annual enrollment guide 2015

Transcription

ANNUAL
ENROLLMENT
GUIDE 2015
Choose the coverage that’s right for you and your family
Click here to get started
COVERAGE THAT’S RIGHT FOR YOU
As a part of our Total Rewards package, Farmers offers comprehensive and
competitive benefits to our employees.
When it comes to benefits, we understand that one size doesn’t necessarily fit all.
That’s why we give you the flexibility to choose the combination of benefits that’s
best for you and your family.
We also provide you with the tools to help you make the right choices. You can start
by reading this guide, which walks you through the enrollment process and gives
you details about your benefits. If you are looking for more information, this guide
also directs you to other resources that can help answer your questions.
MARK YOUR CALENDAR
Annual Enrollment is from
October 20 to November 3.
Enrollment takes place only
once a year, so take this
opportunity to review your
benefits and ensure they fit your
needs. Choose wisely because
you can’t make changes outside
of Annual Enrollment unless you
experience a qualified life change
event, such as a marriage or the
birth of a child.
Remember that you must enroll
in order to have coverage next
year. Your current medical,
dental, vision, supplemental
life insurance, and AD&D
insurance elections do not
carry forward into 2015. Even
if you aren’t changing your
selections, you must enroll or
you will lose these benefits at
the end of 2014.
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Annual Enrollment 2015 begins
October 20 and ends November 3, 2014
Here’s what you’ll find inside
(click on the below chapters)
WHAT’S NEW FOR 2015�� 4
MEDICAL�� 7
SAVING TAXES THROUGH HEALTH
SAVINGS AND FLEXIBLE SPENDING
ACCOUNTS�� 11
EMPLOYEES LIKE YOU�� 15
UHC PLAN COST ESTIMATOR�� 21
WELLNESS RESOURCES –
HEALTHFIRST PLUS�� 22
VISION�� 23
DENTAL�� 24
LIFE AND DISABILITY�� 26
WORK/LIFE BALANCE�� 29
RETIREMENT�� 31
RESOURCES TO HELP YOU �� 33
Contact information�� 33
Glossary�� 34
IMPORTANT NOTICES�� 36
Privacy notice of availablity�� 36
2015 MONTHLY EMPLOYEE
PAYROLL DEDUCTIONS�� 40
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EXTENDED HOURS FOR HR SERVICE CENTER
The HR Service Center is staying open extra hours during
Annual Enrollment to help answer your enrollment questions.
5 a.m. to 5 p.m. PST
October 20 – November 3
(888) 599-3636
[email protected]
WHAT’S NEW FOR 2015
The amount you contribute through payroll deductions for some benefits has gone up – you will find 2015 payroll deductions
on page 40.
2015 KEY MEDICAL PLAN CHANGES
CONSIDERATIONS
CHOICE PLUS HSA
In-network deductibles and out-of-pocket maximums are increasing to:
Employee
Contribute pre-tax dollars to your HSA so you have
enough set aside to cover your deductible and
out-of-pocket expenses.
Family
Deductible
$1,300*
$2,600*
Out-of-pocket maximum
$2,600
$5,200
CHOICE PLUS PPO
In-network deductibles and out-of-pocket maximums are increasing to:
Employee
Family
Deductible
$750
$1,500
Out-of-pocket maximum
$1,500
$3,000
Prescription drug copays are increasing and will apply to the out-of-pocket maximum.
30 day retail
90 day mail-order
Generic
$10
$25
Preferred brand
$30
$75
Non-preferred brand
$50
$125
Use the online UHC Plan Cost Estimator to make
sure you select the most appropriate plan for you
and your family.
ALL PLANS
Certain services under the Farmers medical plan will require prior authorization services in
2015 to determine benefit coverage prior to certain service being rendered. If you utilize a
UnitedHealthcare network provider they will facilitate this process for you, but when you seek
services from a non-network provider you will be responsible for prior authorization.
Use in-network providers as they will facilitate the
prior authorization process for you.
The 2015 Summary Plan Description will provide information on the services that require prior
authorization.
ut-of-network deductibles and out-of-pocket maximums are increasing in all four
O
medical plans.
* Increase due to regulatory requirement in order to remain eligible to contribute to a Health Savings Account.
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Click here to return to Table of Contents
se in-network providers as the deductible and
U
out-of-pocket maximum are lower.
For detailed information on Farmers
benefits, log in to GEMS and go to
Employee Self-Service and select
Benefits & Policies
GET STARTED
Choosing your benefits and maximizing the value of your Total Rewards package is
important. Spend a little time now and reap the benefits in 2015.
A Farmers Today Annual Enrollment web page has been set up as a one-stopshop to access your resources. Simply click on HR Connection and select the
Annual Enrollment link.
WHAT DO I NEED TO DO?

Review this Annual Enrollment guide.

isit UnitedHealthcare’s (UHC) pre-member website, where you can
V
compare your estimated costs under each medical plan option by using
the Plan Cost Estimator at www.welcometouhc.com/farmers. You can also
find medical plan highlights and compare all plans side by side.

I f you already have a Health Savings Account, consider the amount you
expect to have available for eligible health care expenses next year.

I f your spouse or domestic partner has benefits available through his or her
employer, be sure to consider those additional options as well.

Visit Benefits and Policies through HR Connection on Farmers Today to
learn more about your 2015 benefits. Once you log in to the GEMS portal:
––
Click on the Employee Self Service tab at the top of the screen.
––
T hen click on the Benefits and Policies tab located on the
navigation bar below the Employee Self Service tab.
––
ecide which plans best meet your needs and how much to
D
contribute to your Health Savings Account and/or Flexible
Spending Account.
ENROLL
nroll between October 20 and November 3. To enroll, go to Farmers Today and
E
log in to GEMS under HR Connection. Then:

Click on the Employee Self Service tab at the top;

Click on Benefits on the left under Detailed Navigation;

Click on Benefits Enrollment and follow the onscreen instructions;

Save a copy of your benefits confirmation statement for your records.
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WHO IS ELIGIBLE FOR BENEFITS?
You can enroll yourself and your eligible dependents. Your eligible dependents
include:

our legally married spouse or domestic partner, except when legally
Y
separated. Note: If you are adding a domestic partner for the first
time, you will need to complete the appropriate documentation with
the HRSC. Please log in to Farmers Today > HR Connection> GEMS >
Employee Self Service > Benefit and Policies for more information or
contact the HRSC directly at (888) 599-3636.

our children, including your eligible domestic partner’s children,
Y
adopted children and children under your court-appointed legal
guardianship, under age 26, regardless of the child’s student or marital
status. Note: Grandchildren can be covered only if you are the courtappointed legal guardian.

our single children of any age who are handicapped or totally disabled
Y
and who were enrolled in your benefits before age 26.
BENEFIT DOLLARS
Paying for benefits is a shared responsibility. For many benefits, you and Farmers
both make contributions to pay for your coverage. To help pay for your benefits
Farmers also provides Benefit Dollars. You receive a total of $375 per year
equally divided into 24 semi-monthly paychecks. You can use these dollars to
help offset your paycheck deductions for the benefits you choose.
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If you can’t find your answer in Benefits and Policies
email or call the HRSC, they’re standing by.
(888) 599-3636
5 a.m. - 5 p.m. PST Monday - Friday
[email protected]
MEDICAL
WHAT MEDICAL PLANS HAVE IN COMMON
Farmers offers you a choice of four medical options so you
can choose the plan that best fits your needs.
The medical plan options have a lot in common, as well as
some important differences (see page 8 to compare what’s
different). All four options:
The options for 2015, administered by UnitedHealthcare
(UHC), include a choice of three High Deductible Health
Plans and a PPO:

over the same services and give you access
C
to the same network of health care providers
and facilities. You’re free to see any provider you
want, but using providers in UHC’s network will
save you money because they have agreed to
negotiated rates, the plan pays a higher level of
reimbursement and the deductible and out-ofpocket maximums are higher when you go
out-of-network.

over preventive care services at 100 percent
C
when you use in-network providers. Preventive
care includes annual physical exams, routine
immunizations and much more.
High Deductible Health Plans:

Choice Plus HSA

Choice Max HSA

Choice Premier HSA
PPO Plan:

Choice Plus PPO
PRESCRIPTION DRUGS
Your prescription drug benefit is managed by Express
Scripts. The Express Scripts preferred drug list, sometimes
called a formulary, is a list of brand-name and generic
Include prescription drug benefits managed by
medications that are preferred by your plan. This list offers
Express Scripts. To receive benefits, you must
access to safe and effective medications in all therapy
go to an in-network pharmacy. If you go to an
classes based upon guidance from an independent group
out-of-network pharmacy, you’ll pay the full cost
of expert health professionals. Medications are selected
of your prescription.
because they can safely and effectively treat most medical
conditions while helping to contain costs for you and your
plan. Some medications may be removed from this list when safe and effective
alternatives are available.
The Express Scripts preferred drug list contains thousands of commonly prescribed
drugs. For more information, please visit www.express-scripts.com/farmers or call
(800) 987-5248. This toll-free number also appears on your member ID card.
7
COMPARE YOUR MEDICAL OPTIONS
HIGH DEDUCTIBLE HEALTH PLANS (HDHP)
PPO
Plan name
Choice Plus HSA
Choice Plus PPO
When the plan
begins to pay
Pay later through higher deductibles but require lower payroll
contributions for coverage
Pays sooner through a
lower deductible but
requires a higher payroll
contribution for coverage
How the
plan covers
prescription drugs
Subject to the deductible and coinsurance like any other eligible
medical expense
Subject to copays, which
do not count toward your
deductible, but do count
towards your out-ofpocket maximum
Which taxadvantaged
accounts can
be used
Can be used with a Health Savings Account (HSA), which allows you to
save tax-free money for health care expenses now or in the future and
Farmers helps by contributing to your HSA if you contribute a minimum
amount (see page 11 for more details)
Can be used with the
Health Care FSA, which
allows you to save taxfree money for medical,
dental and vision
expenses during the plan
year. You will be able to
rollover up to $500 of
your unused Health Care
FSA balance remaining at
the end of the plan year.
Any carry over amounts
that exceed $500 will be
forfeited. (see page 13 for
more details)
Choice Max HSA
Choice Premier HSA
Can be used with a Dental and Vision FSA (see page 13 for more details)
to pay for dental and vision expenses during the plan year – you will be
able to rollover up to $500 of your unused Dental and Vision FSA balance
remaining at the end of the plan year. Any carry over amounts that exceed
$500 will be forfeited
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8
AT A GLANCE: YOUR MEDICAL OPTIONS
HIGH DEDUCTIBLE HEALTH PLANS
Choice Plus HSA
Annual deductible*
(employee only/family)
Choice MAX HSA
Employee
PPO Self-Service and select
Benefits & Policies
Choice Premier HSA Choice Plus
In-Network
Out-ofNetwork
In-Network
Out-ofNetwork
In-Network
Out-ofNetwork
In-Network
Out-ofNetwork
$1,300/
$2,600
$1,950/
$3,900
$2,000/
$4,000
$3,000/
$6,000
$2,800/
$5,600
$4,200/
$8,400
$750/
$1,500
$1,125/
$2,250
The individual deductible and out-of-pocket maximum does NOT apply if any
dependents are covered. In these cases, the family deductible must be met before the
plan pays a benefit.
Out-of-pocket
maximum* (employee
only/family)
$2,600/
$5,200
$3,900/
$7,800
$4,000/
$8,000
$6,000/
$12,000
$5,600/
$11,200
$8,400/
$16,800
$1,500/
$3,000
$2,250/
$4,500
Preventive care
Plan pays
100%
Plan pays
60%**
Plan pays
100%
Plan pays
60%**
Plan pays
100%
Plan pays
60%**
Plan pays 100%
Plan pays
60%**
Most other eligible
healthcare expenses
Plan pays
80%**
Plan pays
60%**
Plan pays
80%**
Plan pays
60%**
Plan pays
80%**
Plan pays
60%**
Plan pays 80%**
Plan pays
60%**
Prescription drugs
(generic, preferred,
non-preferred brandname)***
Retail and
mail order:
Plan pays
80% after
annual
deductible is
met
Not covered
Retail and
mail order:
Plan pays
80% after
annual
deductible is
met
Not covered
Retail and
mail order:
Plan pays
80% after
annual
deductible is
met
Not
covered
Retail:
$10/$30/$50
Mail order:
$25/$75/$125
Not covered
SAVINGS TIP: USE THE MAIL-ORDER SERVICE
If you take a medication on an ongoing basis, ordering your prescriptions by mail can save you time and hassle by delivering
your maintenance medication right to your home. In addition, if you elect the Choice Plus plan, ordering your prescriptions
by mail can save you time and money. That’s because you’ll be responsible for the full mail-order copay after your third refill of
a maintenance medication at a retail pharmacy. That means you’ll be paying for a 90-day supply but only receiving a 30-day
supply. Start saving by signing up at www.express-scripts.com.
***The annual deductibles and out-of-pocket maximums include expenses for in-network and out-of-network services combined. However, in 2015 the out of network
deductibles and out of pocket maximums will be higher than the in network deductibles and out of pocket maximums. For example, if an employee sees an in-network doctor
and pays $200 for the service, and later sees an out-of-network doctor and pays $500 for services, the combined amount of $700 will apply to the employee’s annual
deductible and out-of-pocket maximum. UHC refers to this as “cross application.”
***Percentage of negotiated fee for in-network or reasonable and customary charges for out-of-network, which the plan covers after you meet your deductible. The out-of-area
option will provide an in-network benefit of 80 percent of reasonable and customary charges.
***Under Choice Plus, when a generic drug is available and a prescription is filled with a brand-name drug, you’ll pay the difference in the cost between the generic drug and the
brand-name drug, in addition to the generic copay. This will apply regardless of whether you or your physician requests the brand-name drug.
9
AVAILABILITY OF SUMMARY
HEALTH INFORMATION
Choosing a health coverage option is an important decision. To help you make an
informed choice, your plan makes available a Summary of Benefits and Coverage
(SBC), which summarizes important information about any health coverage option
to help you compare across options.
The SBC, along with the Summary Plan Description (SPD) is available on the intranet
at: Farmers Today > HR Connection > GEMS > Benefits and Policies. A paper copy is
also available, free of charge, by contacting the HR Service Center at
(888) 599-3636 or email at [email protected].
Out-of-area coverage is available
If you live in an area where the UHC network is not available, there is an out-of-area
plan for each of the medical options. The benefits under these plans are the same as
in the in-network plan. Because the UHC network is not available in your area, you
can go to any doctor or hospital. If you are eligible for out-of-area coverage, it will be
listed on your benefit enrollment screen.
Important note: UHC’s in-network providers request an explanation of benefits
(EOB) for the services provided to determine your out-of-pocket responsibility.
However, the provider has the right to request payment at the time of the visit.
If this happens, you are responsible only for the negotiated fee between UHC and
the provider.
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SAVINGS TIP:
CHOOSE IN-NETWORK
PROVIDERS
Since the out-of-network
deductibles and out-of-pocket
maximums will be higher, using
in-network providers you can
save even more money, so take
a few minutes to use the UHC
Online Provider Directory. This
tool lets you search for innetwork providers and facilities
by geographical area or by name.
You also can designate a medical
specialty and other criteria, such
as a second language, to further
refine your search.
To use the directory, go to
www.myuhc.com and click
“Find Physician or Facility.” The
directory changes as information
is updated so it’s a good idea to
check the status of your doctors
during Annual Enrollment and
throughout the year as you
schedule appointments.
(888) 599-3636
[email protected]
SAVING TAXES THROUGH HEALTH SAVINGS
AND FLEXIBLE SPENDING ACCOUNTS
Want to save on taxes? You can with a Health Savings Account (HSA) or Flexible
Spending Account (FSA). These tax-advantaged accounts let you pay for your outof-pocket health care costs with tax-free dollars. With easy payroll deductions and
convenient debit cards, these accounts may be easier to use than you think.
They sound similar, but they’re very different – it’s important for you to understand
the difference.
HEALTH SAVINGS ACCOUNTS
If you enroll in one of our three High Deductible Health Plans (Choice Plus HSA,
Choice Max HSA or Choice Premier HSA), you can use an HSA to pay for eligible
health care expenses – including medical, prescription drug, dental and
vision expenses.
How you use your HSA is up to you. You can:

S et aside money to cover your expected health care bills for the year while
making the most of the tax advantages.

uild up enough savings to cover your deductible and out-of-pocket
B
maximum so that you’re protected from the costs of a serious illness
or injury.

ake contributions and invest your balance to save for your health care
M
expenses in retirement.
No matter how you choose to use your HSA, be sure to keep your receipts with
your other tax records. You’ll need them at tax time, and the IRS may ask you to
substantiate your eligible health care expenses.
Paying for dependent medical expenses from your HSA
THERE’S MORE ONLINE
To learn more about HSAs, visit
the Annual Enrollment Web
page (http://communications.
farmersinsurance.com/humanresources/Pages/annualenrollment.aspx).
To learn more about eligible
expenses, visit www.treas.
gov and enter “Health Savings
Accounts” in the search bar.
Family situations can vary. Generally, contributions limits to an HSA determined by
the type of coverage – individual or family. Even if your spouse or dependents are not covered by your High Deductible Health
Plan, you may use your HSA dollars to pay for qualified medical expenses for them.
If you have adult children under your health plan, you may not use your HSA to pay or reimburse yourself for their qualified
medical expenses if they are not your tax dependents. However, single adult children who have coverage under a parent’s
family HDHP can open their own HSAs and contribute up the yearly family maximum.
Visit www.irs.gov or www.treasury.gov for answers to frequently asked questions on these topics. Consult your tax advisor for
guidance on your specific situation.
11
HOW THE HSA WORKS
MEDICARE AND THE HSA
When you contribute to an HSA, so does Farmers.
As long as you make the minimum contribution with company payroll deductions
through Optum Bank, Farmers will make a contribution to your HSA:

I f you have employee only coverage and contribute at least $100 to the
HSA, Farmers will contribute $500.

I f you cover any dependents and contribute at least $200 to the HSA,
Farmers will contribute $1,000.
Your HSA contributions – and those you may receive from Farmers – are not
subject to federal income tax, and in most cases, state income tax. Currently,
the states of California, New Jersey and Alabama do not allow pre-tax HSA
contributions and they are subject to state tax. You also don’t pay taxes when you
spend your HSA money on qualified medical expenses.
If you are enrolled in Medicare Part
A or B in 2014, or will be enrolled
in 2015, federal regulations don’t
allow you to open and contribute to
an HSA. So, if you already have an
HSA you can keep your account and
use the funds for eligible health care
expenses but you cannot continue
to contribute to it, and you may not
open a new HSA.
Although you make contributions evenly over the course of the year, the company contribution will appear as a lump-sum
deposit into your HSA in conjunction with the January 15, 2015 pay period. As soon as the company contribution is in your HSA,
it’s yours to save or spend on qualified health care expenses.
Both your contributions and the company contribution count toward the HSA annual maximum, as shown in the chart:
2015 HSA Annual Maximum Contributions (All HSA Plans)
Coverage Level
Maximum Employee
Contribution
+
Company
Contribution
=
Annual
Maximum HSA
Contribution
Employee only
$2,850
+
$500
=
$3,350
Family
$5,650
+
$1,000
=
$6,650
If you’ll be age 55 or older in 2015 and not enrolled in Medicare, you can contribute up to an additional $1,000 to your HSA in
catch-up contributions. That means your maximum annual HSA contribution is $4,350 for employee only medical coverage and
$7,650 for employee plus family medical coverage.
Your account also can earn tax-free interest. Optum Bank charges monthly maintenance fees if minimum balances are not
maintained. In addition, other fees may be associated with the Optum Bank HSA options. Three bank account options are
available to you. Refer to Benefits and Policies or call Optum Bank Customer Service at (800) 791-9361 for details.
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Benefits & Policies
FLEXIBLE SPENDING ACCOUNTS
THERE’S MORE ONLINE
How the Health Care FSA works
If you enroll in Choice Plus PPO, you can use a Health Care FSA to pay for eligible
health care expenses – including medical, dental and vision expenses – with tax-free
dollars. You can contribute up to $2,500 per year into your FSA. You can contribute
from a minimum of $10 per pay period to a total of $2,500 in 2015. The company
does not contribute to your FSA (unlike an HSA).
If you choose to use an FSA, remember to plan your contributions carefully. Due to
IRS rules, and unlike a Health Savings Account, your expenses need to be incurred
during the plan year to be reimbursed from your FSA, but you can submit claims for
your qualifying expenses through April 30 of the following year. Also you will be able
to rollover up to $500 of your unused Health Care or Dental and Vision FSA balance
remaining at the end of the plan year. Any carry over amounts that exceed $500 will
be forfeited.
How the Dental and Vision FSA works
If you enroll in one of the High Deductible Health Plans, the IRS does not allow you
to use a Health Care FSA in combination with your HSA, but you can set aside taxfree money in a Dental and Vision FSA. You can contribute up to $2,500 per year into
your Dental and Vision FSA.
Just like the name says, this FSA can be used for dental and vision expenses only.
Expenses subject to your medical deductible, including prescription drugs, must be
paid with money from your HSA. You can pay for your dental and vision expenses
with money from either your Dental and Vision FSA or from your HSA – but not both.
The Dental and Vision FSA is subject to the same rules as the Health Care FSA,
including the “use it or lose it” rule, so you’ll want to set aside just enough money to
cover your 2015 eligible dental and vision expenses.
13
For a complete list of qualified
health care and dependent care
expenses, visit www.irs.gov, click
on “Forms and Publications” and
then select IRS Publication 502
for health care expenses and IRS
Publication 503 for dependent
care expenses.
COMPARING AN HSA TO AN FSA
Questions
Health Savings Account (HSA)
Flexible Spending Account (FSA)
Choice Plus PPO or if you are not enrolled
in a Farmers medical plan
With which medical plan can I
have this account?
High Deductible Plans: Choice Plus HSA, Choice Max HSA or Choice
Premier HSA
If you contribute to an HSA, you can also
Who funds the account?
You and Farmers
You
How much can you
contribute?
$2,850 for employee only (plus $500 Farmers contribution)
$5,650 for family (plus $1,000 Farmers contribution)
You may contribute up to $2,500
Employees age 55 or older can contribute an additional $1,000
Does the money in the account Yes, it grows tax-free with interest and can be withdrawn tax-free to
earn interest?
pay for eligible health care expenses
What happens to any money
left in my account at the end of
the year?
What happens to any money
left in my account if I leave or
retire?
Am I eligible to contribute?
contribute to the Dental and Vision FSA,
which is for dental and vision expenses only
No, but it can be withdrawn tax-free to pay for
eligible health care expenses
If you don’t spend it within the calendar year,
Your unused money rolls over from year to year – can be used anytime,
it’s forfeited except you can rollover up to
even in retirement
$500 to the following year
Your account balance must be used for
expenses incurred up to the end of the month
following your date of termination, but you
can submit claims through April 30 of the
following year
The money is yours to take with you
Yes. If you contribute to an HSA, you can only
contribute to the Dental and Vision FSA, which
is for dental and vision expenses only
Yes, if you are enrolled in a high deductible plan
No, if you are enrolled in Medicare Part A or B
How the Dependent Care FSA works
If you have child care or elder care expenses, be sure to consider taking advantage of the Dependent Care FSA. In the same way
that a Health Care FSA lets you set aside before-tax money for eligible health care expenses, you can use the Dependent Care
FSA to set aside a minimum of $10 per pay period, up to $5,000 per year, in before-tax money for child care expenses while you
and your spouse/domestic partner work or attend school full time.
Examples of eligible dependent care expenses include:

Charges for day care centers for children or adults

Before- and after-school programs

Babysitters

Summer day camps

Nursery school
Important tax rules apply to the Dependent Care FSA. You can’t be reimbursed from your FSA for any expense that’s also
covered by a tax credit on your federal tax return. Talk to your tax advisor to decide whether enrolling in a Dependent Care FSA
or taking the Child Care Tax Credit is better for your financial situation.
14
(888) 599-3636
[email protected]
EMPLOYEES LIKE YOU
How do you pick the right medical plan? There’s a lot to consider: your monthly
payroll deductions, deductibles, coinsurance, tax savings opportunities and more.
Take a look at these examples of fictional Farmers employees to learn from their
thought processes – and their math.
It’s important to understand what you expect to spend for health care. It’s also
important to plan for the unexpected when selecting a medical plan. Make sure
that you’re aware of your out-of-pocket maximum and that you are able to cover
this potential expense. Take full advantage of an HSA if you’re enrolled in the one of
the High Deductible Health Plans.
In 2015 the out-of-network deductible and out-of-pocket maximums will be higher
than the in-network deductible and out-of-pocket maximums. So using in-network
providers can save you money.
In the following examples, you will see how to calculate your total estimated
healthcare costs, but don’t worry; you don’t need to pull out the calculator and
do this by hand. UHC’s Plan Cost Estimator does it for you and makes it easy to
determine which medical plan makes the most sense – and can save you the most
money. See page 21 for more information.
Note: Only in-network services have been used under each of these examples.
15
MEET MARK
Age: 49
Status: Looking for employee plus family coverage
Health snapshot: Healthy – but his son’s asthma requires regular care
Mark, his wife and teenage son have predictable health care expenses. As a family,
they lead healthy lives by eating well and exercising often. Outside of regular
checkups, Mark and his wife use minimal health care. However, their teenage son
was born with a chronic condition and needs regular care. Mark also expects there
may be a couple of unplanned trips to the doctor or emergency room in the year.
To help cover their out-of-pocket costs, they use an HSA. For 2015, Mark estimates
his family’s medical expenses will come to $1,800 (the plan pays preventive care
100%).
Mark also contributes $1,500 to his HSA. He can use the money to offset his
deductible or save for future use. Based on Mark’s expected health care needs, the
Choice Premier HSA is the least expensive plan, but he’ll need to be sure he has
enough money set aside in his HSA or personal savings if he incurs unexpected
medical costs – he could be responsible for up to $11,200 (in-network).
Because of his lower medical contributions, he can afford to contribute more
money into this tax-advantaged account.
Here’s what his math looks like for each of the plans:
PPO
Considerations
Choice Plus HSA
Choice Max HSA
Choice Premier HSA
Choice Plus*
Mark’s 2015 payroll deductions for
employee plus family coverage
$4,788
$2,520
$936
$9,600
Pays toward deductible
(in-nework)
$1,800 of the
$2,600 deductible
$1,800 of the
$4,000 deductible
$1,800 of the
$5,600 deductible
$1,500 of the
$1,500 deductible
$0
$0
$60
(20% of his remaining
$300 in expenses)
Dollars in excess of deductible paid
through coinsurance (Mark pays
20% and the plan pays 80%, up to
the out-of-pocket maximum)
$0
HSA dollars**
(Farmers contribution)
– $1,000
– $1,000
– $1,000
N/A
Total Cost for Mark:
$5,588
$3,320
$1,736
$11,160
Maximum exposure for out-ofpocket (in-network) medical
expenses (does not include payroll
deductions)
$5,200
$8,000
$11,200
$3,000
**Under Choice Plus, prescription drugs are covered with copays and are not subject to the deductible. To simplify these examples, no prescription drug expenses were included.
**If Mark elects Choice Plus HSA, Choice Max HSA or Choice Premier HSA and contributes at least $200 to an Optum Bank HSA through payroll deductions, Farmers will
contribute $1,000 to his HSA. Mark can contribute the money he’s saving on his monthly contributions to further increase his HSA savings.
16
Benefits & Policies
MEET JANET
Age: 26
Status: Looking for employee coverage
Health snapshot: Healthy – uses minimal health care
Janet takes good care of herself. She eats a balanced diet and exercises regularly.
She does not have any chronic conditions and does not take any regular
medication. Aside from her annual physical and lab work, she rarely goes to the
doctor. Because she doesn’t need a lot of health care, she doesn’t want to pay for
coverage she’s not going to use.
Janet keeps a tight budget and wants to keep her payroll contributions as low
as possible. But she also wants to protect herself in case something unexpected
happens. She could consider putting the money she saves from lower
contributions into her HSA, which she can use as a health emergency fund if she
needs it in the future.
For 2015, Janet estimates her medical expenses will be no more than $200
(plan pays for preventive care at 100%). Janet also makes a $500 contribution to
her HSA. She can use this money to offset her deductible or save for future use.
Based on Janet’s expected health care needs, the Choice Premier HSA is the least
expensive plan.
Still, she needs to be able to pay $5,600 (out-of-pocket maximum in-network), and/or $8,400 (out-of-network) in the
event she has an unexpected illness or injury and plan accordingly.
Here’s what her math looks like for each of the plans:
PPO
Considerations
Choice Plus HSA
Choice Max HSA
Choice Premier HSA
Choice Plus*
Janet’s 2015 payroll deductions for
employee coverage
$1,572
$828
$312
$3,144
$200 of the
$1,300 deductible
$200 of the
$2,000 deductible
$200 of the
$2,800 deductible
$200 of the
$750 deductible
through coinsurance (Janet pays
$0
$0
$0
$0
HSA dollars**
– $500
– $500
– $500
N/A
Total Cost for Janet
$1,272
$528
$12
$3,344
Maximum exposure for out-ofpocket medical expenses (does not
include payroll deductions)
$2,600
$4,000
$5,600
$1,500
**Under Choice Plus, prescription drugs are covered with copays and are not subject to the deductible. To simplify these examples, no prescription drug expenses were included.
**If Janet elects Choice Plus HSA, Choice Max HSA or Choice Premier HSA and contributes at least $100 to an Optum Bank HSA through payroll deductions, Farmers will
contribute $500 to her HSA. Janet can contribute the money she’s saving on her monthly contributions to further increase her HSA savings.
17
MEET DENISE
Age: 38
Status: Looking for employee plus child(ren) coverage
Health snapshot: Uses health care frequently for family needs
Denise and her husband know that in a family of five, health care expenses can
be hard to predict. Her husband has coverage through his employer but Denise
covers the children under Farmers’ plan. Having three active children under
the age of 12 means injuries are not uncommon. Additionally, Denise has minor
surgery planned for the coming year. To help cover expected and unexpected
costs, they use an HSA. Because of their lower medical contributions, they can
afford to contribute money into this tax-advantaged account.
For 2015, Denise thinks her family’s health care costs may reach $20,000. Denise
also contributes $3,000 to her HSA. She can use the money to offset her deductible
or save for future use. Based on Denise’s expected health care needs, the Choice
Plus HSA is the least expensive plan.
Here’s what her math looks like for each of the plans:
PPO
Considerations
Choice Plus HSA
Choice Max HSA
Choice Premier HSA
Choice Plus*
Denise’s 2015 payroll deductions for
employee plus child(ren) coverage
$2,664
$1,404
$456
$5,352
$2,600 of the
$2,600 deductible
$4,000 of the
$4,000 deductible
$5,600 of the
$5,600 deductible
$1,500 of the
$1,500 deductible
through coinsurance (Denise pays
$2,600 (hits out-of-pocket
maximum)
$3,200 (20% of her
remaining $16,000 in
expenses)
$2,880 (20% of her
remaining $14,400 in
expenses)
$1,500 (hits out-of-pocket
maximum)
HSA dollars**
– $1000
– $1000
– $1000
N/A
Total Cost for Denise
$6,864
$7,604
$7,936
$8,352
Maximum exposure for out-ofpocket (In-network) medical
expenses (does not include payroll
deductions)
$5,200
$8,000
$11,200
$3,000
*Under Choice Plus, prescription drugs are covered with copays and are not subject to the deductible. To simplify these examples, no prescription drug expenses were included.
**If Denise elects Choice Plus HSA, Choice Max HSA or Choice Premier HSA and contributes at least $200 to an Optum Bank HSA through payroll deductions, Farmers will
contribute $1,000 to her HSA. Denise can contribute the money she’s saving on her monthly contributions to further increase her HSA savings.
18
(888) 599-3636
[email protected]
MEET LARRY
Age: 61
Status: Looking for employee plus spouse coverage
Health snapshot: Fairly healthy, uses health care moderately
Larry and his wife are just a few years away from retirement, so he’s been preparing
by contributing as much as possible to his HSA. He likes the pre-tax savings
opportunity available with the HSA, and he knows that these funds will be useful in
his retirement years to help pay for his eligible expenses.
Larry and his wife are generally healthy. He has high blood pressure, but he takes
medication and receives regular care so his condition is well-managed. On top of
his regular care, Larry thinks there might be only one or two trips to the doctor’s
office for allergies or other minor illnesses.
For 2015, Larry expects his medical expenses will come to $2,700 (beyond
preventive care). Larry also contributes $6,650 to his HSA (because he is over 55,
he takes advantage of the additional $1,000 catch-up contribution). He can use
this money to offset his deductible and coinsurance or save for future use. Here’s
what his math looks like for each. Based upon Larry’s expected health care costs,
the Choice Premier HSA looks like the best option. Larry knows this plan has an
in-network out-of-pocket maximum of $11,200; the most he’ll have to pay if
he incurs unexpected medical costs. Turn the page to see what happens.
PPO
Considerations
Choice Plus HSA
Choice Max HSA
Choice Premier HSA
Choice Plus*
Larry’s 2015 payroll deductions for
employee plus spouse coverage
$3,612
$1,896
$708
$7,236
$2,600 of the
$2,600 deductible
$2,700 of the
$4,000 deductible
$2,700 of the
$5,600 deductible
$1,500 of the
$1,500 deductible
Dollars in excess of (in-network)
deductible paid through
coinsurance (Larry pays 20% and
the plan pays 80%, up to the out-ofpocket maximum)
$240 (20% of his remaining
$100
in expenses)
$0
$0
$240 (20% of his
remaining $1,200
in expenses)
HSA dollars**
– $1000
– $1000
– $1000
N/A
Total Cost for Larry
$5,232
$3,596
$2,408
$8,976
Maximum exposure for out-ofpocket in-network medical expenses
$5,200
(does not include
payroll deductions)
$8,000
$11,200
$3,000
**If Larry elects Choice Plus HSA, Choice Max HSA or Choice Premier HSA and contributes at least $200 to an Optum Bank HSA through payroll deductions, Farmers will
contribute $1,000 to his HSA. Larry can contribute the money he’s saving on his monthly contributions to further increase his HSA savings.
19
PLAN FOR THE
UNEXPECTED:
Make sure you know the out-ofpocket maximum for the medical
plan you select – and that you
are able to cover this potential
expense. Take full advantage of
an HSA if you’re enrolled in one
of the High Deductible Health
plans.
AS IT TURNS OUT…
Larry’s wife needed multiple surgeries and physical therapy after she fell and broke her leg. This caused their 2015 health care
expenses to rise to $68,000. The out-of-pocket maximum under all four medical options protected them from paying the full
cost of their large claims from their own pocket. Based on Larry’s expectations, the Choice Premier HSA originally looked like
the best option. However, Larry’s plan met with the unexpected. If Larry could have forseen the future, the Choice Plus HSA plan
would have been the best choice. However, since he’s been putting money into his HSA, he has the funds to pay for his portion
of the medical expenses, which are capped by out-of-pocket maximums.
Here’s what their 2015 costs actually look like.
PPO
Considerations
Choice Plus HSA
Choice Max HSA
Choice Premier HSA
Choice Plus*
Larry’s 2015 payroll deductions for
employee plus spouse coverage
$3,612
$1,896
$708
$7,236
(in-network)
$2,600 of the
$2,600 deductible
$4,000 of the
$4,000 deductible
$5,600 of the
$5,600 deductible
$1,500 of the
$1,500 deductible
through coinsurance (Larry pays
$ 2,600 in coinsurance,
plus her deductible, puts
Larry at the $5,200 out-ofpocket maximum
$4,000 in coinsurance,
plus her deductible,
puts Larry at the
$8,000 out-of-pocket
maximum
$5,600 in coinsurance, plus
her deductible, puts Larry
at the $11,200 out-ofpocket maximum
$1,500 in coinsurance,
plus her deductible, puts
Larry at the $3,000 out- ofpocket maximum
HSA dollars**
– $1000
– $1000
– $1000
N/A
Total Cost for Larry
$7,812
$8,896
$10,908
$10,236
Maximum exposure for out-ofpocket medical expenses
(in-network)
$5,200
$8,000
$11,200
$3,000
**If Larry elects Choice Plus HSA, Choice Max HSA or Choice Premier HSA and contributes at least $200 to an Optum Bank HSA through payroll deductions, Farmers will
contribute $1,000 to his HSA. Larry can contribute the money he’s saving on his monthly contributions to further increase his HSA savings.
20
Benefits & Policies
MAKE A SMART CHOICE –
VISIT UHC’S PRE-MEMBER WEBSITE
When you consider which medical option is right for you, remember that the
monthly employee contribution is only a part of your health care costs.
Your total health care expenses include your payroll contributions and your out-ofpocket health care expenses. The UHC Plan Cost Estimator can help you add up all
of these considerations.
The UHC Plan Cost Estimator analyzes your unique needs – like your prescription
drug costs, treatment for chronic conditions and any planned procedures – and
compares what your health care expenses could be under each of the medical plan
options. You can use the UHC Plan Cost Estimator to model contributions to your
HSA and Health Care FSA to maximize your tax savings and manage your total outof-pocket costs.
When using the Plan Cost Estimator, remember to plan for the unexpected and
consider what you have and what you can contribute to your HSA when making
your medical plan decisions.
The Plan Cost Estimator is located within United Healthcare’s pre-member website
where you can also find medical plan highlights, a link to find a network doctor
or hospital near you and you can also learn about Optum Bank and eligibility
requirements to open an HSA, as well as access to other tools and resources.
21
REMEMBER:
As you consider your health
care costs for 2015, remember
to take into account your Benefit
Dollars and HSA Dollars, which
further offset the cost of your
Farmers benefits.
HEALTHFIRST PLUS
We’re in this together! Your health care is a shared responsibility – your health care
costs reflect our actual claims experience. Taking care of yourself and getting the
right care at the right time benefits you and Farmers.
With a single call to HealthFirst, you can start living a healthier life. Call anytime and
speak with a health specialist, wellness coach or nurse, who will provide assistance
and help you find the health program or service that best meets your needs.
Consider this your personal health care concierge service to help you:
USE HEALTHFIRST PLUS
HealthFirst Plus makes your
life easier and healthier. Learn
more about all the HealthFirst
Plus services available to you by
calling (866) 553-8713.

Find a doctor (they’ll even schedule your appointment)

Compare treatment options and costs

ork with a nurse who can provide support and help you live better with an ongoing condition
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such as back pain, diabetes, or heart disease

Better understand your medications, tests and procedures

Create a personalized fitness plan

Enroll in the diabetes prevention and control program

Understand your symptoms and decide if you should see a doctor

Connect with the Employee Assistance Program (EAP)
HealthFirst Plus makes your life easier and healthier. Learn more about all the HealthFirst Plus services available to you by calling
(866) 553-8713. So, whether you have a short-term health situation or a long-term health condition, HealthFirst Plus has health
specialists, wellness coaches, and registered nurses available to provide specialized support.
In certain situations, you may be contacted directly by a HealthFirst nurse or health specialist. If that happens, take advantage of
it. The service is private and confidential, and is available at no additional cost to you as part of your Farmers benefits.
Some services are available to all employees, while for others you must be covered under a Farmers medical plan.
22
(888) 599-3636
[email protected]
VISION
Take care of your eyes with vision coverage through Farmers. Our vision plan offers the convenience of being able to use any
vision care provider, but a lower out-of-pocket expense for you if you choose an EyeMed provider. To find an EyeMed provider
near you, visit www.eyemedvisioncare.com.
At a glance: Your vision coverage
Coverage
In-network
Out-of-network
Exams
$10 copay, once every calendar year
$50 allowance
Lenses
$25 copay, once every calendar year
$50 to $75 allowance
Frames
$0 copay with a $150 retail allowance, once
every two calendar years
$70 allowance
Contact lenses
$0 copay with a $150 retail allowance, once
every calendar year instead of lenses
$105 allowance for elective contact lenses
$210 allowance for necessary contact lenses

THE EYEMED PLAN OFFERS YOU THESE EXTRA DISCOUNTS:

Save 40 percent on all additional complete eyeglasses pair purchases (unlimited use)

S ave an average of 15 percent on regular price services through Laser Vision Correction or 5 percent off promotional
prices through the U.S. Laser Network
Going to an in-network provider provides a higher benefit and lower, discounted rates. To receive in-network benefits in 2015,
you will need to select an EyeMed provider. For more information, visit www.eyemedvisioncare.com. Click on the drop-down
menu in the “Locate a Provider” box and choose the “Select” network.
23
DENTAL
Good dental care plays an important part in your overall health. Take care of your
teeth and gums with dental coverage through Farmers. You have a choice of two
Aetna dental plan options: the Dental PPO and the Dental DMO. You can also enroll
in the MetLife DMO (formerly known as Safeguard DMO) if you live in California,
Texas or Florida. The plans generally cover the same types of services, but how you
access care and share costs differ.
How the Dental PPO works
The Dental PPO offers coverage for a broad range of services with a low deductible,
and your preventive dental care is covered at 100 percent. For other dental services,
you’ll share the cost with the plan by paying coinsurance. You can see any provider
but you’ll maximize your benefits when you see in-network providers.
How the Dental DMO and MetLife DMO work
The Dental DMO administered by Aetna is available in most areas and the MetLife
DMO is available to you if you live in the DMO service areas in California, Texas or
Florida. Both offer coverage for a broad range of services with no deductibles or
annual maximums, and you’ll pay a fixed copay for services other than diagnostic
and some preventive dental care. If you’re eligible for either DMO, it will be listed as
an available option on your benefit enrollment screen.
Under the DMO options, you and each of your covered family members must
choose a participating primary care dentist (PCD) for coverage (generally there
are no out of network benefits). If you do not choose a PCD by contacting Aetna
or MetLife before the beginning of the year, you will not be able to obtain dental
services until a provider is selected.
You can find an Aetna PCD by calling Aetna Customer Service at (877) 238-6200 or
using the DocFind® tool at www.aetna.com/docfind. To find a MetLife PCD, visit
www.metlife.com/mybenefits or call (800) 880-1800.
24
Benefits & Policies
At a glance: Your dental options
You can find the schedule of dental benefits for each dental plan and for specifics on how procedures are paid for the dental
plans on “Benefits & Policies.”
Dental DMO
Dental PPO
(if available in your area)
MetLife DMO (California, Florida and
Texas only)
Deductible
$50 per person, up to $100
per family
None
None
Annual plan
maximum
$1,500
None
None
Preventive
services, such
as cleanings
and oral exams
(up to two per
calendar year)
Plan pays 100% (not subject $3 to $50 copay depending on the type of
to deductible)
procedure
Basic services,
such as
extractions and
fillings
Plan pays 80% after
deductible
$5 office copay for all office visits plus fixed
copay per service, ranging from $3 to $50
depending on the type of procedure
$5 to $80 copay, depending
on the type of procedure***
Major services,
such as crowns
and bridges
Plan pays 50% after
deductible
$5 office copay for all office visits plus fixed
copay per service, ranging from $5 to $350
depending on the type of procedure
$10 to $300 copay, depending
on the type of procedure***
$3 to $35 copay depending on
the type of procedure
T reatment of adolescent/
adult dentition: $725
Orthodontic treatment
adolescent and adult:
$1,695
Orthodontic treatment plan
and records: $250

Orthodontia*
Plan pays 50% after
deductible, up to a lifetime
maximum of $1,500**
(children only)
Screening exam: $30
Diagnostic records: $150
Adolescent and adult: $1,845
Orthodontic retention: $275

*To be eligible for the orthodontia benefits in any of the dental options, the treatment must begin after the first day your dental coverage takes effect. This means if
orthodontia treatment began in 2014 and you are initially enrolling for dental coverage as of January 1, 2015, the orthodontia benefit is excluded.
* *The Dental PPO option provides orthodontia coverage only for eligible dependent children under the age of 26.
***Refer to the schedule of benefits that can be found on “Benefits & Policies.”
25
LIFE AND DISABILITY
Farmers pays for basic life insurance equal to your annual salary up to $500,000.
You can use after-tax dollars to buy supplemental life insurance for yourself of one
to six times your annual salary. Your cost of coverage will be based on your age and
whether you have used tobacco products within the last 12 months. The maximum
coverage, including your company-paid coverage, is $3.5 million.
The plan is administered by Prudential. Visit www.prudential.com/farmers where
you can find an interactive tool “Talk to Pete” for help in determining your life
insurance needs under the “Watch and Learn More” tab.
For your spouse/domestic partner
You can use after-tax dollars to buy life insurance coverage for your spouse/
domestic partner. The amount of coverage depends on whether you elect
supplemental life insurance coverage for yourself:

ithout supplemental coverage for yourself, you can purchase coverage
W
equal to $10,000 or $25,000 for your spouse/domestic partner

ith supplemental coverage for yourself, you can purchase coverage
W
equal to $10,000, $25,000, $50,000, $75,000 or $100,000 for your
spouse/domestic partner, so long as the amount does not exceed the
combined total of your basic and supplemental coverage
For your children
You can use after-tax dollars to buy life insurance coverage for your eligible
dependent children in the amount of $10,000.
EVIDENCE OF
INSURABILITY
Any increase to your
supplemental or spouse life
insurance is subject to evidence
of insurability (EOI) and approval
by Prudential. If you elect to
increase your coverage, you will
receive an email from Prudential
in late November or early
December with instructions on
how to provide EOI.
It’s your responsibility to
complete and submit evidence
of insurability to Prudential and
to ensure your application has
been processed and approved.
Your election will not become
effective until your application
has been approved. If approved,
the effective date of coverage will
be the date of approval.
TOBACCO-FREE
DISCOUNT
If you elect supplemental or
spouse life insurance and the
insured has not used tobacco
products within the past year,
you’ll pay a lower rate than those
who have used tobacco products.
26
(888) 599-3636
[email protected]
ACCIDENTAL DEATH &
DISMEMBERMENT BENEFITS
Accidental death & dismemberment (AD&D) coverage pays a benefit if you die or
suffer serious injury as a result of a covered accident. You can buy AD&D coverage
of one to six times your annual salary, up to a maximum of $1.5 million, on a pre-tax
basis for yourself and your family. The plan is administered by Zurich.
If you elect employee-only coverage, AD&D benefits will be paid at 100 percent of
the amount you selected. If you elect family coverage, AD&D benefits will be paid
as follows:

For you: 100 percent of the amount selected

For your spouse/domestic partner if there are no children:
60 percent of the amount you selected (no maximum benefit)

For your spouse/domestic partner if there are child(ren):
50 percent of the amount you selected for your spouse/domestic partner
(no maximum benefit)

F or your child(ren) if there is a spouse/domestic partner:
15 percent of the amount you selected for each child, up to $100,000

F or child(ren) if there is no spouse/domestic partner:
20 percent of the amount you selected for each child, up to $100,000
Business travel accident benefits
Farmers pays the full cost of your business travel accident benefits. This coverage
provides financial protection in case of your injury or death as a result of an accident
while traveling on company business, excluding vacations and regular commutes to
and from work. Depending on your injury, the benefit may be up to three times your
annual salary to a maximum of $500,000.
Zurich Travel Assist
As an enhancement to your Business Travel Accident Plan, Zurich Travel Assist
provides you access to emergency medical, informational, legal, and personal
assistance while travelling 100 or more miles from home – on business or pleasure.
To find out more about this benefit log into GEMS > Employee Self Service and select
Benefits & Policies.
27
DISABILITY
To help you protect your income in the event of an accident or injury, Farmers
offers you short-term and long-term disability benefits, accidental death &
dismemberment benefits, life insurance and business travel accident benefits.
Short-term disability benefits
Farmers pays the full cost of your short-term disability insurance, administered
by Liberty Mutual. After seven consecutive calendar days of total disability (called
the elimination period) your short-term disability payments will begin and may
continue for up to an additional 25 weeks. During the elimination period, you’ll be
paid through PTO, if available. After the elimination period, short-term disability
coverage will provide:

100 percent of your pay for the first five weeks

85 percent of your pay for the next 11 weeks

70 percent of your pay for the remaining nine weeks
Your short-term disability payment will be offset by the amount you receive from
state disability insurance, if any.
If you were a Farmers employee with 20 or more years of service as of December 31,
2008, you have a modified schedule for short-term disability benefits.
For more information, go to Farmers Today and log in to the GEMS portal through
HR Connection. Click on the “Employee Self Service” tab. Then, access
“Benefits & Policies.”
Long-term disability benefits
Farmers pays the full cost of your long-term disability coverage, administered
by Liberty Mutual. An employee is eligible for long term disability after 90 days
of employment. If you’re partially or totally disabled for more than 26 weeks,
long-term disability coverage will provide 60 percent of your pay, up to a monthly
maximum of $30,000.
28
Benefits & Policies
WORK/LIFE BALANCE
Legal plan
Hyatt Legal Plans, a MetLife company, offers you access to a nationwide network
of attorneys. The plan provides coverage for attorney fees for routine legal
matters, including:

Will planning, living wills, trusts

Civil litigation defense, consumer protection, real estate matters

Purchase, sale or refinancing of your home

Adoption, name change and premarital agreements

Traffic ticket defense

Debt collection defense, including identity theft defense

Preparation of affidavits, powers of attorney, deeds, demand letters

Document review
For coverage in 2015, you must enroll by December 15, 2014. If you enroll, you’ll
pay for legal plan coverage with after-tax dollars at a rate of $10.33 per paycheck.
For more information, or to enroll, call Hyatt Legal at (800) 821-6400 or visit
www.legalplans.com, click on “Thinking About Enrolling” and enter password
1500997. You may also link to this site through the Annual Enrollment online portal.
Adoption assistance
Farmers provides an adoption benefit of up to $4,000 for each legal adoption with
a maximum of two adoptions per household. In addition, the adoption benefit
provides up to two weeks of continuous paid leave (prorated based on part-time
scheduled hours). The adoption benefit is available to all regular salaried employees
who work 20 or more hours each week and who are the adopting parents. For more
information on the adoption benefit, go to Farmers Today and log in to the GEMS
portal under HR Connection. Click on “Employee Self Service” and then “Benefits
and Policies.”
29
Employee Assistance Program (EAP)
Farmers offers an Employee Assistance Program through United Behavioral Health
to help you and your family manage work and personal life. The EAP includes up to
six free face-to-face counseling sessions per person and information about many
lifestyle issues. The EAP is a free, confidential service provided to all employees,
their household members, and eligible dependents.
For EAP services, call (866) 533-8713 or visit www.liveandworkwell.com
(access code: farmersins).
Commuter plan
The Commuter Benefit Plan enables employees to use tax-free income to pay for
mass transit expenses (trains, subways, buses, ferries and vanpools) as well as pay
for work-related parking expenses. The current 2014 monthly tax-free limit for
mass transit is up to $130 a month and up to $250 a month for parking expenses.
Election amounts that exceed this monthly limit will be treated as after-tax
contributions. As of the date this guide was developed, the IRS has not yet released
the 2015 limits. Check www.irs.gov for more information on 2015 limits.
If you choose to enroll in this plan you will receive a Beniversal MasterCard from
Benefit Resource, the vendor for this plan. The Beniversal card is accepted only by mass transit and parking vendors. Benefit
Resource offers a cash reimbursement option for expenses incurred where MasterCard is not accepted.
Your initial enrollment in this plan may occur at any time during the year, not just during open enrollment. Please be aware that
your elections are made on a monthly, rather than annual, basis. Your monthly election will self-renew each month and you are
able to make changes as often as you wish. Unused balances on your Beniversal card will rollover month after month, year after
year.
Note: Greater Los Angeles Rideshare participants currently enrolled in payroll deductions may not select this Commuter Benefit
Plan in addition to current enrollment.
And there’s more
In addition, Farmers also provides a number of benefits that will help meet other needs you and your family may have:

Credit union

Tuition assistance
For more information about these benefits and programs, go to Farmers Today and log in to the GEMS portal through HR
Connection. Click on the “Employee Self Service” tab. Then, access “Benefits and Policies.”
30
(888) 599-3636
[email protected]
RETIREMENT
The Farmers 401(k) Savings Plan and Pension Plan give you the opportunity to
build financial security for your retirement. Although you don’t need to make any
decisions related to your retirement benefits during Annual Enrollment, it’s a good
time of year to review these benefits to ensure that you are prepared for the future.
Farmers Group, Inc. 401(k) Savings Plan
The Farmers Group, Inc. 401(k) Savings Plan is a defined contribution plan,
administered by Vanguard. The plan allows you to set aside 1 percent to 50 percent
of your eligible pay, and for certain eligible employees, 1 percent to 85 percent of
your Short Term Incentive Plan (STIP) or Sales Incentive Plan (SIP) award, on a pretax basis, a Roth after-tax basis, or a combination of both, up to the IRS maximum
(indexed each year). The maximum contribution for 2014 is $17,500. As of the date
this guide was printed, the IRS has not yet released the maximum contribution for
2015. Check on Vanguard at www.vanguard.com/retirementplans or www.irs.gov
for more information on 2015 maximum contributions.
If you will be age 50 or older in 2015 and contribute the maximum allowed, you
can make additional contributions to the plan on a pre-tax or Roth after-tax basis.
This additional amount is allowed as a catch-up contribution (indexed each year).
The maximum catch-up contribution for 2014 is $5,500, for a total contribution
maximum of $23,000 for 2014. As of the date this guide was printed, the IRS has
not yet released the maximum catch-up contribution for 2015. Check Vanguard or
www.irs.gov for more information on 2015 maximum catch-up contributions.
In addition, Farmers matches your contributions dollar for dollar up to the first 6
percent of earned base pay. You’re immediately vested in your contributions and
any contributions made by the company. To get the maximum company match, you
should save at least 6 percent of your eligible pay.
31
How the Roth 401(k) contributions work
Be sure to visit www.vanguard.com/retirementplans
where you can:
A Roth 401(k) contribution combines the best features
of a 401(k) plan and a Roth IRA. Similar to a Roth IRA, you
contribute after-tax dollars to the account. Because you pay
taxes on the money at the time of your contributions, you can
withdraw the money tax free at retirement, provided you’re
at least age 59½ and you’ve held the account for at least
five years. The benefit of a Roth 401(k) is that you can save
more than with a Roth IRA – for 2014 the maximum allowed
(combination of pre-tax and Roth contributions) by the IRS is
$17,500, or $23,000 for employees age 50 or older.
Farmers Group, Inc. Employees’ Pension Plan

View your savings plan balance and
pension plan benefit

Change your savings plan deferral percentage

Estimate your pension benefit at retirement

View electronic statements and confirmations

Update your beneficiary designations

And much more
You can also contact Vanguard Participant Services at
(800) 523-1188, Monday through Friday, from
5:30 a.m. to 6 p.m. PST.
The Farmers Group, Inc. Employees’ Pension Plan is a
company-paid, pension plan. There is no cost to you for this
benefit. You’re automatically a participant in the Pension
Plan as of your hire date, and you become vested in the Plan
benefits after three years of service.
32
CONTACT INFORMATION
If you have questions about your Farmers benefits or about Annual Enrollment, go online to “Benefits
and Self-Service
Policies” through
Employee
and select
HR Connection on Farmers Today. If you can’t find your answer, call the HR Service Center at (888) 599-3636. For
more
specific
Benefits &
Policies
information, use this list to find the right contact.
For questions about…
Contact…
UHC
Medical Benefits
HealthFirst Plus
(NurseLine, EAP, Wellness Program)
( (800) 752-7451
: www.myuhc.com
HealthFirst Plus (UHC/OptumHealth)
( (866) 553-8713
: www.liveandworkwell.com (EAP - access code: farmersins)
Express Scripts
Prescription Drug Benefits
( (800) 987-5248 (members)
: www.express-scripts.com
( (877) 722-6279 (non-members –
annual enrollment)
: www.express-scripts.com/farmers
Aetna
MetLife
Dental Benefits
( (877) 238-6200
: www.aetna.com
( (800) 880-1800
: www.metlife.com/mybenefits
EyeMed
Vision Benefits
( (866) 299-1358 (non-members) or (866) 723-0514 (members)
: www.eyemedvisioncare.com
Optum Bank
Health Savings Accounts
( (800) 791-9361
: www.optumbank.com or myuhc.com
Benefit Resource, Inc.
Flexible Spending Accounts
( (800) 473-9595
: www.benefitresource.com
Liberty Mutual
Short-Term Disability
Commuter Program
(mass transit commuting and parking)
( (800) 793-2797
: www.mylibertyclaim.com to file a claim
: www.mylibertyclaimstatus.com for claim status
Benefit Resource, Inc.
( (800) 473-9595
: www.benefitresource.com
Liberty Mutual
Long-Term Disability
( (800) 793-2797
: www.mylibertyclaim.com to file a claim
: www.mylibertyclaimstatus.com for claim status
HR Service Center
Life Insurance
( (888) 599-3636
( (888) 257-0412 (Prudential) for evidence of insurability
: [email protected]
HR Service Center
AD&D and Business Travel Insurance
( (888) 599-3636
: [email protected]
Vanguard
Farmers Group, Inc. 401(k) Savings Plan
( (800) 523-1188
: www.vanguard.com
Plan #: 093492
Vanguard
Pension Plan
( (800) 523-1188
: www.vanguard.com
33
Plan #: 020245
CONTACT INFORMATION CONT.
For questions about…
Contact…
( (800) 263-0261 (U.S. and Canada)
( (416) 977-0277 (Outside U.S. and Canada)
Hyatt Legal
Legal Plan
( (800) 821-6400
: www.legalplans.com
GLOSSARY
Benefit Dollars: Additional income provided by Farmers to offset the total cost of your benefit elections. Benefit dollars will be
paid to you in your regular paychecks.
Coinsurance: The percentage of the bill you pay after you meet the deductible.
Copay: A set fee you pay for prescription drug purchases under Choice Plus.
Deductible: The amount of out-of-pocket expenses you pay before the plan begins to pay benefits for covered services.
Dental and Vision FSA: A Flexible Spending Account (FSA) that can be used in combination with a High Deductible Health Plan
to pay for eligible dental and vision expenses only.
Flexible Spending Account (FSA): A financial account that allows you to set aside pre-tax money to use on expected health
care expenses or dependent day-care expenses incurred during the plan year.
Generic drugs: Drugs that are chemically identical to brand-name drugs in dosage form, safety, strength and quality and they
cost significantly less.
Health Savings Account (HSA): A special savings account available to High Deductible Health Plan participants only.
Participants contribute pre-tax dollars to pay for eligible health care expenses. HSA money earns interest, and any unused HSA
money rolls over from year to year.
High Deductible Health Plan (HDHP): A type of health plan that has lower paycheck contributions and a high deductible and
out-of-pocket maximum. This type of plan is compatible with a Health Savings Account.
HSA dollars: The organization’s contribution to your HSA if you make the
minimum contribution through payroll deductions to an existing or a new Optum Bank HSA.
In-network: A provider or facility that has contracted with UHC to provide services at negotiated rates.
Long-term disability plan: An insurance plan that provides income-replacement benefits for disabilities that continue beyond
26 weeks.
Non-preferred brand-name drugs: Non-preferred brand-name drugs are not considered preferred because there are less
expensive drugs with similar efficacies.
Out-of-network: A provider or facility that has not contracted with UHC to provide services at negotiated rates.
Payroll deductions: The amount you pay out of your paycheck for your chosen Farmers benefits.
Plan Cost Estimator: UHC’s online tool that can help you determine the best medical plan option for you and your family based
on your estimated out-of-pocket costs (contributions and expenses) for each option by comparing plan costs and features. To
log in, go to www.welcometouhc.com/farmers.
Preferred drugs: Preferred drugs are either generic or brand-name drugs that are preferred by the plan because they are safe,
effective alternatives to other generics or brands that may be more expensive.
34
(888) 599-3636
[email protected]
Reasonable and Customary: Reasonable and customary charges apply to
non-network covered services and mental health/substance abuse non-network
benefits. The charges made by a physician, surgeon or supplier of services,
medicines or supplies that does not exceed the general level of charges made
by others rendering or furnishing like services, medicines or supplies, within the
geographic areas in which the charge is incurred.
Short-term disability plan: A short-term plan that helps ensure that income and
benefits continue when you are disabled for more than five continuous work days
due to injury or illness.
Total Rewards: A comprehensive compensation and benefits program that
rewards you for performance, and gives you and your family a flexible package of
benefits to choose from to meet your ever-changing lifestyle needs.
35
IMPORTANT NOTICES
Privacy Notice of Availability
Under the Health Insurance Portability and accountability Act of 1996 (HIPAA),
Farmers Group, Inc., as sponsor of our medical plans (the “Plan”) is required
to provide you with a HIPAA Notice of Privacy Practices (“Notice”) at the time
of your enrollment and at certain other times. In addition, the Plan is required
to periodically notify you of the availability of the Notice and provide you with
information on how to obtain a copy of the Notice.
You may obtain a copy of the Plan’s Notice at any time by visiting Benefits & Policies.
From Farmers Today, click on GEMS under HR Connection > Employee Self Service
> Benefits and Policies. To request a paper copy of this Notice, contact the HRSC at
(888) 599-3636. This reminder pertains only to those health care benefits provided
under the Plan that are covered under HIPAA’s privacy rules.
Note: If you’re covered by one or more fully-insured group health plans offered by
Farmers, you will receive a separate note regarding the availability of the Notice and
how to obtain a copy of the Notice directly from the insurance carrier.
Women’s Health and Cancer Rights Act
The Women’s Health and Cancer Rights Act is a Federal law. It protects breast
cancer patients who elect breast reconstruction due to a mastectomy. Health care
plans must cover reconstructive surgery following a mastectomy, as determined in
consultation with the attending physician and the patient.
Reconstructive benefits must include coverage for:

Reconstruction of the breast on which the mastectomy has
been performed

S urgery and reconstruction of the other breast to produce a
ymmetrical appearance

rosthesis and physical complications at all stages of mastectomy,
P
including lymphedemas
These benefits are subject to the Farmers Plan’s regular copayments
and deductibles.
36
(888) 599-3636
[email protected]
Premium Assistance Under Medicaid and the Children’s Health Insurance
Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for
health coverage from your employer, your state may have a premium assistance
program that can help pay for coverage, using funds from their Medicaid or CHIP
programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t
be eligible for these premium assistance programs but you may be able to buy
individual insurance coverage through the Health Insurance Marketplace. For more
information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a
State listed below, contact your State Medicaid or CHIP office to find out if premium
assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you
think you or any of your dependents might be eligible for either of these programs,
contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or
www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it
has a program that might help you pay the premiums for an employer-sponsored
plan.
If you or your dependents are eligible for premium assistance under Medicaid or
CHIP, as well as eligible under your employer plan, your employer must allow you
to enroll in your employer plan if you aren’t already enrolled. This is called a “special
enrollment” opportunity, and you must request coverage within 60 days of being
determined eligible for premium assistance. If you have questions about enrolling
in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or
call 1-866-444-EBSA (3272).
To see if any more states have added
a premium assistance program since
July 31, 2014, or for more information
on special enrollment rights, you can
contact either:
U.S. Department of Labor
Employee Benefits Security
Administration
www.dol.gov/ebsa
(866) 444-EBSA (3272)
U.S. Department of Health and Human
Services Centers for Medicare &
Medicaid Services
www.cms.hhs.gov
(877) 267-2323,
Menu Option 4, Ext. 61565
OMB Control Number 1210-0137 (expires 09/30/2014)
37
STATE MEDICAID AND CHIP CONTACT INFO
If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The
following list of states is current as of July 31, 2014. Contact your State for more information on eligibility.
State
Contact information
ALABAMA – Medicaid
Website: http://www.medicaid.alabama.gov
Phone: 1-855-692-5447
ALASKA – Medicaid
Website: http://health.hss.state.ak.us/dpa/programs/medicaid/
Phone (Outside of Anchorage): 1-888-318-8890
Phone (Anchorage): 907-269-6529
ARIZONA – CHIP
Website: http://www.azahcccs.gov/applicants
Phone (Outside of Maricopa County): 1-877-764-5437
Phone (Maricopa County): 602-417-5437
COLORADO – Medicaid
Medicaid Website: http://www.colorado.gov/
Medicaid Phone (In state): 1-800-866-3513
Medicaid Phone (Out of state): 1-800-221-3943
FLORIDA – Medicaid
Website: https://www.flmedicaidtplrecovery.com/
Phone: 1-877-357-3268
GEORGIA – Medicaid
Website: http://dch.georgia.gov/
Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP)
Phone: 1-800-869-1150
IDAHO – Medicaid
Medicaid Website: http://healthandwelfare.idaho.gov/Medical/Medicaid/PremiumAssistance/
tabid/1510/Default.aspx
Medicaid Phone: 1-800-926-2588
INDIANA – Medicaid
Website: http://www.in.gov/fssa
Phone: 1-800-889-9949
IOWA – Medicaid
Website: www.dhs.state.ia.us/hipp/
Phone: 1-888-346-9562
KANSAS – Medicaid
Website: http://www.kdheks.gov/hcf/
Phone: 1-800-792-4884
KENTUCKY – Medicaid
Website: http://chfs.ky.gov/dms/default.htm
Phone: 1-800-635-2570
LOUISIANA – Medicaid
Website: http://www.lahipp.dhh.louisiana.gov
Phone: 1-888-695-2447
MAINE – Medicaid
Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.html
Phone: 1-800-977-6740
TTY 1-800-977-6741
MASSACHUSETTS – Medicaid and CHIP
Website: http://www.mass.gov/MassHealth
Phone: 1-800-462-1120
MINNESOTA – Medicaid
Website: http://www.dhs.state.mn.us/
Click on Health Care, then Medical Assistance
Phone: 1-800-657-3629
MISSOURI – Medicaid
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm
Phone: 573-751-2005
MONTANA – Medicaid
Website: http://medicaidprovider.hhs.mt.gov/clientpages/
clientindex.shtml
Phone: 1-800-694-3084
NEBRASKA – Medicaid
Website: www.ACCESSNebraska.ne.gov
Phone: 1-855-632-7633
NEVADA – Medicaid
Medicaid Website: http://dwss.nv.gov/
38
State
NEW HAMPSHIRE – Medicaid
Website: http://www.dhhs.nh.gov/oii/documents/hippapp.pdf
Phone: 603-271-5218
Benefits & Policies
Contact information
NEW JERSEY – Medicaid and CHIP
Medicaid Website: http://www.state.nj.us/humanservices/
dmahs/clients/medicaid/
Medicaid Phone: 609-631-2392
CHIP Website: http://www.njfamilycare.org/index.html
CHIP Phone: 1-800-701-0710
NEW YORK – Medicaid
Website: http://www.nyhealth.gov/health_care/medicaid/
Phone: 1-800-541-2831
NORTH CAROLINA – Medicaid
Website: http://www.ncdhhs.gov/dma
Phone: 919-855-4100
NORTH DAKOTA – Medicaid
Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/
Phone: 1-800-755-2604
OKLAHOMA – Medicaid and CHIP
Website: http://www.insureoklahoma.org
Phone: 1-888-365-3742
OREGON – Medicaid
Website: http://www.oregonhealthykids.gov
http://www.hijossaludablesoregon.gov
Phone: 1-800-699-9075
PENNSYLVANIA – Medicaid
Website: http://www.dpw.state.pa.us/hipp
Phone: 1-800-692-7462
RHODE ISLAND – Medicaid
Website: www.ohhs.ri.gov
Phone: 401-462-5300
SOUTH CAROLINA – Medicaid
Website: http://www.scdhhs.gov
Phone: 1-888-549-08200
SOUTH DAKOTA - Medicaid
Website: http://dss.sd.gov
Phone: 1-888-828-0059
TEXAS – Medicaid
Website: https://www.gethipptexas.com/
Phone: 1-800-440-0493
UTAH – Medicaid and CHIP
Website: http://health.utah.gov/upp
Phone: 1-866-435-7414
VERMONT– Medicaid
Website: http://www.greenmountaincare.org/
Phone: 1-800-250-8427
VIRGINIA – Medicaid and CHIP
Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm
CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm
CHIP Phone: 1-855-242-8282
WASHINGTON – Medicaid
Website: http://www.hca.wa.gov/medicaid/premiumpymt/pages/index.aspx
Phone: 1-800-562-3022 ext. 15473
WEST VIRGINIA – Medicaid
Website: www.dhhr.wv.gov/bms/
Phone: 1-877-598-5820, HMS Third Party Liability
WISCONSIN – Medicaid
Website: http://www.badgercareplus.org/pubs/p-10095.htm
Phone: 1-800-362-3002
WYOMING – Medicaid
Website: http://health.wyo.gov/healthcarefin/equalitycare
Phone: 307-777-7531
To see if any other states have added a premium assistance program since July 31, 2014, or for more information on special enrollment rights, contact either:
U.S. Department of Labor, U.S. Department of Health and Human Services, Employee Benefits Security Administration, Centers for Medicare & Medicaid
Services
www.dol.gov/ebsa
www.cms.hhs.gov
1-866-444-EBSA (3272), 1-877-267-2323, Menu Option 4, Ext. 61565 , OMB Control Number 1210-0137 (expires 10/31/2016)
39
2015 MONTHLY EMPLOYEE PAYROLL DEDUCTIONS
The chart below shows your monthly payroll deduction for the benefit plans offered in 2015. Beginning with the first paycheck
in January 2015, half of this amount will be deducted each pay period.
Medical, dental and vision coverage
Employee only
Employee plus
spouse (or
domestic partner)
Employee plus
child(ren)
Employee plus family
UHC Choice Plus HSA
$131
$301
$222
$399
UHC Choice Max HSA
$69
$158
$117
$210
UHC Choice Premier HSA
$26
$59
$38
$78
$262
$603
$446
$800
MetLife DMO
$11.10
$19.00
$20.00
$28.50
Dental PPO
$45.90
$100.80
$87.00
$146.40
Dental DMO
$24.40
$53.50
$46.30
$77.90
$7.54
$11.56
$14.98
$16.40
Non-Smoker
Smoker*
Under 25
$0.036
$0.054
25 – 29
$0.043
$0.063
30 – 34
$0.058
$0.084
35 – 39
$0.064
$0.097
40 – 44
$0.072
$0.109
45 – 49
$0.107
$0.162
50 – 54
$0.165
$0.249
55 – 59
$0.309
$0.483
60 – 64
$0.474
$0.790
65 – 69
$0.912
$1.568
70 and over
$1.478
$2.541
Medical
UHC Choice Plus PPO
Dental
Vision
EyeMed
Supplemental life insurance and dependent life insurance
Below are the monthly rates per $1,000 of insurance, based on age as of January 1, 2015.
Employee’s age (spouse’s age for spouse life insurance)
Spouse life insurance: You may choose spouse life insurance in the amounts of $10,000, $25,000, $50,000, $75,000 or $100,000 (only $10,000 or $25,000 if employee does not
have supplemental life insurance).
Child life insurance: Rate is $0.86 per month regardless of how many children you cover under the plan. Coverage amount is $10,000 per child.
*Smoked or used tobacco products within the past year
Accidental Death and Dismemberment (AD&D)
You may elect coverage from 1x to 6x your annual base salary, up to $1.5 million of coverage.
Employee only
$0.015 per $1,000 of coverage
Employee and family
$0.025 per $1,000 of coverage
40
Benefits & Policies
This document is not intended to replace advice you may receive from a professional advisor, including a financial or
tax advisor. Summaries or references to benefits provided under certain plans sponsored by Farmers, the plans
themselves and the terms and conditions of such plans are governed by the formal plan documents. In the event of
any discrepancy between this document or the summary plan documents and plan documents, the plan documents
govern. Farmers may modify, amend, suspend or terminate these benefits or the plans at any time and for any reason
at its sole discretion or change any information in this document without advance notice. This document, plan
provisions or summaries of eligibility for coverage do not constitute a contract of employment with any individual
and do not alter the at-will nature of employment to any extent.
41