Contents
Eligibility ....................................................... 3 required documents and timelines
Medical ......................................................... 5
changes , updates , and plan options health savings account ( hsa ) flexible spending accounts ( fsas ) telehealth
Dental ......................................................... 10 benefit plans
Vision .......................................................... 12 benefit plan
Life and AD & D ............................................ 14
basic life and AD & D voluntary life and AD & D
Disability ..................................................... 16
short-term disability long-term disability
Employee Assistance Program ................... 20
EAP
Employee Contributions .............................. 22
2023 employee contributions
Contact ........................................................ 24 key contact information
Notices ........................................................ 26
health insurance portability and accountability act ( HIPAA ) of 1996 HIPAA privacy notice family status changes family and medical leave act of 1993 your continuation coverage rights under COBRA premium assistance under medicaid and the children ’ s health insurance program ( CHIP ) women ’ s health and cancer rights act mental health parity ERISA notice of creditable coverage notice regarding wellness program
401 ( k ) ......................................................... 18 retirement plan
IMPORTANT :
If you ( and / or your dependents ) have Medicare or will become eligible for Medicare in the next 12 months , federal law gives you more choices about your prescription drug coverage . Please see page 36 for more details .
This document is an outline of the coverage provided under your employer ’ s benefit plans based on information provided by your company . It does not include all the terms , coverage , exclusions , limitations , and conditions contained in the official Plan Document , applicable insurance policies and contracts ( collectively , the “ plan documents ”). The plan documents themselves must be read for those details . The intent of this document is to provide you with general information about your employer ’ s benefit plans . It does not necessarily address all the specific issues which may be applicable to you . It should not be construed as , nor is it intended to provide , legal advice . To the extent that any of the information contained in this document is inconsistent with the plan documents , the provisions set forth in the plan documents will govern in all cases . If you wish to review the plan documents or you have questions regarding specific issues or plan provisions , you should contact your Human Resources / Benefits Department .
2 HRAccess