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BHT Investment - 2023 Benefit Guide FINAL

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<strong>BHT</strong> <strong>Investment</strong> Co.<br />

<strong>2023</strong> BENEFITS<br />

ENROLLMENT GUIDE<br />

<strong>BHT</strong> <strong>Investment</strong> Company, Inc.<br />

Effective 1/1/<strong>2023</strong> to 12/31/<strong>2023</strong>


CONTENTS<br />

4 <strong>Benefit</strong>s Overview<br />

6 Medical Insurance<br />

8 Dental Insurance<br />

9 Vision Insurance<br />

10 Life Insurance<br />

12 Disability Insurance<br />

13 Voluntary Accident Insurance<br />

14 Voluntary Cancer Insurance<br />

15 Voluntary Hospital Indemnity Insurance<br />

16 Open Enrollment Information<br />

17 Important Contacts<br />

18 Glossary


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 />

• Basic Life and AD&D Insurance<br />

• Voluntary Life Insurance<br />

• Short Term Disability Insurance<br />

• Voluntary Accident Insurance<br />

• Voluntary Cancer Insurance<br />

• Voluntary Hospital Indemnity Insurance<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 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 on a<br />

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<br />

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


MEDICAL INSURANCE<br />

CARRIER: QualChoice<br />

Plan Options: High-Deductible Health Plan (HDHP) (Option 1) or two PPO Plans<br />

(Options 2 or 3).<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 Buy-Up Plan<br />

Option 3<br />

PPO Buy-Up Plan<br />

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

Individual $5,700 $3,000 $6,000 $1,000 $2,000<br />

Family $11,400 $6,000 $12,000 $2,000 $4,000<br />

Out-of-Pocket Maximum<br />

Included Deductible, Copays & Coins.<br />

Individual $5,700 $10,700 $5,500 $9,000 $2,000 $7,000<br />

Family $11,400 $21,400 $11,000 $18,000 $4,000 $14,000<br />

Coinsurance (Plan Pays)<br />

100% after<br />

deductible<br />

50% after<br />

deductible<br />

80% after<br />

deductible<br />

60% after<br />

deductible<br />

80% after<br />

deductible<br />

60% after<br />

deductible<br />

Preventive Care Plan pays 100% N/A Plan pays 100% N/A Plan pays 100% N/A<br />

Physician Services<br />

Primary Care<br />

Specialist<br />

Urgent Care<br />

Emergency Services<br />

Emergency Room<br />

Ambulance<br />

Hospital Services<br />

Inpatient<br />

Outpatient<br />

Prescription Drugs<br />

Tier 1<br />

Tier 2<br />

Tier 3<br />

Tier 4<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

50% after<br />

deductible<br />

50% after<br />

deductible<br />

50% after<br />

deductible<br />

0% after<br />

deductible<br />

0% after<br />

deductible<br />

50% after<br />

deductible<br />

50% after<br />

deductible<br />

$30 copay<br />

$50 copay<br />

$50 copay<br />

40% after<br />

deductible<br />

40% after<br />

deductible<br />

40% after<br />

deductible<br />

$250 copay $250 copay<br />

20% after<br />

deductible<br />

20% after<br />

deductible<br />

20% after<br />

deductible<br />

20% after<br />

deductible<br />

40% after<br />

deductible<br />

40% after<br />

deductible<br />

$20 copay<br />

$35 copay<br />

$35 copay<br />

20% after<br />

deductible<br />

20% after<br />

deductible<br />

20% after<br />

deductible<br />

20% after<br />

deductible<br />

40% after<br />

deductible<br />

40% after<br />

deductible<br />

40% after<br />

deductible<br />

20% after<br />

deductible<br />

20% after<br />

deductible<br />

40% after<br />

deductible<br />

40% after<br />

deductible<br />

Not Covered $15 copay Not Covered $10 copay Not Covered<br />

Not Covered $35 copay Not Covered $30 copay Not Covered<br />

Not Covered $50 copay Not Covered $50 copay Not Covered<br />

Not Covered $100 copay Not Covered $100 copay Not Covered<br />

6


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 options<br />

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

MEDICAL RATES<br />

Option 1<br />

HDHP Plan Medical Rates<br />

Employee Weekly Cost<br />

(52 Pay Periods)<br />

Employee Only $400.68 $246.26 $154.42 $35.64<br />

COVERAGE LEVEL Monthly Employer Pays Employee Monthly<br />

Employee & Spouse $801.35 $333.51 $467.84 $107.96<br />

Employee & Child(ren) $641.07 $298.61 $342.46 $79.03<br />

Employee & Family $1,081.80 $394.57 $687.23 $158.59<br />

Option 2<br />

PPO Buy-Up Plan Medical Rates<br />

COVERAGE LEVEL Monthly Employer Pays Employee Monthly<br />

Employee Weekly Cost<br />

(52 Pay Periods)<br />

Employee Only $669.08 $291.89 $377.19 $87.04<br />

Employee & Spouse $1,338.14 $416.85 $921.29 $212.61<br />

Employee & Child(ren) $1,070.50 $366.86 $703.64 $162.38<br />

Employee & Family $1,806.46 $504.31 $1,302.15 $300.50<br />

Option 3<br />

PPO Buy-Up Plan Medical Rates<br />

Employee Weekly Cost<br />

(52 Pay Periods)<br />

Employee Only $839.86 $346.77 $493.09 $113.79<br />

COVERAGE LEVEL Monthly Employer Pays Employee Monthly<br />

Employee & Spouse $1,679.70 $534.52 $1,145.18 $264.27<br />

Employee & Child(ren) $1,343.75 $459.42 $884.33 $204.08<br />

Employee & Family $2,267.55 $665.91 $1,601.64 $369.61<br />

PPO<br />

• Higher cost per paycheck<br />

• Lower deductible<br />

COMPARING YOUR MEDICAL PLAN OPTIONS<br />

HDHP<br />

• Lower cost per paycheck<br />

• Higher deductible<br />

• Can fund a health savings account (HSA)<br />

7


DENTAL INSURANCE<br />

CARRIER: Delta Dental<br />

● You will pay less out of pocket when you choose an in-network provider.<br />

● Locate an in-network provider at www.deltadentalar.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<br />

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

DENTAL<br />

ELECTION<br />

MONTHLY<br />

PREMIUM<br />

WEEKLY COST<br />

(52 Pay Periods)<br />

Employee Only $27.16 $6.27<br />

Employee & Spouse $54.26 $12.52<br />

Employee & Child(ren) $57.96 $15.68<br />

Employee & Family $100.88 $23.28<br />

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

Deductible (per calendar year) $50 per person, $150 per family $50 per person, $150 per family<br />

Annual Plan <strong>Benefit</strong> Maximum $1,000 per covered member $1,000 per covered member<br />

Preventive Care<br />

Exams, cleanings, fluoride, x-rays, sealants<br />

Basic Services<br />

Simple extractions, space maintainers, oral surgery, fillings<br />

Major Services<br />

Crowns, inlays, onlays, veneers, bridges, dentures, implants<br />

100% 90%<br />

80% 72%<br />

50% 45%<br />

Orthodontia Services (to age 19) 50% 45%<br />

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

Annual Maximum Carryover* $250 max $1,000 max<br />

*Carryover Eligibility: Must received at least one covered dental service and claims not to exceed $499 per year.<br />

8


VISION INSURANCE<br />

CARRIER: VSP<br />

● You will pay less out of pocket when you choose an in-network provider.<br />

● Locate an in-network provider at www.vsp.com.<br />

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

● LASIK surgery discounts available<br />

VISION<br />

ELECTION<br />

MONTHLY<br />

PREMIUM<br />

WEEKLY COST<br />

(52 Pay Periods)<br />

Employee Only $9.35 $2.16<br />

Employee & Spouse $14.97 $3.45<br />

Employee & Child(ren) $15.28 $3.53<br />

Employee & Family $24.63 $5.68<br />

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

Eye Exam (every 12 months) $10 copay $45 allowance<br />

Frames (every 24 months) $130 allowance $40 allowance<br />

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

Single Vision<br />

Bifocal<br />

Trifocal<br />

Standard Progressive<br />

Premium Progressive<br />

Custom Progressive<br />

Contact Lenses (every 12 months)<br />

Elective<br />

Fitting & Evaluation<br />

$20 copay<br />

$20 copay<br />

$20 copay<br />

$55 allowance<br />

$95 - $105 allowance<br />

$150 - $175 allowance<br />

$130 allowance<br />

Up to $60 copay<br />

$30 allowance<br />

$50 allowance<br />

$65 allowance<br />

$50 allowance<br />

$50 allowance<br />

$50 allowance<br />

$120 allowance<br />

9


GROUP LIFE INSURANCE<br />

CARRIER: QualChoice<br />

LIFE and ACCIDENTAL DEATH & DISMEMBERMENT (AD&D)<br />

Basic Life and AD&D insurance are automatically provided to all benefitseligible<br />

employees at no cost if you enroll in any medical insurance plan. This<br />

also includes an AD&D Rider which will pay double in the event of your death. If<br />

you die as a result of an accident, your beneficiary would receive both the life<br />

and the AD&D benefits.<br />

● <strong>Benefit</strong> Amount: $15,000<br />

VOLUNTARY LIFE INSURANCE<br />

CARRIER: Lincoln Financial<br />

WHAT IS VOLUNTARY LIFE<br />

INSURANCE? Voluntary Life Insurance is<br />

offered through an employer but is paid by<br />

employees.<br />

WHY PURCHASE VOLUNTARY LIFE INSURANCE?<br />

● This type of Life Insurance has limited underwriting required. This allows for people with health<br />

conditions or lifestyles that might otherwise disqualify them to qualify 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 />

● You may purchase a policy for your spouse and children IF you elect coverage for yourself.<br />

REMINDER<br />

Review your beneficiary designations<br />

10


VOLUNTARY LIFE INSURANCE<br />

CARRIER: Lincoln Financial<br />

Employee <strong>Benefit</strong><br />

● <strong>Benefit</strong> Amount: $10,000 increments up to $500,000 not to exceed 5x your annual base salary<br />

● Employees age 70+ Maximum <strong>Benefit</strong>: $50,000<br />

● Guarantee Issue: $150,000 (only available during New Hire eligibility)<br />

● AD&D <strong>Benefit</strong>: Equal to Life amount elected<br />

● <strong>Benefit</strong> Reduction Schedule: 35% at age 65<br />

○ Additional 25% of original amount at age 70<br />

○ Additional 15% of original amount at age 75<br />

○ Additional 15% of original amount at age 80<br />

● <strong>Benefit</strong> Termination: <strong>Benefit</strong>s terminate at retirement<br />

Spouse <strong>Benefit</strong><br />

● <strong>Benefit</strong> Amount: $5,000 increments up to $250,000, not to exceed Employee amount<br />

● Guarantee Issue: $30,000 (only available during New Hire eligibility)<br />

● AD&D <strong>Benefit</strong>: Equal to Spousal Life amount elected<br />

● <strong>Benefit</strong> Reduction Schedule: 35% at Employee age 65<br />

● <strong>Benefit</strong> Termination: <strong>Benefit</strong>s terminate at Employee age 70 or retirement, whichever occurs first.<br />

Child(ren) <strong>Benefit</strong><br />

● Child 14 days to 6 months old: $250<br />

● Child 6 months to age 19 years (25 if a full-time student): $10,000<br />

OPEN ENROLLMENT<br />

If you are currently enrolled and your benefit is under Guarantee Issue, the employee can increase your<br />

benefit by $10,000 or $20,000 without medical questions will be required.<br />

If you waived coverage during your New Hire eligibility period and want to elect coverage now, medical<br />

questions will be required and subject to approval.<br />

REMINDER<br />

Review your beneficiary designations<br />

11


DISABILITY INSURANCE<br />

CARRIER: Lincoln Financial<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.<br />

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

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

●<br />

●<br />

●<br />

●<br />

<strong>Benefit</strong>: 60% of base weekly salary up to $1,500 per week<br />

Elimination Period: 1 st day Accident / 8 th day Illness<br />

<strong>Benefit</strong> Durations: Up to 13 weeks<br />

Pre-Existing Conditions Limitation: 3/6 – You may not be eligible for benefits<br />

if you have received treatment for a condition within 3 months prior to your<br />

effective date under this policy until you have been covered by the policy for 6<br />

months.<br />

Attained Age<br />

Premium Factor<br />

0-29 0.01412<br />

30-34 0.01315<br />

35-39 0.01205<br />

40-44 0.01108<br />

45-49 0.01135<br />

50-54 0.01260<br />

55-59 0.01482<br />

60-64 0.01758<br />

65-69 0.01994<br />

70+ 0.02395<br />

Premium calculated<br />

in MyPay during<br />

enrollment<br />

REMINDER<br />

Review your beneficiary designations<br />

12


VOLUNTARY ACCIDENT INSURANCE<br />

CARRIER: Aflac<br />

Accident Insurance supplements your existing<br />

medical insurance in case you have an<br />

accident, medical insurance alone may not be<br />

enough to cover your expenses. The plan pays<br />

a cash benefit during the term of your<br />

coverage following a covered accident and<br />

could help cover:<br />

● Out-of-pocket expenses such as copays and<br />

deductibles<br />

● Transportation<br />

● Lodging costs<br />

● Emergency room expenses<br />

PLAN FEATURES<br />

● 24 hour coverage<br />

● Coverage is guaranteed-issue, provided the applicant is eligible for coverage.<br />

● The plan features benefits for both inpatient and outpatient treatment of covered accidents.<br />

● <strong>Benefit</strong>s are payable regardless of any other insurance programs.<br />

● <strong>Benefit</strong>s are available for spouse and/or dependent children.<br />

● There's no limit on the number of claims an insured can file.<br />

ELECTION Monthly Weekly (52)<br />

Employee Only $20.43 $4.71<br />

Employee + Spouse $30.62 $7.07<br />

Employee + Child(ren) $35.46 $8.18<br />

Employee +Family $45.65 $10.53<br />

See <strong>Benefit</strong> Summary for complete benefit listing and coverage amounts.<br />

13


VOLUNTARY CANCER INSURANCE<br />

CARRIER: AllState<br />

Cancer Insurance supplements your existing<br />

medical insurance in case you are diagnosed with<br />

cancer; medical insurance alone may not be<br />

enough to cover your expenses. The plan pays a<br />

cash benefit during the term of your coverage<br />

following a positive diagnosis of an internal cancer.<br />

WHY PURCHASE CANCER<br />

INSURANCE? You and your loved ones can<br />

rest a little easier knowing you have protection in<br />

place to help avoid depleting your bank accounts<br />

or taking on additional debt to cover day-to-day<br />

living expenses.<br />

●<br />

●<br />

●<br />

●<br />

Help cover medical plan deductibles, co-pays and other out-of-pocket costs<br />

Help cover everyday living expenses such as groceries, rent and mortgage payments<br />

Hire extra help for around the house, such as in-home caregivers<br />

Pay for travel to treatment facilities away from home as well as family visits<br />

BENEFITS<br />

● Continuous Hospital Confinement (daily): $400<br />

● Government or Charity Hospital (daily): $400<br />

● Radiation/Chemotherapy for Cancer (every 12 months): $15,000<br />

● Blood, Plasma, and Platelets (every 12 months): $15,000<br />

● Surgery (maximum, depending on surgery): $3,000<br />

● Anesthesia (% of surgery benefit): 25%<br />

●<br />

Cancer Initial Diagnosis:<br />

○ 1 time benefit of $5,000 when a covered person is diagnosed for the 1st time in their life as<br />

having cancer other than skin cancer.<br />

○ 1st diagnosis must occur after the effective date of coverage.<br />

● Pre-Existing Condition: 12 / 12<br />

ELECTION Monthly Weekly (52)<br />

Employee Only $35.41 $8.18<br />

Employee + Spouse $55.13 $12.73<br />

Employee + Child(ren) $50.21 $11.59<br />

Employee +Family $69.91 $16.14<br />

See <strong>Benefit</strong> Summary for complete benefit listing and coverage amounts.<br />

14


VOLUNTARY HOSPITAL INDEMNITY<br />

INSURANCE<br />

CARRIER: Aflac<br />

Hospital Indemnity Insurance helps protect your<br />

finances if an unexpected hospital stay occurs and<br />

those expenses are not covered by your health plan.<br />

This benefit would pay in addition to any other<br />

coverage(s) you may already have. <strong>Benefit</strong>s are<br />

payable for hospital stay due to:<br />

●<br />

●<br />

●<br />

●<br />

●<br />

Sickness<br />

Mental and nervous disorders<br />

Substance abuse<br />

Accidents*<br />

Routine pregnancy**<br />

PLAN FEATURES<br />

●<br />

●<br />

●<br />

●<br />

●<br />

●<br />

●<br />

●<br />

●<br />

<strong>Benefit</strong>s are paid directly to the insured, unless otherwise assigned.<br />

<strong>Benefit</strong>s are paid for covered sickness and accidents.<br />

Coverage is available for all family members.<br />

Guaranteed-Issue coverage during New Hire Eligibility<br />

Applicable to only In-Patient Admissions, not included ER Treatment or Outpatient Treatment<br />

There are no pre-existing condition limitations.<br />

The plan doesn't have a waiting period for benefits.<br />

<strong>Benefit</strong>s do not reduce as insured gets older.<br />

Annual Health Screening <strong>Benefit</strong> is included.<br />

ELECTION Monthly Weekly (52)<br />

Employee Only $16.72 $3.86<br />

Employee + Spouse $29.26 $6.75<br />

Employee + Child(ren) $24.38 $5.63<br />

Employee +Family $36.92 $8.52<br />

See <strong>Benefit</strong> Summary for complete benefit listing and coverage amounts.<br />

15


OPEN ENROLLMENT INSTRUCTIONS<br />

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

package that <strong>BHT</strong> <strong>Investment</strong> Company, Inc. offers eligible employees, including Medical/Dental/Vision<br />

insurance, Life Insurance, Short-Term Disability, Voluntary Life, Accident, Cancer and Hospital Indemnity<br />

Insurance.<br />

STEP 1: Go to the following link<br />

to create an account as an<br />

employee:<br />

www.hralliance.net/ee<br />

STEP 2: You will be asked for<br />

personal identifying data.<br />

STEP 3: Write down the<br />

username and password you<br />

created for future reference.<br />

STEP 4: You are ready to make your benefit elections! Please select the “Start Enrollment” button.<br />

The system will guide you through the process when you select “Save & Continue” on every screen.<br />

Note: IF you are covering a spouse and /or child, please have their full name, DOB, and SSN available.<br />

STEP 5: Choose the “Click to Sign” button to complete your enrollment.<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 <strong>BHT</strong> <strong>Investment</strong> Company, Inc.’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 <strong>BHT</strong> <strong>Investment</strong> Company, Inc. maintains its benefit plans on an ongoing basis, <strong>BHT</strong> <strong>Investment</strong><br />

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

16


IMPORTANT CONTACTS<br />

BENEFIT CARRIER PHONE WEBSITE<br />

Medical Insurance QualChoice 800-235-7111 www.qualchoice.com<br />

Dental Insurance Delta Dental 800-462-5410 www.deltadental.com<br />

Vision Insurance VSP 800-877-7195 www.vsp.com<br />

Life and AD&D Insurance QualChoice 800-235-7111 www.qualchoice.com<br />

Voluntary Life and AD&D<br />

Insurance<br />

Short Term Disability<br />

Insurance<br />

Accident &<br />

Hospital Indemnity<br />

Insurance<br />

Lincoln Financial 800-423-2765 www.lincolnfinancial.com<br />

Lincoln Financial 800-423-2765 www.lincolnfinancial.com<br />

Aflac 800-992-3522 www.Aflac.com<br />

Cancer Insurance Allstate <strong>Benefit</strong>s 800-521-3535 www.allstateatwork.com<br />

Employer Contact Cindy Allison 501-268-6107 callison@doublebees.com<br />

Employer Contact Blake Hummer 501-279-7663 bhummer@doublebees.com<br />

YOUR CADENCE INSURANCE ACCOUNT REPRESENTATIVE:<br />

(formerly BXS Insurance)<br />

Ashley Bray<br />

870-974-7424<br />

ashley.bray@cadenceinsurance.com<br />

17


GLOSSARY<br />

Coinsurance: Your share of the cost of a covered health care service, calculated as a percent (for example, 20%)<br />

of the allowed amount for the service, typically after you meet your deductible. For instance, if your plan’s<br />

allowed amount for an office visit is $100 and you’ve met your deductible (but haven’t yet met your<br />

out-of-pocket maximum), your coinsurance payment of 20% would be $20. Your plan sponsor or employer<br />

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 received.<br />

Deductible: The amount you owe for medical services before your medical insurance or plan sponsor<br />

(employer) begins to pay its portion. For example, if your deductible is $3,000, your plan does not pay anything<br />

until you’ve met your $3,000 deductible for covered health care services. This deductible may not apply to all<br />

services, including preventive care. Preventive care is 100% covered by the plan.<br />

Employee Contribution: The amount you pay per pay period for your insurance coverage.<br />

Explanation of <strong>Benefit</strong>s (EOB) / Personal Health Statement (PHS): A statement sent by your insurance carrier<br />

that explains which procedures and services were provided, how much they cost, what portion of the claim<br />

was paid by the plan, and what portion is your liability, in addition to how you can appeal the insurer’s<br />

decision. These statements are also posted on the carrier’s website for your review. Health Care Cost<br />

Transparency: Also known as Market Transparency or Medical Transparency. Health care provider costs can<br />

vary widely, even within the same geographic area. To make it easier for you to get the most cost-effective<br />

health care products and services, online cost transparency tools, which are typically available through health<br />

insurance carriers, allow you to search an extensive national database to compare costs for everything from<br />

prescription drugs and office visits to MRIs and major surgeries. Health Savings Account (HSA): A personal<br />

health care bank account funded by your or your employer’s tax-free dollars to pay for qualified Medical<br />

expenses. You must be enrolled in a HDHP to open an HSA. Funds contributed to an HSA roll over from year to<br />

year and the account is portable, meaning if you change jobs, your account goes with you.<br />

High Deductible Health Plan (HDHP): Plan option that provides choice, flexibility and control when it comes to<br />

spending money on health care. Preventive care is covered at 100% with in-network providers, there are no<br />

copays, and all qualified employee-paid Medical expenses count toward your deductible and your<br />

out-of-pocket maximum.<br />

In-Network: In-network providers are doctors, hospitals and other providers that contract with your insurance<br />

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 contracted<br />

with your insurance company. If you choose an out-of-network doctor, services will not be provided at a<br />

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 the plan<br />

year. The out-of-pocket maximum is the sum of your deductible and coinsurance payments.<br />

18


NOTES<br />

19


Prepared for:<br />

Prepared for:<br />

<strong>BHT</strong> INVESTMENT COMPANY, INC.

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