Welcome Benefit Checklist Benefit Details 2022 Medical Plans The BAS Blue, White, and Yellow Plans The Green Plan Dental Vision Employee Assistance Plan (EAP) The Signature Wellness Plan Protecting You Financially Health Savings Account (HSA) Flexible Spending Account (FSA) Basic Life Insurance Voluntary Life Insurance Disability Benefits The 401(k) Plan Supplemental Plans Additional Benefits Inspire Foundation QSC Summary Sheet Contact Information
Table of Contents
Click here to schedule your enrollment appointment online
Book Your Appointment
2017 Benefits Enrollment
Benefits For You and Your Family
Welcome to Your
This site describes the benefit plans and policies available to employees of Signature HealthCARE who meet eligibility requirements. The details of these plans and policies are contained in the official plan and policy documents, including some insurance contracts. This site is meant only to cover the major points of each plan or policy. It does not contain all of the details included in your Summary Plan Descriptions (as required by ERISA) found in other employee benefit materials. If there is a question about these plans and policies, or if there is a conflict between the information in this site and the formal language of the plan or policy documents, the formal wording in the plan or policy documents will govern. Note: The benefits highlighted and described in this site may be changed at any time and do not represent a contractual obligation on the part of Indigo Golf.
Legal Statement
Welcome
Dear Stakeholder, Welcome to your 2022 Stakeholder’s Benefits Guide. As a member of the Signature family, your benefits and financial well being are very important to us. Every year, we strive to offer the highest quality care at the most affordable price to you and your family. This benefit guide is designed with you, the Stakeholder, in mind. Here you will find information about your benefits that will help you make informed choices for you and your family this plan year. If you still have questions after going through this information, we have other options available to you: • Our Stakeholder Benefits Call Center is available Monday – Friday, 8:00 a.m. – 9:00 p.m. EST at (877) 901-1634. To schedule an appointment, or for enrollment related questions, press 1. For Qualifying Life Events or Mid-Year Enrollments, please press 2 and leave a voicemail. For general benefits questions, press 6. • Your Signature HealthCARE Benefits information can be found here. You will also find benefits information and plan documents on the Ultipro Employee Self Service Portal at selfservice.shccs.com. Remember! The benefits you choose now will remain in effect until the end of December 2022 unless you experience a qualified life event. Take time with your loved ones and discuss which options will benefit you the most in 2022. As always, we are here to help. Thank you, The Signature Benefits Team
Your Checklist
• You must schedule an appointment with a Benefits Educator to enroll in benefits for the 2022 plan year. • To make an appointment: - Call 877-901-1634; or - Visit signaturehealthcarebenefits.com and follow these steps: • Click on “Book Your Enrollment Appointment.” • Enter your last name and date of birth. • Enter your phone number and best email address. • Pick your appointment date from one of the blue highlighted dates on the calendar, choose the time, and click “Next.” • Confirm your information and click “Save.” - Your DirectPath Benefits Educator will call you within 15 minutes of your scheduled appointment. • Review your benefits information prior to your appointment with your Benefits Educator. • Prepare for your appointment: - Make sure you have your spouse and/or children’s Social Security Numbers and dates of birth if you are enrolling them in Signature HealthCARE benefits. You will also need your date of marriage if you are enrolling a spouse. - During your appointment, you will be asked to verify whether or not your spouse has access to health insurance through his or her employer. If your spouse is offered medical coverage under any other employer-sponsored health plan, he or she is not eligible for coverage under Signature HealthCARE medical benefits. - If you are electing a Mutual of Omaha Life Insurance plan, your Benefits Educator can help you select or update your beneficiary information. If an EOI is required, the Benefits Educator will provide you with a link to answer the required questions. • Update your phone number in UltiPro Web at selfservice.shccs.com. • If you enroll in a BAS Medical Plan, look for more information about the Signature HealthCARE Wellness Program provided through Bravo Wellness. Important Reminder: There is a $75 Tobacco Surcharge per month if you are a tobacco user and enroll in the BAS Blue, White, or Yellow Medical Plan.
for Benefits Enrollment
Signature HealthCARE provides you the opportunity to enroll in benefits via a confidential, one on one, 30-minute, telephonic session. This is your chance to speak with a licensed, non-commissioned DirectPath Benefits Educator and get all your benefits questions answered. Here’s what you need to know:
Making Benefit Election Changes During the Year
You cannot make changes to your benefits during the year, unless you experience a qualifying event (as defined by the IRS Section 125). Qualifying events include, but are not limited to, marriage, birth, adoption, divorce, and loss/gain of other coverage. For a complete listing, see the Qualified Change in Status section. If you do experience a qualifying event, you must submit changes and supporting documentation within 30 days of the event. Changes will be effective and premiums are due the first of the month following the date of the qualifying event, unless it is a birth, adoption, or loss of other coverage (which is effective the date of the event).
Below are the benefits Signature HealthCARE offers to protect your health: • Medical and Prescription* o BAS Blue Plan, White Plan, or Yellow Plan o Pan-American Green Plan • Dental* • Vision* • Employee Assistance Program (EAP)º • Teladocº (for BAS Plan Participants) • Wellness Program (for ALL Stakeholders enrolled in a Signature HealthCARE health plan) • Diabetes Program (for BAS Plan Participants) º = Company-Provided * Active Election Required
Protecting Your Health
The following terms are important to understanding your health benefits. • Copay: A specific dollar amount that you are required to pay for some services and supplies. • Coinsurance: After you meet your deductible (if applicable), you and Signature HealthCARE share in the cost of certain services and supplies. The coinsurance is the percentage for which you are responsible until you meet any out-of-pocket maximum. • Deductible: The amount of money you are required to pay out of pocket before any benefits will be paid. • Out-of-Pocket Maximum: The maximum amount of money you will pay towards the cost of services and supplies each year. After you have paid deductibles, copays and coinsurance up to this amount, the administrator of the plan covers any costs incurred for the remainder of the Plan Year. Note: Premiums, balance-billed charges, and services not covered by the plan do not contribute to the out-of- pocket maximum.
Terms You Need To Know
Click the buttons below for more information
Additional Eligibility Requirement for Spouse
Who Can Be Covered Under Your Plan
Eligibility
Helpful Terms
As you focus on the health of others in our communities, Signature HealthCARE is focused on keeping you well, both mentally and physically. This section of your site provides detailed information about the competitive benefits and multiple selections Signature HealthCARE provides to meet your current needs.
Benefit Details
Effective Date of Coverage
When Coverage Ends
Spousal Surcharge
Your benefit choices take effect on January 1, 2022 or the date you first become eligible to participate and will remain in effect until December 31, 2022. REMEMBER: After initial enrollment, you may only change your benefit elections if you experience a qualifying event (as defined by the IRS Section 125). For more information on how to report a Qualified Status Change (QSC) and what constitutes a QSC, see the Qualified Change in Status section.
Stakeholders Full-time and part-time, insurance-eligible Stakeholders (PTI) working 30+ hours a week are eligible for benefits the first day of the month following the 60-day waiting period or the first day of the month following the 30-day waiting period (depending on the division to which you are assigned). Dependents You have the opportunity to enroll your eligible spouse and children for medical, dental, vision, and voluntary life insurance. Eligible dependent children include children under 26 years of age that are your natural children, stepchildren, children legally placed for adoption, legally adopted children, and children incapable of self-support because of a physical or mental disability (regardless of age).
All benefits end on the date you terminate employment or change to a non-benefits eligible status. Continuation of Coverage Under certain circumstances, you may continue your health care coverage - when it would otherwise end - through COBRA coverage (the Consolidated Omnibus Budget Reconciliation Act). A COBRA information packet will be mailed to you and your enrolled dependents when you terminate coverage.
What You Need To Know About The Affordable Care Act (ACA)
The ACA REQUIRES you to have “Minimum Essential Coverage” for yourself and your family members. This requirement is known as the “Individual Mandate” and is enforced with a financial penalty for every month you go without health insurance. Minimum Essential Coverage is defined as a plan that covers at least 60% of expected claims costs. Here are your options: • The Marketplace (the “Exchange”) • Medicaid or another government-sponsored program • Signature HealthCARE’s Health Plan • Your spouse’s Employer Health Plan The Marketplace If you do not meet the requirements for employer coverage and are not enrolled in any federal or state public health insurance program, the Marketplace offers you an option to purchase health insurance through a federally-facilitated Exchange or State-run Exchange if you live in the United States, are a U.S. citizen or national, and are not incarcerated. There are multiple options to meet coverage needs and budgets. You may qualify for lower premiums based on your income. Note: This subsidy may not be available if you are eligible for an employer’s health plan. To research this option, visit www.HealthCare.gov. Medicaid Medicaid is the nation’s health benefit program that provides for individuals with a low income or limited financial resources. If you did not qualify for Medicaid or some other governmental programs in the past, you may qualify under the requirements that were expanded as a result of ACA. Researching this option may offer a significant savings to you and your family. For more information, contact your local Medicaid office or visit www.Medicaid.gov or www.HealthCare.gov. Employer Plans Make sure you understand the plans offered by Signature HealthCARE and, if applicable, your spouse’s plan. Understand the eligibility requirements, level of coverage, cost and your responsibilities for enrollment in these plans. For most eligible stakeholders, Signature HealthCARE provides a benefit plan that meets the ACA required standards in providing health coverage that is both affordable and minimum essential coverage.
What You Need To Know About the Affordable Care Act
Qualified Status Change (QSC) Summary Sheet
The following rules are applicable to a stakeholder’s participation in the company’s medical, dental and vision insurance coverage. Enrollment changes for these plans are only permitted during the annual Open Enrollment period, unless there is a Qualified Status Change (QSC) as detailed below. Further, the QSC must result in the stakeholder, spouse or dependent gaining or losing eligibility for coverage under the company’s plan or a plan sponsored by the spouse’s or dependent’s employer. Enrollment changes must be consistent with the circumstances of the QSC. It is the stakeholder’s responsibility to notify the Benefits Department, complete any necessary forms and supply proof of the QSC within 30 days of the QSC event. If a stakeholder fails to complete an enrollment form within 30 days, enrollment and contribution changes will not be permitted until the next Open Enrollment period or the next QSC. (Note that the Plan Administrator retains the discretion to make all QSC determinations.) Coverage is effective on the first of the month following the event (except for Birth/Adoption or Loss of other Coverage which is effective on the date of the event) Premiums are due back to the effective date.
Understanding the Affordable Care Act
You have the choice between four medical options: • The BAS Blue Plan • The BAS White Plan • The BAS Yellow Plan • The Pan-American Green Plan Note: If you enroll in the BAS Yellow Plan, you will be automatically enrolled in the Accident plan for you and any of your covered dependents, at no charge. Your dependents only get the Accident Plan if they are enrolled in the Yellow Plan.
Establishing a relationship with a PCP is key to maintaining good health. A PCP will help keep you healthy and assist in helping you make positive lifestyle choices. If you already have a PCP, you may select that provider.
1. SELECT A PRIMARY CARE PROVIDER (PCP):
Biometric health screenings help you understand your current health status so you can take steps to improve it. The screening includes blood pressure, weight/BMI measurements and lab work. You can complete a health screening with your PCP or at a CVS MinuteClinic.
2. COMPLETE A BIOMETRIC HEALTH SCREENING:
Developed by CareFirst’s trusted partner, Sharecare**, RealAge is a confidential health assessment that helps determine your body’s physical age compared to your calendar age. You’ll discover the lifestyle behaviors helping you stay younger or making you age faster and receive insightful recommendations based on your results.
3. ANSWER THE REALAGE® HEALTH ASSESSMENT:
Check out what is available to you: • A personalized health newsfeed: Receive insights, content and services tailored to you. • Trackers: Connect your wearable devices to monitor daily habits like sleep, steps, nutrition and more. • Challenges: Having trouble staying motivated? Join a challenge to make achieving your health goals more entertaining. • A health profile: Access your important health data like biometric information, vaccine history, lab results and medications all in one place.
2021 Medical Plans
The ACA requires you to have health coverage for yourself and your family members or pay a penalty. This coverage can be through the Marketplace (or “Exchange”), Medicaid or other government-sponsored programs, Signature HealthCARE’s health plan, or your spouse’s employer health plan. For a more detailed explanation of ACA, click here.
The BAS Blue, White, & Yellow Plan Options
Benefit Administrative Systems (BAS) is the Health Insurance Administrator for the BAS Blue Plan, White Plan, and Yellow Plan. You have the freedom to go to any doctor, hospital, or outpatient facility you choose. You are not restricted to a network. All providers are eligible for reimbursement. The Yellow Plan differs from the Blue and White Plans because it offers the option of enrolling in the Health Savings Account (HSA). For more information, see Health Savings Account (HSA) in the “Protecting You Financially” section. If you enroll in either the BAS Blue Plan, White Plan, or Yellow Plan, you will be responsible for the deductibles, copays, and coinsurance levels outlined in the benefit descriptions. The plan will reimburse the difference up to what is considered a reasonable reimbursement. (See the “Understanding Payment of Your BAS Plan Benefits” section below for more information on reasonable reimbursement.)
BAS Medical Plan Summary of Benefits
Opportunities as a BAS Health Plan Participant
The BAS Plan Prescription Drug Benefit
Understanding Payment of Your BAS Plan Benefits
Health Equity – Health Savings Account (HSA) (Available to BAS Yellow Plan Participants) An HSA allows for pre-tax payroll deductions that roll over year to year and can be used to pay for qualified medical, dental, and vision expenses. Teladoc (Available to BAS Blue Plan, White Plan, or Yellow Plan Participants) Teladoc provides you and your dependents with telephonic access to U.S. board-certified doctors 24 hours a day, 7 days a week at 800-Teladoc (800-835-2362) when you have questions and your doctor is unavailable or you are considering an ER or Urgent Care visit. This is available at no cost to you ($0 copay). Teladoc doctors can treat many medical conditions, including: Signature HealthCARE Diabetes Program (Available to BAS Blue Plan, White Plan, or Yellow Plan Participants) The Livongo Transform Diabetes Care Program is a voluntary program offered to BAS medical plan participants (including stakeholders and family members) through Capital Rx and Livongo (at no additional cost). It includes free digital connected glucose meter, strips and lancets, real time diabetes health coaching and support, two free health evaluation visits at the Minute Clinic, and one-on-one counseling.
• “REASONABLE” AMOUNT: The “reasonable” amount is what BAS considers to be normal or acceptable payment for specific services or procedures. The average fee that doctors and facilities are charging in a specific geographic location is typically used to decide what is reasonable; therefore, the “reasonable” amount may differ by location. • EXPLANATION OF BENEFITS: After any medical service you will receive an Explanation of Benefits (EOB) in the mail from BAS telling you what you owe. In addition to the EOB, you will also receive a letter and contact information from ELAP Services, your health plan’s affordability partner. • BALANCE BILLS: BAS plans reimburse a portion of the cost for medical services, up to a “reasonable” amount. “Balance bill” comes into play when BAS submits payment to the provider for what is considered the reasonable amount and the physician or facility then bills the patient for the remaining amount. The balance bill will come directly from the provider or facility. As long as you have paid your share of the cost, as indicated on the EOB, you do not owe any more money. Notify BAS immediately if you receive any request for additional money. What to do if you receive a balance bill? • First of all, make sure you are checking your mail after you’ve received medical services. Being timely with inquiries will help BAS better assist you. • Know what you are receiving. A balance bill will not be communicated as a balance bill. It will look like a statement of owed amount from your provider or facility where services were provided. It is not the EOB that you receive from BAS. • If you’ve paid your share of the cost (as shown on the EOB), do not pay the bill from the provider. Contact BAS immediately by phone at 866-936-0726 or by email at balancebills@elapservices.com. • Once you reach out to BAS, they will assist you with the balance bill process.
This chart is only a summary of the more common benefits of your plan. This chart summarizes amounts paid by the plan, benefit maximums and additional explanations of your benefits. If there is a discrepancy between the information contained herein and the plan document, the plan document governs. This chart does not describe the other plan exclusions and limitations that are included in the plan document.
If you enroll in the BAS Blue Plan, White Plan, or Yellow Plan, your 2022 prescription drug plan administrator is Capital Rx. With Capital Rx, you have access to: • Member services available 24-hours a day, 7-days a week at 844-732-2779 or 800-424-8274 (for Mail Order) • The Capital Rx digital portal, which allows you to: - Search for the lowest cost drug at surrounding pharmacies - Find a pharmacy - View your claims history - Download a digital pharmacy card - Find your plan benefit and formulary - See copay and coinsurance information - Access helpful resources on Capital Rx website
Applied Behavior Analysis (ABA) therapy will be paid the same as other outpatient related services. Authorization is required for the ABA assessment (first visit) and the treatment. Once the member has the initial visit, the provider establishes the clinical background and submits the authorization request to pre-service review either by fax or online. Going forward, the provider assesses the number of OT/PT/ST visits required to treat the member.
NEW!
.
• Cold & flu symptoms • Allergies • Bronchitis • Skin problems • Respiratory infection • Sinus problems • And more!
Great News!
Generic Oral Diabetes Medications are covered at a $0 copay under the BAS medical plans.
Your BAS Identification Card (ID)
Be on the lookout! If you elect the BAS Blue Plan, White Plan, or Yellow Plan, you should receive a health identification card from BAS (effective for the Plan Year) within 10 days of your enrollment. This new ID card must be presented to your health care providers and pharmacy. You will receive one ID card that includes both your medical and Rx/prescription benefits. Although your prescription drug benefit is offered through Capital Rx, information regarding Rx benefits is included on your BAS identification card.
The Green Plan Option
Once you have been employed with Signature HealthCARE for 6 consecutive months, the cost of the plan for individual coverage will be paid 100% by Signature HealthCARE. Pan-American is the Health Insurance Administrator for the Green Plan Option. This Plan is a limited benefit indemnity plan that pays a clearly defined, fixed amount to help you cover the cost of common medical services, such as doctor’s office visits, hospitalization, accidents, and more. This plan is designed to provide the most value for your everyday healthcare expenses and differs from other plans that cover major illness and catastrophic injuries. You should familiarize yourself with the plan and what it pays for different services BEFORE you seek care. Preventive services are only covered when performed by an in-network provider.
Pan-American Green Plan Summary of Benefits
Your Green Plan Identification Card (ID)
The Green Plan Prescription Drug Benefit
Be on the lookout! Your health identification card (ID) from Pan-American (effective for the Plan Year) should arrive within 10 days of your enrollment. This new ID card must be presented to your health care providers and pharmacy. You will receive one ID card that includes both your medical and Rx/prescription benefits.
Prescription Drug coverage includes generic drugs at a $10 benefit per day. Brand drugs are discounted. The prescription drug maximum is one per day and a maximum of 12 days per calendar year, per person. If the pharmacy charge is less than the per day indemnity benefit, you will be mailed a check for the difference. If the pharmacy charge is more than the per day benefit, you will be responsible for the difference. If the maximum limit is met a discount will be applied. The Pharmacy network includes over 68,000 participating retail pharmacy locations nationwide; all major chains are included in addition to 20,000 + independent pharmacies. For questions or drug look-up, go to www.rxedo.com or call 888-879-7336. If you enroll in the Pan-American Green Plan, you will receive ONE identification card that includes your medical and prescription drug benefits.
TIP! Ask your Benefits Educator how to locate an in-network provider. When you do need care, be sure to seek out a provider who participates in the First Health Network. Using in-network providers can stretch your benefit dollars. First Health Network provides access to more than 5,000 hospitals and 695,000 physicians and health care professionals nationwide. First Health is committed to patient safety at a high level by exercising care in the selection and evaluation of providers for our network. NOTE ABOUT WELLNESS: The Green Plan is not associated with the Wellness Program. If you enroll in this plan, you are not eligible for the premium discounts or incentives. To obtain an electronic copy of the Summary of Benefits and Coverage and Benefit Guide, please visit www.panamericanbenefitsenrollment.com, enter your group ID SE687, then select View Summary. You may also request a paper copy at any time by calling 800-999-5382.
The Limited Benefit Indemnity Plan alone does not constitute comprehensive health insurance coverage (major medical coverage) and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. However, the Preventive Care Plan offered as part of Panabridge Advantage does not meet the individual responsibility requirement under the Affordable Care Act as it provides minimum essential coverage. Preventive Care coverage is offered under a self-funded plan maintained by the plan sponsor.
The Standard - Dental
If you have questions about your benefits, contact The Standard: • By Phone: 800-547-9515 (5 a.m. – 10 p.m. PT, Monday – Thursday; 5 a.m. – 4:40 p.m. PT, Friday; Interactive Voice available 24 hours a day, seven days a week) • Online: www.standard.com/services
Dental Benefits through The Standard offer you the opportunity to minimize out-of-pocket costs by taking advantage of a large network of providers. Your benefits include preventive, basic, major, and orthodontic services.
Your Dental Identification Card (ID)
Be on the lookout! The Standard will provide you a dental identification card (ID), effective for the plan year, to provide your dental provider when you receive services or make purchases covered by your dental plan. Here’s a quick glance at what Dental coverage offers: • Preventive care is covered at 100%. • Child orthodontia is included ($1,000 lifetime maximum). • In and out-of-network benefits. NOTE: There is a chance that you will encounter balance billing when you receive dental services.
Summary of Benefits
Using Out-of-Network Dentists
Procedure Limitations
You and your dependents have access to an extensive nationwide network of member dentists. The cost-saving benefits of visiting a network member provider are automatically available to all employees and dependents who are covered by any of The Standard's dental plans and who live in areas where the nationwide network is available. To find member dentists in your area, visit http://www.standard.com/services and click on "Find a Dentist." When prompted to select a network, choose “Classic PPO.” REMINDER: If you use an out-of-network dentist, you will receive the same coverage amount; however, costs are not negotiated and may result in additional costs for you from the provider. In addition, you may be responsible for filing your own claim.
The following describe the limits on certain procedures and services, as well as what is covered under each category within your dental program.
Avesis - Vision
Go to www.avesis.com or call 800-828-9341.
Vision benefits are provided through Avesis, a nationwide network of vision care providers. Here’s a quick glance at what Vision coverage offers: • Covers eye exams • Covers glasses and contact lenses • In and out-of-network benefits
Your Vision Identification Card (ID)
Be on the lookout! Your vision identification card (ID) from Avesis (effective for the Plan Year) should arrive within 10 days of your enrollment. This ID card must be presented to your vision provider when you receive services or make purchases covered by your vision plan.
TO FIND AN AVESIS PROVIDER
Employee Assistance Plan (EAP)
Life’s not always easy. Sometimes a personal or professional situation can get in the way of maintaining a healthy, productive life.
The Employee Assistance Program (EAP), provided through Mutual of Omaha, is a Company-provided benefit that offers a confidential service providing assessment, counseling, and referral services if you or your family need assistance with things you may be struggling with, such as: emotional well-being, family and relationships, legal and financial matters, living a healthier life, and work and life transitions. Your EAP benefit includes: • Access to EAP professionals, including licensed mental health professionals, 24 hours a day, seven days a week for you and your eligible dependents • Access to a library of educational articles, handouts and resources via mutualofomaha.com/eap • Referral Resources • Three face-to-face sessions per household per year with a counselor (Note: Face-to- face visits can also be used toward legal consultations. If you are a California resident, Knox-Keene Statute limits no more than three face-to-face session per six-month period.) • Legal assistance and financial resources, including: - Online will preparation - Legal library and online forms - Financial tools and resources • Substance abuse and other addiction resources • Dependent and elder care resources
– Company-Provided
Don’t Delay If You Need Help
Visit mutualofomaha.com/eap or call 800-316-2796 for confidential consultation and resource services.
The Signature Wellness Plan
A Healthier Signature, A Healthier Purpose
Participating is your chance to reach personal goals and learn what improvements you need to make to avoid future health problems. Plus, when you complete the program steps, you can save money on your health insurance! Beginning January 1, 2022, ALL stakeholders enrolled in a Signature HealthCARE health plan are eligible to participate in the Signature HealthCARE Wellness Program delivered by Bravo Wellness. To successfully complete the program and receive up to $2,100 in discounts on your health insurance, complete the four steps to a healthier you!
Dates to Remember: • January 1, 2022: Participation begins. • October 15, 2022: Date you must complete all requirements by to receive the highest discount on your monthly medical premium. • January 1, 2023: Date you will begin receiving the premium discount for requirements completed in 2022 (including completion of the Tobacco Cessation Program). What It Means to Be a Non-Tobacco User A non-tobacco user is defined as someone who has not used any tobacco products (including cigarettes, cigars, smokeless tobacco, pipe tobacco, e-cigarettes, chewing tobacco and roll-your-own tobacco) for the last six months. Providing false information on this certification/affidavit will subject the employee to immediate revocation of the discount and can subject the employee to disciplinary action, including termination of employment. For more information or to review the notices regarding the Notice Concerning Employee Wellness Programs, the wellness plan, reasonable alternatives, and your protections under the ADA, GINA, and HIPAA, please visit: selfservice.shccs.com, and follow the links at the bottom of the page under Equal Employment Opportunity Commission Guidelines. Beginning January 1, 2022 go to www.bravowell.com/signature to register for the program. If you have additional questions, please contact 855-208-1821.
Signature HealthCARE provides options to protect your income now and in the future. Below are options you have to guard your finances, save on current expenses using pre-tax dollars, and save for your future.
PROTECTING YOU FINANCIALLY
• Health Savings Account (HSA)* (for BAS Yellow Plan Participants) • Flexible Spending Account (FSA)* • Basic Life Insuranceº • Short-Term Disability* • Long-Term Disability* • Voluntary Life Insurance* • Accident Insurance* • Critical Illness + Cancer Coverage* • Life Insurance (to Age 121) with Long Term Care Benefits* • Hospital Indemnity Insurance* • 401(k) Plan
º = Company-Provided * Active Election Required
Filing Claims and Reimbursement
Eligible Expenses
Additional Information
• 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)
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.
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
Signature HealthCARE partners with HealthEquity to administer and act as custodian of the HSA funds. An HSA allows you to contribute pre-tax dollars (through payroll deductions) to pay for medical, dental, vision, and over-the-counter medications with a prescription. There is no “use it or lose it” rule. The HSA is portable and is owned and managed by you. Any amount you have in your account at the end of the year will roll over into the next year, which provides you a tax-free way to save for health care expenses over your lifetime (such as COBRA or retiree expenses). For full details on HSAs, see IRS Publication 969, IRS Publication 502, or Section 213 of the Internal Revenue Code.
Only offered to stakeholders enrolled in the BAS Yellow Plan.
Maximum Contributions
How It Works
How do I use my HSA funds?
• Only stakeholders enrolled in the BAS Yellow Plan are eligible to enroll in the HSA. • You are NOT eligible to contribute to the HSA if: - You are claimed as a dependent on another’s tax return. - You are covered by any other non-high deductible medical plan, such as an individual plan, spouse’s plan, Medicare, Medicaid, retiree or government plan. - You have received VA benefits within the last three months.
Because HSAs offer special tax advantages, the IRS puts limits on the maximum amount you can contribute to the account. Below are the 2022 maximums.
• You decide how to use your money in the HSA. • You may use your pre-tax savings to pay for eligible medical expenses not paid for by the plan or use your savings for non-eligible expenses. The amount you spend on non-eligible expenses will be subject to ordinary income tax and, if you are under age 65, a 20% tax penalty. • You will receive an HSA VISA card that can be used at pharmacies, medical offices, and hospitals. • Each month, you receive a monthly account statement. It will show the earned interest you’ve made on your account and will reflect the $2.50 monthly fee required for administration of the plan.
Investments
Once your HSA account reaches $1,000 or more, you can invest amounts above $1,000 in a variety of investment funds, which includes an interest-bearing account or a mutual funds account. • When the account base balance exceeds $1,000, you are eligible to open a self-directed basic investments account. • When the account base balance exceeds $10,000, you are eligible to open a self-directed brokerage investments account. What Next? You will be able to access your investment account online within two to three business days after you open it. Please note: There is an additional annual fee for an investment account. Monies invested are not FDIC-insured and are subject to market risk.
To use the funds in your HSA for qualified medical expenses, you may: 1. Use the “Pay My Provider” feature on the HealthEquity website to send an online payment to your medical provider. 2. Use the HealthEquity-issued debit card to pay for eligible expenses at the point of purchase. 3. Pay for your expenses with other funds and reimburse yourself with the HSA dollars. Qualified health care expenses may be incurred by you, your spouse or any of your eligible dependents and include: • Deductibles • Copays and coinsurance • Over-the-counter drugs (with a prescription) • Glasses and contact lenses • Laser eye surgery • Dental and orthodontic expenses (excluding cosmetic procedures)
2022 Maximums (based on a 12-month period)
Health Care FSA
Basics
The Health Care FSA allows you to contribute a minimum of $250 up to $2,000 annually to the Health Care FSA to cover health-related expenses that qualify as a medical deduction for federal income tax purposes, as described in IRS Publication 502. Healthcare expenses reimbursed through the account cannot be claimed as a deduction for federal income tax purposes. At the end of the Plan Year, you have the option to carry over up to $500 of your unused Health Care FSA funds into the next plan year. Any unused amount above $500 will be lost. Note: If you are enrolling in the Yellow Plan and elect an HSA, you are not eligible for a traditional Health Care FSA. However, you may participate in a Limited Purpose FSA used for non-covered dental and vision expenses. You may also enroll in the Dependent Care FSA.
Comparing the Medical Flexible Spending Account (FSA) and the Health Savings Account (HSA)
Dependent Care FSA
The FSA allows you to contribute pre-tax dollars (through payroll deductions) to cover expenses not covered by insurance. The more you elect, the more your taxable income is reduced – which means more take-home pay! During enrollment, you decide how much, if any, you want to deposit in one or both accounts for the year. Money is deducted from your paycheck each pay period. As you incur expenses throughout the Plan Year, you pay yourself back with the money in your account. If you are a new hire, there will be a one-year waiting period before you are eligible to participate in the Health Care FSA. Once you are eligible, you are only allowed to enroll during the Open Enrollment Period. Mid-year enrollments are not allowed. IMPORTANT: Keep your receipts! It is your responsibility to keep all receipts for items reimbursed by an FSA and to be able to provide those if you are audited.
1. Enroll in FSA and fund your account through payroll contributions. You must select your goal amount for the year and re-enroll every Open Enrollment. Your per pay contribution will depend on your goal amount and is subject to maximums. You cannot make changes to your FSA election throughout the year unless you experience a qualifying event. For more information regarding qualifying events, please refer to Benefit Details. 2. Use it or Lose it! Plan for your goal amount carefully as these are use it or lose it plans! Expenses submitted for reimbursement must be incurred prior to the end of the plan year or prior to your last day. 3. Accessing Funds – Employees enrolled in the medical FSA will receive an FSA Debit Card. Dependent care claims and medical claims can also be submitted for reimbursement by uploading to Flores’s secure website at www.flores247.com, through their smartphone app, mail or fax. (See more information on Caspernet by navigating to the HR, benefits section.) 4. Account Management – Register for your online account to submit claims, view balances and more at www.flores247.com.
Depen
The Dependent Care FSA allow you to set aside pre-tax dollars to provide for your dependents. Eligible expenses include payment for assistance that allows you to work or look for work such as adult or child daycare, before or after school programs for child(ren), elder care, and at-home care that is not provided by a tax dependent. Eligible dependents include anyone under age 13, your disabled spouse or other disabled persons (a child of any age or a parent) whom you claim as dependents for Federal Income Tax purposes. You may contribute a minimum of $250 up to a maximum of $5,000 per year. Funds remaining in your account at the end of the Plan Year or at termination of employment will be forfeited.
Flexible Spending Account (FSA)
Single: $2,750 Family: 5,500
Maximum Annual Contribution
Single: $3,550 Family: $7,100
Who can enroll?
Employees enrolled in the Medical PPO Plan
Employees enrolled in the CDHP 1 or CDHP 2 Plan
Funds for the year are available October 1
Funds are available as you contribute them
When are funds available?
Yes
Are contributions made before taxes?
You can file for reimbursement through www.flores247.com
Use your HSA debit card or file for reimbursement through your account at www.CareFirst.com /myaccount
How do I access funds?
No
Yes, you can invest any amounts over $1,000
Can I invest any funds?
You forfeit any unused funds
Any unused funds roll over to the next plan year
You take your funds with you
What happens at the end of the plan year?
May I enroll in both accounts?
What happens if I leave Billy Casper Golf?
FSA HSA
Basic Life Summary (PT)
Basic Life Summary (FT)
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 and AD&D Insurance
Basic Life Insurance
Accelerated Death Benefit
The Company-provided Basic Life Insurance plan provides you the option to withdraw a portion of your life insurance coverage during your lifetime if you are diagnosed as terminally ill. Your life insurance death benefit is reduced by any accelerated death benefit amount you withdraw. To apply for an accelerated death benefit you must provide a written request, proof of your terminal condition (including a Physician’s statement), and a statement of consent from any beneficiary. Beneficiary authorization dictates the amount you may withdraw.
If you are classified as Regular Full-Time, you have access to Company-provided Basic Life Insurance, provided through Mutual of Omaha, that pays a benefit to your designated beneficiary if you die. You also have the option to withdraw a portion of your coverage if you are diagnosed as terminally ill.
REMEMBER TO ASSIGN YOUR BENEFICIARY!
Travel Assistance
The Company-provided Basic Life Insurance plan provides you access to the Travel Assistance Program. This program provides you access to services while traveling abroad or more than 100 miles from home 24 hours a day, seven days a week. Examples of services include (but are not limited to): • Help with locating medical providers • Emergency medical evacuation • Prescription replacement assistance • Assistance with the return of a vehicle • Passport replacement assistance
Age Reduction Schedule
Company-Provided Life Insurance Benefits decrease with age. Coverage amounts will reduce according to the following schedule: Age: Insurance Amount Reduces to: 65 65% of original amount 70 45% of original amount 75 30% of original amount 80 20% of original amount 85 15% of original amount
Voluntary Life and AD&D
Defining Evidence of Insurability (EOI)
Evidence of Insurability (EOI) is documented proof of good health that must be provided to receive certain amounts of insurance or increase insurance amounts after your initial enrollment. EOI requirements may include proof through medical examination or answering of health-related questions.
You may purchase voluntary life insurance for yourself, your spouse, and/or your dependent children. This benefit is offered through Mutual of Omaha and is 100% paid by you.
Delays in Insurance
• Voluntary Employee Life Insurance will be delayed if you are not actively employed because of injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise be effective. • Voluntary Spousal Life Insurance will be delayed if your spouse is totally disabled on the date the insurance would otherwise be effective. Totally disabled means that as a result of injury, sickness or a disorder, your spouse is confined in a hospital or similar institution; is unable to perform two or more activities of daily living (ADLs) because of a physical or mental incapacity resulting from an injury or a sickness; is cognitively impaired; or has a life threatening condition. • Infant coverage is not subject to delays.
Voluntary Life Insurance Benefits decrease with age. Coverage amounts will reduce according to the following schedule: Age: Insurance Amount Reduces to: 65 65% of original amount 70 45% of original amount 75 30% of original amount 80 20% of original amount 85 15% of original amount Benefits will be reimbursed according to the age restriction schedule. Any payroll deductions in excess will be credited back. NOTE: Enrollment in the Voluntary Life plans does not guarantee payment. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage please refer to the Mutual of Omaha policy located on the Benefits Website under the Resource Center tab in the Document Library.
Note: Some provisions may apply. You must be actively at work to qualify for the Voluntary Life Benefit.
Disability Benefits
Click here to watch a short video about this benefit
Disability coverage helps protect a valuable asset: your income. These benefits replace a portion of your income in the event you are unable to work due to illness or accidental injury—providing more financial security to you and your family during a challenging time—and are provided through Mutual of Omaha.
All benefit-eligible employees are automatically covered for long-term disability at no cost. It provides income replacement for employees who are disabled and no longer able to work their normally scheduled hours. Our long-term disability program is administered by Unum.
Long-Term Disability Insurance
To file a claim, contact Mutual of Omaha at 833-743-8185.
All active benefits-eligible employees working a minimum of 39 hours per week, 10 months a year
Who is eligible?
60% of monthly earning to a maximum benefit of $10,000 per month
Benefit amount
You will begin to receive payments when your claim is approved, providing the elimination period of 90 days has been met and you are disabled.
When are you eligible to receive benefits?
Age at Disability Maximum Period of Payment Less than age 60: To age 65, but not less than 5 years Age 60: 60 months Age 61: 48 months Age 62: 42 months Age 63: 36 months Age 64: 30 months Age 65: 24 months Age 66: 21 months Age 67: 18 months Age 68: 15 months Age 69 and over: 12 months
Benefit duration
Short-Term Disability: Helps replace a portion of your lost income during the early part of a disability. Long-Term Disability: Helps replace a portion of your lost income for an extended period of time due to accident or illness.
If you apply for these benefits during your initial enrollment period or during Open Enrollment, you may receive coverage without answering any medical questions or providing Evidence of Insurability (EOI). Here is a summary of these coverages:
Note: Waiting periods and duration may vary depending on the division you work for and your position. You will be provided additional information about this benefit should the change impact you. If you are not in active employment because of injury, sickness, temporary layoff, or leave of absence on the date that coverage would have otherwise become effective, insurance will be delayed.
The 401(k) Plan
Partnering with you for a better tomorrow!
Offered through Fidelity Investments, the 401(k) Plan provides you with the opportunity to contribute pre-tax dollars to saving for retirement after you are continuously employed with Signature HealthCARE for 90 days.
Because we know the importance of planning for the future and remain committed to supporting your ability to save, Signature HealthCARE automatically enrolls New Hires for a 4% pre-tax contribution each pay period. Each year, this automatic pre-tax deduction is increased by 1% to a maximum of 10% for all stakeholders. Although it is important to save for retirement, you do have the option to change your contribution or opt out of the program at any time by calling Fidelity directly at 800-294-4015.
Automatic Enrollment
The 401(k) plan year is based on a calendar year (January – December). Once you have completed five years with Signature HealthCARE (the “vesting schedule”), you are eligible to receive a discretionary company match of up to 20% per year if you remain actively employed through the last day of the calendar year. The vesting schedule is based on your hire date. Signature HealthCARE makes an annual determination on the discretionary contribution.
Vesting Schedule
You have two contribution options from which to choose: • Traditional 401(k): You contribute on a pre-tax basis and are taxed on your entire distribution when you withdraw funds. • Roth 401(k): You contribute on an after-tax basis and pay no taxes* on qualified distributions when you withdraw funds. *You may incur taxes if the withdrawal is taken less than five tax years after the year of the first Roth 401(k) contribution and if taken before you reach age 59½. A qualified distribution is one made at least five years after the tax year you make a designated Roth contribution to the plan AND one made either to you after you turn 59½, to a beneficiary (or your estate) after you die, or to you if you are disabled.
Contribution Options
Supplemental Plans
Supplemental Plans, provided through Chubb, provide added protection if you are hurt in an accident, have an unexpected hospital stay, are diagnosed with a critical illness, die or need assisted care while living. Below are your supplemental care options. Your Benefits Educator can explain the benefit of these options during your appointment. If you have changes (including cancellation of policies) you would like to make to your supplemental plans after enrollment, contact Customer Service at the numbers below: • Hospital Indemnity (Administered by Administrative Concepts, Inc. (ACI)): 800-964-7096 • Accident and Critical Illness (Administered by Chubb): 866-445-8874 • Permanent Life Insurance w/Long-Term Care (Administered by Selman Company for Chubb): 855-241-9891
Hospital Indemnity
Permanent Life with Long-Term Care
Accident
Critical Illness
Accident Insurance
You do everything you can to stay active and healthy, but accidents happen every day, including sports-related accidents. An injury that hurts an arm or leg can hurt your finances too. Accident Insurance pays cash benefits directly to you or anyone you choose, regardless of any other coverage you have, if you are accidentally injured and need treatment outside of work. Here’s how it works: • Designed to cover gaps in your health plan for out-of-pocket expenses like deductibles, copays, and coinsurance. Whether you go to a physician’s office, urgent care center, or the emergency room, there are no restrictions on how the money can be used. • Pays you $100 upfront when you file your first accident claim with Chubb. • Benefits are paid directly to you, regardless of any insurance you may have with other companies. • There are no exclusions for pre-existing conditions, and no answers to medical questions are required to enroll.
Critical Illness Insurance
Critical illnesses don’t give you time to prepare. Heart attacks, cancer and strokes happen every day, and often unexpectedly. They can take a serious toll on both your physical and financial well-being. When a critical illness happens, your health insurance plan may cover some of your medical and hospital costs, but not everything. Critical Illness Insurance pays a lump sum cash benefit upon diagnosis of a covered condition, in addition to what health insurance may pay, for expenses such as: • Out-of-Pocket Medical Costs – deductibles, copays, coinsurance, prescriptions, and medical travel • Everyday Costs – rent or mortgage payments, credit card debt, car payments, household necessities, and savings for college & retirement • Recovery Costs – loss of income, rehabilitation, and childcare or parent care Note: A monthly benefit is payable while undergoing Cancer treatment. Standard conditions covered by this benefit include (but are not limited to): Alzheimer’s, Cancer, Coma, Coronary Artery Obstruction, End Stage Renal Failure, Heart Attack, Multiple Sclerosis, Parkinson’s, and Stroke.
Hospital Indemnity Insurance
No one plans for hospital stays, but just in case, Hospital Indemnity Insurance has you covered. This benefit provides assistance with out-of-pocket costs (such as deductibles, copays, coinsurance, and prescriptions) associated with hospital admission and confinement and everyday living expenses (such as mortgage or rent, car payments, student loans, and credit card debt) that further complicate the stress of accumulating hospital bills. Here’s a quick summary: • Enrolling for this benefit is easy – there are no health questions asked, health exams required, or limitations for pre-existing conditions (except pregnancy and childbirth if conception occurred before effective date). • If you have an out-of-pocket expense resulting from a hospitalization, this benefit provides financial support. • Your benefit is paid regardless of any other medical coverage. • You can choose to extend coverage to cover your spouse and children.
Permanent Life Insurance with Long-Term Care
You work hard to provide a good life for your family. However, what if something happened to you? Would your family be able to continue covering expenses you may have today like mortgage payments, childcare, credit card payments, college tuition, and other household expenses? What about burial expenses or expenses for long-term care like nursing home or assisted living care? Permanent Life Insurance with Long-Term Care helps protect you and your family if you were no longer able to provide for them. When you purchase coverage, no medical questions or exams will be required. Your family can receive cash benefits paid directly to them upon your death, or you can receive that cash benefit, while you are living, for long-term care expenses. Here’s how it works: • You lead a full life and do not need Long Term Care: Your beneficiary receives a death benefit at the time of your death. • You lead a full life and need assisted living or nursing home care: You receive long-term care funds to cover those expenses. • You lead a full life but also need some long-term care funds: You will receive 4% of your death benefit per month – while you are living – for up to 25 months. At your death, your beneficiary will receive the remainder of your benefit. An additional option to purchase Permanent Life Insurance coverage for your children is also available.
ADDITIONAL BENEFITS & SERVICES
Will Preparation Services – Company-Provided
Pet Insurance
MetLife Auto and Home
Travel Services – Company-Provided
Start saving today with special auto and home discounts and features. Signature HealthCARE has negotiated discounted home and auto rates of up to 15% for our stakeholders. If you have a stellar driving record, decide to pay premiums through automatic payment, have been with Signature HealthCARE for a long time, insure more than one vehicle, or insure both home and auto, you can save even more!
Call MetLife Auto and Home today for your free quotes! Call 800-GET-MET8 (800-438-6388) and mention the Signature HealthCARE Group Discount Code: BB5.
Pets are part of our family. It’s important to keep them safe and healthy. Pet Insurance, offered by MetLife, helps you pay for unexpected vet expenses that keep your furry family members healthy.
Creating a will is an important investment in your future. It specifies how you want your possessions to be distributed after you die. Whether you are single, married, have children or are a grandparent, your will should be tailored for your life situation. Signature HealthCARE provides you free online will preparation services provided through Epoq, Inc. (Epoq). This service provides you a secure account space that allows you to prepare documents such as: • Last Will and Testament • Power of Attorney • Healthcare Directive • Living Trust Here’s how it works: • Log on to www.willprepservices.com and use the code MUTUALWILLS to register. • Answer simple question, and your chosen document type will be customized for you. • Download and check your State for requirements to make the document legally binding. • Don’t forget to keep the document updated when you experience major life changes.
To get a quote or enroll, call 800- GET-MET8 (800-438-6388).
How does it work? • Select the coverage that’s best for your pet. • After your vet visit or procedure, pay the bill and send a claim plus your bill to MetLife. • MetLife will reimburse you by check or direct deposit.
What's Covered? Coverage includes (but is not limited to): • Accidental injuries • Illnesses • Exams, surgeries, and hospital stays • Ultrasounds, x-rays, and other diagnostics • Chronic, congenital, and hereditary conditions • Hip dysplasia • Alternative therapies
Travel Assistance provides you access to a network of professionals who can help you with local medical referrals or provide other emergency assistance services in foreign locations. This assistance is available to you, your spouse, and your dependent children on any single trip, up to 120 days in length, more than 100 miles from home. Prior to Your Trip Minimize travel hassles by contacting travel assistance prior to your trip to gain knowledge regarding required documentation and inoculation, health advisories, weather forecasts, currency exchange rates, and consulate and embassy locations. During Your Trip While you are on your trip, we can help with travel services (such as translation, legal issues, and documentation needs), medical assistance (such as location of providers, emergency evacuation, medical transportation arrangements, coordination), and identity theft. For more information on services available for business and personal travel, call: • 800-856-9947 (in the U.S.) • 312-935-3658 (outside the U.S.)
Inspire Foundation
The Signature Inspire Foundation is a 501(c)(3) non-profit organization that was created to empower and expand Signature HealthCARE’s community philanthropy, while continuing to grow and spread its roots from The Compassion Fund in providing needed assistance to our stakeholders and residents. The Foundation consists of 3 parts:
• The Compassion Fund, which brings awareness and financial support to our own stakeholders and/or their families in times of domestic or financial crisis, and unexpected natural disasters or pandemics like COVID-19. • The Dream Equation, which supports opportunities to enhance quality of life for elders such as vacations, outings, art exhibits, intergenerational programming and more • Education Assistance is a new arm that will offer scholarships to stakeholders and/or their dependents to cover tuition and related supplemental educational expenses. We believe that education gives people the means to grow and help become our future community leaders.
Click here to download the Inspired Influencer Form.
QUALIFIED STATUS CHANGE (QSC) SUMMARY SHEET
Contact Information
