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What’s New for 2017 2
MarketLink Service Center 3
Enrollment Instructions 4
Eligibility, Status Changes 5
Tobacco/Spouse Surcharge 6
Medical Benefits 7
Prescription Drug Coverage 9
Obeo Decision Support 10
Dental Plans 11
Vision 12
HSA and FSA 14
Life, AD&D, Disability and
Voluntary Benefits 15
EAP 18
Important Regulations 19
At Tech Mahindra, benefit plans are an important part of the compensation we
offer our associates. We have designed our benefit programs to offer you and
your family a broad choice of offerings. Our benefits are competitive within our
industry, and it is our strategy to keep them there. You will see changes as we
adjust to the changing business environment and react to legislation changes,
particularly around health care—but the overall suite of benefits available is
comprehensive and competitive in the marketplace in which we do business.
We continue to work together to be educated consumers of our benefits, so our
benefits package will continue to offer the protection we feel every associate
deserves.
Before you enroll in your benefits, take the time to review your options and
determine what plans and coverage levels are right for you and your family. You
can find the information you need to make informed decisions in this Benefits
Guide. Additional details can be found on the benefits website.
Between December 13th and December 27th, you have an opportunity to enroll
or make changes to your benefit elections. To enroll in your benefits, please log
into benefits website by December 27, 2016. IMPORTANT: If you are currently
enrolled in one of the medical plans and you do not take action during the open
enrollment, you will be automatically enrolled into the Bronze Plan with
Associate Only coverage. If you want to select another plan and wish to have
your eligible dependents covered, you must participate in the online open
enrollment.
You will not be able to make changes until next Open Enrollment, unless you
have a Qualifying Change in Status. Please see page 3 of this guide for more
information on how to enroll. You can also speak with or email one of our
benefits representatives for assistance with any of your benefits or enrollment
questions. M-F 8:30 AM to 5:30 PM* Eastern Time at 1-844-316-6131 or
* Note: Closed December 23rd at 1PM Eastern and December 26th.
2017 Open Enrollment Period Begins: December 13, 2016 | Ends: December 27, 2016
Key Features for the
2017 plan year: You must participate in the
online enrollment if you want to
choose your medical, dental,
vision coverage, if you want to
cover any dependents or enroll
in the HSA or FSA for the 2017
plan year.
2017 Open Enro l lment
webinars will be held. Please
make every effort to attend.
Dates, times and registration
links are provided in the Open
E n r o l l m e n t e m a i l
communications.
Webinar dates (PST):
Wednesday, December 7 9:00AM
Thursday, December 8 11:00AM
Friday, December 9 1:00PM
Monday, December 12 3:00PM
2017 Benefits
Guide
Just as your life changes, so do
your benefit needs! Don’t miss your
opportunity to make benefit
elections for you and your family.
2 | 2017 Plan Year
What’s New for 2017 We have several new things to review about our benefits programs for 2017.
Benefits Administrator and Enrollment System The method you enroll in benefits and who you contact for questions about your benefits will now be handled by MarketLink.
MarketLink is part of the Marsh & McLennan Agency LLC (MMA), who partners with thousands of companies to provide
employee benefit services. MarketLink will be the system platform that you will use to select your 2017 benefits, enroll your
eligible dependents, provide beneficiary information for your life insurance coverage, and so much more. Later in this
newsletter, we will explain in greater detail how you will gain access to the enrollment website to complete your online open
enrollment.
Active Enrollment—What This Means and Why Is It So Important? With the transition of our benefits enrollment system, we will be holding what is referred to as an “Active Enrollment” for this
years annual open enrollment period. This is important because if you do not participate in the online open enrollment, you
may not be enrolled in the coverage you want AND you will have no coverage for your eligible dependents even if they are
covered currently. Active enrollment will be your opportunity to be a real consumer of your healthcare needs and the needs of
your family. If you do not participate in the online open enrollment here is what will happen.
You will be defaulted in the following healthcare plans with Associate Only coverage (no dependents) :
Medical—Bronze Plan ¹ Dental—Savings Plan Vision—Standard Plan
Insurance Changes While many of the insurance carriers and vendors we use today will remain the same for 2017, there are a few important
changes to review.
Medical and Prescription
Our new medical and prescription insurance administrator will be Aetna. Aetna is one of the largest health care companies in
the United States. When you enroll in medical coverage, prescription coverage is provided automatically.
Aetna has built some of the largest networks of medical providers in the country, and they hold them to the highest standards
which translates to quality care for their members. This does not guarantee they have every provider in their network, so we
encourage you to check their website to see if your medical and pharmacy providers participate. But even if they do not
participate, all our medical plans provide coverage on an out of network basis. A word of caution, when you choose an out-of-
network provider, these providers are not contracted with the insurance carrier. This means the provider may bill you the
difference between the negotiated amount and the provider’s actual charge, this amount could be significant. Whenever
possible choosing an Aetna provider is your best option.
Dental
Next year, Delta Dental will be our dental insurance provider. Delta Dental is America’s largest dental benefits carrier serving
more than one third of the estimated 191 million Americans with dental insurance. Their cost-control measures and
contractual agreements with dentists help to ensure quality care at moderate fees, collectively saving expenses for their
members. You should check with your dental provider and/or on their website to see if your provider participates. For members
with past or active orthodontia care, the claim amounts considered to date will be reduced from the orthodontia lifetime
benefit.
Tobacco Surcharge
Like many companies, we are focusing on the health and wellbeing of our associates. Statistics show that awareness,
education, and prevention may reduce the risk factors of certain preventable diseases. One major factor which can improve
overall health is to be tobacco-free. For our tobacco-free members, you will enjoy a lower medical cost than associates who are
tobacco users. Please refer to the full details about this program on page 6 of this newsletter.
Spousal Surcharge
Beginning in January 2017, we will implement a spousal surcharge. The surcharge applies only to those associates who cover
their spouses on the medical plan when the spouse has access to healthcare coverage through their employer. Please refer to
the full details about this program on page 6 of this newsletter.
¹ Refer to page 6 of this newsletter for further details about additional cost implications.
3 | 2017 Plan Year
When you are in need of assistance, simply contact the Benefits
Service Center to work with an experienced benefit expert who has an
in-depth knowledge of your benefit plans. The representative can:
Assist you with the annual benefits enrollment process (i.e. plans
being offered, how to enroll, etc.)
Answer questions about Tech Mahindra’s benefit plans: medical,
prescription, dental, vision, life/disability insurances and more
Provide special assistance when you need help to resolve difficult
claims problems
Assist with issues involving an insurer or another provider
Discuss your choices when you have a “qualified life change,” such
as marriage, divorce, or the birth/adoption of a child
Help you identify a network physician, lab, or other provider in your
geographic area
MarketLink Benefit Service Center
1-844-316-6131
Monday through Friday
8:30 am—8:00 pm Eastern Time *
* Note: Closed December 23rd at 1:00PM and December 26th
MarketLink Benefit Service Center
The MarketLink Benefits Service Center: Here to Serve YOU! Help is just a phone call away with the Benefit Service Center—a phone number you can call to speak with a benefits expert
about your insurance plans. Whether you have questions regarding copays, co-insurance, deductibles, prescriptions, claims
payments or what happens when you get married or have a baby, the Benefits Service Center is ready to answer your
questions. You can also email your questions to the same benefits experts. Tech Mahindra Associates will be able to contact
the Benefits Services Center when Open Enrollment begins on December 13, 2016.
Toll free number: 1-844-316-6131
Educate Yourself About Your Benefits Before you enroll in your benefits, take the time to review your options and determine what plans and coverage levels are right
for you and your family. You can find the information you need to make informed decisions in this Benefits Guide. Inside, you’ll
find the basics of health care, details on the benefit plans, learn why preventive care is critical, and get tips on what you can do
to stay healthy and save money.
Tech Mahindra will be conducting the Open Enrollment Webinars. If you are not able to attend any of the meetings, please
review the Open Enrollment presentation/benefit guide. Should you have any questions, please do not hesitate to the benefit
desk at 1-844-316-6131 or by email at [email protected].
4 | 2017 Plan Year
Dependent Enrollment Tips
You will need the following
information for your eligible
Dependents while completing
your online enrollment:
First and Last Name
Gender
Date of Birth
Social Security Numbers *
Relationship
R e m i n d e r : B e n e f i c i a r y
information for the life
insurance coverage will also be
needed during the Open
Enrollment period, be sure to
have this information available.
* If your dependent does not have
an SSN you will need to contact the
cal l center for enrollment
assistance.
Instructions for Participating in 2017 Open Enrollment
Website:
www.mymarketlink.com/TechMahindra
For your first visit to the enrollment site, following the instructions
below for your USERNAME and PASSWORD:
USERNAME is your Employee ID number
PASSWORD is your birth date in the YYYYMMDD format, your
first name initial (lower case), your last name initial (UPPER
CASE), plus an exclamation point (!)
Example: Rebecca Gray, Date of Birth August 14, 1962
USERNAME: EE ID number
PASSWORD: 19620814rG!
Note: After entering this default password, you will be instructed to change to a more secure password. The minimum
standards for password strength are outlined on the website. Once your new password meets these minimum requirements
you will see a green checkmark allowing you to proceed with the enrollment process.
You will then be on the Welcome Screen. From this screen, you will be able to enroll in your benefits, link out to compare
benefit choices, see your benefits summary, and review Benefit Plan Information among other resources. Select the ENROLL
NOW link and the enrollment wizard will walk you through the available benefit choices.
For questions, contact the benefits desk at 1-844-316-6131. Representatives are available 8:30 AM to 8:00 PM Eastern
time Monday through Friday. You can also send questions to [email protected].
5 | 2017 Plan Year
Your Benefits Program Together with your paycheck, the Tech Mahindra Employee Benefits Plan provides a comprehensive and competitive
compensation package. To maximize the value of the Plan, you need to understand how it works. It is important that you
carefully read through this entire 2017 Employee Benefits Booklet and share it with your eligible dependents. This booklet
highlights Tech Mahindra benefits program. If you have any questions regarding any of the information in this book, please
contact any member of Human Resources.
Who’s eligible to enroll? You and your dependents are eligible for the benefits
as described below, if you are paid through U.S.
Payroll and you are a regular, full-time Associate,
working a minimum of thirty (30) hours per week.
Temporary associates are not eligible to participate in
the Tech Mahindra benefits program.
Dependent eligibility Your dependents are also eligible to participate in
certain plan options. An eligible dependent is defined
as:
Your legally married spouse
Your dependent children
Included in the definition of dependent child(ren) are:
Your naturally born child(ren), legally adopted child(ren), step-child(ren) or court-ordered dependent child(ren) for whom you
are the court-appointed legal guardian
Your dependent child(ren) up to age 26. Coverage ends at the end of the month following the date they turn 26
Your continuously disabled dependent child(ren) (if disabled prior to age 26) who are incapable of self-sustaining
employment and dependent upon you for support, regardless of age
New Employee / New Hire Enrollment Deadline: Newly hired associates must make their benefit elections via the enrollment website within the first 30 days of employment. It
is requested that you inform Human Resources even if you are not going to elect coverage.
What if I don’t enroll? You MUST make your benefit elections via the enrollment website within 30 days of your date of hire. If you do not make your
elections, you will not be enrolled in any of Tech Mahindra voluntary benefits and you will not be able to make any changes
until the next Open Enrollment for the following calendar year.
Qualifying Changes in Status You may only make benefit election changes within the first 30 days of hire, during open enrollment and if you experience a
qualifying change in status. Please notify us within 30 days if you would like to change your benefits based on the following:
marriage, divorce, death of a covered dependent, change in your dependents residence affecting benefits, court orders, FMLA
entitlement, Medicaid loss or eligibility, birth or adoption of a child, loss of coverage under another group health plan, etc.
If you need to report a status change during the year, you will need to contact Human Resources with the necessary
changes within 30 days of the event.
Some examples of life events and changes in status are:
Birth or adoption of child
Marriage
Divorce and/or legal separation
Eligibility for Medicare
Death or loss of a dependent (including loss of dependent status)
Change in your spouse’s employment status causing a loss or gain of benefits
Change in your own employment status
Arrival of dependents from another country (which resulted in a loss of coverage)
6 | 2017 Plan Year
Medical Spousal Surcharge We considered additional ways to manage our costs that are in keeping with trends and common practices for companies
today. We have decided to include what is known as a Spousal Surcharge in our medical plans. Often an associate’s working
spouse has health care available to them through their own employer and they choose to participate on our plan instead. It is
increasingly common to include a surcharge for that spouse to be on our plan.
This is one way in which we make choices on how we spend our health care dollars, and so next
year we will subsidize those who have other choices less than we subsidize those who do not have
other choices. Non-working spouses who do not have access to medical coverage will not be subject
to the surcharge. We support you and your families’ need for health coverage and be assured that
your spouse may be on our plan with a surcharge that is pre-tax like all medical deductions. We
recommend you compare plans to which you have access so that you can make the best choice for
your situation.
The Spousal Surcharge is $23.08 per pay check and will be a pre-tax payroll deduction.
Non-working spouses who do not have access to medical coverage will not be subject to the
surcharge.
The surcharge ONLY applies to spouses. It does not apply if you are covering only your child(ren).
If you have a working spouse, you can avoid the surcharge by having your spouse enroll in
medical coverage with his/her employer.
Note: If your spouse loses or obtains medical coverage through his/her employer after completion of this certification, you have 31 days to notify
the HR Team of the change. Failure to make changes within 31 days will prohibit you from making any changes until the next annual enrollment
period. Additionally, Tech Mahindra reserves the rights to validate your certification at any time in the future to confirm if other coverage is
available. Any false certification may be grounds for disciplinary actions, up to and including termination of employment.
Tobacco Users Will Pay More for Medical Coverage Statistics show that the cost of providing health care to tobacco users is significantly higher than for non-
tobacco users. To help lower costs and also ensure that you are healthier in the future, starting in January 2017, Tech Mahindra
will implement a tobacco use surcharge for associates who use tobacco products. Tobacco products include cigarettes, pipes,
cigars, chewing tobacco, snuff, e-cigarettes or other vapor-emitting device, or any other tobacco related product. Associates
who qualify for tobacco free rates will pay lower contribution rates for their medical coverage than associates who are designated
to be a tobacco user. The tobacco surcharge is $23.08 per pay check. It will be necessary for you to certify your tobacco status
on the online enrollment site.
IMPORTANT: If you do not participate in the online Open Enrollment, you will be automatically defaulted into Associate Only
medical coverage in the Bronze Plan and the tobacco surcharge will be reflected. In order to avoid being automatically defaulted,
you must certify your tobacco status on the enrollment site.
Would you like to kick the habit for good? Through our medical insurance partnership with Aetna, you can participate in their
Healthy Lifestyle Coaching Tobacco Free program to avoid the Tobacco Surcharge. The program will focus on helping you live a
tobacco free life. In addition to coaching sessions, you can chat by phone or email. You can join a group coaching session that
meets regularly with others who have similar goals. You can also try other online programs which are available 24/7. All programs
are available at no cost to you and will be available January 1, 2017. When you complete 3 sessions with a coach, whether you
successfully quit tobacco or not, a monthly report will be sent to Tech Mahindra by Aetna showing the associates with course
completion. The Healthy Lifestyle Coaching Tobacco Free program allows for one session per week with a coach and is available
M-F from 8 am – 10 pm EST. To enroll in the program, simply call the toll-free number, 1-866-213-0153.
If you complete the program by March 31, 2017, we will then remove the surcharge back to January 1, 2017. If you complete the
program later during the year then you will be credited back to when you started the Tobacco free program*. The surcharge only
applies to the associates’ use of tobacco products. If your covered dependents are also tobacco users we strongly encourage
them to participate in the program as well, but it is not required at this time.
* Retroactive payroll credits will be limited to four (4) months (e.g.: Start program April 1st, complete program September 1st; payroll credit
provided back to May 1st.)
Important
In order to have any coverage
for your dependents in 2017,
you must participate in the
online Open Enrollment.
If you intend to cover your
spouse, you must certify their
availabil i ty for other
coverage. If the surcharge
should not apply because
your spouse does not work
and/or does not have other
coverage available, then you
must take action during the
online Open Enrollment to
certify their status.
You can do it! Contact a coach today —
for free.
1-866-213-0153 or www.aetna.com and click on the Healthy Lifestyle Coaching
NOTE: Tech Mahindra reserves the right to test for tobacco use at any time and falsifying your tobacco status
could result in future medical claims that are related or linked to tobacco use may be denied by the insurance
carrier; the non-tobacco user status will be rescinded; your insurance rates will increase and you may also be
subject to disciplinary action up to and including termination of employment. For associates for whom it is
unreasonably difficult to meet the Non-Tobacco status due to a medical condition, or for whom it is medically
inadvisable to attempt to cease tobacco usage, you will have to contact the Human Resource Department with
your medical providers supporting information to make arrangements to have tobacco surcharge waived.
7 | 2017 Plan Year
Medical Benefits There will be three plan options to choose: Gold Plan, Silver Plan and the Bronze Plan. Choose the plan which best meets your
needs and the needs of your family. All three medical plans are designed to provide you and your family with access to quality,
affordable health care coverage. The plans cover the same types of services, but differ in how they share costs with you and
how they provide access to care. All Plans provide you with the flexibility of using an in-network or out-of-network provider
whenever you need medical care. When you use in-network providers, you will receive a higher level of benefit reimbursement
from the Plan then when you use out-of-network providers. The choice of health care provider is entirely up to you.
Aetna’s provider network is the same for each of the plans and their network includes a wide variety of doctors including
primary care providers, specialists, hospitals, laboratory and x-ray facilities and other health care providers. You do not need to
select a primary care physician (PCP) for your care, but having a PCP is suggested as they can coordinate your care. If you
receive treatment from an out-of-network provider you could be subject to balance billing for the difference in cost between
what Aetna allows and the amount the provider charges, and higher out-of-pocket costs will also apply. Try to utilize in-network
providers whenever possible to maximize savings.
Aetna Member Services
1-800-458-2883 M-F, 8am-6pm CST
Aetna Navigator:
Register on Aetna navigator where you can do the following:
Contact Member Services
Print a digital ID card
Check your PayFlex Health Savings Account (HSA)
Find in-network doctors, hospitals and other providers
Check on claims and payments
Use the Member Payment Estimator to compare costs for
procedures and treatments
Use “Ask Ann,” the virtual assistant
Click here for a DEMO of Aetna Navigator:https://kvgo.com/
aetna-pm/welcome-aetna-navigator
Note: You will need your Member ID number and/or your social
security number to register.
Aetna Mobile Application:
Aetna Mobile puts your secure member website
at your fingertips. Download the free app to find
in-network doctors, view and show your ID card,
check on claims and benefits contact Member
Services and more. The Aetna Mobile app works
with Apple®mobile digital devices and Android™
powered phones.
To download the Aetna app to your iPhone or
Android device, text “Apps” to 44040 or visit
www.aetna.com/mobile to download today!
Need Care Before Your Aetna ID Card Arrives
Call Aetna Member Services at 1-800-458-2883
M-F 8am-6pm CST.
Register with Aetna Navigator—you will need your
Social Security Number to get started. Go to
www.aetna.com, click on the “Log In/Register” link
and follow the simple prompts. Once you complete
your registration, you will be able to click on the
“View/Print an ID Card” option.
Email Member Services—you will need to first be a
registered user on Aetna Navigator (see above)
and from the home page you can click on the
“Contact” link at the top of the screen.
Reminder:
Medical claims
incurred though
December 2016 need
to be sent to UHC. Use
your new Aetna ID card
in January 2017 for
new claims.
8 | 2017 Plan Year
Services
Gold Plan Silver Plan Bronze Plan
In-Network In-Network In-Network
HSA Compatible HDHP? ¹ No Yes Yes
Deductible
Individual / Family $800 / $2,400 $1,300 / $2,600 $3,000 / $6,000
Coinsurance (after deductible)
Plan pays
You pay
85% 15%
80% 20%
70% 30%
Out-of-Pocket Maximum ²
Individual / Family $2,000 / $6,000 $2,600 / $5,200 $5,000 / $10,000
Preventive Care
Preventive Exam / Immunizations
Routine GYN Exam / Pap
Routine Mammogram
100%, deductible waived 100%, deductible waived 100%, deductible waived
Doctor’s Office Visits
Office Visit (General Practitioner)
Specialist Office Visit
$25 copay
$40 copay
80% after deductible
80% after deductible
70% after deductible
70% after deductible
Diagnostic Services
Outpatient Laboratory / Pathology
Outpatient X-ray / Radiology
MRI / CT Scan
85%, deductible waived 80% after deductible 70% after deductible
Emergency Medical Care
Emergency Room (facility)
Ambulance
Urgent Care Center
$50 copay, then 85% of balance
85% after deductible
$25 copay
80% after deductible 80% after deductible
80% after deductible
70% after deductible 70% after deductible
70% after deductible
Hospital Care
Inpatient Hospital Services
Outpatient Surgery
85% after deductible
85% after deductible
80% after deductible
80% after deductible
70% after deductible
70% after deductible
Services Out-of-Network Out-of-Network Out-of-Network
Deductible
Individual / Family $2,000 / $6,000 $1,300 / $2,600 $6,000 / $12,000
Coinsurance - Plan pays 50% after deductible 50% after deductible 50% after deductible
Out-of-Pocket Max ¹ Individual / Family
$7,000 / $21,000 $2,600 / $5,200 $10,000 / $20,000
Bi-Weekly Payroll Deduction ³ Associate Only
Associate Plus Spouse
Associate Plus Child(ren)
Associate Plus Family
$59.08
$141.69
$127.85
$212.77
$29.54
$66.46
$64.15
$97.85
$4.62
$28.62
$25.85
$42.92
¹ Health Savings Account (HSA) / High Deductible Health Plan (HDHP). A HDHP is a health insurance plan that meets IRS requirements (deductible, out-of-pocket and first dollar coverage), making it eligible for a tax-favorable HSA account. ² The out-of-pocket maximum includes deductible, copays and coinsurance amounts.
³ Tobacco Surcharge ($23.08/pay) and/or Spousal Surcharge ($23.08/pay) may apply. Refer to the information on page 4 for further details. If you are currently a tobacco user but successfully complete a tobacco cessation program during the year, contact the HR Department to re-certify.
Medical Benefits The chart below contains a side-by-side comparison of the medical benefit choices. This is a high level summary of the more
widely used services. Prescription coverage is automatically included with your medical election, but not detailed below. Refer
to the prescription section of this guide for those details.
9 | 2017 Plan Year
Prescription Drug Coverage When you enroll in Aetna medical coverage, you will automatically receive prescription
drug benefits.
Save Money - Use Mail Order! The prescription plan also includes a Mail Order program, which allows you to
purchase a 90-day supply of medications you take on an ongoing basis (known as
maintenance drugs). When you order prescriptions through the mail, you pay two
copays, rather than three, for a 90-day supply.
To access the mail order program, call
the customer service number on your
Aetna member ID card or access the
Aetna web site at www.aetna.com.
Get started on your own:
Online: Log in to www.aetna.com. With
just a few clicks, you can request home
delivery.
Phone: Call Aetna’s customer service
department at 800-458-2883 and then
we will contact your doctor for you. Be
sure to let your doctor know we will be
reaching out to speed up the process.
Ask your doctor for help:
Mail: Request a 90-day prescription
from your doctor. Mail the prescription
along with the completed mail order
form (available on the Benefits
Information website). The address is
located on the form.
Fax: Your doctor can fax the 90-day
prescription along with the completed
mail order form to Aetna. They should
include your member ID number, date
of birth and mailing address. Only your
doctor can use the fax option.
GOOD TO KNOW
Switching to Mail Order Retail prescriptions are perfect for medicine that you take sometimes,
but home-delivery is for medication you take all the time. Here are some
tips to get started. You can get started on your own or you can ask your
doctor for help.
Generic Medications: Keep You and Your Wallet Healthy
Keep in mind that generic
drugs are as safe and
effective as their brand name
counterparts , and are
significantly less expensive. If
you are taking several
medications, the difference in
cost for generics and brand
nam e d r ugs ca n be
significant. When you need a
new prescription, ask your
doctor whether a generic can
be substituted for a brand
name. You can also check
your local pharmacies and
supermarkets for discounts on
generic brands.
To find out if a medication
you are currently taking has
a generic version, visit the
U.S. Food and Drug
Administration (FDA) at
www.fda.gov and look for the
FDA Listing of Authorized
Generics.
Type
Prescription Drug Coverage Gold Plan Silver Plan Bronze Plan
Generic $20 copay 80% after deductible 70% after deductible
Brand $40 copay 80% after deductible 70% after deductible
Non-Formulary
Brand $75 copay 80% after deductible 70% after deductible
Mail Order
(90-day supply) 2 x retail 80% after deductible 70% after deductible
Prescription copays, deductible and coinsurance amounts all count towards the medical
out-of-pocket maximum.
10 | 2017 Plan Year
Key features include:
Personalized ratings for each plan -> See how your
options stack up
Estimate of total cost -> including premium and out-of-
pocket charges
Recommendations for pre-tax contribution to your
health spending account -> HSA or FSA
Forecast the cost of potential health events -> new
diagnoses, injuries or pregnancy
OBEO Health—Decision Support Tool
Obeo Health is a free web-based tool that Tech
Mahindra is offering this year to help you select a
medical plan. Through a secure connection from the
MarketLink enrollment site, you connect to the Obeo
tool. Obeo can show you the cost of each plan based
on the care and coverage you need and then
recommends a plan based upon your information.
You can access the Obeo Health website directly from the MarketLink enrollment system. Once you click the
“Compare My Plans” button in Marketlink, the single sign on process will direct you to Obeo’s terms and conditions
page. When the terms and conditions are accepted you can start using the decision support services.
♫ WIN A PAIR OF BEATS HEADPHONES ♫ Use Obeo Health and provide your feedback. When your comments are received, your name will be entered to win
Beats headphones. Beats Headphone registration and contest official rules are available on the Obeo Health website.
11 | 2017 Plan Year
Importance of Oral Health There is a strong relationship between your oral health
and general health. For example:
Tobacco, alcohol and illicit drugs affect both your overall and oral health
Dry mouth, or a lack of saliva, increases your risk of tooth decay
Oral pain resulting in an inability to eat properly can prevent you from getting the
nutrition your body needs to stay healthy
GOOD TO KNOW
Dental Plans Delta Dental will manage our dental care coverage for the 2017 plan year. The Delta Dental benefit offers preventive, basic and
major care services. There are three different plan options to choose from—the Premier Plan, Standard Plan and Savings Plan. The
following is a side-by-side comparison of the available dental plans.
Services
Delta Dental Premier Plan
(In-Network)
Standard Plan
(In-Network)
Savings Plan
(In-Network)
Deductible
Individual
Family
$25
$75
$50
$150
$50
$150
Calendar Year Maximum $2,000 per person $1,500 per person $1,000 per person
Diagnostic & Preventive
Office visits, Teeth Cleaning,
X-ray, Sealants
100%
100%
100%
Basic Services
Fillings (Restorations), Extractions,
Oral Surgery, Root Canals,
Endodontic, Periodontics
90%
80%
80%
Major Services
Inlays, Onlays, Crowns,
Prosthondontic Services,
Dentures, Bridges
60%
50%
50%
Orthodontia
Eligibility
Lifetime Maximum
50%
$2,000
50%
$1,500
Not Covered
N/A
Bi-Weekly Payroll Deductions
Associate Only
Associate Plus Spouse
Associate Plus Child(ren)
Associate Plus Family
$11.40
$15.42
$15.26
$23.12
$5.12
$8.85
$8.75
$14.43
$2.72
$5.43
$5.35
$8.15
This table only provides the plan differences at a high level. For a more detailed summary, including out of network benefits, refer to the
Benefits Summary for each plan.
12 | 2017 Plan Year
Vision Plan Tech Mahindra provides a comprehensive optional vision benefit through the VSP Choice program for you and your eligible
family members. VSP’s vision benefits are designed to provide routine preventive care such as eye exams, eyewear and other
vision services. VSP has a large network of providers that offer a wide selection of eyewear for you to choose from. You’ll receive
the most out of your benefit when you visit a VSP network eye doctor.
Things to Think About…
How many people in your family will take advantage of vision benefits?
Do you, or someone in your family, wear glasses or contacts?
GOOD TO KNOW Because many eye and vision conditions exhibit no obvious symptoms, individuals are
often unaware that there is a problem. Early diagnosis and treatment of eye disorders
such as cataracts, glaucoma and macular degeneration are important for maintaining
good vision and preventing permanent vision loss.
Adults should have at least one eye exam between the ages of 20 and 29, two exams between ages
30 and 39, one exam every four years from age 40 to 65 and one exam every one or two years after
age 65.
Tech Mahindra is focused on your vision wellness VSP’s quality vision care
program is important to
every member of your
family. By getting regular
eye exams, you can help
prevent vision problems and
even detect warning signs of
more serious undiagnosed
health concerns.
VSP makes it easy to protect
your fami ly ’s v is ion
wellness:
S i m p l y l o g o n t o
www.vsp.com to locate a
provider near you.
Schedule an appointment
or stop by one of the many
providers who offer walk-in
appointments.
Present your ID card when
you arrive so the provider
knows you have an VSP
plan.
Services
VSP
Premier Plan
(In-Network)
Standard Plan
(In-Network)
Annual Copayment
Examination
Materials
$10 copay
N/A
$10 copay
$10 copay
Examinations
Frequency
Benefit
Once every calendar year
100% after $10 copay
Once every calendar year
100% after $10 copay
Lenses
Frequency
Benefit
Single Vision
Bifocal Vision
Trifocal Vision
Once every calendar year
100%
100%
100%
Once every calendar year
100%
100%
100%
Contacts (in lieu of glasses)
Frequency
Benefit
Once every calendar year
Covered up to $200 for
contacts; copay does not apply
Contact lens exam (fitting and
evaluation) up to $60 copay
Once every calendar year
Covered up to $150 for
contacts and contact lens
exam (fitting and
evaluation)
Frames
Frequency
Benefit
Once every 12 months
Covered 100% up to $200
Once every 12 months
Covered 100% up to $200
Bi-Weekly Payroll Deductions
Associate Only
Associate Plus Spouse
Associate Plus 1 Child
Associate Plus Family
$2.60
$3.79
$3.79
$6.79
$2.33
$3.39
$3.39
$6.07
This table only provides the plan differences at a high level. For a more detailed summary, including out of network benefits, refer to the Benefits Summary for each plan.
13 | 2017 Plan Year
Pairing your HDHP with an HSA An HSA is a tax-advantaged account
that is used in combination with a
qualified HDHP. The money you put into
your HSA can help pay your health
insurance plan’s annual deductible, as
well as any other qualified medical
expenses that may not be covered by
your health insurance plan after you
meet your deductible. Contributions to
your HSA account cannot be used to pay
for health insurance premiums.
Some of the Benefits of an HSA include:
Pretax contributions: If you are an HSA- eligible individual, you can make tax-free contributions to your HSA, up to the statutory maximum
Tax-free withdrawals: Withdrawals are tax-free when HSA funds are used for qualified medical expenses
Portability: Your HSA stays with you, even if you change employers or health plans
Who is eligible to establish an HSA? You are eligible to open an HSA
provided you have met the following:
Must be enrolled in an HDHP and not also be covered by another health plan that is not an HDHP
Not listed as a dependent on another person’s tax return
Not entitled to benefits under Medicare
What expenses are applied towards
your deductible? (information below for in-network services; information varies when using out-of-network providers)
Under the HDHP, any services received
with the exception of Preventative Care
are applied towards your deductible.
This includes (but is not limited to):
Office visits
Hospitalization
Emergency room visits/care
Lab tests/scans/x-rays
Prescription drug coverage
Contributing to your HSA Account The maximum amount you can
contribute to your HSA account during
the 2017 plan year is $3,400 for single
enrollments and $6,750 for family
enro l lments . The cont r ibut ions
maximums are set by the IRS at the
beginning of each year.
If you are married and your spouse has
a family HDHP, then both spouses are
determined to have family coverage.
This is true even if one spouse has a
family plan and the other has a self-only
plan. Each spouse may have an HSA,
and together you may contribute up to
the family limit. You may not each
contribute up to the family limit.
If you are age 55 and older, you may
contribute an additional $1,000 to your
HSA. This is a “catch up” contribution
that may be made each year that you
are eligible for a HDHP. Once you enroll
in Medicare you may no longer do this.
Who Administers the HSA? Through our relationship with Aetna, the
custodian for the HSA account is
PayFlex. You may open your account
online after you enroll in one of the two
eligible medical plan options, Silver or
Bronze. There are no bank account fees
to set up your account, but fees will
apply depending upon your account
balance. Complete details will be
provided when your account is
established.
How Health Care Reform Impacts
Your HSA Your medical health plans with Tech
Mahindra allow you to provide coverage
for your eligible dependents until they
reach age 26; however, the IRS tax law
did not change the definition of a
dependent for Health Savings
Accounts. A tax-dependent is defined as
up to age 19 or, if full-time student, age
24. There can be instances where you
can have an adult dependent child
covered under your health plan as
allowed under the Affordable Care Act
(less than age 26) BUT they are not a
dependent for tax purposes. If you use
the pretax dollars from your Health
Savings Account to pay for health
expenses for your covered dependent
(who is not a dependent for tax
purposes) you’ll pay a penalty plus
taxes.
Here is an option you can take
to avoid tax issues:
Your covered adult dependent child may
open his or her own Health Savings
Account and contribute up to the
allowed individual maximum ($3,400 in
2017.) Please be aware that the
deposits to the account will be on a post
-tax basis and are not handled through
any payroll deductions.
You may also continue to save up to the
maximum family contribution amount in
your own HSA ($6,750 in 2017; if 55 or
older an additional $1,000). No penalty
will apply as long as you do not use your
HSA to cover eligible expenses for a non
-tax dependent child.
Health Savings Account — PayFlex Tech Mahindra is committed to helping you and your family manage the high costs of healthcare by providing you with a Health
Savings Account (HSA) program that you can use in conjunction with the Silver or Bronze High Deductible Health Plans (HDHP).
The following includes a few important things you should know about how the HSA works with the HDHP.
Optum HSA Funds—Two Options:
Leave your account with
Optum: you will be responsible
for future bank fees.
If enrolling in the Silver or
Bronze HDHP plans and
contributing to the HSA
account, a new PayFlex HSA
account will be established
and your Optum funds can be
transferred to this account.
Transfer information will be
sent to you provided by
PayFlex once your new
account is established.
14 | 2017 Plan Year
Use it or Lose it!
As you think about your FSA for
this plan year, be sure to carefully
estimate your expenses and, in
turn, the amount you want to
contribute to your account. The
goal in estimating carefully is to
use whatever you set aside so you
don’t lose it. That’s because the
Internal Revenue Service (IRS)
has a “use it or lose it” rule, which
means if you don’t spend
everything in your FSA by the end
of the plan year, you’ll forfeit
whatever funds remain.
Flexible Spending Account(s)
The Flexible Spending Accounts (FSA) allow you to use pre-tax dollars to pay for
certain health related expenses that are not covered by your dental or vision
insurance and for certain dependent expenses. FSAs are designed to let you budget
and pay for these kind of expenses with pre-tax dollars.
Pre-tax dollars come “off the top” of your pay before federal income taxes, Social
Security and, in some cases, state income taxes are calculated. When you use pre
-tax dollars, your taxable income is reduced dollar for dollar. When you lower your
taxable income, you pay less in taxes – it’s that simple. The money you save in
taxes increases your spendable income.
There are two types of FSAs that are available: a Limited Purpose Health Care FSA
and a Dependent Care FSA.
Limited Purpose Health Care FSA A Limited Purpose Health Care FSA lets you use pre-tax dollars to pay
unreimbursed dental and vision related expenses. Eligible expenses dental
deductibles, dental coinsurance, vision copays and other unreimbursed dental
and vision expenses. This plan cannot be used for medical related expenses.
You may elect to contribute up to $2,600 per year into a Limited Purpose Health
Care FSA. Each pay period a portion of your annual election accumulates in your
FSA. You can use all or some of the total amount you elected as soon as the plan
year begins regardless of what you have accumulated in your account year-to-
date.
Dependent Care FSA A Dependent Care FSA allows you to use pre-tax dollars to pay for care-related
expenses incurred so that you and, if you are married, your spouse can work or
attend school full-time. These include expenses for a child day care center, day
camp, after-school care expenses, or day care expenses for an elderly member of
your household.
For purposes of setting up a Dependent Care FSA, a dependent is defined as a
child under age 13 or a dependent of any age who is mentally or physically
disabled and relies on you for financial support. If you are single or married and
filing a joint income tax return, you may fund your Dependent Care FSA each year
with up to $5,000 deducted from your pay on a pre-tax basis. If you are married
and filing an individual tax return, you may direct up to $2,500 into a Dependent
Care FSA each year. Each pay period, a portion of your annual election
accumulates in your Dependent Care FSA. Unlike a Health Care FSA, you can only
use up to the amount you have funded in your account as you incur eligible
expenses.
Some eligible Limited Purpose
Health FSA expenses: Dental plan deductibles and
coinsurance
Eyeglasses and contact lenses
Out-of-pocket dentist or other
provider fees
Patient balance due
Orthodontics
Some ineligible Health FSA
expenses: Premiums (per pay deductions) for
dental or vision coverage.
Amounts reimbursed by the dental or
vision care plans
Cosmetic procedures
15 | 2017 Plan Year
Life and Accidental Death & Dismemberment Insurance Things to Think About….
How much life insurance do I need?
Should I cover my spouse? My children?
Who are my current beneficiaries?
Evidence of Insurability (EOI) may be required, depending on your election
Tech Mahindra provides: Basic Group Life/AD&D Insurance - Guardian
All associates will receive a group life/AD&D insurance benefit.
You can elect: Employee Voluntary Life Insurance - Unum
Coverage in $10,000 Increments up to $500,000 or 5x’s your annual salary, whichever is less (see below for premium
rates)
If you enroll within 31 days of your eligibility date, you may apply for any amount of additional Life insurance coverage up to
$250,000 without EOI.
Spouse Voluntary Life Insurance - Unum
Coverage in $5,000 increments (see below for premium rates)
If you enroll within 31 days of your eligibility date, you may apply for any amount of spouse life insurance coverage up to
$25,000 without EOI
You must elect employee voluntary life insurance for yourself to elect coverage for your spouse. Spouse insurance maximum
is 100% of the employee’s amount or $500,000 whichever is less.
Child Voluntary Life Insurance - Unum
Coverage in $2,000 increments up to a maximum of $10,000
Coverage for children age 14 days to 6 months is limited to $1,000
Coverage for children age 6 months to 25 years (if full time student) is limited to $10,000
You must elect employee voluntary life insurance for yourself to elect coverage for your children. Child insurance maximum
is 100% of the employee’s amount or $10,000 whichever is less.
Child(ren) Life Rate (per $1,000) will be $0.175 bi-weekly (no matter the number of children).
Age Range Employee (Rate per $1,000) Spouse (Rate Per $1,000)
<25 $0.020 $0.016
25 – 29 $0.023 $0.018
30 – 34 $0.030 $0.025
35 – 39 $0.041 $0.039
40 – 44 $0.046 $0.058
45 – 49 $0.069 $0.090
50 – 54 $0.106 $0.138
55 - 59 $0.198 $0.210
60 – 64 $0.304 $0.348
65 - 69 $0.586 $0.581
70 - 74 $0.946 $1.032
75 - 99 $0.946 $2.138
16 | 2017 Plan Year
Disability Insurance
Tech Mahindra provides:
Short Term Disability (STD) - Guardian
STD provides you with income protection if you become
disabled from a covered injury, sickness, or pregnancy.
STD benefits will pay the lesser of 66 2/3% of the employee's
weekly salary or $1,000 reduced by other income benefits
7 day elimination period before Short Term Disability benefits
begin with maximum benefit duration of 12 weeks
Long Term Disability (LTD) - Guardian
LTD provides you with long-term income protection if you
become disabled from a covered injury, sickness or pregnancy
Long Term Disability benefits will pay 60% of the employee's
monthly salary up to a maximum monthly benefit of $5,000
90 day elimination period before Long Term Disability benefits
begin and it ends at Social Security Normal Retirement Age
You can elect: Employee Voluntary AD&D Insurance - Unum
Coverage in $10,000 Increments up to $500,000 or 5x’s your annual salary, whichever is less
Employee Voluntary AD&D Rate (per $1,000) will be $0.034 per month
Spouse Voluntary AD&D Insurance - Unum
Coverage in $5,000 increments
You must elect employee voluntary AD&D insurance for yourself to elect coverage for your spouse. Spouse insurance
maximum is 100% of the employee’s amount or $500,000 whichever is less.
Spouse Voluntary AD&D Rate (per $1,000) will be $0.036 per month
Child Voluntary AD&D Insurance - Unum
Coverage in $2,000 increments up to a maximum of $10,000
Coverage for children age 14 days to 6 months is limited to $1,000
Coverage for children age 6 months to 25 years (if full time student) is limited to $10,000
You must elect employee voluntary life insurance for yourself to elect coverage for your children. Child insurance maximum
is 100% of the employee’s amount or $10,000 whichever is less.
Child(ren) Life Rate (per $1,000) will be $0.034 per month (no matter the number of children).
17 | 2017 Plan Year
Voluntary Benefits
Voluntary benefits give you an opportunity to choose additional benefits to supplement the benefit offerings currently
available through our group benefit program. Each plan provides a unique set of benefits. You decide what plans, if any, you
would like to choose to meet your needs. For 2017, we are offering
the following voluntary benefits:
Group Accident Insurance—Unum
Unum’s accident insurance can pay benefits based on the injury you
receive and the treatment you need, including emergency-room care
and related surgery. The benefit can help offset the out-of-pocket
expenses that medical insurance does not pay, including deductibles
and co-pays. Family coverage is available. Bi-Weekly premium rates
are:
Critical Illness Insurance—Unum
Unum’s group critical illness insurance can help protect your finances from
the expense of a serious health problem, such as a stroke or heart attack.
Cancer coverage is also included. You choose a lump-sum benefit that’s paid
directly to you at the first diagnosis of a covered condition.
Associates may elect $5,000 increments up to $30,000
Associates may cover Spouses at $5,000 increments up to $15,000
Your child(ren) will automatically be covered at 25% of your coverage amount when
you enroll.
Rates are based upon age when your coverage is effective and per $1,000 of
coverage:
Wellness benefit included. Carrier will pay a calendar year $50 benefit for each
insured who has a wellness test performed
Hospital Indemnity Insurance —Unum Our Hospital Indemnity insurance pays a cash benefit for a hospital
confinement. This benefit is payable directly to you and can keep you from withdrawing money from your personal bank
account (or Health Savings Account) for hospital –related expenses. This is especially helpful since statistics show the
average hospital stay is approximately 5 days in duration, which can add up quickly. This makes it increasingly important to
not only protect your finances if faced with an unexpected illness, but also to empower yourself to seek the necessary
treatment. The coverage is provided through Unum so you can feel assured you have the protection you need if faced with a
hospitalization.
Key features include:
Guaranteed Issue coverage, meaning no medical
questions to answer when initially eligible. Late
entrants will have to provide medical history.
Coverage available for you, your spouse & child(ren)
Bi-weekly premiums are affordable, payroll deducted
on a post-tax basis and based upon coverage selected
as follows:
Plan Description Hospital Indemnity Benefit
Hospital Admission $1,500
Daily Hospital Confinement $100/day, to a max of 15 days/calendar year
Emergency Room Treatment Accident only: $150 per insured/calendar year
Ambulance Transport $100 per trip/calendar year
Wellness Benefit $50/calendar year
Age Range Employee and
Child(ren) Spouse
<25 $1.00 $1.00
25 – 29 $1.04 $1.04
30 – 34 $1.14 $1.14
35 – 39 $1.30 $1.30
40 – 44 $1.54 $1.54
45 – 49 $1.84 $1.84
50 – 54 $2.21 $2.21
55 - 59 $2.65 $2.65
60 – 64 $3.11 $3.11
65 - 69 $3.34 $3.34
70 + $5.23 $5.23
Employee EE + Spouse EE+ Child(ren) EE/Spouse/
Child(ren)
$6.36 $10.47 $12.03 $16.13
Employee EE + Spouse EE + Child(ren) EE / Spouse / Child(ren)
$11.14 $20.31 $16.31 $25.48
18 | 2017 Plan Year
Employee Assistance Program (EAP)
Tech Mahindra offers an EAP, which is a professional, confidential counseling service with WorkLifeMatters.
WorkLife Matters provides guidance for personal issues that you might be facing and information about other
concerns that affect your life, whether it’s a life event or on a day-to-day basis.
Unlimited free telephonic consultation with an EAP counselor available 24/7 at 800-386-7055
Referrals to local counselors—up to three sessions free of charge
State-of-the-art website featuring over 3,400 helpful articles on topics like wellness, training courses
and a legal and financial center
WorkLifeMatters can offer help with:
Connect to a counselor for free support services:
1-800-386-7055 Available 24 hours a day, 7 days a week
Visit www.ibhworklife.com (User name: Matters Password: wlm70101)
- Education
- Dependent Care & Care Giving
- Legal and Financial
- Lifestyle Management
- Fitness Management
- Working Smarter
DISCLAIMER: The information contained in this summary should in no way be construed as a promise or guarantee of
employment. The company reserves the right to modify, amend, suspend, or terminate any plan at any time for any reason. If
there is a conflict between the information in this brochure and the actual plan documents or policies, the plan documents or
policies will always govern. Complete details about the benefits can be obtained by reviewing current plan descriptions,
contracts, certificates, policies and plan documents available from your Human Resources Office. The Benefits Enrollment
Guide highlights recent plan design changes and is intended to fully comply with the requirements under the Employee
Retirement Income Security Act (“ERISA”) as a Summary of Material Modifications and should be kept with your most recent
Summary Plan Description.
19 | 2017 Plan Year
Important Regulations Patient Protection – Patient Access
t o O b s t e t r i c a l a n d
Gynecological Care
You do not need prior authorization in order
to obtain access to obstetrical or
gynecological care from a health care
professional in our network who specializes
in obstetrics or gynecology. The health care
professional, however, may be required to
comply with certain procedures, including
obtaining prior authorization for certain
services, following a pre-approved treatment
plan, or procedures for making referrals. For a
list of participating health care
professionals who specialize in obstetrics or
gynecology, visit your medical carriers
website or contact the customer service
number on your medical id card.
Women’s Health and Cancer Rights
Act
On October 21, 1998, the Women’s Health
and Cancer Rights Act became effective.
This law requires group health plans that
provide coverage for mastectomies to also
cover reconstructive surgery and prostheses
following mastectomies. As the Act requires,
we have included this notification to inform
you about the law’s provisions. The law
mandates that a plan participant receiving
benefits for a medically necessary
mastectomy who e lects breast
reconstruction after the mastectomy will
also receive coverage for: 1. Reconstruction
of the breast on which the mastectomy has
been performed; 2. Surgery and
reconstruction of the other breast to
produce a symmetrical appearance; 3.
Prostheses; 4. Treatment of physical
complications of all stages of mastectomy,
including lymphedema.
This coverage will be provided in
consultation with the attending physician
and the patient, and will be subject to the
same annual deductibles and coinsurance
provisions that apply for the mastectomy.
Health Insurance Portability and
Accountability Act (HIPAA) – State
Children's Health Insurance Program
(SCHIP)
Loss of other coverage: If you decline
enrollment for yourself or for an eligible
dependent (including your spouse) while
other health insurance or group health plan
coverage is in effect, 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 31 days
after your or your dependents' other
coverage ends (or after the employer stops
contributing toward the other coverage).
Loss of Medicaid or SCHIP coverage: If you
decline enrollment for yourself or for an
eligible dependent (including your spouse)
while Medicaid coverage or coverage under
a state children's health insurance program
is in effect, you may be able to enroll
yourself and your dependents in this plan if
you or your dependents lose eligibility for
that other coverage. However, you must
request enrollment within 60 days after you
or your dependents' coverage ends under
Medicaid or a state children's health
insurance program.
New dependent: If you have a new
dependent as a result of marriage, birth,
adoption, or placement for adoption, you
may be able to enroll yourself and your new
dependents. However, you must request
enrollment within 31 days after the
marriage, birth, adoption, or placement for
adoption.
Eligibility for Medicaid or SCHIP premium
assistance: If you or your dependents
(including your spouse) become eligible for
a state premium assistance subsidy from
Medicaid or through a state children's
health insurance program with respect to
coverage under this plan, you may be able
to enroll yourself and your dependents in
this plan. However, you must request
enrollment within 60 days after your or your
dependents' determination of eligibility for
such assistance.
Medicaid and the Children’s Health
Insurance Program (CHIP) Offer Free
Or Low-Cost Coverage
CHIP is short for the Children’s Health
Insurance Program—a program to provide
health insurance to all uninsured children
who are not eligible for or enrolled in
Medical Assistance. CHIPRA is the
reauthorization act of CHIP which was
signed into law in February 2009. Under
CHIPRA, a state CHIP program may elect to
offer premium assistance to subsidize
employer-provided coverage for eligible low
-income children and families. All
employers are required to provide
associates notification regarding CHIPRA.
More information on CHIP is provided later
in this document.
Medicare Part D Credi table
Coverage / Non-Creditable Coverage
Notice
The Centers for Medicare and Medicaid
(CMS) requires employers to notify their
Medicare Part D-eligible individuals about
their creditable coverage status prior to the
start of the annual Medicare Part D election
period that begins on October 15 of each
year. A full copy of the annual notice was
sent to all Associates earlier this year.
Health Care Reform Update
The Affordable Care Act (ACA) is here to stay
and we will continue to monitor our medical
plans to make sure they meet all of the
law’s requirements. This means your
benefits will continue to evolve. As always,
we will make you aware of any future
changes before they become effective.
You should also be aware that the ACA’s
“individual mandate” remains in effect for
2017. The individual mandate requires most
Americans to have health insurance that
meets certain criteria or pay a penalty when
filing their taxes. With this in mind, it’s good to
know that all of Tech Mahindra medical plans
provide the kind of coverage the government
requires in order to avoid the penalty.
Keep in mind too, that while you may not see
big changes to your benefits this year
because of the ACA, there are important
changes for employers. For example, the
“employer mandate”—the provision of the
law that requires employers to provide
minimum essential health coverage for their
associates or pay a penalty—goes into effect
in 2015 for employers with 100 or more full-
time associates. Rules like this, as well as
new taxes and fees for employers under the
ACA, affect the overall cost of our plans.
Tech Mahindra must follow rules
established by the ACA for determining
eligibility for our medical plans. This may
affect you if you are a part-time or “variable-
hour” associate, i.e., the number of hours
you work changes from week to week. You
will receive more detailed information if you
are affected.
For more information about the ACA, visit
the website at www.hhs.gov/healthcare and
www.HealthCare.gov to review the plans
available in your state or call 800-318-2596
for assistance with reviewing the plans
available in your state.
20 | 2017 Plan Year
Important Regulations (continued)
Notice Regarding Wellness Program
The Tech Mahindra Wellness Program is a voluntary wellness program available to all employees. The program is administered
according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent
disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the
Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in any of the
wellness programs you may be asked to complete a voluntary health risk assessment that asks a series of questions about
your health-related activities and behaviors and whether you have or had certain medical conditions (e.g., cancer, diabetes, or
heart disease). You are not required to complete the health risk assessment.
The information from your health risk assessment and any other wellness program may be used to provide you with
information to help you understand your current health and potential risks, and may also be used to offer you additional
services through the wellness program. You also are encouraged to share your results or concerns with your own doctor.
Protections from Disclosure of Medical Information
We are required by law to maintain the privacy and security of your personally
identifiable health information. Although the wellness program and Tech
Mahindra may use aggregate information it collects to design a program
based on identified health risks in the workplace, the wellness program will
never disclose any of your personal information either publicly or to the
employer, or as expressly permitted by law. Medical information that
personally identifies you that is provided in connection with the wellness
program will not be provided to your supervisors or managers and may never
be used to make decisions regarding your employment.
Your health information will not be sold, exchanged, transferred, or otherwise
disclosed except to the extent permitted by law to carry out specific activities
related to the wellness program, and you will not be asked or required to
waive the confidentiality of your health information as a condition of
participating in the wellness program or receiving an incentive. Anyone who
receives your information for purposes of providing you services as part of the
wellness program will abide by the same confidentiality requirements. The
only individual(s) who will receive your personally identifiable health
information is our wellness program partner so they may provide you with
services under the wellness program.
In addition, all medical information obtained through the wellness program
will be maintained separate from your personnel records, information stored
electronically will be encrypted, and no information you provide as part of the
wellness program will be used in making any employment decision.
Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information
you provide in connection with the wellness program, we will notify you immediately.
You may not be discriminated against in employment because of the medical information you provide as part of participating in
the wellness program, nor may you be subjected to retaliation if you choose not to participate.
If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation, please
contact the HR Team.
21 | 2017 Plan Year
Important Regulations (continued)
Qualified Changes in Status / Changing Your Pre-Tax Contri-
bution Amount Mid-Year
We sponsor a program that allows you to pay for certain
benefits using pre-tax dollars. With this program, contributions
are deducted from your paycheck before federal, state and Social
Security taxes are withheld. As a result, you reduce your tax-
able income and take home more money. How much you
save in taxes will vary depending on where you live and on
your own personal tax situation.
These programs are regulated by the Internal Revenue Ser-
vice (IRS). The IRS requires you to make your pre-tax elec-
tions before the start of the plan year [January 1 – December
31]. The IRS permits you to change your pre-tax contribution
amount mid-year only if you experience a change in status,
which includes the following:
Birth, placement for adoption, or adoption of a
child, or being subject to a Qualified Medical
Child Support Order which orders you to pro-
vide medical coverage for a child.
Marriage, legal separation, annulment or di-
vorce.
Death of a dependent.
A change in employment status that affects
eligibility under the plan.
A change in election that is on account of, and
corresponds with, a change made under an-
other employer plan.
A dependent satisfying, or ceasing to satisfy,
eligibility requirements under the health care
plan.
Electing coverage under your state’s Market-
place (also known as the Exchange) during
annual enrollment or as a result of a special
enrollment.
The change you make must be consistent with the change in
status. For example, if you get married, you may add your
new spouse to your coverage. If your spouse’s employment
terminates and he/she loses employer-sponsored coverage,
you may elect coverage for yourself and your spouse under
our program. However, the change must be requested within
30 days of the change in status. If you do not notify Human
Resources within 30 days, you must wait until the next an-
nual enrollment period to make a change.
These rules relate to the program allowing you to pay for
certain benefits using pre-tax dollars. Please review the
medical booklet and other vendor documents for information
about when those programs allow you to elect or cancel cov-
erage, add or drop dependents, and make other changes to
your benefit coverage, as the rules for those programs may
differ from the pre-tax program.
HIPAA Notice of Special Enrollment Rights
If you are declining enrollment for yourself or your depend-
ents (including your spouse) because of other health insur-
ance or group health plan coverage, you may be able to en-
roll yourself and your dependents in this plan if you or your
dependents lose eligibility for that other coverage (or if the
employer stops contributing towards your or your depend-
ents’ 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
other coverage).
In addition, if you have a new dependent as a result of mar-
riage, 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, adoption or placement for adoption.
To request special enrollment or obtain more information,
contact Human Resources.
The Children’s Health Insurance Program Reauthorization Act
of 2009 added the following two special enrollment opportu-
nities:
The employee’s or dependent's Medicaid or
CHIP (Children's Health Insurance Program)
coverage is terminated as a result of loss of
eligibility; or
The employee or dependent becomes eligible
for a premium assistance subsidy under Medi-
caid or CHIP.
It is your responsibility to notify Human Resources within 60
days of the loss of Medicaid or CHIP coverage, or within 60
days of when eligibility for premium assistance under Medi-
caid or CHIP is determined. More information on CHIP is pro-
vided later in this document.
22 | 2017 Plan Year
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may
have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or
your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be
able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit
www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, 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, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or
www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the
premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2016. Contact your State for more information on eligibility –
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
ALABAMA – Medicaid IOWA – Medicaid
Website: http://myalhipp.com/
Phone: 1-855-692-5447
Website: http://www.dhs.state.ia.us/hipp/
Phone: 1-888-346-9562
ALASKA – Medicaid KANSAS – Medicaid
The AK Health Insurance Premium Payment Program
Website: http://myakhipp.com/
Phone: 1-866-251-4861
Email: [email protected]
Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx
Website: http://www.kdheks.gov/hcf/
Phone: 1-785-296-3512
KENTUCKY – Medicaid
Website: http://chfs.ky.gov/dms/default.htm
Phone: 1-800-635-2570
ARKANSAS – Medicaid LOUISIANA – Medicaid
Website: http://myarhipp.com/
Phone: 1-855-MyARHIPP (855-692-7447)
Website: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331
Phone: 1-888-695-2447
COLORADO – Medicaid MAINE – Medicaid
Medicaid Website: http://www.colorado.gov/hcpf
Medicaid Customer Contact Center: 1-800-221-3943
Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.html
Phone: 1-800-442-6003
TTY: Maine relay 711
FLORIDA – Medicaid MASSACHUSETTS – Medicaid and CHIP
Website: http://flmedicaidtplrecovery.com/hipp/
Phone: 1-877-357-3268
Website: http://www.mass.gov/MassHealth
Phone: 1-800-462-1120
GEORGIA – Medicaid MINNESOTA – Medicaid
Website: http://dch.georgia.gov/medicaid
- Click on Health Insurance Premium Payment (HIPP)
Phone: 404-656-4507
Website: http://mn.gov/dhs/ma/
Phone: 1-800-657-3739
INDIANA – Medicaid MISSOURI – Medicaid
Healthy Indiana Plan for low-income adults 19-64
Website: http://www.hip.in.gov
Phone: 1-877-438-4479
All other Medicaid
Website: http://www.indianamedicaid.com
Phone 1-800-403-0864
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm
Phone: 573-751-2005
MONTANA – Medicaid
Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084
23 | 2017 Plan Year
U.S. Department of Labor Employee Benefits Security Administration
www.dol.gov/ebsa
1-866-444-EBSA (3272)
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services
https://www.cms.gov/Medicare/Medicare.html
1-877-267-2323, Menu Option 4, Ext. 61565
To see if any other states have added a premium assistance program since July 31, 2016, or for more information on special
enrollment rights, contact either:
OMB Control Number 1210-0137 (expires 10/31/2016)
NEBRASKA – Medicaid SOUTH CAROLINA – Medicaid
Website: http://dhhs.ne.gov/Children_Family_Services/AccessNebraska/Pages/accessnebraska_index.aspx
Phone: 1-855-632-7633
Website: http://www.scdhhs.gov
Phone: 1-888-549-0820
NEVADA – Medicaid SOUTH DAKOTA - Medicaid
Medicaid Website: http://dwss.nv.gov/
Medicaid Phone: 1-800-992-0900
Website: http://dss.sd.gov
Phone: 1-888-828-0059
NEW HAMPSHIRE – Medicaid TEXAS – Medicaid
Website: http://www.dhhs.nh.gov/oii/documents/hippapp.pdf
Phone: 603-271-5218
Website: http://gethipptexas.com/
Phone: 1-800-440-0493
NEW JERSEY – Medicaid and CHIP UTAH – Medicaid and CHIP
Medicaid Website:
http://www.state.nj.us/humanservices/dmahs/clients/medicaid/
Medicaid Phone: 609-631-2392
CHIP Website: http://www.njfamilycare.org/index.html
CHIP Phone: 1-800-701-0710
Website:
Medicaid: http://health.utah.gov/medicaid
CHIP: http://health.utah.gov/chip
Phone: 1-877-543-7669
NEW YORK – Medicaid VERMONT– Medicaid
Website: http://www.nyhealth.gov/health_care/medicaid/
Phone: 1-800-541-2831
Website: http://www.greenmountaincare.org/
Phone: 1-800-250-8427
NORTH CAROLINA – Medicaid VIRGINIA – Medicaid and CHIP
Website: http://www.ncdhhs.gov/dma
Phone: 919-855-4100
Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm
Medicaid Phone: 1-800-432-5924
CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm
CHIP Phone: 1-855-242-8282
NORTH DAKOTA – Medicaid
Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/
Phone: 1-844-854-4825
OKLAHOMA – Medicaid and CHIP WASHINGTON – Medicaid
Website: http://www.insureoklahoma.org
Phone: 1-888-365-3742
Website: http://www.hca.wa.gov/free-or-low-cost-health-care
Phone: 1-800-562-3022 ext. 15473
OREGON – Medicaid WEST VIRGINIA – Medicaid
Website: http://healthcare.oregon.gov/Pages/index.aspx
Phone: 1-800-699-9075
Website: http://www.dhhr.wv.gov/bms/Medicaid%20Expansion/Pages/default.aspx
Phone: 1-877-598-5820, HMS Third Party Liability
PENNSYLVANIA – Medicaid WISCONSIN – Medicaid and CHIP
Website: http://www.dhs.pa.gov/hipp
Phone: 1-800-692-7462
Website:
https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf
Phone: 1-800-362-3002
RHODE ISLAND – Medicaid WYOMING – Medicaid
Website: http://www.eohhs.ri.gov/
Phone: 401-462-5300
Website: https://wyequalitycare.acs-inc.com/
Phone: 307-777-7531
