Medical Benefits
Welcome
Bensonwood and Unity offers a health insurance plan administered by UltraBenefits. The plan uses the the Cigna provider network.
Eligibility
All employees working 30 or more hours per week are eligible to enroll in health insurance. Eligibility for newly hired, hourly employees is following 90 days of full-time employment.
Benefit Information
How do I enroll?
Open Enrollment is your time to make new benefit elections or make changes to your current benefit elections. During Open Enrollment, June 2023, your Arcoro Benefits Portal.
Waiving or Declining Health Insurance
If you are eligible for health insurance and will not be enrolling because of alternative coverage, or choose not to have insurance, a waiver form must be signed during the enrollment period. If you elect not to enroll, you may not join the plan until the next Open Enrollment period, unless there is a “qualifying event.” A Qualifying Life Event is a life-changing situation that allows you to make changes to your benefit elections, outside of the normal, Open Enrollment period. Examples of Qualifying Life Events include: the birth of a child, marriage, divorce and a loss of other coverage.
All employees should be aware of possible Federal tax penalties for declining Bensonwood’s health insurance plan enrollment, as well as alternatives for health insurance available through the Health Insurance Exchange. For more information about declining health insurance, see: https://www.healthcare.gov/get-coverage/ and http://www.valuepenguin.com/ppaca/exchanges/nh.
What happens if I leave Bensonwood/Unity?
Under certain circumstances, you and your dependents may continue to participate in health coverage, dental insurance, and the Medical Flexible Spending Account through the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA is a federal guarantee of the continuation of health insurance plan coverage after employment ends, which allows you to remain on medical and dental coverage, at the employee’s expense, for up to 18 or 36 months, depending on the circumstances. Former employees who enroll via COBRA will be responsible for the full cost of the monthly premiums.
Summary of Benefits & Coverages
There are three major components of a Health plan.
Network – Bensonwood/ Unity’s Health plan, administered by Ultra Benefits, uses the Cigna network.
- For a list of the participating In-network providers,
visit www.mycigna.com.
Cost To Use – For in-network services, you will have copays for office visits, outpatient mental health and emergency care. You will be responsible for meeting the deductible for most other in-network and out-of-network services, before the plan begins to pay. Once the deductible has been met, you will pay 20% coinsurance for most in-network services and 50% for out-of-network services. Coinsurance will be paid until the Out-of-Pocket Maximum (OOP) has been met. The Out-of-Pocket maximum refers to the most you will pay for covered expenses under the plan. You will experience a much higher OOP for Out-of-Network services.
Cost To Own – The amount that will be deducted from each paycheck is listed below.
Contributions & Rates
The chart below shows the weekly payroll deduction for various coverage levels of each plan.
Carrier Contact Information
Plan Documents
Prescription Coverage
Prescription Drug Plan
Maximum Out of Pocket (MOOP): $7,900 Individual / $15,800 Family
The plan year MOOP applies to pharmacy and medical claims. Each individual family member must meet the single MOOP unless the family MOOP has been met by any two or more covered family members. Once met, your covered prescriptions are paid at 100%. Generic dispense as written penalties do not apply to the MOOP.
Specialty Medications: Specialty medications must be ordered through Caremark Specialty Pharmacy at 1-800-237-2767. Medications are limited to a 30-day supply and may require prior authorization.
Generic Policy: If your doctor writes a prescription stating that a Generic may be dispensed, we will only pay for the Generic drug. If you choose to buy the Brand name drug in this situation, you will be required to pay the Brand copay plus the difference in cost between the Generic and Brand name drug. The Generic Policy does not apply if your doctor requires a brand name medication.
Maintenance Medication Coverage: The Prescription Drug Card Program will only cover maintenance medications through the Caremark Mail Order pharmacy or your local CVS pharmacy. Maintenance medications are those that treat an ongoing condition such as high blood pressure, diabetes or contraception. You can get up to two fills (original and 1 refill) from your local participating pharmacy. After that, the program will cover the medication ONLY if you order it from the Caremark Mail Order pharmacy or a local CVS pharmacy.
Drugs covered may be subject to Utilization Management which may include prior authorization and/or quantity limits. Please contact Member Services at 1-800-334-8134 if you have specific drug questions or register at caremark.com to check coverage.
For general questions contact RxBenefits at RxHelp@rxbenefits.com
Carrier Contact Information
Forms and Plan Documents
Flexible Spending Accounts (FSA) and Dependent Care Accounts (DCA)
Medical Flexible Spending Account (FSA)
What is a Medical Flexible Spending Account? A Medical FSA is a tax-advantaged employee benefit that allows eligible employees to voluntarily set aside pre-tax dollars through equal payroll deductions to be used for eligible health care expenses.
Who is eligible? The medical FSA is available to all regular full-time employees, working 30 or more hours per week, whether or not they participate in Bensonwood/Unity’s Health insurance. For new hourly employees, eligibility begins on the first of the month, following the 90 days of employment.
Eligible employees may elect to contribute up to $3,050 in 2023.
Medical FSA Basics
- Medical FSAs are used to set aside money for planned or reoccurring qualified medical expenses that are not covered by insurance, such as dental care, vision care, contact lenses, co-pays, deductibles, out-of-network expenses. For a list of qualified expenses visit: https://www.irs.gov/pub/irs-pdf/p502.pdf
- Under the Coronavirus Aid, Relief and Economic Security Act (CARES Act), the definition of a qualifying medical expense now includes certain over-the-counter (OTC) medications and products. For some examples of these products, see the “Expanded FSA Expense” flyer.
- You have full access to your total election amount on the 1st day of that plan year. You do not need to wait until your FSA payroll deductions equal the amount of your qualified medical expense.
- Most transactions can be paid at the point of sale with a debit card pre-loaded with your total FSA amount for that plan year.
- You may carry $610 or less into the next plan year. Any remaining funds exceeding $610, would be forfeited.
What is the most I can contribute?
- $3,050 for plan year
- Payroll deductions are based on 26 paychecks per year.
- For new employees enrolling after January 1, the maximum allowable amount to be set aside is prorated. Payroll deductions will be based on the remaining number payroll checks in the plan year.
Dependent Care Account (DCA)
What is a Dependent Care Flexible Spending Account?
A dependent care FSA (DCA) allows employees to set aside pre-tax dollars to pay for daycare expenses for your children under 13, or qualifying dependents. To qualify for a DCA, the IRS requires that both spouses be employed or full-time students.
The amount you may contribute to the dependent care FSA is $5,000, if single or married filing jointly; $2,500, if married and filing separately.
Please note that the DCA is 100% employee funded and is only available to use as monetary contributions are made.
Eligible Daycare Expenses :
- Childcare or Adult Care by a licensed childcare facility, for children under 13 years of age who qualify as tax dependents.
- Childcare or Adult care for children or adults of any age who are physically or mentally unable to care for themselves and qualify as dependents.
Ineligible Daycare Expenses :
- Educational expenses including kindergarten or private school tuition fees
- Amounts paid for food, clothing, sports lessons, field trips, and entertainment
- Overnight camp expenses
- Transportation expenses
- Child Support payments
For additional information, please contact csONE Benefit Solutions at 888-227-9745 x2040 or email at flexiblebenefits@csONE.com.
Visit https://www.irs.gov/forms-pubs/about-publication-503 for a comprehensive list of eligible expenses, federal laws and regulations.
How do I enroll in the FSA or DCA?
Whether you are enrolling for the first time, or continuing to participate in the new plan year, you would need to complete your enrollment through your Paylocity Benefits Portal at access.paylocity.com/
Once you have made an election, unless you experience a qualifying event, you are unable to make changes until the next open enrollment period.
Carrier Contact Information
Forms and Plan Documents
Dental Benefits
Eligiblity
All employees who work a minimum of 30 hours per week are eligible, first of the month, following 90 days of employment.
Summary of Benefits and Coverages
Plan Overview
Bensonwood/Unity offers it’s employees the PPO Plus Premier plan through Northeast Delta Dental. The plan covers Preventive Care, Minor and Major Restorative procedures, as well as Orthodontics.
The chart below provides a high level overview of the dental plan design and features offered to eligible employees by Bensonwood/Unity.
When considering whether purchasing dental insurance makes sense for you and your family, there are three things you should consider:
Network – Northeast delta dental has an extensive network. For a complete list of in-network dentists, visit https://portal1.nedelta.com/DentistSearch. In the “Network” field, enter “Delta Dental Premier”. If you visit a non-participating (Out-of-Network) dentist, you may be required to submit your own claim and pay for services at the time they are provided.
Cost to Use – There is no deductible for Preventive Services (Coverage A) or Orthodontia (Coverage D). For Basic services (Coverage B) and Major services (Coverage C) you will pay a one-time, Individual deductible of $100 or Family deductible of $300.
The annual maximum for the PPO plus Premier plan is $2,000 per member. The annual maximum may be increased to as much as $4,000 per person with the Double-Up Max program. See the attached Double-Up Max flyer for more information.
After meeting the deductible, you will be responsible for 20% of the cost of in-network Basic services, 50% of Major services, and 100% of all services once you’ve reached your annual max of $2,000, unless you benefited from the Double-Up Max rollover provision. You would be responsible for orthodontia costs beyond $1,500 per member, per lifetime.
Cost to Own – What will your per paycheck deduction be? The amount that will be deducted from each paycheck is listed below.
Contributions & Rates
Enrolled employees pay premiums through payroll deductions, over 26 pay periods.
With Dental Insurance, it might be helpful to conduct a cost-benefit analysis for yourself and your family before enrolling. Once you’ve determined your annual cost to own the insurance, based on the premium chart above, consider the following:
- How often do you and your family members receive preventive dental care?
- Do you expect to need major, non-cosmetic dental work in the coming year?
- Do you have a dentist you know and trust that is included in this plan’s network?
- Would making tax favorable elections/contributions to an FSA be a less expensive way for you to pay for dental care?
Carrier Contact Information
Northeast Delta Dental: Dental Insurance
Customer Service: 800-832-5700
Website: www.nedelta.com
Plan Documents
Vision Benefits
Eligiblity
All employees who work a minimum of 30 hours per week are eligible, first of the month, following 90 days of employment.
Summary of Benefits and Coverages
Plan Overview
Bensonwood/Unity offers it’s employees an opportunity to enroll in a voluntary vision plan through Delta Dental operating on the nationwide EyeMed Vision Care Access Network.
This plan provides hardware benefits only.
To locate a participating EyeMed Access Network provider, log on to https://eyedoclocator.eyemedvisioncare.com/nedd/en or call 1-866-723-0513.
The chart below provides a high level overview of the vision plan design and features offered to eligible employees by Bensonwood/Unity.
Contributions & Rates
Enrolled employees pay premiums through payroll deductions, over 26 pay periods.
Carrier Contact Information
Northeast Delta Dental: Vision Insurance
Customer Service: 866-723-0513
Website: www.eyemed.com
Plan Documents
Group Life Insurance
Eligibility
Employees who work 30+ hours per week are eligible on the first of the month, following 90 days of employment.
Summary of Group Basic Life and AD&D Benefits and Coverages
Group Basic Life
COVERAGE:
Benefits are 1x salary to a maximum of $100,000.
AD&D: Amount is equal to life coverage
PORTABILITY: You may continue the policy for you and your spouse at the same group rates if your employment ends. The policy continues until the employer’s policy cancels.
REDUCTION SCHEDULE:
AGE:
65-99 65% of original coverage amount
70-74 50% of original coverage amount
75-79 35% of original coverage amount
80+ 20% of original coverage amount
Voluntary Supplemental Life
COVERAGE:
Employee: Benefits available in increments of $5,000, up to 7x salary to a maximum of $500,000.
Spouse: Benefits available in increments of $5,000, not to exceed 50% of the employee amount, up to a maximum of $150,000.
Child: Less than 26 – $2,500, $5,000, $7,500 or $10,000. Rate is $.20 per $1,000, per month.
GUARANTEE ISSUE: Only applies during initial enrollment period.
Employee: $150,000
Spouse: $25,000
Child: All amounts guaranteed
PORTABILITY: You may continue the policy for you and your spouse at the same group rates if your employment ends. The policy continues until the employer’s policy cancels.
REDUCTION SCHEDULE:
AGE:
65-99 65% of original coverage amount
70-74 50% of original coverage amount
75-79 35% of original coverage amount
80+ 20% of original coverage amount
Coverage ends at retirement if occurring prior to age reductions.
AD&D: Amount is equal to life coverage and not available on dependent life plans. Rate is $.03 per $1,000.
Carrier Contact Information
Symetra: Life and AD&D
Customer Service: 800-796-3872
Website: www.symetra.com
Forms & Plan Documents
STD Coverage
Eligibility
Employees who work 30+ hours per week are eligible on the first of the month, following 90 days of employment.
Voluntary Short-Term Disability
Elimination Period: Benefits begin on the 15th day after an Accident, or 15th day after an illness
Max Benefit Duration: 13 weeks
Maximum Benefit: 66 2/3% of salary or $1,250
Minimum Benefit: $50
- As long as an employee remains enrolled, the premium payable for the selected insurance coverage will always be based upon the employee’s age at the time of original enrollment.
- Program includes $10,000 Accidental Death and Dismemberment (AD&D) coverage.
Note: There is a pre-existing condition limitation that applies to new enrollees for the 1st 12 months of coverage
Carrier Contact Information
csONE & Companion Life: Short-Term Disability
Customer Service: 888-227-9745
Website: www.csONE.com
Forms & Plan Documents
Accident & Critical Illness
Eligibility
All employees who work 30 or more hours per week are eligible beginning on the first of the month, following 90 days of employment.
Critical Illness
CriticalEvents® is voluntary, critical illness insurance that can help ease financial stress by paying a cash benefit that can be used however you need it — from deductibles and healthcare expenses not covered by major medical, to paying everyday living expenses while you’re out of work.
Benefit Amount: $10,000, $15,000, $20,000, $25,000, $30,000, $35,000, $40,000, $45,000 or $50,000
- Spouse and eligible children benefit amount will be 50% of the benefit you elect.
Covered Illnesses: : Heart Attack, Severe Stroke, End-Stage Renal Failure, Miscellaneous Diseases, Alzheimer’s Disease, Coronary Artery Disease Requiring Bypass Grafts, Coronary Artery Disease Requiring Angioplasty/Stent
Optional Riders: Cancer Benefit Rider, Recurrent Critical Illness Benefit Rider (50%), and Health Screening Indemnity Benefit Rider ($75)
Accident
Accident pays benefits for accidental injuries. Your coverage will pay benefits for things like X-rays, dislocations, bone fractures, follow-up physical therapy, Hospitalization, Ambulance rides, along with Accidental Death and Dismemberment (AD&D) benefits.
Carrier Contact Information
csONE & Trans America: Accident & Critical Insurance
Customer Service: 888-227-9745
Website: www.csONE.com
Forms & Plan Documents
401(k) Retirement Plan
Eligibility
401(k) Plan Details
Bensonwood/Unity’s retirement plan is administered by Empower Retirement. Associates are eligible after 1 year of service if they are at least 18 years of age. The company may match up to one-third of the first 6% when profits can support the match.
The online portal is: https://regn.lincolnfinancial.com/ent-ui-registration/index.html#/
Associates are given an enrollment code and walk through the prompts to enroll themselves in either a Traditional or Roth 401k.
Upon departure, associates with a vested balance may leave their 401k within the plan (though we do not prefer it), or they may request a rollover or withdrawal on the online portal. If the vested account balance is $1,000 or less and the distribution form is completed within 30 days, then the benefit will be distributed to the associate and will be subject to federal and state income taxes. Associates may also incur an early withdrawal penalty on the amount distributed. If the vested account balance is more than $1,000 but less than $5,000, if the form is not completed within 30 days, the benefit will then be rolled over to an IRA established by the plan on the associate’s behalf through Millennium Trust.
Retirement 401(k): Lincoln Financial Group
Participant Services: 800-510-4015
Website: www.http://www.lincolnfinancial.com
Employee Assistance Program (EAP)
Eligibility
This program is available to all employees and their household family members.
Plan Details
Bensonwood/Unity promotes the health of employees and their household members by offering immediate access to free, confidential counseling through Invest EAP, for a wide range of life issues. This program is available to all employees and their family members.
Invest EAP is a Vermont-based public and private non-profit collaborative that has offered comprehensive Employee Assistance Program (EAP) services since 1986. Invest EAP provides short-term counseling and referral, management consultation, wellness workshops and resource information.
Invest EAP’s comprehensive confidential services include:
- 24/7 telephone access to counselors
- In-person counseling sessions
- Management consultation
- Counseling, resource and referral information to address issues involving:
- Relationships and Family
- Drug and Alcohol
- Mental Health
- Grief and Loss
- Medical
- Disability
- Eldercare
- Childcare
- Parenting Techniques
- Workplace Conflict
- Legal Issues
- Financial Problems
- Wellness workshops
- Critical Incident Stress Debriefings
- Facilitated discussions
- Organizational development
- Workplace wellness program development
- Much, much more!
Need Assistance?
Go to: www.investeap.org
Call:1-866-660-9533
EAP: Invest EAP
Participant Services: 866-660-9533
Website: www.investeap.org
SmartConnect- Medicare Resource
The Richards Group has partnered with SmartConnect™, an exclusive, no-cost program created specifically to connect Medicare-eligible working adults to the world of Medicare benefits. Whether an employee plans to continue working or is transitioning to retirement, we tailor solutions designed around their needs. Our agents provide an unfiltered view of the entire range of options and prices available to the employee.
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SmartConnect Contact Information
For more information or to get started, please click on the following link: https://gps.smartmatch.com/
Additional Information
