IS OUR PRIORITY
At BFCB Restaurants we are proud of our accomplishments and especially proud of our people. As a valued employee, your health and the health of your family are important to us. Each year, we hold an open enrollment in June. Elections you make during open enrollment will remain in effect throughout the plan year, from July 1st, 2024 through June 30th, 2025, with the exception of qualified life status changes. To be eligible, employee's must be full-time and have been with the company for 90 days. Please find the enclosed benefit offerings and take some time to review.
Medical coverage is offered through BlueCross BlueShield of North Carolina and you have two plan options to pick from
Our benefit offerings are managed by Flatlands Jessup and they are here to serve you throughout the year if you have any questions at all Please reach out to Joni Faulkner on any of the following.
Faulkner +252-275-8082 Joni@FlatlandsJessup com 1420 E. Arlington Blvd. Suite A Greenville, NC 27858
Morgan +252-275-8082 Rem@FlatlandsJessup com 1420 E. Arlington Blvd. Suite A Greenville, NC 27858
OUR MISSION What we offer Health Insurance Dental Insurance
Employee Benefit Offerings Contact Info For Flatlands Jessup:
YOUR HEALTH
WHEN ITS
ENROLL NEED HELP FILING
NEW ID CARDS QUESTIONS OR
TIME TO
A CLAIM
CONCERNS
Vision Insurance
Joni
Rem
Dental coverage is offered through Principal
50% of the employee’s premium is paid for by BFCB. Vision coverage is offered
Principal
50%
employee’s premium
paid
by BFCB.
and
through
and
of the
is
for
Health Insurance Base Plan
BlueCrossBlueShieldofNC
All full-time employees at BFCB Restaurants, are offered health insurance through BCBS of NC. 50% of the employee only premium is paid for by BFCB on the base plan and you have the option to chose the Buy Up plan and cover the difference The plans cost and coverage highlights can be found below
Buy Up Plan
$47.99
BlueConnectNC.com is your go-to source for information about your health plan Look up in-network doctors, get cost estimates, check claims, progress towards deductibles and more
Preventive Care Both plans cover a broad range of preventive services at no charge to you when using an in-network provider.
Who's In-Network? In-network providers save you money, so be sure to find doctors, specialists, urgent care facilities and hospitals that are in your plan's network For more info, visit the website: BlueCrossNC com/Search Doctors
How Drug Benefits Work. Getting prescription drugs is simple Learn how a standard plan works for pharmacy and prescription drug coverage at: BlueCrossNC com/RxBenefits
Primary Care Provider. You can visit your PCP for most medical procedures and services and when you do, you could save money Once your plan is active, log in to BlueConnectNC com and choose the innetwork PCP you want and your first 3 visit copays are waived
$35
BlueCross BlueShield Contact Info: Individual Deductible Individual Out-of-Pocket Max Family Deductible Family Out-of-Pocket Max Preventive Care Primary Care Specialist Urgent Care Emergency Room Virtual Visits (Teladoc) Hospital In/Out Patient In-Network Drugs Tier 1 / 2 Tier 3 / 4 Tier 5 $2,500 $9,100 $5,000 $18,200 0% no deductible $30 Copay $150 Copay $150 Copay $1,750 Copay $10 40% after deductible 0%, no deductible $15
$35 $45 / $90 25% or $90 min, up to $200 max $6,000 $9,100 $12,000 $18,200 0% no deductible $95 Copay 60% after deductible 60% after deductible 60% after deductible $10 40%/60% after deductible 0%, no deductible $15/
$45
25% or $90 min, up to $200 max
/
/ $90
Weekly
Employee
The BCBS Summary of Benefits offers comprehensive detail about each plans benefits. 1 877 258 3334 www.BlueCrossNC.com or login to BlueConnectNC.com. PO Box 35, Durham, NC 27702
Cost
Only
Weekly
Employee Only
Cost
Employee + Spouse = $143.98 Employee + Children = $129.58 Family = $249.56 Employee + Spouse = $171.45 Employee + Children = $154 99 Family = $292.14 $61.73
Dental Insurance
What's available to me?
Dental insurance helps pay for all, or a portion, of the costs associated with dental care, from routine cleanings to root canals. Our dental insurance is through Principal and you may elect to purchase coverage if you're an active, full-time employee. Employer pays for 50% of the Employee only Premium.
Getting Started
1. Select Create an Account 2. Enter Personal Information like date of birth and ID number.
Go to Principal.com and select log in. Or download the Principal app.
3. Create a Username and Password, and provide an email address.
5.
4. You will receive an email within a few minutes to confirm your account is ready to go. You can access your account information anytime, 24/7, with the username and password you’ve just set.
With access to your online portal you can view benefits, eligibility and claims. Search in network or out of network providers. View and print your Dental ID card.
Plan Highlights:
$1,000 Annual Maximum
Preventive Care is covered 100%
Routine exams and cleanings are covered twice per year. Bitewing X-rays are covered once per calendar year. Full mouth X-rays are covered every 60 months.
Basic Care
$50 Deductible with 80% Coinsurance
Major Care
$50 Deductible with 50% Coinsurance
For additional information and plan details, please visit the Principal Summary of
Things to Remember:
Our deductibles and the annual maximum operate on a calendar year and reset January 1st of every year. When you select a dentist within the Principal dental network, your cost may be lower.
To find a dentist within the Principal Plan Dental network, visit Principal.com/dentist or call 1-800-247-4695.
DentalInsurance $3.78 Weekly Cost Employee + Spouse = $12 31 Employee + Child/Children = $15.73 Family Premium = $25.71 BFCB Restaurants pays 50% of the Employee Only Premium
Principal Contact Info: 1.800.247.4695 www.principal.com PO Box 10357, Des Moines, IA 50306
Benefits
Our Vision insurance is offered through Principal and you may elect to purchase coverage if you're an active, full-time employee. This plan provides choice, flexibility and savings through a VSP doctor. If you elect this coverage, an established network of VSP doctors will provide quality care for you and your dependents. Employer pays for 50% of the Employee only Premium.
Getting Started
1. Select Create an Account 2. Enter Personal Information like date of birth and ID number.
Go to Principal.com and select log in. Or download the Principal app.
3. Create a Username and Password, and provide an email address.
5.
4. You will receive an email within a few minutes to confirm your account is ready to go. You can access your account information anytime, 24/7, with the username and password you’ve just set.
With access to your online portal you can view benefits, eligibility and claims. Search in network or out of network providers. View and print your Vision ID card.
Plan Highlights:
Every 12 months, one exam is covered in full after a $10 copay
Prescription glasses or Necessary Contacts: 1 pair of lenses or contacts are covered every 12 months with a $25 copay.
Frames: $150 allowance for a wide selection of frames; 20% off amount over allowance 1 per 24 months
Elective contacts: Covered up to $150 every 12 months. Contact lenses can be chosen instead of glasses.
Member pays up to $60 for contact lense fitting and follow up exams
For additional information and plan details, please visit the Principal Summary of Benefits
Things to Remember:
How do I find a VSP doctor? Visit VSP.com and select "Choice" to locate VSP doctors close to you or to see if your current eye care professional is in the VSP Network
Additional savings with VSP: You can save an average of 20% off glasses or sunglasses from any VSP doctor within 12 months of your last covered exam.
If you need additional information regarding the VSP network, please call 1.800.877.7195.
VisionInsurance Whatsavailabletome? $0.83 Weekly Cost Employee + Spouse $2.37 Employee + Child/Children $2 59 Family Premium $4 48 Vision Insurance
BFCB Restaurants Pays 50% of the Employee Only Premium
Principal Contact Info: 1.800.247.4695 www.principal.com PO Box 10357, Des Moines, IA 50306
https://benefitsflj.com/bfcb/ EMPLOYEE BENEFITS MANAGED BY TO VIEW YOUR
Glossary of Health Coverage & Medical Terms
AllowedAmount-Maximumamountonwhichpaymentisbasedforcoveredhealthcareservices Thismaybecalled“eligible expense, ”paymentallowanceor“negotiatedrate”Ifyourproviderchargesmorethantheallowedamount,youmayhavetopay thedifference (SeeBalanceBilling)
Appeal-Arequestforyourhealthinsurerorplantoreviewadecisionoragrievanceagain
BalanceBilling-Whenaproviderbillsyouforthedifferencebetweentheprovider’schargesandtheallowedamount For example,iftheprovider’schargeis$100andtheallowedamountis$70,theprovidermaybillyoufortheremaining$30 A preferredprovidermaynotbalancebillyouforcoveredservices
Co-insurance-Yourshareofthecostsofacoveredhealthcareservice,calculatedasapercent(forexample,20%)ofthe allowedamountfortheservice Youpayco-insuranceplusanydeductiblesyouowe Forexample,ifthehealthinsuranceor plan’sallowedamountforanofficevisitis$100andyou’vemetyourdeductible,yourco-insurancepaymentof20%wouldbe $20 Thehealthinsuranceorplanpaystherestoftheallowedamount
Co-payment-Afixedamount(forexample,$15)youpayforacoveredhealthcareservice,usuallywhenyoureceivetheservice Theamountcanvarybythetypeofcoveredhealthcareservice
Deductible-Theamountyouoweforhealthcareservicesbeforeyourhealthinsuranceorplanbeginstopay Forexample,if yourdeductibleis$1,000,yourplanwon’tpayanythinguntilyou’vemetyour$1,000deductibleforcoveredhealthcareservices subjecttodeductible Thedeductiblemaynotapplytoallservices
EmergencyMedicalCondition-Anillness,injury,symptomorconditionsoseriousthatareasonablepersonwouldseekcare rightawaytoavoidsevereharm
EmergencyRoomCare-Emergencyservicesyougetinanemergencyroom
HealthInsuranceAcontractthatrequiresyourhealthinsurertopaysomeorallofyourhealthcarecostsinexchangefora premium
Hospitalization-Careinahospitalthatrequiresadmissionasaninpatientandusuallyrequiresanovernightstay Anovernight stayforobservationcouldbeanoutpatientcare
In-networkCo-insurance-Thepercent(forexample,20%)youpayoftheallowedamountforcoveredhealthcareservicesto providerswhocontractwithyourhealthinsuranceorplan In-networkco-insuranceusuallycostsyoulessthanout-of-network co-insurance
In-networkCo-payment-Afixedamount(forexample,$15)youpayforcoveredhealthcareservicestoproviderswhocontract withyourhealthinsuranceorplan In-networkco-paymentsusuallyarelessthanout-of-networkco-payments
Network-Thefacilities,providersandsuppliersyourhealthinsurerorplanhascontractedwithtoprovidehealthcareservices
Non-PreferredProvider-Aproviderwhodoesn’thaveacontractwithyourhealthinsurerorplantoprovideservicestoyou. You’llpaymoretoseeanon-preferredprovider Checkyourpolicytoseeifyoucangotoallproviderswhohavecontractedwith yourhealthinsuranceorplan,ofifyourhealthinsuranceorplanhasa“tiered”networkandyoumustpayextratoseesome providers
Out-of-networkCo-payment-Afixedamount(forexample,$30)youpayforcoveredhealthcareservicesfromproviderswho donotcontractwithyourhealthinsuranceorplan Out-of-networkco-paymentsusuallyaremorethanin-networkco-payments
Out-of-PocketLimit-Themostyoupayduringapolicyperiod(usuallyayear)beforeyourhealthinsuranceorplanbeginsto pay100%oftheallowedamount.Thislimitneverincludesyourpremium,balance-billedchargesorhealthcareyourhealth insuranceorplandoesn’tcover Somehealthinsuranceorplansdon’tcountallofyourco-payments,deductibles,co-insurance payments,out-of-networkpaymentsorotherexpensestowardsthislimit
PhysicianServices-Healthcareservicesalicensedmedicalphysicianprovidesorcoordinates
Pre-AuthorizationCertainproceduresorhospitalizationsmayrequirethattheproviderreceiveauthorizations Theprovideris typicallytheonetogothroughtheprocesswiththeinsurancecompanyandobtainpre-authorization
Pre-Determination-Ifyouarehavingamajorproceduredone,yourdoctorordentistcansubmitapre-determinationtothe insurancecompanysoyoucanknowinadvanceoftreatmenthowmuchofthebillyouwillberesponsiblefor