BENEFITS
GUIDE 2017
A
healthy
balance
A HEALTHY BALANCE
Welcome to the BSN SPORTS, LLC Employee Benefits Guide. As you review this
guide, you will notice that not only do you have a full array of benefits, but also a
number of choices.
Having choices means that employees can select those plans and options best suited to
their family’s particular needs. To make informed choices regarding your benefits,
please take the time to learn about the features of the various plans offered. The
information in this guide can help you do this by providing an overview of the benefits.
This guide also contains information on how to enroll in each benefit plan and how to
change your current elections.
This summary contains highlights only and is subject to change. The specific terms of
coverage, exclusions, and limitations are contained in the Plan Document or insurance
certificate. If you have any questions about a specific service or treatment, please contact
the Dallas Human Resources department directly at 1.800.230.0055.
What’sNEW
NewINin2017...
2017…
WHAT’S
AT A GLANCE
 Benefits Eligibility changes to the 1st of the month following 30 days of employment
for all benefits including 401k.
 New Care Management resources to assist you and your family through major
medical conditions via proactive outreach and engagement with dedication clinical
teams
 New Pharmacy Management changes that could impact the cost of your
medication(s) (higher or lower) for the coming year. Some medications could also
require pre-authorizations or be excluded for a therapeutic equivalent.
 Dental Orthodontic maximum is increased from $1,000 to $1,500
GETTING STARTED WITH OPEN ENROLLMENT
• Review your current benefits enrollment and contributions on the ADP portal or
contact HR for assistance.
• Watch all enrollment videos. Your HR Department is available to answer your
questions.
• Read your 2017 Benefits Guide.
• Review and compare the benefit plans that are available through your spouse’s
employer or other available plans.
• Compare premium costs that are available, keeping in mind that all premium costs
are based on 24-paycheck deductions.
• If you are enrolling dependents for the first time, you will be required to furnish to
your HR Department eligible proof of your dependents (e.g. birth certificate,
marriage license or latest tax returns). If you have provided this information in
the past you do not need to do it again. This only applies to new dependents
enrolling into the plan.
• All full-time employees must complete open enrollment. Elections and
deductions do not carry forward from the previous year. You must elect or waive
all benefits offered to you during any enrollment period.
• Remember if you do not enroll, your benefits will end effective December 31st.
• If you are enrolling outside of open enrollment, you must enroll before the 1st
day of the month following 30 days of employment.
4
Table of Contents
5
Table of Contents
6
Willis Patient Care…………………………………………………………….……..….…………
New Hire Enrollment/Life Event Changes …………….……..….………………..……
Eligibility
……………………………………………………………..…………………….…..……
Willis Patient
Care…………………………………………………………….……..….…………
7
New Hire Enrollment/Life Event Changes …………….……..….………………..……
Benefits……………………………...……………………..………………………………………..…
8
Eligibility
……………………………………………………………..…………………….…..……
Medical Plan Summary ..……………………………………………………..…………………
9
Benefits……………………………...……………………..………………………………………..…
Medical Plan Options.…………………………………..............................................
10
Medical
Plan
Summary
..……………………………………………………..…………………
Non-Traditional Plan FAQ..………………………….............................................
11
Medical
PlanPlan
Options.………………………………….............................................
Traditional
FAQ..……………………...............................................................
12
Non-Traditional
Plan
FAQ..………………………….............................................
Benefit Rates……………….…………………………………....................................................
13
Traditional
FAQ..……………………...............................................................
Prescription
Drug Plan
Information……………….................................................................
14-15
Benefit
Rates……………….…………………………………....................................................
Know Before You Go……….…………………………….......................................................
16
Prescription
Drug Information……………….................................................................
Dental
Benefits………………………………………………………………………………..……
17
Know
Before
You
Go……….…………………………….......................................................
Vision Benefits….…………..……………………..…..……………………………………………
18
Dental Benefits………………………………………………………………………………..……
Flexible
Spending Accounts…………………………….....................................................
29
Vision
Benefits….…………..……………………..…..……………………………………………
TelaDoc/LifeLock…………….…………………….................................................................
20
Flexible Spending
Accounts…………………………….....................................................
Colonial
Plan Offerings
TelaDoc/LifeLock…………….…………………….................................................................
Accident Plan ……………………………………………..............................................
21
Colonial
Plan Plan
Offerings
Cancer
………………………………………………..............................................
22
Accident
Plan
……………………………………………..............................................
Critical Illness Plan……………………………………...............................................
23
CancerTerm
PlanDisability
………………………………………………..............................................
Short
………………………………................................................
24
Critical
Illness
Plan……………………………………...............................................
Long
Term
Disability
(Unum)..……………………..............................................
25
Short Term
Disability ………………………………................................................
Hospital
Confinement
(Medical Bridge)………..............................................
26
Long Term
Disability…………………………….......................................................
(Unum)..…………………….............................................
Term
Life Insurance
27
Hospital
(Medical Bridge)……….............................................
Whole
orConfinement
Universal Life…..…………………………...............................................
28
Term Life Insurance ……………………………......................................................
401(k)………….…………………….……………………….........................................................
29
Universal Life…..…………………………..............................................
30-32
How toWhole
Enrollor…………………….………………………………..............................................
401(k)………….…………………….……………………….........................................................
Online
Benefits
Center............................... 33
Benefits
ContactInformation
Information………..…………………………………………………..……
How Some
to Enroll
…………………….………………………………..............................................
Take
“Notes”.............................................................
34
Benefits Contact Information………..…………………………………………………..……
35
5
BSN has partnered with Willis Patientcare to provide employees with an independent
confidential healthcare advocate to assist you with your everyday benefits needs. They
are here to help you navigate through the healthcare system and help you become a
better healthcare consumer. Your Patientcare representative is not affiliated with any
insurance company. Headquartered in Milwaukee WI they are available to assist you
with all of the following:









Explain in detail the plan options available to you through BSN
Help you make your Plan Choices each year
Billing questions and concerns
Work with providers to get questions answered
Answer Network questions
Estimate Procedure and Plan Costs
Audit Explanation of Benefits and provider bills
Get billing errors corrected
Assist with questions about Medicare & Medicaid
1-800-640-1898
Monday – Friday 8am–9pm ET
Saturday 9am–2pm ET
[email protected]
Se habla español
6
NEW HIRE/LIFE
CHANGES…
NEW
HIRE / LIFEEVENT
EVENT
CHANGES
NEW HIRE ENROLLMENT
• You are eligible to enroll in benefits the first of the month following 30 days of
employment.
• If you are part of an acquisition and are considered “Grandfathered” or you converted
from Temporary to Permanent Employment you are eligible to enroll in the benefits
the first of the month following the date of acquisition of your previous company or
your date of conversion.
• You should watch the benefits videos after you begin employment with BSN or at close
of acquisition of your previous company. Once you have completed the video’s you
can log onto ADP to complete your enrollment. If you have any questions about your
benefits, you contact Patientcare or Human Resources.
•
To complete your enrollment, watch the ADP enrollment video by visiting:
https://support.adp.com/basic/cr/matraining/sims/wfn/80929/enroolinginabenefitplan.htm
or by signing into the ADP portal, clicking on “MYSELF”, “BENEFITS”,
“ENROLLMENTS” then click on the play button next to the question mark at the top of
the page. Finally click on “Enrollments Learning Byte(s), “Enrolling in a Benefit Plan”.
• Review your first paycheck after enrolling to make certain your deductions are coming
out of your check appropriately. If you find any errors, notify Human Resources
immediately. BSN will only make corrections retroactively for 60 days. Mistakes
beyond that time period may not be changed until the next open enrollment
period.
LIFE EVENT CHANGES
You may be able to change your coverage if you have a life changing event. YOU MUST
NOTIFY HUMAN RESOURCES WITHIN 30 DAYS OF THE LIFE EVENT IN ORDER TO
QUALIFY FOR COVERAGE. Requests for changes after that date are not allowed and will
not be considered. The following list constitutes a life changing event, but is not limited
to:
 Change in the marital status (marriage, death of spouse, divorce, legal
separation).
 Change in number of dependents (birth, death, adoption, eligibility status, child
support order).
 Change in employment status for you or your spouse (commencement,
termination, leave of absence, full-time to part-time or vice-versa).
 Special enrollment right under HIPAA
 You, your spouse or child gains or loses Medicare or Medicaid coverage.
7
ELIGIBILITY…
ELIGIBILITY
WHO IS ELIGIBLE TO ENROLL IN BSN HEALTH PLANS?
If you are a full-time employee, or a part time employee working 30 hours per week or
more you are eligible for all health benefits summarized in this guide.
Eligible dependents may include:
 Your lawful spouse.
 Your unmarried child who is less than 26 years old.*
 Your same sex domestic partner.
Note: The term “child” means a child born to you, legally adopted by you, a stepchild living
with you, or a child related to you by blood or marriage or which you are the legal guardian.
A dependent child who is no longer eligible, due to attainment of the limiting age of 26, is
eligible to continue benefits under COBRA.
Note: If you are enrolling dependents for the first time, you will be required to
furnish proof of dependents to your HR Department (i.e. latest tax returns or birth
certificate and/or marriage license or domestic partner affidavit) before coverage
will take effect.
Both full-time and part-time employees are eligible to participate in the 401(k) plan
the 1 st of the month following 30 days of employment and have met the age
requirement of 21 years of age.
Once eligible, you can enroll in the 401(k) plan or make changes to your contribution the
first of any month by visiting the Principal website at www.principal.com. If you have
not registered on the site before, you will need your Social Security Number and address
on file with BSN in order to complete the registration process. Human Resources is
available to assist you with any questions you may have or address any concerns with the
registration process.
8
Benefits…
BENEFITS
High quality, affordable health care is the number one concern for most people.
That’s why BSN SPORTS, LLC “BSN” is pleased to offer you options when choosing
your benefit plans.
BSN pays a large portion of the cost of your health coverage. The amount you contribute
depends upon the plan(s) you choose and the coverage level you select.
WE OFFER A FULL BENEFIT PACKAGE INCLUSIVE OF THE FOLLOWING










Health Plan sponsored by AETNA
Dental Plan sponsored by MetLife
Prescription plan sponsored by AETNA Home Delivery & Specialty Pharamacy
HSA Bank Account sponsored by PayFlex
Flexible Spending Account (FSA) administered by ADP
401(k) Plan with a Match administered by Principal Financial
TelaDoc/LifeLock/Petassure
Long Term Disability Insurance through Unum
HIPPA - PRIVACY
Vision Plan through EYEMED
Please be aware that your
Ancillary Benefits sponsored by Colonial Life
personal data, including
• Accident Insurance
any nonpublic information
• Cancer Insurance
we receive enrolling you in
• Critical Illness Insurance
your individual and group
• Short Term Disability through Colonial
benefits, is protected in
• Hospital Confinement (Medical Bridge)
accordance with the Health
• Term Life Insurance
Insurance Portability and
• Universal Whole Life Insurance
Accountability Act
OPTIONS FOR MEDICAL COVERAGE
To provide all employees and their families with the most suitable coverage, BSN offers
two (2) medical options from which to choose:
 Traditional Plan
 Non-Traditional Plan with a Health Savings Account (HSA)
All of our options provide high quality, affordable medical care, which include doctor’s
visits, hospitalization, pharmacy and prescription, and emergency care.
Each option has unique characteristics and advantages. In the following pages, we will
look at each of these options and by learning about the options, you can make an
informed decision about the coverage that best meets your needs and those of your
covered dependents.
9
MEDICAL
Medical
MedicalPLAN
Plan
PlanBENEFITS
Benefits…
Benefits…
AETNA
AETNAPLAN
PLANSCHEDULE
SCHEDULEOF
OFMAJOR
MAJORMEDICAL
MEDICALBENEFITS
BENEFITS
Plan
PlanDesign
Design
Deductible
Deductible(Individual/Family)
(Individual/Family)
HSA
HSAEmbedded
EmbeddedFamily
FamilyDeductible
Deductible
Out
OutofofPocket
PocketMaximum
Maximum(Includes
(Includes
Deductible,
Deductible,Co-pays,
Co-pays,RX
RXcharges)
charges)
Coinsurance
Coinsurance
Preventative
Preventative
Primary
PrimaryCare
Care
Specialist
Specialist
Urgent
UrgentCare
Care
Traditional
Traditional
Non-Traditional
Non-Traditional
With
WithHSA
HSA
$6,350
$6,350//$12,700
$12,700
$5,000
$5,000//$10,000
$10,000
Free
Free
Free
Free
$3,500
$3,500//$7,000
$7,000
N/A
N/A
You
YouPay
Pay30%
30%
$2,000
$2,000//$4,000
$4,000
$2,600
$2,600
You
YouPay
Pay20%
20%
$30
$30
D/Coinsurance
D/Coinsurance
$50
$50
D/Coinsurance
D/Coinsurance
$60
$60
ER
ER
$150
$150
Hospitalizations/Mental
Hospitalizations/MentalHealth
Health&&
D/Coinsurance
D/Coinsurance
Substance
SubstanceAbuse
Abuse(In
(InPatient)
Patient)
Mental
MentalHealth
Health&&Substance
SubstanceAbuse
Abuse(Out
(Out
$30
$30or
or$60
$60
Patient)
Patient)
RX
RXRetail
Retail(Generic,
(Generic,Formulary,
Formulary,NonNon$10,
$10,$30,
$30,$50,
$50,$200
$200
Formulary,
Formulary,Specialty)
Specialty)
RX
RXMail
MailOrder
Order(Generic,
(Generic,Formulary,
Formulary,
$10,
$10,$60,
$60,$100,
$100,$200
$200
Non-Formulary,
Non-Formulary,Specialty)
Specialty)
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
D/Coinsurance
MONTHLY
MONTHLY
MONTHLY
MONTHLY
24
24
–
–
CHECK
CHECK
24
24––CHECK
CHECK
NONNONCOVERAGE
COVERAGE TRADITIONAL
TRADITIONAL
DEDUCTION
DEDUCTION
DEDUCTION
DEDUCTION
TRADITIONAL
TRADITIONAL
TIER
TIER
PLAN
PLAN
AMOUNT
AMOUNT
AMOUNT
AMOUNT
PLAN
PLANWITH
WITH
HSA
HSA
HSA
HSA
ANNUAL
ANNUAL
FUNDING
FUNDING
Employee
Employee
$167.41
$167.41
$83.71
$83.71
$131.28
$131.28
$65.64
$65.64
$350*
$350*
Only
Only
Employee
Employee&&
$466.12
$466.12
$233.06
$233.06
$393.86
$393.86
$196.93
$196.93
$700*
$700*
Spouse
Spouse
Employee
Employee&&
$396.19
$396.19
$198.10
$198.10
$334.77
$334.77
$167.39
$167.39
$700*
$700*
Child(ren)
Child(ren)
Family
Family
$713.92
$713.92
$356.96
$356.96
$612.75
$612.75
$306.38
$306.38
$700*
$700*
Note:
Note: HSA
HSAFunding
Fundingisisdone
doneinintwo
twoSemi-annual
Semi-annualpayments
payments$175/$350
$175/$350on
on1/1
1/1&&7/1
7/1
with
withNew
Newhires
hiresprorated
prorated
10
MedicalPLAN
PlanOPTIONS
Options…
MEDICAL
WHICH PLAN IS RIGHT FOR YOU?
When choosing medical coverage for you and your family members, it’s important to first
review how you and your family members use health care.
TRADITIONAL PLAN OPTION
The Traditional Plan is comprehensive health coverage that is designed to reduce up
front medical out of pocket costs through utilization of Co-pay’s for payment of routine
office visits and prescription needs. The Traditional Plan Option offers the following:





Coinsurance
Deductible
Maximum Out of Pocket
Co-pay’s
Pharmacy Co-pay’s with Mail Order options for maintenance medications
The Traditional Plan can be paired with the Regular FSA account which allows you set
aside up to $2,550 on a pretax basis to help cover any out of pocket expenses you incur.
NON-TRADITIONAL PLAN WITH HSA OPTION
The Non-Traditional Plan is comprehensive health coverage that is designed for those
who are light users of health care. The non-traditional plan has a Health Savings Account
paired with it that allows you to set aside additional funds on a pretax basis to cover out
of pocket costs for medical, dental and vision expenses. BSN funds a portion of the
account and then you can invest the account in mutual funds so that your account grows
in value over time into a nest egg. The Non-Traditional Plan with the HSA Option offers
the following:
Coinsurance
Deductible
Maximum Out of Pocket
Pharmacy benefits with Mail Order options for maintenance medications
Tax Free Savings Account of up to $3,400/$6,750 for individuals/family with
investment options
 Bank account with PayFlex that includes a Debit MasterCard





The Non-Traditional Plan can be paired with the Limited FSA account to increase your
pretax savings and allows you to set aside up to $2,550 additional to help cover any out
of pocket expenses you incur for Dental and Vision only.
11
Non-Traditional
(HSA)…
NON-TRADITIONAL HSA
HOW DOES THE NON-TRADITIONAL HSA PLAN WORK?
What do I pay if I go to a physician’s visit, Urgent Care Center, or ER?
You pay the discounted cost out of your HSA account. Once you have met your
deductible of $2,000 for individual or $4,000 for any other coverage, you pay 20% of
the discounted charges until you have paid another $3,000 for invidual or $6,000 for
any other coverage.
What do I pay if I’m admitted to the Hospital?
You pay the discounted cost out of your HSA account. Once you have met your
deductible of $2,000 for individual or $4,000 for any other coverage, you pay 20% of
the discounted charges until you have paid another $3,000 for invidual or $6,000 for
any other coverage.
What do I pay if I have lab work done?
You pay the discounted cost out of your HSA account. The deductible on lab work for
this plan is not waived. Once you have met your deductible of $2,000 for individual or
$4,000 for any other coverage, you pay 20% of the discounted charges until you have
paid another $3,000 for invidual or $6,000 for any other coverage.
If I have more than Employee Only coverage how many deductibles do I have to
meet?
Once one person has met $2,600 the plan will begin to pay per person once a total of
$4,000 has been paid towards deductibles of all combined persons you are done with
deductibles for the year.
What do I pay if what I’m doing is preventative services?
All preventative is covered at 100% under the plan so you pay nothing.
What do I pay if I have prescriptions?
You pay the discounted cost out of your HSA account. Once you have met your
deductible of $2,000 for individual or $4,000 for any other coverage, you pay 20% of
the discounted charges. Prescriptions count against your deductibles and out of pocket
maximums.
What if I don’t have enough money in my HSA account to pay, can I change it?
You would pay the charges out of your pocket at the discounted rates. You can fund
your HSA post tax directly via bank to bank transfer at any time.
12
Traditional PLAN
Plan…
TRADITIONAL
HOW DOES THE TRADITIONAL PLAN WORK?
What do I pay if I go to a physician’s visit?
You pay the office visit Co-pay of $30 primary care or $60 for a specialist.
What do I pay if I have to go to an Urgent Care Center?
You pay the office visit Co-pay of $50.
What do I pay if I have to go to the ER?
You pay the Co-pay of $150. If your admitted, the Co-pay is waived.
What do I pay if I’m admitted to the Hospital?
You pay the first $3,500 out of your pocket. After that, you pay 30% of the remaining
charges until you have paid another $2,850 for a total out of pocket of $6,350 for the
year for an individual, or $7,000 for family, then another $5,700 for a total family out
of pocket of $12,700 for the year.
What do I pay if I have lab work done?
The deductible for lab work is waived on this plan, therefore, you pay 30% of the lab
charges until you have met your total out of pocket for the year.
If I have more than Employee Only coverage how many deductibles do I have to
meet?
Once two individuals have met their deductible you are done with deductibles for the
year.
What do I pay if what I’m doing is preventative services?
All preventative is covered at 100% under the plan so you pay nothing.
What do I pay if I have prescriptions?
You pay your RX Co-pay of $10 for generic, $30 for formulary, $50 for non-formulary
and $100 for Speciality Drugs if you use Prime or $200 if you use Retail Walk-in.
Do my Co-Pays count towards my deductible and Out of Pocket?
All Co-pays count toward your deductible and Out of Pocket Maximum.
coverage is listed below along with the deduction amo
will make all benefit deductions in 24 pay-periods. will make all benefit deductions in 24 pay-periods.
AETNA
COVERAGE TIER
MONTHLY
TRADITIONAL
PLAN
24 – CHECK
DEDUCTION
AMOUNT
$167.41
$83.71
13
AETNA
MONTHLY
NON-TRADITIONAL
COVERAGE TIER
PLAN WITH HSA
2017
BENEFIT
RATES
2017
Benefit
Rates…
Employee Only
Employee & Spouse
$466.12
24 MONTHLY
– CHECK
HSA
24 – CHECK
DEDUCTION
TRADITIONAL ANNUAL
DEDUCTION
AMOUNT
PLAN
AMOUNT
FUNDING
$131.28
Employee
Only
$233.06
$393.86
Employee
& Spouse
$65.64
$167.41
$196.93
$466.12
NON
PL
$350*
$83.71
$700*
$233.06
The
cost of&your coverage$396.19
is paid with deductions
from
your
pay
monthly cost
of
Employee
Employee
& checks. The
$198.10
$334.77
$167.39
$700*
$396.19
$198.10
Child(ren)
Child(ren)
coverage is listed below along with the deduction amount taken from each pay check. BSN
Family
$713.92 in 24 pay-periods.
$356.96
$612.75
$306.38
$700*
will
make all benefit deductions
Family
$713.92
$356.96
*Note: HSA Funding is done in two Semi-annual payments *Note:
$175/$350
on 1/1 & is
7/1
with
hires prorated
HSA Funding
done
inNew
two Semi-annual
payments $17
AETNA
MONTHLY
METLIFE DENTAL PLAN
COVERAGE TIER
COVERAGE TIER
TRADITIONAL
MONTHLY
PLAN
DEDUCTION
24 – CHECK
DEDUCTION
24 – CHECK
AMOUNT
DEDUCTION
MONTHLY
24 – CHECK
METLIFE
DENTAL PLAN
HSA
NON-TRADITIONAL DEDUCTION
ANNUAL
MONTHLY
24 – CHECK
AMOUNT
PLAN WITH HSA
DEDUCTIONFUNDING
DEDUCTION
COVERAGE TIER
AMOUNT $350*
AMOUNT
$131.28
$65.64
AMOUNT
AMOUNT
Employee Only
$167.41
$83.71
Employee Only
$16.00
$8.00
Employee Only
$16.00
$8.00
Employee & Spouse
$466.12
$233.06
$393.86
$196.93
$700*
Employee &
& Spouse
$36.00
$18.00
Employee & Spouse
$36.00
$18.00
Employee
$396.19
$198.10
$334.77
$167.39
$700*
Child(ren)
Employee & Child(ren)
$43.00
$21.50
Employee & Child(ren)
$43.00
$21.50
Family
$713.92
$356.96
$612.75
$306.38
$700*
Family
$66.00
$33.00
Family
$66.00
$33.00
*Note: HSA Funding is done in two Semi-annual payments $175/$350 on 1/1 & 7/1 with New hires prorated
EYEMED DENTAL PLAN
METLIFE
MONTHLY
DEDUCTION
AMOUNT
24 – CHECK
DEDUCTION
AMOUNT
Employee
Employee
OnlyOnly
$7.54
$16.00
$3.77
$8.00
Employee&&Child(ren)
Child(ren)
Employee
$15.09
$43.00
COVERAGE TIER
Employee
& Spouse
Employee
& Spouse
Family Family
TELADOC/LIFELOCK
EYEMED
COVERAGE TIER
Employee Only
Employee Only
Employee & Spouse
$14.33
$36.00
$7.17
$18.00
$22.18
$66.00
$11.09
$33.00
MONTHLY
DEDUCTION
AMOUNT
$19.50
$7.54
$14.33
EYEMED
$7.55
$21.50
24 – CHECK
DEDUCTION
AMOUNT
$9.75
$3.77
COVERAGE TIER
MONTHLY
DEDUCTION
AMOUNT
24 – CHECK
DEDUCTION
AMOUNT
Employee Only
$7.54
$3.77
$15.09
$7.55
Employee & Spouse
$14.33
Family
$22.18
$11.09
MONTHLY
DEDUCTION
AMOUNT
$19.50
24 – CHECK
DEDUCTION
AMOUNT
$9.75
Employee & Child(ren)
TELADOC/LIFELOCK
$7.17
COVERAGE TIER
Employee Only
$7.17
COLONIAL & UNUM VOLUNTARY PRODUCTS COLONIAL & UNUM VOLUNTARY PRODUCTS
Employee
& Child(ren)
$15.09 choices $7.55
Priced
individually
based on coverage
Family
$22.18
$11.09
MONTHLY
DEDUCTION
AMOUNT
$19.50
24 – CHECK
DEDUCTION
AMOUNT
$9.75
TELADOC/LIFELOCK
COVERAGE TIER
Employee Only
COLONIAL & UNUM VOLUNTARY PRODUCTS
Priced individually based on coverage choices
Priced individually based on coverage choices
14
PRESCRIPTION DRUGS
Prescription Drugs…
WE OFFER A 4-TIER DRUG PLAN WITH GENERICS AUTOMATICALLY DISPENSED.
MAIL ORDER PRESCRIPTIONS ARE DEEPLY DISCOUNTED PROVIDING YOU WITH
ADDITIONAL SAVINGS FOR A 90-DAY SUPPLY OF MEDICATIONS.
You receive prescription drug coverage automatically by enrolling in any of the BSN
medical plans. AETNA utilizes AETNA Home Delivery and AETNA Specialty as their
providers to manage the administration of our prescription drug programs.
The prescription plan divides medications into four tiers:
• Generic (1st tier) drugs: A generic drug has the same active ingredients, safety,
dosage, quality and strength as its brand drug counterpart and is sold under the
chemical or scientific name for the drug. These medications typically cost less than
brand name drugs. If you choose to take a brand name drug when a generic is
available, you will pay the applicable brand name cost plus the difference in cost
between the brand and generic medications.
• Preferred Brand (2nd tier) drugs: Preferred brand drugs are those which
generally have no generic equivalent and are either more effective than other drugs
in the same class or are equally effective but less costly than the other drugs. If
your physician requires you to take a brand name medication, the prescription must
indicate “dispense as written”.
• Non-Preferred Brand (3rd tier) drugs: Non-preferred brand drugs are those
which generally have generic equivalents and/or have one or more Preferred Brand
options within the same drug class. These medications are typically expensive
medications.
• Specialty Drugs (4th tier) drugs: These
medications are used to treat complex, chronic
and often costly conditions and require special
handling. Check with your provider to see if
there are other medications available.
• Drugs that REQUIRE a Prior Authorization:
As a plan cost control measure, some drugs
may require a prior authorization before being
dispensed. A complete list of these drugs can
be obtained from HR.
15
PRESCRIPTION
PrescriptionDRUGS
Drugs…
MAIL ORDER PHARMACY
BSN incentivizes you to fill your prescriptions through AETNA Home Delivery. A 30-day
supply of your medication will cost you less for generic, formulary and non-formulary
than at your retail center. You can get 90 days worth of medication for one or two
times the cost you pay at the retail center for 30 days!
Please note: You are required to use the AETNA Speciality Pharmacy if you are
taking a speciality medication.
Start the Mail Order Program in two easy steps:
Tell your physician you would like to start mail order service. Once you and your
physician are confident you will continue taking medication on an ongoing basis, your
physician will write you a prescription for a 90-day supply plus 3 refills.
Log-on to www.aetnanavigator.com. Register as a user then enter your prescription
information. If you are not comfortable doing this via their website, you can complete
the New Prescription Mail-In Form that you can obtain from Human Resources. You can
also call AETNA Home Delivery at (888)792-3862.
When your order arrives, it enters their automated system. A licensed pharmacist
reviews your order for drug interactions, allergies and dosage information. After your
medication is dispensed, another pharmacist reviews it a final time to ensure accuracy.
Your medication is then sealed in a discreet, tamper-evident package. It is then mailed
directly to you and they let you know when it has been shipped.
New orders should arrive approximately 7 days after your completed order is received,
unless they need additional information from your prescribing physician. They will
notify you automatically when it is time to refill your prescription. You can reorder by
mail, phone or online.
How to start the Specialty Drug Program:
Contact AETNA Specialty Customer Service at (866)782-2779. Getting your Specialty
Medications through AETNA Specialty Pharmacy provides our members with savings,
safety and superior support with their specialty medications.
16
KNOW
Know BEFORE
Before YOU
YouGO
Go…
WHAT YOU MUST KNOW & ASK BEFORE YOU USE YOUR BENEFITS EVERY TIME
When you schedule your appointment ask...
• Are you a member of the AETNA POS II Network?
• Will I need to have any lab work or diagnostic testing done?
• Do you use Quest Labs?
When you arrive for your visit ask...
• Are you STILL a member of the AETNA POS II Network?
• Is my lab work/diagnostic testing processed/read/evaluated here or do you send
any part of it out?
• If you send it out, where is it sent?
• Will you send it to Quest for me? If not, please provide me with what I need so I
can take it to Quest?
• Will anything I have done today be billed as a surgical procedure?
When you are with the doctor or pharmacy ask...
• Is there a Generic equivalent available for the script you are giving me today?
• If not, is there a Non-Formulary equivalent available?
• Are there any other equivalent drugs that might be more cost effective (over-thecounter)?
• If this is a maintenance or long-term medication, can you give me a 90-day script for
the mail-order program?
• Is there any quantity or duration dispensing limit on any of the medications you
have prescribed for me today?
If you are having surgery, be sure BEFORE your surgery you ask...
• Can this procedure be done as an outpatient or day surgery?
• If not, what In-Network hospitals do you have rights at?
• Is the Anesthesiologist an In-Network provider?
• If not, do I have a choice of providers that are In-Network?
• How long will I be in the hospital?
• How much time will I need for recovery?
• Will I require any Durable Medical Equipment for my recovery?
• Will I need any Physical Therapy or Rehabilitation during my recovery?
• Will I be able to drive after the procedure? If not, for how long?
At the Pharmacy:
• If the pharmacy says the drug is not covered, then what? Ask the pharmacist if there
are dispensing limitations for the drug and if your doctor’s prescription is outside
of those guidelines. If this is the case, call your doctor for a prescription that is
within the dispensing limits for the drug (Note: This may mean more refills for
fewer pills at one time).
17
DENTAL
Dental BENEFITS
Benefits…
Dental Benefits…
Dental care is an important part of total health care. To reduce high dental expenses
Dental care
an important
part of total health
care. prevention
To reduceishigh
dental
expenses
andishelp
prevent uncomfortable
treatments,
the key.
The
dental plan pays
nd help aprevent
uncomfortable
treatments,
prevention
is
the
key.
The
dental
plan
pays
higher level of benefit when you utilize contracted MetLife providers. Should
you decide
higher level
of
benefit
when
you
utilize
contracted
MetLife
providers.
Should
you
decide
to use a dentist of your choice, the plan will reimburse up to usual and customary charges.
o use a dentist of your choice, the plan will reimburse up to usual and customary charges.
In-Network
Out of Network
Out of Network
Deductible
$50/$150
$50/$150
Deductible
$50/$150
$50/$150
Plan Year Maximum
$1,500
$1,500
Plan Year Maximum
$1,500
$1,500
Orthodontia
50%
50%
Orthodontia
50%
50%
Lifetime Maximum
$1,000
$1,000
Lifetime Maximum
$1,000
$1,000
Type I – Diagnostic & Preventative
100%
100%
Dental
care
is
an
important
part
of
total
health
care.
To reduce
high dental expenses
Type I – Diagnostic
& Preventative
(Deductible
waived for Preventative)100%
100%
(Deductible
for Preventative)
and helpwaived
prevent
uncomfortable treatments, prevention is the key. The dental plan pays
Type II – Basic Services
80%
60%
a higher
of Services
benefit when you utilize
Typelevel
II – Basic
80% contracted MetLife
60% providers. Should you decide
Type III – Major Services
50%
to use
a dentist
of your choice, the plan
will reimburse
up
to usual35%
and customary charges.
Type III – Major Services
50%
35%
Waiting Periods
None
None
Waiting Periods
None
None
PlanAge
Design
In-Network
Out19
of Network
Orthodontia
Limit
19
Orthodontia Age Limit
19
19
Deductible
$50/$150
$50/$150
Rates
Monthly
Pay period
Rates
Plan Year Maximum Monthly
$1,500 Pay period
$1,500
Employee Only
$16.00
$8.00
Employee Only Orthodontia
$16.00
$8.00
50%
50%
Employee & Spouse
$36.00
$18.00
Lifetime
Maximum
$1,000
$1,000
Employee & Spouse
$36.00
$18.00
Employee & Child(ren)
$43.00
$21.50
Type
I – Diagnostic & Preventative
Employee &
Child(ren)
$43.00
100% $21.50
100%
(DeductibleFamily
waived for Preventative)
$66.00
$33.00
Family
$66.00
$33.00
Type II – Basic Services
80%
60%
Plan Design
Plan Design
In-Network
Dental Benefits…
Type III – Major Services
50%
35%
Rates
Monthly
Pay period
Employee Only
$15.20
$7.60
Employee & Child(ren)
$42.16
To find a nearby provider or to check on your benefits you can logon to the MetLife web
o find a nearby
provider or to check
your benefits
you can
logon
to the
MetLife
Waiting on
Periods
None
None web
site at www.mybenefits.metlife.com
and choose
the
PDP Plus
Network.
ite at www.mybenefits.metlife.com
and choose the PDP Plus
Network.
Orthodontia Age Limit
19
19
Employee & Spouse
Family
$35.93
$17.97
$65.94
$32.97
$21.08
To find a nearby provider or to check on your benefits you can logon to the MetLife web
site at www.mybenefits.metlife.com and choose the PDP Plus Network.
18
Vision
Benefits…
Vision
Benefits…
VISION
BENEFITS
YourYour
eyesight
is anisintegral
partpart
of your
overall
health
and and
a key
component
to safety.
eyesight
an integral
of your
overall
health
a key
component
to safety.
Your
vision
benefits
will
be
provided
through
EYEMED,
Good
vision
care
is
essential.
Good vision care is essential. Your vision benefits will be provided through EYEMED,
which
provides
coverage
for preventive
care,care,
as well
as for
and and
contact
lenses.
which
provides
coverage
for preventive
as well
aseyeglasses
for eyeglasses
contact
lenses.
EYEMED
has has
one one
of the
nation’s
largest
eye eye
carecare
doctor
networks,
withwith
thousands
of of
EYEMED
of the
nation’s
largest
doctor
networks,
thousands
doctors
throughout
the United
States.
YourYour
membership
givesgives
you you
immediate
access
to to
doctors
throughout
the United
States.
membership
immediate
access
benefits
without
any any
paperwork
hassle.
By obtaining
youryour
vision
carecare
and and
materials
benefits
without
paperwork
hassle.
By obtaining
vision
materials
through
the
EYEMED
network,
you
can
count
on
a
uniform
schedule
of
rates
that
are are
through the EYEMED network, you can count on a uniform schedule of rates that
significantly
below
retail
prices.
significantly
below
retail
prices.
To find
a nearby
provider
or toorcheck
on your
benefits
logon
to www.eyemed.com
To find
a nearby
provider
to check
on your
benefits
logon
to www.eyemed.com
PlanPlan
Services
Services
Every
12
EveryMonths
12 Months
Member
Member
Services
Services
Out Out
of of
Network
Network
ExamExam
with Dilation
with Dilation
$10 $10
Up to Up
$35to $35
Lenses:
Lenses:
SingleSingle
VisionVision
Bifocal
Bifocal
Trifocal
Trifocal
Lenticular
Lenticular
$15
$15
$15
$15
$15
$15
$15
$15
Frames
Frames
$150 &
20%
$150
& off
20% off
Allowance
towards
any frame
at provider
location
Allowance
towards
any frame
at provider
location
Lens Options
Standard
Plastic:
Lens Options
Standard
Plastic:
UV Coating
UV Coating
Tint (Solid
and Gradient)
Tint (Solid
and Gradient)
Standard
Scratch
Resistance
Standard Scratch
Resistance
Standard
Polycarbonate
Standard
Polycarbonate
Standard
Progressive
Standard
Progressive
Standard
Anti-Reflective
Coating
Standard Anti-Reflective
Coating
OtherOther
Add-Ons
and Services
Add-Ons
and Services
Contact
Lenses:
Contact
Lenses:
In lieuInoflieu
frames
and lenses
of frames
and lenses
Fit & follow-up
Fit & follow-up
Conventional
Conventional
Disposables
Disposables
Medically
Necessary
Medically
Necessary
$15 $15
$15 $15
$15 $15
$40 $40
$65 $65
$75 $75
20% off
Retail
20%
off Retail
Up to Up
$30to $30
Up to Up
$45to $45
Up to Up
$60to $60
Up to Up
$60to $60
Up to Up
$75to $75
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Rates
Rates
Up to Up
$55to $55
Up to Up
$150
to $150
Up to Up
$150
to $150
100%100%
Monthly
Monthly
PayPay
period
period
Employee
OnlyOnly
Employee
Employee
& Spouse
Employee
& Spouse
$7.54
$7.54
$14.33
$14.33
$3.77
$3.77
$7.17
$7.17
Employee
& Child(ren)
Employee
& Child(ren)
Family
Family
$15.09
$15.09
$22.18
$22.18
N/A N/A
Up to Up
$120
to $120
Up to Up
$120
to $120
Up to Up
$200
to $200
$7.55
$7.55
$11.09
$11.09
19
FLEXIBLE
SPENDING
(FSA)
Flexible
Spending
(FSA)…
Flexible
Spending
(FSA)…
A Flexible Spending Account (FSA) offers you a tax-free way to set aside money for certain
A Flexible Spending Account (FSA) offers you a tax-free way to set aside money for certain
health carehealth
and/or
dependent day care expenses. If you have eligible expenses, a medical or
care and/or dependent day care expenses. If you have eligible expenses, a medical or
dependentdependent
day care reimbursement
account may
be a useful
your benefits
day care reimbursement
account
may beaddition
a usefulto
addition
to yourpackage.
benefits package.
Because FSA
contributions
are
taken
out
of
your
pay
BEFORE
federal
or
state
income
and
Socialand Social
Because FSA contributions are taken out of your pay BEFORE federal or state income
Security taxes,
100%
of each
dollar
youdollar
contribute
goes toward
eligible
As a
Security
taxes,
100%
of each
you contribute
goesyour
toward
yourexpenses.
eligible expenses.
As a
result, youresult,
save on
taxes.
The
amount
you
save
in
taxes
by
using
one
or
both
of
these
you save on taxes. The amount you save in taxes by using one or both of these
reimbursement
accounts depends
yourupon
income
and
tax bracket.
minimum
annual annual
reimbursement
accountsupon
depends
your
income
and taxThe
bracket.
The minimum
contribution
for the medical
account
is account
$250 per
year and
maximum
is $2,550isper
year. per year.
contribution
for the
medical
is $250
perthe
year
and the maximum
$2,550
Regular - Regular
FSA Standalone
or pairedorwith
the with
Traditional
Plan (Healthcare,
Dental Dental
- FSA Standalone
paired
the Traditional
Plan (Healthcare,
& Vision)& Vision)
This tax-sheltered
account helps
you pay
foryou
health
care
expenses
are not
covered
your by your
This tax-sheltered
account
helps
pay for
health
care that
expenses
that
are notby
covered
health plan.
You
can
claim
reimbursement
for
expenses
incurred
by
you
and
dependents,
health plan. You can claim reimbursement for expenses incurred by you and dependents,
through the
convenience
of your debit
card,
or file
a claim
have and
yourhave
reimbursement
through
the convenience
of your
debit
card,
or fileand
a claim
your reimbursement
account.
regular
FSA
account
be used
the Nondirect deposited
your bank
direct into
deposited
into your
bankThe
account.
The
regular
FSAcan’t
account
can’twith
be used
with the NonTraditionalTraditional
HSA plan. HSA plan.
Examples of
eligible expenses
Examples
of eligibleinclude:
expenses include:
• Medical •co-payments,
deductibles
and coinsurance
Medical co-payments,
deductibles
and coinsurance
• Uninsured
expenses such
as hearing
aids,
eyeglasses,
contact lenses
andlenses
certain
eye
• Uninsured
expenses
such as
hearing
aids, eyeglasses,
contact
and
certain eye
surgeries surgeries
• Your out-of-pocket
costs for dental
expenses,
including including
orthodontia.
• Your out-of-pocket
costs for
dental expenses,
orthodontia.
– FSA
paired
with the Non-Traditional
HSA &
(Dental
Vision Only)
Limited –Limited
FSA paired
with
the Non-Traditional
HSA (Dental
Vision&Only)
This tax-sheltered
account
you
pay for
Dental
and
Vision
care expenses
that are not
This tax-sheltered
account helps
you helps
pay for
Dental
and
Vision
care
expenses
that are not
excess
of account
your HSAexpenses.
account expenses.
You can
claim reimbursement
for expenses
covered in covered
excess ofinyour
HSA
You can claim
reimbursement
for expenses
you and dependents,
through
the convenience
of your
debit
card,
file a claim
incurred byincurred
you andbydependents,
through the
convenience
of your debit
card,
or file
a or
claim
and
have
your
reimbursement
direct
deposited
into
your
bank
account.
and have your reimbursement direct deposited into your bank account.
Dependent
Dependent
Care FSA Care FSA
This
account
you totax-free
set asidedollars
tax-free
payofthe
costorofelder
childcare
or elder
This account
allows
youallows
to set aside
to dollars
pay thetocost
child
that care that
youspouse
and your
spouse
(if you areto
married)
workschool.
or attend
school.
You may
claim eligible
enables youenables
and your
(if you
are married)
work orto
attend
You
may claim
eligible
day
care
expenses
for
a
child
under
age
13
whom
you
claim
as
a
dependent
on
your
federal tax
day care expenses for a child under age 13 whom you claim as a dependent on your federal tax
or a dependent
parent or
spouse
who is incapable
ofand
self-care
and who on
depends
return or areturn
dependent
parent or spouse
who
is incapable
of self-care
who depends
you on you
for
support.
for support.
Examples
of eligibleinclude:
expenses include:
Examples of
eligible expenses
Day careinprovided
in your
home orperson’s
anotherhome
person’s home
• Day care•provided
your home
or another
Licensed
daycare
center expenses
• Licensed• daycare
center
expenses
• Elder
carefor
expenses
forora their
parent
or their
relative
• Elder care
expenses
a parent
relative
who
lives who
withlives
you with you
20
TELADOC.
LIFELOCK. PETASSURE
TelaDoc/LifeLock/PetAssure
…
TELADOC
National network of state licensed primary care physicians providing cross coverage consultations
24 hours/365 days a year at no extra fee.
• Physicians diagnose medical problems and prescribe short-term medication when appropriate
• Service provided for dependents 10 years of age or older.
• TelaDoc is not available in the state or to the residents of ARK & does not prescribe DEA controlled
substances or lifestyle drugs.
LIFELOCK
•
•
•
•
Place fraud alerts on your credit reports so only you can use them.
A $1 million service guarantee
Reduce credit card offers and reduce junk mail
Wallet lock assistance in the event that your wallet is stolen.
PETASSURE
Pet Assure will give you 25% off all in-house medical services, no questions asked. The discount is on:
• Office Visits & Exams
• Vaccines & Shots
• Elective Procedures (e.g., dental care)
• Surgery (e.g., spaying & neutering, emergency surgery)
• Hospitalization (in Network)
• Any other medical service and procedure
• Pet Assure has no preexisting exclusions, no annual limits, no deductibles and no waiting periods.
ROADSIDE/EMERGENCY TRAVEL ASSISTANCE
•
•
•
•
Emergency roadside assistance available 24 hours a day, 365 days a year
Flat tire, lock-out, battery, and collision assistance.
Fuel, oil, and other fluid delivery.
Members have access to a worldwide network of medical and travel assistance personnel and emergency
evacuation benefits when traveling over 100 miles away from home and suffering illness or injury.
• Not available to OR, CT, and WA residents.
PHARMACY DISCOUNT
• Save 10% to 60% on most acute-care medications with over 56,000 participating locations
• The Mail Order Prescription Plan delivers your maintenance medications directly to your door
DENTAL/VISION CARE DISCOUNT/HEARING
• Dental Services – Save 15% to 50% at over 71,000 dental providers.
• Eyewear and Eye Care-Save 20% to 60% off normal retail on frames, lenses and specialty items at over
12,000 eye care professionals nationwide. Save 10% to 30% on eye exams. Save 40% to 50% off the
overall national average on LASIK surgery (PRK and CK available at select locations). Replacement
Contact Lenses -Save 10% to 40% on most mail order replacement contact lenses.
• Hearing Aids- Save 15% at retail locations and 40%-60% off retail pricing
Monthly Rate: $19.50 for Employees and Dependents or $9.75 a paycheck
21
COLONIAL
Colonial –- ACCIDENT
Accident…
COMPREHENSIVE ACCIDENT COVERAGE WITH FLEXIBLE
DESIGN PARAMETERS
Accidents happen in places where you and your family spend the most time – at work,
in the home or during sports and leisure activities.
The benefits are paid regardless of other coverage that may be in force, including
primary health insurance. Coverage is available to the insured, spouse, and children –
it’s a plan the whole family can utilize over and over because there are no calendar year
maximums.
ACCIDENT CARE IS MORE THAN AN ORDINARY ACCIDENT PLAN
Accident Care is supplemental accident insurance that provides employees with 24hour coverage for accident related expenses such as ambulance services, emergency
room visit, hospital confinement and medical treatment. The embedded features of
Accident Care include:
• Accident Medical Expense – Pays $150 per accident for emergency room visit
and $50 per accident for initial doctor’s office visit, including an additional $50 for
follow up care.
• Ambulance Benefit –Pays $500 for air ambulance and $100 for ground
ambulance.
• Hospital Confinement – Provides a $750 hospital admission benefit and a $200
daily benefit for up to 365 days.
• Accidental Death, Dismemberment – Provides a death benefit of $25,000, as a
result of an accidental death. A percentage of the benefit is paid for
dismemberment or loss of sight, hearing, or speech, due to a covered accident.
INCLUDED IN YOUR COVERAGE ARE THE FOLLOWING BENEFITS:
•
Hospital Intensive Care – Provides coverage for intensive care costs due to a covered
accidental injury. The benefit is payable for a maximum of 15 days for any one accident.
Benefits are paid up to $400 per day.
• Bone Fracture and Dislocation – Pays for a single covered bone fracture or dislocated
joint up to $2,500. Medical equipment and physical therapy included.
22
COLONIAL
Colonial -–CANCER
Cancer…
PLAN FOR THE –
UNEXPECTED
Colonial
Cancer…
Cancer is one of life’s most devastating experiences for two major reasons. First, it almost
Second, the expenses associated with its
plus most
ancillary
costs take
those affected
and major
their families,
surprise
as
Cancertreatment,
is one of life’s
devastating
experiences
for two
reasons.by
First,
it almost
– even
if they areby
already
coveredSecond,
by existing
health
insurance.
alwayswell
takes
individuals
surprise.
the
expenses
associated with its
PLAN
FOR
THE
UNEXPECTED
always
takes
individuals
by surprise.
treatment, plus ancillary costs take those affected and their families, by surprise as
well – The
even
if they
already
covered
bysurviving
existing cancer
health increases
insurance.
great
newsare
is the
number
of people
annually with about
10 million survivors today. The increased survival rate is attributed to earlier diagnosis
The great
is the number
of people
increases
annually
with
and news
improvements
in treatment.
Thesurviving
challenge cancer
is the costs
for fighting
cancer
are about
also
10 million survivors today. The increased survival rate is attributed to earlier diagnosis
increasing.
and improvements in treatment. The challenge is the costs for fighting cancer are also
increasing.
Cancer 1000 is a cancer expense insurance policy designed to provide funds to help
incurred
for a covered
cancer.
Cancer
1000 to
is unlimited
which means
Canceroffset
1000expenses
is a cancer
expense
insurance
policy
designed
provide funds
to help
the
benefits
will
continue
as
expenses
are
incurred.
This
benefit
helps
offset
the
longoffset expenses incurred for a covered cancer. Cancer 1000 is unlimited which means
the benefits
willwhich
continue
asassociated
expenseswith
are incurred.
This benefit helps offset the longterm costs
may be
cancer.
term costs which may be associated with cancer.
A WIDE MENU OF BENEFITS
A WIDE MENU OF BENEFITS
Cancer 1000 offers a comprehensive array of services and benefits:
Cancer 1000 offers a comprehensive array of services and benefits:
•
•
•
•
•
•
•
•
• Benefits
are paid
directly
to the
insured
are paid
directly
to the
insured
Benefits
• types:
Plan types:
employee,
employee
spouse,
employeeand
andchild(ren)
child(ren) or
Plan
employee,
employee
andand
spouse,
employee
orfamily
family
• Unlimited
lifetime
benefits
Unlimited
lifetime
benefits
Guaranteed
renewable
for life
• Guaranteed
renewable
for life
Pays
various
charges,
including,
butbut
notnot
limited
to:
• Pays various charges, including,
limited
to:
• Hospital
stays
(daily
benefit)
• Hospital stays (daily benefit)
• Surgical Procedures
• Surgical Procedures
• Laboratory tests
• Laboratory tests
• Chemotherapy/Radiation
• Chemotherapy/Radiation
• Transportation/Lodging
Transportation/Lodging
• Cancer
• Skin
Cancer
• Skin
The policy
is fully
portable
No •deductibles
The policy is fully portable
Issue
18-69 varies by state
• ages
No deductibles
• Issue ages 18-69 varies by state
23
COLONIAL
Colonial -–CRITICAL
CriticalILLNESS
Illness…
VOLUNTARY CRITICAL ILLNESS INSURANCE
Critical Illness protection for the way employees live
Critical Illness helps to protect an employee’s and family’s assets in the event of a
critical illness. It offers valuable peace of mind from the rising costs of specialized
healthcare, which are often not covered by ordinary health insurance.
A strong base of coverage
Critical Illness offers benefits for vascular coverage and other critical illnesses. All
benefit payments are made directly to you. Benefits are payable in addition to any
other coverage you may have.
Vascular coverage includes benefits for:
• Heart attack
• Transplant as a result of heart failure
• Stroke
• Coronary artery bypass surgery as a result of
coronary artery disease (25% of the benefit)
Benefits are also available for other critical illnesses such as
• Transplant, other than heart
• End-stage renal failure
• Blindness
• Coma
• Permanent paralysis due to an accident
• Occupational HIV or Hepatitis B,C, or D
Benefit amounts:
• $5,000 to $50,000 for employees
• 50% of the employee benefit to a maximum of
$25,000 for a spouse
• 25% of the employee benefit to a maximum of
$12,500 for each eligible child
Health Screening Benefit:
• Included in coverage up to $50
24
BSN&&COLONIAL
ColonialDISABILITY
Disability…
BSN
BSN SHORT TERM DISABILITY
BSN provides all full-time employees who have completed 12 months or more with short
term disability. Benefits for STD are paid at 60% of base wages (Base Draw) for each day
missed after an employee has missed 5 consecutive work days due to their own illness.
You can purchase additional coverage through Colonial as outlined below.
VOLUNTARY SHORT TERM DISABILITY
Disability 1000 can be there to help you when an accident or illness totally disables.
This voluntary disability coverage provides a monthly disability income benefit due to
a non-occupational “off-the-job” accident or sickness, covering you above and beyond
any existing disability coverage you may have.
Your coverage includes both accident and sickness
Accident and sickness – Provides coverage for disabilities caused by either an
accidental injury or sickness. Coverage is available from a minimum of $400 per month
to a maximum $3,000 per month up to 60 percent of monthly income with various
elimination and benefit period options.
Elimination period is the number of continuous days, beginning with the first day
of a total disability, before any monthly benefit amount is payable. Your elimination
period may be 7 days for both accident and sickness
Benefit period is that period of time for which monthly income benefits are payable after
the Elimination Period ends. You can choose a benefit period of either 3, 6, 12, or 24
months.
Disability Definition
Total Disability – Unable to perform the material and substantial duties of your job
and under the regular and appropriate care of a doctor
Partial Disability – Unable to perform the material and substantial duties or your job
for 20 hrs. or more and under the regular and appropriate care of a doctor. The total
disability benefits must have been paid for at least one full month immediately prior to
your being partially disabled.
When accidents or illnesses totally disable employees, Disability 1000 can be there to
help pay the bills that won’t go away, just because they can’t work. The benefit may be
used to cover every day costs such as housing, food, car payments, and even additional
medical costs. Disability 1000 can help employees concentrate on what’s most
important – a full recovery and successful return to the workplace, free from the burden
of excess accumulated debt.
25
UNUM
Unum- -DISABILITY
Disability…
VOLUNTARY LONG TERM DISABILITY
If you can’t work, why should your bank account suffer? Help keep your finances
together with Unum’s Group Long Term Disability Insurance.
Your disability benefits help cover what matters most.
Unum’s long term disability (LTD) insurance pays you a percentage of your gross
monthly salary if you cannot work due to a covered injury or illness. It can provide a
benefit whether your disability is total or partial. These benefits can help you cover
your expenses and protect your finances at a time when you’re paying extra medical
bills.
Reason to buy this coverage at work - now
• No medical questions to answer. If you sign up during your initial enrollment at
work*.
• No checks to write - your cost is conveniently deducted from your paycheck.
• You can take advantage of affordable group rates.
Plan features
• Monthly Benefit - 60% of monthly earnings to a maximum benefit of $6,000 per
month
• Definition of Disability
• Two (2) year regular occupation
• Zero-day residual
• Accelerated elimination period
• Work incentive benefit during the first 12 months of disability payments
• Elimination Period - this is the number of days that must pass between your first
day of a covered disability and the day you can begin to accrue your disability
• 90 days & 30 day accumulation feature
• Benefit Duration - to age 65/reducing benefit duration (ADEA I)
• Social Security Integration - Primary and Family
• Work-life balance employee assistance
program
• Worldwide emergency travel assistance
• Rehabilitation and return to work
assistance program
• HR compliance solutions
• Dependent care benefit
• Guaranteed insurability
• Full maternity benefits
*Benefits may be subject to pre-existing condition provision
26
COLONIAL
Colonial –- MEDICAL
MedicalBRIDGE
Bridge…
VOLUNTARY HOSPITAL CONFINEMENT INSURANCE
The perfect supplement to your medical plans
Medical Bridge is a supplemental medical plan that may be beneficial to employees
because it offers additional benefits for everyday medical costs such as physician’s office
and emergency room treatment. There is no coordination of benefits with existing
coverage, so this is truly a benefit you can reap immediately.
Medical Bridge is a great way to pay “first dollar” health care expenses. With increasing
co-pays and high risk deductibles required by many major medical plans, this is a good
solution for recouping that payment. This plan offers these benefits:
• Pays a specified amount for covered hospital confinement or outpatient surgery.
• This benefit is payable regardless of any additional coverage in force.
• There is no coordination of benefits.
• Covers sickness and injuries after date of policy, subject to pre-existing
condition and policy limitations.
• Includes coverage for pregnancy (subject to state mandated waiting periods).
• No physical examination is required.
• Covers pre-existing conditions after 12 months from the date of policy.
Sickness and wellness benefits
• Physician’s office visit – Pays $25 for each visit to a physician’s office for
non-emergency sickness up to three (3) visits per year.
• Wellness benefit – Pays $50 each calendar year for an annual physical
conducted 30 days or more after the date of policy. If more than one person is
insured under the policy, the calendar year maximum is a total of $100.
• Hospital admission – Pays $1,000 lump sum per occurrence for an
overnight stay in the hospital due to an accident or sickness.
• Outpatient surgery – Pays a lump sum benefit of $750 to $1,500 per occurrence,
based on a surgical schedule for a particular procedure.
• Rehabilitation unit - Pays $100 day for up to 15 Days.
Insuring family members is simple
The benefit amount that you select will be the same amount of coverage available to
your spouse and/or dependents. Children from newborn to age 18, or up to age 25 if
unmarried and a full-time student, may be covered. There is no waiting period for
newborns or newly adopted children.
Help cover first dollar costs
Medical bridge is an effective way to add another layer of insurance protection to help
cover “first dollar costs”. Since there is no coordination of benefits and no co-pays
required, receiving reimbursement is a simple one-page form. Sometimes the little
things in life do make life a little better!
27
COLONIAL
TERM
LIFE
Colonial – Term Life…
Colonial – Term Life…
VOLUNTARY
TERMLIFE
LIFEINSURANCE
INSURANCE
VOLUNTARY TERM
Term
InsuranceHelps
Helpsprotect
protect
your
assets
Term Life
Life Insurance
your
assets
Employees
(and their
theirloved
lovedones)
ones)
concerned
about
financial
security.
Employees (and
areare
concerned
about
financial
security.
Each Each
plan plan
offers employees
employees coverage
can
access
in health,
life and
death
circumstances.
When When
offers
coveragethey
they
can
access
in health,
life and
death
circumstances.
you compare
compare these
coverage,
you’ll
findfind
levellevel
TermTerm
Life offers
solid solid
you
theseplans
planstotocomparable
comparable
coverage,
you’ll
Life offers
coverage
per
payroll
deduction
dollar.
That
means
you
get
increased
protection
at
coverage per payroll deduction dollar. That means you get increased protection
at
surprisingly
affordable
rates.
If
you
enroll
when
you
are
first
eligible
you
can
receive
surprisingly affordable rates. If you enroll when you are first eligible you can receive
guarantee issue
review
(levels
depend
on age).
The benefits
are clear
guarantee
issuewithout
withouta amedical
medical
review
(levels
depend
on age).
The benefits
are clear
and easy to understand. Best of all, you can enroll at work with just a few simple
and easy to understand. Best of all, you can enroll at work with just a few simple
questions — and there’s no medical exam. What could be simpler?
questions — and there’s no medical exam. What could be simpler?
Term Life is a dependable plan
Term
Lifebegins
is a dependable
planlife insurance for a duration of 10, 20, or 30 year
Coverage
with level term
Coverage
options. begins with level term life insurance for a duration of 10, 20, or 30 year
options.
• Premiums are based on age and tobacco/non-tobacco use.
•• Premiums
areranges
basedfrom
on age
and tobacco/non-tobacco
use.
Death benefit
$10,000
- $100,000
Offers portability
should
you$10,000
terminate
or retire.
•• Death
benefit ranges
from
- $100,000
Protection
is offered
through
age
75
•• Offers
portability
should
you
terminate
or retire.
•
Work
life
benefits
offer
24/7
grief
counseling
as well an access to an exclusive
• Protection is offered through age 75
web portal
which features
articles,
videos
and financial
planning
tools.
• Work
life benefits
offer 24/7
grief
counseling
as well
an access
to an exclusive
• web
Terminal
illness
benefits
accelerate
payment
of
the
life
insurance
death
benefit.
portal which features articles, videos and financial planning tools.
Payment is available in the event of your future terminal illness diagnosis (with
• Terminal
illness benefits accelerate payment of the life insurance death benefit.
12 months or less to live). For the terminal illness benefit, the maximum
Payment is available in the event of your future terminal illness diagnosis (with
advance is 75 percent of the base policy.
12 months or less to live). For the terminal illness benefit, the maximum
advance
is 75 percent of the base policy.
Optional
benefits
• Waiver of premium – Available to employees through age 55. This optional
Optional
benefits
benefit
waives the employee’s premium in the event his or her total disability
• Waiver
premium
– Available to employees through age 55. This optional
lasts for of
more
than 6 months.
• benefit
Accidental
death,
of sight and
dismemberment
– Offers
an additional
waives
theloss
employee’s
premium
in the event
his or her
total disability
payment
of thethan
life 6insurance
lasts
for more
months. benefit when a loss results from a serious
accident or death.
• Accidental
death, loss of sight and dismemberment – Offers an additional
• payment
Increasing of
death
– At each of
the first
five coverage
anniversaries,
the benefit
life insurance
benefit
when
a loss results
from athe
serious
death
benefit
can
be
increased
by
the
coverage
amount
purchased
for
an
accident or death.
additional $1 or $2 weekly premium.
• Increasing
death benefit – At each of the first five coverage anniversaries, the
• Family coverage – Offers spouse (to Age 65) coverage up to $50,000 and child
death benefit can be increased by the coverage amount purchased for an
coverage up to $10,000 (for each insured child). Insurance for a dependent
additional
$1 or
weekly premium.
cannot exceed
the$2
employee’s
coverage amount.
•• Family
coverage
–
Offers
spouse
(to Age
65) coverage
up to with
$50,000
and child
Children are covered through age 25.
All children
are covered
a single
coverage
up to $10,000
each
premium, regardless
of the (for
number
of insured
children. child). Insurance for a dependent
cannot exceed the employee’s coverage amount.
• Children are covered through age 25. All children are covered with a single
28
Colonial – -Universal
Life...
COLONIAL
UNIVERSAL
LIFE
VOLUNTARY UNIVERSAL LIFE INSURANCE
Universal Life insurance offers permanent protection while living. Universal life
insurance can be a solid foundation upon which to build a long-term financial plan
because it guarantees lifetime protection for your family. Purchasing life insurance is
an important decision — one that impacts both current financial needs as well as future
financial requirements. Universal life insurance is a product that can have a positive
influence on both of these areas of life. Universal Life ensures that family and
dependents are financially protected with money that can be used for:
•
•
•
•
•
Final expenses such as funeral costs.
Immediate needs such as probate expenses.
Continuing needs – ongoing bills such as utilities.
Debt liquidation such as paying off loans or a mortgage.
Future expenses such as education funds or retirement needs.
Universal Life plan features:
•
•
•
•
•
•
•
•
•
Guaranteed renewable to age 100 with a guaranteed death benefit payable to your
beneficiary’s tax free.
Guaranteed cash value - The policy accumulates cash that can be withdrawn (upon the
policy’s surrender), borrowed against as a loan, annuitized and paid out as a monthly
income (upon the policy’s surrender), or used to purchase extended term or reduced
paid-up insurance.
Policy is portable.
Loans available at any time while policy has a cash value.
Accelerated Benefit for Terminal Illness:
Provides a lump sum of 75% of death benefit (base and term rider) upon diagnosis of a
terminal illness.
Life expectancy of 12 months or less.
Twelve (12) month waiting period (illness must be diagnosed at least 12 months after
the date of policy).
Benefit may be used only once.
Family Term Rider
•
•
•
•
•
•
May be added at original policy issue
Terminates when base plan is terminated
Spouse Benefit
Benefit Amount – Up to $50,000 (not to exceed primary insured’s benefit)
Issue Ages and Rate Ages – 18-55; Uni-sex / Uni-Tobacco
Child(ren) Benefit Amount – Coverage up to $10,000 not to exceed primary insured’s
benefit available in ($1,000 increments).
Available on employee or spouse standalone policy.
29
401K…
401K
There are many great benefits to being part of the BSN 401(k) Plan. One of those benefits is
exceptional customer service – online or by phone. In fact, you can count on your company
and Principal Financial to help support you every step of the way.
Best practices to consider:
• The impact of an early start. Your decision to start today could give you quite a bit more at
retirement than starting five years from now.
• We recommend starting your 401(k) at 3% to take full advantage of the BSN match but do
what you can afford. You can change it the first of any month. The important thing is to invest
what you can afford and start right away.
• Invest more in your plan, pay less in taxes. Your pretax contributions come out of your pay
before income taxes are taken out. You can actually lower your current taxes by investing in
the plan today. The plan also offers a post-tax or Roth contribution option. You can enroll
in by visiting the Principal Fidelity website at www.principal.com or call (800)9863343. Enroll Today!!!!
Who can join the plan?
Eligibility
Requirements
Contributions
Vesting
All contributions
Employee Contributions
1% to 80% of eligible pretax pay
EGTRRA Catch Up Provision
Employee Contributions
100% immediate
Company Matching
Company Matching
Loans
Withdrawals
Attain Age 21
Completed 1 month of service
Discretionary
Years of Service for Vesting Percentage
less than 2
0
2
20
3
40
4
60
5
80
6
100
You may have one (1) loan outstanding at one time. Be sure you understand the plan
guidelines and impact of taking a loan before initiating a loan from your plan.
They are generally permitted in the event of termination of employment, retirement,
disability, or death. You may also be eligible for a withdrawal in the case of a severe
financial hardship as defined by your plan and at age 59.5 years of age.
2016 Calendar year Limits
Regular 401k Employee Contributions
$18,000
Roth Contributions
$5,500
Catchup Contributions (Age 50 Older)
Catchup Contributions for Roth
$6,000
$1,000
30
ENROLLING
EASY
Enrolling is IS
Easy...
TAKE CARE OF YOUR BENEFITS IN A FEW SIMPLE STEPS.
Just follow the steps below to make your benefit choices. For benefits and/or enrollment
questions, contact HR at 800-230-0055. FOR PASSWORD RESETS CONTACT THE IT
HELP DESK.
STEP 1
 Review your Benefits Guide so you are prepared for your enrollment.
 Keep a pen or pencil handy to make notes about your benefit elections.
 Have the social security numbers and dates of birth of your applicable
dependents and beneficiaries.
 Go to www.workforcenow.adp.com to enroll online.
 The Company Key is BSNSPORTS-IPAY
If you have never registered on the portal before, please go to First Time Users and click
on “REGISTER HERE” and follow the screen prompts to get registered.
If you have previously registered, begin by clicking on “User ID”. Your user name, in
most cases, is your first initial and your last name@BSNsports.
Note, there is no “.com” after the BSNsports. Example: Joe Sport’s login would be
jsport@BSNsports
Your password is something you set up when you registered. If you forget your
password, click on “Forgot Your User ID/Password” and answer the challenge
questions.
If you are still unable to access the ADP portal, please contact the IT Helpdesk at
(877)711-2920 or email them at [email protected].
31
Enrolling is
Easy…
ENROLLING
IS EASY
STEP 2
Once you enter the site, click on “MYSELF” then “BENEFITS” then “ENROLLMENTS”
STEP 3
Watch the how to enroll video by clicking on the “Play Button” then click on
“Enrollments Learning Byte(s)”
32
ENROLLING IS EASY
The following webpage will open, click on “Enrolling in a Benefit Plan”, the
instructional video will play.
The video will show you step by step instructions on how to complete your enrollment.
You can re-watch the video at any time for help.
THINGS YOU NEED TO KNOW:
 You will not be able to see Colonial benefits pricing. If you are interested in
obtaining pricing for the colonial products, contact: Melinda Albritton at
(817)992-0262 or via email at [email protected]. HR will enter the
appropriate deduction into payroll once received from Colonial.
 If you are enrolling dependents, you must add them to the ADP database before
you can enroll as outlined in the video.

You cannot be enrolled in the regular FSA and the HSA at the same time. If you
elect the Non Traditional plan with the HSA you may elect to participate in the
Limited FSA plan. If you elect the Traditional Plan you may enroll in the Regular
FSA plan.
 Your enrollment is not complete until you have clicked on “Complete
Enrollment” and see the green changes submitted bar.
33
BENEFITS
INFORMATION CENTER
Watch our series of helpful videos @
www.BSNSPORTS.com/hrbenefits2017
34
NOTES
Payroll Manager
(800)230-0055 X 7186
35
Benefits
Manager
Benefits
Manager
(800)230-0055
(800)230-0055
X 7189X 7189
AETNA MEDICAL & METLIFE
DENTAL
VPHR
VPHR
AETNA
– (800)222-1519
(800)230-0055
BSN HR CONTACTS (800)230-0055
BSN HR CONTACTS
7187X 7187
Group#X283924
Payroll
Manager
TS
Benefits
Manager
Benefits
Manager
Payroll
Manager
Website:
www.aetnanavigator.com
(800)230-0055
7186
Benefits
Manager
SN HR CONTACTS
(800)230-0055
X 7189
Benefits
Manager
(800)230-0055
7189X
(800)230-0055
XX7186
Medical Network:
POS II
(800)230-0055
X 7189
VPHR
Benefits Manager VPHR
(800)230-0055
X 7189
BSN
HR
CONTACTS
VPHR
(800)230-0055
X 7187
AETNA
MEDICAL
& METLIFE
DENTAL
(800)230-0055
X 7189
VPHR
(800)230-0055
X 7187
AETNA
MEDICAL
&
METLIFE
DENTAL
MetLife
–
(800)942-0854
Benefits
Manager
(800)230-0055
Manager
Benefits
ManagerX 7187
VPHR Payroll
AETNA
–Payroll
(800)222-1519
(800)230-0055
X 7187
Manager
Group#0314118
AETNA
–
(800)222-1519
(800)230-0055
X
7189
Payroll
Manager
(800)230-0055
(800)230-0055
X
7189
(800)230-0055(800)230-0055
X 7187 Group#
283924 X 7186
Payroll
Manager
X 7186
Website:
www.mybenefits.metlife.com
Group#
283924
VPHR
(800)230-0055
X 7186
VPHR
Payroll Manager
Website: www.aetnanavigator.com
(800)230-0055
X 7186
Dental
Network:
PDPIIPlus
Website:
(800)230-0055
XMetLife
7187 POS
(800)230-0055 X
7187 MEDICAL
(800)230-0055
Xwww.aetnanavigator.com
7186
Medical
Network:
AETNA
&
METLIFE
DENTAL
AETNA
MEDICAL & METLIFE Medical
DENTAL
Network:
POS II
Payroll
Manager
Payroll
Manager
METLIFE
DENTAL
AETNA
– (800)222-1519
& METLIFE
DENTAL
AETNA
–
(800)222-1519
(800)230-0055
X
7186
VOLUNTARY
PROVIDERS
(800)230-0055
X 7186
MetLife –Group#
(800)942-0854
AETNA
–&(800)222-1519
ETNA MEDICAL
METLIFE
DENTAL
283924
AETNA
– (800)222-1519
Group#
283924
MetLife
–
(800)942-0854
EYEMED
–
(866)804-0982
Group#0314118
Group# 283924 AETNA – (800)222-1519
Website:
www.aetnanavigator.com
Group#
283924
Website:
www.aetnanavigator.com
Group#0314118
AETNA
MEDICAL & METLIFE
DENTAL
Group
# 1003330
Website:www.mybenefits.metlife.com
www.mybenefits.metlife.com
Website:
www.aetnanavigator.com
TLIFEWebsite:
DENTAL
Medical
Network: POS II
Group# 283924
Website: www.aetnanavigator.com
Medical
Network:
POS
II PDP Plus
Website:
www.mybenefits.metlife.com
Website:
www.eyemed.com
Dental
MetLife
AETNA
– Network:
(800)222-1519
Medical
Network:Website:
POS II www.aetnanavigator.com
AETNA
– (800)222-1519
Medical Network: POS II Dental Network:
MetLife
Plus
Group#
283924
––PDP
(800)942-0854
Group# 283924
Medical Network:
POS
II MetLife
TelaDoc/LifeLock
(800)800-7616
MetLife
– (800)942-0854
MetLifeVOLUNTARY
– (800)942-0854
Website:
www.aetnanavigator.com
Group#0314118
Website: www.aetnanavigator.com
PROVIDERS
Client ID# 75241L
MetLife
–
(800)942-0854
Group#0314118
VOLUNTARY
PROVIDERS
Group#0314118
Website:
www.mybenefits.metlife.com
Medical
Network:
POS II
Medical
Network:
POS
II MetLife – (800)942-0854
EYEMED
– (866)804-0982
Website:
http://www.mymemberportal.com
Group#0314118
Website:
www.mybenefits.metlife.com
Website: www.mybenefits.metlife.com
Dental
Network:
MetLife PDP Plus
EYEMED
– (866)804-0982
Group
# 1003330
Colonial & Unum: Group#0314118
Website:
www.mybenefits.metlife.com
Dental
Network:
PDP Plus
Dental Network:
MetLife
PDP Plus
MetLife
– (800)942-0854
Website:
www.mybenefits.metlife.com
Website:
www.eyemed.com
Group
#MetLife
1003330
MetLife
– (800)942-0854
Melinda
Albritton
Colonial
Life
–
(800)325-4368
Dental
Network:
MetLife
PDPPROVIDERS
Plus MetLife
Group#0314118
Dental Network:
PDP
Plus
Website:
www.eyemed.com
Group#0314118
VOLUNTARY
[email protected]
TelaDoc/LifeLock
– (800)800-7616
Website:
www.coloniallife.com
VOLUNTARY
PROVIDERS
Website: www.mybenefits.metlife.com
IDERS
(817)992-0262
Website: www.mybenefits.metlife.com
EYEMED
–
(866)804-0982
Client
ID# 75241L
TelaDoc/LifeLock
–
(800)800-7616
Unum
–
(800)679-3054
OVIDERS
Dental Network:
MetLife
PDP Plus
EYEMED
– (866)804-0982
EYEMED
– (866)804-0982
OLUNTARY
PROVIDERS
Group
# 1003330
Dental
Network:
MetLife
PDP
Plus
Website:
http://www.mymemberportal.com
Client
ID#
75241L
EYEMED
– (866)804-0982
Website:
www.unum.com
Group
# 1003330
Group #Colonial
1003330
Website:
www.eyemed.com
EYEMED – (866)804-0982
& Unum:
Website:
http://www.mymemberportal.com
#PROVIDERS
1003330
Website: Group
www.eyemed.com
RS
Website: www.eyemed.com
Group # 1003330
Albritton
VOLUNTARY
Colonial
Life – (800)325-4368
Principal
Financial
(800)986-3343
Colonial &Melinda
Unum:
TelaDoc/LifeLock
– (800)800-7616
www.eyemed.com
[email protected]
EYEMEDWebsite:
–
(866)804-0982
Website:
www.eyemed.com
EYEMED
– (866)804-0982
Melinda Albritton
Website:
www.coloniallife.com
TelaDoc/LifeLock
– (800)800-7616TelaDoc/LifeLock
ID# 75241L
Website:
www.principal.com
– Client
(800)800-7616
Colonial
Life
– (800)325-4368
(817)992-0262
Group
#
1003330
[email protected]
Group
#
1003330
Client ID# 75241L
TelaDoc/LifeLock
– (800)800-7616
Website:
http://www.mymemberportal.c
TelaDoc/LifeLock
– (800)800-7616
Client
ID#
Unum
–75241L
(800)679-3054
Website:
www.coloniallife.com
Website: www.eyemed.com
(817)992-0262
Colonial
&Client
Unum:
www.eyemed.com
Website: http://www.mymemberportal.com
Client ID#
75241L
ID#Website:
75241L
Website:
http://www.mymemberportal.com
Website:
www.unum.com
Unum
– (800)679-3054
Melinda
Albritton
Website:
http://www.mymemberportal.com
TelaDoc/LifeLock
– (800)800-7616
Colonial
& Unum:
Website: http://www.mymemberportal.com
Website:
http://www.mymemberportal.com
Colonial
Life – (800)325-4368
TelaDoc/LifeLock
– (800)800-7616
[email protected]
Website:
www.unum.com
Principal
Financial
(800)986-3343
ColonialColonial
&
Unum:
Melinda
Client
ID#
Life75241L
–Albritton
(800)325-4368
Website:
www.coloniallife.com
Colonial
Life
– (800)325-4368
(817)992-0262
Client
ID#
75241L
Website: www.principal.com
Melinda
Albritton
[email protected]
Website:
http://www.mymemberportal.com
Website:
www.coloniallife.com
Colonial Life
–Website:
(800)325-4368
Unum
– (800)679-3054
Colonial
Life
–
(800)325-4368
Principal
Financial
(800)986-3343
www.coloniallife.com
http://www.mymemberportal.com
[email protected]
(817)992-0262 Website: Website:
net
www.coloniallife.com
Unum
– (800)679-3054
Website:
www.coloniallife.com
Website:
www.coloniallife.com
Website:
Website: www.unum.com
Colonial
&
Unum:
(817)992-0262
Unum www.principal.com
– (800)679-3054
Colonial
Life
–
(800)325-4368
Unum – (800)679-3054
Website:
www.unum.com
Melinda
Albritton
Unum
– (800)679-3054
Website:
www.unum.com
Colonial
Life
– (800)325-4368
Principal
Financial (800)986-3343
Website:[email protected]
www.coloniallife.com
Website:
www.unum.com
Website:
www.unum.com
Website:
www.unum.com
Principal
Financial (800)986-3343 Website: www.coloniallife.com
Website:
www.principal.com
(817)992-0262
Unum – (800)679-3054
Principal Financial
(800)986-3343
Website:
www.principal.com
Principal
Financial
(800)986-3343
Unum
–www.principal.com
(800)679-3054
Principal
Financial
(800)986-3343
Website:
Website:
www.unum.com
Website: www.principal.com
Website: www.unum.com
Website: www.principal.com
Principal Financial (800)986-3343
Principal Financial (800)986-3343
Website: www.principal.com
Website: www.principal.com
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