2013 De s ig n P a c
B e n ef it s
P ro g ra m
2013 Benefits
Page 2
Introduction
Who is eligible for healthcare, life and disability benefits?
1800Flowers.com continues to offer a comprehensive and competitive health and welfare benefits package to ensure that we are one of the best places to work and that we retain the best people. The benefits you elect are there for you day in and day out. Your benefits help to keep you and your families healthy and secure.
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Core and Full-time employees who work at least 30 hours per week
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Spouses (as defined by federal law)
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Children up to age 26 regardless of full-time student status
We hope you find this benefits guide to be a helpful tool as you make your benefit choices. Review it carefully, as it gives specific information about each of the options available to you.
Choices to Make 1800Flowers.com offers you coverage in several categories as follows:
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Medical and Prescription Drug Insurance
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Dental Insurance
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Vision Insurance
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Basic Life Insurance
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Optional Life Insurance (Employee, Spousal and Child Life)
When do your healthcare, life and disability benefits begin? Basic and Supplemental Short and long Term Disability Accidental Death and Dismemberment (AD&D)
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Health Savings Account (HSA)
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Medical and Dependent Care Flexible Spending Accounts (FSA)
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Health Advocate
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Employee Assistance Program (EAP)
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Salaried employees: Date of hire
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Nurseline
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401(k) Retirement Savings plan (turn to page 11
Hourly Employees: 1st of the month following 90 days of continuous service
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You are eligible to contribute to the 401(k) plan after 30 days of service
for eligibility details)
Carefully read through this benefits guide for more details on the different benefit options available to you and your family.
How to elect or make changes to the healthcare, life and disability benefits?
C h a n g i n g Yo u r E l e c t i o n s : If you are a new hire, the benefit elections you make now will be in effect for this current plan year.
Under federal law, your benefit elections that are paid with pre-tax dollars cannot be changed unless:
If you are a current employee making benefit elections during Open Enrollment, your elections will remain in effect for the plan year beginning on January 1 and ending December 31st.
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It is Open Enrollment and you are making changes for the next plan year Or if you experience a qualifying family status change
A family status change may include:
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Visit the benefits portal at www.1800flowers.essbenefits.com
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You will need your six-digit employee ID number found in this packet or on your paystub
Birth, adoption
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You or your eligible dependent(s) gain or lose coverage elsewhere, etc.
Your default passcode will be the MMYY of your birthdate (e.g. January 1950, your passcode will be 0150)
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You have 31 days from your date of hire or family status change to make or change your benefit elections
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Marriage or divorce
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Death of a spouse, child,
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2013 Benefits
Medical Plan Info:
Medical
Carrier: United Healthcare Network: Choice Plus Phone: 800.504.5568
1800Flowers.com offers two medical options through United Healthcare:
Website: www.myuhc.com
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The Core Plan: A High Deductible Health Plan
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The Middle Plan: An In-network only Plan
Health Savings Account Info: Carrier: Optum Health Bank
Please find below a high level summary of the coverage levels provided under these two options. For more detailed information regarding the services provided or covered by each plan, please refer to the United Healthcare Summary of Benefits Coverage (SBCs) found in this packet or on the benefits portal.
Phone: 800.791.9361 Website: https://enrollhsa.optumhealthbank. com
Note: As of 1/1/2012, the High plan is no longer offered as a medical option to new enrollees. Those who were enrolled in the High Plan on December 31, 2011, have been grandfathered. For more details on the high plan rates and services, please refer to the Summary of Benefits Coverage from United Healthcare.
“When searching for in-network United Healthcare providers, be sure to use the UHC Choice Plus Network.”
Core Plan
Middle Plan
High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) Network Non-Network Annual Deductible Individual Family Coinsurance Out-of-Pocket Max. (Includes deductible) Individual Family Office Visits Preventive Care Primary Care Specialists Prescription Drug Tier 1 Tier 2 Tier 3 Bi-Weekly Employee Contributions Non-Smoker Employee Employee + One Family Smoker Employee Employee + One Family
In-Network Only In-Network Only
$1,250 $2,500 90% after deductible (ded.)
$2,100 $4,200 70% after deductible (ded.)
$500 $1,500 80% after deductible (ded.)
$2,100 $4,200
$4,100 $8,200
$1,750 $5,250
100% no ded. 90% after ded. 90% after ded.
70% after ded. 70% after ded. 70% after ded.
100% no ded. 100% after $20 100% after $40
10% 20% 20%
$15 $30 $50
$27.50 $59.40 $89.10
$44.93 $96.95 $146.61
$42.10 $78.34 $113.42
$61.46 $119.15 $175.58
Health Savings Account (HSA) for Core Plan
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•18F contributes $15 for single and $20 for family coverage bi-weekly
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•Maximum annual contributions: $3,250 single & $6,450 for family
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HSA account must be activated in order for expenses to be considered eligible
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HSA card will be mailed when account is opened
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Application can be expedited by going online
https://enrollhsa.optumhealthbank.com
2013 Benefits
Page 4
Dental In addition to medical, 1800Flowers.com also offers a dental plan (DPPO) which provides both in and out-of-network benefits. The chart below provides you with some of the services covered by the plan. For more detailed dental information including exclusions, please see the dental summary plan description found on the benefits portal. In-Network Calendar Year Maximum (Class 1, 2 and 3 expenses) Annual Deductible Reimbursement Levels
Out-of-Network
$1,000 $50 per person / $150 per family Subject to Reasonable & Customary allowBased on reduced contracted fees ances Plan Pays
Class 1- Preventive & Diagnostic Care Oral exams (two per year) Routine cleanings (two per year) Full mouth x-rays (1 complete set every three years) Bitewing x-rays (two per year) Panoramic x-ray (once every three years) Fluoride application (once per year for persons under 19) Sealants (limited to posterior tooth/one treatment per tooth every 3 years) Space maintainers (limited to nonorthodontic treatment) Emergency care to relieve pain Histopathologic exams
100%
Class 2- Basic Restorative Care Fillings Root canal therapy Osseous surgery Periodontal scaling and root planing Denture adjustments and repairs Oral surgery Anesthetics Surgical extractions for impacted teeth Repairs to bridges, crowns and inlays Class 3- Major Restorative Care Crowns Dentures Bridges Class 4- Orthodontia Lifetime Maximum
90%
60% 50% $1,000 for dependent children up to age 19
Dental Plan Info:
Bi-weekly Cost for Dental:
“Visit the benefits portal to see a
Carrier: Cigna
Employee Only: $0.00
detailed summary of all covered
Dental Preferred Provider Network (DPPO)
Employee + One: $14.17
dental benefit services and
Family: $37.35
exclusions.�
Phone: 888.336.8258 Website: www.mycigna.com
Page 5
Vision Plan Info: Carrier: United Healthcare
2013 Benefits
Vi s i o n
Phone: 800.638.3120 Website: www.myuhcvision.com
Your vision is important to your health. Whether your vision is 20/20 or less than perfect, everyone should receive regular vision care.
In-Network
Bi-weekly Cost for Vision: Employee Only: $2.76 Employee + One: $4.98 Family: $8.61 Examination
Materials
Visit myuhcvision com: •
Frames
To locate in-network vision providers
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Comprehensive eye examination from a state-licensed optometrist or ophthalmologist, $10 copay (every covered in full after exam co12 months) pay The materials copayment is a single payment that applies to the entire purchase of eyeglasses (lenses and frames) or $25 copay contacts, in lieu of eyeglasses $130 frame allowance at priOnce every 24 vate practice and retail chain months providers
Print a vision card
Pair of Lenses
Lens Options
Once every 12 months Standard scratchresistant coatingcovered in full. Other optional upgrades may be offered at discount (varies by providers)
Out-of-Network If you choose an outof-network provider, you may be reimbursed up to:
$40
$45
If prescribed, one pair of standard single vision or standard multi-focal lenses is covered in $40-80 (depending on type) full
Covered in full elective contact lenses: The fitting/evaluation fees, contact lenses and up to two follow up visits are covered in full (after copay). If you choose disposable contacts, up to 8 boxes are included when obtained from a network provider.
Where to send claims: If you visit an out-of-network provider, you will need to send your itemized receipts with the primary insured’s unique identification number and the
All other elective contact lenses: A $200 allowance is applied toward the fitting/evaluation fees and purchase of contact lenses outside the covered selection (materials copay does not apply)
patient’s name and date of birth to: United Healthcare Vision Claims Department PO BOX 30978 Salt Lake City, UT 84130 Fax: 248.733.6060 Contact Lenses
In lieu of eyeglass- Necessary Contact Lenses: es (once every 12 Covered in full after applicable months) copay
Elective $200 Necessary $210
2013 Benefits
Page 6
Flexible Spending Accounts (FSA) For Healthcare Expenses
FSA Plan Info:
A healthcare flexible spending account (FSA) helps you save big on healthcare expenses that are not covered by the medical, dental and vision plans.
receive insurance coverage through your spouse’s employer. Your FSA funds can be used to cover eligible expenses for all your qualified dependents.
Website: www.flexdirect.adp.com
Because your FSA contributions are exempt from federal, social security taxes (FICA) and, in most cases, state income tax, you can save 20%40% on health services and products.
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Receive reimbursements on an extensive list of eligible expenses
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Fund your account with paycheck deductions
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Reduce your income taxes
You may enroll in your employer’s FSA plan even if you
To view a list of eligible expenses, visit www.flexdirect.adp.com You can enroll in the FSA during Open Enrollment or during your new hire election period. Please note that once you make your FSA election for the year, you cannot change it until the next open enrollment or if you experience a qualifying family status change.
Flexible Spending Accounts Dependent Care A dependent care FSA helps you save on the care and supervision of your child. Whether you are a single parent or you and your spouse work or attend school fulltime, providing supervised care for your dependents is essential to your livelihood. Your dependent care FSA can be used to cover expenses
such as daycare, before afterschool care and day camps. Because your dependent care FSA is funded before any taxes are taken from your salary, the IRS determines which expenses are eligible for reimbursement. Some eligible expenses include:
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Care at licensed nursery
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Care provided in or outside your home during working hours
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Before and after-school care
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Day camps
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Eldercare
Healthcare Flexible Spending Accounts (FSA)
You must be enrolled in the 1800Flowers.com Core You can be enrolled in the 1800Flowers.com medical medical plan to participate plan or a plan through your spouse's employer Savings account owned by you Maximum annual contributions: $3,250 for employee only coverage $6,450 for family coverage Employer Contributions: $15 per pay period for employee only coverage $20 per pay period for family coverage Set-up and annual fees may apply (please see the HSA fee schedule on the benefits portal) Unused funds roll over from year to year
Phone: 800.654.6695
Important Points on the FSA (healthcare and dependent care):
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The FSA is not a savings account. You must use all of your contributions each year or risk losing any unused balance at the end of the plan year.
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Be sure to submit all claims for eligible expenses by March 31st of the current year for claims incurred during the prior plan year.
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The 2013 maximum amounts that you can contribute to the FSA:
schools or child centers
What’s the difference? Health Savings Account vs. Flexible Spending Accounts Health Savings Accounts (HSA)
Carrier: ADP Flex Direct
Healthcare: $2,500 Dependent Care: $5,000 (varies on filing status)
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Save your receipts, because no taxes are taken on the funds in your FSA, the IRS requires that you retain all of your itemized receipts for purchases made with your FSA accounts/card.
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It may be necessary for you to submit a receipt to prove eligibility of a purchase you have made.
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You cannot have both an FSA and HSA at the same time.
Not a savings account and is not owned by you Maximum annual contributions: $2,500
No employer contributions
No set-up or annual fees Unused funds are forfeited if not used by 12/31
How to submit FSA claims: Complete and follow the instructions on the FSA claim forms which can be found on the benefits portal: www.1800flowers.essbenefits.com
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2013 Benefits
Basic Life Insurance and Accidental Death and Dismemberment (AD&D) (Company-Paid) Benefit Amount: One Time Annual Earnings Rounded Up To The Next Thousand Subject To a Maximum of $50,000 *Based on gross earnings excluding bonus for the calendar year prior to the date the covered loss occurs. Your Benefit Will Reduce 35% Upon The Attainment Of Age 65 An Additional 15% Of The Original Amount At Age 70
Supplemental Life Insurance for E mployee, Spouse and Child Employee Benefit Amount
Spouse Benefit Amount $10,000 or $25,000
You Choose the Protection You Want! 1 to 6 times Annual Earnings
Employees must participate in voluntary plan for
Guaranteed Issue: The Lesser of 4 Times Your Annual Earnings to a Maximum of $500,000 If you request an amount over the Guaranteed Issue you will be required to complete an Evidence of Insurability
dependents to participate * The Spouse Life Benefit cannot exceed the employee’s * Coverage ends 1st of the month after spouse reaches age 70. You may convert the coverage to an individual policy, please see your HR Specialist for additional information
Maximum Benefits: The Lesser of 6 Times Your Annual Earnings to a Maximum of $850,000
Dependent Children Benefit Amount
Your Benefit Will Reduce
$4,000 or $10,000
35% Upon The Attainment Of Age 65
(Up To 25 Years If Full-Time Student)
An Additional 15% Of The Original Amount At Age 70
Employee Monthly Cost Age Under 20
Rate/1000 Age
Rate/1000
45-49 50-54 55-59 60-64 65-69 70+
0.165 0.275 0.506 0.693 1.17 1.82
0.044
20-24
0.044
25-29
0.055
30-34
0.077
35-39
0.088
40-44
0.110
___________________ Coverage Amount (rounded to the nearest $1,000)
_______ á
1,000
x
Rate
______________ =
Monthly Cost
Spouse Monthly $10,000
$25,000
$2.50
$6.25
Child(ren) Monthly Cost: $4,000 $10,000 $0.48
$1.20
2013 Benefits
Page 8
S h o r t Te r m D i s a b i l i t y Short Term Disability (STD) is designed to help you replace a portion of your salary in the event of a covered sickness or off the job accident. 1800Flowers.com provides basic STD coverage at no cost to you. The plan pays 50% of your weekly earnings up to $170 per week. There is an 8 day elimination period, which is the period of time you must be disabled before benefits begin. Benefits may continue for up to 26 weeks Voluntary Short Term Disability. You have the option to select additional STD to cover 60% of your weekly earnings up to a maximum of $1,500 per week at no cost to you for calendar year 2013. If you would like to select the additional STD coverage, be sure to make your election on the benefits portal although there is no cost to you.
BENEFIT DEFINITIONS & REQUIREMENTS
California Residents:
Definition of Total Disability:
Benefit duration for approved disability is 52 weeks. The California maximum benefit is $987.
Total Disability means you are unable to perform all of the material duties of your occupation on a full-time basis due to a non-work related injury or sickness. Eligibility Requirements: You must be a core employee regularly scheduled to work at least 30 hours per week; be actively at work* on the coverage effective date; and have worked at least 15 out of the 20 working days immediately preceding the coverage effective date. * Actively at work means the full-time performance of all customary duties of your occupation. SPECIAL NOTE: The above is just a brief summary of benefits and does not constitute a contract. Please refer to your Plan
New Jersey Residents: The New Jersey maximum benefit is $559.
Document for further information on your Employee Benefits.
Program Effective Date: The effective date of your coverage will be the first day of the month following the completion of your waiting period. Late entrants are required to complete satisfactory Evidence of Insurability
8 th D a y A c c i d e n t & 8 th D a y Sickness Elimination Period This is the number of days you must be disabled before benefit payments start.
Earnings are based on gross earnings excluding bonus for the calendar year prior to the date the covered loss occurs.
Page 9
To Social Security Normal Retirement Age Benefit Duration This is the period of time that benefits will continue to be paid to you during a period of disability.
180 Day Elimination Period This is the number of days you must be disabled before benefit payments start.
2013 Benefits
L o n g Te r m D i s a b i l i t y Long Term Disability (LTD) is designed to help you replace a portion of your salary in the event of a covered sickness or off the job accident. 1800Flowers.com provides basic LTD coverage at no cost to you. The plan pays 50% of your monthly earnings up to $2,500 per month. There is an 180 day elimination period, which is the period of time you must be disabled before benefits begin. Voluntary Long Term Disability. You have the option to select additional LTD to cover 60% of your monthly earnings up to a maximum of $10,000 per month at no cost to you for calendar year 2013. If you would like to select the additional LTD coverage, be sure to make your election on the benefits portal although there is no cost to you.
Earnings are based on gross earnings excluding bonus for the calendar year prior to the date the covered loss occurs.
BENEFIT DEFINITIONS & REQUIREMENTS Pre-Existing Condition Exclusion: “Pre-Existing Condition� means any sickness or injury for which you have received medical treatment, consultation, care or services (including diagnostic measures or the taking of prescribed drugs or medicines) during the 3 months prior to the coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for 12 months following the coverage effective date. Definition of Total Disability: Total Disability means you are unable to perform all of the material duties of your occupation on a full-time basis due to a non-work related injury or sickness. Eligibility Requirements: You must be a core employee regularly scheduled to work at least 30 hours per week; be actively at work* on the coverage effective date; and have worked at least 15 out of the 20 working days immediately preceding the coverage effective date.
Program Effective Date: The effective date of your coverage will be the first day of the month following the completion of your waiting period. Late entrants are required to complete satisfactory Evidence of Insurability.
SPECIAL NOTE: The above is just a brief summary of benefits and does not constitute a contract. Please refer to your Plan Document for further information on your Employee Benefits.
2013 Benefits
Page 10
Health Advocate and EAP services become effective on your date of hire. Call Today!
Health Advocate Call Health Advocate with your healthcare and insurance-related problems. Services are provided by personal Health Advocates, typically registered nurses, supported by a team of medical directors and benefits and claims specialists. You, your spouse, dependent children, parents and parentsin-law are covered.
Top Reasons to Call Health Advocate:
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Work with insurance companies to obtain approvals for needed services
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Answer questions about tests, exams, treatments and medications
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Find the right doctors
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Facilitate appointments with providers
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Help resolve insurance claims and negotiate payment arrange• ments
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Health Advocate services are available to you and your eligible family members at no • cost.
Assist with eldercare and related healthcare issues your par• ents and parents-in-law are facing Get cost estimates for procedures
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Health Advocate and EAP services are available to you and your eligible family members at no cost to you.
Assist in the transfer of records, x-rays and lab results Locate and research the newest treatments for a medical condition And more
Your privacy is protected by both the EAP and Health Advocate. Your medical and personal information is kept strictly confidential.
Call Health Advocate 1.866.695.8622 Visit HealthAdvocate.com/members You can reach the CIGNA EAP 24/7, at anytime.
Employee Assistance Program (EAP) CIGNA’s Employee Assistance Program (EAP) also known as Life Assistance is a FREE, confidential and voluntary service that provides eligible Associates and their families telephone, on-line and face-to-face consultations. The consultations can be used for personal life issues including finances, adoption, child care, senior care and more. The EAP is available to all Associates, regardless of enrollment in any of the other benefit plans.
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24-hour/365-day live telephonic access
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24-hour crisis intervention
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Referrals for up to 3 face-to-face counseling visits for behavioral issues
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An online resource library
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Identity Theft Services
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Travel Assist / Will Preparation
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Healthy Rewards Program– discounts up to 60% on a range of products and services
Health Advocate can also be accessed 24/7. Normal business hours are Monday-Friday, between 8am and 9pm EST. After hours and during weekends, staff is available for assistance.
Visit www.cignabehavioral.com/cgi User ID: rewards
The EAP services can be used by you, your spouse and dependent children.
Password: savings Call 1.800.538.3543
Health Advocate services can be used by you, your spouse, dependent children, parents and parents-in-law.
Page 11
Smoking Cessation Plan Info: Carrier: Alere
2013 Benefits
Smoking Cessation Program
Phone: 866.Quit.4.Life Website: www.quitnow.net
“Be Tobacco Free, get lower medical premiums, call Alere today!”
All employees who are eligible to participate and enroll in the 1800Flowers Team Services, Inc. Medical and Prescription Drug plan (Plan) and who use tobacco products will be charged a higher rate based on the cost of the tier (e.g., employee, family, etc.) they elect under the Plan. If you are not a tobacco user, to avoid the tobacco-user higher rates, you must complete and submit a tobaccouse affidavit to Human Resources. A copy of the affidavit is enclosed with this enrollment packet or can be found on the benefits portal.
If you are a tobacco user, 1800Flowers.com offers a smoking cessation program to you at no cost. The Alere’s Quit for Life Program provides:
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One-on-one telephonebased treatment sessions with a professional Quit Coach, scheduled at your convenience.
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FREE Nicotine replacement therapy (up to 8 weeks of the patch or gum).
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Access to Chantix or bupropion (if appropriate,
in conjunction with your physician’s approval; check with your health plan for coverage details)
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A Quit Kit of materials designed to help you stay on track between calls.
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Access to Web Coach, Alere’s interactive website.
There is no better time than now to become free of tobacco. For more information on the program or to register, call 1.866.Quit.4.Life (784-8454).
How to Receive Lower Medical Premium Rates by using the Alere Smoking Cessation Program For purposes of this Program, participation or “engagement” will be defined as enrolling in the Alere Quit For Life Program and completing 3 calls with a Quit Coach and completing the 6-month follow up survey. Upon meeting the criteria the employee will receive their premium discount for the remainder of the plan year, regardless of quit status. If an employee does not meet the engagement criteria they will not receive the lower premiums. 401(k) Plan Info: Carrier: Fidelity Phone:
401(k) Retirement Savings Plan
800.835.5097 (English) 800.587.5282 (Spanish) Website: www.401k.com You are eligible to participate in the 401(k) after 30 days of service. Automatic enrollment occurs after 120 days of service. You can optout of the automatic enrollment at anytime after 30 days of service.
“Start saving for your retirement by enrolling in the Fidelity 401(k) plan. Go to www.401k.com”
You are eligible to enroll in the 1800Flowers.com 401(k) retirement savings plan if:
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You are 21 and older
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Have worked 30 days of service
You can contribute to the annual IRS maximum. Employees over age 55 may be able to contribute additional catch-up contributions. To enroll in the 401(k), please visit www.401k.com. On this website, you will be able to
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Enroll in the 401(k)
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View your investment options and historical performance
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Designate your 401(k) beneficiaries
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View your balances and change your contributions
It is important to note that you will be automatically enrolled in the 401(k) after 120 days of service if you do not take any action within this time frame.
Three percent of your pay will be deducted and contributed to the 401(k). You can opt out of the automatic enrollment at any time after your first 30 days of service. A separate 401(k) informational booklet will be mailed to your home as you approach 30 days of service.
2013 Benefits
Page 12
Benefits Contact Cheat Sheet
Important Notices P r e / P o s t Ta x B e n e f i t P r e m i u m C o n v e r s i o n
1800Flowers.com Benefits Solution Center www.1800flowers.essbenefits.com
Our benefit plans are part of a Premium Conversion Plan or Cafeteria Plan regulated by the IRS Code Section 125. Under this code, eligible Associates have the choice to select to pay for their share of medical, dental and vision premiums on a pre or post tax basis.
866.594.3246
By electing pre-tax premiums, eligible benefit premiums are not subject to federal income, social security or unemployment taxes. Therefore, increasing your take-home pay.
Medical - United Healthcare
Important Points:
800.504.5568
♦
Amounts deferred under this plan are not counted as wages when determining your social security benefits and there is a possibility of a reduction in social security benefits
♦
Social Security taxes are reduced on salary amounts up to and including $110,100 (2012 Social Security wage base); for salaries above that amount, Associates will continue to save on the 1.45% Medicare tax that applies to all wages
♦ ♦
Once pre or post tax premiums are elected, they cannot be changed until the following Open Enrollment unless there is a qualifying family status change Pre or post tax elections can be made through the Benefits Website or by calling the Benefits Solution Center
www.myuhc.com
Dental - CIGNA www.cigna.com 888.336.8258 Vision - United Healthcare www.myuhcvision.com 800.638.3120 Employee Assistance Program
COBRA
CIGNA www.Cignabehavioral.com/cgi
COBRA (The Consolidated Omnibus Budget Reconciliation Act) is offered to employees and/or their dependents with the right to continue group healthcare benefits for a specific time due to a COBRA qualifying event. Please contact ADP Cobra Services at 1-800-526-2720 for more information.
800.538.3543 Health Savings Account - UHC https://enrollhsa.optumhealthbank. com 800.791.9361
Thanks for reading the 2013 Benefits Guide. Bye!
Flexible Spending Accounts – ADP www.flexdirect.adp.com 800.654.6695 Health Advocate www.healthadvocate.com/members
This document is NOT a “ Benefits Summary Plan Description”. If there are any differences between this information and the “Benefits Plan Document” or “Summary Plan Description”, the Plan Document will be considered accurate.
866.695.8622