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2023-2024Benefits GuideEffective September 1, 2023 - August 31, 2024
You must request a change to yourbenefits within 30 days of your lifeevent (60 days for changes involvingMedicaid eligibility). Documentation may be required.Open Enrollment begins August14th and runs through August 16th.Your 2023 Benefits Enrollment Open Enrollment Open Enrollment is your one chance eachyear to review your coverage options andmake changes to your benefits.Your choices are in effect from September1, 2023-August 31, 2024 unless you havea qualifying life event.marriage or divorce, birth or adoption, death of a covered dependent, and a change in eligibility throughMedicare, Medicaid, or a spouse orparent's coverage. Qualifying life events allow you tochange your coverage during the yearoutside of Open Enrollment. Theseinclude:New for 2023EligibilityQualifying Life EventChoice + HSA Deductible increase $3,000Individual/$6,000 Family. Increased Out ofPocket Maximum and Copay changes.Choice + Deductible plan Deductibledecrease $500 Individual/$1,000 Family.Increased Out of Pocket Maximum andCopay changes. Choice + No Deductible plan increase outof pocket maximums and copay changes.Please see pageMedical Plan ChangesMedical, dental and vision: until age 26regardless of student or marital statusCovering your FamilyYou may also cover your eligible dependents whenyou elect coverage for yourself.You may cover your legal spouse .Dependent children are eligible:Your Legal Spouse Your Children
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Medical insuranceUnitedHealthcarerefer to your ID card forcontact information andgroup numberwww.www.myuhc.comDental insuranceDelta DentalGroup: 100989800-237-6060www.deltadentalva.comVision insuranceSuperior VisionGroup:18090301800-507-3800www.superiorvision.comHealth Savings Health Equity855-428-0447www.healthequity.comLife InsuranceMetLifeGroup: 5953868800-638-5433www.metlife.comOne Digital Account TeamLaura HamiltonSenior Benefits Consultant804-249-5155lhamilton@onedigital.comCiara WhiteAccount Manager804-523-7163ciara.white@onedigital.com540-371-7600 ext 210cleite@gastrofbg.comImportant ContactsHuman Resources Cheryl Leite
Ever have questions about yourBenefits?Bonnie Templemanbtempleman@onedigital.com+1 804-249-5150Responsible for day-to-daycustomer relationships,troubleshoots billingdiscrepancies, and addressesclaim issues and other clientsprojects Troubleshoots billingdiscrepancies and facilitatesresolution on plan eligibiltyissues+1 804-249-5172vskinarakis@onedigital.comVickie SkinarakisOur Team is easily accessible. We areonly a phone call or email away!Email: ART@OneDigital.com Phone: 866-802-6311Address: 9954 Maryland Drive, 2200, Richmond, VA23233
In-network careChoice + Ins BZEM HSAChoice + Ins CP76Choice + Ins CKCNNetwork name:Choice + Ins BZEM HSAChoice + Ins CP76Choice + Ins CKCNAnnual Deductible (DED)Out-of-pocket maximum$3,000 per person $6,000 family max$6,000 per person $12,000 family max$500 per person $1,000 family max$7,350 per person $14,700 family max$0 per person $0 family max$3,000 per person $6,000 family maxPreventive screeningPrimary care visitSpecialist visitUrgent CareDeductible, then $15 copayDeductible, then $30 copayDeductible, then $75 copay100% covered100% covered $0 copay $60 copay $50 copay100% covered $20 copay $40 copay $75 copayInpatient ProcedureOutpatient ProcedureEmergency Room VisitDeductible, then $500 copayDeductible, then $250 copayDeductible, then $150 copayDeductible, then 20%Deductible, then 20% Deductible, then $250 copay10% coinsurance10% coinsurance$350 copayPrescription drugsGeneric Preferred brand Non-preferred brandSpecialtyDeductible, then $5 copay Deductible, then $40 copayDeductible, then $100 copayDeductible, then $250 copay$10 copay $35 copay$60 copay$60 copay$10 copay $35 copay$60 copay$60 copayYour cost for coverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyPer paycheck$41.84$377.39$241.85$419.31Per paycheck$84.38$476.58$316.54$554.85Per paycheck$126.87$575.63$391.13$690.20See plan detailsMedical InsuranceSee plan detailsSee plan detailsThe 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.Medical insurance help you pay for preventive care, routine health needs,prescriptions, and advance procedures by cost-sharing with your insuranceprovider. ** All deductibles are embedded for each of the medical plans. Meaning,no one person in a family is required to meet more than the individualdeductible Select from three medical options through UnitedHealthcare.For out-of-network benefits, refer to your plan documents.Connect to you plan to stay In Network, Find aprovider, or get help with understanding your plan.Click on Blue Doc page for more information.
Additional Benefits with Your UnitedHealthcare CoverageSee detailsSee detailsSee detailsSee detailsSee detailsSee detailsEligible plan participants and enrolled spousesmay each earn up to $1,095 this year towardcopay, prescriptions and deductibles ( forthemselves or covered dependents). Real Appeal is an online weight loss program that providespersonal coaching to help you and eligible family members loseweight and keep it off. On average, participants lose 20pounds after attending just 4 online sessions. 24/7 Virtual Visits are covered by your UHC plan whenyou use one of the provider groups in our 24/7 VirtualVisits network.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.There's more to love with these extra benefits. Get support to help reach your goals!1-on-1 Coaching $0 out-of-pocketSuccess Kit UnitedHealthcare, Employee Assistance Program provides24/7 services at no cost , which are 100% confidential. They'retrained to understand your concerns and connect you with aspecialist or service that will best help you. UnitedHealthcare Rewards is an incentive programthat's included in your health plan. It rewards you as anemployee with dollars for reaching program goals andcompleting one-time activities. Earn up to $300UHC Maternity Member SupportWhether you’re thinking about having a baby or haveone on the way, maternity support is here to provideinformation and support — throughout your pregnancyand after giving birth. See detailsQuit Tobacco for good Whether you’re thinking about having a baby or haveone on the way, maternity support is here to provideinformation and support — throughout your pregnancyand after giving birth.
Dental InsuranceStay in-network to avoid balance billing (the difference between what anout-of-network provider charges and the amount your insurance pays). Low Plan High PlanAnnual Deductible (DED)$50 per person $150 Family max$50 per person $150 Family maxAnnual Plan Maximum $ 1,000$1,500Preventive care100% covered100% coveredBasic care*80%*80%Major careN/A*50%Orthodontic careCoverageLifetime max benefitN/A*50% covered (child to age 19)$1,500 lifetime max benefitYour cost for coverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyPer paycheck$13.86$29.57$30.59$47.20Per paycheck$20.58$43.91$45.90$74.16See plan detailsSee plan detailsThe 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, the maximum amount Delta Dental will pay each year fordental care (annual maximum benefit), andwhether orthodontic care is covered.Both plans cover in-network preventive care at 100%. Thedifferences are: Select from two dental options through Delta Dental.Good dental hygiene has substantial impact on youroverall health. Prevent both oral conditions and otherdiseases through regular preventive dental care
Superior National NetworkNetwork name:National PPOAnnual eye exam (1 per plan year)$10 copayLenses (1 per plan year)Single: $10Bifocal: $10Trifocal: $10Lenticular: $10Frames(1 per plan year)$150 allowance + 20% off balanceContact lenses(1 per plan year)Conventional: $150 allowance + 20% off balanceDisposable: $150 allowance + 10% off balanceMedically necessary: $ 250 allowance +10% off balanceFrequency ofServices Exams: 1 x per plan yearLenses: 1 x per plan yearFrames: 1 x per plan yearContact Lenses: 1 x per plan yearYour cost forcoverageEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyPer paycheck$3.16$5.89$6.19$10.31See plan detailsPlease note: You are not permitted to receive benefits for both contact lenses and frames in the same benefityear.Protect your sight and enjoy those sunsets even morewith vision insurance. Receive both preventative andmaterials coverage!Your vision coverage is through Superior Vision.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.
If you coveryourself onlyIf you coverdependents2023 IRSmaximumcontribution $3,850$7,7502024 IRSmaximumcontribution $4,150$8,300Health Savings Account (HSA)55 or older? You can contribute an extra$1,000 per year 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.ContributionsYou may contribute tax-free funds to save for currentand future health expenses - and retirement!HSA FundsSpend your HSA balance on health careexpenses (medical, prescription, dental, andvision) for you and your tax dependents, ORLet your balance grow for retirement.Using your moneyThe money in your HSA is always yours andavailable for qualified health care expenses -even if you change jobs or health plans. Beforeretirement, any funds used for non-healthcareexpenses are subject to tax penalties. Keep yourreceipts!Growing your money + tax savingsHSA dollars go in tax-free, grow tax-free, andcome out tax-free when you use them forqualified health expenses. You may also be ableto invest part of your balance once it meets acertain level.In retirementAt age 65, you can withdraw the funds in yourHSA for any use (not just health care!) without taxpenalties. EligibilityBe enrolled in a qualified High DeductibleHealth Plan (HDHP),NOT be covered under any other non-HDHPhealth coverage, including a full health care FSAthrough your spouse,NOT be anyone else’s tax dependent, and NOT be eligible for or enrolled in Medicare A orB, Tricare, or VA benefits.In order to make – or receive – contributions toa Health Savings Account (HSA), you must:An HSA through Health Equity is paired with a HighDeductible Health Plan (HDHP).Take Advantage of triple tax savings through as HSA.Reduce your taxable income by contribution into thisaccount, purchase qualified healthcare items free of tax,and earn tax-free interest on HSA investment dollars.Unused funds will roll over from year to year. Savings Plan
EmployeeSpouseChild(ren)Coverageincrements$10,000$5,000Flat amount: $1,000,$2,000 $4,000, $5,000or $10,000CoveragemaximumThe lesser of 5x yourannual earnings to$500,000$100,000$10,000Guarantee Issue$100,000$25,000$10,000See plan detailsyour beneficiary if youpass away due to anaccidentyou a partial benefit if youlose specified bodilyfunctions (sight, limbs,etc.)What's AD&D?Accidental death anddismemberment (AD&D)insurance may pay:Guarantee IssueAmountWhen you’re first eligible (anew hire), you can purchaseadditional life insurance up tothis limit without any medicalquestions required. Medical questions andapproval will be required forall future increase andpurchase requests.You can purchase additional Life and AD&D insurance for you andyour dependents . This plan is optional and paid 100% by youthrough payroll deductions if you choose to sign up.Voluntary Life and AD&D InsuranceLife insurance pays a benefit if you pass away while you'recovered. Accidental Death and Dismemberment (AD&D)insurance offers additional support if you pass away or areseriously injured due to an accident.Financial peace of mind through MetLife.Life and AD&D 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.You must submit an Evidence of Insurability ( EOI) form to the insurance carrier if you select anamount of insurance over the " Guarantee Issue Amount ( GI) Any coverage amount over the GI issubject to the carrier's approval. If approved, you will receive a letter in the mail notifying you of theapproval. Note: Voluntary life coverage is available up to the GI amount without the need for anEOI form at an employee's initial eligibility only.
Employee NoticesPlease review the following required employeenotices detailing your rights and options. Youcan also request a paper copy of any of thesenotices at any time.Benefits EnrollmentYour company uses the online enrollment system.Employer Navigator, to make enrollment and futurechanges easy on employees. This system will allowyou make all of your benefit elections online withoutany forms. You can also access this systemthroughout the plan year to review benefitinformation or make demographic or enrollmentchanges. Click Here toDownload Notice!ENROLL NOW!
2023-2024 Benefits Guide