2020-2021 BENEFIT GUIDE - Team Member & Shift - Border Foods Benefits
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2020-2021 BENEFIT GUIDE
Team Member & Shift
WELCOME Welcome to Border Foods! We at Border Foods know that our employees are our biggest asset so it is our goal to offer a complete benefits package that can properly meet your needs. The following pages will introduce you to Border Foods employee benefits, eligibility requirements, costs of coverage and how to enroll. We encourage you to read this guide in its entirety so you can make the choices that are right for you and your family. CONTENTS ELIGIBILITY/ENROLLMENT . . . . . . . . . . . . . . . . . . . . . . . . . . 1 MEDICAL COVERAGE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 MEDICAL BENEFITS AT-A-GLANCE. . . . . . . . . . . . . . . . . . . . 3 HEALTH SAVINGS ACCOUNT (HSA) . . . . . . . . . . . . . . . . . . . 5 FLEXIBLE SPENDING ACCOUNTS (FSA). . . . . . . . . . . . . . . . 6 DENTAL COVERAGE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 VISION COVERAGE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ACCIDENT COVERAGE. . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 LIFE AND DISABILITY INSURANCE. . . . . . . . . . . . . . . . . . . 11 CRITICAL ILLNESS INSURANCE. . . . . . . . . . . . . . . . . . . . . . 12 ADDITIONAL BENEFITS. . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 DEFINITIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 GETTING STARTED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 CONTACT INFORMATION. . . . . . . . . . . . . . . . . . . . . . . . . . 19 IMPORTANT NOTICES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
ELIGIBILITY / ENROLLMENT
As a Border Foods Team Member/Shift employee, you are eligible for benefits on the first of the month following 12
months of employment if during your first 11 months your average hours worked per week is 30+.
You continued eligibility will be determined annually based on the same criteria.
Dependents
When you enroll in the Benefits Program, you may also cover your eligible dependents for medical, accident, dental,
vision and life insurance.
Eligible dependents include your:
n Legal spouse (unmarried individuals and/or domestic partners are not eligible)
n Dependent Child(ren)
n Medical, Dental and Vision coverage up to age 26 regardless of student status
n Other benefits up to age 19 or 26 (if a full-time student)
Changing Your Benefits During the Year
Your benefit elections remain in effect for the entire plan year (April 1 – March 31), unless you have an IRS qualified life
event (proof will be required). All changes as a result of a qualified life event must be made within 30 days of the event.
Eligible qualified life events include the following:
n Legal marital status – any event that changes your legal marital status, including marriage, death of spouse,
divorce, legal separation, or annulment.
n Number of dependents – any event that changes the number of your dependents, including birth, adoption,
placement for adoption, divorce or death of a dependent, or assuming primary support of the child of an unmarried
dependent child.
n Employment status – any event in which an eligible dependent gains or loses access to employer-sponsored
coverage.
n Dependent status* – any event, due to age or similar circumstances, which causes your dependent to satisfy or
cease to satisfy eligibility requirements under the plan which you receive coverage.
n Medicare or Medicaid eligible status – you or your spouse become Medicare or Medicaid eligible.
*If at any time during the year your enrolled dependents no longer meet eligibility requirements, you must notify the Human
Resources Department to remove the individual from coverage.
Accessing the benefits portal is simple!
Simply go to: www.borderfoods.bswift.com
Username: first initial of first name + full last name + month and day of birth
(i.e. John Brown, born on January 26th,1984 would be “JBrown0126”)
Password: last four digits of your SSN
Please Note: On your initial log in you will be required to change your password for security purposes
ENROLLMENT REMINDERS
You must:
n Register prior to your effective date upon notification of eligibility.
n www.borderfoods.bswift.com
n Enroll during the enrollment period or you will not have coverage until the next Open Enrollment time period,
unless you have a Qualifying Life Event.
1
MEDICAL COVERAGE - MEDICA
High quality, affordable health care is a high priority for most people. That is why Border Foods
is pleased to continue to offer you and your family two PPO plans – the Basic Plan and the
Premium Plan through Medica.
Basic Plan – Health Savings Account (HSA) Eligible
The Basic plan has the lowest cost to you per pay period and the highest deductible. You must
pay all expenses for services except as noted in the Medical Benefits At-A-Glance Chart (see
page 4) until you meet the deductible. Once the deductible is met you will pay coinsurance for
services in the amounts noted on the chart. If you choose the Basic Plan, you can open an HSA
account, fund it with pre-tax contributions throughout the year and use that money to pay for
qualified healthcare expenses. See page 5 for more details on the Health Savings Account.
Premium Plan – Flexible Spending Account (FSA) Eligible
The Premium plan offers a lower deductible but has a higher per pay period cost. If you choose
this plan you are not eligible to open an HSA but you can open a Health Care Flexible Spending
Account (FSA) to help you with meeting your deductible. You can make pre-tax contributions
to this account to be set aside to pay for medical expenses including deductible, coinsurance,
co-pays and IRS 213(d) expenses. See page 8 for more details on the Health Care FSA.
Bi-Weekly Medical Plan Cost Comparison
Coverage Basic Plan - HSA Eligible Premium Plan - FSA Eligible
Non-Tobacco Tobacco Non-Tobacco Tobacco
Employee Only (MN) $61.11 $113.35 $113.36 $163.09
Employee Only (IA, IL,
$46.85 $97.31 $113.36 $163.09
MI, SD, WI & WY)
Employee + 1
$113.36 $215.93 $221.31 $327.65
Family $140.35 $269.90 $278.53 $415.64
*You will be subject to a $45.00 per pay period surcharge if your spouse has coverage available through another
employer and you choose to enroll him/her in the Border Foods Plan. Documentation may be required if your spouse is
not eligible for coverage elsewhere.
Please note: Employee Only rates differ by state due to state specific regulations that Border
Foods adheres to.
Network of Providers
Both plans offer considerable advantages when you use network providers. Besides the financial
benefit of pre-negotiated rates, the network also provides reassurance about the level of care
available. In addition, using the services of network providers eliminates the hassle of filing claim
forms, since the providers take care of this. To find out if a certain doctor or hospital is a network
provider, visit www.medica.com and click “Find Physician or Facility” then select “Medica
Choice Passport with UnitedHealthcare Choice Plus” or call 1-800-952-3455.
2
MEDICAL BENEFITS AT-A-GLANCE
Coverage Basic Plan – HSA Eligible Premium Plan – FSA Eligible
Network Out-of-Network Network Out-of-Network
Deductible
n Employee Only $3,500 $7,000 $1,250 $2,500
n Family $7,000 $9,000 $2,500 $5,000
Out-of-Pocket Limit
n Employee Only $6,350 $12,700 $6,350 $12,700
n Family $12,700 $25,700 $12,700 $25,700
Routine Care
n Preventive Care
No charge 50% after deductible No charge 40% after deductible
n Screening
n Immunization
Primary Care/
Specialist Visit
n Illness or injury
20% after deductible 50% after deductible $30 co-pay 40% after deductible
n Physical, speech,
occupational therapy
n Chiropractic Care**
Convenience Care
n Retail Health Clinics 20% after deductible 50% after deductible $10 co-pay 40% after deductible
n Virtual Care
Emergency Care
n Urgent Care 20% after deductible 20% after deductible $50 co-pay $50 co-pay
n Emergency Room 20% after deductible 20% after deductible 20% after deductible 20% after deductible
Hospital and
Outpatient Care
20% after deductible 50% after deductible 20% after deductible 40% after deductible
n Facility Fee
n Physician/Service Fees
Maternity Care
n Prenatal No Charge 50% after deductible No Charge 40% after deductible
n Postnatal 20% after deductible 50% after deductible No Charge 40% after deductible
n Delivery/Inpatient 20% after deductible 50% after deductible 20% after deductible 40% after deductible
Mental/Behavioral
Health Care
n Outpatient 20% after deductible 50% after deductible $30 co-pay 40% after deductible
n Inpatient 20% after deductible 50% after deductible 20% after deductible 40% after deductible
Substance Abuse Care
n Outpatient 20% after deductible 50% after deductible $30 co-pay 40% after deductible
n Inpatient 20% after deductible 50% after deductible 20% after deductible 40% after deductible
Prescription
Co-pay/Coinsurance
n Tier 1 $15 co-pay after deductible* 50% or $50 co-pay $15 co-pay Greater of 40%
n Tier 2 $25 co-pay after deductible* after deductible $25 co-pay coinsurance or $50
n Tier 3 $50 co-pay after deductible $50 co-pay co-pay after deductible
n Specialty Tier 1&2 20% coinsurance Not covered 20% coinsurance Not covered
after deductible
*No charge for preventive drugs listed on the approved list. Access the HSA Preventive Drug List at medica.com by typing “HSA Preventive Drug
List” into the Search bar then select “Member: HSA Preferred Drug List for Exchange Members”. Preventive drugs are covered at 100% until you
reach the deductible, then standard co-pay amounts will apply.
**Chiropractic visits are limited to a 15 visit annual max per member for out-of-network chiropractic care. 3
MEDICAL COVERAGE - MEDICA
Prescription Drug Benefits
If you choose to elect medical coverage, you will receive prescription drug coverage through
Medica’s pharmacy program. You can get prescription drugs filled through a network of retail
pharmacies. Find out more about your pharmacy and prescription options. Go to mymedica.com,
click on pharmacy information and select Medica Choice Passport. From there you can estimate
drug costs and view preferred drug lists.
In an effort to help keep health care costs as low as possible, while still providing continued
access to safe, affordable and effective prescription medication, effective January 1, 2020, Medica
utilizes Express Scripts, Inc. as its pharmacy benefit manager.
Medications considered “specialty” drugs must be filled through an approved specialty
pharmacy or there will be no coverage. Medica partners with Accredo to provide specialty
pharmacy services. The Accredo clinical team offers one-on-one counseling and assistance as
well as opportunities to engage through web, mobile, text, chat and email to make refilling
medications as easy as possible. Specialty medications are conveniently delivered to members
via FedEx or UPS. You can contact Accredo by phone at 1-877-ACCREDO (222-7336) or access
their website: www.accredo.com.
Manage Your Health Online:
Once you are enrolled in the medical plan, you can create an account at mymedica.com which
will provide you access to:
n Look up your benefits information
n See your claims and explanations of benefits (EOBs)
n Search for doctors in your network
n Sign up to get your health plan documents delivered online
Virtuwell
This virtual clinic can diagnose and treat over 40 common conditions, such as pink eye, ear infection
and sinus infections, 24 hours a day, 7 days a week. Each visit is $49 or less*, depending on which
medical plan you have. If they can’t treat you, you don’t pay! Prescriptions, if needed, can be sent
to the pharmacy of your choice. Visit virtuwell.com or amwell.com whenever you need care.
* Virtual care providers must be in your plan’s network. Search for providers in your plan’s network at medica.com/members
or call the number on the back of your Medica ID card. Amwell is available in every state. Not available in SD, WY, or IL.
My Health RewardsSM by Medica
Earn rewards for your healthy behaviors. My Health Rewards by Medica offers you the
opportunity to earn up to $100 in gift cards to your favorite stores, restaurants and entertainment
venues just by completing their web activities. Every 100 points earns a $20 gift card. The new
Invest program is now available to employees enrolled in HSA. This innovative platform allows
employees who meet monthly wellness goals related to sleep, nutrition, and activity to earn up to
$75 per month (up to $900 per calendar year). Log in to mymedica.com and select the “Health
and Wellness” tab to get started.
Fit ChoicesSM - Medica
Employees enrolled in the Medica Medical Plan are eligible to receive savings at participating
fitness facilities. Employees who work out 12 days or more in a calendar month will receive a $20
credit towards that month’s membership dues.
Visit www.medica.com/fitchoices for more information on the Fit Choices program and to find
out if your health club is a participating facility.
4
HEALTH SAVINGS ACCOUNT (HSA) - TASC
How the HSA works
You can open an HSA account and fund it with pre-tax contributions through bi-weekly
payroll deductions throughout the year. You can then withdraw the funds tax-free to reimburse
yourself for eligible expenses including deductibles, coinsurance and co-pays. After incurring a
qualified expense and submitting any required documentation, you will receive reimbursement
for this expense.
You must enroll in the High Deductible Health Plan (Basic Plan) to be eligible to participate in
the HSA. In addition, in order to be eligible to participate in an HSA, you can not:
n Be claimed as a dependent on someone else’s tax return
n Have a spouse with a Health FSA that could reimburse your medical expenses
n Be enrolled in a government health plan, such as Medicare or Medicaid
You do not need to use all of the money you contribute to the account in any given year.
Unused HSA funds will rollover from year to year so you can used it when you need it most.
If you change jobs you can take the money with you.
HSA Annual Contribution Limits:
Employee only coverage: $3,550
All other coverage levels: $7,100
Age 55+ catch up: $1,000
Employer Contributions NEW!
Effective April 1, 2020, Border will begin contributing to HSAs for those employees that choose
to actively participate and contribute to their HSA.
The annual employer contribution amounts are as follows:
Employee $340
Employee + 1 $560
Family $720
These amounts will be posted to employees accounts on a quarterly basis (1st of the months
of April, July, October and January). Please note: You will only be eligible for the quarterly
contribution if you are an active employee at the start of each quarter.
HSA TAX ADVANTAGES
n Employee contributions are tax-free
reducing your taxable income.
n Distributions of HSA funds are tax-free
when used to cover qualified health
care expenses.
n HSA balances grow tax free.
Learn more and manage your account
at tasconline.com
5
FLEXIBLE SPENDING ACCOUNTS (FSA)
HEADER TEXT
A Flexible Spending Account (FSA) is a voluntary account that allows you to use pre-tax
funds to pay for certain health care and dependent day care expenses as determined by IRS
regulations. You can set up two separate accounts- one for qualified health care expenses and
one for qualified dependent care expenses. The monies in one account cannot be used to
satisfy expenses in the other account. TASC is the claims administrator for both FSA programs.
You can not contribute to both a Health Care FSA and a HSA.
Your FSA Contributions
When you establish a Health Care and/or a Dependent Care FSA, you choose the annual
amount you wish to contribute, up to certain plan limits. This amount is deducted from your
paycheck in equal installments before Federal and Social Security taxes are withheld. If you
experience a qualified life event, you are eligible to change your FSA election during the year.
Health Care Flexible Spending Account
You may make a pre-tax contribution of up to $2,750 per year to your Health Care FSA. If you set
up a Health Care FSA, you can be reimbursed for eligible expenses that you or your dependents
incur after your effective date and during the plan year in which you participate. Examples of
eligible health care expenses*, to the extent not covered by another plan (through June 15th,
2021), include:
n Copayments and deductibles not covered by medical or dental insurance
n Uninsured expenses, such as hearing aids, eyeglass, contact lenses and certain eye surgeries
n Orthodontia
n Diabetic supplies
n Smoking cessation programs
n Fertility services
*For a complete list of eligible and ineligible Health and Dependent Care FSA expenses visit www.IRS.gov and review
Publications 213(d), 502, and 503. A list can be obtained from your local IRS office.
IMPORTANT REMINDER
Be sure to calculate your FSA election carefully, as any unused funds in your account
will be forfeited at the end of the plan year.
Please note: you may still submit eligible claims for reimbursement through the 2 1/2
month grace period (through June 15th, 2021) after the plan year ends.
6FLEXIBLETEXT
HEADER SPENDING ACCOUNTS (FSA) - TASC
Dependent Care Flexible Spending Account
In the Dependent Care FSA, you may contribute up to $5,000 per year, per family household,
on a pre-tax basis. This annual maximum applies to all contributions made by you and your
spouse to a dependent care account. Therefore, if you are married and filing separately for
federal income tax purposes, you may elect to contribute up to $2,500 per year.
Eligible dependents
You can be reimbursed for dependent care expenses if they are necessary to allow you or your
spouse to work. These services may be provided inside or outside your home by babysitters,
companions, or eligible day care centers. Services may not, however, be provided by someone
you claim as a dependent on your tax return.
Your day care expenses must be for:
n Your dependent under age 13 who lives with you for more than half the year and
for whom you can claim an exemption
n Your dependent under age 13 for whom you have custody if you are divorced or
legally separated
n Your spouse who is physically or mentally incapable of self-care
n Your dependent of any age, such as an elderly parent or other adult dependent,
who meets all of the following criteria:
n Is physically or mentally incapable of caring for himself or herself,
n Receives over half of his or her support from you,
n Lives with you for more than half the year, and
n Is your sibling, step-sibling or any of their descendants; a parent or step-parent
or any of their ancestors; an aunt, uncle, niece or nephew; children or parents-in-law;
or an unrelated individual who shares your residence as a member of the household.
7DENTAL
HEADER COVERAGE
TEXT – DELTA DENTAL
Dental Coverage is an often overlooked but important health benefit. Routine dental care can improve your oral health
and your overall health and well-being. Delta Dental of Minnesota offers two great networks, Delta Dental PPO and
Delta Dental Premier, that work together to provide the greatest access to providers and help control your costs.
Four out of five dentists nationally are Delta Dental Network dentists. You can choose to see a dentist outside of
the network but your expenses may be higher and you may be responsible for submitting your own claim. To find a
participating dentist, simply visit www.deltadentalmn.org and use the interactive Find a Dentist tool or call Customer
Service toll free at 800-448-3815.
Summary of Dental Coverage
Delta Dental PPO Delta Dental Premier Non-Participating
Deductible
Per person/per family (calendar year)
$50/$150 $50/$150 $75/$225
No deductible for diagnostic and
preventive services or orthodontics
Calendar Year Plan Per person $1,500 $1,500 $1,000
Lifetime Ortho Maximum Per covered person $1,500 $1,500 $1,200
What the Plan Pays*
Service & Description Delta Dental PPO Delta Dental Premier Non-Participating
Diagnostic & Preventive Services
90% of maximum
n Exams & cleanings n Routine x-rays 100% 100%
allowable fee**
n Fluoride treatments n Sealants
Basic Services
70% of maximum
n Fillings n Oral Surgery, Extractions 80% 80%
allowable fee**
n Periodontics
Endodontics
70% of maximum
n Pulpotomies on primary teeth 80% 80%
allowable fee**
n Root canal therapy on permanent teeth
Major Restorative
40% of maximum
n Crowns and crown repair 50% 50%
allowable fee**
n Bridges n Dentures
Orthodontics
40% of maximum
Coverage available for dependent children 50% 50%
allowable fee**
only, age 8 - 18
*This is a summary of benefits only and does not guarantee coverage. For a complete list of covered services, limitations, exclusions, and benefit
frequencies, please refer to the Dental Benefit Plan Summary.
**Dentists who have signed a participating network agreement with Delta Dental have agreed to accept the maximum allowable amount as payment
in full. Non-participating dentists have not signed an agreement and are not obligated to limit the amount they charge; the member is responsible
for paying any difference to the non-participating dentists.
Coverage Bi-Weekly Cost
Employee Only $14.89
Employee + One Dependent $28.72
Family $45.60
8HEADERCOVERAGE
VISION TEXT - EYEMED
Your eyesight is an integral part of your overall health and key component of safety. Your vision benefits are
provided through EyeMed and covers eye exams, eyeglasses, and contact lenses. Services are provided through
the extensive EyeMed Vision Care network of optometrists, ophthalmologists, and other eye care professionals.
Receiving benefits from a network provider is as easy as making an appointment with the provider of your choice
from the list of EyeMed Vision Care providers. The provider will coordinate all necessary authorizations from
EyeMed Vision Care once you supply your membership information. To find a list of Advantage network providers,
contact EyeMed Vision Care at 1-888-203-7437 or www.eyemed.com.
You may also choose to use providers outside the network, but you’ll pay more for rendered services. You will
be responsible for paying the entire service fee and then requesting reimbursement of the scheduled allowance
(shown in the chart below) from EyeMed Vision Care.
What the Plan Pays
Coverage In-Network Out-of-Network
Well Vision Exam
$10 Co-pay Plan pays up to $35
(once every 12 months)
Frames $140 allowance:
Plan pays up to $56
(once every 24 months) 20% off retail price over $140
Standard Plastic Lenses
(once every 12 months) Plan pays up to:
n Single Vision $10 Co-pay $25
n Bifocal $10 Co-pay $40
n Trifocal $10 Co-pay $60
n Standard Progressive Lens $10 Co-pay $85
n Premium Progressive Lens $10, % of charge less $110 allowance $85
Contact Lenses
n Medically Necessary $0 Co-Pay: Paid in full Plan pays up to $200
n Conventional $155 allowance: 15% off retail price over $155 Plan pays up to $109
n Disposable $155 allowance; balance over $155 Plan pays up to $109
Contact Lens Fit and
Follow-Up
n Standard Up to $40 N/A
n Premium 10% off Retail N/A
Laser Vision Correction 15% off retail price OR 5% off promotional price N/A
Coverage Bi-Weekly Cost
Employee Only $4.00
Employee + One Dependent $7.58
Family $11.13
9ACCIDENT COVERAGE - UNUM
HEADER TEXT
Accident Insurance can help your family cover unexpected out-of-pocket expenses and
supplement lost income due to a covered off-job accident. Accident Insurance covers a wide
range of injuries and accident-related expenses such as hospitalization, emergency room visits,
physical, occupational and speech therapy, accidental death and catastrophic accidents.
Sample Coverage and Benefits
Treatment, Services, and Covered Injuries Coverage Amounts
Initial Hospital Confinement (pays once/year) $1,000
Daily Hospital Confinement (pays daily) $200
Intensive Care (pays daily) $1,500
Dislocations Up to $6,000
Emergency Room Services $150
Physical/Occupational/Speech Therapy (pays daily) $25
The money is paid directly to you and you decide how to spend it. You can also purchase
coverage for your spouse and dependent children.
Coverage Bi-Weekly Cost
Employee Only $5.34
Employee and Spouse $8.64
Employee and Child(ren) $9.97
Family $13.27
Please see the specific plan document or plan summary on bswift while enrolling for specific
coverage and benefits.
TOP 5 ACCIDENT RELATED CLAIMS
(BY OCCURRENCE)
n Follow-up Care
n Emergency Room Treatment
n Physician Office Visit
n Fracture
n Hospitalization
10HEADER
LIFE ANDTEXT
DISABILITY INSURANCE - UNUM
An illness or injury that keeps you out of work for a long period of time can be financially
devastating for you and your family. Our Short-Term disability plan is designed to help protect
your financial security by providing replacement income if you are ever disabled due to a
non-work related injury or illness, including pregnancy. When you are disabled, your medical
insurance generally covers most of your medical expenses, including doctor visits, physical
therapy and prescription drugs. Disability benefits can help cover your day-to-day living
expenses. This program is insured through Unum.
Voluntary Short-Term Disability (STD)
This voluntary benefit provides bi-weekly income benefits to covered employees. You are
eligible to elect a benefit up to 60% of your monthly earnings subject to a $400 minimum and
$5,000 maximum. In the event that you become disabled, the maximum period of payment is
three months.
Voluntary Whole Life Insurance - Unum
Whole life insurance provides consistent coverage with premiums and benefits that won’t
change as you grow older. The policy can build cash value over time — which you can
apply toward a paid-in-full life policy or even borrow against later. It is offered to all eligible
associates, ages 15–80, who are actively at work.
Other features:
n Cash value — Accumulates at a guaranteed rate of 4.5%.* Over time, you can borrow from
the cash value or use it to buy a reduced policy with no more premiums due.
n No physical exam — During your initial enrollment, you can get this insurance up to a
specified amount without a health exam. You may be asked a few health questions.
n You own the policy — The payment is deducted from your paycheck and coverage
becomes effective the first day of the month. You can keep the policy even if you leave or
retire; Unum will bill you directly for the same premium amount.
n You can purchase policies for your spouse and eligible children.
n Rates are based on your age, tobacco status and the policy amount you elect.
n Please refer to the Policy form for more details and any limitations and exclusions.
* The policy accumulates cash value based on a non-forfeiture interest rate of 4.5% and the 2001 CSO mortality table.
The cash value is guaranteed and will be equal to the values shown in the policy. Cash value will be reduced by any
outstanding loans against the policy.
11CRITICAL
HEADER TEXT
ILLNESS INSURANCE
Critical Illness insurance can pay a $10,000 or $20,000 lump sum benefit at the diagnosis of a
specified disease.
Benefits are paid directly to you to use any way you see fit.
n Includes a Recurrence Benefit which provides an additional payout for a second occurrence
of an initial critical illness for which a benefit was previously paid. Initial and subsequent
diagnoses must be separated by at least 12 months.
n Health Screening Benefit – Unum will pay a health screening benefit of $50 upon submission
of proof that a covered test was taken. This benefit can be paid out once per covered
person per calendar year.
n Covered Spouses and Children are eligible for 50% of the insured employee benefit
amount.
n Does not include a pre-existing condition limitation.
n Rates are calculated based on age, policy amount and smoker status.
n This is a limited policy. Please refer to the Summary Plan Description for more details, any
exclusions and policy limitations.
n Rates are based on issue age and will not increase for as long as you are enrolled in the
plan. (Please see plan documents or bswift while enrolling for rates specific to you.)
PLAN 1 PLAN 2
Covered Conditions
$10,000 Coverage $20,000 Coverage
Heart Attack (100%) $10,000 $20,000
Stroke (100%) $10,000 $20,000
Major Organ Transplant (100%) $10,000 $20,000
End Stage Renal Failure (100%) $10,000 $20,000
Coronary Artery Bypass Surgery (25%) $2,500 $5,000
Invasive Cancer (100%) $10,000 $20,000
Carcinoma in Situ (25%) $2,500 $5,000
Benign Brain Tumor (100%) $10,000 $20,000
12ADDITIONAL BENEFITS
Tuition Reimbursement (Shift Managers Only)
Border Foods Inc. offers educational assistance to its employees. It is the intention that this
plan qualifies as a plan providing qualified educational assistance under Code Section 127 and
will be non-taxable.
Plan Limits: $1,000 annually
Eligibility: Employees must have 1 year of service and work an average of 30 hours per week
during the previous 52 weeks. They must also be in good standing with no performance,
disciplinary, or attendance concerns.
Education Covered and Expenses Reimbursed:
For tuition to be reimbursed, the course(s) must be either
a.) Undergraduate courses that are part of a degree program
b.) Job related Graduate level courses
Other expenses that are eligible for reimbursement include required books for college
accredited courses.
Grade earned Reimbursement amount
“A” “B” or “Pass” 100%
“C” 75%
Less than “C” or “Fail” 0%
Expectations & Continued Employment:
Class schedules must not conflict with work. Employees must be employed with the Company
when taking the course(s), when receiving reimbursement and 12 months afterwards. If
employment ends within 12 months after of the reimbursement date, the Company requires
repayment of all education costs reimbursed during the prior 12 months.
Payment Procedure:
Upon successful completion of the course, the employee must complete a Tuition
Reimbursement Payment Request and provide proof of itemized expenses & final grades from
the school. This information must be submitted to Miranda Ziebell. Upon receipt; she will
request the applicable reimbursement.
All tuition reimbursement requests must be pre-approved prior to registering for a course.
For additional information or to receive pre-approval paperwork, please contact Maricela
Alatorre at 763.489.2954 or malatorre@borderfoods.com.
College Scholarships
All Team members and Shift Managers employed for at least 90 days may be eligible for
one of ten $1,000 college scholarships provided by Border Foods. Please contact Human
Resources to learn more.
Earned Vacation
On an annual basis, Team Members and Shift Managers with 1 year of service earn a vacation
amount of the average weekly hours worked in the previous year not to exceed 40 hours. Shift
Managers can earn up to 2 times the average number of hours worked after 2 years of service.
13HEADER TEXTBENEFITS
ADDITIONAL
Legal Protection Plan – Legal Club of America
This plan covers your entire family and includes: free and discounted legal care, life events
counseling, and ID Theft protection including prevention, restoration and insurance. It also
offers tax advice and preparation including a free tax return. For coverage details, see the
benefit summary on the enrollment site.
Coverage Per Paycheck
Family $6.46
Employee Assistance Program (EAP) - Unum
The Company offers an EAP through Unum, administered by HealthAdvocate, free of charge,
designed to help you and your dependents address life’s daily challenges. From workplace
stress to a variety of family issues, the EAP provides confidential telephone consultations that
can help and up to 3 in-person sessions, per issue, for you to talk with a counselor if needed.
Contact the EAP at 800-854-1446 or learn more at www.unum.com/lifebalance.
Worldwide emergency travel assistance program –
Assist America, Inc. through Unum
For travel 100 miles or more from your home you have 24-hour phone access to professionals
who can help you in an emergency offering services such as connecting you with pre-qualified
medical providers, access to western-style medicine, ambulance and air ambulance, lost/
stolen medication replacement, and more.
Various Discounts and Services
The Work Number: The Work Number is an automated service that provides instant
employment and income verification. To verify employment and or income verification, please
have the verifier call 1-800-367-5690 or visit www.theworknumber.com and use the Border
Foods employer code 11740 and your Social Security Number.
Employee Meal Discount: All employees can receive a 20% discount on food purchased at
any Border Foods restaurant when off duty. You must present paycheck stub or ID card.
Workplace Banking: U.S. Bank offers perks to Company employees including: Free Checking,
Free 1st Box of Checks, Free Internet Banking, discounts and preferred rates on various U.S.
Banking services and more. See a banker for more information.
Additional Discounted Services: Taco Bell offers multiple discounts that change often. Check
out https://tb.hrdiscounts.com/perks/ for the latest discounts. Use SAVENOW to register.
If you have questions about anything in this benefit guide please contact
benefits@borderfoods.com.
Any human resources related questions should be directed to your Border
Foods HR Representative.
14HEADER TEXT
DEFINITIONS
Affordable Care Act (ACA): The Patient Copayment: A set dollar amount you pay
Protection and Affordable Care Act, for network doctors’ office visits, emergency
commonly called the Affordable Care Act room services and prescription drugs.
(ACA) is a United States federal statute
signed into law by President Obama Deductible: Total dollar amount, based on
in March 2010. The law puts in place the allowed amount, you must pay out of
comprehensive health insurance reforms. pocket for covered medical expenses each
calendar year before the plan pays for most
Annual Maximum: Total dollar amount a services. The deductible does not apply to
plan pays during a calendar year toward network preventive care and any services
the covered expenses of each person where you pay a copayment rather than
enrolled. coinsurance. Some of your dental options
also have an annual deductible, generally
Out-of-Pocket Maximum: The maximum for basic and major dental care services.
amount of coinsurance a Plan member
must pay towards covered medical Brand Formulary Drugs: The brand
expenses in a calendar year for both formulary is an approved, recommended
network and non-network services. list of brand-name medications. Drugs
Once you meet this out-of-pocket on this list are available to you at a lower
maximum, the Plan pays the entire cost than drugs that do not appear on this
coinsurance amount for covered services preferred list.
for the remainder of the calendar year.
Deductibles and copays apply to the Generic Drugs: These drugs are usually
annual out-of-pocket maximum. most cost-effective. Generic drugs are
chemically identical to their brand-name
Coinsurance: A percentage of the medical counterparts. Purchasing generic drugs
costs, based on the allowed amount, you allows you to pay a lower out-of-pocket
must pay for certain services after you meet cost than if you purchase formulary or
your annual deductible. non-formulary brand name drugs.
Conversion: an employee changes or Maintenance Drugs: Prescriptions
“converts” her / his Group Life coverage to commonly used to treat conditions that are
an Individual Life Insurance policy without considered chronic or long-term. These
having to answer any medical questions. conditions usually require regular, daily use
Conversion is for an employee who is of medicines. Examples of maintenance
leaving her/his job, reducing hours, or has drugs are those used to treat high blood
reached the age when coverage may be pressure, heart disease, asthma and diabetes.
reduced or eliminated, and still wants to
maintain the protection that life insurance
provides.
15DEFINITIONS
HEADER TEXT
Non-Formulary Drugs: These drugs are Provider: Any type of health care
not on the recommended formulary list. professional or facility that provides
These drugs are usually more expensive services under your plan.
than drugs found on the formulary. You may
purchase brand-name medications that do Network: A group of health care providers,
not appear on the recommended list, but including dentists, physicians, hospitals and
at a significantly higher out-of-pocket cost. other health care providers, that agrees to
accept pre-determined rates when serving
PDP Fee: PDP Fee refers to the fees that members.
participating PDP dentists have agreed to
accept as payment in full, subject to any Qualifying Event: An occurrence that
copayments, deductibles, cost sharing and qualifies the Subscriber to make an
benefits maximums. insurance coverage change outside of the
Open Enrollment window.
Portability: An employee carries or “ports”
her/his current Group Life coverage after Reasonable and Customary Charge
employment ends, without having to (R&C): R & C fee refers to the Reasonable
answer any medical questions. Portability is and Customary (R&C) charge, which is
for an employee who is leaving her/his job based on the lowest of (1) the dentist’s
and still wants to maintain the protection actual charge, (2) the dentist’s usual charge
that life insurance provides. for the same or similar services, or (3)
the charge of most dentist’s in the same
Pre-tax Plan: A plan for active employees geographic area for the same or similar
that is paid for with pre-tax money. The services as determined
IRS allows for certain expenses to be paid by MetLife.
for with tax-free dollars. The state takes
premiums out of your check before taxes Specialty Drugs: Prescription medications
are calculated, increasing your spendable that require special handling, administration
income and reducing the amount you owe or monitoring. These drugs may be used
in income taxes. Consequently, the IRS to treat complex, chronic and often costly
has tax laws that require you to stay in the conditions.
plans you select for a full plan year (January
through December). You can only make
changes during Open Enrollment or if you
have a Qualifying Event.
Primary Care Physician (PCP): The health
care professional who monitors your
health needs and coordinates your overall
medical care, including referrals for tests or
specialists.
16GETTING STARTED
Your Next Steps
After allowing one week for information processing, please complete the enrollment process.
As a reminder, please complete this within 30 days of your promotion/hire date.
1. Register for benefits at www.borderfoods.bswift.com (See below for detailed instructions)
Benefits Online Enrollment
Please complete this process within 30 days of hire/promotion
Benefits enrollment process is quick, easy and is completed online. Be sure to have
SSN and DOB information for you and your dependents ready!
www.borderfoods.bswift.com
Your username will be your First Initial + Last Name + Month and Day of your birth.
Your initial password will be the last four digits of your social security number. You will
be prompted to change your password when you log in.
Example:
Employee Date of Birth Employee SSN Username Initial Password
Robert Smith 01/01/1975 123-45-6789 RSmith0101 6789
Sarah Anderson 02/02/1980 111-222-3333 SAnderson0202 3333
17GETTING STARTED
General Navigation
You & Your Family: View/change your information (address, phone number, etc.), your
dependents information or enter a Qualified Life Event (QLE).
My Benefits: View your current coverage elections.
To Change Benefit Elections:
Benefit election changes outside of initial enrollment require a qualifying life event (QLE) and
must be processed within 30 days of the QLE. Check with Human Resources for eligible QLEs.
n Log onto the bswift website
n Click on “My Benefits”, then “Life Events”
n Choose the applicable QLE
n Follow the prompts to make coverage changes
To Change Personal or Dependent information:
n Log onto the bswift website
n Click on “My Profile”, then “Change my address” or “Edit dependent profiles”
n Enter your new information, click “Save”
18CARRIER CONTACT INFORMATION
Benefit Policy Number Provider Call Visit
952-945-8000 www.medica.com
Medical 741938 Medica
800-952-3455 www.mymedica.com
Accident
Critical Illness R0534560 Unum 866-679-3054 www.unum.com
Whole Life
Unum /
EAP 800-854-1446 www.unum.com/lifebalance
HealthAdvocate
651-406-5916
Dental Insurance 050986 Delta Dental www.deltadentalmn.org
800-553-9536
Vision Insurance 9745720 EyeMed 866-939-3633 www.eyemedvisioncare.com
608-241-1900
HSA and FSA 4706-0572-9952 TASC www.tasconline.com
800-422-4661
For benefit support please email: benefits@borderfoods.com
19IMPORTANT NOTICES
HEADER TEXT
Special Enrollment Rights
If you are declining enrollment for yourself or your dependents (including your spouse) because
of other health insurance or group health plan coverage, you may be able to enroll yourself and
your dependents in this plan if you or your dependents lose eligibility for that other coverage
(or if the employer stops contributing towards your or your dependents’ other coverage).
However, you must request enrollment within 30 days after your or your dependents’ other
coverage ends (or after the employer stops contributing toward the other coverage).
If you have a new dependent as a result of marriage, birth, adoption, or placement for
adoption, you may be able to enroll yourself and your dependents. However, you must request
enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
If you decline enrollment for yourself or for an eligible dependent (including your spouse) while
Medicaid coverage or coverage under a state children’s health insurance program is in effect,
you may be able to enroll yourself and your dependents in this plan if you or your dependents
lose eligibility for that other coverage. However, you must request enrollment within 60 days
after your or your dependents’ coverage ends under Medicaid or a state children’s health
insurance program.
If you or your dependents (including your spouse) become eligible for a state premium
assistance subsidy from Medicaid or through a state children’s health insurance program with
respect to coverage under this plan, you may be able to enroll yourself and your dependents in
this plan. However, you must request enrollment within 60 days after your or your dependents’
determination of eligibility for such assistance.
To request special enrollment or obtain more information, contact the Border Foods Human
Resources Department.
Newborns’ and Mothers’ Health Protection Act
Under federal law, health care plans may not restrict any hospital length of stay in connection
with childbirth for the mother or newborn child to less than 48 hours following a normal
delivery, or less than 96 hours following a Cesarean section. However, federal law generally
does not prohibit the mother’s or newborn’s attending provider, after consulting with the
mother and with the mother’s consent, from discharging the mother or her newborn earlier than
48 hours (or 96 hours as applicable).
Women’s Health and Cancer Rights Act of 1998
Under the Women’s Health and Cancer Rights Act, group health plans must make certain
benefits available to participants of health plans who have undergone a mastectomy. In
particular, plans that provide medical and surgical benefits for a mastectomy must also provide
coverage for:
n Reconstruction of the breast on which the mastectomy has been performed
n Surgery and reconstruction of the other breast to produce a symmetrical appearance;
n External breast prostheses (breast forms that fit into a bra) that are needed before or during
the reconstruction; and
n Treatment of physical complications in all stages of mastectomy, including lymphedemas.
Coverage is determined by the health plan, in coordination with the physician and patient.
20HEADER TEXT
IMPORTANT NOTICES
Important Notice from Border Foods about your Prescription
Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information
about your current prescription drug coverage with Border Foods and about your options
under Medicare’s prescription drug coverage. This information can help you decide whether or
not you want to join a Medicare drug plan. If you are considering joining, you should compare
your current coverage, including which drugs are covered at what cost, with the coverage
and costs of the plans offering Medicare prescription drug coverage in your area. Information
about where you can get help to make decisions about your prescription drug coverage is at
the end of this notice.
There are two important things you need to know about your current coverage and Medicare’s
prescription drug coverage:
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare.
You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare
Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare
drug plans provide at least a standard level of coverage set by Medicare. Some plans may
also offer more coverage for a higher monthly premium.
2. Border Foods has determined that the prescription drug coverage offered by the Medica
is, on average for all plan participants, expected to pay out as much as standard Medicare
prescription drug coverage pays and is therefore considered Creditable Coverage. Because
your existing coverage is Creditable Coverage, you can keep this coverage and not pay a
higher premium (a penalty) if you later decide to join a Medicare drug plan.
When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year
from October 15th to December 7th.
However, if you lose your current creditable prescription drug coverage, through no fault of
your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a
Medicare drug plan.
21IMPORTANT NOTICES
HEADER TEXT
What Happens To Your Current Coverage If You Decide to Join A Medicare
Drug Plan?
If you decide to join a Medicare drug plan, your current Border Foods coverage will not be
affected. If you or your dependents are Medicare Part D eligible, there are certain options
available to you:
• Retain your existing coverage and choose not to enroll in a Part D plan; or
• Enroll in a Part D plan as a supplement to your existing coverage with Border Foods.
Note: Information about the prescription drug plan provisions/options available to Medicare
Part D eligible individuals is available at http://www.cms.hhs.gov/CreditableCoverage/
If you do decide to join a Medicare drug plan and drop your current Border Foods coverage,
be aware that you and your dependents will be able to get this coverage back during the
qualified life event or the annual open enrollment period for Border Foods group plan.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with Border Foods and
don’t join a Medicare drug plan within 63 continuous days after your current coverage ends,
you may pay a higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your
monthly premium may go up by at least 1% of the Medicare base beneficiary premium per
month for every month that you did not have that coverage. For example, if you go nineteen
months without creditable coverage, your premium may consistently be at least 19% higher
than the Medicare base beneficiary premium. You may have to pay this higher premium (a
penalty) as long as you have Medicare prescription drug coverage. In addition, you may have
to wait until the following October to join.
22HEADER TEXT
IMPORTANT NOTICES
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have
a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children
aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual
insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or
CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible
for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov
to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored
plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your
employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity,
and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about
enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of
states is current as of January 31, 2020. Contact your State for more information on eligibility –
To see if any other states have added a premium assistance COLORADO – Health First Colorado (Colorado’s Medicaid
program since January 31, 2020, or for more information on Program) & Child Health Plan Plus (CHP+)
special enrollment rights, contact either: Health First Colorado
https://www.healthfirstcolorado.com/
U.S. Department of Labor
1-800-221-3943 / State Relay 711
Employee Benefits Security Administration
CHP+: https://www.colorado.gov/pacific/hcpf/child-health-
www.dol.gov/agencies/ebsa | 1-866-444-EBSA (3272) plan-plus
U.S. Department of Health and Human Services 1-800-359-1991 / State Relay 711
Centers for Medicare & Medicaid Services FLORIDA – Medicaid
www.cms.hhs.gov | 1-877-267-2323, Option 4, Ext. 61565 http://flmedicaidtplrecovery.com/hipp/
1-877-357-3268
OMB Control Number 1210-0137 (expires 1/31/2023)
GEORGIA – Medicaid
ALABAMA – Medicaid https://medicaid.georgia.gov/health-insurance-premium-
http://myalhipp.com payment-program-hipp
1-855-692-5447 1-678-564-1162, ext 2131
ALASKA – Medicaid INDIANA – Medicaid
The AK Health Insurance Premium Payment Program Healthy Indiana Plan for low-income adults 19-64
http://myakhipp.com/ http://www.in.gov/fssa/hip/
1-866-251-4861 1-877-438-4479
CustomerService@MyAKHIPP.com All other Medicaid
Medicaid Eligibility http://www.indianamedicaid.com
http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx 1-800-403-0864
ARKANSAS – Medicaid IOWA – Medicaid and CHIP (Hawki)
http://myarhipp.com/ Medicaid
1-855-MyARHIPP (855-692-7447) https://dhs.iowa.gov/ime/members
CALIFORNIA – Medicaid 1-800-338-8366
https://www.dhcs.ca.gov/services/Pages/TPLRD_CAU_cont.aspx Hawki
1-800-541-5555 http://dhs.iowa.gov/Hawki
1-800-257-8563
KANSAS – Medicaid
http://www.kdheks.gov/hcf/default.htm
1-800-792-4884
23IMPORTANT NOTICES
KENTUCKY – Medicaid NORTH CAROLINA – Medicaid
Kentucky Integrated Health Insurance Premium Payment https://medicaid.ncdhhs.gov/
Program (KI-HIPP) 1-919-855-4100
https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx NORTH DAKOTA – Medicaid
1-855-459-6328 | KIHIPP.PROGRAM@ky.gov http://www.nd.gov/dhs/services/medicalserv/medicaid/
KCHIP 1-844-854-4825
https://kidshealth.ky.gov/Pages/index.aspx OKLAHOMA – Medicaid and CHIP
1-877-524-4718 http://www.insureoklahoma.org
Medicaid 1-888-365-3742
https://chfs.ky.gov OREGON – Medicaid
LOUISIANA – Medicaid http://healthcare.oregon.gov/Pages/index.aspx
www.medicaid.la.gov or www.ldh.la.gov/lahipp http://www.oregonhealthcare.gov/index-es.html
1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (LaHIPP) 1-800-699-9075
MAINE – Medicaid PENNSYLVANIA – Medicaid
http://www.maine.gov/dhhs/ofi/public-assistance/index.html https://www.dhs.pa.gov/providers/Providers/Pages/Medical/
1-800-442-6003 | TTY: Maine relay 711 HIPP-Program.aspx
MASSACHUSETTS – Medicaid and CHIP 1-800-692-7462
http://www.mass.gov/eohhs/gov/departments/masshealth/ RHODE ISLAND – Medicaid and CHIP
1-800-862-4840 http://www.eohhs.ri.gov/
MINNESOTA – Medicaid 1-855-697-4347 or 401-462-0311 (Direct RIte Share Line)
https://mn.gov/dhs/people-we-serve/children-and-families/ SOUTH CAROLINA – Medicaid
health-care/health-care-programs/programs-and-services/ https://www.scdhhs.gov
medical-assistance.jsp 1-888-549-0820
- Under ELIGIBILITY tab, see “what if I have other health
SOUTH DAKOTA - Medicaid
insurance?”
http://dss.sd.gov
1-800-657-3739
1-888-828-0059
MISSOURI – Medicaid
TEXAS – Medicaid
http://www.dss.mo.gov/mhd/participants/pages/hipp.htm
http://gethipptexas.com/
1-573-751-2005
1-800-440-0493
MONTANA – Medicaid
UTAH – Medicaid and CHIP
http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP
Medicaid: https://medicaid.utah.gov
1-800-694-3084
CHIP: http://health.utah.gov/chip
NEBRASKA – Medicaid 1-877-543-7669
http://www.ACCESSNebraska.ne.gov
VERMONT– Medicaid
1-855-632-7633
http://www.greenmountaincare.org/
Lincoln: 1-402-473-7000 | Omaha: 1-402-595-1178
1-800-250-8427
NEVADA – Medicaid
VIRGINIA – Medicaid and CHIP
http://dhcfp.nv.gov
https://www.coverva.org/hipp/
1-800-992-0900
Medicaid: 1-800-432-5924
NEW HAMPSHIRE – Medicaid CHIP: 1-855-242-8282
https://www.dhhs.nh.gov/oii/hipp.htm
WASHINGTON – Medicaid
1-603-271-5218
https://www.hca.wa.gov/
Toll free number for the HIPP program: 1-800-852-3345, ext 5218
1-800-562-3022
NEW JERSEY – Medicaid and CHIP
WEST VIRGINIA – Medicaid
Medicaid: http://www.state.nj.us/humanservices/dmahs/clients/
http://mywvhipp.com/
medicaid/
Toll-free: 1-855-MyWVHIPP (1-855-699-8447)
1-609-631-2392
CHIP: http://www.njfamilycare.org/index.html WISCONSIN – Medicaid and CHIP
https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf
1-800-701-0710
1-800-362-3002
NEW YORK – Medicaid
https://www.health.ny.gov/health_care/medicaid/ WYOMING – Medicaid
https://wyequalitycare.acs-inc.com/
1-800-541-2831
1-307-777-7531
24This brochure provides a summary of benefits under the Border Foods health and welfare plans. It is not intended to give advice and does not provide every plan detail. Every effort has been made to ensure the accuracy of this brochure. However, if there are any discrepancies between this guide and the actual plan documents that govern the plans, the plan documents will control in all cases.
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