2025
EMPLOYEE BENEFITS GUIDE
IMPORTANT ENROLLMENT INFORMATION
Eligibility
If you are a benefits-eligible employee (regular full time employee scheduled to work a minimum of 30 hours per week), you can enroll in the benefits described in this Guide. starting the following 1st of the month, from 30 days of date of hire. Please remember that only eligible dependents can be enrolled. Eligible dependents include an employee’s spouse or civil union partner a natural child, adopted child, foster child, stepchild or grandchild (if court-ordered custody); or a disabled dependent.
Eligible dependent child(ren) are covered until the age 26; regardless of student status until the end of the calendar year of the attained age. This pertains to the Medical/Rx, Dental and Vision coverages.
Medical, Dental and Vision coverage is available for employees with same-sex domestic partnerships in states that do not recognize civil union partnerships. However, the domestic partnership must be legally recognized by the state and the employee would need to present a certificate to certify such. Opposite-sex domestic partnership is not covered.
Making Plan Changes
IRS Section 125 prohibits you from changing your enrollment during the plan year unless you experience a qualifying life event, such as marriage, divorce, death of a spouse, civil union partner or a dependent, birth or adoption of a child, termination or commencement of employment for your spouse/civil union partner, a change in employment status (full-time to parttime or part-time to full-time) for you or your spouse/civil union partner that affects benefits eligibility, or taking an unpaid, medical leave of absence by either you or your spouse/ civil union partner.
If you experience one of these qualifying life events, you must contact HR within 30 days of the event.
MEDICAL PLAN OPTIONS
Below is a summary of the medical plans available to you. All medical plans cover a wide range of services, from preventive and routine care to hospitalization and surgery. The medical plans include a prescription drug benefit, which covers prescriptions at participating pharmacies and mail-order maintenance drugs (see page 5 for details).
OAMC HDHP with HSA
To locate in-network medical providers:
• Go to www.aetna.com
• Select “Find a Doctor” at the top of the page
• If registered, log into your account under “Have a member account”
• Not registered yet? Under “Don’t have a member account”, select “Plan from an Employer”
• Enter your zip code and select a plan from the following page:
- Aetna Open Access Managed Choice POS if enrolled in the PPO HDHP with HSA
- Aetna Open Access Elect Choice EPO if enrolled in either the Low or High EPO
PRESCRIPTION DRUG PLAN
Below is a summary of the prescription benefits available to you. When you enroll in one of the medical plans, you are automatically enrolled in the corresponding prescription plan.
Save on your prescriptions with Mail Order!
Using the mail order program for your maintenance medications will save you money. You will receive up to a 90-day (3-month) supply. In addition to the savings, your prescriptions will be delivered right to your home.
HEALTH SAVINGS ACCOUNT (HSA)
Inspira
If you participate in the HDHP with HSA Plan, you are automatically enrolled in a Health Savings Account (HSA). An HSA is a tax-exempt savings account that can be used for contributions, earnings and withdrawals for eligible expenses.
HSA Highlights
An HSA is portable, meaning that if you leave your employer, you can take your HSA funds with you. There is no “use it or lose it” provision with an HSA. If you don’t use the money in your account by the end of the year, it just stays there and collects interest on a tax-deferred basis.
An HSA includes a banking partner that offers you several investment options that suit your needs. An HSA does not require third party substantiation for transactions; however, you should keep records of these transactions in the event of an IRS audit.
HSA Eligibility
You may contribute to an HSA if you:
• Are covered under an HSA Qualified high deductible health plan (HDHP)
• Do not have disqualifying coverage such as other “first dollar” medical coverage etc.
• Are not entitled to (eligible and enrolled) Medicare
• Cannot be claimed as a dependent on someone else’s tax return
HSA Eligible Expenses Include:
• Medical and prescription drug deductibles, coinsurance and copayments
• Dental deductibles, coinsurance and copayments
• Orthodontia or other dental care
• Eye exams, contact lenses and glasses
HSA Contributions
The maximum amount that can be contributed to the HSA in a tax year is established by the IRS and is dependent on whether you have individual or family coverage. For 2025, the contribution limits are:
• $4,300 for individual coverage
• $8,550 for family coverage
• The annual catch-up contribute for age 55 and older is $1,000
Did you know you can save now to pay for Medicare premiums?
• Medicare Part B premiums
• Medicare Part C premiums
• Medicare Part D premiums
• Deductibles for all parts of Medicare
TELEMEDICINE
CVS Virtual Primary Care (for Aetna enrolled members)
Life is busy, and we know it can be hard to set aside time to take care of your health. But with access to virtual care, it’s never been simpler.
You’ll have access to primary care, 24/7 ondemand care and mental health services. It’s quality care with shorter wait times and affordable pricing. This virtual care option is in addition to your traditional network of providers. Access is included in your medical plan, made available through Aetna, a CVS Health company.
Using Telemedicine is a convenient option when it’s not possible to visit your doctor’s office for non-emergency medical conditions such as:
• Allergies
• Asthma
• Acne
• Pink eye
• Ear infections
• Sinus issues
• Respiratory infections
• Urinary tract infections
• Cold and flu symptoms
AETNA PLAN RESOURCES for Aetna enrolled members
Talkspace
Talkspace is a digital space for private and convenient mental health support. With Talkspace, you can choose a dedicated therapist and/or prescriber from a list of recommended, licensed providers and receive support day and night. Talkspace is available for members who are ages 13 and up.
Members can begin to exchange unlimited messages (text, voice, and video) with their personal therapist immediately after registration. Therapists engage daily, five days per week, which often includes weekends.
For more information; visit www.talkspace.com/aetna:
Brightline
Members enrolled in the medical plan have access to virtual Behavioral Coaching and Therapy sessions through Brightline. Brightline is for children age 18 months through 17 years old. You have access to:
• On-the-go access to personalized content, group classes, interactive exercises, and chat with coaches for tips and guidance.
• Programs to help tackle everyday common challenges with expert behavioral health coaches in as few as four (4) sessions.
• Personalized behavior therapy and medication evaluation and support from licensed Brightline clinicians.
For more information and to get started, call 888-224-7332 or visit www.hellobrightline.com/benefits.
Meru
Meru Health is a personalized mental health program built around continuous support from a dedicated therapist—plus a suite of transformative digital tools.
Sign up today to experience the new science of feeling better. The Meru Health therapy program is available to eligible members ages 18 and up. With Meru, you receive:
• Continuous therapist support
• Faster, more effective care
• Connecting your mind and body
For more information, visit www.meruhealth.com/aetna.
VOLUNTARY DENTAL PLAN
Aetna
Did you know dental hygiene and oral health are directly linked to health in other areas of the body? For example, taking proper care of your gums can actually help prevent heart disease. The Aetna dental plan makes it easy to care of your smile and your health, with 100% coverage for preventive services such as routine dental exams, cleaning and x-rays.
DHMO Plan
Preventative & Diagnostic Services
Exams: 2 routine and 2 problem-focused visits per year
Cleanings: 3 per year
Bitewing X-rays: 1 per year
Fluoride Treatment: 1 per year, children up to age 19
Please note: Out-of-Network plan payments are based on the Maximum Allowable Charge (MAC). You also have access to out-of-network providers. This means you can receive eligible dental services from an out-of-network provider. If you use an out-of-network provider to receive eligible dental services, you are subject to a higher out-of-pocket expense and are responsible for: paying your out-of-network deductible, your out-of-network coinsurance, any charges over our recognized charge and submitting your own claims.
See the following page for instructions to locate a dental provider.
DPPO Plan
LOCATING DENTAL PROVIDERS
Aetna
Locating an in-network dental provider is easy! Simply follow the steps below to locate an in-person or virtual dental provider.
To locate in-network dental providers:
• Go to www.aetna.com
• Select “Find a Doctor” at the top of the page
• If registered, log into your account under “Have a member account”
• Not registered yet? Under “Don’t have a member account”, select “Plan from an Employer”
- For DPPO, select Dental PPO/PDN with PPO II
- For DHMO, selection DMO/DNO
Please note: Aetna Dental members do not need a member ID card to get dental care. When you go to the dentist, tell the office staff that you have Aetna Dental and they will verify your coverage.
To locate a 24/7 virtual dental provider
• Go to www.theteledentists.com/aetna
• Select "See a Teledentist Right Now"
• If registered, log into your account under "I already have account, Log in"
• Not registered yet? Fill out the requested fields including name, email, location, and subscriber ID
• Once inside the portal, click on "Schedule an appointment" and answer all necessary questions pertaining to your appointment
VOLUNTARY VISION PLAN
Take care of your vision and overall health while saving on your eye care and eyewear needs. Vision insurance can help you maintain your vision as well as detect various health problems. Health conditions such as diabetes and high blood pressure can be detected early through a comprehensive eye exam. Eligible employees have the option of electing the vision plan outlined below. Our vision plan is administered by Aetna and provides coverage for a range of vision care including exams, frames, lenses and contact lenses.
* Allowances are one-time use benefits. No remaining balance may be used. The plan does not provide a declining balance benefit
Please note: Out of network coverage is available. To receive reimbursements up to the amounts listed above, a claim form with itemized receipt is required. Reimbursement will not exceed the providers actual charge. Claims forms can be found at aetnavision.com or by calling customer service Monday through Sunday at 1-877-973-3238. Completed claim forms can be submitted electronically or mailed to Aetna, PO Box 8504 Mason, OH 45040-7111. You can also have access to Allied Providers, such as Costco Vision, who will apply your out-of -network benefits at the point of service and handle the claim submission process for you.
To locate in-network vision providers:
• Go to www.aetnavision.com
• Select “Find a Provider”
• Enter your zip code and select "Search by Zip" to see results
• Please call to check with the provider before scheduling your appointment or receiving services to confirm if he/she is still participating in the network
Aetna Vision Plan
2025 EMPLOYEE CONTRIBUTIONS
The contributions will be taken out each payroll period on a pre-tax basis unless you notify management that you want your contributions to be made using after-tax money. The benefit choices made will be irrevocable for the Plan Year unless you have a qualified change in family status. Any change in status must be reported to HR within 30 days of the status event.
LIFE & LONG TERM DISABILITY
New York Life
Employees are automatically enrolled in Basic Life and AD&D Insurance and Long Term Disability Insurance. Vital Health America pays 100% of the premium for both of these benefits. Eligible employees will automatically be enrolled.
Basic Life and AD&D
All active employees working at least 30 hours per week are eligible for the basic life and accidental death and dismemberment (AD&D) plan. This plan is available to employees at no cost - Vital Health America pays 100% of the premium. AD&D coverage equals the basic life benefit.
The Basic Life and AD&D benefit is one times your annual salary up to $200,000. Amount reduces by 35% at age 65, 60% at age 70, 75% at age 75 and 85% at age 80.
Long Term Disability (LTD)
All active employees working at least 30 hours per week are eligible for Long Term Disability (LTD) benefits. This plan is also available at no cost to the employee - Vital Health America pays 100% of the disability premium. Disability plans provide insurance to protect a portion of your income in the event you are incapable of working due to a qualified illness or injury.
COMMUTER BENEFITS
ConnectYourCare
Reduce your commuting expenses by taking advantage of Commuter Benefits. The IRS allows for certain work-related transit and parking expenses to be deducted from your paycheck on a pre-tax basis. Because you do not pay taxes on these expenses, you can SAVE BIG!
For tax years beginning after January 1, 2021, the IRS allows up to $325 per month to be deducted pre-tax for commuter costs, and up to $325 per month pre-tax for parking costs. Any amount beyond that becomes a post-tax deduction.
Transportation & Parking
Benefits
• Transit Passes – You may purchase a transit pass for a specific vendor, such as subway, train or bus line. Passes are available from hundreds of vendors. You can pick the exact pass you use every day to commute to work, and we will mail it directly to your home every month. Or you can choose to receive a check that you will then use to purchase your transit pass. Types of transit passes include:
- Standard Transit Pass – This type of transit pass is a disposable pass that may be used to pay for transportation. If lost, this pass cannot be reissued and the value is gone.
- Smart Card Transit Pass – This type of transit pass is reloaded electronically and can be replaced if lost. Not every vendor offers a Smart Card.
• Commuter Check Voucher for Transit –Commuter Check Vouchers are redeemable for transit passes, tickets, cards, tokens and other fare media. The voucher is also accepted by participating vanpools. Vouchers may be used to purchase one or more types of transportation and you may use more than one voucher at a time. Change will not be given by the transportation provider, so be sure to order your check in the closest full dollar denomination to the charge. Commuter checks are valid for 15 months.
• Commuter Check Prepaid MasterCard for Transit and Parking – This is a reloadable prepaid card that can be used for qualified transit and parking expenses where Debit MasterCard®, Maestro® cards and NYCE® cards are accepted.
• Direct Pay for Parking – This option is for people with an existing relationship with a parking provider. With Direct Pay, the parking provider is paid directly on your behalf. It’s a great choice for people who pay their parking on a monthly basis.
• Commuter Check Vouchers for Parking –Like the Commuter Check Vouchers for Transit, vouchers can be used to pay for eligible parking expenses. Vouchers may be used to purchase one or more types of parking, and you may use more than one check at a time. Change will not be given by the parking provider, so be sure to order your check in the closest full dollar denomination to the charge. Each Commuter Check Voucher for parking must be made payable to the Parking Operator. Commuter checks are valid for 15 months.
• Parking reimbursement – If offered by your employer, you can get reimbursed for eligible work-related parking expenses paid out of pocket. You may file a reimbursement claim online, create a recurring reimbursement, or contact ConnectYourCare customer service to receive a claim form. You will need to provide documentation that includes your name, description of service, date of service, and amount changed. Cancelled checks, credit card receipts, or balance forward statements are not acceptable.
• Shared Rides – If you leverage uberPOOL or Lyft Line to get to work each day, you can now use your Commuter Check Prepaid MasterCard to pay for this service. Simply select this payment method prior to requesting the chosen service for your work commute so that funds are properly allocated and enjoy the tax-free savings!
ID THEFT & LEGAL PLAN
IDIQ
What is ID Theft?
Ever wonder what’s going on with your credit and wish you could keep an eye on it 24 hours a day? With our ID Theft and Credit Monitoring plan, you can stop wondering and leave the credit watching to someone else.
Credit monitoring is the only automated way to keep a constant eye on your credit so you can be made aware of any changed that could signal identity theft right away. If there are any suspicious changes made to your file, you will receive an alert via email.
Services
• Up to $1 Million in identity Theft Insurance
• Coverage for Lawyers and Experts
• Coverage for Personal Expense Compensation
• Stolen Funds Reimbursement
• 100% U.S. Based Customer Service
• 100% U.S. Based ID Restoration Service
• Lost Wallet Assistance
• Opt-Out IQ (Junk Mail/Do-Not-Call List)
• File Sharing Network Searches
• Dark Web & Internet Monitoring
• SSN Alerts
• Synthetic ID Theft Protection
• IQ Alerts with Application Monitoring
• IQ Center
• Change-of-Address Monitoring
What is a Legal Plan?
A legal plan will provide you access to attorneys in an affordable way. This voluntary benefit is offered to all regular full-time and regular part-time employees, and is designed to provide specific legal services when the need arises, in an affordable way
The legal plan is available through payroll deduction for benefit eligible employees, their spouses and dependents up the age of 23 at no additional cost.
Please contact Beverly Adler in Human Resources or call the designated IDIQ Legal customer service phone number on page 16 with questions regarding this program or how to enroll.
Services
• Unlimited Phone Consultations and Advice
• Face to Face Consultations
• Simple Wills
• Livings Wills and Medical Power of Attorney
• Legal Documents Reviewed
• Advice on Government Programs
• Legal Letters and Phone Calls
• Consumer Protection & Warranty Problems
• Identity Theft Prevention & Assistance
• Advice on Small Claims Court
• IRS & State Tax Relief Advice
• Guaranteed Reduce Rates on Other Legal Matters
• Receive cash rebates or a home warranty
• Online Legal Library and DIY Forms
This plan is a voluntary payroll deduction benefit and is available to benefit eligible employees, with coverage also available for your spouse and dependents over 18. Contact IDIQ at 800.550.5297. The ID theft services are prepaid through a bi-weekly payroll deduction of $5.52. Enroll by completing the IDIQ enrollment form.
This plan is a voluntary payroll deduction benefit and is available to benefit eligible employees, with coverage also available for spouses, domestic partners and dependents up to age 26. Contact IDIQ at 800.550.5297. The legal plan services are prepaid through a bi-weekly payroll deduction of $6.90. Enroll by completing the IDIQ enrollment form.
Colonial Life Supplemental Benefits
All employees are eligible to participate in supplemental insurance with Colonial Life. These plans are designed to offset your elected plans and supplement any unexpected accident, sickness or hospital stay. These services are paid by the employee through bi-weekly payroll deductions by plan selected.
Products Available
• Short-Term Disability
• Life Insurance
• Accident Insurance
• Cancer/Critical Illness Insurance
• Hospital Confinement Indemnity Insurance
Why Choose Colonial Life Insurance?
• Benefits are paid directly to you tax-free regardless of any other benefits you may receive.
• Coverage is available for you, your spouse and dependent child(ren).
• All plans are guaranteed renewable and portable at the same cost and benefit even if you leave or retire.
• All plans can be customized based on your individual needs and income.
Please email morgan@colonialnj.com or call/text 856-242-0292. Scan the QR Code Below With Your Cell Phone Camera
For More Information
CONNER STRONG & BUCKELEW
Employee Resources
HUSK Marketplace
Achieving optima health and wellness doesn’t have to be complicated or expensive. Access exclusive best-in-class pricing with some of the biggest brands in fitness, nutrition, and wellness with HUSK Marketplace (formerly GlobalFit). As part of the HUSK Marketplace program, you are eligible for exclusive discounts on Gyms & Fitness Centers, HUSK Nutrition, Home Equipment & Tech, On-Demand Fitness and more! For more information visit: marketplace.huskwellness.com/ connerstrong.
HealthyLearn
HealthyLearn covers over a thousand health and wellness topics in a simple, straightforward manner. The data and information is laid out in an easy-to-follow format. Learn more and get started on your path to wellness today by visiting HealthyLearn at www.healthylearn.com/connerstrong
Download the HealthyLife Mobile App for access on-the-go!
1. Search your app store for “healthylife mobile”
2. Download and open the app
3. Enter the Conner Strong & Buckelew special access code: CSB (all caps)
Please note: you must use the special access code above each time you open the app.
Good Rx
GoodRx allows you to simply and easily search for retail pharmacies that offer the lowest price for specific medications. Use GoodRx to compare drug prices at local and mail-order pharmacies and discover free coupons and savings tips. Find out how GoodRx can save on your prescription drugs by visiting: https://connerstrong.goodrx.com
Benefit Perks
Benefit Perks is a discount and rewards program available to all employees at no additional cost. The program offers discounts for online shopping to major retailers and is connected to national merchants with access to premier organizations and products. Start saving today by registering online at https://connerstrong.corestream.com.
YOUR BENEFIT RESOURCES
Benefits Member Advocacy Center: Conner Strong & Buckelew
We know it is often difficult to fully understand your health benefits and use them properly, especially when insurance companies make more and more changes to the way plans are administered and how claims are paid. Please contact the Conner Strong & Buckelew Benefits Member Advocacy Center (“Benefits MAC”) for assistance for all benefits except the Voluntary Benefits through Colonial Life, if:
• Find answers to your benefits questions
• Search for participating providers
• Clarify information received from a provider or your insurance company, such as a bill, claim, or explanation of benefits (EOB)
• Guide you through the enrollment process or how you can add or delete coverage for a dependent
• Rescue you from a benefits problem you’ve been working on
• Discover all that your benefit plans have to offer!
You can contact the Benefits Member Advocacy Center Monday through Friday, 8:30 am to 5:00 pm (Eastern Time) at 800-563-9929, or go to www.connerstrong.com/memberadvocacy.
For assistance with all other benefits offered through Vital Health America, please contact the HR Manager or reach out directly to the carriers listed below.
Carrier Contacts
LEGAL NOTICES
Notice Regarding Special Enrollment Loss of other Coverage (excluding Medicaid or a State Children’s Health Insurance Program) If you decline enrollment for yourself or for an eligible dependent (including your spouse) while other health insurance or group health plan coverage (including COBRA coverage) is in effect, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the Company stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within [30 days or any longer period that applies under the plan] after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). If you request a change within the applicable timeframe, coverage will be effective the first of the month following your request for enrollment. When the loss of other coverage is COBRA coverage, then the entire COBRA period must be exhausted in order for the individual to have another special enrollment right under the Plan. Generally, exhaustion means that COBRA coverage ends for a reason other than the failure to pay COBRA premiums or for cause (that is, submission of a fraudulent claim). This means that the entire 18-, 29-, or 36-month COBRA period usually must be completed in order to trigger a special enrollment for loss of other coverage. Coverage will be effective the first of the month following your request for enrollment. However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). If you request a change within the applicable timeframe, coverage will be effective the first of the month following your request for enrollment.
Loss of coverage for Medicaid or a State Children’s Health Insurance Program
If you decline enrollment for yourself or for an eligible dependent (including your spouse) while Medicaid coverage or coverage under a state children’s health insurance program is in effect, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage. However, you must request enrollment within 60 days after your or your dependents’ coverage ends under Medicaid or a state children’s health insurance program (CHIP). If you request a change within the applicable timeframe, coverage will be effective the first of the month following your request for enrollment.
New dependent by marriage, birth, adoption, or placement for adoption
If you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your new dependents. However, you must request enrollment within 30 days or any longer period that applies under the plan] after the marriage, birth, adoption, or placement for adoption. If you request a change within the applicable timeframe, coverage will be effective the date of birth, adoption or placement for adoption. For a new dependent as a result of marriage, coverage will be effective the first of the month following your request for enrollment
Eligibility for Medicaid or a State Children’s Health Insurance Program. If you or your dependents (including your spouse) become eligible for a state premium assistance subsidy from Medicaid or through a state children’s health insurance program (CHIP) with respect to coverage under this plan, you may be able to enroll yourself and your dependents in this plan. However, you must request enrollment within 60 days after your or your dependents’ determination of eligibility for such assistance. If you request a change within the applicable timeframe, coverage will be effective the first of the month following your request for enrollment.
To request special enrollment or obtain more information, contact Human Resources.
Newborns’ and Mothers' Health Protection Act Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).
Women's Health and Cancer Rights Act
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women's Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:
• all stages of reconstruction of the breast on which the mastectomy was performed;
• surgery and reconstruction of the other breast to produce a symmetrical appearance; prostheses; and
• treatment of physical complications of the mastectomy, including lymphedema. These benefits will be provided subject to the same deductibles and coinsurance applicable to other benefits. If you have any questions, please speak with Human Resources.
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, 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, 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, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2024. Contact your State for more information on eligibility –
ALABAMA – Medicaid
Website: http://myalhipp.com/ Phone: 1-855-692-5447
ALASKA – Medicaid
The AK Health Insurance Premium Payment Program
Website: http://myakhipp.com/ Phone: 1-866-251-4861
Email: CustomerService@MyAKHIPP.com
Medicaid Eligibility: https://health.alaska.gov/dpa/ Pages/default.aspx
ARKANSAS – Medicaid
Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447)
CALIFORNIA - Medicaid
Health Insurance Premium Payment (HIPP) Program
http://dhcs.ca.gov/hipp
Phone: 916-445-8322
Fax: 916-440-5676
Email: hipp@dhcs.ca.gov
COLORADO - Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+)
Health First Colorado Website: https:// www.healthfirstcolorado.com/
Health First Colorado Member Contact Center: 1-800-221-3943/State Relay 711
CHP+: https://hcpf.colorado.gov/child-health-plan-plus
CHP+ Customer Service: 1-800-359-1991/State Relay 711
Health Insurance Buy-In Program (HIBI): https:// www.mycohibi.com/
HIBI Customer Service: 1-855-692-6442
LEGAL NOTICES
FLORIDA – Medicaid
Website: https://www.flmedicaidtplrecovery.com/ flmedicaidtplrecovery.com/hipp/index.html Phone: 1-877-357-3268
GEORGIA – Medicaid
GA HIPP Website: https://medicaid.georgia.gov/healthinsurance-premium-payment-program-hipp Phone: 678-564-1162, Press 1
GA CHIPRA Website: https://medicaid.georgia.gov/ programs/third-party-liability/childrens-health-insuranceprogram-reauthorization-act-2009-chipra Phone: 678-564-1162, Press 2
INDIANA – Medicaid
Health Insurance Premium Payment Program
All other Medicaid Website: https://www.in.gov/medicaid/ http://www.in.gov/fss/dfr/ Family and Social Services Administration Phone: 1-800-403-0864
Member Services Phone: 1-800-457-4584
IOWA – Medicaid and CHIP (Hawki)
Medicaid Website: https://dhs.iowa.gov/ime/members
Medicaid Phone: 1-800-338-8366
Hawki Website: http://dhs.iowa.gov/Hawki Hawki Phone: 1-800-257-8563
HIPP Website: https://dhs.iowa.gov/ime/members/ medicaid-a-to-z/hipp
HIPP Phone: 1-888-346-9562
KANSAS – Medicaid
Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884
HIPP Phone: 1-800-967-4660
KENTUCKY – Medicaid
Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website: https://chfs.ky.gov/agencies/ dms/member/Pages/kihipp.aspx
Phone: 1-855-459-6328
Email: KIHIPP.PROGRAM@ky.gov
KCHIP Website: https://kynect.ky.gov
Phone: 1-877-524-4718
Kentucky Medicaid Website: https://chfs.ky.gov/agencies/ dms
LOUISIANA – Medicaid
Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-6185488 (LaHIPP)
MAINE – Medicaid
Enrollment Website: www.mymaineconnection.gob/ benefits/s/?language=en_US
Phone: 1-800-442-6003 TTY: Maine relay 711
Private Health Insurance Premium Webpage: https://www.maine.gov/dhhs/ofi/applications-forms
Phone: 800-977-6740 TTY: Maine relay 711
MASSACHUSETTS – Medicaid and CHIP
Website: https://www.mass.gov/masshealth/pa
Phone: 1-800-862-4840 TTY: 711
Email: masspremassistance@accenture.com
MINNESOTA – Medicaid
Website: https://mn.gov/dhs/health-care-coverage/ Phone: 1-800-657-3672
MISSOURI – Medicaid
Website: http://www.dss.mo.gov/mhd/participants/pages/ hipp.htm
Phone: 1-573-751-2005
MONTANA – Medicaid
Website: http://dphhs.mt.gov/ MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084
Email: HHSHIPPProgram@mt.gov
NEBRASKA – Medicaid
Website: http://www.ACCESSNebraska.ne.gov
Phone: 855-632-7633
Lincoln: 402-473-7000
Omaha: 402-495-1178
NEVADA – Medicaid
Medicaid Website: http://dhcfp.nv.gov
Medicaid Phone: 1-800-992-0900
NEW HAMPSHIRE – Medicaid
Website: https://www.dhhs.nh.gov/programs-services/ medicaid/health-insurance-premium-program Phone: 603-271-5218
Toll free number for the HIPP program: 1-800-852-3345, ext 15218
Email: DHHS.ThirdPartyLiabi@dhhs.nh.gov
NEW JERSEY – Medicaid and CHIP
Medicaid Website: http://www.state.nj.us/humanservices/ dmahs/clients/medicaid/ Phone: 800-356-1561
CHIP Premium Assistance Phone: 609-631-2392
CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 (TTY: 711)
NEW YORK – Medicaid
Website: https://www.health.ny.gov/health_care/ medicaid/ Phone: 1-800-541-2831
NORTH CAROLINA – Medicaid
Website: https://medicaid.ncdhhs.gov/ Phone: 919-855-4100
NORTH DAKOTA – Medicaid
Website: https://www.hhs.nd.gov/healthcare Phone: 1-844-854-4825
OKLAHOMA – Medicaid and CHIP
Website: http://www.insureoklahoma.org Phone: 1-888-365-3742
OREGON – Medicaid and CHIP
Website: http://healthcare.oregon.gov/Pages/index.aspx Phone: 1-800-699-9075
PENNSYLVANIA – Medicaid and CHIP
Website: https://www.pa.gov/en/services/dhs/apply-formedicaid-health-insurance-premium-payment-programhipp.html
Phone: 1-800-692-7462
CHIP Website: https://www.pa.gov/en/agencies/dhs/ resources/chip.html
CHIP Phone: 1-800-986-KIDS (5437)
RHODE ISLAND – Medicaid and CHIP
Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line)
SOUTH CAROLINA - Medicaid
Website: https://www.scdhhs.gov
Phone: 1-888-549-0820
SOUTH DAKOTA - Medicaid
Website: http://dss.sd.gov
Phone: 1-888-828-0059
TEXAS - Medicaid
Website: https://www.hhs.texas.gov/services/financial/ health-insurance-premium-payment-hipp-program Phone: 1-800-440-0493
UTAH – Medicaid and CHIP
Utah’s Premium Partnership for Health Insurance (UPP) Website: https://medicaid.utah.gov/upp/ Email: upp@utah.gov Phone: 1-888-222-2542
Adult Expansion Website: https://medicaid.utah.gov/ expansion/
Utah Medicaid Buyout Program Website: https:// medicaid.utah.gov/buyout-program/ CHIP Website: https://chip.utah.gov/
VERMONT– Medicaid
Website: https://dvha.vermont.gov/members/medicaid/ hipp-program Phone: 1-800-562-3022
VIRGINIA – Medicaid and CHIP
Website: https://coverva.dmas.virginia.gov/learn/premiumassistance/famis-select https://coverva.dmas.virginia.gov/learn/premiumassistance/health-insurance-premium-payment-hippprograms Phone: 1-800-432-5924
WASHINGTON – Medicaid Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022
WEST VIRGINIA – Medicaid and CHIP
Website: http://mywvhipp.com/ and https://dhhr.wv.gov/ bms/
Medicaid Phone: 304-558-1700
CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)
WISCONSIN – Medicaid and CHIP
Website: https://www.dhs.wisconsin.gov/badgercareplus/ p-10095.htm Phone: 1-800-362-3002
LEGAL NOTICES
WYOMING – Medicaid
Website: https://health.wyo.gov/healthcarefin/medicaid/programs-and-eligibility/ Phone: 800-251-1269
To see if any other states have added a premium assistance program since July 31, 2024, or for more information on special enrollment rights, contact either:
U.S. Department of Labor
Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
www.cms.hhs.gov
1-877-267-2323, Menu Option 4, Ext. 61565
Important Notice From Vital Health America About Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Vital Health America and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Vital Health America has determined that the prescription drug coverage offered by the Horizon plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th.
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current Vital Health America coverage will not be affected.
If you do decide to join a Medicare drug plan and drop your current Vital Health America coverage, be aware that you and your dependents may not be able to get this coverage back.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare
Drug Plan?
You should also know that if you drop or lose your current coverage with Vital Health America and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.
For More Information About This Notice Or Your Current Prescription Drug Coverage…
NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Vital Health America changes. You also may request a copy of this notice at any time.
For More Information About Your Options Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov
• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help
• Call 1-800-MEDICARE (1-800-633-4227). TTY uses should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov or call them at 1-800-772-1213 (TTY 1-800-3250778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
Date: January 2025
Name of Entity/Sender: Vital Health America
Contact: HR Manager
Phone: 973-952-6937
Address: 100 Lehigh Drive Fairfield, NJ 07004
Email Address: bhinkelman@vhamerica.com
LEGAL NOTICES
Insurance Marketplace Notice
PART A: General Information
When key parts of the health care law took effect in 2014, there was a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment-based health coverage offered by your employer.
What is the Health Insurance Marketplace?
The Marketplace is designed to help you find health insurance that meets our needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Open enrollment for health insurance coverage through the Marketplace began in October 2013 for coverage starting as early as January 1, 2014.
Can I Save Money on my Health Insurance Premiums in the Marketplace?
You may qualify to save money and lower your monthly premium, but only if your employer does not offer coverage, or offers coverage that doesn’t meet certain standards. The savings on your premium that you’re eligible for depends on your household income.
Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace?
Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer's health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the "minimum value" standard set by the Affordable Care Act, you may be eligible for a tax credit.1
3. Employer Name Vital Health America LLC
5. Employer Address 100 Lehigh Drive
7. City Fairfield
10. Who can we contact about employee health coverage at this job? HR Manager
11. Phone number (if different from above) 973-952-6937
Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution, as well as your employee contribution to employeroffered coverage- is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis.
How Can I Get More Information?
For more information about your coverage offered by your employer, please check your summary plan description or contact the insurance carrier’s customer service number located on your ID card. The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area. To get information about the Marketplace coverage, you can call the government’s 24/7 Help-Line at 1-800-318-2596 or go to https://www.healthcare.gov/ marketplace/individual/.
PART B: Information about Health Coverage Offered by Your Employer
This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
8. State NJ
4. Employer Identification Number (EIN) 86-1614992
6. Employer phone number 973-952-6937
9. Zip Code 07004
12. Email address bhinkelman@vhamerica.com
1 An employer-sponsored health plan meets the "minimum value standard" if the plan's share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs.
Vital Health America reserves the right to modify, amend, suspend or terminate any plan, in whole or in part, at any time. The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer. The text contained in this Guide was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies, or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. If you have any questions about your Guide, contact Human Resources.