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2022 Employee Benefits Guide

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<strong>2022</strong> BENEFITS<br />

ENROLLMENT GUIDE<br />

Allen Engineering Corporation<br />

Effective 1/1/<strong>2022</strong> to 12/31/<strong>2022</strong>


LETTER FROM THE PRESIDENT


CONTENTS<br />

4 <strong>Benefits</strong> Overview<br />

7 Medical Insurance<br />

10 Wellness Overview<br />

11 Health Savings Account<br />

14 Flexible Spending Accounts<br />

18 Dental & Vision Insurance<br />

21 Short-Term Disability Insurance<br />

23 Voluntary Group Life and AD&D Insurance<br />

25 Evidence of Insurability (EOI) and Disclaimer<br />

26 Open Enrollment Instructions<br />

27 Important Contacts


BENEFITS<br />

OVERVIEW<br />

4


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 />

BENEFIT OPTIONS<br />

We offer a comprehensive benefits package consisting of:<br />

• Medical Insurance<br />

• Health Savings Account<br />

• Flexible Spending Accounts<br />

• Voluntary Dental Insurance<br />

• Voluntary Vision Insurance<br />

• Voluntary Group Life and AD&D Insurance<br />

• Voluntary Short-Term Disability Insurance<br />

5


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 or coinciding with 60 days of<br />

employment. Many of the plans offer coverage for eligible dependents,<br />

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<br />

for adoption, or a child for whom you are the legal guardian)<br />

• Your dependent children over age 26 who are physically or mentally<br />

unable to care for themselves<br />

CHANGING BENEFITS AFTER OPEN ENROLLMENT<br />

You may pay your portion of the medical, dental, and vision plan costs, and<br />

fund the flexible spending accounts, on a pre-tax basis. Thus, due to IRS<br />

regulations, once you have made your elections for the plan year, you<br />

cannot change your benefits until the next annual open enrollment period.<br />

The only exception is if you experience a qualifying event, and election<br />

changes must be consistent with your life event.<br />

To request a benefits change, notify your Business Office or Human<br />

Resources within 30 days of the qualifying life event. Change requests<br />

submitted after 30 days cannot be accepted. You may need to provide<br />

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 />

6


MEDICAL<br />

INSURANCE<br />

7


MEDICAL INSURANCE<br />

CARRIER: Arkansas Blue Cross Blue Shield<br />

Plan Options: High-Deductible Health Plan (HDHP) and a PPO plan<br />

Please refer to the official plan documents for additional information on coverage and exclusions.<br />

COVERED BENEFITS<br />

Year Deductible<br />

Option 1<br />

HDHP Plan<br />

Option 2<br />

PPO Plan<br />

In-Network Out-of-Network In-Network Out-of-Network<br />

Individual $6,650 $13,300 $5,000 $15,000<br />

Family $13,300 $26,600 $10,000 $30,000<br />

Out of Pocket Maximum<br />

Includes deductibles, copays and coinsurance Includes deductibles, copays and coinsurance<br />

Individual $6,650 $26,600 $8,150 $31,150<br />

Family $13,300 $53,200 $16,300 $62,300<br />

Coinsurance (Plan Pays) 100% 80% 80% 60%<br />

Preventive Care<br />

Well-Child Care Plan Pays 100% Deductible & Coins. Plan Pays 100% Deductible & Coins.<br />

Adult Preventive Care Plan Pays 100% Deductible & Coins. Plan Pays 100% Deductible & Coins.<br />

Physician Services<br />

Primary Care Deductible & Coins. Deductible & Coins. $30 Copay Deductible & Coins.<br />

Specialist Deductible & Coins. Deductible & Coins.<br />

$50 Copay<br />

(coins may apply to<br />

additional services)<br />

Deductible & Coins.<br />

Urgent Care Deductible & Coins. Deductible & Coins. $50 Coppay Deductible & Coins.<br />

Emergency Services<br />

Emergency Room Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />

Ambulance Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />

Diagnostic Lab/X-Ray Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />

Hospital Services<br />

Inpatient Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />

Outpatient Deductible & Coins. Deductible & Coins. Deductible & Coins. Deductible & Coins.<br />

Prescription Drugs<br />

Generic Deductible & Coins. Deductible & Coins. $20 copay Deductible & Coins.<br />

Preferred Brand Deductible & Coins. Deductible & Coins. $50 Copay Deductible & Coins.<br />

Non-Preferred Brand Deductible & Coins. Deductible & Coins. $70 Copay Deductible & Coins.<br />

Specialty Deductible & Coins. Deductible & Coins. $250 Copay Deductible & Coins.<br />

8


WHICH MEDICAL INSURANCE PLAN IS<br />

RIGHT FOR YOU?<br />

Choosing the right medical plan is an important decision. Take the time to learn about your<br />

options to ensure you select the right plan for you and your family.<br />

THINGS TO CONSIDER<br />

1. Do you prefer to pay more for medical insurance out of your paycheck, but less when you need<br />

care?<br />

2. Or, do you prefer to pay less out of your paycheck, but more when you need care?<br />

3. What planned medical services do you expect to need in the upcoming year?<br />

4. Are you able to budget for your deductible by setting aside pre-tax dollars from your paycheck in<br />

an HSA or FSA?<br />

5. Do you or any of your covered family members take prescription medications on a regular basis?<br />

MEDICAL<br />

RATES<br />

COVERAGE LEVEL<br />

Monthly<br />

Rate<br />

Employer Monthly<br />

Contribution<br />

Option 1<br />

HDHP Base Plan<br />

<strong>Employee</strong> Monthly<br />

Contribution<br />

<strong>Employee</strong> Rate<br />

52 Pay Periods<br />

<strong>Employee</strong> Rate<br />

26 Pay Periods<br />

<strong>Employee</strong> Only $308.51 308.51 $0.00 $0.00 $0.00<br />

EE & Spouse* $774.40 308.51 $465.89 $107.51 $215.03<br />

EE & Child(ren) $510.60 308.51 $202.09 $46.64 $93.27<br />

EE & Family* $1,026.97 308.51 $718.46 $165.80 $331.60<br />

MEDICAL RATES<br />

Option 2<br />

PPO Buy-Up Plan<br />

COVERAGE LEVEL<br />

Monthly<br />

Rate<br />

Employer Monthly<br />

Contribution<br />

<strong>Employee</strong> Monthly<br />

Contribution<br />

<strong>Employee</strong> Rate<br />

52 Pay Periods<br />

<strong>Employee</strong> Rate<br />

26 Pay Periods<br />

<strong>Employee</strong> Only $387.44 $329.32 $58.12 $13.41 $26.82<br />

EE & Spouse* $972.57 $329.32 $643.25 $148.44 $296.88<br />

EE & Child(ren) $641.23 $329.32 $311.91 $71.98 $143.96<br />

EE & Family* $1,289.73 $329.32 $960.41 $221.63 $443.26<br />

*As an <strong>Employee</strong>, I understand that if my spouse is offered coverage through their employer, coverage is NOT available<br />

through Allen Engineering Corporation.<br />

COMPARING YOUR MEDICAL PLAN OPTIONS<br />

PPO Plans<br />

• Higher cost per paycheck<br />

• Lower deductible<br />

• Can fund a Health Care Flexible Spending Account<br />

(FSA)<br />

HDHP Plans<br />

• Lower cost per paycheck<br />

• Higher deductible<br />

• Can fund a Health Savings Account (HSA)<br />

• Allen Engineering Corporation HSA contribution $500<br />

annually<br />

9


WELLNESS OVERVIEW<br />

ANNUAL WELLNESS CHECK UP!<br />

Be sure to complete your preventive care check up between December 1, 2021 and<br />

November 30, <strong>2022</strong>. You will need to take the ’Physician Attestation’ Form with you<br />

when you go for your check up. After your doctor signs the form, return the form to the<br />

HR Department no later than November 30, <strong>2022</strong>. Check with the HR Department for<br />

further details.<br />

HEALTH RISK ASSESSMENT<br />

Be sure to complete your health assessment on the Arkansas Blue Cross website by November 30,<br />

<strong>2022</strong>.<br />

BIOMETRIC SCREENING<br />

Make plans to participate in the biometric screening event in February <strong>2022</strong>. More details to<br />

come.<br />

USE TOBACCO?<br />

Take advantage of the smoking cessation products now available to you at low or no cost through<br />

our BC health plan. Contact Arkansas Blue Cross at 1-800-238-8379 to learn more about how<br />

your new benefits can help you quit.<br />

10


HEALTH<br />

SAVINGS<br />

ACCOUNT<br />

11


HEALTH SAVINGS ACCOUNT<br />

CARRIER: Consolidated Admin Services<br />

If you enroll in the High-Deductible Health (HDHP) Plan, you may be eligible to<br />

fund a Health Savings Account (HSA). An HSA is a personal health care savings<br />

account that you can use to pay out-of-pocket health care expenses with pre-tax<br />

dollars. Your contributions are tax free and the money remains in the account<br />

for you to spend on eligible expenses no matter where you work or how long it<br />

stays in the account.<br />

WHO IS ELIGIBLE?<br />

You are eligible to open and fund an HSA if:<br />

● You are enrolled in the High Deductible Health Plan (HDHP).<br />

● You are not covered by a non-HSA plan, Health Care FSA, or Health Reimbursement<br />

Arrangement.<br />

● You are not eligible to be claimed as a dependent on someone else’s tax return<br />

● You are not enrolled in Medicare<br />

● You have not received Veterans Administration <strong>Benefits</strong> in the last three months<br />

HSA EMPLOYER CONTRIBUTIONS<br />

Allen Engineering Corporation will help you save with an<br />

annual contribution of $600.<br />

● Contributions to a Health Savings Account (including<br />

the employee contributions) cannot exceed the<br />

annual IRS contribution maximums.<br />

● <strong>Employee</strong>s age 55+ by 12/31/<strong>2022</strong> may contribute<br />

additional funds to their HSA (up to $1,000).<br />

● You must open your HSA through Consolidated Admin<br />

Services to receive contributions.<br />

ALLEN ENGINEERING<br />

CORPORATION<br />

CONTRIBUTES $600<br />

TO YOUR HSA<br />

ANNUALLY<br />

$3,650<br />

$7,300<br />

$1,000<br />

INDIVIDUAL<br />

for <strong>2022</strong><br />

ALL OTHER TIERS<br />

for <strong>2022</strong><br />

Age 55+<br />

CATCH-UP<br />

CONTRIBUTION<br />

for <strong>2022</strong><br />

12


HEALTH SAVINGS ACCOUNT<br />

MAXIMIZE YOUR TAX SAVINGS<br />

• Contributions to an HSA are tax-free and can be made through payroll deduction on a pre-tax<br />

basis.<br />

• This money in your HSA (including interest and investment earnings) grows tax-free.<br />

• As long as you use the funds to pay for qualified medical expenses, the money is spent<br />

tax-free.<br />

YOU INDIVIDUALLY OWN YOUR HSA<br />

• You own and administer your HSA.<br />

• You determine how much you will contribute to your account and when to use the money to<br />

pay for eligible health care expenses.<br />

• You can change your contributions at any time during the plan year without a qualifying event.<br />

• Like a bank account, you must have a balance in order to pay for eligible health care expenses.<br />

• Keep all receipts for tax documentation.<br />

• An HSA allows you to save and “rollover” money from year to year.<br />

• The money in the account is always yours, even if you change health plans or jobs.<br />

• There are no vesting requirements or forfeiture provisions.<br />

ACCESSING YOUR HSA FUNDS<br />

Debit Card: Draws directly from your HSA and can be used to pay for eligible expenses at your<br />

doctor’s office, pharmacy, or other locations where you purchase health related items or services.<br />

Checkbook: Works just like your personal checkbook, with the exception that it draws from your<br />

HSA, and can be used to pay for expenses you’ve paid out of your pocket. Checkbooks are issued<br />

upon request by Health Equity.<br />

USE YOUR HSA TO PAY QUALIFIED MEDICAL EXPENSES<br />

• You can use your HSA money to pay for eligible expenses now or in the future.<br />

• Funds in your HSA can be used for your expenses and those of your spouse and eligible<br />

dependents, even if they are not covered by the Arkansas Blue Cross Blue Shield HDHP<br />

(Option 1).<br />

• Eligible expenses include deductibles, doctor’s office visits, dental expenses, eye exams,<br />

prescription expense and LASIK eye surgery.<br />

• A complete list of eligible expenses can be found at www.irs.gov.<br />

13


FLEXIBLE<br />

SPENDING<br />

ACCOUNTS<br />

14


FLEXIBLE SPENDING ACCOUNTS<br />

CARRIER: Consolidated Admin Services<br />

Allen Engineering Corporation offers a Health Care Flexible Spending Account (FSA) that allows you to<br />

pay for eligible health care expenses with the pre-tax dollars.<br />

Log into your account at www.consolidatedadmin.com to view your account balance(s), calculate tax<br />

savings, view eligible expenses, download forms, view transaction history, and more.<br />

HEALTH CARE FSA<br />

●<br />

●<br />

Set aside pre-tax money from your paycheck to pay for eligible out-of-pocket expenses, such as<br />

deductibles, copays, and other health-related expenses, that are not paid by the medical, dental, or vision<br />

plans.<br />

Over-the-counter (OTC) medications are not eligible for reimbursement without a prescription.<br />

HOW DOES AN FSA WORK?<br />

You decide how much to contribute to an FSA on a plan year basis up to the maximum allowable amount. Your<br />

annual election will be divided by the number of pay periods and deducted evenly on a pre-tax basis from<br />

each paycheck throughout the year.<br />

You will receive a debit card from Consolidated Admin Services, which can be used to pay for eligible health<br />

care expenses at the point of service. If you do not use your debit card, submit a claim form and a bill or<br />

itemized receipt from the provider to Consolidated Admin Services. Keep all receipts in case Consolidated<br />

Admin Services requires you to verify the eligibility of a purchase.<br />

THINGS TO CONSIDER<br />

• Healthcare FSA dollars are use-it or lose-it.<br />

• Up to $500 of unused dollars can be rolled over to <strong>2022</strong>.<br />

• You cannot take income tax deductions for expenses you pay<br />

with your FSA(s)<br />

• You cannot stop or change your FSA contribution(s) during the<br />

plan year unless you experience a qualifying life event.<br />

HEALTHCARE FSA LIMIT<br />

$2,750<br />

*<strong>2022</strong> limits have not been released<br />

SPECIAL FSA ACCOUNT FEATURES<br />

RUNOUT<br />

Runout is the 90 days after your<br />

plan year ends during which<br />

you may submit last year’s<br />

expenses to be reimbursed<br />

with last year’s FSA funds.<br />

GRACE PERIOD<br />

The grace period is 2 months +<br />

15 days after the end of the<br />

plan year during which you may<br />

incur new expenses but be<br />

reimbursed with last year’s<br />

FSA funds.<br />

ROLLOVER<br />

You have the ability to roll over<br />

up to $500 from one plan year<br />

to the next.<br />

15


LIMITED-PURPOSE FLEXIBLE SPENDING<br />

ACCOUNTS<br />

CARRIER: Consolidated Admin Services<br />

A Limited-Purpose Flexible Spending Account (FSA) is a special account that lets you set aside<br />

money (before it is taxed) to help pay for eligible dental and vision expenses.<br />

HOW DOES A LIMITED-PURPOSE FSA WORK?<br />

You decide how much to contribute to each FSA on a plan year basis up to the maximum allowable<br />

amounts. Your annual election will be divided by the number of pay periods and deducted evenly on<br />

a pre-tax basis from each paycheck throughout the year.<br />

You will receive a debit card from TASC, which can be used to pay for eligible health care expenses at<br />

the point of service. If you do not use your debit card or if you have dependent care expenses to be<br />

reimbursed, submit a claim form and a bill or itemized receipt from the provider to TASC. Keep all<br />

receipts in case TASC requires you to verify the eligibility of a purchase.<br />

WHAT’S THE DIFFERENCE BETWEEN A STANDARD HEALTH CARE FSA AND<br />

A LIMITED-PURPOSE FSA?<br />

Under current IRS rules, you cannot deposit money into a Health Savings Account (HSA) if<br />

you participate in a standard Health Care FSA. However, because a Limited-Purpose FSA<br />

restricts reimbursements to specific dental and vision care expenses, the IRS allows you to<br />

participate in both a Limited-Purpose FSA and an HSA at the same time. By having both<br />

accounts, you can maximize your tax and savings benefits.<br />

+<br />

LIMITED-PURPOSE FLEXIBLE<br />

SPENDING ACCOUNT<br />

(FSA)<br />

HEALTH SAVINGS ACCOUNT<br />

(HSA)<br />

LIMITED-PURPOSE FSA<br />

$2,850<br />

16


LIMITED-PURPOSE FLEXIBLE SPENDING<br />

ACCOUNTS<br />

17


DENTAL<br />

& VISION<br />

INSURANCE<br />

18


VOLUNTARY DENTAL INSURANCE<br />

CARRIER: Arkansas Blue Cross Blue Shield<br />

●<br />

●<br />

●<br />

●<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/findcare.<br />

Be sure to ask for a pre-treatment estimate.<br />

Out-of-network providers can balance bill, or bill you for the difference<br />

between the provider’s charge and the allowed amount.<br />

DENTAL<br />

ELECTION<br />

Monthly<br />

Rate<br />

<strong>Employee</strong> Rate<br />

52 Pay Periods<br />

<strong>Employee</strong> Rate<br />

26 Pay Periods<br />

<strong>Employee</strong> Only $29.77 $6.87 $13.74<br />

EE & Spouse $63.72 $14.70 $29.41<br />

EE & Child(ren) $47.91 $11.06 $22.11<br />

EE & (Family) $87.16 $20.11 $40.23<br />

COVERED BENEFITS IN-NETWORK OUT-OF-NETWORK<br />

Deductible (per calendar year)<br />

$50 per person<br />

$150 per family<br />

$50 per person<br />

$150 per family<br />

Annual Plan Benefit Maximum $1,000 $1,000<br />

Preventive Care<br />

Oral exams, cleanings, X-rays, sealants<br />

Basic Services<br />

Fillings, extractions, non-surgical periodontics, endodontics,<br />

oral surgery, anesthesia<br />

Major Services<br />

Surgical periodontics, inlays/onlays, crowns, partials,<br />

dentures, implants<br />

100% 90%<br />

80% 70%<br />

50% 40%<br />

Orthodontia Services (to age 18) 50% 40%<br />

Lifetime Orthodontia Plan Max $1,000 $1,000<br />

Annual Maximum Carryover*<br />

Included*<br />

*Please refer to the official plan documents for additional information Annual Maximum Carryover.<br />

19


VOLUNTARY VISION INSURANCE<br />

CARRIER: Arkansas Blue Cross Blue Shield<br />

●<br />

●<br />

●<br />

●<br />

●<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/findcare.<br />

You must submit a claim form for out-of-network expenses.<br />

LASIK surgery discounts available<br />

Don’t forget about glasses.com and contactsdirect.com!<br />

VISION<br />

ELECTION<br />

Monthly<br />

Rate<br />

<strong>Employee</strong> Rate<br />

52 Pay Periods<br />

<strong>Employee</strong> Rate<br />

26 Pay Periods<br />

<strong>Employee</strong> Only $9.00 $2.08 $4.15<br />

EE & Spouse $16.67 $3.85 $7.69<br />

EE & Child(ren) $18.02 $4.16 $8.32<br />

EE & (Family) $25.67 $5.92 $11.85<br />

COVERED BENEFITS IN-NETWORK OUT-OF-NETWORK<br />

Eye Exam (every 12 months) $10 Copay $45 Allowance<br />

Frames (every 24 months) $150 Allowance + 20% off balance $70 Allowance<br />

Standard Plastic Lenses (every 12 months)<br />

Single / Bifocal / Trifocal / Lenticular<br />

Progressive<br />

$20 Copay<br />

$20 Copay<br />

$30 / $50 / $65 / $100 Allowance<br />

$50 Allowance<br />

Contact Lenses, in lieu of glasses (every 12 months)<br />

Elective<br />

Medically Necessary<br />

Up to $150, in lieu of glasses<br />

Plan Pays 100%<br />

Up to $85<br />

Up to $210<br />

20


SHORT-TERM<br />

DISABILITY<br />

INSURANCE<br />

21


VOLUNTARY SHORT-TERM DISABILITY<br />

INSURANCE<br />

CARRIER: USAble Life<br />

SHORT-TERM DISABILITY INSURANCE<br />

Short-Term Disability (STD) Insurance is designed to help you meet your financial<br />

needs if you become unable to work due to a non-work related illness or injury. This<br />

is a voluntary plan; employees are responsible for 100% of the cost. Premiums are<br />

calculated as a percentage of you annual base salary.<br />

• Benefit Amount: 60% of base weekly salary up to $1,000 per week<br />

• Elimination Period: 7 days<br />

• Benefit Durations: Up to 26 weeks<br />

• Pre-Existing Conditions Limitation: 3 months prior/12 months after<br />

AGE RATE PER $10 OF BENEFIT<br />

0-24 $0.666<br />

25-29 $0.666<br />

30-34 $0.739<br />

35-39 $0.602<br />

40-44 $0.547<br />

45-49 $0.575<br />

50-54 $0.728<br />

55-59 $0.962<br />

60-64 $1.241<br />

65-69 $1.241<br />

How to Calculate your Weekly Rate<br />

Your annual base salary: $__________<br />

Divide by 52: ÷ 52<br />

Equals:<br />

= __________<br />

Multiply by 60%: x 0.60<br />

Equals (cannot be greater than<br />

$1,300):<br />

= __________<br />

Divide by 10: ÷ 10<br />

Multiply Total by age-based rate:<br />

Equals Your Monthly Cost:<br />

Multiply monthly cost by 12, then<br />

divide by 26:<br />

x __________<br />

= __________<br />

= __________<br />

Review your beneficiary designations<br />

22


VOLUNTARY<br />

LIFE<br />

INSURANCE<br />

23


VOLUNTARY LIFE INSURANCE<br />

CARRIER: USAble Life<br />

WHAT IS VOLUNTARY LIFE<br />

INSURANCE? Voluntary Life Insurance, also called<br />

group life insurance, is offered through an employer but is<br />

paid for partially or solely by employees.<br />

WHY PURCHASE VOLUNTARY<br />

LIFE INSURANCE?<br />

• This type of life insurance has limited underwriting<br />

required. This allows for people with health conditions or<br />

lifestyles that might otherwise disqualify them to qualify<br />

for life 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 />

<strong>Employee</strong> Plan Highlights<br />

● Guarantee Issue: $150,000<br />

● Benefit Amount: Available in increments of $10,000 (minimum of $20,000) up to a max of 5x annual<br />

salary or $500,000<br />

● Accelerated Death Benefit: Included which will be the lesser of 75% of the life amount or $250,000<br />

● Rates: Age-banded; cost increases as employee ages<br />

● <strong>Employee</strong> must be enrolled in Voluntary Life coverage in order to enroll dependents in life<br />

insurance<br />

● After your “initial enrollment” amounts requested OVER $150,000 require Evidence of<br />

Insurability (EOI) to be submitted and approved by Assurant<br />

● Voluntary Life coverage terminates upon Retirement<br />

● Age reductions apply upon reaching 65 years of age<br />

● No guarantee issue over age 69<br />

○<br />

Spouse Plan Highlights<br />

● Benefit Amount: Available in increments of $10,000 from a minimum of $10,000 to a max of<br />

$300,000<br />

● Rates: Age-banded and are based on <strong>Employee</strong>’s age<br />

● Amounts requested after your “initial enrollment” will require Evidence of Insurability (EOI)<br />

completed the <strong>Employee</strong><br />

○<br />

Child(ren) Plan Highlights<br />

● Benefit Amount: Children age live birth to 6 months - $1,000; Children age 6 months but less than<br />

26 years - $5,000 units up to a max of $10,000<br />

Note: <strong>Employee</strong>s and spouses may increase benefit by $10,000 each annual enrollment, up to the Guarantee<br />

Issue Amount without an Evidence of Insurability (EOI) form if they are currently enrolled.<br />

24


EVIDENCE OF INSURABILITY<br />

Will I need to answer any medical questions to enroll?<br />

EVIDENCE OF INSURABILITY FORM (EOI)<br />

A Carrier’s “medical questionnaire” may be required to be completed by an <strong>Employee</strong>/Spouse/Child<br />

periodically when enrolling for certain benefits. If you enrolled in benefits when you were first eligible, you<br />

may not have had to complete a form. However, in subsequent enrollments, any “late applicant” must<br />

complete this form to be considered for coverage. Completing this form DOES NOT GUARANTEE<br />

COVERAGE. Please see your HR Department for the appropriate EOI form and/or medical questionnaire.<br />

USABLE BENEFITS:<br />

Voluntary Life<br />

Guarantee Issue will be issued if employee applies when first eligible OR during their FIRST annual<br />

enrollment. Otherwise, employees are considered a late entrant and will required to fill out the EOI -<br />

answer medical questions. This pertains to employee, spouse and child(ren). <strong>Employee</strong>s and spouses may<br />

increase by $10K each annual enrollment, up to the GI, without EOI. ANY amount over the GI amount will<br />

require an EOI.<br />

Disclaimer: The terms “you” and “your” as used in this Annual Enrollment Overview refer to an employee<br />

of Allen Engineering who meets all the eligibility and participation requirements under the Allen<br />

Engineering Corporation Medical Plan (the “Plan”). Receipt of this document does not guarantee that the<br />

recipient is a participant under the Plan and/or otherwise eligible for benefits under the Plan.<br />

Allen Engineering Corporation reserves the right to make changes or to terminate any benefit plan or plans<br />

at any time, without prior notice to or consent from any employee or participant. If there is any<br />

inconsistency between this document and the official plan documents and contracts, the official carrier<br />

plan documents and contracts will control.<br />

The information contained in this Annual Enrollment Overview may have been supplied by third parties.<br />

Although BXS Insurance has no reason to doubt the accuracy of information used to prepare this document,<br />

we make no representation and give no warranty as to the accuracy, currency or completeness of any<br />

information contained in this document or its relevance to the recipient.<br />

This summary of benefits is not intended to be a complete description of the terms of Allen Engineering Corporation’s<br />

insurance benefit plans. Please refer to the plan document(s) for a complete description. Each plan is governed in all<br />

respects by the terms of its legal plan document, rather than by this or any other summary of the insurance benefits<br />

provided by the plan. In the event of any conflict between a summary of the plan and the official document, the<br />

official document will prevail. Although Allen Engineering Corporation maintains its benefit plans on an ongoing basis,<br />

Allen Engineering Corporation reserves the right to terminate or amend each plan, in its entirety or in any part at any<br />

time.<br />

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OPEN ENROLLMENT INSTRUCTIONS<br />

During the <strong>Employee</strong> <strong>Benefits</strong> Enrollment process, a representative will cover the extensive benefits package<br />

that Allen Engineering Corporation offers eligible employees, including Medical/Dental/Vision Insurance,<br />

Short-Term Disability and Voluntary Life Insurance.<br />

Step 1: Go to the following link to create an account as an employee:<br />

https://employeenavigator.com/benefits/Account/Login<br />

Step 2: Enter your Username and Password and click Login. You will<br />

then be prompted to review your current elections and may any changes<br />

for the elections effective 1/1/<strong>2022</strong>.<br />

●<br />

●<br />

If you do not have a username, click “Register as a new user”. You will<br />

be asked to enter your First Name, Last Name, Company Identifier of<br />

ALLEN ENGINEERING, PIN (last 4 of SSN) and Birth Date.<br />

If you have previously logged in but do not remember your password,<br />

click “Reset a forgotten password”. You will be prompted to enter your<br />

username and birth year to reset your password.<br />

IMPORTANT! If you do not log in and request any changes<br />

for the new plan year, your current elections WILL<br />

automatically renew with the exception of the Flexible<br />

Spending Account (FSA) as this benefit must be re-elected<br />

each year. Please review the new plan year information<br />

closely. After you have completed your enrollment, be sure<br />

to click the Agree button on your Enrollment Summary<br />

page.<br />

REMEMBER: Open Enrollment must be completed by the deadline or<br />

you may not be able to enroll yourself and/or your eligible dependents until our<br />

next open enrollment, or a qualifying event occurs.<br />

This summary of benefits is not intended to be a complete description of the terms of Allen Engineering Corporation’s insurance benefit plans. Please<br />

refer to the plan document(s) for a complete description. Each plan is governed in all respects by the terms of its legal plan document, rather than by<br />

this or any other summary of the insurance benefits provided by the plan. In the event of any conflict between a summary of the plan and the official<br />

document, the official document will prevail. Although Allen Engineering Corporation maintains its benefit plans on an ongoing basis, Allen<br />

Engineering Corporation reserves the right to terminate or amend each plan, in its entirety or in any part at any time.<br />

26


IMPORTANT CONTACTS<br />

BENEFIT CARRIER PHONE WEBSITE<br />

Medical Insurance Arkansas BCBS 800-229-4124 www.arkansasbluecross.com<br />

Health Savings Account<br />

Flexible Spending Account<br />

Consolidated Admin<br />

Services<br />

Consolidated Admin<br />

Services<br />

877-941-5956 www.consolidatedadmin.com<br />

877-941-5956 www.consolidatedadmin.com<br />

Dental Insurance Arkansas BCBS 888-223-4999 www.arkansasbluecross.com<br />

Vision Insurance Arkansas BCBS 800-877-7195 www.arkansasbluecross.com/findcare<br />

Voluntary Life and AD&D<br />

Insurance<br />

Voluntary Short-Term<br />

Disability Insurance<br />

USAble Life 800-370-5856 www.usablelife.com<br />

USAble Life 800-370-5856 www.usablelife.com<br />

Allen Engineering Corporation<br />

<strong>Benefits</strong> Manager<br />

Suzi Hall<br />

870-236-7751<br />

x151<br />

shall@alleneng.com<br />

Allen Engineering Corporation<br />

Office Manager<br />

Jennifer<br />

Barrington<br />

870-236-7751<br />

x129<br />

jbarrington@alleneng.com<br />

YOUR BXS INSURANCE ACCOUNT REPRESENTATIVES:<br />

Ashley Bray<br />

870-974-7424<br />

Ashley.Bray@bxsi.com<br />

DiAlma Young<br />

870-974-7440<br />

DiAlma.Young@bxsi.com<br />

27


Allen Engineering Corporation<br />

Phone: 870.236.7751<br />

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