ROSE MANAGEMENT GROUP
Employee Benefit Summary
7/01/2014—6/31/2015
Dear Employee,
Rose Management Group is pleased to provide you and your family with a comprehensive, market competitive benefits package that protects your personal health and financial well being.
Rose Management believes that our success is due, in large part, to the efforts of our employees. We continually keep this in mind every year when evaluating our employee benefit programs. It is important to emphasize that we always work hard to strike a balance the increasing costs of em-ployee benefits, and controlling emem-ployee out-of-pocket costs. Effective 7/1/2014, the Rose Acad-emy benefits package will include the following benefits available to all eligible employees:
Medical Plan through Health Net of Arizona
Supplemental Gap coverage with included Critical Illness coverage from Transamerica
Dental Plan from United Healthcare
Vision Plan through SightCare
AFLAC Supplemental Benefits
Remember...
Benefit Plan Eligibility
Employees must be considered benefits eligible to enroll in the medical and dental plans.
New employees become eligible for coverage on the first of the month following 30 days of employment.. All forms must be returned to Human Resources by the enrollment deadline for any of your coverage changes to be effective for the new plan year.
You can enroll the following dependents in your benefit plans
:
Your legal spouse or Domestic Partner Your dependent children:
Medical Plan: dependent children are covered up to age 26.
Dental Plan: dependent children are covered up to age 26.
Important Information Regarding Plan Changes
Each year during the annual open enrollment, you have the opportunity to make new benefit elections for the coming year. All eligible employees who wish to make any benefit changes must complete and return an enrollment form by the due date.
Changes to your medical and dental benefits are allowed only during the annual open enrollment each year. Per IRS rules, employees cannot drop or add coverage for yourself or your dependents mid-plan year unless you have a qualifying change in family status such as loss of benefits under another plan, marriage, divorce, legal separation, birth, adoption or placement for adoption, or a HIPAA qualifying “special event.”
If you have a qualifying change in family status, or HIPAA qualifying event, and want to drop, add or make any changes to your coverage, you must request this change within 31 days of the qualifying event (e.g. within 31 days of marriage or divorce, within 31 days of date of birth, within 31 days of the date you lose coverage under another plan) by completing a new enrollment form and giving it Human Resources. It is your responsibility to notify Human Resources of a qualifying or special enrollment event.
Per IRS rules, if you waive or terminate coverage during your annual open enrollment period, you will not be able to enroll in Rose Management’s plans until 7/1/2015 unless you have a qualifying change in family status.
Deductible and out-of-pocket maximums are administered on a calendar year basis.
It is important that employees enrolled in the medical benefits see providers in the Health Net net-work. If you see providers outside of the Health Net network, you will pay considerably more. To find providers in the Health Net network, you can go to www.healthnet.com
GAP Plan Coverage—Transamerica
NEW MEDICAL PLANS FROM UNITED HEALTHCARE
Only In Network Benefits Shown Here
CORE OPTION
HMO PLAN 4
Gap Plan Coverage
Transamerica
Major Medical
Deductible
$2,500 single
$5,000 family
Coinsurance
100%
Maximum Out-of-Pocket
Includes deductible
$2,500 single
$5,000 family
Physician Office Visits
$15 PCP / $30 Specialist
Out Patient Surgery
Covered 100% after
deductible
Gap Plan Pays:
First $1,250 *
Inpatient
Hospitalization
Covered 100% after
deductible
Gap Plan Pays:
First $2,500 *
Emergency Room
Waived if admitted
$250 copay
Urgent Care
$50 copay
Prescription Drugs
$20 / $40 / $60 / $120
Critical Illness Benefit—
This policy will pay a lump sum benefit when initially diagnosed with cancer, heart attack, stroke, end stage renal failure, and major organ transplants.$5,000 lump sum
Employee Cost per Paycheck
Employee Only
$85.23
Employee Plus Spouse
$268.12
Employee Plus Child(ren)
$231.94
Employee Plus Family
$440.34
UNITED DENTAL
PPO Denta
l
In Network
Out-of-Network
Annual Maximum Per Calendar Yr. $1,500 per person
Deductible
(Must be met before plan benefits will be paid) $50 individual—$150 family max
Deductible Waived for Preventive Yes No
Preventive
(Limited to 2 exams per year) 100% 100% Basic
(See Summary of Benefits for applicable procedures) 80% 80% Major
(See Summary of Benefits for applicable procedures) 50% 50%
Employee Cost per Paycheck
Employee Only $13.22
Employee Plus Spouse $26.62
Employee Plus Child(ren) $26.34
Employee Plus Family $41.38
United Dental Plan Options
Pre-Tax Premiums
The Flexible Benefit Plan allows for your healthcare premiums to be automatically deducted from your paychecks on a pre-tax basis. If you enroll in Rose Management’s medical, dental, or supple-mental plan benefits, you are able save money with every paycheck because your premiums are deducted on a pre-tax basis and it reduces your taxable income. You must notify Human Resources in writing during the annual open enrollment period, if instead, you elect to have your medical, dental or supplemental plan premiums deducted on a post tax basis.
Employer Paid Life/AD&D Insurance—UNITED HEALTHCARE
Every benefits eligible employee will continue to have a Basic Life Insurance plan provided and 100% paid for by Rose Management Group.
Accidental Death and Dismemberment (AD&D) - UNITED HEALTHCARE
All employees enrolled in the basic life plan also have included AD&D coverage and are eligible to receive double the life benefit should a death occur as part of an accident.
Employer Paid Basic Life Benefit
Sight Care Vision Plan
Routine Exam each year
$25 allowance out of network
$20 In Network
Frames each year
$80 allowance out of network
$125 allowance in network
Lenses — single focal plane
$25 allowance out of network
100% covered in network
Contact Lenses — in lieu of glasses
$80 allowance out of network
$120 allowance in network
Vision Plan—SightCare
More choices means it’s easier for you to find the eye care provider who is best for you.
SightCare’s Vision Plan offers you one of the broadest eyewear and eye care programs available with a large network of qualified eye doctors and optical retailers.
Routine vision exam (including refraction) paid in full after copay
Preferred pricing offered by network providers on frames, lenses and lens options
Routine Vision Network of credentialed private practice providers and retail optical providers
Access to discounts on laser vision correction through a nationwide network of more than 300 laser vision correction specialists
24-hour access to benefit information through myuhc.com and toll-free automated information line
No claim forms
Employee Cost per Paycheck
Employee Only
$3.01
Employee Plus Spouse
$6.02
Employee Plus Child(ren)
$5.41
Voluntary Supplemental Plans—AFLAC
Rose Management will offer AFLAC voluntary benefit plans to all benefit eligible employees. AFLAC policies help to cover unexpected medical bills, co-payments, deductibles, out of pocket ex-penses and more. We highly encourage you to consider enrolling in the AFLAC plans to ensure you have adequate insurance protection for all of life’s unexpected health care expenses and disa-bility issues.
AFLAC voluntary benefit plans are available to you, your spouse and children with most prod-ucts
The premiums for these voluntary benefit plans are paid by you via payroll deductions
AFLAC insurance benefits pay cash benefits directly to you, unless you choose otherwise
AFLAC pays benefits regardless of any other insurance coverage. Therefore, these benefits are paid in addition to the benefits provided under your Rose Management UHVC medical plan, if you are enrolled in the UHC benefits
With most plans, you can continue benefits when you retire or change jobs, with no increase in premiums. Policyholders can keep coverage for a lifetime as long as they continue to pay
pre-miums.
Short Term Disability Insurance
Replaces a portion of your income to help make ends meet if you become disabled from a covered accident or covered sickness.
Accident Insurance
Helps offset the unexpected medical expenses, such as emergency room fees, deductibles and co-payments that can result from a fracture, dislocation or other covered accidental injury.
Cancer Insurance
Helps offset the out of pocket medical and indirect, non-medical expenses related to cancer that most medical plans don’t cover. This coverage also provides a benefit for specified cancer-screening tests. Included in this plan is the option to also purchase a Critical illness rider which provides a lump-sum benefit that you can use to pay the direct and indirect costs related to a cov-ered critical illness, which can often be expensive and lengthy.
Hospital Confinement Insurance
WHO
WHAT
PHONE
WEBSITE - E-MAIL
HEALTH NET Medical Plan (800) 289-2818 WWW. HEALTHNET.COM
UNITED
DENTAL & LIFE Dental & Life Plan (877) 816-3597 WWW.UHC.COM
SIGHTCARE Vision Plan (480) 961-1702 WWW.SIGHTCARE.COM
TRANSAMERICA GAP PLAN (866) 224-3100 WWW.TRANSAMERICAEMPLOYEEBENEFITS.COM
Insurance Broker Chris Gordon or Heather Rivera Benefits & enrollment (520) 881-5760 [email protected] [email protected]
