2019 BENEFITS PROGRAM AND ENROLLMENT GUIDE - MISSION:YOU - NAF Health Plans
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MISSION:YOU
2019 BENEFITS PROGRAM
AND ENROLLMENT GUIDE
Overview of your health, life and wellness benefits
YOUR 2019 BENEFITS ENROLLMENT GUIDE
IN THIS GUIDE: PAGE Dear Associate,
As a valued associate of our NEXCOM Enterprise, we provide you
with a first-class compensation and benefits package. Our goal is to
Who is Eligible? 1 provide a competitive package that is high in value that few employers
can match. Your comprehensive benefit package includes: medical,
Open Enrollment: dental, vision, life and disability plans along with our outstanding
November 1 – 30, 2018 2 pension and 401(k) programs.
This enrollment guide highlights the 2019 benefits package that is
Your 2019 Health Plan Contributions 2 available to you. Whether you are just joining NEXCOM or if you are
looking for Open Enrollment information, this guide is a great resource
Medical Benefits 3 that can be used throughout the year.
The 2019 Open Enrollment period for Medical/Dental and Flexible
Prescription Drug Benefits 4
Spending Accounts is November 1 – November 30, 2018, with an
effective date of January 1, 2019. I recommend that you review
Aetna Health and Wellness Programs 5 this guide and view the 2019 Open Enrollment video posted on
nafhealthplans.com. This video will inform you of the Aetna medical/
Dental Benefits 6 dental plan changes for 2019 as well as what actions you need to take
during the Open Enrollment period.
Medical and Dental Coverage
Here are a just a few highlights I want to share:
After Retirement 6
• N
ew in 2019 is “Alex”, your on-line benefits counselor. Alex is an
Flexible Spending Accounts 7 easy to use online interactive tool that walks you through your
plan options and makes recommendations based on the
Health Plan Online Resources 8
information you submit. He can be found online on the
nafhealthplans.com website.
Key Provisions 8 • In addition to Quest Diagnostics, LabCorp has been added as an in-
network provider for diagnostic testing.
Disability Benefits 9 • T
eladoc is expanding to include dermatology and mental health for
a $45 copay.
Life Insurance Benefits 10 • T
he Health Incentive Credit Program has been enhanced to provide
more flexibility in earning credits for taking healthy actions.
Long Term Care Insurance 12
• T
he Health Care Flexible Spending Account Maximum has
increased to $2,650.
EAP Program 12
In addition to this Benefits Enrollment Guide, excellent resources are
Retirement Plans 13 available on the nafhealthplans.com website along with the Code H
NEXCOM Hub. I encourage you to use these valuable resources to
End-of-Life Planning Services 13 learn more. As always, your Human Resources team is available to
assist you in the enrollment process.
Contacts and Resources Back Cover
Robert J. Bianchi
Rear Admiral, Supply Corps, USN (Ret.)
Chief Executive Officer
Navy Exchange Service Command
YOUR NEXCOM BENEFITS PROGRAM —
CHART YOUR COURSE
Who Is Eligible?
Benefits Plan Regular Regular Additional Initial Enrollment After Initial
Full-Time Part-Time Eligibility Time Frame Enrollment
Requirements Time Frame
Medical/Dental Within 31 days of hire date Open Enrollment
3 3 or attaining eligibility
Stand Alone Dental Not enrolled in Within 31 days of hire date Open Enrollment
3 3 Medical/Dental Plan or attaining eligibility
Flexible Savings Account Within 31 days of hire Open Enrollment
(HFSA/DFSA) 3 3 date. For continued
participation, must
re-enroll during Annual
Enrollment. Enrollments
or plan changes are not
accepted from October 1
through December 31.
Short-Term Disability* Enrollment is automatic N/A
3
Long-Term Disability* Within 31 days of hire date Biennial Enrollment
3 (subject to insurance
company approval)
Long Term Care (subject Enroll anytime through Enroll anytime through
to insurance company 3 3 the FLTCIP only. (Subject the FLTCIP only. (Subject
approval) to insurance company to insurance company
approval) approval)
Basic Group Life Within 31 days of hire date Biennial Enrollment
Insurance* 3 (subject to insurance
company approval)
Optional Group Life Regular full-time Within 31 days of hire date Biennial Enrollment
Insurance 3 3 associates must be (subject to insurance
enrolled in Basic company approval)
Group Life Insurance
Dependent Group Enrolled in Basic Within 31 days of hire date Biennial Enrollment
Life Insurance* 3 Group Life Insurance or acquiring a dependent (subject to insurance
company approval)
Pension If not auto-enrolled, Automatic enrollment for Any pay period thereafter
3 3 complete one year new hires. Earn one year
of cumulative regular credited service first year
service (after August 1, 2015).
401(k) 18 years of age Enroll at any pay period Enroll at any pay period.
3 3
*Regular full-time associates who are involuntarily converted to regular part-time status may continue to participate in the plans.
When Are You Eligible?
If you are a new hire or newly eligible associate, you may enroll in benefits during your eligibility period. Your
eligibility period is the 30- or 31-day period starting on the day you are hired or otherwise become eligible
for benefits. If you don’t enroll during your eligibility period, you’ll need to wait until the next Open Enrollment
or Biennial Enrollment period, as applicable. You may enroll in the 401(k) plan any time after attaining eligibility.
New hires are automatically enrolled in the NEXCOM Pension Plan. Contributions will begin after your one-year
anniversary. You may opt out anytime by completing an opt-out form.
1
2019 OPEN ENROLLMENT
FOR MEDICAL, DENTAL PLANS
NOVEMBER 1 – 30, 2018
During Open Enrollment, you may make medical and dental plan choices and changes. You can join or
switch from one plan to another. You can add dependents (supporting documentation is required) or
remove dependents from your coverage. You cannot add dependents or drop coverage during the year
unless you have a qualifying event (e.g., marriage, divorce, adoption, birth of a child). Please refer to the
Summary Plan Description if you have questions. You have 31 days from the time of the event to take action.
Otherwise, you must wait for the next Open Enrollment.
Your 2019 Aetna Medical & Dental Plans Contributions
Aetna Medical includes medical, prescription and vision coverage. You may enroll in Aetna Medical only,
Aetna Medical and Dental, or Aetna Dental if you are enrolled in a NEXCOM‑sponsored HMO. If you are
not enrolled in a NEXCOM-sponsored medical plan (Aetna or HMO), you may enroll in Stand Alone Dental.
Below are your 2019 biweekly contribution rates:
Tier Medical Dental Medical & Dental Stand Alone Dental
Employee only $81.39 $4.50 $85.89 $16.10
Employee + child(ren) $157.08 $8.68 $165.76 $36.24
Employee + spouse $188.01 $10.38 $198.39 $32.21
Employee + family $249.05 $13.76 $262.81 $52.34
Meet Alex®, your interactive
benefits counselor
ALEX* is an online tool that can help you
choose the right benefits. He’s smart,
friendly and easy to use. Just give him
some basic information and he’ll walk
you through your plan options for medical
and dental — Flexible Spending Accounts
too. At the end, he’ll suggest benefits to
match your needs, budget and preferences.
To meet ALEX, go to nafhealthplans.com.
While you’re there, you’ll find detailed
information about the medical and
dental plans and programs. You’ll
also find information about Flexible
Spending Accounts and the Health
Incentive Credit program. The site is
designed to give you quick and
easy-to-use access from any device.
*ALEX is not available to retirees.
Watch the Enrollment Video at nafhealthplans.com to learn more about your benefits!
2
MEDICAL BENEFITS
NEXCOM’s health benefits are offered as part of the Department of Defense (DoD) Nonappropriated
Fund (NAF) Health Benefits Program (HBP). Health benefits include medical, vision and prescription
drug coverage. The following Aetna medical plans and benefits are available based on where you live:
Aetna Choice® POS II Traditional Choice®
(including Aetna
In-Network Out-of-Network International)
Annual Deductible*
• Employee only $500 $1,500 $500
• Family (employee + one or $1,500* $4,500* $1,500*
Update more dependents)
Out-of-Pocket Maximum
• Employee only $4,000 $8,000 $4,000
• Family (employee + one or $8,000* $16,000* $8,000*
more dependents)
Preventive Care** 100%, no copay Not covered 100%, no deductible
Primary Care $30 copay 60% after deductible 80% after deductible
Physician (PCP) Visit
Specialist Visit $45 copay 60% after deductible 80% after deductible
Walk-in Clinic 100% after $30 copay 60% after deductible 80% after deductible
Urgent Care Center 100% after $30 copay 60% after deductible 80% after deductible
Emergency Room (ER) 90% after $350 ER copay 90% after $350 ER copay 80% after deductible
(waived if admitted); no (waived if admitted); no
calendar year deductible calendar year deductible
Emergency Room (ER) 50% after $350 ER copay 50% after $350 ER copay 50% after deductible
(non-emergency visit)
Teladoc®*** $10, general medicine N/A $10, general medicine
New $45, dermatology and $45, dermatology and
behavioral health behavioral health
*The new family deductible and out-of-pocket maximum can be met by one or any combination of family members. Once the expenses
of any family member(s) reaches the deductible, the deductible will be considered met for all family members.
**Routine colonoscopies and other outpatient procedures may be subject to the maximum allowable amount. Please call Aetna Member
Services for more information at 1-800-367-6276.
***Teladoc may not available in all states or overseas.
Health Maintenance Organizations (HMOs) Two new Teladoc programs
HMOs may also be available to you as an alternative Teladoc lets you consult with a doctor and get
to the Aetna medical plans, depending on where you diagnosed, treated and prescribed — without the
live. HMOs provide medical and prescription drug travel and waiting room time — for just a $10 copay.
coverage to eligible associates living in specific areas. In 2019, your plan will add two new Teladoc services
HMOs are available in: Tidewater, VA, San Diego/ — each for a $45 copay. These include:
Central CA, Hawaii, Baltimore/Washington, D.C., • D
ermatology, for help with skin conditions. You’ll
the Pacific Northwest, and Guam. Ask your local HR be able to share a photo of your skin condition
representative for details about HMOs in your area. for review by a credentialed dermatologist and
Visit nafhealthplans.com to view comparisons of Aetna receive a diagnosis and treatment plan within two
and the HMO available in your area (if applicable). business days.
• A
behavioral health program, for video counseling
from an experienced psychiatrist, psychologist or
Find medical and dental plan details online masters-level therapist. Get help with issues such as
Go to nafhealthplans.com to view the plan(s) anxiety, depression, substance abuse and stress.
you are eligible for based on your ZIP code. You
will also find details about the health plan(s) and ppointments can be scheduled via the Teladoc app,
A
other related information. at teladoc.com/aetna or by phone at 1-800-835-2362.
3
PRESCRIPTION DRUG BENEFITS
When you enroll in an Aetna medical plan, you will also have prescription drug benefits. Beginning
January 1, 2019, the Aetna plan will use the standard formulary. There are four levels, or “tiers,” of benefits
as shown in the chart below:
Short-Term Prescriptions: Long-Term Prescriptions:
Drug Tier Any network pharmacy for Aetna Rx Home Delivery or Maintenance
up to a 30-day supply Choice, up to a 90-day supply***
Tier One – Generic drugs $10 copay per prescription $20 copay per prescription
Tier Two – Preferred brand-name drugs $35 copay per prescription $70 copay per prescription
35% of negotiated price** 35% of negotiated price**
Tier Three – Non-preferred
The minimum you pay per prescription is $60; The minimum you pay per prescription is $120;
brand-name drugs*
maximum is $125 maximum is $250
40% of negotiated price**
Tier Four – Specialty drugs The minimum you pay per prescription is $60; N/A
maximum is $125
*Your pharmacy will automatically fill your prescription with a generic drug, if one is available. Learn more about the Choose Generics Program
at nafhealthplans.com > Health Benefits > Pharmacy Program.
**Participating pharmacies agree to charge discounted prices for prescriptions filled by Aetna members. Your share of Tier Three and Tier
Four drug costs is a percentage of these discounted (or “negotiated”) prices.
***With Maintenance Choice, you can get a 90-day supply of maintenance medications listed on the Maintenance Medicine List, by using
either The Aetna Rx Home Delivery mail-order pharmacy or a CVS pharmacy near you. After two fills at your local retail pharmacy, you will
pay the full cost of the drug if you choose to continue to receive a 30-day supply.
Filling short-term prescriptions Maintenance Choice®
When you need to fill a short-term prescription, you Maintenance medications are those used on a regular
can get up to a 30-day supply of medication at retail basis to treat or manage conditions such as asthma,
pharmacies that belong to the Aetna network. Take diabetes, high blood pressure or high cholesterol.
your prescription and your Aetna medical ID card to With the Maintenance Choice program, you may fill
any participating pharmacies located in the United a 30-day supply of a maintenance drug, listed on the
States, Puerto Rico, Guam and the U.S. Virgin Islands. Maintenance Medicine List, at any retail pharmacy in
Depending on the type of drug prescribed, you pay the Aetna network two times. Thereafter, maintenance
your share of the cost in full at the time of purchase. drugs are to be filled in 90-day levels.* You have
To find a participating pharmacy near you, log in to a choice of how you want to fill your maintenance
aetna.com > Find Care. prescriptions:
• U
se Aetna’s Rx Home Delivery mail-order
Filling long-term prescriptions program. To get started with the service, call
Use Aetna’s Rx Home Delivery® mail-order program 1-888-RX AETNA (1-888-792-3862), or
to save on medications you need on a regular, long- • F
ill your 90-day prescription at your local CVS
term basis. You may order a 31- to 90-day supply and pharmacy. To find a local CVS pharmacy, log in
enjoy the convenience of home delivery. Shipping is to aetna.com > Find Care.
free and the packaging is confidential. You can order
*If you continue to fill your ongoing maintenance drugs with
a 90-day supply of medication for what you would pay a 30-day supply, you will have to pay the full cost of the drug.
for a 60-day supply at a participating retail pharmacy.
Note: Not all maintenance drugs are on the list.
Visit the Maintenance Medicine List to see if your
Get drug costs ahead of time
maintenance drugs fall under these provisions. Go to
Not all pharmacies charge the same amount for the nafhealthplans.com > Health Benefits > Pharmacy
same prescription. The cost depends on where you Program.
get it filled. To estimate and compare costs, log in
to aetna.com > Manage Prescriptions > Estimate
drug costs.
4
AETNA HEALTH AND WELLNESS PROGRAMS
New When you enroll in an Aetna medical plan, you can take advantage of wellness programs that help you live
healthier. Beginning in 2019, your will have access to Healthy Lifestyle Coaching. With this program, you can
participate in online group sessions with people who want to make the same healthy changes you want to
make, along with one-on-one sessions with your wellness coach. The coach will help you with wellness goals,
such as losing weight, eating better, reducing stress, quitting smoking and more.
When you join, you’ll take part in a series of weekly interactive, online group coaching sessions over a 6-week
period. You’ll enjoy the support and encouragement of your peers as you work toward your goals.
To learn more, call 1-866-213-0153 or log in to aetna.com > Stay Healthy > Health Programs.
*Healthy Lifestyle Coaching is not available to overseas employees.
Earn Health Incentive Credits
Aetna members can earn Health Incentive Credits to help with your share of covered medical expenses. In 2019,
employees enrolled in employee-only coverage will be able to earn up to $300 in Health Incentive Credits.
(This is a $50 increase over last year!) Also, you’ll earn $75 just for completing the online Health Assessment.
The chart below shows all the activities you can complete to earn credits to be applied to your deductible or
coinsurance expenses.
Activity Health Incentive Credit amount
Employees, retirees and covered spouses can each earn:
Complete your online Health Assessment on aetna.com $75
Complete biometric screening between January 1 and $150
November 30, 2019
Disease Management (DM) goal* — complete 3 calls with a DM nurse $75
*This program is not available to overseas employees.
Complete online Journey® (average Journey time 32 days) $75, up to 4 Journeys
Dependent children under age 18 can each earn:
Complete preventive exam for children under age 18 $50
For all activities, you can earn up to the calendar year maximum of $300 for employee only or $600 for employees
that cover dependents.
The Health Assessment is your first step these factors: 1) blood pressure 2) blood sugar
The Health Assessment is a questionnaire that takes just 3) triglycerides 4) waist circumference and 5) HDL
10 minutes to complete. You answer questions about cholesterol. If three or more of these measurements
personal and family health history, lifestyle habits, recent are too high, you may have metabolic syndrome.
health screening results and other health factors. To In many cases, these factors can be positively
take the assessment, log in to aetna.com > Stay Healthy impacted by lifestyle changes, such as regular
> Complete Your Assessment. exercise and eating a healthy diet.
Earned Health Incentive Credits are applied
What is biometric screening? automatically to your deductible or coinsurance*
A biometric screening includes a blood test, waist amounts. For more information, visit
measurement and blood pressure reading to nafhealthplans.com > Wellness > Health Incentive
determine if you are at risk for metabolic syndrome. Credit Program.
Metabolic syndrome is a group of factors that raise *Health Incentive Credits are not applied to copay amounts.
your risk of developing conditions such as heart Copays are flat fees paid for certain types of expenses, such
as prescription drugs.
disease and diabetes. A biometric screening measures
5
DENTAL BENEFITS
MEDICAL AND DENTAL COVERAGE
AFTER RETIREMENT
NEXCOM Offers Two Dental Plans
The Aetna PPO Network Dental Plan or International The Stand Alone Dental Plan. If you only want dental
Dental Plan. When you enroll in an Aetna medical benefits, you can choose the Stand Alone Dental Plan.
plan (or an HMO plan) you are eligible to enroll in This plan cannot be combined with any of the Aetna
the PPO Network Dental Plan. With this plan, you medical plans offered under the DoD NAF Health
may visit any licensed dentist and be reimbursed Benefits Program or with a NEXCOM-sponsored
for your qualified dental care expenses. For CONUS HMO plan.
associates, you can save when you use dentists You will find detailed information about each of these
who belong to Aetna’s dental network since plans at nafhealthplans.com.
those dentists provide their services at lower,
Aetna-negotiated rates. You can find participating
dentists at aetna.com > Find Care.
PPO Dental/International Dental Stand Alone Dental
Annual Deductible
• Individual $100 $100
• Family of 2 $200 $200
• Family of 3 or more $300 $300
Annual Maximum Benefit $2,500 $2,000
Preventive Care 100%, no deductible 100%, no deductible
Basic Care 80% (fillings, root canal, extractions) 80% (fillings, extractions)
Restorative/Major Care 50% (inlays, crowns, bridgework) 50% (root canal, inlays, crowns, bridgework)
Orthodontia Coverage 50%, no deductible; $2,000 lifetime maximum, 50%, no deductible; $1,500 lifetime maximum,*
includes TMJ appliances excludes TMJ appliances
Oral Surgery (dental in nature) 100% off first $1,000, then 80% thereafter Not covered
TMJ Coverage 50%, no deductible; $750 lifetime maximum Not covered
*12-month waiting period for members who enrolled on or after 1/1/2010
Medical and Dental Coverage
After Retirement
You and your dependents may be eligible to
continue medical only, or medical and dental
coverage after you retire. To continue both
medical and dental coverage, you must be
enrolled in the medical and dental plan on
the day before retirement and have 15 years
of accumulated participation in a DoD
NAF-sponsored medical and dental plan or
HMO, and be the recipient of an immediate
NAF Annuity (from The Retirement Plan).
Note: The Stand Alone Dental Plan does not
continue after retirement.
6
FLEXIBLE SPENDING ACCOUNTS
With a Flexible Spending Account (FSA), you can set • F
or eligible expenses that require substantiation,
money aside to pay yourself back for certain types of PayFlex, our FSA administrator, makes it easy
expenses. There are two types of FSAs: to substantiate these expenses and file claims.
• A
Health Care Flexible Spending Account (HFSA) Register and log in to payflex.com, then click
is used for eligible health care expenses. These the link for the Financial Center. Here you can
include medical, prescription drug, dental and vision file paperless claims and upload your receipts.
care expenses you pay out of your own pocket. Download the PayFlex Mobile® app from the site
and you can do it all with your smartphone or other
• A
Dependent Care Flexible Spending Account
mobile device. Enter your claim information, take a
(DFSA) is used for eligible dependent care
photo of the receipt and you’re done.
expenses. These include expenses for child
(up to age 13) or adult day care, preschool and • R
eal-time account balances, account alerts
after-school programs. and other information is also available online
at payflex.com. In addition, you can check your
Tax Advantages FSA balance and log in to PayFlex directly from
When you enroll in an FSA, you will set an annual aetna.com.
contribution amount for the coming year. This
Annual HFSA Carryover and
amount will be divided into equal amounts and
DFSA “Use It or Lose It” Rule
deducted from your biweekly pay before taxes
are withheld — reducing your taxable income and You may carry over up to $500 of unused HFSA
what you pay in taxes. contributions into the next plan year. This money will
be available for eligible health care expenses in addition
HFSA Basics to your regular contributions. Any amounts remaining in
Minimum Annual Contribution = $200
your HFSA exceeding $500 will be forfeited.
The $500 carryover rule does not apply to DFSA.
Maximum Annual Contribution = $2,650
However, there is a grace period provision that
Annual election amount is available the first day of the plan year. allows you to spend down unused DFSA dollars
DFSA Basics until March 15th of the following calendar year. After
that, DFSA monies remaining in your account will be
Minimum Annual Contribution = $200
forfeited. You have until April 30th to file your claims.
Maximum Annual Contribution = $5,000
Before you enroll, evaluate your health care and/
Contributions must be in your DFSA before you can be or dependent care expenses for the coming year.
reimbursed for your eligible expenses.
Find Full Details on FSAs Online
HFSA Features
Visit the DoD NAF Benefits website at
If you enrolled in an HFSA, you will receive a debit nafhealthplans.com or PayFlex at
card “loaded” with the full amount you have elected payflex.com to learn more about FSAs.
to contribute to your FSA account during the current
You can also manage your FSA on the go with the
plan year. This debit card has the following features
PayFlex Mobile app. Use this free app to access your
and benefits:
account, check on your claims, view transaction
• Works
just like a credit card for authorized details and more. Look for it in your app store and
expenses download it for access from almost anywhere.
• S
ome expenses paid with the debit card will require
substantiation (i.e., send receipt/Explanation of
Benefits to PayFlex®) to verify that the purchase/
If you want to participate in one or both FSA(s) for
service was for an authorized HFSA expense.
2019, you must take action during Open Enrollment
• N
o substantiation needed for medical plan copays, (November 1 - 30, 2018). Current FSA elections do
or Rxs purchased at an IIAS-certified merchant. not automatically renew year to year. Contact your
A complete list of IIAS-certified merchants can be local HR representative to enroll or re-enroll.
viewed at payflex.com.
7
HEALTH PLAN ONLINE RESOURCES
KEY PROVISIONS
Aetna Navigator at aetna.com Maximum Allowable Amount
Aetna Navigator is your member website where Not all in-network health facilities charge the same
you can take care of benefits-related tasks, locate amount for the same procedure. This is especially
in-network providers, view your Explanation of important since your DoD NAF Health Plan sets a
Benefits (EOB), look up costs of procedures and maximum allowable amount it will pay toward the
prescription costs and much more. To use Aetna facility cost for common outpatient procedures such
Navigator, log in or register at aetna.com and click as MRIs and colonoscopies. You will have to pay for
“Login.” charges above that amount. But don’t worry. You
For health on the go, download the free Aetna can shop around ahead of time so you can plan for
mobile app to be able to access the best features your share, if any, of the cost. Fortunately, these
of Aetna Navigator from your mobile device. To procedures show little to no variation in quality
download the app, text Apps to 23862 or visit regardless of where the procedure is performed.
aetna.com/mobile. Contact Aetna Member Services at 1-800-367-6276 for
more information before you schedule your procedure.
Find network providers online To see a list of outpatient procedures and their
To locate doctors, hospitals, specialists, dentists maximum allowable amounts, log in to aetna.com >
and pharmacies who participate in Aetna’s network, See Coverage & Costs > Financial Overview > Medical
use Aetna’s online provider directory. Log in to balances & limits. Then, scroll to the bottom to see the
aetna.com > Find Care. page for the Maximum Allowable Amount chart.
Know your options for immediate care
When an unexpected health issue comes up, there may not be time to make an appointment with your
primary care physician (PCP). Get to know your other options for care, so you can save time and money.
The Emergency Room (ER) is your most expensive option and should only be used in true emergencies.
Teladoc* Walk-In Clinic Urgent Care Center ER
$10 copay $30 copay $30 copay $350 copay
($45 for dermatology and (for non-emergencies)
behavioral health)
• Allergies • Colds and flu • Allergies • Chest pain or severe pain
• Bronchitis • Ear infections • Burns and rashes • Difficulty breathing
• Colds and flu • Minor insect bites • Cough • Major trauma
• Ear infections • Routine allergies • Cuts and minor lacerations • Severe abdominal pain
• Respiratory infections • Sprains • Fractures • Uncontrollable bleeding
• Skin problems and more • Strep throat and more • Sports injuries and more • Other symptoms that may
put your life at risk
*Teladoc may not be available in all states and overseas.
Not sure where to go? Call Aetna’s 24-Hour Nurse Line at 1-800-556-1555.
8DISABILITY BENEFITS
If you are a regular full-time associate, you are eligible Long-Term Disability (LTD)
for disability benefits to help replace lost income when
You are eligible to enroll in LTD within 31 days of your
you are not able to work because of a disabling illness
employment or attainment of regular full-time status.
or injury. There are two types of disability
If you enroll within this 31-day period, you don’t need
insurance available to you:
to provide medical evidence to join the plan. You must
be actively at work on the effective date of coverage
Short-Term Disability (STD)
or be in an approved leave status for reasons
STD is provided at no cost immediately upon your other than disability to be eligible for LTD benefits.
employment or attainment of regular full-time Otherwise, coverage begins on the first day you return
employment status. STD benefits start two months to work. You pay for LTD insurance according to your
after you become disabled or once you have used biweekly earnings.
up sick leave, whichever happens later. To receive
LTD pays benefits when your disability lasts longer
benefits, you must be unable to perform the duties
than the period covered by STD. After 24 months
of your occupation. STD benefits are integrated with
of combined STD and LTD benefits, you must be
your sick leave benefit. If you have four months or
unable to perform the duties of any occupation
more sick leave in your account, no separate STD
you are qualified for through training, education or
benefits will be paid.
experience, in order to continue receiving benefits.
The chart below shows how benefits are paid: Your benefits are reduced by any Social Security
Benefit Waiting Period Two months or exhaustion of sick
benefits and NEXCOM Retirement Plan benefits*
leave, whichever is later you may be receiving.
Benefit Amount 60% of basic weekly earnings The chart below shows how benefits are paid:
Benefit Duration Four months Benefits Begin Seventh month of disability
Cost $0 Benefit Amount 60% of basic monthly earnings
Benefit Duration Up to age 65 if disabled prior to age 62.
If disabled after age 62, benefits are paid
for a reduced period of time.
Cost $0.209 per $100 of biweekly earnings
(e.g., $1,000 biweekly: 10 x $0.209 =
$2.09 per pay period)
*Applies only to associates age 62 or older. If 62 or younger,
you must make a decision to keep LTD benefits or retire.
9LIFE INSURANCE BENEFITS
Three Life Insurance plans are available to help you Optional Group Life and Accidental Death
protect your family’s financial security. & Dismemberment Insurance (OGL)
For full-time and part-time associates
Basic Group Life and Accidental Death &
Dismemberment Insurance (BGL) OGL insurance pays a benefit based on your annual
earnings. You have 31 days from your date of hire or
For full-time associates only
the day you become eligible to join OGL without
BGL insurance pays a benefit based on your annual providing medical evidence of good health.
earnings. You have 31 days from your date of hire
Note: Regular full-time associates must enroll in BGL
or the day you become eligible to join BGL without
to enroll in OGL.
providing medical evidence of good health.
You may elect OGL coverage equal to 1, 2 or 3 times
Your BGL benefit is equal to one times your basic
your basic annual earnings rounded to the next higher
annual earnings rounded to the next $1,000 plus
$1,000. The cost of coverage is based on your age
$2,000. Here’s an example of how the cost for
and increases in five-year increments as shown below:
coverage is determined:
If basic annual earnings are $25,500: Cost per $1,000 Coverage
BGL benefit = $26,000 + $2,000 = $28,000
under age 25 $0.032
Cost $0.05 per $1,000 of coverage
25 – 29 $0.037
$0.05 x $28 (per thousand) = $1.40 per pay period
30 – 34 $0.046
Biennial Enrollment Period Life Insurance 35 – 39 $0.051
Coverage 40 – 44 $0.072
If you do not enroll in Life Insurance plans when 45 – 49 $0.106
you first become eligible, you may apply during any
50 – 54 $0.157
Biennial Enrollment period. The Biennial Enrollment
period is held in November every two years (always 55 – 59 $0.268
an odd-numbered year). The next Biennial Enrollment 60 – 64 $0.360
is November 2019. Enrollment during this period
requires medical evidence of good health, and is 65 – 69 $0.595
subject to approval by the insurance carrier. 70+ $0.960
Example
John is 40 years old and his basic Rounded up to the next
annual earnings = $25,500. thousand = $26,000.
He elected OGL 2 x earnings
$26 (per thousand) x $0.072 x 2 (2 times his benefit)
= $3.744 per pay period
10LIFE INSURANCE BENEFITS
Dependent Life Insurance At Retirement
For full-time associates enrolled in BGL If you are enrolled in BGL or OGL insurance at
Dependent Life Insurance lets you cover your spouse retirement and have participated for 15 or more years,
and unmarried dependent children up to the age coverage will be continued at no cost when you retire.
of 26. There are three benefit options, and the cost After retirement, your BGL coverage will be reduced
is based on your age. You have 31 days from your by 25% at ages 66, 67 and 68. Your OGL coverage
date of hire, the day you become eligible to elect will be reduced to 25% of your pre-retirement benefit
Dependent Life Insurance or the day you acquire upon your retirement. You may not carry Dependent
dependents without providing medical evidence — Life Insurance into retirement. You have the
whichever comes later. opportunity to convert to an individual policy.
You have three coverage options, as shown below: About Beneficiary Designation
Spouse Children Children When you enroll in BGL or OGL insurance, you
under 1 between must choose a beneficiary. This is the person to
1 and 26*
whom benefits are paid in the event of your death.
Option 1 $5,000 $1,000 $2,500 Remember, it is your responsibility to update
Option 2 $10,000 $2,500 $5,000 your beneficiary choices taking into consideration
Option 3 $20,000 $2,500 $5,000 certain life events, such as marriage, divorce, birth
or adoption of children, or the death of a named
*Dependent children are covered up to age 26. You must ensure beneficiary.
your dependents are removed from coverage when they are no
longer eligible. Beneficiary designation is also required for the
Pension Plan and 401(k) Plan, described on page 13.
Your biweekly cost is based on your coverage option
and your age:
Cost Option 1 Option 2 Option 3
Under age 35 $0.28 $0.56 $0.78
35 – 39 $0.34 $0.68 $1.02
40 – 44 $0.46 $0.92 $1.50
45 – 49 $0.58 $1.16 $1.98
50 – 54 $0.74 $1.48 $2.62
55 – 59 $1.22 $2.44 $4.54
60 – 64 $1.68 $3.36 $6.38
65 – 69 $1.83 $3.66 $6.98
70+ $4.27 $8.54 $16.74
Example
Option 2 x age 40 = $0.92 per pay period
Important! Associates must remove dependents
who are no longer eligible. Associates have the
opportunity to convert their Dependent Life
Insurance coverage to an individual policy at
the time of termination.
11LONG TERM CARE INSURANCE AND
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Long Term Care Resource Center Employee Assistance Program
NEXCOM’s Long Term Care Resource Center is NEXCOM offers a comprehensive Employee
available to all NEXCOM associates, spouses and Assistance Program (EAP) to all associates, spouses,
extended family members. The NEXCOM LTC and household members. The program is provided
Resource Center, offered by ACSIA Partners, through Magellan Health Services, a leading EAP
is available to help you with your group long services provider.
term care policy questions, offer rate increase The EAP provides confidential counseling and referral
information, give direction on claims submissions, services to assist associates in coping with personal,
provide free caregiving resources and more. Go to emotional, family and financial issues. The program
nexcomltccenter.com or call LTC Resource Center is offered at no cost to NEXCOM associates and
at 1-877-736-5086, Monday – Friday, 8:30 a.m. to dependents. Through the EAP, NEXCOM associates
5:30 p.m. EST. and their household members may receive up to
three counseling sessions “per incident” at no charge.
CNA Insurance LTC Policy Holders Assistance is provided for the following:
Under the CNA Insurance contract, your coverage
• Grief or bereavement
cannot be cancelled provided premiums are paid.
However, the carrier can file for premium increases. • Marital and family problems
CNA Insurance has applied for premium increases • Emotional issues
in all 50 states due to poor economic marketplace • Coping with change and burnout
conditions. Increases were approved in some states
and are pending in others. Take advantage of the • Substance abuse
Long Term Care Resource Center to learn about • L
imited legal and financial counseling services are
your options. also available.
EAP services are confidential and counseling is
Federal Long Term Care Insurance provided by professional, licensed clinicians. Services
Program (FLTCIP) are available 24/7/365, by telephone, Internet or
New coverage can be obtained by applying through face-to-face.
the Federal Long Term Care Program. Approval
CONUS and Hawaii Associates
for this coverage is based on age and medical
underwriting at the time of application and is not To schedule an EAP consultation or to get
a guarantee of approval. This plan is subject to more information on the services available call
premium increases. You can apply for coverage 1-800-424-5988 or go to magellanassist.com/
at ltcfeds.com or by calling 1-800-LTC-FEDS nexcom. At the login screen click on “New/
(1-800-582-3337) TTY 1-800-843-3557. unregistered user” and enter the phone number
1-800-424-5988.
Associates in Guam and Foreign Countries
To receive EAP services, visit magellanhealth.com/global.
Enter “nexcom” (case sensitive) for the Company Code,
then choose your language and click “Login.” See the
links above under “Overseas EAP Info” for toll-free and
reverse-charge calling information.
12RETIREMENT PLANS
The NEXCOM Retirement Plan (Pension) Example
Newly hired regular full-time and part-time associates Savings and employer match
are automatically enrolled in the Retirement Pension Plan.
Your biweekly earnings $1,000
After reaching your first anniversary, you will receive
one year of credited service. If you are not currently Your contributions of 6% $60
participating and are a regular full-time or part-time
associate and have one or more years of cumulative Employer contribution of 3% $30
regular service (including breaks in service), you may Total biweekly contribution $90
enroll at any time and receive credited service for your
time in the plan. The cost of the plan is 1% of your biweekly A beneficiary designation is required for the Pension
pensionable earnings. To learn more, go to the NEXCOM Plan and 401(k) plan. See page 11 for details.
HUB > Benefits > Retirement > Retirement/Pension Plan
and click on NEXCOM Retirement Plan Booklet. End of Life Planning Services
You will be vested in NEXCOM’s contributions to the If you participate in NEXCOM’s Life Insurance Plans
plan (you own them) after five years of regular service. (Basic or Optional), you have access to a full suite of
You can start receiving full benefits at age 62 (or 52, end of life planning services, at no cost, including:
in a reduced amount), if you meet the years-of-service • W
ill Preparation: wills for you and your spouse,
requirements. If you retire with an immediate annuity, Power-of-Attorney and medical directives
benefits may be increased by cost-of-living adjustments. • E
state Resolution Services: services provided to
Survivor benefits are also available. the executor of your estate to assist with settling
Calculate a retirement plan estimate at the NEXCOM your estate including: consultations to discuss
HUB > Code H > Retirement > Pension Plan Calculator probating your estate; preparation of documents
(Normal Retirement). Give it a whirl! and representation at probate-related court
hearings; correspondence necessary to transfer
The NEXCOM 401(k) Plan nonprobate assets to heirs; and related tax filings.
You are eligible to participate in the 401(k) plan at For Will Preparation and Estate Resolution Services,
the time you are hired or attain regular full or part- contact Hyatt Legal Services at 1-800-821-6400, Monday
time employment status. You may enroll anytime. – Friday 8 a.m. to 7 p.m. Provide the client representative
You can make pretax contributions of up to 90% of with NEXCOM’s Group Number — 109800.
your compensation, subject to IRS limits. When you
• D
igital Storage: MetLife Infinity is a resource
contribute to the plan, your federal, state and Social
that can help you create a digital legacy for
Security taxes are lower.
beneficiaries, estate administrators and others.
For every 1% you contribute up to 6%, NEXCOM matches Capture and securely store photos, videos, audio
half of your contributions. You are 100% vested in files and important documents as a collection in
NEXCOM’s match after you’ve been in the plan for three one online location. You can access MetLife Infinity
years. To grow your retirement savings, you have a at metlifeinfinity.com. It is also available as a
choice of 26 investment funds and a brokerage account. mobile app.
There are three ways to join: • F
uneral Planning Guide: This will allow you to
1. EZ Join Form — paper enrollment document your funeral preferences and provide
2. Quick Join — go online at prudential.com/QuickJoin other key information for your survivors. You can
3. Traditional Method — select your own funds. find this guide on the NEXCOM HUB under the
Code H > End of Life Planning Services Program.
If you enroll using EZ Join form or Quick Join, your
contributions will be invested in your age-appropriate
Day One Fund.
Experts say you will need 70% to 80% of your
current annual income to maintain your current
Visit prudential.com/NEXCOM to learn more standard of living in retirement. Social Security
about your 401(k), access planning tools and only provides 40% of what you will need. Start
log in to your personal Prudential account. building your retirement nest egg now.
13CONTACTS AND RESOURCES
The chart below shows telephone numbers and websites for the companies and organizations that
administer your benefits on behalf of NEXCOM.
Benefit Plan Insurance Carrier/ Point of Contact Internet Address/ NEXWEB
Code H Intranet Location
Medical/Dental (CONUS) Aetna Member Services aetna.com and
1-800-367-6276 nafhealthplans.com
Aetna International Member Services aetnainternational.com
1-888-506-2278 (outside the USA, via AT&T +
access code)
Teladoc teladoc.com/aetna
1-800-835-2362
24-Hour Nurse Line
1-800-556-1555
Medical Plan HMOs Optima Health Plan optimahealth.com
1-757-552-7325
1-800-394-2237, weekends and holidays
Kaiser Washington Options kp.org/wa
1-888-901-4636
Kaiser Hawaii kaiserpermanente.org
1-808-432-5955
HMSA Hawaii hmsa.com
1-800-776-4672
Kaiser California kaiserpermanente.org
1-800-464-4000
Kaiser Mid-Atlantic kaiserpermanente.org
1-800-777-7902
Take Care Asia takecareasia.com
1-877-484-2411
Stand Alone Dental Aetna Member Services nafhealthplans.com
1-800-367-6276
Flexible Savings Account Aetna FSA Member Services payflex.com
(HFSA/DFSA) 1-800-416-7053 nafhealthplans.com
Short and Long Term Disability MetLife Customer Service Code H > Benefits > Disability Insurance
1-800-275-4638
Group Insurance Examiner
1-757-440-4756
Long Term Care (CNA) 1-800-262-4580 (non-claim)
Closed to new enrollments 1-866-308-0278 (claims)
1-877-736-5086 (Resource Center) nexcomltccenter.com
Federal Long Term Care 1-800-LTC-FEDS (1-800-582-3337) ltcfeds.com
Insurance Program (FLTCIP) TTY 1-800-843-3557
Life Insurance Plans Code H > Benefits > Life Insurance
• Basic Group MetLife
• Optional Group 1-800-638-6420
• Dependent Group
NEXCOM Group Health Ms. Rosie Serrano Roseann.Serrano@nexweb.org
and Life Insurance Plans Group Insurance Manager, NEXCOM Code H > Benefits > Life Insurance
1-757-440-4752
Pension Ms. Mary Holmes Mary.L.Holmes@nexweb.org
Retirement Plan & 401(k) Manager, NEXCOM Code H > Benefits > Retirement
1-757-440-4718
401(k) Prudential Retirement prudential.com/NEXCOM
1-877-778-2100
Will Preparation & Estate Hyatt Legal Services
Resolution Services 1-800-821-6400
NEXCOM Group #109800
Employee Assistance Program Magellan Health magellanhealth.com/member
(EAP) 1-800-424-5988
This brochure highlights the key features of the NEXCOM Benefits Program, including the DoD NAF Health Benefits Program. It
does not attempt to cover all plan details, which are contained in the official Plan Documents and insurance contracts that govern
the various plans within the program. Please reference the Summary Plan Description (SPD), available for each plan, for a complete
description of benefits, exclusions, limitations and conditions of coverage. Should there be any conflict in this brochure and the
provisions of the legal documents and contracts, the terms of those documents and contracts will control.
CCG DODNEXCOM-0021 (10/18) ©2018 Aetna Inc.You can also read
