compassionate Physicians and Physician Assistants via phone and secure video conference. They can diagnose, treat, prescribe medications when appropriate, order labs/diagnostic imaging and make recommendations to the best specialist in the area if needed. UCM does not replace your Primary Care Provider for well visits or any Specialist for a chronic illness/disease; however, for all other illness and injury, consider calling UCM first.
Download the UCMnow App as this is the best way to reach out for a consult whenever you need them. Complete your profile online now to save you time when you need this service. You can also go to www.GoSeeSam.com or call (844)484-7362.
Plan Information
Which plan is right for you?
| High Deductible Health Plan | Traditional Plan |
|---|---|
| High Deductible Health Plan | Traditional Plan |
| Lower Payroll Deductions | Higher Payroll Deductions |
| Deductible Applies First | Copays Apply First |
| Pre-Tax and Tax Benefits: contributions reduce your taxable income; enrollment in a Health Savings Account (HSA) also accrues savings that are tax-deferred and distributions for qualified medical expenses are tax-free. | Pre-Tax Benefit: contributions reduce your taxable income |
| Great way to save pre-tax dollars if you don’t expect significant health issues. | Manage your budget with copays if you expect to utilize the medical plan and have multiple prescriptions. |
Routine Preventive Exam
Our medical plans cover one annual preventive (wellness) examination at 100%, when no diagnostic issues are identified. Appropriate biometric screenings based on age or risk status are covered at 100%.
Upon any diagnosis, future tests and exams are not considered preventive.
Plan Information
What is an embedded deductible?
A medical plan with an embedded deductible tracks both the individual and family deductible. An individual with healthcare needs and family coverage will not have to meet the entire family deductible before the plan begins to pay for services.
Urgent Care Facility vs. Hospital Emergency Room
If you are faced with a sudden illness or injury, making an informed choice on where to seek medical care is crucial to your personal and financial well-being. Below are examples (not all inclusive) of when the Hospital Emergency Room should be used vs. an Urgent Care Facility. remember, certain Urgent Care conditions may be treatable without Telemedicine service.
Be sure to review the details about your financial responsibility when using a Hospital Emergency Room vs. an Urgent Care Facility. Be an informed consumer and know your benefit options. In an emergency, call 911 and go to the Hospital Emergency Room.
| Hospital Emergency Room This should be used for health conditions that require a high level of care. | Urgent Care Facility This is an extension of your primary care physician. |
|---|---|
| Hospital Emergency Room This should be used for health conditions that require a high level of care. | Urgent Care Facility This is an extension of your primary care physician. |
| Compound Fracture | Controlled bleeding |
| Deep Knife or Gunshot Wound | Diagnostic services (x-ray, lab tests) |
| Moderate to Severe Burns | Ear Infections |
| Poisoning or suspected poisoning | High fever or the flu |
| Seizures or loss of consciousness | Minor broken bones (toes, fingers) |
| Serious head, neck or back injuries | Severe sore throat or cough |
| Severe abdominal pain | Sprains or strains |
| Severe chest pain or difficulty breathing; Signs of heart attack or stroke | Skin rashes and infections |
| Suicidal or homicidal feelings | Urinary tract infections |
| Uncontrollable bleeding | Vomiting, diarrhea or dehydration |
Be sure to review the details about your financial responsibility when using a Hospital Emergency Room vs. an Urgent Care Facility. Be an informed consumer and know your benefit options. In an emergency, call 911 and go to the Hospital Emergency Room.
FSA & HSA
Flexible Spending Account
A Flexible Spending Account (FSA) allows you to set aside pre-tax payroll deductions to pay for out-of-pocket health care expenses such as deductibles, copays and coinsurance, as well as dependent care expenses. Depending on your health plan election, you may be eligible for a regular purpose FSA or a limited purpose FSA. Below outlines the differences:
Unused funds are lost each calendar year. Budget wisely, once you pledge your FSA payroll deduction, you cannot change it for the calendar year.
| Description | Regular Purpose Spending Account | Limited Purpose Spending Account |
|---|---|---|
| Description | Regular Purpose Spending Account | Limited Purpose Spending Account |
| Health Plan | Traditional Plan or Waiving Medical | High Deductible Health Plan |
| Qualified Expenses | Medical, Dental, Vision and Prescription with a doctor’s prescription | Dental and Vision |
| Tax Advantage | Pre-tax Contributions and Payments for Qualified Expenses | Pre-tax Contributions and Payments for Qualified Expenses; enrollment in a Health Savings Account (HSA) also accrues savings that are tax-deferred. |
| 2023 Contribution Limit | $3,050 | $3,050 |
| Dependent Care Spending Account | $5,000 | $5,000 |
BPC Benefits Debit Card
Grace Period – 90 Days
Our FSA plan has a 90 day grace period.
An FSA grace period is an extended period of
coverage at the end of every plan year that allows
you extra time to incur expenses to use your
remaining FSA balance after the close of the plan
year.
Online & Mobile App Capabilities
Visit www.bpcinc.com/participants/home or call (877) 272-8880
Health Savings Account
Your Health Savings Account (HSA) is tax free. The money in your account is yours to use to pay for eligible health care expenses when you are enrolled in a qualified high deductible health plan. Unused funds roll over year-to year.
What is a Health Savings Account?
A HSA is an individual health care bank account that you can use to pay out-of-pocket health care expenses with pre-tax dollars. You will own and administer your account and there are no “use it or lose it” restrictions like a Flexible Spending Account (FSA). HSAs allow you to save and “roll over” money if you do not spend it in the calendar year. The money is yours if you change health plans or jobs. You can open and fund a HSA when you meet the following guidelines:
| 2023 HSA Contribution Limits | ||
|---|---|---|
| Single | $3,850 | |
| Family | $7,750 | |
| Catch-up (ages 55+) | $1,000 | |
| The Internal Revenue Service (IRS) places a limit on the maximum contributions each year from yourself or any other contributor. | ||
Qualified Expenses
You can use your HSA funds to pay for medical, dental and vision expenses, i.e., surgery expenses, prescriptions, chiropractor, dental treatment, etc.
Non-qualified expenses will be taxed plus a 20% tax penalty under IRS regulations.
What is a Health Savings Account?
A HSA is an individual health care bank account that you can use to pay out-of-pocket health care expenses with pre-tax dollars. You will own and administer your account and there are no “use it or lose it” restrictions like a Flexible Spending Account (FSA). HSAs allow you to save and “roll over” money if you do not spend it in the calendar year. The money is yours if you change health plans or jobs. You can open and fund a HSA when you meet the following guidelines:
| 2023 HSA Contribution Limits | ||
|---|---|---|
| Single | $3,850 | |
| Family | $7,750 | |
| Catch-up (ages 55+) | $1,000 | |
| The Internal Revenue Service (IRS) places a limit on the maximum contributions each year from yourself or any other contributor. | ||
Qualified Expenses
You can use your HSA funds to pay for medical, dental and vision expenses, i.e., surgery expenses, prescriptions, chiropractor, dental treatment, etc.
Non-qualified expenses will be taxed plus a 20% tax penalty under IRS regulations.
PHARMACY BENEFITS
Our Pharmacy Benefit Manager is ProAct and is available 24/7/365 to help answer your pharmacy benefit questions whether it is for retail or mail order. The ProAct national retail network has over 66,000 pharmacies in the United States.
Mail Order Pharmacy Advantages
The Southern Scripts app includes access to:
Submitting a New Prescription:
E-Prescribing: Physician Can Call ProAct Mail Order: 1-866-287-9885
Via Mail: Print and complete an order form by clicking here to download (PDF)
Via Fax: Your physician’s office can fax new prescriptions to: 1-315-287-3330
FIND A PHARMACY
www.proactrx.com
1-877-635-9545
Important Things To Know About Your Pharmacy Benefits
| Prior Authorization | Generic Drugs |
|---|---|
| Prior Authorization | Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered under your medical plan. Even if a drug is listed or on a formulary, you should check your schedule of benefits to verify it is a covered benefit. |
| Generic Drugs | When a patent or exclusivity expires on a Food and Drug Administration (FDA)-approved drug, other companies can make the drug in a generic form. The FDA requires generic drugs have the same high quality, strength, purity and stability as brand-name drugs. On average, the cost of a generic drug is 80-85% lower than the brand -name equivalent. |
| Generic Drugs |
|---|
| Prior Authorization: Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered under your medical plan. Even if a drug is listed or on a formulary, you should check your schedule of benefits to verify it is a covered benefit. |
| Generic Drugs: When a patent or exclusivity expires on a Food and Drug Administration (FDA)-approved drug, other companies can make the drug in a generic form. The FDA requires generic drugs have the same high quality, strength, purity and stability as brand-name drugs. On average, the cost of a generic drug is 80-85% lower than the brand -name equivalent. |
Save Money On Your Prescriptions
This is a discount program and does not apply to your deductible or coinsurance.
CanaRx Savings Program
CanaRx Savings Program is a voluntary international prescription drug program available to eligible members and their dependents enrolled in a traditional plan with ProAct.
Program Savings: All member copayments have been waived for this program only.
Ordering Instructions: To place your first order, please submit a completed enrollment form; a new prescription for each medication; and a copy of your photo identification.*
Ask your doctor for a prescription for a 3 month supply with 3 refills. CanaRx will call you prior to each renewal to ensure that you have a continuous supply. Please allow 4 weeks for delivery.
*Similar to a number of states in the US, some CanaRx pharmacies require a copy of photo ID be provided prior to dispensing the medications. In order to prevent order delays, we encourage patients to include a clear copy of their photo identification with their enrollment form or upload directly to our secure site www.CanaRxDocs.com. If not included, a CanaRx representative will contact you when required by the pharmacy dispensing your medication.
Medications must be tried for 30 days before ordering through CanaRx Savings Program.
RETURN YOUR COMPLETED AND SIGNED ENROLLMENT FORM AND ORIGINAL PRESCRIPTIONS:
Fax: 1-866-715-MEDS (6337)
Faxed prescriptions are ONLY accepted if sent directly from the physician’s office.
Mail: CanaRx Savings Program
235 Eugenie St. West, Suite 105D, Windsor, ON Canada N8X 2X7
OR
P.O. Box 3009, Windsor, ON Canada N8N 2M3
Forms Available:
www.CanaRxSavingsProgram.com OR by contacting Customer Services at 1-866-893-6337
WELLNESS PROGRAMS & SERVICES
Wellness Disclaimer: Before beginning any health and wellness program, you should seek the advice of your physician or other qualified health provider with any questions that you may have regarding a medical condition or potential medical condition. Also, you should never disregard professional medical advice, or delay seeking medical advice or treatment. Any wellness program participant further understands that the recommendations made to you by the American Health & Wellness Group Health Coach is not intended to diagnose, treat, prescribe, cure or prevent any disease.
Your Health Coaching Team
American Health & Wellness health coaches are graduates of accredited colleges with bachelor degrees in nursing, kinesiology, exercise science and have a collection of certifications amongst them, i.e., Certified Integrative Nutritional Health Coach; Lifestyle Health Coaching; Wellcoaches® Health & Wellness Coach; ACSM Certified Exercise Physiologist; Certified Health Coach through Health Coaching Institute and Certified Stress Management Coach (CSMC).
What Is Health Coaching?
Your Health Coach will provide wellness education on a variety of subjects via seminars, videos, social media, group coaching circles and challenges. The information should empower and inspire you to make choices that improve your physical, mental and emotional wellbeing!
Your Health Coach cares about you and is here to partner with you to maximize your personal strengths. Support will be provided to create action steps to support achieving your health goals. Motivation, positivity and wellbeing will be the focus for health improvement and maintenance.
Seminars
Monthly seminars are engaging, inspiring and relevant and FUN! Seminars will be available for viewing either virtually or recorded. If you miss a seminar you can contact your health coach for the recorded version.
Challenges
Several times a year, we will be offering challenges using the MoveSpring app. We will be focused on activity, nutrition, positive support and fun. Best of all, there will be prizes! Your spouse is welcome to join!
Group Coaching
Group coaching circles are a safe place to connect with others who have the same goal in mind as you. Facilitated by your Health Coach, group coaching has proven results in providing momentum to help you manage and meet your goals. The meetings are held 16 times a month at different times and days for your convenience. Your health coach will text you the link to join.
Text Reminders From Your Health Coach
Your American Health & Wellness Health Coach will text you reminders of upcoming seminars, challenges & group coaching circles. Add AHW Texts to your contacts: (765) 256-6400.
Social Media Community
With our closed Facebook group, you will want to stay informed and connected. And, have a safe place to share your successes! The coaches post weekly interesting articles, recipes, and relevant news about your company’s wellness program! Don’t hesitate to share your wellness journey with us!
Wellness Credit #1
Wellness Physical Exam
Visit your physician for a wellness physical exam AND submit the results form to your AHW health coach by 5/31/2023 to keep your credit for 2023.
Wellness Credit #2
Monthly Wellness Activities
From 1/1/2023—5/31/2023, participate in one wellness activity every month to keep your wellness credit.
From 6/1/2023-10/31/2023, participate in one wellness activity every month to earn your wellness credit for 2024.
Wellness activities include:
Seminars, Group Coaching Circles and Challenges
Wellness Credit #3
Non-Nicotine User
Must not use any nicotine products and must be nicotine free for six months or complete a nicotine cessation program and receive a certificate of completion.
Wellness activities include:
Contact your health coach for information about nicotine cessation programs.
New Hires
We are glad you have joined our team. If you enroll in the medical plan, you will automatically receive the wellness credits applied to your medical premium upon your effective date.
To keep your wellness credits for 2024, you will need to complete the criteria in the New Hire grid.
| New Hire Grid | ||||
|---|---|---|---|---|
| New Hires | Hired Before 8/1/2023 | Hired After 8/1/2023 | ||
| Wellness Credit #1 Wellness Physical Exam | To keep credit, turn in your exam results by 10/31/2023. | To keep credit, turn in your exam results by 5/31/2024. | ||
| Wellness Credit #2 Activity | To keep credit, participate in a monthly activity. Deadline is 10/31/2023. | To keep credit, participate in a monthly activity. Deadline is 5/31/2024. | ||
| Wellness Credit #3 Non-Nicotine User | Submit proof of non-nicotine usage by 5/31/2024. | To keep credit, submit proof of non-nicotine usage by 5/31/2024. | ||
Confidentiality
To protect your privacy and protected health information, American Health & Wellness Group (AHW) administers our wellness program. All health coaches are HIPAA (Health Insurance Portability and Accountability Act) certified. This means the information you share with your health coach is private and secure.
Nicotine Cessation
If you are a current nicotine user and ready to quit, there are options available to help.
Take Charge
Taking charge of your health starts with getting your annual, preventive exam to know your biometric numbers. Your weight, cholesterol, blood pressure and blood glucose numbers are key indicators of health. Your health coach will help you review your physician results and help create a lifestyle plan if you need to improve your numbers.
DENTAL BENEFIT SUMMARY
(Scroll sideways to see all options)
| Benefit Summary | In-Network | ||
|---|---|---|---|
| Benefit Summary | In-Network | ||
| Preventive Expenses | > Exams and cleanings (two per calendar year) > X-rays (full mouth once/24 months) > Fluoride treatment to age 18 (once/year) > Sealants to age 16 (once/36 months) > Space maintainers to age 15 | Covered at 100% | |
| Basic Expenses | > Fillings > Periodontal maintenance (once/3 months) > Periodontal services > Endodontic services (root canal) > General anesthesia > Bridges and dentures | Covered at 80% | |
| Major Expenses | > Bridges & dentures > Single crowns > Complex extractions > Periodontal surgery > Inlays, onlays & veneers | Covered at 50% | |
| Deductible | Single Family | $50 $150 | |
| Calendar Year Maximum | Per Person | $1,000 | |
| Orthodontia | Dependent Children Only | $1,000 Lifetime Maximum Covered at 50% | |
| Out-Of-Network | Employees using out-of-network providers may be responsible for the difference between the discounted PPO fees and the out-of-network dentist’s regular fees for the services performed. | ||
| Benefit Summary | In-Network | ||
|---|---|---|---|
| Benefit Summary | In-Network | ||
| Preventive Expenses | > Exams and cleanings (two per calendar year) > X-rays (full mouth once/24 months) > Fluoride treatment to age 18 (once/year) > Sealants to age 16 (once/36 months) > Space maintainers to age 15 | Covered at 100% | |
| Basic Expenses | > Fillings > Periodontal maintenance (once/3 months) > Periodontal services > Endodontic services (root canal) > General anesthesia > Bridges and dentures | Covered at 80% | |
| Major Expenses | > Bridges & dentures > Single crowns > Complex extractions > Periodontal surgery > Inlays, onlays & veneers | Covered at 50% | |
| Deductible | Single Family | $50 $150 | |
| Calendar Year Maximum | Per Person | $1,000 | |
| Orthodontia | Dependent Children Only | $1,000 Lifetime Maximum Covered at 50% | |
| Out-Of-Network | Employees using out-of-network providers may be responsible for the difference between the discounted PPO fees and the out-of-network dentist’s regular fees for the services performed. | ||
Dental Employee Bi-Weekly Contribution
| Dental Care | ||
|---|---|---|
| Dental - Your Weekly Contribution | ||
| Employee Only | $2.94 | |
| Employee + Spouse | $5.72 | |
| Employee + Child(ren) | $6.99 | |
| Employee + Family | $9.76 | |
| Dental Care | ||
|---|---|---|
| Dental - Your Weekly Contribution | ||
| Employee Only | $2.94 | |
| Employee + Spouse | $5.72 | |
| Employee + Child(ren) | $6.99 | |
| Employee + Family | $9.76 | |
FIND A DENTIST
www.GuardianAnytime.com
Network DentalGuard Preferred
1-888-482-7342
NO ID CARD NEEDED
Your dentist only needs your social
security number and your
Group ID# 00581741
to confirm your eligibility.
VISION BENEFIT SUMMARY IN-NETWORK
(Scroll sideways to see all options)
| High Plan | |||
|---|---|---|---|
| Benefit Summary | In-Network | ||
| Copay | Benefit Frequency | ||
| Eye Exam | $10 copay | Once per Calendar Year | |
| Lenses | $10 for single vision, bifocal | Once per Calendar Year | |
| Contact Lenses (in lieu of eyeglass lenses and/or frames) | > Covered if medically necessary > $120 maximum, if elective + 15% off balance > Fitting and evaluation covered in the Davis Vision Contact Lens Collection. | Once per Calendar year | |
| Frames | $120 retail maximum + 20% off balance *Costco, Walmart and Sam's Club frames are covered at $120 maximum | Every Other Calendar Year | |
| Network | Find A Provider www.GuardianAnyTime.com Click Davis Vision 1-877-393-7363 | DavisVision | |
| Out-of-Network Benefits | Out-of-network benefits are allowed, however, copays and maximums are less. Employees using out-of-network providers may be responsible for additional fees. | ||
| High Plan | |||
|---|---|---|---|
| Benefit Summary | In-Network | ||
| Copay | Benefit Frequency | ||
| Eye Exam | $10 copay | Once per Calendar Year | |
| Lenses | $10 for single vision, bifocal | Once per Calendar Year | |
| Contact Lenses (in lieu of eyeglass lenses and/or frames) | > Covered if medically necessary > $120 maximum, if elective + 15% off balance > Fitting and evaluation covered in the Davis Vision Contact Lens Collection. | Once per Calendar year | |
| Frames | $120 retail maximum + 20% off balance *Costco, Walmart and Sam's Club frames are covered at $120 maximum | Every Other Calendar Year | |
| Network | Find A Provider www.GuardianAnyTime.com Click Davis Vision 1-877-393-7363 | DavisVision | |
| Out-of-Network Benefits | Out-of-network benefits are allowed, however, copays and maximums are less. Employees using out-of-network providers may be responsible for additional fees. | ||
Vision Employee Bi-Weekly Contribution
| Vision - Your Weekly Contribution | ||
|---|---|---|
| Vision - Your Weekly Contribution | ||
| Employee Only | $1.54 | |
| Employee + Spouse | $3.08 | |
| Employee + Child(ren) | $2.55 | |
| Employee + Family | $4.27 | |
| Vision - Your Weekly Contribution | ||
|---|---|---|
| Vision - Your Weekly Contribution | ||
| Employee Only | $1.54 | |
| Employee + Spouse | $3.08 | |
| Employee + Child(ren) | $2.55 | |
| Employee + Family | $4.27 | |
LIFE INSURANCE BENEFITS
Basic Life & Accidental Death & Dismemberment (AD&D)
We provide basic life and accidental death and dismemberment insurance at no cost for our employees.
| Benefits | Details |
|---|---|
| Benefits | Details |
| Coverage Amount | Employee: please log onto Employee Navigator for life amount Spouse: $5,000 Child(ren): $2,500; 14 days to age 26 years |
| Insurance Carrier | Guardian |
| Age Reduction Rule | Benefit reduces by 35% at age 65, 60% at age 70, 75% at age 75 and 85% at age 85 |
| Portability | Allows the employee to take coverage with them if employment has ended (application timeline and age limitations apply, see Human Resources) |
Beneficiary Designation is the person you designate to receive your life insurance benefits in the event of your death. During your enrollment, you will be asked to provide a primary and contingent beneficiary.
Voluntary Life & Accidental Death & Dismemberment (AD&D)
Employees can purchase additional life insurance at group rates. Rates are age banded based on $1,000 of covered benefit.
| Benefits | Details |
|---|---|
| Benefits | Details |
| Guaranteed Coverage Amount and Benefit Maximums | Employee: $150,000, under age 65; $50,000, 65-69; $10,000, 70+ $10,000 minimum to $150,000 maximum ($10,000 increments) Spouse: $30,000, under age 65; $10,000, 65-69; $0, 70+ $5,000 minimum to $30,000 maximum not to exceed 50% of employee's amount ($5,000 increments) Rates based on employee’s age; Coverage ends at age 70 Child: $10,000 $1,000 increments to a maximum of $10,000, not to exceed 100% of employee's amount. Same rate and coverage for all children. Infant coverage is limited based on age. |
| Insurance Carrier | Guardian |
| Age Reduction Rule | Employee benefit reduces by 35% at age 65, 60% at age 70, 75% at age 75. Spouse reduces by 35% at age 65. |
| Portability | Allows the employee to take coverage with them if employment has ended. (application timeline and age limitations apply, see Human Resources) |
| Evidence of Insurability | Evidence of Insurability is required for employees that do not elect the benefit when initially eligible or for coverage amounts over the Guaranteed Issue amount. |
| Benefits | Details |
|---|---|
| Benefits | Details |
| Guaranteed Coverage Amount and Benefit Maximums | Employee: $150,000, under age 65; $50,000, 65-69; $10,000, 70+ $10,000 minimum to $150,000 maximum ($10,000 increments) Spouse: $30,000, under age 65; $10,000, 65-69; $0, 70+ $5,000 minimum to $30,000 maximum not to exceed 50% of employee's amount ($5,000 increments) Rates based on employee’s age; Coverage ends at age 70 Child: $10,000 $1,000 increments to a maximum of $10,000, not to exceed 100% of employee's amount. Same rate and coverage for all children. Infant coverage is limited based on age. |
| Insurance Carrier | Guardian |
| Age Reduction Rule | Employee benefit reduces by 35% at age 65, 60% at age 70, 75% at age 75. Spouse reduces by 35% at age 65. |
| Portability | Allows the employee to take coverage with them if employment has ended. (application timeline and age limitations apply, see Human Resources) |
| Evidence of Insurability | Evidence of Insurability is required for employees that do not elect the benefit when initially eligible or for coverage amounts over the Guaranteed Issue amount. |
INCOME PROTECTION BENEFITS
Other than medical and life insurance, disability insurance is one of the most important benefits you can elect. If you are disabled and unable to work, short term and long term disability insurance can help replace lost income and make a difficult time a little easier. Disability benefits are available to full-time employees. PTO/vacation time may be required to meet the elimination period before benefits begin. Evidence of Insurability is required for employees that do not elect the disability benefits when initially eligible for coverage.
| Details | Short Term Disability | Long Term Disability |
|---|---|---|
| Details | Short Term Disability | Long Term Disability |
| Benefit | 60% of your pre-disability base salary to a maximum weekly benefit of $1,000 | 60% of your pre-disability base salary to a maximum monthly benefit of $5,000 |
| Waiting (Elimination) Period | Benefits begin on the 1st day for accident, 8th day after sickness | Benefits begin after 180 days |
| Benefit Duration | 26 weeks | For benefit details, please log onto Employee Navigator |
| Benefits Based On | N/A | Your own occupation for the first 24 months; any occupation thereafter |
| Earnings Definition | Base salary with bonus and commission (12 month average) | Base salary with bonus and commission (12 month average) |
| Pre-existing Conditions Limitation | Any condition/symptom for which you, for three months prior to the coverage in this plan, consulted with a physician, received treatment, or took prescribed drugs. Coverage exclusion for the pre-existing condition applies for the first 12 months of coverage. | Any condition/symptom for which you, for three months prior to the coverage in this plan, consulted with a physician, received treatment, or took prescribed drugs. Coverage exclusion for the pre-existing condition applies for the first 12 months of coverage. |
| Contribution | 100% Employee Paid | 100% Employee Paid |
| Insurance Carrier | Guardian | Guardian |
ADDITIONAL BENEFITS
Cancer Insurance
Cancer Insurance can help ease the burden of out-of-pocket expenses related to a cancer diagnosis. Benefits would apply if a cancer diagnosis occurs while insured under the policy. Benefits are paid directly to the insured and can be used under their discretion for medical or household expenses.
| Benefits | Details |
|---|---|
| Benefits | Details |
| Initial Diagnosis Benefit Amount | Employee: $2,500 Spouse: $2,500 Child: $2,500 |
| Cancer Means | An insured has been diagnosed with a disease manifested by the presence of a malignant tumor characterized by the uncontrolled growth and spread of malignant cells in any part of the body. This includes, but may not be limited to, leukemia, Hodgkin’s disease, lymphoma, sarcoma, malignant tumors and melanoma. (see plan highlights on Employee Navigator for a complete list and benefits). |
| Cancer Screening | $50; $50 for follow-up screening |
| Radiation Therapy Chemotherapy | Scheduled amounts up to a $5,000 benefit year maximum |
| Other Per Day Benefit Allowances | Air ambulance, ambulance, blood, experimental treatment, skilled nursing care, hospital confinement, outpatient surgical center, family member lodging. |
| Insurance Carrier | Guardian |
| Pre-existing Condition Limitation | 12 month look back period, 12 month exclusion period |
| Portability | Allows the employee to take the coverage with them even if employment has ended (application timeline and age limitations apply, see Human Resources). |
| Evidence of Insurability | Evidence of Insurability is required for employees that do not elect the benefit when initially eligible. |
Cancer policies have exclusions and limitations that may impact the eligibility for or entitlement to benefits under each covered condition. The certificate of coverage provides full details. This policy will not pay for diagnosis cancer that is made before the covered person’s Cancer insurance effective date with the carrier.
PAYROLL CONTRIBUTIONS
Accident Insurance
Accident Insurance is available to our employees and eligible dependents. The coverage is for off the job accidents. Benefits are paid directly to the insured and can be used under their discretion for medical or household expenses. Benefits are paid on a schedule basis for most accidents.
| Benefits | Details |
|---|---|
| Benefits | Details |
| Accidental Dealth | Employee: $50,000 Spouse: $25,000 Child: $10,000 |
| Covered Accidents/Expenses | Accidental Dismemberment, Air Ambulance expense, Ambulance expenses, Blood, Accidental Burns, Child Organized Sports, Concussions, Dislocations, Fractures, Hospital ICU Admission, Lacerations (see plan highlights on Employee Navigator for a complete list of benefits) |
| Wellness Benefit | $50 per year for completing certain routine wellness screenings or procedures and registration of a covered child in an organized sport (see plan highlights for example procedures) |
| Scheduled Payment Examples | Ambulance: $200 Concussion: $200 Fractures: Schedule up to $6,000 Hospital Admission: $1,000 |
| Insurance Carrier | Guardian |
| Portability | Allows the employee to take the coverage with them if employment has ended (application timeline applies, see Human Resources) |
Accident policies have exclusions and limitations that may impact the eligibility for or entitlement to benefits under each covered accident. The certificate of coverage provides full details. This policy will not pay for diagnosis of a listed accident that occurs before the covered person’s Accident insurance effective date with the carrier. Exclusions include, but not limited to, accident related to covered person being legally intoxicated, armed aggression, service in the armed forces, suicide or attempted suicide, travel, air travel, professional sports, hang gliding, bungee jumping, parachuting, ballooning, substance abuse, etc.
| Payroll Contributions Weekly | ||
|---|---|---|
| Payroll Contributions Bi-Weekly | ||
| Employee | $3.77 | |
| Employee + Spouse | $6.01 | |
| Employee + Child(ren) | $6.20 | |
| Employee + Family | $8.44 | |
Employee Assistance Program
Employee Assistance Program (EAP)
We care about you and your family’s total health management. For that reason, we are providing you access to an Employee Assistance Program at no cost to you.
Employee Assistance Program (EAP) consultative services
Face-to-face counseling – up to 3 visits per employee/household member per issue
Telephonic counseling – unlimited 24/7 consultations with master’s and doctoral-level counselors
Bereavement – support available through telephonic or face-to-face sessions; online resources available on EAP website
Online modules and coaching – learn, develop, and practice new skills to improve mental fitness; includes a well-being check, online modules selected specifically for you and up to 3 coaching sessions
EAP website resources – comprehensive website that includes articles, videos, FAQs, etc.; additionally, individuals can chat online with an EAP consultant or email an EAP counselor through the website
Work/Life assistance & resources
Work/Life services – unlimited 24/7 access to Work/Life specialists (subject matter experts) in the areas of: family and caregiving, health and wellness, emotional well-being, daily living, balancing work and life responsibilities
Child and elder care referral – unlimited telephonic consultation with a Work/Life specialist (part of Work/Life services)
Employee discounts – access to discounts on a large number of products and services, from gym memberships to dental, vision and pharmacy items, entertainment, restaurants, computers, cars and much more
Medical bill negotiation tools – information and guidance on negotiating medical bills
Legal/financial assistance & resources
Legal consultation – unlimited telephonic support and free initial 30-minute face-to-face consultation with an attorney, with a 25% discount on attorney services thereafter; online legal forms; extensive online law library
Financial consultation – unlimited telephonic support for financial problems or planning needs; 30 days of financial coaching; extensive online financial library and calculators
ID theft – free consultation with a trained Fraud Resolution specialist who will assist with ID theft resolution and education; ID theft educational materials available online
Will preparation – online self-service documents available on EAP website; 30-minute consultation (part of Legal Consultation offering) can be used for estate planning/will preparation
Legal document preparation – online self-service documents available on the EAP website
Tax consultation – tax questions only can be answered as part of the Financial Consultation offering
Online self-service documents – examples include, but are not limited to living trust, will, power of attorney, deeds
Resources for managers
Introductory employee orientation – complimentary webinars with on-site orientation available for additional hourly fees
Phone:
1-800-386-7055
24/7
Web:
www.ibhworklife.com
User Name: Worklife
Annual Notices: Under federal law, we are required to provide or have available specific benefit notices for your review. All annual notices are available on our benefit administration platform or from Human Resources. If you would like to review the Annual Notices now, please CLICK HERE.
Disclaimer: This benefit guide provides highlights of the benefits available. Please request a copy of the plan certificate for additional coverage details, limitations, exclusions and restrictions. If any conflict shall arise between this document and the plan certificate, the plan certificate will govern in all cases.