At OneStreet Residential, we know that our associates are crucial to our success. That’s why we provide you with an excellent, diverse benefits package that helps protect you and your family, now and into the future.
This Benefit Guide outlines the health and welfare plans offered to you and your family. It contains general information and is meant to provide a brief overview. For complete details regarding each benefit plan offered, please refer to the individual plan documents as the information contained herein is for illustrative purposes. Details can be found in the plan specific Summary of Benefits & Coverage located in Employee Navigator. In the case of a discrepancy, the plan specific documents will prevail.
TABLE OF CONTENTS
Page 2 A Smarter Way to Better Health
Page 3 Eligibility & Enrollment
Page 4-6 Medical Plans (rates on page 34)
Page 7-8 Anthem - Registration and Mobile App
Page 9-13 Anthem - Value Added Programs
Page 14-15 Anthem - Find Care
Page 16 Medical Plan – Important Notes
Page 17 RelyMD - Telemedicine
Page 18 Dental Plans (rates on page 34)
Page 19 Dental Extra Benefits
Page 20 Accidental Dental Injury Benefit Summary
Page 21 SmileDirectClub Dental Benefit Summary
Page 22 Vision Plan (rates on page 34)
Page 23 Basic Life/AD&D and Voluntary Life/AD&D Insurance
Page 29-30 ADP Benefits Enrollment via Employee Navigator
Page 31 401(k)
Page 32 EAP Work/Life HealthAdvocate
Page 33 Medicare Assistance & Education
Page 34 Associate Payroll Deductions
Page 35 Key Contacts & Resources
Page 36-42 Important Notices
It’s Your Health. Get Involved.
A SMARTER WAY TO BETTER HEALTH
Your health is a work in progress that needs your consistent attention and support Each choice you make for yourself, and your family, is part of an ever-changing picture Taking steps to improve your health such as going for annual physicals and living a healthy lifestyle can make a positive impact on your well-being.
It’s up to you to take responsibility and get involved, and we are pleased to offer programs that will support your efforts and help you reach goals
Preventive Health Care Services
Preventive care includes services like checkups, screenings and immunizations that can help you stay healthy and may help you avoid or delay health problems. Many serious conditions such as heart disease, cancer, and diabetes are preventable and treatable if caught early. It’s important for everyone to get the preventive care they need Some examples of preventive care services are:
▪ Blood pressure, diabetes, and cholesterol tests
▪ Certain cancer screenings, such as mammograms, colonoscopies
▪ Counseling, screenings and vaccines to help ensure healthy pregnancies
▪ Regular well-baby and well-child visits
Immunizations
Understanding What’s Covered
Some immunizations and vaccinations are also considered preventive care services. Standard immunizations recommended by the Centers for Disease Control (CDC) Include: hepatitis A and B, diphtheria, polio, pneumonia, measles, mumps, rubella, tetanus and influenza although these may be subject to age and/or frequency restrictions
Generally speaking, if a service is considered preventive care, it will be covered at 100% If it’s not, it may still be covered subject to a copay, deductible or coinsurance The Affordable Care Act (ACA) requires that services considered preventive care be covered by your health plan at 100% in-network, without a copay, deductible or coinsurance To get specifics about your plan’s preventive care coverage, call the customer service number on your member ID card. You may want to ask your doctor if the services you’re receiving at a preventive care visit (such as an annual checkup) are all considered standard preventive care.
If any service performed at an annual checkup is as a result of a prior diagnosed condition, the office visit may not be processed as preventive, and you may be responsible for a copay, coinsurance or deductible To learn more about the ACA or preventive care and coverage, visit www.healthcare.gov.
ELIGIBILITY & ENROLLMENT
Who is Eligible to Join the Benefit Plan?
You and your dependents are eligible to join OneStreet Residential’s health and welfare benefit plans if you are a full-time associate who works an average of at least 30 hours per week You must be enrolled in the plan to add dependent coverage
Who is an Eligible Dependent?
• Your spouse to whom you are legally married
• Your dependent child under the maximum age specified in the Carriers’ plan documents including:
o Natural child
o Adopted child
o Stepchild
o Child for whom you have been appointed as the legal guardian
*Your child’s spouse and a child for whom you are not the legal guardian are not eligible.
The Dependent Maximum Age Limits is up to age 26 The dependent does not need to be a full-time student; does not need to be an eligible dependent on parent’s tax return; is not required to live with you; and may be unmarried or married
Once the dependent reaches age 26, coverage will terminate on the last day of the birth month.
A totally disabled child who is physically or mentally disabled prior to age 26 may remain on the plan if the child is primarily dependent on the enrolled member for support and maintenance.
When Do Benefits Become Effective?
Your benefits become effective on the first day of the month following 60 days as a full-time associate with OneStreet Residential All associates (full-time and parttime) are eligible for the Employee Assistance Program (EAP) through HealthAdvocate upon date of hire.
Annual Open Enrollment
Each year during the annual open enrollment period, you are given the opportunity to make changes to your current benefit elections Annual open enrollment is the only time during the year you can make changes to your benefits unless you experience a qualified life status change (qualifying event).
The annual enrollment period occurs each year during the month of September.
Qualifying Event Changes
You are allowed to make changes to your current benefit elections during the plan year if you experience an IRS-approved qualifying change in life status If you have a status change, you must notify Human Resources within 30 days of the event. If you do not notify Human Resources during that time, you and/or your dependents must wait until the next open enrollment to change your coverage
IRS-approved qualifying life status changes include:
• Marriage, divorce or legal separation
• Birth or adoption of a child or placement of a child for adoption
• Death of a dependent
• Child no longer eligible due to reaching age limit
• Change in employment status, including loss or gain of employment, for your spouse or a dependent
• Change in work schedule, including switching between full-time and part-time status, by you, your spouse or a dependent
• Change in residence or work site for you, your spouse, or a dependent that results in a change of eligibility
• If you or your dependents lose eligibility for Medicaid or the Children’s Health Insurance Program (CHIP) coverage or become eligible for a state’s premium assistance subsidy under Medicaid or CHIP, then you have 60 days from the date of the Medicaid/eligibility change to request enrollment in OneStreet Residential’s plans.
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage A special enrollment period is a time outside of the annual open enrollment period during which you and your family have a right to sign up for health coverage In the Marketplace, you qualify for a special enrollment period 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage. Job-based plans must provide a special enrollment period of 30 days Some events will require additional documentation to be submitted with the application at the time of enrollment Find more information on page 30 You should read this notice even if you plan to waive coverage at this time
Please note, loss of coverage due to non-payment or voluntary termination of other coverage outside a spouse’s or parent’s open enrollment is not an IRS-approved qualifying life event and you do not qualify for a special enrollment period.
MEDICAL
OneStreet Residential offers you three medical plan choices through Anthem. Please refer to the following charts for a list of the major features for each plan. As a plan member, you have access to many consumer education tools and value-added programs designed to help you manage you and your dependents’ medical care. Visit www.anthem.com/register and register as a member. You can estimate your medical costs, view your Explanation of Benefits (EOB), and more. The network for all three Anthem plans is the Blue Open Access POS in Georgia, and the National BlueCard PPO in all other states. You can search for an in-network doctor, hospital or other providers by following the step-by-step instructions on page 7 of this guide See page 34 for plan payroll deduction amounts.
The prescription drug coverage provided by all three medical plans are expected to pay out as much as standard Medicare prescription drug coverage pays. This is important because members who enroll in a Medicare prescription drug plan after their initial eligibility period, may pay a higher premium (a penalty) if they were enrolled in a group health plan with noncreditable prescription drug coverage.
This chart is a summary of your benefits. If there is a discrepancy between the chart and official documents, the documents will prevail. Diagnostic Lab - if performed as part of a physician office visit and billed by the physician, expenses are covered subject to the applicable physician’s office visit member cost sharing.
MEDICAL
MEDICAL
Find a doctor, hospital, or other care provider by following the steps below at www.anthem.com/register:
1. Click on Find Care
2. Click on Select a plan for basic search
3. Select the type of plan or network from drop down menu ‘Medical Plan’
4. Select the appropriate state from drop down menu
5. Select how you get health insurance from drop down menu ‘Medical (employer sponsored)’
6. Select a Plan or Network from drop down menu GA residents - ‘Blue Open Access POS’; Other states‘National BlueCard PPO’
ANTHEM VALUE ADDED PROGRAMS
Save money with discounts at anthem.com
AsanAnthemmember,youqualify for discounts on products andservices that help promote better health and well-being.* Thesediscounts areavailable through SpecialOffersto help yousavemoney while taking care of yourhealth.
Vision,hearingand dental
Glasses.com and1-800-CONTACTS® Shopfor the latest brand-nameframesat afraction of the cost for similar framesat other retailers. Youarealsoentitled to anadditional $20 off orders of $100or more,free shipping andfreereturns.
EyeMed Take30%off anewpair of glasses,20% off non-prescription sunglassesand20% off all eyewear accessories.
PremierLASIK Save$800on LASIKwhenyou choose any“featured” Premier LASIKNetworkprovider.Save15% with all other in-networkproviders.
TruVision Saveup to 40%on LASIKeyesurgeryat more than 1,000locations.
NationsHearing Receivehearingscreenings and in-home service at no additional cost.All hearingaids start at $599each.
Hearing CareSolutions Digital instruments start at $500, and a hearing exam is free. Hearing Care Solutions has 3,100 locations and eight manufacturers, and offers a three-year warranty, batteries for two years and unlimited visits for oneyear.
Amplifon Take25%off,plusanextra $50off one hearingaid; $125offtwo.
ProClear Aligners Take$1,200off aset of custom aligners. Youcanimproveyour smile without metal braces andtime-consumingdental visits. Yourorder is 50%off andcomeswith afree whitening kit.
MANAGE
**DispatchHealth coverage area is limited to select zip codes throughout metro Atlanta and some neighboring suburbs. Reach out to Anthem member services for details.
MANAGE YOUR IN-NETWORK
NOTE: The above costs are examples of what you might incur and may not be representative of your specific medical plan.
MEDICAL PLANS – IMPORTANT NOTES
ALL THREE MEDICAL PLANS
• Receive services from a national network of providers and facilities – Blue Open Access POS network in Georgia; National BlueCard PPO in all other states. Receive the best rates by staying in network; reserve the Emergency Room for life threatening situations.
• “Open Access”- you may choose any provider without having a Primary Care Physician (PCP) identified or requiring a referral from a PCP to see a specialist.
• You pay copays for day-to-day services such as doctor visits, urgent care & prescriptions.
• Preventive Care is covered at no cost.
• All deductible, coinsurance and copay expenses accrue toward the out-of-pocket maximum.
• Great incentives for Major Imaging & Outpatient Surgery at Freestanding Centers instead of the hospital – pay a copay only instead of the deductible. Contact Anthem member services to find a Center near you.
• Some plans offer Mail Order Pharmacy at a reduced cost.
• Chiropractic visits limited to 20 per year. Speech Therapy limited to 20 visits per year. Physical and Occupational Therapy limited to 20 visits per year, combined.
OPTION #3 $4500 MEDICAL PLAN
• Deductible applies to Emergency Room visits. Reserve the Emergency Room for life threatening situations.
• Additional copays apply, after the deductible, for Inpatient Hospitalization, Outpatient Surgery at the Hospital, Emergency Room and Major Imaging at the Hospital.
• Pharmacy – Regular copays for Generic and Preferred Brand Drugs. The medical deductible applies first for Non-Preferred Brand and Specialty Drugs.
MEDICAL THINGS TO CONSIDER
• Since your medical plans run on a calendar year basis, all deductible and out of pocket amounts will reset to $0 on January 1.
o 4th quarter deductible carryover feature: If you have any deductible-related services that actually occur in October, November or December, those deductible amounts satisfied will automatically be applied to your 2025 calendar year deductible by Anthem.
• This does NOT include any coinsurance, copays or out of pocket amounts, ONLY deductible.
• Members and new covered associates will receive ID cards 7-10 business days after Anthem concludes entering enrollment in their system. Please do not schedule appointments at the start of your new coverage unless it is unavoidable. Providers cannot always immediately find your information in the system.
• Members can view/print a copy of their ID cards and search for care via the Anthem member website https://www.anthem.com/register or the Anthem Mobile App (Sydney).
Unlimited visits at $0 copay. This service also covers your spouse and dependents to age 26.
DENTAL
OneStreet Residential sponsors two dental plan choices through Anthem To find a participating dental provider, visit www.Anthem.com and select Find Care or call 877-604-2158 These are PPO Plans and use the Anthem Dental Complete network See page 34 for plan payroll deduction amounts You get the best deal by staying in-network You can be balance billed if you go out-of-network Your out-of-network dentist would only be paid 90% of what Anthem pays to contracted innetwork dentists
(Base) Plan 1
Preventive & Diagnostic Services Exams, Cleanings & Bitewing X-Rays, Fluoride, Sealants and Space Maintainers
Exams, Cleanings & Bitewing X-Rays, Fluoride, Sealants and Space Maintainers
Filings, Extractions, Endodontics (root canal), Periodontics (gum surgery), Oral Surgery
Inlays/Onlays, Dentures, Implants
(Deductible
(After deductible)
(After deductible)
Didyou know?
91% of adults age 20 to 64 have tooth decay1
1 in5 cases of total tooth loss is linked to diabetes2
Want to know moreabout yourextra dental services?
Not in one of our care management programs, but have one of the qualifying conditions? You can sign yourself up for the dental extras. Just call the Member Services number on your ID card.
Somethingextrafor you– andyour health
Your dental plan offers extra benefits if you have certain medical conditions
Good dental health can help your overall health, especially if you have certain medical conditions. That's why if you have an ongoing condition and you take part in one of our care management programs, you get extra dental services like more cleanings or gum maintenance at no extra cost! You’ll get 100% coverage of extra dental services with no out-of-pocket costs. And the extras won’t count against your plan’s annual coverage maximum.
If you have any of these conditions:
Diabetes
Pregnancy
Stroke
Organ and bone marrow
transplant Cancer treated with chemotherapy
Head or neck cancer treated with chemotherapy and/or radiation
Suppressed immune system (HIV/AIDS) End-stage kidney disease
You’ll get extra dental services for your health needs, such as:
Cleanings
Gum maintenance
Fluoride
Sealants
Gum scaling and root planing (deep cleaning) Routine or problem-focused exams
All you have to do is call your dentist’s office to set up your appointment!
Accidental Dental Injury Benefit
Anthem Benefits
• Provides a per person, accidental dental injury benefit for things like slips and falls, car accidents,or sporting event injuries
• Dental care is covered at 100% with no deductibles, coinsurance, copays, or waitingperiods
• No limit on the number of accidents each coverage year with the option of an unlimited annual maximum benefit
• Covered accidental care coordinates with medical and other insurances to help offset member out-ofpocket costs such as medical or automobile insurancedeductibles
Market Comparison
• Many dental plans exclude coverage for accidental dental injuries or use limitations and exclusions to apply accidental dental injuries to medical or automobileinsurance
• Some dental plans may require member payment of deductibles, coinsurance, and copays forcovered accidental dental injuries
• Benefit waiting periods may be applied to accidental dental care resulting in member out-of-pocket costs for services including crowns, bridges, or evendentures
• In some cases, dental policies may limit the accidental dental injuries eligible for coverage to as littleas once per lifetime
• Dental plans often apply an annual or lifetime benefit maximum for covered accidental dentalinjuries
1/3 of preschool children and adults have suffered a dental trauma at least once during their lifetime
About 90% of all dentalinjuries occur before the age of 202
49% of school children ages 6-18years who experience one dental injury will experience another3 $1,000 or more is the average cost to treata complicated dental injury4
1 Glendor U. Epidemiology of traumaticdental injuries – a 12-year review of the literature. Dent Traumatol2008;24:603-11. 2Eilert-Petersson E, Andersson L, Sörensen S. Traumaticoral vs. non-oral injuries. An epidemiologic study during one year in a Swedish county. Swed Dent J 1997;21:55-68. 3-Glendor U, Koucheki B, Halling A. Risk evaluation and type of treatment of multiple dental trauma episodes to permanent teeth. Endod Dent Traumatol2000;16:205-210. 4- Borum MK, Andreasen JO. Therapeutic and economic implications of traumaticdental injuries in Denmark: an estimate based on 7549 patients treated at a major trauma centre. Int J Paediatr Dent. 2001 Jul;11(4):249-58. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky:Anthem Health Plans of Kentucky,Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), and Healthy Alliance®
Anthem covers remote teeth straightening
ClearalignersfromSmileDirectClub are coveredaspart ofour Ortho@Homesolution
If you ever need mild-to-moderate teeth straightening, we want to make sure you have options. That’s why we have partnered with SmileDirectClub . If you have orthodontia coverage with your Anthem dental plan, you can receive invisible orthodontic aligners remotely, at a cost that’s often less than regular braces.1
SmileDirectClub provides a more convenient way to straighten your teeth by using telehealth for checkins without the need for monthly office visits. The company offers two choices to straighten teeth:
Original clear aligners are worn 22 hours a day, for 4 to 6 months.
Nighttime clear aligners are worn 10 hours a day, while you sleep, for 10 months.
Whichever option you choose, you will receive:
Expert, remote treatment and care through your computer or smartphone from a licensed dentist ororthodontist.
Your complete kit of Made in the USA invisible aligners sent directly to you.
You can see the savings
Not only is remote orthodontic treatment more convenient than having to go to the dentist’s office for teeth alignment, SmileDirectClub can also help you save money
Bright On premium teeth whitening.
Aretainer at no additionalcharge.
Begin treatment at a SmileDirectClub SmileShop locationnear you where you, will receive a no-cost 3D digital image of your teeth, or you can choose a doctor-prescribed impression kit sent directly to your home.
RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO
OneStreet Residential offers you vision coverage through Anthem. The plans uses the Anthem Blue View Vision network. To find participating providers and answers to general questions go to https://www.anthem.com/accountlogin/ or call 877-875-1223. See page 34 for plan payroll deduction amounts.
LIFE AND AD&D
Basic Life/AD&D Insurance provided by OneStreet Residential
Life Insurance is a key element of proper financial planning and helps provide financial stability and protection for families in case of an untimely death. If you are an eligible full-time associate, OneStreet Residential provides $25,000 of basic group term Life insurance and an additional matching amount of Accident Death and Dismemberment (AD&D) insurance through MetLife. This coverage is guarantee issue, which means there are no health questions
There is a reduction in benefit by 35% ($16,250) at age 65, and again by 50% ($12,500) at age 70. This is a company paid benefit.
Supplemental Term Life Insurance And Accidental Death & Dismemberment (AD&D)
Associates have the option of purchasing Supplemental Term Life and AD&D Insurance through MetLife, in addition to their employer-paid life insurance. Supplemental Term Life Insurance and Accidental Death and Dismemberment (AD&D) are intended to provide additional protection to full-time associates AD&D provides double the benefit in the event of accidental death. It also provides a partial benefit for loss of limb or eye due to an accident. Those interested can elect the amount that suits their needs at an affordable rate. Rates are based on age and when you enroll for this benefit, it will illustrate the cost in Employee Navigator
Supplemental Term Life Insurance and AD&D coverage is portable (you may take it with you when you leave OneStreet Residential by contacting MetLife within 30 days).
Associate: Increments of $10,000 up to the lesser of 5 times base annual earnings or a maximum of $500,000. The guarantee issue amount at your initial offering of this plan is $100,000. Associates wishing to apply for coverage above $100,000 will need to seek approval for this coverage by completing an Evidence of Insurability (EOI) form, where they will answer a series of simple health questions for MetLife underwriting to review
If electing coverage for yourself, you may also elect coverage for your spouse, and/or children.
Spouse: Increments of $5,000 up to the lesser of 50% of your Supplemental amount or $100,000 maximum. The guarantee issue amount is $25,000. Spouse rates are based on the associate’s age.
Child (age 6 months – 26): Options of $1,000, $2,000, $4,000, $5,000 or $10,000. All child life is guarantee issue. One monthly premium covers all dependent children.
Choose Your Beneficiary: Make sure your life and accidental death benefits will be paid as you intend. Be sure you name a beneficiary when you enroll in Life and AD&D benefits.
If you do not enroll in supplemental associate or spouse life when you are first eligible (within 30 days of your eligibility), you will be subject to Evidence of Insurability (EOI) when you apply for coverage at a later date. You will also be subject to EOI when requesting an increase to your coverage outside of your initial eligibility date.
Empathy
Supporting families every step of the way
Empathy gives beneficiaries complimentary access to 24/7 support forchallenges that the loss of a loved one brings, helping them save time, money, andstress. Empathy helps ease the burden, so loved ones can pay attention to the things that matter most. MetLife will make beneficiaries aware of Empathyservices following a loss.
Probate & estatesettlement
A personalized, step-by-step checklist, as well as secure document storage in a digital vault that can be accessed anytime. In addition, a family collaboration tool allows beneficiaries to share tasks with up to 9 people.
Personal belongings
Help with the deeply emotional task of clearing the house: taking inventory, making decisions about who gets what, and finding professionals like appraisers and home liquidators.
Closing open accounts
Account closure service, for everything from bank accounts to gym memberships, with Care Managers available to solve thorny issues or act on beneficiaries’ behalf.
Bills & debt
Empathy’s Care Teamcan help beneficiaries locate andprioritize debts, so that they are paid in accordance with probate law.
Taxes
In-depth guidance on income taxes, estate taxes, applying for a tax ID, and necessary paperwork as well as finding professional financial advice, if necessary.
Grief support
Dedicated, one-on-one support from Empathy’s Care Team, as well as tools on Empathy’s platform: a daily journal with prompts to reflect on challenging feelings, guided meditations, and more.
Identity theft protection
Preventative actions to protect a loved one's estate, and steps to take if identity theft issuspected.
Applying for ancillary benefits
A benefits assessment thathelps families get the funds they are entitled to quickly andefficiently.
Property & assets
A personalized checklist to appraise assets duringprobate and support with major inheritance issues.
Selling the house
Support for one of the most challenging inheritanceissue most beneficiaries will face: selling real estate, including connecting with a broker, if necessary.
The funeral
A tailored checklist with guidance on every step of the process from choosing a funeral home to planning the service and writing the eulogy plus hands-on assistance from the CareTeam.
The obituary
Empathy’s obituary-writing service creates a beautifully written tribute, ready for publication, with information from a series of questions.
The will Help in determiningwhether a will is valid, as well as online search support to locate any other versions of the will.
Immediatearrangements
Essential, timely instructions on obtaining a pronouncement of death, death certificates, and arranging transport to a funeral home or crematorium.
Searchingfor documents
Where to find documents needed to settle a lovedone's affairs, from the will to household bills to banking information.
Informing others
Support for beneficiaries in the early hours of loss: everything from scripting the conversation to making a list of who needs to be informed.
metlife.com
Empathy’s bereavement services and platform are provided through an agreement with The Empathy Project, Inc., (doing business as Empathy). Empathy is not an affiliate of MetLife, and the services Empathy provides are separate and apart fromthe insurance provided by MetLife. This program is available to beneficiaries, and insureds who are terminally ill and eligible to accelerate life proceeds under MetLife's Accelerated Benefit Option. Not available on all policy forms or in all jurisdictions. Empathy is only available to insureds and beneficiaries who are US residents. Information disclosed directly to Empathy is not disclosed to MetLife, and therefore is not subject to MetLife’s privacy policy.
Disability coverage provides the financial security of knowing that you will continue to receive income if you are unable to work due to illness or injury. Rates are based on age and basic earnings. You will be able to determine the cost in Employee Navigator.
Voluntary Short-Term Disability
OneStreet Residential offers all full-time associates the opportunity to purchase short-term disability coverage through MetLife. This coverage pays up to a weekly benefit of 60% of the associate’s pre-disability income (up to a maximum of $2,000 per week) during periods of disability resulting from injury, sickness, or pregnancy STD benefits begin on the 8th day after an accident, sickness, or pregnancy STD benefits pay weekly for a duration of up to 12 weeks *There is a 3/12 pre-existing condition limitation which means the plan will not pay a claim anytime in the first 12 months of coverage due to a condition for which a member received medical care anytime in the 3 months prior to the effective date.
Voluntary Long-Term Disability
OneStreet Residential offers all full-time associates the opportunity to purchase longterm disability coverage through MetLife Long-term disability pays 60% of monthly earnings to a maximum of $10,000 Benefits begin after 90 days of being disabled and can last up to Social Security Normal Retirement Age. *There is a 12/12 pre-existing condition limitation which means the plan will not pay a claim anytime in the first 12 months of coverage due to a condition for which a member received medical care anytime in the 12 months prior to the effective date
*The pre-existing condition limitation does apply to pregnancy (i.e. if you are already pregnant when you elect STD, you cannot make a claim when you deliver. The plan will only pay if you become pregnant AFTER the effective date of your STD coverage).
If you do not enroll in the Disability plans when you are first eligible (within 30 days of your eligibility), you will be subject to Evidence of Insurability (EOI) when you apply for coverage at a later date.
LEGAL PLAN
OneStreet Residential offers all full-time associates the opportunity to enroll in Metlife’s Legal Plan, MetLaw. Many people will need an attorney at some point in their lives. Associates who enrolled in MetLife’s Legal Plan will have unlimited access to professional attorneys who can help navigate through life’s major milestones
You can meet an attorney in person, or contact them over the phone, or online using our Law Firm E-Panel® And MetLaw has a range of self-service tools to give associates and their family members a helping hand and a little guidance.
For some legal matters, the attorneys may even be able to appear on your behalf in court, so you don’t have to take time away from work or your families to attend a court hearing
ACCIDENT & CRITICAL ILLNESS
Accident Insurance
OneStreet Residential offers an Accident plan through Allstate Benefits are paid directly to you based on a flat schedule when an accident occurs. Some examples of when the plan would pay a benefit are the following: fracture, dislocation, burn, concussion, coma, torn cartilage in knee, laceration, broken tooth, eye injury, ambulance, emergency room, hospital admission, paralysis and more. The plan has a $25 annual benefit (reward; 2 per covered member, per calendar year payable up to FOUR times a year) for preventive screenings. If enrolling, you may also cover a spouse and/or children Rates are based on who you cover on the plan and can be found in Employee Navigator This plan is portable at the same rate should you leave the company
Critical Illness Insurance
OneStreet Residential offers a Critical Illness plan through Allstate. A lump sum benefit is paid out when diagnosed with a critical illness. Consider this plan as a way to help with your medical plan expenses and other daily living expenses if you were to be diagnosed with a critical illness The plan pays $10,000 for diagnosis of Heart Attack, Stroke, Major Organ Transplant, End-Stage Renal Failure & Invasive Cancer The plan pays $2,500 for diagnosis of Coronary Artery Bypass and Carcinoma in situ The plan has a $5,000 specified illness rider if the insured is certified by a physician as having one of the additional chronic illnesses listed in the policy and is unable to perform at least two activities of daily living for 90 days The plan has a $50 annual benefit (reward; 1 per covered member, per calendar year) for preventive screenings. If enrolling, you may also cover a spouse and/or children, and they are eligible for 50% of the associate’s benefit amount. Rates are based on age and can be found in Employee Navigator. This plan is portable at the same rate should you leave the company
MyBenefits: 24/7 Access
An easy-to-use website that offers 24/7 access to important information about your benefits. Plus, you can submit and check your claims (including claim history), request your cash benefit to be direct deposited, make changes to personal information, and more Please register at www allstatebenefits com/mybenefits
IDENTITY THEFT PROTECTION
Allstate Identity Protection Select is a new product that provides comprehensive financial and identity monitoring to help associates protect themselves against the impact of identity theft.
OneStreet Residential offers all full-time associates the opportunity to enroll in Allstate’s Identity Protection Select With this plan, associates are able to:
• Check their identity health score
• Get comprehensive identity and financial monitoring
• View and manage alerts in real time
• Receive high-risk financial transaction alerts
• Depend on in-house customer care specialists 24/7
• Rely on $1 million identity theft expense coverage
• Protect themselves and their family (everyone that’s “under the member’s roof and wallet”)
ADP BENEFITS ENROLLMENT
EMPLOYEE NAVIGATOR
NOTE:
• You must login and submit your elections or actively WAIVE the benefits.
• Please make sure to designate a beneficiary for your life insurance benefits.
• Have your dependent’s information readily available when enrolling in the benefits, such as date of birth and social security numbers.
Step 1: Access Your Benefits Portal in ADP: In ADP WorkForce Now, navigate to the Benefits tile.
401(k)
Savings for retirement can seem overwhelming. Looking out, a retirement date seems so far into the future and something to think about at a later time. But in reality, retirement is sometimes closer than you think. Will you be ready? One way to start saving for retirement is with the company’s 401(k) Plan.
Enrollment
Associates who are age 18+, have completed at least 1,000 hours of service and have been employed for a minimum of 6 months of service are eligible to enroll the first of the month following the 6-month waiting period
Contributions
An associate can make contributions on a pre-tax basis as a Traditional 401(k) deferral or an after-tax basis as a Roth 401(k) deferral All contributions and rollovers are 100% vested
Company Match
Additionally, the company matches 100% up to 1% of your contributions. Matching contributions are made during the first quarter of the following year and an associate must be employed on 12/31 of the current year unless the associate retired at age 65, deceased or became disabled. Matching contributions follow the vesting schedule below:
EMPLOYEE ASSISTANCE PROGRAM
Help, when you need it most.
With your Employee Assistance Program and Work/Life Balance services, confidential assistance is as close as your phone or computer.
When you experience life’s challenges, the Employee Assistance Program (EAP) through HealthAdvocate is available to help 24/7/365. This free, confidential program is available to you and members of your household. You do not need to be enrolled in one of OneStreet Residential’s medical plans in order to take advantage of this valuable benefit. The program is designed to offer short-term counseling and support for a range of personal, family, financial and work/life issues This service is available to you and your dependents, including your spouse, children, parents and parent-in-laws. All associates (full-time and part-time) are eligible for the Employee Assistance Program (EAP) upon date of hire.
• 24-hour Emergency Hotline answered by a Licensed Master’s-level Counselor
• Professional telephone evaluation for the nature/scope of the issue and referral (if needed) to appropriate professional counseling or other necessary care
• Up to 5 In-person counseling sessions, per person per issue per year
• Video Counseling available for face-to-face sessions only
Work/Life Support: Telephonic, Online and Mobile Associates have unlimited 24/7 access to call, go online or use the app for help locating resources to better balance your work and life responsibilities, such as:
• Financial: online Financial Wellness portal and Financial Fitness Center for help with debt management, budgeting, college funding, retirement strategies and other issues; free 30-minute consultation with a financial specialist
• Employee Discount Center: online savings program with 25% discounts on name-brand items
• Childcare: childcare centers, family childcare homes, nanny agencies, summer camps, babysitter tips, community resources
• Eldercare: nursing homes, assisted-living facilities, independent living facilities, home healthcare, hospice, respite care, geriatric Care Managers, senior centers, adult day care, community services and resources
• Legal: family law, real estate, estate planning, motor vehicle, elder law, criminal matters; free 30-minute consultation with a legal specialist; access to discounted legal services
Visit Health Advocate at www.healthadvocate.com/members, or call 877-240-6863.
MEDICARE ASSISTANCE & EDUCATION
Take the Uncertainty Out of Medicare!
As we begin the journey to retirement, planning for and understanding the intricacies of Medicare can be difficult. Our Benefits Broker, Sterling Seacrest Pritchard, has endorsed John Mudrock at Medicare Plan Pro to aid you in navigating your options as you approach Medicare eligibility.
John Mudrock
As Co-Founder of Medicare Plan Pros John brings 13 years of Medicare industry experience with him. His first 10 years in the industry were spent with Humana before venturing out in 2015 to start what is now Medicare Plan Pros. He likes to take a consultative approach with his clients educating them on all of their options so that they may make the best decision for themselves
Discover What We Do Best
Find expert Medicare advise with Medicare Plan Pros! Let us take the worry and stress out of your future. We know picking a Medicare plan can be an overwhelming process. That’s why we are here. Contact us and let an independent agent do the work for you today to insure your tomorrow.
• Medicare Advantage: Also known as Medicare Part C These plans allow for a private insurance company to provide your Medicare benefits These plans cover all the benefits of Original Medicare and can include Medicare Part D prescription coverage as well as vision, dental, and hearing
• Medicare Supplements: These plans help cover Medicare Part A and Part B deductibles, as well as Medicare coinsurance. Each policy is standardized and must offer you the same basic benefits no matter which company sells it to you. Costs are typically more predictable and not limited to the use of specific networks.
• Medicare Part D: Medicare Part D coverage can come in the form of a standalone Prescription Drug Plan (PDP). Someone might combine this coverage with Original Medicare. Also, in some cases, Part D may come included with a Medicare Advantage Plan. For more detailed information visit www.medicareplanpros.com Or call John Mudrock, (404) 376-3449
ASSOCIATE PAYROLL DEDUCTIONS
KEY CONTACTS & RESOURCES
JEN
Client
678-553-8293
jrakestraw@sspins.com
ABIGAIL (ABBY)
Client
404-698-4419
arives@sspins.com
KEY CONTACTS & RESOURCES
IMPORTANT NOTICES
COBRA Continuation of Coverage
The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end For more information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator For additional information regarding COBRA qualifying events, how coverage is provided and actions required to participate in COBRA coverage, please see your Human Resources department.
Newborns’ and Mothers’ Health Protection Act
The group health coverage provided complies with the Newborns’ and Mothers’ Health Protection Act of 1996 Under this law group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable ) In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours)
Premium Assistance under Medical and CHIP
If you or your children are eligible for Medicaid or CHIP (Children’s Health Insurance Program) and you are eligible for health coverage from your employer, your State may have a premium assistance program that can help you pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employersponsored health coverage but need assistance in paying their health premiums. If you or your dependents are already enrolled in Medicaid or CHIP you can contact your State Medicaid or CHIP office to find out if premium assistance is available If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1877-KIDS NOW or www.insurekidsnow.gov to find out how to apply If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan Please see Human Resources for a list of state Medicaid or CHIP offices to find out more about premium assistance.
Special Enrollment Events
An Eligible Person and/or Dependent may also be able to enroll during a special enrollment period A special enrollment period is not available to an Eligible Person and his or her dependents if coverage under the prior plan was terminated for cause, or because premiums were not paid on a timely basis
An Eligible Person and/or Dependent does not need to elect COBRA continuation coverage to preserve special enrollment rights. Special enrollment is available to an Eligible Person and/or Dependent even if COBRA is elected. Please be aware that most special enrollment events require action within 30 days of the event Please see Human Resources for a list of special enrollment opportunities and procedures
Women’s Health and Cancer Rights Act
If you have had or are going to have a mastectomy , you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: All stages of reconstruction of the breast on which the mastectomy has been performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; and Prostheses and treatment of physical complications of the mastectomy, including lymphedemas These benefits will be provided subject to deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan If you would like more information on WHCRA benefits, call your plan administrator
IMPORTANT NOTICES
The Genetic Information Nondiscrimination Act (GINA) prohibits health benefit plans from discriminating on the basis of genetic information in regard to eligibility, premium and contributions This generally also means that private employers with more than 15 employees, its health plan or “business associate” of the employer, cannot collect or use genetic information, (including family medical history information). The once exception would be that a minimum amount of genetic testing results make be used to make a determination regarding a claim.
You should know that GINA is treated as protected health information (PHI) under HIPAA The plan must provide that an employer cannot request or require that you reveal whether or not you have had genetic testing; nor can your employer require that you participate in a genetic test An employer cannot use any genetic information to set contribution rates or premiums.
PPACA Compliant Plan Notice
Since key parts of the health care law took effect in 2014, there is a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment-based health coverage offered by your employer
If your employer offers health coverage that meets the “minimum value” plan standard, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan The “minimum value” plan standard is set by the Affordable Care Act. Your health plans offered by [Company] are ACA compliant plans (surpassing the “minimum value” standard), thus you would not be eligible for the tax credit offered to those who do not have access to such a plan
NOTE: If you purchase a health plan through the marketplace instead of accepting health coverage offered by your employer, then you will lose the employer contribution to the employer offered coverage Also, this employer contribution, as well as your employee contribution to employer offered coverage, is excluded from income for Federal and State income tax purposes.
USERRA Notice
The Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) established requirements that employers must meet for certain employees who are involved in the uniformed services. In addition to the rights that you have under COBRA, you (the employee) are entitled under USERRA lo continue the coverage that you (and your covered dependents, if any) had under the [Company] plan
You Have Rights Under Both COBRA and USERRA Your rights under COBRA and USERRA are similar but not identical. Any election that you make pursuant to COBRA will also be an election under USERRA, and COBRA and USERRA will both apply with respect to the continuation coverage elected. If COBRA and USERRA give you different rights or protections, the law that provides the greater benefit will apply The administrative policies and procedures described in the attached COBRA Election Notice also apply to USERRA coverage, unless compliance with the procedures is precluded by military necessity or is otherwise impossible or unreasonable under the circumstances
Definitions
"Uniformed services" means the Armed Forces, the Army National Guard, and the Air National Guard when an individual is engaged in active duty for training, inactive duty training, or full-time National Guard duty (i e , pursuant to orders issued under federal law), the commissioned corps of the Public Health Service, and any other category of persons designated by the President in time of war or national emergency.
"Service in the uniformed services" or "service" means the performance of duty on a voluntary or involuntary basis in the uniformed services under competent authority, including active duty, active and inactive duty for training, National Guard duty under federal statute, a period for which a person is absent from employment for an examination to determine his or her fitness to perform any of these duties, and a period for which a person is absent from employment to perform certain funeral honors duty. It also includes certain service by intermittent disaster response appointees of the National Disaster Medical System.
IMPORTANT NOTICES
Duration of USERRA Coverage
General Rule: 24-Month Maximum. When a covered employee takes a leave for service in the uniformed services, USERRA coverage for the employee (and covered dependents for whom coverage is elected) can continue until up to 24 months from the date on which the employee's leave for uniformed service began However, USERRA coverage will end earlier if one of the following events takes place:
A premium payment is not made within the required time; You fail to return to work or to apply for reemployment within the time required under USERRA (see below) following the completion of your service in the uniformed services; You lose your rights under USERRA as a result of a dishonorable discharge or other conduct specified in USERRA.
Notice of Privacy Provision
This Notice of Privacy Practices (the "Notice") describes the legal obligations of [Company] (the "Plan") and your legal rights regarding your protected health information held by the Plan under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Among other things, this Notice describes how your protected health information may be used or disclosed to carry out treatment, payment, or health care operations, or for any other purposes that are permitted or required by law We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA
The HIPAA Privacy Rule protects only certain medical information known as "protected health information " Generally, protected health information is health information, including demographic information, collected from you or created or received by a health care provider, a health care clearinghouse, a health plan, or your employer on behalf of a group health plan, from which it is possible to individually identify you and that relates to:
• Your past, present, or future physical or mental health or condition;
• The provision of health care to you; or
• The past, present, or future payment for the provision of health care to you
If you have any questions about this Notice or about our privacy practices, please contact your Human Resources department The full privacy notice is available with your Human Resources Department
IMPORTANT NOTICES
This guide provides a summary of you employee benefits rights and regulations as determined by Federal and State Laws. Information included in this guide includes the following:
Special Open Enrollment Rights
Children’s Health Insurance Program (CHIP) Premium Assistance
General Notice of the Cobra Continuations Rights
Affordable Care Act (ACA) – Insurance Mandate
Health Insurance Marketplace Coverage Options and Your Group Health Coverage
Affordable Care Act (ACA) – Preventive Services for Non-grandfathered Plans Newborns’ and Mothers’ Health Protection Act of 1996
Break Time for Nursing Mothers Under the Fair Labor Standards Acts (FLSA) Women’s Health & Cancer Rights Act
The Generic Information Nondiscrimination Act of 2008 (GINA)
HIPAA Privacy Rules
SPECIAL OPEN ENROLLMENT RIGHTS
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. A special enrollment period is a time outside of the annual open enrollment period during which you and your family have a right to sign up for health coverage. In the Marketplace, you qualify for a special enrollment period 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage Job-based plans must provide a special enrollment period of 30 days Some events will require additional documentation to be submitted with the application at the time of enrollment You should read this notice even if you plan to waive coverage at this time
If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, or placement for adoption.
If you are declining coverage for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage) However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the othercoverage)
If you or your dependents lose eligibility for coverage under Medicaid or the Children’s Health Insurance Program (CHIP) or become eligible for a premium assistance subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents You must request enrollment within 60 days of the loss of Medicaid or CHIP coverage or the determination of eligibility for a premium assistance subsidy
To request special enrollment or obtain more information, please contact HR.
HEALTH INSURANCE MARKETPLACE
PART A: GENERAL INFORMATION
To assist you as you evaluate options for you and your family, this notice provides some basic information about the Marketplace and employment-based health coverage offered by your employer.
What is the Health Insurance Marketplace?
The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options You may also be eligible for a new kind of tax credit that lowers your monthly premium right away Open enrollment for health insurance coverage through the Marketplace runs from November 1, 2024, through December 15, 2024, for coverage starting as early as January 1, 2025.
Can I Save Money on my Health Insurance Premiums in the Marketplace?
You may quality to save money and lower your monthly premium, but only if our employer does not offer coverage, or offers coverage that doesn’t meet certain standards The savings on your premium that you’re eligible for depends on your household income
Does Employer Health Coverage Affect Eligibility for Premium Savings Through the Marketplace?
Yes If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit
If you purchase a health plan through the Marketplace instead of accepting health coverage by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage Also, this employer contribution – as well as your employee contribution to employer-offered coverage – is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an alter-tax basis.
How
Can
I Get More Information?
For more information about your coverage offered by your employer, please check your summary plan description or contact Human Resources.
The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.healthcare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area
HEALTH INSURANCE MARKETPLACE
PART B: INFORMATION ABOUT HEALTH COVERAGE OFFERED BY YOUR EMPLOYER
This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information This information is numbered to correspond to the Marketplace application
3. Employer Name OneStreet Residential, LLC
5. Employer Address 104 Interstate N Pkwy E SE
4. Employer Identification Number (EIN) 81-4913089
6. Employer Phone Number 404-974-4691
7. City Atlanta 8. State GA
10. Who can we contact about health coverage at this job?
Karen Thompson
11. Phone Number (if different from above)
12. Email Address Karen@onestreetres.com
Here is some basic information about health coverage offered by this employer:
As your employer, we offer a health plan to:
All employees. Eligible employees are:
Active full-time employees working 30 or more hours a week.
Some employees. Eligible employees are:
With respect to dependents:
We do offer coverage. Eligible dependents are:
Spouses and children up to age 26
We do not offer coverage.
9. Zip Code 30339
If checked, this coverage meets the minimum value standard and the cost of this coverage to you is intended to be affordable, based on employee wages
** Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount through Marketplace The Marketplace will use your household income, along with other factors, to determine whether you may be eligible for a premium discount If for example, your wages vary from week to week (perhaps you are an hourly employee or you work on a commission basis), if you are newly employed mid-year, or if you have other income losses, you may still qualify for a premium discount
If you decide to shop for coverage in the Marketplace, Healthcare.gov will guide you through the process Here’s the employer information you’ll enter when you visit to find out if you can get a tax credit to lower your monthly premiums.
IMPORTANT NOTICE ABOUT PRESCRIPTION
DRUG COVERAGE & MEDICARE
CREDITABLE
Please read this notice carefully and keep it where you can find it This notice has information about your current prescription drug coverage with OneStreet and about your options under Medicare’s prescription drug coverage This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice
There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:
• Medicare prescription drug coverage became available in 2006 to everyone with Medicare You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium
• OneStreet Residential has determined that all of the prescription drug coverage offered by the Anthem plans in this Benefit Guide are, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
When Can You Join a Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan
What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current OneStreet Residential coverage will not be affected Please review prescription drug coverage plan provisions/options under the certificate booklet provided by Anthem See pages 7- 9 of the CMS Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance which outlines the prescription drug plan provisions/ options that Medicare eligible individuals may have available to them when they become eligible for Medicare Part D If you do decide to join a Medicare drug plan and drop your current OneStreet Residential coverage, be aware that you and your dependents may not be able to get this coverage back
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with OneStreet Residential and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage In addition, you may have to wait until the following October to join.
For more information about this notice or your current prescription drug coverage, contact your carrier.
NOTE: You’ll get this notice each year You will also get it before the next period you can join a Medicare drug plan, and if this coverage through OneStreet Residential changes. You also may request a copy of this notice at any time
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare You may also be contacted directly by Medicare drug plans For more information about Medicare prescription drug coverage Visit www.medicare.gov. Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help Call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486- 2048 If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-7721213 (TTY 1-800-325-0778)
Remember: Keep this Creditable Coverage notice If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty)
