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Why are we here today?

Why are we here today?. JUNE is OPEN ENROLLMENT for all benefits: HEALTH DENTAL VISION LONG TERM DISABILITY OPTIONAL LIFE OPTIONAL LONG-TERM DISABILITY

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Why are we here today?

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  1. Why are we here today? • JUNE is OPEN ENROLLMENT for all benefits: • HEALTH • DENTAL • VISION • LONG TERM DISABILITY • OPTIONAL LIFE • OPTIONAL LONG-TERM DISABILITY • This is your opportunity to change your current benefits, add additional benefits or join for the first time if you have been employed since March 1, 2013 or before. • Benefits will be effective July1st • Your employer may offer some benefits (such as LTD) to you at no cost. Please see your HR representative to be sure what benefits you may or may not be eligible for.

  2. What if I have benefits now and I do not want to make any changes? • You do not have to do anything. You will automatically be enrolled onto the benefits you currently have. • The only reason to act is to make changes to your current benefits. You can do this by visiting yourebl.com and clicking on “Get Application” to pull up your original application to make changes.

  3. Benefit Administrator: EMPLOYEE BENEFIT LOGISTICS

  4. Where do I fill out an app? Your application and all health, dental, and vision information will be available on the Internet. Simply search for yourebl.com–access your company - and you will have everything you need.

  5. Vision WellVision Exam, Lenses, Frames, or Contacts EVERY 12 MONTHS

  6. MetLife Dental In-NetworkOut-of-Network Paid at R & C 90th percentile. You may have more OOP • Type A – Preventative 100% 100% • Type B – Basic 80% 80% • Type C – Major 50% 50% (12 month waiting period) • Calendar Year Deductible Individual $50 $75 Family $150 $225 • Maximum benefit $1,000 / Individual

  7. MetLife OPTIONAL Life and Long-Term Disability • This benefit is above and beyond what the employer provides for all full-time staff as a life benefit. You may also enroll your spouse and dependents in your Optional Life benefits. • To find out what you are receiving as a full-time staff member please see your HR representative. • In order to receive this benefit you must fill out BOTH the Application and Statement of Health.

  8. MetLife Optional Life Benefits • This is Life Insurance that is above and beyond what your employer provides for you, and enables you to enroll your family in optional life benefits. • Employees are eligible for benefits in $10,000 increments up to $500,000 (not to exceed 5x your salary, whichever is less). So someone making $15/hr would be eligible for $150,000. • $15/hr x 2080 (full time hours in a year) x 5 = $156,000 • This benefit is not guaranteed. Therefore, you must qualify for this benefit by completing a Statement of Health. • Spouses are eligible for amounts that do not exceed 50% of the your Optional life amount. Spouses MUST fill out a SEPARATE Statement of Health Form to be submitted with your application. If you apply for : $100,000 Your Spouse can apply for: $50,000 • Dependents are eligible for 10% of your Optional life amount, with a MAX of $10,000 per dependent. Changes can be made on the online enrollment form at yourebl.com

  9. Optional LTD Benefit Changes • As of July 1st we will no longer have Guardian Optional Long Term Disability. • All employee’s currently enrolled in Guardian Optional LTD will be given the same, or a matched, Optional LTD policy (with equal or less premiums) through MetLife Optional LTD. • If you wish to make any changes to your current Guardian (soon to be MetLife) LTD, now is your chance. Changes can be made on the online enrollment form at yourebl.com

  10. MetLife OPTIONAL Long Term Disability Benefits • Who can apply? Any Full-Time employee who does NOT receive LTD benefits from your employer. • What is the benefit coverage? Maximum LTD benefit is 60% of your pre-disability earnings, with a maximum monthly benefit of $4,000. Premium is based on your income and age. • Why should you apply for Optional LTD Benefits? LTD insurance replaces a portion of your income (60% of your pre-disability monthly earnings) when you can’t work, due to illness or injury, to help you pay for your essential living expenses after a 90 day elimination period. Social Security benefits are not available if your are expected to be out of work for LESS than one year. LTD insurance could help supplement your income if you don’t qualify for Social Security benefits. If you or others depend on your income LTD insurance helps you to maintain a steady income when you can’t work due to illness or injury.

  11. Pharmacy

  12. Rxa benefit only with health coverage Low co-pay $10 Generic $20 Brand no generic $40 Brand with generic ava or DAW 50% Designer Drug 0% on any med covered in the OTC program Some medications under this program are classified as “non-preferred”. This means there are alternative medications which are therapeutically equivalent. If your physician writes for a medication that is part of our “non-preferred” list you may want to discuss alternative medications which are just as effective. THE NON-PREFERRED LIST IS AT YOUREBL.COM

  13. Rx $0 Co-pay on OTC If you are currently taking an anti-ulcer or allergy medication talk to your physician about using an OTC drug. OTC drugs that are a $0 co-pay are: Axid Allegra Pepcid Allegra-D Prevacid OTC Benadryl Prilosec 20mg Claritin / Alavert Tagamet Claritin-D/Alavert-D Zantac Zyrtec Zegerid OTC Zyrtec-D If your physician writes a prescription, then you get these medications for free!

  14. Health Plan coverage Cofinity Is your NETWORK To find an In-Network physician or hospital in your area please visit: cofinity.net

  15. Sponsored Dependant • An employee's child, who is mentally or physically incapable of sustaining his or her own living. • If you have this situation see you HR representative.

  16. Preventative care Each year you can have one of the following services at no cost* to you. Health maintenance exam including chest x-ray, EKG, cholesterol screening and other select lab procedures. Routine Gynecological exam including lab and test fees. Well-baby and child care exams and immunizations. Fecal occult blood screening. Prostate exam. Colonoscopy. Routine mammogram. Routine digital rectal exam. Routine Immunizations (including flu shot). Women’s Services. *The service must be performed by an in-network physician to be no cost to you. Any service performed by an out-of-network physician may have balance bill fee’s that YOU will be 100% responsible for.

  17. Durable Medical Equipment • DME benefits are covered at 50% with a benefit maximum of $1,000 per plan year. Diabetic Testing Supplies for 1 month $100 Your DME Co-pay $50 The plan pays $50 • Once the Plan has paid out $1,000 in DME charges for each plan year, YOU will be responsible for 100% of DME charges for the remainder of the benefit plan year. • Employee Benefit Logistics has an arrangement with a DME supplier. Please call Employee Benefit Logistics before you purchase medical supplies (even diabetic supplies) to see if we can help lower your cost.

  18. Health Plan • As of July 1st you will have a deductible. The deductible is the amount you must pay first, before the plan pays. What is your deductible amount? $300 per person insured

  19. Health Plan Co-Insurance This means the Plan will pay up to 80% of in-network approved charges and you are responsible for the remaining 20% up to a maximum out-of-pocket.

  20. Health Plan Your Maximum out-of-pocket: $2,500 per person $5,000 per family Remember you still get your preventative visits for free. Preventative has $0 out-of-pocket. The out-of-pocket includes all in-network deductible, co-insurance and co-pay. After you have satisfied your max for out-of-pocket, the Plan will pay 100% for in-network approved charges.

  21. COFINITY – PPO Network Point-of service or Co-pay fee schedule: Physician Office Outpatient Clinic $10 / per visit Specialist Office Urgent Care Center $10 / per visit Emergency room $150 per visit waived if admitted Ambulance ground transport $500 per transport

  22. Example of in-network bill You go in to your in-network hospital for a procedure. Your hospital charges $10,135 Your provider’s agreement with Cofinity allows $7,540 for this procedure Your Deductible is $300 Your Co-Insurance is $1,448 The Plan pays $5,792 The total amount YOU will be responsible for $1,748 After you have met your deductible and co-insurance max for in-network approved charges the plan will pay $7,540

  23. What if my doctor does not participate with Cofinity ? • If you go to a hospital and/or are seen by a provider who does not participate with Cofinity: The plan will pay up to 100% of reasonable and customaryfees for OUT-OF-NETWORK. This means YOU may be responsible for any remaining balance of the actual billed amount if the provider will not negotiate their fee down to a reasonable rate.

  24. More about out-of-network There is NO maximum out-of-pocket for out-of-network claims. How does this work? You see a provider who does not participate with Cofinity for a routine office visit. The doctor charges $200 for the visit. Reasonable and customary for this service is $50. You will pay a $10 office visit co-pay, and the plan will pay $40 (because the plan pays 100% of reasonable and customary after your co-pays are met) and you will be responsible for $160. This example assumes your deductible has been met first.

  25. How will I know what was paid on my behalf and if I owe anything? • You will receive an EOB (explanation of benefits) from Employee Benefit Logistics at your home. It will state how much the plan has paid and how much you owe the provider. • Keep all of these documents for your records. • The provider will receive the same EOB and expect payment from you for any expense you may owe.

  26. ALERT • It is of the utmost importance that you keep your address current with Employee Benefit Logistics so that you receive your information on time

  27. When does your new benefit year begin? July 1, 2013

  28. IT’S UP TO YOU! • If you want benefit coverage or coverage changes you must complete the on-line application, or update your previous on-line application. Visit: yourebl.com • After you complete the on-line application you must go to your human resource office where the application will be printed out and you will go over all the benefits you have chosen and sign the application. Only after you have signed your application is it considered a valid submission and request for benefits.

  29. IMPORTANT! • You must enroll online at yourebl.com and sign for all benefits with your HR representative BEFORE June 30th In order to begin benefits on July 1st • Any applications that are incomplete or received AFTER June 30th will NOT be accepted. • Please be sure each application is filled out completely, legibly, and signed & datedbefore submission.

  30. Dis-Enrolling From Benefits • If you wish to dis-enroll from a specific benefit, please fill out a Dis-Enrollment Form in your HR office BEFORE June 30th • You will continue to pay for any benefits you are currently enrolled in, and do not specifically dis-enroll from.

  31. Change your mind after July 1? • You will not be able to make any plan changes to your benefits until the next open enrollment period which is June 2014 for the effective date of July 1, 2014 There are a few exceptions to this rule. If you have what you think is a qualifying event such as divorce, birth or adoption of a child, marriage – please see your HR rep.

  32. ?Questions? • I will not be taking questions here. • Questions regarding specific coverage or benefits should be directed to Employee Benefit Logistics. • Questions regarding specific deductions or coverage should be directed to Human Resources. • The details of the plans are on yourebl.com. Please refer to the website.

  33. IT IS TIME TO ACT • If you wish to sign up or make changes to your benefits please visit yourebl.com today. • Your HR rep has the amount each of the benefits cost per pay.

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