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Over the past year, the OCA Benefits team has been working closely with Olympus Scientific Solutions (OSSA) to harmonize the benefits provided to employees of both companies. As a result of this project, a number of benefits for both OCA and OSSA will be changing effective January 1, 2016. Every effort was made to minimize the impact to employees; however, we recognize that some disruption may occur.
While enrollment is generally passive for all employees, everyone is encouraged to review ALL of their personal and benefit information on HRInTouch. With the exception of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA), employees have been enrolled in the 2016 benefits based upon current enrollments.
Open Enrollment is your once-a-year opportunity to change plans and add or drop eligible dependents from coverage. The only other time you have an opportunity to make changes is when you experience a qualifying life event such as divorce, marriage, birth or adoption of a child, or other “qualifying life event” in 2016. It is also the time when you must specify how much you will contribute to a Flexible Spending Account (FSA) or a Health Savings Account.
Benefit Elections must be completed online through
or call 1-855-294-2820
Tuesday, October 13 – Wednesday, November 4
Note: The website DOES NOT support Internet Explorer 8 or lower. You can use the Compatibility mode.
What You Need to Know…
Make informed decisions by reviewing ALL of your 2016 benefit options, including other medical or dental plans available to you through your spouse or domestic partner’s employer. Compare medical and dental plans and determine which are best for you and your family.
- A new PPO medical plan is being offered and all core Olympus medical plans are through United Healthcare.
- All employees will have imputed income on the Olympus provided LTD coverage.
- Supplemental Life insurance rates have changed for many levels and are on a Smoker/Non-Smoker basis.
- OCA employees enrolled in Supplemental Life have been enrolled in the new Smoker/Non-Smoker rates based upon their Tobacco Certification. You need to review the new rates and the impact on you.
- OCA employees enrolled in a United Healthcare plan have been automatically enrolled in the new 100% employee paid NVA vision plan. If you do not want this plan, you must opt out. OSSA employees have been enrolled based upon current enrollment.
- Everyone should confirm their dependents and their life insurance beneficiary information.
- The PTO purchase plan has been eliminated.
Medical Plan Designs and Rates
All employees, with the exception of California, Puerto Rico and Hawaii residents, will have a choice of 2 medical plans through United Healthcare (UHC). California employees may also select a Kaiser HMO. Hawaii residents may choose from three HMSA plan offerings and Puerto Rico continues to have Triple S.
United Healthcare Plan Designs
High Deductible Healthcare Plan (HDHP) with an annual Olympus contribution to a Health Savings Account (HSA) of $600 for single coverage and $1200 for all other coverage levels.New for 2016: Each person in a family needsto only reach the $2000 single deductible level before the plan starts to pay. The $4000 family deductible still applies before other family members begin having claims paid by the plan.
Preferred Provider Organization (PPO). This is NEW for everyone. Deductibles, coinsurance, out of pocket limits and copays have changed from the current PPO offering for both OCA and OSSA.
The OSSA EPO medical plan is frozen to new participants. No new enrollments (other than dependents) are allowed. If you are currently in the EPO, you are grandfathered for eligibility. United Healthcare will be the plan administrator.
Optum Rx isthe provider of prescription drug benefits. Optum utilizes a three (3) tier formulary Prescription Drug List (PDL). The PDL organizes all brand and generic prescription drugs into tiers based on Total Cost
2016 Bi-Weekly - Below Director LevelCoverage Level / UHC HDHP Plan / UHC Basic PPO Plan / Kaiser HMO (CA Only) / UHC EPO / HMSA (Hawaii Only) / Triple S (Puerto Rico)
Employee Only / $11.04 / $57.23 / $46.18 / $64.62 / $45.00 / $37.00
Employee + Child(ren) / $17.08 / $114.46 / $97.50 / $135.69 / $135.00
(EE+1 Child only) / $75.00
Employee + SP/DP / $36.03 / $159.69 / $147.79 / $142.15 / $135.00 / $115.00
Family / $53.55 / $193.85 / $219.63 / $174.46 / $170.00 / $145.00
Director & Above and/or > $140,000
Employee Only / $13.25 / $80.12 / $73.89 / $90.46 / Tobacco Premium -
Employee + Child(ren) / $20.49 / $160.25 / $153.95 / $189.97 / $20 per employee and/or spouse applies to all plans.
Employee + SP/DP / $43.23 / $223.57 / $220.66 / $199.02
Family / $64.26 / $271.38 / $326.37 / $244.25
Management. The PDL promotes medications with the greatest overall healthcare value, regardless of brand or generic status. Participants are encouraged to review the PDL list available on the United Healthcare website for the categorization of your drugs. This list is subject to change throughout the year.
Review the medical plan designs on the separate plan comparison sheet. Hawaii and Puerto Rico employees need to contact Benefits or HRInTouch for the most recent plan summaries.
Medical Rates
All medical rates are offered on a 4 tier basis: Employee, Employee + Child(ren), Employee + Spouse or Employee + Family. Child(ren) means one or more child.
A Tobacco Premium applies to employees and/or spouse/domestic partner who use tobacco products and participate in any medical plan sponsored by Olympus. This includes United Healthcare, Kaiser, Triple S and HMSA. The premium is $20 biweekly per person, or $40 if both you and your spouse/domestic partner use tobacco products. Upon enrolling in medical, you will be asked to confirm Yes or No to your tobacco usage. This also applies to the Supplemental Life Insurance.
Norwalk Union: Weekly pay rates are ½ of the rates listed below for the UHC HDHP or Basic PPO Plans.
OLYMPUS MEDICAL PLAN COMPARISON CHARTAll locations except Hawaii & Puerto Rico
High Deductible Health Plan / PPO / Kaiser HMO (California Only
Plan Provision / In Network / Out of Network / In Network / Out of Network / In-Network Only
Annual Deductible / Single: $2,000 Family: $4,000 / Single: $4,000 Family: $8,000 / Single: $500 Family: $1,000 / Single: $2,000 Family: $4,000 / Single: $500 Family: $1,000
Annual Out of Pocket Maximum / Single: $5,000 Family: $10,000 / Single: $9,000 Family: $18,000 / Single: $2,500 Family: $5,000 / Single: $6,000 Family: $12,000 / Single: $3,000 Family: $6,000
Coinsurance / 90% / 70% / 85% / 70% / 90%
Preventive Care / 100% / 70% after deductible / 100% / 60% after deductible / 100%
Office Visit / 90% after deductible / 70% after deductible / $25 Primary Care $40 Specialist / 60% after deductible / $20 Primary Care $20 Specialist
Emergency Room / 90% after deductible / 70% after deductible / $150 Copay then 80% Coinsurance / 60% after deductible / 90% after Deductible
Urgent & Convenience Care / 90% after deductible / 70% after deductible / $30 Copay / 60% after deductible / $20 Copay
Labs, X-rays, Outpatient & inpatient Surgery / 90% after deductible / 70% after deductible / 80% after deductible / 60% after deductible / $10 per Encounter
Rehabilitative Services / 90% after deductible / 70% after deductible / $40 Copay / 60% after deductible / $20 Copay
Retail Pharmacy UP to 30 Day Supply / Annual deductible must be met before Rx copays apply $10 Tier 1 $30 Tier 2 $50 Tier 3 / No out of network prescription benefits / $10 Tier 1 $40 Tier 2 $75 Tier 3 / No out of network prescription benefits / $10 Generic $30 Preferred Brand
Mail Order Up to 90 Day Supply / Annual deductible must be met before Rx copays apply $20 Tier 1 $60 Tier 2 $100Tier 3 / No out of network prescription benefits / $20 Tier 1 $80 Tier 2 $150 Tier 3 / No out of network prescription benefits / $20 Generic $60 Preferred Brand
Pre Certification Required / Yes for In-patient Hospitalizations or 50% penalty / Yes for In patient Hospitalizations, Hospice and Home Health, else 50% coverage penalty / Yes
Olympus HSA Contribution / Single: $600 Family $1,200 / No Contribution / No Contribution
Annual Notice of Post-Mastectomy Coverage
The Women’s Health and Cancer Rights Act of 1998 requires group health plans to cover certain reconstructive surgery following a mastectomy and notify Plan participants and beneficiaries annually. In particular, a plan must offer:
- Reconstruction of the breast on which the mastectomy was performed.
- Surgery and reconstruction of the other breast to produce a symmetrical appearance.
- Prostheses and treatment of physical complications of all stages of mastectomy, including lymphedemas.
All of Olympus’ medical plans comply with these requirements. Benefits for these items generally are comparable to those provided under our plan for similar types of medical services and supplies. If you would like more information about WHCRA required coverage, you can contact your medical carrier directly.
Dental Plan Designs and Rates
Delta Dental continues to be the dental plan provider. We offer one plan which allows you to use Delta Dental’s PPO and Premier Dentist Networks. Out of Network coverage is available but you are subject to being balanced billed for charges above the reasonable and customary as determined by Delta Dental. An annual deductible applies to all services with the exception of preventive care.
Employees in Hawaii and Puerto Rico are not eligible for the dental as it is available through their medical carrier.
DELTA DENTAL PLAN HIGHLIGHTSCoverage Area / Covered Services / In Network
PPO & Premier Dentist * / Out of Network Dentist** / Deductibles & Maximums
Preventive Care /
- Oral Exams
- Teeth Cleaning
- Sealants
- X-rays
- Child Fluoride Treatments
Basic Restorative /
- Fillings
- Extractions
- Oral Surgery
- Periodontics
- Bridge/Denture Repair
- Root Canal
$50 per person
$150 maximum per family
Annual Maximum:
$2,000 per person
Major Restorative /
- Bridge & Denture Installation
- Crowns
- Onlays and cast restorations
- Inlays
Orthodontia /
- Preliminary examinations,
- X-rays
- Appliance therapy
- Monthly active treatment
Coverage for children to age 19
*To find a participating provider visit and click Find a Dentist
**The provider has the right to balance bill you any amount not paid by Delta Dental
Healthcare ID and HSA/FSA Debit Cards
ID cards for the medical, dental and vision plans will be mailed to all new enrollees in early January 2016. This means that OSSA employees will get all new ID cards. If you previously had vision coverage through NVA, you will also get a new card as the old one will no longer be valid.
New debit cards for Optum HSA and FSA accounts will be sent to all new enrollees as well. If you currently have an Optum debit card, it will be reloaded with your newly elected amounts.
2016 Dental Plan RatesCoverage Level / Delta Dental Plan (Bi-Weekly) / Norwalk Union Delta Dental Plan (Weekly)
Employee Only / $4.15 / $8.60
Employee plus Child(ren) / $7.25 / $15.45
Employee plus Spouse or Domestic Partner / $7.40 / $18.97
Family / $11.35 / $26.48
Dependents and Beneficiaries
Annual enrollment is a good time to review your covered dependents and Life Insurance beneficiaries. Other than during Open Enrollment, you generally cannot change your covered dependents unless you incur a Qualified Life Event such as marriage, divorce, the birth or adoption of a child or loss of coverage elsewhere. If you add new dependents during this time, you have until November 13 to complete your Dependent Verification. Dependent Verification includes a copy of your most recent tax filing showing your dependent(s), a marriage certificate or a birth certificate.
To change your 401k beneficiary, contact Empower at or call 800-345-2345.
NVA Vision Plan Design and Rates
National Vision Administrators (NVA) was selected as the vision provider for all of Olympus. The NVA Vision Plan is a standalone employee benefit. Coverage levels are consistent with the medical and dental plans- Employee only, Employee + Spouse, Employee + Child(ren) and Family.
Providers include many national chains such as VisionWorks, LensCrafters and Sears as well as many local opticians and doctors. While many chains participate, you cannot assume all of the chain’s locations participate. Confirm or find a Participating Provider, in addition to other helpful information, by visiting and click on ‘Find a Provider’. Use account number 12150001.
OCA and OSSA employees have been enrolled in the new standalone vision plan based upon their current United Healthcare or VSP enrollment. If you do not want this benefit, you must actively opt out through OlympusBenefits.HRIntouch.com or by calling the Benefits Hotline at855-294-2820.
NVA Vision Benefit HighlightsAll Locations except Puerto Rico
Plan Provision / Frequency / Participating Provider / Non Participating Provider
Examination / Once every 12 months / Covered 100% / Reimbursed up to $50
Lenses / Once every 12 months / Standard Glass or Plastic Covered 100% / Single Vision $50 Bifocal $75 Trifocal Lenticular $100
Frames / Once every 24 months / Covered up to $130 Retail / Up to $70
Contact Lenses - in lieu of Lenses / Once every 12 months / Elective - up to $130 Retail Medically Necessary - up to 100% with Prior Authorization / Daily Wear $20 Extended Wear $30
EyeEssential Discount – For services if you exhaust the basic frequency and benefit level:
Examinations / Member cost
Retail less $10 / Not Applicable
Contact Lens Evaluation Fitting / Retail less 10%
Lenses / Not Applicable / Single Vision $35
Bifocal $55
TrifocalLenticular $70
Frame / Retail less 35%
Contacts: Conventional
Contacts: Disposable / Retail less 15%
Retail less 10%
2016 NVA Vision Plan Rates
Coverage Level / Bi-weekly Rate
Employee Only / $2.14
Employee plus Children / $5.57
Employee plus Spouse or Domestic Partner / $4.28
Family / $6.85
Health and Flexible Savings Plan Accounts
2016 Health Savings Account LimitsMaximum Contribution / Single / Family
$3,350 / $6,750
Catch-up Contribution (55+) / $1,000 / $1,000
Reminders:
You must be enrolled in a High Deductible Health Plan to contribute.
These limits are inclusive of any contributions by Olympus, including the Wellness Incentive.
Health Savings Account (HSA)
Employees who enroll in High-Deductible Health Plan have the option to enroll in a HSA. Employees that open an account through OptumBank will receive an annual Olympus HSA contribution of $600 for employee-only coverage and $1200 for all other levels of coverage. Contributions are made by January 31st provide you have opened an account.
You may also add to your account through payroll deductions. If you are currently enrolled in the OptumBank HSA you will need to enroll again during this Open Enrollment to have your HSA continue in 2016. These deductions can be changed at anytime throughout the year.
If you already have a personal HSA, you can still open one with OptumBank. Just be sure the total amount you contribute to both accounts, plus all company contributions, does not exceed the 2016 contribution maximum.
Note: You cannot open an HSA if you are enrolled in secondary coverage such as through a spouse’s plan that is not a qualified HDHP. Employee payroll deductions will not begin until an account has been opened with OptumBank.
Flexible Spending Accounts (FSA)
Optum administers all the Flexible Spending Accounts:
- Healthcare FSA – You can use the Healthcare FSA to pay for eligible expenses related to medical, dental or vision for you and your dependents regardless of whether or not they are covered by an Olympus plan. You cannot enroll in this FSA is you are enrolled in an HDHP.
- Limited-Use Healthcare FSA – You can enroll in this FSA if you are enrolled in a HDHP. Funds may be used to pay for eligible expenses related to dental or vision ONLY for you and your dependents, regardless of whether or not enrolled in the Olympus HDHP.
- Dependent Daycare FSA – Contributions may be used to pay for eligible expenses related to child care or adult dependent care expenses for qualified dependents that are necessary for you and your spouse to work, look for work or attend school full-time.
2016 Flexible Spending Accounts and Limits
Account / Coverage for / Limit
Healthcare FSA / Eligible expenses related to medical, dental, vision, and Rx. / $2,550
Limited-Use FSA / Eligible expenses related ONLY to dental or vision for you or your dependents. / $2,550
Dependent Daycare FSA / Eligible child or adult dependent care. Child expenses limited for care up TO age 13. Child(ren) or adults must be tax dependent upon you.* / $5,000
*You are limited to $5000 if filing a joint tax return or are a single parent and $2500 if married and filing taxes separately.
Life Insurance & Long Term Disability
CIGNA is the carrier for all of our life insurance coverages and long term disability. Rates for all coverages – supplemental, voluntary AD&D and Child Life have changed. The employee and spouse/domestic partner coverages are based upon smoker/non-smoker status.
Current OCA supplemental life participants have been enrolled to either the smoking or non smoking rates based upon their medical plan Tobacco Certification Question. OSSA participants are being enrolled based upon their current enrollment in supplemental life insurance.
Warning: If you are a smoker and you fail to confirm this through the Tobacco Certification question, CIGNA has the right to deny any benefits payable under the plan.
Anyone requesting an increase in their supplemental amounts may be subject to Evidence of Insurability (EOI) by CIGNA.
Long Term Disability (LTD) – Tax Free Through CIGNA
Effective January 1, 2016, the current LTD benefits provide 60% of your annual salary, or Annual Benefits Base Rate (“ABBR”) for certain sales representatives up to a maximum of $10,000 per month. Additionally, this will become a tax free benefit as you will pay “imputed income” beginning with your first 2016 pay. By paying imputed income, this simply means that if you pay taxes now then your LTD benefit will be tax free and available to you at a significantly higher amount should you need this benefit.