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CLYDE COMPANIES
2018BENEFITS
GUIDE
The focus on “Building a Better Community” and “Valuing People” begins first and foremost with each and every employee. With this in mind, great care and thought have been taken to provide a best-in-class benefits program. This program can provide a financial safety net for you and your family in the event of unexpected and potentially catastrophic events. In the pages that follow, you will learn more about the specifics of each plan.
CLYDE COMPANIESB u i l d i n g a B e t t e r C o m m u n i t y
It is our pleasure to introduce the Clyde Companies (the Company) 2018 Benefits Guide. Clyde Companies is a premier construction service provider in the Intermountain West that offers quality career opportunities, profitable growth, and value to all our customers. Our Vision is to “Build a Better Community”, which we achieve by focusing on our core values that include the following:
WE VALUE PEOPLE
QUALITY PRODUCTS AND SERVICES AT THE BEST VALUE
ALWAYS GIVE A FULL MEASURE
OUR WORD IS OUR BOND
Eligibility
WELCOME
CLYDEC O M P A N I E S
This benefits guide applies to all Clyde Companies benefit eligible employees.
Eligibility
WELCOME
About This GuideThis benefits guide shows only highlights of your Company benefits. This is not a complete, detailed description, contract of employment or a guarantee of benefits. More detailed information is contained in the Summary Plan Descriptions (SPD) which are available at www.clydebenefits.com.
This benefits guide has been reviewed for accuracy; however, oversights can occur and condensed summaries can be misinterpreted. If there is a difference between this benefits guide or the SPD and the official plan documents or contracts that govern the plan, the plan documents or contracts will be followed. The Company reserves the right to amend or terminate any program in whole or in part at any time.
If you cannot find the answers you need, please see the directory on the back cover of this guide for contact information for the different carriers and the benefits available.
Please contact your Human Resources Department if you need further assistance. See the inside back cover page for contact information.
Eligibility
WELCOME
1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-3
Available Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Enrollment Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-5
Special Enrollment Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
New Employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Rehired Employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Making Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Waiving Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Plan Choices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Key Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Health Savings Account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-9
Medical Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-11
Network Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-13
Telehealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Dental Benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Vision Benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Employee Healthcare Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Provider Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Clyde Wellness Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19-20
Group Term Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Voluntary Term Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Accidental Death & Dismemberment (AD&D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Voluntary Short-Term Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Group Long-Term Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Voluntary Long-Term Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Supplemental Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27-28
Flex Spending (Section 125 Plan) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29-30
Health Care FSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Dependent Care FSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Limited Dental/Vision FSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Identity Theft Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Employee Assistance Program (EAP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
401(k) Retirement Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Paid Time Off (PTO) & Holiday Pay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Inside Back Cover
Provider Directory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Outside Back Cover
CONTENTS
2
W elcome to the Clyde Companies 2018 Benefits Guide. This guide provides a quick overview of
our health-related benefit program and helps remove the confusion that sometimes surrounds employee benefits. It will also clarify plan coverage and eligibility to prepare you to make informed choices about your benefit options.
Benefit programs provide a financial safety net for you and your family in the event of unexpected and potentially catastrophic events. We have structured our programs around life events that trigger the need for coverage – caring for your physical well-being as well as that of your dependents in case of illness or injury and providing for your family in the event of your disability or death.
In the pages that follow, you will learn more about the specifics of each plan. We encourage you to frequently refer back to this guide as it will provide answers to many questions you may have throughout the year. Please read through this guide carefully.
Eligibility
INTRODUCTION
Available Benefits
Eligibility
New-Hire Waiting Period
3
• Medical Insurance
• Dental Insurance
• Vision Insurance
• Telehealth
• Group Life and AD&D
• Voluntary Life Insurance and AD&D
• Voluntary Short Term Disability (STD)
• Group Long Term Disability (LTD)
• Voluntary Long Term Disability (LTD)
• Accident Insurance
• Critical Care Insurance
• Medical Bridge Insurance
• Employee Assistance Program (EAP)
• Flex Spending Account (FSA)
• Health Savings Account (HSA)
• 401(k) Retirement Plan
• Paid Time Off (PTO)
• Holiday Pay
• Identity Theft Protection
You are eligible to enroll for benefits if you are a full-time employee. Children are eligible for continued coverage on health insurance policies until they turn 26 years old. Children with disabilities are always eligible after approval of necessary applications. Please see page 33 for 401(k) eligibility.
Exempt (salaried) employees become eligible for benefits on their first day of full-time employment. Non-exempt (hourly) employees become eligible for benefits the first of the month following 60 days from their first day of full-time regular employment. Please see page 33 for 401(k) eligibility.
Eligibility
INTRODUCTION
4
ENROLLMENT INFO
During the open enrollment period, you are eligible to makes changes to your benefits. Open enrollment is held once a year for employees to sign up for all benefits, change plans, drop coverage, or add someone to their coverage. Once enrolled, you cannot make changes until the next open enrollment unless you have a special enrollment event.
During the open enrollment period, you can also make changes to your life and disability plans. If you previously waived this coverage, you will need to provide evidence of insurability. If you already have voluntary life coverage equalling less than the guarantee issue amount, you can increase your coverage to the guarantee issue amount without completing evidence of insurability. Any requests for more than the guarantee issue need to be accompanied by an evidence of insurability form.
Open enrollment is also the time to elect your FSA and HSA amounts for next year. A new election is needed even if you choose to have the same amount withheld.
Life events allow you to make changes to your benefits package, or to enroll if you previously waived coverage. Examples of life events are marriage, birth, adoption, or loss of other coverage. These events will give you a 30 day window to make changes which will become effective the date of the event.
In addition, 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 dependents, provided that you request enrollment within 30 days after the qualifying event.
The elections you make now stay in effect through December 31, 2018, unless you have a change in family or employment status. Please notify your Human Resources Department within 30 days of a change.
The following are examples of a change in status:
• Your marriage, legal separation, or divorce
• Birth, adoption, or a change in custody for an eligible child
• Death of your spouse or covered child
• Change in your work status that affects your benefits
• Your dependent loses eligibility for coverage
• Change in your spouse’s work status that affects his or her benefits
• You or your spouse and dependents gain or lose Medicare or Medicaid coverage
• You receive a qualified medical child support order (QMCSO)
• Change in residence or work site that affects your benefits
Special Enrollment EventsOpen Enrollment
ENROLLMENT INFO
5
You may make certain changes to your benefit elections under two different circumstances: during the annual open enrollment period and when you have an eligible qualifying event. Because your benefit elections are part of a Section 125 plan, IRS rules determine what changes are permitted outside the normal enrollment period. Thoughtful consideration of your benefit elections are critical during open enrollment as you will be limited in most cases in making any changes.
If you do not want to enroll in these plans at this time or you are waiving dependent coverage, you are still required to complete the enrollment process online and waive coverage. Thoughtful consideration of your benefit elections are critical during open enrollment as you will be limited in most cases in making any changes.
Employees hired after the plan year begins will select their coverage choices for the remainder of the plan year within 30 days of eligibility. New employees will be required to sign up online for all benefits.
If you are rehired within six (6) months following a layoff, your insurance will be effective on your rehire date, provided you sign up online and complete the rehire enrollment process. If your rehire date falls outside of the six (6) month window, a new waiting period will apply.
If you do not sign up for coverage within 30 days of your eligibility date, you will be considered a late entrant. If you decide to enroll later, you will be subject to additional waiting periods for certain services, and may need to be approved by the insurance company before gaining coverage. You may also be required to wait until the next open enrollment period based on the reason for the late enrollment.
If you elect medical, dental or vision coverage and are covered for at least one day, you will have the right to continue your coverage upon termination of employment. Further details will be given to you at that time.
New Employees Making Changes
Waiving Coverage
COBRA Coverage
Late Entrants
Rehired Employees
6
Clyde Companies will offer a comprehensive benefit package for 2018. Health and dental coverage will continue to be offered through individual elections, vision and telehealth coverage are included with the medical plan. In addition to our core coverage, other voluntary coverage options are available including life insurance, short and long term disability, and supplemental products including accident, critical illness, and identity theft. Additional information on each of these benefits is available within this benefits guide.
Clyde Companies will continue to offer the High Deductible Health Plan (HDHP) with a Health Savings Account (HSA). This will provide employees the opportunity to save on their out-of-pocket costs and save money for future medical expenses. Detailed information on the HSA is available on pages 8 and 9.
You will need to carefully select your coverage during the open enrollment period. Changes during the plan year are not allowed without an eligible qualifying event, due to IRS and ERISA guidelines.
Medical Clyde Companies will continue to offer the traditional and high deductible HSA plans this year. Each of these plans includes comprehensive coverage to meet your medical needs. Each plan is very different in how claims are paid, so careful consideration will be needed to evaluate which plan will work the best for you. Preventive services will continue to be covered 100% under both plans. Plan summaries are located on pages 10 and 11 of this benefits guide, and full summary plan descriptions (SPD) are available at www.clydebenefits.com or by request from your Human Resources Department.
Dental
A single dental option through Regence Dental will be available as a separate election. The plan includes a $1,500 annual max benefit and a $1,500 lifetime orthodontic benefit for children. The dental plan summary is located on page 15 of this benefits guide, and a full summary plan descriptions (SPD) is available at www.clydebenefits.com or by request from your Human Resources Department.
Vision
Our vision coverage will now be provided by Superior Vision. Vision coverage is included with the medical election. The plan covers vision exams, frames, lenses and contacts. The vision plan summary is located on page 16 of this benefits guide, and full summary plan descriptions (SPD) is available at www.clydebenefits.com or by request from your Human Resources Department.
PLAN CHOICES
7
Co-pay: A fixed dollar amount payable by the member directly to a provider at the time covered services are rendered. Co-pay amounts do not apply towards the deductible or coinsurance.
Deductible: The portion of eligible charges payable by the member each year directly to providers for covered services before benefits are paid.
Coinsurance: The percentage (%) of eligible charges payable by the member directly to a provider for covered services. Coinsurance percentages generally apply after the deductible has been satisfied.
Out-of-pocket Maximum: The maximum dollar amount per year of eligible medical charges payable by the member directly to providers.
Preventive Care: Services such as annual physical exams with associated tests, well-child visits, flu shots, immunizations, and cancer screenings. Care provided for the diagnosis or monitoring of illness based on symptoms the member is experiencing is not considered preventive care and will apply to the appropriate medical benefit.
In-Network: Use of a health care provider that is a member of the plan’s provider network.
Out-of-Network: Use of a health care provider that is not in the plan’s provider network. The medical plans generally pay reduced benefits for out-of-network services.
FSA: A Flexible Spending Account (FSA) is a voluntary employer-sponsored program for employees to save a portion of their income to be used to pay for qualified medical or dependent care expenses incurred during their benefit plan year. Contributions are tax-free through payroll deductions. Funds in a health care and/or dependent care FSA can only be used throughout the plan year.
Limited FSA: This Limited Flexible Spending Account (FSA) is available to employees that have selected a Health Savings Account (HSA) medical option. These employee funds are limited to reimbursement of dental and vision expenses only.
HSA: A Health Savings Account (HSA) is a tax-free savings account that belongs to you. Money deposited into your HSA account can be a combination of employee and/or employer contributions. You can use HSA funds to pay eligible medical, dental, and vision expenses similar to the Medical FSA. Funds can roll over from year to year.
HDHP: A high-deductible health plan (HDHP) is a health insurance plan with lower premiums and a higher deductible than a traditional health plan. Being covered by an HDHP is also a requirement in order to have a Health Savings Account (HSA).
KEY TERMS
8
Eligibility
HEALTH SAVINGS ACCOUNT (HSA)
What Is a Health Savings Account (HSA)?
Why Should I Choose an HSA?
If I’m Healthy, Is an HSA Right for Me?
Who Is Eligible to Have an HSA?
Why Is an HSA Better Than Other Retirement Plans?
A health savings account (HSA) is a tax-free savings account
that belongs to you. You can use your HSA to pay for your
insurance deductible and qualified out-of-pocket medical
expenses. Your HSA works with your lower-premium, higher-
deductible medical plan to cover your major medical expenses.
An HSA Puts More Money Into Your Pocket.
With an HSA, you get to take some of the money that would
have gone to pay for higher health insurance premiums and
put it into your own pocket.
You can use the HSA to pay for qualified medical expenses, or
you can save it and let it grow with tax-free interest from year
to year. With an HSA:
• You don’t lose it if you don’t spend it.
• You don’t have to pay taxes on withdrawals for eligible
medical expenses.
• And even if you lose your qualified lower premium plan,
you can still use the remaining funds in your HSA on
qualified medical expenses.
The HSA, including all the money you and your employer
contribute, is yours to use. You take the account with you when
you change jobs, retire or leave your qualified health plan.
An HSA Gives You More Control Over How You Spend Your Health Care Dollars.
• You can keep your own doctor. An HSA-qualified plan is
flexible and your Regence Network will remain the same
for both plans.
• You can cover expenses that your health plan might not include. For example, if your health plan limits the number
of chiropractic treatments you can have during the year,
you can pay for additional treatments with your HSA.
More than 70% of insured people incur less than $1,000 a year
in medical expenses (including what both the patient and the
health plan pay). HSA-qualified health plans cover preventive
care services at 100% and have a fixed limit on your out-of-
pocket costs (see medical plan summary on page 11).
If you take advantage of those preventive care services and
adopt healthy lifestyle habits, it’s likely you won’t have to
spend much of your HSA. The unspent portion of your HSA
can then grow tax-free from year to year.
To be eligible to open an HSA, you must meet the following requirements:
• Be covered under an HSA-qualified health plan on the
first day of any month for which eligibility is claimed
(as described in IRS Publication 969—Health Savings
Accounts and Other Tax-Favored Health Plans).
• Not be enrolled in Medicare.
• Not be claimed as a dependent on someone else’s tax return.
• Have no other insurance except what is permitted by the
IRS (see IRS Publication 969).
Think of an HSA as a Medical 401(k)—Only Better.
Ways an HSA is like a 401(k):
• You and your employer can make pre-tax contributions to
your HSA.
• Clyde Companies’ annual contributions are $550 for a
single and $1,300 for a family, deposited semi-annually.
• Your HSA can grow tax-free for as long as you own
the account.
9
2018 CLYDE COMPANIES CONTRIBUTION SCHEDULEEmployees must be benefit eligible and actively covered on the high deductible health plan during the time the distribution is made to receive that contribution.Month Single FamilyJanuary $275 $650July $275 $650Yearly Total $550 $1,300
The IRS allows a special enrollment into an HSA for individual’s participating in an FSA with a grace period. In order for you to qualify to participate in the HSA on January 1st your FSA balance must be zero on December 31st, otherwise you will not be eligible to begin your HSA until the first of the month after the grace period ends on April 1st, 2018.
How Can I Build the Balance in My HSA?
Whose Medical Expenses Can I Pay for Out of My HSA?
What Kinds of Medical Expenses Will My HSA Pay For?
Contributions Can Be Changed Monthly
You and/or Your Employer Can Make Pre-Tax Contributions to
Your HSA Up to the Yearly IRS Limits.
• The maximum contribution limit for individuals is
$3,450 in 2018.
• The maximum contribution limit for family coverage is
$6,900 in 2018.
• Participants aged 55 and over can make an additional
“catch-up” contribution of $1,000 per year.
• You can make the choice to keep your money liquid in an
FDIC-insured bank account or, when the balance grows
high enough, invest it in mutual funds.
• You can contribute money up to the IRS yearly limit at
any time during the year—as long as you’re covered by
an HSA-qualified health plan and aren’t on Medicare
or covered by other insurance. Even family members
can contribute to your account (but only you and your
employer can deduct your contributions from your taxes).
• If you’re no longer employed, you can still make
contributions to your HSA—as long as you’re still covered
by an HSA-qualified health plan and aren’t on Medicare
or covered by other insurance.
• You don’t have to be of retirement age to make tax-free
withdrawals at any time—as long as you use the funds for
qualified medical expenses.
Spouse and Dependents
In addition to your own medical expenses, you can use your
HSA to pay the medical expenses of any family member who
is reported as a dependent on your tax return, even if they’re
not covered by your health plan (however, their expenses
won’t be applied toward your health plan’s deductible if
they’re not on your plan).
You can use HSA funds to pay for qualified medical expenses
as defined by the IRS. A partial list is included on page 30, as
FSA and HSA expenses follow the same IRS guidelines.
With an HSA you have the added flexibility of changing
your contributions throughout the year. You may increase or
decrease your contributions at the beginning of each month.
Additionally, if you wish to opt out of making contributions
you can do so at any time.
You Can Roll Over Funds From Other Tax-Advantaged Accounts.
Transfers from other HSAs into the Clyde Companies HSA are
permitted as long as you’re the owner of both accounts.
You can also do a once per lifetime transfer from an IRA
to your HSA. This transfer is limited to the annual HSA
contribution limit set by the IRS. You must remain in your
HSA-qualified health plan for the entire period following the
month in which the transfer was completed in order to avoid
taxes and penalties.
Eligibility
HEALTH SAVINGS ACCOUNT (HSA)
10
Regence $1,000 Traditional PlanBluePoint $1,000 Ded, $3,000 OOP, $25 / $35 Copays
Benefit: In-network Out-of-network*
Annual Maximum Benefit Unlimited Unlimited
Deductible (Included in Out of Pocket Maximum) $1,000 Individual / 2,000 Family $2,000 Individual / $4,000 Family
Out of Pocket Maximum $3,000 Individual / $6,000 Family $6,000 Individual / $12,000 Family
Office Visits $25 PCP / $35 Specialist (deductible waived) 25%*
Office Visit – Blue Distinction Total Care Provider $15 PCP / $20 Specialist (deductible waived) 25%*
Coinsurance 20%* 40%*
Ambulance Services 20%* 20%*
Durable Medical Equipment 50% (deductible waived) 50% (deductible waived)
Emergency Room $100 Copay, 20%* $100 Copay, 20%*
Home Health (60 visits) 20%* 40%*
Hospice Care (14 days) 20%* 40%*
Hospital Services 20%* 40%*
Maternity 20%* 40%*
Mental Health / Chemical Dependency-Inpatient 20%* 40%*
Mental Health / Chemical Dependency-Outpatient $25 Copay (deductible waived), 20%* 25%*
Neurodevelopmental Therapy (40 visits) 20%* 40%*
Nutritional Counseling (3 visits) 20%* 40%*
Diabetic, Anorexia, Bulemia Counseling 20%* 40%*
Orthotics/Prosthesis 20%* 40%*
Preventive Services/Immunizations (deductible waived) 0% (deductible waived) 25% (deductible waived)
Major Radiology & Laboratory 20%* 40%*
Minor Radiology & Laboratory 0% (deductible waived) 0% (deductible waived)
Rehabilitation- Inpatient (15 days) 20%* 40%*
Rehabilitation- Outpatient (40 visits) 20%* 40%*
Skilled Nursing Facility (60 days) 20%* 40%*
Spinal Manipulations (limit of 20 visits) 20%* 40%*
TMJ 50%* 50%*
Transplants 20%* 40%*
Urgent Care $25 PCP / $35 Specialist (deductible waived) 25%*
PHARMACY
Prescription Retail Mail Order
Deductible $0 $0
Out of Pocket Maximum Shared with Medical Shared with Medical
Generic $10 $25
Brand Name- Formulary $25 $62.50
Brand Name- Non-Formulary $50 $150
PLEASE NOTE: To remain compliant with State and Federal regulations including the Affordable Care Act, these benefits are subject to change. Any errors are unintentional and non-binding. For final benefits, please refer to the group’s Benefit Booklet. *Out-of-network payments are based on eligible charges, and are subject to balance billing.
*These are the amounts you pay after your deductible is satisfied
Eligibility
MEDICAL BENEFITS
11
*These are the amounts you pay after your deductible is satisfied
Regence $1,500 HSA PlanHSA 3.0 $1,500 Ded, $3,000 OOP
Benefit: In-network Out-of-network*
Annual Maximum Benefit Unlimited Unlimited
Deductible (Included in Out of Pocket Maximum) $1,500 Individual / $3,000 Family $3,000 Individual / $6,000 Family
Out of Pocket Maximum $3,000 Individual / $6,000 Family $6,000 Individual / $12,000 Family
Office Visits 20%* 40%*
Office Visit – Blue Distinction Total Care Provider 10%* 25%*
Coinsurance 20%* 40%*
Ambulance Services 20%* 20%*
Durable Medical Equipment 50%* 50%*
Emergency Room 20%* 20%*
Home Health (60 Visits) 20%* 40%*
Hospice Care (14 days) 20%* 40%*
Hospital Services 20%* 40%*
Maternity 20%* 40%*
Mental Health / Chemical Dependency-Inpatient 20%* 40%*
Mental Health / Chemical Dependency-Outpatient 20%* 40%*
Neurodevelopmental Therapy (40 visits) 20%* 40%*
Nutritional Counseling (3 visits) 20%* 40%*
Diabetic, Anorexia, Bulemia Counseling 20%* 40%*
Orthotics/Prosthesis 20%* 40%*
Preventive Services/Immunizations 0% (deductible waived) 25%*
Major Radiology & Laboratory 20%* 40%*
Minor Radiology & Laboratory 20%* 40%*
Rehabilitation- Inpatient (15 days) 20%* 40%*
Rehabilitation- Outpatient (40 visits) 20%* 40%*
Skilled Nursing Facility (60 days) 20%* 40%*
Spinal Manipulations (limit of 20 visits) 20%* 40%*
TMJ 50%* 50%*
Transplants 20%* 40%*
Urgent Care 20%* 40%*
PHARMACY
Prescription Retail Mail Order
Deductible Shared with Medical Shared with Medical
Out of Pocket Maximum Shared with Medical Shared with Medical
Generic $10* $30*
Brand Name- Formulary $25* $75*
Brand Name- Non-Formulary $50* $150*
PLEASE NOTE: To remain compliant with State and Federal regulations including the Affordable Care Act, these benefits are subject to change. Any errors are unintentional and non-binding. For final benefits, please refer to the group’s Benefit Booklet. *Out-of-network payments are based on eligible charges, and are subject to balance billing.
Eligibility
MEDICAL BENEFITS
HospitalPreferred
FocalPoint (PFP)
Preferred ValueCare
(PVC)
Participating (PAR)
Alta View Hospital •
American Fork Hospital •
Ashley Regional Medical Center • •
Bear River Valley Hospital • •
Beaver Valley Hospital • •
Blue Mountain Hospital • •
Brigham City Hospital • • •
Cache Valley Hospital • •
Castleview Hospital • •
Cedar City Hospital • •
Central Valley Medical Center • •
Davis Hospital and Medical Center • •
Delta Community Medical Center • •
Dixie Regional Medical Center • •
Fillmore Hospital • •
Garfield Memorial Hospital • •
Gunnison Valley Hospital • •
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Employees in certain geographic regions will have the ability to select their network of participating providers. The table below shows the network options and eligibility:
Now that you’ve chosen your plan, you’ll want to choose the network that will work best for you and your family. Visit
www.regence.com to find your doctors. You are able to look up by name, location, and/or specialty. Once you find
a doctor on the website, you will want to look at the details of the networks that they accept. You will be looking for
either the Preferred FocalPoint, Preferred ValueCare or the Participating network.
Please make sure that you verify that your doctor is covered by your network choice. If you are unsure please call
Regence at 888-231-8424 to verify. Changes to your network can only be made during open enrollment or when
you have an eligible qualifying event.
NETWORK ELIGIBLE EMPLOYEES
FocalPoint Employees living within Box Elder, Weber, Davis, Salt Lake and Utah counties
Participating Employees living within the State of Utah
ValueCare All Employees
Eligibility
NETWORK OPTIONS
HospitalPreferred
FocalPoint (PFP)
Preferred ValueCare
(PVC)
Participating (PAR)
Heber Valley Medical Center • •
Huntsman Cancer Hospital • • •
Intermountain Medical Center •
Jordan Valley Medical Center • •
Jordan Valley Pioneer Campus • •
Kane County Hospital • •
Lakeview Hospital • • •
LDS Hospital •
Logan Regional Hospital • •
Lone Peak Hospital • • •
McKay-Dee Hospital •
Milford Memorial Hospital • •
Moab Regional Hospital • •
Mountain Point Medical Center • •
Mountain View Hospital • • •
Mountain West Medical Center • •
Ogden Regional Medical Center • • •
Orem Community Hospital •
Park City Medical Center • •
Primary Children's Medical Center • • •
Riverton Hospital •
Riverton Hospital Children’s Unit • • •
Salt Lake Regional Medical Center • •
San Juan County Hospital • •
Sanpete Valley Hospital • •
Sevier Valley Medical Center • •
St. Mark's Hospital • • •
The Orthopedic Specialty Hospital (TOSH) •
Timpanogos Regional Hospital • • •
Uintah Basin Medical Center • •
University Hospital • • •
University of Utah Orthopedic Center • • •
Utah Valley Hospital •
Doctors and Professional Providers 3,814 9,449 9,602
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Eligibility
NETWORK OPTIONS
14
• Call HealthiestYou or schedule your appointment online
or on the smartphone app
• Provide a brief medical history
• A call back is scheduled with a doctor, based on your
need
• Doctor reviews online patient history and calls the
member back
• If a prescription is required, it is sent via Escript to
member’s choice of pharmacy
• Doctor updates records with consultation notes and they
are stored in your HealthiestYou member portal
Whenever you have questions or are simply not feeling well, you can effortlessly connect to the 24 x 7 x 365 telehealth hotline via phone, video and email for the diagnosis and treatment of illness, second opinions and consultations. There are board-certified, licensed physicians in every state waiting to provide exceptional care, prescribe medication, and ultimately save you a trip to the doctor’s office, whether you are at home or on the road. Residents of Idaho are currently limited to video conferences only due to state law.
—Wellness Council of America
“More than 70% of all ER, urgent care, and doctor office visits can be safely handled over the phone.”
• 94% of patient medical issues are resolved with consultation
• 9 minute average call back time from a board-certified, licensed physician
• 13 minute average consultation
• $0 consultation fee
EMERGENCY
HealthiestYou Primary Care Urgent Care Emergency Room
Consult/Visit Fee: $0 Avg $125 Avg $175 Avg $1200
Germs: No Yes Yes Yes
Travel Time/Expense:
No Yes Yes Yes
Claim: No Yes Yes Yes
Availability 24/7/365 Limited Limited 24/7/365
START HERE!
Allergies
Bronchitis
Earache
Sore Throat
Pink Eye
Sinusitis
Strep Throat
Upper Respiratory Infections
Urinary Tract Infections
A free benefit to those enrolled in a Clyde Companies medical plan.
Eligibility
TELEHEALTH
Consultation Process Skip a Visit to the Emergency Room
Cost
HealthiestYou doctors can address some of the most common visits:
15
Eligibility
DENTAL BENEFIT
Covered Dental Services (Per Member) Member Responsibility
Preventive Dental Services
• Bitewing x-rays: 2 per calendar year• Complete intra-oral mouth x-rays: Once in a 3-year period• Cleanings: 2 per calendar year (in lieu of periodontal maintenance)• Oral examinations: 2 per calendar year• Panoramic mouth x-rays: Once in a 3-year period• Sealants (bicuspids and molars only): Under 18 years of age• Space Maintainers: Under 12 years of age• Topical fluoride application: Under 18 years of age, 2 treatments per calendar year
0% Deductible Waived
Basic Dental Services
• Endodontic services including root canal treatment, pulpotomy and apicoectomy• Emergency treatment for pain relief• Fillings consisting of composite and amalgam restorations• General dental anesthesia or intravenous sedation (subject to necessity)• Uncomplicated and complex oral surgery procedures• Periodontal maintenance: 2 per calendar year (in lieu of preventive cleanings)• Periodontal debridement: Once in a 3-year period• Periodontal scaling and root planing: Once per quadrant in a 2-year period
20%
Major Dental Services
• Bridges: Except no benefits are provided for replacement made fewer than 7-years after placement
• Crowns, inlays and onlays: Except no benefits are provided for replacement made fewer than 7-years after placement
• Dentures (full and partial): Except no benefits are provided for replacement made fewer than 7-years after placement
• Implants (endosteal): 4 per member lifetime
50%
Orthodontia Services (12 month waiting period applies if no previous coverage)
• Orthodontic treatment: Covered only for dependent to age 26• $1,500 per member lifetime maximum benefit
50%
Regence ExpressionsSM Dental PlanBenefit Summary
Deductible per calendar year $50 Per Member $150 Per Family (3 times the member amount)
Maximum benefit per calendar year $1,500 Per Member
Understanding Your Benefits
• We will begin to pay benefits for covered services in any calendar year only after your deductible is satisfied unless otherwise specified.
• Once you have satisfied any applicable deductible, we pay a percentage of the allowed amount for covered services up to any maximum benefit. When our payment is less than 100%, you pay the remaining percentage. This is your Coinsurance (Member Responsibility).
• We do not reimburse Dentists for charges above the allowed amount. A Participating Dentist will not charge you for any balances for covered services beyond your deductible and/or coinsurance amount. Nonparticipating Dentists, however, may bill you for any balances over our payment level in addition to any deductible and/or coinsurance amount. You can find a list of providers at our website or by calling Customer Service.
16
Benefits Through Superior Vision NetworkVision Benefit In-network Out-of-network
Exam (Ophthalmologist) $10 co-pay Up to $45 retail
Exam (Optometrist) $10 co-pay Up to $39 retail
FramesLenses (standard)
Single VisionBifocalTrifocal
$130 retail allowance
Up to $63 retail
Up to $32 retailUp to $46 retailUp to $60 retail
Contact Lens Fitting (standard) $30 copay Not covered
Contact Lens Fitting (specialty) $50 retail allowance Not covered
Contact Lenses (in lieu of eyeglass lenses and frames) $130 retail allowance Up to $100 retail
Eligibility
VISION BENEFIT
Refractive Surgery Discount Features
Superior Vision has a nationwide network of refractive surgeons and leading LASIK networks who offer members a discount. These discounts range from 15%-50%, and are the best possible discounts available to Superior Vision.
Look for providers in the Provider Directory (www.superiorvision.com) who accept discounts, as some do not; please verify their services and discounts (range from 10%-30%) prior to service as they vary.
The Plan discount features are not insurance.
All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan.
Co-Pays (In-Network)Exam (1 every calendar year) $10
Lenses and Frames (1 every calendar year) $25
Contact Lens Fitting (1 every calendar year) $30
Discounts on Covered MaterialFrames 20% off amount over allowance
Lens Options 20% off retail
Progressives20% off amount over retail lines trifocal lens,
including lens options
17
EMPLOYEE COST PER WEEK
$1,000 Traditional $1,500 HSA
FocalPoint ValueCare Participating FocalPoint ValueCare Participating
Employee Only $24 $39 $45 $19 $29 $36
Family $49 $79 $91 $39 $59 $73
CLYDE COMPANIES SEMI-ANNUAL HSA CONTRIBUTION
Employee Only $275 $275 $275
Family $650 $650 $650
WELLNESS INCENTIVEEmployee Only $14 per week
Family Coverage w/ Employee & Spouse $14 per week per participant ($14 for the Employee, $14 for the Spouse)Family Coverage w/ Employee & Child(ren) $28 for Employee participation, due to no covered Spouse
MEDICAL & VISION EMPLOYEE COST PER WEEK WITH FULL WELLNESS INCENTIVES
$1,000 Traditional $1,500 HSA
FocalPoint ValueCare Participating FocalPoint ValueCare Participating
Employee Only $10 $25 $31 $5 $15 $22
Family $21 $51 $63 $11 $31 $45
EMPLOYEE COST PER WEEK
REGENCE $1,500 PPO
Employee Only $3
Family $8
Employees in certain geographic regions will have the ability to select their network of participating providers. The table below shows the network options and eligibility:
NETWORK ELIGIBLE EMPLOYEES
FocalPoint Employees living within Box Elder, Weber, Davis, Salt Lake and Utah counties
Participating Employees living within the State of Utah
ValueCare All Employees
Eligibility
EMPLOYEE HEALTHCARE COSTS
Medical, Vision & Telehealth
Dental
Wellness Incentive
18
Your BlueCross/BlueShield benefits card is used to obtain Medical and Dental services.
Eligibility
PROVIDER RESOURCES
Locate a Provider
BlueCard
Regence Vision
To locate an in-network provider, you can call Regence at 888-231-8424 or go online to www.regence.com, login to your account and select “Find A Doctor.” Remember to select your specific network.
BlueCross and BlueShield plans give you access to doctors and hospitals almost everywhere, giving you peace of mind that you’ll always find the care you need. Go online to www.bcbs.com to locate In-Network providers throughout the nation. Remember to enter the first 3 letters of your Member ID to use the correct network.
www.regence.com offers a complete source of health and wellness information. As a registered member you can view personal claims and benefit info.
• Review details about your coverage
• View claims and personal account information
• Compare costs and quality of hospitals, clinics and providers
• Find a doctor and read patient reviews
• Earn Rewards points for healthy living (see next page for information about the Clyde Wellness program)
Find an In-Network Provider by visiting www.superiorvision.com and searching the Superior National network. You may also contact customer service at 800-507-3800.
19
Clyde Wellness is dedicated to promoting the health of our employees. The program can be used to help guide and coach employees to lead a healthier lifestyle, promote wellness through the work force and focus on improving an individual’s quality of life.
Enrollment:Employees and/or spouses participating in the health insurance benefit can enroll in Clyde Wellness by completing the following steps:
1 Complete an annual preventative physical and routine lab work with your in-network primary care physician. Routine lab work may be waived by your primary care physician.
As part of your physical, partner with your physician to create a wellness strategy, if needed.
3 Complete the optional General Health Assessment (GHA) on www.regence.com.
2 Log the date of your physical at www.regence.com.
4 Successfully implement your wellness strategy. Use the free resources available on www.regence.com.
Eligibility
CLYDE WELLNESS PROGRAM
PROGRAM SUMMARY FOR THE YEAR 2018
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Eligibility
CLYDE WELLNESS PROGRAM
Clyde Wellness is a voluntary wellness program available to all eligible 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. You will be asked to complete an annual physical with biometric screening, which will include a blood test for items determined by your physician. You are not required to participate in the blood test or other medical examinations.
However, employees who choose to participate in the wellness program will receive an incentive of $14 per week for employee and/or $14 per week for spouse for having an annual physical with your doctor. Although you are not required to complete the physical or participate in the biometric screening, only employees who do so will receive $14 or $28 incentive.
The results from your biometric screening will be used to provide you with information to help you understand your current health and potential risks. You are encouraged to share your concerns with your own doctor.
Continued Participation:
Incentive: $14 or $28 per weekEmployees and/or spouses who choose to participate in Clyde Wellness and complete the requirements will be eligible to receive an incentive. The incentive is $14 per week for employee and/or $14 per week for spouse. Employees who provide coverage for children only (no covered spouse) will receive the full $28 per week incentive.
Note: Participants who fail to meet the requirements and/or have not participated in Clyde Wellness in the past can join the program at the beginning of any quarter by completing the requirements above.
1 Complete an annual preventative physical and routine lab work with your in-network primary care physician in the same month each year. Routine lab work may be waived by your primary care physician.
2 Log the date of your physical at www.regence.com.
21
Coverage Amounts Will Reduce According To The Following Schedule:Age Insurance amount reduces to:
65 65% of original amount
70 45%
75 30%
80 20%
Clyde Companies is committed to providing physical and financial stability and protection for employees. The Basic Life coverage provided by Clyde Companies includes coverage for yourself, your spouse and your children at no cost to you.
Eligibility
GROUP TERM LIFE
Eligibility
Coverage Amounts
Cost
Portability/Conversion
Dependent Benefit
All active, full-time Corporate Officers, exempt and non-exempt employees are eligible for participation in this program.
Your Term Life and AD&D coverage options are:
Corporate Officers: One (1) times your annual earnings (rounded to the next higher $1,000), to a maximum of $100,000.
Exempt Employees: .7 times your annual earnings (rounded to the next higher $1,000), to a maximum of $50,000.
Non-Exempt Employees: .7 times your annual earnings (rounded to the next higher $1,000), to a maximum of $50,000.
AD&D Benefit Schedule: The full benefit amount is paid for loss of:
• Life
• Both hands or both feet or sight of both eyes
• One hand and one foot
• One hand and the sight of one eye
• One foot and the sight of one eye
• Quadriplegia
Other losses may be covered as well. Please see your Plan Administrator.
Clyde Companies pays 100% of the cost for this benefit. Coverage may not be increased after a reduction.
If you retire, reduce your hours or leave your employer, you can take this coverage with you according to the terms outlined in the contract. However, if you have a medical condition which has a material effect on life expectancy, you will be ineligible to port your coverage. You may also have the option to convert your Term Life coverage to an individual life insurance policy.
Spouse: $5,000 Children: $5,000, full coverage from birth
22
MONTHLY COVERAGE RATES
Age Employee per $10,000 Spouse per $5,000
0-34 .68 .34
35-39 1.01 .51
40-44 1.62 .81
45-49 2.63 1.32
50-54 3.90 1.95
55-59 5.86 2.93
60-64 9.69 4.85
65-69 17.43 8.72
70-74 24.63 12.32
75+ 53.19 26.60
Eligibility
VOLUNTARY TERM LIFE
Eligibility
Coverage Amounts
Cost
StepUp GuaranteeGuarantee Issue
All active, full-time exempt and non-exempt employees are eligible for participation in this program.
Your Term Life coverage options are:
Employee: Up to seven (7) times salary in increments of $10,000, not to exceed $500,000.
Spouse: Up to 100% of employee coverage amount in increments of $5,000, not to exceed $250,000.
Child: Up to $10,000 in increments of $2,000. Full coverage from birth.
Employee guarantee issue amount of $400,000 or seven (7) times salary whichever is less. Spouse guarantee issue amount of $50,000.
Rates shown below are your monthly deduction:
If you purchase an amount of $10,000 or greater during your initial new hire enrollment you can increase up to Guarantee Issue amount at future annual enrollments without medical questions. This guarantee is only available to new hires, during their initial enrollment.
Voluntary Term Life insurance coverage purchased through your employer is affordable and requires no physical exam. Coverage can be purchased for yourself, your spouse and dependent children.
23
Eligibility
ACCIDENTAL DEATH & DISMEMBERMENT
Eligibility
Coverage Amounts
Cost
All active, full-time exempt and non-exempt employees are eligible for participation in this program.
Employee: Up to seven (7) times salary in increments of $10,000, not to exceed $500,000.
Spouse: Up to 100% of employee coverage amount in increments of $5,000, not to exceed $250,000.
Child: Up to $10,000 in increments of $2,000.
Employee and Spouse coverage is $.40 per month for $10,000 of coverage, regardless of age.
Children coverage is $.01 per month for $2,000 of coverage, regardless the number of children in the family.
Accidental Death and Dismemberment (AD&D) insurance provides financial protection for your beneficiaries by paying a benefit in the event of your death or for you in the event of any other covered loss.
24
Voluntary Short-Term Disability (STD) coverage provides benefits when you are unable to work for a short period of time due to a covered illness or injury. This valuable benefit is available to you through a post-tax payroll deduction.
CALCULATE YOUR COST
Annual Salary
÷
Weeks
x
Weekly Benefit %
=
Weekly Benefit
Sample $30,000 52 60% $346.15
You
COST PER MONTH
Employee’s Age
@
Weekly Benefit
÷ 10 x
Rate
=
Cost Per Month
Sample 30 $346.15 .17 $5.88
You
COST PER WEEK
Cost Per Month
x
Months
= ÷
Weeks
=
Cost Per Week
Sample $5.88 12 $70.56 52 $1.36
You
Weekly Rate Per $10 of Weekly Covered Salary
Age Rate
15-24 .17
25-29 .18
30-34 .17
35-39 .19
40-44 .22
45-49 .24
50-54 .28
55-59 .36
60-64 .43
65-69 .48
70+ .48
Eligibility
VOLUNTARY SHORT-TERM DISABILITY
Eligibility
Weekly Benefit Amount
Definition of Disability
Elimination Period
Benefit Duration
Cost
All active, full-time exempt and non-exempt employees are eligible for participation in this program.
If you meet the definition of disability, you would be eligible to receive a weekly benefit equal to 60% of your weekly earnings, up to a maximum of $750 per week.
You are considered disabled when LifeMap determines that due to sickness or injury:
• You are unable to perform all the material and substantial duties of your regular occupation
• And, you have a 20% or more loss in your monthly earnings
You must be under the appropriate care of a doctor to be considered disabled.
The Elimination Period is the length of time of continuous disability which must be satisfied before you are eligible to receive benefits. If your disability is due to sickness or the result of an injury that occurs while you are covered under the plan, your Elimination Period is 14 days.
If you meet the definition of disability you may claim this benefit for up to 11 weeks.
Voluntary LTD coverage is $.27 per month for each $100 of covered payroll.
Rates shown below are your monthly cost per $10 of covered weekly salary.
25
Group Long-Term Disability (LTD) insurance provides you with a portion of your income if a covered injury or illness keeps you from working. It can provide benefits for events like an injury, surgery or long-term illness. Long-Term Disability coverage starts after a specific waiting period.
Eligibility
GROUP LONG-TERM DISABILITY
Eligibility
Benefit Amount
Definition of Disability
Elimination Period
Benefit Duration
Cost
All active, full-time exempt and non-exempt employees are eligible for participation in this program.
Monthly LTD benefit:
Corporate Officers: 60% of your monthly earnings, to a maximum of $10,000 per month.
Exempt & Nonexempt Employees: 60% of your monthly earnings, to a maximum of $5,000 per month.
You are considered disabled when LifeMap determines that due to sickness or injury:
• You are unable to perform all the material and substantial duties of your regular occupation
• And, you have a 20% or more loss in your monthly earnings
You must be under the appropriate care of a doctor to be considered disabled.
The Elimination Period (90 days) is the length of time of continuous disability which must be satisfied before you are eligible to receive benefits.
Your duration of benefits is based on your age when the disability occurs. Your LTD benefits are payable for the period during which you continue to meet the definition of disability for two (2) years. If your disability occurs at or after age 70, benefits would be paid for a reduced period of time.
Clyde Companies pays 100% of the cost for this benefit.
26
The Voluntary Long-Term Disability (LTD) Buy-Up/Buy-Out insurance allows you to expand on the company provided LTD insurance. You have the option to add additional coverage and have that coverage for an extended amount of time.
Eligibility
Eligibility
Benefit Amount
Definition of Disability
Elimination Period
Benefit Duration
Cost
All active, full-time exempt and non-exempt employees are eligible for participation in this program.
Monthly Voluntary LTD benefit:
Corporate Officers: 60% of your monthly earnings, to a maximum of $10,000 per month.
Exempt & Nonexempt Employees: 60% of your monthly earnings, increase to a maximum of $10,000 per month.
You are considered disabled when LifeMap determines that due to sickness or injury:
• You are unable to perform all the material and substantial duties of your regular occupation
• And, you have a 20% or more loss in your monthly earnings
You must be under the appropriate care of a doctor to be considered disabled.
The Elimination Period (90 days) is the length of time of continuous disability which must be satisfied before you are eligible to receive benefits.
The voluntary buy-out option will increase the length of LTD coverage from the current two (2) year benefit out to your eligible Social Security Retirement Age (SSRA). If your disability occurs at or after age 69, benefits would be paid for a reduced period of time.
Voluntary LTD coverage is $.27 per month for each $100 of covered payroll.
VOLUNTARY LONG-TERM DISABILITY
27
Each employee’s lifestyle and needs are different. Supplemental Insurance products offer a broad range of benefit options that enhance the core insurance coverage. Enrollment is voluntary and fully customizable to your needs and budget. Most premiums are payroll deducted on a pre-tax basis. IRS rules prohibit midyear termination of pre-tax premiums unless there is an eligible qualifying event.
ISSUE AGE
EMPLOYEE ONLY
EMPLOYEE & SPOUSE
EMPLOYEE + CHILD(REN)
FAMILY
17-99 $3.45 $4.94 $6.58 $8.07
ISSUE AGE
EMPLOYEE ONLY
EMPLOYEE & SPOUSE
EMPLOYEE + CHILD(REN)
FAMILY
17-99 $4.15 $8.02 $5.93 $9.79
Eligibility
SUPPLEMENTAL INSURANCE
Group Accident Insurance Group Medical Bridge Insurance
You can’t predict when or where an accident will strike.
But you can make sure you have a safety net of financial
protection to help if an accidental injury occurs. Colonial Life’s
Group Accident Insurance helps fill some of the gaps caused
by increasing deductibles, co-payments and out-of-pocket
costs related to an accidental injury.
• Benefits are paid directly to you to help with the care and
treatment of a covered accidental injury
• Benefits are paid based on the type of injury you have
and how your doctor treats it. You may look up the plan
brochure through your enrollment site or contact the local
service specialist for more details
• Benefits are paid regardless of any other insurance you may
have, such as health insurance and/or workers compensation
• Includes a health screening benefit
• Worldwide coverage – you and your covered family
members have coverage even if the accident happens
outside of the U.S.
• You can keep the coverage in-force if you change jobs or retire
Being admitted to the hospital as a result of an accident or
illness may leave you with bills not covered under your health
insurance; specifically you may need to cover your deductible,
if you haven’t already done so for the year. With Colonial Life’s
Group Medical Bridge coverage, benefits are paid directly to
you if you, or a covered family member, are admitted to the
hospital, to help cover those out-of-pocket costs that are your
responsibility.
Benefits of the plan are:
Hospital Confinement Benefit: $1,000 benefit payable
once per covered person per calendar year for a hospital
admission with a minimum stay of 20 hours.
Accident Only Emergency Room Visit Benefit: $150 benefit
payable once per covered person per calendar year for
treatment in an emergency room due to accidents only. ER
treatment must be within 72 hours of the accident occurring.
Other features:
• Benefits are paid regardless of any other coverage you
may have with another insurance company
• Includes a Health Screening Benefit
• There is no lifetime maximum to any of the benefits under
this policy
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FOR COVERAGE DETAILS, LIMITATIONS, OR EXCLUSIONS, PLEASE SPEAK WITH OUR SERVICE SPECIALIST OR CONSULT EACH PLANS BROCHURE AVAILABLE IN YOUR ONLINE ENROLLMENT SYSTEM.
For questions regarding coverage, claims, or enrollment, please contact our local service specialist:
Tobacco Rates
Non-Tobacco Rates
Stephanie Coltrin 801-528-1316 ext. 101 Fax:801-261-9083 [email protected]
ISSUE AGE EMPLOYEE ONLY EMPLOYEE & SPOUSE EMPLOYEE + CHILD(REN) FAMILY
16-29 $2.10 $3.21 $2.33 $3.39
30-39 $3.67 $5.47 $3.85 $5.70
40-49 $6.99 $10.50 $7.27 $10.78
50-59 $12.30 $18.76 $12.53 $19.04
60-74 $19.50 $29.70 $19.78 $30.02
ISSUE AGE EMPLOYEE ONLY EMPLOYEE & SPOUSE EMPLOYEE + CHILD(REN) FAMILY
16-29 $2.98 $4.45 $3.21 $4.68
30-39 $5.24 $7.78 $5.47 $8.01
40-49 $10.59 $15.90 $10.82 $16.18
50-59 $18.99 $29.10 $19.27 $29.38
60-74 $30.99 $47.47 $31.32 $47.75
Critical Care Insurance
The diagnosis of a critical illness can mean large out-of-pocket expenses. Colonial Life’s Group Critical Care plan pays a lump
sum benefit if you, or a covered family member, are diagnosed with a covered critical illness. The benefit is paid upon diagnosis
of one of the critical illnesses listed in the policy. Please refer to the plan brochure on your enrollment site or speak to your
representative about the covered conditions and the percentage of benefit paid.
Benefits of the plan are:
Employee face amount: $20,000
Spouse or dependent child(ren) face amount: $10,000
Other features:
• Benefits are paid directly to you to help with the care and treatment of a covered critical illness
• The benefit is paid regardless of any other coverage you may have with another insurance company
• A portion of the original face amount is payable upon a diagnosis of the same or a different covered critical illness
• There is no lifetime benefit maximum
Eligibility
SUPPLEMENTAL INSURANCE
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Eligibility
FLEX SPENDING (SECTION 125 PLAN)
What Is a Flexible Spending Account (FSA)?
Limited Dental/Vision FSA
FSA Elections
Use It or Lose It
How It Works
Health Care FSA
Dependent Care FSAs
Reimbursement
A flexible spending account (FSA) is a voluntary employer-
sponsored program for employees to save a portion of their
income to be used to pay for qualified medical or dependent
care expenses incurred during their benefit plan year. All
contributions to an FSA are tax-free.
Health and dependent care FSA plans give employees the
opportunity to realize tax savings on medical and day care
expenses through separate pre-tax accounts.
The money employees contribute to their health care FSA
can be used to reimburse eligible, out-of-pocket health care
expenses made for themselves and/or covered dependents.
Accounts are funded through payroll deductions. The plan
year maximum is $2,650 per eligible employee.
A dependent care FSA is set up to reimburse an employee
for their eligible, dependent care expenses. Eligible expenses
include dependent care expenses for children under age 13,
a disabled spouse, and/or a disabled relative or household
member who depends on the account holder for at least
half of his or her support. All guardians must be gainfully
employed to qualify for incurred dependent care expenses.
Accounts are funded through payroll deductions. The IRS
limits dependent care maximums to $5,000 per year or $2,500
if the employee is married and filing separately.
For employees that elect the HSA medical plan and
accompanying Health Saving Account, a limited dental/vision
FSA is available. The money employees contribute to their
limited dental/vision FSA can be used to reimburse themselves
for eligible, out-of-pocket dental and vision care expenses made
for themselves and/or covered dependents ONLY. Accounts are
funded through payroll deductions. The plan year maximum is
$2,650 for all Clyde Company employees.
When an employee enrolls in any of the FSA options, they
need to elect the total amount of coverage they need for the
plan year. This means they will have to decide up front how
much money they want to have deducted from each of their
paychecks to fund this account. These deductions are exempt
from state, federal and FICA taxes.
Once enrolled, an employee can’t change their annual
contribution election unless they experience a qualified status
change, such as marriage, divorce, birth or adoption of a
child, death of a dependent, or a change in the employment
status of their spouse.
Funds in a health care and/or dependent care FSA can only
be used to pay for services provided throughout the plan
year; however the plan does allow a “Grace Period”. The
Grace Period allows participants an additional 2 ½ months
(until March 15th) to incur new services and still claim any
unused balances from the prior plan year. All claims for a plan
year must be submitted for reimbursement by the end of the
“Run out Period”. The Run out Period ends on June 15th, 90
days after the grace period ends. Unused funds will revert
to the employer at the end of this period. Funds cannot be
transferred from one account to another or rolled into the
next plan year.
To receive a reimbursement from the FSA, employees
must submit a completed reimbursement/claim form with
an itemized receipt or bill that indicates the date, type of
services and the amount they are responsible for. The plan
administrator pays claims weekly.
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FSA debit cards will now be included at no additional cost to those enrolled in the Health Care FSA or the Limited Dental/Vision FSA to simplify the reimbursement process.
(Keep all itemized receipts and copies of prescriptions for over-the-counter medications in case of an IRS audit.)
See the complete list of qualified and unqualified medical expenses in IRS Publication 502—Medical and Dental Expenses. The complete list of qualified dependent care expenses for a dependent care FSA can be found in IRS Publication 503—Child and Dependent Care Expenses. These IRS publications are available at www.clydebenefits.com.
• Acupuncture
• Alcoholism (rehab, transportation
for medically advised attendance
at AA)
• Ambulance
• Amounts covered under another
health plan
• Annual physical examination
• Artificial limbs/teeth
• Birth control pills/prescription
contraceptives
• Body scans
• Breast reconstruction surgery
• Chiropractor
• Contact lenses
• Crutches
• Dental treatments
• Eyeglasses/eye surgery
• Hearing aids
• Home care
• Long-term care expenses
• Medicines (prescribed, not
imported from other countries)
• Nursing home
• Nursing services
• Optometrist
• Oxygen
• Stop-smoking programs
• Surgery
• Telephone equipment and repair for
hearing-impaired
• Therapy
• Transplants
• Weight loss program
(if prescribed by a physician for a
specific disease)
• Wheelchairs
Questions?For questions regarding your FSA, including determination of eligible items for healthcare or dependent care FSAs, please contact Alliance Benefit Group at 800-421-4758.
A Sample of Qualified Expenses:
Employees participating in the FSA generally are not eligible to participate in the HSA until the month after the grace period ends (March 15th). However, the IRS does allow for a special enrollment for those FSA participants that have a zero balance in their FSA on December 31st, which allows them to begin their HSA on January 1st. If you do not have a zero balance in your FSA on December 31st, you will be required to wait until April 1st, 2018 to begin your HSA.
Eligible Expenses
Eligibility
FLEX SPENDING (SECTION 125 PLAN)
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Identity theft is increasing at an alarming rate around the world, with losses in the United States now reaching $50 billion per year. With more personal information floating around the Internet and held in government and corporate databases, you and your dependents may be at risk. Identity theft coverage helps to monitor your personal information and restore you to good standing if an identity theft occurs.
Eligibility
IDENTITY THEFT PROTECTION
LegalShield’s suite of services addresses all seven types of
identity theft:
Credit Report
Personal Credit Score with Analysis
Continuous Monitoring with Activity Alerts
Identity Restoration Services
Cost
1. Drivers License Identity Theft
2. Social Security Number (SSN)/Social Insurance Number
(SIN) Identity Theft
3. Medical Identity Theft
4. Character/Criminal Identity Theft
5. Financial Identity Theft
6. Synthetic Identity Theft
7. Identity Theft of Minor Children
Conveniently log in to LegalShield’s secure website for access
to your up-to-date credit report based on data from Experian.
In addition to your credit report, this service also provides
a detailed analysis of your Personal Credit Score with your
first credit report.
• Activate continuous credit monitoring via a
secure website.
• Your Experian credit file will be monitored continuously.
• Email alerts will notify you of any activity on your credit
file. This email will direct you to a secure site where you
can log in to view the alert data.
• The experts in identity theft restoration will step in and
take over the restoration process for you, should you face
an identity theft issue. They will customize the solution
and work on your behalf to correct identity theft issues
with affected agencies and institutions.
• Fraud alert notifications will be sent to all three national
credit repositories.
• LegalShield will perform proactive searches of local and
national databases for any activity in your name that you
may not be aware of.
Identity Theft Shield: $2.99 Weekly
Identity Theft Shield and Safeguard for Minors: $3.22 Weekly
For questions regarding identity theft protection, please call
our LegalShield team leader:
Scott Viette: 540-797-9393 or Member Services: 800-654-7757
This is a general overview of your Identity Theft Plan coverage
for illustration purposes only. See a plan contract for complete
terms, coverage, amounts, conditions and exclusions.
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The Company recognizes that employees may experience personal problems at different times in their lives, and that in such circumstances employees may be uncertain where to turn for help. Because a company is only as healthy as its employees, the Company has established an Employee Assistance Program (EAP).
Your EAP provides no-cost, confidential assistance for you and your family members. By calling the EAP, you can identify solutions to assist with life, work and family concerns. No problem is too large or too small for the EAP. Your EAP Counselor will help you assess your concern and identify resources and assistance. The information you discuss with the EAP is kept confidential
and in accordance with federal and state laws.
EAP Services can help with:
• Depression/Stress Management
• Anxiety
• Family Conflict
• Relationship Problems
• Financial or Legal Concerns
• Alcohol or Drug Addictions
• Gambling Problems
• Parenting Concerns
• Child or Elder Care
Your EAP Counselor can refer you for in-person assessment at a location that is convenient to your home or work. A professionally trained clinician assists you with problem identification, analysis and short-term problem resolution. In addition, your EAP Counselor can provide a referral for services within your health insurance benefits or to community resources/self-help groups. Referrals are also available to specialized resources for elder or child care, legal or debt management questions.
This service is available 24 hours a day via telephone and internet access.
To learn more about the EAP program, visit www.myRBH.com (Group Code: lifemap) or speak with a specialist at: 866-750-1327
Eligibility
EMPLOYEE ASSISTANCE PROGRAM (EAP)
LifeMap EAP
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Clyde Companies provides a 401(k) retirement plan for all eligible employees. The Company has adopted the 401(k) plan to provide you with the opportunity to save for retirement on a tax advantage basis. All eligible employees are encouraged to participate in the plan. For more detailed information, please access the Summary Plan Description (SPD) at www.my401klink.com, or at www.clydebenefits.com.
Eligibility
401(k) RETIREMENT PLAN
Eligibility
Employee Contribution Types
Employer Match
Vesting on Employer Match
Profit Sharing
Vesting on Profit Sharing
Investment Changes
Loans
Distributions
Rollover
Participants 21 years of age and older will be automatically enrolled into the 401(k) plan on the first of the month following 90 days from their first day of employment. Participants are automatically enrolled to defer 6% of pay on a pre-tax basis with the contributions invested into the Balanced Growth Lifestyle Portfolio. Participants may opt out of the plan or change their salary contribution at the beginning of each month.
Limits may be applied according to the traditional pre-tax contributions or ROTH (k) after tax contributions or a combination of both up to the 2018 limit. Pre-tax grows tax-deferred and is taxed as income at retirement. ROTH (k) can be withdrawn tax free if taken after age 59 ½ and a 5 year contribution clock is completed.
Clyde Companies matches dollar for dollar up to 6% of adjusted compensation (ROTH (k) or Pre-tax).
100% after 2 years
Employer Discretionary Contribution consists of a 6% salary match for all eligible employees, assuming subsidiary is profitable. Employees are eligible after one (1) full calendar year of employment, provided they have worked a minimum of 1000 hours.
100% after 3 years
You may change your investments and allocations at any time by phone or going to www.my401klink.com.
Participants may apply for a 401(k) loan. The interest rate on the loan is prime +1%.
Distributions can be approved for the following: hardship reasons, termination of employment, and retirement at age of 59 ½. Withdrawals are subject to income tax and early withdrawal penalties may apply.
Participants may roll previous qualified 401(k) balances or IRAs into the Clyde Companies 401(k) Plan. Contact your previous 401(k) provider for distribution forms and/or instructions. Contact Soltis at 800-735-1601 for assistance with completing the distribution form.
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Full-time regular employees are eligible to accrue PTO. PTO is a bank of hours that may be used for all paid leave from work and includes, but is not limited to, vacation, sick days, and/or bereavement leave. In the case of sick days or bereavement leave, provide as much advance notice to your supervisor as possible. Submit in advance a completed “Time Off” form to your supervisor requesting PTO.
• For new employees an additional ten (10) days will be added to the PTO bank of hours after 90 days of employment
• Time must be used in four (4) or eight (8) hour increments
• You may accrue in your PTO bank a maximum of three (3) times your annual limit. You may not carry more than three (3) times the accrual maximum beyond the end of February of the next calendar year
• Accruals can be credited for work at Clyde Companies or any of its subsidiaries
• PTO is used for time away from work and may not be used to exceed a 40 hour work week
• Employees who leave the Company are paid out their unused PTO balance in a lump sum
Following is the PTO accrual schedule:
For additional information on PTO, please see your employee handbook.
Full-time regular employees are eligible for paid holidays after 30 days of employment. Exempt employees are eligible from date of hire. The Company provides eight (8) paid holidays per year as listed below:
• New Year’s Day
• Memorial Day
• Independence Day
• Pioneer Day
• Labor Day
• Thanksgiving Day
• Day after Thanksgiving
• Christmas Day
Should a holiday fall on a Saturday, exempt and eligible non-exempt employees are credited with eight (8) hours to their PTO bank. Holidays that fall on Sunday will be recognized the following Monday.
Schedule Weekly Annually
First year of employment 1.08 hours 56 hours or 7 days
2 through 4 years 2.31 hours 120 hours or 15 days
5 through 14 years 3.08 hours 160 hours or 20 days
15 through 24 years 3.85 hours 200 hours or 25 days
25 through 34 years 4.62 hours 240 hours or 30 days
35+ years 5.39 hours 280 hours or 35 days
Eligibility
PAID TIME OFF (PTO) & HOLIDAY PAY
Paid Time Off (PTO) Holidays
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The elections you make now stay in effect through December 31, 2018. You cannot make changes unless you have a change in employment status or a qualifying life event. Qualifying life events allow you to make changes to your benefits package, or to enroll if you previously waived coverage. Examples of life events are found on page 4 of this guide. Qualifying changes must be reported to your Human Resources Department within 30 days of a change.
Review this 2018 Benefits Guide
Complete Benefits Enrollment by November 17th, 2017
Submit 401(k) changes …. For a January 1st, 2018 effective date.
Check your January 5th, 2018 paycheck to ensure your new deductions are correct for 2018
Eligibility
CHECKLIST
A customer service representative is also available to assist all Clyde Companies’ employees with any questions or claim issues that are unresolved with any of the carriers in this booklet. For assistance please email or call us:
Email . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected] Employee Benefits Department . . . . . . . . . . . . . . . 801-685-6860 or 800-323-6303
BEEHIVE INSURANCE
• Benefit Change forms
• Provider Directories
• Payroll Deductions
• Enrollment Questions
• General Carrier Info
• Questions About Specific Benefits
• Change in Status
Qualifying changes must be reported and the appropriate paperwork completed within 30 days of the event.
Failure to do so may result in the loss of coverage or coverage restrictions until the next open enrollment period or a waiting period.
If you cannot find the answers you need after reviewing this summary of benefits, please contact your Human Resources Department for common inquiries such as:
Clyde Companies, Inc., Sunroc Corporation, Sunroc Building Materials, Beehive Insurance, DDF
Dan Walker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801-802-6975 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Tom Cannon . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801-802-6953 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Clyde Companies Benefits Administration
Dan Walker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801-802-6975 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Amy Powell . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801-802-6952 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
W.W. Clyde & Co.
James Robertson . . . . . . . . . . . . . . . . . . . . . . . . 801-868-7686 . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Dan Lueken . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801-802-6835 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Geneva Rock Products
Bryan Flake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801-765-7825 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Maggie Powell . . . . . . . . . . . . . . . . . . . . . . . . . . 801-765-7842 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Eligibility
CONTACT INFO
CLYDE COMPANIES
CLYDE COMPANIES
For questions regarding your elected coverage including deductible, co-pays, procedures, claims questions, prescriptions, or when requesting pre-authorization for procedures please call the carrier in question.
Customer Service . . . . . . . . . . . . . . . . 877-694-3942 . . . . . www.myhealthequity.com
HSA ADMINISTRATOR
Customer Service . . . . . . . . . . . . . . . . 800-654-7757 . . . . . www.legalshield.com
IDENTITY THEFT
Customer Service . . . . . . . . . . . . . . . . 888-367-2119 . . . . . www.regence.com
MEDICAL, DENTAL
Customer Service . . . . . . . . . . . . . . . . 800-507-3800 . . . . . www.superiorvision.com
VISION
Customer Service . . . . . . . . . . . . . . . . 866-703-1259 . . . . . member.healthiestyou.com
TELEHEALTH
Customer Service . . . . . . . . . . . . . . . . 800-286-1129 . . . . . .www.lifemapco.com
EAP - Employee Assistance Program . . 866-750-1327 . . . . . .www.myRBH.com
LIFE, DISABILITY, EAP
Customer Service . . . . . . . . . . . . . . . . 801-528-1316 . . . . . www.coloniallife.com
VOLUNTARY BENEFITS
Customer Service . . . . . . . . . . . . . . . . 800-735-1601 . . . . . www.soltisadvisors.com
RETIREMENT ADVISORS
Customer Service . . . . . . . . . . . . . . . . 800-421-4758 . . . . . www.my401klink.com
FSA & RETIREMENT ACCOUNTS
Eligibility
DIRECTORY
