Employment - Benefits

2008 COPLEY BENEFIT PLAN

Copley’s Benefit Plan provides you with an opportunity to personalize your benefit package to meet your individual needs.  The benefits you choose now will be your individual benefits program for calendar year 2007.  Benefit changes may only be made during the year if you have a “change in family or life status” as defined by the Internal Revenue Service.  A change in family/life status includes marriage, divorce, birth or adoption, death, termination or commencement of your spouse’s employment, a change from full-time to part-time status or vice versa.

HEALTH INSURANCE
Copley offers three managed care health insurance options; a $10 Point-of-Service Plan, and two $25 Point-of-Service Plans, all administered by Blue Cross and Blue Shield of Vermont

BLUE CROSS & BLUE SHIELD POINT OF SERVICE (POS)  PLANS:

The Point-Of-Service Plans provide both In-Network benefits (called “Preferred Benefits”) and Out-Of-Network  benefits (called “Standard Benefits”).  You are required to select a Primary Care Physician (PCP) for each insured member.  

In-Network (“Preferred”) benefits for the $10 POS and $25 POS Plan A:  In-Network (“Preferred”) benefits provide the highest level of coverage. In using your In-Network benefits, your PCP will direct most of your care and you may self-refer for specialty care provided you stay within the Blue Cross & Blue Shield Network. You pay a $10 or $25 co-payment for most routine care. Hospitalization is covered in full.  Prescriptions are covered at participating pharmacies at a cost of $5 for generic drugs on their drug formulary and $20 for name brand formulary drugs and $40 for non-formulary drugs.

In-Network (“Preferred”) benefits for the $25 POS Plan B:  In-Network (“Preferred”) benefits provide the highest level of coverage. In using your In-Network benefits, your PCP will direct most of your care and you may self-refer for specialty care provided you stay within the Blue Cross & Blue Shield Network.   You pay a $25 co-payment for most routine care and $10 for generic drugs on their drug formulary and $30 for name brand formulary drugs and $50 for non-formulary drugs.   

Out-of-Network (“Standard”) benefits for the $10 POS and $25 POS Plan A:  If you choose to use Out-of-Network providers, there are deductibles to be met and co-payments to be made.  The deductible for the $10 POS and $25 POS Plan A is $1,000 per calendar year for a 1-Person Plan, and $2,000 for a Family Plan.  These two plans will then pay 70% of covered services for the next $2,500 per person ($5,000 per family) and 100% thereafter.  These deductibles must be met before any benefits are paid.  Benefits are subject to reasonable and customary limits.  

Out-of-Network (“Standard”) benefits for the $25 POS Plan B:  If you choose to use Out-of-Network providers, there are deductibles to be met and co-payments to be made. The deductible for the $25 POS Plan B is $250 per calendar year for a 1-Person Plan, and $500 for a 2-Person or Family Plan.   This plan will then pay 80% of covered services for the next $2,500 per person ($5,000 per family) and 100% thereafter.  These deductibles must be met before any benefits are paid. Benefits are subject to reasonable and customary limits.  In addition to the above referenced deductibles, there are deductibles for outpatient surgery/procedures and inpatient surgery and/or admissions. 

SPECIAL PROVISIONS FOR POS PLANS:

*      If an emergency arises, and you are able, call your PCP for authorization for emergency care.  In the event of a life threatening emergency, where a phone call is not possible, your primary care physician must be notified as soon as possible thereafter.  Emergency room co-pays will apply if you are not admitted.
*      If you or a covered dependent are injured or suddenly become ill while away from your Blue Cross & Blue Shield network area, you should call your PCP for instructions as to what you should do.  Care will be arranged or authorized by your PCP. If you have a life threatening medical emergency and are unable to contact your primary physician, seek care immediately and then notify your PCP.  You do not need to call your PCP, but benefits will then be paid under the non-network part of the plan.
*      Mental health services are available only upon approval from the Blue Cross & Blue Shield Plan network.  You will be provided the telephone number you must call to obtain the approval when you receive your new member ID card.  
 

The biweekly payroll deduction for Health Insurance Benefits is as follows:

HEALTH INSURANCE  

                                  [  ]                I do not want Health Insurance Coverage through Copley.   

 

                                  [  ]           OBTAIN  Plan indicated below at the following biweekly cost:

 (Please Circle)

$10 POS	.9 & 1.0 FTE  72-80 hours	.8 FTE 64 hours	.7FTE 56 hours	.6 FTE 48 hours	.5 FTE 40 hours
1-Person Plan	$ 70	$ 99	$113	$127	$141
2-Person Plan	$141	$197	$225	$254	$282
Family Plan	$190	$266	$304	$342	$380

(Please Circle)

$25 POS Plan A	.9 & 1.0 FTE  72-80 hours	.8 FTE 64 hours	.7FTE 56 hours	.6 FTE 48 hours	.5 FTE 40 hours
1-Person Plan	$ 69	$ 96	$110	$124	$138
2-Person Plan	$138	$193	$220	$248	$275
Family Plan	$186	$260	$298	$335	$372

(Please Circle)

$25 POS Plan B	.9 & 1.0 FTE 72-80 hours	.8 FTE 64 hours	.7FTE 56 hours	.6 FTE 48 hours	.5 FTE 40 hours
1-Person Plan	$ 65	$ 92	$105	$118	$131
2-Person Plan	$131	$183	$209	$236	$262
Family Plan	$177	$247	$283	$318	$354

You are eligible for health insurance coverage on the first of the month following one month of employment or attaining benefit eligibility status and may change health insurance plans in January of each year.

DENTAL INSURANCE The Dental Program is intended to encourage you and your eligible dependents to seek preventive dental care and to help pay expenses for restorative care and treatment. 

                                                                                                                Core Plan

Core Plan provides coverage for reasonable and customary charges up to a maximum of $750 per person per calendar  year, based upon the following schedule:

*      100% of the cost of diagnostic and preventative services, including exams, cleanings and x-rays.

*      60% for minor restorative services, including fillings, oral surgery, root canal therapy, periodontics, and denture repair.

*      50% of the cost of inlays, crowns and fixed & removable dentures

*      50% orthodontia procedures – child only - $1,500 maximum lifetime benefit

 

                                                                                                                Buy Up Plan

The Buy Up Plan provides coverage for reasonable and customary charges up to a maximum of $1,500 per person per calendar  year, based upon the following schedule:

*      100% of the cost of diagnostic and preventative services, including exams, cleanings and x-rays.

*      80% for minor restorative services, including fillings, oral surgery, root canal therapy, periodontics, and denture repair.

*      60% of the cost of inlays, crowns and fixed & removable dentures

*      65% orthodontia procedures – child only - $2,500 maximum lifetime benefit

SHORT TERM DISABILITY

Short Term Disability (STD) provides for weekly benefit payments that help replace lost income should you become totally disabled due to a non-occupational accident or illness.  The duration of STD benefits is 90 days and begins on the 1st day for an accident and 8th day for illness.  Pregnancy or its complications are covered under this benefit and for purposes of this benefit is considered to be an illness.  You choose the appropriate benefit amount, however, it may not exceed 70% of basic weekly income, excluding overtime, differentials or any other form of extra pay.

LONG TERM DISABILITY

Long Term Disability (LTD) insurance covers employees who become disabled as a result of an injury or sickness for a period beginning after, and extending beyond, what is normally covered by Short Term Disability Insurance.  It replaces a percentage of the income employees would have earned had they been able to continue working.  LTD insurance is provided to non-union benefit eligible employees at no cost to you.  Coverage is provided on the first of the month following 3 months of employment or attaining benefit eligibility status.

HEALTH CARE REIMBURSEMENT ACCOUNT

The Health Care Reimbursement Account can help you reduce the cost of health related services not covered by medical and dental plans.  When you elect this benefit, you request Copley to deposit a portion of your paycheck into this account on a before tax basis.  The maximum you can deposit is $3,000 per year, which is withheld in equal amounts biweekly.

You can use this money for expenses that qualify as medical deductions under IRS regulations such as:

        *Health insurance deductibles and coinsurance expenses

        *Dental expenses not covered by a dental program

        *Services of health care providers not covered by medical insurance 

The advantage of using this account is that the money deposited in your account is in pre-tax dollars.  Therefore, you do  not pay federal, state or social security taxes on the amount of money you spend on these health care services. This reduces the cost of such care to you and your family.  Note:  The biweekly premiums you have deducted for Health and/or Dental insurance through Copley are already deducted on a pre-tax basis. If you do not want to have these deductions on a pre-tax basis, you must notify Human Resources, in writing.

It is essential for you to plan ahead and anticipate what your yearly expenses will be.  Due to federal regulations, if you do not use all the money in your account for expenses incurred in the calendar year, you will forfeit the balance.  You will be required to submit your receipts to Benefit Strategies for reimbursement.  Please note, if you terminate your employment with Copley during the year only those expenses incurred prior to your termination date will be reimbursed.  However, you are entitled to maintain your Flexible Spending Account through COBRA.  You would need to continue the requisite payments through the end of the year in order to receive reimbursement.   Please complete the Benefit Strategies “Flex Enrollment Form”.

 DEPENDENT CARE REIMBURSEMENT ACCOUNT

This account can help you reduce the cost of childcare or the cost of care of an incapacitated spouse or other adult dependent. When you elect this benefit, you request Copley to deposit a portion of your paycheck into this account on a before tax basis. The maximum you can deposit is $5,000 per year, which is withheld in equal amounts biweekly.  The advantage of using this account is that the money deposited in your account is in pre-tax dollars.  Therefore, you do not pay federal, state or social security taxes on the amount of money you spend on these health care services. This reduces the cost of such care to you and your family.   You will need to determine if taking a Federal Tax Credit on your IRS Income Tax filing is better for you.

 
It is essential for you to plan ahead and anticipate what your yearly expenses will be.  Due to federal regulations, if you do not use all the money in your account for expenses incurred in the calendar year, you will forfeit the balance.  You will be required to submit your receipts to Benefit Strategies for reimbursement. Please note, if you terminate your employment with Copley during the year, you are entitled to continue the requisite payments and reimbursements through COBRA.

Please complete the Benefit Strategies “Flex Enrollment Form”.