2024-BenefitsGuide-V16-Final
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2024 BENEFITS GUIDE
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Welcome to Reliance Rewards 2024 Reliance and its Family of Companies is committed to providing a safe and healthy work environment. It is our priority to maintain a strong benefits package with flexible plans to protect you and your family against unforeseen circumstances as well as opportunities to improve your health and wellbeing. Alongside our industry-leading operational results, we are pleased to offer medical, pharmacy, dental, and vision coverage in which your share of the cost is much lower than the national average. On average, Reliance pays over 91% of the claims cost for the medical/pharmacy plans, which is significantly above the industry average. Our health and welfare programs, which we call Reliance Rewards, are designed to promote peace of mind and good health for you and your family. These programs provide access to affordable, high quality, and comprehensive coverage that reflects our strong commitment to your wellbeing. This Reliance Rewards Benefits Guide provides information that you will need to know about your 2024 benefits. Please take time to read it carefully so you can make the best coverage choices for you and your family. You can find additional information by logging in to the company intranet, RELIANCEroots (www.relianceroots.com) and clicking on “Reliance Rewards” under the “Employee Resources” section.
Table of Contents Reliance Rewards Benefits Eligibility���������������������������������������������������������������������������������������������������������������������������������� 2 Electing Your Benefits ��������������������������������������������������������������������������������������������������������������������������������������������������������� 2 Enrolling in Reliance Rewards��������������������������������������������������������������������������������������������������������������������������������������������� 2 2024 Monthly Employee Contributions�������������������������������������������������������������������������������������������������������������������������������� 3 wellness@reliance. ............................................................................................................................................................. 3 Changing Your Benefits ������������������������������������������������������������������������������������������������������������������������������������������������������� 8 Medical Benefits������������������������������������������������������������������������������������������������������������������������������������������������������������������ 9 Medical Benefits Plan Feature Comparison ���������������������������������������������������������������������������������������������������������������������� 11 Prescription Drug Benefits ������������������������������������������������������������������������������������������������������������������������������������������������ 12 Dental Benefits������������������������������������������������������������������������������������������������������������������������������������������������������������������ 14 Vision Benefits ������������������������������������������������������������������������������������������������������������������������������������������������������������������ 14 Flexible Spending Accounts ���������������������������������������������������������������������������������������������������������������������������������������������� 15 Life and Accidental Death & Dismemberment Benefits����������������������������������������������������������������������������������������������������� 16 Disability Benefits ������������������������������������������������������������������������������������������������������������������������������������������������������������� 18 Employee Assistance Program������������������������������������������������������������������������������������������������������������������������������������������ 19 Reliance Rewards Dependent Verification ������������������������������������������������������������������������������������������������������������������������ 20 Working Spouse Provision������������������������������������������������������������������������������������������������������������������������������������������������� 20 When Coverage Ends��������������������������������������������������������������������������������������������������������������������������������������������������������� 21 Required Notices ��������������������������������������������������������������������������������������������������������������������������������������������������������������� 22 Resource Directory������������������������������������������������������������������������������������������������������������������������������������������������������������ 29
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Reliance Rewards Benefits Eligibility
ELIGIBLE EMPLOYEES You are eligible to participate in the Reliance Rewards benefits plans if you are an active, full-time employee regularly scheduled to work 30 or more hours per week. If you are a member of a union, please refer to your Collective Bargaining Agreement or ask your local HR representative about benefits eligibility. ELIGIBLE DEPENDENTS Eligible dependents include your spouse, domestic or civil union partner, natural children, stepchildren or legally adopted children, children for whom you are the legal guardian, or children of your domestic or civil union partner. See the dependent verification required documentation section on page 20.
IS YOUR SPOUSE OR CHILD ALSO AN ELIGIBLE EMPLOYEE? Your spouse or child may not be covered as both a Dependent and an Employee.
Electing Your Benefits New employees must enroll themselves and their eligible dependents in Reliance Rewards within the first 30 days of their hire date. Once enrolled, benefits will be effective on the 31st day after hire, unless otherwise specified in a collective bargaining agreement. All employees must make separate elections to enroll or waive participation in Medical, Dental, Vision, and Flexible Spending Accounts (FSA). Your contributions for these benefits are deducted from your paycheck on a pre-tax basis. Reliance Rewards provides basic insurance coverage for Life, Accidental Death and Dismemberment (AD&D) and Short-Term Disability (STD), as well as access to the Employee Assistance Program (EAP) at no cost to employees. You can purchase supplemental Employee Life, Dependent Life, and AD&D, and Supplemental Employee STD. Enrollment is required for the supplemental coverages.
WHEN DO I ENROLL? You must enroll within the first 30 days of your date of hire or Qualifying Life Event. Otherwise, you must wait until the next Annual Enrollment.
Enrolling in Reliance Rewards
BEFORE ENROLLING Review this Benefits Guide to learn about the benefits available under Reliance Rewards. We recommend you log in to www.benefitenroll.com, download, print, and complete your personalized Enrollment Worksheet. If you are making changes to your dependents’ benefits or other information, gather all necessary legal names, birth dates, and Social Security numbers.
ENROLL ONLINE OR BY PHONE
GO ONLINE to www.benefitenroll.com and log in: User ID: First initial, full last name, and the last 4 digits of your SSN (e.g., jdoe1234) Temporary Password: Last 4 digits of your SSN (e.g., 1234)
CALL the Reliance Rewards Call Center 855-RRR-WARD (855-777-9273) Monday through Friday, 8 a.m. to 8 p.m. ET
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2024 Monthly Employee Contributions
The table below shows your 2024 Medical, Dental, and Vision monthly contributions, which depend on the plan you choose and the number of dependents you cover. We encourage you to do your part to moderate plan costs, and future cost increases, by participating in wellness@reliance and using in-network providers. Actual paycheck deductions for your elected benefits and coverage tiers are based on your payroll frequency. Contributions for medical, dental, and vision plans are deducted from your paycheck on a pre-tax basis, resulting in tax savings for you.
IF THEWELLNESS BONUS IS APPLIED, MONTHLY MEDICAL PLAN RATES CAN BE OFFSET BY
PERMONTH!
COVERAGE TIER
HIGH PPO PLAN LOW PPO/ SAVER PLAN
DENTAL
VISION
Employee
$159
$85
$5
$2
Employee & Spouse
$306
$170
$10
$5
Employee & Child(ren)
$248
$120
$9
$5
Employee & Family
$358
$185
$15
$8
Working Spouse Provision (Additional)*
$200
$200
*See page 20 for the reference as to whether this additional cost applies
wellness@reliance
Maintaining a positive culture of health and wellbeing is important to us – it’s who we are! That’s why we proudly sponsor our corporate wellness program, wellness@reliance. A variety
of wellness activities, programs, and resources are offered through wellness@reliance to support the health of our employees and their families. Your commitment to your and your family’s health, combined with your medical plan coverage decisions are all inter-related and part of our overall benefits program. Healthy living makes everyday life more enjoyable whether you’re at work, at home, on the road, or anywhere in between. wellness@reliance is a voluntary program, and participation is not required to receive any other benefits offered by Reliance. When you take advantage of wellness@reliance, you are investing in your personal health and wellbeing, while also positively impacting our ongoing culture of overall wellness. We want to reward you for doing this! That’s why we offer a Wellness Bonus for employees and spouses/domestic partners enrolled in a Reliance Rewards medical plan who participate in and achieve certain quarterly wellness@reliance goals. Reliance partnered with WebMD, an independent wellbeing company, to offer a practical and engaging wellness program and to provide administration and program support for wellness@reliance. This partnership allows you to access mobile and online tools to support you and your unique wellbeing journey. See the “Access Your Wellness Account” section (page 5) for information on how to login or create your account via app or online.
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How the Wellness ProgramWorks The Wellness Plan operates on a calendar year basis (January through December) and promotes year-round engagement with the “Gateway +10 +10 +10” program design. JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Q1 Q2 Q3 Q4 Gateway Activities +10 Points +10 Points +10 Points $150 Wellness Bonus $150 Wellness Bonus $150 Wellness Bonus $150 Wellness Bonus
$300 Wellness Bonus (when your spouse or domestic partner participates)
$300 Wellness Bonus (when your spouse or domestic partner participates)
$300 Wellness Bonus (when your spouse or domestic partner participates)
$300 Wellness Bonus (when your spouse or domestic partner participates)
This table shows a traditional, full-year participation schedule
What are Gateway Activities? The Wellness Questionnaire and Biometric Screening are called “Gateway Activities” because you must complete them both before you can start to earn Wellness Activity Points. As soon as you complete your Gateway Activities, you will earn your first Wellness Bonus in that quarter. BIOMETRIC SCREENING A Biometric Screening is a short, confidential, no-cost health examination that provides a snapshot of your current health status and helps determine your risk level for certain diseases and medical conditions. Understanding this information can help you take positive steps toward a healthier future, including saving on healthcare costs. The following values are measured during a Biometric Screening: • Height and weight – used to calculate body mass index (BMI) • Waist circumference • Systolic blood pressure • Diastolic blood pressure • Total cholesterol • HDL cholesterol • LDL cholesterol • Blood sugar • Triglycerides
There are three options to complete your Biometric Screening. 1. On-site Screenings will take place at many company locations from January through March. Results will automatically be synced with your wellness account within 10 business days of your screening. 2. You canmake an appointment at a participating Quest Patient Service Center (Lab) (“Quest”) near you to have your screening completed. Appointmentsmust be scheduled on theWAYS app or online at www.wellnessatreliance.com. Your results will automatically be synced with your wellness account within 10 business days of your screening. 3. You can request that your physician complete the Physician Form with the results of your most recent biometric screening if that screening took place within the current plan year. You are responsible for submitting the completed Physician Form to Quest. Screening credit will be awarded in the quarter that the Physician Form is received by Quest, not the quarter the screening occurred.
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WELLNESS QUESTIONNAIRE The Wellness Questionnaire is a brief, confidential online survey that asks about your health and daily habits relating to such things as: • Demographic characteristics (age, gender) • Lifestyle (physical activity, diet, smoking, stress)
• Physiological data (weight, height, blood pressure, cholesterol) • Attitudes and motivation to change behavior to improve health
Once completed, you will receive an analysis of your results that may include targeted, practical advice for making the most of the wellness@reliance program offerings. Results will also inform you if you are at risk for certain health conditions. You can access the Wellness Questionnaire on the WAYS app or at www.wellnessatreliance.com.
Access Your Wellness Account Reliance’s partnership withWebMD gives you access to tools and resources that can help you reach your personal health and wellbeing goals. This includes a mobile app (WebMDWellness At Your Side™) and a wellness website (www. wellnessatreliance.com). Already have an account? Log in today to start participating. Don’t have an account yet? It’s easy to create an account on the WAYS app or online. All wellness@reliance participants must create their own individual wellness account.
Mobile App: WebMD Wellness At Your Side TM Free to download! When prompted for the connection code, enter: reliance
Wellness Bonus To promote the continued health and
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wellness of our employees, Reliance will pay a $150 quarterly Wellness Bonus (up to $600 annually) to employees and their spouse/ domestic partner enrolled in a Reliance Rewards medical plan who participate in and achieve certain wellness@reliance goals. Bonuses will be processed via company payroll shortly after the end of each quarter. Only those who are enrolled in a Reliance Rewards medical plan on the last day of each calendar quarter and are employed by Reliance when bonuses are paid are eligible to receive the Wellness Bonus. *When an incentive-eligible Reliance employee and their incentive-eligible spouse/domestic partner both participate, the employee can receive up to $1,200 in Wellness Bonuses annually.
Gateway Activities
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Earning Wellness Points After completing theGateway Activities, it’s time to earnWellness Points. Complete any of the following activities to earn a total of 10Wellness Points each quarter so that you continue earning your quarterlyWellness Bonuses. Note that Points do not roll over fromquarter to quarter –make sure you earn at least 10 Points each quarter to receive your quarterlyWellness Bonus.
ACTIVITY
DESCRIPTION
POINTS
COACHING PROGRAMS HEALTH COACHING
A one-on-one program designed to provide tools and support on a variety of topics. Earn 10 Points each time you complete three telephonic or virtual calls with your WebMD Health Coach. This offering fromWebMD integrates telephonic coaching and online resources. Earn 10 Points each time you complete three telephonic or virtual calls with your WebMD Tobacco Treatment Specialty Coach. This program offers personalized support and guidance before more complex health issues arise. If eligible, you will be contacted by the health guides. If you choose to participate, you will earn 10 Points each time you complete three calls with your Anthem Total Health, Total You Select health guide. Reliance has partnered with WW (formerly Weight Watchers) to offer you 50% savings on both their traditional and digital programs. Earn 10 Points upon registration and an additional 10 Points each quarter that you are enrolled and actively participating in WW. Select from a variety of lifestyle and condition management plans and stay engaged by completing simple daily tracking. Daily Habits plans range in duration from 28 to 84 days, depending on the topic. Earn 10 Points per completed plan. Track daily steps on the wellness website, the WAYS app, or by syncing your device. Earn 10 Points each quarter when you reach 350K steps. (Tip: Aim for approximately 4,000 steps per day.) Step total resets to zero each quarter. Choose from 40 different activities such as golf, tennis, swimming, and strength training. Earn 10 Points each quarter when you reach 240 minutes of physical activity. (Tip: Aim for at least 10 minutes of physical activity on at least 2 days each week.) Activity minutes total resets to zero each quarter.
10 per quartermax
WEBMD TOBACCO CESSATION COACHING
10 per quarter max
ANTHEM TOTAL HEALTH, TOTAL YOU SELECT PROGRAM
10 per quarter max
WW
10 per quarter
DAILY ONLINE ACTIVITIES DAILY HABITS
10 per completed plan (10max per quarter)
DAILY STEPS TRACKING
10 per quarter
DAILY PHYSICAL ACTIVITY TRACKING
10 per quarter
CHALLENGES WELLNESS ACTIVITY CHALLENGES
Challengeswill be offered throughout the programyear. Duration and completion criteriawill vary; detailswill be promoted prior to start date.
5 per completed challenge
SELF-REPORTED ACTIVITIES PREVENTIVE CARE – ROUTINE CHECKUPS PREVENTIVE CARE – EXAMS & VACCINATIONS
Stay up to date with your routine checkups: – Colonoscopy Stay up to date with your exams and vaccinations: – Dental Exam – Vision Exam – Flu Vaccine – COVID Vaccine
10 per checkup (10 max per quarter) 5 per exam or vaccination (10 max per quarter) 5 per event (5 max per quarter) 5 per event (10 max per quarter) 5 per webinar (5 max per quarter) 5 per topic (5 max per quarter) 5 per podcast or video (10 max per quarter)
– Mammogram – Annual Physical
COMMUNITY EVENTS
Any eligible community event, including walks/runs, or volunteering.
COMPANY-SPONSORED EVENTS
Any approved company-sponsored event, such as a lunch and learn, an activity fair, or another on-site wellness event. Self-report participation in up to two company- sponsored events per quarter. Anthem’s Employee Assistance Program (EAP) offers online Wellness Webinars with new health and wellness topics each month.
EAP WELLNESS WEBINARS
FIDELITY 401(K) FINANCIAL WELLNESS RESOURCES
Online webinars on a variety of financial wellness topics are available through Fidelity.
PODCASTS & VIDEOS
Choose a wellbeing podcast or video from the selection available on the wellness portal. Listen/view the topic of your choice to earn Points.
CERTIFICATIONS
Stay up to date with your certifications: – Volunteer First Responder – CPR – First Aid
5 per programyear
THE BETTER NUTRITION PROGRAMWEBINARS
Join a live quarterly nutrition webinar or view the recording to earn Points. Webinars hosted by The Better Nutrition Program.
5 per webinar (5max per quarter)
If you are unable to complete an activity in the wellness program due to your health status, you might qualify for an opportunity to earn the same Points by different means. Contact WebMD customer service at 800-721-2798 and they will work with you to find wellness activities that are right for you.
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Wellness Points Do Not Carry Over While we encourage you to take part in all wellness activities available and of interest to you, Points earned do not carry over from quarter to quarter. For example, if you record 20 Points in the second quarter and zero Points in the third quarter, you will not receive a Wellness Bonus for the third quarter. Make sure to earn at least 10 Points every quarter.
Privacy The privacy and security of your personal information is extremely important to Reliance. The Gateway Activity (Wellness Questionnaire and Biometric Screening) information collected will be treated in a confidential manner. Individual results will only be seen by those employees of WebMD Health Services Group, Inc. who are collecting the samples and reporting the results. Neither Reliance Steel & Aluminum Co. nor any of its subsidiaries will have access to your individual Wellness Questionnaire or Biometric Screening results. Moreover, neither Reliance nor any of its subsidiaries will see your Wellness Point totals or activities. WebMD can only use and share your Protected Health Information (PHI) pursuant to the provisions of the Health Insurance Portability and Accountability Act (HIPAA). This includes using PHI for routine benefit plan operations. For example, WebMD may contact you about your biometric screening results. They may also share the results of your biometric screening with one of their health coaches or with a Reliance Rewards medical carrier. Eligibility All U.S. employees of Reliance Steel & Aluminum Co. and its subsidiaries are eligible and encouraged to participate in wellness@reliance. Spouses/Domestic partners enrolled in a Reliance Rewards medical plan are also eligible. While the program is open to all employees, only those enrolled in a Reliance Rewards medical plan on the last day of each calendar quarter, and who are active employees on the date the Wellness Bonus is paid, are eligible to receive the Wellness Bonus, as described below. Newly hired or rehired employees Newly hired or rehired employees and their spouse/domestic partner (if enrolled in a Reliance Rewards medical plan) are eligible to participate in wellness@reliance once they have access to the wellness website. Note that this may take up to three weeks after hire or rehire date for employees; it may take longer for spouses/domestic partners due to the timing of the Reliance Rewards enrollment. Employee transfers Transferring within the Reliance Family of Companies has no impact on eligibility for wellness@reliance. Changes in Reliance Rewards medical plan coverage during the wellness plan year There is no impact to wellness plan eligibility if an employee’s Reliance Rewards medical coverage is dropped for any reason (e.g., voluntarily due to a qualifying life event or involuntarily due to a reduction in work hours) during the wellness plan year. However, it may affect Wellness Bonus eligibility. If the medical coverage for a spouse/domestic partner is dropped during the year, they are no longer eligible to participate in wellness@reliance or receive the Wellness Bonus.
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Changing Your Benefits
QUALIFYING LIFE EVENTS Qualifying Life Events allow you to make changes to your benefit elections during the Plan year. The requested change must be consistent with the event. For example, if your spouse/domestic partner and/or dependent children lose coverage under their employer’s medical plan, you can add them to your medical plan. The change in coverage will be effective retroactive to the Qualifying Life Event date, and you must provide proof consistent with the event. In the example above, if your spouse/domestic partner loses coverage under their employer’s medical plan, you would need to provide proof of the loss of coverage as well as eligibility documentation for any newly added dependents.
To make a change to your benefit elections due to a Qualifying Life Event, go to www.benefitenroll.com or call the Reliance Rewards Call Center at 855-777-9273.
ANNUAL ENROLLMENT You can change your benefit elections during Annual Enrollment in the fall each year. Benefit elections are effective for the following plan year, January 1 through December 31. During Annual Enrollment you have the opportunity to: • Make changes to your current benefits • Add or remove dependents or beneficiaries • Enroll in the 2024 Healthcare FSA and/or Dependent Day Care FSA If you are enrolled in the Saver Plan, you may: • Enroll in the Limited Purpose Flexible Spending Account (LPFSA); and/or • Enroll in you Health Savings Account (HSA)— Contribution changes can be made at any time during the plan year
CHANGES TO YOUR BENEFIT ELECTIONS MUST BE MADEWITHIN 30 DAYS OF THE QUALIFYING LIFE EVENT; OTHERWISE, YOUMUSTWAIT UNTIL THE NEXT ANNUAL ENROLLMENT.
EXAMPLES OF QUALIFYING LIFE EVENTS
MARRIAGE, DIVORCE, OR ANNULMENT
SPOUSE OR CHILD GAINS OR LOSES OTHER COVERAGE
BIRTH OR ADOPTION OF A CHILD
For more information on Qualifying Life Events and required Eligibility Documentation, refer to “How Your Qualifying Life Events Affect Your Benefits” on RELIANCEroots (go to “Employee Resources” and click “Reliance Rewards,” then click on “How to Enroll &Make Changes” from the left navigation menu, and click on the “Changing Your Benefits” tab on the right).
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Medical Benefits
HIGH PPO PLAN The High PPO Plan is the most comprehensive of the plans. It has the lowest deductible and covers your expenses at a higher coinsurance rate. The plan also offers the lowest primary care and specialist copays and lowest out-of-pocket limits. Overall, the High PPO Plan requires a higher monthly contribution, but offers lower out-of-pocket costs when medical services are utilized. LOWPPO PLAN The Low PPO Plan is the next most comprehensive plan. The deductibles are higher, and your medical expenses are covered at a lower coinsurance. In this plan, the copays and out-of-pocket limits are higher. Overall, the Low PPO Plan offers a lower monthly contribution, but requires higher out-of-pocket costs when medical services are utilized. SAVER PLAN The Saver Plan is a High Deductible Health Plan (HDHP) which carries a higher deductible with higher out-of-pocket limits. In an HDHP, you pay the cost of the doctor’s office visits and prescription drugs until you meet the Plan’s annual deductible. Although this plan is good choice for some people, it may not be the best choice for others. For example, if you do not have the financial means to cover the full deductible amount in the event of a large medical expense, this plan may not be right for you. If the Saver Plan is of interest to you, we highly recommend you visit the Fidelity NetBenefits website (www.netbenefits.com) for detailed Health Savings Account (HSA) information. Health Savings Account (HSA) for Saver Plan Participants If you enroll in The Saver Plan, Reliance will contribute $250 per year for those effective between January 1 - June 30. For those effective between July 1 and December 31, Reliance will contribute $125 to your Health Savings Account (HSA). You can also contribute to your HSA. Your contributions can be made every pay period via payroll deduction before federal taxes and before most state taxes. The money in this account can be used for qualified healthcare expenses, such as the annual deductible and coinsurance, or future qualified medical expenses. This account can accumulate on a tax-free basis, and withdrawals to pay for qualified medical expenses are free from federal income taxes (state taxation rules vary from state to state). Funds can roll over from year to year, as the HSA does not have a yearly “use it or lose it” feature. If you pay for your current qualified medical expenses out of pocket, your HSA funds can be used to pay for expenses in your retirement. You must enroll in the Saver Plan to be eligible to contribute to the HSA.
KEY FEATURES OF THE HIGH AND LOW PPO MEDICAL PLANS COPAY The flat dollar amount you pay for each office visit when you go to an in-network doctor or a specialist. Copays do not apply towards your deductible. Copays apply towards the out-of-pocket limit. ANNUAL DEDUCTIBLE The amount you pay for all other medical services before the plan begins to pay. COINSURANCE This is your share of the cost after you have met your deductible. OUT-OF-POCKET MAXIMUM The plan limits the amount you pay for eligible out-of-pocket medical and prescription drug services during the plan year. Copays, deductibles, and coinsurance all count toward your annual out-of-pocket maximum. Once the out- of-pocket maximum has been met in the calendar year, the plan pays 100% of your eligible expenses for the rest of the year. IN-NETWORK VS. OUT-OF- NETWORK You may select any medical provider in the Anthem Blue Cross network, or any licensed medical provider outside the network. Electing in-nework providers can save you and/or your covered family members money on medical expenses. In-network care is subject to a lower deductible and reimbursed at a higher coinsurance rate. Out-of-network care is subject to a higher deductible and is reimbursed at a lower coinsurance percentage. It may also include possible balance billing for reasonable and customary fee adjustments.
IN- AND OUT-OF-NETWORK DEDUCTIBLES AND OUT-OF- POCKET LIMIT
Both in- and out-of-network deductibles and coinsurance limits cross apply. This means that in network expenses count toward your out-of-network limits, and vice versa.
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What type of expenses does an HSA cover? You can use your HSA to pay for medical expenses that are not covered by a health plan and meet the IRS definition of a qualified medical expense for you, your spouse, and dependents. See IRS Publications 969 and 502 at www.irs. gov. Many medical and health expenses are covered by an HSA: • Health plan deductibles and coinsurance • Prescription drugs and insulin • Medical care and services • Dental and vision care (after deductible has been met) Understanding the Reliance Saver Plan The Saver Plan requires you to pay more of your medical expenses upfront before the plan begins to pay. Below is an example of how the Saver Plan would work compared to the High and Low PPO Plans. Note: In-network medical expenses include discounts and negotiated rates. Out-of-network medical expenses can cost you much more than the examples below.
LOW PPO PLAN You Pay 20% In-Network $850 Individual Deductible
SAVER PLAN You Pay 20% In-Network $1,600 Individual Deductible
HIGH PPO PLAN You Pay 10% In-Network $300 Individual Deductible
Medical Expense (In-Network) $100 Specialist Office Visit
Plan Pays
You Pay
Plan Pays
You Pay
Plan Pays
You Pay
$35 Copay No Deductible
$40 Copay No Deductible
$100 towards Deductible
$65
$60
$0
$200 Generic Preventive Rx
No Copay No Deductible
No Copay No Deductible
$200
$200
$200
$0
$125 Generic Non-Preventive Rx
$10 Copay No Deductible $300 towards Deductible + $50 (10% Coinsurance)
$10 Copay No Deductible
$125 towards Deductible
$115
$115
$0
$800 Outpatient Surgery
$450 (90% Coinsurance)
$800 towards Deductible
$800 towards Deductible
$0
$0
$50 towards Deductible + $130 (20% Coinsurance)
$575 towards Deductible + $25 (20% Coinsurance)
$700 Physician Fees (Non- Office Visit)
$630 (90% Coinsurance)
$70 (10% Coinsurance)
$100 (80% Coinsurance)
$520
Subtotal
$1,460
$465
$895
$1,030
$300
$1,625
LIVEHEALTH ONLINE Save time andmoney with LiveHealth Online. All you need is amobile phone/ tablet or a computer (with video camera) with an internet connection. You or your covered dependent may see a LiveHealth Online doctor for a $15 copay for PPO enrollees and $59 for Saver Plan enrollees. Inmost cases, a doctor can send a non-controlled substance prescription electronically to your local pharmacy.
Common concerns include: flu, minor rashes, sore throat, pink eye, allergies, fever, skin infections, headache, cold, diarrhea, anxiety, depression, andmuchmore.
DOCTOR VISITS
With your Employee Assistance Program (EAP), you can schedule a video visit with a licensed counselor when you need support. Use your phone, tablet, or computer with a camera to have a secure visit on LiveHealth Online fromhome.
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Medical Benefits Plan Feature Comparison
HIGH PPO PLAN
LOW PPO PLAN
SAVER PLAN
Coverage
In-Network
Out-of-Network
In-Network
Out-of-Network
In-Network Out-of-Network
Applies to Medical Expenses AND Prescription Drugs
Deductible
Applies to Medical Expenses
Single
$300
$800
$850
$2,000
$1,600
$3,200
Family
$600
$1,600
$1,700
$4,000
$3,200
$6,400
Out-of-Pocket Maximums
Non-Copay Amounts Apply to Medical Expenses After Deductible
Single
$1,500
$5,000
$4,500
$8,000
$4,500
$8,000
Family
$3,000
$9,500
$9,000
$15,500
$9,000
$15,500
Applies to Medical AND Prescription Drug Expenses after Deductible
Coinsurance
Applies to Medical Expenses after Deductible
Physician Office Visits
$25 Copay
You Pay 30%
$40 Copay
You Pay 40% You Pay 20% You Pay 40%
Specialist Office Visits
$35 Copay
You Pay 30%
$40 Copay
You Pay 40% You Pay 20% You Pay 40%
Most Covered Services
You Pay 10% You Pay 30% You Pay 20% You Pay 40% You Pay 20% You Pay 40%
Preventive No Cost to You
You Pay 30% No Cost to You
You Pay 40% No Cost to You
You Pay 40%
Inpatient Hospital
You Pay 10% You Pay 30% You Pay 20% You Pay 40% You Pay 20% You Pay 40%
Outpatient Surgery
You Pay 10% You Pay 30% You Pay 20% You Pay 40% You Pay 20% You Pay 40%
Emergency Room (Max. 25 non-admission visits per calendar year)
You Pay 10% after $150 Copay
You Pay 20% after $150 Copay
You Pay 20%
Urgent Care You Pay 10% You Pay 30% You Pay 20% You Pay 40% You Pay 20% You Pay 40%
Mental Health/Substance Abuse – Inpatient
You Pay 10% You Pay 30% You Pay 20% You Pay 40% You Pay 20% You Pay 40%
Mental Health/Substance Abuse – Outpatient
$35 Copay
You Pay 30%
$40 Copay
You Pay 40% You Pay 20% You Pay 40%
Chiropractic Care (30 visits max per calendar year)
$35 Copay
You Pay 30%
$40 Copay
You Pay 40% You Pay 20% You Pay 40%
Prescription Drugs
Rx Copays Apply Some Preventive at No Cost to You
Rx Copays Apply Some Preventive at No Cost to You
Waive Deductible Some Preventive at No Cost to You
Preventive
Generic / Preferred / Non-preferred
Retail: $10 Copay / 25% / 40%Mail Order*: $20 Copay / 20% / 35%
Retail: $10 Copay / 25% / 40% Mail Order*: $20 Copay / 20% / 35%
Subject to the Deductible & You Pay 20% / 40% Coinsurance
PrudentRx Specialty Medication
With PrudentRx: $0 Copay Without PrudentRx: You Pay 30%
With PrudentRx: $0 Copay Without PrudentRx: You Pay 30%
HSA Calendar Year Maximum for Employee and Employer Contributions (Saver Plan Only)
Employer
$250**
Employee Only
$4,150*** + $1,000 Age 55+
Family
$8,300*** + $1,000 Age 55+
FSA Calendar Year Maximum for Employee Contributions
Healthcare FSA
$3,050
$3,050
$3,050 LPFSA****
Dependent Day Care FSA
$2,500 Single / $5,000 Family
$2,500 Single / $5,000 Family
$2,500 Single / $5,000 Family
* Discounted pricing for mail order prescriptions is not allowed in OK or MN **Saver Plan employer contribution reduces to $125 for those effective after June 30 ***Includes employer contribution ****Limited Purpose FSA – covers dental and vision expenses only; available only to those enrolled in the Saver Plan
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Prescription Drug Benefits
Reliance Rewards plans include comprehensive prescription drug benefits through CVS Caremark. The CVS Caremark prescription drug benefits are the SAME for the High PPO and Low PPO plans. You share in the cost of the prescription drugs through copays and/or a percentage of the costs each time you fill a prescription. The CVS Caremark prescription drug benefits for the Saver Plan are treated as any other medical expense – subject to the annual deductible and plan coinsurance (no copays). Preventive drugs (for the treatment of high blood pressure, diabetes, etc.) covered at the plan coinsurance without being subject to the plan’s deductible. Prescription drugs are the fastest rising cost of healthcare today, affecting all employers and plans, including Reliance Rewards. You have the ability to help manage our costs by always asking your doctor if there is an equivalent generic prescription drug available. You can also save money if you utilize the CVS Caremark Maintenance Choice Mail Order Service for your maintenance prescriptions (not allowed in OK and MN).
CVS/CAREMARK MAINTENANCE CHOICE MAIL ORDER SERVICE* Up to a 90-day supply
RETAIL PHARMACY Up to a 30-day supply
HIGH PPO/LOW PPO
SAVER PLAN
HIGH PPO/LOW PPO
SAVER PLAN
$20 Copay
$10 Copay
Generic Drugs
You Pay 20% Coinsurance $60 minimum and $120 maximum You Pay 35% Coinsurance $100 minimum and $200 maximum
You Pay 25%Coinsurance $30minimumand $50 maximum You Pay 40%Coinsurance $50minimumand $80 maximum
In-Network 20% Coinsurance Out-of-Network 40% Coinsurance***
In-Network 20% Coinsurance*** Out-of-Network 40% Coinsurance***
Preferred Brand- Name Drugs**
With PrudentRx: $0 Copay Without PrudentRx: You Pay 30%
PrudentRx Specialty Medication
Healthcare Reform Preventive Drugs
$0 copay** for contraceptives, aspirin, and folic acid. If a generic equivalent is available, then the copay or coinsurance amount above will apply to obtain the brand name version of the medication.
* Discounted pricing for mail order prescriptions is not allowed in OK or MN ** If a generic equivalent is available and either you or your doctor requests a brand-name drug, you’ll pay the applicable generic copay amount (if any) plus the difference in cost between the brand-name drug and its generic equivalent *** After you meet your Saver Plan medical deductible
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Important Features of the Prescription Drug Policy
Maintenance Choice Mail Order Service This CVS Caremark service can provide valuable savings on certain maintenance medications that can be mailed directly to your home or picked up at your local CVS pharmacy (not allowed in OK and MN). AUTOMATIC ENROLLMENT After two regular fills, you will be automatically enrolled in the CVS Caremark Maintenance Choice Mail Order Service and your maintenance medication will be mailed directly to your home. You can request to pick up your maintenance medications at a local CVS pharmacy by going to www.caremark.com or contacting CVS Caremark Customer Service at 877-494-9519. OPTING OUT By opting out of the CVS Caremark Maintenance Choice Mail Order Service program, you will be able to get your medications at any network pharmacy, but the supply will be limited to 30 days, and the standard copay will apply. This is a more expensive option for you and Reliance Rewards. You may opt out of the CVS Caremark Maintenance Choice Mail Order Service by contacting CVS Caremark Customer Service at 877-494-9519. Reliance Rewards utilizes a step therapy program for prescription drugs associated with rheumatoid arthritis or osteoarthritis. The step therapy preferred drug strategy encourages the use of safe, equally effective, and less expensive drugs before “stepping up” to a more expensive brand-name therapeutic alternative. You will be required to try the preferred drug before a brand-name drug is dispensed. If the brand-name drug is dispensed before approved as part of the step therapy program, you will be required to pay 100% of the drug cost. STEP THERAPY PROGRAM FOR RHEUMATOID ARTHRITIS OR OSTEOARTHRITIS
DISPENSE AS WRITTEN POLICY A generic medicine is a Food and Drug Administration (FDA) approved copy of a brand-name drug. The FDA reviews each generic medicine to ensure that it is the same as the brand-name drug in safety, effectiveness, quality, and performance (how it works in the body). The generic version is available for the same use (high blood pressure, allergies, etc.) and in the same form (pill, liquid, cream, etc.) as its brand-name equivalent. Under the Dispense as Written Policy, if you or your doctor requests a brand-name drug when a generic is available, you are responsible for the difference in cost between the brand-name and generic drug, plus the applicable generic copay. PRIOR AUTHORIZATION REQUIRED Certain prescription drug classes require authorization from CVS Caremark prior to dispensing. These drugs have the potential for serious side effects or inappropriate use. The best way to avoid inconvenience is to have your physician call the CVS Caremark Prior Authorization department at 800-294-5979 to determine whether the drug will be covered. SPECIALTY MEDICATION GUIDELINE MANAGEMENT This is a comprehensive program to help ensure specialty medication use is appropriate, safe, and effective. By working with the physician, this program confirms appropriate use prior to dispensing a specialty medication, according to evidence-based medicine standards. In addition, there will be continual monitoring throughout treatment to assure appropriate use within clinical guidelines. The coordination of the program is usually handled between CVS Caremark and your physician. No action is required by you. PRUDENTRX (PPO ONLY) This is a prescription manufacturer copay assistance programwhich offers enrolled members a $0 copay for selected specialty medications. Participation in this program is voluntary and requires enrollment in PrudentRx. PrudentRx sends enrollment instructions to newmembers in the plan.
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Dental Benefits
Reliance Rewards offers a PPO dental plan administered by Delta Dental of California. It covers preventive, basic, and major dental services on an in-network and out-of-network basis. You may use any dental provider you choose, but you will save the most when you use a dentist who participates in the Delta Dental PPO network. To view dentists in the Delta Dental PPO and Premier networks, go to www.deltadentalins.com/reliancerewards.
IN-NETWORK
OUT-OF-NETWORK
Delta Dental PPO Lower deductible and coinsurance, lowest negotiated rates, no claim forms
Delta Dental Premier Higher deductible and coinsurance, negotiated rates
Non-Delta Dental Higher deductible and coinsurance
Annual Deductible Individual Family
$50 $100
$100 $200
$100 $200
Annual Benefit Maximum – per Individual
$1,500
$1,500
$1,500
Diagnostic & Preventive Services Exams, x-rays, cleanings, fluoride treatments Basic Services Fillings, extractions, sealants, root canals, gum treatment, and oral surgery Major Services Crowns, inlays, onlays, implants, cast restorations, bridges, dentures
No Cost to You, However May be Subject to Balance Billing
No Cost to You
No Cost to You
You Pay 30% after Deductible
You Pay 30% after Deductible
You Pay 10%
You Pay 40% after Deductible
You Pay 50% after Deductible
You Pay 50% after Deductible
Member Responsible for Balance Billing? Orthodontic Services for Children under 26
NO
YES
$750 LifetimeMaximum
Vision Benefits
Vision benefits offered under Reliance Rewards are provided by VSP. The vision plan helps cover the cost of annual eye exams and prescription glasses or contact lenses. Youmay use any eye care provider you choose, but you will save themost when you use a VSP Preferred Provider. VSP also has special offers, including discounts on hearing aids. Visit www.VSP.com for details.
IN-NETWORK
OUT-OF-NETWORK
Eye Exam Once every calendar year
$10 Copay
Up to $45 allowance after $10 Copay
Prescription Glasses
$25 Copay*
$25 Copay*
Covered up to $175 allowance after Copay; 20% off the amount over the allowance
Frames Every other calendar year
Up to $70 allowance after Copay
Single Vision – Up to $45 allowance after Copay Lined Bifocal Vision – Up to $65 allowance after Copay Lined Trifocal Vision – Up to $85 allowance after Copay Covered up to $150 allowance; allowance applies to contact lenses and contact lens exam, fitting, and evaluation
Lenses Once every calendar year
$25 Copay*
Contact Lenses Once every calendar year (Instead of lenses and frames)
Covered up to $175 allowance. Allowance applies to contact lenses and contact lens exam, fitting, and evaluation
*Only one $25 copy applies when receiving frames and lenses
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Flexible Spending Accounts
A Flexible Spending Account (FSA) is an individual account that allows you to set aside part of your pre-tax earnings each pay period. This plan is administered by Anthem Blue Cross. You can use the Healthcare FSA funds to pay for qualified healthcare expenses for you (and your eligible dependents) that are not covered under your medical, dental, or vision plans. Dependent Day Care FSA funds can be used to pay for child and dependent care expenses that qualify as a credit or deduction on your tax return.
Neither you nor your dependents have to be enrolled in a Reliance Rewards medical plan for eligible expenses to be reimbursable under the FSA.
LIMITED PURPOSE (for Saver Plan Enrollees)
HEALTHCARE
DEPENDENT DAY CARE
Youmay contribute from$130 to $5,000 per year per household. Eligible day care expenses for dependents under age 13, or for your spouse, your parents, or your parent(s) in-law who are mentally or physically incapable of caring for themselves and declared as a dependent on your federal income tax return. Qualified dependent day care expenses include day care or elder care and are the same as those you are allowed to take as a credit or deduction on your federal income tax return. To qualify for reimbursement, these expenses must be necessary to allow you and your spouse (if applicable) to work outside the home.
Annual Contribution Limits
You may contribute from $130 to $3,050 per year. You may be reimbursed for certain healthcare expenses, provided they are not reimbursed by any health plan, and qualify as a medical deduction on your federal
You may contribute from $130 to $3,050 per year. If you enroll in the Saver Plan, you can enroll into a “Limited Purpose” Healthcare FSA. As noted, you may be reimbursed for certain healthcare expenses that are not covered by your HSA, provided they are not reimbursed by any health plan, and qualify as a medical deduction on your federal income tax return. Examples include: • Dental/Vision plan copays, deductibles, and coinsurances • Acupuncture • Contact lens solution • Hearing aids and exams
income tax return. Examples include: • Medical and dental plan deductibles • Copays and coinsurance • Prescription drug copays • Acupuncture • Contact lens solution • Hearing aids and exams
Eligible Expenses
• Expenses not covered/partially covered by the medical, dental, and vision plans
Reimbursements can be made by: • Use your Anthem Blue Cross FSA Debit Card or • Submit a paper or online claim to Anthem Blue Cross FSA
Getting Reimbursed
2024 Healthcare FSA and Dependent Day Care FSA dollars can be used to reimburse expenses incurred beginning January 1, 2024, through March 15, 2025
Eligible Expenses
You have through March 30, 2025, to submit claims for reimbursement against the 2024 plan year FSA dollars. Anthem Blue Cross FSA may request verification of expenses before they process your claim. Keep your receipts!
Claim Deadline
IMPORTANT RULES FOR FLEXIBLE SPENDING ACCOUNTS • As required by the IRS, any money in your FSA accounts that is not used for expenses incurred from January 1, 2024, through March 15, 2025, will be forfeited. This is called the “use it or lose it” rule. • Your payroll contributions will stay the same for the entire plan year. You cannot change your contribution level during the plan year unless you have a Qualifying Life Event – for example, marriage, the birth of a child, or a change in employment. • You cannot use money in your Healthcare FSA to pay for Dependent Day Care expenses or vice versa.
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