Your Benefits Overview
This Document is designed to give you a brief overview of all the benefits available to you as an eligible management employee of Apple American Group LLC.The information set forth in this summary is not intended to be all inclusive, but to serve as a guideline. It is subject to change from time to time at the discretion of management.
In this document we will provide a summary of the following management benefits programs:
· Medical, Dental & Prescription Coverage
· Optional Vision
· Life Insurance & AD&D
· Short & Long Term Disability
· 401k Retirement Plan
· Time Away from Work
Health Plan Eligibility
Who can you cover in our plans?
As a full time member of our management team, benefits are available to you, as well as members of your immediate family (your “dependents”).
So, who qualifies as a dependent?
You may cover:
§ Legal spouse
§ Children (including natural children, adopted children or children placed with you for adoption)
§ Any person for whom you have legal guardianship (proof required)
§ A child can be covered up to age 26.
When can you change your coverage?
Outside of Open Enrollment during this acquisition, you will have the opportunity to make changes once a year, during annual Open Enrollment (May 2013). Once you’ve made your choices during the Acquisition Open Enrollment, you cannot make changes until the next annual enrollment period, unless you have a qualifying change in status such as:
§ Change in legal marital status due to marriage, death of a spouse,
divorce, annulment or legal separation
§ Change in number of dependents due to birth, adoption, placement
for adoption or death of a dependent
§ Changes in employment status of associate, spouse or dependent
resulting in eligibility or ineligibility for coverage
§ Changes which cause a dependent to become eligible or ineligible
for coverage
You must request a change within 31 days of a qualifying event.
You may be required to provide documentation of the event. Your change in coverage must be consistent with your qualifying event.
Medical, Dental & Prescription Plans
Not everyone has the same needs when it comes to health care. That is why you have a choice in medical plans – Economy, Standard and Enhanced Plans.
What is the difference between the three options?
Each plan provides exceptional coverage through United Healthcare; all three plans use the same UHC hospital and physician networks. The covered services are also the same for the three options. The difference is the amount you pay for premiums, co-pays, and deductibles.
To determine which plan is best for you, review your medical costs from the last several years and think about your likely costs in the future.
· How many times will you likely visit the doctor next year?
· Will you meet your deductible?
The Economy & Standard plans offer you the ability to save money by reducing your premium costs. Alternatively, the Enhanced plan requires that you pay more from your paycheck, but then offers lower co-pays, deductibles and prescription costs.
Medical, Dental & Prescription Plans – Management Bi-Weekly Pay Deductions (Tobacco users pay a higher premium)
Non-Tobacco User Rates
Coverage Type / Economy Plan / Standard Plan / Enhanced PlanSingle / $53.16 / $72.56 / $86.35
Single + Spouse / $119.49 / $145.65 / $179.17
Single + Child(ren) / $127.67 / $136.45 / $168.94
Family / $156.90 / $178.76 / $220.03
Tobacco User Rates
Coverage Type / Economy Plan / Standard Plan / Enhanced PlanSingle / $71.77 / $97.95 / $116.57
Single + Spouse / $161.32 / $196.62 / $241.87
Single + Child(ren) / $172.36 / $184.21 / $228.08
Family / $211.82 / $241.32 / $297.16
A non-tobacco status is defined as an employee and/or spouse who has been completely tobacco free for two (2) months. If the tobacco status of an employee or spouse changes, a new affidavit form should be signed and scanned to the Benefits Department at the Support center and then a premium change will be effective on the next paycheck.
United Health Care / Economy / Standard / EnhancedIn- Network / Out-of-Network / In- Network / Out-of-Network / In- Network / Out-of-Network
Calendar Year Deductible* / $1,000 Ind*/
$2,000 Family* / $3,000 Ind*/ $6,000 Family* / $500
Ind*/
$1,000 Family* / $2,000 Ind*/
$4,000 Family* / $300
Ind*/
$600
Family* / $500
Ind*/
$1,000
Family*
Co-insurance % / 80/20 / 70/30 / 90/10 / 70/30 / 90/10 / 70/30
Primary
Out-of-Pocket** / $4,500 Ind/
$9,000 Family / $9,000 Ind/
$18,000 Family / $3,000 Ind/
$6,000 Family / $6,000 Ind/
$12,000 Family / $1,000 Ind/
$2,000 Family / $3,000
Ind/
$6,000 Family
Secondary Co-insurance % / 80/20 / 70/30 / 95/5 / 70/30 / 95/5 / 70/30
Secondary Out-of-Pocket*** / No limit / No limit / No limit / No limit / No limit / No limit
Lifetime Maximum Benefit / N/A / $1,000,000 per Person / N/A / $1,000,000per Person / N/A / $1,000,000
per Person
Office Copay / 80%
(+ Ded) / 70%
(+ Ded) / $20 Copay / 70%
(+ Ded) / $20 Copay / 70% (+ Ded)
Specialist Visit / 80%
(+ Ded) / 70%
(+ Ded) / $40 Copay / Not Covered / $20 Copay / 70%
(+ Ded)
Hospital / 80%
(+ Ded) / 70%
(+ Ded) / 90% (+Ded) / 70%
(+ Ded) / 90%(+Ded) / 70% (+ Ded)
Emergency Room / $200 Copayment / $150 Copayment / $125 Copayment
Prescription Drugs
(30 days) / $15
$45
$90 / Covered
in-network / $10
$30
$50 / Covered
in-network / $10
$25
$50 / Covered
in-network
Mail Order (90 Days) / $37.50
$112.50
$225 / Covered
in-network / $25
$75
$150 / Covered in-network / $25
$62.50
$125 / Covered
in-network
Dental Benefits / Dental is included in medical plan
Deductible / $50 Ind / $100 Family / $50 Ind./
$100 Family / $50 Ind/ $100 Family
Annual Maximum**** / $1,000* / $1,000* / $1,000*
Preventive Services / 100% / Covered in-network / 100% / Covered in-network / 100% / Covered in-network
Basic Dental / 80% / Covered in-network / 80% / Covered in-network / 80% / Covered in-network
Major Dental / 50% / Covered in-network / 50% / Covered in-network / 50% / Covered in-network
Orthodontics / 50% of eligible charges / $1,000 Lifetime / child only to age 26
Vision Benefits / Optional Vision Benefit
Vision / In network: 80% of eligible expenses after $1,000 deductible; Out of network: 70% of eligible expenses after $3,000 deductible
*Deductibles run by calendar year but you will only need to satisfy 25% of these deductible amounts until 1/1/13.
**Primary Out of Pocket – Includes Deductible
***Secondary out of Packet – unlimited & applies to all eligible expenses in the calendar year that are in the excess of the Primary Out of Pocket
****Annual maximum for Dental in 2012 will be $250. Maximum will reset in 2013 to $1,000.
Optional vision plan through VSP
VSP offers a vision exam including a thorough eye exam every 12 months. Prescription glasses are covered for lenses every 12 months and new frames every 24 months. You also have the option to choose contacts instead of glasses every 12 months. There are additional discounts on options such as anti-reflective coating and transitions lenses. See http://aag2.appleamerican.com/acquisition/AmRest for further details.
Life Insurance & AD&D
Basic Life/AD&D Insurance
Life and Accidental Death and Dismemberment (AD&D) insurance can offer valuable financial protection. That’s why Apple American Group LLC provides Basic Life and Accidental Death & Dismemberment (AD&D) insurance as part of your benefits package. These plans pay an amount equal to your annual salary.
Employee Paid Optional Life Insurance
Optional Life Insurance is offered to benefits eligible management employees at date of hire with 30 days to enroll with no health questionnaire or physical. After 30 days an employee is subject to a questionnaire and/or physical. An employee is eligible for any amount between $10,000 and $500,000, in increments of $10,000. Maximum coverage is five times your basic annual earnings.
Short & Long Term Disability
On your anniversary date of full time eligible management employment, Apple American Group provides you both a short-term disability (STD) and long-term disability (LTD) benefit plan at no cost to you.
Short Term Disability (STD)
Eligible vacation must be used in the first five days of an approved STD leave. If vacation is not available, those five days will go unpaid. STD will then pay a benefit equal to 80% of the base salary for the next 10 days of disability (in a 12 month period) and 60% thereafter. The benefit is calculated from your basic weekly earnings. You must be deemed disabled and unable to work for AAG or another employer by a physician and absent from work due to sickness or injury for more than five (5) consecutive working days. STD benefits will continue while you are disabled, for up to 90 days. The company reserves the right to limit the use of vacation upon return from a leave.
Long Term Disability (LTD)
LTD benefits help replace your income for a disability that lasts longer than 90 days. LTD benefits are paid at 66.6% of your basic weekly earnings, and can continue to age 65 if you become disabled before age 60. If you become disabled after age 60, the length of time you can receive benefits is fixed according to a schedule.
401k Retirement Plan
Apple American Group offers a qualified 401(k) program to employees immediately upon hiring, who are at least 21 years of age. This plan is managed by Nationwide Investments and offers a variety of investment funds with varying degrees of risk from which you may choose.
Employees can include up to 15% of their annual income on a tax deferred-basis. Apple American Group will match $.25 up to 8% for every $1.00 that you invest. The company contributions vest according to the following schedule:
Years of Service / 1 / 2 / 3 / 4 / 5% Vested / 0% / 25% / 50% / 75% / 100%