1. Dachser USA Benefits

2. Short Term Disability
60% of weekly earnings up to $300 weekly based upon employee status
Begins after the 8th day of illness/accident (non work related)
Benefit period is 13 weeks
Premiums paid by Dachser USA

3. Long Term Disability 60% of earnings up to $6,000 of monthly salary
Begins at the cessation of the Short Term Disability
90 day waiting period
Benefits payable to age 65
Three month survivor benefit
Partial disability covered
Residual disability covered
Premiums paid by Dachser USA

4. Group Term Life Insurance
One times annual earnings up to $200,000
Accidental death benefits of one time annual earnings up to $200,000
Premiums paid by Dachser USA

5. Employee Voluntary Life Insurance
Benefit amounts available from $10,000 to $100,000
Spouse and dependent children benefits available
Coverage is portable after 12 months
Premiums paid by employee

6. Meritain – Aetna Choice POS II
Cost of Insurance
Meritain – Aetna Choice POS II
Annual Gross Income Employee Employee Employee Family
+ Child(ren) Spouse
$40,000 - Under $ $ $ $260.00
$40,001 - $60,000 $ $ $ $280.00
$60,001 – Above $ $ $ $300.00
Deductions are per pay period and include medical, dental & vision insurance.

7. Medical Benefits Meritain – Aetna Choice POS II Co-Pay
Meritain In-Network Providers
Calendar Year Deductible
Individual $
Family $1,800.00
(Up to 3 members)
Out of Pocket Maximum
(Includes Deductible)
Individual $2,400.00
Family $7,200.00
(Up to 3 members, All copays, coinsurance and benefit deductibles contribute towards your out- of-pocket maximum)
Meritain Out-Of-Network Providers Calendar Year Deductible Individual $ 2, Family $ 7, (Up to 3 members) Out of Pocket Maximum (Includes Deductible) Individual $ 9, Family $28,800.00

8. Medical Benefits Meritain – Aetna Choice POS II Co-Pay
Meritain In-Network Providers Physician Office Visits Primary Care Physician $15 Co-Pay then 90% Specialist $30 Co-Pay then 90% Urgent Care $50 Co-Pay then 90% Preventive/Routine Services 100% Covered Emergency Room visit $ Co-Pay
Meritain Out-Of-Network Providers All Physician Office Visits Subject to deductible and then 60% then 70% $ Co-Pay

9. Medical Benefits After the Deductible
Meritain – Aetna Choice POS II Co-Pay
Meritain In-Network Providers Inpatient Mental/Chemical Dependency 90% after the deductible Hospice and Home Care covered at 90% after the Deductible. Chiropractic, Occupational, Physical, and Speech therapy limit 20 visits annually $15 Co-Pay Primary Physician $30 Co-Pay Specialist
Meritain Out-Of-Network Providers 60% after deductible

10. No Annual Maximum Yearly or Lifetime
Medical Benefits
Meritain – Aetna Choice POS II Co-Pay
Retail Prescription Drugs Generic $15 Co-Pay Brand Name $40 Co-Pay Non-Preferred $60 Co-Pay
Mail Order (3 Months) Prescription Drugs Generic $ 30 Co-Pay Brand Name $ 80 Co-Pay Non-Preferred $120 Co-Pay
No Annual Maximum Yearly or Lifetime

11. Medical Benefits Meritain – Aetna Choice POS II Co-Pay
Express Scripts Home Delivery (Mail Order) for 90-Day maintenance medications.
Benefit Cost Savings: member pays only 2 times the 30-day supply.
Three easy ways to order mail service: 1)online, 2)by telephone, or 3) by mail
NEW: members must elect to “opt-in” for maintenance drugs 90- Day maintenance drugs are those that you take on a recurring basis for chronic, long-term conditions.
Electing to “Opt-In” for maintenance drugs; if not, you will be charged for 30-day supply and will miss out on the savings.
Scrip World Customer Service:
direct link to Rx Plan via

12. Health Reimbursement Account Meritain
Cost of Insurance
Health Reimbursement Account Meritain
Annual Gross Income Employee Employee Employee Family
+ Child(ren) Spouse
$40,000 - Under $ $ $ $210.00
$40,001 - $60,000 $ $ $ $230.00
$60,001 – Above $ $ $ $250.00
Deductions are per pay period and include medical, dental and vision insurance.

13. Meritain Health Reimbursement Account
Medical Benefits
Meritain Health Reimbursement Account
Dachser USA will fund the first $1,000 (individual) and the first $2,000 (family) of the calendar year deductible. If not used during the year, the amount will carry over.
Meritain In-Network Providers
Calendar Year Deductible
Individual $2,000.00
Family $4,000.00
Out of Pocket Maximum
(Includes deductible, copays and coinsurance)
Individual $4,000.00
Family $8,000.00
(One individual is $6,850 and second individual is $1,150 totaling $8,000 for your total out of pocket max or all individuals can collectively reach $8,000.)
Meritain Out-Of-Network Providers Calendar Year Deductible Individual $ 8, Family $16, (Up to 3 members) Out of Pocket Maximum (Includes Deductible) Individual $16, Family $30,000.00

14. Medical Benefits Meritain Health Reimbursement Account
Meritain In-Network Providers All Physician Office Visits 90% After Deductible Routine/Preventive Care 100% Covered Emergency Room visit
Meritain Out-Of-Network Providers All Physician Office Visits 60% After Deductible Routine/Preventive Care 70% After Deductible Emergency Room visit

15. Medical Benefits After the Deductible
Meritain Health Reimbursement Account
Meritain In-Network Providers Inpatient Mental/Chemical Dependency 90% after Deductible Hospice and Home Care 90% after Deductible. Chiropractic, Occupational, Physical, and Speech therapy limit 20 visits annually
Meritain Out-Of-Network Providers 60% after deductible

16. Medical Benefits After the Deductible
Meritain Health Reimbursement Account
Meritain In-Network Providers (MRI, MRA, CAT Scan, PET Scan, etc.) at Physician office 90% after Deductible MRI, MRA, CAT Scan, PET Scan, etc.) Inpatient/Outpatient at hospital covered at 90% after deductible In-Patient Hospitalization
Meritain Out-Of-Network Providers 60% after Deductible

17. No Annual Maximum Yearly or Lifetime
Medical Benefits
Meritain Health Reimbursement Account
Retail Prescription Drugs Generic $15 Co-Pay Brand Name $40 Co-Pay Non-Preferred $60 Co-Pay
Mail Order (3 Months) Prescription Drugs Generic $ 30 Co-Pay Brand Name $ 80 Co-Pay Non-Preferred $120 Co-Pay
No Annual Maximum Yearly or Lifetime

18. Medical Benefits Meritain Health Reimbursement Account
Express Scripts Home Delivery (Mail Order) for 90-Day maintenance medications.
Benefit Cost Savings: member pays only 2 times the 30-day supply.
Three easy ways to order mail service: 1)online, 2)by telephone, or 3) by mail
NEW: members must elect to “opt-in” for maintenance drugs 90- Day maintenance drugs are those that you take on a recurring basis for chronic, long-term conditions.
Electing to “Opt-In” for maintenance drugs; if not, you will be charged for 30-day supply and will miss out on the savings.
Scrip World Customer Service:
direct link to Rx Plan via

19. Dental Benefits
Meritain – Aetna Choice POS II & Health Reimbursement Account
Dental Benefits
Preventive Services 100% Deductible Waived Calendar Year Deductible Individual $ 50 Family $150

20. Dental Benefits
Meritain – Aetna Choice POS II & Health Reimbursement Account
Dental Benefits
Basic Services 80% After Deductible Major Services 50% After Deductible Calendar Year Maximum $1, Orthodontia coverage 50% After Deductible up to Age 19. Maximum coverage $1000

21. Vision Care
Meritain – Aetna Choice POS II & Health Reimbursement Account
Vision Benefits
CIGNA In-Network Out-Of-Network Benefit
Routine Eye Exams Maximum Benefit
$ Copay per 12 Months Up to $45.00
Eyeglass Lenses (12) month Period
Single Vision 100% After Co-Pay Up to $32.00
Bifocial % After Co-Pay Up to $55.00
Trifocal % After Co-Pay Up to $65.00
Lenticular % After Co-Pay Up to $80.00
Frames (24) month Period
Up to $ Up to $66.00
Contacts (12) month Period
Elective Up to $ Up to $98.00
Therapeutic 100% Up to $210.00

22. Flexible Spending
The Flexible Benefit Plan is an employer-sponsored plan that allows you to pay for certain premiums, eligible medical expenses and dependent care expenses on a pre-tax basis. Paying for these expenses with pre-tax dollars saves you money by lowering your taxable income.
Health Care Reimbursement FSA: $2,550 maximum per plan year. Dependent Care FSA: $5,000 per plan year maximum if married filing jointly or $2,550 per plan year maximum if single or married but filing separately.
You should only set aside amounts that you expect to incur during the plan year, January 1st – December 31st, Amounts can include expenses for yourself, your spouse or your dependents as long as you claim them as a dependent.
Any amounts left in your account at the end of the plan year will be forfeited; essentially use-it-or-lose-it. Therefore, please plan carefully when making your election. It cannot be changed during the plan year unless you have a qualified status change.