T Square Logistic Services Corp.

Table of Content

  1. Header
  2. Page
    1. WELCOME
    2. ELIGIBILITY OVERVIEW
    3. ENROLLMENT
    4. MEDICAL/RX
    5. PLAN OPTIONS
    6. PHARMACY
    7. Virtual Care
    8. DENTAL
    9. VISION
    10. LIFE & DISABILITY
    11. VOLUNTARY LIFE
    12. VOLUNTARY SHORT AND LONG TERM DISABILITY
    13. 401K
    14. UNDERSTANDING YOUR BENEFITS
    15. Additional Resources
    16. Contact Us
  3. Footer

WELCOME

Helping you and your family reach and maintain good health is very important to T Square Logistic Services Corporation. T Square is pleased to offer a selection of benefits designed with your health and financial wellbeing in mind. We review our benefit programs each year to ensure we consider the best combination of benefit coverage, network access and affordability for employees.

 

In the sections below you will find valuable information on your benefit offerings through T Square. You can click on links and download forms as needed to complete your enrollment and you can also use the navigation bar on the left help you navigate through the site.

ELIGIBILITY OVERVIEW

EMPLOYEE ELIGIBILITY

Regular employees working at least 30 hours per week are eligible to participate in benefits offered by T Square. When you enroll in the benefits program, you may also

cover your eligible dependents. Your coverage will be effective 1st of the month following your date of hire.


Who is Eligible for Benefits?

You are eligible to participate in medical, dental, and vision if you are an active, full time employee working at least 30 hours per week. When you enroll yourself in

the medical, dental, vision, and life you may also cover your eligible dependents.


Eligible dependents include your:

•Your Spouse

•Children: Your natural children, adopted children, step children, or your covered spouse’s or domestic partner’s children. Your children must be under age 26.

•Dependent children who cannot support themselves due to a physical or mental handicap that began before they reached age 26.


The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire year.

 You can, however, modify your elections under certain circumstances, called "Qualifying Events". These are events such as marriage, divorce, court order, change in employment status for you or your spouse/children, birth or adoption of a child, loss of eligibility under another plan. If you experience a qualifying event, you may make changes to your benefits within 30 days of the event. Note: Newborns will NOT be Automatically added to your coverage, please notify HR immediately if you experience a new birth and want your dependent added to your plans.


For all employee elections and changes please see complete the applicable enrollment documents contained below:

BENEFIT ELECTION FORM

BENEFIT ELECTION FORM

BENEFIT ELECTION FORM

BENEFIT ELECTION FORM

EOI FORM

EOI- EVIDENCE OF INSURABILITY

EOI FORM

EOI- EVIDENCE OF INSURABILITY

BENEFICIARY UPDATE

BENEFICIARY DESIGNATION FORM

BENEFICIARY UPDATE

BENEFICIARY DESIGNATION FORM

ENROLLMENT

How To Enroll In Benefits

Action Required:


For Open Enrollment All elections must be submitted by 9/21/2022. The benefits you elect during open enrollment will be effective from 10-1-2022 through 9-30-2023.

This is a passive open enrollment so you only need to submit a change form if making changes to your election.


NEW HIRE(s)

All new hires must complete a benefit election form contained below regardless of election. Please complete your new hire enrollment or waiver within 30 days of your date of hire. Provide your supervisor with a copy of your election form to then be submitted to your Benefits Team and processed with the carriers.


Reminder!! The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire year.

Note: Rates and Premiums can be found in the Additional Resources section of this page.


You can, however, modify your elections under certain circumstances, called "Qualifying Events" These are events such as marriage, divorce, birth or adoption of a child, loss of eligibility under another plan. If you experience a qualifying event, you may make changes to your benefits within 30 days of the event or 60 days if the event is due to birth or adoption of a child.


Contact Human Resources if you have questions about qualifying events.

MEDICAL/RX

BLUECROSS BLUESHIELD OF TEXAS

MEDICAL COVERAGES


Did You Know? 

  • Preventive Services are covered at 100% In-Network and copays & deductibles do not apply.
  • You pay less out of pocket if you receive care from an In-Network provider.  
  • You do not need a referral to see a Specialist.


Medical Benefits are provided by BlueCross BlueShield of Texas. You can locate in network providers at the BlueCross BlueShield of Texas website: www.bcbstx.com . Benefits illustrated below are for in network only. For details on the out of network coverage, please consult the Summary of Benefits and Coverage.


Preferred Provider Organization (PPO) Plans have copays for doctor visits, prescription drugs, and other services. All copays, the deductible, and your portion of the coinsurance count towards the out-of-pocket maximum.


To find out if your provider is in-network, please visit the BCBS of Texas website below.

BlueCross BlueShield of Texas

Find An In-Network Provider

BlueCross BlueShield of Texas

Find An In-Network Provider

Preferred Provider Organization (PPO) Overview

Preferred Provider Organization (PPO) Overview

Prescription Drug Benefits Overview

Prescription Drug Benefits Overview

PPO PLAN OPTION

PPO Plan Options

PPO Plan Options

PHARMACY


Prescription drugs are a vital part of your health care coverage. If you have prescription drug coverage through Blue Cross and Blue Shield of Texas (BCBSTX), this information can help you and your doctor get the most from your prescription drug coverage. The Pharmacy Benefit Manager for BCBS is Prime Therapeutics. You can access more information about your pharmacy coverage by visiting www.myprime.com.


A drug list is a list of drugs that are covered under your prescription drug benefit. How much you pay out of pocket is determined by whether your drug is on the list and at what coverage level, or tier. A generic drug is often at the lower tier. See if your drug is covered by reviewing your formulary drug list using the link below!


Express Scripts® Pharmacy, the mail order pharmacy for members with BCBSTX prescription drug coverage, provides safe, fast and cost-effective pharmacy services that can save you time and money. With this program, you can obtain up to a 90-day supply of long-term (or maintenance) medications through Express Scripts® Pharmacy. 


Ordering Through Express Scripts® Pharmacy


Getting Started Online

You have more than one option to fill or refill a prescription online or from a mobile device:


Order Over the Phone

Call 1-833-715-0942, 24/7, to refill, transfer a current prescription or get started with home delivery. Please have your member ID card, prescription information and your doctor’s contact information available.

PPO RX

PPO RX

Virtual Care

MDLIVE
MDLIVE

With Virtual Visits, the doctor is always in. Get 24/7 non-emergency care from a board-certified doctor by phone, online video or mobile app from the privacy and comfort of your own home.

Don’t risk crowded waiting rooms, expensive urgent care or ER bills, or waiting weeks or more to see a doctor, when you can speak with a Virtual Visits doctor within minutes.


Virtual Visits, provided by Blue Cross and Blue Shield of Texas (BCBSTX) and powered by MDLIVE®, are a convenient alternative for treatment of more than 80 health conditions, including:

Allergies, Headaches, Cold/Flu, Nausea, Fever, Sinus Infections and more


Virtual Visit doctors can even send an e-prescription to your local pharmacy


• Call MDLIVE at 888-680-8646

• Go to MDLIVE.com/bcbstx

• Text BCBSTX to 635-483

• Download the MDLIVE app

DENTAL

Delta Dental Plan

Employees have the option to enroll in the Delta Dental Plan. The dental plan allows you to go in-network or out-of-network when selecting a dentist. We encourage you to utilize in-network dentists to minimize your out of pocket expenses. You may locate participating network providers by visiting www.deltadentalins.com.


Did You Know? 

You have the freedom to select the dentist of your choice; however, when you visit a participating in-network dentist, you will have lower out-of-pocket costs, no balance billing, and claims will be submitted by your dentist on your behalf.


Pre-treatment Estimate

If your dental care is extensive and you want to plan ahead for the cost, you can ask your dentist to submit a pre-treatment estimate. While it is not a guarantee of payment, a pre-treatment estimate can help you predict your out-of-pocket costs.

 

To find out if your provider is in-network, please visit the Delta Dental website below.

DENTAL OVERVIEW

DENTAL OVERVIEW

Delta Dental

Find An In-Network Provider

Delta Dental

Find An In-Network Provider

Dental Insurance Overview Video

Dental Insurance Overview Video

VISION

SUPERIOR Vision Plan

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


Eligible employees have the option to enroll in the Superior Vision Plan. The vision plan allows you to go in-network or out-of-network when selecting a provider. We encourage you to utilize in-network providers to maximize the coverage you receive from the plan. You may locate in-network vision care providers by visiting www.superiorvision.com or contacting customer services at 800.507.3800.

VISION OVERVIEW

VISION OVERVIEW

Superior Vision

Find An In-Network Provider

Superior Vision

Find An In-Network Provider

Vision Insurance Overview

Vision Insurance Overview

VOLUNTARY LIFE

SUNLIFE

Voluntary Life/AD&D

A sudden accident or death can leave you or your loved ones in a vulnerable position. Employees have the opportunity to enroll in Term 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.


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.


FOR YOU:

You can choose from $20,000 to $500,000—in increments of $10,000, not to exceed 5 times your basic annual earnings with no medical questions asked up to the Guaranteed Issue amount of $100,000. The benefit amount is reduced to 67% at age 70 and to 45% at age 75. Your coverage ends at termination of employment or retirement.


FOR YOUR SPOUSE:

If you elect coverage for yourself, you can choose from $5,000 to $250,000—in increments of $5,000 —with no medical questions asked up to the Guaranteed Issue amount of $25,000.

(The amount you select for your spouse cannot exceed 50% of your coverage amount.) The benefit amount may be reduced when the employee benefit amount is reduced.


FOR YOUR CHILD(REN):

If you elect coverage for yourself, you can choose $1,000, $5,000 or $10,000—with no medical questions asked. (The amount you select for your child(ren) cannot exceed 50% of

your coverage amount.) The benefit amount may be reduced when the employee benefit amount is reduced. A full benefit is payable for a dependent child from birth to 19 years old or to age 25 if a full-time student.


*Guaranteed Issue (GI) and Evidence of Insurability (EOI)

When you are first eligible (at hire) for Voluntary Life and AD&D, you may purchase up to the Guaranteed Issue (GI) for yourself and your spouse without providing proof of good health (EOI).


Any amount elected over the GI will require EOI. If you elect voluntary life coverage and are required to complete an EOI, it is your responsibility to complete the EOI and send to the provider (address will be listed on your form). In addition, your spouse will need to provide EOI to be eligible for coverage amounts over GI, or if coverage is requested at a later date

VOLUNTARY SHORT AND LONG TERM DISABILITY

SUNLIFE

Short Term Disability

Everyday illnesses or injuries can interfere with your ability to work. Even a few weeks away from work can make it difficult to manage household costs. Short Term 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. Your coverage through SunLife pays 60% of your income to a maximum of $750 per week after a 15 day elimination period due to an injury or illness. Benefits may be paid for up to 11 weeks, as long as you are still unable to work due to a covered disability.


Long Term Disability

Serious illnesses or accidents 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. Benefits begin after a 90 day elimination period are are equal to 60% of covered monthly earnings up to $4,000 for full-time employees. Benefits may be paid for up to your Social Security Normal Retirement age or longer, depending on your age at disability, as long as you are still unable to work due to a covered disability.


Please review the benefit summaries for additional details.

DISABILITY INSURANCE OVERVIEW

DISABILITY INSURANCE OVERVIEW

DISABILITY INSURANCE OVERVIEW

DISABILITY INSURANCE OVERVIEW

401K

T Square 401K offered by Voya. SEE RESOURCE INCLUDED BELOW


The very last page provide the instructions on how to sign up and the codes you will need. The pages in between describe the investment options, forms for non-traditional beneficiary elections, a form for rolling over funds from previous plans, and a risk self-assessment. Most employees sign up online, but there is also a phone number in the packet, 800-584-6001, if you’d like to talk through the choices and enroll during the call with a Voya customer service representative.

UNDERSTANDING YOUR BENEFITS

What is Preventive Care?

What is Preventive Care?

Benefit Terms Explained

Benefit Terms Explained

How to Read An Explanation of Benefits (EOB)

How to Read An Explanation of Benefits (EOB)

What is Balance Billing?

What is Balance Billing?

What is a Qualifying Event?

What is a Qualifying Event?

Primary Care vs. Urgent Care vs. ER

Primary Care vs. Urgent Care vs. ER

Contact Us

As you consider your benefit options, please be sure to review all available information: Plan Summaries, forms, and other videos and flyers found on this webpage. If you don''t understand your benefits or need any assistance, please contact:


T Square