YourBenefitsEffective December 2023 - November 2024
You must request a change to your benefitswithin 30 days of your life event (60 days forchanges involving Medicaid eligibility). Documentation may be required.Enroll nowYour benefit plans are in effect December 1st –November 30th each year. In general, there arethree times you can make benefit selections:Making benefit selectionsGetting startedEligibility Enrolling in coverageFor youYou are eligible for benefits as a full-timeemployee working at least 30 hours per week.Your Spouse or PartnerYour benefits begin on the first day of the monthfollowing date of employment. Be sure to submityour selections within your first 30 days ofemployment. Your benefit selections will be in effect throughNovember 30th. When you're first eligible Open Enrollment is your one chance each year toreview your coverage options and make changesto your benefits.Your choices are in effect from January –December of the following year unless you have aqualifying life event. At Open Enrollmentmarriage or divorce, birth or adoption, death of a covered dependent, and a change in eligibility through Medicare,Medicaid, or a spouse or parent's coverage. Qualifying life events allow you to change yourcoverage during the year outside of OpenEnrollment. These include: If you have a qualifying life eventYou may also cover your eligible dependents whenyou elect coverage for yourself.Covering your familyMedical, dental and vision: until age 26regardless of student or marital statusChild life insurance: until age 21, or 26 if afull-time studentDependent children are eligible:You may cover your legal spouse or domesticpartner.Your children
Balance billingWhen you use an out-of-networkmedical or dental provider, theymay bill you the difference betweenwhat they charge and the amountyour insurance pays.Medical: balance billing is inaddition to – and does not counttowards – your out-of-pocketmaximum.CoinsuranceAfter you’ve met your deductible,you’re sometimes responsible for apercentage of the cost of themedical care, dental care, orprescription medication youreceived. This percentage iscoinsurance.CopayA flat fee you pay each time youreceive a copay-eligible medical,dental, or vision service orprescription medication. DeductibleThe amount you’re responsible forpaying in care expenses before themedical or dental plan starts payingdeductible-eligible expenses.In-networkIn-network care is always yourlowest-cost option. Networks aregroups of medical, dental, andvision providers, pharmacies, andfacilities that agree to discount thecost of their care or service.Out-of-pocket maximumThe most you’ll pay for covered in-network medical care in a year. Thisincludes your deductible, anycoinsurance or copays, andprescription drugs. The out-of-pocket maximum doesnot include your premium (theamount you pay for coverage), non-covered expenses, or out-of-network care that’s been balancebilled.Primary care physicianA primary care physician (PCP) isyour main medical doctor – usuallya general practitioner (GP), familydoctor, internist, OB/GYN, orpediatrician (for children).Referral/pre-authorizationSome specialty medical providersand services require a referral froma primary doctor. These may include- but are not limited to -cardiology, psychiatry, orthopedicsurgeons, rheumatology, surgery,and imaging (CT or MRI).Have questions? Your advocate is here to help youwith all things benefits. See theircontact information on the nextpage.How to handlemedical bills (4:46)Annual NoticesWe’re required to tell you about certainrights and responsibilities you have as anemployee of Epic Gardening. You can request a paper copy at no chargefrom:Erin Highbloom, Director, People & Culture636-751-1473ehighbloom@epicgardening.comDownload nowHelpful terms & resourcesGetting startedWe've removed as much jargon as possible.But you’ll probably still encounter some terms as you enroll in and use your benefits, andwe want you to be prepared!
Medical insuranceCigna Group# 6520841-866.494.2111www.my.cigna.comDental insurancePrincipal Group # 11819621-800-247-4695www.Prinicpal.comVision insurancePrincipal - VSP Network Group # 11819621-800-877-7195www.VSP.comGroup Life AD&DPrincipal Group # 11819621-800-245-1522www.Principal.comVoluntary Life AD&DPrincipal Group # 11819621-800-245-1522www.Principal.comDisability (STD,LTD, PFML) Principal Group # 11819621-800-245-1522www.Princpal.comAccident Principal Group # 11819621-800-245-1522www.Principal.comHospital Indemnity Principal Group # 11819621-800-245-1522www.Principal.comCritical Illness Principal Group # 11819621-800-245-1522www.Principal.comEmployee Assistance Program (EAP)Vendor name1-xxx-xxx-xxxxwww.website.comContact informationGetting started
In-network careOAP Buy upOAP Base PlanHDHP Plan (HSA)Network name:National PPONational PPONational PPOAnnual Deductible (DED)Out-of-pocket maximum$2,500 per person $4,500 family max$7,000 per person $14,000 family max$3,500 single coverage $5,500 with dependents$7,500 per person $15,000 family max$4,000 single coverage $7,500 with dependents$7,000 per person $14,000 family maxPre-tax accountavailabilityHealth care FSAHealth care FSA Health Savings Account (HSA)Preventive carePrimary care visitSpecialist visitVirtual visit100% covered$25 copay$50 copay$0 copay100% covered$20 copay $40 copay$0 copay 100% coveredDED then you pay 20%DED then you pay 20%DED then you pay 20%Urgent careEmergency roomInpatient hospital care$85 copay$350 copay DED then you pay 20%$85 copay$350 copayDED then you pay 20%DED then you pay 20%DED then you pay 20%DED then you pay 20%Prescription drugsGeneric Preferred brand Non-preferred brandSpecialty (30 days | 90 days)$10 copay | $30 copay$45 copay | $135 copay$70 copay | $210 copay30%/$250 | 30%/$750(30 days | 90 days)$10 copay | $30 copay$45 copay | $135 copay$70 copay | $210 copay30%/$250 | 30%/$750(30 days | 90 days)Plan Ded $10 copay | $30 copayPlan Ded $45 copay | $135 copayPlan Ded $70 copay | $210 copayPlan Ded 30%/$250 | 30%/$750Out-of-network careAnnual deductible Out-of-pocket maximum Balance billing applies$5,000 / $9,000$14,000 / $28,000Balance billing applies$7,000 / $11,000$15,000 / $30,000Balance billing applies$7,500 / $15,000 $14,000 / $28,000Your cost for coverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyEmployee Monthly Cost $124.58$539.93$480.32$692.50Employee Monthly Cost $115.59$520.12$462.36$664.64Employee Monthly Cost $50.00$281.57$238.81$474.00See plan detailsMedical insuranceSee plan detailsSee plan detailsMental health supportThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.what you pay for the plan, what you pay when you get care, how out-of-network care is covered, andyour annual maximum cost for care (out-of-pocket maximum).All plans cover in-network preventive care at 100%, prescription drugs, andinclude an annual limit on your expenses. The differences are: Select from three medical options through Carrier.See your plan documents for out-of-network benefits.
If you coveryourself onlyIf you coverdependents2023 IRS maximumcontribution $3,850$7,7502024 IRS maximumcontribution $4,150$8,300Learn how HSAs canhelp you save fortoday and tomorrow.Health SavingsAccount (HSA)55 or older? You can contribute an extra $1,000 peryear in catch-up contributions.The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.You may contribute tax-free funds to save for currentand future health expenses - and retirement!An HSA through vendor is paired with a High DeductibleHealth Plan (HDHP).Save pre-tax money for health care expenses – or retirement!Contributions HSA funds Spend your HSA balance on health care expenses(medical, prescription, dental, and vision) for youand your tax dependents, ORLet your balance grow for retirement.Using your moneyThe money in your HSA is always yours and availablefor qualified health care expenses - even if you changejobs or health plans. Before retirement, any funds usedfor non-healthcare expenses are subject to taxpenalties. Keep your receipts!Growing your money + tax savingsHSA dollars go in tax-free, grow tax-free, and come outtax-free when you use them for qualified healthexpenses. You may also be able to invest part of yourbalance once it meets a certain level.In retirementAt age 65, you can withdraw the funds in your HSA forany use (not just health care!) without tax penalties. Eligibilitybe enrolled in a qualified High Deductible HealthPlan (HDHP),not be covered under any other non-HDHP healthcoverage, including a full health care FSA throughyour spouse,not be anyone else’s tax dependent, and not be eligible for or enrolled in Medicare A or B,Tricare, or VA benefits.In order to make – or receive – contributions to a HealthSavings Account (HSA), you must:
Eligible expensesFlexible Spending Accounts (FSAs)2024 maximum contribution$3,200Annual rollover amount$02024 maximum contribution$3,200Annual rollover amount$0Pay for eligible child or disabled adult care while youwork or attend school.Dependent care FSA2024 maximum contribution$5,000Married filing separately: contribute up to $2,500 per person.Only the amount you’ve actually contributed isavailable for use at any one time.Estimate carefully! Unused funds will be forfeited atthe end of the year per IRS regulations.Enrolled in an HDHP plan and eligible for HSA contributions? You’re not eligible for a health care FSA; you can contribute to alimited purpose FSA instead.The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.Pay for eligible medical, prescription, dental, andvision expenses.Health careHealth care FSAPay for eligible dental and vision expenses whenyou're also contributing to an HSA.Limited purpose FSAHealth and dependent care expenses can add up. Paying with tax-free fundscan help. Enroll in one or more flexible spending accounts (FSAs) dependingon your needs.Pay for qualifying expenses with tax-free money using yourFlexible Spending Account.
OAP Buy Up PlanOAP Base PlanOAP HDHP (HSA)$0 copay $0 copay DED then you pay 20%Access quality care in the convenience of your own home, on your lunchbreak, or on the way to your child’s soccer game! Whether it's a nagging cough, middle-of-the-night fever, or a suspicious-looking mole or rash — telehealth through VENDOR is here when you need it.Connect with a board-certified physician 24 hours a day, 7 days a week.Your cost per visit depends on your medical plan:Telehealth: virtual health care that fits your scheduleSee plan detailsTotal wellbeing:caring for all of youSupport for your health, finances, and life.There are five ingredients to wellbeing — each is just as important as the others:The recipe to living wellConnection to your passion, the reason you get out of bed every day.PurposeFeeling connected to where you live, work and play through activities such as volunteering and mentoring.CommunityThe benefit plan information shown in this guide is illustrative only. To the extent the benefit plan information summarized herein differs from the underlyingplan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlyinginsurance documents will govern in all cases.Social & EmotionalHealthy, supportive relationships with family, friends, and mostimportantly, yourself. Effectively managing feelings and emotions andpracticing healthy ways to manage stress and adapt to challengesPhysicalHaving good health and the energy to perform your job life outside of work, such as spending time with familyand friends, or participating in activities you enjoy. Think of physical wellbeing as nutrition, staying hydrated,getting rest, avoiding illness through vaccines, preventive screenings, and following doctors’ orders!The ability to effectively understand and plan for day-to-day expenses, short-term, and long-term goals, likepaying back student loans, saving for a house, sending children to college, retirement, or caring for agingfamily membersFinancialMental health care isessential health care.Managing work, family,relationships, and finances canbe tough. Our Employee AssistanceProgram (EAP) provides youand your family with no-cost,confidential assistance with allthings related to your life.24/7/365.
Employee AssistanceProgram (EAP)Confidential. No one at Epic Gardening will ever know you called orwhat was discussed.Available 24/7/365. Life doesn't happen during office hours. The EAP ishere when you need them.Family care is included. Anyone living in your home is eligible for EAPservices at no cost.Face-to-face visits. When needed, each person can receive up to 3face-to-face (or virtual) visits with a licensed counselor per issue peryear. At no cost. Additional visits - if needed - will go through yourhealth insurance.EAP features:When you create an account, enterPrincipal Core as the program name.24/7/365 access to care. 1-800-450-1327Member.Magellanhealthcare.comThe benefit plan information shown in this guide is illustrative only. To the extent the benefit plan information summarized herein differs from the underlyingplan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlyinginsurance documents will govern in all cases.mental health concerns (including substance abuse or addiction),adoption, parenting, or caregiving needs,financial or legal support,familial relationships and friendships,coping with day-to-day challenges, andso much more.Our Employee Assistance Plan (EAP) is a confidential service with access toguidance and resources at no cost for: Essentially, if it's part of your life, our EAP is here for you.Access support online, through live chat, or over the phone. 24/7/365.Everyone needs support sometimes (even superheroes)Care for your mind – and your life – with support throughvendor.Confidential care designed for all that life brings.See plan details
Dental insuranceThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.Stay in-network to avoid balance billing (the difference between what an out-of-network provider charges and the amount your insurance pays). You'll get in-network preventive care at 100% along with coverage for basicand major dental services.Orthodontic care is covered.Your dental coverage is through Principal.Learn about dental care categoriesIn-network careDental planNetwork name:National PPOAnnual Deductible (DED)$50 per person $150 family maxAnnual maximum benefit$1500 per person Preventive care100% coveredBasic careDED then you pay 20%Major careDED then you pay 50%Orthodontic careCoverageLifetime maximum benefitDED then you pay 50%$1,500Your cost for coverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyEmployee Monthly Cost$8.44$22.72$38.32$60.90See plan details
You'll get an annual exam with coverage for lenses and frames, or contactsin lieu of glasses.Your vision coverage is through Principal VSP network.Vision insuranceThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.Your vision plan covers either glasses (lenses and frames) or contact lenses each year. If you receive contact lenses, they will be instead of your glasses benefit.In-network careBase planNetwork name:VSPAnnual eye exam (every 12 months)$10 copayMaterials copay(lenses & frames)$10 copayLenses (every 12 months)Included in materials copayFrames(every 12 months)$150 allowance, plus 20% off amount over allowanceContact lenses(every 12 months)Elective: $150 allowanceMedically necessary: $10 copayYour cost for coverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyEmployee Monthly Per Cost $1.85$3.87$4.29$8.49See plan details
Basic lifeBasic AD&DEpic Gardening provides$50,000$50,000See plan detailsFor youFor your spouseFor your child(ren)Coverageincrements$10,000$5,000$5,000Coveragemaximum$200,000$50,000$10,000Medicalquestion limit$150,000$30,000Does not applyYou may also purchase additional coverage for you, your spouse, and youreligible child(ren). Additional life and AD&D insuranceSee plan detailsLife insurance pays a benefit if you pass away while you're covered.Accidental Death and Dismemberment (AD&D) insurance offers additionalsupport if you pass away or are seriously injured due to an accident.Financial peace of mind through Principal .Life and AD&D insuranceyour beneficiary if you passaway due to an accidentyou a partial benefit if youlose specified bodilyfunctions (sight, limbs, etc.)What's AD&D?Accidental death anddismemberment (AD&D)insurance may pay:Make sure to designate a beneficiary for your life insurance coverage to ensureyour family is cared for according to your wishes.Medical question limitWhen you’re first eligible (a newhire), you can purchaseadditional life insurance up tothis limit without any medicalquestions required. Medical questions and approvalwill be required for all futureincrease and purchase requests.The benefit plan information shown in this guide is illustrative only. To the extent the benefit plan information summarized herein differs from the underlyingplan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlyinginsurance documents will govern in all cases.Basic life and AD&D insuranceEpic Gardening provides life and AD&D insurance at no cost to you.
Benefits beginAccident: On the 8th day you're unable to workIllness: On the 8th day of inability to work Coverage amount60% of your income up to $2,500 per weekPayments may continueUp to 12 weeks if you’re unable to return to workSee plan detailsSee plan detailsIf you make a disability claimwithin the first year of beingcovered, check your plan detailsto see how pre-existingcondition limitations mightimpact your coverage.Pre-existing conditionlimitations Benefits beginAfter 90 days of inability to work (once short-termdisability ends)Coverage amount60% of your income up to $10,000 per monthPayments may continueUntil your Social Security Normal Retirement Age ifyou remain unable to work.Wish you knew moreabout finances? Nowyou can - at no cost!Disability insuranceThe benefit plan information shown in this guide is illustrative only. To the extent the benefit plan information summarized herein differs from the underlyingplan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlyinginsurance documents will govern in all cases.Protect your paycheck with disability insurance throughCarrier.Disability coverage insures your paycheck, replacing a portion of your incomeif you’re unable to work due to a covered illness or injury.Short-term disability coverage can replace part of your paycheck if you’re unableto work for a shorter period of time. Epic Gardening provides this coverage at nocost to you.Short-term disabilityLong-term disability coverage can provide lasting income protection if youremain unable to work. Epic Gardening provides this coverage at no cost to you.Long-term disability
See plan detailsSee plan detailsSee plan detailsAdditional benefit plans are a great way to customizeyour benefits package.Additional benefit optionsHospital Indemnity coverage through Principal paysyou a cash benefit to help with your expenses - yourdeductible or copays, transportation, groceries andmore - if you or a covered family member is admitted tothe hospital. The money is yours to use as you choose.Hospital indemnityThe benefit plan information shown in this guide is illustrative only. To the extent the benefit plan information summarized herein differs from the underlyingplan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlyinginsurance documents will govern in all cases.Accident coverage through Principal pays you a cashbenefit to help with your expenses –your deductible orcopays, transportation, groceries and more – if you or acovered family member is injured due to an accident.The money is yours to use as you choose.Accident coverageCritical illness coverage through Principal pays you acash benefit to help with your expenses– yourdeductible or copays, transportation, groceries andmore – if you or a covered family member is diagnosedwith a covered critical illness. The money is yours to useas you choose.Critical illness
2023-24 benefits