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2015 Benefits Guide

Contact Information .................................................................................................................................................... 1

Enrolling in the Plans.................................................................................................................................................. 2

Eligibility...................................................................................................................................................................... 2

Domestic Partner Coverage ....................................................................................................................................... 3

Frequently Asked Questions ...................................................................................................................................... 4

Pre-Notification Information........................................................................................................................................ 4

United Healthcare Providers ...................................................................................................................................... 4

Out of Network Providers ........................................................................................................................................... 4

Medical Insurance ...................................................................................................................................................... 5

Base Plan Option .................................................................................................................................................. 5

High Plan Option ................................................................................................................................................... 6

Prescription Benefits .................................................................................................................................................. 7

Preventive Care.......................................................................................................................................................... 7

Women’s Preventive Care Coverage ......................................................................................................................... 7

Summary of Material Modification .............................................................................................................................. 7

Dental Insurance ........................................................................................................................................................ 8

Vision Insurance ......................................................................................................................................................... 9

Basic Life and Accidental Death & Dismemberment Insurance............................................................................... 10

Voluntary Life and Accidental Death & Dismemberment Insurance ........................................................................ 10

Voluntary Long Term Disability ................................................................................................................................ 11

Voluntary Worksite Benefits ..................................................................................................................................... 11

Long Term Care ....................................................................................................................................................... 12

Employee Assistance Program (EAP) ..................................................................................................................... 13

Flexible Spending Accounts (FSAs)......................................................................................................................... 14

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