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Wilmington Health FT Regular Employees 2018 Benefits Digest

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Page 1: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

Wilmington Health

FT Regular Employees

2018 Benefits Digest

Page 2: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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TABLE OF CONTENTS

WELCOME

We are pleased to provide you with the 2018 Benefits Digest booklet. This guide is intended to provide a summary of the benefit programs available to all benefit eligible employees. It is only an overview and you must review specific plan brochures and plan documents for full program details, limitations and exclusions. At Wilmington Health, we are confident that our people are the reason behind our successes. We truly value you as an employee

and part of our professional family. Our goal is to offer the very best healthcare possible to you and your loved ones. With this in

mind, we have developed a comprehensive employee benefit package designed to protect you and your family.

This brochure provides benefit information available January 1, 2018 through December 31, 2018.

After January 1, 2018, please make sure that you visit our benefits web page at www.hcwbenefits.com for a complete summary

of our benefit package. You will also find links to our insurance carriers, enrollment and claim forms, as well as links to other

resources. Our user name is “wilmhealth” and “28401” is our password. If you have comments, questions or other inquiries,

please contact Human Resources.

Pre-Tax Premium Plan

Wilmington Health’s Pre-Tax Premium Plan applies to any employee enrolled in the medical plan, dental plan, vision

plan and/or FSA. This means that the employee’s premiums/contributions will be deducted from pay pretax, saving

the employee tax dollars. This process reduces and employee’s social security income benefits & their net after tax

income will increase. Employees may only change over or evoke the above benefits only when any of the qualifying

events (changes in family status events) described below occur & only when the change is effective within 30 days of

the event. Otherwise, the only time a pretax benefit may be changed or evoked is during Wilmington Health’s Annual

Open Enrollment, for an effective date of the following January 1st . Qualifying events include:

• Marriage, Divorce

• Birth or Adoption

• Change in numbers worked

• Any significant change in other

coverage

• Death of Spouse/Dependent

• Termination of Employment

• Loss of other coverage

• Termination of the plan

General Information……………..……….….………………………….…………………………………………………………………………………….………...3

Medical Plan……………….……..…………..…………………………….……………………………………………………………....……………………………...4

Health Savings Account…….…….…………………………………………………………………………………………..……..………………………………….5

Dental Plan…….………………………..….………….……………………….……………………………………………………………………..……………………..6

Vision Plan…….…………………………..………….…………………………..……………………………………………………………..…………………………...7

Life & Disability Plans…………………..…………….……………………………………………………………………………..…………………………………...8

Flexible Spending Accounts………………………………………………………..………………………….…………………………………………….………...9

Additional Benefits.…………………..……………………………………………………………………………..……………….……………………………….…10

Page 3: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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GENERAL INFORMATION

Employee Eligibility

All employees working 30 hours or more per week are

eligible for benefits.

Benefits Begin: 1st of the month

following 60 days

Benefits Terminate: End of the month

Dependent Age Limits

Age 26 for all benefits, except Voluntary Life:

Benefit is to Age 23/25 FT Student

Page 4: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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MEDICAL PLAN

IN-NETWORK BENEFITS HDHP W/ HSA PPO

Annual Deductible Single Family

$2,700

$5,400

Wilmington Health: $800/$2,400

All Other: $1,000/$3,000

Out-of-Pocket Maximum

Single Family

$2,700

$5,400

$4,000

$12,000

Office Visit 100% after deductible

Virtual Visit: Up to $45 Fee

Wilmington Health Providers: $20/$40 Copay

All Others: $50/$60 Copay

Virtual Visit: $50 Copay

Prescription Drugs (Retail/Mail order) Tier 1 Tier 2 Tier 3

100% after deductible

$10 / 2.5 X Copay

$35 / 2.5 X Copay

$60 / 2.5 X Copay

Emergency Room 100% after deductible $150 Copay

Urgent Care 100% after deductible Wilmington Health: $20 Copay

All Other: $50 Copay

Inpatient Care 100% after deductible 80% after deductible

Outpatient Care 100% after deductible 80% after deductible

Routine Vision Exam 100% (every benefit period) 100% (every benefit period)

BLUE CROSS BLUE SHIELD OF NC (BCBSNC) | 1-877-258-3334 | WWW.BCBSNC.COM

Your medical coverage through Blue Cross Blue Shield of NC is an “open access” PPO plan, which means that you do not need to select a primary care doctor, nor will you need a referral to visit a specialist. As long as you re-main in the network, your benefits will be covered at the higher in-network benefit amount.

Spouses are not allowed on the medical plan if they have access to other group level health coverage. Please see HR for more details HDHP - for Family coverage, the Family Deductible must be met, by any one or combination of family members, before benefits will be paid for any individual member. There is no Individual Deductible to satisfy within Family Deductible. Preventive Care is covered at 100% with a preventive primary diagnosis code. The service must be a covered preventive care benefit under healthcare reform. Certain over the counter preventive medications for which you have a prescription are now available at no cost. During your annual physical if anything is discussed or performed outside of the healthcare reform approved screenings, your visit may not be covered at 100%. For a list of covered preventive benefits under healthcare reform please visit www.bcbsnc.com/preventive

Page 5: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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HEALTH SAVINGS ACCOUNT

If you participate in the High Deductible Health Plan (HDHP), you are eligible to open or

maintain a Health Savings Account (HSA). The HSA is a personal savings account for health

expenses, much like an IRA is used to save for retirement. Employees may make pre-tax

contributions to their HSA that can then be used to pay for eligible medical, dental or vision

expenses. Items to consider:

In 2018 participants can choose to save up to $3,450 for an individual and $6,900 for a family

Eligible contributions are not taxable

Funds roll over from year to year

The account is yours and is portable should you leave

You are not eligible to contribute to an HSA if you are on Medicare or covered under your spouse’s non-HDHP or if you partici-

pate in the FSA

HSA funds may be used for any medical eligible expense noted in Section 502 of the IRS Code. Examples of eligible expenses

include, but are not limited to, dental treatment, corrective vision surgery, hearing aids, etc..

HEALTH EQUITY | 1-866-346-5800 | WWW.HEALTHEQUITY.COM

Page 6: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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DENTAL PLAN

GUARDIAN| 1-800-451-7846 | WWW.GUARDIANANYTIME.COM

Timely entrants will not be subject to benefit waiting period. You will be considered a timely entrant if you enroll when first eligible,

upon a qualifying event or during open enrollment. If you do not enroll at these times, you will be considered a late entrant. Late

entrants will be subject to a 6 month benefit waiting period for basic, 12 months for major and 24 months for orthodontic services.

Please note: This applies to employees and dependents.

LEVEL OF COVERAGE IN-NETWORK OUT-OF-NETWORK

Annual Deductible

• Individual

• Family

$50

$150

Benefit Maximum $1,000 + Maximum Rollover

Rollover Maximum $250 up to $1,000 max

Preventive Care 100%

Basic Care 100% after deductible 80% after deductible

Major Care 60% after deductible 50% after deductible

Orthodontia Care (child only) 50%

Orthodontia Lifetime Maximum $1,000

Your dental plan is provided by Guardian.

Page 7: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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VISION PLAN

CEC | 1-888-254-4290 | WWW.CECVISION.COM

Your vision plan is provided by CEC. While a large number of people wear corrective lenses or contacts,

detection is very important in catching diseases and impairments at an early stage when treatment can

prevent further damage.

LEVEL OF COVERAGE IN-NETWORK OUT-OF-NETWORK1

Lenses & Contacts / Frames Frequency 12/12/12

Exam $10 Copay

Frames & Lenses $10 Copay2

Contact Lenses in lieu of lenses & frames Up to $150 Allowance

1 Member submits claim, reimbursement minus copay for cost of eyewear, up to allowed amount

2Frames are covered up to $150 Allowance plus discount on balance over allowance after copay

Page 8: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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LIFE & DISABILITY PLANS

LINCOLN | 1-800-432-2765 | WWW.LFG.COM

BASIC AND ADDITIONAL LIFE INSURANCE

Employees eligible first of the month after 90 days of FT employment

100% Employer paid benefit of 1.5x earnings, up to a maximum of $150,000; Guarantee Issue $150,000

Additional life insurance (voluntary life) is available for the employee, spouse and dependents

Employee - $10,000 increments, up to $500,000; $250,000 guarantee issue

Spouse - $5,000 increments up to the lesser of 100% of employee amount or $500,000; $25,000 guarantee issue

Dependents $10,000 (6 mos. to age 23/25 FT Student); ($250 - 14 days to 6 mos.); $10,000 Guarantee Issue

Evidence of insurability (EOI) is required if enrolling after you are first eligible

LONG TERM DISABILITY

Employees eligible first of the month after 90 days of FT employment

100% Employer-paid

Benefit begins after 90-day elimination period

Monthly benefit is 66.67% of your salary to a maximum of $10,000

Benefit period is to Social Security Normal Retirement Age

Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product

OTHER BENEFITS

A Wilmington Health corporate discount is available for employee & family membership at various business throughout Wilming-

ton such as O2 Fitness, Gold’s Gyms and Verizon Wireless. There are other benefits as well from various businesses in the Wilming-

ton area for WH employees. See Human Resources for details

Page 9: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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FLEXIBLE SPENDING ACCOUNT

HEALTH EQUITY | 1-877-713-7682 | WWW.HEALTHEQUITY.COM

During the open enrollment period, you should make

elections regarding the amount that you wish to con-

tribute to your FSA. As a reminder, Health FSA partici-

pants will be able to carryover unused amounts of up

to $500 for expenses incurred in the next plan year,

and still contribute up to $2,650 annually. The carryo-

ver feature does not apply to Dependent care ac-

counts.

Contribute up to $2,650 to your Medical Spending Ac-

count

Contribute up to $5,000 to your Dependent Care Ac-

count

The only way to change your election during the plan

year is to have a qualifying event.

You have 90 days following the end of the plan year to

file for reimbursement for expenses incurred during

the plan year

The only way to change your election during the plan

year is to have a qualifying event.

Enrollment for the FSA plans is required each year.

You do not need to be enrolled in the Wilmington

Health Medical Plan to participate in the FSA Plan.

The FSA plan year runs from January 1—December 31.

You have until March 31st to submit claims for ex-

penses incurred during the prior plan year.

If your employment ends, only claims incurred prior to

your last day will be considered for reimbursement.

If you enroll in the HDHP, the Health Care Flexible

Spending Account will be limited to dental and vision

expenses only.

IMPORTANT NOTES ABOUT THE FSA

Page 10: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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Additional Benefits

401(k)/ Profit Sharing Plan NEW PORT GROUP| 1-888-401-5629 | WWW.NEWPORTGROUP.COM

Eligible to participate on 1st day of employment

Automatic enrollment for 3% of gross wages at time of hire unless WAIVED in writing

Employee can elect to increase or decrease % withheld or set a fixed dollar amount to come out of each paycheck. Employee can choose investments online once enrolled.

2018 Contribution Limits: $18,000< Age 50; $6,000 Catch Up per year > Age 50

Employee contribution amount can be changed at any time online at www.newportgroup.com, or by calling 888.401.5629. if you have any questions regarding your 401(k), please contact Rachel Carter, Financial Advisor with Merrill Lynch at 910.256.7731 or [email protected].

Company contribution: Safe Harbor 3% of gross wages contributed to employee’s account each pay period starting with month after one-year anniversary date with WH.

Wilmington Health may also make Discretionary Contribution to accounts of participating employees who have been

employed at least one year. The amount, if any, of the discretionary contribution for any plan year (calendar year) is

not determined until April of the following year. Discretionary contributions are vested over a six (6) year period as fol-

lows: End of year 1 = 0%; End of year 2 = 20% vested; End of Year 3 = 40% vested; End of Year 5 = 80% vested; end of

year 6 = 100% vested.

EMPLOYEE ASSISTANCE PROGRAM GUIDANCE RESOURCES| 1-888-628-4824 | WWW.GUIDANCERESOURCES.COM

This service offers information & resources that can help employees and their dependents identify & resolve problems

affecting emotional & physical health. Financial & legal consultations are also available. The premium is paid by Wil-

mington Health and the service is provided by Guidance Resources. Contact Guidance Resources at

www.GuidanceResources.com Username: LFGSupport, Password: LFGSupport1 or 1-888-628-4824.

ADDITIONAL VOLUNTARY BENEFITS GUARDIAN | 1-855-439-8398 | [email protected]

Please see Human Resources if you are interested in these benefits through Guardian. These are 100% Employee-paid.

Post-tax deductions will be taken via payroll. These benefits include, Short Term Disability, Critical Illness, Accident, and

Hospital.

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Additional Benefits

PAID DAYS OFF (PDO’s)

Holiday: New Year’s; Memorial Day; Independence Day; Labor Day; Thanksgiving; Day after Thanksgiving; 1/2 Day

Christmas Eve; Christmas Day

Accumulated as HOURS

Eligible Date: 1st day of employment

PDO Hours are deposited into Employee’s PDO Bank on each pay date; Employee PDO balance shown on each pay stub

Usage of PDO HOURS: Eligible to use following (6) consecutive months of service and includes time for office closings

due to holidays. (If employee has depleted their PDO bank at the time of a company holiday, they will not be paid for

that time.)

Accumulation Rate: Based on hours worked and length of service, using the following calculation: number of hours

worked in a pay period * accrual rate/ hour = amount accrued, not to exceed the max/pay period. The accrual schedule

is as follows:

Full time Hourly (non-exempt): Employed by WH 0-5 years = 7.7 hrs per pay period; Employed 5-8 years = 10.29 PDO

hrs per pay period; Employed 8-10 years = 10.58 PDO hrs per pay period; Employed 10+ years = 10.82 PDO hrs per pay

period

Full time Salary (exempt): Employed by Wilmington Health 0-5 years = 8.34 hrs per pay period; Employed 5-8 years =

11.15 PDO hrs per pay period; Employed 8-10 years = 11.46 PDO hrs per pay period; Employed 10+ years = 11.76 PDO

hrs per pay period.

All PDO Accrual Pay Day Period above represent the maximum # of PDO hours that can accrue for a pay period.

OTHER BENEFITS

A Wilmington Health corporate discount is available for employee & family membership at various businesses through-

out Wilmington such as O2 Fitness, Gold’s Gyms and Verizon Wireless. There are other benefits as well from various

businesses in the Wilmington area for WH employees. See Human Resources section of Intranet for details.

Page 12: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health

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EMPLOYEE CONTRIBUTIONS

MEDICAL SEMI-MONTHLY CONTRIBUTION

Employee $21.57

Employee / Spouse $213.29

Employee / Child $83.00

Employee / Children $164.90

Family $352.88

DENTAL SEMI-MONTHLY CONTRIBUTION

Employee $19.92

Employee / Spouse $36.03

Employee / Children $43.17

Family $60.81

VISION SEMI-MONTHLY CONTRIBUTION

Employee $4.75

Employee / Spouse $9.03

Employee / Children $8.55

Family $13.76

Payroll deductions, as listed below, are deducted on a pre-tax basis.

If you have comments, questions, or other inquiries please contact Human Resources.

Wilmington Health Definitions:

Full-Time (FT) Employee: Employee who is not hired as TEMPORARY or PRN (as needed) & works at least 30 hours per week

Part Time Employee: Employee who is not hired as TEMPORARY or PRN & works less than 30 hours per week

PRN Employee: Employee who is hired on an “as needed” basis—may cover another employee’s absence

Temporary Employee: Employee who is hired on a seasonal or project basis only (i.e. Flu Booth Nurse, summer employee)

Work Week: Monday—Sunday

Voluntary Benefit: 100% of premium paid by Employee

All benefits (plans, eligibility requirements, premiums & details) are subject to change each year effective January 1. Any such

changes will be explained during Open Enrollment each year which is in November of the following year’s benefits.

I have read this benefit summary and understand its content and have received a copy of the same.

Date:______________________________ Signature: _________________________________

Page 13: Wilmington Healtha… · Evidence of insurability (EOI) is required if enrolling after you are first eligible- please add if a voluntary product OTHER ENEFITS A Wilmington Health