annual open enrollment guide - collaborative

2016

Annual Open Enrollment

Guide

Open Enrollment

May 16th—

May 27th, 2016

Informa onal Mee ngs

May 17th and

24th, 2016

2

BENEFITS

AT A GLANCE

Benefit Provider Page

Medical

Harvard Pilgrim

Healthcare

7

Dental

Blue Cross Blue Shield

12

Voluntary Vision

VSP 13

FOR FINANCIAL HEALTH


Life Insurance

Symetra 15

Long Term Disability Insurance

Symetra 15

Voluntary Life Accidental Death &

Dismemberment

Symetra 15

FOR PHYSICAL HEALTH

3

FOR FINANCIAL HEALTH


Voluntary Short Term Disability

Symetra 15

Flexible Spending Account

American Benefit Group

17

Health Savings Account (H S A)

Wells Fargo 18

Voluntary Hospital Indemnity

Symetra 20

Voluntary Cri cal Illness

Symetra 21

Voluntary Accident Insurance

Symetra 22

Voluntary Pet Insurance

VPI 23

FOR PERSONAL HEALTH


Employee Assistance Plan

Educators EAP

24

Add‐Value Symetra 25

LEGAL


Annual Legal No ces

CES 27

4

Annual Open Enrollment Federal legisla on requires all health plans to allow employees an annual opportunity to change their benefit elec ons without penalty and without requiring evidence of good health. Examples of changes that can be made during an open enrollment include: Enroll yourself or any eligible family member in the medical or dental program Change from one medical plan to another Drop the medical, and or dental/vision coverage for yourself or any family member Change your elec on from single, dual or family Change your medical plan selec ons

Changing Your Benefits During the Year Make your elec ons during your enrollment period carefully because you can only make changes during the year if you have a qualified life event according to IRS regula ons. The following events qualify for a mid‐year change in coverage: Marriage Divorce or legal separa on Birth or placement for adop on of a child Death of a dependent Ineligibility of a dependent Loss of other coverage Change in your employment status or that of your spouse Significant change in health coverage a ributable to your employment or that of your spouse A qualified domes c rela ons order or similar court order En tlement to Medicare or Medicaid You must make the change within 31 days a er the event occurs by contac ng a member of the Benefits Team: Human Resources at 413‐588‐5925 or 5923 hr@collabora ve.org

BENEFITS

Enrollment

5

Open Enrollment

Meetings

MON TUE WED THU FRI May 16

Open

Enrollment Begins

May 17

Onsite Meetings

10:00am—11:30am & 2:30pm—4:00pm

May 18

Webinar Meetings

2:30pm—3:30pm

May 19

May 20

May 23

Webinar Meetings 2:30-3:30

May 24

Onsite Meetings

2:00pm—3:30pm

May 25 May 26 May 27

Open Enrollment

Ends

Deadline: Changes must completed by May 27th

Understanding the benefit program you receive as a Collabora ve for Educa onal Services Employee is important! These benefits are a significant part of your total compensa on and an important component of your and your family’s financial security. Collabora ve for Educa onal Services’ FY17 open enrollment will be held from May 16th through May 27th and all changes will be effec ve July 1, 2016.

WEBINAR MEETINGS

Conference Call #:

866‐628‐8620

Code: 161874

Web Access Address:

h p://ajg. adobecon‐nect.com/ces/

BENEFIT FAIR MEETINGS

Conference Rooms

A & B

97 Hawley Street

Northampton, MA

6

How Do I Enroll? To Enroll or Change any benefit elec ons go

to: h p://collabora ve.org/openenrollment

The enrollment link and instruc ons will be

available on our website.

All Changes and elec ons must be done no

later than May 27, 2016

Medical: Harvard Pilgrim Health Care—Go to

www.harvardpilgrim.org and select “Members”,

Enter your HPHConnect username/password, Select

“Update my Informa on”, Select “Edit Plan Op ons”

and follow the instruc ons

Dental: Blue Cross Blue Shield—h ps://

bcbsma.secure‐enroll.com/go/

bcbsma#sthash.keUJLmdT.dpuf The enrollment link

and instruc ons will be available on our website.

Life & Disability: Symetra —All employees must log

into Symetra’s web‐site to confirm or change

coverage, failures to do so may result in a loss of

benefits. Don’t forget to log‐in to update your

beneficiary!! h ps://www.bentegrity‐

online.com/CES

Voluntary Life: Symetra—Log into h ps://

www.bentegrity‐online.com/CES, to enroll or

make a change

Voluntary Short Term Disability: Symetra— Log

into h ps://www.bentegrity‐online.com/CES, to

enroll or make a change

Voluntary Gap Benefits: Symetra —If you would

like to enroll in the new Voluntary Gap Coverages

being offered this open enrollment, be sure to

visit our website for a link to the form.

NOTE: Your Accident coverage will be moving to

Symetra effec ve 7/1/16, your Reliance Standard

coverage will be termina ng effec ve 6/30/16. If

you would like to enroll in the new Accident

Insurance Coverage be sure to visit our website for a

link to the enrollment form.

Voluntary Vision: VSP—The enrollment form and

instruc ons will be available on our website.

FSA: American Benefits Group —w.amben.com/

enroll

Pet Insurance: Na onwide—Go to: h p://

www.pe nsurance.com/collabora ve

7

Contact:

Harvard Pilgrim Healthcare Member Services: 888.333.4742 www.harvardpilgrim.org

Medical Coverage

Refer to Harvard Pilgrim Healthcare plan summary for complete benefit details, exclusions and provisions.

Medical coverage is one of the most important and necessary components of an employee benefits package. This year we are pleased to announce that CES will con nue to offer our current benefit package with Harvard Pilgrim.

As an employee, you may choose between the Harvard Pilgrim Best Buy HMO $3,000 plan, or two H.S.A Best Buy PPO plans to enroll in. Both PPO plans are Health Savings Account (H.S.A) compa ble plans.

CES will be moving from a calendar year deduc ble to a plan year deduc ble for all plans effec ve July 1st. With this change the out‐of‐pocket maximum on the HMO is increasing to $6,600 for individual and $13,200 for family. The H.S.A. Best Buy PPO $3,000 plan will now have a chiropractor for 12 visits per year benefit. Please reference page 8 for medical plan benefits. Harvard Pilgrim Health Care will credit all deduc ble expenses incurred between January 2016 and June 2016.

Harvard Pilgrim Best Buy HMO $3,000

The Best Buy HMO $3,000 plan is a Health Maintenance Organiza on (HMO) plan. If you elect this plan, you will be required to choose a primary care physician (PCP). Your PCP will guide you through the medical system, referring you to specialists when needed. If you require hospital care, your PCP will arrange for that as well. The HMO is funded with a health reimbursement account (HRA) and members pay the first $1000 of the deduc ble ($2000 for family), CES will con nue to fund the remaining deduc ble expenses via an HRA.

Harvard Pilgrim H.S.A Best Buy PPO

The Harvard Pilgrim H.S.A Best Buy PPO $2,000 and H.S.A Best Buy PPO $3,000 plans are Preferred Provider Organiza on (PPO) plans. With a PPO plan, you have the freedom to seek services both in and out‐of‐network, however, you will receive the highest level of coverage in‐network, at a lower cost.

If you are currently enrolled and are not changing your medical plan, please hold onto your ID card. New ID Cards will only be issued if you change your plan or if you enroll for the first me.

8

2016 Best Buy HMO $3,000

(In Network coverage Only)

BEST BUY HSA PPO $2,000

In‐Network

Annual Deduc ble

Coinsurance (you pay)

None None

Annual Out‐of‐Pocket Maximum

Office Visit $20 Co‐pay 100% a er the Deduc ble

Preven ve Care Covered In Full Covered In Full

Inpa ent Hospital Services

100% a er the Deduc ble 100% a er the Deduc ble

Outpa ent Hospital Services


Emergency Room $100 a er the Deduc ble 100% a er the Deduc ble

Rehabilita on Therapy Services


Lab and X‐ray 100% a er the Deduc ble 100% a er the Deduc ble

Advanced Radiology 100% a er the Deduc ble 100% a er the Deduc ble

Rx Co‐Pays Tier 1: Tier 2: Tier 3: Tier 4: Tier 5:

Retail Mail Order 1 month 3 month

$15 $30 $30 $60

$50 $100 20% Coinsurance up to $250 Retail ($750 Mail Order) Maximum per

Prescrip on/Refill


Co‐pay a er In‐Network Deduc ble

$10 $20 $25 $50

$40 $120 20% Coinsurance up to $250

Retail ($750 Mail Order) Maximum per Prescrip on/

Refill

BEST BUY HSA PPO $3,000

In‐Network

None

100% a er the Deduc ble

Covered In Full








Co‐pay a er In‐Network Deduc ble

$5 $10 $15 $30 $25 $50

$40 $120 20% Coinsurance up to $250

Retail ($750 Mail Order) Maximum per Prescrip on/

Refill

Medical Plan Comparison

Refer to Pilgrim Healthcare plan summary for out of network benefits and complete benefit details, exclusions and provisions.

Single $6,600

Family $13,200

Single $2,000

Family $4,000

Single $4,000

Family $8,000

Single $3,000

Family $6,000

Single $3,000

Family $6,000

Single $5,000

Family $10,000

9

HPHC Value-Add

Vision Programs

Up to off

vision

correc on

procedures

eyewear program at

Have your rou ne eye exam1 at par cipa ng and get a free pair of p ip io from a select store collec on. Just show your Harvard Pilgrim ID d arrival for your appointment. You must choose and order your free eyewear on the day of your exam.

With a covered eye exam, you get FREE:

rames from the Harvard Pilgrim Silver Collec on Single vision, non‐coated plas c lenses (or single vision polycarbonate lenses for children ages 14 and

und

If you upgrade your frames and lenses, you’ll s ll receive great savings on Harvard Pilgrim’s Pla num and Designer collec ons, bifocal lenses, and standard progressive/ mul focal lenses. Visit

for details.

More eyewear savings

big at many popular loca ons2

Purchase a complete pair of glasses and get 35% off frames, plus addi onal discounts on lenses and lens

p io 3 And save 20% on any frame or lens op ons purchased separately, or on any op cal accessory. Loca ons

include:

a Pearle JCPenney p Sears Op cal Target Op cal

Get more at many independent eyewear providers To learn more about these savings, visit or call Harvard Pilgrim.

Two great op ons to save on laser vision procedures, including LASIK and

Photorefrac ve Keratectomy (PRK)! Choose from more than 20 facili es in

Massachuse s, Maine and New Hampshire. Visit www.hardvardpilgrim.org/savings

for details.

1 program only at par cipa ng in Rhode and New Offer to limited to one free pair of per per year.

2 offer on and contact Not all with to making an appointment, refer to the most up‐to‐date lis ng of online at or

at a number on the back.

3 at par cipa ng only. apply.

10

HPHC Value-Add

Fitness & Health Programs pays!

Harvard who belong to a qualified health and ne for four mon h get up to $150 ba k.4 How you’re eligible

You’re eligible for money back as long as your employer offers fitness reimbursement or enrolled in one of our Buy Direct plans. You can receive up to $150 reimbursement both a member of Harvard Pilgrim and any qualified health and fitness club for four months in the current calendar year. Don’t wait to get fit. It pays! Most health and

If your health and fitness club is a full‐service facility that offers cardiovascular and strength‐training equipment and facili es for exercising and improving physical fitness, it likely qualifies. Most “tradi onal” health and fitness clubs, and Jewish Community Centers (JCCs) qualify. Facili es and/or programs that don’t qualify for reimbursement include country or social clubs, spas, fees for trainers, gymnas cs centers, mar al arts studios, tennis, aerobic or pool‐only facili es, as well as sports teams or leagues. Individual and group classes are not eligible for reimbursement. Complimentary and Alterna ve Medicine

Take a to up to Save 10%‐30% on a wide range of services offered through our partnership with Healthways Whole‐Health Networks. With more than 40,000 creden aled prac oners na onwide, Healthways manages one of the leading Complimentary and Alterna ve Medicine networks in the Choose from more than 30 op ons, including:

6 6 Massage and bodywork Chinese herbal medicine Naturopathic medicine Yoga and Pilates Tai chi and qigong And more Visit to learn more.

4 $150 per in a or family policy). not to all or for tax informa on, with your employer.)

5 A club one that open to the public with mul ple of equipment and strength training.

6 not or under your plan. plans and/or in which the networks and office benefits differ. a with your plan for informa on or for details.

11

HPHC Value-Add

Discount Programs

8 and, if not Offer to ini al fee only and at par cipa ng U.S., and and through At Home®.

9 at all Weight North owned and not honor this not Weight online programs.

Nutri on programs DASH for

‐ 50% a

‐ Save up to 35%

iDiet in‐person or

‐ 15% the

Jenny ‐ Free 30‐day

‐ 25% a

Meals to Heal – 10%

meals for cancer and their caregivers Weight

Registra on fee at tradi onal

‐ In

purchase pass

and clubs

Select fitness ‐ Special discounts

select fitness

Boston Ski & Sports Club ‐ Save 23% on

Appalachian

Club ‐ Save 20% on

Genavix Wellness

‐ Discounts on “90

To Get and

Health and fitness magazine

Save up to 83% magazine subscrip ons

New parent support

Safe Beginnings ‐ 15% The Happiest Baby™ ‐ 40% select CDs

and DVDs Complementary and Alterna ve Medicine

Headspace ‐ Save on a

Ivy Child ‐ 15%

for Massage Envy ‐ Savings in MA, ME and Mindful ‐ 25% Mindfulness course

(UMass Medical School) ‐ 15%

Blood Pressure

‐ $50 Athle c needs

Sports, Running Co.,

& ‐ Save 15% on

Workout ‐ Save 5% on

and services

Eldercare Home Instead Senior Care ‐ $100

offices and free safety

for caregivers

‐ $500 for services

My Vigorous ‐ Save up to 25%

CareScout ‐ 20% on

Eldercare

Hearing aids Save at the

Amplifon Hearing

Care Flynn Associates

Speech‐Language Hearing Greater Boston, PC

cessa on

Craving to ‐ 25% this

based

‐ 18% cessa on

More ways to save! My No fica on Service ‐ 50%

Newbury ‐ 35% hypnosis services Care.com ‐ 25% Green City ‐ 15% Community

educa on ‐ Up to 25%

pill dispensers ‐ 20% The Original

Threads™ ‐ 15% Sense‐Able

Spectrum Disorder Products ‐ 15% on

In Control Crash ‐ 15% for

and Support Plus™ ‐ 10% Personal Emergency

System ‐ $10% New England Spas ‐ Save $300 on hot

or spa

12

Contact:

BCBSMA Dental Blue Program 2 (with Orthodon cs) Customer Service: 800.486.1136 CES BCBS Plan #2329848

Dental

Coverage

Refer to BCBSMA Dental plan summary for complete benefit details, exclusions and provisions.

Dental Blue

Network

Calendar Year Deduc ble $50 per person $150 per family

Calendar Year Maximum $1,000 per person

Diagnos c/Preven ve 100% Covered

Basic Restora ve Services 80% Covered a er Deduc ble

Major Restora ve Services 50% Covered a er Deduc ble

Orthodon cs Life Time Maximum

Full coverage for dependents up to age 25 $1,000

Rollover Benefit Rollover $350; Threshold $500 Maximum $1,000

The CES plan covers many dental needs ranging from preventa ve services and basic care to major restora ve procedures and orthodon a for children under the age of 19. There are no changes to the dental coverage. If your den st does not par cipate in the Dental Blue Network Plan, you do not necessarily have to switch den sts. Non‐par cipa ng den st’s services may be covered at a percen le of the reasonable and customary costs. For more informa on, read the details in the plan’s Benefit Summary. If you haven’t reached the $1000 maximum this year, a certain por on of any unspent annual benefit dollars can be used in a future year benefit through the plan’s Maximum Rollover Benefit. To qualify for this benefit you must: receive at least one service during the plan year; remain a member of the plan for the en re plan year; not exceed the claim payment threshold in the plan year.

13

Voluntary Vision 2016 Biweekly Payroll Deduc ons

Individual $3.14

Individual & Spouse $5.02

Individual & Children $5.13

Family $8.26

Vision Insurance

Contact:

VSP 800.877.7195 www.vsp.com

On July 1st, CES will be offering the Voluntary Vision Insurance through VSP. This plan covers an exam every

12 months and benefits for frames, premium lenses and contacts.

Refer to VSP plan summary for complete benefit details, exclusions and provisions.

2016 In‐Network

Exam (once every 12 months) $10 co‐pay

Frames (once every 24 months) Covered up to the retail allowance of $130 with 20% discount on amounts over $130

Single Vision, Lined Bifocal and Trifocal Lenses (once every 12 months)

$25 co‐pay

Other Lens Op ons Network Discounts (Employee Pays)

UV Coa ng ‐ $16 Tint (solid and gradient) ‐ $17

Scratch Resistance ‐ $17 Polycarbonate ‐ $31

Progressive (add‐on to bifocal)‐ $55‐$105 An ‐reflec ve ‐ $41

Contact Lenses (instead of eyeglass lenses) Every 12 months

Maximum copay of $60 for fi ngs, $130 Allowance

14

2016 Dental Payroll Deduc ons Dental Biweekly Level I

50% Level II

60% Level III

65% Level IV

75%

Single $10.09 $8.07 $7.06 $5.04

2 Person $21.50 $17.20 $15.05 $10.75

Family $30.07 $24.06 $21.05 $15.03

Medical and Dental Employee Contributions

2016 Medical Payroll Deduc ons Best Buy HMO $3,000 Biweekly

Level I 50%

Level II 60%

Level III 65%

Level IV 75%

Single $174.52 $139.61 $122.16 $87.26

2 Person $349.04 $279.23 $244.33 $174.52

Family $521.46 $417.17 $365.02 $260.73

Best Buy H.S.A PPO $2,000 Biweekly

Level I 50%

Level II 60%

Level III 65%

Level IV 75%

Single $143.11 $108.20 $90.75 $55.85

2 Person $286.22 $216.41 $181.51 $111.70

Family $428.26 $323.97 $271.82 $167.53

Best Buy H.S.A PPO $3,000 Biweekly

Level I 50%

Level II 60%

Level III 65%

Level IV 75%

Single $114.29 $79.38 $61.93 $27.03

2 Person $228.58 $158.77 $123.87 $54.06

Family $342.08 $237.79 $185.64 $81.35

15

For

FINANCIAL HEALTH

Life and Disability Insurance

Refer to Symetra plan summary for complete benefit details, exclusions and provisions.

Basic Life Insurance You are provided with company paid Life Insurance through Symetra. Life insurance provides a valuable asset to your beneficiaries in the event of your death or dismemberment. Collabora ve for Educa onal Services is increasing the amount they will provide to all eligible employees. The new benefit amount is a flat $30,000 (the current benefit is $10,000).

Supplemental Life Insurance You may purchase Voluntary Life Insurance through Symetra to protect your beneficiaries from financial hardship in the event of your death. You may also purchase Voluntary Life Insurance on your spouse and/or your eligible dependent children if you par cipate in the plan. Coverage is available in $10,000 increments for employees and dependents. Premiums are based on the coverage amount you elect and your age. Premiums will be paid through the convenience of payroll‐deduc on. Employee coverage is available in amounts from

$10,000 to $300,000, Guarantee issue of $250,000

Spouses may be insured for between $10,000 and $100,000, Guarantee issue of $50,000

Premiums for spouse coverage is based on the employee’s age. The monthly rate per $1,000 of coverage is based on your age band. Dependent children, up to age 26, may be covered for $10,000. The cost of this coverage is $0.60/month; one charge regardless of the number of eligible dependents.

Important No ce: When a par cipant moves from one age category to the next (e.g. 49 to 50), rates change the following July 1.

Long Term Disability You are provided with company paid Long Term Disability insurance through Symetra. This coverage will provide you with a source of income, should you become disabled for a long period of me and you exhaust your Short Term Disability period. Long Term Disability coverage replaces 60% of monthly earnings up to a monthly maximum of $6,000 per month. The Long Term Disability plan pays benefits a er being disabled for 90 days.

Voluntary Short Term Disability You have the opportunity to purchase Short Term Disability through Symetra. This coverage will provide you with a source of income replacement should you become disabled due to an injury or illness. Short Term Disability coverage replaces 60% of weekly earnings in increments of $25 from a minimum of $100 to a maximum of $1,250. Benefits begin on the 14th day of an accident or illness. The maximum dura on of the benefit is up to 13 weeks.

If you wish to elect/increase your life coverage amount above

the Guarantee Issue amount or enroll/change your Short Term

Disability an EOI will be required.

*Evidence of Insurability (EOI) ‐ a statement of medical history

and related informa on, which the insurance carrier will use to

determine whether an applicant will be approved for coverage.

Contact: Symetra Life Insurance Company Phone: 800.796.3872 | TTY/TDD 800.833.6388

16

Supplemental Life Insurance Monthly Rates

Per $1,000 of coverage

Under age 30 $0.047

30‐34 $0.048

35‐39 $0.069

40‐44 $0.114

45‐49 $0.192

50‐54 $0.327

55‐59 $0.571

60‐64 $0.724

65‐69 $1.099

70+ $2.132

Employee Spouse

$0.047

$0.048

$0.069

$0.114

$0.192

$0.327

$0.571

$0.724

$1.099

$2.132

Child $0.06 $0.06

Voluntary Life and Short Term Disability Insurance

Employee Rates

Supplemental Short Term Disability Insurance Monthly Rates

Per $1,000 of coverage

Under age 30 $0.64

30‐34 $0.64

35‐39 $0.64

40‐44 $0.57

45‐49 $0.57

50‐54 $0.73

55‐59 $0.73

60‐64 $1.00

65‐69 $1.00

70+ $1.00

17

Contact: American Benefit Group (ABG) 800.499.3539 [email protected]

Flexible Spending

Accounts

A Flexible Spending Account (FSA) allows you to save on your eligible healthcare and/or dependent care expenses by using pre‐tax dollars.

Health Care Account Three reimbursement accounts are available, the Health Flexible Spending Account (FSA), Dependent Care Assistance Plan (DCAP) and a Limited Purpose Medical FSA (for members who are enrolled in a High Deduc ble PPO Plan). Using these plans will save you money by allowing you to pay for medical and dependent care expenses with pre‐tax dollars.

If you are par cipa ng in either of the PPO plans, you are eligible to enroll in a “Limited Purpose FSA”. This benefit can help with any out‐of‐pocket dental and vision expenses that you might have during the plan year. Healthcare FSA’s: You can elect up to $2,550 to be

used to pay for items such as doctor’s visit copays, prescrip on copays, dental expenses, prescrip on glasses/contacts, and some over the counter items.

Your en re annual healthcare elec on is made available to you on a pre‐loaded Visa Debit card on the first day of your eligibility and you pay it back through pre‐tax payroll deduc ons over the course of the plan year.

Dependent Care Account This account helps you pay for eligible child care or adult day care with tax‐free dollars. Reimbursable expenses may include day care and even elder care in or out of your home. Your funds are available as they accumulate through payroll deduc ons.

You may deposit up to $5,000 into the Dependent Day Care FSA (combined with your spouse’s FSA elec on, if applicable). Reimbursement Op ons: The FSA Card If you already have an ABG Benefits Card please keep it, your balance will be loaded onto your card for the new plan year. If this is your first me enrolling in the Flexible Spending Account (FSA) please look for your ABG Benefits Card in the mail. The cards are good for three years and as long as the card is not set to expire, your new funds will be loaded on your current card for July 1st. If your card is going to expire on 6/30/2016, a replacement card will be issued 30 days prior to the expira on date as long as you re‐enroll.

2015 elec ons will not roll over. You must re‐enroll for 2016.

Refer to American Benefits Group plan summary for complete benefit details, exclusions and provisions.

18

PPO members are able to par cipate in a Health Savings Account which can be used for many medical expenses. HSA funds are yours to keep ‐ there is no "use it or loose it" rule ‐ the money is yours and you can take it with you should you leave CES. Consider a Health Savings Account (HSA) to pay for deduc ble expenses. In addi on to contribu ng to the HSA, you also have the op on to contribute to a Limited Purpose FSA for any vision or dental expenses. Please review the FSA page for more informa on and instruc ons on how to enroll! What is Health Savings Account? Health Savings Accounts (HSAs) are designed to help individuals save for medical and re ree health expenses on a tax‐advantaged basis.

For 2016, you can elect up to $3,350 for an individual or $6,650 for a family.

In 2017 you can elect up to $3,400 for an individual or $6,750 for a family

If you are aged 55 or older, you can contribute an addi onal catch‐up contribu ons of $1,000.

The amount you contribute to a HSA can be used to pay for items such as medical deduc bles, prescrip on copays, dental expenses, prescrip on glasses/contacts, and some over the counter items. ― The amount available in the

account is equal to the amount that has been deducted from your paycheck to date for the plan year.

Your balance is portable and can be invested to grow over me.

Funds remaining in your HSA when you reach the age of 65 can be used for non‐healthcare expenses.

You cannot contribute to an HSA unless you are enrolled in a high deduc ble health plan.

How do I set up or change my investment elec ons? Once you have enrolled in an HSA ‐ qualified health plan, it is easy to set up your Wells Fargo Health Savings Account. You can enroll online by comple ng your applica on by following the simple steps online. Once enrolled you will need to fill out the HSA Salary Reduc on Agreement that can be found on the CES’ site. You will receive your HSA debit card and your personal iden fica on number (PIN) within 10 business days of enrolling in the Wells Fargo HSA. For security, the HSA debit card and PIN will arrive in separate mailings. Your HSA debit card is ed to the available deposit account balance in your HSA. The HSA debit card can be used to pay for qualified medical expenses billed from an insurance company, at a doctor’s office or pharmacy, or at any merchant that accepts the Visa debit card. You can also use the card to make withdrawals from your HSA at an ATM.

Health Savings Account

Contact: Administered by Wells Fargo 866.884.7374 Wellsfargo.com/hsa Employer HSA ID number 913691000000000

19

Flexible Spending vs Health Savings Account

Health Savings Account (HSA) Flexible Spending Account (FSA)

Eligibility Requirements Eligibility requirements include having a high‐deduc ble health plan (HDHP)

No eligibility requirements

Contribu on Limit 2016 contribu ons capped at $3,350 for individuals or $6,750 for families,

2017 contribu ons capped at $3,400 for an individual or $6,750 for a family

2016 contribu ons capped at $2,550

Changing Contribu ons Amounts

You can change how much you contrib‐ute to the account at any point during

the year.

Contribu on amounts can be adjusted only at open enrollment or with a

change in employment or family status.

Rollover Unused balances roll over into the next year.

With a few excep ons, FSAs are “use it or lose it,” and you forfeit any unused

balance.

Connec on to Employer Your HSA can follow you as you change employment.

In most cases, you’ll lose your FSA with a job change. One excep on: if you’re eligible for FSA con nua on through

COBRA.

Effects on Taxes Contribu ons are tax‐deduc ble, but can also be taken out of your pay pret‐ax. Growth and distribu ons are tax‐

free.

Contribu ons are pretax, and distribu‐ons are untaxed.

Important differences between FSAs and HSAs As you can see in the following table, there are several addi onal differences between these accounts. Things like your flexibility in contribu ng, the ability to keep your unused balance and addi onal tax benefits make HSAs the wisest choice if you have the op on. S ll, either account stands to save you money and make budge ng for medical costs easier.

You cannot choose both, unless … If you qualify for an HSA, you cannot elect to set up both an HSA and an FSA, unless the FSA is a “limited purpose” FSA. A limited purpose FSA works like a regular FSA but can be used only for vision care and dental expenses. If you expect to have high medical costs throughout the year, or want to maximize contribu ons to your HSA while minimizing your withdrawals, using a limited purpose FSA for expected vision and dental expenses could be a smart choice.

20

Contact: Symetra Select Benefits Member Services: 800.497.3699 [email protected]

NEW! Hospital Indemnity A trip to the hospital can be stressful, and so can the bills. Even with major medical insurance, you may s ll be responsible for co‐payments, deduc bles and other out‐of‐pocket costs. The hospital indemnity plan pays a cash benefit directly to you whenever you or your covered family members are admi ed to the hospital.

Your

Deduc ‐

Voluntary Hospital Indemnity Insurance Biweekly Rates

Coverage Amounts Plan 1 Plan 2

Employee Only $6.61 $11.00

Employee & Spouse $14.08 $23.46

Single Parent $10.83 $18.05

Family $19.60 $32.66


Hospital Daily Benefit—Per Person Per Calendar Year

Plan 1 Plan 2

Regular Inpa ent Room $300/10 Days $500/10 Days

Intensive Care $600/10 Days $1,000/10 Days

Mental Health & Substance Abuse Inpa ent Benefits

$150 per day/10 days per per‐son/per calendar year

(180 days life me maximum)

$250 per day/10 days per per‐son/per calendar year

(180 days life me maximum)

Skilled Nursing Facility (Following a three day hospital stay)

$150 per day/60 consecu ve days per stay maximum. This

benefit is paid only if following a covered hospital stay of at least three consecu ve days and the

insured is under age 65.

$250 per day/60 consecu ve days per stay maximum. This

benefit is paid only if following a covered hospital stay of at least three consecu ve days and the

insured is under age 65.

Voluntary Hospital Indemnity

Insurance

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Covered condi ons are grouped into three categories. If the diagnosed cri cal illness does not qualify for the full benefit amount, you could receive an addi onal lump‐sum benefit upon diagnosis of a different type of cri cal illness within the same category up to the 100% maximum. Benefits in different categories are subject to a separa on period of 12 months between diagnoses. *The benefit amount reduces by 50% at age 70. 2—May vary by state

NEW! Cri cal Illness Cri cal Illness insurance helps you and your family maintain financial security during the lengthy, expensive recovery period of a cri cal illness. It provides a lump sum benefit to help with the out‐of‐pocket medical and non‐medical expenses of employees who suffer a cri cal illness. Coverage amounts $5,000, $10,000 and $15,000 are available for employees. Spouse’s are eligible for up to 50% of the employee’s benefit. If you are diagnosed with a covered cri cal illness a er the policy is in effect, you will receive payment that is equal to the benefit amount of your policy mul plied by the percentage for that covered illness as shown in the table below.


Voluntary Critical Illness Insurance


22


Accident Insurance Most tradi onal insurance doesn’t cover every medical expense, leaving you to pay out‐of‐pocket expenses such as deduc bles, office visit co‐payments, and transporta on and lodging costs. You are being offered group accident coverage for three separate accidents per year. The coverage pays benefits for eligible expenses incurred as a result of an accident up to the benefit specific accident occurrence.

Eligible expenses related to an accident occurrence will be paid at 100% up to the preselected benefit amount. You are responsible for any remaining balances. You may receive up to three benefits per year. Each occurrence benefit is ed to a specific accident and cannot be used to cover expenses related to any other accident occurrence.

Examples of covered services:


If you are currently enrolled with Reliance Standard Accident Insurance, you will need to enroll with Symetra for July 1, 2016.

Voluntary Accident Insurance

Voluntary Accident Insurance Biweekly Rates

Employee Only $9.87

Employee & Spouse $21.03

Single Parent $16.17

Family $29.28

$11.02

$23.48

$18.06

$32.70

Plan 1 Plan 2

Coverage Amounts Pays up to $5,000; 3 Accidents per Calendar Year

Pays up to $10,000; 3 Accidents per Calendar Year

Medical Benefits: Nursing services Physician's office visits Urgent care visits

Dental Benefits

Disloca on of the jaw A closed or open reduc on of a fracture Injury to natural teeth

Surgical Benefits Inpa ent hospital benefits X‐ray and laboratory benefits Inpa ent prescrip on drugs

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Contact: Na onwide (formally VPI) 877.738.7874 PetsNa onwide.com

Voluntary Pet Insurance

Per‐paycheck pricing is based on a 26 week pay period per year cycle. Your pricing may vary depending on your employer’s payment schedule. Premiums vary based on the age of the pet, species, size (as an adult), plan type, deduc ble and state of residence.

VPI covers dogs, cats, birds, ferrets, rep les and pocket pets. There are a variety of medical plan op ons to choose from and a wide range of available coverage: accident, illness, hereditary problems and preven ve care. All policies are individually underwri en and monthly rates are subject to animal breed, age, state of residence and plan type, premiums will be payroll deducted.

24

Contact: Educators EAP Call any me 800.225.2527 or 800.252.4555 www.educatorsEAP.com

Your

Deduc ble

& Prescrip on

Drugs

Employee Assistance

Program

Type of Issues that counselors may assist you with: Counseling Benefits

Work/Life Benefits

Educator Resource Centers

Informa on Resource Centers

Lifestyle Benefits

Personal Development Benefits

Wellness Benefits

Employees are eligible for short‐term counseling from the Educators EAP at no cost for themselves and immediate family members. This program is outside of the Collabora ve and completely confiden al. Support and referrals are available for work or family ma ers, debt counseling, legal problems, stress‐related issues, substance abuse, etc.

25

Symetra - Beneficiary Companion

Program and ID Theft

Contact: Symetra 877.823.5807 www.symetra.com

Beneficiary Companion Program

Managing a loved one’s final affairs can be overwhelming.The amount of me and effort needed to close an estatecan make an already stressful me even more difficult. Your Beneficiary Companion Program can offer some relief and provide guidance to help with paperwork, no fica ons and other me‐consuming details.

Guidance Services

Dedicated Beneficiary Assistance Coordinators are available 24/7 to:

Answer any ques ons

Offer guidance on how to obtain death cer ficate copies

Manage no fica ons, including:

Social security administra on

Credit repor ng agencies

Credit card companies/financial ins tu ons

Third‐party vendors

Government agencies

Fraud Resolu on

A deceased’s iden ty is an a rac ve target for criminals—and rela vely easy to obtain. Beneficiary Assistance Coordinators will help protect your loved one’s iden ty and lend a hand in case their iden ty is stolen. Services include:

A credit report review with the beneficiary

Suppression of the deceased’s credit report or an offer to freeze/close the account with credit bureau’s

Full‐service resolu on assistance if the deceased’s iden ty is stolen, including affidavit assistance, credit bureau and fraud department no fica on, help with filing a police report, and creditor follow‐up

Iden ty The Protec on Program

Iden ty the is a rising concern and it can happen to any‐one. That’s where your Iden ty The Protec on Program comes in. It provides you with informa on to protect your‐self and step‐by‐step coaching to help you iden fy and re‐solve iden ty the .

If you think your iden ty has been stolen

Just pick up the phone—24 hours a day, seven days a week—and call 877‐823‐5807 if you’re in North America or (240) 330‐1422 from anywhere else in the world.

A Symetra Iden ty The Expert will help you obtain a copy of your credit report from all three major credit‐repor ng agencies. All three agencies will also place a fraud alert on your records.

Once you receive your reports, your Iden ty The Expert will walk you through the documents to determine if fraud or the has occurred.

Here’s the help you’ll receive

Lost wallet assistance

Credit informa on review

3‐bureau fraud alert placement assistance

ID the affidavit assistance

Transla on services while traveling

Emergency cash while traveling (a repayment guaran‐tee is needed)

Who’s Eligible?

Once enrolled in a Symetra group insurance plan, you, your spouse, and your dependents under the age of 25 are eligi‐ble for all services provided by the Iden ty The Protec on Program. Iden ty the s discovered prior to enrollment in a Symetra group insurance plan are not eligible for ser‐vices.

Don’t wait un l the occurs

There’s no be er me to deal with iden ty the than be‐fore it happens. Be sure to call 877‐823‐5807 and men on you’re calling about the Symetra Iden ty The program to get your Iden ty The Protec on Kit. It covers the ins and outs of iden ty the and provides advice on how to avoid it. And just in case your iden ty is stolen, the kit includes forms you’ll need to help resolve the problem.

26

Symetra—Travel Assistance Program

Travel Assistance Program

Emergencies happen. When they happen far from home, it’s comfor ng to know there's a team of mul lingual professionals standing by to help. Your Travel Assistance Program (provided by Europ Assistance) offers a variety of 24‐hour‐a‐day services in more than 200 countries and territories worldwide—and each one is just a phone call away.

Medical Services

Assistance finding physicians, den sts and medical facili es

Monitoring during a medical emergency to determine if care is appropriate or if evacua on is required

Free transporta on under medical supervision to a hospital/treatment facility or to your place of residence for treatment

Arrangement for your traveling companion’s return home if previously‐made arrangements are lost due to your medical emergency

Free transporta on home for dependent children under the age of 16 who were traveling with you and are le una ended because of your hospitaliza on. A qualified escort will be arranged if necessary.

Free round‐trip transporta on for one immediate family member or friend to visit you if you’re traveling alone and are likely to be hospitalized for seven consecu ve days

Replacement of medica on and eyeglasses

Other Key Services

Pre‐trip informa on, including visa, passport, inocula on and immuniza on requirements; cultural informa on; embassy and consulate referrals; foreign exchange rates; and travel advisories

Emergency message relay to and from friends, rela ves and business associates

If appropriate, new travel arrangements or change of airline, hotel and car rental reserva ons

An advance of up to $500 in emergency cash a er sa sfactory guarantee of reimbursement from you. You are responsible for any fees associated with the transfer or delivery of funds.

Help loca ng and replacing lost or stolen luggage, documents and personal possessions

Help loca ng an a orney and advancement of bail bond, where permi ed by law, a er sa sfactory guarantee of reimbursement from you. You are responsible for a orney fees.

Assistance with telephone interpreta on in all major languages, or referral to an interpreta on or transla on service for wri en documents

In the event of death while traveling, all necessary government authoriza ons and a container appropriate for transporta on will be arranged and paid for, as well as return home of the remains for burial

Who’s Eligible?

You, your spouse and your dependents under the age of 25 are eligible for all services provided by the Travel Assistance Program.

You can receive pre‐trip informa on at any me

All other services take effect when you’re on a trip 100 miles or more from home las ng 90 days or less.

27

Your

Deduc ble

Legal Notices Premium Assistance under Medicaid and the Children’s Health Insurance Programs (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or

CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t bethrough the Health Insurance

Marketplace. For more informa on, visit www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your

dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1‐877‐KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might

help you pay the premiums for an employer‐sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called

a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have ques ons about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1‐866‐444‐EBSA (3272).

If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of January 31, 2016. Contact your State for more informa on on eligibility –

ALABAMA – Medicaid GEORGIA – Medicaid

‐ Click on Health Insurance Premium Payment (HIPP)

ALASKA – Medicaid INDIANA – Medicaid

Website:Phone

(Outside of Anchorage): 1‐888‐318‐8890

Healthy Indiana Plan for low‐income adults 19‐64

All other Medicaid

COLORADO – Medicaid IOWA – Medicaid

Medicaid Customer Contact Center: 1‐800‐221‐3943

FLORIDA – Medicaid KANSAS – Medicaid

28

Legal Notices

KENTUCKY – Medicaid NEW HAMPSHIRE – Medicaid

Website:

LOUISIANA – Medicaid NEW JERSEY – Medicaid and CHIP

Website:

dmahs/clients/

medicaid/

CHIP Phone: 1‐800‐701‐0710

MAINE – Medicaid NEW YORK – Medicaid

assistance/index.html

TTY: Maine relay 711

MASSACHUSETTS – Medicaid and CHIP NORTH CAROLINA – Medicaid

MINNESOTA – Medicaid NORTH DAKOTA – Medicaid

Website:

MISSOURI – Medicaid OKLAHOMA – Medicaid and CHIP

Website:

MONTANA – Medicaid OREGON – Medicaid

Website:

NEBRASKA – Medicaid PENNSYLVANIA – Medicaid

Website:

ska/Pages/accessnebraska_index.aspx

29

Legal Notices

To see if any other states have added a premium assistance program since January 31, 2016 , or for more informa on on special enrollment rights, contact either: U.S. Department of Labor U.S. Department of Health and Human Services Employee Benefits Security Administra on Centers for Medicare & Medicaid Services www.dol.gov/ebsa www.cms.hhs.gov

1‐866‐444‐EBSA (3272) 1‐877‐267‐2323, Menu Op on 4, Ext. 61565 OMB Control Number 1210‐0137 (expires 10/31/2016)

NEVADA – Medicaid RHODE ISLAND – Medicaid

SOUTH CAROLINA – Medicaid VIRGINIA – Medicaid and CHIP

CHIP Website:

CHIP Phone: 1‐855‐242‐8282

SOUTH DAKOTA ‐ Medicaid WASHINGTON – Medicaid

Website:

x.aspx

TEXAS – Medicaid WEST VIRGINIA – Medicaid

Website:

s/default.aspx

Phone: 1‐877‐598‐5820, HMS Third Party Liability

UTAH – Medicaid and CHIP WISCONSIN – Medicaid and CHIP

Website:

Website:

VERMONT– Medicaid WYOMING – Medicaid

HIPAA Privacy Notice Availability We take your privacy seriously… We will provide a copy of our HIPAA privacy no ce and talk to you about our privacy prac ces. Please contact the Human Resource Department if you have any ques ons.

30

Please read this no ce carefully and keep it where you can find it. This no ce has informa on about your current prescrip on drug coverage with CES and about your op ons under Medicare’s prescrip on drug coverage. This informa on can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescrip on drug coverage in your area. Informa on about where you can get help to make decisions about your prescrip on drug coverage is at the end of this no ce.

There are two important things you need to know about your current prescrip on drug coverage and Medicare’s prescrip on drug coverage:

1. Medicare prescrip on drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescrip on Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescrip on drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

2. CES has determined that the prescrip on drug coverage offered by the CES Health Plan is, on average for all plan par cipants, expected to pay out as much as standard Medicare prescrip on drug coverage pays and is therefore considered Creditable Coverage. Because your exis ng coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

When Can You Join A Medicare Drug Plan?

You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. If you decide to join a Medicare drug plan, your coverage in the CES Health Plan will not be affected.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?

You should also know that if you drop or lose your current coverage with CES and you do not join a Medicare drug plan within 63 con nuous days a er your current

coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.

If you go 63 con nuous days or longer without creditable prescrip on drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescrip on drug coverage. In addi on, you may have to wait un l the following October to join.

For More Informa on About This No ce Or Your Current Prescrip on Drug Coverage…

Please contact Human Resources for further informa on.

NOTE: You will receive this no ce each year during open enrollment, before the next period you can join a Medicare drug plan, and if your prescrip on drug coverage through CES changes. You also may request a copy of this no ce at any me.

For more informa on about Medicare prescrip on drug coverage:

Visit www.medicare.gov Call your State Health Insurance Assistance

Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help

Call 1‐800‐MEDICARE (1‐800‐633‐4227). TTY users should call 1‐877‐486‐2048.

If you have limited income and resources, extra help paying for Medicare prescrip on drug coverage is available. For informa on about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1‐800‐772‐1213 (TTY 1‐800‐325‐0778).

Legal Notices Notice on Your Prescription Drug & Medicare Coverage

31

Legal Notices HIPAA Special Enrollment Right

If you are declining enrollment for yourself or your

dependents (including your spouse) because of other health insurance or group health plan coverage, you may

be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage).

However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other

coverage).

In addition, if you have a new dependent as a result of

marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days

after the marriage, birth, adoption, or placement for adoption.

To request special enrollment or obtain more

information, contact Lynn Rulnick, Human Resources Generalist at 413‐588‐5923, lrulnick@collabora ve.org.

Mental Health Benefit Changes

The Federal Emergency Economic Stabilization Act of

2008 went into effect for employees on January 1,

2011. This Act requires group health plans that provide

physical and mental health/substance abuse disorder

benefits, ensure member financial requirements and

treatment limitations that apply to mental health and

substance abuse disorder benefits are no more restrictive

than the financial requirements and treatment limitations

on physical benefits. Consequently, deductibles, co‐

insurance, copays, and out‐of‐pocket expenses for mental

health and substance abuse disorder benefits will be no

more restrictive than those for medical/surgical benefits.

Also, treatment limits, such as frequency and number‐of‐

visit limits, and coverage days will be no more restrictive

than those for medical/surgical services.

The Newborns’ and Mothers’ Health Protection Act (NMHPA)

Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any

hospital length of stay in connec on with childbirth for

the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours

following a cesarean sec on. However, Federal law generally does not prohibit the mother’s or newborn’s a ending provider, a er consul ng with the mother, from discharging the mother or her newborn earlier than

48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authoriza on from the plan or the insurance issuer for prescribing a length of stay not in

excess of 48 hours (or 96 hours). Plans may be subject to State law requirements, please refer to the Plan Summary Plan Document for details describing any applicable State

law.

Uniformed Services Employment and Reemployment Rights Act

Your right to con nued par cipa on in the Plan during

leaves of absence for ac ve military duty is protected by the Uniformed Services Employment and Reemployment

Rights Act (USERRA). Accordingly, if you are absent from work due to a period of ac ve duty in the military for less than 31 days, your Plan par cipa on will not be interrupted. If you do not elect to con nue to par cipate

in the Plan during an absence for military duty that is more than 31 days, you and your covered family members will have the opportunity to elect COBRA

Con nua on Coverage only under the medical insurance policy for the 24‐month period that begins on the first day of your leave of absence. You must pay the premiums for Con nua on Coverage with a er‐tax funds, subject to the

rules that are set out in that plan.

Consolidated Omnibus Budget Reconciliation Act (COBRA)

The Consolidated Omnibus Budget Reconcilia on Act (COBRA) gives workers and their families who lose their health benefits the right to choose to con nue group

health benefits provided by their group health plan for limited periods of me under certain circumstances such as voluntary or involuntary job loss, reduc on in the hours worked, transi on between jobs, death, divorce,

and other life events. Qualified individuals may be required to pay the en re premium for coverage up to 102 percent of the cost to the plan.

annual open enrollment guide - collaborative

Documents