EMPLOYEE BENEFITSGUIDE2023 - 2024An overview of the wide array of benefits provided byTriangle Dermatology Associates, P.A. to help you enjoy increased well-being and financial security.
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 Triangle Dermatology Associates, P.A.As an employee of Triangle Dermatology Associates, P.A., 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, Triangle Dermatology Associates, P.A. 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 Triangle Dermatology Associates, P.A. 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 Triangle Dermatology Associates, P.A. 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 90 days after date of hireBenefits End Last day of employmentDependents Your legal spouse, dependent children up to age 26Domestic Partner Same and opposite sex
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 Triangle Dermatology Associates, P.A.Comparison of PlansCoverage Provided by NCMS through Blue Cross of NCIn-Network PPO 4000-70 HDHP 5000-100Benefit Period Plan Year: 12/1 – 11/30 Plan Year: 12/1 – 11/30Deductibles (Individual / Family) $4,000/$8,000Individual: $5,000/ Family Member: $6,550/ Family Total: $10,000Preventive Care Covered in full Covered in fullPrimary Care Visit$50 Copay*Register your PCP on BlueConnectNC.com and 1st three visits’ copay waived.0% after deductibleSpecialist Visit $100 Copay 0% after deductibleTelehealth via Teladoc $50 Copay 0% after deductibleUrgent Care $100 Copay 0% after deductibleEmergency Room $1,000 Copay 0% after deductibleOutpatient Procedure 30% after deductible 0% after deductibleInpatient Visit 30% after deductible 0% after deductiblePharmacy / RX (30 Day Supply)Tiers 1-5$15, $35, $45, $90, 25% (max $200) 0% after deductibleOut-of-Pocket Max (Individual / Family)$8,550/$17,100Individual: $5,000/ Family Member: $6,550/ Family Total: $10,000MEDICALThe chart below is an overview of the In-Network benefits. Out-of-Network benefits are available; please review your NCMS 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 Triangle Dermatology Associates, P.A.Wellness 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 Triangle Dermatology Associates, P.A., 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 (26) PPO 4000-70 HDHP 5000-100Employee$53.53 $58.24Employee + Spouse$274.06 $298.19Employee + Child$124.18 $135.12Employee + Children$218.39 $237.62Employee + Family$434.64 $472.91Your Cost
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 Triangle Dermatology Associates, P.A.Employees 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 Triangle Dermatology Associates, P.A.Through our partnership with NCMS, enrolled members have access to several additional programs to help support you in achieving a healthy balanced life.Nurse Support Program Condition CareManaging a chronic condition can be complicated. This BCBSNC program connects you to additional tools, resources and care if you have a condition such as:• Asthma• Chronic Obstructive Pulmonary Disease• Congestive Heart Failure• Coronary Artery Disease• Diabetes• HypertensionA Nurse Advocate may call you to provide one-on-one support. If you have not already been contacted by the Nurse Advocate, you can call 1-888-229-8510, Monday through Friday, between 9:00 a.m. and 7:00 p.m.Eat Smart, Move More, Weigh LessEat Smart, Move More, Weigh Less is an online weight management program that uses strategies proven to work for weight loss and maintenance. Each lesson informs, empowers and motivates participants to live mindfully as they make choices about eating and physical activity.To register visit: https://esmmweighless.com/howitwork/enroll-choose-a-class/ For questions, please contact Administrator@ESMMWeighLess.com.Nutrition Counseling Total Nutrition Technology provides members with a custom-built nutrition plan and exercise guidelines to fit each member’s lifestyle and dietary objectives. To get started on your wellness journey, complete and submit this form: https://www.totalnutritiontechnologycharlotte.com/curi-member-form/. Employee Assistance ProgramVITAL WorkLife is available to assist you and your family with life issues which are confronting you., such as grief, anxiety, problems with your children, substance abuse and more. Unlimited phone consultation and website access to articles, assessments, seminars and much more. Face to face counseling is available. Legal, financial and identity theft services can also be accessed. Contact VITAL WorkLife at 800-383-1908 or visit www.vitalworklife.com username: ncmsplan; password: ncmsplan.MEDICAL SUPPORT PROGRAMS
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 Triangle Dermatology Associates, P.A.Our EAP through VITAL WorkLife offers free, confidential assistance at no cost to you.• Unlimited phone support 24/7• Face-to-Face or Virtual Counseling sessions• Coaching Sessions• Online Resources• Articles• Website• Online Seminars• Guided Education ModulesOur EAP Provides Support For:• Grief• Anxiety/Stress• Problems with your children• Substance Abuse• Financial Counseling• Legal advice and referrals• And moreEMPLOYEE ASSISTANCE PROGRAM (EAP)Call: 800.383.1908 Or visit: VITALWorkLife.com Username: ncmsplanPassword: ncmsplan
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 Triangle Dermatology Associates, P.A.A health savings account (HSA) is a health care account and savings account in one. HSA helps offset the cost of a HDHP whilesaving for your out-of-pocket eligible health care expenses. The HSA is your personal bank account and can be used for you and your dependents now and in the future.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. Yousave 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.Who is Eligible?You are eligible to contribute to an HSA if:• You are enrolled in a qualified HDHP• You are not enrolled in a copay plan such as a spouse’s non-HDHP, Medicare, Medicaid or Tri-Care• You or your spouse is not enrolled in a full purpose Health Care Flexible Spending AccountRefer to your HSA documentation for more information.HSA Contribution LimitsYou can contribute to your Health Equity HSA on a pre-tax basis through payroll deductions up to the IRS statutory maximums. The IRS has established the following maximum HSA contributions:2023 Tax Year 2024 Tax Year$3,850 Individual / $7,750 Family $4,150 Individual / $8,300 FamilyIf you are age 55 and over, you may contribute an extra $1,000 catch-up contribution. 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 Guide2023 - 2024 Triangle Dermatology Associates, P.A.Summary of CoverageCoverage Provided by Companion Life In-NetworkDeductibles(Individual / Family)$100 Lifetime per covered member Preventive Care Covered in fullBasic Procedures (extractions, fillings, etc.)20% after deductibleMajor Procedures(crowns, dentures, etc.)50% after deductibleChild Orthodontics $1,000 Lifetime maxContract Year Maximum Benefit $1,000 DENTALBelow is a high-level summary of our dental benefits. 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 Period (26)Employee $18.68Employee + Spouse $37.35Employee + Child(ren) $41.59Employee + Family $61.18Your Cost
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 Triangle Dermatology Associates, P.A.Summary of CoverageCoverage provided by Community Eye Care In-NetworkVision Exam (Once every year)$15 CopayFrames/Lenses (Once every year)$15 Copay / $130 allowanceStandard Contact Lenses Fit/Evaluation (Once every year)$15 CopayEyewear DiscountsMembers who exceed their allowanceare eligible for discounts on theoverage when seeing a networkprovider - a 20% discount for glassesand a 10% discount for contactlenses.VISIONOur vision coverage is provided by Community Eye Care. Please review your plan documents for additional details.Pricing Per Pay Period (26)Employee $3.95Employee + One $7.70Employee + Family $11.84Your Cost
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 Triangle Dermatology Associates, P.A.Colonial Life – Voluntary Benefits You never know when an unexpected illness or injury could leave you and your family with financial difficulties. Health insurance can help, but you can still have deductibles, co-payments, and other out-of-pocket expenses.That’s where voluntary benefits come in. Sometimes called supplemental insurance, voluntary benefits are designed to complement your health insurance and help provide extra financial protection. This year, your employer is helping you protect your way of life by giving you the opportunity to purchase the following voluntary benefits from Colonial Life:Group Medical Bridge – Hospital Indemnity insuranceDisability insuranceIf guaranteed-issue coverage is available, you won’t have to answer health questions. For more details and rates, talk with your Colonial Life benefits counselor. Benefits may be subject to a pre-existing condition provision.Group Medical Bridge (Hospital Indemnity Insurance) – HELP COVER DEDUCTIBLE AND CO-INSURANCE COSTIf you’re admitted to the hospital because of a covered accidents, sickness, and maternity it’s important to focus on your recovery – not your finances. That’s easier said than done if you have costly co-payments, deductibles and other expenses coming your way. Plan-1 is HDHP-HSA Compliant, Plan-2 is a Traditional PPO Non-HSA Compliant coverage. Hospital indemnity insurance from Colonial Life can help you pay for medical expenses that your health insurance may not cover for the following medical services: • Hospital confinement• Outpatient surgical procedures• Diagnostic procedures• Wellness screenings• Medical treatment packageWITH THIS COVERAGE:• Benefits are payable directly to you (unless you specify otherwise) and can be used as you see fit.• Coverage is available for you, your spouse, and eligible dependent children.• Benefits are payable regardless of any other insurance you may have with other companies.
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 Triangle Dermatology Associates, P.A.Disability Insurance - HELP PROTECT YOUR INCOME Losing just one paycheck would be difficult, but a disability could have you out of work for weeks or even months. And while your paychecks might stop, your bills would continue coming. Without your income, how would you pay for housing, utilities, and other everyday living expenses?Disability insurance from Colonial Life helps protect your income, so you can have help paying the bills while you recover from a covered accidents, sickness, and maternity.FEATURES – Colonial Life – ISTD3000: • Employee may choose plan design and amount of disability benefits to meet their needs – subject to income requirements.• Benefits are payable for as long as the employee remains disabled up to the benefit period selected.• Monthly Benefit amounts: coverage maximum is up to 60% of gross monthly earnings from $400 - $6,500. • Premiums do not go up with your age; Age rated premium – Age brackets include: (17-49) (50-64) (65-74)• Coverage - Off-Job Only Accident and Off-Job Only Sickness • Benefit Period options: 3 Months or 6 Months; ask Rep for details.• Elimination Period: is the number of days following a Disability before benefits again. Various options include: o 0-day Accident & 7-day Sicknesso 0-day Accident & 14-day Sicknesso 14-day Accident & 14-day Sickness• Maternity benefit, Complications due to pregnancy are viewed as a normal sickness.• First Day Hospital Benefit (Waiver of Elimination Period for 1stDay of Hospital Confinement Benefit.• Benefits are paid directly to the insured unless they specify otherwise.• Total and partial disability benefits. Pays partial benefits after total disability benefits are paid, if the insured returns towork less than 20 hours per week.• Guaranteed renewable. • Coverage is portable. An employee can take this coverage with him if he changes jobs or leaves your company.• Worldwide coverage. Unisex rates. Premiums are the same for males and females.• Waiver of premium after insured is disabled for 90 consecutive days.• No integration. WITH THIS COVERAGE:• You can choose the amount of your disability benefits, subject to income.• Benefits are payable regardless of any other insurance you may have with other companies.• Benefits are payable directly to you, and you can use these benefits however you choose.
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 Triangle Dermatology Associates, P.A.This page was intentionally left blank.
EMPLOYEE BENEFITS GUIDEPrepared By Sentinel Benefits Consulting | sentinelra.com2023 - 2024Triangle Dermatology Associates, P.A.