scott mcrae group employee benefits guide
DESCRIPTION
January 1, 2015 - December 31, 2015TRANSCRIPT
2015 Employee Benefits Guide
Coverage Effective January 1, 2015 - December 31, 2015
Scott-McRae —2
NOTE: If you are covered by Medicare or will become eligible for Medicare in the next
12 months, federal law gives you more choices about your prescription drug coverage.
Please see page 19-20 for more details.
Summary of Benefits and Coverage (SBC)
As an employee, the health benefits available to you represent a significant component of your compensation
package. They also provide important protection for you and your family in the case of illness or injury.
Your plan offers a series of health coverage options. Choosing a health coverage option is an important decision.
To help you make an informed choice, your plan makes available a Summary of Benefits and Coverage (SBC)
which summarizes important information about any health coverage option in a standard format, to help you
compare across options.
The SBC will be available on the Scott-McRae Employee Benefits website located at
www.employeebenefitswebsite.com/scottmcrae. A paper copy will also be available, free of charge, by
contacting your local HR Representative.
Scott-McRae —3
Enrollment Highlights 3
Online Enrollment Process 4
General Information 5
Wellness Initiative 6
Wellness Initiative 7
Medical Plan Highlights 8
Medical Plan Contributions 9
HRA—How does it work? 10
Dental Benefits 11-13
Basic Life A&D & Voluntary Life AD&D 14-16
Voluntary Short & Long Term Disability 17
Flexible Spending Accounts 18
Additional Benefits 19
Medicare Notice 20-21
Legal Updates 22-24
Contact Information 25
Leaving the Company 26
Enrollment Highlights Welcome to Scott-McRae Automotive Group!
This benefit guide contains an overview of the valuable benefits package available to you through Scott-
McRae Automotive Group. You will find helpful information herein to assist you in understanding all
benefits offered. Please read your materials carefully to choose the plans that best meet the needs of you
and your family.
As you prepare to enroll for benefits or make changes to your coverage, consider the needs of you and
your family throughout the entire year. Think about the types and level of coverage and associated costs
of each. Keep this guide as a reference to use throughout the year. If you have any questions, contact
Human Resources or the plan provider directly.
Table of Contents Important Information for the 2015
Benefit Plan Year
Annual enrollment will be November 3 through November
11, 2014 for the 2015 plan year.
All employees are required to enroll for benefits online. You
must visit https://ew32.ultipro.com/default.aspx See Page
4 for step-by-step instructions on how to log in and enroll
online.
United Healthcare will continue to be our Medical and
Dental provider.
Cigna will now be our Short and Long Term Disability plan
provider.
Cigna will continue to be our Basic Life and Voluntary Life
plan provider in 2015.
U.S. Legal will now be our Group Legal plan provider.
Infinisource will continue to be our Flexible Spending
Account vendor.
Life Lock will continue to be our voluntary Identity Theft
Protection partner in 2015.
Continued for the 2015 plan year - Non-tobacco/Nicotine
users will receive a discount on Medical insurance
premiums.
Continued for the 2015 plan year - Wellness initiatives
must be complete to get HRA funds!
The information contained in this summary should in no way be construed as a promise or guarantee of employment or benefits. The company
reserves the right to modify, amend, suspend, or terminate any plan at any time for any reason. If there is a conflict between the information in
this brochure and the actual plan documents or policies, the documents or policies will always govern. Complete details about the benefits can be
obtained by reviewing current plan descriptions, contracts, certificates, policies and plan documents available from Human Resources.
Scott-McRae —4
Online Enrollment Process Making Annual Enrollment Elections
Annual enrollment is the time each year to make changes to your benefits. You may make changes online at https://ew32.ultipro.com/
default.aspx as well as add or drop coverage provided your dependent(s) meet all eligibility requirements. Any changes made during annual enrollment must remain until the following annual enrollment period, unless you experience a qualifying life event.
Please follow the step-by-step instructions listed below when making your 2015 benefit elections.
First, log in to Ultipro - https://ew32.ultipro.com/default.aspx using your regular User Name beginning with SCTMA+EE # and then your Password. To begin Annual Enrollment, hover over the blue tab (Myself) on the top Menu bar, then click “Open Enrollment”:
To proceed through your enrollment, use the blue “next” arrow to move to the next page. If you need to go back, click the blue
back arrow: Read the Welcome Message for additional instructions and the information you will need to have prior to selecting your 2015 Benefits. 1. On the “Verify Beneficiaries and Dependents” page, you can add or edit emergency contacts, beneficiaries for voluntary life
insurance and any dependents that will be on your medical or dental plans.
a. Click the green plus button to add: b. If you have a dependent in the system already, you can click their name and then use the edit button to make changes. c. Fill in all required information (indicated by a red dot) and save. d. If you plan to enroll the dependent in medical or dental coverage, remember to check the box next to “Dependent” and save.
2. Once all of your dependents are listed, click the blue Next to get to the next page. 3. For each page you can elect the benefit if you would like to enroll, or re-elect your current coverage. Simply select the plan (and
tier if applicable). If you would like to decline the plan, put a check in the decline box. Additional information and rate charts about each benefit plan are in the area to the right of the blue “Options” heading. Then click next.
4. Once you have made decisions for all your plans, you will get to a “Confirm Your Changes” screen. Review your information carefully to be sure that all of your elections are correct. If a blue box appears, you have not made an election or declined for a specific benefit plan and need to go back to the plans listed.
a. If you would like to make a change, click the back button or scroll down to and click the “New Benefits” plan name
in the steps box on the left hand side.
b. If you are happy with your elections, click the “Submit” button at the top of the page. This will save your elections for the new year.
Scott-McRae —5
Benefit Plan Eligibility:
You and your dependents become eligible for Scott-McRae Automotive Group’s plan of benefits on the first of the month following 60 days of c o n t i n u o u s employment. You must work an average of 30 hours per week to be eligible for these benefits. After you become eligible for benefits, you will have an opportunity to change your benefits once each year during Annual Enrollment. The elections you make during this enrollment will be in effect until the start of our next plan year.
Your dependents include: Your Legal Spouse Dependent Children
Naturally born to you, adopted by you, under your foster care, under your legal guardianship Up to age 26 - Medical/Dental Up to age 27-30 - Medical
- Unmarried and has no dependents of his or her own/a resident of Florida or a student/ does not have coverage as a named subscriber under any other group or individual health insurance policy.
Annual Enrollment: Each year during Annual Enrollment you will have an opportunity to make new benefit elections for the coming year.
All eligible employees who wish to enroll in benefits, drop benefits or make any benefit changes must do so by logging in to the UltiPro system.
You pay for your medical and/or dental premiums on a pre-tax basis through an IRS Section 125 Plan; therefore, mid-year coverage changes are limited as described below.
General Information
When Can I Make Changes? You may only make changes to your benefit elections during the year if you have a Family Status Change. Family Status Changes are also called Qualifying Events and are defined by the Internal Revenue Service (IRS). If you have a Family Status Change, you have 30 days in which to provide documentation and initiate your change in your Benefit Elections. Failure to initiate the change in UltiPro within 30 days will result in your loss of the ability to make changes to your Benefit Elections, therefore you must wait until the next Annual Enrollment.
Family Status Change Reasons (IRS defined) Marriage or Divorce; Birth or Adoption of a Child; Death of a Spouse or Child; Change in Spouse’s employment or health insurance that
affects your family benefits; Change in residence or worksite if it affects the health
coverage; Change in spouse’s coverage/enrollment. NOTE: If a newborn is not added to your medical plan within
31 days of the birth, this child will not be a covered
dependent on your Health Insurance.
Scott-McRae —6
2015 Wellness—Rewards Driven
The rewards program is for employees on the medical plan beginning January 1, 2015. All employees on the
medical plan who participate in the Health Screenings have an opportunity to receive a deposit into your Health
Reimbursement Account (HRA) toward medical expenses. Employees with single coverage can earn maximum
rewards of $500; Employees with family coverage can earn maximum rewards of $1,000.
EARN 50%
HRA Deposit
Three ways to earn the remaining 50%
On Cruise Control
SCREENING RESULTS
(low/moderate risk)
All of your results of the following
tests are within the low/moderate
range below:
BMI less than 30
Blood Pressure less than 140
over less than 90
Blood Glucose less than 125
EARN ADDITIONAL 50%
HRA Deposit
Flat Tire
Change it Yourself
SCREENING RESULTS
(high/very high risk)
One or more of your results of the
following tests are within the high/
very high range below:
BMI 30 or greater
Blood Pressure 140 or greater
over 90 or greater
Blood Glucose greater than
125
1. Make dietary and physical activi-
ty modifications, or see your doctor
for help.
2. Re-test in December 2014 and
improve high/very high results to
moderate / low risk range shown
below:
BMI less than 30
Blood Pressure less than 140
over less than 90
Flat Tire -
Call for Assistance
SCREENING RESULTS
(high/very high risk) One or more of your results of the
following tests are within the high/very
high range below:
BMI 30 or greater
Blood Pressure 140 or greater over
90 or greater
Blood Glucose greater than 125
1. Complete 6-session
Workshop
with an eHealthScreen Nurse
GUARANTEED ADDITIONAL 25%
HRA DEPOSIT
2. Re-test in December 2014 and
improve one of your high/very
high results:
BMI - improve by 1 point
Blood Pressure - improve by 1
risk range
Blood Glucose - improve by 1
risk range
EARN REMAINING
25% HRA DEPOSIT
EARN ADDITIONAL 50%
HRA Deposit
COMPLETE SCREENING ONLY
Blood Pressure, Height/Weight, Blood Draw,
On-Line Health Assessment
Scott-McRae —7
2015 Wellness—Rewards Driven
Tobacco/Nicotine Surcharge
Tobacco/Nicotine use remains the single largest preventable cause of disease and premature death in the US.
Using tobacco/nicotine also contributes to chronic and serious diseases, which results in increased
healthcare costs.
Again in 2015 Tobacco/Nicotine users will have a $46.15 per bi-weekly pay period surcharge added to
their Medical plan premiums.
You should print the 2015 non-tobacco/nicotine affidavit form on the Ulti Pro site and that must be signed
and returned to HR no later than November 11, 2014. You must be a non-tobacco/nicotine user to receive
the Non-tobacco Rate. This affidavit remains in effect for the remainder of the year and a new affidavit
will be signed during each Annual Enrollment thereafter. Please review the rate tables on page 8 of the
benefit guide to see the appropriate premiums.
After conclusion of the 2015 Annual Enrollment period, Scott-McRae will test all employees who certify
themselves as non-tobacco/nicotine users on the affidavit form. Testing will be conducted on-site at
several locations in mid-December. For remote employees, test request forms will be provided and test
results must be received by the HR Department by December 12, 2014. Failure to submit final tobacco/
nicotine test results will automatically default you to a tobacco medical rate.
For purposes of this policy, “smoking” means inhaling, exhaling, burning, carrying or possessing any
lighted tobacco/nicotine product, including cigarettes, cigars, pipe tobacco, and any other lit tobacco/
nicotine products.
For purposes of this policy, “tobacco/nicotine use” means the personal use of any tobacco/nicotine
product, whether intended to be lit or not, which shall include smoking, as defined above, as well as the
use of an electronic cigarette or any other device intended to simulate smoking and the use of smokeless
tobacco, including snuff; chewing tobacco; smokeless pouches; any other form of loose-leaf, smokeless
tobacco; and the use of unlit cigarettes, cigars, and pipe tobacco.
Your health plan is committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all employees. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact the Human Resources Department and we will work with you to find a wellness program with the same reward that is right for you in light of your health status.
Scott-McRae —8
Medical Plan Highlights Administered by UnitedHealthcare - 866-633-2446 | www.myuhc.com
Our health insurance plan includes a HRA (Health Reimbursement Account) component. An HRA allows you to obtain
greater value for your healthcare dollars through choice and personal accountability. Employees who elect the Medical
plan will be eligible to receive HRA funds by completing the SMAG wellness initiatives by December 12, 2014. After
completion of the SMAG wellness initiatives, Scott-McRae will add funds to your HRA account to be used for medical
expenses throughout the year.
Effective January 1, 2015, funds left over in your HRA account may roll over to the 2015 plan year.
Employees who elect the medical plan are encouraged to utilize the network providers to receive a higher level
of benefit.
Benefits In-Network Out-of-Network
Office Visits Deductible, then 25% Deductible, then 50%
Deductible - Calendar Year* (Individual/Family)
$3,000 / $6,000
$6,000 / $12,000
Co-insurance Out-of-Pocket Maximum (Individual/Family)
$2,000 / $4,000 $4,000 / $8,000
Total Out-of-Pocket Maximum** (Individual/Family)
$5,000 / $10,000 (Includes Deductible)
$10,000 / $20,000 (Includes Deductible)
Preventive Care – Unlimited Maximum per Calendar Year Examples: Well Baby Care, Well Child Care through Age 15, Immunizations, Vaccinations. Routine Preventive Care—Gynecological care, Physical Exams, Mammograms, PSA, etc.
Covered @ 100% (Deductible Waived)
Not Applicable, Applies to In-Network
Coverage Only
Inpatient Hospital Deductible, then 25% Deductible, then 50%
Outpatient Surgery Deductible, then 25% Deductible, then 50%
Emergency Room Deductible, then 25% Deductible, then 25%
(If True Emergency); Otherwise Deductible, then 50%
Prescription Drugs $10 Generic
$30 Preferred Brand $70 Non-Preferred Brand
$10 Generic $30 Preferred Brand
$70 Non-Preferred Brand
Percentage 75/25% 50/50%
*All individual deductible amounts will count toward the family deductible, but an individual will not have to pay more than the individual amount. **All individual out-of-pocket maximum amounts will count toward the family out-of-pocket maximum, but an individual will not have to pay more than the individual out-of-pocket maximum amount.
Scott-McRae HRA Contributions (after completion of the SMAG wellness initiatives)
Employee Only - $500
Employee + Spouse - $1,000
Employee + Child(ren) - $1,000
Employee + Family - $1,000
Scott-McRae —9
Medical Plan Contributions
Employee Contributions – Medical:
Scott-McRae contributes a large percentage towards your medical cost. The following illustrates your employee
contributions for the 2015 plan year.
COVERAGE TIER TOBACCO
BI-WEEKLY
TOBACCO
WEEKLY
NON-TOBACCO
BI-WEEKLY
NON-TOBACCO
WEEKLY
Employee Only $102.95 $51.48 $56.80 $28.40
Employee + Spouse $275.26 $137.63 $229.10 $114.55
Employee + Child(ren) $250.68 $125.34 $204.53 $102.26
Employee + Family $387.49 $193.74 $341.34 $170.67
There is NO increase to medical insurance premiums for the
2015 plan year!
Scott-McRae —10
HRA—How does it work?
This diagram assumes employee has completed the wellness
initiatives to receive the $500 in their Health Reimbursement
Account (HRA).
Scott-McRae —11
Dental Benefits (PPO Option)
About Your Benefits:
Dental expenses may be one of the most predictable expenses you have. Before you elect dental coverage, you may want to consider the following questions:
♦ What dental expenses do I know that my family or I will have each year?
♦ Do I, or does my spouse have coverage elsewhere?
Eligible employees have the opportunity to participate in the Scott-McRae Automotive Group Dental Plan. Florida employees have the option of choosing from two Dental Plans allowing you to select the one that best meets your current needs. The chart shown below provides a highlight of the PPO dental plan option.
Employee Contributions — Dental:
The following illustrates your employee contributions for the
2015 plan year.
COVERAGE TIER BI-WEEKLY WEEKLY
Employee Only $15.43 $7.72
Employee + 1 $34.98 $17.49
Employee + 2 or more dependents $45.22 $22.61
Administered by UnitedHealthcare - 877-816-3596 | www.myuhcdental.com
*$50/$150 deductible on all Basic and Major services only.
If you previously waived coverage during your initial eligibility period and elect to join the plan during annual enrollment, please refer to the guidelines and exclusions listed in the plan summary for limitations that may apply.
The Reimbursement Plan provides the following benefits:
Option #1 (Available to Florida and Non-Florida Employees)
Plan Benefits In-Network Out-of-Network
Benefit Year Deductible*
(Individual / Family) $50 / $150
Benefit Year Maximum $1,500 per person
Preventive Care 100% 100%
Basic 70% 50%
Major 50% 50%
Scott-McRae —12
Dental Benefits (DHMO Option)
Employee Contributions — Dental:
The following illustrates your employee contributions for the 2015
DHMO Dental Plan year.
COVERAGE TIER BI-WEEKLY WEEKLY
Employee Only $6.58 $3.29
Employee + 1 $11.49 $5.74
Employee + 2 or more dependents $17.06 $8.53
Administered by UnitedHealthcare - 877-816-3596 | www.myuhcdental.com
This dental insurance plan provides pre-paid dental benefits. The plan provides comprehensive coverage at a
small out-of-pocket cost when you receive services from contracted plan providers. You may visit
www.myuhcdental.com to find a provider nearest you.
Benefits include:
♦ Office co-payment of $5
♦ No charge for oral exams, semi-annual cleanings, x-rays
♦ Pre-determined copayments for other services
♦ No deductibles
♦ No claim forms
♦ No annual dollar maximum
♦ Orthodontic coverage
♦ No need to select a dentist
Reminder: This DHMO plan is for Florida Residents Only!
Option #2 (Available to Florida Employees Only)
Scott-McRae —13
Dental Benefits (DHMO cont.) Administered by UnitedHealthcare - 877-816-3596 | www.myuhcdental.com
Benefit Schedule Amount Patient Pays
Office Visit Fee (Per Patient, Per Visit) $5
1110 Routine Cleaning No Charge
0330 X-Ray/Panoramic Film No Charge
0274 Bitewings - Four Films No Charge
4210 Gingivectomy - Per Quadrant $175
7240 Surgical Tooth Extraction (Impacted) $80
2140 Restorative Filing (Silver/1 Surface) No charge
2160 Restorative Filing (Silver/3 Surfaces) No charge
2330 Anterior One Surface $30
7230 Partial Bony Impaction $65
5110 Prosthodontics - Complete Upper $325
3330 Root Canal – Molar $245
2750 Crown - Porcelain Fused to Metal $245
5211 Partial Dentures (Upper or Lower/1 Clasp) $400
Orthodontics - Routine 24 Mo. Banded
D8070 – Comprehensive Orthodontic Treatment $2,200
D8040 – Limited Orthodontic Treatment $1,350
Soltice S700/D0035—Dental Schedule
This list is not all inclusive. Please refer to your plan summary for a complete benefit schedule.
Scott-McRae —14
Basic Life and AD&D Benefits
About Your Benefits:
As a part of your benefits package as an active, full-time employee working an average of 30 hours per week, Scott-
McRae provides you with a Basic Life and Accidental Death and Dismemberment (AD&D) Insurance benefit, at no
cost to you.
Scott-McRae provides you with group Basic Life and AD&D insurance in the amount of $15,000.
This benefit is provided to you by Scott-McRae.
At age 65, the benefit will be reduced to the percentage shown below:
Administered by Cigna - 800-238-2125 | www.cigna.com
See plan summary for full reduction schedule.
It’s important to review your beneficiary information during annual enrollment so that you are sure
your listed beneficiary is the designated individual you wish to receive any Life AD&D and/or
Voluntary Life AD&D benefits that would be paid out if you passed away.
Complete the Beneficiary table below prior to making your benefit elections in Ulti-Pro. (for personal use only)
Name Social Security # Relationship
Percentage
(must equal 100%)*
Primary:
Contingent:**
*All Primary Beneficiary percentages must add to 100% and all Contingent Beneficiary Percentages must add to 100%. **Contingent Beneficiaries are only considered if all Primary Beneficiaries are deceased at the time of your death.
Age Based Reductions
65% of the Life Insurance Benefit at age 65
40% of the Life Insurance Benefit at age 70
25% of the Life Insurance Benefit at age 75
Scott-McRae —15
Voluntary Life Insurance:
With Voluntary Life Insurance, your family will be protected with benefits and a variety of support services designed to help
them cope with emotional and financial issues. It can help you preserve your dream of a secure lifestyle for your family, even
if you can’t be there.
In addition to Basic Life and AD&D provided by Scott-McRae, eligible employees have the opportunity to purchase additional
Life and AD&D insurance.
Coverage Available:
For You:
Apply for Voluntary Life and AD&D coverage in amounts of $25,000, $50,000, $100,000, $150,000, $200,000 and
$250,000.
For new hires and those employees within their eligibility waiting period, the Guarantee Issue amount, which means the
amount you can be issued without submitting Evidence of Insurability (EOI), is $250,000.
If you have previously waived coverage, EOI will be required.
Starting at age 65 Voluntary Life coverage for employees will be reduced to the percentage shown below:
For Your Spouse:
Your spouse may apply for Voluntary Life and AD&D coverage in amounts of $10,000, $25,000 or $50,000.
Employee coverage is required for spouse to elect coverage.
Your spouse may elect up to 100% of the employee’s election, not to exceed the maximum of $50,000.
Spouse coverage ends at age 70.
The spouse is charged based upon his/her individual age (see rate table on page 15).
The Guarantee Issue amount, which means the amount you can be issued without submitting Evidence of Insurability
(EOI), when initially eligible, is $50,000.
If you have previously waived coverage, EOI will be
required.
For Your Child(ren):
Elect Life insurance for your unmarried child(ren)
Birth to 6 months: $500
6 months to 19 years (or age 26 if full-time student and primarily
supported by the Employee): $10,000.
All Child Life insurance is Guarantee Issue.
Child(ren) benefit must not exceed 100% of the employee’s coverage. This is a summary of benefits only. A complete description of benefits and limitations will be provided in the certificate of coverage.
Voluntary Life and AD&D Benefits Administered by Cigna - 800-238-2125 | www.cigna.com
Current participants enrolled in
the Voluntary Life plan will
continue with current amounts
of coverage.
You may also choose to join the
plan for the first time with no
medical questions asked up to
the guarantee issue amounts
listed.
Age Based Reductions
65% of the Life Insurance Benefit at age 65
40% of the Life Insurance Benefit at age 70
25% of the Life Insurance Benefit at age 75
Note: Benefit reductions will be effective on the policy anniversary date coinciding with or next following the employee’s attainment of age specified in the schedule.
Scott-McRae —16
Voluntary Life and AD&D Rate Table
Cigna Voluntary Life and AD&D Rates for 2015
Note: Spouse rates are based on the spouse’s date of birth. A change in rates due to a change in the Spouse’s age
will become effective on the Policy Anniversary coinciding with or following the Spouse’s birthday.
Child coverage rate: $0.69 bi-weekly or $1.50 monthly.
25,000$ 50,000$ 100,000$ $150,000 200,000$ 250,000$ 10,000$ 25,000$ 50,000$
Under 25 1.04$ 2.08$ 4.15$ 6.23$ 8.31$ 10.38$ 0.42$ 1.04$ 2.08$
25 - 29 1.04$ 2.08$ 4.15$ 6.23$ 8.31$ 10.38$ 0.42$ 1.04$ 2.08$
30 - 34 1.15$ 2.31$ 4.62$ 6.92$ 9.23$ 11.54$ 0.46$ 1.15$ 2.31$
35 - 39 1.38$ 2.77$ 5.54$ 8.31$ 11.08$ 13.85$ 0.55$ 1.38$ 2.77$
40 - 44 2.08$ 4.15$ 8.31$ 12.46$ 16.62$ 20.77$ 0.83$ 2.08$ 4.15$
45 - 49 3.35$ 6.69$ 13.38$ 20.08$ 26.77$ 33.46$ 1.34$ 3.35$ 6.69$
50 - 54 5.42$ 10.85$ 21.69$ 32.54$ 43.38$ 54.23$ 2.17$ 5.42$ 10.85$
55 - 59 8.31$ 16.62$ 33.23$ 49.85$ 66.46$ 83.08$ 3.32$ 8.31$ 16.62$
60 - 64 12.69$ 25.38$ 50.77$ 76.15$ 101.54$ 126.92$ 5.08$ 12.69$ 25.38$
65 - 69 14.78$ 29.55$ 59.10$ 88.65$ 118.20$ 147.75$ 9.09$ 22.73$ 45.46$
70 - 74 14.68$ 29.35$ N/A N/A N/A N/A N/A N/A N/A
75 - 79 9.17$ 18.35$ N/A N/A N/A N/A N/A N/A N/A
AGEEmployee
Employee Bi-Weekly Premium
For Employees 75-79 Years Old
Benefit is 25% of Original Face Amount (75% Reduction)
Spouse
For Employees 65-69 Years Old
Benefit is 65% of Original Face Amount (35% Reduction)
For Employees 70-74 Years Old
Benefit is 40% of Original Face Amount (60% Reduction)
Scott-McRae —17
What is “Disability”?
“Disabled” or “disability” means that, due to sickness, pregnancy or accidental injury, the employee is receiving appropriate care and treatment from a doctor on a continuing basis and is unable to earn more than 80% of his/her pre-disability earnings at his/her own occupation for an employer in his/her local economy.
“Own occupation” means the activity that the employee regularly performs and that serves as the employee’s source of income. It is not limited to the specific position that the employee held with the employer. It may be a similar activity that could be performed with the employer or any other employer.
Voluntary Short Term Disability Benefits (VSTD):
All active full-time employees are eligible to participate in the voluntary STD plan. The Group STD plan replaces 60% of your weekly income to a cap of $1,846 per week for up to 13 weeks if you are deemed to be disabled. Benefits are subject to a 8 day elimination period for injury and a 8 day elimination period for sickness.
Voluntary Long Term Disability Benefits (VLTD):
All active full-time employees are eligible to participate in the voluntary LTD plan. The Group LTD plan replaces 60% of your gross monthly earnings, less income you may receive from other sources (such as Social Security, Workers’ Compensation, etc.), up to a maximum monthly benefit of $8,000.
When do benefits begin and how long do they continue?
Benefits begin following a 90-day elimination period and continue as long as you are disabled, up to Social Security Normal Retirement Age. Throughout your disability you must be receiving appropriate care and treatment from a physician on a continuing basis.
Pre-Existing Conditions:
The STD and LTD plans do have limitations. The plans do not cover pre-existing conditions, unless your disability begins after you have been covered under the plan for 12 months. A pre-existing condition is an injury, sickness, or pregnancy for which you in the 6 months before your effective date; received medical treatment, consultation, care, or services; took prescription medications or had medication prescribed; or had symptoms or conditions which would cause a reasonably prudent person to seek diagnosis, care, or treatment.
These “Plan Highlights” provides a brief overview of the STD and LTD plans. A complete description of the benefit provisions, conditions, limitations, and exclusions will be included in the Certificate Booklet.
Voluntary STD and LTD Benefits Administered by Cigna - 800-238-2125 | www.cigna.com
Current participants enrolled in the STD & LTD benefit will have their benefits continue.
Employees not enrolled on the STD or LTD plans can join the plans during this annual
enrollment with no medical questions ask!
Scott-McRae —18
Flexible Spending Accounts Administered by Infinisource - 866-370-3040 | www.infinisource.com
Flexible Spending Accounts are a way of making pre-tax payroll deductions for either dependent care or non-reimbursable health
expenses. These Flexible Spending Accounts (FSAs) allow you to increase your spendable income! You do not pay taxes, nor
do you pay Social Security on the FSA payroll deduction.
Health Care Flexible Spending Accounts:
You can receive tax-free reimbursement from your Health Care Flexible Spending Account (FSA) for eligible medical and dental
expenses incurred by you or an eligible dependent if the expenses are not covered by other plans. The maximum amount that you
may contribute during the 2015 Benefit Plan Year (January—December) to the Health Care FSA is $2,500. You can use the account
to receive reimbursement for healthcare related expenses such as:
Deductibles and co-pays; cost of eligible services above the reasonable and customary limits or above other plan limits;
transportation costs to receive care; other health-related expenses not paid by other plans that are eligible for tax deduction by
the I.R.C. Section 213.
Each year you MUST make new choices in the Flexible Spending Account. You have the opportunity to enroll in the Health
Care and the Dependent Care FSA on-line at https://ew32.ultipro.com/default.aspx Infinisource will be administering the FSA for the
2015 plan year.
For more information, visit www.irs.gov and download Publication 502 which contains updated information on FSAs.
Dependent Care Flexible Spending Accounts:
You can receive tax-free reimbursement from your Dependent Care Flexible Spending Account (FSA) for expenses incurred by you
for the care of an eligible dependent or related household expenses. You must be gainfully employed in order to be eligible to claim
dependent care expenses. The maximum amount that you can contribute during the Benefit Plan Year (January—December) to the
Dependent Care FSA is $5,000. If you are married and file a separate Federal Income Tax Return, the maximum amount that you
can contribute during the Benefit Plan Year is $2,500. Eligible dependents qualifying for dependent care FSA include:
A dependent under age 13 for whom you are entitled to a deduction for income taxes;
A dependent who is physically or mentally incapable of self care for whom you are entitled to a deduction for income taxes;
Dependent means any individual considered your dependent within the meaning of Section 152 of the I.R.C.
Debit Cards:
All employees that enroll into the Flexible Spending Accounts will receive a Debit Card to pay for their Health Care FSA-eligible
expenses at the point of sale. Vendors that choose to accept the debit card as payment will disallow transactions at point of sale if
the participant attempts to pay for items that are not eligible under FSA. In addition, employees are required to provide
itemized receipts for all expenses charged to the Debit Card upon request.
Carryover Provision:
Scott-McRae will allow employees to carryover up to $500 of their unused Health
Care FSA balance at the end of the year into the 2015 plan year. This carryover
provision will continue in future plan years should you choose to participate in the
Health Care FSA. The carryover of up to $500 may be used to pay or reimburse
medical expenses under the Health Care FSA which are incurred during the plan year
to which it is carried over.
Scott-McRae —19
Additional Benefits U.S. Legal Services - 800-356-5297
Empower yourself and the people close to you today by taking advantage of the opportunity to enroll in legal benefits. As a U.S. Legal plan member, you’re covered as well as your spouse and dependent children. Covered legal services include, (but not limited to):
Consultations
Will and Trust
Living Wills
Estate Planning
Debt Collect Defense
Foreclosure Assistance
Real Estate
Domestic Adoption
Divorce
Child Support
Child Custody
One flat monthly premium of $18.75 allows you access to over 10,000 attorneys nationwide, all of whom are Martindale-Hubble listed with an average of over 17 years experience practicing law.
Start defending yourself TODAY! To learn more, visit http://www.uslegalservices.net/companies/smagcorp or call (800)356-LAWS (5297)
DUI
Traffic Violations
Juvenile Law
Consumer Law
Criminal Law
Online Will Preparation
24/7 Emergency Services
ID Theft Protection
Financial & Tax Planning
LifeLock - Identity Theft Protection
Administered by LifeLock - 800-607-9174
Identity Theft is still the #1 reported crime affecting more than 1 out of 20 Americans in 2012. LifeLock’s goal is to help stop
Identity Theft before it happens to you. In the unlikely event an identity theft does happen to you, a dedicated team of expert
resolution specialists will work on your behalf to restore your identity, so you don’t have to. LifeLock focuses on helping
protect you against all forms of ID theft, including Medical, Criminal, Child, IRS, SSN, and much more.
If you want to avoid or minimize the nightmare of identity theft then make sure to sign up with LifeLock by visiting:
https://www.yigenroll.com/SelectPlan.aspx?groupcode=mcrae14
This benefit will be payroll deducted if elected. To receive the discount you must enroll through the provided link above.
This benefit is available only one time each year. If you waive coverage during Annual Enrollment, you must wait until the
next Annual Enrollment to enroll.
Scott-McRae —20
Important Notice from Scott-McRae Automotive Group, LLLP about
Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current
prescription drug coverage with Scott-McRae Automotive Group and about your options under Medicare’s prescription
drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are
considering joining, you should compare your current coverage, including which drugs are covered at what cost, with
the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about
where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
There are two important things you need to know about your current coverage and Medicare’s prescription drug
coverage:
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this
coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that
offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by
Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Scott-McRae Automotive Group has determined that the prescription drug coverage offered by the Scott-McRae
Automotive Group Benefit Plan is, on average for all plan participants, expected to pay out as much as standard
Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing
coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later
decide to join a Medicare drug plan.
When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th through
December 7th.
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible
for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
What Happens To Your Current Coverage If You Decide To Join A Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current Scott-McRae Automotive Group coverage will not be affected. If you do
decide to join a Medicare drug plan and drop your current Scott-McRae Automotive Group coverage, be aware that you and your
dependents will not be able to get this coverage back until the next open enrollment period. Unless you experience a qualified
life event.
Note that your current coverage pays for other health expenses, in addition to prescription drugs, and you will still be eligible to
receive all of your current health and prescription drug benefits if you choose to enroll in a Medicare prescription drug plan and
keep your coverage under the Scott-McRae Automotive Group Benefit Plan.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with Scott-McRae Automotive Group and don’t join a
Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to
join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at
least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For
example, if you go 19 months without creditable coverage, your premium may consistently be at least 19% higher than the
Medicare base beneficiary premium.
Medicare Notice
Scott-McRae —21
Medicare Notice (cont.) You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition,
you may have to wait until the following October to join.
Summary Of Options For Medicare Eligible Employees (and/or Dependents):
Medical and prescription drug coverage are offered as a package under the Scott-McRae Automotive Group Plan (you cannot
elect medical coverage without prescription drug coverage).
1. Continue medical and prescription drug coverage under the Scott-McRae Automotive Group Benefit Plan and do not elect
Medicare D coverage. Impact – your claims continue to be paid by the Scott-McRae Automotive Group Benefit Plan.
2. Continue medical and prescription drug coverage under the Scott-McRae Automotive Group Benefit Plan and elect
Medicare D coverage. Impact – As an active employee (or dependent of an active employee) the Scott-McRae Automotive
Group Benefit Plan continues to pay primary on your claims (pays before Medicare D).
3. Drop the Scott-McRae Automotive Group Benefit Plan coverage and elect Medicare Part D coverage. Impact – Medicare is
your primary coverage. You will not be able to rejoin the Benefit Plan unless you experience a family circumstance change
or until the next open enrollment period.
For More Information About This Notice Or Your Current Prescription Drug Coverage…
Contact the Human Resource Department for further information. NOTE: You’ll get this notice each year. You will also get it
before the next period you can join a Medicare drug plan, and if this coverage through the Scott-McRae Automotive Group
Plan changes. You also may request a copy of this notice at any time.
For More Information About Your Options Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
Visit www.medicare.gov
Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help
Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
For more information about Medicare prescription drug coverage:
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be
required to provide a copy of this notice when you join to show whether or not you have maintained creditable
coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
Date: November 2014
Name of Entity: Scott-McRae Automotive Group, LLLP
Contact: Human Resource Department
Office Address: 701 Riverside Park Place, Suite 110
Jacksonville, FL 32204
Phone: (904) 380-4226
Scott-McRae —22
Legal Updates
The Women’s Health and Cancer Rights Act
The Women’s Health and Cancer Right Act requires group health plans that provide coverage for mastectomy to provide
coverage for certain reconstructive services. This law also requires that written notice of the availability of the coverage be
delivered to all plan participants upon enrollment and annually thereafter. This language serves to fulfill that requirement for
this year. These services include:
Reconstruction of the breast upon which the mastectomy has been
performed;
Surgery/reconstruction of the other breast to produce a symmetrical
appearance;
Prostheses; and
Treatment for physical complications during all stages of mastectomy,
including lymphedemas.
In addition, the plan may not:
Interfere with a participant’s rights under the plan to avoid these
requirements; or
Offer inducements to the healthcare provider, or assess penalties against
the provider, in an attempt to interfere with the requirements of the law.
However, the plan may apply deductibles, coinsurance, and co-pays consistent with other coverage provided by the Plan.
HIPAA Privacy Notice For the Scott-McRae Automotive Group Employee
Health Plan
The Plan’s policies protecting your privacy rights and your rights under the law are described in the Plan’s Notice of Privacy
Practices. The HIPAA Omnibus Final Rules required that we update our Notice of Privacy Practices to better inform you of
our Privacy obligations. Our Notice now addresses our duty to notify individuals in the event of a breach of unsecured
Protected Health Information (PHI) and that we may not use or disclose genetic information for underwriting purposes.
Please contact your Human Resource Department to request a copy of the Notice.
Know Your COBRA Notification Responsibilities
It is your responsibility to notify Human Resources when a dependent becomes eligible or ceases to be eligible for coverage
under our benefit plans. All eligibility changes should be reported within 30 days of the event. Failure to report changes in a
timely manner can impact your ability to add newly eligible dependents of discontinue pre-tax premium contributions on
ineligible dependents. In addition, failure to report a loss of eligibility due to legal separation or divorce or a dependent that
has otherwise ceased to be eligible, such as a child reaching the maximum dependent child age limit, can impact your
dependent’s rights for group health plan coverage under the federal law known as COBRA. If you fail to report the loss of
eligibility within 60 days of the event, your dependents may be left with no continuation coverage under our plan. Please see
your COBRA notice or your group health plan summary plan description for additional information.
Scott-McRae —23
Scott-McRae Automotive Group’s Initial Notice of your HIPAA Special Enrollment Rights Loss of Other Coverage - If you are declining enrollment for yourself and/or your dependents (including your spouse) because of other health insurance coverage or group health plan coverage, you may be able to enroll yourself and/or your dependents in this plan if you or your dependents lose eligibility for that other coverage or if the employer stops contributing towards your or your dependent’s coverage. To be eligible for this special enrollment opportunity you must request enrollment within 30 days after your other coverage ends or after the employer stops contributing towards the other coverage.
New Dependent as a Result of Marriage, Birth, Adoption or Placement for Adoption - If you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and/or your dependent(s). To be eligible for this special enrollment opportunity you must request enrollment within 30 days after the marriage, birth, adoption or placement for adoption. You must provide the proper documentation to make these changes. Medicaid Coverage - Scott-McRae Automotive Group’s, group health plan, will allow an employee or dependent who is eligible, but not enrolled for coverage, to enroll for coverage if either of the following events occur: 1. TERMINATION OF MEDICAID OR CHIP COVERAGE- If the employee or dependent is covered under a Medicaid plan or
under a State Child Health Plan (SCHIP) and coverage of the employee or dependent under such a plan is terminated as a result of loss of eligibility.
2. ELIGIBILITY FOR PREMIUM ASSISTANCE UNDER MEDICAID OR CHIP- If the employee or dependent becomes eligible
for premium assistance under Medicaid or SCHIP, including under any waiver or demonstration project conducted under or in relation to such a plan. This is usually a program where the state assists employed individuals with premium payment assistance for their employer’s group health plan rather than direct enrollment in a state Medicaid program.
To be eligible for this special enrollment opportunity you must request coverage under the group health plan within 60 days after the date the employee or dependent becomes eligible for premium assistance under Medicaid or SCHIP or the date you or your dependent’s Medicaid or state-sponsored CHIP coverage ends. To request special enrollment or obtain more information, please contact your Human Resources Department.
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) If you are eligible for health coverage but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in the state listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply.
Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, you must request coverage within 60 days of being determined eligible for premium assistance.
Legal Updates
Scott-McRae —24
Legal Updates
Florida – Medicaid GEORGIA – Medicaid
Website: https://www.flmedicaidtplrecovery.com/ Phone: 1-877-357-3268
Website: http://dch.georgia.gov/ Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP) Phone: 1-800-869-1150
NORTH CAROLINA – Medicaid SOUTH CAROLINA – Medicaid
Website: http://www.ncdhhs.gov/dma Phone: 919-855-4100
Website: http://www.scdhhs.gov Phone: 1-888-549-0820
VIRGINIA – Medicaid and CHIP MONTANA – Medicaid
Medicaid Website: http://www.dmas.virginia.gov/rcp-HIPP.htm Medicaid Phone: 1-800-432-5924 CHIP Website: http://www.famis.org/ CHIP Phone: 1-866-873-2647
Website: http://medicaidprovider.hhs.mt.gov/clientpages/ clientindex.shtml Phone: 1-800-694-3084
ALABAMA – Medicaid
Website: http://www.medicaid.alabama.gov Phone: 1-855-692-5447
Scott-McRae —25
Contact Information
Please contact the vendors listed below with any questions you may have regarding your benefit plans.
Employee Benefit Website
All employees have access to the Scott-McRae Employee Benefit Website.
To access the site, simply go to www.employeebenefitswebsite.com/scottmcrae.
OR
Employee Benefit Hotline
Don’t forget to take advantage of the Scott-McRae Employee Benefit Hotline for escalated
benefit and insurance claims questions.
1-877-798-0830 or [email protected]
The call center is open Monday through Friday, 9am to 5pm.
Coverage Carrier/Contact Website or Email Phone Number
Medical and HRA UnitedHealthcare www. myuhc.com 866-633-2446
Dental UnitedHealthcare www.myuhcdental.com 877-816-3596
Flexible Spending Accounts Infinisource www.infinisource.com 866-370-3040
Basic and Voluntary Life Cigna www.cigna.com 800-238-2125
STD and LTD Cigna www.cigna.com 800-238-2125
Legal U.S. Legal www.uslegalservices.net/
companies/smagcorp 800-356-5297
Identity Theft Protection LifeLock https://www.yigenroll.com/
SelectPlan.aspx?groupcode=mcrae14
800-607-9174
Benefits Department Cheryl Coward, Benefits Manager [email protected] 904-380-4226
Human Resource Department
Monica Hillin, Vice President
Mary Neff, Administrative Assistant
Terrell Miller, Administrative Assistant
904-354-5319
904-380-4219
904-380-4225
Scott-McRae —26
Leaving the Company
Leaving Scott-McRae - Facts about your benefits What Happens to My Benefits? GROUP HEALTH INSURANCE When leaving the Scott-McRae Group, the health insurance terminates at midnight on the last day of employment. The company notifies Infinisource, our Cobra continuation service, of your departure from Scott-McRae. Infinisource will send you information about the cost of continuing your health coverage. If you elect to continue, you will pay the full cost of the health benefits. After receiving your payment, Infinisource will notify the company to reinstate your health coverage. Contact Infinisource at 800-594-6957 or Email - [email protected] DENTAL INSURANCE The dental plans work the same as the health insurance. The company will automatically notify Infinisource to send you the information and cost of continuing dental coverage. Dental coverage terms the last day of employment. LIFELOCK- Employees can continue the Lifelock Identity Theft Plan on an individual plan. Contact LifeLock at 800-607-7205 METLAW– Benefit stops on the termination date, but may cover legal issues already began. Contact MetLaw Benefits provided by Hyatt Group Legal Plans 800-821-6400 BASIC AND SUPPLEMENTAL LIFE INSURANCE Life insurance ceases on the last day of the month in which your employment ceases. You may request conversion of the basic life to an individual policy. Also, you may request to continue Voluntary Life Insurance. Go to www.employeebenefitswebsite.com/scottmcrae to request forms. Forms must be completed and received by Cigna Life Insurance Company within 30 days of your last day of employment in order to be eligible. FLEXIBLE SPENDING ACCOUNT (FSA) Eligible expenses for these benefits (expenses incurred through the last date of employment) can be turned in for reimbursement through March 31st, of the following year. If you had future plans for using your FSA money, and the expenses were not incurred prior to leaving the company, you may want to continue the FSA through COBRA to extend the timeframe for incurring expenses. Payments to Infinisource for FSA would not be pre-taxed. Infinisource Flex handles our Flex Spending Accounts. Contact FSA Infinisource at 866-370-3040 LONG-TERM/SHORT-TERM DISABILITY Ends last date of employment. You may not continue this policy. PROFIT SHARING/401k If you contributed to the 401k Plan or received Profit Sharing and are vested, Mass Mutual will send you a distribution form to complete indicating if you would like to take a cash distribution or an IRA rollover of your vested account balance. You will receive this form approximately 10 days after your last paycheck. After returning the completed form to Mass Mutual, your account balance will be distributed in about two weeks. Contact Mass Mutual at 800-743-5274 or log in to www.retiresmart.com VIEWING PAY INFORMATION & OBTAINING MY 2011 W-2. Pay History is maintained in UltiPro. Terminated employees may continue to access this system for pay history and to obtain a W-2 for year end wages. Paper copies of W-2’s will not be mailed if you elected for Electronic delivery only. Contact UltiPro https://ew32.ultipro.com/default.aspx This information is intended to provide you with a brief description of the employee benefits when leaving the Scott-McRae Group. A Summary Plan Description for each benefit plan is available through the Scott-McRae Benefits Department. If there is a discrepancy between this description and the actual provision of the Plan, the Plan shall govern.
Scott-McRae —27