2018 Benefits Guide - Allstate Benefits
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2018 Benefits Guide
Your 2018 Benefits
TopBuild’s benefits framework and our Health Promise is built around health care tools, prevention, choices and action, and is designed to support the
health and well being of our employees and their families. Your benefits are an important part of your total compensation and we remain committed to
providing quality, cost-effective health care coverage.
For New Employees Enrolling for the First Time
When do I enroll? • Before your 30th day of employment for salary employees
• Before your 90th day of employment for hourly employees
If you do not enroll by your deadline, you will not have coverage for any plans requiring an employee contribution, except disability, for the rest of the
calendar year unless you have a life event.
How do I enroll? • Read the Benefits Enrollment Guide
• To enroll, log into http://www.allstatevoluntary.com/topbuild/
When does my Generally:
coverage begin? • On the 1st of the month following 30 days for salary employees
• On the 1st of the month following 90 days for hourly employees
For All Other Employees
When do I enroll? During Open Enrollment
How do I enroll? • Read the Benefits Enrollment Guide
• To enroll, log into http://www.allstatevoluntary.com/topbuild/ or by calling 877-627-0334 option 2
When does my Generally, on the following January 1st
coverage begin?
For All Employees
How do I access Log into http://www.allstatevoluntary.com/topbuild/
from work?
How do I access Log into http://www.allstatevoluntary.com/topbuild/
from home?
How do I decide? Need assistance choosing which plan is best for you, try Alex - http://www.allstatevoluntary.com/topbuild/
Confirm your Review your elections online and report any discrepancies within 30 days of your effective date
enrollment
2Step 1) Determine Who’s Eligible
You may choose:
Yourself
You are eligible to enroll for health care benefits if you are an active employee, regularly working at least 30 hours per week.
If you enroll a new
dependent, you must Your legal spouse
provide the required
documentation (e.g.,
You are eligible to enroll your legal spouse. Review the Affidavit for plan participation requirements and provide the required
birth certificate, marriage documents for approval.
certificate, current tax
form and working spouse Working Spouse Rule
affidavit). Dependent Our health care plans have the “Working Spouse Rule,” which means that if your spouse is employed, and his or
audits have been
outsourced to HMS.
her employer contributes to the cost of medical coverage, your spouse MUST be enrolled for at least individual
Spouses must be coverage in that company’s plan in order to be covered on a secondary basis under our medical and/or
recertified annually. dental plan.
See enrollment website
for additional details.
Your and/or your spouse’s child(ren)
Eligible children (described below) can be covered until the end of the month in which they turn age 26 regardless of financial
dependence, marital status or eligibility for their own employer-sponsored coverage.
Biological or Legally Adopted Children
Including those for whom you or your spouse are obligated through a court order to provide health care coverage,
or for whom the plan is obligated under a Qualified Medical Support Order or a National Medical Support Notice
to provide health care coverage.
Children Placed with You
For adopted, foster children placed by authorized placement agency or by judgment decree/court order, or any
children for whom you or your spouse are named legal guardian/custodian.
Physically or Mentally Incapacitated Children
May be eligible for coverage beyond age 26 if enrolled in the plan before their 26th birthday.
3Step 2) Review Your Plan Options and Costs
The Company pays a significant amount of your health care benefit costs. However, you are asked to share a portion of the
cost. You can choose who you cover for medical, dental, and vision coverage. For example, you can choose “Employee Only”
for medical, “Family” for dental, and “Waive” for vision. See the Employee Contributions in each section for your 2018 costs.
TOBACCO USERS
The tobacco user charge NON-TOBACCO USER TOBACCO USER
is $70 per month.
Certain medications to WEEKLY RATES SEMI-MONTHLY RATES WEEKLY RATES SEMI-MONTHLY RATES
MEDICAL MEDICAL
help you stop smoking (Hourly) (Salary) (Hourly) (Salary)
are 100% covered.
For information contact ENHANCED ENHANCED
Aetna. Employee Only $39.46 $85.50 Employee Only $55.62 $120.50
Employee & Spouse $136.62 $296.00 Employee & Spouse $152.77 $331.00
Employee & Child(ren) $121.62 $263.50 Employee & Child(ren) $137.77 $298.50
Family $193.38 $419.00 Family $209.54 $454.00
CONSUMER CONSUMER
Employee Only $28.38 $61.50 Employee Only $44.54 $96.50
Employee & Spouse $97.62 $211.50 Employee & Spouse $113.77 $246.50
Employee & Child(ren) $64.62 $140.00 Employee & Child(ren) $80.77 $175.00
Family $142.38 $308.50 Family $158.54 $343.50
BEST VALUE BEST VALUE
Employee Only $22.15 $48.00 Employee Only $38.31 $83.00
Employee & Spouse $88.62 $192.00 Employee & Spouse $104.77 $227.00
Employee & Child(ren) $60.92 $132.00 Employee & Child(ren) $77.08 $167.00
Family $134.08 $290.50 Family $150.23 $325.50
You may still qualify for the non-tobacco user rates if you participate in the stop smoking program that the Company makes available. Additionally,
the Company will accommodate the recommendation of your physician in certain circumstances, if the program is not medically appropriate for you.
Contact the Benefits Department at 1-877-627-0334 (option 2) for details on the stop smoking program or with any questions.
4Medical Plan Overview
Enhanced Plan Consumer Plan Best Value Plan
COVERAGE HIGHLIGHTS
Lowest Deductible High Deductible Mid Deductible
Co-pays for More Services Higher Out of Pocket Max Lowest Out of Pocket Max
Benefits for Bariatric Co-pays for More Services Will Cost the least from your Paycheck
Benefits for Orthopedic Footcare In and Out of Network Care Narrow Network Only
Will Cost the most from your Paycheck Will Cost less from your Paycheck
WHAT TO EXPECT AT TIME OF SERVICE
You may see an In or Out-of-Network Doctor You may see an In or Out-of-Network Doctor, You must see an In-Network Doctor. Show the
of your choice. Show the provider your ID card of your choice. Show the provider your ID card provider your ID card with the Aetna logo.
with the Aetna logo. The Provider will submit with the Aetna logo. The Provider will submit You will pay 100% of the negotiated rate until
the claim to Aetna and you will only have to the claim to Aetna and you will only have to your deductible is met.
pay your co-pay or deductible/coinsurance pay your co-pay or deductible/coinsurance
after Aetna pays it’s portion. after Aetna pays it’s portion.
5ENHANCED PLAN CONSUMER PLAN BEST VALUE PLAN
IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK NARROW NETWORK ONLY OUT-OF-NETWORK
(MEMBER RESPONSIBILITY) (MEMBER RESPONSIBILITY) (MEMBER RESPONSIBILITY) (MEMBER RESPONSIBILITY) (MEMBER RESPONSIBILITY) (MEMBER RESPONSIBILITY)
Deductible - (Individual / Family) $800/$1,600 $1,600/$3,200 $2,500/$5,000 $5,000/$10,000 $2,000/$4,000 N/A
Out of Pocket Maximum - (Individual / Family) $5,000/$10,000 $10,000/$20,000 $5,000/$10,000 $10,000/$20,000 $4,000/$8,000 N/A
Coinsurance (after deductible is met) Plan pays 80%: You pay 20% Plan pays 50%: You pay 50% Plan pays 80%: You pay 20% Plan pays 50%: You pay 50% Plan pays 70%: You pay 30% N/A
Physician Office Visit
Preventive Care No cost to you, covered at 100% 50% after deductible No cost to you, covered at 100% 50% after deductible No cost to you, covered at 100% N/A
Primary Care Physician $25 co-pay 50% after deductible $35 co-pay 50% after deductible N/A
30% after deductible
Specialist $40 co-pay 50% after deductible $50 co-pay 50% after deductible N/A
Teladoc No cost to you, covered at 100% Not covered No cost to you, covered at 100% Not covered No cost to you, covered at 100% N/A
Diagnostic Lab & Xray
Independent Clinical Lab - (Routine) No cost to you, covered at 100% 50% after deductible No cost to you, covered at 100% 50% after deductible No cost to you, covered at 100% N/A
Independent Clinical Lab - (Non-Routine) 20% after deductible 50% after deductible 20% after deductible 50% after deductible 30% after deductible N/A
Independent Diagnostic Testing Facility 20% after deductible 50% after deductible 20% after deductible 50% after deductible 30% after deductible N/A
Hospitalization &
Outpatient Services
Inpatient Hospital 20% after deductible 50% after deductible 20% after deductible 50% after deductible 30% after deductible N/A
Outpatient Hospital 20% after deductible 50% after deductible 20% after deductible 50% after deductible 30% after deductible N/A
In-network level if emergency, In-network level if emergency,
Emergency Room* $150 co-pay (waived if admitted) $250 co-pay (waived if admitted) 30% after deductible N/A
if not, 50% after deductible if not, 50% after deductible
Urgent Care Center $50 50% after deductible $75 50% after deductible 30% after deductible N/A
Prescription Drug Benefit**
Standalone Rx Deductible
$50/$150 N/A $100/$300 N/A $150/$450 N/A
(Individual / Family)
30 Day Retail Supply
Generic $15 $15 $15
Brand 30% 30% 30%
Non-Preferred 45% Benefits are not provided for 45% Benefits are not provided for 45% Benefits are not provided for
prescription filled at pharmacy prescription filled at pharmacy prescription filled at a pharmacy
90 Day Mail Order Supply that is not in-network with that is not in-network with that is not in-network with
Generic $30 Aetna Pharmacy $30 Aetna Pharmacy $30 Aetna Pharmacy
Brand 30% 30% 30%
Non-Preferred 45% 45% 45%
*50% after deductible if non-emergency
**Plans may require quantity/age/gender limitations, prior authorization, step therapy and/or other rules and limitations before covering prescription drugs. If a brand name drug is dispensed when a generic is available, you will pay the
difference in the cost of the drug plus the brand coinsurance, even after the annual out-of-pocket maximum is met.
6Step 2) Review Your Plan Options and Costs
PPO VISION
DENTAL (DELTA DENTAL PREMIER) CONTRIBUTIONS WEEKLY (HOURLY) SEMI-MONTHLY (SALARY)
CONTRIBUTIONS WEEKLY (HOURLY) SEMI-MONTHLY (SALARY)
Employee Only $0.96 $2.09
Employee & Spouse $1.94 $4.21
Employee Only $7.65 $16.59
Employee & Spouse $14.54 $31.51 Employee & Child(ren) $1.94 $4.21
Employee & Child(ren) $16.71 $36.22 Family $3.24 $7.02
Family $25.30 $54.83 EYEMED VISION CARE
HMO EYEMED VISION MEMBER COST IN-NETWORK
DENTAL (DELTACARE USA) Exam $10 co-pay
CONTRIBUTIONS WEEKLY (HOURLY) SEMI-MONTHLY (SALARY) Frames $0 co-pay; $130 allowance, 20% off balance
Employee Only $4.80 $10.41 Standard Lenses $25 co-pay
Progressive Lens $90 co-pay
Employee & Spouse $9.25 $20.04
Conventional Contact Lenses $0 co-pay; $130 allowance, 15% off balance
Employee & Child(ren) $9.80 $21.23
Disposable Contact Lenses $0 co-pay; $130 allowance, plus balance
Family $14.53 $31.48
40% discount off complete pair eyeglass purchases.
Additional Pairs Benefit
15% discount off contacts.
DENTAL COVERAGE 40% off hearing exams.
Hearing Benefit Discounted, set pricing on hearing aids.
BENEFITS PPO PLAN HMO PLAN Free batteries for 2 years.
Diagnostic & Preventative 100% 100%
MyLibertyAssist: Employee Assistance Program (EAP)
Oral Exam & Cleanings Twice per calendar year Provided by Bensinger, DuPont & Associates. Available to employees and their immediate family members.
Once per calendar year
Bitewing Xray
(twice per year, up to age 19)
SERVICES FINANCIAL LEGAL FAMILY
5 face-to-face sessions 1,2
Toll-free information line:
Assistance from Attorneys: Assistance from Work
Fluoride Treatments Once per calendar year, children to age 14 only
Telephonic assistance - Credit - One free 30-minute tele- Life Specialists:
Basic Restorative Care 100% co-pays only - Debt phonic or face-to-face - One free telephonic
- Available 24/7
- Request educational session session
Major Reconstructive Care 60% after deductible co-pays only - Marital/Family material - Up to 25% employee - Online access to
- Personal
Financial advice sessions discount
Orthodontia Care-Child Only 60% after deductible co-pays only on additional information and
- Alcohol/Drug abuse services provider locators
Deductible Per Patient $50 $0 - Stress/Anger - One free telephonic
- Death and dying session and financial Assistance with: Assistance with:
Deductible Per Family $150 $0 worksheet review - Document preparation - Child care
Also available: - Divorce/separation
Annual Max Per Patient $1,500 no annual maximum - Elder care
- Online access to - Real estate - Adoption
information - Civil matters - Education
1.
In California, sessions are limited to three (3) in a six-month period, not to exceed a total of five (5) sessions per year.
2.
Individual face-to-face sessions are available for covered individuals 16 years and older. Family/group face-to-face sessions are available for covered individuals 12 years and older, and their parents. Services are not
available to children under the age of 12.
Employee Assistance Program
MyLibertyAssist® 7FLEXIBLE SPENDING ACCOUNT LIFE INSURANCE PROTECTION Company Paid
IN THE FSA PLANS, YOU CAN SET ASIDE YOUR OWN MONEY BY PRE-TAX DEDUCTIONS TO PAY FOR LIBERTY MUTUAL LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT. THE COMPANY PROVIDES YOU WITH A
HEALTH CARE OR DEPENDENT (DAY) CARE OUT-OF-POCKET EXPENSES. BY USING YOUR PRE-TAX LIFE INSURANCE BENEFIT THAT IS PAID TO YOUR BENEFICIARY IF YOU DIE.
INSTEAD OF AFTER-TAX DOLLARS, YOU SAVE MONEY.
Definition Of “Pay” Base pay (as defined in your Summary Plan Description) plus commissions
TRADITIONAL HEALTH CARE SPENDING ACCOUNT (if applicable).
Basic Life And AD&D—Cost Company paid
Who Can Elect All employees enrolled into one of our group health plans.
Benefit Level Salary: 2x pay for Basic Life and 2x pay for AD&D
Eligible Expenses Out-of-pocket health care expenses not covered by your medical, (maximum benefit applies) Hourly: 1x pay for Basic Life and 1x pay for AD&D
dental or vision plan, including deductibles and co-pays. You can Business travel: 2x pay
also use the PayFlex debit card for heathcare expenses at point of
purchase. Age Reduction 50% at age 70 for employee coverage
Amount You Can Deposit $130 to $2,600 a year SUPPLEMENTAL LIFE
YOU CAN PURCHASE ADDITIONAL LIFE INSURANCE COVERAGE FOR YOURSELF AND ELIGIBLE SPOUSE AND
CHILDCARE/ELDERCARE SPENDING ACCOUNT CHILDREN.
Who Can Elect Any employee, regardless of medical plan election. Cost Employee paid (voluntary election)
Eligible Expenses Out-of-pocket expenses for care of children under age 13 or disabled Benefit Level—Employee Life 1x to 5x pay to $1 million maximum
dependents when required so that you (and your spouse, if married) can Benefit Level— Spouse Life $10,000 to $100,000 in $10,000 increments (coverage cannot exceed 100%
work or attend school full-time. of employee’s total coverage); election independent of employee. If your
spouse also works for a TopBuild company you cannot elect this coverage
Amount You Can $130 to $5,000 a year if you are single or married filing a joint tax return
(but they can enroll in their own supplemental life).
Deposit ($2,500 if married filing separately)
Benefit Level—Child Life $10,000 coverage from date of birth; election independent of employee
Evidence Of Insurability At your initial election opportunity only, you can elect up to the lesser of 3x
pay, or $500,000 for employee coverage and $50,000 for spouse coverage
without evidence of insurability (EOI). If you elect coverage after your initial
opportunity, or are increasing a current election, you/your spouse may
have to complete an EOI application and coverage will not be effective
until approved by Liberty Mutual.
AUTO & HOME OWNERS INSURANCE DISABILITY PROTECTION
TOPBUILD OFFERS EMPLOYEES A SPECIAL AUTO & HOME INSURANCE PROGRAM. LIBERTY MUTUAL DISABILITY COVERAGE.
This is a service available from Travelers, Liberty Mutual Insurance, and MetLife Auto & Home. It ALL DISABILITY COVERAGE FOR NEW HIRES WILL DEFAULT TO ELECTED STATUS. SHOULD YOU
allows you to compare the special discounts and savings available to employees. Plus, you can CHOOSE TO WAIVE YOUR COVERAGE YOU WILL NEED TO DO SO ON EMPLOYEE SELF SERVICE.
choose from several convenient payment options, including automatic payroll deduction or through
an escrow account for home insurance. How It Works Replaces a portion of your income if you become disabled due to an
accident, injury, or illness.
You may take advantage of this service at any time. There’s no obligation or designated enrollment Cost STD: Employee paid (voluntary election)
period. Licensed insurance representatives from each carrier can help you find the insurance that’s LTD: Salary and Administrative Hourly: Company paid
right for you! Hourly field and piece rate: Employee paid (voluntary election).
Any voluntary deductions will not change during the year if your rate of
pay changes.
Short-Term Disability (STD) 60% of pay up to $2,000/week after 7-day illness/injury waiting period up to
26 weeks.
1 (888) 695-4640 1 (800) 524-9400 1 (800) GET-MET8 Long-Term Disability (LTD) After STD, benefit paid to maximum age limit if you are totally disabled.
Benefit Level 60% of pay to monthly maximum of $12,000
Elimination Period 180 days
8
Note: The disability coverage may contain certain eligibility requirements, exclusions, limitations and waiting periods (including pre-existing condition waiting
periods) and may be replaced or offset by state disability benefits. Evidence of insurability may also apply.Step 3) Review Your Additional Benefits
These benefits are being offered to help employees make decisions about costs and treatment options. Employees must be covered by a company sponsored
medical plan to use Teladoc. All benefit eligible employees can enroll in the voluntary products.
Our Health Promise
We recognize that there is a direct correlation between healthy lifestyles and
Allstate Benefits Group Voluntary Critical Illness
medical costs and we want to reward you for taking care of yourself. By taking
the steps to receive a health risk assessment and biometric screening, not only Along with the advancements in medical technology that can increase life span
will Aetna use this information to provide additional wellness support and coaching and chances of surviving critical illnesses, comes an increasing appreciation of
so that you can lead a happy and healthy life, but TopBuild will reward you with a the personal economic strain people face with the diagnosis and lifestyle changes
wellness incentive credit. associated with a critical illness. Group Voluntary Critical Illness Insurance from
Allstate Benefits pays benefits that can be used for non-medical, critical illness-
If it is unreasonably difficult due to a medical condition for you to achieve the related expenses that health insurance might not cover. The Group Voluntary Critical
standard for the reward under this program, or if it is medically inadvisable for Illness benefit is in the form of a lump sum payment, which is paid to the employee
you to attempt to achieve the standard for the reward under this program, call at diagnosis.
the Benefits Department at 877-627-0334 (option 2) and we will work with you
to develop another way to qualify for the reward. • Category 1 Benefits include; Heart Attack, Heart Transplant, Stroke and
Coronary Artery By-Pass Surgery.
• Category 2 Benefits include; Major Organ Transplant, End Stage Renal Failure,
– COMPANY PAID BENEFIT Paralysis and Alzheimer’s Disease.
• Individual, spouse and child(ren) coverage.
What is Teladoc? • Coverage is portable.
Teladoc is a benefit that gives you and your covered dependents 24/7/365 access • Coverage does not replace any other group medical benefits. Instead,
to U.S. board-certified doctors who can resolve many of your medical issues via it is designed to supplement an employee’s present coverage.
phone or online video. • $100 Wellness Benefit included.
The consultation is paid for by your employer at no cost to you. This can help • Recurrence Benefit pays 25% of a previously paid benefit in category
you avoid the out-of-pocket cost of an office or urgent care visit. 1 or 2.
When can you use Teladoc? Allstate Benefits Group Voluntary Accident
Examples: If you’re considering the ER or urgent care center for a Accidents happen. Having a plan in place that pays cash benefits for out-of-pocket
non-emergency issue, on vacation, on a business trip or away from home. expenses associated with an on or off-the-job accidental injury can help protect
your hard-earned savings. Because accident insurance is supplemental, it pays in
What can I use it for? addition to other coverage the insured may already have in place. This coverage
Examples: Cold and flu symptoms, respiratory/sinus infection, allergies, pays a benefit up to a specified amount for:
ear infection, pink eye, allergies, urgent care needs and most prescription refills. • Accidental death and dismemberment
• Dislocation/Fracture
NEW • Initial hospitalization confinement ongoing hospitalization confinement
With Teladocs new Caregiver Services employee’s can now add family members • Intensive care
not covered by their health insurance plan. The cost for a visit is always $45. • Ambulance service
www.teladoc.com | 1-800-Teladoc • Medical expenses
• Outpatient physician’s treatment
• Burns, Paralysis, Surgeries, and more 9Step 3) Review Your Additional Benefits (Continued)
ALLSTATE BENEFITS VOLUNTARY PRODUCTS CONTRIBUTIONS
Allstate Benefits Group Voluntary Cancer
GROUP VOLUNTARY CRITICAL ILLNESS
A cancer diagnosis can be difficult on your MONTHLY PREMIUMS ($20,000 BENEFIT AMOUNT)
family’s financial and emotional stability. Having
Issue Issue
the right coverage to help when you are sick Insured Non Tobacco Tobacco Insured Non Tobacco Tobacco
Age Age
and undergoing treatment or when you cannot
work is important. Includes coverage for 29 18-35 Employee Only $5.08 $7.28 60-64 Employee Only $33.88 $56.88
other specified diseases. The Group Voluntary 18-35 Employee & Spouse $7.80 $11.40 60-64 Employee & Spouse $50.80 $84.80
Cancer and Specified Disease insurance can 18-35 Employee & Child(ren) $5.28 $7.48 60-64 Employee & Child(ren) $34.08 $57.08
help provide security when you need it most.
This coverage pays a benefit up to a specified 18-35 Family $8.20 $11.80 60-64 Family $51.00 $84.80
amount for: 36-49 Employee Only $10.68 $18.28 65-69 Employee Only $43.48 $66.08
• C
ancer initial diagnosis 36-49 Employee & Spouse $16.40 $27.60 65-69 Employee & Spouse $65.00 $98.40
• Surgery and related benefits 36-49 Employee & Child(ren) $10.88 $18.28 65-69 Employee & Child(ren) $43.68 $66.48
• Radiation/Chemotherapy 36-49 Family $16.60 $27.60 65-69 Family $65.40 $98.60
• Continuous hospital confinement 50-59 Employee Only $21.48 $39.88 70+ Employee Only $52.48 $74.68
• Non-Local Transportation and Lodging
50-59 Employee & Spouse $32.20 $59.60 70+ Employee & Spouse $77.80 $111.00
• At Home Nursing
• Second surgical opinion 50-59 Employee & Child(ren) $21.68 $40.28 70+ Employee & Child(ren) $52.68 $74.88
• New or Experimental Treatment 50-59 Family $32.60 $59.80 70+ Family $78.20 $111.40
• Comfort/Anti-nausea benefit
GROUP VOLUNTARY ACCIDENT GROUP VOLUNTARY CANCER
(MONTHLY PREMIUMS) (MONTHLY PREMIUMS)
Employee Only $14.52 Employee Only $17.59
Employee & Spouse $26.88 Family $29.49
Employee & Child(ren) $24.60
Family $36.96
Want more information about the Allstate Benefits products available? Visit http://allstatevoluntary.com/topbuild/ for informational
brochures on the Group Voluntary Critical Illness, Accident, and Cancer plans!
This information is incomplete without brochures ABJ17350X, ABJ20177X, ABJ17346X which contain full details of the benefits,
limitations and exclusions of the coverage. Go to http://allstatevoluntary.com/topbuild/.
This is a brief overview of the benefits available under the Group Voluntary Policies underwritten by American Heritage Life Insurance Company. Details of the insurance, including exclusions, restrictions and
other provisions are included in the certificates issued.
10Step 3) Review Your Additional Benefits (Continued)
LEGAL INSURANCE & IDENTITY THEFT PROTECTION EMPLOYEE PURCHASING PROGRAM
Provided by ARAG Provided by PayCheck Works
Legal Insurance helps you address everyday situations like dealing with Interest-Free Shopping for Employees!
traffic tickets, resolving warranty issues, or buying a home. When you need You have access to a smart shopping program that is easy and affordable.
help, rather than wasting time and money on costly attorney fees, ARAG You buy what you want and need today then make low interest-free pay-
offers top-performing legal services and most covered legal matters are ments, through the ease of payroll deduction, over 6 months.
100% paid in full when you work with a network attorney.
By shopping Paycheck Works, you have thousands of name-brand selec-
• In Office access to a nationwide network of more than 10,000 attorneys tions from such top names as Sony, Apple, and KitchenAid in categories
• Call and access a network attorney by phone for unlimited advice from patio furniture and pools to TVs and computers and so much more!
• Help preparing documents, letters, or a will You can purchase a big ticket item like a riding lawn mower or you can buy
several smaller items like counter top appliances up to your purchase limit.
For services such as... Your purchase limit is based on your salary, which helps you stay on bud-
Consumer issues Criminal Matters get. Payments made through worry-free payroll deduction, you won’t need
Estate Planning Taxes to worry about missing one.
Debt Resolution Disputes with Landord
Civil Defense Child Support & Custody with PayCheck Works employees get:
Family Matters Immigration Services • Interest-free financing
Real Estate Financial Counseling • Payments made through payroll deduction
Criminal Matters and much more • No credit checks
• No down payments
Identity Theft Protection is also included. This service can track your • Thousands of name-brand products
credit activity or online identity and you’re notified immediately of
suspicious activity. You are eligible to participate when you:
• Are 18 years or older
Additionally, should you be a victim of identity theft, the ARAG service will • Earn at least $18,000 per year
assist you in achieving recovery and resolution. • Have been an active employee of TopBuild for at least 6 months
The following payroll deduction amount, provides legal insurance and
identity theft protection for you & your family.
Weekly Semi-Monthly
Employee Only $4.28 $9.27
Family $5.65 $12.24
11Step 4) Make Your Elections
To enroll in 2018 coverage, you will need to make your Current employees: If you do not enroll, your current
elections using the call center or enrollment website (as coverage will roll over except FSA; to have an FSA
shown on page 2). The benefits you choose will remain in account in 2018 you must make an election.
effect through 12/31/18.
ENROLLING FOR You have 30 days from your coverage effective date to
2018 COVERAGE
This is also a good
Before you make your coverage elections, check that enroll. All disability coverage will default to elected status.
time to review your any dependents you enroll meet the eligibility rules (see Should you choose to waive your coverage you will need
beneficiaries, e-mail Who’s Eligible), and review and submit any required doc- to do so on Employee Self Service.
and home address, uments by the deadline.
and 401(k) elections. If you do not enroll within 30 days, you will not have
coverage for any plans requiring an employee contribution,
except disability.
You may make certain changes during the year to the Legal marital status
CHANGING YOUR benefits you choose only if you have a qualified status
ELECTIONS Number of children
change in one of the events listed to the right.
Contact the Benefits Eligibility of a spouse or child
Department for instruc- You must make all benefit changes within 60 days of
tions on how to make a Employment status or work schedule
benefit change. any qualifying event. If any of these changes occur,
contact the Benefits Department for instructions on how Residence or worksite
to make a benefit change.
Medicare or Medicaid entitlement
Step 5) Review Your Benefit Elections
After enrollment ends, you should review your benefit confirmation of your 2018 elections. If any of your elections are incorrect,
you must call the Benefits Department at 1-877-627-0334 (option 2) by the deadline. Otherwise, unless you have a
qualified status change, you cannot change your elections until the next open enrollment.
12TopBuild Corp. 401(k) Plan
The 401(k) Plan is a convenient way to save for your retirement using pre-tax dollars. Your contributions are automatically
deducted from your paycheck before income taxes are taken out. Plan highlights:
• Your employer will match 25% of the first 10% of eligible • Set up your investment elections and select/update your
earnings that you contribute to the plan, per pay period. 401(k) Plan beneficiary at www.401k.com.
These matching contributions are vested after 1 year.
• Take advantage of the numerous educational
• New hires are automatically enrolled in the plan at a 3% con- resources Fidelity offers by logging into your account
tribution rate. You may choose to opt out of this enrollment at www.401k.com.
or elect a different percentage.
Provider Networks: Medical, Dental Complete Benefit Details
and Vision Plans A complete description of your benefits is contained in
each plan’s Summary Plan Description (SPD). This guide is
Provider networks change as new hospitals, physicians, intended only to provide an overview of your benefits. Refer
dentists and vision care specialists join or leave networks. to the SPD for more detailed information on coverage and
OTHER INFORMATION You should contact your current health care provider to verify exclusions.
that he or she participates in your chosen plan. You may also
contact your health plan’s customer service or visit the plan’s In addition, the Patient Protection and Affordable Care Act
website for a current listing of providers. requires that you have access to a Summary of Benefits and
Coverage (SBC) for each medical plan. The SBC is separate
Aetna (Medical)
from this guide and a copy will be provided for your reference.
Plan Name: Aetna Choice POS II (Open Access)
Plan Name Best Value Only: Aetna Premier Care Network
Pharmacy Plan Name: Aetna RX Preferred Should there be any conflict between the explanations in
this guide or the SBC and the actual terms and provisions
Delta Dental (Dental) of the plan documents and contracts, the terms of the plan
Plan Name PPO: Delta Premier documents and contracts will govern in all cases. You will not
Plan Name HMO: Delta Care USA gain any new rights or benefits because of a misstatement
or omission in this guide or the SBC. The Company reserves
EyeMed (Vision) the right to change or terminate any or all of these benefits
Plan Name: Insight at any time.
HIPAA
This notice is provided in accordance with the Health
Insurance Portability and Accountability Act of 1996 (HIPAA).
Certain plans contain special enrollment provisions applica-
ble to new enrollees. Please contact the Benefits Department
for additional details regarding these provisions. A Notice of
Privacy Practices (NOPP) that applies to the Company’s health
plans is available. The NOPP describes how all the plans will
use and disclose your individual health information. It also tells
you that your individual health information will be kept private
and secure. For a current copy of the NOPP, contact the
Benefits Department. 13Required Legal Notices
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or If you live in one of the following states, you may be Indiana – Medicaid
CHIP and you’re eligible for health coverage from eligible for assistance paying your employer health
Healthy Indiana Plan for low-income adults 19-64
your employer, your state may have a premium plan premiums. The following list of states is current
Website: http://www.in.gov/fssa/hip/
assistance program that can help pay for cov- as of August 10, 2017. Contact your State for more Phone: 1-877-438-4479
erage, using funds from their Medicaid or CHIP information on eligibility. All other Medicaid
programs. If you or your children aren’t eligible Website: http://www.indianamedicaid.com
for Medicaid or CHIP, you won’t be eligible for Alabama - Medicaid Phone 1-800-403-0864
these premium assistance programs but you Website: http://myalhipp.com/
may be able to buy individual insurance coverage Iowa - Medicaid
Phone: 1-855-692-5447
through the Health Insurance Marketplace. Website: http://dhs.iowa.gov/ime/members/medicaid-a-to-z/hipp
Alaska - Medicaid
For more information, visit www.healthcare.gov. Phone: 1-888-346-9562
The AK Health Insurance Premium Payment Program Kansas - Medicaid
If you or your dependents are already enrolled in Website: http://myakhipp.com/
Phone: 1-866-251-4861 Website: http://www.kdheks.gov/hcf/
Medicaid or CHIP and you live in a State listed
Email: CustomerService@MyAKHIPP.com Phone: 1-785-296-3512
below, contact your State Medicaid or CHIP of-
fice to find out if premium assistance is available. Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/ Kentucky - Medicaid
default.aspx Website: http://chfs.ky.gov/dms/default.htm
If you or your dependents are NOT currently Arkansas – Medicaid Phone: 1-800-635-2570
enrolled in Medicaid or CHIP, and you think you Website: http://myarhipp.com/ Louisiana - Medicaid
or any of your dependents might be eligible for Phone: 1-855-MyARHIPP (855-692-7447) Website: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331
either of these programs, contact your State
Colorado - Health First Colorado Phone: 1-888-695-2447
Medicaid or CHIP office or dial 1-877-KIDS NOW or
(Colorado’s Medicaid Program) & Child Health Plan Maine - Medicaid
www.insurekidsnow.gov to find out how to apply. Plus (CHP+)
If you qualify, ask your state if it has a program Website:
that might help you pay the premiums for an Health First Colorado Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.html
employer-sponsored plan. https://www.healthfirstcolorado.com/ Phone: 1-800-442-6003
Health First Colorado Member Contact Center: TTY: Maine relay 711
If you or your dependents are eligible for premium 1-800-221-3943/ State Relay 711
CHP+: Colorado.gov/HCPF/Child-Health-Plan-Plus Massachusetts - Medicaid & CHIP
assistance under Medicaid or CHIP, as well as
CHP+ Customer Service: 1-800-359-1991/ Website:
eligible under your employer plan, your employer
State Relay 711 http://www.mass.gov/eohhs/gov/departments/masshealth/
must allow you to enroll in your employer plan
Florida - Medicaid Phone: 1-800-862-4840
if you aren’t already enrolled. This is called a
“special enrollment” opportunity, and you must Website: http://flmedicaidtplrecovery.com/hipp/ Minnesota - Medicaid
request coverage within 60 days of being deter- Phone: 1-877-357-3268 Website: http://mn.gov/dhs/people-we-serve/seniors/health-care/
mined eligible for premium assistance. If you Georgia - Medicaid health-care-programs/programs-and-services/medical-assistance.
have questions about enrolling in your employer jsp
plan, contact the Department of Labor at www. Website: http://dch.georgia.gov/medicaid Phone: 1-800-657-3739
askebsa.dol.gov or call 1-866-444-EBSA (3272). - Click on Health Insurance Premium Payment (HIPP)
Phone: 404-656-4507 Missouri - Medicaid
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm
Phone: 573-751-2005 14Montana - Medicaid Pennsylvania - Medicaid Wisconsin - Medicaid & CHIP
Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Website: http://www.dhs.pa.gov/provider/medicalassistance/ Website:
Phone: 1-800-694-3084 healthinsurancepremiumpaymenthippprogram/index.htm https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf
Nebraska - Medicaid Phone: 1-800-692-7462 Phone: 1-800-362-3002
Website: http://www.ACCESSNebraska.ne.gov Rhode Island - Medicaid Wyoming - Medicaid
Phone: (855) 632-7633 Website: http://www.eohhs.ri.gov/ Website: https://wyequalitycare.acs-inc.com/
Lincoln: (402) 473-7000 Phone: 855-697-4347 Phone: 307-777-7531
Omaha: (402) 595-1178 South Carolina - Medicaid
Nevada - Medicaid Website: https://www.scdhhs.gov To see if any other states have added a premium
Medicaid Website: https://dwss.nv.gov/ Phone: 1-888-549-0820 assistance program since August 10, 2017, or
Medicaid Phone: 1-800-992-0900 South Dakota - Medicaid for more information on special enrollment rights,
New Hampshire - Medicaid contact either:
Website: http://dss.sd.gov
Website: http://www.dhhs.nh.gov/oii/documents/hippapp.pdf Phone: 1-888-828-0059 U.S. Department of Labor Employee Benefits
Phone: 603-271-5218 Texas - Medicaid Security Administration
New Jersey - Medicaid & CHIP www.dol.gov/agencies/ebsa
Website: http://gethipptexas.com/
1-866-444-EBSA (3272)
Medicaid Website: Phone: 1-800-440-0493
http://www.state.nj.us/humanservices/ Utah - Medicaid & CHIP U.S. Department of Health and Human Services
dmahs/clients/medicaid/ Centers for Medicare & Medicaid Services
Medicaid Phone: 609-631-2392 Medicaid Website: https://medicaid.utah.gov/
CHIP Website: http://health.utah.gov/chip www.cms.hhs.gov
CHIP Website: http://www.njfamilycare.org/index.html 1-877-267-2323, Menu Option 4, Ext. 61565
CHIP Phone: 1-800-701-0710 Phone: 1-877-543-7669
Vermont - Medicaid
New York - Medicaid Paperwork Reduction Act Statement
Website: http://www.greenmountaincare.org/ According to the Paperwork Reduction Act of 1995 (Pub. L.
Website: https://www.health.ny.gov/health_care/medicaid/ 104-13) (PRA), no persons are required to respond to a collection
Phone: 1-800-541-2831 Phone: 1-800-250-8427 of information unless such collection displays a valid Office of
Management and Budget (OMB) control number. The Department
Virginia - Medicaid & CHIP
North Carolina - Medicaid notes that a Federal agency cannot conduct or sponsor a collection
Medicaid Website: of information unless it is approved by OMB under the PRA, and
Website: https://dma.ncdhhs.gov/ displays a currently valid OMB control number, and the public is not
Phone: 919-855-4100 http://www.coverva.org/programs_premium_assistance.cfm required to respond to a collection of information unless it displays
Medicaid Phone: 1-800-432-5924 a currently valid OMB control number. See 44 U.S.C. 3507. Also,
North Dakota - Medicaid CHIP Website:
notwithstanding any other provisions of law, no person shall be sub-
ject to penalty for failing to comply with a collection of information if
Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ http://www.coverva.org/programs_premium_assistance.cfm the collection of information does not display a currently valid OMB
control number. See 44 U.S.C. 3512.
Phone: 1-844-854-4825 CHIP Phone: 1-855-242-8282
The public reporting burden for this collection of information is
Oklahoma - Medicaid & CHIP Washington - Medicaid estimated to average approximately seven minutes per respondent.
Interested parties are encouraged to send comments regarding the
Website: http://www.insureoklahoma.org Website: http://www.hca.wa.gov/free-or-low-cost-health-care/ burden estimate or any other aspect of this collection of informa-
Phone: 1-888-365-3742 program-administration/premium-payment-program tion, including suggestions for reducing this burden, to the U.S.
Department of Labor, Employee Benefits Security Administration,
Oregon - Medicaid & CHIP Phone: 1-800-562-3022 ext. 15473 Office of Policy and Research, Attention: PRA Clearance Officer, 200
West Virginia - Medicaid Constitution Avenue, N.W., Room N-5718, Washington, DC 20210
Website: http://healthcare.oregon.gov/Pages/index.aspx or email ebsa.opr@dol.gov and reference the OMB Control Number
http://www.oregonhealthcare.gov/index-es.html Website: http://www.dhhr.wv.gov/bms/Medicaid%20Expansion/ 1210-0137.
Phone: 1-800-699-9075 Pages/default.aspx OMB Control Number 1210-0137 (expires 12/31/2019)
Phone: 1-877-598-5820, HMS Third Party Liability
15Required Legal Notices
Important Notice About Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you What Happens To Your Current Coverage If You For more information about this notice or your
can find it. This notice has information about your Decide to Join A Medicare Drug Plan? current Prescription Drug Coverage…
current prescription drug coverage and about your
If you decide to join a Medicare Drug Plan, your Contact the person listed below for further information.
options under Medicare’s prescription drug coverage.
coverage will not be affected. See below for more NOTE: You’ll get this notice each year. You will also
This information can help you decide whether
information about what happens to your current get it before the next period you can join a Medicare
or not you want to join a Medicare Drug Plan. If you
coverage if you join a Medicare Drug Plan. Drug Plan, and if this coverage changes. You also may
are considering joining, you should compare your
request a copy of this notice at any time.
current coverage, including which drugs are covered Your current coverage pays for other health expens-
at what cost, with the coverage and costs of the plans es in addition to prescription drugs. If you enroll in a For more information about your options under
offering Medicare prescription drug coverage in your Medicare Drug Plan, you and your eligible dependents Medicare Prescription Drug Coverage…
area. Information about where you can get help to will still be eligible to receive all of your current health
make decisions about your prescription drug coverage More detailed information about Medicare plans that
and prescription drug benefits; however, this plan will
is at the end of this notice. offer prescription drug coverage is in the “Medicare &
coordinate with Part D coverage.
You” handbook. You’ll get a copy of the handbook in
There are two important things you need to know See pages 7-9 of the CMS Disclosure of Creditable the mail every year from Medicare. You may also be
about your current coverage and Medicare’s Coverage to Medicare Part D Eligible Individuals contacted directly by Medicare Drug Plans.
prescription drug coverage: Guidance (available at http:// www.cms.hhs.gov/Cred-
For more information about Medicare Prescription
itable Coverage/), which outlines the prescription drug
1. M
edicare prescription drug coverage became Drug Coverage:
plan provisions that Medicare eligible individuals may
available in 2006 to everyone with Medicare. You
have available to them when they become eligible for • Visit www.medicare.gov
can get this coverage if you join a Medicare
Medicare Part D.)
Drug Plan or join a Medicare Advantage Plan (like • C
all your State Health Insurance Assistance Program
an HMO or PPO) that offers prescription drug If you do decide to join a Medicare Drug Plan and drop (see the inside back cover of your copy of the
coverage. All Medicare drug plans provide at least your current prescription drug coverage, be aware that “Medicare & You” handbook for their telephone
a standard level of coverage set by Medicare. you and your dependents may not be able to get this number) for personalized help,
Some plans may also offer more coverage for a coverage back.
higher monthly premium. • C
all 1-800-MEDICARE (1-800-633-4227). TTY users
When Will You Pay A Higher Premium (Penalty) To should call 1-877-486-2048.
2. Y
our Company has determined that the prescription Join A Medicare Drug Plan?
drug coverage offered is, on average for all plan If you have limited income and resources, extra help
participants, expected to pay out as much as You should also know that if you drop or lose your paying for Medicare prescription drug coverage is
standard Medicare prescription drug coverage pays current coverage with your Company and don’t join available. For information about this extra help, visit So-
and is considered Creditable Coverage. Because a Medicare drug plan within 63 continuous days after cial Security on the web at www. socialsecurity.gov, or
your existing coverage is Creditable Coverage, you your current coverage ends, you may pay a higher call them at 1-800-772-1213 (TTY 1-800- 325-0778).
can keep this coverage and not pay a higher premium (a penalty) to join a Medicare Drug Plan later.
Remember: Keep this Creditable Coverage notice. If
premium (a penalty) if you later decide to join a If you go 63 continuous days or longer without you decide to join one of the Medicare drug plans, you
Medicare Drug Plan. creditable prescription drug coverage, your monthly may be required to provide a copy of this notice when
When Can You Join A Medicare Drug Plan? premium may go up by at least 1% of the Medicare you join to show whether or not you have maintained
base beneficiary premium per month for every month creditable coverage and, therefore, whether or not you
You can join a Medicare Drug Plan when you first that you did not have that coverage. For example, if are required to pay a higher premium (a penalty).
become eligible for Medicare and each year from you go nineteen months without creditable coverage,
October 15th through December 7th. However, if you your premium may consistently be at least 19% higher Name of Entity/Sender: TopBuild Corp.
lose creditable prescription drug coverage, through than the Medicare base beneficiary premium. You may Contact--Position/Office: Benefits Department
no fault of your own, you will also be eligible for a two have to pay this higher premium (a penalty) as long as
(2) month Special Enrollment Period (SEP) to join a Address: 4
75 N. Williamson Blvd., Daytona Beach, FL 32114
you have Medicare prescription drug coverage. In
Part D plan. addition, you may have to wait until the following Phone Number: 1-877-627-0334
November to join.
16AETNA LIBERTY MUTUAL DISABILITY
877-212-1329 Disability Claim Intake number: 1-800-713-7384
www.aetna.com Disability Claim Support Team: 1-800-291-0112
www.mylibertyconnection.com
FLEXIBLE SPENDING ACCOUNT
CONTACT INFORMATION
(managed by PayFlex) MY LIBERTY ASSIST (EAP)
877-212-1329 (option 3) Bensinger Dupont & Associates
1-877-695-2789
DELTA DENTAL www.bensingerdupont.com/MLA
800-521-2651 – PPO Enter Password: MLASSIST
800-422-4234 – HMO
www.deltadentalins.com TELADOC
1-800-Teladoc (835-2362)
EYEMED VISION www.teladoc.com
866-800-5457
www.eyemed.com ALLSTATE BENEFITS
866-828-8501
LIBERTY MUTUAL LIFE www.allstatevoluntary.com/topbuild
Life Claim Team: 1-888-787-2129
www.mylibertyconnection.com BENEFITS DEPARTMENT
1-877-627-0334 (option 2)
ARAG LEGAL E-mail: Benefits@topbuild.com
800-247-4184
www.ARAGLegalCenter.com FIDELITY INVESTMENTS–401(k) PLAN
Enter Access Code: 18099tb 1-800-835-5091
www.401k.com
PAYCHECK WORKS
844-729-7678
www.topbuildstore.paycheckworks.com
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