Your Employee-Owner Benefits Guide
TO OUR VALUED EMPLOYEE OWNERS:
In this Employee-Owner Benefits Guide, you will find explanations of HB Global’s benefits programs, detailed plan information, phone numbers, websites, and plan comparisons. In addition, there is information to guide you through various benefit related events that may occur during your employment or with your family. We hope you will consider this document not only as a benefits guide, but also as a valuable resource to use throughout the year as you have questions.
- Your Human Resources TeamCONTENTS
Your Employee-Owner Benefits Guide 1
Benefits Eligibility ...................................................................................................... 2
Eligible Dependents 2
Qualifying Life Event 3
Electing Benefits ........................................................................................................ 4
Medical Plan Options ................................................................................................ 5
PPO 500 Plan 5
PPO 500 Prescription Drug Plan 5
PPO 750 Plan ............................................................................................................. 6
PPO 750 Prescription Drug Plan ................................................................................ 6
PPO 1250 Plan 7
PPO 1250 Prescription Drug Plan 7
HSA 1750 Plan ........................................................................................................... 8
HSA 1750 Prescription Drug Plan 8
Express Scripts Mail Order 9
Accredo Retail Exclusivity .......................................................................................... 9
Flexible Spending Account (FSA) .............................................................................. 9
Health Savings Account (HSA) 9
Cost Saving Programs 10
KISx Card ................................................................................................................. 10
Care Cost Estimator ................................................................................................ 10
Share Care 10
Blue 365 10
Dental Plan .............................................................................................................. 11
Sample of Services Covered by Your Dental Plan 12
Vision Plan 13-14
Life Insurance..................................................................................................... 15-16
Disability Benefits .............................................................................................. 17-18
Additional Voluntary Benefits 19
Blue 365 20
Employee Assistance Program (EAP) ....................................................... Back Cover
Megan Luther 717.766.8844 x5710 or ML@bdsadmin.com
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CONTACT INFORMATION Company Description Contact Benefit Design Specialists, Inc. Broker
IMPORTANT
Benefit Design Specialists, Inc. HSA & FSA Administration
Medical Carrier
Sun Life Dental, Life, LTD, STD, Cancer and Accident Carrier
NVA Vision Carrier
Express Scripts Mail Order Carrier
Accredo Specialty Med Carrier
KISx Surgical & Imaging Program 877.GET.KISX info@getkisx.com Conrad Siegel 401(k) and ESOP benefits 800.577.3675
Stacey Young 717.766.8844 x5711 or SY@bdsadmin.com or claims @bdsadmin.com Highmark
Customer Service 800.345.3806
Customer Service 800.247.6875 sunlifeconnect.com
Customer Service 800.672.7723
Customer Service 800.903.6228
Customer Service 877.895.9697
BENEFITS ELIGIBILITY
All full-time employee owners regularly scheduled to work at least thirty (30) hours per work week shall be eligible to enroll in employee-owner benefits. Newly hired eligible employee owners may participate in the insurance benefits program on the first (1st) day of the month following thirty (30) days of full-time employment. (Example: Penelope Finn begins her employment on January 4th. Her 30th day of employment is February 2nd. She will be eligible for the insurance benefits program as of March 1st.)
This does not include temporary or seasonal employee owners working less than an average of twenty (20) hours per week over the employer’s measurement period. If HB Global acquires a new company, they may waive the waiting period for the new employee owners. Therefore, the new employee owners would have coverage the day they transition to HB Global, LLC.
Benefit Plan Eligibility New Hire Waiting Period
Medical, Dental, Vision
1st of the month following 30 days of the status change date
Basic Life/AD&D (company paid)
Short Term Disability (company paid)
401(k)
1st of the month following 30 days of the status change date
1st of the month following 30 days of employment
1st of the month following 30 days of employment
1st of the month following 30 days of the status change date 1st of the month following 30 days of employment
1st of the quarter following 90 days of the status change date 1st day of the quarter following 90 days of employment
ELIGIBLE DEPENDENTS
The following describes status of eligible dependents. The employer requires proof of dependent status.
Spouse to whom an employee owner is legally married
· A dependent under the age of 26
Dependent is eligible for coverage through the end of the month in which they turn 26
· Disabled children of any age who live with and depend on the employee owner for support due to a mental or physical disability
Additional documentation required after the child reaches age 26 to prove incapacitation
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QUALIFYING LIFE EVENT
A qualifying life event may allow you to make changes to your benefits throughout the plan year. Life changes are effective as of the date of the change and must be reported to Human Resources within 30 days of the event to ensure the changes may be made before the next open enrollment period. The following list provides some examples of qualifying life changes. • Marriage • Birth of a child • Adoption of a child • Spouse’s job change (termination, retirement, new job, etc.) • Spouse’s loss of medical coverage • Death • Divorce • Separation • Dependent child reaches age 26 • Medicare eligibility
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Username: First initial, Last name (ex. PFinn)
Go To: www.hbmcclure.bswift.com (will also be sent to your email)
ELECTING BENEFITS
on “Start Your Enrollment” at the top
personal info, DOB, SSN, dependents, etc. 2022-2023 Per Pay Deduction $500 PPO $750 PPO $1,250 PPO $1,750 HSA Sun Life Dental NVA Vision Employee Owner $46.39 $39.90 $26.94 $22.53 $5.42 $1.06 Employee Owner & Child $92.88 $79.89 $53.99 $47.00 $18.74 $2.61 Employee Owner & Children $98.44 $85.46 $59.54 $52.43 $18.74 $2.61 Employee Owner & Spouse $99.50 $86.55 $60.64 $53.50 $18.74 $2.61 Family $106.79 $93.81 $67.90 $60.58 $18.74 $2.61 4
Password: Last 4 digits of your social security number *It will prompt you to create a new password
Click
**Review
MEDICAL PLAN OPTIONS *Covered in full after deductible is met **Select Brands include contraceptives for which there is no generic equivalent. Copayments Participating Providers Non-Participating Providers Office Visits $20 copayment per visit 40% coinsurance Specialist $40 copayment per visit 40% coinsurance Emergency Room $150 copayment per visit, waived if admitted Urgent Care $50 copayment per visit Inpatient (per admission) Covered in full* 50% coinsurance Outpatient Surgery (facility) Covered in full* 40% coinsurance Deductible $500 per member $10,000 per member $1,000 per family $10,000 per family Out-of-Pocket Maximum $6,350 per member $5,000 per member $12,700 per family $10,000 per family Coinsurance Not Applicable 40% coinsurance Preventive Care Covered in full 40% coinsurance after deductible Prescription Drug Tier Retail Pharmacy (Up to a 30-day supply) Mail Service Pharmacy (Up to a 90-day supply) Specialty Pharmacy (Up to a 30-day supply) Generic Preferred $15 copayment $30 copayment $15 copayment Generic Non-Preferred $15 copayment $30 copayment $15 copayment Brand Preferred $30 copayment $60 copayment $30 copayment Brand Non-Preferred Not covered Not covered Not covered Contraceptives Generic $0 copayment $0 copayment Not covered Select Brand** $0 copayment $0 copayment Not covered Brand Preferred $30 copayment $60 copayment Not covered Deductible $0 per member $0 per family Restrictive Generic Substitution – In addition to the coinsurance/copayment, the member pays the difference between the brand drug and generic drug price (when there is a generic drug alternative) unless the prescribing physician requests that the brand drug be dispensed. PPO 500 Plan PPO 500 Prescription Drug Plan 5 HB Global offers four (4) different medical plan options through Highmark to best suit your needs. The following is a breakdown of general coverage for each plan available to you.
*Covered in full after deductible is met **Select Brands include contraceptives for which there is no generic equivalent. Prescription Drug Tier Retail Pharmacy (Up to a 30-day supply) Mail Service Pharmacy (Up to a 90-day supply) Specialty Pharmacy (Up to a 30-day supply) Generic Preferred $15 copayment $30 copayment $15 copayment Generic Non-Preferred $15 copayment $30 copayment $15 copayment Brand Preferred $30 copayment $60 copayment $30 copayment Brand Non-Preferred Not covered Not covered Not covered Contraceptives Generic $0 copayment $0 copayment Not covered Select Brand** $0 copayment $0 copayment Not covered Brand Preferred $30 copayment $60 copayment Not covered Deductible $0 per member $0 per family Restrictive Generic Substitution – In addition to the coinsurance/copayment, the member pays the difference between the brand drug and generic drug price (when there is a generic drug alternative) unless the prescribing physician requests that the brand drug be dispensed. Copayments Participating Providers Non-Participating Providers Office Visits $20 copayment per visit 40% coinsurance Specialist $40 copayment per visit 40% coinsurance Emergency Room $150 copayment per visit, waived if admitted Urgent Care $50 copayment per visit Inpatient (per admission) Covered in full* 50% coinsurance Outpatient Surgery (facility) Covered in full* 40% coinsurance Deductible $750 per member $10,000 per member $1,500 per family $10,000 per family Out-of-Pocket Maximum $6,350 per member $5,000 per member $12,700 per family $10,000 per family Coinsurance Not Applicable 40% coinsurance Preventive Care Covered in full 40% coinsurance after deductible PPO 750 Prescription Drug Plan PPO 750 Plan 6
Copayments Participating Providers Non-Participating Providers Office Visits $20 copayment per visit 40% coinsurance Specialist $40 copayment per visit 40% coinsurance Emergency Room $150 copayment per visit, waived if admitted Urgent Care $50 copayment per visit Inpatient (per admission) Covered in full* 40% coinsurance Outpatient Surgery (facility) Covered in full* 50% coinsurance Deductible $1,250 per member $10,000 per member $2,500 per family $10,000 per family Out-of-Pocket Maximum $6,350 per member $5,000 per member $12,700 per family $10,000 per family Coinsurance Not Applicable 40% coinsurance Preventive Care Covered in full 40% coinsurance after deductible PPO 1250 Plan **Select Brands include contraceptives for which there is no generic equivalent. Prescription Drug Tier Retail Pharmacy (Up to a 30-day supply) Mail Service Pharmacy (Up to a 90-day supply) Specialty Pharmacy (Up to a 30-day supply) Generic Preferred $15 copayment $30 copayment $15 copayment Generic Non-Preferred $15 copayment $30 copayment $15 copayment Brand Preferred $30 copayment $60 copayment $30 copayment Brand Non-Preferred Not covered Not covered Not covered Contraceptives Generic $0 copayment $0 copayment Not covered Select Brand** $0 copayment $0 copayment Not covered Brand Preferred $30 copayment $60 copayment Not covered Deductible $0 per member $0 per family Restrictive Generic Substitution – In addition to the coinsurance/copayment, the member pays the difference between the brand drug and generic drug price (when there is a generic drug alternative) unless the prescribing physician requests that the brand drug be dispensed. PPO 1250 Prescription Drug Plan *Covered in full after deductible is met 7
cost
Copayments Participating Providers Non-Participating Providers Office Visits Covered in full* 20% coinsurance Specialist Covered in full* 20% coinsurance Emergency Room Covered in full* Urgent Care Covered in full* Inpatient (per admission) Covered in full* 50% coinsurance Outpatient Surgery (facility) Covered in full* 50% coinsurance Deductible $1,750 per member $5,000 per member $3,500 per family $5,000 per family Out-of-Pocket Maximum $5,000 per member $5,000 per member $5,000 per family $5,000 per family Coinsurance Not Applicable 20% coinsurance Preventive Care Covered in full 20% coinsurance HSA 1750 Plan **Select Brands include contraceptives for which there is no generic equivalent. Prescription Drug Tier Retail Pharmacy (Up to a 30-day supply) Mail Service Pharmacy (Up to a 90-day supply) Specialty Pharmacy (Up to a 30-day supply) Generic Preferred $0 copayment $0 copayment $0 copayment Generic Non-Preferred $0 copayment $0 copayment $0 copayment Brand Preferred $0 copayment $0 copayment $0 copayment Brand Non-Preferred Not covered Not covered Not covered Contraceptives Generic $0 copayment $0 copayment Not covered Select Brand** $0 copayment $0 copayment Not covered Brand Preferred $0 copayment $0 copayment Not covered Deductible Deductible is combined to include medical & prescription drug benefits. Mandatory Generic Substitution – In addition to the coinsurance/copayment, the member pays the difference between the brand drug and generic drug price (when there is a generic drug alternative) regardless of whether the prescribing physician requests that the brand drug be dispensed. HSA 1750 Prescription Drug Plan *Covered in full after deductible is met 8
The
summaries provided in this Employee-Owner Benefits Guide are not exhaustive descriptions of the plans and should not be interpreted as such. To receive answers to any questions you may have about your medical benefits or the enrollment process, please reach out to Human Resources for assistance.
EXPRESS SCRIPTS
Express Scripts is our mail order provider. Home delivery sends your maintenance medications (those you need on a long-term basis) straight to your doorstep. You should use a retail pharmacy for medications your take on a short-term basis, such as antibiotics. Mail order forms can be found on Bswift. For additional information or help, visit Express-Scripts.com or call Member Services at the phone number found on your ID card.
ACCREDO RETAIL EXCLUSIVITY PROGRAM
Our health plan includes a Retail Exclusivity Program Drug (REP). The REP is designed for access to specialty pharmacy treatments for relatively rare, chronic, and potentially life-threatening conditions. Specialty drugs on the REP list must be obtained at Accredo Specialty Pharmacy effective 1/1/2023. Members will be able to take advantage of a superior level of specialty pharmacy service with Accredo, including a dedicated Care Team led by pharmacists and nurses who specialize in the member’s healthcare condition, who can help members manage side effects, and find financial assistance. An Accredo specialty medications list can be found on Bswift.
FLEXIBLE SPENDING ACCOUNT (FSA)
An FSA is used to pay for qualified Medical, Dental, and Vision expenses for you and your dependents. Benefit Design Specialists (BDS) administrates our FSA plan. You can access funds through a debit card or paper claim (within a 2.5-month grace period). FSA accounts are accessible 24/7 at Bdsadmin.summitfor.me and the employer id is 30. If you are currently enrolled in the FSA plan, you will need to make a new election for each plan year. Your FSA is “use it or lose it.”
HEALTH SAVINGS ACCOUNT (HSA)
Only available to participants of high-deductible health plans, an HSA lets you build tax-free savings for qualified medical, dental, and vision expenses. The HSA earns interest after reaching a minimum balance and the funds never expire. Both company funding and employee contributions are 100% owned by the employee, even if the employee leaves. The Company contributes $750 for individuals and $1,500 for families per plan year. Company contributions are made weekly and are pro-rated based on entry in the plan year. Funds can be accessed through a debit card or paper claim. Everything goes to your deductible including office visits and Rx costs. You can’t have an HSA if you are covered by another medical plan including General Purpose FSA. For 24/7 access to claims and account information, visit www.myhsatoday.com
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COST SAVING PROGRAMS
KISX CARD
KISx provides an opportunity to have your medical deductible waived and for a cash bonus. The program applies to many surgical conditions. If you believe you may need surgery in the immediate future, contact BDS to confirm KISx eligibility. BDS will complete a brief intake, provide participating providers/physicians options, and assist in scheduling. Contact BDS at KISx@bdsadmin.com or call 1-877-get-kisx (438-5479) for your exact incentive.
CARE COST ESTIMATOR
Before making an appointment for a test, scan, or procedure, Care Cost Estimator helps you estimate what that care may cost. Available on your member website, highmarkblueshield.com.
SHARE CARE
Looking to lose weight? Quit smoking? Be more active? Get guidance based on your lifestyle, trackers to measure your progress, and resources like Sharecare® to make healthy choices and keep you motivated. Once you’re enrolled, visit mycare.sharecare.com.
BLUE 365
From workout gear to personal wellness to healthy meal services, we’ll take a little off the top while you’re taking a little off your middle. Member-only deals are at blue365deals.com.
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Join to learn more about Surgery and Imaging
SURGERY. SIMPLIFIED.
To help you be healthy.
The KISx Card is a surgery & imaging program that your employer has made available to you for the most common surgical & imaging procedures. Some of the most typical procedures through The KISx Card include: Orthopedic, General Surgery, Colonoscopies, MRl, CT and PET Scans. If you utilize the program, you will receive your procedure at *NO COST.
CALL
Call a KISx Card Nurse at 877-GET-KISX to find out more about your procedure and how the program works. We will assist you in finding the right facility nearby.
SCHEDULE
A KISx Card Nurse will help schedule your procedure. Upon scheduling, they will then provide you with a voucher to take to your initial consultation.
H OW IT WORKS?
Before seeking In-Network Providers through your health plan, just call a KISx Card Nurse regarding your elective procedure. By choosing a KISx Card provider, you will always pay *$0.
BE HEALTHY
After you have had your procedure through a KISx Card Provider, your KISx Card Nurse will follow up to make sure you are making a full recovery. We want to make sure you are getting better so you can live a healthy life!
You will *NOT pay anything out of pocket for choosing a KISx Card provider. Every aspect of your procedure is covered through the KISx Card.
*HSA Plans require first dollar coverage from patient before procedure up to IRS Minimum, before program incentives are received.
SAVE
GET IN TOUCH Phone: 877-GET-KISX Email:
CALL, SCHEDULE, SAVE BE HEALTHY PROCESS
info@getKISx.com
DENTAL
HB Global offers Dental benefits through Sun Life. You are eligible to participate if you are a full-time employee, as defined by your employer, at active work and working in the United States. Other employer defined eligibility requirements may apply. Temporary or seasonal workers are not eligible. Group Number: 947629
Class I: Diagnostic & Preventive
Class II: Basic
Class III: Major
100% InNetwork 100% Out of Network
100% InNetwork 80% Out of Network
60% InNetwork 50% Out of Network
Oral evaluations, routine cleanings, bitewing X-rays, fluoride treatments to age 19, sealants to age 16, space maintainers to age 19, intraoral complete series X-rays or panoramic film, other X-rays.
Fillings, simple extractions, root canal therapy, oral surgery, biopsy, periodontics, general anesthesia and intravenous sedation.
Crowns, stainless steel crowns, full and partial dentures, bridges, implants.
Class IV: Child Only
Orthodontia
50% InNetwork 50% Out of Network
Orthodontic extractions, full or partial bands, appliances (removable and fixed).
PLAN
PLAN DESCRIPTION
Year Deductible Individual $50 Family
individuals Deductible Applies Class II & III
Year Max Benefit $2,500
Out-Of-Network Orthodontia Children to age 26 Orthodontia Deductible $0 Orthodontia Lifetime Max $1,000 Coinsurance
of Covered Services
Calendar
3
Calendar
In-Network $2,200
Highlights
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Sun Life Dental NetworkSM, the dental network for your plan, includes 120,000+ unique dentists contracted with Dental Health Alliance, L.L.C. ® (DHA®) and dentists under access arrangements with other dental networks. To find a dentist in your area, or to nominate your dentist to participate in our network, go to www. sunlife.com/findadentist under PPO plan select your network, or call Customer Service at 800-733-7879. Go to www.sunlife.com and register for an account to obtain a copy of your dental card. You will not receive one in the mail.
Pre-Estimation: If the charge for any dental treatment is expected to exceed $300, Sun Life recommends a dental treatment plan be submitted to Claims for review before treatment begins.
COMMONLY ASKED QUESTIONS ABOUT DENTAL BENEFITS:
Q: What are my deductibles?
A: Your plan has a $50 per person deductible. The family deductible is satisfied when 3 family members meet their $50 per person deductible. The deductible is waived for Preventive services. Your Orthodontia coverage has no deductible.
Q: Can I see my own dentist?
A: You are free to use the dentist or specialist of your choice. However, when you choose a dentist in your plan’s PPO network, you may save money. Using a network dentist may lower your out-of-pocket costs and may make your annual maximum go further.
Q: Who is a Late Entrant?
A: A “Late Entrant” is anyone who enrolls in this dental plan more than 31 days after becoming eligible for the plan. Late Entrants may be subject to additional waiting periods for Class III Major, and Class IV Orthodontia services. Late Entrant Waiting Periods may also apply to employees who were not covered under their employer's prior dental plan.
Q: Who are eligible dependents?
A: Those qualified to be covered under your dental plan include your spouse or domestic partner or party to a civil union and your children less than age 26. See your plan document for additional eligibility details.
For more information regarding claims and services, please visit our website at: www.sunlife.com/findadentist, under PPO Plan, select your network, or call us at 800.733.7879. This summary provides only a general overview and does not contain or describe all plan details. The plan document determines all plan features and benefits. Please consult your plan documents for a complete description, including all applicable limitations, exclusions, reductions, and restrictions. Please contact Sun Life for additional information.
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VISION PLAN
HB Global offers comprehensive vision insurance through National Vision Administrators, LLC (NVA). Eligible members and dependents are entitled to receive a vision examination and one (1) pair of lenses/frames or contacts and contact lens evaluation/fitting once every twelve (12) months from the last date of service.
NVA automated customer service is available 24 hours a day, 7 days a week to assist you with verifying eligibility, locating a provider, and check claims status. If you need to speak with a customer service representative, they are available to assist by calling 1-800-672-7723 (Monday-Friday 8:00am6:00pm and Saturday 8:30am-5:00pm (EST). In-Network
Plan Year Copayment None None Examination (Reimbursed Amounts)
Once Every 12 Months Covered 100%
Up to $32
Contact Lens Evaluation/ Fitting Covered 100% Daily Wear: $20
Once Every 12 Months Extended Wear: $30 Lenses
Once Every 12 Months
Standard Glass/Plastic Covered 100%
Up to $25 Bifocal Up to $36 Trifocal Up to $42
Single Vision
Lenticular Up to $72 Frames
Once Every 12 Months
Contact Lenses
Up to $60 Retail Allowance
Up to $30
Once Every 12 Months (in lieu of Lenses/Frame) (in lieu of Lenses/Frame)
Ellective Contact Lenses Up to $85 Retail Allowance
Up to $85 Medically Necessary* Covered 100% Up to $225
*Pre-approval from NVA necessary
Out-of-Network Provider
Provider
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Lens options purchased from a participating NVA provider will be provided to the member at the amounts listed in the fixed option pricing list below.
Options not listed will be priced by NVA providers at their usual & customary retail price.
Lens Option
Price
Solid Tint $10
Fashion/Gradient Tint $12
Standard ScratchResistant Coating $10
Ultraviolet Coating $12
Standard Anti-Reflective $40
Glass Photogrey (Single Vision) $20
Glass Photogrey (Multi-Focal) $30
Polarized $75
Progressive Lenses Standard $50
Transitions Single Vision Standard $65
Transitions Multi-Focal Standard $70
Polycarbonate (Single Vision) $25
Polycarbonate (Multi-Focal) $30
Blended Segment $30
High Index $55
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LIFE INSURANCE
Sun Life Insurance also provides HB Global Employee-Owners with additional life insurance. The following chart illustrates what your life benefits cover, permitted you enroll. You may review your coverage in more detail at www.sunlife.com
Basic Life
Employee-Owner Benefit
Your employer provides Basic Life Coverage for all full-time employee owners in the amount of 100% of your annual salary, to a maximum of $50,000 with a minimum of $10,000
Accidental Death and Dismemberment
Your Basic Life coverage includes Accidental Death and Dismemberment coverage equal to one times the employee-owner’s life benefits.
Spouse Benefit N/A
Child Benefit N/A
Guarantee Issue: The “guarantee” means you are not required to answer health questions to qualify for coverage up to and including the specified amount, when you sign up for the coverage during the initial enrollment period.
Premiums
Portability: Allows you to take your coverage with you if you terminate employment.
Underwriting may be required, depending on amount and/or age
Voluntary Term Life
$10,000 increments to a maximum of $500,000.
Covered by your company if you meet eligibility requirements.
Yes, with age and other restrictions, including evidence of insurability.
Employee-Owner, Spouse, and Child(ren) coverage. Maximum 1 times life amount.
$5,000 increments to a maximum of $100,000.
Your dependent children age 14 days to 26 years. $1,000 increments to a maximum of $10,000. Subject to state limits.
We guarantee issue coverage up to: $150,000 for employee owner and $50,000 for spouse. An additional $100,000 per employee owner, $25,000 for a spouse can be obtained with a “No” response to the health question (on your enrollment form). Evidence of insurability is required if the elected amount exceeds the guarantee issue plus additional amount.
Increase on plan anniversary after you enter next five-year age group.
Yes, with age and other restrictions.
15
Conversion: Allows you to continue your coverage after your group plan has terminated.
Accelerated Life Benefit: A lump sum benefit is paid to you if you are diagnosed with a terminal condition, as defined by the plan.
Waiver of Premiums: Premium will not need to be paid if you are totally disabled.
Basic Life
Yes, with restrictions.
Voluntary Term Life
Yes, with restrictions.
Yes Yes
Yes
Benefit Reductions: Benefits are reduced by a certain percentage as an employee owner ages.
35% at age 65, 50% at age 70.
For employee owners disabled prior to age 60, with premiums waived until normal retirement age, if conditions met.
35% at age 65, 50% at age 70
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DISABILITY BENEFITS
Sun Life offers plans for Short-Term Disability and Long-Term Disability. The following gives an overview of each to help you determine if you are interested in enrolling.
Short-Term Disability
Core Buy-Up Option 1
Coverage Amount
Maximum payment period:
Long-Term Disability
60% of salary to maximum $600/ week. 60% of salary to maximum $2,000/week 60% of salary to maximum $5,000/month
Maximum length of time you can receive disability benefits. 24 weeks 24 weeks Social Security normal retirement age
Accident benefits begin: The length of time you must be disabled before benefits begin. Day 15 Day 15 Day 181
Illness benefits begin: The length of time you must be disabled before benefits begin. Day 15 Day 15 Day 181
Evidence of Insurability: A health statement requiring you to answer a few medical history questions.
Health Statement may be required Health Statement may be required Health Statement may be required Guarantee Issue: The “guarantee” means you are not required to answer health questions to qualify for coverage up to and including the specified amount, when applicant signs up for coverage during the initial enrollment period.
Minimum work hours/week: Minimum number of hours you must regularly work each week to be eligible for coverage.
We guarantee issue $600 in coverage We guarantee issue $2,000 in coverage We guarantee $5,000 in coverage
Plan holder Determines
Plan holder Determines Plan holder Determines
17
Short-Term Disability
Core Buy-Up Option 1
Pre-existing conditions:
A pre-existing condition includes any condition/ symptom for which you, in a specified time period, consulted with a physician, received treatment, or took prescribed drugs.
Premium waived if disabled: Premium will not need to be paid when you are receiving benefits.
Not Applicable Not Applicable
Long-Term Disability
3 months look back; 12 months after exclusion
Not Applicable Yes Yes
Survivor benefit: Additional benefit payable to your family if you die while disabled.
No No 3 Months
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ADDITIONAL VOLUNTARY BENEFITS
ACCIDENT INSURANCE
Accident Insurance through Sun Life gives you the option to enroll in a program that will help cover you in the case of a non-work-related accident. The benefit payment can help with medical expenses and copayments, as well as things like household expenses (groceries, mortgage payments, childcare, etc.). This benefit is portable, meaning you may carry it after termination of employment.
CANCER INSURANCE
Sun Life offers Cancer Insurance as a means to supplement your medical and disability income, should you be diagnosed with an Internal cancer. Cancer Insurance pays benefits to you based on the treatments you receive related to a covered cancer diagnosis. The benefit payment is paid in addition to your medical insurance plan. Initial benefit payment would come after a thirty (30) day waiting period.
Initial Diagnosis Benefit Benefit is paid when you are diagnosed with internal cancer for the first time while insured under this plan
Initial Diagnosis Benefit Amount $5,000
Cancer Screening $75
Radiation Therapy or Chemotherapy $500-$1,000 Schedule amount to a $12,000 benefit year maximum
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Coverage - Details Cancer
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