Signature Healthcare Physician and Executive Director : simplebooklet.com

IntroductionBenefits for 2024 - 2025 SignatureHealthcareThis booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.2024-2025 Benefit GuideAs an employee of Signature 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 ourorganization.For the 2024 - 2025 plan year, Signature Healthcare has worked hard to offer a competitive total rewards package that includes valuable and competitive benefits plans. These programs reflect our commitment to keeping our staff healthy and secure. We understand that your situation is unique, and Signature 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 Signature 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 ofemployment.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.

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What If I Have Questions?Detailed information on each plan is enclosed in this packet. Please carefully review that information to better understand the coverage each plan provides. If you still have questions after reading your benefits material, you may refer those questions to Human ResourcesCarrier ContactsCarrier Name Website Phone NumberBlue Cross Blue Shield NC www.bluecrossnc.com 888-206-4697Delta Dental of NC www.deltadentalnc.com800-662-8856VSP www.vsp.com800-877-7195The Hartford www.thehartford.com800-523-2233Please keep in mind that each carrier utilizes a specific network of physicians. It is important that you check each physician and facility for network status PRIOR to your appointment. Refer to the below list when you need to contact one of your benefit vendors.Contact InformationWe speak insurance. We’re Here to Help!This booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.2024-2025 Benefit Guide

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TIPEligibility & EnrollmentSignature Healthcare provides an array of benefits that are affordable, comprehensiveand competitive. All employees who work 30 or more hours per week on a regular basis and who are not temporary, seasonal, or contracted labor are eligible for group insurance.When Coverage Begins The Benefits you elect during open enrollment will be effective from April 1, 2024 - March 31, 2025. Newly hired employees are eligible following a 30-day waiting period.o During this waiting period you should fill out all your paperwork, so that you have benefit cards in hand by your coverage effective date. Forms must be completed even if you choose to decline employee-paid coverageOpen Enrollment During open enrollment, you can add, terminate, or change your coverage. Your open enrollment period is held for a two-week period every March. Elections made during open enrollment are effective on April 1st.Eligible Dependents Your legal spouse Children up to age 26 (includes birth children, stepchildren, legally adopted children, and children for whom legal guardianship has been awarded to you or your spouse) Employees must elect a benefit for their dependents to be enrolled.Qualifying Events Eligible employees may enroll or make changes to their benefits elections during the annual open enrollment period. As with most benefits, once you elect an option you are bound to that choice for the entire plan year unless you experience a "Qualifying Event". These may include, but are not limited to:o Changes in employment statuso Changes in legal marital statuso Birth or adoption of a childo Change in child's dependent statuso Death of a spouse, child or other qualified dependento Change in coverage under another employer-sponsored plano Entitlement to Medicare or Medicaido A COBRA-qualifying eventPre-tax deductions save you federal, state and FICA on each premium dollar. If benefits are being deducted pretax, you CANNOT change your benefit selections during the Plan Year unless you have a Qualifying Life Event.2024-2025 Benefit GuideThis booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.

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Plan ComparisonBenefits for 2024 - 2025 SignatureHealthcareThis booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.2024-2025 Benefit GuideSummary of Coverage*The below table illustrates only In-Network coverages. For Out-of-Network coverages please refer to your Summary of Benefits.MedicalPlan BenefitsBlue Options HSA Gold 2750 Blue Options Gold 2500In-Network In-NetworkDeductibleIndividual $2,750 $2,500Family $5,500 $5,000Out-of-Pocket Maximum Includes deductible, coinsurance and copaysIncludes deductible, coinsurance and copaysIndividual $2,750 $6,000Family $5,500 $12,000Office CarePrimary Care Visit Deductible only $25 Copay ($10 virtual visit via Teladoc)*Register your PCP on BlueConnectNC.com and 1st three visits’ copay waived.Specialist Visit Deductible only $50 CopayPreventive Care No Charge No ChargeUrgent Care Deductible only $50 CopayHospital CareInpatient Deductible only Deductible, then 20%Outpatient Deductible only Deductible, then 20%Emergency Room Deductible only $750 CopayPrescription Drugs Retail & Mail Order Service(copay per 30-day supply)Retail & Mail Order Service(copay per 30-day supply)Rx Deductible Medical Deductible n/aTier 1 Deductible only $4Tier 2 Deductible only $15Tier 3 Deductible only $35Tier 4 Deductible only $50Tier 5 Deductible only 25%, min of $50 to a max of $100

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“An ounce of prevention is worth a pound of cure”-Ben FranklinMedicalPayroll DeductionsEMPLOYEE DEDUCTIONS PER PAY PERIOD (26)Medical & PrescriptionEmployee OnlyEmployee & SpouseEmployee & Child(ren)Employee & FamilyBlue Option HSA Gold 2750 $0.00 $337.01 $286.45 $707.71Blue Options Gold 2500 $0.00 $344.70 $293.00 $723.88To find healthcare providers in your area who participate in your network,Visit https://www.bluecrossnc.com/find-a-doctor-or-facility to easily search for a doctor by name, location or specialty.What Preventive Care Services Are Covered?For the most updated list of general preventive/screenings, immunizations, baby/ childcare, women’s preventive care services, nutritional counseling and other services mandated under Federal law, see carrier website listed above.This booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.2024-2025 Benefit Guide

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Medical ClaimsInsult to InjuryHow to Avoid Paying Too Much for Your Medical ExpensesRecovering from illness or injury is bad enough, but if you add piles of mounting medical bills your situation can become overwhelming. Even a short illness or minor injury could generate bills from doctors, the hospital, physical therapists, labs, and more! Health care claims don’t have to be difficult to figure out. It just takes a few simple tricks and soon you’ll be a whole lot clearer about the actual bottom line.What type of plan do you have?• Co-Pay PlansIf you are required to pay a co-pay for a doctor’s office visit or prescription, simply pay for it. Most of the time you will never owe more than the co-pay. If you do receive a bill, question the medical facility as well as your insurance company to make sure that the claim processed correctly.• No Co-Pay Plans (Health Savings, Health Reimbursement)If there is no co-pay attached to the service, you will likely be billed later by the medical facility. Follow these tips for easy tracking:1. When you receive the bill, ALWAYS wait until you receive an Explanation of Benefits (EOB) from your insurance company before you pay something.Did you know invoices from medical facilities are often generated automatically on a monthly basis? Sometimes the insurance company hasn’t even been billed yet!2. Once you receive your EOB, compare it to the latest bill from the medical facility.• How do they match up?• Does the balance match the amount on your EOB?3. Read your EOB carefully. Were things paid for by your insurer as you thought theywould? Ask Questions! Call the insurance company and ask questions. The phonenumber is located on both the EOB and the back of your insurance card.IMPORTANT TIPS TO REMEMBER• Use your resources. Most insurance carriers also provide a website where you can create a user ID and a log on to view your claims. This is a very useful tool!• Stay in Network! If the provider you used was in network, never pay more than what the EOB says you owe, regardless of what the invoice says.• Know your options. An appeal can always be filed if you feel that something was not paid correctly.• Keep track of your expenses. Staple your portion of the invoice to the EOB, then write down the date and the check number or your payment and how much you actually paid.2024-2025 Benefit GuideThis booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.

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Health Savings Account (HSA)What is an HSA?Health Savings Accounts (HSAs) are tax-exempt accounts that can be used for your health care expenses. Money comes out of each paycheck and is deposited into the account for future use. If you have a high deductible health insurance plan, an HSA can help provide some security for your health care costs and limit out-of-pocket expenses.Your money rolls over every year. There is no “use it or lose it” requirement.Advantages of an HSAAn HSA can help you save money and conveniently pay for health care costs.An HSA provides triple tax benefits. Since the deposits are coming straight out of each paycheck, the money you contribute to an HSAis pre-tax and the interest that accumulates in the account is tax free.In addition, money withdrawn from an HSA is not taxed, provided thatyou use it for qualified medical expenses.You can budget how much you want to contribute to your HSA and your unspent money rolls over every year. There is no “use it or lose it” requirement.For example: You have a $1,500 annual deductible health plan and contribute $1,000 each year to an HSA. During that first year you add a total of $1,000 to your HSA and your total health care expenses are $150. If you use the money from your HSA to pay your health care expenses, then your balance at the end of the year will be $850 (not including interest earnings) and will roll over to the next year.Is an HSA right for you?HSA’s can be very cost effective, but they are not for everyone.An HSA is a good option for the two extremes: if you are young and generally healthy OR if you have a chronic condition and/or upcoming surgery but know your annualexpenses.2024 HSA Annual Contribution LimitCoverage Type Individual Family$4,150 $8,300HSA Annual Catch-Up ProvisionFor persons age 55+, all years and all coverage types $1,000The IRS determines the guidelines for qualified HDHPs. The current IRS guidelines are:If enrolled in the HSA plan, your employer contributes$9.61 per payroll ($250 annually) to your Health Savings Account.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 Benefit Guide

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DentalSummary of CoverageDelta Dental PPO Delta Dental Premier Out of NetworkCalendar Year MaximumUnlimitedAnnual Deductible$50 Individual / $150 FamilyPreventiveServices Covered at 100% Covered at 100% Covered at 100%Routineexams3 oral exams per calendar yearCleanings3 cleanings per calendar yearBitewingX-rays1 per calendar yearBasicServices 10% after deductible 20% after deductible 20% after deductibleMajorServices 40% after deductible 50% after deductible 50% after deductiblePeriodontics10% after deductible 20% after deductible 20% after deductibleEndodontics10% after deductible 20% after deductible 20% after deductibleOralSurgery10% after deductible 20% after deductible 20% after deductibleOrthodontia (children up to age 19)50% of covered services up to maxOrthodontia Maximum$1,000 per person total per lifetimeEMPLOYEE DEDUCTIONS PER PAY PERIOD (26)Employee Only $0.00Employee + Spouse $20.61Employee + Child(ren) $34.89Employee + Family $56.01Benefits for 2024 - 2025SignatureHealthcareThis 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 Benefit GuideOut-of-Network DentistsYou can see an out-of-network dentists, however, please note there are no network discounts, you may need to file your own claims and you may be balance billed.To locate an in-network provider, visit www.deltadentalnc.com

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VisionSummary of CoverageIn NetworkExam Copay $10Materials Copay $10Frames $150 allowanceElective Contact Lenses$150 allowanceMedically Necessary Contacts Covered in full after copay(for members who have specific condition)Laser Vision Correction 15% average discountExam Frequency One per 12-month periodLenses Frequency One pair per 12-month periodFrames Frequency One pair per 24-month periodContacts Frequency One pair per 12-month periodEMPLOYEE DEDUCTIONS PER PAY PERIOD (26)Employee Only $2.88Employee + Spouse $5.76Employee + Child(ren) $6.18Family $9.86Benefits for 2024 - 2025SignatureHealthcareThis 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 Benefit GuideTo find vision providers in your area who participate in your network,visit www.deltadentalnc.com/deltavisionto easily search for a doctor by name, location or specialty.

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Benefits for 2024 - 2025 SignatureHealthcarePlan FeaturesLong-Term DisabilityEmployee benefit amount60% of your regular monthly salaryMaximum benefit amount$10,000 per monthElimination period90 daysBenefit durationIf your disability occurs prior to age 63, benefits may continue as long as you are disabled or until the greater of when you reach SSNR or 4 years. If it occurs at age 63 or later, the number of payments may reduce.Long-Term Disability InsuranceSummary of CoverageDisability 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.Long-term disability (LTD) coverage is a type of disability insurance that pays you a set percentage of your regular income after a specified waiting period. For example, if you’re covered under short-term disability (STD) insurance as well, the LTD insurance would kick in once the STD policy is exhausted, typically after three to six months.The length of LTD plans varies—some may be limited to a period between two and 10 years, while other plans continue paying out until age 65.This booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.2024-2025 Benefit GuideCoverage for this benefit is 100% employer paid via salary gross up covering the full premium deduction.

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Benefits for 2024 - 2025 SignatureHealthcarePlan Features Basic Life - GroupEmployee benefit amount $50,000The following shows how much benefits are reduced at certain ages.Age band Benefit reduction65 35%70 additional 35%75 additional 35%80 additional 25%85 additional 25%90 additional 25%95 additional 25%Group Life and Accidental Death & Dismemberment (AD&D) InsuranceSummary of CoverageLife insurance isn’t a fun thing to think about, but, if you have people who depend on you for financial support, then life insurance is really about protecting them in case something happens to you—your designated beneficiary would collect a financial benefit upon your death.Group life insurance coverage is a 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.This booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.2024-2025 Benefit GuideCoverage for this benefit is 100% Employer-paid!

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Benefits for 2024 - 2025 SignatureHealthcarePlan Features Basic Life - VoluntaryGuaranteed Issue amountIncrements of $10,000 up to $150,000Minimum benefit amount $10,000Maximum benefit amountThe lesser of 5x earnings or $500,000Increments of $10,000 up to $150,000, then increments of $50,000 up to a max of $500,000.Spouse benefitUp to $100,000: Increments of $5,000Benefit cannot exceed 50% of employee's benefit or $250,000Over $100,000: Increments of $25,000Employee must elect coverageDependent benefitIncrements of $2,500 up to $10,000Employee must elect coverageThe following shows how much benefits are reduced at certain ages.Benefit Reduction 50% reduction at age 70 for employee and for spouseVoluntary Life and AD&D InsuranceSummary of CoverageVoluntary life insurance is similar to group life insurance, except it is paid for by you. It can provide additional financial security to you family in case the worst happens.With voluntary life insurance, you pay a monthly premium and then your beneficiaries receive a guaranteed amount in the event of your death. Plans are typically flexible and allow you to set your contribution and payment amounts, allowing you more control.While this type of insurance isn’t fun to think about, it can be a vital lifeline for your family.This booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.2024-2025 Benefit GuideEmployees must fill out an Evidence of Insurability (EOI) form if they exceed the guaranteed issue amount.If you do NOT elect to take Voluntary Life coverage at initial offering and wish to elect at a future date, then coverage is no longer guaranteed, and completion of a health questionnaire will be required.

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Online Enrollment OverviewEmployee NavigatorEmployee Navigator allows you to view your benefit options and make benefit elections for you and your family. You can view plan details, coverage amounts and costs. Your family’s information only needs to be entered once, in one place and all carrier application forms will automatically be completed.You will receive an email with a log in link that you will use to register and access Employee Navigator. To go to the Employee Navigator website, click the “Registration” link within the email message.Your “Company Identifier” is provided by HRYou may begin your open enrollment process by clicking the “Start Enrollment” box.Review your personal information and provide any missing information, if needed. Click “Next” once finished. Enter your dependent info before beginning elections.2024-2025 Benefit GuideThis booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.

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Online Enrollment OverviewEmployee NavigatorYou will be guided through your benefit options. Select “Enroll” or “Waive” for yourself and/or your dependents. Provide reason if waiving.Once you have made all of your plan choices you must agree to your elections by clicking the green “Click to Sign” box as seen below.Congratulations! You have completed enrollment.If you ever need to revisit your personal page to review your benefits or plan information you can do so by going to https://www.employeenavigator.com/benefits/Account/Login2024-2025 Benefit GuideThis booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.

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Completion of Enrollment• Pick what products you would like to enroll in!• Go online to Employee Navigator to complete your enrollment.• You will need information on yourself & any dependents you are choosing to enroll, including:• Name• Date of Birth• Social Security Number• Address• GenderRemember:Open Enrollment or New Hire status is your only time to enroll or decline coverages until next year, unless you have a qualifying life event.• What if I want to decline?• That’s perfectly fine! Go online to Employee Navigator to complete your enrollment.You will be given the opportunity to decline any coverage you don’t want to elect.• Remember: You, your spouse and your children are not eligible for a subsidythrough the Marketplace since this medical health plan is being offered anddeemed affordable by the ACA.• Make sure you have provided correct information.• You may run into issues if we have not supplied the carrier with your correct information - i.e., correct spelling of name, social security number, and date of birth for all enrolling.• Your medical I.D. cards will be mailed to your home directly; so, please make sure your address is correct.• See online benefits portal to access your annual notices.Please see your employee booklet for complete coverage, limitations, exclusions, and filing requirements. In the event of a discrepancy between the information contained herein and the information contained in the Plan Document/Summary Plan Description, the Plan Document/Summary Plan Description shall govern benefit determinations.2024-2025 Benefit GuideThis booklet provides only a summary of your benefits. All services described within are subject tothedefinitions, limitations and exclusions set forth in each insurance carrier's or provider'scontract.

Signature Healthcare Physician and Executive Director

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