EMPLOYEE BENEFITSGUIDE2023-2024An overview of the wide array of benefits provided bySylvester & Cockrum 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.2023-2024 Employee Benefits GuideSylvester & CockrumAs an employee of Sylvester & Cockrum, 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 2023-2024 plan year, Sylvester & Cockrum 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 Sylvester & Cockrum 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 Sylvester & Cockrum 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 Day following 90 days of employmentBenefits End Date of TerminationDependents Legal Spouse and children to age 26
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.2023-2024 Employee Benefits GuideSylvester & CockrumCoverage Provided by Blue Cross of NCIn-Network PPO Copay Plan with HRA HDHP with HSABenefit Period Plan Year: 7/1 – 6/30 Plan Year: 7/1 – 6/30Deductibles (Individual / Family) $5,000/$10,000 $7,500/$15,000Out-of-Pocket Max (Individual / Family)$9,100/$18,200 $7,500/$15,000Preventive Care 100% covered 100% coveredPrimary Care Visit$35 Copay(register your PCP on BlueConnect.com and the 1stthree visits’ copay waived)0% after deductibleSpecialist Visit $70 Copay 0% after deductibleTelehealth via Teladoc $10 Copay 0% after deductibleUrgent Care $70 Copay 0% after deductibleEmergency Room $500 Copay 0% after deductibleOutpatient Care 30% after deductible 0% after deductibleInpatient Care 30% after deductible 0% after deductiblePharmacy / RX (30 Day Supply)Essential FormularyTier 1-5: $10/$30/40%/60%/60% $100 per prescription max for each 30-day supply of tier 3, 4 & 5 drugsEnhanced Preventive: 0%All Others: 0% after deductibleMEDICALThe chart below is an overview of the In-Network benefits of our Blue Options plan offerings. The following page has our High Performance Network offerings. Out-of-Network benefits are available for the plans below; 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.2023-2024 Employee Benefits GuideSylvester & CockrumCoverage Provided by Blue Cross of NCIn-NetworkHigh Performance NetworkCopay Plan with HRAHigh Performance NetworkHDHP with HSABenefit Period Plan Year: 7/1 – 6/30 Plan Year: 7/1 – 6/30Deductibles (Individual / Family) $5,000/$10,000 $6,000/$12,000Out-of-Pocket Max (Individual / Family)$9,100/$18,200 $6,000/$12,000Preventive Care 100% covered 100% coveredPrimary Care Visit$35 Copay(register your PCP on BlueConnect.com and the 1stthree visits’ copay waived)0% after deductibleSpecialist Visit $70 Copay 0% after deductibleTelehealth via Teladoc $10 Copay 0% after deductibleUrgent Care $70 Copay 0% after deductibleEmergency Room $500 Copay 0% after deductibleOutpatient Care 30% after deductible 0% after deductibleInpatient Care 30% after deductible 0% after deductiblePharmacy / RX (30 Day Supply)Essential FormularyTier 1: $10 CopayTier 2-5: 100% up to $200 per prescription max for each 30-day supplyEnhanced Preventive: 0%All Others: 0% after deductibleMEDICALThe chart below is an overview of the benefits of our High Performance Network offerings. 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.2023-2024 Employee Benefits GuideSylvester & CockrumHEALTH REIMBURSEMENT ACCOUNT (HRA)Sylvester & Cockrum has set up an HRA to help offset the out-of-pocket medical deductible expenses incurred by our members enrolled in the Blue Options Copay Plan or the High Performance Network Copay Plan. How Does an HRA Work?• Employees enrolled in the Blue Options Copay Plan or the High Performance Network Copay Plan are eligible to utilize the HRA. • The HRA is funded by Sylvester & Cockrum.• The HRA will reimburse covered, in-network, medical deductible expenses based on the schedule below. • The HRA will not reimburse non-covered, out-of-network, copays or non medical plans such as dental or vision claims.Employee Responsibility First Sylvester & Cockrum Reimburses NextIndividual $1 - $1,500 $1,501 - $5,000Family $1 - $3,000 $3,001 - $10,000Filing a ClaimOnly eligible expenses can be reimbursed under your HRA. Once you meet the thresholds above then you can submit for reimbursement through Flores & Associates website: www.flores247.com. Claims must be filed by the claims deadline.Refer to your HRA documentation for more information.
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.2023-2024 Employee Benefits GuideSylvester & CockrumWellness 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 Sylvester & Cockrum, 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 PeriodBlue OptionsCopay Plan with HRABlue OptionsHDHP with HSAHigh Performance NetworkCopay Plan with HRAHigh Performance NetworkHDHP with HSAEmployee $50.05 $38.58 $39.58 $36.92Employee + Spouse $241.47 $186.22 $176.85 $164.98Employee + Child(ren) $167.66 $129.31 $119.47 $111.45Employee + Family $390.38 $301.01 $294.84 $275.05Your Weekly Cost
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.2023-2024 Employee Benefits GuideSylvester & CockrumEmployees 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 1-800-835-2362Refer 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.2023-2024 Employee Benefits GuideSylvester & CockrumA 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 is 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 Health Equity HSA on a pre-tax basis through payroll deductions up to the IRS statutory maximums. The IRS has established the following maximum HSA contributions:2023 Tax Year 2024 Tax Year$3,850 Individual / $7,750 Family $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.2023-2024 Employee Benefits GuideSylvester & CockrumSummary of CoverageCoverage Provided by Principal In-NetworkAnnual Deductibles(Individual / Family)$25/$75Preventive Care 100%Basic Procedures (extractions, fillings, etc.)100% after deductibleMajor Procedures(crowns, dentures, etc.)60% after deductibleCalendar Year Maximum Benefit $1,000 per person per calendar yearMaximum AccumulationRollover $250 per year up to a maximum of $1,000(to qualify have at least one service per year with benefits paid under the $500 threshold)DENTALBelow 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 PeriodEmployee $6.92Employee + Spouse $13.84Employee + Child(ren) $14.83Employee + Family $25.04Your Weekly Cost
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.2023-2024 Employee Benefits GuideSylvester & CockrumSummary of CoverageCoverage provided by Principal In-NetworkVision Exam (Once per plan year) $10 CopayLenses (Once per plan year) $25 CopayFrames (Once every 2 years)$25 Copay up to $130 allowance; plus discount on remaining balanceStandard Contact Lenses Fit & Follow Up Exam Up to $60 CopayElective Contact Lenses $25 CopayMedically Necessary Contact Lenses Covered up to $130 in leu of glassesVISIONOur vision coverage is provided by Principal. Out-of-Network coverage is available. Please review your plan documents for additional details.Pricing Per Pay PeriodEmployee $1.26Employee + Spouse $2.40Employee + Child(ren) $2.52Employee + Family $3.72Your Weekly Cost
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.2023-2024 Employee Benefits GuideSylvester & CockrumSummary of CoverageCoverage provided by The HartfordPlan FeaturesEmployee Benefit Amount $25,000AD&D Benefit $25,000Group 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 INSURANCESummary of CoverageLife Benefit Employee Spouse DependentAmount $10,000 increments $5,000 increments $10,000Maximum AmountLesser of 5 x earnings or $200,000Lesser of 50% of employee coverage or $25,000$10,000Guarantee Issue (Newly Eligible Employees)$150,000 $25,000 $10,000Evidence of Insurability Required for late entrants and amounts over the GIRequired for late entrants and amounts over the GINAVOLUNTARY LIFE and AD&D INSURANCEFor summary of rate sheet, please see carrier summary or Employee Navigator.
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.2023-2024 Employee Benefits GuideSylvester & CockrumSummary of CoverageCoverage provided by The HartfordPlan Features Short Term Long TermCoverage Paid By Employee EmployeeTaxation Post Tax Deductions Post Tax DeductionsEmployee Benefit Amount 60% of your weekly earnings 60% of your monthly earningsMaximum Benefit Amount $1,000 per week $6,000 per monthElimination Period (Accident & Sickness)7 days 90 daysBenefit DurationUp to 12 weeks (including elimination period)Your Social SecurityNormal Retirement AgeEvidence of Insurability Required for late entrants Required for late entrantsDisability 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.
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.2023-2024 Employee Benefits GuideSylvester & CockrumVoluntary Benefits are offered to assist employee's personal insurance needs. These programs, offered through The Hartford, are designed to fill the gaps in coverage such as your deductibles and co-insurance under your major medical.Worksite BenefitsHospital IndemnityPays a cash benefit if you or a covered family member are confined in a hospital for a covered illness or injury. The benefits are paid in lump sum amounts and can help offset expenses.AccidentPays a lump sum benefit if you or a covered family member experience an accident. Coverage can be purchased for employee and dependents.Critical IllnessPays a lump sum benefit should a covered family member experience a heart attack, stroke or other covered serious illnesses.Additional Hartford ServicesThe Hartford offers additional services through their voluntary products. These may include Ability Assist Counseling, Health Champion, Estate Guidance, Travel Assistance and more. Please see The Hartford 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.2023-2024 Employee Benefits GuideSylvester & CockrumCarrier ResourcesBENEFIT CARRIER GROUP # PHONE NUMBER WEBSITEMedical BCBSNC 14162123 888-206-4697www.bluecrossnc.comHRA Flores and Associates 800-532-3327 www.flores247.comDental & Vision Principal 1128755 800-843-1371 www.principal.comLife, Disability & Worksite The HartfordGLT/GRH-891366860-547-5000www.thehartford.com/employee-benefits/employeesHow to access ID CardsBENEFIT CARRIER HOW TO ACCESSMedical BCBSNCHard copy ID cards are issued and mailed to your home address; electronic copies can be accessed via www.bluecrossnc.comDental & Vision PrincipalHard copy ID cards are issued and mailed to your home address; electronic copies can be accessed via www.principal.com
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.2023-2024 Employee Benefits GuideSylvester & CockrumThis page was intentionally left blank
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