Guide to benefits Your guide to the PSEB associate benefit programs for June 2020-May 2021 - psebllc.com
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Guide to benefits
Your guide to the PSEB associate benefit
programs for June 2020-May 2021
1
Content
Focus on what matters
Everyone who works at PSEB has an impact First things first...................3
on our success. And we know that we can’t be
the best possible us, unless you are the best Your health...........................5
possible version of you!
Medical.......................................................................... 5
Your health and wellbeing are important, so we’re pleased Health Reimbursement Arrangement (HRA)....... 7
to offer a comprehensive benefits package to all eligible Dental............................................................................ 11
associates. Vision............................................................................ 12
Our benefits are designed to support you when you need
it most. Some of them are paid for in full by PSEB and will
Your money........................ 13
support you automatically. Others are available for you to Flexible Spending Accounts (FSA)......................... 13
choose from to build a benefits package that suits your needs. Life and AD&D insurance.........................................14
Disability insurance................................................... 15
This guide includes detail about all of the benefits available.
Additional benefit options.......................................16
Please take the time to read through it and understand the
Associate discounts................................................... 17
choices available to you. If you need any more information,
you can visit The Collective at thecollective.psebllc.com or
contact the benefits department using the details on
Your life.............................. 18
page 19. When you’re ready to enroll, log into UltiPro. Employee Assistance Program (EAP)...................18
Peace of mind so you can focus on what matters.
Important contacts............. 19
This document is an outline of the coverage proposed by the carrier(s), based on information provided by your company. It does not include all the terms, coverages,
exclusions, limitations, and conditions of the actual contract language. The policies themselves must be read for those details. The intent of this document is to provide you
with general information about your employee benefit plans. It does not necessarily address all the specific issues which may be applicable to you. It should not be construed
as, nor is it intended to provide, legal advice. Questions regarding specific issues should be directed to the Benefits Department.
2
First things first
Eligibility Making your benefit selections
Active, full-time associates Benefit plans are effective each year from June 1 through
working at least 30 hours May 31. In general, you may make benefit choices as a
per week are eligible for newly eligible associate, during Open Enrollment and if you
benefits with PSEB. have a qualifying life change.
Associates in Hawaii working • Newly eligible associates: When you’re first eligible for benefits with PSEB,
at least 20 hours per week make your benefit selections within 30 days of your hire or eligibility date.
are eligible for most benefits. Benefits begin on the first day of the month following 30 days of employment
and remain in effect through May 31, 2021 unless you have a qualifying life
Some benefits are paid for 100% by change. If you are a variable hour associate, the date your benefits begin is
PSEB, and coverage is automatic if you based on when your measurement period is satisfied.
are eligible. Other benefits give you
• Open Enrollment: Choices you make during Open Enrollment are in effect
choices and require you to enroll.
through May 31, 2021 unless you have a qualifying life change.
Eligibility groups • Qualifying life change: Certain events throughout the year such as marriage
or divorce, birth or adoption of a child, death of a covered family member, or
• Group 1: Executive Office Team, gain/loss of other coverage can allow you to make changes to your benefit plans
Executive Team consistent with your life change. You have 30 days (31 days for Triple S) from
the date of the event to submit this request, and documentation is required.
• Group 2: District Directors, District
Please review the information in UltiPro or on The Collective for more details.
Managers, Area Managers,
Regional Managers, Distribution
Center Managers, Corporate Enrollment occurs in UltiPro; login instructions are
Directors, Corporate Managers available on The Collective.
• Group 3: Store Managers, Co-
Managers, FT Assistant Store
Managers, Stock Leads, Distribution Contact the Benefits Department if you have questions about
Center Supervisors, Distribution your eligibility or enrollment.
Center Front Office (non-mgt),
Distribution Center (non-mgt),
Corporate Associates (non-mgt)
• Group 4: PT Assistant Store
Managers, Sales Supervisors, Store The measurement period is the time the company uses to track hours worked and determine if you have worked an
average of 30 hours per week or more. If it has been determined that you have worked an average of 30 hours or
Associates, Stock Associates,
more during your measurement period, you are eligible to enroll in health benefits and receive coverage for up to
Distribution Center PT Variable
12 months while the company tracks your hours to determine eligibility for the next 12 months.
Hour Associates, PT Corporate
Associates (non-mgt)
3
First things first
Covering your family
In addition to associates, we extend benefit coverage to eligible
dependents.
Your Spouse
You may cover your legal spouse on medical, dental, vision, and additional voluntary life
insurance coverage.
Your Children
Your natural, adopted, foster, stepchildren, and children in your custody due to a court order are
eligible for benefits:
• Medical, Dental, Vision: until the end of the month when they reach age 26 regardless of
any other status.
Disabled dependents: adult dependent children who became disabled before age 26 and meet
carrier requirements are also eligible for coverage. Please contact the benefits department at
benefits@psebllc.com or 1-866-989-6958, #2 if this applies to you.
• Child Life Insurance: from live birth until their 26th birthday if unmarried.
Factors that impact your cost for
coverage
Spousal surcharge
If your spouse has health coverage available through their own employer but is covered under the
PSEB medical plan, a $46 bi-weekly spousal surcharge will apply to your medical coverage. More
information is available on The Collective.
Non-tobacco discount
If you and/or your enrolled spouse use tobacco products, a $46 bi-weekly increase will be added to
the rates shown on the medical pages. Please contact the benefits department at benefits@psebllc.
com or 1-866-989-6958, #2 to learn about removing the surcharge by completing our tobacco
cessation program. More information is available on The Collective.
The rates shown on the medical pages are for associates that are non-tobacco users
and who do not have a spousal surcharge. If you are a tobacco user and/or if your
enrolled spouse has other health coverage available through their own employer, the
additional cost(s) above would apply.
4
Helpful insurance
terms
These terms will help you understand
your benefits and coverage options.
Copay – a set fee you pay whenever
you use certain medical services, like a
doctor visit.
Deductible – the dollar amount you pay
before your medical insurance begins
paying deductible-eligible claims.
Coinsurance – the percentage of
Your health
covered medical expenses you continue
to pay after you’ve met your deductible
and before you reach your out of pocket
maximum.
Out-of-pocket maximum – the most
you will pay annually / during the year
for covered expenses. This includes
Medical
copays, deductibles, coinsurance, and
prescription drugs.
Balance billing – the amount you are
billed by your out-of-network provider
We know the peace of mind that great medical to make up the difference between
coverage can provide, and we want you to have what your provider charges and what
just that. PSEB offers several medical plans insurance reimburses. This amount is in
addition to, and does not count toward
so you can choose the one that suits you best. your out-of-pocket maximum.
Each of our medical plans covers in-network preventive care at Plan year – June-May
100% when received in a physician’s office. Beyond that, your
responsibility depends on the plan you choose, the services you Calendar year – January-December
need, and where you receive your care.
Plan options at-a-glance: Mainland US Associates
Anaheim, CA or Bellevue, WA
All mainland US associates
corporate associates only
California Washington
HRA PPO Plan PPO Plan
HMO HMO
Network options In- and out-of-network In- and out-of-network In-network only (Kaiser)
A mix of copays and deductible A mix of copays and deductible
Paying for care Mostly deductible then coinsurance
then coinsurance then coinsurance
Health Reimbursement Arrangement
Health account
(HRA) Health Care FSA Health Care FSA
eligibility
Health Care FSA
An HRA helps you pay for eligible The Aetna PPO plan has a higher These plans offer in-network
medical and pharmacy expenses premium, but with more predictable care at predictable costs when
with money contributed by PSEB. costs during the year. you use Kaiser facilities.
Plan information See page 7 for Corporate associates in Anaheim,
additional information. CA or Bellevue, WA have the Kaiser
option in addition to Aetna. See
Deductibles and out-of-pocket maximums run June - May. page 8 for more information.
Associates in Puerto Rico and Hawaii have separate plan options; see page 9 for details.
5
Your health
Medical plan comparison
When you need care, your medical plan with Aetna is here for you – regardless of the selection you make.
Take a moment to review the options available to you, and head over to The Collective for additional details.
Mainland US - all locations
HRA PPO Plan PPO Plan
Network name Aetna Choice POS II (Aetna HealthFund) Aetna Choice POS II (Open Access)
In-network care
Plan year deductible DED $3,000 single coverage; $6,000 with dependents $1,500 per person; $3,000 family maximum
Out-of-pocket maximum $6,000 per person; $12,000 family maximum (plan year) $3,000 per person; $9,000 family maximum (plan year)
Health account: HRA (annually)
Not eligible
PSEB contribution Single coverage: $500 | With dependents: $1,000
Preventive care 100% covered 100% covered
Primary care physician DED then you pay 10% $20 copay
Specialist DED then you pay 10% $40 copay
Virtual doctor (Teladoc) DED then you pay 10% $20 copay
Urgent care DED then you pay 10% $40 copay
Emergency room $250 copay then DED then you pay 10% $250 copay then DED then you pay 20%
Outpatient surgery DED then you pay 10% DED then you pay 20%
Inpatient hospitalization DED then you pay 10% DED then you pay 20%
Prescription drug coverage (CVS Caremark)
30-day fill 90-day fill 30-day fill 90-day fill
Generic You pay 30% (to $25) You pay 30% (to $50) You pay 30% (to $25) You pay 30% (to $50)
Preferred Brand You pay 40% (to $50) You pay 40% (to $100) You pay 40% (to $50) You pay 40% (to $100)
Non-Preferred Brand You pay 50% (to $75) You pay 50% (to $150) You pay 50% (to $75) You pay 50% (to $150)
Specialty You pay 40% (to $200) Not covered – use retail You pay 40% (to $200) Not covered – use retail
After the 3rd fill of long-term maintenance drugs, use CVS Caremark mail or a CVS/Target retail pharmacy to receive a 90-day supply, otherwise you will pay 100%
of the drug cost.
Out-of-network cost basics (plus balance billing)
Plan year deductible DED $4,000 single coverage; $8,000 with dependents $3,000 per person; $6,000 family maximum
Coinsurance (you pay) 50% after DED 40% after DED
Out-of-pocket maximum $8,000 per person; $16,000 family maximum $6,000 per person; $18,000 family maximum
Your per-paycheck (bi-weekly) cost for coverage
HRA PPO Plan PPO Plan
Associate Only $32.02 $95.05
Associate + Spouse $77.75 $237.48
Associate + Child(ren) $69.98 $212.24
Associate + Family $110.91 $337.81
The Aetna HRA PPO plan does not comply with Massachusetts Minimum Creditable Coverage (MCC) requirements.
6
Your health
Health Reimbursement
Arrangement (HRA)
An HRA is a company-provided allowance to use
towards eligible health care expenses.
When you enroll in the HRA PPO Plan, PSEB sets aside money on an
annual basis for your medical and pharmacy care.
Plan year allowance
The HRA is funded by PSEB; you do not contribute. The amount of your
allowance depends on your coverage level:
Single coverage With dependents
Plan year allowance $500 $1,000
Paying for care
Your eligible medical and pharmacy expenses (deductible and/or copay) are
automatically deducted from your HRA allowance first. Once your HRA is
depleted, you may pay out of pocket or use your FSA funds.
Unused funds and more
Unused funds at the end of the plan year will roll into the next year’s
allowance, up to a maximum of $2,250 for individuals or $4,500 if you
cover any dependents. Your funds are non-transferable and are forfeited if
your employment with PSEB terminates for any reason.
7
Your health
Anaheim, CA and Bellevue, WA corporate locations
Additional options with Kaiser Permanente are available for associates in the Anaheim and Bellevue
corporate locations. These plans require the designation of a Primary Care Physician. Although you do not
need to select one at enrollment, be sure to designate one within 90 days or one will be assigned to you.
California HMO (Anaheim, CA) Washington HMO (Bellevue, WA)
Network name Kaiser: Core Kaiser: HMO
In-network care
Plan year $750 per person $750 per person
deductible DED $1,500 family maximum $1,500 family maximum
Plan year out-of- $3,000 per person $3,500 per person
pocket maximum $6,000 family maximum $7,000 family maximum
Preventive care 100% covered 100% covered
Primary care physician $25 copay $25 copay
Specialist $25 copay $25 copay
Virtual doctor (Kaiser) 100% covered 100% covered
Urgent care $25 copay $25 copay
$250 copay then DED then you pay
Emergency room $250 copay (waived if admitted)
20% (waived if admitted)
Outpatient surgery DED then you pay 20% DED then you pay 20%
Inpatient hospitalization DED then you pay 20% DED then you pay 20%
Prescription drug coverage
30-day fill 100-day fill 30-day fill 90-day fill
Preferred Generic $10 copay $20 copay $10 copay $20 copay
Preferred Brand $30 copay $60 copay $20 copay $40 copay
Non-Preferred Brand Not covered Not covered Not covered Not covered
Specialty You pay 20% (to $200) Not covered – use retail You pay 50% (to $150) Not covered – use retail
Out-of-network cost basics (plus balance billing)
Deductible DED
Coinsurance (you pay) Not covered unless a true emergency. Not covered unless a true emergency.
Out-of-pocket maximum
Your per-paycheck (bi-weekly) cost for coverage
California HMO (Anaheim, CA) Washington HMO (Bellevue, WA)
Associate Only $95.05 $95.05
Associate + Spouse $237.48 $237.48
Associate + Child(ren) $212.24 $212.24
Associate + Family $337.81 $337.81
State registered domestic partner coverage is permitted on Kaiser plans. Spousal surcharge requirements
apply to domestic partners as well. Visit The Collective for details.
8
Your health
Hawaii and Puerto Rico locations
Hawaii Plan (HMAA) Puerto Rico plan (Triple-S Salud)
Network name HWMG Commercial (PPO)
In-network care Calendar year June - May (Plan year)
Annual deductible $100 per person $100 per person (major medical)
DED $300 family maximum $300 family maximum (major medical)
Medical: $2,000 per person; $6,000 family maximum Medical/Hospital/Rx: $6,350 per person
Out-of-pocket maximum $12,700 family max.
Prescription: $5,350 per person; $8,700 family maximum Major medical: $2,000 per person | $4,000 family max.
Preventive care 100% covered 100% covered
Primary care physician $15 copay $10 copay
Specialist $15 copay $10 copay
Virtual doctor (page 10) 100% covered Not covered (Nurseline)
Urgent care $25 copay Illness: $50 copay | Accident: no charge
Emergency room You pay 20% Illness: $50 copay | Accident: no charge
Outpatient surgery You pay 20% $100 copay
Inpatient hospitalization You pay 20% $100 copay
Prescription drug coverage
30-day fill 90-day fill 30-day fill 90-day fill
Drug cost over $250: 30-day retail drug cost over
Generic you pay 20% $250: you pay 20% You pay 30% (to $25) You pay 23% (to $50)
Otherwise, $12 copay Otherwise, $24 copay
You pay 20% if drug 30-day retail drug cost over
Preferred Brand cost is over $250 $250: you pay 20% You pay 40% (to $50) You pay 30% (to $100)
Otherwise, $24 copay Otherwise, $48 copay
You pay 20% if drug 30-day retail drug cost over
Non-Preferred Brand cost is over $250 $250: you pay 20% You pay 50% (to $75) You pay 38% (to $150)
Otherwise, $48 copay Otherwise, $96 copay
You pay 40% (to $200)
Specialty Not applicable Not covered – use retail Not covered – use retail
In-network only
Out-of-network cost basics (plus balance billing)
Annual deductible DED $100 per person; $300 family maximum
Coinsurance (you pay) 20% after DED Not covered unless a true emergency.
Out-of-pocket maximum Single: $2,000 | Family: $6,000
Your per-paycheck (bi-weekly) cost for coverage
Hawaii Plan (HMAA) Puerto Rico plan (Triple-S Salud)
Associate Only $5.66 $27.82
Associate + Spouse $75.65 $67.82
Associate + Child(ren) $82.52 $59.36
Associate + Family $106.60 $82.97
Hawaii associates are automatically given the non-tobacco discount.
9
Your health
Choices for health care
Making smart healthcare choices helps you – and your wallet – feel healthy, secure, and supported.
Try virtual visits Outpatient imaging
Do you have a smart phone or tablet? Virtual visits allow you to In most cases, imaging services (MRI, CT, and X-ray) can be done
get fast, convenient care with a board-certified physician – no in outpatient centers that are not attached to a hospital.
matter where you are or what time it is. Smaller buildings generally mean smaller bills – a big savings
opportunity if you’re paying a percentage of the cost.
Virtual physicians can diagnose symptoms and prescribe
medications for minor health concerns. Use it when your
primary doctor is not available, if you’re sick while traveling, on Go generic and save
nights and weekends, or when it’s inconvenient to leave home.
Generic drugs are the non-brand-name, FDA-approved versions
Use virtual doctor visits for: of their brand-name counterparts. They’re required to have the
same active ingredients as the brand-name drug – but at a
• Allergies • Nausea fraction of the price.
• Cold and flu • Rashes
• Ear infections • Sinus infection Ask your doctor or pharmacist if a generic is a good option
• Fever • And more! for you.
• Headache
Save the emergency room for
Your source for virtual visits depends on your emergencies
medical plan:
Unless loss of life or limb is imminent, consider using Urgent
• Aetna: Teladoc.com/aetna Care or a Virtual Visit to save money, time, and aggravation.
Consider creating an account and providing your medical If you have a true emergency – head injury, severe trauma,
information once you get your medical ID card so care is chest pain, allergic reaction, etc. – get care from your nearest
available when you need it. emergency room as quickly as possible. Coverage is the same
in- and out-of-network for true emergencies
• Kaiser California: Log into your Kaiser account for care or
call 1-833-574-2273.
website: https://kp.org/getcare
• Kaiser Washington: Log into your Kaiser account for care
or call 1-800-297-6877.
website: https://kp.org/wa/getcare
• HMAA Hawaii: Visit www.HiDocOnline.com or call
1-844-423-6242.
• Triple-S Salud Puerto Rico: Nurseline available through
TeleConsulta at 1-800-255-4375 (not board-certified
physicians).
Visit The Collective for more information about Virtual Visits.
10Your health
Dental
Dental coverage is a highly valued benefit, and for good reason! Good oral
health has been shown to enhance your mental and overall wellbeing, and
knowing that you’re covered should you need to see a dentist or specialist
for a big-ticket procedure is a big relief.
We offer you dental insurance through Aetna. This coverage is optional (like flossing!), so you must actively
elect the plan when you make your benefit selections in order to be covered.
For more information on dental coverage, visit the dental page on The Collective.
Coverage summary
Basic PPO Enhanced PPO
In-network Out-of-Network In-Network Out-of-Network
Plan year Deductible $100 per person $100 per person $50 per person $50 per person
June - May $300 max per family $300 max per family $150 max per family $150 max per family
Plan year Maximum Benefit
$1,000 per person $1,000 per person $2,000 per person $2,000 per person
June - May
Dental network name Dental PPO/PDN with PPO II Dental PPO/PDN with PPO II
Preventive Services 100% covered (plus 100% covered (plus
100% covered 100% covered
Exams, cleanings, and X-rays balance billing) balance billing)
Basic Services You pay 40% after You pay 20% after
You pay 40% You pay 20% after
Fillings, root canals, extractions, oral deductible (plus deductible (plus
after deductible deductible
surgery, endodontics, periodontics balance billing) balance billing)
You pay 60% after You pay 50% after
Major Services You pay 60% You pay 50%
deductible (plus deductible (plus
Crowns, inlays/onlays, bridges and dentures after deductible after deductible
balance billing) balance billing)
Implants Not covered Covered as a Major Service
Orthodontics $50 lifetime deductible, then 50% coverage
Not covered
Child and adult $1,500 lifetime benefit maximum
Tip: If you choose to use a dentist who doesn’t participate in the Aetna dental network, your out-of-pocket costs will be higher and you
will be subject to balance billing.
Your per-paycheck (bi-weekly) cost for coverage
PSEB contributes to the cost of your dental coverage.
Basic PPO Enhanced PPO
Associate Only $11.11 $20.01
Associate + Spouse $22.23 $40.04
Associate + Child(ren) $20.00 $36.04
Associate + Family $33.34 $60.07
11Your health
Vision
Regular eye exams are an important part of health maintenance, no matter
your age. And if you or your family members wear glasses or contact lenses,
you already know that the cost of vision care can quickly add up. Not only
that, but regular eye examinations can detect general health problems at
their earliest stages.
We offer comprehensive vision coverage through VSP which provides you and your family with access to
great eye doctors, quality eyewear and affordable eye care. This plan is also optional; you’ll need to elect it
at enrollment to be covered.
Your costs will depend on the services you require and whether it is received in the Choice network.
Coverage summary
In-Network Out-of-Network
Exam $10 copay $10 copay, then up to $45
available once every 12 months (exam + materials) reimbursement
Lenses No charge after copay for basic lenses Up to $30 - $65 reimbursement
available once every 12 months (add-ons may incur a charge) (based on lens type)
Plan pays up to $200 retail,
Frames
20% discount amounts over $200 Up to $70 reimbursement
available once every 12 months
$110 allowance at Costco
Contact lenses
Fitting & Evaluation: up to $60 copay Up to $105 reimbursement for
available once every 12 months
$200 allowance for lenses services and materials
in lieu of lenses & frames
Suncare benefit
$200 allowance for ready-made non-prescription sunglasses after $10 copay
in lieu of contacts or glasses
For more information on vision coverage, visit the vision page on The Collective. To find
an in-network provider in your area, search the Choice network at vsp.com.
Your per-paycheck (bi-weekly) cost for coverage
Associate Only $3.87
Associate + Spouse $6.33
Associate + Child(ren) $5.70
Associate + Family $12.64
12Your money
Flexible Spending Accounts (FSA)
Our Flexible Spending Accounts (FSA) allow you to pay for eligible out-of-pocket expenses with
pre-tax dollars.
Health and Dependent Care Commuter & Parking
Our Health and Dependent Care FSA options are administered through Navia Benefit You can pay for eligible parking and transit
Solutions. FSA elections must be made on the Navia website. expenses through our Commuter Plan,
administered through Navia Benefit
Health Care FSA Dependent Care FSA Solutions. This plan runs on a monthly
basis so you can stop, start, or change your
Pay for qualified medical, pharmacy, contributions from month to month. Visit
Pay for qualified child or elder care expenses. the Navia website for more information.
dental, and vision expenses.
Maximum monthly contribution
All contributions to your FSA are tax free. If you don’t spend the money in your
account during the plan year (June - May), you will lose it. You cannot transfer money $270 per month
from one FSA to another.
Contribution limits New for 2020: manage your commuter
plan enrollment on the Navia website.
You tell us how much you want to save each pay check into your FSA, adding up to no
Bellevue associates are eligible to either
more than the limits shown below. PSEB will not make contributions into your FSA.
participate in the Commuter FSA or receive
an ORCA Pass/on-site parking subsidy.
Maximum plan year contributions
Health Care FSA $2,750
Dependent Care FSA $5,000; $2,500 if married and filing separately
FSA elections do not roll over and must be made each
plan year.
For more information on the FSA options available to you, visit the FSA page on
The Collective or the Navia website.
13Your money
Life and AD&D insurance
While nothing can take away the pain of losing a loved one, life insurance can help to ease the
financial pressure on your family should something happen to you. Accidental Death and
Dismemberment (AD&D) insurance provides additional financial support if you are killed or
seriously injured as the result of an accident.
Basic coverage
PSEB provides you with life insurance and AD&D coverage through Cigna. Not sure what group you’re in?
Click the group numbers for definitions.
Group 1 Groups 2 and 3
$1,000,000 1x annual salary up to $250,000
This benefit is automatic for all eligible associates and provided at no cost to you. Be sure to verify your
beneficiary designation.
Additional life insurance
You have the option to purchase additional life insurance through Cigna for yourself, your spouse, and dependent child(ren). This year
only, elect up to the medical question limit with no medical questions or underwriting required (unless previously declined by Cigna).
Associate Spouse Child
Elect a flat dollar amount:
$5,000 or $10,000
• $10,000 • $75,000 Coverage ends at age 26
Increments Increments of $10,000
• $25,000 • $100,000
• $50,000 • 125,000 Under 6 months of age: $500
100% of associate election to $10,000
Coverage maximum $500,000
a maximum of $125,000 (under 6 months: $500)
Medical question limit $250,000 $50,000 Not applicable
Your cost for coverage is dependent on your age and your coverage amount, and is paid through post-tax payroll deductions. You can
review your cost when you elect your coverage.
Additional AD&D insurance
Additional AD&D insurance is also available through Cigna. You can enroll yourself in the associate only plan or you can choose to
enroll yourself, your spouse and/or your dependent children.
Associate Spouse Child
Coverage options Increments of $100,000 Increments of $50,000 $5,000 or $10,000
5x annual salary to a 100% of associate election to
Coverage maximum $10,000
maximum of $500,000 a maximum of $250,000
14Your money
Disability insurance
Sometimes life throws you a curve ball and you may be
unable to work due to illness or injury. Disability
insurance is available to help meet your financial needs.
Disability benefits are available to eligible associates on the first day of the
month following 180 days of eligibility.
Short-term disability insurance
Applies to Groups 1, 2 and 3
PSEB provides you with short-term disability insurance through Cigna at no
cost to you.
• Benefits begin after 7 days of inability to work due to a covered illness
or injury
• May pay 60% of your base pay, up to $1,500 per week
• Up to 12 weeks of pay continuation
Depending on where you live/work, you may be entitled to a state disability
benefit. Benefits under this plan would be reduced by the benefit you receive
from your state.
Long-term disability insurance
Groups 1, 2, and Store Managers
PSEB provides you with long-term disability insurance through Cigna at no
cost to you.
• Benefits begin after 90 days of inability to work due a covered disability.
• May pay 60% of your base pay, up to:
Group 1 Group 2 and Store Managers
$20,000 per month $12,000 per month
Payments may continue until you reach your Social Security Disability
Retirement Age if you remain unable to work. Certain exclusions, along
with any pre-existing condition limitations, may apply.
Group 3 (excluding Store Managers)
You may purchase long-term disability insurance through Cigna to
provide lasting income support if you are unable to work for an extended
period of time.
• Benefits begin after 90 days of inability to work due to illness or injury
• May pay 60% of your base pay, up to $5,000 per month
• Payments may continue until you reach your Social Security Disability
Retirement Age if you remain unable to work.
Certain limitations and exclusions, along with pre-existing condition
limitations, may apply.
For more information on the disability options
available to you, and what you’re eligible for, visit the
disability insurance page on The Collective.
15Your money
Additional benefit options
401(k) Retirement Plan
PSEB continues to offer 401(k) to eligible associates. For more information, please visit The Collective.
Critical illness insurance
The expenses associated with a critical illness, such as a heart attack,
stroke or cancer, can be overwhelming. Even with a comprehensive medical
plan you may be hit with significant out-of-pocket expenses at an already
stressful time.
Critical illness insurance through Aetna pays out a cash benefit which you can use to help cover costs that
your medical plan doesn’t cover, like your deductible or out-of-pocket maximum, if you or a covered family
member experiences a covered critical illness such as heart attack, stroke, major organ failure, or cancer.
The cash benefit amount is $10,000 for you (associate). You may also elect to cover your spouse and
child(ren) – the available benefit is $5,000.
The insurance premiums are paid through post-tax payroll deductions; and are available when you enroll.
Your cost depends on the plan you choose, your age, your tobacco status, and who you cover.
Hospital indemnity insurance
PSEB offers access to hospital indemnity insurance through Aetna to help
you cover the costs of hospital admission, whether for planned or unplanned
reasons.
Hospital indemnity insurance pays you a cash benefit for medical and non-medical expenses related to a
covered inpatient hospital stay. You have two plan options; the difference is the admission benefit.
Plan one Plan two
Hospital admission $500 benefit $1,000 benefit
Hospital stay $100 benefit per day $100 benefit per day
Hospital stay (ICU) $200 benefit per day $200 benefit per day
Newborn routine care $100 benefit $100 benefit
The insurance premiums are paid through post-tax payroll deductions; and are available when you enroll.
Your cost depends on the plan you choose and who you cover.
16Your money
Accident insurance
Accidents happen and can cause huge financial strain. Accident insurance
helps you cover the costs of an injury, giving you an extra level of financial
protection when you need it most.
The accidental injury insurance is provided through Aetna. In the event of an injury, this coverage will pay
out a cash benefit you can use to help cover your deductible, copays, emergency medical transportation
and more.
Plan one Plan two
Ground ambulance $300 benefit $300 benefit
Initial treatment (ER/
$100 benefit $150 benefit
Urgent Care/Office Visit)
Fracture Up to $2,750 benefit Up to $4,125 benefit
Surgery Up to $1,000 benefit Up to $1,500 benefit
The insurance premiums are paid through post-tax payroll deductions; and are available when you enroll.
Your cost depends on the plan you choose and who you cover.
Identity theft protection
Identity theft is a leading cause of financial loss. Protection through
InfoArmor can help you monitor your personal information and protect your
financial wellbeing.
PrivacyArmor, a service of InfoArmor, can monitor everything from your credit inquiries to your social
media accounts. This service is available for purchase with premiums paid through post-tax payroll
deductions.
Cost information is available at enrollment.
Legal services
Access to quality, prepaid legal services can give you peace of mind.
In-network providers who contract with MetLife Legal can provide you with legal advice and consultation
without additional costs. Available topics include money matters, home and real estate, personal issues,
estate planning, civil lawsuits, family or elder-care issues, and vehicle and driving matters.
Cost information is available at enrollment.
Associate discounts
As an associate of PSEB, you and your eligible dependents receive a discount of 30%-50% off full-priced
products at PacSun and Eddie Bauer. Log into the UltiPro homepage for up-to-date information.
17Your life
Employee Assistance Program (EAP)
Balancing the demands of work, home, family, finances, health and
wellbeing can be challenging at times. We want to make sure that when
issues do arise, you won’t have to face them alone.
As a member of Group 1, Group 2, or Group 3, you have access to our Employee Assistance Program
(EAP) run by Cigna. Our EAP is a confidential service, paid for by PSEB, offering you access to
experienced counselors who can help with stress, anxiety, drug and alcohol dependence, grief, loss
and more.
The Cigna EAP won’t cost you anything to use and any calls you make are confidential; no one at
PSEB will be informed of your call.
You or your family can reach a counselor by visiting www.cignalap.com or dialing 1-800-538-3543 – any
time of day or night. If necessary, you are provided with up to 3 face-to-face visits at no cost to you.
Our EAP can support you with Highlights
• Family or relationship issues • Confidential
• Stress • Unlimited telephonic consultations
• Substance abuse • Up to 3 face-to-face visits at no cost
• Identity theft • Available 24/7
• Adoption
• Child and elder care
• Education or work/life support
• Legal or financial questions
18Important contacts
Benefit Benefit
Health
Aetna CVS Caremark
Pharmacy
Medical www.Aetna.com Specialty Rx: www.aetnaspecialtyrx.com
Aetna plans
1-877-204-9186 1-800-238-6279
Aetna Teladoc
Health Reimbursement Virtual Doctor
Mainland US
www.Aetna.com www.Teladoc.com/aetna
Arrangement (HRA) Aetna plans
1-877-204-9186 1-855-835-2362
Kaiser (California) Kaiser (Washington)
Medical Medical
www.kp.org www.kp.org/wa
Anaheim, CA Corporate Bellevue, WA Corporate
1-800-464-4000 1-888-901-4636
Virtual Doctor www.kp.org/getcare Virtual Doctor www.kp.org/wa/getcare
Kaiser California 1-833-574-2273 Kaiser Washington 1-800-297-6877
HMAA Triple-S Salud
Medical Medical
www.hmaa.com www.ssspr.com
Hawaii Puerto Rico
Hawaii & Puerto Rico
1-800-621-6998 1-800-981-3241
Optum Rx
Abarca
Pharmacy www.hmaa.com/healthplans/ Pharmacy
www.ssspr.com
Hawaii prescription-plan-info/ Puerto Rico
1-800-981-3241
1-808-941-4622
Virtual Doctor www.HiDocOnline.com Virtual Visit (Nurseline) Nurseline through TeleConsulta
Hawaii 1-844-423-6242 Puerto Rico 1-800-255-4375
Aetna VSP
Dental www.Aetna.com Vision www.VSP.com
1-877-204-9186 1-800-877-7195
Money
Navia Cigna
Flexible Spending Life and AD&D
www.naviabenefits.com www.cigna.com
Accounts insurance
1-800-669-3539 1-800-362-4462
Cigna Critical illness Aetna
Disability insurance www.cigna.com Hospital indemnity www.aetna.com
1-800-362-4462 Accident 1-800-607-3366
InfoArmor MetLife Legal
Identity theft
www.myprivacyarmor.com Legal Plan www.legalplans.com
protection
1-800-789-2720 1-800-821-6400
Life
Cigna PSEB
Employee Assistance PSEB Benefits
www.cignaLAP.com benefits@psebllc.com
Program (EAP) Department
1-800-538-3543 1-866-989-6958, #2
19Explore your new benefits 2021 Open Enrollment Guide 20
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