AP Professionals of Phoenix
Employee Benefit Summary
PLAN YEAR
| 2016
Our employees are our
most valuable asset.
That’s why at AP Professionals of Phoenix we are committed to a comprehensive
employee benefit program that helps our employees stay healthy, feel secure and maintain
a work/life balance.
Stay Healthy
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Medical, Dental and Vision
Health Reimbursement Arrangement (HRA)
Flexible
Spending
Accounts
(FSA) Feeling Secure
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 Disability Insurance / Short Term, Supplemental Short Term, Long Term
 401(k)/Profit Sharing
 Basic Life and Accidental Death & Dismemberment
 Optional Life Insurance
Work/Life Balance

Employee Assistance Program
Contact Information
Refer to this list when you need to contact one of your benefit vendors. For general
information contact Human Resources.
MEDICAL:
HEALTH REIMBURSEMENT ARRANGEMENT (HRA):
FLEXIBLE SPENDING ACCOUNT (FSA):
DENTAL
VISION:
SHORT TERM DISABILITY
OPTIONAL LIFE:
Medical Insurance
Plan Type:
BlueCross BlueShield of WNY
PPO 6317 High Deductible Health Plan
Effective Date:
First of the month following date of hire
Group Number:
00404874
In Network Deductible (per Calendar Year):
$1,500 Single ($1,500 employer funded HRA, $0 employee responsibility)
$3,000 Family ($3,000 employer funded HRA, $0 employee responsibility)
6317 PPO HDHP Plan Features
Medical Services
Office Visits
In-Network
Out-of-Network
(Deductible Applies)
Deductible then $30 Copay
30% Coinsurance
Specialists Visits
Deductible then $30 Copay
30% Coinsurance
Emergency Room Visit
Urgent Care Center
Outpatient Surgery Facility
In-Patient Hospitalization
($0 copay for Maternity Admissions)
Prescription Drug Coverage
Not subject to the deductible, NOT
covered by HRA
Plan Cost Sharing
Deductible
Coinsurance
Out-of-Pocket
Other Plan Highlights
Dependent Coverage
Deductible then $100 Copay
Deductible then $35 Copay
Deductible then $200 Copay
30% Coinsurance
30% Coinsurance
30% Coinsurance
Deductible then $0
30% Coinsurance
$5/$50/$75
$1,500 Single/ $3,000 Family
N/A
$5,000 Single/ $10,000 Family
Annual/ Lifetime Maximum
Employee Cost per pay period (Biweekly):
Employee: $0.00
Family: $0.00
26/26
None
$5/$50/$75
$3,000 Single/$6,000 Family
70%/30%
$5,000 Single/ $10,000 Family
26/26
none
Health Reimbursement
Arrangement
The HRA is an account that is funded by AP to help employees pay for medical deductible
expenses that have incurred while participating in the High Deductible Health Plan (HDHP).
Plan Type:
Nova Healthcare
Health Reimbursement Arrangement – (HRA)
Effective Date:
First of the month following date of hire
Note: In order to be eligible for the HRA, you must be enrolled in the BlueCross
BlueShield of WNY PPO 6317 High Deductible Health Plan (HDHP).
Benefits:
Single – $1,500 Available January 1st, 2016
Family – $3,000 Available January 1st, 2016
Eligible Expenses:
Covered medical deductible expenses only
Note: Prescription Copays Are Not Eligible
Flexible Spending Accounts
(FSA)
FSAs provide you with an important tax advantage that can help you pay health care and
dependent care expenses on a pre-tax basis. By anticipating your family’s health care
and dependent care costs for the next year, you can actually lower your taxable income.
Plan Type:
Nova Healthcare
Health Care Flexible Spending Account – (FSA)
Effective Date:
First of the month following 1 year with the company
Benefits:
By participating in the FSA, AP Professionals of Phoenix employees can pay for certain
IRS-approved medical care expenses not covered by their insurance plan with pre-tax
dollars. Some examples include:
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Hearing services, including hearing aids and batteries
Vision services, including contact lenses, contact lens solution, eye examinations, and eyeglasses
Dental services and orthodontia
Chiropractic services
Acupuncture
Prescription contraceptives
Over the Counter Items, are still NO longer eligible in 2016
Employees can contribute up to $2,550 annually to a Health Care FSA.
Plan Type:
Nova Healthcare
Dependent Care Flexible Spending Account – (DCA)
Effective Date:
First of the month following date of hire
Benefits:
By participating in the DCA, AP Professionals of Phoenix employees can pay for certain
IRS approved dependent care expenses for children under the age of 13 (or certain
eldercare expenses) with pre-tax dollars. Some examples include:
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The cost of child or adult dependent care
The cost for an individual to provide care either in or out of your house
Nursery schools and preschools (excluding kindergarten)
Employees can contribute up to $5,000 annually to a Dependent Care Account (or $2,500 if
married and filing separately)
Dental Insurance
3
Plan Type:
Guardian Dental Guard
Effective Date:
First of the month following date of hire
Group Number:
00482351
In-Network
Percentage Paid
Out-of-Network
Percentage Paid*
100%
*No Deductible
100%
*No Deductible
100%
80%
60%
50%
Orthodontia Services
60%
50%
Calendar Year Deductible
(Does not apply to Preventive Services)
$50 (3 per Family)
Calendar Year Benefit Maximum Per Person
Lifetime Orthodontia Maximum to Age 19
$1,000
$1,000
Services
Preventive Services*
Emergency Treatment
Oral Examinations
Teeth Cleaning
X-Rays
For Children:
Fluoride Treatments
Topical Sealants
Space Maintainers
Harmful Habit Appliances
Basic Services
Fillings: Amalgam, Silicate & Acrylic
Acrylic/Plastic Crowns
Maintain Bridgework & Dentures
Periodontic Services
Oral Surgery
Root Canal
Major Services
Gold & Porcelain Fillings & Crowns
Installation of Bridgework & Crowns
*Covered out-of-network charges will be based on the reasonable and customary allowances for the area
in which services are rendered.
Employee Cost per pay period (Bi-Weekly):
Employee: $0.00
Family: $31.14
Vision Insurance
4
Plan Type:
Guardian (Davis Full Feature)
Effective Date:
First of the month following date of hire
Group Number:
00482351
Davis - Full Feature - Designer
What's the most cost-effective way
to use vision benefits?
You may go to any eye doctor, however if you go to a Davis Vision network provider you will
usually pay less. Out of network providers may balance bill.
In-Network
Out-Of-Network
Exams
$20
$20
Materials
$20
$20
Frequency
Exams/Lenses/Materials: once per year; Frames: once every other year
Lenses : Single vision lenses
Copay applies
In-Network
Lenses: Lined bifocal lenses
Lenses: Lined trifocal lenses
Out-Of-Network
Amount over: $48
Lenses: Lenticular lenses
Copay applies
$135, 15% discount on amount over $135
Contact Lenses - Conventional
Contact Lenses - Planned replacement
and disposable
$135, 15% discount on amount over $135
Amount over: $67
Amount over: $86
Amount over:
$126
Amount over:
$105
Medically necessary
Covered in full with prior approval. Copay does not apply
Evaluation and fitting
15% off professional fee
Amount over:
$105
Amount over:
$210
$135, 20% discount on amount over $135, except Sam's Club/Walmart
Included in
Elective Contact
Lens allowance
Frames
Lens & Frame Allowance
Cosmetic Extras
Laser correction surgery
No discounts
No additional charge for: Oversize lens, polycarbonate for kids,
polycarbonate for adults with strong prescriptions, tinting. Other
discounts at 20% - 50% off retail price.
Amount over: $48
Up to 25% off usual and customary
No discounts
Employee Cost per Pay Period (Bi-Weekly):
Employee: $2.49
Family: $5.36
No discounts
Group Life and AD&D
Insurance
6
AP Professionals of Phoenix provides full-time employees group life and accidental death and
dismemberment (AD&D) insurance, and pays the full cost of this benefit. Contact Human
Resources to update your beneficiary information.
Plan Type:
Guardian Basic Life Insurance and AD&D
Effective Date:
First of the month following date of hire
Group Number:
00482351
Benefits You Receive:
Basic Coverage, Employee:
Age Reduction Schedule:
1x Salary, $50,000 Maximum
50% at age 70
Employee Cost per Pay Period (Bi-Weekly):
Employee: $0.00
Family: $0.00
Supplemental Life and AD&D
Insurance
AP Professionals of Phoenix provides full-time employees the opportunity to enroll
in additional life and accidental death and dismemberment (AD&D) insurance above
the company paid benefit, at a reasonable cost through Guardian.
Plan Type:
Guardian Supplemental Life Insurance
Effective Date:
First of the month following date of hire
Group Number:
00482351
Benefits You Receive:
Voluntary Life & AD&D Insurance
Employee - may elect one of the following benefit options: $25,000; $50,000; $75,000;
$100,000; The Guarantee Issue (G.I.) amount is $100,000.
Spouse is eligible for 50% of the employee’s amounts to a maximum of $50,000. The
Guarantee Issue (G.I.) amount is $25,000.
Dependent child(ren) birth to 14 days are not eligible, age 15 days to 6 Months are eligible for
$100; 6 months to age 21 or (or 23 if a full-time student) are eligible for $1,000, $2000, $4000,
$5,000, or $10,000. The Guarantee Issue (G.I.) amount is $10,000.
Age Reduction Schedule: 50% at age 70
Employee Cost per pay period:
Monthly Cost for Each $1,000 of Employee & Spouse Life Insurance Coverage
Age
Life
Dependent
Children
15-29
.070
30-34
.090
35-39
.120
40-44
.150
45-49
.220
50-54
.360
55-59
.640
60-64
.890
65-69
1.640
70+
N/A
$0.160 / $1,000 per child unit (rate is the same regardless of the number of eligible
children)
Basic Disability Insurance
AP Professionals of Phoenix provides full-time employees with short term disability income
benefits, and pays the full cost of this coverage. In the event you become disabled from a nonwork related injury or sickness, disability income benefits are provided as a source of income.
Plan Type:
Guardian Basic Disability
Effective Date:
Date of hire
Group Number:
00482351
Benefits You Receive:
Benefit Begins:
Weekly Benefit:
Duration:
Pre-Existing Clauses:
8 Days Accident/8 Days Illness
50% of Salary up to $170 weekly max.
26 weeks
None
Note: You are not eligible to receive short-term disability benefits if you are receiving
workers’ compensation benefits.
Employee Cost per Pay Period (Bi-Weekly):
Employee: $0.00
Family: $0.00
Supplemental Short Term
Disability Insurance
AP Professionals of Phoenix offers additional Short Term Disability coverage to eligible
employees. In the event you become disabled from a non-work related injury or sickness,
disability income benefits are provided as a source of income. These benefits are paid in
addition to your current “company sponsored” short term disability income.
Plan Type:
Guardian Supplemental Short Term Disability
Effective Date:
First of the Month following Date of Hire
Group Number:
00482351
Benefits You Receive:
Benefit Begins:
Weekly Benefit:
Duration:
Pre-Existing Clauses:
8 Days Accident/8 Days Illness
60% of Salary up to $1,500 weekly max
13 weeks
3/12 with 2 week limitation*
*Any condition treated up to 3 months prior to effective date of coverage will not be a covered
benefit until coverage has been in force 12 months
Evidence of Insurability is conditional – employees must complete medical
questionnaire.
Late entrants (employees offered benefit who previously waived coverage) must
complete an Evidence of Insurability Form. Coverage for late entrants is subject
to the Insurance Company’s approval.
Employee Cost per pay period:
Rates are based on age, coverage amount and location of employee.
Rates per $10 of Weekly Indemnity
Age
Rate:
<25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60+
$0.350 $0.460
$0.610
$0.460
$0.390
$0.410
$0.480
$0.590
$0.870
$0.320 $0.390
$0.490
$0.390
$0.370
$0.420
$0.510
$0.650
$0.900
(NY, NJ, CA
employees)
Rate:
(Non-Statutory
Employees)
Long Term Disability
Insurance
AP Professionals of Phoenix provides full-time employees with short and long-term disability
income benefits. Employees must elect Long term Disability and are responsible for the entire
cost of this coverage. In the event you become disabled from an injury or sickness (on or off
the job), disability income benefits are provided as a source of income.
Plan Type:
Guardian Voluntary Long Term Disability
Effective Date:
First of the Month following Date of Hire
Group Number:
00482351
Benefits You Receive:
Elimination Period:
90 Days
Weekly Benefit:
60% of salary up to $6,000 monthly maximum
Duration:
To age 65 or Social Security Retirement Age
Coverage Type:
2 year Own Occupation / After 2 years Any Occupation*
Pre-Existing Clauses:
3/12 with 2 week limitation**
*For the first two years of disability, you will receive benefit payments while you are
unable to work in your own occupation. After two years, you will continue to receive
benefits if you cannot work in any occupation based on training, experience and
education.
**Evidence of Insurability is conditional – employees must complete
medical questionnaire.
Late entrants (employees offered benefit who previously waived coverage) must
complete an Evidence of Insurability Form. Coverage for late entrants is subject to the
Insurance Company’s approval.
Employee Cost:
Rates are based on age and coverage amount.
Monthly Cost for Each $100 of Employee Long Term Disability Coverage
Age
Rate
15-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-99
$0.140
$0.150
$0.190
$0.270
$0.420
$0.720
$1.050
$1.180
$0.830
401k
To help you prepare for the future, AP Professionals of Phoenix sponsors a 401(k) plan as part
of its benefits package. As an employee, you may start participating in this plan on the first
day of the calendar quarter and after completing 90 days of service. Enrollments will be
January 1, April 1, July 1 and October 1.
Plan Type:
VOYA (ING)
Effective Date:
90 days of employment on the following quarter
Benefits You Receive:
With this plan, you may save up to 15 percent of your pay on a before-tax basis (traditional
plan). By saving on a before-tax basis, you reduce the taxes you pay today and delay paying
taxes on the money you save, as well as your account earnings, until you withdraw the money
from the plan. You also have the option to contribute to a post-tax Roth plan or you may
participate in both a traditional and Roth plan.
Contributions as well as allocations can be changed anytime (even daily).
Maximum Contribution:
For the 2016 calendar year you may contribute anywhere from 1 - 96% for a max of $18,000
for the year.
Employee Cost:
Employee allocated, percentage of pay
Employee Benefits Costs
Listed below are the employee payroll deductions for the Employee Benefits AP
Professionals of Phoenix provides. This includes the voluntary and employer paid coverage.
2016 Employee Benefits Costs
Medical Insurance
6317 PPO HDHP Single
6317 PPO HDHP Family
Health Reimbursement ArrangementEmployer Funded
Single Benefit
$0.00
$0.00
$1,500.00
Family Benefit
$3,000.00
Flexible Spending Account
Medical Expenses
Voluntary Election up to $2,550
Dependent Care
Voluntary Election up to $5,000
Dental Insurance
Single
$0.00
Family
$31.14 Bi-Weekly
Single
$2.49 Bi-Weekly
Family
$5.36 Bi-Weekly
$0.00
Vision Insurance
Group Life AD&D Insurance
Voluntary Life AD&D Insurance
Short Term Disability Insurance
Long Term Disability Insurance
401 K
Employee Assistance Program
Employee
Spouse
Voluntary Election
Voluntary Election
Dependent
Voluntary Election
Voluntary Election
Voluntary Election
Voluntary Election
$0.00
Employee Assistance
Programs
The Employee Assistance Program is offered to all employees and immediate family members
of AP Professionals of Phoenix. It is a completely confidential counseling program that
covers issues such as marital and family concerns, depression, substance abuse, grief and
loss, financial entanglements, and other personal stressors.
For further information in regard to services please see the Guardian enrollment booklet.
You can contact Guardian “WorkLifeMatters” toll free at 1-800-386-7055, or you can visit their
website at www.ibhworklife.com.
The information in this Benefits Summary is presented for illustrative purposes and is based
on information provided by the employer. The text contained in this Summary was taken
from various summary plan descriptions and benefit information. While every effort was
taken to accurately report your benefits, discrepancies, or errors are always possible. In case
of discrepancy between the Benefits Summary and the actual plan documents the actual plan
documents will prevail. All information is confidential, pursuant to the Health Insurance
Portability and Accountability Act of 1996. If you have any questions about this summary,
contact Human Resources.
Annual Vacation, Holiday, &
Sick Days
Annual Vacation Accrual:
Holiday pay is available immediately upon employment. Vacation and sick days begin to accrue after
60 days of employment at a rate of 1 ½ days (8 hours Vacation and 4 hours Sick) per month
until reaching the maximum paid time-off per year.
25 Annual Days with Paid Time-off:
Vacation = 10 Days
Holidays = 10 Days
Sick Days = 5 Days
Holiday Schedule Breakdown:
AP Professionals has six scheduled Holidays:
New Year’s Day, Memorial Day, 4th of July, Labor Day, Thanksgiving, and Christmas
The remaining four days are floating days to be used according to the client’s holidays:
MLK Day, Presidents Day, Columbus Day, Day after Thanksgiving