Benefits Orientation Presentation. Today’s Agenda ● All About ADP Totalsource All About ADP...

Benefits Orientation Presentation

Today’s Agenda

●All About ADP Totalsource●What’s Going on in the

Benefits Marketplace●Health Care Options●Medical & Dental Plan

Information●Vision Information●Life/STD/LTD●FSA

*Click on the link of the topic that you would like to go to above

●Additional Benefit Options

●Enrollment Checklist●MyTotalSource.com

How to Login to MyTs.com Making Benefit Elections

● Important Items to Note●Summary Plan Description (SPD)

Return Home

ADP TotalSource TotalBenefits

● Medical Insurance

● Aetna Life and Accidental Death & Personal Loss Insurance

● Aetna Short and Long Term Disability Coverage

● Vision Insurance

● Dental Insurance

● Health Care and Dependent Care Flexible Spending Accounts (FSAs)

● JPMorgan Chase Health Savings Accounts (HSAs)

● Health Advocate

● Commuter Benefits

● CIGNA Medical Benefits Abroad

● Universal Life Insurance

● Accidental Death & Dismemberment Insurance

● Legal Services

● Auto and Home Insurance

● Pet Insurance

● Disability Income Insurance

● Critical Illness Plan

● Level Term Life Insurance

● Accident and Sickness Hospitalization Plan

● Cancer Plan

● Employee Service Center (ESC)

● My TotalSource

● Life’s Solutions Employee Assistance Program

● ADP Personal Discounts Program

● TotalSource University

Return Home

Why Consider TotalBenefits?●Think of your benefits package as a whole

Medical

DentalVision

Life & Disability

401(k)

Flexible Spending Accounts

Health Savings Accounts

Commuter Benefits

Group Voluntary Options

Individual Voluntary Options EAP

Perks/Personal Discounts

Health Care

Tax Savings Accounts

Retirement

Financial Protection

VoluntaryBenefits

Automatic, No-CostBenefits

Return Home

Being With ADP Has Its Perks…

●Enhanced Benefit Package:

●Multiple Medical & Dental Plan Options, Vision coverage, Life, and Disability Offerings, Flexible Spending Accounts – Health and Dependent Savings Accounts

●Employee Perks include:

●Employee Service Center, Employee Assistance Program, Direct Deposit in up to 3 checking accounts and 2 savings accounts, 24/7 Online Access to Personal information/Changes, Optional Supplemental Insurance, Personal discounts and much more!

Your Employer continues to make decisions regarding the organization, day-to-day operations and your job responsibilities.

Return Home

Are You Ready to Enroll?

Enrollment Checklist

Return Home

Prior to enrolling make sure you have the following information…

Have you read your benefits package?

If you are enrolling dependents, do you have their social security numbers and dates of birth? (Dependent social security numbers are now a mandatory requirement for enrolling dependents)

If you are enrolling in an HMO or Dental HMO plan, have you selected a primary care physician (PCP)?

Have you read the acknowledgement section of your benefits package?

If applicable, have you read the California Arbitration and/or the SRC Limited Benefits Disclosures?

Return Home

MyTotalSource.com

Return Home

About MyTotalSource.com

Log onto www.adptotalsource.com Secure Access 24/7 View your paycheck View your benefits View & change direct deposit, tax withholdings & update your personal

profile Link to the personal discount programs

Return Home

Return Home

First Time My TotalSource Users – User Name

● Your User Name is constructed by using:

● Your first initial

● The first seven characters of your last name and

● The last four digits of your social security number.

● If your last name is shorter than three characters:

● Add a one (1) after the last letter of your last name to make a minimum user name of 8 characters.

● Examples:

ssmithjr7896Sam Smith Jr233447896

slo19989Sue Lo123669989

bbutterw4444Bob Butterworth123554444

jsong5678Joann Song123445678

ResultName SSN

ssmithjr7896Sam Smith Jr233447896

slo19989Sue Lo123669989

bbutterw4444Bob Butterworth123554444

jsong5678Joann Song123445678

ResultName SSN

Return Home

First Time My TotalSource Users - Password

Your initial Password will be:

• The first character of your first name

• The six-digit file number (located in the paycheck detail section of your earnings statement) and

• The first character of your last name

Example: If your name is Fred Smith and your paycheck file number is 000056, your initial password will be: F000056S

To protect your privacy and My TotalSource's security, you will be prompted to change your password after you log in the first time. Choose something that will be easy for you to remember but hard for others to guess.

If you are unsuccessful in logging in, please call the Employee Service Center at: 800-554-1802.

Return Home

Enrolling in Benefits via MyTotalSource.comStep 1. Click benefits link

Return Home

Step 2. Review & Elect Your Benefits

Return Home

Step 3. Elect FSA Plan Year Amount

Return Home

Step 4. Select your PCP or Dentist

Return Home

Step 5. Enter Dependent & Beneficiary Info

Return Home

Step 6. Determine Life Insurance Distribution amounts

Return Home

Step 7. View your elections and Accept!

Return Home

Step 8. Print Confirmation Page & Temporary Insurance Card

Return Home

Factors Currently Impacting Health Care Costs In General

Return Home

H1N1: Impact on Health Care Costs● A study was conducted by the Centers for Disease Control to analyze the cost impact

of the H1N1 virus. They estimate that a patient with an undiagnosed infection or a visitor in a hospital with no protection will result in 2,580 infected patients within 30 days. The cost of treating H1N1 will vary based on the different alert levels:

Green alert (mandates personal protective equipment for health care workers in direct contact with patients suspected of having H1N1) - this would result in an additional $95 to prevent one additional infected patient and $23,600 to prevent one death;

Yellow alert (mandates enhanced personal protective equipment at all high-risk areas) - this would result in an additional $3,221 to prevent one additional infected patient and $828,000 to prevent one death;

Orange alert (mandates N95 masks for all patient contact as well as all other stated measures) - this would result in $7,153 to prevent one additional infected patient and a staggering $2.5 million for one death averted.

Return Home

COBRA Participation has increased with ARRA Subsidy

A study conducted from March 2009 to June 2009 of 200 large U.S. companies, which covered 8 million employees. The study found that:

● COBRA enrollments doubled to 38% for eligible Americans. This figure is up from 19% for the previous period of September 2008 through February 2009.

● COBRA enrollments in the industrial manufacturing industry jumped 800% since the subsidy became available. Original enrollment was just 7% and rose to 59% in the four months following the subsidy.

A recent survey of more than 300 employers who attended Aon Consulting's webinars on the COBRA subsidy, found that:

● Nearly 60% expected their overall health care costs to increase as a direct result of the new federal COBRA subsidy.

Return Home

Health Care Options

Return Home

Health Care Options

●As we review the available Health options, we should keep in mind that our needs and the needs of our families will be unique.

●Our Core F3Q and Buy Up 7AB plans are the same with no increase in Deductibles, Co-pays, or Prescription drugs.

●Our current H.S.A. 7AI (hdhp) is no longer available. The renewal plan is the 7AT. Difference: Prescription co-pays after meeting the deductible.

●At most, the increase is 3% of the average $30k salary.

All elections are:• Deducted on a pre-tax basis each pay period• Part of Section 125 – Cafeteria Plans

Return Home

Benefit Effective Dates

January 1st – December 31stDeductible and Out-of-Pocket Maximums are effective from:

June 1st – May 31stADPTS’ Plan Year is effective from:

January 1st – December 31stDeductible and Out-of-Pocket Maximums are effective from:

June 1st – May 31stADPTS’ Plan Year is effective from:

Return Home

FLS/SST Plan Offerings

Type Carrier

Medical United Healthcare: High Deductible Health Plan and two POS (Point of Service) plans

Dental Aetna: DMO (Dental Maintenance Organization) and PPO (Preferred Provider)

Vision VSP

FSA ADP Flex Direct

HSA Chase

Life and Disability (Employer Paid) Aetna

** Enrollment form indicates monthly premium amount.

** Premiums are deducted per pay

period.

Return Home

Medical Plan Information

Return Home

Provider: UHC

Member Service Phone #

800.357.0978

Carrier Web address: www.uhc.com

Employee

$75.00 $34.62 $57.90

Employee + Spouse

$166.25 $121.02 $128.73

Employee + Children

$166.25 $121.02 $128.73

Employee + Family

$234.09 $181.93 $175.19

7AB F3Q 7AT Buy Up Core H.S.A.

FLS/SST Plan Offerings

Per Pay Period DeductionsMedical – United Health Care

Employee

Additional $10 mo

WAS:

$30

NOW:

$34.62

Employee + Spouse

Additional $20 mo

$111.79 $121.02

Employee + Children

Additional $20 mo

$111.79 $121.02

Employee + Family

Additional $30 mo

$163.47 $181.93

Core – F3Q

Return Home

Currently Enrolled:

Employee Only - 25

Employee + Sp – 10

Employee + Child – 6

Family - 9

**Ideal for those who have not been to the hospital or plan to go.

Core Plan F3Q

Return Home Carrier/Product Info

General Plan Info In-Network

Deductible - Individual/Family

2500/5000

Annual Out of Pocket Max

5500/11000

Life Time Maximum 1,000,000

Co-Insurance 80%

Office Visits Copay Amts

Per Visit

PCP $25

Specialist $50

RX Benefits

Tier 1 $10

Tier 2 $35

Tier 3 $60

Mail Order Discounted 90 days supply

Core Plan F3Q



Hospital Care

Inpatient **Per occurrence Deductible of $500,

then covered at 80% after Deductible

Outpatient **Per occurrence Deductible of $300,

then covered at 80% after Deductible

Emergency Care

Emergency Room Covered at 80% after Deductible

Urgent Care Facility $75 per visit

Ambulance Covered at 80% after Deductible

Maternity Care

Pregnancy & Maternity (Pre-Natal Care)

$25 copay for initial visit only

Preventive Care Most items covered at $25/$50 Copay.


Employee

Additional $20 mo

WAS:

$66

NOW:

$75.24

Employee + Spouse

Additional $40 mo

$147.79 $166.25

Employee + Children

Additional $40 mo

$147.79 $166.25

Employee + Family

Additional $75 mo

$199.47 $234.09

Buy Up – 7AB

Return Home

Currently Enrolled:

Employee Only - 19

Employee + Sp – 15


Family – 29

*Our plan with the most coverage possible. If you do not know what to expect, but want to be safe and covered for any obstacle.

Buy Up 7AB



Deductible - Individual/Family

1000/3000

Annual Out of Pocket Max

3500/7000

Life Time Maximum 5,000,000

Co-Insurance 80%

Office Visits Copay Amts

Per Visit

PCP $25

Specialist $50

RX Benefits

Tier 1 $10

Tier 2 $35

Tier 3 $60

Mail Order

Discounted 90 days supply

Buy Up 7AB



Hospital Care

Inpatient Covered at 80% after Deductible

Outpatient Covered at 80% after Deductible

Emergency Care

Emergency Room $200 copay per visit

Urgent Care Facility $75 per visit

Ambulance Covered at 80% after Deductible

Maternity Care

Pregnancy & Maternity (Pre-Natal Care)

$25 copay for initial visit only

Preventive Care Most items covered at $25/$50 Copay.


Employee

Additional $10 mo

WAS:

$53.29

NOW:

$57.90

Employee + Spouse

Additional $20 mo

$119.50 $128.73

Employee + Children

Additional $20 mo

$119.50 $128.73

Employee + Family

Additional $30 mo

$161.34 $175.19

H.S.A. – 7AT

Return Home

Currently Enrolled:

Employee Only - 3

Employee + Sp – 4


Family – 3

**Good tax breaks for H.S.A. Accounts

**Ideal plan for heavy medical users that will reach their deductibles or for medical users that do not go to the doctor except for their annual physical.

H.S.A. HDHP 7AT



Deductible - Individual/Family 2,000 individual – 4,000 Combined

Annual Out of Pocket Max 4,000 / 8,000 - Includes Deductible

Change from 7AI (Additional 2k/4k for Prescription Co-pays)

Life Time Maximum Unlimited or None

Co-Insurance 100%

Office Visits Copay Amounts Per Visit

PCP Covered at 100% after deductible

*Pay contracted rate per reason code for each visit

Specialist Covered at 100% after deductible

*Pay contracted rate per reason code for each visit

H.S.A. HDHP 7AT



Hospital Care

Inpatient Covered at 100% after deductible

Outpatient Covered at 100% after deductible

Emergency Care

Emergency Room Covered at 100% after deductible

Urgent Care Facility Covered at 100% after deductible

Ambulance Covered at 100% after deductible

Maternity Care

Pregnancy & Maternity (Pre-Natal Care) Covered at 100% after deductible

Preventive Care (Annual Physical) Covered at 100%

H.S.A. HDHP 7AT



RX Benefits

Tier 1 Covered at 100% after deductible + $10



Mail Order Discounted 90 day supply Covered at 100% after deductible + $100

Per Pay Period DeductionsOverview and Comparison

Return Home

Employee

$75.00 $34.62 $57.90

Employee + Spouse

$166.25 $121.02 $128.73

Employee + Children

$166.25 $121.02 $128.73

Employee + Family

$234.09 $181.93 $175.19

7AB F3Q 7AT Buy Up Core H.S.A.

Dental Provider Information

Provider: Aetna (Same)

Product: DMO 54 (Must Select Specific Dentist)

Plan Description DMO

Member Service Phone # 800.357.0978

Carrier Web address: www.aetna.com

Provider: Aetna

Product: PPO (In/Out of Network Benefits)

Plan Description PPOA

Member Service Phone # 800.357.0978

Carrier Web address: www.aetna.com


Per Pay Period Deductions Dental – Aetna DMO Core PPO Buy Up

Return Home

Employee $4.23

Change of $.15

$11.42

Change of $.74 mo.

Employee + Spouse $12.60

Change of $.30

$27.92

Change of $1.49 mo.

Employee + Children $14.00

Change of $.32

$30.28

Change of $1.60 mo.

Employee + Family $23.77

Change of $.49

$48.20

Change of $2.43 mo.

Dental Option - DMODMO / Managed Care Plan

Deductible - Individual/Family No deductible or calendar year maximum

Copay $5 Copay for office visits

Coverage

Preventative Services Covered at 100%

Basic Services Covered at 100%

Major Services High level of coverage for most Major Dental services

Orthodontic Services Coverage for child & adult services

Dental Option - PPO


PPO Dental Preferred Provider Organization

Deductible - Individual/Family 50/150

Calendar Year Benefit Maximum $1250 per member

Coverage

Preventative Services Covered at 100%

Basic Services Covered at 80%

Major Services Covered at 50%

Orthodontic Services Coverage for dependents up to age 19 with life time maximum of $1,250 in network

Vision Information

Return Home

Monthly Deductions Vision –VSP

Return Home

Employee

$2.63

Employee + Spouse $5.27

Employee + Children $5.64

Employee + Family $9.01

Vision OptionsBenefit Copay Frequency

In-Network

Well Vision Examination $5 Once every 12 months

Single Vision, Lined Bifocal and Lined Trifocal

$10 Once every 12 months

Retail Allowance for Frames $180

Contact Lenses (instead of glasses) None Once every 12 months with an allowance of $150

Lasik None $150 allowance for both eyes, 5-15% discount

Out-of Network

All Services N/A Services are reimbursed up to a maximum amount depending on service.

Return Home

Vision - VSP

●Save on exams, eyeglasses or contact lenses and Laser eye surgery.

●Benefits vary depending on whether services are provided in or out of network

●No paper forms required, call your VSP participating provider to begin the pre-approval process!

●Participating providers can be found at vsp.com

Return Home

Life/STD/LTD

Return Home

Life, Accidental Death & PL

●Employer Paid

●Basic Life insurance – $25,000

●Offered to all Full-Time eligible Employees

(working a minimum of 30 hours a week)

Provided by AetnaReturn Home

Long Term Disability (LTD)

●Employer Paid

●60% up to $5,000/month

●Benefit begins after 180 days of disability

● *Offered to all Full-Time eligible Employees

(working a minimum of 30 hours a week)

Provided by AetnaReturn Home

Employee Assistance Program (EAP)

NEW! 24-hour toll free number dedicated to

ADP TotalSource worksite employees: 1-888-231-7015

●All worksite employees and their dependents are eligible

● Initial assessment by an EAP counselor

●Referral to a provider best suited to deal with issue

●Up to 3 face-to-face visits annually with licensed, certified counselor at no cost to individual

●Extensive Nationwide Network

●Voluntary and Confidential Service

●Assistance with Stress, Anxiety, Depression, Grief, ADD/ADHD, Eating Disorders, Financial issues, Family Issues, Alcohol and Substance Abuse Issues, Relationship Issues, Financial or Legal Counseling

Return Home

EAP Statistics

●EAP treated 2,688 members during the 2nd quarter of 2008

●Ages 18-44 were the highest utilizing age group for the quarter

Return Home

TotalSource University

●Classroom Training, in-person with an ADP TotalSource Instructor

●Virtual Classroom Training, including My TotalSource Training and Management

●Webinars (coming soon!)

●Online Seminars, delivered via streaming video

●Online Training, available 24/7 at affordable prices

• 2,826 clients attended TSU Classroom sessions

• TSU Classroom sessions were offered in 48 major metropolitan cities across 18 states

• Over 3,000 courses are available through TSU Online University

• Over 25,000 clients trained onsite by HRBPs

• Top three training requests:

• Preventing Harassment in the Workplace

• Diversity in the Workplace

• Customer Service

Return Home

Employee Personal Discounts

●Program offers discounts from brand name retailers

●Employees leverage ADP’s buying power to save money and time

●Discounts also available for your business needs

●Real Estate & Financial Services

●Sign up for premium-level savings on luxury brands**

** Available at a modest monthly fee

Return Home

Flexible Spending Accounts

Return Home

What are Flexible Spending Accounts (FSA)

●FSA’s are accounts that allow you to pay for certain medical and dependent care expenses with pretax dollars.

●Employee contributions are deducted from each paycheck before Federal Income and Social Security taxes are calculated.

●You will not pay taxes on eligible reimbursements.

•Please note: Use it or lose it – is an IRS requirement that if you do not spend all the money you have in your FSA, that money remaining in after July 31st of the following year will be forfeited because it cannot be rolled over or refunded to you.

Refer to your Summary Plan Description

Health Care FSADependent Care FSA

Return Home

What are Flexible Spending Accounts (FSA)

● You can enroll initially when your worksite Employer begins the relationship with ADP TotalSource or during FSA Open Enrollment every spring, for an effective date of June 1st

● If participating in a HSA, you may only use FSA for dental and vision.

Health Care FSA

Dependent Care FSA

Refer to your Summary Plan DescriptionReturn Home

Health Care FSA

●Allows you to pay for certain medically necessary expenses with pre-tax dollars.

● *Contribute up to $3,500.00 for the plan year ($50.00 minimum).

●You may use the money even if not yet in the account.

●Direct Deposit Reimbursements

Health Care Reform Alert!●Although the Reconciliation Bill delayed the imposition of a *$2,500 cap on all

health care FSA plans until 2013, the Reconciliation Bill did not alter a provision included in H.R. 3590 that prohibits a participant in a health care FSA or health savings account from being reimbursed for over the counter medications, unless such medications are prescribed by a doctor. This provision is effective beginning January 1, 2011.

Return Home

Health Care FSA

Examples of eligible expenses are:

• Copays • Deductibles• Eye glasses/contact lenses • Orthodontia • X-rays • Vaccinations/immunizations • Routine physicals• Infertility treatment

Return Home

Dependent Care FSA

●Allows you to pay for dependent care with pre-tax dollars.

●Contribute up to $5,000 for the plan year ($2500 if married and filing separately) ($50 minimum)

Return Home

Dependent Care FSA

Examples of eligible expenses are:

• Care for dependent under the age of 13

• Regardless of age if they are physically/mentally incapable of self care

Expenses for care while at work include:

• Care provided in your home (not by another dependent)

• Qualified child care centers and after school programs

• Certified ‘away from home’ facilities (provided not more than 12 hours/day)

Return Home

Highly Compensated Employee (HCE) Dependent Care FSA

For the 2010-2011 plan year a Highly Compensated Employee is defined by the IRS as an individual that:

• Owns (or constructively owns) more than 5% of the stock, capital or profits interest of a Client Company on any day during the Plan Year, or

• Will be paid compensation by ADP TotalSource in excess of $110,000 annually.

The definition of a HCE may change for future plan years.

Return Home

Highly Compensated Employee (HCE) Dependent Care FSA

●Highly compensated Employees are only permitted to contribute up to $2000 per plan year to Dependent Care FSA.

●ADP TotalSource may at any time before or during the plan year impose additional pre-tax contribution limits on a HCE if necessary to satisfy the non-discrimination requirements applicable to the Dependent Care FSA.

●Open Enrollment and New Hire Enrollment materials disclose the new requirement.

●Enrollment form and My TotalSource will recognize a HCE and limit their Dependent Care FSA contribution accordingly.

Return Home

Tax Advantage of FSA’s

Without Medical Reimbursement AccountWith the Medical Reimbursement Account

Annual Gross

(Taxable Income) ........................$30,000

Annual Gross

(Taxable Income) .....................$30,000

Less Federal Income ax/FICA.......-$6,040

Less Medical Reimbursement Account…………….…………... -$1,000

Joe’s Annual Net Income….....….$23,960 Joe’s Taxable Income…............$29,000

Less Medical Expenses……….… -$1,000

Less Federal Income Tax/FICA……………...……...-$5,813.50

Joe’s Spendable income…….......$22,960 Joe’s Spendable income…...$23,186.50

That’s $226.50 more dollars in Joe’s pocket for the year!Return Home

Additional Value Added Benefit Options

Return Home

Principal 401(k) Plan

●Regardless of the economy’s performance, a 401(k) plan can help you retain and recruit talented worksite employees.

How? The plan is no cost to you Easy plan administration Your own 401(k) Specialist Lifetime Funds - Choices made easy

Return Home

https://secure05.principal.com/http.www/

Ancillary (Voluntary) Benefits

●Colonial Insurance - Post Tax Benefits – Can make changes any time for no reason!

Universal Life Term Life Voluntary AD&D Individual Accident Hospital – Medical Bridge Individual disability income policy Cancer insurance

US Legal services ($8.65 per pay)

Return Home

Ancillary (Voluntary) Benefits

●ADP TotalSource Auto/home insurance Group Universal Life Voluntary AD&D Legal services Pet insurance Individual universal and level term life Individual disability income policy Cancer insurance Employee Electronic Purchase Program (coming in 2010) ID TheftSmart (coming in 2010) Life-Prints (coming in 2010)

Return Home

HSA and HDHP

How Do I Qualify for a Health Savings Account?

To be eligible for HSA contributions, you must satisfy several

requirements on a monthly basis:

● Must have health coverage under a qualified High Deductible

Health Plan (HDHP)

● Cannot be covered under another health plan that is not a HDHP,

unless the health plan provides very limited coverage such as

dental or vision

● You must not be entitled to Medicare benefits or be eligible to be

claimed as a dependent on another person’s tax return Refer to page 20 in your Summary Plan Description

Return Home

Health Savings Account

How do I open my Health Savings Account?

● Complete the JP Morgan Chase application & send to the Employee

Service Center via mail or fax.

● It can take 30-45 days for the account to be set up.

● You can enroll online via the MyTotalSource.com website.

● Don’t Delay!

● After initial screening, the ESC will forward to Chase for the Identity

Verification Process. They will make 3 attempts to contact you.

● Provide necessary information as requested by JP Morgan Chase.

Return Home

HSA and HDHP – Additional Information

There is an Investment Fund Option:

● Account holders with a minimum balance of $2,000 will have access to enroll in

the HSA Investment Account which allows for a number of mutual fund options.

● Detailed information is available in the HSA Investment Service Description

booklet.

There are limitations for the use of FSA & HSA accounts:

● Participants can have both accounts during a plan year - provided that the FSA

is used to reimburse dental and vision expenses only.

● If you enroll in both the FSA and HSA, the FSA will be “limited’ to these

expenses only.

● Over-the-Counter drugs cannot be reimbursed under the FSA if you have an

HSA.

Return Home

HSA Enrollment Process

● Individual submits completed HDHP and HSA enrollment forms to ADPTS

(Note there is a separate HSA application to complete)

● ADPTS reviews the enrollment form for completeness and confirms the

applicant’s eligibility

● ADPTS verifies that all enrollment data matches the ADPTS database

● After the Employee’s enrollment return date has passed, ADPTS forwards

enrollment form to JPMC HSA Operations Center

● JPMC establishes the cardholder account

● JPMC stores image of application, including beneficiary information

● JPMC verifies applicant’s identity

● Card and welcome kit are sent to applicant by Chase’s fulfillment center after

the account opening date, along with the terms and conditions and a supply

of deposit slips

Return Home

Important Items to Note!

Return Home

What are pre-existing conditions?

●Only applicable with PPO Plans

● * Pre-existing conditions will be covered if you have had continuous health coverage with no longer than a 63 day break

●May be required to provide the carrier with a HIPAA certificate to show proof of prior coverage

Return Home

Pre-Certification & Step Therapy

●Pre-certification – encourages safe, cost-effective use of prescription drugs by requiring prior authorization by the carrier before certain drugs will be covered.

●Step-Therapy – some drugs are covered only after one or more prerequisites, clinically appropriate and cost-effective alternative drugs, are tried first – unless your doctor obtains a medical exception.

●Prescription drugs that require Pre-certification or Step-Therapy can be found on the carriers website

Return Home

Making Changes to your Benefits●You can make changes to your Pre-Tax benefit elections during the

following times:● Open Enrollment

Employee would make changes during the Spring months for an effective date of June 1st.

● Qualifying Event under Section 125 of IRS Code Employee must request QE change no later than 60 days from the date of the QE. (Reference page 28 of the Summary Plan Description)

Examples of Qualifying Events: • Change in Marital Status such as marriage, divorce, separation• Addition in Dependents such as birth, adoption, court order• Change in Employment such as hiring, termination,

beginning/ending of unpaid leave.

Return Home

Summary Plan Description BookletThis booklet summarizes the available benefit plan options.

● It will also include pertinent information about: Enrollment processes Flexible Spending Accounts (FSA) Health Savings Accounts (HSA) Consolidated Omnibus Budget Reconciliation Act (COBRA) Health Insurance Portability and Accountability Act (HIPAA) Qualifying Events Pre-Existing Conditions Other pertinent health care information

Return Home

Summary Plan Description Booklet

●Plan options may include for both Medical and Dental: HMO (Health Maintenance Organization) OA (Open Access) POS (Point of Service) PPO (Preferred Provider Organization) HDHP (High Deductible Health Plan)

●Please note: Plan options may vary by market/Employee location

Return Home

We value your partnership. Thank you for your time!

Return Home

Benefits Orientation Presentation. Today’s Agenda ● All About ADP Totalsource All About ADP...

Documents

Transcript of Benefits Orientation Presentation. Today’s Agenda ● All About ADP Totalsource All About ADP...