2019 2020 Employee Benefits Guide - Explain My Benefits...Cough/cold Diarrhea Fever Pink eye Rash...
Transcript of 2019 2020 Employee Benefits Guide - Explain My Benefits...Cough/cold Diarrhea Fever Pink eye Rash...
2019 – 2020 Employee Benefits Guide
Table of Contents
Contact Information 3
Your 2019-2020 Benefits 4
A whole new way to buy benefits 5
Shopping for benefits 7
Enrolling in your benefits 8
Changing your benefits selections 9
Visiting your marketplace year round 10
Things to keep in mind 11
Getting started 12
The cost of your benefits 13
Medical/Rx Plans 14
Health savings account 16
Motion Program 18
Flexible savings account 19
Dental plan 20
Vision Plan 21
Life Insurance 22
Short term disability 23
Voluntary long term disability 24
Voluntary benefits 25
2019 Rates 28
Glossary of important benefits terms 29
Required Notices 30
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Contact Information
Benefit Vendor Phone
Number Website
Medical/Rx NHP (800) 357-0978 www.myuhc.com
Telehealth – Virtual Visits UHC N/A www.myuhc.com or download the
UnitedHealth4Me app
24 Hour Nurse Line NHP (888) 887-4114
TTY/TDD call (800) 828-1120
www.myuhc.com
Healthy Pregnancy Program
NHP (888) 246-7389 https://cx.optum.com/optumhealthlibrary
Healthy Pregnancy under Wellness tab
Advocacy Program DirectPath (800) 640-1898 www.directpathhealth.com
Flexible Spending Accounts (FSA)
Discovery Benefits
(866) 451-3399 www.discoverybenefits.com/employees
Dental MetLife (800) 275-4638 www.metlife.com/mybenefits
Vision MetLife (800) 275-4638 www.metlife.com/mybenefits
Basic Life/AD&D & Voluntary Life/AD&D
MetLife (800) 275-4638 www.metlife.com/mybenefits
Long-Term Disability MetLife (800) 275-4638 www.metlife.com/mybenefits
Employee Assistance Program (EAP)
MetLife (888) 319-7819 www.metlifeeap.lifeworks.com
Username: metlifeeap; Password: eap
Grief Counseling MetLife (888) 319-7819 https://metlifegc.lifeworks.com
Username: metlifeassist; Password: support
Travel Assist MetLife (800) 454-3679 http://webcorp.axa-assistance.com
Short-Term Disability, Accident, Critical Illness and Hospital Indemnity
BenTec (800) 282-0732
Dial 0 www.trustmarksolutions.com
www.metlife.com
Legal Services Preferred
Legal (888) 577-3476 www.preferredlegal.com
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Eden Roc offers a comprehensive suite of benefits to contribute to the
present and future well-being of our employees and families. This booklet
provides you with a summary of benefits. Please review it carefully so you
can choose the coverage that is right for you and your family.
Benefit basics
As an Eden Roc regular full-time employee scheduled to work at least 30 hours per week, you are eligible
for all of our benefit programs. Your benefits are effective the 1st of the month following 30 days of hire.
Once your benefit elections become effective, they remain in effect until the end of the plan year or if
you experience a Qualified Life Event. You may only change coverage within 30 days of a Qualified Life
Event.
Get more bang for your
benefits buck.
Benefit Basics
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Eligibility
Full-time employee First of the month following 30 days of hire. Eligible dependents
You are required to certify that any dependents you enroll meet the eligibility requirements. In addition,
you may be asked to provide supporting documentation. Your eligible dependents include legal spouse,
domestic partner (Domestic partner is eligible if he or she lived with you for at least six months in a
committed relationship. A Domestic Partnership Affidavit form must be completed) and children under
the age of 26 (biological, legally adopted, legal guardianship, or stepchildren).
Qualified life event
Generally, you may only change your benefit elections during the annual enrollment period. However,
you may change your benefit elections during the year if you experience a Qualified Life Event such as
marriage or the birth of a child.
Depending on the type of event, you may need to provide proof of the event. If you do not contact
Human Resources within 30 days of the Qualified Life Event, you will have to wait until the next annual
enrollment period to make changes (unless you experience another Qualified Life Event).
You may also choose to change the amount you allocate to certain savings accounts you may have been
eligible for and selected during the enrollment process at any time throughout the year.
The Cost of Your Benefits
Eden Roc pays the full cost of some of your benefits, you share the cost for
some others. In addition, you pay the full cost for any voluntary benefits
elected.
Ready to get started?
Be on the lookout for more information
soon including your login credentials.
Questions?
[SERVICE CENTER NAME AND PHONE
NUMBER] [BENEFITS PORTAL URL]
?
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Benefit Who Pays Tax Treatment
Medical Coverage Company/You Pre-tax
Dental Coverage Company/You Pre-tax
Vision You Pre-tax
Flexible Spending Accounts (FSA) You Pre-tax
Basic Life and Accidental Death & Dismemberment (AD&D) Insurance
The Company After-tax
Voluntary Life and Accidental Death & Dismemberment (AD&D) Insurance
You After-tax
Long-Term Disability Coverage The Company After-tax
Voluntary Worksite Benefits (Accident, Critical Illness, Hospital Indemnity and Short-Term Disability)
You After-tax
Simply Engaged – Take Care of Your Health and be Rewarded
Simply Engaged is a personal health and wellness program which allows you to earn rewards when you complete these
health and wellness actions. It’s easy to start earning rewards! Access the Reward Program Overview through Rally when
you log in to www.myuhc.com for specific details regarding your wellness incentive program.
Participate in a biometric health screening and get $75 reward
Participate in a confidential event through any of the following convenient options: Worksite event (if employer has elected), Health Provider For, or Lab Screening.
Learn more about your important health numbers: total cholesterol, blood pressure and Body Mass Index (BMI).
Complete an online health survey through Rally when you log in to www.myuhc.com within 90 days of the start of the
program and get a $25 reward
Answer all of the survey questions to personalize your overall experience.
Complete the survey and receive your results as a “Rally Age” – an indicator of how your health age compass with your actual age.
Get a $20 reward each month that you visit a participating fitness center at least 12 times per month
Register at a participating fitness center or YMCA through the Health and Wellness tab on www.myuhc.com.
You must present your fitness ID card each time you go to the gym.
Complete a telephone-based health coaching program and get a $75 reward
Complete the health survey in order to participate in this health coaching program. Call the Health Coach at (800) 478-1057 to begin working on your personal health improvement plan.
Plan accordingly. A telephone-based health coaching session takes three to five months to complete.
Complete at least 3 Missions through the Rally experience and get a $50 reward
Complete the health survey to receive suggested online health actions or Missions. Missions are interactive and provide choice that may help you maintain your health.
Plan accordingly. Each mission can take at least four weeks to complete.
Healthy Pregnancy Program
NHP wants to help ensure you have a smooth pregnancy, delivery and a healthy baby. That’s why we created the Healthy
Pregnancy Program. By seeing your doctor regularly, and by enrolling in our Healthy Pregnancy Program, which is provided at
no additional cost, for NHP plan members, you’ll have built-in support through every stage of your pregnancy. After you
enroll in the program, you can call the maternity nurses 24 hours a day to ask questions or talk over your concerns. Call
(888) 246-7389.
Care 24
Care24 is a health and well-being concierge in which members are connected with a single point of contact who guides them
to clinical, wellness, financial, legal or counseling resources through NurseLine and the Employee Assistance Program
(EAP) – 24 hours a day, seven days a week.
NurseLine – Better clinical advocacy helping drive better health outcomes.
NurseLine’s registered nurses connect members to the right treatment, right
provider, right medication and right lifestyle by:
Providing support on managing a chronic condition or assessing
treatment options
Identifying UnitedHealth Premium providers and even scheduling
appointments
Care24®
services Available 24 hours a day, 7 days a week.
Call 1-888-887-4114.
myuhc.com®
TTY/TDD callers, please call
the National Relay Center at
1-800-828-1120 and ask
for the number above.
Care24 Services
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Additional Services for UHC Members
Virtual Visits
When you don’t feel well, or your child is sick, the last thing you want to do is
leave the comfort of home to sit in a waiting room. Now, you don’t have to.
A virtual visit lets you see and talk to a doctor from the comfort of your home or
office without an appointment. And it’s part of your health benefits.
Appointments can take place by mobile device or computer. Most visits take
10-15 minutes. And, doctors can write a prescription, if needed, that you can
pick up at your local pharmacy.
Access Virtual Visits
Login to www.myuhc.com or download the UnitedHealthcare
Health4Me app.
Click on the “Physician & Facilities” tab at the top of the page.
There you will find information where you can:
Learn more about virtual visits, and
Access direct links to provider sites where you can register and receive care.
It’s Part of your Health Benefits
Virtual visits are part of your health benefits which are administered by
UnitedHealthcare. You can expect to pay a portion of the costs according to your
medical plan. Your costs may be lower than an in-person appointment with your
doctor. All virtual visits will appear in claim summaries the same as any other
medical plan.
When to use a virtual visit
Talk to a doctor about non-emergency
conditions, including:
Allergies
Bladder infection
Bronchitis
Cough/cold
Diarrhea
Fever
Pink eye
Rash
Seasonal flu
Sinus problems
Sore throat
Stomach ache
Use virtual visits when:
Your doctor is not available
You become ill while traveling
You are considering visiting a hospital
emergency room for a non-emergency
health condition
$10 copay for in-network services only.
Telehealth – Virtual Visits
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About Your Benefits
Tips
When you enroll in a Eden Roc’s Medical/Rx plans, you will automatically receive prescription drug coverage through NHP/UHC. If you take medications regularly prescriptions can add up to a significant part of your health care expenses. Knowing how the Eden Roc prescription drug plan works and what to do to manage expenses can help you make good buying decisions and lower your out-of-pocket costs.
Get the most from your pharmacy benefit services
NHP/UHC provides access to a wide variety of U.S. Food & Drug Administration (FDA) approved medications. The program is designed to help you make informed decisions about your choice of prescription medications and pharmacy products. Follow these guidelines in order to get the most from your pharmacy benefits:
Choose a pharmacy that’s in the NHP/UHC network. Be aware that filling your prescriptions at a non-network pharmacy will increase your costs, and your prescriptions may not
be covered. To find a pharmacy, you can log into www.myuhc.com. When you visit a pharmacy, simply show your health plan ID card to the pharmacist, and they will inform you of your costs
for the prescription.
Remember—Go Generic and Get a Dose of Savings!
When it comes to prescription medications, you and your doctor usually have a choice between a brand name drug and its generic equivalent. Generic drugs offer the same strength and active ingredients as the brand name - but often cost much less.
In most cases, when you take your prescription for a brand name medication to the pharmacy, your prescription will be filled with the generic equivalent.
However, if you ask for the brand name medication instead of the generic, even though you doctor is ok with you taking the generic, you will pay a higher amount, which will be your generic copay plus the difference in cost between the brand name medication and the generic.
Urgent Care vs ER. Don’t pay for more if you don’t have to. The ER is meant for true emergencies such as life threatening illnesses and injuries. The ER costs an average of three times more than a visit to the UC. In a non-life threatening situation, you can most likely be treated at an UC.
Emergency Room Urgent Care
Chest Pain Coughs and Sore Throat
Broken Bones Minor Injuries and Burns
Allergic Reactions Ear / Sinus Infections
Continuous Bleeding Flu and Cold
Head Injury Sprains and Strains
Severe Shortness of Breath Fever
Deep Wounds Vaccinations
Savings Tips
Below are a few ideas on how to spend
your dollars or save on prescriptions
and medications.
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Tips
Make sure you’re always seeing a Contracted NHP/UHC Provider!
How do I locate an NHP/UHC Contracted provider?
Online: Register on www.myuhc.com to locate a contracted provider
Phone: Call (800) 357-0978 What if I receive an invoice from a provider or a facility and I verified
they were Contracted with NHP/UHC?
Retrieve your Explanation of Benefits (EOB) from NHP/UHC for that specific claim/date of service. If the amount that you owe on the EOB is equal to the amount on the invoice, then the invoice should be paid
in full. If the amount that you owe on the EOB is less than the amount on the invoice (the invoice is greater) you can
contact DirectPath at (800) 640-1898 and they can assist you.
NHP/UHC’s Contracted Lab is LabCorp, so please ensure you’re always seeking Lab Services from a Contracted LabCorp facility.
When you visit your Contracted NHP/UHC provider for your Annual Physical/Exam make sure you’re stating that this visit should be coded as your “Preventive Visit” so that you’re not charged a copay. (Remember if you’re treated for an illness during this visit it will no longer be considered a preventive visit and you will be charged the applicable copay/coinsurance.
If your Doctor orders an MRI, CT Scan or an Ultrasound, remember that a Standalone Testing Facility is much more cost effective than a hospital.
Don’t forget the Generic Drug Discount programs that are available at most retail chains. (Publix, Wal-Mart, Target)
Don’t forget the Minute Clinic’s and the Take Care Clinic’s at Walgreens & CVS. You only have to pay your PCP copay,
however please make sure you’re going to a Contracted clinic.
Medical Tips
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Medical/Rx Plans
Medical coverage offers health care protection for you and your family. You may visit any medical provider you choose, but in-network providers offer the highest level of benefits and lower out-of-pocket costs. Network providers charge members reduced, contracted fees instead of their typical fees. Providers outside the plan’s network set their own rates, so you may be responsible for the difference if a provider’s fees are above the Reasonable and Customary (R&C) limits.
Your 2019-2020 Benefits Eden Roc believes in making a positive impact not only within our industry but also with our employees – the organization’s greatest asset. We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families. Some benefits are provided at no cost, while others require a cost share between employees and Eden Roc. Employees may also select voluntary plans and pay for these benefits through convenient payroll deductions. While you have many options to select from, getting the best value depends on understanding and using your benefits wisely. Take the following into account: 1. The premium cost (your
payroll deductions) 2. Your out-of-pocket cost when
you receive care 3. The type of health care
services you expect to use 4. Other coverage you might
have
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Medical/Rx Plans
Eden Roc offers a choice of three Medical/Rx plan options so that you can choose the plan that best meets your needs. Each plan includes comprehensive healthcare benefits including free preventative care services and coverage for prescription drugs.
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Plan Provisions NHP BAY3-M1 $500 POS Plan NHP F0SC-M2 $1,000 HMO Plan
In-Network Out-of-Network In-Network Only
Annual Deductible (Individual/Family) $500 / $1,000 $1,500 / $3,000 $1,000 / $2,000
Out-of-Pocket Maximum (Includes Deductible)
$3,000 / $6,000 $8,000 / $16,000 $6,000 / $12,000
Lifetime Maximum Unlimited Unlimited
Preventive Care Covered 100% 40%* Covered 100%
Telehealth $10 Not covered $10
Primary Physician Office Visit $25 40%* $25
Specialist Office Visit Open Access – no referrals required
$45 40%* $45
Inpatient Hospital Services 10%* 40%* 10%*
Outpatient Hospital Services 10%* 40%* 10%*
Diagnostic Lab Facility Covered 100% 40%* Covered 100%
Diagnostic X-ray Facility Covered 100% 40%* Covered 100%
Major Services – PET Scans, MRI, CT Scans 10%* 40%* 10%*
Urgent Care $50 40%* $100
Emergency Room Care $150; waived if admitted $200; waived if admitted
Retail Prescription Drugs (30-day supply)
Generic Brand Preferred
Brand Non-preferred Specialty: Generic, Brand Preferred & Brand
Non-Preferred
$10 $30 $50
$10/$125/$250
Not Covered
$10 $30 $50
$10/$125/$250
Mail Order Prescription Drugs (90-day supply)
Generic Brand Preferred
Brand Non-preferred
$25 $75
$125
Not Covered
$25 $75
$125
Employee Bi-Weekly Contribution NHP BAY3-M1 $500 POS Plan NHP F0SC-M2 $1,000 HMO Plan
Employee $88.32 $70.15
Employee + Spouse $190.09 $150.99
Employee + Child(ren) $172.51 $137.02
Employee + Family $274.27 $217.85
*After deductible
Medical/Rx Plans
Medical/Rx Plans
Wellness Tip – Adopting a healthy lifestyle, such as eating nutritious foods and exercising regularly can help you stay well and avoid unpleasant surprises at check up time. It can help you keep more serious problems from developing – and this saves time, money and worry!
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Plan Provisions NHP BAZ4-M1 HMO Plan
In-Network Only
Annual Deductible (Individual/Family) $5,000 / $10,000
Out-of-Pocket Maximum (Includes Deductible)
$6,850 / $13,700
Lifetime Maximum Unlimited
Preventive Care Covered 100%
Telehealth $10
Primary Physician Office Visit $35
Specialist Office Visit Open Access – no referrals required
$65
Inpatient Hospital Services 0%*
Outpatient Hospital Services 0%*
Diagnostic Lab Facility Covered 100%
Diagnostic X-ray Facility Covered 100%
Major Services – PET Scans, MRI, CT Scans $200
Urgent Care $75
Emergency Room Care $300; waived if admitted
Retail Prescription Drugs (30-day supply)
Generic Brand Preferred
Brand Non-preferred Specialty: Generic, Brand Preferred & Brand
Non-Preferred
After $100 Individual/$200 Family Deductible $10 $35 $60
$10/$125/$250
Mail Order Prescription Drugs (90-day supply)
Generic Brand Preferred
Brand Non-preferred
$25 $87.50 $150
Employee Bi-Weekly Contribution NHP BAZ4-M1 HMO Plan
Employee $34.32
Employee + Spouse $73.87
Employee + Child(ren) $67.04
Employee + Family $106.59
*After deductible
Medical/Rx Plans
The nation’s leading advocacy service retained to help
employees navigate the health care system and become better
healthcare consumer.
Who Do We Help?
Employees (and their dependents) with health care benefits through their
employer
What Do We Help With?
Providing cost & quality research for planned medical tests/procedures
Resolving claims & billing issues
Finding in-network providers
Verifying coverage
Educating employees about their health plan choices during Open Enrollment
Resolving prescription drug issues
Coordinating primary & secondary coverage benefits
Assisting with medical, dental, vision, and FSA benefits
Why Should A Member Call DirectPath For Help?
Company-paid benefits (costs nothing to use)
100% confidential
Totally independent and not affiliated with any insurance company
800-640-1898
Monday–Friday: 8 a.m. – 9 p.m. ET Saturday: 9 a.m. – 2 p.m. ET
DirectPath | Quick Guide
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Dental Plan
Strong teeth and gums are an important part of good health, which is why Eden Roc offers
you and your eligible dependents comprehensive dental coverage through MetLife. To
help you and your family prevent the incidence of higher cost treatments, the dental
plans cover preventive exams at 100%.
Ready to get started?
Be on the lookout for more information
soon including your login credentials.
MetLife
Plan Provision DHMO PPO Plan
In-Network Only In-Network Out-of-Network
Annual deductible (Individual/Family)
None None $50/$150
Annual Benefit Maximum (per person)
None $2,200
Preventative
Refer to Benefit Summary for Fee
Schedule
100% 90%
Basic 90% 60%
Major 60% 40%
Orthodontia (Children to Age 19)
50%, deductible does not apply $1,500 lifetime maximum
Choose Well Tip: Be a Smart Dental Consumer! Establish a relationship with a dentist you trust. Visit www.metlife.com or call (800) 275-4638 to find a participating dentist. Schedule regular dental cleanings and exams to reduce the risk of gum disease. Request a pre-determination of benefits before you have major services to help you project your costs.
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3 Wellness Tip Preventive services usually cost a lot less than fillings, root canals, and extractions. Therefore, routine exams and dental cleanings may help prevent the incidence of these higher–cost treatments and medical related issues. Remember to establish a relationship with a dentist you trust.
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Dental Plan
Vision Plan
Wellness is also about keeping your eyes healthy. That’s why everyone should get
regular vision check-ups by qualified doctors. Eden Roc offers voluntary vision plan
through MetLife which provides coverage for eye exams, prescription lenses and
frames, or contact lenses for you and your eligible family members.
Ready to get started?
MetLife Voluntary Vision Plan Highlights
Benefit PPO Plan
In-Network Out-of-Network
Exam $5 copay $45 allowance
Hardware $10 copay See Below
Frequency Exams
Once every 12 months Once every 12 months Lenses
Frames
Frames
$10 copay $180 Allowance, you will receive
an additional 20% off any amount that you pay over your allowance
$70 allowance
Lenses Single Lenses Bifocal Lenses Trifocal Lenses
Covered 100%
$30 allowance $50 allowance $65 allowance
Medically necessary contact lenses
Covered 100% after eyewear copay
$210 allowance
Elective Contact Lenses
$180 allowance $105 allowance
Wellness Tip Consider using MetLife providers for eye care needs to help save on out-of-pocket expenses. You want the best possible care, so on your next visit to your eye doctor be sure to: Take your list of medications — prescriptions and non prescriptions, including vitamins and share
this information with your doctor. Tell your doctor about any vision problems and share your family health history. If you have
medical conditions such as high blood pressure or diabetes, let your doctor know. Talk about your daily habits and hobbies, such as how often you use a computer each day or
whether you do a lot of close-up work or work outdoors. Hobbies like sports, reading and needlework can impact eyewear suggestions, so share this information too!
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Vision Plan
Flexible Spending Account
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A Flexible Spending Account (FSA) is a program that helps you pay for health care and
dependent care costs using tax free dollars. Each pay period, you decide how much
money you would like to contribute to one or both accounts. Your contribution is
deducted from your paycheck on a pre-tax basis and is put into the Health Care FSA, the
Dependent Care FSA, or both. When you incur expenses, you can access the funds in
your account to pay for eligible health care or dependent care expenses.
This chart shows the eligible expenses for each FSA; how much you can contribute to
each FSA each year, and how you benefit by using an FSA.
Example of Annual Savings With FSA Without FSA
Annual taxable income $50,000 $50,000
Pre-tax money deposited into an FSA ($2,700) $0
Remaining taxable income $47,300 $50,000
Minus Federal and Social Security
taxes* ($10,714) ($11,325)
Take-home pay spent on FSA eligible
expenses $0 ($2,650)
Remaining take-home pay $36,586 $35,975
Annual Savings $611 No Savings
What Are the Advantages of an FSA? Your contributions are not taxed, nor are you taxed when you receive reimbursements from the account or when you file your income tax returns at the end of the year. Example Here’s a look at how much you can save when you use an FSA to pay for your healthcare FSA, Dependent Care FSA and Limited Purpose FSA expenses.
Account Type Eligible Expenses Annual
Contribution Limits
Benefit
Healthcare FSA
Most medical, dental and vision care expenses that are not covered by your health plan (such as copayments, coinsurance, deductibles, eyeglasses and doctor- prescribed over the counter medications)
Maximum contribution is $2,700 per year
Saves on eligible expenses not covered by insurance; reduces your taxable income
Dependent Care FSA
Dependent care expenses (such as day care, after school programs or elder care programs) so you and your spouse can work or attend school full-time
Maximum contribution is $5,000 per year ($2,500 if married and filing separate tax returns)
Reduces your taxable income
Flexible Spending Accounts (FSA)
Life Insurance Coverage
Life and Accidental Death & Dismemberment (AD&D) Insurance
Company-paid Life/AD&D insurance: Work and life balance isn’t only for you, it’s also for your family. And part of achieving that balance is making sure your loved ones are taken care of in the event of an emergency. Because Eden Roc understands how important financial stability is to you and your family, the company provides this benefit to all eligible employees. Coverage is provided through MetLife. It is automatic and there is no cost to you.
Ready to get started?
Be on the lookout for more information
soon including your login credentials.
Wellness Tip Think about how much of your current paycheck is used for day-to-day living expenses. This can provide a guideline for the amount of income you need life insurance to replace. When you’re determining your life insurance needs, consider other coverage you have — including individual coverage, as well as coverage through your spouse’s employer and other insurance that provides a death benefit, like mortgage insurance. Also look at what savings and investments you have, and think about how many people depend on you for financial support.
Optional Term Life – Yourself, Spouse and Child(ren)
You may purchase additional Optional Life and AD&D insurance for yourself in increments of $10,000 to a maximum of the lesser of five times annual salary or $300,000. If you purchase Optional Life insurance when you are first eligible, you can obtain a guarantee issue up to $100,000 of coverage without providing evidence of insurability. Your Optional AD&D benefit amount is equal to the Life amount elected by you.
If you enroll in Optional Life, you may also elect Optional Life coverage for your spouse and children:
Spouse: $5,000 increments to a maximum amount of $150,000, with a guarantee issue of $25,000.
Child(ren): Increments of $1,000, $2,000, $4,000, $5,000 or $10,000 with a guaranteed issue of $10,000
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Insurance Coverage
Optional Term Life
Monthly contributions per $1,000 of coverage
Age <19 $0.068
Age 20 - 24 $0.068
Age 25 - 29 $0.068
Age 30 - 34 $0.080
Age 35 - 39 $0.091
Age 40 - 44 $0.137
Age 45 - 49 $0.217
Age 50 - 54 $0.343
Age 55 - 59 $0.535
Age 60 - 64 $0.792
Age 65 - 69 $1.454
Age 70+ $2.336
Dependent Child $0.240
Short -term disability insurance
When you’re healthy it’s hard to imagine not being able to work because of a serious
illness or injury. But a disability that keeps you out of work could have a devastating
impact on your income, jeopardizing your ability to cover normal household
expenses. That’s why Eden Roc provides Long-Term Disability coverage at no cost to
you. This benefit is 100% company-paid and is provided through MetLife.
Ready to get started?
Be on the lookout for more information
soon including your login credentials.
Wellness Tip
Low Impact Exercise
While most people desire the health benefits of exercise, not all exercise can or should be performed by everyone. For many people, health conditions or long-term injuries prevent them from taking up some of the more demanding forms of exercise. If you fall into one of those categories, low-impact exercise may be what you’re looking for. Designed to limit stress on the body, low-impact exercise can still be intensive enough to provide cardiovascular and musculoskeletal benefits. You don’t need to be a mountain climber or marathoner to obtain rewarding levels of personal fitness, but you do need regular exercise in order to maintain your health and well-being. Consider the following forms of exercise as a way to meet your fitness goals: Walking. The simplest form of exercise is still one of the best. This low-cost, low-stress workout will
benefit your body and mind without taking a toll on your body. Just make sure your shoes are up to the distance and terrain challenges.
Cycling. Whether stationary or in motion, pedaling a bike burns major calories without punishing your body.
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Long-Term Disability Insurance
Long-Term Disability
Plan Provisions Regular Full-Time Employees
Maximum Monthly Benefit
60% of salary up to $10,000 per month
Maximum Benefit Duration
Retirement Benefit Duration or Social Security Normal Retirement Age
Elimination Period
180 days (the number of days you must be disabled prior to receiving disability benefits)
Benefit Reductions
LTD benefits integrate with Social Security, and any other disability or retirement benefits, under a retirement plan to provide you with a combined monthly benefit (varies by option), up to the monthly benefit maximum
Voluntary long -term disability insurance
Life’s personal and family related issues shouldn’t make it hard to get through the
day. It can make a difference just knowing that you will have someone who will
listen, understand and suggest next steps. That is why Eden Roc provides you and all
members of your household with a free, confidential EAP service to help with such
issues as:
Be on the lookout for more information
soon including your login credentials.
Wellness Tip
Walking Walking is a great form of exercise for achieving better health and burning calories. But do you know the recommended amount of walking to achieve optimum benefits? Studies show that walking 10,000 steps, or about 5 miles, is an excellent daily goal for most people. But you don’t have to do endless laps around the local high school track; steps throughout your day all add up to a healthier you. Try wearing a pedometer to help you monitor how close you are to reaching your goal. Every step counts, so keep walking!
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Employee Assistance Program (EAP)
Stress, Anxiety and Depression Parent and Child Relationships Depression Alcohol and Drug Dependency Legal and Financial Counseling Financial Planning Family & Marital Conflicts Job Related Difficulties Identity Theft Counseling Grief Counseling and more This is a confidential service and is available 24 hours a day, seven days week. The EAP benefit includes five consultations per individual, per calendar year. When you call, you will speak to a friendly, compassionate professional who will genuinely care about your situation, help you clarify your concerns, and offer your guidance and support. If necessary, you will be connected with experts who can provide additional assistance. You may access information, benefits, educational materials and more either by phone at (888) 319-7819 or online at www.metlifeeap.lifeworks.com; Username: metlifeeap and Password: eap. You and your family members are automatically enrolled in the EAP plan. This service is provided through MetLife at no cost to you.
Voluntary benefits- Bridge the gap with hospital indemnity- AFLAC
Ready to get started?
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Worksite Benefits
Voluntary benefits- Voluntary benefits- Accident & Critical Illness Insurance
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Additional Services from MetLife
Grief Counseling
Facing a major loss is never easy, and how you cope and grieve is very personal. No matter the
circumstances, whether it’s a death, an illness, a divorce, or even a child leaving home, there are
valuable resources available to you that can help.
MetLife is here to help at your time of need, you and your dependents have 24/7 access to a work/life
counselor. Simply call a dedicated toll-free number to speak with a licensed professional. To contact a
professional counselor simply call (888) 319-7819 or you can visit https://melifegc.lifeworks.com;
Username: metlifeassist, Password: support.
You now have the opportunity to enroll in the MetLife Optional Life Insurance that can financially help
protect your loved ones should something happen to you. An when you enroll in Optional Life
Insurance, you have access to another service to protect the ones you love – Will Preparation.
Step 1: Call Hyatt Legal Plans’ toll-free number (800) 821-6400, and a Client Service Representative will
assist you in locating a participating plan attorney in your area and provide you with a case number.
Step 2: Call and make an appointment with a participating attorney – many plan attorney even have
evening and weekend appointments for your convenience.
Step 3: That’s it! When you use a plan attorney, you do not need to submit any claim forms. You also
have the flexibility of using a non-network attorney and being reimbursed for covered services according
to a set fee schedule. Optional Life Insurance and Will Preparation Service are two important ways to
protect yourself – and the ones you love.
Is a valuable benefit that is provided and administered by AXA Assistance USA, Inc. through an
arrangement with MetLife. This service offers you and your dependents medical, travel, legal, financial
and concierge services, 24 hours a day, 365 days a year, while traveling internationally or domestically.
When your AD&D coverage become effective, you will be provided with a travel assistance identification
card, along with an informative brochure that highlights the available services. If you become sick or
injured, require travel or financial assistance when traveling 100 miles or more from home, call the
number on the identification card to access services. You will promptly be connected to a multilingual
assistance coordinator who will be happy to assist you, 24 hours a day, 365 days a year. It’s that easy!
You can also obtain 24-hour pre-departure information on weather, currency or holidays through the
toll free number or by visiting the AXA website at http://webcorp.axa-assistance.com. These benefits
are provided to Eden Roc employees at no cost to you.
Life Insurance Coverage & Will Preparation Service
Travel Assist
Voluntary benefits
Preferred Legal
You never know when a legal problem is going to effect your work, your life, or your
wellness. With Preferred Legal plan, you will have access to professional attorneys,
financial planners, and other valuable resources to help you protect yourself and
everything that you’ve worked so hard to attain.
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Legal Services and Identity Theft
Identity Theft
STOP Identity Theft in its tracks with the power of Experian! ProtectMyID is pleased to
partner with Preferred Legal Plan. ProtectMyID provides more than identity protection.
They provide peace of mind. As a part of Experian, a leader in credit services and
decision analytics they use world-class security and technology standards. Here are
some features to fight identity theft.
Early warning Surveillance Alert notifications via email or text inform members of new activity related to their identities through daily monitoring
$1,000,000 Identity Theft insurance to cover items like electronic fund transfers, lost wages, legal fees and private investigator costs
Identity Theft Resolution Agents help resolve potential identity theft from start to finish. With a highly trained dedicated agent, members aren’t left on their own to contact creditors
A complete personal Experian credit report so members can check for inaccurate information that may be a sign of past identity theft
Additional resources so consumers can learn more about identity protection
Bi-Weekly Cost Preferred Legal
Only Identity Theft
Only Preferred Legal &
Identity Theft
Employee only $4.60 $4.16 $7.83
Employee + Spouse N/A $8.31 $11.06
Unlimited FREE legal advise via phone consultation Unlimited FREE review of legal documents (real estate
contracts, lease agreements, etc.) Unlimited FREE letters and phone calls on Employee’s behalf to third
parties Unlimited FREE credit report analysis and repair and settling
accounts in collection Unlimited FREE Identity Theft protection and restoration FREE loan modification assistance and foreclosure defense FREE Wills for Employee and Spouse FREE legal forms available through PLP Form Library FREE notary services Up to 40% reduced legal fee for panel attorney representation on all types of legal services
(pursuant to Fee Schedule) 24 hours a day, 7 days a week access
Glossary of important benefits terms
Here are some of the important benefits terms and types of insurance
coverages referenced in this guide:
Benefits Portfolio
A comprehensive package of various types of
insurance and benefits products that work together to
create the best protection based on your individual
needs.
Coinsurance
The amount you pay for services after you meet your
deductible. For example, your coinsurance might be
20% of the total charge, while your insurance
company pays the other 80%.
Copay
A flat fee you pay for health care services; your
insurer pays the balance. You may have one copay for
in-network (e.g., $20) while out-of-network copays
might be higher (e.g., $40).
Deductible
The amount you’ll pay toward medical expenses
before your insurer begins to pay for them.
Dependent
A qualifying child or relative, including a spouse or
domestic partner, who relies on you for financial
support.
Disability Insurance
Cash paid to you by your insurance company in the
event that an illness or accidental injury causes you
to be out of work for a certain amount of time.
Generic Drugs
Generic drugs are less expensive versions of brand
name drugs that have the same intended use, dosage,
effects, risks, safety and strength. The strength and
purity of generic medications are strictly regulated by
the Federal Food and Drug Administration.
Flexible Spending Account (FSA)
A tax-advantaged financial account set up through your
employer that allows you to set aside a portion from your
paycheck to pay for qualified expenses, such as
dependent or child care, transit or parking. Money
deducted from pay into an FSA is not subject to taxes.
Inpatient
Services provided to individual during an
overnight hospital stay.
Life Insurance
A specific amount of money paid to designated
beneficiaries in the event of the insured person’s
death.
Mail Order Pharmacy
Mail order pharmacies generally provide a
90-day supply of a prescription medication for
the same cost as a 60-day supply at a retail
pharmacy. Plus, mail order pharmacies offer the
convenience of shipping directly to your doctor.
Out-of-Pocket Maximum
The highest amount you’ll pay toward medical
expenses in a year including deductibles, copays,
and coinsurance, but not monthly premiums. If the
out-of- pocket-maximum is met, any further
qualified expenses will be 100% covered by the
insurance company for the remainder of the year.
Outpatient
Services provided to an individual at a hospital
facility without an overnight hospital stay.
Primary Care Physician (PCP)
Physician (generally a family practitioner, internist
or pediatrician) who provides ongoing medical
care. A primary care physician treats a wide
variety of health-related conditions.
Specialist
A physician who has specialized training in a
particular branch of medicine (e.g., a surgeon,
gastroenterologist or neurologist).
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Glossary of Medical Plan Terms
About This Guide This benefit summary provides selected highlights of the Eden Roc employee benefits program. It is not a legal document and shall not be construed as a guarantee of benefits nor of continued employment at Eden Roc. All benefit plans are governed by master policies, contracts and plan documents. Any discrepancies between any
information provided through this summary and the actual terms of such policies, contract and plan documents shall be governed by the terms of such policies, contracts and plan documents. Eden Roc reserves the right to amend, suspend or terminate any benefit plan, in whole or in part, at anytime. The authority to
make such changes rests with the Plan Administrator.
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