2023-2024Benefits GuidePart Time Employees
Welcome!Welcome to your 2023-2024 benefits! Your health and the health of your family is as important to us as it is to you. That’s why we have carefully considered the available healthcare options and selected the plans that we feel offer first-rate benefits at a good value. During this enrollment period, please carefully review each of your options so that you can choose the plans that will best meet your needs. If you have any questions regarding your benefits, please contact us in Human Resources.Sincerely,Human Resources02. MAXISIQHR Contact: Janel Michaelis703-652-6676 | HR@iomaxis.com03. Eligibility04. Medical Plans - Cignawww.mycigna.com05. Health Savings Account – HSA Bank800-357-6246 | www.HSABank.com06. Cigna Resources07. Dental Plan - Cignawww.mycigna.com08. Vision Plan - Cignawww.mycigna.com2Contents & Contacts09. Dependent Care Flexible Spending Account - HealthEquity866-346-5800 | www.healthequity.com10. Life and Disability Plans - Lincoln800-423-2765 | www.LincolnFinancial.com12. Additional BenefitsEmployee Assistance Program (EAP) -ComPsych888-628-4824 | www.GuidanceResources.comRetirement and 401(k) - Nationwide800-772-2182 | www.nationwide.com14. Required Notices & Enrollment
How to EnrollYou will receive information on how to log into Paycom during your new hire window. Once logged in, review your plan options and elect your benefits for the plan year that ends June 30, 2024.Changes Throughout the Year Once your new hire window ends, you will not be able to make changes to your benefit elections until our next Open Enrollment (unless you experience a qualifying life event). Examples of life events are:• Marriage• Divorce or Legal Separation• Childbirth• Adoption or placement for adoption• Your spouse obtaining new coverage• Your spouse losing coverageIf you experience a qualifying life event, you have 31 days from the life event date to make changes to your coverage. For more information on qualifying life events, contact the Human Resources Department.If you are an employee regularly scheduled to work 20 or more hours, you will be eligible for Medical, Dental and Vision benefits. In order to enroll in ancillary benefits, you must be an active employee scheduled to work at least 30 hours per week. For new hires, benefits go into effect on the 1st if they are hired on the 1st or on the 1st of the month following date of hire. The 401(k) eligibility date is the first of the month after completion of three (3) consecutive months of employmentEligible DependentsAs an eligible employee, you may also cover your eligible family members. For the Medical and Dental plans your eligible dependents include your spouse, your children up to age 26 and your disabled children of any age (if disabled prior to age 26 and totally dependent on you). For the Voluntary Life/AD&D plan, eligible dependents include your spouse and unmarried dependent children up to age 26.Coverage LevelsYou may choose from the following coverage levels for Medical and Dental:• Employee Only• Employee + Spouse• Employee + Child• Employee + Children• FamilySBC & Uniform GlossaryYour employer is required to provide you with an easy-to-understand summary about the health plan benefits available to you, aka Summary of Benefits and Coverage (SBC) and a Uniform Glossary that outlines insurance definitions. SUMMARY OF BENEFITS & COVERAGE (SBCs) are available free of charge from your HR department. Please contact HR to request copies of any or all of the medical plans that are offered to you during your plan year.The UNIFORM GLOSSARY is a glossary of insurance definitions in standard, consumer-friendly terms. You may find this helpful as you are evaluating your options. To access the glossary visit: www.healthcare.gov/glossaryWho can enroll in benefits?EligibilityWant to learn more about qualifying events? Watch this video HERE! 3Return to Table of Contents
Monthly CostOAP Plan OAP HSA PlanEmployee Only $284.18 $67.13Employee + Spouse $1,229.47 $757.02Employee + Child $484.29 $274.57Employee + Children $742.57 $274.57Family $1,669.39 $835.09You have the choice of choosing between two Cigna medical plans. Both plans utilize Cigna’s Open Access Plus network. Please see the detailed benefit comparison below and benefit summaries which are posted to Paycom. Open Access Plus Network – you have the freedom to use any provider or facility of your choice, whether they are in the Cigna OAP network or out of the network. However, staying in-network will help keep your costs down and avoid any additional paperwork. We encourage you to call your provider to verify that they participate in the Cigna OAP network. To see if your doctor is in-network, go to www.cigna.com and click “Find a Doctor”.Medical PlansCIGNA MEDICAL PLAN DETAILSOpen Access Plus (OAP) PlanOpen Access HSA Plan Annual Deductible In-NetworkOut-of-Network$250 Single / $500 Family$500 Single / $1,000 Family$1,800 Single / $3,600 Family$3,000 Single / $6,000 FamilyOut-Of-Pocket MaximumIn-NetworkOut-of-Network$4,000 Single / $8,000 Family$5,500 Single / $11,000 Family$3,600 Single / $7,200 Family$6,000 Single / $12,000 FamilyPHYSICIAN SERVICESPreventive CareIn-NetworkOut-of-NetworkCovered in fullYou pay 20%, after deductibleCovered in fullYou pay 30%, after deductibleOffice VisitsIn-NetworkOut-of-Network$25 PCP / $50 SpecialistYou pay 20%, after deductibleYou pay 0%, after deductibleYou pay 30%, after deductibleHOSPITAL SERVICESInpatient CareIn-NetworkOut-of-Network$500 copayYou pay 20%, after deductibleYou pay 0%, after deductibleYou pay 30%, after deductibleEmergency Room In-NetworkOut-of-Network$250 copay, after deductiblePaid as in-network$250 copay, after deductiblePaid as in-networkPRESCRIPTIONS After Medical Deductible:Generic$10 copay $10 copayBrand$30 copay $30 copayNon-Formulary$60 copay $60 copaySpecialty20% to $150 20% to $1504Return to Table of Contents
How to Use an HSASTART ITHSA Bank will send a welcome kit. BUILD ITYour contributions to your HSA are pre-tax through payroll contributions (Limits apply).USE ITYou can use the money in your HSA to pay for covered health care for you and your qualified dependents (like the deductible and coinsurance). Withdrawals from your HSA (for qualified expenses) are tax-free!Are you eligible for an HSA?If you enroll in the Cigna OAP HSA Medical plan, you will have access to a Health Savings Account (HSA) through HSA Bank. Funds in the account can be used to pay for current or future qualified healthcare expenses and help you meet your annual deductible. The HSA is owned by you, even if you leave MAXISIQ and allows you to have more control over your healthcare dollars. Unused funds and interest roll over without limit from year to year.Health Savings Accounts go into your account tax-free, grow tax-free and you’re able to withdrawal funds tax free for eligible expenses. You are eligible to open and fund an HSA if:• You are enrolled in the HSA medical plan as your sole health plan coverage• You are not eligible to be claimed as a dependent on someone else’s tax return• You are not enrolled in Medicare, TRICARE or a full purpose Health FSA• You have not received Veterans Administration (VA) Benefits within the past 3 months (excludes VA benefits received for a combat- related condition/disability)Using your HSA as a powerful retirement toolThe funds in an HSA can be used for general non-medical purposes, without penalty, once you reach age 65. While HSAs are not intended to be used for retirement — they're designed for you to use funds to pay for qualifying healthcare expenses — they are a tax-friendly investment vehicle and can act as a powerful retirement-savings tool if you let your balance compound over years.HSA Bank2023 IRS MAXIMUM ANNUAL CONTRIBUTIONEnrolled as Employee Only$3,850Enrolled with Dependent(s)$7,750MAXISIQ CONTRIBUTION TO YOUR HSAMAXISIQ’s contributions factor into the annual maximumEnrolled as Employee Only$325Enrolled with Dependent(s)$700GROW ITUnused money in your account will roll over to the next year. Your account will earn interest and grow over time.KEEP ITYou always own the money in your HSA, including all contributions and any interest and other investment earnings. You can also take the account with you if you change employers.HealthSavingsAccount (HSA)5If you are 55 or older, you can contribute an extra $1,000 each year through the HSA Catch-Up Contribution. Return to Table of Contents
Cigna ResourcesOnce you enroll in a medical plan, you can register for access to a member portal at www.mycigna.com and take advantage of all the resources the website has to offer. You can also download the MyCigna app to your smart device.• Manage and track claims• See cost estimated for medical procedures• Track your account balances and deductibles• Print a temporary ID card• Use the easy health and wellness toolsMyCigna Member Portal & AppCigna contracts with several digital and virtual providers including MDLive, Ginger, TalkSpace and Meru Health. This increases access to care and allows for anonymous, convenient care. Plus, members can self-manage care through online tools.Whether you’re looking for virtual visits with a licensed therapist or psychiatrist, behavioral health coaching, peer support or self-service digital tools, Cigna has a virtual service to support your needs. Simply log into your www.mycigna.com member portal to get started.Cigna Virtual CareCall a Cigna One Guide representative during pre-enrollment to get personalized, useful guidance. They can answer questions about benefits and check if your doctors are in-network. Call (888) 806-5094 to speak with a Cigna One Guide rep today.After enrollment, the support continues. Your Cigna One Guide rep will be there to guide you through the complexities of the health care system and help you avoid costly missteps. Cigna One Guide service provides personalized assistance to help you:• Resolve health care issues• Save time and money• Get the most out of your plan• Find the right hospitals, dentists and other health care providers in your plan’s network• Get cost estimates and avoid surprise expenses• Understand your billsCigna One Guide6Return to Table of Contents
CIGNA DENTAL PLAN In-Network Out-of-NetworkAnnual Deductible (applies to Basic/Major Services Only)$50 Single$150 Family$50 Single$150 FamilyAnnual Maximum$1,500$1,500Preventive Services(exams, cleanings, x-rays)Covered at 100%Covered at 100% of UCRBasic Services(endodontics, periodontics, fillings)Covered at 90%, after deductibleCovered at 80%, after deductible*Major Services(crowns, dentures, bridges)Covered at 60%, after deductibleCovered at 50%, after deductible*Orthodontia(children to age 19)Covered at 50%Covered at 50%Orthodontic Lifetime Maximum$1,500$1,500Dental PlanMonthly CostCigna DentalEmployee Only $6.91Employee + Spouse $14.60Employee + Child(ren) $17.80Family $27.52You and your dependents can enroll in Dental coverage through Cigna. With this plan you have access to coverage both in and out-of-network. However, if you visit an out-of-network dentist, you will be responsible for any charges that are more than the Usual, Customary and Reasonable fees charged by dentists, plus any applicable deductibles and coinsurance.To see if your dentist participates with Cigna:1. Visit cigna.com and click on “Find a Doctor, Dentist or Facility”2. Enter your location and choose “Cigna DPPO Advantage” as your plan7*If you are a resident of Texas or Georgia, your out-of-network coinsurance will match the in-network coinsurance as require by state law. Return to Table of Contents
CIGNA VISION PLAN In-Network Out-of-NetworkEye Exam $10 copayReimbursed up to $45Eyeglass LensesSingle VisionLined BifocalLined TrifocalLenticular$25 copayReimbursed up to $32Reimbursed up to $55Reimbursed up to $65Reimbursed up to $80Frames$130 allowance, plus 20% off balanceReimbursed up to $71Elective Contact Lenses(in lieu of glasses)$130 allowanceReimbursed up to $105Service FrequencyExam: once every 12 monthsLenses: once every 12 monthsFrames: once every 24 monthsVision PlanMonthly CostCigna VisionEmployee Only $7.90Employee/Spouse $15.79Employee/Child(ren) $15.95Employee/Family $25.46You and your dependents can enroll in Vision coverage through Cigna (using the EyeMed network). Vision benefits are so much more than an eye exam. They help you save money, stay healthy and see everything life has to offer. With this plan, you have coverage for both in and out-of-network providers. However, your out-of-pocket costs will be significantly less when you use an in-network vision provider.To find a participating provider, go to https://eyedoclocator.eyemedvisioncare.com/cigna/en. 8Return to Table of Contents
Dependent Care Flexible Spending Account (FSA)Who are my eligible dependents?You can use your FSA to pay for care for children under age 13 that you claim as dependents, as well as adults or other relatives that are incapable of caring for themselves (if you provide more than 50% of their support).What type of care is eligible?Eligible expenses must be for the purpose of allowing you to work or look for work. Services may be provided at a child or adult care center, nursery, preschool, after-school, summer day camp, or a nanny in your home.What type of care is not eligible?You cannot use your FSA funds to pay for overnight camp, babysitting that is not work- related, school fees for kindergarten and higher grades, and long-term care services.MAXISIQ offers the option to enroll in a Dependent Care FSA through HealthEquity (formerly WageWorks). The Dependent Care FSA can reimburse you for daycare expenses provided for your dependents so that you (and your spouse, if you are married) can work. Each plan year you elect the total amount you will use for dependent care expenses, and it will then be deducted, pre-tax, in equal increments from your paycheck over the course of the plan year. Your overall family contribution to a dependent care account cannot exceed $5,000 ($2,500 if married and filing separately).9How do I use the funds in my account?You will pay for care out-of-pocket and then file a reimbursement claim. The easiest way to submit a claim is through the HealthEquity Mobile App. All you must do is download the free app onto your smartphone. Then log into your account and go. You can also submit claims by logginginto your HealthEquity account through your computer.Important notes to remember:• Our plan year runs 7/1—6/30.• You have until August 31, 2024, to submit claims from the 2023-2024 plan year.• It is important to estimate conservatively the amount you want to contribute to your FSA. If there is a remaining balance in your account after the plan year ends, the balance will be forfeited. Budget carefully!• Your care provider must report any amounts earned under this plan as taxable income.9Return to Table of Contents
Our Life Insurance plans are offered through Lincoln. These plans are available to you and your dependents. When enrolling, don’t forget to assign your beneficiary!Life PlansBasic Life InsuranceIn the event of your death, your beneficiary will receive a flat $50,000 benefit. Benefits reduce to 65% at age 65 and to 50% at age 70. MAXISIQ provides this coverage at no cost to you.Voluntary Life/AD&DYou can purchase additional Life/AD&D insurance for you and your dependents through the Voluntary Life/AD&D plan. This plan is optional and paid 100% by you through payroll deductions if you choose to sign up.Below is a basic summary of benefits. You may be required to submit Evidence of Insurability (EOI) before being approved for coverage. See Paycom for more information.LincolnMAX BENEFIT AMOUNTEmployee Coverage$500,000 in increments of $10,000, not to exceed 5x annual salarySpouse Coverage100% of employees benefit up to $250,000, in increments of $5,000Dependent CoverageBetween $2,000 -$10,000 in increments of $1,00010Return to Table of ContentsCost per month per $1,000 of coverageLife Age Bands Employee/Spouse Rates0-29$0.0630-34$0.0835-39$0.0940-44$0.11345-49$0.17950-54$0.28555-59$0.44660-64$0.67365-69$1.2770-99$2.06Child Life Rate$0.27AD&D Rate$0.02Accidental Death & Dismemberment (AD&D) InsuranceIf your death is the result of an accident, your beneficiary will receive an additional flat $50,000. Certain other benefits are paid for loss of limb, loss of speech or loss of use of certain parts of your body. MAXISIQ provides this coverage at no cost to you.
MAXISIQ provides this benefit at no cost to you. Please contact HR for more information.Employer-PaidShort-term DisabilityYour income is often your most important financial asset. Disability insurance will help to replace a portion of your income if you experience a covered illness or injury. Disability PlansLong term disability insurance will start paying out at the end of the short-term disability coverage period. Please contact HR for more information. The cost of coverage is included in your taxable income so that any benefits received will be tax-free.Employer-PaidLong-term DisabilityLincolnWEEKLY BENEFITPercentage of Salary60%Maximum Weekly Benefit$3,000PLAN DETAILSBenefit Begins(days after an accident/illness)8/8Maximum Benefit Duration12 weeksLincolnMONTHLY BENEFITPercentage of Salary50%Maximum Monthly Benefit$12,500PLAN DETAILSElimination Period90 daysMaximum Benefit DurationSocial Security Normal Retirement Age11Return to Table of Contents
Additional BenefitsLincoln’s EAP through ComPsych assists employees and their eligible dependents with personal or job-related concerns, including emotional well-being, family and relationships, legal and financial issues, healthy lifestyles, work / life transitions and more! You have unlimited telephone access to professionals 24/7 and access to online resources and 5 in-person sessions with a counselor (per person, per issue, per year).For more information about the program, visit GuidanceResources.com, download the Guidance-Now mobile app or call (888) 628-4824. Login credentials to access the site:Username: LFGSupportPassword: LFGSupport1Employee Assistance Program (EAP) 12Return to Table of ContentsTravelConnect services offer help, comfort and reassurance—helping make travel less stressful. As part of the Life/AD&D plan, you and your loved ones can count on TravelConnect services 24/7. You’ll have dedicated support if you face an emergency when you’re 100 or more miles from home. Services include:• Emergency medical evacuation• Planning and paying for a safe evacuation because of natural disaster or a political or security threat.• Medication and vaccine delivery• Legal consultation• Recovering lost or stolen documents/luggage• Language translation services• ID recovery assistanceFor a complete list of services go to mysearchlightportal.com and enter your Group ID: LFGTravel123Travel ConnectNo matter how well you plan, unexpected challenges will arise. When they do, help and support are nearby—thanks to LifeKeys services. Services include:• Save money on shopping and entertainment• Protection against identity theft• Online will preparation• Guidance and support for your beneficiariesIt’s easy to access LifeKeys. Just visit GuidanceResources.com, download the GuidanceNow mobile app or call (855) 891-3684. First-time user: Enter Web ID LifeKeysLifeKeys
Additional BenefitsMAXISIQ offers retirement planning assistance with a 401(k) plan through Nationwide.The 401(k) eligibility date is the first of the month after completion of three (3) consecutive months of employment. MAXISIQ will match your eligible contributions up to 3% and 50% of contributions that exceed 3% but do not exceed 5%. Contact Human Resources for more information.Visit www.nationwide.com to access your personal account.401(k) Retirement Savings Plan13Return to Table of ContentsThe company will observe the following eleven paid holidays each year:• New Year’s Day - 1 January• Martin Luther King, Jr.’s Birthday - 3rd Monday in January• President’s Day - 3rd Monday in February• Memorial Day - Last Monday in May• Juneteenth - 19 June• Independence Day - 4 July• Labor Day - 1st Monday in September• Veteran’s Day - 11 November• Thanksgiving Day - 4th Thursday in November• The Day after Thanksgiving• Christmas Day - 25 DecemberWhen a paid holiday falls on a Saturday or Sunday, customarily either the Friday before or the Monday after is observed as the paid holiday.Martin Luther King Jr.’s Birthday, President’s Day, Juneteenth, The Day After Thanksgiving, Veteran’s Day and Christmas Day are eligible “floating” holidays. In recognition that employees may have differing beliefs, MAXISIQ employees are also authorized to float Christmas day. Floating Holidays may be taken either on the observed day or on another day, with manager permission. Employees will not normally be allowed to work on non-float holidays unless supervision is available. The floating holiday must be taken within the calendar year which they are earned. Paid Holiday Schedule
Required Notices &EnrollmentPlease review the required employee notices detailing your rights and options by clicking the link below. You can also request a paper copy of any of these notices at any time. Employee Notices14DOWNLOAD NOTICES HEREAre you ready to make your benefit elections? Click the link below to log into your enrollment system and begin your enrollment.Ready to Enroll? ENROLL NOWThe rates and benefit plan information shown in this guide are illustrative only. To the extent the rates or the benefit plan information summarized hereindiffers from the underlying plan details specified in the insurance documents and/or plan document(s) that govern the terms and conditions of the plansdescribed in this guide, the underlying insurance and/or plan documents will govern in all cases. The insurance carrier will determine the actual ratesbased upon the final member enrollment, plan selection, funding, type, and eligibility criteria. Until that time, and the carrier's final communication, therates will be subject to change.Return to Table of Contents