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<strong>2021</strong> BENEFITS<br />
ENROLLMENT GUIDE<br />
Southern Marketing Affiliates, Inc.<br />
EMPLOYEES<br />
Effective 10/1/<strong>2021</strong> to 9/30/2022
CONTENTS<br />
03<br />
07<br />
10<br />
<strong>Benefits</strong> Overview<br />
Medical Insurance<br />
Dental Insurance<br />
11 Vision Insurance<br />
13 Group Life and Accidental Death & Dismemberment Insurance<br />
14 Voluntary Life Insurance<br />
16<br />
18<br />
20<br />
22<br />
26<br />
Long-Term Disability Insurance<br />
Accident Insurance<br />
Critical Illness + Cancer Insurance<br />
401(k) Retirement Plan<br />
Important Contacts<br />
27 Glossary
BENEFITS<br />
OVERVIEW<br />
3
BENEFITS OVERVIEW<br />
ENROLLMENT<br />
You can enroll in benefits or change your elections at the following times:<br />
• 30 days prior to your initial eligibility date (as a newly hired employee)<br />
• During the annual benefits open enrollment period<br />
• Within 30 days of experiencing a qualifying life event<br />
OPTIONS<br />
We offer a comprehensive benefits package consisting of:<br />
• Medical Insurance<br />
• Dental Insurance<br />
• Vision Insurance<br />
• Group Life and Accidental Death & Dismemberment Insurance<br />
• Voluntary Life Insurance<br />
• Long-Term Disability Insurance<br />
• Accident Insurance<br />
• Critical Illness + Cancer Insurance<br />
• 401(k) Retirement Plan<br />
4
BENEFITS OVERVIEW<br />
ELIGIBILITY<br />
Full-time employees working at least 30 hours per week are eligible for<br />
benefits on the first of the month following 60 days of employment. Many of<br />
the plans offer coverage for eligible dependents, including:<br />
• Your legal spouse<br />
• Your children to age 26, regardless of student, marital, or tax-dependent<br />
status (including stepchild, legally adopted child, a child placed with you for<br />
adoption, or a child for whom you are the legal guardian)<br />
• Your dependent children over age 26 who are physically or mentally unable<br />
to care for themselves<br />
CHANGING BENEFITS AFTER OPEN ENROLLMENT<br />
You may pay your portion of your select coverages (medical, dental and vision)<br />
on a pre-tax basis. Thus, due to IRS regulations, once you have made your<br />
elections for the plan year, you cannot change your benefits until the next<br />
annual open enrollment period. The only exception is if you experience a<br />
qualifying event, and election changes must be consistent with your life event.<br />
To request a benefits change, notify Human Resources within 30 days of the<br />
qualifying life event. Change requests submitted after 30 days cannot be<br />
accepted. You may need to provide proof of the life event.<br />
Qualifying life events include, but are not limited to:<br />
• Marriage, divorce, or legal separation<br />
• Birth or adoption of an eligible child<br />
• Death of your spouse or covered child<br />
• Change in your spouse’s work status that affects his or her benefits<br />
• Change in your child’s eligibility for benefits<br />
• Qualified Medical Child Support Order<br />
5
BENEFITS OVERVIEW<br />
<strong>2021</strong> <strong>Benefits</strong> Review<br />
●<br />
●<br />
●<br />
●<br />
●<br />
●<br />
●<br />
●<br />
Medical Insurance <strong>Benefits</strong> - Arkansas Blue Cross Blue Shield<br />
o Change in benefits<br />
o Change in premium<br />
o <strong>SMA</strong> pays 90% employee only costs; employee pays 10% plus dependent costs<br />
Dental Insurance <strong>Benefits</strong> - Arkansas Blue Cross Blue Shield<br />
o Change in benefits<br />
o Change in premium<br />
o <strong>SMA</strong> pays 90% employee only costs; employee pays 10% plus dependent costs<br />
Vision Insurance <strong>Benefits</strong> - Arkansas Blue Cross Blue Shield<br />
o Change in benefits<br />
o Change in premium<br />
o <strong>SMA</strong> pays 90% employee only costs; employee pays 10% plus dependent costs<br />
Group Life and Accidental Death & Dismemberment Insurance <strong>Benefits</strong> - USAble Life<br />
o Change in benefits<br />
o Benefit Amount: $25,000<br />
o Employer paid<br />
Supplemental Life Insurance <strong>Benefits</strong> - USAble Life<br />
o Change in benefits<br />
o No change in premium<br />
o <strong>Employee</strong> paid<br />
Long-Term Disability Insurance <strong>Benefits</strong> - USAble Life<br />
o Change in benefits<br />
o No change in premium<br />
o <strong>Employee</strong> paid<br />
Accident Insurance <strong>Benefits</strong> – Guardian<br />
o <strong>Employee</strong> paid benefit<br />
Critical Illness + Cancer Insurance <strong>Benefits</strong> - Guardian<br />
o <strong>Employee</strong> paid<br />
6
MEDICAL<br />
INSURANCE<br />
7
MEDICAL INSURANCE<br />
CARRIER: Arkansas Blue Cross Blue Shield<br />
Please refer to the official plan documents for additional information on coverage and<br />
exclusions.<br />
COVERED BENEFITS<br />
PPO PLAN<br />
In-Network<br />
Out-of-Network<br />
Calendar Year Deductible<br />
Individual $3,500 $10,500<br />
Family $7,000 $21,000<br />
Out of Pocket Maximum<br />
Includes deductible and coinsurance<br />
Individual $5,500 $21,000<br />
Family $11,000 $42,000<br />
Coinsurance (Plan Pays) 80% 60%<br />
Preventive Care Plan pays 100% 20% after deductible<br />
Physician Services<br />
Primary Care $30 copay 40% after deductible<br />
Specialist $50 copay 40% after deductible<br />
Urgent Care $80 copay 40% after deductible<br />
Emergency Room 20% after deductible 20% after deductible<br />
Lab / X-Ray<br />
Diagnostic Lab/X-Ray 20% after deductible 40% after deductible<br />
High-Tech Services (MRI, CT/PET scans) 20% after deductible 40% after deductible<br />
Hospital Services<br />
Inpatient 20% after deductible 40% after deductible<br />
Outpatient 20% after deductible 40% after deductible<br />
Prescription Drugs Retail Mail Order<br />
Generic $20 copay $40 copay<br />
Preferred Brand $50 copay $100 copay<br />
Non-Preferred Brand $70 copay $140 copay<br />
Specialty Brand $250 copay $500 copay<br />
Coverage Level<br />
MEDICAL RATES<br />
<strong>Employee</strong> Monthly<br />
Contribution<br />
<strong>Employee</strong> Only $48.03<br />
<strong>Employee</strong> & Spouse $576.34<br />
<strong>Employee</strong> & Child(ren) $297.77<br />
<strong>Employee</strong> & Family $1,028.39<br />
8
DENTAL<br />
& VISION<br />
INSURANCE<br />
9
DENTAL INSURANCE<br />
CARRIER: Arkansas Blue Cross Blue Shield<br />
● You will pay less out of pocket when you choose an in-network provider.<br />
● Locate an in-network provider at www.arkansasbluecross.com.<br />
● Be sure to ask for a pre-treatment estimate.<br />
● Out-of-network providers can balance bill, or bill you for the difference between<br />
the provider’s charge and the allowed amount.<br />
Dental Election<br />
<strong>Employee</strong> Monthly<br />
Contribution<br />
<strong>Employee</strong> Only $3.10<br />
<strong>Employee</strong> & Spouse $38.35<br />
<strong>Employee</strong> & Child(ren) $61.85<br />
<strong>Employee</strong> & Family $98.82<br />
COVERED BENEFITS<br />
PLAN PAYS<br />
Deductible (per calendar year)<br />
Annual Plan Benefit Maximum<br />
Diagnostic & Preventive Services<br />
Oral exams, cleanings, X-rays, fluoride treatments, sealants<br />
Basic Services<br />
Fillings, extractions, non-surgical periodontics, endodontics<br />
(root canals), oral surgery, anesthesia<br />
Major Services<br />
Bridges, crowns, inlays/onlays, dentures (full/partial),<br />
surgical periodontics, implants<br />
$50 per person, $150 (3) per family<br />
$1,500 per covered member<br />
100%<br />
80%<br />
50%<br />
Orthodontia Services (Dependent Children to age 18) 50%<br />
Lifetime Orthodontia Plan Max $1,500<br />
10
VISION INSURANCE<br />
CARRIER: Arkansas Blue Cross Blue Shield<br />
● You will pay less out of pocket when you choose an in-network provider.<br />
● Locate an in-network provider at www.arkansasbluecross.com.<br />
● You must submit a claim form for out-of-network expenses.<br />
● LASIK surgery discounts available<br />
Vision Election<br />
<strong>Employee</strong> Monthly<br />
Contribution<br />
<strong>Employee</strong> Only $1.03<br />
<strong>Employee</strong> & Spouse $11.37<br />
<strong>Employee</strong> & Child(ren) $12.80<br />
<strong>Employee</strong> & Family $26.03<br />
COVERED BENEFITS IN-NETWORK OUT-OF-NETWORK<br />
Eye Exam (every 12 months) $10 copay $45 allowance<br />
Standard Plastic Lenses (every 12 months)<br />
Single: $10 copay<br />
Lined Bifocal: $10 copay<br />
Lined Trifocal: $10 copay<br />
Lenticular: $10 copay<br />
Single: $30 allowance<br />
Lined Bifocal: $50 allowance<br />
Lined Trifocal: $65 allowance<br />
Lenticular: $100 allowance<br />
Frames (every 24 months) $150 allowance $70 allowance<br />
Contact Lenses (instead of glasses; every 12<br />
months)<br />
Elective<br />
Medically Necessary<br />
$150 allowance<br />
Plan Pays 100%<br />
$105 allowance<br />
$210 allowance<br />
11
GROUP LIFE &<br />
VOLUNTARY LIFE<br />
12
GROUP LIFE INSURANCE<br />
CARRIER: USAble Life<br />
LIFE and ACCIDENTAL DEATH & DISMEMBERMENT (AD&D)<br />
Basic life and AD&D insurance are automatically provided to all benefits-eligible<br />
employees at no cost. If you die as a result of an accident, your beneficiary<br />
would receive both the life and the AD&D benefit.<br />
● Life Insurance Amount: $25,000<br />
● Guaranteed Issue: $25,000<br />
● AD&D Amount: Equal to life insurance amount<br />
● Benefit Reduction Schedule: 35% at age 65 and 50% at age 70<br />
● Waiver of Premium: Limiting age 60; Elimination period 6 months;<br />
Coverage termination at age 65<br />
● Accelerated Death Benefit: 75% of life benefit to a max of $250,000<br />
REMINDER<br />
Review your beneficiary designations<br />
13
VOLUNTARY LIFE INSURANCE<br />
CARRIER: USAble Life<br />
WHAT IS VOLUNTARY LIFE INSURANCE? Voluntary life insurance is offered<br />
through an employer but is paid by employees.<br />
WHY PURCHASE VOLUNTARY LIFE INSURANCE?<br />
● This type of life insurance has limited underwriting required. This allows for people with<br />
health conditions or lifestyles that might otherwise disqualify them to qualify for life<br />
insurance.<br />
● The group rates are lower than what you could purchase on your own.<br />
● You may purchase a policy for your spouse and children.<br />
● You may purchase a policy for your spouse and children IF you elect coverage for<br />
yourself.<br />
REMINDER<br />
Review your beneficiary designations<br />
14
VOLUNTARY LIFE INSURANCE<br />
CARRIER: USAble Life<br />
<strong>Employee</strong><br />
●<br />
Benefit Amount: $10,000 increments to a maximum of 5x annual salary not to exceed<br />
$500,000<br />
● Guarantee Issue Amount: $100,000<br />
● Age Reduction: 35% at age 65 and 50% at age 70<br />
Spouse<br />
● Benefit Amount: $5,000 increments to a maximum of $100,000<br />
● Guarantee Issue Amount: $25,000<br />
● Age Reduction: 35% at age 65 and 50% at age 70<br />
Child(ren)<br />
● Newborn child to 6 months old: $1,000<br />
● Child more than 6 months to 19 years (23 years if full-time student): minimum of $1,000 to a<br />
maximum $10,000<br />
Voluntary Life<br />
Monthly Rate<br />
Per $1,000 Benefit<br />
Age <strong>Employee</strong> Rate Spouse Rate<br />
Under 30 $0.095 $0.095<br />
30-34 $0.127 $0.127<br />
35-39 $0.160 $0.160<br />
40-44 $0.190 $0.190<br />
45-49 $0.283 $0.283<br />
50-54 $0.472 $0.472<br />
55-59 $0.842 $0.842<br />
60-64 $1.183 $1.183<br />
65-69 $2.079 $2.079<br />
70+ $3.620 $3.620<br />
Child(ren) $0.240<br />
REMINDER<br />
Review your beneficiary designations<br />
15
LONG-TERM<br />
DISABILITY<br />
INSURANCE<br />
16
LONG-TERM DISABILITY INSURANCE<br />
CARRIER: USAble Life<br />
Long-term disability (LTD) insurance is designed to help you meet your financial<br />
needs during longer disability periods. This is a voluntary plan; employees are<br />
responsible for 100% of the cost. Premiums are calculated as a percentage of<br />
your annual base salary. Benefit may be offset due to other benefits such as<br />
paid sick leave, workers’ compensation.<br />
● Benefit Amount: 60% of base monthly salary up to a maximum of $5,000<br />
per month and minimum of $100<br />
● Benefit Durations: Until Social Security Normal Retirement Age<br />
● Pre-Existing Condition Waiting Period: Condition treated within last 3<br />
months will not be covered for 12 months.<br />
LTD Rate<br />
Per $100 of payroll<br />
$0.68<br />
17
ACCIDENT<br />
INSURANCE<br />
18
ACCIDENT INSURANCE<br />
CARRIER: Guardian<br />
Accident insurance supplements your existing medical insurance in case you are have an accident;<br />
medical insurance alone may not be enough to cover your expenses. The plan pays a cash benefit during<br />
the term of your coverage following a covered accident and could help cover:<br />
●<br />
●<br />
●<br />
●<br />
Out-of-pocket expenses such as copays and deductibles<br />
Transportation<br />
Lodging costs<br />
Emergency room expenses<br />
Accident Coverage<br />
Accidental Death and Dismemberment Benefit<br />
<strong>Employee</strong><br />
Spouse<br />
Child<br />
Catastrophic Loss<br />
Quadriplegia<br />
Loss of speech and hearing (both ears)<br />
Loss of cognitive function<br />
Hemiplegia<br />
Paraplegia<br />
Portability<br />
Wellness<br />
$50,000<br />
$25,000<br />
$10,000<br />
100% of AD&D<br />
100% of AD&D<br />
100% of AD&D<br />
50% of AD&D<br />
50% of AD&D<br />
You may continue coverage for yourself and your covered dependents if you<br />
cease to qualify as an employee. You must be insured under the policy for at<br />
least 12 consecutive months and enroll within 60 days from the date you<br />
cease to qualify.<br />
If you or your covered spouse has a covered wellness test performed, you<br />
may be eligible for a $50 benefit. This benefit is payable once per calendar<br />
year. Wellness tests or procedures covered are limited to:<br />
➢ Breast cancer screening, prostate cancer screening, ovarian cancer<br />
screening, diabetes testing, pap smear<br />
For a complete list of benefits, please refer to your booklet.<br />
Accident Election<br />
<strong>Employee</strong> Monthly Contribution<br />
<strong>Employee</strong> Only $14.52<br />
<strong>Employee</strong> & Spouse $24.08<br />
<strong>Employee</strong> & Child(ren) $24.97<br />
<strong>Employee</strong> & Family $34.53<br />
19
CRITICAL ILLNESS +<br />
CANCER INSURANCE<br />
20
CRITICAL ILLNESS WITH CANCER<br />
INSURANCE<br />
CARRIER: MetLife<br />
Cancer insurance supplements your existing medical insurance in case you are diagnosed with<br />
cancer; medical insurance alone may not be enough to cover your expenses. Critical illness insurance<br />
also supplements your existing medical insurance in case you are diagnosed with a covered<br />
condition, like a heart attack or stroke. This plan pays a cash benefit during the term of your coverage<br />
following a positive diagnosis of an internal cancer or a covered diagnosis.<br />
BENEFITS<br />
➢ <strong>Employee</strong> may choose a benefit of $20,000<br />
➢ Spouse may choose a benefit of $10,000, up to 50% of the employee benefit.<br />
➢ Child: 25% of employee benefit<br />
Wellness<br />
Covered Conditions (1st occurrence/2nd occurrence)<br />
Invasive Cancer<br />
Carcinoma In Situ<br />
Benign Brain Tumor<br />
Skin Cancer<br />
Heart Attack<br />
Stroke<br />
Heart Failure<br />
Organ Failure<br />
Kidney Failure<br />
If you or your covered spouse has a covered wellness test performed, you may<br />
be eligible for a $50 benefit. This benefit is payable once per calendar year.<br />
Wellness tests or procedures covered are limited to:<br />
➢ Breast cancer screening, prostate cancer screening, ovarian cancer<br />
screening, diabetes testing, pap smear<br />
100%<br />
30% / 0%<br />
75% / 0%<br />
$250 / Not Covered<br />
100% / 50%<br />
100% / 50%<br />
100% / 50%<br />
100% / 50%<br />
100% / 50%<br />
For a complete list of benefits, please refer to your booklet.<br />
MONTHLY PREMIUM<br />
Benefit Amounts
401(k)<br />
RETIREMENT<br />
PLAN<br />
22
401(k) RETIREMENT SAVINGS PLAN<br />
PROVIDER: CUNA<br />
WHAT IS A 401(k) PLAN? A 401(K) is an employer-sponsored<br />
retirement savings plan that allows employees to save and invest a<br />
percentage of their paycheck before taxes are taken out. Employers may<br />
also choose to make matching contributions.<br />
WHO IS ELIGIBLE? Participation in the plan is open to employees who meet the following<br />
requirements:<br />
✔ Age 21<br />
✔ Completion of 1 year of employment<br />
WHAT ARE THE ADVANTAGES OF A 401(k) PLAN? Participation in this plan is a good<br />
way to invest money for retirement. You can reduce your current income taxes and set aside<br />
money for retirement at the same time. Since federal income taxes re calculated on your<br />
income after your retirement plan contribution has been deducted, you may pay less in federal<br />
income taxes. Most states also exempt 401(k) plan contributions from state income taxation<br />
until a distribution is taken from the plan. Thus, you may actually have more spendable income<br />
than you would if you were contributing a comparable amount to a savings account where<br />
contributions and earning are subject to current income tax rules.<br />
HOW MUCH CAN I CONTRIBUTE TO A 401(k) PLAN? For the <strong>2021</strong> calendar year,<br />
you may contribute up to $19,500. This amount will be adjusted for inflation as needed in<br />
future years, Additional deferral amounts for participants 50 years and older are available<br />
through catch-up contributions.<br />
HOW CAN I CHANGE THE AMOUNT THAT IS CONTRIBUTED TO MY 401(k)<br />
ACCOUNT? You can request a change at anytime through your iSolved self service or by<br />
logging into your CUNA (benefits for you) website - https://www.benefitsforyou.com. You may<br />
also stop contributions at any time, or increase or decrease your contributions at the beginning<br />
of each quarter.<br />
23
401(k) RETIREMENT SAVINGS PLAN<br />
WHEN CAN I WITHDRAW MY<br />
401(K) CONTRIBUTIONS?<br />
Like other retirement plans, a 401(k)<br />
plan is intended to be a long-term<br />
retirement investment vehicle. As a<br />
result, withdrawals are allowed when<br />
you reach age 59 ½, terminate<br />
employment, retire, become disabled or<br />
experience financial hardship.<br />
Withdrawals of both contributions and<br />
earnings will be subject to ordinary<br />
income taxes in the year in which you<br />
received the money. Withdrawals prior<br />
to age 59 ½ may also be subject to early<br />
withdrawal and tax penalties.<br />
CAN I ROLL OVER OR TRANSFER AN EXISTING QUALIFIED RETIREMENT PLAN<br />
ACCOUNT INTO MY 401(K) ACCOUNT? Yes, you can rollover or transfer an existing<br />
qualified retirement plan account in to your 401(k) account. Please contact Human Resources for<br />
information on qualifying roll over plans and eligibility.<br />
WHAT OPTIONS ARE AVAILABLE WHEN I TERMINATE EMPLOYMENT OR RETIRE?<br />
When you terminate employment or retire, depending on your account balance, you may keep your<br />
money in the plan, transfer or roll it over to another eligible retirement plan or Individual<br />
Retirement Account (IRA), receive the money in a lump sum or select annuity payments (if allowed<br />
by your plan).<br />
24
401(k) RETIREMENT SAVINGS PLAN<br />
➢<br />
➢ Employer match of 5%<br />
All company matches are immediately vested<br />
➢ Match is on a payroll-by-payroll basis<br />
REPRESENTATIVE INFORMATION<br />
Tim Fitzgerald<br />
Financial Advisor<br />
870-520-7020<br />
Tim.fitzgerald@benjaminfedwards.com<br />
TO ENROLL:<br />
1. Go to https://www.benefitsforyou.com/Register/.<br />
2. Enter the information requested. It only takes a minute!<br />
3. After you complete your registration, you will receive an email telling you that your benefits<br />
for your participant account have been activated. You may then go to<br />
www.benefitsforyou.com, sign in with your User ID and password and begin to enjoy the many<br />
services that ‘<strong>Benefits</strong> for You’ has to offer, including:<br />
• Use ReitreOnTarge4t, the online planning tool that helps you set goals and guides you in<br />
making decisions to achieve those goals<br />
• See you balances, manage your investment choices, transfer funds, etc.<br />
• Access the Financial Resource Center for a variety of tools to help you manage your<br />
overall finances<br />
<strong>Benefits</strong> for You provides all the tools and resources you need to actively manage your retirement<br />
plan. If you have questions or need help accessing the <strong>Benefits</strong> for You website, contact the<br />
Participant Service Center toll-free at 800-279-4015 ext 206.<br />
25
IMPORTANT CONTACTS<br />
BENEFIT CARRIER PHONE WEBSITE<br />
Medical Insurance Arkansas BCBS 800-588-5733 www.arkansasbluecross.com<br />
Dental Insurance Arkansas BCBS 800-588-5733 www.arkansasbluecross.com<br />
Vision Insurance Arkansas BCBS 800-588-5733 www.arkansasbluecross.com<br />
Life and AD&D Insurance USAble Life 877-203-9921 www.usablelife.com<br />
Long Term Disability Insurance USAble Life 877-203-9921 www.usablelife.com<br />
Accident Insurance Guardian 888-600-1600 www.guardiananytime.com<br />
Critical Illness + Cancer Insurance Guardian 888-600-1600 www.guardiananytime.com<br />
401k Plan Tim Fitzgerald 870-520-7020 timfitzgerald@benjaminfedwards.com<br />
<strong>SMA</strong> <strong>Benefits</strong> & Payroll Paige Russell 870-910-6317 paige.russell@smalink.com<br />
<strong>SMA</strong> CFO Jane Mote 870-935-3291 Jane.mote@smalink.com<br />
YOUR BXS INSURANCE ACCOUNT REPRESENTATIVES:<br />
Ashley Bray<br />
Account Manager<br />
870-974-7474<br />
Ashley.Bray@bxsi.com<br />
DiAlma Young<br />
Sr. VP <strong>Employee</strong> <strong>Benefits</strong><br />
870-974-7440<br />
DiAlma.Young@bxsi.com<br />
Steve Shoemaker<br />
Sr. VP Commercial Lines<br />
870-974-7441<br />
Steve.Shoemaker@bxsi.com<br />
26
GLOSSARY<br />
27
GLOSSARY<br />
Coinsurance: Your share of the cost of a covered health care service, calculated as a percent (for<br />
example, 20%) of the allowed amount for the service, typically after you meet your deductible. For<br />
instance, if your plan’s allowed amount for an office visit is $100 and you’ve met your deductible<br />
(but haven’t yet met your out-of-pocket maximum), your coinsurance payment of 20% would be<br />
$20. Your plan sponsor or employer would pay the rest of the allowed amount.<br />
Copay: The fixed amount, as determined by your insurance plan, you pay for health care services<br />
received.<br />
Deductible: The amount you owe for medical services before your medical insurance or plan<br />
sponsor (employer) begins to pay its portion. For example, if your deductible is $3,000, your plan<br />
does not pay anything until you’ve met your $3,000 deductible for covered health care services.<br />
This deductible may not apply to all services, including preventive care. Preventive care is 100%<br />
covered by the plan.<br />
<strong>Employee</strong> Contribution: The weekly amount you pay for your insurance coverage.<br />
Explanation of <strong>Benefits</strong> (EOB) / Personal Health Statement (PHS): A statement sent by your<br />
insurance carrier that explains which procedures and services were provided, how much they cost,<br />
what portion of the claim was paid by the plan, and what portion is your liability, in addition to how<br />
you can appeal the insurer’s decision. These statements are also posted on the carrier’s website for<br />
your review.<br />
In-Network: In-network providers are doctors, hospitals and other providers that contract with<br />
your insurance company to provide health care services at discounted rates.<br />
Out-of-Network: Out-of-network providers are doctors, hospitals and other providers that are not<br />
contracted with your insurance company. If you choose an out-of-network doctor, services will not<br />
be provided at a discounted rate and your cost sharing (deductibles and coinsurance) will increase.<br />
Out-of-Pocket Maximum: The maximum amount of money you will pay for medical services during<br />
the plan year. The out-of-pocket maximum is the sum of your deductible and coinsurance<br />
payments.<br />
28
Southern Marketing Affiliates, Inc.<br />
STEPHANIE.MONTGOMERY@<strong>SMA</strong>LINK.COM | 870.935.3291