EMPLOYEE BENEFITSGUIDE2024 - 2025An overview of the wide array of benefits provided byNorth Carolina Football Club 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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubAs an employee of North Carolina Football Club, 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, North Carolina Football Club 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 North Carolina Football Club 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 North Carolina Football Club 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 1stof month following date of hireBenefits EndEnd of month following last day of employment(Life & Disability coverage ends last day of employment)Dependents 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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubCoverage Provided by Blue Cross of NCIn-Network Blue Options HSA Blue Options PPOBenefit Period Plan Year: 3/1 – 2/28 Plan Year: 3/1 – 2/28Deductibles (Individual / Family) $3,200 / $6,400 $1,500 / $3,000Out-of-Pocket Max (Individual / Family)$7,500 / $15,000 $4,500 / $9,000Preventive Care Covered 100% Covered 100%Primary Care Visit 20% after deductible$25 Copay(Register your PCP in Blue Connect and copay is waived for 1stthree visits)Specialist Visit 20% after deductible $50 CopayTelehealth via Teladoc 20% after deductible $10 CopayUrgent Care 20% after deductible $50 CopayEmergency Room 20% after deductible $300 CopayOutpatient Procedure 20% after deductible 20% after deductibleInpatient Visit 20% after deductible 20% after deductiblePharmacy / RX (30 Day Supply)Essential FormularyEnhanced Preventive: 20% no deductibleAll Other: 20% after deductibleRetail: $10/$35/$60/25%*/25%**$100 maxMEDICALThe chart below is an overview of the In-Network benefits. Out-of-Network benefits are available; please review your 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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubUnderstanding 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 North Carolina Football Club, all covered individuals and family members are eligible to receiveroutine wellness services like these, at no cost; all copays, coinsurance, and deductibles are waived.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 HSA Blue Options PPOEmployee $46.63 $60.42Employee + Spouse $118.00 $160.15Employee + Child(ren) $103.08 $139.00Employee + Family $162.79 $223.62Your Cost (24 Semi-Monthly Deductions) 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.
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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubEmployees and dependents enrolled in our medical plan 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 specialists. Telehealth is a good option for minor health problems when you can’t see your regular doctor. It is also a convenient choicewhen 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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubA 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 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 AccountRefer to your HSA documentation for more information.HSA Contribution LimitsYou can contribute to your HealthEquity HSA on a pre-tax basis through payroll deductions up to the IRS statutory maximums. The IRS has established the following maximum HSA contributions:2024 Tax Year$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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubThis 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 forHealth 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 monitorsIf enrolled in a HDHP with an HSA, then you can enroll in a limited purpose FSA. Limited 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 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 on our plan through HealthEquity. 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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubSummary of CoverageCoverage Provided by MetLife In-Network Out-of-NetworkAnnual Deductibles(Individual / Family)$50 / $150 $50 / $150Calendar Year Benefit Maximum $1,250 $1,250Preventive Care 100% 80%Basic Procedures 80% after deductible 60% after deductibleMajor Procedures 50% after deductible 40% after deductibleChild Orthodontics50%(Up to age 19)50%(Up to age 19)Orthodontics Lifetime Maximum $1,250 $1,250DENTALBelow 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 Employee $13.52Employee + Spouse $27.87Employee + Child(ren) $32.95Employee + Family $50.85Your Cost (24 Semi-Monthly Deductions)
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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubSummary of CoverageCoverage provided by MetLife In-NetworkVision Exam (once every 12 months)$10 CopayLenses (once every 12 months)$15 CopayFrames (once every 12 months)Up to $200 AllowanceElective Contact Lenses (in lieu of lenses and frames)Up to $200 AllowanceVISIONOur vision coverage is provided by MetLife. Please review your plan documents for additional details.Pricing Per Pay PeriodEmployee $4.95Employee + Spouse $9.92Employee + Child(ren) $8.40Employee + Family $13.85Your Cost (24 Semi-Monthly Deductions)
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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubCoverage provided by MetLifePlan FeaturesEmployee Benefit Amount 1 times your annual earningsMaximum Benefit Amount $200,000Benefit 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.GROUP LIFE and AD&D INSURANCELife Benefit Employee Spouse DependentBenefit Amount $10,000 Increments $5,000 Increments$100 (15 days to 6 months), then choice of $1,000, $2,000, $4,000, $5,000 or $10,000 (6 months to age 26/full-time student)Maximum AmountLesser of 5 times your annual earnings or $500,000Lesser of 50% of employee amount or $100,000$10,000Guarantee Issue (Newly Eligible Employees)$100,000 $25,000 $10,000VOLUNTARY LIFE and AD&D INSURANCECost is age-banded and based on employee’s age. Summary of CoverageSummary 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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubSummary of CoverageCoverage provided by MetLifePlan Features Short-Term Disability Long-Term DisabilityCoverage Paid By North Carolina Football Club North Carolina Football ClubTaxation Benefit is taxed Benefit is taxedEmployee Benefit Amount 60% of Earnings 60% of EarningsMaximum Benefit Amount $1,000/weekly $5,000/monthlyElimination Period 7 days accident / 7 days sickness 180 daysBenefit Duration Up to 25 weeks RBD w/ SSNRADisability 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. DISABILITY INSURANCEPlease note, a pre-existing condition period may apply once you become covered. Please see policy for more information.EMPLOYEE ASSISTANCE PROGRAM (EAP)Our EAP through TELUS Health provides access to professional support and guidance at no cost to you.This program includes up to 5 phone or video consultations per year with licensed counselors.Call 1.888.319.7819 to speak with a counselor or schedule an appointment, 24/7/365For educational tools and resources visit www.metlifeeap.lifeworks.com/Username: metlifeeapPassword: eap
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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubVoluntary 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.WORKSITE BENEFITSCoverage provided by MetLifeAccidentPays a lump sum benefit if you or a covered family member experience an accident. • A set amount is payable based on the injury you suffer and the treatment you receive.• 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. Pet InsuranceDiscounts on products, prescriptions and Veterinary Care. Pet Telehealth available.
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.2024 – 2025 Employee Benefits GuideNorth Carolina Football ClubCarrier ResourcesBENEFIT CARRIER WEBSITEMedical BCBSNC www.blueconnectnc.comHSA HealthEquity www.healthequity.comFSA HealthEquity www.healthequity.comDental MetLife www.metlife.comVision MetLife www.metlife.comLife & Disability MetLife www.metlife.comEAP MetLife / TELUS Health www.metlifeeap.lifeworks.com/Accident MetLife www.metlife.comPet Insurance MetLife www.metlifepetinsurance.comHow to access ID CardsBENEFIT CARRIER HOW TO ACCESSMedical BCBSNCWill receive an ID Card in the mail. Once enrolled, you can also access through the portal (www.blueconnectnc.com) or mobile app.Dental MetLifeOnce enrolled, provider can verify coverage by SS#. Can also access digital card through the portal (www.mybenefits.metlife.com) or mobile app.Vision MetLife Once enrolled, provider can verify coverage by SS#.
EMPLOYEE BENEFITS GUIDEPrepared By Sentinel Benefits Consulting | sentinelra.com2024 - 2025North Carolina Football Club