ENROLLMENT GUIDE
CHAPARRAL IS COMMITTED TO PROVIDING COMPREHENSIVE HEALTH AND WELLNESS BENEFITS FOR OUR EMPLOYEES AND THEIR FAMILIES.
Our annual benefits open enrollment is your opportunity to review and make changes to your health and wellness elections for the upcoming year. From medical plans to flexible spending accounts, we are here to help you understand and select the best options for you and your family.
Chaparral will be holding benefits meetings at each of our office locations. Please take the time to read through this guide with your family before your meeting. We encourage you and your spouse to both attend the open enrollment meeting at your location. Our Human Resources team will be on hand to discuss options and talk personally with you about any questions you may have.
Open enrollment will be held from October 22 to November 16. Remember, the elections you make during this time will be effective from January 1 to December 31, 2019 and cannot be changed during the calendar year without a qualifying life event. If you have any questions, please visit the Benefits section of The Wire or email benefits@chaparralenergy.com .
OPEN ENROLLMENT IS YOUR CHANCE TO:
• Update dependent coverage and beneficiary information
• Update your medical, dental, prescription and/or vision coverage
• Elect contributions to a medical or dependent care Flexible Spending Account (FSA) and a limited-purpose FSA if you enroll in the High Deductible Health Plan
• Elect or increase supplemental life insurance for you and/or your dependents (requires evidence of insurability)
VISIT THE HRM TOOL AT HTTPS://HRM. CHAPARRALENERGY. COM/BENEFITS TO MAKE YOUR 2019 ELECTIONS. ONCE LOGGED IN, YOU CAN BEGIN TO MAKE SELECTION AND MONITOR YOUR PROGRESS.
OPEN ENROLLMENT CHECKLIST
THIS
TO HELP YOU MAKE YOUR 2019 BENEFITS SELECTIONS.
Review your current benefits and coverage levels in ADP.
Read this guide and attend a benefits meeting to fully understand your benefits options.
Collect necessary documentation, such as Social Security numbers for eligible dependents you want to cover.
Gather a summary of 2018 health and childcare expenses to help you estimate next year’s flexible spending account or health saving account elections if you enroll in the High Deductible Health Plan.
Log in to the HRM tool to make your elections.
Update your beneficiary information for your life insurance.
If you are a full-time employee regularly working 30 hours or more per week, you and your eligible dependents can enroll in Chaparral’s benefits program on the first day of your employment. Eligible dependents include:
• Spouse
• Children under the age of 26, including adopted and stepchildren, as well as children who do not reside in your home
• Unmarried, dependent children 26 years or older who are medically certified as disabled
Please note, dependent coverage automatically terminates at the end of the month in which a child turns 26. Dependents may be verified through a formal audit process.
QUALIFYING EVENT CHANGES
Changes to your elections can only be made within 30 days of your hire date, during Chaparral’s annual open enrollment period or within 30 days of a qualifying life event, which include:
• Marriage, divorce or legal separation
• Birth or adoption of a child
• Change in a child’s dependent status
• Death of a qualified dependent
• Change in residence due to an employee transfer
• Loss or gain of other coverage
MEDICAL, PRESCRIPTION AND VISION OPTIONS
Chaparral will continue to offer a traditional Preferred Provider Organization (PPO) plan and a High Deductible Health Plan (HDHP) combined with a Health Saving Account (HSA) in 2019.
TRADITIONAL PPO
A traditional PPO is what you most likely associate with health insurance. Through a traditional PPO you, the patient, are responsible for a co-pay each time you receive care. After meeting your deductible, you and the insurance company share the cost of the health care services you receive until you reach your out-of-pocket maximum. Under Chaparral’s PPO plan, prescription drugs have a separate out-of-pocket maximum and co-pay.
If you select the traditional PPO plan, the cost of your coverage will be pre-tax deducted from your paycheck twice a month throughout the calendar year.
HIGH DEDUCTIBLE HEALTH PLAN WITH HEALTH SAVINGS ACCOUNT
High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) is Chaparral’s alternative approach to how you pay for health care and save for the future. Our HDHP offers you medical coverage at a lower monthly premium because you are responsible for the Blue Cross Blue Shield (BCBS) negotiated rate for any care or prescriptions received prior to reaching a deductible. After the deductible has been reached, you and the insurance will share the cost of services or prescriptions received until the out-of-pocket maximum is reached.
Chaparral’s HDHP meets the federal requirements that allow a participant to also qualify for a tax-advantaged HSA. HSAs allow you to make pre-tax contributions for qualified medical expenses, such as routine care, imaging, prescription drugs and more. HSAs behave much like a personal bank account and are owned by you, regardless of your employment. In addition, account balances can be invested and carried over each year.
There are a few key features to consider when contemplating a HDHP, such as:
• The HDHP provides you the flexibility to receive care from the same network of providers as our PPO plan.
• In-network preventive care services, as defined by BCBS, are still 100 percent covered. Preventive medication is also 100 percent covered.
• Chaparral will contribute $1,000 for individual coverage or $2,000 for employee+spouse, employee+child(ren) or employee+family to your HSA account.
HSA DETAILS
According to the IRS, participants eligible for a Health Savings Account (HSA) plan may not:
• Be covered by any other non-HSA compatible health plan
• Be receiving Medicare, TRICARE or Veterans Administration benefits
• Be claimed as a dependent on another person’s tax return (unless it is your spouse)
• Use a traditional Flexible Spending Account (FSA) with a HSA
CHAPARRAL’S
HDHP
WITH A
HSA
As part of your HDHP, you can make pre-tax payroll deductions or after-tax contributions to your HSA. This money can then be used to pay for any necessary IRSeligible health care expenses for you and your family, including:
• Office visits
• Dental work and orthodontics
• Vision exams and eyeglasses
• Prescription medications
• Chiropractic treatment
• Surgeries
• Nursing home expenses
In addition, your HSA can act as a savings account earning tax-deferred interest or invested into mutual funds. This allows you to grow your money and save more for future medical expenses. Most importantly, the account is yours and stays with you even if you change jobs, health care coverage or move to another state.
For a complete list of eligible HSA expenses, visit hsabank.com/IRSQualifiedExpenses or irs.gov.
HSA DETAILS
CONTRIBUTIONS AND IRS LIMITS
Chaparral will contribute an initial $1,000 for employee only coverage and $2,000 for family coverage to your HSA. You may then elect your own desired semi-monthly contributions, which will be payroll deducted in the same manner as our traditional PPO option. You do, however, have the ability to adjust your semi-monthly contribution throughout the year. In addition, you can also add funds to your HSA at any time on a post-tax basis through an electronic transfer from your bank account or by mailing a check to HSA Bank.
The 2019 IRS contribution limits are $3,500 for employee only coverage and $7,000 for family coverage. If you are 55 years or older, you can make up an extra $1,000 annual catch-up contribution.
SUBMISSIONS
HDHP claim submissions work the same as with a traditional PPO plan. They too must be submitted through BCBS to ensure you receive the in-network discounts.
Please note, any money taken out of your HSA to pay for qualified medical expenses is tax-free, however, non-qualified expense withdrawals are taxable, carry a 20 percent penalty and must be added back into your gross income for tax filings. Although you are not required to maintain receipts, it is highly recommended you keep them on file.
Participating HSA members will receive a packet from HSABank with information to help you make the most of your account. A visa debit card will also be sent separately.
FLEXIBLE SPENDING ACCOUNTS
If you enroll in the PPO medical plan, you may also establish a Flexible Spending Account (FSA) for health care expenses and/or dependent care expenses. When you elect a FSA, you authorize pre-tax deductions from your paycheck to be put into an account you can access later for reimbursement of out-of-pocket costs associated with qualified medical and dependent care. As these deductions are pre-tax, your yearly income reported to the IRS and subsequent income taxes are reduced, which results in an annual tax savings.
FSA elections and modifications can only be made during open enrollment or as a result of a qualifying life event.
Please note, if you have contributed to a FSA in 2018 and elect to enroll in the HDHP/HSA plan for 2019, your deadline to incur expenses for your current FSA plan is December 31, 2018. You, however, have until March 30, 2019 to file a reimbursement claim.
HEALTH CARE FSA
Expenses must be for services already received and cannot be reimbursed by insurance or another source. The IRS 2018 maximum annual contribution for a health care flexible spending account is $2,650*.
DEPENDENT CARE FSA
A Dependent Care FSA option is available to everyone regardless of medical plan coverage. Eligible reimbursements are for child or elder care expenses that are incurred if both spouses are employed outside of the home. Generally, eligible expenses are only for the care of qualified dependents under 13 years of age or those who are physically or mentally incapable of caring for themselves. The maximum contribution allowed by the IRS is $5,000 per year if you are married and file a joint income tax return, $2,500 per year if you are single and file as a single head of household or if you are married and file separate income tax returns.
All FSA accounts are administered through HSABank. You must submit receipts for anything that is not a standard co-pay. For a complete list of eligible FSA expenses, visit hsabank.com/IRSQualifiedExpenses or irs.gov.
*Please note, this is the 2018 IRS limit. The 2019 limit has yet to be issued. Once released, however, you can check irs.gov to verify the 2019 limit.
FSA LIMITS
co-pays
day care
after-school programs
to $5,000 (or $2,500 if you and your spouse file separate income tax returns) Dependent care while you are at work, including:
care in your home irs.gov
HDHP/HSA
COMPARING MEDICAL, PRESCRIPTION AND VISION PLAN OPTIONS
Maternity Inpatient Care
Outpatient Care/Hospital Service
Outpatient Therapy Service
Chiropractic Care
(muscle manipulations limited to 25 visits per benefit period)
WELLNESS
As part of our commitment to encourage consistent, long-term healthy behavior, Chaparral encourages employees to lead a healthy lifestyle and as such offer a discounted insurance premium for those who earn 200 wellness points during the year. You will still be required to complete a member health assessment and three preventive care items, which are worth 100 points. You can also earn points for completing a variety of challenges and online videos throughout the year. Points must be recorded through your SimplyWell account (formerly known as MyViverae) to receive credit. Those who earn 250 or 300 points will receive their insurance wellness discount, as well as a wellness prize(s) at the end of the year.
ITEM POINTS
Member health assessment (required) 50
Preventive care compliance (required) 50
Self-reported tobacco free 25
Targeted tobacco cessation program passed 25
PROGRAM ACTIVITIES
Online videos 5 each/50 max
Online articles 5 each/50 max
Employee challenge goals 25 each/100 max
Peer seven-day challenges 1 each/50 max
FinFit (financial wellness) 10 each/50 max
PRIZE TIER LEVELS
Tier 1 Goal (wellness discount) 200
Tier 2 Goal (wellness discount + prize) 250
Tier 3 Goal (wellness discount + prize + prize) 300
Skip the trip to the doctor’s office or after-hours visits to urgent care clinics for non-emergency aliments. MDLIVE allows you to consult a physician over the telephone, online or through its mobile app around the clock. In fact, the average wait time for those using MDLIVE is less than 10 minutes.
Doctors and pediatricians contracted through MDLIVE are state-licensed and board-certified, and have an average of at least 15 years of experience. They can recommend treatment and write prescriptions, if appropriate, for many non-emergency medical conditions, such as:
• Acne
• Allergies
• Cold & flu • Constipation • Cough
• Earache
• Fever
• Headache
• Insect bites
• Nausea, vomiting or diarrhea
• Pink eye
• Rash
• Sore throat
• Urinary problems
If enrolled in the HDHP/HSA plan, there is a $40 per visit cost, which is treated like any other medical expense. If enrolled in the PPO plan, there is a $25 copay.
For additional information or to activate your personal account, visit members.mdlive.com/bcbsok or call 800-400-6354.
Note, MDLIVE is not appropriate for every medical condition and is not intended to replace your primary care doctor for common or chronic conditions.
LIFE ASSISTANCE PROGRAM
Cigna’s Life Assistance Program (LAP) provides resources to help you deal with potentially stressful or emotional situations. The LAP can serve as your personal research center to help you find potential resources to assist with a variety of issues, including:
• Child and elder care providers
• Daily living services
• Financial services
• Health and wellness concerns
• Legal services
• Marriage, relationship and family counselors
• Personality changes
• Professional issues
• Stress and anxiety
You and your family are eligible for up to three consultations with a licensed professional per incident, per individual, per calendar year. These services include a choice between telephonic or webvideo consultations.
Consultations are free and completely confidential and available 24 hours a day, 365 days a year. The LAP also provides access to helpful articles, interactive assessments, financial calculators, service locators, online newsletters, podcasts and more. Contact Cigna LAP for more information at cignabehavioral.com/cgi or 800-538-3543.
BASIC TERM LIFE AND AD&D
Basic term life insurance provides a benefit in the event of a covered participant’s death.
Accidental Death and Dismemberment (AD&D) is an additional benefit that pays in the event a covered participant dies or is dismembered in a covered accident.
Chaparral provides all active, full-time employees who regularly work a minimum of 30 hours per week the following at no charge: Life Benefit 2x annual compensation rounded up or down to the nearest $1,000 not to exceed $750,000
Guaranteed Issue Amount The lesser of 2x annual compensation rounded up or down to the nearest $1,000 or $500,000
Minimum Benefit $10,000
Employees also have an option to purchase additional term life and AD&D insurance.
Spouse
(eligible only if an employee is eligible to participate)
Benefit Amount: $5,000 increments up to the lesser of 5x your annual salary rounded up or down to the nearest $5,000 or $500,000
Employee guaranteed issue amount of $200,000 or less; amounts between $200,000 to $500,000 will require completion of evidence of insurability
Amount: $5,000 increments up to $100,000
Spouse guaranteed issue amount of $30,000 or less; amounts between $30,000 to $100,000 will require completion of evidence of insurability Infant/Child Life Benefit Amount (Age 14 days to six months): $100 Benefit Amount (Age six months to 26 years): $1,000, $2,000, $4,000, $5,000 or $10,000
Satisfactory evidence of insurability will not go into effect until approved by Cigna and is required when:
• Requesting more than the guaranteed issue amount
• Requesting increases in current coverage amounts
• Applying after your initial eligibility period (more than 30 days after first eligible)
All basic term life, AD&D and short- and long-term policies are administered through Cigna. Visit cigna.com or call 888-84-CIGNA (888-842-4462) for more information.
DISABILITY
SHORT-TERM DISABILITY
LONG-TERM
DISABILITY
Pre-existing condition for increases in amounts of insurance means during the three months prior to the employee’s effective date of any increase in an employee’s
401(K) PAID TIME OFF
Chaparral’s paid time off (PTO) model combines traditional vacation and sick time into a single account, which allows you to determine the best use of your time off. PTO accruals are based on years of relevant work experience and are earned incrementally every pay period.
YEARS OF EXPERIENCE
Your 401(k) plan is a powerful tool to help you achieve your retirement goals. Chaparral offers fulltime employees the opportunity to participate in our 401(k) plan through Fidelity Investments.
Elected contribution amounts are effective the first day of each month. Chaparral’s plan features:
• Automatic enrollment at three percent of earnings
• 100 percent matching contribution from Chaparral, up to the first seven percent of your eligible contributions
• 100 percent vest after three years of service
• Ability to contribute the IRS maximum allowable amount of $18,500* per calendar year
• $6,000 catch-up contribution for those over the age of 50
• Ability to take loans and hardship withdrawals
• A wide variety of investment options, including target date funds selection for those who do not wish to pick individual funds
• 24/7 account access at 401k.com
• Comprehensive communications and planning tools, including an annual retirement quick check to help you stay on track and remain focused on what is most important to you
If you have questions or need help getting started, please visit 401k.com or call Fidelity at 800-835-5097.
*Please note, this is the 2018 IRS limit. The 2019 limit has yet to be issued. Once released, however, you can check irs.gov to verify the 2019 limit.
CONTACT INFORMATION
For more information about Chaparral benefits, please visit the Benefits section of The Wire or email benefits@chaparralenergy.com.
MEDICAL/VISION
BCBS of Oklahoma 800-942-5837
bcbsok.com
PHARMACY RX
Prime Therapeutics
877-357-7463 myprime.com
MDLIVE
MDLIVE
800-400-6354 mdlive.com
WELLNESS PROGRAM
SimplyWell (Formerly MyViverae)
888-848-3723 MyViverae.com
DENTAL
Delta Dental
800-522-0188 deltadentalok.org
HSA, LPFSA OR FSA ACCOUNT
HSABank
800-357-6246 hsabank.com
BASIC & VOLUNTARY TERM LIFE & AD&D
Cigna
888-842-4462 cigna.com
SHORT- & LONG-TERM DISABILITY & FML
Cigna
888-842-4462 cigna.com
LIFE ASSISTANCE PROGRAM
Cigna
800-538-3543 cignabehavioral.com/cgi 401(K) Fidelity
800-835-5097 401k.com