KCHC | Benefit

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IS OUR PRIORITY YOUR HEALTH

OUR MISSION

At Kinston Community Health Center, 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 December. Elections you make during open enrollment will remain in effect throughout the plan year, from January 1st through December 31st of the following year, with the exception of qualified life status changes To be eligible, employee's must be full-time and have been with the company at least (insert probationary period) . Please find the enclosed benefit offerings and take some time to review.

What we offer

FLATLANDS JESSUP INSURANCE GROUP

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 Melissa Calhoun on any of the following.

WHEN ITS TIME TO ENROLL

Employee Benefit Offerings Contact Info For Flatlands Jessup : +252-527-6100 Kristy@FlatlandsJessup.com www.FlatlandsJessup.com
NEED HELP FILING
NEW ID CARDS
**This booklet is for informational purposes only. It does not amend, extend, or alter the current policy in any way. In the event the information in this booklet differs from the Plan Document, the Plan Document will prevail. Health Dental Group Life Insurance Vision Group Disability Supplemental Benefits
A CLAIM
QUESTIONS OR CONCERNS

HOW TO ENROLL AND REVIEW YOUR BENEFITS

Kinston Community Health Center utilizes an Online Benefits Administration System called Employee Navigator.

All full-time eligible employees will be provide with a unique and personalized login to access all benefits, rates, and plan summaries.

This does NOT take the place of our personalized service. We also have a dedicated agent through Flatlands Jessup Insurance Group that can assist you in making the best plan decision for your health and budget.

FLATLANDS JESSUP INSURANCE GROUP

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 Kristy Harrell on any of the following.

WHEN ITS TIME TO ENROLL NEED HELP FILING A CLAIM

NEW ID CARDS

QUESTIONS OR CONCERNS

Contact Info For Flatlands Jessup : +252-527-6100

Kristy@FlatlandsJessup.com 2120 N Queen St, Kinston www.FlatlandsJessup.com

This booklet is for informational purposes only. It does not amend, extend, or alter the current policy in any way. In the event the information in this booklet differs from the Plan Document, the Plan Document will prevail.

Health Insurance

BlueCrossBlueShieldofNC

Bi-Weekly Cost

As a full-time employee with Kinston Community Health Center, 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 biweekly costs for coverage,

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 your in-network PCP to waive your first three (3) copays

Bi-Weekly Deduction Employee Only

PleasevisityourBCBSSummaryofBenefitsfor additionalplaninformationandoutofnetworkbenefits

Ifyouhaveadditionalquestions,pleasefeelfreetocall KristyHarrellat252-527-6100

Employee + Spouse = $x xx Employee + Children = $x.xx Family = $x xx Base Plan $x.xx
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 Prescription Tier: Tier 1/2/3/4 Tier 5 Tier 6 Prescription Deductible (insert summary of benefits) Prescription Cost

Health Insurance

AdditionalBenefitInformation

Have you heard of the Amazon Mail-Order Pharmacy?

BCBS of NC is now offering access to Amazon Pharmacy, which lets you easily order and quickly get non-specialty medicines delivered at home. Plus, you'll get access to MedsYourWay prescription drug discount card pricing, which give yous up to 80% savings on brand and generic medicines. For additonal information and plan details, please refer to www Amazon com/BlueCrossNC

Start Saving Today

Sign up and learn more at www.Amazon.com/BlueCrossNC. Then click on the "Get Started" link or scan the QR code on your smartphone.

For questions, call Amazon Pharmacy Customer Care at 855-9634546.

TeleHealth

Your Blue Cross and Blue Shield of North Carolina health plan includes telehealth services from Teledoc It's affordable, convenient, with low wait times!

AnHRAisanemployer-fundedaccountthat reimbursesemployeesbasedonafixed allowanceforout-of-pocketexpenses.Itisan addedbonustoeaseemployeeexpenses.

Onceyouhavemet$x,xxxofthe$x,xxxdeductible,KCHCwill reimbursemedicalexpensesinreal-timefortheremaining $x,xxx

Thisreducesyourdeductibleto$x,xxxandyourmaximumout ofpocketcostto$x,xxx

ThiswillNOTreflectonyourIDcardfromBlueCrossNC

+An FSA is an account that allows you to set aside a portion of your income each year on a pre-tax basis - so you can pay for qualified health care expenses with taxfree dollars. Because the money you contribute is deducted from your paycheck before taxes and the withdrawals are tax-free, your FSA can mean significant savings.

+Examples of IRS Qualified Medical Expenses:

Doctors visits

Deductibles and Coinsurance

Prescriptions

Dental and orthodontic care

Hearing aids

Eyeglasses, contact lenses, laser eye surgery

-And more

+Dependent Care Reimbursement Accounts (DCRA)

A DCRA is a great way to pay for dependent care with tax-free dollars

Pay dependent care costs out-of-pocket

Submit expenses for a DCRA reimbursement

Eligible expenses:

Daycare/preschool centers

Before- and after-school or extended day prgrams

Summer/track-out day camps

Nanny/babysitter inside or outside household

-And more

**Requires enrollment in the Medical plan.

NOTE: Unused FSA funds do NOT rollover unlike HSA funds. This is a "use it or lose it" benefit. Please take careful consideration when choosing to enroll.

F t

Dental Insurance

What'savailabletome?

Dentalinsurancehelpspayforall,oraportion,ofthecostsassociatedwithdentalcare,fromroutine cleaningstorootcanals.OurdentalinsuranceisthroughPrincipalandyoumayelecttopurchase coverageifyou'reanactive,full-timeemployee.

Plan Highlights:

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 (insert carrier) network your cost may be lower

To find a dentist within the (insert carrier) Plan Dental network, visit (insert website) or call (insert phone number)

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

DentalInsurance $x.xx Employee Only Cost Monthly Employee + Spouse $x.xx Employee + Child/Children $x xx Family Premium $x.xx
Keepyoursmilesweet
Annual Maximum Major
Coinsurance Preventive
Basic
Coinsurance
$x,xxx
Care $xx/$xxx (Ind/Fam) Deductible with 50%
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.
Care $xx/$xxx (Ind/Fam) Deductible with 80%

Vision Insurance

What'savailabletome?

OurVisioninsuranceisofferedthrough(insertcarrier)andyoumayelecttopurchase coverageifyou'reanactive,full-timeemployee.Thisplanprovideschoice,flexibilityand savingsthroughaninnetworkdoctor.Ifyouelectthiscoverage,anestablishednetworkof VSPdoctorswillprovidequalitycareforyouandyourdependents.

Plan Highlights:

Every xx months, one exam is covered in full after a $xx copay.

Prescription glasses: 1 pair of lenses are covered every xx months with a $xx copay.

Frames: covered up to $xxx every xx months; xx% off amount over the allowance.

Lens enhancements: Standard progressive lenses covered once every xx months with $0 copay.

Elective contacts: Covered up to $xxx every xx months with a $xx copay that includes fitting and evaluation.

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

Things to Remember:

How do I find a doctor?

Visit (insert carrier website)

Additional savings (insert additional information

If you need additional information (insert carrier phone number)

VisionInsurance $x.xx Employee Only Cost Bi-Weekly Employee + Spouse $x.xx Employee + Child/Children $x xx Family Premium $x.xx
Seewhatyoucansave

Life Insurance

KinstonCommunityHealthCenterprovides$xx,xxxbasictermlifeinsurancebenefitto allactivefull-timeemployeesatnocosttoyou.Thisofferingprotectswhatmeansthe most,thepeopleyoulove.Ifsomethingweretohappentoyou,yourlifeinsurance proceedswouldgotothepeopleyou'vedesignatedasyourbeneficiaries.

*Benefitsreducedbyage:35%atage65to50%atage70

For additional information and plan details, please visit the Summary of

Benefits.
Informationneededforbeneficiaryelection: FirstandLastname SocialSecurityNumber Birthdate Relationshiptoyou Youcanelectmultiple
beneficiaries.Totalsmust equal100%. **Benefitvariesbyclassandarereducedbyage:35%atage65to50%atage70.

Disability Insurance for Income Replacement

Short-Term Disability

KinstonCommunityHealthCenterprovidesshort-termdisabilityandisusedasanincome replacementbenefitthatprovidesapercentageoftheirearningsonaweeklybasiswhenthe employeeisofoutofworkonadisabilityclaim.Onceenrolled,employeesareeligibleto receive60%oftheirweeklywagesuptoamaximumof$x,xxperweekiftheybecomesickor disabledandwillstartonthexthdayandareeligibletoreceiveitsbenefitsuptoxxweeks.

Themostcommonreasonsforashort-termdisabilityclaimare:

Long-Term Disability

The Best For Your Family

Long-termdisabilityisusedtoextendincomereplacementatpercentageoftheirearningson amonthlybasiswhentheemployeeisofoutofworkonadisabilityclaim.Onceenrolled, employeesareeligibletoreceive60%oftheirwagesuptoamaximumof$x,xxxpermonthif theybecomesickordisabledandwillstartonthexxthday.

the Carrier Summary of Benefits Carrier Contact Info:
For additional information and plan details, please visit
Accidents Injuries Illnesses Pregnancy/maternityleave

(Insert Carrier)

Kinston Community Health Center offers each full time employee the opportunity to enroll in Supplemental Benefits through (insert carrier). These benefits are paid for by the employee.

These benefits offer cash reimbursements based on certain medical events such as Accident, Hospital stays, and Critical Illness Diagnoses.

Supplemental Options are listed below:

Options Include:

and

Things to Remember:

Some Options include a Health Screening benefit which is free money to claim for receivng certain annual screenings

Claim Forms are available in your Employee Navigator portal.

SupplementyouBenefits& ProtectyourIncome Hospital Indemnity Insurance Accident Insurance
Summary
Benefits.
For additional information
plan details, please visit the
of
Illness Insurance
Critical
This booklet is for informational purposes only. It does not amend, extend, or alter the current policy in any way. In the event the information in this booklet differs from the Plan Document, the Plan Document will prevail.

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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