Benefit Details Medical Insurance Livongo Dental Insurance Vision Insurance Health Savings Account (HSA) Flexible Spending Account (FSA) Life and AD&D Insurance Disability Insurance Whole Life Insurance Critical Illness Insurance myKlovr Additional Benefits Advocacy and Transparency Where Should I Go For Care? Important Contacts
Table of Contents
Click Here for the PDF Version of your Benefits Guide
Eligibility & Enrollment
HydroChemPSC strives to provide you with a high-quality, flexible benefits package. We also recognize that each employee is unique and has different benefit needs. That is why we provide you with multiple options whenever possible: choice of plans, choice of coverage levels, and choice of benefit amounts.
Dependent Eligibility
What's New This Year?
Spousal Surcharge
Helpful Terms
Who Is Eligible?
Who Can Be Covered Under Your Plan
Additional Eligibility Requirement for Spouse
Appeals Process
Whom Can I Cover?
Click the buttons below for more information
If I paid a health care bill with my credit card, can I pay myself back from my HSA?
Yes, as long as the service is a qualified expense. You can take money out of your HSA to pay yourself back with no penalty.
How do I pay with an HSA?
If you receive a bill from your doctor or if you are paying for a prescription, you can pay from your HSA using your HSA debit card or checks provided by your bank.
Enrollment Made Simple
Licensed Benefits Educators will be available telephonically and on-site at certain locations to enroll you in all of your benefit offerings. The Benefits Educators will help ensure that you understand the plans and help you select the right benefits for you and your family. The Educators will also help you familiarize yourself with the new benefits enrollment platform which you will use to enroll in ALL benefits moving forward.
What To Expect
• Active Open Enrollment for the 2020 Plan Year • All Benefits Eligible Employees are required to make an appointment with a Benefits Educator to enroll in benefits for the 2020 plan year • Online Appointment Scheduling • Open Enrollment Period: October 2 - October 18, 2019 • NEW! Supplemental Insurance Offerings (Permanent Life, Critical Illness, myKlovr College Prep Platform) • Benefits Effective January 1, 2020
This year, all Benefits Eligible Employees will meet with a licensed Benefits Educator who will enroll you in all of your benefits for the 2020 plan year. All enrollments will be completed online with an Educator. Paper enrollment forms will not be used.
Who is Eligible?
If you are an exempt or non-exempt full-time employee regularly scheduled to work 30 hours or more per week, and you are actively at work, you are eligible to participate in the HydroChemPSC benefits program.
Making Changes During the Year
You cannot change your benefit elections during the plan year unless you have a life status change event in your immediate family. Life status change events include: • Marriage, divorce or legal separation • Birth, death or adoption of a dependent • Dependent reaching age limit • Change in employment status of you or your spouse • Change in coverage for you or your dependent • Qualified medical support order • Loss of coverage and/or eligibility under Medicare, Medicaid or a Children’s Health Insurance Program If you have a life status change event, you must report the change to HydroChemPSC Benefits Department within 30 days of the event if you want to change coverage. Changes will be effective on the day of the event. If you do not make your changes during the 30-day change-in-status period, your changes cannot be made until the next Open Enrollment period.
When To Enroll
As A New Hire (Beginning 1/1/2020): To enroll for the first time you must make your election by your designated eligibility date. Enrolling for coverage as soon as possible will ensure that your coverage is effective when you need it. If you do not enroll within 30 days from your eligibility date, you will not be able to enroll until the next Open Enrollment Period unless you experience a Life Status Change Event. Once you enroll for benefits your coverage will begin on your designated eligibility date. If you enroll after your eligibility date, you will be subject to retroactive premium deductions that were missed. When your eligibility window opens, you will receive a call to remind you to set up your new hire benefits appointment. You may schedule your appointment with a Benefits Educator beginning 1/1/2020. During Open Enrollment: Open Enrollment is your once-a-year opportunity to make changes to your benefit elections or add/remove dependents from your insurance coverage. Open Enrollment is the only time you may change coverage without a Life Status Change.
You may also cover your eligible dependents under many of HydroChemPSC’s benefit plans. Your eligible dependents include: • Your legal spouse, common law spouse or domestic partner. • Your dependent children under the age of 26, as long as they meet the requirements to be a dependent under the terms of the plan, including children for whom you are required to provide health care coverage under a Qualified Medical Child Support Order (QMCSO); and • Child of any age who is medically certified as disabled and dependent on you for support and maintenance. Dependent coverage takes effect on the same date your coverage begins. If this is your first time enrolling your spouse, domestic partner or child(ren) you must submit documentation of their eligibility to participate in the HydroChemPSC Benefit Program.
Dependent(s) will not be enrolled until required documentation is provided. Documentation must be provided within 30 days of your eligibility date. You may experience retroactive premium charges for dependents added after your eligibility date.
Click Here for Required Documentation
Making Changes During The Year
*The out-of-pocket maximum illustrated includes the deductible, coinsurance, medical and prescription drug copays for all covered services. ** CVS Pharmacies, CVS Pharmacies in Target stores and some individual pharmacies are no longer in your pharmacy network. If you continue to fill your prescriptions at a CVS pharmacy, you will pay more .To locate a preferred/participating pharmacy in your area, go to myprime.com or contact customer service at the phone number on the back of your ID card.
Medical Rates
RX Overview
Medical Overview
HydroChemPSC is pleased to offer three options for Medical Insurance to you and your family. See plan documents for details. Click on the buttons below to view an illustration of the in-network benefits. While out-of-network benefits are available in some instances, you will save on out of pocket expenses by using network providers. The HDHP, PPO and Buy - Up PPO plan options provide an in-network preventive care benefit and limited medical indemnity benefits that stipulate daily benefit allowances and annual maximums.
Your health-related needs and considerations are unique to you and your family.
Medical Insurance
Many employees don't understand what their medical insurance covers.
We’re here to help you understand your benefits and make the best choices for you and your family. See the details below.
Value/MDLive
24/7 Nurseline: 800-581-0393
Need help deciding where to go for care? On hand 24 hours a day, seven days a week, bilingual nurses are available to identify options when you or your family member has a health problem or concern.
Virtual Visits - MDLIVE: 800-770-4622
Getting sick is never convenient, and finding the time to get to the doctor can be hard. BCBSTX provides you access to care for non-emergency medical issues through MDLIVE. You will have access to a board-certified doctor 24 hours a day, seven days a week. If you are enrolled in the PPO, the cost of this service is a $40 copay. Members enrolled in the HDHP will be responsible for the contracted rate, which is subject to the plan deductible. MDLIVE doctors can help treat the following conditions:
• Allergies • Asthma • Joint aches • Sinus infections • Colds • Flu • Ear infections • Pink eye • And more!
NOTE: You must be a BCBS member (enrolled in the medical) to be eligible for these benefits.
*Spousal Surcharge-If your spouse has coverage available through their employer and you elect to cover them on a HydroChemPSC medical plan, you will pay an additional $600 annually.
Click here to view the Base PPO Plan Booklet Click here to view the Buy Up PPO Plan Booklet Click here to view the HDHP Plan Booklet Click here to view the Base PPO SBC Click here to view the Buy Up PPO Plan SBC Click here to view the HDHP SBC
Click here to watch a short video about this benefit
Diabetes Management, Simplified
• Coverage is available to all eligible employees who are actively at work.* • You can buy coverage for your spouse and dependent children. • No health questions to answer. If you apply, you automatically receive the base plan. • This plan includes convenient payroll deduction, so you don’t have to remember to write a check for your premiums. • Coverage is portable. You may take the coverage with you if you leave the company or retire without having to answer new health questions. Unum will bill you directly. • Coverage becomes effective on the first day of the month in which payroll deductions begin. • Benefits are paid for accidents that occur on and off the job. • A Catastrophic Benefit is included with this plan. This pays an additional sum if a covered individual has a serious injury — such as loss of sight, hearing or a limb. Benefit amounts reduce after age 65.
Advantages of the Plan
Personalized tips with each blood glucose check
When you sign up for Livongo, you’ll receive a blood glucose meter, charger, and lancing device, as well as unlimited lancets and test strips covered through BCBS TX.
It’s all in the meter and covered by your health plan.
Join today at join.livongo.com/BCBSTX/register or call (800) 945-4355
LIvongo
Get strips and lancets. Covered by your health plan.
Optional family alerts keep everyone in the loop
Real-time support when you’re out of range
Send a health summary report directly from your meter
Strip reordering, right from your meter
Automatic uploads mean no more paper logbooks
Click to view a Livongo Flyer
Click here to view more information
Delta Dental Overview
Delta Dental Rates
Dental Insurance
Dental benefits provide you and your family with comprehensive coverage to keep your smile shining bright!
HydroChemPSC offers you the choice between 2 dental plans through Delta Dental that help you pay for preventive, basic, and major care, as well as orthodontic treatments. Your dental plans vary by Annual Maximums and Orthodontia Lifetime Maximums. You will find richer benefits on the PPO Plus Plan.
ProTec Safety Plan (additional cost) ProTec Safety coverage is available for employees only. Dependents aren't eligible for this benefit. Safety Exam (Every 12 months): Determines your needs for eye protection at work. Covered 100% Prescription Lenses (Every 12 months): ANSI certified (American National Standards Institute). Covered 100% ProTec Eyewear frame (Every 24 months): ANSI certified. Fully covered when you choose a safety frame from your VSP provider’s ProTec Eyewear collection.
Vision Insurance
All the more reason to have vision coverage for you and your family
Periodic eye examinations not only only determine the need for corrective eyewear, but may also detect general and severe health problems in their earliest stages. HydroChemPSC provides a voluntary vision care program through VSP. Under this plan, you have access to routine vision care, such as annual exams, and eyewear, at significantly reduced costs through a network of contracted vision care providers. You can choose to have Safety Eyewear benefit as well. You can find an in-network provider by visiting www.vsp.com.
of all visual impairment can be prevented or cured.
80%
VSP Vision Overview
VSP Vision Rates
*If you choose contact lenses, you will be eligible for eyeglass lenses 12 months from the date the contact lenses were obtained. You are eligible for frames every 24 months, regardless of when the lens/contact lens benefit was used.
**This coverage is available for employees only.Dependents aren’t eligible for this benefit
An HSA is a tax-exempt savings account you establish exclusively for the purpose of paying for qualified medical expenses. HSAs are only available to individuals who are enrolled in a High Deductible Health Plan (HDHP). HSA dollars can be used to pay for medical and prescription drug expenses that are applied toward deductibles, over-the-counter medications if purchased with a prescription, and non-covered medical, dental, and vision expenses, all subject to IRS guidelines. HSA dollars may only be used for expenses incurred while covered under an HDHP and after your HSA bank account is opened.
Use Your Funds With A Debit Card
HSA By The Numbers
Contributing and Using HSA Funds
HSA Rules
Filing Claims and Reimbursement
Eligible Expenses
Additional Information
Do The Math!
The below table will help you to determine the annual payroll deduction as well as the annual out of pocket maximum for each plan. Remember contributions are a GUARANTEED COST! Which plan is best for you?
Are you paying for a benefit that you aren’t using?
Choose The Right Plan For You
All the money in your account is yours to spend on qualified health care expenses or to save for future expenses. The maximum amount that can be contributed to your HSA in 2020 is $3,550 for individual-only coverage or $7,100 for all other levels of coverage. Remember that anyone age 55 and older can contribute an additional $1,000 annually. You can change your HSA contribution at any time and there is no “use it or lose it” rule. 100% of your HSA balance automatically rolls over year-to-year.
Dependent Care • Child care (at a day care center, day camp, sports camp, nursery school or by a private sitter) • Before and after-school care (must be billed separately from tuition) • Adult day care expenses • Expenses for a housekeeper whose duties include caring for an eligible dependent • Placement fee expenses and stipend for an au pair This is a sample list only. Eligible expenses are subject to change based on IRS guidance. Please review your employer’s benefit plan documents for specifics regarding eligible expenses under your spending account plan. Your employer’s plan documents have final authority on eligibility. This document provides a general overview and is not inclusive, nor a guarantee of eligibility or payment. *Expenses that require a letter of medical necessity from your health care provider in order to be considered eligible for reimbursement.
Qualified Expenses
You can use your HSA for out-of-pocket expenses that would generally qualify for the medical, dental, and vision income tax reduction. Some qualified expenses include: • Deductibles • Office visits • Prescription drugs • Hospital stays and lab work • Speech/occupational/physical therapists • Dental care
Your HSA works like a savings account. You decide whether to use the funds to pay for health care expenses out of your pocket or from your HSA using a convenient debit card.
• Choose a specific amount of money to contribute each pay period, pre-tax, to one or both accounts during the year. • The amount is automatically deducted from your pay at the same level each pay period. • As you incur eligible expenses, you may use your flexible spending debit card to pay at the point of service or submit the appropriate paperwork to be reimbursed by the plan.
Health Savings Account (HSA)
How much of your HSA balance automatically rolls over year-to-year.
How much of your HSA balance you can take with you if you leave the company.
How much of the money in your HSA grows tax-free.
Taxes you pay on the money you contribute to the HSA or withdraw for qualified expenses (see above).
0%
100%
The HSA has many benefits. It also has some important rules.
Annual Limits The IRS limits the amount you can contribute to an HSA each year. These limits may change each year. It’s your responsibility to ensure your contributions don’t exceed the annual limit. Tax penalties may apply on excess contributions.
Dependents’ Participation Your spouse and/or dependent can be enrolled in other coverage or no coverage and your HSA can still reimburse their medical expenses, as long as the expenses aren’t reimbursed elsewhere.
Not Everyone Can Open an HSA You will not be eligible to open an HSA if you are: • Enrolled in another medical plan, unless it’s an HDHP • Enrolled in Medicare • Enrolled in a Health Care FSA (may open a Limited Purpose FSA) • Not a US resident • Eligible to be claimed as a dependent on someone’s tax return • Active military • A veteran who has received veteran’s benefits in the last 3 months unless for preventive or coverage for a service-connected disability.
3
2
1
Flexible Spending Account (FSA)
The Flexible Spending Account (FSA) plan allows you to set aside pre-tax dollars to cover qualified expenses. You can save money with a health care spending account and/or a dependent care account. You pay no federal or state income taxes on the money you place in an FSA.
How an FSA Works
Health Care Flexible Spending Account
FSA Reimbursements
Dependent Care Flexible Spending Account
The Dependent Care FSA lets you set aside tax-free dollars to pay for expenses such as day care for a child or an elderly or disabled adult relative. Your Dependent Care FSA lets you pay for these types of care in the most tax-efficient method the government allows. For the Dependent Care FSA, election funds are only available as they are payroll deducted. The IRS limits how much you can contribute to your FSAs each year. For 2020, those limits are $5,000 (or $2,500 if you are married and filing separately).
The Health Care FSA lets you set aside tax-free dollars to pay for many medical, dental, and vision expenses that aren’t covered by your other benefit coverages. Eligible expenses include your annual deductibles, copayments, and out-of-pocket costs for eyeglasses and physical exams. For a complete list of eligible expenses, refer to IRS Publication 502 or visit www.irs.gov. Keep in mind: • You may not use money in your Health Care FSA to pay for your medical, dental or vision group coverage contributions, because those contributions are automatically deducted from your pay on a before-tax basis. • You may be reimbursed for any eligible expenses incurred by you or any dependents you claim for income tax purposes.You are not required to have any other API Group health coverage to participate in the Health Care FSA. The IRS limits how much you can contribute to your FSAs each year. For 2020, those limits are $2,700.
Important Rules to Keep In Mind
Because Health Care FSA funds become available at the beginning of the plan year, you must plan wisely to ensure that you have enough funds to last you throughout the year. If you elect the Healthcare FSA, you will receive a Flex Card. Your Flex Card makes it easy to use your FSA dollars for eligible expenses. However, you may be asked to document your expense after using the card. If you have any FSA dollars left at the end of the plan year, you will have until March 15th of the following year to use the remaining funds in your account for expenses incurred in the prior plan year. 2019 expenses must be filed with BPI by March 31, 2020. You will not be able to use any remaining Dependent Care funds left over at the end of 2019. The deadline for filing a claim and requesting reimbursement is March 31, 2020 or 30 days after termination unless you elect COBRA.
Use it or Lose it! Plan carefully when you are deciding how much money to contribute to your FSA. You are able to roll over up to $500 of unused funds at the end of the plan year. The IRS dictates that you forfeit any contributions left over this amount. This is called the “use it or lose it” rule.
How An FSA Works
When you participate in an FSA, you have money withdrawn from your paycheck pre-tax. This lowers your taxable income each pay period, meaning you keep more money in your pocket. Then, when you pay for eligible expenses, you can request reimbursement from the account. The plan reimburses you with tax-free dollars. You cannot stop or change your FSA contributions unless you have a life status change event. There are two FSAs available to you through BPI: the Health Care FSA and the Dependent Care FSA. Members enrolled in the HDHP may elect a limited purpose health FSA. Limited purpose FSAs may be used for vision and dental expenses until your HDHP plan deductible is satisfied. Once you enroll in a Flexible Spending Account (FSA) you can establish your online account on the BPI Portal at www.Mycafeteriaplan.com.
Because Health Care FSA funds become available at the beginning of the plan year, you must plan wisely to ensure that you have enough funds to last you throughout the year. If you elect the Healthcare FSA, you will receive a Flex Card. Your Flex Card makes it easy to use your FSA dollars for eligible expenses. However, you may be asked to document your expense after using the card. If you have any FSA dollars left at the end of the plan year, you will have until March 15th of the following year to use the remaining funds in your account for expenses incurred in the prior plan year. 2020 expenses must be filed with BPI by March 31, 2021. You will not be able to use any remaining Dependent Care funds left over at the end of 2020. The deadline for filing a claim and requesting reimbursement is March 31, 2021 or 30 days after termination unless you elect COBRA.
A fundamental element of any benefits package is life and disability insurance.
You are automatically enrolled for Basic Life and AD&D. Your benefits differ by class. Your coverage amount will be based on the coverage amount as indicated in your specific group certificate. Contact the benefits department for questions regarding your coverage.
Life and AD&D Insurance
Basic Life and AD&D Insurance
A fundamental element of any benefits package is life insurance designed to protect you and your loved ones from financial hardships related to an untimely death. You may receive basic life insurance and accidental death and dismemberment (AD&D) insurance automatically, at no cost to you This provides a benefit if you die in a covered accident or you suffer certain serious injuries, such as loss of eyesight or a limb. You may purchase voluntary life and AD&D coverage in increments of $10,000, up to a maximum of 5 times your annual earnings, not to exceed $500,000. Coverage will be provided to you at your initial enrollment on a Guaranteed Issue basis (no medical questions) for any amounts up to a maximum of $150,000 for employees, $25,000 for spouses and up to $10,000 for dependent children (some limitations may apply for currently disabled dependents or those with a life-threatening condition). Eligible Employees: If you and your dependents do not enroll within 31 days of your initial eligibility date, you may apply for coverage at your next annual enrollment period, but you will be subject to medical questions, and this review may result in coverage being declined. Imputed Income: Federal tax laws require you to pay taxes (based on IRS tables) on the cost of any company-provided life insurance coverage over $50,000. This cost is considered imputed income and will be added to your gross taxable income.
Basic Life Summary (FT)
Basic Life Summary (PT)
Dependent Life and AD&D Insurance
Eligible Dependents: Your spouse and dependent children are also eligible for coverage. • Spouse coverage will be applied for in $5,000 increments; however, the spouse coverage amount cannot exceed 100% of your own voluntary life election. • Child coverage will be applied for in $2,000 increments to a maximum of $10,000 (the cost of this coverage is the same for one or multiple children). • Annual Enrollment Flexibility: As long as you elect at least the minimum coverage amount ($10,000) at your initial enrollment, you can increase your amount up to the Guaranteed Issue maximum ($150,000) at any future annual enrollment period with NO MEDICAL QUESTIONS (must be actively at work to increase). • Portability: If your employment ends, you retire from your employer or you are working less than the minimum number of hours, you may be eligible to elect portable coverage and continue your term insurance at group rates.
Voluntary Life and AD&D Insurance
Note: upon termination, you have an opportunity to continue Group Life and/or Voluntary Life Insurance. Forms and premiums must be remitted to Dearborn within 31 days of termination. Please contact Benefits Department with any questions.
Enrolled employees are allowed to increase coverage by one $10,000 increment up to the guaranteed issue amount without submitting Evidence of Insurability. You must submit Evidence of Insurability (proof of good health) for Voluntary Term Life plans if any of the following conditions are met: • You waived coverage the first time you were eligible to elect Voluntary Life and AD&D coverage and would like to enroll as a late entrant. • You are enrolled but would like to increase your election by more than one $10,000 increment. • You are newly eligible and electing an amount in excess of the Guaranteed Issue amount.
Click Here to download the EOI Form
Voluntary Long Term Disability (LTD)
Short Term Disability (STD)
The plan is designed to protect you and your loved ones from financial hardships due to a non-work related illness or injury.
Disability Insurance
Short-Term Disability Insurance
Employees can choose to purchase this benefit at 50% of the total cost. Any benefit you receive will not be subject to income taxes because you pay for the premium post-tax. If you waived coverage when first eligible and wish to elect coverage at a later date, you will be subject to a longer pre-existing limitation period.
Long-Term Disability Insurance
Long Term Disability coverage is provided to you through Dearborn. You can purchase this coverage for 50% of the total premium.
STD/LTD Pre-Existing Limitation Note Disability benefits will not be paid for a disability that begins during the first 12 months of coverage for conditions that are determined to be pre-existing conditions. A pre-existing condition is an injury or illness for which you received medical treatment, consultation, diagnostic measures, prescribed drugs or medications or for which you followed treatment recommendations during the three months prior to your coverage effective date.
Unum’s Whole Life Insurance is designed to pay a death benefit to your beneficiaries, but it can also build cash value you can use while you are living.
Basic Life for Physicians
A fundamental element of any benefits package is life insurance which is designed to protect you and your loved ones from financial hardships related to an untimely death. NMHS provides you with 1 times your annual compensation rounded to the next higher $1,000 up to $50,000 of Basic Life Insurance. This benefit is provided to you at no cost. When you are age 70 or older, your Basic Life Insurance benefit will reduce to 50% of the benefit at age 70. Spouses and dependents will receive $10,000 of coverage.
Basic Life for All Other Employees
Whole Life Insurance
When you buy life insurance, you name the people who will receive the money from the policy when you die. These people are called beneficiaries. Unum will pay benefits to the beneficiaries in one lump sum; however, if a beneficiary is a minor (typically younger than 18, but this may vary by state) and no financial guardian has been appointed, the benefits will be paid to that minor through a Unum Retained Asset Account. A Unum Retained Asset Account is a fund held in Unum’s general account for the named minor beneficiary. The account accrues interest regardless of Unum’s actual investment performance, and, while not FDIC insured, the account funds are fully guaranteed by Unum. For more information about the retained asset account, please contact Unum. *The policy accumulates cash value based on a non-forfeiture interest rate of 4.5% and the 2017 CSO mortality table. The cash value is guaranteed and will be equal to the values shown in the policy. Cash value will be reduced by any outstanding loans against the policy. Eligible employees must be actively at work to apply for coverage. Employees are not considered actively at work if they are on a leave of absence. Employees must be U.S. citizens, Canadian citizens working in the U.S., or have a Green Card to receive coverage. Effective date of coverage Your coverage will be effective on the first day of the month in which payroll deductions begin. Exclusions Life Insurance benefits will not be paid for deaths caused by suicide. If within two years from the policy effective date, the insured commits suicide, whether sane or insane, Unum will not pay the death benefit. The amount payable by us in place of all other benefits, shall be the sum of premiums paid, without interest, less the sum of any debt and the cost of any riders. Termination of coverage All coverage under this policy will terminate on the earliest of the following:• Written request by you to terminate the policy;• The insured dies;• The policy matures; or• The loan value exceeds the guaranteed cash value of this policy.This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Form L-21848 et al. or contact your Unum representative.Unum complies with state civil union and domestic partner laws when applicable. Underwritten by:Provident Life & Accident Insurance Company, Chattanooga, TN© 2018 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.
Death is not the most popular topic, but it’s inevitable for us all. Preparing for that day is our responsibility.
The policy accumulates cash value at a guaranteed rate of 4.5%.* Once your cash value builds to a certain level, you can borrow from the cash value or use it to buy a smaller “paid-up” policy with no more premiums due. If you are diagnosed with a medical condition that limits life expectancy to 12 months or less, you can request up to 100% of the benefit amount, to a maximum of $150,000. Your spouse and dependents have this option as well.
• Premiums are paid through convenient payroll deduction. • The coverage is portable, so you may take it with you if you leave your employer (with certain stipulations).
Who Is Covered?
Additional Features
• Employee • Employee’s spouse • Employee’s dependent children under age 26, regardless of student or marital status
Could your bank account survive a serious illness?
Unum’s Group Critical Illness Insurance can help protect your finances from the expense of a serious health problem, such as a stroke or heart attack. Cancer coverage is also available. You choose a lump-sum benefit that’s paid directly to you at the first diagnosis of a covered condition. You can use the benefit any way you choose. You can use this coverage more than once. If you receive a full benefit payout for a covered illness, your coverage can be continued for the remaining covered conditions. The diagnosis of a new covered illness must occur at least 90 days after the most recent diagnosis. Each condition is payable once per lifetime. What's Covered? • Heart attack • Blindness • Major organ failure • End-stage kidney failure • Benign brain tumor • Coronary artery bypass surgery (pays at 25% of lump sum benefit) • Coma that lasts at least 14 consecutive days • Stroke whose effects are confirmed at least 30 days after the event • Occupational HIV • Permanent paralysis of at least two limbs due to a covered accident Coverage is also included for: • Cancer • Carcinoma in situ — pays 25% of your coverage amount.(Carcinoma in situ is defined as cancer that involves only cells in the tissue in which it began and that has not spread to nearby tissues.) Who Can get coverage Coverage is guaranteed up to the stated amount. If you don’t sign up now but decide to apply later, you may have to answer medical questions.
Critical Illness Insurance
Exclusions and limitations Individuals must have comprehensive medical coverage to be eligible for this critical illiness insurance. Reduction of benefits Any coverage inforce prior to the insured’s 70th birthday will be reduced on the policy anniversary date following the insured’s 70th birthday. The insured’s face amount will be reduced to 50% of the face amount the insured had prior to the policy anniversary date. Any coverage inforce after the policy anniversary date following the insured’s 70th birthday will not be subject to a benefit reduction on subsequent policy anniversary dates. Exclusions and limitations Unum will not pay benefits for a claim that is caused by, contributed to by or occurs as a result of: • Participating or attempting to participate in a felony or being engaged in an illegal occupation; or • Committing or trying to commit suicide or injuring oneself intentionally, whether sane or not; or • Participating in war or any act of war, whether declared or undeclared; or • Committing acts of terrorism; or • Being under the influence of or addicted to intoxicants or narcotics. This would not include physician-prescribed medication, taken in the prescribed dosage Termination of employee coverage If you choose to cancel your coverage under the policy, your coverage ends on the first of the month following the date you provide notification to your employer. Otherwise, your coverage under the policy ends on the earliest of the:• Date this policy is canceled; • Date you are no longer in an eligible group; • Date your eligible group is no longer covered; • Date of your death; • Last day of the period for which you made any required contributions; or • Last day you are in active employment. However, as long as premium is paid as required, coverage will continue if you elect to continue coverage under the portability provision or in accordance with the Layoff and Leave of Absence provisions of this policy. Coverage on your dependent children ends on the earliest of the date your coverage under this policy ends or the date a dependent child no longer meets the definition of dependent children.Unum will provide coverage for a payable claim which occurs while you are covered under this policy. THIS INSURANCE PROVIDES LIMITED BENEFITS This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and imitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Form CI-1 or contact your Unum representative. Underwritten by:Unum Life Insurance Company of America, Portland, Maine© 2018 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.
Click Here to view the wellness flyer
What is myKlovr? MyKlovr is the first-of-its-kind virtual college counselor and platform that accompanies high school college-bound students starting in the 9th grade until the application submission. It uses data science and artificial intelligence to provide high schoolers and their parents with guidance on how to choose the right colleges and how to increase every student’s chances of college admission.
Helping Every Student Get Into College
• Comprehensive Student Portfolio • Personalized Goal Recommendations • Individual Action Plan • Progress Dashboard
• Advanced College Finder • Your Own Supportive Network • Premium - Plus Only: Dedicated College Counselor • Coming Soon: The All - Education Marketplace
MyKlovr is an online tool designed for high school college-bound students from the 9th grade onward.
How Does myKlovr Work?
Contact Us:
info@myklovr.com
(646) 380 -2424
www.myklovr.com
facebook.com/myklovr
1350 Ave of the Americas, 2nd FL New York, NY 10019
Myklovr
EE + Child / $17.99 monthly
EE + 2 + Children / $29.99 monthly
myKlovr Rates
Additional Resources
Employee Assistance Program
Your well-being is important to us. That is why HydroChemPSC pays the full cost of the Employee Assistance Program (EAP) that you can access 24 hours a day, seven days a week. The EAP is a confidential service that can provide you with information, referral services, and counseling for personal issues, financial advice, and legal consultation. You’ll also have unlimited website access at magellanhealth.com where you can read articles, view videos, find informational resources, and subscribe to helpful resources.
Worldwide Travel Assistance
Immediate Attention For Emergencies While Traveling
While traveling more than 100 miles from home you may access Travel Assistance services 24/7 by calling the toll-free number for immediate help from a travel assistance professional.
Services available for business and personal travel.
For inquiries within the U.S. call toll free:
1-800-856-9947
Outside the U.S. call collect:
312-935-3658
• Telephonic translation and interpreter services – 24/7 access to telephone translation services • Locating legal services – referrals for local attorney or consular offices and help maintain business and family communications until legal counsel is retained (includes coordination of financial assistance for bonds/bail) • Baggage – assistance with lost, stolen or delayed baggage while traveling on a common carrier • Emergency payment and cash – assistance with advance of funds for medical expenses or other travel emergencies by coordinating with your credit card company, bank, employer, or other sources of credit; includes arrangements for emergency cash from a friend, family member, business or credit card • Emergency messages – assistance with recording and retrieving messages between you, your family and/or business associates at any time • Document replacement – coordination of credit card, airline ticket or other documentation replacement • Vehicle return – if evacuation or repatriation is necessary, return your unattended vehicle to the car rental company
Emergency Travel Support Services
Travel Assistance can help you avoid unexpected bumps in the road anywhere in the world. For you, your spouse and dependent children on any single trip, up to 120 days in length, more than 100 miles from home. Minimize travel hassles by calling us pre-departure for: • Information regarding passport, visa or other required documentation for foreign travel • Travel, health advisories and inoculation requirements for foreign countries • Domestic and international weather forecasts • Daily foreign currency exchange rates • Consulate and embassy locations
Identity Theft Assistance
Access ID Theft Assistance services by calling AXA Assistance toll-free at (800) 856-9947.
Identity Theft Assistance, provided by AXA Assistance, helps you and your dependents understand the risks of identity theft, learn how to prevent it, and most importantly, assist you if your information is compromised.
We help you understand the growing threat of identity theft by: • Promoting awareness of identity theft • Answering your questions about identity theft and how to recognize if you’ve become a victim • Educating you on how to avoid having your identity stolen
Awareness and Education
If your identity is compromised, the most important thing to do is respond quickly. We assist you by: • Connecting you to the fraud departments at your bank(s) and credit card companies • Facilitating access to credit bureaus and obtaining a complimentary credit report • Guiding you in contacting federal government and local law enforcement agencies and filing reports and complaints
Recovery Assistance
401(k) Retirement Plan
HydroChemPSC offers a 401(k) Retirement Plan. The plan includes an automatic enrollment feature. This means employees will be automatically enrolled at a default contribution rate of 3% on the 1st of the month following 90 days of service. Employees may opt out of or change their contribution rate at any time. Additional 401(k) details will be provided in a separate mailing from Principal Financial Group.
HydroChemPSC is excited to offer some additional benefits to all of our employees. Read the details below to see more!
DirectPath Advocates can help you navigate the health care system. Your Advocate becomes your first point of contact for all benefits-related questions and will educate you on the benefits programs offered through HydrochemPSC to help you make the choices best suited for you and your family!
You have a Health Care Advocate for that!
Advocacy & Transparency
Your DirectPath Advocate can: • Answer questions about your benefits • Resolve claims and billing issues • Assist with referrals and prior authorization • Compare pricing for an upcoming procedure • Answer general questions about health care reform • Answer questions about open enrollment
Rewards Program
How Does It Work?
Call DirectPath to compare costs before scheduling any elective inpatient or outpatient service. Choose a low cost provider based on the physicians/facilities YOU want to compare. Submit your Explanation of Benefits (EOB) and Reward Form to DirectPath. GET REWARDED with up to $500 of the plan savings for choosing a lower cost option!*
Get rewarded for making informed decisions about health care procedures!
*Members are eligible for one reward per test or procedure per year.
1. Colonoscopy 2. Mammogram 3. MRI 4. Ultrasound 5. Delivery (Routine) 6. Bone Density Test 7. CT Scan 8. X-ray 9. Vasectomy 10. Sleep Study
Facility A – $3,100 Facility B – $600 Facility C – $1,500
Look at the cost difference for this MRI:
Top 10 reports we create:
Transparency Cost & Quality
Did you know the cost of health care tests and procedures can vary from doctor to doctor and location to location?
You can call 877-760-0592 to speak with an Advocate!
Hours of Operation: Monday - Friday (7:00 AM – 8:00 PM Central Standard Time) Saturday (8:00 AM – 1:00 PM Central Standard Time)
Where Should I Go For Care?
your benefits
For specific plan information, click the links below:
Critical Illness Flyer
Whole Life Insurance Flyer
Printable Version of the Benefits Guide
For specific plan information, click the links below.
resources & Contacts
Important
Flexible Spending Account Info
Accident Insurance Flyer
Critical Illness Insurance Flyer
Dental & Vision Plan Details
Medical Plan Details
Short-Term Disability Plan Highlights
Basic & Voluntary Life Insurance Highlights
MyKlovr Flyer
EOI Form (Dearborn)
EOI Signature Page (Dearborn)
Livongo Flyer
Vision Benefits Summary
Dental Benefits Summary
Critical Illness Wellness Flyer