LaFevers | Benefits

YOUR HEALTH

IS OUR PRIORITY

OUR MISSION

At LaFevers Dental Team, 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 for benefits the 91st day 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 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 Kristy Harrell on any of the following.

This is a voluntary coverage and is offered through MetLife.

Vision Life Insurance

A $10,000 Employer paid Life Insurance Benefit is offered to all eligible employees.

Long-Term Disability

Employer Paid Long Term Disability is offered to all eligible employees

Accident, Term Life, & Critical Illness

Is offered through AllState and is a voluntary coverage.

WHEN ITS TIME TO ENROLL

NEED HELP FILING A CLAIM

NEW ID CARDS

QUESTIONS OR CONCERNS

Contact Info For Flatlands Jessup:

Kristy Harrell +252-527-6100

Kristy@FlatlandsJessup.com 2120 N. Queen Street Kinston, NC 28501

HOW TO ENROLL AND REVIEW YOUR BENEFITS

LaFevers 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

QUESTIONS OR CONCERNS

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

Health Insurance

Blue Cross Blue Shield of NC Plan Option 1: Silver Copay Plan

As a full-time employee with LaFevers Dental Team, you are eligible to enroll in one of our group's health insurance plans through BCBS of NC.

The SILVER COPAY plan's cost and coverage highlights can be found in the below which lists your bi-weekly costs for coverage which represents your portion of the employee premium.

LaFevers Dental Team contributes to each employee's premium based on longevity.

<10 Years of Service

Employee Only = $54.18

Employee + Spouse = $270.90

Employee + Child(ren) = $238.39

Employee + Family = $509.29

75% of Employee Only Premium 10+ Years of Service

100% of Employee Only Premium

Employee Only = $0.00

Employee + Spouse = $216.72

Employee + Child(ren) = $184.21

Employee + Family = $455.11

Health Insurance

Blue Cross Blue Shield of NC Plan Option 2: HSA Plan

As a full-time employee with LaFevers Dental Team, you are eligible to enroll in one of our group's health insurance plans through BCBS of NC.

The HSA (Health Savings Account) plan's cost and coverage highlights can be found in the below which lists your bi-weekly costs for coverage which represents your portion of the employee premium.

LaFevers Dental Team contributes to each employee's premium based on longevity.

Employee Only = $51.53

Employee + Spouse = $257.65

Employee + Child(ren) = $226.74

+ Family = $484.39

Employee Only = $0.00

Employee + Spouse = $206.12

Employee + Child(ren) = $175.20

Employee + Family = $432.86

Please visit your BCBS Summary of Benefits for additional plan information and out of network benefits.

If you have additional questions, please feel free to call

An HSA allows you to put money away for future healthcare costs while still saving on taxes. HSAs are never taxed federally when used for qualified medical expenses. Contributions can be automatically deducted straight out of your paycheck while your account balance grows Tax-Free.

It rolls over from year to year. Keep it until you need it

Create a healthcare emergency safety net

Invest in your HSA tax-free, like a 401(k)

1 All contributions are Tax Deductible

$1,660$830

Members that are 55+ can contribute an extra $1000

2 Earnings and interest invested grow Tax-Free Medical expense withdrawals are Tax-Free

Vision Insurance

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 a voluntary coverage you may elect to enroll in if you're an active, full-time employee. This plan provides choice, flexibility and savings through the VSP network.

Plan Highlights:

Plan Highlights:

Every 12 months, one exam is covered in full after a $10 copay.

Prescription glasses: 1 pair of lenses are covered every 12 months with a $25 copay.

Frames: covered up to $130 every 24 months; 20% off amount over the allowance.

Lens enhancements: Standard lenses covered once every 12 months with $0 copay. Progressive has an additional copay

Elective contacts: Covered up to $130 every 12 months with a $60 copay that includes fitting and evaluation.

Necessary contacts covered in full after $25 copay every 12 months.

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

Things to Remember:

How do I find a doctor?

Visit metlife.com/vision to locate doctors close to you or to see if your current eye care professional is in the carrier's Network.

Additional savings with Carrier: You can save an average of 20% to 25% off glasses or sunglasses from any in network doctor within 12 months of your last covered exam

If you need additional information regarding the network, please call Kristy Harrell at 252-527-6100

www.metlife.com/mybenefits

LaFevers Dental Team provides a $10,000 term life insurance benefit to all active full time employees at no cost to you. This offering protects what means the most, the people you love. If something were to happen to you, your life insurance proceeds would go to the people you've designated as your beneficiaries.

Voluntary Life Insurance

Employees ages 18-65 have the option to purchase additional Group Term Life insurance in the amounts of $30,000, $40,000, and $50,000 as well as their Spouse. Coverage can also be purchased for dependent Children ages 0-18 up to $20,000 with no medical questions.

Employees ages 18-80 can purchase up to $250,000, Spouses ages 18-80 can purchase up to $150,00 and Children ages 0-25 can purchase up to $150,000 with approved Evidence of Insurability.

Long-Term Disability

The Best For Your Family Life Insurance

LaFevers Dental Team provides long-term disability at no cost to the employee and is used as an income replacement benefit that provides a percentage of their earnings on a monthly basis when the employee is of out of work on a disability claim. Once enrolled, employees are eligible to receive 60% of their predisability monthly earnings up to a maximum of $10,000 per month if they become disabled and will start on the 90th day of disability.

For additional information and plan details, including how to file a claim, please contact Kristy Harrell at Flatlands Jessup Insurance Group at 252-527-6100.

What is group accident insurance?

Accident insurance is a layer of financial protection should an off the job accident occur. The benefit is paid in a lump sum that you can use to relieve the sting of unanticipated expenses after an accident.

Is it the right fit for me?

Accidents can happen to any of us. Based upon the type of accident and injury you have there are benefit amounts paid to the member specific to the type of injury incurred. Please see the full list of injuries and benefit amounts listed on Principals Summary of Benefits page.

Burns varying in severity pay $200 to $1,000 in benefit.

Coma pays a flat $20,000 benefit.

Dislocations depending on surgical or non surgical pay benefits ranging from $125 to $4.000

Varying benefit amounts are paid towards fractures that range from $280 to $4.000

Ruptured disc, tendon, ligament or rotator cuff with surgical repair all pay a flat $1,000 benefit.

This coverage also has Accidental Death and Dismemberment benefits.

Please contact Kristy Harrell at Flatlands Jessup, 252-527-6100, for a full list of Injury types and their benefits and for assistance in filing a claim

Critical illness insurance is a special form of insurance that provides policyholders with a lump sum payment in the event of a catastrophic diagnosis. The policyholder can use the money they receive however they like. Many put it toward medical bills while others use it to replace lost wages while they go through recovery.

Pre-existing exclusions apply.

Your cost for Coverage: The Critical Illness coverage is based on benefit amount and age and will be calculated when you enroll.

Employees can elect $10,000 or $20,000 in lump sum coverage.

Guaranteed issue up to $20,000.

Spouse & Child(ren) benefits available at $5,000 or $10,000 depending on the sum purchased by Employee. Their guaranteed issue amount is $10,000.

Wellness Benefit of $100 per person per year is included! For

information and plan details, please contact Kristy

Glossary of Health Coverage and Medical 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)

Appeal - A request for your health insurer or plan to review a decision or a grievance again.

Balance Billing - When a provider bills you for the difference between the provider’s charges and the allowed amount. For example, 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.

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

Co-payment - A fixed amount (for example, $15) 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.

Deductible - The amount you owe for health care services before your health insurance or plan begins to pay. For example, 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 deductible. The deductible may not apply to all services.

Emergency Medical Condition - An illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe harm

Emergency Room Care - Emergency services you get in an emergency room.

Health Insurance A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.

Hospitalization - Care in a hospital that requires admission as an inpatient and usually requires an overnight stay. An overnight stay for observation could be an outpatient care.

In-network Co-insurance - The percent (for example, 20%) you pay of the allowed amount for covered health care services to providers who contract with your health insurance or plan. In-network co-insurance usually costs you less than out-of-network co-insurance.

In-network Co-payment - A fixed amount (for example, $15) you pay for covered health care services to providers who contract with your health insurance or plan. In-network co-payments usually are less than out-of-network co-payments.

Network - The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services

Non-Preferred Provider - A provider who doesn’t have a contract with your health insurer or plan to provide services to you. You’ll pay more to see a non-preferred provider. Check your policy to see if you can go to all providers who have contracted with your health insurance or plan, of if your health insurance or plan has a “tiered” network and you must pay extra to see some providers.

Out-of-network Co-payment - A fixed amount (for example, $30) you pay for covered health care services from providers who do not contract with your health insurance or plan. Out-of-network co-payments usually are more than in-network co-payments.

Out-of-Pocket Limit - The most you pay during a policy period (usually a year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit never includes your premium, balance-billed charges or health care your health insurance or plan doesn’t cover. Some health insurance or plans don’t count all of your co-payments, deductibles, co-insurance payments, out-of-network payments or other expenses towards this limit.

Physician Services - Health care services a licensed medical physician provides or coordinates.

Pre-Authorization Certain procedures or hospitalizations may require that the provider receive authorizations. The provider is typically the one to go through the process with the insurance company and obtain pre-authorization.

Pre-Determination - If you are having a major procedure done, your doctor or dentist can submit a pre-determination to the insurance company so you can know in advance of treatment how much of the bill you will be responsible for.