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2015 BENEFITS GUIDE

Welcome!Your Resurgens benefits package is an important and significant part of your total compensation. As a Resurgens employee, it is very important for you to be knowledgeable about the benefits we offer. This benefits guide is designed to help you make the best choices for you and your family and to help you under-stand how to take full advantage of your Resurgens benefits.

Resurgens Orthopaedics 1

Making Changes:At any time throughout the year, you may log on to the benefits por-tal and make changes such as an ad-dress change, beneficiary change or a change due to a qualifying change in status as described on page 4. Your request will be reviewed and upon approval, you will receive an email confirmation and your Human Resources and Payroll departments will be notified of any pertinent information.

As you enroll, the system auto-matically calculates the cost per pay period of your choices. Once completed, you may either print or email a confirmation of your new hire elections.

The contact for the Resurgens em-ployee benefit plans outlined in this guide is:

The Benefits HotlineArgus BenefitsPhone: (404) 974-3950Internal Extension: 50551Fax: (404) 260-6300Email: [email protected]

We encourage you to spend time reviewing your Ben-efits Guide and to keep it handy as your benefit needs arise. This guide will provide you with:• Important eligibility information• A general description of the benefits offered• How much the plans cost• How to make the most of the available plans

Online Enrollment/Benefits PortalFor your convenience, Resurgens utilizes an online ben-efits portal/enrollment system that allows for 24-hour access to your benefits information.http://resurgens.argusbenefitsonline.com

New Resurgens Employees:If you are a new Resurgens employee, you will re-ceive an email inviting you to go online and enroll for benefits. The invitation will provide instructions for your initial log on. Because Resurgens provides some benefits at no cost to you, you must go online to enroll even if you do not intend to participate in all of the of-fered benefits.

Employees in Open Enrollment:During Resurgens’ annual open enrollment (in April of each year), you will be provided instructions to log on and re-elect or confirm your benefits and update any personal information that needs to be changed.

Please contact the Benefits Hotline with your benefit and enrollment questions.

2015 BENEFITS GUIDE

Tips for Managing Your Health Care Costs!

Understanding how your benefits work and how to make them work for you can help you spend less money in health care costs.

• Review your 2015-2016 medical plan options care-fully.

• The POS Plan Option has a 4th Quarter Deductible Carry-Over feature. Any deductible amount you or your dependents incur in October - December of the calendar year will be carried over to the new calen-dar year.

• An FSA may allow you to pay for eligible out-of-pock-et expenses on a pre-tax basis. Take a few minutes to determine if this is a good option for you and your family.

• Get regular preventive care checkups.

• There are many generic prescription savings pro-grams available through local pharmacies. Printing the lists provided online by these pharmacies for your doctors’ visits could enable you to get your pre-scriptions at a reduced cost or even for free.

• Use in-network providers whenever possible.

• Ask questions.

• Ask for generic prescription drugs.

• Utilize the mail order prescription benefit.

• Request prescription drug samples.

• Establish a relationship with a primary care provider.

• Establish a relationship with a pharmacy.

• Carefully review your medical bills.

• Become a more knowledgeable consumer. It’s your health - manage it wisely!

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AVAILABLE BENEFITSFor the Plan Year May 1, 2015 to April 30, 2016

Is my family eligible for the benefit plans?• Your legal spouse or same-sex

domestic partner is eligible.

• Your dependent children from birth to age 26 are eligible. “Chil-dren” includes your children by birth, legal adoption, legal guard-ianship and step children.

• Your children age 26 years or older who are incapable of self-support (because of mental or physical incapacity which oc-curred prior to age 26) are also eligible for benefits subject to carrier approval.

Note Regarding Dependent Eligibil-ity: To protect the integrity of the Resurgens Health & Welfare plans and to control costs for you and Resurgens, we require proof of dependent status for each of your eligible dependents. We can provide a list of acceptable documentation, but generally a mar-riage certification for your spouse and birth certificates for your children are the simplest documents to provide.

What benefits does Resurgens offer?Medical (Meritain Health, a division of Aetna Insurance

Company)Vision (EyeMed)Dental (Guardian)Basic & Supplemental Life Insurance (Guardian) Basic & Supplemental AD&D Insurance (Guardian)Short Term & Long Term Disability (Guardian)Employee Assistance Program (EAP Works) Group Auto & Homeowners Insurance (MetPay)Flexible Spending Account (Basic)

Health CareLimited PurposeDependent Care

Health Savings Account (UMB Bank) Voluntary Legal Plan (Hyatt Legal)Health Reimbursement Account (Basic)

ELIGIBILITYWho can receive benefits?Regular full-time employees working 30 hours or more per week are eligible for the benefits described in this guide.

When do my benefits go into effect?New Resurgens Employees:

For new employees who enroll in a timely manner (within 31 days of your date of hire), coverage is effec-tive on the first day of the month following or coincid-ing with one month of employment. For example, if your date of hire is September 1, then your effective date is October 1. If your date of hire is September 2, then your effective date is November 1.

Employees in Open Enrollment:All changes for open enrollment are effective May 1, 2015.

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MAKING CHANGES TO YOUR BENEFITS

• A dependent child’s eligibility status changes (dependent turns age 26)

• Death of a spouse or child

• Change in residence that affects coverage

• A dependent child’s loss of cover-age under Medicaid or a state plan

• A dependent child becoming eligible for group health plan premium assistance, or losing cov-erage under a Medicaid or State plan.

Please note that the Flexible Spend-ing Account (FSA) status changes are more limited. Contact the Benefits Hotline at (404) 974-3950 if you have questions about those guidelines.

Should you experience one of the “change in status” events listed above and need to change your benefit elections, you must com-plete the change online within 30 days of the event. Argus Benefits will receive the request and notify you of the approval or request ad-ditional information as needed. The change you make to your coverage must be consistent with the change in status event.

You can make changes at any time to your elections for supplemental life, supplemental AD&D and/or long term disability (LTD) coverage because the payroll deductions for these benefits are taken after taxes. Changes will be subject to evidence of insurability and carrier approval.

The Children’s Health Insurance Pro-gram Reauthorization Act (CHIPRA) allows employees 60 days from the qualifying event to request a change in benefits.

Can I make changes and if so, how often?Once you make your benefits selections as a new hire, you will not be able to make a change to your benefits until one of the following situations occurs:

Annual Open EnrollmentOpen Enrollment occurs once a year during April for a May 1st effective date. During this time you are able to drop, add and change your level of coverage on the medical/vision, dental and FSA plans.

You Experience a “Change in Status Event”Because the medical/vision, dental, and Flexible Spending Account (FSA) plans are deducted from your paycheck before taxes, the IRS imposes restrictions on when you can make changes to these benefit plans. The only way you will be allowed to make a change during the plan year (May 1, 2015 through April 30, 2016) is if you experience a “change in status event”.

A change in status event includes the following:

• Marriage

• Divorce or legal separation

• Birth or adoption of a child

• Change in you or your spouse’s employment or insurance status


MEDICAL BENEFITS

Resurgens offers two medical/Rx plan choices, all of which are insured through Meritain Health, a division of Aetna Insurance Company. The cost of these plans is shared by you and Resurgens. Your portion is de-ducted on a pre-tax basis through payroll deductions.

Option 1: Choice Plus POS (Point of Ser-vice) Plan with an HRAKey Features of the POS Option with HRA

• The POS plan is a plan that generally covers 80% of your medical costs after your deductible is met. The deductible with this plan is $4,000 In-Network per Individual and $8,000 for the Family.

• Resurgens has added an HRA, a Health Reimburse-ment Account, with the POS Option to reduce the cost of the deductible for you. (See more about the HRA below.)

• The POS option does not require you to choose a Primary Care Physician and referrals to specialists are not required.

• Benefits include office visit and prescription co-pays

Please review the following pages as well as the sum-maries included in the Meritain Health enrollment booklet online for an overview of the benefits.

Health Reimbursement AccountAs part of the POS Option, employees have an HRA funded by Resurgens.

Single Coverage: The single deductible is $4,000. You will need to fund $2,500 of the deductible. Any amounts over $2,500 the company will reimburse you through the HRA, up to the total deductible. You will need to submit claim forms with a copy of the Merit-ain Health Explanation of Benefits (EOB) showing you are due the reimbursement.

Family Coverage: The family deductible is $8,000. You will need to fund $4,500 of this deductible. Any amounts over $4,500 the company will reimburse you through the HRA, up to the total deductible. You will

need to submit claim forms with a copy of the Meritain Health Explana-tion of Benefits (EOB) showing you are due the reimbursement.

Please note: Deductibles for Resur-gens’ Meritain Health plans are on a calendar year basis (January through December). The HRA will renew each January 1st unless you are otherwise notified. HRA funds may only be used to reimburse monies that you have paid towards your calendar year deductible. You have until March 31st, following the calendar year for which deductible expenses were incurred, to file your claims. Any unused HRA funds do not roll over to the next year.

Basic administers the Health Reim-bursement Account (HRA) plan on behalf of Resurgens. Employees who elect the POS Option will auto-matically be enrolled in the HRA.

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PRESCRIPTION DRUG BENEFIT with the POS option:

High Deductible Heath Plan(HDHP)

Health Savings Accounts(HSA)

With an HDHP / HSA, the employee is in control and will determine the best way to spend his or her healthcare dollars. This is achieved by designing a plan that is lower in monthly premiums and having an HSA as a savings account to be used if you need it. If it is not needed, it is a tax free way to help you build savings for future medical expenses. By making prudent healthcare buy-ing decisions, you can benefit from the savings of being enrolled in an HDHP/HSA. These plans provide greater flexibility and discretion over how healthcare dollars are spent, to encourage you to be a bet-ter healthcare consumer.

HSA contributions are deposited into an investment account much like an IRA that you control. The money contributed to an HSA can be used to pay for eligible health-care expenses that are typically not covered by the plan until you have met the calendar year deductible under the HDHP. Contributions to the HSA carry over from year to year and are portable so unused funds remain in your account without the risk of forfeiture, even if you termi-nate your employment with Resur-gens. This includes funds that the company deposits into your HSA, as well as any contributions you may make.

The copayments are:Generic: $4 copayBrand: $30 copayNon-Preferred: $50 copaySpecialty: $100 copay

You can determine if your medications are covered and at what copay level, prior to enrolling by following any of these steps:

• Access the 2015 Meritain Health Drug List on the benefits portal.

• Call your Employee Benefits Hotline at (404) 974-3950 or send an email to [email protected] for help determining how a specific drug is covered under your plan.

Option 2: High Deductible Health Plan with a Health Savings Account (HSA)

High Deductible Health Plan (HDHP) Option:• High Deductible Health Plan: $4,000 In-Network

Individual / $8,000 Family Deductible with a Health Savings Account

The High Deductible Health Plan (HDHP) / Health Sav-ings Account (HSA) option is considered “consumer driven healthcare”. The idea behind these types of plans is to put individuals in charge of their health care decisions. As medical costs continue to rise, we as consumers play an important role in keeping costs down. Becoming more aware of our medical expendi-tures, pursuing healthy lifestyles and getting routine preventive healthcare screenings are big steps toward taking control of our healthcare spending.


How does the HSA work?An HSA is a government regulated savings account for healthcare ex-penses that an employer and an em-ployee can contribute to for the em-ployee. Each year the U.S. Treasury sets the maximum annual contribu-tion limit. For the 2015 tax year, the limit is $3,350/single or $6,650/family (if you are covering dependents).

HSA Catch Up ContributionIf you are 55 or older or will turn age 55 during the plan year and you are currently eligible to contribute to a HSA, you are can make an additional catch up contribution of up to $1,000 pre-tax on a calendar year basis into your HSA.

If your spouse is 55 or older and meets the eligibility requirements, he could contribute an additional $1,000; however he would have to establish his own HSA in which to make that deposit. HSAs are individual custodial accounts; therefore the person who qualifies for the additional contribu-tion must place the money in his own account.

Resurgens will make contributions to your HSA, based on your level of medical coverage. On an annual basis you will receive:

• $800 for individual

• $1,600 for employee + spouse

• $1,600 for employee + child/ children

• $2,400 for family coverage

Resurgens will deposit its contribu-tion and your voluntary payroll con-tribution into your HSA on a monthly basis in the middle of the next month following your effective date.

Key Features of a HDHP (High Deductible Health Plan)• Lower insurance premium compared to the POS

Option.

• 90% benefit after deductible is met.

• No copays or coinsurance, but preventative health services are covered at 100% without being subject to the deductible.

• Once the deductible is met, there will be a copay on prescription drugs.

Key Features of a HSA (Health Savings Account)• Account funds can be used for qualified healthcare

expenses such as deductibles, prescriptions, lab fees, chiropractors, dental and vision claims, etc.

• Account funds can be accessed at a provider’s office or pharmacy via the VISA card, or claims for reim-bursement can be filed at any time in the future.

How does an HDHP work?The HDHP, administered by Meritain Health, an Aetna Insurance Company, has lower monthly premiums, however, you are responsible for all costs, includ-ing prescriptions, until the deductible is met. After the deductible has been satisfied, the plan pays 90% and you pay 10% until you satisfy your calendar year out-of-pocket maximum. For prescriptions, once your deductible is satisfied, you will move to a tiered-copay prescription plan to help pay your prescription costs until you reach your calendar year out-of-pocket maximum.

HSA EligibilityTo be eligible to open a HSA, you must satisfy the fol-lowing requirements:

• You cannot be covered be another health plan that is not an HDHP (including a Healthcare FSA that is not a Limited Purpose FSA).

• You cannot be enrolled in Medicare.

• You or your spouse cannot be claimed as a depen-dent on another person’s tax return.

• You must be enrolled in an HDHP as of the first of the month for which you are contributing.

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use the VISA Debit Card or submit a paper claim for reimbursement at a later date. Reimbursement and debit card usage is limited to the available balance. In other words, you can only be reimbursed up to the amount of funds in the HSA.

HSA VISA CARDYou will receive a VISA Debit Card from UMB Bank when you enroll in the HDHP/HSA; the card will be sent to your home address. You may use your debit card at doctors’ offices, pharmacies, hospitals, grocery stores, and any retailer where you may spend your HSA dollars for qualified medical, dental, or vision expenses. Card swipes at non-medical retailers like restaurants and gas stations are not allowed. If the provider does not accept VISA, you may pay for the service and request reimbursement over the phone by calling the toll-free number on the back of your debit card.

HSA VISA CARDResurgens partners with UMB Bank, located in Kansas City, Missouri, to provide seven fund families and over 188 mutual fund options. Once you have a $2,000 minimum balance in your HSA, your funds will initially be depos-ited into a money market account. You may access your individual account and change your initial in-vestments by logging onto www.umb.com. UMB’s HSA Customer Service is available to answer your questions Monday through Friday, 8:00 AM – 7:00 PM EST at (866) 520-4472.

If you would like to contribute the maximum amount allowed by the US Treasury, please contact the Benefits Hotline, so that they may assist you in the calculation. Please note that the deductible for the Resurgens plan runs on a Calendar Year basis.

If your contributions exceed the maximum limit, you may need to report the difference on your tax return, as the amount is subject to penalties and/or excise tax. Please consult your tax advisor for more information.

The money deposited into your HSA is available for eligible out-of-pocket medical, dental, and vision expenses this year or at any time in the future. If you elect this plan during the 2015 calendar year, the full calendar year deductible would apply for the remain-der of 2015. On January 1, 2016, your deductible will start over at $4,000/single or $8,000/family. Per IRS regulations for HDHP’s, the amount you accumulate towards your deductible in 2015 will not carry over to 2016 for the HDHP.When you incur a qualified medical expense, you can


MERITAIN HEALTH TOOLS AND PROGRAMS (AVAIL-ABLE ON BOTH MEDICAL OPTIONS)

To Find a ProviderNeed to find a Meritain Health in-network provider quickly? Meritain Health’s provider search is easy to use and no login is necessary. Just click on the “Start A New Search” link on the following site: http://www.aetna.com/docfind/custom/mymeritain/.

Your Network is the Aetna Choice POS II. From there you can choose to find a doctor, hospital, urgent care provider, pharmacy and more. You can also call Meritain/Aetna at 1(800) 343-3140 for assistance find-ing a provider.

ID CardsAll employees who enroll in a Resur-gens medical plan will receive an ID card at their home address.

Internet ServicesMeritain Health offers a wealth of health and wellness information at www.myMERITAIN.com. After enrolling in one of the Resurgens medical plans, you can regis-ter on www.myMERITAIN.com and view your benefits on Meritain Health’s member website. You can also:

• View your medical/prescription claims

• View Explanation of Benefits (EOB)

• View/order member ID cards

You can also get help by calling Customer Service at 1(800)-925-2272. Your Resurgens Group Number is 14464.

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Calendar Year Deductible• Individual• Family

Calendar Year Out-of-Pocket Max• Individual• Family

Coinsurance

Physician Office Visits

• Primary Care Physician • Specialist

Maternity Services • Physician Services • Inpatient Maternity Care

Inpatient Hospital

Outpatient Hospital

Routine Laboratory Services

Outpatient Advanced Imaging (PET, MRI, MRA, CAT, SPECT scans)

Emergency Services

Urgent Care Services

Mental Health and Substance Abuse

• Inpatient • Outpatient

Prescription Drug Benefits (30 day supply)• Generic • Brand• Non-Preferred• Specialty

• Mail Order (90 day supply)

$4,000$8,000

NOTE: includes Annual Deductible + Copays

$6,600$13,200

Plan pays 80%, you pay 20% up to the out-of-pocket max

Preventive Care is covered at 100%NOTE: Office Visit Copay will be waived for

Resurgens EEs & Covered Dependents to Resurgens facilities

(Exception-Rehab visits)

$25 Copay$40 Copay

One-Time $40 CopayYou pay Ded. + 20%

You pay: Deductible + 20%


Plan pays 100% after copay

$40 copay

$150, waived if admitted$200 ambulance

$50

$4,000$8,000

NOTE: includes Annual Deductible + Copays

$6,050$12,100

Plan pays 90%, after deductible

Preventive Care is covered at 100%& Deductible is waived. Deductible applies for all

other provider office visits.








You pay Ded. + 20%$25 copay

$4 copay$30 copay$50 copay

$100 copay

$25 for Generic / $75 for Brand / $125 for Non-Preferred / $250 for

Specialty


$10 copay$35 copay$60 copay

$25 for Generic / $87.50 for Brand / $150 for Non-Preferred

NOTE: Mental health benefits no longer have limitations and are treated as any other illness per the Mental Health Parity and Addiction Equity Act

2015-2016 Meritain Health an Aetna Insurance Company Medical Plan OptionsIn-Network Benefits

Choice Plus POS Option High Deductible Health Plan with HSA


The Prescription Drug Prior Authorization & Step Therapy Programs:

Meritain Health / Mail Order Pharmacy ServicesFor your convenience, plan-ap-proved maintenance medications are available through mail order from Scrip World, powered by CVS Caremark. You may receive up to a 90-day supply per prescription or refill through the mail.

If you have the POS you could re-ceive a 90-day supply by mail order and only pay:

• $25 for a Generic drug

• $75 for a Brand drug

• $125 for a Non-Preferred drug

• $250 for a Specialty drug

If you have the HDHP you could re-ceive a 90-day supply by mail order and only pay:

• $25 for a Generic drug

• $87.50 for a Brand drug

• $150 for a Non-Preferred drug

For additional information or help, visit www.caremark.com or call member services at the number located on the back of your Meritain ID card. For assistance with mail or-der or specialty drugs, contact Scrip World at 866-475-7589.

The Prior Authorization program requires approval for select medications to ensure that 1) the drug is covered under the Rx benefit, and 2) the drug is pre-scribed following FDA guidelines/indications. Before coverage for these drugs can be obtained, your physi-cian must obtain prior authorization from Meritain Health.

There may also be dispensing limits on certain medi-cations. These limits may be based on FDA or manu-facturer’s recommendations. For a listing of medica-tions requiring prior authorization or medications with dispensing limits, please visit www.caremark.com.There are some drugs on the pre-authorization drug list that may require step therapy. Step therapy means that your doctor will need to prescribe one medica-tion before trying another. You only “walk the steps” once, but prior approval may be needed since Meri-tain Health may not have a record from your health care provider that you have already tried a certain drug once.

Step therapy requires the use of a more cost-effective (Step 1) drug rather than a less cost effective (Step 2) drug. Drugs that qualify for step therapy are often high priced and largely advertised. The program’s goal is to have members try lower cost alternatives be-fore jumping to the most expensive brand-name drug. The program operates according to accepted medical guidelines and standards.

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TOBACCO FREE DISCOUNT

declined coverage with his or her employer, then the spousal sur-charge will be applied.

Commonly Asked Questions:Why did Resurgens add this sur-charge?Resurgens is proud to offer a highly competitive benefits package to its employees. In order to continue to offer these very attractive benefits we must do everything possible to keep our costs in line. Resurgens is implementing the surcharge to encourage spouses to participate in plans made available to them through their own employers or through the government.

What is a surcharge?A surcharge is an additional cost to you above the normal per pay period deduction associated with the health plan and coverage level you select.

How much is the surcharge in 2015?The surcharge is $85.00 per month

Who is NOT subject to the surcharge?Employees who have spouses who do not have medical insurance available through their employer or through a government plan (not including government exchange option) are not subject to the sur-charge. A Spouse Surcharge Waiver must be completed to waive the sur-charge in 2015. This form is electron-ic and is completed as part of the benefits open enrollment process.

Does the Working Spouse Surcharge apply to the dental plan?No

Beginning May 1, 2009 Resurgens Orthopaedics be-gan offering tobacco-free employees an opportunity to receive a discount of $75 per month on their health plans. In order to qualify for this discount, a Tobacco Free Attestation must be completed attesting that you have not used tobacco products during the past 90 days and have no intention of using any form in the future and therefore qualify for the discount.

If you do not remain tobacco-free you are required to inform Resurgens’ benefits administrator at [email protected]. You will then cease to qualify for the monthly discount. You may qualify for the discount even as a tobacco user by providing a certification from your personal physician indicating:

1. that it is unreasonably difficult, due to a medical condition, for you to cease tobacco use or that it is medically inadvisable for you to attempt to cease tobacco use; and

2. that I am currently participating in a medically supervised program designed to help you become tobacco-free or to achieve a standard that your physician believes is an acceptable alternative to being tobacco-free.

SPOUSAL SURCHARGE

Resurgens has a monthly surcharge of $85 to em-ployee insurance contributions when an employee chooses to carry his/her spouse on Resurgens’ medi-cal insurance and the spouse has insurance coverage available through his/her employer.

If the employee’s spouse does not have coverage available through his/her employer, the spousal sur-charge will not apply.

It is the responsibility of the employee to notify Resurgens Orthopaedics of coverage availability for a spouse who is enrolled in the medical program with an effective date on or after May 1, 2015. If coverage has become available to that spouse through his/her employer after enrollment in the Resurgens Ortho-paedics Medical Benefits Program, the spouse has an effective date of May 1, 2015 or later, and the spouse


VISION PLAN

Contact Lenses Each calendar year you may choose to receive contact lenses instead of eye glasses. For disposable contacts, there is a $140 allowance. Conven-tional contacts have a $140 allow-ance and 15% off balance over $140. Medically Necessary contacts are paid in full.

Please note you may receive glasses (lenses and frames) or contacts, but not both in the same 12-month period.

To Find a Provider To locate a participating provider, you can access the EyeMed Pro-vider Directory by going online to www.eyemed.com and choose the INSIGHT network. Or, you may call EyeMed directly at 1(866)-939-3633.

To File an Out-of-Network ClaimIf you choose an out-of-network provider, you will need to complete the out-of-network claim form and submit it along with your itemized receipt via fax to 866-296-7373 or you may mail it to: EyeMed Vision Care, Attn: OON Claims, P.O. Box 8504, Mason, Ohio 45040-7111. You can also email your claim to [email protected].

ID Cards Though an ID card is not required, EyeMed will mail members two ID cards each. If you would like to request additional cards, please call the EyeMed Customer Care Center at 1(866)-939-3633

A vision plan is included as part of the Resurgens med-ical benefit. The vision carrier is EyeMed. If you enroll in one of the Meritain medical plans, you automati-cally receive the vision benefit at no additional cost to you. You and all dependents that you cover under the medical plan are also covered with vision. Employ-ees cannot elect vision without taking the Resurgens medical plan. EyeMed has a network of participating providers from which you may choose. The EyeMed vision provider network has a wide variety of participating optom-etrists, including LensCrafters, Pearle Vision, Sears Op-tical, Target Optical, and JCP Optical. You will receive the best benefit by going to an in-network provider. Although you do receive the best discount by visiting a participating provider, there is still a benefit should you go out-of-network. For out-of-network benefits, you will be partially reimbursed for the cost of exams and materials. The frequency limitation is the same as in-network. You will need to submit your itemized receipts to the EyeMed Claims Department for reim-bursement.

Eye ExamThe plan provides covered members with one refrac-tive exam once every 12 months. There is a $10 in-network exam copay.

GlassesSeparate from the vision exam is the materials benefit. Every two years you may select any eyeglass frame and receive a $140 allowance. Lenses are a $10 copay and each calendar year you may receive one stan-dard plastic single vision lenses, one standard plastic bifocal lenses, or one standard plastic trifocal lenses. There are additional costs associated with certain lens upgrades.

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Routine Eye Exam

Exam Frequency

Lenses for Glasses• Single Vision• Bifocal• Trifocal

Lens Options-Upgrades • UV Coating • Tint (Solid and Gradient)• Standard Polycarbonate• Transitions

Lenses Frequency

Frames

Frames Frequency

Contact Lenses• Elective: Disposable• Elective: Other Elective Contact Lenses• Medically Necessary

$10 exam copay

(This does not include charges for follow-up

contact fitting exams, which may be extra).

$10 materials copay

$0$0

$40 ($0 for children under 19)$75

$140 allowance

$140 allowance$140 allowance + 15% off remaining balance

Covered in full

Up to $30

Up to $25Up to $40Up to $60

Up to $11Up to $11

N/A ($0 for children under 19)N/A

Up to $112

Up to $112Up to $112Up to $140

Once every 12 months



EyeMed Vision Plan Overview

Vision Benefits In-network Meritain Provider Out-of-Network ProviderReimbursement


DENTAL BENEFITS

Please visit www.guardianany time.com and click on Find a Pro-vider or call your dentist’s office and ask if they are in the DentalGuard Preferred Network. Or, you may call Guardian directly at 1-888-600-1600.

Your plan is the PPO and the net-work the DentalGuard Preferred Network. Below is a brief overview of the plan design.

Please note: If you do not elect dental when it is first available to you and you enroll late, there will be a 12 month waiting period for basic, major, and orthodontic coverage.

Resurgens offers two dental plan options through Guardian: the Value Plan and the Network Access Plan (NAP). The Value Plan is a great option if you always use network providers. With this plan, member ben-efits are based on discounted (negotiated) rates at in-network dentists. If you go out-of-network, you would pay the difference over the network negotiated rates. If you want freedom to choose between in-network and out-of-network providers, the Network Access Plan (NAP) might be the best option for you. In-Network, member benefits are based on discounted (negotiated) rates. If you go out-of-network, member costs are based on usual and customary (UCR) rates.

Calendar Year Maximum per person

Calendar Year Deductible($50 per person to a maximum of three family members, at which point the fam-ily deductible would be met in full)

Diagnostic & Preventative Services(Deductible Waived)Oral exams, cleanings, x-rays, specialist consultations, fluoride treatment, sealants, and space maintainers

Minor ServicesOral surgery, restorative services, palliative treatments, denture repairs, endodontics (root canals), periodontics (gum treatment) and general anesthesia

Major ServicesCrowns, cast restorations and prosth-odontics (bridges, partial and full dentures)

Orthodontia Services(For Adults and Children)

Orthodontia Lifetime Maximum

100% covered

100% covered after deductible(up to the Calendar Year Maximum)

You pay 40% after deductibleThe plan pays 60%

(up to the Calendar Year Maximum)

You pay 50% after deductibleThe plan pays 50% (up to the

Orthodontia LIFETIME Maximum)

100% covered





You pay 50% after deductibleThe plan pays 50% (up to the

Orthodontia LIFETIME Maximum)

$1,500

$1,500

$50 Individual / $150 Family

Dental Benefits

2015-2016 Guardian Dental Plan Overview

Value Plan Network Access Plan (NAP)

2015-2016 Guardian Dental Plan Overview

2015 BENEFITS GUIDE

16

Dental Maximum Rollover – Save Your Unused Claims Dollars For When You Need Them Most

MRA may not exceed the MRA limit. You can view your annual MRA statement detailing your account and those of your dependents on www.guardiananytime.com.

College Tuition Benefit RewardsUp to one year’s tuition at a SAGE Scholar College. There are over 330 private colleges and universi-ties across the nation in the SAGE Consortium. One Tuition Reward point = $1.

2,000 Tuition Rewards are given to each dental plan subscriber when they register an eligible student or students. Subscriber Tuition Rewards can be allocated to any registered student.

500 Tuition Rewards are given to each student registered.

2,000 additional Tuition Rewards are given to the subscriber, annually in the month following the Dental Plan’s renewal.

2,500 bonus Tuition Rewards are given to the subscriber the month following the Dental Plan’s third renewal (4th year), for a total reward of $4,500 for that year. Additional information and registra-tion is available at: www.guardian.collegetuitionbenefits.com.

Guardian will roll over a portion of your unused an-nual maximum into your personal Maximum Rollover Account (MRA). If you reach your Plan Annual Maxi-mum in future years, you can use money from your MRA. To qualify for an MRA, you must have a paid claim (not just a visit) and must not have exceeded the paid claims threshold during the benefit year. Your

Plan Annual Maximum

$1,500

Maximum claims reimbursement

Threshold

$700

Claims amount that determines rollover

eligibility

Maximum Rollover Amount

$350

Additional dollars added to Plan Annual Maximum for future

years

Maximum Rollover Account Limit

$1,250

Plan Annual Maximum plus Maximum Rollover cannot exceed

$2,750 in total


PREMIUM CONVERSION AND FLEXIBLE SPENDING ACCOUNTS

from each paycheck, deducting it from your earnings on a pre-tax basis. Throughout the plan year, you can use your Basic Benefits VISA Card to pay for qualified expenses or you can manually submit a claim form for reimbursement.

What kinds of expenses qualify?Expenses must be medically neces-sary, including approved over-the-counter medications. You can get reimbursed for items such as:

• Deductibles under health plans

• Copayments

• Coinsurance

• Dental Expenses

• Vision care and related hardware

• Prescription drugs

• Approved over-the-counter (OTC) medications

• Durable medical equipment

How much should you contribute to the Healthcare FSA?Review provider bills, tax receipts, checkbook register and other records for the past two years to estimate your healthcare expenses. If you need help estimating the amount of eligible out-of-pocket ex-penses you will have, please contact your Employee Benefits Hotline at 404-974-3950 for assistance.

You may elect to contribute up to $2,550 per plan year (5/1/15 – 4/30/16) into the Standard or Limited Purpose Healthcare FSA.

Resurgens Orthopaedics offers its employees the op-portunity to save tax dollars through a special provi-sion under IRC Section 125. This is known as a Flexible Benefit Plan. There are two components to a Flexible Benefit Plan: the Premium Only Plan and the Flexible Spending Accounts.

The Premium Only component allows employees to pay their medical/vision and dental insurance con-tributions on a pre-tax basis. Your taxable income is reduced by your pre-tax deductions, therefore the amount of taxes taken from your paycheck is lower and your take-home pay is higher than it would be if you were not in the premium conversion plan. The plan year runs from May 1 through April 30 with an annual enrollment period usually held in April. If you elect to participate in the medical/vision and dental insurance programs through Resurgens Orthopaedics, you will automatically participate in the Premium Only Plan and receive the benefit of pre-tax deductions.

The second component in the Section 125 Plan is the Flexible Spending Accounts for Healthcare and Dependent Care reimbursement. You have the option to set aside funds each pay period, on a pre-tax basis, which can be used for reimbursement of qualified expenses. Basic administers the Flexible Spending Accounts for Resurgens. The FSA plans require re-enrollment each year.

FLEXIBLE SPENDING ACCOUNTS Resurgens offers three types of Flexible Spending Accounts: 1) Healthcare FSA, 2) Dependent Care FSA, and 3) Limited Purpose FSA.

Healthcare FSAThe Healthcare FSA allows you to set aside pre-tax earnings to pay eligible healthcare expenses for the plan year. By having your estimated expenses deduct-ed from your paycheck before taxes are taken out, you can save money on the taxes you pay.

How does it work?You decide how much money you want to set aside for healthcare expenses for the coming plan year. Re-surgens will withhold an equal portion of that amount

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18

Note: In certain situations, a Depen-dent Care FSA may not work to your advantage. Lower income families may recognize more tax benefit by not electing to utilize a Dependent Care FSA.

What kinds of expenses qualify?Dependent Care refers to the care of a dependent under age 13, or a mentally or physically disabled de-pendent of any age. In addition:• Dependent care must be neces-

sary so that you and your spouse (if applicable) can work

• Monthly dependent expenses cannot exceed the income of you or your spouse, whichever is less

• Selected daycare facility must be state licensed

• Summer day camp

• Eligible housekeeping services

• Adult and senior daycare services (subject to IRS limitations)

• Before-school and after-school care

How much should you con-tribute to the Dependent Care FSA?Review all bills, expense vouchers, tax receipts, checkbook register and other records for the past two years. With this guide, estimate the expenses you may incur for the coming plan year.

You may elect up to $5,000 per year based on current IRS regulations, or $2,500 for married couples filing separately.

There Are Special Rules That Apply To FSA PlansIn return for tax-saving advantages, the federal gov-ernment has certain restrictions on FSA Plans:• Plan carefully. Any funds left over at the end of the

year will be forfeited. However, with proper plan-ning, no money should be lost.

• Healthcare and Dependent Care FSA plans are sepa-rate – dollars you put into one account cannot be transferred to another.

• Save your receipts. You should save all of your re-ceipts in case you need to verify a purchase or if you were to ever be audited by the IRS.

• You can only change the amount of your contribu-tion if you have a qualifying event or family status change, such as:

- Marriage- Divorce or legal separation- Change of employment by spouse- Birth or adoption of a child- Death of a child or spouse- Change in daycare provider (applies to Depen-

dent Care FSA only)- Change in cost of daycare (applies to Dependent

Care FSA only)

You may elect to contribute up to $2,550 per plan year (5/1/15 – 4/30/16) into the Standard or Limited Purpose Healthcare FSA.

Dependent Care FSA The Dependent Care Plan allows you to set aside pre-tax money to pay dependent care expenses for the coming plan year. By having your estimated expenses deducted from your earnings pre-tax, you can save money on the taxes you pay.

How does it work?Decide how much money you want to set aside for the coming plan year’s dependent care expenses. Resur-gens will withhold an equal portion of that amount from each paycheck on a pre-tax basis. Throughout the year, you can manually submit a claim for reim-bursement or use your Basic card.


Online Access Basic makes it easy with around the clock online access to your accounts to keep track of your funds and submit claims at https://hrbenefits direct.com/Basic. You can also sub-mit a claim form to Basic through fax at 800-731-1922.

BASIC’s Customer Service Line: 1(800)-444-1922

Administrative Information You must enroll online for the Healthcare FSA, Limited Purpose FSA and/or Dependent Care FSA each year. You will be asked to designate the amount(s) you want redirected from your paycheck to your FSA account(s). Keep in mind that you won’t be able to make a change to your election(s) until the next open enrollment period unless you experience a change in status event that warrants altering your election. Also remember that amounts unused as of April 30, 2016 will be forfeited.

Limited Purpose FSAResurgens Orthopaedics offers employees enrolled in the HDHP Option the ability to enroll in a Limited Pur-pose FSA. A Limited Purpose FSA is a pre-tax saving option for employees who are also enrolled in a Health Savings Account (HSA). The Limited Purpose FSA works in much the same way that a regular FSA does. You still need to plan carefully. Any funds left over at the end of the year will be forfeited.

The main difference in the Limited Purpose FSA and the Standard FSA is that it limits what expenses are eligible for reimbursement. In a Limited Purpose FSA, you can only submit claims for eligible vision and den-tal expenses that are not covered by the Medical Plan and that are Code Section 213(d) Health Expenses.

Important: Claims must be filed within 90 days of the end of the plan year (by July 31st) in order to be consid-ered for payment.

Basic Visa Debit Card The Healthcare FSA, Limited Purpose FSA, and Depen-dent Care plans from Basic automatically include the Visa Debit Card which makes using your benefit dol-lars simple. Whether you use the card for medical ex-penses, dental expenses, or vision expenses, the card deducts each purchase or payment directly from the appropriate account, so it’s as convenient as using an ordinary credit card. What’s more, the Debit Card and easy online account access virtually eliminate the end-less paperwork and reimbursement wait time which used to complicate flexible benefit plans. Be sure to save your receipts when you use the card. Although rare, in some cases, you may be asked to provide them for verification purposes.

If you sign up for the Healthcare FSA, Dependent Care FSA, or the Limited Purpose FSA, you will receive a Visa Debit Card at your home address.

2015 BENEFITS GUIDE

20

LIFE INSURANCE BENEFITS

your application is approved. If Guardian were to deny your applica-tion, you would still have coverage up to the GIA level.

Supplemental Life InsuranceResurgens provides an opportunity for you to purchase life insurance coverage on your spouse and/or de-pendent children. For your spouse, you may purchase coverage in incre-ments of $5,000 up to a maximum of 50% of your life benefit rounded to the next higher $5,000 or $250,000, whichever is less. The GIA for a spouse is $25,000. You must purchase coverage on yourself in order to purchase coverage on your family members. You may purchase $5,000 of coverage for each child.

Important Note: If you don’t enroll in Supplemental Life coverage when first eligible as a new hire, you will be required to submit an Evidence of Insurability Form (EOI) medical ques-tionnaire, if you decide to elect cover-age at a later date, even if the elected amount is below the GIA. Guardian must approve your application before your coverage will go into effect.

The Resurgens Basic Life Insurance Plan offers protec-tion through Guardian. Resurgens pays the full cost of Basic Life Insurance. All eligible employees are auto-matically enrolled in the Basic Life plan.

Basic Life InsuranceThe amount of your Basic Life insurance policy is equal to the amount of your annual earnings rounded to the next highest thousand, up to a maximum of $50,000. For example, if your earnings are $35,500 per year, Resurgens provides you with $36,000 in Basic Life Insurance.

Supplemental Life InsuranceYou may elect supplemental life coverage for yourself in increments of $10,000 up to a maximum of five (5) times your basic annual earnings or $500,000, which-ever is less.

You pay the full cost of your supplemental life cover-age through payroll deductions on an after-tax basis. The cost is determined by age, salary and the amount of coverage you elect. The Guaranteed Issue Amount (GIA) for the supplemental life is $200,000. The GIA is the amount of coverage you may elect without hav-ing to provide an Evidence of Insurability (EOI) form (medical questionnaire) to Guardian. If you elect an amount above the GIA, you will be required to submit an EOI form to Guardian. The amount of coverage elected in excess of the GIA will not go into effect until

Minimum Benefit

Maximum Benefit

Guaranteed Issue Amount (GIA)

Flat Rate - Age 6 months to 21 years old

Age 14 days to 6 months

Minimum Benefit

Maximum Benefit

Guaranteed Issue Amount (GIA)

$10,000

Lesser of $500,000 or 5x Basic Annual Earnings

$200,000

$5,000

$500

$5,000

$250,00 up to a maximum of 50% of the Employee Supplemental Life amount

$200,000

Benefits reduce to 65% at age 65, to 45% at age 70, to 30% at age 75, to 20% at age 80, and 15% at age 85 for active employees

Benefits reduce to 65% at age 65, to 45% at age 70, to 30% at age 75, to 20% at age 80, and 15% at age 85 for active employees

Employee Supplemental Life Options - Purchase in increments of $10,000

Child Supplemental Life

Spouse Supplemental Life Options - Purchase in increments of $5,000


How To EnrollYou will indicate the employee and dependent supplemental life cover-age amounts on the enrollment website. Please remember that you cannot elect supplemental life cov-erage on your dependents unless you elect it on yourself.

How To Calculate Your Benefit CostTo determine how much will be deducted from your paycheck, take the rate for your age group and multiply by the amount of coverage you want to elect (in thousands). If you are paid bi-weekly, use the rates from the bi-weekly column. If you are paid semi-monthly, use the rates from the semi-monthly column. Remember the system will automat-ically calculate your payroll deduc-tions as you enroll online. You will see a running total on the screen as you make your election entries.

Accelerated Life BenefitThe Resurgens life insurance pro-gram offers an accelerated benefit. If you are diagnosed as terminally ill with six months or less to live, you may apply for an advanced benefit of up to $100,000 of your life insurance prior to death. Please consult the life insurance booklet on the benefits portal for more details.

WillPrep ServicesWillPrep Services are available to eligible members who enroll in a Voluntary Life plan. WillPrep Services offer support and guidance to help you properly prepare the documents necessary to preserve your family’s financial security. WillPrep has a range of services including online planning docu-ments, a resource library and access to professionals to help with issues related to Financial Power of At-torney, Estate Taxes and Living Wills.

For more information about WillPrep Services, go to www.ibhwillprep.com; User Name: WillPrep; Password: GLIC09 or call 1-877-433-6789.

Beneficiary InformationMake sure to assign a beneficiary for your life insur-ance through the Resurgens benefits portal. Provide the name of your primary beneficiary and his/her relationship to you for all your life insurance policies. It is suggested that you name a contingent beneficiary in the event something happens to your primary. You will automatically be the beneficiary for any supplemental life insurance coverage elected on your dependents.

Even if you do not enroll in supplemental life insurance, you still must designate a beneficiary online for the Basic Life Insurance Plan.

2015 BENEFITS GUIDE

Age

Under 30

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75+

Rate

$0.07

$0.09

$0.11

$0.14

$0.22

$0.32

$0.54

$0.89

$1.46

$2.26

$3.40

Rate

$0.07

$0.09

$0.11

$0.14

$0.22

$0.32

$0.54

$0.89

$1.46

$2.26

$3.40

Bi-Weekly Cost per $1,000

$0.032

$0.042

$0.051

$0.065

$0.102

$0.148

$0.250

$0.411

$0.674

$1.043

$1.570

Semi-Weekly Cost per $1,000

$0.035

$0.045

$0.055

$0.070

$0.110

$0.160

$0.270

$0.445

$0.730

$1.130

$1.700

SUPPLEMENTAL LIFE RATES FOR THE EMPLOYEE AND SPOUSE:(Per $1,000 per Month)

CHILD LIFE RATES:The child life rate is $.60 per month for $5,000 of coverage regardless of how many children are cov-ered under your plan. Certain age limits apply. Please see the preceding page for additional details.

Making Changes To Your Life InsuranceYou may make changes or terminate your supplemen-tal life insurance elections at any time throughout the year. This includes dropping some or all of your Supplemental Life coverage, or purchasing additional amounts of coverage on yourself and/or your depen-dents. Please indicate any changes on the Resurgens enrollment website, or contact the Employee Benefits Hotline for assistance. Evidence of Insurability will be required when increasing life insurance amounts.

File A ClaimIn the event of death, a certified copy of the death cer-tificate is required to file a claim. Please contact the Benefits Hotline for assistance in filing a claim.

Please refer to the official plan documents for detailed information on plan limitations and exclusions.

22

Please contact your Employee Benefits Hotline with any life insurance questions.Phone: (404) 974-3950Internal Extension: 50551Fax: (404) 260-6300Email: [email protected]

Resurgens Orthopaedics

ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) COVERAGE

up to $250 per family member, up to $1,000 total per insured’s death.

• Helmet: Pays an additional 50% of coverage, up to $25,000, if death occurs in a motorcycle ac-cident while wearing a helmet.

• Seat Belt: Pays an additional 25% of coverage, up to $25,000, if death occurs in an automobile ac-cident while wearing a seat belt.

• Air Bag: Pays an additional 10% of coverage, up to $5,000, if a Seat Belt benefit is paid, and if an air bag was also in place and inflated on impact.

• Dependent Education – Child: Reimburses education costs for dependent children who are enrolled full-time in a post-sec-ondary school before age 26 and within 1 year of the employee’s death. The annual payment per child is capped at 5% of coverage, up to $2,500, for up to 4 consecu-tive years.

• Dependent Education – Spouse: Reimburses retraining expenses for the spouses, which are in-curred within one year of the employee’s death, up to $3,000.

In the event of accidental death or dismemberment (AD&D), an AD&D Plan can provide additional coverage above other insurance benefits.

Employee AD&D CoverageResurgens provides Basic AD&D cover-age to you as part of your Basic Life Insurance. The amount of AD&D cover-age provided to you equals the amount of your Basic Life coverage.

You have the opportunity to purchase additional supplemental AD&D coverage on yourself. You may purchase AD&D coverage in increments of $10,000 up to $500,000, not to exceed ten times your basic annual earnings.

Family AD&D CoverageIn addition to yourself, you may purchase Family AD&D coverage at a low group rate. Coverage is as follows:

• For your spouse: Coverage equals 40% of your (em-ployee) amount to a maximum of $250,000. Spouse coverage will be raised to 50% of employee amount if there are no covered children at time of death.

• For your eligible children: Coverage equals 10% of your (employee) amount. Child coverage will be raised to 15% of employee amount if there is no covered spouse at time of death

Additional AD&D BenefitsOther Benefits included in this plan (the following benefits apply for all participants in the plan):

• Felonious Assault: Pays an additional 25% of cover-age, up to $25,000, if an employee’s loss is due to a felonious assault while at work or while traveling on business.

• Bereavement Counseling: Reimburses expenses incurred for bereavement counseling for immediate family members within one year of a covered death,

23

2015 BENEFITS GUIDE

24

2015 – 2016 Voluntary AD&D Insurance CostThe table below shows the employee and dependent rates, per thousand dollars of coverage. Remember that the online enrollment system will calculate your portion of the cost for benefits as you go through the enrollment process.

Employee

Family

Monthly

$0.022

$0.041

Semi-Monthly

$0.011

$0.021

Bi-Weekly

$0.010

$0.019

Rate per $1,000 of coverage

Voluntary AD&D Insurance Cost

CoverageLevel


SHORT TERM DISABILITY (STD) COVERAGE

• If you are in an occupation that requires you to maintain a license, your failure to pass a physical examination required to maintain a license to perform the duties of your occupation alone, does not mean that you are disabled from your occupation.

Or

• You are prevented by Injury, Sick-ness, Mental Illness, Substance Abuse or Pregnancy from per-forming some, but not all of the essential duties of your occupa-tion, are working on a part-time or limited duty basis and as a result, your current weekly earnings are more than 20%, but are less than or equal to 80% of your pre-dis-ability earnings.

How To File A ClaimIf you become disabled, please call Guardian/Teleguard at (888) 262-5670 immediately. They will take your claim information over the phone. Your group number is 00511827.

In addition, please review your official plan documents and con-sult with the Benefits Hotline as to whether or not you will be required to continue payroll deductions/contributions for any Supplemental Life/AD&D insurance you may have while you are on leave.

Please contact the Benefits Hotline with questions.Phone: (404) 974-3950Fax: (404) 260-6300Email: [email protected]

Resurgens provides eligible employees with Short Term Disability (STD) coverage at no cost to the employee through Guardian. Disability insurance can replace a substantial portion of your income if you become disabled.

Class 1:All active full-time executives, directors, administra-tors, physician assistants and nurse practitioners

Class 2:All other active full-time employees

Note: Physicians are not eligible for STD

Plan DesignThe STD plan provides you a weekly income of 60% of your basic weekly earnings (including bonuses and commissions, but not overtime or other forms of ad-ditional compensation). The maximum weekly benefit is $3,333 for Class 1 employees and $1,300 for Class 2 employees. STD benefits are offset by any disability or retirement income from Social Security, Workers Compensation or any other insurance made available through an employer.

STD income benefits start on the 8th day of an ac-cident and on the 8th calendar day of a sickness. Benefits under the STD plan end on the 90th day of disability. If your disability lasts longer than 13 weeks and you have elected Long Term Disability (LTD) coverage, the claim will automatically be referred to Guardian’s LTD unit for review.

Definition of DisabilityYou are considered “disabled” if:

• You are prevented by Injury, Sickness, Mental Illness, Substance Abuse or Pregnancy from performing the essential duties of your occupation, and as a result, you are earning less than 20% of your pre-disability earnings.

25

2015 BENEFITS GUIDE

26

LONG TERM DISABILITY (LTD) COVERAGE

You are considered “disabled” if:

Class 1: Employees are considered disabled if you cannot perform one or more of the essential duties of:

• Your occupation during the 90-day Elimination Period, and,

• Your occupation following the Elimination Period and as a result current monthly earnings are less than 80% of your indexed pre-disability earnings.

Class 2: Employees are considered disabled if you cannot perform one or more of the essential duties of:

• Your occupation during the 90-day elimination period,

• Your occupation for the 24 months following the elimina-tion period, and as a result your current monthly earnings are less than 80% of your indexed pre-disability earnings, and,

• After that, any occupation.

Important Note: Please be aware that you could waive your right to elect LTD coverage as a new hire, but then sign up for it later. If you wish to add coverage at any time other than as a new hire, you will be required to complete a medical questionnaire and satisfy evidence of insurability.

How To File A ClaimPlease call Guardian/Teleguard at (888) 262-5670 to file a claim. The intake process can be done over the telephone. Your group number is 00511827.

Please contact the Benefits Hotline at (404) 974-3950 with questions about the process.

Have you ever wondered how you would pay your bills or provide for your family if something were to happen and you were unable to work?

LTD insurance can replace a substantial part of your compensation if you become disabled, as it could pro-vide you with a regular monthly income. Resurgens feels strongly that employees need this benefit. So Resurgens pays 74.5% of the cost of the LTD coverage for eligible employees.

If you elected LTD coverage and were still disabled af-ter you exhausted your STD benefits, the claim would be forwarded to Guardian’s Long Term Disability de-partment. If the claim is approved, your LTD benefits will go into effect. The plan works similarly to the STD plan, except that the benefits are paid on a monthly basis. In other words, the LTD benefit will pick up where the short term disability leaves off.

Class 1:All active full-time physicians, executives, directors, administrators, physician assistants and nurse practi-tioners

Class 2:All other active full-time employees

Plan DesignYou would receive 60% of your basic monthly earn-ings up to a maximum monthly benefit:

• Class 1 maximum monthly benefit is $15,000

• Class 2 maximum monthly benefit is $10,000

When LTD Benefits Begin and EndLTD benefits begin after you have been disabled for ninety (90) days (which would coincide with the termination of the STD benefits). The benefit could remain in place up to the Social Security Retirement Age (SSNRA). Please see the following page for the LTD Benefit Duration Schedule.


LONG TERM DISABILITY (LTD) COVERAGE

Prior to Age 63

63

64

65

66

67

68

69 and over

1937 or before

1938

1939

1940

1941

1942

1943 thru 1954

1955

1956

1957

1958

1959

1960 or after

Age When Disability Stats

Year of Birth

Duration of Benefits

Normal Retirement Age

To Normal Retirement Age* or 48 months, if greater

To Normal Retirement Age* or 48 months, if greater

36 months

30 months

27 months

24 months

21 months

18 months

65

65 + 2 months

65 + 4 months

65 + 6 months

65 + 8 months

65 + 10 months

66

66 + 2 months

66 + 4 months

66 + 6 months

66 + 8 months

66 + 10 months

67

*Normal Retirement Age is the Social Security Normal Retirement Age as stated in the 1983 revision of the United States Security Act. It is determined by your

date of birth.

Duration Schedule

2015 BENEFITS GUIDE

EMPLOYEE ASSISTANCE PROGRAM (EAP)

2016. You will not be permitted to drop coverage until the next Annual Open Enrollment period, unless you terminate employment or are no longer in an eli-gible class. The cost for this coverage is below and will be payroll deducted after taxes.

GROUP AUTO & HOME INSURANCE – METPAYYou have the opportunity to obtain quality coverage for your auto, home and other personal insurance through MetPay (a MetLife Company).

The best way to learn more about the program is to call (800) 438-6388 for a free, no obligation quote (at the voice prompt say Resurgens). A voluntary benefits specialist can review your needs, explain the coverage available and help you make cost and coverage comparisons.

Healthy Paws Pet InsuranceOne Plan. Four Paws. All Covered!:Resurgens is now offering an affordable pet health insurance plan covering everything that matters including inju-ries, illnesses, genetic conditions, and emergency care.

Premium Coverage:Unlimited lifetime benefits, no caps on claims, and see any licensed veterinarian in the U.S.

Lifetime Discounts:Employees receive a special lifetime discount of up to 15% when you enroll your pets with Health Paws!

Sign up at on the Healthy Paws website: www.healthypawsinsurance.com.

You and your family members have access to the Resurgens EAP, provided by EAP Works. The EAP is a company-paid benefit that provides assistance with everyday work and life issues. When you feel like you need help dealing with a situ-ation, you can call (800) 882-1985 and speak with a counselor, 24 hours a day, 7 days a week. You may also access their website which is linked to the Resurgens benefits portal, or you may go directly to www.eapworklife.com, and then when prompted, enter the user name: resurgens and the password: orthopaedics.

The EAP can help with personal concerns such as:

• Marital problems

• Grief or bereavement

• Parenting issues or other family issues

• Stress management

• Substance abuse/dependencies

• Goal setting

• Financial or legal concerns

You also get up to 6 face-to-face or telephonic coun-seling sessions. All calls and sessions are kept confi-dential except as required by law.

VOLUNTARY LEGAL PLANThis plan covers you, your spouse and dependents. In addition to the fully covered services such as wills, real estate closings and debt collection defense, the plan also includes unlimited telephone advice and office consultations with a local attorney. If you use a participating attorney, there are no claim forms or out-of-pocket expenses for attorney’s fees.

Call (800) 821-6400 and a client representative will be available to answer questions or provide more infor-mation by mail or fax. You may also visit the website www.legalplans.com and enter in the password 571115 under the “Thinking about Enrolling” section.

If you would like to participate in this plan, you must enroll online. Be aware that if you elect his coverage, you must stay enrolled in the plan through April 30,

2015 Hyatt Legal Plan Rates

Employee (also covers spouse and children)

Semi-Monthly

$7.50

Bi-Weekly

$6.92

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Who pays for the plans?Resurgens pays 100% of the cost of:

• Basic Life Insurance & Basic AD&D Insurance

• Short Term Disability (not available to Physicians)

• Employee Assistance Program

You share the cost with Resurgens for:

• Medical (includes Vision)

• Dental

• Long Term Disability

Your medical/vision and dental contributions are deducted from your paycheck on a pre-tax basis. Your Long Term Disability contributions are deducted from your paycheck after taxes.

You pay 100% of the cost of:

• Supplemental Life Insurance & Voluntary AD&D Insurance

• Flexible Spending Accounts (Healthcare and/or Dependent Care)

• Voluntary Legal Assistance Plan

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2015 BENEFITS GUIDE

2015-2016 Medical Plan Costs – Includes Vision Plan

Meritain Health POS

Employee Only

Employee + Spouse

Employee + Child(ren)

Employee + Family

Employer MonthlyContributions

$532.10

$699.28

$609.11

$1,082.14

Employee MonthlyContributions

$95.00

$471.55

$421.27

$646.60

Semi-MonthlyCheck Amount

$47.50

$235.78

$210.64

$323.30

Bi-WeeklyCheck Amount

$43.85

$217.64

$194.43

$298.43

Non-Tobacco User

Meritain Health POS

Employee Only

Employee + Spouse


Employee + Family


$457.10

$624.28

$534.11

$1,007.14


$170.00

$546.55

$495.27

$721.60


$85.00

$273.28

$248.14

$360.80


$78.46

$252.25

$229.05

$333.05

Tobacco User

Meritain Health HDHP

Employee Only

Employee + Spouse


Employee + Family

Meritain Health HDHP

Employee Only

Employee + Spouse


Employee + Family


$392.27

$508.67

$406.54

$733.85


$317.27

$433.67

$311.54

$658.85


$52.97

$322.62

$325.03

$493.56


$127.97

$397.62

$400.03

$568.56


$26.49

$161.31

$162.52

$246.78


$63.99

$198.81

$200.02

$284.28


$24.45

$148.90

$150.01

$227.80


$59.06

$183.52

$184.63

$262.41

PLEASE NOTE: For the HDHP Option, Resurgens makes a monthly contribution to your HSA Account. See chart for amounts.

NOTE: There are special tax implications required as well as criteria that must be met in order to cover your same-sex domestic partner.

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Employee Only

Employee + Spouse


Employee + Family

Annual EmployerContributions

$800.00

$1,600.00

$1,600.00

$2,400.00

2015-2016 HSA Contribution(Contributed by Resurgens for employees enrolled in the HDHP)

2015-2016 Dental Plan Costs(Same for both NAP and Value Dental Plan)

Supplemental Life Rates for Employee and Spouse(Per $1,000 per Month)

Employee Only

Employee + Spouse


Employee + Family

MonthlyContributions

$6.15

$15.05

$14.84

$35.81

Semi-MonthlyContributions

$3.08

$7.53

$7.42

$17.91


$2.84

$6.95

$6.85

$16.53

Age

Under 30

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75+

Rate

$0.07

$0.09

$0.11

$0.14

$0.22

$0.32

$0.54

$0.89

$1.46

$2.26

$3.40

Rate

$0.07

$0.09

$0.11

$0.14

$0.22

$0.32

$0.54

$0.89

$1.46

$2.26

$3.40

Bi-Weekly Cost per $1,000

$0.032

$0.042

$0.051

$0.065

$0.102

$0.148

$0.250

$0.411

$0.674

$1.043

$1.570

Semi-Monthly Cost per $1,000

$0.035

$0.045

$0.055

$0.070

$0.110

$0.160

$0.270

$0.445

$0.730

$1.130

$1.700

SUPPLEMENTAL LIFE RATES FOR THE EMPLOYEE AND SPOUSE:(Per $1,000 per Month)

CHILD LIFE RATES:The child(ren) rate is $.60 per month for $5,000 of coverage regardless of how many children are cov-ered under your plan. Certain age limits apply. Please see the preceding pages for additional details.

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2015 BENEFITS GUIDE

Employee

Family

Monthly

$0.022

$0.041

Semi-Monthly

$0.011

$0.021

Bi-Weekly

$0.010

$0.019

Rate per $1,000 of coverageCoverageLevel

Voluntary AD&D Rates

Long-Term Disability RatesResurgens feels strongly that employees need this benefit. Because of this, Resurgens pays 74.5% of the cost of the LTD coverage for eligible employees.

Your monthly contribution is your ANNUAL SALARY times .0034425/12.

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Resurgens benefits guide final (2)

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