Your Benefits Guidebook

Urological Associates of Savannah, PC

Benefits Guidebook

II

We are committed to your physical well-being, and financial success and to that end, offer you a robust array of benefits plans and programs. As an employee, you are a valued part of our team and we recognize that your best contributions to our team come when you are healthy, present, and have a manageable work-life balance. All of our health and welfare programs are specifically tailored to give you the opportunity to succeed in your role within our organization by securing your financial future and also the health of you and your family.

This Guidebook serves as a general point of reference of our benefits program as a whole and is intended to be your introduction to our various programs. Insurance programs are bound by specific certificates and agreements, so please be sure to register for your various portals for the most accurate and up-to-date information about your policies. You will find details in the back of this Benefits Guidebook indicating which web address to navigate to for each of your plans. Of course, offering best-in-market coverage is a fine balance of choosing quality insurance carriers with expansive networks and rich benefits that are in line with our mission of providing you with excellent options and controlling costs both in the long and short-term. Your understanding of our programs and initiatives will help you to make the best decisions for your unique situation.

We have provided you with the tools to engage your health and well-being and encourage you to take advantage of the various programs that we offer. Good health is priceless and we support you on your journey. Physical, emotional, and financial well-being are all important aspects of leading a productive and happy life, so be sure to learn about our employee assistance programs and group retirement program structure.

learn about Your Coverage

Better Health is on the way

Welcome to ‘Urological Associates!’

Benefits Guidebook

III

We are pleased to provide you with a vast array of benefits programs in which you may choose to participate, and please utilize this guidebook as a point of reference to become acquainted with your various programs. It is encouraged that you register for your various carrier portals so that you may access certificates of coverage, ID cards, claims data, network information, carrier tools, and more. To make the most of your benefits plan, we encourage your interaction with our chosen carriers to deliver the best possible experience for you and your dependents. Carrier registration information can be found at the end of your benefits guidebook.

ELIGIBILITY

“Employees are eligible to participate in our various insurance programs herein described if they are scheduled to work 32 or more hours per week on a regular basis.  Your insurance becomes effective on the first day of the month following 30 days of eligible employment.”

DEPENDENTS

Your dependent children can be covered on our plans up to age 26 regardless of student, marital, or work status. When your dependent children turn 26, they will lose group coverage, and this is a qualifying event. They will then be able to join another employer group’s plan, purchase an individual policy, or be added to their spouse (if applicable). If you have a dependent child that is disabled, they may be covered on our plan provided certain criteria are met. Please contact HR for more details.

Qualifying events enable individuals to enroll in health coverage. Those newly eligible due to a new hire event are able to join the plans also, but must do so within 30 days of the effective date or they will have missed their opportunity to join the group benefits plan. It is the employee’s responsibility to enroll in his or her benefits. Some common qualifying events are: loss of other coverage, changes in household (marriage, having a baby or adopting, or a death in the family), or changes in residence zip code or county. A comprehensive list can be found here: https://www.healthcare.gov/glossary/qualifying-life-event/

Qualifying Events and why they matter

General Definitions

Benefits Guidebook

IV

MEDICAL

Overview:

We have selected Nova Healthcare to provide our group medical benefits. We use the CIGNA PPO Network with this plan. Have your providers call the health plan if they are unfamiliar with the company. Please register for your member portal to view network, claims, plan, wellness, and other useful information. You will find instructions within this Guidebook.

Your Group Insurance a closer look at your benefits plans

Benefit Options

You have an option to choose between a traditional copay-type plan and a high-deductible health plan. The HDHP policy allows you to opt into our HSA, meaning you can set aside pre-tax dollars to pay for your qualifying health expenditures. We encourage you to set aside a small part of your check into your HSA account so that you can pay for your medical expenses with pre-tax dollars. Even if you are not able to do this, you can claim out-of-pocket expenses by logging into BenefitWallet so you are able to reap the tax advantages of your HSA when it comes time to do your yearly taxes with your preparer.

Service or Benefit Item Traditional HDHP

Deductibles Single Family

$5,000 $10,000

$5,000 $10,000

Coinsurance In-Network Out-of-Network

80% 60%

80% 60%

Coinsurance Maximums Individual Family

$6,500 $13,000

$6,350 $12,700

Primary Care Copay $35 20% after deductible

Specialist Copay $50 20% after deductible

Emergency Room Copay $350 20% after deductible

Pharmacy Benefits, 30 Day Supply Copays Listed

Generic $10 Ded, 20%

Preferred Brand $40 Ded, 20%

Non-Preferred Brand $70 Ded, 20%

Level 4/Specialty 25% or 35% for specialty Ded, 20%

Benefits Guidebook

V

DENTAL

Overview:

We have selected MetLife provide our group dental benefits. It is important to note that our dental carrier, along with most others in the industry, include both in and out-of-network benefits. Even if your provider doesn’t participate in the given network, the carrier will reimburse 90% of reasonable and customary charges for the services you receive. Please always have your provider pre-certify procedures over $300 so that you know if it will be covered and what your responsibility is to be.

Your Group Insurance a closer look at your benefits plans

Service or Benefit Item In-Network Out-of-Network

Deductibles Single Family

$50 $50 per covered life, up to $150

$50 $50 per covered life, up to $150

Annual Maximum Benefit $1,500 per covered life $1,500

Preventive Service Coinsurance 100% 100%

Basic Service Coinsurance 90% 90%

Major Service Coinsurance 60% 60%

Orthodontia Covered, 50% to 1k lifetime max Covered, 50% to 1k lifetime max

Common Procedures and How Your Plan Covers Them

Routine Exam Preventive

Cleaning Preventive

X-Rays Preventive

Fillings Basic

Root Canals Basic

Simple Extractions Basic

Periodontal Cleaning Basic

Periodontal Surgery Basic

Crowns, Implants, Complex Surg. Major

Benefits Guidebook

VI

VISION

Overview:

Routine vision care has benefits that extend far beyond ensuring optimal sight to include early disease detection for chronic systemic diseases like diabetes and high blood pressure. Vision premiums can even result in a positive return on investment for participating employees as the benefits received and financial discounts outweigh the cost of coverage in some instances. As with dental, your vision plan has in and out-of-network benefits, meaning you are free to choose whichever provider you like. You don’t need your vision ID card to receive care, but can simply provide the provider with your name, SSN, and carrier name so that they can verify benefits and assist with filing your claim if they are out-of-network.

Your Group Insurance a closer look at your benefits plans

Service or Benefit Item In-Network Out-of-Network

Exam Copay or Allowance $10 $45 allowance

Materials Copay $25 $20

Single Lens Copay or Allowance $25 $30 allowance

Bifocal Copay or Allowance $25 $50 allowance

Trifocal Copay or Allowance $25 $65 allowance

Frame Allowance $130 $70 allowance

Contact Lens Allowances

Medically Necessary $25, 100% $210 allowance

Elective $130 $105 allowance

DID YOU KNOW

Every $1 invested in vision insurance results in $7 saved for an organization that offers the coverage, according to a study by Dr.’s Kent Daum and Katherine Clore. Additionally, because the premiums are so low relative to the benefits offered and savings opportunities presented by using the networked providers and facilities, an insured may spend much less by being insured including the actual cost of the premiums. Positive ROI’s are hard to find in insurance, but it is commonplace with vision!

Benefits Guidebook

VII

LIFE

Overview:

Your employer provides you with up to $50,000 of life and accidental death coverage at no cost to you by virtue of your full-time employment with the company. If your employment ends, you may contact the carrier for portability options for both core and voluntary life benefits, if applicable.

Your Group Insurance a closer look at your benefits plans

VOL LIFE

Overview:

In addition to your employer-sponsored core life coverage, you may purchase additional voluntary life insurance that is payroll-deducted from your check. Of the many advantages of this type of coverage are the low premiums, simplicity of enrollment, ability to insure your dependents, and high guaranteed-issue death benefits.

Typically, employer-based voluntary life coverage comes with Guaranteed Issue amounts of $50,000 or more for the employee. What this means is that regardless of health status, as long as the employee is actively at work, the Guaranteed Issue amount will be approved. Most policies are structured to offer much more coverage that can be applied for by submitting an Evidence of Insurability Form to the issuing carrier. It is not uncommon to see maximum benefit levels of $300,000 to $500,000, subject oftentimes to a multiple of an employee’s earnings (5x is typical), whichever is lower. Please refer to your benefits portal or HR department for more information.

DID YOU KNOW

Group voluntary term life insurance is extremely easy to sign up for and it is yours to keep should you choose to do so if your employment with the company ends. Term life insurance is usually 10 to 20 times less costly when compared to whole life, meaning insuring the financial future of your loved ones does not have to be a costly proposition.

Benefits Guidebook

VIII

PRODUCT INFO

LONG TERM DISABILITY

Overview:

Long-term disability is designed to provide an income for those that are disabled for periods of 3 months or much longer. Your employer pays 100% of these costs. More detailed benefits and definitions are available in your policy certificate. Please contact HR for more information.

Your Group Insurance a closer look at your benefits plans

Please see the insert from Colonial Life for additional product details. Your group benefits pay your providers, and Colonial pays the insured member. Several policies include wellness benefits that pay you just to stay healthy. Worksite policies are a hedge against future illness that may result in financial stress. Once you purchase a plan, the premiums stay the same for the life of the policy unless you choose to increase or decrease coverage. They are built to last!

WORKSITE BENEFITS

Overview:

Urological Associates of Savannah, PC also provides access to several voluntary coverage options through Colonial Life & Accident Insurance Company for you and your dependents.  Please review the plan options on the following page.  If you are interested in coverage under any of these plans, contact Carie Chaney Hunsinger at Colonial Life.

Service or Benefit Item In-Network

Covered Earnings (your benefit received) 60%

Maximum Monthly Benefit $10,000

Waiting period (before benefits are paid) 180 days

Maximum Benefit Duration Social Security National Retirement Age

Carie Chaney Hunsinger Office: (912)352-9683, ext 103

Fax: (912)352-3233 Carie.Chaney@ColonialLifeSales.com

www.ColonialLife.com

COLONIAL CONTACT

Benefits Guidebook

IX

Benefits Guidebook

X

Coverage TiersMonthly Total Practice Pays/Mo You Pay/Mo Per-Check

CoPay Health Plan

Employee Only $769.90 $380.00 $389.90 $179.95

Employee and Spouse $1,397.95 $380.00 $1017.95 $469.82

Employee and Child(ren) $1,252.97 $380.00 $872.97 $402.91

Full Family $2,031.07 $380.00 $1651.07 $762.03

MEDICAL

Coverage TiersMonthly Total Practice Pays/Mo You Pay/Mo Per-Check

HSA Health Plan

Employee Only $629.92 $380.00 $249.92 $115.35

Employee and Spouse $1,143.77 $380.00 $763.77 $352.51

Employee and Child(ren) $1,025.15 $380.00 $645.15 $297.76

Full Family $1,661.79 $380.00 $1281.79 $591.60

DENTAL

Coverage TiersVoluntary Dental Voluntary Vision

Monthly Total Per-Check Monthly Total Per-Check

Employee Only $33.75 $15.58 $8.35 $3.85

Employee and Spouse $68.54 $31.63 $16.74 $7.73

Employee and Child(ren) $74.36 $34.32 $14.18 $6.54

Full Family $116.43 $53.74 $23.37 $10.79

VISION

“NO CHANGES to ANY Products!”

WORKSITE BENEFITS Please contact Carie Cheney for product details, pricing, policy service, and more!

Carie Chaney Hunsinger Office: (912)352-9683, ext 103

Fax: (912)352-3233 Carie.Chaney@ColonialLifeSales.com

www.ColonialLife.com

Benefits Guidebook

XI

Medical Dental

Customer Service 800-999-5703 Customer Service 800-942-0854

Web Portal Registration/Login

https://www.novahealthcare.com/

Members

Web Portal Registration/Login

www.mybenefits.metlife.com

Vision Life

Customer Service 1-800-METLIFE Customer Service 1-888-563-1124

Web Portal Registration/Login

https://www.metlife.com/insurance/vision-insurance/

Web Portal Registration/Login n/a

Disability Worksite

Customer Service 1-800-303-9744 Customer Service n/a

Web Portal Registration/Login n/a Web Portal

Registration/Login n/a

HR Department Consultancy Contact

Your In-House Go-To Escalated Benefits Issues

Mrs. Wendy Partain Niko J. Caparisos Principal

How to best reach herwpartain@urologysavannah.com

912-790-4070How to best reach him

niko@prosperitybenefits.com

501-303-6456

Carrier Portals Obtaining help with your benefits plans