My Benefits: 2014 Employee Guide

Benefits 2014

employee

Guide

promoting your health and well-being

Table of Contents Health Care Reform Highlights...............................

3

Enrollment Resources................................................................

Who Are My Dependents......................................

5

Snapshot of Core Benefits..........................................................

2014 Price Sheet..................................................

7

Medical Plan Options.................................................................

Medical Plan Details.............................................

9

Pharmacy Program....................................................................

Dental Plan........................................................

12

Life, Supplemental Life & AD&D Insurance.................................

LMC Retirement Benefits...................................

14

Snapshot of Additional Benefits.................................................

Short- and Long-term Disability.........................

16

Dependent Life Insurance Coverage..........................................

Flexible Spending Accounts...............................

18

4 6 8 11

13 15 17

19

Educational Assistance and Opportunities..................................

Other Valuable LMC Resources & Benefits........

20

SouthCarolinaBlues.com.........................................................

Benefits from The Hartford...............................

24

Glossary of Terms..................................................................

Important Contact Information...........................

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Welcome to the 2014 Benefits Guide!

Dear Lexington Medical Center Employee: LMC is committed to providing our employees with quality, cost-effective benefits choices.

We offer a comprehensive package of benefits that can help you make sound decisions for you and your family. LMC believes in the total well-being of our employees and understands that when they are successful, we are all successful.

We promote the health and wellness of our employees, which is why LMC pays approximately 75% of our employees’ health care costs. That’s an average of $10,000 per employee per year. LMC also works to help employees navigate the new world of health care with innovative strategies that reduce costs and improve efficiencies, satisfaction and quality. You will see some of these strategies in this Benefit Guide, including two new programs to help you manage your health care expenses.

If you have any questions, please contact Human Resources at (803) 791-2131, Monday through Friday from 7:30 a.m. to 5:00 p.m.

————————— We’re glad you are here!

LMC is unique in that it makes medical, dental and life insurance benefits available on your date of hire or on the date your status changes from PRN to benefits-eligible. The same is true for participation in health care and dependent care flexible spending accounts (FSAs). Eligible employees may also enroll in LMC’s retirement plans on their date of hire. As a participating employer in the South Carolina Retirement System (SCRS), LMC’s employee plan members contribute 7.5% of their pre-tax gross earnings each pay period, while LMC contributes a total of 10.6% on their behalf.1 Employees may also choose to participate in LMC’s 401(k) and 457 supplemental retirement plans. Other benefits become available on the 91st day of employment or on the 91st day following a change in status to a benefits-eligible position.

Be sure to review this entire package in order to make the best selections for you and your family.

Please note: Because LMC offers “day one” medical, dental, life insurance and FSA benefits, employees who do not return their benefits enrollment forms prior to receiving their first paycheck may miss having any premiums deducted for these benefits. These missed payments are known as “arrears” and will be deducted from the next available paycheck(s) following receipt of the benefits enrollment forms in Human Resources. In addition, returning your completed enrollment forms late may delay notification of your elected coverage to insurance carriers and the mailing of your insurance identification card(s). Most importantly, you must return you enrollment forms within 31 days of employment or you will not be able to enroll in coverage until the next annual enrollment period. Our plan year is January 1 – December 31.

Sincerely,

Susan Boone Benefits Manager —————————————————————————————————————————————

E ffective July 1, 2014, the SC Public Employee Benefit Association will increase the employer contribution rate to SCRS, including the incidental death benefit, to 10. 9% and the employee contribution rate to 8%.

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Health Care Reform Highlights

H

H

It has been four years since the Patient Protection Affordable Care Act (PPACA), more commonly known as health care reform, was enacted.

In order to comply, we have made certain changes to our benefits programs through the years. We will continue to implement changes as required by PPACA.

New in 2014

?

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Notice of Exchange

The Notice of Exchange was included in your New Hire Journey packet. The notice provides basic information about individual health insurance options that will be available through the Health Insurance Marketplace (also referred to as the Exchange or Marketplace). The notice also explains that some individuals may be eligible for federal subsidies to help pay for some of the cost of their health care policy sold through the Exchange.

Please visit HealthCare.gov for more information.

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No Annual Limit

The maximum benefit payable in a plan year per covered individual will be unlimited. In previous years, the annual limit had been set to $2,000,000 per covered individual.

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Dependent to Age 26

Beginning with the 2014 plan year, eligible dependents up to age 26 may remain covered under the plan even if they have coverage offered through their own employer’s plan.

Please refer to page 5 for dependent definition and certification requirements.

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Grandfathered Health Plan

Lexington Medical Center’s health plan remains a “grandfathered health plan” under PPACA. A grandfathered health plan can preserve certain basic health coverage that was already in effect when the law was enacted in 2010 and does not have to comply with all changes required under PPACA; however, grandfathered plans are not exempt from all of PPACA’s requirements. Some provisions of our program were already stronger than provisions required by the law. For example, although PPACA requires the elimination of pre-existing condition limitations on health benefits, LMC medical plans eliminated preexisting condition limitations years before PPACA was passed.

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Questions

regarding which protections apply and which ones do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to Human Resources at (803) 791-2131.

You may also contact the U.S. Department of Health and Human Services at HealthReform.gov.

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Resources & Information Before making your benefits selections, consider these helpful tips.  Read this Benefits Guide. This booklet will guide you through the enrollment process and answer many of your questions.

 Remember that federal regulations require you to provide each dependent’s social security number to complete the enrollment process. Refer to page 5 for help identifying eligible dependents.

 Review the Snapshot of Benefits on pages 6 and 15. Familiarize yourself with the benefits LMC provides free and those that are available to purchase.

 Talk about your benefits needs with your spouse and any dependents. This may help you decide which benefits to select.

IMPORTANT!

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Employees must notify Human Resources within 31 days of any qualified change in status.

When can I change my benefits selections?

Once you make your benefits selections, IRS regulations limit your ability to make any changes prior to the next annual enrollment period.

2. I f you have a qualifying change in status: During the year, you can change your elections

Generally, you cannot make changes during the plan year unless you have a qualifying change in family status or employment status.

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1. D uring annual enrollment: You will have an opportunity to change your benefits selections during annual enrollment; however, future increases to supplemental life insurance and dependent life insurance coverage are limited.

OR (e.g., from single to family medical coverage) or change your contributions to a spending account only if you have a qualified status change, which includes:  M arriage or divorce  B irth or adoption of a child  D eath of your spouse or child  L oss or gain of spousal

employment

QUESTIONS? Call the helpline (803) 791-2131 Monday – Friday 7:30 a.m. – 5:00 p.m.

 C hange to your employment status

(e.g., full time to part time)  S ignificant change to your spouse’s and/or

child’s coverage  S ignificant change in your health coverage

due to your spouse’s employment ————————————————————

How does this apply to me?

Changes in your elections must be consistent with your qualifying change in status. For example, if you select Employee + Family HMO coverage and you get divorced, you may remove your spouse from HMO coverage, but you may not change your coverage to the PPO option until the annual enrollment period.

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Who Depends on Me? Lexington Medical Center offers cost-effective health plans and benefits for employees’ spouses and children.

These plans include medical, dental and life insurance. Please read the information below for help determining your eligible dependents. Be sure to have each dependent’s social security number to complete enrollment.

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Spouse:

An employee’s legally married (as recognized by South Carolina) or common law spouse with signed affidavit.

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Children: An employee’s natural or adopted children as well as any foster children, stepchildren, or children of whom an employee has custody or legal guardianship.

important

 Children (as defined above) are eligible for coverage

When enrolling

under LMC’s health benefits plan (PPO and HMO), dental plan and dependent life insurance program whether or not they reside with you, whether or not they legally depend on you for financial support, whether or not they are tax dependents, whether or not they are students, and whether or not they are married.  Children may be covered until they turn 26 years

of age. Coverage for such dependent children will terminate on their date of birth the year they reach age 26. They may, however, be eligible to extend coverage under COBRA.

for benefits, you must confirm that each child whom you wish to cover is your child as defined on this page.

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Remember You are required to provide each dependent’s social security number to complete benefits enrollment.

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Snapshot of Core Benefits Lexington Medical Center is pleased to provide a benefits program that can be customized by each employee.

LMC offers a wide range of options for employees to choose the benefits that best address their individual, financial and dependent needs and interests.

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Medical

 BlueCross/BlueShield – PPO 500

Supplemental Life Insurance

 BlueCross/BlueShield – PPO 750

 Your choice of one, two or three times

 BlueChoice (HMO)

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Dental

 BlueCross/BlueShield Traditional Plan

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Basic Life Insurance

 One times your base annual earnings

Eligibility

for benefits and provisions may differ by employee category (Full-time, Part-time, Flex employees, Lex Plan employees, etc.).

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(BAE) up to $1,500,000  No medical underwriting for coverage up

to $1,000,000 —————————————————

your BAE, up to $1,500,000 when combined with basic life insurance  No medical underwriting unless your total

basic and supplemental life insurance is more than $1,000,000 or supplemental coverage increases by more than one level (e.g., 1x BAE to 3x BAE) —————————————————

Retirement

 Deferred compensation with 401(k),

Roth 401(k), 457 and Roth 457  South Carolina Retirement Plan

Accidental Death & Dismemberment (AD&D)  Matches the amount of basic life

insurance  Provides coverage for accidental loss

of life, limb or sight

DISCLAIMER: Details are contained in the official plan documents, insurance contracts or Human Resources policies. In the event of any conflict between this Benefits Guide and the official plan documents, insurance contracts or HR policies, the terms of the plan documents, insurance contracts and HR policies will always govern. LMC reserves the exclusive right to modify, amend or terminate any and all plans at any time.

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2014 Employee Price Sheet Biweekly Payroll Deduction Amounts OPTION 1 — bluecross/blueshield — Preferred Provider Organization (PPO) 500 FULL TIME 32 hours or more

lmc contribution cost

part time 20–31 Hours

lmc contribution cost

part time 16–19 Hours

lmc contribution cost

Employee Only

$80

$288

$137

$231

$164

$204

Employee + Child(ren)

$163

$515

$238

$440

$275

$403

Employee + Family

$226

$772

$347

$650

$392

$605

OPTION 2 — bluecross/blueshield — Preferred Provider Organization (PPO) 750 FULL TIME 32 hours or more

lmc contribution cost

part time 20–31 Hours

lmc contribution cost

part time 16–19 Hours

lmc contribution cost

Employee Only

$42

$198

$89

$151

$117

$123

Employee + Child(ren)

$68

$374

$149

$293

$185

$257

Employee + Family

$119

$530

$233

$416

$286

$363

OPTION 3 — bluechoice — Health Maintenance Organization (HMO) FULL TIME 32 hours or more

lmc contribution cost

part time 20–31 Hours

lmc contribution cost

part time 16–19 Hours

lmc contribution cost

Employee Only

$64

$245

$130

$179

$163

$146

Employee + Child(ren)

$119

$440

$206

$353

$253

$306

Employee + Family

$192

$628

$322

$498

$389

$431

dental FULL TIME 32 hours or more

part time 20–31 Hours

part time 16–19 Hours

Employee Only

$16

$16

$16

Employee + Family

$42

$42

$42

* LMC contribution costs are rounded to the nearest dollar and displayed for information purposes only. supplemental life/ad&d — per $1,000 of coverage FULL TIME 32 hours or more

part time 20–31 Hours

part time 16–19 Hours

Age < 25

$0.025

$0.025

$0.025

Age 25 – 29

$0.025

$0.025

$0.025

Age 30 – 34

$0.029

$0.029

$0.029

Age 35 – 39

$0.037

$0.037

$0.037

Age 40 – 44

$0.051

$0.051

$0.051

Age 45 – 49

$0.076

$0.076

$0.076

Age 50 – 54

$0.119

$0.119

$0.119

Age 55 – 59

$0.180

$0.180

$0.180

Age 60 – 64

$0.236

$0.236

$0.236

Age 65 – 69

$0.370

$0.370

$0.370

Age 70 – 74

$0.642

$0.642

$0.642

Age > 75

$1.040

$1.040

$1.040

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Medical Plan Options Lexington Medical Center offers three medical plans.

Each of the medical plans differs in the amount you contribute through payroll deduction, the amount you pay for the medical services you use and the cost to LMC. Your expenses for medical services will typically be less when you use LMC as compared to using other providers. As an employee, you and your family are encouraged to use LMC services whenever possible.

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Option 1: BlueCross/BlueShield PPO 500

IMPORTANT! If you choose another facility for an inpatient service that LMC can provide, there is an additional $500 co-pay that you will need to pay.

This additional co-pay does not go toward your out-of-pocket limit.

Please refer to the 2014 Medical Plan Details on pages 9 and 10 of this guide to help you compare and choose the medical plan that best meets the needs of you and your family.

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This plan is a Preferred Provider Organization and, under this medical option, you will not be required to coordinate care through a Primary Care Physician (PCP). You will, however, need to have medical services provided through a network provider to receive the maximum coverage allowance. You will pay the highest biweekly premium for this level of coverage.

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Option 2: BlueCross/BlueShield PPO 750

This medical option is exactly like the first option (PPO 500) except that you will assume a slightly higher financial responsibility by paying higher deductibles and annual out-ofpocket expenses. You will, however, pay significantly lower biweekly premiums. Many employees consider this option as the best value for medical coverage because of the lower biweekly premium.

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Option 3: BlueChoice (HMO)

This plan is more restrictive than the PPO options because all of your care is coordinated through a PCP and there is no coverage for care received out-of-network (except for emergencies). If you are enrolling in HMO for the first time, be sure to let Human Resources or BlueChoice know the PCP you have chosen. You can change your PCP anytime by calling BlueChoice (1-800-868-2528) or by visiting BlueChoiceSC.com.

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2014 Medical Plan Details Option 1 PPO 500

Option 2 PPO 750

Option 3 BlueChoice (HMO)

Annual Deductible Per Person

$500

$750

$500

Per Family

$1,500

$2,250

$1,500

Inpatient

After Deductible

After Deductible

After Deductible

LMC

90%

90%

90%

In-Network

*70%

*70%

*70%

Out-of-Network

*50%

*50%

Not Covered

* Additional $500 co-pay for inpatient services outside LMC. This doesnâ&#x20AC;&#x2122;t apply to the out-of-pocket limit. For covered inpatient services LMC does not provide, the plan pays at 80% and the $500 co-pay will be waived.

Outpatient LMC

90%

90%

90%

In-Network

*70%

*70%

*70%

50%

50%

Not Covered

Out-of-Network

*For covered outpatient services LMC does not provide, the plan pays at 80%.

Emergency Care/Urgent Care LMC

90%/90%

90%/90%

90%/100% after $20 LMC Co-pay

In-Network

70%/70%

70%/70%

70%/70% after $50 Non-LMC Co-pay

Out-of-Network

70%/70%

70%/70%

70%/70% after $50 Non-LMC Co-pay

if services meet definition of emergency

Minute Clinic

Not Covered

Not Covered

Not Covered

Physician Benefits ď ˝ LMC/In-Network/Out-of-Network Surgery/Anesthesia

90%/80%/50%

90%/80%/50%

90%/80%/Not Covered

Gyn/Prenatal

90%/80%/50%

90%/80%/50%

90%/80%/Not Covered2

Hospital Visits

90%/80%/50%

90%/80%/50%

90%/80%/Not Covered

Chemotherapy

90%/80%/50%

90%/80%/50%

90%/80%/Not Covered

Emergency Room1

90%/80%/50%

90%/80%/50%

90%/80%/Not Covered

Urgent Care

90%/80%/50%

90%/80%/50%

$20 LMC/$50 Non-LMC

Office Visits 90%/80%/50% 90%/80%/50%

$20 LMC (PCP)/$25 In-Network (PCP)/ Not Covered2

Office Visit Lab/X-ray 90%/80%/50% 90%/80%/50%

$20 LMC (PCP)/$25 In-Network (PCP)/ Not Covered2

Required Pre-Approval for Health Care Services Pre-approval is required for all hospital, psychiatric, skilled nursing facility admissions, home health, hospice, RN at home and durable medical equipment more than $500.

Please make sure your health care providers obtain the necessary pre-approval.

1. F or true emergencies, benefits for out-of-network providers will be identical to what would have been paid at an in-network provider.

2. I n the HMO, all care must be coordinated through a Primary Care Physician (PCP). Out-of-network physicians are not covered. Authorizations are not required for an annual routine Ob/Gyn visit.

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2014 Medical Plan Details Continued

Option 1 PPO 500

Option 2 PPO 750

Option 3 BlueChoice (HMO)

Routine Health Maintenance

90%/80%/50% After Deductible

90%/80%/50% After Deductible

$20 (PCP)/$25 (PCP)/Not Covered

Well Baby Care

$35 Co-pay

$35 Co-pay

$20 (PCP)/$25 (PCP)/Not Covered

Screening/Mammography, PAP Test, Prostate Exam

$20 Co-pay

$20 Co-pay

$20 (PCP)/$25 (PCP)/Not Covered

Well-Woman Exam Gyn Visit

Included in Routine Health Maintenance

Included in Routine Health Maintenance

$20/$25 In-Network/Not Covered 1/year (no authorization/referral)

Wellness

Pharmacy

Online Services Check eligibility, deductible, out-of-pocket limits, authorizations, claims, other health insurance questionnaires, customer service questions, online provider directories, request new ID cards or make changes to your PCP online at: BlueChoiceSC.com SouthCarolinaBlues.com

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Retail (31-day) 90% After Deductible

(Generic)

80% After Deductible

(Brand Name)

90% After Deductible $10 Co-pay (Generic) (Generic) 80% After Deductible $30 Co-pay (Preferred (Formulary)) (Brand Name) $40 Co-pay (Non-preferred

(Non-Formulary))

Mail Order (90-day)

No Deductible 10% Coinsurance (Generic) 20% Coinsurance (Brand Name)

No Deductible 10% Coinsurance (Generic) 20% Coinsurance (Brand Name)

$20 Co-pay Generic $60 Co-pay Preferred

Not Covered

Not Covered

100% Eye Exam*

$80 Co-pay Non-preferred

}

For a 90-day supply

Vision Routine Eye Care

100% Eye Wear/Every Other Year

BlueChoice Selection of Frames

Non-covered frames or contacts may receive up to $120 credit

Designated Providers: Columbia Eye Clinic Eye Physicians & Surgeons Sansbury

* Services provided outside BlueChoice network will not be covered.

Coinsurance Out-of-Pocket Limits (Does not include deductible, co-pays or penalties) In-Network

$1,000 Per Person

$1,250 Per Person

$2,000 Per Person

Out-of-Network

$2,500 Per Person

$3,250 Per Person

$4,000 Per Family

Maximum Benefits Payable by the Plan Annual Maximum Unlimited Unlimited Unlimited Lifetime Maximum Unlimited Unlimited Unlimited

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Pharmacy Programs New for 2014 Lexington Medical Center is offering two pharmacy programs to PPO participants.

These programs are aimed at providing safe, clinically appropriate and cost-effective medications to treat medical conditions. Both programs are similar to those in the HMO plan and will help plan participants manage their costs.

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Step Therapy

Step Therapy medications are organized in a series of “steps.” The program requires participants to try a cost-effective “First Choice” drug before “stepping up” to a more expensive “Second Choice” drug. Participants will work with their physicians to choose the most costeffective and appropriate medication.

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Generic Incentive

The Generic Incentive program requires participants to try a generic equivalent medication before using a brand-name medication. Generic medications are safe, effective and cost less than brand-name drugs.

Examples of How the Generic Incentive Plan Pays and Your Responsibility Medication A (brand name with a generic equivalent – e.g. Lipitor®).....Allowed Amount : $118.00 Medication B (generic equivalent – e.g. Atorvastatin®)...........................Allowed Amount: $22.00 Example 1: Current Pharmacy Plan (How the Plan Pays) Brand-name Medication (e.g. Lipitor) Plan Pays 80%.............................................................................................$94.40 (or $118.00 x 80%)

For more information on the pharmacy programs, visit LexLoop.

You Pay 20%................................................................................................$23.60 (or $118.00 x 20%) Example 2: Brand-name Medication Prescribed (e.g. Lipitor)

Your physician prescribes a brand-name medication when only a brand-name medication will work (i.e., Brand Specific, Brand Only, Medically Necessary or Dispensed as Written)

Plan Pays 80% ............................................................................................$94.40 (or $118.00 x 80%) You Pay 20% ...............................................................................................$23.60 (or $118.00 x 20%) Example 3: Generic Incentive Penalty

Your physician prescribes generic substitution allowed (e.g. Atorvastatin); however, you request a brand-name medication (e.g. Lipitor). Your request for a brand-name medication triggers the Generic Incentive Penalty.

Plan Pays 80% of Generic Allowed Amount....................................................$17.60 (or $22 x 80%) You Pay 20% coinsurance plus the difference in cost ................................$100.40 between the brand and generic (but no more than the total remainder after plan allowed amount) Which is: $4.40 (or $22.00 x 20%) + $96.00 (or $118.00 – $22.00)

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Dental Plan Lexington Medical Center gives you the option to select dental coverage for you and your family.

The only decision you have to make about dental benefits is whether you want to cover yourself or your entire family.

Covered Services P reventive — oral exams, X-rays, emergency treatment, cleanings, fluoride

treatments and space maintainers (up to age 19) B asic — anesthesia, extractions, fillings, endodontics (root canal), periodontics

(gum treatments), prosthodontic maintenance (dentures, crowns and fixed bridge work), oral surgery and antibiotic injections  major — crowns, inlays, onlays, gold fillings and prosthodontic installation and

replacement (dentures and fixed bridge work)  Orthodontia — braces to straighten teeth

$25 Annual Deductible Preventive

basic

major

orthodontia

Pays 100%

Pays 80%

Pays 50%

Pays 50%

reasonable and customary charges ——————

reasonable and customary charges —————— Employee Coinsurance 20%

reasonable and customary charges —————— Employee Coinsurance 50%

reasonable and customary charges —————— Employee Coinsurance 50%

$1,000 Annual limit

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$2,000 Lifetime Limit

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Life, Supplemental Life & AD&D Insurance Employees can purchase supplemental life and accidental death and dismemberment (AD&D) insurance at highly affordable rates for additional protection beyond Lexington Medical Center’s core life insurance program.

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Life and AD&D Insurance

This coverage is term life insurance and does not build cash value. It provides a lump sum benefit to the person you name as your beneficiary in the event of your death.

LMC provides life and AD&D benefits equal to one times your base annual earnings (1x BAE) to all eligible full-time and part-time employees (working 16 or more hours per week) at no cost. You can opt to purchase additional supplemental life and AD&D coverage in increments of one times, two times or three times your BAE. You do not need to answer medical questions unless:  Your total basic and supplemental life insurance is more than $1,000,000.  You increase optional supplemental coverage by more than one level (e.g., changing from 1x BAE to 3x BAE during annual enrollment).

If you exceed the limit, contact Human Resources for a personal health assessment form.

The combined maximum coverage level for life, supplemental life and AD&D insurance is $1,500,000.

————————————————————————————————————— Age-rated Premiums for Supplemental Life and AD&D Insurance The life insurance premiums that apply to you are provided on your New Hire Enrollment form. Or you can use the rates shown in the 2014 Price Sheet (on page 7 of this guide) to determine your cost. To calculate the cost, use the formula below.

Example for a 35-year-old employee earning $37,000: A. Enter your earnings rounded to the next higher thousand.

$37,000

B. Enter the supplemental coverage level (1x, 2x or 3x earnings).

C. Multiply A times B. This will equal your coverage amount.

2 $74,000

D. Divide C by 1,000.

Tax regulations require

that when the value of any companyprovided, pre-tax employee life insurance amount is greater than $50,000, the company must report the premium cost as imputed taxable income on your W-2.

This generally has a very small impact on take-home pay.

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E. Find the rate per $1,000 of coverage for your age on the 2014 Price Sheet.

$.037

F. Multiply D times E. This is your premium amount.

$2.74

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LMC Retirement Benefits South Carolina Retirement System (SCRS) Established by South Carolina statute in 1945, SCRS is a traditional defined benefit retirement plan that provides members with a fixed monthly annuity at retirement. The monthly annuity amount is calculated using a predetermined formula that includes years of service, the member’s average final compensation and a benefit multiplier of 1.82 percent.

Lexington Medical Center is a participating employer in the retirement system, which means LMC employees are required to join SCRS with a few limited exceptions. Contact Human Resources to determine if your position is one in which participation in SCRS is optional. Please note that even if your current position at LMC is one in which participation is optional, if you have ever been a member of SCRS and have not withdrawn your account funds, you are still required to participate in SCRS. Participating employees have an eight-year vesting schedule.  LMC contributes 10.45% of employees’ gross earnings + .15% for incidental death benefit.1  Employees contribute 7.5% of their pre-tax gross earnings.1  After 1 year of membership, employees are eligible for a life insurance policy equal to 1 times

annual salary (capped at $255,000).  Employees’ retirement accounts earn 4% interest (compounded annually).

Contribution rates are subject to change as governed by the South Carolina Public Employee Benefit Authority (PEBA). There is a scheduled increase to both employee and employer contributions for 7/1/14.

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South Carolina Deferred Compensation Plans South Carolina Deferred Compensation is another powerful tool to help you reach your retirement dreams.

As a supplement to other retirement benefits or savings, this voluntary program allows you to save and invest extra money for retirement through before-tax or after-tax contributions. For 2014, employees may contribute up to $17,500. Employees age 50 and older may contribute an additional $5,500. LMC does not match these contributions.  Traditional 401(k) Plan – pre-tax  Roth 401(k) Plan – after-tax  Traditional 457 Plan – pre-tax  Roth 457 Plan – after-tax

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Snapshot of Additional Benefits Lexington Medical Center is pleased to offer a suite of additional benefits for our employees.

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 Continues a percentage of your pay

Educational Assistance and Opportunities

 For non-occupational illness or injury

 Tuition reimbursement

Short-term Disability

 Scholarships

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 Stipends and on-the-job opportunities

Long-term Disability  Continues a percentage of your pay  For non-occupational illness or injury

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And More  Adoption benefits

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 Annual leave

Dependent Life Insurance

 Bereavement leave

 Spouse: $5,000, $10,000 or $20,000

 Cafeteria savings

 Child/Children: $5,000

 Credit union  Employee health program

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 Jury duty

College Plans

 Military leave/reserve duty

 529 College Savings

 Staff training and education  Workers’ compensation

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Flexible Spending Accounts  Health care up to $2,500  Dependent day care up to $5,000

DISCLAIMER: Details are contained in the official plan documents, insurance contracts or Human Resources policies. In the event of any conflict between this Benefits Guide and the official plan documents, insurance contracts or HR policies, the terms of the plan documents, insurance contracts and HR policies will always govern. LMC reserves the exclusive right to modify, amend or terminate any and all plans at any time.

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Eligibility

for benefits and provisions may differ by employee category (Full-time, Part-time, Flex employees, Lex Plan employees, etc.).

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Short- and Long-term Disability Coverage Disability coverage continues a portion of your salary if you are unable to work due to a non-occupational illness or injury.

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Short-term Disability Insurance

If you are eligible for full-time benefits (standard hours of 32 or more per week, 24 standard hours for Lex Plan or at least 8 standard hours for Flex employees), LMC provides shortterm disability coverage on the 91st day of eligible employment and benefit payable day 1 for an accident and day 6 from treatment for a sickness.

If you are a part-time employee whose standard hours are 16–31 hours per week, you have the option of purchasing short-term disability coverage. Eligibility is on the 91st day of eligible employment and benefit begins after 30 days of approved disability.

Coverage Terms:  66-2/3% of monthly earnings for up to 6 months of your disability  Provided at no cost to full-time, Flex and Lex Plan employees  Part-time employees may purchase short-term disability coverage ———————————————————————————————————

Long-term Disability Insurance

If you are eligible for full-time benefits (standard hours of 32 or more per week or 24 standard hours for Flex and Lex Plan), LMC provides long-term disability coverage on the 91st day of eligible employment and benefit begins on the 181st day of approved disability.

Coverage Terms:  60% of monthly earnings after 6 months of your disability  Provided at no cost to full-time, Flex and Lex Plan employees  Part-time employees are NOT eligible The total benefits payable to you on a monthly basis (including all benefits provided under the plan) will not exceed 100% of your monthly earnings. Your long-term disability benefit may be reduced by deductible sources of income and any earnings you have while disabled.

Disability coverage applies to your income only (not available for dependents).

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Dependent Life Insurance Coverage Dependent life insurance provides protection to you and your loved ones.

In the event of the death of your spouse or children, you will receive a cash payment from The Hartford.

The amount of this payment will be determined by the coverage options you select.

Dependent life insurance will cover children up to age 26, regardless of whether they live with you or depend on you for financial support.

Options Biweekly Premium Option 1: Spouse $5,000/Child(ren) $5,000

$0.58

Option 2: Spouse $10,000/Child(ren) $5,000

$0.98

Option 3: Spouse $20,000/Child(ren) $5,000

$1.78

Imputed Income According to IRS regulations, dependent life insurance plans offered by employers may be subject to imputed income.

For more information, please visit IRS.gov or contact your tax advisor.

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Flexible Spending Accounts Health Care Reimbursement Plan Lexington Medical Center’s health care FSA allows you to use pre-tax dollars to reimburse out-of-pocket costs (deductibles, coinsurance and co-pays), as well as medical expenses not covered by the medical plan.

Health Care FSA Debit Card

Important Points!

You have until March 31, 2015 to submit claims for expenses incurred in 2014.  If your spouse has a health

savings account (HSA) through his or her employer, you cannot participate in the health care flexible spending account (FSA).  Maximum joint contribution

(you and your spouse) for your dependent day care flexible spending account is $5,000.  In 2013, the IRS

implemented federal regulations to allow up to $500 in unused health care FSA contributions to be carried over to the following plan year.

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The health care FSA debit card works like a bank debit card and gives you immediate, electronic access to funds stored in your health care account. You may use this debit card at your doctor’s office, pharmacy, retail stores or any store that can identify FSA-eligible expenses at checkout. The debit card will eliminate the need for filing most claims forms and there is no wait for reimbursement.

Be sure to keep itemized receipts on hand to substantiate purchases.

Annual Contribution Limits  Minimum $100  Maximum $2,500 As a result of health care reform, the amount you can contribute to your health care FSA remains at $2,500. This does not affect the dependent day care account as those limits will remain the same.

With the introduction of the debit card, please remember to retain your receipts as you may be required to provide them.

Over-the-counter Items All medications – even over-the-counter (OTC) items — require a prescription from a licensed physician in order to be reimbursed from your FSA. It is still necessary to retain a copy of your physician’s prescription as you may be required to provide it. This does not apply to reimbursements for the cost of insulin, which continues to be permitted for reimbursement even if purchased without a prescription.

To view a list of OTC medications that do or do not require a physician-prescription visit or health care contribution limit, visit SHDR.com. If you have additional questions, contact our FSA administrator at 1-800-768-4873 or 1-800-930-2441.

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Dependent Day Care Reimbursement Plan Annual Contribution Limits  Minimum $100  Maximum $5,000

This plan allows you to use pre-tax dollars to reimburse eligible expenses for dependent day care that enables you (and your spouse, if married) to work. Eligible expenses include day care or after-school care expenses for a child under age 13 or care for a spouse or a qualified adult dependent incapable of self-care. The debit card cannot be used for reimbursement of dependent day care expenses.

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Educational Assistance and Opportunities

$ Lexington Medical Center is committed to the professional and personal development of our employees by offering educational assistance to help employees achieve their goals.

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Tuition Reimbursement

With director pre-approval, employees who work 24 hours or more per week and have at least one year of continuous service may be eligible for tuition reimbursement.

Tuition reimbursement is awarded based upon an employee’s work status while enrolled in the course(s). Full-time employees are eligible to receive 100% reimbursement and part-time employees (20–31 hours) are eligible to receive 60% reimbursement.

Generally, to be eligible for reimbursement, classes must be related to an employee’s current job.

Employees may receive up to a $7,500 lifetime reimbursement amount.

For more information, a copy of the policy and the application, please visit LexLoop or contact Human Resources.

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BSN/MSN Scholarship Program

Employees in good standing who have at least one year of service and who work a minimum of 24 hours per week may be eligible to receive a BSN/MSN scholarship.

This program is designed to increase the number and quality of individuals trained in the nursing field by awarding deserving employees with financial support to further their education.

An employee desiring to study under the provisions of this program must demonstrate acceptance into a nationally accredited RN to BSN or MSN program and submit a BSN/MSN Scholarship Application prior to beginning classes.

Additional Assistance  Scholarship opportunities

for employees pursuing nursing degrees are available through the LMC Foundation.  LMC offers stipends

to qualified individuals pursuing a career as a certified registered nurse anesthetist (CRNA).  LMC has an on-site Med

Tech program through our Clinical Laboratory. To be eligible for this program, employees must hold a bachelor's degree in biology, chemistry, etc.

Detailed instructions and application forms can be found on LexLoop.

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Other Valuable LMC Resources & Benefits Health Directions Lexington Medical Center’s health and wellness center offers a Wellness Path for every body.  PATH screenings All employees, employee spouses, chaplains and volunteers are eligible for a free and confidential annual health screening during their birthday month. Participants receive a comprehensive lab assessment, valued at $300 and accepted by LMC physicians, that includes lipid (cholesterol) profile, fasting blood sugar, complete blood cell count and thyroid stimulating hormone. You can also choose to participate in the complete screening that measures your body composition and blood pressure. Appointments can be scheduled online or by calling (803) 936-7126.

 Membership and Reimbursement Plan LMC employees and family members receive discounted memberships at Health Directions full-service wellness facility that features cardio and weight equipment as well as a wide variety of group fitness classes and personal training. If you visit the Wellness Center at least 10 times per month for 12 consecutive months, Health Directions will reimburse an employee’s membership fees (up to $375).

 Weight Watchers® At Work and Reimbursement Plan

Q uit for Life Lexington Medical Center has partnered with BlueCross BlueShield of South Carolina to offer the free Quit for Life tobacco cessation program to our employees. Components include a Quit Coach, one-onone phone-based sessions, recommendations for Nicotine Replacement Therapy (NRT), a Quit Kit of materials and access to online resources. To enroll, call 1-866-784-8454.

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The traditional Weight Watchers program is offered with the convenience of meeting at LMC. Sessions last for 10 weeks and cost $98 (payroll deduction available). Registration is required.

To be added to the waiting list for upcoming sessions, contact abcastles@lexhealth.org.

Employees who participate in Weight Watchers At Work and attend 8 out of 10 meetings are eligible for a one-time reimbursement of 50% of the program fees. *As a wellness benefit, this reimbursement is subject to tax.

 Mammograms All employees, chaplains and volunteers are eligible for a free yearly mammogram during their birthday month beginning at age 40. Younger employees with a strong family history of breast cancer that includes their mother or sister may start their screenings 10 years earlier than the age the family member was diagnosed. To schedule an appointment, call Women’s Imaging Center at (803) 791-2486. You must present your employee ID badge at your appointment.

For more information on Health Directions’ programs, visit lmcWellnessPath.com.

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Other Valuable LMC Resources & Benefits Employee Health Clinic Lexington Medical Center’s Employee Health Clinic plays a central role in the health and well-being of our employees across the Lexington County Health Services District.

Available Services  Pre-placement health

assessments of candidates and volunteers to ensure proper job placement  TB screening and annual

assessments for those infected with latent TB (previously positive reactors)  Annual TB screening for those

in identified core groups  Health assessments  Immunization for specific

disease protection  Substance abuse screening  Sick visits  Medical clearance, training

and fit testing for employees in the LMC Respiratory Protection Program

 Screenings for employees

returning to work from a nonwork related illness/injury  Medical management for

employees exposed to blood and body fluids or other communicable diseases  Screening of employees with

communicable diseases and determines work restrictions as needed  Medical management for

work-related injuries and illnesses  Assistance with

accommodation issues associated with work or nonwork related illnesses and injuries to ensure safe job placement

 Employee referrals to the

Employee Assistance Program  Assistance with contact

information regarding Americans with Disabilities Act, short-term disability and Family and Medical Leave Act  Workers’ Compensation

claims management services  Employee Safety Services

including accident investigation, respiratory protection, environmental health, ergonomics assistance, workplace hazards assessments, etc.

The Employee Health Clinic is open Monday – Friday from 7:30 a.m. to 4:00 p.m.

For more information, please call (803) 791-2199.

 Voluntary screening for

bloodborne diseases

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Child Development Center

Lexington Medical Center offers a unique benefit exclusively to employees through our on-site Child Development Center.

The goal is to provide quality care and educational opportunities in a safe and loving environment.

The Child Development Center staff strive to partner with families as they meet the needs of parents and their careers. You are encouraged to come by and visit. If you have any questions, call (803) 791-2339.

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Other Valuable LMC Resources & Benefits Employee Assistance Program Through First Sun EAP, Lexington Medical Center offers employees and their families a program to help deal with professional and personal challenges as well as improve their emotional well-being.

Counseling, education and support are available on a variety of topics including stress management, workplace concerns, substance abuse, financial matters and parenting. Legal services are also available through this program. For more information, visit FirstSunEAP.com or call (800) 968-8143.

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Emergency Care Fund

The LMC Foundation established the Emergency Care Fund with donations from hospital employees as a way to help those who experience a catastrophic event: • House fire/natural disaster (e.g., flood, hurricane, tornado) • Domestic violence • Unaffordable Funeral Travel Expenses – in accordance with the Bereavement Policy for covered individuals (e.g.: airline ticket to another state to attend parent's funeral) • Medical/Prescription for a life-threatening ilness for legal dependents, spouses and children.

To apply for assistance or for more information, visit LexLoop.

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Employee Discounts

LMC has partnered with local businesses to offer a multitude of discounts and special offers. From automobile repairs and beauty salons to recreation and tax preparation, LMC employees have access to discounted prices by presenting their employee ID badge. For a complete listing of participating businesses, visit LexMedEmployeeDiscounts.com.

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SouthCarolinaBlues.com BlueCross BlueShield of South Carolina is pleased to announce the official relaunch of SouthCarolinaBlues.com.

The new look and enhanced functionality of its website offers members an engaging online destination with fast and easy access to popular information and resources.

Exciting Enhancements:  Fast access to popular tools. Quick links to My Health Toolkit, Shop for Insurance and Find a Doctor or Hospital are prominently displayed on the home page.

Members no longer have to search for their favorite applications or they may discover a tool they’ve been missing.

 Understanding reform. Review extensive information on health care reform in easy to understand language. Members can learn about each of the changes taking place under reform and what it might mean to them.

 Connect. Using social media links, members can quickly connect and stay updated by following BlueCross on Facebook, LinkedIn, Twitter and YouTube.

 Live Healthy. A new wellness section provides a rotating list of tips, challenges and recipes for maintaining a healthy lifestyle. It also provides a monthly health spotlight to increase awareness and prevention of common conditions and diseases.

 Blue Gives Back. BlueCross is more than just a health insurance provider; they are an active part of the community. A new section shares the different ways that they promote health, support non-profits and give back.

 Blue Retail. Members now have a direct link to the home page for BLUE Retail Centers. Here they can learn about location openings, schedule an appointment online, or view the calendar of upcoming events.

 Improved Technology. The new site is optimized for viewing on tablets and mobile devices. In addition, it is accessible for people with disabilities.

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The Future You can expect the site to evolve as BlueCross gathers feedback and builds new features.

Their goal is to consistently enhance the member experience.

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Benefits from The Hartford Your life insurance coverage comes with value-added services to help with challenges that come before and after a claim.  Funeral Planning and Concierge Services A suite of online tools guides you through key decisions before a loss, including help comparing funeral-related costs. After a loss, this service includes family advocacy and professional negotiation of funeral prices with local providers—often resulting in significant financial savings.

Call 1-866-854-5429 or visit EverestFuneral.com/Hartford (code: HFEVLC).

 EstateGuidance® Will Services Protect your family’s future by creating a will online—backed by online support from licensed attorneys. Your will is customized and legally binding. Visit EstateGuidance.com/Wills (code: WILLHLF).

 Beneficiary Assist® Counseling Services Compassionate expertise helps you or your beneficiaries (those you name in your policy) cope with emotional, financial and legal issues that arise after a loss. Services include unlimited phone contact with a counselor, attorney or financial planner for up to a year and five face-to-face sessions. Call 1-800-411-7239.

 Travel Assistance Services with ID Theft Protection Pre-trip information helps you feel more secure while traveling. It can also help you access medical assistance when traveling 100+ miles away from home for 90 days or less. ID theft services are available to you and your family at home and when you travel.

For more information on Travel Assistance Services or ID Theft Services, call 1-800-243-6108 or 1-202-828-5885 (collect from other locations). Send emails to idtheft@europassistance-usa.com.

Provide your employer’s name, a phone number where you can be reached, nature of the problem, Travel Assistance Identification Number (GLD-09012), and your company policy number (398395), which can be obtained through Human Resources. If you have a serious medical emergency, please seek emergency medical services first, and then contact Europ Assistance USA for follow-up.

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Glossary of Terms Allowed Amount: Maximum amount on which payment is based for covered health care services. This may be called “eligible expense,” “payment allowance” or “negotiated rate.” If your provider charges more than the allowed amount, you may have to pay the difference. (See Balance Billing.)

Annuity: A guaranteed fixed monthly retirement benefit paid until death.

Arrears: Unpaid or late payments for benefit premiums that should have been deducted from an employee’s paycheck.

Balance Billing: When a provider bills you for the difference between the provider’s charge and the allowed amount. Ex: if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services.

Beneficiary: The person named (as in an insurance policy) to receive proceeds or benefits.

Coinsurance: Your share of the costs of a covered health care service, calculated as a percent of the allowed amount for the service (Ex: 20%). You pay co-insurance plus any deductibles you owe.

Ex: if the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your co-insurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.

Co-payment: A fixed amount (Ex: $15) that you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service.

Defined Benefit Plan: Provides participants a guaranteed fixed benefit amount at retirement that generally depends on a calculation including factors such as salary and years of service.

Defined Contribution Plan: Provides participants a benefit payout at retirement, the actual amount depends on your contributions as well as the gains or losses of the account.

Deductible: The amount you owe for health care services covered by your health insurance plan before the health insurance plan begins to pay. Ex: if your deductible is $1,000, your plan won’t pay anything until you’ve met your $1,000 deductible for covered health care services subject to the deductible. The deductible may not apply to all services.

Dependent Coverage: Health insurance coverage that is extended to a spouse and/or child(ren) of the primary insured member. Certain age restrictions on the coverage of children may apply.

Excluded Services: Health care services that your health insurance plan doesn’t pay for or cover.

Medically Necessary: Health care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine.

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Glossary of Terms (Continued) Network: The facilities, providers and suppliers your health insurance plan has contracted to provide health care services.

Out-of-Pocket Maximum: The most you pay during a plan year before your health insurance plan begins to pay 100% of the allowed amount. This limit never includes your premium, balance-billed charges or health care services not covered by your health insurance or plan. Some health insurance plans don’t count all of your co-payments, deductibles, coinsurance payments, out-of-network payments or other expenses toward this limit.

Plan Year: The period from January 1 through December 31 in which all deductibles and benefit maximums accumulate.

Preauthorization: A decision by your health insurance plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes it is called prior authorization, prior approval or precertification. Your health insurance plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance plan will cover the cost.

Premium: The amount that must be paid for your health insurance plan. You and/or your employer usually pay it monthly, quarterly or yearly.

UCR (Usual, Customary and Reasonable): The amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. The UCR amount sometimes is used to determine the allowed amount.

Vested: If you participate in an employer pension plan or participate in an employer-sponsored retirement plan, such as a 401(k), you become fully vested — or entitled to the contributions your employer has made to the plan, including matching contributions — after a certain period of service with the employer. You are always vested in the contributions you make to a pension plan or retirement plan through salary reduction or after-tax payments.

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Important Contact Information Medical  P PO 500 and PPO 750

BlueCross/BlueShield of SC 1-800-760-9290 SouthCarolinaBlues.com

H MO – BlueChoice 1-800-821-3023 BlueChoiceSC.com

Prescriptions  C areMark 1-888-963-7290 CareMark.com

Dental

B lueCrossBlue/Shield of SC 1-800-222-7156 SouthCarolinaBlues.com

Life Insurance and AD&D (Basic/Supplemental/Dependent)  The Hartford 1-800-523-2233 HartfordLife.com

South Carolina Retirement System

401(k) and 457 Plans

 Great West 1-800-695-4952 SouthCarolinaDCP.com

Flexible Spending Accounts (Health Care/Dependent Care)  Stanley Hunt Dupree & Rhine

1-800-930-2441 or 1-800-768-4873 shdr.com

Short-Term Disability/ Long-Term Disability and FMLA  The Hartford 1-877-822-3183 TheHartfordAtWork.com

Employee Assistance Program  First Sun EAP 1-800-968-8143 FirstSunEAP.com

COBRA  Ceridian COBRA Services 1-800-877-7994 Ceridian-Benefits.com

(803) 737-6800 Retirement.SC.gov

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checklist Have you read this Benefits Guide? id you provide your dependents’ social security D numbers?

Have you completed your Benefits Election Form?

Have you assigned your beneficiaries?

Have you signed your Benefits Election Form? ave you reviewed your Benefits Election Form H for accuracy? ave you returned your completed Benefits H Election Form to Human Resources?

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Congratulations!

If you answered “yes” to these questions, you have successfully completed the Lexington Medical Center benefits enrollment process.

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LexMed.com