2020 Benefits Guide - Dermalogica Benefits Portal
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2020 Benefits Guide
NON-CALIFORNIA
Corporate Headquarters | 1535 Beachey Place, Carson, CA 90746
Benefits Website | dermalogicabenefits.com | u: dermalogica | p: wellness
Benefit Resource Center (BRC) | 888-336-7463 | brcca@usi.com
| Monday-Friday, Excluding Holidays
| 8:00am to 5:00pm Pacific Time
table of contents contact information
MEMBER SERVICE NUMBERS
Aetna
Medical OAMC PPO....................................................877-204-9186
Welcome......................................................... 3 Medical OAMC HSA....................................................877-204-9186
Benefit Resource Center/Mobile App.............. 3 Dental DMO/PPO.........................................................877-238-6200
Eligibility/Benefits Website............................... 4 Teladoc........................................................................855-835-2362
Medical.........................................................5-6 Discovery Benefits
Cost of Coverage............................................ 7 Flexible Spending Accounts.........................................866-451-3399
Teladoc/How to Find a Provider....................... 8 EyeMed
Aetna Member Portal....................................... 9 Vision...........................................................................866-939-3633
Maternity Program........................................... 9 Mutual of Omaha
Aetna Mobile App............................................ 9 Life/AD&D....................................................................800-775-8805
Dental............................................................ 10 Long Term Disability.....................................................800-877-5176
Vision............................................................ 11 Employee Assistance Program.....................................800-316-2796
Life and AD&D............................................... 12 Worldwide Travel Assistance
Employee Assistance Plan (EAP)................... 13 Within the U.S..............................................................800-856-9947
Long Term Disability....................................... 13 Outside of the U.S.......................................................312-935-3658
401(k)............................................................ 13 Legal Shield
Flexible Spending Accounts........................... 14 Legal/Identity Theft.......................................................800-654-7757
United Pet Care............................................. 15 Unum
Legal and Identity Theft................................. 15 Long Term Care...........................................................800-227-4165
Voluntary Worksite Benefits........................... 16 Voluntary Worksite Benefits..........................................800-635-5597
Mutual of Omaha Value Added Services........ 17 Fidelity
Long Term Care............................................. 18 401(k)..........................................................................800-797-2363
Product Allocation......................................... 18 United Pet Care
How To Enroll Using PlanSource...............19-21 Pet Discount Program..................................................888-781-6622
DERMALOGICA CONTACT INFORMATION
Human Resources Service Center....................................310-900-4000
Email............................................................ESC.HR@dermalogica.com
W
hile every effort has been made to be
as accurate as possible in developing BENEFIT RESOURCE CENTER (BRC)
the enclosed information, the official Toll Free............................................................................888-336-7463
plan documents prevail in all cases. This is Email...............................................................................brcca@usi.com
not a legal document. It is a brief summary
of benefits and is not considered “Evidence MOBILE BENEFITS APP (USI)
of Coverage.” Please refer to the policy/plan Free Download............................................................................... usieb
documents for a complete description of the Enter Code................................................................................. 128812
controlling terms, coverages, exclusions,
limitations and conditions of coverage. In case HELPFUL WEBSITES
of any discrepancy between this information Benefits Website............................................dermalogicabenefits.com
and the policy/plan documents, the policy/plan Username: dermalogica
documents will prevail. Password: wellness
Aetna............................................................................ www.aetna.com
Dermalogica reserves the right to terminate,
suspend, withdraw, or modify the benefits Teladoc............................................................www.teladoc.com/aetna
described in the policy/plan documents in whole Mutual of Omaha.........................................www.mutualofomaha.com
or in part, at any time. No statement in this or Mutual of Omaha EAP..........................www.mutualofomaha.com/eap
any other document, and no oral representation Discovery Benefits................................... www.discoverybenefits.com
should be construed as a waiver of this right. EyeMed.................................................................... www.eyemed.com
This summary is the confidential property of LegalShield...........................................................www.legalshield.com
Dermalogica. Insurance information prepared Unum........................................................................... www.unum.com
by USI. Fidelity.................................................... www.netbenefits.com/unilever
United Pet Care......................... www.unitedpetcare.com/dermalogica
welcome
Benefit Resource Center (BRC)
F
rom day one at Dermalogica, you’ll Understanding your employee benefit options can be complicated.
find a common purpose linking every That’s why as an employee of Dermalogica we provide access to
the Benefit Resource Center. The BRC gives you unlimited direct
employee: bringing respect and
access to experts who are dedicated to knowing your plan options
success to the professional skin therapist
inside and out. They’ll help you understand how our plans work and
through top-quality education, innovative
make selections to fit your needs and lifestyle. They can also provide
products and outstanding customer service. guidance with:
We focus on skin health and products that
truly deliver, not false “beauty” claims or • Enrollment
• Finding in-network service providers
miracle cures. To reward you for your efforts
• General benefit questions
and help you be the healthiest you, we are
• Claim issues
pleased to offer a generous benefits package
• Life changing events
and valuable resources at competitive rates. • And much more
We invite you to take a close look at the
information provided in this guide to learn So if you have any benefits related questions, call or email the Benefit
Resource Center. Spanish speaking representatives are available.
more about the benefits program we offer
to you and your family. Taking the time to TOLL FREE: 888-336-7463
research your options now will help you EMAIL: brcca@usi.com
choose the plans that best meet your family’s Benefit Resource Center (BRC) Hours of Operation:
needs for the future. M-F, 8:00am – 5:00pm PST, Excluding Holidays
mobile app
Free Mobile Benefits App
access all your benefits insurance
policy details and contact information
on the go!
• Stay organized – access all your plan information and ID cards
in one place
• Stay up to date – receive the most updated plan information
automatically
• Lighten up your wallet – store your ID cards in the app
• Get in touch – convenient contact information
FIND IT IN YOUR APP STORE
Search for ‘usieb’ and download our free app. After scrolling
through the intro, enter this code when prompted: 128812
to access the benefit details.
2020 BENEFITS • P3
eligibility | benefits website
who is eligible?
New Hires: Newly hired employees are eligible to
participate in the Dermalogica plan the first of the month
after satisfying 1 month of continuous employment.
Full-Time Employees: Employees who work a
minimum of 30 hours per week are eligible to
participate.
Dependents: You may cover your spouse or domestic
partner and children. Children can be up to age 26
regardless of student status.
qualifying event?
During the year, you can change your benefit elections
only if you experience a qualifying event. You must notify
HR within 30 days from the qualifying event to make any
changes to your benefits.
Examples include changes in:
• Marital status (marriage, divorce, legal separation)
• Number of dependent children (birth, adoption)
• Employment status (part-time to full-time)
• Eligibility status (change in hours, job loss)
benefits website
The Dermalogica Benefits Website is an online
destination for you to find benefits information, carrier
forms, educational resources and enrollment information.
This site, which is available 24/7, will allow you to quickly
access the information you need to make an informed
decision about choosing your benefit plans. To access
the site, simply log on to:
dermalogicabenefits.com
username: dermalogica
password: wellness
2020 BENEFITS • P4
medical
Dermalogica offers two choices of medical Aetna Open Access Managed Choice (OAMC) PPO
insurance plans: an (OAMC) PPO plan and When you enroll in the Aetna Open Access Managed Choice (OAMC),
a high deductible (OAMC) PPO plan with an you are free to seek medical care from both in and out-of-network
providers. There is also no requirement that you select a primary
HSA option. Each of our medical insurance
care physician or receive authorized referrals to specialists (certain
plans offers different levels of deductibles, services will require if treatment is out of network). In order to receive
copayments, and out-of-pocket maximums. the highest level of coverage under the plan, simply obtain care from
an in-network provider.
Aetna Open Access Managed Choice (OAMC) HSA
The Aetna Open Access Managed Choice (OAMC) HSA works just
like a traditional PPO plan in that members can seek care from the
provider of their choice, whether in or out of the plan’s network. And
just like a traditional PPO, there is no requirement that you select a
primary care physician or obtain referrals to specialists – you have the
freedom of choice to control how you access health care services.
However, the HSA plan is one of a new generation of plans known
as “consumer driven health care plans,” or CDHPs for short. CDHPs
combine a high deductible PPO style health plan with an underlying
Health Savings Account (HSA).
What is an HSA?
An HSA is a special type of tax-preferred savings account that
allows you to cover your deductible and pay for other out-of-pocket
health care spending with pre-tax dollars. You do not pay taxes on
contributions to your account*, nor do you pay taxes on your earnings
or your account withdrawals, as long as your withdrawals are for
eligible health care spending. Your HSA balance can accumulate from
year to year and there is no “use it or lose it” rule for your HSA funds.
The choice is yours, you can use your HSA to pay your eligible health
care expenses now or you can save your HSA dollars to help pay
for future medical expenses, COBRA premiums, or long-term care
insurance premiums. And you can grow your HSA by earning tax-free
interest accrued on your HSA deposits or investing the funds.
2020 HSA Contribution Limits
Individuals: $3,550
Family: $7,100
Age 55 or over Catch-Up Contribution: $1,000
For more information
* State taxes will apply in CA & NJ.
about HSAs, log on to
dermalogicabenefits.com
(u: dermalogica, p: wellness).
2020 BENEFITS • P5
medical
The following chart summarizes the benefits for the medical plans offered to all eligible employees of Dermalogica.
As an eligible employee, you may choose from one of the following plans.
Aetna Open Acess Aetna Open Access
Managed Choice PPO Managed Choice HSA
Group #: 847288 In-Network Out-of- In-Network Out-of-
Network5 Network5
Annual Deductible
Individual $500 $750 $3,000 $3,000
Family $1,500 $2,250 $6,000 $6,000
Annual Out-of-Pocket Max $3,500 $7,000 $3,000 $6,000
Individual $7,000 $14,000 $6,000 $12,000
Family
Physician Services
Primary Care $30 copay 30% after ded 0% after ded 50% after ded
Specialist Visits $30 copay 30% after ded 0% after ded 50% after ded
Preventive Care No copay 30% after ded No charge Not covered
Hospital Services
Inpatient Hospitalization 10% after ded 30% after ded 0% after ded 50% after ded
Outpatient Surgery 10% after ded 30% after ded 0% after ded 50% after ded
Diagnostic X-Ray & Lab
Advanced Imaging 10% after ded 30% after ded 0% after ded 50% after ded
Lab/X-Ray 10% after ded 30% after ded 0% after ded 50% after ded
Other Covered Services
Chiropractic Care $30 copay2 30% after ded2 0% after ded2 50% after ded2
Acupuncture $30 copay2 30% after ded2 0% after ded2 50% after ded2
Urgent Care/Emergency
Urgent Care $50 copay 30% after ded 0% after ded 50% after ded
Emergency Room1 $100 + 10% $100 + 10% 0% after ded 0% after ded
Prescriptions Subject to Subject to
Annual Deductible $100 / $3003 $100 / $3003 plan ded plan ded
Generic $10 copay 50% AWP4 0% after ded 50% AWP4
Brand Name $30 copay 50% AWP4 0% after ded 50% AWP4
Non-Formulary $50 copay 50% AWP4 0% after ded 50% AWP4
Specialty Drugs 20% ($20 min/$80 max) Not covered 0% after ded Not covered
Cost Per Pay Period
Employee only $60.22 $81.30 $49.73 $69.00
Employee + 1 $210.47 $284.13 $171.57 $231.62
Employee + 2 or more $283.80 $383.12 $221.67 $299.25
1. $100 copay waived if admitted.
2. 20 visits per calendar year.
3. Individual/Family; does not apply to generic drugs from in-network pharmacies.
4. When filling prescriptions at non-participating pharmacies, you are required to pay 50% of the prescription drug’s Average Wholesale Price (AWP),
plus any amounts the pharmacy charges in excess of the AWP, to a maximum $250 copay per fill.
5. For out-of-network services, members pay applicable deductibles and coinsurance plus any amount that exceeds Aetna’s allowable amount; excess
amounts do not apply toward the deductible or out-of-pocket maximum.
Indicates wellness participation.
2020 BENEFITS • P6
cost of coverage
how you pay for health care costs: YOUR TOTAL COST OF CARE
Remember, your total health care cost for
You share the cost of services with Dermalogica and the insurance the year is the combination of your out-of-
plans you select. As you review your plan options you should pocket expenses when you access medical
consider the following types of costs: care and the premium contributions you
Premium: A premium is the total cost for your medical insurance. make for coverage.
You and Dermalogica share this cost. You pay your portion through
pre-tax payroll deductions. Premiums
+ Out-of-Pocket Costs
Copay: A copay is a set payment you make for a specific service.
For example, in the OAMC PPO plan you will have a $30 copay for Total Cost of Health Care
visits to your primary care physician.
Coinsurance: When you are paying coinsurance, you are sharing
a percentage of the cost of services with the medical plan. For
example, on the OAMC PPO plan, after you satisfy your in-network
deductible, the plan will pay 90% and you will pay 10% coinsurance
for most medical care that you receive from contracted providers.
Out-of-Pocket Maximum: The annual out-of-pocket maximum
protects you from major medical expenses. This is the most you
would pay, including your deductible, for eligible expenses during
a plan year. Once you reach the out-of-pocket maximum, the plan
pays 100% of the allowable charges for covered services. For
example, if you are enrolled in the OAMC PPO plan, your calendar
year out-of-pocket maximum for in-network care is $3,500 per
person or $7,000 per family, which includes the annual deductible.
Deductible: A deductible is the amount you must pay before the
medical plan begins sharing the cost of services. You pay this full
amount, if required by your plan, before the plan pays benefits. For
example, if you are enrolled in employee only coverage in the Aetna
OAMC HSA plan, you must pay $3,000 per individual ($6,000 max
per family) for covered care, over the course of the plan year before
the plan pays any benefits.
Depending on your personal situation, the plan with the lowest deductibles
and copays may not be the best plan for you. Take the HSA plan for example.
Although the cost of prescription drugs is higher than that of the (OAMC) PPO
plan, this may be the plan for you if you like the flexibility of managing your
health care costs. Be sure to take a good look at the total cost of your expected
care before making your plan decisions for 2020.
P7 • 2020 BENEFITS
teladoc get started today with teladoc
Step 1: Set-up your account. We’ve made it quick and easy to set up your
account online. Simply visit Teladoc.com/Aetna and click “Set up account”.
Step 2: Update your medical history. Make sure the “My Medical History”
tab is updated so the doctor has the information needed to provide an
We are pleased to provide you with accurate diagnosis.
access to Teladoc, an added benefit Step 3: Request a consult. Teladoc doctors are available when you need
that gives you 24/7 access to a national care now. Request a consult anytime online or by phone at 855-Teladoc
network of U.S. board-certified doctors. (835-2362). With your consent, Teladoc is happy to provide information
Call Teladoc from anywhere – home, about your Teladoc consult to your primary care physician.
work, or on the road – and let the doctor
come to you! Teladoc doctors diagnose
nonemergency medical problems,
recommend treatment, and can even
call in a prescription to your pharmacy
of choice, when necessary.
save money
Teladoc costs significantly less than urgent
care and emergency room visits. Plus, you
can use Teladoc from the convenience of
home or work, allowing you to avoid the
hassle of sitting in a waiting room.
costs are as follows:
• OAMC PPO cost is your PCP copay, $30 how do i find an Aetna provider?
• OAMC HSA cost is $40
There are a few different ways to find an in-network provider. Choose the
method below that is most convenient for you and begin your search!
treat many conditions
1. AETNA MEMBER 3. GUEST SEARCH
Teladoc has a 90% medical resolution rate PORTAL Log in to www.aetna.com and click on
and can provide treatment for: “Find a Doctor” at the top of the page.
Aetna members can log into
• Urinary tract infection their Aetna member account Click on “Plan from an employer” on the
• Respiratory infection and search for providers that right hand side of page. Type in doctor
are in their plan network. To name, specialty or click an option listed,
• Sinus problems
begin searching, log in at and enter your zip code. When asked to
• Pediatric care select a plan, choose the following from
www.aetna.com.
• Cold and flu symptoms the drop down menu:
2. MEMBER SERVICES
• Allergies Medical – Choose the following network:
Call member services and
• Bronchitis they can help you find an • OAMC PPO and OAMC HSA: Under
• Pink eye in-network doctor that is Aetna Open Access Plans choose
• Ear infection convenient for you. Give “Managed Choice POS (Open Access)”
• Dermatology (psoriasis, acne, moles, them a call at: Dental – Choose the following network:
rosacea and more) Medical • DMO: DMO/DNO
• Therapist (anxiety, depression, stress, • OAMC PPO: 877-204-9186 • DPPO: Dental PPO/PDN with PPOII
panic disorder and more) • OAMC HSA: 877-204-9186
Dental
• DMO/PPO: 877-238-6200
2020 BENEFITS • P8
aetna member portal maternity program
When you’re an Aetna member, you get tools and You get the Aetna Maternity Program with your Aetna health
resources to help you easily manage your health and your benefits and insurance plan. You can use it throughout
benefits. All of your health benefits and health insurance your pregnancy, and even after your baby is born. We will
plan information and cost-savings tools are in one place. make information for a healthier pregnancy available to
Once you’re a member, you can easily: you, including:
•F ind the right doctor – and save money. Locate • Care during pregnancy
in-network doctors who accept your plan. • Preterm or early labor symptoms
• Manage prescriptions. Find a pharmacy, order • What to expect before and after delivery
medicine, see what’s covered, learn side effects and • Newborn care – and more
ask a pharmacist.
•S ee what you owe. Look up claims to see how The program will also provide guidance and
much the plan paid and what you may have to pay. support for:
• Know your plan. Check who is covered by your plan • High-risk pregnancies
and what it covers. • Follow-up calls after your delivery
•G et valuable information. See which doctors and • A screening for depression
hospitals have met extra standards for quality and • Extra support for lactation and breastfeeding
efficiency.
• Lower your risk for early labor
• Know costs before you go. See cost estimates
before you make an appointment for an office visit, • An online source: http://womenshealth.aetna.com
test or procedure. Why not give your baby the healthiest start
•C heck your health accounts. Easily look up your possible? Sign up today.
health savings account. • Call us toll free at 1-800-CRADLE-1 (1-800-272-3531),
Please note that if you are enrolled on the Aetna Member weekdays from 8:00am – 7:00pm EST.
Portal, you will receive a digital ID card only, no hard copies • Or log in to your secure member website (Aetna
will be mailed. Sign up at www.aetna.com once you are an Member Portal) at www.aetna.com, and look under
Aetna member. Then you can start using the Aetna Member “Stay Healthy”.
Portal’s valuable features and tools.
aetna mobile app
When you’re an Aetna member, you get tools and resources
to help you easily manage your health and your benefits.
All of your health benefits and health insurance plan
information and cost-savings tools are in one place.
Download the free app:
• From the Apple Store • From Google Play
P9 • 2020 BENEFITS
dental
The following chart summarizes the benefits for the dental plans offered to all eligible employees of Dermalogica. As an
eligible employee, you may choose from one of the following plans.
ADA Code Aetna DMO Aetna PPO
Group #: 847288 In-Network In-Network Out-of-Network
Annual Deductible None $50 per member $75 per member
(waived for preventive care) $150 per family $225 per family
Annual Benefit Maximum None $2,500 per person $2,500 per person
Preventive & Diagnostic Services
Prophylaxis (Cleaning) D1110 No charge Plan 100% You 0% Plan 90% You 10%
Bitewing X-Rays D0210 No charge Plan 100% You 0% Plan 90% You 10%
Basic Services
Amalgam Restoration (Filling) one surface D2140 No charge Plan 80% You 20% Plan 70% You 30%
Scaling & Root Planing - Per Quadrant D4341 $37 copay Plan 80% You 20% Plan 70% You 30%
Root Canal, Molar D3330 $161 copay Plan 80% You 20% Plan 70% You 30%
Major Services
Porcelain Crown D2752 $207 copay Plan 50% You 50% Plan 40% You 60%
Orthodontic Benefits – Child D8080 $1,545 copay Plan 50% You 50% Plan 50% You 50%
Orthodontic Benefits – Adult D8090 $1,545 copay Plan 50% You 50% Plan 50% You 50%
Orthodontic Lifetime Maximum Benefit N/A $1,500 $1,500
Cost Per Pay Period
Employee only $1.73 $5.19
Employee + 1 $5.85 $21.57
Employee + 2 or more $13.81 $24.84
Dental Maintenance Organization (DMO)
The DMO features unlimited benefits but does require a copay for
most covered procedures. Examples of copays are provided in
the chart above. If you elect coverage in this plan you must select
a contracted dentist from the DMO Provider list. All care must be
provided by the primary care dentist. To find an Aetna Network
Provider, please see page 8 of this Benefit Guide. The Aetna DMO
plan is not available in AK, AL, AR, LA, ME, MS, MT, ND, NH, SC,
SD, VT and WY.
NOTE: Some areas may not be eligible for the DMO as it is zip
code based. For more information, please contact Aetna Dental
at 877-238-6200.
Dental Preferred Provider Organization (DPPO)
The Dental PPO allows you to choose an in-network or out-of-network
provider. When visiting an out-of-network dentist, please remember
that you are responsible for amounts in excess of charges above the
allowable amounts. Out-of-network dentists are not contracted with
the carrier; therefore, members may expect to pay more for utilizing
a dentist outside of the network. To find an Aetna Network Provider,
please see page 8 of this Benefit Guide.
2020 BENEFITS • P10vision
The following chart summarizes the benefits for the vision plan offered to all eligible employees of Dermalogica.
EyeMed Vision
Group #: 9772245 In-Network Out-of-Network
Basic Eye Exam $10 copay Plan pays up to $49
$150 allowance + 20% off remaining
Frames Plan pays up to $105
balance
Lenses
Single Vision No charge Plan pays up to $35
Bifocal Lenses No charge Plan pays up to $49
Trifocal Lenses No charge Plan pays up to $74
Medically Necessary Contacts (in lieu of lenses) No charge Plan pays up to $200
Elective Contacts (in lieu of lenses) $150 allowance Plan pays up to $150
Frequency (based on last date of service)
Eye Exams Every 12 months
Frames Every 12 months
Lenses Every 12 months
Cost Per Pay Period
Employee only $2.16
Employee + 1 $6.09
Employee + 2 or more $9.93
Vision Value-Adds
• To see a list of participating providers near you, log on to
www.eyemed.com and choose SELECT from the provider
locater dropdown box. You can also call 866-939-3633.
• Members will receive a 20% discount on remaining balance at
participating providers beyond plan coverage; this does not
pertain to disposable contacts.
• Save 15% off the retail price or 5% off the promotional price for
LASIK or PRK procedures.
• Discounts on hearing aids and exams through Amplifon.
Sun Perks
With Sun Perks through EyeMed, you’ll receive $20 off any
purchase, or $50 off a purchase of $200 or more toward premium,
non-prescription sunglasses at Sunglass Hut (some limitations
apply, see the flyer on the benefits website for more details).
We make it easy for you to take this extra step to protect your eye
health. Simply redeem your sun savings online at sunglasshut.com
or at any participating Sunglass Hut store. For more information,
log in to the benefits website and view the Sun Perks flyer posted
under the vision section.
2020 BENEFITS • P11life/ad&d
Basic Life/AD&D
Dermalogica provides all active employees with a basic life insurance
and accidental death and dismemberment (AD&D) benefit* of 1.5x your
annual salary up to a maximum of $500,000. This benefit provides
valuable income protection in the case that you suffer a severe accident
or loss of life. You and your spouse/domestic partner may be eligible to
receive up to 75% of your life insurance coverage, if diagnosed with a
terminal or serious medical condition. You can download a complete
Benefit Summary from the benefits website.
Voluntary Life/AD&D
As an employee of Dermalogica, you have the option of purchasing
additional life insurance for yourself, spouse/domestic partner and/or
children. When you purchase additional life insurance, it includes the
same amount of accidental death & dismemberment insurance. When
you enroll yourself and your dependents in this benefit, you pay the full
cost through post-tax payroll deductions. Please note that you may need
to complete an evidence of insurability form if you elect an amount above
the guaranteed issue or if you declined to enroll at your initial eligibility
date. Employees need to elect coverage before they can elect coverage
for a spouse/domestic partner or child(ren). You and your spouse/
domestic partner may be eligible to receive up to 75% of your life insurance Voluntary Life/AD&D Premium Example:
coverage if diagnosed with a terminal or serious medical condition. You Employee age 35 who wants $50,000 of
can download a complete Benefit Summary from the benefits website. Voluntary Life/AD&D Coverage
Employee ($50,000 / $1,000 ) x $0.11 = $5.50 per month
Coverage Option: $10,000 Increments *There is an age reduction schedule
Guarantee Issue Amount: $150,000*** that reduces the benefit at age 65+.
Maximum Amount: $500,000 or **Spouse/Domestic Partner and Child
Coverage
5x salary, whichever is less coverage only available if Employee amount Rate
has coverage under this plan. Spouse
Spouse/Domestic Partner** coverage terminates at age 70.
Unmarried children are eligible for
Coverage Option: $5,000 Increments coverage from 14 days to age 26. Voluntary Life and AD&D Monthly Premiums
Guarantee Issue Amount: $30,000***
Maximum Amount: $100,000 or 100% *** Evidence of Insurability is required
for all amounts if you decline to enroll Age Employee Cost Spouse Cost
of employee benefit, whichever is less at your initial eligibility date. per $1,000 per $1,000
Child(ren)** Under age 30 $0.07 $0.07
Coverage Option: $10,000 30 – 34 $0.08 $0.08
Guarantee Issue Amount: $10,000*** 35 – 39 $0.11 $0.11
40 – 44 $0.17 $0.17
45 – 49 $0.23 $0.23
50 – 54 $0.44 $0.44
Naming Your Beneficiary
55 – 59 $0.66 $0.66
Dermalogica requires all eligible employees to designate at 60 – 64 $0.68 $0.68
least one primary beneficiary online in PlanSource. You may 65 – 69 $1.20 $1.20
name anyone as your beneficiary to receive your Life and 70 - 74 $3.13 $3.13
AD&D benefits in case of your death. Once you have named 75 - 79 $12.63 $12.63
your beneficiary, your designation will remain unchanged until
you change it. You may change your beneficiary as often as Child(ren) - Per
$0.22 per $1,000
Family Unit
you wish.
Spouse rate based on employee age.
2020 BENEFITS • P12employee assistance plan (eap)
The EAP, administered by Mutual of Omaha, is a free, • Eldercare – Nursing homes, assisted-living facilities,
confidential program that provides you with information independent living facilities, home healthcare, hospice,
and resources to help you deal with life’s problems. respite care, geriatric care managers, senior centers,
You’ll get a 24-hour toll-free number, short-term problem adult day care centers, community services, resources.
resolution, unlimited critical incident stress debriefing and 3 • Legal – Family law issues, real estate, criminal matters,
face-to-face sessions per year. You will also will have access estate planning, motor vehicle, elder law.
to the online Work/Life resource center with
detailed information to help you with: • Financial – Debt management, budgeting, college
funding, retirement strategies, life insurance needs.
• Childcare – Child care centers, family child care
homes, nanny agencies, summer camps, babysitter • Identity Theft Assist – Online resources and consultation
tips, community resources. with a fraud recovery specialist.
• Learning Center – Life Lessons to improve your mental
and physical health; and relationships at work and at
home. Listen, read, assess and make plans using the
information and interactive tools online.
• Resource Links – Access more than 4,000 continually
updated articles and “Best of Web” resource links.
IT’S EASY TO GET STARTED.
Go to mutualofomaha.com/eap or call toll-free at
800-316-2796, 24 hours a day, 7 days a week.
long term disability 401(k)
Dermalogica provides you with an employer paid plan for
Long Term Disability coverage. This coverage provides
group #: 32097
financial assistance if you are unable to work for an With our 401(k) retirement
extended period of time due to an illness or injury. savings plan through Fidelity,
Dermalogica has established
a tax-favored program that will
Long Term Disability
help you save for retirement.
Here are some of the highlights
Employee
of our 401(k) plan:
Coverage Option 60% of monthly salary Contribution Limit: You can
contribute up to 50% of your
Maximum Amount $14,000 / month pay. Your contribution must equal a
minimum of 6% of compensation to
Less Any Amount State Disabiility, receive the maximum employer match.
Payable by Social Security Income (SSI) Waiting Period: There is no waiting period to begin
participating in the 401(k) plan. If you do not enroll in the
Elimination Period 180 days
plan within 60 days of eligibility, you will be automatically
enrolled at 6%. Contributions will automatically increase
Benefit Duration SSNRA – Social Security Normal
every year on April 1 by 1% to a maximum of 10%.
Retirement Age
Company Match: $0.50 for every dollar you contribute
Pre-existing 3 month look back; 12 month exclusion up to a maximum match of 3% of salary or IRS limit.
Conditions of pre-existing condition found during the
3 month look back Vesting: You are always fully vested in your employee
and company matching contributions.
2020 BENEFITS • P13flexible spending accounts (FSA)
The Flexible Spending Account (FSA) allows employees to set aside Limited Purpose Health Care FSA
pre-tax dollars for unreimbursed, qualified health care and dependent (for HSA Participants only)
care expenses. The money that is deposited into your FSA comes If you are enrolling in the Health Savings
directly from your gross pay, which reduces your taxable income. There Account medical plan and will be participating in
are three separate accounts and enrollment is completely optional. the funding option, you may enroll in the limited
purpose FSA plan. This plan will allow you to
use the FSA funds for dental, vision and other
Health Care FSA
expenses except medical.
You may set aside up to $2,700* per year; these funds may be used
during the plan year (January 1, 2020 to December 31, 2020). Use Dependent Care FSA
the FSA to pay yourself back for out-of-pocket medical, dental and Dependent care expenses are those which
vision expenses that your plan doesn’t cover. Transportation and other allow you to pay a licensed caregiver to take
travel costs for medical care may also be covered. Please note that care of your children or an adult dependent
over-the-counter medications, without a prescription, are not considered while you work. You may put aside up to the
max of $5,000 ($2,500 each if your spouse
an FSA eligible expense. Most importantly—always keep your receipts!
also has a Dependent Care account).
$500 Rollover (Health Care FSAs and Limited Purpose FSAs) Commuter & Parking FSA
Current participants can roll over up to $500 of unused health FSA funds This program allows you to redirect a portion
for use in the next plan year. Here is how it works: First, you have until of your paycheck to pay for Transit Passes,
the end of March 2021 (2020 run-out period) to file any remaining health Parking and Commuter highway vehicle
FSA claims for services in 2020 (January thru December 31, 2020). Any expenses on a pre-tax basis through the
funds that can be rolled over will be calculated in April 2021. You will still FSA plan.
have access to these funds after April 2021, even if you do not re-enroll in Expense Limitations Include*:
the plan. If you wish to continue your enrollment, you can roll-over up to • Transportation: $265
$500, and still elect the maximum for the new plan year! • Qualified Parking: $265
*IRS limits may change. Please review to www.irs.gov for the most up-to-date IRS limits, rules and regulations.
2020 BENEFITS • P14pet discount program
The pet care discount program through United Pet Care puts an end
to deductibles and frustrating claim forms that traditional pet insurance
requires. As a United Pet Care member, you simply take your pet to the
vet as often as you need and instantly save 20-50% on everything from
check-ups, vaccines, skin treatments, and surgeries.
United Pet Care Pet Savings Program Note: It is the member’s responsibility to seek
services with a United Pet Care contracted
# of Pets Preferred Select Partner facility, provider, and specialist. Non-contracted
facilities, providers and specialists do not
1 pet $12.50 $10.75 $12.50
2 pets $24.20 $20.60 $24.20
recognize United Pet Care discounts.
3 pets $35.60 $30.30 $35.60 For more details and to enroll, call 888-781-6622
Additional 1 pet $11.30 $9.70 $11.30
or visit www.unitedpetcare.com/dermalogica.
legal & identity theft
Comprehensive Legal Plan
Legal Shield offers a pre-paid legal plan that allows you to consult an
experienced lawyer whenever you and/or your family encounter a legal
issue, major or minor. Members are given access to a nationwide network
of Provider Law Firms prepared to advise in a number of areas. Benefits
include:
• Advice on any personal legal matter, even on preexisting conditions
• 24/7 emergency assistance
• Legal document review, up to 15 pages each
• Trial defense hours assistance if you or your spouse is named Identity Theft Plan - Shield
defendant or respondent in a covered civil action suit Legal Shield’s comprehensive identity theft plan
• Will preparation and review monitors for signs of criminal activity and gives
• Residential loan document assistance you all you need to keep your identity secure from
• Uncontested name change, adoption, separation and divorce thieves and fraud. Benefits include:
representation • Comprehensive restoration services
• IRS audit assistance • Live member support
• Speeding ticket assistance • Unlimited identity theft consultation
• 25% off additional various legal services • Experian credit monitoring and activity alert
• Monthly ID updates
Legal Shield • Lost/stolen wallet assistance
• Reduced pre-approved card offers
Comprehensive Legal Plan Cost • Data breach notifications
• Credit inquiry alerts
Per Month (Employee & Family) $18.95
• Credit report with score and analysis
Identity Theft Plan - Shield Cost • Quarterly credit score tracker
• Bank account number monitoring
Employee $8.95 • Passport number monitoring
Family $18.95 • SSN fraud detection
Legal and Identity Combined Cost For more information, call 800-654-7757 or visit
www.legalshield.com.
Employee $27.90
Family $33.90
2020 BENEFITS • P15voluntary worksite benefits
Dermalogica makes a broad array of voluntary benefits available to you
through UNUM. These voluntary coverages have unique features that are
highlighted below:
• Most benefits are paid directly to you unless otherwise specified.
• Individual coverage purchased through payroll deductions.
The coverage stays with you beyond employment.
• Most plans pay benefits regardless of other insurance coverage.
Choose from the following plans according to your needs:
voluntary accident voluntary critical illness
Dermalogica provides employees the opportunity to purchase Critical Illness Insurance compliments your major medical
Voluntary Accident Insurance. This policy is designed to help coverage by providing a lump sum benefit you can use to
employees deal with the out-of-pocket costs of medical pay the direct and indirect costs related to a covered critical
treatment for accidental injuries, from everyday incidents to illness. This product focuses on critical illnesses like heart
catastrophic events. attack, stroke, end-stage renal failure or a major organ
transplant. This plan pays a lump sum benefit for diagnosis
Accident Coverage Rates of a covered critical illness.
Accident Benefit
Critical Illness Coverage (Rates per $1,000 of coverage)1
Employee only $12.31
Age Employee Spouse Child2
Employee + SP/DP $19.72
Employee + Child(ren) $24.40 < 25 $0.58 $0.58 included
Employee + Family $31.81
25-29 $0.63 $0.63 included
Hospitalization Due to Covered
30-34 $0.83 $0.83 included
Sickness Benefit
35-39 $1.13 $1.13 included
Employee $2.29 per $100 of coverage
40-44 $1.60 $1.60 included
Spouse $2.29 per $100 of coverage
Dependent Children $2.48 per $75 of coverage 45-49 $2.20 $2.20 included
50-54 $2.90 $2.90 included
voluntary short-term 55-59 $3.82 $3.82 included
disability (STD) 60-64 $4.89 $4.89 included
65-69 $5.50 $5.50 included
Short-Term Disability insurance assists in replacing a portion 70+ $9.86 $9.86 included
of your income if you become unable to work because of a
covered accident or illness. With UNUM, you may customize 1. N
on-Tobacco user rates shown, please reference your Unum
your Short-Term Disability plan according to what best fits brochure for tobacco rates
your needs. For rates, log in to PlanSource. 2. C
hild insurance is automatic. A separate premium is not required
Please log in to PlanSource for rates and complete summaries.
2020 BENEFITS • P16mutual of omaha value added services
When you enroll in one of our Mutual of Omaha benefit plans,
you are eligible to take advantage of the following value
added services.
worldwide travel assistance
Experiencing an emergency while traveling can be especially
difficult. Knowing who to call for medical problems, currency
exchange issues or lost luggage is critical. Take comfort in
knowing that Travel Assistance travels with you worldwide!
Minimize travel hassles by calling pre-departure for:
• Foreign travel documentation requirements such as
passports or visas
• Travel/health advisories and inoculation requirements for
foreign countries
• Domestic and international weather forecasts
• Daily foreign currency exchange rates
• Consulate and embassy locations
Immediate assistance with emergencies while traveling:
While traveling more than 100 miles from home you may
access a travel assistance professional 24/7 by calling the
toll-free number for immediate help.
medical assistance will preparation service
• Locating medical providers and referrals Willing is a service that provides free, online will preparation
services to employees who have life insurance coverage with
• Communicating your medical status with family,
physicians, employer, travel company and consulate Mutual of Omaha. It’s a benefit that helps you invest in the
future and protect what’s important. Willing uses bank-level
• Emergency evacuation if adequate medical facilities are security to keep your information safe and secure. In just 10
not available, including payment of covered expenses
minutes, you can create a personalized will. The process is
• Transportation home for further treatment. In the event easy and it’s free! Here’s how it works:
of death, assist in the return of mortal remains
• Log on to www.willing.com/mutualofomaha
• Transportation arrangements for the visit of a family mem-
ber or friend, or the return home for dependent children • Answer simple multiple choice questions on a computer or
if your hospitalization is more than seven calendar days smartphone
• Assistance with lodging arrangements if convalescence • Download and print any document instantly
is needed prior to, or after, medical treatment • Update information with any major life change
• Coordination with your health insurance carrier during a
medical emergency
• Assistance obtaining prescription drugs or other necessary
medical items
Services are available for business and personal travel
24 hours a day, seven days a week.
For inquiries within the U.S. call toll free, 800-856-9947.
If you are outside the U.S. call collect, 312-935-3658.
2020 BENEFITS • P17long term care
Long Term Care (LTC) through UNUM is income protection
coverage that you may use in the event that you’re
incapacitated/disabled and unable to perform functions
of daily living such as bathing, dressing, transferring,
continence and eating. LTC helps you pay for care received
either at home or in a facility.
• Adults age 18 to 80
• Guaranteed issue only available to new hires
• You may purchase $3,000, $4,000 or $6,000 of benefit
per month for 3 or 6 years
• You may also add compound inflation protection to your
coverage
For more information, call 800-227-4165
or visit unuminfo.com/dermalogica.
product allocation
Dermalogica employees are provided • Regular full-time emloyees working 30 or more hours per week will receive up
with an excellent product allocation to $100 wholesale value of free products once per month.
benefit. The monthly allocation is • Employees working less than 30 hours per week [i.e. part-time], interns, and
calculated at wholesale price. temporary employees will receive up to $50 wholesale value of free products
once per month.
This benefit begins your very 1st month!
2020 BENEFITS • P18how to enroll using plansource
With our benefits website and our online enrollment
accessing plansource
system (powered by PlanSource), you can view our New Users
benefit offerings, learn about the plans, their costs, Once in PlanSource, your username is the first initial of
your first name followed by up to the first six characters
and select what is best for you and your family. You will
of your last name and then the last four digits of your social
have instant access to all of your benefits and personal security number (SSN) with no spaces and no hyphens.
information and can visit the site at any time during the For example, if your name is Jane Anderson and the last
year to view your plan selections. Follow the easy steps four digits of your SSN is 1234, your username would be
janders1234.
outlined on the next pages and your enrollment will be
complete. Your password is your birthday in YYYYMMDD format.
For example, if you were born on May 1, 1973, your
password would be 19730501. At the time of your initial
login, you will be prompted to change your password.
start at our benefits website Follow the instructions on the screen and enter your
To view our plan options, learn more about what each plan initial password, your desired new password, and your
has to offer and review costs, start at our benefits website. desired new password a second time for confirmation.
Log in to: Once you have changed your password, you will use
dermalogicabenefits.com your new password, along with your username, to
username: dermalogica access your account.
password: wellness
Returning Users
Once you have logged into the benefits website, review your You will need the username and password you created
plan options, eligibility and more. when you first logged on to the site. If you can’t remember
your username and password, click the “Forgot your
When you are ready to enroll, select “Enrollment Instructions” Password?” link. You will be asked to enter your username
from the “Enrollment” drop down menu at the top right of and email associated with your account.
the screen. Click on the blue “Enroll Now” button to log into
the PlanSource enrollment system where you will complete
your enrollment. welcome screen
Be sure to review each benefit and the plan details before
choosing which plan is right for you. You can only make
changes once each year unless you have a Qualifying Life
Event. To begin, click on “Get Started” to begin managing
your benefit enrollment.
2020 BENEFITS • P19complete your enrollment
4 Easy Steps to Complete Your Enrollment
1. Review your personal information.
2. Add, review or change your dependent(s). Please note that you will need your dependents’ SSN in order to enroll online.
3. Enroll in your benefits and add your beneficiary information.
4. Review and confirm your selections.
step 1
Review your personal information.
Under “Your Info” review your personal
information, then click continue.
If any changes need to be made to this
information, please access your ADP Workforce
Now portal. Examples include, address and/or
phone numbers.
Click “Next: Review My Family”.
step 2
Add, review or change your dependent(s).
Add your dependent(s). Review/edit if you are
a returning user.
You will be required to enter the following for
each dependent:
• Full Name • Social Security Number
• Date of Birth • Relationship to Employee
• Gender
Once you have completed reviewing/adding
your dependents, click “Next: Shop for
Benefits”.
Please Note: Unless you want to remove your
dependents from ALL plans, do not click the
“Remove Coverage” under each dependent.
You will need to go into each benefit section
to remove the dependent from that specific
coverage.
2020 BENEFITS • P204 easy steps continued
step 3
Enroll in your benefits and add your
beneficiary information.
Enroll you and your dependent(s) into each
benefit offering or decline coverage (after
each benefit selection, click continue).
Review, change or add your beneficiary
information and click “Review and Checkout”.
step 4
Final Review.
Review your personal and dependent
information, benefit selections, and costs to
ensure all the information and selections are
correct, then click the “Checkout” button
at the bottom of the page to complete your
enrollment.
To make any adjustments to your elections,
click on the “Enroll in Benefits” link in the left
column.
Important Note: Before you log out, remember
to click the “Checkout” button to complete your
enrollment process. Once you have confirmed
your enrollments, please be sure to print a copy
of your benefit statement for your records.
2020 BENEFITS • P21While every effort has been made to ensure accuracy of this
benefits guide, the plan documents and contracts will prevail in
case of discrepancy between this guide and the plan documents
© USI 2020 and contracts. In addition, the company reserves the right to
USI Insurance Services LLC | CA License #0G11911 modify or terminate any benefit plans at any time.
The information in this booklet constitutes a Summary of Material
Modifications (SMM). Please retain this guide for reference.You can also read
