2013-2014 Employee Benefits

Open Enrollment

November 7th , 2013

Medical Insurance

• Plan Choices– Blue Shield HMO Premier 35 Plan (CA Only)– Blue Shield PPO 1000 Value Plan– Blue Shield Base PPO 40– Blue Shield Simple Saving 3500/7000 PPO-HSA

(PPO Health Savings Account)

– Kaiser HMO $30/$3,000 HSA Plan (CA Only)– Kaiser HMO $40/$3,000 (CA Only)

• Employee’s Share of Premium– Varies by plan

• Dependent Coverage to age 26– Available on all medical plans– Refer to contribution rate sheet for premium amount

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Blue Shield (CA Only)Access + HMO Premier 35 Plan

• Plan Highlights– No annual deductible– $35 co-pay for PCP office visits– No charge for professional services, lab, x-ray– Emergency room: $100 co-pay (waived if admitted)– Hospital: $350 / day - 3 day maximum per admission– Annual out-of-pocket maximum: $3,500 individual / $7,000

family– Prescriptions

• $10 Generic/ $30 formulary , $50 Non formulary– Primary Care Physician Assignment is mandatory– No charge or copay for Preventive Care

• Employee Share of Premium– $155 per month, pre-tax– Dependent coverage available at additional employee paid

premiums* Refer to summary of benefits for plan details 3

Blue ShieldPPO 1000 Value Plan

• Plan Highlights– Annual deductible: $1,000 per member– $20 co-pay for initial 3 in-network office visits (calendar year) – 30% coinsurance in-network– 50% coinsurance out-of-network– $5,000 annual out-of-pocket maximum per member (in-

network)– $250 brand-name drug deductible

• 2-tier prescription co-pays: $15 / $30 or 30%• Non-formulary not covered

– No charge or copay for Preventive Care• Employee Share of Premium

– $110 per month, pre-tax– Dependent coverage available at additional employee paid

premiums* Refer to summary of benefits for plan details* Refer to summary of benefits for plan

details4

Blue Shield Base PPO 40

• Plan Highlights– Annual deductible: $4,000 individual / $8,000 family– $40 co-pay for all office visits (deductible does not apply)– 40% coinsurance in-network– 50% coinsurance out-of-network– $6,000 / $12,000 annual out-of-pocket maximum (in-network)– $300 brand-name drug deductible

• 3-tier prescription co-pays: $10 / $30/ $50 – No charge or copay for Preventive Care– Not H.S.A. compatible

• Employee Share of Premium– $85 per month, pre-tax– Dependent coverage available at additional employee paid

premiums

5* Refer to summary of benefits for plan details

Blue ShieldSS 3500/7000 PPO-HSA Plan

• Plan Highlights– Annual deductible in-network: $3,500 individual / $7,000 family– Preventive care not subject to deductible – No charge or copay– Deductible applies to all other covered benefits – 20% co-insurance in-network after deductible– 50% co-insurance out-of-network after deductible– Annual out-of-pocket maximum: $4,500 individual / $9,000

family– After deductible - 3-tier Prescription co-pays:

• $10 / $30 / $50

• Employee Share of Premium– $100 per month, pre-tax– Dependent coverage available at additional employee paid

premiums

* Refer to summary of benefits for plan details 6

Kaiser Permanente$30 / $3,000 HSA Plan (CA Only)

• Plan Highlights– Annual deductible: $3,000 individual / $6,000 family– Preventive care not subject to deductible – No charge or copay– Deductible applies to all other covered benefits– $30 office visit copay after deductible– 30% for most major medical after deductible– Annual out-of-pocket maximum: $5,950 individual / $11,900

family– After deductible - 2-tier prescription co-pays:

• $10 / $30; non-formulary not covered– Must obtain all services at a Kaiser facility

• Employee Share of Premium– $90 per month, pre-tax– Dependent coverage available at additional employee paid

premiums

* Refer to summary of benefits for plan details 7

Kaiser Permanente $40/$3000 (Not HSA Eligible)

• Plan Highlights– Annual deductible: $3,000 individual / $6,000 family– Preventive care not subject to deductible – No charge or copay– Deductible is waived for office visits and prescriptions– $40 office visit copay – 30% for most major medical after deductible– Annual out-of-pocket maximum: $6,000 individual / $12,000

family– After deductible - 2-tier prescription co-pays:

• $10 / $35; non-formulary not covered– Must obtain all services at a Kaiser facility

• Employee Share of Premium– $95 per month, pre-tax– Dependent coverage available at additional employee paid

premiums

HSA Overview

• Also known as a “Medical IRA”– Provides vehicle for employees to set aside pre-tax funds

(outside of plan premiums) for payment of medical expenses– No time limitation for use of funds– Funds accrue and accumulate (roll-over) year to year– Funds are FDIC insured and accrue interest

• Investment options are available– Contributions are made pre-tax from payroll– Interest and distributions for qualified expenses are tax-free*

• Use tax-free* funds to pay for medical expenses(and non-covered dental and vision expenses)

* Federal Tax-free only – CA state taxes still apply

Note: Government regulations prevent HSA participants from having dual-coverage (i.e. participants are not eligible to also be covered under their spouse’s plan)

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HSA Logistics

• Self-Managed Health Care– Responsible for payment of all medical bills, including

prescriptions up to the plan deductible– Once deductible is met, “traditional” aspect of plan takes

affect with respective in-network or out-of-network co-insurance

• Contributions– aap3 contributes $20 per month to participant’s HSA account– You may contribute up to the IRS allowable amount less the

company contributed amount each calendar year:• $3,300 individual maximum / $6,550 family maximum for 2014

– You can change your contribution election any given month• HSA Account

– May never “withdraw” (reimburse) more than what is in the account at the time of reimbursement

– Visa Debit Card vs. Paper reimbursement request10

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How Does theHSA Work?

Co-Insurance based on In-Networkor Out-of-Network Services

Annual Deductible

Pre-Annual DeductibleInsured pays 100% of negotiated costs from

H.S.A.(Except preventative care and wellness

benefits)

0%

100%

GuardianPPO Dental Plan

• Plan Highlights:– 100% paid for preventive services– 80% paid for basic services– 50% paid for major services – $50 deductible (waived for preventive care)– $2,000 annual benefit maximum per person– $1,500 lifetime orthodontia benefit

• Employee Share of Premium– $20 per month, pre-tax– Dependent coverage available at additional employee paid

premiums

* Refer to summary of benefits for plan details 12

Guardian – VSP 12/24 Vision Care Plan

• Plan Highlights:– Exam & lenses available every 12 months– Frames available every 24 months– $10 co-pay – exams– $25 co-pay – glasses or lenses

• Employee Share of Premium– $5 per month, pre-tax– Dependent coverage available at additional employee paid

premiums

• Guardian vision enrollment will match current enrollment unless new vision enrollment form is submitted

* Refer to summary of benefits for plan details 13

GuardianEmployee Assistance Program

• Available to all employees• Access to licensed counselors for:

• 3 face to face sessions with a counselor free of charge• Licensed counselors available by phone 24/7

– Masters level counselors• Unlimited telephone calls for counseling• Online assessments (health / wellness / stress)

−Stress −Depression

−Legal −Alcoholism −Drug Abuse

−Parenting

−Finances −Grief −Relationships

−Identity Theft

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GuardianDisability & Life

• Short-Term Disability– Benefit is 60% of weekly

salary– Maximum benefit is $1,500

/wk– Benefit is offset by state

disability or other earnings– 8 day elimination period – Benefit duration is 12 weeks

• Long-Term Disability– Benefit is 67% of monthly

salary– Maximum benefit is

$8,000/mo– Elimination period is 91 days– Own Occupation for life of

benefit– Benefit is offset by state

disability or other earnings

• Life Insurance Benefit– Flat $50,000– AD&D $50,000– Conversion privileges included– Living benefits option

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Timing, Paperwork & Contacts

Benefits Program 2013

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Making Changes?

• All new members must complete an Enrollment Application

• Employees electing a new plan or changing dependent status must complete the Subscriber Change Request Form

• Vision/ Dental plan paperwork only needed for changes in election/decline

• Complete and submit all forms to aap3 HR by 12:00pm Noon (PST) on:

Thursday, November 21, 2013• Fax: 1-408-886-9424

• Email: hrus@aap3.com

• Benefits Plan premium contribution rates will reflect in the December 2013 payroll cycle

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Who to Contact About Benefits?

• Overall Benefit Program or Benefit Plan Questions– aap3 HR (HRUS@aap3.com

)

• Individual Specific Insurance Plan & Coverage Questions– Bedrosian & Associates

• Alex Bedrosian , Acct Mgr(650) 367-0259alex@bedrosian-associates.com

• Forms & Insurance Plan Information– aap3 HR

• Primary Plan Provider Websites:– Blue Shield (Medical)

• www.blueshield.com / www.blueshieldca.com

– Kaiser (Medical)• www.kaiserpermanente.org

– HSA Bank (HSA)• www.hsabank.com

– Guardian (Dental, EAP, Disability & Life)

• www.guardian life.com – VSP (Vision)

• www.vsp.com

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2013 - 2014 Benefit Plans – Open Enrollment

Any Questions?

November 7th , 2013

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