GUIDE OCTOBER 1, 2022 - SEPTEMBER 31, 2023
At Technifab we understand the important role that our benefit programs play in the lives of our employees and their families. Technifab would not be the successful company it is today without the dedication of our hard-working employees. We are proud to offer a comprehensive benefits package that is designed to insure and protect you and your family against financial hardship and loss. WE OFFER THE FOLLOWING BENEFITS: Medical, Dental, Vision, Wellness Program, Health Savings Account (HSA), Basic Life and AD&D, Voluntary Life and AD&D, Short-Term Disability (STD), Long-Term Disability (LTD), Employee Assistance Program (EAP), Travel Assistance, ID Theft, and a 401(k) Retirement Plan to all full-time employees. NEW CARRIER CHANGES THIS YEAR: • Dental | Your dental benefits have enhanced, and will now be provided by Delta Dental AZ. • Vision | Your vision benefits will now be provided by Delta Dental AZ. WELCOME TO YOUR BENEFITS
CARRIER/VENDOR FIND IT ON PAGE HEALTH BENEFITS Medical UnitedHealthcare 9 Employee Wellness Clinic Proactive MD 11 HSA Fidelity 12 Virtual Visits UnitedHealthcare 15 Dental Guardian 16 Vision Guardian + VSP 18 FINANCIAL BENEFITS Life and AD&D Insurance Guardian 20 Disability Guardian 22 3 YOUR BENEFITS DISCOVERING
4Return to my benefit options. DIGITALNAVIGATIONGUIDE Use the side arrows to help you jump to the next page or the previous page. Toggle thumbnails to quickly glance through the pages and pick which one you want to view. Display your screen in full screen mode for a closer look. If you need an even closer look, zoom in with the magnifying glass. Download a PDF to save the guide to your device and print it. Please note that some digital functions may get lost. WHAT ONLINE FUNCTIONS ARE AVAILABLE? Your Home Screen. Navigation Bar on the bottom of the page. A SIMPLE WAY TO HELP YOU NAVIGATE THROUGH YOUR BENEFITS. Your Benefit Guide is accessible online through your computer, tablet, or smartphone. It is designed to help you navigate through your benefits with a few simple clicks! If you are using your computer, be sure to use your mouse to hover over graphics — some will lead you to interactive links. If you are using a tablet or smartphone, look for the cursor icon and be sure to tap it on certain pages.
Health Savings Account (HSA)
Annual Out-of-Pocket Maximum (Jan 1 through Dec 31)
Annual Deductible (Jan 1 through Dec 31) The amount you are required to pay per calendar year before certain benefits are paid for by the plan. Once you meet the deductible amount, expenses are covered by the plan based on the coinsurance percentage. This deductible starts over every January 1st.
Medicare A federal program of medical care benefits designed for those permanently disabled or over age 65. Created under the Social Security Medicare law, A. Hospital Insurance Benefits for the Aged and Disabled, a basic plan covering hospital and related care. Persons age 65 are automatically eligible for this plan, but they must enroll before they become covered (entitled).
The flat dollar amount you pay for certain innetwork services.
Charges Healthcare charges that are determined by your health plan vendor and are based on the range of fees charged by doctors with comparable training and experience for the same or similar service in your area. When you receive innetwork care, UCR charges do not apply. You are responsible for amounts over UCR for out-ofnetwork care.
Similar to the HSA, an FSA is also a savings account used to save and pay for qualified medical expenses. Except while this account is tax-advantaged, it doesn’t gain interest and is only good for one year. There are medical FSAs and Dependent Care FSAs.
Return to my benefit options.THAT WORD MEAN? WHAT DOES ANNUAL DEDUCTIBLE ANNUALMAXIMUMOUT-OF-POCKET BALANCE BILLING COINSURANCE COPAYMENTS OR COPAYS HEALTH SAVINGS ACCOUNT (HSA) EXPLANATION OF BENEFITS (EOB) IN-NETWORK MEDICARE USUAL, CUSTOMARY, AND REASONABLE (UCR) CHARGES
In-Network
Preferred Provider Organization (PPO)
Usual, Customary, and Reasonable (UCR)
B. Supplementary Medical Insurance Benefits for the Aged and Disabled, a voluntary supplementary plan covering the doctor’s bills and other costs of medical and health services.
The percentage you pay for covered expenses. Copayments or Copays
Balance Billing When you are billed for the difference between the provider’s actual charge and the amount reimbursed under the medical or dental plan. This occurs when you go outside of the preferred provider network. Balance billing does not apply towards out-of-pocket maximum. Coinsurance
The deductible is included in this amount. If you reach the annual out-of-pocket maximum, the plan pays 100% of covered in-network eligible expenses for the remainder of the plan year. Office visits and prescription copays are included in the annual out-of-pocket maximum for our medical plans. This maximum starts over every January 1st.
A healthcare arrangement designed to provide healthcare services at a discounted cost for members to use designated providers (the network), but which also provides coverage (at a lower level) for services received from providers that are not part of the network.
The most you pay in a calendar year for covered services that are subject to coinsurance/copays.
A group of doctors, hospitals and other healthcare providers that contract with a plan vendor to provide quality healthcare services at favorable rates.
Flexible Spending Account (FSA)
Explanation of Benefits (EOB) Provides information about how your claim was processed by the insurance company. The EOB details what portion of the claim was paid by the insurance company and what portion is your responsibility.
A special, tax-advantaged, interest bearing account to help plan and pay for qualified health care expenses (including plan deductible) while covered by a qualified high deductible health plan.
6Return to my benefit options.YOU AND YOUR FAMILY COVERING EMPLOYEES Regular full time employees working at least 30 hours per week are eligible for coverage on the 31st day of employment. DEPENDENTS Eligible dependents for benefits plans include: • Legal spouse • •••Children*BiologicalAdoptedAnychild you support who lives with you in a parent-child relationship and for whom you are the legal guardian** • Disabled children of any age who are (or become) physically or mentally incapable of self-support while covered by our employee benefits program
Return to my benefit options.IN YOUR BENEFITS ENROLLING NEW HIRE Benefits go into effect on the 31st day of employment. Enroll at www.employeenavigator.com What should you know? • Elections made now will remain until the next open enrollment • You may elect to participate or waive benefits that are offered to you • You must complete enrollment even if waiving coverage • Open Enrollment period is Sept. 9-16, 2022 • New enrollees: use company identifier Tfab when setting up your account. Everyone else can use current username and password. SEPTEMBER After Open Enrollment, benefits begin on October 1st. OPEN ENROLLMENT Enroll at www.employeenavigator.com During the annual benefits open enrollment period. QUALIFIED LIFE EVENTS The only time you can make changes outside of open enrollment is when you have a change in status, called a qualified life event (QLE), as defined by the Internal Revenue Service (IRS). EXAMPLES OF QLE • Change in Marital Status • Birth or Adoption of child • You and/or planwitheligibledependentsyourbecomeorlosecoverageanothergrouphealth • Spouse’s Open Enrollment • Change in work status (part-time to full-time) REMEMBER! You must provide proper documentation within 30 days of the QLE in order to obtain coverage.
HEALTH BENEFITS
9Return to my benefit options.INSURANCE OPTIONS YOUR MEDICAL Administered through UnitedHealthcare HSA PLAN IN-NETWORK OUT-OF-NETWORK WHAT IS THE MOST I WILL PAY? Annual Deductible Individual | Family $3,000 | $6,000 $9,000 | $18,000 Out-of-Pocket Maximum Individual | Family $6,250 | $12,500 $18,750 | $37,500 Coinsurance After Deductible Plan Pays 100% Co-pays apply for Rx, ER, UC, OV Plan Pays 60% HOW WILL IT WORK AT THE HOSPITAL? Inpatient Surgery Subject to deductible and coinsurance Subject to deductible and coinsurance Outpatient Surgery Emergency Room $300 After Deductible $300 After Deductible HOW DOES IT WORK AT THE DOCTOR’S OFFICE? Preventive Care Covered 100% Not Covered Office Visit $30 co-pay After Deductible Subject to deductible and coinsuranceSpecialist $60 co-pay After Deductible Urgent Care $100 After Deductible Virtual Visits $25 co-pay After Deductible View more plan details on the next page!
10Return to my benefit options. HSA PLAN IN-NETWORK OUT-OF-NETWORK HOW MUCH DOES IT COST FOR PRESCRIPTIONS? Prescription Drugs Retail • Tier 1 • Tier 2 • Tier 3 • Specialty Tier 2 • Specialty Tier 3 After Deductible then, $10 copay $35 copay $60 $300$100copaycopaycopay Prescription Drugs Mail Order • Tier 1 • Tier 2 • Tier 3 • Specialty Tiers After Deductible then, $25 $87.50copaycopay$150copaynotcovered Technifab will contribute $700 to your HSA annually! This will be paid out weekly in $13.46 increments.
Return to my benefit options. YOU NOW HAVE ACCESS TO FREE MEDICATIONS THROUGH THE CLINIC. VISIT THE SITE TO SEE IF YOURS ARE ON THE LIST: www.dpcindiana.com WELLNESS CENTER HEALTH AND REAL LIFE. EVERY DAY LIFE. YOUR LIFE. With the Proactive MD Health and Wellness Center, employees of Technifab can access affordable healthcare at a convenient location with above average care. As part of our mission to maintain a great employee experience for you, we know that health and wellness are key to a successful work life. If you’re enrolled in our medical plan, you and any dependents who are also on the plan will automatically have clinic access at no additional cost. You can also purchase access to the clinic for dependents who aren’t on our medical plan.
12Return to my benefit options. By enrolling in the HDHP medical plan, you get access to a Health Savings Account (HSA), which can be used to pay for qualified health care expenses. HEALTH SAVINGS ACCOUNT (HSA) ANNUAL CONTRIBUTIONS ANNUAL CONTRIBUTION LIMITS 2022 (Individual | Family) $3,650 | $7,300 Individuals age 55 and older are eligible to make catch-up contributions of an additional $1,000 annually.2023 (Individual | Family) $3,850 | $7,750 HSA ADVANTAGES QUICK FACTS ELIGIBLE EXPENSES WHO IS ELIGIBLE? Anyone who fits all of the following conditions is eligible for our HSA: ✓ IS enrolled in our HDHP medical plan. x IS NOT enrolled (and not planning to enroll) in: any other medical plan that has copays, Medicare, Tri-Care, or Medicaid. x IS NOT eligible to be claimed as a dependent on someone else’s tax return. HSA FACTS YOU HAVE CONTROL • You can use the funds on medical, dental and vision expenses for you and your family. • There is no “use it or lose it” rule. YOU SAVE ON TAXES • All money deposited is tax free. • Withdrawals for eligible expenses are exempt from federal income tax. • You can earn interest tax free. EXAMPLES OF ELIGIBLE EXPENSES • Costs incurred at, Hospitals, Dr’s offices, the Pharmacy and expenses for Acupuncture, Hearing Aids including batteries, Infertility Treatment, and Medical Supplies.
| Gender
✓ Proactively
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THE PREVENTIVEIMPORTANCECARE of
13Return to my benefit options.
WHY PREVENTIVE CARE?
✓
✓ Preventing
Even when you’re feeling fine, a serious condition could later put your health at risk. Your health coverage offers specific preventive care services at no out-of-pocket cost when completed by an in-network provider. If you’re enrolled in our medical plan, you can also visit the Health and Wellness Clinic to receive preventive care. Taking advantage of available services at the right time can help you stay healthier by: Identifying minor issues now before they develop into a major issue later certain illnesses and conditions detecting health problems at early stages, when treatments may be more successful
WHAT IS NOT PREVENTIVE CARE?
If you have been diagnosed by a doctor with a health issue, the additional screenings and tests following this diagnosis are no longer considered preventive. Your health plan may still provide coverage, but it will not fall under the preventive category of care.
Services are considered preventive when you don’t have any symptoms or diagnosed health issues connected with the preventive service. These services are often provided as part of your wellness exam.
You and your doctor will determine what services are right for you based on your: Age | Personal health history Current health
14 HOW MONEYTO save more UTILIZE IN-NETWORK PROVIDERS. Your medical costs increase when you visit a provider that is not in your network. Make sure to check and confirm your provider is in the correct Cigna network based on your plan selection (Open Access Plus or Local Plus), especially when being referred to another facility for services. LIMIT YOUR VISITS TO THE EMERGENCY ROOM. Visit the emergency room only in the case of a true emergency. Check your area for an Urgent Care location or Convenience Care Clinic. SAVE TIME AND MONEY. Take advantage of the mail order prescription drug program. Check out cigna.com for more details. USE GENERIC PRESCRIPTIONS IF AVAILABLE. Ask your doctor for a Generic or request the Generic equivalent when having your prescription filled. Check with your local retail pharmacy (Fry’s, Walmart, Sam’s Club, Target, Costco, etc.) to see if your generic medication is on their $4 or $10 Generic Prescription List. If your generic medication is on their list, you can save money and also reduce plan costs. SAVE MONEY ON PRESCRIPTIONS WITH GOODRX. GoodRx is 100% free - no obligations, no sign-ups. All you do is download the app, search for your medication, and save money. Even when a prescription drug is covered by insurance, GoodRx is frequently able to find cheaper prices (you will not automatically receive credit toward your plan deductible or out-of-pocket maximum, but you may be able to receive credit by submitting a manual claim yourself). ✓✓✓✓✓
15Return to my benefit VIRTUALoptions.RESOURCESVISITVIRTUAL VISITS A telehealth option to talk to a doctor by phone or video, 24/7 When you need care — anytime, day or night — Virtual Visits can be a convenient option. From treating flu and fevers to caring for migraines and allergies, you can chat with a doctor 24/7.•Use your mobile device, tablet or computer • Connect with a doctor by phone or video • Get prescriptions, if needed SIGN IN TO START YOUR VIRTUAL VISIT Set up a myuhc.com account if you don’t already have one or sign in to get started. THEY ARE GREAT FOR... • Abdominal pain • Allergies • Bladder / urinary tract infection • Bronchitis • Coughing • Diarrhea • Fever • Migraine / headache • Pinkeye • Rash • Seasonal flu • Sinus problem • Sore throat • Stomachache • Yeast infection • And much more OR CLICK HERE!
16Return to my benefit options.INSURANCE OPTION YOUR DENTAL Provided through Guardian NAP PLAN VALUE PLAN IN AND OUT-OF-NETWORK IN AND OUT-OF-NETWORK In-Network Calendar Year Deductible Individual $50 $50 Network Deductible $50 Non-Network Deductible Maximum Benefit Per Person per Calendar Year $1,000 $1,000 Network Plan Max $1,000 Non-Network Plan Max HOW DOES THE PLAN WORK? Preventive Services Cleanings (every 6 months) and X-rays Covered 100% Basic Services Fillings and Extractions Covered 80% Covered 100% Major Services Crowns and Bridgework Covered 50% Covered 60% Orthodontics Child Only (up to age 19) $1,000 maximum per person 50% coverage $1,000 maximum per person 50% coverage (network only) Technifab Products is offering you two options through Guardian. This benefits you because you can choose the network that suits your family. VALUE PLAN: Choose this plan if your dentist is included in the guardianpreferred network. If you use a dentist that isn’t in the network, the insurance will only pay what a network dentist receives, leaving you with a greater out-of-pocket and having to pay more. NAP PLAN: Choose this plan if you want to be able to use any dentist and still receive the highest amount of benefits.
17Return to my benefit options.MEMBER BENEFITS GUARDIAN DENTAL GUARDIAN MAX ROLLOVER PROGRAM To qualify, you must submit a claim for covered services for which a benefit is paid, in excess of deductible or co- pay, and you must not exceed the paid claims threshold during the benefit year. Covered members maintain separate rollover amounts based on your own claim activity. You can view your rollover statement at www.guardiananytime.com. Threshold Maximum Rollover Amount In-Network Only Maximum Rollover Amount Maximum Rollover Account Limit $500 $250 $350 $1,000 POLICY YEAR SUBSCRIBER REWARD SUBSCRIBER’S REWARD BALANCE Initial Registration 500 2,500 2 2,000 4,500 3 2,000 6,500 4 4,500 (bonus year) 11,000 5 2,000 13,000 6 2,000 15,000 7 2,000 17,000 TO REGISTER Tuition Rewards can only be earned if you are registered for benefit. www.guardian.collegetuitionbenefit.com User ID: 486780 | Password: Guardian
18Return to my benefit options.INSURANCE OPTION YOUR VISION Provided by Guardian + VSP VISION PLAN IN-NETWORK VSP OUT-OF-NETWORK BENEFITS Eye Exam (once every 12 months) $10 copay $39 maximum benefits Eyeglass Lenses (once every 12 months) Single | Bifocal | Trifocal | Progressive $25 co-pay, with additional discounts available with lens enhancements maximum benefits of $27 | $37 | $49 | NA Frames (once every 24 months) A frame allowance up to $130 is included in the $30 co-pay. Additional 20% discount is provided for any balance $46 maximum Contacts Lenses (instead of glasses) Allowance of $130 for contact lenses $100 maximum MATERIALS ONLY
FINANCIAL BENEFITS
20Return to my benefit options. AD&D INSURANCE LIFE AND Administered through Guardian BASIC LIFE AND AD&D COVERAGE AMOUNT $20,000. AGE REDUCTION Coverage reduces by age. You must designate a beneficiary for Basic Life and AD&D. You have the right to change the beneficiary at any time by written or electronic notice. You can change your beneficiary through Employee Navigator.
Daily Living Expenses Mortgages and Other Loans Children’s or Grandchildrens’ College Tuition
calculator.”Whenitcomes
2. If you wish to enroll in the Voluntary Life and AD&D plan or increase your coverage after your initial eligibility period, you will be required to complete the Evidence of Insurability form which contains questions about your health. Rates are based on your age and the amount of coverage you elect. Spouse rates are also based off of the employee age. HOW MUCH LIFE INSURANCE DO I NEED? If you have expected expenses like these, you may want to consider purchasing additional coverage. For help deciding how much coverage you need, go online and search for “life insurance to protecting the nancial security of you and your family, nothing is more important than planning ahead. Even if you already have a life insurance policy in addition to the company-provided policy, it’s impor tant to ask yourself: “Do I have the protection I need to cover all of my nancial responsibilities?” A few categories to consider include:
3.
21Return to my benefit options. VOLUNTARY LIFE AND AD&D This is a voluntary plan though Guardian that provides you the option to purchase coverage beyond the Basic Term Life Insurance provided by Technifab. BENEFITEMPLOYEE $10,000 increments up to $400,000 Guarantee Issue: $100,000 BENEFITSPOUSE 50% of employee benefit up to $200,000 Guarantee Issue: $10,000 BENEFITCHILD 10% of employee benefit up to $10,000 Guarantee Issue: N/A THINGS TO KNOW CONTINUED 1. A “guarantee issue” amount is the dollar amount of coverage you can be approved for without completing a health Guaranteequestionnaire.issueamounts only apply during the 31 days following your initial eligibility period when hired.
22Return to my benefit options. If you purchase STD coverage, you will receive disability income during the duration of disability or until such time that you are able to return to work per a doctor’s release. If elected, you pay the full cost of these voluntary coverages through payroll deductions. Benefit Amount 60% of weekly salary When are Benefits Payable? 1st consecutive day of accident or the 8th day of illness Maximum Benefit $500/week Maximum Benefit Duration 26 weeks DISABILITYINSURANCE VOLUNTARY SHORT TERM DISABILITY The plan offers a monthly benefit to help replace lost income if you experience a disability lasting longer than 180 days. Benefit Amount 60% monthly salary When are Benefits Payable? After 180 days of disability Maximum Benefit $5,000/month Maximum Benefit Duration Until you are no longer disabled or reach age 65 VOLUNTARY LONG TERM DISABILITY Administered through Guardian DID YOU KNOW?1INEVERY 8 people lifetime.moreforbecomewilldisabledfiveyearsorintheir 30% of people use disability. 46% of all foreclosures are caused by financial hardship due to a disability. Return to my benefit options.
23Return to my benefit options.BENEFIT CONTACTS IMPORTANT BENEFIT PROVIDER PHONE WEBSITE/EMAIL Medical UnitedHealthcare Refer to the number on your ID card www.uhc.com Vision Guardian + VSP 800-877-7195 www.vsp.com Health Savings Account Fidelity 800-343-3548 www.fidelity.com/go/hsa/hsa-provider Dental Life and AD&D Voluntary Life and AD&D DisabilityWillPrep Guardian 888-428-7342 www.guardiananytime.com Employee Wellness Clinic Proactive MD 888-862-9525 www.dpcindiana.com Human Resources Laura Drake 812-442-0520 HumanResources@technifab.com
The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer. The text contained in this Guide was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential pursuant to the Health Insurance Portability and Accountability Act of 1996.
