NEW HIRE BENEFITS GUIDE July 1, 2017 – June 30, 2018
What’s Inside
New Hire Enrollment Information
Eligibility 2
Medical Insurance
Prescription Drugs
5 Ways To Save
Cigna Telehealth Connection
Health Advocate 9
Dental Insurance
Vision Insurance
Life Insurance
Disability Insurance 14
Flexible Spending Account (FSA)
Allstate Supplemental Products
Consumerism Card
Pet Insurance
401(k)
Paid Time Off (PTO) 19
Employee Assistance Program (EAP) 20
Important Contacts 21
Dear Team Members,
Welcome to Team Focus Insurance Group. We look
forward to a long and successful working relationship
with our employees. We recognize that our employees
are our most valuable resource. Therefore, we strive
to provide competitive salaries and a comprehensive
benefits program designed to meet everyone’s
individual needs. This New Hire Benefits Information
Guide provides an overview of the benefits we offer.
We encourage you to take the time to educate
yourself about your options and choose the best
coverage for you and your family. The plans selected
will be effective from your initial eligibility date through
June 30, 2018.
Your HR team is here to answer questions and get you the
information you need so that you can choose the best
coverage for you and your family.
Best Regards,
Laura DeCespedes
Chief Human Resource Officer
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Qualifying Change in Status Examples of qualified family status change events include:
1. Special Enrollment Events (Add coverage).
• Loss of other coverage
• Acquire a new dependent through marriage,
birth or adoption
• Change in eligibility for Medicaid or CHIP
2. IRC Section 125 Status Change Events (Add,
cancel or change coverage).
• Loss or gain of other coverage
• Divorce
• Death of covered dependent
• Change in employment status
• Medicare Entitlement
You should verify the eligible events with Human
Resources. You must notify Human Resources within 30
days of an event (60 days in the case of Medicaid or CHIP
eligibility).
Benefit Election
Under Section 125 of the Internal Revenue Service (IRS)
code, you are allowed to pay for certain group insurance
premiums with tax free dollars. However, you must make
your benefit elections carefully, including the choice to
waive coverage. Your pre-tax elections will remain in
effect until the next annual Open Enrollment period
unless you experience an IRS approved qualifying
change in status.
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How to Enroll
1. Carefully review the plan information in this New Hire
Benefit Guide and all other plan materials included in
your enrollment packet. The insurance carrier’s
websites also provide important information and tools
that can help you make enrollment decisions.
2. Consider the needs of your dependents. If you are
married, review any coverage currently offered through
your spouse’s employer to avoid costly duplicate
coverage.
3. Once you have reviewed all of the options available to
you, log into the UltiPro self-serve system and follow the
simple step-by-step instructions for your online
enrollment.
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Eligibility
Team Member Eligibility
All regular full-time team members working at least 30 hours
per week will be eligible for benefits on the 1st of the month
following date of hire.
Dependent Eligibility You may also elect coverage for your dependents including:
• Your spouse
• A domestic partner
• Your dependent children
Your dependent child’s eligibility varies by line of coverage
as follows:
Proof of Dependency Proof of dependency will be required at time of
enrollment. Examples of acceptable documentation
include:
Proof for Dependent Child
• Birth Certificate
• Document from Hospital with Name and Birth
Date
• Adoption papers
• Legal Guardianship substantiated by a Court
Order
• Medical Support Court Order
Proof for Dependent Spouse or a Domestic Partner
• Proof of common residence (example: utility bill)
• Proof of financial interdependency (example:
shared bank statement)
• Most recent year’s 1040 Married filing jointly
federal tax return that lists the spouse
• Marriage License
• Affidavit
You should verify the acceptable documentation with
Human Resources. Please be sure to submit your
documentation to Human Resources during the
enrollment period.
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Dependent Definitions
A Dependent Child consists of:
The team member’s children or the children of the
team member’s spouse. This includes natural children,
legally adopted children, step children, children placed
for adoption, children under legal guardianship
substantiated by a court order and living with the team
member and children who are entitled to coverage
under a medical support order. Dependent children’s
spouses and/or children are not eligible dependents of
the team member.
Children of a Domestic Partner consist of:
The children of the domestic partner, including natural
children, legally adopted children and children under
legal guardianship substantiated by a court order.
These children are eligible for dependent coverage if
they are primarily dependent on the domestic
partnership for support, reside with the domestic
partners in a regular parent child relationship, meet
the age/school requirements of the benefit plan and
meet the definition of an eligible child under the
Internal Revenue Service Code § 152.
Medical ─ Up to 26 years old
─ Up to 30 years old if the child:
Is unmarried and does not have a
dependent of his or her own;
Is a resident of this state or a full-time or
part-time student; and
Is not provided/offered coverage as a
named subscriber, insured, enrollee, or
covered person under any other group,
blanket, or franchise health insurance policy
or individual health benefits plan, or is not
entitled to benefits under Title XVIII of the
Social Security Act.
Dental & Vision ─ Up to 26 years old
Life ─ Up to age 19
─ Up to age 25 if full-time student
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Medical Insurance
We offer three (3) Cigna medical plan options. All three plans are
Open Access, so referrals from your Primary Care Physician (PCP)
are not required to visit a Specialist.
LocalPlus Open Access Plus In-Network Plan (HMO)
Cigna has developed a local network called LocalPlus in order to offer
members quality and cost-effective health care coverage. The Cigna
LocalPlus network includes all hospitals in the Open Access Plus
network and a select group of local, quality health care professionals.
Refer to the listing of Cigna’s LocalPlus service areas and major
physician groups and hospital systems.
This plan only provides coverage for services performed by providers
in the plan’s network, with the exception of true emergencies. In
service areas where the LocalPlus Network is not available, members
can access doctors and hospitals in Cigna’s national Away From
Home (Open Access Plus) Network and receive coverage at the in-
network level.
Open Access Plus In-Network Plan (HMO)
This plan only provides coverage for services performed by providers
in the plan’s network, with the exception of true emergencies. The
plan utilizes Cigna’s national Open Access Plus network.
Open Access Plus Plan (PPO)
This plan provides In-Network and Out-of-Network benefits. In-
Network services yield the highest level of benefits with the lowest
out-of-pocket expenses because services are paid based on
contracted rates.
LocalPlus
Service Area
Broward, Sarasota, Martin, Miami-Dade, Monroe,
Palm Beach and St Lucie counties
*Also available in Orlando and Tampa
Major Physician Groups Cleveland Clinic Physician Group
Medical Specialists of the Palm Beaches
Miami Children's Physician Group
University of Miami Physicians
Holy Cross Medical Group
VitalMD
Gastro Health, PL
Pediatric Associates
Major Hospital Systems
Baptist Health South Florida
Bethesda Medical
HCA
Jupiter Medical Center
Martin Memorial Medical Center
Memorial Healthcare System
North Broward Hospital District
Tenet System
University of Miami
LocalPlus - Other States
Arizona: Phoenix
California: Northern/Bay Area, Southern
Colorado: Front Range, Mountain, Southwest
Georgia: Atlanta, Augusta, Columbus, Macon,
Rome, Savannah
Illinois: Chicago
Kansas: Butler, Harvey, Kingman, Sedgwick,
Sumner
Massachusetts: Statewide
Missouri: St. Louis (IFP only)
Nevada: Las Vegas
Rhode Island: Statewide
South Carolina: Greenville, Spartanburg
Tennessee: Statewide
Texas: Austin, Brazos, Dallas, Ft Worth, Houston
Find a Provider…
Visit www.cigna.com, and click “Find a Doctor”.
Choose “For plans offered through work or school”
Enter your search criteria
Choose the “LocalPlus” network for the LocalPlus plan
Choose the “Open Access Plus” network for the Open
Access Plus HMO and PPO plans
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LocalPlus Open Access Plus
(HMO)
Open Access Plus (HMO)
Open Access Plus (PPO)
In Network Benefits
Calendar Year Deductible (CYD)
Single / Family $1,000 / $3,000
Single / Family $1,000 / $3,000
Single / Family $500 / $1,500
Coinsurance 20% 20% 20%
PCP Visit $20 copay $20 copay $20 copay
Specialist Visit $40 copay $40 copay $40 copay
Express Clinics $20 copay $20 copay $20 copay
Urgent Care $50 copay $50 copay $50 copay
Emergency Room $250 copay $250 copay $200 copay
Inpatient Hospital 20% after CYD 20% after CYD 20% after CYD
Outpatient Surgery 20% after CYD 20% after CYD 20% after CYD
Out-of-Pocket Maximum1
Single / Family $4,000 / $8,000
Single / Family $4,000 / $8,000
Single / Family $4,000 / $8,000
Out of Network Benefits
Calendar Year Deductible (CYD) Not Applicable Not Applicable Single / Family
$1,000 / $3,000
Coinsurance Not Applicable Not Applicable 50%
Out-of-Pocket Maximum1 Not Applicable Not Applicable Single / Family
$8,000 / $16,000
Glossary of Terms
Calendar Year Deductible (CYD) –
The amount each member or family
must pay before Cigna and the member
each pay their portion of the bill.
Coinsurance – The sharing of health
care expenses for covered services
between the member and Cigna.
Copayment – The dollar amount
required to be paid by a member to a
Provider when services are rendered.
Inpatient – A patient who is admitted for
an overnight stay in a medical facility
(i.e. hospital).
Network – The group of Providers who
are approved for services and are
available for treatment under Cigna’s
contract.
Outpatient – A patient who receives
treatment at a hospital or an outpatient
facility without being admitted overnight.
Out-of-Pocket Maximum – The
maximum dollar amount that each
member will pay each plan year. Once
the out-of-pocket maximum is reached,
Cigna will pay 100% for the remainder
of the plan year.
Primary Care Physician (PCP) – A
Physician who provides medical
services to members.
Specialist – A Physician who limits
practice to specific services (i.e.
Surgery, Radiology, Pathology), certain
body systems (i.e. Dermatology,
Orthopedics, Cardiology), or types of
diseases (i.e. Allergy, Oncology).
1Out-of-Pocket Maximum includes deductible, coinsurance, and co-pays, excluding Rx.
Refer to SBC and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.
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LocalPlus Open Access Plus
(HMO)
Open Access Plus (HMO)
Open Access Plus (PPO)
Retail (30 day supply)
Tier 1 $15 copay $15 copay $15 copay
Tier 2 $40 copay $40 copay $40 copay
Tier 3 $60 copay $60 copay $60 copay
Tier 4 20% to $100 max/script 20% to $100 max/script 20% to $100 max/script
Mail Order (90 day supply)
2.5 x retail copay 2.5 x retail copay 2.5 x retail copay
Rx Out-of-Pocket Maximum 1
$2,000 / $4,000 $2,000 / $4,000 $2,000 / $4,000
LocalPlus Open Access Plus
(HMO)
Open Access Plus (HMO)
Open Access Plus (PPO)
Team Member Only $27.91 $40.36 $62.95
Team Member + Spouse $115.86 $141.26 $264.41
Team Member + Child(ren) $111.30 $136.03 $259.12
Family $265.38 $312.80 $422.85
1Rx Out-of-Pocket Maximum applies to Rx copays only.
Step Therapy
Step Therapy through Cigna’s
Pharmacy Management involves a two
or three “step” sequence of medication
used to treat certain conditions including
high blood pressure, high cholesterol,
and stomach acid conditions.
Members are required to try a “first
step” medication, generally a generic,
before stepping to a higher cost
medication, if medically necessary.
Physicians can request prior
authorization for a second or third step
medication for the medical necessity by
contacting Cigna directly. Coverage will
be provided for an affected medication
(new and existing prescriptions) for a
60-day grace period. You will then
receive an education letter so you can
speak to your physician to determine if
a more cost-effective prescription is
appropriate and/or discuss how to
submit a request for authorizations.
Future refills of impacted medications
will not be covered unless prior
authorization is obtained. Contact Cigna
for more information.
Mail Order
Cigna’s Home Delivery Pharmacy
Program offers a convenient and cost-
effective way to obtain your medications
without leaving the comfort of your own
home. All maintenance medications,
including contraceptives, must be
purchased through the Cigna Tel-Drug
Home Delivery Pharmacy Program.
Contact Cigna for more information or
log onto www.cigna.com to print an
order form or place an order online.
Prescription Drugs
The prescription drug program is also through Cigna.
We have included information regarding the Step
Therapy Program and Mail Order Program.
Bi-Weekly Cost
Below are your bi-weekly payroll contribution amounts for medical insurance,
depending on the coverage and plan you elect.
Refer to SBC and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.
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4. Use Telehealth, Retail & Urgent Care
Centers for non-emergencies, and the
Emergency Room for true emergencies.
Telehealth Connection.
See page 8.
Retail / Convenience Health Clinic.
While these clinics lack the personal
nature of seeing a family physician who
knows your complete medical history,
their appeal is the temporary relief
when your doctor is not available and
low cost.
Urgent Care Center. If you need
medical care when your regular doctor
is not available, think about going to an
urgent care center rather than a
hospital emergency room. They usually
have a lower copayment and seeking
care is faster than at an emergency
room.
Emergency Room. A visit to the
hospital emergency room is the most
expensive type of outpatient care.
Emergency rooms should only be used
for true emergencies, as they are
staffed, equipped, and best suited for
medical emergencies. Do not return to the Emergency Room for follow-up visits; these visits will not be covered; visit a participating provider for your follow-up care.
5. Use in-network providers. Participating
providers generally charge discounted
rates for plan members. When you go to a
non-participating provider you will likely pay
a higher coinsurance percentage and will
likely have to pay the difference in price
between the participating provider’s
discounted fee and the non-participating
provider’s “regular” fee.
1. Look into discount generic drug programs offered by local
pharmacies.
Publix
5 FREE Antibiotics (up to 14-day supply) FREE Amlodipine (up to 90 day supply) FREE Lisinopril (up to 90 day supply) FREE Metformin (up to 90 day supply)
Wal-Mart 30-day supply for $4 90-day supply for $10
Winn Dixie 30-day supply for $4 90-day supply for $10
Kmart 30-day supply for $5 90-day supply for $10 or $15
2. Research brand name drug rebates online. Many
manufacturers offer discounts/rebates.
3. Look into freestanding surgical and diagnostic centers. If
you need surgery, you might save money by having it
performed at an ambulatory surgical center (a clinic that is not
associated with a hospital.) These sites usually charge less
than hospitals or their outpatient surgical centers. Freestanding
diagnostic centers are also available and tend to charge less for
certain tests like MRIs, CAT scans, X-rays and bone density
scans. Always make sure the facility is in your plan’s network
and that your plan’s benefits cover the service.
- Membership fees may apply - Offers are subject to change
5 Ways To Save
Health care costs continue to increase. This
continuing trend can significantly impact
your budget. Here are some helpful tips on
how to save on your medical and pharmacy
expenses.
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Cigna Telehealth Connection
Cigna provides access to two telehealth services as part of your medical
plan – AmWell and MDLIVE.
Cigna Telehealth Connection lets you get the care you need – including
most prescriptions – for a wide range of minor conditions with a $20 copayment. Now you can connect with a board-certified doctor via
secure video chat or phone, without leaving your home or office. When,
where and how it works best for you!
Choose when: Day or night, weekdays, weekends and holidays.
Choose where: Home, work or on the go.
Choose how: Phone or video chat.
Choose who: AmWell or MDLIVE doctors.
The cost savings are clear.
Televisits with AmWell and MDLIVE can be a cost-effective alternative to
a convenience care clinic or urgent care center, and cost less than going
to the emergency room. And the cost of a phone or online visit is the
same as your primary care provider. Remember, your telehealth
services are only available for minor, non-life threatening conditions. In
an emergency, dial 911 or go to the nearest hospital.
How to Use
AmWell and MDLIVE are both quality
national telehealth providers so you
can choose your care confidently.
When you can’t get to your doctor,
Cigna Telehealth Connection is here
for you.
Signing up is easy!
Set up and create an account
with one or both AmWell and
MDLIVE
Complete a medical history using
their “virtual clipboard”
Download vendor apps to your
smartphone/mobile device
If you pre-register on both AmWell
and MDLIVE, you can speak with a
doctor for help with:
Sore throat
Headache
Stomachache
Fever
Cold and flu
Allergies
Rash
Acne
UTIs and more
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Health Advocate
Team Focus Insurance Group provides access to
Health Advocate, at no cost.
Health Advocate is a program that provides you with
your own personal health advocate to help with your
and your entire family’s healthcare needs. Through
this program you can receive assistance to navigate
the healthcare system and maximize your healthcare
benefits.
Clinical services
• Find the best doctors and hospitals
• Locate and research treatments for a medical condition
• Secure second opinions
Health coaching
• Help prepare patients for healthcare appointments
• Help members better understand their conditions
Administrative services
• Resolve insurance claims issues
• Assist with correcting billing mistakes
Personal Health Advocate
• Registered Nurse
• Medical Director Support
To access this program, please contact Health Advocate at (866) 695-8622, and make sure to let the
representative know that you are affiliated with Team Focus Insurance Group.
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DHMO Routine Cleanings 1110/1120 2 per Calendar Year No charge
Routine X-Rays No charge
Resin Based Filling Posterior One Surface 2391 $45 copay
Root Canal – Molar 3330 $530 copay, excludes final restoration
Orthodontics Start-Up 8660 Comprehensive Treatment Retention 8680
$66 copay $2,472 Child / $3,336 Adult
$345 copay
PPO
In-Network Out-of-Network
Calendar Year Deductible (CYD) $50 Individual $150 Family
$50 Individual $150 Family
Calendar Year Maximum $1,500 per member $1,500 per member
Preventive Services Cleanings, Exams, X-Rays
Member 0% Cigna 100%, CYD Waived
Member 0% Cigna 100%,
after CYD
Basic Services Filings, Oral Surgery, Non-routine X-Rays
Member 10%, Cigna 90%, after CYD
Member 20%, Cigna 80%, after CYD
Major Services Crowns, Bridges, Dentures, Root Canals
Member 40% Cigna 60%, after CYD
Member 50% Cigna 50%, after CYD
Orthodontia Not Covered
Wellness Plus Reward Members will receive an additional $250
per year when a preventive service is utilized
DHMO PPO
Team Member Only $3.16 $11.91
Tem Member + Spouse $7.16 $29.84
Team Member + Child(ren) $7.20 $29.98
Family $12.68 $41.28
Bi-Weekly Cost Below are your bi-weekly payroll contribution
amounts for dental insurance, depending on the
coverage and plan you elect.
Find a Provider…
Visit www.cigna.com, and click “Find a Doctor”.
Choose “For plans offered through work or
school”
Enter your search criteria
Choose the “Cigna Dental Care” network for
the DHMO plan
Choose the “Cigna Dental PPO or EPO”
network for the PPO plan
DHMO WAOV9 Plan: The DHMO plan requires
you to select a primary dentist, receive referrals for
specialist care, and seek care exclusively from
participating providers. Services are paid through
copayments. The plan provides you with an
unlimited benefit maximum. Two routine cleanings
and X-Rays are covered every year at no cost to
you. Orthodontic services for children and adults are
covered through copayments.
PPO Plan: The PPO plan allows
you to seek care from participating
and non-participating providers
with no referrals needed. A
calendar year maximum benefit
will apply to In and Out of Network
services. In-Network benefits are
paid based on contracted rates
and Out-of-Network benefits are
paid based on reasonable and
customary rates. Orthodontic
Services are not covered by the
plan.
Refer to Benefit Summary and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.
Dental Insurance
We offer a DHMO plan and a PPO plan through Cigna:
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VSP Vision Plan
In-Network Out-of-Network
Exam Once Every 12 Months $10 copay Up to $45
Lenses Once Every 12 Months Single Bifocal Trifocal
$25 copay
Up to $30 $50 $65
Frames Once Every 24 Months
$25 copay. $130 allowance, then 20% off the amount over your
allowance. Up to $70
Contact Lenses In Lieu of Eyeglasses Once Every 12 Months
$130 allowance Up to $105
Vision
Team Member Only $3.35
Team Member + Spouse $5.36
Team Member + Child(ren) $5.47
Family $8.83
Refer to Benefits Summary and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.
Bi-Weekly Cost
Below are your bi-weekly payroll contribution amounts for
vision insurance, depending on the coverage and plan
you elect.
Find a Provider…
Visit www.vsp.com, and click “Find a Doctor”.
Enter your search criteria
Choose the “Choice” network
Vision Insurance
We offer a vision plan through VSP (Vision Service Plan). Benefits are available every 12 months for exams and
lenses or contact lenses and every 24 months for frames.
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Voluntary Life/AD&D: All full-time benefits-eligible team
members may purchase additional Life and AD&D
insurance through CIGNA. During your initial enrollment
period, Evidence of Insurability will not be required if you
are applying for an amount under the Guarantee Issue.
Voluntary Life & AD&D coverage’s are not bundled and
are available on a standalone basis.
Life Coverage AD&D Coverage
Team Member
$25,000 increments to a maximum of $500,000 Guarantee Issue: $200,000 $25,000 increments to a maximum of $500,000
Spouse $5,000 increments to a maximum of $250,000 Guarantee Issue: $25,000 50% of Team Member’s coverage amount
Children
Infant = $500 6 Months – Age 19 = $1,000 increments to a maximum of
$10,000 Guarantee Issue: Full amount
$2,000 increments to a maximum of $10,000
Age Restriction *Only covers dependent children under age 19 (or 25 if full time student) and spouse under age 70.
Voluntary Life Bi-Weekly Rates Team Member or Spouse (not combined)
Age $25,000 $50,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000 0-24 $0.85 $1.71 $2.56 $3.42 $4.27 $5.12 $5.98 $6.83 $7.68 $8.54
25-29 $0.97 $1.94 $2.91 $3.88 $4.85 $5.82 $6.78 $7.75 $8.72 $9.69
30-34 $1.10 $2.19 $3.29 $4.38 $5.48 $6.58 $7.67 $8.77 $9.87 $10.96
35-39 $1.34 $2.68 $4.02 $5.35 $6.69 $8.03 $9.37 $10.71 $12.05 $13.38
40-44 $1.94 $3.88 $5.82 $7.75 $9.69 $11.63 $13.57 $15.51 $17.45 $19.38
45-49 $3.39 $6.78 $10.18 $13.57 $16.96 $20.35 $23.75 $27.14 $30.53 $33.92
50-54 $5.57 $11.15 $16.72 $22.29 $27.87 $33.44 $39.01 $44.58 $50.16 $55.73
55-59 $8.72 $17.45 $26.17 $34.89 $43.62 $52.34 $61.06 $69.78 $78.51 $87.23
60-64 $13.73 $27.46 $41.19 $54.92 $68.65 $82.38 $96.12 $109.85 $123.58 $137.31
65-69 $24.46 $48.92 $73.38 $97.85 $122.31 $146.77 $171.23 $195.69 $220.15 $244.62
70-74 $42.58 $85.15 $127.73 $170.31 $212.88 $255.46 $298.04 $340.62 $383.19 $425.77
75-79 $73.50 $147.00 $220.50 $294.00 $367.50 $441.00 $514.50 $588.00 $661.50 $735.00
80-100 $123.23 $246.46 $369.69 $492.92 $616.15 $739.38 $862.62 $985.85 $1,109.08 $1,232.31
Life Insurance
Basic Life & AD&D – Employer Paid: All full-time benefits-eligible team members will receive Group Life & AD&D
Insurance that will cover 2 times their covered annual earnings up to a maximum of $300,000 through CIGNA. Please
make your beneficiary designations during this initial enrollment. Please see HR for additional information.
Refer to Benefits Summary and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.
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Voluntary Life Bi-Weekly Rates Team Member or Spouse (continued)
Age $275,000 $300,000 $325,000 $350,000 $375,000 $400,000 $425,000 $450,000 $475,000 $500,000 0-24 $9.39 $10.25 $11.10 $11.95 $12.81 $13.66 $14.52 $15.37 $16.22 $17.08
25-29 $10.66 $11.63 $12.60 $13.57 $14.54 $15.51 $16.48 $17.45 $18.42 $19.38 30-34 $12 06 $13 15 $14 25 $15 35 $16 44 $17 54 $18 63 $19 73 $20 83 $21 92 35-39 $14.72 $16.06 $17.40 $18.74 $20.08 $21.42 $22.75 $24.09 $25.43 $26.77 40-44 $21 32 $23 26 $25 20 $27 14 $29 08 $31 02 $32 95 $34 89 $36 83 $38 77 45-49 $37.32 $40.71 $44.10 $47.49 $50.88 $54.28 $57.67 $61.06 $64.45 $67.85 50-54 $61 30 $66 88 $72 45 $78 02 $83 60 $89 17 $94 74 $100 32 $105 89 $111 46 55-59 $95.95 $104.68 $113.40 $122.12 $130.85 $139.57 $148.29 $157.02 $165.74 $174.46 60-64 $151 04 $164 77 $178 50 $192 23 $205 96 $219 69 $233 42 $247 15 $260 88 $274 62 65-69 $269.08 $293.54 $318.00 $342.46 $366.92 $391.38 $415.85 $440.31 $464.77 $489.23 70-74 $468 35 $510 92 $553 50 $596 08 $638 65 $681 23 $723 81 $766 38 $808 96 $851 54 75-79 $808.50 $882.00 $955.50 $1,029.00 $1,102.50 $1,176.00 $1,249.50 $1,323.00 $1,396.50 $1,470.00
80-100 $1,355 54 $1,478.77 $1,602 00 $1,725 23 $1,848 46 $1,971 69 $2,094 92 $2,218 15 $2,341 38 $2,464 62
Voluntary Life Bi-Weekly Rates Child(ren)
$1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 $9,000 $10,000
$0.116 $0.233 $.349 $.465 $.582 $.698 $.814 $.930 $1.047 $1.163
Voluntary AD&D Bi-Weekly Rates Team Member
$25,000 $50,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000
$0.40 $0.81 $1.21 $1.62 $2.02 $2.42 $2.83 $3.23 $3.63 $4.04
$275,000 $300,000 $325,000 $350,000 $375,000 $400,000 $425,000 $450,000 $475,000 $500,000
$4.44 $4.85 $5.25 $5.65 $6.06 $6.46 $6.87 $7.27 $7.67 $8.08
Voluntary AD&D Bi-Weekly Rates Spouse
$12,500 $25,000 $37,500 $50,000 $62,500 $75,000 $87,500 $100,000 $112,500 $125,000
$0.20 $0.40 $0.61 $0.81 $1.01 $1.21 $1.41 $1.62 $1.82 $2.02
$137,500 $150,000 $162,500 $175,000 $187,500 $200,000 $212,500 $225,000 $237,500 $250,000
$2.22 $2.42 $2.63 $2.83 $3.03 $3.23 $3.43 $3.63 $3.84 $4.04
Voluntary AD&D Bi-Weekly Rates Children (One premium rate covers all eligible children)
$2,000 $4,000 $6,000 $8,000 $10,000
$0.03 $0.06 $0.10 $0.13 $0.16
* Rates are subject to change.
Refer to Benefits Summary and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.
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Disability Insurance
Long-Term Disability – Employer Paid: All full-
time benefits-eligible team members receive Long-
Term Disability Insurance through Cigna. The
Long-Term Disability Insurance is designed to
protect your earnings for an extended disability. A
monthly benefit will be paid based on 60% of your
covered monthly earnings up to a maximum benefit
of $10,000 per month. The policy includes a 90 day
elimination period before benefits are payable.
Voluntary Short-Term Disability: All full-time benefits-eligible team members may purchase Short-Term
Disability Insurance through Cigna. A weekly benefit will be paid based on 60% of your covered weekly
earnings up to a maximum benefit of $2,000 per week. Benefits begin on the 8th day of disability. Benefits
are paid for a maximum of 12 weeks During your initial enrollment period, Evidence of Insurability will not
be required.
Voluntary Short-Term Disability Bi-Weekly Rates
Use the calculation below to determine your STD bi-weekly payroll deductions.
____________ X 60% = ___________ X .034 = ____________ X 12 ÷ 26 _____________
Weekly Salary* STD Benefit Monthly Cost Your bi-weekly Cost
(Maximum $2,000)
* Note this is an estimate of premium cost. Actual deductions may vary slightly due to rounding andpayroll frequency. Maximum weekly covered salary is $3,335.
Refer to Benefits Summary and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.
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Please note the following:
• If eligible, you may elect to have both types of FSAs and contribute separate pretax dollar amounts to each.
• Your contributions are deducted from your paycheck in equal installments each pay period.
• “Use It or Lose It” –You must use your contributions or lose them at the end of the plan year.
• Under a Section 125 plan, participant elections generally must be irrevocable until the beginning of the next plan
year. However, when a participant experiences one of several specific recognized events, he or she may be
permitted to make a change in election that is consistent with the event.
Health Care Reimbursement FSA: The maximum annual contribution is $2,600.
With pre-tax dollars, you may use your funds for health care expenses not covered by your insurance.
Eligible expenses include medical, dental and vision. For a complete list of eligible expenses, please
refer to IRC Section 213. Under a rule that went into effect January 1, 2011, claims for over-the-counter
medicine or drug expenses (other than insulin) cannot be reimbursed without a prescription.
Dependent Care FSA: The annual limit a team member may contribute is $5,000 ($2,500 for a married
individual filing taxes separately).
A dependent care FSA allows you to use pretax dollars towards
qualified dependent care; care must be provided by a qualified
dependent care service, not a relative. Funds may be used for the
care of eligible dependent children (under the age of 13 who live with
you) by a babysitter, day care center, or before-school or after-school
program. Care for an eligible disabled spouse, parent or child over the
age of 12 who lives with you, may also be eligible for reimbursement.
Care must be provided to keep you and your spouse gainfully
employed. For a complete list of eligible expenses, please refer to
IRC Sections 21 and 129.
At any given time, Dependent Care FSA distributions are limited to the amount you have in your account.
Dependent care expenses cannot be reimbursed until they are actually incurred.
Flexible Spending Account (FSA)Through a Section 125 Plan, Team Focus Insurance Group offers eligible team members the opportunity to open a
Flexible Spending Account(s) (FSAs). An FSA is a tax-free account, in your name, that pays or reimburses you for
qualified health care or dependent care expenses. Your FSA contributions are made pretax (no employment or
federal income taxes are deducted) through payroll deductions. When you receive a distribution from your FSA, the
reimbursements are tax-free. Eligible expenses must be incurred from July 1, 2017 – September 15, 2018.
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Consumerism Card
The Consumerism Card is offered to compliment your “true”
insurance saving you additional money, which includes the
following:
• Access to discounted services, providers and
products
• Additional savings when you or a family member
reach the maximum annual benefit on your
insurance plan
• Doctors by phone/video and medical bill negotiation
Base Card ($10 per month)
• Teladoc (No Consult fee)
• Dental
• Vision
• Pharmacy
• Travel Assistance
• Vitamins
• Diabetic Supplies
• Hearing Aids
• Lab Testing & Imaging Services
Upgraded Card ($15 per month)
• ALL Benefits from Base Card
• Identity Theft
• Legal Services
Allstate Supplemental Products
Other Supplemental Coverage is available through
Allstate. Critical Illness
Critical Illness helps provide much needed cash
when a catastrophic illness strikes (heart attack,
stroke, renal failure). Benefits are paid directly to
you regardless of other insurance. You may also
add a health screening and/or cancer rider to this
policy.
Accident Care Insurance
Helps you pay unexpected expenses from covered
accidents that result in lacerations, fractures, broken
bones and other injuries. This coverage is also
available for family members.
Hospital Indemnity
Helps you pay unexpected expenses from illness,
injury, or pregnancy where there is a hospitalization.
This coverage is also available for family members.
Cancer
Helps you pay expenses from cancer diagnosis and
treatment of cancer. This coverage is also available
for family members.
If you are interested in obtaining additional
information, please contact Heather Peruzzi at
Benefits Technologies at 561-922-3960.
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Pet Insurance
Team Focus Insurance Group knows that pets are part of your
family, so we are excited to offer the opportunity to purchase pet
insurance through Nationwide, the #1 choice for pet insurance.
You can choose a pet health plan that fits your needs, whether
you are looking for basic wellness coverage or comprehensive
major medical coverage for your pet. It’s easy to use the plan!
Nationwide Pet Insurance Plans offer the following
benefits:
• Members may visit any veterinarian, at anytime,
anywhere in the world
• Never any hassle of membership cards
• Members are free to continue seeing their trusted, long-
time veterinarians
• Visits to any emergency hospital or specialist are covered
• Plans are available in all 50 states, and coverage extends
to treatment received anywhere in the world.
• Members are reimbursed for all covered conditions
Using Your Pet Insurance Policy
1. Pay your vet
Pay for your pet’s treatment at the
time of service
2. Submit your claimMail or email your claim form along
with your vet bill
3. Get reimbursed!
According to your plan, after
meeting the deductible (if any)
To enroll in Pet Insurance, visit Nationwide
at www.petinsurance.com/teamfocusins.
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Reasons to Join the
401(k) Plan
• Tax-deferred savings let you
increase your take home pay and
decrease your current taxable
income.
• Team Focus Insurance Group
may offer a discretionary match,
that’s free money. The company
match can help your investments
grow.
• Automatic payroll deductions
make it easy to save. It’s easy to
pay yourself first by setting up
contributions right from your
paycheck.
401(k)
Team Focus Insurance Group offers a 401(k) retirement plan though John
Hancock, a well-established financial services leader serving the financial
needs of millions of customers in 22 countries, as part of our
Comprehensive Benefit Package.
A 401(k) plan allows you to contribute an amount from your income to a
retirement account and to defer taxes until withdrawal.
Full-time regular team members who are over 18 years of age are eligible
to enroll the first of the quarter after a 90 day waiting period.
Quarters begin January 1, April 1, July 1 and October 1.
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Paid Time Off (PTO)
Paid Time Off (PTO) Accrual Rates
Years of Service Days Accrued per Year
Hours Accrued per Year
Hours Accrued per Pay Period
Maximum Accrual Cap
0 through 1 year 13 days 104 hours 4.00 hours 104 hours
1+ Years 15 days 120 hours 4.62 hours 160 hours
5+ Years 20 days 160 hours 6.15 hours 200 hours
10+ Years 25 days 200 hours 7.69 hours 240 hours
The Team Focus Insurance Group Paid Time Off (PTO) benefit program provides you with the flexibility to use your
time off to meet your personal needs, while recognizing your individual responsibility to manage your paid time off. The
information below outlines how the benefit is earned and intended to be used along with the benefit accrual schedule.
Full-time, regular status team members who work at least 32 hours per week, begin accruing PTO on a bi-weekly basis
upon their date of hire. The PTO accrual rates are determined by the team member’s length of service with the
company. Team members can earn and maintain in their PTO Benefit bank up to the maximum accrual cap.
In addition to the PTO benefit, the company also observes 7 holidays: New Year’s Day, Memorial Day, Fourth of July,
Labor Day, Thanksgiving and the day after Thanksgiving, and Christmas Day. Full-time, regular team members will be
paid holiday pay for these observed holidays.
For additional information regarding the Team Focus Insurance Group PTO policy, please visit the UltiPro homepage.
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Employee Assistance Program (EAP)
Team Focus Insurance Group provides our team members with an Employee Assistance Program
through Cigna that is available at no cost. The program includes three face-to-face sessions with a
behavioral counselor for you and your household members, as well as telephonic and online support.
Legal consultation. Receive a free 30-minute consultation. And up to a 25%
discount on select fees.
Parenting. Get guidance on child development, sibling rivalry, separation
anxiety and much more.
Senior care. Learn how to solve the challenges of caring for an aging loved
one.
Child care. Whether you need care all day or just after school, find a place
that’s right for your family.
Pet care. From grooming to boarding to veterinary services, find what you
need to care for your pet.
Financial Services & Referral. Receive a free 30-minute consultation and
25% discount on select fees with network providers.
Refer to Benefits Summary and SPD for more details This is a general outline of covered benefits and does not include all the benefits, limitations, and exclusions of the policy. If there are any discrepancies between the illustrations contained herein and the insurance carrier proposal or contract, the insurance carrier materials prevail. See insurance company contract for full list of exclusions.
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Important Contacts Need additional information? Have a question about one of your benefits? Keep this brochure handy for a quick reference for all your benefit needs. Below is contact information for each of our providers.
Human Resources Department
Team Focus Insurance Group HR Team Ext. 4411 [email protected]
Medical
Cigna Group #3333453 1-800-244-6224 www.mycigna.com
Cigna Telehealth Connection
AMWell MDLIVE
1-855-667-9722 1-888-726-3171
www.AmWellforCigna.com wwwMDLIVEforCigna.com
Health Advocacy
Health Advocate 1-866-695-8622 www.healthadvocate.com
Dental
Cigna Group #3333453 1-800-244-6224 www.mycigna.com
Vision
VSP Group #30020064 1-800-877-7195 www.vsp.com
Life & Disability
Cigna 1-800-362-4462 www.cigna.com
Flexible Spending Account
Diversified 1-954-983-9970 www.div125.com
Allstate Supplemental Products
Benefit Technologies 1-561-922-3960 [email protected]
Consumerism Card
New Benefits 1-800-800-7616 www.mymemberportal.com 401(k)
John Hancock 1-800-395-1113 www.jhancockpensions.com
Employee Assistance Program
Cigna 1-800-538-3543 www.cignabehavioral.com/cgi
Pet Insurance
Nationwide 1-877-738-7874 www.petinsurance.com/teamfocusins www.petnationwide.com
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