EMPLOYEE BENEFITSGUIDE2024 - 2025An overview of the wide array of benefits provided byCatawba Valley Healthcare 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 GuideAs an employee of Catawba Valley Healthcare, 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, Catawba Valley Healthcare 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 Catawba Valley Healthcare 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 Catawba Valley Healthcare 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.2024 - 2025Catawba Valley HealthcareINTRODUCTIONEligibility & EnrollmentAs a full-time employee working 30+ hours/week you are eligible for health insurance. You are eligible for all other benefits if you work 40 hours/week. 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 Begin1st of the month following 30 days of full-time employment*Full-time employment is 30 hours per week for medical benefits and 40 hours per week for all other benefits.Benefits End End of the month following terminationDependents 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 GuideCatawba Valley HealthcareComparison of PlansMEDICALThe 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.*The HPN out-of-network benefits include Emergency Care and Urgent Care only. Look up in-network providers at: www.BlueCrossNC.com/HPNdoctors 2024 - 2025Coverage Provided by NCMS Employee Benefit PlanIn-NetworkBlue Options Low PlanPPO 4000-70Blue Options High PlanPPO 2500-70Blue High Performance NetworkHPN 2500-70*Benefit Period Plan Year: 7/1 – 6/30 Plan Year: 7/1 – 6/30 Plan Year: 7/1 – 6/30Deductibles (Individual / Family)$4,000/$8,000 $2,500/$7,500 $2,500/$7,500Out-of-Pocket Max (Individual / Family)$8,550/$17,100 $8,150/$16,300 $8,150/$16,300Preventive Care Covered in Full Covered in Full Covered in FullPrimary Care Visit$50 Copay*Register your PCP in Blue Connect and copay is waived for 1st three visits$35 Copay*Register your PCP in Blue Connect and copay is waived for 1st three visits$35 Copay*Register your PCP in Blue Connect and copay is waived for 1st three visitsSpecialist Visit $100 Copay $70 Copay $70 CopayTelehealth via Teladoc $50 Copay $35 Copay $35 CopayUrgent Care $100 Copay $100 Copay $100 CopayEmergency Room $1,000 Copay $1,000 Copay $1,000 CopayOutpatient Procedure 30% after deductible 30% after deductible 30% after deductibleInpatient Visit 30% after deductible 30% after deductible 30% after deductiblePharmacy / RX (30 Day Supply)Essential Formulary$15/$35/$45/$90/ 25%* *$50 min to $200 maxEssential Formulary$10/$25/$40/$80/25%**$100 maxEssential Formulary$10/$25/$40/$80/25%**$100 maxLens and Frames CoverageCovered up to $130, then 90%Covered up to $130, then 90%Covered up to $130, then 90%
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 GuideCatawba Valley HealthcareWellness 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 Catawba Valley Healthcare, 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 PeriodLow PlanPPO 4000-70High PlanPPO 2500-70HPN 2500-70Employee$41.46 $129.89 $101.14Employee + Spouse$323.64 $503.16 $444.79Employee + Child$131.87 $249.48 $211.24Employee + Children$252.41 $408.93 $358.04Employee + Family$529.11 $774.95 $695.02Your Cost 2024 - 2025
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 www.teladochealth.com and click “Log in/Register”• Call 1-800-835-2362Refer to your plan documentation for more information.TELEHEALTHCatawba Valley HealthcareWhat 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 more2024 - 2025
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 GuideCatawba Valley HealthcareThrough 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/ and enter the employer code: ASONCMSMentalHealthFund. 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/. MEDICAL SUPPORT PROGRAMS2024 - 2025
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 Catawba Valley HealthcareAmazon 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. Mail Order Pharmacy ProgramsNeed an urgent care medication quickly?Need a medication that is not covered for free?Weight Loss Prescription DrugsEffective November 1, 2023, coverage for anti-obesity “weight loss” drugs will be discontinued. These drugs will no longer be covered due to safety concerns, as well as the lack of data supporting long-term use of these drugs. The following products will be excluded as covered medications:Wegovy LomairaSaxenda PhendimetrazineAdipex-P ContraveBenzphetamine QsymiaDiethylpropion
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 - 2025Catawba Valley HealthcareThis Is How An FSA Works:• You set aside money for your FSA 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.• For the 2024 plan year (7/1/24 – 6/30/25), you may elect up to $2,500.Our plan through Flores offers a carry over up to $500 of unused funds to the following year. If you don’t use it, you lose it. Funds must be used during the plan year. There is a run-out period during which you can submit claims incurred during the plan year that ends on 8/31/2025.Refer to your FSA documentation for more information.Health FSA Eligible Expenses• Medical expenses: copays, coinsurance and deductibles• Dental expenses: exams, cleanings, X-rays and braces• Vision expenses: exams, contact lenses, eyeglasses and laser eye surgery• Professional services: physical therapy, chiropractic and acupuncture• Prescription drugs and insulin• Over-the-counter health care items such as bandages, pregnancy tests and blood pressure monitorsDependent 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 information. FLEXIBLE SPENDING ACCOUNT (FSA)
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 GuideCatawba Valley HealthcareSummary of CoverageCoverage Provided by Sun LifeIn-Network Benefits Base Plan Buy-Up PlanAnnual Deductibles(Individual / Family)$50 / $150 $50 / $150Type I: Preventive Care(exams, cleanings, x-rays, etc.)100% 100%Type II: Basic Procedures (extractions, fillings, etc.)100% 100%Type III: Major Procedures(crowns, dentures, etc.)0% 60%Child OrthodonticsN/A N/ACalendar Year Maximum Benefit$1,000 $1,200Waiting Period12 months for Major Services if you enroll more than 31 days after becoming eligible12 months for Major Services if you enroll more than 31 days after becoming eligibleDENTALBelow 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 Base Plan Buy-Up PlanEmployee$11.78 $24.83Employee + Spouse$23.18 $49.72Employee + Child(ren)$27.75 $48.18Employee + Family$40.89 $74.97Your Cost2024 - 2025
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 GuideCatawba Valley HealthcareSummary of CoverageCoverage provided by Sun Life / VSP Network In-NetworkVision Exam (Once every 12 months) $10 CopayLenses (once every 12 months) Single / Bifocal / Trifocal $25 CopayFrames (Once every 24 months)$150 Copay plus 20% off the amount over the allowanceElective Contact Lenses (once every 12 months) $150 CopayStandard Contact Lenses Fit & Follow Up Exam Up to $60Medically Necessary Contact Lenses $25 CopayVISIONOur vision coverage is provided by Sun Life using the VSP Network of doctors. Please review your plan documents for additional details.Pricing Per Pay PeriodEmployee$3.33Employee + Spouse$7.01Employee + Children$8.35Employee + Family$12.06Your Cost2024 - 2025
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 GuideCatawba Valley HealthcareSummary of CoverageCoverage provided by The HartfordPlan FeaturesEmployee Benefit Amount 1 x earnings rounded to the nearest $1,000Maximum Benefit Amount $350,000Guaranteed Issue $150,000Benefit Reductions begin at age 65Group 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.To be eligible for these benefits, you must work 40 or more hours per week.GROUP LIFE and AD&D INSURANCESummary of CoverageLife Benefit Employee SpouseChildren Up to age 26Amount Increments of $10,000 Increments of $5,000 $10,000Minimum Amount $10,000 $5,000 $10,000Maximum Amount $300,000Lesser of your election or $150,000$10,000Guarantee Issue (Newly Eligible Employees)$100,000 $50,000 $10,000Benefit Reductions begin at age65 65N/AVOLUNTARY LIFE and AD&D INSURANCEFor the Voluntary Life and AD&D rates, please see carrier summary. Cost is age-banded and based on the employee’s age.The amount of AD&D coverage is equal to the life insurance amount. The amount of AD&D coverage is equal to the life insurance amount. 2024 - 2025
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 GuideCatawba Valley HealthcareDisability Summary of CoverageCoverage provided by The HartfordPlan Features Short-Term Long-TermCoverage Paid By You Catawba Valley HealthcareEmployee Benefit Amount 60% of your base earnings 60% of your base earningsMaximum Benefit Amount $1,000 per week $5,000 per monthElimination Period 14 days 90 daysBenefit Duration 11 weeksThe greater of your Social Security Normal Retirement Age or 4 yearsEvidence of Insurability Required if you elect coverage after your initial eligibility periodNot 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. To be eligible for this benefit, you must work 40 or more hours per week.DISABILITY INSURANCEPlease note, a pre-existing condition period may apply once you become covered. Please see policy for more information.2024 - 2025
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 GuideCatawba Valley HealthcareYou 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:• Medical Bridge - Hospital indemnity insurance• Accident insurance• Critical illness insuranceWorksite BenefitsGroup Medical Bridge – GAPIf you’re admitted to the hospital because of a covered accident or sickness, 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.Hospital indemnity insurance from Colonial Life can help you pay for medical expenses that your health insurance may not cover for Accidents, Illnesses and Maternity. WITH 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.PLAN OPTIONS:Plan 1• Hospital Confinement benefit - $2,000 per day • Wellness/ Health screening benefit - $100 Plan 2• Hospital Confinement benefit - $1,500 per day • Diagnostic Procedure - $250 per day • Outpatient Surgical procedures - $2,500 • Wellness/ Health screening benefit - $100 • Medical Treatment Package2024 - 2025
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 GuideCatawba Valley HealthcareWorksite BenefitsGroup AccidentYou never know when you or someone you love could get hurt in an accident. And accidents come with costs, such as emergency room fees, doctor’s bills, and lost income from missing work. Even if you have good health insurance, deductibles and co-pays can really add up.With accident insurance from Colonial Life, you can receive benefits to help with the expenses of a covered accident. This financial protection can help you focus on what really matters: healing. WITH THIS COVERAGE:• A set amount is payable based on the injury you suffer and the treatment you receive.• You do not need to answer medical questions or have a physical exam to get basic coverage.• Unlike workers’ compensation, which only covers on-the-job injuries, accident insurance covers injuries that happen on the job or off the job.• Coverage is available for you, your spouse, and eligible dependent children. Group Critical IllnessNo matter where you are in life, you never know when you or a loved one could experience a critical illness, such as a heart attack or stroke. Medical advancements and early detection are helping many people survive critical illnesses. However, preventive tests and treatment can lead to increased medical expenses, and your health insurance may not cover these costs.Critical illness insurance from Colonial Life helps supplement your major medical coverage by providing a lump-sum benefit you can use to pay the direct and indirect costs related to a covered critical illness.WITH THIS COVERAGE:• Benefits are payable directly to you unless you specify otherwise.• You may receive additional benefits if you’re diagnosed with more than one critical illness.• Coverage options are available for you, your spouse, and eligible dependent children.2024 - 2025
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 GuideCatawba Valley HealthcareCall: 800.383.1908 Or visit: VITALWorkLife.com Username: ncmsplan Password: ncmsplanEmployee Assistance Program (EAP)The NCMS sponsored 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 ModulesThe NCMS sponsored EAP Provides Support For:• Grief• Anxiety/Stress• Problems with your children• Substance Abuse• Financial Counseling• Legal advice and referrals• And more2024 - 2025
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 GuideCatawba Valley HealthcareBENEFIT CARRIER GROUP # PHONE NUMBER WEBSITEMedical NCMS/BCBSNC 141745361001 888-206-4697www.bluecrossnc.comDental Sun Life 954290 800-442-7742 www.sunlife.comVisionSun Life VSP Vision954290 800-877-7195 www.vsp.com Group Life and AD&D The Hartford GL897963 800-523-2233 www.thehartford.com Long-Term DisabilityThe Hartford GLT897963 800-523-2233 www.thehartford.com Short-Term DisabilityThe Hartford GRH897963 800-523-2233 www.thehartford.com Supplemental Life and AD&DThe Hartford GL897963 800-523-2233 www.thehartford.com Telehealth Teledoc n/a 800-835-2362 www.teladochealth.com Voluntary Benefits Colonial Life n/a 800-325-4368 www.coloniallife.com EAP Vital WorkLifeUsername & password: ncmsplan800-383-1908 www.VITALWorkLife.com FSA & Dependent Care FSA Flores N/A 800-532-3327 www.flores247.com Carrier Resources2024 - 2025
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 GuideCatawba Valley HealthcareHow to access ID CardsBENEFIT CARRIER HOW TO ACCESSMedical NCMS/BCBSNCHard copy ID cards are issued and mailed to your home address.Electronic copies can be accessed here: https://member.bcbsnc.com/blueconnect/web/registrationDental Sun LifeNo ID card is issued. Once enrolled, you can generate a generic card from the Sun Life portal.www.sunlife.comVision VSPNo ID card is issued. www.vsp.com/eye-doctor FSA FloresHard copy ID cards are issued and mailed to your home address.If you’d like to request an additional card for a spouse or dependent, please request through the Flores portalwww.flores247.com Dependent Care FSA FloresNo ID card is issued. Flores will issue you a Participant ID number to help you manage your account on the Flores mobile app or website.www.flores247.com 2024 - 2025
Know Your BenefitsBrought to you by: Sentinel Risk Advisors, LLCMedical Insurance InformationDeductible: A deductible is the amount of money you or your dependents must pay toward a health claim before your organization’s health plan makes any payments for health care services rendered. For example, a plan participant with a $100 deductible would be required to pay the first $100, in total, of any claims during a plan year.Copayment (Copay): A copay is a flat fee you pay upfront for doctor visits, prescriptions, and other healthcare services. It does not count toward your deductible. Coinsurance: On top of your deductible, coinsurance is a provision in your health plan that shows what percentage of a medical bill you pay and the percentage a health plan pays.Out-of-pocket Maximum (OOPM): An OOPM is the maximum amount (deductible and coinsurance) that you will have to pay for covered expenses under a plan. Once the OOPM is reached the plan will cover eligible expenses at 100 percent.Explanation of Benefits (EOB): An EOB is a description your insurance carrier sends to you explaining the health care benefits that you received and the services for which your health care provider has requested payment.Preferred Provider Organization (PPO): A PPO is a group of hospitals and physicians that contract on a fee-for-service basis with insurance companies to provide comprehensive medical service. If you have a PPO, your out-of-pocket costs may be lower than in a non-PPO plan.High Performance Network Plan: Remember to stay in-network. For a health care service to be covered under your plan, you must receive the service from a BlueHPN provider, except for emergency care services which are covered regardless of whether the provider is in-network. When outside a BlueHPN service area, emergency care and urgent care services are covered, regardless of whether the provider is in-network. See maps of the BlueHPN coverage areas at BlueCrossNC.com/BlueHPNmap. Of course, if you’re ever in an emergency situation, always seek medical attention immediately. This Know Your Benefits article is provided by Sentinel Risk Advisors, LLC and is to be used for informational purposes only and is not intended to replace the advice of an insurance professional. © 2005, 2011, 2013-2014, 2020 Zywave, Inc. All rights reserved.
Know Your BenefitsBrought to you by: Sentinel Risk Advisors, LLCFlexible Spending AccountsInformation for EmployeesFlexible spending accounts, or FSAs, provide you with an important tax advantage that can help you pay health care and dependent care expenses on a pre-tax basis. By anticipating your family’s health care and dependent care costs for the next plan year, you can lower your taxable income.Essentially, the Internal Revenue Service (IRS) set up FSAs as a means to provide a tax break to employees and their employers. As an employee, you agree to set aside a portion of your pre-tax salary in an account, and that money is deducted from your paycheck over the course of the year. The amount you contribute to the FSA is not subject to social security (FICA), federal, state or local income taxes—effectively adjusting your annual taxable salary. The taxes you pay each paycheck and collectively each plan year can be reduced significantly, depending on your tax bracket. As a result of the personal tax savings you incur, your spendable income will increase.The Health Care Reimbursement FSAThe health care reimbursement FSA lets you pay for certain IRS-approved medical care expenses not covered by your insurance plan with pre-tax dollars. For example, cash that you now spend on deductibles, copayments or other out-of-pocket medical expenses can instead be placed in the health care reimbursement FSA pre-tax. The annual maximum contribution for Catawba Valley Healthcare employees to the health care reimbursement FSA is $2,500.Health FSAs employ a “use-it-or-lose-it” model. If you do not use the funds that you contribute to your FSA within the end of the year, you will have to forfeit those funds. However, employers also have the option of allowing employees to carry over up to $500 of unused funds from one year to the next. In addition, any amount that is carried over does not count toward the maximum contribution limit.Eligible ExpensesEligible health care expenses for the health care reimbursement FSA include more than just your deductible and copayments. You can also reimburse items such as prescription drugs, dental expenses, eyeglasses and contacts, certain medical equipment and many more items. For more information about eligible medical expenses, please refer to IRS Publication 502, Medical and Dental Expenses, available at www.irs.gov/publications/p502/index.html.Over-the-counter drugs used to be eligible expenses, but a law effective Jan. 1, 2011, only allows claims for over-the-counter medication or drug expenses (other than insulin) to be reimbursed if the patient has a prescription. This new rule does not apply to items for medical care that are not considered medication or drugs. Equipment such as crutches, supplies such as bandages and diagnostic devices such as blood sugar test kits still qualify for reimbursement without a prescription.
The Dependent Care FSAThe Dependent Care FSA lets you use pre-tax dollars toward qualified dependent care. The annual maximum amount you may contribute is $5,000 (or $2,500 if married and filing separately) per calendar year.If you elect to contribute to the dependent care FSA, you may be reimbursed for:The cost of child or adult dependent careThe cost for an individual to provide care either in or out of your house Nursery schools and preschools (excluding kindergarten)Eligible ExpensesIn order for dependent care services to be eligible, they must be for the care of a tax-dependent child under age 13 who lives with you, or a tax-dependent parent, spouse or child who lives with you and is incapable of caring for himself or herself. The care must be needed so that you and your spouse (if applicable) can go to work. Care must be given during normal working hours (instances such as Saturday night babysitting does not qualify) and cannot be provided by another of your dependents.Is the FSA program right for me?The flexible spending accounts offered by Catawba Valley Healthcare are beneficial for anyone who has out-of-pocket medical, dental, vision, hearing or dependent care expenses beyond what his or her insurance plan covers.It’s easy to determine if an FSA will save you money. At enrollment time, you will need to determine your annual election amount. Estimate the expenses that you know will occur during the year. These include out-of-pocket expenses for yourself and anyone claimed as a dependent on your taxes. If you had $100 or more in recurring or predictable expenses, the accounts can help you stretch your dollars.How do the accounts work?If you decide to enroll in one or more accounts, your contributions are taken out of eachpaycheck—before taxes—in equal installments throughout the plan year. These dollars arethen placed into your FSA. When you have an eligible health care or dependent care expense,you must submit a claim form along with an itemized receipt to be reimbursed from youraccount.The health care reimbursement FSA will reimburse you for the full amount of your annual election(less any reimbursement already received), at any time during the plan year, regardless of theamount actually in your account. Check with your employer to learn how these flexibilities impactyour HSA. The dependent care FSA will only reimburse you for the amount that is in your accountat the time you make a claim.
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 GuideCatawba Valley HealthcareCatawba Valley Healthcare Contact InformationCONTACT PHONE EMAILAngela Daughtrey,Payroll/Benefits Manager828-695-5935 adaughtrey@cvhnc.orgWanda Edmunds, Human Resources Director828-695-5910 wedmunds@cvhnc.orgCatawba Valley Healthcare shall provide a continuum of high-quality evidence–based, recovery-oriented and integrated health services to people in our community in need, promoting emotional, mental, physical and social health and functioning while respecting the dignity and rights of the unique individuals we serve.Catawba Valley Healthcare, a private nonprofit organization, promotes active partnerships between persons served, organizations, employees, communities, purchasers of service, and stakeholders. These active partnerships value organizational viability, performance, ethical responsibility and quality. Resources will support each consumer’s right to have a choice, build on strengths, exist in a natural environment, and advance the consumer’s sense of worth, personal dignity, and recovery. Catawba Valley Healthcare believes consumers have a right to timely and appropriate services, supplied by competent employees that have specialized knowledge and skill in the prevention, treatment, and recovery of health disorders and works toward the day when resources will be available to provide such services to all persons in need.Catawba Valley Healthcare MissionCatawba Valley Healthcare Vision2024 - 2025
EMPLOYEE BENEFITS GUIDEPrepared By Sentinel Benefits Consulting | sentinelra.com2024 - 2025