2020 Benefits Summary - MEDICAL DENTAL VISION LIFE INSURANCE DISABILITY 401(k) RETIREMENT
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Benefits Summary
2020
MEDICAL
DENTAL
VISION
LIFE INSURANCE
DISABILITY
FSAs
401(k) RETIREMENT
PLAN
Milwaukee Bi-Weekly 2020 NEXT u
TTI Benefits Summary 3
TABLE OF CONTENTS
Introduction to the TTI Benefits Program............................................................................................................................. 4
Core Benefits and Additional Coverage................................................................................................................................. 4
TTI Benefit Program Eligibility....................................................................................................................................................5
TTI Benefit Enrollment Events....................................................................................................................................................5
TTI Medical Plans.............................................................................................................................................................................6
TTI Prescription Drug Plan...........................................................................................................................................................7
TTI Flexible Spending Accounts................................................................................................................................................8
TTI Dental Plan..................................................................................................................................................................................9
TTI Vision Plan.................................................................................................................................................................................10
TTI Life Insurance Plan.................................................................................................................................................................. 11
TTI Disability Program................................................................................................................................................................. 12
Plan ID & Debit Cards................................................................................................................................................................... 13
TTI 401(k) Plan................................................................................................................................................................................ 14
Other TTI Benefit Programs....................................................................................................................................................... 15
IRS Plan Limits for TTI Benefits Programs........................................................................................................................... 16
Contact Information...................................................................................................................................................................... 16
2020 Milwaukee Contribution Schedule............................................................................................................................... 17
t BACK NEXT u
TTI Benefits Summary 4
INTRODUCTION TO THE TTI BENEFITS PROGRAM
Your benefits are a valuable part of the awards
of working at TTI. To make the most of your
benefits, you need to understand how they
work. This summary is an introduction to some
of the basic information that you need to make
informed decisions on which plans are best for
you and your family. Plan details and official
documents can be found in the Summary Plan
Description and the accompanying Summary of
Material Modifications documents.
TTI provides a basic level of benefits coverage,
called “Core Benefits”, as well as the opportunity
to enroll in “Additional Coverage” for yourself and
your family. For most plans, coverage is effective
on your first day of active employment.
Every effort has been made for this summary to accurately represent the content of TTI’s benefit
programs. If differences exist then the formal plan documents will govern. Nothing in this document or
any written or verbal statements by a company representative may alter the content of the formal plan
documents.
TTI CORE BENEFITS AND
ADDITIONAL COVERAGE
TTI Core Benefits TTI Additional Benefits
Core benefits provided at no cost to Additional benefits are:
you are:
lM
edical—Choice of 3 plans; including a High Deductible Healthcare
lS
hort Term Disability Coverage Plan (HDHP) that is HSA qualified
(STD)
lF
lexible Spending Account (FSA)—both Healthcare and
lB
asic Life Insurance—Equal to 2X Dependent Day Care FSAs
your annual base pay
l Dental
lB
asic Accidental Death and
l Vision
Dismemberment Insurance—Equal
to 2X your annual base pay l Supplemental Life and AD&D for you, your spouse, and children
l Business Travel Accident Insurance l Auto and Home insurance coverage
lL
ong Term Disability Insurance— l LiveHealth Online—when enrolled in medical coverage
covers 60% of your annual base pay l4
01(k) with pre-tax, ROTH and after-tax options including a
generous company match
t BACK NEXT u
TTI Benefits Summary 5
TTI BENEFIT PROGRAM ELIGIBILITY
Eligible Employees
All regular full and part-time TTI employees are
eligible for TTI Benefits. Temporary employees
are eligible to participate in the TTI 401(k) Plan
regardless of hours worked.
Eligible Dependents
The legal spouse and children of eligible TTI
employees may be enrolled in TTI Benefits.
TTI BENEFIT
ENROLLMENT EVENTS
There are three events that will allow you to
enroll in or make changes to your TTI Benefits.
Those events are:
Open The 2020 Open Enrollment runs from October 28, 2019 through November 11, 2019.
Enrollment Benefit elections during this period will be effective January 1, 2020.
New Hire Event Eligible employees may elect benefits within 30 days of their hire date. New hire
elections are effective on the date of hire.
Qualifying TTI Benefits may be elected on or up to 30 days after the occurrence of a
Life Event Qualifying Life Event. Qualifying Life Event elections are effective on the date that
the event occurred.
Examples of Qualifying Life Events are marriage, adoption, birth, death, divorce,
and loss of other insurance coverage.
Important Reminder:
You are responsible for ensuring that your dependents meet the eligibility requirements of all the
plans you enroll in. TTI conducts audits to confirm eligibility.
t BACK NEXT u
TTI Benefits Summary 6
TTI MEDICAL PLANS
TTI offers three comprehensive Preferred Provider Organization (PPO) Medical Plans through
Anthem/Blue Cross Blue Shield (BCBS). All TTI Medical Plans offer access to the same PPO
network and broad list of services. When enrolled in any TTI Medical Plan, prescription drug coverage is
provided through Express Scripts.
TTI Medical Plan Summary of Plan Benefits
The table below describes the TTI Medical Plan Network and Non-Network deductibles, out-of-pocket
maximums, and coinsurance percentages. For a full description of plan costs and services, please refer
to the TTI Medical Plan section in the Benefits Summary Plan Description.
Plan 1 Plan 2 Plan 3 (HDHP)
Non- Non- Non-
Network Network Network Network Network Network
Deductible
Individual $500 $1,000 $1,000 $2,000 $1,400 $2,800
Family $1,000 $2,000 $2,000 $4,000 $2,800 $5,600
Out-of-Pocket Maximum
Individual $2,500 $5,000 $3,500 $7,000 $4,500 $10,000
Family $5,000 $10,000 $7,000 $14,000 $6,650 $20,000
Coinsurance Percentage
Plan Pays 80% 60% 80% 50% 80% 50%
Member Pays 20% 40% 20% 50% 20% 50%
Important Reminder:
Medical Plan 3 is a High Deductible Health Plan (HDHP) that allows an employee to enroll for a
tax-free savings account known as a Health Savings Account (HSA). Except for a limited list of
preventive services, all services under Plan 3, including prescription drugs, will not be paid until
you have satisfied your annual deductible.
You should carefully review all the requirements before enrolling in Plan 3. Please refer to the TTI
Medical Plan section in the Benefits Summary Plan Descriptions for more details.
Key features of an HSA: lF
unds deposited into your account can earn
interest, be invested, and be used tax-free for
l Available with Medical Plan 3 only
qualified health, Rx, dental and vision care
lP
re-tax contributions up to $3,550 expenses.
single/$7,100 family. An additional
lS
hould you leave the company, you can take your
$1,000 may be contributed if age 55
HSA account and the funds in it with you.
or older.
For a full description HSA features, please refer to the HSA section in the Benefits Summary Plan
Description.
t BACK NEXT u
TTI Benefits Summary 7
TTI Prescription Drug Coverage Summary Table of Plan Benefits
The table below describes the TTI Medical Plan Network prescription drug costs. For a full description
plan costs and services, please refer to the Prescription Drug Benefits section in the Benefits Summary
Plan Description. This plan does not provide for any Non-Network benefits.
Prescription Drug Retail (up to 30-day supply) Mail Order (up to 90-day supply)*
You Pay You Pay
Generic $10 Copay $25 Copay
Preferred 25% Copay 25% Copay
$30 Minimum $75 Minimum
$75 Maximum $150 Maximum
Non-Formulary 40% Copay 40% Copay
$50 Minimum $125 Minimum
$155 Maximum $300 Maximum
Trend Management Programs Traditional Prior Authorization
Step Therapy
Quantity Duration
*You are allowed two courtesy refills at a retail pharmacy before you must use the mail order program. After two
retail refills, you will be responsible for 100% of the cost of the medication.
Important Reminder:
Medical Plan 3 is a High Deductible Health
Plan (HDHP). All costs for prescription drugs,
will be your responsibility to pay until you
have satisfied your annual deductible.
You should carefully review all the
requirements before enrolling in Plan 3. Please
refer to the TTI Medical Plan section in the
Benefits Summary Plan Description for more
details.
t BACK NEXT u
TTI Benefits Summary 8
TTI FLEXIBLE SPENDING ACCOUNTS
(FSAs)
TTI provides you with the opportunity to pay
for out-of-pocket medical, dental, vision and
dependent day care expenses with pre-tax
dollars through Flexible Spending Accounts, or
FSAs. Contributions to your FSA are deducted
before any taxes are taken out of your paycheck,
which means that you never pay taxes (Federal,
Social Security, State and Local) on contributions
to your FSA. Some states may tax FSA
deductions
The table below describes the Health Care and
Dependent Day Care FSAs. For a full description
plan costs and services, please refer to the
TTI Flexible Spending Account section in the
Benefits Summary Plan Description.
Key Features of the l Not available with Medical Plan 3
Heath Care FSA l Employee’s may defer pre-tax contributions up to $2,700 (2020).
l Funds can be used to reimburse out-of-pocket medical expenses
incurred by you and your dependents.
Key Features of the l A Dependent Day Care FSA is used to reimburse expenses related to
Dependent Day Care FSA care of eligible dependents while you and your spouse are at work.
l The maximum that you can contribute to the Dependent Day Care
FSA is $5,000
l Dependent Day Care FSA cannot be used for dependent child
health care expenses. You must elect the Health Care FSA for those
expenses.
Important Reminder:
It is important that you calculate your contribution amount carefully. Remember you can only get
reimbursed for eligible out-of-pocket expenses incurred in the 2020 calendar year. TTI Health Care
FSA Plan allows you to carryover up to $500 of unused Health FSA dollars from one year into the
next year. Any unused Health FSA dollars above $500 and all unused Dependent Day Care FSA
dollars are forfeited.
t BACK NEXT uTTI Benefits Summary 9
TTI DENTAL PLAN
The TTI Dental Plan covers a wide
range of services including diagnostic
and preventive care, restorative services, major
procedures and orthodontia.
TTI Dental Plan Summary Table
of Plan Benefits
The table below describes the Network and
Non-Network Deductibles, annual maximums,
and costs of common services covered under
the TTI Dental Plan. For a full description of
plan costs and services, please refer to the TTI
Dental Plan section in the Benefits Summary
Plan Description.
Network Non-Network
Annual Maximum Per Person $1,500
Annual Deductible $50 Individual $50 Individual
$150 Family $150 Family
Diagnostic & Preventive—Exams, 100% No Deductible, 100% No Deductible,
Cleanings, X-Rays, Sealants, Fluoride Limit 2 Exams Per Year Limit 2 Exams Per Year
Basic Restorative Procedures 80% 80%
Major Restorative Procedures 50% 50%
Major Services— 50% After Deductible 50% After Deductible
Crowns, Bridges, Implants
Child Orthodontia $1,500 Lifetime Maximum, Age 26 Limit
100% After Deductible
t BACK NEXT uTTI Benefits Summary 10
TTI VISION PLAN
The TTI Vision Plan covers a wide range of services including routine eye exams and new
glasses or contact lenses.
TTI Vision Plan Summary Table of Plan Benefits
The table below describes the Network and Non-Network Coverages, annual maximums, and costs
of common services covered under the TTI Vision Plan. For a full description plan costs and services,
please refer to the TTI Vision Plan section in the Benefits Summary Plan Description.
Vision Benefits Network Coverage Non-Network Coverage
Copay $10 Per Exam N/A
Annual Maximum None
Exam Coverage 100% Less Copay Up to $50 Reimbursed
Frame Coverage—every 2 years $175 Up to $70 Reimbursed
Lens (Pair)—annually Glass or Plastic
l Single Vision 100% Up to $50 Reimbursed
l Bifocal 100% Up to $75 Reimbursed
l Trifocal 100% Up to $100 Reimbursed
l Polycarbonate 100% $0
Contact Lenses $175 Allowance
l Elective
Contact lens allowance applies
l Diagnostic, Fitting & Evaluation
Additional Options/Costs
l Standard Progressive Lenses Contact VSP Customer Service at 800-877-7195 to discuss pricing
questions
l Scratch Resistant Coating Controlled pricing, varies by service
l Tints
l Other Add On Items Up to 15% discount
l Lasik/Laser Surgery Discount
Provider Network Most independent N/A
vision care providers
Frequency of Benefits
l Vision Exam Every 12 Months
l Frame Every 24 Months
l Lenses or Contacts Every 12 Months
t BACK NEXT uTTI Benefits Summary 11
TTI LIFE INSURANCE PLAN
TTI’s Life Insurance Plan offers several types of financial protection for you and your family if
you should die or be injured in an accident.
TTI Life Insurance Plan Summary Table of Plan Benefits
The table below describes Basic & Supplemental Life Insurance, Accidental Death & Dismemberment
(AD&D), and Business Travel Accident coverages covered under the TTI Life Insurance Plan. For a full
description of plan costs and coverage levels that may require you to provide evidence of insurability,
please refer to the TTI Life Insurance Plan section in the Benefits Summary Plan Description.
Type of Coverage Cost Amount of Coverage
Basic Life Insurance Company Paid 2X Basic Annual Earnings, $50,000 Minimum,
$400,000 Maximum
Basic AD&D Insurance Company Paid 2X Basic Annual Earnings, $50,000 Minimum,
$400,000 Maximum, $750,000 Maximum
Supplemental Employee Employee Paid 1X to 4X Basic Annual Earnings,
Life Insurance
Supplemental Spouse Employee Paid Options: $10,000; $25,000; $50,000;
Life Insurance $100,000; $150,000; $200,000
Supplemental Child Employee Paid $10,000 Per Child
Life Insurance
Supplemental Employee Employee Paid $25,000 increments ranging from $25,000 to $300,000;
AD&D Insurance Not to exceed 10x Basic Annual Earnings
Supplemental Spouse & Employee Paid Spouse Only—Equals 100% of Employee Supplemental;
Child AD&D Insurance Spouse & Children—Equals 100% of Employee
Supplemental for Spouse and 15% for Children;
Children Only—Equals 15% of Employee Supplemental
Business Travel Company Paid Basic life insurance equal to 2X your basic
Accident Insurance annual earnings—rounded to the next higher $1,000;
Minimum of $50,000 to a maximum of $400,000;
t BACK NEXT uTTI Benefits Summary 12
TTI DISABILITY
PROGRAM
TTI provides two levels of income protection
for employees, Short-Term Disability (STD)
and Long-Term Disability (LTD).
TTI Disability Plan Summary
Table of Benefits
The table below describes the STD and
LTD benefit programs. For a full description
of these programs, please refer to the
TTI Disability Program section in the
Benefits Summary Plan Description.
STD STD replaces all or part of your income if you are unable to work due to a non-work-related
illness or injury. For an approved disability, you can receive STD benefits for up to 180 days.
STD benefits may vary depending upon your employment status and years of service.
Contact your Human Resources Representative to confirm which STD schedule applies to you.
LTD If you are still unable to work after 180 calendar days of continuous disability, then you
may be eligible for LTD coverage if enrolled. If your LTD claim is approved, you may receive
monthly LTD benefits equal to 60% of your annual base pay.
t BACK NEXT uTTI Benefits Summary 13
PLAN ID & DEBIT CARDS
Medical & l Medical/Pharmacy ID cards are issued
Pharmacy by Anthem/Blue Cross Blue Shield.
l All employees and covered dependents
will receive new Medical/Pharmacy ID
cards in January of each year.
l For newly hired employees, ID cards
will arrive at the address on file within
3 to 4 weeks from the date you
confirm your elections.
l Temporary Medical/Pharmacy ID cards
can be downloaded after you register
at www.anthem.com.
Dental ID Cards l Delta Dental does not mail Dental ID cards.
l Temporary Dental ID cards can be downloaded at www.deltadentalwi.com
Vision ID Cards l VSP does not mail Vision ID cards.
l Log onto www.vsp.com to print your Vision ID card.
FSA Debit Card lW
hen you enroll in the Health Care FSA for the first time, you will be issued a
HealthEquity FSA Debit Card. The Debit Card will be mailed to the address on
file within 2 to 3 weeks after you confirm your enrollment.
HSA Debit Card lW
hen you enroll in an HSA for the first time, you will be issued a HealthEquity
HSA Debit Card. The Debit Card will be mailed to your address on file within
2 to 3 weeks after you confirm your enrollment.
t BACK NEXT uTTI Benefits Summary 14
TTI 401(k) PLAN
The TTI 401(k) Plan is a tax-qualified
savings plan to help you save for
your retirement. The Plan provides you with
the option to elect Pre-Tax, ROTH or After-Tax
options. Regardless of how you choose to save,
TTI provides you with a generous match. Your
contributions are automatically deducted from
each paycheck and deposited into your account
along with any Company match you may be
eligible to receive. Vesting on the Company
match is 100% and immediate. The Plan provides
you with a variety of investment options and you
can change your contributions and investments
at any time. All employees, regardless of full-
time, part-time or temporary status are eligible to
contribute immediately. The plan has feature that
will automatically enroll you for 5% Pre-tax after about 30-days of employment.
The table below describes the Techtronic Industries 401(k) Retirement Plan. For a full description of the
plan, please refer to the 401(k) Summary Plan Description.
The 401(k) Plan
lA
llows you to contribute 1% to 75% of your pay, lC
ompany match of 50% on the first 8%
up to IRS maximum of $19,000 (2019 limit) saved
through one or more of the following options:
l 1 00% immediate vesting on Company
—Pre-Tax match
—ROTH After Tax
l Administered by T. Rowe Price
—After Tax
l Wide range of investment options
Before making any elections, you should
lA
ccepts for rollovers from other qualified
carefully review any restrictions and limits
plans
under each option listed above.
lA
utomatic enrollment for newly hired
lA
llows catch-up contributions if you are age
employees at 5% of pay following 30 days
50 and older, up to IRS maximums of $6,000
of employment.
(2019 limit)
t BACK NEXT uTTI Benefits Summary 15
OTHER TTI BENEFIT PROGRAMS
TTI offers several additional benefit programs to help you improve and maintain your health, or to help
you to insure assets like automobiles or housing. These programs are voluntary and may be utilized at
your convenience.
The table below outlines the additional benefit programs. For a full description of these programs,
please refer to the Benefits Summary Plan Description.
LiveHeath Online LiveHealth Online is a convenient way for you to interact with a doctor via
live, two-way video on a computer or mobile device to address a medical
situation and in some cases receive a prescription (in most states). You
just need to be enrolled in the TTI Medical Plan and have the LiveHealth
Online smartphone app or a computer with a webcam for access to live
consultations—anytime, anywhere.
Teladoc Health Facing any medical situation can be stressful enough without worrying if you
(formerly or a family member are getting the right diagnosis and the most effective
Best Doctors) treatment. Teladoc offers you peace of mind by giving you access to advice
from the world’s leading physicians. It’s for everything from minor surgery to
serious issues like cancer and heart disease.
Future Moms The Future Moms program is designed to manage the three stages of
pregnancy: preconception, pregnancy and parenting. Expectant mothers are
identified and proactively managed to reduce the risk of premature birth or
other serious maternal issues.
Employee Assistance Mental health and substance abuse conditions are serious and sometimes
Program (EAP) require 24/7 access to resources. All TTI employees and their families are
eligible for the Employee Assistance Program.
24/7 NurseLine Receive immediate assistance from a registered nurse, toll-free, 24-hours,
7-days-a-week for situations such as comforting a baby in the middle of the
night or need to locate a doctor.
24/7 NurseLine is not for emergencies. Call 911 or your local emergency
service as soon as possible.
MetLife Auto & The MetLife Auto & Home Insurance Program allows employees to secure
Home Insurance auto and home insurance and pay for it through convenient payroll
deductions. Discounts may apply.
t BACK NEXT uTTI Benefits Summary 16
IRS PLAN LIMITS FOR TTI BENEFIT PROGRAMS
401K PLAN LIMITS FOR PLAN YEAR 2020 2019
401k Elective Deferrals (Combined Pre-Tax or Roth) $19,500* $19,000
401(k) After-Tax Only (after 401k elective limits) $28,500* $27,500
Catch-Up Contribution Limit (age 50 or older) $6,500* $6,000
Maximum Company Match (50% of first 8% Contributed) $9,750* $9,500
HEALTH PLANS 2020 2019
Max FSA Health Care Contributions $2,700 $2,650
Max FSA Dependent Day Care Contributions $5,000 $5,000
Max Annual HSA Plan 3 Contribution (Single) $3,550 $3,500
Max Annual HSA Plan 3 Contributions (Family) $7,100 $7,000
Min In-Network Annual Plan 3 Deductible (Single) $1,400 $1,350
Min In-Network Annual Plan 3 Deductible (Family) $2,800 $2,700
Max In-Network Annual Out-Of Pocket Plan 3 (Single) $4,500 $4,500
Max In-Network Annual Out-Of Pocket Plan 3 (Family) $6,650 $6,650
Annual HSA Plan 3 Catch-Up (age 55 or older) $1,000 $1,000
*At the time of publication, the IRS had not formally confirmed these amounts.
CONTACT INFORMATION
PLAN PROVIDER PHONE WEBSITE
Medical Anthem 866-862-4862 www.anthem.com
Pharmacy Express Scripts 800-711-0917 www.express-scripts.com
Dental Delta Dental 800-236-3712 www.deltadentalwi.com
Vision VSP 800-877-7195 www.vsp.com
FSAs HealthEquity 877-713-7712 www.healthequity.com/TTI
HSA HealthEquity 877-713-7712 www.healthequity.com/TTI
401(k) T. Rowe Price 800-922-9945 TTIRetire.com
EAP Anthem 800-999-7222 www.anthemeap.com
Teladoc Health Teladoc Health 866-904-0910 members.bestdoctors.com
Future Moms Anthem 800-828-5891 www.anthem.com
24/7 Nurseline Anthem 800-700-9184 www.anthem.com
Live Health Online Anthem 888-548-3432 www.livehealthonline.com
Auto & Home Insurance Metlife 800-438-6388 http://choices.metlife.com
Benefits Center ADP 844-884-2363
t BACK NEXT uTTI Benefits Summary 17
2020 MILWAUKEE CONTRIBUTION SCHEDULES
MEDICAL PLAN
BI-WEEKLY
Plan 1 Plan 2 Plan 3
Plan Option
NS/NT Std NS/NT Std NS/NT Std
EE 33.23 56.31 19.38 42.46 17.08 40.15
EE+S 78.46 101.54 47.08 70.15 44.77 67.85
EE+C 54.92 78.00 34.62 57.69 32.31 55.38
EE+S+C 105.23 128.31 64.15 87.23 61.85 84.92
EE = Employee Only; EE+S = Employee + Spouse; EE+C = Employee + Children;
EE+S+C = Employee + Spouse + Children; NS/NT = Non-Smoking/Non-Tobacco; Std = Standard
IMPORTANT REMINDER: Requirements for electing Tobacco-Free/Smoke-Free contributions
To be eligible for the lower cost Non Smoking/Non Tobacco (NS/NT) contributions, you and all family members
you cover under the Medical Plan must have been smoke free and tobacco free for 6 full calendar months prior
to your elections. If only one covered family member smokes, uses tobacco of any type, vaping of any kind or
method or uses e-cigarettes in any manner, you must pay the Standard (STD) contribution rate. See the Benefits
Summary Plan Description for more information on this requirement.
DENTAL PLAN VISION PLAN
BI-WEEKLY BI-WEEKLY
Employee Only 2.77 Employee Only 4.02
Employee + Spouse 5.54 Employee + Spouse 6.42
Employee + Children 5.54 Employee + Children 6.55
Employee + Spouse + Children 8.31 Employee + Spouse + Children 10.56
SUPPLEMENTAL LIFE INSURANCE PLAN VOLUNTARY AD&D INSURANCE PLAN
MONTHLY COVERAGE MONTHLY COVERAGE
RATE/$1,000 OPTIONS RATE/$1,000 OPTIONS
Less Than 25 0.050 Employee Only 0.020 $25,000
Age 25 to 29 0.060 Employee + Spouse 0.030 increments
($300,000
Age 30 to 34 0.060 Employee + Children 0.030 maximum/
Age 35 to 39 0.070 $25,000
Employee + Spouse + 0.030
Age 40 to 44 0.100 Children minimum)
1X, 2X, 3X or 4X
Age 45 to 49 0.150 Annual Earnings—
Age 50 to 54 0.230
$750,000 Maximum LONG TERM DISABILITY
Age 55 to 59 0.430 The Company pays the full Refer to the Summary Plan
cost of LTD coverage Description for detailed
Age 60 to 64 0.660 information
Age 65 to 69 1.270
Age 70 & Older 1.989
Spouse Coverage 0.180 $10,000; $25,000;
$50,000; $100,000;
$150,000; $200,000
Children Coverage 0.080 $10,000 Per Child
t BACKYou can also read
