Lighthouse Company 2022 2023 An overview of the wide array of benefits provided by Lighthouse Company to help you enjoy increased well being and financial security EMPLOYEE BENEFITS GUIDE
INTRODUCTIONThis booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits GuideAs an employee of Lighthouse Company, enjoying your work and making valuable contributions to business are equally vital. The health, satisfaction and security of you and your family are important, not only to your well-being, but ultimately, in terms of achieving the goals of our organization.For the 2022 – 2023 plan year, Lighthouse Company has worked hard to offer a competitive total rewards package that includes valuable and competitive benefits plans. These programs reflect our commitment to keeping our staff healthy and secure. We understand that your situation is unique, and Lighthouse Company is offering an overall benefits package that can be shaped and molded by you to fit your needs.This benefits booklet is a summary description of your Lighthouse Company benefit plans. If there is a discrepancy between these summaries and the written legal plan documents, the plan documents shall prevail. This booklet and plan summaries do not constitute a contract of employment.We hope this benefits booklet, along with our additional communication and decision-making tools, will help you make the best health care choices for you and your family.2022 - 2023Lighthouse CompanyEligibility & EnrollmentBenefits Begin Date of hireBenefits EndEnd of the month following termination; Life & Disability end on date of terminationDependents Your legal spouse, dependent children up to the age of 26As a full-time employee working 30+ hours/week you are eligible for benefits. You can enroll or make changes during our annual enrollment period or if you experience a qualifying life event during the year. Qualifying Life Events include changes in marital status, employment status, birth or adoption of a child, death of a dependent, entitlement to Medicaid or Medicare, loss of other coverage or eligibility of dependents.
MEDICALThis booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022 - 2023Lighthouse CompanyBlue Cross Blue Shield of North Carolina Summary of Coverage: Blue Options HSA 1500IN NETWORK OUT OF NETWORKDeductibles (Individual / Family) $1,500/$3,000 $3,000/$$6,000Out-of-Pocket Max (Individual / Family)$3,000/$6,000 $6,000/$12,000Coinsurance 20% 50%Preventive Care Covered in full 30% after deductiblePrimary Care Visit 20% after deductible 50% after deductibleSpecialist Visit 20% after deductible 50% after deductibleDiagnostic Exam 20% after deductible 50% after deductibleX-Rays 20% after deductible 50% after deductibleOutpatient Procedure 20% after deductible 50% after deductibleInpatient Visit 20% after deductible 50% after deductibleEmergency Room 20% after deductible 20% after deductibleUrgent Care 20% after deductible 50% after deductibleTelehealth 20% after deductible 50% after deductiblePharmacy / RX (30 Day Supply) 20% after deductible N/APRICING PER PAY PERIODEmployee $0Employee + Spouse $279.49Employee + Child(ren) $209.67Employee + Family $488.93
HEALTH SAVINGS ACCOUNT (HSA)This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022 - 2023Lighthouse CompanyA health savings account (HSA) is a health care account and savings account in one. The main purpose of this account is to offset the cost of a qualifying high deductible health plan (HDHP) and provide savings for your out-of-pocket eligible health care expenses - those you and your tax dependents may have now, in the future, and during your retirement.Why Is It A Good Idea To Have An HSA?HSAs benefit everyone who is eligible to have this account, including single individuals, families and soon-to-be retirees. You save money on taxes in three ways:• Tax-Free Deposits: The money you contribute to your HSA isn't taxed (up to the IRS annual limit)• Tax-Free Earnings: Your interest and any investment earnings grow tax-free• Tax-Free Withdrawals: The money used toward eligible health care expenses isn't taxed now or in the futureSetting aside pre-tax dollars into your HSA means you pay fewer taxes and increase your take-home pay by your tax savings. You save money on eligible expenses that you are paying for out of your pocket. The amount you save depends on your tax bracket. For example, if you are in the 30% tax bracket, you can save $30 on every $100 spent on eligible health care expenses.HSA funds roll over from year to year and accumulate in your account. There is no "use-it-or-lose-it" rule with HSAs, and you decide how and when to use your HSA funds, which can be used for eligible expenses you have now, in the future, or during retirement. Also, when you have a certain balance in your HSA, investment opportunities are available.Refer to your HSA documentation for more information.2022 HSA Contribution LimitsLighthouse Company will contribute $65 per pay period to your Optum Bank HSA up to an annual amount of $1,560. This amount counts to the IRS annual maximum listed below. You can contribute to your HSA on a pre-tax basis through payroll deductions up to the IRS statutory maximums. The IRS has established the following maximum HSA contributions:FOR THE 2022 TAX YEAR: $3,650 Individual / $7,300 FamilyIf you are age 55 and over, you may contribute an extra $1,000 catch-up contribution. FOR THE 2023 TAX YEAR: $3,850 Individual / $7,750 FamilyIf you are age 55 and over, you may contribute an extra $1,000 catch-up contribution.
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits GuideEmployees and dependents enrolled in our medical have access to telemedicine through Teladoc. telehealth provides acute and behavioral care 24 hours a day via phone or video by board-certified doctors and behavioral health specialist. Telehealth is a good option for minor health problems when you can’t see your regular doctor. It is also a convenient choice when you want to speak to a counselor or therapist. Some providers will also offer telehealth appointments. Check with your provider on the availability and cost.How Does Telehealth Work?Your virtual visit will take place via phone, video call on a laptop, tablet or cellphone; or through an app. The provider will ask you the same questions you'd be asked at an in-person visit and may recommend treatment based on their findings.What Can’t Telehealth Be Used For?• Life-threatening or emergency situations • Situations in which diagnostic care (e.g., blood work, imaging or lab tests) are required• Situations of severe illness or complex conditionsHow Do I Access Telehealth?There are 3 ways to access Teladoc:• Download the Teladoc mobile app• Go to Teladoc.com and click “Log in/Register”• Call 1-800-835-2362Refer to your plan documentation for more information.TELEHEALTH2022-2023Lighthouse CompanyWhat Can Telemedicine Be Used For?General, non-life-threatening doctor's visits or consultations for acute care, such as:• Allergies• Cough, cold and flu• Diarrhea, nausea and vomiting• Ear problems• Insect bites• Sinus problems• Urinary problems• And moreBehavioral health issues such as:• Addictions• Anxiety• Depression• Grief and loss• Relationship issues• And more
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits GuideManifest RxLighthouse Company provides additional pharmacy benefits to all employees through Revive Health. Over 425 generic medications are available at no cost. Check online at www.Revive.ManifestRx.comto see if your medications are available. Amazon PharmacyBlue Cross NC now offers access to Amazon Pharmacy for your mail order needs. This includes Meds Your Way, a discount card that provides additional savings through Amazon Pharmacy. At check out you’ll see the lowest cost available for your prescription. Sign up and learn more at www.amazon.com/bluecrossnc. Pharmacy Programs2023-2023Lighthouse CompanyNeed anurgent caremedication quickly?No problem! 40 urgent care medications areavailable for FREE at your local pharmacyNeed a medication that is not covered for free?No problem! Use your ManifestRx discount card and receive up to 80% savings.Need support or a pharmacist consultation?No problem! Call or email us and speak to our member services team or a pharmacist for support.PRICING PER PAY PERIODEmployee $0Employee + One $2.00Employee + Family $4.00Please note the following regarding the rates:•Employee Only - includes you and your children between the ages of 2-17•Employee + One - includes you and your spouse or adult child between the ages of 18-26, plus all dependents in the home ages 2-17.•Employee + Family - includes all family members with a maximum of 7 enrolled
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022 - 2023Lighthouse CompanyIn addition to a HSA, Lighthouse Company offers a company-sponsored limited purpose Flexible Savings Account (FSA) and a Dependent Care Flexible Savings Account (DCFSA). Flexible Spending Accounts allow you to set aside money from your paycheck before taxes are taken out. You then use your pre-tax FSA funds throughout the plan year to pay for eligible health care or dependent care expenses. You save money on expenses you're already paying for.Limited Purpose Health FSA • Contribution limit for our 2022-2023 plan year is $2,850• These are use it or lose it accounts, however you can carry over up to $610 of unused funds to the following year• Administered by FloresLimited Purpose Health FSA Eligible Expenses• Dental expenses: exams, cleanings, X-rays and braces• Vision expenses: exams, contact lenses, eyeglasses and laser eye surgeryDependent Care FSA • Contribution limit for our 2022-2023 plan year is $5,000• These are use it or lose it accountsDependent Care FSA Eligible Expenses• Care for your child who is under the age of 13• Before-school and after-school care• Babysitting and nanny expenses• Day care, nursery school and preschool• Summer day camp• Care for a relative who is physically or mentally incapable of self-care and lives in your homeRefer to your FSA documentation for more details.LIMITED-PURPOSE FSA and Dependent Care FSA
DENTALThis booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022 – 2023Lighthouse CompanySun Life Summary of CoverageIN NETWORK OUT OF NETWORK1Annual Deductibles(Individual / Family)$50/$150 $50/$150Preventive Care 100% 100%Basic Procedures (extractions, fillings, etc.)Covered in full after deductible 20% coinsurance after deductibleMajor Procedures(crowns, dentures, etc.)40% coinsurance after deductible 50% coinsurance after deductibleChild Orthodontics N/A N/ACalendar Year Maximum Benefit $1,250 $1,250PRICING PER PAY PERIODEmployee $18.80Employee + Spouse $37.50Employee + Children $43.31Employee + Family $64.951While Out-of-Network coverage is available, using an In-Network provider will result in less out of pocket expenses. In-Network dentist cannot balance bill you for the amount over the allowable charges.
VISIONThis booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022 - 2023Lighthouse CompanySun Life VSP Vision Summary of CoverageIN NETWORK OUT OF NETWORKVision Exam (1 per 12 months)$10 Up to $45Lenses (1 per 12 months)Single $25 Up to $30Bifocal $25 Up to $50Trifocal $25 Up to $60Lenticular $25 Up to $100Frames (1 per 24 months) Up to $130, then 20% Up to $70Elective Contact Lenses (1 per 24 months)$60 for exam$130 for lenses$Up to $105Medically Necessary Contact Lenses (1 per 24 months)$25 $Up to $210Standard Progressive Lens Enhancements$55 N/APremium Progressive Lens Enhancements$95-$105 N/ACustom Progressive Lens Enhancements$150-$175 N/APRICING PER PAY PERIODEmployee $3.55Employee + Spouse $6.74Employee + Children $7.88Employee + Family $11.10
DISABILITY INSURANCEThis booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022 - 2023Lighthouse CompanySun Life Summary of CoveragePLAN FEATURES Short Term Long TermEmployee Benefit Amount 60% of your weekly earnings 60% of your monthly earningsMaximum Benefit Amount $1,500/week $10,000Elimination Period (Accident & Sickness)7 days 90 daysBenefit Duration 12 weeksSSNRA – Age 65Disability Definition “24-month own occupation” Loss of duties and loss of earnings requiredDisability insurance is coverage that provides you with income protection should you be unable to work due to an injury or illness. With disability coverage, you are compensated for a portion of your lost income. Short-Term disability provides coverage in the near term, while Long-Term coverage is available for extended disabilities.
GROUP LIFE INSURANCEThis booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022 - 2023Lighthouse CompanySun Life Summary of CoveragePLAN FEATURESEmployee Benefit Amount 1 x annual earningsMaximum Benefit Amount $150,000Maximum AD&D Benefit $150,000The Following Shows How Much Benefits Are Reduced At Certain AgesAge Band Benefit ReductionAge 65 Reduced to 65%Age 70 Reduced by 50%Group life insurance coverage is an employer-sponsored safety net in case the worst happens, with no out-of-pocket costs to you. If you believe you need additional coverage, you may wish to enroll in voluntary life insurance as well. Employees must fill out an EOI form if they exceed the guaranteed issue amount.LIFE BENEFIT EMPLOYEE SPOUSE DEPENDENTAmount Increments of $10,000 Increments of $5,000 $2,000/$4,000/$10,000Minimum Amount $10,000 $5,000$2,000$500 for age 14 days–6mthsMaximum AmountThe lesser of $350,000 or 5 x annual earnings$100,000 $10,000Guaranteed Issue (Newly Eligible Employees)$150,000 $30,000Notes Benefits reduce at age 65 Benefits end at age 70 Benefits end at age 26VOLUNTARY LIFE INSURANCESun Life Summary of Coverage
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022-2023Lighthouse CompanyVoluntary Benefits are offered to assist employee's personal insurance needs. These programs are designed to fill the gaps in coverage such as your deductibles and co-insurance under your major medical. We offer legal and pet insurance as well.Worksite BenefitsAccidentPays a lump sum benefit if you or a covered family member experience an accident. Coverage can be purchased for employee and dependents.Critical IllnessPays a lump sum benefit should a covered family member experience a heart attack, stroke or other covered serious illnesses.LegalFree and discounted legal care for divorce, traffic ticket defense, document review, etc. This benefit includes free tax return preparation and identity theft solutions.Pet InsuranceDiscounts on products, prescriptions and Veterinary Care. Telehealth available 24/7 and lost pet recovery service.
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations and exclusions set forth in each insurance carrier's or provider's contract.Employee Benefits Guide2022-2023Lighthouse CompanyCarrier ResourcesBENEFIT CARRIER GROUP # PHONE NUMBER WEBSITEMedical BCBSNC 123456 888-206-4697www.bluecrossnc.comDental Sun Life 78910 800-442-7742 www.sunlife.com/accountVision Sun Life 111213 800-877-7195 www.sunlife.com/accountRx Discount Manifest Rx 141516 888-220-6650 https://member.myrevive.healthHSA Optum Bank NA 866-234-8913 www.optumbank.comFSA Flores NA800-532-3327www.flores247.comLife Sun Life 171819 800-247-6875 www.sunlife.com/usDisability Sun Life 202122 800-247-6875 www.sunlife.com/us401(K) MVP Administrators 232425 919- 465-2220 www.mvp401k.comLegal Legal Club NA 800 -305 -6816 www.legalclub.comPet Insurance Total Pet Plan 262728 800-891-2565 www.petbenefits.comCritical Illness Transamerica 293031 888-763-7474 www.tebcs.comAccident Transamerica 323334 888-763-7474 www.tebcs.comHow to access ID CardsBENEFIT HOW TO ACCESSMedicalHard copy ID cards are issued and mailed to your home address;electronic copies can be accessed via www.bluecrossnc.comDentalGeneric ID cards can be accessed via the following link:www.sunlife.com/accountVisionGeneric ID cards can be accessed via the following link:www.sunlife.com/account
EMPLOYEE BENEFITS GUIDEPrepared By Sentinel | sentinelra.com2022 - 2023