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plan year | 2011

employee BENEFITs GUIDE Your Benefits at a Glance This guidebook serves as a quick reference for Tidelands Bank employees regarding their employee benefits, costs and coverages.


Welcome to your Employee Benefits Guide for the 2011 Plan Year We are committed to providing employees with a benefits program that is both comprehensive and competitive. Our program offers a range of plan options to meet the needs of our diverse workforce. We know that your benefits are important to you and your family. This program is designed to assist you in providing for the health, well–being and financial security of you and covered dependents. Helping you understand the benefits Tidelands Bank offers is important to us. That is why we have created this Employee Benefits Guide.

Welcome

Benefits Guide Overview

2 Employee Benefits Guide

This guide provides a general overview of your benefit choices to help you select the coverage that is right for you. Be sure to make choices that work to your best advantage. Of course with choice comes responsibility and planning. Please take time to read about and understand the benefit, plan thoughtfully, and enroll on time. Included in this guide are summary explanations of the benefits and costs as well as contact information for each provider. It is important to remember that only those benefit programs for which you are eligible and have enrolled in apply to you. We encourage you to review each section and to discuss your benefits with your family members. Be sure to pay close attention to applicable co-payments and deductibles, how to file claims, preauthorization requirements, networks and services that may be limited or not covered (exclusions). This guide is not an employee/employer contract. It is not intended to cover all provisions of all plans but rather is a quick reference to help answer most of your questions. Please see your Summary Plan Description for complete details. We hope this guide will give you a clear explanation of your benefits and help you be better prepared for the enrollment process.

Contents Eligibility Details............................................................................................................................................. 3 Medical Insurance........................................................................................................................................... 4 Dental Insurance............................................................................................................................................. 6 Vision Insurance...............................................................................................................................................7 Flexible Spending Account..................................................................................................................... 8 Long Term Care.............................................................................................................................................10 EAP......................................................................................................................................................................... 11 Short term Disability.................................................................................................................................... 12 Long term Disability..................................................................................................................................... 12 Basic Life and AD&D Insurance............................................................................................................. 13 Voluntary Life Insurance...........................................................................................................................14 Chip Notice ..................................................................................................................................................... 15 Medicare Notice............................................................................................................................................ 16


Eligibility Details

Are you eligible for benefits? To determine the benefits for which you may be eligible, please refer to the chart below. You are eligible to participate in these plans upon meeting each plan’s eligibility requirements. You also have the option to enroll your eligible dependents in some of these plans. Eligible dependents may include: • Your spouse or your children (dependent age limit to 26*) Individuals whose coverage ended, or who were denied coverage (or were not eligible for coverage), because the availability of dependent coverage of children ended before attainment of age 26 are eligible to enroll in the Healthplan. Employees requesting to enroll eligible dependents will have the opportunity during this open enrollment period. Enrollment will be effective January 1, 2011. *Certain limitations apply. Please call the Employee Service Hotline for additional information, 1-888-408-9144

Benefit Plan

Employees working 25+ hours per week

New Hire Eligibility Waiting Period

Medical/Prescription

Eligible

First of the month following date of hire

Dental

Eligible

First of the month following date of hire

Vision

Eligible

First of the month following date of hire

Basic Life

Eligible

First of the month following date of hire

STD & LTD

Eligible

First of the month following date of hire

Voluntary Term Life

Eligible

First of the month following date of hire

Long Term Care

Eligible

First of the month following date of hire

Employee Benefits Hotline: 1-888-408-9144 3


Medical Plan BENEFITS

Administered by BlueCross BlueShield of SC

IN-NETWORK

OUT-OF-NETWORK

Deductible

Single Family

$1,000 $2,000

$1,000 $2,000

Out-of-Pocket Maximum

Single Family

$1,500 $3,000

$3,000 $6,000

80%

50%

$20 – Primary Care Physician $40 - Specialist

Deductible, 50%

Deductible, 80%

Deductible, 50%

100% 100%

N/A

Co-Insurance Physician Services Charges for services in the office

(excluding surgery, obstetrical delivery, dialysis treatment and second surgical opinion)

(Includes labs, x-rays and office surgery)

Other Physician Services

Inpatient/Outpatient hospital, anesthesia services, lab work, x-rays, pathology, mental health and substance abuse, obstetrical delivery, initial new born pediatric exam and all other outpatient office services.

Preventive Care (In Network coverage only) Mammograms (women 40 and over; one per year.) Pap Smear Test/Prostate Screening (100% coverage of test only)

Well Child to Age 6 Physical Exam (Maximum of $300 per year) Hospital / Skilled Nursing Facility Charges

$20 Copay, then 100% $20 Copay, then 100% $0 Copay, 80%

$500 Copay, 50%

Outpatient Facility Charges

Deductible, 80%

Deductible, 50%

Ambulance

Deductible, 80%

Deductible, 50%

Emergency Room

$75 Copay, 80%

Deductible, 50%

Deductible, 80% Deductible, 80%

Deductible, 50% Deductible, 50%

Deductible, 80%

Deductible, 50%

$40 Co-pay, then 100%

Deductible, 50%

Other Services Colonoscopy Physical/Occupational Therapy ($1,000 combined maximum) Home Healthcare Chiropractic Benefits ($500 Max per year) Prescriptions

(Includes diabetic supplies and oral contraceptives) Retail (31 day supply) Retail - Generic Only (90 day supply) Mail Order Prescriptions (90 day supply) Specialty Drugs (31 day supply)

Annual Maximum

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IN NETWORK ONLY --Mandatory Generic* $15 (Generic) / $35 (Preferred) / $55 (Non-Preferred) 3 Generic Copays will apply $30 (Generic) / $80 (Preferred) / $140 (Non-Preferred) $100 $2,000,000


Medical Plan

Administered by BlueCross BlueShield of SC

Eligible Employees: Full-time employees working at least 25 hours per week are eligible the first of the month following date of hire. Monthly Pay Period Contribution: Employee Monthly Contribution

Medical tier Employee Only

$47.69

Employee + Spouse

$292.51

Employee + Children

$249.19

Employee + Family

$489.64

*Mandatory Generic: If a generic version of a drug is available, but a member chooses a brand drug instead, he or she must pay the appropriate brand copay (preferred or non-preferred), plus the difference in the cost of the generic and the brand drug. The member will never pay more than the total cost of the brand drug. This applies even if a doctor indicates substitution of a generic is not acceptable. If a generic does not exist, the penalty does not apply Mental Health: Mental Health and Substance Abuse Services must be Pre-Authorized by CBA prior to services being rendered. Call: 1-800-868-1032 Pre-Authorization: The following outpatient procedures need pre-authorization: Chemotherapy or Radiation Therapy (one time notification), Hysterectomy, Septoplasty, Sclerotherapy, all Cosmetic procedures, Investigational procedures performed in outpatient or office setting and Durable Medical Equipment over $500.00. All inpatient hospital or skilled nursing facility admissions, home health care, hospice care or inpatient physical rehabilitation, and services and supplies related to human organ and tissue transplants. South Carolina: 1-800-327-3238 Out of State: 800-334-7287. Appeal Rights: Except in the absence of legal capacity, claims must be filed no later than 15 months from the end of the benefit period in which you or your dependents receive medical services or supplies. You have 60 days from the date you receive an Explanation of Benefits regarding a claim to request a review of all or part of the claim. Mail Claims to: Blue Cross Blue Shield of SC, Columbia Service Center, PO Box 100300, Columbia, SC 29202 BCBS Customer Service: 1-800-760-9290 (Medical) / 1-888-963-7290 (Prescription Drugs)

Employee Benefits Hotline: 1-888-408-9144 5


Dental Plan

Administered by MetLife

Coverage Type Type A - Preventive Type B - Basic Restorative Type C - Major Restorative Type D - Orthodontia

In-Network

Out-of-Network

100% 100% 60% 50%

100%* 80% 50% 50%

$50 $150

$50 $150

$2500 $1500

$2500 $1500

Deductible Individual Family Annual Maximum Benefits Per Person Orthodontia Lifetime Maximum Ortho Applies to Child Only

Child to Age 19

Type A - Preventive (*covered 100% after $50 deductible, out-of-network ONLY) Prophylaxis - Cleanings Oral Examinations Topical Fluoride Applications Full Mouth X-Rays

Bitewing X-Rays (Adult/Child) Sealants Emergency Palliative Treatment

Type B - Basic Restorative Space Maintainers Repairs Endodontics - Root Canal General Anesthesia Amalgam & Composite Fillings Type C - Major Restorative Implants Bridges Dentures Crowns/Inlays/Onlays Type D - Orthodontia

Other Oral Surgery Periodontal Surgery Periodontal Scaling & Root Planing Periodontal Maintenance

Consultations Prefabricated Stainless Steel Crowns Resin Crowns

Dependent children are covered up to 19th birthday. All dental procedures performed in connection with orthodontic treatment are payable as Orthodontia. Payments are on a repetitive basis. 20% of the Orthodontia Lifetime Maximum will be considered at initial placement of the appliance and paid based on the plan benefit’s coinsurance level for Orthodontia as defined in the Plan Summary. Orthodontic benefits end at cancellation of coverage. This is only a selection of the services offered in this benefit. Please refer to your plan’s full summary of benefits for a complete listing as well as the limitations.

dental tier

Employee Monthly Contribution

Employee Only

$3.12

Employee + Spouse

$21.34

Employee + Children

$17.83

Employee + Family

$46.21

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Vision Plan

Administered by VSP

Keep your eyes healthy & your vision clear

Your Coverage from a VSP doctor: WellVision Exam¨ focuses on your eye health and wellness • $10 copay...................................................every 12 months Prescription Glasses • $25 copay Lenses..................................................every 12 months • Single vision, lined bifocal and lined trifocal lenses. • Polycarbonate lenses for dependent children. Frame................................................... every 24 months • $150 allowance for frame of your choice. • 20% off amount over your allowance ~OR~ Contact Lens Care • NO copay............................. every 12 months $150.00 allowance for contacts and the contact lens exam (fitting and evaluation). This additional exam ensures proper fit of contacts. If you choose contact lenses you will be eligible for a frame 12 months from the date the contact lenses were obtained. Current soft contact lens wearers may qualify for a special program that includes a contact lens evaluation and initial supply of replacement lenses.

Extra Discounts and Savings Glasses and Sunglasses •Average 30% savings on lens options like progressives and scratch-resistant and anti-reflective coatings •20% off additional glasses and sunglasses, including lens options Contacts* •15% off cost of contact lens exam (fitting and evaluation) *Available from any VSP doctor within 12 months of your last eye exam

Laser Vision Correction •Average 15% off the regular price or 5% off the promotional price from contracted facilities •After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor.

Welcome to VSP Vision Care. We’ll help keep you and your eyes healthy through personal care from a doctor you can trust. Your eyes say a lot about you and can even tell your doctors about you. During your WellVision Exam, your doctor will look for vision problems and signs of health conditions too. FIND a doctor that’s right for you. You will have plenty to choose from by visiting www.vsp.com or calling 1-800-877-7195. ALREADY have a VSP doctor? Make an appointment today and tell them you are a VSP member. CHECK out your coverage savings. Visit www.vsp. com to see your benefits anytime or to view how much money you have saved with VSP after your appointment. www.VSP.com 1-800-877-7195

You get the best value from your benefit when you see a VSP doctor. If you see a non-VSP provider, you’ll typically pay more out of pocket. You’ll pay the provider in full and must submit a claim to VSP for partial reimbursement less copays. Before seeing a non-VSP provider, call us at 800.877.7195.

Out-of-Network Reimbursement Amounts: Exam........................................................$35.00 Single Vision Lenses.............................$25.00 Lined Bifocal Lenses.............................$40.00 Lined Trifocal Lenses...........................$55.00 Frame..................................................... $45.00 Contacts.............................................. $105.00 VSP guarantees service from VSP doctors only. In the event of a conflict between this information and your organization’s contract with VSP, the terms of the contract will prevail.

vision tier

Employee Monthly Contribution

Employee Only

$9.48

Employee + 1

$13.75

Employee + Family

$24.65

Employee Benefits Hotline: 1-888-408-9144 7


FSA Your Flexible Spending Account (FSA) What is a FSA? There are two types of Flexible Spending Accounts: Health Care and Dependent Care Flexible Spending Accounts (FSA) help you save money by providing a way to pay for certain types of health care and dependent care on a pre-tax basis.

How a FSA works

Administered by Blue Water Administrators

the plan year and have an account balance you may be eligible to elect Cobra for this benefit. If you do not elect Cobra, any unclaimed contributions will be forfeited. You have 60 days from date of termination to file claims for expenses incurred prior to termination. Please see SPD for complete plan details.

Do not over estimate Be conservative in your calculations. If you do not incur eligible expenses for the full amount you elected to put in your FSA, the remaining balance in your account will be forfeited according to IRS regulations. Use it or lose it!

During Open Enrollment you decide how much money you want to contribute for the year (there are limits). You have only one opportunity a year to enroll, unless you have a qualified “life change”. The amount you designate for the year is taken out of your paycheck in equal installments each pay period and placed in a FSA account. As you incur medical expenses that are not fully covered by your insurance, you may submit your expenses for claims transactions using one of the following options:

Changing your enrollment

1) Explanation of Benefits form from your insurance carrier after a claim has been paid;

If you are a full-time employee, you may enroll in a Flexible Spending Account.

2) Detail claim from the provider of services (ex: physician/dentist) on the provider of services form with all information related to the service and expenses;

NOTE: Starting January 1, 2011

3) A Prescription form that you receive from the Pharmacy with the information on each prescription you are submitting;

Health Care Flexible Spending Accounts allow employees to set aside pre-tax dollars taken through a payroll deduction to pay for expenses not covered by any medical or dental plan in which you may be enrolled. These pre-tax dollars are set aside in a personal flexible spending account until needed. The most you may set aside for this account is $3,500 per year.

4) A computer form from a Pharmacy for prescriptions filled at that Pharmacy with all detail information related to the prescriptions/date/costs You may submit any one of the above to evidence claim payment to Blue Water Administrators.

A way to save taxes Enrolling in a FSA can save you money by reducing your taxable income. Your total savings will depend upon your family income, tax status, and expected amount of health and dependent care costs. The contributions you make to a Flexible Spending Account are deducted from your pay BEFORE your Federal, State, or Social Security Taxes are calculated and are never reported to the IRS. The end result is that you decrease your taxable income and increase your spendable income. You can save hundreds or even thousands of dollars a year.

Estimate expenses carefully To receive the greatest savings, you must carefully estimate the amount of eligible out-of-pocket expenses you will have for the year. Once you have estimated the total annual amount, divide it by 24 for semi-monthly pays and divide by 12 for monthly pays. That amount is what you may want to have deducted from your gross pay (before taxes) each pay period to be used to fund your Flexible Spending Account. If you terminate before the end of

8 Employee Benefits Guide

You should also remember that once you have made an election for the plan year, you cannot change it until the next annual Open Enrollment period unless you have a qualifying life event. If you do have a qualifying life event and you want to change an FSA, it is your responsibility to do so within 31 days of the life event.

Eligibility

A closer look at Health Care FSA’s

Eligible expenses According to IRS regulations, the following expenses are eligible to be claimed against a Health Care FSA. These expenses must be incurred during the plan year and must not be eligible for reimbursement from insurance policies or any other source. Also, expenses can only be incurred by you, your spouse, or any dependent (if you furnished over one half of the dependent’s support during the plan year). Please use the list on the next page to estimate the amount you wish to put in your Health Care FSA. We encourage you to refer to this list during the year to be sure you are taking full advantage of your FSA.


FSA

Administered by Blue Water Administrators

Eligible expenses examples

What’s best for you?

• artificial limbs, eyes, etc.

Your total savings will depend upon your family income, tax status, and total expenses. If you have Dependent Care expenses, you may choose to claim a tax credit when you file your Federal taxes rather than contribute to a Dependent Care FSA. Your own circumstances will determine whether using a Dependent Care FSA or the Federal income tax credit will be better for you.

• chiropractic care, licensed services/practitioner • deductibles/co-insurance (if not reimbursed from another source) • dental fees, including braces, treatments, etc. • drugs, prescription • durable medical equipment, wheelchairs, etc. • eyeglasses (if for medical reasons), contact lenses, solutions, enzymes • hearing aids and batteries • maternity (delivery) expenses, midwife • nursing home, if for medical reasons • ophthalmologist, optometrist services • orthodontic expenses • orthopedic shoes and corrective devices

The Dependent Care FSA allows employees to set aside pre-tax dollars taken through a payroll deduction to pay for work-related child care expenses (daycare must have a valid Tax ID) or adult dependent care. Up to $5,000 can be set aside for this purpose.

Checking your FSA balance

• physical examinations • physician fees • radial keratotomy (PRK, LASIK) • smoking cessation programs and prescription medication • transportation, tolls or parking expense for medical care • vaccinations, immunizations

For more information on eligible and ineligible expenses, visit www.irs.gov and refer to Publication 502.

Changes to the Over the Counter Eligibility for Reimbursement - January 1, 2011 Healthcare Reform has changed the allowable FSA over the counter drugs. The list below has been provided in categories of items that will be removed from the *IIAS list. Please note this is not the complete listing of items. This list may assist you in determining the amount that you allow for your Flexible Spending Account election, and if you have a Health Reimbursement Account that allows all IRS 213 expenses. These items require a prescription from a medical doctor to be filled by a pharmacy: • Acid Controllers • Antibiotic Products • Anti-Gas • Anti-Parasitic Treatments • Cold Sore Remedies • Digestive Aids • Hemorrhoid Preps • Motion Sickness • Respiratory Treatments • Stomach Remedies

Contributions limits

• Allergy & Sinus • Anti-Diarrheal • Anti-Itch - Insect Bites • Baby Rash Ointments/Creams • Cough, Cold, Flu Remedies • Feminine Anti-Fungal/Anti-Itch • Laxatives • Pain Relief • Sleep Aids & Sedatives

A closer look at Dependent Care FSA’s Dependent Care Flexible Spending Accounts may be used to pay for expenses you incur for the care of dependent children under age 13 or any disabled dependent who lives with you and who you claim on your taxes. If you use Dependent Care services for a child, you know how much you need to budget for this expense every month. With an FSA, you set aside money to pay this expense with pre-tax dollars.

To check your balance on the FSA visit the website: https://employeebwa.lh1ondemand.com The first time you log onto this site use these credentials: username: your social security # no dashes password: changeme1 Once you have logged on for the first time you will be prompted to create a new unique password for future login. Upon login you will be able to check your FSA account balance. Click on the My Account button and choose to view your account balance. You may also check your FSA account balance by contacting the Customer Service Hotline at 1-888-408-9142.

How to file an online claim File your claims by logging onto the website: https://employeebwa.lh1ondemand.com Click on the FILE CLAIMS link and select the file claim button next to the appropriate account. Fill out the form and click submit. Print your confirmation page and send a copy of it along with your claim (detail claim from provider, explanation of benefits form from insurance carrier or copy of prescription) to: Blue Water Administrators FAX#: 843-375-0157

How to file a paper claim File your paper claims by logging onto the website https://employeebwa.lh1ondemand.com Click on the FORMS link and print. Fill out the form and send a copy of it along with your claim (detail claim from provider, explanation of benefits form from insurance carrier or copy of prescription) to: Blue Water Administrators | Attn: Flex 1024 eWall Street, Ste 101 | Mt. Pleasant, SC 29464 FAX: 843.375.0157 fsa-HSAcustomerservice@bwadministrators.com

Employee Benefits Hotline: 1-888-408-9144 9


Long Term Care

Administered by John Hancock

What is long-term care? Long term care is the type of assistance given to people who need help with activities such as bathing, continence, dressing, transferring, toileting or eating – or who need substantial supervision due to a cognitive impairment. Care That Meets Your Needs: Whether you need care early on due to an unforeseen accident or illness, or later in life, Custom Care II Enhanced provides comprehensive coverage for all levels of care, including skilled, intermediate, and custodial care. Your Benefits are available for Home care, Adult day care, Assisted Living Facilities, Nursing Home, or Hospice care. Comprehensive LTCI Policy Custom Care II Enhanced is an innovative, competitively priced LTCI product that provides individuals and their families with rich built-in benefits and optional riders that enable you to tailor the plan to meet your needs. It covers care in a variety of settings. Highlights include:

• Inflation Protection • Caregiver Support Services • Consumer Protection Provisions • Care Advisory Services • Waiver of Premium • Partner, Family and Preferred Health Discounts • Limited Pay Options are available

Why John Hancock You want to be sure the company behind your clients’ LTC insurance policies will be there well into the future. John Hancock is that company. John Hancock Life Insurance Company a Highly Rated Company. Standard & Poor’s AAA (Extremely Strong*) Moody’s Aa1 (Excellent) A.M. Best A++ (Superior*) Fitch Ratings AA+ (Very Strong) Comdex5 99 out of 100

10 Employee Benefits Guide


EAP

Administered by UNUM

Life can pull you in many directions. Find your balance.

You also have unlimited website access at www.lifebalance.net

When you have questions, concerns or emotional issues surrounding either your personal or work life, there are resources that can help you. Through your employer’s worklife balance employee assistance program (EAP), you have unlimited access to consultants by telephone, resources and tools online and up to 3 face-to-face visits with counselors for help with a short-term problem.

• read books, life articles and guides

Your well-being, productiveness and happiness depend on balancing your life at home and your life at work. It’s difficult to be on task in the office or on the job if you’re worried about problems at home and you can’t devote your full attention to work when you are there.

Help for personal challenges, big and small Personal problems can occur unexpectedly, and unnecessary worrying can affect your health and your professional life. Ease the stress of any uncomfortable situation by calling and speaking with Master’s level consultants when you or your family members need confidential information to: • Locate childcare and eldercare services and obtain matches to the appropriate provider based on your (or your family’s) preferences and criteria (the consultant will even confirm space availability). • Speak with financial experts by phone regarding issues such as budgeting,controlling debt, teaching children to manage money, investing for college and preparing for retirement. • Work through complex, sensitive issues such as personal or work relationships, depression and substance abuse. • Get advice on how to deal with a conflict between you and a co-worker. • Get a referral to a local attorney for a free, 30-minute inperson or telephonic legal consultation. You’ll have access to an attorney for state-specific legal information and services. (If you decide to retain the attorney, you may be eligible to receive a 25% discount on additional services.)

• view videos and listen to audio files online • subscribe to customized email newsletters • find information on parenting, retirement, finances, education and more. • use health management online calculators and other tools to help you with topics such as losing weight or starting a new exercise program • access links to other informative websites • use school, camp, eldercare and childcare locators • use financial calculators, retirement planners, worksheets and more.

Guidance for work-related conflicts If you’re a manager and recognize issues with your staff such as an employee who’s feeling overwhelmed by his or her workload, you have unlimited access to guidance from a team of Master’s level consultation experts. Call the toll-free work-life balance EAP number to: • have a confidential sounding board and objective view • work on communication and problem-solving skills • learn techniques to stay productive and motivated Supervisors or those who are working to become supervisors can visit the website at www.lifebalance.net to get information on managing people using resources such as: • email management newsletters • recommended reading lists on management • self-assessment tools to be a better manager • monthly management quick tips

Call: 1-800-854-1446 or online: www.lifebalance.net username & password: lifebalance

Employee Benefits Hotline: 1-888-408-9144 11


Short term Disability

Employer

Paid

Administered by UNUM

Eligibility: All employees working 25 or more hours per week Elimination Period: 1st day non-occupational accidental injury 8th day non-occupational sickness Benefit Amount: 60% of weekly earnings, Not to exceed $3,000 per Week Maximum Payment Period: 13 weeks Definition of Disability: The insured must be totally disabled throughout the elimination period and must remain totally disabled to receive benefits. Maternity coverage: Is covered the same as a sickness. Your Short Term Disability benefits will be provided by UNUM LIFE Insurance Company. UNUM was founded in 1848. UNUM is the largest provider of group disability in the United States.

Long term Disability

Employer

Paid

Administered by UNUM

Eligibility: All employees working 25 or more hours per week Elimination Period: 90 Days

Benefit Amount: 66 2/3% of salary, Not to exceed $7,500 per Month for employees Not to exceed $14,000 per Month for executives. Maximum Payment Period: Normal Retirement Age Definition of Disability: 2 year own occupation Assist America: Free worldwide travel assistance, when 100 miles or more from home. LifeBalance EAP Program: Service that provides information for employees on a wide range of topics and issues including legal and financial issues, older adults and parenting resources and personal and work-related concerns. 2 year Own Occupation with zero day residual: The insured is disabled when UnumProvident determines that the insured is limited from performing the material and substantial duties of his/her own occupation and the insured has a 20% or more loss of indexed monthly earnings due to the same cause. Work Incentive Benefit: UNUM will allow a disabled employee be paid their full UNUM benefit and any part time earnings for one year of a disability as long as the total does not exceed 100% of his or her pre-disability income. Thus, in the first year an employee may receive up to 100% of prior income. After one year UNUM will pay a partial benefit, based on the amount of earnings lost. Three Month Survivor Benefit: UNUM will pay 3 times your gross monthly disability payment to your survivors if, when you die, you were receiving or were entitled to receive UNUM disability payments and your disability had continued for 180 or more consecutive days.

12 Employee Benefits Guide


Basic Life and AD&D

Employer

Paid

Administered by UNUM

Eligibility: All employees working 25 or more hours per week

Benefit Amount: 2 times Salary Maximum of $500,000 with a minimum of $10,000 Maximum Payment Period: Reduces 65% at the age of 70 Reduces 50% at the age of 75

AD&D Differentiators Event Period: UNUM will pay an AD&D benefit if death occurs within 365 days of the accident. Seat Belt Rider: $10,000 additional AD&D benefits payable if an insured dies in a car accident while wearing a seat belt. Air Bag Rider: $5,000 additional AD&D benefits if an insured dies in a car accident, while wearing a seat belt, and the vehicle is equipped with an air bag. Education Benefit: Pays the lesser of 12.5% of the face amount of the deceased’s policy or $12,500 per semester to a child who is enrolled in college (or who enrolls in 1 year). Life Differentiators Accelerated Death Benefit: If an insured is diagnosed as terminally ill and is expected to die within 12 months, then he or she may take up to 100% of the benefit to a maximum of $25,000 for living expenses. The death benefit payable will be reduced by any amount of Accelerated Benefit that has been paid. Survivor Support: Provided by Ayco Company, L.P. this free service provides financial counseling to the survivor of a deceased employee. The survivor will be eligible for a face-to-face financial planning visit with a master’s degreed professional, as well as continued guidance for up to six months via toll-free telephone access.

Employee Benefits Hotline: 1-888-408-9144 13


Voluntary Term Life | AD&D

Administered by UNUM

LIFE and AD&D COVERAGE Employee:

Up to 5 times salary in increments of $10,000. Not to exceed $500,000. Guarantee Issue for employee is $70,000.

Spouse:

Up to 100% of employee amount in increments of $5,000. Not to exceed $250,000. Guarantee Issue for Spouse is $25,000. Benefits will be paid to the employee.

Child:

Coverage amount in increments of $2,000. Not to exceed $10,000. The maximum death benefit for a child between the ages of live birth and 6 months is $1000. Benefits will be paid to the employee.

In order to purchase Life or AD&D coverage for your spouse and/or child, you must purchase coverage for yourself. AD&D Benefit Schedule: The full benefit amount is paid for loss of: a) Life b) Both hands or both feet or sight of both eyes c) One hand and one foot d) One hand and the sight of one eye e) One foot and the sight of one eye f) Speech and hearing g) Other losses may be covered as well. Please see your Plan Administrator. Coverage amount(s) will reduce according to the following schedule: Age: 70 Insurance Amount Reduces to: 65% of original amount Age: 75 Insurance Amount Reduces to: 50% of original amount Coverage may not be increased after a reduction.

Term Life Coverage Employee per $10,000 Age <25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

NON Tobacco .52 .60 .74 1.03 1.41 2.25 3.45 5.64 9.00 15.18 28.52 57.76

Term Life Coverage Spouse per $5,000

Tobacco

Age

Spouse

.77 .88 1.10 1.65 2.49 3.94 6.65 9.38 14.02 23.44 41.20 74.53

<25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

.37 .42 .53 .78 1.11 1.74 2.71 4.15 7.09 12.11 21.58 43.22

Term Life Coverage Child per $2,000 $.675 NOTE: The premium paid for child coverage is based on the cost of coverage for one child, regardless of how many children you have.

AD&D Coverage Rates AD&D Cost Per: Monthly Rate Employee: $10,000 $0.27 Spouse: $ 5,000 $0.14 Child: $ 2,000 $0.07 For questions about your Voluntary Term Life and AD&D coverage please refer to the complete plan summary or contact Human Resources. To enroll in this coverage or make changes to your coverage please complete the following form and submit it to Human Resources. 14

Employee Benefits Guide


1/1/2011

CHIP & Dependent Children Coverage Notice Medicaid and the Children’s Health Insurance Program (CHIP) Offer Free Or Low-Cost Health Coverage To Children And Families If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums. If you or your dependents are already enrolled in Medicaid or CHIP, you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP

office or dial 1-877-KIDS NOW or www.insurekidsnow. gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

You should contact your State for further information on eligibility SOUTH CAROLINA – Medicaid Website: http://www.scdhhs.gov Phone: 1-888-549-0820 For more information on special enrollment rights, you can contact either: U.S. Department of Labor U.S. Employee Benefits Security Administration www.dol.gov/ebsa 1-866-444-EBSA (3272)

dependent children coverage Notice Individuals whose coverage ended, or who were denied coverage (or were not eligible for coverage), because the availability of dependent coverage of children ended before attainment of age 26 are eligible to enroll in Tidelands Bank health plan. Individuals may request enrollment for such children during open enrollment November 1-30. Enrollment will be effective January 1, 2011. For more information contact the Benefits Hotline at 1-888-408-9144.

Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Ext. 61565

Your adult children can join or remain on your plan whether or not they are: • Married; • Living with you; • In school; • Financially dependent on you; • Eligible to enroll in their employer’s plan, with one temporary exception: Until 2014 “grandfathered” group plans do not have to offer dependent coverage up to age 26 if a young adult is eligible for group coverage outside their parents’ plan.

Employee Benefits Hotline: 1-888-408-9144 15


Medicare & Lifetime Limit Notices Medicare Part D Credible Coverage Notice Prior to November 15, 2007, all employers who offer a medical plan that provides pharmacy coverage are required to send a notice to all plan participants who are eligible for Medicare. Because we do not track which of our employees are eligible for Medicare, we are meeting this obligation by providing this notice to all employees who are eligible for our benefits program. This notice does not apply to you if you or your dependents are not Medicare eligible. If you or a covered dependent are Medicare eligible or will become Medicare eligible in 2010 or 2011, this notice is important to you and contains important, time sensitive information. Please read it carefully and act accordingly to protect your interests. Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Tidelands Bank, and prescription drug coverage available for people with Medicare. It also tells you where to find more information to help you make decisions about your prescription drug coverage. • Medicare prescription drug coverage became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plans that offer prescription drug coverage. All Medicare prescription drug plans provide at least a standard of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. • Tidelands Bank has determined that the prescription drug benefit offered through Tidelands Bank medical plan is, on average for all plan participants, expected to pay as much as the standard Medicare prescription drug coverage and is considered creditable coverage.

You should also know that if you drop or lose your coverage with Tidelands Bank and don’t enroll in Medicare prescription drug coverage after your current coverage ends, you may pay more to enroll in Medicare prescription drug coverage later. If you go 63 days or longer without prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage, your monthly premium will go up at least 1% per month for every month that you did not have that coverage. For example, if you go nineteen months without coverage, your premium will always be at least 19% higher than what most other people pay. You’ll have to pay this higher premium as long as you have Medicare coverage. In addition, you may have to wait until the following November to enroll. For more information about this notice or your current prescription drug coverage, contact our customer service team for further information at 1-800-370-1578. NOTE: You may receive this notice at other times in the future such as before the next period you can enroll in Medicare prescription drug coverage, and if this coverage changes. You also may request a copy at any time. More detailed information about Medicare plans that offer prescription drug coverage is available in the ’Medicare & You’ handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. You can also get more information about Medicare prescription drug plans from these places: • Visit www.medicare.gov. • Call your State Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number) for personalized help.

Individuals can enroll in a Medicare prescription drug plan when they first become eligible for Medicare and each year from November 15th through December 31st. However, because you have existing prescription drug coverage that, on average, is as good as Medicare coverage, you can choose to join a Medicare prescription drug plan later. Each year after that, you will have the opportunity to enroll in a Medicare prescription drug plan between November 15th through December 31st. If you do decide to enroll in a Medicare prescription drug plan and want to drop your Tidelands Bank prescription drug coverage you will have to drop all of your healthcare coverage with Tidelands Bank since prescription drug coverage is a part of your Tidelands Bank healthcare plan. Please be aware that you may not be able to get this coverage back should you decide to drop it.

• Call 1–800–MEDICARE (1–800–633–4227).

You should compare your current coverage, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Your current coverage pays for other health expenses in addition to prescription drugs. You will be eligible to receive all of your current health and prescription drug benefits even if you choose to enroll in a Medicare prescription drug plan.

lifetime limit change notice

TTY users should call 1–877–486–2048 For people with limited income and resources, extra help paying for a Medicare prescription drug plan is available. Information about this extra help is available from the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.ssa.gov, or call them at 1–800–772–1213 (TTY1–800–325–0778). Remember: Keep this notice. If you enroll in one of the Medicare approved plans offering prescription drug coverage, you may need to provide a copy of this notice when applying for the coverage to show that you are not required to pay a higher premium amount.

The lifetime limit on the dollar value of benefits under Tidelands Bank no longer applies. Individuals whose coverage ended by reason of reaching a lifetime limit under the plan are eligible to enroll in the plan. For more information contact Blue Water Benefits at 1-888-408-9144.

2011 Tidelands Bank Employee Benefit Guide  

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

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