Microsoft Word - 2022 - FT Employee Benefits Enrollment Guid

Commonwealth Emergency Physicians

Pick the best benefits for you and your family.

Commonwealth Emergency Physicians strives to provide you and your family with a comprehensive and valuable benefits package. We want to make sure you’re getting the most out of our benefits—that’s why we’ve put together this Open Enrollment Guide. Open enrollment is a short period each year when you can make changes to your benefits. This guide will outline all of the different benefits Commonwealth Emergency Physicians offers, so you can identify which offerings are best for you and your family. Elections you make during open enrollment will become effective on January 1 st , 2022. If you have questions about any of the benefits mentioned in this guide, please don’t hesitate to reach out to HR.

Table of Contents Health Insurance ---------------------------------------------------------------------------------------------4

Dental Insurance ---------------------------------------------------------------------------------------------6

Vision Insurance----------------------------------------------------------------------------------------------7

Disability Income Benefits----------------------------------------------------------------------------------8

Basic Life Insurance------------------------------------------------------------------------------------------9

Flexible Spending Accounts--------------------------------------------------------------------------------10

Health Savings Accounts------------------------------------------------------------------------------------11

Additional Benefit Offerings -------------------------------------------------------------------------------12

Questions & Answers ---------------------------------------------------------------------------------------13

This guide is intended for informational purposes only. © 2020-2021 Zywave, Inc. All rights reserved.

Commonwealth Emergency Physicians

Who Is Eligible? If you’re a full-time employee with Commonwealth Emergency Physicians, you’re eligible to enroll in the benefits outlined in this guide. How to Enroll Are you ready to enroll? The first step is to review your current benefits. Did you move recently or get married? Verify all of your personal information and make any necessary changes. Once all your information is up to date, it’s time to make your benefit elections. The decisions you make during open enrollment can have a significant impact on your life and finances, so it is important to weigh your options carefully. When to Enroll Open enrollment begins on December 10th and runs through December 20th. The benefits you choose during open enrollment will become effective on January 1 st , 2022. How to Make Changes Unless you experience a life-changing qualifying event, you cannot make changes to your benefits until the next open enrollment period. Qualifying events include things like:  Marriage, divorce, or legal separation  Birth or adoption of a child  Change in child’s dependent status  Death of a spouse, child, or other qualified dependent  Change in residence  Change in employment status or a change in coverage under another employer-sponsored plan

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Commonwealth Emergency Physicians

What’s new for 2022 Health Insurance - Medical We are offering the same 2 medical and prescription drug benefits for the upcoming plan year through Cigna: The Open Access Plus 500 and the Open Access Plus HSA plans. The following chart shows a brief comparison of the benefit choices available; however, please reference carrier plan summaries for detailed benefit structure.

OAP PLUS 500

OAP PLUS HSA

Services

In Network

Out-of-Network

In-Network

Out-of-Network

Physician Visit Copay (Primary/Specialist)

$25/$50

Deductible + 60%

Deductible + Coins

Deductible + Coins

$3,000/$6,000

$6,000/$12,000

CEP will fund $200 monthly into the HSA for full-time employees

CEP will fund $200 monthly into the HSA for full-time employees

Deductible (Individual/Family)

$500/$1,000

$750/$1,500

Inpatient-facility

Deductible + 20% Deductible + 60% Deductible + Coins

Deductible + Coins

Urgent Care Copay

$50

Deductible + 60% Deductible + Coins

Deductible + Coins

80%

60%

100%

80%

Coinsurance

Emergency Room Copay Out-of-pocket Maximum (Individual/Family) Prescription Drugs Deductible Copay

Deductible + 20%

Deductible + 20%

Deductible + Coins

Deductible + Coins

$4,000/$8,000

$5,500/$11,000

$4,000/$8,000

$10,000/$20,000

N/A $10/$40/$60

N/A 40%/60%

Combined w/Medical $10/$40/$60

Combined w/Medical 20%/80%

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Commonwealth Emergency Physicians

Your Cost in 2022

Monthly payroll deductions for full-time employees are detailed below:

EMPLOYEE MONTHLY DEDUCTIONS

Employee Only

Employee & Spouse Employee & Children

Employee & Family

$0.00

$547.27

$333.76

$1205.99

OAP PLUS 500 OAP PLUS HSA

$0.00

$285.16

$173.91

$785.48

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Commonwealth Emergency Physicians

Health Insurance - Dental In addition to protecting your smile, dental insurance helps pay for dental care and usually includes regular checkups, cleanings and X-rays. Several studies suggest that oral diseases, such as periodontitis (gum disease), can affect other areas of your body—including your heart. Receiving regular dental care can protect you and your family from the high cost of dental disease and surgery. We’re keeping Cigna as our dental provider for 2022. The following chart outlines the dental benefits we offer.

Type of Service

CIGNA DENTAL DPPO

Deductible (Ind/Fam)

$50/$150

Preventive & Diagnostic Services

Exams, Cleanings, Routine X-rays, Sealants – 100%

Basic Services

Fillings, Extractions, Periodontics, Root Canal - 90%

Major Services

Crowns, Dentures, Bridges —50%

Orthodontia

50% No Ortho Deductible - $ 1,500 Lifetime Max

Implants

50% after Deductible

Annual Maximum

$1,600

Employee only—$0.00 Employee & spouse—$43.26 Employee & child—$45.83 Family—$104.17

Monthly Payroll Deductions for all eligible employees

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Commonwealth Emergency Physicians

Health Insurance - Vision Driving to work, reading a news article, and watching TV are all activities you likely perform every day. Your ability to do all of these activities, though, depends on your vision and eye health. Vision insurance can help you maintain your vision as well as detect various health problems. Commonwealth Emergency Physicians’s vision insurance entitles you to specific eye care benefits. Our vision policy has been renewed with Cigna for the period 2022. Your vision benefits include the following:

Type of Service

CIGNA VISION – C1 Standard PPO Comprehensive In Network Out-of-Network Frequency

Exam Copay

$10

N/A

12 months

Up to $45

12 months

Exam Allowance

100% covered after copay

Materials Copay

$25

N/A

12 months

Eyeglass Lenses Allowances Single Vision Lined Bifocal Lined Trifocal Lenticular Contact Lenses Allowances Elective Therapeutic

100% covered after copay 100% covered after copay 100% covered after copay 100% covered after copay

Up to $32 Up to $55 Up to $65 Up to $80

12 months 12 months 12 months 12 months

Up to $130 100% covered

Up to $105 Up to $210

12 months 12 months

Frame Retail Allowance

Up to $140

Up to $77

12 months

Employee only—$6.21 Employee & spouse—$12.41 Employee & child—$12.54 Family—$20.01

Monthly Payroll Deductions

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Commonwealth Emergency Physicians

Disability Income Benefits Commonwealth Emergency Physicians provides full-time employees working 20 or more hours per week, except any person working on a temporary or seasonal basis, with short- and long-term disability income benefits. At Commonwealth Emergency Physicians, we want to do everything we can to protect you and your family. That’s why Commonwealth Emergency Physicians pays for the full cost of short- and long-term disability insurance—meaning that you owe nothing out of pocket. This year Reliance Standard is again our disability income benefits provider. In the event that you become disabled from a non-work-related injury or sickness, disability income benefits will provide a partial replacement of lost income. Please note, though, that you are not eligible to receive short-term disability benefits if you are receiving workers’ compensation benefits. A Brief description of the key features of the RSL insurance plan is described below. Insurance is provided under group policy form LRS-6564.

Short-term Disability

Long-term Disability

Injury (accident): On the 1 st consecutive day of disability Sickness (illness): On the 8 th consecutive day of disability Or the day following the number of accumulated sick days applicable to the employee The weekly benefit is an amount equal to 60% of covered earnings, up to a maximum benefit of $2,500 per week. Maternity covered as any other illness Non-Occupation coverage Partial Disability benefit included Transfer of Coverage provision

90 consecutive days of total disability

Day Benefits Begin

The monthly benefit is an amount equal to 60% of covered earnings, up to a maximum benefit of $10,000 per month.

Benefit Amount

Work Incentive & Child Care provisions Extended Disability Benefit FMLA Continuation Minimum Benefit Payable - $100 Own Occupation Coverage – 24 months Survivor Benefit – 3 months Benefits will not extend beyond the longer of Social Security Normal Retirement Age or Duration of Benefits according to the chart.

Features

Maximum Benefit Duration

Paid up to a maximum of 13 weeks.

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Commonwealth Emergency Physicians

Basic Life & AD&D Insurance Life insurance can help provide for your loved ones if something where to happen to you. Commonwealth Emergency Physicians provides full-time employees with $50,000 in group life and accidental death and dismemberment (AD&D) insurance. Commonwealth Emergency Physicians pays for the full cost of this benefit—meaning you are not responsible for paying any monthly premiums. Contact HR if you would like to update your beneficiary information.

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Commonwealth Emergency Physicians

Flexible Spending Accounts Paying for health care can be stressful. That's why Commonwealth Emergency Physicians offers an employer-sponsored flexible spending account (FSA) through Total Administrative Services Corporation - TASC. What Is a Health Care FSA? A health care FSA lets you use pre-tax dollars for certain IRS-approved medical care expenses not covered by your insurance plan. For example, cash that you now spend on deductibles, copayments or other out-of-pocket medical expenses can instead be placed in the health care FSA on a pre-tax basis. For 2021, the FSA maximum contribution limit is $2,750. For 2022, the limit is $2,850. The qualified transportation limits in 2022 are $280 per month for parking and $280 per month for transit. What Are the Benefits of a Health Care FSA? There are a variety of different benefits of using a health care FSA, including the following:  It saves you money . Allows you put aside money tax-free that can be used for qualified medical expenses.  It’s a tax - saver . Since your taxable income is decreased by your contributions, you’ll pay less in taxes.  It is flexible . You can use your FSA funds at any time, even if it’s the beginning of the year. For the 2022 plan year, you may roll over unused funds—up to $570 to use in the following year. What Is a Dependent Care FSA? Similar to health FSAs, dependent care FSAs allow you to contribute pre-tax dollars to qualified dependent care. The maximum amount you may contribute each year is $5,000 (or $2,500 if married and filing separately). How Do I Enroll? Fill out the FSA Enrollment Form during open enrollment at the online portal. Even if you signed up last year, you must re-enroll for 2022.

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Commonwealth Emergency Physicians

Health Savings Accounts Health savings accounts (HSAs) are a great way to save money and budget for qualified medical expenses. HSAs are tax- advantaged savings accounts that accompany high deductible health plans (HDHPs). HDHPs offer lower monthly premiums in exchange for a higher deductible (the amount you pay before insurance kicks in). What Are the Benefits of an HSA? There are many benefits of using an HSA, including the following:  It saves you money. HDHPs have lower monthly premiums, meaning less money is being taken out of your paycheck.  It is portable. The money in your HSA is carried over from year to year and is yours to keep, even if you leave the company.  It is a tax-saver . HSA contributions are made with pre-tax dollars. Since your taxable income is decreased by your contributions, you’ll pay less in taxes. The maximum amount that you can contribute to an HSA in 2021 is $3,600 for individual coverage and $7,200 for family coverage. In 2022, it increases to $3,650 for individual coverage and $7,300 for family coverage. Additionally, if you are age 55 or older, you may make an additional “catch-up” contribution of $1,000. You may change your contribution amount at any time throughout the year as long as you don’t exceed the annual maximum.

The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer. The text contained in this guide was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the guide and actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about the guide, please contact HR. The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer. The text contained in this guide was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the guide and actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about the guide, please contact HR.

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Commonwealth Emergency Physicians

Additional Benefits Offerings As a Commonwealth Emergency Physicians employee, you are also eligible to enroll or participate in the following voluntary programs:  Legal Shield – Legal Services. Please contact HR for the details.

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Commonwealth Emergency Physicians

Questions & Answers What changes are effective Jan. 1, 2022?  Enrollment in an FSA plan. What Forms Must Be Completed?  Fill out the Flexible Spending Account Enrollment Form/Direct Deposit Form to enroll, re-enroll or waive enrollment for the new plan year. If I Want to Make Changes, What Forms Must Be Completed?  Make your changes online. Other Information:  New elections must be made to continue participating in an FSA.  If you do not make changes to your current medical, dental, and vision elections, those elections will remain the same for the plan year Jan. 1st to Dec. 31st, 2022.

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