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2016 - 2017 Benefits DTL Transportation
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Benefit Offerings for 2016 - 2017 Medical – Aetna Healthcare –DTL is offering three medical plans through Aetna Healthcare –$5,000 Deductible Choice Plan –$3,500 Deductible Network Only Plan –$2,500 Deductible / 80% Coinsurance POS Plan Dental – Guardian Insurance Co. –High and Low plan options –Plan will renew on July 1, 2017 for current members –New hires may enroll when they become eligible for benefits Vision – Guardian Insurance Co. –Plan will renew on July 1, 2017 for current members –New hires may enroll when they become eligible for benefits Life/AD&D and Voluntary Life/AD&D – Met Life – Plans will renew on July 1, 2017 –New hires may enroll when the become eligible for benefits Voluntary Short and Long Term Disability – Reliance Standard –Plans will renew on July 1, 2017 –New hires may enroll when they become eligible for benefits
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Benefit Offerings for 2016 - 2017 Colonial Medical Bridge Plans – Hospital Confinement plan that pays a lump-sum benefit directly to members to help cover out-of-pocket expenses with a covered hospital stay or outpatient surgical procedure –$1,000 per year benefit for hospital confinement –$500 per year benefit for Tier 1 outpatient surgical procedures –$1,000 per year benefit for Tier 2 outpatient surgical procedures Sample Tier 1 Outpatient Surgical Procedures –Lumpectomy –Pacemaker insertion –Colonoscopy –Tonsillectomy –Laparoscopic hernia repair Sample Tier 2 Outpatient Procedures – Angioplasty –Cataract surgery –Cardiac catheterization –Exploratory laparoscopy –Arthroscopic knee surgery with cartilage repair
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Welcome to Benefits Enrollment! Section 125 and Benefit Election Changes Under Section 125 of the Internal Revenue Service (IRS) code, you are allowed to pay certain group insurance premiums with tax- free dollars. This means your premium deductions are taken before Federal Income and Social Security taxes are calculated. You must make your benefit elections carefully, including the choice to waive coverage. Your pretax elections will remain in effect until the next annual open enrollment period unless you experience an IRS approved qualifying change in status. Qualifying change in status events include, but are not limited to: · Marriage, divorce, legal separation or annulment · Birth, adoption or placement for adoption of an eligible child · Death of your spouse or your covered child · Change in your spouse’s work status that affects benefits · Change in dependent status (i.e. dependent child reaches age limit) You must contact Human Resources within 30 days of the date of the change. If you fail to notify Human Resources within the allotted 30 day period, you will be required to wait until our next annual enrollment period to make benefit changes.
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Welcome to Open Enrollment! Section 125 and Benefit Election Changes 1.Carefully review the plan information in this benefit enrollment guide and all other plan materials included in your enrollment packet. 2.Consider the needs of any dependents you may have. If you are married, review the benefits package currently offered through your spouse’s employer to avoid costly duplicate coverage. Keep in mind, a more detailed description of each benefit may be found in your Employee Certificate of Coverage or Summary Plan Descriptions (SPD) 3.Let us know if you need help! DTL Human Resources Team Patty Temple ptemple@dtltransportation.com 321.257.1932 Sterling Risk Advisors Laura Delavan laurad@sterlingra.com Amy Matthes amatthes@sterlingra.com 770.635.4016 770.635.0785
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Medical Benefits Provided by Aetna Healthcare Three plans offered in 2016:. HNOnly – Florida Residents Only –In-Network Only –$3,500 Individual Deductible / 70% Coinsurance –$200 Individual Pharmacy Deductible / $400 Family $5,000 Deductible Choice Plan –In-Network and Out-of-Network benefits –$20 PCP Copay; Generic drug co-pays and discounts on Aetna’s full drug list –Specialist, Urgent Care and Emergency Room visits are subject to the Deductible $2,500 Deductible Point of Service Plan –80% Coinsurance after Deductible –In-Network and Out-of-Network benefits –$35 PCP Copay; $65 Specialist Copay –$100 Individual Pharmacy Deductible / $200 Family If a non-network physician is chosen, out-of-pocket costs may be higher and the member must obtain approvals and submit claims
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Medical Benefits Provided by Aetna Healthcare 2016 – 2017 Health Network Only Plan For Florida Residents Deductible Individual Family $3,500 $7,000 Coinsurance70% Out of Pocket Maximum (includes medical/pharmacy deductibles, coinsurance and copays) Individual Family $6,350 $12,700 Well CareCovered at 100% Office Visits PCP Specialist $40 Copay $65 Copay Urgent Care Emergency Room Ambulance $60 Copay $300 Copay Plan pays 70% after Deductible Inpatient Hospitalization Outpatient Hospital Plan pays 70% after Deductible and $100 Copay Plan pays 70% after Deductible and $250 Copay Prescription Drug Deductible Individual - $200 / Family - $400 Preferred Generic Preferred Brand Name Non-Preferred Generic and Brand Retail $10 Copay – 30 Day Supply $45 Copay – 30 Day Supply $70 Copay – 30 Day Supply Mail Order $25 Copay – 90 Day Supply $112.50 Copay – 90 Day Supply $175.00 Copay – 90 Day Supply
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Medical Benefits Provided by Aetna Healthcare 2016 – 2017 OAMC $5,000 Deductible Option Deductible Individual Family $5,000 $10,000 $20,000 Coinsurance100% After Service Copay70% Out of Pocket Maximum (includes medical/pharmacy deductibles and copays) Individual Family $6,600 $13,200 $20,000 $40,000 Well CareCovered at 100%Plan pays 70% after Deductible Office Visits PCP Specialist $20 Copay $55 Copay After Deductible Plan pays 70% after Deductible Urgent Care Emergency Room Ambulance $75 Copay after Deductible Plan pays 100% after Deductible and $500 Copay Plan pays 70% after Deductible Same as In-network benefit Inpatient Hospital Outpatient Hospital Plan pays 100% after Deductible and $500 Copay Plan pays 70% after Deductible Prescription Drug Value Drugs – No Deductible Preferred Generic – No Deductible Preferred Brand – Discount/Med Ded Non-Preferred – Discount/Med Ded Retail $3 Copay – 30 Day Supply $15 Copay – 30 Day Supply $35 Copay – 30 Day Supply $65 Copay – 30 Day Supply Mail-order $7.50 Copay – 90 Day Supply $37.50 Copay – 90 Day Supply $87.50 Copay – 90 Day Supply $162.50 Copay – 90 Day Supply
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Medical Benefits Provided by Aetna Healthcare 2016 - 2017 OAMC $2,500 Deductible Option Deductible Individual Family $2,500 $7,500 $22,500 Coinsurance80%50% Out of Pocket Maximum (includes medical/pharmacy deductibles, coinsurance and copays) Individual Family $6,850 $13,700 $13,500 $27,000 Well CareCovered at 100%Plan pays 50% after Deductible Office Visits PCP Specialist $35 Copay $65Copay Plan pays 50% after Deductible Urgent Care Emergency Room Ambulance $75 Copay $300 Copay Plan pays 80% after Deductible Plan pays 50% after Deductible $300 Copay Plan pays 80% after Deductible Inpatient Hospital Outpatient Hospital Plan pays 80% after Deductible Plan pays 80% after Deductible and $250 Copay Plan pays 50% after Deductible Prescription Drug Deductible Individual-$100 Family-$200 Preferred Generic Preferred Name Brand Non-Preferred Generic/Brand Retail $10 Copay – 30 Day Supply $45 Copay – 30 Day Supply $70 Copay – 30 Day Supply Mail-order $25.00 Copay – 90 Day Supply $112.00 Copay – 90 Day Supply $175.00 Copay – 90 Day Supply
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Medical Benefits Provided by Aetna Healthcare To locate an Aetna participating provider: 1.Visit www.aetna.com and click on the ‘Find A Doctor’ tab at the top of the pagewww.aetna.com 2.Select “If you are shopping for a plan offered by my employer’ 3.Select the type of Doctor you are looking for or Search by Physician’s name 4.Enter your zip code, then scroll down to the Aetna Open Access Plans section 5.For the HNOption, choose the HMO network 6.For the two Open Access Managed Choice plans, choose the Managed Choice POS (Open Access) network
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Teladoc Provided by Aetna Healthcare Your Aetna plan provides you with access to Teladoc, an added benefit that gives you 24/7 access to a national network of U.S. board-certified doctors. A Teladoc doctor is just a call or a click away. Call Teladoc from anywhere – home, work or on the road – and let the doctor come to you! Teladoc doctors diagnose non-emergency medical problems, recommend treatment, and, when necessary, can even call in a prescription to your pharmacy It’s quick and easy to set up your account. Visit the Teladoc website at Teladoc.com/Aetna, click “Set up account” and provide the required information. You can also call Teladoc for assistance – (855 -Teladoc) – 855.835.2362 You can download the Teladoc app on your phone – Teladoc.com/mobile
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Medical Benefits Provided by Aetna Healthcare After you receive your Aetna ID card, be sure to register your membership at aetnanavigator.com. This website provides a great deal of information you’ll find helpful during the year, such as: Access to your specific benefit plan, claim status, history and electronic access to your Explanation of Benefits (EOBs) Health Assessments Health Calculators Access to a cost estimator for common procedures; - Cost estimates based on procedure, your benefits and your chosen provider - Quality ratings for network providers and facilities based on experience, complications and outcome Personal health record; - Electronic access to you health history - Privately and easily keep track of progress for ongoing conditions
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Both our High and Low Guardian dental plans are designed to encourage regular preventive care that may help you avoid extensive and costly care later. Although both plans offer In-Network and Out-of-Network benefits, there are advantages of using a contracted network dental provider: No balance billing over the reasonable/customary charge The provider’s office will precertify your benefits and file your claims It stretches your benefit dollars In-network negotiated rates for all procedures To locate a contracted network provider: 1.Visit www.guardianlife.com 2.Click on the Find a Provider tab 3.Select Find a Dentist 4.Select PPO 5.Search by location or provider name Dental Benefits Provided by Guardian Life Insurance
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2016 - 2017 Dental Plan A “Low” Deductible Individual Family $50 $150 Annual Maximum$1,000 Lifetime Orthodontia Maximum$1,000 Preventive Care Covered at 100% - Routine Exams - Bitewing X-Rays - Cleanings - Fluoride Treatment (to age 18) Basic Care Covered at 80% after Deductible - Fillings - Emergency Treatment - Nonsurgical Endodontics - Periodontics - Oral Surgery Major Care Covered at 50% after Deductible - Extractions - Crowns, Inlays, Onlays - Dentures - Surgical Endodontics Orthodontia Covered at 50% $1000 lifetime max - Treatment to age 18
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Dental Benefits Provided by Guardian Life Insurance 2016 - 2017 Dental Plan B “High” Deductible Individual Family $50 $150 Annual Maximum$1,000 Lifetime Orthodontia Maximum$1,000 Preventive Care Covered at 100% - Routine Exams - Bitewing X-Rays - Cleanings - Fluoride Treatment (to age 18) Basic Care Covered at 100% after Deductible - Fillings - Emergency Treatment - Nonsurgical Endodontics - Periodontics - Oral Surgery Major Care Covered at 60% after Deductible - Extractions - Crowns, Inlays, Onlays - Dentures - Surgical Endodontics Orthodontia Covered at 50% $1000 lifetime max - Treatment to age 18
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Vision Benefits Provided by Guardian Life Insurance 2016 - 2017 Guardian Life Vision using the Davis Vision Network of Providers In Network Out of Network Reimbursement Exam Covered in Full after $10 Copay Up to $50 Frames $130 Allowance after $25 Deductible Up to $48 Lenses Single Bifocal Trifocal Lenticular Covered in Full after $25 Copay Up to $48 Up to $67 Up to $86 Up to $126 Contact Lenses Elective Medically Necessary $130 Allowance $0 Copay Up to $105 Up to $210 Frequency Exams Frames Lenses 1 every 12 months 1 every 24 months 1 every 12 months
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To locate a contracted network provider: 1.Visit www.guardianlife.com 2.Click on Find a Provider 3.Click on Find a Vision Provider 4.Select A Plan - Davis Vision 5.Search by location or provider’s name Vision Benefits Provided by Guardian Life Insurance
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Basic Life Insurance: DTL Transportation provides each full-time employee with a Basic Life and Accidental Death and Dismemberment benefit of $10,000. This coverage is offered at no cost to you and does not require you to elect coverage, however, it is very important you complete a Beneficiary Form and return it to Human Resources along with your other applications. Your beneficiary may be changed at any time during the plan year and we strongly encourage you to update information with any life event change. Life and AD&D Coverage Provided by MetLife
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Voluntary Life Insurance: To supplement the Basic Life/AD&D you have the option of purchasing additional life insurance for yourself and your dependents Voluntary Life Coverage Provided by Met Life EmployeeSpouseChild(ren) Benefit Available You may purchase coverage for yourself in $10,000 increments You may purchase coverage for your spouse in increments of $5,000 if you purchase coverage for yourself You may purchase up to $10,000 of coverage for your dependent children, if you purchase coverage for yourself Maximum Benefit Amount The lesser of $500,000 or 5x your annual earnings $100,000 or the lesser or 50% of your coverage amount $10,000 Guarantee Issue Reduction $150,000$25,000 $10,000 (Under 15 days – No Benefit, 15 days to 6 months - $250) Benefit Age Reduction Standard Age Reductions beginning at age 65 Coverage terminates at age 26 Newly hired employees may enroll without medical questionnaire up to the Guaranteed Issue amount anytime within 3 1 days of becoming eligible for coverage. Those who decide to enroll later will have to provide acceptable evidence of good health, which may require a questionnaire or medical examination and coverage may not be approved.
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Voluntary Short Term Disability Insurance: Short Term Disability (STD) coverage pays a percentage of your salary, for a specified period of time, if you are ill or injured and unable to perform the duties of your job. The most common uses for utilizing Short Term Disability benefits are: Pregnancy Surgery/Hospitalization Illness (cancer, stroke, heart attack) Non-work related injuries (auto wreck, recovery from accident) You have the opportunity to purchase STD coverage through Met Life. STD Benefits: Begin on the 15 th day of Disability Pay up to 60% of your pre-disability earnings to a maximum of $1,000 per week Are payable for up to 11 weeks Newly hired employees may enroll anytime within the 31 days of becoming eligible for coverage. Those who decide to enroll later will have to provide acceptable evidence of good health, which may require a medical questionnaire or examination, and coverage may not be approved. Disability Coverage Provided by Reliance Standard
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Voluntary Long Term Disability Insurance: Long Term Disability (LTD) coverage is also available through Reliance Standard. LTD provides income replacement when STD benefits cease. LTD benefits: Begin on the 91 st day of disability Pay 60% of your pre-disability earnings to a maximum of $6,000 per month Benefits may continue up to 2 years Newly hired employees may enroll anytime within the 31 days of becoming eligible for coverage. Those who decide to enroll later will have to provide acceptable evidence of good health, which may require a medical questionnaire or examination, and coverage may not be approved. Disability Coverage Provided by Reliance Standard
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