Employee Benefit Guide 2017 - SmartBen · Employee Benefit Guide 2017 Hourly Employees. 2016 Alorica Inc. All rights reserved. 2 You’re awesome. Frankly, it’s one of the reasons

Employee Benefit Guide 2017Hourly Employees

2© 2016 Alorica Inc. All rights reserved.

You’re awesome. Frankly, it’s one of the reasons we hired you. And with that in mind, we are proud to offer a benefits program that says thank you for your hard work and dedication to Alorica. These programs provide flexibility for the diverse and changing needs of our employees, and are designed to help you stay healthy and productive throughout the year.

The following brochure highlights the Medical, Dental, Vision, Life/AD&D, Disability and other Voluntary insurance benefits available to you in 2017.

You work hard to make lives better—we’re happy to return the favor. Now let’s get to it.

2017 BENEFIT HIGHLIGHTS 2016 is going the way of TRL, Dunkaroos and Taylor Swift’s relationship with, well, anyone…in other words, it’ll be gone before we know it. So for now, let’s look ahead and evaluate the highlights of our 2017 benefits program:

Hourly Benefit Plan Options:

Limited Medical Benefits • Century Healthcare MEC Basic

• Century Healthcare MEC Plus Plans

Dental Benefits • Cigna Dental HMO

• Cigna Dental PPO

Vision Benefits • UHC Vision

Disability Benefits • Unum Voluntary Short Term Disability

• Unum Voluntary Long Term Disability

Life and AD&D Benefits • UNUM Voluntary Life and AD&D

Additional Voluntary Benefits • UNUM Whole Life Insurance

• UNUM Critical Illness Insurance

• UNUM Accident Insurance

• Liberty Mutual Auto & Property Insurance

• Pet Assure Discount Program

• Commuter Benefits

Hourly 30 Benefit Plan Options (pages 16-21):In addition to the Benefit Plan Options listed above the following plan options are available only to employees that meet the ACA minimum 30 hours paid requirement:

• UHC Medical PPO

• UHC Medical HRA

• UHC Medical HSA

• Flexible Spending Accounts

If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, federal law gives you more choices about your prescription drug coverage. Please see pages 26-27 for more details.

DISCLAIMER The information in this brochure is a general outline of the benefits offered under the Alorica benefits program. This brochure may not include all relevant limitations and conditions. Specific details and limitations are provided in the plan documents, which may include a Summary Plan Description(SPD), Evidence of Coverage (EOC), and/or insurance policies. The plan documents contain the relevant plan provisions. If the information in this brochure differs from the plan documents, the plan documents will prevail.

Get to Know Your Benefits

What’s InsideIntroduction ...................................................................... 22017 Benefit Highlights ............................................... 2Benefits Eligibility .......................................................... 3How To Enroll ................................................................... 4Rules For Benefit Changes During The Year ....... 5ACA Requirements ........................................................ 6Limited Medical Benefits Plan ................................... 7-9Dental Plan Benefits ...................................................... 10Vision Plan Benefits ....................................................... 11Additional Voluntary Benefits ................................... 12-14 Commuter Benefits ....................................................... 15Hourly 30 Medical Plans .............................................. 16-19UHC Employee Assistance Program ....................... 20Flexible Spending Account ........................................ 21 ACA Measurement Method ........................................ 22 Required Federal Notices ........................................... 23-25SBC Notice ....................................................................... 25 Medicare Part D Notice ................................................ 26-27Who to Contact .............................................................. 28


EMPLOYEE ELIGIBILITY Hourly Benefit Plans:In order to get these sweet, sweet benefits, you must be a regular hourly employee of Alorica. If elected, eligible employee coverage will begin first of the month following 30 days of employment for the following benefit plans.

• Century Healthcare MEC Plans • Cigna Dental HMO or PPO • UHC Vision

• Unum Term Life/AD&D & LTD • Unum Accident and Critical Illness • Commuter Benefits

• Unum Whole Life • Liberty Mutual Auto & Property • Pet Assure

Hourly 30 Benefit Plans:The Affordable Care Act (ACA) requires Alorica to track employee’s average hours paid during a prescribed measurement period to determine eligibility for additional benefit plans. If we determine that you have met the ACA average 30-hour requirement, you will be eligible for additional plan options described on pages 16-21 of this Benefit Guide. For additional details on our prescribed measurement method, please refer to page 22.

DEPENDENT ELIGIBILITYYour eligible dependents may participate in the plans as well (supporting documentation may be required). An eligible dependent includes:

• Your legal spouse or registered domestic partner (RDP)

• Your dependent children up to age 26, regardless of student status (for medical/dental/vision/accident/critical illness/term life/whole life)

• Dependent children include stepchildren, legally adopted children and children for whom you or your spouse/ RDP has been appointed legal guardian

If you do not enroll yourself or your dependents when initially eligible or during Open Enrollment, you will not be able to enroll until the next Open Enroll-ment period unless you experience a qualifying change in family status as defined by the IRS. See “RULES FOR BENEFIT CHANGES DURING THE YEAR” section for more information. Coverage for dependents added due to a qualifying event, with the exception of a newborn, will become effective the first of the month following the date of the qualifying event.

When You Can Enroll• Alorica’s benefit plan year is January 1st to December 31st.

• You must be actively employed to enroll.

• Employees have until your benefits effective date to enroll or during Open Enrollment.

• Your enrollment choices or declination of coverage when you are first eligible or during Open Enrollment will remain in place until the next Open Enrollment period.

Benefits Eligibility

HOW TO ENROLLEnroll online at https://enroll.smartben.com/

(directions on next page)

3


To enroll in the Alorica benefit plans, log into SmartBen, Alorica’s online enrollment system.

STEPS TO COMPLETE YOUR ENROLLMENTStep 1: Log on to https://enroll.smartben.com/ and enter your Username (1st initial of your first name, last name and last four digits of your Social Security number) and Password (last six digits of your Social Security number)

Example Username: jsmith6789Example Password: 456789

Step 2: On the home page, you will see a Benefits Enrollment box. This box has a countdown of the number of days remaining to enroll. Underneath the countdown, there is a Begin Enrollment button. Click the button to begin enrollment.

Step 3: On the next page, there is a box with Available Enrollments, telling you what enrollments are available. You will see a button for New Hire Enrollment or Annual Enrollment if you are enrolling during Open Enrollment. Select the button to begin your enrollment session.

Step 4: You will enter the Enrollment process at the Benefit Manager page. To make changes to a benefit, click on the benefit name. To make an election, click on the option you want to elect. You will first need to select which individuals are being covered by making your selection in the Who Is Being Covered box on the right. Then select the plan you want to enroll in. The selection you made will turn green. Click the green Continue button at the top right of the page when you are finished.

People Manager: This is where your Personal, Spouse/Dependent, and Beneficiary information is stored. Adding people into the People Manager section DOES NOT assign them to coverage. You will assign your spouse, dependents, and beneficiaries in the enrollment process. To return to enrollment simply click Manage Benefits or Return to Lights.

Step 5: Once all of your elections are complete each benefit will have a green light. To proceed to the next step, click the green button labeled “Elect & Continue.”

Step 6: Verify Required Data: If you have not entered all required information, SmartBen will not process your enrollment. Click on each item in the Enrollment Task List and SmartBen will take you to the required page for corrections. Make your corrections, click Submit, Enroll or Save, whichever is applicable. Be sure to review any items in the “Information” box on this task page, click on “click here” to make changes, and then click the green “Continue” button.

Step 7: You will now have the opportunity to Review your Confirmation. Examine your elections thoroughly, including dependent and beneficiary assignments, and enter your initials to acknowledge your agreement before clicking “Continue”.

Step 8: You have successfully completed the enrollment process! Select the Click Here link for a copy of your Confirmation Statement.

TIP: Click on the Beneficiary Type drop down box to designate your beneficiary as primary or secondary.TIP: If you need to add more than one beneficiary, click on the Add a Person button to designate the additional beneficiaries.

How to Enroll

Trouble Enrolling Online?Employee Benefit 1-877-801-7928 Resource Center: [email protected] Monday-Friday from 8am to 8pm Eastern Time


Other than during annual open enrollment, you may only make changes to your benefit elections if you experience a qualifying life event or qualify for a “special enrollment”. If you qualify for a mid-year benefit change, you may be required to submit proof of the change or evidence of prior coverage. Coverage for dependents added due to a qualifying event, with the exception of a newborn, will become effective the first of the month following the date of the qualifying event.

Qualifying Life Event Changes include:

• Change in legal marital status, including marriage, divorce, legal separation, annulment and death.

• Change in number of dependents, including birth, adoption, placement for adoption, or death.

• Change in employment status that affects benefit eligibility, including the start or termination of employment by you, your spouse/RDP, or your dependent child.

• Change in work schedule, including an increase or decrease in hours of employment by you, your spouse/RDP, or your dependent child, including a switch between part-time and full-time employment that affects eligibility for benefits.

• Change in a child’s dependent status, either newly satisfying the requirements for dependent child status or ceasing to satisfy them.

• Change in place of residence or worksite, that affects the accessibility of network providers.

• Change in your health coverage or your spouse/RDP coverage attributable to your spouse/RDP employment.

• Change in an individual’s eligibility for Medicare or Medicaid.

• A court order resulting from a divorce, legal separation, annulment, or change in legal custody (including a Qualified Medical Child Support Order) requiring coverage for your child.

• An event that is a “special enrollment” under the Health Insurance Portability and Accountability Act (HIPAA) including acquisition of a new dependent by marriage, birth or adoption, or loss of coverage under another health insurance plan.

• An event that is allowed under the Children’s Health Insurance Program (CHIP) Reauthorization Act. Under provisions of the Act, employees have 60 days after the following events to request enrollment if:

1) Employee or dependent loses eligibility for Medicaid or CHIP or 2) Employee or dependent becomes eligible to participate in a premium assistance program under Medicaid or CHIP.

Two rules apply to making changes to your benefits during the year:

• Any change you make must be consistent with the change in status, AND

• You must make the change within 30 days of the date the event occurs (unless otherwise noted above).

Rules For Benefit Changes During The Year


The Affordable Care Act (ACA) mandates that all individuals have health coverage beginning January 1, 2014, or pay a tax penalty. Employees can prevent being taxed the “individual mandate” tax penalty by purchasing a qualified minimum essential coverage health plan.

The Century Healthcare MEC plans offered to Hourly employees DO provide the “ minimum essential coverage” as required by the Affordable Care Act. If you qualify for Hourly 30 benefits, the UHC plans also meet the ACA requirement.

HOURLY 30 BENEFITS ELIGIBILITYAlorica will track your average hours paid during a “Prescribed Measurement Period” to determine your eligibility for our Health & Welfare benefit plans, as required by ACA. As a new hire, your initial Prescribed Measurement Period consists of an initial measurement period of 11 months, plus a two-month administrative period. When your “Prescribed Measurement Period” ends, your “Benefits Effective Date” will begin.

If Alorica has determined that you have met the 30 hours average requirement (the “Hourly Average Test”) as of your earliest Benefits Effective Date or some subsequent date, you will be eligible to participate in our “Hourly 30” benefit plans. In addition to the Hourly benefit plans available to you, Hourly 30 employees will also be eligible for the UHC medical plans. By enrolling in one of these plans, you will avoid the tax penalty.

Please see local HR to determine your earliest Benefits Effective Date based upon your hire date.

If you do NOT meet the minimum hours paid requirement as defined by the ACA, you will not be eligible to enroll in these additional plan options and should look into other individual plan options, such as the Marketplace, for more comprehensive medical plan options.

What is the Health Insurance Marketplace? The Marketplace is designed to help you find private individual health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options. Open Enrollment for health insurance coverage though the Marketplace begins November 15, 2016 for coverage starting as early as January 1, 2017.

Am I Eligible for Premium Savings through the Marketplace? You may be eligible for premium savings through the marketplace if you meet certain income requirements and are not offered qualified coverage through your employer (Hourly employees). Therefore, depending on your income you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing.

How Can I Get More Information About the Health Insurance Marketplace? HealthCompare experts can help you for free. Call them at (877) 470-3075.

Affordable Care Act (ACA) Insurance Requirements

2014 2015 2016$95per adult

$325per adult

$695per adult

OR OR OR

FLAT $ AMOUNT OR % OF INCOME(whichever is greater)



1% of yearly household income

2% of yearly household income

2.5% of yearly household income

IN 2014, individuals and families with income under approximately $28,500 will pay a flat dollar penalty amount if they fail to obtain minimum essential coverage. Individuals and families with income over $28,500 will pay a penalty equal to 1 percent of their income.

IN 2015, individuals and families with income under approximately $48,750 will pay a flat dollar penalty amount if they fail to obtain minimum essential coverage. Individuals and families with income over $48,750 will pay a penalty equal to 2 percent of their income.

IN 2016, individuals and families with income under approximately $83,400 will pay a flat dollar penalty amount if they fail to obtain minimum essential coverage. Individuals and families with income over $83,400 will pay a penalty equal to 2.5 percent of their income.

$47.50per child

$162.50per child

$347.50per child

up to $285 per household

up to $975 per household

up to $2,085 per household


Limited Medical Benefits Plan MEC Basic PlanCentury Healthcare’s MEC Basic Plan covers all of the preventive services required by the Affordable Care Act (ACA). In-network services are covered at 100% with no member cost share (PHCS Network). If you utilize a non-network provider, you will be responsible for the full cost of provider charges. The following is a brief description of preventive services available to members and is subject to change. To learn more, visit www.healthcare.gov.

IMPORTANT DETAILSNetwork providers: Health plans are required to provide these preventive services only through an in-network provider.Office visit fees: Your doctor may provide a preventive service, such as a cholesterol screening test, as part of an office visit. Be aware that your plan can require you to pay some costs of the office visit, if the preventive service is not the primary purpose of the visit, or if your doctor bills you for the preventive services separately from the office visit.

Coverage: Coverage is provided for preventive services only. Once a diagnosis has been made, the services are not covered under the MEC Basic Plan.

Talk to your health care provider: To find out which covered preventive services are right for you—based on your age, gender, and health status—ask your health care provider. For information on preventive practices, visit healthcare.gov.

Questions: If you have questions regarding your coverage, please call Customer Service at (877) 685-2432.

NOTE: All costs for medical plans can be found online or by calling the Employee Benefit Resource Center. If reviewing medical costs online, please ensure to waive coverage if you do not intend to enroll.

• Routine physical exam

• Well women exam (annual)

• Annual mammogram

• Annual pap smear and other routine lab work

• Breast thermography

• Bone density test

• Well baby / well child care exam

• Routine immunizations

• Flu and pneumonia vaccines

• Routine lab, x-rays, diagnostic testing and other

medical screenings including:

- Blood pressure- Diabetes- Cholesterol test

• Many cancer screenings including:- Cervical cancer- Breast cancer- Colorectal cancer

• Contraception (FDA):- Approved contraceptive methods- Sterilization procedures- Patient education and counseling (Covered contraceptives do not include

abortifacient drugs)

• Counseling on topics such as:- Obesity & eating healthy- Treating depression- Alcohol & drug abuse- Smoking cessation- Domestic & interpersonal violence- Sexually transmitted diseases


Limited Medical Benefits Plan MEC Plus Plan Options

BENEFIT DESCRIPTION MEC PLUS VALUE MEC PLUS SELECT

Preventive Services All preventive services as specified by the Affordable Care Act such as annual physicals, mammograms, pap smears, preventive cancer screenings, routine lab and x-rays, and immunizations.

100% Covered through in-network

providers

100% Covered through in-network

providers

Physician Office Visit

Benefits paid if a covered person visits a doctor’s office or a facility other than a doctor’s office, as defined in the policy, for medically necessary treatment, care or advice of an injury or sickness covered under the policy, including Outpatient Physical Therapy, for the treatment of physical dysfunction or injury by the use of therapeutic exercise and the application of modalities, intended to restore or facilitate normal function or development and including Outpatient Manipulative Therapy. Physical Therapy does not include speech therapy or occupational therapy.

Pays $60 per day (5 days)


Class I: Laboratory - Blood work, CMP, Lipid Panel, ECG, Pap/PSA, UA and all other labBenefits paid for outpatient laboratory tests if a covered person is not confined in a hospital and the tests are ordered by a doctor and performed by an appropriately licensed technician.



Class II: Radiology, Ultrasound, Mammogram, Sonogram, Angiogram, Xrays Benefits paid for outpatient radiology if a covered person is not confined in a hospital and the tests are ordered by a doctor and performed by an appropriately licensed technician.

Pays $70 per day (1 day)

Pays $100 per day (1 day)

In-Patient/Out-Patient Surgery Benefits Benefit paid if a covered person undergoes medically necessary surgery at the direction of a doctor for a covered injury or sickness

In-Patient Pays $500 Out-Patient Pays $300 (1 IP and 1 OP surgery)

In-Patient Pays $500 Out-Patient Pays $500 (1 IP and 1 OP surgery)

First Hospital ConfinementBenefits paid when a covered person is confined in a hospital for the first time in the Plan Year; no benefits are available for any subsequent hospitalizations in the same Plan Year. This benefit is paid in addition to the Hospital Confinement benefit.

Day 1: Pays $500 Day 1: Pays $800

Daily Hospital Confinement Benefits paid if a covered person is confined as an inpatient in a hospital because of a covered injury or sickness.

Pays $350 per day

(Max of 7 days)

Pays $550 per day

(Max of 7 days)

MaternityBenefits paid under the applicable provision for Doctor’s Office Visits, Outpatient X-ray & Lab, Surgery or Hospital Confinement for pregnancy-related expenses.

Included Included

All of the above benefits are per covered person per Benefit Year.“Benefit Year” means the 12 consecutive months beginning on the group’s effective date of coverage.

The Century Healthcare MEC Plans are limited medical plans that cover preventive services and additional indemnity benefits. Benefits provided are supplemental and are not intended to cover all medical expenses. These plans pay a fixed dollar amount per day regardless of the amount that the provider charges. The plan typically has no copays, deductibles or coinsurance (except for Rx). If you choose a preferred (in-network) provider, then you may pay less, because the provider may accept payment for the negotiated charge.


Limited Medical Benefits Plan MEC Plus Plan Options Cont’d

BENEFIT DESCRIPTION MEC PLUS VALUE MEC PLUS SELECT

ICU Confinement Pays in addition to the Hospital Confinement Benefit.

Pays $350 per day

(Max of 7 days)

Pays $550 per day

(Max of 7 days)

Accident Medical($100 deductible per occurrence)

Up to $5,000 per occurrence

Up to $5,000 per occurrence

Accidental Death & Dismemberment EmployeeSpouseChild(ren)

$15,000 $7,500 $3,000

$15,000 $7,500 $3,000

Pharmaceutical Benefits Copay Rx Plan

Tier 1 (Most Generics): $10 copay

Tier 2 (Some Generics & Preferred/Formulary Brand Name): $50 or 50%; whichever is greater.

Tier 3 (Non-Preferred / Non-Formulary Brand Name): Employees pay 100% of the cost after pharmacy discounts.

Monthly Maximum of $100 Employee / $200 Family.

No Deductible. Restricted Formulary.

Tier 1 (Most Generics): $10 copay

Tier 2 (Some Generics & Preferred/Formulary Brand Name): $50 or 50%; whichever is greater.

Tier 3 (Non-Preferred / Non-Formulary Brand Name): Employees pay 100% of the cost after pharmacy discounts.

Monthly Maximum of $100 Employee / $200 Family.

No Deductible. Restricted Formulary.

PHCS PPO Limited Benefit Network All plan designs provide covered individuals access to a PPO Network that allows them to take advantage of network negotiated rates prior to the above benefits being applied.

24-Hour Nurseline All plan designs provide covered individuals with 24-hour telephone access to nurses for medical decision support and patient advocacy (available in multiple languages with an audio health information library).

Find a Provider: To locate a participating PHCS Limited Benefit Network provider in your area, please call PHCS at (888) 371-7427 or visit www.multiplan.com/chc.

All of the above benefits are per covered person per Benefit Year.“Benefit Year” means the 12 consecutive months beginning on the group’s effective date of coverage.


Keep your teeth pearly white! Alorica provides dental coverage that is designed to help keep you and your family smiling with coverage through a choice of the Cigna Dental HMO Plan or the Cigna Dental PPO Plan.

Voluntary Dental Plan Options: Cigna DENTAL HMO PLAN (Not available in all areas. The SmartBen enrollment system will identify if you live in a city where the DHMO plan is available.) You and your eligible dependents must select a primary dentist from the Cigna network. There is no deductible or annual benefit maximum. Copayments are required for basic, major, and orthodontia services. Network providers may be accessed online through www.mycigna.com or by calling Customer Service at (800) 244-6224. Bi-Weekly Rates for the Cigna Dental HMO plan are (per pay period):

Employee only: $6.00 Employee + Child(ren): $12.58

Employee + Spouse: $10.49 Employee + Family: $17.68

Cigna DENTAL PPO PLAN You have the flexibility of receiving your care from an in-network or out-of-network dentist. The Cigna PPO network is a nationwide network of participating dentist locations consisting of carefully credentialed general and specialty dentists, such as orthodontists, endodontists and periodontists. Network providers may be accessed online through www.mycigna.com or by calling Member Services at (800) 244-6224.

Bi-Weekly Rates for the Cigna Dental PPO plan are (per pay period):

Employee only: $15.74 Employee + Child(ren): $23.27

Employee + Spouse: $28.09 Employee + Family: $39.66

1. Please refer to the full CIGNA Patient Charge Schedule for detailed information on covered services and member copayments.2. Out-of-Network coinsurance may differ for employees in KS and TX. Please review the specific benefit summary for details.

The information contained in this summary is not intended to take the place of, or change the carrier’s schedule of benefits. In the event the information contained herein varies from the carrier’s schedule of benefits, the carrier information shall prevail.

Dental Plans

BENEFIT ATTRIBUTES Cigna DHMO1

In-Network

Cigna DPPOIn-Network

DPPO Advantage Out-of-Network2

Annual DeductibleIndividual None $50 per person $50 per person

Annual Maximum None $1,500 per person

Preventive Services Member Pays Member Pays

X-raysExamCleaning(limit 2 per calendar year)

No CopayNo CopayNo Copay

0% Deductible Waived

10% Deductible Waived

Basic Services Member Pays Member Pays

FillingsExtractions / Oral SurgeryEndodonticPeriodontics

$30 - $120$35 - $150$45 - $415$60 - $425

20% After Deductible


Major Services Member Pays Member Pays

CrownsBridge WorkDentures

$265 - $365 $265 - $365 $65 - $425



Orthodontics Children - $1,800 Adults - $2,400

plus initial consultation, banding and

retention charges

50% 50%

Orthodontics Lifetime Maximum $1,500Children & Adults

$1,500Children & Adults


Hindsight is 20/20. Shouldn’t your nowsight be the same? Alorica offers comprehensive vision benefits to you and your eligible dependents through UHC Vision. You may begin receiving substantial savings on your eye care and eyewear needs at any one of UHC’s thousands of provider locations, including optometrists, ophthalmologists and opticians located throughout the country. Network providers may be accessed online at www.myuhcvision.com.

When you use a UHC provider, you are responsible for a copay at time of service. The provider will file a claim for you and be reimbursed directly from UHC. If you see an out-of-network provider, you pay all expenses at time of service and submit a claim for reimbursement up to the allowance shown in the Vision Highlights chart below. Remember to ask your UHC provider about special discounts for additional pairs of glasses, special lens options and other vision services including LASIK surgery. You will not receive a UHC Vision ID card. Select a UHC provider from www.myuhcvision.com or by calling Member Services at (800) 839-3242.

Bi-Weekly Rates for the UHC vision plan are (per pay period):

Employee only: $2.97

Employee + 1: $4.15

Employee + Family: $8.07

Vision Plan

PLAN HIGHLIGHTSUHC VISION

In Network Out-of-Network Frequency

Annual Deductible None None N/A

Well Vision Exam $10 Copay $50 Allowance Every 12 Months

Prescription Glasses Lenses Single Vision Lined Bifocal Lined Trifocal

$25 Copay $25 Copay $25 Copay

$50 Allowance $75 Allowance

$100 Allowance

Every 12 Months Every 12 Months Every 12 Months

Frames $150 Allowance $70 Allowance Every 24 Months

Contact Lens Care (in lieu of frames/lenses)

Fitting Exam & Contact Lens$150 Allowance $150 Allowance Every 12 Months



Voluntary Short Term Disability (STD)Short Term Disability (STD) is offered through Unum. The voluntary STD plan pays a percentage of your salary if you become temporarily disabled, meaning that you are not able to work for a short period of time due to sickness or injury. There are two plan options available and plans vary based on your state of residence. Rates are based on your age.

Employees Residing in a State with a State Disability ProgramOption 1: Benefits begin on the 1st day for an injury and on the 8th day for sickness. The benefit will provide up to 40% of your weekly earnings to a maximum of $1,500 for up to 26 weeks.

Option 2: Benefits begin on the 15th day for sickness or injury. The benefit will provide up to 40% of your weekly earnings to a maximum of $1,500 for up to 24 weeks.

Employees Residing in a State without a State Disability ProgramOption 1: Benefits begin on the 1st day for an injury and on the 8th day for sickness. The benefit will provide up to 60% of your weekly earnings to a maximum of $1,500 for up to 26 weeks.

Option 2: Benefits begin on the 15th day for sickness or injury. The benefit will provide up to 60% of your weekly earnings to a maximum of $1,500 for up to 24 weeks.

The following states have a State Disability Program: California, Hawaii, New Jersey, New York, Puerto Rico, Rhode Island.

Voluntary Long Term Disability (LTD) The Unum Long Term Disability plan benefits help to provide you with monthly income if you become disabled and are unable to work.

After you have been disabled for 180 days due to sickness or injury, this benefit will provide up to 60% of your monthly earnings to a maximum of $10,000. If you are permanently disabled, you will receive this benefit up to your Social Security Normal Retirement Age (SSNRA). Rates are based on your age.

If you apply more than 30 days after your initial eligibility date, your coverage will be medically underwritten, and you will be required to qualify based on information you provide on your overall medical health. An Evidence of Insurability form is required.

Voluntary LTD rates are age-banded. When an employee has a birthday and moves into the next age bracket, the rate will change on the next policy anniversary date.

NOTE: Both the STD and LTD include pre-existing condition limitations. Please review the plan summaries posted online for more details.

Earnings for STD and LTD benefits are based on your base annual earnings and do not include other income such as bonuses and commissions.

Voluntary Benefits


Employee Assistance ProgramThe Unum Work-Life Balance Employee Assistance Program is provided at no additional charge when you enroll in the Voluntary Long Term Disability plan. Through the EAP, you have unlimited access to consultants by telephone, resources and tools online, and up to 3 face-to-face visits with counselors for help with a short-term problem. Examples of counseling topics include child/elder care referrals, legal consultation, financial planning assistance, stress management and career development.

Contact Member Services at (800) 854-1446 or www.lifebalance.net (User ID and password: lifebalance)

Voluntary Term Life / AD&DVoluntary Life and AD&D insurance is available for employees and their eligible dependents. Rates are based on your age.

For YourselfYou may apply for term life insurance in increments of $10,000 up to five (5) times Basic Annual Earnings; the maximum amount is $1,000,000. During your initial eligibility, you may elect up to $350,000 with no medical underwriting.

If you apply more than 30 days after your initial eligibility date, your coverage will be medically underwritten and you will be required to qualify based on information you provide on your overall medical health. An Evidence of Insurability form will be required. If you previously purchased life insurance coverage, you are able to purchase up to $350,000 during future annual open enrollment periods without medical questions.

For Your Spouse/Registered Domestic Partner (RDP)If you enroll, your spouse/RDP may also apply for term life insurance in increments of $5,000 not to exceed 100% of the employee’s Life amount; the maximum amount is $500,000. During your spouse/ RDP’s initial eligibility, he or she may elect up to $50,000 with no medical underwriting.

If your spouse/RDP applies more than 30 days after their initial eligibility date, their coverage will be medically underwritten and they will be required to qualify based on information they provide on their overall medical health. An Evidence of Insurability form will be required. If you previously purchased life insurance coverage for your spouse/RDP, you are able to purchase up to $50,000 during future annual open enrollment periods without medical questions. If your eligible dependent is totally disabled, your dependent’s coverage will begin on the first day of the month following the date your dependent is no longer totally disabled. For Your ChildrenIf you enroll, child life coverage is also available. You may purchase life insurance for children in $2,000 increments up to $10,000. The premium payment for child coverage is based on one child, regardless of the number of children with coverage.

Auto & Property InsuranceAlorica understands the importance of protecting your property and other items critical to maintaining your lifestyle. Through Liberty Mutual, Alorica employees receive discounted group rates on insurance for Homeowners, Renters, Automobiles and Additional Property.

How to EnrollVisit www.libertymutual.com/alorica or call Liberty Mutual Member Services at (800) 524-9400.

Voluntary Benefits Cont’d


Voluntary Whole LifeEmployees have the opportunity to buy Whole Life Insurance for as little as $3.00 a week. Unum’s whole life insurance is designed to pay a death benefit to your beneficiaries but it can also build cash value you can use while you are living. This benefit offers an affordable, guaranteed level of premium that won’t increase with age. Unlike term life insurance offered, this coverage can continue into retirement. Here are some reasons why you may consider purchasing a Whole Life Insurance plan:

• Accumulates Cash Value – Guaranteed at a rate of 4%. You can borrow from the cash value or use it to buy a reduced policy with no premiums due.

• Offers a Permanent Insurance Benefit – You own the policy so you can keep it even if you leave the company or retire. Unum will bill you directly for the same premium amount.

• Flexibility – You choose a coverage amount that is affordable for you.

• Family Coverage – Available for your spouse/registered domestic partner and children.

Voluntary Critical IllnessUnum’s Critical Illness plan helps you offset the financial effects of a catastrophic illness with a lump sum benefit if an insured individual is diagnosed with the first occurrence of a heart attack, stroke, major organ transplant, permanent paralysis, end-stage renal failure, or the need for coronary artery bypass surgery. Also included is a health screening/wellness benefit that pays an employee for conducting a qualified preventive care visit. Coverage is available to an employee’s spouse/registered domestic partner and dependents.

Voluntary Accident InsuranceWhile major medical coverage is a significant part of your benefit package, an accident can lead to expenses that may not be covered by medical insurance. Unum’s voluntary accident plan is designed to help you with uncovered medical costs due to qualified accidents. The plan covers a range of injuries and accident related expenses such as hospitalization, physical therapy, hospital intensive care, transportation and lodging. Coverage is available to an employee’s spouse/registered domestic partner and dependents.

Pet Assure & PETPlus Plans

Pet Assure Discount PlanTo cover the needs of a pet, discounted pet care is offered through Pet Assure. Every pet is covered and there are no deductibles or maximum number of claims per year. Discounts on services are applied at time of purchase at the veterinary clinic.

PETPlus PlanPetPlus is a wholesale pricing club that will save you money on all your pets’ prescriptions and preventatives. It includes a 24/7/365 Ask-A-Vet service. You can enroll any type of cat or dog or an unlimited number of pets.

Voluntary Benefits Cont’d


Commuter BenefitsWe think the journey should be as insanely great as the destination. So with that in mind, we’re thrilled to be offering benefits to offset the cost of your daily commute.

Transit & Parking Reimbursement AccountsTransit and Parking Reimbursement accounts allow you to set aside funds through payroll deduction to pay for work-related transportation and/or parking expenses.

Types of Allowable Expenses:

• Mass Transit/Vanpool – $255 Maximum Monthly Pre-Tax Contribution: If employees commute to work via mass transit (i.e. public transportation including bus, train or rail systems) or by vanpool, employees can use pre-tax dollars to pay for those mass transit costs related to their commute.

• Parking – $255 Maximum Monthly Pre-Tax Contribution: Employees who commute to work by car and pay to park, or commute via mass transit and pay to park at or near the mass transit site, can use pre-tax dollars to pay for parking costs related to their commute to work.

Features of the Transit and Parking Reimbursement Accounts include:

• Members can change their elected contribution amount on a monthly basis.

• Unused balances can be rolled over month to month.

• Members save money by reducing their taxable income.

• You may access your account to check balances and submit claims by visiting the Discovery Benefits online portal.

• 24/7 online account access

• Mobile apps and text alerts

• Single sign-on for all reimbursement accounts

• Use the same debit card to access both parking and transit funds

Simple Access to Your FundsWith the benefits debit card, participants can pay providers at the time of service directly from their transit and/or parking account. If the parking facility does not accept debit card payments, participants may also pay out of pocket and then submit a reimbursement request. Participants may submit parking claims to Discovery Benefits online through the consumer web portal. Sign up for free direct deposit to receive your reimbursement as quickly as possible. Parking and transit receipts may or may not be required, depending on your employer’s plan setup. However, we recommend that participants keep receipts for their own records regardless of whether receipts are required for the plan.

Metro CommutersIf you live in the Washington, D.C. area, your commuter benefits may work a bit differently. You will be able to load commuter funds onto your WMATA SmarTrip® card from a commuter page on your consumer web portal.

Interested in commuter benefits? The knowledgeable Discovery Benefits Participants Services team is available from 6:00 am to 9:00 pm CST Monday through Friday. Please contact them with any questions about your benefit plan. Toll-Free: 866-451-3399Email: [email protected].

Access additional information on your Commuter Benefits Plan at www.discoverybenefits.com.


We know that keeping you and your family healthy is a top priority—and it’s our priority to provide you with health care benefits that help keep you healthy and provide quality coverage when you or your dependents are ill.

Our benefit program offers the following medical plan choices to our employees and their dependents:

• UnitedHealthcare (UHC) PPO Plan

• UnitedHealthcare (UHC) Health Reimbursement Account Plan (HRA)

• UnitedHealthcare (UHC) Health Savings Account Plan (HSA)

• Century Healthcare MEC Basic, MEC Plus Value and MEC Plus Select

Please review the Medical Plan Comparison Chart following this section for a summary of the plan benefits, copayments, deductibles, maximum out-of-pocket expenses and other components.

UHC – Choice Plus PPO Plan: Choice Plus provides you with access to an expansive network of providers and offers members a level of benefits should they choose to seek care outside the network, normally at a higher coinsurance and/or deductible level. Choice Plus does not require members to designate a “primary care physician” to coordinate care, nor are specialist referrals required for eligible services. Services for preventive care, such as routine physical exams, health screenings, immunizations and well-child visits are covered at 100% in-network before the deductible is met. Copayments, coinsurance and deductibles accumulate towards the out-of-pocket maximum. Network providers may be accessed online at www.myuhc.com or by calling Member Services at (800) 377-5154.

UHC – Health Reimbursement Account (HRA): The UHC HRA plan combines the flexibility of the PPO plan with an employer-funded account. You have the freedom to receive care from in-network physicians and hospitals, and preventive care is covered at 100%. Copayments, coinsurance and deductibles accumulate towards the out-of-pocket maximum. Your HRA fund account is used to pay eligible healthcare expenses (these include the deductible and co-insurance) during the plan year. If you don’t spend all of your HRA dollars they will be rolled over and added to your HRA fund account the following year should you enroll in the Plan again. The maximum amount you may have in your account is $4,000. After you exhaust the health fund account and have met the deductible there are shared in-network and out-of-network expenses. If you are hired after January 1st, your fund amount will be prorated based upon the remaining quarters of the plan year. If you discontinue or terminate coverage, your HRA fund account will be forfeited. Network providers may be accessed online at www.myuhc.com or by calling Member Service at (866) 314-0335.

UHC – Health Savings Account (HSA): The UHC HSA plan provides you with access to an expansive network of providers and offers members a level of benefits should they choose to seek care outside the network, normally at a higher coinsurance and/or deductible level. The UHC HSA plan does not require members to designate a “primary care physician” to coordinate care, nor are specialist referrals required for eligible services. Services for preventive care, such as routine physical exams, health screenings, immunizations and well-child visits are covered at 100% in-network before the deductible is met. All other services, including prescription drugs, are subject to the plan deductible. Copayments, coinsurance and deductibles accumulate towards the out-of-pocket maximum. Network providers may be accessed online at www.myuhc.com or by calling Member Services at (866) 314-0335.

• When you enroll in a qualified High Deductible Health Plan (our UHC HSA medical plan), you are eligible to contribute to a tax-advantaged Health Savings Account up to the annual IRS limit. The money you contribute can be used to pay for eligible health care related expenses (deductibles, coinsurance, and prescriptions, as well as other eligible expenses as approved by the IRS) or you may leave the money in your account and let it grow over time. The money you contribute remains in your account until you use it for qualified health expenses, even if you leave the company. There is no “Use It or Lose It Rule”.

2017 HSA Contribution Limits

• $3,400 for individual coverage

• $6,750 for family coverage

- $1,000 catch-up for participants age 55 or older

NOTE: All costs for medical plans can be found online or by calling the Employee Benefit Resource Center. If reviewing medical costs online, please ensure to waive coverage if you do not intend to enroll.

See the HSA summary of benefits on page 19 for eligibility restrictions.

Medical Plans Applies to Hourly 30


Medical Plan Summary UnitedHealthcare PPO Plan

BENEFIT ATTRIBUTES In-Network Out-of-Network2

Annual Deductibles Individual Family

$1,250 $2,500

$2,500$5,000

Annual Out-of-Pocket Maximum1

Individual Family

(Includes Plan Deductible) $5,000 $10,000


Coinsurance Percentage After Plan Deductible

Plan Pays 80% Member Pays 20%


Professional Services

Office Visits Primary Care Provider Specialist

$30/visit $40/visit


Preventive Care Primary Physician Office VisitLab, X-ray or other preventive tests

No Charge, Deductible Waived Covered In-Network Only

Lab and X-Ray - Outpatient Routine Diagnostics Major Diagnostics (CT, PET, MRI, MRA and Nuclear)

No Charge, Deductible Waived 20% After Deductible

50% After Deductible2


Hospital Services

Inpatient Services 20% After Deductible 50% After Deductible2

Outpatient Facility Services Surgery/Therapeutic 20% After Deductible 50% After Deductible2

Hospital Emergency Room 20% After Deductible 20% After Deductible

Skilled Nursing Facility, Rehabilitation Hospital and Sub-Acute Facilities (60 days max per calendar year)

20% After Deductible 50% After Deductible2

Home Health Care (100 visits max per calendar year) 20% After Deductible 50% After Deductible2

Durable Medical Equipment (covers 1 per type of DME every 3 years) 20% After Deductible 50% After Deductible2

Prescription Drugs Benefits provided by Express Scripts

Retail (30-day supply) Generic Preferred BrandNon-Preferred Brand

$15$30 $50

$15$30 $50

Mail Order (90-day supply) Generic Preferred BrandNon-Preferred Brand

$30$60 $100

Covered In-Network Only

1. Copayments, coinsurance and deductibles accumulate towards the out-of-pocket maximum.2. Prior authorization required.3. Infertility services are not covered.


Applies to Hourly 30


Medical Plan Summary Cont’d UnitedHealthcare HRA Plan


Health Fund Amount Individual Family

$500 $1,000


$2,250 $4,500

$4,000 $8,000


Individual Family







Office Visits Primary Care Provider/Specialist 25% After Deductible 40% After Deductible


No Charge, Deductible Waived Covered In-Network Only


25% After Deductible 25% After Deductible



Hospital Services








Prescription Drugs Benefits provided by Express Scripts

Retail (30-day supply) Generic Preferred BrandNon-Preferred Brand

$10$30 $50

$10$30 $50

Mail Order (90-day supply) Generic Preferred BrandNon-Preferred Brand

$25$75 $125






Medical Plan Summary Cont’d UnitedHealthcare HSA Plan



IMPORTANTIn order to contribute funds to an HSA you must:

• Not be enrolled in another medical plan that is not a high deductible health plan• You cannot be enrolled in Medicare• You cannot be claimed as a dependent on someone else’s tax return




$5,000 $10,000

$10,000 $20,000


Individual Family







Office Visits Primary Care Provider/Specialist 30% After Deductible 50% After Deductible


No Charge, Deductible Waived Not Covered Out-of-Network


30% After Deductible 30% After Deductible



Hospital Services








Prescription Drugs Benefits provided by Express Scripts After the above annual deductible is met, you pay:

Retail (30-day supply) Tier 1Tier 2Tier 3

$10$35 $60

$10$35 $60

Mail Order (90-day supply) Tier 1Tier 2Tier 3

$25$87.50 $150



Sometimes, we all need someone to talk to. All UHC members are eligible for the UHC EAP program, Care24. This confidential program gives you the opportunity to speak with professionals about any questions or issues you may be dealing with. Available professionals include:

• Registered nurses (for health-related questions)

• Masters-level counselors (for personal or emotional issues)

• Legal and financial professionals (for personal issues)

• Community resources (to help you locate service providers in your area)

You can also research topics such as insomnia or healthy eating online at www.liveandworkwell.com.

Confidential Care24888-887-4114 TTY/TDD: Call National Relay Center at 800-828-1120 and ask to be connected to the 888 number above. 24-Hour Nurseline:In California: 877-268-5378

Outside California: 877-268-5373

Employee Assistance Program (EAP) Applies to Hourly 30


Flexible Spending Accounts (FSA)Who doesn’t want a little extra cha-ching? One way to keep more in your pockets is to reduce the amount you pay in taxes by reducing your taxable income. Flexible Spending Accounts (FSA) can help. As an employee of Alorica, you can reduce your taxable income by participating in the FSA program administered by Discovery Benefits.

Your FSA OptionsYou may choose to participate in one or both of the following accounts:

• General Purpose Health Care Account (for employees/families NOT contributing to an HSA) $2,600 maximum limit per plan year

• Limited Purpose Health Care Account (for employee/families who ARE contributing to an HSA) $2,600 maximum limit per plan year. Eligible expenses limited to dental and vision.

• Dependent Care Account—$5,000 household maximum limit per calendar year (or $2,500 if married and filing separately)

The money that you contribute is deducted from each paycheck throughout the year on a pre-tax basis before Federal, State and Social Security taxes are taken out.

You may use an FSA Debit Card to pay for your eligible FSA expenses. All enrollees will be issued a debit card that can be used for both health care and/or dependent care expenses. And while most transactions will not require additional substantiation, we recommend that you always save your receipts and documentation.

Your Health Care FSAThe Health Care FSA lets you pay for eligible out-of-pocket healthcare costs from your FSA such as:

• Deductibles and copayments for your medical (general purpose FSA only), dental and vision plans

• FSA-eligible expenses that are not covered by your plans

• Any other healthcare expenses that qualify under Internal Revenue Service (IRS) rules

Health Care FSA Carryover: The Alorica Health Care FSA plan allows employees to carryover up to $500 of their unused healthcare FSA balance into the next Plan Year. Employees may use this carryover balance for claims incurred during the next Plan Year, in addition to any newly elected FSA contributions. Balances above the $500 carryover amount that are remaining from the prior Plan Year will be forfeited.

Your Dependent Care FSAThe Dependent Care FSA gives you the opportunity to pay for childcare, elder care, or other dependent care services so that you and your spouse/RDP can work or attend school full-time. In order to qualify for reimbursement, services need to be related to the care of:

• Children under the age of 13 who are listed as dependents on your income tax return (if your child turns 13 during the year, contributions do not stop, so plan accordingly)

• Dependents of any age who are incapable of caring for themselves and who regularly spend at least 8 hours a day in your home

Important FSA Rules to Remember• Any money in your account(s) that is not used by the end of the plan year (December 31) will be forfeited

(with the exception of amounts eligible under the health care carryover provision).

• You cannot stop or change contributions during the year unless you have an IRS qualified life event change (see page 5).

• Once you terminate employment, only expenses incurred before you terminate are eligible, unless you elect to continue your FSA through COBRA.

• Dependent care providers must have a valid tax ID # or U.S. Social Security Number.

• You will be reimbursed for dependent care expenses only up to the funded amount.



Look Back Measurement MethodYou and your dependents are eligible for the medical plan if you are a full-time employee. A full-time employee is generally an employee who works on average 30 hours per week, as defined by the ACA. ACA full-time status can affect or determine medical benefits eligibility but is not a guarantee of benefits eligibility. Alorica uses the Look-Back Measurement Method to determine whether an employee meets this eligibility threshold.

New EmployeesIf you are a new employee hired to work at least 30 hours a week, you will be offered medical benefits 1st of Month Following 30 days. If—as of your date of hire—Alorica is unable to determine that you are a full-time employee, you will not be offered medical benefits immediately. Instead, you will be placed into an Initial Measurement Period; an 11-month period to determine whether you are a full-time employee and eligible for benefits. Employees hired with the following schedules will be placed into an Initial Measurement Period, including those hired into a:

• Hourly position

• Position where hours vary and Alorica is unable to determine whether you will work on average 30 or more hours a week

• Seasonal position where the you are expected to work for six (6) consecutive months or less (regardless of monthly hours worked)

Your Initial Measurement Period will begin on the first of the month following your date of hire and will last for 11 months. If, during your Initial Measurement Period, you average 30 or more paid hours a week over that 11 month period, you will become full-time and, if otherwise eligible for benefits, you will be offered coverage by the first of the second month after your Initial Measurement Period ends. Your full-time status will remain in effect during an associated stability period that will last 12 months. If your employment is terminated during that stability period, and you were enrolled in benefits, you will be offered coverage under COBRA.

Ongoing EmployeesAlorica uses the look-back measurement method to determine medical plan eligibility for ongoing employees. An ongoing employee is an individual who has been employed for an entire Standard Measurement Period. A Standard Measurement Period is the 12-month period of time over which Alorica counts employee hours to determine which employees work full-time.

An employee is deemed full-time if he or she averages 30 or more paid hours a week over the 12-month standard measurement period. Those employees who average 30 or more paid hours a week over the 12-month standard measurement period will be full-time and, if otherwise eligible for benefits, offered coverage as of the first day of the stability period associated with the standard measurement period, which is the same as our plan year.

Full-time status will be in effect for the 12-month stability period. If your employment is terminated during a stability period, and you were enrolled in benefits, you will be offered coverage under COBRA. Alorica uses the Standard Measurement Period and associated Stability Period annual cycle outlined below.

Standard Measurement PeriodTime to determine if you work 30 paid hours per week on average–used to establish if you are “full-time” or “part-time” for medical eligibility

October 13 – October 12

Stability Period Time during which you will be considered “full-time” or “part-time” for medical plan eligibility - based on hours worked during preceding Measurement Period

January 1 – December 31


ALABAMA – Medicaid INDIANA – Medicaid

Website: www.myalhipp.com Phone: 1-855-692-5447

Healthy Indiana Plan for low-income adults 19-64:Website: hip.in.gov Phone: 1-877-438-4479 All other Medicaid: Website: indianamedicaid.com Phone 1-800-403-0864

ALASKA – Medicaid IOWA – MedicaidThe AK Health Insurance Premium Payment Program Website: www.myakhipp.comPhone: 1-866-251-4861 Email: [email protected] Medicaid Eligibility: dhss.alaska.gov/dpa/Pages/medicaid/default.aspx

Website: www.dhs.state.ia.us/hipp Phone: 1-888-346-9562

ARKANSAS – Medicaid KANSAS – MedicaidWebsite: www.myarhipp.com Phone: 1-855-MyARHIPP (855-692-7447)

Website: www.kdheks.gov/hcf Phone: 1-785-296-3512

COLORADO – Medicaid KENTUCKY – MedicaidMedicaid Website: www.colorado.gov/hcpf Medicaid Customer Contact Center: 1-800-221-3943

Website: www.chfs.ky.gov/dms/default.htm Phone: 1-800-635-2570

FLORIDA – Medicaid LOUISIANA – MedicaidWebsite: www.flmedicaidtplrecovery.com/hipp/ Phone: 1-877-357-3268

Website: dhh.louisiana.gov/index.cfm/subhome/1/n/331Phone: 1-888-695-2447

GEORGIA – Medicaid NEW HAMPSHIRE – Medicaid

Website: www.dch.georgia.gov/medicaid-Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP) Phone: 404-656-4507

Website: www.dhhs.nh.gov/oii/documents/hippapp.pdfPhone: 603-271-5218

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)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 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 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 ataskebsa.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.

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:

Required Federal Notices

U.S. Department of LaborEmployee Benefits Security Administrationwww.dol.gov/ebsa1-866-444-EBSA (3272)

U.S. Department of Health and Human ServicesCenters for Medicare & Medicaid Serviceswww.cms.hhs.gov1-877-267-2323, Menu Option 4, Ext. 61565


Required Federal Notices Cont’dMAINE – Medicaid NEW JERSEY – Medicaid and CHIP

Website: www.maine.gov/dhhs/ofi/public-assistance/index.htmlPhone: 1-800-442-6003TTY: Maine relay 711

Medicaid Website:state.nj.us/humanservices/dmahs/clients/medicaid/Medicaid Phone: 609-631-2392CHIP Website: njfamilycare.org/index.htmlCHIP Phone: 1-800-701-0710

MASSACHUSETTS – Medicaid and CHIP NEW YORK – MedicaidWebsite: www.mass.gov/MassHealth Phone: 1-800-462-1120

Website: www.nyhealth.gov/health_care/medicaid/ Phone: 1-800-541-2831

MINNESOTA – Medicaid NORTH CAROLINA – MedicaidWebsite: mn.gov/dhs/ma Click on Health Care, then Medical AssistancePhone: 1-800-657-3739

Website: www.ncdhhs.gov/dma Phone: 919-855-4100

MISSOURI – Medicaid NORTH DAKOTA – MedicaidWebsite: www.dss.mo.gov/mhd/participants/pages/hipp.htmPhone: 573-751-2005

Website: www.nd.gov/dhs/services/medicalserv/medicaidPhone: 1-844-854-4825

MONTANA – Medicaid OKLAHOMA – Medicaid and CHIP

Website: dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084

Website: www.insureoklahoma.org Phone: 1-888-365-3742

NEBRASKA – Medicaid OREGON – MedicaidWebsite: dhhs.ne.gov/Children_Family_Services/Access Nebra ska/Pages/accessnebraska_index.aspx Phone: 1-855-632-7633

Website: www.oregonhealthykids.gov http://www.hijossaludablesoregon.govPhone: 1-800-699-9075

NEVADA – Medicaid PENNSYLVANIA – MedicaidMedicaid Website: dwss.nv.gov/ Medicaid Phone: 1-800-992-0900

Website: dhs.pa.gov/hipp Phone: 1-800-692-7462

SOUTH CAROLINA – Medicaid RHODE ISLAND – MedicaidWebsite: http://www.scdhhs.gov Phone: 1-888-549-0820

Website: www.eohhs.ri.gov/ Phone: 401-462-5300

SOUTH DAKOTA - Medicaid VIRGINIA – Medicaid and CHIP

Website: dss.sd.gov Z Phone: 1-888-828-0059

Medicaid Website: www.coverva.org/ programs_premium_assistance.cfmMedicaid Phone: 1-800-432-5924CHIP Website: www.coverva.org/ programs_premium_assistance.cfmCHIP Phone: 1-855-242-8282

TEXAS – Medicaid WASHINGTON – Medicaid

Website: gethipptexas.com Phone: 1-800-440-0493

Website: www.hca.wa.gov/medicaid/premiumpymt/pages/index.aspxPhone: 1-800-562-3022 ext. 15473

UTAH – Medicaid and CHIP WEST VIRGINIA – MedicaidWebsite: Medicaid: health.utah.gov/medicaid CHIP: health.utah.gov/chipPhone: 1-877-543-7669

Website: www.dhhr.wv.gov/bms/Medicaid% 20Expansion/Pages/default.aspxPhone: 1-877-598-5820, HMS Third Party Liability

VERMONT– Medicaid WISCONSIN – Medicaid and CHIPWebsite: www.greenmountaincare.org/ Phone: 1-800-250-8427

Website: dhs.wisconsin.gov/publications/p1/p10095.pdfPhone: 1-800-362-3002

WYOMING – Medicaid

Website: wyequalitycare.acs-inc.com/ Phone: 307-777-7531

OMB Control Number 1210-0137 (expires 10/31/2016)


The Women’s Health and Cancer Rights ActThe Women’s Health and Cancer Rights Act (WHCRA) requires employer groups to notify participants and beneficiaries of the group health plan, and their rights to mastectomy benefits under the plan. Participants and beneficiaries have rights for coverage to be provided in a manner determined in consultation with the attending Physician for:

• All stages of reconstruction of the breast on which the mastectomy was performed;

• Surgery and reconstruction of the other breast to produce a symmetrical appearance;

• Prostheses; and

• Treatment of physical complications of the mastectomy, including lymphedema.

These benefits are subject to the same deductible and co-payments applicable to other medical and surgical procedures provided under this plan. You can contact your health plan’s Member Services for more information.

Newborns’ and Mothers’ Health Protection Act of 1996 (NMHPA) Disclosure RequirementGroup health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

Notice of Availability of HIPAA Privacy NoticeThe Federal Health Insurance Portability and Accountability Act (HIPAA) requires that we periodically remind you of your right to receive a copy of the Insurance Carriers’ HIPAA Privacy Notices. You can request copies of the Privacy Notices by contacting the carriers directly using the contact numbers included in this guide.

SBC NoticeYour plan offers a choice of health coverage options. Choosing a health coverage option is an important decision. To help you make an informed choice, your plan makes available a Summary of Benefits and Coverage (SBC), which summarizes important information about any health coverage option in a standard format, to help you compare across options. If you are not clear about any of the bolded terms used in the SBC, you can view the glossary at www.cciio.cms.gov, or by calling the number on your medical ID Card. Copies of the SBC’s can be found on the SmartBen online enrollment site or by contacting Human Resources to obtain a copy.

Michelle’s Law Notice—Extended Dependent Medical Coverage During Student Medical LeavesThe Alorica plan may extend medical coverage for dependent children if they lose eligibility for coverage because of a medically necessary leave of absence from school. Coverage may continue for up to a year, unless your child’s eligibility would end earlier for another reason.

Extended coverage is available if a child’s leave of absence from school—or change in school enrollment status (for example, switching from full-time to part-time status)—starts while the child has a serious illness or injury, is medically necessary and otherwise causes eligibility for student coverage under the plan to end. Written certification from the child’s physician stating that the child suffers from a serious illness or injury and the leave of absence is medically necessary may be required.

If your child will lose eligibility for coverage because of a medically necessary leave of absence from school and you want his or her coverage to be extended, contact your local HR Department as soon as the need for the leave is recognized. In addition, contact your child’s health plan to see if any state laws requiring extended coverage may apply to his or her benefits.

Required Federal Notices Cont’d


Important Notice from Alorica About Your Prescription Drug Coverage and MedicarePlease read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Alorica and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:

1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

2. Alorica has determined that the prescription drug coverage offered by the UHC PPO and HRA plans are, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

3. Alorica has determined that the prescription drug coverage offered by the UHC HSA & Century Healthcare plans are NOT, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Non-Creditable Coverage. This is important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage from the UHC HSA and Century Healthcare plans. This also is important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first become eligible.

When Can You Join A Medicare Drug Plan?You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th.

However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

Medicare Part D Notice


What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?If you decide to join a Medicare drug plan, your Alorica coverage will not be affected. See below for more information about what happens to your current coverage if you join a Medicare drug plan.

Since the existing prescription drug coverage under the UHC PPO and HRA plans are creditable (e.g., as good as Medicare coverage), you can retain your existing prescription drug coverage and choose not to enroll in a Part D plan; or you can enroll in a Part D plan as a supplement to, or in lieu of, your existing prescription drug coverage.

If you do decide to join a Medicare drug plan and drop your Alorica prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?You should also know that if you drop or lose your current coverage with Alorica and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.

If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.

For More Information About This Notice Or Your Current Prescription Drug CoverageContact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Alorica changes. You also may request a copy of this notice at any time.

For More Information About Your Options Under Medicare Prescription Drug Coverage....More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage:

• Visit medicare.gov

• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help

• Call 800-MEDICARE (800-633-4227). TTY users should call 877-486-2048.

If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at socialsecurity.gov, or call them at 800-772-1213 (TTY 800-325-0778).

Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

Date: January 1, 2017 Name of Entity/Sender: AloricaContact-Position/Office: BenefitsAddress: 8151 Peters Road, Suite 2000, Plantation FL 33324Phone Number: 954-693-3700

Medicare Part D Notice Cont’d


Who to ContactQuestions Regarding Contact Group Number Phone Number Website/Email

Benefits Q&A, Technical Support and Enrollment Assistance

• Plan coverage questions• Assistance with online enrollment

SmartBen Employee Benefit Resource Center

(877) [email protected]

Century Healthcare MEC Plans

• Questions and/or Assistance• Claims• Locate a participating provider

Century HealthcarePHCS Limited

Benefit NetworkCHC3001

(877) 685-2432 (888) 371-7427

www.centuryhealthcare.com www.multiplan.com/chc

UHC Medical Plans / Employee Assistance Program

• Questions and/or Assistance• Claim Forms• Locate a participating provider

UnitedHealthcareMember Services 752845

PPO: (800) 377-5154HRA/HSA:

(866) 314-0335Care 24 EAP:

(888) 887-4114

www.myuhc.comwww.liveandworkwell.com

Express Scripts

• Questions and/or Assistance• Formulary guidelines

Express Scripts Member Services NMWRX4U (877) 567-5549 www.express-scripts.com

Dental Plan

• Eligibility• Locate a dental provider• Check Status of a Claim

Cigna DPPOCigna Dental Care DHMO

Member Services3330355

(800) CIGNA24(800) 244-6224

www.cigna.comwww.mycigna.com

Vision Plan

• How to use the plan• What is covered

UnitedHealthcareMember Services 752845 (800) 638-3120 www.myuhcvision.com

Aetna Resource For Living

For Assistance (available in OK only) AetnaMylife values 835885 (800) 599-7158

www.mylifevalues.comUsername: MY123EAPPassword: MY123EAP

Voluntary Benefits

Voluntary Short Term Disability (STD) Unum 633493 (800) 421-0344 www.unum.com

Voluntary Long Term Disability (LTD) Unum 092153 (800) 421-0344 www.unum.com

Voluntary Life and AD&D Unum 092154 (800) 421-0344 www.unum.com

Critical Illness Unum R0284018 (800) 635-5597 www.unum.com

Whole Life & Accident Unum 7920053 (800) 635-5597 www.unum.com

Employee Assistance Program (EAP)if enrolled in LTD Lifeworks N/A (800) 854-1446

www.lifebalance.net User ID/Password: lifebalance

Additional Voluntary Benefits

Auto & Property Insurance Liberty Mutual 117687 (800) 524-9400 www.libertymutual.com/alorica

Pet Discount Program Pet Assure 82 (888) 789-7387 www.petassure.com

Flexible Spending Account / Commuter Benefits

• Download Reimbursement Form• Online Claims Submission• Order Passes

Discovery Benefits 20165 (866) 451-3399 www.discoverybenefits.com

ID & Debit Cards:

· UHC Health Plans – All UHC medical plan members will receive an ID card from UHC. The ID cards will list all your enrolled dependents.

· Express-Scripts Prescription – All UHC medical plan members will receive a prescription ID card from Express-Scripts. Please present this new ID card when picking up your new or refilled prescriptions.

· HSA Debit Cards – All UHC HSA medical plan participants will receive an Optum Bank HSA debit card.

· Century Healthcare Med Plans – All members will receive an ID card following enrollment. The ID card will include your ID number and prescription information. The cards will include your dependents.

· Cigna DHMO – New Cigna DHMO members will receive a personalized ID card.

· Cigna PPO – This plan does not require you to show an ID card when you receive services. If you would like a generic card, you can download one at www.mycigna.com.

· UHC Vision – This plan also does not require you to show an ID card when you receive services. If you would like a card, you can print one at www.myuhcvision.com.

· Discovery Benefits – New FSA participants will receive a debit card following enrollment. Current participants can continue to use their existing debit cards.

Please note: If you need additional ID cards, you may visit any of the above carrier websites to register and print temporary ID cards or to request additional ID cards.

Documents

Employee Benefit Guide 2017 - SmartBen · Employee Benefit Guide 2017 Hourly Employees. 2016 Alorica Inc. All rights reserved. 2 You’re awesome. Frankly, it’s one of the reasons