2014-2015 benefits guide -...

Right for you. Right for your family.

See inside for important information about your benefits.

2014-2015 Benefits Guide

2

2014-2015 BENEFITS GUIDE

Welcome

We are committed to providing you with a competitive, comprehensive benefits program that provides the care you and your family need to lead healthy, productive lives. Please review this guide carefully for highlights of our benefits and discuss your options with your family.

Eligibility

• Full-time employees working 30 or more hours per week• Benefits are effective on the first of the month following 60 days of full-time

employment

Qualified Life Events

Elections you make at this time will remain in effect until our next Open Enrollment period. In addition, if you decline coverage for yourself and/or your dependent(s) when first becoming eligible, you must wait until the next Open Enrollment period to enroll. However, if you experience a qualified life event during the year, you may make changes to your elections at that time.

Qualified life events include:• Change in status: Marriage, divorce, legal separation, annulment or death• Change in number of dependents: Birth, death, adoption/placement for

adoption or dependent reaching limiting age• Change in employment status of employee, dependent or spouse that affects

that individual’s eligibility• Change in employee, spouse or dependent coverage on spouse’s plan

during spouse’s Open Enrollment period• Changes in entitlement to Medicare, Medicaid or State Children’s Health

Insurance Program (CHIP)* for employee, dependent or spouse• Change in eligibility for group health plan premium assistance under

Medicaid or CHIP* for employee, dependent or spouse

It is your responsibility to notify Human Resources (HR) within 31 days of the event. If you fail to do so, you will not be able to enroll or make changes until the next Open Enrollment period. When you, your dependent(s) or your spouse become enrolled as a result of a qualified life event, coverage will be made effective retroactive to the date of the event. For more information, please contact HR.

*In such cases you have 60 days to notify HR of the event instead of 31.

Medical Coverage

Dental Coverage

Vision Coverage

Basic Life and AD&D Coverage

Supplemental Coverage

Disability Coverage

Additional Benefits

Benefits Contact Directory

Important Notices

LOOK INSIDE

2

STEP 1: Review your benefit options in this Benefits Guide.

STEP 2. Select your benefits, complete the Benefit Election Form and submit it to Human Resources.

HOW TO ENROLL

3

Benefits

Medical Coverage: Blue Cross® Blue Shield® of Illinois (BCBSIL)

We’re proud to offer employees medical coverage that not only provides coverage for illness and injury, but also enables you and your family to focus on staying well. Following is a high-level overview of the coverage available. For complete coverage details, please refer to the Summary Plan Description (SPD).

Plan FeatureBlue Advantage

HMO PlanHMO Illinois PPO

In-Network In-Network In-Network Out-of-Network

Annual Deductible

�� Employee only None None $500 $1,000

�� Family None None $1,500 $4,500

Annual Out-of-Pocket Maximum

�� Employee only None None $1,000 $2,000

�� Family None None $3,000 $6,000

Preventive Care Plan pays 100% Plan pays 100% Plan pays 100% Plan pays 70%

Office Visit

�� Primary Care Physician $20 copay per visit $20 copay per visit$20 copay per visit, then 100% of the

maximum allowancePlan pays 70%

�� Specialist $20 copay per visit $20 copay per visit Plan pays 90% Plan pays 70%

Emergency Room Visit (copay waived if admitted) $150 copay $150 copay $150 copay $150 copay

Inpatient Hospital Stay $500 per inpatient admission

$500 per inpatient admission

Plan pays 90%$300 copay, plan

pays 70%

Prescription Drugs (Tier 1/Tier 2/Tier 3)

�� Retail (up to a 30-day supply) $15/$30/$50 $15/$30/$50 $15/$30/$50 $15/$30/$50

�� Mail Order (up to 90-day supply) $30/$60/$100 $30/$60/$100 $30/$60/$100 $30/$60/$100


4 4

Dental Coverage: MetLife

Following is a high-level overview of your dental coverage. For complete coverage details, please refer to the Summary Plan Description (SPD).

Plan FeaturePPO

In-Network Out-of-Network

Annual Deductible (single/family) $50 per person per year up to $150 $50 per person per year up to $150

Annual Maximum Benefit$1,500 per person $1,500 per person

Preventive Plan pays 100% Plan pays 100% of MAC*

Basic Plan pays 80% after deductible Plan pays 80% of MAC*

Major Plan pays 50% after deductible Plan pays 50% of MAC*

Orthodontia Not covered Not covered

Vision Discount: BCBSIL vision discount for Blue Advantage HMO, HMO of Illinois and PPO Plan participants.

Following is a high-level overview of your vision coverage. For complete coverage details, please refer to the Summary Plan Description (SPD).

Plan FeatureBlue Advantage HMO &

HMO IL PlanPPO Plan

You Pay: You Pay:

Examination One eye exam every 12 months for the cost of your preventive

health services copay

15% off or $5 off retail

Basic Lenses (uncoated plastic)*�� Single Vision�� Bifocal�� Trifocal�� Lenticular

$35$55$65$110

Frames�� Priced up to $70 retail�� Priced over $70 retail

$40

$40 plus 10% off the amount over $70

Contact Lenses�� Conventional**�� Disposable/Planned replacement**

20% off10% off

Contact Lenses and Evaluation

One contact lens evaluation and fitting, after your exam copay

15% off or $10 off retail

*The Dental MAC Plan is a preferred provider organization (PPO) plan, meaning you have access to a network of providers who have agreed to charge the negotiated network fee, or maximum allowable charge (MAC). This means you will often pay less for in-network care than you would at an out-of-network provider. If you receive care out of network, you are responsible for paying the difference between the MAC and out-of-network fee. This is known as “balance billing.”

*Special lens designs, materials, powers and frames may require additional cost. **Discount will be applied to the provider’s usual and customary price for services.



5

Basic Life and AD&D Coverage: Unum

We help our eligible employees maintain financial security by providing a group life and accidental death and dismemberment (AD&D) benefit. This benefit is company paid.

Employee Life and AD&D

Amount One times the employee’s salary not to exceed $150,000

Supplemental Life Coverage: Unum

You also have the opportunity to purchase additional life and AD&D coverage for yourself and your dependents at group rates. The chart below shows the coverage available. Note: Spouse and child coverage is only available when the employee elects voluntary coverage for him or herself.

Amount Guaranteed Issue

Employee Available in $10,000 increments up to a $ 500,000 maximum benefit $110,000

Spouse Available in $5,000 increments. Maximum benefit is the lesser of 100% of the employee amount of insurance or $500,000

$25,000

Child(ren) Available in $2,000 increments up to $10,000, with a minimum benefit of $2,000

$0

Employees and dependents who elect coverage when first eligible can receive up to the Guaranteed Issue amounts without being required to submit Evidence of Insurability (EOI). If you wish for more than the Guaranteed Issue amount or to waive coverage now and elect at a later date, you will be required to submit EOI.

6

Disability Coverage: Unum

We offer eligible employees short-term disability (STD) and long-term disability (LTD) coverage for your financial needs should you need to leave work due to a serious illness or non-work-related injury. Following is a brief summary of our STD and LTD coverage. These benefits are company paid.

Short-Term Disability Coverage Features

Income Replacement 60%

Weekly Maximum Benefit $1,000

When Benefit Begins After 14 days for accident or injury

Maximum Benefit Period 12 weeks

Long-Term Disability Coverage Features

Income Replacement 60%

Monthly Maximum Benefit $5,000

When Benefit Begins After 12 weeks of time off

Maximum Benefit Period Age 65

Additional BenefitsEmployee Assistance Program (EAP): Perspectives

We understand that it can be difficult to manage family, work-related and personal issues. That’s why we offer an EAP at no cost to you. To help guide you through difficult situations or simply assist you with day-to-day tasks like finding a last-minute dog sitter, trained professionals work with you as you search for solutions. The program is completely confidential and can help you work through issues related (but not limited) to:• Family: Child care, elder care, communication, conflict,

serious illness and parenting issues• Relationships: Domestic violence, dual careers, conflict

resolution and separation/divorce issues• Your job: Career, interpersonal and job “burnout” issues• Finances: Budget control, credit problems and identity

theft issues• Emotional well-being: Anger, anxiety, depression, eating

disorders, grief/loss, life transition, addiction and stress issues

Your Benefits PTO & Holiday ScheduleWe offer a paid time off (PTO) and holiday policy to help our employees achieve greater work-life balance.

PTO

You are eligible to receive PTO if you are a regular full- or part-time employee (exempt and non-exempt). You may use PTO to meet your personal needs (except for funeral or jury duty leave). You accrue PTO at the end of each pay period based on the following schedule:

Exempt Professional and Supervisory Staff

Years of Service Hours Accrued Per Pay Period Maximum Annual Cap Maximum Annual Rollover

1-5 years 7.385 24 days 29 days

6+ years 8.923 29 days 29 days

Non-Exempt Regular Staff

Years of Service Hours Accrued Per Pay Period Maximum Annual Cap Maximum Annual Rollover



11+ years 8.615 28 days 28 days

Note: You will cease to accrue PTO once you reach the maximum annual cap. You may once again continue accruing PTO once your balance falls below that amount.

HolidaysAll full- and part-time employees are eligible to receive the following 11 paid holidays:

Retirement Savings Account

• New Year’s Eve and New Year’s Day• Martin Luther King Jr.’s Birthday• Good Friday• Memorial Day

• Independence Day • Labor Day• Thanksgiving Day and the Day After Thanksgiving• Christmas Eve and Christmas Day

Retirement Plan Contributions Eligibility Vesting Savings Grow Tax-Deferred?

403(b): Employee Contributions

Up to IRS limit of $17,500 or 80% of earnings (special catch-up provisions may apply)

Upon hire Immediately Yes

401(a): Employer Matching Contributions

Amount equal to 40% of the first 6% of earnings deferred per payroll period into your 403(b)

Regularly scheduled to work at least 40 hours per pay period

Immediately Yes

401(a): Employer Automatic Contributions

2% of your pay or $600 minimum

First calendar year you work at least 1,000 hours and at least 500 hours per calendar year thereafter

100% vested after five years of service or more

Yes

We offer two retirement savings options through Transamerica. To see how your options compare, refer to the chart shown here. For more information, contact Transamerica at 877-346-7284 or www.trsretire.com.

Topic ContactPhone Number

Website & Network

General Benefits and/or Enrollment Billy Treece

312-278-4216 (Monday, Wednesday and Friday) 773-584-3253 (Tuesday and Friday)

[email protected]

Medical Coverage BCBSIL 800-548-1686 www.bcbsil.com

Dental Coverage MetLife 800-942-0854 www.metlife.com

Vision Discount BCBSIL or Davis Vision

800-892-2803 or 877-393-8844

www.bcbsil.com orwww.davisvision.com

Basic Life and AD&D Coverage Unum 800-275-8686 www.unum.com

Disability Coverage Unum 800-275-8686 www.unum.com

Employee Assistance Program (EAP) Perspectives 800-456-6327 www.perspectivesltd.com

Benefits Contact Directory

7

8

Mental Health Parity Act

Per the Mental Health Parity Act, benefits for mental health and substance-use disorder must be treated like benefits for regular medical and surgical care. For example, if there is no limitation on the number of days for inpatient and number of visits for outpatient medical care, then there can be no limitation for mental health and substance-use disorder treatments. As always, treatments must be medically necessary to qualify for coverage. Plan participants should review their plan’s certificate of coverage or benefit document for specific information about coverage, limitations and exclusions for mental health care and substance-use disorder treatments.

Women’s Health and Cancer Rights Act

On January 1, 1999, a federal law, the Women’s Health and Cancer Rights Act of 1998, became effective, which affects our company plan options. This law requires group health plans that provide coverage for mastectomies (ours does) and to also provide coverage for reconstructive surgery and prostheses following mastectomies. As required under the law, we have included this notice to inform you about it.

The law mandates that a participant or eligible beneficiary who is receiving benefits, on or after the law’s effective date (January 1, 1999, for our Plan), for a covered mastectomy and who elects breast reconstruction in connection with the mastectomy, will also receive coverage for:• All stages of reconstruction of the breast on which the

mastectomy has been performed;• Surgery and reconstruction of the other breast to produce

a symmetrical appearance; and• Prostheses and treatment of physical complications of all

stages of mastectomy, including lymphedemas.

This coverage will be provided in consultation with the patient and the patient’s attending physician and will be subject to the same annual deductible, coinsurance and/or copayment provisions otherwise applicable under the Plan.

If you have any questions about coverage for mastectomies and post-operative reconstructive surgery, please contact your local HR representative.

Summary of Benefits and Coverage (SBC)

As an employee, the health benefits available to you represent a significant component of your compensation package. They also provide important protection for you and your family in the case of illness or injury. To help you make an informed choice, the company makes available a Summary of Benefits and Coverage (SBC), which summarizes important information about our health coverage in a standard format, to help you compare across options. The SBC also includes a Glossary of Health Coverage and Medical Terms to help you better understand health care terms used in the SBC. You can obtain a copy of the SBC at no cost to you by contacting your local HR representative.

Please note: This guide is intended to provide you with highlights of our benefits program. It is not intended to address all details. Actual benefit coverage is specified in the Summary Plan Descriptions (SPDs). In the event of any differences between this guide and the SPDs, the SPDs will govern.

Important Notices

2014-2015 benefits guide -...

Documents