action required your what’s plan? - L Brands Hire... · what’s your plan? 2016 health and...
Transcript of action required your what’s plan? - L Brands Hire... · what’s your plan? 2016 health and...
what’s your plan?
2016 health and wellness benefits enrollment information
action
required
Enrollment Deadline
Take action within 30 days of hire,
or the date you become eligible
for benefits.
Enrollment election become effective immediately. (If you
miss this window, you’ll have to wait until open enrollment
or life change event to enroll or make changes.)
Enroll: Log on to L Brands Access
https://associateresources.limitedbrands.com
Click on My Benefits > Enroll in Benefits and follow the
instructions to enroll
Learn more about your 2016 benefits. Watch
these short videos and get access to the
What’s Your Plan? enrollment book!
https://lbrands.a.guidespark.com
For questions about your benefits, or to request a free
paper copy of the What’s Your Plan? enrollment book,
call HR Direct at 1.866.473.4728.
choose your
2016 benefits(medical, dental, vision, flexible spending
account, legal (full-time only) and optional
life insurance (full-time only)
what’s your plan?
2016 health and wellness benefits open enrollment information
action
required
Enrollment Deadline
November 29, 2015!
GET MORETIME OFF!
(see details inside)
table of contents
2 what’s our plan?
3 what’s your plan?
3 who is eligible?
4 enrollment to do list
4 here’s how to enroll
5 after you’ve enrolled
6 medical program
12 pharmacy program
16 dental program
18 vision program
21 health & dependent care flexible spending accounts (FSA)
25 life insurance
28 legal insurance program
32 why preventive care is important
35 Anthem’s wellness services and disease management programs
37 matrix employee assistance program (eap)
38 a few other things
40 notice of health plan privacy practices
45 other benefits we offer
47 benefits eligibility and enrollment guide: full-time
48 benefits eligibility and enrollment guide: part-time, temporary and seasonal
49 benefits resources & contacts
2 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
If you have questions or need help with your enrollment, HR Direct representatives are available at 1.866.473.4728 Monday through Friday 9:00 am to 8:00 pm EST.
what’s our plan?Our goal is simple: we’re here to improve lives. We do it through our inspiring brands
and products. And we design our benefits the same way.
When it comes to health and wellness, we want you to spend more time at your best,
at work and at home. It’s a partnership between our associates and our benefits
programs that starts with the business’s investment in comprehensive, cost-effective
and competitive plans. But it really only comes to life when each of us as associates
use those plans to take great care of ourselves.
ComprehensiveWe design our benefits to support the overall well-being of you and your family with a variety of plans and options, so you can choose coverage that bests meets your needs.• Medical• Pharmacy• Dental• Vision• Legal insurance• Health and dependent care flexible spending accounts• Optional life insurance for you and your dependents Some benefits are provided to you even if you’re not enrolled in any of the above plans.• Company-provided disability• Company-provided life insurance• Employee assistance program (EAP)
Cost effectiveBecause of several factors, including medical inflation and new requirements in the Affordable Care Act, health care costs continueto rise. While our 2016 associate biweekly premiums will increase for all of our health plan options, L Brands will continue to pay approximately 75 percent of health care costs.
CompetitiveThere’s nothing like good competition. Throughout the year, we review our benefits plans to ensure we offer you cost-effective options while remaining competitive in the marketplace.
3For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Family
You can also enroll your dependents. Their coverage becomes effective the same day as yours. Eligible dependents include:• Spouse2
• Same or opposite-sex civil union or domestic partner2
• Children under the age of 26 through: – Birth – Legal adoption or the verifiable process of legal adoption – Marriage, civil union or domestic partnership – Foster care – Legal guardianship
Covering a child
Your child is eligible regardless of whether he or she is a student, married, eligible for coverage from his or her own job, or your tax dependent. However, in the case of a child of your domestic partner or a child subject to guardianship, you may be taxed on the value of the child’s benefits if he or she is not your tax dependent2.
Covering a domestic partner2
A same or opposite-sex domestic partnership or civil union partnership must meet the following requirements:• You have a legal civil union in a state that uses the civil union to
formally recognize same-sex relationships or, if you don’t have a civil union, you:
– are in a single dedicated relationship of at least 12 months and intend to remain in the relationship indefinitely; and
– share the same permanent residence and have done so for at least 12 months
• Are not related by blood or a degree of closeness that would prohibit marriage in the law of the state in which you reside
• Each are at least 18 years old• Each are mentally competent to consent to a contract• Neither you nor your domestic partner is married to another person
under either statutory or common law• Are financially interdependent• Both would sign an affidavit of domestic partnership and furnish evidence of the partnership if asked
1 Benefit-eligible part-time or seasonal associates are eligible for many of the same health and wellness benefits offered to full-time associates (see chart on page 47), and are eligible due to one of the following:
(a) grandfathered home office distribution center and client contact center associates hired prior to January 1, 2004, or grandfathered store management
(b) have worked an average of 30 or more hours per week (or for Hawaii, 20 or more hours per week) over a defined period of time. For Hawaii hours are measured over four weeks.
Benefits-eligibility of non-seasonal temporary associates will based on their full-time or part-time status. 2 To receive appropriate tax treatment, be sure to properly designate your dependent during your benefits enrollment: • Domestic partner: for same or opposite sex domestic partnerships, or for civil
union partnerships • Child of your domestic partner, or child subject to guardianship who is not
your tax dependent
what’s your plan?This is your opportunity to enroll in or make changes to your health and wellness
benefits for 2016.
Everything you need to know to make your enrollment decisions is included in this book.
So, read through all the benefits outlined on the following pages, think about your
personal situation and select what’s best for you — what you need to be at your best.
who is eligible?You’re eligible to enroll in benefits if you’re a full-time associate, or if you are a part-time,
temporary, or seasonal associate in a benefits-eligible job classification.1
DEADLINE
4 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
enrollment to do list
here’s how to enroll
Read this booklet and watch these videos to understand the benefits.
https://lbrands.a.guidespark.com
Gather all information you need to enroll:• dependent(s) date(s) of birth• dependent(s) Social Security number(s)
Compare L Brands benefits with those of your spouseor domestic partner to determine which options best suits you and your family’s needs.
Enroll online through L Brands Access 24/7 on any computer with an internet connection.
Log on, then click on my benefits > enroll in benefits and follow the enrollment instructions
https://associateresources.limitedbrands.com
You have 30 days from your date of hire,or the date you become eligible for benefitsto enroll in benefits or make edits to your elections.
Note: To effectively process life insurance payments it is important you assign a beneficiary(ies) within L Brands Access. Please take time to assign yours while you’re enrolling in benefits. You can make changes to your beneficiary(ies) any time.
Enrollment elections become effective immediately.
Be careful...don’t miss it! If you miss this opportunity,you’ll have to wait a year to enroll or make changes unless you experience a qualifying event, such as marriage or the birth of a child.
5For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Now that’s a plan!
after you’ve enrolledAll the 2016 benefits outlined in this booklet will be effective from January 1 through
December 31, 2016.
Payroll Deductions Your first payroll deduction for your 2016 benefits elections will be taken from your first paycheck (if enrolled) and will continue each pay period throughout 2016.
Confirmation Statement After you enroll, a confirmation statement will be mailed to your home confirming your enrollment elections. Upon receipt, please review it and notify HR Direct immediately if it is not correct.
Medical and Pharmacy You will receive a new combined medical and pharmacy card from Anthem after you enroll.
Each enrolled dependent will receive their own ID card, however the account information will be the same for each dependent.
Note: Even though Catamaran will transition to OptumRx, your ID card will say Catamaran. Your prescription will be processed through OptumRx.
Dental Benefits You will not receive a dental ID card. Tell your dentist you work for L Brands and have dental coverage through MetLife. Most dentists will automatically submit your claim without the need for a claim form. To request a claim form, see page 16.
Health Care Flexible Spending Account You will receive your health care spending card from WageWorks after you enroll.
Vision Benefits You will not receive a vision ID card for the vision plan or vision discount program. See page 18 for information regarding how to receive your benefits.
Legal Insurance A membership kit will be sent to you from ARAG after you enroll.
Changes after Enrollment You must experience one of these qualified life status changes in order to make a change to your elections after your enrollment period ends.Changes must be made within 30 days of the event. • Birth or adoption or placement for adoption of a child • Marriage• Divorce or legal separation• Termination of same or opposite-sex domestic partnership, or civil
union relationship• Death of a spouse or dependent• Dependent child reaches age 263
• Termination of foster care placement or guardianship• Change in employment status impacting your dependent’s benefit
eligibility• National Medical Child Support Notice or Qualified Medical Child
Support Order (not limited to 30 days but coverage won’t be retroactive)• Entitlement to Medicare or Medicaid• Loss of other health insurance (for a reason other than failure to pay
premium)• Unpaid leave of absence• Loss of Medicaid or SCHIP or becoming eligible for premium assistance under Medicaid or SCHIP (change must be made within
60 days for Medicaid and SCHIP events)• Reduction in hours (full-time to part-time or part-time 30+ hours to
under 30 hours). You may discontinue medical coverage for you and your enrolled dependents, if you certify that you and your enrolled dependents intend to enroll in other medical coverage within two months of discontinuing your L Brands medical coverage.
Managing your Benefits To manage your benefits, see the benefits resources and contacts at the back of this booklet.
3 Coverage will end on the last day of the month of the dependent’s 26th birthday.
6 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Review the table below, considering your personal health, your family’s health, and the coverage you’ll need.
2016 Anthem Blue Cross/BlueShield Medical Plan Overview
medical programL Brands offers medical coverage through Anthem. This means you’ll have a choice of
plans that vary based on price, risk and coverage — it’s up to you to choose the plan that
fits your lifestyle and financial needs. The plan choices and possible lifestyle scenarios are
outlined below. Read on to decide the best coverage for you and your family.
ANTHEM LOW PREMIUM ANTHEM LOW DEDUCTIBLE ANTHEM IN-NETWORK ONLY
Plan profile:
You are ...
An infrequent user of health care because you are healthy. You want coverage if the unexpected happens and are okay with a higher out-of-pocket maximum.
You want to pay less out of each paycheck knowing your out-of-pocket costs may be minimal due to your good health.
A more typical user of health care – you use health care about the same amount as other people you know.
You prefer a lower out-of-pocket maximum.
You are okay paying more on a biweekly basis and prefer a lower deductible and out-of-pocket maximum. You are comfortable using ONLY in-network doctors and realize out-of-network care will not be covered.
Plan overview: Lowest biweekly premiums, but higher deductibles and out-of-pocket expenses when health care is needed.
Instead of co-pays for medical services, pay a percentage of total cost once entire deductible is paid.
Option to use any in-network or out-of-network doctor (in-network will save money).
Higher biweekly premiums than the Anthem Low Premium plan, but less out-of-pocket exposure when health care is needed.
Standard doctor and hospital visit co-pays.
Option to use any in-network or out-of-network doctor (in-network will save money).
Highest biweekly premiums, but lower out-of-pocket exposure when health care is needed.
Standard doctor and hospital visit co-pays.
Must use an in-network doctor/facility (NO COVERAGE out-of-network – you’ll pay 100% of costs).
Plan that best meets my needs:
Anthem Low Premium
Anthem Low Deductible
Anthem In-Network Only
7For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
2016 Medical Biweekly Premiums(what you’ll pay for medical coverage, pre-tax, biweekly)
Use this table to determine who will be covered with you under the plan and how much will be deducted from each paycheck for medical coverage.
Premiums above reflect the $25 non-tobacco discount. Associates
who use tobacco should add $25 to the biweekly premium amounts
listed above.
Working Spouse PremiumL Brands pays the majority of the cost of health care coverage for associates and their families.
If your spouse or domestic partner has medical coverage available through their own employer, and you choose to enroll them in the L Brands Medical Plan, this shifts health care costs from their employer to L Brands.
We charge $55 biweekly if you choose to enroll your working spouse or domestic partner in our plan and they are eligible to participate in a medical plan through their own employer. This means you’ll pay the biweekly premium for the medical plan of your choice, plus the $55 biweekly working spouse premium. You are responsible to indicate if your spouse or domestic partner has access to coverage through their own employer (during enrollment or status change).
Tobacco Differential• Non-tobacco users will pay $25 less per pay period. The biweekly
premium rates shown in the chart reflect the non-tobacco user discount. • Associates will indicate they are tobacco users through L Brands
Access (during enrollment).• A tobacco user is considered any associate who has used any
tobacco products at least one time or more per week over the prior six months. Tobacco products include: cigarettes, cigars, loose pipe tobacco, chewing tobacco, and snuff.4
• We’ll offer a tobacco cessation program to help associates quit and If they complete the program, they can have the charge removed. Recommendations from your personal physician will be accommo-dated. To learn more about the tobacco cessation program, contact HR Direct at 1-866-473-4728.
Confirm your doctor is in the Anthem network:1. Go to anthem.com2. Click on Find a Doctor (under Useful Tools – right hand side of screen)3. Enter your doctor’s name and speciality, if known4. Enter your city and state or zip (i.e. Columbus, OH or 43230)5. Indicate the plan type in the drop-down boxes: State: enter your state Plan Type: PPO Plan Name: National PPO (BlueCard PPO)6. Click on Search to confirm if your doctor is in the Anthem network7. If not, talk to your doctor about joining the network
ANTHEM LOW PREMIUM
ANTHEM LOW DEDUCTIBLE
ANTHEM IN-NETWORK
ONLY
Associate only $27.70 $46.56 $75.90
Associate
+ child(ren)
$62.08 $104.32 $170.04
Associate
+ spouse/
domestic partner
$74.10 $124.54 $203.00
Associate +
family
$89.02 $149.62 $243.88
Spousal
surcharge
if you cover a spouse or domestic partner who has medical coverage avail-able through his/her own employer
+$55 +$55 +$55
Tobacco
differential
if you use tobacco (cigarettes, cigars, loose pipe tobacco, chewing tobacco, and/or snuff)
+$25 +$25 +$25
4 Electronic cigarettes (or e-cigarettes) will not count as a tobacco product for purposes of the tobacco differential.
WAYS TO SAVE
Preventive Health CareThe enterprise will pay the entire cost of your in-network preventive health-care visits. Take care of your health now so you can avoid serious health problems – and high medical costs in the future.
WAYS TO SAVE
Sticking with doctors
and hospitals
that are in-network
can save you
a lot of money.
Emergency room
If you visit the emergency room
and it’s not a true emergency, you
will be charged a $150 emergency
emergency room penalty, on top
of your deductible and coinsurance
costs. Urgent Care or “minute
clinics” in retail locations are a
great alternative.
WAYS
TO SAVE
Health Care Flexible Spending Account (FSA)• Enroll in the FSA and set aside up to $2,550 pre-tax per year from your paycheck into an account to pay for eligible health-care expenses like co-pays, deductibles, coinsurance,
prescriptions, eye glasses, contacts and covered
dental expenses. Rollover up to $500 of your unused funds so you can spend it in the following year.• The money you set aside is added to a Visa
card on January 1. Use the money throughout
the year and then pay it back through biweekly payroll deductions. And since the money you
set aside is pre-tax, you’ll lower your taxable income – and you won’t pay taxes on the money in your account.
WA
YS
TO SA
VE
8 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
9For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
WAYS TO SAVE Telemedicine: LiveHealth OnlineInteract with a doctor live online through your Android or iOS computer, tablet and mobile device.• Available real-time, 24 hours a day/7 days a week/365 days
a year in most states• Doctors are in-network, U.S. board-certified and can ePrescribe to local pharmacies (where applicable)• Low Deductible and In-Network Only Plans: $15 co-pay
(Visa, MasterCard and Discover) • Low Premium Plan: $49 applied to deductible, once deductible is met, 20% coinsurance applies To learn more and use telemedicine services, log on to www.livehealthonline.com
Medical Services CostsExplore what you’ll pay on an annual basis for medical services.
If you visit the emergency room for a non-emergency, you will be charged $150 emergency room penalty along with any other incurred expenses-subject to your deductible and coinsurance.
Common TermsCo-pay: a flat fee for medical service. Your co-pays will count toward your out-of-pocket maximum.
Deductible: The amount you pay up front for covered medical services before coinsurance kicks in and then you’re done with the deductible for the year. Your deductible will count toward your out-of-pocket maximum.
Coinsurance: The percentage you pay for covered medical services once your deductible is paid – and then L Brands pays the balance.
Out-of-pocket maximum: The most you’ll pay for covered medical services in a year – so you’re protected from high-cost claims. Once your share of medical expenses reaches the maximum, L Brands will pay 100% of your covered services for the balance of the year. These apply to your out-of-pocket maximum: co-pays, deductibles and coinsurance (excluding pharmacy). Out-of-pocket maximums exclude balance billing by out-of-network providers.
ANTHEM LOW PREMIUM ANTHEM LOW DEDUCTIBLE ANTHEM IN-NETWORK ONLY
IN-NETWORK OUT-OF-NET-WORK
IN-NETWORK OUT-OF-NET-WORK
IN-NETWORK OUT-OF-NET-WORK
Preventive Care
- preventive physical exams- well woman- well baby/child- immunizations
Company pays 100%
Deductible + CoInsurance
Company pays 100%
Deductible + Coinsurance
Company pays 100%
You pay 100% (except emer-gency-covered in-network)
Co-pay: Telemedicine Anthem Low Premium is a coinsur-ance plan. Pay your deductible first, then pay coinsurance up to the out-of–pocket maximum
$15 Co-pays do not apply. Pay your deductible first, then coinsurance up to the out-ofpocket maximum
$15
Co-pay: Retail Clinics $25 $25
Co-pay: Primary Care Doctor
$35 $35
Co-pay: Specialist $50 $50
Co-pay: Urgent Care $50 $50
Co-pay: Outpatient Care $50 $50
Co-pay: Inpatient Care $150 $150
Deductible: Individual $1,000 $2,000 $500 $1,000 $250
Deductible: Family $2,000 $4,000 $1,000 $2,000 $500
Coinsurance: 20% 50% 20% 40% 10%
Out-of-Pocket Maximum:
Individual$4,500 $10,000 $1,500 $3,000 $1,000
Out-of-Pocket Maximum:
Family$9,000 $20,000 $3,000 $6,000 $2,000
Each of our medical plans will protect your finances with an out-of-pocket maximum. That means if you encounter a
high-cost claim, you’ll never pay more than the out-of-pocket maximum amount each year.
10 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Exa
mp
leMedical CostsBelow are hypothetical medical cost examples based on different health-related scenarios.
LOW PREMIUM
LOWDEDUCT-
IBLE
IN-NET-WORK ONLY
Associate only
Annual biweekly premium
$500 $900 $1,500
Deductible, coinsurance, copays
$150 $50 $50
Total $650 $950 $1,550
Associate + child and has knee surgeryAnnual biweekly premium
$1,200 $2,000 $3,300
Deductible, coinsurance, co-pays
$1,600 $1,100 $650
Total $2,800 $3,100 $3,950
Associate + spouse - Chronic health issues (both hit their out-of-pocket maximum)
Annual biweekly premium
$1,400 $2,400 $4,000
Deductible, coinsurance, co-pays
$9,000 $3,000 $2,000
Total $10,400 $5,400 $6,000
Associate + family - Having a baby (normal delivery)Annual biweekly premium
$1,700 $2,900 $4,800
Deductible, coinsurance, co-pays
$2,650 $1,600 $1,100
Total $4,350 $4,500 $5,900
Annual premiums include 25% pre-tax savingsEach covered member sees doctor one time
(non-preventive)
Doesn’t include prescriptions costs
Doesn’t include tax savings if you enroll in the FSA
Note: Do not use these examples to estimate your actual cost for these or other
medical situations. The medical services you receive and the cost of those
medical services are likely to differ. These examples are solely intended to
illustrate the general relationship between premiums and your out-of-pocket
costs. You must consider what you are willing to pay for coverage on a biweekly
basis vs. what you can afford to pay out-of-pocket when you receive medical
services. Think about your current medical needs and the possibility of
unexpected medical needs. Use the worksheet on page 11 to help you
determine the best plan choice for you.
Don’t overpay for a medical
plan that you might not use.
The reality is many people only get
a physical, or might have a minor medical
need during the year – so that means a no
cost preventive physical exam – and maybe
a trip to a “minute clinic” or urgent care. Determine your medical needs and
what you can afford to pay in out-of-
pocket costs. If you enroll in a less costly
medical plan, consider setting aside the
money you save into a healthcare flexible
spending account - or into your personal
savings account.
Use The Wellness Center at DC 5 For your convenience, we have a wellness center in our
DC 5 office in Reynoldsburg, Ohio. If you’re an associ-
ate who lives or works near DC 5 consider using the
wellness center for these services:
• Primary care, preventive services
• Walk-in examinations and treatment
• Physical therapy
• Lab work and biometric screenings
• Immunizations, allergy shots, vaccinations
(including flu shots)
• Workplace injury/illness management
(occupational health care and rehabilitation)
• A full-service pharmacy
The Wellness Center generally offers lower costs for
service compared to a primary care doctor or special-
ist. Associates also receive special pricing, including
waived dispensing fees, at the pharmacy.
For questions or to make an appointment contact
The Wellness Center at 1.614.577.CARE (2273)
11For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
ANTHEM LOW PREMIUM
ANTHEM LOW DEDUCTIBLE
ANTHEM IN-NETWORK ONLY
Annual biweekly premium $_____x 26 biweekly pays $ _____________ $ _____________ $ _____________
Spousal surcharge $55 x 26 biweekly pays = $1430
+ $1,430 (if applicable) + $1430 (if applicable) + $1,430 (if applicable)
Smoker differential $25 x 26 biweekly pays = $650
+ 650 (if applicable) + 650 (if applicable) + 650 (if applicable)
Total annual payroll deductions$ _____________ $ _____________ $ _____________
Preventive care (company pays 100%)- Preventive physical exam- Well woman- Well baby/child- Immunizations
$0 $0 $0
Co-payPrimary doctor $ _____________
An average visit costs $90 until deductible is paid -
then pay 20% of cost
$ _____________ $ _____________
Co-paySpecialist $ _____________
An average visit costs $135 until deductible is paid -
then pay 20% of cost
$ _____________ $ _____________
Co-payUrgent Care $ _____________
An average visit costs $150 until deductible is paid -
then pay 20% of cost
$ _____________ $ _____________
Co-payRetail Clinics $ _____________
An average visit costs $75 until deductible is paid -
then pay 20% of cost
$ _____________ $ _____________
Other medical servicessubject to deductible and coinsurance (i.e. surgery, hospital visits)
$ _____________ $ _____________ $ _____________
Annual cost estimate (Annual payroll deductions + possible out-of-pocket costs)
$ _____________ $ _____________ $ _____________
Pick a Plan WorksheetUse this worksheet to think through the type of coverage you’ll need and what you might spend on medical care annually.
Annual payroll deductions
Use the medical biweekly premium chart on page 7 to determine the biweekly payroll deductions for each medical plan – and if applicable the biweekly spousal/domestic partner surcharge and smoker differential.
Out-of-pocket costs
Estimate your 2016 annual out-of-pocket costs for the various medical services you may need. Work with your doctor to understand actual service costs – then factor in fixed co-pays – and if applicable your deductible and coinsurance.
Assumes in-network care. Using out-of-network will increase your costs.
Out-of-network services are not covered under the Anthem In-Network
Only plan – you’ll pay 100% of the cost.
$35 per visit x ______ visits
$50 per visit x ______ visits
$50 per visit x ______ visits
$25 per visit x ______ visits
12 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
pharmacy program
Whatever medical plan you choose, you’ll receive pharmacy benefits through OptumRx
(formally Catamaran), our pharmacy administrator. Over the following months, Catamaran
will transition to OptumRx. Your pharmacy benefits will not change, and any information
regarding the transition will be sent to your home from Catamaran and OptumRx.
5 Compounded medications containing one or more ingredients that are prepared on-site by a pharmacist are classified at the tier three level, provided that the indi-
vidual ingredients used in compounding are covered under the pharmacy benefit.
LOWEST COINSURANCE OPTIONAlways consider tier one medications if you and your doctor decide they are right for your treatment.
TIE
R 1
MIDDLE COINSURANCE OPTIONConsider tier two medications if you and your doctor decide there are no tier one options appropriate to treat your condition.
Ask your doctor if there are tier one alternatives or
over-the-counter brands that are equivalent to tier two
medications — they may be used to treat the same
condition, but are less expensive.
TIE
R 2
HIGHEST COINSURANCE OPTIONIf you are currently taking a medication in tier three, ask your doctor whether there are tier one or two alternatives appropriate for your condition.5
The most current Prescription Drug List (PDL) can be found
on www.mycatamaranrx.com. Keep in mind the PDL changes
periodically which means cost may fluctuate throughout
the year.
TIE
R 3
TIER ONETIER TWOPreferred
Brand
TIER THREENon-
Preferred Brand
MAXIMUM SUPPLY
ANNUAL PHARMACY
DEDUCTIBLE
CO-INSURANCE
CO-INSURANCE
CO-INSURANCE
Retail Prescriptions
30-days $50 Individual$100 Family(amount you pay first)
15%Min: $15 Max: $30
20%Min: $40Max: $80
40%Min: $55Max: $95
Retail Prescriptions (90 days)
90-days15%Min: $45Max: $90
20%Min: $120Max: $240
40%Min: $165Max: $285
Mail Order 90-days No Deductible15%Min: $35Max: $75
20%Min: $95Max: $200
40%Min: $130Max: $270
When covered prescriptions are filled under the pharmacy program, you share a portion of the cost, and we pay the rest.
Calendar Year Pharmacy Out-of Pocket Maximum
WAYS TO SAVE
No-cost preventive
care drugs
Certain preventive care drugs are
offered at no-cost when you fill your
prescription through a network
pharmacy - contraceptives, aspirin,
fluoride, folic acid and iron supple-
ments, smoking cessation drugs
and preventive immunizations.
Ask your doctor about no-cost options
that are right for you.
ANTHEM LOW
PREMIUM
ANTHEMLOW
DEDUCT-IBLE
ANTHEM IN-NET-WORK ONLY
Individual $2,350 $5,350 $5,850
Family $4,700 $10,700 $11,700
13For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Exa
mp
le
ACTUAL DRUG COST
$176.29
YOU PAY$26.44
• Actual drug cost is more than $15 and
• 15% of actual drug cost is between the $15 minimum and $30 maximum ($176.29 x 15% = $26.44) therefore
• You pay $26.44
ACTUAL DRUG COST
$308.46
YOU PAY$30.00
• Actual drug cost is more than $15 and
• 15% of actual drug cost is more than the $30 maximum ($308.46 x 15% = $46.27) therefore
• You pay the $30 maximum
ACTUAL DRUG COST
$5.72
YOU PAY$5.72
• Actual drug cost is less than $15
• You pay actual cost of the drug
ACTUAL DRUG COST
$18.95
YOU PAY$15.00
• Actual drug cost is more than $15 and
• 15% of actual drug cost is less than the $15 minimum ($18.95 x 15% = $2.84) therefore
• You pay the $15 minimum
How the Pharmacy Plan WorksBelow are hypothetical pharmacy cost examples based on Tier One (typically generics). Coinsurance is 15% with a $15.00 minimum and $30.00 maximum once your annual individual or family deductible has been paid. Ways to saveSince you’ll be sharing in the cost of your prescriptions, it will pay to shop around – and find ways to save:• Use OptumRx’s cost comparison tools – online, on your smartphone or tablet to identify: – lower cost drug alternatives – pharmacies with lowest
prices
Connect with OptumRx Note: Until further notice,
you’ll continue to access
your account through
mycatamaranrx.com.
Find a pharmacy – with the lowest cost drug, learn about your drug, manage your Home Delivery prescriptions, keep track of your health history, and more!
www.mycatamaranrx.com
Download the Catamaran app on your smartphone
You’ll need your member ID (found on your ID card) to register.
Contact member services 24 hours-a-day, 7 days-a-week1.855.395.2022
ANTHEM LOW
PREMIUM
ANTHEMLOW
DEDUCT-IBLE
ANTHEM IN-NET-WORK ONLY
Individual $2,350 $5,350 $5,850
Family $4,700 $10,700 $11,700
14 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
What are tiers, and how do they affect what I actually pay at the pharmacy?Prescription medications are categorized within three tiers. Each tier is assigned a coinsurance, which is the amount you pay, after the deductible, when you visit the pharmacy or order your medications at www.CatermaranRx.com.
How do I know what tier my medication falls under?A prescription drug list (PDL) is created by OptumRx that categorizes brand name and generic medications that have been approved by the U.S. Food and Drug Administration as safe and effective. Once you and your doctor have agreed upon a treatment plan, your doctor can consult the PDL to prescribe you the most effective, affordable option. • Doctors in the Anthem network receive a copy of the PDL from
OptumRx. In addition, the PDL is available to doctors online at www.mycatamaranrx.com.• The PDL does not restrict what your physician can prescribe or what a pharmacist can dispense. You and your physician decide
which medications you should take.
How does my pharmacist know which tier my medication falls under?The pharmacist receives an electronic message advising the applicable coinsurance based on the medication prescribed by your doctor.
What if I am currently taking a medication that moves up a tier and causes me to pay higher coinsurance? Ask your doctor if there are alternatives under a lower tier, or over-the-counter medications. Also, keep in mind there are other savings opportunities such as the home delivery pharmacy.
Where do I find information regarding my pharmacy benefits such as tier pricing?Go to www.mycatamaranrx.com.
Can my medication change tiers throughout the year?Updates to the PDL are made periodically which means when a medication changes tiers, you may be required to pay more or less for that medication. These changes may occur without prior notice to you. Log on to www.mycatamaranrx.com, or call the customer service number on your medical/prescription ID card for prescription tier information about a particular medication.
6 You will be charged a home delivery coinsurance regardless of the days supply written on the prescription (i.e., a 30-day supply prescription filled through the
home delivery pharmacy service will be assessed the 90-day home delivery coinsurance). Therefore, to maximize your savings, be sure your physician writes
the prescription for a 90-day supply with up to three refills as appropriate.
Use the home delivery pharmacyIf you take a prescription medication on an ongoing basis, consider the home delivery pharmacy.
Home delivery pharmacy service (HDPS) is the fastest and easiest way to get your ongoing prescription medications. And it costs less than going to your local retail pharmacy. • Prescription drugs are sent directly to your home. Plus, standard shipping is always free!• Orders include up to a 90-day supply on most medications
(with up to three refills).6
• Save on medications, compared to your local pharmacy costs.• If you’re enrolled in the health care flexible spending account
(FSA), use your WageWorks visa card to pay for your home delivery prescriptions. You’ll not only save by using the home delivery service, you’ll also save by using your pre-tax
FSA dollars!
Keep these things in mind
1 When your doctor prescribes a new medication that you will be taking on an ongoing basis, consider using the HDPS.
2 When using HDPS for a new medication, be sure to request two copies of the prescription. The first prescription, up to a
one–month supply to be filled at your local retail pharmacy. The second prescription, for a 90–day supply with additional
refills, to be filled by HDPS. (When half of the first prescription is gone, mail in the 90–day prescription to the home delivery service.)
3 You can fill your first prescription of a new medication by mail. All subsequent refill prescriptions can be filled online (www.mycatamaranrx.com), mail, fax or phone. And remember,
vitamins and other over-the-counter medicines are available at discounted prices.
To get started, call 1.855.395.2022 or log on to www.mycatamaranrx.com > Pharmacies & prescriptions
WAYS
TO SAVE
15For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
WA
YS
TO SA
VE
Generic medications
will save you money!
What is the difference between brand
name and generic medications?
Generic medications are medications that contain the same
active ingredients as brand name medications, but they often
cost less. Generic medications become available after the
patent on the brand name medication expires. Generic
medications cost less because they do not require the same
level of sales, marketing, research and development as
brand name equivalents.
Ask your doctor about lower cost alternatives so you’ll pay
less at the pharmacy.
Half Tablet ProgramAsk your doctor if your medication is appropriate for the voluntary tablet splitting program. Here’s how it works:1. Doctor writes your prescription for twice the
dosage and half the quantity, noting your in-tent to split the tablets on your prescription.
2. Fill prescription at your local “network” pharmacy or through the on-line home delivery program.3. Split each tablet and take half – you’ll get
your usual dose for half the cost. Note: Not all medications are appropriate for tablet splitting. Always consult with your doctor before splitting any medication. Ask your pharmacist about devices that are appropriate for tablet splitting.
Visit a pharmacy that offers reduced-cost prescription optionsIf your prescription drug is offered at an amount that is less than the tier-one coinsurance, take advantage of it.
If you live or work near DC 5 in Reynoldsburg, Ohio, consider using the Walgreens pharmacy in the DC 5 lobby. L Brands associates get discounts on prescriptions and over-the-counter medications and products.
WAYS
TO SAVE
16 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
2016 Dental Biweekly Contributions
Go In-Network and SaveOnce enrolled, save money by going to an in-network dentist in the preferred dental provider network (PDP). When you do you’ll get network discounts, better coverage and lower cost sharing. To find an in-network dentist log on to www.metlife.com/mybenefits or search from your metlife smart phone app.
An example of savings by visiting a participating MetLife PDP DentistIn the example below you save $29 by using a PDP provider. For additional savings, you could also enroll in the health care FSA and use the money you set aside pre-tax to pay for the eligible dental expenses not covered by the plan.
Dental Claims/ID CardsYou will not receive a dental ID card. Tell your dentist you work for L Brands and have dental coverage through MetLife. Most dentists will automatically submit your claim without the need for a claim form. To request a claim form log on to www.metlife.com/mybenefits or call 1.800.942.0854.
dental programL Brands offers one dental plan through MetLife with two ways to use it: in-network
coverage or out-of-network coverage.
Find a dentist, or ask a question. www.metlife.com/mybenefits
Download the Metlife app to your smart phone.
1.800.942.0854
COVERAGE LEVELDENTAL PLAN
BIWEEKLY CONTRIBUTION
Associate Only $4.46
Associate + Child(ren) $9.48
Associate + Spouse or domestic partner $11.50
Associate + Family $16.08
Working Spouse Premium
n/a
ADULT CLEANING, ORAL EXAM, FILMIN-
NETWORK
OUT-OF-
NETWORK
Amount billed $180 $180
Network discount - $80 - $50
Total cost of care $100 $130
Cost you share with L Brands
L Brands pays $100 X 90%
$90
$130X 70%
$91Your out-of-pocket costs $10 $39
17For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
2016 Dental Plan Coverage
ANNUAL DEDUCTIBLES IN-NETWORK OUT-OF-NETWORK
• Preventive and diagnostic services• Basic and major restorative services
No deductible $50 per person7
No deductible$50 per person7
COVERED SERVICES
Preventive and Diagnostic
• Up to two oral examinations per calendar year• Up to two prophylaxis per calendar year (cleaning and scaling of teeth)• One fluoride treatment per calendar year for dependent children up to age 14• One sealant per tooth (on permanent first & second molars) every 60 months for dependent children up to age 19• One set of full mouth x-rays every 60 months• One set of bitewing x-rays per calendar year• X-rays to diagnose a specific condition (except for orthodontics)• Space maintainers up to age 14• Emergency palliative treatment
90% coverage 70% coverage
Basic Restorative
• Fillings (including composite, silver amalgam, silicate and acrylic restorations)• Outpatient oral surgery• Extraction (with the exception of impacted wisdom teeth)• Endodontics (including root canal therapy)
80% coverage after satisfaction of the calendar year deductible.
60% coverage after satisfaction of the calendar year deductible.
Major Restorative
• Gold fillings• Crowns - one every 84 months (per tooth)• Inlays and onlays (cast restoration replacement every 84 months)• Up to four periodontal treatments per calendar year - Periodontal surgery limited to one per area every 36 months (same surgery) - Scaling and root planing limited to one per area every 24 months• Impacted wisdom teeth extractions• Dental implants – one every 84 months• Temporomandibular Joint (TMJ syndrome appliances or treatment; up to $500 over your lifetime• The initial installation of fixed bridge work and partial or fully removable denture or bridgework• Replacement of an existing fully removable denture if over 84 months since installed• The addition of teeth to an existing partially-removable denture or to bridge work is also covered. Before you can do this, you need to provide proof of the following: - The existing denture or bridgework cannot be made serviceable and was installed at least
84 months ago. - The existing denture is an immediate temporary denture which cannot be made permanent. - Replacement by a permanent denture must take place within twelve months of the date of
the initial installation.
50% coverage after satisfaction of the calendar year deductible.
50% coverage after satisfaction of the calendar year deductible.
Orthodontics8
You or any of your dependents must be under the age of 19 to be eligible for orthodontic coverage. No benefits are payable after attainment of age 19.
50% coverageNo Deductible
50% coverageafter satisfactionof a one-time $100deductible.
Maximum Benefits
• Combined annual maximum for preventive/diagnostic, basic restorative and major restorative.• Lifetime maximum for orthodontics• Lifetime maximum for treatment of TMJ
$1,5009
$1,2509
$50010
$1,5009
$1,0009
$50010
7 If you have satisfied the Deductible for either Basic or Major Restorative Services, you have satisfied the annual Deductible requirement. The $50 Deductible for Basic and Major Restorative Services is a combined Deductible for both In- and Out-of-Network services.
8 If you are considering orthodontic services, MetLife strongly suggests that you have your provider submit a pre-treatment estimate to MetLife. MetLife’s response will outline what services will be covered and how your benefits will be paid. The pre-treatment estimate will help you calculate your out-of-pocket costs for orthodontia treatment, which will vary based on whether or not your provider is in or out-of-network, our plan’s deductible requirements, and the length of the proposed treatment plan.
MetLife’s dental claim forms include a pre-treatment checkbox. You can obtain a dental claim form via L Brands Access > My Benefits > Benefits Forms > Health > Dental Expense Claim Form or by calling MetLife. If total charges for a course of treatment are expected to be $300 or more, check the box noted “Pre-treatment estimate” and complete items 23 through 39. The completed claim form should be sent to MetLife prior to the commencement of the course of treatment. A pre-treatment estimate of benefits is not intended to preclude a course of treatment agreed upon by you and your Dentist. The intent is to avoid any misunderstanding concerning
the benefits payable under the dental plan. A pre-treatment estimate is not necessary for oral examinations, cleanings, fluoride applications, dental x-rays, or emergency treatment.9 Annual and lifetime maximum benefits are cumulative for services paid both in- and out-of-network. 10 TMJ includes a separate $500 lifetime maximum and is not subject to the annual maximum.
18 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Register on the web or over the phoneOnce enrolled, register as a member on the VSP web/over the phone. You’ll be asked to enter a member id. Follow the format below to create your member ID.Assume your birthday is March 19, 1963 and the last four digits of your SSN are 1234.
Birth year (4 digits) + birth month (2 digits) + birth day (2 digits) + last 4 digits of your SSNYour member id = 196303191234
2016 Vision Biweekly Contributions
VSP Vision PlanIf you are eligible for benefits you may choose and pay for vision plan benefits. You’ll receive vision care services from any licensedoptometrist, ophthalmologist, or dispensing optician, whether they are in- or out-of-network providers.
If you go to an in-network doctor from the VSP provider network you’ll receive a higher level of coverage and your out-of-pocket costs will be lower.
The 2016 vision plan coverage chart outlines the coverage under the vision plan.
Is my Doctor inthe Network?To determine if your doctor is a part of the VSP providernetwork:1 Log on to www.vsp.com
2 Select Members or Prospective Members > Find a VSP Network Doctor or call 1.800.877.7195
Not every doctor will be in-network. However, it’s your choice — if you choose a network doctor you will save money! Keep in mind it is not necessary to specify if your doctor is in- or out-of-network at the time of enrollment.
COVERAGE LEVELVSP VISION PLAN
BIWEEKLY CONTRIBUTION
Associate Only $3.78
Associate + Child(ren) $5.10
Associate + Spouse or Domestic Partner $5.60
Associate + Family $10.16
Working Spouse Premium
n/a
vision programL Brands offers vision coverage through Vision Service Plan (VSP). VSP offers a vision plan
option or a vision discount program.
If you choose the vision plan, you’ll find it works like our medical and dental plans.
You’ll pay before tax biweekly premiums, doctor visit co-pays and you’ll receive in- and
out-of-network benefits based on the chart on the following page. If you choose the
vision discount program, you’ll receive discounts off vision services and materials.
19For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
2016 Vision Plan Coverage
IN-NETWORK OUT-OF-NETWORK
Eye Examination11 100% after $15 Co-Pay $15 Co-Pay and allowance13 up to $50Prescription Lenses12 Lenses and frames include necessary professional services as listed:
• Prescribing and ordering proper lenses; • Assisting in the selection of frames;• Verifying the accuracy of finished lenses; • Proper fitting and adjustment of frames;• Subsequent adjustments to frames to maintain comfort and efficiency; • Progress or follow-up work as necessary.
Single Vision 100% after $25 Co-Pay $25 Co-Pay and allowance14 up to $50
Lined Bifocal 100% after $25 Co-Pay $25 Co-Pay and allowance14 up to $75
Lined Trifocal 100% after $25 Co-Pay $25 Co-Pay and allowance14 up to $100
Lenticular 100% after $25 Co-Pay $25 Co-Pay and allowance14 up to $125
Polycarbonate 100% after $25 Co-Pay No coverageFrames 100% up to $130 after payment of $25 Co-Pay
and 20% off any out-of-pocket costs.$25 Co-Pay and allowance14 up to $70
Contact Lenses13 Contact lens services and materials are covered once every calendar year instead of a frameand lenses. When contact lenses are obtained, you will not be eligible for contact lenses orframes again until the next calendar year.
Elective $120 allowance (no Co-Pay) $105 allowance (no Co-Pay)14
Necessary 100% ($25 Co-Pay) up to $210 allowance ($25 Co-Pay)14
FREQUENCY
Examination Frames, Lenses or Contacts (not both)
Once every 12 months Once every 12 months
ADDITIONAL BENEFITS
• 30% off additional glasses and sunglasses, including lens options from the same VSP doctor on the same day as your exam. Or get 20% off from any VSP doctor within 12 months of your last WellVision Exam.• 20% discount on additional nonprescription sunglasses.• Discounts on noncovered glasses and contact lens services are available from any VSP doctor within 12 months of the last covered eye exam.
ADDITIONAL EXPENSES
The vision plan covers visual needs and not cosmetic materials. If you select any of the following extras, the vision plan pays for the basiccost of the allowed lenses (as denoted on the Vision Plan Coverage chart above), and you will be responsible for paying the additionalcosts for these options:• Optional cosmetic processes • Anti-reflective coating • Color coating• Mirror coating • Scratch coating • Blended lenses• Cosmetic lenses • Laminated lenses • Oversize lenses• Photochromic lenses, tinted lenses except • A frame that costs more than the • Contact lenses (except as noted on Pink #1 and Pink #2 vision plan allowance the Vision Plan Coverage chart)• Certain limitations on low vision care • UV (ultraviolet) protected lenses
VISION PLAN EXPENSES NOT COVERED
We offer a comprehensive vision plan. However, it is not possible to cover every expense. The following list will tell you generally what isnot covered. This is not a complete or all-inclusive list, so if you still have questions, call 1.800.877.7195 for more information. Below is apartial list of vision expenses not covered:• Orthoptics or vision training and any associated supplemental testing • Plano lenses (less than a + .50 diopter power)• Two pairs of glasses in lieu of bifocals• Replacement of lenses and frames that are lost or broken, except at the normal intervals when services are otherwise available• Medical or surgical treatment of the eyes• Any eye examination or any corrective eyewear required by an employer as a condition of employment• Corrective vision treatment of an experimental nature, such as, but not limited to, RK and PRK surgery15
11 Complete initial vision analysis that includes an appropriate examination of visual functions, including the prescription of corrective eyewear where indicated. Subsequent regular vision exams every plan year beginning in January.12 Up to 30% savings in-network on lens extras such as scratch resistant and anti-reflective coatings and progressives and additional glasses and sunglasses.13 15% discount in-network of contact lens exam (fitting and evaluation). Available from any VSP doctor within the last 12 months of your last eye exam.14 If you go to an out-of-network doctor you will be required to pay for your vision related expenses in full at the time of your visit. VSP will reimburse you for any allowable
expenses once you submit a claim form. Claim forms can be found on www.vsp.com or by calling VSP at 1.800.877.7195.15 Contact VSP for Laser Vision Correction discounts. • average 15% off the regular price or 5% off the promotional price from contracted facilities. • after surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor.
20 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
WAYS TO SAVE
For additional savings, enroll
in the health care FSA and
use the money you set aside
pre-tax to pay for the eligible
vision care expenses.
VSP Vision Discount ProgramIf you choose not to enroll in the vision plan, L Brands offers the VSP vision discount to all benefits-eligible associates and their covered dependents at no cost.
The vision discount program includes:• Vision care services and materials from licensed optometrists or
ophthalmologists in the VSP provider network.• Extended customer service hours through a toll-free number
(1.800.877.7195) or through VSP’s website (www.vsp.com).• Discounts toward frames from the industry’s top manufacturers.
Receiving the Vision Discount
To ensure your doctor offers the VSP discount and to verify your discount membership, simply:• Call 1.800.877.7195 or log into www.vsp.com to locate a VSP doctor
(see Is My Doctor in the Network?). • Make an appointment and tell the doctor you are a VSP discount member. • Provide the doctor with your date of birth and last four digits of
your Social Security Number so they can confirm you’re in their system as a VSP discount member.
• Review your coverage details before your appointment.
2016 Vision Discount
VISION CARE SERVICES
Eye Examination 20% discount
PRESCRIPTION LENSES
Single Vision LenticularLined Bifocal Polycarbonate Lined Trifocal Frames
20% discount
CONTACT LENSE
NecessaryElective
15% discount on fitting and evaluation services (discount does not apply to materials)
FREQUENCY
ExaminationFramesLenses or Contacts (not both)
No limitations
SERVICE OR MATERIALS NOT OFFERED UNDER THE VISION DISCOUNT
There are no benefits for professional services or materials under the Vision Discount Program connected with the following:• Solutions or cleaning products for spectacle glasses or contact lenses.• Low vision services and materials.• Orthoptics or vision training and any associated supplemental
testing.• Plano lenses.• Medical or surgical treatment of the eyes.
ADDITIONAL DISCOUNTS
• 20% discount on additional non-prescription sunglasses.
Receiving benefits authorization under the vision plan If you enroll in the vision plan, you must receive benefit authorization before receiving services.
You will not receive a vision ID card from VSP, and you will not be required to fill out any claim forms if you use an in-network provider. Once you have been confirmed as a VSP member, your doctor will take it from there! It’s that easy.
1 Call 1.800.877.7195 or log onto www.vsp.com to locate a VSP doctor (also see is my doctor in the network?).
2 Make an appointment and tell the doctor’s office you are a VSP member. 3 Provide the doctor’s office with your date of birth and last four
digits of your Social Security Number. The doctor’s office will use this information to obtain Benefits authorization.
4 Review your coverage details before your appointment.
IMPORTANT NOTE: If you are in the vision plan and receive services from an in-network doctor prior to receiving benefit authorization, the services will be paid at the out-of-network level even if received by an in-network doctor.
21For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
health & dependent care flexible spending accounts (FSA) A flexible spending account (FSA) lets you set aside a certain amount from
your paycheck into health and dependent care accounts before federal,
FICA and most state taxes are applied to your pay. During the plan year,
you can use money from your health account to pay for eligible items like
eye glasses, co-payments, and prescriptions.16 With the dependent care FSA
you can cover expenses like day care and preschool.17
The Pre-Tax AdvantageBecause you never pay taxes on the money in your FSA, you will see savings on your paycheck — in the form of reduced tax withholding. For example, every $100 set aside through the FSA, can save some people from $30 to $40 on their federal, FICA (Social Security) and state (in most states) income taxes.
Eligibility All benefits-eligible associates can enroll in the FSA.17 You do not need to be enrolled in the medical or dental plans to participate.
You can use your health care account to pay for eligible expenses incurred by any of the following family members even if they are not covered by the medical, dental or vision plans:• You• Your spouse• Your qualifying child18
You can use your dependent care account to pay for dependent care expenses incurred by your qualifying child.18
If Your Spouse/Child Has An HSA Important consideration before you enroll: If your eligible spouse or child enrolls in medical coverage outside L Brands, and their coverage includes a Health Savings Account (HSA) account, the IRS does not allow them to contribute to their HSA if you are enrolled in the L Brands health care FSA. In part, this is because you are able to use your FSA for out-of-pocket healthcare costs of your eligible spouse/child(ren), even if you are not covering them in an L Brands medical plan.
2016 Spending Account LimitsYou can elect to set up an account for health and/or dependent care spending. In each account you can contribute amounts as indicated below:
The dependent care FSA is federally capped at $5,000 per household based on the qualifying child rule ($2,500 if married filing separately).
Estimating amounts to put in each accountYou’ll need to estimate the health and/or dependent care dollars you’ll need to set aside each year.19
WageWorks provides easy-to-use online tools that help you learn more about what expenses are covered and how much you can save.
16 A doctor’s prescription will be required for reimbursement of over-the-counter drugs and medicines.
17 If you enroll in the dependent care account the care is provided while you work or to enable you to work. If you are married, the care is provided while your spouse also works or to enable your spouse to work or go to school full-time (at least 5 months a year) or while your spouse is incapable of self care.
If you are an associate earning wages in excess of the IRS highly-compensated limit ($120,000 in 2015) you will not be eligible to participate in the dependent care flexible spending account. You are eligible to participate in the health care flexible spending account.
18 As defined by current tax law (definitions available at www.wageworks.com/employees/support-center/important-forms-aspx or call WageWorks customer service at 1.877.924.3967). Under limited circumstances your account may be used for qualifying relatives. See your tax accountant.
19 Check with your tax advisor to determine if it is best for you to take advantage of the child care tax credit or to enroll in the dependent care FSA.
HEALTH DEPENDENT
Minimum $130 per year($5 per pay check)
$130 per year($5 per pay check)
Maximum $2,550 per year($98.08 per pay check)
$5,000 per year($192.30 per pay check)
MUST RE-ENROLL ON AN ANNUAL BASIS!
22 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Managing your FSA AccountYou can get up-to-the-minute account information at any time by logging into your account at www.wageworks.com or by calling WageWorks at 1.877.924.3967. It’s always safe to set aside money for expenses you’re sure about.
Election ChangesOther than open enrollment, you can only change your enrollment election if you experience a life-changing event.
For the health care accounts, this includes:
• A change in your legal marital status (marriage, legal separation, divorce, annulment, or death of spouse).
• A change in the number of your dependents (birth, adoption, placement for adoption, or death).• A change in your or your spouse’s employment status impacting
benefits eligibility (including an unpaid leave of absence).• A dependent who satisfies or ceases to satisfy eligibility requirements.
For the dependent care accounts, this includes:
• All of the above.• Change in coverage (change in provider, cost, and/or hours).
All election changes must be made within 30 days of the date of the qualifying events listed above by contacting HR Direct.
Unused Funds
Up to $500 of your unused health care FSA
funds will roll over so you can spend it in the
following year. The $500 roll over does not
reduce the maximum amount you are able to
set aside into your health care FSA ($2,550 in
2016) – instead it will increase your account
$500, to a maximum amount of $3,050 in the
following year.
Please visit https://www.wageworks.com/
employees/benefits/healthcare-flexible-
spending accounts - fsa/fsa-eligible-expenses.
aspx for a complete list of eligible expenses.
For more information on Wageworks: www.wageworks.com 1.877.924.3967
Still not sure if a health or dependent care FSA is for you? Find out more by reading about them in the Benefits Guide, logging on to www.wageworks.com or by asking your co-workers who have participated in the FSAs.
Health CareCard Verification DeadlineAll unverified health care card purchases
will require verification within 90 days of
the transaction date. WageWorks will notify you if the transaction cannot
be automatically verified. If you do not take action and the transaction remains unverified for 90 days, the Card
will be at risk of suspension and the unverified amount will be deducted from
future reimbursement payments. Card
privileges will be automatically reinstated
once outstanding unverified card transactions no longer account for more than 50% of available balance.
need to know more? If you want to read more about our benefits, it’s all in the At Your Best Benefits Book. Log on 24/7 to L Brands Access at https://
associateresources.limited-
brands.com > My Benefits
> Benefits Books and
Resources
Health Care FSAAccount AccessThroughout the year, you’ll have access to the money you’ve saved in your health and/or dependent care accounts. WageWorks Visa provides these easy ways to access your money:
1 Use your WageWorks Card. You’ll receive your personalized WageWorks Card by mail once you enroll (unless you were
enrolled previously and your card is not due to expire). Keep it in your wallet with your other credit cards, and use it for instant access to your FSA account. Whenever you make an eligible purchase or pay a provider, use it just like a credit card. The card pays directly from your account — so you don’t have to pay the expense out-of-pocket, file a claim form, and wait for reimbursement. The dollars you elect when you enroll will all be available to use upon receipt of your card.
2 Pay online. Pay bills directly from your FSA account using the online Pay My Provider tool available through WageWorks. Just log in to your account, identify your health care provider and the amount, upload your receipts and pay your bill online. You can even schedule automatic payments for recurring expenses, like adjusting braces or chiropractic treatments.
3 File a claim. Claims are easy to complete and submit through either a paper form or online.
If you elected to put $2,000 into your health care
FSA for the year, $2,000 will be available to you
immediately to pay for your eligible health care
expenses. Once you have spent $2,000 in the given
year, you will no longer have available FSA health
care dollars to pay for eligible expenses, but will
continue to pay the account back through your
payroll deductions.Exa
mp
le
For dependent care expenses 1 Pay online. Pay your dependent care providers directly using
Pay My Provider. Not waiting for reimbursement checks saves time and gives you more control over your money.
2 File a claim. Use regular claims and get quick reimbursement with a Pay Me Back form. Unlike the healthcare account, you will only have access to your dependent care dollars equal to the amount you have contributed in to your dependent care account. For example, on February 1, you have contributed $300 in your dependent care account, You submit a day care claim for $400 (two weeks worth of day care expenses). WageWorks will automatically reimburse you $300 (what you currently have in your account) and will then reimburse the remaining $100 as your account builds back up.
23For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
2015 health, wellness, financial and lifestyle benefits
US benefits-eligible associates
Stores, home-office, distribution center and customer care center
24 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Here’s an example of how someone might use their health and dependent care FSA to save on taxes.
HEALTH CARE FSA
ELIGIBLE EXPENSES EXAMPLE YOUR ESTIMATE
Estimated yearly eligible expenses
Prescription drugs $110Doctor visits $100Annual health plan deductible
Annual dental plan deductible $50Dental fillings and crowns $200
Orthodontia (braces) $1,500Chiropractor visits
Acupuncture treatmentsCounselor or therapist visits
Prescription glasses $150Prescription sunglasses $150
Contact lenses and solutions
Diabetic supplies $240
Suggestedplan yearelection
Total of estimated expenses = $2,500 =
Estimated Taxes (40%)20 x 0.40
EstimatedSavings20
= $1,000 =
DEPENDENT CARE FSA
ELIGIBLE EXPENSES EXAMPLE YOUR ESTIMATE
Estimated yearly eligible expenses
Day care/nursery school $3,600Babysitting/au pairBefore- & after-school programs
$1,400
Summer day carePre-school
Elder careSuggestedplan yearelection
Total of estimated expenses = $5,000 =
Estimated Taxes (40%)20 x 0.40
EstimatedSavings20
= $2,000 =
Know What’s Covered (and what isn’t)Health Care FSA AccountVisit www.wageworks.com for a complete list of eligible expenses. However, generally, your health care account will cover:• Prescriptions for almost any medical condition• Bandages, band-aids, wraps and splints• Co-pay, coinsurance and deductibles — but not insurance premiums• Dental care, both preventive and restorative• Orthodontia, child and adult• Vision care, including eyeglasses, contact lenses and saline
solution• Eye surgery, including laser vision correction• Counseling and therapy• Insulin, glucose test strips, other medical devices (crutches,
blood sugar monitors, etc.) and supplies• Chiropractic care, acupuncture and some other alternative treatments• Sunscreens with SPF 30+
Dependent Care FSA AccountIf you pay to care for dependents while at work, your dependent care account will cover these types of expenses for your eligible dependents:• Babysitting (work-related, your home or someone elses home)
or au pair services• Before- and after-school programs• Expenses for pre-school, day care, summer day camps, nursery
school or similar pre-kindergarten programs• Adult or senior day care or elder care in or outside of your home
20 Tax savings amounts are examples provided for illustrative purposes only. They are based on federal, state, and FICA (Social Security) taxes that you do not have to pay through payroll deductions on amounts used to fund your account. Your actual savings may vary depending on your marginal income tax rate, whether you pay state income taxes, and other factors. Some states do not recognize tax exclusions for FSA contributions. No part of this document is tax, financial, or legal advice. You should consult your own advisors regarding your personal situation and whether this is the right program for you.
25For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
life insuranceBasic Term Life InsuranceL Brands provides all full-time benefits-eligible associates, at no cost, with basic term life insurance at one times your annual base salary through MetLife.21, 22
We automatically enroll you whether or not you enroll in the medical or dental plan. So, for example, if you enroll in your spouse’s medical plan, you’ll still have life insurance provided and paid for by L Brands.
The maximum coverage amount is $2 million.
Optional Life InsuranceIf you want to increase your total life insurance coverage beyond the basic term life coverage that L Brands provides, you may choose and pay for optional life insurance coverage through MetLife. You’ll also have the option to purchase life insurance for your spouse, civil union or domestic partner and/or dependents.
Associate Coverage
All full-time, benefits-eligible associates may purchase from one to six times their annual base salary up to $3 million. This coverage is being offered through MetLife at affordable group rates and in most cases below what you could purchase on an individual basis.
The optional life insurance rates are based on your age and your annual base salary. Rates and coverage amounts will automatically adjust during the year as you receive pay increases.
Guaranteed Issue
You will be guaranteed coverage up to three times your annual base salary at the highest multiple of your annual base salary that does not exceed $500,000. Any coverage you elect above these amounts will require Evidence of Insurability (EOI) prior to being granted.23
Evidence of Insurability (EOI)
If you enroll in coverage amounts that require Evidence of Insurability (EOI), MetLife will mail you a “Statement of Health” to be filled out and returned to them. MetLife will review the statement and respond to you in writing to confirm or deny coverage based on the information you provide. Depending on your health status, additional information may be required. Until you receive confirmation from MetLife, you will be covered at the maximum guaranteed issue amount (amount that does not require EOI). The confirmation will state the date as of which the higher level of coverage will be effective. However, if you are not actively at work on the date an increase in optional life insurance coverage would be effective, the increase in coverage will be postponed until you return to work.
Coverage Maximums
Basic Term Life: $2 millionOptional Life: $3 millionCombined Maximum (Basic Term Life and Optional Life): 7 x annual base salary
Associate with annual salary of $50,000.
1 May elect up to three times annual base salary on a guaranteed-issued basis, because that amount ($50,000 x 3 = $150,000) doesn’t exceed the guaranteed-issue amount.
2 May elect more than three times annual base salary, but will be given only three times until successfully passing EOI.E
xam
ple
21 Benefits-eligible part-time associates will receive $10,000 in annual basic term life insurance, but are not eligible for optional life insurance.
22 If you were a full-time benefits-eligible associate enrolled in the health plan on December 31, 2005, your Basic Term Life insurance coverage amount will continue to be two times your December 31, 2005 annual base salary (grandfathered) until which point one times your current annual base salary becomes equal to or greater than your grandfathered coverage amount. If you leave the company for any reason and return after 30 days, you will lose your grandfathered status. Vice Presidents and above receive basic life insurance equal to two times annual
base salary.23 Evidence of insurability = proof of good health
26 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
24 If you enroll your spouse/domestic partner in coverage amounts that require EOI, MetLife will mail your spouse/domestic partner in a Statement of Health to be filled out and returned to them. MetLife will review the statement and respond to your spouse/domestic partner in writing to confirm or deny coverage based on the information they provide. Based on their responses to the Statement of Health and the amount of coverage they elected, they may also be required to undergo a brief medical examination. Until your spouse/domestic partner receives confirma-tion from MetLife, they will be covered at the maximum guaranteed issue amount ($20,000).
Associate Calculation
If you would like to purchase optional life insurance for yourself, please refer to the Rate Calculation Chart below. To calculate your cost per pay after tax, divide the dollar amount of coverage you would like to purchase by 1000 and multiply by the rate associated with your age range.
Rate Calculation Chart
Optional Dependent Life InsuranceSpouse/Domestic Partner Coverage/Child(ren)
You can purchase life insurance for your spouse/domestic partner or child(ren) in the following amounts:
ASSOCIATE’S AGE
BIWEEKLY RATE PER $1,000 OF COVERAGE
under 25 $0.01292425 - 29 $0.01523030 - 34 $0.020770
35 - 39 $0.02353840 - 44 $0.025384
45 - 49 $0.03877050 - 54 $0.059538
55 - 59 $0.11030860 - 64 $0.169384
65 - 69 $0.32630870 and above $0.528924
You are 43 years old, and earn an annual base salary of $50,000 per year. You would like to purchase two times your annual base salary which is equal to $100,000 ($50,000 x 2).
You would be charged a biweekly rate of $0.025384 per $1,000 of coverage for an after tax deduction totaling $2.54 ($0.025384 x 100).E
xam
ple
SPOUSE/DOMESTIC PARTNER CHILDREN(14 days old through age 25)
Coverage Amount Choices
$10,000$20,000$30,000$40,000$50,000$60,000$70,000$80,000$90,000$100,000
$5,000 $10,000 The coverage amount you choose covers each eligible child for the full dollar amount.
Evidence ofInsurability(EOI)
$10,000 - $20,000 — None Required$30,000 - $100,000 — Proof of EOI24
None required.
Terminationof Coverage
At termination of employment, divorce or termination of the domestic partnership. See Continuing Life Insurance Coverage on the following page.
At termination of employ-ment or the child reaches age 26. See Continuing Life Insurance Coverage on the following page.
Costs See Rate Calculation chart on following page
$5,000 = .20 biweekly; $10,000 = .40 biweekly
need to know more? If you want to read more about our benefits, it’s all in the At Your Best Benefits Book. Log on 24/7 to L Brands Access at https://
associateresources.limited-
brands.com > My Benefits
> Benefits Books and
Resources
2015 health, wellness, financial and lifestyle benefits
US benefits-eligible associates
Stores, home-office, distribution center and customer care center
27For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Spouse/Domestic Partner Rate Calculation
If you would like to purchase spouse/domestic partner optional life insurance coverage, please use the rate calculation table below. To calculate your cost in each paycheck after tax, take the rate associated with your spouse’s age and multiply by the dollar amount of coverage you would like to purchase.
Rate Calculation Chart
TAKE NOTE:
• If an associate is enrolled in Optional Life, he/she cannot be covered by spouse/domestic partner under Spousal Life when both work for L Brands.
• An associate cannot enroll in Optional Life if he/she is already covered by spouse/domestic partner under Spousal Life when both work for L Brands.
• If an associate is enrolled in Optional Life, he/she cannot be covered by the Parent under Child Life when both work for L Brands.
• An associate cannot enroll in Optional Life if already covered by parent (when both work for L Brands) under Child Life.• If an associate is covering children under Child Life, the same children cannot be covered by his/her spouse (when both work for
L Brands) under Child Life.• Benefits-eligible part-time associates are not eligible for Optional
Associate and Dependent Life Insurance. • A spouse/domestic partner or child who is in the military or who is
living outside the United States and Canada cannot be covered.
BeneficiariesYou have the ability to name one or more beneficiaries to your term life insurance benefits at any time. To designate or change a beneficiary log on to L Brands Access at https://associateresources.limitedbrands.com or contact HR Direct. If no beneficiary exists at the time of your death, your life benefits may be paid to one or more of the following who survive you: your estate, your Spouse/Domestic Partner, your child(ren), your parent(s) or your sibling(s).
Continuing Life Insurance CoverageIf you leave the company, (or lose coverage for a certain reason) but still want life insurance coverage, there is a conversion option or a portability feature that will allow you to continue your basic term life and associate/dependent optional life insurance. Contact HR Direct for more information regarding the life insurance conversion and portability options.
For more information on life insurance, see the Benefits Guide on L Brands Access at https://associateresources.limitedbrands.com
SPOUSE/DOMESTIC PARTNER AGE
BIWEEKLY RATE PER $1,000 OF COVERAGE
under 25 $0.02307625 - 29 $0.02769230 - 34 $0.036924
35 - 39 $0.04153840 - 44 $0.046154
45 - 49 $0.07384650 - 54 $0.140770
55 - 59 $0.22984660 - 64 $0.425076
65 - 69 $0.72646270 - 74 $1.083230
75 - 79 $1.779692
80 and above $2.831538
Your spouse/domestic partner is 43 years old and you would like to purchase $50,000 of coverage.
You would be charged a biweekly rate of $0.046154 per $1,000 of coverage for an after tax deduction totaling $2.31 ($0.046154 x 50) subject to successfully passing EOI.E
xam
ple
28 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
legal insurance programL Brands offers UltimateAdvisor®, a legal insurance plan from ARAG®. If you are a full-time,
benefits eligible associate, you may enroll in and pay for legal insurance benefits for you
and your dependents.
2016 Legal Insurance Biweekly Contribution
Legal insurance helps you address everyday situations like dealing with traffic tickets, resolving warranty issues or buying a home. When you need help, don’t waste time looking for the right attorney or paying costly attorney fees, which average $323 per hour.25 Like health insurance, legal insurance offers:
Protection: feel secure knowing if you or one of your dependents suffered a serious legal issue, your assets would be protected.
Prevention: legal insurance will help you gain and maintain your legal health by offering legal preventative maintenance services — like wills and estate planning.
Convenience: enroll in the legal plan via L Brands Access.
Coverage: As an UltimateAdvisor® member, you have access to professional Network Attorneys, financial planners and other valuable resources.
You’ll simply pay the biweekly contribution for legal coverage - with no co-pays or deductibles required. Additionally, when you work with a Network Attorney for a covered legal matter, you don’t pay any attorney fees for legal consultation, office work or representation. Your legal plan covers both contested and uncontested matters, plaintiff and defendant issues – which means lower out-of-pocket costs for you compared to other legal plans.
What Do I Get When I Enroll?• In-office access to a nationwide network of more than 10,000 credentialed attorneys.• Phone access to a Network Attorney for unlimited legal advice to
help prepare documents, letters or a Will.• You can use DIY Docs® to help you create any of 300+ state-specific, legally valid documents online.
Is my attorney in the network?To determine if your attorney is a part of the ARAG Network or to locate an attorney in the ARAG Network:1 Log on to www.ARAGLegalCenter.com and enter Access Code: 15661ltd2 Click on Plan Details scroll down and select search the Attorney Finder
If you choose to use a non-network attorney you can still receive coverage for the amount listed in the certificate of insurance. Contact ARAG’s Customer Care Center for a list of covered services and amounts.
COVERAGE LEVELLEGAL INSURANCE PLAN
BIWEEKLY CONTRIBUTION
Covers yourself and all eligible dependents
$8.78
25 Average attorney rates in the United States of $323 per hour for attorneys with 11 to 15 years of experience, Survey of Law Firm Economics, The National Law Journal and ALM Legal Intelligence, July 2014.
Insurance products are underwritten by ARAG® Insurance Company of Des Moines,Iowa, GuideOne® Mutual Insurance Company of West Des Moines, Iowa or GuideOneSpecialty Mutual Insurance Company of West Des Moines, Iowa. Service products areprovided by ARAG LLC, ARAG Services LLC or Advisory Communication Systems Inc,depending on the product and state. Some products are only available through membership in the ARAG Association LC. This material is for illustrative purposes only and is not a contract. Exclusions and limitations may apply. For terms, benefits or exclusions, call our toll-free number.
29For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Legal Representation: While many legal situations can be prevented with proper advice and counsel, some require additional assistance. For those situations, the plan includes protection and legal representation. Whether in the attorney’s office or the courtroom, network attorney fees for most covered matters are 100% paid in
full, including:
You’ll also receive a minimum 25% reduced fee discount on attorney’s fees for non-covered, non-excluded issues.
Waiver of Premium If a military member who participates in the plan is called away on active duty, they receive a Waiver of Premium. Or if a plan member should die while enrolled in the plan, their dependents can remain in the plan with the premium waived for the remainder of the policy year.
Financial Education & Counseling ServicesWhen you enroll in the UltimateAdvisor, you will have access to professional financial counselors and an interactive financial planning website to help secure your financial future.
Experienced financial counselors are available to answer questions and provide guidance on a range of financial topics including:• General Financial Planning Information and Guidance• Enhanced Cash and Debt Management/Budgeting• Retirement and Investment Planning• Federal Tax Information and Education• Individual Retirement Accounts (IRAs) You also have access to an interactive financial planning website that offers:• A Personalized Financial Plan• A Step-by-Step Action Plan• Life Events Guides and Financial Articles• Online Courses• Financial Calculators• A Mutual Fund Center• Webcasts
Consumer Issues
• Auto Repair• Buy/Sell a Car• Consumer Fraud• Contractors Estate Planning
• Wills• Living Wills• Powers of Attorney• Estate Administration Debt
• Bankruptcy• Debt Collection• Garnishments• Civil Damage Defense• Libel/Slander• Pet-Related Matters Small Claims Court
• Case Assistance
Family
• Adoption• Divorce• Domestic Violence• Guardianship• Insanity/Infirmity• Name Change• Pre-Marital• School Hearings
Real Estate
• Buy/Sell a Home• Building/Zoning• Refinance a Home• Easements• Foreclosure• Neighbor Disputes Criminal Matters
• Habeas Corpus• Juvenile• Parental Responsibility
Immigration
Assistance
Taxes
• IRS Tax Audit• IRS Tax Collection Traffic without DUI
• Suspension/ Revocation• Restoration• Traffic Tickets Benefit Disputes
• Medicare/Medicaid• Social Security• Veterans Disputes with
a Landlord
• Contracts/Lease• Eviction• Security Deposit General Matters
• Affidavits• Demand Letters• Property Disputes• Promissory Notes
For more information
on UltimateAdvisor:
Talk to an ARAG Customer Care Specialist
toll-free from 7:00 a.m. to 7:00 p.m. Central Time,
Monday through Friday at 1.800.247.4184.
Visit www.ARAGLegalCenter.com and enter
Access Code: 15661ltd for more information,
including a complete list of covered matters and
coverage levels, or e-mail an ARAG Customer
Care Specialist at [email protected].
NEW FOR 2016• Identity Theft Protection with Credit Monitoring, ID Theft Restoration and $1,000,000 of Identity Theft Insurance
• Caregiving Services direct from elder care experts• Revocable Trust• Prenuptial Agreements• Expanded coverage for Minor
Traffic Tickets• Refinancing
30 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
enrollIt takes just minutes to enroll in medical, dental, vision, optional life insurance, flexible spending accounts and the legal plan.
For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
at your best
prevention, wellness and disease management
32 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Preventive Versus Diagnostic CareWhat’s the difference? Preventive care helps protect you from getting sick. Diagnostic care is used to find the cause of existing illnesses.
For example, say your doctor suggests you have a colonoscopy because of your age when you have no symptoms. That’s preventive care. On the other hand, say you have symptoms and your doctor suggests a colonoscopy to see what’s causing them. That’s diagnostic care.
No Cost Preventive Care ServicePreventive care physical exams, screenings, tests and vaccines are covered at no cost to you when you use an in-network doctor. Not all services may be right for every person, so seek your doctor’s guidance. Here’s a list of the types of covered preventive services.
why preventive care is importantWe know being at our best physically takes planning. We also know that, in matters
of health, a small act of prevention can save your life. That’s why our medical plan offers
no-cost preventive health services. We encourage you to use these services to help
prevent and detect disease early, through regular check-ups and screenings.
PREVENTIVE SERVICE
CHILD (birth through
18 years)
ADULT (19 years
and older)
Preventive physical exams • •SCREENING TESTS
Aortic aneurysm screening (men who have smoked) •Behavioral screening and counseling to promote a healthy diet • •Blood pressure • •Bone density test to screen for osteoporosis •Breast cancer, including exam and mammogram •Breastfeeding support, supplies and counseling (female) •Cervical dysplasia screening •Cholesterol •Lipid level •Colorectal cancer, including fecal occult blood test, bariumenema, flexible sigmoidoscopy, screening colonoscopy and CT colonography (as appropriate)
•
Depression screening • •Development and behavior screening •Type 2 diabetes screening • •Hearing screening • •Height, weight and body mass index (BMI) • •Hemoglobin or hematocrit (blood count) •HIV screening and counseling • •HPV screening (female) •Lead testing •
33For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
SCREENING TESTS (CONTINUED)
CHILD (birth through
18 years)
ADULT (19 years
and older)
Intervention services (includes counseling and education): • Counseling related to aspirin use for the prevention of cardiovascular disease
•
• Counseling related to genetic testing for women with a family history of breast or ovarian cancer
•
• Counseling related to chemoprevention for women with a high risk of breast cancer.
•
• Primary care intervention to promote breastfeeding • •• Screening and behavioral counseling related to alcohol misuse • •
• Screening and behavioral counseling related to tobacco use • •• Screening and counseling for interpersonal and domestic
violence • •
Newborn screening •Oral (dental health) assessment when done as part of a preventive care visit •Pelvic exam and Pap test, including screening for cervicalcancer •Screenings during pregnancy (including, but not limited to,gestational diabetes4, hepatitis, asymptomatic bacteriuria, Rh incompatibility, syphilis, iron deficiency anemia, gonorrhea,chlamydia and HIV)
•
Screening and counseling for obesity • •Screening and counseling for sexually transmitted infections. • •Vision screening when done as part of a preventive care visit •
IMMUNIZATIONS
Diphtheria, tetanus and pertussis (whooping cough) • •Haemophilus influenza type b (Hib) •Hepatitis A • •Hepatitis B • •Human papillomavirus (HPV) • •Influenza (flu) • •Measles, mumps and rubella (MMR) • •Meningococcal (meningitis) • •Pneumococcal (pneumonia) • •Polio •Rotavirus •Varicella (chicken pox) • •Zoster (shingles) •
(60 years or older)
preventive or not?When you visit your doctor, the services you receive will be considered either preventive
or non-preventive. See if you can determine in the following scenarios whether the care
received would be considered preventive or non-preventive.
Situation 1An associate visits her network doctor for her annual mammogram.
Answer: This is considered preventive care because her visit is part of a routine annual exam and has not been prompted by any sort of previous diagnosis.
Situation 2An associate visits her primary doctor and has a skin cancer screening as part of her preventive exam.
Answer: This is considered preventive care because her visit is part of a routine annual exam and has not been prompted by any sort of previous diagnosis.
Situation 3A spouse makes an appointment with a dermatologist to obtain a skin cancer screening.
Answer: The visit to the dermatologist is not considered preventive care. The spouse would be responsible for any deductible, coinsurance,or applicable co-payment.
Situation 4An associate who takes medicine for high cholesterol has an annual wellness exam and receives a blood test to measure her cholesterol level.
Answer: Although the associate is taking cholesterol medicine, the office visit and the blood test are considered preventive care because they are part of her overall wellness exam.
Situation 5A spouse makes quarterly visits to the doctor for blood tests to check his cholesterol level and to confirm the medication dosage level is appropriate.
Answer: The quarterly blood tests are considered non-preventive because they are treatment for an existing condition.
Situation 6An associate has an annual wellness exam and receives blood tests to screen for iron, kidney or liver function, in addition to a urinalysis.
Answer: If the physician orders lab work during a preventive care visit some of the tests may be covered as preventive care, such as a cholesterol screening. However, other blood chemistry panels like iron, kidney or liver function and urinalysis, would not be covered as preventive care. These are not considered services covered without cost, under the preventive care guidelines. The associate would be responsible for any deductible, coinsurance, or co-pay.
TEST YOUR KNOWLEDGE
34 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
35For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Anthem’s wellness services and disease management programsEveryone has different health needs and learning styles. Whatever yours are, Anthem’s
360° Health is here to help. From online resources to personal attention from registered
nurses, 360° Health can help you be more engaged in your health and help you make
more informed health care decisions.
Participating in the Disease Management Programs
Participation in the disease management programs is completely voluntary and without extra charge. If you think you may be eligible to participate or would like additional information regarding the program, please log on to anthem.com, or call the phone numbers provided for each service.
Anthem.comAnthem.com offers valuable health and wellness tools and resources to help you and your family make the most of - and manage - your health care. You can also find up-to-date health information, watch videos about health and wellness topics, and take advantage of health-related discounts. Log on to anthem.com and click Register to get started.
www.anthem.com
24/7 NurseLine Contact Anthem’s Nurse Coaches to talk about your general health issues any time of the day or night. Can you treat the problem at home? Do you need to see your doctor? Or should you head straight to the emergency room? Making the right call can help you avoid needless worry and expense. And, most importantly, safeguard your health and the health of your family.
24/7 NurseLine: 1.800.700.9184
Telemedicine: LiveHealth Online Interact with a doctor live online through your Android or iOS computer, tablet and mobile device.• Available real-time, 24 hours a day/7 days a week/365 days a year in most states• Doctors are in-network, U.S. board-certified and can ePrescribe to local pharmacies (where applicable)• Low Deductible and In-Network Only Plans: $15 co-pay (Visa, MasterCard and Discover)
• Low Premium Plan: $49 applied to deductible, once deductible is met, 20% coinsurance applies
To learn more and use telemedicine services, log on to
www.livehealthonline.com
MyHealth Advantage MyHealth Advantage is a free service that helps keep you and your bank account healthier.
Here’s how it works: Anthem reviews your incoming health claims to see if they can save you any money. They can check to see what medications you’re taking and alert your doctor if we spot a potential drug interaction. Anthem will also keep track of your routine tests and checkups, reminding you to make these appointments by mailing you MyHealth Note. MyHealth Notes summarize your recent claims. From time to time, Anthem will offer tips to save you money on prescription drugs and other health care supplies. If you’re eligible for this program you’ll be contacted by Anthem.
To learn more call MyHealth Advantage: 1.866.408.7197
ComplexCareYou may need ComplexCare if you have more than one health issue or a condition that could mean frequent or high levels of health care. This program can connect you, your family and your doctors with a ComplexCare nurse and other experts to help you reach your personal health goals and avoid costly hospital re-admissions.
You get 24-hour toll-free access to ComplexCare nurses for personal education, along with preventive care and self-management tips. The nurses give you personal attention and lifestyle coaching, help you make better decisions about your options, help you transition your care, and coordinate care between doctors and other health services. A nurse will contact you if you are eligible for the program.
To learn more, log on to anthem.com or call 1.888.249.3828
36 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
ConditionCare Core ProgramsIf you or someone you love suffers from a chronic health condition, let Anthem help you get more out of life. Anthem’s ConditionCare nurses help people of all ages manage the symptoms of asthma and diabetes. And they work closely with adults who are dealing with chronic obstructive pulmonary disease (COPD), heart failure and coronary artery disease. With ConditionCare you’ll get the information you need to feel your very best day after day. Anthem’s ConditionCare nurses gather information from you and your doctor and then create a personalized plan for you. A nurse will contact you if you are eligible for the program.
To learn more or to enroll in ConditionCare call: 1.800.638.4814
ConditionCare Support ProgramsIf you or a family member is diagnosed with certain types of cancer, vascular or musculoskeletal diseases, or low back pain, ConditionCare may be able to help. It’s a no-extra-charge program that gives you toll-free, 24-hour access to Nurse Coaches registered nurses who can help you better manage your health and help you follow your doc-tor’s care plan. And it’s all backed by a clinical team of pharmacists, dietitians and exercise physiologists. ConditionCare also gives you the information and tools that can help you avoid unnecessary doctor’s office visits, hospitalizations, and time away from your job.
To learn more or to enroll in ConditionCare call: 1.800.638.4814
Future MomsWe know your goal is to have a safe delivery and a healthy baby. That’s why Anthem offers Future Moms, a voluntary program to help you take care of your baby before you deliver. Register for Future Moms and you’ll get:• 24/7 toll-free access to a registered nurse who’ll answer your questions and talk about pregnancy issues with you• A helpful book: Your Pregnancy Week by Week• Materials to help you know what to do if something unexpected
happens• A questionnaire to check your risk of delivering too early• Useful tools to help you, your doctor and your Future Moms nurse
coach track your pregnancy and spot possible problems
Future Mom’s program, all or a portion of your in-patient co-pay willbe waived.26 Register for the Future Moms program at no additionalcost by calling 1.800.828.5891.
Autism Spectrum Disorder ProgramStarting January 1, 2016, L Brands will offer the following Autism Spectrum Disorder (ASD) benefits through Anthem. The ASD benefits were designed for L Brands families with children or dependents who have ASD to help find heath care and applicable resources, provide coverage for care, and lend support.
Program Benefits
Coverage for Applied Behavior Analysis (ABA)• Eligibility: Children and dependents up to age 21 years old.• Coverage is based on the plan you are enrolled in and where services are rendered (i.e. Low Deductible Plan: co-pay for office
visit or deductible and coinsurance at an outpatient facility)
• Pre-certification is required for coverage of ABA services – If your family is currently using ABA services, please verify the
provider’s network status as this may impact your share of treatment costs under your plan benefits. – In-network ABA providers can be found at Anthem.com or by
calling the Member Services number on the back of your Anthem ID card.
– Your ABA provider will need to call the pre-certification number on the back of your member ID card to initiate the pre-certification process. Pre-certification for 2016 services begins December 1, 2015.
ASD Case Management
Anthem has a dedicated team of clinicians and board certified behavioral therapists specializing in the unique challenges and needs of families impacted by ASD. The ASD Case Management program focuses on the entire family unit creating a strong system of care through engagement of community resources, medical services, behavioral health services and other supports. The program goal is better outcomes, more effective use of benefits, and healthier kids and families. Case Management support will be available beginning January 1, 2016 and can be accessed by calling the ASD Program directly at (844) 269-0538.
Behavioral Health ResourceThe Behavioral Health Resource program is a total-health solution that can help you or your loved ones deal with anxiety, depression, drug or alcohol abuse, eating disorders, autism and other personal issues.
When you call the Behavioral Health Resource center, you’ll talk with someone who has experience helping others manage problems and finding the right treatment programs and care. They want to find out what’s important to you and how they can help you cope with your situation before it takes a greater toll on your life and your health. The Behavioral Health Resource program is a comprehensive, single-source 24/7 Resource Line for access to: • Crisis management and clinical triage, including emergency or urgent behavioral health guidance, support and information• Routine inquiries about behavioral health services, providers and
hospitals• Coaching to help members make appropriate treatment decisions• Support in identifying providers with required behavioral health
specialties• Information and tools to support member health activities• Help in coordinating behavioral health, EAP and medical services• Guidance for engaging members in other beneficial care programs
and health care decisions can reduce time lost on the job and optimize costs of care
There is no cost to use the program. To get the help you need, call the Behavioral Health Resource Center any time of day or night at 1.866.621.0554.
Note: L Brands also offers behavioral health resources through the Maxtrix EAP. See page 37 for more information.
26 Completion of the Future Moms program results in eligibility for the incentive pro-vided by L Brands. Depending on time of registration, you can earn either a $150 (first trimester), $100 (second trimester) or $75 (third trimester) in-patient co-pay reimbursement. This incentive will be adjudicated via Anthem’s provider payment process. In the event your out-of-pocket maximum has already been met, Anthem will apply your incentive to any other open claim opportunities. Please review your Explanation of Benefit statements provided by Anthem for applicable adjustments.
37For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
With the Matrix EAP, you’ll find services, referrals and support that will improve your life at home and at work. • Seek help 24 hours a day — nationwide.• No cost to all eligible associates and their eligible dependents
whether or not you are enrolled in the medical plan. • All services are strictly confidential.• No information about your case can be released without your written consent.
Confidential Counseling Matrix will provide eight counseling sessions27 with a Psychologist for you and your covered dependents. Matrix will put you in touch with a trained professional who is prepared to help you and your family with each specific need— especially when situations are too difficult to handle alone.
In most situations, your case will conclude within the sessions provided. However, if your situation requires additional sessions, you may continue to see your Psychologist or may be referred to another therapist under the terms of the medical plan.28
Legal and Financial Resources and Referrals Matrix can help if you or your covered dependents are experiencing legal or financial challenges. You can arrange for one free telephone consultation with an attorney or financial counselor, or you can schedule a free half hour, face-to-face appointment with an attorney.
You may not use the Matrix EAP for any legal actions against L Brands.
Help with Elder Care Issues If you or your covered dependent are faced with caring for an adult or elder dependent, you can access elder care resources and references through the EAP. Specially trained professionals in geriatrics are available via the telephone to listen to your concerns, answer questions, and put you in touch with community resources best suited to your needs.
Scheduling an Appointment You and your family can contact the EAP personally and privately to ask about services and make an appointment — simply contact Matrix.
In Columbus Outside Columbus
1.614.475.9500 1.800.886.1171
The experienced staff at Matrix will schedule an appointment with a Psychologist at a time and place that is convenient for you. Telephone coverage is provided 24 hours a day.
If you’re enrolled in the medical plan, you also have access
to the Anthem Behavioral Health Resource program. Together,
Matrix and the Anthem Behavioral Health program can
help you when you need it
most. See page 36 to learn
more about the Anthem
Behavioral Health program.
matrix employee assistance program (eap)The EAP is a service that can help you and your eligible family members identify and
resolve personal situations before they negatively affect your health, your interpersonal
relations, and your work performance.
contact
matrix
In Columbus
614.475.9500
Outside Columbus
1.800.886.1171
www.matrixpsych.
com
Matrix EAP Services Alcoholism/drug abuseAnger managementAnxiety or depressionChildren & family issuesCrisis intervention
Eating disorders and ObesityElder careEmployment stressFinancial or legal problemsGrief & loss
Marital issues
27 Associates or family members are entitled to eight sessions per individual issue, renewable on the anniversary date of the first appointment.
28 The Associate must be enrolled in one of the Anthem medical plans for further treatment as described.
38 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
a few other thingsThis booklet provides general explanations of the 2016 L Brands health and wellness
benefits programs. While every effort has been made to ensure accuracy, if any
discrepancies exist between this booklet and the governing plan documents, the
governing plan documents will prevail. If you need legal, financial or other professional
advice, you should seek the services of a competent professional.
While L Brands intends to continue its benefits program, the company retains the absolute and unconditional right to change, suspend or discontinue any of the benefits described in this booklet. For matters identified as new, this booklet also serves as the summary of material modifications to the benefits programs in the At Your Best Benefits Book.
Where to find benefits information and notificationsTo learn more about your benefits, reference benefits books and legal notices listed below on L Brands Access (https://associateresources.limitedbrands.com > My Benefits > Benefits Books and Resources)
Benefits Guides At Your Best Benefits Book: Description of all benefits offered by the enterprise. What’s Your Plan?: Provides general explanations of the L Brands health and welfare benefits programs, including how and when to enroll during open enrollment and when an associate is newly hired.
Summary of Medical Coverage (by plan type)
• Anthem Benefits Book: Description of the medical plans offered through Anthem.
• Summary of Benefits Coverage: Summary of coverage for each medical plan offered to participants enrolling this year.
401(k) Savings and Retirement Guide: Describes the L Brands, Inc. Savings and Retirement Plan, including how to enroll and manage your account.
Benefits Notifications Credible Prescription Drug Coverage Disclosure Notice for
Medicare-Eligible Associates and Medicare-Eligible Family Members
of Associates: A notice that provides information about prescription drug coverage under the L Brands medical plans and your option under Medicare’s prescription drug coverage (Medicare Part D).
Medicaid and CHIP Notice: A notice that explains programs that help Medicaid and CHIP-eligible children and families in some states pay for health coverage from their employers.
Privacy Notice (HIPAA): A notice that describes how medical information about you may be used and disclosed.
Summary Annual Report (Health Plan and Savings and Retirement
Plan): A summary of the main points made in the annual financial report for each of the plans.
Women’s Health and Cancer Rights Act: A notice of post-mastectomy services to group health plan participants.
Insurance MarketplacesThe Affordable Care Act has created “insurance marketplaces” for individuals and families to shop for medical care. In additional to our company’s medical plan, some associates may now be eligible for coverage under Medicaid or through an insurance exchange. To learn more, log on to the government’s website at https://www.healthcare.gov/health-insurance-marketplace/.
Marketplace Notice: A notice that explains the availability of health insurance in the new health insurance marketplace and when you might qualify for federal help to buy health insurance in a marketplace. The Marketplace Notice is posted on L Brands Access and is described above.
If you want a paper copies of
the of benefits books, legal
notices and/or any other
materials related to your
benefits, call HR Direct
at 1.866.473.4728 to request
that a free paper copy be
mailed to you.
39For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Notice of Special Enrollment RightsIf you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance, or group health plan coverage, you may be able to enroll yourself and your dependents in the medical plan if you or your dependents lose eligibility for that other coverage (or if the other employer stops contributing towards your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the other employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. Similarly, if you or your dependents lose coverage under Medicaid or SCHIP or you or by your dependents become eligible for premium assistance under Medicaid or SCHIP, you may be able to enroll yourself and your dependents provided you request enrollment within 60 days from the date of the loss of eligibility for Medicaid or SCHIP or the date of eligibility for premium assistance. To request enrollment or obtain more information regarding enrollment rights refer to At Your Best Benefits Book or contact HR Direct at 1.866.473.4728.
40 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
The L Brands benefits under the plan are administered through insurance companies and other service providers. For purposes of simplification, this Notice will use the term “claims administrator” to refer to Anthem (also known as Anthem Blue Cross/Blue Shield), MetLife, Vision Service Plan, Matrix, OptumRx and WageWorks. You may receive separate Notices from one or more of the claims administrators describing how they use and disclose protected health information. If so, the claims administrator will follow its own privacy practices to the extent those practices are more restrictive (i.e., more protective of your privacy) than those described in this Notice.
The plan is required by law to maintain the privacy of participants’ protected health information and to provide participants with notice of its legal duties and privacy practices regarding your protected health information.
Your health information is highly personal, and the plan is commit-ted to safeguarding your privacy. For plan administration purposes, the plan and the claims administrators (and any other outside service providers working with the plan) create records (such as records of health claims), which comprise your protected health information, and this Notice applies to all such records. Your actual health care provider (like your doctor) may deliver its own notices and practices, as well.This Notice summarizes how the plan may use and disclose your protected health information, and describes your ability to access and control the use and disclosure of your protected health information.
The plan must abide by the terms of this Notice of Privacy Practices as currently in effect. L Brands reserves the right to change the terms of this Notice and to make the new Notice effective for all protected health information held by or on behalf of the plan. In the event of a change, you will be provided with a revised dated Notice of Privacy Practices.
Use or Disclosure of Your Protected Health InformationThe plan may use or disclose your protected health information without your authorization for the following reasons:
Treatment
Your protected health information may be used or disclosed to carry out medical treatment or services by providers. For example, in carrying out treatment functions, the plan claims administrators could use or disclose your protected health information to protect you from receiving inappropriate medications, or share information with relevant parties about prior prescriptions if a newly prescribed drug could cause problems for you. The plan also may share information about prior treatment with a provider who needs that information to treat you or your family properly.
Payment
Your protected health information may be used or disclosed to determine your eligibility for plan benefits, to coordinate coverage between this plan and another plan, and to facilitate payment for services you receive. For example, the plan may share your information with an outside vendor, to review how certain services are used, or to help ensure that the plan is properly reimbursed, where a third party is ultimately responsible for bearing the medical costs in question.
Health Care Operations
Your protected health information may be used and disclosed for various administrative purposes that are called health care operations of the plan. For example, your information might be included as part of an audit designed to ensure that the plan’s outside claims administra-tor is performing its job as well as it should be. And your information, along with that of all other participants, may be used and disclosed
notice of health plan privacy practicesTHIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW
THIS NOTICE CAREFULLY.
This Notice applies to the L Brands medical, dental and vision benefits, EAP and health
FSA, effective January 1, 2016. For purposes of simplification, this Notice uses the term
“plan” to refer to these different benefits. This Notice does not apply to other L Brands
benefit programs such as long- and short-term disability, workers compensation, life
insurance, or travel accident insurance.
41For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
each year to set appropriate premiums for the plan or to secureinsurance to protect the plan or its sponsor, financially. The plan may not use or disclose genetic information for underwriting purposes.
Communications about Benefits
The plan may use or disclose your protected health information to send you (1) treatment reminders for services like mammograms or prostate cancer screenings, and (2) information about alternative medical treatments and programs or health-related products and services that may interest you. For example, the plan might send you information about smoking cessation or weight-loss programs.
Disclosures to the Plan Sponsor
To determine if and when you and your family members are covered by the plan, the plan will share enrollment information about you and your family members with L Brands. The plan will also periodically disclose protected health information to designated employees of L Brands so that they can (1) assist participants with benefits questions, problems and appeals; (2) perform financial planning and projections; (3) monitor the performance of third parties; and (4) oversee and assist with the administration of the plan. L Brands will only use the protected health information for these purposes, for the purposes you authorize, or as the law requires.
Disclosures to Business Associates
The plan often relies on the Claims Administrator and outside ser-vice providers (generally known as “business associates”) to handle important administrative tasks on behalf of the plan. These business associates are contractually required to safeguard your information and perform its duties in a manner consistent with this Notice.
As Required by Law
The plan will use or disclose your personal health information when required to do so by federal or state law, including in response to a court or administrative order, subpoena, discovery request, warrant, summons or other lawful process. The plan also may disclose protect-ed health information to law enforcement personnel or similar persons to avoid a serious threat to the health or safety of a person or the public.
Disclosures to Friends and Family
With your authorization, the plan may disclose protected health infor-mation to a family member, a friend or any other person you identify, provided that information is directly relevant to enable that person’s involvement with your health care or payment for that care. You have the right to stop or limit this kind of disclosure.
No Other Uses or Disclosures without Your Authorization
Other than the uses and disclosures described in this Notice, the plan may not disclose your protected health information or make any other use of it without your written authorization. Certain actions — such as most uses or disclosures of psychotherapy notes, the use or disclosure of protected health information for marketing purposes, or the sale of protected health information — may be made only with your written permission (authorization). You may revoke any such authorization by writing to the claims administrator at Anthem Customer Service P.O. Box 105557, Atlanta, GA 30348. Once you revoke your permission, the plan will stop using or disclosing such information for the reasons
covered by your written authorization. However, the plan cannot take back any disclosures made with your permission. To submit or revoke authorizations for other L Brands Plans, please write to:
Vision Service Plan (VSP)
3333 Quality Drive Rancho Cordova, CA 95670
Matrix
2 Easton Oval, Suite 450 Columbus, OH 43219
OptumRX
1600 McConnor Parkway Schaumburg, IL 60173-6801
Metropolitan Life Insurance Company
1900 E. Golf Road, Suite 500 Schaumburg, IL 60173 WageWorks, Inc.
1100 Park Place 4th Floor San Mateo, CA 94403
Certain states provide special privacy protections for particularly sen-sitive conditions or illnesses such as HIV/AIDS. The plan will disclose protected health information related to those conditions or illnesses only in a manner that is consistent with those laws.
Your Rights regarding your Protected Health InformationRight to Inspect and Copy
You may access your protected health information maintained by the plan. You will be able to inspect and copy your protected health infor-mation as long as it is maintained by the plan or on behalf of the plan. You must make your request for access to your information in writing to the appropriate claims administrator contact.
The claims administrator may deny your request for access to your protected health information only under certain limited circumstances. In the event of a denial, the claims administrator will provide access to any part of the requested material that would not cause these problems. In most situations, you are entitled to request review of an access denial. In these instances, a health care professional that the claims administrator has chosen may review your protected health information. This person will not have been involved in the original decision to deny your request. Generally, your information will be provided to you in a form regularly maintained by the claims administrator. If you consent, the claims administrator may provide a summary or explanation of your information that it holds instead of providing you access to the information.
You may be charged a reasonable fee to cover costs related to copying your protected health information, preparing an explanation or summary of it, and paying for postage.
42 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Right to Request an Amendment
If you feel the medical information the plan has about you is incorrect or incomplete, you may request to amend your protected health information. To do so, you must make your request for amendment of your protected health information in writing to the appropriate claims administrator, and provide a reason to support your request. Your request for amendment may be denied if the:• plan or its claims administrators (or its service providers) did not create the information;• information is not part of the records maintained by or on behalf of the plan;• information would not be available for your inspection (for one of
the reasons described above); or• claims administrator determines that the information is accurate and complete without the amendment.
If your request for changes in your protected health information is denied, you will be notified in writing of why it was denied, and of your right (along with procedures) for submitting a written statement of disagreement.
Right to Request an Accounting of Disclosures
You may request a list of the disclosures of protected health informa-tion that the plan has made within the last six years (1) for purposes other than treatment, payment, healthcare operations and certain other purposes, or (2) in reliance of your written authorization. You must make your request for an accounting of disclosures of your protected health information in writing to the claims administrator. For each disclosure, you will receive:• the date of the disclosure;• the name of the receiving entity and address, if known;• a brief description of the protected health information that was disclosed; and• a brief statement of the purpose of the disclosure, or a written copy
of the request that necessitated the disclosure, if any.
In any given 12-month period, you may receive one accounting of the disclosures of your protected health information, at no charge. Any additional request for an accounting during that period may result in a reasonable fee to cover the plan’s costs in preparing the accounting.
Right to Restrict or Limit Disclosures
You may request restrictions on certain uses and disclosures of your protected health information, even to carry out treatment, payment or health care operations functions as described in this Notice. Your request must be made in writing to the appropriate contact for the applicable benefit option, as listed below. Your request must state the specific restriction requested and to whom you want it to apply.
The claims administrator is not required to agree to the requested restriction, unless it relates to an item or service for which you paid in full and out of pocket. In this case, you may request that the plan not share health information pertaining only to that product or service for the purposes of carrying out payment or healthcare operations. If the claims administrator does agree to honor your request, it will not use or disclose your information in the way you specified unless it is required by law, or needed for emergency treatment.
Right to Request Confidential Communications
In certain circumstances, you may ask to receive confidential communications of protected health information by other means or at different locations. For example, if receiving communications at a particular location could put you in danger, you may request that the claims administrator contact you only at your work telephone number or address. Reasonable requests that clearly state, in writing, that the disclosure of all or part of your protected health information could endanger you will be honored by the claims administrator.
Right to Notification in the Event of a Breach
Consistent with federal and state laws, the claims administrator will notify you in the event your unsecured protected health information is used or disclosed by an unauthorized individual, or is lost or stolen.
Copy of Notice
If this Notice is provided to you in electronic form, you may obtain a paper copy of it by printing this electronic copy or by requesting one from HR Direct.
Contacts
Behavioral Health Resource: 1.866.621.0554
Claims Administrators Anthem Blue Cross/Blue Shield: 1.855.839.4533
MetLife: 1.800.842.3718 (prompt 2)
Vision Service Plan: 1.800.877.7195
Matrix: In Columbus – 1.614.475.9500 Outside Columbus – 1.800.886.1171
WageWorks: 1.877.924.3967
OptumRx: 1.855.395.2022
Eligibility, enrollment and contribution information. L Brands HR Direct: 1.866.473.4728 Complaints
If you believe the plan has violated your privacy rights, you may file a complaint in writing directly with the claims administrator or you may call 1.855.839.4533
You may also file a complaint in writing with the Secretary of the U.S. Department of Health and Human Services in Washington, D.C. or through its regional office in Chicago at 233 N. Michigan Ave., Suite 1300, Chicago, IL 60601. The complaint must be filed within 180 days of the alleged violation.
You will not be penalized in any way for filing such a complaint.
Additional Information
For further information regarding the issues covered by this Notice of Health Plan Privacy Practices, please contact: The L Brands Health Plan Privacy Office PO Box 16000 Columbus, OH 43216
other benefits we offer
44 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Get financially fit.
Log on to retirement-
communications.com/
lbrands to access:
– Associate stock purchase plan
– Financial education worksheets
and webinars.
– Skill-building and budgeting basics.
– Variable income budgeting resources
– 401(k) planning tools (eligible associates)
Don’t have a QR reader? Get one from your app store.
(Most are free!)
45For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Stock Purchase ProgramWe believe it is important for all associates to be partners and “own” part of the business. To make this easy, a company stock purchase plan is available to you from day one. You may purchase shares of L Brands, Inc. through payroll deduction. The company pays all expenses associated with the purchase of company stock and reinvestment of dividends into your account.
401(k) Savings and Retirement Plan (SARP)The SARP provides two ways for all eligible associates to save for their future:
401(k) Savings and Company Match
Enroll in the 401(k) and elect to save up to 75% of your pay (base pay + overtime + incentive compensation/bonus) and the first 4% you save will be matched 100% by L Brands.29
Eligibility 401(k): Full-time associates: Immediate as long as you are at least 21 years oldPart-time associates: Immediate as long as you are at least 21 years oldand worked a year with 1000 hours 401(k) Match:Full-time and part-time associates: After one year of eligibility service.You will be immediately 100% vested.
Retirement Contributions30
L Brands automatically deposits an annual retirement contribution into your SARP account as long as you have met the eligibility requirements.
Deposit Amount
• 3% when you earn up to $118,500• 6% when you earn between $118,500 and $265,000
(Percentages increase to 4% and 8% respectively after five years of service)
• Retirement contributions provide you with additional income whether or not you’re saving in the 401(k).• Retirement contributions begin vesting after 2 years and are fully
vested after 6 years.
Eligibility
Full-time and part-time associates: After one year of eligibility service. You also must be employed on December 31, and worked at least 1,000 hours during the payroll calendar year.
Investment Funds
The SARP offers several investment funds from which you can choose to invest your 401(k) savings and company contributions.
HolidaysL Brands recognizes the following six holidays each year: • New Year’s Day• Memorial Day• 4th of July• Labor Day• Thanksgiving• Christmas
Paid Time Off (PTO)Our Paid Time Off (PTO) program offers you flexibility when you want to take time away from work. Rather than providing traditional vacation, sick and personal days, PTO provides you with paid time off that you can use however you wish, including personal or family needs.
29 2016: IRS 401(k) Annual Maximum = $18,000, IRS Qualified Plan Maximum Compen-sation Limit = $265,000, Social Security Wage Base (SSWB) Limit = $118,500
30 During your first year of participation your Retirement Contribution under the SARP will be prorated based on compensation earned after you become eligible for the SARP. You must be actively employed on December 31 to receive these benefits.
other benefits we offerHere’s an overview of the other benefits we offer. See the eligibility and enrollment guide
on page 47-48 to learn more about eligibility, and whether or not it’s necessary to enroll.
More details about these benefits can be found in the At Your Best Benefits Book on
L Brands Access, or by accessing the benefits resources and contacts on page 49.
FULL-TIME
ASSOC
46 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
How and when you use PTO is up to you. You can even spend it by the day or half day, so you have more flexibility when scheduling your time away from work.
Your PTO will accumulate based on your months and years of service.
Note: The PTO description above does not apply to associates working
in the State of California. Please see the At Your Best Benefits Book for
more information regarding the California PTO program.
Disability Short Term Disability
Benefits begin on the 8th calendar day of a continuous eligible absence and can continue through the 30th calendar day of absence. You receive 100% of your regular base pay.
Long Term Disability
If you are disabled from work for more than 30 days, you may be eligible to receive 60% of your base salary up to a maximum benefit of $11,000 per month. This is a company paid benefit and is automatically provided to you whether or not you are enrolled in the medical plan.
Parental Leave - Time Off for New Parents (moms and dads) We recognize and support your commitment to family, and the need for time off from work – especially following the birth or adoption of a child. Parental Leave allows associates who become moms and dads 2 weeks of time off, paid, if taken within 12 weeks of birth or adoption to bond with baby, be home to help your spouse or partner, and supplement weeks where you would not be paid during maternity leave/FMLA.
Merchandise DiscountYou will receive a merchandise discount. Your discount amount works like this:
Tuition ReimbursementFull-time associates with at least one year of consecutive full-time service are eligible for education reimbursement for a GED, or for work related undergraduate or graduate course work up to $3,000 per year.
Commuter ProgramIf you take public transportation, ride in a vanpool or pay to park near work or public transportation, the commuter program helps you use pre-tax dollars to save up to 40% on commuting costs. What that means is deductions to pay for your parking or transportation are taken from your paycheck before federal, FICA and most state taxes are applied to your pay. Like the FSA, you’ll benefit by automatically paying less taxes in each paycheck.
Home, Auto and Pet InsuranceL Brands offers MetLife’s home, auto and pet insurance programs to full-time associates, and part-time associates with one year of service. The programs give you access to special discounts and convenient payment options for your personal insurance needs.
Back-Up Child, Adult and Elder CareIf you need to be at work and your regular child care is unavailable, or your adult/elder relative is mildly ill or needs temporary assistance, L Brands offers 12 days of back-up care through Bright Horizons.
Early Education and Child-Care DiscountsThe Learning Care Group offers a 10% tuition discount, to dependent children between the ages of 2 and 12 years old, at each of their early education and child-are service centers. The Learning Care brands include: Childtime, Tutor Time, The Children’s Courtyard and La Petite Academy.
Adoption AssistanceWe recognize that families grow in lots of ways. If you choose adoption, L Brands provides financial assistance. Eligible associates may receive reimbursement for adoption-related expenses up to $5,000.
LENGTH OF SERVICE
FULL-TIMEDISCOUNT
PART-TIMEDISCOUNT
At Hire 20% 20%
60th Day 40% 30%
FULL-TIME
ASSOC
FULL-TIME
ASSOC
FULL-TIME
ASSOC
FULL-TIME
ASSOC
FIRST CALENDAR YEAR MONTH HIRED
TOTAL PTO*(In a Calendar Year)
Jan/Feb/Mar 19 days (152 hours)
Apr/May/Jun 11 days (88 hours)
Jul/Aug/Sep 6 days (48 hours)
Oct/Nov 2 days (16 hours)
Dec 0 days
YEARS OF SERVICE TOTAL PTO(In a Calendar Year)
2nd-5th calendar year 19 days (152 hours)
6th-10th calendar year 24 days (192 hours)
11th-14th calendar year 28 days (224 hours)
15th calendar year 32 days (256 hours)
FULL-TIME
ASSOC
* After an initial waiting period of 30 days, 6 days (48 hours) may
be taken (2 days or 16 hours if hired in Oct or Nov). The remainder
taken after 90 days of full time continuous active service.
47For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
WHEN AM I ELIGIBLE WHEN SHOULD I ENROLL
Immediate 30-Days 60-days 1 YearFirst 30 days (or annual open
enrollment)Anytime Automatic
Health + Wellness Benefits
Medical and Pharmacy X X
Dental X X
Vision Plan and Discount X XHealth and Dependent Care FSA X X
Legal Insurance X XOptional Life Insurance (associate and dependent) X XEmployee Assistance Program (EAP) X X
Basic Term Life Insurance X X
Long-Term Disability X X
Savings and Retirement
401(k) Savings X X
401(k) Company Match X
X (if
contributing to 401(k) savings plan)
Company Retirement Contribution X X
Associate Stock Purchase Plan X X
Lifestyle Benefits
PTO X X
Parental Leave XX
(contact HR Direct)
Merchandise Discount 20% 40% X
Tuition Assistance X X
Commuter Benefit X XHome, Auto and Pet Insurance X XChild and Adult Back Up Care and Service Discounts X X
Adoption Assistance X X
NOV20
benefits eligibility and enrollment guide: full-time
48 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
31 Part-time, temporary and seasonal associates are 401(k) eligible after having worked 1 year with 1000 hours. Eligibility is not lost once it is earned.
32 Part-time and seasonal associates are measured at 1 year anniversary and at annual enrollment to see if worked an average of 30+ hours per week over the
past year (Hawaii: 20+ hours over first 4 weeks). If eligible at anniversary, they stay eligible for remainder of current year and all of the coming year. If eligible at open enrollment, they stay eligible during all of the coming year. If a full-time associate moves to part-time or seasonal, they remain eligible for the balance of the current year and then will be measured as mentioned above. Benefits-eligibility of non-seasonal temporary associates is based on their full-time or part-time status.
33 Benefits-eligible part-time associates will receive $10,000 in annual basic term life insurance.
WHEN AM I ELIGIBLE WHEN SHOULD I ENROLL
Immediate 30-Days 60-days 1 Year
Per 30-HourMeasurement
(once eligible or open
enrollment)
Within 30 days of Eligibility
(or open enrollment)
Anytime Automatic
Health + Wellness Benefits
Medical and Pharmacy X32 X
Dental X32 X
Vision Plan and Discount X32 XHealth and Dependent Care FSA X32 XEmployee Assistance Program (EAP) X32 XBasic Term Life Insurance X32, 33 X
Savings and Retirement
401(k) Savings X31 X
401(k) Company Match X31
X(if
contributing to 401(k)
savings plan)
Company Retirement Contribution X31 X
Associate Stock Purchase Plan X X
Lifestyle Benefits
Merchandise Discount 20% 30% X
Commuter Benefit X X
Home, Auto and Pet Insurance X X
benefits eligibility and enrollment guide: part-time, temporary and seasonal
49For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
GENERAL
HR Direct 1.866.473.4728 The single resource for all your L Brands benefits & payroll information. HR Direct representatives will assist you Monday - Friday between 9:00 a.m. and 8:00 p.m. EST.
L Brands Access https://associateresources.limitedbrands.com
• Enroll in benefits (web only). • Reference, update and access all personal and benefits information. – Home address – Benefits information – PTO (paid time off) – Tax withholding – Add/update life insurance beneficiaries – And more!
It’s your responsibility to ensure that your personal information on file is accurate and up-to-date.
LIFESTYLE & EMPLOYMENT PERKS
Tuition Assistance
HR Direct 1.866.473.4728 Discuss tuition assistance for work-related undergraduate or graduate course work.
Associate Advantages
You Decidewww.youdecide.com/LTD7111.800.207.5467
Research products and services with flexible corporate rates for auto insurance, home owners insurance, mortgages, etc.
Adoption Assistance
HR Direct1.866.473.4728 Discuss adoption assistance benefits.
Child-care
Learning Care Groupwww.mylearningcaregroup.com/limitedbrands1.877.747.2492
Inquire about a 10% discount on early education and child-care services at Childtime, Tutor Time, The Children’s Courtyard and La Petite Academy.
Back-Up Care
Advantage Bright Horizons
www.careadvantage.com/lbrands (username: LTDnewuser password: Password1)1.877.BH-CARES (1.877.242.2737) Download Bright Horizons app
Access back-up care up to 8 times per year when you need to be at work and your regular child or adult/elder care is unavailable. Also, get free access to a database of nannies and sitters for evening and weekend care, elder care resources, pet sitters and homework help. And get preferred enrollment access and tuition discounts at affiliated child care centers (may exclude infant care).
Commuter Benefit
Wage Works®www.wageworks.com1.877.924.3967 Download WageWorks app
Manage your commuter account.
Legal Insurance
ARAGwww.araglegalcenter.com(Access Code: 15661ltd)1.800.247.4184 7a.m. to 7p.m. CST
Access free educational tools and resources as well as information regarding your legal benefits, find legal references and other related information.
Auto, Home and
Pet Insurance
MetLife
www.metlife.com/mybenefits 1.800.GET.MET8 (1.800.438.6388)
Get special group discounts to cover your auto, home and pet.
Employment
Verification
The Work Number©
www.theworknumber.com1.800.996.75661.800.367.5690 (outside verifiers)
Access W-2, instant employment and income verification when applying for a mortgage or loan, reference checking, leasing an apartment or other instances where proof of employment or income is needed.
SAVINGS & FINANCES
Associate Stock
Purchase Plan
AST
www.astepsdiv.com1.866.709.7704
Access free educational tools and resources as well as information regarding your personal stock account.
benefits resources & contacts
50 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
401(k) Savings
and Retirement Plan
(SARP)
Wells Fargo
www.wellsfargo.com/retirementplan 1.800.525.SARP (7277) Download Wells Fargo app
Enroll, designate your pre-tax savings amount, name your beneficiary, make your investment choices, and obtain other general account information.
Financial Tools
& Resources
retirement-communications.com/lbrands
Get access to: • Associate stock purchase plan• Financial education worksheets and webinars.• Skill-building and budgeting basics. • Variable income budgeting resources• 401(k) account and planning tools (eligible associates)
HEALTH BENEFITS
Medical
Anthemwww.anthem.com1.855.839.4533 (8:00 a.m. to 8:00 p.m. EST Monday-Friday) Download Anthem Blue Cross and Blue Shield app
Log-on or contact Anthem customer service to manage your health care benefits
Telemedicine LiveHealth Online
www.livehealthonline.com Download LiveHealth Online app
Interact with a doctor live online through your Android or iOS computer, tablet and mobile device.- Available real-time, 24 hours a day/7 days a week/365 days a year in most states- Doctors are in-network, U.S. board-certified and can ePrescribe to local pharmacies (where applicable)
Nurseline 1.800.700.9184 A 24-hour hotline answered by registered nurses to answer your health-related questions
Future Moms Program 1.800.700.9184 A service that provides nurse support, tools and resources throughout your pregnancy. Enroll up to your third trimester and all or part of your in-patient co-pay will be waived.
MyHealth Advantage 1.866.408.7197 A service that helps keep you and your bank account healthier when it comes to managing your healthcare
ComplexCare 1.888.249.3828 A service that helps you manage more than one health issue or a condition that could mean frequent or high levels of health care.
ConditionCare 1.800.638.4814 A service that helps you manage the symptoms of asthma, diabetes, chronic obstructive pulmonary disease (COPD), heart failure and coronary artery disease.
Behavioral Health
Resource
1.866.621.0554 A total-health solution that can help you or your loved ones deal with anxiety, depression, drug or alcohol abuse, eating disorders, autism and other personal issues.
Pharmacy
OptumRx (formally Catamaran)
www.mycatamaranrx.com1.855.395.2022 Download Catamaran app
Manage your prescriptions and home delivery drug orders.
Dental
Metlifewww.metlife.com/mybenefits1.800.942.0854 Download Metlife app
MetLife representatives will respond to your questions about dental health care and help you find Dentists and orthodontists in the dental Network.
Vision
VSPwww.vsp.com1.800.877.7195 Download VSP app
Access information regarding your vision plan or vision discount.
Employee
Assistance Program
Matrix
www.matrixpsych.comL Brands password: limit1.614.475.9500, within Columbus1.800.886.1171, outside Columbus
A confidential counseling service designed to help when you need it most. In addition to counseling, you’ll find services, referrals and support that will improve your life at home and at work. Services include, but are not limited to, legal and financial resources, elder care, family/child-care issues, and drug abuse.
Flexible Spending
Account
Wage Works®
www.wageworks.com1.877.924.3967 Download Wage Works®
app
Manage your dependent care and health care accounts. Update your profile information, including your email and home address.
Note: For life and disability insurance questions, contact HR Direct at 1.866.473.4728
51For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Notes
52 For more information contact HR Direct at 1.866.473.4728 or go to https://associateresources.limitedbrands.com.
Notes
11.15