Peace Medical Center2014 Employee Benefits

Welcome• The details of various 2014 Benefit Plans offered, are

detailed below to assist you to select the plans that are appropriate for you and your family.

• The effective date of the Health Plan is December 1,2013 and for all other plans it is January 1,2014.

• Please contact the Purnima at 864-335-2488/ purnima.mainkar@peacemedicalcenter.com

to add, remove or make changes to your benefits.

Benefits Summary

•Health Insurance 1. BCBS PPO – Premier Saver Plan 2. BCBS HDHP – HSA Plan•Life /AD & D - BCBS•Dental Insurance – Delta Dental•Vision insurance - Alwayscare•AFLAC -Short Term Disability Insurance/Life Insurance

Blue Cross Blue ShieldPPO / Premium Saver Plan

Benefit

BCBS of South Carolina PPO / Premium Saver

PlanDeductible with BCBS /

Calendar YearEE $7,500Family

$15,000

Lifestyle Deductible With Premium Saver Plan

EE $2,000,

Family $4,000Covera

ge Premium Monthly Per Pay COBRACoinsurance 70% Single $ 598.23 $248.23 $114.57 $ 607.74

Office Visit $20 Co-pay EE + SP $ 1183.74 $833.74 $384.80

$ 1204.97

Specialist $40 Co-pay EE + CH $983.80 $ 633.80 $292.52 $ 1001.03

Vision No Coverage Family $ 1566.90 $1216.90 $561.65 $1595.79Preventive 100%

Urgent Care $40 Co-pay NOTE The monthly premium includes

Prescription Drugs $8, $30, $60 $2.4 towards Life / AD & D coverage

Emergency RoomDeductible,

Then 100%

Out of Pocket MaximumEE $1,500,

Family $3,000

Explanation of Medical Benefits Including Premium Saver

• Premium Saver is a secondary insurance to the medical PPO.• Employees will receive a separate ID card from Premium Saver that will

need to be presented at the time of service.• The Premium Saver Plan lowers the BCBS deductible from $7,500

Individual and $15,000 Family to $2,000/4,000 and OOP of $1,500/$3,000. Total OOP for an Individual is $3,500.

• There are no limitations on inpatient or outpatient expenses.• Claims are not automatically transferred from BCBS to Premium Saver so

both cards need to be presented at time of service for Inpatient and Outpatient treatment.

Blue Cross Blue Shield HSA Plan

BenefitBCBS of South Carolina , HSA

PLANDeductible with BCBS /

Calendar YearEE $1,500 Family

$3,000Lifestyle Deductible With

Premium Saver Plan N/A

Coinsurance 100% Coverage HDHP Monthly Per Pay COBRA

Office Visit Deductible, Then 100% Single $ 614.34 $ 264.34 $ 122.00 $ 624.18

Specialist Deductible, Then 100% EE + SP

$ 1205.71 $ 855.71 $ 394.94 $ 1227.38

Vision N/A EE + CH $999.91 $ 649.91 $ 299.95 $ 1017.46

Preventive 100% Family$

1591.27 $ 1241.27 $ 572.89 $ 1620.65

Urgent Care Deductible, Then 100%

Prescription Drugs Deductible, Then 100% NOTE

The monthly premium includes

Emergency Room Deductible, Then 100% $2.4 towards Life / AD & D coverage

Out of Pocket Maximum $0

Explanation of HSA

• Employees that elect the HSA option can set up a separate bank account.• All contributions into the HSA account are 100% tax deductible. • Money that is spent on qualified medical expenses comes out of the

account tax free.• Single employees can contribute up to $3300 in 2014 to the account and

Employees with dependent coverage can contribute up to $6,550 in 2014.• HSA catch-up contributions is $1000.00 for account holder age 55 or

older.• All unused money remains in the account and rolls to the next year. • At age 65 employees can take the money out for non-medical expenses

and the account is taxed just like an IRA.

Life/ AD & D InsuranceBCBS Plan

• $20, 000 Benefit• Basic Life / AD & D• Required for BCBS Health • (Included in rates on those slides)• All Eligible F/T employees may be covered if they do not waive coverage.

Coverage Level

Monthly Rate

Bi Weekly Rate

Employee $2.40 $1.11

Dental Benefits

Benefit Delta Dental PPO

  www.deltadentalsc.com Deductible $50 Individual / $150 Family Waived for Preventive

Preventive Services 100%

Basic Services 80%

Major Services 50%

Annual Maximum $1,000

Orthodontics Not Covered

This Coverage is Voluntary and sponsored by the employee Employee Cost Per Pay Period

Customer Service : 800-335-8266 Delta Dental   

Employee 12.46

Emp/Spouse 24.79

Emp/Children 24.60

Family 39.53

AlwaysCareVision Insurance

Vision – Always Care Plan A• Co Pays: In Network Out Of Network• Exam $10 Up to $35• Materials $10

• Std Plastic Lenses : • Single Vision Co Pay Up to $25 • Bifocal Co Pay Up to $40 • Trifocal Co Pay Up to $50 • Lenticular $ 80 Allowance Up to $50 • Progressive $ 70 Allowance Up to $ 40

• Frames• At Provider $120 Allowance Up to $50• WM, Sams, Costco $ 94 Allowance Up to $50

• Contact Lenses :• Elective Up to $120 Up to $100• Medical Nec. Up to $210 Up to $210

Coverage LevelMonthly Rate Bi Weekly Rate

Employee $7.38 $3.41 Employee + Spouse $14.74 $6.80 Employee + Children $15.60 $7.20 Employee + Family $24.50 $11.31

Life and AD&D

• You are provided with a flat $20,000 Term Life insurance coverage.• The Life can be purchased as a stand alone benefit. Payable by the

employee per pay period deduction.• The life Benefit is automatically added if an employee elects any tier of

Medical Coverage with BCBS

• Coverage Level Monthly Rate Bi weekly Rate Employee $ 2.40 $1.11

401K -2014 Maximum Allowable Contributions

• The maximum amounts individuals are permitted to contribute to their retirement plans for the year 2014 are as under:

• Annual employee contribution limit for 401(k) - $17,500.

• Annual catch-up contribution limit for 401(k), if employee is age 50 or over - $5,500

• Please advise the HR if you want to make changes to your 401(k)

contributions.

Contact Information

• Gibson & Associates is ready to assist you in any way possible. For any questions regarding any part of your Health plan or benefits please call 1-800-733-3391

• You may also submit your inquiry at www.gibsoninsurance.net

• Peace Medical Center service representatives will be Jennifer Nelson and Allison Hunt

• Aflac contact – Michele Jain – 864-551-0802