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To Learn More, visit MyCHCBenefits.com

To Learn More, visit MyCHCBenefits.com 2

Introduction .......................................................................... 3 Eligibility - Who is Eligible? ................................................ 4 Open Enrollment Instructions ............................................. 5 MyCHCBenefits.com ............................................................ 6 Changes for the Year ........................................................... 7 Medical Plans ...................................................................... 8-10 . Major Medical Compliment Plan …………………….……….11 Prescription Coverage………………………………………….12 Dental Plan............................................................................ 13 Vision Plan………………………………………………………..14 Supplemental Plans ............................................................. 15 Critical Illness Plan .............................................................. 16 Accident Plan ....................................................................... 17 Disability Income Plans ....................................................... 18 Term Life Insurance ............................................................. 19 Universal Life Insurance ..................................................... 20 Affordable Care Act Update ................................................ 21

Legal Notices ........................................................................ 22-24

Rates…………………………...………………………………….25-27

Important Phone Numbers .................................................. 28

Every reasonable effort has been made for the information provided in this booklet to be accurate. It is intended to provide the employees

with Chris Hill Construction an overview of the coverages offered. It is in no way a guarantee or offer of coverage. Each carrier has the

ability to underwrite based on its contract with Chris Hill Construction or its employees. Each carrier’s contract, underwriting, and policies

will supersede this document. Please be aware that each carrier may have exclusions or limitations and you must consult your summary

plan description and/or policies for details.

Look for the Different Colors at

the top of each page to Designate

the Section you are Viewing TA

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E O

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ON

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Your Chris Hill Construction

Benefits Package

Chris Hill Construction takes pride in providing our employees with one of the most competitive and affordable benefit packages in the industry. Employees enjoy favorable purchasing power due to negotiated discounts as well as a company contribution towards your healthcare coverage. In addition, our Cafeteria Plan allows our employees to pay for certain benefit plans with pre-tax dollars.

All of our benefit programs are designed to work cohesively to protect you and your family from catastrophic loses. Keeping our annual healthcare increases year-over-year to a minimum takes a joint effort. We depend on our employees to become educated healthcare consumers and to spend your health care dollars wisely. Visit your primary care physician annually and take advantage of the ‘no cost to you’ preventive screenings included in all of our medical plan options. When medical tests or surgical procedures are recommended, use United Healthcare’s on-line quality and cost comparison tools. This will reduce your out-of-pocket expenses and helps manage the cost to the plan.

Employees have an annual opportunity to review benefit option selections and make changes to plan selections.

During this annual open enrollment period you will have a one-on-one meeting with an Enrollment Counselor to discuss your personal benefit needs for the upcoming new plan year (10/1/16-9/30/17). If you’re confused about putting together a benefit package,

this personalized meeting can be a valuable resource for you.

Your Benefit Options…

Medical Plan - Choose from 3 different UHC plans & 1 Allstate plan.

GAP Plan - Choose from 2 different Medical GAP Plans.

Dental Plan - Plan covers routine annual cleanings and x-rays at no cost to you.

Vision Plan - Choose to enroll in a PPO Vision plan.

Critical Illness with option to elect Cancer coverage - What can living with a Critical

Illness mean to you?

Disability Income Plan - Protecting your paycheck.

Accident Plan - Protected from life accidents?

Term Life Insurance - For you and your dependents. Take care of those you love.

Universal Life Insurance - Life Insurance that builds cash value.

Check with your Human Resources Department to learn when your employee open

enrollment meetings are scheduled.


ELIGIBILITY - WHO IS ELIGIBLE?

When am I Eligible for Benefits?

Employees working 30 hours per week are eligible for benefits.

When does my coverage begin

as a new full-time employee?

Benefit Eligible Employee Waiting Periods:

All Coverage is Effective after 60 Days and First of Month Following

Contact your local Human Resources Department for

the dates and times of the one-on-one enrollment

sessions with a BenefitHelp Enrollment Counselor.

If you have questions about adding your spouse or

children, please contact HR.


OPEN ENROLLMENT INSTRUCTIONS

What does Active Enrollment mean?

You will be required to review and make benefit elections in order to be covered under the plans offered by Southern College of Optometry. As part of the Active Enrollment process you will be required to review and update dependent and beneficiary information as well. The Affordable Care Act does require that dependent social security numbers be captured so please be sure to have this information available during enrollment.

During your one-on-one enrollment meeting your Enrollment Counselor will:

1. Assist you with using the new enrollment system.

2. Explain the benefit offerings and answer questions.

3. Make your benefit elections and explain how to print a

confirmation of your elections.

You must participate in the enrollment process.

Schedule your One-on-One

Enrollment Meeting

1

Meet with Enrollment Counselor to Review

Benefit Offerings

2

Enroll through eBenCom® system with Assistance of

Enrollment Counselor

3

At the end of your enrollment

session, you will be provided

with an enrollment survey.

Your feedback is important to

us…so please tell us how we are

doing.

This year’s Open Enrollment will be an Active Open Enrollment for all plans. ALL

EMPLOYEES must actively re-enroll in benefits to have coverage in the new plan year.

Check with your Human Resources Department to learn when your employee open enrollment meetings are scheduled. You can also sign up with Human Resources

for a one-on-one, personalized meeting time that is convenient to your schedule.

2016

Open Enrollment


MYCHCBENEFITS.COM

Have you ever had trouble locating information about your benefits?

What about trying to remember how

to find a participating doctor or dentist?

Problem Solved!

It’s All Online

One place to go, just an internet connection away.

Get Important Phone

Numbers & Carrier

Information

Search for Providers

& Facilities

Benefit News &

Updates

Frequently Asked

Questions

24 Hours a Day

7 Days a Week

Where can I get More Information

about My Benefits?

Watch Videos About

Your Benefits.

Print Important

Documents & Forms

Get Benefit

Information 24/7/365

from ANY device.


CHANGES FOR THE YEAR

Benefit Plan Changes Effective October 1, 2016

Your medical plan coverage through United Healthcare will remain the same. However,

you may experience a minimal increase in your per paycheck contributions.

Critical Illness coverage will be offered through Allstate Benefits. During this Open

Enrollment Allstate is providing the ability to enroll in a Critical Illness plan, with or with-

out coverage for cancer, without any medical questions if you are a New Hire Only.

If you were offered Critical Illness in 2015, you may elect to enroll by completing an

Evidence of Insurability Form. Please note, pre-existing conditions may apply.

Accident Plan coverage will be offered through Allstate Benefits during this open enroll-

ment and will be made available on a guarantee issue basis. You may select coverage

for yourself, spouse and children.

Need Help with Enrollment?

Contact BenefitHelp at 888-663-1285 option #2

or email [email protected] for assistance.

1

2

3

5 You have the option to purchase additional life insurance coverage through

Allstate Benefits. The Universal Life Insurance coverage provides permanent life

insurance coverage at group rates, with minimal health questions.

4 You have the option to purchase additional disability income insurance coverage

through Allstate Benefits. The Disability Income coverage helps to protect your most

valuable asset… your ability to earn an income.


To fit your specific needs, your benefit package provides you with three options in medical plans. The plan with the lowest deductible has the highest payroll deduction. The plan with the highest deductible has the lowest payroll deduction. All three plans cover the same services, just with different copayments and deductibles that apply. It’s up to you to take advantage of everything your health plan offers. To choose the plan that is right for you ask yourself the questions that will help you assess your needs. Think about the ways you use healthcare, the medical needs you can foresee, and how you can balance cost and coverage.

Terms and Definitions

Deductible

This is the amount of money you pay for health services before your medical Insurance begins paying. For some services you have to pay the deductible before the plan pays. Your deductible starts over each January 1st.

Copay

This is the amount of money that you pay each time a particular service is utilized.

Coinsurance

This is the rate that you will essentially be splitting the cost of your healthcare with your insurance provider. For instance, if your health plan has an 80/20 coinsurance rate, your insurance plan pays for 80% of your eligible medical expenses and you’re responsible for the remaining 20%.

Out-of-pocket Coinsurance Maximum

This is the most you will have to pay under your medical plan each year. Includes copays, deductible & coinsurance. This protects you from the financial drain of high medical expenses. Copays do count towards your out-of-pocket maximum and still apply after you meet your maximum.

In-Network / Out-of-Network

If your medical plan has “in and out” coverage, this means you can see any provider you wish. However, if you choose to see a provider that is not on the approved in-network list, you will pay a greater share of the cost. Determining whether or not a provider is in-network is your responsibility. Please check with the provider to see if he or she is in the network. before services are rendered, preferably when making the appointment.

To locate a provider or to review the policy

details, please visit:

www.MyCHCBenefits.com

UHC

MEDICAL OVERVIEW

MyCHC

Benefits


Pick the medical plan that best fits your needs...

MEDICAL PLANS

Rates

Page 29

Need HELP meeting your out of pocket expenses?

Find out how supplemental plans can help you on pages 15-17.

CHRIS HILL CONTSTRUCTION MEDICAL PLANS (in network benefits)

OPTION -$1,500

25/1500/80%

OPTION 2-$3,000

25/3000/80%

OPTION 3-$5,000

30/5000/80%

Physician Office Visit $25 copay $ 25 copay $ 30 copay

Specialist Office Visit $50 copay $ 50 copay $ 60 copay

Wellness Benefit (age appropriate

screenings apply)

100% Coverage

(no copay, no annual

maximum if in-network)

100% Coverage



100% Coverage



Urgent Care Center $ 75 copay $ 75 copay $ 75 copay

Emergency Room Visit $ 250 copay $ 250 copay $ 250 copay

Major Diagnostic Testing 80% coverage after

deductible

80% coverage after

deductible

80% coverage after

deductible

Inpatient Hospitalization 80% coverage after

deductible

80% coverage after

deductible

80% coverage after

deductible

Outpatient Hospitalization 80% coverage after

deductible

80% coverage after

deductible

80% coverage after

deductible

Prescription Benefit 80% coverage after

deductible

80% coverage after

deductible

80% coverage after

deductible

Annual Deductible $ 1,500 Single

$ 3,000 Family

$ 3,000 Single

$ 6,000 Family

$ 5,000 Single

$ 10,000 Family

Coinsurance 80% coverage after

deductible

80% coverage after

deductible

80% coverage after

deductible

Annual Out-of-Pocket Maximum (includes

copays, deductibles and coinsurance) $ 5,000 Single

$10,000Family

$ 6,600 Single

$ 13,200 Family

$ 6,600 Single

$ 13,200 Family


MEDICAL GAP INSURANCE

Rates

Page 29

INDEMNITY MEDICAL PLAN

CHRIS HILL CONTSTRUCTION INDEMNITY MEDICAL PLAN

DESCRIPTION BENEFIT

Hospitalization Benefits

Initial Hospital Confinement (payable once/covered person/year; excludes pregnancy and birth) $750 / year

Daily Hospital Confinement (maximum 180 days/ confinement/covered person) $300/day

Hospital Intensive Care (maximum 60 days/confinement/covered person); paid in addition to the DHC benefit $300/day

Surgery Benefits

Surgery (according to schedule) $225 each day

Anesthesia Benefit (pays if anesthesia received during covered surgical operation) 25% of surgical benefit

Inpatient Physician’s Treatment Benefit (while receiving DHC benefit) $75/day

Outpatient Benefits

Outpatient Emergency Accident Benefit (maximum 2 times/person/year) $750/occurrence

At-Home Nursing Benefit (maximum 30 days if authorized by attending physician within 60 days after

hospitalization) $150/day

Transportation Benefit

Ambulance (double for Air Ambulance; maximum 3 times/person/year)

Non-Local Transportation (max 3 times/person/year)

$450

$450

Outpatient Physicians Benefit (5 times/person, 10 maximum visits for Employee + Spouse and Employee +

Child(ren); 15 maximum visits for Family) $75

Diagnostic & Wellness Benefits

Outpatient Diagnostic X-Ray & Laboratory Benefit (maximum 3 times/covered person/year) $50

Wellness & Preventative Test Benefit (1 time/covered person/year) $100

Prescription Drug Benefit

12 days/person/year; 24 days maximum for Employee + Spouse and Employee + Child(ren); 36

days maximum for Family $20 per day

The plan has limitations and exclusions that may affect benefits payable. This guide is for illustrative purposes only.

Refer to your certificate for complete details, definitions, limitations, and exclusions.

Supplements existing medical coverage to help you pay for out-of-pocket medical expenses

with hospital confinements

Coverage is Guaranteed Issue: There are No Medical Exams

Benefits paid directly to you

Benefits include hospitalization for pregnancy

Portable; if you leave your job, you can take the coverage with you

Rates

Page 29


MEDICAL COMPLIMENT PLAN



CHRIS HILL CONTSTRUCTION MAJOR MEDICAL COMPLIMENT PLANS

GAP 1500

PLAN

GAP 3000

PLAN

In-Hospital Benefit Maximum $1,500 $3,000

Individual Out-Patient Benefit Maximum 50% 50%

Family Outpatient Benefit Maximum $3,000 $6,000

Deductible Type High High

Employee Only Deductible $1,500 $3,000

Family Deductible $3,000 $6,000

Individual Physician’s Office Visit Benefit Maximum $0 $0

Family Physicians Office Visit Benefit Maximum 0 0

Coverage that helps by reimbursing out-of-pocket medical expenses for deductibles, coinsurance and copayment amounts under your

company medical plan

Rates

Page 29


PRESCRIPTION DRUG COVERAGE

A number of factors are considered when classifying drugs into tiers, including, but not limited to: the absolute

cost of the drug; the cost of the drug relative to other drugs in the same therapeutic class; the availability of over-

the-counter alternatives; and other clinical and cost-effectiveness factors.

To View the Drug List, visit www.MyCHCBenefits.com Note: Drug coverage goes with certain plan options and is only covered on UHC plans.

RETAIL PHARMACY MAIL ORDER

(Up to 31-day supply) (Up to 90-day supply)

Tier Level Network Non-Network Tier Level Network

Tier 1 $ 10 Copay $ 10 Copay Tier 1 $ 25 Copay

Tier 2 $ 35 Copay $ 35 Copay Tier 2 $ 87.50 Copay

Tier 3 $ 60 Copay $ 60 Copay Tier 3 $ 150 Copay

Drugs on the Drug List/Formulary are grouped by ‘tiers’.


Chris Hill Construction offers dental protection through United Healthcare.

The dental plan services are only covered when you see a dentist in United Healthcare dental network. United has contracts with a large network of dentists who have agreed not to charge more than a specified amount for particular services. If you use one of these network dentists, you won’t have to worry about being charged for additional amounts above the allowable amount covered by the plan.

Rates

Page 29

Preventive Services Benefit

Oral exams, X-Ray, Cleanings, Brush Biopsy, Topical fluoride, Space

maintainers, Sealants 100% Coverage

Basic Services

Restorative services using amalgam, synthetic porcelain, and plastic

filling material, Periodontics, Endodontic, Oral surgery, Nitrous Oxide 80% Coverage

Major Services

Prosthetics: Bridges and Dentures, Crowns, Jackets, Labial Veneers,

Implants, Inlays, and Onlays 50% Coverage

Orthodontia Services

Dependent Child(ren) up to age 19 $1,000 per person

per calendar year

Plan Deductible and Maximums

Deductible (waived for preventive services) $50 Single / $150 Family

Benefit Maximum (per covered member) $1,000

Waiting Periods None unless no prior dental.

DENTAL PLAN




VISION PLAN

Rates

Page 29

See a participating

provider

See a non-participating

provider

Exam1 with dilation as necessary 100% after $10 copay Up to $40 allowance

Lenses

Single Bifocal Trifocal

100% after $25 copay 100% after $25 copay 100% after $25 copay

$40 allowance $60 allowance $80allowance

Frames $130 Retail allowance–

additional 30% off overage.

$45 retail allowance

Contact Lenses

Covered Selection Contact Lenses Non Selection Contacts Medical necessary (limit one pair)

Up to 4 boxes plus fitting and evaluation fees and up to 2 follow up visits are covered in full after applicable copay. $125 allowance 100% after $25 copay

$125 allowance $210 allowance

Frequency (based on date of service)

Examination Lenses or contact lenses Frame

Once every 12 months Once every 12 months Once every 24 months

1 Material copay is required for a complete pair of eyeglasses, lenses or frames.

Chris Hill Construction offers Vision protection through

United Healthcare.



Under the United Healthcare Vision Plan you may receive care from

any vision care provider. However, UHC has an extensive nationwide

network of doctors who provide eye care and eye wear. When you

receive care through these vision care providers, you simply pay the

appropriate co-payment. If you visit an out-of-network provider,

be aware that your out-of-network benefits do not guarantee full

payment.


SUPPLEMENTAL PLANS

62.1% Of Bankruptcies in the

U.S. are directly related

to illness or medical bills.

34 Every seconds,

an American will

suffer a heart attack.

-American Heart Association

What would happen if you had a medical

catastrophe or accident that you could

not afford?

When this happens, enormous bills and

expenses can add up fast.

You may not be able to earn a living which could be devastating.

How would you be able to support yourself or your family? The cost

of financial misfortune can escalate quickly.

But what can you do now to help prevent a

crisis?

Hospital charges

Surgeon fees

Physician fees

Medication & drug costs

Radiological fees

Nursing costs

Direct Costs Most

Major Medical

38% 62%

Loss of wages or salary

Deductibles & coinsurance

Travel expenses to and

from treatment centers

Lodging & meals

Indirect Costs

You Pay:

One way is through Supplemental Benefit Plans. Supplemental benefits

provide cash directly to you to use as you need it. Only you can

decide if a supplemental plan is right for you.




How it Works...

What can living with a Critical Illness mean to you?

Plans Available from $0.14 / Day

What is the need?

Critical illness benefits help families pay off debts and other

expenses not covered by medical insurance such as loss of

income, childcare services, and travel to treatment centers.

What are the key features?

With critical illness coverage, employees receive a lump sum benefit after a serious

condition such as a heart attack, stroke, coronary artery disease, or cancer occurs.

You can take it with you if you change jobs.

Coverage is available for you and your family members.

What plans are available?

You can select $15,000 in coverage with or without a

Cancer Rider. New Hires can enroll with no medical

questions. (12 month Pre existing waiting period does

apply. )

Every 40 seconds,

on average, someone in the United States has a stroke.

-American Heart Association

CRITICAL ILLNESS PLANS

John chooses to

enroll in a $20,000

Critical Illness plan

during his annual

enrollment.

Some time later, John

suffers a heart attack.

His prognosis is good

and he is expected to

make a full recovery.

However, John is unable

to work during his recov-

ery period and bills con-

tinue to pile up.

BILLS

John can focus on his

recovery without worry,

because John has a

Critical Illness Policy

paying him a $20,000

benefit.

Rates

Page 29

Guaranteed Issue!

For New Hires!

$100 Wellness Benefit (per year)


Protected from life’s accidents?

Plans Available from

$0.39 / Day

What is the need?

Accidents can happen anytime,

anywhere and can often lead to

medical care. In your lifetime, which

of these accidental injuries has

happened to you or someone you

know?

Sports-related accidental injury

Broken bone

Burn

Concussion

Laceration

Back or knee injuries

Accident coverage provides cash

benefits to help cover out-of-pocket

medical costs and other incidental

expenses. Even if you already have

life and disability, accident coverage

is a complementary plan because

the benefits don’t overlap.

What are the key

features?

A schedule of benefits based

upon your injury and treatments

are paid directly to you.

You can take it with you if you

change jobs.

Available to protect you, your

spouse, your children or your

family.

What plans are

available?

Covers you for off the job

accidents.

Includes Outpatient

Physician’s Benefit

ACCIDENT PLAN — Off Job Coverage

How it Works...

Melissa elected during her

open enrollment period an

Accident Plan. Some time

later, she took a nasty spill.

Melissa incurred expenses

for services provided to

treat her injuries. The plan

paid the following:

What a difference an

accident plan can make

when life takes a tumble!

Ambulance………………….…..$200

Emergency Room………….… $200

X-Ray……………………………….$200

Broken Arm…………………… $2200

Hospitalization……………… $1000

* This is an example.

With Accident Coverage: $3800

Additional dollars to pay for copay, deductible

and other expenses

Without Accident Coverage: $0

In a year,

more than 1 in 5

children go to the

Emergency

Room. National Center for Health Statistics

Health, United States 2007

Rates

Page 30


TERM LIFE AND AD&D

Chris Hill Construction provides an employee benefits program that is

intended to protect you and your family from catastrophic financial

losses.

Employer paid life and AD&D rate for 15,000 in coverage per employee. Then age reductions will

lessen coverage and cost if applied.

Please visit www.MyCHCBenefits.com for more details.

Who depends on you? Term life

insurance can help you take care

of those you love. How much life

insurance do you need?

Then, from the total in question 1, subtract the total in question 2. = $________

1. If you or your spouse die, how much money will your family need to:

Live on each year (75% of current net income)

Pay for child care

Provide for your children’s education

Pay for major purchases (cars, home repair, etc.)

Pay off estate and funeral expenses

Pay off your mortgage loan or pay your rent

Pay off debts, such as credit cards, auto loans, student loans, etc.

Have available for an emergency fund, or provide for a family member

with special needs

Add up the above to estimate the total amount your family will need: = $________

$____________ annually x ______ years = $__________

$____________ annually x ______ years = $__________

$____________ annually x ______ years = $__________

$____________ annually x ______ years = $__________

$__________

$__________

$__________

$__________

2. Consider how much money would be available in the event of your or your spouse’s death:

Life insurance you now have (including employer-paid coverage)

Cash and savings

Retirement Savings (IRA, 401(k), etc.)

Stocks and bonds (at current market value)

Income from your spouse (multiply by 60%)

Other assets (e.g. pension plans)

$__________

$__________

$__________

$__________

$_______________annually x _______years= $__________

=+$__________

Add up this total =+$________

http://www.MyCHCBenefits.com


UNIVERSAL LIFE

What is Universal Life Insurance?

As a complement to Term Life coverage, you may want to consider

purchasing Universal Life insurance coverage. Universal Life is permanent life insurance you

can take with you when you leave or retire.

Permanent life insurance builds cash value that earns interest. The interest rate credited will never be less

that the guaranteed minimum rate built into the coverage. Under current law, taxes are deferred on these

interest earnings. You may also borrow or withdraw from your fund value once sufficient cash value has

accumulated.

Coverage: You may purchase coverage for yourself, spouse and/or children. Policy issue ages for

employee and spouse are 18-65 and for dependent children to age 18. You may purchase this coverage

on your spouse or child with purchasing coverage on yourself.

How Much Do You Need?

You decide how much life insurance fits your family’s needs and your budget. Once you start paying

premiums, they’re added to your fund value. Cost of insurance charges and expense charges are

deducted each month.

Whether or not you have dependents yet, it’s smart to consider applying for permanent life insurance now.

The younger you are when you start, the lower your cost of insurance. And the sooner you start, the longer

your fund value has to build.

You may purchase permanent life insurance with minimal

health questions.


SHORT TERM DISABILITY

Meeting your needs

Our coverage offers support during a period of

unexpected sickness or an off -the-job injury.

Choose a guaranteed issue** maximum monthly

benefit ranging from $400 - $5,000, up to

60%*** of income

A benefits representative may help you deter-

mine the following:

Maximum Monthly Benefit: varies

Maximum Benefit Period: 3-6 months

Elimination Periods:

Accident: 7-14 days

Sickness: 7-14 days

Premium: varies

(waiting) period, when you are totally disabled and can-

not work

Group voluntary disability Allstate Benefits (AB) Group Voluntary Disability coverage provides a

monthly cash benefit when you suffer a sickness or off -the-job injury

that leaves you totally disabled or partially disabled.

You can’t predict if or when you will become disabled in your lifetime.

But you can plan for a disability by having coverage in place to help

provide an income should you become disabled due to a sickness or

injury and are unable to work. Our coverage can help provide a

monthly income when it is needed most. 12 mos. Pre X does apply.

Your benefit coverage

Terms and conditions for each benefit vary. Please review your cover-age carefully.

Total Disability - Pays for total disability that begins while actively at

work. Monthly benefit starts after the waiting period. Benefits contin-

ue while totally disabled up to the maximum benefit period.

Partial Disability - Pays 50% of the monthly benefit when partially disa-

bled immediately after at least one month of total disability. Payments

continue while partially disabled for up to 3 months, but not beyond the

maximum benefit period.

Concurrent Disability - Pays one monthly benefit even if you are

disabled due to more than one cause. Being disabled due to more

than one cause will not extend the time benefits are paid.

Recurrent Disability - Pays when disabled from the same or related

cause within 6 months without a new waiting period or maximum

benefit period.

Pregnancy - Pays for pregnancy if total disability first begins after

your coverage has been in force for at least 9 months.

Organ Donor - Pays when disabled from donating an organ to another.

Jane chooses $3,000 in disability coverage. 8 months later she

suffers a disabling injury, is air lifted to the local hospital

emergency room, hospitalized (3 days), and is disabled for 6

months. 1

Jane and John

are offered

group

disability by

their

employer

John declines coverage. 6 months later he suffers a disabling

back injury, is rushed to the hospital by ambulance, treated,

hospitalized (2 days), and is disabled for 4 months.

In addition to her medical coverage our disability insurance

provided Jane the following:

Total Disability Monthly Benefit-$3,000

John does not have disability coverage. His medical cover-

age will pay for a portion of his hospital expenses, but his

monthly expenses while out of work will be paid out of his

own pocket.

**You must apply during your initial enrollment period to be

eligible. If enrolling after your

will be required.

***May be less depending on state.

Rates

Page 30

Guaranteed Issue!


Our Responsibility Under Health Care Reform

Under the Employer Shared Responsibility provisions of Health Care Reform, employers with 50 or more full-time employees must offer affordable health coverage that provides a minimum level of coverage to their full-time employees2 (and their dependents), or pay a penalty. All of Chris Hill Construction United Healthcare medical plans do provide minimum essential coverage and are deemed to be affordable using the IRS federal poverty line safe harbor definition.

2For purposes of the Employer Shared Responsibility provisions, an employee is a full-time employee for a calendar month if he or she averages at least 30 hours of service per week. http://www.irs.gov/Affordable-Care-Act/Employers/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act

What is the Health Insurance Marketplace?

The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace at www.healthcare.gov offers "one-stop shopping" to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away.

Your Responsibility Under Health Care Reform

Individual Mandate. The law now requires that most individuals maintain health insurance coverage or otherwise pay a penalty. If you don’t have medical coverage in 2016, you’ll pay the higher of these two amounts1:

2.5% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

$695 per person for the year ( $347.50 per child under 18 ). The maximum penalty per family using this method is $2,085. 1https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/

As a result of some key parts of the health care law that took effect in 2014, there are now new ways to buy health insurance:

the Health Insurance Marketplace.

Can I Save Money on my Health Insurance Premiums

in the Marketplace?

You may qualify to save money and lower your monthly premium, but only if your employer does not offer coverage, or offers coverage that doesn't meet certain standards. The savings on your premium that you're eligible for depends on your

household income.

Does Employer Health Coverage Affect Eligibility for Premium

Savings though the Marketplace?

Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer's health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.66% of your household income for the year, or if the coverage your employer provides does not meet the "minimum value" standard set by the Affordable Care Act, you may be eligible for a tax credit.1

Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution -as well as your employee contribution to employer-offered coverage- is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. 1https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/

AFFORDABLE CARE ACT UPDATE

http://www.irs.gov/Affordable-Care-Act/Employers/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act

Legal Notices 22

HEALTHCARE REFORM AND YOU

The Patient Protection and Affordable Care Act & The Health Care and Education Affordability Reconciliation Act of 2010, together, create

the most comprehensive health insurance reform ever under taken in recent history by our Country.

Many of the new law’s required changes have already been incorporated into company health plans across the country since the effective

date in September of 2010. However, there will be many more changes taking place in the months to come, as more guidance is issued by

the government to employers, insurance carriers and individuals.

One of the key requirements of the new law beginning in 2014, is the mandate that all U.S. citizens & legal residents either carry health

insurance or pay an income tax penalty. While the tax penalty is not too severe in the first year, it becomes progressively more costly

each year thereafter.

Penalties for failing to buy coverage

Tax penalties for failing to buy coverage are phased in according to the following schedule:

In 2014, the greater of $95 or 1% of taxable income;

In 2015, the greater of $325 or 2% of taxable income;

In 2016, the greater of $695 or 2.5% of taxable income; and

After 2016, the penalty is indexed for inflation.

However, there are two ways to avoid the tax penalty:

You can buy coverage for you and your family through your place of employment, if your employer offers such coverage. That coverage

must meet certain standards set by the law in order for you and the employer to escape respective tax penalties. The coverage must meet

certain minimum coverage standards (Generally pays at least 60% of your covered medical expenses) and must be considered

“affordable” (Employer cannot charge you a premium for single or employee only coverage greater than 9.66% of your W-2 earnings for

the year). The 9.66% would apply to annual salaries of up to about $45,000.

Or, you can provide coverage for you and your family through a Federally run Insurance Exchange. Essentially, an Exchange is an interac-

tive site where an individual can go to research, evaluate and buy health plans.

If you obtain coverage through an Exchange:

The Exchange will sell insurance policies at certain levels of coverage:

Bronze level – a medical plan designed to pay 60% of covered medical benefits;

Silver level – a medical plan designed to pay 70% of covered medical benefits;

Gold level – a medical plan designed to pay 80% of covered medical benefits;

Platinum level – a medical plan designed to pay 90% of covered medical benefits;

Catastrophic – available to young adults up to age 30 or those exempt from the individual mandate

(additional requirements may apply)

You may only obtain coverage through an Exchange if you are not participating in your employer’s plan.

If you satisfy certain low income thresholds and do not have medical coverage through an employer, or have employer-provided coverage

Legal Notices 23

that is considered “unaffordable” or pays benefits that are below the “Bronze” plan discussed above, there are tax credits available to help

you pay the premiums for coverage purchased through the Exchange. The credits also help pay for expenses like deductibles and

copays. More information on these credits will be provided to you later.

If you and your family are below 101% of the Federal Poverty Level in 2014, you may qualify for Medicaid.

THE WOMEN’S HEALTH CANCER RIGHTS ACT OF 1998 (WHCRA)

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights

Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in

consultation with the attending physician and the patient, for:

All stages of reconstruction of the breast on which the mastectomy was performed;

Surgery and reconstruction of the other breast to produce a symmetrical appearance;

Prostheses; and

Treatment of physical complications of the mastectomy, including lymphedema.

These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided

under this plan. Therefore, the following deductibles and coinsurance apply: [$0/100%, $1000/80%, $2000/80%, $500/80%].

NOTICE OF SPECIAL ENROLLMENT RIGHTS

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 your-

self and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adop-

tion.

Further, if you decline enrollment for yourself or eligible dependents (including your spouse) while Medicaid coverage or coverage under a

State CHIP program is in effect, you may be able to enroll yourself and your dependents in this plan if:

coverage is lost under Medicaid or a State CHIP program; or

you or your dependents become eligible for a premium assistance subsidy from the State.

In either case, you must request enrollment within 60 days from the loss of coverage or the date you become eligible for premium assis-

tance.

To request special enrollment or obtain more information, contact person listed at the end of this summary.

HEALTHCARE REFORM AND YOU

Legal Notices 24

IMPORTANT NOTICE: This document is provided to help employers understand the compliance obligations for qualified employee benefit plans, but it may not take into account all the circumstances relevant to a particular plan or situation. It is not exhaustive and is not a substitute for legal advice. Updated March 2016

Premium Assistance Under Medicaid and the

Children’s Health Insurance Program (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 be eligible for these premium assistance programs but you may be able to buy individual

insurance coverage through the Health Insurance Marketplace. For more information, 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 questions about

enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).

For more information on special enrollment rights, contact either:

U.S. Department of Labor U.S. Department of Health and Human Services Employee Benefits Security Administration Centers for Medicare & Medicaid Services www.dol.gov/ebsa www.cms.hhs.gov 1-866-444-EBSA (3272) 1-877-267-2323, Menu Option 4, Ext. 61565

OMB Control Number 1210-0137 (expires 10/31/2016)

NEWBORNS ACT DISCLOSURE – FEDERAL

Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in

connection 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 section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting 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 authorization from the plan or the insurance issuer for prescribing a length of stay not in ex-

cess of 48 hours (or 96 hours).

IMPORTANT LEGAL NOTICES AFFECTING

YOUR HEALTHPLAN COVERAGE

http://www.healthcare.gov

http://www.askebsa.dol.gov

http://www.dol.gov/ebsa

http://www.cms.hhs.gov/

Rates 25

Me

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al

(pg

. 8-1

0)

Medical Plan - Weekly Payroll Deduction

Who to Cover? OPTION 1

25/1500/80%

OPTION 2

25/3000/80%

OPTION 3

30/5000/80%

INDEMNITY

PLAN

Employee $ 80.90 $ 75.40 $ 72.31

*$ 30.00 $ 18.85

Employee + Spouse $ 169.89 $ 158.33 $ 151.87 $ 35.58

Employee + Child(ren) $ 149.66 $ 139.48 $ 133.79 $ 33.51

Employee + Family $ 234.60 $ 218.65 $ 209.72 $ 49.84

Dental Plan - Weekly Payroll Deduction

Who to Cover? Base Plan

Employee $ 2.90

Employee + Spouse $ 5.80

Employee + Child(ren) $ 6.78

Family $ 10.20 Den

tal

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isio

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pg

. 13

-14)

Review your worksheet prior to your enrollment session.

RATES

Vision Plan - Weekly Payroll Deduction

Who to Cover? Base Plan

Employee $ 0.70

Employee + Spouse $ 1.32

Employee + Child(ren) $ 1.55

Family $ 2.18

Medical Compliment Plan- Weekly Payroll Deduction

$1,500 / $3,000 Gap Under Age 40 Ages 40– 49 Ages 50+

Employee $ 2.76 / $ 3.95 $ 3.82 / $ 5.48 $ 6.17 / $ 8.85

Employee + Spouse $ 4.96 / $ 7.11 $ 6.88 / $ 9.86 $ 11.11 / $ 15.92

Employee + Child(ren) $ 6.09 / $ 8.73 $ 7.04 / $ 10.08 $ 10.00 / $ 14.33

Family $ 8.30 / $ 11.89 $ 10.09 / $ 14.46 $ 14.94 / $ 21.41

Me

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. 11)

Medical Compliment Rates Weekly Payroll Deduction

Major Medical Plan Rates Weekly Payroll Deduction

Dental Plan Rates Weekly

Payroll Deduction

Vision Plan Rates Weekly

Payroll Deduction

* Class 1 Employees Only

Rates 26

Accident Plan Rates—Weekly Payroll Deduction

Named Insured

(Employee, Spouse, or Child) EE EE + SP EE + CH EE + Family

Weekly Premiums $ 2.69 $ 3.93 $ 5.42 $ 6.78

Ac

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lan

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17)

Protected from Life’s Accidents?

RATES

Vo

lun

tary

Dis

ab

ilit

y I

nc

om

e—

(pg

.18

)

RATES

Short Term Disability—SAMPLE Monthly Rates

per $100 of Benefit

Elimination Period/Benefit Period

7/7/3 14/14/6

18-49 .81 .79

50-59 .98 1.05

60-64 $ 1.33 $ 1.41

65-69 $ 1.45 $ 1.52

70+ $ 1.53 $ 1.67

Protecting Your Paycheck...

Rates are based on a $15,000 policy - non-

tobacco user without Cancer

Age EE EE +

FAMILY

EE +

SP EE +CH

18 - 35 $ 1.69 $ 2.72 $ 2.62 $ 1.76

36 - 49 $ 3.42 $ 5.28 $ 5.21 $ 3.52

50 - 59 $ 6.74 $ 10.20 $ 10.09 $ 6.81

60 - 64 $ 10.55 $ 15.84 $ 15.77 $ 10.65

65 - 69 $ 13.49 $ 20.24 $ 20.13 $ 13.60

70 + $ 16.23 $ 24.22 $ 24.11 $ 16.30

Cri

tic

al

Illn

es

s (

pg

. 16)

Critical Illness Plan Rates Weekly Payroll Deduction

Rates are based on a $15,000 policy - non-

tobacco user with Cancer

Age EE EE +

FAMILY

EE +

SP EE +CH

18 - 35 $ 2.76 $ 4.42 $ 4.21 $ 2.93

36 - 49 $ 6.02 $ 9.23 $ 9.05 $ 6.22

50 - 59 $ 12.45 $ 18.75 $ 18.54 $ 12.63

60 - 64 $ 19.24 $ 28.79 $ 28.61 $ 19.45

65 - 69 $ 23.88 $ 35.71 $ 35.50 $ 24.08

70 + $ 28.00 $ 41.73 $ 41.52 $ 28.17

Universal Life Rates will be given at Enrollment – There are

several age groups and categories.


Every reasonable effort has been made for the information provided in this booklet to be accurate. It is intended to provide the employees

with Chris Hill Construction an overview of the coverages offered. It is in no way a guarantee or offer of coverage. Each carrier has the

ability to underwrite based on its contract with Chris Hill Construction or its employees. Each carrier’s contract, underwriting, and policies

will supersede this document. Please be aware that each carrier may have exclusions or limitations and you must consult your summary

plan description and/or policies for details.

WHO TO CONTACT

UNITED HEALTHCARE Customer Service ………….……..800-842-8000

ALLSTATE BENEFITS Customer Service ..................... …...800-521-3535

ALLSTATE BENEFITS Customer Service (Spanish) ... …...800-211-5535

CLAY FARRELL Insurance Broker for UHC, GIM & GAP …..901-207-7175

BENEFITHELP Enrollment and Allstate Voluntary Broker .…901-201-5040

Need Help with Enrollment?

Are you a New Hire?

Contact BenefitHelp at 888-663-1285 option #2

or email [email protected]

for assistance.

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