Table of Content
- Header
-
Page
- Welcome to Open Enrollment
- Medical Benefits
- AultCare Benefits
- RX Benefits
- HSA
- FSA
- Dental Benefits
- Vision Benefits
- Life & Disability
- Contact Us
- Footer
Welcome to Open Enrollment
Your Benefit Period
January 1, 2023 – December 31, 2023
For Full-Time Employees Only
Buckingham, Doolittle & Burroughs, LLC sponsors the Buckingham, Doolittle & Burroughs, LLC Welfare Benefit Plan under plan number 501 and hereby provides notice of the plan offerings which are effective on 1/1/2023. Please refer to the section below for an overview of benefits and plan changes. If you have any questions about these changes in benefits, please contact, Caytie Matti at
(330) 643-0351 or cmatti@bdblaw.com.
EFFECTIVE January 1, 2023 Overview of Changes:
Medical/RX: Provided through Medical Mutual of Ohio
- PPO $1,500/$3,000 deductible with 80% coinsurance
- HSA $3,000/$6,000 deductible with 100% coinsurance
Medical/RX: Provided through Aultcare with no plan changes
- PPO $1,000/$2,000 deductible with 80% coinsurance
Dental: Provided through Lincoln
- Value Plan: $50/$150 deductible; 100%/100%/60%
- NAP Plan: $50/$150 deductible; 100%/80%/50%
Vision: Provided through EyeMed with no plan changes
Basic Life/AD&D: Provided through Lincoln. 100% Employer paid benefit at no cost to you.
Long-Term Disability: Provided through Lincoln. 100% Employer paid benefit at no cost to you
Voluntary Life/AD&D: Provided through Lincoln. Available for employees.
Medical Benefits
Buckingham, Doolittle & Burroughs, LLC offers healthcare plans to best fit the needs of you and your family. All medical plans use the Anthem network. See the below options to find what works best for you!
Medical Mutual PPO $1,500
Single: $1,500
Family: $3,000
Out Of Pocket Max
Single :$3,000
Family: $6,000
Preventive Services: Covered at 100%
Primary Care: $25 copay
Specialist Visits: $50 copay
Urgent Care: $75 copay
Emergency Room Visits: $250 copay
Medical Mutual HSA $3,000
Single: $3,000
Family: $6,000
Out Of Pocket Max
Single :$3,000
Family: $6,000
Preventive Services: Covered at 100% after Deductible
Primary Care: Covered at 100% after Deductible
Specialist Visits: Covered at 100% after Deductible
Urgent Care: Covered at 100% after Deductible
Emergency Room Visits: Covered at 100% after Deductible
New Medical Mutual of Ohio ID Cards will be mailed in December due to the out of Ohio network changing from Aetna to Cigna effective 01/01/2023
Click on the button below to see the Medical Mutual web site
AultCare Benefits
AultCare PPO $1,000
Single: $1,000
Family: $2,000
Out Of Pocket Max
Single :$1,500
Family: $3,000
Preventive Services: Covered at 100%
Primary Care: Covered at 80%
Specialist Visits: Covered at 80%
Urgent Care: Covered at 100%
ER Visit : Covered at 100%
RX Benefits
Medical Mutual is implementing the following pharmacy program enhancements:
SaveonSP – Manufacturers provide savings for certain specialty drugs
•Target specialty drugs across several therapy classes
•Members who enroll in this program will receive a $0 copay amount of these drugs
•Specialty drugs are filled exclusively by these pharmacies:
•Accredo (owned by Express Scripts)
•Gentry Health Solutions (owned by Discount Drug Mart)
•University Hospitals Specialty Program
Home Delivery Active Choice – Member’s choice Mail Order or Retail
•Letters will be sent to members who are currently filling long-term prescriptions at a retail pharmacy
Opt out of mail order by calling Express Scripts (Rx number on ID card) and advise they want to continue to fill prescriptions at their retail pharmacy.
MMO PPO
30 -Day Supply 90- Day Supply
Tier 1 $10 Tier 1 $25
Tier 2 $40 Tier 2 $120
Tier 3 $70 Tier 3 $210
Tier 4 25% to $350 Tier 4 25% to $350
MMO HSA
RX is covered at 100% after deductible for all tiers 30 or 90 day supply
AultCare PPO $1,000
30 -Day Supply 90- Day Supply
Tier 1 $10 Tier 1 $27
Tier 2 $20 Tier 2 $45
Tier 3 $30 Tier 3 $55
Tier 4 $45 Tier 4 $85
HSA
Take charge of your health care spending with a Health Savings Account (HSA). Contributions to an HSA are tax-free, and no matter what, the money in the account is yours!
A Health Savings Account (HSA) is a tax-free savings account is owned by you, is 100% vested from day one, and let’s you build up savings for future needs. The funds may be used to pay for qualifying healthcare expenses not covered by insurance or any other plan for yourself, your spouse, or tax dependents. You decide how much you would like to contribute, when and how to spend the money on eligible expenses, and how to invest the balance.
UNDERSTANDING YOUR HSA – Pre-tax contributions are deducted through payroll and deposited into your HSA account; – You can use your HSA available funds to pay for qualified medical expenses tax-free; – HSA funds can be used for non-eligible expenses but will be subject to regular income taxes and a 20% excise tax penalty. – Unused funds remain in your account for future use and roll over each calendar year; – HSAs remain with you even if you change health plans or companies. If you open an HSA and later become ineligible to make contributions, you can still use your remaining funds; and – You can change your HSA contribution at any time during the plan year for any reason
HSA Contribution Limits 2023
- Employee: $3,650
- Two person/family: $7,300
HSA "Catch-Up" Contributions
- Age 55 and older: $1,000 a year
HSA Employer Contributions
- Employee/Family: $500 annually ($125 per quarter)
You may use the bank of your choosing for your Health Savings Account.
HSA Eligibility Requirements
To have an HSA and make contributions to the account, you must meet several basic qualifications.
- To be eligible to open and contribute to an HSA, you must have coverage under a qualified High Deductible Health Plan (HDHP).
- Participants cannot be covered by any other health insurance plan (this exclusion does not apply to certain other types of insurance, such as dental, vision, disability or long-term care coverage);
- Participants cannot participate in a Healthcare FSA or spouse/domestic partner’s Healthcare FSA or Health Reimbursement Account (HRA). Participants cannot be enrolled in Medicare or Medicaid.
- You cannot be eligible to be claimed as a dependent on someone else’s tax return.
- You have not received Department of Veterans Affairs Medical benefits in the past 90 days, unless the Veteran has a disability rating. (There may be additional special circumstances, check with your tax preparer).
Maintaining Records
To protect yourself in the event that you are audited by the IRS, keep records of all HSA documentation and itemized receipts for at least as long as your income tax return is considered open (subject to an audit), or as long as you maintain the account, whichever is longer. The IRS requires HSA funds to be used for qualified expenses only. If you use HSA funds for non-eligible expenses, you will be subject to regular income taxes and an additional 20% excise tax penalty.
FSA
Enrollment for the FSA plans occurs in the fall for the calendar year. The Health Care and Dependent Care Flexible Spending Accounts (FSA) allow you to set aside pre-tax dollars to pay for eligible expenses. By contributing to one or both of the Flexible Spending Accounts you reduce your taxable income, so you pay less in taxes — which saves you money.
Contributions
The election you make during enrollment is your election for the entire plan year. You may change it only if you have a qualifying life event and the change request must be consistent with the event.
You may contribute as follows:
Health Care FSA
- Up to [$3,050] annually
- All benefit eligible can participate, unless you or your spouse are contributing to an HSA.
- Reimbursements allowed for unreimbursed medical, prescription, dental, and vision expenses
Dependent Care FSA
- Up to [$5,000] annually
- Limited to [$2,500] if you are married and file separate tax returns
How the Plan Works
You must incur your eligible expenses during the plan year — January 1 to December 31. An expense is considered to be incurred when the service is performed, not when you are billed or pay for the service. You do, however, have until March 31st annually to file your claims. Any funds after March 31 unclaimed will be forfeited.
Dental Benefits
Dentists in your plan network.
- You’ll save money when you visit a dentist in your plan network because Anthem and the dentists have agreed on pricing for covered services. Dentists who are not in your plan network have not agreed to pricing and may bill you for the difference between what Anthem pays them and what the dentist usually charges.
- To find a dentist by name or location, go to anthem.com or call dental customer service at the number listed on the back of your ID card.
MAC Plan
Deductible
Single: $50
Family: $150
Preventive Service: 100% covered
Basic Service: 100% covered
Major Service: 50% covered
Ortho: 50% covered
For more detail or to find a dentist click on the Anthem logo below to see the site.
Vision Benefits
Did You Know?
- Eye exams can help detect serious eye and general health conditions sooner: high blood pressure, diabetes, heart disease, high cholesterol
- Babies should receive their first professional eye exam at 6 months
- 80% of learning in the first 12 years comes through the eyes
Under this plan, you may use the eye care professional of your choice. However, when you visit a participating in-network provider, you receive higher levels of coverage. If you choose to receive services from an out-of-network provider, you will be required to pay that provider at the time of service and submit a claim form for reimbursement.
Plan Features
- Vision Exam: $0 copay
- Single Lenses: $10 copay
- Bifocals: $10 copay
- Trifocals: $10 copay
- Frames: up to $130, plus 15% off remaining balance
Covered Services - Contacts
- Conventional Contacts: $130 retail allowance, plus 20% off remaining balance
- Disposable Contacts: $130 retail allowance
- Contact Lenses Evaluation Fitting: Up to $40
Benefit Frequency
- Exams: Once every 12 months
- Lenses: Once every 12 months
- Frames: Once every 12 months
- Contacts: Once every 12 months (contacts in lieu of frames/lenses)
Life & Disability
Basic Life/AD&D
Coverage Amount: Flat $50,000 Benefit or 1.5x your annual salary, rounded to the next higher $1,00 Accidental Death and Dismemberment (AD&D) - Amount equal to your Life benefit
Guaranteed Issue: $250,000
Benefit Reduction Schedule
- Your insurance will reduce to:
- 65% of the original amount at age 70
- 50% of the original amount at age 75
Additional Plan Provisions
- Conversion: when coverage ends under the plan, you can convert to an individual permanent life policy without evidence of insurability.
*Shareholders and Directors have additional Supplemental Life. Please see Human Resources for additional Details.
Voluntary Life/AD&D
Employees have the opportunity to enroll in supplemental Life insurance. If you choose to enroll in employee coverage, this will be in addition to your employer provided Basic Life coverage.
Plan Options:
- Cost of Coverage: Premiums are based on age-rated tables and paid by the employee every pay period through a payroll deduction. These premiums are post-tax and benefits payable are tax-free.
- Coverage Options: Choose in $10,000 increments up to the lesser of 5x your annual salary or $250,000. Rounded to the nearest $10,000.
- *Employees age 70+ maximum coverage: $50,000
- Do I have to take a health exam to get coverage?
- If you and your dependents enroll in coverage at your initial eligibility date, you may apply for up to the Guaranteed Issue amounts without medical questions.
- Guaranteed Issue: $150,000
Plan Provisions:
- Benefit Reduction Schedule
- 65% of the original amount at age 70
- 50% of the original amount at age 75
- Waiver of Premium: If you become totally disabled while insured under the group policy, your benefit will be continued without payment of the premium for the duration of your disability, or when you attain SSNRA.
- Conversion: when coverage ends under the plan, you can convert to an individual permanent life policy without evidence of insurability.
- Portability: you may apply to keep your coverage after leaving employment with the group. Written application along with the required premium must be made no later than 31 days after the date the insurance would normally terminate.
Long term Disability: Serious illnesses or accidents can come out of nowhere. They can interrupt your life, and your ability to work for months – even years. Long Term Disability provides financial protection for you by paying a portion of your income, so you have financial support to manage your disability and your household.
- Cost of Coverage - 100% Employer Paid. Benefit at no cost to you.
- Elimination Period - This is the number of days that must pass between your first day of a covered disability & the day you can begin to receive your disability benefits.
- Your elimination period is 180 days
- Benefit Duration -The maximum number of weeks you can receive benefits while you are sick or disabled.
- Payments will last for as long as you are disabled, or until you reach the later of age 65 or SSNRA You must be sick or disabled for the duration of the elimination period before you can receive a benefit payment.
- Coverage Amount - Covers 60% of your monthly income, up to a maximum benefit of $5,000 or $10,000 per month.
- What's covered? - A variety of conditions and injuries. Typical claims would include cancer, back disorders, injuries and poison, cardiovascular, joint disorders.
- Definition of Earnings - Base Salary including Commissions
- Excluding overtime & bonuses