Table of Content
- Header
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Welcome
- OPEN ENROLLMENT REMINDER!
- Wellbeing
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Eligibility & Enrollment
- Eligibility
- Enrollment
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Medical & Rx
- Medical/Rx Plans Overview
- Rx Information
- Providers & Networks
- Virtual Visits
- Carrier Resources & Education
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Accounts
- Health Savings Account (HSA)
- Flexible Spending Accounts (FSA)
- Dependent Care Reimbursement Account (DCRA)
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Dental
- Dental Plans Overview
- Providers & Networks
- Carrier Resources & Education
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Vision
- Network & Resources
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Financial Protection
- Life/AD&D
- Disability
- Voluntary Benefits
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Personal Support & Assistance
- Employee Assistance Plan (EAP)
- Travel Assistance
- 401k
- Additional Educational Videos
- Have Questions?
- Footer
OPEN ENROLLMENT REMINDER!
Open Enrollment is from October 15, 2023 through October 25, 2023. This is the time of year where you can elect new plans with Sample, Inc. You may switch between plans and make changes without being required to have a qualifying life event. Please also keep in mind the following when making your elections for 2024:
- If you are currently covered by the Voluntary Life/AD&D, you may increase your benefit by $10,000 with no evidence of insurability!
- Evidence of Insurability is not required if you are electing the Critical Illness Insurance for the first time during open enrollment, however preexisting condition limitations apply.
- THIS IS AN ACTIVE ENROLLMENT! You must make an active election for all benefits. Current elections will not carry forward.
Wellbeing
In today's fast-paced and interconnected world, where stress and mental health issues are on the rise, effective well-being plays a crucial role. At Sample, Inc., we recognize that a healthy, content workforce is not only more productive but also fosters a positive culture. We strive for a supportive and inclusive environment where we encourage and support improvement of physical, mental, emotional, and social well-being. Whether within a corporate setting, a community, or on a personal level, well-being focuses on fostering awareness, empathy, and support to create a healthier and more balanced workplace and environment for all. Prioritizing employee wellness and wellbeing is not just a policy but a reflection of our commitment to both the individual and collective success of team.
To access the wellbeing newsletter, which includes resources, tips, recipes, and more, please select the button below.
All FULL-TIME employees working at least 30 hours per week are eligible to participate in the benefit plans offered by Bluewater Technologies. Newly hired employees will be eligible the 1st of the month following 30 days of full-time employment. When you enroll in the benefits program, you may also cover your eligible dependents. Dependents include your legal spouse and children.
Children are eligible for benefits as follows:
•Medical, Dental and Vision: Until the last day of the year in which the child turns 26
•Dependent Child Life Insurance & AD&D: Until the last day of the year in which the child turns 26
Should your employment with Bluewater Technologies end, your coverage will end as of the date of termination.
Below is a high-level overview of your plan options and in-network benefit information:
You can view more details of these plans by accessing the benefit summaries provided below.
The three medical plans function differently when it comes to networks and access. The PPO and POS plans provide out-of-network coverage for a variety of services, whereas the HMO only provides out-of-network coverage in the event of a true emergency. If you do seek care out of network, you will experience higher cost sharing in addition to possible balance billing. View the comparison below for additional details on the differences between the PPO, POS, and HMO plans when it comes to networks and access.
Instructions and tips for locating participating providers below --
- PPO PROVIDERS Enter your zip code and select "Yes this is Correct" - then in the upper right corner select your plan "PPO Plans"
- POS MI PROVIDERS Use this button if you are a MI Resident electing a POS Plan or a non-MI resident traveling to MI. Enter your zip code and select "Yes this is Correct" - then in the upper right corner select your plan "Blue Care Network HMO & POS Plans"
- POS NON-MI PROVIDERS Use this button if you live outside of MI or are a MI resident traveling outside of MI. Enter your zip code and select "Yes this is Correct" - then rather than entering your card information, select "Browse a list of plans" and select "BlueCard Traditional"
- HMO PROVIDERS Available to MI residents only. Enter your zip code and select "Yes this is Correct" - then in the upper right corner select your plan "Blue Care Network HMO & POS Plans"
NEW! Blue Cross Online Visits is transitioning to Virtual Care through Teladoc Health
Members will continue to get the same urgent and behavioral health virtual care that they do today but with a new look and feel with better integration with other virtual care solutions they may be engaged in.
All eligible members will need to download the Teladoc Health app and create a new account with Teladoc Health. The Blue Cross Online Visits app will no longer be available as of 1/1/24.
Virtual Urgent Care
Have a virtual visit with a U.S. board-certified doctor for minor illnesses such as colds, sore throats, urinary tract infections and pink eye. Visits are available for adults and children 24/7.
Mental Health Services
Through the Mental Health option, you can connect with a licensed therapist or U.S. board-certified psychiatrist when you’re dealing with stressful situations or issues such as grief, anxiety and depression. Mental health visits require an appointment, but many therapists and psychiatrists have evening and weekend availability.
The Health Savings Account (HSA) allows you to set aside pre-tax dollars to pay for eligible medical, dental, and vision expenses. The POS Medical Plan is qualified for an HSA. By contributing to an HSA you reduce your taxable income, so you pay less in taxes — which saves you money.
HSA IRS Maximums are as follows and are on a calendar year basis. The maximums indicated below are a combined maximum for participant and any employer provided funds to the HSA. If you elect the HSA plan mid-year, maximums are prorated based on your effective date in the HSA plan.
$3,850 for a single contract | $7,750 for a two person or family
$1,000 "Catch Up" contribution for those age 55+
If you have an HSA with another bank or custodian, you can transfer your funds to the SAMPLEINC HSA's with Health Equity by completing this form.
Visit the Health Equity HSA page for more information by clicking HERE!
The Flexible Spending Account (FSA) allows you to set aside pre-tax dollars to pay for eligible medical and/or dental and vision expenses. The nice part about an FSA is you have access to the full annualized amount on day one!
The election you make cannot be changed throughout the year unless the change aligns with the qualifying event. For example, if you get married, you can increase your contribution, however, you cannot decrease or end your FSA for this type of life event.
There are two types of FSA options:
- General Purpose FSA: To pay for qualifying medical, dental, and vision expenses. This type of FSA is only available if you do not have an HSA.
- Limited Purpose FSA: To pay for qualifying dental, vision, and post-deductible medical expenses. This type of FSA is available for those who have an HSA.
Plan Details are as follows:
- You can contribute up to $3,050 annually.
- At the end of the 2024 plan year, if you have not used all of your FSA funds, a maximum of $610 will carry over into next year's FSA plan (should you elect an FSA for the 2025 plan year).
- You have 90 days after the end of the plan year to submit for expenses that occurred on or before 12/31/2023.
- If you are enrolled in an HSA plan, you will be eligible for the Limited Purpose FSA only which can be used for qualifying dental, vision, and post-deductible medical expenses.
- You have access to your full annualized election amount on day one.
Visit the Health Equity FSA page for more information by clicking HERE!
The Dependent Care Reimbursement Account (DCRA) allows you to set aside pre-tax dollars to pay for eligible dependent care expenses. Qualifying expenses include daycare, nursery & preschool tuition, summer day camps, and more!
The election you make cannot be changed throughout the year unless the change aligns with the qualifying event. For example, you can increase your contribution if you add another member to your family through birth or adoption, however, you cannot decrease your contribution for this type of life event.
Plan Details are as follows:
- You can contribute up to $5,000 annually or limited to $2,500 if you are married and file separate tax returns.
- The plan includes a Grace Period which allows you to incur and submit expenses using your 2024 funds until March 15, 2025.
- You have 90 days after the end of the plan year to submit for expenses that occurred on or before 12/31/2023.
- You only have access to the funds of which you have paid into the account.
- Any unused funds are forfeited.
You have the choice of two dental plans - The Core Plan includes a deductible (for basic and major services only), no ortho coverage, higher cost sharing for your basic and major services, and a lower annual maximum - OR - The Buy-Up Plan. The Buy-Up plan has no deductible, richer benefits for basic and major services, orthodontia coverage is included for dependents (through age 19), and a higher annual maximum
Below is a high-level overview of your plan options and benefit information:
What are Preventive Services? Routine oral exams and cleanings, x-rays,, sealants & fluoride treatments
What are Basic Services? Periodontics, endodontics (root canals), oral surgery, fillings, prosthetic maintenance
What are Major Services? Prosthodontics, crowns, dentures, implants & bridges
You can view more details of these plans by accessing the benefit summaries provided below.
Vision
Group #1234 | 866.939.3633 | www.eyemed.com
SAMPLEINC offers vision coverage through EyeMed to help pay for eye exams, prescription glasses and contact lenses. EyeMed also provides discounts for Hearing Care and Lasik.
If you are already enrolled in one of the SAMPLEINC's EyeMed vision plan today and have not already done so, please be sure to register through the EyeMed member portal where you can access important information pertaining to your vision plan with EyeMed including participating providers, coverage information, and explanation of benefits/claims. If you are not currently covered, you will be able to register in the EyeMed portal as of your effective date of coverage.
Below is a high-level overview of your plan and in-network benefits:
(800) 351-7500 | www.reliancestandard.com
A sudden accident or death can leave you or your loved ones in a vulnerable position. SAMPLEINC provides all eligible employees Basic Life and Accidental Death & Dismemberment (AD&D) coverage in the amount of 1 time's your annual salary up to $500,000 at no cost to you. Employees have the opportunity to enroll in additional Life and Accidental Death & Dismemberment insurance which will supplement lost income in the event of an accident or death. If you choose to enroll in employee coverage, this will be in addition to your employer provided Basic Life coverage.
- Evidence of Insurability (EOI) is required for increases in excess of 1 increment during open enrollment and for those electing voluntary life for the first time after initially waiving the coverage.
- Who's Your Beneficiary? Naming a beneficiary is a crucial part of electing life insurance. Also, don't forget to update your primary or secondary beneficiary if you experience a life event, such as a divorce or birth of a child.
- *Guarantee Issue only applies to new hires or newly eligible spouses (due to marriage) electing benefits for the first time; or, when increasing benefits during open enrollment. You are eligible to increase your benefits by 1 increment, not to exceed the guarantee issue amount, during the 2023 open enrollment period with no evidence of insurability.
(800) 351-7500 | www.reliancestandard.com
SAMPLEINC provides both Short & Long Term Disability benefits at no cost to you!
Everyday illnesses or injuries can interfere with your ability to work, more serious issues can impact your ability to work indefinitely. Even a few weeks away from work can make it difficult to manage household costs. Disability coverage provides financial protection for you by paying a portion of your income, so you can focus on getting better and worry less about keeping up with your bills.
SAMPLEINC provides a competitive benefits package for all employees as part of our total compensation package. We realize you make benefit choices based on what’s important to you and the needs of your changing lifestyle. Therefore, along with our core benefits, we offer these additional benefits which help to provide financial support to you. These benefits are paid for through payroll deduction on a post tax basis so that the benefits are tax free.
Accident, Critical Illness, & Hospital coverage is provided through Reliance Standard Life Insurance. Hopefully you are never in the position to use it, but if you were to experience an accident, illness, or hospitalization, it could end up costing you a lot of money. With these plans, you will be paid money for qualifying situations/services to cover our of pocket expenses or you may use the funds for whatever you like.
Identity Protection and Legal Services are provided through ID Shield/Legal Shield. These benefits are offered in an effort to protect and assist with the expenses and services needed in the event you are faced with compromises to your identity or legal matters.
See plan summaries below for additional details.
Employee Assistance Plan (EAP) - All employees and their families have access to use the EAP services. Representative who can assist you through work-life balance, stress management, grief, counseling, and much more. They will also help you find resources within your community.
- New! Now Includes up to 3 face-to-face visits
- Unlimited Referrals for child, pet, and elder care,
- Unlimited referrals for personal services and community resources
- 50-minute consultation for identity theft matters
- Legals services and support
- Plus much more!
Contact ACI Specialty Benefits toll-free at 855-RSL-HELP (855-775-4357) or rsli@acieap.com for more info and to take advantage of these free services when you need them most.
401k
Employees are eligible to contribute starting the 1st of the month following 60 days of employment.
SAMPLEINC matches up to 5% of your contributions!! FREE MONEY!!!
Fully vested after 2 years of employment
New Hires must complete the 401k enrollment at using the button below.
If you do not complete the enrollment process, you will be “auto enrolled” at a 3% deferral contribution rate and your funds will be deposited in the default investment account.
