EMPLOYEE BENEFITSGUIDE2023 - 2024An overview of the of benefits provided by SciVida.
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 Guide2023 - 2024 SciVidaAs an employee of SciVida, 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 2023 – 2024 plan year, SciVida has worked hard to offer a competitive total rewards package that includes valuable and competitive benefit plans. These programs reflect our commitment to keeping our staff healthy and secure. We understand that your situation is unique, and SciVida 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 SciVida 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.INTRODUCTIONEligibility & EnrollmentAs 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 within 30 days if you experience a qualifying life event during the year. A qualifying life event includes 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.Benefits Begin 1st of the month following date of hireBenefits End Last day of the month following terminationDependents Covered to age 26, regardless of student of marital status
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 Guide2023 - 2024 SciVidaComparison of PlansCoverage Provided by BCBSNCIn-Network Blue Options Silver 5000 Plan Blue Options Platinum 1000 PlanBenefit Period Plan Year: 7/1 – 6/30 Plan Year: 7/1 – 6/30Deductibles (Individual / Family)$5,000/$10,000 $1,000/$2,000Out-of-Pocket Max (Individual / Family)$8,700/$17,400 $3,000/$6,000Preventive Care Covered at 100% Covered at 100%Primary Care Visit $45 Copay $15 CopaySpecialist Visit $135 Copay $30 CopayTelehealth via Teladoc $10 Copay $10 CopayUrgent Care $135 Copay $30 CopayEmergency Room $750 Copay $300 CopayOutpatient Services 30% after Deductible 10% after DeductibleInpatient Services 30% after Deductible 10% after DeductiblePharmacy / RX (30 Day Supply)Tiers 1-6$100 Rx Deductible$15/$35/$45/$90/25%*/50%***Tier 5: $90 min, $200 max**Tier 6: $200 min, $300 maxMail Order: 3 x Copay$4/$15/$35/$50/25%*/50%***Tier 5: $50 min, $100 max**Tier 6: $50 min, $200 maxMail Order: 3 x CopayMEDICALThe chart below is an overview of the In-Network benefits. Out-of-Network benefits are available; please review your Blue Cross Blue Shield of North Carolina (BCBSNC) plan documents for additional details.
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 Guide2023 - 2024 SciVidaWellness and Health ManagementUnderstanding the full value of covered benefits allows you to take responsibility for maintaining good health and incorporating healthy habits into your lifestyle. Some examples include getting regular physical examinations, mammograms and immunizations. Through the plans offered by SciVida, all covered individuals and family members are eligible to receive routine wellness services like these, at no cost; all copays, coinsurance, and deductibles are waived.Which Preventive Care Services Are Covered?The US Preventive Services Task Force maintains a regular list of recommended services that all Affordable Care Act (i.e., Health Care Reform) compliant insurance plans should cover at 100% for in-network providers. Below is a list of common services that are included in the plans offered this year:• Routine physical exam• Well baby and childcare• Well women visits• Immunizations• Routine bone density test• Routine breast exam• Routine gynecological exam• Screening for Gestational diabetes• Obesity screening and counseling• Routine digital rectal exam• Routine colonoscopy• Routine colorectal cancer screening• Routine prostate test• Routine lab procedures• Routine mammograms• Routine pap smear• Smoking cessation• Health education/counseling services• Health counseling for STDs and HIV • Testing for HPV and HIV• Screening/counseling for domestic violencePREVENTIVE CAREPricing Per Pay Period Blue Options Silver 5000 Plan Blue Options Platinum 1000 PlanEmployee $57.05 $126.63Employee + Spouse $114.09 $253.25Employee + Child(ren) $105.54 $234.26Employee + Family $176.84 $392.55Your Cost Payroll deductions are taken on a pre-tax basis and deducted 24 times per year
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 Guide2023 - 2024 SciVidaEmployees 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.TELEHEALTHWhat 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 Guide2023 - 2024 SciVidaSummary of CoverageCoverage Provided by BCBSNC In-NetworkAnnual Deductibles(Individual / Family)$25/$75Preventive Care Covered at 100%Basic Procedures (extractions, fillings, etc.)Covered at 80% after DeductibleMajor Procedures(crowns, dentures, etc.)Covered at 50% after DeductiblePlan Year Maximum Benefit(includes preventive, basic & major care)$1,000DENTALBelow is a high-level summary of our dental benefits with BCBSNC. While 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. Please review your plan documents for additional details.Pricing Per Pay PeriodEmployee $15.54Employee + Spouse $32.94Employee + Child(ren) $39.51Employee + Family $59.04Your CostPayroll deductions are taken on a pre-tax basis and deducted 24 times per year
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 Guide2023 - 2024 SciVidaSummary of CoverageCoverage provided by EyeMed via BCBSNC In-NetworkRoutine Eye Exam (once per plan year) $10 CopayLenses (once per plan year) $25 CopayFrames (once every 2 years) $130 AllowanceElective Contact Lenses $130 AllowanceMedically Necessary Contact Lenses(subject to eligibility review)Covered at 100%VISIONOur vision coverage is provided by EyeMed via BCBSNC. Please review your plan documents for additional details.Pricing Per Pay PeriodEmployee $3.04Employee + Spouse $5.77Employee + Child(ren) $6.07Employee + Family $8.93Your CostPayroll deductions are taken on a pre-tax basis and deducted 24 times per year
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 Guide2023 - 2024 SciVidaCarrier ResourcesBENEFIT CARRIER GROUP # PHONE NUMBER WEBSITEMedical BCBSNC TBD 877-275-9787www.blueconnectnc.com Dental BCBSNC TBD 800-305-6638www.blueconnectnc.com Vision BCBSNC TBD 833-337-3132www.blue2020nc.com How to access ID CardsBENEFIT CARRIER HOW TO ACCESSMedical* BCBSNC ID card is mailed to employee’s home address.Dental* BCBSNC ID card is mailed to employee’s home address.Vision** BCBSNC (EyeMed) ID card is mailed to employee’s home address.*If you are enrolled in medical, dental and/or vision coverage, you will receive one ID card for all coverage**Please note, if you are enrolled in vision coverage, your provider will always validate coverage and should do so by calling Blue 20/20 Customer Service at 855-400-3641 (number is outlined on back of ID card). The member’s coverage should be verified by using the member’s (employee or dependent) name and date of birth.
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 Guide2023 - 2024 SciVidaThis page intentionally left blank.
EMPLOYEE BENEFITS GUIDEPrepared By Sentinel Benefits Consulting | sentinelra.com2023 - 2024SciVida