Dwellworks 2023 Benefits Guide
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HELPINGYOUUNDERSTAND Your Benefit Choices
2023
This is a high-level benefits guide of certain benefits your employer offers. The information in this booklet is intended as a general outline of the benefits offered under your employers benefits program and should not be considered legal, investment or other benefits advice. Specific details and plan limitations are provided in the Summary Plan Descriptions (SPD), which is based on the official Plan Documents that may include policies, contracts and plan procedures. The SPD and Plan Documents contain all the specific provisions of the plans. In the event that the information in this brochure differs from the Plan Documents, the Plan Documents will prevail. Benefit plans are subject to change, amendment, or termination without notice to or the agreement of any employee/participant. All protected health information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources. If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a Federal law gives you more choices about your prescription drug coverage. Please see the “Notices” Section in the back of this benefits booklet. *This guide may or may not be applicable to union employees.
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NFP © 2020. All rights reserved.
CONTENTS
3
TABLE OF CONTENTS
4
PLAN YEAR NEWS
5
2023 OPEN ENROLLMENT
6
ELIGIBILITY
7
HEALTH PLAN COMPARISON
8
MEDICAL / RX
9
PRESCRIPTION DRUGS
10
TELEMEDICINE
12
HEALTH SAVINGS ACCOUNT (HSA)
14
DENTAL
15
VISION
16
FLEXIBLE SPENDING ACCOUNT (FSA)
17
BASIC LIFE
18
SUPPLEMENTAL LIFE
19
DISABILITY
20
EAP
21
EXTRAS
24
REQUIRED NOTICES
35
IMPORTANT CONTACT INFORMATION
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WELCOME 2023 | Plan Year News
Your Benefit Period JANUARY 1, 2023 – DECEMBER 31, 2023
H u m a n R e s o u r c e s C o n t a c t I n f o r m a t i o n
MEDICAL: Medical Mutual of Ohio will continue to administer the medical and drug benefits. 3 NEW plans are being offered for 2023.
Shana Zollar – Chief Human Resources Officer • Email: Shana.Zollar@Dwellworks.com • Phone (216) 682-4203 Jessica Shook - Human Resources Consultant • Email: Jessica.Shook@Dwellworks.com • Phone: (216) 682-4309 Bayron Chaves – HR System Admin • Email: Bayron.Chaves@Dwellworks.com • Phone: (216) 413-3926
• Option 1 - HDHP:
• $3,000/$6,000 Plan 80% Coinsurance
• Option 2 - PPO
• $1,500/$3,000 Plan 80% Coinsurance
• Option 3 – PPO
• $750/$1,500 Plan 80% Coinsurance
HEALTH SAVINGS ACCOUNT : NEW for 2023 Dwellworks contributions $750 if 2+ people are enrolled in the medical plan.
DENTAL: Lincoln • PPO $50/$150 deductible-100%/100%/60% In-Network
VISION: Lincoln
LIFE / AD&D: Lincoln This is a benefit offering for all benefit eligible employees, 100% paid by employer.
NFP (Broker) Contacts
VOLUNTARY LIFE and AD&D : Lincoln Available for employees, spouses and children.
Carolyn Paris – Senior Benefit Coordinator • Email: Carolyn.Paris@nfp.com • Phone (216) 816-0010 Susan Justavick – Senior Account Executive • Email: susan.justavick@nfp.com • Phone: (440) 840-0008
DISABILITY: Lincoln This is a benefit offering for all benefit eligible employees, 100% paid by employer • Short Term Disability • Long-term disability benefits.
For Full-Time Employees Only
Dwellworks sponsors the Dwellworks Welfare Benefit Plan under plan number 501 and hereby provides notice of the plan changes which are effective on 01/01/2023. If you have any questions about these changes in benefits, please contact Kathryn Walko at 216-825-2297 or kathryn.walko@dwellworks.com.
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2023 OPEN ENROLLMENT BENEFITS MENU | ENROLLMENT GUIDE
B E N E F I T S O F F E R E D
MY HEALTH Medical | Medical Mutual of Ohio
Dental | Lincoln Vision | Lincoln
MY LIFE Life and AD&D | Lincoln Disability | Lincoln
MY EXTRAS Virtual Visits | Medical Mutual of Ohio EAP | Lincoln
1. Do you plan to enroll an eligible dependent(s) ? If so, make sure to have their social security numbers and birthdates available. You cannot enroll your dependent(s) without this information. 2. Have you recently been married/divorced or had a baby ? If so, remember to add or remove any dependent(s) and/or update your beneficiary designation. 3. Did any of your covered children reach their 26th birthday this year ? If so, they may no longer be eligible for benefits, unless they meet specific criteria.
Helpful Tips To Consider Before You Enroll
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ELIGIBILITY RULES | REQUIREMENTS
EMPLOYEE ELIGIBILITY You are eligible to participate if you are full- time and work a minimum of 30 hours per week. Your coverage will be effective 1 st of the month following date of hire. DEPENDENT ELIGIBILITY You may also enroll eligible dependents for benefits coverage. A ‘dependent’ is defined as the legal spouse and/or ‘ dependent child(ren)’ of the plan participant or the spouse.
The term ‘child’ refers to any of the following: A natural (biological) child; A stepchild; A legally adopted child; A foster child; A child for whom legal guardianship has been awarded to the participant or the participant’s spouse/domestic partner; or Disabled dependents may be eligible if requirements set by the plan are met.
The chart provided below explains who is eligible for coverage under each benefit plan type:
Line of Coverage
When coverage ends
Medical, Vision, Dental
The last day of the month the child turns age 26
Voluntary Child Life Insurance
The date of birth the child turns age 26
Spouses are Eligible for:
Medical/Rx, dental, vision, voluntary spouse life
Qualifying Life Events
I MP OR T AN T You cannot make changes to these elections during the year unless you experience a qualified family status change, which must be reported to Human Resources within 30 days of the event. If you separate from employment, COBRA continuation of coverage may be available as applicable by law. COBRA Continuation details can be found in the notices section of this employee benefit guide.
If you have a Qualifying Life Event and want to request a mid- year change, you must notify Human Resources and complete your election changes within 30 days following the event. Be prepared to provide documentation to support the Qualifying Life Event. Common life events include; Marriage, Divorce, New Dependent, Loss/gain of available coverage by you or any of your dependents. *A full list of qualifying events can be found in the ‘Required Notices’ section of this benefits guide.
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HEALTH MEDICAL | PRESCRIPTION DRUGS
COMMON INSURANCE TERMS
PPO | In-Network & Out-of-Network Benefits Available The PPO option offers the freedom to see any provider when you need care. When you use providers from within the PPO network, you receive benefits at the discounted network cost. Most expenses, such as office visits, emergency room and prescription drugs are covered by a copay. Other expenses are subject to a deductible and coinsurance. PPO HSA | In-Network & Out-of-Network Benefits The HDHP is similar to the PPO Plan in that you have the option to choose any provider when you need care. However, in exchange for a lower per- paycheck cost, you must satisfy a higher deductible that applies to almost all health care expenses, including those for prescription drugs. All expenses are your responsibility until the deductible is reached, with the exception of preventive care, which is covered at 100% when you visit a physician in the network. Once the deductible is met, you are responsible for coinsurance for medical expenses and a copay for prescription drug expenses. Enrolling in this plan allows you to contribute tax free dollars to a health savings account (HSA). Any dollars that you (and your employer) wish to contribute can be used towards any eligible medical, Rx, dental and vision expenses that you may incur while covered under the plan. See HSA section of this guide for additional details. TRADITIONAL DRUGS Generic | Lowest copay: Most drugs in this category are generic drugs. Members pay the lowest copay for generics, making these drugs the most cost-effective option for treatment. Non-Formulary | Higher copay: This category includes preferred, brand name drugs that don't yet have a generic equivalent. These drugs are more expensive than generics, and a higher copay. Formulary | Highest copay: In this category are nonpreferred brand name drugs for which there is either a generic alternative or a more cost-effective preferred brand. These drugs have the highest copay. Make sure to check for mail order discounts that may be available. Specialty | Lowest Specialty Drug copay: Tier 4 specialty drugs are generally more effective and less expensive than non-preferred specialty drugs in tier 5. Helpful Rx Cost Savings Tools & Tips: MAIL ORDER - Many drugs are available in a 90-day supply, rather than the 30-day retail supply. Typically, you will pay less if you choose to get a mail order 90- day supply. GOOD Rx - T here are many tools online that you can use in order to save on prescription costs. One being GoodRx.com, an online Rx database that allows you to find what pharmacy is the cheapest for your specific prescription. Additionally, you may be able to find a coupon that will greatly reduce your cost. It is important to remember that many of the coupons can only be used outside of your plan (will not count towards your maximums). ASK YOUR DOCTOR – Make sure to ask if there are cost savings alternatives to the prescription they are providing. Many times, there are generic or different manufacturers that will save you money at the pharmacy.
A PREMIUM is the amount you pay for insurance, using pre-tax or post-tax dollars.
A COPAYMENT (COPAY) is a fixed amount you pay to receive services. Your co- payment(s) will count towards your out-of- pocket maximum but not your deductible. (e.g., $30 for every visit to the doctor), while your insurance company pays the rest. A DEDUCTIBLE is the amount of money you are responsible for paying each year before the plan begins to pay for covered services, with the exception of preventive care services, which are covered at 100% In-Network. COINSURANCE This is your share of the expense of covered services after your deductible has been paid when the company plan is paying a percentage. The coinsurance rate is usually a percentage. OUT-OF-POCKET (OOP) MAXIMUM is the most you pay per Plan Year for health care expenses and applies to deductibles, flat-dollar copays and coinsurance for all covered services including cost-sharing amounts for prescription drugs. Once this limit is met, the plan will cover all in-network services at 100% until the end of the plan year. *OUT-OF-NETWORK charges in the above plans are subject to reasonable and customary limitations, which means you are responsible for charges over this amount in addition to separate deductible and coinsurance. Any services received from an out-of-network provider, with the exception of a true emergency, will not be covered.
Save Money With Generic (Tier 1) Drugs
Ask your doctor if it’s appropriate to use a generic drug rather than a brand name.
Generic drugs are less expensive, and according to the FDA, they contain the same active ingredients and are identical in dose, form and administrative method as a brand name.
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MEDICAL / RX – Medical Mutual of Ohio HEALTH | PLAN COMPARISON
Option 1
Option 2
Option 3
HDHP $3,000 Embedded Deductible
PPO $1,500 Embedded Deductible
PPO $750 Embedded Deductible
IN-NETWORK BENEFITS
DEDUCTIBLE Single Deductible
$3,000
$1,500
$750
Two Person/Family Deductible
$6,000
$3,000
$1,500
COINSURANCE (applies after deductible is met) & Out of Pocket Max (includes coinsurance and deductible) Plan Pays 80% 80%
80%
Single Maximum
$5,300
$4,000
$3,000
Two Person/Family Maximum
$10,600
$8,000
$6,000
Health Savings Account
Eligible Plan for HSA
MEMBER COPAYMENT(S) Primary Care (PCP) - Office Visit
80% after deductible
$30 copay
$20 copay
Virtual Visit
80% after deductible
$30 copay
$20 copay
Preventive Services
100%
100%
100%
Specialist - Office Visit
80% after deductible
$30 copay
$20 copay
OP Lab, X-Ray, MRI/Cat Scan
80% after deductible
80% after deductible
80% after deductible
Hospital IP, OP Surgery
80% after deductible
80% after deductible
80% after deductible
Urgent Care Facility
80% after deductible
$75 copay
$75 copay
Emergency Room Visit
80% after deductible
$250 copay
$250 copay
Rx Copays
HDHP $3,000
PPO $1,500
PPO $750
Retail
Mail-Order
Retail
Mail-Order
Retail
Mail-Order
30 Days
90 Days
30 Days
90 Days
30 Days
90 Days
GENERIC
80% after deductible
$10
$25
$10
$25
Preferred Brand
80% after deductible
$30
$75
$30
$75
Non-Preferred Brand
80% after deductible
$50
$125
$50
$125
HDHP $3,000
PPO $1,500
PPO $750
Employee Portion (Per pay)
Employee Portion (Per pay)
Employee Portion (Per pay)
Contributions (24 pays/year) Medical 2023
Dwellworks Portion (Per pay)
Dwellworks Portion (Per pay)
Dwellworks Portion (Per pay)
Employee
$8.00
$208.88 $314.12 $244.79 $444.90
$70.00
$208.78 $393.31 $301.18 $561.42
$90.00
$204.34 $377.54 $287.43 $529.50
Employee + Spouse
$160.00 $120.00 $220.00
$220.00 $170.00 $300.00
$270.00 $210.00 $380.00
Employee + Child(ren)
Family
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PRESCRIPTION DRUGS – Medical Mutual of Ohio Rx |
To access the website Go to: MedMutual.com/member
RX Information Members Use: Pharmacists Use: 1-800-922-1557 RXBIN: 610014 RX Group: MMODRUG
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TELEMEDICINE 24/7 | VIRTUAL DOCTOR VISITS
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TELEMEDICINE 24/7 | VIRTUAL DOCTOR VISITS
Medical Mutual Customer Care 1-800-362-4700
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HEALTH SAVINGS ACCOUNT HSA | TAX SAVING VEHICLE
E N R O L L E D I N AN H S A E L I G I B L E H E A L T H P L AN ?
UNDERSTANDING YOUR HSA – Pre-tax contributions are deducted through payroll and deposited into your HSA account; – You can use your HSA available funds to pay for qualified medical expenses tax-free; – HSA funds can be used for non-eligible expenses but will be subject to regular income taxes and a 20% excise tax penalty. – Unused funds remain in your account for future use and roll over each calendar year; – HSAs remain with you even if you change health plans or companies. If you open an HSA and later become ineligible to make contributions, you can still use your remaining funds; and – You can change your HSA contribution at any time during the plan year for any reason.
A Health Savings Account (HSA) is a tax-free savings account is owned by you, is 100% vested from day one, and let’s you build up savings for future needs. The funds may be used to pay for qualifying healthcare expenses not covered by insurance or any other plan for yourself, your spouse, or tax dependents. You decide how much you would like to contribute, when and how to spend the money on eligible expenses, and how to invest the balance. Contributions to an HSA are tax-free, and no matter what, the money in the account is yours! Take charge of your health care spending with a Health Savings Account (HSA).
2023 | HSA FUNDING LIMITS Each year, the IRS places a limit on the maximum amount that can be contributed to HSA accounts.
HSA Contribution Limits
Employee
$3,850
Two Person/Family
$7,750 HSA “Catch-Up” Contributions
Age 55 or older
$1,000 a year
NEW FOR 2023
Source: IRS, Rev. Proc. 2020-30 Money is contributed each pay period to your HSA bank account. Employer contributions are pro-rated for new hires. Dwellworks contributes $750/year to your HSA account, if you enroll with Employee + Spouse/Child(ren)/Family on the medical plan.
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HEALTH SAVINGS ACCOUNT HSA | TAX SAVING VEHICLE
HSA ELIGIBILIT Y REQU I REMEN T S
ELIGIBLE HSA EXPENSES *
Acupuncture
Alcoholism treatment
Ambulance Artificial limb
To have an HSA and make contributions to the account, you must meet several basic qualifications.
*A full list of qualified expenses can be found in IRS Publication 502 at www.irs.gov. *A full list of qualified expenses can be found in IRS Publication 502 at www.irs.gov. Automobile modifications for a physically handicapped person Birth control pills Blood pressure monitoring device Braille books & magazines Chiropractic care Christian science practitioner COBRA premiums Contact lenses & related materials Crutches Dental treatment Dentures Diagnostic services Drug addiction treatment Eye examination Eyeglasses & related materials Fertility treatment Flu shot Guide dog or other animal aide Hearing aids Hospital services Immunization Insulin Laboratory fees Laser eye surgery Long-term care premiums or expenses Medical testing device Nursing services Obstetrical expenses Organ transplant Orthodontia (not for cosmetic reasons) Oxygen Physical exam Physical therapy Prescription drugs Psychiatric care Retiree medical insurance premiums Smoking cessation program Surgery Transportation for medical care Weight loss program Wheelchairs and more*.
To be eligible to open and contribute to an HSA, you must have coverage under a qualified High Deductible Health Plan (HDHP). Participants cannot be covered by any other health insurance plan (this exclusion does not apply to certain other types of insurance, such as dental, vision, disability or long-term care coverage); Participants cannot participate in a Healthcare FSA or spouse/domestic partner’s Healthcare FSA or Health Reimbursement Account (HRA). Participants cannot be enrolled in Medicare or Medicaid (including dependents). You cannot be eligible to be claimed as a dependent on someone else’s tax return. You have not received Department of Veterans Affairs Medical benefits in the past 90 days. MAINTAINING RECORDS To protect yourself in the event that you are audited by the IRS, keep records of all HSA documentation and itemized receipts for at least as long as your income tax return is considered open (subject to an audit), or as long as you maintain the account, whichever is longer. HSA funds may be used for non-eligible expenses but will be subject to regular income taxes and a 20% excise tax penalty.
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DENTAL – Lincoln COVERAGE OVERVIEW
You have the freedom to select the dentist of your choice; however, when you visit a participating in-network dentist, you will have lower out-of-pocket costs, no balance billing, and claims will be submitted by your dentist on your behalf.
PLAN FEATURES
In-Network
Out of Network
Dentist who are not part of the DentalGuard Network
Dentists who participant in the DentalConnect PPO Network
Network Details
Calendar Year
Benefit Period
DEDUCTIBLE
$50 In-network
Single
$150 In-network
Family
When receiving Basic and Major services (Does not apply for Preventive services)
When does it apply?
COVERED SERVICES
CLASS I: Preventive Services Routine oral exams and cleanings, x-rays (bitewing), sealants & fluoride treatments, space maintainers. CLASS II: Basic Services Periodontics (surgical & non-surgical), endodontics (root canals), oral surgery, fillings, prosthetic maintenance & x-rays (full mouth) CLASS III: Major Services Prosthodontics, crowns, inlays/onlays, dentures, implants & bridges
Covered at 100%
Covered at 100% of Usual and Customary
Covered at 100%
Covered at 80% of Usual and Customary
Covered at 60%
Covered at 50% of Usual and Customary
Ortho Lifetime Maximum - $1,000
Covered at 50%
Covered at 50% of Usual and Customary
PREVENTION FIRST! Your dental health is an important part of your overall health. Make sure you take advantage of your preventive dental visits. Preventive care services are covered at 100% if you visit an In-Network provider. They are also not subject to the annual deductible.
ANNUAL MAXIMUM
Maximum Benefit Allowed per Benefit Period
$1,500
$1,000
Employee Portion (Per pay)
Contributions (24 pays/year) Dental 2023
Dwellworks Portion (Per pay)
Employee
$0.87
$15.63
Employee + Spouse Employee + Child(ren)
$10.75 $13.90 $19.43
$23.30 $30.16 $42.18
Family
How do I find an In-Network Provider? To find an in-network dentist near you, visit www.LincolnFinancial.com/FindADentist This plan lets you choose any dentist you wish. However, your out-of-pocket costs are likely to be lower when you choose an in-network dentist.
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VISION - Lincoln COVERAGE OVERVIEW
Under this plan, you may use the eye care professional of your choice. However, when you visit a participating in-network provider, you receive higher levels of coverage. If you choose to receive services from an out-of-network provider, you will be required to pay that provider at the time of service and submit a claim form for reimbursement.
IN-NETWORK (Spectera) PROVIDER
OUT-OF-NETWORK PROVIDER
PLAN FEATURES
Vision Exam
$10 copay
Up to $40
COVERED SERVICES – LENSES / FRAMES
Single Lenses
$10 copay
Up to $40
Bifocals
$10 copay
Up to $60
Trifocals
$10 copay
Up to $80
Frames
$130 retail allowance
Up to $45
COVERED SERVICES
Contact Lenses
$125 retail allowance
Up to $125
Contact Lens Evaluation Fitting
15% off UCR
No discounts
BENEFIT FREQUENCY
Once every 12 Months
Once every 12 Months
Exams
Lenses
Once every 12 Months
Once every 12 Months
Frames
Once every 24 Months
Once every 24 Months
Once every 12 Months (contacts in lieu of frames/lenses)
Once every 12 Months
Contacts
Laser Vision Correction: Free LASIK consultation with in-network providers. Convenient access to experienced LASIK surgeons at more than 900 locations nationwide. Flexible 0% financing options available to qualified applicants. For more information, visit vision.qualsight.com or call 855-250-2020.
Employee Portion (Per pay)
Contributions (24 pays/year) Vision 2023
Dwellworks Portion (Per pay)
Employee
$0.23
$2.31
Employee + Spouse
$2.34
$2.47
Employee + Child(ren)
$2.38
$3.27
Family
$3.77
$4.17
Did you know your eyes can tell an eye care provider a lot about you?
Need to locate a participating In-Network provider? Visit lvc.lft.com, on the left side of the page, use the Provider Quick Search Box then enter Zip Code. Search by location, doctor name, or office name.
In addition to eye disease, a routine eye exam can help detect signs of serious health conditions like diabetes and high cholesterol. This is important, since you won’t always notice the symptoms yourself and since some of these diseases cause early and irreversible damage.
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FLEXIBLE SPENDING ACCOUNT FSA | TAX SAVING VEHICLE
DEPENDENT CARE FSA The Dependent Care FSA allows you to pay for eligible dependent care expenses with tax-free dollars so that you and your spouse can work or attend school FT. Funds in a Dependent Care FSA are only available once they have been deposited into your account and you cannot use the funds ahead of time. You may set aside up to $5,000 annually in pre-tax dollars, or $2,500 if you are married and file taxes separately from your spouse. If you participate in a Dependent Care FSA, you cannot apply the same expenses for a dependent care tax credit when you file your income taxes. Flexible Spending Accounts (FSA) allow you to reduce your taxable income by setting aside pre-tax dollars from each paycheck to pay for eligible out-of-pocket health care and dependent care expenses* for yourself, your spouse and your dependent children. In order to participate in the FSA, you must enroll each year. Your annual contribution stays in effect during the entire year (January 1st through December 31st) . The only time you can change your election is during the enrollment period or if you experience a change-in-status event. Also, you must elect this benefit within 30 days of your hire date or first date of benefits eligibility. ELIGIBLE EXPENSES A full list of qualified FSA expenses can be found in IRS Publication 502 at www.irs.gov. You can learn more about FSA qualified expenses and also make purchases by visiting the FSA Store at www. fsastore.com. HEALTH CARE & LIMITED PURPOSE FSA MAXIMUM ANNUAL CONTRIBUTION | $3,050 All eligible health care expenses – such as deductibles, medical and prescription copays, dental expenses, and vision expenses – can be reimbursed from your general-purpose FSA account. With the Health Care FSA or Limited Purpose FSA, you can spend up to the full amount of your annual election as soon as your account has been set up.
IMPORTANT FSA RULES
*ELIGIBLE DEPENDENT CARE EXPENSES INCLUDE: 1. ‘Care’ for your dependent child who is under the age of 13 that you can claim as a dependent on your federal tax return; 2. ‘Care’ for your dependent child who resides with you and who is physically or mentally incapable of caring for themselves; or 3. ‘Care’ for your spouse, parent or grandparent who is physically or mentally incapable of caring for themselves and spends at least eight hours a day in your home. ‘Care’ is defined as: In-home baby-sitting services (not by an individual you claim as a dependent); care of a preschool child by a licensed nursery or day care provider; before and after-school care; summer day camp (provided it is not overnight); and in-home dependent day care. Both the Health Care and Dependent Care FSA have a 75 day “grace period”. This means that you have until March 15, 2024 to incur your eligible expenses and until March 31, 2024 to submit the claims HEALTH CARE FSA ROLLOVER Health Care FSA’s have a $610 roll over feature, which allows any amount of $610 or less remaining in your account at the end of the plan year to roll over into the new plan year. At the end of each plan year, you may use these funds left over from the current year FSA balance to pay for eligible expenses incurred in the first 2 ½ months of the following year. Any Unused funds beyond the 2 ½ month grace period will be forfeited. “USE IT” OR “LOSE IT” “Unused” FSA funds do not roll over from year to year. If you don’t use the funds in your account by March 31, 2024, you’ll lose them. Both the Health Care and Dependent Care FSA have a 75 day “grace period”. This means that you have until March 15, 2024 to incur your eligible expenses and until March 31, 2024 to submit your claims. ___________________________________ Dwellworks FSA Allows
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BASIC LIFE - Lincoln COVERAGE OVERVIEW
BASIC LIFE INSURANCE Life insurance is an important part of your financial security. Life insurance helps protect your family from financial risk and sudden loss of income in the event of your death. AD&D insurance is equal to your Life benefit in the event of your death being a result of an accident and may also pay benefits for certain injuries sustained.
BENEFICIARY(IES)
I t’s very important to designate beneficiaries. Taking a few minutes to designate your beneficiaries now will help ensure that your assets will be distributed according to your direction.
Company Paid Benefit - Provided to you at no cost
Coverage Amount
Flat $50,000 Benefit
A Beneficiary is the person you designate to receive your life insurance benefits in the event of your death. It is important that your beneficiary designation is clear so there is no question as to your intentions.
Accidental Death and Dismemberment (AD&D)
Amount equal to your Life benefit
Your insurance will reduce to: – 65% of the original amount at age 65 – 40% of the original amount at age 70 – 25% of the original amount at age 75 – 15% of the original amount at age 80
It is also important that you name a Primary and Contingent Beneficiary. A contingent beneficiary will receive the benefits of your life insurance if the primary beneficiary cannot. You can change beneficiaries at any time.
Benefit Reduction Schedule
ADDITIONAL PLAN PROVISIONS
You should review your beneficiary elections on a regular basis to ensure they are updated as life changes. Even if you are single, your beneficiary can use your Life Insurance to pay off your debts, such as: credit cards, mortgages, and other expenses. *You designate your beneficiary(ies) when enrolling for your benefits.
If your employment ends or you retire, you may be eligible to continue your term insurance at group rates.
Portability
When coverage ends under the plan, you can convert to an individual permanent life policy without evidence of insurability.
Conversion
WHAT WILL MY BENEFICIARY RECEIVE? In The Event That Death Occurs: – Your Basic Life insurance is paid to your beneficiary. – If death occurs from an accident: 100% of the AD&D benefit would be payable to your beneficiary(ies) in addition to your Basic Life insurance.
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SUPPLEMENTAL LIFE - Lincoln COVERAGE OPTIONS FOR YOU & THE FAMILY
SUPPLEMENTAL LIFE INSURANCE
Employees have the opportunity to enroll in supplemental Life insurance. If you choose to enroll in employee coverage, this will be in addition to your employer provided Basic Life coverage. Coverage is also available for your spouse and/or child dependents. It is typically required that you elect coverage for yourself in order to be eligible for coverage on your dependents.
PLAN OPTIONS
Premiums are based on age-rated tables and paid by the employee every pay period through a payroll deduction. These premiums are post-tax and benefits payable are tax-free.
Cost of Coverage
Employee Coverage Choose in increments of $25,000 up to $150,000
Spouse Coverage Choose in increments of $12,500 up to $50,000 *cannot exceed 50% of employee’s elected amount
Dependent Child Coverage Flat amount of $10,000 from age 15 days + *birth – 14 days is not covered
Coverage Options
Do I have to take a health exam to get coverage?
If you and your dependents enroll in coverage at your initial eligibility date, you may apply for up to the Guaranteed Issue amounts without medical questions.
Employee $150,000
Spouse $50,000
Dependent Child $10,000
Guaranteed Issue
PLAN PROVISIONS
Cost Calculation
Age Rated Benefit (Spouse Life based on employee's age)
Employee Coverage Will Reduce To: Your insurance will reduce to: – 65% of the original amount at age 65 – 40% of the original amount at age 70 – 25% of the original amount at age 75 – 15% of the original amount at age 80
Spouse Coverage Will Reduce By: The same amount and at the same time your coverage reduces
Benefit Reduction Schedule
If your employment ends or you retire, you may be eligible to continue your term insurance at group rates.
Portability
When coverage ends under the plan, you can convert to an individual permanent life policy without evidence of insurability.
Conversion
* Guaranteed Issue (GI) and Evidence of Insurability (EOI) When you are first eligible (at hire) for Voluntary Life and AD&D, you may purchase up to the Guaranteed Issue (GI) for yourself and your spouse without providing proof of good health (EOI). Any amount elected over the GI will require EOI. If you elect optional life coverage, and are required to complete an EOI, it is your responsibility to complete the EOI and send to the provider (address will be listed on your form). In addition, your spouse will need to provide EOI to be eligible for coverage amounts over GI, or if coverage is requested at a later date.
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DISABILITY - Lincoln SHORT-TERM | LONG-TERM
SHORT-TERM DISABILITY (STD)
LONG-TERM DISABILITY (LTD)
Serious illnesses or accidents can come out of nowhere. They can interrupt your life, and your ability to work for months – even years. Long Term Disability provides financial protection for you by paying a portion of your income, so you have fina ncial support to manage your disability and your household.
Everyday illnesses or injuries can interfere with your ability to work. Even a few weeks away from work can make it difficult to manage household costs. Short Term Disability coverage provides financial protection for you by paying a portion of your income, so you can focus on getting better and worry less about keeping up with your bills.
LONG-TERM DISABILITY (LTD)
PLAN FEATURES
SHORT-TERM DISABILITY (STD)
Employer Paid Provided at no cost to you
Voluntary Benefit Employee is responsible for 100% of the cost
Cost of Coverage
Elimination Period This is the number of days that must pass between your first day of a covered disability & the day you can begin to receive your disability benefits. Benefit Duration The maximum number of weeks you can receive benefits while you are sick or disabled.
Benefits begin on the 8th day of an accident and the 8th day of an illness (including pregnancy)
Your elimination period is 90 days (if elected, this will be the benefit duration of Short- Term Disability)
Payments may last up to 13 weeks You must be sick or disabled for the duration of the waiting period before you can receive a benefit payment.
Payments will last for as long as you are disabled, or until you reach Retirement Age (age 65), whichever is sooner You must be sick or disabled for the duration of the elimination period before you can receive a benefit payment. Covers 60% of your monthly income, up to a maximum benefit of $6,000 per month. A variety of conditions and injuries. Typical claims would include cancer, back disorders, injuries and poison, cardiovascular, joint disorders.
Covers 60% of your weekly income, up to a maximum benefit of $750 per week. A variety of conditions and injuries. Typical claims would include pregnancy, injuries, joint, back and digestive disorders. Base Salary (excludes commissions and bonuses)
Coverage Amount
What's covered?
Base Salary (excludes commissions and bonuses)
Definition of Earnings
ADDITIONAL PLAN PROVISIONS Benefit Payment Frequency
Monthly benefit may be reduced or offset by other sources of income. Age Rated Benefit – Cost depends on your age upon the effective date
Weekly benefit may be reduced or offset by other sources of income.
Cost Calculation
Composite Rate per $10 of Benefit
If you're disabled and receiving benefit payments, you cost may be waived until you return to work.
If you're disabled and receiving benefit payments, your cost may be waived until you return to work.
Waiver of Premium
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EAP - Lincoln Employee Assistance Program
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EXTRAS - Lincoln Vision Connect & EPIC Hearing
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EXTRAS - Lincoln Travel Connect
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EXTRAS - Lincoln Life Keys
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REQUIRED NOTICES & FEDERAL MANDATES
IRS CODE SECTION 125 Premiums for medical, dental, vision insurance, and/or certain supplemental plans and contributions to FSA accounts (Health Care and Dependent Care FSAs) are deducted through a Cafeteria Plan established under Section 125 of the Internal Revenue Code (IRC) and are pre-tax to the extent permitted. Under Section 125, changes to an employee's pre-tax benefits can be made ONLY during the Open Enrollment period unless the employee or qualified dependents experience a qualifying event and the request to make a change is made within 30 days of the qualifying event. Under certain circumstances, employees may be allowed to make changes to benefit elections during the plan year, if the event affects the employee, spouse, or dependent’s coverage eligibility. An “eligible” qualifying event is determined by the Internal Revenue Service (IRS) Code, Section 125. Any requested changes must be consistent with and on account of the qualifying event. Examples Of Qualifying Events: Legal marital status (for example, marriage, divorce, legal separation, annulment); Number of eligible dependents (for example, birth, death, adoption, placement for adoption); Employment status (for example, strike or lockout, termination, commencement, leave of absence, including those protected under the FMLA); Work schedule (for example, full-time, part-time); Death of a spouse or child; Change in your child’s eligibility for benefits (reaching the age limit); Change in your address or location that may affect the coverage for which you are eligible; Significant change in coverage or cost in your, your spouse’s or child’s benefit plans; A covered dependent’s status (that is, a family member becomes eligible or ineligible for benefits under the Plan); Becoming eligible for Medicare or Medicaid; or Your coverage or the coverage of your Spouse or other eligible dependent under a Medicaid plan or state Children’s Health Insurance Program (“CHIP”) is terminated as a result of loss of eligibility and you request coverage under this Plan no later than 60 days after the date the Medicaid or CHIP coverage terminates; or You, your spouse or other eligible dependent become eligible for a premium assistance subsidy in this Plan under a Medicaid plan or state CHIP (including any waiver or demonstration project) and you request coverage under this Plan no later than 60 days after the date you are determined to be eligible for such assistance. Qualifying Events, which ARE NOT available for a Health Care FSA program, if applicable: Coverage by your spouse or other covered dependent permitted under the spouse’s or covered dependent’s employer’s benefit plan due to a Change Event; The availability of benefit options or coverage under any of the Benefit Programs under the Plan (for example, an HMO is added to or deleted from the Medical Program); An election made by your spouse or other covered dependent during an open enrollment period under your spouse’s or other covered dependent’s employer’s benefit plan that relates to a period that is different from the Plan Year for this Plan (for example, your spouse’s open enrollment period is in July and your spouse changes coverage); or The cost of coverage during the Plan Year, but only if it is a significant increase or decrease. Available for Dependent Care FSA Only, If applicable: Your dependent care provider or cost of dependent care (a significant increase or decrease). Additional Change Events For Health Care Options: In addition to the above Change Events, you may also change elections for the Medical, Dental, Vision and Health Care FSA Programs if: You, your spouse, or other covered dependent become eligible for continuation coverage under COBRA or USERRA; A judgment, decree, or order resulting from a divorce, legal separation, annulment, or change in legal custody (including a Qualified Medical Child Support Order), is entered by a court of competent jurisdiction that requires accident or health coverage for your child; You, your spouse, or other covered dependent become enrolled under Part A, Part B, or Part D of Medicare or under Medicaid (other than coverage solely with respect to the distribution of pediatric vaccines); or You, your spouse, or other covered dependent become eligible for a Special Enrollment Period.
REQUIRED NOTICES
Federal regulations require employers to provide certain notifications and disclosures to all eligible employees. This section of your benefit guide is dedicated to those disclosures for 1.1.2023 – 12.31.2023. If you have any questions or concerns, please contact your plan administrator as follows: Human Resources 216-413-3938 FAMILY MEDICAL LEAVE ACT (FMLA) The Family and Medical Leave Act (FMLA) of 1993 was designed to provide eligible employees with up to 12 workweeks per year of job-protected leave to address critical personal and family matters. It is the policy of Dwellworks and its U.S. subsidiaries to provide eligible employees with a leave of absence in accordance with the provisions of FMLA. You are eligible for an FMLA leave of absence under this policy if you meet the following requirements: You have completed at least 12 months of employment (need not be consecutive, but employment prior to a continuous break in service of seven or more years may not be counted). You have worked at least 1,250 hours during the 12-month period immediately preceding the commencement of the requested leave. You are employed at a work site where 50 or more employees are employed by the Company within 75 miles of that work site (“eligible employees”). To the extent permitted by law, leave taken pursuant to FMLA will run concurrently with Workers’ Compensation, Short Term Disability, and all other Company leave policies. The “break in service cap” doesn’t apply if it: is attributable to fulfillment of National Guard or Reserve military service obligations; or is addressed in a written agreement, including a collective bargaining agreement, that expresses the employer’s intent to rehire the employee after the break in service, such as a break to pursue education or raise children. If you desire and require an FMLA leave of absence under this policy, you must notify your manager and your Human Resources Department and call your FMLA Administrator at least 30 calendar days in advance of the start of the leave when the need for such leave is reasonably foreseeable (as in the case of a birth, the placement for adoption of a son or daughter, or a planned medical treatment for a serious health condition). However, if the date of the birth, placement, or planned medical treatment requires leave to begin in less than 30 calendar days, you must provide such notice to the aforementioned parties as soon as it is both possible and practicable. Failure to provide timely notice may result in a delay or denial of FMLA leave. Procedure for Applying for FMLA Leave
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REQUIRED NOTICES
HEALTH COVERAGE REMINDER The Patient Protection and Affordable Care Act (PPACA) requires most individuals to have minimum essential health coverage or pay a penalty. You may obtain coverage through your employer or through the Marketplace. Depending on your income and the coverage offered by your employer, you may be able to obtain lower cost private insurance in the Marketplace. If you buy insurance through the Marketplace, you may lose any employer contribution to your health benefits. Visit www.healthcare.gov for Marketplace information. In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: All stages of reconstruction of the breast on which the mastectomy was performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; and Prostheses and treatment of physical complications of the mastectomy, including lymphedema. Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan. SPECIAL ENROLLMENT NOTICE This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time. Loss of Other Coverage or Becoming Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP) If you are declining coverage for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage). If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for such assistance. Marriage, Birth or Adoption If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption. For More Information or Assistance To request special enrollment or obtain more information, contact Human Resource Department WOMEN’S HEALTH & CANCER RIGHTS ACT (WHCRA)
MICHELLE’S LAW NOTICE The health plan may extend medical coverage for dependent children if they lose eligibility for coverage because of a medically necessary leave of absence from school. Coverage may continue for up to a year, unless your child’s eligibility would end earlier for another reason. Extended coverage is available if a child’s leave of absence from school — or change in school enrollment status (for example, switching from full-time to part-time status) — starts while the child has a serious illness or injury, is medically necessary, and otherwise causes eligibility for student coverage under the plan to end. Written certification from the child’s physician stating that the child suffers from a serious illness or injury and the leave of absence is medically necessary may be required. If your child will lose eligibility for coverage because of a medically necessary leave of absence from school and you want his or her coverage to be extended, contact your Human Resource Department as soon as the need for the leave is recognized. In addition, contact your child’s health plan to see if any state laws requiring extended coverage may apply to his or her benefits. Genetic Information Non-Discrimination Act (GINA) prohibits discrimination by health insurers and employers based on individuals' genetic information. Genetic information includes the results of genetic tests to determine whether someone is at increased risk of acquiring a condition in the future, as well as an individual's family medical history. GINA imposes the following restrictions: prohibits the use of genetic information in making employment decisions; restricts the acquisition of genetic information by employers and others; imposes strict confidentiality requirements; and prohibits retaliation against individuals who oppose actions made unlawful by GINA or who participate in proceedings to vindicate rights under the law or aid others in doing so. THE GENETIC INFORMATION NON- DISCRIMINATION ACT (GINA) NOTICE OF ELIGIBILITY FOR HEALTH PLANS RELATED TO MILITARY LEAVE If you take a military leave, the Uniformed Services Employment and Reemployment Rights Act (USERRA) provides the following rights: If you take a leave from your job to perform military service, you have the right to elect to continue your existing employer-based health plan coverage at your cost for you and your dependents for up to 24 months during your military service; or If you don’t elect to continue coverage during your military service, you have the right to be reinstated in the Plan when you are reemployed within the time period specified by USERRA, without any additional waiting period or exclusions (e.g., pre-existing condition exclusions) except for service-connected illnesses or injuries. The Plan Administrator can provide you with information about how to elect Continuation Coverage Under USERRA. Group Health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT NOTICE
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