2011 PPCP Employee Benefit Guide

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A quick resource for PPCP employees to access their employee benefit coverage, review contributions and find provider contact information.

Transcript of 2011 PPCP Employee Benefit Guide

  • Welcome to your 2011 Employee Benefits Guide

    We are committed to providing employees with a benefits program that is both

    comprehensive and competitive. Our program offers a range of plan options to

    meet the needs of our diverse workforce. We know that your benefits are important

    to you and your family. This program is designed to assist you in providing for the

    health, wellbeing and financial security of you and covered dependents. Helping you

    understand the benefits PPCP offers is important to us. That is why we have created

    this Employee Benefits Guide.

    Benefits Guide Overview

    This guide provides a general overview of your benefit choices to help you select

    the coverage that is right for you. Be sure to make choices that work to your best

    advantage. Of course with choice, comes responsibility and planning. Please take time

    to read about and understand the benefit, plan thoughtfully, and enroll on time.

    Included in this guide are summary explanations of the benefits and costs as well as

    contact information for each provider.

    It is important to remember that only those benefit programs for which you are

    eligible and have enrolled in apply to you. We encourage you to review each section

    and to discuss your benefits with your family members. Be sure to pay close attention

    to applicable co-payments and deductibles, how to file claims, preauthorization

    requirements, networks and services that may be limited or not covered (exclusions).

    This guide is not an employee/employer contract. It is not intended to cover all

    provisions of all plans but rather is a quick reference to help answer most of your

    questions. Please see your Summary Plan Description for complete details. We hope

    this guide will give you a clear explanation of your benefits and help you be better

    prepared for the enrollment process.

    Contents

    At Your Service .......................................................................................................................................................... 3

    Your Contributions ...................................................................................................................................................4

    Eligibility Details ....................................................................................................................................................... 5

    Medical Insurance .....................................................................................................................................................6

    HSA .................................................................................................................................................................................. 8

    Health & Wellness .....................................................................................................................................................9

    Dental Insurance ...................................................................................................................................................... 10

    Basic Life Insurance ................................................................................................................................................12

    Optional Term Life Insurance.............................................................................................................................13

    Voluntary Long term Disability .........................................................................................................................14

    Voluntary Short term Disability ...................................................................................................................... 15

    Allstate Workplace Benefits ...............................................................................................................................16

    401(k) Plan ..................................................................................................................................................................17

    Pre-Paid Legal Services ...................................................................................................................................... 18

    Identity Theft Protection .................................................................................................................................... 19

    Employee Assistance Program (EAP) .......................................................................................................... 21

    Medicare Notice ....................................................................................................................................................... 21

    Chip Notice ...............................................................................................................................................................22

    Benefit Contacts ......................................................................................................................................................23welco

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    2 Employee Benefits Guide

  • Employee Call Center

    PPCP employees have access to a dedicated employee benefit hotline to answer questions about enrollment, coverage, claims and all other concerns regarding their employee benefit package. Our call center is staffed with trained professionals who understand your benefits plan and are dedicated to providing solutions to your problems. Its easy and its free, just call or email:

    1-877-335-3067 (toll-free) Monday - Friday 9am - 5pm EST email: customerservice@bwbenefits.com

    At Your Service...

    Employee Service Hotline: 1-877-335-3067 3

  • 4 Employee Benefits Guide

    Medical Plan - PPODeduction

    per pay period*

    Employee Only $80.00

    Employee + Spouse $375.50

    Employee + Children $297.00

    Employee + Family $474.00

    Medical Plan - hdhPDeduction

    per pay period*

    Employee Only $47.50

    Employee + Spouse $294.00

    Employee + Children $228.00

    Employee + Family $376.00

    Your ContributionsMe

    dical

    dental PlanDeduction

    per pay period*

    Employee Only $16.50

    Employee + Family $43.00

    Dental

    *Deductions based on 24 pay periods

  • Employee Service Hotline: 1-877-335-3067 5

    Are you eligible for benefits?

    To determine the benefits for which you may be eligible, please refer to the chart below. You are eligible to participate

    in these plans upon meeting each plans eligibility requirements. You also have the option to enroll your eligible

    dependents in some of these plans. Eligible dependents may include:

    Your spouse

    Your children to age 26*

    *Certain limitations apply. Please call the Employee Service Hotline for additional information, 1-877-335-3067

    Eligibility Details

    Benefit Plan Eligibility New Hire Waiting Period

    Medical/Prescription Full time Employee First of the month following 90 days

    Dental Full time Employee First of the month following 90 days

    Basic Life Full time Employee First of the month following 90 days

    Optional Life Full time Employee First of the month following 90 days

    Voluntary LTD Full time Employee First of the month following 90 days

    Voluntary STD Full time Employee First of the month following 90 days

    401 (k) Full time Employee First of the month following 90 days

    Medical Plan - PPODeduction

    per pay period*

    Employee Only $80.00

    Employee + Spouse $375.50

    Employee + Children $297.00

    Employee + Family $474.00

    Medical Plan - hdhPDeduction

    per pay period*

    Employee Only $47.50

    Employee + Spouse $294.00

    Employee + Children $228.00

    Employee + Family $376.00

  • BenefitsIn-Network

    MEMBER PAYSOut-of-Network MEMBER PAYS

    Annual Deductible - Per Member / Per Family $750 / $2,250 $1,500 / $4,500

    Coinsurance - Plan Pays / Member Pays(After the deductible, all covered expenses are paid as follows)

    80% / 20% 60% / 40%

    Maximum Coinsurance - Per Member / Per Family (Once these limits are met, all remaining covered expenses are paid at 100%)

    $3,000 / $6,000 $6,000 / $12,000

    Primary Care Office Services Hospital Services

    $20 copay per visit$0

    Deductible, then 40%Deductible, then 40%

    Specialty Care Office Services Hospital Services (includes inpatient, outpatient & ambulatory care services)Emergency Room care

    $40 copay per visitDeductible, then 20% Deductible, then 20%

    Deductible, then 40%Deductible, then 40% Deductible, then 20%

    Other Routine Care GYN exam Routine Screening Mammogram Routine Screening Colonoscopy

    $20 copay per visit$0 $0

    Deductible, then 40%Deductible, then 40% Deductible, then 40%

    Maternity Care Routine Maternity Physician Services Deductible, then 20% Deductible, then 40%

    Inpatient Hospital/Facility Services (Authorization required) Admission (including maternity) Skilled Nursing and Long-term Acute Care Facility

    Deductible, then 20% Deductible, then 20%

    Deductible, then 40% Deductible, then 40%

    Outpatient/Ambulatory Care Facilities All services (including maternity) Emergency room services Urgent care

    Deductible, then 20% $150 per visit, then 20% $20 copay per visit

    Deductible, then 40%$150 per visit, then 20% Deductible, then 40%

    Other Services Occupational Therapy 20 visits per Benefit Period Physical Therapy 20 visits per Benefit Period Speech Therapy 20 visits per Benefit Period Ambulance Home Health Private Duty