Tyson Foods, Inc.
BENEFITS GUIDE 2016
MAKING A DIFFERENCE
Your Health
Your Security
Your Future
Once each year, eligible TEAM Members have the opportunity to review the benefits Tyson
Foods offers and choose the coverage that works best for them and their families. Be sure to
read this enrollment booklet and make any necessary changes for 2016 by the November 13
thdeadline.
MAKING A DIFFERENCE
Your Health
Your Security
Your Future
2016 Benefits Open Enrollment:
October 15 – November 13, 2015
HOW TO ENROLL
Open Enrollment begins on October 15 and ends on November 13, 2015.
This year TEAM Members will have the option to enroll either online or by phone with an enrollment counselor. Please see the enclosed flier for more details.
TEAM Members will need to complete the Open Enrollment process if they wish to:
• Add, change or remove benefits coverage including tobacco-use status and spousal surcharge
• Enroll or re-enroll in a Flexible Spending Account • Enroll or increase coverage in voluntary term life
insurance
• Enroll or increase coverage in voluntary whole life or critical illness insurance
HIGHLIGHTS OF CHANGES IN 2016
• 2016 Health Plan Premiums: While medical plan premiums will increase slightly in 2016, there will be no change to the dental and vision plan premiums. See page 5 for details.
• Prescription Drug Benefits: Copays for non-preferred brand name drugs will increase. The out-of-pocket maximums will also increase. The formulary drug list will change to CVS/caremark’s Value Formulary. See page 7 for details.
• Voluntary Term Life and Accidental Death and
Dismemberment (AD&D) Insurance: TEAM Members can enroll in or increase coverage in Voluntary Term Life and AD&D Insurance at a lower rate and with no Evidence of Insurability required (unless you were previously declined by Unum). The AD&D plan will also change from a post-tax to a pre-post-tax benefit. See page 9 for details.
• Unum Voluntary Benefits: TEAM Members can enroll in or increase coverage in Whole Life or Critical Illness Insurance up to guaranteed-issue limits with no Evidence of Insurability required. See page 9 for details.
IMPORTANT
If you do not participate in an enrollment session, your 2015 benefit elections (except Flexible Spending Accounts) will carry over into 2016
DOCUMENTATION REQUIREMENTS
Documentation is required only for TEAM Members who wish to add new dependents or newly waive medical coverage or the spousal surcharge. Please refer to the enclosed email/fax cover sheet for details. Your Tyson Benefits Counselor will provide the necessary forms for you to complete.
TEAM MEMBER
If you are currently covered and want to waive the group health plan, you will need to submit:
• Current proof of other medical coverage*
*Other medical coverage must meet the minimum essential coverage requirements of the Affordable Care Act.
SPOUSE
If you want to add a spouse, you will need to submit: • Proof of current marital status:
• Copy of marriage license/certificate AND • A copy of the first page of your current
year’s filed federal or state tax return (please blackout financial information) OR
• If you cannot provide a joint tax return, see your Tyson Benefits Counselor to determine other acceptable documentation such as proof of joint property/asset ownership (recent mortgage, credit card or bank statements, utility bills)
• Proof of the spouse’s Social Security number If you are currently paying the spousal surcharge and want to waive it in 2016, you will need to submit:
• A Tyson Foods Group Health Verification form completed by your spouse’s employer, or
• Verification on company letterhead that your spouse is not eligible for group health coverage, or
• Other current proof that your spouse is not eligible for employer-sponsored coverage
DEPENDENT CHILDREN
If you want to add a dependent, you will need to submit: • Acceptable proof of the dependent relationship such
as a birth certificate or adoption paperwork • Proof of the dependent’s Social Security number
NON-TOBACCO USER PREMIUM INCENTIVE
TEAM Members who certify that they are tobacco free will receive a $10 per week incentive on health plan premiums. If you certify that your spouse is also tobacco free, you will receive an additional $10 per week premium incentive for a total of $20 for TEAM Member and spouse.
Current tobacco user status for TEAM Members and spouses will carry over into 2016. If you would like to update your tobacco status, you MUST complete an enrollment session either online or by phone. Definition of Tobacco Use
“Tobacco use” is smoking tobacco in such forms as a cigarette, pipe or cigar; or smokeless tobacco such as snuff or chewing tobacco (including betel nut), within the last 90 days. “Tobacco use” also includes use of nicotine products, including electronic cigarettes and nicotine replacement therapy (gum, lozenges, patches) within the last 90 days. Quit for Life Tobacco Cessation Program
If you and/or your spouse are tobacco users, you can still qualify for the $10 per week incentive by completing the Quit for Life program.
First – Enroll in the Quit for Life program prior to December 31, 2015
Second – Complete the Quit for Life program prior to March 15, 2016
Third – Complete and submit a Tobacco Use Certification formwithin two (2) monthsof the date you complete the program.
If the deadlines above are met, you and/or your spouse will qualify for the incentive as of your Quit for Life program completion date for the remainder of 2016. You will also receive a refund through payroll deduction for any incentive amount you did not receive retroactive to January 1, 2016. If the deadlines are not met, you will not qualify for the incentive.
Call Quit for Life at 866-QUIT-4-LIFE (866-784-8454) or go to www.quitnow.net/TysonFoods to enroll
.
MAKING A DIFFERENCE
Your Health
YOUR MEDICAL PLAN AT A GLANCE
Here is a summary of your medical benefits. For a more detailed description of your medical plan, please see the Summary Plan Description or the Summary of Benefits and Coverage. The deductible must be met before the plan begins paying benefits.
Medical Plan Coverage In-Network Out-of-Network
Deductible $1,000 individual coverage/$2,000 family coverage $1,000 individual coverage/$2,000 family coverage Out-of-Pocket Maximum $5,000 individual coverage/ $10,000 family coverage No limit
Primary Care Visit (deductible waived)$30 copay 50% coinsurance of Plan Allowance
Specialist Visit 20% coinsurance of Plan Allowance 50% coinsurance of Plan Allowance
Emergency Room $100 copay then 20% of Plan Allowance $100 copay then 50% of Plan Allowance
Hospital Stay 20% coinsurance of Plan Allowance 50% coinsurance of Plan Allowance
Diagnostics (X-rays, MRIs, etc.) 20% coinsurance of Plan Allowance 50% coinsurance of Plan Allowance
ADVANCE MEDICAL – EXPERT MEDICAL OPINION PROGRAM
If you or a covered dependent are diagnosed with a serious or complex illness and would like additional information or a second opinion, Advance Medical can help. Advance Medical can provide quick and easy access to the best national medical specialists to help get the right answers about the medical condition, diagnosis and treatment. This free service will provide an additional layer of support needed to make good medical decisions, without the need to travel and while working side by side with a current physician.
MAKING A DIFFERENCE
Your Health
2016 WEEKLY GROUP HEALTH PLAN RATES
The weekly medical plan rates will increase by 5% in 2016. Tyson and our TEAM Members will share the increase in higher health expenses in order to maintain a quality plan with comprehensive coverage.
2016 EMPLOYER-SPONSORED COVERAGE SURCHARGE
When does the spousal surcharge for employer-sponsored coverage apply?
You can cover your eligible spouse, but you will be charged a $35 weekly surcharge if your spouse is employed and is eligible for coverage through his/her own employer.
If you currently pay the $35 weekly surcharge and your spouse is no longer employed or eligible for coverage through his/ her own employer, you must call in or log in online to declare your intention to waive the surcharge. You must also submit supporting documentation during Open Enrollment. If you do not participate in the enrollment process and submit the documentation, your current election and $35 per week surcharge will continue.
If you cover a spouse who is also employed by Tyson, you are not subject to the spousal surcharge. If your spouse is covered by both the Tyson Foods, Inc. Group Health Plan AND his/her employer’s plan, you will pay the $35 weekly surcharge and coordination of benefits will apply.
HEALTH PLAN ID CARD
You will not receive a new ID card unless you make an election that results in a coverage level change.
Coverage Level
Medical Plan Weekly Rates
Dental
Buy-Up
Plan
Vision Buy-Up
Plan Tobacco-Free
Rates
If TEAM Member uses
Tobacco
If Spouse uses Tobacco
If Spousal Surcharge Applies
TEAM Member Only $12.40 + $10.00 N/A N/A $2.57 $0.82 TEAM Member + 1 child $21.62 + $10.00 N/A N/A $5.46 $1.49 TEAM Member + 2 children $23.94 + $10.00 N/A N/A $7.40 $1.75 TEAM Member + 3 children $26.25 + $10.00 N/A N/A $9.40 $2.02 TEAM Member + 4 children $28.57 + $10.00 N/A N/A $11.34 $2.28 TEAM Member + 5 or more children $30.88 + $10.00 N/A N/A $13.34 $2.54 TEAM Member + spouse $38.58 + $10.00 + $10.00 +$35.00 $5.09 $1.64 TEAM Member + spouse + 1 child $42.37 + $10.00 + $10.00 +$35.00 $8.66 $2.11 TEAM Member + spouse + 2 children $44.69 + $10.00 + $10.00 +$35.00 $10.61 $2.37 TEAM Member + spouse + 3 children $47.00 + $10.00 + $10.00 +$35.00 $12.60 $2.64 TEAM Member + spouse + 4 children $49.32 + $10.00 + $10.00 +$35.00 $14.54 $2.90 TEAM Member + spouse + 5 or more children $51.63 + $10.00 + $10.00 +$35.00 $16.54 $3.16
DENTAL COVERAGE
Remember that the Dental Buy-Up Plan requires a minimum two-year continuous enrollment.
VISION COVERAGE
Dental Plan Coverage Core Plan Buy-Up Plan
Deductible (calendar year) $50 each individual $50 each individual
Annual Maximum Benefit $500 per individual age 19 or older $1,500 per individual
Preventive Routine exams, cleanings and
bitewing X-rays twice each year 100% of the network fee schedule 100% of the network fee schedule
Basic Fillings, extractions, periodontal visits and root canals
For simple extractions, amalgam and
composite fillings only: After deductible,
80% of the network fee schedule
After deductible, 80% of the network fee schedule
Major TMJ, crowns and dentures Not covered After deductible, 50% of the network fee schedule
Orthodontic Not covered covered dependent children up to age 19 – 50% of the network fee schedule for lifetime maximum of $1,500
Vision Plan Coverage Core Plan Buy-Up Plan
Coverage if using a VSP Provider Exam (A routine exam every 12 months)
Prescription glasses Contact lenses
Prescription glasses or contact lenses
$25 copay $25 copay $25 copay Every 24 months up to $75
$20 copay $25 copay $25 copay
Every 12 months up to $200
Coverage if using a Non-VSP Provider Exam
Single vision lenses Bifocal lenses Trifocal lenses Frames Contact lenses
Up to $50 Up to $50 Up to $75 Up to $100
Up to $60 Up to $60
Up to $50 Up to $50 Up to $75 Up to $100
Up to $70 Up to $105
PRESCRIPTION DRUG COVERAGE
You will save money by filling your prescription medications at CVS, Walmart, Kroger, Hy-Vee and Harps retail pharmacies (Tier 1 Pharmacies). Plus, if you use generics for certain maintenance medications, there is a $0 copay at these pharmacies. You also have the option to fill your prescription at all other
CVS/caremark network pharmacies (Tier 2 Pharmacies); however, your out-of-pocket cost will be higher.
If you do not have a Tier 1 Pharmacy within approximately 10-13 miles of your home zip code, you will be considered out-of-area. If you are considered out-of-area for prescription drug plan purposes, you may go to any CVS/caremark Network Pharmacy (Tier 2) and receive the same benefits as you would for a Tier 1 Pharmacy for up to a 30-day supply. Your medical ID card will show “OOA” if you are out-of-area.
Generally, you will save the most on maintenance medications if you purchase a 90-day supply through the CVS/caremark mail order program or at any CVS retail pharmacy. You will only have to pay two copays rather than three for a 90-day supply for most medications.
New for 2016, the formulary drug list will change to CVS/caremark’s Value Formulary. TEAM Members who are affected by this change will receive a letter in the mail from CVS/caremark. For details visit www.caremark.com/ highvalueplan.
PRESCRIPTION DRUG OUT-OF-POCKET
MAXIMUM
Due to Affordable Care Act guidelines, the prescription drug plan will have an annual out-of-pocket maximum of $1,850 for individual coverage and $3,700 for family coverage.
This is the amount you pay out-of-pocket before the plan begins paying the full cost of covered prescriptions for the remainder of the year.
Remember – Use generics for certain conditions and pay nothing at Tier 1 Pharmacies!
Up to a 30-day supply*
2016 Tier 1 Pharmacies
CVS, Walmart, Kroger, Hy-Vee & Harps CVS/caremark Network Pharmacies2016 Tier 2 Pharmacies
Up to a 90-day supply*
2016 Maintenance Choice
CVS/pharmacy or CVS/caremark Mail Order Program
Copays Coinsurance Copays Coinsurance Copays Coinsurance
Select Generic & Select Preventive
$0
20% of network pharmacy price
Select Generic & Select Preventive
Not available at Tier 2 Pharmacies
30% of network pharmacy price
Select Generic & Select Preventive
$0
20% of network pharmacy price Generic $10 Minimum $20 Maximum Generic $20 Minimum $40 Maximum Generic $20 Minimum $40 Maximum Preferred Brand $30 Minimum $60 Maximum Preferred Brand $60 Minimum $120 Maximum Preferred Brand $60 Minimum $150 Maximum Non-Preferred Brand $135 Minimum $240 Maximum Non-Preferred Brand $200 Minimum $360 Maximum Non-Preferred Brand $270 Minimum $485 Maximum
MAKING A DIFFERENCE
Your Security
FLEXIBLE SPENDING ACCOUNTS (FSAs)
You must actively re-enroll in the FSAs each year. You are not automatically re-enrolled.
Flexible Spending Accounts enable you to put aside money for important expenses and help you reduce your income taxes at the same time. Tyson Foods offers two types of accounts — a Health Care FSA and a Dependent Care FSA. These accounts allow you to set aside pre-tax dollars to pay for eligible out-of-pocket health care or dependent care expenses.
How Flexible Spending Accounts Work
1. Each year during Open Enrollment, you decide how much to set aside for health care and/or dependent care expenses.
2. Your contributions are deducted from your paycheck on a pre-tax basis in equal installments throughout the calendar year.
3. If you are enrolled in the Group Health Plan, your Health Care FSA claims will be paid automatically when a covered medical or dental claim is processed. You can also choose to file claims manually either online or via mobile app. The Health Care FSA also includes a prescription debit card that you can use at participating pharmacies. For Dependent Care FSA expenses, you will need to pay upfront and then submit a claim to be reimbursed from your account. Please note that these accounts are separate — you may participate in one, both, or neither. You cannot use money from the Health Care FSA to cover expenses eligible under the Dependent Care FSA or vice versa.
Use It or Lose It Rule: Be sure to calculate your FSA expenses carefully. Funds in excess of $500 will be lost.
Plan Annual Maximum Contribution Covered ExpensesExamples of
Health Care Flexible
Spending Account $2,550 Copays, deductibles, orthodontia, prescription medications, etc.*
Dependent Care Flexible $5,000 ($2,500 if married and filing separate
$500 HEALTH CARE FSA CARRYOVER
If you have money left in your Health Care FSA at the end of 2015, you may carry over up to $500 for use in 2016.
The money you carry over doesn’t count against the $2,550 annual contribution maximum, which means you can start the year with up to $3,050 in your Health Care FSA that you can use throughout the 2016 plan year.
This rule applies each subsequent calendar year.
MAKING A DIFFERENCE
Your Future
VOLUNTARY TERM LIFE AND ACCIDENTAL DEATH
AND DISMEMBERMENT (AD&D) INSURANCE
New for 2016 - TEAM Members can enroll in or increase coverage in Voluntary Term Life and AD&D with no evidence of good health required, unless you were previously declined by Unum. The age-banded rates per $1,000 of Term Life insurance will decrease, so TEAM Members will also see a decrease in premiums, unless you move into a new 5-year age band.Voluntary AD&D insurance will change from a post-tax to a pre-tax benefit. This means you can now only enroll in, change or drop coverage during the annual Open Enrollment period (unless you experience a qualifying change in status event). You will no longer be able to enroll in, change, or drop coverage at any time.
VOLUNTARY LONG TERM DISABILITY AND
LONG TERM CARE INSURANCE
TEAM Members have the option of electing Long Term Disability and Long Term Care Insurance. Long Term Disability Insurance requires evidence of good health.
VOLUNTARY ACCIDENT INSURANCE
Unum’s Group Accident Insurance can pay benefits based on the injury you receive and the treatment you need, including emergency-room care and related surgery. The benefit can help offset the out-of-pocket expenses that medical insurance does not pay, including deductibles and co-pays. Family coverage is available.
Benefits are paid for accidents that occur on or off the job, so you have 24-hour coverage. The plan includes a Health Screening Benefit and a Sickness Hospital Confinement Rider.
VOLUNTARY CRITICAL ILLNESS INSURANCE
Unum’s Group Critical Illness Insurance can help protect your finances from the expense of a serious health problem, such as a stroke or heart attack.You choose a lump-sum benefit up to $30,000 that’s paid directly to you at the first diagnosis of a covered condition. You can use the benefit any way you choose.
Each condition is payable once per lifetime, per covered individual. Benefits are payable for remaining covered conditions if the diagnoses are separated by at least 90 days and deemed medically unrelated.
VOLUNTARY WHOLE LIFE INSURANCE
Unum’s Whole Life Insurance is designed to provide a death benefit to your beneficiaries if you pass away, but it can also build cash value that you can utilize during your lifetime.
At an affordable premium, you can have the added financial protection you and your family may need during times of uncertainty.
No evidence of good health required for certain increases or for those who waived coverage previously. Eligible TEAM Members must be actively at work to apply for coverage. TEAM Members are not considered actively at work if they are on a leave of absence. TEAM Members must be U.S. citizens or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. Underwritten by: Unum Life Insurance Company of America, Portland, Maine
RETIREE MEDICAL ANNOUNCEMENT
Effective January 1, 2016, Tyson Foods, Inc. will no longer offer the Group Retiree Health Plan (the “Retiree Health Plan”). As you may already know, there have been many improvements to the individual health insurance market for those who are not Medicare-eligible since the Patient Protection and Affordable Care Act (commonly referred to as “Obamacare”) was enacted in 2010. These improvements include:
• New opportunities for guaranteed access to quality, affordable health insurance through the various state and federal Health Insurance Marketplaces (commonly referred to as the “Exchanges”), • Health insurance carriers cannot refuse to cover
individuals or charge them more because they have a pre-existing condition,
• Pricing requirements that limit how much an insurance carrier can vary rates based on age, and
• The availability of federal premium tax credits (commonly referred to as “subsidies”) to qualified individuals with household income of less than 400% of the applicable Federal Poverty Level.
Like other large employers, Tyson has been watching these developments for several years and has determined that changes to its retiree health coverage make sense for both the company and its early retirees.
Historically, Tyson has offered health coverage to non-Medicare eligible retirees regardless of health status
because access to pre-Medicare health insurance elsewhere was very limited and often very costly. While premiums under the Retiree Health Plan have remained affordable to most retirees, the benefit designs have not been competitive and expose our retirees to potentially large out-of-pocket costs. Since the availability of the Exchanges and federal subsidies, most of our retirees are no longer electing the coverage under the Retiree Health Plan and are opting for more choice and richer plan designs through the Exchanges. And, many of them qualify for federal subsidies which means some pay less for a higher level of coverage than currently offered through the Retiree Health Plan. Given the availability of individual health insurance and
selected a private exchange administrator, Towers Watson’s OneExchange, which allows eligible pre-Medicare retirees the option to choose a health insurance plan from a large number of insurance carriers that best fits their individual needs. Towers Watson’s knowledgeable, licensed benefit advisors will help retirees navigate this change and ensure they are well informed to make an appropriate enrollment decision. OneExchange will also assist retirees with their health coverage decisions after they become eligible for Medicare.
Is there a transition plan?
If you meet the current eligibility requirements* to participate in the Retiree Health Plan, and you retire
on or before December 31, 2015, Tyson will continue to provide a subsidy to you and each eligible dependent (as determined under the terms of the Retiree Health Plan) for up to three (3) years. The company subsidy will be a defined contribution amount and those funds will be available via a tax-free Health Reimbursement Account (HRA) through OneExchange. The HRA funds will be used to offset the premium cost of the individual medical and prescription drug coverage purchased through the Exchange. In addition, you and each of your dependents will have the option to elect and use the HRA funds for individual dental and/or vision coverage through the Exchange.
The calendar year company subsidy amounts that each eligible retiree and each eligible dependent will qualify for are as follows:
2016: $3,600 2017: $2,400 2018: $1,200
Any dollars remaining in the HRA at the end of the year will roll over and can be used for eligible premium costs in subsequent years. This provides you and your dependents with the flexibility to choose different types of coverages each year. Keep in mind, monthly premium amounts will depend on the type of coverages elected. You and your dependents will pay the premiums and then submit claims to OneExchange and they will reimburse you and your dependents from the HRA up to the limit of the HRA balance. Also, remember that you and your dependents
OneExchange benefit advisors will assist you and your dependents through the process to determine which subsidy will benefit you the most, as you will not be eligible for the company subsidy if you receive the federal subsidy. Any remaining balance in the HRA will be forfeited once the account-holder becomes eligible for Medicare. You must retire on or before December 31, 2015, and enroll in a medical plan through the OneExchange program to qualify for any company subsidy. In addition, you must enroll effective January 1, 2016 to avoid a break in coverage, but no later than January 31, 2016 (the end of the Exchange open enrollment period). If you miss this opportunity or decline coverage through OneExchange,
you cannot enroll later.
If you retire after December 31, 2015, you and any of your dependents will not qualify for any company subsidy towards health insurance. However, you will have access to OneExchange and their benefit advisors to assist you with electing individual coverage through the Exchanges. You are not required to use OneExchange and may choose another provider to help you obtain coverage and any applicable federal subsidy through an Exchange. Why OneExchange?
OneExchange has built the largest Medicare exchange in the country by aggregating a large number of national and regional insurance carriers and plans. In addition, they provide pre-Medicare coverage through their aligned insurance carriers. The Benefit Advisors will provide:
• Individual telephone support to help you make an informed and confident enrollment decision,
• Education about the differences among various plans and the costs of each of those plans,
• Assistance with enrolling in whatever medical, prescription drug, dental and vision plan you may choose, and
• Assistance with determining eligibility for federal subsidies
For those interested in more immediate access to information, OneExchange offers a personalized website for education, evaluation of options and enrollment information. The web address for this site will be included
in your mailing from OneExchange.
What happens when I become eligible for Medicare? Through OneExchange, you gain access to a wide variety of Medicare Advantage, Medicare supplement and prescription drug plans. OneExchange will give you and your eligible spouse personalized assistance via an experienced licensed Benefit Advisor should you choose to use them.
What’s Next?
If you currently meet the eligibility requirements of the Retiree Health Plan, or will meet the requirements prior to January 1, 2016, and you retire on or before December 31, 2015, you will receive a letter in the mail with additional information about the open enrollment window, as well as when and how to contact OneExchange to evaluate and enroll in the coverage.
*You are eligible for the Retiree Health Plan if your age plus credited years of service with Tyson equals seventy (70) or more, and at retirement:
• you are at least fifty-five (55) years old, but under age sixty-five (65); and
• you have at least 10 years of continuous service; and • you are enrolled in a Tyson Group Health Plan
(including any COBRA coverage); and
