2018-2019 Ed Voyles Automotive Groupedvoylesbenefits.com/.../05/2018_Ed_Voyles_FINAL.pdf · Ed...

Inside you will find information about our Group Health Benefits

2018-2019Ed Voyles

Automotive Group

E M P LOY E E B E N E F I T S S U M M A RY

W E LCO M E

2018

-201

9

Benefits Focus � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 1Benefit Costs � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 2HealthEZ: Benefit Administrator� � � � � � � � � � � � � � � � � � � � � 3Benefits Eligibility and Changes � � � � � � � � � � � � � � � � � � � � 4Tobacco Cessation� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 5Medical � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 6-13Dental � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 14

Vision � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 15Disability � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 16Life and AD&D and EAP � � � � � � � � � � � � � � � � � � � � � � � � � � � � 17Accident and Critical Illness � � � � � � � � � � � � � � � � � � � � � � � � 18Annual Notices � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 19-21Important Contacts and Information � � � � � � �Back Cover

Contents

This booklet provides a summary of plan highlights. Please consult the carrier’s contract for complete information on covered charges, limitations, and exclusions. This is not a binding contract. The carrier’s contract will prevail. If you have further questions please contact the carrier or Relation Insurance Services.

Dear Ed Voyles Automotive Group (EVAG) Employees:

It is once again time for the annual renewal for our Benefits Program. In an ongoing effort to provide

high-quality and cost-effective benefit programs, we annually review all of our benefit plans. As a

member of our team, it is important to us that you have access to a choice in medical plan selection so

you can balance your own financial wellbeing with your healthcare needs.

I am pleased to announce some exciting changes to our medical benefits for 2018-2019!

Our medical network will be moving to Cigna. There will be no major benefit changes to the medical

plans, but starting in May, HealthEZ will be the medical benefits administrator for Ed Voyles! HealthEZ

will be your point of contact for medical claims and benefit questions. In addition, MagellanRx will work

with Ed Voyles to administer the prescription benefit portion of your health plan.

When reviewing your medical options, we encourage you to take a look at the High Deductible Health

Plan with the Health Savings Account (HSA). Like we implemented last year, all employees and their

dependents enrolled in the HDHP will gain coverage to an Accident policy and a Critical Illness policy

100% paid for by Ed Voyles. The Accident and Critical Illness policies will be moving to Cigna. These

policies can help with unexpected health costs you may incur through the year. The HDHP with HSA is

designed to give employees maximum control over costs while still providing access to large networks

and free preventive care. Additionally, the HDHP with HSA serves as a savings vehicle allowing you to

accumulate funds to be used for health needs in the future. We continue to offer traditional plans with

copays; however, the out-of-paycheck premium for those plans is more than your out-of-paycheck

premiums for the HDHP with HSA plan.

Our dental, vision, life and disability benefits will be moving to Cigna. This allows us to have all of our

benefits with one carrier. You will have the opportunity to carryover your current life and disability

elections to Cigna. Or you can sign up for the first time, but would be subject to underwriting approval.

At Ed Voyles we believe that by leading healthier lifestyles, our employees can live longer, happier and

more fulfilling lives. We are committed along with our carriers to provide you the tools you need to get

the most “mileage” out of your plans. We believe by giving you more control over how your healthcare

dollars are spent and by offering you incentives for taking smart steps toward a healthier lifestyle, you

can help us control healthcare costs. Not only will this allow for a longer, happier and healthier life, but

it will be a key component in allowing us to maintain benefits to protect you and your family.

Planning for a healthy 2018 – 2019!

____________________________

Bill Brantley

President / COO

2 0 1 8 - 2 0 1 9 | E M P L O Y E E B E N E F I T S S U M M A R Y 1

Relation Insurance is the advisory firm representing Ed Voyles.We have a team of account managers to help you resolve any problems you have with your employee benefits.

If you have a problem or a question about a claim:1. Call your insurance carrier’s customer service department.

Phone numbers can be found on your ID cards and on the back of this booklet.

2. If the carrier does not resolve your problem, contact Paige Foughty at 678.740.0229 or via e-mail at [email protected].

3. If you are still not satisfied after contacting your insurance company and Relation Insurance, please contact Janice Collins at [email protected] or 770.933.5864, or Kellie Jones at [email protected] or 770.933.5945.

Claims Questions or Problems

B E N E F I T S F O C U S

We evaluate our benefit programs each year and make changes and improvements that will help us to better manage our costs as well as help you to better manage your health.

New for 2018 - 2019Ed Voyles believes that healthy employees perform better in all aspects of their life. Health care costs are a shared responsibility of Ed Voyles and its employees. Providing you with incentives to stay healthy is a part of our commitment to promoting health and wellness among employees. To continue to encourage employees to adopt healthy habits, we provide a discount on medical insurance for employees who sign the “Say No to Tobacco” incentive form. Participating employees save by paying lower medical benefit premiums. Employees who don’t use tobacco products pay $55 less per month in medical premiums than employees who use tobacco. Employees who currently use tobacco can lower their premiums if they stop using tobacco.

Lower Costs for Healthy Living

Some key points to remember as you read this booklet:• We are moving our medical insurance to HealthEZ and will be

using Cigna’s network. We will continue to provide three plan options: an HMO, POS, and a HDHP with an HSA.

• All other lines of coverage will be moving to Cigna: Dental, Vision, Life, Voluntary Life, Disability, and Accident and Critical Illness policies.

• Our dental insurance will be moving to Cigna with no plan changes and a slight decrease in rates!

• Our vision insurance will be moving to Cigna with no plan or rate changes!

• Again, there are no changes to Voluntary Life benefits or rates, but you will notice a decrease in rates for Long Term Disability!

• Evidence of Insurability (EOI) will be required for Voluntary Life, Short-Term Disability (STD), and/or Long-Term Disability (LTD) if you are signing up for the first time and not a new hire.

• Accident and Critical Illness plans will be moving to Cigna.• We ask you to continue to help us better manage our medical

costs by leading a healthy lifestyle! Employees can impact the bottom line by:• Using the Emergency Room for true emergencies only• Taking advantage of generic prescriptions when available• Utilizing the preventive care benefits• Staying in-network whenever possible

B E N E F I T S CO S T

LO N G - T E R M D I S A B I L I T Y

Monthly Cost of Long-Term Disability if Your Salary Is... Monthly Years of Service Salary Less than 5 Years More than 5 Years$1,000 $4�35 $0�58$1,500 $6�53 $0�87$2,000 $8�70 $1�16$2,500 $10�88 $1�45$3,000 $13�06 $1�74Costs above are for illustrative purposes. To calculate your total monthly cost, multiply your monthly salary by 0.0058. Employees with less than 5 years of service will multiply the total cost by 0.75 and employees with 5 years of service or more will multiply the total cost by 0.10. Final deductions may vary slightly due to rounding.

MedicalHSAHMOPOS

Dental Vision

TO B ACCO F R E E M O N T H LY B E N E F I T CO S T SEMPLOYEE

ONLY

$123.74$195.98$442.02$30.47$5.47

EMPLOYEE + SPOUSE

$418.80$582.85

$1,076.04$63.86$9.58

EMPLOYEE + CHILD(REN)

$324.10$479.38$921.34$67.03$10.39

EMPLOYEE + FAMILY

$697.40$963.57

$1,688.76$96.52$16.14

MedicalHSAHMOPOS

Dental Vision

TO B ACCO U S E R S M O N T H LY B E N E F I T CO S T SEMPLOYEE

ONLY

$178.74$250.98$497.02$30.47$5.47

EMPLOYEE + SPOUSE

$473.80$637.85

$1,131.04$63.86$9.58

EMPLOYEE + CHILD(REN)

$379.10$534.38$976.34$67.03$10.39

EMPLOYEE + FAMILY

$752.40$1,018.57$1,743.76

$96.52$16.14

S U P P L E M E N TA L L I F E I N S U R A N C E

Monthly Cost of Supplemental Life Insurance per $1,000of Benefit - Employee and Spouse

Age Under 30 $�08 30-34 $�09 35-39 $�13 40-44 $�19 45-49 $�2750-54 $�39

Age 55-59 $�79 60-64 $1�03 65-69 $1�59 70-74 $2�79 75+ $5�70

Monthly Cost of Supplemental Life Insurance - Child(ren) $�16 per $1,000 of coverage

S H O R T - T E R M D I S A B I L I T Y

Monthly Cost of Short-Term Disability per $10 of Weekly Benefit

Age <25 25-34 35-39 40-44 45-49 50-54 55-59 60+ $�467 $�427 $�419 $�435 $�524 $�629 $�878 $1�04To calculate your monthly cost, multiply your weekly salary by .60 and divide that amount by 10. Multiply that amount by the cost figure under your age range. For example, a 30 year old employee making $450 per week, would use the following formula: $450 x .6 /10 x .427 = $11.53 per month.

2 E M P L O Y E E B E N E F I T S S U M M A R Y | 2 0 1 8 - 2 0 1 9

H E A LT H E Z : B E N E F I T S A D M I N I S T R ATO R


HeathEZ: Medical Benefits Administrator

HealthEZ is your new benefits administrator. We help companies all over the US provide custom, personalized benefits, and we’re here to make your life easier! We are a family-owned business serving families like yours for over 35 years. Your employer selected HealthEZ because we are truly a different kind of health care company. We understand health insurance can be very complicated, and it’s our goal to help you navigate the health care maze. We start by answering our phones with human beings – if you’re sick or just have a simple question about your medical benefits, we are here to listen and to help you. You have one dedicated phone number to call no matter what you need. We provide you with a simple online statement once a month if we have processed any claims making it easy for you to understand what your doctor billed, what your insurance paid, and what you owe. You can even pay your part of the bill online!

Welcome!

Your Personal Benefits WebsiteOnce you receive your ID card, you’ll be able to set up your online account to view all your information related to your benefits, including your statements, account balances, recently processed claims, and access your EZpay accounts.

Benefit information, your plan overview, forms and education, access to customer service is also available on the custom website - everything you need, all in one place.

Personalized Customer ServiceEd Voyles has a dedicated phone number 888.701.2994 that is answered by humans beings between the hours of 9am and 8pm Monday through Friday Eastern Time. No phone trees! After business hours, you simply press “3” to reach our 24/7 nurseline.

www.EdVoylesBenefits.com1.888.701.2994

Your primary medical network is CignaGet maximum coverage with the smallest bill possible by ensuring the provider you select is part of your provider network(s). To find a doctor, visit www.EdVoylesBenefits.com.

Your pharmacy benefit manager is Magellan RxThe same prescription rarely costs the same price. Be a savvy customer and compare prices for your prescriptions at different pharmacies to get the best price.

• Ask your doctor to start you on the lowest cost alternative• Check out the “$4 Prescriptions” at places like Walmart• Price Shop your prescriptions at Sam’s Club and Costco; you

don’t have to be a member to access their pharmacy!

Go to www.EdVoylesBenefits.com for more information on prescriptions that will save you money!

The EZ Way to Pay Your Medical BillsPay your medical bills the easy and accurate way.• Safe• Secure• Easy

Spouses and dependent children of the employee are also eligible to participate in our benefit plans. Dependent children include natural children, legally adopted children, stepchildren, and children for whom the employee has been appointed guardian.

You can enroll the following dependents in our group benefits plan:■ Your legal spouse■ Children under age 26■ Unmarried children of any age, if totally disabled and claimed as a dependent on your federal income tax return (documentation of handicapped status must be provided)

Benefits Eligibility

Dependents NOT eligible in benefit plans: ■ Grandchildren, nieces, nephews or other children that do not meet specifications listed to the left■ Common law spouses or domestic partners (same or opposite sex)■ Ex-spouses, unless required via court order (documentation required)■ Parents, step-parents, grandparents, aunts, uncles, or other relatives that are not qualified legal dependents (even if they live in your house)

Many employees have other dependents living with them who are not eligible for our benefit plan.

B E N E F I T S E L I G I B I L I T Y A N D C H A N G E S

Ed Voyles provides a comprehensive employee benefits program to all full-time employees working 30 hours or more per week. Employees are eligible for coverage on the first day of the month following 60 days of full-time employment.

Most benefit deductions are withheld from your paycheck on a pre-tax basis (medical, dental, vision, disability, and flexible spending accounts), and therefore your ability to make changes to these benefits is restricted by the IRS. Once enrolled, most pre-tax benefit elections cannot be changed until the next annual Open Enrollment period, unless you have a qualifying life status change.

Making Changes to Your Benefits

Open Enrollment generally occurs in March with plan changes effective each plan year from May 1

through April 30 of the following year.

To make benefit changes as a result of your life status change as allowed under Section 125 of the IRS Code, you must:■ Notify Human Resources within 30 days of the date

of the qualifying event,■ Provide proof of your life status event, and ■ Complete and submit your enrollment form.

The Most Common Life Status Changes■ Marriage, divorce, or legal separation■ Birth or adoption■ Change in your or your spouse’s work status that

affects your benefits or an eligible dependent’s benefits

■ Change in health coverage due to your spouse’s annual Open Enrollment period

■ Change in eligibility for you or a dependent for Medicaid or Medicare

■ Receipt of a Qualified Medical Child Support Order, or other court order



TO B ACCO C E S S AT I O N

A tobacco user spends on average $2,500 a year on tobacco alone, and incurs higher health care costs over their lifetime. Living a tobacco-free lifestyle can help save you thousands of dollars, and improve your energy level and your quality of life.

The cost of cessation programs and products are eligible for reimbursement through Ed Voyles’s Flexible Spending Account Program, which can reduce the overall cost of programs and products by allowing you to pay using pre-tax money.

Tobacco Cessation treatment options include hypnosis, prescription alternatives, the Smart Shot, acupuncture, and over-the-counter remedies such as patches and gums including nicotine products or natural formulas. Studies show that treatment programs through a facility or physician coupled with therapy and social support are more effective for long-term success than other alternatives.

Ready to End Your Tobacco Addiction?

Resource List• • • • •

Georgia Tobacco Quitline1.877.270.STOP

• • • • •American Cancer Society

1�800�ACS�2345www.cancer.org

• • • • •American Lung Association

1�800�LUNGUSAwww.quitterinyou.org

• • • • •CDC-Tobacco Information

and Prevention Source (TIPS)www�cdc�gov/tobacco

1.800.QUIT-NOW• • • • •

Kill the Canwww.killthecan.org

• • • • •SmokeFree�Gov

www�smokefree�gov1.877.44U.QUIT

• • • • •

Within 20 minutes:n Your blood pressure and pulse rate drop to normal.

Within 24 hours:n Your risk of a sudden heart attack goes down.

Within 2 weeks to 3 months:n Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly.

Within 1 to 9 months:n You have more energy. Your coughing, nasal congestion, fatigue, and shortness of breath improve.

Within 1 year:n Your risk of coronary heart disease is half that of someone still using tobacco.

Within 5 years:n Your chances of developing lung cancer drop by nearly 50% compared to people who smoke one pack a day. Your risk of mouth cancer is half that of a tobacco user.

Within 10 years:n Your risks of cancer goes down. Your risk of stroke and lung cancer are now similar to that of someone who never smoked.

Finding the Right Tobacco Cessation ProgramThe program that works best for you may be very different from the program that works best for someone else. Talk to your primary care physician, one of your best resources for finding cessation programs designed to meet your total health needs. Your physician can discuss over-the-counter and prescription medications, and provide a reference as well.

Studies show that tobacco cessation treatment programs through a facility or physician that also include therapy and social support are more effective for long-term success than other alternatives.


Medical BenefitsEd Voyles provides employees with three medical benefit choices through Cigna.The rising cost of health care is making it harder for some people to find affordable medical benefits. Our goal is to offer affordable benefit options that ensure you have access to high-quality services. You can choose from our High Deductible Health Plan (HDHP) paired with a Health Savings Account (HSA), our Health Maintenance Organization (HMO) plan, or our Point-of-Service (POS) plan.

You will notice some similarities between all of our plans. Preventive care visits (including certain screenings and immunizations) are covered at 100%, so there is no charge to you when you visit an in-network provider. Part of leading a healthy lifestyle means taking care of yourself, so be sure to follow the recommended guidelines on health screenings and have them done at appropriate intervals. All of our plans are also Open Access, meaning you do not need a referral to see a specialist.

ANNUAL HSA CONTRIBUTION• Employee $600• Employee + Spouse $900• Employee + Child(ren) $900• Family $1200

■ What is a HDHP? A High-Deductible Health Plan (HDHP) is a health plan that has a lower monthly cost and pays no benefit until a higher annual deductible is met. Once the annual deductible is met, health expenses are paid at 90% and the prescriptions are covered at a copay. You may see the term HDHP associated with your HSA account.

■ What is the HSA and how does it work? Employees enrolled in a qualified HDHP are eligible to establish an HSA bank account through Payflex that can be used for out-of-pocket health expenses. You will receive a debit card to pay for all eligible expenses, or you can reimburse yourself if you pay out of pocket. Depending on your coverage level, Ed Voyles will contribute annually, $600 (employee only), $900 (employee + spouse and employee + child(ren)), or $1200 (family coverage). You may also make pre-tax contributions via payroll deduction or one-time contributions. The money accumulated in this special account can be used to pay any out-of-pocket expenses incurred prior to the annual deductible being met or other eligible health, vision, or dental expenses.

■ How are medical expenses paid prior to my annual deductible being met? Expenses incurred are paid by the employee until the annual deductible is met. You may use funds in your HSA or pay them as out-of-pocket expenses.

■ What expenses are counted towards my deductible? Only medical expenses covered by your medical plan apply towards your deductible. HSA funds used for qualified health expenses not covered under your medical plan (for example, orthodontia) will not count towards your health plan deductible.

■ Who verifies that my HSA was used for qualified expenses? Save your receipts – in the event of an IRS audit, you are responsible for providing documentation to the IRS.

■ Do doctors require payment at the time of service? Most network physicians will bill Cigna first and then bill you for your adjusted costs.

■ What happens to my HSA if I never withdraw funds, change jobs, or retire? Funds in your HSA are yours, even if you change employers or retire. The less that you spend on current medical expenses, the more money stays in your account accumulating interest. Under IRS guidelines, HSAs are treated like IRAs. HSA funds are never taxed or penalized if they are used for qualified medical expenses. Funds can be withdrawn for any reason, without penalty once you reach age 65.

■ Can I have an HSA and an FSA? No, you cannot have an HSA and Health FSA; however, you can have an FSA for dependent care.

■ What if I already have a health savings account with another bank? If you already have a health savings account open with another bank, you can keep it open and have two separate health savings accounts, or you can transfer your money over to the new health savings account with Payflex via a trustee to trustee transfer form. In order to receive Ed Voyles contribution, you must open a health savings account with Payflex.

■ What will I receive once I have made my election? After Payflex receives your HSA election from Cigna, they will verify your name, SSN, date of birth, and address in compliance with the USA Patriot Act before opening your HSA. If anything does not match, they will reach out to you directly for additional documentation to verify your identity. Once you have verified and the account is opened, you will receive your welcome letter with your debit card to your home address within 7-10 days.

■ How do I make deposits to my account? Deposits to your HSA can be made through pre-tax payroll deductions or as an initial lump sum deposit at enrollment. Unlike an FSA, you can change your payroll deductions for the HSA during the year. You can also make post-tax contributions and deduct them from your income when you file your taxes. For the 2018 calendar year, combined employee/employer contributions cannot exceed $3,450 for individuals or $6,900 for families. Anyone over age 55 can add an additional $1,000 for catch-up contributions.

Frequently Asked Questions About HDHP w/ HSAs

M E D I C A L

HDHP w/ HSA PlanThe HDHP Plan is a great plan if you want your monthly paycheck deductions to be as low as possible and you want access to both in-network and out-of-network health care providers. In addition, participants in this plan receive a contribution to an HSA to help meet their plan deductible or other eligible health care costs. Funds in your HSA can be used towards eligible medical expenses, as well as certain vision or dental expenses, or saved for future health expenses or for retirement. Ed Voyles will continue to provide a Critical Illness Policy and an Accident Policy for HSA enrollees and their covered dependents at NO COST to the employee. These policies will help offset some of the unexpected costs related to a covered critical illness and/or covered accident. Further details on these two policies can be found in this booklet.

Ed Voyles Automotive Contributes to Employee HSAsWe make prorated contributions to employees’ HSAs each pay period to help pay for qualified health expenses. Annual contributions total:

Reimbursements can be submitted to:Mail: HealthEZ | Attn: Claims | 7201 W 78th Street

Bloomington, MN 55439Email: [email protected]

Fax: 952.896.0372


M E D I C A L

Health Reimbursement ArrangementsThe HRA Plan will pay for a portion of in-network deductible expenses incurred by you or a covered dependent. After you pay the first portion of your deductible, Ed Voyles will directly pay the remaining through the HRA.

Sample Eligible Expenses■ Hospital Inpatient Services: room and board, hospital services and

supplies (x-ray, lab, anesthesia, etc.), physician services (surgeon, anesthesiologist, radiologist, pathologist, etc.)

■ Inpatient Mental Health Care■ Inpatient Substance Abuse Treatment■ Intermediate Level Mental Health Care■ Intensive Outpatient Treatment■ Inpatient Substance Abuse Detoxification

■ Outpatient Hospital: outpatient facility (lab, x-ray, anesthesia etc.), outpatient physician services (surgeon, radiologist, anesthesiologist, pathologist, etc.)

■ Chemotherapy ■ Radiation Therapy ■ Respiratory Therapy■ Durable Medical Equipment■ Skilled Nursing Facility

Flexible Spending AccountsA Flexible Spending Account (FSA) allows employees to use pre-tax money for qualified expenses. HealthEZ is administering the FSAs. The annual FSA maximum is $2,650. The annual DCA maximum is $5,000. The rising cost of health and dependent care (or day care) is encouraging more employees to take advantage of FSAs. You can save anywhere from 10–30% by using pre-tax money in an FSA to pay for health or dependent care expenses incurred during the plan year. Determine how much you anticipate spending on qualified expenses throughout the year and fund your FSA for that amount through pre-tax payroll deductions. You can then use those funds to pay for eligible expenses using a debit card at the time of service, or by submitting a receipt after-the-fact.

Health FSA Eligible Expenses■ Medical plan copays and deductible■ Dental and orthodontia expenses■ Vision care expenses including lasik, glasses, and contact lenses■ Over-the-counter drugs prescribed by your physician■ Tobacco cessation programs■ Infertility treatment■ Psychology and psychoanalysis medical expenses■ Massage therapy when deemed medically necessary■ Weight-loss programs when deemed medically necessary■ Services not covered under your health plan as long as

medically necessary■ Medically necessary cosmetic surgery

Dependent Care FSA Expenses:

Dependent Care Ineligible Expenses:

Important Rules Regarding FSAs■ Accounts are separate and you cannot comingle funds.■ Accounts are subject to the USE IT OR LOSE IT provision: unused balances do not carry over after the 2 1/2 month grace period and cannot be refunded.

■ Care at licensed nursery school or day care facility

■ Before and after school care for children 12 and under

■ Day Camps■ Nannies and Au Pairs

■ Services provided by a family member

■ Overnight camp expenses■ Late payment fees

■ Tuition expenses for school■ Baby-sitting expenses for

time when you are not working or at school

ANNUAL HRA CONTRIBUTION

• Employee $1750

• Employee + Spouse; Employee + Child $3500

• Employee + Child(ren); Family $5250

Reimbursements can be submitted to:Mail: HealthEZ | Attn: Claims | 7201 W 78th Street

Bloomington, MN 55439Email: [email protected]

Fax: 952.896.0372


M E D I C A L

Meet ChrisChris is a single employee who doesn’t use tobacco� The examples on this page show how his out-of-pocket expenses change based on his plan choice and his health�

In the best case scenario, Chris has his annual wellness exam and which is the only time he sees a doctor� In the worst case scenario, Chris has 4 visits with his primary care doctor, 4 visits with a specialist and is hospitalized for 3 days�

HMO vs. HDHP – Making the Right Choice

Predicting your future medical expenses is next to impossible. The following scenarios are designed to help you better understand how each plan works. You may find it is also helpful to take your previous year’s medical expenses and figure out how much you would spend this year under each plan.

HMO vs. HDHP — Best Case Scenario: Single Employee

HDHP Annual ExpensesPremiums Paid: $1,485 ($123�74x12)Medical Expenses• Annual Physical Free• No Sick Visits (0x$100) $0• No Specialist Visits (0x$250) $0• No Hospitalization* $0 Total Expenses $1,485 Ed Voyles HSA Contribution ($600)Total Out-of-Pocket Expenses $885

HMO Annual ExpensesPremiums Paid: $2,352 ($195�98x12)Medical Expenses• Annual Physical Free• No Sick Visits (0x$40) $0• No Specialist Visits (0x$50) $0• No Hospitalization* $0 Total Out-of-Pocket Expenses $2,352

Chris saves $1,467 for the year by participating in the HDHP Plan.

HMO vs. HDHP — Worst Case Scenario: Single Employee

HDHP Annual ExpensesPremiums Paid: $1,485 ($123�74x12)Medical Expenses• Annual Physical Free• Sick Visits (4x$100) $400• Specialist Visits (4x$250) $1,000• Hospitalization* $2,100 coinsurance $290Total Expenses $5,275Ed Voyles HSA Contribution ($600)Total Out-of-Pocket Expenses $4,675

HMO Annual ExpensesPremiums Paid: $2,352 ($195�98x12)Medical Expenses• Annual Physical Free• Sick Visits (4x$40) $160• Specialist Visits (4x$50) $200• Hospitalization* $3,500 coinsurance $300Total Expenses $6,512Ed Voyles HRA ($1,750)Total Out-of-Pocket Expenses $4,762

Chris saves $87 for the year by participating in the HDHP Plan.

* Hospitalization estimated at $5,000� Prices will vary by provider and service� **All rate examples for the HDHP are averages and assume in-network pricing discounts�


M E D I C A L

HMO vs. HSA — Best Case Scenario: Family

HDHP Annual ExpensesPremiums Paid: $8,369 ($697�40x12)Medical Expenses• Annual Physical Free• No Sick Visits (0x$100) $0• No Specialist Visits (0x$250) $0• No Hospitalization* $0 Total Expenses $8,369 Ed Voyles HSA Contribution ($1,200)Total Out-of-Pocket Expenses $7,169

HMO Annual ExpensesPremiums Paid: $11,563 ($963�57x12)Medical Expenses• Annual Physical Free• No Sick Visits (0x$40) $0• No Specialist Visits (0x$50) $0• No Hospitalization* $0 Total Out-of-Pocket Expenses $11,563

Sonia saves $4,394 for the year by participating in the HDHP Plan.

HMO vs. HSA — Worst Case Scenario: Family

HDHP Annual ExpensesPremiums Paid: $8,369 ($697�40x12)Medical Expenses• Annual Physical Free• Sick Visits (8x$100) $800• Specialist Visits (8x$250) $2,000• Hospitalization* $4,200 coinsurance $580Total Expenses $15,949Ed Voyles HSA Contribution ($1,200)Total Out-of-Pocket Expenses $14,749

HMO Annual ExpensesPremiums Paid: $11,563 ($963�57x12)Medical Expenses• Annual Physical Free• Sick Visits (8x$40) $320• Specialist Visits (8x$50) $400• Hospitalization* $7,000 coinsurance $600Total Expenses $19,883Ed Voyles HRA ($5,250)Total Out-of-Pocket Expenses $14,633

Sonia saves $116 for the year by participating in the HMO Plan.

Meet SoniaSonia is the mother of twins� Her husband is self-employed and the whole family is covered under her benefits�

In the best case scenario, Sonia and her family have their annual wellness exams and that is the only time they see a doctor� In the worst case scenario, Sonia's children get very sick and they each have 4 visits with their primary care doctor, 4 visits with a specialist and are each hospitalized for 3 days�

* Hospitalization estimated at $5,000 per child� Prices will vary by provider and service�

**All rate examples for the HDHP are averages and assume in-network pricing discounts�


H D H P w/ H S A

M E D I C A L

IN-NETWORK OUT-OF-NETWORKLifetime Maximum Unlimited UnlimitedCalendar Year Deductible (All covered expenses accumulate $3,500 Individual $6,000 Individual toward both In- and Out-of-Network Deductibles� The family $7,000 Family $12,000 Family deductible can be met by a combination of family members; however no individual will pay more than the individual deductible�)Out-of-Pocket Maximum $6,450 Individual $10,000 Individual (includes deductible, coinsurance, and copays) $12,900 Family $20,000 Family AMOUNT PLAN PAYS or COPAY AMOUNT PLAN PAYS or COPAYPreventive Care (includes Preventive Care Services that meet 100%; deductible waived 70% after deductible the requirements of federal and state law, including certain screenings, immunizations, and physician visits)Coinsurance (amount plan pays after you meet the deductible) 90% 60%Prescription Drug (plan benefit applies after you meet the plan deductible� Deductible will be waived for select generic and brand chronic and preventive prescriptions� Each retail prescription has a 30-day limit, mail order maintenance prescriptions have a 90-day limit)• Retail Tier 1 / Mail Order Tier 1 $15 copay after deductible / $30 copay after deductible • Retail Tier 2 / Mail Order Tier 2 $35 copay after deductible / $70 copay after deductible • Retail Tier 3 / Mail Order Tier 3 $60 copay after deductible / $120 copay after deductible • Retail Tier 4 / Mail Order Tier 4 20% after deductible, up to $200 per drug


M E D I C A L

H M OIN-NETWORK

Lifetime Maximum Unlimited

Calendar Year Deductible $3,500 individual$10,500 family

Out-of-Pocket Maximum (includes deductible, coinsurance, medical copays and pharmacy costs) Non-covered items do not apply�

$6,600 individual$13,200 family

Office Visits: Preventive Care

Well Child and Immunizations Plan pays 100% (deductible waived)

Periodic Health Examinations Plan pays 100% (deductible waived)

Prostate Screening or Annual Gynecology Examination Plan pays 100% (deductible waived)

Office Visits: Illness or Injury

Primary Care Physician / Specialty Care Visit $40 copay / $50 copay

Urgent Care Visit $40 copay

Maternity Pre-natal maternity plan pays 100%; delivery and postpartum services $50 copay + plan pays 80% after deductible�

Allergy Care Member cost sharing is based on the type of service performed and the place of service where rendered�

Retail Health Clinic $40 copay

Inpatient Services

Daily Room, Board, Nurse Care (at semi-private room rate), ICU, Physician Services Plan pays 80% after deductible

Outpatient Services

Surgery Facility, Hospital Charges, Physician Services, Diagnostic X-ray, Lab Plan pays 80% after deductible

Emergency Room (Not Covered for Non-Emergency) $150 copay (waived if admitted), then plan pays 80%

Therapy Services

Chiropractic Care $40 copay, 20-visit calendar year max�

Physical and Occupational Therapy $40 copay, 20-visit calendar year max� combined

Speech Therapy $40 copay, 20-visit calendar year max�

Mental Health/Substance Abuse

Inpatient Services Plan pays 80% after deductible

Residential Treatment Facility Services Plan pays 80% after deductible

Outpatient Services $40 copay

Other Services

Skilled Nursing Facility Plan pays 80% after deductible, 30-day calendar year max�

Home Health Care $40 copay, 120-visit calendar year max�

Hospice Care Plan pays 100% (deductible waived)

Ambulance (when medically necessary) Plan pays 80% after deductible

Durable Medical Equipment Plan pays 80% after deductible

Prescription Drug - To receive coverage your prescription must be written by a network physician and filled at a network pharmacy� Each retail prescription has a 30-day limit, mail order maintenance prescriptions have a 90-day limit� All member cost shares (copays, coinsurance, and deductible) for pharmacy benefits will apply to the plan Out-of-Pocket Maximum�

Benefit Period Deductible $200 per member / $600 Family (Does not apply to Tier 1 Retail or Tier 1 Mail Order)

Retail Tier 1 / Mail Order Tier 1 $15 copay / $30 copay

Retail Tier 2 / Mail Order Tier 2 $35 copay after deductible / $70 copay after deductible

Retail Tier 3 / Mail Order Tier 3 $60 copay after deductible / $120 copay after deductible

Retail Tier 4 / Mail Order Tier 4 20% after deductible, up to $200 per drug

M E D I C A L

P O S


IN-NETWORK OUT-OF-NETWORK

Lifetime Maximum Unlimited Unlimited

Calendar Year Deductible (All covered expenses accumulate separately toward the In- and Out-of-Network Deductibles�)



Out-of-Pocket Maximum (includes deductible, coinsurance, medical copays and pharmacy costs) Non-covered items do not apply�



Preventive Care

Well Child and Immunizations Plan pays 100% (deductible waived) Plan pays 70% (deductible waived)

Periodic Health Examinations Plan pays 100% (deductible waived) Plan pays 70% after deductible

Prostate Screening or Annual Gynecology Examination Plan pays 100% (deductible waived) Plan pays 70% after deductible

Office Visits: Illness or Injury

Primary Care Physician / Specialty Care Visit $40 copay / $40 copay Plan pays 70% after deductible

Urgent Care Visit $50 copay Plan pays 70% after deductible

Maternity Pre-natal maternity plan pays 100%; delivery and postpartum services plan pays 80% after deductible�

Plan pays 70% after deductible

Allergy Care Member cost sharing is based on the type of service performed and the place of service where rendered�


Retail Health Clinic $40 copay Plan pays 70% after deductible

Inpatient Services

Daily Room, Board, Nurse Care (at semi-private room rate), ICU, Physician Services

Plan pays 80% after deductible Plan pays 70% after deductible

Outpatient Services

Surgery Facility, Hospital Charges, Physician Services, Diagnostic X-ray, Lab Plan pays 80% after deductible Plan pays 70% after deductible

Emergency Room (Not Covered for Non-Emergency) $200 copay (waived if admitted) $200 copay (waived if admitted)

Therapy Services

Chiropractic Care (20-visit calendar year max�) $40 copay Plan pays 70% after deductible

Speech Therapy (20-visit calendar year max�) $40 copay Plan pays 70% after deductible

Physical and Occupational Therapy (60-visit calendar year max� combined) $40 copay Plan pays 70% after deductible

Mental Health/Substance Abuse

Inpatient Services Plan pays 80% after deductible Plan pays 70% after deductible

Residential Treatment Facility Services Plan pays 80% after deductible Plan pays 70% after deductible

Outpatient Services $40 copay Plan pays 70% after deductible

Other Services

Skilled Nursing Facility (120-visit calendar year max�) Plan pays 80% after deductible Plan pays 70% after deductible

Home Health Care (100-visit calendar year max�) $40 copay Plan pays 70% after deductible

Hospice Care Plan pays 80% after deductible Plan pays 70% after deductible

Ambulance (when medically necessary) Plan pays 80% after deductible Plan pays 80% after deductible

Durable Medical Equipment Plan pays 80% after deductible Plan pays 70% after deductible

Prescription Drug - Each retail prescription has a 30-day limit, mail order maintenance prescriptions have a 90-day limit� All member cost shares (copays, coinsurance, and deductible) for pharmacy benefits will apply to the plan Out-of-Pocket Maximum�

Retail Tier 1 / Mail Order Tier 1 $15 copay / $30 copay $15 copay / N/A



Retail Tier 4 / Mail Order Tier 4 20% up to $200 per drug Not Covered


M E D I C A L

Cigna Healthy Rewards®Looking for more healthy choices? Just use your medical ID card when you visit a participating provider or shop online and let the savings begin. Get discounts on the health products and programs you use every day for:

• Discounted rates at select gyms• One-on-one motivational health coaching• Weight-loss programs or meal plans• Hearing aids and exams• Eye exams, contact lenses, eyeglasses and Lasik

eye surgery• Massage therapy, acupuncture, chiropractic,

nutrition services, over-the-counter vitamins, yoga equipment and homeopathic remedies.

You can choose from a wide network of conveniently located participating providers by visiting Cigna.com/rewards

(password: savings) or by calling 800.258.3312

myCigna

Easy to Register. Easy to Use.

1. Launch the myCigna App or go to myCigna.com and select “Register Now”

2. Enter your personal information 3. Confirm your identity4. Create your security information and provide

your primary email address for enhanced security protection and notifications

5. Review, the select “Submit”

• Find in-network doctors and medical services

• Manage and track claims• See cost estimates for medical procedures• Compare quality of care for doctors and

hospitals• Access a variety of health and wellness

tool and resources

It’s easy to find what you need.

It’s easy to set up. Download the myCigna App or visit myCigna.com.

D E N TA L

Preventive Care Pays

Cigna Dental WellnessPlus® rewards you and your family for getting preventive dental care. The plan encourages good dental care and can help improve the overall health of your whole family.

Cigna Dental WellnessPlus®The key to a healthy smile taking care of your teeth and gums before problems start. With Cigna dental coverage, most preventive care is available at low or no cost. And, with Cigna Dental WellnessPlus®, your annual dollar maximum could increase each year. Visit Your Dentist Regularly

Regular preventive visits to your dentist can help protect your overall wellness, not only your oral health. Recent studies have linked gum disease to damage elsewhere in the body. According to the Centers for Disease Control and Prevention, there may be associations between oral infections and diabetes, heart disease, stroke, and preterm, low-weight births. Research is underway to further examine these connections.

To find an in-network dentist, call Cigna at 888.244.6224 or visit www.cigna.com.


Calendar Year DeductibleOut-of-Network Reimbursement (In-network reimbursement is always paid at the contracted rate)Preventive Services Oral exams and cleanings (two per year), x-rays (two bitewings every year, full mouth every three years), and Fluoride treatments for childrenBasic Services Fillings, oral surgery, surgical extraction of impacted teeth, anesthetics, periodontic services, endodontic servicesMajor Services Inlays, onlays, crowns, dentures and bridgesOrthodontia (dependent up to age 19) Lifetime maximum $1,000, progressive maximum does not applyMaximum Annual Benefit (per individual per calendar year) Cigna Dental WellnessPlus®

Network Access Plan$50 individual / $150 family Based on the 90th percentile of usual, reasonable, and customary rates for a given areaPlan pays 100% - no deductible required



Plan pays 50%

$1,000

When an individual receives preventive care in one plan year, they will qualify for an additional $50 added to their Progressive Maximum Annual Benefit for the following plan year, up to $1,150�

DENTAL


V I S I O N

Cigna VisionTaking care of your vision is important to your overall health.Cigna members can take care of their vision and have routine eye exams while saving on all the their eye care needs. Log in to www.cigna.com to locate a participating provider.

Exam (once every 12 months)Frames (once every 24 months; any frame at provider location)Standard Plastic Lenses• Single Vision• Bifocal• Trifocal• Standard Progressive LensLens Options• UV Coating• Tint (solid and gradient)• Standard Scratch Resistance• Standard Polycarbonate• Standard Anti-Reflective Coating• Other Add-Ons and ServicesContact Lenses (once every 12 months; allowance includes materials only)• Elective• Medically NecessaryLaser Vision Correction (Lasik or PRD from U.S. Laser Network)

IN-NETWORK$10 Copay$130 Allowance, 20% off balance

$25 Copay$25 Copay$25 CopayUp to $25, 20% off balance

20% Discount, employee pays up to $1720% Discount, employee pays up to $1720% Discount, employee pays up to $1720% Discount, employee pays up to $40 20% Discount, employee pays up to $45 20% off retail price

up to $130 allowance $0 Copay, Paid-in-Full 15% off retail price or 5% off promotional price

OUT-OF-NETWORKUp to $45Up to $71

Up to $32Up to $55Up to $65Up to $55

Not coveredNot coveredNot coveredNot coveredNot coveredNot covered

Up to $105Up to $210Not covered

VISION

Taking care of your vision can also mean early detection for symptoms of:

A qualified vision care professional can help treat and manage:

■ Diabetes■ Hypertension■ High cholesterol

■ Tumors■ Thyroid disorders■ Neurological disorders

■ Cataracts■ Corneal diseases■ Diabetic retinopathy

■ Eye infections■ Glaucoma■ Macular degeneration

Short-Term Disability (up to 6 months)If you elect Short-Term Disability (STD) benefits and you suffer a qualified disability while employed at Ed Voyles, your coverage begins after a 14-day waiting period. Your optional STD benefit provides 60% of earnings not to exceed $1,400 per week for up to 6 months. After this period, if you are still disabled AND you elected Long-Term Disability (LTD), benefits would be paid under the below plan. The cost of STD insurance is paid for by the employee.

Long-Term Disability (beyond 6 months)Our LTD benefit provides 60% of your pay up to $7,000 per month, after 6 months of a continuous disability. After 24 months, your disability will be evaluated based on your ability to perform own occupation for which you may be qualified. If you elect LTD insurance, Ed Voyles will pay 25% of the LTD premium costs for employees with less than 5 years of service and 90% of the premium costs for those with 5 or more years of service.

DisabilityOne third of all Americans between the ages of 35 and 65 will become disabled for more than 90 days, according to the American Council of Life Insurers. Short-Term Disability insurance provides income continuation if you are ever unable to work due to a non-work related accident or illness. Long Term Disability Insurance provides income continuation for both non-work and work-related accidents or illnesses. You have the option to purchase both Short- and/or Long-Term Disability insurance if you are a full-time employee working 30 or more hours a week. Ed Voyles offers disability coverage through Cigna.

Disability Insurance provides income protection to insure that you have a consistent flow of income if you are unable to work for an extended period of time due to a disabling illness or injury�

If you suffer from an illness or injury and are unable to work, do you know how you will pay your rent or mortgage, car payments, utilities, and health insurance? The loss of income can be so devastating that the U�S� Department of Housing and Urban Development estimates that 46% of all home foreclosures are caused by a disability�

If you are like most Americans, your monthly expenses eat up most of your paycheck and little is left for saving� If you worry that you haven’t set aside a large enough emergency fund, you should consider purchasing Disability Insurance�

If you were disabled and unable to work, how would you pay your bills?

Points to Remember About STD and LTD■ Evidence of Insurability – STD and LTD enrollment will require Evidence of

Insurability (EOI) if you are not a new hire and would like to sign up for the first time�

■ Pre-Existing Conditions – Medical conditions diagnosed or treated within the 3 months immediately preceding the effective date of coverage will not be covered for the first 12 months under both plans� Note that accidents or illnesses unrelated to a pre-existing condition will be covered�

■ Tax Liability – Any compensation received as STD or LTD may be considered taxable income�

■ Portability – STD and LTD are not portable benefits�

D I S A B I L I T Y


L I F E A N D A D & D A N D E A P

Life Insurance and AD&DEd Voyles is partnering with Cigna to provide Basic and Voluntary Life insurance and AD&D for our employees. We provide all full-time employees working 30 hours per week or more with $20,000 of Basic Life Insurance and $20,000 Accidental Death and Dismemberment insurance at NO COST. Additional voluntary coverage can be elected and paid for by the employee.

Why buy life insurance?Life insurance provides a lump sum cash benefit to surviving dependents to cover immediate expenses such as funeral expenses or ongoing living expenses. Life insurance benefits often help survivors adjust to the loss of income related to the death of a wage earner, or provide funds for college or retirement for the survivors.

Waiver of PremiumIf an insured employee becomes totally disabled (unable to work at any job) prior to age 60, after satisfying the elimination period, insurance will remain in force during that disability without further payment of premiums until age 65, at which time coverage will terminate.

What is Evidence of Insurability?Cigna requires Evidence of Insurability in order for employees to purchase voluntary insurance above $150,000. If you or your dependents have medical conditions that make it difficult to purchase life insurance on your own, this amount is relevant to you. Evidence of Insurability requires you to complete a medical questionnaire, obtain a physical (at the carrier’s request), and

receive carrier approval before your insurance takes effect. Life enrollment time frames are limited as detailed below:

■ New Hires – You may apply for coverage up to $150,000 without Evidence of Insurability through the normal enrollment process.

■ Marriage, Adoption, or Birth – If you are already enrolled in employee life, you can enroll new dependents as long as you follow normal event deadlines. If you wish to increase your employee life amount above $150,000, you must complete the Evidence of Insurability Form and submit it within the normal life event deadlines.

■ 2018 Open Enrollment Period – Your current Voluntary Life elections will be grandfathered from Aetna to Cigna. If you are newly eligible, you may apply for coverage up to $150,000 without Evidence of Insurability. If you would like to increase your current election or sign up for the first time and are not a new hire, you will need to fill out the appropriate forms, which includes an Evidence of Insurability form.

Optional Life InsuranceIn addition to the insurance provided free by Ed Voyles, you can purchase additional life insurance coverage for yourself, up to 50% of the employee amount for your spouse, and up to $10,000 for a child(ren) between 15 days and 26 years old� You must purchase employee coverage to be able to purchase coverage for your spouse and/or child(ren)� Voluntary Life Insurance is a portable benefit�


Cigna’s Employee Assistance ProgramWhen you need someone to listen, Cigna is there.If you need help with an everyday issue that’s becoming a little hard to handle, your Employee Assistance Program (EAP) is there for you. Cigna’s EAP is a confidential and round-the-clock service that offers support and resources. Whether your needs are big or small, your Life Assistance & Work/Life Support Program is there for you.

Cigna’s EAP can connect you with resources and support on:■ Legal consultation■ Parenting■ Senior Care■ Child Care■ Pet Care■ Financial Services & Referral

Your policy includes three face-to-face counseling sessions a year with an EAP network provider. That’s up to three visits a year for you and also for members of your household. Just a call or click away, Cigna can confidentially discuss your situation and help you get information and education, as well as referrals to local counselors if you want face-to-face visits.

We’re available 24 hours a day, 7 days a week, either by phone or online. Toll free 800.538.3543 or visit www.cignabehavioral.com/cgi.

AccidentWhy Accident Insurance?

Claimant - Employee, 40 year old■ Accident - fell down stairs at home■ Injury - fractured toe and ACL tear

Out-of-pocket expenses incurred:■ $150 emergency room copay■ $3,500 deductible■ $400 coinsurance for surgery■ $240 copay for six physical therapy visits

Total out-of-pocket expenses = $4,290

Benefits paid:■ $150 emergency room treatment■ $100 appliance (knee brace)■ $100 fractured toe■ $400 ligament tear with surgical repair■ $150 for six physical therapy visits

Total benefit paid under policy = $900

ACC I D E N T & C R I T I C A L I L L N E S S


Critical Illness CoverageCritical Illness coverage provides a lump sum benefit in the event you are diagnosed with a covered critical illness. Covered critical illnesses include: heart attack, cancer, stroke, organ transplant, or kidney failure.

Critical illness coverage is 100% paid for by Ed Voyles for employees enrolled in the HSA. It covers employees and their enrolled dependents on the medical plan.

Why Critical Illness Insurance?■ Affordable insurance to protect you in the event of a major

illness.■ $5,000 Lump Sum benefit for employees and their families.■ Payout occurs upon first diagnosis. Subsequent and

recurrent payouts will be made after a 6 month separation period.

■ No Pre Existing Condition, No Benefit Waiting Period, No Age Reduction.

Employees must be covered on a major medical plan to be eligible to enroll for Critical Illness

Covered at 100%■ Invasive Cancer ■ Heart Attack■ Kidney Failure■ Major Organ Failure■ Stroke■ Paralysis■ Blindness ■ Benign Brain Tumor

Covered at 25%■ Carcinoma in Situ■ Coronary Artery Bypass

Surgery■ Alzheimer’s Disease ■ Parkinson’s Disease■ Multiple Sclerosis■ Coma

■ Guaranteed Issue ■ Coverage options available for Employee, Spouse and Child(ren) to age 26■ Covers On and Off the Job Accidents■ No Offset for Workers Comp, Disability or Medical Insurance

■ Benefit payment amounts per injury treatment type (broken leg, doctor’s visit, crutches) with multiple payouts available per accident

■ Premiums are 100% paid for by Ed Voyles for all HSA enrollees■ Fully Portable and No Pre Existing Conditions■ Covers Scholastic Sports for Covered Children


Important Notice from Ed Voyles Automotive Group About Your Prescription Drug Coverage and Medicare

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Ed Voyles Automotive Group and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

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

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

2. Ed Voyles Automotive Group has determined that the prescription drug coverage offered by Cigna Medical plans is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

When Can You Join a Medicare Drug Plan?

You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th through December 7th.

However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens to Your Current Coverage If You Decide to Join A Medicare Drug Plan?If you decide to join a Medicare drug plan, your current Ed Voyles Automotive Group coverage will not be affected. The Cigna HMO Medical plan at Ed Voyles Automotive Group offers Tier 1 Drugs at $15, Tier 2 Drugs at $35, Tier 3 Drugs at $60, and Tier 4 Drugs at 20% up to $200 per drug after an individual deductible of $200 is met or a family deductible of $600 is met for tiers two through four. The Cigna National POS Medical plan at Ed Voyles Automotive Group offers Tier 1 Drugs at $15, Tier 2 Drugs at $35, Tier 3 Drugs at $60, and Tier 4 Drugs at 20% up to $200 per drug. The HDHP (HSA) Medical plan offers Tier 1 Drugs at $15, Tier 2 Drugs at $35, Tier 3 Drugs at $60, and Tier 4 Drugs at 20% up to $200 per drug after the medical deductible is met. All prescriptions must be covered by Cigna’s drug formulary. If you keep the Ed Voyles Automotive Group’s coverage and enroll in Medicare Part D, both plans will coordinate coverage. Ed Voyles Automotive Group plan will be primary.

If you do decide to join a Medicare drug plan and drop your current Ed Voyles Automotive Group coverage, be aware that you and your dependents will only be able to get this coverage back at open enrollment.

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

You should also know that if you drop or lose your current coverage with Ed Voyles Automotive Group and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.

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

For More Information About This Notice or Your Current Prescription Drug Coverage…

Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Ed Voyles Automotive Group changes. You also may request a copy of this notice at any time.

For More Information About Your Options Under Medicare Prescription Drug Coverage…

More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.

For more information about Medicare prescription drug coverage:• Visit www.medicare.gov • Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

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

Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty). Date: May 1, 2018Name of Entity/Sender: Janice CollinsContact--Position/Office: Human Resources Administrator / Ed Voyles Automotive GroupAddress: 2103 Cobb Parkway SE Marietta, GA 30076Phone Number: 770.933.5864

M E D I C A R E PA R T D N OT I C E

A N N UA L N OT I C E S

Premium Assistance under Medicaid and theChildren’s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office, dial 1-877-KIDS NOW, or go to www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as being eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).

If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of August 10, 2017. Contact your State for more information on eligibility –

ALABAMA—MedicaidWebsite: http://myalhipp.com/Phone: 1-855-692-5447

ALASKA—MedicaidThe AK Health Insurance Premium Payment Program Web-site: http://myakhipp.com/ Phone: 1-866-251-4861Email: [email protected] Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/med-icaid/default.aspx

ARKANSAS —MedicaidWebsite: http://myarhipp.com/Phone: 1-855-MyARHIPP (855-692-7447)

COLORADO—Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+)Health First Colorado Website: https://www.healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1-800-221-3943/ State Relay 711CHP+: Colorado.gov/HCPF/Child-Health-Plan-PlusCHP+ Customer Service: 1-800-359-1991/ State Relay 711

FLORIDA—MedicaidWebsite: http://flmedicaidtplrecovery.com/hipp/Phone: 1-877-357-3268

GEORGIA—MedicaidWebsite: http://dch.georgia.gov/medicaid- Click on Health Insurance Premium Payment (HIPP)Phone: 404-656-4507

INDIANA—MedicaidHealthy Indiana Plan for low-income adults 19-64Website: http://www.in.gov/fssa/hip/Phone: 1-877-438-4479All other MedicaidWebsite: http://www.indianamedicaid.comPhone 1-800-403-0864IOWA—MedicaidWebsite: http://dhs.iowa.gov/ime/members/medicaid-a-to-z/hippPhone: 1-888-346-9562

KANSAS—MedicaidWebsite: http://www.kdheks.gov/hcf/Phone: 1-785-296-3512

KENTUCKY—MedicaidWebsite: http://chfs.ky.gov/dms/default.htmPhone: 1-800-635-2570

LOUISIANA—MedicaidWebsite: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331Phone: 1-888-695-2447

MAINE—MedicaidWebsite: http://www.maine.gov/dhhs/ofi/public-assistance/index.htmlPhone: 1-800-442-6003TTY: Maine relay 711

MASSACHUSETTS—Medicaid and CHIP Website: http://www.mass.gov/eohhs/gov/departments/masshealth/Phone: 1-800-862-4840

MINNESOTA—MedicaidWebsite: http://mn.gov/dhs/people-we-serve/seniors/health-care/health-care-programs/programs-and-services/medical-assistance.jspPhone: 1-800-657-3739

MISSOURI—MedicaidWebsite: http://www.dss.mo.gov/mhd/participants/pages/hipp.htmPhone: 573-751-2005

MONTANA—MedicaidWebsite: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPPPhone: 1-800-694-3084

NEBRASKA—MedicaidWebsite: http://www.ACCESSNebraska.ne.govPhone: (855) 632-7633Lincoln: (402) 473-7000Omaha: (402) 595-1178

NEVADA—MedicaidWebsite: https://dwss.nv.gov/Phone: 1-800-992-0900

NEW HAMPSHIRE—MedicaidWebsite: http://www.dhhs.nh.gov/oii/documents/hippapp.pdfPhone: 603-271-5218

NEW JERSEY—Medicaid and CHIPMedicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/medicaid/Medicaid Phone: 609-631-2392CHIP Website: http://www.njfamilycare.org/index.htmlCHIP Phone: 1-800-701-0710

NEW YORK—MedicaidWebsite: https://www.health.ny.gov/health_care/medicaid/Phone: 1-800-541-2831

NORTH CAROLINA—Medicaid Website: https://dma.ncdhhs.gov/ Phone: 919-855-4100

NORTH DAKOTA—MedicaidWebsite: http://www.nd.gov/dhs/services/medicalserv/medicaid/Phone: 1-844-854-4825

OKLAHOMA—Medicaid and CHIPWebsite: http://www.insureoklahoma.orgPhone: 1-888-365-3742

OREGON—MedicaidWebsite: http://healthcare.oregon.gov/Pages/index.aspxhttp://www.oregonhealthcare.gov/index-es.htmlPhone: 1-800-699-9075

PENNSYLVANIA—MedicaidWebsite: http://www.dhs.pa.gov/provider/medicalassistance/healthinsurancepremiumpaymenthippprogram/index.htmPhone: 1-800-692-7462

RHODE ISLAND—Medicaid Website: http://www.eohhs.ri.gov/Phone: 855-697-4347

SOUTH CAROLINA—Medicaid Website: https://www.scdhhs.govPhone: 1-888-549-0820

SOUTH DAKOTA—Medicaid Website: http://dss.sd.govPhone: 1-888-828-0059

TEXAS—MedicaidWebsite: http://gethipptexas.com/Phone: 1-800-440-0493

UTAH—Medicaid and CHIPMedicaid Website: https://medicaid.utah.gov/CHIP Website: http://health.utah.gov/chipPhone: 1-877-543-7669

VERMONT—MedicaidWebsite: http://www.greenmountaincare.org/Phone: 1-800-250-8427

VIRGINIA—Medicaid and CHIPMedicaid Website: http://www.coverva.org/programs_pre-mium_assistance.cfmMedicaid Phone: 1-800-432-5924CHIP Website: http://www.coverva.org/programs_pre-mium_assistance.cfmCHIP Phone: 1-855-242-8282

WASHINGTON—MedicaidWebsite: http://www.hca.wa.gov/free-or-low-cost-health-care/program-administration/premium-payment-programPhone: 1-800-562-3022 ext. 15473

WEST VIRGINIA—MedicaidWebsite: http://mywvhipp.com/Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)

WISCONSIN—MedicaidWebsite: https://www.dhs.wisconsin.gov/publications/p1/p10095.pdfPhone: 1-800-362-3002

WYOMING—MedicaidWebsite: https://wyequalitycare.acs-inc.com/Phone: 307-777-7531

To see if any other states have added a premium assistance program since August 10, 2017, or for more information on special enrollment rights, contact either:

U.S. Department of LaborEmployee Benefits Security Administrationwww.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)

U.S. Department of Health and Human Services Centers for Medicare & Medicaid Serviceswww.cms.hhs.gov1-877-267-2323, Menu Option 4, Ext. 61565


A N N UA L N OT I C E S

COBRA Continuation Coverage

A federal law known as the Consolidated Omnibus Reconciliation Act (COBRA) requires that most employers that sponsor group health plans offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) at group rates in certain instances where coverage from the terms of the plan would otherwise end. This notice is intended to inform you of your rights and obligations from the continuation coverage provisions of the law.

If you are an employee and are covered by the group health plan, you have a right to choose this continuation coverage if you lose your group health coverage from the terms of the plan because of reduction in your hours of employment or the termination of your employment (for reasons other than gross misconduct on your part). If you are the spouse of an employee and are covered by the group health plan, you have the right to choose this continuation coverage if you lose your group health coverage from the terms of the health plan for any of the following reasons:• The death of your spouse• A termination of your spouse’s employment (for

reasons other than gross misconduct) or reduction of your spouse’s hours of employment

• Divorce or legal separation from your spouse• Your spouse becomes entitled to Medicare

If an employee’s dependent child is covered by the group health plan, he or she has the right to continuation coverage if group health coverage from the terms of the health plan is lost for any of the following reasons:• The death of a parent• A termination of a parent’s employment (for reasons

other than gross misconduct) or reduction in a parent’s hours of employment

• Parents’ divorce or legal separation• A parent becomes entitled to Medicare• The dependent ceases to be a dependent child within

the terms of the health plan

The individuals described above, who are entitled to COBRA continuation coverage, are called qualified beneficiaries. If a child is born to a covered employee or if a child younger than age 18 is adopted by or placed for adoption with a covered employee during a period of COBRA continuation coverage, the newborn or adopted child also is a qualified beneficiary. These new dependents can be added to COBRA upon timely notification to the plan administrator in accordance with the terms of the group health plan.

Under the law, the employee or a family member has the responsibility to inform the plan administrator of a divorce, legal separation or a child losing dependent status within the terms of the health plan. This information must be provided within 60 days the event or the date on which coverage would end under the terms of the plan because of the event. If the information is not provided within 60 days, rights to continuation coverage through COBRA ends. The employer has the responsibility to notify the plan administrator of an employee’s death, termination of employment or reduction in hours or Medicare entitlement.

When the plan administrator is notified that one of these events has happened, the plan administrator will, in turn, notify you of your right to choose continuation coverage. According to the law, you have 60 days from the date you are notified of your rights, or the date you would lose coverage because of one of the events described above, to inform the plan administrator that you want continuation coverage.

If you do not choose continuation coverage in a timely manner, your group health insurance coverage will end. COBRA continuation coverage is not available to any covered individual if coverage is lost due to termination of employment for gross misconduct.

If you choose continuation coverage, the employer is required to give you coverage, which, as of the time coverage is being provided, is identical to the coverage provided with the plan to similarly situated employees or family members. Any changes made to the health plan for similarly situated employees or family members also will apply to the individual who chooses COBRA continuation coverage. The terms of the coverage are governed by the plan documentation, which is available upon request from the plan administrator in the event you have misplaced your documentation.

The law requires that you are given the opportunity to maintain continuation coverage for up to three years unless you lost group health coverage because of a termination of employment (except for gross misconduct) or reduction in hours. If such termination or reduction of hours is the reason for your loss of coverage, the required continuation coverage period is up to 18 months. These 18 months may be extended to 36 months if other events (such as death, divorce or the employee’s Medicare entitlement) occur during the 18-month period. If the covered employee became entitled to Medicare less than 18 months before a qualifying event that is termination of employment or reduction of hours, then qualified beneficiaries, other than the covered employee, may receive continuation coverage for up to 36 months measured from the covered employee’s Medicare entitlement.

The 18-month continuation coverage period applicable to termination (except for gross misconduct) or to reduction of hours may be extended to up to 29 months if a qualified beneficiary is determined by the Social Security Administration to have been disabled at any time within the first 60 days of continuation coverage. In order to extend the 18-month period, a qualified beneficiary must notify the plan administrator within 60 days of the determination by the Social Security Administration and before the end of the 18-month continuation period.

If the above requirements are satisfied, the continuation coverage for all qualified beneficiaries may continue for up to an additional 11 months beyond the end of the initial 18-month period. A higher monthly premium (150 percent of the applicable premium used to determine regular COBRA rates) will be required. The plan administrator also must be notified within 30 days after the date of any final determination of the Social Security Administration that the disability no longer exists, if such a determination is made before the end of the 29-month continuation coverage period. Continuation coverage will be cut for any of the following reasons:• The employer no longer provides group health coverage

to any of its employees• The premium for your continuation coverage is not

made on time• You become covered under another group health plan

that does not contain any exclusion or limitation with respect to any preexisting condition you have

• You become entitled to Medicare• In the case of the 29-month continuation of coverage

period for the disabled, the disability ends

You do not have to show that you are insurable to choose continuation coverage. However, continuation coverage under COBRA is provided subject to your eligibility for coverage; the plan administrator reserves the right to terminate your COBRA coverage retroactively if you are ineligible.

Under the law, you may have to pay all or part of the premium, plus a 2 percent administration fee, for your continuation coverage. As explained above, higher rates apply to the 11-month extension due to disability. There is a grace period of 30 days for payment of the regularly scheduled premium. In addition, upon the expiration of the 18-month or 36-month continuation coverage period, you are allowed to enroll in an individual conversion plan if conversion is provided from the terms of the health plan.

HIPPA Special Enrollment Right

During the enrollment period, if you decline enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may, in the future, enroll yourself or your dependents in the health plan, provided you request enrollment within 30 days after your other coverage ends. To retain your right for special enrollment, you may be required to certify during enrollment, in writing, that you are covered by another health plan. In addition, if you have a new dependents a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption or placement for adoption.

Women’s Health and Cancer Rights Act

The Women’s Health and Cancer Rights Act requires all group health plans that provide medical and surgical benefits for a mastectomy must also provide certain other related benefits. A participant or beneficiary who is receiving benefits for a mastectomy that is covered by a health plan and elects breast reconstruction is entitled to receive coverage for:• All stages of reconstruction of the breast on which the

mastectomy was performed• Surgery and reconstruction of the other breast to

produce a symmetrical appearance• Prostheses and treatment of physical complications at

all stages of the mastectomy, including lymphedemasThe coverage will be provided in a manner determined in consultation with the attending doctor and the patient. The coverage will be subject to the same annual deductible, coinsurance, copay and other conditions and limitations otherwise applicable under the health plan. If you have any questions about coverage for these benefits, contact the health insurance carrier.

Wellness Program Disclosure

Your health plan is committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all employees. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact your employer Human Resources Department (see back cover) and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status.

Newborns’ and Mothers’ Health Protection

Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).


I M P O R TA N T CO N TAC T I N F O R M AT I O N

Medical Plans■ HealthEZ www�EdVoylesBenefits�com 1�888�701�2994

■ Health Savings Account: Payflex www�payflex�com 1�844�PAYFLEX

Dental Plans■ Cigna www�Cigna�com 1�800�Cigna24

Vision Plan■ Cigna www�cigna�com 1�800�Cigna24

Life Insurance■ Cigna www�Cigna�com 1�800�Cigna24

Short-Term Disability■ Cigna www�Cigna�com 1�800�Cigna24 Long-Term Disability■ Cigna www�Cigna�com 1�800�Cigna24

Accident & Critical Illness Insurance■ Cigna www�Cigna�com 1�800�Cigna24

Flexible Spending Accounts■ HealthEZ service@healthez�com 1�952�896�0372

EAP■ Cigna www�cignabehavioral�com/cgi 1�800�538�3543

Janice Collins■ Ed Voyles Human Resources Administrator 770�933�5864 jcollins@edvoyles�com

Kellie Jones■ Ed Voyles Human Resources Administrator 770�933�5945 kmjones@edvoyles�com

Paige Foughty■ Relation Insurance Services Account Manager 678�740�0229 paige�foughty@relationinsurance�com

Todd Bryant■ Relation Insurance Services President 678�740�0220 todd�bryant@relationinsurance�com

2018-2019 Ed Voyles Automotive Groupedvoylesbenefits.com/.../05/2018_Ed_Voyles_FINAL.pdf · Ed...

Documents

Transcript of 2018-2019 Ed Voyles Automotive Groupedvoylesbenefits.com/.../05/2018_Ed_Voyles_FINAL.pdf · Ed...