Wayne Hardee | Benefits

Page 1

YOUR HEALTH

IS OUR PRIORITY

OUR MISSION

At Hardee, Massey & Blodgett we are proud of our accomplishments and especially proud of our people. Your health and the health of your family are important to us. Each year, we hold an open enrollment in September. Elections you make during open enrollment will remain in effect throughout the plan year, from October 1st through September 30th, with the exception of qualified life status changes. You will be eligible to enroll in our benefits the first of the month, following 60 days of employment. Please find the enclosed benefit offerings and take some time to review.

What we offer Health

Medical coverage is offered through BlueCross BlueShield of NC and is paid for by the firm.

Dental and Vision

The firms dental and vision coverage is through BlueCross BlueShield of NC and is a voluntary coverage

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. WHEN ITS TIME TO ENROLL NEED HELP FILING A CLAIM

Long-Term Disability

Life Insurance
Life Insurance Benefit is offered to
eligible employees Additional Voluntary Life is available up to 100k Employee Benefit Offerings Contact Info For Flatlands Jessup: Joni Faulkner +252-275-8082 Ext: 4007 Joni@FlatlandsJessup
Greenville,
A $50,000 Employer paid
all
com 1420 E Arlington Blvd Suite A
NC 27858
NEW
QUESTIONS
ID CARDS
OR CONCERNS
The firms disability policy is employer paid and offered to all full time eligible employees.

Health Insurance

BlueCrossBlueShieldofNC

Bi-Weekly Cost

As a full-time employee with Hardee, Massey & Blodgett, you are eligible to enroll in our group's health insurance through BCBS of NC. The plan's cost and coverage highlights can be found in the right column which lists your monthly costs for coverage. The firm pays 100% of the employee-only premium.

BlueConnectNC.com is your go-to source for information about your health plan Look up innetwork doctors, get cost estimates, check claims, progress towards deductibles and more

Preventive Care. This health plan covers 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/SearchDoctors

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 (PCP). 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 in-network PCP you want

Employee + Spouse = See Age Banded Chart attached.

Employee + Children = See Age Banded Chart attached

Family = See Age Banded Chart attached.

Ifyouhaveadditionalquestions,pleasefeelfreetocall JoniFaulkner252-275-8082Ext 4007

PleasevisityourBCBSSummaryofBenefitsfor additionalplaninformationandoutofnetworkbenefits
Your Plan $0.00 Employee Only To find an In-Network provider visit www.BlueCrossNC.com/find-adoctor-or-facility or call 877.258.3334 for a list of participating providers. BlueCross BlueShield Contact Info: 1 877 258 3334 www BlueCrossNC com or login to BlueConnectNC com PO Box 35, Durham, NC 27702
Deductible Out-of-Pocket Max Co-Insurance Telahealth Co-Pay Primary Care Co-Pay Specialist/Urgent Care Co-Pay Emergency Room Co-Pay Urgent Care Co-Pay Prescription Tier: Tier 1/2/3/4 Tier 5 Tier 6 $1,500Ind / $3,000 Fam $5,750 Ind / $11,500 Fam 70% BCBS / 30% Ind $10 $35 $70 $500 $70 Prescription Cost $4/$15/$35/$50 25% Min $50 Max $100 50% Min $50 Max $200 Monthly

Allergies

Cough, Cold & Flu

Diarrhea

Ear problems Fever

Headaches Insect Bites

Sinus problems

Nausea & Vomiting

Sore throat

Urinary problems And more!

Teladocisanindependentcompanythatissolelyresponsibleforthetelehealthservicesitisproviding

orBlueShieldproductsorservices

Visit teladoc com and register an account Download the Teledoc mobile app
Addictions Anxiety
Depression Grief & Loss Relationship Issues And more! Behavioral Services Health Services
Telehealthservicesarenot
Teladocissubjecttostateregulations Teladocdoes
Teladocdoesnotguaranteepatientswillreceiveaprescription Healthcareprofessionalsusingthe
basedonprofessionaljudgment acaseisinappropriatefortelehealthorformisuseofservices
TeladocdoesnotofferBlueCross
Teladocinteractiveconsultationsareavailable24hoursaday,7daysaweek Telehealthservicesare subjecttothetermsandconditionsofthemembershealthplan includingbenefits limitationsandexclusions
asubstituteforemergencycare Teladocdoesnotreplaceyourprimarycaredoctorandisnotaninsuranceproduct
notprescribeDEA-controlledsubstancesandmaynotprescribenontherapeuticdrugsandcertainotherdrugswhichmaybeharmful becauseoftheirpotentialforabuse
platformhavetherighttodenycareif

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 BlueCross BlueShield of NC and you will be eligible to enroll, if you're an active, full-time employee.

Remember! Cleanings are covered at no charge twice per year, so make sure you get your appointments scheduled! To find an In-Network dentist, just follow these easy steps below.

Plan Highlights:

$1,500 Annual Maximum

Preventive Care is covered at 100%:

Routine oral exams, Cleanings, Bitewing X-rays, Emergency Palliative, Fluoride Application, Sealants, Space maintainers

Basic Care: Routine Filings, Oral Surgery (including simple extractions), Periodontal Maintenance, Endodontics.

$50 Individual Deductible then 20% Coinsurance

Major Care: Crowns, Inlays and Onlays, Dentures, Periodontics.

$50 Deductible then 50% Coinsurance

For additional information and plan details, please visit the BCBS of NC Summary of Benefits.

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 Dental Blue network, your cost may be lower.

To find a dentist within the Dental Blue network, visit www.BlueCrossNC.com/members/find-care or call 800.305.6638.

EmployeeOnly $40.85 Monthly Rate Employee + Spouse $81 70 Employee + Child/Children $95.55 Family Premium $141.22 Our Dental Insurance is a voluntary coverage
BlueCross BlueShield Contact Info: 1.877.258.3334 Billing & Membership 1.800.305.6638 Claims & Benefits www.BlueCrossNC.com or login to BlueConnectNC.com. PO Box 2100, Winston-Salem, NC 27102

What'savailabletome?

You have so many reasons to keep your eyes healthy. Ongoing vision care will help you maintain the best possible eye - and overall - health and well-being. Our vision insurance is through BlueCross BlueShield of NC and you will be eligible to enroll, if you're an active, fulltime employee. This plan provides choice, flexibility and savings through the EyeMed network.

In-Network Plan Highlights:

Every 12 months, one exam is covered in full after a $0 copay

Lenses or Contact Lenses: 1 pair of lenses are covered every 12 months with a $25 copay $150 allowance on contacts

Allowance amount is for materials only and does not include fittings for contact lenses or follow up services

Frames: covered up to $150 every 24 months

Medically required contact lenses* *subject to eligibility review $0 copay

For additional information and plan details, please visit the BCBS of NC Summary of Benefits.

Things to Remember:

To find an EyeMed provider visit: https://eyedoclocator eyemedvisioncare com /bcbsncind/en

Additional In-Network Discounts:

15% off conventional contact lenses (does not apply to disposable contact lenses). 20% off non prescription sunglasses. 20% off a partial pair of eyeglasses (frames or lenses only).

15% off, or 5% off the promo price of LASIK vision correction.

Retinal images discounted to $39

EmployeeOnly $8.28 Monthly Rate Employee + Spouse $15.73 Employee + Child/Children $16 56 Family Premium $24 34
Insurance Seewhatyoucansave
Vision
Our Vision Insurance is a voluntary coverage
BlueCross BlueShield Contact Info: 1.855.400.3641 Vision Customer Service www.BlueCrossNC.com or login to BlueConnectNC.com. PO Box 2100, Winston-Salem, NC 27102

Life Insurance

Hardee, Massey & Blodgett provides a $50,000 term life insurance benefit to all active full time employees at no cost to you. This offering protects what matters - you, your family and your future. If something were to happen to you, your life insurance proceeds would go to the people you've designated as your beneficiaries and helps pay funeral costs, manage debt and cover ongoing expenses. At the age of 65, the benefit is reduced to 65% and at the age of 70 it reduces to 50% of the benefit amount. Please be sure to fill out your beneficiary form.

Additional Voluntary Term Life Insurance

During open enrollment this year, you can elect up to $100,000 of additional life insurance without submitting any medical questions. Any amount over $100,000 requires Evidence of Insurability. You can elect up to $25,000 on your Spouse in increments of $5,000 and up to $5,000 on your children. The rates for the voluntary coverage are listed in The Hartford Summary of Benefits proposal and vary based upon the members age.

Frequently Asked Questions

What is Guarantee Issue?

The amount of insurance applied without answering any health questions (or which does not require evidence of insurability). Coverage amounts over the Guarantee Issue amount will require evidence of insurability.

The Best For Your Family

What is Evidence of Insurability?

Evidence of insurability or proof of good health - may be required if you are a late entrant and/or you request any additional coverage above your guarantee issue amount

Can I take this insurance with me if I change jobs/am no longer a member of this group?

In the event this insurance ends due to a change in your employment/membership status with the group, or for certain other reasons, you or your insured spouse may have the right to continue this insurance under the Potability or Conversion provision, subject to certain conditions

For additional information and plan details, please visit The Hartford Summary of Benefits. Also, please feel free to contact your Flatlands Jessup representative for assitance.

The Hartford Contact Info: 1.888.563.1124 GBClaimCSLife@TheHartford com

Long-Term Disability

Long-term disability insurance is offered to all full-time eligible employees and is paid for by the firm Our coverage is offered through Unum and it would provide a monthly benefit if you have a covered illness or injury and you can't work for a few months or even longer. There is a 90 day elimination period which applies to the number of days that must pass after a covered accident or illness before you can begin to receive its benefits. These benefits can last up to the Social Security normal retirement age. Your benefit is equivalent to 60% of your before tax monthly earnings, up to a maximum of $10,000 per month.

If you become disabled prior to age 62, benefits are payable to age 65, your Social Security Normal Retirement Age or 3.5 years, whichever is longest. At Age 62 (and older), the benefit period will be based on a reduced duration schedule.

How to File a Disability Claim

Filing Disability Claims can be done Online, App, Mail or by fax:

Online: You can file a claim online by registering for an online account via unum.com/claims or by downloading the Unum Customer App. The mobile app allow you to

Submit your claim or leave

Download claim forms

Upload documents-medical records, claim forms, authorization forms, etc

Access and make changes to your open claims

View updates and available correspondence

By Mail or Fax: You can file by paper and obtain a claim form by contacting your employer's human resource department, or downloading supplemental claim forms at unum com/claims Be sure to follow instructions that explain how to mail or fax your completed form

What information is required to complete my claim?

Employee Statement

Attending physician statement

Employer statement

Signed authorization form for release of ongoing medical information

The Best For Your Family For additional information and plan details, please visit the Unum Summary of Benefits Also, please feel free to contact your Flatlands Jessup representative Summary of Benefits Unum Disability Claims 1.800.877.5176
unum com/claims

GlossaryofHealthCoverageandMedicalTerms

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 Thehealthinsuranceorplanplaystherestoftheallowedamount

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

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