EMPLOYEE BENEFITSGUIDE2024 - 2025An 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 Guide2024 - 2025 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 2024 – 2025 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/coinciding with date of hireBenefits End End of the month following date of 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 Guide2024 - 2025 SciVidaComparison of PlansCoverage Provided by BCBSNCIn-Network Blue Options Silver 3500 HDHP Blue Options Platinum 1000 PlanBenefit Period Plan Year: 7/1 – 6/30 Plan Year: 7/1 – 6/30Deductibles (Individual / Family)$3,500/$7,000 $1,000/$2,000Out-of-Pocket Max (Individual / Family)$8,050/$16,100 $3,000/$6,000Preventive Care Covered at 100% Covered at 100%Primary Care Visit 30% after Deductible $15 Copay*Specialist Visit 30% after Deductible $30 CopayTelehealth via Teladoc 30% after Deductible $10 CopayUrgent Care 30% after Deductible $30 CopayEmergency Room 30% after Deductible $300 CopayOutpatient Services 30% after Deductible 10% after DeductibleInpatient Services 30% after Deductible 10% after DeductiblePharmacy / RX (30 Day Supply)Tiers 1-5Essential QHP FormularyPreventive OTC: Covered at 100%All Other: 30% after DeductibleEssential QHP Formulary$4/$15/$35/$50/25%**Tier 5: $50 min, $100 maxMEDICALThe 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.*1st 3 Copays are waived if you designate PCP in BlueConnect
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 Guide2024 - 2025 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 1-855-549-2214Refer 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 Guide2024 - 2025 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 3500 HDHP Blue Options Platinum 1000 PlanEmployee $59.80 $145.33Employee + Spouse $119.60 $290.65Employee + Child(ren) $110.63 $268.86Employee + Family $185.38 $450.52Your 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 Guide2024 - 2025 SciVidaA health savings account (HSA) is a health care account and savings account in one. HSA helps offset the cost of a HDHP while saving 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 are 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.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 AccountHSA Contribution LimitsYou can contribute to your Flores HSA on a pre-tax basis through payroll deductions up to the IRS statutory maximums. These maximums include employer contributions. SciVida contributes $41.66 per pay period ($1,000 per plan year) for employee only coverage and $62.50 per pay period for employee plus dependent coverage ($1,500 per plan year). The IRS has established the following maximum HSA contributions:2024 Tax Year 2025 Tax Year$4,150 Individual / $8,300 Family $4,300 Individual / $8,550 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 Guide2024 - 2025 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 $16.00Employee + Spouse $33.53Employee + Child(ren) $40.21Employee + Family $59.88Your 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 Guide2024 - 2025 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 Guide2024 - 2025 SciVidaCarrier ResourcesBENEFIT CARRIER GROUP # PHONE NUMBER WEBSITEMedical BCBSNC 14177765 877-275-9787 www.blueconnectnc.com Dental BCBSNC 14177765 800-305-6638 www.blueconnectnc.com Vision BCBSNC 14177765 833-337-3132 www.blue2020nc.com HSA Flores SciVida 704-335-8211 www.flores247.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.HSA FloresDebit Card will be mailed to employee’s home address.*If you are enrolled in medical, dental and/or vision you will receive one ID card for all coverages.**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.
EMPLOYEE BENEFITS GUIDEPrepared By Sentinel Benefits Consulting | sentinelra.com2024 - 2025SciVida