17
2019 BENEFITS GUIDE
2019 BENEFITS GUIDE
2019 Benefits Guide
Gorman & Company 2
TABLE OF CONTENTS
Benefits Overview 2
Team Member Contributions 3
Medical Benefits - Anthem 4
Medical Benefits - Unity (Quartz) 5
Dental Benefits 7
Life and Accidental Death & 8 Dismemberment Insurance
Voluntary Life and AD&D Insurance 8
Short and Long-Term Disability 9
Flexible Spending Account 10
Vision Insurance 11
Pet Insurance 12
401K Retirement Plan 14
Employee Assistance Program 15
Earned Time / Holidays 16
Contact Information 17
BENEFITS OFFERED
Medical Dental Life Insurance and (AD&D) Insurance Voluntary Life and AD&D Voluntary Short Term Disability Long Term Disability Flexible Spending Account (FSA) Voluntary Vision Voluntary Pet Insurance 401K Retirement Plan Employee Assistance Program (EAP) Earned Time Holidays
ELIGIBILITY
You and your dependents are eligible for the company benefits on the first of the month following 60 days of employment.
Eligible dependents are your spouse, children under age 26, or disabled dependents of any age.
Elections made now will remain in effect until the next open enrollment period unless you or your family members experience a qualifying event. If you experience a qualifying event, you must contact human resources within 30 days.
BENEFITS OVERVIEW Gorman & Company is proud to offer a comprehensive benefits package to eligible team members who work 30 or more hours per week. The benefits package is briefly summarized in this booklet. You share the cost of some benefits (medical and dental), the company provides other benefits at no cost to you (life, accidental death & dismemberment, and long-term disability), and you have the option of purchasing other voluntary benefits (vision and short-term disability). Benefits are subject to change at any time.
Contact Human Resources with questions!
2019 Benefits Guide
Gorman & Company 3
TEAM MEMBER CONTRIBUTIONS FOR BENEFITS
BI-WEEKLY
Employee $51.01
Employee + $231.91
Employee + Child(ren) $189.74
Family $338.69
Unity HMO
Employee $57.53
Employee + $178.34
Employee + Child(ren) $145.92
Family $260.46
Unity POS (with HRA)
Employee $69.27
Employee + $188.97
Employee + Child(ren) $154.62
Family $275.99
TEAM MEMBER CONTRIBUTIONS Anthem coverage is available for team members who are outside of the Unity (Quartz) service area (see map on page 6). Unity HMO is for team members within the Unity (Quartz) service area. Unity POS is available to team members within the Unity (Quartz) service area, and provides out-of-network provider options and a Health Reimbursement Account (HRA).
Employee $3.00
Employee + $12.02
Employee + Child(ren) $14.40
Family $22.62
Delta Vision
Employee $4.32
Employee + $8.64
Employee + Child(ren) $8.82
Family $13.14
2019 Benefits Guide
Gorman & Company 4
MEDICAL BENEFITS - ANTHEM Administered by Anthem BlueCross BlueShield
Comprehensive and preventive healthcare coverage is important in protecting you and your family from the financial risks of unexpected illness and injury. A little prevention usually goes a long way—especially in healthcare. Routine exams and regular preventive care provide an inexpensive review of your health. Small problems can potentially develop into large expenses. By identifying the problems early, often they can be treated at little cost. The Summary of Benefits and Coverage can be found on the Gorman intranet site.
BLUE ACCESS PPO
Team Members who reside outside WI
BLUE PREFERRED PLUS PPO
Team Members who reside in WI
In-Network Out-of-Network In-Network Out-of-Network
Lifetime Benefit Maximum Unlimited Unlimited
Annual Deductible
(embedded) $1,000 single
$3,000 family $2,000 single
$6,000 family $1,000 single
$3,000 family $2,000 single
$6,000 family
Annual Out-of-Pocket Maximum (embedded) $5,200 single
$10,400 family $10,400 single
$20,800 family $5,200 single
$10,400 family $10,400 single
$20,800 family
Coinsurance 90% 70% 90% 70%
DOCTOR’S OFFICE
Primary Care Office Visit $20 copay
Deductible, then covered at 70%
$20 copay Deductible, then covered at 70%
Specialist Office Visit
$80 copay Deductible, then covered at 70%
$80 copay Deductible, then covered at 70%
Preventive Care (routine exams, immunizations, well baby care and mammograms)
100% Deductible, then covered at 70%
100%
Deductible, then covered at 70%
PRESCRIPTION DRUGS
Tier 1 $10
$60 or 50%, whichever is greater
$10
$60 or 50%, whichever is greater
Tier 2 $40
$40
Tier 3 $60
$60
Tier 4 25%, up to $300 25%, up to $300
Tier 5 25%, up to $500 25%, up to $500
Mail Order Drugs (90-day supply)
Tier 1
Tier 2
Tier 3
$25
$120
$180
$25
$120
$180
Mail Order Drugs (30-day supply)
Tier 4
Tier 5
25%, up to $300
25%, up to $500
25%, up to $300
25%, up to $500
HOSPITAL SERVICES
Emergency Room $300 copay, then covered at 90%
$300 copay, then covered at 90%
Urgent Care $100 copay, then covered at 90%
Deductible, then covered at 70%
$100 copay, then covered at 90%
Deductible, then covered at 70%
Inpatient Hospital/Surgical Deductible, then covered at 90%
Deductible, then covered at 70%
Deductible, then covered at 90%
Deductible, then covered at 70%
Outpatient Surgery Deductible, then covered at 90%
Deductible, then covered at 70%
Deductible, then covered at 90%
Deductible, then covered at 70%
*Durable Medical Equipment will have 50% coinsurance after the deductible has been met.
2019 Benefits Guide
Gorman & Company 5
MEDICAL BENEFITS - QUARTZ Administered by Quartz Health Insurance (Unity)
Comprehensive and preventive healthcare coverage is important in protecting you and your family from the financial risks of unexpected illness and injury. A little prevention usually goes a long way—especially in healthcare. Routine exams and regular preventive care provide an inexpensive review of your health. Small problems can potentially develop into large expenses. By identifying the problems early, often they can be treated at little cost. The Summary of Benefits and Coverage can be found on the Gorman intranet site.
POS—Quartz Network
*Health Reimbursement Arrangement available
HMO—Quartz Network
Affiliated with UW Health
In-Network Out-of-Network In-Network Out-of-Network Lifetime Benefit Maximum Unlimited Unlimited
Annual Deductible
(embedded) $500 single
$1,000 family $1,000 single / $500*
$2,000 family / $1,000* $500 single
$1,000 family N/A
Annual Out-of-Pocket Maximum (embedded) $1,500 single
$3,000 family $3,000 single
$6,000 family $1,500 single
$3,000 family N/A
Coinsurance 80% 60% 80% N/A
DOCTOR’S OFFICE
Primary Care Office Visit $30 copay
Deductible, then covered at 60%
$30 copay N/A
Specialist Office Visit $30 copay
Deductible, then covered at 60%
$30 copay N/A
Preventive Care (routine exams, immunizations, well baby care and mammograms)
100% Deductible, then covered at 60%
100%
N/A
PRESCRIPTION DRUGS
Prescription Drug Out-of-pocket Maximum
$2,350 single $4,700 family
$2,350 single $4,700 family
N/A
Tier 1 $10
$10
Tier 2 $35
$35
Tier 3 $60
$60
Tier 4 $200
$200
Value Tier $5 Rx Outcomes $5 Rx Outcomes
HOSPITAL SERVICES
Emergency Room $125 copay, then covered at 80%
$125 copay, then covered at 80%
N/A
Urgent Care $60 copay, then covered at 80%
Deductible, then covered at 60%
$60 copay, then covered at 80%
N/A
Inpatient Hospital/Surgical Deductible, then covered at 80%
Deductible, then covered at 60%
Deductible, then covered at 80%
N/A
Outpatient Surgery Deductible, then covered at 80%
Deductible, then covered at 60%
Deductible, then covered at 80%
N/A
* Health Reimbursement Arrangement on the Unity POS plan reimburses expenses up to $500 single / $1,000 family keeping the deductibles at $500 single / $1,000 family. (Gorman pays for the last $500 of the deductible for single coverage, and the last $1,000 of the deductible for family coverage.)
2019 Benefits Guide
Gorman & Company 6
MEDICAL BENEFITS - Quartz Administered by Quartz Health Insurance (Unity)
Map of Quartz service area.
2019 Benefits Guide
Gorman & Company 7
SERVICES IN-NETWORK/OUT-OF-NETWORK
Annual Deductible $25 single $75 family
Annual Benefit Maximum $1,500
Preventive Dental Services (cleanings, exams, x-rays) 100%
(no deductible)
Basic Dental Services (fillings, root canal therapy, oral surgery)
Deductible, then covered at 80%
Major Dental Services (extractions, crowns, inlays, onlays, bridges, dentures, repairs)
Deductible, then covered at 50%
Orthodontia Services (Child and Adult Coverage)
50% to $1,000 lifetime maximum
DENTAL BENEFITS Administered by Delta Dental of Wisconsin
Good oral care enhances overall physical health, appearance and mental well-being. Problems with the teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with the company dental benefit plan. The dental plan includes a vision-care discount program administered by EyeMed Vision Care, providing up to 35% savings on exams, eyewear, and contact lenses. Voluntary Vision Insurance is also available (see page 11).
2019 Benefits Guide
Gorman & Company 8
LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE Insured by Prudential
Life Insurance
Life insurance provides financial security for the people who depend on you. Your beneficiaries will receive a lump sum payment if you die while employed by Gorman & Company. The company provides basic life insurance of $50,000 at no cost to you. If you are 65, benefits decrease to 65% and to 50% at age 70.
Accidental Death and Dismemberment (AD&D) Insurance
Accidental Death and Dismemberment (AD&D) insurance provides payment to you or your beneficiaries if you lose a limb or die in an accident. The company provides AD&D coverage of $50,000 at no cost to you. This coverage is in addition to your company-paid life insurance described above.
VOLUNTARY LIFE AND AD&D INSURANCE Insured by Prudential
You may purchase life and AD&D insurance in addition to the company-provided coverage. You may also purchase life and AD&D insurance for your dependents if you purchase additional coverage for yourself. You are guaranteed coverage (up to $150,000 and up to $20,000 for your spouse) without answering medical questions if you enroll when you are first eligible. Late entrants will be required to provide evidence of insurability to enroll more than 31 days after initial eligibility.
Employee: Up to seven times your salary in increments of $10,000; $500,000 maximum amount
Spouse: Up to $250,000 (not to exceed 50% of your optional life coverage amount) in increments of $5,000
Children: $2,000 increments from $2,000 to $10,000, not to exceed 50% of your optional life amount
During annual enrollment periods, if you have not been previously denied coverage, you may select to increase your current employee optional life insurance coverage amount by up to $40,000, without providing evidence of insurability satisfactory to Prudential.
LIFE INSURANCE BENEFITS
2019 Benefits Guide
Gorman & Company 9
VOLUNTARY SHORT-TERM DISABILITY INSURANCE Insured by Prudential
If you elect coverage, your weekly short-term disability benefits will be 60% of your weekly pre-disability earnings, up to a maximum of $500. If you meet the definition of a disability, your benefits will begin on the 8th day following a non-occupational injury or the 8th day following a non-occupational sickness. Late entrants will be required to provide evidence of insurability to enroll more than 31 days after initial eligibility.
LONG-TERM DISABILITY INSURANCE Insured by Prudential
The company provides Long-Term Disability insurance coverage for you at no cost.
Long-term disability coverage provides income when you have been disabled for 90 days or more. Your benefit is 60% of your monthly earnings, up to $5,000 per month. This amount may be reduced by other deductible sources of income or disability earnings. Benefit payments can continue to age 65 if you are under age 60 at the time of disability.
DISABILITY BENEFITS Meeting your basic living expenses can be a real challenge if you become disabled. Your options may be limited to personal savings, spousal income and possibly Social Security. Disability insurance provides protection for your most valuable asset—your ability to earn an income.
2019 Benefits Guide
Gorman & Company 10
FLEXIBLE SPENDING ACCOUNT You can save money on your healthcare and/or dependent care expenses with an FSA. You set aside funds each pay period on a pre-tax basis.
FLEXIBLE SPENDING ACCOUNT (FSA) Administered by Employee Benefits Corporation
You pay no federal income or Social Security taxes on your contributions to an FSA. (That’s where the savings comes in.) Your FSA contributions are deducted from your paycheck before taxes are withheld, so you save on income taxes and have more disposable income.
The Healthcare FSA can be used for qualified expenses such as co-pays, coinsurance, deductibles, prescribed over-the-counter medications, eyewear, contact lenses, prescription sunglasses, sunscreen, and more. The Healthcare FSA comes with a Benefits Card that you can use for eligible health care expenses instead of using cash.
The Dependent Care FSA is used to reimburse you for daycare expenses incurred for the care of your child(ren) or other dependents while you work.
Healthcare Spending Limit $2,700
Dependent Care Spending Limit $5,000
2019 Benefits Guide
Gorman & Company 11
SERVICE IN-NETWORK OUT-OF-NETWORK
Eye Exam — once every 12 months
Covered in full
Up to $35
LENSES: ONCE EVERY 12 MONTHS Single Vision Lenses Covered in full Up to $25 Lined Bifocal Lenses Covered in full Up to $40 Lined Trifocal Lenses Covered in full Up to $55 FRAMES: ONCE EVERY 12 MONTHS
$150 allowance, then 20% off
balance
Up to $75
CONTACT LENSES: ONCE EVERY 12 MONTHS
Contact Lenses
Disposable Medically necessary
$150 allowance, then 15% off balance
$150 allowance
Covered in full
Up to $120
Up to $120
Up to $200
VISION BENEFITS Delta Vision is administered by EyeMed Vision Care
Regular eye examinations can not only determine your need for corrective eyewear but also may detect general health problems in their earliest stages. Protection for the eyes should be a major concern to everyone.
2019 Benefits Guide
Gorman & Company 12
2019 Benefits Guide
Gorman & Company 13
2019 Benefits Guide
Gorman & Company 14
401K RETIREMENT PLAN
401K RETIREMENT PLAN Administered by Empower Retirement
Gorman & Company has a 401K plan which you may be eligible to participate in through pre-tax payroll deductions, or after-tax payroll deductions for Roth contributions. You are allowed to rollover existing qualified plan contributions into this plan. A match from Gorman & Company cannot be made until you have met the participation criteria which are 1,000 hours of service and one year of employment with the company. The entry date for participation in the employer match is the first of the month following the date on which you meet these criteria. The current discretionary employer match is 100% (dollar for dollar) of up to 6% of your annual pay. The employer match contributions are deposited on an annual basis and you must be employed at the end of the calendar year in order to receive it. There is a 6-year vesting schedule for the 401K plan.
Gorman & Company’s 401K plan is set up for Auto Enrollment. This means that when you become eligible to participate in the plan, you will be automatically enrolled in the plan at 3%. You will receive a notice from Empower Retirement one month prior to your eligibility date explaining this and giving you the opportunity to go online and “opt out” or edit your contribution percentage.
2019 Benefits Guide
Gorman & Company 15
EMPLOYEE ASSISTANCE PROGRAM Administered by ComPsych Guidance Resources Worldwide
COMPSYCH GuidanceResources® Worldwide
2019 Benefits Guide
Gorman & Company 16
EARNED TIME / PAID HOLIDAYS
EARNED TIME ACCRUAL
Earned Time is paid time off that can be used for vacation, sick, and/or personal days. Full-time benefits- eligible team members will accrue Earned Time according to the schedule below. Part-time 75 benefits-eligible team members (30+ hours per week) will receive a pro-rated amount of Earned Time, calculated based upon the number of hours they are regularly scheduled to work. Accrual of Earned Time commences on your start date and accrues on a per pay period basis. Earned Time may not be used during the first 3 months of employment.
FULL-TIME ACCRUAL SCHEDULE
PART-TIME 75 ACCRUAL SCHEDULE
PAID HOLIDAYS
Currently, all regular-status full-time and part-time 75 team members are eligible for the following paid holidays:
New Year’s Day Thanksgiving Day
Good Friday (½-day) Day after Thanksgiving
Memorial Day Christmas Eve Day (½-day)
Independence Day Christmas Day
Labor Day New Year’s Eve Day (½-day)
Length of Employment
Accrual per Pay Period
Maximum Days Accrued per Year
Number of Carryover Days Allowed
0 - 5 years 5.5385 hours 18 days/144 hours 15 days/120 hours
6+ years 7.0769 hours 23 days/184 hours 35 days/280 hours
Length of Employment
Accrual per Pay Period
Maximum Days Accrued per Year
Number of Carryover Days Allowed
0 - 5 years 4.1538 hours 14.5 days/116 hours 11.25 days/90 hours
6+ years 5.308 hours 17.25 days/138 hours 26.25 days/210 hours
2019 Benefits Guide
Gorman & Company 17
BENEFIT ADMINISTRATOR PHONE WEBSITE/EMAIL
Medical - Anthem Anthem BlueCross
BlueShield Call the number on your
ID card www.anthem.com
Medical - Quartz Quartz (Unity) Call the number on your
ID card https://quartzbenefits.com/
Dental Delta Dental of Wisconsin 800-236-3712 www.deltadentalwi.com
Vision EyeMed Vision Care 844-848-7090 www.eyemed.com
Pet Insurance Nationwide 877-738-7874 www.petinsurance.com/
gormanusa
Flexible Spending Account
Employee Benefits Corporation
800-346-2126 www.ebcflex.com
Life / Disability Prudential 877-232-3619 www.prudential.com
401K Plan Empower Retirement 800-338-4015 www.empower-
retirement.com/participant
EAP Program ComPsych 800-311-4327 www.guidanceresources.com
Web ID: GEN311
Human Resources [email protected]
Contact Information If you have specific questions about a benefit plan, please contact the administrator listed below, or the human resources department.
![Index [about.usps.com]about.usps.com/manuals/elm/elmindx.pdf · Employee and Labor Relations Manual Index 886 ELM 44 Accidental death claims, 538.35 FEGLI benefits, 538.23 Accidental](https://static.documents.pub/doc/80x56/5b142eb37f8b9a2f7c8bb9d2/index-aboutuspscomaboutuspscommanualselm-employee-and-labor-relations.jpg)
