Texas Farm Enrollment Guide 2023

Plan Year 2023 

Effecve January 1, 2023 to December 31, 2023 

EMPLOYEE 

BENEFITS 

ENROLLMENT 

GUIDE 

1

Table of Contents 

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Resource Directory ………………………..3 

Benefits Overview ………………………….4 

Membership Guidelines………………….5 

Employee Navigator Instrucons…...6 

Medical ……………………………………......7-13 

Employer Paid Life & AD&D …..……14-15 

Open Enrollment 

November 14—November 29, 2022 

You will need to complete any enrollment 

changes online through Employee 

Navigator (see page 6 for instrucons). 

Enrollment must be completed online 

by 11/29/22 

¨ Short and Long Term Disability .....16-23 

¨ 

¨ 

Dental and Vision ……………………….24-28 

Voluntary Life & AD&D…………………29-30 

Please take me to read the benefit 

summaries carefully. This informaon will 

help you in deciding the best benefit for 

you and your family. 

¨ 

¨ 

¨ 

Accident……………………………………….31-32 

Crical Illness……………………………….33-35 

Addional Informaon ………………….36 

2

Resource Directory 

Coverage Carrier Phone Website/Email 

Medical 

Blue Cross Blue Shield 

of Texas 

1-800-521-2227 www.bcbstx.com 

Employer Paid Life & AD&D 

Employer Paid Short Term Disability 

Employer Paid Long Term Disability 

Dental 

Vision 

Voluntary Life 

Accident 

Crical Illness 

Principal 1-800-986-3343 www.principal.com 

Human Resources Keisha Ray 936-560-8216 HR@pnutrion.com 

BXS / Cadence Insurance Lacey Parmer 936-564-1713 Lacey.parmer@cadenceinsurance.com 

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Benefits Overview 

Texas Farm Products is proud to offer a comprehensive benefits package to eligible, full-me employees regularly 

scheduled to work at least 30 hours per week. The complete benefits package is briefly summarized in this booklet. 

You share the costs of some of the benefits and Texas Farm Products provides other benefits at no cost to you. In 

addion, there are voluntary benefits with reasonable group rates that you can purchase through payroll deducons. 

Benefit Plans Offered 

· Medical 

· Employer Paid Life & AD&D 

· Employer Paid Short Term Disability 

· Employer Paid Long Term Disability 

· Vision 

· Voluntary Life 

· Accident 

· Crical Illness 

· Dental 

Enrollment Changes 

In most cases, your pre-tax benefits elecons are unchangeable and remain in effect for the enre plan year. During this 

annual enrollment period, you will have the opportunity to review your benefit elecons and make changes for the 

coming year. You may only make changes at other mes of the year if you experience a family status change that is a 

qualifying event. 

Qualifying Events Include 

· Marriage, divorce, or legal separaon 

· Gain or loss of an eligible dependent for reasons such as birth, adopon, court order, disability, death, marriage or 

reaching the dependent child age limit 

· Changes in employment that affects benefits eligibility 

· Changes in your spouse’s benefits coverage with another employer that affects benefit eligibility. 

The change to your benefit elecons must be consistent with the qualifying event. You have 31 days from the date of 

a qualifying event to complete an enrollment change form and return it to Human Resources. Your elecon will 

become effecve the date of the qualifying event. 

The benefits plan year is 1/1/2023. The elecons you make will remain 

in effect through 12/31/2023, unless you, your spouse, or your 

dependent child(ren) experience a qualifying event. 

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Membership Guidelines 

Pre-Tax Payroll Deducons 

To help offset your contribuons for the medical, dental and vision plans, we offer these benefits on a pre-tax basis 

through the Texas Farm Products Secon 125 (or “cafeteria”) plan. By making your contribuons for these benefits on a 

pre-tax basis, the premium is withheld from your pay before federal, state (in most cases) and FICA taxes are calculated. 

This can reduce the amount of taxes you pay per paycheck. 

Employee Eligibility 

· To be eligible for benefits, you must be a full-me employee working 30 hours or more per week. 

· You are eligible to enroll for Medical on the 90th day of employment. All other benefits are effecve the first of the 

month following 90 days of employment. 

Dependent Eligibility 

· You must be enrolled in a benefit plan to enroll your eligible dependents. Your eligible dependents include your: 

· Legal spouse 

· Children: 

* Children up to age 26 

* Natural or legally adopted 

* Stepchildren of lawful spouse who reside in your home 

* Children for whom benefits must be provided through a Qualified Medical Support order 

* Grandchildren who are entled to be claimed as your dependents for federal income tax purposes 

5

Employee Navigator Instrucons 

Open Enrollment is available online! 

Please visit hps://employeenavigator.com/benefits/Account/Login to review your current 

benefits and make any desired plan changes for the new plan year. If you do not request any 

changes for the new plan year, your current enrollment WILL automacally renew. Please 

review the new plan year informaon closely. Aer you have completed your enrollment, be 

sure to click the agree buon on your Enrollment Summary page. 

If you have already registered an account with Employee Navigator, use the username you 

created. If you have forgoen your password you may request a password reset at 

hps://employeenavigator.com/benefits/Account/Reset/ResetEmployee. 

If you do not have a username, please go to hps://www.employeenavigator.com/ 

benefits/Account/Register to register. You will be asked for personal idenfying data as well 

as the company idenfier which is pnutrion. 

If you have any quesons, contact Human Resources at 936-560-8216. 

This summary of benefits is not intended to be a complete descripon of the terms of Texas Farm Product’s insurance benefit plans. Please refer to the 

plan document(s) for a complete descripon. Each plan is governed in all respects by the terms of its legal plan document, rather than by 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 document, 

the official document will prevail. Although Texas Farm Products maintains its benefit plans on an ongoing basis, Texas Farm Products reserves the right 

to terminate or amend each plan, in its enrety or in any part at any me. 

6

Medical Coverage 

Your employer will contribute $1,500.00 to your HSA account should you elect this plan; 

Contribuons are pro-rated based on me of year you join the plan. 

HSA Plan 

Non-Network 

Individual 

Family 

$7,000 

$14,000 

$14,000 

$28,000 

100 / 0% 70 / 30% 

Prevenve 

100% of allowable 

Office Visit (Primary/Specialist) 

Virtual Visit (MD Live) 

Urgent Care 

100% of allowable aer deducble 


2023 contracted fee: $48 


N/A 

Diagnosc Test (x-ray, blood work) 100% of allowable aer deducble 70% of allowable aer deducble 

Imaging (CT/PET scans, MRI) 100% of allowable aer deducble 70% of allowable aer deducble 

Emergency Room 

Facility charges 

Physician charges 


Inpaent Facility 

Deducbles are applied to Out of Pocket Maximum. Plan includes embedded deducble. 

Family Coverage: When one family member meets the deducble, benefits become available under the plan for that individual. 

Tier Level 

Generic 

Retail (30 day) 

Mail Order (90 day) 

Brand Name 

Specialty Drugs 


Prime Specialty Pharmacy Only 

Medical – Employee Contribuons 

Coverage Type 

Employee Only $3.67 $7.95 

Employee + 1 $96.18 $208.40 

Employee + 2 or more $142.44 $308.63 

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Plan A 

Non-Network 

Individual 

Family 

Prescripon Drug Deducble 

$1,000 

$3,000 

$100 combined Retail & Mail Service 

$3,000 

$9,000 

80 / 20% 60 / 40% 

Prevenve 



Virtual Visit (MD Live) 

Urgent Care 



2023 contracted fee: $48 


N/A 






80% of allowable amount aer $300 Copay 



Deducble and copay amounts apply to the Out of Pocket Maximum. Copayment amounts and per admission deducble are applied 

but will connue to be required aer the benefit percentages increase to 100% 

Tier Level 



Generic 

Preferred/Non-Preferred Brand 


Prime Specialty Pharmacy Only 

Coverage Type 

100% of allowable aer prescripon deducble 


Generic: 100% allowable aer prescripon deducble 

Preferred/Non-Preferred Brand: 80% of allowable aer prescripon deducble 



Employee + 1 $183.73 $398.08 


8


Plan B 

Non-Network 

Individual 

Family 

Prescripon Drug Deducble 

$3,000 

$9,000 

$100 combined Retail & Mail Service 

$6,000 

$18,000 

$8,000 

$24,000 

80 / 20% 60 / 40% 

Prevenve 



$40 / $60 Copay 

Virtual Visit (MD Live) $40 Copay N/A 

Urgent Care 

$75 Copay 






80% of allowable amount aer $500 Copay 



Deducble and copay amounts apply to the Out of Pocket Maximum. Copayment amounts and per admission deducble are applied 

but will connue to be required aer the benefit percentages increase to 100% 

Tier Level 



Generic 

Preferred/Non-Preferred Brand 


(Prime Specialty Pharmacy Only) 



Generic: 100% allowable aer prescripon deducble 

Preferred/Non-Preferred Brand: 80% of allowable aer prescripon deducble 


Coverage Type 


Employee + 1 $136.20 $295.09 


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2023 Maximums: 

Individual: $3,850 | All other ers: $7,750 

Age 55+ catchup contribuon: $1,000 

Your employer will contribute $1,500.00 to your HSA 

account should you elect this plan; 

Contribuons are pro-rated based on me of year 

you join the plan. 

Contribuon will not be made unl your HSA 

account is opened. 

For new HSA elecons, the employee must complete 

the HSA Applicaon. It is included in Employee 

Navigator as a link on the Health Savings Account 

screen. Once completed, return to Human 

Resources. 

10


11


12


13

Medical Employer Coverage Paid—Basic Life & AD&D 

14

Medical Employer Coverage Paid—Basic Life & AD&D 

15


Employer Paid—STD for Semi Monthly Employees 

16


Employer Paid—STD for Semi Monthly Employees 

17

Medical Employer Coverage Paid—STD for Weekly Employees 

18

Medical Employer Coverage Paid—STD for Weekly Employees 

19

Medical Employer Coverage Paid—LTD for President, Vice Presidents & Officers 

20

Medical Employer Coverage Paid—LTD for President, Vice Presidents & Officers 

21

Medical Employer Coverage Paid—LTD for Semi-Monthly and Weekly Employees 

22

Medical Employer Coverage Paid—LTD for Semi-Monthly and Weekly Employees 

23

Dental Coverage 

24

Dental Coverage 

25

Vision Coverage 

26

Vision Coverage 

27

Dental and Vision Rates 

Dental—Employee Contribuons 

Coverage Type Weekly Semi– Monthly 

Employee only $ 5.16 $ 11.17 

Employee and Spouse $ 10.42 $ 22.58 

Employee and Child(ren) $ 14.10 $ 30.56 

Employee and Family $ 19.37 $ 41.96 

Vision—Employee Contribuons 

Coverage Type Weekly Semi-Monthly 

Employee only $ 1.58 $ 3.43 

Employee and Spouse $ 3.00 $ 6.49 

Employee and Child(ren) $ 3.51 $ 7.62 

Employee and Family $ 4.94 $ 10.71 

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29


Voluntary Life premiums are based on age and the benefit amount chosen. You will be 

able to view these premiums when you login to Employee Navigator and make selecons. 

30

New benefit offering 

Accident 

31

Accident 

You will be able to view the Accident Plan premiums when you login to Employee Navigator 

and make selecons. 

32

New benefits offering 


33


34


You will be able to view the Crical Illness Plan premiums when you login to Employee Navigator and 

make selecons. 

35

Addional Informaon 

Keep In Mind 

· Employees are responsible for notifying Human Resources if a dependent is no longer eligible for 

coverage. Failure to notify HR will affect COBRA availability and premium refunds. 

· From time to time, other coverage information and accident details may be requested by the carriers— 

please respond promptly to expedite processing of claims. 

Reminders 

· If electing the HSA for the first time you must complete the HSA application found online in 

Employee Navigator on the HSA link and turn into Human Resources by November 29th. 

If you have questions contact: 

Human Resources - Texas Farm Products Company at 936-560-8216 

Lacey Parmer - BXS / Cadence Insurance at 936-564-1713 

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Texas Farm Enrollment Guide 2023

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