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OPEN ENROLLMENT
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YOUR BROKERAGE PARTNER
Filice InsuranceEric Bjornson, Benefits Consultant
[email protected] 925.385.5303 DirectJoyce Manansala, Client Service Manager
[email protected] 925.299.7203 Direct Tina Bauer Ochoa, Benefits Administrator
[email protected] 925.385.5308 Direct
Employee Website: benefits.filice.com/vertical
BENEFITS OVERVIEW
Medical: Blue Shield PPO and HSA
Kaiser for Georgia and CA employees
Dental: Guardian
Life and Disability: UHC
Vision: UHC
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Once-a-year opportunity to make election changes to medical, dental, or vision plans
Change plans Add or drop coverage for yourself Add or drop coverage for your dependents Update Life insurance beneficiary
OPEN ENROLLMENT
WHAT CHANGES CAN I MAKE NOW?
WHAT IS OPEN ENROLLMENT?
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What changes can I make outside of Open Enrollment?
If you do not make changes during open enrollment, the only time you can make an election or enrollment change is if you experience an eligible qualifying event.
Common examples of qualifying events include, but are not l imited to the following:
MID-YEAR QUALIFYING EVENTS
Marriage or domestic partner unionDivorce or legal separationBirth or adoptionGain or loss of other coverage
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Plan Features In-Network Non-Network
DeductiblePer MemberPer Family
$500$1,500
$500$1,500
Out-of-Pocket MaximumPer MemberPer Family
$4,000$8,000
$10,500$21,000
Coinsurance Plan pays: 80% Plan pays: 60%
Preventive CareRoutine exam, screenings; labs $0 (deductible waived) Not covered
Office Visit $35 (deductible waived) 40% after deductible
Advanced Imaging 20% after deductible 40% after deductible
Chiropractic (limited to 20 visits/yr) $25 (deductible waived) 40% after deductible
Acupuncture (limited to 20 visits/yr) $25 (after deductible) 40% after deductible
Inpatient Hospital Services 20% after deductible 40% after deductible
Emergency Services $150 (waived if admitted) + 20%
Prescription MedicationTier 1Tier 2Tier 3Tier 4
Retail RX $10
$30 (after $250)$50 (after $250)
30% (up to $200) (after $250)
Mail Order $20
$60(after $250)$100 (after $250)
30% (up to $400) (after $250)
BLUE SHIELD PPO
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Plan Features40 In-Network Non-Network
Deductible Per MemberPer Family
$1,800$3,600 (ind with fam - $2,800)
$1,800$3,600 (ind with fam - $2,800)
Out-of-Pocket MaximumPer MemberPer Family
$4,500$9,000
$8,000$16,000
Coinsurance (after deductible) Plan pays: 80% Plan pays: 60%
Preventive CareRoutine exam, screenings $0 (deductible waived) Not Covered
Office Visits 20% after deductible 40% after deductible
Diagnostic and lab 20% after deductible 40% after deductible
Inpatient Hospital Services 20% after deductible 40% after deductible
Chiropractic (limited to 20 visits/yr) 20% after deductible 40% after deductible
Acupuncture (limited to 20 visits/yr) 20% after deductible 40% after deductible
Emergency Services $150 + 20% after deductible (copay waived if admitted)
Prescription MedicationTier 1Tier 2Tier 3Tier 4
Retail RX (after deductible)$10$25$40
30% (up to $200)
Mail Order (after deductible)$20$50$80
30% (up to $400)
BLUE SHIELD HSA
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KAISER HSA (CA ONLY)Plan Features Kaiser California
DeductiblePer MemberPer Family
$1,500$3,000 (individual with fam - $2,800)
Out-of-Pocket MaximumPer MemberPer Family
$3,000$6,000
Preventive CareRoutine exam, screenings $0
Office Visits 10% – after deductible
Diagnostic Lab & X-rayAdvanced imaging
10% – after deductible10% – after deductible
Inpatient hospitalServices 10% – after deductible
Outpatient Surgery 10% – after deductible
Emergency Services 10% – after deductible
Prescription MedicationGenericBrandSpecialty
Pharmacy (up to 30-day supply) / Mail Service (up to 100-day supply)$10 / $20 - after deductible$30 / $60 - after deductible
20% (up to $150) Pharmacy Only 8
KAISER HSA (GA ONLY)
Plan Features Kaiser Georgia
DeductiblePer MemberPer Family
$1,500$3,000
Out-of-Pocket MaximumPer MemberPer Family
$3,000$6,000
Preventive CareRoutine exam, screenings $0
Office Visits 20% – after deductible
Diagnostic Lab & X-rayAdvanced imaging
20% – after deductible20% – after deductible
Inpatient hospital Services 20% – after deductible
Outpatient Surgery 20% – after deductible
Emergency Services 20% – after deductible
Prescription MedicationGenericBrandSpecialty
Pharmacy 20% – after deductible20% – after deductible20% – after deductible 9
The Health Savings Account works in conjunction with a High Deductible Health Plan (HDHP).
The account is a tax-advantaged fund used to pay qualif ied expenses.
HEALTH SAVINGS ACCOUNTS (HSA)
HDHPLower-Premium, High-Deductible Health Plan
THE HEALTH INSURANCE PLAN
HSAHealth Savings Account
AN ACCOUNT TO FUND DEDUCTIBLE, COINSURANCE: TAX-FREE
Qualified Expenses
Office visit copays Prescriptions Dental & Vision
Hospital charges Diagnostic lab/ imaging Chiropractic & Acupuncture
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HSA CONTRIBUTION LIMITS
Each year, the IRS sets contribution limits:
These limits are for the total funds contributed, including employee and employer contributions
For individuals 55 years and older, the IRS allows additional “catch-up contributions” of up to $1,000.
2019 2020
Individual Coverage $3,500 $3,550
Family Coverage $7,000 $7,100
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HSA DISTRIBUTION RULES
Distributions are tax-free if used for “qualified medical expenses”
HSA distributions can be taken for qualified medical expenses for the following people:The account holder (person covered by the HDHP) Spouse of that individual (even if not covered by the
HDHP)Dependents of that individual (even if not covered by
the HDHP)
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PPOPlan Features In-Network Non-NetworkDeductible
Per MemberPer Family
$50$150
$50$150
Annual Maximum Benefit $2,000 $1,500
Preventive & DiagnosticCleanings, exams, x-rays
100%Deductible waived 100% of UCR*
BasicPeriodontics, Fillings
80% 80% of UCR*
MajorCrowns, Bridges, Dentures
50% 50% of UCR*
Orthodontia – Child only (to age 19) 50% up to $2,000 lifetime
Maximum Rollover Threshold: $700Max Rollover Amount: $350
In Network Only Max Bonus Rollover Amount: $500Rollover Account Limit: $1,250
GUARDIAN DENTAL PPO
* UCR means the Usual, Customary & Reasonable charge which represents the lowest of (1) the dentist’s actual charge for the service, (2) the dentist’s usual charge for the same or similar service, and (3) the usual charge of other dentists in the same geographical area.
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UNITED HEALTHCARE VISION
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Services In-Network Out-of-Network Reimbursement
Annual Eye Exam (every 12 months) $10 copay Up to $40
Prescription Glasses:Frames (every 24 months) Lenses (every 12 months)
Plan pays up to $130 + 30% discount
$10 copay
Frames: Up to $45Lenses: From $40 to
$80
Contact Lenses (every 12 months)(in lieu of glasses) Plan pays up to $125 Up to $125
Cosmetic Extras Average 30% off retail price No discounts
RETAIL OPTIONS
UHC LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D)
* Basic Life and AD&D are 100% employer-paid benefits.**Buy-up options available for Employee, Spouse, and Child coverage at an additional cost to you and will require Evidence of Insurability.
Features Basic Life and AD&D*
Benefit 1x Basic Annual Earnings up to $500,000
Coverage Optional Life and AD&D**
Employee • $10,000 increments up to 7 x annual salary up to $500,000
Spouse• $5,000 increments up to $250,000• Spouse coverage cannot exceed 50% of Employee
Amount
Child(ren)• $2,000 increments up to $10,000 for children at least 6
months old• Child coverage cannot exceed 50% of Employee Amount
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UHC DISABILITY
Features Short Term Disability Long Term Disability
Benefits Begin 8 days after disability 90 days after disability
Percentage of Income Replaced 67% 60%
Maximum Benefit $2,309 per week $10,000 per month
Benefit Duration 12 weeks Up to age 65 or Social SecurityNormal Retirement Age
* Disability plans are 100% employer-paid benefits.17
Three face-to-face sessions per person, per year Unlimited telephonic support for information from an
attorney and unlimited referrals Free 30-minute telephone or in-person consultation
with an attorney for help with legal concerns (an attorney may be retained for ongoing services at a 25% discounted rate)
Referrals for childcare, elder care, adoption, and pet care
Relationships counseling and referrals State-specific online wills and legal l ibrary
MEMBER ASSISTANCE PROGRAM EAP(UHC)
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Confidential support and guidance available 24 hours a day, 7 days a week.
• Emergency Travel Arrangements • Embassy & Consular Assistance• Lost Document Assistance• World Wide Physician & Hospital Referrals• Emergency Prescription Replacement• Evacuation & Repatriation• Medical Transportation• Return of Minor Children• Joining of Disabled Family Member• And more!
TRAVEL ASSISTANCE SERVICES (UHC)
Frontier MEDEX, a travel assistance service, provides a range of travel services to eligible members to help with issues related to:
2020 EMPLOYER CONTRIBUTIONS
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Medical Please refer to rate sheet in your benefit guide for 2020 rates. HSA Contributions: If you elect the Blue Shield HSA Plan, Vertical will
contribute $900 per employee or $1,800 if you enroll dependents, into your HSA account. Kaiser HSA participants will receive $750 per employee and $1,500 if you enroll dependents
Guardian Dental: Please refer to benefit guide
UHC Vision: 50% employee paid
UHC Life and Disability: 100% employer-paid
ALL COSTS ARE REFLECTED IN PAYCOM WHEN YOU ENROLL
2020 RATES
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HEALTH CARE & DEPENDENT CAREFLEXIBLE SPENDING ACCOUNTS –
A Flexible Spending Account (FSA) is an IRS-approved account that al lows you to pay for el igible medical and dependent care expenses on a tax-free basis.
There are three components of the FSA that you can take advantage of:1. Health Care FSA - You can elect pre-tax deductions of up to $2,750 annually
to use towards eligible medical, Rx, dental and vision expenses2. Limited Purpose FSA – You are not eligible for the Health Care FSA if enrolled
on an HSA medical plan. You can enroll on the Limited Purpose FSA for dental and vision or post deductible medical expenses only
3. Dependent Care FSA – You can elect pre-tax deductions of up to $5,000 annually to use towards eligible child and adult day care expenses
Use-It-or-Lose-It Forfeiture Rule – Rollover provision – any unused funds in excess of $500 will be forfeited. Rollover does not apply to Dependent Care.
Examples of Eligible ExpensesHealth Care Dependent Care
• Prescription and office visit copays• Acupuncture / Chiropractic• Hearing aids• Dental and orthodontia• Vision services, glasses and contact lenses
• Before/after school care• Child care / in-home dependent care• Day care facility• Nursery school• Adult care
The Fami ly Defender lega l insurance p lan i s des igned to defend you and your fami ly wi th a wide array of ser v ices . Empower yoursel f and your loved ones by enro l l ing in lega l insurance today. - http ://www.uslegalserv ices.net
Consul tat ions Consumer Law Wil l , L iv ing Wi l l , Trust Civ i l Act ions Pla int i f f/Defendant Adoptions Real Estate Transact ions Landlord/Tenant Law Traff i c V io lat ions Preparat ion of Legal Documents Juveni le Defense Fami ly Law Cr iminal V io lat ions Benefit is 100% Employee Paid: $18.75/month Personal In jury Bankruptcy Chapter 7 on ly Immigrat ion Ident i ty Theft
US LEGAL SERVICES
401(K)
Administered by Nationwide, the Vert ical 401(k) ret irement plan al lows employees to accumulate personal savings so that you can enjoy a higher standard of l iv ing at ret irement.
Employee contributions are made via payrol l deduction.
2020 pre-tax l imit for employee contributions: $19,500. I f you are over age 50, you may contribute an addit ional $6,000 under the “catch up” provis ion.
**Important note – Open Enrol lment is the one time during the year that contribution changes can be made in Paycom. Any 401K changes made in Paycom must also be made in the Nationwide Portal .
• For more information, please contact Human Resources
SUPPLEMENTAL INSURANCE
Vert ical Communicat ions offers employees the option to purchase AFLAC supplemental insurance on a pre-tax basis through convenient payrol l deductions.
Products include: • Disabi l i ty Insurance• Cancer/Specif ied Disease• Accident• Hospital Indemnity
• For more information, please contact Human Resources
TIPS – STRETCHING YOUR DOLLARS
• Use the mail order pharmacy
• Ask for generic drugs
• Compare prices at different pharmacies
• Go to Urgent Care instead of the Emergency Room
• Make sure your doctor, lab, hospital, or pharmacy are
in-network
• Schedule your annual routine physical exam and
recommended screenings
• Obtain a pre-estimate for medical and dental services
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2020 WELLNESS REWARD
Visit your primary care physician for an annual physical exam between January 1st, 2020 and December 31st, 2020 to receive an Amazon Gift Card valued at $50.
Download the form to be signed by your physician on the Vertical Employee website under the forms tab at http://benefits.filice.com/vertical
Forms can be returned to Nick Smith in Human Resources
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benefits.filice.com/vertical
FILICE BENEFITS WEBSITE
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1. Paycom Overview:• Enroll in your benefit plans – If you don’t go into the system to
re-enroll, you will automatically be placed on the same plans for 2020
• If you want to participate in the FSA for 2020, you do need to re-enroll
• Verify your selections throughout the year• Update your personal information• Access forms and links to websites• To enroll simply visit:
• https://www.paycom.com• Select “Employee”• Enter Username, Password and last 4 digits of SSN• Make your Benefit Elections
2. ALL ELECTIONS MUST BE COMPLETED IN PAYCOM BY December 6th!
WHAT DO I NEED TO DO?
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YOUR BROKERAGE PARTNER
Filice InsuranceEric Bjornson, Benefits Consultant
[email protected] 925.385.5303 DirectJoyce Manansala, Client Service Manager
[email protected] 925.299.7203 Direct Tina Bauer Ochoa, Benefits Administrator
[email protected] 925.385.5308 Direct
Employee Website: benefits.filice.com/vertical
QUESTIONS?
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?