2022 Employee Benefits Guide
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<strong>2022</strong> BENEFITS<br />
ENROLLMENT GUIDE<br />
Allen Engineering Corporation<br />
Effective 1/1/<strong>2022</strong> to 12/31/<strong>2022</strong>
LETTER FROM THE PRESIDENT
CONTENTS<br />
4 <strong>Benefits</strong> Overview<br />
7 Medical Insurance<br />
10 Wellness Overview<br />
11 Health Savings Account<br />
14 Flexible Spending Accounts<br />
18 Dental & Vision Insurance<br />
21 Short-Term Disability Insurance<br />
23 Voluntary Group Life and AD&D Insurance<br />
25 Evidence of Insurability (EOI) and Disclaimer<br />
26 Open Enrollment Instructions<br />
27 Important Contacts
BENEFITS<br />
OVERVIEW<br />
4
BENEFITS OVERVIEW<br />
ENROLLMENT<br />
You can enroll in benefits or change your elections at the following times:<br />
• 30 days prior to your initial eligibility date (as a newly hired employee)<br />
• During the annual benefits open enrollment period<br />
• Within 30 days of experiencing a qualifying life event<br />
BENEFIT OPTIONS<br />
We offer a comprehensive benefits package consisting of:<br />
• Medical Insurance<br />
• Health Savings Account<br />
• Flexible Spending Accounts<br />
• Voluntary Dental Insurance<br />
• Voluntary Vision Insurance<br />
• Voluntary Group Life and AD&D Insurance<br />
• Voluntary Short-Term Disability Insurance<br />
5
BENEFITS OVERVIEW<br />
ELIGIBILITY<br />
Full-time employees working at least 30 hours per week are eligible for<br />
benefits on the first of the month following or coinciding with 60 days of<br />
employment. Many of the plans offer coverage for eligible dependents,<br />
including:<br />
• Your legal spouse<br />
• Your children to age 26, regardless of student, marital, or tax-dependent<br />
status (including stepchild, legally adopted child, a child placed with you<br />
for adoption, or a child for whom you are the legal guardian)<br />
• Your dependent children over age 26 who are physically or mentally<br />
unable to care for themselves<br />
CHANGING BENEFITS AFTER OPEN ENROLLMENT<br />
You may pay your portion of the medical, dental, and vision plan costs, and<br />
fund the flexible spending accounts, on a pre-tax basis. Thus, due to IRS<br />
regulations, once you have made your elections for the plan year, you<br />
cannot change your benefits until the next annual open enrollment period.<br />
The only exception is if you experience a qualifying event, and election<br />
changes must be consistent with your life event.<br />
To request a benefits change, notify your Business Office or Human<br />
Resources within 30 days of the qualifying life event. Change requests<br />
submitted after 30 days cannot be accepted. You may need to provide<br />
proof of the life event.<br />
Qualifying life events include, but are not limited to:<br />
• Marriage, divorce, or legal separation<br />
• Birth or adoption of an eligible child<br />
• Death of your spouse or covered child<br />
• Change in your spouse’s work status that affects his or her benefits<br />
• Change in your child’s eligibility for benefits<br />
• Qualified Medical Child Support Order<br />
6
MEDICAL<br />
INSURANCE<br />
7
MEDICAL INSURANCE<br />
CARRIER: Arkansas Blue Cross Blue Shield<br />
Plan Options: High-Deductible Health Plan (HDHP) and a PPO plan<br />
Please refer to the official plan documents for additional information on coverage and exclusions.<br />
COVERED BENEFITS<br />
Year Deductible<br />
Option 1<br />
HDHP Plan<br />
Option 2<br />
PPO Plan<br />
In-Network Out-of-Network In-Network Out-of-Network<br />
Individual $6,650 $13,300 $5,000 $15,000<br />
Family $13,300 $26,600 $10,000 $30,000<br />
Out of Pocket Maximum<br />
Includes deductibles, copays and coinsurance Includes deductibles, copays and coinsurance<br />
Individual $6,650 $26,600 $8,150 $31,150<br />
Family $13,300 $53,200 $16,300 $62,300<br />
Coinsurance (Plan Pays) 100% 80% 80% 60%<br />
Preventive Care<br />
Well-Child Care Plan Pays 100% Deductible & Coins. Plan Pays 100% Deductible & Coins.<br />
Adult Preventive Care Plan Pays 100% Deductible & Coins. Plan Pays 100% Deductible & Coins.<br />
Physician Services<br />
Primary Care Deductible & Coins. Deductible & Coins. $30 Copay Deductible & Coins.<br />
Specialist Deductible & Coins. Deductible & Coins.<br />
$50 Copay<br />
(coins may apply to<br />
additional services)<br />
Deductible & Coins.<br />
Urgent Care Deductible & Coins. Deductible & Coins. $50 Coppay Deductible & Coins.<br />
Emergency Services<br />
Emergency Room Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />
Ambulance Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />
Diagnostic Lab/X-Ray Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />
Hospital Services<br />
Inpatient Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />
Outpatient Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />
Prescription Drugs<br />
Generic Deductible & Coins. Deductible & Coins. $20 copay Deductible & Coins.<br />
Preferred Brand Deductible & Coins. Deductible & Coins. $50 Copay Deductible & Coins.<br />
Non-Preferred Brand Deductible & Coins. Deductible & Coins. $70 Copay Deductible & Coins.<br />
Specialty Deductible & Coins. Deductible & Coins. $250 Copay Deductible & Coins.<br />
8
WHICH MEDICAL INSURANCE PLAN IS<br />
RIGHT FOR YOU?<br />
Choosing the right medical plan is an important decision. Take the time to learn about your<br />
options to ensure you select the right plan for you and your family.<br />
THINGS TO CONSIDER<br />
1. Do you prefer to pay more for medical insurance out of your paycheck, but less when you need<br />
care?<br />
2. Or, do you prefer to pay less out of your paycheck, but more when you need care?<br />
3. What planned medical services do you expect to need in the upcoming year?<br />
4. Are you able to budget for your deductible by setting aside pre-tax dollars from your paycheck in<br />
an HSA or FSA?<br />
5. Do you or any of your covered family members take prescription medications on a regular basis?<br />
MEDICAL<br />
RATES<br />
COVERAGE LEVEL<br />
Monthly<br />
Rate<br />
Employer Monthly<br />
Contribution<br />
Option 1<br />
HDHP Base Plan<br />
<strong>Employee</strong> Monthly<br />
Contribution<br />
<strong>Employee</strong> Rate<br />
52 Pay Periods<br />
<strong>Employee</strong> Rate<br />
26 Pay Periods<br />
<strong>Employee</strong> Only $308.51 308.51 $0.00 $0.00 $0.00<br />
EE & Spouse* $774.40 308.51 $465.89 $107.51 $215.03<br />
EE & Child(ren) $510.60 308.51 $202.09 $46.64 $93.27<br />
EE & Family* $1,026.97 308.51 $718.46 $165.80 $331.60<br />
MEDICAL RATES<br />
Option 2<br />
PPO Buy-Up Plan<br />
COVERAGE LEVEL<br />
Monthly<br />
Rate<br />
Employer Monthly<br />
Contribution<br />
<strong>Employee</strong> Monthly<br />
Contribution<br />
<strong>Employee</strong> Rate<br />
52 Pay Periods<br />
<strong>Employee</strong> Rate<br />
26 Pay Periods<br />
<strong>Employee</strong> Only $387.44 $329.32 $58.12 $13.41 $26.82<br />
EE & Spouse* $972.57 $329.32 $643.25 $148.44 $296.88<br />
EE & Child(ren) $641.23 $329.32 $311.91 $71.98 $143.96<br />
EE & Family* $1,289.73 $329.32 $960.41 $221.63 $443.26<br />
*As an <strong>Employee</strong>, I understand that if my spouse is offered coverage through their employer, coverage is NOT available<br />
through Allen Engineering Corporation.<br />
COMPARING YOUR MEDICAL PLAN OPTIONS<br />
PPO Plans<br />
• Higher cost per paycheck<br />
• Lower deductible<br />
• Can fund a Health Care Flexible Spending Account<br />
(FSA)<br />
HDHP Plans<br />
• Lower cost per paycheck<br />
• Higher deductible<br />
• Can fund a Health Savings Account (HSA)<br />
• Allen Engineering Corporation HSA contribution $500<br />
annually<br />
9
WELLNESS OVERVIEW<br />
ANNUAL WELLNESS CHECK UP!<br />
Be sure to complete your preventive care check up between December 1, 2021 and<br />
November 30, <strong>2022</strong>. You will need to take the ’Physician Attestation’ Form with you<br />
when you go for your check up. After your doctor signs the form, return the form to the<br />
HR Department no later than November 30, <strong>2022</strong>. Check with the HR Department for<br />
further details.<br />
HEALTH RISK ASSESSMENT<br />
Be sure to complete your health assessment on the Arkansas Blue Cross website by November 30,<br />
<strong>2022</strong>.<br />
BIOMETRIC SCREENING<br />
Make plans to participate in the biometric screening event in February <strong>2022</strong>. More details to<br />
come.<br />
USE TOBACCO?<br />
Take advantage of the smoking cessation products now available to you at low or no cost through<br />
our BC health plan. Contact Arkansas Blue Cross at 1-800-238-8379 to learn more about how<br />
your new benefits can help you quit.<br />
10
HEALTH<br />
SAVINGS<br />
ACCOUNT<br />
11
HEALTH SAVINGS ACCOUNT<br />
CARRIER: Consolidated Admin Services<br />
If you enroll in the High-Deductible Health (HDHP) Plan, you may be eligible to<br />
fund a Health Savings Account (HSA). An HSA is a personal health care savings<br />
account that you can use to pay out-of-pocket health care expenses with pre-tax<br />
dollars. Your contributions are tax free and the money remains in the account<br />
for you to spend on eligible expenses no matter where you work or how long it<br />
stays in the account.<br />
WHO IS ELIGIBLE?<br />
You are eligible to open and fund an HSA if:<br />
● You are enrolled in the High Deductible Health Plan (HDHP).<br />
● You are not covered by a non-HSA plan, Health Care FSA, or Health Reimbursement<br />
Arrangement.<br />
● You are not eligible to be claimed as a dependent on someone else’s tax return<br />
● You are not enrolled in Medicare<br />
● You have not received Veterans Administration <strong>Benefits</strong> in the last three months<br />
HSA EMPLOYER CONTRIBUTIONS<br />
Allen Engineering Corporation will help you save with an<br />
annual contribution of $600.<br />
● Contributions to a Health Savings Account (including<br />
the employee contributions) cannot exceed the<br />
annual IRS contribution maximums.<br />
● <strong>Employee</strong>s age 55+ by 12/31/<strong>2022</strong> may contribute<br />
additional funds to their HSA (up to $1,000).<br />
● You must open your HSA through Consolidated Admin<br />
Services to receive contributions.<br />
ALLEN ENGINEERING<br />
CORPORATION<br />
CONTRIBUTES $600<br />
TO YOUR HSA<br />
ANNUALLY<br />
$3,650<br />
$7,300<br />
$1,000<br />
INDIVIDUAL<br />
for <strong>2022</strong><br />
ALL OTHER TIERS<br />
for <strong>2022</strong><br />
Age 55+<br />
CATCH-UP<br />
CONTRIBUTION<br />
for <strong>2022</strong><br />
12
HEALTH SAVINGS ACCOUNT<br />
MAXIMIZE YOUR TAX SAVINGS<br />
• Contributions to an HSA are tax-free and can be made through payroll deduction on a pre-tax<br />
basis.<br />
• This money in your HSA (including interest and investment earnings) grows tax-free.<br />
• As long as you use the funds to pay for qualified medical expenses, the money is spent<br />
tax-free.<br />
YOU INDIVIDUALLY OWN YOUR HSA<br />
• You own and administer your HSA.<br />
• You determine how much you will contribute to your account and when to use the money to<br />
pay for eligible health care expenses.<br />
• You can change your contributions at any time during the plan year without a qualifying event.<br />
• Like a bank account, you must have a balance in order to pay for eligible health care expenses.<br />
• Keep all receipts for tax documentation.<br />
• An HSA allows you to save and “rollover” money from year to year.<br />
• The money in the account is always yours, even if you change health plans or jobs.<br />
• There are no vesting requirements or forfeiture provisions.<br />
ACCESSING YOUR HSA FUNDS<br />
Debit Card: Draws directly from your HSA and can be used to pay for eligible expenses at your<br />
doctor’s office, pharmacy, or other locations where you purchase health related items or services.<br />
Checkbook: Works just like your personal checkbook, with the exception that it draws from your<br />
HSA, and can be used to pay for expenses you’ve paid out of your pocket. Checkbooks are issued<br />
upon request by Health Equity.<br />
USE YOUR HSA TO PAY QUALIFIED MEDICAL EXPENSES<br />
• You can use your HSA money to pay for eligible expenses now or in the future.<br />
• Funds in your HSA can be used for your expenses and those of your spouse and eligible<br />
dependents, even if they are not covered by the Arkansas Blue Cross Blue Shield HDHP<br />
(Option 1).<br />
• Eligible expenses include deductibles, doctor’s office visits, dental expenses, eye exams,<br />
prescription expense and LASIK eye surgery.<br />
• A complete list of eligible expenses can be found at www.irs.gov.<br />
13
FLEXIBLE<br />
SPENDING<br />
ACCOUNTS<br />
14
FLEXIBLE SPENDING ACCOUNTS<br />
CARRIER: Consolidated Admin Services<br />
Allen Engineering Corporation offers a Health Care Flexible Spending Account (FSA) that allows you to<br />
pay for eligible health care expenses with the pre-tax dollars.<br />
Log into your account at www.consolidatedadmin.com to view your account balance(s), calculate tax<br />
savings, view eligible expenses, download forms, view transaction history, and more.<br />
HEALTH CARE FSA<br />
●<br />
●<br />
Set aside pre-tax money from your paycheck to pay for eligible out-of-pocket expenses, such as<br />
deductibles, copays, and other health-related expenses, that are not paid by the medical, dental, or vision<br />
plans.<br />
Over-the-counter (OTC) medications are not eligible for reimbursement without a prescription.<br />
HOW DOES AN FSA WORK?<br />
You decide how much to contribute to an FSA on a plan year basis up to the maximum allowable amount. Your<br />
annual election will be divided by the number of pay periods and deducted evenly on a pre-tax basis from<br />
each paycheck throughout the year.<br />
You will receive a debit card from Consolidated Admin Services, which can be used to pay for eligible health<br />
care expenses at the point of service. If you do not use your debit card, submit a claim form and a bill or<br />
itemized receipt from the provider to Consolidated Admin Services. Keep all receipts in case Consolidated<br />
Admin Services requires you to verify the eligibility of a purchase.<br />
THINGS TO CONSIDER<br />
• Healthcare FSA dollars are use-it or lose-it.<br />
• Up to $500 of unused dollars can be rolled over to <strong>2022</strong>.<br />
• You cannot take income tax deductions for expenses you pay<br />
with your FSA(s)<br />
• You cannot stop or change your FSA contribution(s) during the<br />
plan year unless you experience a qualifying life event.<br />
HEALTHCARE FSA LIMIT<br />
$2,750<br />
*<strong>2022</strong> limits have not been released<br />
SPECIAL FSA ACCOUNT FEATURES<br />
RUNOUT<br />
Runout is the 90 days after your<br />
plan year ends during which<br />
you may submit last year’s<br />
expenses to be reimbursed<br />
with last year’s FSA funds.<br />
GRACE PERIOD<br />
The grace period is 2 months +<br />
15 days after the end of the<br />
plan year during which you may<br />
incur new expenses but be<br />
reimbursed with last year’s<br />
FSA funds.<br />
ROLLOVER<br />
You have the ability to roll over<br />
up to $500 from one plan year<br />
to the next.<br />
15
LIMITED-PURPOSE FLEXIBLE SPENDING<br />
ACCOUNTS<br />
CARRIER: Consolidated Admin Services<br />
A Limited-Purpose Flexible Spending Account (FSA) is a special account that lets you set aside<br />
money (before it is taxed) to help pay for eligible dental and vision expenses.<br />
HOW DOES A LIMITED-PURPOSE FSA WORK?<br />
You decide how much to contribute to each FSA on a plan year basis up to the maximum allowable<br />
amounts. Your annual election will be divided by the number of pay periods and deducted evenly on<br />
a pre-tax basis from each paycheck throughout the year.<br />
You will receive a debit card from TASC, which can be used to pay for eligible health care expenses at<br />
the point of service. If you do not use your debit card or if you have dependent care expenses to be<br />
reimbursed, submit a claim form and a bill or itemized receipt from the provider to TASC. Keep all<br />
receipts in case TASC requires you to verify the eligibility of a purchase.<br />
WHAT’S THE DIFFERENCE BETWEEN A STANDARD HEALTH CARE FSA AND<br />
A LIMITED-PURPOSE FSA?<br />
Under current IRS rules, you cannot deposit money into a Health Savings Account (HSA) if<br />
you participate in a standard Health Care FSA. However, because a Limited-Purpose FSA<br />
restricts reimbursements to specific dental and vision care expenses, the IRS allows you to<br />
participate in both a Limited-Purpose FSA and an HSA at the same time. By having both<br />
accounts, you can maximize your tax and savings benefits.<br />
+<br />
LIMITED-PURPOSE FLEXIBLE<br />
SPENDING ACCOUNT<br />
(FSA)<br />
HEALTH SAVINGS ACCOUNT<br />
(HSA)<br />
LIMITED-PURPOSE FSA<br />
$2,850<br />
16
LIMITED-PURPOSE FLEXIBLE SPENDING<br />
ACCOUNTS<br />
17
DENTAL<br />
& VISION<br />
INSURANCE<br />
18
VOLUNTARY DENTAL INSURANCE<br />
CARRIER: Arkansas Blue Cross Blue Shield<br />
●<br />
●<br />
●<br />
●<br />
You will pay less out of pocket when you choose an in-network provider.<br />
Locate an in-network provider at www.arkansasbluecross.com/findcare.<br />
Be sure to ask for a pre-treatment estimate.<br />
Out-of-network providers can balance bill, or bill you for the difference<br />
between the provider’s charge and the allowed amount.<br />
DENTAL<br />
ELECTION<br />
Monthly<br />
Rate<br />
<strong>Employee</strong> Rate<br />
52 Pay Periods<br />
<strong>Employee</strong> Rate<br />
26 Pay Periods<br />
<strong>Employee</strong> Only $29.77 $6.87 $13.74<br />
EE & Spouse $63.72 $14.70 $29.41<br />
EE & Child(ren) $47.91 $11.06 $22.11<br />
EE & (Family) $87.16 $20.11 $40.23<br />
COVERED BENEFITS IN-NETWORK OUT-OF-NETWORK<br />
Deductible (per calendar year)<br />
$50 per person<br />
$150 per family<br />
$50 per person<br />
$150 per family<br />
Annual Plan Benefit Maximum $1,000 $1,000<br />
Preventive Care<br />
Oral exams, cleanings, X-rays, sealants<br />
Basic Services<br />
Fillings, extractions, non-surgical periodontics, endodontics,<br />
oral surgery, anesthesia<br />
Major Services<br />
Surgical periodontics, inlays/onlays, crowns, partials,<br />
dentures, implants<br />
100% 90%<br />
80% 70%<br />
50% 40%<br />
Orthodontia Services (to age 18) 50% 40%<br />
Lifetime Orthodontia Plan Max $1,000 $1,000<br />
Annual Maximum Carryover*<br />
Included*<br />
*Please refer to the official plan documents for additional information Annual Maximum Carryover.<br />
19
VOLUNTARY VISION INSURANCE<br />
CARRIER: Arkansas Blue Cross Blue Shield<br />
●<br />
●<br />
●<br />
●<br />
●<br />
You will pay less out of pocket when you choose an in-network provider.<br />
Locate an in-network provider at www.arkansasbluecross.com/findcare.<br />
You must submit a claim form for out-of-network expenses.<br />
LASIK surgery discounts available<br />
Don’t forget about glasses.com and contactsdirect.com!<br />
VISION<br />
ELECTION<br />
Monthly<br />
Rate<br />
<strong>Employee</strong> Rate<br />
52 Pay Periods<br />
<strong>Employee</strong> Rate<br />
26 Pay Periods<br />
<strong>Employee</strong> Only $9.00 $2.08 $4.15<br />
EE & Spouse $16.67 $3.85 $7.69<br />
EE & Child(ren) $18.02 $4.16 $8.32<br />
EE & (Family) $25.67 $5.92 $11.85<br />
COVERED BENEFITS IN-NETWORK OUT-OF-NETWORK<br />
Eye Exam (every 12 months) $10 Copay $45 Allowance<br />
Frames (every 24 months) $150 Allowance + 20% off balance $70 Allowance<br />
Standard Plastic Lenses (every 12 months)<br />
Single / Bifocal / Trifocal / Lenticular<br />
Progressive<br />
$20 Copay<br />
$20 Copay<br />
$30 / $50 / $65 / $100 Allowance<br />
$50 Allowance<br />
Contact Lenses, in lieu of glasses (every 12 months)<br />
Elective<br />
Medically Necessary<br />
Up to $150, in lieu of glasses<br />
Plan Pays 100%<br />
Up to $85<br />
Up to $210<br />
20
SHORT-TERM<br />
DISABILITY<br />
INSURANCE<br />
21
VOLUNTARY SHORT-TERM DISABILITY<br />
INSURANCE<br />
CARRIER: USAble Life<br />
SHORT-TERM DISABILITY INSURANCE<br />
Short-Term Disability (STD) Insurance is designed to help you meet your financial<br />
needs if you become unable to work due to a non-work related illness or injury. This<br />
is a voluntary plan; employees are responsible for 100% of the cost. Premiums are<br />
calculated as a percentage of you annual base salary.<br />
• Benefit Amount: 60% of base weekly salary up to $1,000 per week<br />
• Elimination Period: 7 days<br />
• Benefit Durations: Up to 26 weeks<br />
• Pre-Existing Conditions Limitation: 3 months prior/12 months after<br />
AGE RATE PER $10 OF BENEFIT<br />
0-24 $0.666<br />
25-29 $0.666<br />
30-34 $0.739<br />
35-39 $0.602<br />
40-44 $0.547<br />
45-49 $0.575<br />
50-54 $0.728<br />
55-59 $0.962<br />
60-64 $1.241<br />
65-69 $1.241<br />
How to Calculate your Weekly Rate<br />
Your annual base salary: $__________<br />
Divide by 52: ÷ 52<br />
Equals:<br />
= __________<br />
Multiply by 60%: x 0.60<br />
Equals (cannot be greater than<br />
$1,300):<br />
= __________<br />
Divide by 10: ÷ 10<br />
Multiply Total by age-based rate:<br />
Equals Your Monthly Cost:<br />
Multiply monthly cost by 12, then<br />
divide by 26:<br />
x __________<br />
= __________<br />
= __________<br />
Review your beneficiary designations<br />
22
VOLUNTARY<br />
LIFE<br />
INSURANCE<br />
23
VOLUNTARY LIFE INSURANCE<br />
CARRIER: USAble Life<br />
WHAT IS VOLUNTARY LIFE<br />
INSURANCE? Voluntary Life Insurance, also called<br />
group life insurance, is offered through an employer but is<br />
paid for partially or solely by employees.<br />
WHY PURCHASE VOLUNTARY<br />
LIFE INSURANCE?<br />
• This type of life insurance has limited underwriting<br />
required. This allows for people with health conditions or<br />
lifestyles that might otherwise disqualify them to qualify<br />
for life insurance.<br />
• The group rates are lower than what you could purchase on your own.<br />
• You may purchase a policy for your spouse and children.<br />
<strong>Employee</strong> Plan Highlights<br />
● Guarantee Issue: $150,000<br />
● Benefit Amount: Available in increments of $10,000 (minimum of $20,000) up to a max of 5x annual<br />
salary or $500,000<br />
● Accelerated Death Benefit: Included which will be the lesser of 75% of the life amount or $250,000<br />
● Rates: Age-banded; cost increases as employee ages<br />
● <strong>Employee</strong> must be enrolled in Voluntary Life coverage in order to enroll dependents in life<br />
insurance<br />
● After your “initial enrollment” amounts requested OVER $150,000 require Evidence of<br />
Insurability (EOI) to be submitted and approved by Assurant<br />
● Voluntary Life coverage terminates upon Retirement<br />
● Age reductions apply upon reaching 65 years of age<br />
● No guarantee issue over age 69<br />
○<br />
Spouse Plan Highlights<br />
● Benefit Amount: Available in increments of $10,000 from a minimum of $10,000 to a max of<br />
$300,000<br />
● Rates: Age-banded and are based on <strong>Employee</strong>’s age<br />
● Amounts requested after your “initial enrollment” will require Evidence of Insurability (EOI)<br />
completed the <strong>Employee</strong><br />
○<br />
Child(ren) Plan Highlights<br />
● Benefit Amount: Children age live birth to 6 months - $1,000; Children age 6 months but less than<br />
26 years - $5,000 units up to a max of $10,000<br />
Note: <strong>Employee</strong>s and spouses may increase benefit by $10,000 each annual enrollment, up to the Guarantee<br />
Issue Amount without an Evidence of Insurability (EOI) form if they are currently enrolled.<br />
24
EVIDENCE OF INSURABILITY<br />
Will I need to answer any medical questions to enroll?<br />
EVIDENCE OF INSURABILITY FORM (EOI)<br />
A Carrier’s “medical questionnaire” may be required to be completed by an <strong>Employee</strong>/Spouse/Child<br />
periodically when enrolling for certain benefits. If you enrolled in benefits when you were first eligible, you<br />
may not have had to complete a form. However, in subsequent enrollments, any “late applicant” must<br />
complete this form to be considered for coverage. Completing this form DOES NOT GUARANTEE<br />
COVERAGE. Please see your HR Department for the appropriate EOI form and/or medical questionnaire.<br />
USABLE BENEFITS:<br />
Voluntary Life<br />
Guarantee Issue will be issued if employee applies when first eligible OR during their FIRST annual<br />
enrollment. Otherwise, employees are considered a late entrant and will required to fill out the EOI -<br />
answer medical questions. This pertains to employee, spouse and child(ren). <strong>Employee</strong>s and spouses may<br />
increase by $10K each annual enrollment, up to the GI, without EOI. ANY amount over the GI amount will<br />
require an EOI.<br />
Disclaimer: The terms “you” and “your” as used in this Annual Enrollment Overview refer to an employee<br />
of Allen Engineering who meets all the eligibility and participation requirements under the Allen<br />
Engineering Corporation Medical Plan (the “Plan”). Receipt of this document does not guarantee that the<br />
recipient is a participant under the Plan and/or otherwise eligible for benefits under the Plan.<br />
Allen Engineering Corporation reserves the right to make changes or to terminate any benefit plan or plans<br />
at any time, without prior notice to or consent from any employee or participant. If there is any<br />
inconsistency between this document and the official plan documents and contracts, the official carrier<br />
plan documents and contracts will control.<br />
The information contained in this Annual Enrollment Overview may have been supplied by third parties.<br />
Although BXS Insurance has no reason to doubt the accuracy of information used to prepare this document,<br />
we make no representation and give no warranty as to the accuracy, currency or completeness of any<br />
information contained in this document or its relevance to the recipient.<br />
This summary of benefits is not intended to be a complete description of the terms of Allen Engineering Corporation’s<br />
insurance benefit plans. Please refer to the plan document(s) for a complete description. Each plan is governed in all<br />
respects by the terms of its legal plan document, rather than by this or any other summary of the insurance benefits<br />
provided by the plan. In the event of any conflict between a summary of the plan and the official document, the<br />
official document will prevail. Although Allen Engineering Corporation maintains its benefit plans on an ongoing basis,<br />
Allen Engineering Corporation reserves the right to terminate or amend each plan, in its entirety or in any part at any<br />
time.<br />
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OPEN ENROLLMENT INSTRUCTIONS<br />
During the <strong>Employee</strong> <strong>Benefits</strong> Enrollment process, a representative will cover the extensive benefits package<br />
that Allen Engineering Corporation offers eligible employees, including Medical/Dental/Vision Insurance,<br />
Short-Term Disability and Voluntary Life Insurance.<br />
Step 1: Go to the following link to create an account as an employee:<br />
https://employeenavigator.com/benefits/Account/Login<br />
Step 2: Enter your Username and Password and click Login. You will<br />
then be prompted to review your current elections and may any changes<br />
for the elections effective 1/1/<strong>2022</strong>.<br />
●<br />
●<br />
If you do not have a username, click “Register as a new user”. You will<br />
be asked to enter your First Name, Last Name, Company Identifier of<br />
ALLEN ENGINEERING, PIN (last 4 of SSN) and Birth Date.<br />
If you have previously logged in but do not remember your password,<br />
click “Reset a forgotten password”. You will be prompted to enter your<br />
username and birth year to reset your password.<br />
IMPORTANT! If you do not log in and request any changes<br />
for the new plan year, your current elections WILL<br />
automatically renew with the exception of the Flexible<br />
Spending Account (FSA) as this benefit must be re-elected<br />
each year. Please review the new plan year information<br />
closely. After you have completed your enrollment, be sure<br />
to click the Agree button on your Enrollment Summary<br />
page.<br />
REMEMBER: Open Enrollment must be completed by the deadline or<br />
you may not be able to enroll yourself and/or your eligible dependents until our<br />
next open enrollment, or a qualifying event occurs.<br />
This summary of benefits is not intended to be a complete description of the terms of Allen Engineering Corporation’s insurance benefit plans. Please<br />
refer to the plan document(s) for a complete description. Each plan is governed in all respects by the terms of its legal plan document, rather than by<br />
this or any other summary of the insurance benefits provided by the plan. In the event of any conflict between a summary of the plan and the official<br />
document, the official document will prevail. Although Allen Engineering Corporation maintains its benefit plans on an ongoing basis, Allen<br />
Engineering Corporation reserves the right to terminate or amend each plan, in its entirety or in any part at any time.<br />
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IMPORTANT CONTACTS<br />
BENEFIT CARRIER PHONE WEBSITE<br />
Medical Insurance Arkansas BCBS 800-229-4124 www.arkansasbluecross.com<br />
Health Savings Account<br />
Flexible Spending Account<br />
Consolidated Admin<br />
Services<br />
Consolidated Admin<br />
Services<br />
877-941-5956 www.consolidatedadmin.com<br />
877-941-5956 www.consolidatedadmin.com<br />
Dental Insurance Arkansas BCBS 888-223-4999 www.arkansasbluecross.com<br />
Vision Insurance Arkansas BCBS 800-877-7195 www.arkansasbluecross.com/findcare<br />
Voluntary Life and AD&D<br />
Insurance<br />
Voluntary Short-Term<br />
Disability Insurance<br />
USAble Life 800-370-5856 www.usablelife.com<br />
USAble Life 800-370-5856 www.usablelife.com<br />
Allen Engineering Corporation<br />
<strong>Benefits</strong> Manager<br />
Suzi Hall<br />
870-236-7751<br />
x151<br />
shall@alleneng.com<br />
Allen Engineering Corporation<br />
Office Manager<br />
Jennifer<br />
Barrington<br />
870-236-7751<br />
x129<br />
jbarrington@alleneng.com<br />
YOUR BXS INSURANCE ACCOUNT REPRESENTATIVES:<br />
Ashley Bray<br />
870-974-7424<br />
Ashley.Bray@bxsi.com<br />
DiAlma Young<br />
870-974-7440<br />
DiAlma.Young@bxsi.com<br />
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Allen Engineering Corporation<br />
Phone: 870.236.7751<br />
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