Benefits Guide. 2022 Please read thoroughly.
Page content transcription
If your browser does not render page correctly, please read the page content below
Benefits Guide. 2022 This publication contains important information about your employee benefit program. Please read thoroughly.
At HALO, we are committed to a comprehensive employee benefit program to help our employees stay healthy, feel secure, and maintain a work/life balance. This guide offers information on each benefit available to you through HALO, contact information for the providers, and instructions on how to enroll. Please read through it carefully and keep it for reference when enrolling in and utilizing your benefits in the future. 2
Benefits Guide • 2022 Table of contents Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 • Life and Disability Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 • Short Term Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 10 • Long Term Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Staying Healthy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • Voluntary Critical Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 • Medical Highlights—CDHP . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 • Voluntary Hospital Indemnity . . . . . . . . . . . . . . . . . . . . . . . . 27 • Medical Highlights—PPO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 • Voluntary Group Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 • Tools and Resources with BCBSIL . . . . . . . . . . . . . . . . . . . . . 15 • 401(k) Savings Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 • Dental Plan Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 • Work/Life Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 • Vision Plan Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 • Access Your Maternity and Family Benefits—BCBSIL . 33 Feeling Secure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 HALO Benefits Information Contact . . . . . . . . . . . . . . . . . . 34 • Health Savings Account (HSA) . . . . . . . . . . . . . . . . . . . . . . . . 19 • Flexible Spending Accounts (FSA) . . . . . . . . . . . . . . . . . . . . . 20 Important Notices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 3
Benefits Guide • 2022 Eligibility Who is Eligible? Employee Eligibility • Actively employed administrative employees scheduled to work a minimum of 30 hours per week. • Actively employed (commissions only) account executives booking a minimum of $40,000 in commissions in the prior calendar year (amount will be estimated or prorated for new hires with mid-year enrollments). The minimum booking threshold is subject to change at the company’s discretion every calendar year. Dependent Eligibility Legal spouses, civil union, or domestic partners of eligible employees are ineligible for coverage in our plans if they are eligible for coverage through their employer and their employer pays at least 50% of the cost. Legal certification of marriage/civil union/ domestic partnership must be provided if covering a spouse, civil union, or domestic partner. Children of eligible employees are eligible for coverage in the health/dental/vision plans up to the age 26, regardless of student, marital, or employment status. Coverage will automatically terminate at the end of the month of the dependent’s 26th birthday. Supplemental child life coverage terminates at the end of the month of the dependent child’s 19th birthday. 5
Benefits Guide • 2022 When Are You Eligible? Newly Eligible Employees Your benefits become effective the first of the month coincident with or following 30 days of employment in an eligible classification. NOTE: You have 30 days from your date of hire or change to eligible status to enroll in or waive coverage. Annual Open Enrollment You may make changes to your benefit elections during your open enrollment period for a September 1st effective date. Qualified Change in Status Your benefit elections will remain in effect for the entire year unless you experience a qualifying life event. You may make benefit changes within 30 days of a qualified event. Examples of qualifying life events include: marriage, civil union, divorce, birth, adoption, death of a dependent, or loss of other coverage, such as spouse/partner losing coverage as a result of a job loss or change. Note: This is only a summary of the benefit plans; refer to the Summary Plan Descriptions or Certificates for each benefit to view full details on coverage, maximums, limitations, and exclusions. If there is any conflict between this document and the official plan documents, the official plan documents govern the plan. 6
Benefits Guide • 2022 What Benefits Note: Are Available? Your basic life and AD&D, short term disability, and long term disability insurance will only be As you consider your plans for the year, provided by HALO if you elect medical coverage. refer to this chart of coverage and enrollment information for the various benefit programs offered through HALO. • If you do not enroll in medical coverage, but to enroll in these benefits, you will pay 100% of the cost. • Basic life and AD&D, short term disability, and long term Reminder: Coverage begins the first of the disability must be elected all together. You cannot elect only month coincident with or following 30 days 1 or 2 of these benefits separately. of employment in an eligible classification. Benefit Plan Vendor Do I Need to Enroll? Health Plans Medical Blue Cross Blue Shield of Illionnis Yes Dental Delta Dental of Illinois Yes Vision BCBSIL + EyeMed Yes Health Savings Account 5th/3rd Bank Yes Flexible Spending Accounts Discovery Benefits Yes Life and AD&D Insurance Enrolled in medical: No Basic Life and AD&D Insurance New York Life Not enrolled in medical: Yes Voluntary Life New York Life Yes (for you and your dependents) Disability Insurance Enrolled in medical: No Short Term Disability New York Life Not enrolled in medical: Yes Enrolled in medical: No Long Term Disability New York Life Not enrolled in medical: Yes Voluntary Options Critical Illness Cigna Yes Hospital Indemnity Cigna Yes Accident Cigna Yes Additional Programs 401(k) Savings Plans Bank of Oklahoma No 7
Benefits Guide • 2022 Enrollment Enrollment Checklist Ready to Enroll? Follow These Steps 01 Write down big things happening next year for your family, do any of these things relate to your benefits? • Planning to bring home a new baby? • Anyone have a big expense coming (orthodontia, major surgery, etc.)? • If something happened to you, does your life insurance provide enough money to your family? ould you benefit from any of 02 W the voluntary products we offer? • C ritical illness, accident, hospital indemnity id you know you can access your 03 D ID cards, find network providers and more via mobile apps? Download them today! • Blue Access for Members • Delta Dental’s mobile app • EyeMed Members How to Enroll: Enroll on access.paylocity.com/ Instructions on how to enroll can be found HERE 9
Benefits Guide • 2022 Staying Healthy Medical Plan CDHP Plan Features In-Network Out-of-Network Highlights—CDHP Coinsurance 80% 60% HALO offers two medical plans plan with Deductible access to a comprehensive national network Individual $2,000 $6,000 (Blue Edge) to cover your medical needs from preventive care to emergency situations. Family $4,000 $12,000 Account Funding (HSA) You must meet your deductible below before coinsurance begins. If you meet your Individual $500 out-of-pocket maximum, you will not pay Family $1,000 any more for the cost of your care for the rest of the year. Note that your deductible Out-of-Pocket Max (includes deductible) and out-of-pocket maximum renew on Individual $4,000 $12,000 a calendar year basis. Family $6,850 $24,000 How the Family Deductible Covered Services and Out-of-Pocket Preventive Care 100% Deductible and coinsurance Maximums Work Office visit Deductible and coinsurance Deductible and coinsurance • The plan will not begin cost sharing Specialist Deductible and coinsurance Deductible and coinsurance for any family member until the family deductible is met Urgent Care Deductible and coinsurance Deductible and coinsurance • Any combination of one or more family Emergency Room Deductible and coinsurance Same as in-network members can incur expenses to meet the family deductible Prescription Drug • All family members’ out-of-pocket Generic Deductible and coinsurance expenses count towards the You pay 25% family deductible Preferred Deductible and coinsurance of the eligible • The family out-of-pocket maximum must Non-Preferred Deductible and coinsurance amount after 20% coinsurance be met by any combination of one or more family members before plan will begin to Speciality Deductible and coinsurance cover in-network expenses at 100% 11
Benefits Guide • 2022 Staying Healthy Medical Highlights—PPO Diagnostic visits are covered at 100% after a copay of $30 or $50 at the time of service at network facilities. All other in-network services are covered at 80% after you meet an annual deductible of $1,000 if you are single, or $2,000 if you have more than one person on the plan. Once you reach your out-of-pocket maximum of $2,000 if you are single, or $4,000 if you have more than one person on the plan, all eligible expenses are covered at 100%. Prescriptions are covered at 100% after a copay of $15, $30, or $50 (depending on the tier). How the Family Deductible Plan PPO Plan and Out-of-Pocket Features In-Network Out-of-Network Maximums Work Coinsurance 80% 60% • A single member of a family does not have Deductible to meet the full family deductible before Individual $1,000 $4,000 the after-deductible benefits kick in • Individual family members only need Family $2,000 $8,000 to meet the individual deductible for Out-of-Pocket Max (includes deductible) the after-deductible benefits to kick in • The money that is paid toward the Individual $2,000 $8,000 individual deductible and out-of-pocket Family $4,000 $16,000 maximums is also credited toward Covered Services the family deductible and out-of-pocket maximums Preventive Care 100% Deductible and coinsurance • Once several different family members Office visit $30 Deductible and coinsurance have each paid enough in individual deductibles that meet the family Specialist $50 Deductible and coinsurance deductible in total, benefits will begin Urgent Care $50 Deductible and coinsurance to be paid for the entire covered family • When family members have paid enough Emergency Room $150 in out-of-pocket maximums to complete Prescription Drug the family out-of-pocket maximum, Generic $15 the plan will begin covering in-network expenses at 100% You pay 25% of Preferred $30 the eligible amount minus the in-network Non-Preferred $50 copay amount Speciality $50 12
Benefits Guide • 2022 Staying Healthy Cost for Medical Medical Plan Contributions Coverage CDHP Bi-Weekly Contributions Tobacco User/Smoker Rates You have the opportunity to engage in HALO’s 1 smoker 2 smokers wellness initiative to take advantage of lower per-pay period medical costs. See next Compliant page for information on how to participate Single $57.92 $75.23 - and receive the lower medical premiums. EE + Spouse $184.62 $201.93 $219.24 EE + Child(ren) $144.69 $162.00 - If you and/or your spouse or domestic partner are a tobacco user, you will be required to Family $260.23 $277.54 $294.85 pay a surcharge on your medical premiums. Non-Compliant While making your elections within the Single $83.58 $100.89 - Paylocity portal, you will be asked to EE + Spouse $239.89 $257.20 $274.51 complete an affidavit for tobacco use. EE + Child(ren) $177.38 $194.69 - Family $323.15 $340.46 $357.77 PPO Bi-Weekly Contributions Tobacco User/Smoker Rates 1 smoker 2 smokers Compliant Single $78.56 $95.87 - EE + Spouse $224.10 $241.40 $258.71 EE + Child(ren) $181.02 $198.33 - Family $334.99 $352.30 $369.61 Non-Compliant Single $104.23 $121.54 - EE + Spouse $279.36 $296.67 $313.98 EE + Child(ren) $213.71 $231.02 - Family $397.90 $415.21 $432.52 Bi-Weekly Smoker Surcharge 1 Smoker $17.31 2 Smokers $34.62 13
Benefits Guide • 2022 Staying Healthy How to Engage Well onTarget in Wellness with HALO Access the Well onTarget Member Wellness If you want to pay the lower compliant portal at www.wellontarget.com. In the rates on the medical plan, you will need Wellness portal, you will have access to a to take action. Tasks completed from wide array of wellness resources, including: 9/1/2021 – 8/31/2022 will apply towards • Challenges that occur year-round on your Wellness Compliance status for a variety of topics like managing money, the plan year starting 9/1/2022.: sleep, healthy eating, etc. Complete one task from each of • Coaching will provide you access to a credentialed expert to support you the three categories shown below: in your unique wellness journey • Digital self-management programs 01 V isit your physician for a physical, on a wide range of topics like tobacco or any of the following screenings: use, weight management, stress, sleep, Biometric, Cervical Cancer, and more • Blue Points Rewards – Get rewarded Mammogram, or Colon Cancer • If getting a physical or biometric for completing healthy activities! Use screening, you should tell your provider this a routine service to ensure your Blue Points in an online marketplace it is covered at 100% through your Well onTarget account. • Get rewarded for completing Health 02 C omplete a Health Risk Assessment Assessments, Self-Management Program, on the Well onTarget portal Fitness Programs, connecting a compatible fitness device or app to the portal, 03 omplete a Corporate Challenge or C and much more! Coaching program within the Well onTarget portal or provide HR@halo.com with COVID vaccination documentation 14
Benefits Guide • 2022 Staying Healthy Tools and resources with BCBSIL Virtual Visits with MDLIVE! Speak With a Physician or No copay on the PPO plan and no cost for CDHP participants after deductible Therapist—Anytime, Anywhere is met for MDLIVE medical and MDLIVE allows you to access board-certified behavioral health visits. physicians or therapists 24/7/365 from any location, whether you are on the road, at work or in the comfort of your own home. This service is available for both physical and behavioral health visits. You may access MDLIVE by mobile app, online video or over Blue Access for the phone. Getting sick after hours or on the weekends used to mean a long, costly trip to Members (BAM) the emergency room or urgent care center. Healthcare at Your Fingertips But with your virtual visits benefit provided With BAM, you can: • Use the Provider Finder tool to search for a by Blue Cross Blue Shield of Illinois and powered by MDLIVE, you may access care at healthcare provider, hospital, or pharmacy a location convenient to you. Virtual visits are for non-emergency situations such as: • Request or print your ID card • Allergies • Ear infections • Check the status or history of a claim • Anxiety • Pink eye • View or print Explanation • Asthma • Rashes of Benefits statements • Cold/flu • Stress • Use the Cost Estimator tool to find • Depression the price of hundreds of tests, management treatments, and procedures If needed, through MDLIVE, you can get a To get started, visit www.bcbsil.com/member prescription called into your local pharmacy. and use the information on your ID card to create an account. To set up an account, you may: • Call MDLIVE at 866.676.4204 • Go to www.MDLIVE.com/BCBSIL BCBSIL App • Text BCBSIL to 635.483 Stay connected with BCBSIL and access • Download the MDLIVE app important health benefit information wherever you are by using the BCBSIL app. Text BCBSILAPP to 33633 to get the app. 15
Benefits Guide • 2022 Staying Healthy Dental Plan Dental Coverage Highlights Reminders There are two dental plans available for you • Two routine dental cleanings to choose from, the Low Plan and the High per benefit year Plan. As a reminder, getting care from an in-network provider will be lower cost • Annual maximum is the most your plan will pay towards your dental services for you than if you were to visit an in the benefit year out-of-network provider. For more details, • A pplies to each covered see the dental plan summaries. person on the plan Plan Design High Plan Low Plan • Orthodontia limit of $2,000 on the High Plan is a lifetime maximum Individual $50 $100 • T his is the most your plan will Deductible pay for orthodontia services Family Deductible $150 $300 per member per lifetime Maximum $1,000 $1,000 • D oes not “reset” each year like your annual maximum Preventive 100% 90% Basic 80% 70% Dental Plan Major 50% 50% Contributions Orthodontia 50% N/A Orthodontia Children N/A Delta Dental of Eligibility under 19 IL—Bi-Weekly Contributions Orthodontia $2,000 N/A Lifetime Maximum High Plan Low Plan Single $11.56 $9.95 Pay Less by Using an EE + Spouse $20.81 $17.91 In-Network Provider EE + Child(ren) $33.63 $24.56 Click here to find an in-network provider near you. Family $45.19 $34.52 16
Benefits Guide • 2022 Staying Healthy Vision Plan Highlights Your vision coverage is offered through BCBSIL. BCBSIL provides you with affordable care options and gives you access to a range of discounts on glasses, frames, lenses, and laser vision correction. BCBSIL vision partners with EyeMed to provide you with an extensive network of optometrists, ophthalmologists and opticians in private practices and at optical retailers including Walmart, Bard Optical, All About Eyes, Target, LensCrafters, and more! For more details on your vision coverage and exclusive savings and promotions, visit member.eyemedvisioncare.com/bcbsilhalo or download the EyeMed Members Mobile App. To locate an in-network provider, visit eyedoclocator. eyemedvisioncare.com/bcbsilhalo/en. Visit Glasses.com to access a huge selection BCBSIL Vision Plan of frames and lenses with your benefits using 3-D virtual try-on technology! Out-of-Network In-Network Reimbursement Vision Plan Contributions Frequency 12/12/24 (Exams/Lens/Frames) BCBSIL Vision—Bi-Weekly Exam $10 copay Up to $45 Contributions Single $2.76 Spectacle Lens • Single Vision $25 copay Up to $30 EE + 1 $4.35 • Bifocal EE + 2 or more $7.80 $25 copay Up to $50 • Trifocal $25 copay Up to $65 • Lenticular $25 copay Up to $100 You do not need ID cards to receive services. Standard Progressive Lens $25 copay Up to $50 BCBSIL will send you two ID cards showing $140 with 20% off for only the employee’s name, no matter who Allowance Up to $70 balances over $140 is covered. To download additional ID Elective Contact cards visit member.eyemedvisioncare.com/ $40 max copay Lens—Fitting and Evaluation bcbsilhalo or the EyeMed app. Up to $105 Elective Contact Lens $140 allowance 17
04 Feeling Secure
Benefits Guide • 2022 Feeling Secure Health Savings Account (HSA) An HSA is an individually owned savings account that accompanies a qualified high deductible health, and the funds may be used towards future eligible medical expenses or retirement. Your HSA funds may be rolled over from year to year. HSAs offer a triple tax advantage: • Contributions are pre-tax or tax-deductible • Earnings on the balance and investments are not taxed • Funds withdrawn for qualified medical expenses are not taxed The IRS has a limit on how much you can contribute to your HSA on an annual basis, these limits are outlined below. Employees age 55 and older may contribute an additional $1,000 annually in catch- up contributions. The maximum HSA contributions are: • Single: $3,600 • Non-single: $7,200 You have the option to invest your HSA funds up to $2,000 annually. For more information, visit www.account.53hsa.com. HALO contributes to your HSA, employees with single coverage receive $500/year and employees with all other coverage receive $1,000/year. This is free money and the funds are yours to keep. You must open your account in order for HALO to be able to make these contributions. 19
Benefits Guide • 2022 Feeling Secure Flexible Spending Accounts (FSA) These are administered through Discovery Benefits. The FSA allows you to contribute pre-tax funds from each paycheck to be used towards eligible healthcare and/or dependent care expenses. You may also contribute to a commuter FSA, for eligible transit/parking expenses for your work commute. IRS rules state you cannot contribute more than the following amounts: • Healthcare FSA: $2,750 annually • Dependent care FSA: $5,000 annually • Commuter FSA: $270 monthly At the end of the year, remaining money up to $500 will be rolled over to the following year for you to continue using. If you have a balance above $500, that money will be forfeited, so choose your FSA election amount wisely. 20
Benefits Guide • 2022 Feeling Secure Healthcare Flexible The dependent care FSA should be used on expenses incurred to work, seek work, Spending Account or attend school. Dependent must be NOTE: You are ineligible to contribute to the under age 13 or incapable of self-care. medical FSA if you are enrolled in the medical HDHP with HSA plan. The dependent care FSA includes a grace period and run-out period, The healthcare FSA can be utilized for any here’s how they work: of the following types of expenses incurred by you and your family: • Grace period—This allows you to continue to incur claims through March 15 following • Copays the close of the plan year • Coinsurance • Run-out period—Claims for the prior year • Some services not covered by medical and incurred during the grace period can or dental insurance, vision care, be filed through March 31 and prescription copays Commuter FSA Dependent Care FSA Commuter FSAs pre-tax funds can be used The dependent care FSA allows you towards expenses related to commuting to to use pre-tax funds towards eligible and from work for mass transit, vanpooling, expenses such as: and work-related parking costs. • Daycare This includes: • Preschool • Transit passes, tokens • Babysitting • Fare cards, vouchers • Summer day camp • Parking passes • Dependent adult daycare Reminder: Unused funds over $500 at the end of the plan year will not be refunded. There are no exceptions to this; it is an IRS regulation. 21
Benefits Guide • 2022 Feeling Secure Life and Disability Benefits Our life and accident insurance plans provide financial protection in the event of the death of a covered person or upon certain other losses suffered as the result of an accident. Life and Disability Reminders • If you are enrolled in medical, the company will provide your basic life and AD&D coverage • If you are not enrolled in medical, you must purchase the basic life and AD&D • Basic life and AD&D, short term disability, and long term disability must be purchased all together and enrollment in one or two plans is not permitted Your basic life and AD&D coverage is two times your annual salary up to a maximum of $250,000. Employee benefits are reduced by 50% at age 70. Plan Design HALO Features Benefit 2x annual salary Lesser of 2x annual Maximum Benefit salary or $250,000 22
Benefits Guide • 2022 Feeling Secure Supplemental Life Supplemental Life You have the option to purchase additional Contributions—Employee Life coverage for yourself, your spouse and and Spouse your dependent children. Premiums for Bi-Weekly Contributions employee and spouse/partner vary based (based on units of $1,000) on your age and will increase according to the age ranges below and your age on Under Age 29 $0.037 September 1 of every calendar year. • Employee coverage is available Age 30–34 $0.051 in $10,000 increments up to $400,000 Age 35–39 $0.055 • Employee benefits reduce Age 40–44 $0.069 by 50% at age 70 • Spouse/partner coverage is available Age 45–49 $0.106 in $5,000 increments up to $50,000 Age 50–54 $0.175 • S pouse/partner coverage cannot exceed 50% of employee coverage Age 55–59 $0.309 • S pouse/partner supplemental Age 60–64 $0.485 life coverage terminates at age 70 • S pouse/partner rates are Age 65–69 $0.637 based upon employee age • Child coverage of $10,000 is available Age 70+ $1.431 for children over 6 months • The guaranteed issue amounts To calculate bi-weekly cost—($ amount of requested additional insurance/$1,000) × rate are $200,000 for employee and (table above) = bi-weekly cost. $30,000 for spouse/partner • To purchase coverage over these Dependent Child Life amounts or after initial eligibility, you will be required to submit an Insurance Contribution evidence of insurability (EOI) form which will be reviewed and Bi-Weekly Contributions approved/rejected by New York Life $0.0508 per $1,000 23
Benefits Guide • 2022 Feeling Secure Short Term Long Term Disability Disability Short term disability (STD) replaces Long term disability (LTD) protects your your weekly income while you are out income by providing you with a percentage of work following a non-work-related of your income while you are disabled. accident or illness. Benefits begin after 90 days of a qualified • Benefits go into effect on the disability until age 65. 8th day of a qualified disability • Maximum of 11 weeks with New York Life doctor certification LTD Benefits • If you are enrolled in the medical plan, short term disability will be provided Benefit Percentage 60% by the company • If you are not enrolled in the medical plan Monthly Benefit Maximum $10,000 and wish to be covered you must purchase Benefits Waiting Period 90 days the plan along with long term disability and basic life and disability insurance New York Life STD Benefits Benefit Percentage 66.67% Weekly Benefit Maximum $1,500 8th day accident Benefits Begin 8th day sickness Benefits Duration 11 weeks 24
Benefits Guide • 2022 Feeling Secure Voluntary Critical You may choose group critical illness insurance as follows: Illness, Hospital • Employee coverage can be elected in increments of $10,000 up to $30,000 Indemnity, and • Spouse coverage can be elected in Group Accident increments of $5,000 up to $15,000, election cannot exceed 50% of the employee coverage amount If you’re concerned about the financial impact large medical expenses can have on • Child coverage can be elected in increments of $5,000 up to $15,000 you and your family or they are diagnosed with a serious illness or sustain a serious injury resulting in a hospital visit, consider Guaranteed Issue enrolling for critical illness, group hospital If you are a new hire, you are not required indemnity, or group accident insurance to provide proof of good health if you enroll coverage through Cigna. during your employer’s eligibility waiting period and you choose an amount of Voluntary Critical Illness coverage up to and including the guaranteed issue amount. If you apply for an amount The critical illness group plan pays a lump- of coverage greater than the guaranteed sum benefit if a covered person is diagnosed issue amount, coverage in excess of the with a heart attack, stroke, cancer or many guaranteed issue amount will not be issued other conditions. It can help cover out-of- until the insurance company approves pocket medical expenses for treatments that acceptable proof of good health. aren’t covered by your medical plan, such as deductibles and coinsurance. 25
Benefits Guide • 2022 Feeling Secure Critical Illness Contributions Age Band $10,000 $20,000 $30,000 Employee (EE)—Bi-Weekly Contributions
Benefits Guide • 2022 Feeling Secure Voluntary Voluntary Hospital Indemnity Group Accident The hospital indemnity insurance program The group accident insurance plan helps pays a cash benefit to you for covered offset your out-of-pocket expenses in the hospital stays, outpatient surgery costs, event of an accident, such as copays, intensive care stays, and post hospital skilled coinsurance, and other medical expenses. nursing facility care. This cash payment can This plan covers accidents that occur off be used however you choose. the job and includes a range of incidents from common injuries to more serious events. Hospital Indemnity You may elect the following group accident insurance: Contributions Bi-Weekly Contributions Group Accident Contributions Single $9.21 EE + Spouse $18.37 Bi-Weekly Contributions EE + Child(ren) $16.52 Single $5.58 Family $25.16 EE + Spouse $8.65 EE + Child(ren) $10.97 Family $14.04 27
Benefits Guide • 2022 Feeling Secure 401(k) Savings Plan Bank of Oklahoma (BOK Financial) administers our 401(k) plan. This benefit allows you to save money for your retirement. Contributing is a convenient way to invest in your future by building a source of income for your retirement. Eligibility You must be 18 years of age and are eligible the first of the month following 30 days of employment to contribute to the 401(k). Auto-Enrollment An automatic deferral amount of 3% of your compensation will be withheld from each of your paychecks. The automatic deferral amount will be contributed as a pre-tax elective deferral to the plan. Contributions You can choose to contribute a percentage of your income (1%-100% in whole percentages only) or a specified dollar amount to the plan biweekly on either a pre-tax or an after-tax (Roth) basis. Contributions are deducted from each biweekly pay check. You are allowed to change, stop, or restart the amount of your contribution at the next reasonable pay period. Company Match The company may offer an annual match of 50% on the first $1,000 of your contributions (maximum match of $500 annually). The match is made in January for the previous year’s contributions. You must work at least 1,000 hours and be employed on the last day of the calendar year to be eligible for the match. 28
Benefits Guide • 2022 Feeling Secure Automatic Enrollment The eligible automatic contribution If automatic deferrals are arrangement (EACA) provisions apply to withheld from my paycheck the Plan. This type of automatic enrollment allows the plan administrator to enroll can I take that money out of employees in the Plan. the Plan right away? Yes, you may request that your automatic What happens when I deferrals and any earnings on those become eligible for the Plan? deferrals be distributed to you as long as you make the request in writing within 90 days If you are eligible to make elective deferrals of when the automatic deferrals were first and meet the requirements below and you withheld from your paycheck. Any matching do not make a deferral election by your contributions associated with the automatic entry date, the plan administrator will begin deferrals that you take from the Plan by the deducting automatic deferrals from each deadline will be forfeited. After that deadline of your paychecks and will submit those has passed you will only be able to take the amounts to the Plan (automatic deferrals) automatic deferrals out of the Plan when on your behalf. elective deferrals can be distributed. An automatic deferral amount of 3% of your compensation will be withheld from each Do the Plan’s automatic of your paychecks. The automatic deferral enrollment features apply amount will be contributed as a pre-tax to me if I have already elective deferral to the Plan. made a deferral election? No, if you have already made a deferral If you do not wish to have automatic election that amount will continue to be deferrals withheld from each of your withheld from each of your paychecks until paychecks or if you want to change the you make a new election. amount withheld, you must make a deferral election. If automatic deferrals have already started, you may make a deferral election to change the amount being withheld or to stop the deferrals entirely. 29
Benefits Guide • 2022 Feeling Secure Elective Deferrals Your elective deferrals are amounts that you chose to (or are assumed to have chosen to) have withheld from your paycheck and contributed to the Plan in your name. Please see the section of your SPD titled “Eligibility for Participation” to determine if you are eligible to make elective deferrals and “Contributions to the Plan” for the type of compensation you may defer into the Plan. How do I make or change my deferral election? You may make or change your deferral election by going to the following web site or calling the voice response unit at the following number: www.startright.bokf.com or calling 800.876.9557. Once I make a deferral election, how often can I change, stop, or re-start the election? You may change or re-start your deferral election as of the next reasonable pay period. You may stop your deferrals at any time. 30
Benefits Guide • 2022 Feeling Secure Elective Deferrals If I make a deferral election is the amount withheld from my paychecks taxed? You will have the option to decide if the The plan administrator may establish amount you elect to defer into the Plan additional rules you will need to follow when is taxed or not. If you chose to have your making your deferral election. Your deferral elective deferrals go into the Plan as pre-tax election is only effective for compensation elective deferrals, you will not be taxed until you have not received yet. The plan you take the money out of the Plan. If you administrator may also reduce or totally chose to have your elective deferrals go into suspend your election if they determine that the Plan as Roth elective deferrals, you will your election may cause the Plan to fail be taxed on that money when it is taken out to satisfy any of the requirements of the of your paycheck, but it will not be taxed Internal Revenue Code. again when you take it out of the Plan. The earnings on those Roth elective deferrals may How will my account be taken out tax-free if certain conditions are balances be invested met. Please see the SPD for more information on Roth elective deferrals. if I do not make an investment election? Are there any limits The Plan’s default investments are to how much I can defer intended to meet the requirements to be a qualified default investment alternative into the Plan? (QDIA). If you do not make an investment Your elective deferrals are subject election your account balances will be to the following limits: placed in investments selected by the plan • Your total amount of deferrals administrator. See the attached Qualified cannot be more than $19,500 Default Investment Alternative information • If you are age 50 or over, you may which provides information on the default fund you will be invested in if you fail to defer an additional amount, called a make an investment election. “catchup contribution,” of up to $6,500 31
Benefits Guide • 2022 Feeling Secure Work/Life Balance Employee Assistance Program Achieve Work/Life Balance Whether your needs are big or small, your life For help handling life’s challenges go on line assistance and work/life support program is for articles and resources including on family, there for you. It can help you and your family care giving, pet care, aging, grief, balancing, finds solutions and restore your peace of working smarter, and more. mind. You and your family may access the life assistance program 24/7 on the phone at no Legal Consultation extra cost to you. An advocate can help you and Referrals* assess your needs and develop a solution. Receive a free 30-minute consultation with a He or she can also direct you to community network attorney. And up to a 25% discount resources and online tools. on select fees. Visit a Specialist You have three face-to-face sessions with a Financial Consultations behavioral counselor available to you—and Receive a free 30-minute consultation your household members. Call New York Life and 25% discount on tax planning and to request a referral. preparation. Monthly Webinars The life assistance program is available Educational seminars on a variety of to you at no additional cost. For more relevant topics such as managing your life, information on 24/7 support, call work, money and health are available in a 800.538.3543 or visit www.cignalap.com. quarterly calendar of monthly webcasts distributed to your employer. 32
Benefits Guide • 2022 Feeling Secure Access Your Maternity and Family Benefits—BCBSIL Ovia Health provides maternity and family apps to support enrolled members through your entire parenthood journey. These apps are included in your health plan benefits, offered through Blue Cross and Blue Shield of Illinois (BCBSIL). Follow These Easy Steps to With Ovia Health, You’ll Download Ovia and Launch Have Access to Enhanced, Your Account: Personalized Health and 01 Download the app that’s right for you Wellness Features: • Ovia Fertility—Health & Fertility Health Assessment • Ovia Pregnancy—Pregnancy & Postpartum and Symptom Tracking • Ovia Parenting—Family & Working Parents Receive alerts and predictive, personal coaching when Ovia detects a potential 02 When signing up, choose “I have Ovia medical issue. Health as a benefit” before tapping “Sign up” and make sure to select BCBSIL as Over Fifty Physician-Developed your health plan and enter your employer Clinical Programs to Help You name (optional). be as Healthy As Possible Engage with personalized health and 03 Already have an Ovia app on your phone? wellness programs to help you navigate • O pen your app and tap “Health” to take infertility, sexual health, birth planning, the Ovia Health Assessment. preterm delivery, mental health, • T ap “Update my healthcare information” breastfeeding, and more. and select BCBSIL as your health plan and enter your employer name (optional). Unlimited 1-on-1 Coaching If You Do Not Indicate BCBSIL Message instantly with Registered Nurse As Your Health Plan, You’ll Only health coaches to ask all your questions. Be Able To Access Some Of The Career and Features Available To You: Return-to-Work Programs • Health and menstrual cycle tracker Find coaching and career advice for • Pregnancy calendar & daily baby updates preparing for maternity leave, returning • Child’s development checklist to work, and being a working parent. • Daily health and wellness content • Data & symptom feedback 33
05 HALO Benefits Contact Information
Benefits Guide • 2022 HALO Benefits Contact Information General Benefits Life and Disability Questions New York Life (formerly Cigna) Matt Barbian 800.362.4462 HR@halo.com newyorklife.com/group-benefit-solutions Group #s: Medical and Pharmacy Basic Life: FLX966896 Basic AD&D: OK968384 Blue Cross Blue Shield of Illinois Supplemental Voluntary Life: FLX966876 800.676.BLUE (2583) STD:LK751865 bcbsil.com LTD: LK964719 HDHP Group #PI3985 PPO Group #PI4019 Life Assistance Program MDLIVE Virtual Visits Cigna 800.538.3543 888.676.4204 cignalap.com MDLIVE.com/bcbsil 401(k) Health Savings Account (HSA) Bank of Oklahoma 800.876.9557 Fifth Third Bank startright.bokf.com 888.350.5353 www.53.com Accident Code: FTB- 149704 Cigna Flexible Spending 800.351.9214 Account (FSA) my.cigna.com Group #AI961176P Wex (formerly Discovery Benefits) 866.451.3399 Critical Illness www.wex.com Cigna Dental 800.351.9214 my.cigna.com Delta Dental of Illinois Group #CI96113P 800.323.1743 www.deltadentalil.com Hospital Indemnity Group #20210 Cigna Vision 800.351.9214 my.cigna.com Blue Cross Blue Shield of Illinois Group #HC960527P 855.362.5539 member.eyemedvisioncare.com/ bcbsilhalo Group #281298 35
MEDICARE PART D CREDITABLE COVERAGE NOTICE IMPORTANT NOTICE FROM HALO BRANDED SOLUTIONS, INC. 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 HALO Branded Solutions, Inc. and about your options under Medicare’s prescription drug coverage. This information can help you decide whether you want to join a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. If neither you nor any of your covered dependents are eligible for or have Medicare, this notice does not apply to you or your dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice. 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. HALO Branded Solutions, Inc. has determined that the prescription drug coverage offered by the HALO Branded Solutions, Inc. Employee Health Care Plan (“Plan”) is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is considered “creditable” prescription drug coverage. This is important for the reasons described below. ____________________________________________________________ Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare drug plan, as long as you later enroll within specific time periods. Enrolling in Medicare—General Rules As some background, you can join a Medicare drug plan when you first become eligible for Medicare. If you qualify for Medicare due to age, you may enroll in a Medicare drug plan during a seven-month initial enrollment period. That period begins three months prior to your 65th birthday, includes the month you turn 65, and continues for the ensuing three months. If you qualify for Medicare due to disability or end-stage renal disease, your initial Medicare Part D enrollment period depends on the date your disability or treatment began. For more information you should contact Medicare at the telephone number or web address listed below. Late Enrollment and the Late Enrollment Penalty If you decide to wait to enroll in a Medicare drug plan you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7. But as a general rule, if you delay your enrollment in Medicare Part D, after first becoming eligible to enroll, you may have to pay a higher premium (a penalty). If after your initial Medicare Part D enrollment period you go 63 continuous days or longer without “creditable” prescription drug coverage (that is, prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage), your monthly Part D premium may go up by at least 1 percent of the premium you would have paid had you enrolled timely, for every month that you did not have creditable coverage. For example, if after your Medicare Part D initial enrollment period you go 19 months without coverage, your premium may be at least 19% higher than the premium you otherwise would have paid. You may have to pay this higher premium for as long as you have Medicare prescription drug coverage. However, there are some important exceptions to the late enrollment penalty.
Special Enrollment Period Exceptions to the Late Enrollment Penalty There are “special enrollment periods” that allow you to add Medicare Part D coverage months or even years after you first became eligible to do so, without a penalty. For example, if after your Medicare Part D initial enrollment period you lose or decide to leave employer-sponsored or union-sponsored health coverage that includes “creditable” prescription drug coverage, you will be eligible to join a Medicare drug plan at that time. In addition, if you otherwise lose other creditable prescription drug coverage (such as under an individual policy) through no fault of your own, you will be able to join a Medicare drug plan, again without penalty. These special enrollment periods end two months after the month in which your other coverage ends. Compare Coverage 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. See the HALO Branded Solutions, Inc. Plan’s summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get one by contacting us at the telephone number or address listed below. Coordinating Other Coverage With Medicare Part D Generally speaking, if you decide to join a Medicare drug plan while covered under the HALO Branded Solutions, Inc. Plan due to your employment (or someone else’s employment, such as a spouse or parent), your coverage under the HALO Branded Solutions, Inc. Plan will not be affected. For most persons covered under the Plan, the Plan will pay prescription drug benefits first, and Medicare will determine its payments second. For more information about this issue of what program pays first and what program pays second, see the Plan’s summary plan description or contact Medicare at the telephone number or web address listed below. If you do decide to join a Medicare drug plan and drop your HALO Branded Solutions, Inc. prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back. To regain coverage you would have to re-enroll in the Plan, pursuant to the Plan’s eligibility and enrollment rules. You should review the Plan’s summary plan description to determine if and when you are allowed to add coverage. For More Information About This Notice or Your Current Prescription Drug Coverage… Contact the person listed below for further information, or call 815-548-9101. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through HALO Branded Solutions, Inc. changes. You also may request a copy. For More Information About Your Options Under Medicare Prescription Drug Coverage… More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: • Visit www.medicare.gov. • Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help, • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772- 1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty). Date: September 1, 2021 Name of Entity/Sender: Matt Barbian Contact—Position/Office: Benefits Specialist Address: 1500 HALO Way Sterling, IL 61081 Phone Number: 815-548-9101 Nothing in this notice gives you or your dependents a right to coverage under the Plan. Your (or your dependents’) right to coverage under the Plan is determined solely under the terms of the Plan.
plans covering your father and mother), we may share your PHI with the other plans to coordinate payment of your claims. • Health care Operations: The Plan may use and disclose your PHI in the course of its “health care operations.” For example, it may use your PHI in evaluating the quality of services you received or disclose your PHI to an accountant or attorney for audit purposes. In some cases, the Plan may disclose your PHI to insurance companies for purposes of obtaining various insurance coverages. However, the Plan will not disclose, for underwriting purposes, PHI that is genetic information. • Other Uses and Disclosures of Your PHI Not Requiring Authorization. The law provides that the Plan may use and disclose your PHI without authorization in the following circumstances: • To the Plan Sponsor: The Plan may disclose PHI to the employers (such as HALO Branded Solutions, Inc.) who sponsor or maintain the Plan for the benefit of employees and dependents. However, the PHI may only be used for limited purposes, and may not be used for purposes of employment-related actions or decisions or in connection with any other benefit or employee benefit plan of the employers. PHI may be disclosed to: the human resources or employee benefits department for purposes of enrollments and disenrollments, census, claim resolutions, and other matters related to Plan administration; payroll department for purposes of ensuring appropriate payroll deductions and other payments by covered persons for their coverage; information technology department, as needed for preparation of data compilations and reports related to Plan administration; finance department for purposes of reconciling appropriate payments of premium to and benefits from the Plan, and other matters related to Plan administration; internal legal counsel to assist with resolution of claim, coverage, and other disputes related to the Plan’s provision of benefits. • To the Plan’s Service Providers: The Plan may disclose PHI to its service providers (“business associates”) who perform claim payment and plan management services. The Plan requires a written contract that obligates the business associate to safeguard and limit the use of PHI. • Required by Law: The Plan may disclose PHI when a law requires that it report information about suspected abuse, neglect, or domestic violence, or relating to suspected criminal activity, or in response to a court order. It must also disclose PHI to authorities that monitor compliance with these privacy requirements. • For Public Health Activities: The Plan may disclose PHI when required to collect information about disease or injury, or to report vital statistics to the public health authority. • For Health Oversight Activities: The Plan may disclose PHI to agencies or departments responsible for monitoring the health care system for such purposes as reporting or investigation of unusual incidents. • Relating to Decedents: The Plan may disclose PHI relating to an individual’s death to coroners, medical examiners, or funeral directors, and to organ procurement organizations relating to organ, eye, or tissue donations or transplants. • For Research Purposes: In certain circumstances, and under strict supervision of a privacy board, the Plan may disclose PHI to assist medical and psychiatric research. • To Avert Threat to Health or Safety: In order to avoid a serious threat to health or safety, the Plan may disclose PHI as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of harm. • For Specific Government Functions: The Plan may disclose PHI of military personnel and veterans in certain situations, to correctional facilities in certain situations, to government programs relating to eligibility and enrollment, and for national security reasons. • Uses and Disclosures Requiring Authorization: For uses and disclosures beyond treatment, payment, and operations purposes, and for reasons not included in one of the exceptions described above, the Plan is required to have your written authorization. For example, uses and disclosures of psychotherapy notes, uses and disclosures of PHI for marketing purposes, and disclosures that constitute a sale of PHI would require your authorization. Your authorization can be revoked at any time to stop future uses and disclosures, except to the extent that the Plan has already undertaken an action in reliance upon your authorization. • Uses and Disclosures Requiring You to Have an Opportunity to Object: The Plan may share PHI with your family, friend, or other person involved in your care, or payment for your care. We may also share PHI with these people to notify them about your location, general condition, or death. However, the Plan may disclose your PHI only if it informs you about the disclosure in advance and you do not object (but if there is an emergency situation and you cannot be given your opportunity to object, disclosure may be made if it is consistent with any prior expressed wishes and disclosure is determined to be in your best interests; you must be informed and given an opportunity to object to further disclosure as soon as you are able to do so).
You can also read