Your 2015 Benefits Guide Fannie May & Harry London
Page 2
Introduction 1800Flowers.com offers 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. 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.
Core and full-time employees who work at least 30 hours per week
Legally married spouses
Children up to age 26 regardless of fulltime student status
When do healthcare, life and disability benefits begin?
Salaried employees: Date of Hire
Hourly Employees: 90th day following date of hire
When can I enroll in the 401(k) retirement savings plan?
You are eligible to participate in the 401(k) on the entry date following your date of hire:
Who is eligible for healthcare, life and disability benefits?
January 1st or
July 1st
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. Under federal law, your ben-
efit elections that are paid with pre-tax dollars cannot be changed unless:
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
Visit the benefits portal at www.portal.adp.com
Click on “First Time Users Register Here”
Enter the Registration Code: 800Flowers-800Flowers
Click Next and follow the prompts to complete your registration
You have 31 days from your date of hire or family status change to make or change your benefit elections
Our benefit plans are part of a Cafeteria Plan regulated by the IRS Code Section 125. Under this code, eligible employees have the choice to select to pay for their share of medical, dental and vision premiums on a pre or post tax basis. 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.
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.
How to elect or make changes to your benefits?
include:
Marriage or divorce
Death of a spouse, child,
Birth, adoption
You or your eligible dependent(s) gain or lose coverage elsewhere, etc.
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
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
Page 3
2015 Benefits
United Healthcare
Medical Benefits At -A-Glance
Contact Information:
1800Flowers.com offers a comprehensive medical plan through United Healthcare.
Network: Choice Plus
Please find below a high level summary of the coverage levels provided under the medical plan. For more information regarding the services provided by the plan, please refer to the Summary of Benefits Coverage (SBCs) found in your benefits packet or on the benefits portal. When searching for in-network United Healthcare providers, be sure to select the UHC Choice Plus Network.
Phone: 800.504.5568 Website: www.myuhc.com
Core 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
$1,750 $3,500 90% after deductible (ded.)
$3,000 $6,000 70% after deductible (ded.)
$3,000 $6,000
$5,000 $10,000
100% no ded. 90% after ded. 90% after ded.
70% after ded. 70% after ded. 70% after ded.
10% 20% 20% Employee Contributions Per Pay Period
Non-Smoker Employee Employee + One Family
$49.50 $115.50 $148.50
Smoker Employee Employee + One Family
$81.85 $154.35 $192.93
Health Savings Account (HSA) for the Core Plan Only
1800Flowers.com contributes $15 for single and $20 for family coverage bi-weekly
Maximum annual contributions: $3,350 single & $6,650 for family
HSA account must be activated in order for expenses to be considered eligible
Activate your HSA account by going to https://enrollhsa.optumbank.com/hsaAppWeb/WelcomeAction.do
Page 4
Cigna Contact Information:
Dental Benefits At-A-Glance
Network: Choice Plus 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
www.mycigna.com
$1,000 $50 per person / $150 per family Subject to Reasonable & Customary alBased on reduced contracted fees lowances Plan Pays
100%
Class 2- Basic Restorative Care Fillings Root canal therapy Periodontal scaling and root planing Oral surgery
90%
Class 3- Major Restorative Care Crowns Dentures Bridges Class 4- Orthodontia
60% 50%
Employee Employee + One Family
Website:
Out-of-Network
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)
Lifetime Maximum
Phone: 888.336.8258
$1,000 for dependent children up to age 19 Employee Contributions Per Pay Period $10.50 $22.05 $40.95
Page 5
2015 Benefits
Vi s i o n B e n e f i t s A t - A G l a n c e
Eyemed Contact Information: Phone: 866.804.0982
Your vision is important to your health. Whether your vision is 20/20 or less than perfect, everyone should receive regular vision care.
Website: www.eyemed.com
Employee Contributions Per Pay Period Employee
$2.16
Employee + One
$4.01
Family
$7.02
In-Network
Out-of-Network
Examination (every 12 months)
$10 copay
Up to $40
Standard Lenses (every 12 months)
$25 copay
Up to $40 - $80
Frames (every 24 months)
$0 copay up to $130 retail allowance
Up to $65
Contact Lenses (In lieu of eyeglasses)
Medically Necessary: $0 Copay Elective: $0 copay up to $130 allowance
Medically Necessary: Up to $210 Elective: Up to $130
Smoking Cessation Program
Alere Contact Information: Phone: 866.Quit.4.Life
All employees who are eligible to participate and enroll in the 1800Flowers.com medical and prescription drug 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 higher rates, select your tobacco user status on the benefits portal or advise the ADP Benefit Solution Center Representative if you are calling in your elections. If you are a tobacco user,
1800Flowers.com offers a smoking cessation program at no cost to you. The Alere’s Quit for Life Program provides:
One-on-one telephonebased treatment sessions with a professional Quit Coach, scheduled at your convenience. FREE Nicotine replacement therapy (up to 8 weeks of the patch or gum). Access to Chantix or bupropion (if appropriate, in conjunction with your physician’s ap-
proval; check with your health plan for coverage details)
A Quit Kit of materials designed to help you stay on track between calls.
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 (7848454).
Website: www.quitnow.net
Be Tobacco Free and lower your medical premiums, call Alere!
Page 6
ADP Flex Direct
Flexible Spending Accounts (FSA) For Healthcare Expenses A healthcare flexible spending account (FSA) helps you save big on healthcare expenses that are not covered by the medical, dental and vision plans. 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. You may enroll in your em-
ployer’s FSA plan even if you receive insurance coverage through your spouse’s employer. Your FSA funds can be used to cover eligible expenses for all your qualified dependents.
Receive reimbursements on an extensive list of eligible expenses
Fund your account with paycheck deductions
Reduce your income
Phone: 800.654.6695 Website: www.flexdirect.adp.com
taxes 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.
such as daycare, before and after-school 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:
Be sure to submit all claims for eligible expenses by March 31st of the current year for claims incurred during the prior plan year.
The maximum amount you can contribute to the FSA: Healthcare: $2,550
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
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.
Dependent Care: $5,000 (varies on filing status)
Care at licensed nursery schools or child centers
Care provided in or outside your home during working hours
Before and after-school care
Day camps
Eldercare
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.
It may be necessary for you to submit a receipt to prove eligibility of a purchase you have made.
You cannot have both an FSA and HSA at the same time.
Health Savings Account vs. Flexible Spending Account Health Savings Accounts (HSA)
Healthcare Flexible Spending Accounts (FSA)
Must be enrolled in the 1800Flowers Core Plan Maximum annual contributions: $3,350 for employee only coverage $6,650 for family coverage
Not limited to 1800Flowers medical plan enrollment
Employer contributions Set-Up and Annual Fees apply Unused funds roll over from year to year
No employer contributions No set-up or annual fees Unused funds are forfeited if not used by December 31st
Maximum annual contributions: $2,550
Page 7
2015 Benefits
Basic Life Insurance and Accidental Death and Dismemberment (Company-Paid) One Time Base Annual Earnings Rounded Up To The Next Thousand Subject To a Maximum of $50,000 Based on base annual earnings as of the day before the covered loss began. Base annual earnings include:
Commissions for commission-eligible employees which shall be averaged for the most recent 12 month period.
Overtime for hourly employees which shall be averaged for the most recent 12 month period.
Coverage reductions apply when an employee attains age 70. Refer to the plan document for more details.
Supplemental Life Insurance for E mployee, Spouse and Child Employee Benefit Amount
Dependent Benefit Amount
1 to 6 times Base Annual Earnings up to a maximum of $850,000
Spouse: $10,000 or $25,000
Guaranteed Issue: The Lesser of 4 Times Your Annual Earnings to a Maximum of $500,000
Employees must participate in voluntary plan for
If you request an amount over the Guaranteed Issue you will be required to complete a statement of health
Spouse Life Benefit cannot exceed the employee’s
No age reduction schedule
Dependent Children: $4,000 or $10,000
Includes free face to face will preparation & estate resolution services
Up to 25 years old if full-time student
dependents to participate
voluntary life insurance benefit
Employee Monthly Cost
Calculate Your Monthly Life Insurance Cost:
Age
1.
Coverage amount (rounded to nearest $1,000): _________
$0.040
2.
Divide the coverage amount above by $1,000
30-34
$0.050
3.
35-39
$0.060
Multiply the amount from item 2 by the rate for your age bracket
40-44
$0.090
4.
The final amount is your monthly cost for the optional employee life insurance
45-49
$0.140
50-54
$0.210
55-59
$0.320
60-64
Under 25 25-29
Rate/1000 $0.040
Spouse Life Insurance Benefit
Cost
$10,000
$2.50
$25,000
$6.25
Child Life Insurance Benefit
Cost
$0.450
$4,000
$0.48
65-69
$0.770
$10,000
$1.20
70-74
$1.310
75-79
$2.120
80+
$3.430
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 r eplace a por tion of your salar y in the event of a cover ed 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 pur chase additional STD to cover 60% of your weekly ear nings up to a maximum of $1,500 per week. 1.
2.
List Your Weekly Earnings *Maximum Covered Payroll is: $2,500 Multiply by 60%
X 60% =___________
2a. Subtract Employer Paid Benefit. Core= No. 1 X 50% = $_________
- Core =___________
All Other locations Maximum 3.
Divide by 10
4.
Multiply By: 0.194 (Will Vary Slightly Due To Rounding)
$___________
$170 / 10 =___________ X Rate =___________ Bi-Weekly Cost
Based on base annual earnings as of the day before the covered loss began. Base annual earnings include: 
8 th D a y Ac c i d e n t & 8 th Day Sickness Elimination Period This is the number of days you must be disabled before benefit payments start.
California and New Jersey Residents: Disability claims are filed with the state.
Commissions for commission-eligible employees and overtime for hourly employees.
BENEFIT DEFINITIONS & REQUIREMENTS
Definition of Disability: Due to a sickness, or as a direct result of accidental injury, the employee is receiving appropriate care and treatment and complying with the requirements of such treatment, and is unable to earn more than 80% of their predisability earnings at their Own Occupation. 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. Actively at work means the full-time performance of all customary duties of your occupation. Late entrants are required to complete a statement of health. Please refer to your Plan Document for further information.
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.
Based on base annual earnings as of the day before the covered loss began. Base annual earnings include:
2015 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 r eplace a por tion of your salar y 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 pur chase additional LTD to cover 60% of your monthly earnings up to a maximum of $10,000 per month. To calculate Your Premium Please Follow These Instructions:
Commissions for commission-eligible and overtime for hourly employees.
1.
List Your Monthly Earnings
2.
Divide by 100
Commissions and/or overtime shall be averaged for the most recent 12 month period.
3.
Multiply By: 0.065
$___________
*Maximum Covered Payroll is: $16,667
(Will Vary Slightly Due To Rounding)
/ 100 =___________ X Rate =___________ Bi-Weekly Cost
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 Disability: Due to a sickness, or as a direct result of accidental injury, the employee is receiving appropriate care and treatment and complying with the requirements of such treatment, and during the elimination period and the next 24 months is unable to earn more than 80% of their predisability earnings at their Own Occupation for any employer in their local economy, and after such period, is unable to earn more than 80% of their predisability earnings from any employer in their local economy at any gainful occupation for which they are reasonably qualified taking into account their training, prior education and experience. 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. Late entrants are required to complete a statement of health.
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.
Top Reasons to Call Health Advocate:
Work with insurance companies to obtain approvals for needed services
Answer questions about tests, exams, treatments and medications
Find the right doctors
Facilitate appointments with providers
Help resolve insurance claims and negotiate payment ar rangements
You, your spouse, dependent children, parents and parents-in-law are covered. Health Advocate services are available to you and your eligible family members at no cost.
Assist with eldercare and related healthcare issues your parents and parents-in-law are facing Get cost estimates for procedures
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 much more
Your privacy is protected by both the EAP and Health Advocate. Your medical and personal information is kept strictly confidential.
Health Advocate
1.866.695.8622 or visit HealthAdvocate.com/members You can reach the EAP 24/7, at anytime.
Employee Assistance Program (EAP) MetLife’s Employee Assistance Program (EAP) 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.
24-hour/365-day live telephonic access
24-hour crisis intervention
Referrals for up to 3 face-to-face counseling visits
Health and wellness concerns
Identity theft services
Financial and legal services
Childcare and eldercare assistance
Call MetLife’s EAP 1.800.511.3920
Health Advocate can also be accessed 24/7. Normal business hours are MondayFriday, between 8am and 9pm EST. After hours and during weekends, staff is available for assistance.
The EAP services can be used by you, your spouse and dependent children.
Health Advocate services can be used by you, your spouse, dependent children, parents and parents-in-law.
Page 11
Fidelity
2015 Benefits
401(k) Retirement Savings Plan
800.835.5097 (English) 800.587.5282 (Spanish) Website: www.401k.com
You are eligible to enroll in the 1800Flowers.com 401(k) retirement savings plan if:
You are 21 and older
tributed to the 401(k). You can opt-out of the automatic enrollment at anytime prior to or after your entry date.
You are eligible to participate in the 401(k) after the entry dates following your date of hire:
You can contribute to the annual IRS maximum. Employees over age 55 may be able to contribute additional catch-up contributions.
January 1st or July 1st
To enroll in the 401(k), please visit www.401k.com. On this website, you will be able to
Automatic enrollment occurs after your entry date. Three percent of your pay will be deducted and con-
Enroll in the 401(k)
View your investment
options and historical performance
Designate your 401(k) beneficiaries
View your balances and change your contributions
A separate 401(k) informational booklet will be mailed to your home as you approach your entry date.
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 1800-526-2720 for more information.
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 prevail.