B E N E F I T G U I D E
Stein Paint is committed to a comprehensive employee benefit program that helps our employees stay healthy, feel secure and maintain a work/life balance.The benefits program was designed to provide you with a competitive level of standard coverage while allowing you the flexibility to choose benefits that reflect your needs and personal circumstances. In addition to receiving health coverage, you have the opportunity to choose additional coverage that best meets your needs.2
The amount you must pay before your insurancecompany starts to pay for covered services eachyear.DEDUCTIBLEA fixed amount you pay for coveredservices such as doctor visit or diagnostic test.CO-PAYMENTSMedical services included in your insurance plan,such as doctor visits, hospital stays and diagnostictests.COVERED SERVICESA doctor or medical facility that is not contracted withyour insurance company. Using out-of- networkproviders can result in you paying a higher portion ofthe medical bills or possibly the entire bill.OUT-OF-NETWORKThe percentage of a medical expense you areresponsible for paying. This usually kicks in afteryou have met your deductible.COINSURANCEThe most you have to pay for covered services in aplan year.OUT-OF-POCKET MAXIMUMThe doctors, hospitals and other medical facilitiesand suppliers that contract with your insurancecompany to provide medical services.IN-NETWORKThe person or facility providing services to you,including doctors, hospitals and pharmacies.PROVIDERTERMS YOUSHOULD KNOW8www.elitebenefitsgroup.comTERMS YOU3
IN - NETWORKOUT - NETWORK Plan70% Participant30% CALENDAR YEAR DEDUCTIONS Individual$3,500 Family$7,000 MAXIMUM OUT OF POCKET Individual$9,100 Family$18,200 OFFICE VISIT Primary Care Visit (non-surgical)$40 copay, then covered at 100% Specialist Visit (non-surgical)$60 copay, then covered at 100% Urgent Care Visit$75 copay, then covered at 100% Preventive CareNo charge. HOSPITAL In-Patient ServicesDeductible and Coinsurance. Out-Patient ServicesDeductible and Coinsurance. Emergency Room$500 copay, then covered at 100% RETAIL PRESCRIPTION Preferred Generic$20 /$50 / $75 EMPLOYEE CONTRIBUTION (WEEKLY) Employee only$0.00 Employee and Spouse$264.75 Employee and Child (ren)$162.27 Employee and Family$392.86Allstate Benefits (Aetna Signature Administrators) is our medical carrier. Below is a brief summary of the medical plan. Using In- Network facilities and physicians will result in significant cost savings to the member. 4www.elitebenefitsgroup.comMEDICALNetwork: Aetna Signature Administratorswww.aetna.com/ASA888-292-0272N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
$2,000, 100% 80% 50%CLASSTYPE OF SERVICEINSURANCE PAYSCLASS APreventive Services100%CLASS BBasic Services80%CLASS CMajor Services50%DENTALN E T W O R K : ( U N U M )Colonial Life Dental insurance can help preserve your smile with easy-to-use coverage that promotes overallwellness. Benefits can help with a variety of dental costs, from routine cleanings to more advancedprocedures.Additional benefits include, no annual rate increases, fully portable and national networks.www.elitebenefitsgroup.comPlan details The benefit year maximum for this plan is $2,000 per person.Class A, B and C services apply toward the benefit year maximum.This plan has a deductible of $50 per person.Families only pay the deductible for a maximum of three people. Applies only to Class B and C Services.The co-insurance for this plan is:Our national dental network offers more than 323,000 access points. Members may choose any dentist butmay receive additional savings by choosing an in-network dentist. Plus, services not covered by this planmay also still be eligible for in-network savings. Out-of-network benefits are paid at the network negotiatedrate.NetworkWWW.COLONIALLIFEDENTAL.COM 1.888.400.93045
EMPLOYEE CONTRIBUTIONS (WEEKLY)Employee$10.13Employer and Spouse$19.36Employee and Child(ren)$23.77Employee and Family$35.48www.elitebenefitsgroup.comOne additional cleaning per 12 months if member is in second or third trimester of pregnancy.-X-raysBitewing X-rays (up to four films; once every 12 months) Full mouth/panoramic x-rays (once every five years)-Children’s services(up to age 14)Fluoride treatment (once every 12 months) Sealants (once every 36 months)Space maintainers (up to age 14; once every 24 months) Adjunctive pre-diagnostic oral cancer screening (for age 40 or older; once every 12 months).Preventive services (Class A)No waiting period-Routine exams and cleanings (twice every 12 months)COVEREDPROCEDURES &WAITING PERIODSOral surgery (extractions and impacted teeth) Anesthesia (subject to review; covered with complex oral surgery) Periodontics (gum treatments)Endodontics (root canals)Inlays and onlaysCrownsBridgesDenturesEndosteal implants (in lieu of an approved three-unit bridge)Major services (Class C) 12 Month Waiting PeriodSimple restorative services (fillings) Simple extractionsEmergency treatmentRepair of crown, denture or bridgeBasic services (ClassB) No waiting period6
Vision rider helps pay for eye exams and materials, such as glasses and contact lenses. This coverage can help youmaintain healthy vision and overall wellness, as well as provide valuable financial protection for you, your spouse anddependent children.www.elitebenefitsgroup.comVISION BENEFITSCOPAYSIN NETWORKOUT OF NETWORK ALLOWENCE Exam (once per 12 months)$10Up to $35 Materials$25See belowSTANDARD PLASTIC LENSES (once per 12 months) Single VisionCovered by co-payUp to $25 BiofocalCovered by co-payUp to $40 TrifocalCovered by co-payUp to $50 Lenticular$80 allowanceUp to $50 Progressive$70 allowanceUp to $40 Polycarbonate lenses (for children to age 19)Covered by co-payN/AFRAMES Choose any frame available at provider locations$120 allowanceUp to $50CONTACT LENSES (once per 12 months) (Includes fit, follow-up and materials in lieu of eyeglass lenses and frames) ElectiveUp to $120 allowanceUp to $100 allowance Medically NecessaryUp to $210 allowanceUp to $210 allowance EMPLOYEE CONTRIBUTION (WEEKLY) Employee only$ 1.44 Employee and Spouse$ 2.85 Employee and Child (ren)$ 3.00 Employee and Family$ 4.70Vision Rider can not be purchased separately.VISIONNetwork: First Look7www.coloniallifedental.com/vision-search888-400-9304
Voluntary Benefits 101What are voluntary benefits?Sometimes called “supplemental insurance,” voluntary benefits are policies you buy to add to the health and life insurance your employer may already provide. These benefits can help you pay for things your other insurance won’t, such as lost wages, out-of-pocket expenses and household bills.Advantages*Flexibility Use claim payments however you like – pay deductibles, co-payments and other expenses not covered by your health or life insurancePortability Take coverage with you if you leave your job or retireStability Maintain coverage whether or not you’re employedConvenience Pay premiums using your choice of payroll deduction, bank dra or direct billingTo learn more about voluntary benefits, contact us at 713-575-3722ColonialLife.comUnderwritten by Colonial Life & Accident Insurance Company, Columbia, SC ©2017 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.Policies Accident insurance Helps cover out-of-pocket expenses in the event of a covered accidentCancer and critical illness insurance Helps with the high cost of cancer or critical illness diagnosis and treatmentDental insurance Helps pay for dental procedures, like routine cleanings, crowns and root canalsDisability insurance Helps replace part of your regular income if you are unable to work because of a covered injury or illnessHospital confinement indemnity insurance Helps pay for covered hospital-related expenses, such as outpatient surgery and diagnostic proceduresLife insurance Protects the people who depend on you by helping cover final expenses and loss of income*Advantages may not apply to all products. See your Colonial Life benefits counselor forcomplete details.8
www.elitebenefitsgroup.comAllstate Benefits - Aetna Signature AdministratorsVision/Dental Plan Supplemental Benefits through Colonial LifeBENEFITS & ELIGIBILITYAs an employee of Stein Paint you have access to the following benefits for the Plan Year August 1, 2024 – July 31, 2025:Core Plan Benefits Offered:Legal Spouse. Children up to age 26, regardless of student status or marital status, including natural children, stepchildren, and legally adopted children (including children living with you before the adoption is final) who are your dependents or for whom you are required to provide health care coverage under a Qualified Medical Child Support Order. WHO IS ELIGIBILE AND WHENAll active full-time Employees, who work at least 30 hours per week. Employee benefits are effective the first of the month following 90 days of active employment.ELIGIBLE DEPENDENTSYou may enroll your eligible dependents in coverage. They include:If you need to change your coverage throughout theyear, you may only do so if you experience an eligiblechange in status/life event, such as:Birth/AdoptionChange in Insurance Coverage, Address,Employment StatusDeath in the FamilyDependent Child Reaches Limiting AgeDivorce/AnnulmentFMLA-Related LeaveLegal Separation/MarriageSpouse Loss of Other CoverageEnrollment in MarketplaceCHANGING YOUR COVERAGEDURING THE YEARYou must make changes to your benefit coverage within 30 days of an eligible change in status/life event.WHAT HAPPENS IF I DON’T ENROLL? If you do not enroll in the benefits program, you will automatically receive “default” coverage, which is:No Coverage.If later on you decide to enroll in benefits, you may be subject to benefit waiting periods, require evidence of insurability, and/or be required to wait until the next Annual Enrollment.9
CONTACT INFORMATIONHEALTHDENTAL / VISIONCOLONIAL LIFEHUMAN RESOURCESELITE BENEFITS GROUP713-575-3722The information in this Enrollment Guide is intended for illustrative purposes and informational purposes only. Theinformation contained herein was taken from various summary plan descriptions, certificates of coverage and benefitinformation. Every effort was taken to accurately report your benefits however discrepancies and errors are alwayspossible. It is not intended to alter or expand rights or liabilities set forth in the official plan documents or contracts. Itis not an offer to contract nor are there any express or implied guarantees. In case of a discrepancy between thisinformation and the actual plan documents, the actual plan documents will prevail. If you have any questions aboutthis summary, please contact Human Resources or Elite Benefits Group10Allstate Benefitswww.aetna.com/asa888-292-0272www.colonialLifedental.com888-400-9304www.colonialLife.com800-325-4368Angie Galicia305-545-8700