Employee Benefits Guide - MedMark Treatment Centers

2014-2015
Employee Benefits Guide
July 1, 2014 – June 30, 2015
Welcome
At MedMark Services, Inc., our employees are our greatest asset and your well-being
means a healthier, more productive workplace, which is why we are pleased to offer this
comprehensive benefits package. This guide is designed to assist you and your family in
making the best choices to meet your needs for the 2014-2015 plan year.
Please read this guide in its entirety; it explains some very important changes for you
to consider this year. At MedMark Services, Inc., we strive to provide benefits that:
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Meet the needs of our employees and eligible family members
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Are easy to understand and use
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Help keep money in your pockets by delivering great value
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In this guide we use the term “Company” to refer to MedMark Services, Inc. This guide is intended to
describe the eligibility requirements, enrollment procedures and coverage effective dates for the benefits
offered by the Company. It is not a legal plan document and does not imply a guarantee of employment
or a continuation of benefits. While this guide is a tool to answer most of your questions, full details of
the plans are contained in the Summary Plan Descriptions (SPDs) which govern each plan’s operation.
Whenever an interpretation of a plan benefit is necessary, the actual plan documents will be used.
Contents
6Enrollment
22
Survivor Benefits
10Medical
25
Income Protection
14Dental
26
Planning for Retirement
16Vision
28
Additional Benefits
18
Health Savings Accounts
29
Required Notices
19
Flexible Spending Accounts
31
Important Contacts
See Page 29 for important information concerning
Medicare Part D coverage.
Enrollment
We offer a variety of options to help you select the benefit
plans that best suit your and your family’s needs. Consider
factors such as spousal benefits, dependent eligibility and
qualifying life events as you make your benefit selections.
Eligibility
Tip
Enrollment
If you have a
qualifying event
that impacts your
benefits status,
you must make
changes within
31 days of the
event. Evidence
of the event is
required.
You are eligible to participate if you are an active full-time employee working a minimum
of 32 hours per week and you have met the required waiting period. This includes
eligibility to participate in the Medical, Dental, Vision, Life and Disability plans, as well as
any additional benefits.
When does coverage begin?
Annual Enrollment
The elections you make during Annual Enrollment are effective on July 1, 2014. Due to
IRS regulations, once you have made your choices for the 2014-2015 plan year, you can’t
change your benefits until the next enrollment period unless you have a qualifying life event.
New Hire
Coverage becomes effective the first of the month following 60 days of employment.
Your Eligible Dependents
Dependents eligible for coverage in the MedMark Services, Inc. benefit plans include:
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Your legal spouse/domestic partner (or common-law spouse in states which
recognize common-law marriages).
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Your dependent children up to age 26 (includes stepchildren, legally adopted
children or children placed with you for adoption, and foster children).
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Your dependent child, regardless of age, provided he or she is incapable of
self-support due to a mental or physical disability, is fully dependent on you
for support as indicated on your federal tax return and is approved by your
medical plan to continue coverage past age 26.
Please note that verification of eligibility will be required once dependents are enrolled.
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Things to Consider
It is a good time before you enroll to re-assess your benefit decisions and determine if you need to
make changes.
Situations that you should take into account as you assess your benefit decisions:
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Does your spouse/domestic partner have benefits coverage available through another employer?
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Did you get married, divorced or have a baby recently? If so, do you need to add or remove
any dependent(s) or update your beneficiary designation?
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Did any of your covered children reach their 26th birthday this year? If so, they are no longer
eligible for benefits.
Qualifying Life Events
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Change in your legal marital status (marriage, divorce or legal separation)
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Change in the number of your dependents (for example, through birth or adoption, or if a
child is no longer an eligible dependent)
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Change in your spouse/domestic partner’s employment status (resulting in a loss or gain of
coverage)
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Change in your employment status from full time to part time, or part time to full time,
resulting in a gain or loss of coverage
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Entitlement to Medicare or Medicaid
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Change in your address or location that affects the plans for which you are eligible
Enrollment
When one of the following events occurs, you have 31 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.
NOTE: Your change in coverage must be consistent with your change in status.
Your new coverage becomes effective on the date specified for the Open Enrollment period or on your
eligibility date or status change date.
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Preparing to Enroll
Enrollment
MedMark Services, Inc. provides its employees the best coverage possible. As a committed
partner in your health, MedMark Services, Inc. will be absorbing a significant amount of
the costs. Your contributions for medical, dental, and vision benefits are deducted on a
pre-tax basis, which lessens your tax liability.
Please note that employee contributions for medical and dental coverage vary depending
on the level of coverage you select. In general, the higher the level of coverage, the higher
your employee contribution will be.
Keep in mind that you may select any combination of Medical, Dental and/or Vision
plans and any combination of coverage categories. For example, you could select medical
coverage for you and your entire family, but select dental and vision coverage only for
yourself. The only requirement is that you, as an eligible employee of MedMark Services,
Inc., must elect coverage for yourself in order to elect any dependent coverage. You have
the option to select coverage from the following categories:
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Employee Only
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Employee + Spouse/Domestic Partner
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Employee + Child(ren)
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Employee + Family (spouse/domestic partner and child(ren))
Be sure to have the Social Security numbers and birth dates for any eligible dependent(s)
that you plan to enroll. You cannot enroll your dependent(s) without this information.
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Medical
Our medical coverage helps you maintain your well-being
through preventive care and access to an extensive network
of providers, as well as affordable prescription medication.
The choices provided allow you to create a plan that will best
serve you and your family. These resources help you enjoy the
benefits of good health.
It is up to you to choose the plan that best matches your needs. Please keep in mind that
the option you elect will be in place for all of the 2014-2015 plan year, unless you have a
qualifying life event.
Tip
Medical
Urgent Care
Centers are a
great alternative
to hospital
emergency
rooms. Using this
service when
appropriate can
save you time
and money.
How to Find a Provider
To see the current list of Aetna network providers online, go to www.aetna.com.
If you do not have internet access, please call Aetna Customer Care at 888-416-2277
(Gold, Silver, HDHP) or 800-445-5299 (HMO) for assistance.
Aetna Informed Health Line
The Aetna Informed Health Line gives you 24-hour, toll-free access to a team of
registered nurses experienced in providing information on a variety of health topics.
Call 800-556-1555 to speak with a nurse or you can also go online through Aetna
Navigator at www.aetna.com.
Aetna Online Wellness
There are several online programs to help you reach your health goals. If you enroll in the
Aetna plan, these programs are available at no additional cost. To access these programs,
log in to your secure member website at www.aetna.com, click on “Simple Steps To A
Healthier Life” link, choose an online session that interests you the most!
Programs include:
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Quit Smoking with Breathe™
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Deal with Stress with Relax™
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Eat Healthier with Nourish™
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Manage your Weight with Balance™
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Sleep Better with Overcoming™ Insomnia
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Be Happier with Overcoming™ Depression
Medical Plan Summary
The chart below gives a summary of the 2014-2015 plan year medical coverage provided by Aetna.
All covered services are subject to medical necessity as determined by the plan.
Aetna
Gold PPO
Silver PPO
HMO
HDHP
In-Network
In-Network
In-Network
Only
In-Network
Individual
Family
$1,000
$3,000
$3,000
$6,000
$0
$0
$3,000
$6,000
Coinsurance (Plan Pays)
80%*
80%*
100%
Calendar Year Deductible
Calendar Year Out-of-Pocket Maximum (Includes Ded. & Medical Copays)
Individual
Family
80%*
(Includes Ded.
& All Copays)
$2,500
$5,000
$6,000
$12,000
$3,000
$6,000
$6,350
$12,700
Unlimited
Unlimited
Unlimited
Unlimited
Primary Care Physician
$25
$40
$25
80%*
Specialist
$50
$60
$50
80%*
100%
100%
100%
100%
$75
$75
$75
80%*
Lifetime Maximum
Copays / Coinsurance
Urgent Care
Emergency Room
$200
$200
$100
80%*
Outpatient Surgery
80%*
80%*
$500
80%*
Medical
Preventive Care
*After deductible
NOTE: Please refer to Summary Plan Description to review out-of-network benefits.
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Prescription Drug Coverage for Medical Plans
Our Prescription Drug Program is coordinated through Aetna. You will have a single ID Card for
medical and for prescriptions.
Medical
Your cost is determined by the tier assigned to the prescription drug product. All products on the
list are assigned as Generic, Preferred or Non-Preferred.
You may find information on your benefit coverage and search for network pharmacies by
logging on to www.aetna.com or calling the Customer Care number on your ID Card.
Pharmacy
Gold PPO
Silver PPO
HMO
HDHP
In-Network
In-Network
In-Network
In-Network
$20
$40
$70
$20
$40
$70
$20
$40
$70
$20 Copay after Ded.
$40 Copay after Ded.
$70 Copay after Ded.
In-Network
In-Network
In-Network
In-Network
$40
$80
$140
$40
$80
$140
$40
$80
$140
$40 Copay after Ded.
$80 Copay after Ded.
$140 Copay after Ded.
Retail Rx (30-day supply)
Generic
Preferred
Non-Preferred
Mail Order Rx (90-day supply)
Generic
Preferred
Non-Preferred
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Generic Drugs
One way to get more value from your health care plan is to use Generic drugs when they are available,
which lowers the cost of your personal health needs. A Generic drug is chemically identical to the
corresponding Preferred or Non-Preferred version. The additional cost of marketing brand-name drugs is
essentially the only difference between brand-name drugs and the generic options. They provide the same
benefit, but at a lower price.
A generic is not always prescribed. However, that shouldn’t stop you from asking for the generic every
time. In some cases, the prescribed drug will not have an exact generic option, but you can ask for the
generic equivalent. Although the core active ingredient may be slightly different, these equivalents still offer
the same medical benefit and outcome.
Preferred Drugs
A Preferred drug is a brand-name drug that is on your provider’s list of approved drugs. You can check
online to see a complete list of preferred drugs.
Non-Preferred Drugs
Medical
Non-Preferred drugs have higher copayments and are typically newer drugs on the market. Like generic
equivalents, you can request a preferred drug equivalent that can offer the same medical effect. You can
be a better consumer by doing your research, asking the right questions and buying at the lowest price.
Generic Drugs – Questions and Answers
What is a generic drug?
When the patent protection for a brand-name drug expires, companies
can manufacture drugs that contain the same active ingredient, identical
in chemical structure, as the brand-name drug. The generic drug has the
same dosage, strength and quality as its brand-name counterpart.
If generic drugs are less
expensive than their brandname alternatives, should I
question the generic drug’s
effectiveness or quality?
No. Generic drugs have the exact same pharmacological effects as their
brand-name alternative and they must be approved by the FDA as both
safe and effective.
Then why are generic drugs
less expensive?
Generic drugs are less expensive because the drug manufacturers do
not have the added expense of developing and marketing the generic
version; therefore, they can sell it at a lower cost.
What should I do if my
doctor prescribes a
brand-name drug?
You can always ask your doctor or pharmacist if there is a generic
alternative or a generic equivalent (a drug in the same therapeutic class
that has a generic) available.
How do I know if there
is a generic or generic
equivalent for my
brand-name drug?
You can find generic equivalents online on the FDA’s website:
www.fda.gov. Simply search “Drugs@FDA.”
How much do generic drugs
save consumers?
According to the FDA, the price of generic drugs can be up to 85% lower
than the cost of brand-name drugs. This equals $8 to $10 billion
in annual consumer savings at retail pharmacies,
according to the Congressional Budget Office.
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Tip
Dental
You don’t have
to enroll in a
medical plan
to have dental
coverage. You can
select dental only.
Dental
In more ways than one, your smile is a sign of your overall
well-being. Take care of your teeth and you take care
of the rest of your body. Our Dental plan helps you
maintain good dental health through affordable options
for preventive care including regular checkups and other
dental work.
You have the option to choose from two Dental plans – a DPPO plan and a DHMO plan,
both offered through Aetna. With the DPPO plan, you can visit any dentist, but you pay
less out-of-pocket when you choose a PPO network dentist. With the DHMO, you pay a
fixed copay for each covered service. Out-of-network visits are not covered.
Network Dentists
Using a network dentist lowers your out-of-pocket costs. This is because the network
dentists have agreed to charge lower fees, and your plan’s in-network services cover a
larger share of the charges. If you choose to use a dentist who doesn’t participate in
the network, your out-of-pocket costs will be higher. To find a network dentist, visit
www.aetna.com.
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Dental Plan Summary
Dental benefits are available to you on a voluntary basis. The chart below gives a summary of the
2014-2015 plan year dental coverage provided by Aetna. Make sure you have access to a network
dentist prior to electing the DHMO plan.
Aetna
DPPO
DHMO**
In-Network
Out-of-Network
In-Network Only
CA, FL, TX, MD, GA, NM Only
$50
$150
$50
$150
$0
$0
$1,500
$1,500
Unlimited
Preventive Services
100%
100%
See Schedule
Basic Services
80%*
80%*
See Schedule
Major Services
50%*
50%*
See Schedule
Orthodontics
50%
50%
See Schedule
Calendar Year Deductible
Individual
Family
Calendar Year Maximum
Per Person
Services
Dental
(Children only under age 19)
Orthodontic Lifetime Maximum
$1,250
Unlimited
* After deductible
** DHMO only available in California, Florida, Texas, Maryland, Georgia and New Mexico.
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Tip
Vision
Visit
www.aetna.com
to locate network
providers.
Vision
Eye health is an indicator of overall health. Regular eye
exams can detect diseases such as glaucoma, diabetes
and blindness. Vision benefits provide access to quality
vision care. To ensure that you and your family get
the care you need, MedMark Services, Inc. offers a
comprehensive Vision benefit provided by Aetna.
In-network copayments are paid directly to the provider. Out-of-network services will be
reimbursed up to the scheduled amounts listed on the vision chart.
16
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Contact lenses are in lieu of the eyeglass lenses and frames benefit.
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The insured is responsible for paying any charges in excess of this allowance.
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A standard contact lens fitting fee applies to an existing contact lens user who
wears disposable, daily wear or extended wear lenses only.
Vision Plan Summary
Vision benefits are available to you on a voluntary basis. The chart below gives a summary of the
2014-2015 plan year vision coverage provided by Aetna.
Aetna
In-Network
Out-of-Network
$10
$25 Allowance
Copays
Examination
Benefit Frequency
Examination
Lenses
Frames
Contacts (in lieu of Lenses and Frames)
Once every 12 months
Once every 12 months
Once every 24 months
Once every 12 months
Lenses
Single Vision Lens
Bifocal Lens
Trifocal Lens
Lenticular Lens
Frames
Retail Frame Equivalent
Contact Lenses
Elective
$20 Copay
$20 Copay
$20 Copay
$20 Copay
$15 Allowance
$30 Allowance
$60 Allowance
$60 Allowance
$120 Allowance
(additional 20% discount
on remaining balance)
$60 Allowance
$120 Allowance
$100 Allowance
Vision
Covered Materials
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Health Savings Accounts
Health Savings Accounts
Under the HDHP Medical Plan, you may open an HSA to pay for qualified
expenses. An HSA is a financial account that you can use to accumulate tax-free
funds to pay for qualified health care expenses, plus you have coverage from a
medical benefits plan through payroll deductions. You decide how and when to
contribute into your account. You can contribute up to a maximum of $3,300 for
an individual and $6,550 for family coverage. Individuals age 55 and older may
contribute an additional $1,000 into their HSA account. (This is referred to as a
“catch-up contribution.”) Contributions into your HSA account must stop once
you are enrolled into Medicare.
You decide whether or not to use the money in your HSA. Any money left in your
HSA account at the end of the year will carry forward to the next plan year, so you
can save for future expenses. You can also keep the money in your account, even
if you change jobs or health plans.
Your HSA dollars can be used to pay for qualified out-of-pocket medical,
dental and vision expenses. Examples of qualified expenses include deductibles,
coinsurance and copays. A complete list of eligible expenses and can be found at
http://www.irs.gov/pub/irs-pdf/p502.pdf.
Important HSA Information
To establish and contribute to an HSA:
18
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You must be covered by a qualified High Deductible Health Plan.
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You cannot be covered by any other health plan.
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You cannot be enrolled in Medicare.
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Your spouse cannot participate in a Flexible Spending Account (Health Care
Spending Account).
Flexible Spending Accounts (FSAs) offer you an opportunity
to lower your taxable income by allowing you to create an
account with pre-tax dollars to pay for qualified expenses.
FSA Open Enrollment
Election for an FSA can only be made during FSA Open Enrollment, which usually occurs
during the month of June, unless you experience a qualifying event.
Tip
If you have any
money remaining
in your FSA at the
end of the year,
you forfeit it.
In other words:
“Use it or lose it.”
Flexible Spending Accounts
Flexible Spending Accounts
Health Care Flexible Spending Accounts
Health Care FSA allows you to set aside up to $2,500 through payroll deductions on
a pre-tax basis to pay for out-of-pocket healthcare costs such as deductibles, copays,
coinsurance, dental expenses vision expenses and more. You can contribute up to $2,500
for the 2014-2015 plan year (July 1, 2014 - June 30, 2015).
Changes to Over-the-Counter Eligibility
Under the Patient Protection and Affordable Care Act (PPACA) that was signed into law
on March 23, 2010, there are substantial changes to the requirements applicable to
over-the-counter (OTC) medicines and drugs. OTC drugs are no longer eligible for
reimbursement through an FSA without a doctor’s prescription.
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Flexible Spending Accounts
20
Limited Scope FSA
New for the 2014-2015 plan year! You can use this Health Care FSA to pay for qualified dental and vision
expenses only. (HSA must be used to reimburse qualified medical & pharmaceutical expenses). For a
complete list of eligible expenses go to www.irs.gov.
Dependent Care Flexible Spending Accounts
The Dependent Care FSA sets aside pre-tax funds to help pay for expenses associated with caring for elder
or child dependents. Unlike the Health Care FSA, reimbursement from your Dependent Care FSA is limited
to the total amount that is deposited in your account at that time.
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With the Dependent Care FSA you are allowed to set aside up to $5,000
(per household) to pay for child or elder care expenses on a pre-tax basis.
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Eligible dependents include children younger than the age of 13 and dependents of any age
who are incapable of caring for themselves.
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Dependent care expenses are reimbursable as long as the provider is not anyone considered
your dependent for income tax purposes.
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In order to be reimbursed, you must provide the tax identification number or Social Security
number of the party providing care.
Eligible Dependent Care Flexible Spending Account Expenses
This account covers dependent day care expenses that are necessary for you and your spouse to work or
attend school full time. The dependent must be younger than the age of 13 and claimed as a dependent
on your federal income tax return or a disabled dependent who spends at least eight hours a day in your
home. Examples of eligible dependent care expenses include:
In-home babysitting services (not by an individual you claim as a dependent)
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Care of a preschool child by a licensed nursery or day care provider
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Before- and after-school care
»»
Day camp
»»
In-house dependent day care
Due to federal regulations, expenses for your domestic partner and/or your domestic partner’s children may
not be reimbursed under the FSA programs.
Flexible Spending Accounts
»»
General Rules and Restrictions
In exchange for the tax advantages that FSAs offer, the IRS has imposed the following rules and restrictions
for both Health Care and Dependent Care FSAs:
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Your expenses must be incurred during the plan year of 2014-2015.
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Your dollars cannot be transferred from one FSA to another.
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You cannot participate in Dependent Care FSA and claim a tax deduction
at the same time.
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You must “use it or lose it”—any unused funds will be forfeited. Submit claims for
reimbursement up to 90 days after the end of the plan year (June 30, 2015).
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You have a 2.5 month grace period which allows an additional period of time to incur
expenses after the plan year ends on June 30, 2015.
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You cannot change FSA election in the middle of the plan year unless you have a qualifying life
status change such as a marriage, divorce or birth of a child.
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Tip
Survivor Benefits
It is important
that you name
a primary and
contingent
beneficiary to
receive your
life insurance
benefits.
Survivor Benefits
Life and disability insurance are very important to those
who depend on you for financial security. Survivor benefits
provide financial assistance in your absence.
Basic Life/AD&D Insurance
Life insurance benefits are essential to the financial security of you and your family. As such,
it is important to understand how your plan works and what benefits you will receive.
Basic Life/AD&D benefits are provided to you as part of your basic coverage at no cost
to you. MedMark Services, Inc. provides you Basic Life/AD&D insurance through Aetna,
which can help guarantee that loved ones, such as a spouse/domestic partner or other
designated survivors, can continue to receive part of an employee’s benefits after a death.
Your Basic Life/AD&D insurance benefit is $25,000 ($50,000 for Corporate employees).
Beneficiary Designation
A beneficiary is the person you designate to receive your life insurance benefits in
the event of your death. This includes any benefits payable under the Basic/Voluntary
Life insurance plan available through MedMark Services, Inc. Benefits payable for a
dependent’s death under the Voluntary Life insurance plan are payable to you.
It is important that your beneficiary designation is clear so that there will be no question as
to your intentions. It is also important that you name a primary and contingent beneficiary.
When naming your beneficiary(ies) please indicate their full name, address, Social Security
number, relationship, date of birth and distribution percentage. If the beneficiary is
not legally related, insert the words “Not Related” in the relationship field. If you need
assistance, contact Human Resources or your own legal counsel.
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Primary
Contingent
Mary J. Doe, Wife (34%)
Jane Doe, Daughter (33%)
John Doe, Son (33%)
Joseph W. Doe, Son (50%)
Jane Doe, Daughter (50%)
OR
Estate of the Insured (100%)
If you name more than one beneficiary with unequal shares, please show the amount of insurance to be
paid to each beneficiary in percentages, for example “33% to Pauline Smith, Mother, and 67% to Mary J.
Doe, Wife”.
If there is insufficient space for your beneficiary designations, leave it blank and attach a separate sheet of
paper indicating your designations and share percentages.
Voluntary Life and Voluntary Dependent Life Insurance
You may purchase Voluntary Life insurance for yourself in increments of $25,000, up to the lesser of
$150,000 or 5 x your annual salary. You must purchase Voluntary Life insurance for yourself in order
to purchase Voluntary Life insurance for your eligible spouse/domestic partner and child(ren).
Voluntary Life
Coverage Amount:
Increments of $25,000.
Who Pays:
This coverage is available to you on a voluntary basis.
Benefits are Payable:
If you die while covered under the plan. This benefit is in addition to your
Basic Life benefit.
Maximum Benefit:
Up to the lesser of $150,000 or 5 x your annual salary.
Evidence of Insurability (EOI)
is required:
Newly eligible employees are eligible for up to $100,000 of Life insurance
without providing Evidence of Insurability.
Survivor Benefits
Eligible employees may purchase Voluntary Life insurance for themselves and their family. Premiums are
paid through post-tax payroll deductions.
Voluntary Spouse/Domestic Partner Life
Who Pays:
This coverage is available on a voluntary basis.
Benefits are Payable:
If your spouse/domestic partner dies while covered under the plan.
Maximum Benefit:
50% of employee coverage to a max of $25,000
Evidence of Insurability (EOI)
is required:
If you are newly eligible, your eligible spouse/domestic partner
and child(ren) are guaranteed $25,000 of coverage
without providing Evidence of Insurability.
Voluntary Child Life
Who Pays:
This coverage is available on a voluntary basis.
Benefits are Payable:
If your child dies while covered under the plan.
Maximum Benefit:
10% of employee coverage to a max of $10,000.
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Voluntary Employee and Spouse/Domestic Partner Life Insurance
Survivor Benefits
Employee Age
Rates / $1,000
(Biweekly)
Under 30
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69*
70-74*
75-79*
$0.024
$0.028
$0.039
$0.063
$0.098
$0.153
$0.263
$0.424
$0.683
$1.087
$1.852
Voluntary Child Life Insurance
Premium Rates / $1,000 — $0.054 (Biweekly)
* Benefits subject to age reduction schedule.
Note: Eligible spouse/domestic partner coverage is based on employee’s age and terminates at age 70.
To calculate how much your Voluntary Life coverage will cost:
$
÷ 1,000 =
Benefit Elected
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$
x Age Based Rate =
$
Biweekly Premium
Income Protection
Short Term Disability Insurance
Short Term Disability (STD) benefits are provided to you as a part of your basic coverage.
STD insurance protects a portion of your income if you become partially or totally disabled
for a short period of time. STD insurance replaces 60% of your income, up to a maximum
weekly benefit of $1,000, depending on your current annual earnings.
Tip
Disability
insurance protects
a portion of your
income should
you become
disabled.
Income Protection
If you have to miss work due to injury, we help ensure that
at least part of your income continues. Our Disability plans
cover a portion of your income until you can return to
work, or until you reach retirement age.
You must be sick or disabled for at least 14 days before you can receive your Short
Term Disability insurance benefit payment. Payments may last up to 11 weeks. Certain
exclusions as well as pre-existing condition limitations may apply. Please refer to your
Summary Plan Description for details or contact Human Resources for specific benefits.
Long Term Disability Insurance
Long Term Disability (LTD) benefits are provided to you as a part of your basic coverage.
LTD insurance protects a portion of your income if you become partially or totally disabled
for a long period of time. This insurance replaces 60% of your income, up to a maximum
of $5,000 per month – depending on your current annual earnings.
You must be sick or disabled for at least 90 days before you can receive a Long Term
Disability insurance benefit payment. You will be taxed on the premium, resulting in a
non-taxable benefit. The maximum payment period is up to age 62. However, if you
become disabled after age 62, benefits are payable according to an age-based schedule.
Certain exclusions as well as pre-existing condition limitations may apply. Please refer to your
Summary Plan Description for details or contact Human Resources about specific benefits.
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Planning for Retirement
It is critical to plan for your retirement. Making 401(k)
contributions is an important step toward achieving
your financial goals for later in life. We offer several
options to help you make the most of your retirement
and live a secure and happy life once your work years are
behind you.
Planning for Retirement
Tip
Once you are
eligible, you
can change the
contribution rate
to your 401(k)
account any time
during the year.
A 401(k) plan can be a powerful tool in promoting financial security in retirement. The
MedMark Services, Inc.’s 401(k) plan helps eligible associates save and invest for retirement
while receiving certain tax advantages. Administrative and record-keeping services for the
401(k) plan are provided by Securian Retirement Center.
Eligibility
You may participate in the plan the first day of any month when you have met the
following requirement(s):
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Are at least 21 years of age
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Completed three months of service
Note: All participation is voluntary.
Contributing to the Plan
You can save from 1% to 75% of your eligible compensation before you pay taxes on that
income. The IRS limit for 2014 is $17,500. The Company may match the contributions you
make to the plan during the year on a discretionary basis. The Company currently matches
25% of the first 6% of your eligible contributions. Vesting of MedMark Services Inc.’s
contribution occurs at 20% per year after two years.
Catch-up Contributions
If you are or will be age 50 or older in this calendar year and contribute the maximum
allowed to your account, you may also make “catch-up contributions” to your account.
The catch-up contribution is intended to help you accelerate your progress toward your
retirement goals. The maximum catch-up contribution is $5,500 for 2014. See your Plan
Administrator for more details.
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You may change the amount of your contributions any time. All changes will become effective as soon as
administratively feasible and will remain in effect until modified or terminated by you. You may discontinue
your contributions anytime. Once you stop contributions, you may start again any time.
Consolidating Your Retirement Savings
Planning for Retirement
Changing or Stopping Your Contributions
If you have an existing qualified retirement plan (pre-tax) with a prior employer, you may transfer or roll
over that account into the plan anytime. To initiate a rollover into your plan, contact Securian Retirement
at 800-233-2881 for details.
Investing in the Plan
You decide how to invest the assets in your account. The MedMark Services, Inc. 401(k) plan offers a
selection of investment options for you to choose from. You may change your investment choices anytime.
For more details, refer to www.securianretirementcenter.com.
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Tip
Additional Benefits
You can call
855-283-1915
24 hours a day,
365 days a year
to speak with a
specially trained
EAP professional,
ready to help you.
Additional Benefits
MedMark Services, Inc. believes in a well-rounded benefits
package and provides options for additional benefits to
help you manage your life.
Employee Assistance Program
MedMark Services, Inc. cares about you and your family’s total health management—
mental, emotional and physical. For that reason, MedMark Services, Inc. provides an
Employee Assistance Program (EAP) at no cost to you.
This service connects you with the best mental health and counseling services. Whether
you are interested in work/life resources, mental health assistance or legal and financial
advice, the EAP service can connect you and members of your household with a variety
of professionals. With just one phone call, at any hour of the day or night, you can speak
with helpful resources. The EAP benefit includes three face-to-face visits with a licensed
professional. All services provided are confidential and will not be shared with MedMark
Services, Inc. You may also access information, benefits, educational materials and more
either by phone at 855-283-1915 or online at www.mylifevalues.com.
The program provides referrals to help with:
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Emotional problems
Alcohol or drug dependency
Marriage or family relationship problems
Job pressures
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Stress, anxiety, depression
Grief and loss
Financial or legal advice
Employee Assistance Program:
www.mylifevalues.com
Username & Password: RESOURCES
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Required Notices
When Will You Pay A Higher Premium (Penalty) To Join A
Medicare Drug Plan?
Important Notice from MedMark Services, Inc. About
Your Prescription Drug Coverage and Medicare under the
Aetna Plan(s)
You should also know that if you drop or lose your current coverage with
MedMark Services, Inc. and don’t join a Medicare drug plan within 63
continuous days after your current coverage ends, you may pay a higher
premium (a penalty) to join a Medicare drug plan later.
Please read this notice carefully and keep it where you can find it. This
notice has information about your current prescription drug coverage
with MedMark Services, Inc. and about your options under Medicare’s
prescription drug coverage. This information can help you decide whether or
not you want to join a Medicare drug plan. If you are considering joining, you
should compare your current coverage, including which drugs are covered
at what cost, with the coverage and costs of the plans offering Medicare
prescription drug coverage in your area. Information about where you can
get help to make decisions about your prescription drug coverage is at the
end of this notice.
If you go 63 continuous days or longer without creditable prescription drug
coverage, your monthly premium may go up by at least 1% of the Medicare
base beneficiary premium per month for every month that you did not have
that coverage. For example, if you go nineteen months without creditable
coverage, your premium may consistently be at least 19% higher than the
Medicare base beneficiary premium. You may have to pay this higher premium
(a penalty) as long as you have Medicare prescription drug coverage. In
addition, you may have to wait until the following October to join.
There are two important things you need to know about your current
coverage and Medicare’s prescription drug coverage:
1.
MedMark Services, Inc. has determined that the prescription drug
coverage offered by the Aetna plan(s) is, on average for all plan
participants, expected to pay out as much as standard Medicare
prescription drug coverage pays and is therefore considered
Creditable Coverage. Because your existing coverage is Creditable
Coverage, you can keep this coverage and not pay a higher
premium (a penalty) if you later decide to join a Medicare drug plan.
When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for
Medicare during a seven-month initial enrollment period. That period begins
three months prior to your 65th birthday, includes the month you turn 65,
and continues for the ensuing three months. You may also enroll each year
from October 15th through December 7th.
However, if you lose your current creditable prescription drug coverage,
through no fault of your own, you will also be eligible for a two (2) month
Special Enrollment Period (SEP) to join a Medicare drug plan.
What Happens To Your Current Coverage If You Decide to
Join A Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current
MedMark Services, Inc. coverage will not be affected. For most persons
covered under the Plan, the Plan will pay prescription drug benefits first, and
Medicare will determine its payments second. For more information about
this issue of what program pays first and what program pays second, see
the Plan’s summary plan description or contact Medicare at the telephone
number or web address listed herein.
If you do decide to join a Medicare drug plan and drop your current
MedMark Services, Inc. coverage, be aware that you and your dependents
will not be able to get this coverage back.
Contact the person listed at the end of these notices for further information.
NOTE: You’ll get this notice each year. You will also get it before the next
period you can join a Medicare drug plan, and if this coverage through
MedMark Services, Inc. changes. You also may request a copy of this notice
at any time.
For More Information about Your Options under Medicare
Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug
coverage is in the “Medicare & You” handbook. You’ll get a copy of the
handbook in the mail every year from Medicare. You may also be contacted
directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
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Required Notices
2.
Medicare prescription drug coverage became available in 2006
to everyone with Medicare. You can get this coverage if you join a
Medicare Prescription Drug Plan or join a Medicare Advantage Plan
(like an HMO or PPO) that offers prescription drug coverage. All
Medicare drug plans provide at least a standard level of coverage
set by Medicare. Some plans may also offer more coverage for a
higher monthly premium.
For More Information about This Notice or Your Current
Prescription Drug Coverage…
Visit www.medicare.gov
Call your State Health Insurance Assistance Program (see the inside
back cover of your copy of the “Medicare & You” handbook for their
telephone number) for personalized help
Call 1-800-MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048
If you have limited income and resources, extra help paying for Medicare
prescription drug coverage is available. For information about this extra help,
visit Social Security on the web at www.socialsecurity.gov, or call them at
1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Medicare Part D notice. If you decide to join one
of the Medicare drug plans, you may be required to provide a copy of
this notice when you join to show whether or not you have maintained
creditable coverage and, therefore, whether or not you are required to
pay a higher premium (a penalty).
Date:
July 1, 2014
Name of Entity/Sender:
MedMark Services, Inc.
Contact—Position/Office: Human Resources
Address:
401 E. Corporate Dr., Suite 220
Lewisville, Texas 75057
Phone Number:
214-379-3304
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Women’s Health and Cancer Rights Act
The Women’s Health and Cancer Rights Act of 1998 was signed into law
on October 21, 1998. The Act requires that all group health plans providing
medical and surgical benefits with respect to a mastectomy must provide
coverage for all of the following:
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Reconstruction of the breast on which a mastectomy has been
performed
Surgery and reconstruction of the other breast to produce a
symmetrical appearance
Prostheses
Treatment of physical complications of all stages of mastectomy,
including lymphedema
This coverage will be provided in consultation with the attending physician
and the patient, and will be subject to the same annual deductibles and
coinsurance provisions which apply for the mastectomy. For deductibles
and coinsurance information applicable to the plan in which you enroll,
please refer to the summary plan description or contact Human Resources
at 214-379-3304.
HIPAA Privacy and Security
Required Notices
The Health Insurance Portability and Accountability Act of 1996 deals
with how an employer can enforce eligibility and enrollment for health
care benefits, as well as ensuring that protected health information
which identifies you is kept private. You have the right to inspect and
copy protected health information that is maintained by and for the plan
for enrollment, payment, claims and case management. If you feel that
protected health information about you is incorrect or incomplete, you may
ask your benefits administrator to amend the information. The Notice of
Privacy Practices has been recently updated. For a full copy of the Notice of
Privacy Practices, describing how protected health information about you
may be used and disclosed and how you can get access to the information,
contact Human Resources at 214-379-3304.
HIPAA Special Enrollment Rights
If you are declining enrollment for yourself or your dependents (including
your spouse) because of other health insurance or group health plan
coverage, you may be able to later enroll yourself and your dependents in
this plan if you or your dependents lose eligibility for that other coverage
(or if the employer stops contributing towards your or your dependents’
other coverage).
Loss of eligibility includes but is not limited to:
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Loss of eligibility for coverage as a result of ceasing to meet
the plan’s eligibility requirements (i.e. legal separation, divorce,
cessation of dependent status, death of an employee, termination
of employment, reduction in the number of hours of employment);
Loss of HMO coverage because the person no longer resides or
works in the HMO service area and no other coverage option is
available through the HMO plan sponsor;
Elimination of the coverage option a person was enrolled in, and
another option is not offered in its place;
Reaching the plan’s lifetime benefit maximum on all benefits,
if the person is covered under a separate plan or a single plan
with multiple options and the other option has a higher lifetime
maximum, or the benefits paid under the first option were not
integrated with the second option;
Failing to return from an FMLA leave of absence; and
Loss of coverage under Medicaid or the Children’s Health Insurance
Program (CHIP).
Unless the event giving rise to your special enrollment right is a loss of
coverage under Medicaid or CHIP, you must request enrollment within
31 days after your or your dependent’s(s’) other coverage ends (or after
the employer that sponsors that coverage stops contributing toward
the coverage).
If the event giving rise to your special enrollment right is a loss of coverage
under Medicaid or the CHIP, you may request enrollment under this plan
within 60 days of the date you or your dependent(s) lose such coverage
under Medicaid or CHIP. Similarly, if you or your dependent(s) become
eligible for a state-granted premium subsidy towards this plan, you may
request enrollment under this plan within 60 days after the date Medicaid
or CHIP determine that you or the dependent(s) qualify for the subsidy.
In addition, if you have a new dependent as a result of marriage, birth,
adoption, or placement for adoption, you may be able to enroll yourself and
your dependents. However, you must request enrollment within 31 days
after the marriage, birth, adoption, or placement for adoption.
To request special enrollment or obtain more information, contact Human
Resources at 214-379-3304.
Notice of Grandfathered Status
This group health plan believes this plan is a “grandfathered health plan’’
under the Patient Protection and Affordable Care Act (the Affordable Care
Act). As permitted by the Affordable Care Act, a grandfathered health plan
can preserve certain basic health coverage that was already in effect
when that law was enacted. Being a grandfathered health plan means that
your plan may not include certain consumer protections of the Affordable
Care Act that apply to other plans, for example, the requirement for the
provision of preventive health services without any cost sharing. However,
grandfathered health plans must comply with certain other consumer
protections in the Affordable Care Act, for example, the elimination of
lifetime limits on benefits.
Questions regarding which protections apply and which protections do
not apply to a grandfathered health plan and what might cause a plan to
change from grandfathered health plan status can be directed to the plan
administrator at 214-379-3304. You may also contact the U.S. Department
of Health and Human Services at www.healthreform.gov.