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2020 NEW HIRE ENROLLMENT BENEFITS FOR YOU AND YOUR FAMILY
2020
NEW HIRE ENROLLMENT
BENEFITS FOR YOU AND YOUR FAMILY
1 | NEW HIRE ENROLLMENT 2020
Dear ChenMed Employees,
ChenMed, a Family of Companies believes in making a positive impact not only within the health care profession but also with our employees – the organization’s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families. To help promote “healthy choices,” ChenMed offers premium discounts for the Medical/Rx plan for eligible employees and their eligible dependents who complete various wellness activities.
ChenMed believes that education is power. Being an informed consumer regarding your employee benefits is important now more than ever. Everybody has an important role – let’s be healthy and stay well!
Healthy Regards!
TABLE OF CONTENTS Important Telephone Numbers and Websites ....... 2
Benefits for You and Your Family ............................... 3
Medical Insurance ................. 5
Health Savings Account .... 6
Dependent Care Flexible Spending Account (FSA) .. 8
myWell-Being Program ....... 9
my-WELL BEING Points Program .......................10
Dental Insurance .................... 11
Vision Insurance ..................... 12
Basic Group Term Life and Accidental Death & Dismemberment Insurance ................................... 13
Optional Life & Accidental Death & Dismemberment Insurance ................................... 14
Group Short-Term Disability (STD) ......................... 15
Group Long-Term Disability (LTD) ........................ 15
Accident Insurance .............. 16
Critical Illness Insurance ..... 17
Legal Protection Plan .............. 21
Annual Notices .......................... 22Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) ............................................ 27
ABOUT THIS GUIDE This overview guide shows only highlights of your ChenMed benefits. This is not a complete detailed description nor is it a contract of employment or guarantee of benefits. More detailed information is contained in the relevant certificates of coverage/ plan documents provided by your insurance carrier.
Great care has been taken to ensure that this overview is accurate. However, oversights can occur, or condensed summaries can be misinterpreted. If there is a difference between this guide or the plan documents/certificates of coverages, the plan documents/certificates of coverages will govern.
Flexible Spending Account (FSA) & Limited purpose FSA .. 7
Hospital Indemnity Insurance ... 18
Employees have two (2) ways to enroll:1. Via phone at 1.855.874.02292. On-line at www.benefitsgo.com/ChenMed
401(k) Plan ............................... 19
TOTAL REWARDS | 2
IMPORTANT TELEPHONE NUMBERS AND CONTACTS
Plan Carrier Group Number Phone Number Website
Medical Insurance Cigna 3343074 1-800-244-6224 www.mycigna.com
Informed Health Line Cigna www.mycigna.com
Maternity Program Cigna www.mycigna.com
Health Savings Account (HSA)
PNC Bank Individual Identifier
Prescription Express Scripts www.mycigna.comDependent Care/Healthcare Limited
purpose/ Flexible Spending Accounts (FSA)
Discovery Benefits
23006 1-866-451-3399 www.discoverybenefits.com
Dental Insurance Guardian 485904 1-800-541-7846 www.guardiananytime.com
Guardian College Tuition Benefit
Guardian 485904 1-215-839-0119www.guardian.
collegetuitionbenefit.com
Vision Insurance Guardian 485904 1-800-541-7846 www.guardiananytime.com
Basic & Optional AD&D Basic & Optional Life Base & Buy-up Short-Term Disability Insurance Long-Term Disability Insurance
Cigna
OK968996
FLX967486
FLX960935
FLK 960936
Customer Service 1-800-238-2125
www.cigna.com
FMLA FML960935
Claims1-800-362-4462
(English)1-866-562-8421 (Español)
Critical Illness Plan, Hospital Indemnity, Accident Plan & Whole Life
VOYA 70218-8 1-877-236-7564 www.voya.com
Legal Protection Plan Legal Club N/A 1-800-305-6816 www.legalclub.com
Employee Assistance Plan (EAP)
Cigna FLX967486 1-800-538-3543
(English & Español)www.cignabehavioral.com/cgi
Secure Travel (Emergency Travel Assistance)
Cigna OK968996
Within the U.S. 1-888-226-4567
Outside the U.S.(call collect)
202-331-7635
www.cigna.com
401(k) Retirement PlanPrincipal
Financial Group714734 1-800-547-7754 www.principal.com
Compliance, Assistance & Reporting Line (CARL)
ChenMed N/A 1-855-252-7606 [email protected]
HR Operations (Employee Services)
ChenMed N/A1-833-MyAskHR or
1-833-692-7547 [email protected]
1-800-244-6224
1-800-244-6224
1-800-244-6224
www.mycigna.com1-800-244-6224
3343074
3343074
3343074
3 | NEW HIRE ENROLLMENT 2020
BENEFITS FOR YOU AND YOUR FAMILY
ChenMed is pleased to make available our 2020 benefits program, which is designed to help you stay healthy, feel secure, and maintain a work/life balance. ChenMed’s mission is to provide a convenient, patient-centered environment that fosters enduring relationships between doctors, staff, and patients and delivers superior outcomes and a compassionate experience. Offering a comprehensive and competitive benefits package is just one way we strive to show our support and reward your contributions in hopes of fostering a rewarding workplace.
Listed below are some of the ChenMed Benefits available to employees in 2020
• Medical Insurance
• Health Savings Account (HSA)
• Dependent Care Flexible Spending Account (DCFSA)
• Dental Insurance
• Vision Insurance
• Life and Accidental Death & Dismemberment Insurance (AD&D) (Employer provided)
• Optional Life and Accidental Death & Dismemberment (AD&D) Insurance (Employee Paid)
• Short-Term Disability (STD) (Employer provided)
• Optional Buy-Up Short-Term Disability (STD) (Employee paid)
• Long-Term Disability (LTD) (if eligible) (Employer provided)
• Accident Insurance
• Critical Illness Insurance
• Legal Protection Plan
Because ChenMed remains committed to wellness and prevention, our medical and prescription plans cover in-network preventive and wellness care at 100% — with no copayments or coinsurance — and without having to meet an annual deductible for these services.
WELLNESS TIPPREVENTIVE/WELLNESS CARE COVERED AT NO COST TO YOU!
• Healthcare Flexible Spending Account(FSA) and Limited Purpose FSA
• Hospital Indemnity Insurance
• Whole Life Insurance
TOTAL REWARDS | 4
When and How Do I Enroll?Enrollment is available to new employees the first of the month following 30 days of full time employment. New Hires have 2 ways to enroll.
1. Via phone at 1.855.874.02292. On-line at www.benefitsgo.com/ChenMed
ChenMed’s Total Rewards team may also be available to help employees enroll in their benefits on-line.
When Is My Coverage Effective?The effective date for your benefits is the first of the month following 30 days of employment.
Your 2020 Enrollment Benefits Confirmation Statement indicates the effective date of your coverage and the cost of each benefit. Be sure to print out your statement.
Who is Eligible?
You are eligible for coverage if you are a regular full-time employee working at least thirty (30) hours per week, the family members listed below are eligible for Medical, Dental, Vision, and Optional Life and AD&D insurance.
• Your legal spouse (see spouse medical coverage requirement)
• Natural biological child; step child; foster child; a child under a Qualified Medical Child Support Order (QMCSO); andadopted child up to age 26;
• Children under your legal guardianship; and
• Unmarried, dependent children who become mentally or physically incapable of earning a living, before age 26(medical certification required).
Spouse Medical CoverageAt ChenMed we value our employees and their families and want to ensure that if an employee’s spouse is not eligible for medical insurance coverage outside of ChenMed that we provide for their healthcare needs. However, if an employee’s spouse is eligible to participate in an employer-sponsored medical plan through their employer, then they are ineligible to participate in the ChenMed Medical Insurance Plan. If you are enrolling an eligible spouse during enrollment, proof such as but not limited to a certificate of marriage is required.
Dependent (Adult Child) Coverage: Dependents under the age of 26 do not need to be full-time students to be eligible for medical, dental and vision coverage. This includes married dependents but not their spouse and/or children. If you are enrolling an eligible dependent child during enrollment, proof is required. Examples of proof of dependency include but are not limited to: birth certificate, adoption, foster or legal medical support order indicating the participating employee as the parent. To submit proof of dependency in Workday go to Personal Information > View > Worker Documents.
Providing False Information: Employees who submit false information intended to provide health care coverage for alleged “eligible” dependents may be subject to discipline up to and including termination. Such employees will be held financially responsible for premiums and be required to reimburse any payments made on behalf of or for the benefit of an ineligible person claimed as a dependent.
5 | NEW HIRE ENROLLMENT 2020
Group Medical Benefits HSA Choice HSA Premium Traditional PlanIn-Network Benefits In-Network In-Network In-Network
Deductible (Single/Family) $2,000/$4,000 $1,750/$3,500 $1,500/$3,000
Coinsurance 80%/20% 90%/10% 90%/10%
Medical Out-of-Pocket Max $6,000/$12,000 $4,500/$9,000 $3,000/$6,000
Primary Doctor Office Visit Deductible + 20% Deductible + 10% $25 copay
Specialist Doctor Office Visit Deductible + 20% Deductible + 10% $50 copay
Preventive Care (Annual Physical, Lab Work, X-rays)
Covered at 100%
Diagnostic Lab Work (X-rays, CAT Scan, MRI, etc.)
Deductible + 20% Deductible + 10% Deductible + 10%
Inpatient/Outpatient Hospital Deductible + 20% Deductible + 10% Deductible + 10%
Outpatient Surgery Deductible + 20% Deductible + 10% Deductible + 10%
Urgent Care Center Deductible + 20% Deductible + 10% $50 copay
Emergency Services Deductible + 20% Deductible + 10% Deductible + 10%
Prescription Drugs Deductible + 20% Deductible + 10%
Generic: $10 copay Name Brand: $30 copay
Non-Formulary: $50 copay
Mail Order: 90-day supply Deductible + 20% Deductible + 10% 2x copay
Rx Out-of-Pocket Max N/A N/A N/A
Out-of-Network Benefits Out-of-Network Out-of-Network Out-of-Network
Deductible (Single/Family) N/A $3,000/$6,000 $3,000/$6,000
Coinsurance N/A 60%/40% 60%/40%
Out-of-Pocket N/A $6,000/$12,000 $6,000/$12,000
Emergency Services N/A Deductible & 10% Coinsurance Deductible & 10% Coinsurance
Group Medical Benefits
Bi-Weekly Deductions (Reduced from 2019)
HSA Choice HSA Premium Traditional Plan
Standard Deduction
Wellness Credit
myWell-Being
Deduction
Standard Deduction
Wellness Credit
myWell-Being
Deduction
Standard Deduction
Wellness Credit
myWell-Being
Deduction
Employee Only $55.00 $55.00 $0.00 $75.00 $55.00 $20.00 $120.00 $55.00 $65.00
Employee + Child(ren)
$95.00 $55.00 $40.00 $160.00 $55.00 $105.00 $245.00 $55.00 $190.00
Employee + Spouse
$250.00 $110.00 $140.00 $300.00 $110.00 $190.00 $390.00 $110.00 $280.00
Family $320.00 $110.00 $210.00 $400.00 $110.00 $290.00 $550.00 $110.00 $440.00
Cigna offer's 2 Maternity programs free of charge to ChenMed's mothers to be. The Healthy Babies program includes educational materials, along with case management and a 24 health information line. The second program is the Healthy Pregnancies, Healthy Babies (HPHB) which is a maternity management program that members enroll in to have a highly engaged experience with risk assesments and a nurse-line to guide members with any issues they have, or to guide them if they have a high-risk pregnancy. (See internal intranet site for additional details)
WELLNESS TIPCIGNA MATERNITY PROGRAM IS FREE FOR MOMS-TO-BE
MEDICAL BENEFITS OVERVIEW Cigna
Tip: pay attention to the plan design as well as the bi-weekly premiums to choose the plan right for you.
TOTAL REWARDS | 6
HEALTH SAVINGS ACCOUNT (HSA)An HSA is a special tax deferred bank account that allows you to pay for healthcare related expenses on a tax free basis. HSA accounts must be used with qualifying medical plans-like the HSA Choice and HSA Premium. The funds in an HSA are 100% vested to the account holder, and can accumulate from year to year.
How do HSAs work?Each employee must elect to open an HSA account with PNC Bank and choose the amount to contribute on a tax deferred bi-weekly basis (not to exceed the annual maximum). The deposited money is available to you and your dependents to help pay for qualified healthcare expenses. If the money is not used by the end of the year, it will roll over and can be used at anytime.
What Are Qualified Expenses?Your HSA funds can be used for qualified expenses as determined by the IRS. Below is a list of common uses for HSA funds.
• Medical Plan Deductibles
• Medical Plan Coinsurance and Copays
• Prescription Costs
• Dental Bills
• Prescription Eyewear
• COBRA Premiums
• Qualifying LTC Contracts
If you do not use a distribution from your HSA for qualified medical expenses, you must pay tax on the distribution. You may have to pay an additional 20% tax on your taxable distribution.
A complete list can be found in IRS Publication 502 at the IRS website - www.irs.gov.
ChenMed HSA ContributionIf you enroll in the HSA Choice or HSA Premium plan and elect to open an HSA account, ChenMed will deposit $500 into your account for the plan year (this is contingent upon your benefits effective date and electing a minimum annual contribution of $26). Payments will be divided into 26 pay periods for the 2020 plan year.
Please be aware that if you are enrolled in TriCare, TriCare for Life, or Medicare A, B, C or D, you may be ineligible for the ChenMed HSA Contribution. Please contact your accountant or tax professional to determine your eligibility. If you are ineligible, please notify us at [email protected].
HSA Limits for 2020:
Contribution Limit* 55+ Additional Contribution
Single $3,550 $1,000
Family $7,100** $1,000
*Contribution limits do not include the Employer Contribution funded by ChenMed.**For those employees whose spouse is also an employee of ChenMed, the combination of all contributions (yours & ChenMed’s) cannot exceed the IRS family contribution limit of $7,100.
7 | NEW HIRE ENROLLMENT 2020
FLEXIBLE SPENDING ACCOUNT
A Flexible Spending Account (FSA) allows you to budget and save for qualified medical expenses incurred over the course of your plan year. Dollars invested in an FSA are tax-free and can be used for expenses incurred by you, your spouse or eligible dependents. That makes an FSA a great tool for saving money, especially when big expenses are anticipated. ChenMed cares for its Employees and provides another outlet to help cover out of pocket healthcare costs by participating in the new Healthcare and dental and vision cost by participating in the new Limited Purpose Flexible Spending Accounts (FSAs) programs with Discovery Benefits.
Eligible Expenses
In order to have an expense covered by your FSA dollars, that expense has to be considered eligible by the IRS. To find out which specific expenses are eligible, view our searchable eligibility list at www.DiscoveryBenefits.com/eligibleexpenses.
For easy access to your Healthcare and Limited Purpose FSA funds, you can swipe your Discovery Benefits debit card and avoid out-of-pocket costs. If you use your card at a provider with an Inventory Information Approval System (IIAS), the expense will automatically be approved at the point of sale. If your Healthcare and Limited purpose FSA funds are not used by the end of the year, ChenMed allows a carry over period in which funds can be used up to March 15, 2021. Thereafter unused funds are forfeited.
For those enrolled in an HSA eligible medical plan you are able to participate in the new limited purpose FSA plan. The limited purpose FSA allows you to set aside pre-tax dollars to cover out-of-pocket dental, vision, and preventative care expenses. Your funds can be used for expenses incurred by you, your spouse or eligible dependents. Your entire election amount is available on the first day of your plan year.
Maximum Annual Election
Flexible spening Account (FSA) or Limited Purpose FSA
Current 2020 FSA limits:
$2,750 Per Employee
If the card is swiped at a merchant that fails to meet the IRS’ 90% rule, you may need to provide documentation to show the expense is eligible.
CARDHOLDER NAME
12/16 DEBITGOODTHRU
4000 1234 5678 9101
Using Funds
Substantiation
The IRS requires FSA participants to provide documentation (e.g. an Explanation of Benefits) to show that an expense is FSA-eligible. You can easily upload documentation for a claim by logging in to your online account. You can also submit documentation by taking a photo with your phone’s camera and uploading it through the Benefits Mobile App by Discovery Benefits.
Download the app for free on Apple and Android smartphones
and Tablets
LIMITED PURPOSE FLEXIBLE SPENDING ACCOUNTBenefits of a Limited Purpose FSA
For those enrolled in the Traditional medical plan you are eligible to participate in the new Healthcare FSA plan. The healthcare purpose FSA allows you to set aside pre-tax dollars to cover out-of-pocket healthcare expenses. Your funds can be used for expenses incurred by you, your spouse or eligible dependents. Your entire election amount is available on thefirst day of your plan year.
HEALTHCARE FLEXIBLE SPENDING ACCOUNT
8 | NEW HIRE ENROLLMENT 2020
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTDependent Care Flexible Spending Account (DCFSA) is a simple way to save money on care for your dependents. It allows you to set aside a portion of your salary, before taxes, to pay for Eligible Dependents Care Expenses dependent care expenses. Because that portion of your income is not taxed, you end up with more money in your pocket.
ChenMed cares for its caregivers and offers participation in a Flexible Spending Account (FSA) for dependent care expenses through Discovery Benefits.
Eligible Dependents• Children up to age 13 who are claimed as a dependent for tax purposes
• Disabled spouse or disabled dependent of any age
You would normally pay out of your pocket (with post-tax dollars); now you pay no federal taxes on the money you contribute to a Dependent Care FSA.
Qualifying expenses include day care fees, before-school and after-school care and summer day camp. If you are married, your spouse must either be employed or a full-time student in order to use a Dependent Care Flexible Spending Account. Under IRS guidelines, you can only be reimbursed for dependent care expenses for an Eligible Dependent that have taken place. You may receive reimbursement up to the current balance in your account at the time the request is made.
How Does a Dependent Care FSA Work: • Choose a specific amount of money to contribute for 2020. That amount will be divided by 26 pay periods and
deducted pre-tax.
• The IRS has a strict “use it or lose it” rule. If you do not use the full amount in your FSA by December 31, 2020, youwill lose your funds.
Important Rules to Keep In Mind: • You must re-elect Dependent Care FSA each year.
• Once you enroll in the Dependent Care FSA, you cannot change your contribution amount during the year unlessyou experience a qualifying change in status event.
• You cannot transfer funds from one Dependent Care FSA to another.
Maximum Annual Election
Dependent Care FSA
The IRS has not announced the 2020 Dependent Care FSA limits. Current
limits are:
$5,000 Married (joint return) or Single Head of Household
$2,500 Married (separate return)
GIVE YOURSELF A
PAY RAISE.
Bring home more of your
paycheck.
TOTAL REWARDS | 9
CHENMED myWELL-BEING PROGRAMChenMed is pleased to offer our employees a wellness program designed to improve your overall health and reward you for making healthy choices. Employees must complete both activities below in order to receive the myWell-Being credit toward the cost of their medical coverage. There is no cost to participate, and your personal health information is completely confidential. The myWell-Being credit will not apply until ChenMed has record of both activities being completed. Once the two activities are verified, the credit will be applied on a go forward basis ONLY.
The Clinical Health Risk Assessment (CHRA)Completing a clinical health risk assessment (CHRA) is the first step for members. Access the CHRA online via the Cigna website at www.mycigna.com. The CHRA is a compilation of questions regarding medical history and lifestyle habits, such as food choices, activity, tobacco use and readiness to change. It provides members with a comprehensive report on how their health compares to national standards and suggested areas where change would be beneficial.
myWELL-BEING AffidavitEmployees and their enrolled spouses who partake in the myWell-Being program must not use tobacco and comply with the safety items stated in the myWELL-BEING Affidavit. The my WELL-Being Affidavit can be completed on line at www.myCigna.com.
To qualify for the myWELL-BEING credit, employees and their eligible spouses covered under the medical plan are required
to complete the, CHRA, and myWELL-BEING Affidavit. The myWELL-BEING credit will not begin unless both activities are
completed.
CHENMED MYWELL-BEING POINTS PROGRAM
ChenMed Total Rewards
Eligibility: All ChenMed employees and eligible spouses are required to complete the following activities in order to receive the wellness credit and be eligible to earn an additional incentive through the myWell-Being 2020 points program.
• Complete the UMR Clinical Health Risk Assessment(CHRA)
• Complete ChenMed myWell-Being Affidavit
Only employees and eligible spouses who are enrolled in the ChenMed health plan will be eligible to receive an incentive.
Incentives:The incentive plan consists of two (2) key categories:
• Qualifying Activities – defined as those activities thatare required. Completing these required activities willallow employees to obtain payroll credits for theirwellness deductions in the amount of $55.00 foremployees and $55.00 for eligible spouse.
Eligible Spouse – If an employee’s spouse is eligible to participate in an employer sponsored health plan through their employer, then they are not eligible to participate in the ChenMed health plan.
10 | BENEFIT ENROLLMENT 2020
11 | NEW HIRE ENROLLMENT 2020
OUR DENTAL PLANStrong teeth and gums are an important part of good health, which is why ChenMed offers benefit eligible employee and their eligible dependents the opportunity to participate in comprehensive dental plans provided through Guardian.
Guardian Choice Plan Premium Plan Traditional Plan
Yearly Max Per Person $1,000$1,500 In-Network/
$1,000 Out-of-Network$2,000
Annual Max Rollover Yes Yes Yes
In-Network BenefitsCalendar Year Deductible (Max 3 per family) $50 $50 $50Waived for Preventive Services Yes Yes YesCleanings, Exams, X-Rays 100% 100% 100%Basic Services - Fillings, Extractions, Anesthesia, Repairs
80% 90% 100%
Major Services - Gold & Porcelain Fillings, Crowns, Bridgework, Dentures
50% 60% 60%
Periodontics (Gum Disease) Major Basic BasicEndodontic (Root Canal) Major Basic BasicOral Surgery Major Basic BasicOrthodontia Lifetime Max (Child less than 19) Not covered 50% to $1,000 50% to $2,000
Out-of-Network BenefitsCalendar Year Deductible (Max 3 per family) $100 $100 $50Waived for Preventive Services No No YesPreventive Services 90% 100% 100%Basic Services 70% 80% 80%Major Services 40% 50% 50%
Non-Preferred Provider Payment Based on the 90 Percentile of Usual and Customary
Waiting Periods For Late EntrantType 1 - Preventive No Waiting PeriodType 2 - Basic 6 MonthsType 3 - Major 12 MonthsType 4 - Orthodontia 24 MonthsPreferred Provider Network DentalGuard PreferredFind the Network Here
Deductions Per Paycheck For Dental Plans Choice Plan Premium Plan Traditional Plan
Employee $11.49 $14.88 $17.31
Employee + Child(ren) $30.19 $40.86 $49.91
Employee + Spouse $25.05 $31.70 $36.90
Family $43.74 $57.68 $69.50
Therefore, routine exams and dental cleanings may help prevent the incidence of these higher–cost treatments and medical-related issues. Remember to establish a relationship with
WELLNESS TIPPREVENTIVE SERVICES USUALLY COST A LOT LESS THAN FILLINGS, ROOT CANALS AND EXTRACTIONS
Your participation in the Guardian Dental Plan will earn you College Tuition Benefit Rewards! To find out more information, go to: www.Guardian.CollegeTuitionBenefit.com
www.guardiananytime.com
TOTAL REWARDS | 12
OUR VISION PLANChenMed offers vision insurance coverage through Guardian Insurance. Your vision plan provides a benefit option that covers routine eye care, including eye exams through Guardian. This chart gives a side-by-side look at the amounts you pay when you use in-network and out-of-network providers.
Plan Feature In-Network Out-of-Network
Frequency Once every Calendar Year Once every Calendar Year
Eye Exams $10 CopayPlan pays up to $39
after $10 Copay
Lenses
Single $25 CopayPlan pays up to $23
after $25 Copay
Bifocal $25 CopayPlan pays up to $37
after $25 Copay
Trifocal $25 CopayPlan pays up to $49
after $25 Copay
Lenticular $25 CopayPlan pays up to $64
after $25 Copay
Lens Frequency Once every Calendar Year Once every Calendar Year
Frames (enhanced benefit)Plan pays up to $150 retail + 20% dis-count
off balance after $25 CopayPlan pays up to $46 after
$25 Copay
Contact Lenses
“Necessary” $25 Copay Plan pays up to $210 after $25 Copay
Elective Plan pays up to $150 Plan pays up to $100
Contact Lens Frequency Once every Calendar Year Once every Calendar Year
Preferred Provider Network
Find the Network Here
VSP Choice Network
www.guardiananytime.com
Vision VSP A56 Deductions Per Paycheck for Vision Plan
Employee $3.91
Employee + Child(ren) $6.72
Employee + Spouse $6.59
Family $10.63
When you visit your eye doctor, they are not just looking for vision problems. Your eyes are an indicator of your overall health, and eye exams can reveal early warning signs of eye disease, as well as serious health problems such as high blood pressure, high cholesterol, and diabetes. Regardless of your age, it is recommended that you have your eye exam once a year. Visit www.guardiananytime.com or call 1-800-541-7846 to find a VSP Choice network provider.
WELLNESS TIPWELLNESS IS ALSO ABOUT KEEPING YOUR EYES HEALTHY
13 | NEW HIRE ENROLLMENT 2020
BASIC TERM LIFE & ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCEChenMed understands how important financial stability is to you and your family, we provide Basic Life and Accidental Death and Dismemberment (AD&D) insurance at no cost to you.
Basic Group Term Life/AD&D Employer – Paid Benefit
Maximum Benefit AmountFull-Time Employees - $20,000Executives, Physicians, Board Members, Officers, Directors, Physician Assistants and Nurse Practitioners – 3 x Salary up to $500,000
Age Reduction On Jan. 1 coinciding w/ or next following the EE's attained age.65% at Age 65; 50% at Age 70
Conversion Yes
Portability Yes
Cigna Life Assistance Program Employee Assistance Work Life Balance Included
Cigna Secure Travel Emergency Travel Assistance Program Included
Work and life balance isn’t only for you, it’s also for your family. And part of achieving that balance is making sure your loved ones are taken care of in the event of an emergency or everyday issues. You and your family members are automatically enrolled in these programs at no extra cost to you.
CignaLife Assistance Program™Helps people balance work/life and stay productive with counseling, informational seminars and 24/7 consultation services
• Call any time – 1-800-538-3543 for professional and confidential assistance
• Access to consultation by phone 24 hours a day, seven days a week, from licensed Cigna clinicians
• Up to three free in-person counseling sessions from masters’ and PhD-level licensed behavioral health clinicians
• Online resources for work/life challenges – www.cignabehavorial.com
• Monthly webcast seminars on a variety of topics
Cigna Secure Travel®Emergency medical assistance and referrals when traveling, with no dollar limitations on medical evacuation/repatriation coverage
• Pre-Trip planning, assistance while traveling, and emergency medical transportation benefit for coveredpersons traveling 100 miles or more from home
• Service is a phone call away 24/7/365 – 1-888-226-4567. In an emergency you can even call collect 202-331-7635
As a general rule of thumb, for comprehensive and lasting protection, you should cover at a minimum 60% of annual income times the number of years to retirement. Life insurance should equal outstanding debt such as mortgages and loans, plus five years of salary. Remember, your needs change throughout your life—for instance after the birth of a child or losing a second income, therefore it is important to evaluate your life insurance coverage periodically. Important — if your family situation changes, you will want to review the beneficiaries on file with ChenMed and update this information if needed.
WELLNESS TIPHOW MUCH LIFE INSURANCE DO I NEED?
TOTAL REWARDS | 14
OPTIONAL LIFE & ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCEBenefit eligible employees may purchase Optional Life and AD&D Insurance for yourself, spouse, and child(ren). The cost of this coverage depends on your age and the amount of coverage elected. Age reductions also apply to these coverages.
Options Amounts in $10,000 Benefit IncrementsMaximum Benefit (Lesser of 5 x Annual Salary or $500,000)
Employee Guaranteed Issue Amount $200,000
Spouse OptionsAmounts in $10,000 Benefit Increments; Up to
100% of the Employee’s Coverage
Spouse Guaranteed Issue Amount $30,000
Child Option Amounts in $2,000 Benefit Increments; Not to exceed $10,000
Coverage Highlights
Portability & Conversion Yes
Accelerated Benefit50% of your Life Insurance Amount up to $250,000. Any
payout would reduce the death benefit.
AD&DDoes not have to match life amount.
You do not have to complete EOI for AD&D insurance.
Guaranteed Issue at Annual Enrollment
If you were previously eligible to participate in the plan and are enrolling for the first time, Evidence of Insurability (EOI) is NOT required this year. EOI is required for any amount
over the Guaranteed Issue Amount.
If you are newly eligible to participate in the plan and are enrolling in this benefit, EOI is required for any amount over the Employee Guarantee Issue Amount.
EOI must be completed within 31 days from enrollment. If you and your dependents are enrolled and want to increase your coverage, EOI is not required for amounts up to Guarantee Issue
Amounts
If your election requires EOI, please visit https://secure.na1.echosign.com/public/esignWidget?wid=CBFCIBAA3AAABLblqZhA_ceUAE7OgZHkO22vojU0wfwgj5SX_PRYxVIeigXYzCGFBQXcxc02GN2M1pOtU5vA and complete the necessary documentation online.
Note: Dual coverage for married couples is not allowed. If you and your spouse both work for ChenMed, you cannot cover your spouse under the spouse life and AD&D insurance. In addition, you both cannot cover any dependent children under child life and AD&D insurance. If you have any questions, please send an email to [email protected].
Term Life insurance provides your family with additional financial resources if you pass away from a covered circumstance.
It’s hard to think about, but what would your family do without you? Life insurance is an important part of any financial plan. It can help your family:
• Cover your family’s living expenses
• Take care of your children’s education
• Cover your funeral expenses
• Pay off your mortgage and other debts
You’re covered for a specific period of time, or “term.” If you pass away during the term, the beneficiary you designate will receive a payment. Provide protection to those who matter most. Be sure to select or update your beneficiary designations.
85% of U.S. consumers agree thatmost people need life insurance, yet just 62
percent say they have it.LIMRA’s Life Insurance Barometer Study 2013.
15 | NEW HIRE ENROLLMENT 2020
SHORT-TERM DISABILITY (STD) BENEFITSBase STD Plan - ChenMed provides company-paid Short-Term Disability (STD) coverage through Cigna for all eligible employees. STD coverage provides a portion of your income to you when you are unable to work due to an illness, maternity or injury. The STD benefit is 50% of your weekly eligible earnings to a maximum of $1,000 per week, after one day inpatient hospitalization or after a 7-day elimination period. STD benefit is paid for maximum of 13 weeks.
Buy-Up STD Plan - The buy-up STD provides a combined benefit of up to 60% of your weekly earnings to a maximum of $2,500. When reviewing this coverage, consider how long you can personally go without receiving a paycheck.
STD BASE STD Plan – Company Paid BUY-Up STD Plan – Employee Paid (Optional)
Weekly Benefit Amount 50% of your weekly eligible Earnings Up to 60% of your weekly eligible Earnings
Weekly Maximum Benefit Amount $1,000 Up to $2,500 combined eligible earnings.
Elimination Period 7-day Injury or Sickness; 1st Day Hospitalization.
Maximum Benefit Duration 13 weeks.
Cost ChenMed pays 100%!!!You pay 100%. Rates based on your age
and annual salary.
Definition of Disability You are unable to perform the material duties of your regular job and you are unable to earn 80% or more of your covered earnings from working in your regular job.
Coverage Type Off job.
Guarantee Issue at Initial Eligibility
Evidence of Insurability (EOI) is NOT required this year if you were previously eligible to participate in the plan and are now enrolling for the first time.
If you are newly eligible to participate in the plan and are enrolling in this benefit, EOI is not required.
EOI must be completed within 31 days from enrollment.
Note: If you are currently enrolled in any benefits through ChenMed, while you are on a leave of absence, you will remain responsible for paying the cost of your benefits. For additional information contact HR at [email protected].
GROUP LONG-TERM DISABILITY (LTD) Insurance ChenMed provides LTD benefit for Executives, Physicians, Board Members, Officers, Directors, Physician Assistants, and Nurse Practitioners.
Disability does not always mean a serious handicap. In reality, it can be as simple as an illness or injury that prevents you from earning a living.
of employees live paycheck topaycheck.
Forsyth J. More than two-thirds in U.S. live paycheck to paycheck: survey. Reuters; September 2012.
68%
TOTAL REWARDS | 16
Accident Insurance pays you benefits for specific injuries and events resulting from a covered accident that occurs on or after your coverage effective date. The benefit amount depends on the type of injury and care received. The bi-weekly cost of this coverage depends on the tier you chose: Waive $0.00
$9.69 $16.65 $18.86
Employee Only Employee + Spouse Employee + Child Family $25.82
What else does my Accident Insurance include?
Sickness Hospital Confinement coverage (SHCC):
If you are confined to a hospital due to a covered sickness, a daily benefit may be payable for each day you are in the
hospital.
• If your spouse and children are covered for Accident Insurance, their coverage includes SHCC.
• A benefit waiting period of 30 days from your effective date of coverage needs to be completed before you are eligible toreceive benefit payments.
• Coverage amounts - Employee: $100 per day up to 30 days. Spouse: $100 per day up to 30 days. Children: $75 per day for upto 30 days.
• A 3/12 Pre-Existing Condition Limitation applies to this coverage. A pre-existing condition means a sickness which, within the 3months period prior to the SHCC effective date, resulted in the covered person receiving medical treatment, consultations, careof services (including diagnostic measures). For the first 3 months following the SHCC effective date, benefits are not payable forany hospital confinement resulting from a pre-existing condition. If the hospital confinement begins more than 12 months afterthe coverage effective date, benefits are payable for any eligible hospital confinement even if resulting from a pre-existingcondition.
Sports Accident Benefit
If your accident occurs while participating in an organized sporting activity as defined in the certificate, the Accident Hospital Care, Accident Care or Common Injuries benefit will be increased by 25%, to a maximum additional benefit of $1,000. If your spouse and children are covered for Accident Insurance, their coverage includes this benefit.
Meet Amanda - Amanda works full-time while raising two energetic children and playing in a summer softball league. While sliding into home
base, she broke her ankle and tore her ACL. Fortunately, the accident didn’t break Amanda’s bank account - and the family vacation was saved.
Benefits paid by Amanda’s Accident Insurance:
Accident Insurance Benefit Base Sports Accident Benefit Base Rider
Urgent care facility treatment $300 $75
X-ray and MRI $575 $143.75
Tendon/ligament/rotator cuff surgery $1,020 $255
Broken ankle, closed reduction $1,800 $450
Medical equipment $250 $62.50
Follow-up doctor visit $120 $30
Physical therapy (6 sessions) $450 $112.50
Total $4,515 $1,000*
Accident Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. For a complete description of your benefits, along with applicable provisions, conditions on benefit determination, exclusions and limitations, see your certificate of insurance and any riders. May vary by state.ReliaStar Life Insurance Company, a member of the Voya® family of companies
WELLNESS BENEFIT TIP:
VOYA $50 Employee, $50 Spouse, and $25 Child up to $100 Max for all children for completing a Health Screening Test per Calendar Year Per insured.
ACCIDENT INSURANCE
17 | NEW HIRE ENROLLMENT 2020
CRITICAL ILLNESS INSURANCE Critical Illness Insurance pays a lump-sum benefit if you are diagnosed with a covered illness or condition on or after your coverage effective date. You have the option to elect Critical Illness Insurance to meet your needs.
You have the option to elect Critical Insurance to meet your needs. The cost of this coverage depends on your age and/or your spouse’s age along with your and/or your spouse’s Tobacco Usage Status.
What critical illnesses and conditions benefits are available? Critical Illness Insurance provides a benefit payment for the following illnesses and conditions. Benefits are paid at 100% of the Maximum Critical Illness Benefit amount unless otherwise stated.
• Benign brain tumor
• Stroke
• Permanent paralysis
• Infectious disease
• Parkinson’s disease
• Occupational HIV
• Coronary arterybypass (25%)
• Coma
• Carcinoma insitu (25%)
• Amyotrophic lateralsclerosis (ALS)
• Blindness
• Major organ failure
• Multiple sclerosis
• Skin cancer (10%)
• Heart attack*
• End stage renal(kidney) failure
• Alzheimer’s disease
• Cancer
In addition, there are additional benefits available if your children are diagnosed after the benefit’s effective date with: Down Syndrome, Cerebral Palsy, Cystic Fibrosis and Congenital Birth Defects.
Employee & Spouse No Age Restriction. No PRE-EX or EOI required.
APPLICANT EMPLOYEE-PAID COVERAGE OPTIONS
EMPLOYEE $5,000, $10,000, $15,000, $20,000, $25,000, or $30,000
SPOUSE CRITICAL ILLNESS INSURANCE RIDER $5,000, $10,000, or $15,000
$1,000, $2,500, $5,000, or $10,000
How many times can I receive the Maximum Critical Illness Benefit?Usually you are only able to receive the Maximum Critical Illness Benefit once for each covered condition. Your plan includes the Recurrence Benefit, which allows you to receive a benefit for the same condition a second time. It’s important to note that in order for the second occurrence of the illness to be covered, it must occur after 12 consecutive months without the occurrence of any covered critical illness named in your certificate, including the illness from the first benefit payment.
If you have reached the benefit limit by receiving the maximum benefit for each covered condition, you may choose to end your coverage; however, if you have coverage for your spouse and/or children, you must continue your coverage in order to keep their coverage active. Please see your certificate of coverage for details
Meet Julie - When Julie looks at her life, she thinks she’s in pretty good health. Sure, she has a sedentary job, but Julie feels she offsets sitting 40 hours a week by eating fairly well, getting enough sleep and taking regular walks around her neighborhood. That’s why the heart attack she suffered just three months after her 42nd birthday came as such a shock. While Julie is expected to make a full recovery, her recuperation could have been more challenging had it not been for the benefit paid by her Critical Illness Insurance.
Expenses incurred over two months*:
$3,000 Out-of-pocket medical expenses $2,800 Mortgage
$1,500 Food and utilities $800 Car payment
$150 Car insurance $500 Other living expenses
$8,750 Total out-of-pocket expenses Maximum Critical Illness Benefit paid under Julie’s policy = $10,000
*Julie’s cost for a $10,000 policy (non-smoker age 40-44) is $4.20 on a bi-weekly basis (26 times per year). To learn moreabout Critical Illness Insurance check out this short video: https://eb.voyacdn.com/172783/CriticalIllness.htmlCritical Illness Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Af-fordable Care Act. For a complete description of your benefits, along with applicable provisions, conditions on benefit determination, exclusions and limitations, see your certificate of insurance and any riders. May vary by state. ReliaStar Life Insurance Company, a member of the Voya® family of companies
CHILD CRITICAL ILLNESS INSURANCE RIDER
18 | NEW HIRE ENROLLMENT 2020
HOSPITAL INDEMNITY INSURANCEHospital Confinement Indemnity Insurance pays a daily benefit if you have a covered stay in a hospital, critical care unit or rehabilitation facility on or after your coverage effective date. You can use this money for any purpose you like, including: to help pay for expenses not covered by your medical plan, lost wages, child care, travel, home health care costs or any of your regular household expenses. Compass Hospital Confinement Indemnity Insurance is a limited benefit policy. This is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.
If you enroll in Hospital Confinement Indemnity Insurance coverage, you have access to the Wellness Benefit, which provides an annual benefit if you complete a health screening test, whether or not there were any out-of-pocket costs. The Wellness Benefit is designed to encourage you to maintain a healthy lifestyle, since the tests screen for a wide range of potential illnesses and diseases.
Features of Hospital Confinement Indemnity Insurance include:• Guaranteed Issue: No medical questions or tests are required for coverage.• Flexible: You can use the benefit payments for any purpose you like.• Payroll deductions: Premiums paid through convenient payroll deductions.• Affordable coverage: Rates are typically lower when you purchase coverage through your employer.
1See the product brochure, certificate of coverage and any applicable riders for the definition of covered facilities, along with complete provisions, exclusions and limitations.
Hospital Confinement Indemnity Insurance products are issued by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Policy provisions and product availability may vary by state.
What Hospital Confinement Indemnity Insurance Benefits are Available?ChenMed offers you the opportunity to purchase a daily benefit amount of $200. The benefit amount is determined by the type of facility in which you are confined. Any combination of confinement benefits payable will not exceed a total of 30 days during a period of confinement(s).
• Hospital—The benefit payment is 1x the daily benefit amount $200, up to 30 days per confinement.• Critical care unit (CCU)—The benefit payment is 2x the daily benefit amount $400, up to 15 days per confinement.• Rehabilitation facility—The benefit payment is one-half of the daily benefit amount $100, up to 30 days per confinement.• Initial Confinement Benefit: This provides an additional payment of 5x the daily benefit amount after confinement in a hospital,critical care unit and or rehabilitation facility. This benefit is limited to a maximum of four Initial Confinement Benefits per calendar year for all covered persons, but no more than one for each covered person.
For a complete description of your benefits, along with applicable provisions, conditions on benefit determination, exclusions and limitations, see your certificate of insurance and any riders. May vary by state. ReliaStar Life Insurance Company, a member of the Voya® family of companies
How can Hospital Confinement Indemnity Insurance help?Below are a few examples of how your Hospital Confinement Indemnity Insurance benefit could be used (coverage amounts may vary):• Medical expenses, such as deductibles and copays• Travel, food and lodging expenses for family members• Child care• Everyday expenses like utilities and groceries
Coverage Type Deductions Per Paycheck
Employee $10.86
Employee + Child(ren) $16.63
Employee + Spouse $21.34
Family $27.12
All coverage tiers based on a $200 daily benefit
ChenMed, LLC 401(K) Plan ChenMed makes it easy to save for retirement through Principal Financial Group. The Plan allows you and ChenMed to work together to help ensure that you have the financial resources you need for your retirement. You decide how much to contribute to the Plan through convenient payroll deductions, and ChenMed will match a portion of what you save.
Automatic Enrollment: This retirement plan includes an automatic contribution arrangement that applies to all eligible participants. If you are a new participant, you will be automatically enrolled in the retirement plan at a 6% pre-tax rate. If you do not wish to be automatically enrolled, you may elect to waive or to defer another percentage. You always have the option to decrease, increase, or stop your contributions altogether. 401k elections are administered through Workday.
If you are not a new participant, you will maintain your current salary deferral amount unless you elect a different salary deferral percentage.
Eligibility: You are eligible to participate in the plan if you:
• Are at least age 18.
• Have completed 60 days of service with the company.
Salary Deferral Contributions: Federal law limits the amount of pre-tax contributions and/or after-tax Roth 401(k) contributions you may make to the Plan each year. For 2020, you may defer up to $19,500 annually, and when over the age of 50 an additional $6,500. The annual limit may be adjusted by the IRS in future years.
This Plan allows you to defer 92% of your eligible pay.
QACA Safe Harbor Matching Contributions: If you make salary deferrals to the plan, you will be eligible to receive a matching contribution equal to 100% of the salary deferral contributions up to 1% of pay, plus 50% of salary deferral contributions (in excess of 1%) up to 6% of pay for the plan year. Your pay may be restricted to the annual compensation limit announced by the IRS.
TOTAL REWARDS | 19
You enter the Plan on the first day of the month on or after you meet the eligibility requirements. You begin making contributions as soon as administratively feasible.
20 | NEW HIRE ENROLLMENT 2020
Withdrawal Plan Provisions:
• Termination of employment
• Death
• Disability
• Attainment of age 59½ while working
• Retirement (Age 65)
• Qualified Reservist
Most withdrawals/distributions are subject to taxation and required withholding. Check with your financial/tax advisor on how this may affect you.
Loan Guidelines: You may borrow up to 50% of the vested account balance or $50,000.00 (whichever is less). The minimum loan amount is $500.00. You are permitted two outstanding loans at a time and only two loans can be approved in a 12-month period.
The interest rate will be determined when you apply for your loan. You pay back both the principal and interest directly to the account held for you in the plan through payroll deductions. New loans will incur a one time set up fee and a quarterly maintenance fee will be deducted from your account.
If you have questions about the ChenMed, LLC 401(k) Plan call 1-800-547-7754 Monday – Friday, 7 a.m – 9 p.m. (Central time) to speak to a retirement specialist at Principal or visit principal.com anytime.
You are always 100% vested in the part of the account resulting from the following:
• Elect Deferral
• Elect Deferral Catch-up
• Roth Elect Deferral
• Roth Deferral Catch-up
• 401(k) Rollover
• Roth Rollover
You may be vested in a percentage of the account from the following contributions:
• Employer QACA Match Safe Harbor
The schedule below determines your vesting percentage:
Years of Service Vesting Percentage:2 100%
You may be vested in a percentage of the account from the following contributions:
• Employer Discretion
The schedule below determines your vesting percentage:
Years of Service: Vesting Percentage:2 20%
3 40%
4 60%
5 80%
6 100%
Vesting Plan Provisions
TOTAL REWARDS | 21
LEGAL PLAN
The Family Protection Plan from Legal Club provides you and your family with access to a nationwide network of attorneys who can help you with all your legal needs. It also provides you and your family with:
Did you know that every year 1 in 2 families require services of an attorney? In many instances, legal issues are precipitated by other personal and professional challenges. Mounting debt, tax season, or a personal crisis may be the catalyst for legal assistance. To help address these multiple needs, Legal Club created the Family Protection Plan (FPP).
WELLNESS TIPPEACE OF MIND
Free and Discounted Legal Advice: Free Legal Services: Examples of services available at no charge from your plan attorney:
• Initial consultation for each new legal matter
• Simple Will for you and your family with annualupdates
• State specific, web based, Living Will form (can benotarized by a Notary Public)
• Phone calls and letters written on your behalf (oneeach per legal matter) when considered appropriateby plan attorney;
Discounted Legal Services: Examples of discounted services for which attorneys will charge a one-time, deeply discounted fee:
• Traffic Ticket Defense $89
• Simple Will $250
• Simple Divorce $275
• Personal Real Estate Closing $250
• Reduced Hourly Rate Plan attorneys have contractedto charge 40% off their normal hourly rate, with aminimum of $125 per hour, for legal care beyond thefree and discounted services. Retainers In certainsituations, attorney liability may require planattorneys.
Free Tax Preparation and Advice: Members and their families receive free tax preparation and unlimited advice on federal taxation, IRS notice and audit assistance, tax planning services, and small business tax support from tax attorneys, CPAs, financial analysts, and/or Enrolled Agents certified by the IRS.
Identity Theft Solutions: Identity theft is the fastest growing financial crime in America, striking thousands of victims each year. In a matter of seconds, personal information such as a social security number, a credit card number or an address can be stolen and used to obtain a new mortgage, line of credit or additional credit cards. Members will have 24/7 access to Identity Theft Restoration paralegals who will provide them with comprehensive, personalized recovery services. If a member becomes a victim of identity theft, the plan administrator assigns a Privacy
Advocate to manage the case. The Advocate mobilizes a Recovery Team to assist with the recovery process from beginning to end. The team includes fraud investigators, legal counsel, paralegals and other identity theft experts.
Financial Education and Credit Counseling: Offering free consultations, financial assessments, assistance with first-time home ownership, credit and debt analysis, and pre-bankruptcy counseling.
Eligibility: Membership includes the member’s spouse, dependent children and any dependent individuals living in the plan member’s home such as a parent or grandparent.
$6.46 per pay period
$14/month INCLUDES DEPENDENTS as defined above
22 | NEW HIRE ENROLLMENT 2020
ANNUAL NOTICES - PLAN YEAR 2020
Genetic Information Non-Discrimination Act of 2008 (GINA)The Genetic Information Non-Discrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information.
Genetic information, as defined by GINA, includes an individual’s family medical history, the results of an individual’s or family member’s genetic tests, the fact that an individual or an individual’s family member sought or received genetic services, and genetic information of a fetus carried by an individual’s family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services.
Protections from Disclosure of Medical Information
We are required by law to maintain the privacy and security of your personally-identifiable health information. Although the wellness program and ChenMed may use aggregate information it collects to design a program based on identified health risks in the workplace, the ChenMed Wellness Program will never disclose any of your personal information either publicly or to the employer, except as necessary to respond to a request from you for a reasonable accommodation needed to participate in the wellness program, or as expressly permitted by law. Medical information that personally identifies you that is provided in connection with the wellness program will not be provided to your supervisors or managers and may never be used to make decisions regarding your employment.Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program, and you will not be asked or required to waive the confidentiality of your health information as a condition of participating in the wellness program or receiving an incentive. Anyone who receives your information for purposes of providing you services as part of the wellness program will abide by the same confidentiality requirements. The only individual(s) who will receive your personally-identifiable health information is your physician in order to provide you with services under the wellness program.In addition, all medical information obtained through the wellness program will be maintained separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellness program will be used in making any employment decision. Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellness program, we will notify you immediately.You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellness program, nor may you be subjected to retaliation if you choose not to participate.If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation, please contact Human Resources at [email protected].
ChenMed’s Wellness Program is a voluntary wellness program available to all employees. The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you will be asked to complete a Health Risk Assessment, Well-Being Affidavit, a health and wellness program/disease management coaching if invited.
However, employees who choose to participate in the wellness program will receive a wellness credit for completing a Health Risk Assessment, Well-Being Affidavit, a health and wellness program/disease management coaching if invited. Although you are not required to complete a Health Risk Assessment, Well-Being Affidavit, a health and wellness program/disease management coaching if invited, only employees who do so will receive the wellness credit. ChenMed does not receive individual data or health results.
Notice Regarding Wellness Program
TOTAL REWARDS | 23
THE WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998The Women’s Health and Cancer Rights Act of 1998 (WHCRA) requires all health plans to cover reconstructive surgery following a mastectomy. Your health program currently covers such reconstructive surgery. This law also requires that we provide you with this notice.
Coverage for Reconstructive Surgery Following MastectomyWhen a covered individual receives benefits for a mastectomy and decides to have breast reconstruction based on consultation between the attending physician and the patient, the health plan must cover:
• Reconstruction of the breast on which the mastectomy was performed;
• Surgery and reconstruction of the other breast to produce symmetrical appearance; and
• Prosthesis and treatment of physical complications in all stages of mastectomy, including lymphedema.
• This coverage must be the same as for any other benefit under the plan.
Additional Continuation of CoverageUnder the federal law, known as COBRA, you and your dependents generally may continue medical, dental, and vision coverage if coverage ends due to either:
• A reduction in the number of hours you work or
• Termination of your employment for any reason other than gross misconduct.
• Your dependents may continue their medical, dental and vision coverage under this plan if their coverage ends for any of the following reasons:
• Your death
• You become entitled to Medicare
• Your divorce, annulment, or legal separation, provided the company is notified within 60 days
• Your dependent loses dependent status, provided the company is notified within 60 days
This is not a complete description of all COBRA-related provisions. You should consult your SPD for more details. The following chart shows how long you can continue your COBRA coverage:
IF YOU LOSE COVERAGE…THEN YOU CAN CONTINUE
COVERAGE FOR. . . IF YOUR DEPENDENT LOSES
COVERAGE BECAUSE . . . THEN YOUR DEPENDENT CAN CONTINUE COVERAGE FOR . . .
You are no longer eligible 18 months Of your death 36 months
You are no longer eligible and either you or your dependent is disabled (according to the Social Security Administration) within 60 days of your loss of eligibility
29 months You become eligible for Medicare after
your COBRA election begins36 months
You and your spouse divorce 36 monthsHe or she is no longer a dependent
(because of age or divorce)36 months
Additional incentives of up to $200 may be available for employees who participate in certain health-related activities, or achieve certain health outcomes. Please reference page 11 of your 2020 Benefit Enrollment Guide.
If you are unable to participate in any of the health-related activities or achieve any of the health outcomes required to earn an incentive, you may be entitled to a reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative standard with the same reward that is right for you in light of your health status by contacting [email protected].
The information from your health risk assessment, will be used to provide you with information to help you understand your current health and potential risks, and may also be used to offer you services through the wellness program. ChenMed does not receive individual data or health results.
24 | NEW HIRE ENROLLMENT 2020
FAMILY AND MEDICAL LEAVE ACT OF 1993 You are eligible for leave under the Family and Medical Leave Act (FMLA) if you have been employed for a total of 12 months and worked at least 1,250 hours during the 12 months preceding the leave.
Eligible employees will receive up to 12 weeks of leave within any rolling 12-month period for the birth or adoption of a child, for the employee’s own serious health condition, or to care for a child, spouse, or parent with a serious health condition.
Eligible employees may also be eligible for FMLA leave to care for a family member who is a member of the Armed Forces under certain circumstances.
FMLA also provides certain military family leave entitlements.
Eligible employees may take may take up to 26 weeks of FMLA leave in a single 12-month period to care for a covered servicemember with a serious injury or illness related to certain military deployments of their family members.
THE NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT OF 1996 The Newborns’ and Mothers’ Health Protection Act of 1996 prohibits group and individual health insurance policies from restricting benefits for any hospital length of stay for the mother or newborn child in connection with childbirth; (1) following a normal vaginal delivery to less than 48 hours; and (2) following a cesarean section, to less than 96 hours. Health insurance policies may not require that a provider obtain authorization from the health insurance plan or the issuer for prescribing any such length of stay. Regardless of these standards, an attending health care provider may, in consultation with the mother, discharge the mother or newborn child prior to the expiration of such minimum length of stay.
• Further, a health insurer or health maintenance organization may not:
• Deny to the mother or newborn child eligibility, or continued eligibility, to enroll or to renew coverage underthe terms of the plan, solely to avoid providing such length of stay coverage
• Provide monetary payments or rebates to mothers to encourage such mothers to accept less than theminimum coverage
• Provide monetary incentives to an attending medical provider to induce such provider to provide care inconsistentwith such length of stay coverage
• Require a mother to give birth in a hospital
• Restrict benefits for any portion of a period within a hospital length of stay described in this notice
These benefits are subject to the plan’s regular deductible and copay. For further details, refer to your SPD.
SPECIAL ENROLLMENT NOTICEIf 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 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). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).
TOTAL REWARDS | 25
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 30 days after the marriage, birth, adoption, or placement for adoption.
Special enrollment rights also exist in the following circumstances:
If you or your dependents experience a loss of eligibility for Medicaid or your State Children’s Health Insurance Program (SCHIP) coverage;
If you or your dependents become eligible for premium assistance under an optional state Medicaid or SCHIP program that would pay the employee’s portion of the health insurance premium.
Note: In the two above listed circumstances only, you or your dependents will have 60 days to request special enrollment in the group health plan coverage.
Important Notice from ChenMed About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with ChenMed 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.
There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:
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.
ChenMed has determined that the prescription drug coverage offered by Cigna, 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 and 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.
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What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you or a covered dependent decide to enroll in a Medicare drug plan, Medicare will be the secondary payer for prescription drug costs. In other words, eligible prescription claims will be paid by the ChenMed plan first. If there are prescription drug claims that are not covered or partially covered by the ChenMed plan, Medicare may pay for eligible expenses that are not paid by the ChenMed plan.
You should compare your current prescription drug coverage (including which drugs are covered) and costs in the ChenMed plan to the plans offering Medicare prescription drug coverage in your area. By comparing the coverage and costs of the plans, you can determine if adding the Medicare prescription drug coverage will be beneficial to you. Since you now have prescription drug coverage that, on average, is as good as Medicare coverage, you can choose to join a Medicare prescription drug plan later. You will not have to pay the higher premium (described below) as long as you do not go 63 days or longer without prescription coverage that is as good as Medicare.
If you do decide to join a Medicare drug plan and drop your current ChenMed coverage, be aware that you and your dependents will not be able to get this coverage back. Please contact us for more information about what happens to your coverage if you enroll in a Medicare prescription drug plan.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with ChenMed 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.
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 November to join.
For further information, please contact the ChenMed Total Rewards Team. 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 ChenMed changes. You also may request a copy of this notice at any time.
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:
• 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).
October 15, 2019 ChenMed Total Rewards
1505 NW 167th Street Miami Gardens, FL 33169
TOTAL REWARDS | 27
PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) If you or your children are eligible for Medicaid or CHIP and you re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren t eligible for Medicaid or CHIP, you won t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren t already enrolled. This is called a “special enrollment” opportunity and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of January 31, 2019. Please contact your State for more information on eligibility.
ALABAMA Medicaid FLORIDA Medicaid
Website: http://myalhipp.com/
Phone: 1-855-692-5447
Website: http://flmedicaidtplrecovery.com/hipp/
Phone: 1-877-357-3268
ALASKA Medicaid GEORGIA Medicaid
Medicaid Eligibility:http://dhss.alaska.gov/dpa/Pages/medicaid/
default.aspx
Website: http://dch.georgia.gov/medicaid - Click on Health Insurance Premium Payment(HIPP)
Phone: 404-656-4507
The AK Health Insurance Premium Payment Program
Website: http://myakhipp.com/ Phone: 1-866-251-4861
Email: [email protected]
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ARKANSAS Medicaid INDIANA Medicaid
Website: http://myarhipp.com/
Phone: 1-855-MyARHIPP (855-692-7447)
Healthy Indiana Plan for low-income adults 19-64
Website: http://www.in.gov/fssa/hip/
Phone: 1-877-438-4479
All other Medicaid
Website: http://www.indianamedicaid.com
Phone 1-800-403-0864
COLORADO Health First Colorado (Colorado’s Medicaid Program) & Child
Health Plan Plus (CHP+)IOWA Medicaid
Health First Colorado Website: https://www. healthfirstcolorado.com/
Health First Colorado Member Contact Center: 1-800-221-3943/ State Relay 711
CHP+: Colorado.gov/HCPF/Child-Health-Plan-Plus
CHP+ Customer Service: 1-800-359-1991/ State Relay 711
Website: http://dhs.iowa.gov/hawk-iPhone: 1-800-257-8563
KANSAS Medicaid NEW HAMPSHIRE Medicaid
Website: http://www.kdheks.gov/hcf/
Phone: 1-785-296-3512
Website: https://www.dhhs.nh.gov/oii/hipp.htmPhone: 603-271-5218
Toll Free: 1-800-852-3345 ext. 5218
KENTUCKY Medicaid NEW JERSEY Medicaid and CHIP
Website: https://chfs.ky.gov
Phone: 1-800-635-2570
Medicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/
medicaid/
Medicaid Phone: 609-631-2392
CHIP Website: http://www.njfamilycare.org/index.html
CHIP Phone: 1-800-701-0710
LOUISIANA Medicaid NEW YORK Medicaid
Website: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331
Phone: 1-888-695-2447
Website: https://www.health.ny.gov/health_care/medicaid/
Phone: 1-800-541-2831
TOTAL REWARDS | 29
MAINE Medicaid NORTH CAROLINA Medicaid
Website: http://www.maine.gov/dhhs/ofi/publicassistance/index.html
Phone: 1-800-442-6003TTY: Maine relay 711
Website: https://dma.ncdhhs.gov/
Phone: 919-855-4100
MASSACHUSETTS Medicaid and CHIP NORTH DAKOTA Medicaid
Website: http://www.mass.gov/eohhs/gov/departments/masshealth/
Phone: 1-800-862-4840
Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/
Phone: 1-844-854-4825
MINNESOTA Medicaid OKLAHOMA Medicaid and CHIP
Website: http://mn.gov/dhs/people-weserve/ seniors/health-care/health-careprograms/ programs-
and-services/medicalassistance.jsp
Phone: 1-800-657-3739
Website: http://www.insureoklahoma.org
Phone: 1-888-365-3742
MISSOURI Medicaid OREGON Medicaid
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm
Phone: 573-751-2005
Website: http://healthcare.oregon.gov/Pages/index.aspx
http://www.oregonhealthcare.gov/index-es.html
Phone: 1-800-699-9075
MONTANA Medicaid PENNSYLVANIA Medicaid
Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084
Website: http://www.dhs.pa.gov/provider/medicalassistance/he
althinsurancepremiumpaymenthippprogram/index.htm
Phone: 1-800-692-7462
NEBRASKA Medicaid RHODE ISLAND Medicaid
Website: http://www.ACCESSNebraska.ne.gov
Phone: (855) 632-7633
Lincoln: (402) 473-7000
Omaha: (402) 595-1178
Website: http://www.eohhs.ri.gov/
Phone: 855-697-4347
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NEVADA Medicaid SOUTH CAROLINA Medicaid
Medicaid Website: https://dwss.nv.gov/
Medicaid Phone: 1-800-992-0900
Website: https://www.scdhhs.gov
Phone: 1-888-549-0820
SOUTH DAKOTA - Medicaid WASHINGTON Medicaid
Website: http://dss.sd.gov
Phone: 1-888-828-0059
Website: http://www.hca.wa.gov/free-or-low-costhealth-care/program-administration/premium-
paymentprogram
Phone: 1-800-562-3022 ext. 15473
TEXAS Medicaid WEST VIRGINIA Medicaid
Website: http://gethipptexas.com/
Phone: 1-800-440-0493
Website: http://mywvhipp.com/Toll-free phone: 1-855-MyWVHIPP
(1-855-699-8447)
UTAH Medicaid and CHIP WISCONSIN Medicaid and CHIP
Medicaid Website: https://medicaid.utah.gov/
CHIP Website: http://health.utah.gov/chip
Phone:1-877-543-7669
Website: https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf
Phone: 1-800-362-3002
VERMONT Medicaid WYOMING Medicaid
Website: http://www.greenmountaincare.org/
Phone: 1-800-250-8427
Website: https://health.wyo.gov/healthcarefin/medicaid/
Phone: 307-777-7531
VIRGINIA Medicaid and CHIP
Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm
Medicaid Phone: 1-800-432-5924
CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm
CHIP Phone: 1-855-242-8282
TOTAL REWARDS | 31
To see if any other states have added a premium assistance program since January 31, 2019, or for more information on special enrollment rights, contact either:
U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565
Paperwork Reduction Act StatementAccording to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number.
The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collect ion of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512.
The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, EmployeeBenefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email [email protected] and reference the OMB Control Number 1210-0137.
